Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
MOUNT AUBURN HOSPITAL
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
330 MOUNT AUBURN STREET
 
Room/suite
City or town, state or country, and ZIP + 4
CAMBRIDGE, MA02138
D Employer identification number

04-2103606
E Telephone number

G Gross receipts $ 319,684,597
F Name and address of principal officer:
WILLIAM SULLIVAN
330 MOUNT AUBURN ST
CAMBRIDGE,MA02138
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MOUNTAUBURNHOSPITAL.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1871
M State of legal domicile: MA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 26
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 22
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 2,591
6 Total number of volunteers (estimate if necessary) .... 6 285
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 3,592,883
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 3,934,496 5,282,673
9 Program service revenue (Part VIII, line 2g) ......... 291,066,717 298,224,358
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 3,710,365 3,968,178
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 8,475,339 8,713,018
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 307,186,917 316,188,227
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,004,500 244,586
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 161,057,880 163,974,318
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,240,002    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 122,289,198 123,921,848
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 284,351,578 288,140,752
19 Revenue less expenses. Subtract line 18 from line 12...... 22,835,339 28,047,475
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 352,860,070 360,780,006
21 Total liabilities (Part X, line 26)............ 159,892,507 154,477,103
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 192,967,563 206,302,903
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 102,554,062 including grants of $ 4,500 ) (Revenue $ 109,261,189 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $ 20,971,911 including grants of $   ) (Revenue $ 27,533,465 )
SEE SCHEDULE O
4c (Code:   ) (Expenses $ 16,611,661 including grants of $   ) (Revenue $ 21,702,396 )
SEE SCHEDULE O
(Code:   ) (Expenses $ 111,937,522 including grants of $ 244,586 ) (Revenue $ 139,727,308 )
4d Other program services. (Describe in Schedule O.)
(Expenses $ 111,937,522 including grants of $ 244,586 ) (Revenue $ 139,727,308 )
4e Total program service expensesMediumBullet$ 252,075,156
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
Yes
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
 
No
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
201
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
2,591
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
No
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
26
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
22
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MA , CT , ME , MO , NH , NJ , NY , RI , VT , DC
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
WILLIAM SULLIVAN
330 MOUNT AUBURN STREET
CAMBRIDGE,MA02138
(617) 499-5021
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) CALANO DANIEL V
TRUSTEE
 5.00 X           0 0 0
(2) CANEPA JOHN J
TRUSTEE & VICE-CHAIR
 5.00 X           0 0 0
(3) CHICOS FREDERICK H
TRUSTEE
 5.00 X           0 0 0
(4) CHRISTODOULO GEORGE E
TRUSTEE
 5.00 X           0 0 0
(5) CHUBB STEPHEN D
TRUSTEE & BD CHAIR
 5.00 X           0 0 0
(6) CLOUGH JEANETTE G
TRUSTEE, PRES & CEO
 60.00 X           852,105 138,715 841,976
(7) GORDON LISA
TRUSTEE
 5.00 X           0 0 0
(8) HATEM MD CHARLES J
TRUSTEE & MED ED DIR
 60.00 X           311,499 0 45,357
(9) KANEB CHRISTOPHER
TRUSTEE
 5.00 X           0 0 0
(10) KETTYLE MD WILLIAM
TRUSTEE
 5.00 X           0 0 0
(11) KIM KIJA
TRUSTEE
 5.00 X           0 0 0
(12) LUCCHINO DAVID L
TRUSTEE
 5.00 X           0 0 0
(13) MAMBRINO MD LAWRENCE
TRUSTEE
 5.00 X           0 0 0
(14) MASSARO GEORGE
TRUSTEE
 5.00 X           0 0 0
(15) NAUTA MD RUSSELL J
TRUSTEE & SURG CHAIR
 60.00 X           459,951 114,989 100,433
(16) NELSEN LITA L
TRUSTEE
 5.00 X           0 0 0
(17) PALANDJIAN LEON
TRUSTEE & TREASURER
 5.00 X   X       0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) RAFFERTY JAMES J
TRUSTEE & CLERK
 5.00 X   X       0 0 0
(19) REARDON GERALD
TRUSTEE
 5.00 X           0 0 0
(20) ROLLER JOSEPH
TRUSTEE & VICE-CHAIR
 5.00 X           0 0 0
(21) SAAL MD A KIM
TRUSTEE & CARDIO CHIEF
 60.00 X           28,013 0 0
(22) SHACHOY CHRISTOPHER
TRUSTEE
 5.00 X           0 0 0
(23) SHORTSLEEVE MD MICHAEL
TRUSTEE & RAD CHAIR
 60.00 X           23,332 0 0
(24) SIMONS TOM
TRUSTEE & BOARD CHAIR
 5.00 X           0 0 0
(25) SMERLAS DONNA
TRUSTEE
 5.00 X           0 0 0
(26) STEVENSON HOWARD H
TRUSTEE
 5.00 X           0 0 0
(27) SWANN ERIC
TRUSTEE
 5.00 X           0 0 0
(28) WAGNER HERBERT
TRUSTEE
 5.00 X           0 0 0
(29) ZINNER MD STEPHEN
TRUSTEE & MED CHAIR
 60.00 X           345,065 56,174 26,835
(30) DILESO NICHOLAS
COO
 60.00     X       402,264 0 474,549
(31) SEMENZA PETER
VP FIN & CFO
 60.00     X       1,526,498 248,500 123,133
(32) SULLIVAN WILLIAM
VP FIN & CFO
 60.00     X       0 0 0
(33) ABOOKIRE MD SUSAN
QUAL & SAFETY CHAIR
 60.00       X     341,888 0 100,217
(34) BAKER DEBORAH
VP PATIENT CARE SVCS
 60.00       X     270,407 0 69,816
(35) BRIDGEMAN JOHN
VP CLINICAL SVCS
 60.00       X     222,447 0 74,106
(36) BURKE KATHRYN
VP CONTRACT & BUS DEV
 60.00       X     288,674 0 93,244
(37) O'CONNELL MICHAEL L
VP PLAN & MKTG
 60.00       X     275,432 0 91,780
(38) KAWADA MD CHARLES Y
OB/GYN CHAIR
 60.00         X   262,934 175,289 97,800
(39) JOSEPH ESQ LESLIE
VP & GEN COUNSEL
 60.00         X   287,822 0 101,441
(40) LUKASIK CHARLES
MAPS COO & CLERK
 60.00         X   14,213 270,048 100,749
(41) SHUGERT JOHN
VP DEVELOPMENT
 60.00         X   266,124 0 77,243
(42) SANCHEZ MD LUCIENNE
NEWBORN SVC DIR
 60.00         X   288,570 0 26,835
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 6,467,238 1,003,715 2,445,514
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet282
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
WALSH BROTHERS INC
210 COMMERCIAL STREET
BOSTON,MA02109 		CONTRACTOR 9,982,610
CAREGROUP INC
109 BROOKLINE AVENUE
BOSTON,MA02215 		MANAGEMENT SERVICES 2,158,848
QUEST DIAGNOSTICS NICHOLS INSTITUTE
12436 COLLECTIONS CENTER DRIVE
CHICAGO,IL606932436 		LAB TESTING 1,764,199
ANGELICA TEXTILE SERVICES
PO BOX 823283
PHILADELPHIA,PA191823283 		LAUNDRY SERVICES 1,378,133
ANESTHESIA ASSOCIATES OF MASSACHUSETTS
690 CANTON STREET - SUITE 325
WESTWOOD,MA02090 		MD SERVICES 1,128,609
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet56
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 167,570
d Related organizations...1d  
e Government grants (contributions)1e 478,203
f All other contributions, gifts, grants, and
similar amounts not included above1f 		4,636,900
g Noncash contributions included in lines 1a-1f:$ 85,974
h Total. Add lines 1a-1f.......MediumBullet 5,282,673
Program Service Revenue Business Code
2a INPATIENT MED/SURGICAL 900,099 109,261,189 109,261,189    
b OUTPATIENT RADIOLOGY 900,099 27,533,465 27,533,465    
c INPATIENT OBSTECTRICS 900,099 21,702,396 21,702,396    
d OUTPATIENT SURGERY 621,990 18,705,633 18,705,633    
e EMERGENCY DEPARTMENT 621,990 16,003,646 16,003,646    
f All other program service revenue . 105,018,029 105,018,029    
g Total. Add lines 2a–2f........MediumBullet 298,224,358
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet -14,147   35,795 -49,942
4 Income from investment of tax-exempt bond proceeds..MediumBullet 109,520     109,520
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 1,636,756  
b Less: rental expenses 911,398  
c Rental income or (loss) 725,358  
d Net rental income or (loss).......MediumBullet 725,358     725,358
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 6,132,744  
b Less: cost or other basis and sales expenses 2,259,939  
c Gain or (loss) 3,872,805  
d Net gain or (loss)..........MediumBullet 3,872,805   7,744 3,865,061
8a Gross income from fundraising events (not including
$ 167,570
of contributions reported on line 1c). See Part IV, line 18 ...
a 320,303
b Less: direct expenses ...b 321,117
c Net income or (loss) from fundraising events..MediumBullet -814   -814
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 4,730
b Less: direct expenses ...b 3,916
c Net income or (loss) from gaming activities...MediumBullet 814     814
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a NON PATIENT LAB REVENU 541,380 3,467,357   3,467,357  
b PARKING REVENUE 812,930 2,240,849     2,240,849
c CAF, COFFEE SHOP & VEN 722,210 1,661,865     1,661,865
d All other revenue .... 617,589   81,987 535,602
e Total. Add lines 11a–11d ......MediumBullet 7,987,660
12 Total revenue. See Instructions....MediumBullet 316,188,227 298,224,358 3,592,883 9,088,313
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 240,086 240,086
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 4,500 4,500
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 3,790,645 1,784,531 2,006,114  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 130,860,140 117,451,876 12,768,108 640,156
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 6,041,011 5,376,500 604,101 60,410
9 Other employee benefits ....... 15,200,531 13,528,473 1,520,053 152,005
10 Payroll taxes ........... 8,081,991 7,192,972 808,199 80,820
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 415,000   415,000  
c Accounting ........... 33,500   33,500  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 13,854,433 11,785,780 1,998,656 69,997
12 Advertising and promotion .... 1,213,877 40,716 1,173,161  
13 Office expenses ....... 45,656,538 44,482,360 1,115,844 58,334
14 Information technology ...... 6,691,505 5,541,671 1,138,570 11,264
15 Royalties ..        
16 Occupancy ........... 6,999,712 5,280,172 1,645,821 73,719
17 Travel ............ 353,356 324,321 28,027 1,008
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 1,541,796 1,468,608   73,188
20 Interest ........... 6,068,795 4,490,908 1,577,887  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 15,415,268 11,891,322 3,523,946  
23 Insurance .............. 3,935,450 3,803,593 131,857  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a MISCELLANEOUS 9,857,942 6,081,189 3,757,652 19,101
b UNCOMPENSATED CARE 6,091,120 6,091,120 0 0
c PATIENT SERVICES 4,297,484 4,290,790 6,694 0
d DUES, LICENSES & FEES 1,496,072 923,668 572,404 0
e   0 0 0 0
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 288,140,752 252,075,156 34,825,594 1,240,002
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 10,410,762 1 17,777,171
2 Savings and temporary cash investments ....... 13,042,898 2 2,711,911
3 Pledges and grants receivable, net ......... 604,399 3 506,621
4 Accounts receivable, net ......... 30,265,997 4 33,244,931
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 3,362,925 8 3,224,310
9 Prepaid expenses and deferred charges ............ 3,799,984 9 3,275,444
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 385,849,831
b Less: accumulated depreciation. ..... 10b 223,401,538 157,704,408 10c 162,448,293
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 123,243,982 12 122,009,589
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 10,424,715 15 15,581,736
16 Total assets. Add lines 1 through 15 (must equal line 34)... 352,860,070 16 360,780,006
Liabilities 17 Accounts payable and accrued expenses . 34,089,452 17 30,095,703
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 115,884,124 20 113,498,524
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 9,918,931 25 10,882,876
26 Total liabilities. Add lines 17 through 25..... 159,892,507 26 154,477,103
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 183,320,810 27 196,847,292
28 Temporarily restricted net assets ..... 5,494,233 28 5,053,091
29 Permanently restricted net assets ..... 4,152,520 29 4,402,520
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 192,967,563 33 206,302,903
34 Total liabilities and net assets/fund balances ..... 352,860,070 34 360,780,006
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
316,188,227
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
288,140,752
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
28,047,475
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
192,967,563
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-14,712,135
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
206,302,903
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(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
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
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.            
Section B. Total Support
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).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
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.)            
Section B. Total Support
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.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
MOUNT AUBURN HOSPITAL
  		Employer identification number

04-2103606
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
MOUNT AUBURN HOSPITAL
  		Employer identification number

04-2103606
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
MOUNT AUBURN HOSPITAL
  		Employer identification number

04-2103606
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
69,477
j
Total. lines 1c through 1i ...................................
69,477
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: FROM TIME TO TIME, CERTAIN EXECUTIVES OF MOUNT AUBURN HOSPITAL (MAH) ENGAGE IN LOBBYING EFFORTS RELATED TO THE HOSPITAL'S ACTIVITIES. AS SUCH, A PORTION OF THEIR SALARIES HAS BEEN LISTED AS A LOBBYING EXPENSE. ADDITIONALLY, MAH PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS, A PIECE OF WHICH MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS AND HAS BEEN QUANTIFIED HERE. FINALLY, BETH ISRAEL DEACONESS MEDICAL CENTER, A SISTER CORPORATION TO MAH, MAY HAVE ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF THIS ENTITY AND OTHER AFFILIATED NETWORK ENTITIES. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2011 MAH IS REPORTING INDIRECT LOBBYING EXPENSES THROUGH MEMBERSHIP ORGANIZATIONS AND DIRECT LOBBYING EXPENSES OF $47,623 AND $21,855 RESPECTIVELY. TOTAL COMBINED LOBBYING EXPENDITURES OF MAH WERE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 9,646,753 10,168,224 11,461,701
b Contributions ........ 3,969,080 3,298,045 2,711,304
c Investment earnings or losses ... -88,866 454,217 349,071
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		4,071,356 4,273,733 4,353,852
f Administrative expenses ....      
g End of year balance ...... 9,455,611 9,646,753 10,168,224
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet47.000 %
c
Term endowment: SchDMd Bullet53.000 %
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   169,000 169,000
b Buildings ................   194,328,236 66,754,417 127,573,819
c Leasehold improvements ............   3,180,258 1,816,110 1,364,148
d Equipment ................   186,377,304 154,831,011 31,546,293
e Other .................   1,795,033   1,795,033
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 162,448,293
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) INVEST HELD THRU CGCIP EIN 04-3278109 		122,009,589 F








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 122,009,589
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
ACCRUED POST RETIREMENT BENEFITS 875,719
DUE TO AFFILIATES 327,234
OTHER LIABILITIES 6,618,249
PROFESSIONAL LIABILITY CLAIMS RESERVE 3,061,674





Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 10,882,876
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 316,188,227
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 288,140,752
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 28,047,475
4 Net unrealized gains (losses) on investments .......................... 4 -2,926,616
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 -11,785,519
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 -14,712,135
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 13,335,340
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 364,038,000
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -3,929,000
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d 51,824,802
e Add lines 2a through 2d ..................... 2e 47,895,802
3 Subtract line 2e from line 1..................... 3 316,142,198
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b 46,029
c Add lines 4a and 4b....................... 4c 46,029
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 316,188,227
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 349,184,000
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 61,043,248
e Add lines 2a through 2d...................... 2e 61,043,248
3 Subtract line 2e from line 1..................... 3 288,140,752
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 288,140,752
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT/SPECIAL FUND MONIES ARE HELD TO SUPPORT THE OPERATING AND CAPITAL NEEDS OF VARIOUS PATIENT CARE PROGRAM SERVICES. IN ADDITION, THE INCOME FROM THE PERMANENT ENDOWMENT IS USED TO FUND FREE CARE. ANNUALLY, THE BOARD ALSO APPROPRIATES 5% OF THE ACCUMULATED APPRECIATION ON THE PERMANENT ENDOWMENT TO FUND FREE CARE. FOR THE PERIOD ENDED SEPTEMBER 30, 2011, THESE SOURCES INCREASED FREE CARE PROVIDED TO PATIENTS BY $250,000.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN FIFTY PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE CORPORATION DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS IN 2011.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   TRANSFER OF UNRESTRICTED CASH TO MAPS (AFFILIATE) -9,980,928. CHANGE IN FUNDED STATUS OF EMPLOYEE BENEFIT PLANS -126,874. CHANGE IN VALUE OF LIMITED PARTNERSHIPS -1,003,322. PLEDGES RECEIVED BEYOND CASH PAYMENTS -628,361. UBIT FROM CIP -43,539. OTHER ACCOUNTING ADJUSTMENTS -2,490. ROUNDING -5.
PART XII, LINE 2D - OTHER ADJUSTMENTS:   EXPENSES ASSOCIATED WITH REAL ESTATE RENTAL 911,398. EXPENSES ASSOCIATED WITH SPECIAL EVENTS 325,033. CONSOLIDATED AFFILIATE NET OF ELIMINATIONS 51,216,732. PLEDGE ACTIVITY -628,361.
PART XII, LINE 4B - OTHER ADJUSTMENTS:   CAREGROUP INVESTMENT PARTNERSHIP INCOME 43,539. OTHER ADJUSTMENTS 2,490.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   EXPENSES ASSOCIATED WITH REAL ESTATE RENTAL 911,398. EXPENSES ASSOCIATED WITH SPECIAL EVENTS 325,033. CHANGE IN FUNDED STATUS OF BENEFIT PLANS 127,000. CONSOLIDATED AFFILIATE NET OF ELIMINATIONS 59,679,817. ROUNDING
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,
Part IV, line 14b, 15, or 16.
Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS   43,479,005
EUROPE 0 0 INVESTMENTS   90,712
CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICE JOINTLY OWNED FOREIGN INSURANCE 645,539
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 44,215,256
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 44,215,256
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 5
Part V
Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.
Identifier ReturnReference Explanation
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2010
Additional Data


Software ID:  
Software Version:  



SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

GALA
(event type) 		(b) Event #2

GOLF CLASSIC
(event type) 		(c) Other Events

2
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 348,950 67,175 71,748 487,873
2 Less: Charitable
contributions . . . 		132,371 17,171 18,028 167,570
3 Gross income (line 1
minus line 2) . . . 		216,579 50,004 53,720 320,303
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . .        
7 Food and beverages . .        
8 Entertainment . . .        
9 Other direct expenses . 216,579 50,818 53,720 321,117
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 321,117
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -814
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
 
No
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    4,564,117 1,209,881 3,354,236 1.170 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    10,322,076 7,605,884 2,716,192 0.950 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     1,953,457 199,422 1,754,035 0.610 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    16,839,650 9,015,187 7,824,463 2.740 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    1,232,832   1,232,832 0.430 %
f Health professions education
(from Worksheet 5) .. 		    8,945,648 3,617,904 5,327,744 1.860 %
g Subsidized health services
(from Worksheet 6) .. 		    185,074   185,074 0.060 %
h Research (from Worksheet 7)     46,598   46,598 0.020 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    132,610   132,610 0.050 %
jTotal Other Benefits ...     10,542,762 3,617,904 6,924,858 2.420 %
kTotal. Add lines 7d and 7j. ..     27,382,412 12,633,091 14,749,321 5.160 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     42,167   42,167 0.010 %
9 Other            
10 Total     42,167   42,167 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
1,912,014
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
81,503,047
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
80,940,710
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
562,337
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
11 NA
  		       
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 MOUNT AUBURN HOSPITAL
330 MOUNT AUBURN STREET
CAMBRIDGE,MA02138 		X X   X     X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NA
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 7: ELIGIBILITY FOR FREE CARE TO LOW INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 200% FOR FULL FREE CARE AND 201%-400% FOR PARTIAL FREE CARE.ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSAS REPORTED IN THE MAH CONSOLIDATED FINANCIAL STATEMENT AND IN THIS FORM 990 SCHEDULE H, MAH'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON- PAYING PATIENTS AND INCLUDING PAYMENTS TO AND RECEIPTS FROM THE HEALTH SAFETY NET TRUST, WAS A COMBINED $5,349,000 IN FISCAL YEAR ENDED SEPTEMBER 30, 2011 AND $5,108,271 AND HAS BEEN REPORTED ON THIS SCHEDULE H LINES 7A AND 7C. CHARITY CARE AT COST WAS CALCULATED USING AN INTERNAL COST TO CHARGE RATIO CALCULATION.
    PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES - MOUNT AUBURN HOME CARE MOUNT AUBURN HOSPITAL'S CAREGROUP HOMECARE PROGRAM STRIVES TO IMPROVE THE HEALTH OF OUR PATIENTS, AND TO FOSTER INDEPENDENCE IN OUR PATIENTS AND THEIR FAMILIES. SERVICES ARE PROVIDED IN A PROFESSIONAL AND COMPASSIONATE MANNER, WITH UTMOST RESPECT FOR THE DIGNITY OF OUR PATIENTS AND THEIR CAREGIVERS. ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS (JCAHO) CAREGROUP HOMECARE ADDRESSES SPECIFIC PHYSICIAN REQUESTS BY OFFERING:- A BROAD ARRAY OF SERVICES ACROSS THE SYSTEM - SPECIALIZED HOME-CARE EXPERTISE - EASY ACCESS WITH ONE PHONE CALL - COST-EFFECTIVE TREATMENT - HIGH-QUALITY, PATIENT-CENTERED CARE CAREGROUP HOME CARE PROVIDES THE FULL CONTINUUM OF CARE AND SERVICES WHICH PHYSICIANS AND PATIENTS HAVE COME TO APPRECIATE AND EXPECT, INCLUDING:- IMMUNIZATIONS AND OTHER PREVENTIVE CARE - SKILLED NURSING CARE - MEDICAL SOCIAL SERVICES - PHYSICAL, OCCUPATIONAL AND SPEECH-LANGUAGE THERAPY - NUTRITION SERVICES - CERTIFIED HOME HEALTH AIDE SERVICES - MATERNAL CHILD HEALTH - PATIENT AND FAMILY EDUCATION - BEHAVIORAL HEALTH CAREGROUP HOMECARE ALSO PROVIDES SEVERAL SPECIALTY PROGRAMS. OUR SYMPTOM MANAGEMENT PROGRAM FOCUSES ON PAIN, SYMPTOM MANAGEMENT AND CONTINUITY OF CARE, WORKING VERY CLOSELY WITH HOSPICE PROGRAMS. OUR BEHAVIORAL HEALTH PROGRAM IS COMPRISED OF MENTAL HEALTH NURSES AND SOCIAL WORKERS. THESE HIGHLY-SKILLED AND COMPASSIONATE CLINICIANS FOCUS ON THE DIVERSITY OF OUR PATIENTS' NEEDS. FINALLY, OUR WOUND CARE PROGRAM, LED BY A WOUND CARE NURSE SPECIALIST, PROVIDES ADVANCED, MULTI-DIMENSIONAL WOUND CARE TREATMENT FOR OUR PATIENTS.THE TELEHEALTH PROGRAM PROVIDES 7 DAYS A WEEK REMOTE MONITORING OF VITAL SIGNS AND KEY CLINICAL DATA.CAREGROUP HOMECARE SERVICES 42 COMMUNITIES INCLUDING BOSTON AND SURROUNDING COMMUNITIES. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $185,074 REPORTED ON THIS SCHEDULE H RELATED TO MAH'S SUBSIDIZED HEALTH CARE SERVICES.
    PART I, L7 COL(F): OTHER UNCOMPENSATED CHARITY CARE - BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, MAH ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS, AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES WERE $4,138,000 DURING THE FISCAL PERIOD COVERED BY THIS FILING AND ARE INCLUDED IN THE UNCOMPENSATED CARE EXPENSE ON FORM 990 PART IX, FUNCTIONAL EXPENSES. THE ESTIMATED COST OF PROVIDING SUCH SERVICES WAS APPROXIMATELY $1,912,014 IN 2011. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, THIS AMOUNT HAS NOT BEEN INCLUDED IN THE CALCULATION OF CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED.
    PART II: MOUNT AUBURN HOSPITAL - COMMUNITY BUILDING ACTIVITIESMOUNT AUBURN HOSPITAL IS ACTIVELY ENGAGED IN COALITION BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF OUR COMMUNITY INCLUDING WORKFORCE DEVELOPMENT PROGRAMS AS REPORTED IN THIS FORM 990 SCHEDULE H.HEALTH PROFESSIONS EDUCATIONMAH'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES, AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE MAH A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. WE TRAIN MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS. MAH HAS TWO APPROVED RESIDENCY PROGRAMS WITH APPROXIMATELY 42 INTERNAL MEDICINE RESIDENTS AND APPROXIMATELY 12 RADIOLOGY RESIDENTS.STAFF PHYSICIANS AT MAH WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES.AS PART OF OUR COMMITMENT TO MEDICAL STUDENT EDUCATION AND OUR AFFILIATION WITH HARVARD MEDICAL SCHOOL, WE ARE A CORE SITE FOR THE HARVARD MEDICAL SCHOOL SUB-INTERNSHIP IN MEDICINE. ALSO, WE PARTICIPATE IN THE INTRODUCTORY COURSES IN CLINICAL MEDICINE FOR FIRST AND SECOND-YEAR HARVARD MEDICAL STUDENTS AND THE BIOMEDICAL DOCTORAL STUDENTS FROM THE MASSACHUSETTS INSTITUTE OF TECHNOLOGY'S HEALTH SCIENCES AND TECHNOLOGY PROGRAM. ADDITIONALLY, MEDICAL STUDENTS FROM MANY OTHER MEDICAL SCHOOLS CHOOSE TO DO SUBINTERNSHIPS AND SUBSPECIALTY ELECTIVES DURING THEIR FOURTH YEAR.IN ADDITION TO THE INTERNAL MEDICINE TRAINING PROGRAM, MOUNT AUBURN HOSPITAL IS A SITE FOR OTHER POST-GRADUATE MEDICAL EDUCATION DISCIPLINES. OUR RESIDENTS BENEFIT FROM OUR INSTITUTION'S RESIDENCY PROGRAM IN DIAGNOSTIC RADIOLOGY, ITS PARTICIPATION AS A CORE SITE FOR THE BETH ISRAEL DEACONESS MEDICAL CENTER SURGICAL TRAINING PROGRAM, AND IN THE HARVARD-AFFILIATED EMERGENCY MEDICINE RESIDENCY. WE ALSO WELCOME ROTATING INTERNS FROM THE HARVARD/LONGWOOD PSYCHIATRY RESIDENCY, GERIATRIC FELLOWS FROM THE BETH ISRAEL DEACONESS/HARVARD MEDICAL SCHOOL DIVISION ON AGING FELLOWSHIP PROGRAM, AND PEDIATRIC/NEONATOLOGY RESIDENTS FROM MASSACHUSETTS GENERAL HOSPITAL/ CAMBRIDGE HOSPITAL PROGRAM IN NEONATOLOGY.THE TRACKS OF TRAINING IN INTERNAL MEDICINEMOUNT AUBURN HOSPITAL OFFERS A THREE-YEAR CATEGORICAL MEDICINE TRACK AND A ONE-YEAR PRELIMINARY MEDICINE TRACK.THE CATEGORICAL TRACKOUR THREE-YEAR CATEGORICAL INTERNAL MEDICINE TRACK PREPARES OUR RESIDENT TRAINEES FOR BOARD CERTIFICATION BY THE AMERICAN BOARD OF INTERNAL MEDICINE AND CAREERS THAT COVER THE FULL SPECTRUM OF OPPORTUNITIES IN BOTH GENERAL INTERNAL MEDICINE AND MEDICINE SUB-SPECIALTIES. RESIDENT TRAINEES ARE ABLE TO TAILOR THEIR FLOW OF THE 36 MONTHS OF TRAINING TO OBTAIN THE STRONG BACKGROUND AND EXCELLENT CLINICAL SKILLS TO PURSUE SUBSEQUENT CAREERS IN PRIMARY CARE PRACTICE, HOSPITALIST MEDICINE, AND PLACEMENT IN COMPETITIVE SUB-SPECIALTY FELLOWSHIP TRAINING PROGRAMS.ONE WAY WE SUPPORT OUR TRAINEES IN THEIR INTENDED CAREER GOALS IS THROUGH OUR USE OF DEFINED PATHWAYS. THESE PATHWAYS, IN SUB-SPECIALTY FELLOWSHIP, PRIMARY CARE, HOSPITALIST MEDICINE, AND MEDICAL EDUCATION, OUTLINE FOR THE TRAINEE THE MILESTONES THAT SHOULD BE MET THROUGHOUT THE COURSE OF TRAINING. THE PRELIMINARY TRACKTHE PRELIMINARY MEDICINE INTERNSHIP TRACK OFFERS ONE YEAR OF TRAINING IN MEDICINE FOR PHYSICIANS WHO WILL CONTINUE THEIR TRAINING IN SPECIALTIES OTHER THAN INTERNAL MEDICINE, SUCH AS RADIOLOGY, OPHTHALMOLOGY, ANESTHESIOLOGY, RADIATION ONCOLOGY, NEUROLOGY, DERMATOLOGY, PHYSICAL MEDICINE & REHABILITATION, AND OTHERS. THIS TRACK'S MAJOR STRENGTH, AS WELL AS ITS MAJOR ATTRACTION, IS THAT THE YEAR IS VIRTUALLY IDENTICAL IN STRUCTURE AND CONTENT TO THE FIRST YEAR FOR PHYSICIANS WHO TRAIN AT MOUNT AUBURN HOSPITAL FOR THREE YEARS IN THE CATEGORICAL INTERNAL MEDICINE TRACK. THE ONLY DIFFERENCE BEING THE QUANTITY OF AMBULATORY MEDICINE EXPERIENCE, BECAUSE PRELIMINARY INTERNS ARE NOT ASSIGNED A CONTINUITY CLINIC DURING THEIR YEAR.RADIOLOGY RESIDENCY PROGRAMRESIDENTS ARE TYPICALLY ASSIGNED IN ONE MONTH BLOCKS TO ONE OF THE DIFFERENT MODALITIES. EARLY IN TRAINING, RESIDENTS ARE EXPECTED TO READ EXTENSIVELY, MASTER ANATOMY, PARTICIPATE IN THE PROTOCOLLING AND INTERPRETATION OF PATIENT EXAMINATIONS, AND TO PARTICIPATE IN DISCUSSIONS CONCERNING DIAGNOSTIC PROBLEMS. RESIDENTS ADVANCE TO INCREASED LEVELS OF RESPONSIBILITY, AND SOUND JUDGMENT AS A RADIOLOGIST IS ESTABLISHED DURING OVERNIGHT CALL.ROTATIONS AVAILABLE:- CT AND MR WHICH INCLUDES NEURO-, HEAD AND NECK, CARDIOTHORACIC, GI, GU AND MUSCULOSKELETAL RADIOLOGY - SPECIAL PROCEDURES (INTERVENTIONAL RADIOLOGY) WHICH INCLUDES VASCULAR RADIOLOGY AND INTERVENTION, THORACIC PROCEDURES, ABDOMINAL PROCEDURES, UTERINE FIBROID EMBOLIZATION PROGRAM, VERTEBROPLASTY - FLUOROSCOPY WHICH INCLUDES GI, GU AND MUSCULOSKELETAL PROCEDURES - ULTRASOUND, INCLUDING OBSTETRIC ULTRASOUND - NUCLEAR MEDICINE, INCLUDING CARDIAC - BREAST IMAGING, INCLUDING MAMMOGRAPHY, MR, AND PROCEDURES - EMERGENCY RADIOLOGY (2ND YEAR, 3 MONTHS PERFORMED AT MASSACHUSETTS GENERAL HOSPITAL) - PEDIATRIC RADIOLOGY (2ND YEAR, 3 MONTHS PERFORMED AT BOSTON CHILDREN'S HOSPITAL) - ARMED FORCES INSTITUTE OF PATHOLOGY (3RD YEAR, 4 WEEK COURSE, WASHINGTON, D.C.) - ROTATIONS IN CARDIAC RADIOLOGY AND CAROTID ULTRASOUND ARE ALSO INCLUDED IN CONJUNCTION WITH THE DEPARTMENTS OF CARDIOLOGY AND VASCULAR SURGERY. - ONE MONTH OF RESEARCH OR OTHER SCHOLARLY ACTIVITY DURING THE THIRD YEAR - THREE MONTHS OF THE 4TH YEAR IS SET ASIDE FOR AN ELECTIVE, ALLOWING THE RESIDENT TO DEVELOP IN-DEPTH KNOWLEDGE IN A SPECIFIC AREA OF INTEREST. THREE RESIDENTS ARE CHOSEN EACH YEAR FOR A FOUR-YEAR PROGRAM AND APPOINTED AS CLINICAL FELLOWS AT HARVARD MEDICAL SCHOOL. THE RATIO OF STAFF RADIOLOGISTS TO RESIDENTS RESULTS IN CLOSE CONTACT BETWEEN THE STAFF AND RESIDENTS THROUGHOUT THE TRAINING PROGRAM. AFTER THE RESIDENT HAS OBTAINED THE NECESSARY FIRM FOUNDATIONS IN THE FUNDAMENTALS OF RADIOLOGY, HE OR SHE IS ENCOURAGED TO TAKE INCREASING RESPONSIBILITY IN BOTH ROUTINE AND SPECIALIZED EXAMINATIONS AND PROCEDURES. THE MAJORITY OF OUR RESIDENTS PURSUE SUBSPECIALTY FELLOWSHIP TRAINING. HOWEVER, THE GOAL OF THE RADIOLOGY RESIDENCY PROGRAM IS TO TRAIN RESIDENTS TO BE FULLY QUALIFIED IN DIAGNOSTIC RADIOLOGY AND SPECIAL PROCEDURES BY THE TIME THEY HAVE COMPLETED THE FOUR-YEAR PROGRAM. GRADUATES HAVE PURSUED CAREERS IN ACADEMIA AND PRIVATE PRACTICE.DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $5,176,187 REPORTED ON THIS SCHEDULE H RELATED TO MAH'S TEACHING FUNCTION. CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS - RESEARCHTHE INCREASE IN INTERNATIONAL TRAVEL FROM THE UNITED STATES, ESPECIALLY BY HIGH RISK TRAVELERS, AND CONCERN ABOUT NEW AND RE-EMERGING INFECTIOUS DISEASES AND THEIR SPREAD BY GLOBAL MIGRATION, MAKES IT IMPERATIVE THAT BETTER METHODS ARE SOUGHT TO REDUCE TRAVEL-RELATED ILLNESS. TO THAT END, MOUNT AUBURN HOSPITAL IS STUDYING LARGE GROUPS OF TRAVELERS, ESPECIALLY THOSE WHO ARE AT HIGH RISK. THE DATA FROM THESE STUDIES WILL BE USED TO DEVELOP STRATEGIES AND INTERVENTIONS TO REDUCE TRAVEL RELATED ILLNESS, ESPECIALLY FOR HIGH RISK TRAVELERS, AND TO USE THE OPPORTUNITY OF THE TRAVEL CLINIC VISIT TO ENHANCE OVERALL HEALTH. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $46,598 REPORTED ON THIS SCHEDULE H RELATED TO MAH'S RESEARCH FUNCTION. MOUNT AUBURN HOSPITAL - EMERGENCY CARE ACCESSMOUNT AUBURN HOSPITAL IS THE FRONTLINE CAREGIVER PROVIDING MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO OUR FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR.
    PART III, LINE 4: MOUNT AUBURN HOSPITAL IS PART OF THE MOUNT AUBURN HOSPITAL AND SUBSIDIARY CONSOLIDATED AUDIT. THE FOOTNOTE THAT REFERENCES BAD DEBT EXPENSE IN THE 2011 CONSOLIDATED AUDIT IS AS FOLLOWS:(1)COMMUNITY BENEFITS AND UNCOMPENSATED CARETHE COST OF UNREIMBURSED CHARITY AND OTHER UNCOMPENSATED CARE CONSISTED OF THE FOLLOWING FOR THE YEARS ENDED SEPTEMBER 30, 2011 AND 2010:UNREIMBURSED CHARITY CARE 3,940 AND 3,191UNCOMPENSATED CARE 6,922 AND 6,357TOTAL 10,862 AND 9,548 (A)UNREIMBURSED CHARITY CARETHE AMOUNT OF CHARITY CARE AT ESTABLISHED CHARGES AND THE ESTIMATED COST OF UNREIMBURSED CHARITY CARE PROVIDED ARE COMPRISED OF THE FOLLOWING COMPONENTS FOR THE YEARS ENDED SEPTEMBER 30, 2011 AND 2010:CHARITY CARE - AT ESTABLISHED CHARGES 10,670 AND 10,595ESTIMATED COST OF CHARITY CARE 5,349 AND 5,292LESS REIMBURSEMENT FROM THE HSN (1,409) AND (2,101)UNREIMBURSED CHARITY CARE - AT COST 3,940 AND 3,191 (B)UNCOMPENSATED CARETHE HOSPITAL ALSO PROVIDES FOR THE DELIVERY OF CHARITY CARE TO THE INDIGENT STATEWIDE THROUGH PAYMENTS TO THE HSN, WHICH IS OPERATED BY THE COMMONWEALTH OF MASSACHUSETTS. IN ADDITION, THE CORPORATION PROVIDES SERVICES, WHICH WERE NOT PAID BY PATIENTS AND, THEREFORE, ARE RECORDED AS PROVISION FOR BAD DEBTS. THE GROSS OBLIGATION TO THE HSN FOR THE DELIVERY OF CHARITY CARE TO THE INDIGENT STATEWIDE AND BAD DEBTS ARE REPORTED AS UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AS FOLLOWS, FOR THE YEARS ENDED SEPTEMBER 30, 2011 AND 2010:GROSS OBLIGATION TO THE HSN FOR THE DELIVERY OF CHARITY CARE TO THE INDIGENT STATEWIDE 1,953 AND 2,300PROVISION FOR BAD DEBTS 4,969 AND 4,057UNCOMPENSATED CARE EXPENSE 6,922 AND 6,357
    PART III, LINE 8: OTHER UNCOMPENSATED CHARITY CARE - MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, THE HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS WHICH INSURE LOW INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. UNREIMBURSED MEDICAID COSTS REPORTED HERE WERE CALCULATED BY APPLYING THE COST TO CHARGE RATIO TO GROSS CHARGES AND SUBTRACTING THE MEDICAID NET REIMBURSEMENT. DURING THE FISCAL PERIOD COVERED BY THIS FILING MAH REPORTED $7,605,884 IN MEDICAID REVENUE WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY THE HOSPITAL FOR SUCH SERVICES BY $2,716,192, AS REPORTED ON THIS SCHEDULE H. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS AND MAH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 27.3% OF MAH'S PATIENT REVENUE DERIVED FROM MEDICARE PATIENTS. THIS TRANSLATED TO $81,503,047.
    PART III, LINE 9B: MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY GUIDING PRINCIPLES:THE HOSPITAL ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, MOUNT AUBURN HOSPITAL MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS.THE MOUNT AUBURN HOSPITAL'S CREDIT AND COLLECTION POLICY, WHICH APPLIES TO THE HOSPITAL AND ANY OTHER ENTITY WHICH IS PART OF THE HOSPITAL'S LICENSE OR TAX IDENTIFICATION NUMBER, IS DESIGNED TO COMPLY WITH BOTH THE MASSACHUSETTS HEALTH SAFETY NET REGULATIONS ON CREDIT AND COLLECTION POLICIES, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES MEDICARE BAD DEBT REQUIREMENTS, THE MEDICARE PROVIDER REIMBURSEMENT MANUAL AND THE FEDERAL HEALTHCARE REFORM LAW'S "FINANCIAL ASSISTANCE POLICY" FOR WHICH THE IRS HAD PROVIDED PRELIMINARY GUIDANCE AT THE TIME THE HOSPITAL FINALIZED THIS POLICY. THE HOSPITAL CONTINUES TO MONITOR GUIDANCE FROM THE IRS AS IT IS ISSUED. MOUNT AUBURN HOSPITAL DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, CITIZENSHIP, ALIENAGE, RELIGION, CREED, SEX, SEXUAL ORIENTATION, DISABILITY, OR AGE IN ITS POLICIES OR IN ITS APPLICATION OF POLICIES CONCERNING THE ACQUISITION AND VERIFICATION OF FINANCIAL INFORMATION, PRE-ADMISSION OR PRE-TREATMENT DEPOSITS, PAYMENT PLANS, DEFERRED OR REJECTED ADMISSIONS, LOW INCOME PATIENT STATUS AS DETERMINED BY THE MASSACHUSETTS OFFICE OF MEDICAID, DETERMINATION THAT A PATIENT IS LOW-INCOME, OR IN ITS BILLING AND COLLECTION PRACTICES.MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY: STANDARD COLLECTION PRACTICESAS PREVIOUSLY NOTED IN THE NARRATIVE TO THIS FORM 990 SCHEDULE H, MOUNT AUBURN HOSPITAL ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. ADDITIONALLY, TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, THE HOSPITAL MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. AS SUCH, THE HOSPITAL HAS A FIDUCIARY DUTY TO SEEK REIMBURSEMENT FOR SERVICES IT HAS PROVIDED FROM INDIVIDUALS WHO ARE ABLE TO PAY, FROM THIRD PARTY INSURERS WHO COVER THE COST OF CARE, AND FROM OTHER PROGRAMS OF ASSISTANCE FOR WHICH THE PATIENT IS ELIGIBLE. TO DETERMINE WHETHER A PATIENT IS ABLE TO PAY FOR THE SERVICES PROVIDED AS WELL AS TO ASSIST THE PATIENT IN FINDING ALTERNATIVE COVERAGE OPTIONS IF THEY ARE UNINSURED OR UNDERINSURED, THE HOSPITAL HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS.THE HOSPITAL MAKES THE SAME REASONABLE EFFORT AND FOLLOWS THE SAME REASONABLE PROCESS FOR COLLECTING ON BILLS OWED BY AN UNINSURED PATIENT AS IT DOES FOR ALL OTHER PATIENTS. THE HOSPITAL WILL FIRST SHOW THAT IT HAS A CURRENT UNPAID BALANCE THAT IS RELATED TO SERVICES PROVIDED TO THE PATIENT AND NOT COVERED BY A PRIVATE INSURER OR A FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL ALSO HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS.
    MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY: ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMSMOUNT AUBURN HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR THROUGH THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. FOR PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS THEM BY SCREENING FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. THESE PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO: MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START AND HEALTH SAFETY NET. WHEN APPLICABLE THE HOSPITAL MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED FAMILY INCOME, CURRENT AND PRIOR INSURANCE COVERAGE AND ALLOWABLE MEDICAL EXPENSES. IT IS THE PATIENT'S OBLIGATION TO PROVIDE THE HOSPITAL WITH ACCURATE AND TIMELY INFORMATION REGARDING THEIR FULL NAME, ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, INCLUDING OTHER INSURANCE OR COVERAGE OPTIONS (SUCH AS MOTOR VEHICLE POLICY OR WORKER'S COMPENSATION POLICY) THAT CAN COVER THE COST OF THE CARE RECEIVED AND ANY OTHER APPLICABLE FINANCIAL RESOURCES, AND CITIZENSHIP AND RESIDENCY INFORMATION - ALL TO DETERMINE IF THE PATIENT IS ELIGIBLE TO APPLY FOR CERTAIN HEALTH INSURANCE PROGRAMS. IF THERE IS NO SPECIFIC COVERAGE FOR THE SERVICES PROVIDED, THE HOSPITAL WILL USE THE INFORMATION TO DETERMINE IF THE SERVICES MAY BE COVERED BY AN APPLICABLE PROGRAM THAT WILL COVER CERTAIN SERVICES DEEMED BAD DEBT. IN ADDITION, THE HOSPITAL WILL USE THIS INFORMATION TO DISCUSS ELIGIBILITY FOR CERTAIN HEALTH INSURANCE PROGRAMS. THE SCREENING AND APPLICATION PROCESS FOR A PUBLIC HEALTH INSURANCE PROGRAM IS DONE THROUGH THE VIRTUAL GATEWAY, WHICH IS AN INTERNET PORTAL DESIGNED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES IN ORDER TO PROVIDE THE GENERAL PUBLIC, MEDICAL PROVIDERS, AND COMMUNITY-BASED ORGANIZATIONS WITH AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE STATE OR THROUGH A STANDARD PAPER APPLICATION THAT IS COMPLETED BY THE PATIENT AND ALSO SUBMITTED DIRECTLY TO THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR PROCESSING AS THIS OFFICE SOLELY MANAGES THE APPLICATION PROCESS LISTED ABOVE, WHICH IS AVAILABLE FOR CHILDREN, ADULTS, SENIORS, VETERANS, HOMELESS, AND DISABLED INDIVIDUALS. THE HOSPITAL SPECIFICALLY ASSISTS THE PATIENT IN COMPLETING THE APPLICATION AND SECURING THE NECESSARY DOCUMENTATION REQUIRED BY THE APPLICABLE FINANCIAL ASSISTANCE PROGRAM. NECESSARY DOCUMENTATION INCLUDES PROOF OF: (1) ANNUAL HOUSEHOLD INCOME (PAYROLL STUBS, RECORD OF SOCIAL SECURITY PAYMENTS, AND A LETTER FROM THE EMPLOYER, TAX RETURNS, OR BANK STATEMENTS), (2) CITIZENSHIP AND IDENTITY, AND (3) IMMIGRATION STATUS FOR NON-CITIZENS (IF APPLICABLE), AND (4) ASSETS OF THOSE INDIVIDUALS WHO ARE ALSO ENROLLED IN THE MEDICARE PROGRAM.THE HOSPITAL WILL THEN SUBMIT THIS DOCUMENTATION TO THE COMMONWEALTH OFFICE OF MEDICAID AND ASSIST THE PATIENT IN SECURING ANY ADDITIONAL DOCUMENTATION IF SUCH IS REQUESTED BY THE COMMONWEALTH AFTER COMPLETING THE APPLICATION. THE COMMONWEALTH PLACES A THREE DAY TIME LIMITATION ON SUBMITTING ALL NECESSARY DOCUMENTATION FOLLOWING THE SUBMISSION OF THE APPLICATION FOR A PROGRAM. FOLLOWING THIS THREE DAY PERIOD, THE PATIENT MUST WORK WITH THE MASSHEALTH ENROLLMENT CENTERS TO SECURE THE ADDITIONAL DOCUMENTATION NEEDED FOR ENROLLMENT IN THE APPLICABLE FINANCIAL ASSISTANCE PROGRAM.IN SPECIAL CIRCUMSTANCES, THE HOSPITAL MAY APPLY FOR THE PATIENT USING A SPECIFIC FORM DESIGNED BY THE MASSACHUSETTS DIVISION OF HEALTH CARE FINANCE AND POLICY. SPECIAL CIRCUMSTANCES INCLUDE INDIVIDUALS SEEKING FINANCIAL ASSISTANCE COVERAGE DUE TO BEING INCARCERATED, VICTIMS OF SPOUSAL ABUSE, OR APPLYING DUE TO A MEDICAL HARDSHIP.ALL VIRTUAL GATEWAY APPLICATIONS ARE REVIEWED AND PROCESSED BY THE COMMONWEALTH OF MASSACHUSETTS, OFFICE OF MEDICAID, WHICH USES THE FEDERAL POVERTY GUIDELINES, ASSET INFORMATION AS WELL AS NECESSARY DOCUMENTATION LISTED ABOVE AS THE BASIS FOR DETERMINING ELIGIBILITY FOR STATE SPONSORED PUBLIC ASSISTANCE PROGRAMS. MOUNT AUBURN HOSPITAL HAS NO ROLE IN THE DETERMINATION OF PROGRAM ELIGIBILITY MADE BY THE COMMONWEALTH, BUT AT THE PATIENT'S REQUEST MAY TAKE A DIRECT ROLE IN APPEALING OR SEEKING INFORMATION RELATED TO THE COVERAGE DECISIONS. IT IS STILL THE PATIENT'S RESPONSIBILITY TO INFORM THE HOSPITAL OF ALL COVERAGE DECISIONS MADE BY THE COMMONWEALTH TO ENSURE ACCURATE AND TIMELY ADJUDICATION OF ALL HOSPITAL BILLS.MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY: OUTSIDE COLLECTION AGENCIESTHE HOSPITAL CONTRACTS WITH AN OUTSIDE COLLECTION AGENCY TO ASSIST IN THE COLLECTION OF CERTAIN ACCOUNTS, INCLUDING PATIENT RESPONSIBLE AMOUNTS NOT RESOLVED AFTER ISSUANCE OF HOSPITAL BILLS OR FINAL NOTICES. HOWEVER, AS DETERMINED THROUGH THE HOSPITAL'S CREDIT AND COLLECTION POLICY, THE HOSPITAL MAY ASSIGN SUCH DEBT AS BAD DEBT OR CHARITY CARE (OTHERWISE DEEMED AS UNCOLLECTIBLE) PRIOR TO 120 DAYS IF IT IS ABLE TO DETERMINE THAT THE PATIENT WAS UNABLE TO PAY FOLLOWING THE HOSPITALS' OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM.MOUNT AUBURN HOSPITAL HAS A SPECIFIC AUTHORIZATION OR CONTRACT WITH ITS OUTSIDE COLLECTION AGENCY AND REQUIRES SUCH AGENCY TO ABIDE BY THE HOSPITAL'S CREDIT AND COLLECTION POLICIES FOR DEBTS THAT THE AGENCY IS PURSUING. IN ADDITION, THE HOSPITAL REQUIRES THAT ANY OUTSIDE COLLECTION AGENCY THAT IT USES MUST BE LICENSED BY THE COMMONWEALTH OF MASSACHUSETTS AND BE IN COMPLIANCE WITH THE MASSACHUSETTS ATTORNEY GENERAL'S DEBT COLLECTION REGULATIONS. FINALLY, ANY OUTSIDE COLLECTION AGENCY HIRED BY THE HOSPITAL WILL PROVIDE THE PATIENT WITH AN OPPORTUNITY TO FILE A GRIEVANCE AND WILL FORWARD TO THE HOSPITAL THE RESULTS OF ANY SUCH PATIENT GRIEVANCE.MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY: EXEMPTION FROM HOSPITAL COLLECTION PRACTICESMOUNT AUBURN HOSPITAL EXEMPTS PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN AND "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID, SUBJECT TO SOME EXCEPTIONS, FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS.
    PART VI, LINE 2: COMMUNITY BENEFITS MISSION STATEMENTMOUNT AUBURN HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH STATUS OF COMMUNITY MEMBERS BY COLLABORATING WITH COMMUNITY PARTNERS TO REDUCE BARRIERS TO HEALTH AND EDUCATE ABOUT PREVENTION, EARLY DETECTION AND SELF-CARE.DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $1,365,442 REPORTED ON THIS SCHEDULE H RELATED TO THESE ACTIVITIES. COMMUNITY HEALTH IMPROVEMENT SERVICESMOUNT AUBURN HOSPITAL IS ACTIVELY ENGAGED IN COMMUNITY HEALTH IMPROVEMENT ACTIVITIES WHICH PROMOTE THE HEALTH OF OUR COMMUNITY. BELOW ARE SOME EXAMPLES OF THESE ACTIVITIES.LISTEN AND LEARNOVER THE PAST FEW YEARS MOUNT AUBURN HOSPITAL HAS DEVELOPED THE LISTEN AND LEARN COMMUNITY HEALTH MODEL OF COMMUNITY ENGAGED COLLABORATIONS THAT AIM TO ADDRESS HEALTH DISPARITIES BY BRIDGING THE GAP BETWEEN COMMUNITY MEMBERS AND CLINICIANS. IN EACH LISTEN AND LEARN PROGRAM, COMMUNITY MEMBERS AFFECTED BY A HEALTH DISPARITY SHARE THEIR BELIEFS AND PERCEPTIONS AND PARTICIPATE IN A PLANNING PROCESS. DURING THE PERIOD COVERED BY THIS FILING, THERE WERE TWO LISTEN AND LEARN PROGRAMS. THE FIRST WAS DESIGNED TO ADDRESS THE INCREASED RATE OF TYPE 2 DIABETES AMONG LATINOS. TO THAT END A HEALTH LEADERSHIP TEAM WITH STUDENTS FROM THREE WALTHAM ENGLISH FOR SPEAKERS OF OTHER LANGUAGES (ESOL) PROGRAMS AND HEALTH CARE PROVIDER GROUPS AT MOUNT AUBURN HOSPITAL AND JOSEPH M. SMITH COMMUNITY HEALTH CENTER, ONE OF OUR COMMUNITY HEALTH CENTERS, WERE CREATED. BUILT ON THE DATA COLLECTED IN THE PRIOR FISCAL PERIOD, EACH OF THESE GROUPS FURTHER EXPLORED THE CAUSES OF HEALTH DISPARITIES AND CULTURAL COMPETENCY CONTENT. A JOINT MEETING BETWEEN THE HEALTH LEADERS AND THE CLINICIANS FOCUSED ON BETTER UNDERSTANDING CULTURAL BELIEFS AND HOW THEY IMPACT HEALTH DECISIONS. SIMILAR PROGRAMS IN SOMERVILLE AND CAMBRIDGE ADDRESSED IMMIGRANT WOMEN'S BARRIERS TO BREAST CANCER SCREENING AND INVOLVED ONCOLOGY NURSES AS WELL AS MAMMOGRAPHY THERAPISTS. IMMIGRANT HEALTH WAS ALSO ADDRESSED MORE BROADLY IN THE BRIDGE TO HEALTHCARE PROGRAM WHICH PROVIDES HEALTH EDUCATION AT LOCAL ESOL PROVIDERS IN CAMBRIDGE, SOMERVILLE WALTHAM, AND WATERTOWN.OTHER COMMUNITY PROGRAMSIN ADDITION TO MOUNT AUBURN HOSPITAL'S CONTINUING TO PROVIDE SUPPORT TO ITS COMMUNITY HEALTH CENTER PARTNER, JOSEPH M. SMITH COMMUNITY HEALTH CENTER, THE HOSPITAL WAS INVOLVED WITH, AND PROVIDED, SEVERAL OTHER COMMUNITY BENEFIT PROGRAMS THROUGHOUT THE PERIOD COVERED BY THIS FILING. MAH ADDRESSED ELDER HEALTH ISSUES WITHIN THE FOLLOWING PROGRAMS: 1) A BROWN BAG MEDICATION REVIEW PROGRAM PILOT, 2) COMMUNITY BASED BLOOD PRESSURE SCREENINGS AND 3) THE MATTER OF BALANCE FALL PREVENTION PROGRAM FOR COMMUNITY MEMBERS AT RISK FOR FALLING. PROGRAMS WHICH ADDRESSED THE NEEDS OF OTHER VULNERABLE POPULATIONS INCLUDED: 1) EDUCATIONAL SESSIONS TO BUILD THE CAPACITY OF HOMELESS COMMUNITY MEMBERS TO DEVELOP SELF-CARE SKILLS; 2) FOOD PANTRY DRIVES: 3) SYSTEMS TO ENROLL COMMUNITY MEMBERS IN SUPPLEMENTAL NUTRITION PROGRAM ASSISTANCE (SNAP); 4) A SAFE BEDS PROGRAM WHICH PROVIDES VICTIMS OF DOMESTIC VIOLENCE WHO CANNOT ACCESS A SHELTER A SAFE PLACE AT THE HOSPITAL; AND, 5) SYSTEMS TO PROVIDE TRANSPORTATION TO MEDICAL SERVICES. MORE BROADLY, MAH WORKED TO RAISE AWARENESS ABOUT HEALTH DISPARITIES IN WALTHAM USING LIBRARY VIEWING OF UNNATURAL CAUSE AND A WALK IN MY SHOES (COMMUNITY CATALYST TRADEMARK) EVENT AS A TOOL. YOUTH WERE SERVED THROUGH THE WALTHAM WELLNESS, PROGRAM WHICH ADDRESSES OBESITY PREVENTION USING SCHOOL AND COMMUNITY GARDENS AND TARGET WORK WITH SCHOOL CAFETERIA STAFF TO ADDRESS ISSUES OF NUTRITION AND BETTER FOOD CHOICES. YOUTH IN ARLINGTON WERE ENGAGED IN A TOBACCO FREE PEER LEADERSHIP CAMPAIGN AIMED AT PROMOTING THE NORM THAT MOST MIDDLE SCHOOL CHILDREN DO NOT USE TOBACCO. COMMUNITY MEMBERS HAVE RECEIVED INCREASED SUPPORT THROUGH OUR SUPPORT GROUPS AND RELATED PROGRAMMING WHICH INCLUDES FREE SMOKING CESSATION CLASSES. COMMUNITY HEALTH NETWORK AREA 17MOUNT AUBURN HOSPITAL WORKED CLOSELY WITH LOCAL COMMUNITY HEALTH NETWORK AREA (CHNA) MEMBERS AND OTHER LOCAL HEALTHY COALITIONS. WITH CHNA 17 MAH HELPED COMPLETE A NEEDS ASSESSMENT, PRIORITIZE INTERVENTIONS AND DEVELOP GUIDING PRINCIPLES BY SERVING ON THE STEERING COMMITTEE AND PARTICIPATING FULLY IN THE GENERAL MEMBERSHIP. MAH IS ALSO A MEMBER OF HEALTHY WALTHAM STEERING COMMITTEE. THE REGIONAL CENTER FOR HEALTHY COMMUNITIESTHE MISSION OF THE REGIONAL CENTER FOR HEALTHY COMMUNITIES (RCHC), A PROGRAM OF MOUNT AUBURN HOSPITAL, IS TO HELP COMMUNITIES REALIZE THEIR VISION FOR A HEALTHIER PLACE TO LIVE. THE CENTER DOES THIS BY 1) SUPPORTING AND ENCOURAGING COALITIONS TO DESIGN AND IMPLEMENT INCLUSIVE COMMUNITY HEALTH PLANNING AND ASSESSMENT PROCESSES; AND 2) PROVIDING TOOLS AND TEMPLATES, TRAINING, FACILITATION, LIBRARY RESOURCES AND OPPORTUNITIES FOR SHARING AND COLLABORATION ACROSS THE METROWEST REGION. THE EFFORT WORKS TO REDUCE ALCOHOL, TOBACCO, AND OTHER DRUG USE IN THE GENERAL POPULATION BY STRENGTHENING COALITIONS, AND BY MOBILIZING YOUTH AND YOUNG ADULTS FOR LEADERSHIP AND CIVIC ACTION IN THIS ARENA. IN ADDITION, THE CENTER SUPPORTS COMMUNITIES IN BROADER HEALTH ASSESSMENT AND WELLNESS EFFORTS. THE RCHC ALSO DEVELOPS LEADERSHIP FOR REGIONAL HEALTH PLANNING THROUGH ITS WORK WITH COMMUNITY HEALTH NETWORK AREAS 15, 17, 18, AND THE COMMUNITY HEALTH COALITION OF METROWEST). THE CENTER HAS AN EXTENSIVE HEALTH AND SOCIAL RESOURCE LIBRARY AVAILABLE FOR LOAN, FREE OF CHARGE FOR THOSE LIVING AND/OR WORKING IN THE METROWEST REGION. ADDITIONALLY, THE REGIONAL CENTER'S STAFF PROVIDES TECHNICAL ASSISTANCE, TRAINING, AND SUPPORT TO LOCAL COALITIONS. BASED ON THE RESULTS OF TRAINING NEEDS ASSESSMENT CONDUCTED THROUGHOUT THE REGION, THE RCHC HAS HELD WORKSHOPS ON A BROAD RANGE OF TOPICS, INCLUDING GRANT WRITING, COMMUNITY ASSESSMENT MODELS, HOARDING AND YOUTH DEVELOPMENT. THE RCHC FOSTERS STRATEGIES THAT:- HAVE BEEN RIGOROUSLY EVALUATED AND ARE SHOWN TO BE EFFECTIVE. THIS IS OFTEN REFERRED TO AS "EVIDENCE-BASED PREVENTION". - ARE DEVELOPED TO REDUCE 'RISK' FACTORS AND ENHANCE 'PROTECTIVE' FACTORS FOR YOUNG PEOPLE. RISK FACTORS ARE INDIVIDUAL CHARACTERISTICS OR SOCIAL ENVIRONMENTS THAT ARE ASSOCIATED WITH AN INCREASED LIKELIHOOD OF SUBSTANCE USE. CONVERSELY, PROTECTIVE FACTORS SUCH AS SUCCESS IN SCHOOL AND STRONG FAMILY BONDS ASSIST IN PREVENTING YOUNG PEOPLE FROM SUBSTANCE USE. THIS IS A CRITICAL FRAMEWORK FOR ENABLING COMMUNITIES TO PURSUE STRATEGIES THAT CAN ASSIST YOUNG PEOPLE, EVEN IN HIGH-RISK ENVIRONMENTS. - BUILD UPON THE STRENGTHS AND RESOURCES OF DIVERSE COMMUNITY MEMBERS. THE SUBSTANCE ABUSE PREVENTION WORK UNDERTAKEN BY THE RCHC SUPPORTS COMMUNITIES IN BUILDING AND SUSTAINING COALITIONS COMPRISED OF POLICE, SCHOOL PERSONNEL, YOUNG PEOPLE, PARENTS, LOCAL SERVICE PROVIDERS AND OTHER KEY COMMUNITY STAKEHOLDERS. THE MISSION OF THESE COALITIONS IS TO PREVENT SUBSTANCE ABUSE AMONG YOUTH AND YOUNG ADULTS USING THE EVIDENCE-BASED MODEL "COMMUNITIES MOBILIZING FOR CHANGE ON ALCOHOL" (CMCA). IN THIS MODEL, REDUCTIONS IN UNDERAGE DRINKING ARE ACHIEVED THROUGH POLICIES AND PRACTICES THAT REDUCE ACCESS TO ALCOHOL AND ADDRESS SOCIAL NORMS REGARDING UNDERAGE DRINKING. A RIGOROUS EVALUATION OF THIS MODEL UNDERTAKEN BY THE UNIVERSITY OF MINNESOTA HAS REVEALED SIGNIFICANT REDUCTION IN UNDERAGE ACCESS TO ALCOHOL, CHANGES IN ALCOHOL BEHAVIORS OF YOUNG PEOPLE, AND A REDUCTION IN SELLING TO UNDERAGE DRINKERS. IN ADDITION TO CAMBRIDGE, QUINCY, SOMERVILLE AND WATERTOWN, THE RCHC ALSO SUPPORTS OTHER COMMUNITIES IN THE REGION IN THESE EFFORTS AND WORKS WITH COALITIONS AS THEY IMPLEMENT STRATEGIES AND BUILD PARTNERSHIPS TO REDUCE OVERDOSES.
    PART VI, LINE 3: MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY - NOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE AND OTHER COVERAGE OPTIONS:FINANCIAL ASSISTANCE IS INTENDED TO ASSIST LOW-INCOME PATIENTS WHO DO NOT OTHERWISE HAVE THE ABILITY TO PAY FOR THEIR HEALTH CARE SERVICES. SUCH ASSISTANCE TAKES INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.MOUNT AUBURN HOSPITAL PROVIDES THIS ASSISTANCE FOR BOTH RESIDENTS AND NON-RESIDENTS OF MASSACHUSETTS; HOWEVER, THERE MAY NOT BE COVERAGE FOR A MASSACHUSETTS HOSPITAL'S SERVICES THROUGH AN OUT-OF STATE PROGRAM. IN ORDER FOR THE HOSPITAL TO ASSIST UNINSURED AND UNDERINSURED PATIENTS FIND THE MOST APPROPRIATE COVERAGE OPTIONS, AS WELL AS TO DETERMINE IF THE PATIENT IS FINANCIALLY ELIGIBLE FOR ANY PAYMENT DISCOUNTS, PATIENTS MUST ACTIVELY WORK WITH THE HOSPITAL TO VERIFY THEIR FINANCIAL AND OTHER INFORMATION THAT COULD BE USED IN DETERMINING ELIGIBILITY. THE HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR THROUGH THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM, WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. FOR THOSE PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS PATIENTS BY SCREENING THEM FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. THESE PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO: MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET. WHEN APPLICABLE, THE HOSPITAL MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED FAMILY INCOME, CURRENT AND PRIOR INSURANCE COVERAGE AND ALLOWABLE MEDICAL EXPENSES.IN ADDITION, IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS WHO HAVE A FINANCIAL LIABILITY AS WELL AS IN GENERAL NOTICES THAT ARE POSTED THROUGHOUT THE HOSPITAL.THE HOSPITAL WILL TRY TO IDENTIFY AVAILABLE COVERAGE OPTIONS FOR PATIENTS WHO MAY BE UNINSURED OR UNDERINSURED WITH THEIR CURRENT INSURANCE PROGRAM WHEN THE PATIENT IS SCHEDULING SERVICES, WHILE THE PATIENT IS IN THE HOSPITAL, UPON DISCHARGE, AND/OR FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THE HOSPITAL WILL DIRECT ALL PATIENTS SEEKING INFORMATION ON AVAILABLE COVERAGE OPTIONS OR FINANCIAL ASSISTANCE TO THE HOSPITAL'S PATIENT FINANCIAL COUNSELING OFFICE TO DETERMINE IF THEY ARE ELIGIBLE AND THEN TO SCREEN PATIENTS FOR ELIGIBILITY IN AN APPROPRIATE COVERAGE OPTION. THE HOSPITAL WILL THEN ASSIST THE PATIENT IN APPLYING FOR APPROPRIATE COVERAGE OPTIONS THAT ARE AVAILABLE TO THEM OR NOTIFY THEM OF THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM.FOR CASES WHERE THE HOSPITAL IS USING THE VIRTUAL GATEWAY APPLICATION, THE HOSPITAL WILL ASSIST THE PATIENT IN COMPLETING THE APPLICATION FOR MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR OTHER FORMS OF FINANCIAL ASSISTANCE PROGRAMS AS THEY BECOME PART OF THE VIRTUAL GATEWAY PROGRAM, WHICH IS AN INTERNET PORTAL DESIGNED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES IN ORDER TO PROVIDE THE GENERAL PUBLIC, MEDICAL PROVIDERS, AND COMMUNITY-BASED ORGANIZATIONS WITH AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE COMMONWEALTH.
   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
    PART VI, LINE 6: MOUNT AUBURN HOSPITAL IS GOVERNED BY A BOARD OF TRUSTEES MADE UP OF 28 VOLUNTEERS, MANY OF WHOM LIVE AND WORK IN THE COMMUNITY AND SERVE TO SUPPORT THE MISSION AND VALUES OF THE HOSPITAL. MAH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY AND ENDEAVORS TO PROVIDE THEM WITH THE SAFEST AND MOST TECHNOLOGICALLY ADVANCED ENVIRONMENT POSSIBLE THROUGH THE EFFECTIVE USE OF SURPLUS FUNDS. SOME OF OUR SURPLUS FUNDS HAVE BEEN USED TO FUND THE CONTINUING RENOVATION OF OUR EXISTING FACILITIES, INCLUDING INPATIENT UNITS AND OTHER CLINICAL AREAS. MAH STRIVES TO FULLY SERVE THE COMMUNITY THROUGH PARTICIPATION IN GOVERNMENT SPONSORED HEALTHCARE PROGRAMS SUCH AS MEDICARE, MEDICAID, CHAMPUS AND TRICARE. AS PREVIOUSLY NOTED, MAH ALSO SERVES AS A TEACHING HOSPITAL AFFILIATED WITH THE HARVARD MEDICAL SCHOOL AND MAINTAINS TWO RESIDENCY PROGRAMS SPECIALIZING IN PRIMARY CARE AND RADIOLOGY. COMMUNITY MEMBERS ALSO USE MAH AS A CONDUIT FOR VOLUNTEERING AS EVIDENCED BY MORE THAN 280 VOLUNTEERS WHO ASSIST WITH PATIENT SERVICES, ADMINISTRATION AND THE GIFT SHOP.
    PART VI, LINE 7: MOUNT AUBURN HOSPITAL - AFFILIATED HEALTH CARE SYSTEMMAH IS A MEMBER OF CAREGROUP HEALTH SYSTEM, A REGIONAL HEALTHCARE DELIVERY SYSTEM COMPRISED OF TEACHING AND COMMUNITY HOSPITALS, PHYSICIAN GROUPS, AND OTHER CAREGIVERS. IT IS COMMITTED TO PERSONALIZED, PATIENT CENTERED CARE, AND EXCELLENCE IN MEDICAL EDUCATION AND RESEARCH. CAREGROUP SERVES THE HEALTH NEEDS OF PATIENTS AND COMMUNITIES EXTENDING FROM NORTH AND SOUTH OF BOSTON TO THE WESTERN SUBURBS BEYOND THE ROUTE 495 BELT, AND IS COMPRISED OF: FOUR HOSPITALS (BETH ISRAEL DEACONESS MEDICAL CENTER, INC, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC., MOUNT AUBURN HOSPITAL AND NEW ENGLAND BAPTIST HOSPITAL); A COMMITTED MEDICAL STAFF OFFERING COMMUNITY BASED PRIMARY CARE AND A WIDE RANGE OF SPECIALTY SERVICES, AND; A BROAD SPECTRUM OF COMPREHENSIVE HEALTH SERVICES RANGING FROM WELLNESS PROGRAMS TO HOME CARE.
REPORTS FILED WITH STATES PART VI, LINE 7 MA
  FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN GREATER DETAIL HOW MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) CARES FOR ITS COMMUNITY BY PROVIDING CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS, AS WELL AS COMMUNITY BUILDING ACTIVITIES. AS DEMONSTRATED IN THIS SCHEDULE H, 5.16% OF MAH'S TOTAL EXPENSES ARE INCURRED IN PROVIDING CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST.MOUNT AUBURN HOSPITAL IS AN ACUTE CARE MEDICAL/SURGICAL HOSPITAL AND A FRONTLINE CAREGIVER PROVIDING MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO OUR FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR. MAH IS ALSO A HARVARD MEDICAL SCHOOL AFFILIATED TEACHING HOSPITAL WITH GRADUATE MEDICAL EDUCATION PROGRAMS IN THE AREAS OF PRIMARY CARE AND RADIOLOGY. MAH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL EACH YEAR. THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE AND ON THEIR WEBSITE AND AT MAH UPON REQUEST. A COPY IS ATTACHED ANNUALLY TO THE MAH FORM 990 FILING AND IS INCORPORATED WITH THIS SCHEDULE H. THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE (IRS) DEFINITION OF COMMUNITY CARE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT MAH HAS FILED WITH THE ATTORNEY GENERAL'S OFFICE.
Schedule H (Form 990) 2010
Additional Data


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Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number
04-2103606
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) ON THE RISE341 BROADWAY
CAMBRIDGE,MA02139 		04-3290689   5,000       ANNUAL DINNER SUPPORT FOR HOMELESS SHELTER.
(2) FINANCIAL COUNSELORS AT JMSCHC564 MAIN STREET
WALTHAM,MA02452 		23-7221597   66,319       PROVIDES FINANCIAL COUNSELORS TO AUGMENT HEALTH CARE CENTER STAFF AT JOSEPH M. SMITH COMMUNITY HEALTH CENTER - A FEDERALLY QUALIFIED HEALTH CARE CENTER. THEY ENROLL UNDERSERVED COMMUNITY MEMBERS IN INSURANCE PROGRAMS. FINANCIAL COUNSLERS - 2FTE (+ 22% BENEFITS) BASED ENTIRELY AT JOSEPH M. SMITH COMMUNITY HEALTH CENTER. (THIS IS NOT FOR ENROLLMENT IN MEDICAL COVERAGE WHICH BENEFITS MAH. THIS IS SUPPORT FOR THE COMMUNITY HEALTH CENTER.)
(3) INSTITUTE OF COMMUNITY HEALTH163 GORE STREET GROUND FLOOR
CAMBRIDGE,MA02141 		04-3543853   110,000       THE INSTITUTE FOR COMMUNITY HEALTH (ICH) IS A UNIQUE COLLABORATION AMONG THREE MASSACHUSETTS HEALTH CARE SYSTEMS TO IMPROVE THE HEALTH OF CAMBRIDGE, SOMERVILLE, AND SURROUNDING TOWNS. THE INSTITUTE WAS FOUNDED IN 2000 BYCAMBRIDGE HEALTH ALLIANCE, MT AUBURN HOSPITAL, AND MASSACHUSETTS GENERAL HOSPITAL OF PARTNERS HEALTHCARE. THE GOALS OF ICH ARE TO ADVANCE COMMUNITY HEALTH RESEARCH; PROMOTE COMMUNITY HEALTH EDUCATION AND TRAINING; DEVELOPCOMMUNITY ACTION PROGRAMS AND POLICY; AND FORGE LINKAGES AMONG HEALTH CARE SYSTEMS, COMMUNITY PARTNERS, AND ACADEMIC INSTITUTIONS WITH SHARED COMMUNITY HEALTH OBJECTIVES.
(4) JOSEPH M SMITH COMMUNITY564 MAIN STREET
WALTHAM,MA02452 		23-7221597   20,000       TO SUPPORT JMSCHC FOR DEVELOPMENT OF A PHARMACY TO MEET THE NEEDS OF THEIR UNDERSERVED CLIENTS.
















2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
 
3
Enter total number of other organizations ................................ . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANT FUND USAGE IS MONITORED BY REQUIRING THE SUBMISSION OF REPORTS BY GRANT RECIPIENTS.
Schedule I (Form 990) 2010


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
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 in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
No
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in 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) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in 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," to line 5a or 5b, describe in Part III.
6
For persons listed in 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," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in 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) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (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
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) CLOUGH JEANETTE G (i)
(ii)		 428,724
69,792 		349,962
56,971 		73,419
11,952 		705,771
114,893 		18,328
2,984 		1,576,204
256,592 		0
0
(2) HATEM MD CHARLES J (i)
(ii)		 304,559
0 		500
0 		6,440
0 		19,600
0 		25,757
0 		356,856
0 		0
0
(3) NAUTA MD RUSSELL J (i)
(ii)		 428,046
107,012 		29,750
7,438 		2,155
539 		64,330
16,082 		16,017
4,004 		540,298
135,075 		0
0
(4) ZINNER MD STEPHEN (i)
(ii)		 337,013
54,863 		0
0 		8,052
1,311 		14,749
2,401 		8,329
1,356 		368,143
59,931 		0
0
(5) DILESO NICHOLAS (i)
(ii)		 280,898
0 		74,625
0 		46,741
0 		453,418
0 		21,131
0 		876,813
0 		0
0
(6) SEMENZA PETER (i)
(ii)		 280,967
45,739 		67,389
10,970 		1,178,142
191,791 		99,293
16,164 		6,601
1,075 		1,632,392
265,739 		0
0
(7) ABOOKIRE MD SUSAN (i)
(ii)		 248,306
0 		66,310
0 		27,272
0 		79,886
0 		20,331
0 		442,105
0 		0
0
(8) BAKER DEBORAH (i)
(ii)		 227,837
0 		41,308
0 		1,262
0 		49,485
0 		20,331
0 		340,223
0 		0
0
(9) BRIDGEMAN JOHN (i)
(ii)		 183,196
0 		37,140
0 		2,111
0 		53,775
0 		20,331
0 		296,553
0 		0
0
(10) BURKE KATHRYN (i)
(ii)		 229,126
0 		57,944
0 		1,604
0 		71,353
0 		21,891
0 		381,918
0 		0
0
(11) O'CONNELL MICHAEL L (i)
(ii)		 177,885
0 		45,952
0 		51,595
0 		70,149
0 		21,631
0 		367,212
0 		0
0
(12) KAWADA MD CHARLES Y (i)
(ii)		 207,604
138,403 		30,375
20,250 		24,955
16,636 		46,484
30,989 		12,196
8,131 		321,614
214,409 		0
0
(13) JOSEPH ESQ LESLIE (i)
(ii)		 228,195
0 		58,490
0 		1,137
0 		76,810
0 		24,631
0 		389,263
0 		0
0
(14) LUKASIK CHARLES (i)
(ii)		 11,557
219,584 		2,576
48,935 		80
1,529 		3,871
73,547 		1,167
22,164 		19,251
365,759 		0
0
(15) SHUGERT JOHN (i)
(ii)		 180,794
0 		44,783
0 		40,547
0 		56,912
0 		20,331
0 		343,367
0 		0
0
(16) SANCHEZ MD LUCIENNE (i)
(ii)		 287,752
0 		390
0 		428
0 		17,150
0 		9,685
0 		315,405
0 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 1B PETER SEMENZA, CHIEF FINANCIAL OFFICER, AND JOHN SHUGERT, VICE PRESIDENT OF DEVELOPMENT, EACH RECEIVED AN ANNUAL PAYMENT PURSUANT TO THEIR EMPLOYMENT AGREEMENTS AND DESIGNED TO ENSURE THAT THEIR ANNUAL LEVEL OF RETIREMENT FUNDING AT MOUNT AUBURN HOSPITAL (MAH) MATCHED THEIR PRE-MAH LEVEL OF ANNUAL RETIREMENT FUNDING. THE PAYMENTS ARE TAXABLE INCOME TO THEM AND AS SUCH, MAH GROSSES-UP THESE PAYMENTS. THE AMOUNTS ARE QUANTIFIED IN OTHER COMPENSATION ON FORM 990 PART VII AND IN OTHER REPORTABLE COMPENSATION ON FORM 990 SCHEDULE J. THE AMOUNTS RECEIVED BY MR. SEMENZA AND MR. SHUGERT, INCLUDING GROSS-UP RELATED TO THESE PAYMENTS WERE $21,260 AND $10,147 RESPECTIVELY. ALTHOUGH THESE PAYMENTS WERE NOT MADE PURSUANT TO A WRITTEN POLICY REGARDING GROSS-UPS, THESE PAYMENTS ARE PART OF MR. SEMENZA'S AND MR. SHUGERT'S OVERALL COMPENSATION PACKAGES AND AS SUCH, THEY ARE REVIEWED BY THE COMPENSATION COMMITTEE AS PREVIOUSLY DESCRIBED IN THIS FORM 990.
  PART I, LINE 4B AS PREVIOUSLY NOTED, CAREGROUP, INC. IS THE SOLE MEMBER OF MOUNT AUBURN HOSPITAL. THE CEO OF MAH/MAPS WAS PAID BY CAREGROUP WHICH IS A PARTICIPATING EMPLOYER IN THE CAREGROUP ANNUITY RETIREMENT PLAN (ARP). UNDER THE DEFINITIONS TO THIS FORM 990, THE ARP IS CONSIDERED A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. PARTICIPANTS RECEIVE BOTH CURRENTLY TAXABLE AND DEFERRED BENEFITS FROM THIS PLAN AND ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. ADDITIONAL DETAILS RELATED TO SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS ARE INCLUDED IN THE COMPENSATION EXPLANATORY NOTES TO SCHEDULE J BELOW.
  PART I, LINE 7 THE PRESIDENT, VICE PRESIDENTS, DEPARTMENT CHAIRS AND OTHER SENIOR MANAGEMENT ARE ELIGIBLE TO RECEIVE ANNUAL INCENTIVE COMPENSATION PAYMENTS BASED ON COMPARISON OF ACTUAL ACCOMPLISHMENTS WITH PRE-DETERMINED GOALS.
SUPPLEMENTAL INFORMATION PART III ADDITIONAL EXPLANATORY FOOTNOTES: 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 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 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 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/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 AND MOUNT AUBURN PROFESSIONAL SERVICES MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS MAH AND MAPS RESPECTIVELY.
SUPPLEMENTAL INFORMATION PART III CHUBB, STEPHEN D. TRUSTEE & BOARD CHAIR- MOUNT AUBURN HOSPITAL DIRECTOR (EX-OFFICIO)- CAREGROUP MR. CHUBB'S TERM ON THE MOUNT AUBURN HOSPITAL BOARD ENDED DECEMBER 31, 2010. CLOUGH, JEANETTE G. PRESIDENT & CEO- MOUNT AUBURN HOSPITAL PRESIDENT & CEO- MOUNT AUBURN PROFESSIONAL SERVICES IN HER POSITIONS AS PRESIDENT & CEO FOR MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES, MS. CLOUGH RECEIVES PAYMENTS DIRECTLY FROM MAH AS WELL AS FROM CAREGROUP, THE SOLE MEMBER OF MAH, 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. ADDITIONALLY, MS. COUGH PERFORMS SERVICES FOR BOTH MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES BUT NOT DIRECTLY FOR CAREGROUP. AS SUCH AND AS REQUIRED BY THIS FORM 990, MS. CLOUGH'S COMPENSATION IS REPORTED HERE AS IF PAID BY MAH AND MAPS. THE 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: 428,724 INCENTIVE COMPENSATION: 349,962 OTHER REPORTABLE COMPENSATION: 73,419 DEFERRED COMPENSATION: 705,771 NON-TAXABLE BENEFITS: 18,328 PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 69,792 INCENTIVE COMPENSATION: 56,971 OTHER REPORTABLE COMPENSATION: 11,952 DEFERRED COMPENSATION: 114,893 NON-TAXABLE BENEFITS: 2,984 INCENTIVE COMPENSATION REPORTED FOR THE 2010 CALENDAR YEAR INCLUDES 1) PAYMENTS IN 2010 PURSUANT TO A LONG TERM INCENTIVE PLAN RELATED TO MOUNT AUBURN HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2009 IN THE AMOUNT OF $214,207 AND 2) A PAYMENT PURSUANT TO AN ANNUAL INCENTIVE PLAN RELATED TO THE FISCAL YEAR ENDED SEPTEMBER 30, 2009 IN THE AMOUNT OF $191,358. AS REQUIRED BY THIS FORM 990, THESE INCENTIVE COMPENSATION PAYMENTS WERE REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES AN ACTUARIAL CHANGE IN THE PROJECTED BENEFIT OBLIGATION OF MS. CLOUGH'S SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) OF $380,000. THE SERP DOES NOT VEST UNTIL MS. CLOUGH REACHES AGE 62. DEFERRED COMPENSATION REPORTED FOR THE 2010 CALENDAR YEAR INCLUDES TWO INCENTIVE PAYMENTS RELATED TO THE SERVICES MS. CLOUGH PERFORMED DURING MOUNT AUBURN'S FISCAL YEAR ENDED SEPTEMBER 30, 2010 BUT WHICH WERE NOT PAID TO MS. CLOUGH UNTIL AFTER DECEMBER 31, 2010 -- ONE IN THE AMOUNT OF $214,207 RELATED TO AN ANNUAL INCENTIVE PLAN, AND ANOTHER FOR $214,207 RELATED TO A LONG TERM INCENTIVE PLAN. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. CLOUGH INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $58,188. ADDITIONALLY, OTHER REPORTABLE COMPENSATION IN THE AMOUNT OF $17,867 WAS REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990, AS REQUIRED. KETTYLE, M.D., WILLIAM TRUSTEE - MOUNT AUBURN HOSPITAL DR. KETTYLE'S TERM ON THE MOUNT AUBURN HOSPITAL BOARD BEGAN JANUARY 1, 2011. MAMBRINO, M.D. LAWRENCE TRUSTEE- MOUNT AUBURN HOSPITAL DR. MAMBRINO'S TERM ON THE MOUNT AUBURN HOSPITAL BOARD BEGAN JANUARY 1, 2011. NAUTA, M.D., RUSSELL J. TRUSTEE & CHAIR, DEPT. OF SURGERY- MOUNT AUBURN HOSPITAL PROFESSOR OF SURGERY- HARVARD MEDICAL SCHOOL DR. NAUTA PERFORMS SERVICES FOR BOTH MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. NAUTA IS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF DR. NAUTA'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: 428,046 INCENTIVE COMPENSATION: 29,750 OTHER REPORTABLE COMPENSATION: 2,155 DEFERRED COMPENSATION: 64,330 NON-TAXABLE BENEFITS: 16,017 PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 107,012 INCENTIVE COMPENSATION: 7,438 OTHER REPORTABLE COMPENSATION: 539 DEFERRED COMPENSATION: 16,082 NON-TAXABLE BENEFITS: 4,004 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. NAUTA'S POSITION AS CHAIR OF THE MOUNT AUBURN HOSPITAL DEPARTMENT OF SURGERY AND PROFESSOR OF SURGERY, HARVARD MEDICAL SCHOOL: $150,514 BASE AND OTHER REPORTABLE COMPENSATION AND $19,821 NON-TAXABLE BENEFITS AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $37,188 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION FOR THE 2009 CALENDAR YEAR INCLUDES A BONUS IN AMOUNT OF $63,262 RELATED TO DR. NAUTA'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO DR. NAUTA UNTIL AFTER DECEMBER 31, 2010. SAAL, M.D., A. KIM TRUSTEE & CHIEF, DIVISION OF CARDIOLOGY - MOUNT AUBURN HOSPITAL DIRECTOR - CAREGROUP PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 28,013 AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES $28,013 PAID TO DR. SAAL BY MOUNT AUBURN CARDIOLOGY ASSOCIATES AND RELATED TO DR. SAAL'S POSITION AS CHIEF OF THE DIVISION OF CARDIOLOGY AT MOUNT AUBURN HOSPITAL. DR. SAAL'S TERM ON THE MOUNT AUBURN HOSPITAL BOARD ENDED DECEMBER 31, 2010. SHORTSLEEVE, M.D., MICHAEL TRUSTEE & CHAIR, DEPT. OF RADIOLOGY - MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 23,332 AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES $23,332 PAID TO DR. SHORTSLEEVE BY SCHATZKI ASSOCIATES AND RELATED TO DR. SHORTSLEEVE'S POSITION AS CHAIR OF THE DEPARTMENT OF RADIOLOGY AT MOUNT AUBURN HOSPITAL. SWANN, ERIC TRUSTEE- MOUNT AUBURN HOSPITAL MR. SWANN'S TERM ON THE MOUNT AUBURN HOSPITAL BOARD BEGAN JANUARY 1, 2011. ZINNER, M.D., STEPHEN TRUSTEE, CHAIR DEPARTMENT OF MEDICINE - MOUNT AUBURN HOSPITAL TRUSTEE, CHAIR DEPARTMENT OF MEDICINE - MOUNT AUBURN PROFESSIONAL SERVICES DR. ZINNER PERFORMS SERVICES FOR BOTH MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ZINNER IS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF DR. ZINNER'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: 337,013 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 8,052 DEFERRED COMPENSATION: 14,749 NON-TAXABLE BENEFITS: 8,329 PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 54,863 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 1,311 DEFERRED COMPENSATION: 2,401 NON-TAXABLE BENEFITS: 1,356 DIIESO, NICHOLAS COO- MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 280,898 INCENTIVE COMPENSATION: 74,625 OTHER REPORTABLE COMPENSATION: 46,741 DEFERRED COMPENSATION: 453,418 NON-TAXABLE BENEFITS: 21,131 AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $74,625 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES AN ACTUARIAL CHANGE IN THE PROJECTED BENEFIT OBLIGATION OF MR. DIIESO'S SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) OF $357,700. THE SERP DOES NOT VEST UNTIL MR. DIIESO REACHES AGE 60. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES A BONUS IN AMOUNT OF $76,118 RELATED TO MR. DIIESO'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO MR. DIIESO UNTIL AFTER DECEMBER 31, 2010.
SUPPLEMENTAL INFORMATION PART III SEMENZA, PETER VICE PRESIDENT & CFO - MOUNT AUBURN HOSPITAL VICE PRESIDENT FINANCE & TREASURER - MOUNT AUBURN PROFESSIONAL SERVICES MR. SEMENZA RETIRED ON AUGUST 15, 2011. IN HIS ROLE AS CHIEF FINANCIAL OFFICER OF BOTH MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES, MR. SEMENZA PERFORMED SERVICES FOR BOTH ENTITIES. AS REQUIRED BY FORM 990, ALTHOUGH MR. SEMENZA WAS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF MR. SEMENZA'S COMPENSATION ATTRIBUTABLE TO SERVICES PROVIDED TO EACH ENTITY HAS BEEN SEPARATELY REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 280,967 INCENTIVE COMPENSATION: 67,389 OTHER REPORTABLE COMPENSATION: 1,178,142 DEFERRED COMPENSATION: 99,293 NON-TAXABLE BENEFITS: 6,601 PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 45,739 INCENTIVE COMPENSATION: 10,970 OTHER REPORTABLE COMPENSATION: 191,791 DEFERRED COMPENSATION: 16,164 NON-TAXABLE BENEFITS: 1,075 AS REQUIRED BY FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $78,359 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. OTHER REPORTABLE COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES FOR THE 2010 CALENDAR YEAR INCLUDES PAYMENTS PURSUANT TO A SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) WHICH VESTED IN AUGUST OF 2010 AND IN THE AMOUNT OF $1,301,046 FOR THE CALENDAR YEAR 2010. THE SERP RECOGNIZED MR. SEMENZA'S MORE THAN ELEVEN YEARS SERVING AS CHIEF FINANCIAL OFFICER FOR MAH AND MAPS. MAH/MAPS REPORTED ANNUAL ACTUARIAL CHANGES IN THE BENEFIT OBLIGATION RELATED TO THIS SERP AS DEFERRED COMPENSATION IN PRIOR FORM 990 FILINGS AS REQUIRED. AS NOTED ABOVE, MR. SEMENZA CONTINUED TO SERVE IN HIS ROLE AS CHIEF FINANCIAL OFFICER UNTIL HE RETIRED IN AUGUST OF 2011. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES FOR THE 2010 CALENDAR YEAR INCLUDES AN INCENTIVE PAYMENT OF $95,857 RELATED TO MR. SEMENZA'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO MR. SEMENZA UNTIL AFTER DECEMBER 31, 2010. SULLIVAN, WILLIAM VICE PRESIDENT & CFO - MOUNT AUBURN HOSPITAL VICE PRESIDENT FINANCE & TREASURER - MOUNT AUBURN PROFESSIONAL SERVICES MR. SULLIVAN COMMENCED HIS ROLES AS VICE PRESIDENT AND CHIEF FINANCIAL OFFICER OF MOUNT AUBURN HOSPITAL AND AS VICE PRESIDENT FINANCE AND TREASURER OR MOUNT AUBURN PROFESSIONAL SERVICES ON JUNE 27, 2011. ABOOKIRE, M.D., SUSAN CHAIR OF QUALITY & SAFETY - MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 248,306 INCENTIVE COMPENSATION: 66,310 OTHER REPORTABLE COMPENSATION: 27,272 DEFERRED COMPENSATION: 79,886 NON-TAXABLE BENEFITS: 20,331 AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $66,310 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES A BONUS IN AMOUNT OF $67,636 RELATED TO DR. ABOOKIRE'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO DR. ABOOKIRE UNTIL AFTER DECEMBER 31, 2010. BAKER, DEBORAH VICE PRESIDENT PATIENT CARE SERVICES - MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 227,837 INCENTIVE COMPENSATION: 41,308 OTHER REPORTABLE COMPENSATION: 1,262 DEFERRED COMPENSATION: 49,485 NON-TAXABLE BENEFITS: 20,331 AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $41,308 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES A BONUS IN AMOUNT OF $42,135 RELATED TO MS. BAKER'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO MS. BAKER UNTIL AFTER DECEMBER 31, 2010. BRIDGEMAN, JOHN VICE PRESIDENT CLINICAL SERVICES - MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 183,196 INCENTIVE COMPENSATION: 37,140 OTHER REPORTABLE COMPENSATION: 2,111 DEFERRED COMPENSATION: 53,775 NON-TAXABLE BENEFITS: 20,331 AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $37,140 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES A BONUS IN AMOUNT OF $37,885 RELATED TO MR. BRIDGEMAN'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO MR. BRIDGEMAN UNTIL AFTER DECEMBER 31, 2010. BURKE, KATHRYN VICE PRESIDENT CONTRACTING & BUSINESS DEVELOPMENT - MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 229,126 INCENTIVE COMPENSATION: 57,944 OTHER REPORTABLE COMPENSATION: 1,604 DEFERRED COMPENSATION: 71,353 NON-TAXABLE BENEFITS: 21,891 AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $57,944 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES A BONUS IN AMOUNT OF $59,103 RELATED TO MS. BURKE'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO MS. BURKE UNTIL AFTER DECEMBER 31, 2010. O'CONNELL, MICHAEL L. VICE PRESIDENT PLANNING & MARKETING- MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 177,885 INCENTIVE COMPENSATION: 45,952 OTHER REPORTABLE COMPENSATION: 51,595 DEFERRED COMPENSATION: 70,149 NON-TAXABLE BENEFITS: 21,631 AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $45,952 WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES A BONUS IN AMOUNT OF $50,549 RELATED TO MR. O'CONNELL'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO MR. O'CONNELL UNTIL AFTER DECEMBER 31, 2010. KAWADA, M.D., CHARLES Y. CHAIR, DEPT. OF OB/GYN - MOUNT AUBURN HOSPITAL TRUSTEE & CHAIR, DEPT. OF OB/GYN - MOUNT AUBURN PROFESSIONAL SERVICES ASSISTANT CLINICAL PROFESSOR OF OBSTETRICS, GYNECOLOGY AND REPRODUCTIVE BIOLOGY, HARVARD MEDICAL SCHOOL DR. KAWADA PERFORMS SERVICES FOR BOTH MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. KAWADA IS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF DR. KAWADA'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: 207,604 INCENTIVE COMPENSATION: 30,375 OTHER REPORTABLE COMPENSATION: 24,955 DEFERRED COMPENSATION: 46,484 NON-TAXABLE BENEFITS: 12,196 PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 138,403 INCENTIVE COMPENSATION: 20,250 OTHER REPORTABLE COMPENSATION: 16,636 DEFERRED COMPENSATION: 30,989 NON-TAXABLE BENEFITS: 8,131 AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES FOR THE 2010 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. KAWADA'S POSITION AS CHAIR OF THE MOUNT AUBURN HOSPITAL DEPARTMENT OF OBSTETRICS AND GYNECOLOGY AND ASSISTANT CLINICAL PROFESSOR OF OBSTETRICS, GYNECOLOGY AND REPRODUCTIVE BIOLOGY, HARVARD MEDICAL SCHOOL: $100,546 BASE AND OTHER REPORTABLE COMPENSATION, $9,698 DEFERRED COMPENSATION AND $1,706 NON-TAXABLE BENEFITS. DEFERRED COMPENSATION REPORTED BY MAH AND MAPS FOR THE 2010 CALENDAR YEAR INCLUDES AN INCENTIVE PAYMENT OF $50,625 RELATED TO DR. KAWADA'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO DR. KAWADA UNTIL AFTER DECEMBER 31, 2010. AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $50,625 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990.
SUPPLEMENTAL INFORMATION PART III JOSEPH, ESQ, LESLIE VICE PRESIDENT GENERAL COUNSEL - MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 228,195 INCENTIVE COMPENSATION: 58,490 OTHER REPORTABLE COMPENSATION: 1,137 DEFERRED COMPENSATION: 76,810 NON-TAXABLE BENEFITS: 24,631 AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $58,490 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES A BONUS IN AMOUNT OF $59,660 RELATED TO ATTORNEY JOSEPH'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO MS. JOSEPH UNTIL AFTER DECEMBER 31, 2010.
SUPPLEMENTAL INFORMATION PART III LUKASIK, CHARLES COO & CLERK - MOUNT AUBURN PROFESSIONAL SERVICES IN HIS ROLE AS CHIEF OPERATING OFFICER OF MAPS, MR. LUKASIK PERFORMS SERVICES FOR BOTH MOUNT AUBURN PROFESSIONAL SERVICES AND MOUNT AUBURN HOSPITAL. AS REQUIRED BY THIS FORM 990, ALTHOUGH MR. LUKASIK IS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF MR. LUKASIK'S COMPENSATION ATTRIBUTABLE TO SERVICES PROVIDED TO EACH ENTITY HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 11,557 INCENTIVE COMPENSATION: 2,576 OTHER REPORTABLE COMPENSATION: 80 DEFERRED COMPENSATION: 3,871 NON-TAXABLE BENEFITS: 1,167 PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 219,584 INCENTIVE COMPENSATION: 48,935 OTHER REPORTABLE COMPENSATION: 1,529 DEFERRED COMPENSATION: 73,547 NON-TAXABLE BENEFITS: 22,164 AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $51,511 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES FOR THE 2010 CALENDAR YEAR INCLUDES AN INCENTIVE PAYMENT OF $60,268 RELATED TO MR. LUKASIK'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO MR. LUKASIK UNTIL AFTER DECEMBER 31, 2010.
SUPPLEMENTAL INFORMATION PART III SHUGERT, JOHN VICE PRESIDENT DEVELOPMENT- MOUNT AUBURN HOSPITAL PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 180,794 INCENTIVE COMPENSATION: 44,783 OTHER REPORTABLE COMPENSATION: 40,547 DEFERRED COMPENSATION: 56,912 NON-TAXABLE BENEFITS: 20,331 AS REQUIRED BY THIS FORM 990, BONUS & INCENTIVE COMPENSATION FOR THE 2010 CALENDAR YEAR IN THE AMOUNT OF $44,783 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2010 CALENDAR YEAR INCLUDES A BONUS IN AMOUNT OF $44,662 RELATED TO MR. SHUGERT'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010, BUT NOT PAID TO MR. SHUGERT UNTIL AFTER DECEMBER 31, 2010.
Schedule J (Form 990) 2010

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number
04-2103606
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A MA DEVELOPMENT FINANCE AGENCY
  		04-3431814 NONEAVAIL 09-15-2001 120,280,000 REFUND ISSUES DATES 2/11/1998   X   X   X
B MA HLTH & ED FAC AUTH
  		04-2456011 57586C3S2 06-09-2008 377,527,010 REFUND ISSUES DATED 1/19/1989; 9/23/1992; 8/12/2004; & FIN VARIOUS CAP EXP   X   X   X
C MA HLTH & ED FAC AUTH
  		04-2456011 57586CDK8 08-12-2004 187,125,000 REFUND ISSUES DATED 9/23/1992; 11/09/1994   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 35,475,000 35,475,000 146,675,000  
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 120,280,000 378,911,689 187,125,000  
4 Gross proceeds in reserve funds . . 27,256,617 27,256,617    
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . . 119,989,328 204,075,167 177,336,000  
7 Issuance costs from proceeds . . . 290,672 3,929,289 1,796,643  
8 Credit enhancement from proceeds. 7,991,727   7,991,727  
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . . 127,932,058 127,932,058    
11 Other spent proceeds . . 8,993,760 8,993,760    
12 Other unspent proceeds. . . 6,614,451 6,614,451    
13 Year of substantial completion . . . 2011 2011
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X          
15 Were the bonds issued as part of an advance refunding issue?   X   X   X    
16 Has the final allocation of proceeds been made? . . X     X X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X      
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X              
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X              
b Are there any research agreements that may result in private business use of bond-financed property? . . X              
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.600 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0.100 %      
6 Total of lines 4 and 5 . . .. . . . . . 0.700 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X    
2 Is the bond issue a variable rate issue? X     X X      
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X X      
b Name of provider . CITIBANK
  		 
  		CITIBANK
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .   X       X    
e Was a hedge terminated? . X       X      
4a Were gross proceeds invested in a GIC? .   X   X   X    
b Name of provider .  
  		 
  		 
  		 
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .                
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X    
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
PART II, COLUMN A, LINE 1:   138,075,000 OF THE 2004C1&2 PORTION OF THE 2004 ISSUE WAS REFUNDED BY THE 2008 SERIES. 8,600,000 OF 2004D HAS REACHED MATURITY.
PART I LINE F DESCRIPTION OF PURPOSE: PURPOSES OF THE 2008 CAREGROUP SERIES E BONDS: -TO FINANCE OR REFINANCE VARIOUS RENOVATION AND CONSTRUCTION PROJECTS AND CAPITAL EQUIPMENT ACQUISITIONS FOR BIDMC -TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR MAH'S NEW AND EXPANDED FACILITIES WITH APPROXIMATELY 250,000 SQUARE FEET OF NEW AND RENOVATED SPACE TO INCLUDE: A NEW SIX-STORY ACUTE CARE FACILITY TO SUPPORT ADDITIONAL CRITICAL CARE AND MEDICAL /SURGICAL BEDS, EXPANDED OPERATING ROOMS AND INTERVENTIONAL RADIOLOGY ROOMS AND A NEW PARKING GARAGE -TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR NEBH'S MASTER FACILITY PLAN, INCLUDING A NEW ATRIUM OF APPROXIMATELY 2,740 SQUARE FEET, A PRE-OPERATIVE AND POST ANESTHESIA UNIT OF APPROXIMATELY 14, 310 SQUARE FEET, CONSTRUCTION OF A CENTRAL STERILE SUPPLY AREA OF APPROXIMATELY 8,290 SQUARE FEET AND CONSTRUCTION OF NEW OPERATING ROOMS OF APPROXIMATELY 18,615 SQUARE FEET; -TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR BIDN'S NEW AND EXPANDED FACILITIES INCLUDING AN APPROXIMATELY 59,000 SQUARE FOOT PROJECT ON TWO FLOORS TO RENOVATE AND EXPAND SERVICES IN THE EMERGENCY DEPARTMENT, INPATIENT UNITS, RADIOLOGY DEPARTMENT AND ASSOCIATED SUPPORT SERVICES; -TO REFINANCE 201,975,000 OF DEBT PREVIOUSLY ISSUED BY MEMBERS OF THE OBLIGATED GROUP, INCLUDING 138,075,000 OF THE CAREGROUP SERIES C BONDS DESCRIBED BELOW PURPOSES OF THE 2004 CAREGROUP SERIES D BONDS: -REFUNDING OF THE OUTSTANDING PRINCIPAL BALANCE OF THE MOUNT AUBURN HOSPITAL SERIES B BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUSTS DATED JULY 13, 2004 PURPOSES OF CAREGROUP SERIES C BONDS: -REFUNDING OF THE OUTSTANDING PRINCIPAL BALANCE OF THE BETH ISRAEL HOSPITAL ASSOCIATION SERIES G BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUSTS DATED JULY 13, 2004
PART III QUESTIONS 2 AND 3:   FACILITIES FINANCED WITH TAX-EXEMPT BONDS ARE PRIMARILY OCCUPIED BY CAREGROUP AND ITS AFFILIATED TAX-EXEMPT ENTITIES, INCLUDING BUT NOT LIMITED TO BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, NEW ENGLAND BAPTIST HOSPITAL, NEW ENGLAND BAPTIST MEDICAL ASSOCIATES, MOUNT AUBURN HOSPITAL, MOUNT AUBURN PROFESSIONAL SERVICES AND MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP. SOME FINANCED SPACE MAY CONTAIN LEASE ARRANGEMENTS, AND THE AFFILIATES WHICH OWN THE DEBT FINANCED SPACE MAY OPT TO ENGAGE A MANAGEMENT SERVICES COMPANY (IE CLEANING, PATIENT TRANSPORT, FOOD SERVICES) OR ENGAGE IN RESEARCH PURSUANT TO RESEARCH AGREEMENTS WITHIN TAX EXEMPT DEBT FINANCED SPACE. ANY SUCH AGREEMENTS IN PLACE AS OF SEPTEMBER 30, 2011 WERE REVIEWED TO ENSURE PROPER ACCOUNTING OF ANY PRIVATE USE GENERATED FROM SUCH ACTIVITIES. IN ADDITION, SUCH AGREEMENTS ARE GENERALLY REVIEWED BY INSIDE COUNSEL PRIOR TO FINALIZING.
SCHEDULE K - EXPLANATORY STATEMENT   CAREGROUP, INC., (CAREGROUP) IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, THAT SERVES AS A SUPPORT ORGANIZATION AND OVERSEES A REGIONAL HEALTH CARE DELIVERY SYSTEM COMPRISED OF TEACHING AND COMMUNITY HOSPITALS, PHYSICIAN GROUPS AND OTHER CAREGIVERS. CAREGROUP'S PURPOSES INCLUDE THE SUPPORT OF PERSONALIZED, PATIENT CENTERED CARE AND EXCELLENCE IN MEDICAL EDUCATION AND RESEARCH. CAREGROUP AND SOME OF ITS AFFILIATES JOINTLY BORROW DEBT AS AN OBLIGATED GROUP. THE OBLIGATED GROUP MEMBERS ARE: CAREGROUP, BETH ISRAEL DEACONESS MEDICAL CENTER, MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BID-NEEDHAM, MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) AND MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP (APG). THE INFORMATION REPORTED ON SCHEDULE K FOR BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) REFLECTS THE COMBINED CAREGROUP OBLIGATED GROUP DEBT ISSUED AFTER DECEMBER 31, 2002 WITH AN OUTSTANDING PRINCIPAL BALANCE IN EXCESS OF $100,000.
PART II, COLUMN B, LINE 3:   THE DIFFERENCE BETWEEN THE TOTAL PROCEEDS OF THE ISSUE AND THE ISSUE PRICE IS, 1,348,679 OF INVESTMENTS EARNINGS EARNED TO DATE.
PART II, COLUMN B, LINE 11:   THIS AMOUNT WAS SPENT ON THE TERMINATION OF THE 2004 SWAP AGREEMENT.
PART II, COLUMN A,B&C, LINE 6:   THE AMOUNTS LISTED IN THE REFUNDING ESCROW ARE THE REFUNDING PROCEEDS OF THE ISSUES BUT AS OF THE FISCAL YEAR END ONLY 1,187,000 OF PROCEEDS REMAIN IN THE 2011 ESCROW, ALL OTHER PROCEEDS HAVE BEEN DISBURSED.
Schedule K (Form 990) 2010

Additional Data


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Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) STEPHEN ZINNER MD TRUSTEE 141,130 SEE BELOWSTEPHEN ZINNER, MD, CHAIR OF THE DEPARTMENT OF MEDICINE AND A MEMBER OF THE MAH BOARD OF TRUSTEES, ALSO SERVES ON THE BOARD OF THE INSTITUTE FOR COMMUNITY HEALTH IN CAMBRIDGE. DURING THE PERIOD COVERED BY THIS FILING, MAH MADE PAYMENTS OF $141,130 TO THE INSTITUTE FOR COMMUNITY HEALTH, TO FURTHER ITS MISSION OF IMPROVING COMMUNITY HEALTH.   No
(2) DR SUSAN ABOOKIRE FAMILY MEMBER 241,629 SEE BELOWDR. SUSAN ABOOKIRE, CHAIR OF QUALITY AND SAFETY FOR MOUNT AUBURN HOSPITAL, IS MARRIED TO CHRISTOPHER PECKINS, MD. DR. PECKINS IS EMPLOYED AS A PRIMARY CARE PHYSICIAN BY MAPS, A SUPPORTING ORGANIZATION OF MAH. HIS SALARY AND OTHER INCOME INCLUDE:BASE COMPENSATION: $210,852INCENTIVE COMPENSATION: $21,479OTHER REPORTABLE COMPENSATION: $825CONTRIBUTION TO EMPLOYEE BENEFIT PLANS INCLUDES:DEFERRED COMPENSATION: $8,273NON-TAXABLE BENEFITS: $200   No
(3) PATSY AND GEORGE CONRADES FORMER TRUSTEE 17,920,779 SEE BELOWPATSY CONRADES AND GEORGE CONRADES, ARE HUSBAND AND WIFE AND EACH IS A FORMER MEMBER OF THE MAH BOARD OF TRUSTEES. GEORGE CONRADES IS ALSO A MEMBER OF THE CARDINAL HEALTH BOARD OF DIRECTORS. DURING THE PERIOD COVERED BY THIS FILING, MAH MADE PAYMENTS TO CARDINAL HEALTH IN THE AMOUNT OF $17,920,779 FOR MEDICAL/SURGICAL SUPPLIES, PHARMACEUTICALS AND MEDICATIONS. AMOUNTS PAID FOR THESE ITEMS REPRESENT FAIR MARKET VALUE.   No
(4) KATHERINE RAFFERTY FAMILY MEMBER 96,107 SEE BELOWKATHERINE RAFFERTY, SISTER OF JAMES RAFFERTY WHO IS ONE OF THE MAH TRUSTEES, SERVES AS DIRECTOR OF COMMUNITY RELATIONS FOR MAH. HER SALARY AND OTHER INCOME INCLUDES:BASE COMPENSATION: $83,808INCENTIVE COMPENSATION: $500OTHER REPORTABLE COMPENSATION: $65CONTRIBUTION TO EMPLOYEE BENEFIT PLANS INCLUDES:DEFERRED COMPENSATION: $4,322NON-TAXABLE BENEFITS: $7,412   No
(5) A KIM SAAL MD FAMILY MEMBER 112,320 SEE BELOW A. KIM SAAL, MD, A TRUSTEE AND THE CHIEF OF CARDIOLOGY AT MAH AND A MEMBER OF THE CAREGROUP BOARD OF DIRECTORS, IS MARRIED TO JANICE SAAL, MD, A DIRECTOR OF ASSOCIATED SURGEONS, P.C (ASPC). ASPC PROVIDED MEDICAL SERVICES TO MAPS, A SUPPORTING ORGANIZATION OF MAH AND A MEMBER OF THE CAREGROUP NETWORK OF AFFILIATED ENTITIES. CHARGES FOR THOSE SERVICES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2011 WERE $112,320.   No
(6) AKIM SAAL MD TRUSTEE 431,950 SEE BELOWA.KIM SAAL, MD, A TRUSTEE AND THE CHIEF OF CARDIOLOGY AT MAH AND A MEMBER OF THE CAREGROUP BOARD OF DIRECTORS, IS ALSO AN OFFICER AND DIRECTOR OF MOUNT AUBURN CARDIOLOGY ASSOCIATES, INC. (MACA). MACA PROVIDED MEDICAL SERVICES TO MAH DURING THE PERIOD COVERED BY THIS FILING. CHARGES FOR THESE SERVICES TOTALED $328,750 IN ADDITION, MACA MADE PAYMENTS TO MAH FOR RENT AND PARKING SERVICES TOTALING $103,200. ALL PAYMENTS REFLECT FAIR MARKET VALUE RATES.   No
(7) MICHAEL SHORTSLEEVE MD TRUSTEE 322,578 SEE BELOWMICHAEL SHORTSLEEVE, M.D., A MEMBER OF THE MAH BOARD OF TRUSTEES AND CHAIR OF THE MAH DEPARTMENT OF RADIOLOGY, IS THE PRESIDENT OF SCHATZKI ASSOCIATES. SCHATZKI ASSOCIATES PROVIDED RADIOLOGY AND TEACHING SERVICES TO MAH. CHARGES FOR THOSE SERVICES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2010 WERE $322,578. THE FEES PAID TO SCHATZKI REFLECTED FAIR MARKET VALUE RATES.   No
(8) KARLA HANIFY FAMILY MEMBER 30,848 SEE BELOWKARLA HANIFY, IS THE DAUGHTER OF JOHN HANIFY, WHO SERVED ON THE MAH BOARD OF TRUSTEES THROUGH DECEMBER 31, 2008. MS. HANIFY'S SALARY AND OTHER INCOME INCLUDE:BASE COMPENSATION: $30,723INCENTIVE COMPENSATION: $125OTHER REPORTABLE COMPENSATION: $0CONTRIBUTION TO EMPLOYEE BENEFIT PLANS INCLUDES:DEFERRED COMPENSATION: $0NON-TAXABLE BENEFITS: $0   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
    MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 SCHEDULE L PART IV AND MASSACHUSETTS FORM PC AS MAH AND MAPS RESPECTIVELY.
    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. MOUNT AUBURN HOSPITAL (MAH) MAINTAINS AN ACCOUNTABLE BUSINESS EXPENSE REIMBURSEMENT PLAN. FROM TIME TO TIME, MAH MAY REIMBURSE ITS OFFICERS, DIRECTORS/TRUSTEES AND/OR KEY EMPLOYEES FOR EXPENSES THEY INCURRED AND WHICH ARE PROPERLY ORDINARY AND NECESSARY BUSINESS EXPENSES OF THE REPORTING ENTITY. THE POLICIES AND PROCEDURES REQUIRED BY THE ACCOUNTABLE BUSINESS PLAN MUST BE FOLLOWED IN ORDER TO RECEIVE REIMBURSEMENT FOR SUCH EXPENSES AND IT IS POSSIBLE THAT ONE OR MORE INDIVIDUALS RECEIVED NON-TAXABLE REIMBURSEMENTS WHICH TOTALED $10,000 OR MORE DURING THE FISCAL PERIOD COVERED BY THIS FILING.ALL OF THE ABOVE TRANSACTIONS WERE NEGOTIATED AT ARMS LENGTH AND IN ACCORDANCE WITH THE MOUNT AUBURN HOSPITAL CONFLICT OF INTEREST POLICY AND REFLECT FAIR MARKET PAYMENTS AND RATES.
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 8 85,974 COST OR SELLING PRICE
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
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 to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Identifier Return Reference Explanation
  FORM 990, PART I LINE 1 & PART III, LINE 1 MOUNT AUBURN HOSPITAL'S PRIMARY PURPOSE IS TO IMPROVE THE HEALTH OF THE RESIDENTS OF CAMBRIDGE, MA AND THE SURROUNDING COMMUNITIES. OUR SERVICES ARE DELIVERED IN A PERSONABLE, CONVENIENT AND COMPASSIONATE MANNER, WITH RESPECT FOR THE DIGNITY OF OUR PATIENTS AND THEIR FAMILIES.
INPATIENT MEDICAL SERVICES FORM 990, PART III LINE 4A SURGEONS IN MOUNT AUBURN HOSPITAL'S GENERAL SURGERY DIVISION USE THE LATEST TECHNOLOGIES COMBINED WITH ADVANCED SURGICAL EXPERTISE TO PERFORM SURGERIES THAT ARE AS MINIMALLY INVASIVE AND PAINLESS AS POSSIBLE. OUR SURGEONS PERFORM BOTH ELECTIVE AND EMERGENT SURGERIES. ELECTIVE SURGERY INVOLVES A COMBINATION OF DIAGNOSTIC AND INTERVENTIONAL PROCEDURES RESULTING IN PERTINENT FOLLOW-UP WITH THE PATIENT'S REFERRING PHYSICIAN. IT IS PLANNED FOR AND SCHEDULED IN ADVANCE. EMERGENT SURGERY IS MOST OFTEN THE RESULT OF A MEDICAL EMERGENCY, SUCH AS AN APPENDICITIS ATTACK, AND IS MOST OFTEN REFERRED FROM THE EMERGENCY DEPARTMENT PHYSICIAN. IN EITHER SITUATION, MOUNT AUBURN'S SURGEONS ARE AVAILABLE TWENTY-FOUR HOURS A DAY, SEVEN DAYS A WEEK, TO ENSURE THAT PATIENTS RECEIVE THE MOST ADVANCED TREATMENT POSSIBLE. OUR SURGEONS FOCUS ON A DUAL MISSION OF CLINICAL CARE AND PATIENT EDUCATION. BECAUSE WE ARE A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL, WE ARE ABLE TO OFFER MORE SURGICAL SERVICES THAN MOST HOSPITALS OF OUR SIZE, INCLUDING NEUROSURGERY AND CARDIOVASCULAR SURGICAL PROCEDURES, AS WELL AS CONTINUAL SURGICAL RESPONSES IN ALL DISCIPLINES. HOWEVER, WE ARE SMALL ENOUGH TO OFFER PERSONALIZED CARE THROUGHOUT A PATIENT'S SURGERY, INCLUDING PREPARATION AND RECOVERY. OUR INSTITUTION IS ENRICHED BY THE ENTHUSIASM OF OUR MEDICAL RESIDENTS. ALONG WITH PRIMARY CARE (INTERNAL MEDICINE) AND GENERAL SURGERY, MOUNT AUBURN HOSPITAL STAFFS PHYSICIANS WHO SPECIALIZE IN A WIDE VARIETY OF MEDICAL AND SURGICAL DISCIPLINES INCLUDING, ALLERGY, ANESTHESIOLOGY, CARDIOLOGY, CARDIOVASCULAR AND THORACIC SURGERY, DERMATOLOGY, EAR NOSE AND THROAT, EMERGENCY MEDICINE, ENDOCRINOLOGY AND METABOLISM, FAMILY MEDICINE, GASTROENTEROLOGY, GERIATRIC MEDICINE, HAND SURGERY, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASES, NEPHROLOGY, NEUROLOGY, NEUROSURGERY, OCCUPATIONAL HEALTH, OPHTHALMOLOGY, ORAL SURGERY, ORTHOPEDIC SURGERY, PATHOLOGY, PLASTIC SURGERY, PODIATRY, PULMONARY MEDICINE, RHEUMATOLOGY, UROLOGY AND VASCULAR SURGERY. DURING FISCAL 2011, MOUNT AUBURN HOSPITAL HAD 167 LICENSED MEDICAL/SURGICAL BEDS, AND PROVIDED INPATIENT MEDICAL SERVICES TO 7,055 PATIENTS, AND INPATIENT SURGICAL SERVICES TO 2,267 PATIENTS.
RADIOLOGIC SERVICES FORM 990, PART III LINE 4B AT MOUNT AUBURN HOSPITAL'S RADIOLOGY DEPARTMENT, WE PROVIDE COMPASSIONATE, PROFESSIONAL CARE THROUGH OUR HIGHLY-SKILLED TEAM OF BOARD-CERTIFIED RADIOLOGISTS, TECHNOLOGISTS AND NURSES. WE COLLABORATE WITH THE PATIENT'S PERSONAL PHYSICIAN AND OTHER EXPERIENCED HEALTHCARE PROFESSIONALS, WORKING TOWARD THE SINGULAR GOAL OF PATIENT SATISFACTION BY ENSURING DETAILED, ACCURATE DIAGNOSES AND OPTIMAL TREATMENT PLANS. WE ENSURE THE PATIENT'S PRIVACY AT ALL STAGES OF TREATMENT, INCLUDING TRANSMISSION AND DISTRIBUTION OF FILMS AND REPORTS. OUR RADIOLOGY DEPARTMENT UTILIZES THE LATEST IMAGING TECHNOLOGY, INCLUDING ULTRASOUND, DIGITAL RADIOGRAPHY, DIGITAL IMAGING, MULTI DETECTOR CT SCAN, ADVANCED MRI, COMPUTER ASSISTED DIAGNOSIS (CAD), BREAST IMAGING AND A PICTURE ARCHIVING AND COMMUNICATION SYSTEM (PACS). THE COMBINATION OF OUR ADVANCED TECHNOLOGIES AND SKILLED DEPARTMENT MEMBERS ENSURES THAT THE PATIENT WILL REMAIN AS COMFORTABLE AS POSSIBLE DURING THEIR RADIOLOGIC PROCEDURE. IN ADDITION TO OFFERING STATE-OF-THE-ART IMAGING FACILITIES, OUR STAFF STRIVES TO PROVIDE THE PATIENT WITH IMMEDIATE APPOINTMENTS AND TO KEEP THEIR WAIT BETWEEN APPOINTMENTS TO A MINIMUM. AT MOUNT AUBURN HOSPITAL'S DEPARTMENT OF RADIOLOGY, OUR UTILIZATION OF STATE-OF-THE-ART IMAGING TECHNOLOGY, COMBINED WITH THE SERVICES OF OUR HIGHLY-SKILLED, COMPASSIONATE TEAM OF PROFESSIONALS ENSURES THAT THE PATIENT WILL BENEFIT FROM OUR SUPERIOR LEVEL OF CARE. DURING FISCAL 2011, MOUNT AUBURN HOSPITAL PROVIDED OUTPATIENT RADIOLOGY SERVICES TO 79,989 PATIENTS.
INPATIENT OBSTETRICS / NEWBORN SERVICES FORM 990, PART III LINE 4C AT MOUNT AUBURN HOSPITAL, YOU CAN BE ASSURED THAT AN EXCEPTIONAL LEVEL OF CARE AND SUPPORT IS AVAILABLE FOR YOU AND YOUR NEWBORN THROUGHOUT YOUR PREGNANCY AND DELIVERY. WOMEN CAN CHOOSE FROM A VARIETY OF HIGHLY TALENTED PROVIDERS, INCLUDING OBSTETRICIANS, NURSE-MIDWIVES AND NURSE PRACTITIONERS, ALL OF WHOM COLLABORATE WITH EACH OTHER AS NEEDED. THESE PROVIDERS OFFER PERSONAL AND INDIVIDUALIZED CARE, PROVIDING SUPPORT THROUGH LABOR AND ENCOURAGING FAMILY PARTICIPATION. OUR GOAL IS A SAFE AND HEALTHY PREGNANCY AND DELIVERY FOR EACH MOTHER AND BABY. MOUNT AUBURN HOSPITAL OFFERS GUIDANCE, OPTIONS AND A SEASONED TEAM OF PROVIDERS WHO ARE COMMITTED TO DELIVERING INDIVIDUALIZED CARE. WOMEN WHO SEEK A MORE NATURAL APPROACH TO CHILDBIRTH ARE ENCOURAGED AND SUPPORTED. WOMEN WHOSE PREGNANCIES ARE CONSIDERED TO BE HIGH RISK, SUCH AS THOSE HAVING TWINS OR MEDICAL PROBLEMS COMPLICATING THE PREGNANCY, WILL FIND THE SPECIALIZED EXPERTISE AND TECHNOLOGY THAT THEY NEED. THAT INCLUDES OUR LEVEL II NURSERY FOR NEWBORNS WHO REQUIRE EXTRA MEDICAL ATTENTION AND MONITORING DURING THE FIRST DAYS OF LIFE. LABOR, DELIVERY AND POSTPARTUM CARE ARE ALL CENTERED AT THE BIRTHPLACE, MOUNT AUBURN'S OBSTETRICAL UNIT. AFTER DELIVERY, MOST NEW MOTHERS NEED SUPPORT FROM NURSING STAFF AND LACTATION CONSULTANTS ON INFANT CARE AND BREASTFEEDING. MOUNT AUBURN'S BIRTHPLACE IS WHERE NEW MOTHERS AND BABIES RECEIVE ALL THE ATTENTION THEY NEED. AT MOUNT AUBURN, WOMEN CAN CHOOSE FROM A VARIETY OF HIGHLY-QUALIFIED PROVIDERS, INCLUDING OBSTETRICIANS, NURSE-MIDWIVES AND NURSE PRACTITIONERS, ALL OF WHOM COLLABORATE WITH EACH OTHER AS NEEDED IN CARING FOR THEIR PATIENTS. FOR EXAMPLE, IF A WOMAN DEVELOPS COMPLICATIONS DURING PREGNANCY, SHE CAN CONTINUE TO RECEIVE PRENATAL CARE FROM HER NURSE-MIDWIFE, IN ADDITION TO SEEING MATERNAL-FETAL MEDICINE SPECIALISTS ON A REGULAR BASIS. OUR MAIN PROVIDERS INCLUDE: OBSTETRICIANS - DOCTORS WHO SPECIALIZE IN PREGNANCY AND CHILDBIRTH; THEY HAVE THE TRAINING TO PROVIDE THE FULL SCOPE OF OBSTETRICAL PRACTICE, INCLUDING PERFORMING CESAREAN SECTIONS NURSE-MIDWIVES - NURSES WHO SPECIALIZE IN NORMAL PREGNANCY AND CHILDBIRTH AND COLLABORATE WITH OBSTETRICIANS IN CASES WHERE COMPLICATIONS ARISE; NURSE-MIDWIVES SUPPORT WOMEN THROUGHOUT LABOR AND ENCOURAGE FAMILY INVOLVEMENT NURSE PRACTITIONERS - NURSES WITH SPECIALIZED EXPERIENCE IN OBSTETRICS WHO PRACTICE IN COLLABORATION WITH OBSTETRICIANS AND NURSE-MIDWIVES IN PROVIDING PRENATAL CARE MATERNAL-FETAL MEDICINE SPECIALISTS - OBSTETRICIANS WHO HAVE SPECIAL TRAINING IN THE COMPLICATIONS OF PREGNANCY AND CHILDBIRTH MOUNT AUBURN HOSPITAL HAS A TALENTED NURSING STAFF IN PRENATAL/ANTENATAL TESTING, LABOR AND DELIVERY, ON THE POSTPARTUM UNIT AND IN THE NURSERY. ANESTHESIOLOGISTS ARE AVAILABLE 24 HOURS A DAY TO PROVIDE PAIN RELIEF DURING LABOR. IN ADDITION, NEONATOLOGISTS, WHO SPECIALIZE IN CARING FOR NEWBORNS, AND PEDIATRICIANS ARE ON SITE AROUND THE CLOCK TO CARE FOR NEWBORNS. MOUNT AUBURN ALSO OFFERS ADDITIONAL SERVICES TO WOMEN WHO ARE PLANNING TO HAVE THEIR BABIES AT OUR HOSPITAL: FERTILITY SERVICES, INCLUDING OPTIONS, TESTING AND TREATMENT: MANY COUPLES NEED THE EXPERTISE OF A FERTILITY SPECIALIST. MOUNT AUBURN HOSPITAL HAS FERTILITY SPECIALISTS ON STAFF WHO COUNSEL COUPLES ON THE MOST CURRENT AVAILABLE OPTIONS AND DIRECT THE NECESSARY TESTING AND TREATMENT AIMED AT A HEALTHY PREGNANCY AND BIRTH. THIS INCLUDES ACCESS TO IN VITRO FERTILIZATION AND OTHER PROCEDURES. HIGH-RISK PREGNANCY SPECIALISTS: A FULL RANGE OF SERVICES IS AVAILABLE FOR WOMEN WHO ARE EXPERIENCING HIGH-RISK PREGNANCIES. IN THOSE INSTANCES, A MATERNAL-FETAL MEDICINE SPECIALIST, A PHYSICIAN WHO SPECIALIZES IN THE COMPLICATIONS OF PREGNANCY AND CHILDBIRTH, BECOMES PART OF THE TEAM AND SEES THE WOMAN ON A REGULAR BASIS. NURSERIES, CARING FOR YOUR BABY: MOST NEWBORNS SPEND MOST OF THE DAY WITH THEIR MOTHERS. WHEN NEWBORNS NEED SPECIAL CARE, THEY STAY IN THE HOSPITAL'S LEVEL II NURSERY, WHICH IS STAFFED BY NEONATOLOGISTS AND NEONATAL NURSES. BY STAYING AT MOUNT AUBURN, WHERE A PEDIATRICIAN IS ON SITE 24 HOURS A DAY, BABIES REMAIN CLOSE TO THEIR FAMILY MEMBERS WHILE A PEDIATRICIAN IS AROUND THE CORNER IF NEEDED. IN ALL PREGNANCIES, A SAFE AND HEALTHY DELIVERY FOR MOTHER AND BABY IS THE PRIORITY. THE ADDITIONAL GOAL IS TO MAKE PRENATAL CARE AND CHILDBIRTH A SMOOTH, WELL-COORDINATED EXPERIENCE. THE BAIN BIRTHING CENTER THE BAIN BIRTHING CENTER AT MOUNT AUBURN HOSPITAL PROVIDES A COMFORTABLE, HOME-LIKE SETTING FOR CHILDBIRTH, BUT WITH ALL THE ADVANCED TECHNOLOGY THAT MIGHT BE NEEDED. MOUNT AUBURN IS PROUD TO OFFER TOP-NOTCH PRENATAL AND ANTENATAL FACILITIES IN AN INTIMATE SETTING. BIRTH AT MOUNT AUBURN IS AN INCLUSIVE EXPERIENCE. THE BAIN BIRTHING CENTER FEATURES A WARM, PERSONAL AND NURTURING ATMOSPHERE, PAYING SPECIAL ATTENTION TO THE COMFORT OF THE MOTHER BY OFFERING SPECIAL FEATURES LIKE JACUZZI TUBS, RESTAURANT-STYLE MEALS, PARTNER CHAIRS THAT RECLINE INTO BEDS FOR FATHERS OR OTHER SUPPORT PERSONS, AND ROOMS FEATURING VIEWS OF THE CHARLES RIVER AND BOSTON SKYLINE. IN CASES WHERE A CAESARIAN SECTION NEEDS TO BE PERFORMED, SURGICAL SUITES ARE LOCATED ADJACENT TO THE LABOR AND DELIVERY AREA. A STATE-OF-THE-ART MONITORING SYSTEM ALLOWS WOMEN TO SAFELY WALK AROUND THE UNIT WHILE THEY ARE IN LABOR. AT THE MOUNT AUBURN HOSPITAL BAIN BIRTHING CENTER, WE OFFER CHOICE. PAIN RELIEF DURING LABOR IS AN ISSUE THAT EACH WOMAN SHOULD EXPLORE WITH HER PROVIDER. MANY WOMEN CHOOSE TO HAVE AN EPIDURAL, BUT PROVIDERS AT MOUNT AUBURN, ESPECIALLY NURSE-MIDWIVES, ALSO SUPPORT ALTERNATIVE METHODS SUCH AS PRESSURE-POINT MASSAGE, AND HYPNO-BIRTHING (SELF-HYPNOSIS DURING THE BIRTH PROCESS). WOMEN WHO SEEK AN ALTERNATIVE APPROACH TO CHILDBIRTH ITSELF, SUCH AS A WATER BIRTH, WILL ALSO FIND NURSE-MIDWIVES TO HELP THEM WITH SUCH OPTIONS. IN CASES WHERE A CAESARIAN SECTION NEEDS TO BE PERFORMED, SURGICAL SUITES ARE LOCATED ADJACENT TO THE LABOR AND DELIVERY AREA. AT MOUNT AUBURN HOSPITAL, WE PROVIDE SUPPORT AND INFORMATION; PRIVACY AND CHOICE. THE POSTPARTUM NURSING STAFF PROVIDE NEW MOTHERS WITH ONE-ON-ONE CARE AND EDUCATION. THE BAIN BIRTHING CENTER OFFERS A VARIETY OF SERVICES FOR PREGNANT AND NEW MOTHERS, INCLUDING CHILDBIRTH EDUCATION CLASSES, BIRTHPLACE TOURS AND BREAST PUMP RENTALS. SERVICES FOR NON-ENGLISH SPEAKING PATIENTS INCLUDE STAFF INTERPRETERS, SPANISH-SPEAKING NURSE-MIDWIVES AND INTERPRETER SERVICES FOR VARIOUS LANGUAGES AND ACCESS TO 24-HOUR TELEPHONE INTERPRETER SERVICES FOR MORE THAN 100 LANGUAGES. ONCE FAMILIES LEAVE THE BAIN BIRTHING CENTER, THEY HEAD HOME KNOWING THAT THE NURSING STAFF IS AVAILABLE AFTER DISCHARGE TO ANSWER ANY QUESTIONS THAT MAY ARISE ABOUT THE HEALTH OF MOTHER AND BABY 24 HOURS A DAY. LEVEL II NURSERY IF YOUR NEWBORN NEEDS SPECIAL CARE, REST ASSURED THAT MOUNT AUBURN'S LEVEL II NURSERY IS EQUIPPED TO ADDRESS YOUR INFANT'S CRITICAL HEALTH ISSUES, INCLUDING PREMATURITY, MEDICAL AND FEEDING DIFFICULTIES. THIS SEVEN-BED NURSERY IS STAFFED BY A HIGHLY SKILLED TEAM OF NEONATOLOGISTS AND NEONATAL NURSES WHO ARE CERTIFIED TO RESUSCITATE AND ALSO TO STABILIZE AND PREPARE CRITICALLY ILL INFANTS FOR TRANSFER TO A BOSTON-AREA LEVEL III NURSERY IN THE EVENT OF AN EMERGENCY. OUR NURSERY HAS A SPECIALIST PEDIATRICIAN ON CALL 24 HOURS A DAY, AS WELL AS 'ROUND THE CLOCK NEONATAL BACKUP COVERAGE. ANESTHESIA IS AVAILABLE 24 HOURS A DAY, AS WELL. IN ADDITION TO OUR EXPERT OBSTETRIC TEAM, MOUNT AUBURN'S LEVEL II NURSERY FEATURES STATE-OF-THE-ART MONITORING EQUIPMENT FOR OUR NEONATES. IF YOUR NEWBORN IS SERIOUSLY ILL, YOU CAN BE ASSURED THAT HE OR SHE WILL RECEIVE THE BEST CARE POSSIBLE IN MOUNT AUBURN'S LEVEL II NURSERY. DURING FISCAL 2011, MOUNT AUBURN HOSPITAL HAD 20 LICENSED OB/GYN BEDS PROVIDING SERVICES TO 2,271 PATIENTS AND 25 BASSINETS PROVIDING INPATIENT SERVICES TO 2,340 NEWBORNS.
OTHER FORM 990, PART III LINE 4D MOUNT AUBURN HOSPITAL'S NUMEROUS CLINICAL STRENGTHS ARE THE RESULT OF A COMMITMENT TO EXCELLENCE BY THE HOSPITAL AND ITS STAFF, WHICH INCLUDES RECOGNIZED AND RESPECTED PROFESSIONALS, AS WELL AS TALENTED STUDENTS AND TRAINEES WHO COME TO MOUNT AUBURN HOSPITAL FOR THE OUTSTANDING EDUCATIONAL OPPORTUNITIES IT PROVIDES. THIS COMMITMENT BY OUR STAFF IS MATCHED BY THE CUTTING-EDGE CLINICAL TECHNOLOGY USED THROUGHOUT THE HOSPITAL. AT MOUNT AUBURN, OUR PATIENTS RECEIVE CARE THAT IS FIRST-RATE, AS WELL AS COMPASSIONATE. MOUNT AUBURN HOSPITAL'S CLINICAL SERVICES BEYOND THOSE LISTED ABOVE INCLUDE: CANCER CARE, DIABETES EDUCATION, EMPLOYEE ASSISTANCE PROGRAM, OUTPATIENT SURGERY, NUTRITION SERVICES, OCCUPATIONAL HEALTH, PEDIATRICS, PHARMACY, PREVENTION AND RECOVERY, PSYCHIATRY, QUALITY AND SAFETY, REHABILITATION, HOME CARE, LABORATORY, TRAVEL MEDICINE, UROGYNECOLOGY AND WALK-IN CLINIC. DURING FISCAL 2011, MOUNT AUBURN HOSPITAL HAD 16 LICENSED INPATIENT PSYCHIATRY BEDS, AND PROVIDED INPATIENT PSYCHIATRY SERVICES TO 271 PATIENTS. THE HOSPITAL HAS A 24 HOUR EMERGENCY DEPARTMENT THAT SERVICED 37,595 VISITS. IN ADDITION, THE HOSPITAL PROVIDED A VARIETY OF OUTPATIENT SERVICES TO MORE THAN 170,000 PATIENTS IN VARIOUS SPECIALTIES LISTED ABOVE, AND CONDUCTED MORE THAN 80,000 VISITS TO PATIENTS' HOMES THROUGH OUR HOME CARE DEPARTMENT. FOR ADDITIONAL INFORMATION ON MAH'S ACCOMPLISHMENTS AND HOW IT HELPS SUPPORT CAMBRIDGE AND THE SURROUNDING COMMUNITIES, PLEASE SEE THE ATTACHED MOUNT AUBURN HOSPITAL COMMUNITY BENEFITS STATEMENT WHICH IS INCLUDED IN SCHEDULE H.
  FORM 990 PART IV QUESTION 12 AS DESCRIBED IN THIS FILING, MOUNT AUBURN HOSPITAL (MAH) IS A PUBLIC CHARITY AND A REGIONAL TEACHING HOSPITAL, EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THE FINANCIAL RECORDS OF MAH ARE AUDITED EACH YEAR AS PART OF THE MAH CONSOLIDATED AUDITED FINANCIAL STATEMENT PROCESS AND FOR THE FISCAL PERIOD COVERED BY THIS FILING, THE AUDIT WAS PREPARED AND SIGNED BY THE BOSTON, MA OFFICE OF KPMG.
  FORM 990 PART IV QUESTION 24A AS DESCRIBED IN THIS FORM 990, CAREGROUP, INC., IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, IS A SUPPORT ORGANIZATION OF AND SOLE MEMBER OF MOUNT AUBURN HOSPITAL (MAH). MAH IS A MEMBER OF THE CAREGROUP OBLIGATED GROUP AND ITS TAX EXEMPT BOND FINANCING IS ISSUED THROUGH CAREGROUP. THE SCHEDULE K AS INCLUDED IN THIS FORM 990 INCLUDES ALL OF THE CAREGROUP OBLIGATED GROUP OUTSTANDING DEBT FOR BONDS ISSUED AFTER DECEMBER 31, 2002 ONLY A PORTION OF WHICH IS ALLOCABLE TO AND REPORTED ON THE BALANCE SHEET OF MAH.
  FORM 990 PART IV QUESTION 24B PROCEEDS IN THE PROJECT FUND WERE UNEXPECTEDLY HELD BEYOND THE THREE-YEAR TEMPORARY PERIOD, BUT WERE YIELD RESTRICTED IN COMPLIANCE WITH FEDERAL TAX REQUIREMENTS.
FORM 990, PART VI, SECTION A, LINE 2   THE FOLLOWING INDIVIDUALS HAVE BUSINESS RELATIONSHIPS WHICH ARISE FROM THEIR ROLES AS OFFICERS AND/OR TRUSTEES OF CAMBRIDGE TRUST COMPANY: JEANETTE CLOUGH LEON PALANDJIAN JOSEPH ROLLER
FORM 990, PART VI, SECTION A, LINE 6   EXPLANATION OF CLASSES OF MEMBERS OR SHAREHOLDERS. CAREGROUP, INC., AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) OF 1986, AS AMENDED AND A SUPPORT ORGANIZATION OF MOUNT AUBURN HOSPITAL (MAH). ACTING THROUGH ITS BOARD OF DIRECTORS, CAREGROUP IS THE SOLE MEMBER OF MAH.
FORM 990, PART VI, SECTION A, LINE 7A   ACCORDING TO MAH BYLAWS, CAREGROUP APPROVES GROUP 2 TRUSTEES WHICH COMPOSE UP TO 21 OF A MAXIMUM OF 28 TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B   THE MEMBER RESERVES THE RIGHT TO SELECT THE CORPORATION'S INDEPENDENT AUDITORS AND HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS PRIOR TO IMPLEMENTATION THEREOF: - ESTABLISHMENT OR MODIFICATION OF COMPENSATION OF OR REMOVAL OF THE CHIEF EXECUTIVE OFFICER, IF ANY, OR PRESIDENT OF THE CORPORATION - ENTERING INTO CONTRACTS WHICH BIND THE CORPORATION AND WHICH ARE MANAGED CARE CONTRACTS, EXCLUSIVE CONTRACTS, AGREEMENTS-NOT-TO-COMPETE OR USE SIMILAR ARRANGEMENTS, CONTRACTS FOR MANAGEMENT SERVICES OR OTHER MULTI-YEAR SERVICE CONTRACTS WITH POTENTIALLY SIGNIFICANT MULTI-YEAR BUDGETARY IMPACT - ADOPTION OF A MISSION STATEMENT AND STRATEGIC, FINANCIAL AND OPERATIONAL PLAN FOR THE CORPORATION - ADOPTION OF AN ANNUAL OPERATING BUDGET AND ALL CAPITAL BUDGETS - THE BORROWING OF, OR INCIDENCE OF DEBT IN, ANY AMOUNT OTHER THAN (I) FOR PURPOSE OF SECURING WORKING CAPITAL FROM A LENDER WHICH SHALL HAVE BEEN APPROVED BY THE MEMBER AND PURSUANT TO THEN EXISTING AND PROVISIONS RELATING TO SUCH BORROWING WHICH SHALL HAVE BEEN APPROVED BY THE MEMBER, AND (II) DEBT INCURRED IN THE ORDINARY COURSE OF BUSINESS WHICH IS ANTICIPATED IN AND CONSISTENT WITH THE ANNUAL OPERATING BUDGET OR A CAPITAL BUDGET WHICH SHALL HAVE BEEN APPROVED BY THE MEMBER FOR THE YEAR IN WHICH INCURRED - ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE CORPORATION, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION OR THE ADDITION OR ELIMINATION OF ANY CLINICAL DEPARTMENT OR PROGRAM, WHICH DEPARTMENT OR PROGRAM COULD REASONABLY BE ANTICIPATED TO MATERIALLY AFFECT THE FINANCIAL STATUS OF THE CORPORATION, OR ITS ABILITY TO CONDUCT ITS BUSINESS, OR THE ENTERING INTO OF ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE ENTITY - INITIATION OF ANY BANKRUPTCY OR INSOLVENCY ACTION ON BEHALF OF THE CORPORATION OR ANY SUBSIDIARY THEREOF.
FORM 990, PART VI, SECTION B, LINE 11   THE FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER OF MOUNT AUBURN HOSPITAL (MAH), THE TAX DIRECTOR OF CAREGROUP, WHICH IS THE MEMBER OF MAH AND DELOITTE TAX, LLP. THE COMPLETE FORM 990 IS PRESENTED TO THE AUDIT COMMITTEE OF MAH FOR REVIEW AND DISCUSSION. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF THE BOARD OF TRUSTEES OF THE FILING ENTITY PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE.
  FORM 990, PART VI, SECTION B, LINE 12C MOUNT AUBURN HOSPITAL (MAH) HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO BOTH MAH AND ITS AFFILIATE, MOUNT AUBURN PROFESSIONAL SERVICES (MAPS). PURSUANT TO THAT POLICY, ALL OFFICERS, TRUSTEES AND KEY EMPLOYEES OF BOTH ENTITIES ARE ASKED TO COMPLETE AN ANNUAL CONFLICT DISCLOSURE STATEMENT WHICH IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS RELATIONSHIPS MAINTAINED BY OFFICERS, TRUSTEES OR KEY EMPLOYEES AND THEIR FAMILY MEMBERS WHICH MAY RESULT IN A CONFLICT OF INTEREST. IN ADDITION, ANY INDIVIDUAL WHO COMMENCES A TERM AS AN OFFICER, DIRECTOR, TRUSTEE OR KEY EMPLOYEE IS REQUIRED TO COMPLETE THE ANNUAL CONFLICT DISCLOSURE AT THE TIME SUCH POSITION COMMENCES. ALL ANNUAL DISCLOSURES ARE REVIEWED BY THE MAH OFFICE OF GENERAL COUNSEL FOR DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT AND ANY ACTIVITY THAT REQUIRES ACTION UNDER THE CONFLICT OF INTEREST POLICY IS SUBJECT TO ONGOING REVIEW AND ACTION THROUGH THE GENERAL COUNSEL'S OFFICE. PURSUANT TO THE CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A PLAN TO REQUIRE DISCLOSURE AND RECUSAL, INCLUDING APPROPRIATE DOCUMENTATION IN THE MINUTES. CAREGROUP, INC. IS THE SOLE MEMBER OF MAH. IN ADDITION TO THE CONFLICET OF INTEREST PROCESS OUTLINED ABOVE, THE MAH OFFICE OF THE GENERAL COUNSEL AND THE CAREGROUP TAX DEPARTMENT JOINTLY ISSUE A TAX QUESTIONNAIRE TO ALL CURRENT AND FORMER MEMBERS OF THE BOARD OF TRUSTEES AS WELL AS CURRENT OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR MAH TO COMPLETELY AND ACCURATELY PROCESS AND COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS.
  FORM 990, PART VI, SECTION B, LINE 15 MOUNT AUBURN HOSPITAL (MAH) HAS A COMPENSATION COMMITTEE (THE "COMMITTEE")THAT IS COMPRISED OF SIX MEMBERS OF THE BOARD OF TRUSTEES INCLUDING THE CURRENT CHAIRMAN OF THE BOARD OF TRUSTEES AND THE MAH CEO, WHO SERVES ON THE COMMITTEE AS AN "EX OFFICIO" MEMBER WITHOUT VOTING RIGHTS. ALL OTHER MEMBERS OF THE COMMITTEE ARE INDEPENDENT. THE COMMITTEE OPERATES TO FULFILL THE FOLLOWING RESPONSIBILITIES: - TO REVIEW AND APPROVE THE TOTAL COMPENSATION OF EACH MEMBER OF THE HOSPITAL'S SENIOR MANAGEMENT TEAM SO AS TO ENSURE THAT SUCH COMPENSATION REMAINS COMPETITIVE IN THE MARKETPLACE, REPRESENTS GOOD VALUE TO THE HOSPITAL FOR THE QUALITY AND QUANTITY OF SERVICES PROVIDED AND CONSTITUTES REASONABLE TOTAL COMPENSATION TO THE EMPLOYEE IN LIGHT OF THE EMPLOYEE'S POSITION, RESPONSIBILITIES, QUALIFICATIONS AND PERFORMANCE IN ACCORDANCE WITH INTERNAL AND EXTERNAL REASONABLE COMPENSATION STANDARDS APPLICABLE TO THIS TAX EXEMPT HOSPITAL - TO RECOMMEND TO THE BOARD OF TRUSTEES THE TERMS AND CONDITIONS OF ANY EMPLOYMENT AGREEMENTS BETWEEN THE HOSPITAL AND ITS PRESIDENT/CHIEF EXECUTIVE OFFICER INCLUDING BASE SALARIES, INCENTIVE COMPENSATION, SUPPLEMENTAL EMPLOYEE RETIREMENT PLANS, BENEFITS AND OTHER LAWFUL METHODS OF REASONABLE COMPENSATION - TO RECOMMEND TO THE BOARD OF TRUSTEES FOR THE BOARD'S APPROVAL THE TERMS AND CONDITIONS OF ANY SUPPLEMENTAL EMPLOYEE RETIREMENT PLANS FOR HOSPITAL EXECUTIVES - TO REVIEW AND APPROVE THOSE PORTIONS OF THE FEDERAL FORM 990 AND THE MASSACHUSETTS FORM PC, OR THEIR EQUIVALENTS, PERTAINING TO THE COMPENSATION OF HOSPITAL EMPLOYEES PRIOR TO THE HOSPITAL'S FILING OF SUCH FORMS WITH THE REGULATORY AUTHORITIES - AS DETERMINED TO BE ADVISABLE BY THE COMMITTEE FROM TIME TO TIME, TO ENGAGE OUTSIDE COMPENSATION CONSULTANTS AND LEGAL AND OTHER ADVISORS TO PROVIDE TO THE COMMITTEE APPROPRIATE AND RELIABLE COMPARABLE COMPENSATION DATA FOR SIMILARLY SITUATED EMPLOYEES OF NATIONAL, REGIONAL AND LOCAL PEER INSTITUTIONS AND OTHER EXPERT ADVICE TO ASSIST THE COMMITTEE IN FULFILLING ITS RESPONSIBILITIES - TO WORK WITH THE HOSPITAL'S MANAGEMENT AND AUDITORS TO RESOLVE, OR TO RECOMMEND TO THE BOARD OF TRUSTEES RESOLUTION OF, ANY ISSUES OF CONCERN PERTAINING TO THE COMPENSATION OF HOSPITAL EMPLOYEES THAT MAY ARISE DURING THE COURSE OF THE HOSPITAL'S INDEPENDENT AUDIT OR MAY BE PRESENTED IN THE INDEPENDENT AUDITOR'S MANAGEMENT LETTER TO THE HOSPITAL - TO REVIEW AND APPROVE EMPLOYEE BENEFITS PROGRAMS INCLUDING WELFARE, FRINGE AND RETIREMENT PLANS AND PROGRAMS, AND ANY MATERIAL AMENDMENTS THERETO - TO ADOPT SUCH POLICIES AND PROCEDURES AS THE COMMITTEE MAY DETERMINE FROM TIME TO TIME TO BE NECESSARY OR USEFUL TO ENSURE THAT THE HOSPITAL PAYS REASONABLE AND COMPETITIVE COMPENSATION TO ITS MANAGEMENT TEAM WHILE PRESERVING THE TAX EXEMPT STATUS OF THE HOSPITAL - TO REVIEW AND REASSESS THE COMMITTEE'S CHARTER FROM TIME TO TIME AND TO RECOMMEND ANY PROPOSED CHANGES TO THE HOSPITAL'S BOARD OF TRUSTEES FOR ITS CONSIDERATION AND APPROVAL. THE COMMITTEE MEETS SEVERAL TIMES DURING THE YEAR TO REVIEW AND APPROVE INDIVIDUAL PERFORMANCE GOALS FOR MANAGEMENT AND THE CEO, TO REVIEW PERFORMANCE AGAINST SUCH GOALS, TO APPROVE INCENTIVE COMPENSATION PAYMENTS TO MANAGEMENT, TO RECOMMEND COMPENSATION PAYMENTS TO THE CEO FOR APPROVAL BY THE TRUSTEES IN COMMITTEES TO APPROVE SALARY ADJUSTMENTS FOR THE NEXT YEAR. FURTHER, THE COMMITTEE WILL ADDRESS AS REQUIRED ANY CHANGES IN INDIVIDUAL OR GROUP COMPENSATION ARRANGEMENTS AT SUCH MEETINGS. THE COMMITTEE UNDERSTANDS THAT ONE OF ITS CORE RESPONSIBILITIES IS TO ENSURE THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT ALL ARRANGEMENTS COMPLY WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE COMPENSATION COMMITTEE HAS HISTORICALLY RELIED UPON GUIDANCE OUTLINED IN WRITTEN COMPENSATION SURVEYS/STUDIES PRODUCED UNDER AN ARRANGEMENT WITH AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF ORGANIZATIONS SIMILAR TO MAH. THE COMMITTEE HAS HISTORICALLY HAD A FULL STUDY CONDUCTED BY SUCH FIRM EVERY OTHER YEAR WITH AN UPDATED STUDY IN THE OTHER YEARS. THIS SURVEY HAS FORMED THE BASIS FOR THE COMMITTEE FULFILLING ITS RESPONSIBILITY IN THIS REGARD. FOR THE PERIODS COVERED IN THIS FORM 990, THE COMMITTEE MET SEVERAL TIMES TO REVIEW THE COMPENSATION OF EACH OF THE INDIVIDUALS DESCRIBED ABOVE. TOOLS UTILIZED FOR THIS REVIEW INCLUDED THE COMPENSATION STUDY PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM CONTRACTED BY THE COMMITTEE. FURTHER, PERFORMANCE OF EACH INDIVIDUAL WAS MEASURED AGAINST PREVIOUS APPROVED GOALS AND OBJECTIVES IN DETERMINING INCENTIVE COMPENSATION PAYMENTS. AFTER DISCUSSION AND ANALYSIS AT SEVERAL MEETINGS, THE COMPENSATION COMMITTEE VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE CEO. UPON EXCUSING THE CEO FROM ITS MEETING, THE COMPENSATION COMMITTEE DISCUSSED THE COMPENSATION OF THE CEO AND THE PERFORMANCE OF THE CEO AGAINST PREVIOUSLY APPROVED GOALS AND OBJECTIVES AND WITH THE INPUT OF THE COMPENSATION STUDY AND VOTED TO RECOMMEND FOR APPROVAL BY THE BOARD OF TRUSTEES THE COMPENSATION ARRANGEMENT OF THE CEO. AT A FUTURE BOARD OF TRUSTEES MEETING, THE COMMITTEE CHAIRMAN MADE A FULL REPORT TO THE INDEPENDENT TRUSTEES OF THE COMMITTEES ANALYSIS OF CEO COMPENSATION AND AFTER DISCUSSION RECOMMENDED THAT THE TRUSTEES APPROVE THE CEO COMPENSATION. THE TRUSTEES VOTED AND APPROVED THE COMPENSATION. ALL DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION OF THE MAH CEO WAS THEN ALSO APPROVED BY THE CAREGROUP COMPENSATION COMMITTEE.
  FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: MOUNT AUBURN HOSPITAL OFFICES 330 MOUNT AUBURN ST CAMBRIDGE, MA 02138
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -2,926,616. TRANSFER OF UNRESTRICTED CASH TO MAPS (AFFILIATE) -9,980,928. CHANGE IN FUNDED STATUS OF EMPLOYEE BENEFIT PLANS -126,874. CHANGE IN VALUE OF LIMITED PARTNERSHIPS -1,003,322. PLEDGES RECEIVED BEYOND CASH PAYMENTS -628,361. UBIT FROM CIP -43,539. OTHER ACCOUNTING ADJUSTMENTS -2,490. ROUNDING -5. TOTAL TO FORM 990, PART XI, LINE 5: -14,712,135.
  FORM 990, PART XII QUESTION 2B AND 2C AS PREVIOUSLY REPORTED IN THIS FILING, MOUNT AUBURN HOSPITAL (MAH) IS A PUBLIC CHARITY AND A REGIONAL TEACHING HOSPITAL, EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THE FINANCIAL RECORDS OF MAH ARE AUDITED EACH YEAR AS PART OF THE MAH CONSOLIDATED AUDITED FINANCIAL STATEMENT PROCESS AND FOR THE FISCAL PERIOD COVERED BY THIS FILING. THE AUDIT WAS PREPARED AND SIGNED BY THE BOSTON, MA OFFICE OF KPMG. THIS PROCESS IS MONITORED AND REVIEWED INTERNALLY BY THE MAH AUDIT COMMITTEE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MOUNT AUBURN HOSPITAL
 
Employer identification number

04-2103606
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) ASSOC PHYS HARVARD MED FAC OHY AT BUDMC

275 LONGWOOD AVE

BOSTON,MA02215
32-0058309 		TO PROVIDE EMERGENCY MEDICAL SERVICES MA 501(C)(3) LINE 11, TYPE I: 509 HARVARD MED FAC PHYS AT BIDMC INC
 
 
No
(2) BETH ISRAEL ANAESTHESIA FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
04-2997215 		SUPPORT PATIENT CARE, RESEARCH & TEACHING BIDMC, HMFP & HMS MA 501(C)(3) LINE 11A, I HARVARD MED FAC PHYS AT BIDMC INC
 
 
No
(3) BETH ISRAEL DEACONESS DPT MED FOUNDATION

330 BROOKLINE AVE

BOSTON,MA02215
04-3079630 		SUPPORT PATIENT CARE, RESEARCH & TEACHING BIDMC, HMFP & HMS MA 501(C)(3) LINE 11A, I HARVARD MED FAC PHYS AT BIDMC INC
 
 
No
(4) BI DEAC DPT NEONATOLOGY FOUNDATION

330 BROOKLINE AVE

BOSTON,MA02215
20-8253452 		SUPPORT PATIENT CARE, RESEARCH & TEACHING BIDMC, HMFP & HMS MA 501(C)(3) LINE 11A, I HARVARD MED FAC PHYS AT BIDMC INC
 
 
No
(5) BI DEACONESS DPT OF NEUROLOGY FOUNDATION

330 BROOKLINE AVE

BOSTON,MA02215
04-3030397 		SUPPORT PATIENT CARE, RESEARCH & TEACHING BIDMC, HMFP & HMS MA 501(C)(3) LINE 11A, I HARVARD MED FAC PHYS AT BIDMC INC
 
 
No
(6) BI DEAC DPT ORTHOPAEDIC SURG FOUNDATION

330 BROOKLINE AVE

BOSTON,MA02215
20-4974585 		SUPPORT PATIENT CARE, RESEARCH & TEACHING BIDMC, HMFP & HMS MA 501(C)(3) LINE 11A, I HARVARD MED FAC PHYS AT BIDMC INC
 
 
No
(7) BI DEACONESS DPT OF SURGERY FOUNDATION

110 FRANCIS STREET

BOSTON,MA02215
02-0671240 		SUPPORT PATIENT CARE, RESEARCH & TEACHING BIDMC, HMFP & HMS MA 501(C)(3) LINE 11A, I HARVARD MED FAC PHYS AT BIDMC INC
 
 
No
(8) BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM INC

148 CHESTNUT STREET

NEEDHAM,MA02492
04-3229679 		HOSPITAL IN NEEDHAM MA FOR TREATMENT OF SICK AND SUFFERING PERSONS. MA 501(C)(3) LINE 3 BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(9) BETH ISRAEL DEACONESS MEDICAL CENTER

330 BROOKLINE AVE

BOSTON,MA02215
04-2103881 		THE OPERAION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA MA 501(C)(3) LINE 11A, I CAREGROUP INC
 
 
No
(10) BIDMC & CHILDRENS HOSPITAL MED CTR CORP

300 LONGWOOD AVE

BOSTON,MA02215
04-3200113 		OUTPATIENT AMBULATORY CARE CENTER IN LEXINGTON, MA MA 501(C)(3) LINE 11A, I N/A
 
No
(11) BIDMC OBSTETRICS AND GYNECOLOGY FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
04-2794855 		PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(12) BETH ISRAEL DERMATOLOGY FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
04-3117601 		PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HMFP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(13) BIH PATHOLOGY FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
22-2548374 		PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HMFP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(14) BIH RADIOLOGIC FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
04-2571853 		PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HMFP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(15) CARDIO ASSOC PHYS OF HMFP AT BIDMC

185 PILGRIM ROAD BOST

BOSTON,MA02215
04-3208878 		SPECIALIZED CARDIOVASCULAR MED SVCS TO PATIENTS OF CARDIO VSUCAL INSTITUTES MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(16) CARDIOVASCULAR MANAGEMENT ASSOCIATES INC

185 PILGRIM ROAD

BOSTON,MA02215
20-8550792 		FACILITATE COMP CARDIOVASCULAR CARE, EDU, AND RESEARCH, WITHIN BIDMC, HMFP MA 501(C)(3) LINE 11A, I BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(17) CAREGROUP INC

109 BROOKLINE AVE

BOSTON,MA02215
22-2629185 		DEVELOP AND COORDINATE INTEGRATED HEALTH CARE DELIVERY SYSTEM MA 501(C)(3) LINE 11D, III-O NONE
 
 
No
(18) CONTINUING EDUC PROG DBA BID DEPT OF PSYCH FOUND

401 PARK DR

BOSTON,MA02215
04-3242952 		PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HMFP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(19) MED CARE OF BOSTON MGMT CORP DBA AFF PHYS GROUP

400 HUNNEWELL ST

NEEDHAM,MA02494
04-2810972 		MEDICAL SERVICES ORGANIZATION MA 501(C)(3) LINE 9 BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(20) MOUNT AUBURN PROFESSIONAL SERVICES INC

330 MOUNT AUBURN ST

CAMBRIDGE,MA02138
04-3026897 		OFFERING MEDICAL CARE IN GENERAL AND SPECIALIZED PRACTICES MA 501(C)(3) LINE 11A, I MOUNT AUBURN HOSPITAL
 
 
No
(21) NEW ENGLAND BAPTIST HOSPITAL

125 PARKER HILL AVE

BOSTON,MA02120
04-2103612 		ORTHOPEDIC SPECIALTY HOSPITAL MA 501(C)(3) LINE 3 CAREGROUP INC
 
 
No
(22) NEW ENGLAND BAPTIST MEDICAL ASSOC INC

125 PARKER HILL AVE

BOSTON,MA02120
04-3326928 		OUTPATIENT MEDICAL SERVICES TO THE VARIOUS COMMUNITIES SERVICED BY NEBH MA 501(C)(3) LINE 3 NEW ENGLAND BAPTIST HOSPITAL INC
 
 
No
(23) RIVERBROOK CORPORATION

109 BROOKLINE AVE

BOSTON,MA02215
04-2828955 		TO HOLD TITLE TO PROPERTY FOR CAREGROUP, INC. MA 501(C)(2)   CAREGROUP INC
 
 
No
(24) HMFP AT BIDMC INC

375 LONGWOOD AVE

BOSTON,MA02215
22-2768204 		GENERAL AND SPECIALIZED MEDICAL SERVICES TO THE PATIENTS OF BIDMC AND OTHERS MA 501(C)(3) LINE 9 BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(25) HEART CENTER OF METROWEST INC

99 LINCOLN ST

BOSTON,MA01702
03-0390670 		TO PROVIDE OUTPATIENT MEDICAL SERVICES TO THE METROWEST COMMUNITIES MA 501(C)(3) LINE 9 CARDIOVASCULAR MANAGEMENT ASSOCIATES INC
 
 
No
(26) BI COMMUNITY FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
04-2776678 		INACTIVE CORPORATION MA 501(C)(3) LINE 7 N/A
 
No
(27) CARL J SHAPIRO INSTITUTE

330 BROOKLINE AVE

BOSTON,MA02215
04-3326928 		DEVELOP INNOVATIVE PROG AND MODELS FOR TEACHING AND RESEARCH MA 501(C)(3) LINE 11A, I N/A
 
No
(28) JOSLIN CLINIC INC

ONE JOSLIN PLACE

BOSTON,MA02215
22-2984590 		TO PROVIDE SPECIALTY MEDICAL AND RESEARCH SERVICES FOR DIABETES MA 501(C)(3) LINE 11A, I N/A
 
No
(29) HARVARD MEDICAL COLLABORATIVE INC

25 SHATTUCK ST

BOSTON,MA02215
04-3476764 		COORDINATE AND PROVIDE STATEGIC PLANNING OPP FOR HMS MA 501(C)(3) LINE 11A, I N/A
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) ADVANCED VASCULAR CARE LLC

375 LONGWOOD AVE
BOSTON,MA02215
26-1647880 		TO PROVIDE MEDICAL SUPPORT SERVICES MA HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC
  		RELATED       No     No  
(2) BETH ISRAEL DEACONESS PHYSICIAN ORG LLC

110 FRANCIS STREET
BOSTON,MA02215
04-3426253 		COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC MA HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC
  		RELATED       No     No  
(3) BEWELL BODY SCAN LLC

25 BOYLSTON ST
CHESTNUT HILL,MA02446
26-0051016 		TO OPERATE A DIAGNOSTIC IMAGING CENTER MA BIH RADIOLOGIC FOUNDATION INC
  		RELATED       No     No  
(4) CAREGROUP CLINICAL RESEARCH LLC

109 BROOKLINE AVENUE
BOSTON,MA02215
30-0228711 		TO PARTICIPATE IN A CLINICAL RESEARCH PARTNERSHIP MA NONE
  		RELATED       No     No  
(5) CAREGROUP INVESTMENT PARTNERSHIP LLP

109 BROOKLINE AVENUE
BOSTON,MA02215
04-3278109 		INVESTMENT PARTNERSHIP MA BETH ISRAEL DEACONESS MEDICAL CENTER
  		EXCLUDED 3,888,352 115,278,342   No 43,539   No  
(6) PHYSICIAN PROFESSIONAL SERVICES LLP

10 CABOT ROAD
MEDFORD,MA02215
04-3275078 		TO PROVIDE MEDICAL BILLING SERVICES MA SEE SUPPLEMENTAL EXPLANATIONS
  		RELATED       No     No  


Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) BIDMCCGSMC JV INC
400 HUNNEWELL ST
NEEDHAM,MA02494
26-4426847 		INACTIVE CO MA N/A
 C      
(2) CHESTNUT HEALTHCARE ALLIANCE INC
148 CHESTNUT ST
NEEDHAM,MA02492
04-3265117 		PROVIDE SUPPORT SERVICES TO MOUNT AUBURN HOSPITAL MA N/A
 C      
(3) MOUNT AUBURN HOSPITAL FOUNDATION INC
330 MOUNT AUBURN STREET
CAMBRIDGE,MA02138
04-2898907 		PHYSICIAN/ HOSPITAL ORGANIZATION MA N/A
 C      








Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
  FORM 990, SCHEDULE R, PART III THE PARTNERSHIP IS CONTROLLED 50% BY THE BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION, INC. AND 50% BY THE BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS DO GYNECOLOGY FOUNDATION, INC.
Additional Data


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Software Version: