SUPPLEMENTAL INFORMATION |
PART III |
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. OTHER REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION MAY INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED FULLY VESTED 457(B) PLAN; TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; EARNED TIME CASHED; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AND OTHER TAXABLE RETIREMENT BENEFITS DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION MAY 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 NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS MAY 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, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ALL DIRECTORS 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 BETH ISRAEL DEACONESS HOSPITAL - MILTON, BETH ISRAEL DEACONESS MEDICAL CENTER, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER AND ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS BID-MILTON, BIDMC, HMFP AND APHMFP RESPECTIVELY. IN ADDITION, BIDMC IS THE SOLE MEMBER OF MEDICAL CARE OF BOSTON MANAGEMENT CORP. D/B/A AFFILIATED PHYSICIANS GROUP AND BID-MILTON IS THE SOLE MEMBER OF COMMUNITY PHYSICIANS ASSOCIATES WHICH MAY BE REFERRED TO IN THESE EXPLANATORY NOTES AS APG AND CPA RESPECTIVELY. FINALLY, THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL AND THE BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION MAY BE REFERRED TO AS PFHC, HMS OR PFHC/HMS AND BIDDM RESPECTIVELY. |
SUPPLEMENTAL INFORMATION |
PART III |
ALEXANDER, BRUCE DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION MR. ALEXANDER DEVOTES, ON AVERAGE, 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. BARRETT, M.D., GEORGE DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DR. BARRETT DEVOTES, ON AVERAGE, 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. BRADY, MICHAEL J. DIRECTOR AND BOARD CHAIR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR,AND BOARD CHAIR - MILTON HOSPITAL FOUNDATION DIRECTOR AND PRESIDENT - COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR AND PRESIDENT - MILTON HOSPITAL DEVELOPMENT FUND DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER MR. BRADY SERVED AS PRESIDENT OF MILTON HOSPITAL FOUNDATION AND MILTON HOSPITAL DEVELOPMENT FUND FROM JANUARY 1, 2013 TO AUGUST 26, 2013. MR. BRADY DEVOTES, ON AVERAGE, A COMBINED 15 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. CICHELLO, ANTHONY DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, INC. D/B/A AFFILIATED PHYSICIANS GROUP MR. CICHELLO DEVOTES, ON AVERAGE, A COMBINED 3 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. CONLON, KATHLEEN DIRECTOR AND CLERK - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR AND CLERK - MILTON HOSPITAL FOUNDATION DIRECTOR AND CLERK - COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR AND CLERK - MILTON HOSPITAL DEVELOPMENT FUND MS. CONLON DEVOTES, ON AVERAGE, A COMBINED 8 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. CRONIN, M.D., JON DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON MEDICAL DIRECTOR, INTENSIVE CARE AND DIRECTOR, CLINICAL DOCUMENTATION MANAGEMENT PROGRAM - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION CLINICAL INSTRUCTOR IN MEDICINE - HARVARD MEDICAL SCHOOL DR. CRONIN'S TERM ON THE BID-MILTON AND MHF BOARDS BEGAN JANUARY 2013. MR. CRONIN DEVOTES, ON AVERAGE, A COMBINED 12 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 73,500 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 DAVIS, III, FRANK L. DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION MR. DAVIS DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. FALLON, CAROL DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - MILTON HOSPITAL DEVELOPMENT FUND MS. FALLON DEVOTES, ON AVERAGE, A COMBINED 3 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. GREENE, DONALD DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - MILTON HOSPITAL DEVELOPMENT FUND MR. GREENE DEVOTES, ON AVERAGE, A COMBINED 3 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. HEALY, PETER DIRECTOR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER - MILTON HOSPITAL FOUNDATION DIRECTOR (EX-OFFICIO) AND PRESIDENT - MILTON HOSPITAL DEVELOPMENT FUND MR. HEALY COMMENCED HIS ROLES AS PRESIDENT, CEO AND DIRECTOR OF BID-MILTON, MHF AND MHDF ON AUGUST 26, 2013. AS REQUIRED BY THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2013, COMPENSATION REPORTED IS FOR CALENDAR YEAR 2012 WHICH WAS PRIOR TO MR. HEALYS EMPLOYMENT AT BID-MILTON AND AS SUCH, NO COMPENSATION IS REPORTED IN THIS FILING. MR. HEALY DEVOTES, ON AVERAGE, 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. HEAVEY, CHRISTOPHER DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION MR. HEAVEY DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. HODGMAN, JANE DIRECTOR AND VICE CHAIR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES MS. HODGMAN DEVOTES, ON AVERAGE, A COMBINED 4 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. |
SUPPLEMENTAL INFORMATION |
PART III |
KERWIN, MARK DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION MR. KERWIN DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. LEWIS, M.D., STANLEY M. DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON SENIOR VICE PRESIDENT, NETWORK INTEGRATION - BETH ISRAEL DEACONESS MEDICAL CENTER CARDIOLOGIST - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A AFFILIATED PHYSICIANS GROUP ASSOCIATE PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. LEWIS DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. LEWIS PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY FORM 990, ALTHOUGH DR. LEWIS IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. LEWIS COMPENSATION ATTRIBUTABLE TO HIS SERVICES PERFORMED AT BIDMC AND HMFP HAS BEEN SEPARATELY REPORTED ON FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 434,903 INCENTIVE COMPENSATION: 114,614 OTHER REPORTABLE COMPENSATION: 182,258 DEFERRED COMPENSATION: 22,500 NON-TAXABLE BENEFITS: 15,832 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 48,323 INCENTIVE COMPENSATION: 12,735 OTHER REPORTABLE COMPENSATION: 20,251 DEFERRED COMPENSATION: 2,500 NON-TAXABLE BENEFITS: 1,759 OTHER REPORTABLE COMPENSATION REPORTED BY BIDMC AND HMFP FOR THE 2012 CALENDAR YEAR INCLUDES PAYMENT OF DR. LEWIS' SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) OF $190,806 WHICH VESTED IN 2012. AS REQUIRED BY FORM 990, $30,492 WAS REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. LONGMAID, M.D., H. ESTERBROOK DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - MILTON PRESIDENT OF THE MEDICAL STAFF - BETH ISRAEL DEACONESS HOSPITAL - MILTON CHIEF OF RADIOLOGY - BETH ISRAEL DEACONESS HOSPITAL - MILTON DR. LONGMAID DEVOTES, ON AVERAGE, 8 HOURS PER WEEK TO THE REPORTING ORGANIZATION FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 22,085 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 LOONEY, M.D., JOHN J. DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON PRIMARY CARE PHYSICIAN - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A AFFILIATED PHYSICIANS GROUP CLINICAL INSTRUCTOR IN MEDICINE - HARVARD MEDICAL SCHOOL PRACTICE PHYSICIAN RECRUITMENT COORDINATOR - COMMUNITY PHYSICIANS ASSOCIATES DR. LOONEY DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. LOONEY PERFORMS SERVICES FOR BOTH APG AND CPA. AS REQUIRED BY FORM 990, PAYMENTS MADE TO DR. LOONEY BY HMFP BUT RELATED TO HIS SERVICES PERFORMED AT APG, HAVE BEEN SEPARATELY REPORTED ON FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY APG: BASE COMPENSATION: 262.973 INCENTIVE COMPENSATION: 109,619 OTHER REPORTABLE COMPENSATION: 3,777 DEFERRED COMPENSATION: 30,000 NON-TAXABLE BENEFITS: 25,598 PAYMENTS REPORTED BY CPA: BASE COMPENSATION: 32,500 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 MARSANO, MARIO DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION MR. MARSANO DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MORRISSEY, JOSEPH V. DIRECTOR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER - MILTON HOSPITAL FOUNDATION DIRECTOR (EX-OFFICIO) AND PRESIDENT - MILTON HOSPITAL DEVELOPMENT FUND FORMER DIRECTOR, PRESIDENT AND TREASURER - COMMUNITY PHYSICIANS ASSOCIATES MR. MORRISSEY RESIGNED FROM THE POSITION OF PRESIDENT AND CHIEF EXECUTIVE OFFICER OF BID-MILTON EFFECTIVE DECEMBER 31, 2012 AT WHICH TIME, HE BECAME ELIGIBLE FOR CERTAIN SEVERANCE PAYMENTS. AS REQUIRED BY THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2013, COMPENSATION REPORTED HERE IS FOR CALENDAR YEAR 2012 AND AS SUCH, NO SEVERANCE PAYMENTS HAVE BEEN REPORTED IN THIS FILING. MR. MORRISSEY DEVOTED, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 606,121 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 9,511 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 34,290 NEEDHAM, ELLEN DIRECTOR AND TREASURER - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR AND TREASURER - MILTON HOSPITAL FOUNDATION TREASURER - MILTON HOSPITAL DEVELOPMENT FUND DIRECTOR AND TREASURER - COMMUNITY PHYSICIANS ASSOCIATES MS. NEEDHAM DEVOTES, ON AVERAGE, A COMBINED 8 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. RABKIN, M.D., MITCHELL T. DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. RABKIN DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. ROSENBERG, M.D., STUART A DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - MILTON PRESIDENT AND CHIEF EXECUTIVE OFFICER - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT - ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT - LONGWOOD MEDICAL INTERNATIONAL FOUNDATION, INC. F/K/A CARDIOVASCULAR ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION DIRECTOR - BETH ISRAEL DEACONESS ORTHOPAEDIC SURGERY FOUNDATION DIRECTOR - CONTINUING EDUCATION PROGRAM, INC. D/B/A BETH ISRAEL DEACONESS DEPARTMENT OF PSYCHIATRY FOUNDATION DIRECTOR - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR - BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION DIRECTOR - BETH ISRAEL DERMATOLOGY FOUNDATION DIRECTOR - BIH PATHOLOGY FOUNDATION, INC. DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORP., D/B/A AFFILIATED PHYSICIANS GROUP SENIOR LECTURER ON MEDICINE - HARVARD MEDICAL SCHOOL DR. ROSENBERG DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 622,430 INCENTIVE COMPENSATION: 125,924 OTHER REPORTABLE COMPENSATION: 17,783 DEFERRED COMPENSATION: 446,875 NON-TAXABLE BENEFITS: 20,006 DEFERRED COMPENSATION REPORTED BY HMFP FOR THE 2012 CALENDAR YEAR INCLUDES $400,000 RELATED TO THE IMPLEMENTATION OF A RETENTION INCENTIVE PLAN ESTABLISHED BY HMFP'S BOARD OF DIRECTORS. AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED HERE IS FOR THE CALENDAR YEAR 2012 AND NO PORTION OF THIS AMOUNT WAS VESTED OR PAID DURING THAT TIME. THIS RETENTION INCENTIVE VESTS IN PERIODIC INCREMENTS IN ACCORDANCE WITH THE PLAN TERMS AND CONDITIONS PURSUANT TO WHICH ALL AMOUNTS WILL BE FULLY PAID BY JANUARY 2015. |
SUPPLEMENTAL INFORMATION |
PART III |
SINKEVICH, DORIS DIRECTOR (EX-OFFICIO) AND INTERIM CHIEF EXECUTIVE OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON CHIEF OPERATING OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR (EX-OFFICIO) AND INTERIM CHIEF EXECUTIVE OFFICER - MILTON HOSPITAL FOUNDATION CHIEF OPERATING OFFICER - MILTON HOSPITAL FOUNDATION VICE PRESIDENT, PATIENT CARE/QUALITY AND CHIEF NURSING OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON DURING THE FISCAL PERIOD COVERED BY THIS FILING MS. SINKEVICH, SERVED IN SEVERAL CAPACITIES. SHE SERVED AS VICE PRESIDENT, PATIENT CARE/QUALITY AND CHIEF NURSING OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON FROM OCTOBER 1, 2012 THROUGH DECEMBER 31, 2012, AS INTERIM CHIEF EXECUTIVE OFFICER (CEO) OF BETH ISRAEL DEACONESS HOSPITAL-MILTON AND MILTON HOSPITAL FOUNDATION FROM JANUARY 1 TO AUGUST 26, 2013, AND THEN AS CHIEF OPERATING OFFICER OF BETH ISRAEL DEACONESS HOSPITAL-MILTON AND MILTON HOSPITAL FOUNDATION FOR THE REMAINDER OF THE PERIOD COVERED BY THIS FILING AND BEYOND. AS REQUIRED BY THIS FORM 990, ALL COMPENSATION REPORTED IS FOR THE CALENDAR YEAR 2012 AT WHICH TIME MS. SINKEVICH SERVED AS VICE PRESIDENT, PATIENT CARE/QUALITY AND CHIEF NURSING OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON. MS. SINKEVICH DEVOTED, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 283,591 INCENTIVE COMPENSATION: 33,000 OTHER REPORTABLE COMPENSATION: 1,188 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 531 STAPLETON, PATRICK DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION MR. STAPLETON DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. TABB, M.D., KEVIN DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL -- MILTON DIRECTOR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DR. TABB DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 832,815 INCENTIVE COMPENSATION: 361,512 OTHER REPORTABLE COMPENSATION: 136,476 DEFERRED COMPENSATION: 7,167 NON-TAXABLE BENEFITS: 41,020 DR. TABB COMMENCED HIS ROLES AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF BIDMC DURING THE 2011 CALENDAR YEAR AND COMPLETED HIS RELOCATION TO MASSACHUSETTS DURING 2012. AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED HERE IS FOR THE CALENDAR YEAR 2012. CERTAIN PAYMENTS MADE TO DR. TABB AND REPORTED HERE WERE INTENDED TO HELP EASE THE FINANCIAL COSTS OF RELOCATION, TEMPORARY HOUSING AND OTHER TRANSITIONAL EXPENSES INCURRED BY DR. TABB AND ARE INCLUDED HERE IN THE AMOUNT OF $93,750 INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION IN THE AMOUNT OF $105,191. THESE AMOUNTS WERE PAID PURSUANT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN TREASURY REGULATIONS SECTION 53.4958-4(A)(3) AND BIDMC FOLLOWED THE REBUTTABLE PRESUMPTION PROCEDURES DESCRIBED IN TREASURY REGULATIONS SECTION 53.4958-6(C) IN SETTING DR. TABB'S COMPENSATION. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $19,994. |
SUPPLEMENTAL INFORMATION |
PART III |
RADZEVICH, JASON VICE PRESIDENT, FINANCE AND CHIEF FINANCIAL OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON VICE PRESIDENT, FINANCE AND CHIEF FINANCIAL OFFICER - MILTON HOSPITAL FOUNDATION CHIEF FINANCIAL OFFICER - MILTON HOSPITAL DEVELOPMENT FUND CHIEF FINANCIAL OFFICER - COMMUNITY PHYSICIANS ASSOCIATES MR. RADZEVICH DEVOTED, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 231,845 INCENTIVE COMPENSATION: 27,106 OTHER REPORTABLE COMPENSATION: 162 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 13,543 HARRINGTON, KATHLEEN VICE PRESIDENT, HUMAN RESOURCES - BETH ISRAEL DEACONESS HOSPITAL - MILTON MS. HARRINGTON DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 150,806 INCENTIVE COMPENSATION: 15,938 OTHER REPORTABLE COMPENSATION: 490 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 12,213 PAGE, CYNTHIA VICE PRESIDENT, CLINICAL SUPPORT SERVICES - BETH ISRAEL DEACONESS HOSPITAL - MILTON MS. PAGE DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 137,019 INCENTIVE COMPENSATION: 16,052 OTHER REPORTABLE COMPENSATION: 173 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 38,031 YEATS, M.D., ASHLEY CHIEF MEDICAL OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON DR. YEATS DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. A PORTION OF DR. YEATS' COMPENSATION WAS PAID DIRECTLY BY ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, AN ENTITY RELATED TO BID-MILTON AND EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AS REQUIRED BY FORM 990, DR. YEATS' COMPENSATION HAS BEEN SEPARATELY REPORTED ON THIS FILING, AS FURTHER OUTLINED BELOW: PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 226,416 BONUS AND INCENTIVE COMPENSATION: 28,708 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY APHMFP: BASE COMPENSATION: 81,079 BONUS AND INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 3,426 DEFERRED COMPENSATION: 4,500 NON-TAXABLE BENEFITS: 7,214 CAMPBELL, ALEXANDER DIRECTOR, HEALTH CARE QUALITY - BETH ISRAEL DEACONESS HOSPITAL - MILTON MR. CAMPBELL DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 114,336 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 183 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 30,119 CRONIN, LYNN CHIEF NURSING OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR, NURSING SERVICES - BETH ISRAEL DEACONESS HOSPITAL - MILTON MS. CRONIN, COMMENCED HER ROLE AS INTERIM CHIEF NURSING OFFICER (CNO) OF BETH ISRAEL DEACONESS HOSPITAL-MILTON ON DECEMBER 23, 2012 AND BECAME CNO ON SEPTEMBER 1, 2013. PRIOR TO THAT TIME, MS. CRONIN SERVED AS NURSING SERVICES DIRECTOR. AS REQUIRED BY THIS FORM 990, ALL COMPENSATION REPORTED IS FOR THE CALENDAR YEAR 2012 AT WHICH TIME MS. CRONIN SERVED AS DIRECTOR, NURSING SERVICES - BETH ISRAEL DEACONESS HOSPITAL - MILTON. MS. CRONIN DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 111,839 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 4,769 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 32,571 FERNANDEZ, JEAN M. CHIEF INFORMATION OFFICER - BETH ISRAEL DEACONESS HOSPITAL - MILTON MS. FERNANDEZ DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 143,728 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 242 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 30,769 MITCHELL, HOLLY DIRECTOR NURSING SERVICES - BETH ISRAEL DEACONESS HOSPITAL - MILTON MS. MITCHELL DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 136,185 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 1,372 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 30,743 PIERRE-HYPPOLITE, MARIE REGISTERED NURSE, OPERATING ROOM - BETH ISRAEL DEACONESS HOSPITAL - MILTON MS. PIERRE-HYPPOLITE DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 113,519 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 90 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 30,071 |
SUPPLEMENTAL INFORMATION |
PART III |
BERRY, M.D., MICHAEL V. FORMER CHIEF, SURGERY - BETH ISRAEL DEACONESS HOSPITAL - MILTON ORTHOPEDIC SURGEON - COMMUNITY PHYSICIANS ASSOCIATES DR. BERRY SERVED AS CHIEF OF SURGERY UNTIL DECEMBER 31, 2011 AND DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE RELATED ENTITY FOR THE POSITION LISTED HERE. PAYMENTS REPORTED BY CPA: BASE COMPENSATION: 959,481 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 29,846 ZEIDEL, M.D. MARK L. FORMER DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR (EX-OFFICIO) AND CHIEF (MEDICINE) - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (MEDICINE) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP DIRECTOR AND PRESIDENT - BETH ISRAEL DEACONESS DEPT. OF MEDICINE FOUNDATION (BIDDM) HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE- HARVARD MEDICAL SCHOOL DR. ZEIDEL DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. ZEIDEL PERFORMS SERVICES FOR BOTH HMFP AND BIDMC. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ZEIDEL IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. ZEIDEL'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. DR. ZEIDEL ALSO PERFORMS SERVICES FOR BIDDM AND COMPENSATION PAID TO DR. ZEIDEL DIRECTLY BY BIDDM IS ALSO REPORTED. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 346,164 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,203 DEFERRED COMPENSATION: 20,440 NON-TAXABLE BENEFITS: 7,847 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 346,164 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,202 DEFERRED COMPENSATION: 20,441 NON-TAXABLE BENEFITS: 7,847 PAYMENTS REPORTED BY BIDDM: BASE COMPENSATION: 5,890 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2012 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. ZEIDEL'S POSITION AS CHIEF OF MEDICINE AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF MEDICINE AND HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: $143,869 BASE AND OTHER REPORTABLE COMPENSATION, $15,881 DEFERRED COMPENSATION AND $1,825 NON-TAXABLE BENEFITS. |