2016-08-15T06:43:47-05:00 2015-09-30 135381590 BDO USA LLP 200 PORTLAND STREET BOSTON MA 02114 990 2014-10-01 043399570 WINCHESTER HOSPITAL FOUNDATION INC WINC 7817562135 41 HIGHLAND AVENUE WINCHESTER MA 01890 HOWARD R GRANT CEO/PRESIDENT 7817562135 2016-08-09 1 JEFFREY T ROGERS P01074284 6177427788 2014 2016-09-27 15:27:22Z HOWARD R GRANT 41 MALL ROAD BURLINGTON MA 01805 2675087 0 X N/A X 1997 MA TO CARE. TO HEAL. TO EXCEL. IN SERVICE TO OUR COMMUNITY. 25 17 0 0 0 0 2805884 2309600 0 0 -820 1580 201817 210139 3006881 2521319 0 0 0 0 620920 629276 0 0 922710 417548 293434 1038468 922710 1968413 1598609 7526492 7158761 2365188 2425638 5161304 4733123 TO CARE. TO HEAL. TO EXCEL. IN SERVICE TO OUR COMMUNITY. 0 0 THE PROVISION OF PHILANTHROPIC AND FUNDRAISING SERVICES TO AFFILIATED ORGANIZATIONS WITHIN THE WINCHESTER HEALTHCARE MANAGEMENT, INC. INTEGRATED HEALTHCARE DELIVERY SYSTEM. 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 25 17 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 0 1 1 0 MA X X MATTHEW WOODS 7817562135 41 HIGHLAND AVENUE WINCHESTER MA 01890 JEANNINE BARRETT DIRECTOR 1.00 X 0 0 0 ANN R BLACKHAM DIRECTOR 1.00 X 0 0 0 DONNA M BURKE DIRECTOR 1.00 X 0 0 0 DARINA GILLEY CHESTERTON DIRECTOR 1.00 X 0 0 0 BRIAN J CONNOR DIRECTOR 1.00 X 0 0 0 KELLEY M CORNELL MD DIRECTOR 1.00 X 0 0 0 LEO C DONAHUE DIRECTOR 1.00 X 0 0 0 PATRICK J FORTIN DIRECTOR 1.00 X 0 0 0 ELISE GARDNER DIRECTOR 1.00 X 0 0 0 HOWARD R GRANT JD MD TRUSTEE/OFFICER/PRESIDENT & CEO 1.00 40.00 X X 0 2012525 278701 KAREN R MCALMON MD DIRECTOR 1.00 X 0 0 0 DEBORAH R MCDONOUGH CHAIR 1.00 X X 0 0 0 ANNE J NEILSON DIRECTOR 1.00 X 0 0 0 ANN NORBERG DIRECTOR 1.00 X 0 0 0 TIMOTHY O'CONNOR TRUSTEE/OFFICER/EVP CFO & TREASURER 1.00 40.00 X X 0 746676 148875 BARBARA ODDO DIRECTOR 1.00 X 0 0 0 JOAN P O'NEIL DIRECTOR 1.00 X 0 0 0 SUSAN E POWERS DIRECTOR 1.00 40.00 X 0 145387 23401 RICHARD H SALTER DIRECTOR 1.00 X 0 0 0 DENNIS S SARGENT DIRECTOR 1.00 X 0 0 0 KEVIN F SMITH DIRECTOR 1.00 40.00 X X 0 1204871 26255 DAVID G SPACKMAN TRUSTEE/OFFICER/SVP GOV AFFAIRS & GEN COUNSEL 1.00 40.00 X X 0 450576 51385 MARLENE V WILLIAMSON DIRECTOR 1.00 40.00 X 0 167101 31196 MATTHEW WOODS ASSISTANT TREASURER 1.00 40.00 X X 0 442587 33201 MARY ELIZABETH CANNING VICE PRESIDENT 1.00 40.00 X X 0 282657 33453 0 5452380 626467 0 0 1 0 0 194080 2115520 2309600 191 191 1389 0 1389 1389 1389 363907 194080 153768 210139 210139 2521319 0 0 211719 469758 469758 121301 121301 38217 38217 375 375 5331 5331 2383 2383 6431 6431 3538 3538 OTHER OPERATING EXPENSE 249179 249179 PRINTING & PUBLICATIONS 26080 26080 TELEPHONE 117 117 922710 0 0 922710 7485566 7098288 18363 41448 23448 4423 22563 19025 7526492 7158761 2365188 2425638 2365188 2425638 X 2304118 1913440 2586459 2548956 270727 270727 5161304 4733123 7526492 7158761 X 1598609 -81652 -1945138 X 0 1 X 1 0 X X 1 WINCHESTER HOSPITAL 042104434 3 1 1925138 0 1 1925138 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 270727 270727 270727 270727 270727 270727 270727 270727 270727 270727 1.00000 0 0 23448 4423 19025 19025 DUE TO AFFILIATES 1280847 OTHER L/T LIABILITIES 1144791 2425638 GALA 376642 92400 284242 115991 32856 GOLF TOURNAMENT 181345 101680 79665 0 4921 557987 194080 363907 115991 37777 153768 210139 X X X X X X 0 1 0 0 0 0 0 1 0 HOWARD R GRANT JD MD TRUSTEE/OFFICER/PRESIDENT & CEO 0 1587025 0 385000 0 40500 0 248405 0 30296 0 2291226 0 0 TIMOTHY O'CONNOR TRUSTEE/OFFICER/EVP CFO & TREASURER 0 590556 0 123120 0 33000 0 121600 0 27275 0 895551 0 0 SUSAN E POWERS DIRECTOR 0 143843 0 0 0 1544 0 2183 0 21218 0 168788 0 0 KEVIN F SMITH DIRECTOR 0 539483 0 328261 0 337127 0 4780 0 21475 0 1231126 0 131813 DAVID G SPACKMAN TRUSTEE/OFFICER/SVP GOV AFFAIRS & GE 0 368475 0 64020 0 18081 0 28405 0 22980 0 501961 0 0 MARLENE V WILLIAMSON DIRECTOR 0 163891 0 0 0 3210 0 2501 0 28695 0 198297 0 0 MATTHEW WOODS ASSISTANT TREASURER 0 355859 0 86096 0 632 0 3760 0 29441 0 475788 0 0 MARY ELIZABETH CANNING VICE PRESIDENT 0 250572 0 30990 0 1095 0 3749 0 29704 0 316110 0 0 PART I, LINE 4B LAHEY CLINIC FOUNDATION (RELATED ORGANIZATION) MAINTAINS A 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN PHYSICIANS, EXECUTIVE MANAGEMENT AND DEFINED MEDICAL STAFF. THE PLAN OFFERS PARTICIPATING EMPLOYEES AN ANNUAL DEFERRAL OF COMPENSATION IN ADDITION TO THEIR SALARIES. AMOUNTS PROVIDED WERE AS FOLLOWS. HOWARD R. GRANT, JD, MD $220,000 TIMOTHY O'CONNOR $121,600 KEVIN SMITH, PRESIDENT OF WINCHESTER HOSPITAL, PARTICIPATES IN A SUPPLEMENTAL NON-QUALIFIED RETIRMENT PLAN. $332,415 WAS REPORTED IN TAXABLE WAGES IN CALENDAR YEAR 2014. PART I, LINE 7 THE NON-FIXED PAYMENT BONUSES REPORTED IN SCHEDULE J, PART II, COLUMN (B)(II) ARE DETERMINED BY AN INDEPENDENT COMPENSATION COMMITTEE, WHICH INCLUDES A GROUP OF TRUSTEES. IN A SUBJECTIVE MANNER, THE COMMITTEE TAKES INTO ACCOUNT THE ACHIEVEMENTS OF BOTH THE ORGANIZATION AND THE INDIVIDUAL TO DETERMINE THE APPROPRIATE AMOUNT OF SUCH BONUSES, WHICH INCLUDE, BUT NOT LIMITED TO, THE ORGANIZATION MEETING ITS CORPORATE GOALS, (INCLUDING NET INCOME) AND QUALITY MEASURES, (SUCH AS PATIENT SATISFACTION AND QUALITY OF CARE). X 2 73429 FMV DATE OF DONATION 1 0 1 0 FORM 990, PART VI, SECTION A, LINE 8B WINCHESTER HOSPITAL FOUNDATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 MANAGEMENT PREPARED THE IRS FORM 990 ALONG WITH INDEPENDENT TAX CONSULTANTS WHO SIGN THE RETURN AS A PAID PREPARER. EXECUTIVE MANAGEMENT REVIEWED AND PRESENTED A DRAFT OF THE IRS FORM 990 TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE LAHEY HEALTH SYSTEM, INC. BOARD OF TRUSTEES. PRIOR TO THE FILING DATE, A DRAFT OF THE IRS FORM 990 AND THE FINAL IRS FORM 990 WERE BOTH PROVIDED TO THE ENTIRE BOARD OF TRUSTEES BEFORE THE FILING DATE VIA A SECURED WEBSITE. FORM 990, PART VI, SECTION B, LINE 12C SEMI-ANNUAL AUDIT AND COMPLIANCE COMMITTEE REVIEWS COMPILED CONFLICT OF INTEREST REPORT FROM LEGAL SERVICES QUESTIONNAIRES SENT TO ALL AFFILATES, DIRECTORS AND TRUSTEES. THE CHAIR OF THE AUDIT/COMPLIANCE COMMITTEE, IN COOPERATION WITH THE COMPLIANCE OFFICER, SHALL CONDUCT THE INITIAL REVIEW OF ANY POTENTIAL CONFLICTS OF INTEREST IDENTIFIED IN THE DISCLOSURES AND SHALL ADOPT A FINDING THAT THE ACTIVITY RAISING THE POTENTIAL CONFLICT OF INTEREST: SHOULD BE PERMITTED UNDER THE POLILCY; SHOULD BE PERMITTED WITH MODIFICATION OR OVERSIGHT; IF UNDERTAKEN, WILL REQUIRE THE DIRECTOR, OR COMPLIANCE OFFICER TO ABSTAIN FROM PARTICIPATING IN GOVERNANCE/MANAGEMENT ACTIVITIES RELATED TO THE ACTIVITY; OR SHOULD NOT BE UNDERTAKEN. UPON FINAL DISPOSITION OF THE POTENTIAL CONFLICT, THE RESULTS OF THE REVIEW SHALL BE REPORTED TO THE AFFECTED LEADER. THE AUDIT/COMPLIANCE COMMITTEE SHALL PROVIDE AN ANNUAL REPORT OF ITS REVIEW TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S OFFICERS' SALARIES AND BENEFITS ARE PAID AND DETERMINED UNDER THE COMPENSATION POLICIES OF WINCHESTER HOSPITAL, THE ORGANIZATION'S AFFILIATE. THIS INCLUDES USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE THAT IS INDEPENDENT OF MANAGEMENT AND FREE OF ANY CONFLICTS OF INTEREST THAT WOULD INTERFERE WITH THE EXERCISE OF THEIR INDEPENDENT JUDGMENT REVIEWS COMPARABILITY DATA PROVIDED BY AN INDEPENDENT EXTERNAL CONSULTANT, LAL ASSOCIATES, INC., TO ESTABLISH COMPENSATION. ALL COMPENSATION DECISIONS ARE DOCUMENTED CONCURRENTLY UPON MAKING THE DECISION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORM 990, PART XI, LINE 9: TRANSFERS TO WINCHESTER HOSPITAL -1,925,138. PLEDGE DISCOUNT ADJUSTMENT -20,000. LAHEY CLINICAL HOSPITAL INC 41 MALL ROAD BURLINGTON MA 01805 042704686 HEALTHCARE MA 501(C) (3) 3 LCF INC 0 LAHEY CLINIC INC 41 MALL ROAD BURLINGTON MA 01805 042704683 HEALTHCARE MA 501(C) (3) 9 LCF INC 0 LAHEY HEALTH SHARED SERVICES INC 41 MALL ROAD BURLINGTON MA 01805 043178972 ADMINISTRATIVE SUPPORT TO LHS AND AFFILIATES MA 501(C) (3) 9 LHS INC 0 NORTHEAST HEALTH SYSTEM INC 85 HERRICK STREET BEVERLY MA 01915 043240453 SUPPORT MA 501(C) (3) 11C LHS INC 0 NORTHEAST BEHAVIORAL HEALTH CORPORATION ZERO CENTENNIAL DRIVE PEABODY MA 01960 042777145 BEHAVIORAL HEALTH CARE MA 501(C) (3) 7 LHS INC 0 HEALTH AND EDUCATION HOUSING SERVICES INC 131 RANTOUL STREET BEVERLY MA 01915 223232914 HUD HOUSING MA 501(C) (3) 9 NEBH CORP 0 NORTHEAST HOSPITAL CORPORATION 85 HERRICK STREET BEVERLY MA 01915 042121317 HEALTHCARE MA 501(C) (3) 3 LHS INC 0 NORTHEAST MEDICAL PRACTICES INC 85 HERRICK STREET BEVERLY MA 01915 043201853 HEALTHCARE MA 501(C) (3) 9 NEH CORP 0 SEACOAST NURSING & REHABILITATION CENTER 300 WASHINGTON STREET GLOUCESTER MA 01930 041305001 HEALTHCARE MA 501(C) (3) 9 LHS INC 0 NORTHEAST PROFESSIONAL REGISTRY OF NURSES 800 CUMMINGS CENTER BEVERLY MA 01915 201287349 HEALTHCARE MA 501(C) (3) 9 NESH CORP 0 NORTHEAST SENIOR HEALTH CORPORATION 131 RANTOUL STREET BEVERLY MA 01915 042731137 HEALTHCARE MA 501(C) (3) 9 LHS INC 0 CAB HEALTH & RECOVERY 111 MIDDLETON ROAD DANVERS MA 01923 042400270 SUBSTANCE ABUSE MA 501(C) (3) 9 NEBH CORP 0 LAHEY HEALTH SYSTEM INC 41 MALL ROAD BURLINGTON MA 01805 611665701 SUPPORT MA 501(C) (3) 11C III-FI N/A 0 WINCHESTER HOSPITAL 41 HIGHLAND AVENUE WINCHESTER MA 01890 042104434 HEALTHCARE MA 501(C) (3) 3 WHM INC 0 WINCHESTER HEALTHCARE INVESTMENTS 41 HIGHLAND AVENUE WINCHESTER MA 01890 222701819 SUPPORT MA 501(C) (3) 11C WHM INC 0 WINCHESTER HEALTHCARE MANAGEMENT 41 HIGHLAND AVENUE WINCHESTER MA 01890 222701817 MANAGEMENT SERVICE MA 501(C) (3) 11A LHS INC 0 WINCHESTER COMMUNITY ACCOUNTABLE CARE ORGANIZATION 41 HIGHLAND AVENUE WINCHESTER MA 01890 223137856 ACO MA 501(C) (3) 11A WHM INC 0 LAHEY CLINIC FOUNDATION 41 MALL ROAD BURLINGTON MA 01805 042323457 SUPPORT MA 501(C) (3) 7 LHS INC 0 ADDISON GILBERT SOCIETY INC 41 MALL ROAD BURLINGTON MA 01805 464371382 SUPPORT MA 501(C) (3) 11A LHS INC 0 VISITING NURSE ASSOCIATION OF MIDDLESEX-EAST INC 607 NORTH AVENUE WAKEFIELD MA 01880 046151973 HEALTHCARE MA 501(C) (3) 11A LHS INC 0 COMMUNITY CARE INC 607 NORTH AVENUE WAKEFIELD MA 01880 900396973 HEALTHCARE MA 501(C) (3) 11A LHS INC 0 LAHEY COMMUNITY PHYSICIAN ORGANIZATION 1 INC 41 MALL ROAD BURLINGTON MA 01805 472248298 HEALTHCARE MA 501(C) (3) 11A LHS INC 0 LAHEY CLINIC INSURANCE CO LTD PO BOX HM 2450 HAMILTON BD INSURANCE BD LHS INC C 1.00000 0 PERPETUAL TRUSTS (8) 41 MALL ROAD BURLINGTON MA 01805 SUPPORT MA SEE PART VII T 1.00000 0 REMAINDER TRUSTS (19) 41 MALL ROAD BURLINGTON MA 01805 SUPPORT MA SEE PART VII T 1.00000 0 POOLED INCOME FUNDS (3) 41 MALL ROAD BURLINGTON MA 01805 SUPPORT MA SEE PART VII T 1.00000 0 NORTHEAST PROPRIETARY CORPORATION 85 HERRICK STREET BEVERLY MA 01915 042855191 MEDICAL SERVICES MA LHS INC C 0 WINCHESTER PHYSICIAN HOSPITAL ORGANIZATION 41 HIGHLAND AVENUE WINCHESTER MA 01890 472646454 PHYSICIAN SERVICE MA WHM INC C 0 WINCHESTER HEALTHCARE ENTERPRISES INC 41 HIGHLAND AVENUE WINCHESTER MA 01890 042932059 HEALTHCARE VENTURES MA WHM INC C 0 WINCHESTER PHYSICIAN ASSOCIATES INC 41 HIGHLAND AVENUE WINCHESTER MA 01890 043262963 PHYSICIAN PRACTICE MA WHM INC C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, SCHEDULE R, PART IV LAHEY CLINIC FOUNDATION, INC., NORTHEAST HOSPITAL CORPORATION AND WINCHESTER HOSPITAL, RESPECTIVELY, HAVE FOUR, FOUR AND ONE PERPETUAL TRUSTS. THE PERPETUAL TRUSTS ARE DOMICILED IN MASSACHUSETTS, PENNSYLVANIA AND FLORIDA. LAHEY CLINIC FOUNDATION, INC. HAS NINETEEN REMAINDER TRUSTS. THE REMAINDER TRUSTS ARE DOMICILED IN MASSACHUSETTS, NEW HAMPSHIRE, WISCONSIN AND NEW YORK. LAHEY CLINIC FOUNDATION, INC. HAS THREE POOLED INCOME FUNDS, DOMICILED IN MASSACHUSETTS. SCHEDULE R, PART V THE LAHEY HEALTH SHARED SERVICES, INC. PHILANTHROPY DEPARTMENT CONDUCTS FUNDRAISING AND SOLICITATION EFFORTS ON BEHALF OF ALL ENTITIES WITHIN THE LAHEY HEALTH SYSTEM, INC. FAMILY OF ORGANIZATIONS, EXCEPT "WINCHESTER" AS LISTED IN IRS FORM 990, SCHEDULE R, PART II. THE WINCHESTER HOSPITAL FOUNDATION, INC. PHILANTHROPY DEPARTMENT CONDUCTS FUNDRAISING AND SOLICITATION EFFORTS ON BEHALF OF ALL ENTITIES WITHIN "WINCHESTER", ALSO LISTED IN IRS FORM 990, SCHEDULE R, PART II. LAHEY HEALTH SYSTEM, INC. AND ITS RELATED ORGANIZATIONS, LAHEY CLINIC FOUNDATION, INC. AND ITS RELATED ORGANIZATIONS, WINCHESTER HEALTHCARE MANAGEMENT, INC. AND ITS RELATED ORGANIZATIONS, NORTHEAST BEHAVIORAL HEALTH CORPORATION AND ITS RELATED ORGANIZATIONS, NORTHEAST SENIOR HEALTH CORPORATION AND ITS RELATED ORGANIZATION, NORTHEAST HEALTH SYSTEM, INC. AND ITS RELATED ORGANIZATION, AND NORTHEAST HOSPITAL CORPORATION AND ITS RELATED ORGANIZATION, PROVIDE VARIOUS CORPORATE AND OTHER SERVICES TO EACH OTHER. THE ORGANIZATIONS REIMBURSE EACH OTHER FOR EXPENSES INCURRED SUCH AS EMPLOYEE SALARIES AND BENEFITS, MATERIALS, SUPPLIES, UTILITIES, ETC. CASH IS TRANSFERRED BETWEEN THE ORGANIZATIONS.