2013-11-14T11:38:22-06:00 2012-12-31 420714325 MCGLADREY LLP 80 CITY SQUARE BOSTON MA 02129 990 2012-01-01 043756900 COMMONWEALTH CARE ALLIANCE INC COMM 6174260600 30 WINTER STREET 11TH FL BOSTON MA 02108 ROBERT J MASTER MD 6174260600 2013-11-14 1 LYNNE JOHNSON P00757336 6129129000 2012 2016-02-24 21:20:13Z LOIS S SAULS 30 WINTER STREET 11TH FL BOSTON MA 02108 231793025 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 ELDERS THROUGHOUT THE COMMONWEALTH OF MASSACHUSETTS BY BRINGING TO SCALE PROVEN CLINICAL CARE STRATEGIES THAT IMPROVE THE CARE AND MANAGE COST. 12 12 331 12 0 0 0 0 173962433 224851049 73920 783091 109721 16000 174146074 225650140 0 82085 0 0 8586408 13378540 0 0 0 156389154 208341478 164975562 221802103 9170512 3848037 46812237 58691238 25563967 33765040 21248270 24926198 COMMONWEALTH CARE ALLIANCE INC.'S MISSION IS TO PROVIDE THE BEST POSSIBLE CARE TAILORED TO THE INDIVIDUAL'S NEEDS OF ALL ELDERS THROUGHOUT THE COMMONWEALTH OF MASSACHUSETTS BY BRINGING TO SCALE PROVEN CLINICAL CARE STRATEGIES THAT IMPROVE THE CARE AND MANAGE COST. 0 0 197557760 82085 224867049 COMMONWEALTH CARE ALLIANCE (CCA) HAS CONTRACTED 21 COMMUNITY BASED HEALTHCARE PRACTICES THAT HAVE DEMOSTRATED EXPERIENCE SERVING ELDERS 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 OPTIONS 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. 197557760 1 0 0 1 0 0 0 0 0 0 1 1 0 0 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 0 1 1 1 0 0 1 1322 0 331 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X EUGENE C WALLACE CFO 6174260600 30 WINTER STREET BOSTON MA 02108 DEAN RICHLIN 10.00 0.00 X 0 0 0 FRANCES HUBBARD 5.00 0.00 X 0 0 0 JEFFREY SCAVRON MD 5.00 5.00 X 0 0 0 LISA IEZZONI 5.00 0.00 X 0 0 0 MARK REYNOLDS 5.00 0.00 X 0 0 0 MARY LOU MALONEY 5.00 0.00 X 0 0 0 NANCY TURNBULL 5.00 0.00 X 0 0 0 PHILIP THOMPSON 5.00 0.00 X 0 0 0 ROBERT RESTUCCIA 5.00 0.00 X 0 0 0 SERGIO GONCALVES 5.00 5.00 X 0 0 0 SCOTT GERON 5.00 0.00 X 0 0 0 DAVID MARGULIES 5.00 0.00 X 0 0 0 ROBERT J MASTER MD 20.00 20.00 X 345796 42916 45399 LOIS S SAULS 40.00 0.00 X 468621 0 31697 EUGENE WALLACE 25.00 15.00 X 340170 0 2029 JEFFERSON LETT 40.00 0.00 X 282990 0 32746 NANCY ROACH 40.00 0.00 X 232898 0 18518 LISA FLEMING 40.00 0.00 X 304497 0 31697 LARRY GOTTLIEB 40.00 0.00 X 247769 0 31697 JANET LEVINSON 40.00 0.00 X 178433 0 37731 BASEM SHEBLI 40.00 0.00 X 157301 0 32933 ROBERT COHEN 40.00 0.00 X 172720 0 37250 SHONA GIBSON 0.50 40.00 X 148377 0 28506 GREG TOWNSEND 40.00 0.00 X 144429 0 28900 3024001 42916 359103 34 0 1 0 BAYSTATE HOME INFUSION AND RESPIRATORY PO BOX 414051 BOSTON MA 02241 MEDICAL SUPPORT 9248495 NORTH SHORE ARC 64 HOLTEN STREET DANVERS MA 01923 MEDICAL SUPPORT 8303161 CEREBRAL PALSY OF MASSACHUSETTS INC 43 OLD COLONY AVENUE QUINCY MA 02170 MEDICAL SUPPORT 7669906 CAMBRIDGE HEALTH ALLIANCE PO BOX 414006 BOSTON MA 02241 MEDICAL SUPPORT 6982338 BOSTON MEDICAL CENTER PO BOX 845235 BOSTON MA 02284 MEDICAL SUPPORT 6590046 185 ENROLLEE FEES 621300 224831049 224831049 CONSULTING FEES 621300 20000 20000 224851049 844744 844744 6081232 6142885 -61653 -61653 -61653 MISCELLANEOUS 621300 16000 16000 16000 225650140 224867049 0 783091 82085 82085 2416524 2416524 8930880 8930880 210522 210522 1095354 1095354 725260 725260 2142833 2142833 79960 79960 292485 292485 72876 72876 818078 818078 44004 44004 481586 481586 930823 930823 1025244 1025244 135187 135187 182422 182422 205195 205195 742825 742825 113988 113988 MEDICAL EXPENSES 169870530 169870530 CAPITATION EXPENSES 27605145 27605145 CLAIMS ADJUDICATION 3265631 3265631 RECRUITING FEES 249724 249724 82942 82942 221802103 197557760 24244343 0 11153180 15542292 29830981 405731 2761603 4401507 504142 1325309 4947026 3781316 1119884 1165710 34951532 1442447 899157 46812237 58691238 2304636 5387671 23259331 28377369 25563967 33765040 X 21248270 24926198 21248270 24926198 46812237 58691238 3848037 -170109 0 X 0 1 X 1 0 X 500 100000 2560 103060 99313601 27760632 136588042 174011531 224867049 662540855 99314101 27860632 136590602 174011531 224867049 662643915 0 0 0 662643915 63075 7421 22354 73920 844744 1011514 63075 7421 22354 73920 844744 1011514 22500 109721 132221 99377176 27868053 136635456 174195172 225711793 663787650 0.99830 0.99870 0.00150 0.00090 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2010 AMOUNT: $ 22,500. 2011 AMOUNT: $ 109,721. 0 0 0 0 0 0 0 0 1 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: CCA PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS, A PIECE OF WHICH MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. 523264 317684 205580 1296989 752218 544771 3126773 2711414 415359 1165710 CORPORATE BONDS 11265454 F GOVERNMENT AND AGENCY BONDS 18023943 F INTERNATIONAL BONDS 2076420 F MORTGAGE AND ASSET BACKED BONDS 3585715 F 34951532 MEDICAL EXPENSE OBLIGATIONS 24924033 REFUNDABLE ADVANCES 3124617 DUE TO COMMONWEALTH CLINICAL ALLIANCE 128467 DEFERRED RENT 200252 28377369 225650140 0 225650140 0 225650140 221802103 0 221802103 0 221802103 1 HEALTH CARE FOR ALL 30 WINTER STREET SUITE 1010 BOSTON MA 02108 043071598 501(C)(3) 7500 SPONSORSHIP SUPPORT FOR THE PEOPLE - A CELEBRATION OF HEALTH CARE LEADERS. NAMI MASS 400 WEST CUMMINGS PARK SUITE 6550 WOBURN MA 01801 042777012 501(C)(3) 10000 NAMI WALKS SPONSORSHIP BAY COVE HUMAN SERVICES 66 CANAL STREET 2ND FLOOR BOSTON MA 02114 042518575 501(C)(3) 7500 SPONSORSHIP SUPPORT TO THE PEARL 2012 AND THE ELSIE FRANK WALK. BOSTON CENTER FOR INDEPENDENT LIVING 60 TEMPLE PLACE 5TH FLOOR BOSTON MA 02111 042546595 501(C)(3) 20000 CONTRIBUTION 4 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, 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 0 0 0 1 0 1 0 0 0 ROBERT J MASTER MD 265846 42916 74950 0 5000 0 11250 0 34149 0 391195 42916 0 0 LOIS S SAULS 277855 0 188686 0 2080 0 11250 0 20447 0 500318 0 0 0 EUGENE WALLACE 217282 0 117300 0 5588 0 0 0 2029 0 342199 0 0 0 JEFFERSON LETT 188275 0 92800 0 1915 0 10500 0 22246 0 315736 0 0 0 NANCY ROACH 157215 0 75000 0 683 0 10799 0 7719 0 251416 0 0 0 LISA FLEMING 199844 0 103200 0 1453 0 11250 0 20447 0 336194 0 0 0 LARRY GOTTLIEB 245505 0 0 0 2264 0 11250 0 20447 0 279466 0 0 0 JANET LEVINSON 144049 0 32469 0 1915 0 8660 0 29071 0 216164 0 0 0 BASEM SHEBLI 123120 0 33946 0 235 0 7586 0 25347 0 190234 0 0 0 ROBERT COHEN 168845 0 0 0 3875 0 8179 0 29071 0 209970 0 0 0 SHONA GIBSON 118713 0 29238 0 426 0 7060 0 21446 0 176883 0 0 0 GREG TOWNSEND 143146 0 1000 0 283 0 6154 0 22746 0 173329 0 0 0 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 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. FORM 990, PART VI, SECTION B, LINE 15 AN OUTSIDE CONSULTING FIRM WELL KNOWN FOR ITS WORK IN DEVELOPING EXECUTIVE COMPENSATION PRACTICE WAS HIRED BY THE ORGANIZATION IN 2009 TO CREATE A REASONABLE COMPENSATION PACKAGE. 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. IN ADDITION, THE FORM 990 IS AVAILABLE VIA GUIDESTAR AND THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. BOSTON'S COMMUNITY MEDICAL GROUP INC ONE BOSTON MEDICAL CTR PL SUITE 150 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 1 0 0 1 0 0 0 0 COMMONWEALTH CLINICAL ALLIANCE L 12115557 FAIR MARKET VALUE BOSTON'S COMMUNITY MEDICAL GROUP L 182305 FAIR MARKET VALUE