2021-08-13T16:37:43-05:00 2020-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2019-10-01 222747685 Baystate Administrative Services Inc BAYS 4137947872 759 Chestnut Street Springfield MA 011990001 Raymond McCarthy SVP, Finance, CFO & Treasurer 4137947872 2021-08-13 1 Christine Kawecki P00743140 5169187000 2019 2022-09-23 18:48:47Z Raymond McCarthy 759 Chestnut Street Springfield MA 011990001 135152486 0 5611 X www.Baystatehealth.org X 1986 MA The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 5 0 559 20 706221 0 0 201115 126367255 132818647 309307 10005 1591608 2031389 128268170 135061156 0 0 0 0 65123662 74028986 0 0 0 65096305 61730671 130219967 135759657 -1951797 -698501 31030940 31586935 65629671 67743752 -34598731 -36156817 The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 0 0 34712412 51865134 Baystate Administrative Services provides management and administrative support to Baystate Health and its affiliates. These services are an integral part of the healthcare delivery system and include strategic planning, human resources, risk management (insurance) programs, marketing, financial services and benefit plans administration for all health system employees. 78465298 82505192 Baystate Administrative Services provides information technology support to Baystate Health and its affiliates. These services are an integral part of the healthcare delivery system and include all software applications, telecommunications, clinical engineering, and computerized equipment at the hospitals. 113177710 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 205 0 1 559 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 5 0 1 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MA X Laurie Martin Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 Mark A Keroack MD President/Director 8.00 42.00 X X 2412139 0 38835 Nancy Shendell-Falik Director/President BMC SVP Hospital Ops 5.00 45.00 X 1245320 0 46240 Dennis W Chalke Treasurer/Dir (Through 03/01/20) 8.00 42.00 X X 1133942 0 89624 Andrew Artenstein MD Director/President BMP CPE 5.00 45.00 X 1126162 0 42947 Jo-Ann Davis Esq Director/ SVP Chief Admin Officer 45.00 5.00 X 892390 0 60022 Joel L Vengco VP Information Services 50.00 0.00 X 720797 0 48652 Douglas Salvador MD SVP/CQO BH, CMO BMC 10.00 40.00 X 691196 0 54766 Jean Ahn SVP & Chief Strategy Officer 10.00 40.00 X 680160 0 52730 Jane E Albert SVP Communications & Ext Reltn 50.00 0.00 X 582336 0 74367 Ronald P Bryant President Baystate Noble & Franklin 2.00 48.00 X 584390 0 48669 Tejas Gandhi VP/Chief Operating Officer 10.00 40.00 X 540153 0 58867 Raymond McCarthy SVP, Finance, CFO & Treasurer 5.00 45.00 X X 353818 0 24190 Kristin R Delaney Clerk 8.00 42.00 X 159414 0 38701 Nancy Remillard Assistant Clerk 43.00 7.00 X 56181 0 10673 11178398 0 689283 192 0 1 0 Cerner Corporation PO Box 959156 St Louis MO 631959156 Computer Services 9663794 BaytechIT LLC 4 Open Square Way Holyoke MA 01040 IT Services 3315031 Philips Healthcare LLC PO Box 100355 Atlanta GA 30384 Software Maintenance 2040280 Olympus America PO Box 200194 Pittsburgh PA 15251 Equipment Repair 1310734 Dell Financial Services PO Box 6549 carol Stream IL 601976549 Software Maintenance 1136509 92 201115 201115 Affiliate Support 561000 132818647 132592136 226511 132818647 101335 101335 91330 -91330 -91330 -91330 Partners for a Healthi 624200 816962 816962 Workers Comp Rehab 621990 726614 726614 Baycare Health Partner 623000 479710 479710 8103 8103 2031389 135061156 134143815 706221 10005 11867681 9894086 1973595 47932015 36776824 11155191 5237353 4057603 1179750 5266411 4112837 1153574 3725526 2899573 825953 1601604 1601604 37101 37101 8374053 6530523 1843530 819980 792310 27670 1656837 1517407 139430 44241198 42687979 1553219 2680756 2469938 210818 227692 162937 64755 542562 352249 190313 92696 72288 20408 138789 108019 30770 Recruitment 676704 574412 102292 Dues & Memberships 640699 168725 471974 135759657 113177710 22581947 0 10469731 14047232 2542926 704317 426909 692837 278622 436001 9770028 8649990 5857145 5672091 268775 185054 7273949 6871504 31030940 31586935 37510396 44635304 28119275 23108448 65629671 67743752 X -34598731 -36156817 -34598731 -36156817 31030940 31586935 X -698501 -39994 -819591 X 0 1 X 1 0 X X X 9 Baystate Health Inc 042105941 7 1 2436884 0 Baystate Medical Center Inc 042790311 3 1 101791267 0 Baystate Franklin Medical Center 042103575 3 1 8623803 0 Visiting Nurse Association & Hospice of WNE Inc 042105803 10 1 1732727 0 Baystate Medical Practices Inc 042888373 10 1 6450346 0 Baystate Wing Hospital Corporation 222519813 3 1 5835134 0 Baystate Health Foundation Inc 043549011 1 1 107490 0 Baystate Noble Hospital 222547423 3 1 2795458 0 Health New England Inc 042864973 10 1 721811 0 9 130494920 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 Schedule A, Part IV, Section A, Line 3b: A pro forma Form 990 Schedule A Part III supporting organization schedule was prepared using the 4 years that Health New England, Inc., a 501(c)(4) organization has been so designated. The pro forma Schedule A resulted in a 99.55% public support percentage which supports that if Health New England, Inc. was a 501(c)(3) organization, it would qualify as a supporting organization under 509(a)(2). Schedule A, Part IV, Section A, Line 3c: Baystate Health, Inc. is the parent organization of Health New England, Inc. and Baystate Administrative Services, Inc. Baystate Health, Inc. has overlapping governance with Health New England, Inc., including the Treasurer and several board members. They also share the same Audit and Compliance Committee. In addition, the mission of Health New England, Inc., as part of Baystate Health, Inc. (an integrated health care system), is to improve the overall quality of life and health status of the communities we serve and to contribute to the economic success of our region. Health New England, Inc. is committed to meeting the identified health and wellness needs of our communities served through the combined efforts of Baystate health, community organization partners, and affiliated providers. Schedule A, Part IV, Section E, Line 2a & 2b: Organizations supported by BAS are listed on Schedule R, Part II, Identification of Related Tax-Exempt Organizations and Part IV, Identification of Related Organizations Taxable as a Corporation or Trust. Article II of the BAS Articles of Organization states the purposes for which the corporation was formed: To promote the health, charitable and educational purposes of Baystate Health, Inc. and its tax exempt affiliates including Baystate Medical Center, Inc., Baystate Franklin Medical Center, Baystate Wing Hospital Corporation, Baystate Noble Hospital Corporation, Baystate Health Foundation, Inc., Baystate Medical Practices, Inc., Visiting Nurse Association and Hospice of Western New England, Inc., and Health New England, Inc., by managing, operating, and providing management counsel and advice in connection with the provision of medical or health care and services ancillary thereto, and by engaging in such other activities as may be appropriate and as are consistent with Chapter 180 of the Massachusetts General Laws, as now in force or hereafter amended, and with Section 501(c)(3) of the Internal Revenue Code of 1986, as amended (or the corresponding provision of any future United State internal revenue law). Part IV, Section D, Line 3: The Board of Directors of Baystate Administrative Services, Inc. is comprised of Sr. Management of its supported organizations including its parent Baystate Health, Inc. and thus all financially related decisions are made by the supported organizations. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 88080 0 0 88080 0 Part II-B, Line 1: The amount recorded on line j represents BAS salaries and operating expenses as reported on Massachusetts Public Records Division Lobbyist Disclosure for activities related to healthcare policy, bills and appropriations. 531417 503776 27641 5325728 5168315 157413 185054 Due from affiliated companies 6871504 6871504 Due to affiliated companies 8705330 Total accrued pension cost 3284849 Total minimum pension liability 11118269 23108448 X X X X 1 1 0 1 0 0 0 0 0 0 0 Mark A Keroack MD President/Director 1201545 0 815540 0 395054 0 14000 0 24835 0 2450974 0 0 0 Nancy Shendell-Falik Director/President BMC SVP Hospital 645945 0 377325 0 222050 0 18200 0 28040 0 1291560 0 0 0 Dennis W Chalke Treasurer/Dir (Through 03/01/20) 595403 0 290718 0 247821 0 57216 0 32408 0 1223566 0 0 0 Andrew Artenstein MD Director/President BMP CPE 625322 0 302250 0 198590 0 18200 0 24747 0 1169109 0 0 0 Jo-Ann Davis Esq Director/ SVP Chief Admin Officer 482489 0 234825 0 175076 0 43947 0 16075 0 952412 0 0 0 Joel L Vengco VP Information Services 417516 0 186486 0 116795 0 18200 0 30452 0 769449 0 0 0 Douglas Salvador MD SVP/CQO BH, CMO BMC 388922 0 172298 0 129976 0 18200 0 36566 0 745962 0 0 0 Jean Ahn SVP & Chief Strategy Officer 390697 0 170461 0 119002 0 18200 0 34530 0 732890 0 0 0 Jane E Albert SVP Communications & Ext Reltn 317567 0 152754 0 112015 0 45337 0 29030 0 656703 0 0 0 Ronald P Bryant President Baystate Noble & Franklin 422316 0 114750 0 47324 0 18200 0 30469 0 633059 0 0 0 Tejas Gandhi VP/Chief Operating Officer 397507 0 122275 0 20371 0 27337 0 31530 0 599020 0 0 0 Raymond McCarthy SVP, Finance, CFO & Treasurer 267781 0 67856 0 18181 0 21000 0 3190 0 378008 0 0 0 Kristin R Delaney Clerk 143121 0 15567 0 726 0 15203 0 23498 0 198115 0 0 0 Part I, Line 1a Expanation: 1. Companion Travel - Several Trustees, Officers, and/or key employees were provided with compensation for spouses to attend a company board event. 2. Tax Gross up / Discretionary Spending Account - A few key employees were provided with reimbursement for financial and tax and estate planning requiring a tax gross up. The two items above were treated as taxable compensation as appropriate in accordance with Baystate's written policies which require compliance with the IRS's accountable plan rules. Part I, Line 3 The compensation of the President is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs). The individuals responsible for deliberating the compensation arrangement for the President would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously. The Baystate Administrative Services, Inc. Board of Directors is composed of management of Baystate Health, Inc. and its affiliates. Therefore it is more appropriate that the establishment and review of the compensation of the organization's top management officials be performed at the Baystate Health level, which has a more independent board. Part I, Line 4b: Jean Ahn - Supplemental Retirement of $3,154 is included in column B. This amount was earned and paid in 2019. Jane Albert - Supplemental Retirement of $3,891 is included in column B. This amount was earned and paid in 2019. Andrew Artenstein, MD - Supplemental Retirement of $160,138 is included in column B. This amount was earned and paid in 2019. Ronald P. Bryant - Supplemental Retirement of $12,040 is included in column B. This amount was earned and paid in 2019. Dennis W. Chalke - Supplemental Retirement of $168,412 is included in column B. This amount was earned and paid in 2019. Jo-Ann Davis - Supplemental Retirement of $24,463 is included in column B. This amount was earned in 2019. Tejas Gandhi - Supplemental Retirement of $9,155 is included in column B. This amount was earned and paid in 2019. Mark A. Keroack, MD - Supplemental Retirement of $338,646 is included in column B. This amount was earned in 2019. Betty K. Larue - Supplemental Retirement of $13,179 is included in column B. This amount was earned in 2019. Douglas Salvador, MD - Supplemental Retirement of $5,222 is included in column B. This amount was earned and paid in 2019. Nancy Shendell-Falik - Supplemental Retirement of $176,615 is included in column B. This amount was earned and paid in 2019. Joel L. Vengco - Supplemental Retirement of $8,418 is included in column B. This amount was earned and paid in 2019. Form 990, Part VI, Section A, line 1 Baystate Administrative Services (BAS) is part of an integrated delivery system including not for profit community hospitals, which have community boards. BAS is a management services supporting organization, which supports Baystate Health and its affiliates and is comprised primarily of BAS employees. This board structure has not changed significantly since the organization applied for exempt status. Form 990, Part VI, Section A, line 2 Two or more of the persons listed in this Form 990 Part VII have a business relationship with each other by virtue of sitting on one or more Boards of Directors or by serving in an employment relationship with one or more entities in the Baystate Group of affiliated entities and in the community. The following trustees, officers, or key employees have a business relationship: (1) Jo-Ann Davis and Joel L. Vengco. Form 990, Part VI, Section A, line 6 The filing organization has one member, Baystate Health, Inc. (BH). Form 990, Part VI, Section A, line 7a All of the members of the Board of Directors of the filing organization are individuals serving ex officio based on positions they hold with Baystate Health, Inc. (BH). Form 990, Part VI, Section B, line 11b Prior to filing the Form 990, appropriate sections were reviewed by the Tax, Finance, and Human Resources areas of Baystate Health, Inc. (the sole member of the filing organization and the parent organization of the health care system to which the filing organization belongs) and by outside legal counsel. The Form 990 was also reviewed by tax experts from an independent accounting firm and signed-off as a paid preparer. The process, key areas and any new changes were reviewed prior to filing with the Baystate Health Audit and Compliance Committee (ACC). The ACC members had an opportunity to ask questions regarding the tax compliance process and the tax filings in general. The Form 990 was provided to all members of the Baystate Health Board of Trustees prior to filing. Form 990, Part VI, Section B, line 12c Baystate Administrative Service, Inc. is an affiliate of Baystate Health, Inc. (BH). BH and its affiliated entities have a comprehensive conflict of interest policy applicable to all of the affiliated entities. All directors, trustees, officers, key employees, and highest compensated employees of BH and its affiliates are asked to complete an annual "conflict of interest" form. We utilize an electronic database to receive and manage all conflict of interest submissions. This information is reviewed by the Chief Compliance Officer, Chief Executive Officer, Chair of the Board of Trustees, Chief General Counsel and the Chair of the Audit & Compliance Committee. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department. Potential conflict of interest transactions are reviewed as appropriate under the policy, which provides for recusal from discussion and deliberation by any party with a potential conflict of interest. Form 990, Part VI, Section B, line 15 The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs). This committee consists entirely of individuals serving on the board of Baystate Health, Inc. The individuals responsible for deliberating the compensation arrangement for the President and CEO and of other officers would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. The compensation of the Senior Vice President, Finance, CFO and Treasurer is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs). This committee consists entirely of individuals serving on the board of Baystate Health, Inc. The individuals responsible for deliberating the compensation arrangement for the Senior Vice President, Finance, CFO and Treasurer and of other officers would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the Senior Vice President, Finance, CFO and Treasurer is established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the duly authorized compensation committee of Baystate Health, Inc. The compensation of other officers and key employees of the filing organization is determined by the President of the filing organization in accordance with the Executive Compensation Philosophy Statement, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data or the Baystate Health Board approved budget and wage program for each fiscal year. Form 990, Part VI, Section C, line 19 The organization makes its conflict of interest policy and financial statements available to the public at www.baystatehealth.org. Articles of organization and bylaws are generally available at the Commonwealth of Massachusetts website. Form 990, Part XI, line 9: Adjustment for Minimum Pension Liability -819,591. Baystate Franklin Medical Center 164 High Street Greenfield MA 01301 042103575 Hospital MA 501(c)(3) 3 Baystate Health Inc 0 Baystate Health Foundation Inc 759 Chestnut Street Springfield MA 01199 043549011 Fundraising MA 501(c)(3) 7 Baystate Health Inc 0 Baystate Health Systems Inc Health & Welfare Benefits Plan 759 Chestnut Street Springfield MA 01199 222531644 Voluntary Employees' Benefit Association MA 501(c)(9) Baystate Health Inc 0 Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 Healthcare System Parent MA 501(c)(3) 7 Baystate Health Inc 0 Baystate Medical Center Inc 759 Chestnut Street Springfield MA 01199 042790311 Acute Care Teaching Hospital MA 501(c)(3) 3 Baystate Health Inc 0 Baystate Noble Hospital Corporation 115 West Silver Street Westfield MA 010861634 222537423 Hospital MA 501(c)(3) 3 Baystate Health Inc 0 Baystate Total Home Care Inc 280 Chestnut Street Springfield MA 01104 203260764 Real Estate and Other MA 501(c)(3) 12B, II Baystate Medical Center Inc 0 Baystate Wing Hospital Corporation 40 Wright Street Palmer MA 01069 222519813 Hospital MA 501(c)(3) 3 Baystate Health Inc 0 Health New England Inc Monarch Place Suite 1500 Springfield MA 011441500 042864973 HMO/Insurance MA 501(c)(4) Baystate Health Inc 0 HNE of Connecticut Inc Monarch Place Suite 1500 Springfield MA 011441500 465190134 HMO/Insurance CT 501(c)(4) Health New England Inc 0 Visiting Nurse Assn & Hospice of Western New England Inc 30 Capital Drive Suite A West Springfield MA 01089 042105803 Homehealth and Hospice Care MA 501(c)(3) 10 Baystate Health Inc 0 Baystate Health Insurance Company Ltd North Church Street Georgetown CJ 980421413 Offshore Captive Insurance CJ Baystate Health Inc C 0 HNE Advisory Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Services MA HNE Holding Corporation C 0 HNE Holding Corporation Monarch Place Suite 1500 Springfield MA 011441500 464620480 Holding shares in subsidiary corporations MA Health New England Inc C 0 HNE Insurance Company Inc Monarch Place Suite 1500 Springfield MA 011441500 454462433 Health Ins svcs for Mass Medicare supplement members MA HNE Holding Corporation C 0 HNE Insurance Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043183019 Ancillary Insurance MA HNE Holding Corporation C 0 Ingraham Corporation 759 Chestnut Street Springfield MA 01199 043016257 Health care and other business activities MA Baystate Health Inc C 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 HNE Advisory Services Inc Q 65453554 Book Value