2017-11-15T16:03:46-06:00 2016-12-31 420714325 RSM US LLP 80 CITY SQUARE BOSTON MA 021293742 990 2016-01-01 043756900 COMMONWEALTH CARE ALLIANCE INC COMM 6174260600 30 WINTER STREET BOSTON MA 02108 ERIC PRICE CFO 6174260600 2017-11-15 1 LYNNE JOHNSON P00757336 6179129000 108.171.131.189 2017-11-15 16:32:40 ES P 797C4527DD8FA635CA18458D5F36AC81F3168434 808B1D28703E5C3EA38D0C6AFAC88E3156F3957D 2016 2017-02-10 21:41:12Z CHRISTOPHER PALMIERI 30 WINTER STREET BOSTON MA 02108 833898865 0 X WWW.COMMONWEALTHCARE.ORG X 2003 MA COMMONWEALTH CARE ALLIANCE INC.'S MISSION IS TO PROVIDE THE BEST POSSIBLE CARE TAILORED TO THE INDIVIDUAL'S NEEDS OF MEDICARE AND MEDICAID BENEFICIARIES THROUGHOUT THE COMMONWEALTH OF MASSACHUSETTS BY BRINGING TO SCALE PROVEN CLINICAL CARE STRATEGIES THAT IMPROVE THE CARE AND MANAGE COST. 11 11 969 16 0 0 0 5150 762435569 833783707 302515 100258 0 9750 762738084 833898865 62875 81925 0 0 38148864 40168923 0 0 0 713243546 766749166 751455285 807000014 11282799 26898851 175417209 218197004 131905847 169610627 43511362 48586377 X COMMONWEALTH CARE ALLIANCE INC.'S MISSION IS TO PROVIDE THE BEST POSSIBLE CARE TAILORED TO THE INDIVIDUAL'S NEEDS OF MEDICARE AND MEDICAID BENEFICIARIES THROUGHOUT THE COMMONWEALTH OF MASSACHUSETTS BY BRINGING TO SCALE PROVEN CLINICAL CARE STRATEGIES THAT IMPROVE THE CARE AND MANAGE COST. 0 0 725160476 81925 833793457 COMMONWEALTH CARE ALLIANCE (CCA) HAS CONTRACTED WITH COMMUNITY BASED HEALTHCARE PRACTICES THAT HAVE DEMOSTRATED EXPERIENCE SERVING ADULTS IN A MANAGED FRAMEWORK. AS AN EXAMPLE OF THESE PRIMARY CARE SITES INCLUDING AFFILIATED PHYSICIANS GROUP OF JAMAICA PLAIN, BOSTON UNIVERSITY GERIATRICS, BOSTON'S COMMUNITY MEDICAL GROUP, BRIGHTWOOD HEALTH SERVICES, CAMBRIDGE HEALTH ALLIANCE, EAST BOSTON HEALTH CENTER, ELDER SERVICE PLAN OF THE NORTH SHORE, HARBOR HEALTH SERVICE, UPHAM'S CORNER HEALTH CENTER. CCA IS ONE OF MASSACHUSETTS SENIOR CARE OPTION OR "SCO ORGANIZATIONS: THE SCO PROGRAM IS A COMPREHENSIVE HEALTH PLAN THAT COVERS ALL SERVICES REIMBURSABLE UNDER A DELIVERY SYSTEM AND ITS PREFERRED NETWORK OF PROVIDERS TO MEDICARE AND MEDICAID BENEFICIARIES. CCA IS ALSO ONE OF TWO ONE CARE ORGANIZATIONS IN THE COMMONWEALTH. 725160476 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 3457 0 1 969 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X ERIC PRICE CFO 6174260600 30 WINTER STREET BOSTON MA 02108 DEAN RICHLIN BOARD CHAIR/DIRECTOR 6.00 4.00 X 0 0 0 ALAN LONG DIRECTOR 3.00 2.00 X 0 0 0 CAROL RAPHAEL DIRECTOR 3.00 2.00 X 0 0 0 CHRIS KOLLER DIRECTOR 3.00 2.00 X 0 0 0 IRA GOTTLIEB DIRECTOR 3.00 2.00 X 0 0 0 LEN FISHMAN DIRECTOR 3.00 2.00 X 0 0 0 LISA IEZZONI DIRECTOR 3.00 2.00 X 0 0 0 MARK REYNOLDS DIRECTOR 3.00 2.00 X 0 0 0 NANCY TURNBULL DIRECTOR 3.00 2.00 X 0 0 0 ROB RESTUCCIA DIRECTOR 3.00 2.00 X 0 0 0 TOM LYNCH DIRECTOR 3.00 2.00 X 0 0 0 DAVID MARGULIES DIRECTOR (UNTIL SEPT. 2016) 3.00 0.00 X 0 0 0 FRANCES HUBBARD DIRECTOR (UNTIL JAN. 2016) 3.00 0.00 X 0 0 0 MARY LOU MALONEY DIRECTOR (UNTIL DEC. 2016) 3.00 0.00 X 0 0 0 PHILIP THOMPSON DIRECTOR (UNTIL JAN. 2016) 3.00 0.00 X 0 0 0 SERGIO GONCALVES DIRECTOR (UNTIL DEC. 2016) 3.00 0.00 X 0 0 0 SCOTT MIYAKE DIRECTOR (UNTIL JUL. 2016) 3.00 0.00 X 0 0 0 JEFFREY SCAVRON MD DIRECTOR (UNTIL OCT. 2016) 3.00 2.00 X 0 0 0 CHRISTOPHER PALMIERI PRESIDENT & CEO 20.00 20.00 X 655057 0 22609 ERIC PRICE CFO/TREASURER 30.00 10.00 X 157328 0 17862 CINDY NGUYEN CFO (UNTIL SEPT. 2016) 30.00 10.00 X 342189 0 9081 COURTNEY MURPHY COO 40.00 0.00 X 226539 0 19553 NANCY ROACH COO (UNTIL MAR. 2016) 40.00 0.00 X 298408 0 3427 LISA FLEMING GENERAL COUNSEL/SECRETARY & CLERK 30.00 10.00 X 402355 0 41603 LAWRENCE GOTTLIEB VICE PRESIDENT 40.00 0.00 X 374590 0 46830 JOHN LOUGHNANE CMO 40.00 0.00 X 335751 0 16899 OLUWATOYIN AJAYI DOCTOR 40.00 0.00 X 379535 0 26562 MARY GLOVER DIRECTOR (UNTIL MAR. 2016) 10.00 30.00 X 312555 0 3316 PEGGY JOHNSON DOCTOR 40.00 0.00 X 303344 0 23000 VIRGIL PEREZ DIRECTOR (UNTIL MAY 2016) 40.00 0.00 X 270070 0 18610 MIRIAM MANNING DIRECTOR 40.00 0.00 X 248714 0 53187 LOIS SAULS FORMER PRESIDENT 40.00 0.00 X 332724 0 5701 ROBERT MASTER FORMER CEO/CURRENT PHYSICIAN EMPLOYEE 40.00 0.00 X 210476 0 29517 LEANNE BERGE FORMER VICE PRESIDENT 0.00 0.00 X 129404 0 0 4979039 0 337757 132 1 1 0 NAVITUS HEALTH SOLUTIONS 2601 WEST BELTLINE HIGHWAY MADISON WI 53713 MEDICAL SUPPORT 128775018 BAYSTATE MEDICAL CENTER 795 CHESTNUT STREET SPRINGFIELD MA 01199 MEDICAL SUPPORT 34548918 BOSTON MEDICAL CENTER PO BOX 845235 BOSTON MA 02284 MEDICAL SUPPORT 22252242 STAVROS CENTER FOR INDEPENDENT LIVING0 210 OLD FARM ROAD AMHERST MA 01004 MEDICAL SUPPORT 20639403 CAMBRIDGE PUBLIC HEALTH COMMISSION PO BOX 847438 BOSTON MA 02284 MEDICAL SUPPORT 15623411 552 5150 5150 ENROLLEE FEES 621300 833174983 833174983 GRANT REVENUE 900099 608724 608724 833783707 100258 100258 MISCELLANEOUS 900099 9750 9750 9750 833898865 833793457 0 100258 81925 81925 2970081 2970081 29835080 29835080 639794 639794 4312505 4312505 2411463 2411463 191908 191908 416093 416093 18781 18781 11522514 11522514 1878289 1878289 1022204 1022204 10150895 10150895 3355217 3355217 266266 266266 276122 276122 100057 100057 1736591 1736591 520057 520057 MEDICAL EXPENSES 569530854 569530854 CAPITATION EXPENSES 155547697 155547697 CLAIMS ADJUDICATION 8696937 8696937 DUES & SUBSCRIPTIONS 522253 522253 996431 996431 807000014 725160476 81839538 0 36372196 118152504 55175711 65218536 45588299 18022053 1670615 1689060 16524498 9567730 7072064 6956768 29538324 8158083 175417209 218197004 12639021 13282141 100000 119166826 156328486 131905847 169610627 X 43511362 48586377 43511362 48586377 175417209 218197004 X 26898851 6 -21823842 X 0 1 X 1 1 1 X 5150 5150 224867049 297069494 585654491 762435569 833793457 2703820060 224867049 297069494 585654491 762435569 833798607 2703825210 5000 5000 0 5000 5000 2703820210 844744 806116 -296021 -319060 100258 1136037 844744 806116 -296021 -319060 100258 1136037 225711793 297875610 585358470 762116509 833898865 2704961247 0.99960 0.99940 0.00040 0.00050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 0 0 PART II-B, LINE 1: CCA PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS, A PIECE OF WHICH MAY BE USED BY SUCH ORGANIZATIONS FOR FEDERAL LOBBYING ACTIVITIES ON BEHALF OF CCA AND OTHER SIMILARLY SITUATED ORGANIZATIONS. 269083 269083 2891658 142111 2749547 1163798 656294 507504 4041933 2906487 1135446 8158026 5862838 2295188 6956768 MEDICAL EXPENSE OBLIGATIONS 110861708 REFUNDABLE ADVANCES 40425556 DEFERRED RENT 958088 DEFERRED FUNDRAISING 376762 CAPITAL LEASE OBLIGATION PAYABLE 3017698 OTHER LIABILITIES 688674 156328486 X 833898865 0 833898865 0 833898865 807000014 0 807000014 0 807000014 PART X, LINE 2: THE ORGANIZATION IS REQUIRED TO ASSESS UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT THERE WERE NO SUCH POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. 1 NAMI MASS 529 MAIN ST SUITE 1M17 BOSTON MA 02129 042777012 501(C)(3) 5000 HOST SPONSORSHIP BOSTON CENTER FOR INDEPENDENT LIVING 60 TEMPLE PLACE 5TH FLOOR BOSTON MA 02111 042546595 501(C)(3) 20000 HOST SPONSORSHIP MEDICARE RIGHTS CENTER 266 W 37TH STREET NEW YORK NY 10018 133505372 501(C)(3) 15000 HOST SPONSORSHIP EAST BOSTON NEIGHBORHOOD HEALTH CENTER 10 GROVE ST EAST BOSTON MA 02128 237425849 501(C)(3) 5000 HOST SPONSORSHIP HEALTH LAW ADVOCATES 1 FEDERAL STREET 5TH FLOOR BOSTON MA 02110 043298116 501(C)(3) 5000 HOST SPONSORSHIP 5 0 PART I, LINE 2: THE ORGANIZATION PROVIDES GRANTS AND SUPPORT TO OTHER HUMAN SERVICE ORGANIZATIONS AND ORGANIZATIONS WITH SIMILAR MISSIONS. THE GOVERNING BODY AND TOP MANAGEMENT OFFICIALS MAKE DECISIONS OF THE SUPPORT AND MAINTAIN RECORDS TO SUBSTANTIATE THE AMOUNT OF GRANT AND ASSISTANCE TO THESE ORGANIZATIONS. X 0 1 X X X X 1 0 0 0 0 0 0 1 0 CHRISTOPHER PALMIERI PRESIDENT & CEO 606397 0 0 0 48660 0 6742 0 15867 0 677666 0 0 0 ERIC PRICE CFO/TREASURER 139901 0 0 0 17427 0 0 0 17862 0 175190 0 0 0 CINDY NGUYEN CFO (UNTIL SEPT. 2016) 232459 0 44000 0 65730 0 0 0 9081 0 351270 0 0 0 COURTNEY MURPHY COO 226133 0 0 0 406 0 0 0 19553 0 246092 0 0 0 NANCY ROACH COO (UNTIL MAR. 2016) 106704 0 0 0 191704 0 0 0 3427 0 301835 0 0 0 LISA FLEMING GENERAL COUNSEL/SECRETARY & CLERK 339474 0 60162 0 2719 0 11925 0 29678 0 443958 0 0 0 LAWRENCE GOTTLIEB VICE PRESIDENT 300873 0 69525 0 4192 0 11925 0 34905 0 421420 0 0 0 JOHN LOUGHNANE CMO 280335 0 54000 0 1416 0 11925 0 4974 0 352650 0 0 0 OLUWATOYIN AJAYI DOCTOR 332341 0 46656 0 538 0 11925 0 14637 0 406097 0 0 0 MARY GLOVER DIRECTOR (UNTIL MAR. 2016) 118203 0 0 0 194352 0 0 0 3316 0 315871 0 0 0 PEGGY JOHNSON DOCTOR 241929 0 59204 0 2211 0 11925 0 11075 0 326344 0 0 0 VIRGIL PEREZ DIRECTOR (UNTIL MAY 2016) 125800 0 41200 0 103070 0 0 0 18610 0 288680 0 0 0 MIRIAM MANNING DIRECTOR 201040 0 47000 0 674 0 10206 0 42981 0 301901 0 0 0 LOIS SAULS FORMER PRESIDENT 99510 0 0 0 233214 0 0 0 5701 0 338425 0 0 0 ROBERT MASTER FORMER CEO/CURRENT PHYSICIAN EMPLOYE 59976 0 150500 0 0 0 0 0 29517 0 239993 0 0 0 LEANNE BERGE FORMER VICE PRESIDENT 8379 0 0 0 121025 0 0 0 0 0 129404 0 0 0 PART I, LINE 1A THE ORGANIZATION HAS PROVIDED HOUSING ALLOWANCES TO CHRISTOPHER PALMIERI, PRESIDENT & CEO ($48,000) AND ERIC PRICE, CFO ($16,335). BOTH AMOUNTS ARE TAXABLE AND THEY HAVE BEEN REPORTED ON THEIR W-2S. PART I, LINE 3 THE PROVISION OF HOUSING ALLOWANCES ARE CONTAINED IN THE INDIVIDUALS' EMPLOYMENT CONTRACTS. PART I, LINE 4A IN 2016, FOLLOWING A MANAGEMENT RESTRUCTURING, THE FOLLOWING MEMBERS OF SENIOR MANAGEMENT WERE TERMINATED FROM THE ORGANIZATION AND PAID SEVERANCE IN ACCORDANCE WITH THE COMPANY'S WRITTEN SEVERANCE GUIDELINES. IN THE INSTANCE OF LOIS SIMON, FORMER PRESIDENT OF THE COMPANY, SEVERANCE ($232,414) WAS PAID IN ACCORDANCE WITH HER WRITTEN EMPLOYMENT AND SEVERANCE AGREEMENT. CINDY NGUYEN, CFO ($65,308) NANCY ROACH, COO ($191,117) MARY GLOVER, DIRECTOR ($193,157) VIRGIL PEREZ, DIRECTOR ($102,208) LEANNE BERGE, FORMER VICE PRESIDENT ($121,025) ALL AMOUNTS ARE PROPERLY REPORTED ON FORM W-2, ON FORM 990, PART VII, AND ON FORM 990, SCH J, PART II. PART I, LINE 7 BONUSES REPORTED IN PART II, COLUMN (B)(II) WERE DETERMINED BY A FIXED FORMULA BASED ON ATTAINING BOTH COMPANY AND INDIVIDUAL PERFORMANCE GOALS. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS REVIEW THE FORM 990 BEFORE THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE. THE BOARD ALSO REVIEWS THE FINANCIAL STATEMENTS ON A QUARTERLY BASIS. FORM 990, PART VI, SECTION B, LINE 12C THE ANNUAL COMPLIANCE POLICY AND CONFLICT OF INTEREST FORMS ARE DISTRIBUTED TO THE BOARD AND OFFICERS AND THE COMPLIANCE DEPARTMENT MONITORS FOR COMPLETION ANNUALLY. THE BOARD AND OFFICERS ALSO RECEIVE ANNUAL TRAINING ON CONFLICT OF INTEREST. THE COMPANY'S CONFLICT OF INTEREST POLICY COVERS CCA EMPLOYEES, OFFICERS AND DIRECTORS. THE POLICY CALLS FOR CONFLICT OF INTEREST ANALYSIS AND ACTUAL CONFLICTS ARE REVIEWED AND CONFLICTS DETERMINATIONS ARE MADE FOR EMPLOYEES OF DIRECTOR LEVEL AND ABOVE (DIRECTOR, SENIOR DIRECTOR, VICE PRESIDENT, SENIOR VICE PRESIDENT). WHERE AN ACTUAL OR PERCEIVED CONFLICT OF INTEREST INVOLVING A TRANSACTION IS DETERMINED, THE EMPLOYEE IS PROHIBITED FROM PARTICIPATING IN EITHER MANAGEMENT'S OR THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION ENGAGED COMPENSATION CONSULTANTS TO PROVIDE A COMPREHENSIVE COMPENSATION ASSESSMENT AND RECOMMENDATIONS TO CREATE A REASONABLE COMPENSATION PACKAGE FOR TOP MANAGEMENT OFFICIAL. THE ORGANIZATION WORKED WITH THE COMPENSATION CONSULTANT DURING 2016. OTHER OFFICERS AND KEY EMPLOYEES ARE REVIEWED ANNUALLY AND ARE ADJUSTED BY MARKET VALUE OF SURVEY OF POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FORM 990, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). IN ADDITION, THE FORM 990 WITHOUT SCHEDULE B IS AVAILABLE VIA GUIDESTAR AND THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE (BCMG) -21,823,842. CCA CAPITAL LLC 30 WINTER STREET BOSTON MA 02108 999999999 BENEFICIARY OF A STANDBY LETTER OF CREDIT MA COMMONWEALTH CARE ALLIANCE INC BOSTON'S COMMUNITY MEDICAL GROUP INC 30 NORTHAMPTON STREET BOSTON MA 02118 260100022 MEDICAL SERVICE MA 501(C)(3) LINE 3 COMMONWEALTH CARE ALLIANCE INC 1 COMMONWEALTH CLINICAL ALLIANCEINC 30 WINTER STREET BOSTON MA 02108 562382058 MEDICAL SERVICE MA 501(C)(3) LINE 10 COMMONWEALTH CARE ALLIANCE INC 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 COMMONWEALTH CLINICAL ALLIANCE M 28201432 FAIR MARKET VALUE BOSTON'S COMMUNITY MEDICAL GROUP INC M 13136606 FAIR MARKET VALUE BOSTON'S COMMUNITY MEDICAL GROUP INC R 21823842 BOOK VALUE