LGH CHARITABLE TRUST INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
LGH CHARITABLE TRUST INC (EIN 22-2586814)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-13
IRS object ID
201332259349300848
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-13T14:03:15-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN042684828EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1FEELEY & DRISCOLL PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1200 PORTLAND STREETAddressLine1
CityBOSTONCity
StateMAState
ZIP Code02114ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN222586814EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LGH CHARITABLE TRUST INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLGHCNameControl
Phone9786834000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 GENERAL STREETAddressLine1
CityLAWRENCECity
StateMAState
ZIP Code01841ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDEBORAH J WILSONName
TitleCORPORATE ASST TREASURER & CFOTitle
Phone9786834000Phone
Date Signed2013-08-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJEFFREY T ROGERSName
PTINP01074284PTIN
Phone6177427788Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDIANNE J ANDERSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11 GENERAL STREETAddressLine1
CityLAWRENCECity
StateMAState
ZIP Code01841ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3150444GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.LAWRENCEGENERAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionTO PROMOTE THE DEVELOPMENT OF COMPREHENSIVE INTEGRATED HEALTH CARE DELIVERY SERVICES TO SUPPORT LAWRENCE GENERAL HOSPITAL AND TEH HEALTH STATUS OF THE COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year743264ContributionsGrantsPriorYear
Contributions Grants Current Year551820ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year704448InvestmentIncomePriorYear
Investment Income Current Year39849InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year1447712TotalRevenuePriorYear
Total Revenue Current Year591669TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year372616TotalFundrsngExpCurrentYear
Other Expense Prior Year2429OtherExpensePriorYear
Other Expenses Current Year372816OtherExpensesCurrentYear
Total Expenses Prior Year2429TotalExpensesPriorYear
Total Expenses Current Year372816TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1445283RevenuesLessExpensesPriorYear
Revenues Less Expenses CY218853RevenuesLessExpensesCY
Total Assets BOY22209337TotalAssetsBOY
Total Assets EOY23988071TotalAssetsEOY
Total Liabilities BOY23876TotalLiabilitiesBOY
Total Liabilities EOY142385TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY22185461NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY23845686NetAssetsOrFundBalancesEOY
Mission DescriptionPROMOTE THE DEVELOPMENT OF COMPREHENSIVE INTEGRATED HEALTH CARE DELIVERY SERVICES. SUPPORT LAWRENCE GENERAL HOSPITAL AND THE HEALTH STATUS OF THE COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense0Expense
Revenue0Revenue
DescriptionTO PROMOTE THE DEVELOPMENT OF COMPREHENSIVE INTEGRATED HEALTH CARE DELIVERY SERVICES. TO SUPPORT LAWRENCE GENERAL HOSPITAL AND THE HEALTH STATUS OF THE COMMUNITY.Description
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1FELIX MERCADO CONTROLLERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9786834000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11 GENERAL STREETAddressLine1
CityLAWRENCECity
StateMAState
ZIP Code01841ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
BELISARIO ROSAS
CHAIRMAN1.00X000
DIANNE J ANDERSON
PRESIDENT & CEO1.00X0553914120128X
RONALD J POLLINA
TREASURER1.00X000
MATTHEW CAFFREY ESQ
SECRETARY1.00X000
DENISE S PALUMBO
CORPORATE ASSISTANT SECRETARY & COO1.00X030011338892X
DEBORAH J WILSON
CORPORATE ASSISTANT TREASURER & CFO1.00X021120533334X
RICHARD SANTAGATI
TRUSTEE1.00X000
NEIL MEEHAN MD
PHYSICIAN & CMO0.00033954137731X
PATRICK CURRAN MD
PHYSICIAN0.00032513626165X
MARIA DEINHART MD
PHYSICIAN0.00032200910327X
NORMAN STEIN MD
FORMER CMO0.00030862930632X
JORGE BOTERO MD
PHYSICIAN0.00029083218946X
JOSEPH MCMANUS
FORMER PRESIDENT & CEO0.0001445560X
GERALD FOLEY
FORMER COO0.000175985117285X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2971920TotalReportableCompFrmRltdOrgs
Total Other Compensation433440TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1LAWRENCE GENERAL HOSPITALBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11 GENERAL STREETAddressLine1
CityLAWRENCECity
StateMAState
ZIP Code01841ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesMANAGEMENT SERVICESDescriptionOfServices
Compensation366956Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
All Other Contributions551820AllOtherContributions
Total Contributions551820TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column217679TotalRevenueColumn
Exclusion$217,679ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2380945Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2558775Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-177830Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-177830TotalRevenueColumn
Exclusion-$177,830ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column591669TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$39,849ExclusionAmount

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total257832Total
Fundraising257832Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total100771Total
Fundraising100771Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total14013Total
Fundraising14013Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total200Total
Management And General200ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total372816Total
Program Services0ProgramServices
Management And General200ManagementAndGeneral
Fundraising372616Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1204642BOY
EOY1506252EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY361480BOY
EOY328573EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5250LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3950LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1500BOY
EOY1300EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9320107BOY
EOY10831051EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY11321608BOY
EOY11320895EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY22209337BOY
EOY23988071EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY23876BOY
EOY142385EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY23876BOY
EOY142385EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY21921000BOY
EOY23589204EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY264461BOY
EOY256482EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22185461BOY
EOY23845686EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22209337BOY
EOY23988071EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses218853ReconcilationRevenueExpenses
Reconcilation Other Changes1441372ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years786166CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1095596CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years405370CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year743264CurrentTaxYearMinus1Year
Current Tax Year551820CurrentTaxYear
Total3582216Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years786166CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1095596CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years405370CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year743264CurrentTaxYearMinus1Year
Current Tax Year551820CurrentTaxYear
Total3582216Total
FieldValueIRS element (for citing)
Public Support Total1703582216PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years220602CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years201502CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years188318CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year233739CurrentTaxYearMinus1Year
Current Tax Year217679CurrentTaxYear
Total1061840Total
FieldValueIRS element (for citing)
Total Support4644056TotalSupport
Public Support Pertcentage1700.77140PublicSupportPertcentage170
Public Support Pertcent Prior Year0.76410PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Included On FS0IncludedOnFS

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5250OtherCostOrOtherBasis
Depreciation3950Depreciation
Book Value1300BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1300TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
INVESTMENT IN AFFILIATE11315797
A/R OTHER5098
FieldValueIRS element (for citing)
Total Book Value Other Assets11320895TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATE (LAWRENCE GENERAL HOSPITAL)Description
Amount$142,385Amount
FieldValueIRS element (for citing)
Total Of Amounts142385TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DIANNE J ANDERSON
047741407650000050274069854067404200
DENISE S PALUMBO
02551130450000003000008892033900500
DEBORAH J WILSON
016170504950000022000011334024453900
NEIL MEEHAN MD
030454103500000019904017827037727200
PATRICK CURRAN MD
0325136000003000023165035130100
MARIA DEINHART MD
032200900000300007327033233600
NORMAN STEIN MD
03086290000017500013132033926100
JORGE BOTERO MD
0290832000001328017618030977800
JOSEPH MCMANUS
000001445560000014455600
GERALD FOLEY
01759850000017310115554029327000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationPART I, LINE 4C: DURING THE 2011 CALENDAR YEAR, THE ORGANIZATION'S PARENT COMPANY, LAWRENCE GENERAL HOSPITAL, MADE SEVERANCE PAYMENTS OF $175,985 TO GERALD FOLEY. DURING THE 2011 CALENDAR YEAR, THE ORGANIZATION'S PARENT COMPANY, LAWRENCE GENERAL HOSPITAL, MADE CONSULTING SERVICE PAYMENTS OF $144,556 TO JOSEPH S. MCMANUS. PART II PAYROLL RECORDS ARE FOR THE 01/01/2011 TO 12/31/2011 CALENDAR YEAR.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS PREPARED BY THE ORGANIZATION'S ASSISTANT CONTROLLER AND REVIEWED BY THE CONTROLLER AND CFO. FORM 990 IS ALSO REVIEWED BY THE ORGANIZATION'S EXTERNAL ACCOUNTANT. ONCE COMPLETE, THE FORM AND ALL SCHEDULES ARE MADE AVAILABLE TO THE BOARD OF TRUSTEES VIA A SECURE INTERNET PORTAL FOR REVIEW. THE ORGANIZATION'S CONTROLLER AND CFO ARE MADE AVAILABLE TO FACILITATE THE REVIEW AS WELL AS ANSWER ANY QUESTIONS REGARDING THE FORM.
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ALL DOCUMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 1,448,948. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS -7,979. OTHER 403. TOTAL TO FORM 990, PART XI, LINE 5: 1,441,372.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2C:THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS THAT IS DONE BY OUR EXTERNAL ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
LAWRENCE GENERAL HOSPITAL
1 GENERAL STREETLAWRENCEMA01841042103586HOSPITALMA501(C)(3)HOSPITALN/A0
COMMUNITY MEDICAL ASSOCIATES INC
1 GENERAL STREETLAWRENCEMA01841272142635PRIMARY CAREMA501(C)(3)PRIMARY CAREN/A0

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
LGH HEALTH ENTERPRISES INC
38 PROSPECT STREETLAWRENCEMA01842042869696HEALTH CARE MANAGEMENTMALAWRENCE GENERAL HOSPITALC
LGH PHYSICIAN ASSOCIATES PC
38 PROSPECT STREETLAWRENCEMA01842043174041PHYSICIAN GROUPMALAWRENCE GENERAL HOSPITALC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1LAWRENCE GENERAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeNTransactionType
Amount Involved366956AmountInvolved
Method Of Amt DeterminationPER REVIEW OF RECORDSMethodOfAmtDetermination

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