Civic Intelligence

Fallon Total Care Inc.

990 • Fiscal year 2015 • EIN 45-5591420

Jan 01, 2015 to Dec 31, 2015 • Filed on Nov 14, 2016

C/O Fchp 10 Chestnut StreetWorcester, MA 01608

(508) 799-2100

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

74th percentile

0.58x

Higher debt load relative to assets than 74% of similar nonprofits.

2015 filings • 501(c)3 • $50M-$100M nonprofits • Source year 2015

Liabilities / Revenue

22nd percentile

0.14x

Higher debt load relative to revenue than 22% of similar nonprofits.

2015 filings • 501(c)3 • $50M-$100M nonprofits • Source year 2015

Net Margin

20th percentile

-3.3%

Higher net margin than 20% of similar nonprofits.

2015 filings • 501(c)3 • $50M-$100M nonprofits • Source year 2015

Top Officer Pay

73rd percentile

$517,437

Higher top officer pay than 73% of similar nonprofits.

Top officer pay equals 0.6% of source-year revenue.

2015 filings • 501(c)3 • $50M-$100M nonprofits • Source year 2015

Asset Growth

98th percentile

83%

Faster asset growth than 98% of similar nonprofits.

2015 filings • 501(c)3 • $50M-$100M nonprofits • Annualized from 2014 to 2015

Revenue Growth

19th percentile

-8.6%

Faster revenue growth than 19% of similar nonprofits.

2015 filings • 501(c)3 • $50M-$100M nonprofits • Annualized from 2014 to 2015

Assets

Up

$20,671,949

Up $9,399,773 (+83%) from 2014

Net Assets

Up

$8,578,985

Up $17,792,937 (+193%) from 2014

Liabilities

Down

$12,092,964

Down $8,393,164 (-41%) from 2014

Revenue

Down

$86,376,610

Down $8,149,896 (-8.6%) from 2014

Expenses

Down

$89,233,673

Down $14,695,458 (-14%) from 2014

Net Income

Up

-$2,857,063

Up $6,545,562 (+70%) from 2014

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$30M$20M$10M$0-$10MAssets 2013: $1,971,600Liabilities 2013: $1,782,927Net Assets 2013: $188,6732013Assets 2014: $11,272,176Liabilities 2014: $20,486,128Net Assets 2014: -$9,213,9522014Assets 2015: $20,671,949Liabilities 2015: $12,092,964Net Assets 2015: $8,578,9852015Assets 2016: $21,983,152Liabilities 2016: $8,548,516Net Assets 2016: $13,434,6362016Assets 2017: $1,143,922Liabilities 2017: $709,286Net Assets 2017: $434,6362017Assets 2018: $1,594,190Liabilities 2018: $1,159,554Net Assets 2018: $434,6362018Assets 2019: $434,636Liabilities 2019: $0Net Assets 2019: $434,6362019Assets 2020: $434,636Liabilities 2020: $0Net Assets 2020: $434,6362020Assets 2021: $434,636Liabilities 2021: $0Net Assets 2021: $434,6362021Assets 2022: $434,636Liabilities 2022: $0Net Assets 2022: $434,6362022Assets 2023: $217,636Liabilities 2023: $0Net Assets 2023: $217,6362023Assets 2024: $217,636Liabilities 2024: $0Net Assets 2024: $217,6362024

Highlighted filing

2015

Assets$20,671,949
Liabilities$12,092,964
Net Assets$8,578,985

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$150M$100M$50M$0-$50MRevenue 2013: $1,551,981Expenses 2013: $3,920,668Net Income 2013: -$2,368,6872013Revenue 2014: $94,526,506Expenses 2014: $103,929,131Net Income 2014: -$9,402,6252014Revenue 2015: $86,376,610Expenses 2015: $89,233,673Net Income 2015: -$2,857,0632015Revenue 2016: $3,544,001Expenses 2016: $738,350Net Income 2016: $2,805,6512016Revenue 2017: $0Expenses 2017: $0Net Income 2017: $02017Revenue 2018: $0Expenses 2018: $0Net Income 2018: $02018Revenue 2019: $0Expenses 2019: $0Net Income 2019: $02019Revenue 2020: $0Expenses 2020: $0Net Income 2020: $02020Revenue 2021: $0Expenses 2021: $0Net Income 2021: $02021Revenue 2022: $0Expenses 2022: $0Net Income 2022: $02022Revenue 2023: $0Expenses 2023: $217,000Net Income 2023: -$217,0002023Revenue 2024: $0Expenses 2024: $0Net Income 2024: $02024

Highlighted filing

2015

Revenue$86,376,610
Expenses$89,233,673
Net Income-$2,857,063
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Nov 14, 2016
Return Version
2015v2.1
Gross Receipts
$86,641,385
Mission and Program Overview

Mission

Make a positive difference by improving the health and wellness of our communities through the delivery of high quality, economical healthcare services to both medicare and medicaid eligible population from 21 to 64 years of age.

SEE SCHEDULE O

Balance Sheet Detail
LineBeginningEndChange
Assets
Accounts Receivable$9,165,975$20,269,121▲ $11,103,146
Savings and Temporary Cash Investments$1,973,640$400,328▼ $1,573,312
Land, Buildings, and Equipment, Net$93,832--
Prepaid Expenses and Deferred Charges$38,729$2,500▼ $36,229
Cash and Non-Interest-Bearing Accounts$0$0→ $0
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Intangible Assets$0$0→ $0
Inventories for Sale or Use$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$11,272,176$20,671,949▲ $9,399,773
Other Assets Total$0$0→ $0
Liabilities
Accounts Payable and Accrued Expenses$20,181,460$11,958,433▼ $8,223,027
Deferred Revenue$304,668$134,531▼ $170,137
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Other Liabilities$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$20,486,128$12,092,964▼ $8,393,164
Net Assets / Fund Balance
Unrestricted Net Assets$-9,213,952$8,578,985▲ $17,792,937
Permanently Rstr Net Assets$0$0→ $0
Temporarily Rstr Net Assets$0$0→ $0
Total Net Assets Fund Balance$-9,213,952$8,578,985▲ $17,792,937
Total Liabilities and Net Assets / Fund Balance$11,272,176$20,671,949▲ $9,399,773
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Dan RomeMedical Director UNTIL 9/15PT$142,304$103,260$245,564
Lisa Price-StevensMedical Director, UNTIL 7/15PT$163,389$64,838$228,227
Jo Ann SavageDirector, Clinical OperationsFT$104,714$24,713$129,427
Jill BenoitClinical Pharmacist Until 9/15FT$104,417$24,521$128,938
Sonja BrehmVP, Health Care ServicesFT$28,775$21,849$50,624

Board Members and Trustees

NameTitle
Richard P BurkeChairman
Mary RitterPresident & CEO, Until 12/13
Judith Roark-MackeyDirector MKTG&outreach until 12/13
Sarika AggarwalDirector, Ended 9/15
Christine CassidyDirector/Clerk
Matthew CollinsDirector/clerk Until 11/14
R Scott WalkerDirector/Treasurer
Michael NickeyExecutive Director Ftc & Mh

Highest Paid Contractors

ContractorServicesLocationCompensation
Umass Memorial Medical CenterMedical ServicesPO BOX 415353, Boston, MA 02241$9,575,353
Baystate Medical CenterMedical Services759 CHESTNUT ST, Springfield, MA 01199$5,430,609
Stavros Center For Independent LiviCounseling ServicesPO BOX 2130, Amherst, MA 01004$3,691,131
Fallon Community Health Plan INCManagement Fees10 CHESTNUT ST, Worcester, MA 01608$3,022,601
Cerebral Palsy Of Massachusetts INCMedical Services600 TECHNOLOGY CENTER DR, Stoughton, MA 02072$2,849,678
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$86,376,610
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$-2,857,063

Audited Revenue Reconciliation

Revenue per Audited Statements
$86,375,000
Revenue Not Reported on Financial Statements
$1,610
Other Revenue Adjustments
$1,610
Total Revenue per Audited Statements
$86,375,000
Total Revenue per Form 990
$86,376,610
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$5,415,896
Other Expenses$3,958,395
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Benefits to Members$79,859,382--$79,859,382
Other Salaries and Wages-$3,786,418-$3,786,418
Fees for Services Management-$3,022,601-$3,022,601
Other Employee Benefits-$565,931-$565,931
Current Officers, Directors, Trustees, and Key Employees-$524,415-$524,415
Occupancy-$478,045-$478,045
Payroll Taxes-$386,162-$386,162
Fees for Services Other-$160,562-$160,562
Pension Plan Contributions-$152,970-$152,970
Fees for Services Accounting-$128,500-$128,500
Office Expenses-$57,875-$57,875
Insurance-$46,521-$46,521
Depreciation Depletion-$33,478-$33,478
Advertising-$11,790-$11,790
Information Technology-$10,389-$10,389
Interest-$6,004-$6,004
Fees for Service Investment Mgmnt Fees-$1,525-$1,525
Other Expenses-$1,105-$1,105
Total Functional Expenses$79,859,382$9,374,291$0$89,233,673

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Form 990$89,233,673
Expenses per Audited Statements$89,232,000
Total Expenses per Audited Statements$89,232,000
Expenses Not Reported on Financial Statements$1,673
Other Expense Adjustments$1,673
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 15A and 15B

THE PROCESS FOR DETERMINING CEO AND OTHER OFFICERS' COMPENSATION THE CEO POSITION WAS NOT FILLED IN 2015. THE COMPENSATION FOR THE CEO AND OTHER OFFICERS OF FTC WERE DETERMINED BY THE PARENT ORGANIZATION, FCHP, PURSUANT TO FCHP'S PROCESS FOR DETERMINING COMPENSATION FOR SUCH INDIVIDUALS AS FOLLOWS: FCHP HAS ESTABLISHED AN EXECUTIVE EVALUATION AND COMPENSATION COMMITTEE (THE "COMMITTEE") OF THE BOARD OF DIRECTORS THAT ESTABLISHES POLICIES AND THE COMPENSATION STRUCTURE OF CERTAIN FTC AND FCHP EXECUTIVE OFFICERS. THIS COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE EXECUTIVE OFFICERS IS DETERMINED BY A FAIR AND EQUITABLE PROCESS, INFORMED BY CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION, AND COMPLIANT WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN 2015, THE COMMITTEE CONSISTED OF FOUR MEMBERS OF FCHP'S BOARD OF DIRECTORS WHO ARE NOT EMPLOYED BY THE ORGANIZATION. FCHP'S CEO SERVED AS AN EX OFFICIO MEMBER OF THE COMMITTEE WITHOUT A VOTING RIGHT. THE EXECUTIVE OFFICERS OVER WHOSE COMPENSATION THE COMMITTEE IS RESPONSIBLE ARE COMPRISED OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER ("CEO"), AND THE PRESIDENT, EXECUTIVE VICE PRESIDENT, AND SENIOR VICE PRESIDENT POSITIONS THAT REPORT DIRECTLY TO THE CEO ("EXECUTIVE GROUP"). IN 2015, TO DETERMINE THE COMPENSATION STRUCTURE OF THE EXECUTIVE GROUP, THE COMMITTEE RELIED ON A WRITTEN COMPENSATION SURVEY PRODUCED IN 2014 BY AN INDEPENDENT CONSULTING FIRM THAT ASSESSES EXECUTIVE COMPENSATION AND BENEFITS AND REFRESHED IN 2015 BY FALLON HEALTHs COMPENSATION DEPARTMENT. THE COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE EXECUTIVE GROUP AND REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT CONSULTING FIRM and updated by Fallon Health. THE COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION OF THE EXECUTIVE GROUP (OTHER THAN THE CEO). FOR THE CEO'S COMPENSATION THE COMMITTEE (MEETING WITHOUT THE CEO) RECOMMENDED A COMPENSATION STRUCTURE THAT WAS PRESENTED TO THE FCHP'S BOARD OF DIRECTORS. THE BOARD OF DIRECTORS (WITHOUT THE CEO PRESENT), VOTED TO APPROVE THE COMMITTEE'S RECOMMENDATION. ALL THESE DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES OF THE COMMITTEE AND BOARD OF DIRECTORS. THE PROCESS WAS USED TO ESTABLISH THE COMPENSATION FOR THE EXECUTIVE GROUP IN 2015. THIS PROCESS WAS NOT USED TO ESTABLISH COMPENSATION FOR THE "KEY EMPLOYEES" LISTED IN SCHEDULE J. FORM 990, PART VI, LINES 18 AND 19 FTC'S FORM 990 AND ANNUAL AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FTC'S FORM 990, FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY, ARE ALSO PROVIDED UPON REQUEST. FORM 990, PART XI, LINE 9 CAPITAL CONTRIBUTION FROM PARENT: $20,650,000

Filing and Contact Details

Filer

Filer Name
Fallon Total Care Inc
EIN
45-5591420
In Care Of
% R SCOTT WALKER
Phone
5087992100
Address
C/O FCHP 10 CHESTNUT STREET, WORCESTER, MA 01608

Signing Officer

Name
R Scott Walker
Title
Director/treasurer
Phone
5087992100
Signed
2016-11-14
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Richard P Burke
Formed
2013
Legal Domicile
Ma
Voting Board Members
3
Independent Board Members
0
Employees
110
Volunteers
0

Preparer

Firm
PricewaterhouseCoopers LLP
Address
101 SEAPORT BOULEVARD, BOSTON, MA 02210
Preparer
Erin Couture
Phone
6175305000
Supplemental Narrative

Additional Explanations

Form 990, Part I, Line 1

FTC'S MISSION Fallon Total Care, Inc. ("FTC") was formed as a Massachusetts nonprofit corporation on September 20, 2013 for charitable, educational, and scientific purposes, for relief of the poor and distressed and to lessen the burdens of government within the meaning of Sections 170(c)(2)(B) and 501(c)(3) of the Internal Revenue Code of 1986. Specifically, FTC was formed to promote, facilitate, and enhance the delivery of quality, efficient, effective and economical health care and related services to individuals who are dually eligible for both Medicare and Medicaid, and to improve and enhance the health and well-being of those individuals, by providing integrated behavioral and physical health management services on a risk basis. The enrollees are generally underprivileged, underserved, low-income population with major health care needs, including many individuals who suffer from chronic physical and/or mental health conditions. Serving this population is challenging and costly for federal and state governments. Established as a Demonstration Program by the Commonwealth of Massachusetts Executive Office of Health and Human Services' Office of Medicaid and the Center for Medicare Services, participating health plans coordinate and manage integrated behavioral and physical health management services to enrollees ages 21-64 who are eligible for both Medicare and Medicaid. By combining Medicare and Medicaid funding, the Demonstration Program enables a broader menu of services to better meet the needs of Dual Eligibles in the most cost effective way and enables an unprecedented level of integration to achieve better health outcomes for this population and to provide higher quality, more cost effective, person-centered care. FTC was formed by Fallon Community Health Plan, Inc. ("FCHP"), a Section 501(c)(3) tax-exempt Massachusetts nonprofit corporation and licensed Massachusetts health maintenance organization (HMO). FCHP is dedicated to improving the health and welfare of the populations it serves through the delivery of high quality, affordable health care. FCHP formed FTC to further FCHP's charitable health care mission, and FTC's purposes explicitly include supporting, benefiting, performing certain functions of, and carrying out the charitable, educational, or scientific purposes of FCHP. FORM 990, PART III, LINE 3 After careful consideration, FCHP, THE PARENT COMPANY, decided to reluctantly end its participation in the Commonwealth of Massachusetts One Care demonstration program effective September 30, 2015. This decision was reached after exploring alternatives with Medicare and Medicaid but ultimately we determined that our continued participation was not economically sustainable. FCHP worked with Medicare and Medicaid officials throughout the wind down process. We notified each member by mail in advance of the effective date that their coverage would end. This letter also explained the member's options for coverage after September 30 and included telephone numbers to call with any questions. FCHP held informational meetings in two Massachusetts locations to answer questions and help members' understand their choices. FCHP also notified all providers in its network prior to the effective date. FORM 990, PART III, LINE 4 FTC's Program activities consist of prepaid healthcare in the Commonwealth of Massachusetts. The covered population as of September 30, 2015, was 4,684 members. Members pay no premiums, co-payments, or co-insurance while participating in the Plan. All premiums are paid by state and federal agencies to cover traditional Medicaid and Medicare services. In addition to these services, FTC provides comprehensive care management, dedicated Navigators, expanded dental and Long Term Service and Support benefits. FORM 990, PART VI, SECTION A, LINE 1B NONE OF THE VOTING MEMBERS ARE INDEPENDENT BECAUSE THE MEMBERS ARE EMPLOYEES OF THE PARENT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS

Financial Statement Notes

SCHEDULE D, PART XI, LINE 4B

Investment fee reclass to expense 1,525 financial statement rounding 85 ------------------ total on form 990, not on financials 1,610 schedule d, part xii, line 4b investment fee reclass to expense 1,525 financial statement rounding 148 ------------ total on form 990, not on financials 1,673

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