2015-11-16T10:01:41-06:00 2014-12-31 420714325 RSM US LLP 80 CITY SQUARE BOSTON MA 02129 990 2014-01-01 043756900 COMMONWEALTH CARE ALLIANCE INC COMM 6174260600 30 WINTER STREET 11TH FL BOSTON MA 02108 CINDY NGUYEN TREASURER 6174260600 2015-11-16 1 LYNNE JOHNSON P00757336 6179129000 2014 2016-04-25 22:37:26Z LOIS S SAULS 30 WINTER STREET 11TH FL BOSTON MA 02108 594617196 0 X WWW.COMMONWEALTHCARE.ORG X 2003 MA COMMONWEALTH CARE ALLIANCE INC.'S MISSION IS TO PROVIDE THE BEST POSSIBLE CARE TAILORED TO THE INDIVIDUAL'S NEEDS OF ALL ADULTS THROUGHOUT THE COMMONWEALTH OF MASSACHUSETTS BY BRINGING TO SCALE PROVEN CLINICAL CARE STRATEGIES THAT IMPROVE THE CARE AND MANAGE COST. 13 13 799 13 0 0 0 0 297056587 585643670 609404 -319832 12907 10821 297678898 585334659 84205 99697 0 0 21108563 31209967 0 0 0 281398941 542266577 302591709 573576241 -4912811 11758418 78088226 160138570 58636034 128080391 19452192 32058179 COMMONWEALTH CARE ALLIANCE INC.'S MISSION IS TO PROVIDE THE BEST POSSIBLE CARE TAILORED TO THE INDIVIDUAL'S NEEDS OF ALL ADULTS THROUGHOUT THE COMMONWEALTH OF MASSACHUSETTS BY BRINGING TO SCALE PROVEN CLINICAL CARE STRATEGIES THAT IMPROVE THE CARE AND MANAGE COST. 0 0 514989287 99697 585654491 COMMONWEALTH CARE ALLIANCE (CCA) HAS CONTRACTED 21 COMMUNITY BASED HEALTHCARE PRACTICES THAT HAVE DEMONSTRATED EXPERIENCE SERVING ADULTS IN A MANAGED FRAMEWORK. AS AN EXAMPLE OF THESE PRIMARY CARE SITES INCLUDING AFFILIATED PHYSICIANS GROUP OF JAMAICA PLAIN, BOSTON UNIVERSITY GERIATRICS, BOSTON'S COMMUNITY MEDICAL GROUP, BRIGHTWOOD HEALTH SERVICES, CAMBRIDGE HEALTH ALLIANCE, EAST BOSTON HEALTH CENTER, ELDER SERVICE PLAN OF THE NORTH SHORE, HARBOR HEALTH SERVICE, UPHAM'S CORNER HEALTH CENTER. CCA IS ONE OF THE FOUR SENIOR CARE OPTION OR "SCO" ORGANIZATIONS IN THE COMMONWEALTH: THE SCO PROGRAM IS A COMPREHENSIVE HEALTH PLAN THAT COVERS ALL SERVICES REIMBURSABLE UNDER A DELIVERY SYSTEM AND ITS PREFERRED NETWORK OF PROVIDERS. CCA IS ALSO ONE OF THREE ONE CARE OPTION ORGANIZATIONS IN THE COMMONWEALTH. 514989287 1 0 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 3035 0 1 799 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X CINDY NGUYEN CFO 6174260600 30 WINTER STREET BOSTON MA 02108 DAVID MARGULIES DIRECTOR 5.00 0.00 X 0 0 0 DEAN RICHLIN CHAIRMAN OF THE BOARD 10.00 0.00 X 0 0 0 FRANCES HUBBARD DIRECTOR 5.00 0.00 X 0 0 0 JEFFREY SCAVRON MD DIRECTOR 5.00 5.00 X 0 0 0 LISA IEZZONI DIRECTOR 5.00 0.00 X 0 0 0 MARK REYNOLDS DIRECTOR 5.00 0.00 X 0 0 0 MARY LOU MALONEY DIRECTOR 5.00 0.00 X 0 0 0 NANCY TURNBULL DIRECTOR 5.00 0.00 X 0 0 0 PHILIP THOMPSON DIRECTOR 5.00 0.00 X 0 0 0 ROBERT RESTUCCIA DIRECTOR 5.00 0.00 X 0 0 0 SCOTT GERON DIRECTOR 5.00 0.00 X 0 0 0 SERGIO GONCALVES DIRECTOR 5.00 5.00 X 0 0 0 THOMAS LYNCH DIRECTOR 5.00 0.00 X 0 0 0 EUGENE WALLACE CFO & TREASURER 20.00 20.00 X 237513 0 44367 LOIS S SAULS PRESIDENT 40.00 0.00 X 294601 0 37727 ROBERT J MASTER MD CEO 20.00 20.00 X 471426 0 48250 JEFFERSON LETT CIO (UNTIL MAY 2014) 40.00 0.00 X 152514 0 1877 LARRY GOTTLIEB VICE PRESIDENT 40.00 0.00 X 283145 0 38681 LEANNE BERGE VICE PRESIDENT 40.00 0.00 X 253688 0 47539 LISA FLEMING GENERAL COUNSEL & CLERK 40.00 0.00 X 204028 0 36971 NANCY ROACH COO 40.00 0.00 X 199552 0 20169 JOHN LOUGHNANE DOCTOR 20.00 20.00 X 263010 0 16917 MARC EMMERICH DOCTOR 5.00 35.00 X 190030 0 32804 MARY GLOVER VICE PRESIDENT 20.00 20.00 X 235426 0 20712 PEGGY JOHNSON DOCTOR 40.00 0.00 X 215191 0 9522 OLUWATOYIN AJAYI DOCTOR 5.00 35.00 X 209101 0 13359 3209225 0 368895 88 0 1 0 CATAMARANRX PO BOX 27275 NEW YORK NY 10087 MEDICAL SUPPORT 92411438 BAYSTATE HOME INFUSION AND RESPIRATORY PO BOX 414051 BOSTON MA 02241 MEDICAL SUPPORT 21237930 CEREBRAL PALSY OF MASSACHUSETTS INC 43 OLD COLONY AVENUE QUINCY MA 02170 MEDICAL SUPPORT 15212933 BOSTON MEDICAL CENTER PO BOX 845235 BOSTON MA 02284 MEDICAL SUPPORT 12462917 STAVROS CENTER FOR INDEPENDENT LIVING PO BOX 2130 AMHERST MA 01002 MEDICAL SUPPORT 11643866 424 ENROLLEE FEES 621300 585515766 585515766 GRANT REVENUE 900099 127904 127904 585643670 -296021 -296021 9258726 9282537 -23811 -23811 -23811 MISCELLANEOUS 621300 10821 10821 10821 585334659 585654491 0 -319832 99697 99697 3578120 3578120 21249694 21249694 1075000 1075000 3403335 3403335 1903818 1903818 264634 264634 387279 387279 71020 71020 5030191 5030191 1171327 1171327 1493749 1493749 5735858 5735858 1825549 1825549 301226 301226 119973 119973 210000 210000 1699558 1699558 MEDICAL EXPENSES 445585274 445585274 CAPITATION EXPENSES 69304316 69304316 CLAIMS ADJUDICATION 8231024 8231024 RECRUITING FEES 234277 234277 601322 601322 573576241 514989287 58586954 0 20205891 26235694 1485851 163902 9219652 63019551 720326 1222230 12308065 6390212 5193194 5917853 33938374 45320706 7324938 18258634 78088226 160138570 14065776 26315760 10000000 44570258 91764631 58636034 128080391 X 19452192 32058179 19452192 32058179 78088226 160138570 11758418 847567 2 0 X 0 1 X 1 1 1 X 2560 2560 136588042 174011531 224867049 297069494 585654491 1418190607 136590602 174011531 224867049 297069494 585654491 1418193167 0 0 0 1418193167 22354 73920 844744 806116 -296021 1451113 22354 73920 844744 806116 -296021 1451113 22500 109721 132221 136635456 174195172 225711793 297875610 585358470 1419776501 0.99890 0.99780 0.00100 0.00200 X 0 0 0 0 0 0 1 0 1 0 0 PART II-B, LINE 1: CCA PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS, A PIECE OF WHICH MAY BE USED BY SUCH ORGANIZATIONS FOR FEDERAL LOBBYING ACTIVITIES ON BEHALF OF CCA AND OTHER SIMILARLY SITUATED ORGANIZATIONS. 653073 447634 205439 3362927 1978038 1384889 8292065 3964540 4327525 5917853 CORPORATE BONDS 12418016 F GOVERNMENT AND AGENCY BONDS 30248769 F INTERNATIONAL BONDS 1503955 F MORTGAGE AND ASSET BACKED BONDS 1149966 F 45320706 ASSETS LIMITED AS TO USE 2478463 DUE FROM BOSTON COMMUNITY MEDICAL GROUP 15502017 DEPOSITS 90654 DEFERRED FINANCING COSTS, NET 187500 18258634 MEDICAL EXPENSE OBLIGATIONS 86618714 REFUNDABLE ADVANCES 3613054 DUE TO COMMONWEALTH CLINICAL ALLIANCE 88929 DEFERRED RENT 864763 DEFERRED FUNDRAISING 579171 91764631 586182226 847567 847567 585334659 0 585334659 573576241 0 573576241 0 573576241 1 NAMI MASS 400 WEST CUMMINGS PARK SUITE 6550 WOBURN MA 01801 042777012 501(C)(3) 20000 SUPPORT HELP LINE AND SPONSORSHIP BOSTON CENTER FOR INDEPENDENT LIVING 60 TEMPLE PLACE 5TH FLOOR BOSTON MA 02111 042546595 501(C)(3) 21000 HOST SPONSORSHIP ADDP - ASSOCIATION OF DEVELOPMENTAL DISABILITIES PROVIDERS 1671 WORCESTER ROAD NO 201 FRAMINGHAM MA 01701 042859780 501(C)(3) 6000 DCU LUNCHEON AND PURCHASES 3 PART I, LINE 2: THE ORGANIZATION PROVIDES GRANTS AND SUPPORT TO OTHER HUMAN SERVICE ORGANIZATIONS AND ORGANIZATIONS WITH SIMILAR MISSIONS. THE GOVERNING BODY AND TOP MANAGEMENT OFFICIALS MAKE DECISIONS OF THE SUPPORT AND MAINTAIN RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANT AND ASSISTANCE TO THESE ORGANIZATIONS. X X X 1 0 0 1 0 1 0 0 0 EUGENE WALLACE CFO & TREASURER 227377 0 0 0 10136 0 10599 0 33768 0 281880 0 0 0 LOIS S SAULS PRESIDENT 292041 0 0 0 2560 0 11700 0 26027 0 332328 0 0 0 ROBERT J MASTER MD CEO 336609 0 121220 0 13597 0 11700 0 36550 0 519676 0 0 0 JEFFERSON LETT CIO (UNTIL MAY 2014) 152139 0 0 0 375 0 0 0 1877 0 154391 0 0 0 LARRY GOTTLIEB VICE PRESIDENT 279424 0 0 0 3721 0 11700 0 26981 0 321826 0 0 0 LEANNE BERGE VICE PRESIDENT 226437 0 25000 0 2251 0 11700 0 35839 0 301227 0 0 0 LISA FLEMING GENERAL COUNSEL & CLERK 202118 0 0 0 1910 0 9455 0 27516 0 240999 0 0 0 NANCY ROACH COO 197746 0 0 0 1806 0 9000 0 11169 0 219721 0 0 0 JOHN LOUGHNANE DOCTOR 262211 0 0 0 799 0 11700 0 5217 0 279927 0 0 0 MARC EMMERICH DOCTOR 188309 0 0 0 1721 0 8667 0 24137 0 222834 0 0 0 MARY GLOVER VICE PRESIDENT 232256 0 0 0 3170 0 10508 0 10204 0 256138 0 0 0 PEGGY JOHNSON DOCTOR 208285 0 0 0 6906 0 0 0 9522 0 224713 0 0 0 OLUWATOYIN AJAYI DOCTOR 208746 0 0 0 355 0 3469 0 9890 0 222460 0 0 0 PART I, LINE 4A MR. LETT WAS TERMINATED FROM THE ORGANIZATION AND RECEIVED 6 MONTHS OF SEVERANCE IN THE AMOUNT OF HIS THEN CURRENT SALARY AND 6 MONTHS OF OUTPLACEMENT SERVICES. MR. LETT RECEIVED A TOTAL OF $65,862 IN SEVERANCE PAYMENT IN CALENDAR YEAR 2014. PART I, LINE 5 THE CEO'S BONUS IS TIED TO MEETING ANNUAL COMPANY FINANCIAL GOALS. OTHER EMPLOYEES' BONUSES ARE NOT EXPRESSLY TIED TO ANNUAL FINANCIAL GOALS. PART I, LINE 6 THE CEO'S BONUS IS TIED TO MEETING ANNUAL COMPANY FINANCIAL GOALS. OTHER EMPLOYEES' BONUSES ARE NOT EXPRESSLY TIED TO ANNUAL FINANCIAL GOALS. FORM 990, PART VI, SECTION A, LINE 6 CCA HAS TWO CORPORATE MEMBERS WHICH ARE BOTH NON-PROFIT MASSACHUSETTS CORPORATIONS. THOSE TWO ORGANIZATIONS ARE HEALTH CARE FOR ALL (HCFA) AND BOSTON'S CENTER FOR INDEPENDENT LIVING (BCIL). FORM 990, PART VI, SECTION A, LINE 7A IN ACCORDANCE WITH CCA'S BYLAWS, THE TWO CORPORATE MEMBERS HAVE THE POWERS AND AUTHORITY TO APPOINT ADDITIONAL MEMBERS UP TO FIFTEEN IN NUMBER AND ELECT CCA'S DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B IN ACCORDANCE WITH CCA'S BYLAWS, THE TWO CORPORATE MEMBERS HAVE THE POWERS AND AUTHORITY TO ADOPT AND APPROVE BYLAWS AND AMENDMENTS TO THE ARTICLES OF ORGANIZATION OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS REVIEW THE FORM 990 BEFORE THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. THE BOARD ALSO REVIEWS THE FINANCIAL STATEMENTS ON A QUARTERLY BASIS. FORM 990, PART VI, SECTION B, LINE 12C THE ANNUAL COMPLIANCE POLICY AND CONFLICT OF INTEREST FORMS ARE DISTRIBUTED TO THE BOARD AND OFFICERS AND THE COMPLIANCE DEPARTMENT MONITORS FOR COMPLETION ANNUALLY. THE BOARD AND OFFICERS ALSO RECEIVE ANNUAL TRAINING ON CONFLICT OF INTEREST. THE COMPANY'S CONFLICT OF INTEREST POLICY COVERS CCA EMPLOYEES, OFFICERS AND DIRECTORS. THE POLICY CALLS FOR CONFLICT OF INTEREST ANALYSIS AND ACTUAL CONFLICTS ARE REVIEWED AND CONFLICTS DETERMINATIONS ARE MADE FOR EMPLOYEES OF DIRECTOR LEVEL AND ABOVE (DIRECTOR, SENIOR DIRECTOR, VICE PRESIDENT, SENIOR VICE PRESIDENT). WHERE AN ACTUAL OR PERCEIVED CONFLICT OF INTEREST INVOLVING A TRANSACTION IS DETERMINED, THE EMPLOYEE IS PROHIBITED FROM PARTICIPATING IN EITHER MANAGEMENT'S OR THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION ENGAGED COMPENSATION CONSULTANTS IN NOVEMBER 2013 TO PROVIDE A COMPREHENSIVE COMPENSATION ASSESSMENNT AND RECOMMENDATIONS TO CREATE A REASONABLE COMPENSATION PACKAGE FOR TOP MANAGEMENT OFFICIAL. THE ORGANIZATION WORKED WITH THE COMPENSATION CONSULTANT DURING 2014. OTHER OFFICERS AND KEY EMPLOYEES ARE REVIEWED ANNUALLY AND ARE ADJUSTED BY MARKET VALUE OF SURVEY OF POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FORM 990, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). IN ADDITION, THE FORM 990 IS AVAILABLE VIA GUIDESTAR AND THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. CCA CAPITAL LLC 30 WINTER STREET 11TH FLR BOSTON MA 02108 999999999 BENEFICIARY OF A STANDBY LETTER OF CREDIT MA COMMONWEALTH CARE ALLIANCE INC BOSTON'S COMMUNITY MEDICAL GROUP INC 30 NORTHAMPTON STREET BOSTON MA 02118 260100022 MEDICAL SERVICE MA 501(C)(3) LINE 3 COMMONWEALTH CARE ALLIANCE INC 1 COMMONWEALTH CLINICAL ALLIANCEINC 30 WINTER STREET BOSTON MA 02108 562382058 MEDICAL SERVICE MA 501(C)(3) LINE 9 COMMONWEALTH CARE ALLIANCE INC 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 COMMONWEALTH CLINICAL ALLIANCE M 19923853 FAIR MARKET VALUE BOSTON'S COMMUNITY MEDICAL GROUP M 742842 FAIR MARKET VALUE