BAYSTATE ADMINISTRATIVE SERVICES INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- BAYSTATE ADMINISTRATIVE SERVICES INC (EIN 22-2747685)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-13
- IRS object ID
- 201332259349301218
- Schema version
- 2011v1.5
- 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) |
|---|---|---|
| Timestamp | 2013-08-13T09:28:37-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 346565596 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ernst & Young LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 Clarendon Street | AddressLine1 |
| City | Boston | City |
| State | MA | State |
| ZIP Code | 02116 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222747685 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baystate Administrative Services Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BAYS | NameControl |
| Phone | 4137947872 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dennis W Chalke | Name |
| Title | SVP Finance & Treasurer | Title |
| Phone | 4137945740 | Phone |
| Date Signed | 2013-08-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeanne M Schuster | Name |
| PTIN | P00743154 | PTIN |
| Phone | 6172662000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Dennis W Chalke | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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 | 92624612 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.baystatehealth.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1986 | YearFormation |
| State Legal Domicile | MA | StateLegalDomicile |
| Activity Or Mission Description | To improve the health of the people in our communities every day with quality and compassion | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 535 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 671025 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 90423070 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 92270721 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 602184 | InvestmentIncomePriorYear |
| Investment Income Current Year | 323571 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 37783 | OtherRevenuePriorYear |
| Other Revenue Current Year | 30320 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 91063037 | TotalRevenuePriorYear |
| Total Revenue Current Year | 92624612 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 55288000 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 56011441 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 34866938 | OtherExpensePriorYear |
| Other Expenses Current Year | 36195823 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 90154938 | TotalExpensesPriorYear |
| Total Expenses Current Year | 92207264 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 908099 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 417348 | RevenuesLessExpensesCY |
| Total Assets BOY | 37953235 | TotalAssetsBOY |
| Total Assets EOY | 42285246 | TotalAssetsEOY |
| Total Liabilities BOY | 55103222 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 61867093 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -17149987 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -19581847 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 26576484 | Expense |
| Revenue | 40108292 | Revenue |
| Description | 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. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 50370131 | Expense |
| Revenue | 51521724 | Revenue |
| Description | 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. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 76946615 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 277 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 535 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Peter Lyons Baystate Health Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4137940000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 759 Chestnut Street | AddressLine1 |
| City | Springfield | City |
| State | MA | State |
| ZIP Code | 01199 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Mark R Tolosky | |||||||||
| President/Director | 1.00 | X | X | 1536640 | 0 | 99365 | |||
| Dennis W Chalke | |||||||||
| Treasurer/Director | 1.00 | X | X | 672631 | 0 | 92548 | |||
| Donna J Ross | |||||||||
| Clerk/Director-SVP Strategy | 1.00 | X | X | 395331 | 0 | 48303 | |||
| Evan Benjamin MD FACP | |||||||||
| Director/ SVP Hlth Care Quality, CQO | 1.00 | X | 516054 | 0 | 58668 | ||||
| Gregory A Harb DOH 33111 | |||||||||
| Director/EVP/COO-BH | 1.00 | X | 584765 | 0 | 133003 | ||||
| Mark A Keroack MD DOH 61311 | |||||||||
| Director/ Chief Physician Executive & Pres. BMP | 1.00 | X | 301105 | 0 | 80102 | ||||
| Paula C Squires | |||||||||
| Director/SVP Human Resources | 1.00 | X | 821223 | 0 | 44114 | ||||
| Kristin R Delaney | |||||||||
| Assistant Clerk | 1.00 | X | 94511 | 0 | 47834 | ||||
| Mark Gorrell Term 82011 | |||||||||
| VP/CIO Information Services | 50.00 | 194372 | 0 | 12645 | X | ||||
| Gordon Josephson MD | |||||||||
| COO Baystate Medical Pract | 50.00 | 437277 | 0 | 66333 | X | ||||
| Charles D Gijanto | |||||||||
| President FMC, MLH | 50.00 | 329648 | 0 | 112585 | X | ||||
| Joan Sullivan | |||||||||
| President MLH | 50.00 | 324561 | 0 | 52800 | X | ||||
| Peter A Lyons | |||||||||
| VP Finance Support Svcs | 50.00 | 268220 | 0 | 60873 | X | ||||
| Lawrence G Emerson | |||||||||
| VP HR Operations & Total Comp | 50.00 | 259442 | 0 | 82977 | X | ||||
| Hal B Jenson MD Term 52111 | |||||||||
| Former Director | 1.00 | 172000 | 0 | 31081 | X | ||||
| Keith C McLean-Shinaman | |||||||||
| Former Treasurer | 0.00 | 802768 | 0 | 36779 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 7710548 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1060010 | TotalOtherCompensation |
| Number Individuals GT100 K | 115 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Cerner Corporation | |||||
| 2800 Rockcreek Pkwy | Kansas City | MO | 641172521 | Computer Services | 5752676 |
| Siemens Medical Solutions | |||||
| Dept at 40565 | Atlanta | GA | 311920065 | Equipment Maintenance | 2040409 |
| Prudential Insurance Company | |||||
| PO Box 101241 | Atlanta | GA | 303921241 | Life Insurance | 1644498 |
| MassMutual Financial Group | |||||
| 1295 State Street | Springfield | MA | 01111 | Pension | 1317708 |
| Fidelity Security Life Ins | |||||
| PO Box 632530 | Cincinnati | OH | 452632530 | Visioncare Insurance | 1236666 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 89 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Affiliate Support | Description |
| Business Code | 561000 | BusinessCode |
| Total Revenue Column | 92270721 | TotalRevenueColumn |
| Related Or Exempt Function Income | 91599696 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 671025 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 92270721 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 317447 | TotalRevenueColumn |
| Exclusion | $317,447 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 51469 | Securities |
| Other | -45345 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 51469 | Securities |
| Other | -45345 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6124 | TotalRevenueColumn |
| Exclusion | $6,124 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Mini Med School | 611600 | 13120 | 13120 |
| Miscellaneous | 561000 | 9779 | 9779 |
| LTD related income | 561000 | 7421 | 7421 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 30320 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 92624612 | TotalRevenueColumn |
| Related Or Exempt Function Income | 91630016 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 671025 | UnrelatedBusinessRevenue |
| Exclusion | $323,571 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7263820 | Total |
| Program Services | 5886600 | ProgramServices |
| Management And General | 1377220 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37710462 | Total |
| Program Services | 30511267 | ProgramServices |
| Management And General | 7199195 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3949631 | Total |
| Program Services | 3200604 | ProgramServices |
| Management And General | 749027 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4032120 | Total |
| Program Services | 3310667 | ProgramServices |
| Management And General | 721453 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3055408 | Total |
| Program Services | 2475251 | ProgramServices |
| Management And General | 580157 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1177512 | Total |
| Management And General | 1177512 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113683 | Total |
| Management And General | 113683 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3499378 | Total |
| Program Services | 2589709 | ProgramServices |
| Management And General | 909669 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1784411 | Total |
| Program Services | 1650957 | ProgramServices |
| Management And General | 133454 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2366979 | Total |
| Program Services | 2229069 | ProgramServices |
| Management And General | 137910 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21579272 | Total |
| Program Services | 20855790 | ProgramServices |
| Management And General | 723482 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1240919 | Total |
| Program Services | 1063006 | ProgramServices |
| Management And General | 177913 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 610299 | Total |
| Program Services | 408782 | ProgramServices |
| Management And General | 201517 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1236188 | Total |
| Program Services | 856526 | ProgramServices |
| Management And General | 379662 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105810 | Total |
| Program Services | 90636 | ProgramServices |
| Management And General | 15174 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 210270 | Total |
| Program Services | 176918 | ProgramServices |
| Management And General | 33352 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Recruitment | 638210 | 520953 | 117257 |
| Temporary Help | 278181 | 268561 | 9620 |
| Dues & Memberships | 17073 | 17073 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1337638 | Total |
| Program Services | 834246 | ProgramServices |
| Management And General | 503392 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92207264 | Total |
| Program Services | 76946615 | ProgramServices |
| Management And General | 15260649 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 187625 | BOY |
| EOY | 5794 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18954575 | BOY |
| EOY | 24346309 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 286861 | BOY |
| EOY | 1127197 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 451640 | BOY |
| EOY | 157945 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8076348 | BOY |
| EOY | 6905739 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 5145273 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4733799 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 385656 | BOY |
| EOY | 411474 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9610530 | BOY |
| EOY | 9330788 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37953235 | BOY |
| EOY | 42285246 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22709644 | BOY |
| EOY | 24802687 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32393578 | BOY |
| EOY | 37064406 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55103222 | BOY |
| EOY | 61867093 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -17149987 | BOY |
| EOY | -19581847 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -17149987 | BOY |
| EOY | -19581847 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37953235 | BOY |
| EOY | 42285246 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 417348 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2849208 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type3 Func Int | X | SupportingOrg509a3Type3FuncInt |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (5 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| Baystate Health Inc | |||||
| 042105941 | 7 | 1 | 1 | 1 | $0 |
| Baystate Medical Center Inc | |||||
| 042790311 | 3 | 0 | 1 | 1 | $0 |
| Baystate Franklin Medical Ctr | |||||
| 042103575 | 3 | 0 | 1 | 1 | $0 |
| Baystate Mary Lane Hospital Corp | |||||
| 042103584 | 3 | 0 | 1 | 1 | $0 |
| Visiting Nurse Association & Hospice of WNE Inc | |||||
| 042105803 | 9 | 0 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 5 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
| General Explanation | Schedule A, Part IV, Supplemental Information: Schedule A, part I, line 11c Baystate Administrative Services, Inc.(BAS)is a Type III Functionally Integrated supporting organization in accordance with IRS Schedule A Instructions which state that an organization is "operated in connection with" one or more supported organization(s) if it meets a "responsiveness test" and an "integral part test". BAS meets the responsiveness test because its officers, directors, or trustees, have maintained a close continuous working relationship with the officers, directors, or trustees, of the supported organization(s). BAS also meets the integral part test because it engages in activities substantially all of which directly further the exempt purposes of the supported organization(s). Schedule A, part I, line 11h(vii) BAS provides management, administrative, and professional services to support the organizations listed on line h(i). | GeneralExplanation |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $237,080 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 237080 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part IV, Supplemental Information: | Identifier |
| Explanation | The amount recorded on Part II-B, line 1j represents BAS salaries and operating expenses as reported on Massachusetts Public Records Division Lobbyist Disclosures for activities related to healthcare policy, bills and appropriations-related activities. | Explanation |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 498674 | OtherCostOrOtherBasis |
| Depreciation | 456916 | Depreciation |
| Book Value | 41758 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3274653 | OtherCostOrOtherBasis |
| Depreciation | 2904937 | Depreciation |
| Book Value | 369716 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1371946 | OtherCostOrOtherBasis |
| Depreciation | 1371946 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 411474 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Due from affiliated companies | Description |
| Book Value | 9330788 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 9330788 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to affiliated companies | $19,119,933 |
| Total accrued pension cost | $2,133,003 |
| Total minimum pension liability | $15,811,470 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 37064406 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Part X, line 2 : No FIN48 footnote was included in the consolidated audited financial statements of Baystate health, Inc. and Subsidiaries for the year ended September 30, 2012. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 1 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mark R Tolosky | |||||||||||||
| 696553 | 0 | 315856 | 0 | 524231 | 0 | 58633 | 0 | 40732 | 0 | 1636005 | 0 | 0 | 0 |
| Dennis W Chalke | |||||||||||||
| 363180 | 0 | 131625 | 0 | 177826 | 0 | 58000 | 0 | 34548 | 0 | 765179 | 0 | 0 | 0 |
| Donna J Ross | |||||||||||||
| 255000 | 0 | 77877 | 0 | 62454 | 0 | 42782 | 0 | 5521 | 0 | 443634 | 0 | 0 | 0 |
| Evan Benjamin MD FACP | |||||||||||||
| 327662 | 0 | 92768 | 0 | 95624 | 0 | 33833 | 0 | 24835 | 0 | 574722 | 0 | 0 | 0 |
| Gregory A Harb DOH 33111 | |||||||||||||
| 337108 | 0 | 180000 | 0 | 67657 | 0 | 108675 | 0 | 24328 | 0 | 717768 | 0 | 0 | 0 |
| Mark A Keroack MD DOH 61311 | |||||||||||||
| 245679 | 0 | 33750 | 0 | 21676 | 0 | 64800 | 0 | 15302 | 0 | 381207 | 0 | 0 | 0 |
| Paula C Squires | |||||||||||||
| 272852 | 0 | 77071 | 0 | 471300 | 0 | 15925 | 0 | 28189 | 0 | 865337 | 0 | 324655 | 0 |
| Mark Gorrell Term 82011 | |||||||||||||
| 178968 | 0 | 0 | 0 | 15404 | 0 | 0 | 0 | 12645 | 0 | 207017 | 0 | 0 | 0 |
| Gordon Josephson MD | |||||||||||||
| 332901 | 0 | 71071 | 0 | 33305 | 0 | 46725 | 0 | 19608 | 0 | 503610 | 0 | 0 | 0 |
| Charles D Gijanto | |||||||||||||
| 280176 | 0 | 37638 | 0 | 11834 | 0 | 88631 | 0 | 23954 | 0 | 442233 | 0 | 0 | 0 |
| Joan Sullivan | |||||||||||||
| 247428 | 0 | 48527 | 0 | 28606 | 0 | 34277 | 0 | 18523 | 0 | 377361 | 0 | 0 | 0 |
| Peter A Lyons | |||||||||||||
| 208213 | 0 | 43494 | 0 | 16513 | 0 | 38144 | 0 | 22729 | 0 | 329093 | 0 | 0 | 0 |
| Lawrence G Emerson | |||||||||||||
| 206071 | 0 | 39895 | 0 | 13476 | 0 | 63930 | 0 | 19047 | 0 | 342419 | 0 | 0 | 0 |
| Hal B Jenson MD Term 52111 | |||||||||||||
| 136910 | 0 | 0 | 0 | 35090 | 0 | 14100 | 0 | 16981 | 0 | 203081 | 0 | 0 | 0 |
| Keith C McLean-Shinaman | |||||||||||||
| 276485 | 0 | 137200 | 0 | 389083 | 0 | 0 | 0 | 36779 | 0 | 839547 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Part I, Line 1a: 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 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, Lines 4a-c | Line 4a: Keith McLean-Shinaman terminated employment effective 9/30/2011. The compensation numbers include various one time termination payments. Line 4b: Evan Benjamin, MD - Supplemental Retirement of $70,052 is included in column E. This amount was earned in 2011. Dennis W. Chalke - Supplemental Retirement of $145,066 is included in column E. This amount was earned in 2011. Lawrence Emerson - Supplemental Retirement of $1,930 is included in column E. This amount was earned in 2011. Charles Gijanto - Supplemental Retirement of $72,706 is included in column E. This amount was earned in 2011. Gregory A. Harb - Supplemental Retirement of $96,425 is included in column E. This amount was earned in 2011. Gordon Josephson, MD - Supplemental Retirement of $23,507 is included in column E. This amount was earned in 2011. Mark A. Keroack, MD - Supplemental Retirement of $48,875 is included in column E. This amount was earned in 2011. Peter A. Lyons - Supplemental Retirement of $3,644 is included in column E. This amount was earned in 2011. Keith C. McLean Shinaman - Supplemental Retirement of $41,190 is included in column E. This amount was earned in 2011. Donna Ross- Supplemental Retirement of $18,615 is included in column E. This amount was earned in 2011. Paula Squires - Supplemental Retirement of $456,277 is included in column E. This amount consists of $132,622 earned in 2011 as well as $324,655 non-vested amounts that were earned in the previous 5 years and previously reported each year as deferred compensation, and now included again in accordance with reporting requirements. Joan Sullivan - Supplemental Retirement of $7,485 is included in column E. This amount was earned in 2011. Mark R. Tolosky - Supplemental Retirement of $332,054 is included in column E. This amount was earned in 2011. Line 4c: The supplemental retirement plan offered to Mr. Tolosky from 1997-2002 provided the right to purchase mutual fund shares at a specified price, with the rights expiring at the end of the 10 years. The 2011 compensation of $130,991 was based on the difference between the fair market value at the date of exercise and the exercise price. Part II Gregory A. Harb was a Director for the entire fiscal year, however his employment start date was 3/31/2011, therefore his compensation figures do not reflect an entire year of compensation. Mark A. Keroack, MD was a Director for the entire fiscal year, however his employment start date was 6/13/2011, therefore his compensation figures do not reflect an entire year of compensation. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Baycare Health Partners Inc (BHP) | |||
| Common Board Members or Officers | 234354 | See Part V - The filing organization received payments from BHP for management and administrative services. BHP is an affiliate corporation of the filing organization. | 0 |
| Health New England (HNE) | |||
| Common Board Members or Officers | 228000 | See Part V - The filing organization received payments from HNE of $128,000 for reimbursement of benefits related expenses and $100,000 for management and administrative support. HNE is an affiliate corporation of the filing organization. | 0 |
| Ingraham Corporation (IC) | |||
| Common Board Members or Officers | 336671 | 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 | 19562546 | See Part V - The filing organization received payments from BHIC for Claim Insurance reimbursements and Indemnity Pass-Through payments. | 0 |
| Baystate Health Insurance Company Ltd (BHIC) | |||
| Common Board Members or Officers | 13214633 | See Part V - The filing organization made payments to BHIC for Insurance premiums. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Dennis W. Chalke, Kristin R. Delaney, Loring S. Flint, MD, Hal B. Jenson, MD, Keith C. McLean-Shinaman, Donna J.Ross and Mark R. Tolosky are also officers or trustees of Baystate Health, Inc. & its affiliated entities. | |
| 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) 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, the Chief Executive Officer, the Chair of the Board of Trustees, 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 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 established based on information provided by independent third party consultants for reasonableness and appropriate comparability data. The compensation is then established, reviewed and approved by the independent compensation committee of Baystate Health, Inc. (the parent organization of the health care system to which the filing organization belongs) and all such deliberations and decisions are documented contemporaneously. | |
| Form 990, Part VI, Section 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 VII, Section A, Line 1a, Column (B) | Individuals with such reported compensation who have 10 or less average hours per week listed in Part VII, worked between 40 - 60 hours among all related entities. | Average hours per week: |
| Form 990, Part XI, line 5: | Net unrealized gains on investments: 475,014. Pension Adjustment -3,325,222. Net Asset Transfer from affiliated Companies rounding 1,000. Total to Form 990, Part XI, Line 5: -2,849,208. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 Health Inc | 0 | ||||
| BH Insurance Company Ltd | ||||||||||||||
| 980421413 | Offshore captive Insurance | Baystate Health Inc | 0 | North Church Street | Georgetown | CJ | CJ | |||||||
| 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 | ||||
Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| Health New England Inc | ||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 042864973 | HMO/Insurance | MA | Baystate Health Inc | C |
| HNE Advisory Services | ||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 043012347 | Administrative Svs | MA | Health New England Inc | C |
| Health New England Insurance | ||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 043183019 | Ancilliary Insurance | MA | Health New England Inc | C |
| Health New England of Connecticut | ||||||||
| Monarch Place Suite 1500 | Springfield | MA | 011441500 | 061398662 | Dormant | MA | Health New England Inc | C |
| Ingraham Corporation | ||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 043016257 | Health care and other business activities | MA | Baystate Health Inc | C |
| Baystate Health System Ambulance Inc | ||||||||
| 759 Chestnut Street | Springfield | MA | 01199 | 043018550 | Ambulance Svs | MA | Ingraham Corporation | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (13 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Baystate Medical Center | ||
| J | 1096990 | accrual |
| Baystate Medical Center | ||
| K | 73445350 | accrual |
| Baystate Medical Center | ||
| L | 62232 | accrual |
| Baystate Franklin Medical Center | ||
| K | 7182362 | accrual |
| Baystate Mary Lane Hospital | ||
| K | 1498281 | accrual |
| Baystate Visiting Nurse & Hospice | ||
| K | 1769578 | accrual |
| Baystate Health Inc | ||
| K | 1869782 | accrual |
| Ingraham Corporation | ||
| K | 336671 | accrual |
| Baystate Health Insurance Co | ||
| O | 16762633 | cash |
| Baystate Health Insurance Co | ||
| P | 19562546 | cash |
| Health New England Inc | ||
| K | 100000 | accrual |
| Health New England Inc | ||
| P | 127739 | cash |
| BHS Health & Welfare Benefit Trust | ||
| O | 75449132 | cash |