PART I, LINE 4B |
SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN DURING THE 2019 CALENDAR YEAR, INDIVIDUALS LISTED IN THIS FILING MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING NON-QUALIFIED DEFERRED COMPENSATION PLANS: LAHEY CLINIC 457(F) NON-QUALIFIED DEFINED CONTRIBUTION PLAN, LAHEY CLINIC 457(B) RETIREMENT SAVINGS PLAN. BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM WHICH IS A NON-QUALIFIED DEFERRED COMPENSATION PLAN. PURSUANT TO THE PLAN ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS. 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. |
PART I, LINE 7 |
NON-FIXED PAYMENTS ACROSS THE BILH NETWORK OF AFFILIATES, INCLUDING CPHCH, EXECUTIVE COMPENSATION PACKAGES AND CERTAIN EMPLOYEE COMPENSATION PACKAGES INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING PRE-DETERMINED GOALS. FOR THE PERIOD COVERED BY THIS FILING, THE INCENTIVE COMPENSATION FOR EACH EXECUTIVE REPORTED IN THIS FORM 990 WAS REVIEWED AND APPROVED BY THE BILH COMPENSATION COMMITTEE, WHICH AS PREVIOUSLY NOTED, WAS FULLY STAFFED BY INDEPENDENT MEMBERS. |
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES: |
AS REQUIRED BY FORM 990, COMPENSATION REPORTED FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020 IS CALENDAR YEAR 2019 COMPENSATION. 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 THESE 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 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. MOUNT AUBURN HOSPITAL, MOUNT AUBURN PROFESSIONAL SERVICES AND CAREGROUP PARMENTER HOME CARE & HOSPICE MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS MAH, MAPS AND CPHCH RESPECTIVELY. BURKE, KATHRYN MS. BURKE HELD THE POSITIONS NOTED BELOW FOR THE FULL FISCAL YEAR COVERED BY THIS FILING UNLESS OTHERWISE NOTED. - VICE PRESIDENT, CONTRACTING BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK - VICE PRESIDENT CONTRACTING AND BUSINESS DEVELOPMENT, TRUSTEE - CAREGROUP PARMENTER HOME CARE & HOSPICE (THROUGH DECEMBER 21, 2019) ALTHOUGH MS. BURKE SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2019 COMPENSATION. PRIOR TO OCTOBER 1, 2019 MS. BURKE SERVED AS THE VICE PRESIDENT OF CONTRACTING AND BUSINESS DEVELOPMENT FOR MOUNT AUBURN HOSPITAL (MAH) AND WAS COMPENSATED BY MAH THOSE SERVICES. EFFECTIVE OCTOBER 1, 2019, MS. BURKE COMMENCED HER POSITION AS VICE PRESIDENT, CONTRACTING FOR THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK. AMOUNTS PAID TO MS. BURKE BY MAH AND BILH HAVE BEEN SEPARATELY REPORTED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 216,755 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 88,860 DEFERRED COMPENSATION: 19,600 NON-TAXABLE BENEFITS: 22,923 PAYMENTS REPORTED BY BETH ISRAEL LAHEY HEALTH: BASE COMPENSATION: 65,209 INCENTIVE COMPENSATION: 35,000 OTHER REPORTABLE COMPENSATION: 4,156 DEFERRED COMPENSATION: 811 NON-TAXABLE BENEFITS: 8,640 OTHER REPORTABLE COMPENSATION FOR MS. BURKE INCLUDES COMBINED DEFERRALS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $15,621 AND PTO CASHED OUT UPON COMMENCING HER POSITION AT BILH IN THE AMOUNT OF $70,442. CANEPA, JOHN J. - TRUSTEE CAREGROUP PARMENTER HOME CARE & HOSPICE - TRUSTEE AND BOARD CO-CHAIR MOUNT AUBURN HOSPITAL - TRUSTEE MOUNT AUBURN PROFESSIONAL SERVICES - TRUSTEE BETH ISRAEL LAHEY HEALTH MR. CANEPA'S TERM ON THE CAREGROUP PARMENTER HOME CARE & HOSPICE'S BOARD ENDED ON DECEMBER 21, 2019. CLOUGH, JEANETTE G. MS. CLOUGH HELD THE POSITIONS NOTED BELOW FOR THE FULL FISCAL YEAR COVERED BY THIS FILING UNLESS OTHERWISE NOTED. - TRUSTEE (EX-OFFICIO) AND PRESIDENT MOUNT AUBURN HOSPITAL - TRUSTEE (EX-OFFICIO) AND PRESIDENT MOUNT AUBURN PROFESSIONAL SERVICES - TRUSTEE CAREGROUP PARMENTER HOME CARE & HOSPICE (THROUGH DECEMBER 21, 2019) AS REQUIRED IN THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2019 COMPENSATION. IN HER POSITIONS AS PRESIDENT FOR MOUNT AUBURN HOSPITAL (MAH) AND MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) DURING THE 2019 CALENDAR YEAR, MS. CLOUGH RECEIVED PAYMENTS DIRECTLY FROM CAREGROUP, INC. AND BETH ISRAEL LAHEY HEALTH, INC (BILH). BILH BECAME THE SOLE MEMBER OF MAH ON MARCH 1, 2019 AND CAREGROUP WAS THE SOLE MEMBER OF MAH PRIOR TO THAT DATE. EACH OF THESE ENTITIES IS/WAS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND A SUPPORT ORGANIZATION OF MAH. FOR THE PERIOD COVERED BY THIS FILING, MS. CLOUGH PERFORMED SERVICES FOR BOTH MAH AND MAPS BUT NOT DIRECTLY FOR BILH OR CAREGROUP. THE COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MAH: BASE COMPENSATION: 614,999 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 146,255 DEFERRED COMPENSATION: 16,786 NON-TAXABLE BENEFITS: 25,075 PAYMENTS REPORTED BY MAPS: BASE COMPENSATION: 135,000 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 32,105 DEFERRED COMPENSATION: 3,685 NON-TAXABLE BENEFITS: 5,504 OTHER REPORTABLE COMPENSATION FOR MS. CLOUGH INCLUDES COMBINED PAYMENTS FROM, CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS, IN THE AMOUNT OF $177,178. DOERNER-RINALDI, M.D., ALDEN - TRUSTEE AND MEDICAL DIRECTOR CAREGROUP PARMENTER HOME CARE & HOSPICE DR. DOERNER-RINALDI'S TERM ON THE CAREGROUP PARMENTER HOME CARE & HOSPICE'S BOARD ENDED ON DECEMBER 21, 2019 DR. DOERNER-RINALDI PERFORMED SERVICES FOR BOTH MOUNT AUBURN PROFESSIONAL SERVICES AND CAREGROUP PARMENTER HOME CARE & HOSPICE. ALTHOUGH DR. DOERNER-RINALDI IS PAID DIRECTLY BY CAREGROUP PARMENTER HOME CARE & HOSPICE, THE PORTION OF DR. DOERNER-RINALDI'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY: CPHCH BASE COMPENSATION: 183,715 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 741 DEFERRED COMPENSATION: 5,982 NON-TAXABLE BENEFITS: 33,058 PAYMENTS REPORTED BY: MAPS BASE COMPENSATION: 9,669 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 39 DEFERRED COMPENSATION: 315 NON-TAXABLE BENEFITS: 1,740 |
SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) |
EICHHORN, KAREN - TRUSTEE, TREASURER, VICE PRESIDENT, FINANCE CAREGROUP PARAMETER HOME CARE & HOSPICE - VICE PRESIDENT,FINANCE BETH ISRAEL LAHEY HEALTH CONTINUING CARE - VICE PRESIDENT, FINANCE NORTHEAST SENIOR HEALTH CORP. - VICE PRESIDENT, FINANCE SEACOAST NURSING & REHABILITATION CENTER - VICE PRESIDENT, FINANCE NORTHEAST PROFESSIONAL REGISTRY OF NURSES MS. EICHHORN'S TERM ON THE CAREGROUP PARMENTER HOME CARE & HOSPICE'S BOARD STARTEDON DECEMBER 22, 2019. PAYMENTS REPORTED BY: LHSS BASE COMPENSATION: 149,312 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 184 DEFERRED COMPENSATION: 10,302 NON-TAXABLE BENEFITS: 11,624 GIZMUNT, JENNIFER - PRESIDENT, CONTINUING CARE BETH ISRAEL LAHEY HEALTH - TRUSTEE, PRESIDENT AND CHAIR CAREGROUP HOME CARE & HOSPICE - PRESIDENT NORTHEAST PROFESSIONAL REGISTRY OF NURSES - PRESIDENT -- NORTHEAST SENIOR HEALTH CORPORATION MS. GIZMUNT'S TERM ON THE CAREGROUP PARMENTER HOME CARE & HOSPICE'S BOARD BEGAN ON DECEMBER 22, 2019. PAYMENTS REPORTED BY: BILH BASE COMPENSATION: 236,991 INCENTIVE COMPENSATION: 44,688 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 22,973 JOSEPH, ESQ., LESLIE A. - TRUSTEE AND CLERK CAREGROUP PARMENTER HOME CARE & HOSPICE MS. JOSEPH'S TERM ON THE CAREGROUP PARMENTER HOME CARE & HOSPICE'S BOARD BEGAN ON DECEMBER 22, 2019. PAYMENTS REPORTED BY CPHCH: BASE COMPENSATION: 293,000 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 31,097 DEFERRED COMPENSATION: 22,400 NON-TAXABLE BENEFITS: 7,430 OTHER REPORTABLE COMPENSATION FOR MS. JOSEPH INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $25,667. KIM, KIJA - TRUSTEE CAREGROUP PARMENTER HOME CARE & HOSPICE - TRUSTEE MOUNT AUBURN HOSPITAL MS. KIJA'S TERM ON THE CAREGROUP PARMENTER HOME CARE & HOSPICE'S BOARD ENDED ON DECEMBER 21, 2019. COSTELLO, DEBORAH RN MSN - CHIEF OPERATING OFFICER OF HOME, HEALTH, AND HOSPICE PALLIATIVE CARE CAREGROUP PARAMETER HOME CARE & HOSPICE - CHIEF OPERATING OFFICER OF HOME, HEALTH, AND HOSPICE PALLIATIVE CARE PROFESSIONAL REGISTRY OF NURSES PAYMENTS REPORTED BY: NPRN BASE COMPENSATION: 217,179 INCENTIVE COMPENSATION: 16,522 OTHER REPORTABLE COMPENSATION: 877 DEFERRED COMPENSATION: 6,243 NON-TAXABLE BENEFITS: 4,997 SILVA, DONNA - PRESIDENT CAREGROUP PARMENTER HOME CARE & HOSPICE (THROUGH DECEMBER 20, 2019) - ED HOSPICE SERVICES PROGRAM NORTHEAST PROFESSIONAL REGISTRY OF NURSES PAYMENTS REPORTED BY: CPHCH BASE COMPENSATION: 201,225 INCENTIVE COMPENSATION: 10,000 OTHER REPORTABLE COMPENSATION: 20,645 DEFERRED COMPENSATION: 22,968 NON-TAXABLE BENEFITS: 2,413 OTHER REPORTABLE COMPENSATION REPORTED BY CPHCH FOR THE 2019 CALENDAR YEAR INCLUDES TAX GROSS UP OF $9,702 AND PTO CASHED OUT OF $8,078. SULLIVAN, WILLIAM - VICE PRESIDENT AND CHIEF FINANCIAL OFFICER MOUNT AUBURN HOSPITAL - VICE PRESIDENT FINANCE AND TREASURER MOUNT AUBURN PROFESSIONAL SERVICES - VICE PRESIDENT FINANCE AND TREASURER CAREGROUP PARMENTER HOME CARE & HOSPICE (THROUGH DECEMBER 21, 2019) MR. SULLIVAN PERFORMS SERVICES FOR MOUNT AUBURN HOSPITAL, MOUNT AUBURN PROFESSIONAL SERVICES AND PERFORMED SERVICES FOR CAREGROUP PARMENTER HOME CARE & HOSPICE THROUGH DECEMBER 21, 2019. ALTHOUGH MR. SULLIVAN IS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF MR. SULLIVAN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 283,510 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 12,568 DEFERRED COMPENSATION: 15,288 NON-TAXABLE BENEFITS: 21,192 PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 61,791 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 2,739 DEFERRED COMPENSATION: 3,332 NON-TAXABLE BENEFITS: 4,619 PAYMENTS REPORTED BY CAREGROUP PARMENTER HOME CARE & HOSPICE: BASE COMPENSATION: 18,174 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 806 DEFERRED COMPENSATION: 980 NON-TAXABLE BENEFITS: 1,358 OTHER REPORTABLE COMPENSATION REPORTED BY MAH AND MAPS FOR THE 2019 CALENDAR YEAR INCLUDES PTO CASHED OUT IN THE AMOUNT OF $14,282. |
SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) |
OZOONIAN, DEBRA D. - RN CASE MANAGER - CAREGROUP PARMENTER HOME CARE & HOSPICE PAYMENTS REPORTED BY: CPHCH BASE COMPENSATION: 130,999 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 3,382 DEFERRED COMPENSATION: 7,019 NON-TAXABLE BENEFITS: 6,104 FLETCHER, DAVID - DIRECTOR OF IS AND FINANCE CAREGROUP PARMENTER HOME CARE & HOSPICE PAYMENTS REPORTED BY CAREGROUP PARMENTER HOME CARE & HOSPICE: BASE COMPENSATION: 146,719 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 784 DEFERRED COMPENSATION: 11,909 NON-TAXABLE BENEFITS: 2,247 BROWN, HEIDI - DIRECTOR, HOME CARE CLINICAL SERVICES CAREGROUP PARMENTER HOME CARE & HOSPICE PAYMENTS REPORTED BY CAREGROUP PARMENTER HOME CARE & HOSPICE: BASE COMPENSATION: 159,158 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 895 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 11,250 MARSDEN, KELLY COMMUNITY HEALTH NURSE CAREGROUP PARMENTER HOME CARE & HOSPICE PAYMENTS REPORTED BY CAREGROUP PARMENTER HOME CARE & HOSPICE: BASE COMPENSATION: 133,137 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 4,949 DEFERRED COMPENSATION: 11,153 NON-TAXABLE BENEFITS: 1,781 THULIN, ROBIN - THERAPIST - CAREGROUP PARMENTER HOME CARE & HOSPICE PAYMENTS REPORTED BY: CPHCH BASE COMPENSATION: 128,330 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 4,168 DEFERRED COMPENSATION: 11,217 NON-TAXABLE BENEFITS: 27,170 MCQUAIDE, DENISE - FORMER PRESIDENT CAREGROUP PARMENTER HOME CARE & HOSPICE - VICE PRESIDENT, POST-ACUTE CARE SERVICES MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY CAREGROUP PARMENTER HOME CARE & HOSPICE: BASE COMPENSATION: 181,030 INCENTIVE COMPENSATION: 23,410 OTHER REPORTABLE COMPENSATION: 2,182 DEFERRED COMPENSATION: 5,831 NON-TAXABLE BENEFITS: 17,271 |