2013-08-15T15:36:50-05:00 2012-09-30 PricewaterhouseCoopers LLP 125 High Street Boston MA 02110 990 2011-10-01 042704686 Lahey Clinic Hospital Inc % TIMOTHY O'CONNOR LAHE 7817445100 41 Mall Road Burlington MA 018050001 TIM O'CONNOR 2013-08-12 true 6175305000 2011 2016-02-24 21:20:13Z Howard R Grant JD MD 41 MALL ROAD BURLINGTON MA 018050001 802978378 false X www.lahey.org X 1980 MA SEE SCHEDULE O 19 9 4799 200 241567 66742 0 0 751902576 793005182 54686 152867 8737276 9812447 760694538 802970496 0 0 0 0 368832505 401269566 0 0 0 326770560 333140817 695603065 734410383 65091473 68560113 310851110 392952442 374746827 463337910 -63895717 -70385468 X SEE SCHEDULE O false false 564891029 785510957 PATIENT CARE - See Schedule O 30137880 7494225 EDUCATION - See Schedule O 595028909 true false false true false false false false false false false false false true true false false true false false false false false false false false true true false false true false false false false false false false true false false false false false true true true false false true 298 0 true 4799 true true true false false false false false false false false false X 19 9 true false true false true true true true true false false true true true true true false false true false MA X TIMOTHY O'CONNOR 7817445100 41 MALL ROAD Burlington MA 018050001 X Howard R Grant JD MD 8.0 X X 0 960934 84545 John A Libertino MD 1.0 X 0 813060 39384 Richard W Nesto MD 20.0 X 0 595970 101415 Roger L Jenkins MD 1.0 X 0 592138 49628 Richard S D'Agostino MD 1.0 X 0 529013 52842 Judith A Melin MD 20.0 X 0 327467 30355 Carl A Soderland MD 1.0 X 0 389917 36436 Andrew G Villanueva MD 1.0 X 0 327045 37548 Betsey Crawford MD 1.0 X 0 187572 12386 Arthur P Mourtzinos MD 1.0 X 0 403201 43266 Rebecca C Yang MD 1.0 X 0 344322 41513 Irving E Rogers III 2.0 X X 0 0 0 Eric M Bailey 1.0 X 0 0 0 Craig R Benson 1.0 X 0 0 0 Ann Marie Connolly 1.0 X 0 0 0 Jerald G Fishman 1.0 X 0 0 0 James W Henderson 2.0 X X 0 0 0 James D Irving 1.0 X 0 0 0 Charles M Leighton 1.0 X 0 0 0 Peter J Manning 1.0 X 0 0 0 J William Poduska 1.0 X 0 0 0 Windle B Priem 1.0 X 0 0 0 James A Radley 1.0 X 0 0 0 Robert L Reynolds 1.0 X 0 0 0 Michael C Ruettgers 2.0 X X 0 0 0 Carolyn Ain 1.0 X 0 0 0 Jane C Edmonds 1.0 X 0 0 0 Edward Eskandarian 1.0 X 0 0 0 David G Spackman 8.0 X 0 0 0 Timothy O'Connor 8.0 X 0 683581 159274 Donald F Snell 40.0 X 452702 0 25201 Robert J Schneider 40.0 X 362821 0 37095 Jeffrey P Doran 40.0 X 319188 0 38594 Stanley Bello 40.0 X 227862 0 36381 Richard J Guarino 40.0 X 202261 0 38936 Lynn A Stofer 40.0 X 495461 0 83199 Joyce M Shannon 40.0 X 320177 0 0 Wendy Lee 40.0 X 227245 0 21790 C M Crowley Ganser 40.0 X 217917 0 45867 Naimuddin Shaikh 40.0 X 217655 0 40006 David M Barrett MD 0.0 X 0 1388662 200000 3043289 7542882 1255661 421 true true false IMEDX MEDWARE Inc 11711 WEST 79TH STREET LENEXA KS 66214 CONTRACT SERVICES 1314908 ANTHONY VANARIA AND SONS 45 FELTON STREET WALTHAM MA 02453 CONTRACT SERVICES 1221106 FORGET ME NOT SERVICES INC 323 ANDOVER STREET SUITE 7 WILMINGTON MA 01887 CONTRACT SERVICES 864819 CLINICAL FINANCIAL RESOURCES INC PO BOX 100 SEAKONK MA 02771 CONTRACT SERVICES 572317 AMERICAN TRANSLATION PARTNERS INC 834 ALBANY STREET BOSTON MA 02119 contract services 559854 22 0 NET PATIENT SERVICE REVENUE 624100 781081212 781081212 OTHER PATIENT REVENUE 621400 11744759 11744759 OUTSIDE LABORATORY SERVICES 621500 179211 179211 793005182 43874 43874 0 0 6000 0 6000 6000 6000 116875 7882 108993 108993 108993 0 0 0 CAFETERIA REVENUE 722210 4554163 4554163 PARKING GARAGE REVENUE 812930 3312216 3312216 GIFT SHOP REVENUE 453220 62356 62356 1877712 1877712 9806447 802970496 792825971 241567 9902958 0 0 0 0 0 0 0 5920019 0 5920019 0 1083560 0 1083560 0 283306026 225247570 58058456 0 51045402 45088684 5956718 0 39931999 35262737 4669262 0 19982560 15815398 4167162 0 90048 0 90048 0 581404 0 581404 0 379517 0 379517 0 0 0 0 0 0 0 0 0 0 0 25262719 8921059 16341660 0 984965 984965 0 0 8118304 3286502 4831802 0 6668074 73835 6594239 0 0 0 0 0 13867612 11418147 2449465 0 662317 352569 309748 0 0 0 0 0 0 0 0 0 9390571 8508592 881979 0 0 0 0 0 52744984 47791081 4953903 0 1059583 960065 99518 0 MEDICAL SUPPLIES 142543335 142400048 143287 0 GENERAL SUPPLIES 61384846 39515119 21869727 0 MASS HEALTH SAFTEY NET ASSME 9402538 9402538 0 0 734410383 595028909 139381474 0 0 0 185015872 245073177 0 0 83067846 84864102 0 0 0 0 382189 237019 10635564 13069671 3802174 4746497 0 10423138 10952778 0 0 0 0 0 0 17524327 34009198 310851110 392952442 320485986 413004447 0 0 0 0 0 0 0 0 0 0 15802450 14363049 0 0 38458391 35970414 374746827 463337910 X -63895717 -70385468 0 0 0 0 -63895717 -70385468 310851110 392952442 X 68560113 -75049864 X false true true X false X false true false true 1000 false false true 100128 true 57967 false 159095 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1 LAHEY CLINIC HOSPITAL, INC. 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. LAHEY CLINIC HOSPITAL, INC. ALSO PAID MEMBER DUES TO THE AMERICAN HOSPITAL ASSOCIATION, TO THE MASSACHUSETTS HOSPITAL ASSOCIATION AND TO SOME OTHER SMALLER ORGANIZATIONS, OF WHICH A PERCENTAGE OF THE DUES WAS ATTRIBUTED TO LOBBYING EFFORTS. INTERCOMPANY RECEIVABLES 28115822 OTHER INVESTMENTS 513157 INTEREST IN NEPC 3500 MALP INSURANCE FUNDS RECEIVABL 5376719 34009198 0 ESTIMATE DUE TO THIRD PARTY INSURANCE CARRIERS 26374714 ESTIMATE DUE TO THIRD PARTY INSURANCE CARRIERS 9595700 35970414 802970496 734410383 68560113 -75049864 -75049864 -6489751 801878378 801878378 1092118 1092118 802970496 808368129 75049864 75049864 733318265 1092118 1092118 734410383 Schedule D, Part X THE ORGANIZATION'S FINANCIAL STATEMENTS DID NOT REPORT A LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. SCHEDULE D, PART XI, LINE 8 PENSION PLAN, POST RETIREMENT RELATED CHANGES, AND CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE $(75,049,864) SCHEDULE D, PART XII, LINE 4B & SCHEDULE D, PART XIII, LINE 4B OTHER OPERATING REVENUES TRANSFERRED FROM LAHEY CLINIC FOUNDATION, INC. IN THE AMOUNT OF $1,092,118. THIS AMOUNT WAS PREVIOUSLY NETTED AS A NEGATIVE EXPENSES IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. SCHEDULE D, PART XIII, LINE 2D PENSION PLAN, POST RETIREMENT RELATED CHANGES, AND CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE $75,049,864 true true X true X true X true true true false true true 3446399 3446399 0.00470 31253909 24753844 6500065 0.00890 20762178 14106175 6656003 0.00910 55462486 38860019 16602467 0.02270 5982036 5982036 0.00810 30137880 7494225 22643655 0.03080 30616831 25575898 5040932 0.00690 491569 491569 0.00070 67228316 33070123 34158192 0.04650 122690802 71930142 50760659 0.06920 true 15007975 2065020 228127015 252721069 -24594054 X true true 1 1 LAHEY CLINIC HOSPITAL INC

41 MALL ROAD BURLINGTON MA 01805

X X X X X medical research conducted under the Lahey clinic, inc. LAHEY CLINIC HOSPITAL INC 1 true true 200. true 400. true X X X X X true true X X X X X X true false true X false false SCHEDULE H, PART I, LINE 7 THE AMOUNTS LISTED ON SCHEDULE H, PART I, LINE 7, ITEMS A, B, C, AND G WERE DETERMINE BY USING THE COST TO CHARGE RATIO CALCULATION INCLUDED IN THE IRS FORM 990 INSTRUCTIONS REFERENCING SCHEDULE H, PART I, LINE 7, IRS WORKSHEET #2. SCHEDULE H, PART III, LINE 4 IN JULY 2011, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED ACCOUNTING STANDARDS UPDATE 2011-7 (ASU 2011-7), HEALTH CARE ENTITIES: PRESENTATION AND DISCLOSURE OF NET REVENUE, PROVISION FOR BAD DEBTS AND ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS. UNDER THE NEW GUIDANCE, BAD DEBTS RELATING TO PATIENT SERVICE REVENUE WILL BE SEPARATELY DISCLOSED IN THE STATEMENT OF OPERATIONS AND REPORTED AS A COMPONENT OF NET PATIENT SERVICE REVENUE. BAD DEBTS ASSOCIATED WITH ACTIVITIES OTHER THAN PATIENT SERVICE REVENUE WILL CONTINUE TO BE REPORTED AS OPERATING EXPENSE. LAHEY CLINIC HOSPITAL, INC. ELECTED TO EARLY ADOPT ASU 2011-7 FOR 2012 AND CHANGED ITS REPORTING OF THE PROFISION FOR BAD DEBTS. SCHEDULE H, PART III, LINE 8 THE MEDICARE SHORTFALL OF ($24,594,054) REPORTED IN PART III, LINE 7 WAS CALCULATED BASED ON THE COST TO CHARGE RATIO PER LAHEY CLINIC HOSPITAL, INC'S MEDICARE 2552 COST REPORT FOR YEAR ENDING 09/30/2012. THE ENTIRE AMOUNT SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE THE RATES PAID BY MEDICARE DO NOT ACCURATELY REFLECT THE COST OF CARE PROVIDED BY THE HOSPITAL. ACCORDINGLY, THE HOSPITAL MUST SUBSIDIZE THE COST OF CARE PROVIDED TO MEDICARE BENEFICIARIES WITH OTHER REVENUES. SCHEUDLE H, PART III, LINE 9b LAHEY CLINIC HOSPITAL, INC. MAKES THE SAME REASONABLE EFFORT AND FOLLOWS THE SAME REASONABLE PROCESS FOR COLLECTING ON BILLS OWED BY AN UNINSURED PATIENT AS IT DOES FOR ALL OTHER PATIENTS. LAHEY CLINIC HOSPITAL, INC., WHEN REQUESTED BY A PATIENT AND BASED ON AN INTERNAL REVIEW OF EACH PATIENT'S FINANCIAL STATUS, MAY OFFER A PATIENT AN ADDITIONAL DISCOUNT ON AN UNPAID HOSPITAL BILL. ANY SUCH REVIEW SHALL BE PART OF A SEPARATE HOSPITAL FINANCIAL ASSISTANCE PROGRAM THAT IS APPLIED ON A UNIFORM BASIS TO ALL PATIENTS, AND WHICH TAKES INTO CONSIDERATION THE PATIENT'S DOCUMENTED FINANCIAL SITUATION AND THE PATIENT'S INABILITY TO MAKE A PAYMENT AFTER REASONABLE COLLECTION ACTIONS. ANY DISCOUNT THAT IS PROVIDED BY THE HOSPITAL IS CONSISTENT WITH FEDERAL AND STATE REQUIREMENTS, AND DOES NOT INFLUENCE A PATIENT TO RECEIVE SERVICES FROM THE HOSPITAL. BEFORE ANY DEBT COLLECTION EFFORTS BEGIN, LAHEY CLINIC HOSPITAL, INC. WILL FIRST SHOW THAT IT HAS A CURRENT UNPAID BALANCE THAT IS RELATED TO SERVICES PROVIDED TO A PATIENT AND THOSE SERVICES ARE NOT COVERED BY A PRIVATE INSURER, A GOVERNMENT PROGRAM SUCH AS MEDICARE, MEDICAID/MASSHEALTH, THE HEALTH SAFETY NET, TRICARE/VETERANS ADMINISTRATION PROGRAMS OR BY LAHEY CLINIC HOSPITAL, INC'S FINANCIAL ASSISTANCE PROGRAM. LAHEY CLINIC HOSPITAL, INC. FOLLOWS AND DOCUMENTS REASONABLE COLLECTION/BILLING PROCEDURES FOR UNPAID BALANCES, WHICH INCLUDE: (1) AN INITIAL BILL SENT TO THE PATIENT OR THE PARTY RESPONSIBLE FOR THE PATIENT'S PERSONAL FINANCIAL OBLIGATIONS. THE INITIAL BILL WILL INCLUDE INFORMATION ABOUT THE AVAILABILITY OF A FINANCIAL ASSISTANCE PROGRAM THAT MAY COVER THE COST OF THE HOSPITAL'S BILL; (2) SUBSEQUENT BILLINGS, TELEPHONE CALLS, COLLECTION LETTERS, PERSONAL CONTACT NOTICES, COMPUTER NOTIFICATIONS, OR ANY OTHER NOTIFICATION METHOD THAT CONSTITUTES A GENUINE EFFORT TO CONTACT THE PARTY RESPONSIBLE FOR THE OBLIGATION AND INFORMS THE PATIENT OF THE AVAILABILITY OF FINANCIAL ASSISTANCE; (3) IF POSSIBLE, DOCUMENTATION OF ALTERNATIVE EFFORTS TO LOCATE THE PARTY RESPONSIBLE FOR THE OBLIGATION OR THE CORRECT ADDRESS ON BILLINGS RETURNED BY THE POSTAL SERVICE SUCH AS "INCORRECT ADDRESS" OR "UNDELIVERABLE;" (4) SENDING A FINAL NOTICE BY CERTIFIED MAIL FOR UNINSURED PATIENTS (THOSE WHO ARE NOT ENROLLED IN A PUBLIC PROGRAM SUCH AS THE HEALTH SAFETY NET OR MEDICAID/MASSHEALTH) WHO INCUR A BALANCE OF $1,000 AND GREATER, INCLUDING AN EMERGENCY BAD DEBT BALANCE OF $1,000 OR GREATER ON EMERGENCY LEVEL SERVICES, WHERE NOTICES HAVE NOT BEEN RETURNED AS "INCORRECT ADDRESS" OR "UNDELIVERABLE" AND ALSO NOTIFYING THE PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE COMMUNICATION. (5) DOCUMENTATION OF CONTINUOUS BILLING OR COLLECTION ACTION UNDERTAKEN ON A REGULAR, FREQUENT BASIS IS MAINTAINED. SUCH DOCUMENTATION IS MAINTAINED UNTIL AUDIT REVIEW BY A FEDERAL AND/OR STATE AGENCY OF THE FISCAL YEAR COST REPORT IN WHICH THE BILL OR ACCOUNT IS REPORTED. THE FEDERAL MEDICARE PROGRAM AND THE STATE DIVISION OF HEALTH CARE FINANCE AND POLICY FOR PURPOSES OF THE HEALTH SAFETY NET PROGRAM, DEEMS 120 DAYS AS APPROPRIATE FOR CONTINUOUS BILLING OR COLLECTION ACTIONS; AND (6) CHECKING THE MASSACHUSETTS ELIGIBILITY VERIFICATION SYSTEM (EVS) TO ENSURE THAT THE PATIENT IS NOT A LOW INCOME PATIENT AS DETERMINED BY THE OFFICE OF MEDICAID AND HAS NOT SUBMITTED AN APPLICATION TO THE VIRTUAL GATEWAY SYSTEM FOR COVERAGE OF THE SERVICES UNDER A PUBLIC PROGRAM, PRIOR TO SUBMITTING CLAIMS TO THE HEALTH SAFETY NET OFFICE FOR EMERGENCY BAD DEBT COVERAGE OF AN EMERGENCY LEVEL OR URGENT CARE SERVICE. LAHEY CLINIC HOSPITAL, INC. CONTRACTS WITH OUTSIDE COLLECTION AGENCIES TO ASSIST IN THE COLLECTION OF CERTAIN ACCOUNTS, INCLUDING PATIENT RESPONSIBLE AMOUNTS NOT RESOLVED AFTER ISSUANCE OF HOSPITAL BILLS AND/OR FINAL NOTICES. LAHEY CLINIC HOSPITAL, INC. DOES NOT REPORT A PATIENT HOSPITAL DEBT TO A CREDIT REPORTING AGENCY AND HAS NOT REPORTED ANY SUCH DEBTS TO ANY CREDIT REPORTING AGENCY DURING THE TAX YEAR. SCHEDULE H, PART V, SECTION A, LINE 1, HOSPITAL FACILITIES LAHEY CLINIC HOSPITAL, INC.'S MAIN CAMPUS IS LOCATED IN BURLINGTON, MASSACHUSETTS. THE MAIN CAMPUS INCLUDES 330 BEDS, 23 OPERATING ROOMS AND A 24-HOUR EMERGENCY ROOM. LAHEY CLINIC HOSPITAL, INC. ALSO HAS THREE OTHER OFFSITE LOCATIONS, OPERATING UNDER THE HOSPITAL LICENSE OF THE MAIN CAMPUS IN BULRINGTON. THE LARGEST OFFSITE LOCATION, LAHEY CLINIC NORTH SHORE, IS LOCATED IN PEABODY, MASSACHUSETTS. LAHEY CLINIC NORTH SHORE INCLUDES 10 BEDS, 5 OPERATING ROOMS AND OPERATES THE CITY OF PEABODY'S ONLY 24-HOUR EMERGENCY ROOM. SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION & REQUIRED DISCLOSURES #1 - REQUIRED DESCRIPTIONS & SCHEDULE H, PART I, LINE 7, COLUMN F LAHEY CLINIC HOSPITAL, INC. (LAHEY) PROVIDED CHARITY CARE (AT COST) IN THE AMOUNT OF $3.4 MILLION DOLLARS AS A RESULT OF OUR CHARITY CARE POLICY AND FREE CARE REGULATIONS ASSOCIATED TO THE HEALTH SAFETY NET AS PROMULGATED BY THE COMMONWEALTH OF MASSACHUSETTS. LAHEY'S NET COST (PATIENT CARE COSTS MINUS PAYMENTS) TO TREAT MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS, SUCH AS COMMONWEALTH CARE WHICH INCLUDES THE HEALTH SAFETY NET ASSESSMENT HAS AN OVERALL NEGATIVE IMPACT OF $13.1 MILLION DOLLARS. IN 2012, LAHEY GAVE MORE THAN $2.6 MILLION DOLLARS IN SUPPORT OF COMMUNITY PROJECTS, LARGELY FOCUSED ON SENIOR CITIZENS WITH UNDERSERVED HEALTH NEEDS. THESE PROGRAMS INCLUDED SERVICES PROVIDED BY LAHEY, PROGRAMS WE FUNDED DIRECTLY AND PROGRAMS TO WHICH WE CONTRIBUTED DON FUNDING THROUGH OUR ROLE IN THE COMMUNITY HEALTH NETWORK AREAS #13, 14 & 15 (CHNA 13, CHNA 14, & CHNA 15). AS PART OF LAHEY'S MISSION STATEMENT TEACHING AND EDUCATION OF HEALTH CARE PROFESSIONALS, SUCH AS INTERNS, RESIDENTS AND FELLOWS AND OTHER ALLIED HEALTH PROFESSIONALS IS PARAMOUNT TO THE ADVANCEMENT OF HEALTH CARE IN THE COMMUNITY. LAHEY HAS MADE A SUBSTANTIAL INVESTMENT OF $22.6 MILLION DOLLARS TO SUPPORT THIS ENDEAVOR. AS AN ACADEMIC MEDICAL CENTER, LAHEY PROVIDES MUCH NEEDED SERVICES TO THE COMMUNITY IN THE FORM OF BEHAVIORAL HEALTH SERVICES AND EMERGENCY AND TRAUMA SERVICES TO THE COST OF $5.0 MILLION DOLLARS. AS ANOTHER PART OF LAHEY'S MISSION STATEMENT, RESEARCH ACTIVITIES SUCH AS ORGAN TRANSPLANTATION AND CANCER SERVICES ARE STUDIED IN AN EFFORT TO IMPROVE THE OVERALL WELLBEING AND HEALTH CARE SERVICES PROVIDED TO THE COMMUNITY TO THE COST OF $491 THOUSAND DOLLARS. #2 - NEEDS ASSESSMENT BEGINNING IN 2009 AND CONCLUDING IN 2010, JOHN SNOW, INC. (JSI), WAS CONTRACTED BY LAHEY CLINIC HOSPITAL, INC. TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT. THE NEEDS ASSESSMENT WAS AIMED AT IDENTIFYING THE MAJOR HEALTH CONCERNS AND HEALTH-RELATED PRIORITIES OF THE RESIDENTS LIVING IN LAHEY'S CORE SERVICE AREAS. ULTIMATELY, THE ASSESSMENT WAS INTENDED TO GUIDE THE DEVELOPMENT OF LAHEY'S COMMUNITY BENEFIT STRATEGY AND TO ENSURE THAT ITS COMMUNITY HEALTH ACTIVITIES WERE APPROPRIATELY TARGETED AND RESPONSIVE TO COMMUNITY NEEDS. THE JSI PROJECT TEAM APPLIED A MULTI-FACETED APPROACH THAT COMPILED QUANTITATIVE DATA FROM FEDERAL, STATE AND LOCAL DATA SOURCES AND QUALITATIVE DATA THROUGH A SERIES OF COMMUNITY INTERVIEWS. THROUGH LAHEY CLINIC HOSPITAL, INC.'S ROBUST COMMUNITY BENEFITS INITIATIVE (CBI), LAHEY CLINIC HOSPITAL, INC. ASPIRES TO BUILD AND SUSTAIN COLLABORATIVE PARTNERSHIPS WITH OTHER COMMUNITY SERVICES PROVIDERS, SEEK RESOURCES AND INITIATE PROGRAMS IN THE CONTEXT OF DOCUMENTED UNMET HEALTH AND SOCIAL NEEDS. LAHEY CLINIC HOSPITAL, INC. PLANS TO CONDUCT THEIR NEXT COMMUNITY HEALTH NEEDS ASSESSMENT DURI X false false true true false false false false false true false 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 Donald F Snell 438855 0 0 0 13847 0 4900 0 20301 0 477903 0 0 0 Robert J Schneider 324100 0 0 0 38721 0 17500 0 19595 0 399916 0 0 0 Jeffrey P Doran 280430 0 0 0 38758 0 17500 0 21094 0 357782 0 0 0 Stanley Bello 205466 0 0 0 22396 0 13986 0 22395 0 264243 0 0 0 Richard J Guarino 181117 0 0 0 21144 0 13060 0 25876 0 241197 0 0 0 Lynn A Stofer 374823 0 82000 0 38638 0 58500 0 24699 0 578660 0 0 0 Joyce M Shannon 0 0 0 0 320177 0 0 0 0 0 320177 0 0 0 Wendy Lee 205107 0 0 0 22138 0 13801 0 7989 0 249035 0 0 0 C M Crowley Ganser 207835 0 0 0 10082 0 14429 0 31438 0 263784 0 0 0 Naimuddin Shaikh 195259 0 0 0 22396 0 12568 0 27438 0 257661 0 0 0 SCHEDULE J, PART I, LINES 1A, 1B & 2 DONALD F. SNELL RECEIVED $24,032 FROM THE ORGANIZATION IN CALENDAR YEAR 2011 FOR A TEMPORARY HOUSING ALLOWANCE (TAXABLE). THE ITEMS CHECKED IN SCHEDULE J, PART I, LINE 1A, VIA AN EXECUTED EMPLOYEMENT AGREEMENT, WERE NEGOTIATED AND AGREED TO BY BOTH PARTIES AND THEIR REPRESENTATIVES. SCHEDULE J, PART I LINE 4A, SCHEDULE J, PART II COLUMN B(III) JOYCE M. SHANNON WAS TERMINATED FROM LAHEY CLINIC HOSPITAL, INC. ON 10/30/2010. SCHEDULE J REQUIRES THE REPORTING OF COMPENSATION BASED ON CALENDAR YEAR 2011. JOYCE M. SHANNON'S COMPENSATION PAID BY LAHEY CLINIC HOSPITAL, INC. FOR CALENDAR YEAR 2011 INCLUDES $279,118 OF SEVERANCE PAYMENTS PER MS. SHANNON'S EMPLOYMENT CONTRACT AND $41,059 OF VACATION AND SICK TIME CASHED-OUT. SCHEDULE J, PART I LINE 4A, PART II COLUMN B(III) AND COLUMN C 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 LYNN A STOFER - AMOUNT = $ 41,000 SCHEDULE J, PART I, LINE 7 THE NON-FIXED PAYMENT BONUSES REPORTED IN SCHEDULE J, PART II, COLUMN B(II) ARE DETERMINED BY AN INDEPENDENT COMPENSATION COMMITTEE, WHICH INCLUDES A GROUP OF TRUSTEES. IN A SUBJECTIVE MANNER, THE COMMITTEE TAKES INTO ACCOUNT THE ACHIEVEMENTS OF BOTH THE ORGANIZATION AND THE INDIVIDUAL TO DETERMINE AN APPROPRIATE AMOUNT OF SUCH BONUSES. 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. CR BARD COMPANIES INC TRUSTEE ON C.R.BARD BOARD 777655 PURCHASE OF PRODUCTS false FORM 990, PART I, LINE 1 & PART III, LINE 1 LAHEY CLINIC HOSPITAL, INC. A TEACHING HOSPITAL OF TUFTS UNIVERSITY, 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 HOSPITAL, 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 HOSPITAL, 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 III, LINE 4A PATIENT CARE LAHEY CLINIC HOSPITAL, INC. STRIVES EACH DAY TO PROVIDE TOP QUALITY SUPERIOR PATIENT CARE IN INPATIENT HOSPITAL, EMERGENCY, OUTPATIENT TREATMENT, AND DIAGNOSTIC AND OTHER ANCILLARY SERVICES. IN 2012, MORE THAN 21,000 PATIENTS WERE ADMITTED AS INPATIENTS TO LAHEY CLINIC'S HOSPITAL FACILITIES, REPRESENTING MORE THAN 101,000 PATIENT DAYS. MORE THAN 8,000 OF THESE PATIENTS WERE ADMITTED FOR SURGERY. ADDITIONALLY, MORE THAN 13,800 PATIENTS HAD DAY SURGERY AT THE BURLINGTON AND PEABODY MEDICAL CENTERS, WHICH TOGETHER HAVE A TOTAL OF 28 OPERATING ROOMS. HOSPITAL SERVICES INCLUDE 24-HOUR EMERGENCY DEPARTMENTS IN BURLINGTON AND PEABODY. IN 2012, LAHEY CLINIC HOSPITAL'S EMERGENCY ROOMS LOGGED MORE THAN 54,000 PATIENT VISITS. ALSO IN 2012, LAHEY CLINIC HOSPITAL'S OUTPATIENT CLINICS LOGGED MORE THAN 1,090,000 PATIENT VISITS. THE EXPERTISE LAHEY PROVIDES IS VITAL TO THE REGION. IN PARTICULAR, LAHEY OFFERS PROGRAMS SUCH AS LIVER AND KIDNEY TRANSPLANTATION, HEART SURGERY, NEUROSURGERY, AND OTHER SPECIALIZED PROGRAMS NOT WIDELY AVAILABLE IN COMMUNITY HOSPITALS. LAHEY IS DESIGNATED AS A PRIMARY STROKE SERVICE BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH. AMONG OTHER NATIONALLY RECOGNIZED ACHIEVEMENTS, LAHEY IS ACCREDITED BY THE JOINT COMMISSION, THE NATION'S LEADING BODY IN CERTIFYING HOSPITAL QUALITY AND PERFORMANCE, AND WAS REVERIFIED IN 2010 AS A LEVEL II TRAUMA CENTER BY THE AMERICAN COLLEGE OF SURGEONS. LAHEY CLINIC IS CERTIFIED AS A MAGNET HOSPITAL AND RECEIVED THE DESIGNATION AS A NICHE (NURSES IMPROVING THE CARE OF HEALTHCARE SYSTEM ELDERS) INSTITUTION IN JANUARY 2010. LAHEY IS ONE OF ONLY 250 HOSPITALS TO RECEIVE THIS DESIGNATION NATIONWIDE. LAHEY CLINIC HOSPITAL, INC. AFFIRMS ITS COMMITMENT TO IDENTIFYING AND SERVING THE HEALTH AND WELLNESS NEEDS OF ITS COMMUNITY THROUGH A COMMUNITY BENEFITS INITIATIVE (CBI). THE FOUNDATION OF THIS PROGRAM IS BASED UPON A COLLABORATIVE INITIATIVE BETWEEN LAHEY CLINIC EMPLOYEES, COMMUNITY LEADERS, REPRESENTATIVES OF COMMUNITY AGENCIES, AND COMMUNITY RESIDENTS. THROUGH COLLABORATIVE PLANNING, COALITION BUILDING AND FINANCIAL SUPPORT, LAHEY CLINIC STRIVES TO SERVE AS A CATALYST FOR POSITIVE CHANGE WITHIN THE COMMUNITY. LAHEY CLINIC HOSPITAL, INC.'S 2012 COMMUNITY BENEFITS INITIATIVE FOCUSED ON THE FOLLOWING AREAS: 1. ELDER HEALTH ISSUES 2. CHRONIC DISEASE MANAGEMENT 3. COMMUNITY HEALTH IMPROVEMENT AND EDUCATION PROGRAMS DIRECTED TOWARD ADULT, ELDER AND UNDERSERVED POPULATIONS AT RISK. THE PROGRAM ALSO PROVIDES UNCOMPENSATED CARE, FREE COUNSELING SERVICES, FREE SUPPORT SERVICES, A FREE PRESCRIPTION DRUG PROGRAM AND FREE PSYCHIATRY AND BEHAVIORAL MEDICINE CONSULTATIONS AND REFERRAL SERVICES. PLEASE REFER TO SCHEDULE H IN THIS IRS 990 TAX RETURN FOR ADDITIONAL INFORMATION RELATED TO LAHEY CLINIC HOSPITAL, INC. COMMUNITY BENEFIT PROGRAMS AND SERVICES. FORM 990, PART III, LINE 4B EDUCATION LAHEY CLINIC HOSPITAL, INC. IS CLASSIFIED AS A TEACHING HOSPITAL AND IS A MAJOR TEACHING AFFILIATE OF THE TUFTS UNIVERSITY SCHOOL OF MEDICINE AND IN THAT CAPACITY SUPPORTS THE EDUCATION AND TRAINING OF APPROXIMATELY 140 RESIDENTS AND FELLOWS AT A TIME. THE ATTENDING PHYSICIAN STAFF ALSO SUPPORTS A WIDE ARRAY OF CLINICAL EDUCATION AND TRAINING EFFORTS INCLUDING NURSING, PHARMACY, LABORATORY MEDICINE AND THE LATEST ADVANCEMENTS IN RADIOLOGICAL TECHNOLOGY. PLEASE NOTE THAT THE COSTS TO LAHEY CLINIC HOSPITAL, INC. TO PERFORM ADDITIONAL RADIOLOGY, LABORATORY AND OTHER TESTS FOR THE PURPOSES OF TEACHING INTERNS, RESIDENTS, FELLOWS, AND OTHER MEDICAL STUDENTS IS NOT INCLUDED IN THE ABOVE EXPENSE AMOUNT. FORM 990, PART VI, SECTION A, LINE 2 OFFICERS AND TRUSTEES OF LAHEY CLINIC HOSPITAL, INC. ARE OFFICERS AND TRUSTEES OF LAHEY CLINIC FOUNDATION, INC., LAHEY CLINIC, INC. AND LAHEY CLINIC AFFILIATED SERVICES, INC. CERTAIN TRUSTEES ARE ALSO EMPLOYEES OF LAHEY CLINIC FOUNDTION, 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 TRUSTEES AND/OR OFFICERS FOR LAHEY CLINIC INSURANCE COMPANY, LTD. IN ADDITION TO THEIR ROLES AS OFFICERS OF LAHEY CLINIC HOSPITAL, 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 HOSPITAL, 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 HOSPITAL, 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 A RELATED ORGANIZATION TO ESTABLISH THE COMPENSATION OF OFFICERS. THE RELATED ORGANIZATION USES 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 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 HOSPITAL, 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". FORM 990, PART VII, PART IX, LINE 5, SCHEDULE J COMPENSATION, BENEFIT AND PENSION EXPENSES FOR CERTAIN OFFICERS, TRUSTEES AND KEY EMPLOYEES, OF LAHEY CLINIC HOSPITAL, INC., ARE PAID BY LAHEY CLINIC FOUNDATION, INC. LAHEY CLINIC FOUNDATION, INC., AS THE PARENT COMPANY OF LAHEY CLINIC HOSPITAL, INC. AND LAHEY CLINIC, INC., THEN ALLOCATES A SIGNIFICANT PORTION OF THE AFOREMENTIONED EXPENSES TO ITS AFFILIATES. THE AFFILIATES THEN REIMBURSE LAHEY CLINIC FOUNDATION, INC. FOR THESE EXPENSES. FORM 990, PART XI, LINE 5 Pension Plan and Post retirement related changes, amounted to a net loss of $(75,049,864) for fiscal year 2012. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Howard R Grant J.D. M.D. TITLE:TRUSTEE/PRESIDENT/CEO HOURS:57 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:John A Libertino M.D. TITLE:TRUSTEE/CHAIR DEPT OF UROLOGY HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Richard W Nesto M.D. TITLE:TRUSTEE/EVP/CMOO/PHYSICIAN HOURS:41 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Roger L Jenkins M.D. TITLE:TRUSTEE/PHYSICIAN HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Richard S D'Agostino M.D. TITLE:TRUSTEE/CHAIR DEPT CARDIO SURG HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Judith A Melin M.D. TITLE:TRUSTEE UNTIL7/16/12/ASSC CQSO HOURS:41 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Carl A Soderland M.D. TITLE:TRUSTEE UNTIL 7/16/12 /CHAIR HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Andrew G Villanueva M.D. TITLE:TRUSTEE/CMO CLINIC/PHYSICIAN HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Betsey Crawford M.D. TITLE:TRUSTEE START 7/16/12/PHYSICIA HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Arthur P Mourtzinos M.D. TITLE:TRUSTEE START 7/16/12/PHYSICIA HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Rebecca C Yang M.D. TITLE:TRUSTEE START 7/16/12/PHYSICIA HOURS:39 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Irving E Rogers III TITLE:TRUST/CHAIR/CLERK UNTIL7/16/12 HOURS:7 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Eric M Bailey TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Craig R Benson TITLE:TRUSTEE HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ann Marie Connolly TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jerald G Fishman TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James W Henderson TITLE:TRUST/VICE CHAIR UNTIL 7/16/12 HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James D Irving TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Charles M Leighton TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Peter J Manning TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J William Poduska TITLE:TRUSTEE HOURS:4 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Windle B Priem TITLE:TRUSTEE HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James A Radley TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robert L Reynolds TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael C Ruettgers TITLE:TRUSTEE/CHAIR OF BOARD HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Carolyn Ain TITLE:TRUSTEE START 7/16/12 HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jane C Edmonds TITLE:TRUSTEE START 7/16/12 HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Edward Eskandarian TITLE:TRUSTEE START 7/16/12 HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David G Spackman TITLE:CLERK START 7/16/12 /GEN COUNS HOURS:57 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Timothy O'Connor TITLE:OFFICER/TREASURER/EVP/CFO HOURS:57 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David M Barrett M.D. TITLE:FORMER TRUSTEE/PRES/CEO HOURS: 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 LAHEY CLINIC AFFILIATED SERVICES INC 41 MALL ROAD BURLINGTON MA 01805 043178972 HEALTH CARE MA 501(C)(3) 9 LCF INC true NORTHEAST HEALTH SYSTEM INC 85 HERRICK ST BEVERLY MA 01915 043240453 SUPPORT MA 501(C)(3) 11C III-FI LHS INC true NORTHEAST HOSPITAL CORPORATION 85 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 131 RATOUL 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 NEBHC true HEALTH & EDUCATION HOUSING SERVICES INC ZERO 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 true LAHEY CLINIC INSURANCE CO LTD PO BOX HM2450 HAMILTON HM TX, BD INSURANCE BD LCF INC C-CORP PERPETUAL TRUSTS (7) SUPPORT MA SEE PART VII TRUST REMAINDER TRUSTS (17) SUPPORT MA SEE PART VII TRUST POOLED INCOME FUNDS (4) SUPPORT MA SEE PART VII TRUST NORTHEAST PROPRIETARY CORPORATION 85 HERRICK ST BEVERLY MA 01915 042855191 MEDICAL SERVICES MA NEHS INC C-CORP NORTHEAST MASSACHUSETTS INDEMNITY CO LTD GOVERNORS SQ 23 LIME TREE BAY AVE GRAND CAYMAN KY1-1102 GRAND CAYMAN KY1-1102 CJ 980440187 INSURANCE CJ NHS INC C-CORP false false false false false false false false false false true true true true true true true true LAHEY CLINIC FOUNDATION INC K-R 9045977 COST LAHEY CLINIC INC K-R 19950843 COST NORTHEAST HOSPITAL CORPORATION K 890515 COST FORM 990, SCHEDULE R, PART IV, LINE 2 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 K IN ADDITION TO CONDUCTING FUNDRAISING AND SOLICITATION EFFORTS ON ITS OWN BEHALF, LAHEY CLINIC HOSPITAL, INC. CONDUCTS FUNDRAISING AND SOLICITATION EFFORTS ON BEHALF OF LAHEY CLINIC FOUNDATION, INC. AND LAHEY CLINIC, INC. FORM 990, SCHEDULE R, PART V, LINE L IN ADDITION TO CONDUCTING FUNDRAISING AND SOLICITATION EFFORTS ON ITS OWN BEHALF, LAHEY CLINIC FOUNDATION, INC. ALSO CONDUCTS FUNDRAISING AND SOLICITATION EFFORTS ON BEHALF OF LAHEY CLINIC HOSPITAL, INC. 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. FORM 990, SCHEDULE R, PART V. LINES N-R LAHEY CLINIC HOSPITAL, INC., LAYHEY CLINIC, INC. AND LAHEY CLINIC FOUNDATION, INC., PROVIDE VARIOUS CORPORATE AND OTHER SERVICES TO EACH OTHER. THESE CORPORATIONS REIMBURSE ONE ANOTHER FOR EXPENSES INCURRED SUCH AS EMPLOYEE SALARIES, MATERIALS, SUPPLIES, UTILITIES, ETC. CASH IS ALSO TRANSFERRED BETWEEN THE THREE CORPORATIONS.