SOUTH SHORE HEALTH EXPRESS INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SOUTH SHORE HEALTH EXPRESS INC (EIN 45-2385865)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-15
- IRS object ID
- 202332279349304973
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-15T20:52:45-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 4200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 462045108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452385865 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH SHORE HEALTH EXPRESS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 7816248000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 FOGG ROAD | AddressLine1Txt |
| City | SOUTH WEYMOUTH | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02190 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALLEN SMITH | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 7816248000 | PhoneNum |
| Signature | 2023-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ALLEN | PersonFirstNm |
| Person Last | SMITH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHAWNA M JANSONS | PreparerPersonNm |
| PTIN | P01222873 | PTIN |
| Phone | 3174648600 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALLEN SMITH MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 FOGG ROAD | AddressLine1Txt |
| City | SOUTH WEYMOUTH | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02190 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,688,127 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | SOUTH SHORE HEALTH EXPRESS PROVIDES COMPREHENSIVE, URGENT MEDICAL CARE TO THE RESIDENTS OF SOUTHEASTERN MASSACHUSETTS THROUGH MEDICAL FACILITIES IN SEVEN COMMUNITIES. ALSO, SOUTH SHORE HEALTH EXPRESS SUPPORTS AND FURTHERS THE MISSION OF THE SOUTH SHORE HEALTH SYSTEM, INCLUDING THAT OF ITS AFFILIATES, WHICH IS TO PROMOTE THE GENERAL HEALTH AND WELL-BEING OF THE RESIDENTS OF SOUTHEASTERN MASSACHUSETTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 182 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $396,182 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,996,327 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,399,984 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,333 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $425,211 | PYOtherRevenueAmt |
| CY Other Revenue | $288,143 | CYOtherRevenueAmt |
| PY Total Revenue | $13,819,053 | PYTotalRevenueAmt |
| CY Total Revenue | $16,688,127 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,073,041 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,274,590 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,299,021 | PYOtherExpensesAmt |
| CY Other Expenses | $9,344,078 | CYOtherExpensesAmt |
| PY Total Expenses | $14,372,062 | PYTotalExpensesAmt |
| CY Total Expenses | $16,618,668 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$553,009 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $69,459 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $31,558,831 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,491,209 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $33,995,329 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,858,248 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$2,436,498 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$2,367,039 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION SUPPORTS AND FURTHERS THE MISSION OF THE SOUTH SHORE HEALTH SYSTEM, INC. HEALTH CARE SYSTEM, INCLUDING THAT OF ITS AFFILIATE CORPORATION, SOUTH SHORE HOSPITAL, INC. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,985,397 | ExpenseAmt |
| Revenue | $16,688,127 | RevenueAmt |
| Desc | SOUTH SHORE HEALTH EXPRESS PROVIDED URGENT CARE MEDICAL SERVICES TO THE RESIDENTS OF SOUTHEASTERN MASSACHUSETTS THROUGH RETAIL LOCATIONS IN SEVEN COMMUNITIES. ALSO, SOUTH SHORE HEALTH EXPRESS SUPPORTED AND FURTHERED THE MISSION OF THE SOUTH SHORE HEALTH SYSTEM, INCLUDING THAT OF AFFILIATE, SOUTH SHORE HOSPITAL, INC. | Desc |
| Total Program Service Expenses | $7,985,397 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 182 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLEN SMITH MD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7816248000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 FOGG RD | AddressLine1Txt |
| City | SOUTH WEYMOUTH | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01290 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ALLEN SMITH MD | |||||||||
| PRESIDENT/CEO BEGINNING 1/1/21 | 0.50 | 44.00 | Yes (X) | Yes (X) | $0 | $1,051,339 | $182,578 | ||
| KIMBERLY DEVER MD | |||||||||
| DIRECTOR, CHIEF OB/GYN | 0.50 | 43.00 | Yes (X) | $0 | $806,027 | $37,909 | |||
| JUSTIN CAMPBELL | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $185,099 | $0 | |||
| MICHAEL AYERS MD | |||||||||
| CHAIR PROVIDER COUN. THRU 12/31/21 | 0.50 | 44.00 | Yes (X) | $0 | $147,976 | $5,949 | |||
| KENNETH KIRKLAND | |||||||||
| CHAIR THROUGH 12/31/21 | 0.50 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PAMELA O'LEARY | |||||||||
| VC THRU 12/31/21,CHAIR BEG 1/1/22 | 0.50 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| THOMAS MCCARTHY | |||||||||
| DIRECTOR, VICE CHAIR AS OF 1/1/22 | 0.50 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ALAN MCKIM | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| BRADLEY SAMPSON | |||||||||
| DIRECTOR AS OF 1/1/22 | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTOPHER ODDLEIFSON | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| ELLEN ESSENFELD | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| HELEN GARVEY | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| LINDA THOMPSON MPH DRPH RN FAAN | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| LISA WALSH | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL SHEEHAN | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| PAUL WANTANABE PHD | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| PAULA L BECKER | |||||||||
| DIRECTOR | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT PINEAU | |||||||||
| DIRECTOR THROUGH 12/31/21 | 0.50 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| STEPHEN COCO | |||||||||
| TREASURER & CFO THROUGH 11/12/21 | 0.50 | 44.00 | Yes (X) | $0 | $918,235 | $25,066 | |||
| JOSEPH R DRISCOLL ESQ | |||||||||
| SECRETARY | 0.50 | 44.00 | Yes (X) | $0 | $460,273 | $32,578 | |||
| MARY SHAUGHNESSY | |||||||||
| TREAS & CFO 11/13/21 THRU 6/13/22 | 0.50 | 44.00 | Yes (X) | $0 | $45,925 | $0 | |||
| KRISTINE HANSCOM CPA MST CGMA | |||||||||
| TREASURER & CFO AS OF 6/14/22 | 0.50 | 44.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES MENSCHING MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $280,498 | $0 | $87,573 | Yes (X) | |||
| MARK DURFEE MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $249,842 | $0 | $84,864 | Yes (X) | |||
| BARRY FISHER MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $256,772 | $0 | $24,596 | Yes (X) | |||
| ANTOINETTE ENG MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $258,493 | $0 | $21,407 | Yes (X) | |||
| KATHERINE COMIS | |||||||||
| VP OF OPERATIONS | 40.00 | 0.00 | $227,715 | $0 | $19,500 | Yes (X) | |||
| ROSE DIPIETRO | |||||||||
| PRESIDENT/CEO THROUGH 12/31/20 | 0.50 | 44.00 | $0 | $326,869 | $3,806 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,273,320 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,941,743 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $525,826 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| QUEST DIAGNOSTICS LLC | |||||
| PO BOX 844226 | BOSTON | MA | 022844226 | LAB SERVICES | $158,810 |
| TRT KINGSTON II LLC | |||||
| PO BOX 809144 | CHICAGO | IL | 606809144 | MANAGEMENT COMPANY | $146,173 |
| LATE NIGHT LLC | |||||
| ONE VAN DE GRAFF DRIVE SUITE 402 | BURLINGTON | MA | 01803 | MANAGEMENT COMPANY | $116,657 |
| REAL RADIOLOGY LLC | |||||
| 17310 WRIGHT STREET SUITE 103 | OMAHA | NE | 68130 | RADIOLOGY SERVICES | $112,472 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SVCS. REV | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $16,399,984 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,399,984 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,399,984 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OCCUPATIONAL HLTH. SVC | 621999 | $283,276 | $283,276 |
| MEDICAL RECORDS INCOME | 621999 | $3,626 | $3,626 |
| PURCHASE DISCOUNTS | 999999 | $733 | $733 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $508 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $508 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $288,143 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,688,127 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,688,127 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,017,676 | TotalAmt |
| Program Services | $5,323,981 | ProgramServicesAmt |
| Management And General | $693,695 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,631 | TotalAmt |
| Program Services | $99,092 | ProgramServicesAmt |
| Management And General | $13,539 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $718,026 | TotalAmt |
| Program Services | $518,905 | ProgramServicesAmt |
| Management And General | $199,121 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $426,257 | TotalAmt |
| Program Services | $377,471 | ProgramServicesAmt |
| Management And General | $48,786 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,400 | TotalAmt |
| Management And General | $8,400 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,127,956 | TotalAmt |
| Program Services | $284,469 | ProgramServicesAmt |
| Management And General | $843,487 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,577 | TotalAmt |
| Management And General | $19,577 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,233 | TotalAmt |
| Program Services | $69,639 | ProgramServicesAmt |
| Management And General | $117,594 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,431 | TotalAmt |
| Management And General | $110,431 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $720,853 | TotalAmt |
| Program Services | $623,898 | ProgramServicesAmt |
| Management And General | $96,955 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179 | TotalAmt |
| Management And General | $179 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,395 | TotalAmt |
| Program Services | $27,395 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $945,901 | TotalAmt |
| Management And General | $945,901 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,935,303 | TotalAmt |
| Program Services | $539,884 | ProgramServicesAmt |
| Management And General | $2,395,419 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,119 | TotalAmt |
| Program Services | $66,200 | ProgramServicesAmt |
| Management And General | $16,919 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,088,815 | $3,088,815 | |
| REPAIRS | $27,995 | $27,995 | |
| WASTE DISPOSAL | $17,301 | $17,301 | |
| HAZARDOUS WASTE DISP. | $13,490 | $13,490 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,130 | TotalAmt |
| Program Services | $12,978 | ProgramServicesAmt |
| Management And General | $17,152 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,618,668 | TotalAmt |
| Program Services | $7,985,397 | ProgramServicesAmt |
| Management And General | $8,633,271 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,473,779 | BOYAmt |
| EOY | $3,370,280 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,313,276 | BOYAmt |
| EOY | $1,534,581 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $381,934 | BOYAmt |
| EOY | $332,926 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $223,998 | BOYAmt |
| EOY | $136,002 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,767,965 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,713,141 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,649,001 | BOYAmt |
| EOY | $1,054,824 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,833 | BOYAmt |
| EOY | $34,627 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,478,448 | BOYAmt |
| EOY | $17,771,944 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,562 | BOYAmt |
| EOY | $5,256,025 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,558,831 | BOYAmt |
| EOY | $29,491,209 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,684,707 | BOYAmt |
| EOY | $1,157,348 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,310,622 | BOYAmt |
| EOY | $30,700,900 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,995,329 | BOYAmt |
| EOY | $31,858,248 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,436,498 | BOYAmt |
| EOY | -$2,367,039 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,436,498 | BOYAmt |
| EOY | -$2,367,039 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,558,831 | BOYAmt |
| EOY | $29,491,209 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $69,459 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 2 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (2 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| SOUTH SHORE HEALTH SYSTEM INC | ||||
| 042105926 | 3 | Yes (1) | $0 | $0 |
| SOUTH SHORE HOSPITAL INC | ||||
| 042769210 | 3 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 2 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (1) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (1) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Test | Yes (X) | ActivitiesTestInd |
| Activities Further Exempt Prps | Yes (1) | ActivitiesFurtherExemptPrpsInd |
| Activities Engaged Org Invlmnt | Yes (1) | ActivitiesEngagedOrgInvlmntInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART IV, SECTION D, LINE 3: | SOUTH SHORE HEALTH EXPRESS SUPPORTED BOTH SOUTH SHORE HOSPITAL, INC. AND SOUTH SHORE HEALTH SYSTEM, INC. IN JANUARY 2018, THE BOARD COMPOSITION FOR THE HEALTH SYSTEM AND ALL RELATED ORGANIZATIONS WERE ALIGNED. THIS GAVE THE SUPPORTED ORGANIZATIONS SIGNIFICANT SAY IN THE STRATEGIC DIRECTION OF THE CORPORATION. INCOME TO HEALTH EXPRESS DIRECTLY SUPPORTED SOUTH SHORE HOSPITAL IN THE DEVELOPMENT AND IMPLEMENTATION OF HEALTH EXPRESS'S INITIATIVES. |
| SCHEDULE A, PART IV, SECTION E, LINE 2A: | SOUTH SHORE HEALTH EXPRESS (HXP) OPERATED TO EXCLUSIVELY SUPPORT AND FURTHER THE MISSION OF SOUTH SHORE HEALTH SYSTEM, INC. (SSHS) AND SOUTH SHORE HOSPITAL, INC. (SSH). SSHS IS THE PARENT OF SEVERAL CORPORATIONS, INCLUDING SSH AND HXP. HXP DID NOT PROVIDE MONETARY SUPPORT TO SSHS, BUT INDIRECTLY SUPPORTED SSHS THROUGH ITS SUPPORT OF SOUTH SHORE HOSPITAL. 100% OF HXP'S ACTIVITIES DIRECTLY FURTHERED THE EXEMPT PURPOSES OF SOUTH SHORE HOSPITAL BY PROVIDING URGENT MEDICAL CARE SERVICES FOR ALL INDIVIDUALS IN THE HOSPITAL'S SERVICE AREA. |
| SCHEDULE A, PART IV, SECTION E, LINE 2B: | WERE IT NOT FOR HXP, SOUTH SHORE HOSPITAL, A SUPPORTED ORGANIZATION, WOULD ENGAGE IN THE ACTIVITIES HXP UNDERTAKES-PROVIDE URGENT MEDICAL CARE FOR THOSE INDIVIDUALS LIVING IN SOUTHEASTERN MASSACHUSETTS. |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $175,354 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,458 | DepreciationAmt |
| Book Value | $154,896 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,020,370 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,237,943 | DepreciationAmt |
| Book Value | $782,427 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $572,241 | OtherCostOrOtherBasisAmt |
| Depreciation | $454,740 | DepreciationAmt |
| Book Value | $117,501 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,054,824 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| SECURITY DEPOSITS | $17,562 |
| DUE FROM AFFILIATES | $3,103,973 |
| ROU ASSETS | $2,134,490 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,256,025 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| LOANS PAYABLE | $28,482,112 |
| ROU LEASE LIABILITY | $2,184,161 |
| EXECUTIVE BENEFITS | $34,627 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $30,700,900 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CORPORATION FOLLOWS THE PROVISION 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALLEN SMITH MD | ||||||||||||||
| PRESIDENT/CEO BEGINNING 1/1/21 | $0 | $847,107 | $0 | $198,688 | $0 | $5,544 | $0 | $158,700 | $0 | $23,878 | $0 | $1,233,917 | $0 | $0 |
| STEPHEN COCO | ||||||||||||||
| TREASURER & CFO THROUGH 11/12/21 | $0 | $520,192 | $0 | $375,000 | $0 | $23,043 | $0 | $8,700 | $0 | $16,366 | $0 | $943,301 | $0 | $0 |
| KIMBERLY DEVER MD | ||||||||||||||
| DIRECTOR, CHIEF OB/GYN | $0 | $619,719 | $0 | $112,914 | $0 | $73,394 | $0 | $8,700 | $0 | $29,209 | $0 | $843,936 | $0 | $0 |
| JOSEPH R DRISCOLL ESQ | ||||||||||||||
| SECRETARY | $0 | $397,252 | $0 | $45,287 | $0 | $17,734 | $0 | $8,700 | $0 | $23,878 | $0 | $492,851 | $0 | $0 |
| JAMES MENSCHING MD | ||||||||||||||
| PHYSICIAN | $256,313 | $0 | $24,185 | $0 | $0 | $0 | $26,000 | $0 | $61,573 | $0 | $368,071 | $0 | $0 | $0 |
| MARK DURFEE MD | ||||||||||||||
| PHYSICIAN | $212,582 | $0 | $37,260 | $0 | $0 | $0 | $23,291 | $0 | $61,573 | $0 | $334,706 | $0 | $0 | $0 |
| ROSE DIPIETRO | ||||||||||||||
| PRESIDENT/CEO THROUGH 12/31/20 | $0 | $126,869 | $0 | $200,000 | $0 | $0 | $0 | $3,806 | $0 | $0 | $0 | $330,675 | $0 | $0 |
| BARRY FISHER MD | ||||||||||||||
| PHYSICIAN | $244,552 | $0 | $12,220 | $0 | $0 | $0 | $0 | $0 | $24,596 | $0 | $281,368 | $0 | $0 | $0 |
| ANTOINETTE ENG MD | ||||||||||||||
| PHYSICIAN | $249,053 | $0 | $9,440 | $0 | $0 | $0 | $19,500 | $0 | $1,907 | $0 | $279,900 | $0 | $0 | $0 |
| KATHERINE COMIS | ||||||||||||||
| VP OF OPERATIONS | $184,000 | $0 | $20,196 | $0 | $23,519 | $0 | $19,500 | $0 | $0 | $0 | $247,215 | $0 | $0 | $0 |
| JUSTIN CAMPBELL | ||||||||||||||
| DIRECTOR | $0 | $185,099 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $185,099 | $0 | $0 |
| MICHAEL AYERS MD | ||||||||||||||
| CHAIR PROVIDER COUN. THRU 12/31/21 | $0 | $114,196 | $0 | $15,000 | $0 | $18,780 | $0 | $3,249 | $0 | $2,700 | $0 | $153,925 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE PRESIDENT OF AMBULATORY CARE 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. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 A, LINE 6 | COASTAL MEDICAL ASSOCIATES, INC. D/B/A SOUTH SHORE PHYSICIAN AMBULATORY ENTERPRISE IS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | OFFICERS AND DIRECTORS ARE ELECTED ANNUALLY BY A BOARD VOTE OF THE SOLE MEMBER. |
| 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 AMBULATORY CARE, IS CONSIDERED A SOUTH SHORE HEALTH SYSTEM 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 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 | SOUTH SHORE HEALTH EXPRESS 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTH SHORE HOSPITAL INC | |||||||||||
| 55 FOGG ROAD | SOUTH WEYMOUTH | MA | 02190 | 042769210 | HOSPITAL | MA | 501(C)(3) | 3 | SOUTH SHORE HEALTH SYSTEM INC | 0 | |
| 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 | 0 | N/A | |
| SOUTH SHORE PROPERTY INC | |||||||||||
| 55 FOGG ROAD | SOUTH WEYMOUTH | MA | 02190 | 050398822 | DEVELOPS AND MANAGES REAL PROPERTY FOR SOUTH SHORE HOSPITAL | MA | 501(C)(3) | 12A, I | SOUTH SHORE HEALTH SYSTEM INC | 0 | |
| 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 | 0 | |
| SOUTH SHORE MEDICAL CENTER INC | |||||||||||
| 143 LONGWATER DRIVE | NORWELL | MA | 02061 | 042297845 | PROVIDES PRIMARY AND SPECIALIZED MEDICAL CARE | MA | 501(C)(3) | 10 | COASTAL MEDICAL ASSOCIATES INC | 0 | |
| 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 | |
| CONNECTED CARE OF SOUTHEASTERN MASSACHUSETTS INC | |||||||||||
| 55 FOGG ROAD | SOUTH WEYMOUTH | MA | 02190 | 823503666 | OPERATES AN ACCOUNTABLE CARE ORGANIZATION | MA | 501(C)(3) | 10 | SOUTH SHORE HEALTH SYSTEM INC | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH SHORE HEALTH INTEGRATED DELIVERY NETWORK INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 FOGG RD | AddressLine1Txt |
| City | SOUTH WEYMOUTH | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02190 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 852785921 | EIN |
| Primary Activities | TO DEVELOP & MAINTAIN A NETWORK OF PROVIDERS FOR DELIVERY OF HEALTHCARE SERV | PrimaryActivitiesTxt |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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