2018-07-13T15:10:59-07:00 2017-09-30 990 2016-10-01 042297845 South Shore Medical Center Inc SOUT 7818785200 143 Longwater Drive Norwell MA 02061 Stephen Coco Treasurer 7816248626 2018-08-15 2016 2022-09-23 18:48:47Z Stephen Coco 55 Fogg Road South Weymouth MA 02190 69569132 0 X www.ssmedcenter.com X 2004 MA South Shore Medical Center cares for patients compassionately and effectively, with the highest medical and ethical standards. We build a better future for the communities we serve through teaching, leadership in health care innovation and philanthropy. 8 1 700 1 0 0 0 0 88743088 69070738 396756 162779 582882 244009 89722726 69477526 4865 3080 0 0 46396545 50494926 0 0 0 55178698 26575229 101580108 77073235 -11857382 -7595709 18992247 21017168 22810387 20431017 -3818140 586151 South Shore Medical Center delivers effective and compassionate patient care with the highest medical and ethical standards. We build a better future for the communities we serve through teaching and leadership in healthcare innovation. 0 0 53776341 3080 69251890 South Shore Medical Center provided medical, preventative and other clinical services to its patients. For the year ended September 30, 2017 SSMC had 249,278 patient visits (including 23,896 Medicaid and 32,414 Medicare visits). The organization works to improve the quality of health care services provided to patients in southeastern Massachusetts through clinical integration and the implementation of a unified electronic medical records system. South Shore Medical Center participated in educational and training programs for medical students and medical residents and for other healthcare professionals including physician assistants and nurses. 0 0 0 53776341 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 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 1 0 0 0 1 61 0 1 700 1 0 0 0 0 0 0 0 0 0 0 X 8 1 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 MA X Michael Kaplan CFO 7816811646 143 Longwater Drive Norwell MA 02061 Gene Green MD SSHS President/CEO 1 48 X 0 1040024 155692 Thomas Carroll Director/President Ambulatory Care 2 40 X 0 416965 88267 Edward Nalband MD Chairman 40 2 X X 376635 0 2590 Matthew Weiss MD Vice Chair thru 12/16 1 45 X X 0 620465 71408 Richard Kauff MD Vice Chair after 4/17 40 1 X X 274454 0 24740 John Stevenson MD SSHS CMO/Director thru 5/16/17 1 48 X 0 579147 551077 Mark Coyle Director thru 12/31/16 1 40 X 0 210817 38402 Elana Dekkers MD Director thru 12/31/16 1 31 X 0 217933 33215 John Walsh MD Director thru 12/31/16 1 41 X 0 348208 26158 Jason Tracy MD Director thru 12/31/16 1 40 X 0 593364 71408 Benjamin Ryan MD Director 40 9 X 294052 0 0 Ingrid Kotch MD Director 40 1 X 348692 0 23117 Helen Garvey Director 1 1 X 0 0 0 David Halle MD Director 40 1 X 279968 0 20396 Pamela Whelton Treasurer thru 8/22/17 1 49 X 0 563152 104761 Stephen Coco Treasurer beginning 8/23/17 1 49 X 0 265170 80469 Peg Holda Clerk 1 44 X 0 340161 73756 Peggy Hafkemeyer COO 40 0 X 245641 0 0 Michael Kaplan CFO 40 0 X 241034 0 11947 Kylee Eagles MD Physician 40 0 X 493759 0 6184 Matthew Hjort MD Physician 40 0 X 481296 0 3015 Joyce Imahiyerobo MD Physician 40 0 X 457724 0 24963 Joseph Sypchalski MD Physician 40 0 X 442101 0 30817 Mark Bulman MD Physician 40 0 X 382007 0 34583 Timothy R Lynch MD Director thru 4/16 1 45 X 131363 403898 83000 Mark Flieger CIO thru 4/16 0 0 X 281065 0 27875 Richard Aubut Director/SSH&EC CEO thru 11/2/15 0 0 X 0 738132 33221 4729791 6337436 1621061 93 1 1 0 Thomas J Kenney MD Inc 2110 Dorchester Avenue Ste 210 Boston MA 02124 Physician Services 834673 Premier Diagnostic Services 54 Bodwell Street Avon MA 02322 Diagnostic Services 688374 South Shore Orthopedics LLC 2 Pond Park Road Hingham MA 02043 Physician Services 474087 Allergy & Asthma Associates 33 Cohasset Avenue Unit 2 Buzzards Bay MA 02532 Physician Services 247255 Richard Horan MD PC 850 Boylston Street Ste 540 Chestnut Hill MA 02467 Physician Services 244600 9 0 Net Patient Service Revenue 621110 59709775 59709775 0 0 Premium Revenue 621110 7820305 7820305 0 0 Discount Revenue 621110 1030349 1030349 0 0 Clinician Reimbursement Revenue 621110 510309 510309 0 0 0 0 0 0 69070738 162779 0 0 162779 0 0 0 0 0 0 0 0 154463 0 91606 0 62857 0 62857 0 0 62857 0 0 Purchase Discounts 900099 48963 48963 0 0 Medical Records Income 900099 11266 11266 0 0 120923 120923 0 0 181152 69477526 69251890 0 225636 X 1480 1480 1600 1600 2053215 1564157 489058 39332990 27793863 11539127 1769389 1255147 514242 4816280 3417650 1398630 2523052 1789771 733281 250 250 76800 76800 5687638 4337266 1350372 29796 29796 5357885 5009588 348297 4948035 4948035 4561130 3722189 838941 11223 11223 149678 110064 39614 831479 665183 166296 1051463 827732 223731 Physician Services 3135185 3135185 0 0 Equipment Maintenance Agreements 308059 95334 212725 0 Repairs 86629 0 86629 0 Physician Board Fees 52282 0 52282 0 287697 50132 237565 0 77073235 53776341 23296894 0 2719108 5660335 4667319 4061577 589027 500760 1256885 1094698 12109202 8397487 3553286 3711715 4082100 4552939 2124522 1435144 18992247 21017168 2769706 1560172 20040681 18870845 22810387 20431017 X -3818140 586151 0 0 0 0 -3818140 586151 18992247 21017168 X -7595709 0 0 0 0 12000000 X 0 1 X 0 0 X 131279545 156789324 100644328 87977858 69070738 545761793 131279545 156789324 100644328 87977858 69070738 545761793 545761793 221768 195588 118367 456896 225636 1218255 221768 195588 118367 456896 225636 1218255 131501313 156984912 100762695 88434754 69296374 546980048 0.99777 0.99803 0.00223 0.00197 X Schedule A, Part III, Line 2 South Shore Medical Center changed its year end from 12/31 to 9/30 when it merged with Coastal Medical Associates. Column headings for Schedule A, Part III are therefore amended as follows: column (a), 2013 calendar year; column (b), 2014 calendar year; column (c), 2015 short year; column (d), 2015 tax year (fiscal year ended September 30, 2016); and column (e), 2016 tax year (fiscal year ended September 30, 2017). 0 0 0 0 0 0 0 0 3197049 1806482 1390567 0 8774694 6591005 2183689 0 137459 0 137459 3711715 A/R - Other 1139438 Due from Affiliates 146939 Security Deposits 92840 3rd Party A/R 40340 Rent Receivable 15587 1435144 0 Due to 3rd Party Payors 7044259 Accrued Deferred Compensation 4388877 Accrued Salaries, Wages and Other Compensation 3518090 Deferred Rental Expense 1679539 Accrued Pension 1044402 Due to Affiliates 1020950 Physician Benefits Payable 164061 Security Deposits 10667 18870845 X Schedule D, 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. 1 1 0 0 0 0 0 1 0 Edward Nalband MD Chairman 371593 0 2500 0 2542 0 0 0 2590 0 379225 0 0 0 Thomas Carroll Director/President Ambulatory Care 0 415033 0 0 0 1932 0 68400 0 19867 0 505232 0 0 Stephen Coco Treasurer beginning 8/23/17 0 258534 0 0 0 6636 0 61195 0 19274 0 345639 0 0 Gene Green MD SSHS President/CEO 0 800810 0 237282 0 1932 0 135825 0 19867 0 1195716 0 225000 Peg Holda Clerk 0 289334 0 37006 0 13821 0 54482 0 19274 0 413917 0 34502 David Halle MD Director 277024 0 2500 0 444 0 0 0 20396 0 300364 0 0 0 Ingrid Kotch MD Director 345557 0 2500 0 635 0 0 0 23117 0 371809 0 0 0 Benjamin Ryan MD Director 291342 0 2500 0 210 0 0 0 0 0 294052 0 0 0 Matthew Weiss MD Vice Chair thru 4/17 0 619079 0 0 0 1386 0 65083 0 23992 0 709540 0 0 Timothy R Lynch MD Director thru 4/16 99656 399846 1000 0 30707 4052 0 61952 2589 18459 133952 484309 0 0 John Stevenson MD SSHS CMO/Director 0 503509 0 69331 0 6307 0 525664 0 25413 0 1130224 0 69322 Jason Tracy MD Director 0 526335 0 44426 0 22603 0 51541 0 19867 0 664772 0 38863 John Walsh MD Director 0 255808 0 11156 0 81244 0 18975 0 7183 0 374366 0 0 Elana Dekkers MD Director 0 171276 0 1500 0 45157 0 10704 0 22510 0 251147 0 0 Pamela Whelton Treasurer thru 8/22/17 0 499584 0 57938 0 5630 0 103369 0 1392 0 667913 0 57931 Peggy Hafkemeyer COO 242168 0 2500 0 973 0 0 0 0 0 245641 0 0 0 Michael Kaplan CFO 237622 0 2500 0 912 0 0 0 11947 0 252981 0 0 0 Mark Flieger CIO thru 4/16 60627 0 1200 0 219238 0 0 0 0 0 281065 0 0 0 Richard Aubut Director/SSH&EC CEO thru 11/2/15 0 0 0 144648 0 593484 0 33221 0 0 0 771353 0 0 Kylee Eagles MD Physician 493759 0 6025 0 159 0 0 0 0 0 499943 0 0 0 Matthew Hjort MD Physician 481296 0 2500 0 515 0 0 0 0 0 484311 0 0 0 Joyce Imahiyerobo MD Physician 457724 0 2500 0 270 0 0 0 22193 0 482687 0 0 0 Joseph Sypchalski MD Physician 442101 0 2500 0 441 0 0 0 27876 0 472918 0 0 0 Mark Bulman MD Physician 382007 0 2500 0 4207 0 0 0 27876 0 416590 0 0 0 Mark Coyle Director thru 12/31/16 0 202183 0 0 0 8634 0 12991 0 25411 0 249219 0 0 Schedule J, Part I, Line 3 The President, Ambulatory Care, receives compensation for services performed for a related organization. His compensation package was determined by South Shore Health System, parent company of Coastal Medical Associates, prior to the merger between CMA and South Shore Medical Center in August 2015. The President's compensation did not change in FY17. During the merger process, SSHS engaged an independent outside consultant to present comparable industry and market data to determine the President's compensation. Schedule J, Part I, Line 4 Mark Flieger, former SSMC CIO, received $143,258 in salary continuation in 2016. South Shore Hospital has established split dollar arrangements for the individuals listed below. The premiums paid into these policies by South Shore are deemed to be loaned to these individuals and these individuals are therefore subject to income tax on the imputed interest associated with the loans. The individual with an asterisk is provided with an annual gross up to cover the income taxes due with respect to the imputed interest amounts. Amounts related to these arrangements are reported in Schedule J, Part II. Richard Aubut*, Margaret Holda, John Stevenson, Pamela Whelton, Stephen Coco, Jason Tracy, Matthew Weiss Schedule J, Part I, Line 7 Physicians and executives received bonus payments of $2,500 per year to offset taxes owed on LTD insurance. One physician received a bonus for conducting sports medicine physicals at a local high school. Suzanne Carroll Family member of Thomas Carroll, President 25888 Employment 0 Form 990, Part VI, Section A, Line 2 The persons listed in Part VII have a "business" relationship" with one another by virtue of sitting on boards of entities related to South Shore Medical Center. Form 990, Part VI, Section A, Line 6 Coastal Medical Associates, Inc. dba South Shore Physician Ambulatory Enterprise is the sole member of the corporation. Form 990, Part VI, Section A, Line 7a The sole member has the ability to approve any change in membership in the corporation. Form 990, Part VI, Section A, Line 7b The Corporation cannot make certain governance changes without the approval of the sole member. These include changes to the by-laws or Articles of Organization of the Corporation; sale or other distribution of the Corporation's assets, earnings or profits; approval of any change in membership of the Corporation; adoption of annual capital and operating budgets; approval of any capital expenditure in excess of $50,000; approval of the employment, appointment or removal of the President of the Corporation and approval of any plan or petition for liquidation or dissolution of the Corporation. 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. A complete copy of Form 990 is presented for review to the governing body as a whole 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 The President, Ambulatory Care, is considered a South Shore Health System executive; all executive compensation decisions are made by the SSHS President/CEO, using the Compensation Committee of the Board of Director's approved philosophy and pay approach for the executive team. The Compensation Committee is independent and consists solely of members who do not have a conflict of interest with regards to compensation matters. The President's compensation did not change in FY17. Annual compensation decisions for Coastal (SSPAE) physicians and advanced practice clinician employees are also made by SSHS and are based on a combination of advice and research provided by outside consultants, review of comparable industry data and market conditions. Form 990, Part VI, Section C, Line 19 South Shore Medical Center 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 Capitated Program Expenses, $3,579,469; Purchased Services, $1,546,759; Consultants, $357,539; Billing and Collection Fees, $176,713; Recruitment, $27,158. Form 990, Part XI, Line 9 Affiliate transfers, $12,000,000. 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 Health System Inc formerly South Shore Health & Educational Corporation 55 Fogg Road South Weymouth MA 02190 042105926 Supports the charitable mission of South Shore Hospital and its affiliates MA 501(c)(3) 11c, Type III N/A 0 South Shore Property Inc 55 Fogg Road South Weymouth MA 02190 050398822 Develops and manages real property for South Shore Hospital and its affiliates MA 501(c)(3) 11a, Type I South Shore Health System Inc 0 Coastal Medical Associates Inc 55 Fogg Road South Weymouth MA 02190 043170333 Primary and specialized medical care MA 501(c)(3) 3 South Shore Health System Inc 0 MetroSouth Obstetrics & Gynecology Inc 55 Fogg Road South Weymouth MA 02190 330998957 Specialized medical care MA 501(c)(3) 3 South Shore Hospital 0 Atlantic Women's Health Inc 55 Fogg Road South Weymouth MA 02190 200156651 Specialized medical care MA 501(c)(3) 3 South Shore Hospital 0 Health Provider Services Organization of the South Shore Inc 55 Fogg Road South Weymouth MA 02190 452385865 Supports the charitable mission of SSH&E and affiliates MA 501(c)(3) 11c, Type III South Shore Health System Inc 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 1