Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | 24,275,389 | 22,899,486 | 24,616,601 | 29,971,167 | 58,410,712 | 160,173,355 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 24,275,389 | 22,899,486 | 24,616,601 | 29,971,167 | 58,410,712 | 160,173,355 |
| 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).. | 0 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 160,173,355 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 24,275,389 | 22,899,486 | 24,616,601 | 29,971,167 | 58,410,712 | 160,173,355 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 0 | |||||
| 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 VI.).. | 0 | |||||
| 11 | Total support. Add lines 7 through 10. | 160,173,355 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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...... | ||||||
| 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. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| PART I, LINE 1 & PART III, LINE 1: | THE ORGANIZATION PROVIDES IN-PATIENT AND OUT-PATIENT SERVICES TO PATIENTS OF ITS SOLE CORPORATE MEMBER, THE CAMBRIDGE PUBLIC HEALTH COMMISSION D/B/A CAMBRIDGE HEALTH ALLIANCE (CHA), AND SUPPORTS TEACHING AND RESEARCH ACTIVITIES OF THAT INSTITUTION INCLUDING ALL RELATED ORGANIZATIONS. PART III, LINE 4A: THE ORGANIZATION EMPLOYS AND CONTRACTS WITH PHYSICIANS OF VARIOUS SPECIALITIES TO PROVIDE A VARIETY OF SERVICES TO THE PATIENTS OF ITS SOLE CORPORATE MEMBER, CAMBRIDGE PUBLIC HEALTH COMMISSION D/B/A CAMBRIDGE HEALTH ALLIANCE (CHA). PRIMARY CARE PHYSICIANS RENDER SERVICES AT APPROXIMATELY 15 CHA LOCATIONS IN CAMBRIDGE, SOMERVILLE, AND OTHER METRO NORTH COMMUNITIES. PSYCHIATRISTS AND PSYCHOLOGISTS RENDER BOTH OUTPATIENT AND INPATIENT SERVICES. ORGANIZATION PHYSICIANS PROVIDE HOSPITAL BASED SERVICES SUCH AS PATHOLOGY, RADIOLOGY, ANESTHESIA AND HOSPITALIST SERVICES. A WIDE RANGE OF SPECIALIST SERVICES ARE OFFERED TO CHA PATIENTS BY EMPLOYED AND CONTRACTING PHYSICIANS PRACTICING IN SURGERY, CARDIOLOGY, PULMONOLOGY, ONCOLOGY AND OTHER MEDICAL SPECIALTIES. WHILE THE PRIMARY FOCUS OF MOST PHYSICIANS IS CLINICAL SERVICE TO PATIENTS, MANY PHYSICIANS ALSO PARTICIPATE IN TEACHING AND/OR RESEARCH PROGRAMS. TEACHING RESPONSIBILITIES SUPPORT CHA'S FIVE MEDICAL RESIDENCY PROGRAMS (DENTISTRY, FAMILY MEDICINE, INTERNAL MEDICINE, PSYCHIATRY, AND SURGICAL PODIATRY), PRECEPTING OF MEDICAL RESIDENTS FROM NUMEROUS OTHER ENTITIES INCLUDING MGH, BIDMC, TUFTS MC, AND CHA'S AFFILIATION WITH HARVARD MEDICAL SCHOOL FOR MEDICAL STUDENT TRAINING VIA THE INTEGRATED CLERKSHIP PROGRAM. PART VI, LINE 2: CERTAIN TRUSTEES ARE ALSO EMPLOYEES OF CAMBRIDGE PUBLIC HEALTH COMMISSION OR ITS OTHER WHOLLY-OWNED SUBSIDIARIES. PART VI, LINE 6: CAMBRIDGE PUBLIC HEALTH COMMISSION D/B/A CAMBRIDGE HEALTH ALLIANCE IS THE SOLE CORPORATE MEMBER OF CAMBRIDGE HEALTH ALLIANCE PHYSICIANS ORGANIZATION, INC. PART VI, LINE 7A: CAMBRIDGE PUBLIC HEALTH COMMISSION D/B/A CAMBRIDGE HEALTH ALLIANCE (CHA) HAS THE RIGHT TO APPOINT, AND DOES APPOINT, ALL MEMBERS OF THE CAMBRIDGE HEALTH ALLIANCE PHYSICIANS ORGANIZATION, INC. BOARD OF TRUSTEES. PART VI, LINE 7B: CERTAIN ACTIONS OF THE BOARD OF TRUSTEES MUST BE APPROVED BY CAMBRIDGE PUBLIC HEALTH COMMISSION D/B/A CAMBRIDGE HEALTH ALLIANCE (CHA), CAMBRIDGE HEALTH ALLIANCE PHYSICIANS ORGANIZATION, INC.'S SOLE CORPORATE MEMBER, AS SET FORTH IN THE BYLAWS, INCLUDING ADOPTION OF THE BUDGET, ANY MERGER, CONSOLIDATION, JOINT VENTURE, OR AFFILIATION WITH CAMBRIDGE HEALTH ALLIANCE PHYSICIANS ORGANIZATION, INC., ANY CAPITAL TRANSACTION, AND INCURRENCE OF DEBT. CHA HAS AUTHORITY TO APPROVE OR DENY ANY SUCH DECISION MADE BY CAMBRIDGE HEALTH ALLIANCE PHYSICIANS ORGANIZATION, INC.'S BOARD OF TRUSTEES. ITEMS CAN BE RECOMMENDED TO THE BOARD OF CHA OR ITS COMMITTEES FOR REVIEW AND APPROVAL. PART VI, LINE 11: CAMBRIDGE HEALTH ALLIANCE PHYSICIANS ORGANIZATION, INC.'S FORM 990 WAS PREPARED WITH THE ASSISTANCE OF ITS OUTSIDE TAX ACCOUNTANTS AND PAID PREPARER (PRICEWATERHOUSECOOPERS). THE ORGANIZATION'S INTERNAL MANAGEMENT AND CHA EMPLOYEES REVIEWED THE FORM 990 AND PROVIDED COMMENTS AND CHANGES. ONCE THE RETURN WAS UPDATED, THE FORM 990 WAS PRESENTED FOR REVIEW TO EACH VOTING MEMBER OF THE CHA FINANCE COMMITTEE. PRICEWATERHOUSECOOPERS THEN FINALIZED THE FORM 990 BASED ON THE REVIEW AND FEEDBACK OF THE CHA FINANCE COMMITTEE. COPIES OF THE COMPLETED FORM 990 WERE DISTRIBUTED IN ELECTRONIC OR PAPER FORM TO MEMBERS OF THE CAMBRIDGE HEALTH ALLIANCE PHYSICIANS ORGANIZATION, INC.'S GOVERNING BODY PRIOR TO FILING WITH IRS. PART VI, LINE 12C: THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY FOR ITS TRUSTEES AND OFFICERS AND ONE FOR ITS PHYSICIANS. THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THESE CONFLICT OF INTEREST POLICIES BY ANNUALLY SURVEYING ITS OFFICERS, DIRECTORS, AND PHYSICIANS. OFFICERS, DIRECTORS, AND PHYSICIANS ARE ALSO GIVEN A COPY OF THE APPLICABLE CONFLICT OF INTEREST POLICY ALONG WITH THE ANNUAL SURVEY AND ARE REMINDED OF THEIR OBLIGATION TO PROMPTLY REPORT ANY NEW POTENTIAL CONFLICTS THAT ARISE. THE COMPLIANCE OFFICER REVIEWS THE RESPONSES. IF A CONFLICT OF INTEREST IS DETERMINED, THE APPLICABLE INDIVIDUAL IS PRECLUDED FROM PARTICIPATING IN DELIBERATION ON OR DECISION-MAKING REGARDING THE TOPIC GIVING RISE TO THE CONFLICT. EACH CONFLICT POLICY CONTAINS DISCIPLINARY PROVISIONS TO ADDRESS VIOLATIONS OF THE POLICY. PART VI, LINE 14: THE ORGANIZATION HAS AN ACTIVE DOCUMENT RETENTION AND DESTRUCTION POLICY APPROVED BY MANAGEMENT. THIS POLICY HAS NOT BEEN APPROVED BY THE BOARD OR A COMMITTEE OF THE BOARD AS OF JUNE 30, 2016. PART VI, LINE 15A: THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE ORGANIZATION'S SOLE MEMBER, CAMBRIDGE PUBLIC HEALTH COMMISSION D/B/A CAMBRIDGE HEALTH ALLIANCE (CHA), IS THE AUTHORIZED BODY FOR REVIEWING THE PRESIDENT'S COMPENSATION. THE PRESIDENT ALSO SERVES AS THE CHIEF MEDICAL OFFICER OF CHA. THE COMMITTEE RELIED UPON COMPARABILITY DATA OBTAINED BY AN INDEPENDENT CONSULTANT WHEN APPROVING THE CEO'S 2015 COMPENSATION AND DISCUSSED THEIR FINDINGS WITH THE ORGANIZATION'S BOARD AND DOCUMENTED THEIR DECISIONS IN THE BOARD MINUTES. IN ADDITION, BECAUSE THE PRESIDENT IS A PHYSICIAN, THE ORGANIZATION'S COMPENSATION COMMITTEE COMPOSED SOLELY OF NON-PHYSICIAN MEMBERS ALSO REVIEWED THE PRESIDENT'S COMPENSATION. PART VI, LINE 15B: CHA'S COMPENSATION COMMITTEE IS THE "AUTHORIZED BODY" OF THE BOARD FOR REVIEWING COMPENSATION OF ALL OFFICERS AND CERTAIN KEY EMPLOYEES OF CHA AND ITS SUBSIDIARIES, INCLUDING THE ORGANIZATION. THE COMPENSATION COMMITTEE ALSO REVIEWS ALL DEPARTMENT CHIEF COMPENSATION. THE COMPENSATION COMMITTEE CONSISTS OF INDEPENDENT MEMBERS AND REVIEWS AND RECOMMENDS COMPENSATION BASED ON MARKET DATA AND BENCHMARKS PROVIDED BY INDEPENDENT CONSULTANTS. CAMBRIDGE HEALTH ALLIANCE PHYSICIANS ORGANIZATION, INC.'S COMPENSATION COMMITTEE REVIEWS ALL PHYSICIAN COMPENSATION METHODOLOGIES. ANNUALLY, THE COMPENSATION COMMITTEE REVIEWS PHYSICIAN COMPENSATION COMPARED TO NATIONAL BENCHMARKS FOR SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE IS COMPRISED SOLELY OF INDEPENDENT MEMBERS. PART VI, LINE 19: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC EITHER BY MAIL OR IN PERSON AT THE ORGANIZATION'S OFFICE, DEPENDING ON THE FORM OF REQUEST. PART XI, LINE 9: CHANGE IN NET ASSETS OR FUND BALANCE - $4,930,314 INCLUDED: RESTRICTED FUND RECEIPTS - $9,179 RESTRICTED FUND RELEASED -($408,555) TRANSFER OF INTERCOMPANY FUND BALANCE - $5,329,690 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:HOSP BASED PHYS SERVICE CONTRA TOTAL FEES:9193179 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:THIRD PARTY BILLING CONTRACTS TOTAL FEES:3618463 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTTRACTS MD'S ON CALL TOTAL FEES:535095 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHERS TOTAL FEES:166955 |
| Software ID: | |
| Software Version: |