MILFORD REGIONAL PHYSICIAN GROUP INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MILFORD REGIONAL PHYSICIAN GROUP INC (EIN 04-3159969)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-14
IRS object ID
201202289349301265
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2012-08-14T14:26:41-07:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN043159969EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1TRI-COUNTY MEDICAL ASSOCIATES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlTRI-NameControl
Phone5084731480Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line19 Industrial RoadAddressLine1
Address Line2Suite 5AddressLine2
CityMilfordCity
StateMAState
ZIP Code01757ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePhilip CiaramicoliName
TitlePresidentTitle
Phone5084731480Phone
Date Signed2012-08-14DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeXAddressChange
Name Of Principal Officer PersonPhilip CiaramicoliNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line19 Industrial RoadAddressLine1
Address Line2Suite 5AddressLine2
CityMilfordCity
StateMAState
ZIP Code01757ZIPCode
FieldValueIRS element (for citing)
Gross Receipts42125053GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.TRICOUNTYMEDICAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionTRI-COUNTY MEDICAL ASSOCIATES IS A LARGE MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE WITH AN EMPHASIS ON PRIMARY CARE. OUR MISSION IS TO PROVIDE HEALTHCARE SERVICES TO ALL INDIVIDUALS IN OUR COMMUNITY WITH DIGNITY, COMPASSION AND RESPECT. THE VISION OF TRI-COUNTY MEDICAL ASSOCIATES IS TO CONSISTENTLY MEET THE CHANGING HEALTHCARE NEEDS AND EXPECTATIONS OF THE COMMUNITIES WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees381TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year39878035ProgramServiceRevenuePriorYear
Program Service Revenue CY42138316ProgramServiceRevenueCY
Investment Income Prior Year-7623InvestmentIncomePriorYear
Investment Income Current Year-13263InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year39870412TotalRevenuePriorYear
Total Revenue Current Year42125053TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year35203541SalariesEtcPriorYear
Salaries Etc Current Year36208710SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year10241081OtherExpensePriorYear
Other Expenses Current Year10806244OtherExpensesCurrentYear
Total Expenses Prior Year45444622TotalExpensesPriorYear
Total Expenses Current Year47014954TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-5574210RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-4889901RevenuesLessExpensesCY
Total Assets BOY7042343TotalAssetsBOY
Total Assets EOY6474816TotalAssetsEOY
Total Liabilities BOY5046014TotalLiabilitiesBOY
Total Liabilities EOY4896441TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1996329NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1578375NetAssetsOrFundBalancesEOY
Mission DescriptionOur primary mission at Mlford Regional Healthcare System ("MRHCS"), which includes Milford Regional Medical Center and Tri-County Medical Associates, is to provide exceptional healthcare services to all individuals in our community with dignity, compassion and respect.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense23730624Expense
Revenue24972382Revenue
DescriptionPrimary Care - Tri-County Medical Associates has 14 primary care offices servicing the 20 communities of Central Massachusetts. Guided by its mission "to provide quality healthcare services to our community with dignity, compassion, and respect", Tri-County strives to be responsive to diverse constituencies, individuals and families of all ages, employees and employers of large and small businesses, physicians and other healthcare providers. As a charitable organization, we acknowledge our special concern for the need of the un-served and the underserved, especially the poor and minority populations. Our thirty nine primary care providers concentrate in the three following disciplines: Internal Medicine, Family Medicine, and Pediatrics. Patients of Tri-County Medical Associates visited our primary care offices approximately 151,956 times in 2011. These primary care providers work in collaboration with specialists and the hospitals in our service area using a team approach to provide the best health care possible for the members of our community. Over the past several years, Tri-County Medical Associates has made significant strides in the area of healthcare technology. For more efficient, cost effective and well-coordinated care, the group has adopted an electronic medical record system and a patient portal to allow our patients to communicate with their physicians electronically. The availability of quality primary care is a priority to our organization, supports the mission of Tri-County Medical Associates Inc., and strengthens its ability to reach important strategic goals related to patient care.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense13720238Expense
Revenue13096592Revenue
DescriptionSpecialist Care - Tri-County Medical Associates has 13 specialist groups servicing the 20 communities of Central Massachusetts. The group of 22 specialists includes pulmonary and critical care, rheumatology, urology, obstetrics and gynecology, endocrinology, sleep medicine, ear nose & throat and more. Our Lung Allergy & Sleep Pulmonary & Critical Care specialists have expertise in a range of respiratory conditions including but not limited to: lung cancer diagnosis and treatment; chronic obstructive lung diseases including asthma; pulmonary vascular disease including pulmonary hypertension; respiratory failure; and lung infections. Our Rheumatologist specializes in the diagnosis and treatment of arthritis and other diseases of the muscles, joints and bones. Our Urologists perform the evaluation and treatment of diseases of the male and female urinary tract. Our Obstetrics & Gynecology providers manage pregnancy, labor and childbirth, as well as the diagnosis and treatment of diseases of the female reproductive system. Our Endocrinologist specializes in diagnosing and treating diseases that affect the endocrine system. In addition, we work closley with the diabetes program at Milford Regional Medical Center to provide a range of services to help optimize diabetes management. Our sleep Center conducts polysomnograms to diagnose various sleep disorders, the most common of which is obstructive sleep apnea. Our Ear, Nose and Throat specialists are trained in the medical and surgical treatment of the ears, nose, throat and related structures of the head and neck. As Medical Director for the Breast Center, our Surgical Breast specialist develops a multi-discriplinary team approach to all issues related to breast health and diseases. Another important specialist program, the Center for Adolescent Health, provides comprehensive and multi-disciplinary care to adolescent clients and their families on an annual basis. A new Pediatric & Behavioral Health specaialist was hired in fiscal year 2011 to support the mental health needs of our younger patients.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense6459360Expense
Revenue4069342Revenue
DescriptionInpatient Care - Tri-county Medical Associates has an active hospitalists program that serves the inpatients at Milford Regional Medical Center. Our 21 hospitalists work in collaboration with our primary care physicians to provide well coordinated care to our patients while they are hospitalized. The hospitalists can also make on-the-spot decisions about patient care, follow up on test results and modify treatment plans immediately, if necessary. They provide continuity of care, answer questions and provide emotional support to patients and their families.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense43910222TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109643NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees381NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCarman YeeNamePerson
Telephone Number5084731480TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19 Industrial RoadAddressLine1
Address Line2Suite 5AddressLine2
CityMilfordCity
StateMAState
ZIP Code01757ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Roger Calarese
Trustee1X000
Louis Bertonazzi
Trustee1X000
Catherine Burke
Co-Chairperson1X000
Albert Crimaldi
Trustee1X062500
Frederick Curley
Co-Chairperson50X4435767215024717
Tina Robakiewicz
Trustee50X248771955026682
Monica Woodward
Trustee50X2778191440024232
Philip Ciaramicoli
President50350833052917X
Sanjaya Kumar
Physician5057046710008745X
Mitchell Bamberger
Physician50434176022129X
Michael McCormick
Physician50413600292317626X
Kathleen A Richard
Physician503810234000024232X
Jane Curl
Physician503423395353524232X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3462604TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs226116TotalReportableCompFrmRltdOrgs
Total Other Compensation215512TotalOtherCompensation
Number Individuals GT100 K82NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensationAddress Line2AddressOfContractor/AddressUS/AddressLine2
UMASS Memorial Medical
55 Lake AveWorcesterMA01605Physician Services1408863
Riverside Community Care
450 Washington StreetDedhamMA02026Physician Services263000Suite 201
Brigham & Women's Physician Organization
PO Box 3684BostonMA022413684Physician Services335405
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions0AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Primary Physician Care62200024972382249723820$0
Specialty Physician Care62200013096592130965920$0
In Patient Physician Care622000406934240693420$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue42138316TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3094TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,094ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities0Securities
Other-16357Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other-16357Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-16357TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$16,357ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column42125053TotalRevenueColumn
Related Or Exempt Function Income42138316RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$13,263ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1400194Total
Program Services1008651ProgramServices
Management And General391543ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total29204451Total
Program Services27691794ProgramServices
Management And General1512657ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total425598Total
Program Services397838ProgramServices
Management And General27760ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3466571Total
Program Services3201412ProgramServices
Management And General265159ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1711896Total
Program Services1591811ProgramServices
Management And General120085ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total90560Total
Program Services85906ProgramServices
Management And General4654ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total30849Total
Management And General30849ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total15461Total
Management And General15461ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total2068824Total
Program Services1974624ProgramServices
Management And General94200ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total130397Total
Program Services96017ProgramServices
Management And General34380ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2901716Total
Program Services2809116ProgramServices
Management And General92600ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total84288Total
Program Services84288ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2135394Total
Program Services1980937ProgramServices
Management And General154457ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total44282Total
Program Services17368ProgramServices
Management And General26914ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total38995Total
Program Services38995ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1013860Total
Program Services844042ProgramServices
Management And General169818ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1081710Total
Program Services997332ProgramServices
Management And General84378ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
other expense1353275551079817
Bad Debt103458110345810

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total47014954Total
Program Services43910222ProgramServices
Management And General3104732ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY22328BOY
EOY1746EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2999025BOY
EOY2899876EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY104147BOY
EOY201022EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1030526BOY
EOY890746EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8388161LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5929537LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2800049BOY
EOY2458624EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY86268BOY
EOY22802EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7042343BOY
EOY6474816EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4163137BOY
EOY4519860EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY650654BOY
EOY221085EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY232223BOY
EOY155496EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5046014BOY
EOY4896441EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1996329BOY
EOY1578375EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1996329BOY
EOY1578375EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7042343BOY
EOY6474816EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-4889901ReconcilationRevenueExpenses
Reconcilation Other Changes4471947ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1Milford Regional Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
EIN042103602EIN
Type Of OrganizationHospitalTypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Book Value0BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1863789InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation1407511Depreciation
Book Value456278BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis6524372InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation4522026Depreciation
Book Value2002346BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2458624TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to third party payersDescription
Amount$155,496Amount
FieldValueIRS element (for citing)
Total Of Amounts155496TotalOfAmounts
Total Revenue42125053TotalRevenue
Total Expenses47014954TotalExpenses
Excess Or Deficit For Year-4889901ExcessOrDeficitForYear
Net Unrealized GL On Investments0NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS-4889901ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt42138316TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-3094NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues16357OtherRevenues
Revenue Not Rptd F99013263RevenueNotRptdF990
Revenue Subtotal42125053RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99042125053TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt47014954TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal47014954ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99047014954TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchD_P10_S00_L02Schedule D, Part X, Line 2A review has been performed of each of the organization's revenue streams in relation to FIN 48. The result of the review is that we did not generate any unrelated business income for the year ended September 30, 2011.
SchD_P12_S00_L02dSchedule D, Part XII, Line 2d- Loss on disposal of property and equipment

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org1CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Frederick Curley
4435767215000000023788929467364730790
Tina Robakiewicz
2487710000955000266820275453955000
Monica Woodward
27781914400000000240042283018231462800
Philip Ciaramicoli
310833040000000286850242320403750000
Sanjaya Kumar
570467000010000087450579212100000
Mitchell Bamberger
4341760000000221290456305000
Michael McCormick
41360029231000000762604212262923100
Kathleen A Richard
38102340000000000238473854048704038500
Jane Curl
3423395353500000023664568366003541030

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L04Schedule J, Part I, Line 4Philip Ciaramicoli $25,000
SchJ_P01_S00_L05Schedule J, Part I, Line 5The compensation model for physicians is reviewed and approved by the Board of Trustees. Compensation is based on a productivity model where the physicians are paid a fixed dollar amount for each work Related Value Unit (RVU). Work RVUs are determined by CMS (Medicare) to measure the work performed by the physician.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6The organization is governed by a Board of Trustees.
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bThe FORM 990 was provided to the Board of Trustee Compensation Committee and reviewed by them. The FORM 990 was made available to all Trustees in the Hospital's Administration Department.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cThe organization has a written code of Business Conduct which states its conflict of interest policy. A conflict of interest disclosure statement is mailed annually to members of the board of trustees and senior management. They are required to complete the form and submit it to the Corporate Compliance Officer. The forms are reviewed and monitored. The organization also has established a hotline for any staff member who may wish to discuss a potential violation of the Code, our policy or law, on an anonymous basis.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15The Compensation Committee approves all compensation plans and guidelines, as well as all compensation for the organization's senior management employees, in accordance with such plans and guidelines. The committee may consult with a nationally-recognized consultant to assist in determining that the organization's compensation structure and ranges are reasonable.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The organization makes it's governing documents, such as it's bylaws which include the organization's conflict of interest policy, available to the public through the annual filing of the Massachusetts Division of Public Charities Form PC. The Form PC is available for viewing by the public on the Massachusetts Attorney General's website and is also attached to the annual filing of the Massachusetts Form 3ABC which is submitted to town offices where the organization owns or leases property. The organization's financial statements are included in the Form PC filing.
F990_P11_S00_L05Form 990, Part XI, Line 5Transfer from Milford Regional Medical Center.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Milford Regional Medical CenterBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line114 Prospect StreetAddressLine1
CityMilfordCity
StateMAState
ZIP Code01757ZIPCode
FieldValueIRS element (for citing)
EIN042103602EIN
Primary ActivitiesHospitalPrimaryActivities
Legal Domicile StateMALegalDomicileState
Exempt Code Section501 (c) (3)ExemptCodeSection
Direct Controlling Entity NAN/ADirectControllingEntityNA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Milford Regional Medical Center
i75203
Milford Regional Medical Center
j283149
Milford Regional Medical Center
p3535999
Milford Regional Medical Center
r7800000

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