2022-08-05T11:30:46-05:00 2021-09-30 861065772 Deloitte Tax LLP Two Jericho Plaza Jericho NY 11753 990 2020-10-01 042105941 Baystate Health Inc BAYS 4137940000 759 Chestnut Street Springfield MA 01199 Raymond McCarthy SVP, Finance, CFO & Treasurer 4137940000 2022-06-15 1 Raymond McCarthy XXX-XX-XXXX Christine Kawecki P00743140 5169187000 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z Raymond McCarthy 759 Chestnut Street Springfield MA 01199 56481672 0 X www.baystatehealth.org X 1983 MA The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 18 14 0 18 2137230 1522462 24077413 10455409 13588852 18701233 1720724 837614 737473 177498 40124462 30171754 406925 465425 0 0 1593874 585834 0 0 0 32727342 31066209 34728141 32117468 5396321 -1945714 239302322 257276337 134640587 147047265 104661735 110229072 X The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. 0 0 15818528 465425 18810221 Baystate Health, Inc. (Baystate Health or BH) based in Springfield, Massachusetts is the parent corporation of an integrated health care delivery system with the mission "to improve the health of the people in our community every day, with quality and compassion."BH provides funding for strategic initiatives, as necessary, funding for research & education initiatives and support of community health, development, and outreach activities, mostly funded by BH board-designated funds. Public Health Institute of Western Massachusetts, formerly Partners for a Healthier Community, is the primary recipient of BH support.Baystate Health currently includes the following:Baystate Medical Center (BMC), located in Springfield, Massachusetts, is the largest of the four hospitals in the Baystate Health system. BMC, the leading health facility in western Massachusetts, is the only tertiary care referral medical center and Level I trauma center in the region. It is also home to western New England's only neonatal and pediatric intensive care units. BMC is a 746-bed, tax exempt, not-for-profit, academic teaching hospital.Baystate Franklin Medical Center (BFMC), located in Greenfield, Massachusetts, is a 89-bed, tax exempt, not-for-profit, acute care community hospital. BFMC serves the northern tier of northwestern Massachusetts and southern Vermont.Baystate Wing Hospital Corporation (BWH), located in Palmer, Massachusetts, is a 68-bed, tax-exempt, not-for-profit, acute care community hospital.Baystate Total Home Care, Inc. (BTHC), located in Springfield, Massachusetts, is a tax exempt, not-for-profit corporation organized to benefit, support and further the charitable activities of BMC.Baystate Noble Hospital, Inc. (BNH), located in Westfield, Massachusetts, is a 85-bed tax-exempt, not-for-profit acute care community hospital. BNH provides inpatient, outpatient and emergency care services for residents in the greater Westfield community. Baystate Medical Practices, Inc. (BMP) is a multi-specialty academic group practice established as a tax exempt, not-for-profit organization to support the educational and research programs of Baystate Health as well as numerous community primary care and outreach services.Visiting Nurse Association and Hospice of Western New England, Inc. (BVNAH) is a tax exempt, not-for-profit organization that provides comprehensive home health care committed to providing the highest quality care to patients and families, primarily in the home setting. BVNAH meets individual needs by bringing experienced nurses, rehabilitation therapists, social workers, and home care aides to patients' homes.Health New England, Inc. (HNE) is a tax exempt, not-for-profit health maintenance organization. It is located in Springfield, Massachusetts. HNE's service area in Massachusetts includes Franklin, Berkshire, Hampden and Hampshire counties and part of Worcester county. HNE also serves Hartford, Litchfield and Tolland counties in Connecticut.Baystate Administrative Services, Inc. (BAS) is a tax exempt, not-for-profit corporation that provides management support for the BH subsidiaries, including human resources, marketing, strategic planning, information services and financial services.Baystate Health Foundation, Inc. (BHF) is a tax exempt, charitable organization established for the purpose of fund-raising for healthcare related activities, in support, and for the benefit, of BH and those subsidiaries of BH that are tax exempt, not-for-profit corporations, and to hold endowment, charitable donations, and other funds for their benefit.Ingraham Corporation (IC) is a for-profit, taxable corporation whose main purpose is facility support services.Baystate Health Insurance Company, Ltd. (BHIC) is a captive insurance company organized and licensed in the Cayman Islands, British West Indies. BHIC provides professional liability and other insurance coverage to BH and its corporate affiliates and their employees. BHIC also offers malpractice insurance to members of BH's medical staff who meet criteria for participation. 15818528 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 1 0 0 1 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 1 0 1 39 0 1 0 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 18 14 1 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 1 1 1 CA FL GA IL MA NC NY OR X Laurie Martin Baystate Health Inc 4137940000 759 Chestnut Street Springfield MA 01199 X Mark A Keroack MD President, CEO & Trustee 35.00 15.00 X X 0 2511656 39342 Kevin P Moriarty MD Trustee/Chief Ped Surgery 1.00 49.00 X 713152 0 39464 Akinyele K Lovelace Do Trustee/ Per Diem Internist 1.00 49.00 X 56330 0 845 Robert J Bacon Chair 2.00 5.00 X X 0 0 0 Adrian J Levsky Trustee (Thru 3/31/21) 1.00 4.00 X 0 0 0 Anne M Paradis Trustee (Thru 12/31/20) 2.00 4.00 X 0 0 0 Claudia R Coplein Do Trustee 1.00 4.00 X 0 0 0 Colleen W Holmes Trustee 1.00 4.00 X 0 0 0 Denise R Jordan Trustee 1.00 4.00 X 0 0 0 Edward J Noonan Trustee 1.00 4.00 X 0 0 0 Gregory L Braden MD Trustee 1.00 4.00 X 0 0 0 Harriet A Deverry Vice Chair/Trustee 1.00 5.00 X 0 0 0 Hector F Toledo Trustee (Thru 12/31/20) 1.00 5.00 X 0 0 0 Irene Rodriguez Martin Trustee 1.00 4.00 X 0 0 0 James R Phaneuf Trustee 1.00 4.00 X 0 0 0 John F Maybury Trustee 2.00 5.00 X 0 0 0 Kathleen B Scoble Trustee 1.00 5.00 X 0 0 0 Maria P Goncalves Trustee 1.00 6.00 X 0 0 0 Paul C Picknelly Trustee 1.00 4.00 X 0 0 0 Paul R Murphy Trustee 1.00 4.00 X 0 0 0 William R Webber Trustee 1.00 4.00 X 0 0 0 Raymond McCarthy SVP, Finance, CFO & Treasurer 10.00 40.00 X 0 668402 25713 Kristin R Delaney Clerk 34.00 16.00 X 0 168346 40493 Nancy Remillard Assistant Clerk 1.00 49.00 X 0 60003 11278 Dennis W Chalke Former Treasurer 0.00 0.00 X 0 898889 76373 769482 4307296 233508 0 1 1 1 Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 Management Services 2059152 Oliver Wyman Inc 1166 6th Avenue New York NY 10036 Strategic Consulting Services 1610000 Third River Partners LLC 6955 Thomas Blvd Pittsburgh PA 15208 Management Consulting Services 330079 Birdsall Voss & Associates Inc 250 W Coventry Court Suite 300 Milwaukee WI 53217 Consulting / Advertising Services 287013 Kyruus Inc 18 Tremont Street Suite 320 Boston MA 02108 Software Consulting Services 284870 9 10276808 178601 10455409 Subpart F Inc-Captive 525990 13986891 13986891 Premier Invest Income 525990 2044904 2044904 BHIC E&P UBIT 525990 1461345 1461345 MD Dues/Fees 621110 616771 616771 CPIP Admin Revenue 524298 305000 305000 286322 286322 18701233 628751 370885 257866 223 223 26518781 26309918 208863 208863 208863 Fed. Tax Ref. & Res. A 621110 93740 93740 Loans-Principal Pmts 561499 68064 68064 MA State Tax Refund 621110 15248 15248 223 223 177275 30171754 3056985 2137230 14522130 X 465425 465425 585834 585834 166072 166072 31491 31491 354000 354000 58739 58739 3611806 3611806 11667 11667 56834 1762 55072 59181 59181 10540 10540 27095 10383 16712 273639 273639 2543733 1925554 618179 3906 3906 40531 40531 Federal Tax Provision 205305 205305 457b Pension Plan Expen 14509311 14509311 Strategic Initiatives 8252010 8252010 Membership Dues/Fees 303504 303504 546845 530366 16479 32117468 15818528 16298940 0 12270586 11798473 267576 308826 23614717 20558643 348445 289114 68381 59331 17804550 25133441 132539032 144027119 4132000 4132000 48605480 51258504 239302322 257276337 1946378 1784398 1434760 1848997 31725011 30767780 99534438 112646090 134640587 147047265 X 72755931 74668178 31905804 35560894 104661735 110229072 239302322 257276337 X -1945714 23317166 -15804115 X 0 1 X 1 0 X 11468715 15863186 19117934 24077413 10455409 80982657 11468715 15863186 19117934 24077413 10455409 80982657 80982657 1384810 1412504 1670583 1408932 258089 6134918 110186 187625 731263 1552249 2581323 71455 1051263 1468232 708686 177275 3476911 93175809 43551863 0.86910 0.86140 X Schedule A, Part II, Line 10, Explanation of Other Income: Other Income - 2016 Amount: $ 71,455. 2017 Amount: $ 1,051,263. 2018 Amount: $ 1,468,232. 2019 Amount: $ 708,686. 2020 Amount: $ 177,275. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 354000 354000 0 Part II-B, Line 1: BH paid Rauschenbach Associates for lobbying activities related to healthcare policy, bills and appropriations-related activities. BH paid Philip W. Johnston Associates, Capitol Counsel, LLC, Buoniconti & McCary, LLC and Brian P. Lees for technical and strategic advisory services including public advocacy and interpretation of proposed and actual program and legislative changes. 21989215 113781 4093512 26196508 21660762 89825 238628 21989215 21985078 84917 -409233 21660762 21340210 98063 546805 21985078 19873475 93080 1373655 21340210 1.00000 0 1 1 59124 59124 233233 233233 0 18589 18382 207 37499 37499 0 59331 457b plan Assets 88590836 F Investments - Other Securities 5329916 C Investment in Unconsolidated Affiliates 1334298 C Investment in Subsidiaries (Ingraham, Wing and Noble) 48772069 C 144027119 Due from Affiliated Companies 2426525 Affiliate Line of Credit 20250000 Interest in Net Assets of BHF 28581979 51258504 76392 Due to Affiliated Companies 3551568 Due To Board-Designated Funds 1314467 Insurance Reserves 19112827 Deferred Compensation Obligations 88590836 112646090 Part V, Line 4 Endowment assets are to provide funding to support programs that further Baystate Health's mission. Central America and the Caribbean 0 0 Insurance 25230996 Europe (Including Iceland & Greenland) 0 0 Investments 53623899 Central America and the Caribbean 0 0 Investments 17052397 0 0 0 0 0 0 95907292 0 95907292 1 0 1 1 1 0 Part I, line 3: Actual cash transfers for unrelated insurance activity and market value for investment capital balances Part III Accounting Method: Part I, Line 3 Expenditures of $25,230,996 in the Caribbean are comprised of insurance related cash transfers of $25,110,996 and Baystate Health's book value of the $120,000 BHIC investment. 1 Public Health Institute of Western Massachusetts PO Box 4895 Springfield MA 011014895 043342182 501(c)(3) 250000 To assist the Public Health Institute of Western Massachusetts, formerly Partners for a Healthier Community, in narrowing the gap in health disparities for some of Springfield's most vulnerable citizens, and to be a source of support for building civic leaders, creating strategies for change, and promoting policy actions to create healthier communities. Baystate Health Foundation Inc 759 Chestnut Street Springfield MA 01199 043549011 501(c)(3) 123334 To support the Health Science Library and wellness of practicing MDs and other medical staff. Massachusetts Health Policy Forum 415 South Street MS 126 Waltham MA 024549110 042103552 501(c)(3) 30000 To improve health and the health care system in the Commonwealth of MA by convening forums and presenting the highest quality research to legislators, stakeholders and the public. Health Resources in Action Inc 2 Boylston Street 4th Floor Boston MA 02116 042229839 501(c)(3) 20000 To advance public health and medical research by developing programs. The organization collaborates with others to resolve public health issues through policy, research, prevention and health promotion. Physician Health Services Inc 860 Winter Street Waltham MA 024511414 223234975 501(c)(3) 7500 To address issues of physician health, including stress, burnout, work-life balance issues and a variety of physical and behavioral health concerns. 5 0 Part I, Line 2: Grantees are selected that promote or support healthcare advancement objectives and community revitalization. Proposed candidates go through a management approval process. Part II, Line 1, Column (h) Baystate Health, Inc. maintains a close relationship with its grantees, which include Baystate Health Foundation, Inc. (BHF) and Baystate Medical Center, Inc. (BMC). Through this close relationship, management is able to ensure the granted money is used for the intended purposes. For BHF, funds are accounted for and monitored in individual temporarily restricted purpose funds in accordance with the restrictions. Fund administrators of the related entity are assigned responsibility to assure that the fund purpose is met before releasing from restrictions. X X X X 0 1 0 0 0 0 0 0 0 Mark A Keroack MD President, CEO & Trustee 0 1425333 0 677350 0 408973 0 12825 0 26517 0 2550998 0 0 Dennis W Chalke Former Treasurer 0 406832 0 175603 0 316454 0 58691 0 17682 0 975262 0 0 Kevin P Moriarty MD Trustee/Chief Ped Surgery 569741 0 93081 0 50330 0 24225 0 15239 0 752616 0 0 0 Raymond McCarthy SVP, Finance, CFO & Treasurer 0 487508 0 154214 0 26680 0 21375 0 4338 0 694115 0 0 Kristin R Delaney Clerk 0 151161 0 16435 0 750 0 15836 0 24657 0 208839 0 0 Part I, Line 3 The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO 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 duly authorized compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously. Part I, Line 4b Dennis W. Chalke - Supplemental Retirement of $146,809 is included in column B. This amount was earned and paid in 2020. Mark A. Keroack, MD Supplemental Retirement of $363,205 is included in column B. This amount was earned in 2020. Kevin P. Moriarty, MD - Supplemental Retirement of $24,072 is included in column B. This amount was earned and paid in 2020. Raymond McCarthy - Supplemental Retirement of $187 is included in column B. This amount was earned in 2020. Form 990, Part VI, Section A, line 1 The filing organization has a standing executive committee, which is entitled to act between meetings of the Board, on all matters as to which the Board is entitled to act and permitted by law to delegate to a committee. Form 990, Part VI, Section A, line 2 Two or more of the persons listed in this Form 990 Part VII have a business relationship with each other by virtue of sitting on one or more Boards of Directors or by serving in an employment relationship with one or more entities in the Baystate Group of affiliated entities and in the community. The following trustees, officers, or key employees have a business relationship: (1) Anne M. Paradis, Mark A. Keroack, MD and Paul R. Murphy (2) John F. Maybury and Mark A. Keroack, MD. Form 990, Part VI, Section A, line 3 Baystate Health, Inc is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c)(3) organization. Information Technology, Human Resources, Finance, Treasury, Accounting and other management and support functions are delegated to BAS. Form 990, Part VI, Section A, line 7a Two of the Trustees of the filing organization are required to be members of the Board of Directors of Baystate Wing Hospital Corporation (BWH), an affiliated organization, and their election is subject to approval by the Board of Directors of BWH. Form 990, Part VI, Section B, line 11b Prior to filing the Form 990, appropriate sections were reviewed by the Tax, Finance, and Human Resources areas of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) and by outside legal counsel.The Form 990 was also reviewed by tax experts from an independent accounting firm and signed-off as a paid preparer.The process, key areas and any new changes were reviewed prior to filing with the Baystate Health Audit and Compliance Committee (ACC), which is composed of trustees of the filing organization. The ACC members had an opportunity to ask questions regarding the tax compliance process and the tax filings in general. The Form 990 was provided to all members of the Baystate Health Board of Trustees prior to filing. Form 990, Part VI, Section B, line 12c Baystate Health, Inc. (BH) and its affiliated entities have a comprehensive conflict of interest policy applicable to all of the affiliated entities. 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 Chief Compliance Officer, Chief Executive Officer, Chair of the Board of Trustees, Chief General Counsel and the Chair of the Audit & Compliance Committee. A summary of the conflict of interest disclosures is provided to the Baystate Health Board of Trustees and the Tax Department. 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 15b The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. This committee consists entirely of individuals serving on the board of the filing organization. The individuals responsible for deliberating the compensation arrangement for the President and CEO would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the President and CEO 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 duly authorized compensation committee. The compensation of the Senior Vice President, Finance, CFO and Treasurer is reviewed and determined annually by the compensation committee of Baystate Health, Inc. This committee consists entirely of individuals serving on the board of Baystate Health, Inc. The individuals responsible for deliberating the compensation arrangement for the Senior Vice President, Finance, CFO and Treasurer and of other officers would be those individuals who do not have a conflict of interest with respect to the compensation arrangement and would be considered independent for compensation deliberation purposes. The compensation of the Senior Vice President, Finance, CFO and Treasurer 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 duly authorized compensation committee of Baystate Health, Inc. The compensation of other officers of the filing organization is determined by the President of the filing organization in accordance with the Executive Compensation Philosophy Statement, in consultation with Human Resources, based on information provided by independent third party consultants for reasonableness including appropriate comparability data or the Baystate Health Board approved budget and wage program for each fiscal year. Line 15a has been answered No because the President and CEO is paid by Baystate Administrative Services, Inc., an affiliate and related organization of the filing organization. Form 990, Part VI, Section B, Line 16b: Baystate Health, Inc. has a joint venture policy. 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 Medical Practices, Inc. (BMP) EIN 04-2888373, which is part of the health care system to which the filing organization belongs but does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BMP 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 IX, line 11g Consulting Services: Program service expenses 3,611,806. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,611,806. Form 990, Part XI, line 9: Equity Gain / (Loss) in Baycare -632,856. Equity Gain / (Loss) in Ingraham 385,143. Equity Gain / (Loss) in Shields -105,164. BHIC UBTI - prelim -1,461,345. Subpart F Income from Captive Insurance Company -13,986,891. Net Assets Released from Restrictions - BHF -3,002. Baystate Administrative Services Inc 759 Chestnut Street Springfield MA 01199 222747685 Administrative services MA 501(c)(3) 12C, III-FI Baystate Health Inc 1 Baystate Franklin Medical Center 164 High Street Greenfield MA 01301 042103575 Hospital MA 501(c)(3) 3 Baystate Health Inc 1 Baystate Health Foundation Inc 759 Chestnut Street Springfield MA 01199 043549011 Fundraising MA 501(c)(3) 7 Baystate Health Inc 1 Baystate Health Systems Inc Health & Welfare Benefits Plan 759 Chestnut Street Springfield MA 01199 222531644 Voluntary Employees' Benefit Association MA 501(c)(9) Baystate Health Inc 1 Baystate Medical Center Inc 759 Chestnut Street Springfield MA 01199 042790311 Acute Care Teaching Hospital MA 501(c)(3) 3 Baystate Health Inc 1 Baystate Noble Hospital Corporation 115 West Silver Street Westfield MA 010861634 222537423 Hospital MA 501(c)(3) 3 Baystate Health Inc 1 Baystate Total Home Care Inc 280 Chestnut Street Springfield MA 01104 203260764 Real Estate and Other MA 501(c)(3) 12B, II Baystate Medical Center Inc 1 Baystate Wing Hospital Corporation 40 Wright Street Palmer MA 01069 222519813 Hospital MA 501(c)(3) 3 Baystate Health Inc 1 Health New England Inc Monarch Place Suite 1500 Springfield MA 01199 042864973 HMO/Insurance MA 501(c)(4) Baystate Health Inc 1 HNE of Connecticut Inc Monarch Place Suite 1500 Springfield MA 01199 465190134 HMO/Insurance CT 501(c)(4) Health New England Inc 1 Visiting Nurse Assn & Hospice of Western New England Inc 30 Capital Drive Suite A West Springfield MA 01089 042105803 Home Health and Hospice Care MA 501(c)(3) 10 Baystate Health Inc 1 Baystate Health Urgent Care LLC 700 Congress Street Suite 204 Quincy MA 02169 384059312 Urgent healthcare facility MA Baystate Health Inc Related -206257 515318 0 0 0.61480 Baystate Health Insurance Company Ltd North Church Street Georgetown CJ 980421413 Offshore Captive Insurance CJ Baystate Health Inc C 39727227 174683733 1.00000 1 HNE Advisory Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043012347 Administrative Services MA HNE Holding Corporation C 1 HNE Holding Corporation Monarch Place Suite 1500 Springfield MA 011441500 464620480 Holding shares in subsidiary corporations MA Health New England Inc C 1 HNE Insurance Company Inc Monarch Place Suite 1500 Springfield MA 011441500 454462433 Health Insurance Services for MA Medicare Supplement Members MA HNE Holding Corporation C 1 HNE Insurance Services Inc Monarch Place Suite 1500 Springfield MA 011441500 043183019 Ancillary Insurance MA HNE Holding Corporation C 1 Ingraham Corporation 759 Chestnut Street Springfield MA 01199 043016257 Health care and other business activities MA Baystate Health Inc C 700373 5071124 1.00000 1 1 1 1 1 0 0 0 0 0 0 1 1 1 0 0 1 0 1 1 Baystate Medical Center Inc C 9495000 Baystate Medical Center Inc K 277197 Baystate Medical Center Inc M 651932 Baystate Medical Center Inc S 63525000 Baystate Franklin Medical Center S 1500000 Baystate Noble Hospital Corporation R 4525000 Baystate Administrative Services Inc M 2129664 Baystate Health Foundation Inc B 65000 Baystate Health Foundation Inc M 483489 Baystate Health Foundation Inc S 1052691 Baystate Health Insurance Company Ltd P 3548292 Health New England Inc D 158394