2016-05-16T14:43:25-05:00 2015-06-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2014-07-01 043326928 CARL J SHAPIRO INSTITUTE FOR EDUCATION RESEARCH AT HARVARD MEDICAL SCHOOL CARL 6176670608 330 BROOKLINE AVENUE NO ES 2 BOSTON MA 022155400 CHRISTINE COUGHLIN ASSOCIATE DIRECTOR 6176670608 2016-05-16 0 CHRISTINE KAWECKI P00743140 5169187000 2014 2016-08-17 19:52:53Z RICHARD SCHWARTZSTEIN MD 330 BROOKLINE AVENUE NO ES 2 BOSTON MA 022155400 543874 0 X SEE SCHEDULE O X 1996 MA SEE SCHEDULE O. 16 9 0 0 2506 -2344 1825 43500 429087 420838 103811 79536 0 0 534723 543874 198414 225666 0 0 31036 26656 0 0 0 202855 267406 432305 519728 102418 24146 3082734 3008706 118846 75854 2963888 2932852 X SEE SCHEDULE O. 0 0 19200 87584 SIMULATION AND SKILLS 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. 154041 185254 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. 69225 143000 THE SHAPIRO 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 PROMOTE EDUCATION TO MAKE A SIGNIFICANT CONTRIBUTION TO THE DEVELOPMENT AND PROGRESS OF HUMAN HEALTH IN CHINA. THE FIRST EDUCATIONAL PROGRAM FOR CHINESE SENIOR HOSPITAL EXECUTIVES WAS PROVIDED BY THE SHAPIRO INSTITUTE IN BOSTON IN JUNE 2015. 213174 225666 5000 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. 213174 225666 5000 455640 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 33 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 X 16 9 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X CHRISTINE COUGHLIN 6176679120 330 BROOKLINE AVE EAST CAMPUS/ES-20 BOSTON MA 02215 BRENNER-GATI MD LEONA TRUSTEE 1.00 X 0 0 0 CHAIKOF MD PHD ELLIOT L TRUSTEE 1.00 64.00 X 0 485341 55087 DIENSTAG MD JULES TRUSTEE 1.00 X 0 0 0 EDELHEIT PHD LEWIS S TRUSTEE 1.00 X 0 0 0 FLIER MD JEFFREY S TRUSTEE & CO-CHAIR 1.00 59.00 X X 500 601688 53676 GOLDBERG CAROL R TRUSTEE 1.00 0.00 X 0 0 0 GRAY PHD MARTHA TRUSTEE 1.00 X 0 0 0 HUNDERT EDWARD TRUSTEE 1.00 0.00 X 0 0 0 JICK DANIEL J TRUSTEE 1.00 15.00 X 0 0 0 MEEKER MD DAVID TRUSTEE 1.00 X 0 0 0 RABKIN MD MITCHELL T TRUSTEE 1.00 2.00 X 2000 0 0 ROSENBERG MD STUART A TRUSTEE 1.00 64.00 X 1000 0 0 SCHWARTZSTEIN MD RICHARD M TRUSTEE & EXEC DIR 12.00 53.00 X X 86094 296546 35835 STEVENSON MD PHD MARY ANN TRUSTEE 1.00 59.00 X 0 322424 39616 SUKHATME MD SCD VIKAS P TRUSTEE 1.00 59.00 X 1500 590658 49886 TABB MD KEVIN TRUSTEE & CO-CHAIR 1.00 64.00 X X 0 1453194 53346 ZEIDEL MD MARK L TRUSTEE 1.00 64.00 X 0 365821 31967 ZINNER MD STEPHEN TRUSTEE 1.00 X 0 0 0 COUGHLIN CHRISTINE ASSOCIATE DIRECTOR 2.00 18.00 X 5179 46606 5200 HUGHES CAROL A CLERK & OPERATIONS MANAGER 12.00 18.00 X 22470 89880 41190 WANG DIANA TREASURER & FIN ANALYST 8.00 12.00 X 27723 41584 8312 146466 4293742 374115 0 0 1 0 0 43500 43500 PROGRAM FEES 900099 420838 420838 420838 11773 1100 10673 67763 0 67763 67763 1406 66357 543874 420838 2506 77030 225666 225666 26656 23849 2807 29748 29748 4591 4591 873 873 1750 1750 5403 3580 1823 175858 175858 10472 10472 TEACHING HONORARIUM 17722 17722 0 0 COPYRIGHT PERMISSION 2717 2717 0 0 DUES & SUBSCRIPTIONS 1141 236 905 0 17131 4262 12869 519728 455640 64088 0 550580 643144 191307 161984 135870 75735 61360 60135 2030025 1908443 249462 235000 3082734 3008706 10319 17961 90942 57893 17585 0 118846 75854 X 1252927 1301042 812961 733810 898000 898000 2963888 2932852 3082734 3008706 24146 -55182 0 X 1 X 0 1 0 X X X 2 BETH ISRAEL DEACONESS MEDICAL CENTER 042103881 3 1 227820 0 PRESIDENT & FELLOWS OF HARVARD COLLEGE 042103580 4 1 227820 0 2 455640 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 FISCAL YEAR 2015, A MAJORITY OF THE INSTITUTE'S BOARD WAS NOT APPOINTED BY ITS SUPPORTED ORGANIZATIONS, AT ALL TIMES DURING THE YEAR THE INSTITUTE'S SUPPORTED ORGANIZATIONS MAINTAINED A CLOSE WORKING RELATIONSHIP WITH THE INSTITUTE. IN PARTICULAR, ALL OF THE INSTITUTE'S OFFICERS WERE INDIVIDUALS EMPLOYED BY AND/OR APPOINTED BY THE SUPPORTED ORGANIZATIONS. OF THESE, HALF OF THE 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. ADDITIONALLY, FOUR SEATS ON THE BOARD WERE FILLED, EX OFFICIO, BY VIRTUE OF POSITIONS THOSE INDIVIDUALS HELD AT THE SUPPORTED ORGANIZATIONS. UNDER AMENDED AND RESTATED BYLAWS THAT THE INSTITUTE EXPECTS WILL BECOME EFFECTIVE IN 2016, A MAJORITY OF THE INSTITUTE'S OFFICERS WILL BE APPOINTED BY ITS SUPPORTED ORGANIZATIONS. PART IV, SECTION A, LINE 6: AS NOTED IN SCHEDULE I OF FORM 990, DURING FY15, THE FILING ORGANIZATION MADE A GRANT TO HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER ('HMFP') IN SUPPORT OF THE MEDICAL RESEARCH AND PATIENT CARE ACTIVITIES OF BIDMC, ONE OF THE FILING ORGANIZATION'S SUPPORTED ORGANIZATIONS. HMFP IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC ACCOMPLISH ITS CHARITABLE PURPOSES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1710961 14575 20000 73726 1631810 1658531 143793 20000 71363 1710961 1634038 165638 141145 1658531 1655773 20000 20325 62060 1634038 1595377 129560 69164 1655773 0.55000 0.45000 0 0 54962 46821 8141 80908 28914 51994 60135 FINANCIAL DERIVATIVES 898000 C CLOSELY HELD EQUITY INTERESTS 501454 F TIME DEPOSITES AT LOCAL BANKS 508989 F 1908443 TRUST RESIDUARY 235000 235000 654845 -55182 170744 115562 539283 4591 4591 543874 685881 170744 170744 515137 4591 4591 519728 1 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES EDUCATION SEMINARS/PRESENTATION 20000 CENTRAL AMERICA & THE CARIBBEAN 0 0 INVESTMENTS 77962 EAST ASIA AND THE PACIFIC 0 0 INVESTMENTS 986 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 3657 NORTH AMERICA 0 0 INVESTMENTS 3330 SOUTH AMERICA 0 0 INVESTMENTS 846 0 0 0 0 0 0 106781 0 106781 0 0 0 1 0 0 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 TRANSFERS 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. 1 HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS - 375 LONGWOOD AVE BOSTON MA 02215 222768204 501(C)(3) 220911 0 TO SUPPORT THE MEDICAL EDUCATION RESEARCH 1 0 PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANT FUNDS ARE GIVEN TO THE PRINCIPAL INVESTIGATOR'S DEPARTMENT ADMINISTRATOR FOR DISTRIBUTION ACCORDING TO THE GRANT BUDGET. MONITORING OF THE RELATED RESEARCH ACTIVITY IS CONDUCTED BY THE DIRECTOR OF EDUCATION RESEARCH WITH THE PRINCIPAL INVESTGATOR THOURGHOUT THE GRANT YEAR. X 0 1 0 0 0 0 0 0 0 CHAIKOF MD PHD ELLIOT L TRUSTEE 0 477557 0 0 0 7784 0 37764 0 17323 0 540428 0 0 FLIER MD JEFFREY S TRUSTEE & CO-CHAIR 500 597117 0 0 0 4571 0 33150 0 20526 500 655364 0 0 SCHWARTZSTEIN MD RICHARD M TRUSTEE & EXEC DIR 72684 250356 11831 40751 1579 5439 5148 17732 2915 10040 94157 324318 0 0 STEVENSON MD PHD MARY ANN TRUSTEE 0 316734 0 0 0 5690 0 24375 0 15241 0 362040 0 0 SUKHATME MD SCD VIKAS P TRUSTEE 1500 459752 0 117970 0 12936 0 34537 0 15349 1500 640544 0 0 TABB MD KEVIN TRUSTEE & CO-CHAIR 0 967341 0 417000 0 68853 0 13000 0 40346 0 1506540 0 0 ZEIDEL MD MARK L TRUSTEE 0 359745 0 0 0 6076 0 22473 0 9494 0 397788 0 0 HUGHES CAROL A CLERK & OPERATIONS MANAGER 22470 89880 0 0 0 0 2082 8326 6156 24626 30708 122832 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 SHAPIRO INSTITUTE'S FORM 990 FOR THE FISCAL YEAR ENDED JUNE 30, 2015 IS CALENDAR YEAR 2014 DETAIL. DURING THE 2014 CALENDAR YEAR, BETH ISRAEL DEACONESS MEDICAL CENTER WAS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER, INC. ANNUITY RETIREMENT PLAN WHICH, UNDER THE DEFINITIONS TO THIS FORM 990, IS CONSIDERED A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. BIDMC ALSO MAINTAINS AN IRC SEC. 457 PLAN PURSUANT TO WHICH ELIGIBLE EMPLOYEES CAN DEFER PART OF THEIR COMPENSATION. THIS PLAN IS STRICTLY EMPLOYEE FUNDED WITH NO EMPLOYER DEFERRALS. UNDER THE DEFINITIONS TO THIS FORM 990, THIS PLAN IS CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. AMOUNTS DEFERRED BY PARTICIPANTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. 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 (AN UNRELATED EXEMPT ORGANIZATION FOR PURPOSES OF THIS FILING), THE PORTION OF DR. CHAIKOF'S COMPENSATION ATTRIBUTABLE TO BIDMC HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 477,557 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,784 DEFERRED COMPENSATION: 37,764 NON-TAXABLE BENEFITS: 17,323 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY BIDMC FOR THE 2014 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: $214,774 BASE AND OTHER REPORTABLE COMPENSATION, $26,777 DEFERRED COMPENSATION AND $4,186 NON-TAXABLE BENEFITS. DIENSTAG, M.D., JULES TRUSTEE - SHAPIRO INSTITUTE DR. DIENSTAG DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. EDELHEIT, PHD., LEWIS S. TRUSTEE - SHAPIRO INSTITUTE DR. EDELHEIT DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. 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 DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 500 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY PFHC/HMS BASE COMPENSATION: 597,117 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 4,571 DEFERRED COMPENSATION: 33,150 NON-TAXABLE BENEFITS: 20,526 GOLDBERG, CAROL R. TRUSTEE - SHAPIRO INSTITUTE MS. GOLDBERG DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. GRAY, PHD, MARTHA TRUSTEE - SHAPIRO INSTITUTE DR. GRAY SERVED ON THE BOARD THROUGH JUNE 16, 2015 AND DEVOTED, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION DURING THAT TIME. HUNDERT, EDWARD TRUSTEE - SHAPIRO INSTITUTE MR. HUNDERT COMMENCED HIS POSITION ON THE BOARD AS OF JUNE 1, 2015 AND DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION DURING THAT TIME. 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. 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: 2,000 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 SENIOR LECTURER ON MEDICINE - HARVARD MEDICAL SCHOOL DR. ROSENBERG DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL 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 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 THE SHAPIRO INSTITUTE, BIDMC AND HMFP AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL ENTITIES FOR THE POSITIONS LISTED HERE. DR. SCHWARTZSTEIN RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND HMFP (AN UNRELATED ORGANIZATION FOR PURPOSES OF THIS FILING) FOR HIS SERVICES PROVIDED IN THESE ROLES. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. SCHWARTZSTEIN IS PAID DIRECTLY BY SHAPIRO INSTITUTE AND HMFP, THE PORTION OF DR. SCHWARTZSTEIN'S COMPENSATION SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) 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 ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. STEVENSON IS PAID DIRECTLY BY HMFP (AN UNRELATED ORGANIZATION FOR PURPOSES OF THIS FILING), THE PORTION OF DR. STEVENSON'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS ALLOCATED TO BIDMC: BASE COMPENSATION: 316,734 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,690 DEFERRED COMPENSATION: 24,375 NON-TAXABLE BENEFITS: 15,241 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 ENTITIES FOR THE POSITIONS LISTED HERE. DR. SUKHATME RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND HMFP (AN UNRELATED ORGANIZATION FOR PURPOSES OF THIS FILING) FOR HIS SERVICES PROVIDED IN THESE ROLES. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. SUKHATME IS PAID DIRECTLY BY SHAPIRO INSTITUTE AND HMFP, THE PORTION OF DR. SUKHATME'S COMPENSATION ATTRIBUTABLE TO THE FILING ORGANIZATION AND BIDMC HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 1,500 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY BIDMC BASE COMPENSATION: 459,752 INCENTIVE COMPENSATION: 117,970 OTHER REPORTABLE COMPENSATION: 12,936 DEFERRED COMPENSATION: 34,537 NON-TAXABLE BENEFITS: 15,349 AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY BIDMC FOR THE 2014 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: $89,402 BASE AND OTHER REPORTABLE COMPENSATION, $8,940 DEFERRED COMPENSATION AND $140 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 PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. TABB DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 967,341 INCENTIVE COMPENSATION: 417,000 OTHER REPORTABLE COMPENSATION: 68,853 DEFERRED COMPENSATION: 13,000 NON-TAXABLE BENEFITS: 40,346 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $61,750. 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 ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ZEIDEL IS PAID DIRECTLY BY HMFP (AN UNRELATED ORGANIZATION FOR PURPOSES OF THIS FILING), THE PORTION OF DR. ZEIDEL'S COMPENSATION ATTRIBUTABLE TO BIDMC HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 359,745 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,076 DEFERRED COMPENSATION: 22,473 NON-TAXABLE BENEFITS: 9,494 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY BIDMC FOR THE 2014 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: $147,463 BASE AND OTHER REPORTABLE COMPENSATION, $16,345 DEFERRED COMPENSATION AND $1,836 NON-TAXABLE BENEFITS. ZINNER, M.D., STEPHEN TRUSTEE - SHAPIRO INSTITUTE CHARLES S. DAVIDSON PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. ZINNER SERVED ON THE BOARD THROUGH OCTOBER 14, 2014 AND DEVOTED, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION DURING THAT TIME. COUGHLIN, CHRISTINE, M. ASSOCIATE DIRECTOR - SHAPIRO INSTITUTE ADMINISTRATIVE DIRECTOR, CENTER FOR EDUCATION, ACADEMIC AFFAIRS - BETH ISRAEL DEACONESS MEDICAL CENTER MS. COUGHLIN PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 20 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. COUGHLIN RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. COUGHLIN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY THE SHAPIRO INSTITUTE BASE COMPENSATION: 5,178 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 1 DEFERRED COMPENSATION: 437 NON-TAXABLE BENEFITS: 83 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 46,599 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7 DEFERRED COMPENSATION: 3,931 NON-TAXABLE BENEFITS: 749 HUGHES, CAROL A. SECRETARY/CLERK AND OPERATIONS MANAGER - SHAPIRO INSTITUTE OPERATIONS MANAGER, CENTER FOR EDUCATION, ACADEMIC AFFAIRS - BETH ISRAEL DEACONESS MEDICAL CENTER MS. HUGHES PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 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: 22,470 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 2,082 NON-TAXABLE BENEFITS: 6,156 PAYMENTS REPORTED BY THE BIDMC: BASE COMPENSATION: 89,880 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 8,326 NON-TAXABLE BENEFITS: 24,626 WANG, DIANA TREASURER AND FINANCIAL ANALYST - SHAPIRO INSTITUTE FINANCIAL ANALYST - BETH ISRAEL DEACONESS MEDICAL CENTER MS. WANG PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 20 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. WANG RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. WANG'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY THE SHAPIRO INSTITUTE BASE COMPENSATION: 27,700 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 23 DEFERRED COMPENSATION: 1,820 NON-TAXABLE BENEFITS: 1,505 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 41,550 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 34 DEFERRED COMPENSATION: 2,729 NON-TAXABLE BENEFITS: 2,258 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 WILL PROVIDE 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, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. FORM 990, PART J HTTP://WWW.BIDMC.ORG/MEDICAL-EDUCATION/CARL-J,-D-,-SHAPIRO-INSTITUTE- FOR-EDUCATION-AND-RESEARCH.ASPX 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 WILL PROVIDE 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, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. 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, HARVARD MEDICAL FACULTY PHYSICIANS AT 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. 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 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 SUPPORTING ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER)AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. IN ADDITION, 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. PURSUANT TO THIS RELATIONSHIP, THE INSTITUTE HAS ADOPTED THE BIDMC CONFLICT OF INTEREST POLICY AND THE INSTITUTE'S EXECUTIVE DIRECTOR HAS ACCESS TO THE CONFLICT OF INTEREST DISCLOSURES OF INSTITUTE TRUSTEES AND EMPLOYEES COVERED BY THE BIDMC PROCESS AND THE INSTITUTE'S EXECUTIVE DIRECTOR IS RESPONSIBLE FOR MONITORING AND ENFORCING THIS POLICY. FORM 990, PART VI, SECTION B, LINE 15 AS PREVIOUSLY NOTED IN THIS FILING, THE INSTITUTE IS A SUPPORTING ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. AS NOTED IN THE SUPPLEMENTAL INFORMATION TO THIS FORM 990, PART VII AND SCHEDULE J, THE INSTITUTE'S EXECUTIVE DIRECTOR ALSO SERVES AS THE VICE PRESIDENT FOR MEDICAL EDUCATION AT BIDMC. THE MEDICAL CENTER HAS A COMPENSATION COMMITTEE THAT IS COMPOSED OF MEMBERS OF THE BOARD OF DIRECTORS. ALL MEMBERS ARE INDEPENDENT. THE MEDICAL CENTER'S COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE OF MEDICAL CENTER SENIOR MANAGEMENT INCLUDING VICE PRESIDENTS THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT IT COMPLIES WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEYS AND STUDIES PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THESE INDIVIDUALS AND AT THAT TIME REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. THE COMPENSATION COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS. REGULAR COMPENSATION FOR OTHER BIDMC EMPLOYEES WHO ALSO SERVE AS INSTITUTE OFFICERS IS SET THROUGH THE ORDINARY BIDMC PROCEDURES WITH INPUT FROM THE BIDMC VICE PRESIDENT OF MEDICAL EDUCATION/INSTITUTE EXECUTIVE DIRECTOR. IN ADDITION TO THE COMPENSATION PROCESSES NOTED ABOVE, FROM TIME TO TIME THE INSTITUTE MAY ACKNOWLEDGE EFFORTS OF ITS EXECUTIVE DIRECTOR, OFFICERS OR OTHER EMPLOYEES WITH AN HONORARIUM. THE INSTITUTE'S BOARD OF TRUSTEES APPROVES ANY SUCH AMOUNTS FOR THE EXECUTIVE DIRECTOR AND INSTITUTE OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 ALL APPLICABLE DOCUMENTS ARE AVAILABLE FROM THE ORGANIZATION UPON WRITTEN REQUEST. BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVE BOSTON MA 02215 042103881 HOSPITAL MA 501 (C) (3) LINE 3: 170(B)(1)(A) N/A 0 PRESIDENT & FELLOWS OF HARVARD COLLEGE MASSACHUSETTS HALL CAMBRIDGE MA 02138 042103580 COLLEGE MA 501 (C) (3) LINE 3: 170(B)(1)(A) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0