CARL J SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: CARL J SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD (EIN 04-3326928)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-15
IRS object ID: 201421359349300037
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule D
Schedule F
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-15T08:33:50-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	861065772	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DELOITTE TAX LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	TWO JERICHO PLAZA	AddressLine1
City	JERICHO	City
State	NY	State
ZIP Code	11753	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	043326928	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CARL J SHAPIRO INSTITUTE FOR EDUCATION	BusinessNameLine1
Business Name Line2	RESEARCH AT HARVARD MEDICAL SCHOOL	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	CARL	NameControl
Phone	6176670608	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	330 BROOKLINE AVENUE NO ES 2	AddressLine1
City	BOSTON	City
State	MA	State
ZIP Code	022155400	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	RICHARD SCHWARTZSTEIN	Name
Title	MD, EXECUTIVE DIRECTOR	Title
Phone	6176670608	Phone
Date Signed	2014-05-15	DateSigned
Authorize Third Party	0	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
PTIN	P00743140	PTIN
Phone	5169187000	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	RICHARD SCHWARTZSTEIN MD	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	330 BROOKLINE AVENUE NO ES 2	AddressLine1
City	BOSTON	City
State	MA	State
ZIP Code	022155400	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	603040	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	SEE SCHEDULE O	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1996	YearFormation
State Legal Domicile	MA	StateLegalDomicile
Activity Or Mission Description	SEE SCHEDULE O.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	14	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	2	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	237	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	55500	ContributionsGrantsPriorYear
Contributions Grants Current Year	18622	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	945473	ProgramServiceRevenuePriorYear
Program Service Revenue CY	523354	ProgramServiceRevenueCY
Investment Income Prior Year	39403	InvestmentIncomePriorYear
Investment Income Current Year	46567	InvestmentIncomeCurrentYear
Other Revenue Prior Year	0	OtherRevenuePriorYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	1040376	TotalRevenuePriorYear
Total Revenue Current Year	588543	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	104690	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	0	SalariesEtcPriorYear
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	608402	OtherExpensePriorYear
Other Expenses Current Year	534128	OtherExpensesCurrentYear
Total Expenses Prior Year	608402	TotalExpensesPriorYear
Total Expenses Current Year	638818	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	431974	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-50275	RevenuesLessExpensesCY
Total Assets BOY	2863784	TotalAssetsBOY
Total Assets EOY	2864660	TotalAssetsEOY
Total Liabilities BOY	126382	TotalLiabilitiesBOY
Total Liabilities EOY	49407	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	2737402	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	2815253	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	SEE SCHEDULE O	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	10658	Expense
Revenue	27763	Revenue
Description	SIMULATION AND SKILLS CENTER - THE CENTER PROVIDES TRAINEES WITH PRACTICE OPPORTUNITIES FOR LAPAROSCOPIC AND OTHER SURGICAL PROCEDURES AND REALISTIC OPERATING AND INTENSIVE CARE/EMERGENCY ROOM SIMULATIONS WHICH ALLOW FOR TEAM TRAINING AND DISCIPLINE-SPECIFIC EDUCATIONAL EXPERIENCES. THE CENTER'S RESOURCES INCLUDE A WIDE RANGE OF TASK TRAINERS AND SIMULATORS, VIDEOCONFERENCE FACILITIES AND DEDICATED FACULTY AND STAFF TO SUPPORT THE EDUCATION OF STUDENTS, TRAINEES, AND PRACTITIONERS IN ALL OF THE HEALTH CARE PROFESSIONS.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	72629	Expense
Revenue	114970	Revenue
Description	CONTINUING MEDICAL EDUCATION COURSES - THE INSTITUTE SPONSORS CONTINUING MEDICAL EDUCATION COURSES. FOR EXAMPLE "MAXIMIZING YOUR TEACHING SKILLS: PRINCIPLES OF MEDICAL EDUCATION" IS AN INTRODUCTION TO THE PRINCIPLES OF EFFECTIVE CLINICAL TEACHING FOR ADULT LEARNERS. THROUGH DIDACTIC AND INTERACTIVE SESSIONS, PARTICIPANTS LEARN MODELS OF CLINICAL INSTRUCTION AND HOW TO APPLY THESE EFFECTIVE TECHNIQUES TO THEIR OWN TEACHING ACTIVITIES. THE COURSE ALSO PROVIDES AN EXPLORATION OF CRITICAL THINKING, REFLECTION, ASSESSMENT, AND FEEDBACK. THE INSTITUTE HELPS TO FURTHER THE IMPACT OF CUTTING EDGE SIMULATION AND SKILLS CENTER FOR EDUCATION THROUGH A COURSE IN "ESTABLISHING A SIMULATION & SKILLS TRAINING CENTER" THAT HELPS PARTICIPANTS PLAN, IMPLEMENT, AND MANAGE NEW SIMULATION AND SKILLS CENTERS IN THE PARTICIPANTS' RESPECTIVE MEDICAL EDUCATION INSTITUTIONS.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	282403	Expense
Revenue	365961	Revenue
Description	THE SHAPIRO INSTITUTE WORKS IN COLLABORATION WITH OTHERS TO ENHANCE THE PROFESSIONAL TEACHING ABILITIES OF THEIR MEDICAL FACULTY BY PROVIDING EDUCATIONAL PROGRAMS FOR INDIVIDUALS AND GROUPS. IN THESE PROGRAMS, SHAPIRO INSTITUTE FACULTY TEACH DOCTORS THE SKILLS NECESSARY TO BE MEDICAL EDUCATORS. THESE PROGRAMS ARE DESIGNED TO IMPROVE THE EDUCATIONAL KNOWLEDGE AND ABILITIES OF FACULTY RESPONSIBLE FOR TEACHING MEDICAL TRAINEES AND OTHER HEALTH PROFESSIONALS WHO PROVIDE PATIENT CARE. THROUGH THESE EFFORTS, THE INSTITUTE HOPES TO ULTIMATELY IMPROVE THE QUALITY OF HEALTH CARE MORE BROADLY.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	212677	Expense
Grants	104690	Grants
Revenue	14660	Revenue
Description	THE SHAPIRO INSTITUTE'S MEDICAL EDUCATION TRAINING EXTENDS BEYOND TRADITION MEDICAL SURGICAL SKILLS TRAINING. "THE FAMILY MEETING PROJECT" PROVIDES RESIDENTS WITH TRAINING RELATED TO COMMUNICATING AND INTERACTING WITH PATIENTS' FAMILY MEMBERS IN A SIMULATED INTENSIVE CARE UNIT (ICU) AND CRITICAL CARE ENVIRONMENT. THE SHAPIRO INSTITUTE ALSO PROVIDES SUPPORT FOR A RESIDENT TO CONDUCT MEDICAL EDUCATION RESEARCH RELATED TO THE IMPACT OF EDUCATIONAL INTERVENTIONS ON PROVIDING SAFE AND EFFECTIVE PATIENT CARE.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	212677	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	104690	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	14660	TotalOfOtherProgramServiceRev
Total Program Service Expense	578367	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	1	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	1	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Info In Schedule O Part V	X	InfoInScheduleOPartV
Number Forms Transmitted With1096	35	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Number Of8282 Filed	0	NumberOf8282Filed
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Form8899 Filed	0	Form8899Filed
Form1098 C Filed	0	Form1098CFiled
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	14	NbrVotingGoverningBodyMembers
Number Independent Voting Members	2	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	0	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	MA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	CHRISTINE COUGHLIN	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	6176679120	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	330 BROOKLINE AVE EAST CAMPUS/ES-20	AddressLine1
City	BOSTON	City
State	MA	State
ZIP Code	02215	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	FormerFormer
CHAIKOF MD PHD ELLIOT L
TRUSTEE	1.00	64.00	X	0	908734	110681
EDELHEIT PHD LEWIS S
TRUSTEE	1.00		X	0	0	0
FLIER MD JEFFREY S
TRUSTEE & CO-CHAIR	1.00	59.00	X	0	582243	51850	X
GOLDBERG CAROL R
TRUSTEE	1.00	1.00	X	0	0	0
GRAY PHD MARTHA
TRUSTEE	1.00		X	0	0	0
KAY STEPHEN
TRUSTEE	1.00	2.00	X	0	0	0
RABKIN MD MITCHELL T
TRUSTEE	1.00	2.00	X	0	0	0
ROSENBERG MD STUART A
TRUSTEE	1.00	64.00	X	0	766137	466881
SCHWARTZSTEIN MD RICHARD M
TRUSTEE & PRESIDENT	14.00	64.00	X	114681	383931	50599	X
STEVENSON MD PHD MARY ANN
TRUSTEE	1.00	59.00	X	0	601275	72473
SUKHATME MD PHD VIKAS P
TRUSTEE	1.00	59.00	X	0	623519	49475
TABB MD KEVIN
TRUSTEE & CO-CHAIR	1.00	64.00	X	0	1331765	48187	X
ZEIDEL MD MARK L
TRUSTEE	1.00	64.00	X	0	710613	56575
ZINNER MD STEPHEN
TRUSTEE	1.00	0.50	X	0	0	0
HUGHES CAROL M
CLERK & OPERATIONS MANAGER	12.00	48.00		52600	98029	26751	X
COUGHLIN CHRISTINE
ASSOCIATE DIRECTOR	2.00	18.00		3000	48050	2760	X
WANG DIANA
TREASURER	12.00	8.00		19594	13063	1447	X
BUEHRENS ERIC
FORMER TRUSTEE & CO-CHAIR	0.00	0.00		0	706584	33190		X
LEVY MD PAUL F
FORMER TRUSTEE & CO-CHAIR	0.00	0.00		0	777205	9474		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	189875	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	7551148	TotalReportableCompFrmRltdOrgs
Total Other Compensation	980343	TotalOtherCompensation
Number Individuals GT100 K	1	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
All Other Contributions	18622	AllOtherContributions
Total Contributions	18622	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	PROGRAM FEES	Description
Business Code	900099	BusinessCode
Total Revenue Column	523354	TotalRevenueColumn
Related Or Exempt Function Income	523354	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	523354	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	5012	TotalRevenueColumn
Unrelated Business Revenue	192	UnrelatedBusinessRevenue
Exclusion	$4,820	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	56052	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	14497	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	41555	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	41555	TotalRevenueColumn
Unrelated Business Revenue	45	UnrelatedBusinessRevenue
Exclusion	$41,510	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	588543	TotalRevenueColumn
Related Or Exempt Function Income	523354	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	237	UnrelatedBusinessRevenue
Exclusion	$46,330	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	100436	Total
Program Services	100436	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	4254	Total
Program Services	4254	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	34229	Total
Program Services	19729	ProgramServices
Management And General	14500	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	2968	Total
Management And General	2968	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	131330	Total
Program Services	111069	ProgramServices
Management And General	20261	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	11573	Total
Program Services	10902	ProgramServices
Management And General	671	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1645	Total
Program Services	1645	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	9230	Total
Program Services	8438	ProgramServices
Management And General	792	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	110594	Total
Program Services	110054	ProgramServices
Management And General	540	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	10009	Total
Management And General	10009	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
TEACHING HONORARIUM	143400	143400	0
MISCELLANEOUS	12154	2283	9871
COPYRIGHT PERMISSION	6467	6467	0
DUES & SUBSCRIPTIONS	4508	3669	839

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	56021	Total
Program Services	56021	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	638818	Total
Program Services	578367	ProgramServices
Management And General	60451	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	969151	BOY
EOY	512759	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	200981	BOY
EOY	118495	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	152780	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	81131	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	79614	BOY
EOY	71649	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	1284445	BOY
EOY	1897330	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	329593	BOY
EOY	264427	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	2863784	BOY
EOY	2864660	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	22456	BOY
EOY	24980	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	13333	BOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	90593	BOY
EOY	24427	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	126382	BOY
EOY	49407	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1103364	BOY
EOY	1156723	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	736038	BOY
EOY	760531	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	898000	BOY
EOY	898000	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2737402	BOY
EOY	2815253	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	2863784	BOY
EOY	2864660	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-50275	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	128126	ReconciliationUnrealizedInvest
Reconcilation Other Changes	0	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	0	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	X	SupportingOrganization509a3
Supporting Org509a3 Type1	X	SupportingOrg509a3Type1
Certification Checkbox	X	CertificationCheckbox
Written IRS Determination	X	WrittenIRSDetermination
Contrib By Controlling Individual	0	ContribByControllingIndividual
Contribution By Related Party	0	ContributionByRelatedParty
Contrib By35 Controlled Entity	0	ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (2 entries)

EINEIN	Type Of OrganizationTypeOfOrganization	Listed In Governing DocListedInGoverningDoc	Supported Organization NotifiedSupportedOrganizationNotified	Organized In USOrganizedInUS	AmountAmount
BETH ISRAEL DEACONESS MEDICAL CENTER
042103881	3	1	1	1	$319,409
PRESIDENT & FELLOWS OF HARVARD COLLEGE
042103580	4	1	1	1	$319,409

Field	Value	IRS element (for citing)
Total Number Of Supported Orgs	2	TotalNumberOfSupportedOrgs
Sum Of Amounts	638818	SumOfAmounts

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1634038	BeginningOfYearBalance
Investment Earnings Or Losses	165638	InvestmentEarningsOrLosses
Other Expenditures	141145	OtherExpenditures
End Of Year Balance	1658531	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1655773	BeginningOfYearBalance
Contributions	20000	Contributions
Investment Earnings Or Losses	20325	InvestmentEarningsOrLosses
Other Expenditures	62060	OtherExpenditures
End Of Year Balance	1634038	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1595377	BeginningOfYearBalance
Investment Earnings Or Losses	129560	InvestmentEarningsOrLosses
Other Expenditures	69164	OtherExpenditures
End Of Year Balance	1655773	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1607738	BeginningOfYearBalance
Investment Earnings Or Losses	116954	InvestmentEarningsOrLosses
Other Expenditures	129315	OtherExpenditures
End Of Year Balance	1595377	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2208131	BeginningOfYearBalance
Contributions	9456	Contributions
Investment Earnings Or Losses	-370199	InvestmentEarningsOrLosses
Other Expenditures	239650	OtherExpenditures
End Of Year Balance	1607738	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	0.55000	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.45000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	77250	OtherCostOrOtherBasis
Depreciation	19920	Depreciation
Book Value	57330	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	75530	OtherCostOrOtherBasis
Depreciation	61211	Depreciation
Book Value	14319	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	71649	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
CARE GROUP INVESTMENT PARTNERSHIP	1394104	F
TIME DEPOSITS AT LOCAL BANKS	503226	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	1897330	TotalOfBookValueSecurities

Other Assets OtherAssets (2 entries)

DescriptionDescription	Book ValueBookValue
TRUST RESIDUARY	240000
DUE FROM UNRESTRICTED NET ASSETS	24427

Field	Value	IRS element (for citing)
Total Book Value Other Assets	264427	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	DUE TO RESTRICTED NET ASSETS	Description
Amount	$24,427	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	24427	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	750770	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	128126	NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities	37070	DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990	165196	RevenueNotRptdF990
Revenue Subtotal	585574	RevenueSubtotal
Investment Expenses Not Included	2969	InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt	2969	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	588543	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	672919	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	37070	DonatedServicesUseOfFacilities
Expenses Not Rptd F990	37070	ExpensesNotRptdF990
Expenses Subtotal	635849	ExpensesSubtotal
Investment Expenses Not Included2	2969	InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt	2969	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	638818	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	PART V LINE 4 TEMPORARILY RESTRICTED NET ASSETS AT JUNE 30, 2013 CONSISTED OF THE FOLLOWING: MEDICAL EDUCATION $116,146 TRUST RESIDUARY $240,000 ACCUMULATED ENDOWMENT APPRECIATION $404,385 TOTAL TEMP. RESTRICTED $760,531 PERMANENTLY RESTRICTED NET ASSETS AS OF JUNE 30, 2013 CONSIST OF INVESTMENTS, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT THE FOLLOWING: EDUCATION TECHNOLOGY $500,000 MEDICAL EDUCATION $398,000 TOTAL PERM. RESTRICTED $898,000
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X, LINE 2:	THE INSTITUTE HAS EVALUATED THE TAX POSITIONS TAKEN ON RETURNS FOR OPEN YEARS AND THOSE EXPECTED TO BE TAKEN ON RETURNS FOR THE YEAR ENDED JUNE 30, 2013. IT IS MANAGEMENT'S BELIEF THAT SUCH TAX POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY TAX AUTHORITIES. ACCORDINGLY, NO LIABILITY FOR UNCERTAIN TAX POSITIONS HAS BEEN REFLECTED IN THESE FINANCIAL STATEMENTS. RETURNS FOR TAX YEARS BEGINNING WITH THOSE FILED FOR THE YEAR ENDED JUNE 30, 2010 ARE OPEN TO EXAMINATION.

Schedule F IRS990ScheduleF

Field	Value	IRS element (for citing)
Grant Records Maintained	1	GrantRecordsMaintained

Accts Actvs Out US Table AcctsActvsOutUSTable

Field	Value	IRS element (for citing)
Region	MIDDLE EAST AND NORTH AFRICA	Region
Number Of Offices	0	NumberOfOffices
Number Of Employees	0	NumberOfEmployees
Type Of Activities Conducted	PROGRAM SERVICES	TypeOfActivitiesConducted
Specific Services Provided	EDUCATION, TRAINING AND RESEARCH	SpecificServicesProvided
Total Expenditures	282403	TotalExpenditures

Field	Value	IRS element (for citing)
Subtotal Number Of Offices	0	SubtotalNumberOfOffices
Subtotal Number Of Employees	0	SubtotalNumberOfEmployees
Cont Number Of Offices	0	ContNumberOfOffices
Cont Number Of Employees	0	ContNumberOfEmployees
Total Number Of Offices	0	TotalNumberOfOffices
Total Number Of Employees	0	TotalNumberOfEmployees
Subtotal Amount Spent	282403	SubtotalAmountSpent
Cont Amount Spent	0	ContAmountSpent
Total Amount Spent	282403	TotalAmountSpent
Transfer To Foreign Corp	0	TransferToForeignCorp
Interest In Foreign Trust	0	InterestInForeignTrust
Own Foreign Corp	0	OwnForeignCorp
Passive Foreign Invest Co	1	PassiveForeignInvestCo
Foreign Partnership	0	ForeignPartnership
Boycott Countries	1	BoycottCountries

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Purpose Of GrantPurposeOfGrant
HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS
375 LONGWOOD AVE	BOSTON	MA	02215	222768204	501(C)(3)	90000	0	TO SUPPORT THE MEDICAL EDUCATION RESEARCH
BETH ISRAEL DEACONESS MEDICAL CENTER
330 BROOKLINE AVE	BOSTON	MA	02215	042103881	501(C)(3)	10436	0	TO SUPPORT THE MEDICAL EDUCATION RESEARCH ASSOCIATES

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: GRANT FUNDS ARE GIVEN TO THE PRINCIPAL INVESTIGATOR'S DEPARTMENT ADMINISTRATOR FOR DISTRIBUTION ACCORDING TO THE GRANT BUDGET. MONITORING OF THE RELATED RESEARCH ACTIVITY IS CONDUCTED BY THE DIRECTOR OF EDUCATION RESEARCH WITH THE PRINCIPAL INVESTIGATOR THROUGHOUT THE GRANT YEAR.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Substantiation Required	1	SubstantiationRequired
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CHAIKOF MD PHD ELLIOT L
TRUSTEE	0	894601	0	0	0	14133	0	78374	0	32307	0	1019415	0	0
FLIER MD JEFFREY S
TRUSTEE & CO-CHAIR	0	572911	0	0	0	9332	0	31995	0	19855	0	634093	0	0
ROSENBERG MD STUART A
TRUSTEE	0	622430	0	125924	0	17783	0	446875	0	20006	0	1233018	0	0
SCHWARTZSTEIN MD RICHARD M
TRUSTEE & PRESIDENT	102486	343107	10420	34883	1775	5941	5750	19250	5888	19711	126319	422892	0	0
STEVENSON MD PHD MARY ANN
TRUSTEE	0	591265	0	0	0	10010	0	46875	0	25598	0	673748	0	0
SUKHATME MD PHD VIKAS P
TRUSTEE	0	492047	0	111809	0	19663	0	33784	0	15691	0	672994	0	0
TABB MD KEVIN
TRUSTEE & CO-CHAIR	0	832815	0	361512	0	137438	0	7167	0	41020	0	1379952	0	0
ZEIDEL MD MARK L
TRUSTEE	0	698208	0	0	0	12405	0	40881	0	15694	0	767188	0	0
HUGHES CAROL M
CLERK & OPERATIONS MANAGER	52600	98029	0	0	0	0	0	0	0	26751	52600	124780	0	0
BUEHRENS ERIC
FORMER TRUSTEE & CO-CHAIR	0	103861	0	0	0	602723	0	5600	0	27590	0	739774	0	0
LEVY MD PAUL F
FORMER TRUSTEE & CO-CHAIR	0	0	0	0	0	777205	0	0	0	9474	0	786679	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SUPPLEMENTAL INFORMATION	PART III	REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. OTHER REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED FULLY VESTED 457(B) PLAN; TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; EARNED TIME CASHED; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AND OTHER TAXABLE RETIREMENT BENEFITS. DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401K RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403B RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THE NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. AND PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS SHAPIRO INSTITUTE AND PFHC/HMS RESPECTIVELY. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER AND BETH ISRAEL DEACONESS MEDICAL CENTER MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS HMFP AND BIDMC RESPECTIVELY. CHAIKOF, M.D., PHD, ELLIOT TRUSTEE SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) AND CHAIR (SURGERY) HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHIEF (SURGERY) BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR AND PRESIDENT BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION JOHNSON & JOHNSON PROFESSOR OF SURGERY HARVARD MEDICAL SCHOOL DR. CHAIKOF PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. CHAIKOF IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. CHAIKOF'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 447,300 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,067 DEFERRED COMPENSATION: 39,187 NON-TAXABLE BENEFITS: 16,153 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 447,301 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,066 DEFERRED COMPENSATION: 39,187 NON-TAXABLE BENEFITS: 16,154 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2012 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. CHAIKOF'S POSITION AS CHAIR OF SURGERY AND JOHNSON & JOHNSON PROFESSOR OF SURGERY, HARVARD MEDICAL SCHOOL: $197,998 BASE AND OTHER REPORTABLE COMPENSATION, $31,499 DEFERRED COMPENSATION AND $6,675 NON-TAXABLE BENEFITS. EDELHEIT, PHD., LEWIS S. TRUSTEE SHAPIRO INSTITUTE DR. EDELHEIT DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. FLIER, M.D., JEFFREY S. TRUSTEE (EX-OFFICIO) AND CO-CHAIR SHAPIRO INSTITUTE DEAN OF THE FACULTY OF MEDICINE HARVARD MEDICAL SCHOOL CAROLINE SHIELDS WALKER PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL DR. FLIER DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY PFHC/HMS BASE COMPENSATION: 572,911 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 9,332 DEFERRED COMPENSATION: 31,995 NON-TAXABLE BENEFITS: 19,855 GOLDBERG, CAROL R. TRUSTEE SHAPIRO INSTITUTE DIRECTOR MEDICAL CARE OF BOSTON MANAGEMENT CORP., DBA AFFILIATED PHYSICIANS GROUP MS. GOLDBERG DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. GRAY, PHD, MARTHA TRUSTEE SHAPIRO INSTITUTE DR. GRAY DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. KAY, STEPHEN TRUSTEE (EX-OFFICIO) SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) CAREGROUP, INC. DIRECTOR AND BOARD CHAIR BETH ISRAEL DEACONESS MEDICAL CENTER MR. KAY DEVOTES, ON AVERAGE, A COMBINED 3 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. RABKIN, M.D., MITCHELL T. TRUSTEE, CO-FOUNDER AND DISTINGUISHED INSTITUTE SCHOLAR SHAPIRO INSTITUTE DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. DIRECTOR MILTON HOSPITAL FOUNDATION, INC. PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL DR. RABKIN DEVOTES, ON AVERAGE, A COMBINED 3 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. ROSENBERG, M.D., STUART A TRUSTEE SHAPIRO INSTITUTE PRESIDENT AND CHIEF EXECUTIVE OFFICER HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT LONGWOOD MEDICAL INTERNATIONAL FOUNDATION, INC. FKA CARDIOVASCULAR ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION DIRECTOR BETH ISRAEL DEACONESS ORTHOPAEDIC SURGERY FOUNDATION DIRECTOR CONTINUING EDUCATION PROGRAM, INC. D/B/A BETH ISRAEL DEACONESS DEPARTMENT OF PSYCHIATRY FOUNDATION
SUPPLEMENTAL INFORMATION	PART III	DIRECTOR BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION DIRECTOR BETH ISRAEL DERMATOLOGY FOUNDATION DIRECTOR BIH PATHOLOGY FOUNDATION, INC. DIRECTOR (EX-OFFICIO) MEDICAL CARE OF BOSTON MANAGEMENT CORP., D/B/A AFFILIATED PHYSICIANS GROUP DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON SENIOR LECTURER ON MEDICINE HARVARD MEDICAL SCHOOL DR. ROSENBERG DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 622,430 INCENTIVE COMPENSATION: 125,924 OTHER REPORTABLE COMPENSATION: 17,783 DEFERRED COMPENSATION: 446,875 NON-TAXABLE BENEFITS: 20,006 DEFERRED COMPENSATION REPORTED BY HMFP FOR THE 2012 CALENDAR YEAR INCLUDES $400,000 RELATED TO THE IMPLEMENTATION OF A RETENTION INCENTIVE PLAN ESTABLISHED BY HMFP'S BOARD OF DIRECTORS. AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED HERE IS FOR THE CALENDAR YEAR 2012 AND NO PORTION OF THIS AMOUNT WAS VESTED OR PAID DURING THAT TIME. THIS RETENTION INCENTIVE VESTS IN PERIODIC INCREMENTS IN ACCORDANCE WITH THE PLAN TERMS AND CONDITIONS PURSUANT TO WHICH ALL AMOUNTS WILL BE FULLY PAID BY JANUARY 2015. SCHWARTZSTEIN, M.D., RICHARD M. TRUSTEE, PRESIDENT AND EXECUTIVE DIRECTOR SHAPIRO INSTITUTE VICE PRESIDENT, EDUCATION - BETH ISRAEL DEACONESS MEDICAL CENTER PHYSICIAN, PULMONARY AND CRITICAL CARE HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER ELLEN AND MELVIN GORDON PROFESSOR OF MEDICAL EDUCATION HARVARD MEDICAL SCHOOL DR. SCHWARTZSTEIN PERFORMS SERVICES FOR THE SHAPIRO INSTITUTE AND HMFP AND DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. SCHWARTZSTEIN RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND HMFP FOR HIS SERVICES PROVIDED IN THESE ROLES. THE PORTION OF DR. SCHWARTZSTEIN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 102,486 INCENTIVE COMPENSATION: 10,420 OTHER REPORTABLE COMPENSATION: 1,775 DEFERRED COMPENSATION: 5,750 NON-TAXABLE BENEFITS: 5,888 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 343,107 INCENTIVE COMPENSATION: 34,883 OTHER REPORTABLE COMPENSATION: 5,941 DEFERRED COMPENSATION: 19,250 NON-TAXABLE BENEFITS: 19,711 AS REQUIRED BY FORM 990, COMPENSATION REPORTED BY HMFP FOR THE 2012 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. SCHWARTZSTEIN'S POSITION AS ELLEN AND MELVIN GORDON PROFESSOR OF MEDICAL EDUCATION, HARVARD MEDICAL SCHOOL: $1,020 BASE COMPENSATION. STEVENSON, M.D., PHD, MARY ANN TRUSTEE SHAPIRO INSTITUTE CHIEF, RADIATION ONCOLOGY BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR, SECRETARY/CLERK AND CHAIR, RADIATION ONCOLOGY HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER ASSOCIATE PROFESSOR OF RADIATION ONCOLOGY HARVARD MEDICAL SCHOOL DR. STEVENSON PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. STEVENSON IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. STEVENSON'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 295,633 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,005 DEFERRED COMPENSATION: 23,437 NON-TAXABLE BENEFITS: 12,799 PAYMENTS ALLOCATED TO BIDMC: BASE COMPENSATION: 295,632 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,005 DEFERRED COMPENSATION: 23,438 NON-TAXABLE BENEFITS: 12,799 SUKHATME, M.D., PHD, VIKAS P. TRUSTEE (EX-OFFICIO) SHAPIRO INSTITUTE SENIOR VICE PRESIDENT & CHIEF ACADEMIC OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER NEPHROLOGIST HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER VICTOR J. ARESTY PROFESSOR OF MEDICINE- HARVARD MEDICAL SCHOOL DR. SUKHATME PERFORMS SERVICES FOR BOTH BIDMC AND HMFP AND DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. SUKHATME IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. SUKHATME'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC BASE COMPENSATION: 452,224 BONUS AND INCENTIVE COMPENSATION: 102,864 OTHER REPORTABLE COMPENSATION: 18,090 DEFERRED COMPENSATION: 31,081 NON-TAXABLE BENEFITS: 14,436 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 39,823 BONUS AND INCENTIVE COMPENSATION: 8,945 OTHER REPORTABLE COMPENSATION: 1,573 DEFERRED COMPENSATION: 2,703 NON-TAXABLE BENEFITS: 1,255 AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2012 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. SUKHATME'S POSITION AS VICTOR J. ARESTY PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: $92,844 BASE AND OTHER REPORTABLE COMPENSATION AND $8,784 DEFERRED COMPENSATION.
SUPPLEMENTAL INFORMATION	PART III	TABB, M.D., KEVIN TRUSTEE (EX-OFFICIO) AND CO-CHAIR SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL DR. TABB DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 832,815 INCENTIVE COMPENSATION: 361,512 OTHER REPORTABLE COMPENSATION: 137,438 DEFERRED COMPENSATION: 7,167 NON-TAXABLE BENEFITS: 41,020 DR. TABB COMMENCED HIS ROLES AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF BIDMC DURING THE 2011 CALENDAR YEAR AND COMPLETED HIS RELOCATION TO MASSACHUSETTS DURING 2012. AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED HERE IS FOR THE CALENDAR YEAR 2012. ACCORDINGLY, CERTAIN PAYMENTS TO DR. TABB DURING THE PERIOD REPORTED HERE WERE PAYMENTS INTENDED TO HELP EASE THE FINANCIAL COSTS OF RELOCATION, HOUSING AND OTHER TRANSITIONAL EXPENSES INCURRED BY DR. TABB, SUCH AMOUNTS HAVE BEEN REFLECTED HERE IN THE AMOUNT OF $93,750 INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION IN THE AMOUNT OF $105,191. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $19,994. THESE AMOUNTS WERE PAID PURSUANT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN TREASURY REGULATIONS SECTION 53.4958-4(A)(3) AND BIDMC FOLLOWED THE REBUTTABLE PRESUMPTION PROCEDURES DESCRIBED IN TREASURY REGULATIONS SECTION 53.4958-6(C) IN SETTING DR. TABB'S COMPENSATION. ZEIDEL, M.D., MARK TRUSTEE SHAPIRO INSTITUTE DIRECTOR (EX-OFFICIO) AND CHIEF (MEDICINE) BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (MEDICINE) HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) MEDICAL CARE OF BOSTON MANAGEMENT, CORP, D/B/A AFFILIATED PHYSICIANS GROUP PRESIDENT BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION, INC. HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL DR. ZEIDEL PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ZEIDEL IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. ZEIDEL'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 349,104 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,202 DEFERRED COMPENSATION: 20,441 NON-TAXABLE BENEFITS: 7,847 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 349,104 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,203 DEFERRED COMPENSATION: 20,440 NON-TAXABLE BENEFITS: 7,847 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2012 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. ZEIDEL'S POSITION AS CHAIR OF MEDICINE AND HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: $143,869 BASE AND OTHER REPORTABLE COMPENSATION, $15,881 DEFERRED COMPENSATION AND $1,825 NON-TAXABLE BENEFITS. ZINNER, M.D., STEPHEN TRUSTEE SHAPIRO INSTITUTE CHARLES S. DAVIDSON PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL DR. ZINNER DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. COUGHLIN, CHRISTINE, M. ASSOCIATE DIRECTOR SHAPIRO INSTITUTE ADMINISTRATIVE DIRECTOR, CENTER FOR EDUCATION, ACADEMIC AFFAIRS BETH ISRAEL DEACONESS MEDICAL CENTER MS. COUGHLIN PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 20 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. COUGHLIN RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. COUGHLIN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY THE SHAPIRO INSTITUTE BASE COMPENSATION: 3,000 BONUS AND INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 48,050 BONUS AND INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 2,760 HUGHES, CAROL M. SECRETARY/CLERK AND OPERATIONS COORDINATOR SHAPIRO INSTITUTE OPERATIONS COORDINATOR, CENTER FOR EDUCATION, ACADEMIC AFFAIRS BETH ISRAEL DEACONESS MEDICAL CENTER MS. HUGHES PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. HUGHES RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. HUGHES' COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY THE SHAPIRO INSTITUTE BASE COMPENSATION: 52,600 BONUS AND INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY THE BIDMC: BASE COMPENSATION: 98,029 BONUS AND INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 26,751 WANG, DIANA TREASURER SHAPIRO INSTITUTE FINANCIAL ANALYST BETH ISRAEL DEACONESS MEDICAL CENTER MS. WANG PERFORMS SERVICES FOR BOTH THE SHAPIRO INSTITUTE AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 20 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MS. WANG RECEIVED PAYMENTS FROM BOTH THE SHAPIRO INSTITUTE AND BIDMC FOR HER SERVICES PROVIDED IN THESE ROLES. THE PORTION OF MS. WANG'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY THE SHAPIRO INSTITUTE BASE COMPENSATION: 19,294 BONUS AND INCENTIVE COMPENSATION: 300 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 868 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 12,863 BONUS AND INCENTIVE COMPENSATION: 200 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 579 BUEHRENS, ERIC P. FORMER TRUSTEE (EX-OFFICIO) AND CO-CHAIR SHAPIRO INSTITUTE FORMER INTERIM PRESIDENT AND CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER FORMER EXECUTIVE VICE PRESIDENT AND CHIEF OPERATING OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER MR. BUEHRENS SERVED ON THE SHAPIRO INSTITUTE BOARD UNTIL OCTOBER 17, 2011. MR. BUEHRENS SERVED AS THE INTERIM PRESIDENT AND CHIEF EXECUTIVE OFFICER (CEO) OF BETH ISRAEL DEACONESS MEDICAL CENTER FROM FEBRUARY 2 TO OCTOBER 17, 2011, AT WHICH TIME HE RESUMED THE POSITION OF CHIEF OPERATING OFFICER (COO). MR. BUEHRENS SERVED AS COO UNTIL JANUARY 5, 2012 AND WAS EMPLOYED BY BIDMC UNTIL FEBRUARY 29, 2012. DURING THIS TIME, MR. BUEHRENS DEVOTED, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. WHILE MR. BUEHRENS SERVED AS INTERIM PRESIDENT AND CEO OF BIDMC, HE ALSO SERVED IN THE FOLLOWING POSITIONS: DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM
SUPPLEMENTAL INFORMATION	PART III	PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 103,861 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 602,723 DEFERRED COMPENSATION: 5,600 NON-TAXABLE BENEFITS: 27,590 OTHER REPORTABLE COMPENSATION FOR MR. BUEHRENS INCLUDES SALARY CONTINUATION PAYMENTS IN THE AMOUNT OF $568,612 PAID DURING CALENDAR YEAR 2012. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. BUEHRENS INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $39,094. LEVY, PAUL F. FORMER TRUSTEE SHAPIRO INSTITUTE FORMER DIRECTOR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER MR. LEVY SERVED AS PRESIDENT AND CHIEF EXECUTIVE OFFICER (CEO) OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) UNTIL FEBRUARY 2, 2011. MR. LEVY WAS PAID DIRECTLY BY BIDMC AND HIS COMPENSATION IS RPORTED BY BIDMC ON FORM 990, AS FURTHER OUTLINED BELOW: PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 0 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 777,205 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 9,474 OTHER REPORTABLE FOR MR. LEVY REPRESENTS SALARY CONTINUATION PAYMENTS PAID DURING THE CALENDAR YEAR 2012.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990, PART I, LINE 1:	THE MISSION OF CARL J SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER IS TO SUPPORT, PROMOTE, AND DEVELOP INNOVATIVE PROGRAMS AND MODELS FOR THE DUAL ACTIVITIES OF TEACHING AND RESEARCH AT ACADEMIC MEDICAL CENTERS. THE INSTITUTE WILL PROVIDE INTELLECTUAL LEADERSHIP, STATE-OF-THE-ART FACILITIES AND STAFF RESOURCES TO SUPPORT THE EDUCATION AND TRAINING OF MEDICAL STUDENTS AND FELLOWS.
WEBSITE ADDRESS	FORM 990, PART J	HTTP://WWW.BIDMC.ORG/MEDICALEDUCATION/CARLJ-D-SHAPIROINSTITUTEFOR EDUCATIONANDRESEARCH.ASPX
ORGANIZATION'S MISSION	FORM 990, PART III, LINE 1:	THE MISSION OF THE CARL J SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BETH ISRAEL DEACONESS MEDICAL CENTER IS TO SUPPORT, PROMOTE, AND DEVELOP INNOVATIVE PROGRAMS AND MODELS FOR THE DUAL ACTIVITIES OF TEACHING AND RESEARCH AT ACADEMIC MEDICAL CENTERS. THE INSTITUTE WILL PROVIDE INTELLECTUAL LEADERSHIP, STATE-OF-THE-ART FACILITIES AND STAFF RESOURCES TO SUPPORT THE EDUCATION AND TRAINING OF MEDICAL STUDENTS AND FELLOWS.
STATEMENT RE AUDITED FINANCIAL STATEMENTS	PART IV, QUESTION 12 AND 12A	EDELSTEIN & COMPANY ISSUED AN UNQUALIFIED OPINION ON THE AUDITED FINANCIAL STATEMENTS OF THE SHAPIRO INSTITUTE FOR FISCAL YEAR ENDED JUNE 30, 2013. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP).
CONTRIBUTIONS OF INTELLECTUAL PROPERTY	PART V, QUESTION 7G	THE SHAPIRO INSTITUTE DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899.
CONTRIBUTIONS OF CARS, BOATS, AIRPLANES AND OTHER VEHICLES	PART V, QUESTION 7H	THE SHAPIRO INSTITUTE 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, THE SHAPIRO INSTITUTE IS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND SERVES AS A SUPPORT ORGANIZATION, PROVIDING MEDICAL TRAINING AND EDUCATION TO, BETH ISRAEL DEACONESS MEDICAL CENTER, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. AND THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. EACH OF THESE ENTITIES IS ALSO A NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN EMPLOYMENT RELATIONSHIP ONE OR MORE ENTITIES NOTED ABOVE. ADDITIONAL DETAIL RELATED TO EMPLOYMENT RELATIONSHIPS IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J.
	FORM 990, PART VI, SECTION A, LINE 8B	MINUTES ARE DOCUMENTED FOR THE BOARD OF TRUSTEE MEETINGS. HOWEVER, THERE IS NO COMMITTEE THAT HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
	FORM 990, PART VI, SECTION B, LINE 11	FORM 990 REVIEW PROCESS THE FORM 990 IS PREPARED AND REVIEWED BY MANAGEMENT AS WELL AS DELOITTE TAX, LLP. THE COMPLETE FORM 990, INCLUDING ALL REQUIRED SCHEDULES IS PROVIDED TO EACH MEMBER OF THE BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. IN ADDITION, A COPY OF THE FORM 990, ONCE COMPLETED, IS PRESENTED FOR DISCUSSION TO THE BOARD OF TRUSTEES AT THE ANNUAL MEETING SUBSEQUENT TO COMPLETION.
	FORM 990, PART VI, SECTION B, LINE 12C	THE SHAPIRO INSTITUTE HAS A CONFLICT OF INTEREST POLICY WHICH PROVIDES FOR ANNUAL MONITORING OF RELATIONSHIPS WITH ITS TRUSTEES AND EMPLOYEES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) ARE TWO OF THE ENTITIES SUPPORTED BY THE SHAPIRO INSTITUTE, EACH OF WHICH MAINTAINS A CONFLICT OF INTEREST POLICY AND PROCESS WHICH INCLUDES ANNUAL MONITORING AND REPORTING. MANY MEMBERS OF THE SHAPIRO INSTITUTE BOARD OF TRUSTEES ARE ALSO EMPLOYEES OF BIDMC OR HMFP AND AS SUCH, THEY ARE ALSO COVERED BY THE BIDMC OR HMFP CONFLICT OF INTEREST PROCESS.
	FORM 990, PART VI, SECTION B, LINE 15	LINE 15A AND 15B - DESCRIPTION OF PROCESS TO DETERMINE COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES AS NOTED IN THIS RETURN, THE SHAPIRO INSTITUTE EXECUTIVE DIRECTOR, ALSO SERVES AS THE VICE PRESIDENT OF EDUCATION, FOR BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER). THE MEDICAL CENTER HAS A COMPENSATION COMMITTEE THAT IS COMPOSED OF MEMBERS OF THE BOARD OF DIRECTORS. ALL MEMBERS ARE INDEPENDENT. THE COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE OF ALL SENIOR MANAGEMENT AT THE MEDICAL CENTER, INCLUDING VICE PRESIDENTS. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT IT COMPLIES WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEYS AND STUDIES PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. THE COMPENSATION COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS DISCUSSED. ALL DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. SUBSEQUENT TO THE VOTE OF THE COMMITTEE, THE OUTSIDE CONSULTING FIRM PROVIDED A "REASONABLENESS LETTER" ATTESTING TO THE INDEPENDENCE OF THE COMMITTEE AND REASONABLENESS OF THE EXECUTIVE COMPENSATION. IN ADDITION, ANY COMPENSATION PAID TO THE EXECUTIVE DIRECTOR DIRECTLY BY THE SHAPIRO INSTITUTE AND NOT INCLUDED IN THE PROCESS ABOVE, IS APPROVED BY THE SHAPIRO INSTITUTE BOARD.
	FORM 990, PART VI, SECTION C, LINE 19	ALL APPLICABLE DOCUMENTS ARE AVAILABLE FROM THE ORGANIZATION UPON WRITTEN REQUEST.
OTHER FEES	FORM 990, PART IX, LINE 11G	MENTORING AND PROJECT PLANNING: PROGRAM SERVICE EXPENSES 96,250. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,250. SIMULATION EVENT STAFF TIME: PROGRAM SERVICE EXPENSES 8,313. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,313. EDUCATION AND RESEARCH: PROGRAM SERVICE EXPENSES 6,506. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,506. ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 20,261. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,261.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg
BETH ISRAEL DEACONESS MEDICAL CENTER
330 BROOKLINE AVE	BOSTON	MA	02215	042103881	HOSPITAL	MA	501(C)(3)	LINE 3: 170(B)(1)(A)	N/A	0
PRESIDENT & FELLOWS OF HARVARD COLLEGE
MASSACHUSETTS HALL	CAMBRIDGE	MA	02138	042103580	COLLEGE	MA	501(C)(3)	LINE 3: 170(B)(1)(A)	N/A	0
HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC
375 LONGWOOD AVE	BOSTON	MA	02215	222768204	PATIENT CARE	MA	501(C)(3)	LINE 3: 170(B)(1)(A)	N/A	0

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg