2018-08-09T13:11:27-05:00 2017-09-30 861065772 Deloitte Tax LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2016-10-01 042888373 Baystate Medical Practices Inc BAYS 4137940000 759 Chestnut Street Springfield MA 01199 Dennis W Chalke SVP Finance, CFO & Treasurer 4137943290 2018-08-09 1 Christine Kawecki P00743140 5169187000 2016 2022-09-23 18:48:47Z Dennis W Chalke 759 Chestnut Street Springfield MA 01199 288663779 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. 23 1 1914 1 526581 -100540 0 0 262962964 288619925 62147 43854 0 0 263025111 288663779 0 0 0 0 256690319 272958172 0 0 0 41226780 57260132 297917099 330218304 -34891988 -41554525 43356086 50023885 97518736 91598914 -54162650 -41575029 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 316009613 288093344 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. 316009613 1 0 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 1 119 0 1 1914 1 1 1 0 0 0 0 0 0 0 0 0 X 23 1 1 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 MA X Peter Lyons Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 Andrew Artenstein MD President/Director 40.00 6.00 X X 768854 0 62074 Dennis Chalke Treasurer/Director 1.00 50.00 X X 935201 0 89071 Aaron Kugelmass MD Director 50.00 0.00 X 736873 0 37582 Barry Sarvet MD Director 50.00 0.00 X 463047 0 55839 Charlotte Boney MD Director 50.00 0.00 X 460163 0 59200 Cheryl Geoffrion MD Director (as of 2/1/17) 50.00 0.00 X 295817 0 35193 Daniel Grow MD Director (Through 4/1/17) 50.00 0.00 X 593305 0 67072 David Maguire MD Director (Through 1/1/17) 49.00 1.00 X 308877 0 26787 Dennis Oh MD Director 50.00 0.00 X 908786 0 41066 Edward Feldman MD Director 50.00 0.00 X 399557 0 43795 Elizabeth Boyle MD Director 50.00 0.00 X 357901 0 54595 Evan Benjamin MD Director (through 6/26/17) 49.00 1.00 X 781965 0 75088 Heather Sankey MD Director (as of 5/3/17) 50.00 0.00 X 384551 0 47659 Joseph Schmidt MD Director 50.00 0.00 X 366187 0 53311 Kathleen B Scoble Director 1.00 1.00 X 0 0 0 Kevin Hinchey MD Ex-Offico Director/ CAO 40.00 10.00 X 445363 0 74624 Kimberly Bucknor MD Director (as of 3/1/17) 50.00 0.00 X 268276 0 27546 Lisa Erickson MD Director (as of 9/6/17) 50.00 0.00 X 0 0 0 Mark A Keroack MD Director 1.00 49.00 X 2182220 0 38487 Nicolas Jabbour MD Director (as of 2/1/17) 50.00 0.00 X 340475 0 48486 Reginald Alouidor MD Director 50.00 0.00 X 513238 0 36245 Richard Friedberg MD Director 50.00 0.00 X 577259 0 71609 Sara A Rourke MD Director (through 5/3/17) 40.00 10.00 X 293951 0 36959 Sarah Haessler MD Director 50.00 0.00 X 258172 0 40524 Susan DeJoy CNM Director (through 12/31/16) 50.00 0.00 X 160529 0 35809 Ronald P Bryant Director (as of 8/2/17) 1.00 49.00 X 545819 0 44592 Thomas L Higgins MD Director (through 3/31/17) 10.00 40.00 X 477746 0 65927 Timothy Lepore MD Director (as of 6/7/17) 50.00 0.00 X 267106 0 39958 Wilson Mertens MD Director 50.00 0.00 X 457790 0 67559 Kristin R Delaney Clerk 1.00 40.00 X 137437 0 37010 Betty K Larue COO, BMP 40.00 10.00 X 410690 0 70865 Farhad Bahrassa MD Neurosurgeon 50.00 0.00 X 742248 0 52103 Kevin P Moriarty MD Chief Pediatric Surgery 50.00 0.00 X 699348 0 45950 Thomas L Kaye MD Chief Division Of Neurosurgery 50.00 0.00 X 675840 0 34240 Richard J Hicks MD Chair Radiology 50.00 0.00 X 637294 0 66419 John A Rousou MD Cardiac Surgeon 50.00 0.00 X 635790 0 43002 John Schreiber MD Chair/President (Thru 7/15) 1.00 40.00 X 1516773 0 36585 Mohammed S Ahmed MD Obstetrician/Gynecologist 10.00 41.00 X 658788 0 36566 Douglas D Muehlberg Business Consultant 40.00 10.00 X 185159 0 58121 20848395 0 1857518 702 1 1 1 Springfield Medical Associates 2150 Main St Springfield MA 01104 Contracted MD services 8626900 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 Management services 5715404 Baystate Medical Center Inc 759 Chestnut Street Springfield MA 01199 MD scheduling service 4001910 Western Mass Medical Group 100 Wason Ave Suite 230 Springfield MA 01107 Contracted MD services 1043000 Cardiology & Internal Medicine Associate 222 Carew St 4th Fl Springfield MA 01104 Contracted MD services 670000 38 Physician Practice Fees 621110 160500524 160500524 Hospital reimb programs 621110 89298298 89298298 practice lease agreement-SMA 621110 8100000 8100000 Funding for strategic growth proj 621110 7802695 7802695 Physician services for affiliates 621110 5100219 5100219 17818189 17291608 526581 288619925 43854 43854 288663779 288093344 526581 43854 12637703 12637703 221002262 215973736 5028526 14097586 13774848 322738 13407538 13108035 299503 11813083 11557466 255617 6112554 6112554 359749 359749 44917 44917 19984902 19586034 398868 25906 24611 1295 1629590 1548110 81480 247029 234678 12351 7151857 6794264 357593 314720 298984 15736 79950 75952 3998 5423 5423 1525840 1449548 76292 8307420 7892049 415371 Purchased Svcs Clerical 4821571 4580492 241079 Medical Supplies 3062761 3062761 Prof'l Exp Acct 2355176 2237417 117759 Dues & Memberships 928643 882211 46432 302124 290714 11410 330218304 316009613 14208691 0 2507109 2140940 14295560 17281627 1454153 2934419 29702171 20002286 10877580 9699885 14221684 17967014 43356086 50023885 42161018 40754708 15833 15833 55341885 50828373 97518736 91598914 X -54162650 -41575029 -54162650 -41575029 43356086 50023885 X -41554525 54142146 X 0 1 X 1 0 X 218759374 235830282 250588760 262304309 288416270 1255898995 218759374 235830282 250588760 262304309 288416270 1255898995 0 0 0 1255898995 3934 14390 37715 62147 43854 162040 3934 14390 37715 62147 43854 162040 218763308 235844672 250626475 262366456 288460124 1256061035 0.99990 0.99990 0.00010 0.00010 X 1103927 542186 561741 9334449 2818474 6515975 19263795 16641626 2622169 9699885 Due from Affiliated Companies 11468115 Accounts Receivable, Other 6498899 17967014 Due to Affiliated Companies 28265714 Insurance IBNR Loss Reserves 10257739 Accrued Pension Cost 11868458 Line of credit, affiliate 436462 50828373 1 1 0 0 0 0 0 0 0 Andrew Artenstein MD President/Director 526339 0 173565 0 68950 0 36897 0 25177 0 830928 0 0 0 Dennis Chalke Treasurer/Director 489983 0 162064 0 283154 0 63576 0 25495 0 1024272 0 0 0 Aaron Kugelmass MD Director 586323 0 111923 0 38627 0 19875 0 17707 0 774455 0 0 0 Barry Sarvet MD Director 359119 0 90125 0 13803 0 34797 0 21042 0 518886 0 0 0 Charlotte Boney MD Director 361521 0 95206 0 3436 0 38488 0 20712 0 519363 0 0 0 Cheryl Geoffrion MD Director (as of 2/1/17) 278656 0 15192 0 1969 0 19875 0 15318 0 331010 0 0 0 Daniel Grow MD Director (Through 4/1/17) 454464 0 108581 0 30260 0 43723 0 23349 0 660377 0 0 0 David Maguire MD Director (Through 1/1/17) 256278 0 48270 0 4329 0 25175 0 1612 0 335664 0 0 0 Dennis Oh MD Director 594191 0 273007 0 41588 0 21200 0 19866 0 949852 0 0 0 Edward Feldman MD Director 356925 0 39263 0 3369 0 28416 0 15379 0 443352 0 0 0 Elizabeth Boyle MD Director 276184 0 69946 0 11771 0 28819 0 25776 0 412496 0 0 0 Evan Benjamin MD Director (through 6/26/17) 455882 0 146718 0 179365 0 53947 0 21141 0 857053 0 0 0 Heather Sankey MD Director (as of 5/3/17) 330246 0 43631 0 10674 0 32208 0 15451 0 432210 0 0 0 Joseph Schmidt MD Director 310312 0 45875 0 10000 0 35033 0 18278 0 419498 0 0 0 Kevin Hinchey MD Ex-Offico Director/ CAO 352267 0 61661 0 31435 0 56901 0 17723 0 519987 0 0 0 Kimberly Bucknor MD Director (as of 3/1/17) 205703 0 36208 0 26365 0 13698 0 13848 0 295822 0 0 0 Mark A Keroack MD Director 876848 0 401474 0 903898 0 19875 0 18612 0 2220707 0 562123 0 Nicolas Jabbour MD Director (as of 2/1/17) 247639 0 50000 0 42836 0 42000 0 6486 0 388961 0 0 0 Reginald Alouidor MD Director 414376 0 87167 0 11695 0 18550 0 17695 0 549483 0 0 0 Richard Friedberg MD Director 410009 0 111376 0 55874 0 44725 0 26884 0 648868 0 0 0 Sara A Rourke MD Director (through 5/3/17) 249818 0 42077 0 2056 0 16301 0 20658 0 330910 0 0 0 Sarah Haessler MD Director 219626 0 37206 0 1340 0 22067 0 18457 0 298696 0 0 0 Susan DeJoy CNM Director (through 12/31/16) 149898 0 7299 0 3332 0 24771 0 11038 0 196338 0 0 0 Ronald P Bryant Director (as of 8/2/17) 422431 0 97708 0 25680 0 19875 0 24717 0 590411 0 0 0 Thomas L Higgins MD Director (through 3/31/17) 373414 0 70838 0 33494 0 55495 0 10432 0 543673 0 0 0 Timothy Lepore MD Director (as of 6/7/17) 244107 0 22481 0 518 0 17225 0 22733 0 307064 0 0 0 Wilson Mertens MD Director 381860 0 50582 0 25348 0 49010 0 18549 0 525349 0 0 0 Kristin R Delaney Clerk 122188 0 14668 0 581 0 18742 0 18268 0 174447 0 0 0 Betty K Larue COO, BMP 317744 0 77350 0 15596 0 52306 0 18559 0 481555 0 0 0 Farhad Bahrassa MD Neurosurgeon 653982 0 86922 0 1344 0 44287 0 7816 0 794351 0 0 0 Kevin P Moriarty MD Chief Pediatric Surgery 537664 0 124279 0 37405 0 26500 0 19450 0 745298 0 0 0 Thomas L Kaye MD Chief Division Of Neurosurgery 626979 0 0 0 48861 0 19875 0 14365 0 710080 0 0 0 Richard J Hicks MD Chair Radiology 531405 0 99338 0 6551 0 46851 0 19568 0 703713 0 0 0 John A Rousou MD Cardiac Surgeon 490795 0 116400 0 28595 0 29150 0 13852 0 678792 0 0 0 John Schreiber MD Chair/President (Thru 7/15) 383268 0 29400 0 1104105 0 19875 0 16710 0 1553358 0 0 0 Mohammed S Ahmed MD Obstetrician/Gynecologist 159167 0 50000 0 449621 0 27299 0 9267 0 695354 0 0 0 Douglas D Muehlberg Business Consultant 127970 0 0 0 57189 0 51699 0 6422 0 243280 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, Lines 4a-b Line 4a: John Schreiber, MD received $1,060,197 in 2016. Mohammed Ahmed, MD received $374,900 in 2016. Line 4b: Mohammed Shafeeq Ahmed, MD - Supplemental Retirement of $14,156 is included in column E. This amount was earned and paid in 2016. Reginald Alouidor, MD - Supplemental Retirement of $10,124 is included in column E. This amount was earned and paid in 2016. Andrew Artenstein, MD - Supplemental Retirement of $78,433 is included in column E. This amount was earned and paid in 2016. Farhad Bahrassa, MD - Supplemental Retirement of $28,387 is included in column E. This amount was earned in 2016. Evan Benjamin, MD - Supplemental Retirement of $67,182 is included in column E. This amount was earned and paid in 2016. Charlotte Boney, MD - Supplemental Retirement of $18,613 is included in column E. This amount was earned in 2016. Elizabeth Boyle, MD - Supplemental Retirement of $6,434 is included in column E. This amount was earned and paid in 2016. Ronald P. Bryant - Supplemental Retirement of $12,000 is included in column E. This amount was earned and paid in 2016. Dennis W. Chalke - Supplemental Retirement of $257,706 is included in column E. This amount was earned and paid in 2016. Edward Feldmann, MD - Supplemental Retirement of $8,541 is included in column E. This amount was earned in 2016. Richard Friedberg, MD - Supplemental Retirement of $30,539 is included in column E. This amount was earned in 2016. Cheryl Geoffrion, MD - Supplemental Retirement of $377 is included in column E. This amount was earned in 2016. Daniel R. Grow, MD - Supplemental Retirement of $26,633 is included in column E. This amount was earned and paid in 2016. Thomas Higgins, MD - Supplemental Retirement of $26,889 is included in column E. This amount was earned and paid in 2016. Kevin Hinchey, MD - Supplemental Retirement of $27,947 is included in column E. This amount was earned and paid in 2016. Richard Hicks, MD - Supplemental Retirement of $26,976 is included in column E. This amount was earned in 2016. Nicholas Jabbour, MD - Supplemental Retirement of $23,450 is included in column E. This amount was earned in 2016. Thomas Kaye, MD- Supplemental Retirement of $37,488 is included in column E. This amount was earned and paid in 2016. Mark A. Keroack, MD - Total Supplemental Retirement of $881,458 is included in column E. This amount consists of $264,321 earned and paid in 2016 and $562,123 that was previously reported as deferred compensation in prior years Forms 990, and that is currently reported as taxable income. This also includes $55,014 of investment earnings on prior year contributions. The amount is listed in Column F in accordance with reporting requirements. Aaron Kugelmass, MD- Supplemental Retirement of $32,276 is included in column E. This amount was earned and paid in 2016. Wilson Mertens, MD - Supplemental Retirement of $21,445 is included in column E. This amount was earned and paid in 2016. Kevin P. Moriarty, MD - Supplemental Retirement of $33,542 is included in column E. This amount was earned and paid in 2016. Dennis Oh, MD - Supplemental Retirement of $39,877 is included in column E. This amount was earned and paid in 2016. John Rousou, MD - Supplemental Retirement of $13,103 is included in column E. This amount was earned paid in 2016. Heather Sankey, MD - Supplemental Retirement of $8,581 is included in column E. This amount was earned paid in 2016. Barry Sarvet, MD - Supplemental Retirement of $11,951 is included in column E. This amount was earned paid in 2016. Joseph Schmidt, MD - Supplemental Retirement of $8,167 is included in column E. This amount was earned and paid in 2016. David Maguire MD Family member of David Maguire, MD 55145 See Part V - Family member of David Maguire, MD employed by the filing organization. 0 Wilson Mertens MD Family member of Wilson Mertens, MD 154038 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 196130 See Part V - Family member of Reginald Alouidor, MD employed by the filing organization. 0 Sarah Haessler MD Family member of Sarah Haessler, MD 423733 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, 7 of whom were either appointed by BH or serve ex officio based on positions they hold with BH, and 16 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 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. Baystate Health, Inc. 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 other entities which are 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. The entities are Baystate Administrative Services, Inc. (BAS) EIN 22-2747685 and Baystate Wing Hospital Corporation (BWH) EIN 22-2519813. Compensation from BAS and BWH 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 495,531. Transfer to/from affiliate, net 43,338,000. Minimum pension liability adjustment 9,947,102. Property,plant & equipment released from restrictions 38,585. Net assets released from restrictions for operations 322,926. ROUNDING 2.