BAYSTATE MEDICAL PRACTICES INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
BAYSTATE MEDICAL PRACTICES INC (EIN 04-2888373)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-10
IRS object ID
201242239349300909
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)
Timestamp2012-08-10T10:33:07-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Ernst & Young LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1200 Clarendon StreetAddressLine1
CityBostonCity
StateMAState
ZIP Code02116ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042888373EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Baystate Medical Practices IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBAYSNameControl
Phone4137940000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1
CitySpringfieldCity
StateMAState
ZIP Code01199ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDennis W ChalkeName
TitleSVP Finance & TreasurerTitle
Phone4137943290Phone
Date Signed2012-08-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJeanne M SchusterName
Phone6172662000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDennis W ChalkeNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1
CitySpringfieldCity
StateMAState
ZIP Code01199ZIPCode
FieldValueIRS element (for citing)
Gross Receipts207313502GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionTo 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 Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members1NbrIndependentVotingMembers
Total Nbr Employees1494TotalNbrEmployees
Total Nbr Volunteers1TotalNbrVolunteers
Total Gross UBI379972TotalGrossUBI
Net Unrelated Business Txbl Income-166430NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year141153417ProgramServiceRevenuePriorYear
Program Service Revenue CY207309671ProgramServiceRevenueCY
Investment Income Prior Year1540InvestmentIncomePriorYear
Investment Income Current Year3831InvestmentIncomeCurrentYear
Other Revenue Prior Year7100OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year141162057TotalRevenuePriorYear
Total Revenue Current Year207313502TotalRevenueCurrentYear
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 Year120070480SalariesEtcPriorYear
Salaries Etc Current Year183877453SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year24609428OtherExpensePriorYear
Other Expenses Current Year37273564OtherExpensesCurrentYear
Total Expenses Prior Year144679908TotalExpensesPriorYear
Total Expenses Current Year221151017TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3517851RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-13837515RevenuesLessExpensesCY
Total Assets BOY25611499TotalAssetsBOY
Total Assets EOY27863501TotalAssetsEOY
Total Liabilities BOY63122719TotalLiabilitiesBOY
Total Liabilities EOY78100074TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-37511220NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-50236573NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo deliver excellent patient care, provide innovative medical education and pursue meaningful research.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense208308510Expense
Revenue206929699Revenue
DescriptionBaystate 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 Expense208308510TotalProgramServiceExpense
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 Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
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 Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096166NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1494NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members1NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
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 Policy1DocumentRetentionPolicy
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 PersonPeter Lyons Baystate Health IncNamePerson
Telephone Number4137940000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1759 Chestnut StreetAddressLine1
CitySpringfieldCity
StateMAState
ZIP Code01199ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Loring S Flint MD
Chair/Director 10/1/10-11/1/1010.00XX1511683077581
Gordon W Josephson MD
Interim Chair/ Director 11/1/10-6/15/1110.00XX431735094658
Mark A Keroack MD MPH
Chair/Director 6/15/11-9/30/1110.00XX000
Benjamin Liptzin MD
Vice Chair/Director1.00XX4788690114595
Dennis W Chalke
Treasurer/Director1.00XX564783051532
Mohammed Shafeeq Ahmed MD
Director/ CMO - Eastern Region1.00X443029052099
Jeffrey Cossin MD
Director/ Med. Dir. No. Edge Med1.00X220538082621
Wayne Duke MD
Director/ Associate Pathologist1.00X330128056329
Daniel Grow MD
Director/ Chairman Dept of Ob/Gyn1.00X467572053838
Gregory A Harb
Director 5/4-9/30/11/EVP, COO- BH1.00X000
Thomas Higgins MD
Director 1/20-9/30/11/Chair Dept Med1.00X331268017625
Mark K Hirko MD
Director/ Chief, Vascular Surgery1.00X565310057159
M Dale Janes
Director1.00X000
Hal B Jenson MD
Director 10/1/10-3/4/11/Chief Ac Off1.00X497497046780
Laura Koenigs MD
Director/ Med Dir - Adolescent Med1.00X129005051572
Harvey Lederman MD
Director 10/1/10-1/20/11/Internist1.00X134559049545
David L Longworth MD
Dir. 10/1/10-1/20/11/Chair Dept Med1.00X523345059071
Christie L Miller MD
Director/ Med Dir Pioneer Women Hlth1.00X214299045710
Michael Picchioni MD
Director/Internist1.00X192008040825
Joseph Schmidt MD
Director/Physician -ER Svs1.00X258160053355
Joseph Shin MD
Director/Chief Plastic Surgery1.00X475718033503
Scott Siege MD
Director 1/20/11-9/30/11/Med Dir ML Ped1.00X150850022898
Roy Sittig MD
Director /Internist CHMP1.00X252911044487
Mark R Tolosky
Director/ President & CEO BH1.00X16384020112208
Kristin R Delaney
Clerk1.00X92401029700
Richard B Wait MD
Chairman, Dept of Surgery50.00812133085718X
Dennis Oh MD
Neurosurgeon50.00671460050692X
Sherry Taylor MD
Chief Division Of Neurosurgery50.00662257055514X
Aaron Kugelmass MD
Chief Cardio M Dir Vascular50.00601967070248X
Mark Bean MD
Interventional Radiologist50.00578163062138X
Marc J Schweiger MD
Medical Dir Cardiac Cath Lab50.00501754095413X
FieldValueIRS element (for citing)
Total Reportable Comp From Org13731804TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation1667414TotalOtherCompensation
Number Individuals GT100 K415NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Baystate Administrative Services Inc
759 Chestnut StreetSpringfieldMA01199Management services4068157
Baystate Medical Center Inc
759 Chestnut StreetSpringfieldMA01199Patient schedule svcs & rent3900926
Radiology & Imaging Inc
1350 Main St 10th FloorSpringfieldMA011031628Physician contract services579188
Ingraham Corporation
759 Chestnut StreetSpringfieldMA01199Rent530394
Catuogno Court Reporting & Sten-Tel Tran
One Monarch Place Ste 600SpringfieldMA01144Transcription services342005
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Physician Practice Fee621110206929699206929699
BRL Gainshare900099354639354639
BMC Support9000992533325333
FieldValueIRS element (for citing)
Total Program Service Revenue207309671TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3831TotalRevenueColumn
Exclusion$3,831ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column207313502TotalRevenueColumn
Related Or Exempt Function Income206929699RelatedOrExemptFunctionIncome
Unrelated Business Revenue379972UnrelatedBusinessRevenue
Exclusion$3,831ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6307185Total
Program Services6307185ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total151183190Total
Program Services146132827ProgramServices
Management And General5050363ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8717645Total
Program Services8416482ProgramServices
Management And General301163ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total9659217Total
Program Services9334043ProgramServices
Management And General325174ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total8010216Total
Program Services7751660ProgramServices
Management And General258556ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total5138114Total
Management And General5138114ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total290989Total
Management And General290989ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total75196Total
Management And General75196ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3520513Total
Program Services3259674ProgramServices
Management And General260839ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total187435Total
Program Services178063ProgramServices
Management And General9372ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2222879Total
Program Services2058218ProgramServices
Management And General164661ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total78132Total
Program Services56740ProgramServices
Management And General21392ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4554272Total
Program Services4326558ProgramServices
Management And General227714ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total279942Total
Program Services279942ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total305966Total
Program Services290668ProgramServices
Management And General15298ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6892Total
Management And General6892ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1001389Total
Program Services951320ProgramServices
Management And General50069ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total6711102Total
Program Services6592164ProgramServices
Management And General118938ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debts45013714501371
Purchased Svcs Clerical27487622748762
Medical Supplies22645982264598
Prof'l Exp Acct18242721824272
Minor Equipment3677873645433244

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1193953Total
Program Services669420ProgramServices
Management And General524533ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total221151017Total
Program Services208308510ProgramServices
Management And General12842507ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5140408BOY
EOY2818666EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY14099095BOY
EOY15028300EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY251666BOY
EOY267375EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY350106BOY
EOY1144501EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis18876558LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec15295777LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3632498BOY
EOY3580781EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2137726BOY
EOY5023878EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY25611499BOY
EOY27863501EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY20651837BOY
EOY25451203EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY109374BOY
EOY387525EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY42361508BOY
EOY52261346EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY63122719BOY
EOY78100074EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-37511220BOY
EOY-50236573EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-37511220BOY
EOY-50236573EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY25611499BOY
EOY27863501EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-13837515ReconcilationRevenueExpenses
Reconcilation Other Changes1112162ReconcilationOtherChanges
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)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years120783166CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years127231314CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years135989036CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year140855978CurrentTaxYearMinus1Year
Current Tax Year206929699CurrentTaxYear
Total731789193Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years120783166CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years127231314CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years135989036CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year140855978CurrentTaxYearMinus1Year
Current Tax Year206929699CurrentTaxYear
Total731789193Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509731789193PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years134321CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years93647CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years46568CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8640CurrentTaxYearMinus1Year
Current Tax Year3831CurrentTaxYear
Total287007Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years134321CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years93647CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years46568CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8640CurrentTaxYearMinus1Year
Current Tax Year3831CurrentTaxYear
Total287007Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years464754CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years382925CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years309068CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year297439CurrentTaxYearMinus1Year
Current Tax Year379972CurrentTaxYear
Total1834158Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years121382241CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years127707886CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years136344672CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year141162057CurrentTaxYearMinus1Year
Current Tax Year207313502CurrentTaxYear
Total733910358Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99710PublicSupportPercentage509
Prior Year Support Percentage0.99660PriorYearSupportPercentage
Investment Income Percentage0.00040InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00060PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1103927OtherCostOrOtherBasis
Depreciation405258Depreciation
Book Value698669BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1086609OtherCostOrOtherBasis
Depreciation1076116Depreciation
Book Value10493BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis16686022OtherCostOrOtherBasis
Depreciation13814403Depreciation
Book Value2871619BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3580781TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Due from Affiliated Companies692537
Accounts Receivable, Other (net of MD loans)4331341
FieldValueIRS element (for citing)
Total Book Value Other Assets5023878TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Due to Affiliated Companies$11,133,252
Insurance IBNR Loss Reserves$6,397,108
Accrued Pension Cost$33,728,009
Line of credit, affiliate$1,002,977
FieldValueIRS element (for citing)
Total Of Amounts52261346TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
ExplanationSchedule 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

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement1EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
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 (27 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
Loring S Flint MD
9174320360152023409904836102922001589264000
Gordon W Josephson MD
3275830750300291220770000176580526393000
Benjamin Liptzin MD
3460760746000581930859570286380593464000
Dennis W Chalke
315800011322301357600233330281990616315000
Mohammed Shafeeq Ahmed MD
3381510792800255980224840296150495128000
Jeffrey Cossin MD
183601027056098810570000256210303159000
Wayne Duke MD
2509740690190101350268430294860386457000
Daniel Grow MD
3696070561750417900329950208430521410000
Thomas Higgins MD
274258033600023410000176250348893000
Mark K Hirko MD
4757020723750172330312250259340622469000
Hal B Jenson MD
35077507627907044301592503085505442770361560
Laura Koenigs MD
12221005629011660269930245790180577000
Harvey Lederman MD
920920424100570348470146980184104000
David L Longworth MD
4033960822850376640299160291550582416000
Christie L Miller MD
20661200076870200070257030260009000
Michael Picchioni MD
1873280409705830206090202160232833000
Joseph Schmidt MD
228325023955058800273320260230311515000
Joseph Shin MD
384184089627019070219150115880509221000
Scott Siege MD
1405450100000305077650151330173748000
Roy Sittig MD
236319015301012910219170225700297398000
Mark R Tolosky
6806140380604057718407303403917401750610000
Richard B Wait MD
58026501494720823960488200368980897851000
Dennis Oh MD
51098601375000229740338780168140722152000
Sherry Taylor MD
65580700064500435750119390717771000
Aaron Kugelmass MD
4946960104329029420417250285230672215000
Mark Bean MD
507073061921091690358000263380640301000
Marc J Schweiger MD
4282370225620509550700390253740597167000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Lines 4b-cMohammed Shafeeq Ahmed, MD - Supplemental Retirement of $23,789 is included in column E. This amount was earned in 2010. Dennis W. Chalke - Supplemental Retirement of $109,384 is included in column E. This amount was earned in 2010. Wayne Duke, MD - Supplemental Retirement of $7,677 is included in column E. This amount was earned in 2010. Loring S. Flint, MD - Supplemental Retirement of $142,221 is included in column E. This amount was earned in 2010. Daniel Grow, MD - Supplemental Retirement of $25,530 is included in column E. This amount was earned in 2010. Thomas Higgins, MD - Supplemental Retirement of $9,508 is included in column E. This amount was earned in 2010. Mark K. Hirko, MD - Supplemental Retirement of $15,300 is included in column E. This amount was earned in 2010. Hal B. Jenson, MD - Supplemental Retirement of $64,083 is included in column E. This amount was earned in 2010. Gordon Josephson, MD - Supplemental Retirement of $24,243 is included in column E. This amount was earned in 2010. Aaron Kugelmass, MD- Supplemental Retirement of $25,800 is included in column E. This amount was earned in 2010. Benjamin Liptzin, MD - Supplemental Retirement of $33,502 is included in column E. This amount was earned in 2010. David L. Longworth, MD- Supplemental Retirement of $33,629 is included in column E. This amount was earned in 2010. Keith C. McLean Shinaman - Supplemental Retirement of $60,038 is included in column E. This amount was earned in 2010. Dennis Oh, MD - Supplemental Retirement of $21,628 is included in column E. This amount was earned in 2010. Joseph Schmidt, MD - Supplemental Retirement of $1,456 is included in column E. This amount was earned in 2010. Marc J. Schweiger, MD - Supplemental Retirement of $43,732 is included in column E. This amount was earned in 2010. Joseph Shin, MD- Supplemental Retirement of $9,664 is included in column E. This amount was earned in 2010. Roy Sittig, MD - Supplemental Retirement of $789 is included in column E. This amount was earned in 2010. Sherry Taylor, MD Supplemental Retirement of $27,649 is included in column E. . This amount was earned in 2010. Mark R. Tolosky - Supplemental Retirement of $418,714 is included in column E. This amount was earned in 2010. Richard B. Wait, MD - Supplemental Retirement of $73,780 is included in column E. This amount was earned in 2010. 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 2010 compensation of $102,413 was based on the difference between the fair market value at the date of exercise and the exercise price.
Part IIISchedule J, Part 1, 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 II Dr. Flint terminated employment effective 12/30/2010. The compensation numbers include various one time termination payments.Supplemental Information

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
American Excess Insurance Exchange
Board Overlap1541099See 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 Officers2272041See Part V - The filing organization received payments from BHP of $ 2,130,950 for patient care services for which BHP is the intermediary between the filing organization and third party payers and $141,901 for medical services. BHP is an affiliate corporation of the filing organization.0
Baycare Health Partners Inc (BHP)
Common Board Members or Officers97800See 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 Overlap63932See 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 Officers19810887See Part V - The filing organization received payments from HNE of $19,774,709 related to medical claims, $32,082 for medical consulting services and $4,096 for patient related reimbursements. HNE is an affiliate corporation of the filing organization.0
Ingraham Corporation (IC)
Common Board Members or Officers530394See Part V - The filing organization made payments to IC for rent of medical office space. IC is an affiliate corporation of the filing organization.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 2Dennis 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 3Baystate 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 6The Board of Directors consists of 20 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 7aThe 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 7bThe 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 11Prior 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 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 12c
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 B, line 15
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 VI, Section C, line 19
Average hours per week:All individuals with compensation who have 10 average hours per week listed in Part VII, worked between 40 - 60 hours among all related entities.Form 990, Part VII, Section A, Line 1a, Column (B)
Changes in Net Assets or Fund Balances:Current year acquisition from BHF 8,657. Minimum pension liability adj -10,111,281. Transfers from/to affiliates, net 11,214,786. Total to Form 990, Part XI, Line 5: 1,112,162.Form 990, Part XI, line 5:

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