Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014
BCheck if applicable:
CName of organization
Baystate Medical Practices Inc
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
759 Chestnut Street
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Springfield, MA01199
D Employer identification number

04-2888373
E Telephone number

G Gross receipts $ 236,573,335
F Name and address of principal officer:
Dennis W Chalke
759 Chestnut Street
Springfield,MA01199
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
baystatehealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1985
M State of legal domicile: MA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: The mission of the organization is to improve the health of the people in our communities every day, with quality and compassion. Baystate Medical Practice's vision states it will be the multi-specialty group practice of choice, known for exceptional service, quality, value, and academic leadership.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 20
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 0
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 1,587
6 Total number of volunteers (estimate if necessary) ............. 6 1
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 728,665
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -177,138
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 219,743,167 236,558,945
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 3,934 14,390
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 219,747,101 236,573,335
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 197,473,601 216,928,371
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 43,375,752 46,140,594
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 240,849,353 263,068,965
19 Revenue less expenses. Subtract line 18 from line 12....... -21,102,252 -26,495,630
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 34,504,128 41,248,222
21 Total liabilities (Part X, line 26)............. 69,241,657 87,481,931
22 Net assets or fund balances. Subtract line 21 from line 20..... -34,737,529 -46,233,709
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: To deliver excellent patient care, provide innovative medical education and pursue meaningful research.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 249,566,538 including grants of $   ) (Revenue $ 235,830,280 )
Baystate Medical Practices, Inc. provides physician services, medical education and research programs to people in the community within its geographic location. BMP's policy is to provide care to any patient in need of medical care, regardless of the patient's ability to pay for such care. Dependent upon the patient's financial capability to pay, BMP may provide such care free of charge or at amounts below its normal charges. Because BMP does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. In addition to the charity care provided to patients, BMP's physicians participate in many and varied ongoing community outreach initiatives in the areas of education, employment, safety and health. For example, the BMP physicians in the Department of Pediatrics, in collaboration with the Springfield School Department, staff six school-based clinics that enhance school health education programs, provide professional development courses for teachers and administrators and establish a school-to-work program.BMP has also taken a leadership role in strengthening the health of disadvantaged citizens in surrounding communities including specific focus on AIDS and HIV and by providing physician staffing for three community-based health centers through Baystate Medical Center.Part VI, Section A, Line 1b:Baystate Medical Practices, Inc. (BMP) is part of an integrated delivery system including not for profit community hospitals, which have community boards. BMP is a physician organization, which supports Baystate Health and its affiliates and is comprised primarily of BMP employees. This board structure has not changed significantly since the organization applied for exempt status.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet249,566,538
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II...
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................
34
 
No
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
136
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,587
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
20
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
0
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletPeter Lyons Baystate Health Inc759 Chestnut StreetSpringfieldMA01199 (413) 794-0000
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Gordon Josephson MD........................................................................
Chair/President 10/1/13 - 2/03/14
 40.00
.......................10.00 		X   X       529,869 0 62,659
(2) John Schrieber MD........................................................................
Chair/President 2/03/14 - 9/30/14
 40.00
.......................10.00 		X   X       5,036 0 0
(3) Benjamin Liptzin MD........................................................................
Vice Chair/Director
 40.00
.......................10.00 		X   X       527,947 0 53,291
(4) Dennis W Chalke........................................................................
Treasurer/Director
 1.00
.......................49.00 		X   X       769,165 0 75,032
(5) Evan Benjamin MD........................................................................
Director 7/1/-9/30/14/ Sr VP Quality
 1.00
.......................49.00 		X           656,389 0 63,030
(6) Elizabeth Boyle MD........................................................................
Director/ Medical Dir-Health Ctr
 49.00
.......................1.00 		X           234,047 0 46,812
(7) Wayne Duke MD........................................................................
Director/ Vice Chair Pathology
 49.00
.......................1.00 		X           369,538 0 51,804
(8) Oz Harmanli MD........................................................................
Director / Chief Urology
 49.00
.......................1.00 		X           356,987 0 48,619
(9) Thomas Higgins MD........................................................................
Director/ Vice Chair Clinical Affairs
 49.00
.......................1.00 		X           458,665 0 90,008
(10) Kevin Hinchey MD........................................................................
Director/ Chief Academic Affairs
 49.00
.......................1.00 		X           490,558 0 66,584
(11) M Dale Janes........................................................................
Director
 1.00
.......................0.00 		X           0 0 0
(12) Mark A Keroack MD........................................................................
Director/ Exec VP/COO-BH
 1.00
.......................49.00 		X           776,897 0 179,311
(13) Aaron Kugelmass MD........................................................................
Director 10/2/13 -9/30/14 VP Chief Cardio
 49.00
.......................1.00 		X           914,683 0 35,853
(14) Sivakumar Natanasapathy MD........................................................................
Director 10/2/13-9/30/14 Med Dir Adult HMP
 49.00
.......................1.00 		X           423,613 0 44,610
(15) Michael Picchioni MD........................................................................
Director/ Internist
 49.00
.......................1.00 		X           237,937 0 46,393
(16) Sara Rourke MD........................................................................
Director/ Med Dir BFMC
 49.00
.......................1.00 		X           233,357 0 27,009
(17) Joseph Schmidt MD........................................................................
Director/ Vice Chair Emergency Med
 49.00
.......................1.00 		X           341,817 0 52,656
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Scott Siege MD........................................................................
Director/Med Dir BMLH Peds Prac
 49.00
.......................1.00 		X           202,608 0 31,290
(19) Mark R Tolosky........................................................................
Director 10/1/13-7/01/14 President & CEO BH
 1.00
.......................49.00 		X           1,639,060 0 87,835
(20) Kelly Tyler MD........................................................................
Director/ General Surgeon
 49.00
.......................1.00 		X           312,156 0 21,193
(21) Richard Wait MD........................................................................
Director/ Chairman, Dept of Surgery
 49.00
.......................1.00 		X           882,995 0 100,434
(22) Jackson William MD........................................................................
Director / Chief Pedi HMP
 49.00
.......................1.00 		X           207,653 0 23,042
(23) Kristin R Delaney........................................................................
Clerk
 1.00
.......................49.00 		    X       103,365 0 28,954
(24) Andrew Artenstein MD........................................................................
Chairman, Department of Medicine
 50.00
.......................0.00 		      X     406,462 0 46,592
(25) Gerda Maissel MD........................................................................
CMO Northern Region
 50.00
.......................0.00 		      X     576,659 0 42,963
(26) Douglas D Muehlberg........................................................................
COO Baystate Medical Practices
 50.00
.......................0.00 		      X     390,905 0 58,028
(27) M Shafeeq Ahmed MD........................................................................
COO/CMO Eastern Region
 30.00
.......................20.00 		      X     283,562 0 115,751
(28) Dennis Oh MD........................................................................
Neurosurgeon
 50.00
.......................   		        X   774,522 0 30,102
(29) David Refermat MD........................................................................
Chief Plastic Surgery
 50.00
.......................   		        X   716,412 0 31,177
(30) Sherry Taylor MD........................................................................
Chief Division Of Neurosurgery
 50.00
.......................   		        X   708,431 0 33,044
(31) Niels K Rathlev MD........................................................................
Chairman Emergency Services
 50.00
.......................   		        X   595,582 0 39,860
(32) Kevin P Moriarty MD........................................................................
Chief Pediatric Surgery
 50.00
.......................   		        X   585,835 0 44,922
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 15,712,712 0 1,678,858
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet499
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
Yes
 
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Baystate Administrative Services Inc759 Chestnut StreetSpringfieldMA01199 Management services 4,961,168
Baystate Medical Center Inc759 Chestnut StreetSpringfieldMA01199 MD scheduling service 3,714,692
Radiology & Imaging Inc1350 Main St 10th FloorSpringfieldMA011031628 MD services 554,550
Croes Olivia Group Inc2222 Prospect Street Suite 6BelmontMA02478 Consulting services 447,659
Hayes Locums LLC6700 North Andrews Ave Ste 6Fort LauderdaleFL33309 MD services 432,037
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet26
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet  
Program Service RevenueAmt Business Code
2a Physician Practice Fees 621110 149,339,663 149,339,663    
b Hospital reimb programs 621110 61,283,804 61,283,804    
c BH Strategic Initiative funding 621110 5,260,759 5,260,759    
d MD performance incentives 621110 4,639,728 4,639,728    
e EHR incentive Medicare/Medicaid 621110 3,652,029 3,652,029    
f All other program service revenue . 12,382,962 11,654,297 728,665  
g Total. Add lines 2a–2f........MediumBullet 236,558,945
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 14,390     14,390
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet        
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See Instructions......MediumBullet 236,573,335 235,830,280 728,665 14,390
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 9,622,649 9,622,649    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 176,359,563 172,484,762 3,874,801  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 11,852,762 11,596,626 256,136  
9 Other employee benefits ....... 9,622,607 9,410,592 212,015  
10 Payroll taxes ........... 9,470,790 9,273,473 197,317  
11 Fees for services (non-employees):        
a Management ...... 5,361,164   5,361,164  
b Legal ......... 573,689   573,689  
c Accounting ........... 80,393   80,393  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 8,178,079 7,016,379 1,161,700  
12 Advertising and promotion .... 112,849 107,207 5,642  
13 Office expenses ....... 2,501,620 2,269,232 232,388  
14 Information technology ...... 100,640 44,793 55,847  
15 Royalties ..        
16 Occupancy ........... 6,292,375 5,977,756 314,619  
17 Travel ............ 240,355 240,355    
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 173,341 165,876 7,465  
20 Interest ........... 6,536   6,536  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 1,320,564 1,254,536 66,028  
23 Insurance .............. 11,210,326 10,684,172 526,154  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Purchased Svcs Clerical 3,695,875 3,695,875    
b Medical Supplies 3,065,914 3,065,914    
c Prof'l Exp Acct 1,889,490 1,889,490    
d Dues & Memberships 562,962   562,962  
e All other expenses 774,422 766,851 7,571  
25 Total functional expenses. Add lines 1 through 24e 263,068,965 249,566,538 13,502,427 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 3,126,924 1 1,986,545
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 13,482,939 4 17,521,889
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ............. 97,444 7 0
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges .......... 1,531,906 9 1,992,715
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 26,744,264
b Less: accumulated depreciation ..... 10b 16,763,625 7,584,602 10c 9,980,639
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 8,680,313 15 9,766,434
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 34,504,128 16 41,248,222
Liabilities 17 Accounts payable and accrued expenses ......... 31,104,905 17 34,761,893
18 Grants payable .................   18  
19 Deferred revenue ................ 290,625 19 280,208
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 37,846,127 25 52,439,830
26 Total liabilities. Add lines 17 through 25......... 69,241,657 26 87,481,931
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. -34,737,529 27 -46,233,709
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... -34,737,529 33 -46,233,709
34 Total liabilities and net assets/fund balances ........ 34,504,128 34 41,248,222
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
236,573,335
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
263,068,965
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-26,495,630
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-34,737,529
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
14,999,450
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-46,233,709
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Baystate Medical Practices Inc
 
Employer identification number

04-2888373
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... 140,855,978 206,929,699 219,827,643 218,759,374 235,830,282 1,022,202,976
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5. 140,855,978 206,929,699 219,827,643 218,759,374 235,830,282 1,022,202,976
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...           0
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.           0
c Add lines 7a and 7b..           0
8 Public support (Subtract line 7c from line 6.) 1,022,202,976
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
9 Amounts from line 6... 140,855,978 206,929,699 219,827,643 218,759,374 235,830,282 1,022,202,976
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 8,640 3,831 3,428 3,934 14,390 34,223
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b. 8,640 3,831 3,428 3,934 14,390 34,223
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. 297,439 379,972 796,421 983,793 728,665 3,186,290
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.).. 141,162,057 207,313,502 220,627,492 219,747,101 236,573,337 1,025,423,489
14
Section C. Computation of Public Support Percentage
15
15
99.690 %
16
16
99.690 %
Section D. Computation of Investment Income Percentage
17
17
0 %
18
18
0.010 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Baystate Medical Practices Inc
 
Employer identification number

04-2888373
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................   1,103,927 465,983 637,944
c Leasehold improvements ............   7,543,469 1,567,082 5,976,387
d Equipment ................   18,074,243 14,730,560 3,343,683
e Other .................   22,625   22,625
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 9,980,639
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) Due from Affiliated Companies 3,096,234
(2) Accounts Receivable, Other 6,670,200







Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 9,766,434
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
Due to Affiliated Companies 22,602,683
Insurance IBNR Loss Reserves 9,044,184
Accrued Pension Cost 20,071,187
Line of credit, affiliate 721,776





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 52,439,830
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Baystate Medical Practices Inc
 
Employer identification number

04-2888373
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)Gordon Josephson MDChair/President 10/1/13 - 2/03/14 (i)
(ii)		 340,675
0 		152,412
0 		36,782
0 		45,150
0 		17,509
0 		592,528
0 		0
0
(2)Benjamin Liptzin MDVice Chair/Director (i)
(ii)		 366,793
0 		114,369
0 		46,785
0 		35,800
0 		17,491
0 		581,238
0 		0
0
(3)Dennis W ChalkeTreasurer/Director (i)
(ii)		 393,944
0 		159,840
0 		215,381
0 		53,098
0 		21,934
0 		844,197
0 		0
0
(4)Evan Benjamin MDDirector 7/1/-9/30/14/ Sr VP Quality (i)
(ii)		 390,694
0 		138,302
0 		127,393
0 		42,213
0 		20,817
0 		719,419
0 		0
0
(5)Elizabeth Boyle MDDirector/ Medical Dir-Health Ctr (i)
(ii)		 197,816
0 		35,220
0 		1,011
0 		25,797
0 		21,015
0 		280,859
0 		0
0
(6)Wayne Duke MDDirector/ Vice Chair Pathology (i)
(ii)		 312,754
0 		40,512
0 		16,272
0 		33,167
0 		18,637
0 		421,342
0 		0
0
(7)Oz Harmanli MDDirector / Chief Urology (i)
(ii)		 277,700
0 		65,434
0 		13,853
0 		30,626
0 		17,993
0 		405,606
0 		0
0
(8)Thomas Higgins MDDirector/ Vice Chair Clinical Affair (i)
(ii)		 342,123
0 		64,937
0 		51,605
0 		71,760
0 		18,248
0 		548,673
0 		0
0
(9)Kevin Hinchey MDDirector/ Chief Academic Affairs (i)
(ii)		 335,131
0 		119,204
0 		36,223
0 		43,345
0 		23,239
0 		557,142
0 		0
0
(10)Mark A Keroack MDDirector/ Exec VP/COO-BH (i)
(ii)		 537,949
0 		223,630
0 		15,318
0 		165,853
0 		13,458
0 		956,208
0 		0
0
(11)Aaron Kugelmass MDDirector 10/2/13 -9/30/14 VP Chief C (i)
(ii)		 540,375
0 		222,866
0 		151,442
0 		16,575
0 		19,278
0 		950,536
0 		103,513
0
(12)Sivakumar Natanasapathy MDDirector 10/2/13-9/30/14 Med Dir Adu (i)
(ii)		 371,209
0 		38,294
0 		14,110
0 		26,962
0 		17,648
0 		468,223
0 		0
0
(13)Michael Picchioni MDDirector/ Internist (i)
(ii)		 202,998
0 		34,274
0 		665
0 		30,261
0 		16,132
0 		284,330
0 		0
0
(14)Sara Rourke MDDirector/ Med Dir BFMC (i)
(ii)		 185,557
0 		46,422
0 		1,378
0 		11,729
0 		15,280
0 		260,366
0 		0
0
(15)Joseph Schmidt MDDirector/ Vice Chair Emergency Med (i)
(ii)		 295,036
0 		32,881
0 		13,900
0 		33,709
0 		18,947
0 		394,473
0 		0
0
(16)Scott Siege MDDirector/Med Dir BMLH Peds Prac (i)
(ii)		 175,226
0 		26,802
0 		580
0 		13,455
0 		17,835
0 		233,898
0 		0
0
(17)Mark R ToloskyDirector 10/1/13-7/01/14 President & (i)
(ii)		 728,085
0 		456,876
0 		454,099
0 		57,333
0 		30,502
0 		1,726,895
0 		0
0
(18)Kelly Tyler MDDirector/ General Surgeon (i)
(ii)		 304,773
0 		3,432
0 		3,951
0 		12,750
0 		8,443
0 		333,349
0 		0
0
(19)Richard Wait MDDirector/ Chairman, Dept of Surgery (i)
(ii)		 602,783
0 		209,100
0 		71,112
0 		78,413
0 		22,021
0 		983,429
0 		0
0
(20)Jackson William MDDirector / Chief Pedi HMP (i)
(ii)		 177,641
0 		29,669
0 		343
0 		17,457
0 		5,585
0 		230,695
0 		0
0
(21)Andrew Artenstein MDChairman, Department of Medicine (i)
(ii)		 320,073
0 		59,142
0 		27,247
0 		28,145
0 		18,447
0 		453,054
0 		0
0
(22)Gerda Maissel MDCMO Northern Region (i)
(ii)		 447,169
0 		129,240
0 		250
0 		22,913
0 		20,050
0 		619,622
0 		0
0
(23)Douglas D MuehlbergCOO Baystate Medical Practices (i)
(ii)		 281,811
0 		70,659
0 		38,435
0 		42,403
0 		15,625
0 		448,933
0 		0
0
(24)M Shafeeq Ahmed MDCOO/CMO Eastern Region (i)
(ii)		 224,916
0 		41,891
0 		16,755
0 		98,047
0 		17,704
0 		399,313
0 		0
0
(25)Dennis Oh MDNeurosurgeon (i)
(ii)		 614,730
0 		133,440
0 		26,352
0 		12,750
0 		17,352
0 		804,624
0 		0
0
(26)David Refermat MDChief Plastic Surgery (i)
(ii)		 517,308
0 		157,267
0 		41,837
0 		12,750
0 		18,427
0 		747,589
0 		23,849
0
(27)Sherry Taylor MDChief Division Of Neurosurgery (i)
(ii)		 669,193
0 		0
0 		39,238
0 		20,400
0 		12,644
0 		741,475
0 		0
0
(28)Niels K Rathlev MDChairman Emergency Services (i)
(ii)		 396,424
0 		98,655
0 		100,503
0 		20,400
0 		19,460
0 		635,442
0 		61,669
0
(29)Kevin P Moriarty MDChief Pediatric Surgery (i)
(ii)		 472,845
0 		80,916
0 		32,074
0 		26,775
0 		18,147
0 		630,757
0 		8,021
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
Part I, Line 3 The compensation of 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.
Part I, Line 4b Mohammed Shafeeq Ahmed, MD - Supplemental Retirement of $15,187 is included in column E. This amount was earned in 2013. Andrew Artenstein, MD Supplemental Retirement of $22,913 is included in column E. This amount was earned in 2013. Evan B. 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. Wayne Duke, MD - Supplemental Retirement of $14,289 is included in column E. This amount was earned in 2013. Oz Harmanli, MD - Supplemental Retirement of $12,020 is included in column E. This amount was earned in 2013. Thomas Higgins, MD - Supplemental Retirement of $33,423 is included in column E. This amount was earned in 2013. 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. Aaron Kugelmass, MD- Supplemental Retirement of $148,280 is included in column E. This amount consists of $44,767 earned in 2013 and $103,513 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. Benjamin Liptzin, MD - Supplemental Retirement of $32,135 is included in column E. This amount was earned in 2013. Gerda Maissel, MD Supplemental Retirement of $11,015 is included in column E. This amount was earned in 2013. Kevin Moriarty, MD- Supplemental Retirement of $29,460 is included in column E. This amount consists of $21,439 earned in 2013 and $8,021 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. Sivakumar Natanasapathy, MD - Supplemental Retirement of $13,280 is included in column E. This amount was earned in 2013. Dennis Oh, MD - Supplemental Retirement of $24,633 is included in column E. This amount was earned in 2013. Neils K. Rathlev, MD Supplemental Retirement of $88,291 is included in column E. This amount consists of $26,622 earned in 2013 and $61,669 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. David Refermat, MD Supplemental Retirement of $40,730 is included in column E. This amount consists of $16,881 earned in 2013 and $23,849 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. Joseph Schmidt, MD - Supplemental Retirement of $11,427 is included in column E. This amount was earned in 2013. Sherry Taylor, MD - Supplemental Retirement of $32,757 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. Kelly Tyler, MD Supplemental Retirement of $3,281 is included in column E. This amount was earned in 2013. Richard B. Wait, MD - Supplemental Retirement of $70,812 is included in column E. This amount was earned in 2013.
Schedule J (Form 990) 2013

Additional Data


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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Baystate Medical Practices Inc
 
Employer identification number

04-2888373
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) American Excess Insurance Exchange (AEIX)
  		Board Overlap 1,876,951 See Part V - Mark Tolosky, President of the filing organization is also Chairman of the Board of Directors of AEIX. The filing organization purchases general & professional liability insurance from AEIX.   No
(2) Baycare Health Partners Inc (BHP)
  		Common Board Members or Officers 419,425 See Part V - The filing organization made payments to BHP for physician membership dues. BHP is an affiliate corporation of the filing organization.   No
(3) Baystate Radiology & Imaging LLC
  		Common Board Members or Officers 28,385 See Part V - The filing organization made payments to BRI for patient and medical care services. BRI is an affiliate corporation of the filing organization.   No
(4) Baystate Radiology & Imaging LLC
  		Common Board Members or Officers 143,822 See Part V - The filing organization received rent payments from BRI. BRI is an affiliate corporation of the filing organization.   No
(5) Greater Springfield Independent Practice Association (GSIPA)
  		Board Overlap 104,988 See Part V - Benjamin Liptzin, MD, Vice Chair of the filing organization is also a Board Member of GSIPA. The filing organization makes dues/membership payments to GSIPA.   No
(6) Health New England Inc (HNE)
  		Common Board Members or Officers 18,096,053 See Part V - The filing organization received $17,075,543 related to medical claims, $450,000 for medical consulting services and $570,510 in Surplus Sharing payments from HNE. HNE is an affiliate corporation of the filing organization.   No
(7) Ingraham Corporation (IC)
  		Common Board Members or Officers 609,485 See Part V - The filing organization made payments to IC for rental of medical office space. IC is an affiliate corporation of the filing organization.   No
(8) Baycare Health Partners Inc (BHP)
  		Common Board Members or Officers 5,147,234 See Part V - The filing organization received payments from BHP of 5,147,234 for patient care services which BMP is the intermediary between the filing organization and third party payers   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Baystate Medical Practices Inc
 
Employer identification number

04-2888373
Return Reference Explanation
Form 990, Part VI, Section A, line 2 M. Shafeeq Ahmed, Dennis W. Chalke, Kristin R. Delaney, Gordon Josephson, MD, Mark A. Keroack, MD, Benjamin Liptzin, MD, Gerda Maissel, MD, John Schreiber, MD, Scott Siege, MD, Mark R. Tolosky, are also officers or trustees of Baystate Health, Inc. & its affiliated entities.
Form 990, Part VI, Section A, line 3 Baystate Medical Practices, Inc. is affiliated with Baystate Administrative Services, Inc. (BAS) which is a 501(c) (3) organization. Information Technology, Human Resources, Finance, Treasury, Accounting and other management and support functions are delegated to BAS.
Form 990, Part VI, Section A, line 6 The members of the filing organization are physicians, all of whom who have medical staff appointments at a Baystate Health, Inc. (BH) hospital affiliate, provide at least 1,000 hours of professional service annually on behalf of the filing organization, and are parties to a membership agreement with the filing organization approved by the Board of Directors.
Form 990, Part VI, Section A, line 7a The Board of Directors consists of 20 Directors, seven of whom are either appointed by BH or serve ex officio based on positions they hold with BH, and 14 of whom are at large directors elected by the members of the filing organization.
Form 990, Part VI, Section A, line 7b The bylaws of the filing organization provide that the following matters approved by the Board of Directors are also subject to the approval of BH: (1) the filing organizations annual budget, (2) the form and content of agreements with members and other employees of the filing organization for their compensation and benefits, (3) policies regarding personal time, sick time, leaves of absence, hours of work, and number of working days, (4) the establishment of reserves to meet any unusual expense, loss, or anticipated year-end expense or a discretionary fund to support the filing organizations educational and research programs, (5) any pledge of the filing organizations credit, the borrowing of any money, or the execution of any promissory note by the filing organization, (6) amendments to the bylaws of the filing organization, with the exception of certain technical amendments.
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 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 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 15b The compensation of the President 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. Line 15a has been answered No because the President and other officers are paid by Baystate Administrative Services, Inc., an affiliate organization of the filing organization. Key Employees are paid by the filing organization.
Form 990, Part VI, Section C, line 19 Form 990, Part VI, Section C, Line 19 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 5 Certain officers or trustees of the filing organization are paid by an entity,Baystate Administrative Services, Inc. (BAS) EIN 22-2747685, who is part of the health care system to which the filing organization belongs but one that does not meet the technical requirements as a "Related Organization" per Schedule R. Compensation from BAS to the officers and trustees of the filing organization therefore, is reported as paid from an unrelated organization in Line 5 and according to the instructions reported as though paid by the filing organization.
Form 990, Part XI, line 9: Current year acquisitions from other entities 2,785,121. Transfer to/from affiliate, net 20,143,500. Minimum pension liability adjustment -7,929,172. rounding 1.
990 Part XII, line 2c The process has not changed from the prior year.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


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