2017-08-07T13:17:41-05:00 2016-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2015-10-01 222747685 Baystate Administrative Services Inc BAYS 4137940000 759 Chestnut Street Springfield MA 011990001 Dennis W Chalke SVP Finance, CFO & Treasurer 4137945740 2017-08-04 1 Christine Kawecki P00743140 5169187000 2015 2021-01-29 14:40:06Z Dennis W Chalke 759 Chestnut Street Springfield MA 011990001 113793885 0 X www.baystatehealth.org X 1986 MA To improve the health of the people in our communities every day with quality and compassion 8 0 573 0 328290 0 0 0 108282009 112211138 -69787 40442 7300903 1526033 115513125 113777613 0 0 0 0 62776581 63657957 0 0 0 45840436 51563561 108617017 115221518 6896108 -1443905 21026408 18278791 42186486 46307836 -21160078 -28029045 The organization's purpose is to promote the health, charitable and educational purposes of Baystate Health, Inc. whose mission is to improve the health of the people in our communities every day, with quality and compassion. 0 0 32298230 48510543 BAS provides management and administrative support to Baystate Health and its affiliates. These services are an integral part of the healthcare delivery system and include strategic planning, human resources, risk management (insurance) programs, marketing, financial services and benefit plans administration for all health system employees. 62514437 64898338 BAS provides information technology support to Baystate Health and its affiliates. These services are an integral part of the healthcare delivery system and include all software applications, telecommunications, clinical engineering, and computerized equipment at the hospitals. 94812667 1 0 0 1 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 1 0 0 0 1 328 0 1 573 1 1 1 0 0 0 0 0 0 0 0 0 X 8 0 1 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 MA X Peter Lyons Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 X Andrew Artenstein MD Director( As of 7/15/16) 5.00 41.00 X 576652 0 59246 Dennis Chalke Treasurer/Director 39.00 11.00 X X 1085400 0 89529 Evan Benjamin MD Director 1.00 49.00 X 901161 0 73082 Jennifer Endicott Director 50.00 0.00 X 500972 0 98913 Jo-Ann Davis Esq Director (As of 1/1/2016) 50.00 0.00 X 424584 0 69335 John Schreiber Director (Through 7/15/16) 46.00 1.00 X 687979 0 175502 Mark A Keroack MD President/Director 1.00 49.00 X X 1258998 0 213008 Nancy Shendell-Falik Director 3.00 47.00 X 582157 0 151908 Paula C Squires Director 50.00 0.00 X 615137 0 42813 Kristin R Delaney Clerk 1.00 39.00 X 109755 0 31677 Madeline Torres Assistant Clerk 40.00 10.00 X 53103 0 16597 Joel L Vengco VP Information Services 50.00 0.00 X 501854 0 40260 Douglas D Muehlberg COO BMP 10.00 40.00 X 339397 0 139229 Jean Ahn VP Strategic Planning 50.00 0.00 X 326344 0 24168 Kevin Hinchey MD Chief Academic Officer 10.00 40.00 X 493417 0 80492 Neil Kudler Chief Med Info Officer 50.00 0.00 X 413395 0 64616 Steven F Bradley Former President, BFMC 1.00 50.00 X 648442 0 269439 Mark R Tolosky President Emeritus, BH 0.00 0.00 X 745184 0 80519 10263931 0 1720333 153 1 1 0 Cerner Corporation PO Box 959156 St Louis MO 631959156 Computer Services 4886739 Philips Medical Systems PO Box 100355 Atlanta GA 303840355 Maintenance Contracts 1880229 Bulkley Richardson & Gelinas 1500 Main St Suite 2700 Springfield MA 011155507 Legal Services 1501062 Siemens Medical Solutions USA PO Box 120001 Dallas TX 753120733 Maintenance Contracts 1175830 SHI International Corp PO Box 952121 Dallas TX 753952121 Computer Services 1020237 99 Affiliate Support 561000 112211138 112006003 205135 112211138 28984 28984 27730 16272 11458 11458 11458 Partners For a Healthier Communit 624200 707348 707348 Electronic Medical Records 541511 578641 578641 Baycare Health Partners 623000 123155 123155 116889 116889 1526033 113777613 113408881 328290 40442 8348812 6637306 1711506 45542320 36105449 9436871 2205024 1753015 452009 3975914 3267659 708255 3585887 2874433 711454 1002608 1002608 32221 32221 6040965 4134719 1906246 1060216 1059487 729 2996486 2817096 179390 31211102 29234567 1976535 1074943 892343 182600 649147 462490 186657 999350 669350 330000 105329 87437 17892 353002 283080 69922 Workforce Reduction 3309000 2708683 600317 Recruitment 818128 519438 298690 Dues & Membership 697201 374100 323101 Food Services / Interco 203326 160015 43311 1010537 772000 238537 115221518 94812667 20408851 0 111031 1355266 3258523 894091 338842 533141 46839 55891 10103037 9255168 5573199 5279086 464744 294113 6703392 5891121 21026408 18278791 27725165 29119269 14461321 17188567 42186486 46307836 X -21160078 -28029045 -21160078 -28029045 21026408 18278791 X -1443905 494 -5425556 X 0 1 X 1 0 X X 11 Baystate Health Inc 042105941 7 1 2378451 0 Baystate Medical Center Inc 042790311 3 1 87115406 0 Baystate Franklin Medical Ctr 042103575 3 1 7772521 0 Baystate Wing Hospital 222519813 3 1 2264140 0 Visiting Nurse Association & Hospice of WNE Inc 042105803 9 1 1902848 0 Baystate Medical Practices Inc 042888373 9 1 5721027 0 Baystate Health Foundation Inc 043549011 1 1 101376 0 Baystate Mary Lane Hospital Corp 042103584 3 0 1559722 0 Baystate Noble Hospital 222537423 3 1 735851 0 Westfield Medical Corporation 043127730 3 1 0 0 Noble Visiting Nurse and Hospice Services Inc 112757446 9 1 0 0 11 109551342 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 Part IV, Section D, line 1 BAS did not provide notice to Mary Lane Hospital Corporation, because entity had dissolved during the tax year. Notices were provided to all other supported organizations. Part IV, Section E, lines 2a and 2b Organizations supported by BAS are listed on Schedule R, Part II, Indentification of Related Tax-Exempt Organizations and Part IV, Identification of Related Organizations Taxable as a Corporation or Trust. Article II of the BAS Articles of Organization states the purposes for which the corporation was formed: To promote the health, charitable and educational purposes of Baystate Health, Inc. and its charitable affiliates by managing, operating and providing management counsel and advice in connection with the provision of medical or health care and services ancillary thereto. As such BAS serves as a forum for the supported organizations to develop shared services such as Strategic Planning, Information Techology, Financial Services and Human Resources, which elimate duplication of administrative and clinical services in the Baystate system. 0 1 0 0 1 8438 0 1 8439 0 0 16877 0 Part II-B, Line 1: Part IIB, line j The amount recorded on line j represents BAS salaries and operating expenses as reported on Massachusetts Public Records Division Lobbyist Disclosure for activities related to healthcare policy, bills and appropriations. 531417 479998 51419 3650772 3427142 223630 1391010 1371946 19064 294113 Due from affiliated companies 5891121 5891121 Due to affiliated companies 989483 Total accrued pension cost 3419756 Total minimum pension liability 12779328 17188567 X X X 1 1 1 1 0 0 0 0 0 0 0 Andrew Artenstein MD Director( As of 7/15/16) 470754 0 101244 0 4654 0 36473 0 22773 0 635898 0 0 0 Dennis Chalke Treasurer/Director 466083 0 357889 0 261428 0 64000 0 25529 0 1174929 0 0 0 Evan Benjamin MD Director 438130 0 289956 0 173075 0 46398 0 26684 0 974243 0 0 0 Jennifer Endicott Director 312365 0 103635 0 84972 0 85182 0 13731 0 599885 0 0 0 Jo-Ann Davis Esq Director (As of 1/1/2016) 280122 0 66407 0 78055 0 48934 0 20401 0 493919 0 0 0 John Schreiber Director (Through 7/15/16) 500237 0 170417 0 17325 0 152293 0 23209 0 863481 0 0 0 Mark A Keroack MD President/Director 760075 0 310077 0 188846 0 192620 0 20388 0 1472006 0 90766 0 Nancy Shendell-Falik Director 436797 0 116688 0 28672 0 125008 0 26900 0 734065 0 0 0 Paula C Squires Director 302675 0 149836 0 162626 0 21200 0 21613 0 657950 0 0 0 Joel L Vengco VP Information Services 346820 0 150291 0 4743 0 24060 0 16200 0 542114 0 0 0 Douglas D Muehlberg COO BMP 264784 0 59967 0 14646 0 122689 0 16540 0 478626 0 0 0 Jean Ahn VP Strategic Planning 229605 0 96004 0 735 0 15183 0 8985 0 350512 0 0 0 Kevin Hinchey MD Chief Academic Officer 351830 0 91749 0 49838 0 53092 0 27400 0 573909 0 0 0 Neil Kudler Chief Med Info Officer 293739 0 105377 0 14279 0 44756 0 19860 0 478011 0 0 0 Steven F Bradley Former President, BFMC 157831 0 78208 0 412403 0 252324 0 17115 0 917881 0 0 0 Mark R Tolosky President Emeritus, BH 263594 0 150000 0 331590 0 66319 0 14200 0 825703 0 138300 0 Part I, Line 1a Explanation: 1. Companion Travel - Several Trustees, Officers, and/or key employees were provided with compensation for spouses to attend a company board event. 2. Tax Gross up / Discretionary Spending Account - Several employees were provided with reimbursement for financial, tax and estate planning requiring a tax gross up. The two items above were treated as taxable compensation as appropriate in accordance with Baystate's written policies which require compliance with the IRS's accountable plan rules. Part I, Line 3 The compensation of the President and CEO 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). 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 duly authorized compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously. The Baystate Administrative Services, Inc. Board of Directors is composed of management of Baystate Health, Inc. and its affiliates. Therefore it is more appropriate that the establishment and review of the compensation of the organization's top management officials be performed at the Baystate Health level, which has a more independent board. The Baystate Administrative Services, Inc. Board of Directors is composed of management of Baystate Health, Inc and its affiliates. Therefore it is more appropriate that the establishment and review of the compensation of the organization's top management officials be performed at the Baystate Health level, which has a more independent board. Part I, Lines 4a-b 4a Steven F. Bradley received $363,880 in 2015 and $252,324 in 2016. Mark R. Tolosky received $138,300. 4b Jean Ahn - Supplemental Retirement of $1,933 is included in column E. This amount was earned in 2015. Andrew Artenstein, MD - Supplemental Retirement of $19,248 is included in column E. This amount was earned and paid in 2015. Evan Benjamin, MD - Supplemental Retirement of $146,566 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. Jo-Ann Davis - Supplemental Retirement of $56,342 is included in column E. This amount was earned in 2015. Jennifer Endicott - Supplemental Retirement of $71,932 is included in column E. This amount was earned in 2015. Kevin Hinchey, MD - Supplemental Retirement of $31,850 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. Neil Kudler, MD - Supplemental Retirement of $33,397 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. Nancy Shendell-Falik- Supplemental Retirement of $107,783 is included in column E. This amount was earned in 2015. Paula Squires - Supplemental Retirement of $75,107 is included in column E. This amount was earned and paid in 2015. Mark R. Tolosky - Supplemental Retirement of $101,139 is included in column E. This amount was earned and paid in 2015. Joel L. Vengco - Supplemental Retirement of $10,810 is included in column E. This amount was earned in 2015. Form 990, Part VI, Section A, line 1 Baystate Administrative Services Inc. (BAS) is part of an integrated delivery system including not for profit community hospitals, which have community boards. BAS is a management services supporting organization, which supports Bayste Health and its affiliates and is comprised of BAS employees. This board structure has not changed significantly since the organization applied for exempt status. Form 990, Part VI, Section A, line 2 Andrew Artenstein, MD, Evan Benjamin, MD, FACP, Dennis W. Chalke, Jo-Ann Davis, Esq., Kristin R. Delaney, Jennifer Endicott, Mark A. Keroack, MD, John Schreiber, MD, Nancy Shendell-Falik, Paula C. Squires, Madeline Torres, Joel L. Vengco are also officers or trustees of Baystate Health, Inc. & its affiliated entities. The following trustees, officers, or key employees serve on a common board of a non-affiliated entity: Jo-Ann Davis, Joel L.Vengco Form 990, Part VI, Section A, line 6 The filing organization has one member, Baystate Health, Inc. (BH). Form 990, Part VI, Section A, line 7a All of the members of the Board of Directors of the filing organization are individuals serving ex officio based on positions they hold with BH. 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 sole member of the filing organization and 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 15a The compensation of the President and CEO 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 and of other officers 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 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. Form 990, Part VI, Section C, line 19 Public Inspection of Organizational Policies 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 XI, line 9: Adjustment for Minimum Pension Liability -5,438,906. Transfer for PP&E 12,350. Rounding 1,000. Baystate Franklin Medical Center 164 High Street Greenfield MA 01301 042103575 Hospital MA 501 (c ) (3) 3 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 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 Baystate Health Inc 759 Chestnut Street Springfield MA 01199 042105941 Healthcare System Parent MA 501 (c ) (3) 7 Baystate Health Inc 0 Baystate Mary Lane Hospital Corporation 85 South Street Ware MA 01082 042103584 Hospital MA 501 (c ) (3) 3 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 Total Home Care Inc 50 Maple Street Springfield MA 01199 203260764 Real Estate and Other MA 501 (c ) (3) 11b, II Baystate Medical Center Inc 0 Visiting Nurse Assn and Hospice of Western New England Inc 50 Maple Street Springfield MA 01199 042105803 Home Health Care and Hospice MA 501 (c ) (3) 9 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 Baystate Noble Hospital Corporation 115 West Silver Street PO Box 1634 Westfield MA 010861634 222537423 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Westfield Medical Corporation 115 West Silver Street PO Box 1634 Westfield MA 010861634 043127730 Physician Services MA 501 (c ) (3) 11a, I Baystate Noble Hospital Corporation 0 Noble Visiting Nurse Services Inc 115 West Silver Street PO Box 1634 Westfield MA 010861634 112757446 Home Health Care and Hospice MA 501 (c ) (3) 9 Baystate Noble Hospital Corporation 0 Health New England Inc Monarch Place Suite 1500 Springfield MA 01199 042864973 HMO/Insurance MA 501 (c ) (4) Health New England Inc 0 HNE of Connecticut Inc Monarch Place Suite 1500 Springfield MA 01199 455190134 HMO/Insurance CT 501 (c ) (4) Health New England Inc 0 HNE Insurance Company Inc Monarch Place Suite 1500 Springfield MA 011441500 454462433 Health Services for Massachusetts Medicare Supplement Members MA Health New England 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 Services Corporation Monarch Place Suite 1500 Springfield MA 011441500 043183019 Ancilliary Insurance MA Health New England Inc C 0 HNE Advisory Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Services MA Health New England Inc C 0 Ingraham Corporation 759 Chestnut Street Springfield MA 01199 043016257 Health care and other business activities MA Baystate Health Inc C 0 Baystate Health Insurance Company Ltd North Church Street Georgetown Cayman Islands CJ 980421413 Offshore Captive Insurance CJ Baystate Health Inc 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1