LAHEY HEALTH SHARED SERVICES INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- LAHEY HEALTH SHARED SERVICES INC (EIN 04-3178972)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-15
- IRS object ID
- 201302279349303680
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-15T15:36:49-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 High Street | AddressLine1 |
| City | Boston | City |
| State | MA | State |
| ZIP Code | 02110 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 043178972 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lahey Clinic Affiliated Services Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % TIMOTHY O'CONNOR | InCareOfName |
| Name Control | LAHE | NameControl |
| Phone | 7817445100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 Mall Road | AddressLine1 |
| City | Burlington | City |
| State | MA | State |
| ZIP Code | 018050001 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIM O'CONNOR | Name |
| Title | TREASURER/EVP/CFO | Title |
| Date Signed | 2013-08-12 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6175305000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Howard R Grant JD MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 MALL ROAD | AddressLine1 |
| City | BURLINGTON | City |
| State | MA | State |
| ZIP Code | 018050001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 2008159 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.lahey.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1992 | YearFormation |
| State Legal Domicile | MA | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1742364 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 2008159 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1742364 | TotalRevenuePriorYear |
| Total Revenue Current Year | 2008159 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | 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 | 0 | OtherExpensePriorYear |
| Other Expenses Current Year | 0 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 0 | TotalExpensesPriorYear |
| Total Expenses Current Year | 0 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1742364 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2008159 | RevenuesLessExpensesCY |
| Total Assets BOY | 8981548 | TotalAssetsBOY |
| Total Assets EOY | 10989707 | TotalAssetsEOY |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 8981548 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 10989707 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 0 | Expense |
| Grants | 0 | Grants |
| Revenue | 2008159 | Revenue |
| Description | Lahey Clinic Affiliated Services, Inc. is a charitable organization that provides magnetic resonance imaging services and other ancillary services to the surrounding communities and their patients. | Description |
| Total Program Service Expense | 0 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | MA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | TIMOTHY O'CONNOR | NamePerson |
| Telephone Number | 7817445100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 MALL ROAD | AddressLine1 |
| City | Burlington | City |
| State | MA | State |
| ZIP Code | 018050001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (31 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | FormerFormer |
|---|---|---|---|---|---|---|---|
| Howard R Grant JD MD | |||||||
| TRUSTEE/PRESIDENT/CEO | 1.0 | X | X | 0 | 960934 | 84545 | |
| John A Libertino MD | |||||||
| TRUSTEE/CHAIR DEPT OF UROLOGY | 1.0 | X | 0 | 813060 | 39384 | ||
| Richard W Nesto MD | |||||||
| TRUSTEE/EVP/CMOO/PHYSICIAN | 1.0 | X | 0 | 595970 | 101415 | ||
| Roger L Jenkins MD | |||||||
| TRUSTEE/PHYSICIAN | 1.0 | X | 0 | 592138 | 49628 | ||
| Richard S D'Agostino MD | |||||||
| TRUSTEE/CHAIR DEPT CARDIO SURG | 1.0 | X | 0 | 529013 | 52842 | ||
| Judith A Melin MD | |||||||
| TRUSTEE UNTIL7/16/12/ASSC CQSO | 1.0 | X | 0 | 327467 | 30355 | ||
| Carl A Soderland MD | |||||||
| TRUSTEE UNTIL 7/16/12/CHAIR | 1.0 | X | 0 | 389917 | 36436 | ||
| Andrew G Villanueva MD | |||||||
| TRUSTEE/CMO CLINIC/PHYSICIAN | 1.0 | X | 0 | 327045 | 37548 | ||
| Betsey Crawford MD | |||||||
| TRUSTEE START 7/16/12/PHYSICIA | 1.0 | X | 0 | 187572 | 12386 | ||
| Arthur P Mourtzinos MD | |||||||
| TRUSTEE START 7/16/12/PHYSICIA | 1.0 | X | 0 | 403201 | 43266 | ||
| Rebecca C Yang MD | |||||||
| TRUSTEE START 7/16/12/PHYSICIA | 1.0 | X | 0 | 344322 | 41513 | ||
| Irving E Rogers III | |||||||
| TRUST/CHAIR/CLERK UNTIL7/16/12 | 2.0 | X | X | 0 | 0 | 0 | |
| Eric M Bailey | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| Craig R Benson | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| Ann Marie Connolly | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| Jerald G Fishman | |||||||
| TRUSTEE UNTIL 7/16/12 | 1.0 | X | 0 | 0 | 0 | ||
| James W Henderson | |||||||
| TRUST/VICE CHAIR UNTIL 7/16/12 | 2.0 | X | X | 0 | 0 | 0 | |
| James D Irving | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| Charles M Leighton | |||||||
| TRUSTEE UNTIL 7/16/12 | 1.0 | X | 0 | 0 | 0 | ||
| Peter J Manning | |||||||
| TRUSTEE UNTIL 7/16/12 | 1.0 | X | 0 | 0 | 0 | ||
| J William Poduska | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| Windle B Priem | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| James A Radley | |||||||
| TRUSTEE UNTIL 7/16/12 | 1.0 | X | 0 | 0 | 0 | ||
| Robert L Reynolds | |||||||
| TRUSTEE UNTIL 7/16/12 | 1.0 | X | 0 | 0 | 0 | ||
| Michael C Ruettgers | |||||||
| TRUSTEE/CHAIR OF BOARD | 2.0 | X | X | 0 | 0 | 0 | |
| Carolyn Ain | |||||||
| TRUSTEE START 7/16/12 | 1.0 | X | 0 | 0 | 0 | ||
| Jane C Edmonds | |||||||
| TRUSTEE START 7/16/12 | 1.0 | X | 0 | 0 | 0 | ||
| Edward Eskandarian | |||||||
| TRUSTEE START 7/16/12 | 1.0 | X | 0 | 0 | 0 | ||
| David G Spackman | |||||||
| CLERK START 7/16/12 /GEN COUNS | 1.0 | X | 0 | 0 | 0 | ||
| Timothy O'Connor | |||||||
| OFFICER/TREASURER/EVP/CFO | 1.0 | X | 0 | 683581 | 159274 | ||
| David M Barrett MD | |||||||
| FORMER TRUSTEE/PRES/CEO | 0.0 | 0 | 1388662 | 200000 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 7542882 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 888592 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUE FROM JOINT PARTNERSHIP | |||
| WITH SHIELDS MRI | 900099 | 2008159 | 2008159 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 2008159 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2008159 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2008159 | RelatedOrExemptFunctionIncome |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8981548 | BOY |
| EOY | 10989707 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8981548 | BOY |
| EOY | 10989707 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8981548 | BOY |
| EOY | 10989707 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8981548 | BOY |
| EOY | 10989707 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8981548 | BOY |
| EOY | 10989707 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 2008159 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 654439 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1147101 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2469183 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1742364 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2008159 | CurrentTaxYear |
| Total | 8021246 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 654439 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1147101 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2469183 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1742364 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2008159 | CurrentTaxYear |
| Total | 8021246 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 8021246 | PublicSupportTotal509 |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 654439 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1147101 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2469183 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1742364 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2008159 | CurrentTaxYear |
| Total | 8021246 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 1.00000 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 1.00000 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00000 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Land | Land | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements | |
| Equipment | Equipment | |
| Other Land Buildings | OtherLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INVESTMENT IN SHIELDS MRI | 1287262 |
| INTERCOMPANY RECEIVABLES | 9702445 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 10989707 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule D, Part X | Identifier |
| Explanation | THE ORGANIZATION'S FINANCIAL STATEMENTS DID NOT REPORT A LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Howard R Grant JD MD | |||||||||||||
| 0 | 936208 | 0 | 0 | 0 | 24726 | 0 | 26887 | 0 | 57658 | 0 | 1045479 | 0 | 0 |
| John A Libertino MD | |||||||||||||
| 0 | 684189 | 0 | 90000 | 0 | 38871 | 0 | 17500 | 0 | 21884 | 0 | 852444 | 0 | 0 |
| Richard W Nesto MD | |||||||||||||
| 0 | 573574 | 0 | 0 | 0 | 22396 | 0 | 75800 | 0 | 25615 | 0 | 697385 | 0 | 0 |
| Roger L Jenkins MD | |||||||||||||
| 0 | 561129 | 0 | 0 | 0 | 31009 | 0 | 17500 | 0 | 32128 | 0 | 641766 | 0 | 0 |
| Richard S D'Agostino MD | |||||||||||||
| 0 | 490255 | 0 | 0 | 0 | 38758 | 0 | 17500 | 0 | 35342 | 0 | 581855 | 0 | 0 |
| Judith A Melin MD | |||||||||||||
| 0 | 288829 | 0 | 0 | 0 | 38638 | 0 | 17500 | 0 | 12855 | 0 | 357822 | 0 | 0 |
| Carl A Soderland MD | |||||||||||||
| 0 | 351021 | 0 | 0 | 0 | 38896 | 0 | 17500 | 0 | 18936 | 0 | 426353 | 0 | 0 |
| Andrew G Villanueva MD | |||||||||||||
| 0 | 288287 | 0 | 0 | 0 | 38758 | 0 | 17500 | 0 | 20048 | 0 | 364593 | 0 | 0 |
| Betsey Crawford MD | |||||||||||||
| 0 | 170982 | 0 | 0 | 0 | 16590 | 0 | 10626 | 0 | 1760 | 0 | 199958 | 0 | 0 |
| Arthur P Mourtzinos MD | |||||||||||||
| 0 | 386701 | 0 | 0 | 0 | 16500 | 0 | 17500 | 0 | 25766 | 0 | 446467 | 0 | 0 |
| Rebecca C Yang MD | |||||||||||||
| 0 | 327732 | 0 | 0 | 0 | 16590 | 0 | 17500 | 0 | 24013 | 0 | 385835 | 0 | 0 |
| Timothy O'Connor | |||||||||||||
| 0 | 566323 | 0 | 95000 | 0 | 22258 | 0 | 134500 | 0 | 24774 | 0 | 842855 | 0 | 0 |
| David M Barrett MD | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 1388662 | 0 | 200000 | 0 | 0 | 0 | 1588662 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE J, PART I LINE 4A, PART II COLUMN B(III) AND COLUMN C | Identifier |
| Explanation | DR. DAVID M. BARRETT WAS TERMINATED FROM LAHEY CLINIC FOUNDATION, INC. ON 12/31/2010. SCHEDULE J REQUIRES THE REPORTING OF COMPENSATION BASED ON CALENDAR YEAR 2011. DR. BARRETT'S COMPENSATION PAID FOR CALENDAR YEAR 2011 INCLUDES $989,983 OF SEVERANCE PAYMENTS PER DR. BARRETT'S EMPLOYMENT CONTRACT, $346,154 OF VACATION AND SICK TIME CASHED-OUT AND $52,525 OF TAXABLE LIFE INSURANCE BENEFITS. THE REMAINING AMOUNT PAID TO DR. BARRETT OF $200,000 IS DEFErRED COMPENSATION UNDER A SPLIT DOLLAR AGREEMENT WITH LAHEY CLINIC HOSPITAL, INC. SCHEDULE J, PART I, LINE 4B, PART II COLUMN C THE ORGANIZATION MAINTAINS A 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN PHYSICIANS, EXECUTIVE MANAGEMENT AND DEFINED MEDICAL STAFF. THE PLAN OFFERS PARTICIPATING EMPLOYEES AN ANNUAL DEFFERAL OF COMPENSATION IN ADDITION TO THEIR SALARIES. FOR THE CURRENT PERIOD, THE FOLLOWING PERSONS PARTICIPATED IN THE 457F NONQUALIFIED DEFERRED COMPENSATION PLAN: TIMOTHY O'CONNOR - AMOUNT = $117,000 RICHARD W NESTO - AMOUNT = $ 58,300 SCHEDULE J, PART II LAHEY CLINIC FOUNDATION, INC. AND ITS RELATED ORGANIZATIONS DO NOT COMPENSATE ANY TRUSTEE IN THEIR CAPACITY AS TRUSTEE. ALL COMPENSATION PAID IS FOR WORK PERFORMED IN THEIR CAPACITY OTHER THAN TRUSTEE, WHICH IS LISTED ON FORM 990, PART VII, DIRECTLY FOLLOWING THE TITLE OF THE TRUSTEE. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (34 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART I, LINE 1 & PART III, LINE 1 | LAHEY CLINIC AFFILIATED SERVICES, INC. PROVIDES SUPERIOR HEALTH CARE LEADING TO THE BEST POSSIBLE OUTCOMES FOR EVERY PATIENT. AS ONE OF THE WORLD'S PREMIER HEALTH CARE ORGANIZATIONS, LAHEY CLINIC AFFILIATED SERVICES, INC. AIMS TO EXCEED EACH DAY ITS PATIENT'S HIGH EXPECTATIONS FOR SERVICE, AND ADVANCE MEDICINE THROUGH RESEARCH AND THE EDUCATION OF TOMORROW'S HEALTH CARE LEADERS. IN ADDITION, LAHEY CLINIC AFFILIATED SERVICES, INC. IS COMMITTED TO IMPROVING THE HEALTH AND QUALITY OF LIFE OF COMMUNITY RESIDENTS BY SUPPORTING LOCAL ORGANIZATIONS ALIGNED WITH THIS MISSION. | |
| FORM 990, PART IV, LINE 4 | LAHEY CLINIC HOSPITAL, INC., A RELATED ORGANIZATION, IS IN CONTACT WITH FEDERAL AND STATE LEGISLATORS REGARDING HEALTH CARE REFORM ISSUES THAT WOULD POTENTIALLY HAVE AN IMPACT ON THE ORGANIZATION AND ITS RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 2 OFFICERS AND TRUSTEES OF LAHEY CLINIC AFFILIATED SERVICES, INC. ARE OFFICERS AND TRUSTEES OF LAHEY CLINIC FOUNDATION, INC., LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL, INC. CERTAIN TRUSTEES ARE ALSO EMPLOYEES OF LAHEY CLINIC FOUNDATION, INC. OR LAHEY CLINIC, INC. IN ADDITION TO THEIR ROLE AS A TRUSTEE AND/OR OFFICER, HOWARD R. GRANT, J.D., M.D., TIMOTHY O'CONNOR AND JAMES A. RADLEY (UNTIL 07/16/2012) ARE ALSO A TRUSTEE AND/OR OFFICER FOR LAHEY CLINIC INSURANCE COMPANY, LTD. IN ADDITION TO THEIR ROLES AS OFFICERS OF LAHEY CLINIC AFFILIATED SERVICES, INC., TIMOTHY O'CONNOR AND DAVID SPACKMAN ARE ALSO OFFICERS OF NORTHEAST PROPRIETARY CORPORATION, A RELATED ORGANIZATION. THE COMPENSATION FOR THE TRUSTEES AND OFFICERS OF LAHEY CLINIC AFFILIATED SERVICES, INC. LISTED IN FORM 990, PART VII, COLUMN (E) IS FOR EMPLOYEES OF LAHEY CLINIC FOUNDATION, INC. OR LAHEY CLINIC, INC. ALL COMPENSATION PAID IS FOR WORK PERFORMED IN THEIR CAPACITIES OTHER THAN AS TRUSTEES. FORM 990, PART VI, SECTION A, LINES 6 AND 7 THE LAHEY HOSPITAL AND MEDICAL CENTER CONSISTS OF FOUR NON-PROFIT CORPORATIONS, LAHEY CLINIC HOSPITAL, INC. (EIN # 04-2704686), LAHEY CLINIC, INC. (EIN # 04-2704683), LAHEY CLINIC FOUNDATION, INC. (EIN # 04-2323457) AND LAHEY CLINIC AFFILIATED SERVICES, INC. (EIN # 04-3178972). ALL FOUR CORPORATIONS ARE TAX EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). LAHEY CLINIC FOUNDATION, INC. IS THE SOLE CORPORATE MEMBER OF EACH OF THE OTHER THREE CORPORATIONS. THE BOARD OF TRUSTEES (GOVERNING BODY) AND CORPORATE OFFICERS OF THE FOUR CORPORATIONS CONSIST OF THE EXACT SAME MEMBERS. FORM 990, PART VI, SECTION A, LINES 4, 6, 7A & 7B EFFECTIVE MAY 1, 2012, LAHEY CLINIC FOUNDATION, INC. AND NORTHEAST HEALTH SYSTEM, INC. COMPLETED AN AFFILIATION WITH EACH OTHER AND ESTABLISHED A NEW ORGANIZATION, LAHEY HEALTH SYSTEM, INC. ("LHS"), TO SERVE AS THE PARENT OF THE COMBINED HEALTH SYSTEM. LHS IS NOW THE SOLE CORPORATE MEMBER OF LAHEY CLINIC FOUNDATION, INC. AND NORTHEAST HEALTH SYSTEM, INC. THE SOLE CORPORATE MEMBER OF THE REPORTING ORGANIZATION IS LAHEY CLINIC FOUNDATION, INC. THE REPORTING ORGANIZATION'S MEMBER HAS, WITH RESPECT TO THE REPORTING ORGANIZATION, THE RIGHT TO EXERCISE ALL POWERS CONFERRED ON MEMBERS OF NON-PROFIT CORPORATIONS UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 180, INCLUDING, WITHOUT LIMITATION, POWERS WITH RESPECT TO THE FOLLOWING: (A) APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD OF TRUSTEES (SUBJECT TO CERTAIN TRANSITION RULES IN PLACE THROUGH MAY 1, 2016); (B) AMENDMENT OF THE ARTICLES OF ORGANIZATION; (C) AMENDMENT OF THE BY-LAWS; (D) THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; AND (E) THE MERGER OR CONSOLIDATION OF THE CORPORATION WITH ANOTHER CORPORATION. ADDITIONALLY, THE RIGHT OF THE REPORTING ORGANIZATION'S MEMBER, LAHEY CLINIC FOUNDATION, INC., TO EXERCISE ITS AUTHORITY AS A MEMBER OF THE REPORTING ORGANIZATION IS SUBJECT TO THE APPROVAL OF LCF'S CORPORATE MEMBER, LHS, WHICH MAY ALSO EXERCISE SUCH POWERS DIRECTLY. THE ARTICLES OF INCORPORATION OF THE REPORTING ORGANIZATION WERE AMENDED MAY 1, 2012 AND THE BY-LAWS WERE AMENDED ON SEPTEMBER 21, 2012 TO REFLECT THE AFOREMENTIONED CHANGES. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT PREPARED THE IRS FORM 990 ALONG WITH INDEPENDENT TAX CONSULTANTS WHO SIGN THE RETURN AS A PAID PREPARER. LAHEY CLINIC AFFILIATED SERVICES, INC.'S EXECUTIVE MANAGEMENT REVIEWED AND WITH THE INDEPENDENT TAX CONSULTANTS PRESENTED THE FINAL DRAFT OF IRS FORM 990 TO THE AUDIT AND COMPLIANCE COMMITTE OF THE LAHEY HEALTH SYSTEM, INC. BOARD OF TRUSTEES PRIOR TO THE FILING DATE. THE FINAL IRS FORM 990 WAS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES BEFORE THE FILING DATE VIA A SECURED WEBSITE. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, TRUSTEES, KEY EMPLOYEES, PHYSICIANS AND MANAGEMENT EMPLOYEES AT ALL LEVELS, ARE REQUIRED TO FILL OUT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THE LAHEY HOSPITAL AND MEDICAL CENTER'S CORPORATE COMPLIANCE DEPARTMENT MONITORS AND REVIEWS EACH DISCLOSURE FOR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE CORPORATE COMPLIANCE DEPARTMENT MONITORS CONFLICTS OF INTEREST THROUGH DISCLOSURE SOFTWARE, TRAINING, AND INDIVIDUAL REVIEWS WITH PHYSICIANS, KEY EMPLOYEES, AND MANAGERS. DEPENDING ON THE CONFLICT OF INTEREST: A PERSON COULD BE ASKED TO NOT PARTICIPATE IN DECISIONS MADE ON BEHALF OF LAHEY HOSPITAL AND MEDICAL CENTER; A PERSON MAY BE TOLD THEY CANNOT BE A PRINCIPAL INVESTIGATOR ON A RESEARCH STUDY; A PERSON MAY BE TOLD THAT THEY CANNOT PERFORM THE TASK THAT CREATES THE CONFLICT; A PERSON COULD BE ASKED TO REMOVE THEMSELVES FROM A COMMITTEE. FORM 990, PART VI, SECTION B, LINE 14 LAHEY HOSPITAL & MEDICAL CENTER HAS A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY KNOWN AS THE "RETENTION OF ADMINISTRATIVE AND CLINICAL DOCUMENTS". THE POLICIES, PROCEDURES, AND STANDARDS ARE MONITORED, MANAGED, AND REVISED BY THE RECORDS MANAGEMENT STEERING COMMITTEE. THE REVISED "RETENTION OF ADMINISTRATIVE AND CLINICAL DOCUMENTS" POLICY WAS APPROVED BY THE MEDICAL PRACTICE AND UTILIZATION COMMITTEE ON JULY 26, 2012. FORM 990, PART VI, SECTION B, LINE 15 & SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIES ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USE THE FOLLOWING PROCESS: INDEPENDENT MEMBERS OF THE BOARD OF TRUSTEES COMPRISE THE COMPENSATION COMMITTEE. THE COMMITTEE SETS THE COMPENSATION AND BENEFITS FOR THE CEO AND ALSO REVIEWS AND APPROVES RECOMMENDATIONS FOR THE COMPENSATION AND BENEFITS FOR DISQUALIFIED INDIVIDUALS AND OTHERS. OUTSIDE LEGAL COUNSEL ADVISES THE COMMITTEE AND RECORDS MINUTES FROM THE COMMITTEE MEETINGS. THE COMMITTEE SEEKS THE ADVICE OF EXTERNAL COMPENSATION CONSULTANTS. COMPARABILITY DATA IS PROVIDED, ANALYZED, AND DOCUMENTED BY THE EXTERNAL CONSULTANTS. THE LAHEY VICE PRESIDENT OF HUMAN RESOURCE OPERATIONS PROVIDES THE COMMITTEE WITH ANY REQUESTED INFORMATION. THE COMMITTEE MET SEVERAL TIMES THIS YEAR. FORM 990, PART VI, SECTION B, LINE 16B THE ORGANIZATION NEGOTIATES ARRANGEMENTS TO INCLUDE SUCH TERMS AND SAFEGUARDS TO ENSURE THAT THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED. FROM A LEGAL PERSPECTIVE, IN-HOUSE LEGAL COUNSEL, WITH THE INPUT OF EXTERNAL LEGAL COUNSEL, REVIEWS ALL PROPOSED JOINT VENTURE AND PARTNERSHIP AGREEMENTS. FROM A FINANCIAL PERSPECTIVE, LAHEY'S FINANCE MANAGEMENT TEAM REVIEWS ALL PROPOSED JOINT VENTURES AND PARTNERSHIP AGREEMENTS. BOTH REVIEWS TAKE PLACE BEFORE LAHEY HOSPITAL AND MEDICAL CENTER ENTERS INTO ANY SUCH AGREEMENTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND OTHER COMPLIANCE POLICIES ARE MADE AVAILABLE TO THE PUBLIC VIA THE ORGANIZATION'S WEBSITE. IN ADDITION, THE ORGANIZATION PRESENTS FINANCIAL INFORMATION TO THE PUBLIC AS AN ATTACHMENT TO ITS MASSACHUSETTS OFFICE OF THE ATTORNEY GENERAL FORM PC. | |
| FORM 990, PART VII | LAHEY CLINIC AFFILIATED SERVICES, INC. AND ITS RELATED ORGANIZATIONS DO NOT COMPENSATE ANY TRUSTEE IN THEIR CAPACITY AS A TRUSTEE. ALL COMPENSATION PAID IS FOR WORK PERFORMED IN THE EMPLOYEE'S JOB TITLE, WHICH IS LISTED ON FORM 990 PART VII DIRECTLY FOLLOWING THE TITLE OF "TRUSTEE". | |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Howard R Grant J.D. M.D. TITLE:TRUSTEE/PRESIDENT/CEO HOURS:64 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:John A Libertino M.D. TITLE:TRUSTEE/CHAIR DEPT OF UROLOGY HOURS:39 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Richard W Nesto M.D. TITLE:TRUSTEE/EVP/CMOO/PHYSICIAN HOURS:60 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Roger L Jenkins M.D. TITLE:TRUSTEE/PHYSICIAN HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Richard S D'Agostino M.D. TITLE:TRUSTEE/CHAIR DEPT CARDIO SURG HOURS:39 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Judith A Melin M.D. TITLE:TRUSTEE UNTIL7/16/12/ASSC CQSO HOURS:60 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Carl A Soderland M.D. TITLE:TRUSTEE UNTIL 7/16/12/CHAIR HOURS:39 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Andrew G Villanueva M.D. TITLE:TRUSTEE/CMO CLINIC/PHYSICIAN HOURS:39 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Betsey Crawford M.D. TITLE:TRUSTEE START 7/16/12/PHYSICIA HOURS:39 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Arthur P Mourtzinos M.D. TITLE:TRUSTEE START 7/16/12/PHYSICIA HOURS:39 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Rebecca C Yang M.D. TITLE:TRUSTEE START 7/16/12/PHYSICIA HOURS:39 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Irving E Rogers III TITLE:TRUST/CHAIR/CLERK UNTIL7/16/12 HOURS:7 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Eric M Bailey TITLE:TRUSTEE HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Craig R Benson TITLE:TRUSTEE HOURS:4 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Ann Marie Connolly TITLE:TRUSTEE HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Jerald G Fishman TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:James W Henderson TITLE:TRUST/VICE CHAIR UNTIL 7/16/12 HOURS:6 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:James D Irving TITLE:TRUSTEE HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Charles M Leighton TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Peter J Manning TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:J William Poduska TITLE:TRUSTEE HOURS:4 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Windle B Priem TITLE:TRUSTEE HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:James A Radley TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Robert L Reynolds TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Michael C Ruettgers TITLE:TRUSTEE/CHAIR OF BOARD HOURS:6 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Carolyn Ain TITLE:TRUSTEE START 7/16/12 HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Jane C Edmonds TITLE:TRUSTEE START 7/16/12 HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Edward Eskandarian TITLE:TRUSTEE START 7/16/12 HOURS:3 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:David G Spackman TITLE:CLERK START 7/16/12 /GEN COUNS HOURS:64 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Timothy O'Connor TITLE:OFFICER/TREASURER/EVP/CFO HOURS:64 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:David M Barrett M.D. TITLE:FORMER TRUSTEE/PRES/CEO HOURS: | FORM 990 PART VII |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (13 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| LAHEY CLINIC HOSPITAL INC | ||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 01805 | 042704686 | HEALTH CARE | MA | 501(C)(3) | 3 | LCF INC | true |
| LAHEY CLINIC INC | ||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 01805 | 042704683 | HEALTH CARE | MA | 501(C)(3) | 9 | LCF INC | true |
| LAHEY CLINIC FOUNDATION INC | ||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 01805 | 042323457 | SUPPORT | MA | 501(C)(3) | 7 | LHS INC | true |
| NORTHEAST HEALTH SYSTEMS INC | ||||||||||
| 85 HERRICK ST | BEVERLY | MA | 01915 | 043240453 | SUPPORT | MA | 501(C)(3) | 11C III-FI | LHS INC | true |
| NORTHEAST HOSPITAL CORPORATION | ||||||||||
| HERRICK ST | BEVERLY | MA | 01915 | 042121317 | HEALTH CARE | MA | 501(C)(3) | 3 | NEHS INC | true |
| NORTHEAST MEDICAL PRACTICES | ||||||||||
| 85 HERRICK ST | BEVERLY | MA | 01915 | 043201853 | HEALTH CARE | MA | 501(C)(3) | 9 | NEHC | true |
| SEACOAST NURSING & REHABILITATION CENTER | ||||||||||
| 300 WASHINGTON ST | GLOUCESTER | MA | 01930 | 041305001 | HEALTH CARE | MA | 501(C)(3) | 9 | NEHS INC | true |
| NORTHEAST PROFESSIONAL REG OF NURSES | ||||||||||
| 800 CUMMINGS CTR | BEVERLY | MA | 01915 | 201287349 | HEALTH CARE | MA | 501(C)(3) | 9 | NESHC | true |
| NORTHEAST SENIOR HEALTH CORPORATION | ||||||||||
| 85 HERRICK ST | BEVERLY | MA | 01915 | 042731137 | HEALTH CARE | MA | 501(C)(3) | 9 | NEHS INC | true |
| NORTHEAST BEHAVIORAL HEALTH CORPORATION | ||||||||||
| 131 RANTOUL ST | BEVERLY | MA | 01915 | 042777145 | MENTAL ILL | MA | 501(C)(3) | 7 | NEHS INC | true |
| CAB HEALTH & RECOVERY | ||||||||||
| 111 MIDDLETON ROAD | DANVERS | MA | 01923 | 042400270 | SUBS ABUSE | MA | 501(C)(3) | 9 | NEHBC | true |
| HEALTH & EDUCATION HOUSING SERVICES INC | ||||||||||
| 0 CENTENNIAL DRIVE | PEABODY | MA | 01960 | 223232914 | HUD HOUSING | MA | 501(C)(3) | 9 | NEBHC | true |
| LAHEY HEALTH SYSTEM INC | ||||||||||
| 41 MALL ROAD | BURLINGTON | MA | 01805 | 611665701 | SUPPORT | MA | 501(C)(3) | 11C III-FI | NA | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)
| Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Legal Domicile StateLegalDomicileState | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAHEY CLINIC INSURANCE CO LTD | |||||||||||||
| INSURANCE | BD | LCF INC | C-CORP | ||||||||||
| PERPETUAL TRUSTS (7) | |||||||||||||
| SUPPORT | SEE PART VII | TRUST | MA | ||||||||||
| REMAINDER TRUSTS (17) | |||||||||||||
| SUPPORT | SEE PART VII | TRUST | MA | ||||||||||
| POOLED INCOME FUNDS (4) | |||||||||||||
| SUPPORT | SEE PART VII | TRUST | MA | ||||||||||
| NORTHEAST PROPRIETARY CORPORATION | |||||||||||||
| MEDICAL SERVICES | NEHS INC | C-CORP | MA | 85 HERRICK ST | BEVERLY | MA | 01915 | 042855191 | |||||
| NORTHEAST MASSACHUSETTS INDEMNITY CO LTD | |||||||||||||
| INSURANCE | CJ | NHS INC | C-CORP | 980440187 | GOVERNORS SQ 23 LIME TREE BAY AVE | GRAND CAYMAN KY1-1102 | GRAND CAYMAN KY1-1102 | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAHEY CLINIC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionType |
| Amount Involved | 1347500 | AmountInvolved |
| Method Of Amt Determination | COST | MethodOfAmtDetermination |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FORM 990, SCHEDULE R, PART IV, LINE 2 | Identifier |
| Explanation | LAHEY CLINIC FOUNDATION, INC. AND NORTHEAST HOSPITAL CORPORATION, RESPECTIVELY, HAVE FOUR AND THREE PERPETUAL TRUSTS. THE PERPETUAL TRUSTS ARE DOMICILED IN MASSACHUSETTS AND PENNSYLVANIA. FORM 990, SCHEDULE R, PART IV, LINE 3 LAHEY CLINIC FOUNDATION, INC. HAS SEVENTEEN REMAINDER TRUSTS. THE REMAINDER TRUSTS ARE DOMICILED IN MASSACHUSETTS AND NEW HAMPSHIRE. FORM 990, SCHEDULE R, PART IV, LINE 4 LAHEY CLINIC FOUNDATION, INC. AND NORTHEAST HOSPITAL CORPORATION, RESPECTIVELY, HAVE THREE AND ONE POOLED INCOME FUNDS. FORM 990, SCHEDULE R, PART V, LINE M ALL ENTITIES WITHIN THE LAHEY HEALTH SYSTEM, INC. SHARE FACILITIES, EQUIPMENT, MAILING LISTS AND OTHER ASSETS. FOR A LIST OF ALL ENTITIES SEE SCHEDULE R. | Explanation |
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