2025-08-15T10:33:36-05:00 2024-09-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2023-10-01 043170333 COASTAL MEDICAL ASSOCIATES INC COAS 7816248000 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 STEPHEN JENNEY SVP & CFO 7816248000 2025-08-15 1 1 SHAWNA M JANSONS P01222873 3174648600 2023 2025-03-06 01:10:19Z SOUTH SHORE PHYSICIAN AMBULATORY ENT STEPHEN JENNEY 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 2511955 0 X N/A X 1992 MA COASTAL MEDICAL ASSOCIATES D/B/A SOUTH SHORE PHYSICIAN AMBULATORY ENTERPRISE (SSPAE) ORGANIZES, COORDINATES AND INTEGRATES PHYSICIANS, ADVANCED PRACTICE CLINICIANS AND OTHER AMBULATORY CARE PROVIDERS INTO A BROADER SYSTEM OF HEALTH CARE FOR THE BENEFIT OF THE COMMUNITIES SERVED BY SOUTH SHORE HOSPITAL AND ITS AFFILIATES. IN ADDITION, COASTAL MEDICAL ASSOCIATES PROVIDES SPECIALTY CARE PHYSICIANS TO SOUTH SHORE HOSPITAL, SOUTH SHORE MEDICAL CENTER, AND SOUTH SHORE HEALTH EXPRESS, RELATED ORGANIZATIONS. 13 8 75 8 0 0 0 0 5748062 3263449 0 0 3158197 -751494 8906259 2511955 0 0 0 0 6182904 1272065 0 0 0 2723355 1233494 8906259 2505559 0 6396 3807113 853640 3485067 531594 322046 322046 NONE 0 0 1567052 2505559 MEDICAL SPECIALTIES PROGRAMS: PROVIDES SPECIALIZED AMBULATORY MEDICAL CARE, SPECIALTY CARE PHYSICIANS, COORDINATES AND INTEGRATES PHYSICIANS, ADVANCED PRACTICE CLINICIANS, AND RELATED HEALTH CARE SERVICES IN THE BENEFIT AND FURTHERANCE OF THE CHARITABLE PURPOSES OF SOUTH SHORE HOSPITAL, AND ENGAGES IN RESEARCH AND EDUCATION RELATED TO THE ABOVE. 1567052 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 13 0 1 75 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MA X STEPHEN JENNEY 7816248000 55 FOGG RD SOUTH WEYMOUTH MA 01290 ALLEN SMITH MD PRESIDENT & CEO 1.00 43.50 X X 0 1263309 183307 KIMBERLY DEVER MD DIRECTOR, CHIEF OB/GYN 1.00 42.50 X 0 790024 41762 AMANDA MARCHICA DO DIRECTOR AS OF 10/1/2023 1.00 42.50 X 0 285142 31720 BRADFORD SAMPSON DIRECTOR 1.00 3.50 X 0 80000 0 PAMELA O'LEARY CHAIR 1.00 3.50 X X 0 0 0 THOMAS MCCARTHY VICE CHAIR 1.00 3.50 X X 0 0 0 ALAN MCKIM DIRECTOR 1.00 3.50 X 0 0 0 CHRISTOPHER ODDLEIFSON DIRECTOR THRU 12/31/2023 1.00 3.50 X 0 0 0 ELLEN ESSENFELD DIRECTOR 1.00 3.50 X 0 0 0 GRACE LEE DIRECTOR AS OF 10/1/2023 1.00 3.50 X 0 0 0 HELEN GARVEY DIRECTOR THRU 12/31/2023 1.00 3.50 X 0 0 0 KENNETH QUIGLEY JR DIRECTOR AS OF 10/1/2023 1.00 3.50 X 0 0 0 MICHAEL SHEEHAN DIRECTOR 1.00 3.50 X 0 0 0 PAMELA WHELTON DIRECTOR THRU 12/31/2023 1.00 3.50 X 0 0 0 PAUL WANTANABE PHD DIRECTOR 1.00 3.50 X 0 0 0 PAULA L BECKER DIRECTOR 1.00 3.50 X 0 0 0 JOSEPH R DRISCOLL ESQ SECRETARY 1.00 43.50 X 0 571479 36056 STEPHEN JENNEY CFO & TREAS. AS OF 10/1/23 1.00 43.50 X 0 293418 20403 KATIE WAKELEY MD PHYSICIAN 40.00 0.00 X 616487 0 28577 KATELYN DORNEY MD PHYSICIAN 40.00 0.00 X 455731 0 46588 THOMAS BAER MD PHYSICIAN 40.00 0.00 X 363117 0 25400 THOMAS LYONS MD PHYSICIAN 40.00 0.00 X 356612 0 29559 TYLER SILVERMAN MD PHYSICIAN 40.00 0.00 X 360105 0 16360 JUSTIN CAMPBELL DIRECTOR THRU 9/30/2023 0.00 1.00 X 0 91600 0 MICHAEL AYERS MD DIRECTOR THRU 9/30/2023 1.00 4.50 X 0 29133 0 KRISTINE HANSCOM CPA MST CGMA FORMER TREAS. & CFO (THRU 5/31/23) 1.00 43.50 X 0 907550 18546 2152052 4311655 478278 26 1 1 0 CHARTIS CLINICAL QUALITY SOLUTIONS PO BOX 733715 DALLAS TX 753733715 CONSULTING 167600 SUSAN WALSH 981 CANTON AVENUE MILTON MA 02186 PHYSICIAN SERVICES 154350 2 NET PATIENT SVCS. REV. 621110 2938142 2938142 CLINICIAN REIMBURSEMEN 621110 325307 325307 3263449 LEASED SERVICES 900099 9016 9016 PHYSICIAN PERF. INCOME 900099 2652 2652 -763162 -763162 -751494 2511955 2511955 0 0 971107 967597 3510 300958 300185 773 246922 246922 82512 1166 81346 375342 375342 1128 1128 34636 34636 ALLOCATED MGMT EXPENSES 426603 426603 DUES 50057 50057 MEDICAL SUPPLIES 7011 7011 PATIENT RELATED ITEMS 4290 4290 4993 4117 876 2505559 1567052 938507 0 2509261 95534 244803 56649 178325 0 763205 763205 9051 0 53254 0 383713 239646 428706 461811 3807113 853640 971267 291947 2513800 239647 3485067 531594 X 322046 322046 0 0 322046 322046 3807113 853640 6396 0 X 0 1 X 1 0 X SCHEDULE A, PART I, LINE 3: COASTAL MEDICAL ASSOCIATES, INC. IS A HOSPITAL SERVICE ORGANIZATION AS DEFINED IN SECTION 170(B)(1)(A)(III). THE CORPORATION PROVIDES SPECIALIZED MEDICAL CARE TO PATIENTS WITHIN SOUTH SHORE HOSPITAL'S SERVICE AREA. SOUTH SHORE HOSPITAL IS A RELATED ORGANIZATION. COASTAL MEDICAL ASSOCIATES IS NOT LICENSED BY THE COMMONWEALTH OF MASSACHUSETTS AS A HOSPITAL AND IS THEREFORE NOT REQUIRED TO FILE SCHEDULE H FOR THE PURPOSES OF FORM 990. 9076 9076 0 270909 270909 0 492037 492037 0 0 DUE FROM AFFILIATES 461811 461811 ROU LEASE LIABILITY 239647 239647 X PART X, LINE 2: THE CORPORATION FOLLOWS THE PROVISIONS OF FASB ASC 740, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. ASC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. IT PRESCRIBES AN UNCERTAINTY THRESHOLD AND MEASUREMENT ATTRIBUTES FOR FINANCIAL STATEMENT DISCLOSURE OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. 1 0 0 0 0 0 0 1 0 ALLEN SMITH MD PRESIDENT & CEO 0 1082002 0 175763 0 5544 0 159900 0 23407 0 1446616 0 0 KRISTINE HANSCOM CPA MST CGMA FORMER TREAS. & CFO (THRU 5/31/23) 0 275823 0 0 0 631727 0 9900 0 8646 0 926096 0 0 KIMBERLY DEVER MD DIRECTOR, CHIEF OB/GYN 0 671901 0 90317 0 27806 0 9900 0 31862 0 831786 0 0 KATIE WAKELEY MD PHYSICIAN 601884 0 390 0 14213 0 9900 0 18677 0 645064 0 0 0 JOSEPH R DRISCOLL ESQ SECRETARY 0 514628 0 34015 0 22836 0 9900 0 26156 0 607535 0 0 KATELYN DORNEY MD PHYSICIAN 445906 0 565 0 9260 0 9900 0 36688 0 502319 0 0 0 THOMAS BAER MD PHYSICIAN 359537 0 390 0 3190 0 9900 0 15500 0 388517 0 0 0 THOMAS LYONS MD PHYSICIAN 313115 0 31065 0 12432 0 9900 0 19659 0 386171 0 0 0 TYLER SILVERMAN MD PHYSICIAN 354485 0 540 0 5080 0 9900 0 6460 0 376465 0 0 0 AMANDA MARCHICA DO DIRECTOR AS OF 10/1/2023 0 172732 0 112121 0 289 0 7641 0 24079 0 316862 0 0 STEPHEN JENNEY CFO & TREAS. AS OF 10/1/23 0 233482 0 56875 0 3061 0 5960 0 14443 0 313821 0 0 JUSTIN CAMPBELL DIRECTOR THRU 9/30/2023 0 91600 0 0 0 0 0 0 0 0 0 91600 0 0 MICHAEL AYERS MD DIRECTOR THRU 9/30/2023 0 29133 0 0 0 0 0 0 0 0 0 29133 0 0 PART I, LINE 3 THE VICE PRESIDENT OF AMBULATORY CARE, WHO OVERSEES COASTAL MEDICAL ASSOCIATES AND ITS SUBSIDIARIES, RECEIVES COMPENSATION FOR SERVICES PERFORMED FOR A RELATED ORGANIZATION. THE COMPENSATION COMMITTEE OF SOUTH SHORE HEALTH SYSTEM, A RELATED ORGANIZATION, DETERMINES THE PRESIDENT'S COMPENSATION. THE COMPENSATION COMMITTEE MEETS PERIODICALLY AND ENGAGES AN INDEPENDENT EXTERNAL COMPENSATION CONSULTING FIRM TO ESTABLISH THE COMPENSATION OF KEY SYSTEM EMPLOYEES. THE CONSULTING FIRM DEVELOPS AND PRESENTS ALL MATERIALS INCLUDING MARKET TRENDS, COMPENSATION STUDIES AND SURVEYS, AND ADHERES TO BEST PRACTICE GUIDELINES. THE FINAL RECOMMENDATION FOR COMPENSATION CHANGES IS PRESENTED AND APPROVED BY THE ENTIRE INDEPENDENT COMMUNITY OF THE BOARD OF DIRECTORS. PART I, LINE 4A KRISTINE HANSCOM, THE FORMER CFO & TREASURER RECEIVED SEPARATION COMPENSATION IN THE AMOUNT OF $586,000 FROM SOUTH SHORE HOSPITAL, A RELATED ORGANIZATION. PART I, LINE 7 THE NON-FIXED PAYMENTS PROVIDED CONSIST OF STIPENDS. FORM 990, PART VI, SECTION A, LINE 2 PERSONS LISTED IN PART VII HAVE A "BUSINESS RELATIONSHIP" WITH ONE ANOTHER DUE TO THE OVERLAPPING BOARD STRUCTURE OF SOUTH SHORE HEALTH SYSTEM AND ITS RELATED ENTITIES. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS THE CHIEF MEDICAL OFFICER OF SOUTH SHORE HEALTH SYSTEM, INC. OR SOME OTHER MASSACHUSETTS LICENSED PHYSICAN DESIGNEE SELECTED BY THE BOARD OF DIRECTORS. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024, JASON TRACY WAS THE CMO & SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE POWER TO APPOINT AND REPLACE BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER HAS THE POWER TO ELECT THE BOARD, RATIFY CHANGES TO THE CORPORATION'S ARTICLES OF ORGANIZATION, RATIFY THE SALE, CONSOLIDATION OR MERGER OF THE CORPORATION AND DISPOSE OF THE ORGANIZATION'S PROPERTY, AND AMEND OR REPEAL THE BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS PREPARED INTERNALLY AND REVIEWED BY THE TAX PRACTICE OF ITS INDEPENDENT AUDITORS. THE RETURN IS THEN REVIEWED BY THE TREASURER. FORM 990 IS UPLOADED TO THE GOVERNING BOARD'S WEB PORTAL FOR ALL BOD MEMBERS TO REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST FORM ANNUALLY. THE FORMS ARE REVIEWED FOR CONFLICTS OR POTENTIAL CONFLICTS. BOARD MEMBERS ABSTAIN FROM VOTING ON MATTERS THAT PRESENT A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT OF COASTAL MEDICAL ASSOCIATES, INC. D/B/A SOUTH SHORE PHYSICIAN AMBULATORY ENTERPRISE, INC. IS CONSIDERED A SOUTH SHORE HEALTH SYSTEM (SSHS) EXECUTIVE; ALL EXECUTIVE COMPENSATION DECISIONS ARE MADE BY THE SSHS PRESIDENT/CEO, USING THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTOR'S APPROVED PHILOSOPHY AND PAY APPROACH FOR THE EXECUTIVE TEAM. THE COMPENSATION COMMITTEE IS INDEPENDENT AND CONSISTS SOLELY OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH REGARDS TO COMPENSATION MATTERS. ANNUAL COMPENSATION DECISIONS FOR COASTAL (SSPAE) PHYSICIANS AND ADVANCED PRACTICE CLINICIAN EMPLOYEES ARE ALSO MADE BY SSHS AND ARE BASED ON A COMBINATION OF ADVICE AND RESEARCH PROVIDED BY OUTSIDE CONSULTANTS, REVIEW OF COMPARABLE INDUSTRY DATA AND MARKET CONDITIONS. FORM 990, PART VI, SECTION C, LINE 19 COASTAL MEDICAL ASSOCIATES MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR INSPECTION AT THE CORPORATION'S OFFICE. COPIES OF THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. IN ADDITION, CERTAIN GOVERNING DOCUMENTS ARE ALSO AVAILABLE THROUGH THE MASSACHUSETTS SECRETARY OF THE COMMONWEALTH'S CORPORATIONS DIVISION DATABASE. SOUTH SHORE HOSPITAL INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 042769210 HOSPITAL MA 501(C)(3) 3 SOUTH SHORE HEALTH SYSTEM INC 1 SOUTH SHORE PROPERTY INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 050398822 DEVELOPS AND MANAGES REAL PROPERTY FOR SOUTH SHORE HOSPITAL AND AFFILIATES MA 501(C)(3) 12A, I SOUTH SHORE HEALTH SYSTEM INC 1 METROSOUTH OBSTETRICS & GYNECOLOGY INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 330998957 PROVIDES SPECIALIZED MEDICAL CARE MA 501(C)(3) 3 SOUTH SHORE HOSPITAL INC 1 ATLANTIC WOMEN'S HEALTH INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 200156651 PROVIDES SPECIALIZED MEDICAL CARE MA 501(C)(3) 3 SOUTH SHORE HOSPITAL INC 1 SOUTH SHORE HEALTH EXPRESS INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 452385865 OPERATES MEDICAL URGENT CARE CENTERS MA 501(C)(3) 10 COASTAL MEDICAL ASSOCIATES INC 1 CONNECTED CARE OF SOUTHEASTERN MASSACHUSETTS INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 823503666 OPERATE AN ACCOUNTABLE CARE ORGANIZATION MA 501(C)(3) 10 SOUTH SHORE HEALTH SYSTEM INC 1 SOUTH SHORE MEDICAL CENTER INC 143 LONGWATER DRIVE NORWELL MA 02061 042297845 SPECIALIZED AND PRIMARY MEDICAL CARE MA 501(C)(3) 10 COASTAL MEDICAL ASSOCIATES INC 1 SOUTH SHORE HEALTH SYSTEM INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 042105926 SUPPORTS THE CHARITABLE MISSION OF SOUTH SHORE HOSPITAL AND ITS AFFILIATES MA 501(C)(3) 12B, II N/A 0 SOUTH SHORE HEALTH INTEGRATED DELIVERY NETWORK INC 55 FOGG RD SOUTH WEYMOUTH MA 02190 852785921 TO DEVELOP & MAINTAIN A NETWORK OF PROVIDERS FOR DELIVERY OF HEALTHCARE SERV MA N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0