2020-08-14T06:16:24-05:00 2019-09-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2018-10-01 823503666 CONNECTED CARE OF SOUTHEASTERN MA CONN 7816248000 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 STEPHEN COCO TREASURER 7816248000 2020-08-13 1 CHRISTINE A KAWECKI P00743140 5169187000 106.207.252.159 2020-08-13 02:03:26 US P F8AE3CF70B6D5343795F499A8FB4AE99E74455CD F8AE3CF70B6D5343795F499A8FB4AE99E74455CD 2018 2020-11-06 18:47:13Z STEPHEN COCO 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 0 0 X HTTPS://WWW.CONNECTEDCARESEMA.ORG X 2017 MA CONNECTED CARE OF SOUTHEASTERN MASSACHUSETTS WAS FORMED BY SOUTH SHORE HEALTH SYSTEM AND HARBOR MEDICAL TO OPERATE AS A NEXT GENERATION ACCOUNTABLE CARE ORGANIZATION (ACO) FOR MEDICARE BENEFICIARIES. THE ACO BRINGS TOGETHER THE HOSPITAL AND HEALTH CARE PROVIDERS TO PROVIDE HIGH QUALITY, COORDINATED CARE TO MEDICARE FEE-FOR-SERVICES PATIENTS. 9 4 0 4 0 0 0 0 5235500 0 19958 0 0 0 5255458 0 0 0 0 0 0 0 0 0 0 18085723 5780863 18085723 5780863 -12830265 -5780863 10963306 4115852 11543571 6076980 -580265 -1961128 X THE CORPORATION'S MISSION IS TO OWN AND OPERATE AN ACCOUNTABLE CARE ORGANIZATION THAT PARTICIPATES IN VARIOUS ACCOUNTABLE CARE MODELS, INCLUDING THE NEXT GENERATION ACO MODEL (ACO), AND OTHER ACCOUNTABLE CARE ORGANIZATION ARRANGEMENTS. THE INITIATIVE'S AIM IS TO COLLABORATE AND INTEGRATE/COORDINATE CARE FOR MEDICARE FEE-FOR-SERVICE PATIENTS IN A WAY THAT IMPROVES OUTCOMES FOR THE COVERED POPULATION. 0 0 1826734 OWN AND OPERATE A NEXT GENERATION ACCOUNTABLE CARE ORGANIZATION, PARTICIPATE IN THE NEXT GENERATION ACO PROGRAM AND OTHER RELATED PROGRAMS. 1826734 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 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 0 0 1 10 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 4 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X STEPHEN COCO 7816248422 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 ALLEN SMITH MD DIRECTOR 1.00 0.00 X 0 0 0 CAROLE WHITING DIRECTOR 1.00 0.00 X 0 0 0 DAVID HALLE MD DIRECTOR 1.00 40.00 X 0 355768 29486 GLENN TUCKER MD DIRECTOR 1.00 0.00 X 0 0 0 LUKE O'CONNELL MD DIRECTOR 1.00 40.00 X 0 255233 26461 MICHAEL AYERS MD DIRECTOR 1.00 40.00 X 0 53647 0 PETER GRAPE MD DIRECTOR 1.00 0.00 X 0 0 0 TIMOTHY LYNCH MD DIRECTOR 1.00 40.00 X 0 690634 35086 GENE E GREEN MD PRESIDENT/CEO 1.00 43.50 X X 0 1099790 509441 JOSEPH R DRISCOLL ESQ GENERAL COUNSEL/CLERK 1.00 43.50 X 0 380256 29222 STEPHEN COCO TREASURER 1.00 43.50 X 0 496848 28774 0 3332176 658470 0 0 1 0 EVOLENT HEALTH LLC 800 N GLEBE RD STE 500 ARLINGTON VA 22203 CONSULTING 5202077 1 0 0 0 0 X 3928176 3928176 7576 7576 2073 2073 2652 2652 PHYSICIAN SERVICES 773550 773550 PREMIUM REVENUE SHORTFA 568972 568972 SPECIALISTS 385826 385826 INTERCORP FRINGE 98386 98386 13652 13652 5780863 1826734 3954129 0 1490660 0 3468990 4106570 5235500 0 768156 0 11934 2652 0 9282 10963306 4115852 10741771 3734494 801800 2342486 11543571 6076980 X -580265 -1961128 -580265 -1961128 10963306 4115852 X -5780863 4400000 X 0 1 X 0 0 X 0 0 5235500 0 5235500 0 0 0 0 0 0 5235500 5235500 0 0 0 5235500 19958 0 19958 0 0 19958 19958 0 0 5255458 5255458 X PART III, SHORT YEAR EXPLANATION: THE INITIAL YEAR OF THE ORGANIZATION WAS 11/1/2017 TO 9/30/2018 11934 2652 9282 9282 STOP LOSS CREDIT 2229335 DUE TO SS PHYSICIAN HOSPITAL ORG 29110 DUE TO AFFILIATE 84041 2342486 X PART X, LINE 2: THE CORPORATION FOLLOWS THE PROVISIONS OF FASB ASC 740, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. ASC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. IT PRESCRIBES AN UNCERTAINTY THRESHOLD AND MEASUREMENT ATTRIBUTES FOR FINANCIAL STATEMENT DISCLOSURE OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. 0 1 0 0 0 0 0 0 0 DAVID HALLE MD DIRECTOR 0 301928 0 52745 0 1095 0 8250 0 21236 0 385254 0 0 LUKE O'CONNELL MD DIRECTOR 0 246365 0 8087 0 781 0 5225 0 21236 0 281694 0 0 TIMOTHY LYNCH MD DIRECTOR 0 558271 0 126819 0 5544 0 8250 0 26836 0 725720 0 33660 GENE E GREEN MD PRESIDENT/CEO 0 856269 0 239909 0 3612 0 488205 0 21236 0 1609231 0 17393 JOSEPH R DRISCOLL ESQ GENERAL COUNSEL/CLERK 0 328787 0 47778 0 3691 0 8250 0 20972 0 409478 0 38610 STEPHEN COCO TREASURER 0 426240 0 49807 0 20801 0 8250 0 20524 0 525622 0 0 PART I, LINE 3 THE PRESIDENT/CEO OF THE CORPORATION RECEIVES COMPENSATION FOR SERVICES PERFORMED FOR A RELATED ORGANIZATION. THE COMPENSATION COMMITTEE OF SOLE MEMBER, SOUTH SHORE HEALTH SYSTEM, DETERMINES THE PRESIDENT'S COMPENSATION. THE COMPENSATION COMMITTEE MEETS PERIODICALLY AND ENGAGES AN INDEPENDENT EXTERNAL COMPENSATION CONSULTING FIRM TO ESTABLISH THE COMPENSATION OF KEY SYSTEM EMPLOYEES. THE CONSULTING FIRM DEVELOPS AND PRESENTS ALL MATERIALS INCLUDING MARKET TRENDS, COMPENSATION STUDIES AND SURVEYS AND ADHERES TO BEST PRACTICE GUIDELINES. THE FINAL RECOMMENDATION FOR COMPENSATION CHANGES IS PRESENTED AND APPROVED BY THE ENTIRE INDEPENDENT COMMUNITY OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 SEVERAL OF THE PERSONS LISTED IN PART VII HAVE A "BUSINESS RELATIONSHIP" WITH ONE ANOTHER DUE TO THE OVERLAPPING BOARD STRUCTURE OF SOUTH SHORE HEALTH SYSTEM AND ITS RELATED ENTITIES. FORM 990, PART VI, SECTION A, LINE 3 THE CORPORATION RETAINED EVOLENT HEALTH TO MANAGE ITS NEXT GENERATION ACO PROGRAM. ACO OPERATIONS WERE OVERSEEN BY A GENERAL MANAGER, SENIOR DIRECTOR OF MARKET OPERATIONS, SENIOR DIRECTOR OF CLINICAL OPERATIONS AND A PART-TIME MEDICAL DIRECTOR; ALL OF WHOM WERE EVOLENT EMPLOYEES. EVOLENT ALSO PROVIDED A TEAM OF RN CARE ADVISORS TO QUANTIFY RISK AND MANAGE PATIENTS AND TWO POPULATION HEALTH MANAGERS. ADDITIONALLY, EVOLENT PROVIDED DATA ANALYTICS AND FINANCIAL FORECASTING SERVICES. FORM 990, PART VI, SECTION A, LINE 6 SOUTH SHORE HEALTH SYSTEM IS THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THERE ARE TWO CLASSES OF DIRECTORS. THE MEMBER APPOINTS FIVE "MEMBER DIRECTORS" WITH VOTE AND AT LEAST ONE MEDICARE BENEFICIARY/ADVOCATE "REPRESENTATIVE DIRECTOR", WITH VOTE. OTHER ACO PARTICIPANTS MAY APPOINT ONE "PARTICIPANT DIRECTOR", WITH VOTE, FOR EVERY 4,000 LIVES ATTRIBUTED THROUGH THEIR MEMBERSHIP IS THE ACO. FORM 990, PART VI, SECTION A, LINE 7B ALL PARTICIPANT DIRECTOR APPOINTMENTS AND OTHER BOARD ACTIONS REQUIRE UNANIMOUS CONSENT OF THE MEMBER DIRECTORS, ACTING SEPARATELY AS A CLASS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS PREPARED INTERNALLY AND REVIEWED BY THE TAX PRACTICE OF ITS INDEPENDENT AUDITORS. THE RETURN IS THEN REVIEWED BY THE TREASURER. FORM 990 IS PRESENTED FOR REVIEW TO THE GOVERNING BODY AS A WHOLE AT THE NEXT REGULARLY SCHEDULED MEETING PRIOR TO THE FILING DEADLINE. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST FORM ANNUALLY. THE FORMS ARE REVIEWED FOR CONFLICTS OR POTENTIAL CONFLICTS. BOARD MEMBERS ABSTAIN FROM VOTING ON MATTERS THAT PRESENT A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 SOUTH SHORE HEALTH SYSTEM (SSHS), SOLE MEMBER OF CONNECTED CARE, HAS A COMPENSATION COMMITTEE THAT DETERMINES THE COMPENSATION OF THE PRESIDENT/CEO. THE COMPENSATION COMMITTEE MEETS PERIODICALLY, IS INDEPENDENT AND CONSISTS SOLELY OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH REGARDS TO COMPENSATION MATTERS. SSHS UTILIZES AN INDEPENDENT OUTSIDE CONSULTANT TO DETERMINE EXECUTIVE COMPENSATION FOR THE PRESIDENT/CEO, AS WELL AS ALL OTHER MEMBERS OF THE EXECUTIVE TEAM. THE CONSULTANT PRESENTS RELEVANT DATA REGARDING SYSTEM EXECUTIVES TO THE COMMITTEE FOR REVIEW, AND APPROVAL FOR THE PRESIDENT/CEO. ALL DATA PRESENTED, AS WELL AS COMPENSATION DELIBERATIONS AND VOTES, IS DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES. THE BOARD'S REVIEW AND APPROVAL PROCESS TAKES PLACE ANNUALLY FOR IMPLEMENTATION AT THE START OF THE NEW FISCAL YEAR. COMPENSATION DECISIONS FOR OTHER MEMBER DIRECTORS ARE ALSO MADE ANNUALLY AND ARE BASED ON A REVIEW OF COMPARABLE INDUSTRY DATA, MARKET CONDITIONS AND RESEARCH PROVIDED BY OUTSIDE CONSULTANTS. FORM 990, PART VI, SECTION C, LINE 19 CONNECTED CARE OF SOUTHEASTERN MASSACHUSETTS MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR INSPECTION AT THE CORPORATION'S OFFICE. COPIES OF THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. IN ADDITION, CERTAIN GOVERNING DOCUMENTS ARE ALSO AVAILABLE THROUGH THE MASSACHUSETTS SECRETARY OF THE COMMONWEALTH'S CORPORATIONS DIVISION DATABASE. FORM 990, PART IX, LINE 11G CONSULTANTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,615,517. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,615,517. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 312,659. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 312,659. FORM 990, PART XI, LINE 9: AFFILIATE TRANSFERS 4,400,000. SOUTH SHORE HEALTH SYSTEM INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 042105926 SUPPORT THE CHARITABLE MISSION OF SOUTH SHORE HOSPITAL AND ITS AFFILIATES MA 501(C)(3) 12B, II N/A 0 SOUTH SHORE HOSPITAL INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 042769210 HOSPITAL MA 501(C)(3) 3 SOUTH SHORE HEALTH SYSTEM INC 0 SOUTH SHORE PROPERTY INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 050398822 DEVELOPS AND MANAGES REAL PROPERTY FOR SOUTH SHORE HOSPITAL AND AFFILIATES MA 501(C)(3) 12A, I SOUTH SHORE HEALTH SYSTEM INC 0 COASTAL MEDICAL ASSOCIATES INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 043170333 PROVIDES SPECIALIZED MEDICAL CARE MA 501(C)(3) 3 SOUTH SHORE HEALTH SYSTEM INC 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1