SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
CODMAN SQUARE HEALTH CENTER INC
 
Employer identification number

04-2678774
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 7A EXPLANATION: THE BOARD MEMBERS HAVE THE POWER TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND MEMBERS OF THE BOARD MUST COMPLETE ANNUAL SIGN OFFS ON THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE CEO IS DETERMINED AND EVALUATED BY THE BOARD OF DIRECTORS. THE BOARD ENGAGED AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW AND MAKE RECOMMENDATIONS REGARDING COMPENSATION AND BENEFITS FOR ALL POSITIONS. COMPENSATION OF OTHER OFFICERS AND KEY STAFF MEMBERS IS DETERMINED BY HUMAN RESOURCES, IN CONJUNCTION WITH THE CEO AND EXECUTIVE TEAM. THE MASSACHUSETTS LEAGUE OF COMMUNITY HEALTH CENTER'S ANNUAL SALARY AND COMPENSATION SURVEY IS USED DURING SUCH REVIEWS.
FORM 990, PART VI, SECTION C, LINE 19 CODMAN SQUARE HEALTH CENTER MAKES THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9: FORGIVENESS OF DEBT 116,465.
FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


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