2015-08-11T12:44:30-05:00 2014-09-30 861065772 Deloitte & Touche Two Jericho Plaza Jericho NY 11753 990 2013-10-01 042105803 Visiting Nurse Association & Hospice of Western New England Inc VISI 4137940000 50 Maple St PO Box 9058 Springfield MA 011029058 Dennis W Chalke SVP Finance, CFO & Treasurer 4137940000 2015-08-11 1 Christine Kawecki P00743140 5169187000 2013 2016-02-25 16:41:14Z Dennis W Chalke 759 Chestnut Street Springfield MA 01107 23597127 0 X www.baystatehealth.org X 1914 MA The mission of the organization is to improve the health of the people in our communities every day,with quality and compassion. 21 10 266 115 0 0 87379 185271 22299870 22993164 11915 18943 310307 399749 22709471 23597127 0 0 0 0 16205684 16410698 0 0 0 6728048 7917378 22933732 24328076 -224261 -730949 8841182 9389755 6838295 8708401 2002887 681354 The mission of Baystate Visiting Nurse Association and Hospice is to improve the health of the people in our communities every day, with quality and compassion. 0 0 13341150 15937849 Home Care: The Home Care Program of Baystate Visiting Nurse Association and Hospice serves about 6000 patients annually. The services, aimed at allowing patients to recuperate while remaining in the comfort of their homes, include skilled nursing, rehabilitation therapy, medical social work and personal care. The organization assists patients with self-management of chronic disease such as heart failure through technology and teaching by incorporating telemonitoring into the plan of care. Currently, BVNAH provides remote telemonitoring to approximately 125 patients 5942358 6729349 Hospice: The Hospice and Palliative Care Program of Baystate Visiting Nurse Association and Hospice provides end of life care for patients in the community, assisted living facilities and skilled nursing facilities. The program coordinates care for an average daily census of about 150 to 170 patients of all ages. Hospice has an interdisciplinary approach using nursing, social work, chaplains and hospice aides. A unique feature of hospice is its strong team of volunteers which number more than 100 and who provide such services as errands, respite and companionship as well as legal counsel from volunteer attorneys. 0 739474 Other: Miscellaneous 19283508 1 1 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 1 0 0 0 0 0 1 0 0 0 1 49 0 1 266 1 0 0 0 0 0 0 0 0 0 0 X 21 10 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X Peter Lyons Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 X Victor Woolridge Chair 1.00 2.00 X X 0 0 0 James P Sadowsky Vice Chair 1.00 2.00 X X 0 0 0 Gregory L Braden MD Trustee 1.00 1.00 X 0 0 0 Ruth H Constantine Trustee 10/1/13 - 2/04/14 1.00 1.00 X 0 0 0 John H Davis Trustee 1.00 1.00 X 0 0 0 John A Egelhofer MD Trustee 1.00 1.00 X 0 0 0 Mark A Keroack MD Trustee 7/01- 9/30/14 Exec VP COO 1.00 49.00 X 0 776897 179311 John E Kole Trustee 1.00 1.00 X 0 0 0 Grace P Makari-Judson MD Trustee/ Hematologist MD 1.00 49.00 X 367726 0 80725 John F Maybury Trustee 1.00 1.00 X 0 0 0 Steven M Mitus Trustee 1.00 1.00 X 0 0 0 Edward J Noonan Trustee 9/09/14 - 9/30/14 1.00 1.00 X 0 0 0 John M O'Brien III Trustee 1.00 1.00 X 0 0 0 Anne M Paradis Trustee 1.00 1.00 X 0 0 0 James R Phaneuf Trustee 9/09/14 - 9/30/14 1.00 1.00 X 0 0 0 Robert L Pura PhD Trustee 1.00 1.00 X 0 0 0 Katherine E Putnam Trustee 10/1/13 - 12/31/13 1.00 1.00 X 0 0 0 Timothy S Rice Trustee 1.00 1.00 X 0 0 0 Kathleen B Scoble Trustee 2/11/14 - 9/30/14 1.00 1.00 X 0 0 0 David C Southworth Trustee 1.00 1.00 X 0 0 0 Barbara W Stechenberg MD Trustee 10/1-12/31/13/ Physician 1.00 49.00 X 156817 0 44388 Richard B Steele Jr Trustee 1.00 1.00 X 0 0 0 Katherine McG Sullivan Trustee 1.00 1.00 X 0 0 0 Mark R Tolosky Trustee 10/1/13-6/30/14 President BH 1.00 49.00 X 0 1639060 87835 Howard G Trietsch MD Trustee 1.00 1.00 X 0 0 0 Maura McQueeney President 50.00 0.00 X 0 217146 21813 Dennis W Chalke Treasurer 1.00 49.00 X 0 769165 75032 Kristin R Delaney Clerk 1.00 49.00 X 0 103365 28954 Patricia A Sheldon Asst Clerk 10/1/13 - 4/18/14 1.00 49.00 X 0 65029 18760 Madeline Santos Asst Clerk 7/08/14 - 9/30/14 1.00 49.00 X 0 0 0 Linda L Twyeffort Hospice RN IV 50.00 0.00 X 131175 0 21306 Carol D Rodrigues PI Coordinator 50.00 0.00 X 118155 0 20379 Christine D Howe Home Care Clinical Manager 50.00 0.00 X 115867 0 31770 Anna M Michaud Hospice RN II 50.00 0.00 X 108592 0 25041 Heather L Rising Medical Surgical RN 50.00 0.00 X 107335 0 8666 1105667 3570662 643980 6 0 1 1 Baystate Administrative Services 759 Chestnut St Springfield MA 01079 Administrative Services 1955168 Fazzi Associates Inc 11 Village Hill Rd Northampton MA 01060 Consulting Services 355806 Verizon Wireless PO Box 15108 Albany NY 122125108 Telephone Services 269558 Heritage Hall East PO Box 7247-6525 Philadelphia PA 191716525 Nursing & Home Care 240493 Baystate Home Infusion PO Box 414051 Boston MA 022414051 Nursing & Home Care 212422 15 185271 185271 Net Patient Services 621610 22667198 22667198 Rents from Affiliates 900099 184960 184960 141006 141006 22993164 8526 8526 10417 0 10417 10417 10417 Oper Trnsfrs from BHF 900099 166543 166543 Chg Unrestr Int in BHF 900099 92691 92691 Stategic Support 900099 81000 81000 59515 59515 399749 23597127 23392913 0 18943 25094 25094 13304760 11937231 1367529 720257 666679 53578 1425193 1319057 106136 935394 865812 69582 2019168 2019168 44323 44323 2320595 2134622 185973 45544 19796 25748 1226754 1161519 65235 454670 305303 149367 125233 125233 529003 507025 21978 14812 3698 11114 269264 11012 258252 108373 89673 18700 Consulting Fees 525322 172404 352918 Recruitment 79666 22654 57012 Temp Help 63535 63535 Ambulance Services 21711 21711 0 69405 20218 49187 24328076 19283508 5044568 0 637267 702371 3959190 4484086 62069 94209 8689808 6603027 2253831 2086781 1928825 2022308 8841182 9389755 2700130 2980190 507659 670907 3630506 5057304 6838295 8708401 X 483506 -874661 140907 181333 1378474 1374682 2002887 681354 8841182 9389755 X -730949 11911 -602495 X 0 1 X 1 0 X 25000 25000 80808 87379 185271 403458 22319936 21597600 22295900 22610177 23392913 112216526 22344936 21622600 22376708 22697556 23578184 112619984 0 0 0 112619984 12892 9022 5088 5368 8526 40896 12892 9022 5088 5368 8526 40896 22357828 21631622 22381796 22702924 23586710 112660880 0.99960 0.99960 0.00040 0.00040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 3020 3020 0 Part II-B, Line 1: Line 1(i), Other activities: Lobbying expenditures are incurred through membership dues paid to home health care industry trade associations. Lobbying Expenses: Home Care Alliance of MA: Dues: $11,700 Lobbying amount: 14.10% = $1,650 Hospice Palliative Care of MA: Dues: $6,352 Lobbying amount: 9.5% = $603 National Association for Home Care and Hospice Dues: $9099 Lobbying amount: 8.43% = $767 Total lobbying amount = $3,020 126516 126516 2975508 1609977 1365531 929224 670754 258470 4658560 4322296 336264 2086781 Due From Affiliated Entities 110112 Beneficial Interest in Baystate Health Foundation 1912196 2022308 Due to Affiliated Entities 1766197 Estimated Settlements Due to Third Parties 901613 Malpractice Reserve 63000 Pension Liability 2326494 5057304 Schedule D Part V Additional Information: Part V: Certain endowments are held at Baystate Health Foundation (BHF), an affiliate, and are reported as temporarily restricted and permanently restricted but Part V has not been completed as it is already addressed on BHF's Form 990 (EIN 04-3549011). Schedule D Part X Line 2 FIN48 Footnote: The organization's audited financial statements did not contain a footnote regarding liability for uncertain tax positions under FIN 48. X X X X 0 1 0 0 0 0 0 0 0 Mark A Keroack MD Trustee 7/01- 9/30/14 Exec VP COO 0 537949 0 223630 0 15318 0 165853 0 13458 0 956208 0 0 Grace P Makari-Judson MD Trustee/ Hematologist MD 293165 0 48189 0 26372 0 51224 0 29501 0 448451 0 0 0 Barbara W Stechenberg MD Trustee 10/1-12/31/13/ Physician 135195 0 21484 0 138 0 32533 0 11855 0 201205 0 0 0 Mark R Tolosky Trustee 10/1/13-6/30/14 President BH 0 728085 0 456876 0 454099 0 57333 0 30502 0 1726895 0 0 Maura McQueeney President 0 182990 0 31450 0 2706 0 17330 0 4483 0 238959 0 0 Dennis W Chalke Treasurer 0 393944 0 159840 0 215381 0 53098 0 21934 0 844197 0 0 Linda L Twyeffort Hospice RN IV 126983 0 0 0 4192 0 15936 0 5370 0 152481 0 0 0 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), which has been appointed through board resolution as the compensation committee of the filing organization. This committee consists entirely of individuals serving on the board of the filing organization and these individuals 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, Line 4b Dennis W. Chalke - Supplemental Retirement of $135,242 is included in column E. This amount was earned in 2013. Mark A. Keroack, MD Supplemental Retirement of $145,453 is included in column E. This amount was earned in 2013. Grace Makari-Judson, MD- Supplemental Retirement of $10,989 is included in column E. This amount was earned in 2013. Mark R. Tolosky - Supplemental Retirement of $387,879 is included in column E. This amount was earned in 2013. Health New England Inc (HNE) Common Board Members or Officers 621857 See Part V - The filing organization received payments from HNE related to medical claims. HNE is an affiliate corporation of the filing organization. 0 Form 990, Part VI, Section A, line 1 a. The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee. b. Three members of the Board of Trustees of the filing organization are not considered independent as a result of their service on the board of an affiliate of the filing organization. Form 990, Part VI, Section A, line 2 Gregory L. Braden, MD, Dennis W. Chalke, Ruth H. Constantine, John H. Davis, Kristin R. Delaney, John A. Egelhofer, MD, Mark A. Keroack, MD, John E. Kole, Grace P. Makari-Judson, MD, John F. Maybury, Maura McQueeney, Steven M. Mitus, Edward Noonan, John M. O'Brien, III, Anne M. Paradis, James Phaneuf, CIC, Robert L. Pura, PhD, Katherine E. Putnam, Timothy S. Rice, James P. Sadowsky, Madeline Santos, Kathleen B. Scoble, Patricia A. Sheldon, David C. Southworth, Barbara W. Stechenberg, MD, Richard B. Steele, Jr., Katherine McG. Sullivan, Mark R. Tolosky, Howard G. Trietsch, MD and Victor Woolridge are also officers or trustees of its affiliated entities. The following trustees, officers, or key employees serve on a common board of a non-affiliated entity: (1) Katherine E. Putnam and David Southworth; (2) John H. Davis and James P. Sadowsky; (3) Richard B. Steele, Jr. and Katherine McG. Sullivan; (4) Steven M. Mitus, Robert L. Pura, PhD and Richard B. Steele, Jr.; (5) John F. Maybury, David C. Southworth and Mark R. Tolosky; (6) John E. Kole and Richard B. Steele, Jr.; (7) John M. O'Brien, III, James R. Phaneuf, CIC and Victor Woolridge; (8) Steven M. Mitus and David C, Southworth. Form 990, Part VI, Section A, line 3 Visiting Nurse Association and Hospice of Western New England, 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 filing organization has one member, Baystate Health, Inc. (BH) Form 990, Part VI, Section A, line 7a The Board of Trustees of the filing organization are the same individuals serving as members of the Board of Trustees of BH. The Board of Trustees of BH are elected annually by the Board of Trustees of BH at their annual meeting. 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. The entire return was also reviewed prior to filing by the Audit and Compliance Committee of Baystate Health, Inc., which also includes some of the officers and trustees of the filing organization. The Form 990 was provided to all members of the Board of Trustees prior to filing. 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 and CEO and of other officers and key employees 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), which has been appointed through board resolution as the compensation committee of the filing organization. This committee consists entirely of individuals serving on the board of the filing organization and these individuals would be considered independent for compensation deliberation purposes. The compensation of the President and CEO and of other officers and key employees 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. Line 15a and 15b have been answered No because the CEO and other officers are 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 Medical Practices, Inc. (BMP) EIN 04-2888373, which is 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. Compensation from BMP 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: Minimum Pension Liability Adjustment -639,129. Change in Value of Beneficial Interest in Net Assets-Temporarily Restricted 40,426. Change in Value of Beneficial Interest in Net Assets-Permanently Restricted -3,792. Adjustment to Audited Financial Statements 0. Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 222747685 Administrative services MA 501 (c ) (3) 11c, IIIc Baystate Health Inc 0 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 280 Chestnut Street Springfield MA 01104 203260764 Real Estate and Other MA 501 (c ) (3) 11b, II Baystate Medical Center 0 Baystate Wing Hospital Corporation 40 Wright Street Palmer MA 01069 222519813 Hospital MA 501 (c ) (3) 3 Baystate Health Inc 0 Health New England Inc Monarch Place Suite 1500 Springfield MA 011441500 042864973 HMO/Insurance MA 501 (c ) (4) Baystate Health Inc 0 HNE of Connecticut INC Monarch Place Suite 1500 springfield ME 011441500 455190134 HMO/Insurance CT 501 (c ) (4) Health New England Inc 0 HNE Insurance Company Monarch Place Suite 1500 Springfield MA 011441500 454462433 Health Services for Massachusetts Medicare Supplement Members MA Health New England Inc C 0 HNE Advisory Services Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Svs 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 Health New England of Connecticut Monarch Place Suite 1500 Springfield MA 011441500 061398662 Dormant CT 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 System Ambulance Inc 759 Chestnut Street Springfield MA 01199 043018550 Ambulance Svs MA Ingraham Corporation C 0 BH Insurance Company Ltd North Church Street Georgetown CJ 980421413 Offshore captive Insurance CJ Baystate Health 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 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 1 0 1