2017-08-01T12:20:26-07:00 2016-09-30 990 2015-10-01 042297845 South Shore Medical Center Inc SOUT 7818785200 143 Longwater Drive Norwell MA 02061 Pamela Whelton Treasurer 7816248626 2017-08-15 2015 2021-01-29 14:40:06Z Pamela Whelton 55 Fogg Road South Weymouth MA 02190 89815608 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. 14 1 633 1 0 0 0 0 100644328 88743088 118367 396756 259399 582882 101022094 89722726 13120 4865 0 0 36228970 46396545 0 0 0 68823416 55178698 105065506 101580108 -4043412 -11857382 25232234 18992247 17192992 22810387 8039242 -3818140 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 79532986 4865 89265830 South Shore Medical Center provided medical, preventative and other clinical services to its patients. For the year ended September 30, 2016 SSMC had 241,685 patient visits (including 20,769 Medicaid and 31,021 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 79532986 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 1 155 0 1 633 1 0 0 0 0 0 0 0 0 0 0 X 14 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 Thomas Carroll President 1 41 X X 180861 168473 59038 Benjamin Ryan MD Director 40 1 X 321415 0 29833 Edward Nalband MD Chairman 40 2 X X 389172 0 61037 Richard Aubut Director/SSH&EC CEO thru 11/2/15 1 47 X X 0 2404788 394529 Brian Dolan MD Director thru 1/16 1 40 X 0 537798 42201 John Stevenson MD Director 1 47 X 0 584695 118142 Jason Tracy MD Director 1 41 X 0 595462 76073 John Walsh MD Director 1 41 X 0 396586 26378 Mark Coyle PA-C Director 1 40 X 0 210379 39610 Elana Dekkers MD Director 1 25 X 0 198847 21698 Richard Kauff MD Director 40 1 X 314154 0 67748 Ingrid Kotch MD Director 40 1 X 333479 0 64748 Matthew Weiss MD Vice Chair 1 45 X X 0 657310 115425 Timothy R Lynch MD Director 40 5 X 341779 0 61477 Gene Green MD Director/SSHS CEO beginning 11/3/15 1 47 X X 0 139029 335822 Helen Garvey Director 1 1 X 0 0 0 Pamela Whelton Treasurer 1 49 X 0 504757 82405 Peg Holda Clerk 1 43 X 0 328354 74483 Peggy Hafkemeyer COO 40 0 X 238069 0 53887 Michael Kaplan CFO 40 0 X 237649 0 25538 Mark Flieger CIO 40 0 X 231376 0 369694 Stanley Sacon Former CEO 24 0 X 121850 0 29261 2709804 6726478 2149027 87 1 1 0 Thomas J Kenney MD Inc 2110 Dorchester Avenue Ste 210 Boston MA 02124 Physician Services 1007274 Premier Diagnostic Services 54 Bodwell Street Avon MA 02322 Diagnostic Service - Ultrasound 578033 South Shore Orthopedics LLC 2 Pond Park Road Hingham MA 02043 Physician Services 430866 HMFP at Beth Israel Deaconess Medical Center 330 Brookline Avenue Boston MA 02215 Physician Services 307475 Northeast Building Services 77 Accord Park Drive D-14 Norwell MA 02061 Facilities Maintenance 286191 13 0 0 0 0 0 0 0 0 Net Patient Service Revenue 621110 55875042 55875042 0 0 Premium Revenue 621110 31332581 31332581 0 0 Discount Revenue 621110 882494 882494 0 0 Clinician Reimbursement Revenue 621110 652971 652971 0 0 0 0 0 0 88743088 396756 0 0 396756 0 0 0 0 0 0 0 0 153022 0 92882 0 60140 0 60140 0 0 60140 0 0 0 Purchase Discounts 900099 54774 54774 0 0 Medical Records Income 900099 14770 14770 0 0 453198 453198 0 0 522742 89722726 89265830 0 456896 X 4865 4865 1473313 1473313 38323543 27212993 11110550 0 4114575 2965861 1148714 0 2485114 1791316 693798 0 0 0 66200 66200 0 33548041 31835220 1712821 2431 2431 5811807 5202528 609279 4728615 4728615 4227957 3456671 771286 20628 207 20421 167426 107797 59629 0 1129386 903509 225877 1090031 699762 390269 Physician Services 3424629 3424629 0 0 Equipment Maintenance Contracts 326865 246266 80599 0 Dues 181512 91085 90427 0 Repairs 98778 3024 95754 0 354392 113940 240452 0 101580108 79532986 22047122 0 3089473 2719108 3541548 4667319 8936 406700 589027 1083563 1256885 11119296 7566010 4516153 3553286 5159716 4082100 7426145 2124522 25232234 18992247 7270603 2769706 9922389 20040681 17192992 22810387 X 8039242 -3818140 0 0 0 0 8039242 -3818140 25232234 18992247 -11857382 0 0 0 0 0 X X 0 1 X 0 0 X 0 131899822 131279545 156789324 100644328 87977858 608590877 131899822 131279545 156789324 100644328 87977858 608590877 608590877 209120 221768 195588 118367 456896 1201739 209120 221768 195588 118367 456896 1201739 132108942 131501313 156984912 100762695 88434754 609792616 0.99803 0.9986 0.00197 0.0014 X Schedule A, Part I, Line 9 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), 2012 calendar year; column (b), 2013 calendar year; column (c), 2014 calendar year; column (d), 2015 short year (1/1-9/30/2015); column (e), 2015 tax year (10/1/15-9/30/16). 0 0 0 0 0 0 0 0 3224896 1672670 1552226 0 7894400 5893340 2001060 0 0 0 0 3553286 Due from Affiliate 1617253 A/R - Other 353487 Security Deposits 92840 3rd Party A/R 51220 Rent Receivable 9722 2124522 0 Due to 3rd Party Payors 10506915 Accrued Deferred Compensation 4082100 Accrued Salaries, Wages and Other Compensation 3317497 Deferred Rental Expense 1309610 Due to Affiliates 528892 Accrued Profit Sharing 285000 Security Deposits 10667 20040681 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. 0 0 0 0 0 0 0 1 0 Thomas Carroll President 178936 167685 1500 0 425 787 18208 8750 20610 7720 219679 184942 0 0 Benjamin Ryan MD Director 312887 0 8282 0 246 0 29833 0 0 0 351248 0 0 0 Edward Nalband MD Chairman 384246 0 2400 0 2526 0 36833 0 24204 0 450209 0 0 0 Richard Aubut Director/SSH&EC CEO thru 11/2/15 0 1642327 0 361696 0 400764 0 375195 0 19935 0 2799917 0 61696 Brian Dolan MD Director thru 1/16 0 536600 0 0 0 1198 0 15750 0 26451 0 579999 0 0 John Stevenson MD Director 0 512457 0 67968 0 4270 0 91691 0 26451 0 702837 0 67968 Jason Tracy MD Director 0 535730 0 38250 0 21482 0 55398 0 20675 0 671535 0 38250 John Walsh MD Director 0 315791 0 0 0 80795 0 10810 0 15568 0 422964 0 0 Mark Coyle PA-C Director 0 201956 0 0 0 8423 0 13159 0 26451 0 249989 0 0 Elana Dekkers MD Director 0 194127 0 0 0 720 0 11796 0 9902 0 216545 0 0 Richard Kauff MD Director 304748 0 8282 0 1124 0 36833 0 30916 0 381903 0 0 0 Ingrid Kotch MD Director 330551 0 2400 0 528 0 33833 0 30915 0 398227 0 0 0 Matthew Weiss MD Vice Chair 0 486850 0 0 0 170460 0 88974 0 26451 0 772735 0 0 Timothy R Lynch MD Director 337082 0 2400 0 2297 0 27833 0 33643 0 403255 0 0 0 Pamela Whelton Treasurer 0 446270 0 53683 0 4804 0 80973 0 1432 0 587162 0 53683 Peg Holda Clerk 0 292455 0 33783 0 2116 0 54419 0 20065 0 402838 0 33783 Peggy Hafkemeyer COO 234730 0 2400 0 939 0 31806 0 22082 0 291957 0 0 0 Michael Kaplan CFO 234321 0 2400 0 928 0 25538 0 0 0 263187 0 0 0 Mark Flieger CIO 228058 0 2400 0 918 0 338778 0 30916 0 601070 0 0 0 Stanley Sacon Former CEO 118587 0 0 0 3263 0 5057 0 24204 0 151111 0 0 Schedule J, Part I, Line 3 The President's compensation package was determined by SSHS, an affiliate, prior to the merger between Coastal Medical Associates and South Shore Medical Center in August 2015 and remains in effect for two years. The President's compensation did not change in FY16. An outside consultant was engaged to present comparable industry and market data to determine the President's compensation. Schedule J, Part I, Line 7 Discretionary bonuses are determined by the board based on organizational performance. Suzanne Carroll Family member of Thomas Carroll, President 16788 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, Deloitte Tax LLP. The return is then reviewed by the Treasurer. Form 990 is provided to the entire governing body 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 Chairman is considered a South Shore Health System executive; all executive compensation decisions are made by the South Shore Health System Compensation Committee. 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 was determined by SSHS prior to the merger between Coastal Medical Associates and South Shore Medical Center in August 2015. Compensation was determined by comparability studies and market data provided by an outside consultant. The President's compensation did not change in FY16. Annual compensation decisions for SSMC employed directors and key employees were also determined prior to the merger between CMA and SSMC. The compensation models are in effect for two years from the merger date, there were no changes made in FY16. Form 990, Part VI, Section C, Line 19 South Shore Medical Center, Inc. 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 Program service expenses: Capitated Program Expenses, $30,863,135; Purchased Services, $949,685; Consultants, $22,400. Management and general expenses: Consultants, $600,188; Billing & Collection fees, $166,251; Recruitment, $37,446; Purchased Services, $888,279; Temporary Help, $20,589; Transcription Fees, $68. Form 990, Part XII, Line 2b The organization's financial statements are audited as part of consolidated financial statements. As a wholly owned subsidiary, the audit of South Shore Medical Center is combined with Coastal Medical Associates. South Shore Health System and its subsidiaries are audited by independent accountant Deloitte & Touche LLP. The governing body of South Shore Health System (SSHS), acting as a committee of the whole, assumes responsibility for oversight of the audit of its (parent and affiliate) financial statements and selection of an independent auditor. In fiscal 2016 the audit of Coastal Medical Associates, including South Shore Medical Center, was consolidated by Deloitte & Touche LLP into the annual audit of South Shore Health System and Subsidiaries. The financial statements are prepared in accordance with GAAP. 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 0 0 1 1 0 0