2022-05-06T11:42:55-05:00 2021-06-30 135565207 KPMG LLP 60 SOUTH STREET BOSTON MA 02111 990 2020-07-01 900513372 FACULTY PRACTICE FOUNDATION INC & AFFILIATES FACU 6176388000 ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 WILLIAM R CREEVY MD PRESIDENT 6176388000 2022-05-04 1 WILLIAM CREEVY MD 999009999 SMITA BALIGA P01643271 6179881000 2022-05-05 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z WILLIAM R CREEVY MD ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 409797243 1 1 8094 X WWW.BMC.ORG X 1994 MA SEE SCHEDULE O. 39 0 1789 46 596162 0 0 0 417202786 406941549 1216233 2855694 0 0 418419019 409797243 35477 32150 0 0 348803312 345032521 0 0 0 74972390 64269638 423811179 409334309 -5392160 462934 86602730 96526141 27901927 29483406 58700803 67042735 X SEE SCHEDULE O. 0 0 349730633 32150 406941549 THE FACULTY PRACTICE PLANS ("THE PLANS") WERE ESTABLISHED AS NOT-FOR-PROFIT CORPORATIONS OPERATING EXCLUSIVELY FOR THE BENEFIT OF BOSTON MEDICAL CENTER AND BOSTON UNIVERSITY SCHOOL OF MEDICINE. THE PLANS' PURPOSE IS TO PROVIDE, COORDINATE AND FACILITATE THE DELIVERY OF PATIENT CARE SERVICES AND TO PROMOTE THE DEVELOPMENT OF AN INTEGRATED SYSTEM OF DELIVERY TO MORE EFFICIENTLY AND EFFECTIVELY MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY THE INSTITUTIONS. THE PLANS PROVIDE AMBULATORY SERVICES RANGING FROM PRIMARY ADULT AND PEDIATRIC CARE TO ADVANCED SPECIALTY CARE; AFFILIATED PHYSICIANS ALSO STAFF THE LARGEST 24 HOUR LEVEL 1 TRAUMA CENTER IN NEW ENGLAND. 349730633 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1789 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 39 0 1 0 0 0 1 0 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MA X MARY BETH MOLLOY 6174144030 1 BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 X JENNIFER TSENG MD PRS/TRS/CLRK/DIR-CT, PS, SA, GS 50.00 4.00 X X 1040916 0 39753 PAUL TORNETTA MD PRES/TREAS/CLERK/DIR - ORTHO 50.00 X X 1013814 0 42501 JAMES HOLSAPPLE MD PRES/DIRECTOR - NEUROSURG 50.00 X X 982959 0 51702 DAVID COLEMAN MD PRES/TREAS/DIR - EMF 50.00 5.00 X X 885740 0 34897 JORGE SOTO MD PRES/DIRECTOR - RADIO 50.00 X X 727619 0 61809 MINH-TAM TRUONG MD PRES/TREAS/CLERK/DIR - RAD ONC 50.00 X X 712794 0 76522 STEPHEN CHRISTIANSEN MD PRES/TREAS/CLERK/DIR - EYE 50.00 4.00 X X 729682 0 52951 RHODA ALANI MD PRES/DIRECTOR - DERM 50.00 4.00 X X 738848 0 36756 GREGORY GRILLONE MD PRES/DIRECTOR - OTO 50.00 4.00 X X 720499 0 54277 JONATHAN OLSHAKER MD PRES/TREAS/CLERK/DIR - ER 50.00 4.00 X X 710295 0 61837 TOBY CHAI MD PRES/TREAS/CLERK/DIR - URO 50.00 X X 714408 0 28634 DAVID GREER MD PRS/TRS/DIR-REHAB&PRS/DIR-NEURO 50.00 X X 665614 0 61707 RAFAEL ORTEGA MD PRES/TREAS/CLERK/DIR -ANES 50.00 X X 631796 0 53738 ROBERT VINCI MD PRES/CLERK/DIR - CHF 50.00 4.00 X X 625638 0 53409 DAVID HENDERSON MD PRES/TREAS/CLERK/DIR - PSYCH 50.00 4.00 X X 528528 0 53344 AVIVA LEE-PARRITZ MD PRES/DIRECTOR - OBGYN 50.00 4.00 X X 502087 0 42447 CHRISTOPHER ANDRY PHD PRES/TREAS/CLERK/DIR - PATH 50.00 X X 443954 0 41816 ILSE CASTRO-ARAGON MD CLERK/DIRECTOR - RADIO 50.00 X X 403641 0 69270 JAROSLAW TKACZ MD TREASURER/DIRECTOR - RADIO 50.00 X X 414651 0 38924 RONALD IVERSON MD DIRECTOR - OBGYN 50.00 X 331648 0 84402 STEPHEN WILSON MD PRES/TREAS/CLERK/DIR - FAM 50.00 X X 385920 0 18935 MANJU SUBRAMANIAN MD DIRECTOR - EYE 50.00 X 373015 0 27067 FREDERICK RUBERG MD DIRECTOR - EMF (U 7/8/2020) 50.00 X 298626 0 66333 PAUL HENDESSI MD DIRECTOR - OBGYN 50.00 X 319690 0 44871 KATHARINE WHITE MD DIRECTOR - OBGYN 50.00 X 319798 0 38291 CLAUDIA HOCHBERG MD DIRECTOR - EMF (U 7/8/2020) 50.00 X 339416 0 18533 MIRIAM KOMAROMY MD DIRECTOR - EMF (AS OF 8/3/2020) 50.00 X 319077 0 26157 VIPUL CHITALIA MD DIRECTOR - EMF 50.00 X 233314 0 90904 DARRELL KOTTON MD DIRECTOR - EMF (U 7/8/2020) 50.00 X 305300 0 18521 TED CONSTAN TREAS/DIR - OBGYN, CHF 50.00 X X 0 246026 53208 ALLAN WALKEY MD DIRECTOR - EMF (AS OF 8/3/2020) 50.00 X 249550 0 36572 KAREN LASSER MD DIRECTOR - EMF 50.00 X 264176 0 16405 SUSANNAH ROWE MD DIRECTOR - EYE 50.00 X 241880 0 38591 ELISABETH WOODHAMS MD DIRECTOR - OBGYN 50.00 X 241194 0 36813 MICHELLE LONG MD DIRECTOR - EMF (AS OF 8/3/2020) 50.00 X 265298 0 12368 PADMASINI KANDADAI MD DIRECTOR - OBGYN 50.00 X 245477 0 26069 SAMANTHA KAPLAN MD DIRECTOR - OBGYN 50.00 X 197305 0 66620 MANISH SAGAR MD DIRECTOR - EMF 50.00 X 243463 0 20323 NATASHA HOCHBERG MD DIRECTOR - EMF (U 7/8/2020) 50.00 X 219477 0 38127 JULIE MOTTL-SANTIAGO CNM DIRECTOR - OBGYN 50.00 X 160927 0 40050 KETTIE LOUIS DNP DIRECTOR - OBGYN 50.00 X 153942 0 26431 VICTORIA BOLOTINA MD DIRECTOR - EMF (U 7/8/2020) 50.00 X 141962 0 18416 MARKUS BOSMAN MD DIRECTOR - EMF (AS OF 8/3/2020) 50.00 X 139290 0 14464 GERALD DENIS MD DIRECTOR - EMF (U 7/8/2020) 50.00 X 135845 0 7941 EDWARD FEINBERG MD DIRECTOR - EYE 50.00 X 8837 0 5440 DAVID BECK SCHEDULE O DISCLOSURE 5.00 49.00 X 0 633628 57813 JACOB NOORDZIJ MD CLERK - OTO 50.00 X 441032 0 103072 YI-AN HUANG TREASURER - OTO (AS OF 6/8/2021) 50.00 X 0 290823 47850 CARLOS ARELLANO TREASURER - OTO (U 6/8/2021) 50.00 X 0 248350 20869 SHEILA PHICIL TREASURER/CLERK - NEURO 50.00 X 0 175985 30889 JAMIE LEVY TREASURER/CLERK - DERM 50.00 X 0 173319 28432 MALLORY DAVIS TREASURER/CLERK - NEUROSURG 50.00 X 0 162844 30878 CAROL BOUDROT CLERK - OBGYN 50.00 X 0 69406 29127 TONY TANNOURY MD PROFESSOR/PHYSICIAN - ORTHO 50.00 X 1392635 0 98985 XINNING LI MD PHYSICIAN - ORTHO 50.00 X 1422047 0 43331 WILLIAM CREEVY MD PRES - FPF, PROF/PHYS - ORTHO 22.00 32.00 X 1199792 0 58908 CHADI TANNOURY MD PHYSICIAN - ORTHO 50.00 X 1083111 0 50323 ANDREW STEIN MD PHYSICIAN - ORTHO 50.00 X 833024 0 58622 DAVID MCANENY MD FMR PRES/TREAS/CLERK/DIR-CT/PS/SA/GS 50.00 4.00 X 691854 0 55029 CHRISTOPHER MANASSEH MD FMR PRS/TRS/CLRK/DIR-FAM 50.00 4.00 X 406441 0 74334 JOANNA PIECHNICZEK-BUCZEK MD FMR DIR/PRES/TREAS/CLERK - PSYCH 50.00 X 441536 0 36345 MARIE SAINT-HILAIRE MD FMR PRES/TREAS/DIR - NEURO 50.00 4.00 X 289970 0 42177 KENNETH GRUNDFAST MD FMR PRES/DIR - OTO 50.00 4.00 X 254074 0 34521 RICHARD BABAYAN MD FMR PRES/TREAS/CLERK/DIR - URO 50.00 X 173806 0 34370 BRIAN JACK FMR PRES/TREAS/CLERK/DIR - FAM 50.00 4.00 X 164414 0 25856 DANIEL REMICK MD FMR PRES/CLERK/DIR - PATH 50.00 4.00 X 159199 0 27853 28280845 2000381 2837730 886 1 1 0 CHANGE HEALTHCARE LLC 5995 WINDWARD PARKWAY ALPHARETTA GA 30005 BILLING SERVICES 3894061 BU PAYROLL PROCESSING 881 COMMONWEALTH AVENUE BOSTON MA 02215 PAYROLL SERVICES 1033947 CHILDREN'S HOSPITAL OF BOSTON 300 LONGWOOD AVENUE BOSTON MA 02115 PHYSICIAN SERVICES 985178 OPTUM360 LLC 3436 MOMENTUM PLACE CHICAGO IL 60589 BILLING SERVICES 600512 BRIGHAM & WOMENS 75 FRANCIS STREET BOSTON MA 02115 PHYSICIAN SERVICES 552200 10 PATIENT REVENUE 900099 192517902 191921740 596162 INSTITUTIONAL SUPPORT 541380 114109926 114109926 REIMBURSEMENT OF OPERATING EXP 900099 69244766 69244766 CONTRACT & HEALTH CENTER REVENUE 900099 17514881 17514881 CAPITATION REVENUE 900099 339929 339929 13214145 13214145 406941549 2855694 2855694 409797243 406345387 596162 2855694 32150 32150 21178234 17920286 3257948 3341645 2820057 521588 277337157 234381605 42955552 43175485 35977326 7198159 13825241 12009141 1816100 74558 65975 8583 1188772 980868 207904 1636389 1307050 329339 37379 32621 4758 1258740 1098156 160584 19929 15618 4311 7789699 6349381 1440318 632327 505238 127089 6721067 5736283 984784 BAD DEBT EXPENSE 21890837 21890837 MEDICAL & SURGICAL SUPP 5171311 5171311 DUES & LICENSES 1785429 1551378 234051 BU VISITING PROFESSORSH 250000 250000 1987960 1635352 352608 409334309 349730633 59603676 0 8690781 18206865 993100 342827 18120246 17671344 11768727 8395709 2413331 3373018 44455400 49074210 11929872 7857877 86602730 96526141 10100588 18980681 5339006 4188217 12462333 6314508 27901927 29483406 X 58700803 67042735 58700803 67042735 86602730 96526141 462934 6803597 1075401 0 X 0 1 X 1 0 X X 2 BOSTON MEDICAL CENTER 043314093 3 0 10000 0 TRUSTEES OF BOSTON UNIVERSITY 042103547 2 0 0 0 2 10000 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 SCHEDULE A, PART IV, SECTION A, LINE 6 IN ADDITION TO PROVIDING GRANTS TO THEIR SUPPORTED ORGANIZATIONS, THE FACULTY PRACTICE PLANS ALSO PROVIDE GRANTS TO ORGANIZATIONS THAT ADVANCE THE MISSION OF THE PLANS AND THEIR SUPPORTED ORGANIZATIONS TO PROVIDE, COORDINATE, AND FACILITATE THE DELIVERY OF PATIENT CARE SERVICES. GRANTS ARE INCLUDED ON FORM 990, SCHEDULE I. SCHEDULE A, PART IV, SECTION E, LINE 2A & 2B THE FACULTY PRACTICE PLANS ("THE PLANS") WERE ESTABLISHED AS NOT-FOR-PROFIT CORPORATIONS OPERATING EXCLUSIVELY FOR THE BENEFIT OF BOSTON MEDICAL CENTER AND BOSTON UNIVERSITY SCHOOL OF MEDICINE. THE PLANS' PURPOSE IS TO PROVIDE, COORDINATE AND FACILITATE THE DELIVERY OF PATIENT CARE SERVICES AND TO PROMOTE THE DEVELOPMENT OF AN INTEGRATED SYSTEM OF DELIVERY TO MORE EFFICIENTLY AND EFFECTIVELY MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY THE INSTITUTIONS. THE PLANS PROVIDE AMBULATORY SERVICES RANGING FROM PRIMARY ADULT AND PEDIATRIC CARE TO ADVANCE SPECIALTY CARE; AFFILIATED PHYSICIANS ALSO STAFF THE LARGEST 24 HOUR LEVEL 1 TRAUMA CENTER IN NEW ENGLAND. 3552398 2573276 979122 6243373 5347275 896098 1972956 475158 1497798 3373018 OTHER RECEIVABLES 3467474 DUE FROM AFFILIATES 4044704 OTHER ASSETS 345699 7857877 DUE TO AFFILIATES 3473608 LONG TERM CAPITAL LEASE OBLIGATION 842105 LONG TERM PORTION DUE TO REL. ORG. 1554048 OTHER LIABILITIES 444747 6314508 X PART X, LINE 2: FACULTY PRACTICE FOUNDATION, INC. ("FACULTY") AND ITS AFFILIATED FACULTY PRACTICE PLANS ("PLANS") ARE INCLUDED IN COMBINED FINANCIAL STATEMENTS. THE TEXT OF THE UNCERTAIN TAX POSITIONS FOOTNOTE INCLUDED IN THESE FINANCIAL STATEMENTS IS AS FOLLOWS: THE HEALTH SYSTEM CORPORATION, THE MEDICAL CENTER, BMCHP, UDF, ECMF, BUAP, FACULTY AND THE PLANS, BACO, BMCICS, AND BMCIC OF VERMONT ARE ALL NONPROFIT CORPORATIONS THAT HAVE BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HEALTH SYSTEM RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED AS OF SEPTEMBER 30, 2021 AND 2020. THE HEALTH SYSTEM ANNUALLY ASSESSES WHETHER IT MUST RECOGNIZE AN UNRELATED BUSINESS INCOME TAX EXPENSE (UBIT). THE AMOUNTS RECOGNIZED AS UBIT EXPENSE WERE NOT MATERIAL TO THE HEALTH SYSTEM'S CONSOLIDATED OPERATIONS OR CHANGES IN NET ASSETS FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020. 1 BOSTON MEDICAL CENTER ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 043314093 501 (C) (3) 10000 GENERAL SUPPORT ORTHOPAEDIC RESEARCH 6300 N RIVER ROAD 700 ROSEMONT IL 60018 366000946 501 (C) (3) 11250 GENERAL SUPPORT 2 PART I, LINE 2: FACULTY PRACTICE FOUNDATION, INC. AND AFFILIATES DO NOT DISTRIBUTE RESEARCH OR EDUCATIONAL GRANTS TO OTHER ORGANIZATIONS. THE FUNDS NOTED IN PART II REFLECT DONATIONS MADE BY FACULTY PRACTICE FOUNDATION, INC. AND AFFILIATES TO QUALIFIED 501(C)(3) ORGANIZATIONS. ALL DONATIONS ARE SUBJECT TO REVIEW AND APPROVAL BY THE INDIVIDUAL PRACTICE ADMINISTRATION. X X X 0 1 0 0 0 1 0 1 0 TONY TANNOURY MD PROFESSOR/PHYSICIAN - ORTHO 1357197 0 32970 0 2468 0 32970 0 66015 0 1491620 0 0 0 XINNING LI MD PHYSICIAN - ORTHO 1389660 0 24420 0 7967 0 24420 0 18911 0 1465378 0 0 0 WILLIAM CREEVY MD PRES - FPF, PROF/PHYS - ORTHO 943041 0 249730 0 7021 0 32970 0 25938 0 1258700 0 0 0 CHADI TANNOURY MD PHYSICIAN - ORTHO 1057572 0 24420 0 1119 0 24420 0 25903 0 1133434 0 0 0 JENNIFER TSENG MD PRS/TRS/CLRK/DIR-CT, PS, SA, GS 1005433 0 32970 0 2513 0 32970 0 6783 0 1080669 0 0 0 PAUL TORNETTA MD PRES/TREAS/CLERK/DIR - ORTHO 976304 0 32970 0 4540 0 32970 0 9531 0 1056315 0 0 0 JAMES HOLSAPPLE MD PRES/DIRECTOR - NEUROSURG 943249 0 32970 0 6740 0 32970 0 18732 0 1034661 0 0 0 DAVID COLEMAN MD PRES/TREAS/DIR - EMF 842931 0 32970 0 9839 0 32970 0 1927 0 920637 0 0 0 ANDREW STEIN MD PHYSICIAN - ORTHO 796447 0 32970 0 3607 0 32970 0 25652 0 891646 0 0 0 JORGE SOTO MD PRES/DIRECTOR - RADIO 691473 0 32970 0 3176 0 32970 0 28839 0 789428 0 0 0 MINH-TAM TRUONG MD PRES/TREAS/CLERK/DIR - RAD ONC 677893 0 28781 0 6120 0 30120 0 46402 0 789316 0 0 0 STEPHEN CHRISTIANSEN MD PRES/TREAS/CLERK/DIR - EYE 691853 0 32970 0 4859 0 32970 0 19981 0 782633 0 0 0 RHODA ALANI MD PRES/DIRECTOR - DERM 702684 0 32970 0 3194 0 32970 0 3786 0 775604 0 0 0 GREGORY GRILLONE MD PRES/DIRECTOR - OTO 681798 0 32970 0 5731 0 32970 0 21307 0 774776 0 0 0 JONATHAN OLSHAKER MD PRES/TREAS/CLERK/DIR - ER 672583 0 32970 0 4742 0 32970 0 28867 0 772132 0 0 0 DAVID MCANENY MD FMR PRES/TREAS/CLERK/DIR-CT/PS/SA/GS 591766 0 95970 0 4118 0 31191 0 23838 0 746883 0 0 0 TOBY CHAI MD PRES/TREAS/CLERK/DIR - URO 656487 0 32970 0 24951 0 0 0 28634 0 743042 0 0 0 DAVID GREER MD PRS/TRS/DIR-REHAB&PRS/DIR-NEURO 631109 0 32970 0 1535 0 32970 0 28737 0 727321 0 0 0 DAVID BECK SCHEDULE O DISCLOSURE 0 418099 0 156950 0 58579 0 19950 0 37863 0 691441 0 0 RAFAEL ORTEGA MD PRES/TREAS/CLERK/DIR -ANES 592235 0 32970 0 6591 0 31170 0 22568 0 685534 0 0 0 ROBERT VINCI MD PRES/CLERK/DIR - CHF 587756 0 32970 0 4912 0 32260 0 21149 0 679047 0 0 0 DAVID HENDERSON MD PRES/TREAS/CLERK/DIR - PSYCH 493299 0 32970 0 2259 0 26578 0 26766 0 581872 0 0 0 AVIVA LEE-PARRITZ MD PRES/DIRECTOR - OBGYN 465969 0 32970 0 3148 0 24181 0 18266 0 544534 0 0 0 JACOB NOORDZIJ MD CLERK - OTO 387490 0 42132 0 11410 0 21285 0 81787 0 544104 0 0 0 CHRISTOPHER ANDRY PHD PRES/TREAS/CLERK/DIR - PATH 394680 0 47466 0 1808 0 20370 0 21446 0 485770 0 0 0 CHRISTOPHER MANASSEH MD FMR PRS/TRS/CLRK/DIR-FAM 372566 0 32970 0 905 0 21471 0 52863 0 480775 0 0 0 JOANNA PIECHNICZEK-BUCZEK MD FMR DIR/PRES/TREAS/CLERK - PSYCH 408875 0 31770 0 891 0 15270 0 21075 0 477881 0 0 0 ILSE CASTRO-ARAGON MD CLERK/DIRECTOR - RADIO 372849 0 30120 0 672 0 18209 0 51061 0 472911 0 0 0 JAROSLAW TKACZ MD TREASURER/DIRECTOR - RADIO 380781 0 32970 0 900 0 20737 0 18187 0 453575 0 0 0 RONALD IVERSON MD DIRECTOR - OBGYN 297414 0 32970 0 1264 0 16470 0 67932 0 416050 0 0 0 STEPHEN WILSON MD PRES/TREAS/CLERK/DIR - FAM 295170 0 82970 0 7780 0 0 0 18935 0 404855 0 0 0 MANJU SUBRAMANIAN MD DIRECTOR - EYE 336490 0 36015 0 510 0 16888 0 10179 0 400082 0 0 0 FREDERICK RUBERG MD DIRECTOR - EMF (U 7/8/2020) 266865 0 31148 0 613 0 13714 0 52619 0 364959 0 0 0 PAUL HENDESSI MD DIRECTOR - OBGYN 285919 0 32970 0 801 0 16470 0 28401 0 364561 0 0 0 KATHARINE WHITE MD DIRECTOR - OBGYN 289237 0 30120 0 441 0 14995 0 23296 0 358089 0 0 0 CLAUDIA HOCHBERG MD DIRECTOR - EMF (U 7/8/2020) 308824 0 30120 0 472 0 15879 0 2654 0 357949 0 0 0 MIRIAM KOMAROMY MD DIRECTOR - EMF (AS OF 8/3/2020) 268521 0 31770 0 18786 0 0 0 26157 0 345234 0 0 0 YI-AN HUANG TREASURER - OTO (AS OF 6/8/2021) 0 211211 0 61000 0 18612 0 11402 0 36448 0 338673 0 0 MARIE SAINT-HILAIRE MD FMR PRES/TREAS/DIR - NEURO 257365 0 30930 0 1675 0 14046 0 28131 0 332147 0 0 0 VIPUL CHITALIA MD DIRECTOR - EMF 208453 0 24402 0 459 0 12114 0 78790 0 324218 0 0 0 DARRELL KOTTON MD DIRECTOR - EMF (U 7/8/2020) 272571 0 32100 0 629 0 15157 0 3364 0 323821 0 0 0 TED CONSTAN TREAS/DIR - OBGYN, CHF 0 206776 0 18639 0 20611 0 11526 0 41682 0 299234 0 0 KENNETH GRUNDFAST MD FMR PRES/DIR - OTO 224754 0 28818 0 502 0 12294 0 22227 0 288595 0 0 0 ALLAN WALKEY MD DIRECTOR - EMF (AS OF 8/3/2020) 225477 0 23740 0 333 0 9304 0 27268 0 286122 0 0 0 KAREN LASSER MD DIRECTOR - EMF 236258 0 27396 0 522 0 13083 0 3322 0 280581 0 0 0 SUSANNAH ROWE MD DIRECTOR - EYE 211311 0 29537 0 1032 0 12090 0 26501 0 280471 0 0 0 ELISABETH WOODHAMS MD DIRECTOR - OBGYN 219975 0 21016 0 203 0 8893 0 27920 0 278007 0 0 0 MICHELLE LONG MD DIRECTOR - EMF (AS OF 8/3/2020) 244146 0 20939 0 213 0 9854 0 2514 0 277666 0 0 0 PADMASINI KANDADAI MD DIRECTOR - OBGYN 223521 0 21736 0 220 0 9253 0 16816 0 271546 0 0 0 CARLOS ARELLANO TREASURER - OTO (U 6/8/2021) 0 199998 0 25351 0 23001 0 10908 0 9961 0 269219 0 0 SAMANTHA KAPLAN MD DIRECTOR - OBGYN 177480 0 19452 0 373 0 11001 0 55619 0 263925 0 0 0 MANISH SAGAR MD DIRECTOR - EMF 218416 0 24570 0 477 0 12930 0 7393 0 263786 0 0 0 NATASHA HOCHBERG MD DIRECTOR - EMF (U 7/8/2020) 197654 0 21540 0 283 0 10155 0 27972 0 257604 0 0 0 RICHARD BABAYAN MD FMR PRES/TREAS/CLERK/DIR - URO 156496 0 16770 0 540 0 10603 0 23767 0 208176 0 0 0 SHEILA PHICIL TREASURER/CLERK - NEURO 0 151458 0 12600 0 11927 0 1774 0 29115 0 206874 0 0 JAMIE LEVY TREASURER/CLERK - DERM 0 139929 0 9806 0 23584 0 8261 0 20171 0 201751 0 0 JULIE MOTTL-SANTIAGO CNM DIRECTOR - OBGYN 143873 0 16650 0 404 0 9160 0 30890 0 200977 0 0 0 MALLORY DAVIS TREASURER/CLERK - NEUROSURG 0 136727 0 6400 0 19717 0 377 0 30501 0 193722 0 0 BRIAN JACK FMR PRES/TREAS/CLERK/DIR - FAM 147491 0 15979 0 944 0 8198 0 17658 0 190270 0 0 0 DANIEL REMICK MD FMR PRES/CLERK/DIR - PATH 151125 0 8074 0 0 0 10170 0 17683 0 187052 0 0 0 KETTIE LOUIS DNP DIRECTOR - OBGYN 137776 0 15690 0 476 0 8680 0 17751 0 180373 0 0 0 VICTORIA BOLOTINA MD DIRECTOR - EMF (U 7/8/2020) 140806 0 0 0 1156 0 7482 0 10934 0 160378 0 0 0 MARKUS BOSMAN MD DIRECTOR - EMF (AS OF 8/3/2020) 139180 0 0 0 110 0 5160 0 9304 0 153754 0 0 0 PART I, LINE 4B BOSTON MEDICAL CENTER PROVIDES A SUPPLEMENTAL EXECTUTIVE RETIREMENT PLAN TO CERTAIN EXECUTIVES. AMOUNTS ARE CREDITED TO PARTICIPANTS' ACCOUNTS EACH YEAR. PLAN AMOUNTS ARE SUBJECT TO FORFEITURE AND PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET, AS OUTLINED IN THE PLAN AGREEMENT. BOSTON MEDICAL CENTER MAINTAINS AN EXECUTIVE BENEFIT PLAN WHICH OFFERS PARTICIPATING EXECUTIVES THE OPTION OF ANNUALLY ALLOCATING BENEFIT DOLLARS TO A SUPPLEMENTAL RETIREMENT/PRE-TAX SAVINGS ACCOUNT. AMOUNTS VEST ON SPECIFIED DATES BASED ON CONTINUED EMPLOYMENT BUT NO LATER THAN THE EXECUTIVE'S 62ND BIRTHDAY. AMOUNTS ACCRUED IN THE PLAN ARE REPORTED IN SCHEDULE J, PART II, COLUMN C. BOSTON MEDICAL CENTER PROVIDED A 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN TO DAVID BECK, SENIOR VICE PRESIDENT, CHIEF LEGAL COUNSEL, AND CLERK OF BOSTON MEDICAL CENTER. DAVID BECK REACHED THE PLAN RETIREMENT AGE IN 2019 AND VESTED 100% IN THE PLAN. IN ADDITION, PURSUANT TO THE TERMS OF THE PLAN, ONCE THE PLAN PARTICIPANT REACHES THE PLAN RETIREMENT AGE, ALL FUTURE CONTRIBUTIONS ARE MADE IN CASH. ACCORDINGLY, THE AMOUNT OF $50,310 WAS PAID TO DAVID BECK IN CASH IN 2020. PART I, LINE 6 EMPLOYEES OF THE FACULTY PRACTICE PLANS ARE SUBJECT TO THE PLANS' INDIVIDUAL COMPENSATION POLICIES AND/OR THE COMPENSATION POLICIES OF BOSTON MEDICAL CENTER. BASED ON THESE POLICIES, EMPLOYEES MAY RECEIVE COMPENSATION BASED ON NET EARNINGS OF THE DEPARTMENT. PART I, LINE 7 EMPLOYEES OF THE FACULTY PRACTICE PLANS ARE SUBJECT TO THE PLANS' INDIVIDUAL COMPENSATION POLICIES AND/OR THE COMPENSATION POLICIES OF BOSTON MEDICAL CENTER. BASED ON THESE POLICIES, PHYSICIANS MAY RECEIVE NON-FIXED BONUS PAYMENTS REPORTED ON SCHEDULE J, PART II, COLUMN B(II). LISTED INDIVIDUALS LISTED INDIVIDUALS RECEIVE COMPENSATION FOR THE SERVICES THEY PROVIDE AS EMPLOYEES. THEY RECEIVE NO COMPENSATION FOR THEIR ROLES AS DIRECTORS, OFFICERS, OR FORMER OFFICERS. FORM 990, PART I, LINE 1 AND PART III, LINE 1 THE FACULTY PRACTICE PLANS ("THE PLANS") WERE ESTABLISHED AS NOT-FOR-PROFIT CORPORATIONS OPERATING EXCLUSIVELY FOR THE BENEFIT OF BOSTON MEDICAL CENTER AND BOSTON UNIVERSITY SCHOOL OF MEDICINE. THE PLANS' PURPOSE IS TO PROVIDE, COORDINATE AND FACILITATE THE DELIVERY OF PATIENT CARE SERVICES AND TO PROMOTE THE DEVELOPMENT OF AN INTEGRATED SYSTEM OF DELIVERY TO MORE EFFICIENTLY AND EFFECTIVELY MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY THE INSTITUTIONS. THE PLANS PROVIDE AMBULATORY SERVICES RANGING FROM PRIMARY ADULT AND PEDIATRIC CARE TO ADVANCED SPECIALTY CARE; AFFILIATED PHYSICIANS ALSO STAFF THE LARGEST 24 HOUR LEVEL 1 TRAUMA CENTER IN NEW ENGLAND. FORM 990, PART VI, SECTION A, LINE 2 ALL OFFICERS AND DIRECTORS ARE EMPLOYEES OF EITHER THE INDIVIDUAL PRACTICE PLAN, BOSTON UNIVERSITY OR BOSTON MEDICAL CENTER, RELATED ORGANIZATIONS. CERTAIN OFFICERS AND DIRECTORS OF THE PRACTICE PLANS ALSO SERVE AS OFFICERS AND TRUSTEES OF BOSTON MEDICAL CENTER. CLAUDIA HOCHBERG AND NATASHA HOCHBERG HAVE A FAMILY RELATIONSHIP. THEY ARE EACH DIRECTORS OF EVANS MEDICAL FOUNDATION, INC., AN AFFILIATE OF FACULTY PRACTICE FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 6 WITH THE EXCEPTION OF THOSE LISTED BELOW, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS FACULTY PRACTICE FOUNDATION, INC. BU SURGICAL ASSOCIATES IS THE SOLE CORPORATE MEMBER OF THE FOLLOWING: - BOSTON UNIVERSITY CARDIAC AND THORACIC SURGICAL FOUNDATION, INC. - BOSTON UNIVERSITY GENERAL SURGICAL ASSOCIATES, INC. - BOSTON UNIVERSITY NEUROSURGICAL ASSOCIATES, INC. - BOSTON UNIVERSITY ORTHOPAEDIC SURGICAL ASSOCIATES, INC. - BOSTON UNIVERSITY PLASTIC SURGERY ASSOCIATES, INC. - BOSTON UNIVERSITY MEDICAL CENTER UROLOGISTS, INC. - BUMC OTOLARYNGOLOGIC FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN ACTIONS MUST BE APPROVED BY THE ORGANIZATION'S SOLE CORPORATE MEMBER, AS SET FORTH IN THE BYLAWS, INCLUDING ADOPTION OF THE BUDGET, ANY MERGER, CONSOLIDATION, LIQUIDATION OR DISSOLUTION, ANY CAPITAL TRANSACTION, AND INCURRENCE OF DEBT. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO THE FILING OF THE FORM 990 WITH THE IRS, THE FORM 990 WAS PREPARED BY OUR OUTSIDE TAX CONSULTANTS AND REVIEWED BY INTERNAL MANAGEMENT. THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOSTON MEDICAL CENTER BOARD OF TRUSTEES THEN REVIEWED THE RETURN. EACH MEMBER OF THE BOARD OF EACH PLAN WAS PROVIDED A COPY OF THE FINAL FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST QUESTIONNAIRES FOR THE FISCAL YEAR ENDING JUNE 30, 2021 WERE DISTRIBUTED ON 3/1/2022 BY THE COMPLIANCE DEPARTMENT. THE CHIEF COMPLIANCE OFFICER OR HIS DESIGNEE QUERIES TRUSTEES, OFFICERS, AND DIRECTORS ON AT LEAST AN ANNUAL BASIS REGARDING RELATIONSHIPS THAT MAY CREATE POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER OR HIS DESIGNEE REVIEWS ALL DISCLOSURES AND DETERMINES WHETHER THERE ARE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER ADVISES THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION ACCORDINGLY. FORM 990, PART VI, SECTION B, LINE 15 A COMMITTEE COMPOSED OF THE PRESIDENT AND CEO OF BOSTON MEDICAL CENTER AND THE DEAN OF BOSTON UNIVERSITY SCHOOL OF MEDICINE, THE FOUNDATION'S CORPORATE MEMBERS, APPROVES THE COMPENSATION FOR CERTAIN PHYSICIAN EXECUTIVES. A MEETING OF THE COMMITTEE WAS HELD TO REVIEW AND APPROVE THE FY2021 PROPOSED COMPENSATION FOR THE PHYSICIAN EXECUTIVES SERVING AS PRESIDENTS OF THE PLANS. FOR FY2021 THE SALARY OF EACH OF THE PHYSICIAN EXECUTIVES UNDER CONSIDERATION WAS PROVIDED TO THE COMMITTEE. THE COMMITTEE EVALUATED AND RELIED UPON COMPARABLE DATA IN MAKING ITS DECISION. THE COMPARABLE DATA CONSISTED OF COMPENSATION SURVEY INFORMATION FROM THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES FOR EACH SPECIALTY WHERE AVAILABLE, LISTING BOTH THE FIFTIETH AND SEVENTY-FIFTH SALARY PERCENTILES. THE PROPOSED COMPENSATION AS SUBMITTED OR AMENDED BY THE COMMITTEE WAS VOTED UPON BY THE COMMITTEE. THE COMMITTEE'S ASSESSMENT OF THESE CONSIDERATIONS IS CONTAINED IN THE OFFICIAL MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE PLANS DO NOT MAKE THEIR GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE. FORM 990, PART VII, SECTION A SHARED SERVICES AGREEMENT THE PLANS ARE AFFILIATED WITH BOSTON MEDICAL CENTER ("BMC") AND BOSTON UNIVERSITY SCHOOL OF MEDICINE ("BUSM"). THE PLANS EACH ENTERED INTO A COMMON PAYMASTER AGREEMENT WITH BMC AND THE TRUSTEES OF BOSTON UNIVERSITY ("BU"). UNDER THE TERMS OF THEIR PHYSICIAN PRACTICE AGREEMENTS, FACULTY PHYSICIANS AND PRACTITIONERS ("FACULTY MEMBERS") ARE EMPLOYED BY THE INDIVIDUAL PLANS. THE FACULTY MEMBERS SERVE THE BENEFIT OF BOTH BMC (BY PROVIDING CLINICAL SERVICES) AND BUSM (BY SERVING AS FACULTY MEMBERS OF BUSM). EACH PLAN, WITH RESPECT TO EACH FACULTY MEMBER THAT THE PLAN EMPLOYS, PAYS BU A PERCENTAGE OF THE FACULTY MEMBER'S SALARY AND REIMBURSEMENT FOR FRINGE BENEFITS AND RELATED PAYMENT FEES. BOSTON UNIVERSITY, AS COMMON PAYMASTER, THEN MAKES SALARY PAYMENTS AND PROVIDES BENEFITS TO FACULTY MEMBERS. THE PLANS ALSO PAY FOR A PORTION OF ADMINISTRATIVE SALARIES AND FRINGE BENEFITS FOR NONPHYSICIAN EMPLOYEES OF BMC, WHO PROVIDE SERVICES TO THEM. FORM 990, PART VII, LINE 19 DAVID BECK IS ASSISTANT CLERK FOR ALL REPORTING ENTITIES EXCEPT EVANS MEDICAL FOUNDATION AND BOSTON REHABILITATION MEDICINE ASSOCIATES, INC. FOR EVANS AND REHAB, HE SERVES AS CLERK. FOR FACULTY PRACTICE FOUNDATION, INC. HE IS A FORMER ASSISTANT CLERK. BOSTON MEDICAL CENTER ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 043314093 HEALTHCARE MA 501(C)(3) LINE 3 N/A 0 TRUSTEES OF BOSTON UNIVERSITY 881 COMMONWEALTH AVENUE BOSTON MA 02115 042103547 EDUCATION MA 501(C)(3) LINE 2 N/A 0 FACULTY PRACTICE FOUNDATION INC ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 043289381 HEALTHCARE MA 501(C)(3) 12B, TYPE 1 N/A 0 0 1 0 0 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1