2016-08-12T16:33:45-05:00 2015-09-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2014-10-01 043228556 JORDAN PHYSICIAN ASSOCIATES INC JORD 5088302005 275 SANDWICH STREET PLYMOUTH MA 02360 JASON RADZEVICH CFO 5088302005 2016-08-12 1 CHRISTINE KAWECKI P00743140 5169187000 2016-08-11 2014 2016-12-15 16:53:06Z JASON RADZEVICH 275 SANDWICH STREET PLYMOUTH MA 02360 17413949 0 X WWW.BIDPLYMOUTH.ORG X 1994 MA SEE SCHEDULE O. 6 1 0 0 35610 -16390 0 0 18320081 16863729 1101 -1106 316721 499365 18637903 17361988 0 0 0 0 16700259 1519998 0 0 0 5407237 22050865 22107496 23570863 -3469593 -6208875 4731528 6234045 2373461 3155501 2358067 3078544 X SEE SCHEDULE O. 0 0 17143880 15432206 SEE SCHEDULE O. 1895278 1895278 SEE SCHEDULE O. 1285830 SEE SCHEDULE O. 20324988 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 57 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 X 6 1 1 0 0 0 1 1 1 1 1 0 0 1 0 0 0 1 1 0 MA X JASON RADZEVICH 5087462000 275 SANDWICH ST PLYMOUTH MA 02360 CHEN MD WENLIANG TRUSTEE, SURGEON 60.00 X 497763 0 57660 COUGHLIN KEVIN TRUSTEE, SVP SYS DEV 1.00 59.00 X 0 96293 7243 HINKLEY CLARK CHAIR, TRUSTEE 1.00 11.00 X 0 0 0 HOLDEN PETER J PRES, CEO, TRUSTEE (EX-OFF) 12.00 53.00 X X 169093 676369 33940 KOHLER MD ULRIKE TRUSTEE, INTERNIST 60.00 X 235353 0 44079 PASKOWSKI DC IAN TRUSTEE, CHIROPRACTOR 60.00 X 168122 0 25728 NORRIS DENISE CLERK & EXEC ASST 8.00 32.00 X 15855 63421 25890 RADZEVICH JASON TREASURER, CFO, VP FIN 12.00 48.00 X 45729 323089 19488 RUTHERFORD RON VP & CIO 12.00 48.00 X 46640 186562 40233 JAMES DO SCOTT VASCULAR SURGEON 60.00 X 560878 0 26230 TIERNEY DO MATTHEW LAPROSCOPIC SURGEON 60.00 X 471662 0 55160 KOOMEY MD JAMES M MEDICAL ONCOLOGIST 60.00 X 314106 0 52660 WHITE MD DEBRA HOLIK MEDICAL ONCOLOGIST 60.00 X 286236 0 50805 HARVEY MD KYLE SURGEON 60.00 X 296212 0 40435 IANNONI JOSEPH FORMER TREASURER, CFO 12.00 48.00 X 171717 686872 94986 3279366 2032606 574537 0 1 1 0 ASSOCIATED PHYSICIANS OF HFMP PO BOX 414977 BOSTON MA 022414977 PHYSICIAN SERVICES 14194498 AFFILIATED PHYSICIAN GROUP 464 HILLSIDE AVE ST 301 NEEDHAM MA 02494 PHYSICIAN SERVICES 3876665 ATHENA HEALTH PO BOX 415615 BOSTON MA 022415615 IT CONSULTING 827837 ECLINICAL WORKS 2 TECHNOLOGY DRIVE WESTBOROUGH MA 01581 IT SERVICES 187088 4 SPECIALTY CARE 621400 14968451 14968451 HOSPITALISTS 621110 1895278 1895278 16863729 935 935 43776 2500 49920 0 -6144 2500 -3644 -3644 2041 -2041 -2041 -2041 MEDICAL REFUND/REBATES 900099 293330 293330 MISCELLANEOUS REVENUE 900099 170425 170425 MED DIR ADVISORY FEE 900099 39254 39254 503009 17361988 17327484 35610 -1106 X 1329284 1056048 273236 190714 190714 1468467 1468467 3125 3125 14663 14663 16856075 16047840 808235 918496 502793 415703 1321972 1064340 257632 32806 29089 3717 57649 57649 362129 362129 928371 928371 DUES 87112 86015 1097 0 23570863 20324988 3245875 0 345576 332069 1772112 1779423 24877 21748 36252 29863 295024 4033742 554995 2254262 3478747 304838 290782 4731528 6234045 811647 747386 1561814 2408115 2373461 3155501 X 2358067 3078544 0 0 2358067 3078544 4731528 6234045 X -6208875 6929352 X X 0 1 X 1 0 X 16141176 16048516 17239599 18615956 17327484 85372731 16141176 16048516 17239599 18615956 17327484 85372731 0 0 0 85372731 4409 252 1101 935 6697 4409 252 1101 935 6697 20846 35610 56456 16141176 16052925 17239851 18637903 17364029 85435884 0.99930 0.99970 0.00010 0.00010 X 2075323 219076 1856247 1586141 335919 1250222 372278 372278 3478747 ESTIMATED 3RD PARTY SETTLEMENT 370612 DUE TO RELATED PARTIES 1678006 OTHER CURRENT LIABILITIES 359497 2408115 X 233793319 216381411 216381411 17411908 -49920 -49920 17361988 233823876 210203093 210203093 23620783 -49920 -49920 23570863 PART X, LINE 2: AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS THE SOLE MEMBER OF JORDAN HEALTH SYSTEMS, INC (JHSI) AND BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BID-PLYMOUTH) AND JHSI SERVES AS THE SOLE MEMBER OF JORDAN PHYSICIAN ASSOCIATES. THE CONSOLIDATED FINANCIAL STATEMENTS OF BETH ISRAEL DEACONESS HOSPITAL -PLYMOUTH AND AFFILIATES ARE INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF BIDMC AND AFFILIATES. THE TEXT OF THE FOOTNOTE BELOW IS FROM THE BIDMC CONSOLIDATED FINANCIAL STATEMENTS. THE MEDICAL CENTER, MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP (APG), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BIDN), BETH ISRAEL DEACONESS HOSPITAL - MILTON (BIDM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH (BIDP) AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) HAVE ALL BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND, THEREFORE, ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE MEDICAL CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE MEDICAL CENTER DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS IN EITHER 2015 OR 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET TO ELIMINATIONS 216,381,411. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENT EXPENSE -49,920. PART XII, LINE 2D - OTHER ADJUSTMENTS: NET TO ELIMINATIONS 210,203,093. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENT EXPENSE -49,920. X X X X 1 1 0 0 0 0 0 1 0 CHEN MD WENLIANG TRUSTEE, SURGEON 412808 0 79308 0 5647 0 26000 0 31660 0 555423 0 0 0 HOLDEN PETER J PRES, CEO, TRUSTEE (EX-OFF) 111671 446683 23715 94860 33707 134826 2080 8320 4708 18832 175881 703521 0 0 KOHLER MD ULRIKE TRUSTEE, INTERNIST 168528 0 64000 0 2825 0 16774 0 27305 0 279432 0 0 0 PASKOWSKI DC IAN TRUSTEE, CHIROPRACTOR 167787 0 0 0 335 0 6290 0 19438 0 193850 0 0 0 RADZEVICH JASON TREASURER, CFO, VP FIN 40632 263593 4650 37600 447 21896 0 1220 3250 15018 48979 339327 0 0 RUTHERFORD RON VP & CIO 38503 154012 7800 31200 337 1350 3690 14761 4356 17426 54686 218749 0 0 JAMES DO SCOTT VASCULAR SURGEON 457202 0 95243 0 8433 0 26000 0 230 0 587108 0 0 0 TIERNEY DO MATTHEW LAPROSCOPIC SURGEON 378423 0 87038 0 6201 0 26000 0 29160 0 526822 0 0 0 KOOMEY MD JAMES M MEDICAL ONCOLOGIST 307986 0 0 0 6120 0 26000 0 26660 0 366766 0 0 0 WHITE MD DEBRA HOLIK MEDICAL ONCOLOGIST 281216 0 0 0 5020 0 26000 0 24805 0 337041 0 0 0 HARVEY MD KYLE SURGEON 292400 0 0 0 3812 0 26000 0 14435 0 336647 0 0 0 IANNONI JOSEPH FORMER TREASURER, CFO 19678 78713 9866 39466 142173 568693 18000 72000 997 3989 190714 762861 0 0 PART I, LINES 4A-B AS NOTED IN THIS FILING, MR. JOSEPH IANNONI SERVED AS VICE PRESIDENT OF FINANCE AND CHIEF FINANCIAL OFFICER FOR BID-PLYMOUTH, JHSI AND JPA THROUGH FEBRUARY 18, 2014 AND BECAME ELIGIBLE FOR CERTAIN SALARY CONTINUATION PAYMENTS ON LEAVING THESE ROLES AS NOTED IN MORE DETAIL IN THE DISCLOSURES BELOW. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN JORDAN PHYSICIAN ASSOCIATES' (JPA) FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2015 IS CALENDAR YEAR 2014 DETAIL. AS NOTED THROUGHOUT THIS FILING, JORDAN HEALTH SYSTEMS INC. AND BID-PLYMOUTH ARE AFFILIATES OF JPA AND ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. DURING THE 2014 CALENDAR YEAR, JORDAN HEALTH SYSTEMS, INC. (JHSI) MAINTAINED AN IRC SECTION 457(B) PLAN PURSUANT TO WHICH THE ELIGIBLE EMPLOYEE COULD DEFER PART OF HIS 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 AND AMOUNTS PAID OUT TO THE PARTICIPANT ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. DURING THAT SAME PERIOD, BID-PLYMOUTH AND JORDAN HEALTH SYSTEMS, INC. (JHSI) MAINTAINED TWO IRC SECTION 457(F) PLANS. THESE PLANS ARE STRICTLY EMPLOYER FUNDED WITH NO EMPLOYEE DEFERRALS. UNDER THE DEFINITIONS TO THIS FORM 990, THESE PLANS ARE CONSIDERED SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. EMPLOYER CONTRIBUTIONS TO EMPLOYEES ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION. DISTRIBUTIONS FROM THESE PLANS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II COLUMN B(III), OTHER REPORTABLE COMPENSATION, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL DETAIL IS INCLUDED BELOW IN THE ADDITIONAL EXPLANATORY FOOTNOTES TO THIS FORM 990 SCHEDULE J. PART I, LINE 7 NON-FIXED PAYMENTS CERTAIN JPA, BID-PLYMOUTH AND JHSI COMPENSATION PACKAGES INCLUDE OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING JPA'S AND/OR BID-PLYMOUTH'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. THE INCENTIVE COMPENSATION FOR EACH EXECUTIVE IS REVIEWED AND APPROVED BY THE BID-PLYMOUTH EXECUTIVE COMPENSATION COMMITTEE, WHICH AS PREVIOUSLY NOTED, IS FULLY STAFFED BY INDEPENDENT MEMBERS. 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. 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; 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 JORDAN PHYSICIAN ASSOCIATES, BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH, BETH ISRAEL DEACONESS HOSPITAL-MILTON, BETH ISRAEL DEACONESS MEDICAL CENTER, JORDAN HEALTH SYSTEMS INC. AND ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS JPA, BID-PLYMOUTH, BID-MILTON, BIDMC, JHSI AND APHMFP RESPECTIVELY. CHEN, M.D., WENLIANG TRUSTEE - JORDAN PHYSICIAN ASSOCIATES LAPAROSCOPIC SURGEON - JORDAN PHYSICIAN ASSOCIATES DR. CHEN DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, DR. CHEN PERFORMED SERVICES FOR JPA AND WAS COMPENSATED BY APHMFP. AS REQUIRED BY THIS FORM 990, DR. CHEN'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 412,808 INCENTIVE COMPENSATION: 79,308 OTHER REPORTABLE COMPENSATION: 5,647 DEFERRED COMPENSATION: 26,000 NON-TAXABLE BENEFITS: 31,660 COUGHLIN, KEVIN TRUSTEE AND SENIOR VICE PRESIDENT, SYSTEMS DEVELOPMENT - JORDAN PHYSICIAN ASSOCIATES SENIOR VICE PRESIDENT, SYSTEMS DEVELOPMENT - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH SENIOR VICE PRESIDENT, SYSTEMS DEVELOPMENT - JORDAN HEALTH SYSTEMS, INC. MR. COUGHLIN'S TERM BEGAN SEPTEMBER 2, 2014. MR. COUGHLIN DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, MR. COUGHLIN PERFORMED SERVICES FOR BID-PLYMOUTH AND WAS COMPENSATED BY JHSI. AS REQUIRED BY THIS FORM 990, MR. COUGHLIN'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 96,282 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 11 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 7,243 HINKLEY, CLARK CHAIR, TRUSTEE - JORDAN PHYSICIAN ASSOCIATES CHAIR, DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH CHAIR, DIRECTOR - JORDAN HEALTH SYSTEMS, INC. DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER MR. HINKLEY DEVOTES, ON AVERAGE, A COMBINED 12 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. HOLDEN, PETER J. PRESIDENT, CHIEF EXECUTIVE OFFICER, TRUSTEE (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES PRESIDENT, CHIEF EXECUTIVE OFFICER, DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH PRESIDENT, CHIEF EXECUTIVE OFFICER, DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MR. HOLDEN DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, MR. HOLDEN PERFORMED SERVICES FOR BID-PLYMOUTH AND JPA AND WAS COMPENSATED BY JHSI. AS REQUIRED BY THIS FORM 990, THE PORTION OF MR. HOLDEN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 111,671 INCENTIVE COMPENSATION: 23,715 OTHER REPORTABLE COMPENSATION: 33,707 DEFERRED COMPENSATION: 2,080 NON-TAXABLE BENEFITS: 4,708 PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 446,683 INCENTIVE COMPENSATION: 94,860 OTHER REPORTABLE COMPENSATION: 134,826 DEFERRED COMPENSATION: 8,320 NON-TAXABLE BENEFITS: 18,832 OTHER REPORTABLE COMPENSATION FOR MR. HOLDEN INCLUDES A DISTRIBUTION FROM A 457(F) PLAN IN THE AMOUNT OF $138,780 AND A DEFERRAL UNDER A 457(B) PLAN IN THE AMOUNT OF $16,161. KOHLER, M.D., ULRIKE TRUSTEE - JORDAN PHYSICIAN ASSOCIATES INTERNIST - JORDAN PHYSICIAN ASSOCIATES DR. KOHLER DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, DR. KOHLER PERFORMED SERVICES FOR JPA AND WAS COMPENSATED BY APHMFP. AS REQUIRED BY THIS FORM 990, DR. KOHLER'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 168,528 INCENTIVE COMPENSATION: 64,000 OTHER REPORTABLE COMPENSATION: 2,825 DEFERRED COMPENSATION: 16,774 NON-TAXABLE BENEFITS: 27,305 PASKOWSKI, D.C., IAN TRUSTEE - JORDAN PHYSICIAN ASSOCIATES CHIROPRACTOR AND SPINE CARE - JORDAN PHYSICIAN ASSOCIATES DR. PASKOWSKI DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, DR. PASKOWSKI PERFORMED SERVICES FOR JPA AND WAS COMPENSATED BY BID-PLYMOUTH. AS REQUIRED BY THIS FORM 990, DR. PASKOWSKI'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 167,787 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 335 DEFERRED COMPENSATION: 6,290 NON-TAXABLE BENEFITS: 19,438 NORRIS, DENISE CLERK AND EXECUTIVE ASSISTANT - JORDAN PHYSICIAN ASSOCIATES EXECUTIVE ASSISTANT AND CONTRACT SPECIALIST - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH MS. NORRIS DEVOTES, ON AVERAGE, A COMBINED 40 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND BID-PLYMOUTH FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, MS. NORRIS PERFORMED SERVICES FOR BID-PLYMOUTH AND JPA AND WAS COMPENSATED BY BID-PLYMOUTH. AS REQUIRED BY THIS FORM 990, THE PORTION OF MS. NORRIS' COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 13,445 INCENTIVE COMPENSATION: 2,400 OTHER REPORTABLE COMPENSATION: 10 DEFERRED COMPENSATION: 437 NON-TAXABLE BENEFITS: 4,741 PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 53,781 INCENTIVE COMPENSATION: 9,600 OTHER REPORTABLE COMPENSATION: 40 DEFERRED COMPENSATION: 1,746 NON-TAXABLE BENEFITS: 18,966 RADZEVICH, JASON VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER - JORDAN PHYSICIAN ASSOCIATES VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER - JORDAN HEALTH SYSTEMS, INC. FORMER VICE PRESIDENT, FINANCE AND CHIEF FINANCIAL OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON FORMER VICE PRESIDENT, FINANCE AND CHIEF FINANCIAL OFFICER - MILTON HOSPITAL FOUNDATION FORMER CHIEF FINANCIAL OFFICER - COMMUNITY PHYSICIANS ASSOCIATES MR. RADZEVICH RESIGNED FROM HIS POSITIONS AS VICE PRESIDENT, FINANCE AND CHIEF FINANCIAL OFFICER AT BID-MILTON AND THE MILTON HOSPITAL FOUNDATION AND AS CHIEF FINANCIAL OFFICER AT COMMUNITY PHYSICIANS ASSOCIATES EFFECTIVE APRIL 1, 2014. MR. RADZEVICH COMMENCED HIS POSITIONS AS VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER AT JPA, BID-PLYMOUTH AND JORDAN HEALTH SYSTEMS INC. ON MAY 5, 2014. AS REQUIRED BY FORM 990, COMPENSATION REPORTED IN THIS FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2015 REPRESENTS PAYMENTS MADE TO MR. RADZEVICH BY BID-MILTON AND JHSI DURING THE CALENDAR YEAR 2014. MR. RADZEVICH DEVOTED TO HIS FORMER POSITIONS AND NOW DEVOTES TO HIS CURRENT POSITIONS, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 162,527 INCENTIVE COMPENSATION: 18,600 OTHER REPORTABLE COMPENSATION: 1,788 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 13,000 PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 40,632 INCENTIVE COMPENSATION: 4,650 OTHER REPORTABLE COMPENSATION: 447 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 3,250 PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 101,066 INCENTIVE COMPENSATION: 19,000 OTHER REPORTABLE COMPENSATION: 20,108 DEFERRED COMPENSATION: 1,220 NON-TAXABLE BENEFITS: 2,018 RUTHERFORD, RON VICE PRESIDENT AND CHIEF INFORMATION OFFICER - JORDAN PHYSICIAN ASSOCIATES HEDULE J EXPLANATORY FOOTNOTES (CONTINUED) VICE PRESIDENT AND CHIEF INFORMATION OFFICER - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH VICE PRESIDENT AND CHIEF INFORMATION OFFICER - JORDAN HEALTH SYSTEMS, INC. MR. RUTHERFORD DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, MR. RUTHERFORD PERFORMED SERVICES FOR BID-PLYMOUTH AND JPA AND WAS COMPENSATED BY JHSI. AS REQUIRED BY THIS FORM 990, THE PORTION OF MR. RUTHERFORD'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 38,503 INCENTIVE COMPENSATION: 7,800 OTHER REPORTABLE COMPENSATION: 337 DEFERRED COMPENSATION: 3,690 NON-TAXABLE BENEFITS: 4,356 PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 154,012 INCENTIVE COMPENSATION: 31,200 OTHER REPORTABLE COMPENSATION: 1,350 DEFERRED COMPENSATION: 14,761 NON-TAXABLE BENEFITS: 17,426 JAMES, D.O., SCOTT VASCULAR SURGEON - JORDAN PHYSICIAN ASSOCIATES DR. JAMES DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, DR. JAMES PERFORMED SERVICES FOR JPA AND WAS COMPENSATED BY APHMFP. AS REQUIRED BY THIS FORM 990, DR. JAMES' COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 457,202 INCENTIVE COMPENSATION: 95,243 OTHER REPORTABLE COMPENSATION: 8,433 DEFERRED COMPENSATION: 26,000 NON-TAXABLE BENEFITS: 230 TIERNEY, D.O., MATTHEW LAPAROSCOPIC SURGEON - JORDAN PHYSICIAN ASSOCIATES DR. TIERNEY DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, DR. TIERNEY PERFORMED SERVICES FOR JPA AND WAS COMPENSATED BY APHMFP. AS REQUIRED BY THIS FORM 990, DR. TIERNEY'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 378,423 INCENTIVE COMPENSATION: 87,038 OTHER REPORTABLE COMPENSATION: 6,201 DEFERRED COMPENSATION: 26,000 NON-TAXABLE BENEFITS: 29,160 KOOMEY, M.D., JAMES M. MEDICAL ONCOLOGIST - JORDAN PHYSICIAN ASSOCIATES DR. KOOMEY DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, DR. KOOMEY PERFORMED SERVICES FOR JPA AND WAS COMPENSATED BY APHMFP. AS REQUIRED BY THIS FORM 990, DR. KOOMEY'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 307,986 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,120 DEFERRED COMPENSATION: 26,000 NON-TAXABLE BENEFITS: 26,660 WHITE, M.D., DEBRA HOLIK MEDICAL ONCOLOGIST - JORDAN PHYSICIAN ASSOCIATES DR. WHITE DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, DR. WHITE PERFORMED SERVICES FOR JPA AND WAS COMPENSATED BY APHMFP. AS REQUIRED BY THIS FORM 990, DR. WHITE'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 281,216 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,020 DEFERRED COMPENSATION: 26,000 NON-TAXABLE BENEFITS: 24,805 HARVEY, M.D., KYLE PHYSICIAN, GENERAL SURGERY - JORDAN PHYSICIAN ASSOCIATES DR. HARVEY DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2014 CALENDAR YEAR, DR. HARVEY PERFORMED SERVICES FOR JPA AND WAS COMPENSATED BY APHMFP. AS REQUIRED BY THIS FORM 990, DR. HARVEY'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 292,400 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 3,812 DEFERRED COMPENSATION: 26,000 NON-TAXABLE BENEFITS: 14,435 IANNONI, JOSEPH FORMER VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER - JORDAN PHYSICIAN ASSOCIATES FORMER VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH FORMER VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER - JORDAN HEALTH SYSTEMS, INC. MR. IANNONI RESIGNED FROM THE ABOVE ROLES EFFECTIVE FEBRUARY 18, 2014. MR. IANNONI DEVOTED, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE 2014 CALENDAR YEAR, MR. IANNONI PERFORMED SERVICES FOR BID-PLYMOUTH, JHSI AND JPA AND WAS COMPENSATED BY JHSI. AS REQUIRED BY THIS FORM 990, THE PORTION OF MR. IANNONI'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 19,678 INCENTIVE COMPENSATION: 9,866 OTHER REPORTABLE COMPENSATION: 142,173 DEFERRED COMPENSATION: 18,000 NON-TAXABLE BENEFITS: 997 PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 78,713 INCENTIVE COMPENSATION: 39,466 OTHER REPORTABLE COMPENSATION: 568,693 DEFERRED COMPENSATION: 72,000 NON-TAXABLE BENEFITS: 3,989 OTHER REPORTABLE AND DEFERRED COMPENSATION INCLUDES A 457(F) PLAN DISTRIBUTION OF $410,123, WHICH INCLUDED $90,000 OF WHICH WAS REPORTABLE ON PREVIOUS FORM 990 AS DEFERRED COMPENSATION, AND SALARY CONTINUATION PAYMENTS OF $298,732 AND $90,000 OF EMPLOYER CONTRIBUTIONS TO A 457(F) PLAN. FORM 990, PART I & PART III, LINE 1 DESCRIPTION OF ORGANIZATION'S MISSION JORDAN PHYSICIAN ASSOCIATES (JPA) IS A NETWORK OF COMMUNITY BASED PHYSICIANS AFFILIATED WITH BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH. JPA IS AFFILIATED WITH BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BID-PLYMOUTH OR HOSPITAL) AND BOTH ARE COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING HIGH QUALITY, PERSONALIZED HEALTH CARE WITH COMPASSION, DIGNITY AND RESPECT FOR PATIENT RIGHTS IN A COST EFFECTIVE AND SAFE ENVIRONMENT. JPA IS DEDICATED TO PROVIDING CUTTING-EDGE CARE TO PATIENTS IN THE COMMUNITIES WHERE THEY LIVE AND WORK, REGARDLESS OF THEIR RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. THE PHYSICIANS OF JPA PROUDLY SERVE THE COMMUNITIES OF BOURNE, CARVER, DUXBURY, HALIFAX, KINGSTON, LAKEVILLE, PEMBROKE, PLYMPTON, PLYMOUTH, MARSHFIELD, MIDDLEBORO, SANDWICH AND WAREHAM. JORDAN HEALTH SYSTEMS INC. (JHSI) IS THE SOLE MEMBER OF JPA. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), A TERTIARY CARE ACADEMIC MEDICAL CENTER AND FLAGSHIP TEACHING AFFILIATE OF HARVARD MEDICAL SCHOOL, IS THE SOLE MEMBER OF BID-PLYMOUTH AND JHSI. FORM 990, PART III, LINE 4A SPECIALTY CARE JPA PROVIDES SPECIALTY CARE TO THE COMMUNITY IN THE AREAS OF OBSTETRICS, ONCOLOGY, NEUROLOGY, ENDOCRINOLOGY, SPINE CARE AND MULTIPLE SURGICAL SPECIALTY AREAS. DURING THE PERIOD COVERED BY THIS FILING, FIFTY SPECIALISTS PROVIDED 138,294 VISITS TO PATIENTS IN THE COMMUNITIES THEY SERVE. FORM 990, PART III, LINE 4B HOSPITALISTS HOSPITALISTS ARE PHYSICIANS WHO SPECIALIZE IN THE CARE OF THE HOSPITALIZED PATIENT AND THESE PHYSICIANS PROVIDE PATIENT CONTINUITY OF CARE FOR JPA PATIENTS WHEN THEY ARE IN THE HOSPITAL. THEIR EXCLUSIVE FOCUS IS PROVIDING THE BEST PATIENT CARE FOR THE PATIENT DURING A HOSPITAL STAY. HOSPITALISTS ARE IN THE HOSPITAL THROUGHOUT THE DAY AND CAN QUICKLY FOLLOW UP ON PATIENT PROGRESS AND TEST RESULTS AND COMMUNICATE WITH THE PATIENT ON A ROUTINE BASIS WHILE HOSPITALIZED. THEY COORDINATE TREATMENT OF HOSPITALIZED PATIENTS BY COMMUNICATING WITH THE PATIENT'S PRIMARY CARE PHYSICIAN AS WELL AS ENSURING COORDINATION WITH ANY REQUIRED SPECIALISTS DURING A PATIENT'S HOSPITAL STAY. FORM 990, PART III, LINE 4C PRIMARY CARE SERVICES JORDAN PHYSICIAN ASSOCIATES (JPA) HAS FOURTEEN PHYSICIAN OFFICES THAT SPECIALIZE IN THE DELIVERY OF PRIMARY CARE IN PLYMOUTH AND THE OTHER COMMUNITIES SERVED BY JPA AND BID-PLYMOUTH. PRIMARY CARE PHYSICIANS (PCPS) ARE COMMUNITY BASED MEDICAL DOCTORS WHO GENERALLY PROVIDE THE FIRST CONTACT FOR A PATIENT WITH A NON-EMERGENT UNDIAGNOSED HEALTH CONCERN, AS WELL AS CONTINUING CARE FOR A VARIETY OF MEDICAL CONDITIONS, KEEPING CARE IN THE COMMUNITY WHEN IT IS APPROPRIATE. WHEN ADVANCED CARE IS NEEDED, JPA PROVIDES CONVENIENT ACCESS TO HIGH QUALITY COMMUNITY CARE AT ITS AFFILIATE, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, AND LEADING EDGE TREATMENT FROM BETH ISRAEL DEACONESS MEDICAL CENTER, A WORLD RENOWNED TERTIARY CARE ACADEMIC MEDICAL CENTER AND THE SOLE MEMBER OF BID-PLYMOUTH. DURING THE PERIOD COVERED BY THIS FILING, JPA PCPS PROVIDED 32,462 VISITS TO PATIENTS IN THE COMMUNITIES THEY SERVE. QUESTION 12 AND 12A - STATEMENT RE AUDITED FINANCIAL STATEMENTS THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE MEDICAL CENTER AND AFFILIATES FOR FISCAL YEAR ENDED SEPTEMBER 30, 2015. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE MEDICAL CENTER AND ITS SUBSIDIARIES, (MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A AFFILIATED PHYSICIANS GROUP (APG)), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), JORDAN HEALTH SYSTEMS INC. AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER. QUESTION 7G CONTRIBUTIONS OF INTELLECTUAL PROPERTY JORDAN PHYSICIAN ASSOCIATES DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899. QUESTION 7H CONTRIBUTIONS OF CARS, BOATS, AIRPLANES AND OTHER VEHICLES JORDAN PHYSICIAN ASSOCIATES DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 1098-C. FORM 990, PART VI, SECTION A, LINE 2 AS NOTED IN VARIOUS NARRATIVE DISCLOSURES WHICH SUPPORT THIS FORM 990 AND RELATED SCHEDULES, CAREGROUP, INC. (CAREGROUP) IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CAREGROUP'S PURPOSE IS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MAKE UP THE CAREGROUP SYSTEM. CAREGROUP SERVES AS THE SOLE MEMBER AND A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER). BIDMC IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH) AND JORDAN HEALTH SYSTEMS, INC. (JHSI), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BIDN), MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A AFFILIATED PHYSICIANS GROUP (APG) AND BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON). AS NOTED IN THIS FILING, JHSI IS THE SOLE MEMBER OF JPA. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER AND ITS AFFILIATES ACCOMPLISH THEIR CHARITABLE PURPOSES. CAREGROUP ALSO SERVES AS THE SOLE MEMBER AND A SUPPORT ORGANIZATION OF NEW ENGLAND BAPTIST HOSPITAL (NEBH) AND MOUNT AUBURN HOSPITAL (MAH), WHICH IN TURN SERVE AS THE SOLE MEMBER OF NEW ENGLAND BAPTIST MEDICAL ASSOCIATES (NEBMA) AND MOUNT AUBURN PROFESSIONAL SERVICES (MAPS), RESPECTIVELY. EACH OF THE ENTITIES LISTED IN THIS PARAGRAPH MAY, IN TURN, SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE CAREGROUP NETWORK OF AFFILIATES. 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 AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE CAREGROUP NETWORK OF AFFILIATED ORGANIZATIONS. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. FORM 990, PART VI, SECTION A, LINE 6 THE JORDAN HEALTH SYSTEMS, INC. (JHSI) IS A MASSACHUSETTS CHARITABLE CORPORATION, EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986 AS AMENDED, AND ACTING THROUGH ITS BOARD OF DIRECTORS, IS THE SOLE MEMBER OF JORDAN PHYSICIAN ASSOCIATES, INC. (JPA). FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO THE AMENDED AND RESTATED BYLAWS OF JPA, JHSI, AS SOLE CORPORATE MEMBER, HAS THE FOLLOWING RESERVED POWERS WHICH IT MAY EXERCISE ON ITS OWN INITIATIVE UPON A TWO-THIRDS (2/3) VOTE OF ITS DIRECTORS ELIGIBLE TO VOTE ON ITS BOARD OF DIRECTORS (THE "MEMBER BOARD"), WITH OR WITHOUT THE APPROVAL OF THE JPA BOARD OF TRUSTEES ("BOARD") OR UPON A MAJORITY VOTE OF ITS DIRECTORS ELIGIBLE TO VOTE IN THE EVENT THE BOARD HAS RECOMMENDED ANY OF THE LISTED ACTIONS: 1.REMOVE A MEMBER OF THE BOARD; 2.UPON PRIOR DISCUSSION WITH THE BOARD, ESTABLISH OR MODIFY THE COMPENSATION OF, AND/OR APPOINT OR REMOVE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION; 3.AMEND THE CORPORATION BYLAWS OR ARTICLES OF ORGANIZATION; 4.CAUSE THE CORPORATION TO ENTER INTO (I) MANAGED CARE CONTRACTS, OTHER PAYER AGREEMENTS, EXCLUSIVE CONTRACTS, AGREEMENTS-NOT-TO-COMPETE, OR SIMILAR ARRANGEMENTS, (II) CONTRACTS FOR MANAGEMENT SERVICES WITH POTENTIALLY SIGNIFICANT MULTI-YEAR BUDGETARY IMPACT, OR (III) OTHER MULTI-YEAR SERVICE CONTRACTS WITH POTENTIALLY SIGNIFICANT MULTI-YEAR BUDGETARY IMPACT; 5.MERGE OR OTHERWISE CONSOLIDATE THE CORPORATION WITH ANOTHER ENTITY; 6.DISPOSE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION, OR DISPOSE OF ANY SUBSIDIARY OR AFFILIATED CORPORATIONS OF THE CORPORATION; 7.CREATE OR ACQUIRE A SUBSIDIARY OR AFFILIATED CORPORATION OF THE CORPORATION; 8.DISCONTINUE OR INSTITUTE A CLINICAL DEPARTMENT OR DEPARTMENTS OR PROGRAMS WHICH COULD REASONABLY BE ANTICIPATED TO MATERIALLY AFFECT THE FINANCIAL STATUS OF THE CORPORATION OR ITS ABILITY TO CONTINUE TO CONDUCT ITS BUSINESS; 9.TO THE EXTENT LEGALLY PERMISSIBLE, TAKE SUCH ACTIONS TO CAUSE ASSETS OF THE CORPORATION TO BE TRANSFERRED, OTHER THAN IN THE ORDINARY COURSE OF CONDUCT OF THE CORPORATION BUSINESS, TO THE MEMBER TO ADVANCE THE CHARITABLE PURPOSES OF THE MEMBER OR THE CORPORATION; AND 10.DISSOLVE THE CORPORATION TO THE EXTENT PERMITTED BY LAW. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER. BIDMC, A FLAGSHIP TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL, IS KNOWN FOR ITS EXEMPLARY PATIENT CARE, CONDUCTING "LEADING EDGE" CLINICAL AND BASIC SCIENCE RESEARCH AND SUPPORTING OUTSTANDING EDUCATIONAL PROGRAMS. BIDMC IS A HOSPITAL EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986 AS AMENDED, AND ACTING THROUGH ITS BOARD OF DIRECTORS, IS THE SOLE MEMBER OF THE JORDAN HEALTH SYSTEMS, INC. (JHSI). BIDMC ALSO SERVES AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH WHICH, AS NOTED THROUGHOUT THIS NARRATIVE, IS AN AFFILIATE OF BOTH JPA AND JHSI. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION, TO THE RESERVED POWERS NOTED ABOVE, JHSI AS MEMBER OF JPA MAY NOT EXERCISE THE FOLLOWING RESERVED POWERS WITHOUT PRIOR CONSULTATION WITH, AND THE PRIOR APPROVAL OF, BIDMC. 1.ANY ACTION DESCRIBED ABOVE AS A MEMBER RESERVED POWER; 2.APPROVAL OF THE STRATEGIC, FINANCIAL AND OPERATIONAL PLANS; 3.APPROVAL OF THE ANNUAL OPERATING AND CAPITAL BUDGETS; 4.CAPITAL EXPENDITURES BEYOND THE APPROVED CAPITAL BUDGET; 5.BORROWING OR INCURRING OF DEBT; 6.THE APPOINTMENT OF THE INDEPENDENT AUDITOR AND APPROVAL OF THE INDEPENDENT FINANCIAL AUDITS; 7.ENTERING INTO MANAGED CARE CONTRACTS, EXCLUSIVE CONTRACTS, AND OTHER MULTI-YEAR MATERIAL CONTRACTS; 8.ENTERING INTO ANY PARTNERSHIP/AFFILIATION ARRANGEMENTS OR JOINT VENTURE PROPOSALS; 9.THE CREATION, ACQUISITION, OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION, AND THE ADDITION OR ELIMINATION OF ANY CLINICAL DEPARTMENTS OR PROGRAMS; AND, 10.AMENDMENTS TO THE CORPORATION'S BYLAWS OR ARTICLES OF ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING THE FORM 990, RELATED SCHEDULES AND REQUIRED DISCLOSURES (RETURN), THE RETURN IS REVIEWED BY JPA'S CHIEF FINANCIAL OFFICER, THE TAX DIRECTOR OF CAREGROUP, AND THE RETURN IS REVIEWED AND SIGNED BY DELOITTE TAX, LLP. AS NOTED IN THIS RETURN, CAREGROUP IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER WHICH IS, IN TURN, THE SOLE MEMBER OF BID-PLYMOUTH AND JHSI. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF THE JPA BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12 AS NOTED THROUGHOUT THIS FILING, JORDAN HEALTH SYSTEMS, INC. (JHSI) SERVES AS IS THE SOLE MEMBER OF JORDAN PHYSICIAN ASSOCIATES, INC. (JPA). ALTHOUGH JPA'S BOARD OF TRUSTEES HAS NOT SEPARATELY ADOPTED A CONFLICT OF INTEREST POLICY, JHSI HAS ADOPTED A CONFLICT OF INTEREST POLICY ON BEHALF OF JPA WHICH MIRRORS THE JHSI WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND IS THE SOLE MEMBER OF JHSI AND BID-PLYMOUTH. THE BIDMC OFFICE OF COMPLIANCE AND BUSINESS CONDUCT ADMINISTERS A CONFLICT OF INTEREST QUESTIONNAIRE PROCESS ANNUALLY IN CONJUNCTION WITH THE BID-PLYMOUTH OFFICE OF COMPLIANCE AND PROVIDES A SUMMARY OF POSITIVE RESPONSES TO BID-PLYMOUTH'S COMPLIANCE OFFICER FOR REVIEW AND DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. ANY ACTIVITY THAT REQUIRES ACTION UNDER THE CONFLICT OF INTEREST POLICY IS SUBJECT TO ONGOING REVIEW. PURSUANT TO THE CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A PLAN TO REQUIRE DISCLOSURE AND RECUSAL, INCLUDING APPROPRIATE DOCUMENTATION IN THE MINUTES. IN ADDITION TO THE CONFLICT OF INTEREST PROCESS OUTLINED ABOVE, THE CAREGROUP TAX DEPARTMENT ISSUES AN ANNUAL TAX QUESTIONNAIRE TO ALL CURRENT AND FORMER MEMBERS OF THE JPA BOARD OF DIRECTORS AS WELL AS CURRENT AND FORMER BIDP OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR THE HOSPITAL 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 DESCRIPTION OF PROCESS TO DETERMINE COMPENSATION OF THE ORGANIZATIONS CEO AND OTHER OFFICERS AND KEY EMPLOYEES AS NOTED THROUGHOUT THIS FILING, BID-PLYMOUTH IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND AN AFFILIATE OF JORDAN PHYSICIAN ASSOCIATES (JPA). BID-PLYMOUTH HAS AN EXECUTIVE COMPENSATION COMMITTEE WHICH IS COMPOSED OF MEMBERS OF THE BOARD OF DIRECTORS, THE CHIEF FINANCIAL OFFICER AND THE VICE PRESIDENT OF HUMAN RESOURCES. THE BID-PLYMOUTH EXECUTIVE COMPENSATION COMMITTEE ESTABLISHES THE COMPENSATION STRUCTURE OF THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF INFORMATION OFFICER AND OTHER SENIOR MANAGEMENT. THE BID-PLYMOUTH EXECUTIVE 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. THE EXECUTIVE COMPENSATION COMMITTEE APPROVES RECOMMENDATIONS FOR INCENTIVE COMPENSATION TO THESE INDIVIDUALS ON AN ANNUAL BASIS AND AS SUCH, REVIEWS TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS ANNUALLY. IN SETTING COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEY STUDIES PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF SIMILAR ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWED THE COMPENSATION SURVEY DATA PREPARED BY AN INDEPENDENT CONSULTING FIRM. TO ENSURE INDEPENDENCE, ONCE THE DATA WAS PRESENTED, NO BID-PLYMOUTH OR JPA STAFF WAS PRESENT FOR THESE DISCUSSIONS. THE EXECUTIVE COMPENSATION COMMITTEE VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS LISTED ABOVE. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: JORDAN PHYSICIAN ASSOCIATES C/O BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH, INC. 275 SANDWICH STREET PLYMOUTH, MA 02360 FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,240,447. MANAGEMENT AND GENERAL EXPENSES 28,371. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,268,818. REIMBURSEMENT FOR PHYSICIAN/SPECIALIST SERVICES BY APHMFP AT JPA: PROGRAM SERVICE EXPENSES 13,807,393. MANAGEMENT AND GENERAL EXPENSES 779,864. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,587,257. FORM 990, PART XI, LINE 9: NET TRANSFERS FROM AFFILIATES 6,929,352. FORM 990 PART XII QUESTION 2B, 2C AND 2D AS PREVIOUSLY REPORTED IN THIS FILING, JORDAN PHYSICIAN ASSOCIATES (JPA) IS AN AFFILIATE OF BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BIDP), AND BOTH ARE PUBLIC CHARITIES EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. ALSO AS PREVIOUSLY NOTED, BETH ISRAEL DEACONESS MEDICAL CENTER, A TERTIARY CARE ACADEMIC MEDICAL CENTER, FLAGSHIP TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL, AN ENTITY EXEMPT FROM INCOME TAXES UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, IS THE SOLE MEMBER OF BIDP AND JORDAN HEALTH SYSTEMS INC (JHSI). JHSI IS THE SOLE MEMBER OF JPA. THE FINANCIAL RECORDS OF BIDP, JHSI AND JPA ARE AUDITED EACH YEAR AS PART OF THE BIDMC CONSOLIDATED AUDITED FINANCIAL STATEMENT PROCESS, AND FOR THE PERIOD COVERED BY THIS FILING THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THESE FINANCIAL STATEMENTS. THIS PROCESS IS MONITORED AND REVIEWED INTERNALLY BY BOTH THE BIDMC AND BIDP COMPLIANCE, AUDIT AND RISK COMMITTEES. SCHEDULE L PART IV COLUMN (D) DESCRIPTION OF TRANSACTIONS INVOLVING INTERESTED PERSONS VARIOUS CURRENT AND FORMER OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES OF JPA, BID-PLYMOUTH AND JHSI MAY ALSO HOLD POSITIONS WITH OTHER ENTITIES WHICH MAKE CHARITABLE CONTRIBUTIONS TO BID-PLYMOUTH AND/OR JHSI. SUCH CONTRIBUTIONS HAVE NOT BEEN INCLUDED IN THE DISCLOSURES ABOVE. JPA, BID-PLYMOUTH AND JHSI MAINTAIN ACCOUNTABLE BUSINESS EXPENSE REIMBURSEMENT PLANS. FROM TIME TO TIME, JPA, BID-PLYMOUTH OR JHSI MAY REIMBURSE ITS OFFICERS, DIRECTORS/TRUSTEES AND/OR KEY EMPLOYEES FOR EXPENSES THEY INCURRED AND WHICH ARE PROPERLY ORDINARY AND NECESSARY BUSINESS EXPENSES OF THE REPORTING ENTITY. THE POLICIES AND PROCEDURES REQUIRED BY THE ACCOUNTABLE BUSINESS PLAN MUST BE FOLLOWED IN ORDER TO RECEIVE REIMBURSEMENT FOR SUCH EXPENSES AND IT IS POSSIBLE THAT ONE OR MORE INDIVIDUALS RECEIVED NON-TAXABLE REIMBURSEMENTS WHICH TOTALED $10,000 OR MORE DURING THE FISCAL PERIOD COVERED BY THIS FILING. ALL OF THE ABOVE TRANSACTIONS WERE NEGOTIATED AT ARMS-LENGTH AND IN ACCORDANCE WITH THE JPA, BID-PLYMOUTH, JHSI AND/OR BIDMC CONFLICT OF INTEREST POLICIES. ASSOC PHYS HARVARD MED FAC PHY AT BIDMC 375 LONGWOOD AVE BOSTON MA 02215 320058309 TO PROVIDE EMERGENCY MEDICAL SERVICES MA 501(C)(3) LINE 11A, I HMFP AT BIDMC 0 BI ANAESTHESIA FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042997215 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC 0 BI COMMUNITY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042776678 INACTIVE CORPORATION MA 501(C)(3) LINE 7 N/A 0 BI DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043079630 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC 0 BI DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 208253452 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC 0 BI DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043030397 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC 0 BI DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 204974585 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC 0 BI DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC 110 FRANCIS STREET BOSTON MA 02215 020671240 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC 0 BI DEACONESS HOSPITAL - NEEDHAM INC 148 CHESTNUT ST NEEDHAM MA 02492 043229679 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. 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MA 501(C)(2) CAREGROUP INC 0 HARVARD MEDICAL COLLABORATIVE INC 25 SHATTUCK ST BOSTON MA 02215 043476764 COORDINATE AND PROVIDE STATEGIC PLANNING OPP FOR HMS MA 501(C)(3) LINE 11A, I N/A 0 HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC 375 LONGWOOD AVE BOSTON MA 02215 222768204 GENERAL AND SPECIALIZED MEDICAL SERVICES TO THE PATIENTS OF BIDMC AND OTHERS MA 501(C)(3) LINE 9 N/A 0 BETH ISRAEL DEACONESS HOSPITAL - MILTON INC 199 REEDSDALE RD MILTON MA 02186 042103604 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. 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