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
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2011 and ending 09-30-2012
BCheck if applicable:
CName of organization
Lahey Clinic Foundation Inc
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
41 Mall Road
 
Room/suite
City or town, state or country, and ZIP + 4
Burlington, MA018050001
D Employer identification number

04-2323457
E Telephone number

G Gross receipts $ 5,970,051
F Name and address of principal officer:
Howard R Grant JD MD
41 MALL ROAD
BURLINGTON,MA018050001
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.lahey.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: 1963
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 19
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 9
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 600
6 Total number of volunteers (estimate if necessary) .... 6 34
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a -294,355
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -300,265
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,768,044 3,285,682
9 Program service revenue (Part VIII, line 2g) ......... 0 0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 4,236,488 2,677,299
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 8,134 7,070
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 7,012,666 5,970,051
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
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) 2,793,488 3,029,412
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 28,666 141,000
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet4,454,805    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 1,743,096 1,885,452
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 4,565,250 5,055,864
19 Revenue less expenses. Subtract line 18 from line 12....... 2,447,416 914,187
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 676,307,327 685,716,006
21 Total liabilities (Part X, line 26)............. 353,705,642 332,955,737
22 Net assets or fund balances. Subtract line 21 from line 20..... 322,601,685 352,760,269
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 use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
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 organization’s program service accomplishments for each of its three largest program services, as measured 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 $   including grants of $   ) (Revenue $   )
LAHEY CLINIC FOUNDATION, INC., (FOUNDATION) IS THE SOLE CORPORATE MEMBER OF LAHEY CLINIC HOSPITAL, INC. (HOSPITAL), LAHEY CLINIC, INC. (CLINIC) AND LAHEY CLINIC AFFILIATED SERVICES, INC. (LCAS). THE FOUNDATION HOLDS CAPITAL ASSETS, INVESTMENTS, DEBT, AND INFRASTRUCTURE COSTS TO PROVIDE ASSISTANCE TO THE HOSPITAL AND CLINIC FOR THE PROVISION OF PATIENT HEALTH CARE SERVICES, PATIENT EDUCATION, COMMUNITY BENEFITS AND COMMUNITY SERVICE PROGRAMS, CONTINUING EDUCATION OF HEALTH CARE PROVIDERS, AS WELL AS HEALTH CARE RESEARCH ACTIVITIES. PHILANTHROPIC EFFORTS, ALSO IN SUPPORT OF THE HOSPITAL AND CLINIC, ARE CARRIED OUT BY THE FOUNDATION.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$  
Form 990 (2011)
Form 990 (2011)
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 I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
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
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which 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
Yes
 
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 temporarily restricted endowments, permanent endowments, 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
Yes
 
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
 
No
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, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? 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 IClick to see attachment
17
Yes
 
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.......... Click to see attachment
18
 
No
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................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements.
20b
 
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
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.....
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
 
No
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
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? 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
 
No
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
 
No
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 M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
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
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, 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
35b
Yes
 
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 (2011)
Form 990 (2011)
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
195
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
600
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
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletBD , CA
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
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
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
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
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 (2011)
Form 990 (2011)
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
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
19
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
9
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
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
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
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete 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
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
 
No
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 15a or 15b, 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
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
AZ , AR , CA , CO , CT , FL , GA , IL , KY , ME , MA , MN , MO , NH , NJ , NM , NY , OK , PA , RI , VA , WA , WI
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 made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
TIMOTHY O'CONNOR
41 MALL ROAD
Burlington,MA018050001
(781) 744-5100
Form 990 (2011)
Form 990 (2011)
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 (do not check more than one box, unless person is both an officer and a director/trustee) 		(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) Howard R Grant JD MD
TRUSTEE/PRESIDENT/CEO
 8.0 X   X       960,934 0 84,545
(2) John A Libertino MD
TRUSTEE/CHAIR DEPT OF UROLOGY
 1.0 X           0 813,060 39,384
(3) Richard W Nesto MD
TRUSTEE/EVP/CMOO/PHYSICIAN
 20.0 X           595,970 0 101,415
(4) Roger L Jenkins MD
TRUSTEE/PHYSICIAN
 1.0 X           0 592,138 49,628
(5) Richard S D'Agostino MD
TRUSTEE/CHAIR DEPT CARDIO SURG
 1.0 X           0 529,013 52,842
(6) Judith A Melin MD
TRUSTEE UNTIL7/16/12/ASSC CQSO
 20.0 X           0 327,467 30,355
(7) Carl A Soderland MD
TRUSTEE UNTIL 07/16/12 /CHAIR
 1.0 X           0 389,917 36,436
(8) Andrew G Villanueva MD
TRUSTEE/CMO CLINIC/PHYSICIAN
 1.0 X           0 327,045 37,548
(9) Betsey Crawford MD
TRUSTEE START 7/16/12/PHYSICIA
 1.0 X           0 187,572 12,386
(10) Arthur P Mourtzinos MD
TRUSTEE START 7/16/12/PHYSICIA
 1.0 X           0 403,201 43,266
(11) Rebecca C Yang MD
TRUSTEE START 7/16/12/PHYSICIA
 1.0 X           0 344,322 41,513
(12) Irving E Rogers III
TRUST/CHAIR/CLERK UNTIL7/16/12
 2.0 X   X       0 0 0
(13) Eric M Bailey
TRUSTEE
 1.0 X           0 0 0
(14) Craig R Benson
TRUSTEE
 1.0 X           0 0 0
(15) Ann Marie Connolly
TRUSTEE
 1.0 X           0 0 0
(16) Jerald G Fishman
TRUSTEE UNTIL 7/16/12
 1.0 X           0 0 0
(17) James W Henderson
TRUST/VICE CHAIR UNTIL 7/16/12
 2.0 X   X       0 0 0
Form 990 (2011)
Form 990 (2011)
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 (do not check more than one box, unless person is both an officer and a director/trustee) 		(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) James D Irving
TRUSTEE
 1.0 X           0 0 0
(19) Charles M Leighton
TRUSTEE UNTIL 7/16/12
 1.0 X           0 0 0
(20) Peter J Manning
TRUSTEE UNTIL 7/16/12
 1.0 X           0 0 0
(21) J William Poduska
TRUSTEE
 1.0 X           0 0 0
(22) Windle B Priem
TRUSTEE
 1.0 X           0 0 0
(23) James A Radley
TRUSTEE UNTIL 7/16/12
 1.0 X           0 0 0
(24) Robert L Reynolds
TRUSTEE UNTIL 7/16/12
 1.0 X           0 0 0
(25) Michael C Ruettgers
TRUSTEE/CHAIR OF BOARD
 2.0 X   X       0 0 0
(26) Carolyn Ain
TRUSTEE START 7/16/12
 1.0 X           0 0 0
(27) Jane C Edmonds
TRUSTEE START 7/16/12
 1.0 X           0 0 0
(28) Edward Eskandarian
TRUSTEE START 7/16/12
 1.0 X           0 0 0
(29) David G Spackman
CLERK START 7/16/12 /GEN COUNS
 8.0     X       0 0 0
(30) Timothy O'Connor
OFFICER/TREASURER/EVP/CFO
 8.0     X       683,581 0 159,274
(31) Joan M Robbio
CHIEF HUMAN RESOURCES OFFICER
 40.0       X     357,894 0 26,290
(32) Kathleen S Jose
CHIEF NURSING OFFICER
 40.0       X     311,548 0 27,198
(33) Bruce A Metz
CHIEF INFORMATION OFFICER
 40.0       X     0 241,632 23,880
(34) Phillips Axten
CORPORATE COMPLIANCE OFFIC LHS
 40.0         X   347,086 0 44,783
(35) Peter R Lloyd
VP. CORPORATE FINANCE
 40.0         X   305,204 0 36,728
(36) Theorn Bradley
VP. HUMAN RESOURCES COMPENSATI
 40.0         X   278,919 0 48,659
(37) Allen S Danis
VICE PRESIDENT CONTRACTING
 40.0         X   291,896 0 19,693
(38) Joseph C Corkery
PHYSICIAN
 39.0         X   470,778 0 77,279
(39) David M Barrett MD
FORMER TRUSTEE/PRESIDENT/CEO
 0.0           X 1,388,662 0 200,000
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,992,472 4,155,367 1,193,102
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet89
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
Yes
 
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. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
ECLIPSYS SOLUTIONS CORP
PO BOX 8538-0133
PHILADELPHIA,PA191710133 		ELECT. HEALTH SYSTEM 4,162,082
DELOITTE CONSULTING LLP
PO BOX 7247-6447
PHILADELPHIA,PA191706447 		CONSULTING 2,073,831
MEDMATICA CONSULTING ASSOC INC
18 BARRINGTON LANE
CHESTER SPRINGS,PA19425 		CONSULTING 1,902,406
AMERICAN PERSONNEL HEALTHCARE SERVI
133 FEDERAL STREET
BOSTON,MA02110 		PROF. STAFFING SERV. 1,623,589
THE OUTSOURCE GROUP
7 AUDUBON ROAD
WAKEFIELD,MA018801248 		PROF. BILLING AGENCY 1,046,182
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet36
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		3,285,682
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 3,285,682
Program Service Revenue Business Code
2a
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 0
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,873,513   1,880 1,871,633
4 Income from investment of tax-exempt bond proceeds..MediumBullet 50     50
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 75,947 727,789
b Less: cost or other basis and sales expenses    
c Gain or (loss) 75,947 727,789
d Net gain or (loss)..........MediumBullet 803,736   -296,235 1,099,971
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
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 0      
Miscellaneous Revenue Business Code
11a OTHER REVENUE 900,099 7,070     7,070
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 7,070
12 Total revenue. See Instructions....MediumBullet 5,970,051   -294,355 2,978,724
Form 990 (2011)
Form 990 (2011)
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).
Check if Schedule O contains a response to any question in this Part IX. .........
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 United States. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 27,537   27,537  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 22,166   22,166  
7 Other salaries and wages 2,258,637   171,244 2,087,393
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 331,110   31,005 300,105
9 Other employee benefits ....... 229,611   21,110 208,501
10 Payroll taxes ........... 160,351   14,102 146,249
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 29,209   3,763 25,446
c Accounting ........... 2,456   2,456  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 141,000 141,000
f Investment management fees ...... 69,410     69,410
g Other .......... 367,931   43,352 324,579
12 Advertising and promotion .... 8,340   8,340  
13 Office expenses ....... 549,365   15,649 533,716
14 Information technology ...... 39,809   39,809  
15 Royalties .. 0      
16 Occupancy ........... 340,474   8,192 332,282
17 Travel ............ 19,747   1,547 18,200
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 6,829   6,829  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 136,502   118,300 18,202
23 Insurance .............. 6,564   6,564  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a MEDICAL SUPPLIES 36   33 3
b GENERAL SUPPLIES 308,780   59,061 249,719
c
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 5,055,864 0 601,059 4,454,805
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 0 1 0
2 Savings and temporary cash investments ....... 736,490 2 6,831,224
3 Pledges and grants receivable, net ......... 65,400 3 118,200
4 Accounts receivable, net ......... 10,715 4 6,715
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 0 5 0
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 .......... 0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 0 8 0
9 Prepaid expenses and deferred charges ............ 6,666,439 9 4,380,315
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 891,073,181
b Less: accumulated depreciation. ..... 10b 554,552,851 353,910,643 10c 336,520,330
11 Investments—publicly traded securities .......... 67,987,057 11 90,460,862
12 Investments—other securities. See Part IV, line 11 ...... 198,022,672 12 194,043,337
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ......... 0 14 0
15 Other assets. See Part IV, line 11 ........... 48,907,911 15 53,355,023
16 Total assets. Add lines 1 through 15 (must equal line 34)... 676,307,327 16 685,716,006
Liabilities 17 Accounts payable and accrued expenses . 33,690,024 17 37,808,996
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 0 19 0
20 Tax-exempt bond liabilities .......... 181,583,991 20 176,143,259
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 2,806,849 22 2,402,972
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 4,892,555 24 2,431,860
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 130,732,223 25 114,168,650
26 Total liabilities. Add lines 17 through 25..... 353,705,642 26 332,955,737
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 ..... 237,543,125 27 258,376,628
28 Temporarily restricted net assets ..... 29,744,396 28 36,275,143
29 Permanently restricted net assets ..... 55,314,164 29 58,108,498
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 ..... 322,601,685 33 352,760,269
34 Total liabilities and net assets/fund balances ..... 676,307,327 34 685,716,006
Form 990 (2011)
Form 990 (2011)
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
5,970,051
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
5,055,864
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
914,187
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
322,601,685
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
29,244,397
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
352,760,269
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
 
No
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
 
 
Form 990 (2011)
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
2011
Open to Public
Inspection
Name of the organization
Lahey Clinic Foundation Inc
 
Employer identification number

04-2323457
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... 22,246,019 3,904,026 3,963,818 2,768,044 3,285,682 36,167,589
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.. 22,246,019 3,904,026 3,963,818 2,768,044 3,285,682 36,167,589
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)..           13,118,661
6 Public Support. Subtract line 5 from line 4.           23,048,928
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4.. 22,246,019 3,904,026 3,963,818 2,768,044 3,285,682 36,167,589
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 6,226,119 4,023,413 3,204,960 3,684,596 2,873,563 20,012,651
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.. 159 356 6,268 8,134 7,070 21,987
11 Total support (Add lines 7 through 10).           56,202,227
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
41.011 %
15
15
44.326 %
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2011

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
2011
Name of organization
Lahey Clinic Foundation Inc
 
Employer identification number

04-2323457
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 on line H of its
Form 990-EZ or on Part I, 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) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
Lahey Clinic Foundation Inc
  		Employer identification number

04-2323457
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total 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)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
Lahey Clinic Foundation Inc
  		Employer identification number

04-2323457
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(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) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
Lahey Clinic Foundation Inc
  		Employer identification number

04-2323457
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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 $  
Use duplicate copies of Part III if additional space is needed
(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) (2011)

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Lahey Clinic Foundation Inc
 
Employer identification number

04-2323457
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 can 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 through 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 (ASC 958), 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 (ASC 958), 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 (ASC 958), 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) 2011

Schedule D (Form 990) 2011
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 .... 266,009,728 275,817,593 262,176,300 274,357,327
b Contributions ........ 946,986 1,849,984 814,624 987,745
c Net investment earnings, gains, and losses ... 25,996,140 -726,521 23,033,174 8,636,901
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		7,824,838 10,133,190 9,539,545 21,526,729
f Administrative expenses .... 623,817 798,138 666,960 278,944
g End of year balance ...... 284,504,199 266,009,728 275,817,593 262,176,300
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet78.000 %
b
Permanent endowment SchDMd Bullet22.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
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)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   15,393,209 15,393,209
b Buildings ................   486,135,483 230,264,265 255,871,218
c Leasehold improvements ............   8,575,806 5,542,068 3,033,738
d Equipment ................   367,175,671 309,321,511 57,854,160
e Other .................   13,793,012 9,425,007 4,368,005
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 336,520,330
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
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) INVESTMENTS 		194,043,337 F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 194,043,337
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) must 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
(1) DEFERRED DEBT ISSUE COST, NET 3,470,231
(2) INVESTMENT-LAHEY CLINIC INSUR. 120,000
(3) INVESTMENT-FELLSWAY DEVELOP. 5,691,165
(4) OTHER RECEIVABLES 414,838
(5) ASSETS HELD UNDER SPLIT INT AG 11,438,796
(6) BENE INT IN PERP & LEAD TRUSTS 27,946,231
(7) INVESTMENTS - OTHER 4,273,762


Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 53,355,023
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
INTERCOMPANY PAYABLES 106,849,156
SPLIT INTEREST LIABILITY 6,372,443
ASSET RETIREMENT OBLIGATION 947,051






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 114,168,650
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) 2011

Schedule D (Form 990) 2011
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 5,970,051
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 5,055,864
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 1,914,187
4 Net unrealized gains (losses) on investments .......................... 4 15,180,857
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8 13,063,540
9 Total adjustments (net). Add lines 4 through 8 ......................... 9 28,244,397
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 30,158,584
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 27,677,510
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a 15,180,857
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d 8,812,284
e Add lines 2a through 2d ..................... 2e 23,993,141
3 Subtract line 2e from line 1..................... 3 3,684,369
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 3,285,682
c Add lines 4a and 4b....................... 4c 3,285,682
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 6,970,051
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 6,844,007
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 1,788,143
e Add lines 2a through 2d...................... 2e 1,788,143
3 Subtract line 2e from line 1..................... 3 5,055,864
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  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 5,055,864
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
SCHEDULE D, PART III, LINE 4   THE ORGANIZATION MAINTAINS COLLECTIONS OF ART FOR DISPLAY TO IMPROVE THE PATIENT CARE ENVIRONMENT. SCHEDULE D, PART V, LINE 4 THE ORGANIZATION'S ENDOWMENT FUNDS SUBSIDIZE THE COSTS OF PROVIDING SUPERIOR HEALTH CARE LEADING TO THE BEST POSSIBLE OUTCOME FOR EVERY PATIENT. THE COSTS ARE FOR PATIENT CARE, PATIENT EDUCATION, CONTINUING EDUCATION OF HEALTH CARE PROVIDERS, RESEARCH, AND CAPITAL EXPENDITURES. SCHEDULE D, PART X, LINE 2 THE ORGANIZATION'S FINANCIAL STATEMENTS DID NOT REPORT A LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. SCHEDULE D, PART XI, LINE 8 UNRESTRICTED CONTRIBUTIONS $2,985,039 ASSETS RELEASED FROM TIME RESTRICTIONS 1,571,236 ASSETS RELEASED FROM RESTRICTIONS 2,461,577 PENSION AND POST RETIREMENT RELATED CHANGES (485,876) GRANTS AND CONTRIBUTIONS (3,285,682) CHANGE IN TEMPORARY AND PERMANENT NET ASSETS 9,325,081 CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 509,923 REDESIGNATION OF GIFTS (17,758) ____________ TOTAL $13,063,540 SCHEDULE D, PART XII, LINE 2D UNRESTRICTED CONTRIBUTIONS $2,985,039 ASSETS RELEASED FROM TIME RESTRICTIONS 1,571,236 ASSETS RELEASED FROM RESTRICTIONS 2,461,577 CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 509,923 REDESIGNATION OF GIFTS (17,758) OTHER OPERATING REVENUES TRANSFERRED TO LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL, INC. 1,302,267 _________ TOTAL $8,812,284 SCHEDULE D, PART XII, LINE 4B CONTRIBUTIONS, GIFTS, AND GRANTS $3,285,682 SCHEDULE D, PART XIII, LINE 2D OTHER OPERATING REVENUE COLLECTED BY LAHEY CLINIC FOUNDATION, INC. AND CREDITED TO OVERHEAD EXPENSES ALLOCATED TO LAHEY CLINIC INC. AND LAHEY CLINIC HOSPITAL, INC. $1,302,267 PENSION AND POST RETIREMENT RELATED CHANGES 485,876 __________ TOTAL $1,788,143
Schedule D (Form 990) 2011

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
2011
Open to Public Inspection
Name of the organization
Lahey Clinic Foundation Inc
 
Employer identification number

04-2323457
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 its grants
and other 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 its grants and other
assistance 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
North America     Fundraising    
Central America and the Caribbean     Investments   94,396,538
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     94,396,538
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     94,396,538
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
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) 2011
Schedule F (Form 990) 2011Page 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) 2011
Schedule F (Form 990) 2011
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) 2011
Schedule F (Form 990) 2011
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
PART I, LINE 3 (1)   LAHEY CLINIC DOES NOT SEPARATELY TRACK EXPENDITURES FOR FUNDRAISING OUTSIDE THE UNITED STATES IN THE REGION.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2011
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 arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
Lahey Clinic Foundation Inc
 
Employer identification number

04-2323457
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
THE WAYLAND GROUP
1323 BOSTON POST ROAD
 
SUDBURY, MA01776 		Fundraising Counsel   No 0 141,000 -141,000
Total .................right arrow 0 141,000 -141,000
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.
AZ, AR, CA, CO, CT, FL, GA, IL, KY, ME, MA, MN, MO, NH, NJ, NM, NY, OK, PA, RI, VA, WA, WI
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
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

 
(event type) 		(b) Event #2

 
(event type) 		(c) Other Events

  
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . .        
2 Less: Charitable
contributions . . . 		       
3 Gross income (line 1
minus line 2) . . . 		       
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . .        
7 Food and beverages . .        
8 Entertainment . . .        
9 Other direct expenses .        
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow  
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow  
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) 2011
Schedule G (Form 990 or 990-EZ) 2011
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) 2011
Additional Data


Software ID:  
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
2011
Open to Public Inspection
Name of the organization
Lahey Clinic Foundation Inc
 
Employer identification number

04-2323457
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 or provision 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
 
No
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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
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
Yes
 
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 Regulations 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) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Howard R Grant JD MD (i)
(ii)		 936,208
0 		0
0 		24,726
0 		26,887
0 		57,658
0 		1,045,479
0 		0
0
(2) John A Libertino MD (i)
(ii)		 0
684,189 		0
90,000 		0
38,871 		0
17,500 		0
21,884 		0
852,444 		0
0
(3) Richard W Nesto MD (i)
(ii)		 573,574
0 		0
0 		22,396
0 		75,800
0 		25,615
0 		697,385
0 		0
0
(4) Roger L Jenkins MD (i)
(ii)		 0
561,129 		0
0 		0
31,009 		0
17,500 		0
32,128 		0
641,766 		0
0
(5) Richard S D'Agostino MD (i)
(ii)		 0
490,255 		0
0 		0
38,758 		0
17,500 		0
35,342 		0
581,855 		0
0
(6) Judith A Melin MD (i)
(ii)		 0
288,829 		0
0 		0
38,638 		0
17,500 		0
12,855 		0
357,822 		0
0
(7) Carl A Soderland MD (i)
(ii)		 0
351,021 		0
0 		0
38,896 		0
17,500 		0
18,936 		0
426,353 		0
0
(8) Andrew G Villanueva MD (i)
(ii)		 0
288,287 		0
0 		0
38,758 		0
17,500 		0
20,048 		0
364,593 		0
0
(9) Betsey Crawford MD (i)
(ii)		 0
170,982 		0
0 		0
16,590 		0
10,626 		0
1,760 		0
199,958 		0
0
(10) Arthur P Mourtzinos MD (i)
(ii)		 0
386,701 		0
0 		0
16,500 		0
17,500 		0
25,766 		0
446,467 		0
0
(11) Rebecca C Yang MD (i)
(ii)		 0
327,732 		0
0 		0
16,590 		0
17,500 		0
24,013 		0
385,835 		0
0
(12) Timothy O'Connor (i)
(ii)		 566,323
0 		95,000
0 		22,258
0 		134,500
0 		24,774
0 		842,855
0 		0
0
(13) David M Barrett MD (i)
(ii)		 0
0 		0
0 		1,388,662
0 		200,000
0 		0
0 		1,588,662
0 		0
0
(14) Joan M Robbio (i)
(ii)		 318,632
0 		0
0 		39,262
0 		4,900
0 		21,390
0 		384,184
0 		0
0
(15) Kathleen S Jose (i)
(ii)		 272,652
0 		0
0 		38,896
0 		17,500
0 		9,698
0 		338,746
0 		0
0
(16) Bruce A Metz (i)
(ii)		 0
187,198 		0
20,000 		0
34,434 		0
3,876 		0
20,004 		0
265,512 		0
0
(17) Phillips Axten (i)
(ii)		 308,190
0 		0
0 		38,896
0 		17,500
0 		27,283
0 		391,869
0 		0
0
(18) Peter R Lloyd (i)
(ii)		 283,066
0 		0
0 		22,138
0 		17,500
0 		19,228
0 		341,932
0 		0
0
(19) Theorn Bradley (i)
(ii)		 239,657
0 		0
0 		39,262
0 		17,500
0 		31,159
0 		327,578
0 		0
0
(20) Allen S Danis (i)
(ii)		 253,000
0 		0
0 		38,896
0 		17,500
0 		2,193
0 		311,589
0 		0
0
(21) Joseph C Corkery (i)
(ii)		 371,882
0 		60,000
0 		38,896
0 		57,200
0 		20,079
0 		548,057
0 		0
0
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SCHEDULE J, PART I, LINES 1A, 1B & 2   DR. HOWARD GRANT RECEIVED THE FOLLOWING AMOUNTS IN CALENDAR YEAR 2011 FROM THE ORGANIZATION: $1,993 HOUSING ALLOWANCE (TAXABLE) $ 475 TAX GROSS UP PAYMENT FOR HOUSING RELATED EXPENSES (TAXABLE) THE ITEMS CHECKED IN SCHEDULE J, PART I, LINE 1A, VIA AN EXECUTED EMPLOYEMENT AGREEMENT, WERE NEGOTIATED AND AGREED TO BY BOTH PARTIES AND THEIR REPRESENTATIVES. SCHEDULE J, PART I LINE 4a, PART II, COLUMN B(III) AND COLUMN C DR. DAVID M. BARRETT WAS TERMINATED FROM LAHEY CLINIC FOUNDATION, INC. ON 12/31/2010. SCHEDULE J REQUIRES THE REPORTING OF COMPENSATION BASED ON CALENDAR YEAR 2011. DR. BARRETT'S COMPENSATION PAID FOR CALENDAR YEAR 2011 INCLUDES $989,983 OF SEVERANCE PAYMENTS PER DR. BARRETT'S EMPLOYMENT CONTRACT, $346,154 OF VACATION AND SICK TIME CASH-OUT AND $52,525 OF TAXABLE LIFE INSURANCE BENEFITS. THE REMAINING AMOUNT PAID TO DR. BARRETT OF $200,000 IS DEFERRED COMPENSATION UNDER A SPLIT DOLLAR AGREEMENT WITH LAHEY CLINIC HOSPITAL, INC. SCHEDULE J, PART I, LINE 4b, PART II COLUMN C THE ORGANIZATION MAINTAINS A 457F NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN PHYSICIANS, EXECUTIVE MANAGEMENT AND DEFINED MEDICAL STAFF. THE PLAN OFFERS PARTICIPATING EMPLOYEES AN ANNUAL DEFFERAL OF COMPENSATION IN ADDITION TO THEIR SALARIES. FOR THE CURRENT PERIOD, THE FOLLOWING PERSONS PARTICIPATED IN THE 457F NONQUALIFIED DEFERRED COMPENSATION PLAN: TIMOTHY O'CONNOR - AMOUNT = $117,000 RICHARD W NESTO - AMOUNT = $ 58,300 JOSEPH C CORKERY - AMOUNT = $ 39,700 SCHEDULE J, PART I, LINE 7 THE NON-FIXED PAYMENT BONUSES REPORTED IN SCHEDULE J, PART II, COLUMN B(II) ARE DETERMINED BY AN INDEPENDENT COMPENSATION COMMITTEE, WHICH INCLUDES A GROUP OF TRUSTEES. IN A SUBJECTIVE MANNER, THE COMMITTEE TAKES INTO ACCOUNT THE ACHIEVEMENTS OF BOTH THE ORGANIZATION AND THE INDIVIDUAL TO DETERMINE AN APPROPRIATE AMOUNT OF SUCH BONUSES. SCHEDULE J, PART II LAHEY CLINIC FOUNDATION, INC. AND ITS RELATED ORGANIZATIONS DO NOT COMPENSATE ANY TRUSTEE IN THEIR CAPACITY AS TRUSTEE. ALL COMPENSATION PAID IS FOR WORK PERFORMED IN THEIR CAPACITY OTHER THAN TRUSTEE, WHICH IS LISTED ON FORM 990, PART VII, DIRECTLY FOLLOWING THE TITLE OF THE TRUSTEE.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
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 Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
Lahey Clinic Foundation Inc
 
Employer identification number
04-2323457
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 2005 MHEFA SERIES C BONDS
  		04-2456011 57586CKW4 07-14-2005 161,296,967 SEE PART V   X   X   X
B 2007 MHEFA SERIES D BONDS
  		04-2456011 57586CE68 08-17-2007 48,655,976 SEE PART V   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 33,883,577 24,894    
2 Amount of bonds legally defeased . . . . . . . . . . 0 0    
3 Total proceeds of issue . . . . . . . . . . . . . 163,666,057 51,388,809    
4 Gross proceeds in reserve funds . . . . . . . . 0 0    
5 Capitalized interest from proceeds . . . . . . . . . . 0 0    
6 Proceeds in refunding escrows . . . . . . . . . . . 0 0    
7 Issuance costs from proceeds . . . . . . . . . . . 1,259,007 870,765    
8 Credit enhancement from proceeds . . . . . . . . . . 3,594,356 0    
9 Working capital expenditures from proceeds . . . . . . . 0 0    
10 Capital expenditures from proceeds . . . . . . . . . . 51,328,227 50,518,044    
11 Other spent proceeds . . . . . . . . . . . 107,484,467 0    
12 Other unspent proceeds . . . . . . . . . . . 0 0    
13 Year of substantial completion . . . . . . . . . . . 2006 2009
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        
16 Has the final allocation of proceeds been made? . . . . . . X   X          
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . 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   X        
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X     X        
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
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 of bond-financed property? . . . . . . . . . X     X        
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . X              
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . X     X        
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any 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% 0.00000%   %   %
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% 0.00000%   %   %
6 Total of lines 4 and 5 . . .. . . . . . . . . 0% 0.00000%   %   %
7 Does the bond issue meet the private security or payment test? . . . X   X          
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   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        
2 Is the bond issue a variable rate issue?   X   X        
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X        
b Name of provider . . . . . . . . 0
  		0
  		 
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . X   X          
b Name of provider . . . . . . XL ASSET FUND CO I
  		AIG MATCH FUND CORP
  		 
  		 
 
c Term of GIC . . . . . . . 1.83 1.    
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . . X   X          
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X   X        
6 Did the bond issue qualify for an exception to rebate? .   X   X        
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X   X        
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2011

Additional Data


Software ID:  
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
2011
Open to Public Inspection
Name of the organization
Lahey Clinic Foundation Inc
 
Employer identification number

04-2323457
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
(1) BERNARD GORDON -
ASSET ACQUISITION 		  X 5,000,000 2,402,972   No Yes   Yes  
Total ...............Small Bullet $ 2,402,972
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) 2011
Schedule L (Form 990 or 990-EZ) 2011
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) ADAM S AIN SON OF TRUSTEE 14,080 EMPLOYEE COMPENSATION   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
Schedule L (Form 990 or 990-EZ) 2011

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
2011
Open to Public
Inspection
Name of the organization
Lahey Clinic Foundation Inc
 
Employer identification number

04-2323457
Identifier Return Reference Explanation
FORM 990, PART I, LINE 1 & PART III, LINE 1   LAHEY CLINIC FOUNDATION, INC. SUPPORTS LAHEY CLINIC HOSPITAL, INC., LAHEY CLINIC, INC. AND LAHEY CLINIC AFFILIATED SERVICES, INC. LAHEY HOSPITAL & MEDICAL CENTER, IN ASSOCIATION WITH THE TUFTS UNIVERSITY SCHOOL OF MEDICINE, PROVIDES SUPERIOR HEALTH CARE LEADING TO THE BEST POSSIBLE OUTCOMES FOR EVERY PATIENT. AS ONE OF THE WORLD'S PREMIER HEALTH CARE ORGANIZATIONS, LAHEY HOSPITAL & MEDICAL CENTER AIMS TO EXCEED PATIENT'S HIGH EXPECTATIONS FOR SERVICE AND ADVANCE MEDICINE THROUGH RESEARCH AND THE EDUCATION OF TOMORROW'S HEALTH CARE LEADERS. IN ADDITION, LAHEY HOSPITAL & MEDICAL CENTER IS COMMITTED TO IMPROVING THE HEALTH AND QUALITY OF LIFE OF COMMUNITY RESIDENTS BY SUPPORTING LOCAL ORGANIZATIONS ALIGNED WITH THIS MISSION. FORM 990, PART IV, LINE 4 LAHEY CLINIC HOSPITAL, INC., A RELATED ORGANIZATION, IS IN CONTACT WITH FEDERAL AND STATE LEGISLATORS REGARDING HEALTH CARE REFORM ISSUES THAT WOULD POTENTIALLY HAVE AN IMPACT ON THE ORGANIZATION AND ITS RELATED ORGANIZATIONS.
FORM 990, PART VI, SECTION A, LINE 2   OFFICERS AND TRUSTEES OF LAHEY CLINIC FOUNDATION, INC. ARE OFFICERS AND TRUSTEES OF LAHEY CLINIC, INC., LAHEY CLINIC HOSPITAL, INC., AND LAHEY CLINIC AFFILIATED SERVICES, INC. CERTAIN TRUSTEES ARE ALSO EMPLOYEES OF LAHEY CLINIC, INC. IN ADDITION TO THEIR ROLE AS A TRUSTEE AND/OR OFFICER, HOWARD R. GRANT, J.D., M.D., TIMOTHY O'CONNOR AND JAMES A. RADLEY (UNTIL 7/16/2012) ARE ALSO TRUSTEE AND/OR OFFICER FOR LAHEY CLINIC INSURANCE COMPANY, LTD. IN ADDITION TO THEIR ROLES AS OFFICERS OF LAHEY CLINIC FOUNDATION, INC., TIMOTHY O'CONNOR AND DAVID SPACKMAN ARE ALSO OFFICERS OF NORTHEAST PROPRIETARY CORPORATION, A RELATED ORGANIZATION. THE COMPENSATION FOR THE TRUSTEES AND OFFICERS OF LAHEY CLINIC FOUNDATION, INC. LISTED IN FORM 990, PART VII, COLUMN(E) IS FOR EMPLOYEES OF LAHEY CLINIC, INC. ALL COMPENSATION PAID IS FOR WORK IN THEIR CAPACITIES OTHER THAN AS TRUSTEES. FORM 990, PART VI, SECTION A, LINES 6 AND 7 THE LAHEY HOSPITAL & MEDICAL CENTER CONSISTS OF FOUR NON-PROFIT CORPORATIONS, LAHEY CLINIC HOSPITAL, INC. (EIN # 04-2704686), LAHEY CLINIC, INC. (EIN # 04-2704683), LAHEY CLINIC FOUNDATION, INC. (EIN # 04-2323457) AND LAHEY CLINIC AFFILIATED SERVICES, INC. (EIN # 04-3178972). ALL FOUR CORPORATIONS ARE TAX EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). LAHEY CLINIC FOUNDATION, INC. IS THE SOLE CORPORATE MEMBER OF EACH OF THE OTHER THREE CORPORATIONS. THE BOARD OF TRUSTEES (GOVERNING BODY) AND CORPORATE OFFICERS OF THE FOUR CORPORATIONS CONSISTS OF THE EXACT SAME MEMBERS. FORM 990, PART VI, SECTION A, LINES 4, 6, 7A & 7B EFFECTIVE MAY 1, 2012, LAHEY CLINIC FOUNDATION, INC. AND NORTHEAST HEALTH SYSTEM, INC. COMPLETED AN AFFILIATION WITH EACH OTHER AND ESTABLISHED A NEW ORGANIZATION, LAHEY HEALTH SYSTEM, INC. ("LHS"), TO SERVE AS THE PARENT OF THE COMBINED HEALTH SYSTEM. LHS IS NOW THE SOLE CORPORATE MEMBER OF LAHEY CLINIC FOUNDATION, INC. AND NORTHEAST HEALTH SYSTEM, INC. LAHEY HEALTH SYSTEM, INC. HAS, WITH RESPECT TO THE REPORTING ORGANIZATION, THE RIGHT TO EXERCISE ALL POWERS CONFERRED ON MEMBERS OF NON-PROFIT CORPORATIONS UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 180, INCLUDING, WITHOUT LIMITATION, POWERS WITH RESPECT TO THE FOLLOWING: (A) APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD OF TRUSTEES (SUBJECT TO CERTAIN TRANSITION RULES IN PLACE THROUGH MAY 1, 2016); (B) AMENDMENT OF THE ARTICLES OF ORGANIZATION; (C) AMENDMENT OF THE BY-LAWS; (D) THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; AND (E) THE MERGER OR CONSOLIDATION OF THE CORPORATION WITH ANOTHER CORPORATION. THE ARTICLES OF INCORPORATION OF THE REPORTING ORGANIZATION WERE AMENDED MAY 1, 2012 AND THE BY-LAWS WERE AMENDED ON SEPTEMBER 21, 2012 TO REFLECT THE AFOREMENTIONED CHANGES. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT PREPARED THE IRS FORM 990 ALONG WITH INDEPENDENT TAX CONSULTANTS WHO SIGN THE RETURN AS A PAID PREPARER. LAHEY CLINIC FOUNDATION, INC.'S EXECUTIVE MANAGEMENT REVIEWED AND, WITH THE INDEPENDENT TAX CONSULTANTS, PRESENTED THE FINAL DRAFT OF IRS FORM 990 TO THE AUDIT & COMPLIANCE COMMITTEE OF THE LAHEY HEALTH SYSTEM, INC. BOARD OF TRUSTEES PRIOR TO THE FILING DATE. THE FINAL IRS FORM 990 WAS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES BEFORE THE FILING DATE VIA A SECURED WEBSITE. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, TRUSTEES, KEY EMPLOYEES, PHYSICIANS AND MANAGEMENT EMPLOYEES AT ALL LEVELS, ARE REQUIRED TO FILL OUT AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THE LAHEY HOSPITAL & MEDICAL CENTER'S CORPORATE COMPLIANCE DEPARTMENT MONITORS AND REVIEWS EACH DISCLOSURE FOR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. THE CORPORATE COMPLIANCE DEPARTMENT MONITORS CONFLICTS OF INTEREST THROUGH DISCLOSURE SOFTWARE, TRAINING, AND INDIVIDUAL REVIEWS WITH PHYSICIANS, KEY EMPLOYEES, AND MANAGERS. DEPENDING ON THE CONFLICT OF INTEREST: A PERSON COULD BE ASKED TO NOT PARTICIPATE IN DECISIONS MADE ON BEHALF OF THE LAHEY HOSPITAL & MEDICAL CENTER; A PERSON MAY BE TOLD THEY CANNOT BE A PRINCIPAL INVESTIGATOR ON A RESEARCH STUDY; A PERSON MAY BE TOLD THAT THEY CANNOT PERFORM THE TASK THAT CREATES THE CONFLICT; OR A PERSON COULD BE ASKED TO REMOVE THEMSELVES FROM A COMMITTEE. FORM 990, PART VI, SECTION B, LINE 14 LAHEY HOSPITAL & MEDICAL CENTER HAS WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY KNOWN AS THE "RETENTION OF ADMINISTRATIVE AND CLINICAL DOCUMENTS". THE POLICIES, PROCEDURES, AND STANDARDS ARE MONITORED, MANAGED, AND REVISED BY THE RECORDS MANAGEMENT STEERING COMMITTEE. THE REVISED "RETENTION OF ADMINISTRATIVE AND CLINICAL DOCUMENTS" POLICY WAS APPROVED BY THE MEDICAL PRACTICE AND UTILIZATION COMMITTEE ON JULY 26, 2012. FORM 990, PART VI, SECTION B, LINE 15 & SCHEDULE J, PART I, LINE 3 INDEPENDENT MEMBERS OF THE BOARD OF TRUSTEES COMPRISE THE COMPENSATION COMMITTEE. THE COMMITTEE SETS THE COMPENSATION AND BENEFITS FOR THE CEO AND ALSO REVIEWS AND APPROVES RECOMMENDATIONS FOR THE COMPENSATION AND BENEFITS FOR DISQUALIFIED INDIVIDUALS AND OTHERS. OUTSIDE LEGAL COUNSEL ADVISES THE COMMITTEE AND RECORDS MINUTES FROM THE COMMITTEE MEETINGS. THE COMMITTEE SEEKS THE ADVICE OF EXTERNAL COMPENSATION CONSULTANTS. COMPARABILITY DATA IS PROVIDED, ANALYZED, AND DOCUMENTED BY THE EXTERNAL CONSULTANTS. THE LAHEY VICE PRESIDENT OF HUMAN RESOURCE OPERATIONS PROVIDES THE COMMITTEE WITH ANY REQUESTED INFORMATION. THE COMMITTEE MET SEVERAL TIMES THIS YEAR. FORM 990, PART VI, SECTION B, LINE 16B THE ORGANIZATION NEGOTIATES ARRANGEMENTS TO INCLUDE TERMS AND SAFEGUARDS TO ENSURE THAT THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED. FROM A LEGAL PERSPECTIVE, IN-HOUSE LEGAL COUNSEL, WITH THE INPUT OF EXTERNAL LEGAL COUNSEL, REVIEWS ALL PROPOSED JOINT VENTURE AND PARTNERSHIP AGREEMENTS. FROM A FINANCIAL PERSPECTIVE, LAHEY'S FINANCE MANAGEMENT TEAM REVIEWS ALL PROPOSED JOINT VENTURE AND PARTNERSHIP AGREEMENTS. BOTH REVIEWS TAKE PLACE BEFORE LAHEY HOSPITAL & MEDICAL CENTER ENTERS INTO ANY SUCH AGREEMENTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND OTHER COMPLIANCE POLICIES ARE MADE AVAILABLE TO THE PUBLIC VIA THE ORGANIZATION'S WEBSITE. IN ADDITION, THE ORGANIZATION PRESENTS FINANCIAL INFORMATION TO THE PUBLIC AS AN ATTACHMENT TO ITS MASSACHUSETTS OFFICE OF THE ATTORNEY GENERAL FORM PC. FORM 990, PART VII LAHEY CLINIC FOUNDATION, INC. AND ITS RELATED ORGANIZATIONS DO NOT COMPENSATE ANY TRUSTEE IN THEIR CAPACITY AS A TRUSTEE. ALL COMPENSATION PAID IS FOR WORK PERFORMED IN THE EMPLOYEE'S JOB TITLE, WHICH IS LISTED ON FORM 990, PART VII DIRECTLY FOLLOWING THE TITLE OF "TRUSTEE". FORM 990, PART VII; PART IX, LINE 5; SCHEDULE J COMPENSATION, BENEFIT AND PENSION EXPENSES FOR OFFICERS, TRUSTEES AND KEY EMPLOYEES, OF LAHEY CLINIC FOUNDATION, INC. ARE PAID BY LAHEY CLINIC FOUNDATION, INC. AS THE PARENT COMPANY OF LAHEY CLINIC HOSPITAL, INC., AND LAHEY CLINIC, INC., LAHEY CLINIC FOUNDATION, INC. ALLOCATES A SIGNIFICANT PORTION OF THE AFOREMENTIONED EXPENSES TO ITS AFFILIATES. THE AFFILIATES THEN REIMBURSE LAHEY CLINIC FOUNDATION, INC.
FORM 990, PART XI, LINE 5   NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS $ 15,180,857 UNRESTRICTED CONTRIBUTIONS 2,985,039 ASSETS RELEASED FROM TIME RESTRICTIONS 1,571,236 ASSETS RELEASED FROM RESTRICTIONS 2,461,577 PENSION & POST RETIREMENT RELATED CHANGE (485,876) GRANTS & CONTRIBUTIONS (3,285,682) CHANGE IN TEMPORARY & PERMANENT NET ASSETS 9,325,081 CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 509,923 REDESIGNATION OF GIFTS (17,758) _____________ $ 28,244,397
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Howard R Grant J.D. M.D. TITLE:TRUSTEE/PRESIDENT/CEO HOURS:57
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:John A Libertino, M.D. TITLE:TRUSTEE/CHAIR DEPT OF UROLOGY HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Richard W Nesto, M.D. TITLE:TRUSTEE/EVP/CMOO/PHYSICIAN HOURS:41
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Roger L Jenkins M.D. TITLE:TRUSTEE/PHYSICIAN HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Richard S D'Agostino M.D. TITLE:TRUSTEE/CHAIR DEPT CARDIO SURG HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Judith A Melin M.D. TITLE:TRUSTEE UNTIL7/16/12/ASSC CQSO HOURS:41
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Carl A Soderland M.D. TITLE:TRUSTEE UNTIL 07/16/12 /CHAIR HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Andrew G Villanueva M.D. TITLE:TRUSTEE/CMO CLINIC/PHYSICIAN HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Betsey Crawford M.D. TITLE:TRUSTEE START 7/16/12/PHYSICIA HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Arthur P Mourtzinos M.D. TITLE:TRUSTEE START 7/16/12/PHYSICIA HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Rebecca C Yang M.D. TITLE:TRUSTEE START 7/16/12/PHYSICIA HOURS:39
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Irving E Rogers III TITLE:TRUST/CHAIR/CLERK UNTIL7/16/12 HOURS:7
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Eric M Bailey TITLE:TRUSTEE HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Craig R Benson TITLE:TRUSTEE HOURS:4
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Ann Marie Connolly TITLE:TRUSTEE HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jerald G Fishman TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James W Henderson TITLE:TRUST/VICE CHAIR UNTIL 7/16/12 HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James D Irving TITLE:TRUSTEE HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Charles M Leighton TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Peter J Manning TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:J William Poduska TITLE:TRUSTEE HOURS:4
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Windle B Priem TITLE:TRUSTEE HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James A Radley TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robert L Reynolds TITLE:TRUSTEE UNTIL 7/16/12 HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael C Ruettgers TITLE:TRUSTEE/CHAIR OF BOARD HOURS:6
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Carolyn Ain TITLE:TRUSTEE START 7/16/12 HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Jane C Edmonds TITLE:TRUSTEE START 7/16/12 HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Edward Eskandarian TITLE:TRUSTEE START 7/16/12 HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David G Spackman TITLE:CLERK START 7/16/12 /GEN COUNS HOURS:57
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Timothy O'Connor TITLE:OFFICER/TREASURER/EVP/CFO HOURS:57
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Joseph C Corkery TITLE:PHYSICIAN HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:David M Barrett M.D. TITLE:FORMER TRUSTEE/PRESIDENT/CEO HOURS:
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

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
2011
Open to Public Inspection
Name of the organization
Lahey Clinic Foundation Inc
 
Employer identification number

04-2323457
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) LAHEY CLINIC HOSPITAL INC

41 MALL ROAD

BURLINGTON,MA01805
04-2704686 		HEALTH CARE MA 501(C)(3) 3 LCF INC
 
Yes
 
(2) LAHEY CLINIC INC

41 MALL ROAD

BURLINGTON,MA01805
04-2704683 		HEALTH CARE MA 501(C)(3) 9 LCF INC
 
Yes
 
(3) LAHEY CLINIC AFFILIATED SERVICES INC

41 MALL ROAD

BURLINGTON,MA01805
04-3178972 		HEALTH CARE MA 501(C)(3) 9 LCF INC
 
Yes
 
(4) NORTHEAST HEALTH SYSTEM INC

85 HERRICK ST

BEVERLY,MA01915
04-3240453 		SUPPORT MA 501(C)(3) 11C III-FI LHS INC
 
Yes
 
(5) NORTHEAST HOSPITAL CORPORATION

85 HERRICK ST

BEVERLY,MA01915
04-2121317 		HEALTH CARE MA 501(C)(3) 3 NEHS INC
 
Yes
 
(6) NORTHEAST MEDICAL PRACTICES

85 HERRICK ST

BEVERLY,MA01915
04-3201853 		HEALTH CARE MA 501(C)(3) 9 NEHC
 
Yes
 
(7) SEACOAST NURSING & REHABILITATION CENTER

300 WASHINGTON ST

GLOUCESTER,MA01930
04-1305001 		HEALTH CARE MA 501(C)(3) 9 NEHS INC
 
Yes
 
(8) NORTHEAST PROFESSIONAL REG OF NURSES

800 CUMMINGS CTR

BEVERLY,MA01915
20-1287349 		HEALTH CARE MA 501(C)(3) 9 NESHC
 
Yes
 
(9) NORTHEAST SENIOR HEALTH CORPORATION

85 HERRICK ST

BEVERLY,MA01915
04-2731137 		HEALTH CARE MA 501(C)(3) 9 NEHS INC
 
Yes
 
(10) NORTHEAST BEHAVIORAL HEALTH

131 RANTOUL ST

BEVERLY,MA01915
04-2777145 		MENTAL ILL MA 501(C)(3) 7 NEHS INC
 
Yes
 
(11) CAB HEALTH & RECOVERY

111 MIDDLETON ROAD

DANVERS,MA01923
04-2400270 		SUBS ABUSE MA 501(C)(3) 9 NEBHC
 
Yes
 
(12) HEALTH & EDUCATION HOUSING SERVICES INC

ZERO CENTENNIAL DRIVE

PEABODY,MA01960
22-3232914 		HUD HOUSING MA 501(C)(3) 9 NEBHC
 
Yes
 
(13) LAHEY HEALTH SYSTEM INC

41 MALL ROAD

BURLINGTON,MA01805
61-1665701 		SUPPORT MA 501(C)(3) 11C III-FI NA
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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












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) LAHEY CLINIC INSURANCE CO LTD
 
 
INSURANCE BD LCF INC
  		C-CorP 0 42,423,135 100.000 %
(2) PERPETUAL TRUSTS (7)
 
 
SUPPORT MA SEE PART VII
  		TRUST      
(3) REMAINDER TRUSTS (17)
 
 
SUPPORT MA SEE PART VII
  		TRUST      
(4) POOLED INCOME FUNDS (4)
 
 
SUPPORT MA SEE PART VII
  		TRUST      
(5) NORTHEAST PROPRIETARY CORPORATION
85 HERRICK ST
BEVERLY,MA01915
04-2855191 		MEDICAL SERVICES MA NEHS INC
  		C-CORP      
(6) NORTHEAST MASSACHUSETTS INDEMNITY CO LTD
GOVERNORS SQ 23 LIME TREE BAY AVE
GRAND CAYMAN KY1-1102,GRAND CAYMAN KY1-1102  
CJ
98-0440187 		INSURANCE CJ NHS INC
  		C-CORP      


Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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 related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from related 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) Lahey Clinic Hospital Inc

 K-R 9,045,977 COST
(2) LAHEY CLINIC INC

 K-R 6,977,791 COST
(3) PERPETUAL TRUSTS

 R 520,106 CASH
(4) REMAINDER TRUSTS

 R 14,192 CASH
(5) POOLED INCOME FUNDS

 R 135,521 CASH
(6)
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(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 Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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 IV, LINE 2   LAHEY CLINIC FOUNDATION INC. AND NORTHEAST HOSPITAL CORPORATION, RESPECTIVELY, HAVE FOUR AND THREE PERPETUAL TRUSTS. THE PERPETUAL TRUSTS ARE DOMICILED IN MASSACHUSETTS AND PENNSYLVANIA. FORM 990, SCHEDULE R, PART IV, LINE 3 LAHEY CLINIC FOUNDATION, INC. HAS SEVENTEEN REMAINDER TRUSTS. THE REMAINDER TRUSTS ARE DOMICILED IN MASSACHUSETTS AND NEW HAMPSHIRE. FORM 990, SCHEDULE R, PART IV, LINE 4 LAHEY CLINIC FOUNDATION, INC. AND NORTHEAST HOSPITAL CORPORATION, RESPECTIVELY, HAVE THREE AND ONE POOLED INCOME FUNDS. FORM 990, SCHEDULE R, PART V, LINE K IN ADDITION TO CONDUCTING FUNDRAISING AND SOLICIATION EFFORTS ON ITS OWN BEHALF, LAHEY CLINIC FOUNDATION, INC. ALSO CONDUCTS FUNDRAISING AND SOLICITATION EFFORTS ON BEHALF OF LAHEY CLINIC HOSPITAL, INC. AND LAHEY CLINIC, INC. FORM 990, SCHEDULE R, PART V, LINE L IN ADDITION TO CONDUCTING FUNDRAISING AND SOLICITATION EFFORTS ON THEIR OWN BEHALF, LAHEY CLINIC HOSPITAL, INC. AND LAHEY CLINIC, INC. CONDUCT FUNDRAISING AND SOLICITATION EFFORTS ON BEHALF OF LAHEY CLINIC FOUNDATION, INC. FORM 990, SCHEDULE R, PART V, LINE M ALL ENTITIES WITHIN THE LAHEY HEALTH SYSTEM, INC. SHARE FACILITIES, EQUIPMENT, MAILING LISTS, AND OTHER ASSETS. FOR A LIST OF ALL ENTITIES SEE SCHEDULE R. FORM 990, SCHEDULE R, PART V, LINE N-R LAHEY CLINIC HOSPITAL, INC., LAHEY CLINIC, INC. AND LAHEY CLINIC FOUNDATION, INC., PROVIDE VARIOUS CORPORATE AND OTHER SERVICES TO EACH OTHER. THESE CORPORATIONS REIMBURSE ONE ANOTHER FOR EXPENSES INCURRED SUCH AS EMPLOYEE SALARIES, MATERIALS, SUPPLIES, UTILITIES, ETC. CASH IS ALSO TRANSFERRED BETWEEN THE THREE CORPORATIONS.
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