2022-08-15T22:13:35-05:00 2021-09-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2020-10-01 042105926 SOUTH SHORE HEALTH SYSTEM INC SOUT 7816248000 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 KRISTINE HANSCOM SVP & CFO 7816248000 2022-08-15 1 KRISTINE HANSCOM XXX-XX-XXXX CHRISTINE A KAWECKI P00743140 5169187000 2022-08-15 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z KRISTINE HANSCOM 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 5785052 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. 13 10 0 10 0 0 0 0 0 0 15497632 1218355 689 8212 15498321 1226567 0 0 0 0 0 0 0 0 0 20065 13826 20065 13826 15478256 1212741 60248133 65409060 2953278 1323629 57294855 64085431 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. 0 0 6821 8212 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. 6821 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 13 10 1 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA FL GA MA NH NJ NY RI TN X MARY SHAUGHNESSY 7816248166 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 ROSE DIPIETRO PRESIDENT/CEO THROUGH 12/31/20 1.00 43.50 X X 0 802082 10232 KIMBERLY DEVER MD DIRECTOR, CHIEF OB/GYN 1.00 42.50 X 0 775556 36603 MICHAEL AYERS MD CHAIR PROVIDER COUNCIL THROUGH 12/31/21 1.00 43.50 X 0 281429 30502 JUSTIN CAMPBELL DIRECTOR 1.00 3.50 X 0 80000 0 KENNETH KIRKLAND CHAIR THROUGH 12/31/21 1.00 3.50 X X 0 0 0 PAMELA O'LEARY VICE CHAIR THROUGH 12/31/21 1.00 3.50 X X 0 0 0 CHRISTOPHER ODDLEIFSON DIRECTOR 1.00 3.50 X 0 0 0 HELEN GARVEY DIRECTOR 1.00 3.50 X 0 0 0 LINDA THOMPSON DIRECTOR 1.00 3.50 X 0 0 0 LISA WALSH DIRECTOR 1.00 3.50 X 0 0 0 PAUL WANTANABE DIRECTOR 1.00 3.50 X 0 0 0 PAULA L BECKER DIRECTOR 1.00 3.50 X 0 0 0 ROBERT PINEAU DIRECTOR 1.00 3.50 X 0 0 0 THOMAS MCCARTHY DIRECTOR 1.00 3.50 X 0 0 0 STEPHEN COCO TREASURER & CFO THROUGH 11/12/21 1.00 43.50 X 0 702117 376023 JOSEPH R DRISCOLL ESQ GENERAL COUNSEL/CLERK 1.00 43.50 X 0 479379 31485 PAMELA WHELTON TREASURER THROUGH 8/22/17 0.00 0.00 X 0 1222264 375293 RICHARD AUBUT CEO THROUGH 11/2/15 0.00 0.00 X 0 301848 0 GENE GREEN MD PRESIDENT/CEO THROUGH 8/12/19 0.00 0.00 X 0 113631 2906 JOSEPH CAHILL EXECUTIVE VP THROUGH 7/15/16 0.00 0.00 X 0 107558 0 0 4865864 863044 0 1 1 0 0 397445 397445 5379395 4558485 820910 820910 820910 ADJ. TO GIFT ANNUITY 900099 8212 8212 8212 1226567 8212 0 1218355 7200 7200 37 37 -251 -251 PAYMENTS TO ANNUITANTS 6821 6821 MISCELLANEOUS EXPENSE 19 19 13826 6821 7005 0 744701 437460 0 0 0 0 314625 69952 244675 244673 59192757 64660927 66000 66000 60248133 65409060 23858 166052 2929420 1157577 2953278 1323629 X 54097279 60517384 3197576 3568047 57294855 64085431 60248133 65409060 X 1212741 4077835 1500000 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 SUPPORT 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. 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 2852538 0 238220 0 0 0 3090758 0.52000 0.48000 0 0 244673 244673 69952 69952 0 244673 DUE TO AFFILIATES 1083387 OTHER NONCURRENT LIABILITIES 74190 1157577 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 1 0 0 0 0 0 0 0 PAMELA WHELTON TREASURER THROUGH 8/22/17 0 0 0 650000 0 572264 0 354945 0 20348 0 1597557 0 576301 STEPHEN COCO TREASURER & CFO THROUGH 11/12/21 0 457749 0 221354 0 23014 0 358550 0 17473 0 1078140 0 0 ROSE DIPIETRO PRESIDENT/CEO THROUGH 12/31/20 0 705728 0 91450 0 4904 0 8550 0 1682 0 812314 0 0 KIMBERLY DEVER MD DIRECTOR, CHIEF OB/GYN 0 609002 0 137410 0 29144 0 8550 0 28053 0 812159 0 0 JOSEPH R DRISCOLL ESQ GENERAL COUNSEL/CLERK 0 397890 0 77277 0 4212 0 8550 0 22935 0 510864 0 0 MICHAEL AYERS MD CHAIR PROVIDER COUNCIL THROUGH 12/31 0 234210 0 45000 0 2219 0 8541 0 21961 0 311931 0 0 RICHARD AUBUT CEO THROUGH 11/2/15 0 301848 0 0 0 0 0 0 0 0 0 301848 0 0 GENE GREEN MD PRESIDENT/CEO THROUGH 8/12/19 0 113631 0 0 0 0 0 0 0 2906 0 116537 0 114358 JOSEPH CAHILL EXECUTIVE VP THROUGH 7/15/16 0 107558 0 0 0 0 0 0 0 0 0 107558 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, LINES 4A-B IN 2020, PAMELA WHELTON RECEIVED $571,215, AND GENE GREEN RECEIVED $113,631 IN SALARY CONTINUATION PAY FROM SOUTH SHORE HOSPITAL, A RELATED ORGANIZATION. SOUTH SHORE HOSPITAL HAS ESTABLISHED SPLIT DOLLAR ARRANGEMENTS FOR THE INDIVIDUALS LISTED BELOW. THE PREMIUMS PAID INTO THESE POLICIES BY SOUTH SHORE HOSPITAL ARE DEEMED TO BE LOANED TO THESE INDIVIDUALS AND THEREFORE SUBJECT TO INCOME TAX ON THE IMPUTED INTEREST ASSOCIATED WITH THE LOANS. JOSEPH DRISCOLL, STEPHEN COCO, AND KIMBERLY DEVER PARTICIPATED IN THE PLAN. 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 SOUTH SHORE HEALTH SYSTEM'S BOARD OF DIRECTORS ARE MEMBERS OF THE CORPORATION. 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 1,500,000. TRANSFERS TO AFFILIATES 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 HEALHCARE SERV MA SOUTH SHORE HEALTH SYSTEM INC C 3126232 7730745 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 SOUTH SHORE HOSPITAL INC S 1500000 CASH TRANSFER