2020-08-17T22:53:31-05:00 2019-09-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2018-10-01 043326928 CARL J SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL CARL 6176670608 330 BROOKLINE AVENUE NO ES 2 BOSTON MA 022155400 RICHARD M SCHWARTZSTEIN MD EXECUTIVE DIRECTOR 6176670608 2020-08-17 0 CHRISTINE KAWECKI P00743140 5169187000 73.119.154.46 2020-08-17 22:51:43 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 34B5C822FB8BEC5212156A5E7840FB29F1B14B59 2018 2020-11-06 18:47:13Z RICHARD M SCHWARTZSTEIN 330 BROOKLINE AVENUE NO ES 2 BOSTON MA 022155400 974912 0 X WWW.BIDMC.ORG X 1996 MA SEE SCHEDULE O. 15 7 0 7 -3958 -8514 500 500 745898 883242 67940 91170 0 0 814338 974912 210686 234400 0 0 0 0 0 0 0 404541 528661 615227 763061 199111 211851 3739369 3916902 65921 52183 3673448 3864719 X SEE SCHEDULE O. 0 0 24974 40859 SIMULATION AND SKILLS CENTER ("CENTER") - THE CENTER PROVIDES OPPORTUNITIES FOR TRAINEES TO PRACTICE SKILLS FOR LAPAROSCOPIC AND OTHER SURGICAL PROCEDURES, TO ENGAGE IN TEAM-BASED LEARNING, AND TO ENHANCE COMMUNICATION SKILLS. THE CENTER INCORPORATES REALISTIC OPERATING AND INTENSIVE CARE/EMERGENCY ROOMS WHICH ALLOW FOR TEAM TRAINING AND DISCIPLINE-SPECIFIC EDUCATIONAL EXPERIENCES. THE CENTER'S RESOURCES INCLUDE A WIDE RANGE OF TASK TRAINERS AND SIMULATORS, VIDEOCONFERENCE FACILITIES AND DEDICATED FACULTY AND STAFF TO SUPPORT THE EDUCATION OF STUDENTS, TRAINEES, AND PRACTITIONERS IN ALL OF THE HEALTH CARE PROFESSIONS. 111744 205349 THE SHAPIRO INSTITUTE HAS RUN SEVERAL EDUCATION RESEARCH PROGRAMS INCLUDING: THE FAMILY MEETING PROJECT, TO ASSESS AND TRAIN THE COMMUNICATION SKILLS OF RESIDENTS DEALING WITH FAMILY MEMBERS OF PATIENTS IN CRITICAL CARE SITUATIONS IN A SIMULATED ICU ENVIRONMENT. THE INSTITUTE ALSO PROVIDES SUPPORT FOR AN INDIVIDUAL TO CONDUCT MEDICAL EDUCATION RESEARCH, INDEPENDENT OF HIS OR HER OWN RESIDENCY ACTIVITIES, WHICH CAN ASSESS THE SUCCESS OF EDUCATIONAL INTERVENTIONS IN PROVIDING EFFECTIVE AND SAFE PATIENT CARE. 194606 588634 THE INSTITUTE COLLABORATES WITH THE INTERNATIONAL EMERGENCY MANAGEMENT SOCIETY EMERGENCY MEDICAL COMMITTEE AND OTHER EDUCATIONAL ORGANIZATIONS, TO DEVELOP PROGRAMS AND INITIATIVES WHICH PROMOTE THE INTERNATIONAL EXCHANGE OF MEDICAL STUDENTS AND SHARE MUTUAL MEDICAL EDUCATION INTERESTS. THE TWO PARTIES JOINTLY PROMOTED EDUCATION TO MAKE A SIGNIFICANT CONTRIBUTION TO THE DEVELOPMENT AND PROGRESS OF HUMAN HEALTH IN CHINA, INCLUDING AN EDUCATIONAL PROGRAM FOR CHINESE SENIOR HOSPITAL EXECUTIVES IN BOSTON. 357339 234400 48400 THE SHAPIRO INSTITUTE HAS RUN SEVERAL EDUCATION RESEARCH PROGRAMS INCLUDING: THE FAMILY MEETING PROJECT, TO ASSESS AND TRAIN THE COMMUNICATION SKILLS OF RESIDENTS DEALING WITH FAMILY MEMBERS OF PATIENTS IN CRITICAL CARE SITUATIONS IN A SIMULATED ICU ENVIRONMENT. THE INSTITUTE ALSO PROVIDES SUPPORT FOR AN INDIVIDUAL TO CONDUCT MEDICAL EDUCATION RESEARCH, INDEPENDENT OF HIS OR HER OWN RESIDENCY ACTIVITIES, WHICH CAN ASSESS THE SUCCESS OF EDUCATIONAL INTERVENTIONS IN PROVIDING EFFECTIVE AND SAFE PATIENT CARE. 357339 234400 48400 688663 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 45 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 7 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 MA X CHRISTINE COUGHLIN 6176679120 330 BROOKLINE AVE BOSTON MA 02215 ANDERSON CAROL F TRUSTEE (EX-OFFICIO) 1.00 0.00 X 0 0 0 BRENNER-GATI MD LEONA TRUSTEE 1.00 0.00 X 0 0 0 CHAIKOF MD PHD ELLIOT L TRUSTEE 1.00 64.00 X 0 1097731 121758 DAGI MD TEO TRUSTEE 1.00 0.00 X 0 0 0 EDELHEIT PHD LEWIS S TRUSTEE 1.00 0.00 X 0 0 0 GOLDBERG CAROL R TRUSTEE 1.00 0.00 X 0 0 0 HEALY PETER TRUSTEE (EX-OFFICIO) & CO-CHAIR 1.00 59.00 X X 0 783651 87709 MACDOWELL VIRGINIA TRUSTEE 1.00 0.00 X 0 0 0 RABKIN MD MITCHELL T TRUSTEE 1.00 0.00 X 0 0 0 RICCIOTTI MD HOPE A TRUSTEE 1.00 64.00 X 0 533111 84488 ROBERTS MD DAVID TRUSTEE (EX-OFFICIO) & CO-CHAIR 1.00 59.00 X X 5450 396626 65111 SAFFITZ MD PHD JEFFREY E TRUSTEE 1.00 64.00 X 1250 677569 54906 SCHWARTZSTEIN RICHARD M TRUSTEE (EX-OFFICIO), EXECUTIVE DIRECTOR 6.00 54.00 X X 51441 395022 49131 STEVENSON MD PHD MARY ANN TRUSTEE 1.00 59.00 X 0 762550 76214 ZEIDEL MD MARK L TRUSTEE 1.00 64.00 X 0 807791 73326 COUGHLIN CHRISTINE M CLERK/SECRETARY 2.00 18.00 X 7938 47575 4462 WANG DIANA TREASURER & FINANCIAL ANALYST 8.00 12.00 X 39733 51504 7457 105812 5553130 624562 0 0 1 1 0 500 500 EDUCATION PROGRAMS 900099 883242 883242 883242 90541 -4587 95128 629 0 629 629 629 974912 883242 -3958 95128 234400 234400 46544 46544 5635 1690 3945 4534 4534 406210 406210 24076 7945 16131 TEACHING HONORARIUM 25450 25450 TEACHING EXPENSES 8434 8434 DUES AND SUBSCRIPTIONS 1694 1694 6084 6084 763061 688663 74398 0 1767242 1980514 10883 7016 9142 223024 176318 70782 46706 1881320 1882666 3739369 3916902 35921 52183 30000 65921 52183 X 2280740 2459914 494708 506805 898000 898000 3673448 3864719 3739369 3916902 211851 -19696 -884 0 X 0 1 X 1 0 X X X 2 BETH ISRAEL DEACONESS MEDICAL CENTER INC 042103881 3 1 344332 0 PRESIDENT & FELLOWS OF HARVARD COLLEGE 042103580 2 1 344331 0 2 688663 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, SCHEDULE A, PART IV, SECTION A, LINE 6: AS PREVIOUSLY NOTED IN THIS FILING, THE INSTITUTE IS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO BIDMC. ALL OF THESE ENTITIES ARE PUBLIC CHARITIES EXEMPT FROM INCOME TAX UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. DURING THE PERIOD COVERED BY THIS FILING AS REPORTED IN SCHEDULE I, GRANTS AND OTHER ASSISTANT TO ORGANIZATIONS, GOVERNMENTS AND INDIVIDUALS IN THE UNITED STATES, THE SHAPIRO INSTITUTE MADE CASH GRANTS TO BIDMC IN FURTHERANCE OF BIDMC'S MISSION. FORM 990, SCHEDULE A, PART IV, SECTION B, LINE 1: FOR THE PERIOD COVERED BY THIS FILING, ALTHOUGH A MAJORITY OF THE INSTITUTE'S BOARD WAS NOT APPOINTED BY ITS SUPPORTED ORGANIZATIONS, PURSUANT TO THE SHAPIRO INSTITUTE'S BY-LAWS, A MAJORITY OF THE INSTITUTE'S OFFICERS WERE APPOINTED BY ITS SUPPORTED ORGANIZATIONS. IN ADDITION, AT ALL TIMES DURING THE YEAR THE INSTITUTE'S SUPPORTED ORGANIZATIONS MAINTAINED A CLOSE WORKING RELATIONSHIP WITH THE INSTITUTE. IN PARTICULAR, ALL OF THE INSTITUTE'S OFFICERS WERE INDIVIDUALS EMPLOYED BY AND/OR APPOINTED BY THE SUPPORTED ORGANIZATIONS. OF THESE, HALF OF THE OFFICE POSITIONS, THE TWO CO-CHAIRS AND THE EXECUTIVE DIRECTOR, WERE FILLED BY THE ORGANIZATION. SPECIFICALLY THE TWO CO-CHAIRS WERE INDIVIDUALS WHO SERVED IN THOSE POSITIONS, EX-OFFICIO-, BY VIRTUE OF OFFICES TO WHICH THEY WERE NAMED AT THE SUPPORTED ORGANIZATIONS BY THE SUPPORTED ORGANIZATIONS' BOARDS OR OFFICERS OF THE SUPPORT ORGANIZATION ACTING IN THEIR OFFICIAL CAPACITIES, AND THE EXECUTIVE DIRECTOR WAS APPOINTED BY THE CO-CHAIRS ACTING ON BEHALF OF THE TWO SUPPORTED ORGANIZATIONS. 1413708 31097 40000 1404805 1392368 21340 1413708 1723254 112110 20000 422996 1392368 1631810 400000 45924 30000 324480 1723254 1710961 14575 20000 73726 1631810 0.64000 0.36000 0 0 71661 44467 27194 96043 77282 18761 55320 54569 751 46706 CAREGROUP INVESTMENT PARTNERSHIP 1882666 F 1882666 X 1089961 -19696 134745 115049 974912 0 974912 897806 134745 134745 763061 0 763061 PART X, LINE 2: THE INSTITUTE OPERATES AS A PUBLICLY SUPPORTED TAX-EXEMPT ORGANIZATION PURSUANT TO SECTON 501(C)(3) OF THE INTERNAL REVENUE CODE AND, ACCORDINGLY, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME. THE INSTITUTE IS ALSO EXEMPT FROM MASSACHUSETTS INCOME TAX UNDER MASSACHUSETTS GENERAL LAW CHAPTER 180. AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. UNCERTAIN TAX POSITIONS THE INSTITUTE ACCOUNTS FOR THE EFFECT OF ANY UNCERTAIN TAX POSITIONS BASED ON A "MORE LIKELY THAN NOT" THRESHOLD TO THE RECOGNITION OF THE TAX POSITIONS BEING SUSTAINED BASED ON THE TECHNICAL MERITS OF THE POSITION UNDER SCRUTINY BY THE APPLICABLE TAXING AUTHORITY. IF A TAX POSITION OR POSITIONS ARE DEEMED TO RESULT IN UNCERTAINTIES OF THOSE POSITIONS, THE UNRECOGNIZED TAX BENEFIT IS ESTIMATED BASED ON A "CUMULATIVE PROBABILTIY ASSESSMENT" THAT AGGREGATES THE ESTIMATED TAX LIABILITY FOR ALL UNCERTAIN TAX POSITIONS. THE INSTITUTE HAS IDENTIFIED ITS TAX STATUS AS A TAX-EXEMPT ENTITY, AND ITS DETERMINATIONS OF WHICH INCOME IS RELATED AND UNRELATED, AS ITS ONLY SIGNIFICANT TAX POSITIONS; HOWEVER, THE INSTITUTE HAS DETERMINED THAT SUCH TAX POSITIONS DO NOT RESULT IN ANY UNCERTAINTIES REQUIRING RECOGNITION. THE INSTITUTE IS NOT CURRENTLY UNDER EXAMINATION BY ANY TAXING JURISDICTION. THE INSTITUTE'S FEDERAL AND STATE RETURNS ARE GENERALLY OPEN FOR EXAMINATION FOR THREE YEARS FOLLOWING THE DATE FILED. 1 CENTRAL AMERICA & THE CARIBBEAN 0 0 INVESTMENTS 203782 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 29087 0 0 0 0 0 0 232869 0 232869 1 0 1 1 1 0 FORM 990, SCHEDULE F, PART IV, LINE 1 ALTHOUGH THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER WAS AN INDIRECT U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION DURING THE TAX YEAR, SUCH TRANSFERS DID NOT RESULT IN AN OBLIGATION TO FILE FORM 926, RETURN BY A U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION. FORM 990, SCHEDULE F, PART IV, LINE 3 ALTHOUGH THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER HAD AN INDIRECT OWNERSHIP INTEREST IN A FOREIGN CORPORATION DURING THE TAX YEAR, IT DID NOT MEET ANY OF THE FIVE CATEGORIES OF REQUIRED FILER AND AS SUCH WAS NOT REQUIRED TO FILE FORM 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS. FORM 990, SCHEDULE F, PART IV, LINE 4 ALTHOUGH THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER WAS AN INDIRECT SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR A QUALIFIED ELECTING FUND DURING THE PERIOD COVERED BY THIS FILING, SUCH OWNERSHIP DID NOT RESULT IN AN OBLIGATION TO FILE FORM 8621, INFORMATION RETURN BY A SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR QUALIFIED ELECTING FUND. FORM 990, SCHEDULE F, PART IV, LINE 5 ALTHOUGH THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER HELD AN INDIRECT OWNERSHIP INTEREST IN A FOREIGN PARTNERSHIP DURING THE TAX YEAR, THE INTEREST DID NOT RESULT IN AN OBLIGATION TO FILE FORM 8865, RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS. 1 BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVENUE BOSTON MA 02215 042103881 501(C)(3) 234400 TO SUPPORT MEDICAL EDUCATION 1 0 FORM 990, SCHEDULE I, PART IV: AS PREVIOUSLY NOTED IN THIS FILING, BIDMC IS AN ENTITY SUPPORTED BY THE SHAPIRO INSTITUTE. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO BIDMC AND AN ENTITY THAT CONDUCTS RESEARCH AND TEACHING IN CONJUNCTION WITH BIDMC AND IN FURTHERANCE OF BIDMC'S MISSIONS. AS SUCH, ANY SUPPORT PROVIDED TO HMFP IS IN FURTHERANCE OF THE BIDMC PURPOSES AS WELL. X 0 1 0 0 0 0 0 0 0 CHAIKOF MD PHD ELLIOT L TRUSTEE 0 1069600 0 1100 0 27031 0 80510 0 41248 0 1219489 0 0 HEALY PETER TRUSTEE (EX-OFFICIO) & CO-CHAIR 0 591507 0 177703 0 14441 0 46170 0 41539 0 871360 0 0 RICCIOTTI MD HOPE A TRUSTEE 0 524435 0 0 0 8676 0 51563 0 32925 0 617599 0 0 ROBERTS MD DAVID TRUSTEE (EX-OFFICIO) & CO-CHAIR 5450 377846 0 0 0 18780 0 34815 0 30296 5450 461737 0 0 SAFFITZ MD PHD JEFFREY E TRUSTEE 1250 654934 0 1100 0 21535 0 34584 0 20322 1250 732475 0 0 SCHWARTZSTEIN RICHARD M TRUSTEE (EX-OFFICIO), EXECUTIVE DIRE 44468 332263 6104 54937 869 7822 3025 27225 1888 16993 56354 439240 0 0 STEVENSON MD PHD MARY ANN TRUSTEE 0 745219 0 1100 0 16231 0 51563 0 24651 0 838764 0 0 ZEIDEL MD MARK L TRUSTEE 0 788841 0 2300 0 16650 0 47038 0 26288 0 881117 0 0 PART I, LINE 4B AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN THE INSTITUTE'S FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 DETAIL. AS PREVIOUSLY NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER ("MEDICAL CENTER") IS AN ORGANIZATION SUPPORTED BY THE INSTITUTE. DURING THE 2018 CALENDAR YEAR, THE MEDICAL CENTER WAS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM AND THE BETH ISRAEL DEACONESS MEDICAL CENTER 457(B) PLAN. PURSUANT TO THESE PLANS, ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS AND/OR CAN DEFER PART OF THEIR COMPENSATION. UNDER THE DEFINITIONS TO THIS FORM 990, THESE PLANS ARE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. AMOUNTS DEFERRED BY PARTICIPANTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B (III), OTHER REPORTABLE COMPENSATION AND/OR IN FORM 990 SCHEDULE J PART II, COLUMN C, DEFERRED COMPENSATION, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES: REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: REGULAR WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS QUANTIFIED IN OTHER REPORTABLE COMPENSATION WHICH MAY NOT BE SEPARATELY NOTED IN THIS FILING INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; DISTRIBUTIONS FROM A 457(B) PLAN; AMOUNTS INCLUDIBLE IN INCOME UNDER A 457(F) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED RETIREMENT BENEFITS; OTHER TAXABLE RETIREMENT BENEFITS DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401K RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403B RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT, UNFUNDED AND UNVESTED AMOUNTS DEFERRED UNDER 457(F) PLAN NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THE NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. AND PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS SHAPIRO INSTITUTE AND PFHC/HMS RESPECTIVELY. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER AND BETH ISRAEL DEACONESS MEDICAL CENTER MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS HMFP AND BIDMC RESPECTIVELY. ANDERSON, CAROL F. TRUSTEE (EX-OFFICIO) SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) AND CHAIR BETH ISRAEL DEACONESS MEDICAL CENTER MS. ANDERSON DEVOTES, ON AVERAGE, A COMBINED 11 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. BRENNER-GATI, M.D., LEONA TRUSTEE SHAPIRO INSTITUTE DR. BRENNER-GATI DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. CHAIKOF, M.D., PHD, ELLIOT TRUSTEE SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) AND CHAIR (SURGERY) HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHIEF (SURGERY) BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND PRESIDENT BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION JOHNSON & JOHNSON PROFESSOR OF SURGERY HARVARD MEDICAL SCHOOL DR. CHAIKOF PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. CHAIKOF IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. CHAIKOF'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 534,800 INCENTIVE COMPENSATION: 550 OTHER REPORTABLE COMPENSATION: 13,516 DEFERRED COMPENSATION: 40,255 NON-TAXABLE BENEFITS: 20,624 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 534,800 INCENTIVE COMPENSATION: 550 OTHER REPORTABLE COMPENSATION: 13,516 DEFERRED COMPENSATION: 40,255 NON-TAXABLE BENEFITS: 20,624 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2018 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. CHAIKOF'S POSITIONS AS CHIEF OF SURGERY AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF SURGERY AND JOHNSON & JOHNSON PROFESSOR OF SURGERY, HARVARD MEDICAL SCHOOL: $233,158 BASE AND OTHER REPORTABLE COMPENSATION, $28,947 DEFERRED COMPENSATION AND $4,469 NON-TAXABLE BENEFITS. DAGI, M.D., TEO TRUSTEE SHAPIRO INSTITUTE DR. DAGI DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. EDELHEIT, PHD., LEWIS S. TRUSTEE SHAPIRO INSTITUTE DR. EDELHEIT DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. GOLDBERG, CAROL R. TRUSTEE SHAPIRO INSTITUTE MS. GOLDBERG DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. HEALY, PETER PRESIDENT AND DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION DIRECTOR (EX-OFFICIO) HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO, BIDMC CEO DESIGNATE) AND CO-CHAIR CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 591,507 INCENTIVE COMPENSATION: 177,703 OTHER REPORTABLE COMPENSATION: 14,441 DEFERRED COMPENSATION: 46,170 NON-TAXABLE BENEFITS: 41,539 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. HEALY INCLUDES $47,095 COMBINED PAYMENTS TO NONQUALIFIED RETIREMENT PLANS PLUS THE INCREASE/DECREASE IN VALUE OF THOSE ACCOUNTS DURING THE 2018 CALENDAR YEAR. OF THIS AMOUNT, $34,170 WAS UNVESTED AT SEPTEMBER 30, 2019. MACDOWELL, VIRGINIA TRUSTEE SHAPIRO INSTITUTE DIRECTOR MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP MS. MACDOWELL DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. RABKIN, M.D., MITCHELL T. HONORARY TRUSTEE, CO-FOUNDER AND DISTINGUISHED INSTITUTE SCHOLAR SHAPIRO INSTITUTE DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. DIRECTOR MILTON HOSPITAL FOUNDATION, INC. DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL DR. RABKIN DEVOTES, ON AVERAGE, A COMBINED 3 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. FORM 990 SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES (CONTINUED): RICCIOTTI, M.D., HOPE TRUSTEE SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) AND CHAIR OF OBSTETRICS AND GYNECOLOGY HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER CHIEF OF OBSTETRICS AND GYNECOLOGY BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION ASSOCIATE PROFESSOR OF OBSTETRICS, GYNECOLOGY AND REPRODUCTIVE BIOLOGY HARVARD MEDICAL SCHOOL DR. RICCIOTTI DEVOTED, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. RICCIOTTI PERFORMED SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. RICCIOTTI IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. RICCIOTTI'S COMPENSATION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 262,218 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 4,338 DEFERRED COMPENSATION: 25,782 NON-TAXABLE BENEFITS: 16,463 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 262,218 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 4,338 DEFERRED COMPENSATION: 25,782 NON-TAXABLE BENEFITS: 16,463 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2018 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. RICCIOTTI'S POSITIONS AS CHIEF OF OBSTETRICS AND GYNECOLOGY AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF OBSTETRICS AND GYNECOLOGY AND ASSOCIATE PROFESSOR OF OBSTETRICS, GYNECOLOGY AND REPRODUCTIVE BIOLOGY, HARVARD MEDICAL SCHOOL: $1,250 BASE AND OTHER REPORTABLE COMPENSATION. ROBERTS, M.D., DAVID DIRECTOR (EX-OFFICIO, HMS DEAN DESIGNATE) AND CO-CHAIR SHAPIRO INSTITUTE DEAN FOR EXTERNAL EDUCATION HARVARD MEDICAL SCHOOL DR. ROBERTS WAS DESIGNATED TRUSTEE AND CO-CHAIR OF THE SHAPIRO INSTITUTE BY THE DEAN OF HARVARD MEDICAL SCHOOL. DR. ROBERTS DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 5,450 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY PFHC/HMS BASE COMPENSATION: 377,846 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 18,780 DEFERRED COMPENSATION: 34,815 NON-TAXABLE BENEFITS: 30,296 SAFFITZ, M.D., PH.D., JEFFREY E. TRUSTEE SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) AND CHAIR OF PATHOLOGY HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER CHIEF OF PATHOLOGY AND INTERIM CHIEF ACADEMIC OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND PRESIDENT BIH PATHOLOGY FOUNDATION MALINCKRODT PROFESSOR OF PATHOLOGY HARVARD MEDICAL SCHOOL DR. SAFFITZ PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. SAFFITZ IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. SAFFITZ'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 1,250 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 327,467 INCENTIVE COMPENSATION: 550 OTHER REPORTABLE COMPENSATION: 10,768 DEFERRED COMPENSATION: 17,292 NON-TAXABLE BENEFITS: 10,161 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 327,467 INCENTIVE COMPENSATION: 550 OTHER REPORTABLE COMPENSATION: 10,768 DEFERRED COMPENSATION: 17,292 NON-TAXABLE BENEFITS: 10,161 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2018 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. SAFFITZ'S POSITIONS AS CHIEF OF PATHOLOGY AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF PATHOLOGY AND MALINCKRODT PROFESSOR OF PATHOLOGY, HARVARD MEDICAL SCHOOL: 15,836 BASE AND OTHER REPORTABLE COMPENSATION, 1,584 DEFERRED COMPENSATION AND 141 NON-TAXABLE BENEFITS. SCHWARTZSTEIN, M.D., RICHARD M. PRESIDENT, TRUSTEE (EX-OFFICIO), AND EXECUTIVE DIRECTOR SHAPIRO INSTITUTE VICE PRESIDENT OF EDUCATION BETH ISRAEL DEACONESS MEDICAL CENTER CHIEF, DIVISION OF PULMONARY, CRITICAL CARE AND SLEEP MEDICINE HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER ELLEN AND MELVIN GORDON PROFESSOR OF MEDICAL EDUCATION HARVARD MEDICAL SCHOOL DR. SCHWARTZSTEIN PERFORMS SERVICES FOR THE SHAPIRO INSTITUTE, BIDMC AND HMFP AND DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. SCHWARTZSTEIN RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND HMFP FOR HIS SERVICES PROVIDED IN THESE ROLES. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. SCHWARTZSTEIN IS PAID DIRECTLY BY SHAPIRO INSTITUTE AND HMFP, THE PORTION OF DR. SCHWARTZSTEIN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 44,468 INCENTIVE COMPENSATION: 6,104 OTHER REPORTABLE COMPENSATION: 869 DEFERRED COMPENSATION: 3,025 NON-TAXABLE BENEFITS: 1,888 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 79,743 INCENTIVE COMPENSATION: 13,185 OTHER REPORTABLE COMPENSATION: 1,877 DEFERRED COMPENSATION: 6,534 NON-TAXABLE BENEFITS: 4,078 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 252,520 INCENTIVE COMPENSATION: 41,752 OTHER REPORTABLE COMPENSATION: 5,945 DEFERRED COMPENSATION: 20,691 NON-TAXABLE BENEFITS: 12,915 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2018 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. SCHWARTZSTEIN'S POSITIONS AS BIDMC VICE PRESIDENT OF EDUCATION, HMFP PULMONARY AND CRITICAL CARE PHYSICIAN AND ELLEN AND MELVIN GORDON PROFESSOR OF MEDICAL EDUCATION, HARVARD MEDICAL SCHOOL: 2,200BASE AND OTHER REPORTABLE COMPENSATION. FORM 990 SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES (CONTINUED): STEVENSON, M.D., PHD, MARY ANN TRUSTEE SHAPIRO INSTITUTE CHIEF, RADIATION ONCOLOGY BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO), SECRETARY, BOARD CHAIR AND CHAIR, RADIATION ONCOLOGY HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) LONGWOOD MEDICAL INTERNATIONAL FOUNDATION, INC. ASSOCIATE PROFESSOR OF RADIATION ONCOLOGY HARVARD MEDICAL SCHOOL DR. STEVENSON PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. STEVENSON IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. STEVENSON'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 372,610 INCENTIVE COMPENSATION: 550 OTHER REPORTABLE COMPENSATION: 8,116 DEFERRED COMPENSATION: 25,782 NON-TAXABLE BENEFITS: 12,326 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 372,610 INCENTIVE COMPENSATION: 550 OTHER REPORTABLE COMPENSATION: 8,116 DEFERRED COMPENSATION: 25,782 NON-TAXABLE BENEFITS: 12,326 ZEIDEL, M.D., MARK TRUSTEE SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) AND CHIEF (MEDICINE) BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (MEDICINE) HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR LONGWOOD MEDICAL INTERNATIONAL FOUNDATION DIRECTOR (EX-OFFICIO) MEDICAL CARE OF BOSTON MANAGEMENT, CORP, D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP PRESIDENT AND DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION, INC. HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL DR. ZEIDEL PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ZEIDEL IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. ZEIDEL'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 394,421 INCENTIVE COMPENSATION: 1,150 OTHER REPORTABLE COMPENSATION: 8,325 DEFERRED COMPENSATION: 23,519 NON-TAXABLE BENEFITS: 13,144 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 394,421 INCENTIVE COMPENSATION: 1,150 OTHER REPORTABLE COMPENSATION: 8,325 DEFERRED COMPENSATION: 23,519 NON-TAXABLE BENEFITS: 13,144 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2018 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. ZEIDEL'S POSITION AS CHAIR OF MEDICINE AND HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: 155,985 BASE AND OTHER REPORTABLE COMPENSATION, 16,788 DEFERRED COMPENSATION AND 2,037 NON-TAXABLE BENEFITS. COUGHLIN, CHRISTINE, M. CLERK AND ASSOCIATE DIRECTOR SHAPIRO INSTITUTE ADMINISTRATIVE DIRECTOR, CENTER FOR EDUCATION, ACADEMIC AFFAIRS BETH ISRAEL DEACONESS MEDICAL CENTER MS. COUGHLIN PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 20 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. COUGHLIN RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. COUGHLIN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY SHAPIRO INSTITUTE BASE COMPENSATION: 7,938 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 451 NON-TAXABLE BENEFITS: 85 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 47,575 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 3,306 NON-TAXABLE BENEFITS: 620 WANG, DIANA TREASURER AND FINANCIAL ANALYST SHAPIRO INSTITUTE FINANCIAL ANALYST BETH ISRAEL DEACONESS MEDICAL CENTER MS. WANG PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 20 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. WANG RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. WANG'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY SHAPIRO INSTITUTE BASE COMPENSATION: 39,673 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 60 DEFERRED COMPENSATION: 1,383 NON-TAXABLE BENEFITS: 1,227 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 51,393 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 111 DEFERRED COMPENSATION: 2,569 NON-TAXABLE BENEFITS: 2,278 HUGHES, CAROL A. OPERATIONS DIRECTOR SHAPIRO INSTITUTE OPERATIONS DIRECTOR, CENTER FOR EDUCATION, ACADEMIC AFFAIRS BETH ISRAEL DEACONESS MEDICAL CENTER MS. HUGHES PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 40 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. HUGHES RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. HUGHES' COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY SHAPIRO INSTITUTE BASE COMPENSATION: 58,119 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 1,900 NON-TAXABLE BENEFITS: 5,987 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 88,466 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 8,657 NON-TAXABLE BENEFITS: 27,275 FORM 990, PART I, LINE 1 THE MISSION OF THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER ("SHAPIRO INSTITUTE OR "INSTITUTE") IS TO SUPPORT, PROMOTE, AND DEVELOP INNOVATIVE PROGRAMS AND MODELS FOR THE DUAL ACTIVITIES OF TEACHING AND RESEARCH AT ACADEMIC MEDICAL CENTERS. THE INSTITUTE PROVIDES INTELLECTUAL LEADERSHIP, STATE-OF-THE-ART FACILITIES AND STAFF RESOURCES TO SUPPORT THE EDUCATION AND TRAINING OF MEDICAL STUDENTS, RESIDENTS AND FELLOWS. THE INSTITUTE SERVES AS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL (HMS). FORM 990, PART III, LINE 1: THE MISSION OF THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER ("SHAPIRO INSTITUTE OR "INSTITUTE") IS TO SUPPORT, PROMOTE, AND DEVELOP INNOVATIVE PROGRAMS AND MODELS FOR THE DUAL ACTIVITIES OF TEACHING AND RESEARCH AT ACADEMIC MEDICAL CENTERS. THE INSTITUTE PROVIDES INTELLECTUAL LEADERSHIP, STATE-OF-THE-ART FACILITIES AND STAFF RESOURCES TO SUPPORT THE EDUCATION AND TRAINING OF MEDICAL STUDENTS, RESIDENTS AND FELLOWS. THE INSTITUTE SERVES AS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL (HMS). FORM 990, PART VI, SECTION A, LINE 2 THE SHAPIRO INSTITUTE IS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND SERVES AS A SUPPORT ORGANIZATION, PROVIDING MEDICAL TRAINING AND EDUCATION TO BETH ISRAEL DEACONESS MEDICAL CENTER AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. EACH OF THESE ENTITIES IS ALSO A NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS THE DEDUCATED PHYSICIAN PRACTICE OF BIDMC, AN ENTITY INTEGRALLY RELATED TO BIDMC AND ALSO A NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES NOTED ABOVE. ADDITIONAL DETAIL RELATED TO EMPLOYMENT RELATIONSHIPS IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. FORM 990, PART VI, SECTION A, LINE 8B MINUTES ARE DOCUMENTED FOR THE BOARD OF TRUSTEE MEETINGS. NO SUBCOMMITTEE HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE INSTITUTE'S FORM 990 IS PREPARED IN CONJUNCTION WITH THE BETH ISRAEL DEACONESS MEDICAL CENTER TAX DEPARTMENT AND DELOITTE TAX, LLP. BIDMC IS AN ENTITY SUPPORTED BY THE INSTITUTE AND A TERTIARY CARE ACADEMIC MEDICAL CENTER WHICH, AS NOTED ABOVE IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. PRIOR TO FILING THE FORM 990, RELATED SCHEDULES AND REQUIRED DISCLOSURES (RETURN), TIME IS THEN DEDICATED TO DISCUSS THE RETURN, INCLUDING ITS SCOPE AND CONTENTS, AT A BOARD MEETING AND EACH MEMBER OF THE INSTITUTE'S GOVERNING BODY (BOARD OF TRUSTEES) RECEIVES A COPY OF THE RETURN FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C AS PREVIOUSLY NOTED IN THIS FILING, THE INSTITUTE IS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS THE DEDICATED PHYISICAN PRACTICE OF BIDMC, AN ENTITY INTEGRALLY RELATED TO BIDMC AND ALSO A NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AS NOTED IN THE SUPPLEMENTAL INFORMATION TO THIS FORM 990, PART VII AND SCEDULE J, THERE IS SIGNIFICANT OVERLAP BETWEEN THE INSTITUTE'S BOARD OF TRUSTEES AND EMPLOYEES AND BIDMC. BIDMC HAS A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL MEMBERS OF ITS WORKFORCE, INCLUDING EMPLOYEES, PROFESSIONAL STAFF, TRAINEES, CONSULTANTS, CONTRACTORS, AGENTS, AND VENDORS, AND TO THE MEMBERS OF THE BOARD OF DIRECTORS. IN ADDITION, HMFP ALSO HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY. PURSUANT TO THIS CLOSE RELATIONSHIP, THE INSTITUTE HAS ADOPTED THE BIDMC CONFLICT OF INTEREST POLICY. ALL CURRENT AND FORMER MEMBERS OF THE INSTITUTE BOARD OF TRUSTEES AS WELL AS CURRENT AND FORMER INSTITUTE OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO BE SURVEYED ANNUALLY TO GATHER THE INFORMATION NECESSARY FOR THE INSTITUTE TO COMPLETELY AND ACCURATELY PROCESS AND COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 AS PREVIOUSLY NOTED IN THIS FILING, THE INSTITUTE IS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO BIDMC. AS NOTED IN THE SUPPLEMENTAL INFORMATION TO THIS FORM 990, PART VII AND SCHEDULE J, THE INSTITUTE'S EXECUTIVE DIRECTOR ALSO SERVES AS THE VICE PRESIDENT FOR MEDICAL EDUCATION AT BIDMC. THE MEDICAL CENTER HAS A COMPENSATION COMMITTEE THAT IS COMPOSED OF MEMBERS OF THE BOARD OF DIRECTORS. ALL MEMBERS ARE INDEPENDENT. THE MEDICAL CENTER'S COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE OF MEDICAL CENTER SENIOR MANAGEMENT INCLUDING VICE PRESIDENTS. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT IT COMPLIES WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEYS AND STUDIES PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THESE INDIVIDUALS AND AT THAT TIME REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. THE COMPENSATION COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS. REGULAR COMPENSATION FOR OTHER BIDMC EMPLOYEES WHO ALSO SERVE AS INSTITUTE OFFICERS IS SET THROUGH THE ORDINARY BIDMC PROCEDURES WITH INPUT FROM THE BIDMC VICE PRESIDENT OF MEDICAL EDUCATION/INSTITUTE EXECUTIVE DIRECTOR. IN ADDITION TO THE COMPENSATION PROCESSES NOTED ABOVE, FROM TIME TO TIME THE INSTITUTE MAY ACKNOWLEDGE EFFORTS OF ITS EXECUTIVE DIRECTOR, OFFICERS OR OTHER EMPLOYEES WITH AN HONORARIUM. THE INSTITUTE'S BOARD OF TRUSTEES APPROVES ANY SUCH AMOUNTS FOR THE EXECUTIVE DIRECTOR AND INSTITUTE OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 ALL APPLICABLE DOCUMENTS ARE AVAILABLE FROM THE ORGANIZATION UPON WRITTEN REQUEST. BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVE BOSTON MA 02215 042103881 HOSPITAL MA 501(C)(3) LINE 3 N/A 0 PRESIDENT & FELLOWS OF HARVARD COLLEGE 1563 MASSACHUSETTS AVE CAMBRIDGE MA 02138 042103580 HOSPITAL MA 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1