2017-08-07T13:17:41-05:00 2016-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2015-10-01 042888373 Baystate Medical Practices Inc BAYS 4137940000 759 Chestnut Street Springfield MA 01199 Dennis W Chalke SVP Finance, CFO & Treasurer 4137943290 2017-08-04 1 Christine Kawecki P00743140 5169187000 2015 2021-01-29 14:40:06Z Dennis W Chalke 759 Chestnut Street Springfield MA 01199 263025111 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 1848 1 658655 -25955 0 0 251175998 262962964 37715 62147 15100272 0 266313985 263025111 0 0 0 0 238219039 256690319 0 0 0 48947745 41226780 287166784 297917099 -20852799 -34891988 48284355 43356086 99840670 97518736 -51556315 -54162650 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 282259403 262304309 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. 282259403 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 0 0 0 0 0 0 0 0 0 0 0 1 139 0 1 1848 1 1 1 0 0 0 0 0 0 0 0 0 X 22 1 1 1 1 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 X Andrew Artenstein MD President (as of 7/15/16) 40.00 6.00 X X 576652 0 59246 John Schreiber MD Chair/President (Thru 7/15/16) 1.00 40.00 X X 687979 0 175502 Dennis Chalke Treasurer/Director 1.00 50.00 X X 1085400 0 89529 Aaron Kugelmass MD Director 50.00 0.00 X 720215 0 40648 Barry Sarvet MD Director 50.00 0.00 X 409808 0 55114 Charlotte Boney MD Director 50.00 0.00 X 507599 0 47416 Daniel Grow MD Director 50.00 0.00 X 596796 0 70149 David Maguire MD Director (As of 3/2/16) 49.00 1.00 X 256661 0 29790 Dennis Oh MD Director 50.00 0.00 X 786777 0 36062 Edward Feldman MD Director 50.00 0.00 X 375451 0 41363 Elizabeth Boyle MD Director 50.00 0.00 X 337141 0 55705 Evan Benjamin MD Director 49.00 1.00 X 901161 0 73082 Jackson William MD Director (Through 11/30/15) 50.00 0.00 X 211384 0 10748 Joseph Schmidt MD Director 50.00 0.00 X 368633 0 54752 Kathleen B Scoble Director (As of 1/1/16) 1.00 1.00 X 0 0 0 Kevin Hinchey MD Ex-Offico Director/ CAO 40.00 10.00 X 493417 0 80492 Mark A Keroack MD Director 1.00 40.00 X 1258998 0 213008 Mohammed S Ahmed MD Director (Through 2/3/16) 50.00 0.00 X 481064 0 46926 Reginald Alouidor MD Director (As of 1/6/16) 50.00 0.00 X 411636 0 108073 Richard Friedberg MD Director 50.00 0.00 X 525162 0 75358 Sara A Rourke MD Director 40.00 10.00 X 337163 0 30143 Sarah Haessler MD Director (As of 9/7/2016) 50.00 0.00 X 234586 0 31083 Susan DeJoy CNM Director 50.00 0.00 X 161978 0 54641 Thomas L Higgins MD Director 10.00 40.00 X 489225 0 75092 Wilson Mertens MD Director 50.00 0.00 X 448649 0 89974 Kristin R Delaney Clerk 1.00 40.00 X 109755 0 31677 Betty K Larue COO BMP/ VP BH Amb Ops(11/15) 10.00 41.00 X 266248 0 50216 Douglas D Muehlberg COO BMP(Through 11/15) 40.00 10.00 X 339397 0 139229 Kevin P Moriarty MD Chief Pediatric Surgery 40.00 8.00 X 634583 0 46896 David Refermat MD Chief Plastic Surgery 50.00 0.00 X 566632 0 36548 Farhad Bahrassa MD Neurosurgeon 50.00 0.00 X 734351 0 34069 Richard B Wait Director 50.00 0.00 X 1067996 0 19479 Richard J Hicks Chair Radiology 50.00 0.00 X 616240 0 65718 Thomas L Kaye MD Chief Division Of Neurosurgery 50.00 0.00 X 793568 0 47237 Benjamin Liptzin MD Psychiatrist - Inpatient 50.00 0.00 X 355358 0 11303 Gerda Maissel MD Former CMO-Northern Region 0.00 0.00 X 307644 0 72 18455307 0 2126340 661 1 1 1 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 Management services 6118832 Baystate Medical Center Inc 759 Chestnut Street Springfield MA 01199 MD scheduling service 4119447 Echo Locum Tenens Inc PO Box 742936 Los Angeles CA 90074 Contracted MD services 665432 Patientkeeper PO Box 743734 Atlanta GA 30374 Software consulting/maintenenca 625800 Radiology & Imaging Inc 1350 Main St 10th Floor Springfield MA 011031628 MD services 557200 30 Physician Practice Fees 621110 155909507 155909507 Hospital reimb programs 621110 80309258 80309258 Funding for strategic growth proj 621110 6859927 6859927 3rd party contract reimb 621110 4210404 4169604 40800 EHR incentive Medicare/Medicaid 621110 2700244 2700244 12973624 12355769 617855 262962964 62147 62147 263025111 262304309 658655 62147 15995810 15995810 206871629 201429869 5441760 9585127 9382480 202647 12606066 11297080 1308986 11631687 11328322 303365 6118832 6118832 376528 376528 44917 44917 9247435 8141175 1106260 73698 70013 3685 1863612 1770431 93181 157447 149575 7872 7293380 6928711 364669 213285 213285 165299 157034 8265 5770 5770 1678776 1594837 83939 2596778 2466939 129839 Purchased Svcs Clerical 4193172 4193172 Medical Supplies 3474562 3474562 Prof'l Exp Acct 2112673 2112673 Dues & Memberships 661918 628822 33096 948698 924613 24085 297917099 282259403 15657696 0 10113351 2507109 15930303 14295560 1211605 1454153 30224056 19346476 11778436 10877580 9250660 14221684 48284355 43356086 39759244 42161018 184583 15833 59896843 55341885 99840670 97518736 X -51556315 -54162650 -51556315 -54162650 48284355 43356086 X -34891988 32285653 X 0 1 X 1 0 X 219827643 218759374 235830282 250588760 262304309 1187310368 219827643 218759374 235830282 250588760 262304309 1187310368 0 0 0 1187310368 3428 3934 14390 37715 62147 121614 3428 3934 14390 37715 62147 121614 219831071 218763308 235844672 250626475 262366456 1187431982 0.99990 0.99990 0.00010 0.00010 X 1103927 516785 587142 9705640 2626286 7079354 19371291 16203405 3167886 43198 43198 10877580 Due from Affiliated Companies 9248621 Accounts Receivable, Other 4973063 14221684 Due to Affiliated Companies 18649620 Insurance IBNR Loss Reserves 10887940 Accrued Pension Cost 25272319 Line of credit, affiliate 532006 55341885 1 1 0 0 0 0 0 0 0 Andrew Artenstein MD President (as of 7/15/16) 470754 0 101244 0 4654 0 36473 0 22773 0 635898 0 0 0 John Schreiber MD Chair/President (Thru 7/15/16) 500237 0 170417 0 17325 0 152293 0 23209 0 863481 0 0 0 Dennis Chalke Treasurer/Director 466083 0 357889 0 261428 0 64000 0 25529 0 1174929 0 0 0 Aaron Kugelmass MD Director 565821 0 115328 0 39066 0 21200 0 19448 0 760863 0 0 0 Barry Sarvet MD Director 319705 0 79410 0 10693 0 36857 0 18257 0 464922 0 0 0 Charlotte Boney MD Director 355423 0 128300 0 23876 0 29625 0 17791 0 555015 0 0 0 Daniel Grow MD Director 454464 0 69231 0 73101 0 46761 0 23388 0 666945 0 0 0 David Maguire MD Director (As of 3/2/16) 240001 0 12501 0 4159 0 28233 0 1557 0 286451 0 0 0 Dennis Oh MD Director 619485 0 135811 0 31481 0 17225 0 18837 0 822839 0 0 0 Edward Feldman MD Director 333154 0 38160 0 4137 0 24959 0 16404 0 416814 0 0 0 Elizabeth Boyle MD Director 266070 0 64932 0 6139 0 29801 0 25904 0 392846 0 0 0 Evan Benjamin MD Director 438130 0 289956 0 173075 0 46398 0 26684 0 974243 0 0 0 Jackson William MD Director (Through 11/30/15) 177383 0 33548 0 453 0 0 0 10748 0 222132 0 0 0 Joseph Schmidt MD Director 311527 0 42516 0 14590 0 37085 0 17667 0 423385 0 0 0 Kevin Hinchey MD Ex-Offico Director/ CAO 351830 0 91749 0 49838 0 53092 0 27400 0 573909 0 0 0 Mark A Keroack MD Director 760075 0 310077 0 188846 0 192620 0 20388 0 1472006 0 90766 0 Mohammed S Ahmed MD Director (Through 2/3/16) 330994 0 115363 0 34707 0 31023 0 15903 0 527990 0 0 0 Reginald Alouidor MD Director (As of 1/6/16) 350087 0 52346 0 9203 0 74313 0 33760 0 519709 0 0 0 Richard Friedberg MD Director 401438 0 68176 0 55548 0 41280 0 34078 0 600520 0 0 0 Sara A Rourke MD Director 272788 0 62129 0 2246 0 13250 0 16893 0 367306 0 0 0 Sarah Haessler MD Director (As of 9/7/2016) 191599 0 41996 0 991 0 15221 0 15862 0 265669 0 0 0 Susan DeJoy CNM Director 151198 0 8468 0 2312 0 42750 0 11891 0 216619 0 0 0 Thomas L Higgins MD Director 372295 0 76150 0 40780 0 62728 0 12364 0 564317 0 0 0 Wilson Mertens MD Director 375064 0 45788 0 27797 0 71750 0 18224 0 538623 0 0 0 Betty K Larue COO BMP/ VP BH Amb Ops(11/15) 217858 0 37398 0 10992 0 33399 0 16817 0 316464 0 0 0 Douglas D Muehlberg COO BMP(Through 11/15) 264784 0 59967 0 14646 0 122689 0 16540 0 478626 0 0 0 Kevin P Moriarty MD Chief Pediatric Surgery 502996 0 96018 0 35569 0 27825 0 19071 0 681479 0 0 0 David Refermat MD Chief Plastic Surgery 492503 0 52965 0 21164 0 17225 0 19323 0 603180 0 0 0 Farhad Bahrassa MD Neurosurgeon 667234 0 65900 0 1217 0 26560 0 7509 0 768420 0 0 0 Richard B Wait Director 205084 0 0 0 862912 0 0 0 19479 0 1087475 0 0 0 Richard J Hicks Chair Radiology 494291 0 116861 0 5088 0 42508 0 23210 0 681958 0 0 0 Thomas L Kaye MD Chief Division Of Neurosurgery 633769 0 117500 0 42299 0 21200 0 26037 0 840805 0 0 0 Benjamin Liptzin MD Psychiatrist - Inpatient 301378 0 38716 0 15264 0 0 0 11303 0 366661 0 0 0 Gerda Maissel MD Former CMO-Northern Region 9898 0 0 0 297746 0 0 0 72 0 307716 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 and CEO 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 and CEO 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 independent compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously. Part I, Lines 4a-b 4a Gerda Maissel, MD received $294,052. Richard Wait, MD received $831,401. 4b Mohammed Shafeeq Ahmed, MD - Supplemental Retirement of $17,752 is included in column E. This amount was earned and paid in 2015. Reginald Alouidor, MD - Supplemental Retirement of $7,922 is included in column E. This amount was earned and paid in 2015. Andrew Artenstein, MD - Supplemental Retirement of $19,248 is included in column E. This amount was earned and paid in 2015. Farhad Bahrassa, MD - Supplemental Retirement of $15,960 is included in column E. This amount was earned in 2015. Evan Benjamin, MD - Supplemental Retirement of $146,566 is included in column E. This amount was earned and paid in 2015. Charlotte Boney, MD - Supplemental Retirement of $12,400 is included in column E. This amount was earned in 2015. Elizabeth Boyle, MD - Supplemental Retirement of $3,693 is included in column E. This amount was earned and paid in 2015. Dennis W. Chalke - Supplemental Retirement of $171,159 is included in column E. This amount was earned and paid in 2015. Edward Feldmann, MD - Supplemental Retirement of $7,734 is included in column E. This amount was earned in 2015. Richard Friedberg, MD - Supplemental Retirement of $32,015 is included in column E. This amount was earned in 2015. Daniel R. Grow, MD - Supplemental Retirement of $50,697 is included in column E. This amount was earned and paid in 2015. Thomas Higgins, MD - Supplemental Retirement of $19,765 is included in column E. This amount was earned and paid in 2015. Kevin Hinchey, MD - Supplemental Retirement of $31,850 is included in column E. This amount was earned and paid in 2015. Richard Hicks, MD - Supplemental Retirement of $25,283 is included in column E. This amount was earned in 2015. Thomas Kaye, MD- Supplemental Retirement of $31,956 is included in column E. This amount was earned and paid in 2015. Mark A. Keroack, MD - Supplemental Retirement of $328,081 is included in column E. This amount consists of $237,315 earned and paid in 2015 and $90,766 that was previously reported as deferred compensation in prior years Forms 990, and that is currently reported as taxable income. The amount is listed in Column F in accordance with reporting requirements. Aaron Kugelmass, MD- Supplemental Retirement of $33,397 is included in column E. This amount was earned and paid in 2015. Kevin P. Moriarty, MD - Supplemental Retirement of $32,279 is included in column E. This amount was earned and paid in 2015. Dennis Oh, MD - Supplemental Retirement of $29,830 is included in column E. This amount was earned and paid in 2015. David Refermat, MD - Supplemental Retirement of $19,583 is included in column E. This amount was earned and paid in 2015. Barry Sarvet, MD - Supplemental Retirement of $8,717 is included in column E. This amount was earned paid in 2015. Joseph Schmidt, MD - Supplemental Retirement of $11,172 is included in column E. This amount was earned and paid in 2015. John Schreiber, MD - Supplemental Retirement of $131,093 is included in column E. This amount was earned in 2015. Form 990, Part VI, Section A, line 2 M. Shafeeq Ahmed,MD Reginald Alouidor, MD, Andrew Artenstein, MD, Evan B. Benjamin MD, Charlotte Boney, MD, Elizabeth Boyle, MD, Dennis W. Chalke, Susan DeJoy, MD, Kristin R. Delaney, Edward Feldman, MD, Richard Friedberg, Daniel Grow, MD, Sara Haessler, MD, Thomas Higgins, MD, Kevin Hinchey, MD, Mark A. Keroack, MD, Aaron Kugelmass, MD, David Maguire, MD, Wilson Mertens, MD, Doug D Muelberg, Dennis Oh, MD, Sara Rourke, MD, Barry Sarvet, MD, Joseph Schmidt, MD, John Schreiber, MD, Kathleen B. Scoble, Jackson Williams, MD,Betty Larue are also officers or Directors of Baystate Health, Inc. & its 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 4 The filing organization amended its bylaws to (1) change the identified organizations in the language describing its corporate purposes, to reflect name changes and other corporate changes at those organizations, and (2) change the office held by one individual serving ex officio on the filing organizations's board. 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 22 Directors, six 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 organizations 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 organizations educational and research programs, (5) any pledge of the filing organizations 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 11 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), some of whom are officers or trustees of the filing organization 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 Health, Inc. (BH) has a comprehensive conflict of interest policy which has been adopted by the filing organization. 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 BH Chief Compliance Officer, the BH Chief Executive Officer, the Chair of the BH Board of Trustees, and the Chair of the Audit & Compliance Committee of BH. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department and reviewed by outside counsel. 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 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 trustees of the filing organization are paid by an entity, Baystate Administrative Services, Inc. (BAS) EIN 22-2747685, who is part of the health care system to which the filing organization belongs but one that does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BAS 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: Current year acquisitions from other entities 744,711. Transfer to/from affiliate, net 43,871,000. Minimum pension liability adjustment -12,330,058.