Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
|||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| (1)
WINCHESTER HOSPITAL |
042104434 | 03 | Yes | 0 | |||||
| (2)
WINCHESTER HOSPITAL FOUNDATION INC |
043399570 | 07 | Yes | 0 | |||||
| (3)
WINCHESTER HEALTHCARE INVESTMENTS INC |
222701819 | 07 | Yes | 0 | |||||
| Total | 0 | ||||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | ||||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | ||||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| PROGRAM SERVICE ACCOMPLISHMENTS | PART III, LINE 4D | PROVIDING CARE IN MAJOR CLINICAL CATEGORIES INCLUDING MEDICINE, SURGERY, PEDIATRICS, OBSTETRICS/GYNECOLOGY AND A LEVEL IIB SPECIAL CARE NURSERY, WINCHESTER HOSPITAL IS THE LEADING PROVIDER IN SUCH IMPORTANT SUBSPECIALTIES AS CARDIOLOGY, PULMONARY MEDICINE, ONCOLOGY, GASTROENTEROLOGY, ORTHOPEDICS, REHABILITATION, RADIATION ONCOLOGY AND PAIN MANAGEMENT. |
| CONTEMPORANEOUSLY DOCUMENT MEETINGS | PART VI, SECTION A, LINE 8B | WINCHESTER HEALTHCARE MANAGEMENT INC. AND AFFILIATES DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. REVIEW PROCESS PART VI, SECTION B, LINE 11A THE PRESIDENT/CEO, VICE PRESIDENT OF FINANCE/CFO, DIRECTOR OF FINANCE, AND THE MANAGER OF GENERAL ACCOUNTING REVIEW THE FORM 990 BY COMPARING THE PRIOR YEAR RETURN WITH THE CURRENT YEAR FILING. THE FORM 990 IS REVIEWED BY THE PRESIDENT/CEO, VICE PRESIDENT OF FINANCE/CFO, DIRECTOR OF FINANCE, AND THE MANAGER OF GENERAL ACCOUNTING BEFORE THE RETURN IS FILED. THE FORM 990 IS AVAILABLE UPON REQUEST TO BOARD MEMBERS. |
| CONFLICT OF INTEREST POLICY | PART VI, SECTION B, LINE 12C | SEMI-ANNUAL AUDIT AND COMPLIANCE COMMITTEE REVIEWS COMPILED CONFLICT OF INTEREST REPORT FROM LEGAL SERVICES QUESTIONNAIRES SENT TO ALL AFFILIATES, DIRECTORS, AND TRUSTEES. THE CHAIR OF THE AUDIT/COMPLIANCE COMMITTEE, IN COOPERATION WITH THE COMPLIANCE OFFICER, SHALL CONDUCT THE INITIAL REVIEW OF ANY POTENTIAL CONFLICTS OF INTEREST IDENTIFIED IN THE DISCLOSURES AND SHALL ADOPT A FINDING THAT THE ACTIVITY RAISING THE POTENTIAL CONFLICT OF INTEREST: SHOULD BE PERMITTED UNDER THE POLICY; SHOULD BE PERMITTED WITH MODIFICATION OR OVERSIGHT; IF UNDERTAKEN, WILL REQUIRE THE DIRECTOR, OR COMPLIANCE OFFICER TO ABSTAIN FROM PARTICIPATING IN GOVERNANCE/MANAGEMENT ACTIVITIES RELATED TO THE ACTIVITY; OR SHOULD NOT BE UNDERTAKEN. UPON FINAL DISPOSITION OF THE POTENTIAL CONFLICT, THE RESULTS OF THE REVIEW SHALL BE REPORTED TO THE AFFECTED LEADER. THE AUDIT/COMPLIANCE COMMITTEE SHALL PROVIDE AN ANNUAL REPORT OF ITS REVIEW TO THE BOARD OF DIRECTORS OF WINCHESTER. THE BOARD OF DIRECTORS OF WINCHESTER SHALL, UPON WRITTEN REQUEST OF THE MEMBER OF THE BOARD OF DIRECTORS OR THE COMPLIANCE OFFICER, REVIEW A FINDING OF THE AUDIT/COMPLIANCE COMMITTEE. THE BOARD OF DIRECTORS OF WINCHESTER SHALL EITHER REAFFIRM OR REVIEW THE FINDING AND SHALL REPORT SUCH FINDING TO THE AUDIT/COMPLIANCE COMMITTEE AND TO THE LEADER. THIS CONFLICT OF INTEREST POLICY SHALL BE REVIEWED ANNUALLY BY AND ON BEHALF OF WINCHESTER AND ITS AFFILIATES. |
| COMPENSATION POLICY | PART VI, SECTION B, LINE 15 | WINCHESTER HEALTHCARE MANAGEMENT, INC. AND AFFILIATE'S OFFICER SALARIES AND BENEFITS ARE PAID AND DETERMINED UNDER THE COMPENSATION POLICIES OF WINCHESTER HOSPITAL WHICH IS PART OF THE 990 FILING FOR WINCHESTER HEALTHCARE MANAGEMENT, INC. AND AFFILIATES. THIS INCLUDES THE USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEE REVIEWS COMPARABILITY DATA PROVIDED BY AN INDEPENDENT EXTERNAL CONSULTANT, LAL ASSOCIATES INC., TO ESTABLISH COMPENSATION. |
| PUBLIC DISCLOSURE | PART VI, SECTION C, LINE 19 | WINCHESTER HEALTHCARE MANAGEMENT, INC AND AFFILIATES MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE ALSO AVAILABLE ON THE MASSACHUSETTS ATTORNEY GENERAL'S WEBSITE. |
| COMPENSATION OF DIRECTORS | PART VII | THE COMPENSATION REPORTED FOR PETER ROTOLO, JOSEPH TAYLOR, AND KELLEY CORNELL ARE FOR THEIR SERVICES AS MEDICAL DIRECTORS. NO COMPENSATION IS PROVIDED TO DIRECTORS FOR VOTING MEMBER SERVICES. |
| OTHER CHANGE IN NET ASSETS | PART XI, LINE 5 | TRANSFERS TO AFFILIATES (1,938,000) UNREALIZED LOSS ON INTEREST RATE SWAP (2,504,270) UNREALIZED CHANGE IN ANNUITY (208,583) CHANGE IN BENEFICIAL INTEREST IN TRUST (253,857) PLEDGE DISCOUNTS (33,194) UNREALIZED GAIN ON INVESTMENTS 583,381 IMPAIRMENT LOSS ON SECURITIES (40,421) TOTAL (4,394,944) |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JONATHAN L. ADLER, M.D.- WH & TITLE:WHM DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JAMES CONWAY - WH & WHM TITLE:DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JAMES FICOCIELLO, D.D.S. - WH TITLE:& WHM DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROBERT FORTUNATO, M.D. - WH & TITLE:WHM DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JANICE HOUGHTON - WH & WHM TITLE:DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JOHN C. MARTINI - WH & WHM TITLE:DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DEBORAH R. MCDONOUGH - WH, TITLE:WHM, & WF DIR. & WF-CHAIRMAN HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RICHARD C. OCKERBLOOM - WH & TITLE:WHM DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:PETER J. ROTOLO, M.D. - WH & TITLE:WHM DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JOSEPH TAYLOR, M.D. - WH & TITLE:WHM DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MICHAEL TRAVAGLINI - WH & WHM TITLE:DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JAMES H. YOUNG - WH & WHM TITLE:DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JEANNINE BARRETT - WH & WHM TITLE:EX-OFFICIO HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:GAIL CANZANO - WH & WHM TITLE:EX-OFFICIO HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ARTHUR LITTLE, M.D. - WH & TITLE:WHM EX-OFFICIO HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:PAUL J. ANDREWS TITLE:CHAIRMAN OF THE BOARD HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JANE C. WALSH - WH & WHM TITLE:VICE CHAIRMAN & WHI CHAIRMAN HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KEVIN F. SMITH - WH, WHM, WF, TITLE:WI PRESIDENT & CEO OF WH HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DALE M. LODGE - WH, WHM, WF, TITLE:WI PRESIDENT & CEO OF WHM HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MATTHEW WOODS - WH, WHM, WF, TITLE:WI TREASURER HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JOSEPH R. TARBY, III - WH & WHM TITLE:CLERK HOURS:1 |
| Software ID: | |
| Software Version: |
| Name | Address | EIN | Name control |
|---|---|---|---|
| WINCHESTER HOSPITAL |
41 HIGHLAND AVE WINCHESTER, MA 01890 |
04-2104434 |
WINC |
| WINCHESTER HOSPITAL FOUNDATION INC |
41 HIGHLAND AVE WINCHESTER, MA 01890 |
04-3399570 |
WINC |
| WINCHESTER HEALTHCARE INVESTMENTS |
41 HIGHLAND AVE WINCHESTER, MA 01890 |
22-2701819 |
WINC |