2012-08-08T12:00:37-07:00 2011-09-30 990 2010-10-01 042769210 SOUTH SHORE HOSPITAL INC SOUT 7816248000 55 Fogg Road South Weymouth MA 02190 Michael Cullen 7816248431 2012-08-15 2010 2016-02-24 21:20:13Z Michael Cullen 55 Fogg Road South Weymouth MA 02190 437545977 0 X www.southshorehospital.org X 1982 MA South Shore Hospital's primary exempt purpose is to provide health care services to the community including surgical, medical and other treatment of the sick and injured. 14 11 4105 700 544388 -180186 5761810 5625887 400001397 415901917 1885139 1651279 8604695 12448178 416253041 435627261 7446 8000 0 0 258576096 273956739 0 0 2666320 144627339 148867086 403210881 422831825 13042160 12795436 371844763 382439885 260556760 270921378 111288003 111518507 South Shore Hospital's primary exempt purpose is to provide health care services to the community including surgical, medical and other treatment of the sick and injured. 0 0 323888342 8000 415901917 Health Care Programs, General/Other: South Shore Hospital is a not-for-profit, acute care, regional hospital licensed by the Massachusetts Department of Public Health to operate 318 acute care beds (composed of 205 medical/surgical, 32 intensive/coronary care, 53 maternal/newborn, 18 pediatric/young adult and 10 neonatal, and 67 bassinets (composed of 20 Level II special care nursery bassinets and 47 newborn bassinets). The Hospital offers a comprehensive range of health care services to meet diverse community needs, including emergency care, acute care (including medical, surgical, obstetrical/gynecological, pediatric, cardiac and cancer care), outpatient services (including surgical, rehabilitation, wound and specialized orthopedic care), home health services and community services. The Hospital provides free care to those who are unable to pay, sponsors free cancer screenings, other health screenings, various support groups and educational programs, including public health education, wellness programs and the training of health professionals such as physicians, nurses and technicians. During the year ended September 30, 2011, the Hospital had 26,554 discharges and 182,668 outpatient days. The Hospital's emergency center is open 24 hours a day, every day of the year, and had 83,230 visits during the year. The Hospital's home care division helps people maintain their independence at home. The visiting nurses coordinate the appropriate specialists, services and community resources for each patient. Our home care division provided over 142,220 home visits to patients in fiscal 2011. 0 0 0 323888342 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 1 0 0 0 0 1 421 0 1 4105 1 1 1 0 0 0 0 1 1 1 6 0 0 0 X 14 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MA X Michael Cullen SVP CFO Treasurer 7816248431 55 Fogg Road South Weymouth MA 02190 Thomas S Vangel 1 X 0 0 0 J Leonard Bicknell 1 X 0 0 0 Kimberly McLaughlin 1 X 0 0 0 Clifford M Breslow MD 1 X 23900 0 0 Colleen Tondorf 1 X 0 0 0 John C Boucher 1 X 0 0 0 Brian Hotarek 1 X 0 0 0 Sherry Penney 1 X 0 0 0 Kenneth Kirkland 1 X 0 0 0 Laura Avakian 1 X 0 0 0 Paula Becker 1 X 0 0 0 Chris Oddleifson 1 X 0 0 0 Richard Aubut 45 X X 999731 0 2252355 Michael Ayers MD 1 X 1800 0 0 Michael Cullen 45 X 449397 0 39528 Joseph Cahill 45 X 571281 0 75740 Frederick Ayers MD 40 X 415736 0 40834 Kathleen Heffernan 45 X 276325 0 63122 Paul Taylor 45 X 420539 0 49044 Richard Mirel MD 45 X 451807 0 41760 Veronica Ravnikar MD 45 X 505560 0 56511 John Benanti MD 45 X 399671 0 56306 Rose Dipietro 45 X 326857 0 64760 E Delroy Dixon II 45 X 294782 0 64882 Margaret Holda 45 X 204482 0 55141 Timothy Quigley 45 X 319729 0 69299 Robert Wheeler 45 X 285192 0 68048 Pamela Whelton 45 X 298078 0 362819 John Stevenson MD 45 X 397715 0 86371 Sandra Geiger 40 X 186913 0 49208 Simon Roy MD 40 X 404044 0 39618 Kenneth McLaughlin MD 45 X 426843 0 33727 Jeffrey Johnson MD 45 X 361913 0 37190 Wayne Chin MD 45 X 356120 0 36975 John Pehrson MD 45 X 335980 0 26815 8714395 0 3670053 508 0 1 0 Brigham Women's Hospital PO Box 3684 Boston MA 022413684 Physician Services 3801749 Aramark Corporation 12483 Collections Center Drive Chicago IL 60693 Facilities Maintenance 1773172 South Shore Anesthesia Association 163 Libbey Pkwy Weymouth MA 02189 Physician Services 1646667 Medquist MDE PO Box 10832 Newark NJ 07193 Transcription Services 1166696 Specialized Receivables Inc PO Box 12414 Newark NJ 071013514 Billing & Collection 966594 71 0 0 579168 0 392000 4654719 745176 5625887 Net Patient Service Revenue 622000 405420763 405420763 0 0 Ambulatory Cancer Center 621000 8673627 8673627 0 0 Miscellaneous Clinics 621990 965248 965248 0 0 Rental Income - Affiliates 531390 393387 393387 0 0 Outpatient Rehab 621990 149125 149125 0 0 299767 299767 0 0 415901917 1698916 0 0 1698916 0 0 0 0 0 0 0 0 969832 0 664562 0 305270 0 305270 0 0 305270 389970 40052 0 477659 389970 -437607 -47637 0 0 -47637 303187 579168 303187 0 0 0 751564 473308 278256 23018 0 255238 Related Income 900099 6888820 6888820 0 0 Cafeteria Sales 722212 2615516 0 0 2615516 Shields Imaging Income 621000 1619269 0 0 1619269 741047 0 544388 196659 11864652 435627261 422813755 544388 6643231 8000 8000 6128842 1977282 4151560 2386010 2386010 213500799 167094770 44802947 1603082 12599861 9595199 3004662 0 22957924 17547288 5410636 0 16383303 12476412 3906891 0 585208 0 585208 0 1300183 0 1299039 1144 233179 0 229729 3450 37279 0 37279 0 0 0 839555 780706 58849 55646960 52457264 3042856 146840 4311707 0 4311052 655 4999717 3749788 1243741 6188 811680 634823 172526 4331 419616 128562 290779 275 6055232 4541424 1513808 0 18342370 13756777 4585593 0 2416136 1663461 752675 0 Physician Services 11124054 11124054 0 0 Purchased Services 10316056 7737042 1958969 620045 Net Assets Released from Restrictions 6652233 6652233 0 0 Leases 5371122 5212243 123434 35445 Equipment Maintenance Contracts 5240899 2110388 3127897 2614 14163900 5421332 8559166 183402 422831825 323888342 96277163 2666320 15735768 12489108 0 8362941 7217394 44108828 46045837 4489529 4794768 3272006 2387967 368959824 209741070 140159413 159218754 139634094 130026783 7743725 16082184 12515549 371844763 382439885 54419389 50683024 504449 567994 123561233 119142473 82071689 100527887 260556760 270921378 X 95588741 97141214 14423254 13079185 1276008 1298108 111288003 111518507 371844763 382439885 X 12795436 -12564932 X 0 1 0 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 6717 0 1 37279 43996 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 Item g: Amount represents the salaries and expenses of employees who engaged in lobbying activities on behalf of South Shore Hospital. Item i: Amount represents a percentage of the Hospital's annual apportionment of MHA/AHA dues attributable to lobbying expenses. MHA/AHA gives its members an annual percentage breakdown of member dues utilized for lobbying activities. For the year ended September 30, 2011, it was determined that 20.52% of dues was used for lobbying purposes. South Shore Hospital advocates for public policy that positively impacts the health and well-being of the communities we serve. The Hospital works with local, state and federal officials to advance initiatives that will enhance public safety, improve access to health services, assure appropriate health care reimbursements and stimulate economic development. We partner with state and national health care associations to develop and improve government-funded programs. We welcome elected and nonelected officials to visit our hospital to discuss health care policy issues affecting our region, the Commonwealth and the nation. 15699262 4387199 9081 0 5718249 0 14377293 13850141 4476910 118349 0 2746138 0 15699262 12001684 3287147 159536 0 1598226 0 13850141 0 0.09 0.91 0 0 0 5013567 5013567 0 164787970 79900561 84887409 0 11822210 1765340 10056870 0 156062707 121623840 34438867 0 31273370 6451329 24822041 159218754 0 Accrued Pension & Retirement Benefits 46118000 Due to 3rd Party Payors 17303529 Loss on Swaps 14690422 Capital Leases 11286398 Malpractice Payable 3264000 Accrued Workers Compensation 3018169 Billing Reserves 1801273 Physician Benefits Payable 1445335 Executive Benefits Payable 1349632 FIN 47 Liability 251129 100527887 435627261 422831825 12795436 -3913277 0 0 0 -8651655 -12564932 230504 436106961 -3913277 0 0 3255107 -658170 436765131 0 -1137870 -1137870 435627261 435876457 0 0 0 12571324 12571324 423305133 0 -473308 -473308 422831825 SchD_P05_S00_L04 Schedule D, Part V, Line 4 The Hospital maintains its endowment funds to further its charitable purposes and those of its affiliates. In the past, endowment funds have been used to maintain the Hospital's infrastructure, purchase state-of-the-art medical equipment and provide health and wellness services to the community. SchD_P10_S00_L02 Schedule D, Part X, Line 2 The Hospital follows the provisions of FASB Accounting Standards Codification (ASC) No. 740, Income Taxes, relating to accounting for uncertainty in income taxes. ASC 740 clarifies the accounting for uncertainty in income taxes recognized in an entity's financial statements. It prescribes an uncertainty threshold and measurement attributes for financial statement disclosure of tax positions taken or expected to be taken on a tax return. SchD_P11_S00_L08 Schedule D, Part XI, Line 8 Pension-related adjustments; -$8,718,996, gain on interest rate swap agreements; $67,341. SchD_P12_S00_L02d Schedule D, Part XII, Line 2d Uncompensated care; $11,906,762, Pension-related adjustments; -$8,718,996, gain on interest rate swap agreements; $67,341. SchD_P12_S00_L04b Schedule D, Part XII, Line 4b Cost of goods sold; -$473,308, rental expenses; -$664,562. SchD_P13_S00_L02d Schedule D, Part XIII, Line 2d Uncompensated care; $11,906,762, rental expense; $664,562. SchD_P13_S00_L04b Schedule D, Part XIII, Line 4b Cost of goods sold; -$473,308. Moonlight & Miracles Gala 395302 254622 140680 0 6716 42448 47845 22192 21479 Walk for Hospice 210500 131690 78810 0 0 4810 4723 0 69277 6 276553 192856 83697 0 13407 36225 18559 2375 13131 882355 579168 303187 0 20123 83483 71127 24567 103887 303187 0 SchG_P02_S00_L11 Schedule G, Part II, Line 11 Fundraising events listed in Schedule G, with the exception of the Variety Show (a Hospital event), are coordinated by the Friends of South Shore Hospital, an auxiliary organization. Gross receipts in excess of direct expenses goes to the event charitable cause for all fundraising events. 1 1 1 X 1 X 1 1 1 0 1 1 4161515 1908530 2252985 0.0053 41153625 36680265 4473360 0.0106 2911037 2911037 0.0069 0 0 48226177 38588795 9637382 0.0228 730052 31120 698932 0.0017 913777 913777 0.0021 44895467 39340121 5555346 0.0132 265517 138092 127425 0.0003 46800 46800 0.0001 0 0 46851613 39509333 7342280 0.0174 0 0 95077790 78098128 16979662 0.0402 85602 85602 0.0002 118907 118907 0.0003 62139 62139 0.0001 291632 23614 268018 0.0006 328388 328388 0.0008 0 0 886668 23614 863054 0.0020 1 8777960 0 103670329 114921051 -11250722 X 1 1 1 1 South Shore Hospital Inc

55 Fogg Road South Weymouth MA 02190

X X X X See Schedule H, Part VI South Shore Hospital Inc 1 SchH_P01_S00_L07 Schedule H, Part I, Line 7 South Shore Hospital uses the cost to charge ratio for calculating amounts in the table for Line 7. The cost to charge ratio is total patient care costs divided by total patient care charges per Worksheet C of the Medicare Cost Report. Bad debt is not included in any amounts reported in the table. SchH_P01_S00_L072f Schedule H, Part I, Line 7, Column f The Hospital does not include bad debt in its Statement of Functional Expenses, Form 990, Part IX; not applicable. SchH_P01_S00_L07g Schedule H, Part I, Line 7g Not applicable. SchH_P02_S00_L00 Schedule H, Part II Community building activities are undertaken to meet the needs of residents of southeastern Massachusetts. Programs such as the courtesy coach and MD access and referral line help reduce health disparities by providing access to care. South Shore Hospital's emergency preparedness, infection control, clinical and medical workforce development programs insure the needs of the community are met. The Hospital provides services such as pastoral care to patients and their families. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 Uncompensated care in the statements of operations and changes in net assets includes the provision for bad debts and the Hospital's payments to the statewide Health Safety Net Fund (HSN), net of recoveries from HSN for reimbursable bad debts. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 South Shore Hospital provides a valuable community benefit by treating all individuals within the Hospital's service area, regardless of ability to pay. One of 8 people in our area live near or below the poverty level. These individuals would have to travel out of our area or possible forgo medical treatment without the services the Hospital provides. The Hospital uses the cost to charge ratio from the Department of Health Care Finance & Policy 403 report filed with the state. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b The Hospital does not bill the following categories of patients (except that the Hospital will bill patients for any applicable co-pays or deductibles required by a particular assistance program): patients enrolled in MassHealth, patients receiving governmental benefits under the Emergency Aid to the Elderly and Disabled and Children program. Also, participants in the Children's Medical Security Plan whose family income is equal to or less than 400% of the FPL are exempt from collection action. Low income patients determined pursuant to 114.6 CMR 13.04(2) are exempt from collection action for any eligible services, except for co-payments and deductibles that are not eligible services under 114.6 CMR 12.03(6)(b). Low income patients determined pursuant to 114.6 CMR 12.03 (3)(b) within 201-400% of the FPL are exempt from collection action for the portion of the provider bill that exceeds the deductible and may be billed for co-payments and deductibles as set forth in 114.6 CMR 13.04. SSH may bill low income patients for services other than eligible services provided at the request of the patient and for which the patient has agreed to be responsible if providers receive the patient's written consent to be billed for the service. The Hospital will not undertake collection action against an individual that has qualified for medical hardship with respect to the amount of the bill that exceeds the medical hardship contribution. SSH will not continue collection or billings on a patient who is a member of bankruptcy proceedings except to secure its rights as a creditor in the appropriate order. The Hospital may initiate billing for a patient who claims to be eligible for assistance programs but fails to provide proof of eligibility. Upon receipt of satisfactory proof of eligibility, the Hospital shall cease all collection activities. The Hospital, or its agents, will not charge interest on an overdue balance for a low income patient of for patients who are low income based on the Hospital's own internal financial assistance program. SchH_P05_S0A_L00 Schedule H, Part V, Section A Other medical services include: physician offices, outpatient surgical centers (2), radiology/mammography offices (2), wound care center, ambulatory cancer center and center for orthopedics, spine and sports medicine. Some of these services are provided at satellite locations, all of which are included in the Hospital's license. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 The Hospital's most recent Community Health Needs Assessment was completed in September 2010. South Shore Hospital utilizes information from many sources to determine the needs of individuals in the communities it serves. The Hospital reviews and analyzes health trends in our patient population. The Hospital also reviews data from the Massachusetts Community Health Information Profile, American Hospital Association, Massachusetts Hospital Association, Massachusetts Health Data Consortium, Federal Centers for Disease Control, Trust for America's Health and the Kaiser Family Foundation. South Shore Hospital is involved with three Community Health Network Areas (CHNAs), serving 34 communities south of Boston, to address public health priorities. CHNAs were formed in 1992 by the Massachusetts Department of Public Health to encourage public, non-profit and private sectors to work together to build healthier communities. South Shore Hospital is working with these CHNAs to conduct community health assessments. Data collected helps determine unmet health needs in the region. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 South Shore Hospital prominently displays its financial assistance information in public areas throughout the Hospital. Information is provided to individuals during the intake process. The Hospital provides its credit and collection policy on its website. This document explains how individuals may be eligible for assistance under federal and state programs as well as the Hospital's reduced fee and charity care policies. In addition, the Hospital's insurance counselors can explain various options and will help anyone who wants assistance with health insurance enrollment under the Commonwealth's Health Care Reform Law. Counselors are available to assist patients during the intake process and are also available to the public six days a week. In addition to helping patients understand eligibility for reduced or free care, during the fiscal year ended September 30, 2011 counselors assisted roughly 3,100 people in obtaining health insurance. Approximately half of those assisted in obtaining health insurance were not our patients. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 South Shore Hospital serves an area south of Boston with a population of approximately 725,000. The majority of patients identify themselves as Caucasian (94%), followed by Black/African American (1.8%), Other (1.8%) and Asian (.9%). After English, the next most common languages that patients reported speaking as a primary language are Portuguese, Spanish, Vietnamese and Arabic. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 South Shore Hospital is committed to providing community building activities that promote the health and wellbeing of all the people in our area. The Hospital provides pastoral care to patients and their families. People living within the Hospital's service area may receive help in finding affordable health insurance and are assisted in finding medical care through our MD access and referral programs. The Hospital eliminates barriers to care by providing a courtesy coach to any patient needing transportation to or from its facilities. We have made a commitment to physician recruitment in specialties that meet community needs, now and in the future, and to providing our clinicians with continuing medical education. South Shore Hospital has invested in emergency preparedness training and equipment to serve the community in the event of a natural or man-made disaster. The Hospital has partnered with towns in its service area to treat underserved and at-risk populations. The Hospital makes its Community Benefits Report and current year Community Benefits Plan available through mailings and on its website: http://www.southshorehospital.org/communitybenefits. For more information about South Shore Hospital's active role in meeting the needs of our community please visit our website: http://www.southshorehospital.org. SchH_P06_S00_L06 Schedule H, Part VI, Line 6 South Shore Hospital is not part of an affiliated health care system. SchH_P06_S00_L07 Schedule H, Part VI, Line 7 South Shore Hospital files its Community Benefits report in Massachusetts. 1 Friends Scholarships for students pursuing health care degrees 8 8000 0 SchI_P01_S00_L02 Schedule I, Part I, Line 2 South Shore Hospital administers grants in accordance with grantor documents and maintains records to substantiate compliance. Grantees are required to provide evidence of meeting criteria established for various assistance grants or scholarships awarded by the Hospital. SchI_P03_S00_L00 Schedule I, Part III The Friends of South Shore Hospital, an auxiliary Hospital organization, offers several scholarships to students pursuing health care degrees. Individuals must apply for these scholarships and present evidence that they meet the qualifications. The Nursing Scholarship is for a full time or regular part-time employee of South Shore Hospital. The employee must be presently enrolled at an accredited school pursuing a BSN degree or higher. The Marion C. Martinsen Scholarship is for a high school senior or graduate from an accredited public, private or parochial school. The Volunteers and Families Scholarship is for an active volunteer, child or grandchild of an active South Shore Hospital or home care division volunteer. The Health Related Field Scholarship is for a full time or regular part-time employee of South Shore Hospital presently enrolled at an accredited school pursuing an associate degree, a bachelor's degree or for technical accreditation in a health related field. The Terry Ries Nursing Education and Development Scholarship is for full time or regular part-time employees who have been employed for at least a year and accepted into an accredited program to begin or advance their nursing career. Eight scholarships were awarded in fiscal 2011. X X X 1 1 X X X X 0 1 0 0 0 0 0 0 0 Michael Cullen 380755 0 2756 0 65886 0 20387 0 19142 0 488926 0 2756 0 Richard Aubut 700515 0 39135 0 260081 0 2233213 0 19142 0 3252086 0 39135 0 Joseph Cahill 448356 0 33762 0 89163 0 56598 0 19142 0 647021 0 33762 0 Kathleen Heffernan 230700 0 47108 0 -1483 0 44932 0 18190 0 339447 0 47108 0 Paul Taylor 315071 0 75718 0 29750 0 34576 0 14468 0 469583 0 75718 0 Richard Mirel MD 446263 0 0 0 5544 0 41760 0 0 0 493567 0 0 0 Veronica Ravnikar MD 502208 0 0 0 3352 0 55746 0 765 0 562071 0 0 0 John Benanti MD 389376 0 5474 0 4821 0 41366 0 14940 0 455977 0 5474 0 Frederick Ayers MD 381176 0 22991 0 11569 0 22050 0 18784 0 456570 0 22991 0 Rose Dipietro 283867 0 37101 0 5889 0 55961 0 8799 0 391617 0 37101 0 E Delroy Dixon II 245988 0 35674 0 13120 0 45740 0 19142 0 359664 0 35674 0 Margaret Holda 201549 0 8398 0 -5465 0 36951 0 18190 0 259623 0 8398 0 Timothy Quigley 279903 0 28829 0 10997 0 45318 0 23981 0 389028 0 28829 0 Robert Wheeler 240489 0 30373 0 14330 0 48906 0 19142 0 353240 0 30373 0 Pamela Whelton 260370 0 32782 0 4926 0 51661 0 13080 0 362819 0 32782 0 John Stevenson MD 400571 0 0 0 -2856 0 67229 0 19142 0 484086 0 0 0 Sandra Geiger 157149 0 33376 0 -3612 0 30066 0 19142 0 236121 0 33376 0 Simon Roy MD 409254 0 0 0 -5210 0 14854 0 24764 0 443662 0 0 0 Kenneth McLaughlin MD 430316 0 0 0 -3473 0 14943 0 18784 0 460570 0 0 0 Jeffrey Johnson MD 367039 0 0 0 -5126 0 17423 0 19767 0 399103 0 0 0 Wayne Chin MD 360065 0 0 0 -3945 0 17208 0 19767 0 393095 0 0 0 John Pehrson MD 335254 0 0 0 726 0 17423 0 9392 0 362795 0 0 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a Tax indemnification and gross-up payments are reported as income because the Hospital grosses up imputed income from split dollar policies and premiums for long-term disability coverage. Health or social club dues or initiation fees are reported as income for reimbursement of health club memberships/dues up to a certain dollar level. Personal services are reported as income for reimbursement of financial services expenses up to a certain level. SchJ_P01_S00_L03 Schedule J, Part I, Line 3 The Hospital has a Compensation Committee which meets periodically and engages an independent external compensation consulting firm to establish the compensation of the CEO and other key executives. The consulting firm develops and presents all materials including market trends, compensation studies, and surveys and adheres to best practice guidelines. The final recommendation for compensation changes is presented and approved by the entire independent community members (11 of 14) of the Hospital Board of Directors. SchJ_P01_S00_L04 Schedule J, Part I, Line 4 South Shore Hospital offers a split dollar life insurance plan to certain key employees/highly compensated employees. Richard Aubut, Joseph Cahill, Paul Taylor, Frederick Ayers, John Benanti, Michael Cullen, Margaret Holda, Timothy Quigley, Pamela Whelton and John Stevenson participate in this plan. Massachusetts Health and Educational Facilities Authority 042456011 57586CS22 2008-02-28 94585000 See Part V for complete description 0 0 0 6050000 0 94994157 7150153 430596 0 992237 1532325 0 37980165 46929086 0 2009 1 1 1 1 0 0 1 0 1 0.022 0 0.022 1 0 1 1 Deutche Bank 24.3 0 0 1 AIGMFC .6 1 0 1 SchK_P01_S00_L00f Schedule K, Part I, Column f Series G bond issue financed various hospital improvements and construction of the Ambulatory Cancer Center garage, refunded bonds issued 06/15/93 and 07/01/99 . SchK_P02_S00_L03 Schedule K, Part II, Line 3 Differences between the issue price (Part I) and total proceeds (Part II, line 3) are due to investment earnings. SchK_P02_S00_L04 Schedule K, Part II, Line 4 The amount shown here consists of $7,129,749 in a reasonably required reserve or replacement fund plus $20,404 in a bona fide debt service fund. SchK_P04_S00_L05 Schedule K, Part IV, Line 5 This question is being answered without regard to a yield-restricted advance refunding escrow financed with proceeds of the bonds. Gena O'Hara Employee and family member of Director Colleen Tondorf 1000 Friends of South Shore Hospital Scholarship Cliff Breslow MD Director of South Shore Anesthesia Associates 1646667 Independent Contractor 0 Michael Ayers Greater than 5% Member of South Shore Orthopedics, LLC 752855 Independent Contractor 0 Gena O'Hara Family member of Colleen Tondorf, Director 31966 Employment 0 Mallory Stafford Family member of Michael Cullen, officer 10347 Employment 0 X 7 745176 See Part II 6 0 1 1 SchM_P01_S00_L09 Schedule M, Part I, Line 9 Valuations for stock transactions are sales price less commission. SchM_P01_S00_L32b Schedule M, Part I, Line 32b The Hospital liquidates contributions of publicly traded securities through a third party brokerage firm. Whenever possible, the brokerage firm sells stock on the next business day after receipt. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 J. Leonard Bicknell and John Boucher--business relationship. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The organization's Form 990 is prepared internally and reviewed by the tax practice of its independent auditors. The return is then reviewed by the CFO and President/CEO. Form 990 is presented for review to the governing body as a whole at the next regularly scheduled meeting prior to the filing deadline. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c Employees and board members are required to sign a conflict of interest form annually. The forms are reviewed for conflicts or potential conflicts. Board members abstain from voting on matters that present a conflict of interest. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 South Shore Hospital utilizes an outside consultant to determine compensation for Richard Aubut (CEO), Michael Cullen (CFO), and Joseph Cahill (COO). The consultant presents relevant data to the board for review and approval for these three individuals. All data presented, as well as compensation deliberations and votes, is documented in the board minutes. The board's review and approval process takes place annually for implementation at the start of the new fiscal year. Compensation decisions for all other employees, including key employees, are also made annually and are based on a review of comparable industry data, market conditions and research provided by outside consultants. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 South Shore Hospital makes its governing documents, conflict of interest policy and financial statements available for inspection to the general public at the Corporation's office. Copies of these documents are available upon request. In addition, certain governing documents are available through the Massachusetts Secretary of the Commonwealth's Corporations Division database. F990_P11_S00_L05 Form 990, Part XI, Line 5 Change in unrealized loss on investments; -$3,913,277, pension-related adjustment; -$8,718,996, gain on interest rate swap; $67,341. South Shore Health & Educational Corporation 55 Fogg Road South Weymouth MA 02190 042105926 Parent company of South Shore Hospital MA 501(c)(3) 11, Type I South Shore Hospital Inc 0 South Shore Property Inc 55 Fogg Road South Weymouth MA 02190 050398822 Develops and manages real property for South Shore Hospital and its affiliates MA 501(c)(3) 11, Type I South Shore Hospital 1 Coastal Medical Associates Inc 55 Fogg Road South Weymouth MA 02190 043170333 Primary and specialized medical care MA 501(c)(3) 3 South Shore Hospital 1 MetroSouth Obstetrics & Gynecology Inc 55 Fogg Road South Weymouth MA 02190 330998957 Specialized medical care MA 501(c)(3) 3 South Shore Hospital 1 Atlantic Women's Health Inc 55 Fogg Road South Weymouth MA 02190 200156651 Specialized medical care MA 501(c)(3) 3 South Shore Hospital 1 Health Provider Services Organization of the South Shore Inc 55 Fogg Road South Weymouth MA 02190 452385865 Supports the charitable mission of SSH&E and affiliates MA 501(c)(3) 11 N/A 0 South Shore Physician-Hospital Organization Inc 55 Fogg Road South Weymouth MA 02190 043248480 Supports SSH Physicians MA N/A C 1803513 12618008 0.5 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1 1 0 0