BAYSTATE ADMINISTRATIVE SERVICES INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- BAYSTATE ADMINISTRATIVE SERVICES INC (EIN 22-2747685)
- Tax period
- 2013-10-01 to 2014-09-30
- Filed
- 2015-08-11
- IRS object ID
- 201512239349301651
- Schema version
- 2013v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-08-11T12:44:30-05:00 | ReturnTs |
| Tax Period End | 2014-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Two Jericho Plaza | AddressLine1 |
| City | Jericho | City |
| State | NY | State |
| ZIP Code | 11753 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222747685 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Administrative Services Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BAYS | BusinessNameControlTxt |
| Phone | 4137940000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 759 Chestnut Street | AddressLine1 |
| City | Springfield | City |
| State | MA | State |
| ZIP Code | 011990001 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dennis W Chalke | PersonNm |
| Person Title | SVP Finance, CFO & Treasurer | PersonTitleTxt |
| Phone | 4137945740 | PhoneNum |
| Signature | 2015-08-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Christine Kawecki | PreparerPersonNm |
| PTIN | P00743140 | PTIN |
| Phone | 5169187000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Dennis W Chalke | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 759 Chestnut Street | AddressLine1 |
| City | Springfield | City |
| State | MA | State |
| ZIP Code | 011990001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $104,765,694 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.baystatehealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | To improve the health of the people in our communities every day with quality and compassion | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 555 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $569,135 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $94,135,222 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $102,423,858 | CYProgramServiceRevenueAmt |
| PY Investment Income | $473,111 | PYInvestmentIncomeAmt |
| CY Investment Income | -$46,065 | CYInvestmentIncomeAmt |
| PY Other Revenue | $396,039 | PYOtherRevenueAmt |
| CY Other Revenue | $676,429 | CYOtherRevenueAmt |
| PY Total Revenue | $95,004,372 | PYTotalRevenueAmt |
| CY Total Revenue | $103,054,222 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $56,812,708 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $58,116,098 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $38,508,642 | PYOtherExpensesAmt |
| CY Other Expenses | $46,231,275 | CYOtherExpensesAmt |
| PY Total Expenses | $95,321,350 | PYTotalExpensesAmt |
| CY Total Expenses | $104,347,373 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$316,978 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,293,151 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,141,818 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,643,625 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $52,643,724 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $46,583,394 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$12,501,906 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$16,939,769 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The organization's purpose is to promote the health, charitable and educational purposes of Baystate Health, Inc. whose mission is to improve the health of the people in our communities every day, with quality and compassion. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $28,755,954 | ExpenseAmt |
| Revenue | $44,372,503 | RevenueAmt |
| Desc | BAS provides management and administrative support to Baystate Health and its affiliates. These services are an integral part of the healthcare delivery system and include strategic planning, human resources, risk management (insurance) programs, marketing, financial services and benefit plans administration for all health system employees. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $56,688,233 | ExpenseAmt |
| Revenue | $58,158,649 | RevenueAmt |
| Desc | BAS provides information technology support to Baystate Health and its affiliates. These services are an integral part of the healthcare delivery system and include all software applications, telecommunications, clinical engineering, and computerized equipment at the hospitals. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $85,444,187 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 279 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 555 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Peter Lyons Baystate Health Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4137940000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 759 Chestnut Street | AddressLine1 |
| City | Springfield | City |
| State | MA | State |
| ZIP Code | 01199 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Mark A Keroack MD PresDir | |||||||||
| 7/1-9/30/14; Exec VP/COO-BH in 2013 | 1.00 | 49.00 | Yes (X) | Yes (X) | $776,897 | $0 | $179,311 | ||
| Mark R Tolosky | |||||||||
| Pres/Director 10/1/13- 7/01/14 | 1.00 | 49.00 | Yes (X) | Yes (X) | $1,639,060 | $0 | $87,835 | ||
| Dennis W Chalke | |||||||||
| Treasurer/Director | 1.00 | 49.00 | Yes (X) | Yes (X) | $769,165 | $0 | $75,032 | ||
| Evan Benjamin MD FACP | |||||||||
| Director/ SVP Hlth Care Quality | 10.00 | 40.00 | Yes (X) | $656,389 | $0 | $63,030 | |||
| Jennifer Endicott | |||||||||
| Director 2/24/14 - 9/30/14 SVP Strategy | 10.00 | 40.00 | Yes (X) | $0 | $0 | $0 | |||
| Gordon Josephson MD | |||||||||
| Director 10/1/13 - 2/03/14 COO, BMP | 10.00 | 40.00 | Yes (X) | $529,869 | $0 | $62,659 | |||
| John Schrieber MD DOH 2314 | |||||||||
| Director 2/03- 9/30/14 President, BMP | 10.00 | 40.00 | Yes (X) | $5,036 | $0 | $0 | |||
| Paula C Squires | |||||||||
| Director/SVP Human Resources | 10.00 | 40.00 | Yes (X) | $480,554 | $0 | $41,677 | |||
| Kristin R Delaney | |||||||||
| Assistant Clerk | 1.00 | 49.00 | Yes (X) | $103,365 | $0 | $28,954 | |||
| Joel L Vengco | |||||||||
| VP Information Services | 50.00 | 0.00 | $450,814 | $0 | $35,270 | Yes (X) | |||
| Charles Gijanto | |||||||||
| President Regional Markets | 1.00 | 49.00 | $889,781 | $0 | $35,923 | Yes (X) | |||
| Kevin Hinchey MD | |||||||||
| Chief Academic Officer | 5.00 | 45.00 | $490,558 | $0 | $66,584 | Yes (X) | |||
| Donna Ross | |||||||||
| SVP Strategy & Busi Dev | 15.00 | 35.00 | $424,142 | $0 | $53,053 | Yes (X) | |||
| Neil Kudler MD | |||||||||
| Chief Med Information Officer | 15.00 | 35.00 | $376,441 | $0 | $54,300 | Yes (X) | |||
| Peter A Lyons | |||||||||
| VP Finance Support Svcs | 8.00 | 42.00 | $286,734 | $0 | $71,786 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,878,805 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $855,414 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 129 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Cerner Corporation | |||||
| 2800 Rockcreek Pkwy | Kansas City | MO | 641172521 | Computer Services | $5,943,547 |
| Microsoft Licensing GP | |||||
| 6100 Neil Road | Reno | NV | 895111132 | Computer Software | $2,763,365 |
| Siemens Medical Solutions USA | |||||
| PO Box 120001 | Dallas | TX | 753120733 | Medical Equipment | $1,837,926 |
| Philips Medical Systems | |||||
| PO Box 100355 | Atlanta | GA | 303840355 | Medical Equipment | $1,703,126 |
| Bulkley Richardson & Gelinas | |||||
| 1500 Main St Suite 2700 | Springfield | MA | 011155507 | Legal Services | $1,327,076 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 99 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Affiliate Support | Desc |
| Business | 561000 | BusinessCd |
| Total Revenue Column | $102,423,858 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $101,854,723 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $569,135 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $102,423,858 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $58,438 | TotalRevenueColumnAmt |
| Exclusion | $58,438 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,969 | SecuritiesAmt |
| Other | $1,595,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $1,711,472 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,969 | SecuritiesAmt |
| Other | -$116,472 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$104,503 | TotalRevenueColumnAmt |
| Exclusion | -$104,503 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Electronic Medical Records | 541511 | $352,191 | $352,191 |
| Flex Spending Forfeitures | 561000 | $120,000 | $120,000 |
| Diversity Conference | 611430 | $37,522 | $37,522 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $166,716 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $166,716 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $676,429 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $103,054,222 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $102,531,152 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $569,135 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$46,065 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,984,917 | TotalAmt |
| Program Services | $4,692,773 | ProgramServicesAmt |
| Management And General | $1,292,144 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,197,600 | TotalAmt |
| Program Services | $33,032,770 | ProgramServicesAmt |
| Management And General | $9,164,830 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,937,042 | TotalAmt |
| Program Services | $2,302,829 | ProgramServicesAmt |
| Management And General | $634,213 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,723,394 | TotalAmt |
| Program Services | $2,979,484 | ProgramServicesAmt |
| Management And General | $743,910 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,273,145 | TotalAmt |
| Program Services | $2,566,388 | ProgramServicesAmt |
| Management And General | $706,757 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,005,876 | TotalAmt |
| Management And General | $1,005,876 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,014,095 | TotalAmt |
| Program Services | $3,353,220 | ProgramServicesAmt |
| Management And General | $1,660,875 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,781,128 | TotalAmt |
| Program Services | $1,539,238 | ProgramServicesAmt |
| Management And General | $241,890 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,593,466 | TotalAmt |
| Program Services | $2,381,013 | ProgramServicesAmt |
| Management And General | $212,453 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,314,339 | TotalAmt |
| Program Services | $25,358,040 | ProgramServicesAmt |
| Management And General | $956,299 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,054,842 | TotalAmt |
| Program Services | $876,501 | ProgramServicesAmt |
| Management And General | $178,341 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $587,034 | TotalAmt |
| Program Services | $383,647 | ProgramServicesAmt |
| Management And General | $203,387 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,016,448 | TotalAmt |
| Program Services | $780,474 | ProgramServicesAmt |
| Management And General | $235,974 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,265 | TotalAmt |
| Program Services | $132,394 | ProgramServicesAmt |
| Management And General | $26,871 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,463 | TotalAmt |
| Program Services | $197,644 | ProgramServicesAmt |
| Management And General | $47,819 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Recruitment | $1,076,648 | $730,075 | $346,573 |
| Dues & Memberships | $14,215 | $14,215 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,368,456 | TotalAmt |
| Program Services | $4,123,482 | ProgramServicesAmt |
| Management And General | $1,244,974 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,347,373 | TotalAmt |
| Program Services | $85,444,187 | ProgramServicesAmt |
| Management And General | $18,903,186 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $985,106 | BOYAmt |
| EOY | $124,263 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,120,551 | BOYAmt |
| EOY | $4,911,723 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $889,973 | BOYAmt |
| EOY | $874,565 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,048 | BOYAmt |
| EOY | $38,484 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,149,853 | BOYAmt |
| EOY | $11,073,055 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,452,633 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,032,255 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $471,355 | BOYAmt |
| EOY | $420,378 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,407,932 | BOYAmt |
| EOY | $12,201,157 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,141,818 | BOYAmt |
| EOY | $29,643,625 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,534,799 | BOYAmt |
| EOY | $25,540,701 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,108,925 | BOYAmt |
| EOY | $21,042,693 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,643,724 | BOYAmt |
| EOY | $46,583,394 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$12,501,906 | BOYAmt |
| EOY | -$16,939,769 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$12,501,906 | BOYAmt |
| EOY | -$16,939,769 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,141,818 | BOYAmt |
| EOY | $29,643,625 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,293,151 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $36,977 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$3,181,689 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Certification | Yes (X) | CertificationInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp (8 entries)
| EINEIN | Organization TypeOrganizationTypeDesc | Governing Document ListedGoverningDocumentListedInd | Supported Org NotifiedSupportedOrgNotifiedInd | US OrganizedUSOrganizedInd | SupportSupportAmt |
|---|---|---|---|---|---|
| Baystate Health Inc | |||||
| 042105941 | 7 | Yes (1) | Yes (1) | Yes (1) | $1,869,782 |
| Baystate Medical Center Inc | |||||
| 042790311 | 3 | 0 | Yes (1) | Yes (1) | $79,584,024 |
| Baystate Franklin Medical Ctr | |||||
| 042103575 | 3 | 0 | Yes (1) | Yes (1) | $7,249,838 |
| Baystate Mary Lane Hospital Corp | |||||
| 042103584 | 3 | 0 | Yes (1) | Yes (1) | $1,472,048 |
| Baystate Wing Hospital | |||||
| 222519813 | 3 | 0 | Yes (1) | Yes (1) | $101,400 |
| Visiting Nurse Association & Hospice of WNE Inc | |||||
| 042105803 | 9 | 0 | Yes (1) | Yes (1) | $1,788,223 |
| Baystate Medical Practices Inc | |||||
| 042888373 | 9 | 0 | Yes (1) | Yes (1) | $4,961,078 |
| Baystate Health Foundation Inc | |||||
| 043549011 | 7 | 0 | Yes (1) | Yes (1) | $45,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 8 | SupportedOrganizationsTotalCnt |
| Support Sum | $97,071,393 | SupportSumAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $210,265 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $210,265 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, line i,j | FormAndLineReferenceDesc |
| Explanation | The amount recorded on Part II-B, line j represents BAS salaries and operating expenses as reported on Massachusetts Public Records Division Lobbyist Disclosures for activities related to healthcare policy, bills and appropriations. | ExplanationTxt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $525,715 | OtherCostOrOtherBasisAmt |
| Depreciation | $467,547 | DepreciationAmt |
| Book Value | $58,168 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,551,309 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,192,762 | DepreciationAmt |
| Book Value | $358,547 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,375,609 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,371,946 | DepreciationAmt |
| Book Value | $3,663 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $420,378 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due from affiliated companies | Desc |
| Book Value | $12,201,157 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $12,201,157 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to affiliated companies | $10,113,287 |
| Total accrued pension cost | $2,098,483 |
| Total minimum pension liability | $8,830,923 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $21,042,693 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, line 2 | FormAndLineReferenceDesc |
| Explanation | No FIN48 footnote was included in the consolidated audited financial statements of Baystate health, Inc. and Subsidiaries for the year ended September 30, 2014. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mark A Keroack MD PresDir | ||||||||||||||
| 7/1-9/30/14; Exec VP/COO-BH in 2013 | $537,949 | $0 | $223,630 | $0 | $15,318 | $0 | $165,853 | $0 | $13,458 | $0 | $956,208 | $0 | $0 | $0 |
| Mark R Tolosky | ||||||||||||||
| Pres/Director 10/1/13- 7/01/14 | $728,085 | $0 | $456,876 | $0 | $454,099 | $0 | $57,333 | $0 | $30,502 | $0 | $1,726,895 | $0 | $0 | $0 |
| Dennis W Chalke | ||||||||||||||
| Treasurer/Director | $393,944 | $0 | $159,840 | $0 | $215,381 | $0 | $53,098 | $0 | $21,934 | $0 | $844,197 | $0 | $0 | $0 |
| Evan Benjamin MD FACP | ||||||||||||||
| Director/ SVP Hlth Care Quality | $390,694 | $0 | $138,302 | $0 | $127,393 | $0 | $42,213 | $0 | $20,817 | $0 | $719,419 | $0 | $0 | $0 |
| Gordon Josephson MD | ||||||||||||||
| Director 10/1/13 - 2/03/14 COO, BMP | $340,675 | $0 | $152,412 | $0 | $36,782 | $0 | $45,150 | $0 | $17,509 | $0 | $592,528 | $0 | $0 | $0 |
| Paula C Squires | ||||||||||||||
| Director/SVP Human Resources | $282,484 | $0 | $98,252 | $0 | $99,818 | $0 | $20,400 | $0 | $21,277 | $0 | $522,231 | $0 | $0 | $0 |
| Joel L Vengco | ||||||||||||||
| VP Information Services | $326,954 | $0 | $110,914 | $0 | $12,946 | $0 | $15,897 | $0 | $19,373 | $0 | $486,084 | $0 | $0 | $0 |
| Charles Gijanto | ||||||||||||||
| President Regional Markets | $327,104 | $0 | $130,328 | $0 | $432,349 | $0 | $20,400 | $0 | $15,523 | $0 | $925,704 | $0 | $293,474 | $0 |
| Kevin Hinchey MD | ||||||||||||||
| Chief Academic Officer | $335,131 | $0 | $119,204 | $0 | $36,223 | $0 | $43,345 | $0 | $23,239 | $0 | $557,142 | $0 | $0 | $0 |
| Donna Ross | ||||||||||||||
| SVP Strategy & Busi Dev | $210,000 | $0 | $127,148 | $0 | $86,994 | $0 | $49,321 | $0 | $3,732 | $0 | $477,195 | $0 | $0 | $0 |
| Neil Kudler MD | ||||||||||||||
| Chief Med Information Officer | $272,108 | $0 | $77,700 | $0 | $26,633 | $0 | $35,923 | $0 | $18,377 | $0 | $430,741 | $0 | $0 | $0 |
| Peter A Lyons | ||||||||||||||
| VP Finance Support Svcs | $217,773 | $0 | $48,983 | $0 | $19,978 | $0 | $57,333 | $0 | $14,453 | $0 | $358,520 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | Part I, Line 1a: Explanation: 1. Companion Travel - Several Trustees, Officers, and/or key employees were provided with compensation for spouses to attend a company board event. 2. Tax Gross up / Discretionary Spending Account - Several employees were provided with reimbursement for financial, tax and estate planning requiring a tax gross up. The two items above were treated as taxable compensation as appropriate in accordance with Baystate's written policies which require compliance with the IRS's accountable plan rules. |
| Part I, Line 3 | The compensation of the President and CEO is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs). This committee consists entirely of individuals serving on the board of Baystate Health, Inc. and these individuals would be considered independent for compensation deliberation purposes as related to the filing organization. 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 independent compensation committee of Baystate Health, Inc. and all such deliberations and decisions are documented contemporaneously. The Baystate Administrative Services, Inc. Board of Directors is composed of management of Baystate Health, Inc. and its affiliates. Therefore it is more appropriate that the establishment and review of the compensation of the organization's top management officials be performed at the Baystate Health level, which has a more independent board. |
| Part I, Line 4b | Evan Benjamin, MD - Supplemental Retirement of $110,597 is included in column E. This amount was earned in 2013. Dennis W. Chalke - Supplemental Retirement of $135,242 is included in column E. This amount was earned in 2013. Charles Gijanto - Supplemental Retirement of $403,145 is included in column E. This amount was earned in 2013 and $293,474 non-vested amounts that were earned in the previous 4 years and previously reported each year as deferred compensation, and now included again in accordance with reporting requirements. Kevin Hinchey, MD Supplemental Retirement of $17,905 is included in column E. This amount was earned in 2013. Gordon Josephson, MD - Supplemental Retirement of $26,718 is included in column E. This amount was earned in 2013. Mark A. Keroack, MD - Supplemental Retirement of $145,453 is included in column E. This amount was earned in 2013. Neil Kudler, MD Supplemental Retirement of $12,520 is included in column E. This amount was earned in 2013. Peter A. Lyons - Supplemental Retirement of $5,621 is included in column E. This amount was earned in 2013. Donna J. Ross Supplemental Retirement of $64,060 is included in column E. This amount was earned in 2013. Paula Squires - Supplemental Retirement of $70,361 is included in column E. This amount was earned in 2013. Mark R. Tolosky - Supplemental Retirement of $387,879 is included in column E. This amount was earned in 2013. Joel L. Vengco - Supplemental Retirement of $3,147 is included in column E. This amount was non-vested amount earned in 2013. n |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Baycare Health Partners Inc (BHP) | |||
| Common Board Members or Officers | $232,464 | See Part V - The filing organization received payments of $232,464 for management and administrative services from BHP. BHP is an affiliate corporation of the filing organization. | 0 |
| Health New England (HNE) | |||
| Common Board Members or Officers | $106,890 | See Part V - The filing organization received payments of $6,890 for reimbursement of benefits related expenses and $100,000 for management and administrative support from HNE. NHE is an affiliate corporation of the filing organization. | 0 |
| Ingraham Corporation (IC) | |||
| Common Board Members or Officers | $336,672 | See Part V - The filing organization received payments from IC for management, administrative and information systems services. IC is an affiliate corporation of the filing organization. | 0 |
| Baystate Health Insurance Company Ltd (BHIC) | |||
| Common Board Members or Officers | $18,702,384 | See Part V - The filing organization received payments from BHIC for Claim Insurance reimbursements and Indemnity Pass-Through payments. BHIC is an affiliate corporation of the filing organization. | 0 |
| Baystate Health Insurance Company Ltd (BHIC) | |||
| Common Board Members or Officers | $16,405,008 | See Part V - The filing organization made payments for Insurance premiums to BHIC. BHIC is an affiliate corporation of the filing organization. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1 | Baystate Administrative Services Inc. (BAS) is part of an integrated delivery system including not for profit community hospitals, which have community boards. BAS is a management services supporting organization, which supports Bayste Health and its affiliates and is comprised of BAS employees. This board structure has not changed significantly since the organization applied for exempt status. |
| Form 990, Part VI, Section A, line 2 | Evan Benjamin, MD, FACP, Dennis W. Chalke, Kristin R. Delaney, Jennifer Endicott, Gordon Josephson, Mark A. Keroack, MD, John Schreiber, MD, Paula C. Squires and Mark R. Tolosky are also officers or trustees of Baystate Health, Inc. & its affiliated entities. The following trustees, officers, or key employees serve on a common board of a non-affiliated entity: None that we know of. |
| Form 990, Part VI, Section A, line 6 | The filing organization has one member, Baystate Health, Inc. (BH). |
| Form 990, Part VI, Section A, line 7a | All of the members of the Board of Directors of the filing organization are individuals serving ex officio based on positions they hold with BH. |
| Form 990, Part VI, Section B, line 11 | Prior 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 sole member of the filing organization and 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 15 | The compensation of the President and CEO and of other officers and key employees is reviewed and determined annually by the compensation committee of Baystate Health, Inc. (The parent organization of the health care system to which the filing organization belongs). This committee consists entirely of individuals serving on the board of Baystate Health, Inc. and these individuals would be considered independent for compensation deliberation purposes as related to the filing organization. The compensation of the President and CEO and of other 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. |
| Form 990, Part VI, Section C, line 19 | Public Inspection of Organizational Policies 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 XI, line 9: | Pension Adjustment -3,231,706. Transfer for PP&E 50,016. rounding 1. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Baystate Franklin Medical Center | ||||||||||
| 164 High Street | Greenfield | MA | 01301 | 042103575 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Baystate Health Foundation Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 043549011 | Fundraising | MA | 501 (c ) (3) | 7 | Baystate Health Inc | 0 |
| 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 | 0 | |
| Baystate Health Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 042105941 | Healthcare System Parent | MA | 501 (c ) (3) | 7 | Baystate Health Inc | 0 |
| Baystate Mary Lane Hospital Corporation | ||||||||||
| 85 South Street | Ware | MA | 01082 | 042103584 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Baystate Medical Center Inc | ||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 042790311 | Acute Care Teaching Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Baystate Total Home Care Inc | ||||||||||
| 50 Maple Street | Springfield | MA | 01199 | 203260764 | Real Estate and Other | MA | 501 (c ) (3) | 11b, II | Baystate Medical Center Inc | 0 |
| Visiting Nurse Assn and Hospice of Western New England Inc | ||||||||||
| 50 Maple Street | Springfield | MA | 01199 | 042105803 | Homehealth and Hospice care | MA | 501 (c ) (3) | 9 | Baystate Health Inc | 0 |
| Baystate Wing Hospital Corporation | ||||||||||
| 40 Wright Street | Palmer | MA | 01069 | 222519813 | Hospital | MA | 501 (c ) (3) | 3 | Baystate Health Inc | 0 |
| Health New England Inc | ||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 01199 | 042864973 | HMO/Insurance | MA | 501 (c ) (4) | Baystate Health Inc | 0 | |
| HNE of Connecticut Inc | ||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 01199 | 455190134 | HMO/Insurance | CT | 501 (c ) (4) | Health New England Inc | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | Province Or StateForeignAddress/ProvinceOrState | CountryForeignAddress/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HNE Holding Corporation | ||||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 464620480 | Dormant | MA | Health New England Inc | C | 0 | |||||
| HNE Insurance Services Corporation | ||||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 043183019 | Ancilliary Insurance | MA | Health New England Inc | C | 0 | |||||
| HNE Advisory Services Inc | ||||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 043012347 | Administrative Svs | MA | Health New England Inc | C | 0 | |||||
| HNE Insurance Company Inc | ||||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 454462433 | Health Insurance Services for MA Medicare Supplement | MA | Health New England Inc | C | 0 | |||||
| Health New England of Connecticut | ||||||||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 061398662 | Dormant | CT | Health New England Inc | C | 0 | |||||
| Ingraham Corporation | ||||||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 043016257 | Health care and other business activities | MA | Baystate Health Inc | C | 0 | |||||
| Baystate Health System Ambulance Inc | ||||||||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 043018550 | Ambulance Svs | MA | Ingraham Corporation | C | 0 | |||||
| Baystate Health Insurance Company Ltd | ||||||||||||||
| 980421413 | Offshore Captive Insurance | Baystate Health Inc | 0 | North Church Street | Georgetown | Cayman Islands | CJ | CJ | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |