2019-08-09T10:38:08-05:00 2018-09-30 861065772 Deloitte Tax LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2017-10-01 042888373 Baystate Medical Practices Inc BAYS 4137940000 759 Chestnut Street Springfield MA 01199 Dennis W Chalke SVP Finance, CFO & Treasurer 4137940000 2019-08-09 1 Jeanne Fahrenbach P01365953 5169187000 208.99.255.205 2019-08-09 08:50:38 ED P 98200C5E1D152BB5D8EF3C6E8CF5128ADF7B3612 D6D028B83EC7BAE48696A0FE418AC7215527A94E 2017 2019-02-21 02:37:17Z Dennis W Chalke 759 Chestnut Street Springfield MA 01199 307387726 0 X baystatehealth.org X 1985 MA The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. Baystate Medical Practice's vision states it will be the multi-specialty group practice of choice, known for exceptional service, quality, value, and academic leadership. 22 1 2000 1 311589 -88427 0 442650 288619925 306905914 43854 39162 0 0 288663779 307387726 0 0 0 0 272958172 283881961 0 0 0 57260132 67056111 330218304 350938072 -41554525 -43550346 50023885 51574022 91598914 79732612 -41575029 -28158590 X The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. Baystate Medical Practices' vision states it will be the multi-specialty group practice of choice, known for exception service, quality, value and academic leadership. 0 0 335424116 306594325 Baystate Medical Practices, Inc. provides physician services, medical education and research programs to people in the community within its geographic location. BMP's policy is to provide care to any patient in need of medical care, regardless of the patient's ability to pay for such care. Dependent upon the patient's financial capability to pay, BMP may provide such care free of charge or at amounts below its normal charges. Because BMP does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. In addition to the charity care provided to patients, BMP's physicians participate in many and varied ongoing community outreach initiatives in the areas of education, employment, safety and health. For example, the BMP physicians in the Department of Pediatrics, in collaboration with the Springfield School Department, staff six school-based clinics that enhance school health education programs, provide professional development courses for teachers and administrators and establish a school-to-work program.BMP has also taken a leadership role in strengthening the health of disadvantaged citizens in surrounding communities including specific focus on AIDS and HIV and by providing physician staffing for three community-based health centers through Baystate Medical Center.Part VI, Section A, Line 1b:Baystate Medical Practices, Inc. (BMP) is part of an integrated delivery system including not for profit community hospitals, which have community boards. BMP is a physician organization, which supports Baystate Health and its affiliates and is comprised primarily of BMP employees. This board structure has not changed significantly since the organization applied for exempt status. 335424116 1 1 0 0 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 1 0 0 0 0 0 0 0 0 0 0 1 131 0 1 2000 1 1 1 0 0 0 0 0 0 0 0 0 X 22 1 1 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 MA X Dennis W Chalke Baystate Health 4137940000 759 Chestnut Street Springfield MA 01199 Andrew Artenstein MD President 40.00 6.00 X X 964737 0 44398 Dennis Chalke Treasurer/Director 3.00 47.00 X X 994659 0 87008 Aaron Kugelmass MD Director 50.00 0.00 X 821209 0 36988 Barry Sarvet MD Director 50.00 0.00 X 514623 0 58318 Charlotte Boney MD Director 50.00 0.00 X 515801 0 52629 Cheryl Geoffrion MD Director 50.00 0.00 X 327430 0 41046 Dennis Oh MD Director 50.00 0.00 X 1284635 0 42585 Edward Feldman MD Director 50.00 0.00 X 440608 0 32711 Elizabeth Boyle MD Director 50.00 0.00 X 415739 0 52098 Heather Sankey MD Director 50.00 0.00 X 396405 0 46513 Joseph Schmidt MD Director (through 1/23/18) 50.00 0.00 X 425528 0 54639 Kathleen B Scoble Director 1.00 1.00 X 0 0 0 Kevin Hinchey MD Ex-Offico Director/ CAO 40.00 10.00 X 492538 0 74486 Kimberly Bucknor MD Director 50.00 0.00 X 246940 0 31344 Lisa Erickson Director 50.00 0.00 X 127081 0 8590 Mark A Keroack MD Director 1.00 49.00 X 1888794 0 32862 Nicolas Jabbour MD Director 50.00 0.00 X 852099 0 44185 Niels Rathlev MD Director (as of 1/24/18) 50.00 0.00 X 619981 0 41866 Reginald Alouidor MD Director 50.00 0.00 X 472637 0 41803 Richard Friedberg MD Director (through 5/31/18) 50.00 0.00 X 621421 0 70155 Ronald P Bryant Director 1.00 49.00 X 583904 0 46551 Sarah Haessler MD Director 50.00 0.00 X 279784 0 37871 Timothy Lepore MD Director 50.00 0.00 X 276679 0 37631 Wilson Mertens MD Director 50.00 0.00 X 511260 0 67574 Kristin R Delaney Clerk 1.00 40.00 X 143978 0 37512 Betty Larue COO 50.00 0.00 X 499696 0 71473 Joseph Flack MD Cardiac Surgeon 50.00 0.00 X 1019770 0 40048 Thomas L Kaye MD Chief Division Of Neurosurgery 50.00 0.00 X 731230 0 33549 David W Deaton MD Cardiac Surgeon 50.00 0.00 X 726318 0 39675 Richard J Hicks MD Chair Radiology 50.00 0.00 X 705112 0 68856 Farhad Bahrassa MD Neurosurgeon 50.00 0.00 X 687313 0 54318 18587909 0 1429282 732 0 1 1 Springfield Medical Associates 2150 Main St Springfield MA 01104 Contracted MD services 11949304 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 Management services 5886866 Baystate Medical Center Inc 759 Chestnut Street Springfield MA 01199 MD scheduling service 4056967 Valley Medical AssociatesPC 3640 Main St Springfield MA 01107 Contracted MD services 2454000 Western Mass Medical Group 100 Wason Ave Suite 230 Springfield MA 01107 Contracted MD services 950336 35 442650 442650 Physician Practice Fees 621110 170881620 170881620 Hospital reimb programs 621110 89733353 89733353 Practice lease agreement 621110 12802516 12802516 Funding-strategic growth projects 621110 9597767 9597767 MD performance incentives 621110 5540589 5540589 18350069 18038480 311589 306905914 39162 39162 307387726 306594325 311589 39162 10670780 10430687 240093 999825 977329 22496 235138919 229905039 5233880 11072749 10826221 246528 13261725 12966490 295235 12737963 12454299 283664 6284294 6284294 179707 179707 56042 56042 26993806 25884109 1109697 1382 1382 1884459 1842494 41965 158565 155034 3531 7269489 7107603 161886 376500 368116 8384 57377 56099 1278 5877 5877 1493554 1460294 33260 10435769 10203373 232396 Purchased Svcs Clerical 5008874 4758430 250444 Medical Supplies 3226916 3226916 Prof'l Exp Acct 2324421 2324421 Dues & Memberships 816748 816748 482331 477162 5169 350938072 335424116 15513956 0 2140940 407421 17281627 16504948 2934419 2343105 32219616 21770778 9699885 10448838 17967014 21869710 50023885 51574022 40754708 44595856 15833 455833 50828373 34680923 91598914 79732612 X -41575029 -28158590 -41575029 -28158590 50023885 51574022 X -43550346 56966785 X 0 1 X 1 0 X 442650 442650 235830282 250588760 262304309 288416270 306594325 1343733946 235830282 250588760 262304309 288416270 307036975 1344176596 0 0 0 1344176596 14390 37715 62147 43854 39162 197268 14390 37715 62147 43854 39162 197268 235844672 250626475 262366456 288460124 307076137 1344373864 0.99990 0.99990 0.00010 0.00010 X 1103927 567635 536292 10249282 3429886 6819396 20866407 17773257 3093150 10448838 Due from Affiliated Companies 12410897 Other Accounts Receivable 9458813 21869710 Due to Affiliated Companies 20525258 Insurance Liability Loss Reserve 10770403 Accrued Pension Cost 3035324 Affiliate Line of Credit 349938 34680923 0 1 0 0 0 0 0 0 0 Andrew Artenstein MD President 578749 0 196796 0 189192 0 17550 0 26848 0 1009135 0 18347 0 Dennis Chalke Treasurer/Director 518753 0 189630 0 286276 0 58410 0 28598 0 1081667 0 0 0 Aaron Kugelmass MD Director 615415 0 130641 0 75153 0 17550 0 19438 0 858197 0 0 0 Barry Sarvet MD Director 393959 0 100301 0 20363 0 32951 0 25367 0 572941 0 0 0 Charlotte Boney MD Director 388267 0 121811 0 5723 0 32063 0 20566 0 568430 0 0 0 Cheryl Geoffrion MD Director 299885 0 22128 0 5417 0 20250 0 20796 0 368476 0 0 0 Dennis Oh MD Director 593805 0 639366 0 51464 0 20250 0 22335 0 1327220 0 0 0 Edward Feldman MD Director 360031 0 75291 0 5286 0 17550 0 15161 0 473319 0 0 0 Elizabeth Boyle MD Director 300485 0 80273 0 34981 0 28135 0 23963 0 467837 0 0 0 Heather Sankey MD Director 335155 0 49581 0 11669 0 28433 0 18080 0 442918 0 0 0 Joseph Schmidt MD Director (through 1/23/18) 348755 0 65115 0 11658 0 33196 0 21443 0 480167 0 0 0 Kevin Hinchey MD Ex-Offico Director/ CAO 389527 0 76125 0 26886 0 52872 0 21614 0 567024 0 0 0 Kimberly Bucknor MD Director 220034 0 22059 0 4847 0 13595 0 17749 0 278284 0 0 0 Mark A Keroack MD Director 1001554 0 525000 0 362240 0 17550 0 15312 0 1921656 0 0 0 Nicolas Jabbour MD Director 641569 0 204120 0 6410 0 20081 0 24104 0 896284 0 0 0 Niels Rathlev MD Director (as of 1/24/18) 446493 0 118388 0 55100 0 17550 0 24316 0 661847 0 0 0 Reginald Alouidor MD Director 416576 0 35925 0 20136 0 20250 0 21553 0 514440 0 0 0 Richard Friedberg MD Director (through 5/31/18) 427788 0 114161 0 79472 0 43056 0 27099 0 691576 0 0 0 Ronald P Bryant Director 423246 0 111563 0 49095 0 17550 0 29001 0 630455 0 0 0 Sarah Haessler MD Director 232004 0 46439 0 1341 0 17480 0 20391 0 317655 0 0 0 Timothy Lepore MD Director 243560 0 32592 0 527 0 16089 0 21542 0 314310 0 0 0 Wilson Mertens MD Director 396040 0 83013 0 32207 0 46120 0 21454 0 578834 0 0 0 Kristin R Delaney Clerk 128397 0 14975 0 606 0 13738 0 23774 0 181490 0 0 0 Betty Larue COO 356425 0 93844 0 49427 0 49489 0 21984 0 571169 0 0 0 Joseph Flack MD Cardiac Surgeon 473669 0 511560 0 34541 0 20250 0 19798 0 1059818 0 0 0 Thomas L Kaye MD Chief Division Of Neurosurgery 649663 0 37000 0 44567 0 17550 0 15999 0 764779 0 0 0 David W Deaton MD Cardiac Surgeon 474082 0 219815 0 32421 0 20250 0 19425 0 765993 0 0 0 Richard J Hicks MD Chair Radiology 551095 0 145635 0 8382 0 44763 0 24093 0 773968 0 0 0 Farhad Bahrassa MD Neurosurgeon 656760 0 28996 0 1557 0 46105 0 8213 0 741631 0 0 0 Part I, Line 3 The compensation of 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). 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 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 Reginald Alouidor, MD - Supplemental Retirement of $18,506 is included in column B. This amount was earned and paid in 2017. Andrew Artenstein, MD - Supplemental Retirement of $172,937 is included in column B. This amount consists of $153,948 earned and paid in 2017 and $18,347 that was previously reported as deferred compensation in prior years Forms 990 and that is currently reported as taxable income. This also includes $642 of investment earnings on prior year contributions. The amount is listed in Column F in accordance with reporting requirements. Farhad Bahrassa, MD - Supplemental Retirement of $28,555 is included in column C. This amount was earned in 2017. Charlotte Boney, MD - Supplemental Retirement of $14,513 is included in $column C. This amount was earned in 2017. Elizabeth Boyle, MD - Supplemental Retirement of $7,711 is included in column B. This amount was earned and paid in 2017. 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. David W. Deaton, MD - Supplemental Retirement of $23,688 is included in column B. This amount was earned in 2017. Edward Feldmann, MD - Supplemental Retirement of $9,019 is included in column B. This amount was earned in 2017. Joseph Flack, MD - Supplemental Retirement of $25,826 is included in column B. This amount was earned in 2017. Richard Friedberg, MD - Supplemental Retirement of $35,077 is included in column B. This amount was earned in 2017. Cheryl Geoffrion, MD - Supplemental Retirement of $2,061 is included in column B. This amount was earned in 2017. Kevin Hinchey, MD - Supplemental Retirement of $22,758 is included in column B. This amount was earned and paid in 2017. Richard Hicks, MD - Supplemental Retirement of $27,213 is included in column C. This amount was earned in 2017. Nicholas Jabbour, MD - Supplemental Retirement of $2,531 is included in column C. This amount was earned in 2017. Thomas Kaye, MD- Supplemental Retirement of $28,400 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. Aaron Kugelmass, MD- Supplemental Retirement of $32,532 is included in column B. This amount was earned and paid in 2017. Betty K Larue - Supplemental Retirement of $21,003 is included in column B. This amount was earned in 2017. Wilson Mertens, MD - Supplemental Retirement of $21,863 is included in column B. This amount was earned and paid in 2017. Dennis Oh, MD - Supplemental Retirement of $48,400 is included in column B. This amount was earned and paid in 2017. Neils K. Rathlev, MD - Supplemental Retirement of $13,103 is included in column B. This amount was earned paid in 2017. Heather Sankey, MD - Supplemental Retirement of $9,400 is included in column B. This amount was earned paid in 2017. Barry Sarvet, MD - Supplemental Retirement of $16,677 is included in column B. This amount was earned paid in 2017. Joseph Schmidt, MD - Supplemental Retirement of $7,869 is included in column B. This amount was earned and paid in 2017. Wilson Mertens MD Family member of Wilson Mertens, MD 150080 See Part V - Family member of Wilson Mertens, MD is employed by the filing organization. 0 Reginald Alouidor MD Family member of Reginald Alouidor, MD 219948 See Part V - Family member of Reginald Alouidor, MD employed by the filing organization. 0 Sarah Haessler MD Family member of Sarah Haessler, MD 585945 See Part V - Family member of Sarah Haessler, MD employed by the filing organization. 0 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. Form 990, Part VI, Section A, line 3 Baystate Medical Practices, 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 6 The members of the filing organization are physicians, all of whom who have medical staff appointments at a Baystate Health, Inc. (BH) hospital affiliate, provide at least 1,000 hours of professional service annually on behalf of the filing organization, and are parties to a membership agreement with the filing organization approved by the Board of Directors. Form 990, Part VI, Section A, line 7a The Board of Directors consists of 23 Directors, 6 of whom were either appointed by BH or serve ex officio based on positions they hold with BH, and 17 of whom are at large directors elected by the members of the filing organization. Form 990, Part VI, Section A, line 7b The bylaws of the filing organization provide that the following matters approved by the Board of Directors are also subject to the approval of Baystate Health. Inc. (BH): (1) the filing organization's annual budget, (2) the form and content of agreements with members and other employees of the filing organization for their compensation and benefits, (3) policies regarding personal time, sick time, leaves of absence, hours of work, and number of working days, (4) the establishment of reserves to meet any unusual expense, loss, or anticipated year-end expense or a discretionary fund to support the filing organization's educational and research programs, (5) any pledge of the filing organization's credit, the borrowing of any money, or the execution of any promissory note by the filing organization, (6) amendments to the bylaws of the filing organization, with the exception of certain technical amendments. 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. In addition, this return was provided to and reviewed by the Audit and Compliance Committee of Baystate Health, Inc. This committee also reviews the audited financial statements for the health system. This return was also provided prior to filing to the Baystate Health, Inc. Board of Trustees. Form 990, Part VI, Section B, line 12c Baystate Medical Practices, 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 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 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. The compensation of other officers and key employees is administered under 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. Line 15a has been answered No because the President is paid by Baystate Administrative Services, Inc., an affiliate and related organization of the filing organization. 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 directors of the filing organization are paid by an entity, Baystate Administrative Services, Inc. (BAS) EIN 22-2747685, 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 BAS to the officers and directors 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: Current year acquisitions from other entities 1,390,878. Net Transfers (to)/from Affiliates 50,408,000. Minimum pension liability adjustment 5,167,907.