TY 2020 Form 990 Schedule J

efile Public Visual Render ObjectId: 202232279349304838 - Submission: 2022-08-15 TIN: 04-2104338

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
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Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Part I

Questions Regarding Compensation

Yes

No

1a

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

b

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

1b

2

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

2

3

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

4

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

a

Receive a severance payment or change-of-control payment? .............

4a

No

b

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

4b

Yes

c

Participate in, or receive payment from, an equity-based compensation arrangement? .........

4c

No

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

5

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

a

The organization? ....................

5a

No

b

Any related organization? .......................

5b

No

If "Yes," on line 5a or 5b, describe in Part III.

6

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

a

The organization? ..................

6a

No

b

Any related organization? ......................

6b

No

If "Yes," on line 6a or 6b, describe in Part III.

7

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

7

Yes

8

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

8

No

9

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

9

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2020

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Schedule J (Form 990) 2020

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1TABB MD KEVIN TRUSTEE (EX-OFFICIO), CEO	(i) (ii)	0 ------------- 1,607,257	0 ------------- 1,271,689	0 ------------- 499,335	0 ------------- 321,950	0 ------------- 42,947	0 ------------- 3,743,178	0 ------------- 0
2FISCHER STEVEN BILH CFO, TREASURER (EX-OFFICIO)	(i) (ii)	0 ------------- 824,811	0 ------------- 345,240	0 ------------- 154,549	0 ------------- 20,155	0 ------------- 34,545	0 ------------- 1,379,300	0 ------------- 0
3KATZ ESQ JAMIE BILH GEN. COUNSEL, CLERK (EX-OFFICIO	(i) (ii)	0 ------------- 689,655	0 ------------- 463,139	0 ------------- 118,934	0 ------------- 19,114	0 ------------- 13,424	0 ------------- 1,304,266	0 ------------- 0
4NESTO MD RICHARD BILH CMO, TRUSTEE, EX-OFFICIO CEO DE	(i) (ii)	0 ------------- 733,137	0 ------------- 280,922	0 ------------- 143,317	0 ------------- 60,546	0 ------------- 32,191	0 ------------- 1,250,113	0 ------------- 0
5GOLDSTEIN MARK TRUSTEE (EX-OFFICIO); PRESIDENT	(i) (ii)	0 ------------- 563,715	0 ------------- 100,862	0 ------------- 52,499	0 ------------- 65,826	0 ------------- 29,654	0 ------------- 812,556	0 ------------- 0
6PURSLEY MD DEWAYNE M TRUSTEE, PHYSICIAN	(i) (ii)	0 ------------- 668,862	0 ------------- 12,210	0 ------------- 7,566	0 ------------- 57,000	0 ------------- 19,196	0 ------------- 764,834	0 ------------- 0
7FAYRE MD GAIL CMO OF AJH, COO OF SAGP	(i) (ii)	344,189 ------------- 0	39,682 ------------- 0	2,033 ------------- 0	5,700 ------------- 0	43,574 ------------- 0	435,178 ------------- 0	0 ------------- 0
8KILDAY KEVIN CFO	(i) (ii)	333,116 ------------- 0	30,011 ------------- 0	126 ------------- 0	18,974 ------------- 0	44,605 ------------- 0	426,832 ------------- 0	0 ------------- 0
9MAKI DN RN RICHARD CNO	(i) (ii)	249,943 ------------- 0	26,302 ------------- 0	126 ------------- 0	5,172 ------------- 0	34,387 ------------- 0	315,930 ------------- 0	0 ------------- 0
10LEE GARY VICE PRESIDENT, CLINICAL OPERATIONS	(i) (ii)	200,689 ------------- 0	14,314 ------------- 0	106 ------------- 0	8,573 ------------- 0	45,620 ------------- 0	269,302 ------------- 0	0 ------------- 0
11BUCHANAN JRROBERT R DIR IS	(i) (ii)	193,802 ------------- 0	1,499 ------------- 0	34 ------------- 0	3,903 ------------- 0	45,679 ------------- 0	244,917 ------------- 0	0 ------------- 0
12PERRYDANIELLE C VP PUBLIC RELATIONS	(i) (ii)	178,978 ------------- 0	12,560 ------------- 0	20 ------------- 0	16,094 ------------- 0	26,426 ------------- 0	234,078 ------------- 0	0 ------------- 0
13SOLDANOJOSEPH DIR FINANCIAL PLANNING	(i) (ii)	167,305 ------------- 0	0 ------------- 0	29 ------------- 0	8,315 ------------- 0	43,305 ------------- 0	218,954 ------------- 0	0 ------------- 0
14SZUKSTAWALTER F DIR SURGICAL SVCS	(i) (ii)	158,450 ------------- 0	0 ------------- 0	57 ------------- 0	6,422 ------------- 0	42,743 ------------- 0	207,672 ------------- 0	0 ------------- 0
15TURNERCHRISTINE A REGISTERED NURSE	(i) (ii)	147,172 ------------- 0	422 ------------- 0	15 ------------- 0	2,330 ------------- 0	45,804 ------------- 0	195,743 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2020

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Schedule J (Form 990) 2020

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Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 4B	SCHEDULE J PART I QUESTION 4A SEVERANCE AND CHANGE OF CONTROL PAYMENTS AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, AND AS NOTED ABOVE, THE COMPENSATION DETAIL INCLUDED IN ANNA JAQUES HOSPITAL (AJH) FORM 990 FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021 IS CALENDAR YEAR 2020 DETAIL. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. SCHEDULE J PART I QUESTION 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN ANNA JAQUES HOSPITAL'S FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021 IS CALENDAR YEAR 2020 DETAIL. 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. 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.
PART I, LINE 7	SCHEDULE J PART I QUESTION 7 NON-FIXED PAYMENTS ACROSS THE BILH NETWORK OF AFFILIATES, INCLUDING AJH, 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:	FISCHER, STEVEN EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. MR. FISCHER RETIRED FROM HIS POSITION HELD AT BILH AS WELL AS THE POSITIONS DESCRIBED BELOW ON APRIL 2, 2021. UNLESS NOTED BELOW, MR. FISCHER HELD EACH POSITION THROUGH HIS DATE OF RETIREMENT. TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TRUSTEE AND TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH PHARMACY F/K/A BIDMC PHARMACY, INC. O MR. FISCHER HELD THE TRUSTEE POSITION THROUGH DECEMBER 31, 2020. TREASURER (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITALMILTON TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITALNEEDHAM TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITALPLYMOUTH TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) BID-MILTON PHYSICIAN ASSOCIATES F/K/A MILTON HOSPITAL FOUNDATION TREASURER (EX-OFFICIO) MOUNT AUBURN HOSPITAL TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) COMMUNITY PHYSICIANS ASSOCIATES TRUSTEE AND TREASURER (EX-OFFICIO) JORDAN PHYSICIAN ASSOCIATES TRUSTEE AND TREASURER (EX-OFFICIO) THE JORDAN HEALTH SYSTEMS, INC. TREASURER (EX-OFFICIO) ANNA JAQUES HOSPITAL TREASURER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE TRUSTEE AND TREASURER (EX-OFFICIO) LAHEY HEALTH SHARED SERVICES, INC. ASSISTANT TREASURER BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) NORTHEAST HEALTH SYSTEM, INC. TRUSTEE AND TREASURER (EX-OFFICIO) NORTHEAST PROFESSIONAL REGISTRY OF NURSES TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE AND TREASURER (EX-OFFICIO) SEACOAST NURSING & REHABILITATION CENTER, INC. TREASURER (EX-OFFICIO) WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) WINCHESTER HOSPITAL FOUNDATION, INC. TREASURER (EX-OFFICIO) WINCHESTER HEALTHCARE MANAGEMENT, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER MANAGING DIRECTOR AND TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK LLC TREASURER (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) NORTHEAST MEDICAL PRACTICE, INC. TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND TREASURER CAB HEALTH & RECOVERY SERVICES, INC. TREASURER CAREGROUP PARMENTER HOME CARE AND HOSPICE, INC. TRUSTEE AND TREASURER HEALTH & EDUCATION HOUSING SERVICES, INC. ALTHOUGH MR. FISCHER SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2020 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. FISCHER INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $117,139. FUNG, M.D., CLAIRE TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. MRS. FUNG'S TERM AS TRUSTEE OF ANNA JAQUES HOSPITAL BEGAN ON OCTOBER 1, 2020. GHIASUDDIN, MD, SALMAN TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. GOLDSTEIN, MARK UNLESS OTHERWISE NOTED BELOW, MR. GOLDSTEIN HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2021. TRUSTEE (EX-OFFICIO), PRESIDENT ANNA JAQUES HOSPITAL TRUSTEE (EX-OFFICIO), PRESIDENT MEMBER ANNA JAQUES COMMUNITY HEALTH FOUNDATION PRESIDENT AND TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. ALTHOUGH MR. GOLDSTEIN SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2020 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. GOLDSTEIN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $94,491. OF THIS AMOUNT, $47,626 IS UNVESTED. HOLMES, BETTY LANG INTERIM VICE PRESIDENT, HUMAN RESOURCES ANNA JAQUES HOSPITAL INTERIM VICE PRESIDENT, HUMAN RESOURCESANNA JAQUES COMMUNITY HEALTH FOUNDATION INTERIM VICE PRESIDENT, HUMAN RESOURCESSEACOAST AFFILIATED GROUP PRACTICE, INC. MRS. HOLMES'S TERM IN THE ROLES DESCRIBED ABOVE BEGAN IN DECEMBER, 2020 AND ENDED ON MARCH 31, 2021. KATZ, J.D., JAMIE UNLESS OTHERWISE NOTED BELOW, MR, KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2021: GENERAL COUNSEL AND CLERK (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TRUSTEE AND CLERK (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH PHARMACY F/K/A BIDMC PHARMACY, INC. O TRUSTEE TERM ENDED DECEMBER 31, 2020 CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM CLERK BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK, LLC CLERK (EX-OFFICIO) MOUNT AUBURN HOSPITAL CLERK (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITALMILTON CLERK (EX-OFFICIO) COMMUNITY PHYSICIANS ASSOCIATION, INC. CLERK (EX-OFFICIO) BID-MILTON PHYSICIAN ASSOCIATES F/K/A MILTON HOSPITAL FOUNDATION CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITALPLYMOUTH CLERK (EX-OFFICIO) JORDAN PHYSICIANS ASSOCIATES, INC. CLERK (EX-OFFICIO) THE JORDAN HEALTH SYSTEM CLERK (EX-OFFICIO) ANNA JAQUES HOSPITAL CLERK (EX-OFFICIO) SEACOAST AFFILIATED GROUP PRACTICE 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) AND 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 & REHABILITATION CENTER, INC. TRUSTEE (EX-OFFICIO) 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) - LAHEY CLINICAL PERFORMANCE ACCOUNTABLE CARE ORGANIZATION, LLC CLERK (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE NETWORK, LLC CLERK (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) NORTHEAST MEDICAL PRACTICE, INC. TRUSTEE AND CLERK CAB HEALTH & RECOVERY SERVICES, INC. TRUSTEE AND CLERK HEALTH & EDUCATION HOUSING SERVICES, INC. CLERK (EX-OFFICIO) WINCHESTER HOSPITAL MR. KATZ SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2020 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. INCENTIVE COMPENSATION FOR MR. KATZ INCLUDES $225,000 WHICH WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION. OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $87,861.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES:	KERNDL, JOHN UNLESS OTHERWISE NOTED BELOW, MR. KERNDL HELD THE FOLLOWING POSITIONS BEGINNING APRIL 5, 2021 THROUGH SEPTEMBER 30, 2021: EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. TRUSTEE AND TREASURER CAB HEALTH & RECOVERY SERVICES, INC. TREASURER (EX-OFFICIO) COMMUNITY PHYSICIAN ASSOCIATES, INC. TREASURER CAREGROUP PARMENTER HOME CARE & HOSPICE, INC. TRUSTEE AND TREASURER - HEALTH AND EDUCATION HOUSING SERVICES, INC. TREASURER (EX-OFFICIO) - THE JORDAN HEALTH SYSTEM, INC. TREASURER (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, 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 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 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) AND TREASURER (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE, INC. TRUSTEE (EX-OFFICIO) AND 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 TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) WINCHESTER HOSPITAL FOUNDATION, INC. TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TREASURER (EX-OFFICIO) ANNA JAQUES HOSPITAL TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITALMILTON, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITALNEEDHAM, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITALPLYMOUTH, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH PHARMACY F/K/A BIDMC PHARMACY, INC. MANAGING DIRECTOR AND TRUSTEE- BETH ISRAEL DEACONESS PHYSICIAN ORGANIZATION, LLC MANAGING DIRECTOR AND TREASURER (EX-OFFICIO) - 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. AS MENTIONED ABOVE MR. KERNDL SERVED IN THE POSITIONS DETAILED ABOVE BEGINNING ON APRIL 5, 2021. ACCORDINGLY, SINCE COMPENSATION IS REQUIRED TO BE REPORTED IN THIS FORM 990 FOR CALENDAR YEAR 2020 AND MR. KERNDL RECEIVED NO COMPENSATION FROM BETH ISRAEL LAHEY HEALTH OR ITS AFFILIATES DURING CALENDAR YEAR 2020, NO COMPENSATION IS REPORTED IN THIS FILING. KHATIB, MATT TRUSTEE (EX-OFFICIO) ANNA JAQUES HOSPITAL TRUSTEE, BOARD CHAIR ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE (EX-OFFICIO) SEACOAST AFFILIATED GROUP PRACTICE, INC. KILDAY, KEVIN CHIEF FINANCIAL OFFICER ANNA JAQUES HOSPITAL TREASURER ANNA JAQUES COMMUNITY HEALTH FOUNDATION CHIEF FINANCIAL OFFICER SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. KILDAY INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $7,674. OF THIS AMOUNT, $7,674 IS UNVESTED. KIRPAS, JEFF TRUSTEE, VICE CHAIR OF THE BOARD OF TRUSTEES ANNA JAQUES HOSPITAL TRUSTEE, VICE CHAIR OF THE BOARD SEACOAST AFFILIATED GROUP PRACTICES, INC. LAFLAMME, DAVID TRUSTEE, BOARD CHAIR ANNA JAQUES HOSPITAL TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE, BOARD CHAIR SEACOAST AFFILIATED GROUP PRACTICE, INC. MR. LAFLAMME'S TERM ON THE ANNA JAQUES HOSPITAL'S BOARD ENDED ON SEPTEMBER 30, 2021. LEE, GARY VICE PRESIDENT OF CLINICAL OPERATIONS ANNA JAQUES HOSPITAL OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. LEE INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $15,119. OF THIS AMOUNT, $15,119 IS UNVESTED. MAKI, DN, RN, RICHARD CHIEF NURSING OFFICER ANNA JAQUES HOSPITAL OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. MAKI INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $23,040. OF THIS AMOUNT, $20,336 IS UNVESTED. MATHEWS, BRYON TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. NASEER-GHIASUDDIN,SAIRA OTHER REPORTABLE AND DEFERRED COMPENSATION FOR <MR./MS./DR.> NASEER-GHIASUDDIN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $36,516. OF THIS AMOUNT, $18,680 IS UNVESTED. NASEER-GHIASUDDIN, SAIRA FORMER TRUSTEE ANNA JAQUES HOSPITAL PRIMARY CARE PHYSICIAN SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. NASEER-GHIASUDDIN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $36,516. OF THIS AMOUNT, $18,680 IS UNVESTED.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES:	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. TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) ANNA JAQUES HOSPITAL, INC. ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2020 COMPENSATION. INCENTIVE COMPENSATION FOR DR. TABB INCLUDES $250,000 WHICH WAS PREVIOUSLY REPORTED AS DEFERRED 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 $546,890. OF THIS AMOUNT, $62.475 IS UNVESTED AS OF SEPTEMBER 30, 2021. DEFERRED COMPENSATION IN THE AMOUNT OF $250,000 INCLUDED IN THIS FILING FOR DR. TABB RELATES TO CERTAIN MILESTONE PAYMENTS WHICH, AS OF DECEMBER 31, 2020, WERE NOT FUNDED, WERE NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THEY ARE INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. TARKAN, M.D., JOSHUA TRUSTEE (EX-OFFICIO) AND PRESIDENT, MEDICAL STAFF ANNA JAQUES HOSPITAL TRUSTEE (EX-OFFICIO) ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE (EX-OFFICIO) AND PRESIDENT, MEDICAL STAFF SEACOAST AFFILIATED GROUP PRACTICE TRIM, JEAN TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE MR. TRIM'S TERM AS TRUSTEE OF ANNA JAQUES HOSPITAL BEGAN ON OCTOBER 1, 2020. WILEY, MARGARET TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. WILLIAMSON, MARY OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. WILLIAMSON INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $351. OF THIS AMOUNT, $351 IS UNVESTED.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES:	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, 2021. AS REQUIRED BY FORM 990, COMPENSATION REPORTED FOR THIS FISCAL YEAR IS CALENDAR YEAR 2020 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 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 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: BENNETT, MATT VICE PRESIDENT, HUMAN RESOURCES ANNA JAQUES HOSPITAL VICE PRESIDENT, HUMAN RESOURCES ANNA JAQUES COMMUNITY HEALTH FOUNDATION VICE PRESIDENT, HUMAN RESOURCES R SEACOAST AFFILIATED GROUP PRACTICE, INC. MR. BENNETT'S TERM AS VICE PRESIDENT OF HUMAN RESOURCES OF OF ANNA JAQUES HOSPITAL BEGAN ON MARCH 31, 2021. BOUTON, PH.D., CHRISTOPHER TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. CANNON, PATRICIA TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. MRS. CANNON'S TERM AS TRUSTEE OF ANNA JAQUES HOSPITAL BEGAN ON OCTOBER 1, 2020. CAPOLUPO, WAYNE TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. CONNOLLY, ESQ., GRACE GONZALEZTRUSTEE, VICECHAIR OF THE BOARD ANNA JAQUES HOSPITAL TRUSTEE, VICE CHAIR OF THE BOARD SEACOAST AFFILIATED GROUP PRACTICE, INC. COSTELLO, MICHAEL TRUSTEE ANNA JAQUES HOSPITALTRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. COUSINS, JR., FRANK G. TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. DESIMONE, SHELLEY FORMER VICE PRESIDENT OF HUMAN RESOURCES ANNA JAQUES HOSPITAL VICE PRESIDENT OF HUMAN RESOURCES ANNA JAQUES COMMUNITY HEALTH FOUNDATION FORMER VICE PRESIDENT OF HUMAN RESOURCES SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR SHELLEY DESIMONE INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $2,290. OF THIS AMOUNT, $2,290 IS UNVESTED. ERAMO, GINNY TRUSTEE, ASSISTANT CLERK ANNA JAQUES HOSPITAL TRUSTEE, ASSISTANT CLERK SEACOAST AFFILIATED GROUP PRACTICES, INC. FAYRE, M.D., GAIL CHIEF MEDICAL OFFICER ANNA JAQUES HOSPITAL CHIEF OPERATING OFFICER SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MRS. FAYRE INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $46,643. OF THIS AMOUNT, $46,643 IS UNVESTED.

Schedule J (Form 990) 2020

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