MASS GENERAL BRIGHAM INCORPORATED: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MASS GENERAL BRIGHAM INCORPORATED (EIN 02-0497927)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-07
- IRS object ID
- 201723119349303057
- Schema version
- 2016v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-07T16:18:27-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO INTERNATIONAL PLACE | AddressLine1Txt |
| City | BOSTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02110 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020497927 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wentworth-Douglass Physician Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % PETER E WALCEK | InCareOfNm |
| Business Name Control | WENT | BusinessNameControlTxt |
| Phone | 6037425252 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 Central Avenue | AddressLine1Txt |
| City | Dover | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 038202526 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PETER E WALCEK | PersonNm |
| Person Title | CFO/VP of Finance | PersonTitleTxt |
| Phone | 6037425252 | PhoneNum |
| Signature | 2017-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian Vigneault | PreparerPersonNm |
| PTIN | P00540650 | PTIN |
| Phone | 6174220700 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 162.249.80.3 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 04123920173115000002 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2017-11-07 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 6CCC3C025DBC962C57DC39F77614343EB29704E0 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BBC3B4FE2B4BE7D467FE8DB8FE274F6332A7211F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wentworth Health Partners | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PETER E WALCEK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 Central Avenue | AddressLine1Txt |
| City | Dover | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 038202526 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $37,192,306 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.wdhospital.com/whp | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | NH | LegalDomicileStateCd |
| Activity Or Mission | Improve the health of the community by providing high quality healthcare. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 513 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $13 | TotalGrossUBIAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $35,681,675 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $37,083,385 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $76,499 | PYOtherRevenueAmt |
| CY Other Revenue | $73,453 | CYOtherRevenueAmt |
| PY Total Revenue | $35,758,174 | PYTotalRevenueAmt |
| CY Total Revenue | $37,156,838 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $45,729,496 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,335,626 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,679,279 | PYOtherExpensesAmt |
| CY Other Expenses | $18,647,010 | CYOtherExpensesAmt |
| PY Total Expenses | $64,408,775 | PYTotalExpensesAmt |
| CY Total Expenses | $67,982,636 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$28,650,601 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$30,825,798 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,845,627 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,150,143 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,505,847 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,041,432 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,660,220 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$891,289 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Improve the health of the community by providing high quality health care that exceeds expectations through an integrated network of highly qualified professionals. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $62,465,003 | ExpenseAmt |
| Revenue | $37,156,825 | RevenueAmt |
| Desc | Wentworth-Douglass Physician Corporation (WDPC) was formed in response to a community needs assessment that identified a lack of primary care and specialty services in the community. The formation of the Physician Corporation and recruitment of primary care and specialty physicians closed the gap by improving access to medical services in Dover, NH and surrounding areas. (See Schedule O for a list of facilities operated by WDPC.) WDPC provides financial aid and information and resources to assist patients with their healthcare bills. Medical care is provided at no charge for eligible patients at 250% of the federal poverty level (300% of the FPL for Dental Services). (Continued on Schedule O). | Desc |
| Total Program Service Expenses | $62,465,003 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 513 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PETER E WALCEK | PersonNm |
| Phone | 6037402804 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 CENTRAL AVENUE | AddressLine1Txt |
| City | Dover | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 038202526 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Ellen Caille FACHE | ||||||||
| Director/Exec VP, WD | 5.0 | 50.0 | Yes (X) | $0 | $403,334 | $87,458 | ||
| Paul R Cass DO | ||||||||
| Director/Physician | 5.0 | 50.0 | Yes (X) | $0 | $465,716 | $94,298 | ||
| Mary Ann Gagnon APRN | ||||||||
| Director/Physician | 50.0 | 0.0 | Yes (X) | $137,000 | $0 | $24,117 | ||
| Matthew Goldberg DO | ||||||||
| Director/Physician | 50.0 | 0.0 | Yes (X) | $257,224 | $0 | $21,597 | ||
| Hugh MacDonald MD | ||||||||
| Director/Physician | 50.0 | 0.0 | Yes (X) | $280,790 | $0 | $37,876 | ||
| Gary Usher MD | ||||||||
| Director/Physician | 50.0 | 0.0 | Yes (X) | $343,283 | $0 | $20,862 | ||
| Roger Hamel | ||||||||
| Chairman | 1.0 | 6.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Carol Bailey | ||||||||
| Vice Chairman | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Michael Steinberg | ||||||||
| Treasurer | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| John Salmon | ||||||||
| Secretary | 1.0 | 4.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Gregory J Walker | ||||||||
| President/CEO, WDH | 2.0 | 53.0 | Yes (X) | $0 | $820,180 | $149,567 | Yes (X) | |
| Peter E Walcek | ||||||||
| CFO/VP Finance, WDH | 2.0 | 53.0 | Yes (X) | $0 | $451,233 | $90,080 | Yes (X) | |
| Barbara F Civiello MD | ||||||||
| Physician | 50.0 | 0.0 | $550,271 | $0 | $34,593 | Yes (X) | ||
| Paul T Berry MD | ||||||||
| Physician | 50.0 | 0.0 | $590,742 | $0 | $31,943 | Yes (X) | ||
| Lazaro A Diaz MD | ||||||||
| Physician | 50.0 | 0.0 | $548,808 | $0 | $39,153 | Yes (X) | ||
| Gregory Imbrie MD | ||||||||
| Physician | 50.0 | 0.0 | $511,888 | $0 | $32,888 | Yes (X) | ||
| Henry Sonneborn MD | ||||||||
| Physician | 50.0 | 0.0 | $487,352 | $0 | $26,743 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,707,358 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,140,463 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $691,175 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 113 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient Service Revenue | 621110 | $36,245,053 | $36,245,053 | |
| Other Related Function Income | 621990 | $693,422 | $693,409 | $13 |
| Meaningful Use | 621110 | $144,910 | $144,910 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $37,083,385 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $108,921 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $35,468 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $73,453 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $73,453 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $73,453 | RelatedOrExemptFuncIncomeAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,156,838 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,156,825 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $13 | UnrelatedBusinessRevenueAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,493,667 | TotalAmt |
| Program Services | $1,493,667 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,753,046 | TotalAmt |
| Program Services | $37,304,670 | ProgramServicesAmt |
| Management And General | $2,448,376 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $358,668 | TotalAmt |
| Program Services | $332,555 | ProgramServicesAmt |
| Management And General | $26,113 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,439,559 | TotalAmt |
| Program Services | $4,159,834 | ProgramServicesAmt |
| Management And General | $279,725 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,290,686 | TotalAmt |
| Program Services | $3,084,031 | ProgramServicesAmt |
| Management And General | $206,655 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350 | TotalAmt |
| Management And General | $350 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,004 | TotalAmt |
| Management And General | $20,004 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,297,948 | TotalAmt |
| Program Services | $6,845,797 | ProgramServicesAmt |
| Management And General | $1,452,151 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,336 | TotalAmt |
| Management And General | $13,336 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,125,295 | TotalAmt |
| Program Services | $1,836,603 | ProgramServicesAmt |
| Management And General | $288,692 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,510,275 | TotalAmt |
| Program Services | $2,755,566 | ProgramServicesAmt |
| Management And General | $754,709 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,701 | TotalAmt |
| Program Services | $294,180 | ProgramServicesAmt |
| Management And General | $27,521 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $753,598 | TotalAmt |
| Program Services | $753,598 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $893,710 | TotalAmt |
| Program Services | $893,710 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| Provision for Bad Debt | $1,269,136 | $1,269,136 | |
| Dental Community Benefit | $511,897 | $511,897 | |
| Pharmacy Expense | $589,536 | $589,536 | |
| Transcription | $340,224 | $340,223 | $1 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,982,636 | TotalAmt |
| Program Services | $62,465,003 | ProgramServicesAmt |
| Management And General | $5,517,632 | ManagementAndGeneralAmt |
| Fundraising | $1 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,239 | BOYAmt |
| EOY | $25,843 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,664,523 | BOYAmt |
| EOY | $3,355,213 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,197,921 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,428,834 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,158,168 | BOYAmt |
| EOY | $3,769,087 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,697 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,845,627 | BOYAmt |
| EOY | $7,150,143 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,505,847 | BOYAmt |
| EOY | $8,041,432 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,505,847 | BOYAmt |
| EOY | $8,041,432 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,660,220 | BOYAmt |
| EOY | -$891,289 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,660,220 | BOYAmt |
| EOY | -$891,289 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,845,627 | BOYAmt |
| EOY | $7,150,143 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$30,825,798 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $31,594,729 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,171,055 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,798,283 | DepreciationAmt |
| Book Value | $372,772 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,386,219 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,648,983 | DepreciationAmt |
| Book Value | $1,737,236 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,640,647 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,981,568 | DepreciationAmt |
| Book Value | $1,659,079 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $3,769,087 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $36,680,408 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $35,467 | OtherRevenueAmt |
| Revenue Not Reported | $35,467 | RevenueNotReportedAmt |
| Revenue Subtotal | $36,644,941 | RevenueSubtotalAmt |
| Other Revenues Not Included | $511,897 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $511,897 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $37,156,838 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $67,470,739 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $67,470,739 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $511,897 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $511,897 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $67,982,636 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | WDHS, the Hospital, WDPC and the Foundation are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes pursuant to Section 501(a) of the Code. Management evaluated these not-for-profit corporations have maintained their tax-exempt status, do not have any significant unrelated business income and have taken no uncertain tax positions that require adjustment to or disclosure in the accompanying consolidated financial statements. |
| Part XI, Line 2d | Occupancy allocated to building rentals - 35,467 |
| Part XI, Line 4b | Dental Community Benefit (net of allocated overhead) - $511,897 |
| Part XII, Line 4b | Dental Community Benefit (net of allocated overhead) - $511,897 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Ellen Caille FACHE | ||||||||||||
| Director/Exec VP, WD | $287,652 | $56,877 | $58,805 | $59,070 | $28,388 | $490,792 | ||||||
| Paul R Cass DO | ||||||||||||
| Director/Physician | $392,649 | $71,675 | $1,392 | $73,503 | $20,795 | $560,014 | ||||||
| Mary Ann Gagnon APRN | ||||||||||||
| Director/Physician | $125,949 | $10,753 | $298 | $5,324 | $18,793 | $161,117 | ||||||
| Matthew Goldberg DO | ||||||||||||
| Director/Physician | $240,694 | $15,213 | $1,317 | $11,370 | $10,227 | $278,821 | ||||||
| Hugh MacDonald MD | ||||||||||||
| Director/Physician | $215,714 | $63,776 | $1,300 | $9,325 | $28,551 | $318,666 | ||||||
| Gary Usher MD | ||||||||||||
| Director/Physician | $249,343 | $92,553 | $1,387 | $7,148 | $13,714 | $364,145 | ||||||
| Gregory J Walker | ||||||||||||
| President/CEO, WDH | $480,654 | $146,112 | $193,414 | $126,354 | $23,213 | $969,747 | ||||||
| Peter E Walcek | ||||||||||||
| CFO/VP Finance, WDH | $325,475 | $63,486 | $62,272 | $68,787 | $21,293 | $541,313 | ||||||
| Barbara F Civiello MD | ||||||||||||
| Physician | $408,446 | $122,433 | $19,392 | $13,250 | $21,343 | $584,864 | ||||||
| Paul T Berry MD | ||||||||||||
| Physician | $293,606 | $278,464 | $18,672 | $10,600 | $21,343 | $622,685 | ||||||
| Lazaro A Diaz MD | ||||||||||||
| Physician | $460,649 | $68,767 | $19,392 | $8,052 | $31,101 | $587,961 | ||||||
| Gregory Imbrie MD | ||||||||||||
| Physician | $335,992 | $174,504 | $1,392 | $32,888 | $544,776 | |||||||
| Henry Sonneborn MD | ||||||||||||
| Physician | $370,371 | $98,309 | $18,672 | $7,950 | $18,793 | $514,095 | ||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3: | The President/CEO of Wentworth-Douglass Physician Corp (WDPC) is an employee of Wentworth-Douglass Hospital (WDH), a related organization, and WDPC does not maintain any procedures to establish his compensation. However, the Hospital uses its executive committee, an independent national compensation consultant, compensation surveys, and requires final approval by its independent Board Members to determine executive compensation for all vice-presidents and above. |
| Part I, Line 4b: | Gregory J. Walker (President/CEO) - 2016 total contributions to the 457(f) plan = 113,104. This supplemental retirement plan contribution is intended to fund benefits accruing and payable at retirement for multiple years of service that began in calendar year 1997. In 2016, the Hospital funded a supplemental executive retirement plan which provides benefits to other qualifying executives. The contributions are intended to provide a forfeitable supplemental retirement benefit and are being provided in consideration for many years of service to the Hospital. The respective contributions for the 2016 plan year, for those individuals identified in Schedule J - Part II, are as follows: Peter E. Walcek = $52,887, Ellen Caille - $46,941, and Paul R. Cass = $60,253. The following individuals identified in Schedule J - Part II vested in their 2011 457(f) contributions during 2016: Peter E. Walcek = $41,483 and Ellen L. Caille = $38,813. The 2011 amounts are required to be reported on Schedule J, in Column F and as part of the taxable W-2 compensation reported in Column B (iii) of this Form 990. WDH sponsors a split-dollar life insurance employee benefit program for certain officers and key employees. Split dollar life insurance is an arrangement in which the employee is the owner of the life insurance policy and the premiums are paid by the employer. Pursuant to WDH's split-dollar agreement, and the collateral assignment therein, the employer's share of the policy premiums paid is recovered either upon termination of the policy or at the death of the participant. Note that the split-dollar arrangement is part of an employee benefit program and economically not a direct extension of credit. Furthermore, the reportable compensation of the respective employees includes the annual value of the life insurance. Total premiums paid during the year ending 12/31/16 were $21,144 for Peter E. Walcek. The taxable value of the life insurance policy has been included in each individuals' W-2. The policies are intended to provide an additional retirement benefit for these indiviuals' multiple years of service. |
| Part I, Line 7: | At-risk compensation for Wentworth-Douglass executives, which is subject to review and paid annually. Wentworth-Douglass has an incentive-based compensation model that uses relative value units (RVUs) as a measure for determining physician compensation within the Medical Group Management Association published salary ranges. The model included a base salary plus incentive compensation that has both productivity and performance components inclusive of patient satisfaction and quality. Both budgeted performance and actual performance are measured. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 2, New Program Services: | See narrative for Form 990, Part III, Line 4a below. |
| Form 990, Part III, Line 4a, Program Service Accomplishments: | In 2016, WDPC provided $284,888 of financial aid (stated at cost). Medicaid Costs Exceeding Reimbursement totalled $2,946,849 for WDPC in 2016. Wentworth-Douglass Hospital (The Hospital) subsidizes WDPC primary care practices that operate at a loss. The subsidized losses of these primary care practices do not include the financial aid provided to patients (stated at cost) or the Medicaid cost exceeding reimbursement associated with these practices, and totaled $5,336,183 in 2016. The Hospital subsidizes certain WDPC specialty care practices that operate at a loss. The subsidized losses of these specialty care practices do not include the financial aid provided to the patients (stated at cost) or the Medicaid cost exceeding reimbursement associated with these practices, and totaled $9,017,881 in 2016. WDPC supports numerous community based programs, including the COmmunity Dental Center and Behavioral Health Services. In 2015, WDPC acquired Great Bay Mental Health as part of the continued initiative to expand the services offered for behavioral health. WDPC provided $953,100 of behavioral health care services to patients in 2016. The Wentworth-Douglass Community Dental Center is open to low-income, uninsured adults and children living in the Hospital's primary service area (Dover, Durham, Madbury, Lee, Barrington, Somersworth, Rollinsford, NH and Berwick and So. Berwick, ME) or patients of the physician practices who have a family income at or below 300% of the federal poverty level, based on the number of members in the household. Minimum payments are charged on a discounted fee schedule based on household income. In 2016, the Dental Center provided $561,255 of community-based clinic services. |
| Form 990, Part III, Line 4a: | WDPC's Facilities: Wentworth-Douglass Physician Corporation does not file a separate annual community benefit report. Rather, Wentworth-Douglass Hospital (WDH) includes WDPC data with its community benefit report that is filed anually with the State of New Hampshire. WDHS owns 100% of WDPC, and oversees all of WDPC's primary care and specialty practices, outpatient physician clinics and its dental clinic. WDPC practices, or practices with WDPC physicians embedded as of December 31, 2016 are listed below with locations details as follows: Adult & Children's Medicine, 10 Members Way, Suite 201, Dover, NH Barrington Health Center, 8 Century Pines Drive, Suite 2, Barrington, NH Bellamy Health Center, 15 Old Rollinsford Road, Suite 201, Dover, NH Center for Medical Genetics, 15 Old Rollinsford Road, Suite 201, Dover, NH Coastal Neurology Services, 158 E. NH Route 108, Suite 5, Dover, NH Dover Family Practice, 10 Members Way, Suite 203, Dover, NH Dover Internal and Geriatric Medicine, 10 Members Way, Suite 301, Dover, NH Durham Health Center, 36 Madbury Road, Durham, NH Endocrinology and Diabetes, 10 Members Way, Suite 400, Dover, NH Great Bay Family Practice, 60 Exeter Road, Suite 300, Newmarket, NH Great Bay Mental Health, 15 Old Rollinsford Road, Suite 302, Dover, NH Hilltop Family Practice, Somersworth Plaza, 85 Main St, Somersworth, NH Integrative Therapy, 15 Old Rollinsford Road, Suite 204, Dover, NH Lee Family Practice, 65 Calef HIghway, Suite 200, Lee, NH Manchester Urology Association at Dover, 10 Members Way, Suite 402, DOver, NH Marshwood Family Care, 19 Levesque Drive, Suite 2, Eliot, ME OB/GYN & Infertility Associates, 15 Old Rollinsford Road, Suite 102, Dover, NH Outpatient Diabetes Services, 10 Members Way, Suite 400, Dover, NH Supportive & Palliative Care, 789 Central Avenue, Level 2, Dover, NH Plastic Surgery Specialists, 10 Members Way, Suite 303, DOver, NH Primary Care of Dover, 10 Members Way, Suite 300, Dover, NH Prompt Care, 10 Members Way, Suite 203, Dover, NH Seacoast Arthritis & Osteoporosis Center, 10 Members Way, Suite 403, Dover, NH Seacoast Cancer Center, 789 Central Avenue, Dover, NH Seacoast General Surgery, 750 Central Avenue, Suite N, Dover, NH Seacoast Pulmonary (Intensivists), 10 Members Way, Suite 401, Dover, NH South Berwick Family Practice, 31 Colcord Street, South Berwick, ME Strafford Medical Associates, 10 Members Way, Suite 302, DOver, NH Summit Infectious Disease, 789 Central Avenue, Dover, NH The Hospital Medicine Team (formerly Hospitalists), 789 Central Avenue, Level 2, Dover, NH WHP Behavioral Health Services, 10 Members Way, Suite 404, Dover, NH WHP Cardiovascular Group, 19 Old Rollinsford Road, Dover, NH WHP Thoracic Surgery Specialists, 789 Central Avenue, Level 1, Dover, NH WHP COmmunity Dental Center, 668 Central Avenue, Dover, NH Wound Healing Institute and Hyperbaric Oxygen Center, 789 Central Avenue, Dover, NH Head & Neck Specialty Group of NH, 361 High Street, Somerworth, NH Surgical Optimization Center, 789 Central Avenue, Dover, NH WD Center for Orthopedics & Joint Replacement, 789 Central Avenue, Level 2, Dover, NH Primary Care at Pease, 73 Corporate Drive, Portsmouth, NH Prompt Care at Pease, 73 Corporate Drive, Portsmouth, NH Seacoast Arthritis at Pease, 73 Corporate Drive, Portsmouth, NH Seacoast Pulmonary at Pease, 73 Corporate Drive, Portsmouth, NH Vascular Surgery at Pease, 73 Corporate Drive, Portsmouth, NH Chest Clinic, 789 Central Avenue, Level 1, DOver, NH Radiology and PFT at Pease, 73 Corporate Drive, Portsmouth, NH |
| Form 990, Part VI, Section A, Line 6: | Wentworth-Douglass Health System (WDHS), a New Hampshire nonprofit corporation, was formed in 2012 as the result of the corporate restructuring of Wentworth-Douglass Hospital (WDH) into an integrated health system. WDHS serves as the parent company of WDH and its affiliates Wentworth-Douglass Hospital and Health Foundation (WDHHF) and Wentworth-Douglass Physician Corporation (WDPC), all of which are New Hampshire nonprofit corporations that have been recognized as being 501(c)(3) organizations. These corporations share a common mission with WDH. WDHS is intended to act as a supporting organization of WDH, serving in the rold of the "parent company" of the Hospital and the affiliates. WDHS is the sole member of WDPC. Effective Janary 1, 2017, Massachusetts General Hospital (MGH) became the sole corporate member and parent organization of WDH. Contemporaneously, WDH became the sole corporate member and parent organization of WDHHF, WDPC, and the Wentworth-Douglass COmmunity Health Corporation (WDCHC). As part of the transaction, WDHS was spun off with the purpose of monitoring the integration of the Hospital into MGH. |
| Form 990, Part VI, Section A, Line 7a: | WDHS will appoint the Board members for WDPC. Effective January 1, 2017, with MGH becoming the sole corporate member and parent organization of WDH, WDH will now appoint Board members for WDPC. |
| Form 990, Part VI, Section A, Line 7b: | WDHS has the power to appoint and remove directors of WDPC, and all actions pertaining to the property, business, and affairs of WDPC, including WDPC's annual budget, are subject to the approval of WDHS. Effective January 1, 2017, with MGH becoming the sole corproate member and parent organization of WDH, and WDH becoming the sole corporate member of WDPC, WDHS no longer holds these powers. WDHS purpose is to monitor the integration of the hospital into MGH. |
| Form 990, Section B, Line 11: | A draft of the Form 990 is initially reviewed in detail by key WDH finance employees. Thereafter, the final draft is presented to the full board prior to filing with the IRS. Each member of the Board and Finance Committee is provided with a draft of the FOrm 990 in advance of each meeting. |
| Form 990, Part VI, Section B, Line 12c: | A copy of WDPC's Conflict of Interest Policy is distributed annually to all officers, trustees, medical staff officers and committee members, and the management team. All are required to report any conflicts and sign, date, and return the policy, whether or not a conflict exists, to confirm compliance. Conflicts are disclosed in accordance with State of New Hampshire RSA 7:19-a, in the local newspaper, and submitted to the New Hampshire Attorney General. |
| Form 990, Part VI, Section B, Line 15: | CEO's Compensation: The compensation and benefits of WDH's CEO are reviewed, adjusted and voted on by all independent members of the board annually. See WDH's separate Form 990 for further details. Compensation of Key Employees: The CEO reviews the salaries of key employees annually and recommends compensation based on performance, salary ranges and market competitive data. Compensation data is provided by an independent national consulting firm every other year. The CEO presents salary range data for key employees to the board annually for approval. Using the Board approved salary range data, the CEO recommends salary increases for vice presidents to the WDH Board for approval and the vice presidents recommended salary increases for Directors and other management positions to the CEO, for approval. All compensation for vice presidents and above requires final approval by the WDH independent Board Members. |
| Form 990, Part VI, Section C, Line 19: | Audited financial statements are filed annually with the New Hampshire Attorney General's Charitable Trust Unit. The Director of Charitable Trusts is also informed of any pecuniary benefit transactions that have occurred between the Foundation and a board member or officer. Notices of such transactions of $5,000 or more are also published in the local newspaper in accordance with NH RSA 7:19-a. II(d). Current copies of the Bylaws, Conflict of Interest Policy, and Form 990 are on file with the Charitable Trust Unit. The Organization also makes these documents available upon request. |
| Form 990, Part VII, Section A: | Reportable Compensation from Related Organizations: The 2016 compensation reported for Ellen L. Caille, Dr. Paul R. Cass, Gregory J. Walker and Peter E. Walcek was paid by Wentworth-Douglass Hospital for their services as full-time executives. Gregory J. Walker and Peter E. Walcek each worked an average of 55 hours per week, as did Ellen Caille and Dr. Cass. Of the respective hours worked by Ellen Caille and Dr. Cass, an average of 5 hours per week was dedicated to Wentwowrth-Douglass Physician Corporation. |
| Form 990, Part XI, Line 9, Change in Net Assets: | Other Changes in Net Assets: Transfer from WDH $31,559,262 Rental Expense reported by WDH $35,467 |
| Form 990, Part XII, Line 2c: | Audit Review Process: WDH's Finance Committee oversees the audit process for Wentworth-Douglass Health System and all related organizations. The audit process of the financial statements did not change from the prior year. Independent accountants performed the audit on both 2015 and 2016. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TEMP HELP/MNHRS TOTAL FEES:98083 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:8061430 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING TOTAL FEES:122616 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MISC FEES TOTAL FEES:15819 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Wentworth-Douglass Hospital | ||||||||||
| 789 Central Avenue | Dover | NH | 03820 | 020260334 | Health Care | NH | 501(c)(3) | Line 3 | WDHS | false |
| Wentworth-Douglass Hospital & Healt | ||||||||||
| 789 Central Avenue | Dover | NH | 03820 | 510491062 | Fund Raising | NH | 501(c)(3) | Line 11b | WDHS | false |
| Wentworth-Douglass Health System | ||||||||||
| 789 Central Avenue | Dover | NH | 03820 | 461635259 | Support | NH | 501(c)(3) | Line 11b,II | NA | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wentworth Surgery Center LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 71 | AddressLine1Txt |
| City | Somersworth | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03878 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 900975592 | EIN |
| Primary Activities | Surgery Ce | PrimaryActivitiesTxt |
| Legal Domicile State | NH | LegalDomicileStateCd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wentworth-Douglass Community Health | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 789 Central Avenue | AddressLine1Txt |
| City | Dover | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03820 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 020399963 | EIN |
| Primary Activities | Health Fitness | PrimaryActivitiesTxt |
| Legal Domicile State | NH | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WDH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C-Corp | EntityTypeTxt |
| Share Of Total Income | $0 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $0 | ShareOfEOYAssetsAmt |
| Ownership | 0.00000 | OwnershipPct |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II, Identification of Related Tax-Exempt Organizations: | FormAndLineReferenceDesc |
| Explanation | Name of Related Organization: Wentworth-Douglass Health System : Primary activity - Supoort and further charitable activities of hospital and related entities. | ExplanationTxt |
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