2016-07-25T12:50:09-07:00 2015-09-30 990 2014-10-01 043170333 Coastal Medical Associates Inc COAS 7816248626 55 Fogg Road South Weymouth MA 02190 Pamela Whelton Treasurer 7816248626 2016-08-15 2014 2016-12-15 16:53:06Z South Shore Physician Ambulatory Enterprise Inc Pamela Whelton 55 Fogg Road South Weymouth MA 02190 14173245 0 X X 1992 MA Coastal Medical Associates d/b/a South Shore Physician Ambulatory Enterprise (SSPAE) organizes, coordinates and integrates physicians, advanced practice clinicians and other ambulatory care providers into a broader system of health care for the benefit of the communities served by South Shore Hospital and its affiliates. 14 6 125 6 136935 0 0 0 10978269 14170246 29111 0 85116 2999 11092496 14173245 0 0 0 0 9950824 13076650 0 0 0 1679603 3920001 11630427 16996651 -537931 -2823406 2869142 6852231 2639636 7291184 229506 -438953 X Coastal Medical Associates provides primary and specialty care physicians to South Shore Hospital, a related organization. In addition, Coastal Medical Associates d/b/a South Shore Physician Ambulatory Enterprise (SSPAE) organizes, coordinates and integrates physicians, advanced practice clinicians and other ambulatory care providers into a broader system of health care for the benefit of the communities served by South Shore Hospital and its affiliates. 1 0 10484143 0 14035556 Medical Specialties Programs: Provides primary and specialized medical care and related health care services in the furtherance of the charitable purposes of South Shore Hospital, and engages in research and education related to the above. In fiscal year 2015 SSPAE added additional medical specialists in emergency medicine. In August 2015 SSPAE acquired South Shore Medical Center, a primary and specialty medical practice with over 100 clinicians and three locations within South Shore Hospital's service area. 0 0 0 10484143 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 25 0 1 125 1 1 1 0 0 0 0 0 0 0 0 0 X 14 6 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X Pamela Whelton 7816248626 55 Fogg Road South Weymouth MA 02190 Richard Aubut SSHEC President/CEO 1 47 X X 0 1243158 102152 Edward Nalband MD Chairman 1 41 X X 0 0 0 Mark Coyle Director 40 1 X 0 173607 33585 Brian Dolan MD Director 40 1 X 449029 0 38972 Thomas Carroll President 40 2 X X 0 0 0 John Stevenson MD SSHS CMO/Director 1 47 X 0 551101 108293 Jason Tracy MD Director 1 41 X 0 574561 72757 John Walsh MD Director 1 41 X 0 380389 27593 Elana Dekkers MD Director 40 1 X 147901 0 8244 Richard Kauff MD Director 1 40 X 0 0 0 Ingrid E Kotch MD Director 1 40 X 0 0 0 Timothy Lynch MD PAE CMO/Director 1 44 X X 0 0 0 Matthew Weiss MD Vice Chair 40 2 X X 482834 28333 90299 Benjamin C Ryan MD Director 1 40 X 0 0 0 Pamela Whelton Treasurer 1 49 X 0 440291 95132 Michael Cullen Treasurer thru 1/8/15 1 48 X 0 565821 35968 Peg Holda Clerk 1 43 X 0 325039 70755 Rose DiPietro SSPAE COO 40 1 X 0 369975 82436 Katie Wakeley MD Physician 45 0 X 490519 0 38972 Gary Gibbons MD Physician 45 X 440934 26000 63172 Thomas Lyons MD Physician 45 0 X 359362 0 33307 Ben Kerman MD Physician 45 0 X 401066 0 41572 Christopher Locke MD Physician 40 0 X 355006 14000 16653 Robert Wheeler Clerk thru 3/12/14 0 40 X 0 363617 0 3126651 5055892 959862 64 1 1 0 Boston MFM LLC PO Box 983122 Boston MA 022983122 Physician Services 550000 Optum360 LLC 2771 Momentum Place Chicago IL 606895327 Billing & Collection 405892 South Shore Anesthesia Associates Inc 163 Libbey Parkway Suite 301 Weymouth MA 021893118 Physician Services 170820 Foley & Lardner LLP 111 Huntington Avenue 26th Floor Boston MA 02199 Legal 161686 Sullivan Cotter & Associates 62272 Collections Center Drive Chicago IL 606930622 Consulting 153306 9 0 Net Patient Service Revenue 621110 13690984 13690984 0 0 Clinician Reimbursement Revenue 621110 479262 342327 136935 0 0 0 0 0 14170246 0 0 0 0 Medical Records Income 900099 2245 2245 0 0 Miscellaneous Income 900099 754 0 0 754 0 0 0 0 2999 14173245 14035556 136935 754 X 7556243 5388400 2167843 0 1248457 890282 358175 0 2690287 1852341 837946 0 1581663 1127893 453770 0 30000 0 30000 0 511714 0 511714 0 67200 0 67200 0 1954272 136415 1817857 0 42662 8891 33771 0 7531 0 7531 0 86327 86327 0 0 12965 0 12965 0 237714 233596 4118 0 48624 48624 0 0 703511 703511 0 0 Dues 80226 0 80226 0 Physician Board Fees 72100 0 72100 0 Nonpatient Expenses 29157 0 29157 0 Publications/Subscriptions 7863 7863 0 0 28135 0 28135 0 16996651 10484143 6512508 0 1621503 2429746 562655 1040827 139955 642980 825810 222822 159201 602988 220747 2067081 165081 68609 2869142 6852231 2418889 5224103 220747 2067081 2639636 7291184 X 229506 -438953 0 0 0 0 229506 -438953 2869142 6852231 X -2823406 0 0 0 0 2154947 X X 0 1 X 0 0 X Schedule A, Part I, Line 3 Coastal Medical Associates, Inc. is a hospital service organization as defined in section 170(b)(1)(A)(iii). The corporation provides primary and specialized medical care to patients within South Shore Hospital's service area. South Shore Hospital is a related organization. Coastal Medical Associates is not licensed by the Commonwealth of Massachusetts as a hospital. 0 0 0 0 1449 199 1250 0 270909 134617 136292 0 178721 79951 98770 0 374731 8055 366676 602988 0 Physician Benefits Payable 2067081 2067081 X Schedule D, Part X, Line 2 The Corporation follows the provisions of FASB ASC 740, Income Taxes, relating to accounting for uncertainty in income taxes. ASC 740 clarifies the accounting for uncertainty in income taxes recognized in an entity's financial statements. It prescribes an uncertainty threshold and measurement attributes for financial statement disclosure of tax positions taken or expected to be taken on a tax return. 0 0 0 0 0 0 0 1 0 Richard Aubut SSHEC President/CEO 0 802364 0 58587 0 382207 0 84445 0 17707 0 1345310 0 58587 Mark Coyle Director 0 173229 0 0 0 378 0 10933 0 23372 0 207912 0 0 Brian Dolan MD Director 434445 0 0 0 14584 0 15600 0 23372 0 488001 0 0 0 John Stevenson MD Director 0 483947 0 63990 0 3164 0 84922 0 23371 0 659394 0 63990 Jason Tracy MD Director 0 510839 0 43005 0 20717 0 54463 0 18294 0 647318 0 43005 John Walsh MD Director 0 304589 0 75000 0 800 0 10608 0 16985 0 407982 0 0 Matthew Weiss MD Vice Chair 432918 0 49080 0 836 28333 66927 0 23372 0 573133 28333 0 0 Pamela Whelton Treasurer 0 396947 0 39024 0 4320 0 76369 0 18763 0 535423 0 39024 Michael Cullen Treasurer thru 1/8/15 0 454935 0 5376 0 105510 0 18262 0 17706 0 601789 0 5376 Peg Holda Clerk 0 276147 0 30852 0 18040 0 53048 0 17707 0 395794 0 30852 Rose DiPietro SSPAE COO 0 324660 0 42187 0 3128 0 73584 0 8852 0 452411 0 42187 Robert Wheeler Clerk thru 3/12/14 0 303895 0 39091 0 20631 0 64147 0 17706 0 445470 0 39991 Gary Gibbons MD Physician 399758 0 42000 0 25176 0 10400 0 13800 0 491134 0 0 0 Katie Wakeley MD Physician 470892 0 0 0 19627 0 15600 0 23372 0 529491 0 0 0 Ben Kerman MD Physician 386072 0 0 0 14994 0 18200 0 23372 0 442638 0 0 0 Elana Dekkers MD Director 147307 0 0 0 594 0 8244 0 0 0 156145 0 0 0 Thomas Lyons MD Physician 250581 0 106407 0 2374 0 15600 0 17707 0 392669 0 0 0 Christopher Locke MD Physician 259198 0 95248 0 560 14000 7800 0 8853 0 371659 14000 0 0 Schedule J, Part I, Line 3 Compensation paid by the corporation to officers and directors is for services rendered as physician employees only. No compensation was received by the officers and directors of Coastal Medical Associates for their services as officers and directors. Schedule J, Part I, Line 7 Hospitalists employed by Coastal Medical Associates are eligible to receive incentive pay based on their net collections. They may receive a percentage of the balance of their net collections less salary less 8.5% net billing fees. The percentage varies from 50-80% based on each Hospitalist's employment contract. Podiatry program physician incentives are based on a combination of practice metrics, community outreach activities and exceeding monthly productivity targets (work Relative Value Units--wRVUs). Incentive pay for practice development, community outreach and practice standardization are are received if goals are met. Productivity incentive payments are based on exceeding unit targets. If quarterly wRVUs exceed targets, physicians receive incentive pay. If applicable, negative quarterly wRVU totals are used to offset quarters with positive balances. The Wound Center Medical Director is eligible to receive quarterly pay for performance incentives based on quality metrics and patient satisfaction. Form 990, Part III, Line 2 In August 2015 SSPAE acquired South Shore Medical Center, Inc. (SSMC), a primary and specialized medical practice with over 100 clinicians and three locations in affiliate South Shore Hospital's service area. Coastal became the sole corporate member of SSMC. Form 990, Part VI, Section A, Line 2 Persons listed in Part VII have a business relationship with one another by virtue of sitting on boards of entities related to Coastal Medical Associates, Inc. Form 990, Part VI, Section A, Line 4 Coastal Medical Associates, Inc. amended its Bylaws in August 2015. The revised Bylaws changes the date of the Annual Meeting. The number and composition of Coastal's Board of Directors changed due to its acquisition of South Shore Medical Center. The new board will better represent the physicians and clinicians who are employed by the Corporation. Form 990, Part VI, Section A, Line 6 The Sole Member of the Corporation is the Chief Medical Officer or other physician designee of South Shore Health System (SSHS CMO). Form 990, Part VI, Section A, Line 7a The South Shore Health System (SSHS), formerly South Shore Health & Educational Corporation, governing board has the power to appoint the Sole Member. The Sole Member is responsible for election of the initial elected Directors from a slate proposed by the Planning Team that developed the business plan for the Corporation. Thereafter, elected Directors will be nominated and approved after action by the Nominating Committee. The President is appointed by the SSHS CEO, in consultation with the Board of the Corporation. The President of the Corporation, in consultation with the Sole Member, appoints the Chief Medical Officer of the Corporation. SSHS has the power to approve of any lay community member appointed to the Coastal Board. Form 990, Part VI, Section A, Line 7b The Sole Member is appointed by the South Shore Health System (SSHS) governing body and may resign only with the approval of the System Board. Elected Directors may be removed, with cause, by the SSHS Board. The President is appointed by the SSHS CEO, in consultation with Board of the Corporation. A special meeting of the Sole Member of the Corporation may be called at any time at the direction of the SSHS Board. The Chair and Vice Chair of the Corporation are elected by the SSPAE Board, subject to the approval of the SSHS Board. Form 990, Part VI, Section B, Line 11b The organization's Form 990 is prepared internally and reviewed by the tax practice of its independent auditors. The return is then reviewed by the Treasurer. Form 990 is presented for review to the governing body as a whole at the next regularly scheduled meeting prior to the filing deadline. Form 990, Part VI, Section B, Line 12c Board members are required to sign a conflict of interest form annually. The forms are reviewed for conflicts or potential conflicts. Board members abstain from voting on matters that present a conflict of interest. Form 990, Part VI, Section B, Line 15 Annual compensation decisions for Coastal (SSPAE) physicians and advanced practice clinician employees are made by the SSPAE's Compensation Committee and are based on a combination of advice and research provided by outside consultants, review of comparable industry data and market conditions. The Compensation Committee is comprised of the SSHS CEO (or designee) and other persons appointed by the Board. The Compensation Committee will be independent and consist solely of members who do not have a conflict of interest with regards to compensation matters. The committee will ensure that all decisions are made utilizing standards applicable to 501(c)(3) organizations. The PAE Chairman is considered a South Shore Health System executive; all executive compensation decisions are made by the SSHS Compensation Committee. Compensation paid to Directors are for administrative and/or physician services to the corporation or a related corporation, no Director receives compensation for his service as a Director. Form 990, Part VI, Section C, Line 19 Coastal Medical Associates, Inc. makes its governing documents, conflict of interest policy and financial statements available for inspection at the Corporation's office. Copies of these documents are available upon request. In addition, certain governing documents are also available through the Massachusetts Secretary of the Commonwealth's Corporations Division database. Form 990, Part IX, Line 11g Consultants; $1,155,015, Billing and Collection Fees; $552,341, Transcription Fees; $1,420, Recruitment; $125,141, Purchased Services; $110,394, Temporary Help; $9,961. Form 990, Part XI, Line 9 Transfers from affiliates; $2,154,947. Form 990, Part XII, Line 2b The organization's financial statements are audited as part of consolidated financial statements. South Shore Health System and its subsidiaries are audited by independent accountant Deloitte & Touche LLP. The governing body of South Shore Health System, formerly South Shore Health & Educational Corporation, acting as a committee of the whole, assumes responsibility for oversight of the audit of its (parent and affiliate) financial statements and selection of an independent auditor. Beginning in FY15, the audited financial statements of Coastal Medical Associates and its subsidiary, South Shore Medical Center, are combined and presented as the financial statements of Coastal Medical Associates. In fiscal 2015 the audit of Coastal Medical Associates was consolidated by Deloitte & Touche LLP into the annual audit of South Shore Health and Educational Corporation and Subsidiaries. The financial statements are prepared in accordance with GAAP. South Shore Hospital Inc 55 Fogg Road South Weymouth MA 02190 042769210 Hospital MA 501(c)(3) 3 South Shore Health System Inc 0 South Shore Health System Inc formerly South Shore Health & Educational Corporation 55 Fogg Road South Weymouth MA 02190 042105926 Supports the charitable mission of South Shore Hospital and its affiliates MA 501(c)(3) 11c, Type III N/A 0 South Shore Property Inc 55 Fogg Road South Weymouth MA 02190 050398822 Develops and manages real property for South Shore Hospital and its affiliates MA 501(c)(3) 11a, Type I South Shore Health System Inc 0 MetroSouth Obstetrics & Gynecology Inc 55 Fogg Road South Weymouth MA 02190 330998957 Specialized medical care MA 501(c)(3) 3 South Shore Hospital 0 Atlantic Women's Health Inc 55 Fogg Road South Weymouth MA 02190 200156651 Specialized medical care MA 501(c)(3) 3 South Shore Hospital 0 Health Provider Services Organization of the South Shore Inc 55 Fogg Road South Weymouth MA 02190 452385865 Suports the charitable mission of SSH&E and affiliates MA 501 (c)(3) 11c, Type III South Shore Health System Inc 0 South Shore Medical Center Inc 143 Longwater Drive Norwell MA 02061 042297845 Primary and specialized medical care MA 501(c)(3) 9 Coastal Medical Associates Inc 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 1 0 0