BAYSTATE MEDICAL PRACTICES INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- BAYSTATE MEDICAL PRACTICES INC (EIN 04-2888373)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-13
- IRS object ID
- 201322259349301167
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-13T09:28:37-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 346565596 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ernst & Young LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Clarendon Street | AddressLine1 |
| City | Boston | City |
| State | MA | State |
| ZIP Code | 02116 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042888373 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Medical Practices Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BAYS | NameControl |
| Phone | 4137940000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 759 Chestnut Street | AddressLine1 |
| City | Springfield | City |
| State | MA | State |
| ZIP Code | 01199 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dennis W Chalke | Name |
| Title | SVP Finance & Treasurer | Title |
| Phone | 4137943290 | Phone |
| Date Signed | 2013-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeanne M Schuster | Name |
| PTIN | P00743154 | PTIN |
| Phone | 6172662000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Dennis W Chalke | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 759 Chestnut Street | AddressLine1 |
| City | Springfield | City |
| State | MA | State |
| ZIP Code | 01199 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 220627492 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | baystatehealth.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1985 | YearFormation |
| State Legal Domicile | MA | StateLegalDomicile |
| Activity Or Mission Description | 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 multispecialty group practice of choice, known for exceptional service, quality, value, and academic leadership. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 22 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 1 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1505 | TotalNbrEmployees |
| Total Nbr Volunteers | 1 | TotalNbrVolunteers |
| Total Gross UBI | 796421 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -281170 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 207309671 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 220624064 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3831 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3428 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 207313502 | TotalRevenuePriorYear |
| Total Revenue Current Year | 220627492 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 183877453 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 194094105 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 37273564 | OtherExpensePriorYear |
| Other Expenses Current Year | 42203051 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 221151017 | TotalExpensesPriorYear |
| Total Expenses Current Year | 236297156 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -13837515 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -15669664 | RevenuesLessExpensesCY |
| Total Assets BOY | 27863501 | TotalAssetsBOY |
| Total Assets EOY | 28870300 | TotalAssetsEOY |
| Total Liabilities BOY | 78100074 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 85819073 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -50236573 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -56948773 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To deliver excellent patient care, provide innovative medical education and pursue meaningful research. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 221990492 | Expense |
| Revenue | 219827643 | Revenue |
| Description | 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. | Description |
| Total Program Service Expense | 221990492 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 143 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1505 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 22 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 1 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Peter Lyons Baystate Health Inc | NamePerson |
| Telephone Number | 4137940000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 759 Chestnut Street | AddressLine1 |
| City | Springfield | City |
| State | MA | State |
| ZIP Code | 01199 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (31 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Mark A Keroack MD MPH | ||||||||
| Chair/President | 10.00 | X | X | 301105 | 0 | 80102 | ||
| Benjamin Liptzin MD | ||||||||
| Vice Chair/Director | 10.00 | X | X | 468250 | 0 | 66728 | ||
| Dennis W Chalke | ||||||||
| Treasurer/Director | 10.00 | X | X | 672631 | 0 | 92548 | ||
| Mohammed S Ahmed MD | ||||||||
| Director, COO/CMO Eastern Region | 1.00 | X | 357424 | 0 | 71815 | |||
| Jeffrey Cossin MD | ||||||||
| Director, Med. Dir. No. Edge Med. Assoc. | 1.00 | X | 241162 | 0 | 66725 | |||
| Wayne Duke MD | ||||||||
| Director, Vice Chair Pathology | 1.00 | X | 370515 | 0 | 69586 | |||
| Daniel Grow MD | ||||||||
| Director, Chairman Dept of Ob/Gyn | 1.00 | X | 499464 | 0 | 52046 | |||
| Gregory A Harb | ||||||||
| Director, Executive VP, COO Baystate Health | 1.00 | X | 584765 | 0 | 133003 | |||
| Oz Harmanli MD | ||||||||
| Director 3/1/12-9/30/12, Chief Urogynecology | 1.00 | X | 354868 | 0 | 57878 | |||
| Thomas Higgins MD | ||||||||
| Director, Vice Chair Clinical Affairs | 1.00 | X | 488124 | 0 | 70011 | |||
| Kevin Hinchey MD | ||||||||
| Director 5/15/12-9/30/12, Vice Chair Education | 1.00 | X | 289928 | 0 | 94876 | |||
| Mark K Hirko MD | ||||||||
| Director, Chief, Vascular Surgery | 1.00 | X | 915128 | 0 | 63434 | |||
| M Dale Janes | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Laura M Pinkston Koenigs MD | ||||||||
| Director,Med Director, Adolescent Med | 1.00 | X | 207718 | 0 | 41003 | |||
| Christie L Miller MD | ||||||||
| Director,OB/GYN Comm Prac | 1.00 | X | 214048 | 0 | 44644 | |||
| Michael Picchioni MD | ||||||||
| Director, Internist | 1.00 | X | 147112 | 0 | 56586 | |||
| Sara Rourke MD | ||||||||
| Director 3/7/12-9/30/12, Med. Dir. Franklin Medica | 1.00 | X | 194491 | 0 | 22988 | |||
| Joseph Schmidt MD | ||||||||
| Director, Vice Chair Emergency Medicine | 1.00 | X | 280761 | 0 | 57804 | |||
| Scott Siege MD | ||||||||
| Director, Med.Dir. Mary Lane Peds | 1.00 | X | 182446 | 0 | 25095 | |||
| Roy Sittig MD | ||||||||
| Director, Internist CHMP | 1.00 | X | 309971 | 0 | 50471 | |||
| Mark R Tolosky | ||||||||
| Director, President & CEO BHS | 1.00 | X | 1536640 | 0 | 99365 | |||
| Richard Wait MD | ||||||||
| Director, Chairman, Dept. of Surgery | 1.00 | X | 804253 | 0 | 106456 | |||
| Kristin R Delaney | ||||||||
| Clerk | 1.00 | X | 94511 | 0 | 47834 | |||
| Gordon Josephson MD | ||||||||
| COO Baystate Medical Practices | 50.00 | 437277 | 0 | 66333 | X | |||
| Aaron Kugelmass MD | ||||||||
| Chief Cardio M Dir Vascula | 50.00 | 739018 | 0 | 69668 | X | |||
| Gerda Maissel MD | ||||||||
| CMO - Northern Region | 50.00 | 332156 | 0 | 145433 | X | |||
| Sherry Taylor MD | ||||||||
| Chief of Neurosurgery | 50.00 | 688917 | 0 | 59203 | X | |||
| Dennis Oh MD | ||||||||
| Neurosurgeon | 50.00 | 659960 | 0 | 53984 | X | |||
| Thomas Kaye MD | ||||||||
| Neurosurgeon | 50.00 | 534072 | 0 | 44311 | X | |||
| Marc J Schweiger MD | ||||||||
| Medical Dir Cardiac Cath L | 50.00 | 497990 | 0 | 156241 | X | |||
| Clemens Schirmer MD | ||||||||
| Neurosurgeon | 50.00 | 493861 | 0 | 32070 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 13898566 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2098241 | TotalOtherCompensation |
| Number Individuals GT100 K | 466 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Baystate Administrative Services Inc | |||||
| 759 Chestnut Street | Springfield | MA | 01199 | Management services | 4774001 |
| Baystate Medical Center Inc | |||||
| 759 Chestnut Street | Springfield | MA | 01199 | Patient schedule svcs & rent | 4534325 |
| Radiology & Imaging Inc | |||||
| 1350 Main St 10th Floor | Springfield | MA | 011031628 | Physician contract services | 668417 |
| Baystate Franklin Medical Center | |||||
| 164 High Street | Greenfield | MA | 01301 | Rent | 536864 |
| Ingraham Corporation | |||||
| 759 Chestnut Street | Springfield | MA | 01199 | Rent | 517434 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 29 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Physician Practice Fee | 621110 | 219827643 | 219827643 | |
| BRL Gainshare | 900099 | 333449 | 333449 | |
| W.Brookfield profit/lo | 900099 | 262349 | 262349 | |
| Medical Director Contr | 900099 | 176804 | 176804 | |
| BMC Support | 900099 | 23819 | 23819 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 220624064 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3428 | TotalRevenueColumn |
| Exclusion | $3,428 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 220627492 | TotalRevenueColumn |
| Related Or Exempt Function Income | 219827643 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 796421 | UnrelatedBusinessRevenue |
| Exclusion | $3,428 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8249549 | Total |
| Program Services | 8249549 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 158040531 | Total |
| Program Services | 152974356 | ProgramServices |
| Management And General | 5066175 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10174523 | Total |
| Program Services | 9838511 | ProgramServices |
| Management And General | 336012 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9360039 | Total |
| Program Services | 9058614 | ProgramServices |
| Management And General | 301425 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8269463 | Total |
| Program Services | 8015644 | ProgramServices |
| Management And General | 253819 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5173997 | Total |
| Management And General | 5173997 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 197150 | Total |
| Management And General | 197150 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68400 | Total |
| Management And General | 68400 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3440024 | Total |
| Program Services | 3208954 | ProgramServices |
| Management And General | 231070 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168189 | Total |
| Program Services | 159780 | ProgramServices |
| Management And General | 8409 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2313925 | Total |
| Program Services | 2247499 | ProgramServices |
| Management And General | 66426 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109466 | Total |
| Program Services | 57213 | ProgramServices |
| Management And General | 52253 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4787036 | Total |
| Program Services | 4547684 | ProgramServices |
| Management And General | 239352 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 276601 | Total |
| Program Services | 276601 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 425127 | Total |
| Program Services | 403869 | ProgramServices |
| Management And General | 21258 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16181 | Total |
| Management And General | 16181 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 887592 | Total |
| Program Services | 843212 | ProgramServices |
| Management And General | 44380 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9369839 | Total |
| Program Services | 7580388 | ProgramServices |
| Management And General | 1789451 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Bad Debts | 5760992 | 5760992 |
| Purchased Svcs Clerical | 3217759 | 3217759 |
| Medical Supplies | 2674734 | 2674734 |
| Prof'l Exp Acct | 1825644 | 1825644 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1490395 | Total |
| Program Services | 1049489 | ProgramServices |
| Management And General | 440906 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 236297156 | Total |
| Program Services | 221990492 | ProgramServices |
| Management And General | 14306664 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2818666 | BOY |
| EOY | 5131873 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15028300 | BOY |
| EOY | 15717977 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 267375 | BOY |
| EOY | 192708 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1144501 | BOY |
| EOY | 589104 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 17216268 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 14660952 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3580781 | BOY |
| EOY | 2555316 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5023878 | BOY |
| EOY | 4683322 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27863501 | BOY |
| EOY | 28870300 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25451203 | BOY |
| EOY | 29690550 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 387525 | BOY |
| EOY | 461756 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52261346 | BOY |
| EOY | 55666767 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78100074 | BOY |
| EOY | 85819073 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -50236573 | BOY |
| EOY | -56948773 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -50236573 | BOY |
| EOY | -56948773 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27863501 | BOY |
| EOY | 28870300 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -15669664 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 8957464 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 127231314 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 135989036 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 140855978 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 206929699 | CurrentTaxYearMinus1Year |
| Current Tax Year | 219827643 | CurrentTaxYear |
| Total | 830833670 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 127231314 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 135989036 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 140855978 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 206929699 | CurrentTaxYearMinus1Year |
| Current Tax Year | 219827643 | CurrentTaxYear |
| Total | 830833670 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 830833670 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 93647 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 46568 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8640 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3831 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3428 | CurrentTaxYear |
| Total | 156114 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 93647 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 46568 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8640 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3831 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3428 | CurrentTaxYear |
| Total | 156114 | Total |
Net Income From Other UBI NetIncomeFromOtherUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 382925 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 309068 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 297439 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 379972 | CurrentTaxYearMinus1Year |
| Current Tax Year | 796421 | CurrentTaxYear |
| Total | 2165825 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 127707886 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 136344672 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 141162057 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 207313502 | CurrentTaxYearMinus1Year |
| Current Tax Year | 220627492 | CurrentTaxYear |
| Total | 833155609 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99720 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99710 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00020 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00040 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1103927 | OtherCostOrOtherBasis |
| Depreciation | 415181 | Depreciation |
| Book Value | 688746 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1576240 | OtherCostOrOtherBasis |
| Depreciation | 1075809 | Depreciation |
| Book Value | 500431 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14536101 | OtherCostOrOtherBasis |
| Depreciation | 13169962 | Depreciation |
| Book Value | 1366139 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2555316 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Due from Affiliated Companies | 882179 |
| Accounts Receivable, Other (net of MD loans) | 3801143 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 4683322 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to Affiliated Companies | $7,910,663 |
| Insurance IBNR Loss Reserves | $7,362,420 |
| Accrued Pension Cost | $39,483,884 |
| Line of credit, affiliate | $909,800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 55666767 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Uncertain Tax Positions Under FIN 48: | Identifier |
| Return Reference | Part X: | ReturnReference |
| Explanation | Schedule D, Part X, Line 2: Baystate Medical Practices, Inc. does not have a FIN 48 footnote included in its audited financial statements. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 1 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (29 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mark A Keroack MD MPH | |||||||||||||
| 245679 | 0 | 33750 | 0 | 21676 | 0 | 64800 | 0 | 15302 | 0 | 381207 | 0 | 0 | 0 |
| Benjamin Liptzin MD | |||||||||||||
| 351598 | 0 | 59704 | 0 | 56948 | 0 | 41094 | 0 | 25634 | 0 | 534978 | 0 | 0 | 0 |
| Dennis W Chalke | |||||||||||||
| 363180 | 0 | 131625 | 0 | 177826 | 0 | 58000 | 0 | 34548 | 0 | 765179 | 0 | 0 | 0 |
| Mohammed S Ahmed MD | |||||||||||||
| 299673 | 0 | 38395 | 0 | 19356 | 0 | 41613 | 0 | 30202 | 0 | 429239 | 0 | 0 | 0 |
| Jeffrey Cossin MD | |||||||||||||
| 194329 | 0 | 35678 | 0 | 11155 | 0 | 45076 | 0 | 21649 | 0 | 307887 | 0 | 0 | 0 |
| Wayne Duke MD | |||||||||||||
| 286644 | 0 | 72162 | 0 | 11709 | 0 | 38256 | 0 | 31330 | 0 | 440101 | 0 | 0 | 0 |
| Daniel Grow MD | |||||||||||||
| 392676 | 0 | 66780 | 0 | 40008 | 0 | 31149 | 0 | 20897 | 0 | 551510 | 0 | 0 | 0 |
| Gregory A Harb | |||||||||||||
| 337108 | 0 | 180000 | 0 | 67657 | 0 | 108675 | 0 | 24328 | 0 | 717768 | 0 | 0 | 0 |
| Oz Harmanli MD | |||||||||||||
| 265482 | 0 | 82697 | 0 | 6689 | 0 | 31108 | 0 | 26770 | 0 | 412746 | 0 | 0 | 0 |
| Thomas Higgins MD | |||||||||||||
| 390033 | 0 | 68000 | 0 | 30091 | 0 | 49288 | 0 | 20723 | 0 | 558135 | 0 | 0 | 0 |
| Kevin Hinchey MD | |||||||||||||
| 261466 | 0 | 18878 | 0 | 9584 | 0 | 73348 | 0 | 21528 | 0 | 384804 | 0 | 0 | 0 |
| Mark K Hirko MD | |||||||||||||
| 531080 | 0 | 380878 | 0 | 3170 | 0 | 36125 | 0 | 27309 | 0 | 978562 | 0 | 0 | 0 |
| Laura M Pinkston Koenigs MD | |||||||||||||
| 201715 | 0 | 103 | 0 | 5900 | 0 | 21972 | 0 | 19031 | 0 | 248721 | 0 | 0 | 0 |
| Christie L Miller MD | |||||||||||||
| 202978 | 0 | 10446 | 0 | 624 | 0 | 23731 | 0 | 20913 | 0 | 258692 | 0 | 0 | 0 |
| Michael Picchioni MD | |||||||||||||
| 138042 | 0 | 7761 | 0 | 1309 | 0 | 30613 | 0 | 25973 | 0 | 203698 | 0 | 0 | 0 |
| Sara Rourke MD | |||||||||||||
| 175493 | 0 | 17971 | 0 | 1027 | 0 | 7635 | 0 | 15353 | 0 | 217479 | 0 | 0 | 0 |
| Joseph Schmidt MD | |||||||||||||
| 247373 | 0 | 29824 | 0 | 3564 | 0 | 30118 | 0 | 27686 | 0 | 338565 | 0 | 0 | 0 |
| Scott Siege MD | |||||||||||||
| 162464 | 0 | 19628 | 0 | 354 | 0 | 9114 | 0 | 15981 | 0 | 207541 | 0 | 0 | 0 |
| Roy Sittig MD | |||||||||||||
| 273297 | 0 | 33823 | 0 | 2851 | 0 | 26648 | 0 | 23823 | 0 | 360442 | 0 | 0 | 0 |
| Mark R Tolosky | |||||||||||||
| 696553 | 0 | 315856 | 0 | 524231 | 0 | 58633 | 0 | 40732 | 0 | 1636005 | 0 | 0 | 0 |
| Richard Wait MD | |||||||||||||
| 588259 | 0 | 135540 | 0 | 80454 | 0 | 67800 | 0 | 38656 | 0 | 910709 | 0 | 0 | 0 |
| Gordon Josephson MD | |||||||||||||
| 332901 | 0 | 71071 | 0 | 33305 | 0 | 46725 | 0 | 19608 | 0 | 503610 | 0 | 0 | 0 |
| Aaron Kugelmass MD | |||||||||||||
| 550451 | 0 | 185168 | 0 | 3399 | 0 | 39673 | 0 | 29995 | 0 | 808686 | 0 | 0 | 0 |
| Gerda Maissel MD | |||||||||||||
| 277948 | 0 | 34094 | 0 | 20114 | 0 | 128453 | 0 | 16980 | 0 | 477589 | 0 | 0 | 0 |
| Sherry Taylor MD | |||||||||||||
| 667467 | 0 | 15000 | 0 | 6450 | 0 | 46689 | 0 | 12514 | 0 | 748120 | 0 | 0 | 0 |
| Dennis Oh MD | |||||||||||||
| 520854 | 0 | 117476 | 0 | 21630 | 0 | 32532 | 0 | 21452 | 0 | 713944 | 0 | 0 | 0 |
| Thomas Kaye MD | |||||||||||||
| 488359 | 0 | 40759 | 0 | 4954 | 0 | 16786 | 0 | 27525 | 0 | 578383 | 0 | 0 | 0 |
| Marc J Schweiger MD | |||||||||||||
| 437353 | 0 | 8246 | 0 | 52391 | 0 | 129735 | 0 | 26506 | 0 | 654231 | 0 | 0 | 0 |
| Clemens Schirmer MD | |||||||||||||
| 448388 | 0 | 44555 | 0 | 918 | 0 | 19782 | 0 | 12288 | 0 | 525931 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 1a | Club Dues - One member of the Board of Directors was provided with payment for dinner club dues for which the personal use did not exceed $250 for 2011. This item was 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 | Baystate Health, Inc., the parent organization of the health care system to which the filing organization belongs, uses an independent compensation committee, an independent compensation consultant, and appropriate comparability data and approval by the compensation committee to establish the compensation of its key officers, directors, and employees, which includes the filing organization's top management officials. | |
| Part I, Lines 4b-c | Line 4b: Mohammed Shafeeq Ahmed, MD - Supplemental Retirement of $18,342 is included in column E. This amount was earned in 2011. Dennis W. Chalke - Supplemental Retirement of $145,066 is included in column E. This amount was earned in 2011. Wayne Duke, MD - Supplemental Retirement of $10,474 is included in column E. This amount was earned in 2011. Daniel Grow, MD - Supplemental Retirement of $22,492 is included in column E. This amount was earned in 2011. Gregory A. Harb - Supplemental Retirement of $96,425 is included in column E. This amount was earned in 2011. Oz Harmanli, MD - Supplemental Retirement of $5,616 is included in column E. This amount was earned in 2011. Thomas Higgins, MD - Supplemental Retirement of $9,796 is included in column E. This amount was earned in 2011. Mark K. Hirko, MD - Supplemental Retirement of $20,200 is included in column E. This amount was earned in 2011. Gordon Josephson, MD - Supplemental Retirement of $23,507 is included in column E. This amount was earned in 2011. Thomas Kaye, MD- Supplemental Retirement of $861 is included in column E. This amount was earned in 2011. Mark A. Keroack, MD- Supplemental Retirement of $48,875 is included in column E. This amount was earned in 2011. Aaron Kugelmass, MD- Supplemental Retirement of $23,748 is included in column E. This amount was earned in 2011. Benjamin Liptzin, MD - Supplemental Retirement of $31,829 is included in column E. This amount was earned in 2011. Dennis Oh, MD - Supplemental Retirement of $20,282 is included in column E. This amount was earned in 2011. Joseph Schmidt, MD - Supplemental Retirement of $1,830 is included in column E. This amount was earned in 2011. Marc J. Schweiger, MD - Supplemental Retirement of $39,314 is included in column E. This amount was earned in 2011. Clemens Schirmer, MD- Supplemental Retirement of $9,982 is included in column E. This amount was earned in 2011. Roy Sittig, MD - Supplemental Retirement of $1,514 is included in column E. This amount was earned in 2011. Sherry Taylor, MD Supplemental Retirement of $27,089 is included in column E. . This amount was earned in 2011. Mark R. Tolosky - Supplemental Retirement of $332,054 is included in column E. This amount was earned in 2011. Richard B. Wait, MD - Supplemental Retirement of $70,642 is included in column E. This amount was earned in 2011. Line 4c: The supplemental retirement plan offered to Mr. Tolosky from 1997-2002 provided the right to purchase mutual fund shares at a specified price, with the rights expiring at the end of the 10 years. The 2011 compensation of $130,991 was based on the difference between the fair market value at the date of exercise and the exercise price. | |
| Part III | Part II Gregory A. Harb was a Director for the entire fiscal year, however his employment start date was 3/31/2011, therefore his compensation figures do not reflect an entire year of compensation. Mark A. Keroack, MD was the President and Chairman of the Board for the entire fiscal year, however his employment start date was 6/13/2011, therefore his compensation figures do not reflect an entire year of compensation. | Supplemental Information |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| American Excess Insurance Exchange | |||
| Board Overlap | 1634565 | See Part V - Mark Tolosky, President of the filing organization is also Chairman of the Board of Directors of AEIX. The filing organization purchases general & professional liability insurance from AEIX. | 0 |
| Baycare Health Partners Inc (BHP) | |||
| Common Board Members or Officers | 2480780 | See Part V - The filing organization received payments from BHP of $ 2,362,429 for patient care services for which BHP is the intermediary between the filing organization and third party payers and $118,351 for medical services. BHP is an affiliate corporation of the filing organization. | 0 |
| Baycare Health Partners Inc (BHP) | |||
| Common Board Members or Officers | 72600 | See Part V - The filing organization made payments to BHP for physician membership dues. BHP is an affiliate corporation of the filing organization. | 0 |
| Greater Springfield IPA GSIPA | |||
| Board Overlap | 137475 | See Part V - Benjamin Liptzin, MD, Board Member of the filing organization is also a Board Member of GSIPA. The filing organization made payments to GSIPA for physician membership dues. | 0 |
| Health New England Inc (HNE) | |||
| Common Board Members or Officers | 18352825 | See Part V - The filing organization received payments from HNE of $17,752,825 related to medical claims and $600,000 for medical consulting services. HNE is an affiliate corporation of the filing organization. | 0 |
| Ingraham Corporation (IC) | |||
| Common Board Members or Officers | 514434 | See Part V - The filing organization made payments to IC for rental of medical office space. IC is an affiliate corporation of the filing organization. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 1 | Baystate Medical Practices, Inc. is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c) (3) organization. Various management and support functions are delegated to BAS. | |
| Form 990, Part VI, Section A, line 2 | Dennis W. Chalke, Kristin R. Delaney, Loring S. Flint, MD, M. Dale Janes, Hal B. Jenson, MD, Benjaman Liptzin, MD and Mark R. Tolosky are also officers or trustees 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. Various management and supoport functions are delegated to BAS. | |
| 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 21 Directors, seven of whom are either appointed by BH or serve ex officio based on positions they hold with BH, and 14 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 organization's 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 organization's educational and research programs, (5) any pledge of the filing organization's 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 | 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 key 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. (the parent organization of the health care system to which the filing organization belongs) and all such deliberations and decisions are documented contemporaneously. | |
| Form 990, Part VI, Section C, line 19 | 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 VII, Section A, Line 1a, Column (B) | All individuals with compensation who have 10 average hours per week listed in Part VII, worked between 40 - 60 hours among all related entities. | Average hours per week: |
| Form 990, Part XI, line 5: | Current year acquisitions to other entities -721,981. Transfer to/from affiliate, net 17,839,996. Minimum pension liability adjustment -8,160,548. rounding -3. Total to Form 990, Part XI, Line 5: 8,957,464. | Changes in Net Assets or Fund Balances: |
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