2019-08-09T10:38:08-05:00 2018-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2017-10-01 222757446 Noble Visiting Nurse Services Inc NOBL 4135627049 77 Mill Street Suite 201 No 201 Westfield MA 01085 Dennis W Chalke SVP Finance, CFO & Treasurer 4135682811 2019-08-09 1 Jeanne Fahrenbach P01365953 5169187000 208.99.255.205 2019-08-09 09:09:41 ED P CD71869BFC494223FABD92E93AB0669CE7B22062 D6D028B83EC7BAE48696A0FE418AC7215527A94E 2017 2019-02-21 02:37:17Z X Dennis W Chalke 77 Mill Street Suite 201 No 201 Westfield MA 01085 4778422 0 X See Schedule O X 1986 MA The mission of the organization is to provide comprehensive home care services, including skilled nursing, medical social services, with the provision of necessary supplies, to individuals and families in their places of residence for the purpose of promoting, maintaining or restoring health, minimizing the effects of illness and disability, and maximizing the level of independence. X 21 17 87 80 0 0 11909 0 6652080 4778018 233 404 0 0 6664222 4778422 0 0 0 0 6024082 4258428 0 0 0 1477367 2277154 7501449 6535582 -837227 -1757160 2046085 0 1793309 0 252776 0 X The mission of the organization is to provide comprehensive home care services, including skilled nursing, medical social services, with the provision of necessary supplies, to individuals and families in their places of residence for the purpose of promoting, maintaining or restoring health, minimizing the effects of illness and disability, and maximizing the level of independence. 0 1 4670478 4778018 To provide comprehensive home care services, including skilled nursing, therapy, medical social worker, and home health aide services to individuals and families in their places of residence. 4670478 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 0 0 1 0 1 0 1 8 0 1 87 1 0 0 0 0 0 0 0 0 0 0 X 21 17 1 1 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X Martin Degen - Noble Visiting Nurse Services Inc 4135627049 77 Mill Street Suite 201 Westfield MA 01085 X Anne M Paradis Chair 1.00 2.00 X X 0 0 0 John F Maybury Vice Chair 1.00 1.00 X X 0 0 0 Adrian J Levsky Trustee 1.00 1.00 X 0 0 0 Claudia R Coplein DO Trustee 1.00 1.00 X 0 0 0 Colleen W Holmes Trustee 1.00 1.00 X 0 0 0 Edward J Noonan Trustee 1.00 1.00 X 0 0 0 Grace Makari-Judson MD Trustee/Hematologist (thru 12/31/17) 1.00 40.00 X 340368 0 77945 Gregory L Braden MD Trustee 1.00 1.00 X 0 0 0 Harriet A DeVerry Trustee 1.00 1.00 X 0 0 0 Hector Toledo Trustee 1.00 1.00 X 0 0 0 Irene Rodriguez Martin Trustee (as of 1/1/18) 1.00 1.00 X 0 0 0 James P Sadowsky Trustee (through 12/31/17) 1.00 2.00 X 0 0 0 James R Phaneuf Trustee 1.00 1.00 X 0 0 0 John A Egelhofer MD Trustee 1.00 1.00 X 0 0 0 John H Davis Trustee (through 12/31/17) 1.00 1.00 X 0 0 0 Kathleen B Scoble Trustee 1.00 1.00 X 0 0 0 Kevin P Moriarty MD Trustee/ Chief Ped Surgery 1.00 40.00 X 686449 0 38262 Maria P Goncalves Trustee (as of 1/1/18) 1.00 1.00 X 0 0 0 Mark A Keroack MD Trustee 1.00 49.00 X 0 1888794 32862 Paul R Murphy Trustee 1.00 1.00 X 0 0 0 Robert J Bacon Trustee 1.00 1.00 X 0 0 0 Robert L Pura PhD Trustee 1.00 1.00 X 0 0 0 Timothy F Farrell Trustee 1.00 1.00 X 0 0 0 Victor Woolridge Trustee (through 12/31/17) 1.00 1.00 X 0 0 0 William R Webber Trustee 1.00 1.00 X 0 0 0 Dennis Chalke Treasurer 1.00 49.00 X 0 994659 87008 Kristin R Delaney Clerk 1.00 39.00 X 0 143978 37512 Madeline Torres Assistant Clerk 1.00 40.00 X 0 57772 15600 Ronald P Bryant President (through 11/30/17) 50.00 0.00 X 0 583904 46551 Nancy Shendell-Falik President (as of 12/1/17) 1.00 49.00 X 0 840145 211038 Martin Degen Chief Operating Officer 20.00 30.00 X 0 193219 32212 Heidi Landers Chief Clinical Officer 20.00 30.00 X 0 155761 10246 Jennifer A Crain Dir Clinical Ops 50.00 0.00 X 128311 0 7088 1155128 4858232 596324 1 0 1 1 Baystate Visiting Nurse Association of N 50 Maple Street Springfield MA 01102 Administrative Services 1431715 Baystate Administrative Services 759 Chestnut Street Springfield MA 01199 Administrative Services 604522 2 Home Care & Hospice Se 621610 4778018 4778018 4778018 404 404 4778422 4778018 0 404 3247544 2965040 282504 197496 180314 17182 458876 418955 39921 354512 323670 30842 1453056 1453056 69846 69846 16724 15269 1455 211784 193359 18425 90575 82695 7880 166223 166223 24214 22107 2107 Telephone 121364 110805 10559 Program Supplies 109882 109882 Postage Shipping 13486 12313 1173 6535582 4670478 1865104 0 0 351430 0 0 1613184 0 0 0 0 0 0 0 81471 0 0 0 0 0 0 2046085 0 971682 368817 452810 0 1793309 0 X 252776 0 252776 0 2046085 0 X -1757160 1504384 X 0 1 X 1 0 X 103055 103565 61728 11909 0 280257 8662981 9148564 9536290 6652080 4778018 38777933 8766036 9252129 9598018 6663989 4778018 39058190 0 0 0 39058190 49 84 428 233 404 1198 49 84 428 233 404 1198 8766085 9252213 9598446 6664222 4778422 39059388 1.00000 1.00000 0.00000 X 0 1 0 0 0 0 0 0 0 Grace Makari-Judson MD Trustee/Hematologist (thru 12/31/17) 291317 0 44081 0 4970 0 56259 0 21686 0 418313 0 0 0 Kevin P Moriarty MD Trustee/ Chief Ped Surgery 543203 0 100207 0 43039 0 22950 0 15312 0 724711 0 0 0 Mark A Keroack MD Trustee 0 1001554 0 525000 0 362240 0 17550 0 15312 0 1921656 0 0 Dennis Chalke Treasurer 0 518753 0 189630 0 286276 0 58410 0 28598 0 1081667 0 0 Kristin R Delaney Clerk 0 128397 0 14975 0 606 0 13738 0 23774 0 181490 0 0 Ronald P Bryant President (through 11/30/17) 0 423246 0 111563 0 49095 0 17550 0 29001 0 630455 0 0 Nancy Shendell-Falik President (as of 12/1/17) 0 554723 0 262899 0 22523 0 185570 0 25468 0 1051183 0 0 Martin Degen Chief Operating Officer 0 158654 0 25254 0 9311 0 8761 0 23451 0 225431 0 0 Heidi Landers Chief Clinical Officer 0 137045 0 14909 0 3807 0 7187 0 3059 0 166007 0 0 Part I, Line 3 The compensation of the current President of the filing organization was reviewed and determined 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. Part I, Line 4b Ronald P Bryant- Supplemental Retirement of $18,953 is included in column B. This amount was earned and paid in 2017. Dennis W. Chalke - Supplemental Retirement of $186,459 is included in column B. This amount was earned and paid in 2017. Mark A. Keroack, MD - Total Supplemental Retirement of $334,356 is included in column B. This amount was earned in 2017. Grace Makari-Judson, MD- Supplemental Retirement of $9,031 is included in column B. This amount was earned in 2017. Kevin P. Moriarty, MD - Supplemental Retirement of $39,037 is included in column B. This amount was earned and paid in 2017. Nancy Shendell-Falik- Supplemental Retirement of $168,020 is included in column C. This amount was earned in 2017. ACCOUNTS RECEIVABLE, NET 2018-09-30 117077 ACTUAL COST 042105803 VISITING NURSE ASSOCIATION & HOSPICE OF WESTERN NEW ENGLAND INC 50 MAPLE ST PO BOX 9058 SPRINGFIELD MA 011029058 501(C)(3) SAVINGS AND TEMPORARY INVESTMENTS 2018-09-30 33912 ACTUAL COST 042105803 VISITING NURSE ASSOCIATION & HOSPICE OF WESTERN NEW ENGLAND INC 50 MAPLE ST PO BOX 9058 SPRINGFIELD MA 011029058 501(C)(3) LEASEHOLD IMPROVEMENTS 2018-09-30 31174 NET BOOK VALUE 042105803 VISITING NURSE ASSOCIATION & HOSPICE OF WESTERN NEW ENGLAND INC 50 MAPLE ST PO BOX 9058 SPRINGFIELD MA 011029058 501(C)(3) FIXED/MOVEABLE/EQUIPMENT 2018-09-30 26084 NET BOOK VALUE 042105803 VISITING NURSE ASSOCIATION & HOSPICE OF WESTERN NEW ENGLAND INC 50 MAPLE ST PO BOX 9058 SPRINGFIELD MA 011029058 501(C)(3) 1 0 0 0 0 0 0 0 0 Part I, Line 2a Noble Visiting Nurse Services, Inc. (NVNS) merged with and into Visiting Nurse Association and Hospice of Western New England, Inc. ("VNAH"), its sole member, on October 1, 2018. Prior to the merger, the officers and trustees of NVNS were the same individuals serving as the officers and trustees of VNAH, and they have continued to serve in the same capacities following the merger. Form 990, Part III, line 3 Noble Visiting Nurse Services,Inc. last day of existence was Septeber 30, 2018 and it's first day as a consolidated entity with Visiting Nurse and Hospice Association of Western New Englad is October 1, 2018. Form 990, Part VI, Section A, line 1 The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee. The members of the executive committee are the same individuals serving on the executive committee of Baystate Health, Inc. 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) Grace P. Makari-Judson, MD, James P. Sadowsky and John H. Davis, (2) Paul R. Murphy and Robert L. Pura, PhD, (3) John F. Maybury and Mark A. Keroack, MD, (4) Hector F. Toledo and Timothy F. Farrell, (5) Claudia R. Coplein, DO and Victor Woolridge, (6) Colleen W. Holmes and James P. Sadowsky, (7) John F. Maybury and Anne M. Paradis. Form 990, Part VI, Section A, line 3 Noble Visiting Nurse Services, Inc. is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c) (3) organization. Information Technology, Human Resources, Finance, Treasury, Accounting and other management and support functions are delegated to BAS. Form 990, Part VI, Section A, line 4 As of October 1, 2018, Noble Visiting Nurse Services, Inc. merged with Visiting Nurse Association and Hospice of Western New England, Inc. Form 990, Part VI, Section A, line 6 The filing organization has one member, Visiting Nurse Association and Hospice of Western New England, Inc. Form 990, Part VI, Section A, line 7a The board of Trustees of the filing organization consists of the same individuals serving as members of the Board of Trustees of Visiting Nurse Association and Hospice of Western New England, Inc. (VNAH), the organizations sole member. The Board of Trustees of VNAH are the same individuals serving as the Board of Trustees of Baystate Health, Inc. ("BH"), the parent corporation of the health system to which the filing organization belongs. The Board of Trustees are elected annually by the Board of Trustees of BH at their annual meeting. Form 990, Part VI, Section A, line 8b: The Trustees of Noble Visiting Nurse Services, Inc. meet during certain scheduled Baystate Health, Inc. (BH) board meetings. The BH Board of Trustees and its committees, including the Audit and Compliance Committee, contemporaneously document meetings and actions relative to Noble Visiting Nurse Services, Inc. as well as the annual acceptance of the audited financial statements. Form 990, Part VI, Section B, line 11b Prior to the filing of this return appropriate parts of this Form 990 were reviewed by representatives from the Tax, Finance, and Human Resources Departments of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) and by outside legal counsel. The entire return was reviewed by a tax expert from an outside accounting firm. The entire return was also reviewed prior to filing by the Audit and Compliance Committee of Baystate Health, Inc., which also includes some of the officers and trustees of the filing organization. This committee also reviews the audited financial statements for the health system. The Form 990 was provided to all members of the Board of Trustees prior to filing. Form 990, Part VI, Section B, line 12c Noble Visiting Nurse Services, Inc. is an affiliate of Baystate Health, Inc. Baystate Health, Inc. (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 committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) reviews and approves the compensation philosophy that is used to administer the specific pay decisions for the President and employees of the filing organization. The compensation committee consists entirely of individuals serving on the board of Baystate Health. The compensation of the President of the filing organization is determined by the member of the President's Cabinet (the Health System's senior leadership) responsible for that filing organization, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data and based on the Executive Compensation Philosophy Statement established by the compensation committee. The compensation of other officers and 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 VII, Section A, Line 5 Certain officers or trustees of the filing organization are paid by an entity, Baystate Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization. Form 990, Part XI, line 9: Transfer to Affiliates 1,504,384. Form 990, Line J Website: www.baystatehealth.org/services/home-health/home-health-services 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 Franklin Medical Center 164 High Street Greenfield MA 01301 042103575 Hospital MA 501 (c ) (3) 3 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 Visiting Nurse Assn and Hospice of Western New England Inc 50 Maple Street Springfield MA 01199 042105803 Homehealth and Hospice care MA 501 (c ) (3) 10 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 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 222747685 Administrative services MA 501 (c ) (3) 12c, III 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 Noble Hospital Corporation 115 West Silver Street Westfield MA 010861634 222537423 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Westfield Medical Corporation 115 West Silver Street 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 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 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 HNE Advisory Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Services MA HNE Holding Corporation C 0 HNE Insurance Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043183019 Ancilliary 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 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 Baystate Health Insurance Company LTD North Church St Georgetown CJ 980421413 Offshore captive insurance CJ Baystate Health Inc C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 Health New England Inc L 639082 Fair Market Value Visiting Nurse Association & Hospice of M 1431715 Fair Market Value Visiting Nurse Association & Hospice of R 208247 Actual Cost