PHYSICIAN HEALTH SERVICES INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
PHYSICIAN HEALTH SERVICES INC (EIN 22-3234975)
Tax period
2018-06-01 to 2019-05-31
Filed
2020-03-31
IRS object ID
202040919349300109
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-03-31T12:38:33-05:00ReturnTs
Tax Period End2019-05-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN223234975EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PHYSICIAN HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPHYSBusinessNameControlTxt
Phone7814347404PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1860 WINTER STREETAddressLine1Txt
CityWALTHAMCityNm
State AbbreviationMAStateAbbreviationCd
ZIP024511411ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL J FARRELLPersonNm
Person TitleTREASURERPersonTitleTxt
Phone7814347178PhoneNum
Signature2020-03-31SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address50.234.76.254IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-03-31IPDt
IP Tm13:37:39IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id4AC01252EBA54978815ACFE05B64854F2BA74261AtSubmissionCreationDeviceId
At Submission Filing Device IdD41A6DB7246F37A923DE8D81B52D37A161F7E4F5AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-22 18:59:49ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTEVEN ADELMAN MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1860 WINTER STREETAddressLine1Txt
CityWALTHAMCityNm
State AbbreviationMAStateAbbreviationCd
ZIP024511411ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,891,881GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressPHYSICIANHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionSEE FORM 990, PART III LINE 1ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee18TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,778,296PYContributionsGrantsAmt
CY Contributions Grants$1,755,434CYContributionsGrantsAmt
PY Program Service Revenue$43,014PYProgramServiceRevenueAmt
CY Program Service Revenue$21,817CYProgramServiceRevenueAmt
PY Investment Income$76,447PYInvestmentIncomeAmt
CY Investment Income$114,630CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,897,757PYTotalRevenueAmt
CY Total Revenue$1,891,881CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,628,353PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,589,088CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$257,466CYTotalFundraisingExpenseAmt
PY Other Expenses$181,403PYOtherExpensesAmt
CY Other Expenses$175,151CYOtherExpensesAmt
PY Total Expenses$1,809,756PYTotalExpensesAmt
CY Total Expenses$1,764,239CYTotalExpensesAmt
PY Revenues Less Expenses$88,001PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$127,642CYRevenuesLessExpensesAmt
Total Assets BOY$3,016,787TotalAssetsBOYAmt
Total Assets EOY$3,053,569TotalAssetsEOYAmt
Total Liabilities BOY$213,492TotalLiabilitiesBOYAmt
Total Liabilities EOY$212,114TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,803,295NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,841,455NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE OUTREACH SUPPORT AND MONITORING SERVICES TO MASSACHUSETTS PHYSICIANS WHO HAVE, OR ARE AT THE RISK OF HAVING HEALTH CARE PROBLEMS, PRIMARILY RELATING TO SUBSTANCE ABUSE AND MENTAL HEALTH DISORDERS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$829,415ExpenseAmt
DescPERSONALIZED ASSESSMENTS, CONSULTATIVE SUPPORT SERVICES AND MONITORING:MORE THAN 400 PHYSICIANS AND MEDICAL STUDENTS HAVE BEEN HELPED DIRECTLY IN FY19 THROUGH PERSONALIZED ASSESSMENTS, CONSULTATIVE SUPPORT SERVICES, AND MONITORING. 149 NEW PHYSICIANS AND MEDICAL STUDENTS WERE REFERRED IN FY19.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$318,737ExpenseAmt
DescPHYSICIAN SELF HELP PROGRAM:MEDICAL PROFRESSIONAL EMPOWERMENT PROGRAM, A FREE CME RISK MANAGEMENT PODCAST SERIES TO ADDRESS AND REDUCE PHYSICIAN BURNOUT.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$17,690ExpenseAmt
DescEDUCATIONAL SESSIONS, OUTREACH, AND WEBINARS:OVER 96 EDUCATIONAL SESSIONS AND WEBINARS WERE PROVIDED BY PHS TO PHYSICIANS, MEDICAL LEADERS, HOSPITALS, AND INDIVIDUALPRACTICES. PHS REGULARLY HOLD A TWO-DAY CME COURSE ON MANAGING WORKPLACE CONFLICTDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,165,842TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee18EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHAEL J FARRELLBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7814347178PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1860 WINTER STREETAddressLine1Txt
CityWALTHAMCityNm
State AbbreviationMAStateAbbreviationCd
ZIP024511411ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MARY ANNA SULLIVAN MD
PRESIDENT, CHAIR0.40Yes (X)Yes (X)$0$0$0
BOOKER BUSH MD
DIRECTOR0.40Yes (X)$0$0$0
GLENN PRANSKY MD
DIRECTOR0.40Yes (X)$0$0$0
STEPHEN TOSI MD
DIRECTOR0.40Yes (X)$0$0$0
JENNIFER CHILDS-ROSHAK MD
DIRECTOR0.40Yes (X)$0$0$0
MARY KRAFT MD
DIRECTOR0.40Yes (X)$0$0$0
LOIS DEHLS CORNELL ESQ
DIRECTOR0.40Yes (X)$0$693,779$56,24150.00
DUSTIN PATIL MD
DIRECTOR0.40Yes (X)$0$0$0
ALEXA KIMBALL MD MPH
DIRECTOR0.40Yes (X)$0$0$0
BARA LITMAN-PIKE PSYD
EXECUTIVE DIRECTOR40.00Yes (X)$0$0$0
STEVEN ADELMAN MD
MEDICAL DIRECTOR40.00Yes (X)$312,795$0$46,679
MICHAEL FARRELL
TREASURER0.40Yes (X)$0$176,351$54,94140.00
DEBRA GROSSBAUM
CLERK30.00Yes (X)$132,564$0$24,452
WENDY COHEN MD
PHYSICIAN EVALUATION DIRECTOR25.00$133,673$0$35,755Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$579,032TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$870,130TotReportableCompRltdOrgAmt
Total Other Compensation$218,068TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$583,000RelatedOrganizationsAmt
All Other Contributions$1,172,434AllOtherContributionsAmt
Total Contributions$1,755,434TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MISCELLANEOUS900099$10,720$10,720
ADMINISTRATION FEES900099$7,193$7,193
OTHER INCOME900099$3,400$3,400
INTEREST INCOME900099$504$504
FieldValueIRS element (for citing)
Total Program Service Revenue$21,817TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$114,630TotalRevenueColumnAmt
Exclusion$114,630ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,891,881TotalRevenueColumnAmt
Related Or Exempt Func Income$21,817RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$114,630ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$538,371TotalAmt
Program Services$174,259ProgramServicesAmt
Management And General$215,348ManagementAndGeneralAmt
Fundraising$148,764FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$640,828TotalAmt
Program Services$527,594ProgramServicesAmt
Management And General$57,162ManagementAndGeneralAmt
Fundraising$56,072FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$59,706TotalAmt
Program Services$49,156ProgramServicesAmt
Management And General$5,326ManagementAndGeneralAmt
Fundraising$5,224FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$255,585TotalAmt
Program Services$210,423ProgramServicesAmt
Management And General$22,798ManagementAndGeneralAmt
Fundraising$22,364FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$94,598TotalAmt
Program Services$77,883ProgramServicesAmt
Management And General$8,438ManagementAndGeneralAmt
Fundraising$8,277FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$531TotalAmt
Management And General$531ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$10,000TotalAmt
Management And General$10,000ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$14,107TotalAmt
Program Services$14,107ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$23,375TotalAmt
Program Services$17,460ProgramServicesAmt
Management And General$3,313ManagementAndGeneralAmt
Fundraising$2,602FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,200TotalAmt
Program Services$896ProgramServicesAmt
Management And General$170ManagementAndGeneralAmt
Fundraising$134FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$58,240TotalAmt
Program Services$43,499ProgramServicesAmt
Management And General$8,253ManagementAndGeneralAmt
Fundraising$6,488FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$10,259TotalAmt
Program Services$7,662ProgramServicesAmt
Management And General$1,454ManagementAndGeneralAmt
Fundraising$1,143FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$36,155TotalAmt
Program Services$27,004ProgramServicesAmt
Management And General$5,123ManagementAndGeneralAmt
Fundraising$4,028FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$10,496TotalAmt
Program Services$7,840ProgramServicesAmt
Management And General$1,487ManagementAndGeneralAmt
Fundraising$1,169FundraisingAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
DUES & MEMBERSHIP$8,514$6,399$1,214$901
MISC OPERATING EXPENSES$2,274$1,660$314$300

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,764,239TotalAmt
Program Services$1,165,842ProgramServicesAmt
Management And General$340,931ManagementAndGeneralAmt
Fundraising$257,466FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,130,294BOYAmt
EOY$1,128,549EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$6,300EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$4,092BOYAmt
EOY$11,171EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,882,401BOYAmt
EOY$1,907,549EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,016,787BOYAmt
EOY$3,053,569EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$131,199BOYAmt
EOY$153,672EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$15,500EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$82,293BOYAmt
EOY$42,942EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$213,492BOYAmt
EOY$212,114EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,803,295BOYAmt
EOY$2,841,455EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,803,295BOYAmt
EOY$2,841,455EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,016,787BOYAmt
EOY$3,053,569EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$127,642ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$89,482NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1THE MASSACHUSETTS MEDICAL SOCIETYBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN042050773EIN
Organization Type6OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C456Yes (1)SupportedOrgSectionC456Ind
Supported Org QualifiedYes (1)SupportedOrgQualifiedInd
Suprt Exclusively Sec170c2 B0SuprtExclusivelySec170c2BInd
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, SECTION A, LINE 3B:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION RECEIVED A COPY OF THE MASSACHUSETTS MEDICAL SOCIETY'S IRS DETERMINATION LETTER CONFIRMING EXEMPTION UNDER INTERNAL REVENUE CODE SECTION 501(C)(6). IN ADDITION, IT RECEIVED SUPPORT FROM THE MASSACHUSETTS MEDICAL SOCIETY IN THE FORM OF A PRO FORMA SCHEDULE A, PART III REFLECTING THE SATISFACTION OF THE SECTION 509(A)(2) SUPPORT TEST.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO MASSACHUSETTS MEDICAL SOCIETYDesc
Amt$42,942Amt
FieldValueIRS element (for citing)
Total Liability$42,942TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$1,849,555TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$89,482NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$47,156DonatedServicesAndUseFcltsAmt
Revenue Not Reported-$42,326RevenueNotReportedAmt
Revenue Subtotal$1,891,881RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,891,881TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,811,395TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$47,156DonatedServicesUseFcltsAmt
Expenses Not Reported$47,156ExpensesNotReportedAmt
Expenses Subtotal$1,764,239ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,764,239TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LOIS DEHLS CORNELL ESQ
DIRECTOR$0$515,937$0$157,500$0$20,342$0$27,500$0$28,741$0$750,020$0$0
STEVEN ADELMAN MD
MEDICAL DIRECTOR$296,514$0$15,150$0$1,131$0$25,022$0$21,657$0$359,474$0$0$0
MICHAEL FARRELL
TREASURER$0$176,351$0$0$0$0$0$54,941$0$0$0$231,292$0$0
DEBRA GROSSBAUM
CLERK$126,517$0$5,325$0$722$0$2,795$0$21,657$0$157,016$0$0$0
WENDY COHEN MD
PHYSICIAN EVALUATION DIRECTOR$131,598$0$1,700$0$375$0$10,528$0$25,227$0$169,428$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationPHYSICIAN HEALTH SERVICES PROVIDED PAYMENTS FOR BONUSES.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE MASSACHUSETTS MEDICAL SOCIETY, A MASSACHUSETTS NOT-FOR-PROFIT CORPORATION, IS THE SOLE VOTING MEMBER OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE VOTING MEMBER, THE MASSACHUSETTS MEDICAL SOCIETY, SHALL ELECT EIGHT DIRECTORS OF THE BOARD. IN ADDITION, SUCCESSORS TO THE INITIAL DIRECTORS SHALL BE NOMINATED BY PHYSICIAN HEALTH SERVICES BOARD OF DIRECTORS AND SUBMITTED TO THE SOLE VOTING MEMBER, THE MASSACHUSETTS MEDICAL SOCIETY.
FORM 990, PART VI, SECTION B, LINE 11BA COMPLETE COPY OF THE FORM 990 AND ALL RELATED SCHEDULES IS MAILED TO THE MEMBERS OF THE GOVERNING BODY PRIOR TO THE FILING DATE OF THE RETURN. AT THE BOARD MEETING, A PRESENTATION OF THE FORM 990 IS MADE BY THE TREASURER TO THE GOVERNING BODY HIGHLIGHTING MAJOR KEY AREAS AND ADDRESSING BOARD QUESTIONS AND COMMENTS.
FORM 990, PART VI, SECTION B, LINE 12CPHS HAS A PROCESS FOR MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY, AND REGULARLY REVIEW THE CONFLICT OF INTEREST FORMS AS THEY ARE COMPLETED SO THAT ANY STATED CONFLICTS CAN BE ADDRESSED.
FORM 990, PART VI, SECTION B, LINE 15THE PROCESS INCLUDES INDEPENDENT COMPENSATION CONSULTATION, COMPARISON OF FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY, AND APPROVAL BY THE BOARD. GOALS AND OBJECTIVES ARE ALSO DEVELOPED BY THE BOARD AND EVALUATED, INCLUDING A FORMAL WRITTEN PERFORMANCE EVALUATION AND EXTERNAL COMPENSATION REVIEW.
FORM 990, PART VI, SECTION C, LINE 19PHYSICIAN HEALTH SERVICES, INC. DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. PHYSICIAN HEALTH SERVICES PROVIDES SUMMARIZED FINANCIAL SOURCES AND EXPENSES FOR THE FISCIAL YEAR IN ITS ANNUAL REPORT, WHICH IS AVILABLE ON ITS WEBSITE FUNDING PAGE. PHYSICIAN HEALTH SERVICES PROVIDES FINANCIAL DATA AND AS REQUESTED, GOVERNING DOCUMENTS TO THE PUBLIC IN ACCORDANCE WITH THE PUBLIC DISCLOSURE REQUIREMENT OF FORM 990.
LINE 1 A(D)COMPENSATION REPORTED FOR STEVEN ADELMAN M.D. AND DEBRA GROSSBAUM ARE RELATED TO THEIR POSITION WITH PHYSICIAN HEALTH SERVICES, INC. NEITHER OF THESE INDIVIDUALS RECEIVES COMPENSATION IN THEIR ROLE OF DIRECTOR AND CLERK RESPECTIVELY.
LINE 1 A(E)COMPENSATION REPORTED FOR LOIS CORNELL AND MICHAEL FARRELL ARE RELATED TO THEIR POSITION WITH THE MASSACHUSETTS MEDICAL SOCIETY, THEY ARE NOT COMPENSATED FOR THEIR ROLES AT PHYSICIAN HEALTH SERVICES, INC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtControlled OrganizationControlledOrganizationIndPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
THE MASSACHUSETTS MEDICAL SOCIETY
860 WINTER STREETWALTHAMMA02451042050773PROMOTE MA MEDICINEMA501(C)60
MASSACHUSETTS MEDICAL SOCIETY CHARITABLE & EDUCATIONAL FUND
860 WINTER STREETWALTHAMMA02451046075905ISSUANCE OF MEDICAL STUDENT LOANSMA501(C)30LINE 12B, IITHE MASSACHUSETTS MEDICAL SOCIETY
MASSACHUSETTS MEDICAL SOCIETY & ALLIANCE CHARITBALE FOUNDATION
860 WINTER STREETWALTHAMMA02451223199624GRANTMAKINGMA501(C)30LINE 12B, IITHE MASSACHUSETTS MEDICAL SOCIETY

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PHYSICIANS INSURANCE AGENCY OF MASSACHUSETTSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1860 WINTER STREETAddressLine1Txt
CityWALTHAMCityNm
State AbbreviationMAStateAbbreviationCd
ZIP02451ZIPCd
FieldValueIRS element (for citing)
EIN043135954EIN
Primary ActivitiesINSURANCEPrimaryActivitiesTxt
Legal Domicile StateMALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MASSACHUSETTS MEDICAL SOCIETYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
THE MASSACHUSETTS MEDICAL SOCIETY
C$533,000FAIR MARKET VALUE
THE MASSACHUSETTS MEDICAL SOCIETY
K$58,240BELOW COST
THE MASSACHUSETTS MEDICAL SOCIETY
P$483,200COST

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.