2016-02-10T08:42:18-06:00 2014-09-30 042684828 FEELEY & DRISCOLL PC 200 PORTLAND STREET BOSTON MA 02114 990 2013-10-01 042104434 WINCHESTER HOSPITAL WINC 7817562135 41 HIGHLAND AVENUE WINCHESTER MA 018900000 HOWARD R GRANT JD MD PRESIDENT/CEO 7817562135 2016-02-10 1 JEFFREY T ROGERS P01074284 6177427788 2013 2016-08-17 19:52:53Z X HOWARD R GRANT JD MD 41 MALL ROAD BURLINGTON MA 01805 273117840 0 X WWW.WINCHESTERHOSPITAL.ORG X 1906 MA WINCHESTER HOSPITAL IS COMMITTED TO BENEFITTING ALL OF THE COMMUNITIES WE SERVE BY COLLABORATING WITH COMMUNITY PARTNERS TO IDENTIFY HEALTH NEEDS AND IMPROVE THE HEALTH STATUS OF THE COMMUNITY RESIDENTS. 27 20 2898 680 6554256 0 0 261980483 255587182 1361045 8416882 22423575 9113776 285765103 273117840 0 0 124595215 152865807 0 0 144370211 111740144 268965426 264605951 16799677 8511889 383285057 425469449 153549836 172812504 229735221 252656945 X TO CARE. TO HEAL. TO EXCEL. IN SERVICE TO OUR COMMUNITY. 0 0 15000952 15006299 *OBSTETRICS SERVICES* WINCHESTER HOSPITAL IS PROUD TO HAVE BEEN INVOLVED IN THE BEGINNING OF MANY NEW LIVES. RECOGNIZED AS ONE OF THE AREA'S MOST PROMINENT OBSTETRIC HOSPITALS, WINCHESTER HOSPITAL HAS NEARLY 2,000 BABIES BORN PER YEAR AT OUR MOTHER BABY UNIT. THE HOSPITAL ALSO OFFERS A SPECIAL CARE NURSERY FOR NEWBORNS IN NEED OF THE CLINICAL INTERVENTION OF A LEVEL IIB NURSERY. 15313286 13895482 *ORTHOPEDICS SERVICES* WINCHESTER HOSPITAL PROVIDES HIGH QUALITY ORTHOPEDIC CARE IN COLLABORATION WITH WELL-TRAINED, BOARD-CERTIFIED ORTHOPEDIC SURGEONS. WE UTILIZE STATE-OF-THE-ART TECHNIQUES AND OFFER A FULL RANGE OF TREATMENTS FOR MANY DIFFERENT CONDITIONS - FROM SPORTS AND WORK-RELATED INJURIES TO MUSCULOSKELETAL DISORDERS TO JOINT DISEASES. 12488915 13113390 *SURGICAL SERVICES* WINCHESTER HOSPITAL HAS RECEIVED NATIONAL AND STATE RECOGNITION FOR ITS COMMITMENT TO SAFE, HIGH QUALITY SURGICAL SERVICES. THE HOSPITAL WAS NAMED A NATIONAL BARIATRIC SURGERY CENTER OF EXCELLENCE (BSCOE) BY THE AMERICAN SOCIETY FOR BARIATRIC SURGERY. IN ADDITION, WE WERE RECOGNIZED TWICE BY BLUE CROSS/BLUE SHIELD OF MASSACHUSETTS AS A BLUE DISTINCTION CENTER - BOTH FOR BARIATRIC SURGERY AND KNEE AND HIP REPLACEMENT. THE BLUE DISTINCTION DESIGNATION IS AWARDED TO MEDICAL FACILITIES THAT EXHIBIT A COMMITMENT TO HIGH QUALITY CARE, RESULTING IN BETTER OVERALL OUTCOMES FOR PATIENTS. 155526774 213572011 PROVIDING CARE IN MAJOR CLINICAL CATEGORIES INCLUDING MEDICINE, SURGERY, PEDIATRICS, OBSTETRICS/GYNECOLOGY AND A LEVEL IIB SPECIAL CARE NURSERY, WINCHESTER HOSPITAL IS THE LEADING PROVIDER IN SUCH IMPORTANT SUBSPECIALTIES AS CARDIOLOGY, PULMONARY MEDICINE, ONCOLOGY, GASTROENTEROLOGY, ORTHOPEDICS, REHABILITATION, RADIATION ONCOLOGY AND PAIN MANAGEMENT. 155526774 213572011 198329927 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 378 0 1 2898 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 27 20 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 0 1 1 1 1 MA X X MATTHEW J WOODS VICE PRESIDENT OF FINANCE 7817562135 41 HIGHLAND AVENUE WINCHESTER MA 01890 JONATHAN ADLER MD DIRECTOR 1.00 40.00 X 0 691477 667 PAUL ANDREWS CHAIRMAN 1.00 1.00 X X 0 0 0 JAMES CONWAY DIRECTOR 1.00 1.00 X 0 0 0 JAMES FICOCIELLO DIRECTOR 1.00 1.00 X 0 0 0 ROBERT FORTUNATO MD DIRECTOR 1.00 1.00 X 0 0 0 ERIC HAYDEN DIRECTOR 1.00 1.00 X 0 0 0 JANICE HOUGHTON DIRECTOR 1.00 1.00 X 0 0 0 HOWARD R GRANT JD MD PRESIDENT 1.00 40.00 X X 0 1469642 273518 ARTHUR LITTLE DIRECTOR 1.00 1.00 X 0 0 0 DALE LODGE DIRECTOR 43.00 1.00 X 966210 0 32429 JOHN MARTINI DIRECTOR 1.00 1.00 X 0 0 0 DEBORAH MCDONOUGH DIRECTOR 1.00 1.00 X 0 0 0 RICHARD OCKERBLOOM DIRECTOR 1.00 1.00 X 0 0 0 TIMOTHY OCONNOR TREASURER 1.00 40.00 X X 0 726158 162517 PETER ROTOLO MD DIRECTOR 1.00 1.00 X 0 0 0 RICHARD SAYRE DIRECTOR 1.00 1.00 X 0 0 0 KEVIN SMITH CEO, WH, WHM EX-OFFICIO 43.00 1.00 X X 1175067 0 31474 DAVID SPACKMAN CLERK 1.00 40.00 X X 0 438488 44803 JOSEPH TARBY III JD ASSISTANT CLERK 1.00 1.00 X X 0 0 0 JOSEPH TAYLOR MD DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL TRAVAGLINI DIRECTOR 1.00 1.00 X 0 0 0 JANE WALSH VICE CHAIRMAN 1.00 1.00 X X 0 0 0 MATTHEW WOODS ASSISTANT TREASURER 43.00 1.00 X X 403440 0 39913 JAMES YOUNG DIRECTOR 1.00 1.00 X 0 0 0 MARLENE WILLIAMSON EX-OFFICIO 1.00 1.00 X 0 0 0 ROBERT LORD EX-OFFICIO 1.00 1.00 X 0 0 0 DANA ZITKOVSKY EX-OFFICIO 1.00 1.00 X 0 0 0 KATHY ANN SCHULER V.P. - PATIENT CARE SERVICES 40.00 X 361612 0 29766 ANN LANG TALBOT V.P. - HUMAN RESOURCES 40.00 X 330046 0 31837 RICHARD J ISEKE MD V.P. - MEDICAL AFFAIRS 40.00 X 552398 0 16448 MARY ELIZABETH CANNING VICE PRESIDENT 40.00 X 279271 0 39367 WILLIAM ROBERTSON VICE PRESIDENT 40.00 X 249571 0 37127 MARY T SWEENEY VICE PRESIDENT 40.00 X 269561 0 9143 EDWAWRD P SULLIVAN PHYSICIAN RELATIONS 40.00 X 227408 0 34851 4814584 3325765 783860 205 0 1 0 SUFFOLK CONSTRUCTION COMPANY INC 65 ALLERTON STREET BOSTON MA 02119 CONSTRUCTION 3144172 SODEXHO MARRIOTT SERVICES PO BOX 905374 CHARLOTTE NC 28290 MANAGEMENT 2946735 STRATA PATHOLOGY INC 1 CRANBERRY HILL SUITE 303 LEXINGTON MA 02421 LAB 1885425 GRASSODELOURY A JOINT VENTURE 865 TURNPIKE STREET NORTH ANDOVER MA 01845 CONSTRUCTION 1547055 HEALTHCARE SERVICES MANAGEMENT INC 1 BATTERYMARCH PARK SUITE 311 QUINCY MA 02169 INFORMATION SYSTEM 1463516 62 NET PATIENT SERVICE REVENUE 900009 249154212 249154212 OTHER PROGRAM REVENUE 900009 6432970 6432970 255587182 2171879 2171879 6245003 0 6245003 6245003 6245003 LABORATORY REVENUE 621500 4792943 4792943 CAFETERIA 900099 900558 900558 PEDIATRIC REVENUE 621990 869725 869725 2550550 891588 1658962 9113776 273117840 255587182 6554256 10976402 2508626 2508626 83861342 66297108 17564234 28032162 24086884 3945278 38463677 31343640 7120037 456670 137001 319669 119710 35913 83797 14113492 10200663 3912829 468800 468800 1404296 1404296 154990 154990 4987065 4987065 15806237 11064366 4741871 -786443 -786443 SUPPLIES 65336712 48451462 16885250 UTILITIES 3636191 363619 3272572 HEALTH SAFETY NET ASSES 2195485 2195485 OTHER - NON OPERATING 1471343 1066064 405279 2375596 579096 1796500 264605951 198329927 66276024 0 24975407 20158993 25789264 27091434 0 0 1556915 2280163 2878136 3036549 3155476 2822724 147733088 1568397 158632662 146164691 138468750 163238849 27828447 60676046 383285057 425469449 35013922 46034742 103709398 104951717 745443 735098 14081073 21090947 153549836 172812504 X 208014013 228300080 15398597 17978986 6322611 6377879 229735221 252656945 383285057 425469449 X 8511889 18491565 -4081730 X 0 1 X 1 0 X 0 0 0 0 0 0 0 1 39299 0 39299 0 PART II-B, LINE 1: MASSACHUSETTS COUNCIL OF COMMUNITY HOSPITALS (MCCH): THE MASSACHUSETTS COUNCIL OF COMMUNITY HOSPITALS IS A NON-PROFIT CORPORATION FORMED TO ADVOCATE FOR THE COMMONWEALTH'S COMMUNITY HOSPITALS. THESE HOSPITALS PLAY A VITAL ROLE IN PROVIDING CONVENIENT, HIGH QUALITY HEALTH CARE AT A REASONABLE COST. FOR A NUMBER OF REASONS OUR HOSPITALS ARE OFTEN DISADVANTAGED BY THE CURRENT FINANCING AND DELIVERY SYSTEM IN GAINING ACCESS TO CAPITAL, TECHNOLOGY AND CLINICAL RESOURCES. IT IS THE GOAL OF THE COUNCIL TO EDUCATE AND ARGUE OUR CASE TO POLICYMAKERS, EMPLOYERS AND PAYERS TO ELIMINATE INEQUITIES IN THE SYSTEM. ANNUAL PORTION OF DUES RELATED TO LOBBYING - $1,480 MASSACHUSETTS HOSPITAL ASSOCIATION (MHA): THE MASSACHUSETTS HOSPITAL ASSOCIATION IS A VOLUNTARY, NOT-FOR-PROFIT ORGANIZATION COMPRISED OF HOSPITALS AND HEALTH SYSTEMS, RELATED ORGANIZATIONS, AND OTHER MEMBERS WITH A COMMON INTEREST IN PROMOTING THE HEALTH OF THE PEOPLE OF THE COMMONWEALTH. THROUGH LEADERSHIP IN PUBLIC ADVOCACY, EDUCATION, AND INFORMATION, MHA REPRESENTS AND ADVOCATES FOR THE COLLECTIVE INTERESTS OF ITS MEMBER HOSPITALS AND HEALTH SYSTEMS, AND SUPPORTS THEIR EFFORTS TO PROVIDE HIGH QUALITY, COST EFFECTIVE, AND ACCESSIBLE CARE. ANNUAL PORTION OF DUES RELATED TO LOBBYING - $29,939 AMERICAN HOSPITAL ASSOCIATION (AHA): THE AMERICAN HOSPITAL ASSOCIATION (AHA) IS THE NATIONAL ORGANIZATION THAT REPRESENTS AND SERVES ALL TYPES OF HOSPITALS, HEALTH CARE NETWORKS, AND THEIR PATIENTS AND COMMUNITIES. CLOSE TO 5,000 HOSPITALS, HEALTH CARE SYSTEMS, NETWORKS, OTHER PROVIDERS OF CARE AND 37,000 INDIVIDUAL MEMBERS COME TOGETHER TO FORM THE AHA. THROUGH OUR REPRESENTATION AND ADVOCACY ACTIVITIES, AHA ENSURES THAT MEMBERS' PERSPECTIVES AND NEEDS ARE HEARD AND ADDRESSED IN NATIONAL HEALTH POLICY DEVELOPMENT, LEGISLATIVE AND REGULATORY DEBATES, AND JUDICIAL MATTERS. OUR ADVOCACY EFFORTS INCLUDE THE LEGISLATIVE AND EXECUTIVE BRANCHES AND INCLUDE THE LEGISLATIVE AND REGULATORY ARENAS. FOUNDED IN 1898, THE AHA PROVIDES EDUCATION FOR HEALTH CARE LEADERS AN IS A SOURCE OF INFORMATION ON HEALTH CARE ISSUES AND TRENDS. ANNUAL PORTION OF DUES RELATED TO LOBBYING - $7,880 20837955 2823580 23661535 19506178 1331777 20837955 20837590 -1331416 19506174 18301006 2536588 20837594 17077593 1223413 18301006 0.68000 0.32000 0.00000 0 0 18520753 18520753 77764258 965190 76799068 11366301 382692 10983609 34231702 220515 34011187 5850074 5850074 146164691 DEPRECIATION FUND 10589627 F FUNDS HELD BY TRUSTEE UNDER BOND AGREEMENT 30563594 F OTHER INTERNALLY DESIGNATED INVESTMENTS 99066745 F HELD BY TRUSTEE UNDER BOND INDENTURE 1519204 F TEMP RESTRICTED INVESTMENTS 15392527 F PERM RESTRICTED INVESTMENTS 1790975 F PERM RESTRICTED IRREVOCABLE TRUST 4316177 F 163238849 NOTE RECIEVABLE INTERNATIONAL FAMILY CHURCH 2500000 RESERVE- NOTE RECEIVABLE -2500000 SPLIT DOLLAR LIFE EQUITY 3669180 RETIREMENT PLAN - 457B 951412 INVESTMENT IN CAPTIVE INSURANCE 894158 INVESTMENT IN JP-SHIELDS-ONC 2883000 INVESTMENT IN JP-SHIELDS-MRI 8599900 INVESTMENT IN YANKEE ALLIANCE, LLC 3176291 BOND ISSUE COSOTS - SERIES F & H 18330 NOTE RECEIVABLE - RHC PHYS 236439 CERTIFICATE OF NEED - VALUATION 7000000 INDEPENDENT MD NETWORK - VALUATION 5600000 ACCUMULATED AMORTIZATION MD NETWROK -140000 CLINICAL RELATIONSHIP - BCH - VALUATION 1100000 ACCUMULATED AMORTIZATION - BCH -27500 PAYOR RELATIONSHIPS - VALUATION 800000 ACCUMULATED AMORTIZATION-PAYOR RELATIONSHIP -20000 TRADE NAME - VALUATION 5700000 PROFESSIONAL INSURANCE RECEIVABLE 7646992 LEASEHOLDS VALUATION 2559083 BENEFICIAL INTEREST FOUNDATION 2857189 OTHER 7171572 60676046 CURRENT PORTION LONG TERM DEBT AND CAPITAL LEASES 3249937 ESTIMATED SETTLEMENT AMOUNTS DUE THIRD-PARTY PAYORS 11220356 ACCRUED POSTRETIREMENT BENEFITS 331477 OTHER LONG TERM LIABILITIES 6289177 21090947 X PART X, LINE 2: WINCHESTER HOSPITAL HAS EVALUATED ITS TAX POSITIONS AND BELIEVES IT HAS NO UNCERTAIN TAX POSITIONS. 1 1 X 1 X 1 X 1 1 1 0 1 1 540000 540000 0.00210 11006533 8167304 2839229 0.01080 10901479 6026976 4874503 0.01850 22448012 14194280 8253732 0.03140 4205442 2085264 2120178 0.00810 82767 82767 0.00030 4247096 934731 3312365 0.01260 65757 65757 0.00020 8601062 3019995 5581067 0.02120 31049074 17214275 13834799 0.05260 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 0 0 0 0 0.00000 0 4176360 35917 50738426 61035197 -10296771 X 1 1 1 NOT APPLICABLE NOT APPLICABLE 0.00000 0.00000 0.00000 1 1 WINCHESTER HOSPITAL 41 HIGHLAND AVENUE WINCHESTER MA 01890 X X X ACUTE CARE FACILITY WINCHESTER HOSPITAL 1 1 X X X X X X X X X 13 1 0 1 X X X X X 1 0 1 1 200.000000000000 1 400.000000000000 1 X 1 1 X X X X 1 0 X 1 X 0 0 WINCHESTER HOSPITAL PART V, SECTION B, LINE 3: THE APPROACH TAKEN TO DATA COLLECTION INCLUDED RESEARCHING AVAILABLE SECONDARY SOURCE DATA, INCLUDING MASSCHIP TOWN REPORTS, MASSCHIP COMMUNITY HEALTH NETWORK AREA REPORTS AND THE BEHAVIORAL RISK SURVEILLANCE SURVEY (BRSS) ALONG WITH HEALTH AND RISK BEHAVIORS OF MASSACHUSETTS YOUTH. IN ADDITION TO SECONDARY DATA SOURCES, STAFF FROM THE CENTER FOR HEALTHY LIVING HELD FACE-TO-FACE INTERVIEWS WITH THE PUBLIC HEALTH NURSES AND/OR HEALTH AGENTS FROM EACH OF THE SIX TOWNS. SUMMARIZED FINDINGS WERE ALSO SHARED WITH THE MEMBERS OF THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY BOARD. AT EACH STEP IN THE PROCESS, THERE WAS THE OPPORTUNITY FOR QUESTIONS, ADDITIONS, CORRECTIONS AND MODIFICATIONS. WINCHESTER HOSPITAL PART V, SECTION B, LINE 14G: MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICY, PART V, SEC. B, LINE 14G WINCHESTER HOSPITAL PUBLICIZED ITS FINANCIAL ASSISTANCE POLICY IN BROCHURES AND PAMPHLETS. WINCHESTER HOSPITAL PART V, SECTION B, LINE 20D: AMOUNTS BILLED TO INDIVIDUALS WITH NO INSURANCE, PART V, SEC. B, LINE 20D THE HOSPITAL BILLS PATIENTS WITH NO INSURANCE AND THEY SUBSEQUENTLY APPLY FOR FINANCIAL ASSISTANCE. PART V, SECTION B, LINE 5A URL WHERE CHNA CAN BE ACCESSED, PART V, SEC. B, LINE 5A HTTP://WWW.WINCHESTERHOSPITAL.ORG/OUR-PROMISE/SUPPORTING-OUR-COMMUNITY 22 WINCHESTER HOSPITAL 1021 MAIN STREET WINCHESTER MA 01890 ADMIN OFFICES, BILLING, DOCTOR OFFICES WINCHESTER HOSPITAL 200 UNICORN PARK WOBURN MA 01801 COMMUNITY HEALTH, MRI, BREAST CANCER CTR WINCHESTER HOSPITAL 620 WASHINGTON STREET WINCHESTER MA 01890 RADIOLOGY/ONCOLOGY SERVICES FACILITY WINCHESTER HOSPITAL - BALDWIN PARK I 12 ALFRED STREET WOBURN MA 01801 COMMUNITY HEALTH INST., SLEEP CARE & ADMIN OFFICES WINCHESTER HOSPITAL - BALDWIN PARK II 12 ALFRED STREET WOBURN MA 01801 BREAST CARE, IMAGING HEMOTOLOGY/ONCOLOGY LAB, PHARMACY, CHIRO FAMILY MEDICAL SERVICES 500 SALEM STREET WILMINGTON MA 01887 AUDIOLOGY, OB/GYN, CARDIO-PUL, LAB, PT, URGENT CARE, PEDI WINCHESTER HOSPITAL 262/264 W CUMMINGS PARK WOBURN MA 01801 LAB & HOME CARE SERVICE WINCHESTER HOSPITAL RUSSELL HILL BUILDING 955 MAIN STREET WINCHESTER MA 01890 LAB, RADIOLOGY & PHYSICAL THERAPY WINCHESTER HOSPITAL 150 PRUDENTIAL WAY WOBURN MA 01801 MRI SERVICE READING HEALTH CENTER 20 POND MEADOW DRIVE READING MA 01867 LAB PATIENT SPECIMEN COLLECTION& SERV CTR 3 WOODLAND ROAD STONEHAM MA 02180 LAB MONTVALE DIAGNOSTIC CENTER 88 MONTVALE AVENUE STONEHAM MA 02180 LAB WINCHESTER HOSPITAL 790 BOSTON POST ROAD BILLERICA MA 01821 LAB WINCHESTER HOSPITAL 100 BYPASS ROAD NORTH ANDOVER MA 01845 LAB WINCHESTER HOSPITAL 101 CAMBRIDGE STREET BURLINGTON MA 01803 LAB WINCHESTER HOSPITAL 11 SHORE ROAD WINCHESTER MA 01890 LAB WINCHESTER HOSPITAL 75 RIVERSIDE AVENUE MEDFORD MA 02155 LAB, WEIGHT MGMT, WOUND CARE CENTER WINCHESTER HOSPITAL 10P COMMERCE WAY WOBURN MA 01801 ENDOSCOPY CENTER WINCHESTER HOSPITAL 21 MAIN STREET NORTH READING MA 01864 DIAGNOSTIC CENTER PAIN MANAGEMENT CENTER 444 WASHINGTON STREET WOBURN MA 01801 PAIN CLINIC CENTER CHOATE MEDICAL CENTER 23 WARREN AVENUE WOBURN MA 01801 PHYSICAL THERAPY WINCHESTER HOSPITAL 95 MAPLE STREET STONEHAM MA 02180 STOREROOM/WAREHOUSE PART I, LINE 7: WINCHESTER HEALTHCARE MANAGEMENT, INC. AFFILIATES USED THEIR OWN COST ACCOUNTING SYSTEM TO DERIVE THE NUMBER SET FORTH IN PART I, LINE 7 INSTEAD OF THE CHARGE TO COST RATIO OPTION. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $7,734,000 WAS SUBTRACTED FROM TOTAL EXPENSES REPORTING IN FORM 990, PART IX IN CALCULATING THE PERCENTAGE IN PART 1, LINE 7, COLUMN (F). PART III, LINE 2: WINCHESTER HEALTHCARE AND AFFILIATES GRANT CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD PARTY ARRANGEMENTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR CATEGORIES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR CATEGORIES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THROUGHOUT THE YEAR, THE HOSPITAL, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, WILL WRITE OFF THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN ADDITION TO THE REVIEW OF THE CATEGORIES OF REVENUE, MANAGEMENT MONITORS THE WRITE OFFS AGAINST ESTABLISHED ALLOWANCES AS OF A POINT IN TIME TO DETERMINE THE APPROPRIATENESS OF THE UNDERLYING ASSUMPTIONS USED IN ESTIMATING THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS APPROXIMATES 13% FOR THE YEARS ENDED SEPTEMBER 30, 2014 AND 2013.WINCHESTER HEALTHCARE MANAGEMENT INC. AND AFFILIATES UTILIZED WORKSHEET A: ESTIMATED BAD DEBT EXPENSE (AT COST) TO DETERMINE THE AMOUNT FOR SCHEDULE H, PART III, LINE 2. WINCHESTER HEALTHCARE MANAGEMENT INC. AND AFFILIATES USED NET FREE CARE PROVIDED AS A PERCENTAGE OF NET PATIENT SERVICE REVENUE TO REASONABLY ESTIMATE THE AMOUNT IN BAD DEBT THAT COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER OUR CHARITY CARE POLICY HAD SUFFICIENT INFORMATION BEEN SUBMITTED IN ORDER TO DETERMINE ELIGBILITY. PART III, LINE 3: THE METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE FINANCIAL ASSISTANCE POLICY SCHEDULE H, PART III, LINE 3 IS AS FOLLOWS:USED HEALTH SAFETY NET AS A PERCENTAGE OF NET PATIENT SERVICE REVENUE FROM THE DIVISION OF HEALTH CARE FINANCE AND POLICY 403 COST REPORT SCHEDULE VA.HEALTH SAFETY NET - NET REVENUE (SCHEDULE VA LINE 52.01 COLUMN 14) OF $2,195,000 DIVIDED BY TOTAL NET PATIENT SERVICE REVENUE (SCHEDULE VA LINE 52.01 COLUMN 2) OF $253,947,000. THIS YIELDED A .86% THAT WAS MULTIPLIED BY THE BAD DEBT EXPENSE AT COST OF $4,176,360 RESULTING IN THE $35,917 APPLICABLE TO PATIENTS THAT WOULD HAVE QUALIFIED UNDER THE FINANCIAL ASSISTANCE POLICY. PART III, LINE 8: ALL MEDICARE COSTS ARE ALLOCATED BY COST CENTER IN ACCORDANCE WITH MEDICARE REGULATIONS. THIS IS A SIGNIFICANT BENEFIT TO THE COMMUNITY SINCE REIMBURSEMENT FROM THE FEDERAL GOVERNMENT'S MEDICARE PROGRAM IS LESS THAN THE ACTUAL COST FOR THE HEALTHCARE SERVICES PROVIDED TO THE INDIVIDUALS RECEIVING IT. PART III, LINE 9B: THE HOSPITAL HAS A FIDUCIARY DUTY TO SEEK REIMBURSEMENT FOR SERVICES IT HAS PROVIDED FROM INDIVIDUALS WHO ARE ABLE TO PAY, FROM THIRD PARTY INSURERS WHO COVER THE COST OF CARE, AND FROM OTHER PROGRAMS OF ASSISTANCE FOR WHICH THE PATIENT IS ELIGIBLE. TO DETERMINE WHETHER A PATIENT IS ABLE TO PAY FOR THE SERVICES PROVIDED AS WELL AS TO ASSIST THE PATIENT IN FINDING ALTERNATIVE COVERAGE OPTIONS IF THEY ARE UNINSURED OR UNDERINSURED, THE HOSPITAL FOLLOWS THE FOLLOWING CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. THE HOSPITAL MAKES THE SAME REASONABLE EFFORT AND FOLLOWS THE SAME REASONABLE PROCESS FOR COLLECTING ON BILLS OWED BY AN UNINSURED PATIENT AS IT DOES FOR ALL OTHER PATIENTS. THE HOSPITAL WILL FIRST SHOW THAT IT HAS A CURRENT UNPAID BALANCE THAT IS RELATED TO SERVICES PROVIDED TO THE PATIENT AND NOT COVERED BY A PRIVATE INSURER OR A FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL FOLLOWS REASONABLE COLLECTION/BILLING PROCEDURES,WHICH INCLUDE MULTIPLE PROGRESSIVE BILLING NOTICES THAT CONTAIN INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS, DOCUMENTATION OF CONTINUOUS BILLING EFFORTS, CHECKING THE MASSACHUSETTS ELIGIBILITY VERIFICATION SYSTEM TO ENSURE THE PATIENT IS NOT A LOW INCOME PATIENT, AND OUTSIDE COLLECTION AGENCIES. PART VI, LINE 2 THE COMMUNITY HEALTH INSTITUTE AND THE DEPARTMENT OF PLANNING AND BUSINESS DEVELOPMENT COLLABORATED ON THE COMMUNITY NEEDS ASSESSMENT. THE PURPOSE OF THE WINCHESTER HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (WHCHNA) IS TO INFORM AND GUIDE THE HOSPITAL'S SELECTION OF AND COMMITMENT TO PROGRAM AND SERVICE INITIATIVES THAT ADDRESS THE HEALTH AND SOCIAL NEEDS OF THE COMMUNITIES IT SERVES. THE WHCHNA IS UNDERTAKEN EVERY 3 YEARS AND INCLUDES THE FOLLOWING:- RESEARCH THE CHANGING DEMOGRAPHICS OF THE CITIES AND TOWNS THAT COMPRISE THE HOSPITAL'S SERVICE AREA, BASED ON AVAILABLE SECONDARY DATA SOURCES.- STUDY PRELIMINARY DEMOGRAPHIC FINDINGS, ESPECIALLY WITH REGARD TO DEFINED STATEWIDE HEALTH PRIORITIES- SUPPORTING HEALTH CARE REFORM- CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATION- REDUCING HEALTH DISPARITIES- PROMOTING THE WELLNESS OF VULNERABLE POPULATIONS- IDENTIFY POTENTIAL POPULATION GROUPS, RISK FACTORS, AND CAUSES OF ILL HEALTH THAT MAY BE THE TARGET OF PROGRAM AND SERVICE INITIATIVES; PURSUE PRIMARY DATA SOURCES TO VALIDATE AND REFINE PRELIMINARY FINDINGS- COMMUNICATE WITH COMMUNITY LEADERS AND OTHER AGENCIES TO PURSUE PRIMARY DATA SOURCES TO VALIDATE AND REFINE PRELIMINARY FINDINGS- COLLABORATE WITH COMMUNITY LEADERS AND OTHER AGENCIES TO IDENTIFY OPPORTUNITIES FOR PARTNERSHIP IN MEETING HEALTH NEEDS AND IMPROVING HEALTH STATUS- RECOMMEND SPECIFIC PROGRAM AND SERVICE INITIATIVES FOR BUDGET APPROVAL- ESTABLISH METRICS TO MEASURE PROGRAM EFFORTS AND OUTCOMES- ENSURE COMPLIANCE WITH STATE AND FEDERAL REQUIREMENTS FOR COMMUNITY BENEFIT PROGRAMMING BY THE HOSPITAL THE SPECIFIC METHODOLOGY UTILIZED WAS TO:- FOCUS THE ANALYSIS ON THE SIX TOWNS IN THE PSA THAT ARE MOST DEPENDENT OF WINCHESTER HOSPITAL- WOBURN- WILMINGTON- READING- WINCHESTER- STONEHAM- NORTH READING- REVIEW AND ANALYZE DEMOGRAPHIC DATA USING 2009 AND PROJECTED 2015 DATA ON RACE, AGE, GENDER AND INCOME- RESEARCH AVAILABLE SECONDARY SOURCE DATA (MASSCHIP) REPORTS TO DETERMINE HEALTH STATUS OF THE POPULATION- SOLICIT AND REVIEW AVAILABLE PRIMARY SOURCE DATA, GENERATED THROUGH FACE-TO-FACE INTERVIEWS, TO VALIDATE FINDINGS OF UNMET HEALTH NEEDS THAT CAN DRIVE EFFECTIVE COMMUNITY BENEFIT PROGRAM DEVELOPMENT- IDENTIFY COMMUNITY PROGRAM INITIATIVES BASED ON POPULATION NEEDS AND BARRIERS TO CARE THE COMMUNITY BENEFIT ADVISORY BOARD ADDED NEW MEMBERS FROM UNREPRESENTED TOWNS IN WINCHESTER HOSPITAL'S GEOGRAPHIC AREA TO PROVIDE ADDITIONAL COMMUNITY NEEDS INFORMATION. ALL OF THE NOTED SOURCES WERE UTILIZED TO ESTABLISH THE COMMUNITY BENEFIT PROGRAMS FOR THE 2013 AND 2014 FISCAL YEAR. PART VI, LINE 3 PATIENTS IN NEED OF FINANCIAL ASSISTANCE ARE REFERRED TO THE HOSPITAL'S DEDICATED PATIENT FINANCIAL SERVICES ACCOUNT REPRESENTATIVE THAT PROVIDES FINANCIAL ASSISTANCE COUNSELING. THE REPRESENTATIVE PROVIDES PATIENTS WITH INFORMATION ON THE AVAILABLE PROGRAMS AND ASSISTS PATIENTS THROUGHOUT THE APPLICATION PROCESS, INCLUDING COMPLETION OF REQUIRED FORMS TO DETERMINE ELIGIBILITY. PART VI, LINE 4 WINCHESTER HOSPITAL IS THE NORTHWEST SUBURBAN BOSTON AREA'S LEADING PROVIDER OF COMPREHENSIVE HEALTH CARE SERVICES. WITH A TOTAL OF 229 BEDS AND BASSINETS, WINCHESTER HOSPITAL SERVES THE HEALTH CARE NEEDS OF ANDOVER, ARLINGTON, BILLERICA, BURLINGTON, MALDEN, MEDFORD, MELROSE, METHUEN, NORTH ANDOVER, NORTH READING, READING, STONEHAM, TEWKSBURY, WAKEFIELD, WINCHESTER, WILMINGTON, AND WOBURN AND SEVERAL OTHER SURROUNDING COMMUNITIES. IN ADDITION TO ACUTE CARE INPATIENT SERVICES, WINCHESTER HOSPITAL ALSO PROVIDES INTEGRATED HOME CARE.IN REVIEWING THE DEMOGRAPHIC DATA ON THE SIX TOWNS THAT ARE MOST DEPENDENT ON WINCHESTER HOSPITAL FOR THE YEARS 2008 - 2013, THE 0 - 14 YEAR OLD AGE GROUP REMAINS THE LARGEST AGE COHORT; THE 35 - 44 YEAR OLD AGE GROUP IS EXPECTED TO DECLINE AND THE 55+ AGE GROUP IS PROJECTED TO INCREASE. THE FEMALE POPULATION IN THE 55+ AGE GROUP IS ALSO PROJECTED TO INCREASE. IN ADDITION, THE FASTEST GROWING ETHNIC GROUP IN WINCHESTER HOSPITAL'S SERVICE AREA IS THE ASIAN POPULATION. HEALTH INDICATORS SHOW THAT HIGHER-THAN-STATE RATES OF TOTAL CANCER DEATHS ARE FOUND IN THREE OF OUR TARGETED TOWNS. FOUR OF OUR TARGETED TOWNS HAVE HIGHER-THAN-STATE RATES OF BREAST CANCER DEATHS AND A HIGHER-THAN-STATE RATE OF CARDIOVASCULAR DISEASE DEATHS IS FOUND IN THREE OF OUR TARGETED TOWNS. HOSPITAL DISCHARGES FOR ASTHMA, ANGINA, AND BACTERIAL PNEUMONIA ARE ABOVE-THE-STATE RATE IN FIVE OF OUR TARGETED TOWNS. AS A RESULT, WINCHESTER HOSPITAL'S COMMUNITY BENEFIT PROGRAMMING TARGETS THE NOTED POPULATIONS AND THE CHRONIC DISEASES THAT ACCOMPANY THEM. PART VI, LINE 5 WINCHESTER HOSPITAL IS COMMITTED TO BENEFITING ALL OF THE COMMUNITIES WE SERVE BY COLLABORATING WITH COMMUNITY PARTNERS TO IDENTIFY HEALTH NEEDS, IMPROVING THE HEALTH STATUS OF COMMUNITY RESIDENTS, ADDRESSING HEALTH DISPARITIES AND EDUCATING COMMUNITY MEMBERS ABOUT PREVENTION AND SELF-CARE.THROUGHOUT 2013-2014 WINCHESTER HOSPITAL WILL RUN 18 FREE COMMUNITY BENEFIT PROGRAMS DESIGNED TO REDUCE HEALTH CARE DISPARITIES, PROMOTE WELLNESS IN AT-RISK POPULATIONS, AND TEACH RESIDENTS HOW TO PROPERLY MANAGE CHRONIC DISEASES.WINCHESTER HOSPITAL OFFERS SERVICES TO COMMUNITY MEMBERS THROUGH OSTEOPOROSIS SCREENINGS, PEDIATRIC ASTHMA HOME VISITS AND EDUCATION SESSIONS, TELEPHONIC HEART FAILURE COUNSELING SESSIONS, EDUCATIONAL AND SOCIAL SENIOR CITIZEN OUTREACH INITIATIVES, A FREE HOME BLOOD DRAW PROGRAM FOR QUALIFIED INDIVIDUALS, AN ANTICOAGULATION CLINIC, AND BLOOD PRESSURE CLINICS.PARTNERING WITH WOBURN COUNCIL FOR SOCIAL CONCERN AND WOBURN BOYS AND GIRLS CLUB, THE HOSPITAL ALSO OFFERS COMMUNITY MEMBERS FITNESS CLASSES FOR BOTH ADULTS AND CHILDREN, NUTRITION EDUCATION AND INSTRUCTIONAL DISEASE MANAGEMENT SESSIONS FOR CHILD CARE PROVIDERS. THROUGH PARTNERSHIPS WITH AREA SCHOOLS AND THE WINCHESTER MULTICULTURAL NETWORK, WINCHESTER HOSPITAL PROMOTES WELLNESS IN VARIOUS COMMUNITY POPULATIONS. PART VI, LINE 6 WINCHESTER HOSPITAL OFFICIALLY AFFILIATED WITH LAHEY HEALTH SYSTEM ON JULY 1, 2014 AND IS ASSESSING HOW BEST TO MEET THE NEEDS OF THE COMMUNITIES IT SERVES IN CONJUNCTION WITH LAHEY HEALTH SYSTEM, INC. PART VI, LINE 7 WINCHESTER HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF MASSACHUSETTS. X X X X X X 0 1 0 0 0 0 0 1 0 JONATHAN ADLER MD DIRECTOR 0 308439 0 0 0 383038 0 0 0 667 0 692144 0 0 HOWARD R GRANT JD MD PRESIDENT 0 1451746 0 0 0 17896 0 242796 0 30722 0 1743160 0 0 DALE LODGE DIRECTOR 516491 0 326471 0 123248 0 10200 0 22229 0 998639 0 0 0 TIMOTHY OCONNOR TREASURER 0 725900 0 0 0 258 0 136700 0 25817 0 888675 0 0 KEVIN SMITH CEO, WH, WHM EX-OFFICIO 519248 0 318909 0 336910 0 10200 0 21274 0 1206541 0 0 0 DAVID SPACKMAN CLERK 0 437726 0 0 0 762 0 22796 0 22007 0 483291 0 0 MATTHEW WOODS ASSISTANT TREASURER 325936 0 76872 0 632 0 10896 0 29017 0 443353 0 0 0 KATHY ANN SCHULER V.P. - PATIENT CARE SERVICES 289673 0 70128 0 1811 0 10402 0 19364 0 391378 0 0 0 ANN LANG TALBOT V.P. - HUMAN RESOURCES 250589 0 76677 0 2780 0 10224 0 21613 0 361883 0 0 0 RICHARD J ISEKE MD V.P. - MEDICAL AFFAIRS 421507 0 125942 0 4949 0 10200 0 6248 0 568846 0 0 0 MARY ELIZABETH CANNING VICE PRESIDENT 247409 0 30683 0 1179 0 10229 0 29138 0 318638 0 0 0 WILLIAM ROBERTSON VICE PRESIDENT 200604 0 47998 0 969 0 8000 0 29127 0 286698 0 0 0 MARY T SWEENEY VICE PRESIDENT 215324 0 51457 0 2780 0 8576 0 567 0 278704 0 0 0 EDWAWRD P SULLIVAN PHYSICIAN RELATIONS 226442 0 0 0 966 0 9031 0 25820 0 262259 0 0 0 PART I, LINE 4B KEVIN SMITH, PRESIDENT OF WINCHESTER HOSPITAL, PARTICIPATES IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. $332,415 WAS REPORTED IN TAXABLE WAGES IN CALENDAR YEAR 2013. DALE LODGE, DIRECTOR, PARTICIPATES IN A SPLIT DOLLAR LIFE INSURANCE PLAN. THE IMPUTED INCOME OF $117,643 WAS REPORTED IN TAXABLE WAGES IN CALENDAR YEAR 2013. 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. 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). A MASSACHUSETTS HEALTH AND ED FACILITIES AUTHORITY 042456011 57586EWC1 2010-09-09 79047442 SERIAL BOND SERIES H - REFUND 0 0 0 B MASSACHUSETTS HEALTH AND ED FACILITIES AUTHORITY 042456011 57586CDD4 2004-07-08 30340000 SERIAL BON SERIES F - ADV. REF 0 0 0 A 5902442 79047442 25510784 1148365 52388293 2012 0 1 1 1 B 30340000 29927552 412448 2006 0 1 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 1 1 1 MORGAN STANLEY 20.000000000000 0 0 0 0 1 A 1 B 1 MARTINI INSURANCE AGENCY J. MARTINI, OWNER, IS A DIRECTOR OF WINCHESTER HOSPITAL 394129 INSURANCE POLICIES 0 UMS NE LITHOTRIPSY A. LITTLE, OWNER, IS A DIRECTOR OF WINCHESTER HOSPITAL 110525 LASER LITHOTRIPSY SERVICES 0 FORM 990, PART VI, SECTION A, LINE 2 KEVIN F. SMITH, MATTHEW WOODS, JOSEPH R. TARBY III, AND JAMES FICOCIELLO HAVE A BUSINESS RELATIONSHIP. THEY ARE OFFICERS/DIRECTORS OF WINCHESTER HOSPITAL AND ALSO OFFICERS/DIRECTORS OF RELATED FOR PROFIT ENTITY WINCHESTER HEALTHCARE ENTERPRISES, INC. KEVIN F. SMITH, DALE M. LODGE, MATTHEW WOODS, AND ROBERT FORTUNATO HAVE A BUSINESS RELATIONSHIP. THEY ARE OFFICERS/DIRECTORS OF WINCHESTER HOSPITAL AND ALSO OFFICERS/DIRECTORS OF RELATED FOR PROFIT ENTITY WINCHESTER PHYSICIANS ASSOCIATES, INC. FORM 990, PART VI, SECTION A, LINE 8B WINCHESTER HOSPITAL DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE VICE PRESIDENT OF FINANCE AND THE MANAGER OF GENERAL ACCOUNTING REVIEW THE FORM 990 BY COMPARING THE PRIOR YEAR RETURN WITH THE CURRENT YEAR FILING, BEFORE THE RETURN IS GIVEN TO THE BOARD FOR REVIEW. 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 AFFILIATES, 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 POLICY; 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 OF WINCHESTER. THE BOARD OF DIRECTORS OF WINCHESTER SHALL, UPON WRITTEN REQUEST OF THE MEMBER OF THE BOARD OF DIRECTORS OR THE COMPLIANCE OFFICER, REVIEW A FINDING OF THE AUDIT/COMPLIANCE COMMITTEE. THE BOARD OF DIRECTORS OF WINCHESTER SHALL EITHER REAFFIRM OR REVIEW THE FINDING AND SHALL REPORT SUCH FINDING TO THE AUDIT/COMPLIANCE COMMITTEE AND TO THE LEADER. THIS CONFLICT OF INTEREST POLICY SHALL BE REVIEWED ANNUALLY BY AND ON BEHALF OF WINCHESTER AND ITS AFFILIATES. FORM 990, PART VI, SECTION B, LINE 15 WINCHESTER HOSPITAL OFFICER SALARIES AND BENEFITS ARE PAID AND DETERMINED UNDER THE COMPENSATION POLICIES WHICH INCLUDES THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE HOSPITAL'S 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 WINCHESTER HOSPITAL 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 ALSO AVAILABLE ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. FORM 990, PART XI, LINE 9: INDIRECT PUBLIC SUPPORT 2,881,124. CHANGE IN INTEREST OF FOUNDATION -338,723. CHANGE IN VALUATION OF SWAPS -308,533. OTHER CHANGES IN TRUST 55,268. TRANSFERS TO AFFILIATES -2,186,259. VALUATION ACTIVITY DUE TO LAHEY AFFILIATION -4,184,607. LAHEY CLINICAL HOSPITAL INC 41 MALL ROAD BURLINGTON MA 01805 042704686 HEALTHCARE MA 501(C) (3) LINE 3 LCF INC 0 LAHEY CLINIC INC 41 MALL ROAD BURLINGTON MA 01805 042704683 HEALTHCARE MA 501(C) (3) LINE 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) LINE 9 LHS INC 0 NORTHEAST HEALTH SYSTEM INC 85 HERRICK STREET BEVERLY MA 01915 043240453 SUPPORT MA 501(C) (3) LINE 11C, III-FI LHS INC 0 NORTHEAST BEHAVIORAL HEALTH CORPORATION ZERO CENTENNIAL DRIVE PEABODY MA 01960 042777145 BEHAVIORAL HEALTH CARE MA 501(C) (3) LINE 7 LHS INC 0 HEALTH AND EDUCATION HOUSING SERVICES INC 131 RANTOUL STREET BEVERLY MA 01915 223232914 HUD HOUSING MA 501(C) (3) LINE 9 NEBH CORP 0 NORTHEAST HOSPITAL CORPORATION 85 HERRICK STREET BEVERLY MA 01915 042121317 HEALTHCARE MA 501(C) (3) LINE 3 LHS INC 0 NORTHEAST MEDICAL PRACTICES INC 85 HERRICK STREET BEVERLY MA 01915 043201853 HEALTHCARE MA 501(C) (3) LINE 9 NEH CORP 0 SEACOAST NURSING & REHABILITATION CENTER 300 WASHINGTON STREET GLOUCESTER MA 01930 041305001 HEALTHCARE MA 501(C) (3) LINE 9 LHS INC 0 NORTHEAST PROFESSIONAL REGISTRY OF NURSES 800 CUMMINGS CENTER BEVERLY MA 01915 201287349 HEALTHCARE MA 501(C) (3) LINE 9 NESH CORP 0 NORTHEAST SENIOR HEALTH CORPORATION 131 RANTOUL STREET BEVERLY MA 01915 042731137 HEALTHCARE MA 501(C) (3) LINE 9 LHS INC 0 CAB HEALTH & RECOVERY 111 MIDDLETON ROAD DANVERS MA 01923 042400270 SUBSTANCE ABUSE MA 501(C) (3) LINE 9 NEBH CORP 0 LAHEY HEALTH SYSTEM INC 41 MALL ROAD BURLINGTON MA 01805 611665701 SUPPORT MA 501(C) (3) LINE 11C, III-FI N/A 0 WINCHESTER HOSPITAL FOUNDATION INC 41 HIGHLAND AVENUE WINCHESTER MA 01890 043399570 SUPPORT MA 501(C) (3) LINE 11C, III-FI WHM INC 0 WINCHESTER HEALTHCARE INVESTMENTS 41 HIGHLAND AVENUE WINCHESTER MA 01890 222701819 SUPPORT MA 501(C) (3) LINE 11C, III-FI WHM INC 0 WINCHESTER HEALTHCARE MANAGEMENT 41 HIGHLAND AVENUE WINCHESTER MA 01890 222701817 MANAGEMENT SERVICE MA 501(C) (3) LINE 11A, I LHS INC 0 WINCHESTER COMMUNITY ACCOUNTABLE CARE ORGANIZATION 41 HIGHLAND AVENUE WINCHESTER MA 01890 223137856 ACO MA 501(C) (3) LINE 11A, I WHM INC 0 LAHEY CLINIC FOUNDATION 41 MALL ROAD BURLINGTON MA 01805 042323457 SUPPORT MA 501(C) (3) LINE 7 LHS INC 0 ADDISON GILBERT SOCIETY INC 41 MALL ROAD BURLINGTON MA 01805 464371382 SUPPORT MA 501(C) (3) LINE 11A, I LHS INC 0 LAHEY CLINIC INSURANCE CO LTD PO BOX HM 2450 HAMILTON BD INSURANCE BD LHS INC C 0 PERPETUAL TRUSTS (8) 41 MALL ROAD BURLINGTON MA 01805 SUPPORT MA SEE PART VII T 0 REMAINDER TRUSTS (17) 41 MALL ROAD BURLINGTON MA 01805 SUPPORT MA SEE PART VII T 0 POOLED INCOME FUNDS (3) 41 MALL ROAD BURLINGTON MA 01805 SUPPORT MA SEE PART VII T 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 WINCHESTER HEALTHCARE INDEMNIFICATION 41 HIGHLAND AVENUE WINCHESTER MA 01890 980589732 INVESTMENT COMPANY MA LAHEY HEALTH SYSTEM C 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 SCHEDULE R, PART IV LAHEY CLINIC FOUNDATION, INC., NORTHEAST HOSPITAL CORPORATION AND WINCHESTER HOSPITAL, RESPECTIVELY, HAVE FOUR, THREE AND ONE PERPETUAL TRUSTS. THE PERPETUAL TRUSTS ARE DOMICILED IN MASSACHUSETTS, PENNSYLVANIA AND FLORIDA. LAHEY CLINIC FOUNDATION, INC. HAS SEVENTEEN REMAINDER TRUSTS. THE REMAINDER TRUSTS ARE DOMICILED IN MASSACHUSETTS, NEW HAMPSHIRE AND WISCONSIN. LAHEY CLINIC FOUNDATION, INC. HAS THREE POOLED INCOME FUNDS, DOMICILED IN MASSACHUSETTS. SCHEDULE R, PART V IN ADDITION TO CONDUCTING FUNDRAISING AND SOLICITATION EFFORTS ON ITS OWN BEHALF, LAHEY CLINIC FOUNDATION, INC. PHILANTHROPY DEPARTMENT ALSO CONDUCTS FUNDRAISING AND SOLICITATION EFFORTS ON BEHALF OF ALL ENTITIES WITHIN THE LAHEY HEALTH SYSTEM, INC. FAMILY OF ORGANIZATIONS, AS DETAILED IN THE ACCOMPANYING IRS FORM 990, SCHEDULE R, PART II. LAHEY HEALTH SYSTEM, INC. AND ITS RELATED ORGANIZATIONS, AND WINCHESTER HEALTHCARE MANAGEMENT, INC. AND ITS RELATED ORGANIZATIONS (AS DETAILED IN THE ACCOMPANYING IRS FORM 990, SCHEDULE R, PROVIDE VARIOUS CORPORATE AND OTHER SERVICES TO EACH OTHER. THESE ORGANIZATIONS REIMBURSE ONE ANOTHER FOR EXPENSES INCURRED SUCH AS EMPLOYEE SALARIES, MATERIALS, SUPPLIES, UTILITIES, ETC. CASH IS ALSO TRANSFERRED BETWEEN THE CORPORATIONS FOR WORKING CAPITAL PURPOSES ON AN AS-NEEDED BASIS.