2017-05-15T00:00:00-05:00 2016-06-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2015-07-01 043326928 CARL J SHAPIRO INSTITUTE FOR EDUCATION RESEARCH AT HARVARD MEDICAL SCHOOL CARL 6176670608 330 BROOKLINE AVENUE NO ES 2 BOSTON MA 022155400 RICHARD SCHWARTZSTEIN MD EXECUTIVE DIRECTOR 6176670608 2017-05-15 0 CHRISTINE KAWECKI P00743140 5169187000 2017-05-15 2015 2021-01-29 14:40:06Z RICHARD SCHWARTZSTEIN MD 330 BROOKLINE AVENUE NO ES 2 BOSTON MA 022155400 640914 0 X WWW.BIDMC.ORG X 1996 MA SEE SCHEDULE O 15 5 0 5 1752 -3322 43500 0 420838 570076 79536 55838 0 15000 543874 640914 225666 161240 0 0 26656 0 0 0 0 267406 324673 519728 485913 24146 155001 3008706 3161911 75854 137854 2932852 3024057 X SEE SCHEDULE O. 0 0 25368 74478 SIMULATION AND SKILLS CENTER ("CENTER") - THE CENTER PROVIDES OPPORTUNITIES FOR TRAINEES TO PRACTICE SKILLS FOR LAPAROSCOPIC AND OTHER SURGICAL PROCEDURES, TO ENGAGE IN TEAM-BASED LEARNING, AND TO ENHANCE COMMUNICATION SKILLS. THE CENTER INCORPORATES REALISTIC OPERATING AND INTENSIVE CARE/EMERGENCY ROOMS WHICH ALLOW FOR TEAM TRAINING AND DISCIPLINE-SPECIFIC EDUCATIONAL EXPERIENCES. THE CENTER'S RESOURCES INCLUDE A WIDE RANGE OF TASK TRAINERS AND SIMULATORS, VIDEOCONFERENCE FACILITIES AND DEDICATED FACULTY AND STAFF TO SUPPORT THE EDUCATION OF STUDENTS, TRAINEES, AND PRACTITIONERS IN ALL OF THE HEALTH CARE PROFESSIONS. 97959 151218 CONTINUING MEDICAL EDUCATION COURSES - THE INSTITUTE HAS SPONSORED COURSES ON "MAXIMIZING YOUR TEACHING SKILLS: PRINCIPLES OF MEDICAL EDUCATION." THE COURSE CURRICULUM IS AN INTRODUCTION TO THE PRINCIPLES OF EFFECTIVE CLINICAL TEACHING FOR ADULT LEARNERS. THROUGH DIDACTIC AND INTERACTIVE SESSIONS, PARTICIPANTS LEARN MODELS OF CLINICAL INSTRUCTION AND HOW TO APPLY THESE EFFECTIVE TECHNIQUES TO THEIR OWN TEACHING. THE COURSE ALSO PROVIDES AN EXPLORATION OF CRITICAL THINKING, REFLECTION, ASSESSMENT, AND FEEDBACK. 104898 314379 THE INSTITUTE COLLABORATED WITH THE INTERNATIONAL EMERGENCY MANAGEMENT SOCIETY EMERGENCY MEDICAL COMMITTEE, TO DEVELOP PROGRAMS AND INITIATIVES WHICH PROMOTE THE INTERNATIONAL EXCHANGE OF MEDICAL STUDENTS AND SHARE MUTUAL MEDICAL EDUCATION INTERESTS. THE TWO PARTIES JOINTLY PROMOTED EDUCATION TO MAKE A SIGNIFICANT CONTRIBUTION TO THE DEVELOPMENT AND PROGRESS OF HUMAN HEALTH IN CHINA, INCLUDING AN EDUCATIONAL PROGRAM FOR CHINESE SENIOR HOSPITAL EXECUTIVES IN BOSTON. 179449 161240 45001 THE SHAPIRO INSTITUTE HAS RUN SEVERAL EDUCATION RESEARCH PROGRAMS INCLUDING: THE FAMILY MEETING PROJECT, TO ASSESS AND TRAIN THE COMMUNICATION SKILLS OF RESIDENTS DEALING WITH FAMILY MEMBERS OF PATIENTS IN CRITICAL CARE SITUATIONS IN A SIMULATED ICU ENVIRONMENT. THE INSTITUTE ALSO PROVIDES SUPPORT FOR AN INDIVIDUAL TO CONDUCT MEDICAL EDUCATION RESEARCH, INDEPENDENT OF HIS OR HER OWN RESIDENCY ACTIVITIES, WHICH CAN ASSESS THE SUCCESS OF EDUCATIONAL INTERVENTIONS IN PROVIDING EFFECTIVE AND SAFE PATIENT CARE. 179449 161240 45001 407674 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 33 0 1 0 1 1 0 0 0 0 0 0 0 0 0 X 15 5 1 0 1 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 MA X CHRISTINE COUGHLIN 6176679120 330 BROOKLINE AVENUE EAST CAMPUS/ES BOSTON MA 02215 BRENNER-GATI MD LEONA TRUSTEE 1.00 0.00 X 0 0 0 CHAIKOF MD PHD ELLIOT L TRUSTEE 1.00 64.00 X 0 1009330 112366 DIENSTAG MD JULES TRUSTEE 1.00 0.00 X 0 0 0 EDELHEIT PHD LEWIS S TRUSTEE 1.00 0.00 X 0 0 0 FLIER MD JEFFREY S TRUSTEE (EX-OFFICIO), CO-CHAIR 1.00 59.00 X 1000 624343 54967 GOLDBERG CAROL R TRUSTEE 1.00 0.00 X 0 0 0 HUNDERT MD EDWARD TRUSTEE 1.00 59.00 X 0 371890 57414 JICK DANIEL J TRUSTEE (EX-OFFICIO) 1.00 0.00 X 0 0 0 MEEKER MD DAVID TRUSTEE 1.00 0.00 X 0 0 0 RABKIN MD MITCHELL T TRUSTEE 1.00 0.00 X 1000 0 0 ROSENBERG MD STUART A TRUSTEE 1.00 64.00 X 0 1004900 68431 SCHWARTZSTEIN RICHARD M TRUSTEE (EX-OFFICIO), EXECUTIVE DIRECTOR 12.00 53.00 X 91492 391738 45344 STEVENSON MD PHD MARY ANN TRUSTEE 1.00 59.00 X 0 665958 82720 SUKHATME MD SCD VIKAS P TRUSTEE (EX-OFFICIO) 1.00 59.00 X 2250 617538 70146 TABB MD KEVIN TRUSTEE (EX-OFFICIO) & CO-CHAIR 1.00 64.00 X 0 1469783 167856 ZEIDEL MD MARK L TRUSTEE 1.00 64.00 X 0 745663 62830 COUGHLIN CHRISTINE M ASSOCIATE DIRECTOR, CLERK 2.00 18.00 X 7127 46032 5173 HUGHES CAROL M OPERATIONS MANAGER & CLERK 12.00 18.00 X 20345 98480 36431 WANG DIANA TREASURER &FINANCIAL ANALYST 8.00 12.00 X 31894 42140 28860 155108 7087795 792538 0 0 1 1 0 PROGRAM FEES 900099 570076 570076 570076 34132 659 33473 21706 0 21706 21706 1093 20613 TRUST RESIDUARY 525920 15000 15000 15000 640914 585076 1752 54086 161240 161240 10757 10757 400 400 5889 5889 2491 2451 40 175379 175379 22442 22442 TEACHING HONORARIUM 53500 53500 DUES & SUBSCRIPTIONS 30179 30179 TEACHING EXPENSE 10167 10167 COPYRIGHT PERMISSION 3165 3165 10304 1772 8532 485913 407674 78239 0 643144 1522612 161984 227924 9142 211449 98178 60135 113271 1908443 1288962 235000 3008706 3161911 17961 97854 57893 40000 75854 137854 X 1301042 1748871 733810 377186 898000 898000 2932852 3024057 3008706 3161911 155001 -63796 0 X 1 X 0 1 0 X X X 2 BETH ISRAEL DEACONESS MEDICAL CENTER 042103881 3 1 203837 0 PRESIDENT & FELLOWS OF HARVARD COLLEGE 042103580 4 1 203837 0 2 407674 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION B, LINE 1: ALTHOUGH DURING THE FISCAL YEAR 2016 A MAJORITY OF THE INSTITUTE'S BOARD WAS NOT APPOINTED BY ITS SUPPORTED ORGANIZATIONS, AS PREVIOUSLY REPORTED IN THIS FORM 990, PART VI, LINE 4, UNDER THE AMENDED AND RESTATED BY-LAWS THAT BECAME EFFECTIVE DURING THE FISCAL PERIOD COVERED BY THIS FILING, A MAJORITY OF THE INSTITUTE'S OFFICERS ARE APPOINTED BY ITS SUPPORTED ORGANIZATIONS. IN ADDITION, ALTHOUGH FOR A PORTION OF THE FISCAL YEAR 2016 A MAJORITY OF THE INSTITUTE'S OFFICERS AND BOARD WERE NOT APPOINTED BY ITS SUPPORTED ORGANIZATIONS, AT ALL TIMES DURING THE YEAR THE INSTITUTE'S SUPPORTED ORGANIZATION MAINTAINED A CLOSE WORKING RELATIONSHIP WITH THE INSTITUTE. IN PARTICULAR, ALL OF THE INSTITUTE'S OFFICERS WERE INDIVIDUALS EMPLOYED BY AND/OR APPOINTED BY THE SUPPORTED ORGANIZATIONS. OF THESE, HALF OF THE OFFICER POSITIONS, THE TWO CO-CHAIRS AND THE EXECUTIVE DIRECTOR, WERE FILLED BY THE SUPPORTED ORGANIZATIONS. SPECIFICALLY THE TWO CO-CHAIRS WERE INDIVIDUALS WHO SERVED IN THOSE POSITIONS, EX-OFFICIO, BY VIRTUE OF OFFICES TO WHICH THEY WERE NAMED AT THE SUPPORTED ORGANIZATIONS BY THE SUPPORTED ORGANIZATIONS' BOARDS OR OFFICERS OF THE SUPPORTED ORGANIZATIONS ACTING IN THEIR OFFICIAL CAPACITIES, AND THE EXECUTIVE DIRECTOR WAS APPOINTED BY THE CO-CHAIRS ACTING ON BEHALF OF THE TWO SUPPORTED ORGANIZATIONS. 1631810 400000 45924 30000 324480 1723254 1710961 14575 20000 73726 1631810 1658531 143793 20000 71363 1710961 1634038 165638 141145 1658531 1655773 20000 20325 62060 1634038 0.55000 0.45000 0 0 73303 28664 44639 138146 69514 68632 113271 898000 C 242254 F TIME DEPOSITS AT LOCAL BANKS 148708 F 1288962 PART V, LINE 4: ALL ENDOWMENT FUNDS AND INCOME FROM ENDOWMENT FUNDS ARE USED IN SUPPORT OF THE INSTITUTE'S EDUCATIONAL MISSION. 1 CENTRAL AMERICA & THE CARIBBEAN 0 0 INVESTMENTS 129220 EAST ASIA AND THE PACIFIC 0 0 INVESTMENTS 1198 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 7733 NORTH AMERICA 0 0 INVESTMENTS 7510 SOUTH AMERICA 0 0 INVESTMENTS 1060 0 0 0 0 0 0 146721 0 146721 1 0 1 1 1 0 FORM 990, SCHEDULE F, PART IV, LINE 1 ALTHOUGH THE CARL J SHAPIRO INSTITUTE FOR EDUCATION RESEARCH AT HARVARD MEDICAL SCHOOL WAS AN INDIRECT U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION DURING THE TAX YEAR, SUCH TRANSFERS DID NOT RESULT IN AN OBLIGATION TO FILE FORM 926, RETURN BY A U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION. FORM 990, SCHEDULE F, PART IV, LINE 3 ALTHOUGH THE CARL J SHAPIRO INSTITUTE FOR EDUCATION RESEARCH AT HARVARD MEDICAL SCHOOL HAD AN INDIRECT OWNERSHIP INTEREST IN A FOREIGN CORPORATION DURING THE TAX YEAR, IT DID NOT MEET ANY OF THE FIVE CATEGORIES OF REQUIRED FILER AND AS SUCH WAS NOT REQUIRED TO FILE FORM 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS. FORM 990, SCHEDULE F, PART IV, LINE 4 ALTHOUGH THE CARL J SHAPIRO INSTITUTE FOR EDUCATION RESEARCH AT HARVARD MEDICAL SCHOOL WAS AN INDIRECT SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR A QUALIFIED ELECTING FUND DURING THE PERIOD COVERED BY THIS FILING, SUCH OWNERSHIP DID NOT RESULT IN AN OBLIGATION TO FILE FORM 8621, INFORMATION RETURN BY A SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR QUALIFIED ELECTING FUND. FORM 990, SCHEDULE F, PART IV, LINE 5 ALTHOUGH THE CARL J SHAPIRO INSTITUTE FOR EDUCATION RESEARCH AT HARVARD MEDICAL SCHOOL HELD AN INDIRECT OWNERSHIP INTEREST IN A FOREIGN PARTNERSHIP DURING THE TAX YEAR, THE INTEREST DID NOT RESULT IN AN OBLIGATION TO FILE FORM 8865, RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS. 1 BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVE BOSTON MA 02215 042103881 501(C)(3) 161240 TO SUPPORT MEDICAL EDUCATION 1 0 X 0 1 0 0 0 0 0 0 0 CHAIKOF MD PHD ELLIOT L TRUSTEE 0 992334 0 0 0 16996 0 77548 0 34818 0 1121696 0 0 FLIER MD JEFFREY S TRUSTEE (EX-OFFICIO), CO-CHAIR 1000 613432 0 0 0 10911 0 33825 0 21142 1000 679310 0 0 HUNDERT MD EDWARD TRUSTEE 0 369292 0 0 0 2598 0 33825 0 23589 0 429304 0 0 ROSENBERG MD STUART A TRUSTEE 0 751425 0 231282 0 22193 0 49687 0 18744 0 1073331 0 0 SCHWARTZSTEIN RICHARD M TRUSTEE (EX-OFFICIO), EXECUTIVE DIRE 76927 325389 12900 58764 1665 7585 5247 23903 2915 13279 99654 428920 0 0 STEVENSON MD PHD MARY ANN TRUSTEE 0 653250 0 0 0 12708 0 49688 0 33032 0 748678 0 0 SUKHATME MD SCD VIKAS P TRUSTEE (EX-OFFICIO) 2250 476616 0 111225 0 29697 0 46433 0 23713 2250 687684 0 0 TABB MD KEVIN TRUSTEE (EX-OFFICIO) & CO-CHAIR 0 972162 0 452000 0 45621 0 127000 0 40856 0 1637639 0 0 ZEIDEL MD MARK L TRUSTEE 0 729752 0 0 0 15911 0 46016 0 16814 0 808493 0 0 HUGHES CAROL M OPERATIONS MANAGER & CLERK 20325 98400 0 0 20 80 2121 8486 5165 20659 27631 127625 0 0 PART I, LINE 4B SCHEDULE J - PART I QUESTION 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN THE INSTITUTE'S FORM 990 FOR THE FISCAL YEAR ENDED JUNE 30, 2016 IS CALENDAR YEAR 2015 DETAIL. AS PREVIOUSLY NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER ("MEDICAL CENTER") IS AN ORGANIZATION SUPPORTED BY THE INSTITUTE. DURING THE 2015 CALENDAR YEAR, THE MEDICAL CENTER WAS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM AND THE BETH ISRAEL DEACONESS MEDICAL CENTER 457(B) PLAN. PURSUANT TO THESE PLANS, ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS AND/OR CAN DEFER PART OF THEIR COMPENSATION. UNDER THE DEFINITIONS TO THIS FORM 990, THESE PLANS ARE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. AMOUNTS DEFERRED BY PARTICIPANTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR IN FORM 990 SCHEDULE J PART II, COLUMN C, DEFERRED COMPENSATION, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. SCHEDULE J EXPLANATORY FOOTNOTES REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. OTHER REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED FULLY VESTED 457(B) PLAN; TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; EARNED TIME CASHED; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AND 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 NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THE NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. AND PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS SHAPIRO INSTITUTE AND PFHC/HMS RESPECTIVELY. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER AND BETH ISRAEL DEACONESS MEDICAL CENTER MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS HMFP AND BIDMC RESPECTIVELY. BRENNER-GATI, M.D., LEONA TRUSTEE - SHAPIRO INSTITUTE DR. BRENNER-GATI DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. CHAIKOF, M.D., PHD, ELLIOT TRUSTEE - SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) AND CHAIR (SURGERY) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHIEF (SURGERY) -BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND PRESIDENT - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION JOHNSON & JOHNSON PROFESSOR OF SURGERY - HARVARD MEDICAL SCHOOL DR. CHAIKOF PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. CHAIKOF IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. CHAIKOF'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 496,168 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 8,498 DEFERRED COMPENSATION: 38,774 NON-TAXABLE BENEFITS: 17,409 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 496,168 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 8,498 DEFERRED COMPENSATION: 38,774 NON-TAXABLE BENEFITS: 17,409 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2015 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. CHAIKOF'S POSITION AS CHIEF OF SURGERY AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF SURGERY AND JOHNSON & JOHNSON PROFESSOR OF SURGERY, HARVARD MEDICAL SCHOOL: $ 222,393 BASE AND OTHER REPORTABLE COMPENSATION, $ 27,860 DEFERRED COMPENSATION AND $4,308 NON-TAXABLE BENEFITS. DIENSTAG, M.D., JULES TRUSTEE - SHAPIRO INSTITUTE DR. DIENSTAG SERVED ON THE BOARD THROUGH JULY 31, 2015 AND DEVOTED, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION DURING THAT TIME.. DR. EDELHEIT DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. FLIER, M.D., JEFFREY S. TRUSTEE (EX-OFFICIO) AND CO-CHAIR - SHAPIRO INSTITUTE DEAN OF THE FACULTY OF MEDICINE - HARVARD MEDICAL SCHOOL CAROLINE SHIELDS WALKER PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. FLIER SERVED AS CO-CHAIR AND TRUSTEE THROUGH JUNE 30, 2016 AND DEVOTED, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE DURING THAT TIME.. PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 1,000 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY PFHC/HMS BASE COMPENSATION: 612,834 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 10,911 DEFERRED COMPENSATION: 33,825 NON-TAXABLE BENEFITS: 21,142 PAYMENTS REPORTED BY BIDMC BASE COMPENSATION: 598 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 GOLDBERG, CAROL R. TRUSTEE - SHAPIRO INSTITUTE MS. GOLDBERG DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. HUNDERT, M.D., EDWARD TRUSTEE - SHAPIRO INSTITUTE DEAN FOR MEDICAL EDUCATION - HARVARD MEDICAL SCHOOL DR. HUNDERT DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY PFHC/HMS BASE COMPENSATION: 369,292 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 2,598 DEFERRED COMPENSATION: 33,825 NON-TAXABLE BENEFITS: 23,589 JICK, DANIEL J. TRUSTEE (EX-OFFICIO) - SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) - CAREGROUP, INC. DIRECTOR AND BOARD CHAIR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. JICK DEVOTES, ON AVERAGE, 16 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MEEKER, M.D., DAVID TRUSTEE - SHAPIRO INSTITUTE DR. MEEKER DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. RABKIN, M.D., MITCHELL T. TRUSTEE, CO-FOUNDER AND DISTINGUISHED INSTITUTE SCHOLAR - SHAPIRO INSTITUTE DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. DIRECTOR - MILTON HOSPITAL FOUNDATION, INC. DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. RABKIN DEVOTES, ON AVERAGE, A COMBINED 3 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY SHAPIRO INSTITUTE BASE COMPENSATION: 1,000 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 ROSENBERG, M.D., STUART A TRUSTEE - SHAPIRO INSTITUTE PRESIDENT, CHIEF EXECUTIVE OFFICER AND DIRECTOR (EX-OFFICIO) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) -BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - LONGWOOD MEDICAL INTERNATIONAL FOUNDATION, INC. DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION DIRECTOR (EX-OFFICIO) - CONTINUING EDUCATION PROGRAM, INC. D/B/A BETH ISRAEL DEACONESS DEPARTMENT OF PSYCHIATRY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORP., D/B/A AFFILIATED PHYSICIANS GROUP DIRECTOR- BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES SENIOR LECTURER ON MEDICINE - HARVARD MEDICAL SCHOOL DR. ROSENBERG DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 751,425 INCENTIVE COMPENSATION: 231,282 OTHER REPORTABLE COMPENSATION: 22,193 DEFERRED COMPENSATION: 49,687 NON-TAXABLE BENEFITS: 18,744 SCHWARTZSTEIN, M.D., RICHARD M. TRUSTEE (EX-OFFICIO), AND EXECUTIVE DIRECTOR - SHAPIRO INSTITUTE VICE PRESIDENT OF EDUCATION - BETH ISRAEL DEACONESS MEDICAL CENTER PHYSICIAN, PULMONARY AND CRITICAL CARE - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER ELLEN AND MELVIN GORDON PROFESSOR OF MEDICAL EDUCATION - HARVARD MEDICAL SCHOOL DR. SCHWARTZSTEIN PERFORMS SERVICES FOR TH SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 76,927 INCENTIVE COMPENSATION: 12,900 OTHER REPORTABLE COMPENSATION: 1,665 DEFERRED COMPENSATION: 5,247 NON-TAXABLE BENEFITS: 2,915 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 79,363 INCENTIVE COMPENSATION: 14,332 OTHER REPORTABLE COMPENSATION: ,1,850 DEFERRED COMPENSATION: 5,830 NON-TAXABLE BENEFITS: 3,239 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 246,026 INCENTIVE COMPENSATION: 44,432 OTHER REPORTABLE COMPENSATION: 5,735 DEFERRED COMPENSATION: 18,073 NON-TAXABLE BENEFITS: 10,040 STEVENSON, M.D., PHD, MARY ANN TRUSTEE - SHAPIRO INSTITUTE CHIEF, RADIATION ONCOLOGY -BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR, SECRETARY/CLERK AND CHAIR, RADIATION ONCOLOGY - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER ASSOCIATE PROFESSOR OF RADIATION ONCOLOGY - HARVARD MEDICAL SCHOOL DR. STEVENSON PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. STEVENSON IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. STEVENSON'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 326,625 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,354 DEFERRED COMPENSATION: 24,844 NON-TAXABLE BENEFITS: 16,516 PAYMENTS ALLOCATED TO BIDMC: BASE COMPENSATION: 326,625 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,354 DEFERRED COMPENSATION: 24,844 NON-TAXABLE BENEFITS: 16,516 SUKHATME, M.D., SC.D, VIKAS P. TRUSTEE - SHAPIRO INSTITUTE SENIOR VICE PRESIDENT AND CHIEF ACADEMIC OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER NEPHROLOGIST - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER VICTOR J. ARESTY PROFESSOR OF MEDICINE- HARVARD MEDICAL SCHOOL DR. SUKHATME PERFORMS SERVICES FOR THE SHAPIRO INSTITUTE, BIDMC AND HMFP AND DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. SUKHATME RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE, BIDMC AND HMFP FOR HIS SERVICES PROVIDED IN THESE ROLES. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. SUKHATME IS PAID DIRECTLY BY SHAPIRO INSTITUTE, BIDMC AND HMFP, THE PORTION OF DR. SUKHATME'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 2,250 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY BIDMC BASE COMPENSATION: 476,616 INCENTIVE COMPENSATION: 111,225 OTHER REPORTABLE COMPENSATION: 29,697 DEFERRED COMPENSATION: 46,433 NON-TAXABLE BENEFITS: 23,713 AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2015 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. SUKHATME'S POSITION AS VICTOR J. ARESTY PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: $ 91,806 BASE AND OTHER REPORTABLE COMPENSATION, $9,181 DEFERRED COMPENSATION AND $141 NON-TAXABLE BENEFITS. TABB, M.D., KEVIN TRUSTEE (EX-OFFICIO) AND CO-CHAIR - SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. TABB DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 972,162 INCENTIVE COMPENSATION: 452,000 OTHER REPORTABLE COMPENSATION: 45,621 DEFERRED COMPENSATION: 127,000 NON-TAXABLE BENEFITS: 40,856 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $152,775. OF THIS AMOUNT, $109,775 IS BOTH UNFUNDED AND UNVESTED. ZEIDEL, M.D., MARK TRUSTEE - SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) AND CHIEF (MEDICINE) -BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (MEDICINE) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR - LONGWOOD MEDICAL INTERNATIONAL FOUNDATION DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT, CORP, D/B/A AFFILIATED PHYSICIANS GROUP PRESIDENT AND DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION, INC. HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. ZEIDEL PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ZEIDEL IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. ZEIDEL'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 364,876 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,956 DEFERRED COMPENSATION: 23,005 NON-TAXABLE BENEFITS: 8,407 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 364,876 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,956 DEFERRED COMPENSATION: 23,008 NON-TAXABLE BENEFITS: 8,407 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2015 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. ZEIDEL'S POSITION AS CHAIR OF MEDICINE AND HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: $153,633 BASE AND OTHER REPORTABLE COMPENSATION, $16,866 DEFERRED COMPENSATION AND $1,912 NON-TAXABLE BENEFITS. COUGHLIN, CHRISTINE, M. CLERK AND ASSOCIATE DIRECTOR - SHAPIRO INSTITUTE ADMINISTRATIVE DIRECTOR, CENTER FOR EDUCATION, ACADEMIC AFFAIRS - BETH ISRAEL DEACONESS MEDICAL CENTER MS. COUGHLIN BECAME CLERK ON JUNE 23, 2016 AND PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 20 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. COUGHLIN RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. COUGHLIN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY THE SHAPIRO INSTITUTE BASE COMPENSATION: 7,127 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 588 NON-TAXABLE BENEFITS: 33 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 46,032 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 4,310 NON-TAXABLE BENEFITS: 242 HUGHES, CAROL A. CLERK AND OPERATIONS MANAGER - SHAPIRO INSTITUTE OPERATIONS MANAGER, CENTER FOR EDUCATION, ACADEMIC AFFAIRS - BETH ISRAEL DEACONESS MEDICAL CENTER MS. HUGHES' TERM AS CLERK ENDED JUNE 23, 2013 AND PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. HUGHES RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. HUGHES' COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY THE SHAPIRO INSTITUTE BASE COMPENSATION: 20,325 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 20 DEFERRED COMPENSATION: 2,121 NON-TAXABLE BENEFITS: 5,165 PAYMENTS REPORTED BY THE BIDMC: BASE COMPENSATION: 98,400 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 80 DEFERRED COMPENSATION: 8,486 NON-TAXABLE BENEFITS: 20,659 WANG, DIANA TREASURER AND FINANCIAL ANALYST - SHAPIRO INSTITUTE FINANCIAL ANALYST - BETH ISRAEL DEACONESS MEDICAL CENTER MS. WANG PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 20 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) MS. WANG RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. WANG'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY THE SHAPIRO INSTITUTE BASE COMPENSATION: 31,864 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 30 DEFERRED COMPENSATION: 2,104 NON-TAXABLE BENEFITS: 9,440 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 42,095 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 45 DEFERRED COMPENSATION: 3,155 NON-TAXABLE BENEFITS: 14,161 FORM 990, PART I, LINE 1: THE MISSION OF THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER ("SHAPIRO INSTITUTE OR "INSTITUTE") IS TO SUPPORT, PROMOTE, AND DEVELOP INNOVATIVE PROGRAMS AND MODELS FOR THE DUAL ACTIVITIES OF TEACHING AND RESEARCH AT ACADEMIC MEDICAL CENTERS. THE INSTITUTE PROVIDES INTELLECTUAL LEADERSHIP, STATE-OF-THE-ART FACILITIES AND STAFF RESOURCES TO SUPPORT THE EDUCATION AND TRAINING OF MEDICAL STUDENTS, RESIDENTS AND FELLOWS. THE INSTITUTE SERVES AS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL (HMS). FORM 990, PART III, LINE 1: THE MISSION OF THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER ("SHAPIRO INSTITUTE OR "INSTITUTE") IS TO SUPPORT, PROMOTE, AND DEVELOP INNOVATIVE PROGRAMS AND MODELS FOR THE DUAL ACTIVITIES OF TEACHING AND RESEARCH AT ACADEMIC MEDICAL CENTERS. THE INSTITUTE PROVIDES INTELLECTUAL LEADERSHIP, STATE-OF-THE-ART FACILITIES AND STAFF RESOURCES TO SUPPORT THE EDUCATION AND TRAINING OF MEDICAL STUDENTS, RESIDENTS AND FELLOWS. THE INSTITUTE SERVES AS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL (HMS). FORM 990, PART VI, SECTION A, LINE 2 THE SHAPIRO INSTITUTE IS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND SERVES AS A SUPPORT ORGANIZATION, PROVIDING MEDICAL TRAINING AND EDUCATION TO, BETH ISRAEL DEACONESS MEDICAL CENTER AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. EACH OF THESE ENTITIES IS ALSO A NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC, AN ENTITY INTEGRALLY RELATED TO BIDMC AND ALSO A NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN EMPLOYMENT RELATIONSHIP ONE OR MORE ENTITIES NOTED ABOVE. ADDITIONAL DETAIL RELATED TO EMPLOYMENT RELATIONSHIPS IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. FORM 990, PART VI, SECTION A, LINE 4 DURING THE FISCAL PERIOD COVERED BY THIS FILING MADE SIGNIFICANT REVISIONS ITS BY-LAWS. THE INSTITUTE BOARD UNANIMOUSLY VOTED TO: 1.FORMALIZE THAT A MAJORITY OF IT'S OFFICERS ARE APPOINTED BY ITS TWO SUPPORTED ORGANIZATIONS, BETH ISRAEL DEACONESS MEDICAL CENTER AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL, WITH ONE CO-CHAIR APPOINTMENT BY EACH ENTITY, CONSISTENT WITH THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 509(A)(3). SEE FORM 990 SCHEDULE A FOR ADDITIONAL INFORMATION; 2.CONSOLIDATE THE POSITIONS OF SECRETARY AND CLERK INTO A SINGLE OFFICER POSITION; AND, 3.CHANGE ITS FISCAL YEAR TO THE PERIOD OCTOBER 1 TO SEPTEMBER 30, TO ALIGN WITH IS SUPPORTED ORGANIZATION, BETH ISRAEL DEACONESS MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 8B MINUTES ARE DOCUMENTED FOR THE BOARD OF TRUSTEE MEETINGS. NO SUBCOMMITTEE HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE INSTITUTE'S FORM 990 IS PREPARED IN CONJUNCTION WITH THE CAREGROUP TAX DEPARTMENT AND DELOITTE TAX, LLP. CAREGROUP IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) AND AS PREVIOUSLY NOTED IN THIS FILING, BIDMC IS AN ENTITY SUPPORTED BY THE INSTITUTE. BOTH CAREGROUP AND BIDMC ARE ENTITIES EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. PRIOR TO FILING THE FORM 990, RELATED SCHEDULES AND REQUIRED DISCLOSURES (RETURN), EACH MEMBER OF THE INSTITUTE'S GOVERNING BODY (BOARD OF TRUSTEES) RECEIVES A COPY OF THE RETURN FOR THEIR REVIEW. TIME IS THEN DEDICATED TO DISCUSS THE RETURN, INCLUDING ITS SCOPE AND CONTENTS, AT THE NEXT BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C AS PREVIOUSLY NOTED IN THIS FILING, THE INSTITUTE IS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC, AN ENTITY INTEGRALLY RELATED TO BIDMC AND ALSO A NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AS NOTED IN THE SUPPLEMENTAL INFORMATION TO THIS FORM 990, PART VII AND SCHEDULE J, THERE IS SIGNIFICANT OVERLAP BETWEEN THE INSTITUTE'S TRUSTEES AND EMPLOYEES AND BIDMC. BIDMC HAS A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL MEMBERS OF ITS WORKFORCE, INCLUDING EMPLOYEES, PROFESSIONAL STAFF, TRAINEES, CONSULTANTS, CONTRACTORS, AGENTS, AND VENDORS, AND TO THE MEMBERS OF THE BOARD OF DIRECTORS. IN ADDITION, HMFP ALSO HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY. PURSUANT TO THIS RELATIONSHIP, THE INSTITUTE HAS ADOPTED THE BIDMC CONFLICT OF INTEREST POLICY. CAREGROUP IS THE SOLE MEMBER OF THE MEDICAL CENTER. THE CAREGROUP TAX DEPARTMENT DISTRIBUTED A JOINT ANNUAL CONFLICT OF INTEREST DISCLOSURE AND TAX QUESTIONNAIRE TO ALL CURRENT AND FORMER MEMBERS OF THE INSTITUTE BOARD OF TRUSTEES AS WELL AS CURRENT AND FORMER INSTITUTE OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR THE INSTITUTE TO COMPLETELY AND ACCURATELY PROCESS AND COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 AS PREVIOUSLY NOTED IN THIS FILING, THE INSTITUTE IS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO BIDMC. AS NOTED IN THE SUPPLEMENTAL INFORMATION TO THIS FORM 990, PART VII AND SCHEDULE J, THE INSTITUTE'S EXECUTIVE DIRECTOR ALSO SERVES AS THE VICE PRESIDENT FOR MEDICAL EDUCATION AT BIDMC. THE MEDICAL CENTER HAS A COMPENSATION COMMITTEE THAT IS COMPOSED OF MEMBERS OF THE BOARD OF DIRECTORS. ALL MEMBERS ARE INDEPENDENT. THE MEDICAL CENTER'S COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE OF MEDICAL CENTER SENIOR MANAGEMENT INCLUDING VICE PRESIDENTS THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT IT COMPLIES WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEYS AND STUDIES PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THESE INDIVIDUALS AND AT THAT TIME REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. THE COMPENSATION COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS. REGULAR COMPENSATION FOR OTHER BIDMC EMPLOYEES WHO ALSO SERVE AS INSTITUTE OFFICERS IS SET THROUGH THE ORDINARY BIDMC PROCEDURES WITH INPUT FROM THE BIDMC VICE PRESIDENT OF MEDICAL EDUCATION/INSTITUTE EXECUTIVE DIRECTOR. IN ADDITION TO THE COMPENSATION PROCESSES NOTED ABOVE, FROM TIME TO TIME THE INSTITUTE MAY ACKNOWLEDGE EFFORTS OF ITS EXECUTIVE DIRECTOR, OFFICERS OR OTHER EMPLOYEES WITH AN HONORARIUM. THE INSTITUTE'S BOARD OF TRUSTEES APPROVES ANY SUCH AMOUNTS FOR THE EXECUTIVE DIRECTOR AND INSTITUTE OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 ALL APPLICABLE DOCUMENTS ARE AVAILABLE FROM THE ORGANIZATION UPON WRITTEN REQUEST. BETH ISRAEL DEACONESS MEDICAL CENTER 042103881 HOSPITAL MA 501(C)(3) LINE 3 N/A 0 PRESIDENT & FELLOWS OF HARVARD COLLEGE 042103580 HOSPITAL MA 501(C)(3) LINE 3 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0