2023-08-15T20:52:45-05:00 2022-09-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2021-10-01 042105926 SOUTH SHORE HEALTH SYSTEM INC SOUT 7816248000 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 ALLEN SMITH PRESIDENT & CEO 7816248000 2023-08-15 1 ALLEN SMITH XXX-XX-XXXX SHAWNA M JANSONS P01222873 3174648600 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z ALLEN SMITH MD 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 710265 0 X WWW.SOUTHSHOREHEALTH.ORG X 1982 MA SOUTH SHORE HEALTH SYSTEM, INC. MANAGES AND SUPPORTS AFFILIATE OPERATIONS TO (1) SUPPORT THE ADVANCEMENT OF KNOWLEDGE AND PRACTICE OF HEALTHCARE AND (2) SPONSOR PROGRAMS TO SUPPORT THE HEALTH AND WELFARE OF ALL PERSONS. 18 14 0 14 0 0 0 0 0 0 1218355 677514 8212 12320 1226567 689834 0 0 0 0 0 0 0 0 0 13826 196480 13826 196480 1212741 493354 65409060 55436746 1323629 2199284 64085431 53237462 SOUTH SHORE HEALTH SYSTEM'S MISSION IS YOUR HEALTH. OUR PASSION. ONE COMMUNITY. 0 0 6535 12320 HEALTH CARE DELIVERY: MANAGE AND SUPPORT AFFILIATE OPERATIONS TO (1) SUPPORT THE ADVANCEMENT OF KNOWLEDGE AND PRACTICE OF HEALTHCARE AND (2) SPONSOR PROGRAMS TO SUPPORT THE HEALTH AND WELFARE OF ALL PERSONS. 6535 1 0 0 0 0 0 0 0 0 1 1 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 18 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA CO CT DC FL GA MA ME NH NJ NY RI TN X ALLEN SMITH MD 7816248000 55 FOGG RD SOUTH WEYMOUTH MA 01290 ALLEN SMITH MD PRESIDENT/CEO BEGINNING 1/1/21 1.00 43.50 X X 0 1051339 182578 KIMBERLY DEVER MD DIRECTOR, CHIEF OB/GYN 1.00 42.50 X 0 806027 37909 JUSTIN CAMPBELL DIRECTOR 1.00 3.50 X 0 185099 0 MICHAEL AYERS MD CHAIR PROVIDER COU. THRU 12/31/21 1.00 43.50 X 0 147976 5949 KENNETH KIRKLAND CHAIR THROUGH 12/31/21 1.00 3.50 X X 0 0 0 PAMELA O'LEARY VC THRU 12/31/21 CHAIR AS OF 1/1/22 1.00 3.50 X X 0 0 0 THOMAS MCCARTHY DIRECTOR, VICE CHAIR AS OF 1/1/22 1.00 3.50 X X 0 0 0 ALAN MCKIM DIRECTOR AS OF 1/1/21 1.00 3.50 X 0 0 0 BRADLEY SAMPSON DIRECTOR AS OF 1/1/22 1.00 3.50 X 0 0 0 CHRISTOPHER ODDLEIFSON DIRECTOR 1.00 3.50 X 0 0 0 ELLEN ESSENFELD DIRECTOR AS OF 1/1/21 1.00 3.50 X 0 0 0 HELEN GARVEY DIRECTOR 1.00 3.50 X 0 0 0 LINDA THOMPSON MPH DRPH RN FAAN DIRECTOR 1.00 3.50 X 0 0 0 LISA WALSH DIRECTOR 1.00 3.50 X 0 0 0 MICHAEL SHEEHAN DIRECTOR AS OF 1/1/21 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 ROBERT PINEAU DIRECTOR THROUGH 12/31/21 1.00 3.50 X 0 0 0 STEPHEN COCO TREASURER & CFO THROUGH 11/12/21 1.00 43.50 X 0 918235 25066 JOSEPH R DRISCOLL ESQ SECRETARY 1.00 43.50 X 0 460273 32578 MARY SHAUGHNESSY TREAS & CFO 11/13/21 THRU 6/13/22 1.00 43.50 X 0 45925 0 KRISTINE HANSCOM CPA MST CGMA TREASURER & CFO AS OF 6/14/22 1.00 43.50 X 0 0 0 PAMELA WHELTON TREASURER THROUGH 8/22/17 0.00 0.00 X 0 388647 302 ROSE DIPIETRO PRESIDENT/CEO THROUGH 12/31/20 1.00 43.50 X 0 326869 3806 0 4330390 288188 0 1 1 0 0 657085 657085 40860 20431 20429 20429 20429 GIFT ANNUITY 900099 12320 12320 12320 689834 12320 0 677514 7200 7200 182602 182602 PAYMENTS TO ANNUITANTS 6535 6535 TAXES 125 125 18 18 196480 6535 189945 0 437460 801823 0 0 0 0 314625 69952 244673 244673 64660927 54307582 66000 82668 65409060 55436746 166052 17263 1157577 2182021 1323629 2199284 X 60517384 50434518 3568047 2802944 64085431 53237462 65409060 55436746 X 493354 -11041323 -300000 X 0 1 X 1 0 X X 1 SOUTH SHORE HOSPITAL INC 042769210 3 1 0 0 1 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 SCHEDULE A, PART IV, SECTION A, LINE 6: SOUTH SHORE HEALTH SYSTEM, INC. (SSHS) IS PART OF A HEALTH CARE SYSTEM THAT INCLUDES SOUTH SHORE HOSPITAL, THE SPECIFIED SUPPORTED ORGANIZATION, AND OTHER AFFILIATES, ALL LISTED IN PART II OF SCHEDULE R. IN ADDITION TO SOUTH SHORE HOSPITAL, SSHS PROVIDES SUPPORT TO ALL AFFILIATES, ALL OF WHICH ARE RECOGNIZED AS 501(C)(3) ORGANIZATIONS THAT ARE NOT PRIVATE FOUNDATIONS, AND ARE OPERATED, SUPERVISED OR CONTROLLED DIRECTLY BY, OR IN CONNECTION WITH, SOUTH SHORE HOSPITAL. 3568047 -763559 2804488 3197576 0 370471 3568047 3113224 0 84352 0 0 0 3197576 3135690 0 -22466 0 0 0 3113224 3090758 0 44932 0 0 0 3135690 0.66000 0.34000 0 0 244673 244673 69952 69952 0 244673 DUE TO AFFILIATES 2120558 OTHER NONCURRENT LIABILITIES 61463 2182021 X PART V, LINE 4: SOUTH SHORE HEALTH SYSTEM MAINTAINS ITS ENDOWMENT FUNDS TO FURTHER THE CHARITABLE PURPOSES OF SOUTH SHORE HOSPITAL AND ITS AFFILIATES. IN PRIOR YEARS, ENDOWMENT FUNDS HAVE BEEN USED TO MAINTAIN AND IMPROVE INFRASTRUCTURE AND TECHNOLOGY THROUGHOUT THE SYSTEM AND ADD AND EXPAND PROGRAM SERVICE OFFERINGS TO THE COMMUNITY. 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 0 0 ALLEN SMITH MD PRESIDENT/CEO BEGINNING 1/1/21 0 847107 0 198688 0 5544 0 158700 0 23878 0 1233917 0 0 STEPHEN COCO TREASURER & CFO THROUGH 11/12/21 0 520192 0 375000 0 23043 0 8700 0 16366 0 943301 0 0 KIMBERLY DEVER MD DIRECTOR, CHIEF OB/GYN 0 619719 0 112914 0 73394 0 8700 0 29209 0 843936 0 0 JOSEPH R DRISCOLL ESQ SECRETARY 0 397252 0 45287 0 17734 0 8700 0 23878 0 492851 0 0 PAMELA WHELTON TREASURER THROUGH 8/22/17 0 34000 0 0 0 354647 0 302 0 0 0 388949 0 354647 ROSE DIPIETRO PRESIDENT/CEO THROUGH 12/31/20 0 126869 0 200000 0 0 0 3806 0 0 0 330675 0 0 JUSTIN CAMPBELL DIRECTOR 0 185099 0 0 0 0 0 0 0 0 0 185099 0 0 MICHAEL AYERS MD CHAIR PROVIDER COU. THRU 12/31/21 0 114196 0 15000 0 18780 0 3249 0 2700 0 153925 0 0 PART I, LINE 3 THE PRESIDENT/CEO OF SSHS RECEIVES COMPENSATION FOR SERVICES PERFORMED FOR A RELATED ORGANIZATION. SOUTH SHORE HEALTH SYSTEM HAS A COMPENSATION COMMITTEE THAT MEETS PERIODICALLY AND ENGAGES AN INDEPENDENT EXTERNAL COMPENSATION CONSULTING FIRM TO ESTABLISH THE COMPENSATION OF THE CEO AND OTHER KEY EMPLOYEES. THE CONSULTING FIRM DEVELOPS AND PRESENTS ALL MATERIALS INCLUDING MARKET TRENDS, COMPENSATION STUDIES AND SURVEYS, AND ADHERES TO BEST PRACTICES GUIDELINES. THE FINAL RECOMMENDATION FOR COMPENSATION CHANGES IS PRESENTED AND APPROVED BY THE ENTIRE INDEPENDENT COMMUNITY OF THE SYSTEM'S BOARD OF DIRECTORS. PART I, LINE 4A PAMELA WHELTON RECEIVED A SEVEANCE PAYMENT DURING THE YEAR OF $354,647. FORM 990, PART VI, SECTION A, LINE 2 KENNETH KIRKLAND AND THOMAS MCCARTHY HAVE A BUSINESS RELATIONSHIP. IN ADDITION, OTHER 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 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 PARENT CORPORATION SOUTH SHORE HEALTH SYSTEM HAS NO EMPLOYEES, HOWEVER, THROUGH ITS BOARD'S COMPENSATION COMMITTEE, MAKES COMPENSATION DECISIONS FOR ALL SYSTEM EXECUTIVES. THE COMPENSATION COMMITTEE SETS THE COMPENSATION PHILOSOPHY AND PAY APPROACH FOR THE EXECUTIVE TEAM AND MAKES COMPENSATION DECISIONS FOR THE PRESIDENT/CEO. UTILIZING THE ESTABLISHED PHILOSOPHY AND APPROACH, THE COMMITTEE DELEGATES COMPENSATION DECISIONS FOR THE REST OF THE EXECUTIVE TEAM TO THE PRESIDENT/CEO. THE COMPENSATION COMMITTEE MEETS PERIODICALLY, IS INDEPENDENT AND CONSISTS SOLELY OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH REGARDS TO COMPENSATION MATTERS. SSHS UTILIZES AN INDEPENDENT OUTSIDE CONSULTANT TO DETERMINE EXECUTIVE COMPENSATION RECOMMENDATIONS FOR THE SSHS PRESIDENT/CEO, AS WELL AS OTHER MEMBERS OF THE EXECUTIVE TEAM. THE CONSULTANT PRESENTS RELEVANT DATA REGARDING SYSTEM EXECUTIVES TO THE COMMITTEE FOR REVIEW, AND APPROVAL FOR THE PRESIDENT/CEO. ALL DATA PRESENTED, AS WELL AS COMPENSATION DELIBERATIONS AND VOTES, IS DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES. THE BOARD'S REVIEW AND APPROVAL PROCESS TAKES PLACE ANNUALLY FOR IMPLEMENTATION AT THE START OF THE NEW FISCAL YEAR. COMPENSATION DECISIONS FOR ALL OTHER HOSPITAL EMPLOYEES, INCLUDING KEY EMPLOYEES, ARE ALSO MADE ANNUALLY AND ARE BASED ON A REVIEW OF COMPARABLE INDUSTRY DATA, MARKET CONDITIONS AND RESEARCH PROVIDED BY OUTSIDE CONSULTANTS. FORM 990, PART VI, SECTION C, LINE 19 SOUTH SHORE HEALTH SYSTEM 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. FORM 990, PART XI, LINE 9: TRANSFERS FROM AFFILIATES -300,000. 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 COASTAL MEDICAL ASSOCIATES INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 043170333 PROVIDES SPECIALIZED MEDICAL CARE MA 501(C)(3) 3 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 0 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 0 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 0 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 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 SOUTH SHORE HEALTH SYSTEM INC C 4756240 20478658 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 CONNECTED CARE OF SOUTHEASTERN MASSACHUSETTS INC R 300000 CASH TRANSFER