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SOUTHCOAST HEALTH SYSTEM INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SOUTHCOAST HEALTH SYSTEM INC (EIN 04-2794625)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-12
IRS object ID
201302249349302725
Schema version
2011v1.5
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-12T18:47:00-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12 JERICHO PLAZAAddressLine1
CityJERICHOCity
StateNYState
ZIP Code11753ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN042794625EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SOUTHCOAST HEALTH SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSOUTNameControl
Phone5089615000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O ACCOUNTING DEPT 101 PAGE STAddressLine1
CityNEW BEDFORDCity
StateMAState
ZIP Code02740ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGARY CONNERName
TitleTREASURERTitle
Phone5089615000Phone
Date Signed2013-08-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCHRISTINE KAWECKIName
PTINP00743140PTIN
Phone5169187000Phone
Date Prepared2013-07-31DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEITH HOVANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1C/O ACCOUNTING DEPT 101 PAGE STAddressLine1
CityNEW BEDFORDCity
StateMAState
ZIP Code02740ZIPCode
FieldValueIRS element (for citing)
Gross Receipts22226928GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SOUTHCOAST.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1986YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE O.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI-3911TotalGrossUBI
Net Unrelated Business Txbl Income-3911NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year8753973InvestmentIncomePriorYear
Investment Income Current Year4716158InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year8753973TotalRevenuePriorYear
Total Revenue Current Year4716158TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6660923OtherExpensePriorYear
Other Expenses Current Year6061045OtherExpensesCurrentYear
Total Expenses Prior Year6660923TotalExpensesPriorYear
Total Expenses Current Year6061045TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2093050RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1344887RevenuesLessExpensesCY
Total Assets BOY104753339TotalAssetsBOY
Total Assets EOY101735762TotalAssetsEOY
Total Liabilities BOY1494721TotalLiabilitiesBOY
Total Liabilities EOY1787773TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY103258618NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY99947989NetAssetsOrFundBalancesEOY
Mission DescriptionSEE SCHEDULE O.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense5804257Expense
Revenue0Revenue
DescriptionSEE SCHEDULE O.Description
Total Program Service Expense5804257TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities1ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account1ForeignFinancialAccount
Name Of Foreign CountryNLNameOfForeignCountry
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KEITH HOVANBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5089615000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 PAGE STAddressLine1
CityNEW BEDFORDCity
StateMAState
ZIP Code02740ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormer
MAUREEN SYLVIA ARMSTRONG
TRUSTEE1.00X000
M WAJID BAIG MD
TRUSTEE1.00X050000
DOUGLAS BEATON
TRUSTEE1.00X000
R WILLIAM BLASDALE
TRUSTEE1.00X000
PETER BULLARD ESQ
CLERK1.00X000X
CHRISTOPHER CHENEY MD
TRUSTEE1.00X000
KEITH HOVAN
PRESIDENT/EX-OFFICIO1.00X01038235424247X
ELIZABETH KUNZ
CHAIR1.00X000X
ELIZABETH O'NEILL LASTAITI
TRUSTEE1.00X000
JEAN MACCORMACK
VICE CHAIR1.00X000X
PAMELA MCNAMARA
TRUSTEE1.00X000
STEVEN MENDES MD
TRUSTEE1.00X0150000
CARL RIBEIRO
TRUSTEE1.00X000
JASON RUA
TRUSTEE1.00X000
GILBERT SHAPIRO MD
TRUSTEE1.00X000
CARL TABER
TRUSTEE1.00X000
ROBERT TRIPP JR DO
TRUSTEE1.00X000
WILLIAM GRIGG
TREASURER1.000582452105088X
LINDA BODENMANN
ASSISTANT CLERK1.000624370179370X
GARY CONNER
EVP & CFO/TREASURER STARTED 9/17/121.00000X
JOHN DAY
FORMER0.000773852183287X
RONALD GOODSPEED MD
FORMER0.00058090370X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs8847946TotalReportableCompFrmRltdOrgs
Total Other Compensation891992TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2151292TotalRevenueColumn
Unrelated Business Revenue-3911UnrelatedBusinessRevenue
Exclusion$2,155,203ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities20075636Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities17510770Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2564866Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2564866TotalRevenueColumn
Exclusion$2,564,866ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4716158TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue-3911UnrelatedBusinessRevenue
Exclusion$4,720,069ExclusionAmount

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total98177Total
Program Services98177ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total45224Total
Management And General45224ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total211564Total
Management And General211564ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total258551Total
Program Services258551ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total84049Total
Program Services84049ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total143196Total
Program Services143196ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
ADMINISTRATIVE FEES4050235405023500
STRATEGIC PLANNING AND1126616112661600
MISCELLANEOUS434334343300

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6061045Total
Program Services5804257ProgramServices
Management And General256788ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1309364BOY
EOY3650478EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY532693BOY
EOY436176EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis284095LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec284091LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY143200BOY
EOY4EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY81590952BOY
EOY79495594EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY19547028BOY
EOY16516313EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY1320000BOY
EOY1320000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY310102BOY
EOY317197EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY104753339BOY
EOY101735762EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1494721BOY
EOY1787773EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1494721BOY
EOY1787773EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY103258618BOY
EOY99947989EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY103258618BOY
EOY99947989EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY104753339BOY
EOY101735762EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1344887ReconcilationRevenueExpenses
Reconcilation Other Changes-1965742ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (3 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedAmountAmountOrganized In USOrganizedInUS
SOUTHCOAST HOSPITALS GROUP INC
222592333311$0
SOUTHCOAST PHYSICIANS GROUP INC
222703314901$11,752,678
SOUTHCOAST VENTURES INC
0430031721101$692,9231
FieldValueIRS element (for citing)
Total Number Of Supported Orgs3TotalNumberOfSupportedOrgs
Sum Of Amounts12445601SumOfAmounts

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis4InvestmentCostOrOtherBasis
Book Value4BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis284091OtherCostOrOtherBasis
Depreciation284091Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
(A) ALTERNATIVE INVESTMENTS- FAIR MARKET VALUE4700340F
(B) ALTERNATIVE INVESTMENTS- COST11815973C
FieldValueIRS element (for citing)
Total Of Book Value Securities16516313TotalOfBookValueSecurities

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationSHS ADOPTED FIN48 IN FISCAL YEAR 2008. THERE IS NO FOOTNOTE DISCLOSURE IN ITS FISCAL SEPTEMBER 30, 2012 CONSOLIDATED AUDITED FINANCIAL STATEMENTS SINCE THE ADOPTION OF FIN48 WAS NOT MATERIAL.Explanation

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA & THE CARIBBEANRegion
Number Of Offices0NumberOfOffices
Number Of Employees6NumberOfEmployees
Type Of Activities ConductedPROGRAM SERVICESTypeOfActivitiesConducted
Specific Services ProvidedCAPTIVE INSURANCESpecificServicesProvided
Total Expenditures1188800TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees6SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees6TotalNumberOfEmployees
Subtotal Amount Spent1188800SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent1188800TotalAmountSpent
Transfer To Foreign Corp1TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp1OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KEITH HOVAN
0756500021346906826604070730171740146248200
WILLIAM GRIGG
0419260077166086026087914017174068754000
LINDA BODENMANN
04437870847780958050165469013901080374000
JOHN DAY
036900001000000304852017470008587095713900
RONALD GOODSPEED MD
00000580903700000580903700

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ASHS DOES NOT EMPLOY ANY INDIVIDUALS. OFFICERS, DIRECTORS AND TRUSTEES OF SHS RECEIVE NO COMPENSATION FOR THEIR ROLES IN THESE CAPACITIES. OFFICERS, DIRECTORS AND TRUSTEES (CURRENT OR FORMER) WITH REPORTABLE COMPENSATION ARE COMPENSATED BY A NON-PROFIT SUBSIDIARY ORGANIZATION'S PAYROLL FOR SERVICES RENDERED AS EMPLOYEES OF THE SUBSIDIARY, OR AS PART OF A DEFERRED COMPENSATION ARRANGEMENT.
PART I, LINE 4BFORMER SOUTHCOAST HOSPITALS GROUP, INC. (SOUTHCOAST) PRESIDENT & CEO RONALD GOODSPEED, MD RECEIVED DISTRIBUTIONS TOTALING $5,809,037 IN RECOGNITION OF PREVIOUSLY DEFERRED COMPENSATION DUE TO THE RELEASE OF HIS SPLIT DOLLAR LIFE INSURANCE POLICY. THIS AMOUNT WAS REPORTED IN HIS FORM W-2, BOX 5, AND IN COLUMN B(III). OFFICERS, DIRECTORS AND TRUSTEES WHO ARE EMPLOYEES OF SOUTHCOAST PARTICIPATE IN SOUTHCOAST'S 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. ONLY UPON TERMINATION OF EMPLOYMENT DO FULLY VESTED PARTICIPANTS RECEIVE DISTRIBUTIONS FROM THE PLAN. THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES THE VESTED PORTION OF CONTRIBUTIONS MADE TO THE PLAN WHICH ARE NO LONGER SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: KEITH HOVAN $58,659; WILLIAM GRIGG $76,180; LINDA BODENMANN $89,111; JOHN DAY $136,999. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN THE 457(F) PLAN WHICH IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE AND ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN THE INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE WAGES: KEITH HOVAN $173,173; WILLIAM GRIGG $73,214; LINDA BODENMANN $85,769. ALSO INCLUDED IN COLUMN C BUT NOT INCLUDED IN THE INDIVIDUAL'S FORM W-2, BOX 5, WERE CONTRIBUTIONS MADE TO SERP AGREEMENTS OF $219,200 FOR KEITH HOVAN AND $65,000 FOR LINDA BODENMANN AND A $160,000 CONTRIBUTION TO THE SPLIT DOLLAR AGREEMENT FOR JOHN DAY, FORMER PRESIDENT & CEO OF SOUTHCOAST HEALTH SYSTEM, INC.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I & PART III, LINE 1TO CARE FOR AND IMPROVE THE HEALTH AND PROMOTE THE WELLNESS OF THE INDIVIDUALS AND COMMUNITIES SERVED AND OPERATING EXCLUSIVELY FOR THE BENEFIT OF SOUTHCOAST HOSPITALS GROUP, INC (SHG), A SAFETY NET PROVIDER OF HOSPITAL SERVICES AND ITS AFFILIATED ORGANIZATIONS THROUGH THE DEVELOPMENT OF A COMMUNITY OWNED SYSTEM WITH MULTIPLE ACCESS POINTS OFFERING AN INTEGRATED CONTINUUM OF HEALTH CARE SERVICES.
PART III, LINE 4APROGRAM EXPENSES WERE INCURRED IN THE OVERALL MANAGEMENT OF SHG AND ITS AFFILIATES. STRATEGIC PLANNING, DEVELOPMENT AND THE COORDINATION OF SERVICES INVOLVING MULTIPLE AFFILIATES AND THE DEVELOPMENT OF PHYSICIAN MANPOWER IN THE MEDICALLY UNDERSERVED AREA OF SOUTHEASTERN MASSACHUSETTS WERE THE PRIMARY SERVICES PROVIDED AND EXPENSES CONSISTED PRIMARILY OF SALARIES AND BENEFITS OF SHG WHICH WERE TRANSFERRED TO SOUTHCOAST HEALTH SYSTEM, INC. (SHS).
FORM 990, PART VI, SECTION A, LINE 1MEMBERS OF THE BOARD WITH THE DESIGNATION OF PRESIDENT EMERITUS AND TRUSTEE EMERITUS ARE NOT ENTITLED TO VOTE OR BE CONSIDERED FOR THE PURPOSE OF ESTABLISHING A QUORUM AT ANY MEETING OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 4THE SYSTEM'S PROCESS FOR APPOINTING ANY TRUSTEE TO THE BOARD WOULD BE UNIFORM AND WOULD INCLUDE A REVIEW AND INTERVIEW PROCESS OVERSEEN BY THE GOVERNANCE COMMITTEE AND APPROVED BY THE GOVERNANCE COMMITTEE AND THE BOARD OF TRUSTEES. OTHER CHANGES MADE TO THE SYSTEM'S BYLAWS INCLUDED RENAMING THE PHYSICIANS RELATIONS COMMITTEE TO THE MEDICAL AFFAIRS/PHYSICIANS RELATIONS COMMITTEE AND UTILIZING EMAIL AS AN ACCEPTABLE MEANS OF NOTIFICATION.
FORM 990, PART VI, SECTION B, LINE 11THE GOVERNING BOARD OF SHS REVIEWS FORM 990 AND ALL OF ITS RELATED SCHEDULES PRIOR TO FILING. THE REVIEEW IS PERFORMED BY THE GOVERNING BOARD AS IT PROVIDES DIRECT OVERSIGHT FOR COMPENSATION AND CONFLICT OF INTEREST MATTERS ON ITS OWN BEHALF AND ON BEHALF OF ITS AFFILIATES ON A SYSTEM WIDE BASIS. A COMPLETE COPY OF FORM 990 AND ITS SCHEDULES ARE POSTED TO THE SHS BOARD'S WEBSITE PORTAL FOR ALL BOARD MEMBERS TO REVIEW, MAKE INQUIRIES AND HAVE ANY ADJUSTMENTS MADE PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CSHS HAS CONFLICT OF INTEREST, LEGAL COMPLIANCE AND CODE OF CONDUCT POLICIES THAT APPLY TO ALL TRUSTEES, OFFICERS, DIRECTORS AND VOLUNTEERS (REFERRED TO AS "MEMBERS"). THE PRESIDENT OF SHS IS RESPONSIBLE FOR INFORMING ALL MEMBERS OF THIS POLICY. THE CHAIRPERSON OF SHS'S BOARD IS RESPONSIBLE FOR MAKING AN INITIAL DETERMINATION AS TO WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS WITH RESPECT TO ANY TRUSTEE, OFFICER OR DIRECTOR OF SHS OR ANY OF ITS AFFILIATES. THE PRESIDENT OF SHS IS RESPONSIBLE FOR MAKING AN INITIAL DETERMINATION AS TO WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS AS TO ANY MEMBER OTHER THAN A TRUSTEE OR DIRECTOR. IN THE EVENT OF A POTENTIAL CONFLICT RELATING TO THE CHAIRPERSON OF SHS, THE MATTER IS TO BE REPORTED TO THE PRESIDNET OF SHS AND REFERRED AUTOMATICALLY TO SHS'S GOVERNANCE COMMITTEE FOR DETERMINATION AS TO WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS. IN THE EVENT THE AFFECTED MEMBER DISGREES WITH THE INITIAL DETERMINATION OF THE CHAIRPERSON OR PRESIDENT, AS APPLICABLE, THEN UPON REQUEST, HE OR SHE MAY BE AFFORDED THE OPPORTUNITY TO DISCUSS THE ISSUE WITH THE SHS GOVERNANCE COMMITTEE WHICH WILL HAVE FINAL AUTHORITY IN ITS SOLE DISCRETION TO DETERMINE WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS. THE AFFECTED MEMBER, IF A MEMBER OF THE GOVERNANCE COMMITTEE, MUST REMOVE HIMSELF FROM THE ROOM DURING ANY DISCUSSION OF THE MATTER (AFTER HIS INITIAL PRESENTATION) AND REFRAIN FROM PARTICIPATING IN ANY VOTE OR OTHER DECISION MAKING REGARDING THE MATTER. THE MINUTES OF THE MEETING SHOULD REFLECT THAT A FULL AND ACCURATE DISCLOSURE WAS MADE, THAT THE MEMBER ABSTAINED FROM VOTING OR DECISION MAKING AND THAT A QUORUM WAS OTHERWISE PRESENT. VIOLATION OF THIS POLICY IS TO BE REVIEWED ANNUALLY BY THE BOARD AND IS TO BE ADVISED OF THE POLICY PRIOR TO SELECTION AS A MEMBER AND IS REQUIRED TO FILE WITHIN 30 DAYS THEREAFTER, THE CONFLICT OF INTEREST DISCLOSURE STATEMENT OR QUESTIONNAIRE.
SHS DOES NOT EMPLOY ANY INDIVIDUALS AND ALL MEMBERS OF ITS BOARD OF TRUSTEES SERVE IN THESE CAPACITIES WITHOUT COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19SHS MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY PROVIDING THEM UPON REQUEST.
FORM 990 - PART VIIKEITH HOVAN, GARY CONNER, WILLIAM GRIGG AND LINDA BODENMANN WORK 40 HOURS PER WEEK AT A RELATED ORGANIZATION.AVG HOURS WORKED FOR RELATED ORG
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 10,517,674. TRANSFERS TO AFFILIATES -12,445,601. BOOK TO TAX ADJUSTMENT -37,815. TOTAL TO FORM 990, PART XI, LINE 5: -1,965,742.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2A & 2B:FINANCIAL RESULTS FOR SHS ARE INCLUDED IN THE SOUTHCOAST HEALTH SYSTEM, INC. AND AFFILIATES AUDITED FINANCIAL STATEMENTS AS OF AND FOR THE YEARS SEPTEMBER 30, 2012 AND 2011 WHICH WERE ISSUED WITH AN INDEPENDENT AUDITOR'S REPORT WITH AN UNQUALIFIED OPINION. INCLUDED IN THESE AUDITED FINANCIAL STATEMENTS IS SUPPLEMENTAL CONSOLIDATED INFORMATION AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2012. NO STAND ALONE AUDIT AUDITED FINANCIAL STATEMENTS WERE ISSUED FOR SHS FOR THE YEAR ENDED SEPTEMBER 30, 2012.EXPLANATION OF FINANCIAL STATEMENTS:
R-1 SCH R, PART ISHS IS THE SOLE MEMBER OF SOUTHCOAST ACCOUNTABLE CARE ORGANIZATION, LLC WHICH WAS ORGANIZED IN MASSACHUSETTS ON AUGUST 30, 2012.IDENTIFICATION OF DISREGARDED ENTITY
FORM 990 - PART V - LINE 4A:SHS OWNS 100% INTEREST IN COASTLINE PROFESSIONAL ASSURANCE CORPORATION, LTD (CPAC) WHICH IS DOMICILED IN THE CAYMAN ISLANDS. SHS OWNS INTERESTS IN VARIOUS INVESTMENT PARTNERSHIPS WHERE HIRED INVESTMENT MANAGERS HAVE THE AUTHORITY TO INVEST ON BEHALF OF SHS. SHS ALSO OWNS LIMITED LIABILITY INTERESTS IN INVESTMENT PARTNERSHIPS WHERE THE GENERAL PARTNER HAS THE AUTHORITY TO INVEST. TRANSFERS OF FUNDS THROUGH THESE INVESTMENT PARTNERSHIPS WERE MADE TO CORPORATIONS IN THE FOLLOWING COUNTRIES: BRITISH VIRGIN ISLANDS, UNITED KINGDOM, CHINA, GUERNSEY, CANADA, FRANCE, GERMANY, ITALY, NETHERLANDS, BERMUDA, JAPAN, CAYMAN ISLANDS, INDIA, SPAIN, LUXEMBOURG, CYRPUS, BRAZIL, CHILE, MEXICO, JERSEY, AUSTRALIA, NORWAY, CHANNEL ISLANDS, SWEDEN, POLAND, ROMANIA, RUSSIA AND LIBERIA.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1SOUTHCOAST ACCOUNTABLE CARE ORGANIZATION LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1C/O SOUTHCOAST HEALTH SYSTEM INC 10AddressLine1
CityNEW BEDFORDCity
StateMAState
ZIP Code027403464ZIPCode
FieldValueIRS element (for citing)
EIN611577608EIN
Primary ActivitiesACCOUNTABLE CARE ORGANIZATIONPrimaryActivities
Legal Domicile StateMALegalDomicileState
Total Income0TotalIncome
EOY Assets0EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SOUTHCOAST HEALTH SYSTEM INCBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
SOUTHCOAST HOSPITALS GROUP INC
101 PAGE STNEW BEDFORDMA02740222592333ACUTE CARE HOSPITALMA501(C)(3)LINE 3: 170(B)(1)(A)SHS1
SOUTHCOAST PHYSICIANS GROUP INC
200 MILL RD STE 180FAIRHAVENMA02719222703314PHYSICIAN SERVICESMA501(C)(3)LINE 9: 509(A)(2)SHS1
SOUTHCOAST VENTURES INC
101 PAGE STNEW BEDFORDMA02740043003172PHYSICIAN SERVICES/HEALTHCAREMA501(C)(3)LINE 11, TYPE I: 509SHS1
CHARLTON LONG TERM CARE SERVICES INC
363 HIGHLAND AVEFALL RIVERMA02720043109579SUPPORT SHGMA501(C)(3)LINE 11, TYPE I: 509SHS1
SOUTHCOAST VISITING NURSE ASSOCIATION INC
200 MILL RDFAIRHAVENMA02719042105745HOME CARE SERVICESMA501(C)(3)LINE 9: 509(A)(2)SHS1
SAINT LUKE'S NURSING HOME INC
101 PAGE STNEW BEDFORDMA02740042984542INACTIVEMA501(C)(3)LINE 11, TYPE I: 509SHS1

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeLegal Domicile StateLegalDomicileState
COASTLINE PROFESSIONAL ASSURANCE CORPORATION LTD
PO BOX 1085GRAND CAYMANCAYMAN ISLESCJKY1-1102980445031INSURANCECJ-33614338396539
SOUTHCOAST PHYSICIANS NETWORK INC
450568782NETWORK SVCS-2118643199097101 PAGE STNEW BEDFORDMA02740MA
HEALTH MANAGEMENT INITIATIVES INC
042998712COMM RENTALS1353033365499363 HIGHLAND AVEFALL RIVERMA02720MA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
HEALTH MANAGEMENT INITIATIVES INC
A34301COST
SOUTHCOAST PHYSICIANS GROUP INC
Q11752678COST
SOUTHCOAST VENTURES INC
Q692923COST

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE R, PART VReturnReference
ExplanationALL TRANSACTIONS REPORTED WERE CASH TRANSACTIONS, THEREFORE, COST/ACTUAL CASH VALUE WAS THE METHOD USED.Explanation

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