2020-08-13T13:20:58-05:00 2019-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2018-10-01 222747685 Baystate Administrative Services Inc BAYS 4137947872 759 Chestnut Street Springfield MA 011990001 Raymond McCarthy Interim SVP, CFO & Treasurer 4137940000 2020-08-13 1 Jeanne Fahrenbach P01365953 5169187000 208.99.255.62 2020-08-13 13:02:02 ED P FB03248700C55E7316312EA5AE12D7916242AABD BD88743F010F9F35FF8FC0562FA147AF9CEA6F78 2018 2020-09-23 17:36:50Z Raymond McCarthy 759 Chestnut Street Springfield MA 011990001 128268170 0 X www.Baystatehealth.org X 1986 MA To improve the health of the people in our communities every day, with quality and compassion. 5 0 590 0 350569 0 0 0 122531051 126367255 167959 309307 1843431 1591608 124542441 128268170 0 0 0 0 63959225 65123662 0 0 0 60560946 65096305 124520171 130219967 22270 -1951797 25523571 31030940 50140938 65629671 -24617367 -34598731 The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 0 0 34569000 49497006 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. 75378796 78138791 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. 109947796 1 0 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 1 228 0 1 590 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 Raymond McCarthy Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 Mark A Keroack MD President/Director 8.00 42.00 X X 2027506 0 40042 Dennis Chalke Treasurer/Director 8.00 42.00 X X 947658 0 90444 Andrew Artenstein MD Director/President BMP CPE CAO 5.00 45.00 X 1062673 0 41371 Jo-Ann Davis Esq Director/ SVP Chief Admin Officer 45.00 5.00 X 808999 0 58131 Nancy Shendell-Falik Director/ President BMC SVP Hospital Ops 5.00 45.00 X 1719444 0 45207 Kristin R Delaney Clerk 8.00 42.00 X 145051 0 37639 Nancy Remillard Assistant Clerk (as of 11/13/18) 33.00 7.00 X 6630 44373 8249 Joel L Vengco VP Information Services 50.00 0.00 X 647461 0 45991 Ronald P Bryant President Baystate Noble & Franklin 4.00 46.00 X 591144 0 48176 Douglas Salvador MD SVP/CQO BH, CMO BMC 10.00 40.00 X 587784 0 40049 Tejas Gandhi VP/Chief Operating Officer 10.00 40.00 X 515946 0 42500 Jean Ahn SVP & Chief Strategy Officer 10.00 40.00 X 514984 0 43765 Betty K Larue COO BMP/VP BH Ambulatory Officer 10.00 40.00 X 486199 0 74621 10061479 44373 616185 186 0 1 0 Cerner Corporation PO Box 959156 St Louis MO 631959156 Computer Services 10874304 BaytechIT LLC 4 Open Square Way Holyoke MA 01040 IT Services 3078321 Philips Healthcare LLC PO Box 100355 Atlanta GA 30384 Software Maintenence 2016596 Olympus America PO Box 200194 Pittsburgh PA 15251 Equipment repair 1207457 BulkleyRichardson & GelinasLLP 1500 Main St Ste 2700 Springfield MA 01115 Legal Services 1080000 104 Affiliate Support 561000 126367255 126147342 219913 126367255 225127 225127 84180 0 84180 84180 84180 Partners for a Healthier Comm. 624200 788729 788729 Workers Comp Rehab 621990 668092 668092 Baycare Health Partners 623000 130656 130656 4131 4131 1591608 128268170 127608294 350569 309307 7727788 5992668 1735120 46704004 36186250 10517754 2985483 2315168 670315 3864173 3046461 817712 3842214 3010339 831875 819850 819850 37963 37963 8884061 6930002 1954059 834402 823678 10724 1761731 1348406 413325 47506511 46163153 1343358 1311000 1134106 176894 563081 382703 180378 1212697 1022836 189861 109330 94574 14756 75334 65167 10167 Recruitment 1346617 1202144 144473 Dues & Memberships 633728 230141 403587 130219967 109947796 20272171 0 9147828 10469731 2542926 725737 426909 115348 278622 10107391 9770028 5848169 5579394 323498 268775 5103769 7273949 25523571 31030940 34555224 37510396 15585714 28119275 50140938 65629671 X -24617367 -34598731 -24617367 -34598731 25523571 31030940 X -1951797 27503 -8057070 X 0 1 X 1 0 X X 9 Baystate Health Inc 042105941 7 1 2535923 0 Baystate Medical Center Inc 042790311 3 1 95965205 0 Baystate Franklin Medical Ctr 042103575 3 1 8372624 0 Baystate Wing Hospital 222519813 3 1 5665178 0 Visiting Nurse Association & Hospice of WNE Inc 042105803 10 1 1682259 0 Baystate Medical Practices Inc 042888373 10 1 6262472 0 Baystate Health Foundation Inc 043549011 1 1 103639 0 Baystate Noble Hospital 222537423 3 1 2568794 0 Health New England Inc 042864973 10 1 695568 0 9 123851662 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 Sch A, Part IV, Section A, Question 3b & 3c 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). Sch A, Part IV, Section A, Question 3b & 3c 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. " Sch A, Part IV, Section E, Question 2a & 2b Organizations supported by Baystate Administrative Services, Inc. (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., Westfield Medical Corporation, 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. 0 1 0 0 0 0 1 79848 0 0 79848 0 Part II-B, Line 1: Part IIB, line j 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 498369 33048 3931018 3709079 221939 1385734 1371946 13788 268775 Due from affiliated companies 7273949 7273949 Due to affiliated companies 14819876 Total accrued pension cost 3284930 Total minimum pension liability 10014469 28119275 X X X X 1 1 0 1 0 0 0 0 0 0 0 Mark A Keroack MD President/Director 1092918 0 555500 0 379088 0 17875 0 22167 0 2067548 0 4050 0 Dennis Chalke Treasurer/Director 546049 0 196086 0 205523 0 59898 0 30546 0 1038102 0 4050 0 Andrew Artenstein MD Director/President BMP CPE CAO 607372 0 216448 0 238853 0 17875 0 23496 0 1104044 0 63064 0 Jo-Ann Davis Esq Director/ SVP Chief Admin Officer 461756 0 186040 0 161203 0 42975 0 15156 0 867130 0 0 0 Nancy Shendell-Falik Director/ President BMC SVP Hospital 586056 0 270564 0 862824 0 17875 0 27332 0 1764651 0 558992 0 Kristin R Delaney Clerk 129310 0 15113 0 628 0 14190 0 23449 0 182690 0 0 0 Joel L Vengco VP Information Services 393084 0 141647 0 112730 0 17875 0 28116 0 693452 0 0 0 Ronald P Bryant President Baystate Noble & Franklin 450110 0 113625 0 27409 0 17875 0 30301 0 639320 0 0 0 Douglas Salvador MD SVP/CQO BH, CMO BMC 345318 0 127295 0 115171 0 17875 0 22174 0 627833 0 16630 0 Tejas Gandhi VP/Chief Operating Officer 403777 0 84901 0 27268 0 17875 0 24625 0 558446 0 0 0 Jean Ahn SVP & Chief Strategy Officer 316247 0 116867 0 81870 0 17875 0 25890 0 558749 0 0 0 Betty K Larue COO BMP/VP BH Ambulatory Officer 370738 0 96127 0 19334 0 50664 0 23957 0 560820 0 0 0 Part I, Line 1a Explanation: 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 Line 4b: Jean Ahn - Supplemental Retirement of $71,595 is included in column B. This amount was earned and paid in 2018. Andrew Artenstein, MD Total Supplemental Retirement of $223,186 is included in column B. This amount consists of $153,098 earned and paid in 2018 and $63,064 that was previously reported as deferred compensation in prior years Forms 990 and that is currently reported as taxable income. This also includes $7,024 of investment earnings on prior year contributions. The amount is listed in Column F in accordance with reporting requirements. Ronald P Bryant- Supplemental Retirement of $11,081 is included in column B. This amount was earned and paid in 2018. Dennis W. Chalke - Supplemental Retirement of $151,701 is included in column B. This amount was earned and paid in 2018. Jo-Ann Davis - Supplemental Retirement of $115,368 is included in column B. This amount was earned in 2018. Mark A. Keroack, MD Supplemental Retirement of $351,037 is included in column B. This amount was earned in 2018. Betty K. Larue - Supplemental Retirement of $13,709 is included in column B. This amount was earned in 2018. Douglas Salvador, MD - Supplemental Retirement of $ is included in column B. This amount was earned and paid in 2018. Nancy Shendell-Falik- Total Supplemental Retirement of $807,171 is included in column B. This amount consists of $157,132 earned and paid in 2018 and $558,992 that was previously reported as deferred compensation in prior years Forms 990 and that is currently reported as taxable income. This also includes $91,047 of investment earnings on prior year contributions. The amount is listed in Column F in accordance with reporting requirements. Joel L. Vengco - Supplemental Retirement of $93,498 is included in column B. This amount was earned and paid in 2018. Form 990, Part VI, Section A, line 1 Baystate Administrative Services Inc. (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 Bayste Health and its affiliates and is comprised 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 Public Inspection of Organizational Policies: 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 -8,057,070. Baystate Health Foundation Inc 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 Total Home Care Inc 50 Maple Street Springfield MA 01199 203260764 Real Estate and Other MA 501 (c ) (3) 12b, II Baystate Medical Center Inc 0 Visiting Nurse Assn and Hospice of Western New England Inc 50 Maple Street Springfield MA 01199 042105803 Home Health and Hospice Care MA 501 (c ) (3) 10 Baystate Health Inc 0 Baystate Wing Hospital Corporation 40 Wright Street Palmer MA 01069 222519813 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Baystate Noble Hospital Corporation 115 West Silver Street PO Box 1634 Westfield MA 010861634 222537423 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Westfield Medical Corporation 115 West Silver Street PO Box 1634 Westfield MA 010861634 043127730 Healthcare MA 501 (c ) (3) 12a, I Baystate Noble Hospital Corporation 0 Health New England Inc Monarch Place Suite 1500 Springfield MA 01199 042864973 HMO/Insurance MA 501 (c ) (4) Health New England Inc 0 HNE of Connecticut Inc Monarch Place Suite 1500 Springfield MA 01199 465190134 HMO/Insurance CT 501 (c ) (4) Health New England Inc 0 HNE Insurance Company Inc Monarch Place Suite 1500 Springfield MA 011441500 454462433 Health Services for Massachusetts Medicare Supplement Members MA Health New England Inc 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 Services Corporation Monarch Place Suite 1500 Springfield MA 011441500 043183019 Ancilliary Insurance MA Health New England Inc C 0 HNE Advisory Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Services MA Health New England Inc C 0 Ingraham Corporation 759 Chestnut Street Springfield MA 01199 043016257 Health care and other business activities MA Baystate Health Inc C 0 Baystate Health Insurance Company Ltd North Church Street Georgetown Cayman Islands CJ 980421413 Offshore Captive Insurance CJ Baystate Health Inc 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 62774864 Book Value