ANNA JAQUES COMMUNITY HEALTH FOUNDATION: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- ANNA JAQUES COMMUNITY HEALTH FOUNDATION (EIN 04-3318952)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-17
- IRS object ID
- 202042319349300404
- Schema version
- 2018v3.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-17T22:44:01-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | 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 | TWO JERICHO PLAZA | AddressLine1Txt |
| City | JERICHO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 043318952 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANNA JAQUES COMMUNITY HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ANNA | BusinessNameControlTxt |
| Phone | 9784631000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 HIGHLAND AVE | AddressLine1Txt |
| City | NEWBURYPORT | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01950 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN KILDAY | PersonNm |
| Person Title | VP/CFO | PersonTitleTxt |
| Phone | 9784631000 | PhoneNum |
| Signature | 2020-08-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTINE KAWECKI | PreparerPersonNm |
| PTIN | P00743140 | PTIN |
| Phone | 5169187000 | PhoneNum |
| Preparation | 2020-08-17 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 71.184.237.192 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-17 | IPDt |
| IP Tm | 22:29:46 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 99BB87E027D7BD763CC874A5F05ECE6A7EBF22DF | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-22 18:59:49Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK GOLDSTEIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 HIGHLAND AVE | AddressLine1Txt |
| City | NEWBURYPORT | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01950 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,990,191 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AJH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,610,850 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,972,748 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $991,121 | PYInvestmentIncomeAmt |
| CY Investment Income | $897,208 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,900 | PYOtherRevenueAmt |
| CY Other Revenue | $6,256 | CYOtherRevenueAmt |
| PY Total Revenue | $2,604,871 | PYTotalRevenueAmt |
| CY Total Revenue | $3,876,212 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $894,927 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,256,919 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $382,793 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $359,614 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $128,757 | PYOtherExpensesAmt |
| CY Other Expenses | $176,642 | CYOtherExpensesAmt |
| PY Total Expenses | $1,406,477 | PYTotalExpensesAmt |
| CY Total Expenses | $1,793,175 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,198,394 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,083,037 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,084,523 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,218,782 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,984 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | -$96,969 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,067,539 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,315,751 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,728,295 | ExpenseAmt |
| Grant | $1,256,919 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $1,728,295 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | 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 With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | 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 | KEVIN KILDAY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9784631000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 HIGHLAND AVE | AddressLine1Txt |
| City | NEWBURYPORT | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01950 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| ABBOTT MARY ANN | ||||||||
| TRUSTEE (EX-OFFICIO) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BAILEY MARK D | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BYRNES CHARLES | ||||||||
| TRUSTEE, CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CANNON PATRICIA | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CARAS RONNA | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CONNORS KATHY | ||||||||
| TRUSTEE, SECRETARY | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ELIAS CLAUDE | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| FERNANDEZ LUIS | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| FOLEY MELISSA | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| FOULKES KIM | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GANONG JULIE | ||||||||
| TRUSTEE, VICE CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| GASIOROWSKI KEVIN | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GOLDSTEIN MARK | ||||||||
| TRUSTEE (EX-OFFICIO), PRESIDENT & CEO | 6.00 | 54.00 | Yes (X) | $84,444 | $759,997 | $66,220 | Yes (X) | |
| JOHNSTON CHRISTOPHER | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KELLY KATE | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KHATIB MATT | ||||||||
| TRUSTEE, CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| LAFLAMME DAVID | ||||||||
| TRUSTEE (EX-OFFICIO) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| PURINTON LISA | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SULLIVAN CHRISTOPHER R | ||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SWIERZEWSKI DAVID | ||||||||
| TRUSTEE | 0.00 | 60.00 | Yes (X) | $0 | $559,527 | $36,429 | ||
| TWOMBLY DONNA | ||||||||
| TRUSTEE, CLINICAL MGR | 0.00 | 60.00 | Yes (X) | $0 | $114,664 | $25,398 | ||
| WILLIAMSON MARY | ||||||||
| TRUSTEE (EX-OFFICIO), EXEC DIR | 0.00 | 60.00 | Yes (X) | $0 | $80,476 | $16,383 | Yes (X) | |
| KILDAY KEVIN | ||||||||
| TREASURER | 6.00 | 54.00 | $35,133 | $316,196 | $61,809 | Yes (X) | ||
| GNERRE SARAH | ||||||||
| FORMER VP EXEC DIR | 0.00 | 60.00 | $0 | $132,149 | $20,457 | Yes (X) | ||
| O'CONNOR DELIA | ||||||||
| FORMER CHIEF EXECUTIVE OFFICER | 1.00 | 0.00 | $0 | $166,584 | $0 | Yes (X) | ||
| SALVO STEPHEN | ||||||||
| FORMER VP HR | 1.00 | 0.00 | $0 | $175,788 | $39,874 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $119,577 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,305,381 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $266,570 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $112,540 | FundraisingAmt |
| All Other Contributions | $2,860,208 | AllOtherContributionsAmt |
| Noncash Contributions | $70,386 | NoncashContributionsAmt |
| Total Contributions | $2,972,748 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $389,604 | TotalRevenueColumnAmt |
| Exclusion | $389,604 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $585,829 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $78,225 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $507,604 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $507,604 | TotalRevenueColumnAmt |
| Exclusion | $507,604 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $42,010 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $112,540 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $35,754 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,256 | TotalRevenueColumnAmt |
| Exclusion | $6,256 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,876,212 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $903,464 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,256,919 | TotalAmt |
| Program Services | $1,256,919 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,577 | TotalAmt |
| Program Services | $114,794 | ProgramServicesAmt |
| Management And General | $4,783 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,890 | TotalAmt |
| Program Services | $152,077 | ProgramServicesAmt |
| Management And General | $9,813 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,101 | TotalAmt |
| Program Services | $54,101 | ProgramServicesAmt |
| Management And General | $2,000 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,046 | TotalAmt |
| Program Services | $20,929 | ProgramServicesAmt |
| Management And General | $1,117 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,000 | TotalAmt |
| Management And General | $15,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,455 | TotalAmt |
| Management And General | $31,455 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,706 | TotalAmt |
| Program Services | $55,706 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,331 | TotalAmt |
| Program Services | $55,331 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,581 | TotalAmt |
| Program Services | $17,581 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $712 | TotalAmt |
| Management And General | $712 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $857 | TotalAmt |
| Program Services | $857 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,793,175 | TotalAmt |
| Program Services | $1,728,295 | ProgramServicesAmt |
| Management And General | $64,880 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $385,040 | BOYAmt |
| EOY | $221,271 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $437,215 | BOYAmt |
| EOY | $1,855,321 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276 | BOYAmt |
| EOY | $47,661 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,261,992 | BOYAmt |
| EOY | $21,094,529 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,084,523 | BOYAmt |
| EOY | $23,218,782 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,475 | BOYAmt |
| EOY | $34,925 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,509 | BOYAmt |
| EOY | -$131,894 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,984 | BOYAmt |
| EOY | -$96,969 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,676,188 | BOYAmt |
| EOY | $8,669,480 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,673,378 | BOYAmt |
| EOY | $9,030,449 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,717,973 | BOYAmt |
| EOY | $5,615,822 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,067,539 | BOYAmt |
| EOY | $23,315,751 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,084,523 | BOYAmt |
| EOY | $23,218,782 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,083,037 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$834,825 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 Type1 | Yes (X) | SupportingOrgType1Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANNA JAQUES HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 042104338 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $2,216,919 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $2,216,919 | 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 Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $16,236,372 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $14,698 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $333,751 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $35,697 | AdministrativeExpensesAmt |
| End Year Balance | $15,881,622 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,304,864 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,341,021 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $386,000 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $23,513 | AdministrativeExpensesAmt |
| End Year Balance | $16,236,372 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,932,112 | BeginningYearBalanceAmt |
| Contributions | $15,000 | ContributionsAmt |
| Investment Earnings Or Losses | $1,792,855 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $416,628 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $18,475 | AdministrativeExpensesAmt |
| End Year Balance | $15,304,864 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,706,652 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,029,573 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $796,286 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $7,827 | AdministrativeExpensesAmt |
| End Year Balance | $13,932,112 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $14,520,243 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$477,873 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $330,000 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $5,718 | AdministrativeExpensesAmt |
| End Year Balance | $13,706,652 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.47700 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.12600 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.39700 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO/(FROM) AFFILIATES | Desc |
| Amt | -$131,894 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | -$131,894 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,267,670,000 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$406,124 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $3,267,722,606 | OtherRevenueAmt |
| Revenue Not Reported | $3,267,316,482 | RevenueNotReportedAmt |
| Revenue Subtotal | $353,518 | RevenueSubtotalAmt |
| Other Revenues Not Included | $3,522,694 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $3,522,694 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,876,212 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,594,794,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $3,593,225,349 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $3,593,225,349 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,568,651 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $224,524 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $224,524 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,793,175 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ANNA JAQUES COMMUNITY HEALTH FOUNDATION MAINTAINS MULTIPLE ENDOWMENTS WITH DIFFERENT PURPOSES. THE MAJORITY HAVE A PERMANENTLY RESTRICTED CORPUS, WITH THE INCOME AVAILABLE TO SUPPORT THE OPERATIONS OF ANNA JAQUES HOSPITAL. THE INCOME FROM OTHER ENDOWMENTS IS AVAILABLE TO FUND HEALTHCARE EDUCATION FOR AJH EMPLOYEES, OR FOR SCHOLARSHIPS TO AREA HIGH SCHOOL STUDENTS WHO WISH TO PURSUE A HEALTH CARE RELATED DEGREE PROGRAM. THE ENTITIES WHICH USE THE ENDOWMENT FUNDS ARE THE PARENT (SRHS), THE HOSPITAL (AJH), THE FOUNDATION (CHF), AND THE PHYSICIAN GROUP (SAGP). |
| PART X, LINE 2: | EACH ENTITY WITHIN THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. THE SYSTEM DID NOT RECOGNIZED THE EFFECT OF ANY INCOME TAX POSITIONS IN 2019. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | NET ASSETS RELEASED FROM RESTRICTIONS 32,397. UNRESTRICTED NET ASSETS UPON ACQUISITION 8,449,210. CONSOLIDATED AFFILIATES NET OF ELIMINATIONS 3,259,240,999. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | 5 MONTH REVENUE NOT IN FINANCIAL STATEMENTS 585,512. RESTRICTED CONTRIBUTIONS 2,477,317. RESTRICTED REVENUE 495,619. RENTAL/FUNDRAISING EXPENSE RECLASS -35,754. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL/ FUNDRAISING EXPENSE RECLASS 35,754. CONSOLIDATED AFFILIATES NET OF ELIMINATIONS 3,593,189,595. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | 5 MONTH EXPENSES NOT IN FINANCIAL STATEMENTS 224,524. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | 0 | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $154,550 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $112,540 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $42,010 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $5,423 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $13,500 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $12,540 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $4,291 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $154,550 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $112,540 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $42,010 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $5,423 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $13,500 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $12,540 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,291 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $35,754 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $6,256 | NetIncomeSummaryAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, QUESTION 2, 17, 18, 19 AND 29 | FormAndLineReferenceDesc |
| Explanation | AS NOTED IN THIS FILING, ANNA JAQUES COMMUNITY HEALTH FOUNDATION (AJCHF) IS A SISTER-ORGANIZATION TO ANNA JAQUES HOSPITAL (AJH, EIN: 04-2104338) AND SEACOAST AFFILIATED GROUP PRACTICES, INC. (SAGP EIN: 04-3485648). ALL THREE ENTITIES ARE EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AJCHF PERFORMS FUNDRAISING ACTIVITIES ON BEHALF OF, AND IN THE NAME OF, ANNA JAQUES HOSPITAL, INCLUDING SPECIAL FUNDRAISING EVENTS AS WELL AS MAIL AND IN-PERSON SOLICITATIONS FROM INDIVIDUALS, CORPORATIONS AND FOUNDATIONS. DETAILED DISCLOSURES CAN BE FOUND IN THE FORM 990 AND SCHEDULE G, SUPPLEMENTAL INFORMATION REGARDING FUNDRAISING OR GAMING ACTIVITIES, FILED AS PART OF THE AJCHF FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANNA JAQUES HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 HIGHLAND AVE | AddressLine1Txt |
| City | NEWBURYPORT | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01950 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 042104338 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $1,256,919 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AS PREVIOUSLY NOTED IN THE FILING ANNA JAQUES COMMUNITY HEALTH FOUNDATION, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND ANNA JAQUES COMMUNITY HEALTH FOUNDATION WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. ANNA JAQUES COMMUNITY HEALTH FOUNDATION ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GOLDSTEIN MARK | ||||||||||||||
| TRUSTEE (EX-OFFICIO), PRESIDENT & CE | $58,444 | $525,997 | $25,000 | $225,000 | $1,000 | $9,000 | $3,175 | $28,575 | $3,447 | $31,023 | $91,066 | $819,595 | $0 | $0 |
| SWIERZEWSKI DAVID | ||||||||||||||
| TRUSTEE | $0 | $468,016 | $0 | $91,511 | $0 | $0 | $0 | $8,250 | $0 | $28,179 | $0 | $595,956 | $0 | $0 |
| KILDAY KEVIN | ||||||||||||||
| TREASURER | $33,133 | $298,196 | $2,000 | $18,000 | $0 | $0 | $2,146 | $19,312 | $4,035 | $36,316 | $41,314 | $371,824 | $0 | $0 |
| GNERRE SARAH | ||||||||||||||
| FORMER VP EXEC DIR | $0 | $7,409 | $0 | $0 | $0 | $124,740 | $0 | $5,850 | $0 | $14,607 | $0 | $152,606 | $0 | $0 |
| O'CONNOR DELIA | ||||||||||||||
| FORMER CHIEF EXECUTIVE OFFICER | $0 | $0 | $0 | $0 | $0 | $166,584 | $0 | $0 | $0 | $0 | $0 | $166,584 | $0 | $0 |
| SALVO STEPHEN | ||||||||||||||
| FORMER VP HR | $0 | $171,888 | $0 | $0 | $0 | $3,900 | $0 | $17,680 | $0 | $22,194 | $0 | $215,662 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN ANNA JAQUES COMMUNITY HEALTH FOUNDATION'S FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 DETAIL. DURING THE 2018 CALENDAR YEAR, ANNA JAQUES COMMUNITY HEALTH FUNDATION WAS A PARTICIPATING EMPLOYER IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN AND PURSUANT TO THE PLAN ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS. CONTRIBUTIONS RECEIVED BY PARTICIPANTS AND RELATED TO THESE PLANS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR 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. |
| PART I, LINE 7 | THE ANNA JAQUES COMMUNITY HEALTH FOUNDATION EXECUTIVE COMPENSATION PACKAGES AND CERTAIN EMPLOYEE COMPENSATION PACKAGES INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING PRE-DETERMINED GOALS. FOR THE PERIOD COVERED BY THIS FILING, THE INCENTIVE COMPENSATION FOR EACH EXECUTIVE REPORTED IN THIS FORM 990 WAS REVIEWED AND APPROVED BY THE ANNA JAQUES HOSPITAL COMPENSATION COMMITTEE , WHICH AS PREVIOUSLY NOTED, WAS FULLY STAFFED BY INDEPENDENT MEMBERS. |
| SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES: | THE FILING ORGANIZATION HAS PROVIDED DETAILED NARRATIVE DISCLOSURE FOR EACH INDIVIDUAL LISTED IN PART VII. NOTE, HOWEVER, THAT THE ORDER OF THE NARRATIVE DISCLOSURE INCLUDED BELOW MAY NOT COINCIDE WITH THE ORDER OF THE INDIVIDUALS LISTED IN PART VII. 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 THESE 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. ANNA JAQUES HOSPITAL, ANNA JAQUES COMMUNITY HEALTH FOUNDATION AND SEACOAST AFFILIATED GROUP PRACTICES, INC. MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS AJH, AJCHF, AND SAGP RESPECTIVELY. GOLDSTEIN, MARK TRUSTEE (EX-OFFICIO), PRESIDENT, CEO ANNA JAQUES HOSPITAL TRUSTEE (EX-OFFICIO) ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE (EX-OFFICIO), PRESIDENT SEACOAST AFFILIATED GROUP PRACTICES, INC. MR. GOLDSTEIN PERFORMS SERVICES FOR AJH, AJCHF, AND SAGP. ALTHOUGH MR. GOLDSTEIN IS PAID DIRECTLY BY AJH, THE PORTION OF MR. GOLDSTEIN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY AJH: BASE COMPENSATION: 409,109 INCENTIVE COMPENSATION: 175,000 OTHER REPORTABLE COMPENSATION: 7,000 DEFERRED COMPENSATION: 22,225 NON-TAXABLE BENEFITS: 24,129 PAYMENTS REPORTED BY AJCHF: BASE COMPENSATION: 58,444 INCENTIVE COMPENSATION: 25,000 OTHER REPORTABLE COMPENSATION: 1,000 DEFERRED COMPENSATION: 3,175 NON-TAXABLE BENEFITS: 3,447 PAYMENTS REPORTED BY SAGP: BASE COMPENSATION: 116,888 INCENTIVE COMPENSATION: 50,000 OTHER REPORTABLE COMPENSATION: 2,000 DEFERRED COMPENSATION: 6,350 NON-TAXABLE BENEFITS: 6,894 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. GOLDSTEIN INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $18,000. OF THIS AMOUNT, $18,000 IS BOTH UNFUNDED AND UNVESTED. KILDAY, KEVIN CHIEF FINANCIAL OFFICER ANNA JAQUES HOSPITAL TREASURER ANNA JAQUES COMMUNITY HEALTH FOUNDATION CHIEF FINANCIAL OFFICER SEACOAST AFFILIATED GROUP PRACTICES, INC. MR. KILDAY PERFORMS SERVICES FOR AJH, AJCHF, AND SAGP. ALTHOUGH MR. KILDAY IS PAID DIRECTLY BY AJH, THE PORTION OF MR. KILDAY 'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY AJH: BASE COMPENSATION: 198,797 INCENTIVE COMPENSATION: 12,000 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 12,875 NON-TAXABLE BENEFITS: 24,211 PAYMENTS REPORTED BY AJCHF: BASE COMPENSATION: 33,133 INCENTIVE COMPENSATION: 2,000 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 2,146 NON-TAXABLE BENEFITS: 4,035 PAYMENTS REPORTED BY SAGP: BASE COMPENSATION: 99,399 INCENTIVE COMPENSATION: 6,000 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 6,437 NON-TAXABLE BENEFITS: 12,105 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. KILDAY INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $10,458. OF THIS AMOUNT, $10,458 IS BOTH UNFUNDED AND UNVESTED. |
| SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES: | O'CONNOR, DELIA FORMER CHIEF EXECUTIVE OFFICER ANNA JAQUES HOSPITAL FORMER CHIEF EXECUTIVE OFFICER ANNA JAQUES COMMUNITY HEALTH FOUNDATION FORMER CHIEF EXECUTIVE OFFICER SEACOAST AFFILIATED GROUP PRACTICES, INC. PAYMENTS REPORTED BY AJH: BASE COMPENSATION: 0 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 166,584 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. O'CONNOR INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $105,312. WILLIAMSON, MARY TRUSTEE (EX-OFFICIO), EXECUTIVE DIRECTOR ANNA JAQUES COMMUNITY HEALTH FOUNDATION PAYMENTS REPORTED BY AJH: BASE COMPENSATION: 80,476 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 16,383 GNERRE, SARAH FORMER VP EXECUTIVE DIRECTOR ANNA JAQUES COMMUNITY HEALTH FOUNDATION PAYMENTS REPORTED BY AJH: BASE COMPENSATION: 7,409 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 124,740 DEFERRED COMPENSATION: 5,850 NON-TAXABLE BENEFITS: 14,607 SALVO, STEPHEN FORMER VP HR ANNA JAQUES HOSPITAL FORMER VP HR ANNA JAQUES COMMUNITY HEALTH FOUNDATION FORMER VP HR SEACOAST AFFILIATED GROUP PRACTICES, INC. PAYMENTS REPORTED BY AJH: BASE COMPENSATION: 171,888 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 3,900 DEFERRED COMPENSATION: 17,680 NON-TAXABLE BENEFITS: 22,194 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. SALVO INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $17,971. OF THIS AMOUNT, $14,071 IS BOTH UNFUNDED AND UNVESTED. TWOMBLY, DONNA TRUSTEE, CLINICAL MANAGER ANNA JAQUES COMMUNITY HEALTH FOUNDATION PAYMENTS REPORTED BY AJH: BASE COMPENSATION: 105,946 INCENTIVE COMPENSATION: 8,718 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 2,119 NON-TAXABLE BENEFITS: 23,279 BYRNES, CHARLES TRUSTEE, CHAIR ANNA JAQUES COMMUNITY HEALTH FOUNDATION JOHNSTON, CHRISTOPHER TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION SULLIVAN, CHRISTOPHER R. TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION ELIAS, CLAUDE TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION LAFLAMME, DAVID TRUSTEE (EX-OFFICIO) ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE, CHAIRMAN ANNA JAQUES HOSPITAL TRUSTEE, CHAIRMAN SEACOAST AFFILIATED GROUP PRACTICES, INC. SWIERZEWSKI, DAVID TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE (EX-OFFICIO), PRESIDENT OF MEDICAL STAFF SEACOAST AFFILIATED GROUP PRACTICES, INC. TRUSTEE, PRESIDENT OF MEDICAL STAFF ANNA JAQUES HOSPITAL PAYMENTS REPORTED BY AJH: BASE COMPENSATION: 50,925 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY SAGP: BASE COMPENSATION: 417,091 INCENTIVE COMPENSATION: 91,511 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 8,250 NON-TAXABLE BENEFITS: 28,179 GANONG, JULIE TRUSTEE, VICE CHAIR ANNA JAQUES COMMUNITY HEALTH FOUNDATION KELLY, KATE TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION CONNORS, KATHY TRUSTEE, SECRETARY ANNA JAQUES COMMUNITY HEALTH FOUNDATION GASIOROWSKI, KEVIN TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION FOULKES, KIM TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION PURINTON, LISA TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION FERNANDEZ, LUIS TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION MR. FERNANDEZ'S TERM ON THE ANNA JAQUES COMMUNITY HEALTH FOUNDATION BOARD ENDED ON APRIL 1, 2019. BAILEY, MARK D. TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION ABBOTT, MARY ANN TRUSTEE (EX-OFFICIO) ANNA JAQUES COMMUNITY HEALTH FOUNDATION KHATIB, MATT TRUSTEE, CHAIR ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE (EX-OFFICIO), CHAIR ANNA JAQUES HOSPITAL TRUSTEE (EX OFFICIO), CHAIR/PRESIDENT, FOUNDATION SEACOAST AFFILIATED GROUP PRACTICES, INC. FOLEY, MELISSA TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION CANNON, PATRICIA TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION CARAS, RONNA TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (7 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| SUBSTANTIAL CONTRIBUTOR #4 | |||
| SUBSTANTIAL CONTRIBUTOR | $26,400 | MARKETING PURCHASED SERVICES | 0 |
| SUBSTANTIAL CONTRIBUTOR #39 | |||
| SUBSTANTIAL CONTRIBUTOR | $212,977 | RENT PAYMENTS | 0 |
| SUBSTANTIAL CONTRIBUTOR #71 | |||
| SUBSTANTIAL CONTRIBUTOR | $3,136 | XRAY READS FOR EMPLOYEE HEALTH | 0 |
| SUBSTANTIAL CONTRIBUTOR #82 | |||
| SUBSTANTIAL CONTRIBUTOR | $96,221 | LEGAL FEES | 0 |
| SUBSTANTIAL CONTRIBUTOR #83 | |||
| SUBSTANTIAL CONTRIBUTOR | $991,483 | CONSTRUCTION/RENOVATION PROJECTS | 0 |
| SUBSTANTIAL CONTRIBUTOR #87 | |||
| SUBSTANTIAL CONTRIBUTOR | $320,416 | LANDSCAPING AND SNOW REMOVAL | 0 |
| SUBSTANTIAL CONTRIBUTOR #90 | |||
| SUBSTANTIAL CONTRIBUTOR | $416,551 | LABORATORY SEND-OUTS | 0 |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 4 | ContributionCnt |
| Noncash Contributions Rpt F990 | $70,386 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING PRICE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I & III | THE ANNA JAQUES COMMUNITY HEALTH FOUNDATION (FOUNDATION) WAS ESTABLISHED IN 1996 FOR THE PURPOSE OF CULTIVATING AND SOLICITING ON-GOING DONOR SUPPORT FOR THE GENERAL OPERATIONS, CRITICAL PROGRAMS AND CAPITAL EQUIPMENT NEEDS OF ANNA JAQUES HOSPITAL (AJH OR HOSPITAL), A HOSPITAL EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THE FOUNDATION'S MISSION IS TO SUPPORT AJH AND TO FURTHER THE HOSPITAL'S ABILITY TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE AND IMPROVE THE HEALTH OF OUR COMMUNITY. THE FOUNDATION ACCOMPLISHES ITS MISSION THROUGH COMMUNITY OUTREACH AND ENGAGEMENT AND BY SEEKING PHILANTHROPIC SUPPORT FROM GRATEFUL PATIENTS AND COMMUNITY MEMBERS, FOUNDATIONS, AND BUSINESSES. ON MARCH 1, 2019, THE LAHEY HEALTH SYSTEM INCLUDING THE LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER, WINCHESTER HOSPITAL, NORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL AND BAYRIDGE HOSPITAL, THE BETH ISRAEL DEACONESS SYSTEM INCLUDING BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS MILTON, BETH ISRAEL DEACONESS NEEDHAM AND BETH ISRAEL DEACONESS PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND SEACOAST REGIONAL HEALTH SYSTEMS, INCLUDING ANNA JAQUES HOSPITAL AS WELL AS ENTITIES FOR WHICH THESE LISTED ORGANIZATIONS SERVE AS SOLE MEMBER AND ADDITIONAL AFFILIATES CAME TOGETHER TO FORM BETH ISRAEL LAHEY HEALTH (BILH). BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. |
| FORM 990, PART IV, LINE 4A | FUNDRAISING ACTIVITIES AS NOTED PREVIOUSLY IN THIS FILING, THE ANNA JAQUES COMMUNITY HEALTH FOUNDATION (FOUNDATION), IN FURTHERANCE OF ITS EXEMPT PURPOSES, ENGAGES IN DONOR CULTIVATION, SOLICITATION AND STEWARDSHIP TO EXCLUSIVELY SUPPORT ANNA JAQUES HOSPITAL (AJH). THE HOSPITAL, LOCATED IN NEWBURYPORT, MASSACHUSETTS HAS BEEN A VITAL PART OF THE COMMUNITY SINCE IT OPENED ITS DOORS IN 1884. . THROUGH THE DIRECT FUNDRAISING EFFORTS OF THE FOUNDATION, AJH SUPPORTERS ARE ENCOURAGED TO RENEW THEIR ANNUAL SUPPORT TO CREATE A RELIABLE STREAM OF CONTRIBUTED INCOME TO FUND THE HOSPITAL'S GREATEST NEEDS INCLUDING SPECIAL PROGRAMS, GENERAL OPERATIONS AND CAPITAL PRIORITIES. PROGRAMS SUPPORTED INCLUDE A TOP-RATED WOUND HEALING CENTER, THE AJH CANCER CENTER IN AFFILIATION WITH BETH ISRAEL DEACONESS MEDICAL CENTER, A WORLD REKNOWN TERTIARY CARE ACADEMIC MEDICAL CENTER ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND EFFECTIVE MARCH 1, 2019, A SISTER ENTITY TO AJH, THE GERRISH BREAST CARE CENTER, AND THE PERSIST PROGRAM SUPPORTING PREGNANT WOMEN WITH SUBSTANCE USE DISORDER AND THEIR NEWBORNS. DURING THE PERIOD COVERED BY THIS FILING, THE FOUNDATION'S PRINCIPAL FOCUS WAS TO GENERATE COMMUNITY SUPPORT FOR THE STEPPING FORWARD CAMPAIGN TO EXPAND SURGICAL SERVICES. THIS $3.5 MILLION CAMPAIGN WILL HELP AJH BUILD TWO NEW, STATE-OF-THE-ART OPERATING ROOMS TO HELP TO EXPAND AJH'S ORTHOPEDIC PROGRAM IN COLLABORATION WITH NEW ENGLAND BAPTIST HOSPITAL (NEBH),THE PREMIER REGIONAL PROVIDER FOR ORTHOPEDIC SURGERY AND THE TREATMENT OF MUSCULOSKELETAL DISEASES AND DISORDERS, ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND EFFECTIVE MARCH 1, 2019 A SISTER ENTITY TO AJH. IN ADDITION, THE FOUNDATION OPERATES TWO LARGE-SCALE FUNDRAISING EVENTS EACH YEAR THE FORE YOUR HEALTH GOLF TOURNAMENT AND CELEBRATING SURVIVORS, A BRUNCH AND FASHION SHOW FEATURING SURVIVORS OF CANCER CARE PROGRAMS AND THEIR CAREGIVERS. DURING THE FISCAL YEAR COVERED BY THIS FILING, THE FOUNDATION THROUGH ITS FUNDRAISING EFFORTS PROVIDED $1,256,919 OF SUPPORT TO ANNA JAQUES HOSPITAL TO SUPPORT THE HOSPITAL'S OPERATING AND CAPITAL NEEDS. |
| FORM 990, PART IV, LINE 12 | THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2019. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER. |
| FORM 990, PART V, LINE 7G | ANNA JAQUES COMMUNITY HEALTH FOUNDATION DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899. |
| FORM 990, PART V, LINE 7H | ANNA JAQUES COMMUNITY HEALTH FOUNDATION DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 1098-C. |
| FORM 990, PART VI, SECTION A, LINE 2 | FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES, LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL CORPORATION (NBC), AND ANNA JAQUES HOSPITAL. THE LAHEY CLINIC FOUNDATION IN TURN SERVES AS SOLE MEMBER TO LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL DBA LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). ADDITIONAL ENTITIES LISTED HERE MAY ALSO IN TURN SERVE AS MEMBER TO OTHER NETWORK AFFILIATES. 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 WITHIN THE NETWORK OF AFFILIATED ORGANIZATIONS. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. |
| FORM 990, PART VI, SECTION A, LINE 4 | ANNA JAQUES COMMUNITY HEALTH FOUNDATION MADE CHANGES TO ITS BYLAWS DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 AS PART OF THE CREATION OF THE BETH ISRAEL LAHEY HEALTH (BILH), AN INTEGRATED HEALTH CARE SYSTEM PROVIDING PATIENT CARE INFORMED BY WORLD-CLASS RESEARCH AND EDUCATION. BETH ISRAEL LAHEY HEALTH, INC. BECAME THE SOLE MEMBER OF ANNA JAQUES COMMUNITY HEALTH FOUNDATION'S MEMBER. CHANGES TO THE BYLAWS AFFECT: - FREQUENCY OF MEETINGS - MINIMUM & MAXIMUM NUMBER OF TRUSTEES - EX-OFFICIO TRUSTEES - APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES - COMMITTEES - OFFICERS - TERMS AND TERM LIMITS |
| FORM 990, PART VI, SECTION A, LINE 6 | EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL, THE MEMBER OF ANNA JAQUES COMMUNITY HEALTH FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBER HAS THE AUTHORITY TO ELECT SOME OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBER OF ANNA JAQUES COMMUNITY HEALTH FOUNDATION HAS THE FOLLOWING RIGHTS, AS DESIGNATED IN ANNA JAQUES COMMUNITY HEALTH FOUNDATION'S BYLAWS: - WITH RESPECT TO THE MANAGEMENT AND GOVERNANCE OF THE FOUNDATION, THE MEMBER SHALL HAVE ONLY SUCH POWERS AS PROVIDED BY LAW, THE ARTICLES OF ORGANIZATION, OR THESE BYLAWS. THE MEMBER MAY DELEGATE ANY OR ALL OF ITS POWERS PERTAINING TO THE MANAGEMENT AND GOVERNANCE OF THE FOUNDATION TO THE BOARD OF TRUSTEES OF THE FOUNDATION, AT ANY TIME, FROM TIME TO TIME. - IN THE EVENT THE MEMBER CEASES TO OPERATE AS A FULL-SERVICE, ACUTE CARE HOSPITAL, OR FOR ANY REASON CEASES TO QUALIFY AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OR 509(A)(1), (2) OR (3) OF THE INTERNAL REVENUE CODE, THEN THE POWERS OF THE MEMBER PERTAINING TO THE MANAGEMENT AND GOVERNANCE OF THE FOUNDATION, OR AS OTHERWISE CONFERRED UPON MEMBER HEREUNDER, SHALL VEST WITH THE BOARD OF TRUSTEES OF THE FOUNDATION. THE MEMBER MAY NOT SELL, PLEDGE, ASSIGN OR OTHERWISE TRANSFER ANY PART OF ITS INTEREST IN THE ASSETS OF THE FOUNDATION, AND ANY ATTEMPTED PLEDGE, ASSIGNMENT OR OTHER TRANSFER OF THE FOUNDATION'S ASSETS BY THE MEMBER SHALL BE NULL AND VOID. THE ASSETS OF THE FOUNDATION SHALL NOT BE SUBJECT TO BEING ATTACHED OR TAKEN BY THE MEMBER'S CREDITORS BY ANY PROCESS WHATEVER. THE OFFICERS SHALL HAVE THE POWERS AND PERFORM THE DUTIES CUSTOMARILY BELONGING TO THEIR RESPECTIVE OFFICES, INCLUDING THE POWERS AND DUTIES LISTED BELOW: - THE CHAIRMAN SHALL PRESIDE AT ALL MEETINGS OF THE BOARD OF TRUSTEES AT WHICH HE OR SHE IS PRESENT AND SHALL HAVE SUCH DUTIES AND RESPONSIBILITIES AS MAY BE ASSIGNED FROM TIME TO TIME BY THE BOARD OF TRUSTEES. THE VICE CHAIRMAN SHALL PRESIDE IN THE ABSENCE OF THE CHAIRMAN. - THE EXECUTIVE DIRECTOR SHALL BE THE CHIEF EXECUTIVE OFFICER OF THE FOUNDATION, RESPONSIBLE TO THE BOARD FOR THE ADMINISTRATION OF THE FOUNDATION'S BUSINESS AND AFFAIRS. EXCEPT AS OTHERWISE PROVIDED BY THE BOARD OF TRUSTEES OR THESE BY-LAWS, THE EXECUTIVE DIRECTOR SHALL SIGN FOR THE FOUNDATION AL DEEDS, AGREEMENTS, AND OTHER FORMAL INSTRUMENTS. - THE SECRETARY SHALL KEEP RECORDS OF ALL MEETINGS OF THE BOARD OF TRUSTEES AND MAKE A REPORT THEREON AND SHALL ISSUE CALLS AND NOTICES OF MEETINGS. - THE TREASURER SHALL BE THE CHIEF FINANCIAL OFFICER OF THE FOUNDATION AND SHALL ENSURE THAT PROPER FINANCIAL RECORDS ARE KEPT AND THAT APPROPRIATE ARRANGEMENTS ARE MADE FOR THE INVESTMENT OF THE FOUNDATION'' FUNDS. HE OR SHE SHALL RENDER TO THE BOARD OF TRUSTEES AT THE ANNUAL MEETING AND WHENEVER ELSE IT SO REQUESTS AN ACCURATE ACCOUNT OF ALL SUMS RECEIVED AND DISBURSED DURING THE PRECEDING FISCAL YEAR AND OF ALL SUMS AND FUNDS WHICH ARE NOT EXPENDED. |
| FORM 990, PART VI, SECTION B, LINE 11B | AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) BECAME THE SOLE MEMBER OF ANNA JAQUES HOSPITAL, INC., WHICH IS THE SOLE MEMBER OF ANNA JAQUES COMMUNITY HEALTH FOUNDATION. THIS FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER OF ANNA JAQUES HOSPITAL, INC., THE TAX DIRECTOR OF BILH AND DELOITTE TAX, LLP. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF THE ANNA JAQUES COMMUNITY HEALTH FOUNDATION BOARD PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS ANNA JAQUES COMMUNITY HEALTH FOUNDATION (AJCHF) HAS A WRITTEN, CONFLICT OF INTEREST POLICY. TRUSTEES AND SENIOR EXECUTIVES REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY AND EACH IS ASKED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST FORM TO DISCLOSE POSSIBLE CONFLICTS. RESPONSES ARE REVIEWED BY THE BOARD CHAIR TO DETERMINE IF ANY CONFLICT EXISTS. ANY INDIVIDUAL WITH A CONFLICT IS ASKED TO ABSTAIN FROM VOTING ON A RELATED MATTER. THE BOARD CHAIR AND/OR SECRETARY MONITOR SURVEYS TO ENSURE COMPLIANCE. |
| FORM 990, PART VI, SECTION B, LINE 15 | DESCRIPTION OF PROCESS TO DETERMINE COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES AS NOTED THROUGHOUT THIS FILING, ANNA JAQUES HOSPITAL AND ANNA JAQUES COMMUNITY HEALTH FOUNDATION (AJH AND AJCHF RESPECTIVELY) ALONG WITH THEIR OTHER RELATED ENTITIES BECAME MEMBERS OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES WITH BILH SERVING AS AJH'S SOLE MEMBER AND AJH, IN TURN SERVING AS AJCHF'S SOLE MEMBER, EFFECTIVE MARCH 1, 2019. PRIOR TO THAT DATE, ANNA JAQUES COMMUNITY HEALTH FOUNDATION,, .(AJCHF) WHICH WAS ALSO AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, SERVED AS THE SOLE MEMBER OF BOTH AJH AND AJCHF AND MAINTAINED A COMPENSATION COMMITTEE THAT WAS COMPOSED OF MEMBERS OF THE BOARD OF TRUSTEES. ALL MEMBERS WERE INDEPENDENT. AS REQUIRED BY THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, COMPENSATION REPORTED HEREIN IS CALENDAR YEAR 2018 COMPENSATION. AS SUCH, COMPENSATION REPORTED IN THIS FORM 990 FOR AJH AND AJCHF OFFICERS, TRUSTEES AND KEY EMPLOYEES WAS SET BY THE AJCHF COMPENSATION COMMITTEE AND GUIDED BY THE COMMITTEE'S PROCESS AS OUTLINED BELOW. THE COMPENSATION OF THE SENIOR EXECUTIVE TEAM WAS REVIEWED ANNUALLY BY AN INDEPENDENT COMMITTEE OF THE PARENT'S (AJCHF) BOARD. THE COMMITTEE USED DATA RECEIVED FROM AN INDEPENDENT COMPENSATION CONSULTING FIRM TO DETERMINE THE FAIRNESS AND OVERALL COMPARABILITY OF EACH EXECUTIVE'S COMPENSATION PACKAGE INCLUDING POTENTIAL INCENTIVE COMPENSATION. THE COMMITTEE RELIED ON THE SALARY SURVEY DATA TO INFORM WHETHER ANY CHANGES TO AN EXECUTIVE'S COMPENSATION WAS APPROPRIATE. IN ADDITION, THE COMMITTEE AGREED ON AND SET BENCHMARKS FOR EXECUTIVE INCENTIVE PAYMENTS AT THE START OF EACH YEAR, AND REVIEWED PROGRESS RELATED TO THOSE BENCHMARKS AT THE CONCLUSION OF THE YEAR TO DETERMINE WHETHER INCENTIVES WOULD BE PAID AND IF SO, AT WHAT LEVEL. |
| FORM 990, PART VI, SECTION C, LINE 19 | ANNA JAQUES COMMUNITY HEALTH FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL LAHEY HEALTH TAX DEPARTMENT 109 BROOKLINE AVENUE, SUITE 300 BOSTON, MA 02215 |
| FORM 990, PART XII, 2C | ON MARCH 1, 2019, LAHEY HEALTH SYSTEM INCLUDING THE LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER, WINCHESTER HOSPITAL, NORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL AND BAYRIDGE HOSPITAL, THE BETH ISRAEL DEACONESS SYSTEM INCLUDING BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS MILTON, BETH ISRAEL DEACONESS NEEDHAM AND BETH ISRAEL DEACONESS PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL, ANNA JAQUES HOSPITAL AS WELL AS ENTITIES FOR WHICH THESE LISTED ORGANIZATIONS SERVE AS SOLE MEMBER AND ADDITIONAL AFFILIATES CAME TOGETHER TO FORM BETH ISRAEL LAHEY HEALTH (BILH). AS A NEWLY CREATED HEALTHCARE SYSTEM, BILH ENGAGED KPMG TO PERFORM A FINANCIAL AUDIT OF THE SYSTEM. THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2019. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND ITS AFFILIATE |
| SCHEDULE C NARRATIVE | ANNA JAQUES COMMUNITY HEALTH FOUNDATION DOES NOT ENGAGE IN ANY DIRECT LOBBYING EFFORTS. HOWEVER, VARIOUS AFFILIATES OF ANNA JAQUES COMMUNITY HEALTH FOUNDATION, MAY HAVE ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF THEMSELVES AND OTHER AFFILIATED NETWORK ENTITIES. TOTAL LOBBYING EXPENDITURES WERE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (62 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 | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ADDISON GILBERT SOCIETY INC | |||||||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 01805 | 464371382 | SUPPORT | MA | 501(C)(3) | 7 | LAHEY HEALTH SHARED SERVICES INC | Yes (1) | |||||
| ANNA JAQUES HOSPITAL INC | |||||||||||||||
| 25 HIGHLAND AVE | NEWBURYPORT | MA | 01950 | 042104338 | HEALTHCARE | MA | 501(C)(3) | 3 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| ASSOC PHYS HARVARD MED FAC PHY AT BIDMC | |||||||||||||||
| 375 LONGWOOD AVE | BOSTON | MA | 02215 | 320058309 | TO PROVIDE EMERGENCY MEDICAL SERVICES | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BAIM INSTITUTE OF CLINICAL RESEARCH INC FKA HCRI | |||||||||||||||
| 930 COMMONWEALTH AVE | BOSTON | MA | 02215 | 043521077 | SCIENTIFIC & MEDICAL RESEARCH | MA | 501(C)(3) | 7 | Yes (1) | N/A | |||||
| BETH ISRAEL DEACONESS HOSPITAL - MILTON INC | |||||||||||||||
| 199 REEDSDALE RD | MILTON | MA | 02186 | 042103604 | HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. | MA | 501(C)(3) | 3 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM INC | |||||||||||||||
| 148 CHESTNUT ST | NEEDHAM | MA | 02492 | 043229679 | HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. | MA | 501(C)(3) | 3 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH INC | |||||||||||||||
| 275 SANDWICH ST | PLYMOUTH | MA | 02360 | 222667354 | HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. | MA | 501(C)(3) | 3 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| BETH ISRAEL DEACONESS MEDICAL CENTER | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 042103881 | THE OPERATION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA | MA | 501(C)(3) | 3 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| BETH ISRAEL LAHEY HEALTH PRIMARY CARE FKA LPCO | |||||||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 01805 | 472248298 | HEALTHCARE | MA | 501(C)(3) | 10 | LAHEY HEALTH SHARED SERVICES INC | Yes (1) | |||||
| BETH ISRAEL LAHEY HEALTH INC | |||||||||||||||
| 20 UNIVERSITY ROAD | CAMBRIDGE | MA | 02138 | 832671600 | SUPPORT | MA | 501(C)(3) | 12A, I | Yes (1) | N/A | |||||
| BI ANAESTHESIA FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 042997215 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BI COMMUNITY FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE STE 300 | BOSTON | MA | 02215 | 042776678 | INACTIVE CORPORATION | MA | 501(C)(3) | 7 | Yes (1) | N/A | |||||
| BI DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE W/CC-2 | BOSTON | MA | 02215 | 364803234 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BI DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 043079630 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BI DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 208253452 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BI DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 043030397 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BI DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 204974585 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BI DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 020671240 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BI DERMATOLOGY FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 043117601 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP | |||||||||||||||
| 482 BEDFORD STREET | LEXINGTON | MA | 02420 | 043200113 | SUPPORT | MA | 501(C)(3) | 12A, I | 0 | N/A | |||||
| BIDMC OBSTETRICS AND GYNECOLOGY FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 042794855 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BIDMC PHARMACY INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 822526816 | OPERATE A SPECIALTY PHARMACY | MA | 501(C)(3) | 12A, I | BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BID-MILTON PHYSICIAN ASSOCIATES INC FKA MHF | |||||||||||||||
| 199 REEDSDALE RD | MILTON | MA | 02186 | 222566792 | PROMOTE HEALTHCARE | MA | 501(C)(3) | 12A, I | BETH ISRAEL DEACONESS HOSPITAL - MILTON | Yes (1) | |||||
| BIH PATHOLOGY FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 222548374 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| BIH RADIOLOGIC FOUNDATION INC | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 042571853 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| CAB HEALTH AND RECOVERY SERVICES INC | |||||||||||||||
| 199 ROSEWOOD DRIVE SUITE 250 | DANVERS | MA | 01923 | 042400270 | SUBSTANCE ABUSE | MA | 501(C)(3) | 10 | NORTHEAST BEHAVIORAL HEALTH CORPORATION | Yes (1) | |||||
| CAREGROUP PARMENTER HOME CARE & HOSPICE INC | |||||||||||||||
| 330 MOUNT AUBURN ST | CAMBRIDGE | MA | 02138 | 473111453 | HOME CARE & HOSPICE | MA | 501(C)(3) | 12A, I | MOUNT AUBURN HOSPITAL | Yes (1) | |||||
| CAREGROUP INC | |||||||||||||||
| 109 BROOKLINE AVE STE 300 | BOSTON | MA | 02215 | 222629185 | OVERSEE FINANCIAL HEALTH OF AFFILIATES | MA | 501(C)(3) | 12C, III-FI | 0 | N/A | |||||
| CARL J SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH | |||||||||||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 043326928 | DEVELOP INNOVATIVE PROG AND MODELS FOR TEACHING AND RESEARCH | MA | 501(C)(3) | 12A, I | 0 | N/A | |||||
| COMMUNITY PHYSICIAN ASSOCIATES INC | |||||||||||||||
| 199 REEDSDALE RD | MILTON | MA | 02186 | 043243146 | OUTPATIENT AND PRIMARY CARE SERVICES | MA | 501(C)(3) | 3 | MILTON HOSPITAL FOUNDATION | Yes (1) | |||||
| CONTINUING EDU PROGRAM DBA BID DEPT OF PSYCH FDN | |||||||||||||||
| 185 PILGRIM ROAD | BOSTON | MA | 02215 | 043242952 | SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC | |||||||||||||||
| 375 LONGWOOD AVE | BOSTON | MA | 02215 | 222768204 | GENERAL AND SPECIALIZED MEDICAL SERVICES TO THE PATIENTS OF BIDMC AND OTHERS | MA | 501(C)(3) | 10 | BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| HEALTH AND EDUCATION HOUSING SERVICES | |||||||||||||||
| 199 ROSEWOOD DRIVE | DANVERS | MA | 01923 | 223232914 | HUD HOUSING | MA | 501(C)(3) | 10 | NORTHEAST BEHAVIORAL HEALTH CORPORATION | Yes (1) | |||||
| JORDAN HEALTH SYSTEMS INC | |||||||||||||||
| 275 SANDWICH ST | PLYMOUTH | MA | 02360 | 042103805 | PROMOTE HEALTHCARE | MA | 501(C)(3) | 7 | BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| JORDAN PHYSICIANS ASSOCIATES INC | |||||||||||||||
| 275 SANDWICH ST | PLYMOUTH | MA | 02360 | 043228556 | OUTPATIENT AND PRIMARY CARE SERVICES | MA | 501(C)(3) | 10 | JORDAN HEALTH SYSTEMS INC | Yes (1) | |||||
| LAHEY CLINIC CANADIAN FOUNDATION | |||||||||||||||
| FUNDRSG ORG | NON-US | 0 | N/A | 130 KING STREET WEST | TORONTO | CA | CA | ||||||||
| LAHEY CLINIC FOUNDATION INC | |||||||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 01805 | 042323457 | SUPPORT | MA | 501(C)(3) | 7 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| LAHEY CLINIC HOSPITAL INC | |||||||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 018050001 | 042704686 | HEALTHCARE | MA | 501(C)(3) | 3 | LAHEY CLINIC FOUNDATION INC | Yes (1) | |||||
| LAHEY CLINIC INC | |||||||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 018050001 | 042704683 | HEALTHCARE | MA | 501(C)(3) | 10 | LAHEY CLINIC FOUNDATION INC | Yes (1) | |||||
| LAHEY HEALTH SHARED SERVICES INC | |||||||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 01805 | 043178972 | ADMINISTRATION | MA | 501(C)(3) | 10 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| LAHEY HEALTH SYSTEMS INC | |||||||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 01805 | 611665701 | SUPPORT | MA | 501(C)(3) | 12C, III-FI | 0 | N/A | |||||
| LONGWOOD MEDICAL ENERGY COLLABORATIVE | |||||||||||||||
| 160 LONGWOOD AVENUE | BOSTON | MA | 02215 | 043476764 | COORDINATE AND PROVIDE STATEGIC PLANNING OPP FOR HMS | MA | 501(C)(3) | 12A, I | Yes (1) | N/A | |||||
| LONGWOOD MEDICAL INTL FOUNDATION | |||||||||||||||
| 375 LONGWOOD AVENUE | BOSTON | MA | 02215 | 043208878 | INACTIVE CORPORATION | MA | 501(C)(3) | 12A, I | HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| MED CARE OF BOSTON MGMT CORP DBA BID HEALTHCARE | |||||||||||||||
| 400 HUNNEWELL ST | NEEDHAM | MA | 02494 | 042810972 | OUTPATIENT, PRIMARY CARE AND SPECIALTY SERVICES | MA | 501(C)(3) | 10 | BETH ISRAEL DEACONESS MEDICAL CENTER | Yes (1) | |||||
| MOUNT AUBURN HOSPITAL | |||||||||||||||
| 330 MOUNT AUBURN ST | CAMBRIDGE | MA | 02138 | 042103606 | HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS | MA | 501(C)(3) | 3 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| MOUNT AUBURN PROFESSIONAL SERVICES INC | |||||||||||||||
| 330 MOUNT AUBURN ST | CAMBRIDGE | MA | 02138 | 043026897 | OFFERING MEDICAL CARE IN GENERAL AND SPECIALIZED PRACTICES | MA | 501(C)(3) | 12A, I | MOUNT AUBURN HOSPITAL | Yes (1) | |||||
| NEW ENGLAND BAPTIST HOSPITAL | |||||||||||||||
| 125 PARKER HILL AVE | BOSTON | MA | 02120 | 042103612 | ORTHOPEDIC SPECIALTY HOSPITAL | MA | 501(C)(3) | 3 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| NEW ENGLAND BAPTIST MEDICAL ASSOCIATES INC | |||||||||||||||
| 125 PARKER HILL AVE | BOSTON | MA | 02120 | 043235796 | OUTPATIENT MEDICAL SERVICES TO THE VARIOUS COMMUNITIES SERVICED BY NEBH | MA | 501(C)(3) | 3 | NEW ENGLAND BAPTIST HOSPITAL | Yes (1) | |||||
| NORTHEAST BEHAVIORAL HEALTH CORPORATION | |||||||||||||||
| 199 ROSEWOOD DRIVE | DANVERS | MA | 01923 | 042777145 | HEALTHCARE | MA | 501(C)(3) | 10 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| NORTHEAST HEALTH SYSTEM INC | |||||||||||||||
| 85 HERRICK ST | BEVERLY | MA | 01915 | 043240453 | SUPPORT | MA | 501(C)(3) | 12A, I | LAHEY HEALTH SHARED SERVICES INC | Yes (1) | |||||
| NORTHEAST HOSPITAL CORPORATION | |||||||||||||||
| 85 HERRICK STREET | BEVERLY | MA | 01915 | 042121317 | HEALTHCARE | MA | 501(C)(3) | 3 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| NORTHEAST MEDICAL PRACTICE INC | |||||||||||||||
| 85 HERRICK ST | BEVERLY | MA | 01915 | 043201853 | HEALTHCARE | MA | 501(C)(3) | 10 | NORTHEAST HOSPITAL CORPORATION | Yes (1) | |||||
| NORTHEAST PROFESSIONAL REGISTRY OF NURSE | |||||||||||||||
| 800NCUMMINGS CENTER | BEVERLY | MA | 01915 | 201287349 | HEALTHCARE | MA | 501(C)(3) | 10 | NORTHEAST SENIOR HEALTH CORPORATION | Yes (1) | |||||
| NORTHEAST SENIOR HEALTH CORPORATION | |||||||||||||||
| 85 HERRICK STREET | BEVERLY | MA | 01915 | 042731137 | HEALTHCARE | MA | 501(C)(3) | 10 | LAHEY HEALTH SHARED SERVICES INC | Yes (1) | |||||
| SEACOAST AFFILIATED GROUP PRACTICES INC | |||||||||||||||
| 25 HIGHLAND AVE | NEWBURYPORT | MA | 01915 | 043485648 | PHYSICIAN GROUP | MA | 501(C)(3) | 10 | ANNA JAQUES HOSPITAL INC | Yes (1) | |||||
| SEACOAST NURSING AND REHABILITION CENTER | |||||||||||||||
| 300 WASHINGTON ST | GLOUCESTER | MA | 01930 | 041305001 | HEALTHCARE | MA | 501(C)(3) | 10 | LAHEY HEALTH SHARED SERVICES INC | Yes (1) | |||||
| SEACOAST REGIONAL HEALTH SYSTEMS INC | |||||||||||||||
| 25 HIGHLAND AVE | NEWBURYPORT | MA | 01915 | 222814214 | SUPPORT ORG | MA | 501(C)(3) | 12A, I | 0 | N/A | |||||
| SEACOAST REGIONAL MRI INC | |||||||||||||||
| 25 HIGHLAND AVE | NEWBURYPORT | MA | 01915 | 320443663 | HEALTH SVCS | MA | 501(C)(3) | 10 | 0 | N/A | |||||
| WINCHESTER COMMUNITY ACCOUNTABLE CARE ORGANIZATION INC | |||||||||||||||
| 41 HIGHLAND AVENUE | WINCHESTER | MA | 01890 | 223137856 | ACO | MA | 501(C)(3) | 12A, I | WINCHESTER HEALTHCARE MANAGEMENT INC | Yes (1) | |||||
| WINCHESTER HEALTHCARE MANAGEMENT INC | |||||||||||||||
| 41 HIGHLAND AVENUE | WINCHESTER | MA | 01890 | 222701817 | MANAGEMENT | MA | 501(C)(3) | 12A, I | LAHEY HEALTH SHARED SERVICES INC | Yes (1) | |||||
| WINCHESTER HOSPITAL | |||||||||||||||
| 41 HIGHLAND AVENUE | WINCHESTER | MA | 018900000 | 042104434 | HEALTHCARE | MA | 501(C)(3) | 3 | BETH ISRAEL LAHEY HEALTH INC | Yes (1) | |||||
| WINCHESTER HOSPITAL FOUNDATION INC | |||||||||||||||
| 41 HIGHLAND AVENUE | WINCHESTER | MA | 01890 | 043399570 | SUPPORT | MA | 501(C)(3) | 12A, I | WINCHESTER HEALTHCARE MANAGEMENT INC | Yes (1) | |||||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| BIDCO PHYSICIAN LLC | |||||||
| ONE UNIVERSITY AVE NORTH ENTRANCE | WESTWOOD | MA | 02090 | 461589743 | COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC | MA | N/A |
| BIDCO HOSPITAL LLC | |||||||
| 247 STATION DRIVE NORTHWEST 1 | WESTWOOD | MA | 02090 | 461643790 | COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC | MA | N/A |
| CAREGROUP CLINICAL RESEARCH LLC | |||||||
| 109 BROOKLINE AVENUE | BOSTON | MA | 02215 | 300228711 | TO PARTICIPATE IN A CLINICAL RESEARCH PARTNERSHIP | MA | N/A |
| CAREGROUP INVESTMENT PARTNERSHIP LLP | |||||||
| 109 BROOKLINE AVENUE | BOSTON | MA | 02215 | 043278109 | INVESTMENT PARTNERSHIP | MA | N/A |
| PHYSICIAN PROFESSIONAL SERVICES LLP | |||||||
| 10 CABOT ROAD | MEDFORD | MA | 02215 | 043275078 | TO PROVIDE MEDICAL BILLING SERVICES | MA | N/A |
| NEW ENGLAND BAPTIST ORTHOPEDIC NETWORK LLC | |||||||
| 125 PARKER HILL AVE | BOSTON | MA | 02120 | 465120176 | TO PROVIDE ORTHOPEDIC MEDICAL SERVICES | MA | N/A |
| WINCHESTER HOSPITALSHIELDS MRI LLC | |||||||
| 700 CONGRESS ST | QUINCY | MA | 02169 | 462523117 | MRI SERVICES | MA | N/A |
| SHIELDS IMAGING AT ANNA JAQUES HOSPITAL LLC | |||||||
| 700 CONGRESS ST STE 204 | QUINCY | MA | 02169 | 383989358 | MRI SERVICES | MA | N/A |
| HAVERHILL MOB LLC | |||||||
| 50 CHESTNUT ST | NEEDHAM | MA | 02492 | 812856118 | MEDICAL OFFICE BUILDING | MA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JORDAN COMMUNITY ACO INC | |||||||||||||
| 275 SANDWICH ST | PLYMOUTH | MA | 02360 | 454047430 | COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BID-PLYMOUTH | MA | N/A | C | Yes (1) | ||||
| GREATER NEWBURYPORT MANAGEMENT SERVICES ORGANIZATION INC | |||||||||||||
| 25 HIGHLAND AVE | NEWBURYPORT | MA | 01950 | 161744477 | MANAGEMENT SERVICES | MA | N/A | C | Yes (1) | ||||
| LAHEY CLINIC INSURANCE CO LTD | |||||||||||||
| INSURANCE | N/A | C | Yes (1) | CRAIG APPIN HOUSE PO BOX HM 2450 | HAMILTON | BD | BD | ||||||
| LEDGEWOOD HEALTHCARE CORPORATION | |||||||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 042855189 | NURSING HOME | KY | N/A | C | Yes (1) | ||||
| NORTHEAST PROPRIETARY CORP | |||||||||||||
| 85 HERRICK STREET | BEVERLY | MA | 01915 | 042855191 | MEDICAL SERVICES | MA | N/A | C | Yes (1) | ||||
| WINCHESTER PHYSICIAN ASSOCIATES INC | |||||||||||||
| 41 HIGHLAND AVE | WINCHESTER | MA | 01890 | 043262963 | MANAGEMENT SERVICES | MA | N/A | C | Yes (1) | ||||
| WINCHESTER HEALTHCARE ENTERPRISES INC | |||||||||||||
| 41 HIGHLAND AVE | WINCHESTER | MA | 01890 | 042932059 | MANAGEMENT SERVICES | MA | N/A | C | Yes (1) | ||||
| WINCHESTER PHYSICIAN HOSPITAL ORGANIZATION INC | |||||||||||||
| 41 HIGHLAND AVE | WINCHESTER | MA | 01890 | 472646454 | PHYS HOSP ORG | MA | N/A | C | Yes (1) | ||||
| NORTHEAST HEALTH SYSTEMS PHYSICIAN HOSPITAL ORGANIZATION INC | |||||||||||||
| 500 CUMMINGS CENTER STE 6500 | BEVERLY | MA | 01915 | 043258053 | MEDICAL SERVICES | MA | N/A | C | Yes (1) | ||||
| NORTHEAST PHYSICIAN PRACTICE | |||||||||||||
| 85 HERRICK STREET | BEVERLY | MA | 01915 | 043285837 | PHYSICIAN OFFICE | MA | N/A | C | Yes (1) | ||||
| NPP SUPPORT SERVICES | |||||||||||||
| 85 HERRICK STREET | BEVERLY | MA | 01915 | 042721511 | PHYSICIAN OFFICE | MA | N/A | C | Yes (1) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANNA JAQUES HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionTypeTxt |
| Involved | $1,256,919 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I - V: | FormAndLineReferenceDesc |
| Explanation | AS NOTED THROUGHOUT THIS FILING, ON MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH (BILH) BECAME SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES, LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL CORPORATION (NBC), AND ANNA JAQUES HOSPITAL. THE LAHEY CLINIC FOUNDATION IN TURN SERVES AS SOLE MEMBER TO LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL DBA LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). ADDITIONAL ENTITIES LISTED HERE MAY ALSO IN TURN SERVE AS MEMBER TO OTHER NETWORK AFFILIATES. BY-LAW CHANGES WERE MADE TO REFLECT THE CENTRALIZATION OF THE SYSTEM, AND AS SUCH, AFFILIATES WITHIN THE BILH SYSTEM ARE CONSIDERED CONTROLLED ENTITIES UNDER IRC SECTION 512(B)(13), AS EACH AFFILIATE IS UNDER COMMON GOVERNANCE CONTROL, AS DESCRIBED IN TREAS. REGS. 1.512(B)-1(L)(4). UNDER IRC SEC. 512, CONTROL MEANS THAT MORE THAN 50 PERCENT OF THE DIRECTORS OR TRUSTEES OF AN ORGANIZATION ARE EITHER REPRESENTATIVES OF, OR DIRECTLY OR INDIRECTLY CONTROLLED, BY AN EXEMPT ORGANIZATION. A TRUSTEE OR DIRECTOR IS A REPRESENTATIVE OF AN EXEMPT ORGANIZATION IF THEY ARE A TRUSTEE, DIRECTOR, AGENT, OR EMPLOYEE OF SUCH EXEMPT ORGANIZATION. UNDER THIS DEFINITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. AND AFFILIATES ARE INCLUDED IN ANNA JAQUES COMMUNITY HEALTH FOUNDATION'S FORM 990, SCHEDULE R FOR THE CURRENT TAX YEAR. | ExplanationTxt |
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