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Nonprofiteer
← BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH INC

Form 990 for tax year 2022

Filed by BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH INC.

Totals

Total revenue
$369,118,399
Total expenses
$365,010,307
Contributions and grants received
$4,388,076
Grants paid
$0
Program services expenses (Part IX)
$327,014,033
Management and general expenses
$36,794,044
Fundraising expenses
$1,202,230
Program service expenses (Part III)
$327,014,033

Program services were 89.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ROWAN MICHAEL

    TRUSTEE (EX-OFFICIO) (CEO DESIGNEE)

    Total calculated
    $1,335,874
    From this org
    $0
    From related orgs
    $1,298,835
    Other
    $37,039
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,190,783 related
    Bonus
    $0
    Other
    $0 + $108,052 related
    Deferred
    $0 + $9,371 related
    Nontaxable benefits
    $0 + $27,668 related
    Filer's total
    $0 + $1,335,874 related
  • BURNS ERIN

    TRUSTEE

    Total calculated
    $635,649
    From this org
    $0
    From related orgs
    $560,180
    Other
    $75,469
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $526,559 related
    Bonus
    $0 + $25,000 related
    Other
    $0 + $8,621 related
    Deferred
    $0 + $30,500 related
    Nontaxable benefits
    $0 + $44,969 related
    Filer's total
    $0 + $635,649 related
  • VALSKY MD EUGENE

    TTEE (EX-OFF) (PRES, MEDICAL STAFF)

    Total calculated
    $595,677
    From this org
    $0
    From related orgs
    $526,404
    Other
    $69,273
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $432,267 related
    Bonus
    $0 + $68,870 related
    Other
    $0 + $25,267 related
    Deferred
    $0 + $30,500 related
    Nontaxable benefits
    $0 + $38,773 related
    Filer's total
    $0 + $595,677 related
  • COUGHLIN KEVIN

    TRUSTEE (EX-OFFICIO), PRESIDENT

    Total calculated
    $572,121
    From this org
    $0
    From related orgs
    $529,416
    Other
    $42,705
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $501,414 related
    Bonus
    $0
    Other
    $0 + $28,002 related
    Deferred
    $0 + $7,320 related
    Nontaxable benefits
    $0 + $35,385 related
    Filer's total
    $0 + $572,121 related
  • KELLY MD DAVID

    TRUSTEE

    Total calculated
    $415,567
    From this org
    $0
    From related orgs
    $365,765
    Other
    $49,802
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $301,252 related
    Bonus
    $0 + $61,666 related
    Other
    $0 + $2,847 related
    Deferred
    $0 + $28,050 related
    Nontaxable benefits
    $0 + $21,752 related
    Filer's total
    $0 + $415,567 related
  • TAYLOR LISA

    TRUSTEE

    Total calculated
    $312,319
    From this org
    $0
    From related orgs
    $279,849
    Other
    $32,470
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $270,573 related
    Bonus
    $0 + $2,250 related
    Other
    $0 + $7,026 related
    Deferred
    $0 + $26,787 related
    Nontaxable benefits
    $0 + $5,683 related
    Filer's total
    $0 + $312,319 related
  • FOSDICK KENNETH

    CHAIR, TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • KAPELL JEFF

    TRUSTEE, VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • BLAIR RAYMOND

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • CARR ALLISON GILLMORE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • HEWITT CHARLES

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • HORWITZ-WILLIS NATE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • JOHNSON JOHN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • KENNISTON MD JULIA

    TTEE (EX-OFF) (PRES, MEDICAL STAFF)

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • KOWALOFF MD HARVEY

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • MARBLE MEGAN VAYO

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • MARINI ANNA

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • MCGRATH JOHN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • MCKENNA CATHERINE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • PRIMAVERA DENNIS

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • SHIELDS MARY

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 2 related
  • TABB MD KEVIN

    CHIEF EXECUTIVE OFFICER (EX-OFFICIO)

    Total calculated
    $2,807,152
    From this org
    $0
    From related orgs
    $2,507,235
    Other
    $299,917
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $2,103,982 related
    Bonus
    $0
    Other
    $0 + $403,253 related
    Deferred
    $0 + $257,320 related
    Nontaxable benefits
    $0 + $42,597 related
    Filer's total
    $0 + $2,807,152 related
  • KERNDL JOHN

    TREAS (EX-OFF) (EVP & CFO, BILH)

    Total calculated
    $1,335,872
    From this org
    $0
    From related orgs
    $1,301,463
    Other
    $34,409
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,068,846 related
    Bonus
    $0 + $100,000 related
    Other
    $0 + $132,617 related
    Deferred
    $0 + $4,985 related
    Nontaxable benefits
    $0 + $29,424 related
    Filer's total
    $0 + $1,335,872 related
  • RIOS CINDY

    TREAS (EX-OFF) (INTERIM CFO, BILH)

    Total calculated
    $1,022,982
    From this org
    $0
    From related orgs
    $802,046
    Other
    $220,936
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $574,544 related
    Bonus
    $0 + $174,475 related
    Other
    $0 + $53,027 related
    Deferred
    $0 + $188,510 related
    Nontaxable benefits
    $0 + $32,426 related
    Filer's total
    $0 + $1,022,982 related
  • KATZ ESQ JAMIE

    CLERK (EX-OFFICIO)

    Total calculated
    $914,057
    From this org
    $0
    From related orgs
    $898,193
    Other
    $15,864
    Hours/week
    1 + 64 related

    Schedule J breakdown matched by us

    Base
    $0 + $794,826 related
    Bonus
    $0
    Other
    $0 + $103,367 related
    Deferred
    $0 + $7,320 related
    Nontaxable benefits
    $0 + $8,544 related
    Filer's total
    $0 + $914,057 related
  • ARMSTRONG ESQ EMILY

    ASST CLERK(EX-OFF), AVP,ASST DEP GC

    Total calculated
    $305,223
    From this org
    $24
    From related orgs
    $268,194
    Other
    $37,005
    Hours/week
    1 + 63 related

    Schedule J breakdown matched by us

    Base
    $24 + $244,147 related
    Bonus
    $0
    Other
    $0 + $24,047 related
    Deferred
    $0 + $7,915 related
    Nontaxable benefits
    $0 + $29,090 related
    Filer's total
    $24 + $305,199 related
  • JENKINS JIM

    ASST TREAS (EX-OFF), CFO

    Total calculated
    $234,826
    From this org
    $0
    From related orgs
    $233,584
    Other
    $1,242
    Hours/week
    1 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $172,884 related
    Bonus
    $0 + $30,766 related
    Other
    $0 + $29,934 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $1,242 related
    Filer's total
    $0 + $234,826 related
  • TIERNEY MD MATT

    CHIEF OF SURGERY

    Total calculated
    $655,621
    From this org
    $0
    From related orgs
    $584,084
    Other
    $71,537
    Hours/week
    30 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $509,638 related
    Bonus
    $0 + $50,000 related
    Other
    $0 + $24,446 related
    Deferred
    $0 + $30,500 related
    Nontaxable benefits
    $0 + $41,037 related
    Filer's total
    $0 + $655,621 related
  • THOMAS MD TENNY

    CHIEF MEDICAL OFFICER

    Total calculated
    $580,603
    From this org
    $0
    From related orgs
    $440,671
    Other
    $139,932
    Hours/week
    1 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $435,537 related
    Bonus
    $0
    Other
    $0 + $5,134 related
    Deferred
    $0 + $96,500 related
    Nontaxable benefits
    $0 + $43,432 related
    Filer's total
    $0 + $580,603 related
  • CHAPIN RN MS MARY

    VP, AMBULATORY SVS & PROCESS IMPROVE

    Total calculated
    $379,037
    From this org
    $334,377
    From related orgs
    $0
    Other
    $44,660
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $268,194
    Bonus
    $0
    Other
    $66,183
    Deferred
    $12,140
    Nontaxable benefits
    $32,520
    Filer's total
    $379,037
  • DOHERTY RN DONNA

    CNO & SVP, PATIENT CARE SERVICES

    Total calculated
    $356,433
    From this org
    $322,313
    From related orgs
    $0
    Other
    $34,120
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $299,311
    Bonus
    $0
    Other
    $23,002
    Deferred
    $12,776
    Nontaxable benefits
    $21,344
    Filer's total
    $356,433
  • ABOU RJEILY MD CHARBEL

    CHIEF OF MEDICINE

    Total calculated
    $342,764
    From this org
    $0
    From related orgs
    $279,514
    Other
    $63,250
    Hours/week
    1 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $256,987 related
    Bonus
    $0 + $4,244 related
    Other
    $0 + $18,283 related
    Deferred
    $0 + $25,961 related
    Nontaxable benefits
    $0 + $37,289 related
    Filer's total
    $0 + $342,764 related
  • BAKER WENDY

    VP, HUMAN RESOURCES BUSINESS PARTNER

    Total calculated
    $277,877
    From this org
    $0
    From related orgs
    $223,375
    Other
    $54,502
    Hours/week
    1 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $172,016 related
    Bonus
    $0 + $37,921 related
    Other
    $0 + $13,438 related
    Deferred
    $0 + $40,840 related
    Nontaxable benefits
    $0 + $13,662 related
    Filer's total
    $0 + $277,877 related
  • RUTHERFORD RON

    VP, CIO, VP SUPPORT SERVICES

    Total calculated
    $266,092
    From this org
    $247,877
    From related orgs
    $0
    Other
    $18,215
    Hours/week
    55 + 1 related

    Schedule J breakdown matched by us

    Base
    $223,184
    Bonus
    $0
    Other
    $24,693
    Deferred
    $11,077
    Nontaxable benefits
    $7,138
    Filer's total
    $266,092
  • GORSUCH W BRIAN

    CHIEF PHYSICIAN ASSISTANT

    Total calculated
    $355,566
    From this org
    $311,288
    From related orgs
    $0
    Other
    $44,278
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $308,502
    Bonus
    $0
    Other
    $2,786
    Deferred
    $12,256
    Nontaxable benefits
    $32,022
    Filer's total
    $355,566
  • HEBERT RICHARD

    NURSE PRACTITIONER

    Total calculated
    $321,232
    From this org
    $295,223
    From related orgs
    $0
    Other
    $26,009
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $271,920
    Bonus
    $100
    Other
    $23,203
    Deferred
    $4,936
    Nontaxable benefits
    $21,073
    Filer's total
    $321,232
  • SODERSTROM JADE

    REGISTERED NURSE

    Total calculated
    $314,922
    From this org
    $276,942
    From related orgs
    $0
    Other
    $37,980
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $273,364
    Bonus
    $0
    Other
    $3,578
    Deferred
    $9,018
    Nontaxable benefits
    $28,962
    Filer's total
    $314,922
  • GERENIA DARLENE

    REGISTERED NURSE

    Total calculated
    $292,346
    From this org
    $284,859
    From related orgs
    $0
    Other
    $7,487
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $276,173
    Bonus
    $100
    Other
    $8,586
    Deferred
    $7,395
    Nontaxable benefits
    $92
    Filer's total
    $292,346
  • NDUNGU VIRGINIA

    PHYSICIAN ASSISTANT, ICU

    Total calculated
    $270,589
    From this org
    $242,551
    From related orgs
    $0
    Other
    $28,038
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $236,856
    Bonus
    $0
    Other
    $5,695
    Deferred
    $9,340
    Nontaxable benefits
    $18,698
    Filer's total
    $270,589
  • DWYER MARY

    INTM ASST TREAS EXOFF/CFO;CONTROLLER

    Total calculated
    $246,782
    From this org
    $215,598
    From related orgs
    $0
    Other
    $31,184
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $204,815
    Bonus
    $0
    Other
    $10,783
    Deferred
    $10,525
    Nontaxable benefits
    $20,659
    Filer's total
    $246,782
  • BARNES ESQ JARED

    FRMR ASST CLERK (EX-OFF) (ASSOC GC)

    Total calculated
    $152,786
    From this org
    $0
    From related orgs
    $135,849
    Other
    $16,937
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $118,706 related
    Bonus
    $0
    Other
    $0 + $17,143 related
    Deferred
    $0 + $2,826 related
    Nontaxable benefits
    $0 + $14,111 related
    Filer's total
    $0 + $152,786 related
  • BROWNING MD THOMAS

    FORMER CHIEF OF MEDICINE

    Total calculated
    $299,073
    From this org
    $0
    From related orgs
    $245,021
    Other
    $54,052
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $235,284 related
    Bonus
    $0
    Other
    $0 + $9,737 related
    Deferred
    $0 + $24,650 related
    Nontaxable benefits
    $0 + $29,402 related
    Filer's total
    $0 + $299,073 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Tax indemnification and gross-up payments
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 4B
AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, AND AS NOTED ABOVE, THE COMPENSATION DETAIL INCLUDED IN BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH'S (BIDP OR BID-PLYMOUTH) FORM 990 FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 IS CALENDAR YEAR 2022 DETAIL. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. DURING THE 2022 CALENDAR YEAR, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) WAS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM WHICH IS A NON-QUALIFIED DEFERRED COMPENSATION PLAN AND PURSUANT TO THE PLAN ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS. AMOUNTS RECEIVED BY PARTICIPANTS AND RELATED TO THIS PLAN ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. IN ADDITION, DURING THE 2022 CALENDAR YEAR, SEVERAL ENTITIES WITHIN THE LAHEY HEALTH SYSTEM WERE PARTICIPATING EMPLOYERS IN THE LAHEY CLINIC 457(F) NON-QUALIFIED DEFINED CONTRIBUTION PLAN AND THE LAHEY CLINIC 457(B) RETIREMENT SAVINGS PLAN. PURSUANT TO THESE PLANS, ELIGIBLE EMPLOYEES RECEIVED CERTAIN RETIREMENT BENEFITS AND/OR COULD DEFER PART OF THEIR COMPENSATION. UNDER THE DEFINITIONS TO THIS FORM 990, THESE PLANS ARE CONSIDERED SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. AMOUNTS DEFERRED BY PARTICIPANTS OR CONTRIBUTIONS RECEIVED BY PARTICIPANTS AND RELATED TO THESE PLANS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES
ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES IN THE NOTES BELOW AND WAS PAID FOR POSITIONS HELD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED BY FORM 990, COMPENSATION REPORTED FOR THIS FISCAL YEAR IS CALENDAR YEAR 2022 COMPENSATION. COMPENSATION REPORTED FOR INDIVIDUALS MAY REFLECT AN ALLOCATION OF COMPENSATION PAID BY ENTITIES RELATED TO THE FILING ORGANIZATION AND WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK OR OTHER ENTITIES, AS REQUIRED. REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: REGULAR WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN. OTHER REPORTABLE COMPENSATION: AMOUNTS QUANTIFIED IN OTHER REPORTABLE COMPENSATION WHICH MAY NOT BE SEPARATELY NOTED IN THIS FILING INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; DISTRIBUTIONS FROM A 457(B) PLAN; AMOUNTS INCLUDIBLE IN INCOME UNDER A 457(F) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED RETIREMENT BENEFITS; OTHER TAXABLE RETIREMENT BENEFITS. DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401K RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403B RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT, UNFUNDED AND UNVESTED AMOUNTS DEFERRED UNDER 457(F) PLAN. NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THE NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE. COMPLETE TITLES AND ADDITIONAL EXPLANATORY INFORMATION FOR OFFICERS, DIRECTOR/TRUSTEES, KEY EMPLOYEES AND THE ENTITIES FIVE HIGHEST PAID EMPLOYEES OTHER THAN ODTKH ARE LISTED BELOW ALPHABETICALLY: ABOU RJEILY, M.D., CHARBEL -CHIEF OF MEDICINE BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. ABOU INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $14,183. INCLUDED IN THIS AMOUNT IS AN UNREALIZED LOSS IN THE AMOUNT OF $3,817 IMPACTING THE NONQUALIFIED UNVESTED BALANCE. ARMSTRONG, ESQ., EMILY -ASSISTANT VICE PRESIDENT AND ASSISTANT DEPUTY GENERAL COUNSEL BETH ISRAEL LAHEY HEALTH -ASSISTANT CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. -ASSISTANT CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -ASSISTANT CLERK (EX-OFFICIO) - JOSLIN CLINIC, INC. -ASSISTANT CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. -ASSISTANT CLERK (EX-OFFICIO) (HOSPITAL ATTORNEY) - THE JORDAN HEALTH SYSTEMS, INC. -ASSISTANT CLERK (EX-OFFICIO) (HOSPITAL ATTORNEY) - JORDAN PHYSICIAN ASSOCIATES, INC. , INC. -CLERK (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP -TERM ENDED MARCH 30, 2023 -CLERK (EX-OFFICIO) - BAIM INSTITUTE FOR CLINICAL RESEARCH, INC. -CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. -TERM ENDED MARCH 30, 2023 UNLESS OTHERWISE NOTED, MS. ARMSTRONG SERVED IN THE POSITIONS ABOVE FOR THE FULL FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION INCLUDES A PAYMENT FOR PTO CASHED OUT IN THE AMOUNT OF $23,808. BAKER, WENDY -VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. MS. BAKER SERVED IN THIS POSITION DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. BAKER INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $13,049. INCLUDED IN THE AMOUNT IS AN UNREALIZED LOSS OF $398 IMPACTING HER UNVESTED NONQUALIFIED BENEFIT. DEFERRED COMPENSATION IN THE AMOUNT OF $34,200 IS INCLUDED IN THIS FILING FOR MS. BAKER. THAT AMOUNT RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2022, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. BARNES, ESQ., JARED -ASSOCIATE GENERAL COUNSEL- BETH ISRAEL LAHEY HEALTH -ASSISTANT CLERK (EX-OFFICIO), ASSOCIATE GENERAL COUNSEL- BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH, INC. -FORMER ASSISTANT CLERK- JORDAN HEALTH SYSTEMS, INC. -FORMER ASSISTANT CLERK - JORDAN PHYSICIAN ASSOCIATES BLAIR, RAYMOND -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. BROWNING, M.D., THOMAS -FORMER CHIEF OF MEDICINE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., INC. BURNS, ERIN -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. CARR, ALLISON GILLMORE -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. CHAPIN, RN, MS, MARY -VICE PRESIDENT OF AMBULATORY SERVICES & PROCESS IMPROVEMENT - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. CHAPIN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $63,358. THIS AMOUNT IS A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $63,358. COUGHLIN, KEVIN -PRESIDENT AND TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., INC. -PRESIDENT AND TRUSTEE (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. -PRESIDENT AND TRUSTEE (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. MR. COUGHLIN SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. COUGHLIN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $22,976.. THIS AMOUNT INCLUDES A NET UNREALIZED LOSS IN THE AMOUNT OF $30,577 IMPACTING THE NONQUALIFIED BENEFIT AND A PAYOUT FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $34,053. DOHERTY, R.N., DONNA -CHIEF NURSING OFFICER AND SENIOR VICE PRESIDENT, PATIENT CARE SERVICES - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. DOHERTY INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $18,217. DWYER, MARY -INTERIM ASSISTANT TREASURER (EX-OFFICIO)/ CHIEF FINANCIAL OFFICER, CONTROLLER - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. FOSDICK, KENNETH -TRUSTEE AND BOARD CHAIR - JORDAN HEALTH SYSTEMS, INC -TRUSTEE AND BOARD CHAIR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH -TRUSTEE AND BOARD CHAIR - JORDAN PHYSICIAN ASSOCIATES, INC. MR. FOSDICK'S TERM AS CHAIR ON THE BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH'S BOARD BEGAN ON OCTOBER 1, 2021. GERENIA, DARLENE -REGISTERED NURSE- BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES
GORSUCH, W BRIAN -CHIEF PHYSICIAN ASSISTANT - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH HEBERT, RICHARD -NURSE PRACTITIONER - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH HEWITT, CHARLES -TRUSTEE AND BOARD CHAIR - JORDAN HEALTH SYSTEMS, INC -TRUSTEE AND BOARD CHAIR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH -TRUSTEE AND BOARD CHAIR - JORDAN PHYSICIAN ASSOCIATES, INC. HORWITZ-WILLIS, NATE -TRUSTEE - JORDAN HEALTH SYSTEMS, INC -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. -TRUSTEE - BETH ISRAEL LAHEY HEALTH PHARMACY, INC JENKINS, JIM -ASSISTANT TREASURER, EX OFFICIO (HOSPITAL CFO)- JORDAN HEALTH SYSTEMS, INC. -ASSISTANT TREASURER, EX OFFICIO (HOSPITAL CFO)- JORDAN PHYSICIAN ASSOCIATES, INC. -ASSISTANT TREASURER, EX OFFICIO (HOSPITAL CFO)- BETH ISRAEL DEACONESS HOSPITAL- PLYMOUTH, INC. JOHNSON, JOHN -TRUSTEE - JORDAN HEALTH SYSTEMS, INC -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. KAPELL, JEFF -TRUSTEE AND VICE CHAIR - JORDAN HEALTH SYSTEMS, INC -TRUSTEE AND VICE CHAIR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH -TRUSTEE AND VICE CHAIR - JORDAN PHYSICIAN ASSOCIATES, INC. KATZ, ESQ., JAMIE UNLESS OTHERWISE NOTED BELOW, MR. KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2023: -GENERAL COUNSEL AND CLERK (EX-OFFICIO), - BETH ISRAEL LAHEY HEALTH, INC. -CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. -CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. -CLERK (EX-OFFICIO) - MOUNT AUBURN HOSPITAL -CLERK (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL -CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. -CLERK - COMMUNITY PHYSICIANS ASSOCIATES, INC. -CLERK (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. -CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -CLERK (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. , INC. -CLERK (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. -CLERK (EX-OFFICIO) - ANNA JAQUES HOSPITAL -CLERK - SEACOAST AFFILIATED GROUP PRACTICE, INC. -TRUSTEE AND CLERK (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. -TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. -TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. -TRUSTEE (EX-OFFICIO)RAND CLERK (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION -TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION -TRUSTEE AND CLERK (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. -DIRECTOR AND CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. -CLERK (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. -CLERK (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. -CLERK (EX-OFFICIO) - LAHEY CLINIC, INC. -CLERK (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC.D/B/A LAHEY HOSPITAL & MEDICAL CENTER -CLERK (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION -TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. -TRUSTEE AND CLERK - CAB HEALTH AND RECOVERY SERVICES, INC. -TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. -CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL -CLERK (EX-OFFICIO) - JOSLIN CLINIC, INC. -CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. -CLERK (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. -CLERK - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - TERM BEGAN ON MARCH 31, 2023 -CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. -CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - TERM BEGAN ON MARCH 31, 2023 EFFECTIVE JULY 1, 2023, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES INC. WHICH IN TURN SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL AND ADDITIONAL AFFILIATES. AS OF THAT DATE MR. KATZ ASSUMED THE FOLLOWING ADDITIONAL POSITIONS: -CLERK (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. -CLERK (EX-OFFICIO) - EXETER HOSPITAL, INC. -CLERK (EX-OFFICIO) - CORE PHYSICIANS, LLC -SECRETARY (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $68,094. INCLUDED IN THIS AMOUNT IS A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $72,875 AND AN UNREALIZED LOSS IN THE AMOUNT OF $24,281. KELLY, M.D., DAVID -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. KENNISTON, M.D., JULIA -TRUSTEE (EX-OFFICIO) (PRESIDENT, MEDICAL STAFF) - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE (EX-OFFICIO) (PRESIDENT, MEDICAL STAFF) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH -TRUSTEE (EX-OFFICIO) (PRESIDENT, MEDICAL STAFF) - JORDAN PHYSICIAN ASSOCIATES
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES
KERNDL, JOHN UNLESS OTHERWISE NOTED BELOW, MR. KERNDL HELD THE FOLLOWING POSITIONS THROUGH DECEMBER 31, 2023: -EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. -TRUSTEE AND TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. -TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. -TREASURER - CAREGROUP PARMENTER HOME CARE & HOSPICE, INC. -TRUSTEE, TREASURER (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. -TREASURER (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. -TREASURER (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. , INC. -TREASURER (EX-OFFICIO) - LAHEY CLINIC, INC. -TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. -TREASURER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER -TRUSTEE AND TREASURER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. -TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL -TREASURER (EX-OFFICIO) MOUNT AUBURN PROFESSIONAL SERVICES -ASSISTANT TREASURER (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP -TREASURER (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. -TREASURER (EX-OFFICIO) - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. -TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL -TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION -TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. -TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION -TRUSTEE (EX-OFFICIO), TREASURER(EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. -TRUSTEE (EX-OFFICIO), TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION -TREASURER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. -TRUSTEE AND TREASURER (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. -TREASURER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. -TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL -DIRECTOR (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. -TRUSTEE (EX-OFFICIO), TREASURER (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. -TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. -TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. -TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. -TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. -TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. -MANAGING DIRECTOR - BETH ISRAEL DEACONESS PHYSICIAN ORGANIZATION, LLC -MANAGING DIRECTOR, TREASURER - BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK, LLC -TREASURER (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE ACCOUNTABLE CARE ORGANIZATION, LLC -TREASURER (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE NETWORK, LLC -ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. -TREASURER (EX-OFFICIO) - JOSLIN CLINIC, INC. -TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. KERNDL INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $109,434. OF THIS AMOUNT, $89,934 WAS UNVESTED AT SEPTEMBER 30, 2023. OTHER REPORTABLE COMPENSATION FOR MR. KERNDL ALSO INCLUDES $ 7,961 RELATED TO TEMPORARY HOUSING. KOWALOFF, M.D., HARVEY -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. MARBLE, MEGAN VAYO -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. MARINI, ANNA -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. MCGRATH, JOHN -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. MCKENNA, CATHERINE -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. NDUNGU, VIRGINIA -PHYSICIAN ASSISTANT, ICU - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. PRIMAVERA, DENNIS -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. MR. PRIMAVERA'S TERM AS VICE CHAIR ON THE JORDAN PHYSICIAN ASSOCIATES' BOARD BEGAN ON OCTOBER 1, 2021.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES
RIOS, CINDY -TREASURER (EX-OFFICIO) AND INTERIM CHIEF FINANCIAL OFFICER BETH ISRAEL LAHEY HEALTH, INC. - TERM BEGAN JANUARY 1, 2023. -SENIOR VICE PRESIDENT AND OPERATIONS CHIEF FINANCIAL OFFICER BETH ISRAEL LAHEY HEALTH, INC. - TERM ENDED DECEMBER 31, 2022 UNLESS OTHERWISE NOTED, EFFECTIVE JANUARY 1, 2023, MS. RIOS ALSO ASSUMED THE FOLLOWING POSITIONS: -TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - TERM BEGAN MARCH 31, 2023 -TREASURER (EX-OFFICIO) - CAREGROUP PARMENTER HOME CARE & HOSPICE, INC. -TREASURER (EX-OFFICIO) - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. -TRUSTEE & TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. -TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. -TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. -TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. -TREASURER (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. -TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. -TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. -TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - TERM BEGAN MARCH 31, 2023 -TREASURER (EX-OFFICIO) - COMMUNITY PHYSICIANS ASSOCIATES, INC. -TREASURER (EX-OFFICIO) - JOSLIN CLINIC, INC. -TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. -TREASURER (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. -TREASURER (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. , INC. -TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. -TREASURER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER -TREASURER (EX-OFFICIO) - LAHEY CLINIC, INC. -TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL -TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. -TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL -TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION -TREASURER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. -DIRECTOR & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. -TREASURER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. -TRUSTEE & TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. -TRUSTEE & TREASURER (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. -TRUSTEE & TREASURER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. -TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION -TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. -TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE, INC. -TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION -TRUSTEE & TREASURER (EX-OFFICIO) - SEACOAST NURSING & REHABILITATION CENTER, INC. -TRUSTEE & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL EFFECTIVE JULY 1, 2023, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES INC. WHICH IN TURN SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL AND ADDITIONAL AFFILIATES. AS OF THAT DATE MS. RIOS ASSUMED THE FOLLOWING ADDITIONAL POSITIONS: -TREASURER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. -TREASURER (EX-OFFICIO) - EXETER HOSPITAL, INC. -TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOC & HOSPICE MS. RIOS SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR TEMPORARY HOUSING AND MOVING EXPENSES IN THE AMOUNT OF $41,927 AND 9,904, RESPECTIVELY. DEFERRED COMPENSATION IN THE AMOUNT OF $187,500 INCLUDED IN THIS FILING FOR MS. RIOS RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2022, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. ROWAN, MICHAEL UNLESS OTHERWISE NOTED BELOW, MR. ROWAN HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2023: -EXECUTIVE VICE PRESIDENT, HOSPITAL AND AMBULATORY SERVICES - BETH ISRAEL LAHEY HEALTH, INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - NEW ENGLAND BAPTIST HOSPITAL -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - NORTHEAST HOSPITAL CORPORATION -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - COMMUNITY PHYSICIANS ASSOCIATES, INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - THE JORDAN HEALTH SYSTEMS, INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JORDAN PHYSICIAN ASSOCIATES, INC. , INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BID - MILTON PHYSICIAN ASSOCIATES, INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JOSLIN CLINIC, INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JOSLIN DIABETES CENTER, INC. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - ANNA JAQUES HOSPITAL, INC. - TERM BEGAN ON APRIL 1, 2023. -TRUSTEE (CEO DESIGNEE) - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TERM BEGAN ON APRIL 1, 2023. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HOSPITAL - TERM BEGAN ON MARCH 10, 2023. -TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HEALTHCARE MANAGEMENT, INC. -TERM BEGAN ON MARCH 10, 2023. MR. ROWAN SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. ROWAN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $84,688. OF THIS AMOUNT, $65,188 IS UNVESTED AS OF SEPTEMBER 30, 2023. RUTHERFORD, RON -VICE PRESIDENT, CIO, VICE PRESIDENT SUPPORT SERVICES - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -VICE PRESIDENT, CIO, VICE PRESIDENT SUPPORT SERVICES - JORDAN PHYSICIAN ASSOCIATES, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. RUTHERFORD INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $20,906. INCLUDED IN THIS AMOUNT IS AN UNREALIZED LOSS IN THE AMOUNT OF $12,794 IMPACTING THE NONQUALIFIED UNVESTED BALANCE. SHIELDS, MARY -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. SODERSTROM, JADE -REGISTERED NURSE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES
TABB, M.D., KEVIN UNLESS OTHERWISE NOTED BELOW, DR. TABB HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2023: -PRESIDENT AND CHIEF EXECUTIVE OFFICER; TRUSTEE (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. -CHIEF EXECUTIVE OFFICER AND TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. -TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. -TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC, INC. -TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. -TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. -PRESIDENT (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. -TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. -TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION -TRUSTEE, BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HOSPITAL -DIRECTOR AND PRESIDENT (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION -CHIEF EXECUTIVE OFFICER AND TRUSTEE - CAB HEALTH AND RECOVERY SERVICES, INC. -CHIEF EXECUTIVE OFFICER AND TRUSTEE - HEALTH AND EDUCATION HOUSING SERVICES, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. -CHIEF EXECUTIVE OFFICER - COMMUNITY PHYSICIANS ASSOCIATES, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL -CHIEF EXECUTIVE OFFICER - THE JORDAN HEALTH SYSTEMS, INC. -CHIEF EXECUTIVE OFFICER - JORDAN PHYSICIAN ASSOCIATES, INC. , INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN CLINIC, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. EFFECTIVE JULY 1, 2023, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES INC. WHICH IN TURN SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL AND ADDITIONAL AFFILIATES. AS OF THAT DATE DR. TABB ASSUMED THE FOLLOWING ADDITIONAL POSITIONS: -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. -CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HOSPITAL, INC. IN ADDITION TO THE POSITIONS NOTED ABOVE, DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNATE WHO THEN BECAME THE VOTING TRUSTEE IN HIS PLACE: -TRUSTEE (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION -TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, BID-MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATES -TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM -TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, THE JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. , INC. -TRUSTEE (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH PHARMACY, INC. -TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL -TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL -TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL AND WINCHESTER HEALTHCARE MANAGEMENT -TRUSTEE (EX-OFFICIO) ANNA JAQUES HOSPITAL, INC. AND SEACOAST AFFILIATED GROUP PRACTICE -TRUSTEE (EX-OFFICIO) JOSLIN DIABETES CENTER -TRUSTEE (EX-OFFICIO) JOSLIN CLINIC -TRUSTEE (EX-OFFICIO) EXETER HEALTH RESOURCES, INC. -TRUSTEE (EX-OFFICIO) EXETER HOSPITAL, INC. ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $388,031. THIS AMOUNT INCLUDES A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $453,944 AND UNREALIZED LOSSES IMPACTING HIS NONQUALIFIED BENEFIT IN THE AMOUNT OF $85,413. DEFERRED COMPENSATION IN THE AMOUNT OF $250,000 INCLUDED IN THIS FILING FOR DR. TABB RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2022, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. TAYLOR, LISA -TRUSTEE - JORDAN HEALTH SYSTEMS, INC. -TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. MS. TAYLOR'S TERM ON THE JORDAN PHYSICIAN ASSOCIATES' BOARD BEGAN ON OCTOBER 1, 2021. THOMAS, M.D., TENNY -CHIEF MEDICAL OFFICER - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. DR. TENNY SERVED IN THIS POSITION DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. DEFERRED COMPENSATION IN THE AMOUNT OF $66,000 INCLUDED IN THIS FILING FOR DR. TENNY RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2022, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. TIERNEY, M.D., MATT -CHIEF OF SURGERY - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -GENERAL SURGEON - JORDAN PHYSICIAN ASSOCIATES, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TIERNEY INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $16,228. INCLUDED IN THIS AMOUNT IS AN UNREALIZED LOSS IN THE AMOUNT OF $4,272 IMPACTING THE NONQUALIFIED UNVESTED BALANCE. VALSKY, M.D., EUGENE -TRUSTEE (EX-OFFICIO) (PRESIDENT, MEDICAL STAFF) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TRUSTEE (EX-OFFICIO) (PRESIDENT, MEDICAL STAFF) THE JORDAN HEALTH SYSTEMS, INC. -TRUSTEE (EX-OFFICIO) (PRESIDENT, MEDICAL STAFF) - JORDAN PHYSICIAN ASSOCIATES, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. VALSKY INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $19,905. INCLUDED IN THIS AMOUNT IS AN UNREALIZED LOSS IN THE AMOUNT OF $595 IMPACTING THE NONQUALIFIED UNVESTED BALANCE.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
12 August 2024
IRS schema version
2022v5.0
Source object
202432279349303113

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