2012-08-15T10:30:23-07:00 2011-09-30 990 2010-10-01 043127730 WESTFIELD MEDICAL CORPORATION WEST 4135682811 115 W Silver Street Westfield MA 01085 Ronald Bryant 4135682811 2012-08-15 2010 2016-02-24 21:20:13Z Ronald Bryant 115 West Silver Street Westfield MA 01085 3617028 0 X www.noblehospital.org X 1991 MA To operate a non-profit group medical practice exclusively for the benefit of The Trustees of Noble Hospital, Inc. ("Hospital") in furtherance of the Hospital's mission. 20 17 39 0 0 0 0 0 4166498 3303170 0 0 68477 313858 4234975 3617028 0 0 0 0 3983199 3499116 0 0 0 2427428 1865486 6410627 5364602 -2175652 -1747574 846966 535913 255741 174085 591225 361828 To operate a non-profit group medical practice exclusively for the benefit of The Trustees of Noble Hospital, Inc. ("Hospital") in furtherance of the Hospital's mission. 0 0 5213478 0 3303170 Physician medical services provided at Noble Hospital and in the Hospital's service area. 0 0 0 5213478 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 39 1 0 0 0 0 0 0 0 0 0 0 X 20 17 1 1 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X X Ronald Bryant 4135682811 115 W Silver Street Westfield MA 010851634 Robert Bacon 0.25 X 0 0 0 Mark Morin 0.25 X 0 0 0 Robert LaPalme 0.25 X 0 0 0 Mary O'Connell 0.25 X 0 0 0 Donald Bieker 0.25 X 0 0 0 Barbara Braem-Jensen 0.25 X 0 0 0 Roger Butler 0.25 X 0 0 0 Scott Cooper 0.25 X 0 0 0 Harriett Deverry 0.25 X 0 0 0 John Greaney 0.25 X 0 0 0 William Harmon 0.25 X 0 0 0 Carol Kaufman 0.25 X 0 0 0 Joseph Keenan 0.25 X 0 0 0 Kevin Queenin 0.25 X 0 0 0 David Peterson 0.25 X 0 0 0 Donald Pion 0.25 X 0 0 0 Lance Reynolds 0.25 X 0 0 0 John Dillingham 0.25 X 0 0 0 Russell Klaubert 0.25 X 0 0 0 Robert P Perry 0.25 X X 0 135756 15150 Ronald Bryant 0.25 X X 0 14104 0 Stanley Strzempko 0.25 X X 0 142200 0 Denzil Reid 40 X X 245332 14615 29078 Robert Blondin 0.25 X 0 230112 20081 John Shaver 0.25 X 0 128578 3179 Gurpal S Kingra 40 X 422932 0 5667 Heidi Kolek 40 X 310260 0 19848 Kacem A Sekkal 40 X 281584 0 23664 Nathan L Emerson 40 X 250192 0 12848 Armand A Aliotta 40 X 200774 0 0 George Koller 0 X 0 398813 9086 1711074 1064178 138601 10 1 1 1 Staff Care Inc 5001 Statesman Drive Irving TX 75063 Health Care Professionals 582149 Convergent Solutions Inc 9501 Post Office Park Wilbraham MA 01095 Physician Billing 256701 Barton Associates Inc 10 Dearborn Road Peabody MA 01960 Health Care Professionals 178912 Baystate Medical Education & Research Foundation Inc 759 Chestnut Street Springfield MA 01199 Health Care Professionals 154631 Comphealth Associates Inc PO Box 972651 Dallas TX 753972651 Health Care Professionals 139144 5 0 Patient medical care 621110 3253386 3253386 0 0 Rental income 531190 49784 49784 0 0 0 0 0 0 3303170 0 0 0 0 Third party settlements 621110 217491 217491 0 0 96367 96367 0 0 313858 3617028 3617028 0 0 0 0 0 0 0 0 0 0 278299 278299 0 0 0 0 0 0 2812468 2702582 109886 0 48424 46373 2051 0 206551 199003 7548 0 153374 146840 6534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1277566 1274803 2763 0 0 0 0 0 87952 84705 3247 0 0 0 0 0 0 0 0 0 164219 164219 0 0 14815 13815 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21498 18761 2737 0 153735 139083 14652 0 Provision for uncollectible accounts 137916 137916 0 0 7785 7079 706 0 5364602 5213478 151124 0 182879 242045 580739 241638 2111 390 16313 2928 259999 211087 64924 48912 846966 535913 255741 174085 255741 174085 X 591225 361828 0 0 0 0 591225 361828 846966 535913 X -1747574 1518177 X 0 1 1 X 0 X X X 0 0 0 TRUSTEES OF NOBLE HOSPITAL INC 222537423 Hospital 1 1 1 0 1 0 0 0 0 0 0 0 0 0 27080 22462 4618 0 232919 188625 44294 0 0 0 0 48912 3617028 5364602 -1747574 0 0 0 0 0 0 -1747574 3567243 0 0 0 0 0 3567243 0 49785 49785 3617028 5314817 0 0 0 0 0 5314817 0 49785 49785 5364602 SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Rental income from physicians not employed by the organization was reported as a reduction of rent expense in the audited financial statements. SchD_P13_S00_L04b Schedule D, Part XIII, Line 4b Rental income from physicians not employed by the organization was reported as a reduction of rent expense in the audited financial statements. 1 0 0 0 0 1 0 0 0 Robert P Perry 0 135756 0 0 0 0 0 0 0 15150 0 150906 0 0 Ronald Bryant 0 14104 0 0 0 0 0 0 0 0 0 14104 0 0 Denzil Reid 245332 14615 0 0 0 0 2814 0 27433 0 275579 14615 0 0 Robert Blondin 0 204220 0 0 0 25892 0 4113 0 16699 0 250924 0 0 Gurpal S Kingra 142225 0 280707 0 0 0 4892 0 943 0 428767 0 0 0 Heidi Kolek 250360 0 59900 0 0 0 3715 0 17343 0 331318 0 0 0 Kacem A Sekkal 281584 0 0 0 0 0 0 0 24784 0 306368 0 0 0 Nathan L Emerson 250192 0 0 0 0 0 4900 0 9158 0 264250 0 0 0 Armand A Aliotta 200774 0 0 0 0 0 0 0 940 0 201714 0 0 0 George Koller 0 0 0 0 0 398813 0 0 0 9086 0 407899 0 0 SchJ_P01_S00_L04 Schedule J, Part I, Line 4 The organization entered into a severance agreement in September 2009 with George Koller, the Former President & Chief Executive Officer of the organization. The agreement provided for one year of salary to be paid weekly through September 2010 ($5,231 gross weekly) and continuance on the organization's group medical plan through September 2010 at a net cost of approximately $800 monthly. In addition, Mr. Koller received $158,000 as a one-time severance payment on March 12, 2010 and $36,119 as a one-time severance payment on April 8, 2010, all less applicable payroll taxes. The organization entered into a severance agreement in November 2010 with the Former Vice President, Finance. This agreement provided for six months of salary, at his then current rate, to be paid weekly through May 2011 ($3,407 gross weekly) and continuance on the organization's group medical plan through May 2011 at a net cost of approximately $1,289 monthly. SchJ_P01_S00_L06 Schedule J, Part I, Line 6 The organization paid two physician employees additional compensation which was based on the excess of cash collections over expenses of their individual respective practices. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 Certain Directors of the organization had various business relationships with certain other Directors in their respective business capacities within the greater Westfield community. F990_P06_S0A_L03 Form 990, Part VI, Section A, Line 3 On behalf of the organization, the Board of Trustees of a related organization, Trustees of Noble Hospital Inc., contracted both with an executive management company and directly with outside consultants for the services of president and executive vice president. Collectively, those services began on September 23, 2009 and ended on June 30, 2011. F990_P06_S0A_L04 Form 990, Part VI, Section A, Line 4 Effective September 30, 2011, two previously-related companies, Noble Health Systems Inc and Silvermill Realty Corporation, merged with and into another related company, Trustees of Noble Hospital Inc. ("Hospital") with Hospital being the surviving corporation. In connection with the merger, the organization adopted the Amended and Restated Bylaws of Westfield Medical Corporation ("Bylaws") effective September 22, 2011. The Bylaws increased the number of Directors serving on the Board of Directors and stipulated that the Directors of the organization be the same individuals who serve as Trustees of the Hospital. F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 The Member of the organization shall be a physician associated with the practice conducted by the organization. The Member was the Vice President of Medical Affairs of The Trustees of Noble Hospital Inc., an affiliated related organization. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b A copy of this Form 990 was provided to the organization's Finance Committee for their review, discussion and comment prior to filing. It was also distributed to the full Board of Directors prior to filing. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c All directors, officers and senior management employees are required to disclose annually any interests that could give rise to conflicts. Administration periodically reviews the submitted conflict of interest statements to ensure full compliance with the policy. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 The organization makes its governing documents, conflict of interest policy and audited financial statements available to the public upon request. These documents can be reviewed in a conference room adjacent to the Administration offices at Noble Hospital during the regular business hours of 8:00 a.m. through 4:30 p.m. Monday through Friday, excluding recognized holidays. The Form 990 and audited financial statements are also available at various state agencies' offices and websites. F990_P11_S00_L05 Form 990, Part XI, Line 5 The change in net assets includes forgiveness of $1,518,177 of payables due to a related organization. Noble Health Systems Inc 115 West Silver Street Westfield MA 010861634 042131755 Marketing and development support MA 501(c)(3) 11b N/A 0 Trustees of Noble Hospital Inc 115 West Silver Street Westfield MA 010861634 222537423 Acute care hospital MA 501(c)(3) 3 N/A 0 Silvermill Realty Corporation 115 West Silver Street Westfield MA 010861634 222552923 Real estate holding company MA 501(c)(3) 11b N/A 0 Noble Visiting Nurse & Hospice Services Inc 77 Mill Street Westfield MA 01085 222757446 Home health care and hospice MA 501(c)(3) 9 N/A 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 Trustees of Noble Hospital Inc c 1518177 Trustees of Noble Hospital Inc j 94773 An application for an additional three-month extension was approved by the IRS on June 4, 2012. The filing due date is August 15, 2012.