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 private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 10-01-2013 , 2013, and ending 09-30-2014
BCheck if applicable:
CName of organization
MOUNT AUBURN PROFESSIONAL SERVICES INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
330 MOUNT AUBURN STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CAMBRIDGE, MA02138
D Employer identification number

04-3026897
E Telephone number

G Gross receipts $ 66,754,648
F Name and address of principal officer:
JEANETTE CLOUGH
330 MOUNT AUBURN STREET
CAMBRIDGE,MA02138
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1988
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 7
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 3
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 613
6 Total number of volunteers (estimate if necessary) ............. 6 4
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,338,739
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 59,520,047 62,936,823
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 10,227 -13,154
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,238,103 1,273,443
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 60,768,377 64,197,112
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 1,000
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) 56,853,990 59,940,906
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 15,590,479 17,848,203
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 72,444,469 77,790,109
19 Revenue less expenses. Subtract line 18 from line 12....... -11,676,092 -13,592,997
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 37,129,068 34,020,801
21 Total liabilities (Part X, line 26)............. 18,025,804 17,010,354
22 Net assets or fund balances. Subtract line 21 from line 20..... 19,103,264 17,010,447
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 MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line 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 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 $ 33,972,489 including grants of $ 1,000 ) (Revenue $ 28,887,236 )
SEE SCHEDULE O.
4b (Code:   ) (Expenses $ 23,563,171 including grants of $   ) (Revenue $ 20,590,687 )
SEE SCHEDULE O
4c (Code:   ) (Expenses $ 15,705,255 including grants of $   ) (Revenue $ 13,500,015 )
SEE SCHEDULE O
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet73,240,915
Form 990 (2013)
Form 990 (2013)
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 (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
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
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; 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, line 10?
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 VIIClick to see attachment.......
11b
 
No
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 VIIIClick 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 IXClick 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 XClick 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 XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII 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 and XII 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, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
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...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government 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 or 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, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
Yes
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........
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...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II....................
26
 
No
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.........
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 ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
.....................
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 direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
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, Part II, III, or IV, and Part 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
 
No
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...
35b
 
 
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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
66
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
613
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” to line 3b, 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, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
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
0
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.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
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 or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
7
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
3
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
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 this 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
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 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
 
No
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
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MA
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:
MediumBulletWILLIAM SULLIVAN330 MOUNT AUBURN STREETCAMBRIDGEMA02138 (617) 499-5021
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) BALESTRERO MD LORI M........................................................................
TRUSTEE, HOSPITALIST
30.00
.......................30.00
X           141,551 141,551 28,385
(2) BINDER MD DAVID A........................................................................
TRUSTEE, EMRGNCY MED MD
60.00
.......................  
X           329,541 0 40,643
(3) CANEPA JOHN J........................................................................
TRUSTEE
1.00
.......................5.00
X           0 0 0
(4) CLOUGH JEANETTE G........................................................................
TRUSTEE, PRESIDENT & CEO
10.00
.......................55.00
X   X       161,481 915,056 1,131,208
(5) HUANG MD EDWIN........................................................................
TRUSTEE, CHAIR OB/GYN
24.00
.......................36.00
X           209,899 314,849 40,682
(6) LUCCHINO DAVID L........................................................................
TRUSTEE
1.00
.......................1.00
X           0 0 0
(7) MACDONALD MD LESLIE........................................................................
TRUSTEE, MD OB/GYN
60.00
.......................  
X           289,192 0 60,244
(8) SETNIK MD GARY S........................................................................
TEE, CHAIR EMRGNCY MED
24.00
.......................36.00
X           159,780 239,671 56,129
(9) SIMONS THOMAS........................................................................
TRUSTEE
1.00
.......................5.00
X           0 0 0
(10) STEVENSON HOWARD H........................................................................
TRUSTEE
1.00
.......................2.00
X           0 0 0
(11) LUKASIK CHARLES........................................................................
COO & CLERK
57.00
.......................3.00
    X       303,937 15,997 45,332
(12) SULLIVAN WILLIAM........................................................................
VP FINANCE & TREAS
10.00
.......................50.00
    X       55,142 312,473 35,018
(13) BIRJINIUK MD VLADIMIR........................................................................
CHIEF, CARDIO SURGERY
60.00
.......................  
        X   1,046,778 0 69,783
(14) ABNER MD ANTHONY........................................................................
MD, RADIATION ONCOLOGY
60.00
.......................  
        X   664,724 0 41,147
(15) ROSENBLATT MD PETER........................................................................
DIR, UROGYN & RECON SURG
54.00
.......................6.00
        X   482,224 53,581 40,118
(16) NAUTA MD RUSSELL J........................................................................
CHAIR, DEPT. OF SURGERY
12.00
.......................48.00
        X   86,446 345,780 152,658
(17) IMPERATO MD JOHN........................................................................
MD, EMERG DEPT
60.00
.......................  
        X   388,345 0 18,426
Form 990 (2013)
Form 990 (2013)
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 (list any hours for related organizations below dotted line)
(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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) KAWADA MD CHARLES........................................................................
FRMR TEE & CHAIR OB/GYN
60.00
.......................  
          X 161,578 0 31,793
(19) SEMENZA PETER........................................................................
FORMER CFO
0.00
.......................60.00
          X 0 158,971 6,256
(20) ZINNER MD STEPHEN........................................................................
FRMR TEE,CHAIR DEPT MED
9.00
.......................51.00
          X 66,016 374,090 28,442




















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 4,546,634 2,872,019 1,826,264
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet12
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
RESERVOIR MEDICAL ASSOCIATES725 CONCORD AVE 2000CAMBRIDGEMA02238 SHARED SERVICES 612,067
MACIPA INC1380 SOLDIERS FIELD ROADBRIGHTONMA02135 EMR/CREDENTIALING 602,305
ATHENA HEALTH311 ARSENAL STWATERTOWNMA02135 BILLING SERVICES 558,021
BELMONT MEDICAL ASSOCIATES725 CONCORD AVECAMBRIDGEMA02138 SHARED SERVICES 387,229
GE HEALTHCARE IITS USA4Q IDX DRIVESOUTH BURLINGTONVT05403 MAINTENANCE 335,359
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 MediumBullet18
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt 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 above
1f
 
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet  
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REV. 621110 54,875,037 54,875,037    
b AFFILIATE SUPPORT 900099 6,972,146 6,972,146    
c OTHER PATIENT REV. 621110 917,607 917,607    
d REV FROM SVC TO AFFILI 561499 104,975 104,975    
e ADMINISTRATIVE SERVICE 561000 39,070 39,070    
f All other program service revenue . 27,988 27,988    
g Total. Add lines 2a–2f........MediumBullet 62,936,823
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 9,466     9,466
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 2,367,445  
b Less: rental expenses 2,518,533  
c Rental income or (loss) -151,088  
d Net rental income or (loss).......MediumBullet -151,088   -22,883 -128,205
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   16,383
b Less: cost or other basis and sales expenses   39,003
c Gain or (loss)   -22,620
d Net gain or (loss)..........MediumBullet -22,620     -22,620
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      
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        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a UNRELATED MGMT. FEES 561000 1,361,622   1,361,622  
b MEDICAL RECORDS FEES 900099 41,115 41,115    
c RESEARCH 541700 12,000     12,000
d All other revenue .... 9,794     9,794
e Total. Add lines 11a–11d ...... MediumBullet 1,424,531
12 Total revenue. See Instructions......MediumBullet 64,197,112 62,977,938 1,338,739 -119,565
Form 990 (2013)
Form 990 (2013)
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).Check if Schedule O contains a response or note to any line 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 1,000 1,000
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,208,999 1,208,999    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 51,539,253 48,744,534 2,794,719  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 2,171,533 2,005,087 166,446  
9 Other employee benefits ....... 1,993,009 1,826,748 166,261  
10 Payroll taxes ........... 3,028,112 2,832,680 195,432  
11 Fees for services (non-employees):        
a Management ......        
b Legal .........        
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 4,203,836 3,752,925 450,911  
12 Advertising and promotion .... 21,121 15,675 5,446  
13 Office expenses ....... 3,481,472 3,440,528 40,944  
14 Information technology ...... 1,594,652 1,182,605 412,047  
15 Royalties ..        
16 Occupancy ........... 3,880,591 3,657,283 223,308  
17 Travel ............ 31,775 30,940 835  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 31,665 18,125 13,540  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 1,205,687 1,157,756 47,931  
23 Insurance .............. 2,778,690 2,778,690    
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a CONTINUING EDUCATION 405,828 405,828 0  
b DUES 24,183 16,600 7,583  
c HARVARD MED EDUCATION 12,054 12,054    
d
e All other expenses 176,649 152,858 23,791  
25 Total functional expenses. Add lines 1 through 24e 77,790,109 73,240,915 4,549,194 0
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 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 266,037 1 17,185
2 Savings and temporary cash investments ......... 102,701 2 87,707
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 4,428,003 4 4,756,645
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ............. 111,109 7 18,215
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges .......... 1,306,820 9 1,381,897
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 27,926,571
b Less: accumulated depreciation ..... 10b 16,441,366 11,589,305 10c 11,485,205
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 19,325,093 15 16,273,947
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 37,129,068 16 34,020,801
Liabilities 17 Accounts payable and accrued expenses ......... 4,410,026 17 4,520,299
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities .............   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 13,615,778 25 12,490,055
26 Total liabilities. Add lines 17 through 25......... 18,025,804 26 17,010,354
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 19,000,563 27 16,922,740
28 Temporarily restricted net assets ........... 102,701 28 87,707
29 Permanently restricted net assets ...........   29 0
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 19,103,264 33 17,010,447
34 Total liabilities and net assets/fund balances ........ 37,129,068 34 34,020,801
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
64,197,112
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
77,790,109
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-13,592,997
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
19,103,264
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
11,500,180
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
17,010,447
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 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?
2c
 
No
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
MOUNT AUBURN PROFESSIONAL SERVICES INC
 
Employer identification number

04-3026897
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 supported organization? ................
11g(i)
 
No
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
Provide the following information about the supported organization(s).
(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 monetary support
Yes No Yes No Yes No
(A) MOUNT AUBURN HOSPITAL
 
042103606 3 Yes     No   No 77,790,109
Total 77,790,109

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MOUNT AUBURN PROFESSIONAL SERVICES INC
 
Employer identification number

04-3026897
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
0
j
Total. Add lines 1c through 1i ...............................
0
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: MOUNT AUBURN HOSPITAL (MAH), THE PARENT CORPORATION TO MOUNT AUBURN PROFESSIONAL SERVICES, INC. (MAPS) ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF THIS ENTITY AND OTHER AFFILIATED NETWORK ENTITIES. ADDITIONALLY, MAPS PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS, A PIECE OF WHICH MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. TOTAL LOBBYING EXPENDITURES ON BEHALF OF MAPS WERE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES.
Schedule C (Form 990 or 990EZ) 2013

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. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MOUNT AUBURN PROFESSIONAL SERVICES INC
 
Employer identification number

04-3026897
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 section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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 XIII, 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 102,701 107,694 112,687 117,678 122,630
b Contributions ........          
c Net investment earnings, gains, and losses 6 7 7 9 48
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
15,000 5,000 5,000 5,000 5,000
f Administrative expenses ....          
g End of year balance ...... 87,707 102,701 107,694 112,687 117,678
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet0 %
c
Temporarily restricted endowment SchDMd Bullet100.000 %
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 XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. 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 .................   400,000 400,000
b Buildings ................   17,151,998 8,572,892 8,579,106
c Leasehold improvements ............        
d Equipment ................   10,374,573 7,868,474 2,506,099
e Other .................        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 11,485,205
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) AMOUNTS DUE FROM THIRD PARTY PAYORS 5,598,275
(2) PRACTICE ACQUISITION 1,099,855
(3) MALPRACTICE RECOVERY A/R 9,575,817






Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 16,273,947
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
OTHER 350,468
PROFESSIONAL LIABILITY CLAIMS RESERVE 2,563,770
MALPRACTICE RECOVERY LIABILITY 9,575,817






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 12,490,055
2. Liability for uncertain tax positions In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 390,211,000
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d 323,495,000
e Add lines 2a through 2d ..................... 2e 323,495,000
3 Subtract line 2e from line 1..................... 3 66,716,000
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 XIII.) ........... 4b -2,518,888
c Add lines 4a and 4b....................... 4c -2,518,888
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 64,197,112
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 373,109,000
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d 292,801,000
e Add lines 2a through 2d...................... 2e 292,801,000
3 Subtract line 2e from line 1..................... 3 80,308,000
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 XIII.) ............ 4b -2,517,891
c Add lines 4a and 4b....................... 4c -2,517,891
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 77,790,109
Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART V, LINE 4: PART V LINE 4 INTENDED USES OF ENDOWMENT FUND ENDOWMENT/SPECIAL FUND MONIES ARE HELD TO SUPPORT MEDICAL EDUCATION.
PART X, LINE 2: THE CORPORATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN FIFTY PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE CORPORATION DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS IN EITHER 2014 OR 2013.
PART XI, LINE 2D - OTHER ADJUSTMENTS: MOUNT AUBURN HOSPITAL REVENUE 332,087,000. INTERCOMPANY ELIMINATIONS -8,607,000. NET ASSETS RELEASED FROM RESTRICTIONS 15,000.
PART XI, LINE 4B - OTHER ADJUSTMENTS: EXPENSES ASSOCIATED WITH REAL ESTATE -2,410,548. DEPRECIATION EXPENSE ASSOCIATED WITH REAL ESTATE -107,985. ROUNDING -355.
PART XII, LINE 2D - OTHER ADJUSTMENTS: MOUNT AUBURN HOSPITAL EXPENSES 301,408,000. INTERCOMPANY ELIMINATIONS -8,607,000.
PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES ASSOCIATED WITH REAL ESTATE -2,410,548. DEPRECIATION EXPENSE ASSOCIATED WITH REAL ESTATE -107,985. ROUNDING 642.
Schedule D (Form 990) 2013

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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MOUNT AUBURN PROFESSIONAL SERVICES INC
 
Employer identification number

04-3026897
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 of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
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 (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)BALESTRERO MD LORI MTRUSTEE, HOSPITALIST (i)
(ii)
141,092
141,092
0
0
459
459
8,925
8,925
5,268
5,267
155,744
155,743
0
0
(2)BINDER MD DAVID ATRUSTEE, EMRGNCY MED MD (i)
(ii)
302,057
0
24,159
0
3,325
0
20,400
0
20,243
0
370,184
0
0
0
(3)CLOUGH JEANETTE GTRUSTEE, PRESIDENT & CEO (i)
(ii)
79,877
452,634
64,875
367,625
16,729
94,797
166,809
945,253
2,872
16,274
331,162
1,876,583
0
0
(4)HUANG MD EDWINTRUSTEE, CHAIR OB/GYN (i)
(ii)
162,139
243,208
44,800
67,200
2,960
4,441
7,000
10,500
9,273
13,909
226,172
339,258
0
0
(5)MACDONALD MD LESLIETRUSTEE, MD OB/GYN (i)
(ii)
237,484
0
50,821
0
887
0
36,476
0
23,768
0
349,436
0
0
0
(6)SETNIK MD GARY STEE, CHAIR EMRGNCY MED (i)
(ii)
131,400
197,101
26,400
39,600
1,980
2,970
14,160
21,240
8,292
12,437
182,232
273,348
0
0
(7)LUKASIK CHARLESCOO & CLERK (i)
(ii)
241,618
12,717
59,863
3,151
2,456
129
19,380
1,020
23,686
1,246
347,003
18,263
0
0
(8)SULLIVAN WILLIAMVP FINANCE & TREAS (i)
(ii)
44,247
250,734
10,710
60,691
185
1,048
2,125
10,625
3,340
18,928
60,607
342,026
0
0
(9)BIRJINIUK MD VLADIMIRCHIEF, CARDIO SURGERY (i)
(ii)
970,906
0
1,600
0
74,272
0
41,550
0
28,233
0
1,116,561
0
0
0
(10)ABNER MD ANTHONYMD, RADIATION ONCOLOGY (i)
(ii)
248,239
0
414,871
0
1,614
0
12,750
0
28,397
0
705,871
0
0
0
(11)ROSENBLATT MD PETERDIR, UROGYN & RECON SURG (i)
(ii)
444,371
49,375
36,689
4,077
1,164
129
16,065
1,785
20,042
2,226
518,331
57,592
0
0
(12)NAUTA MD RUSSELL JCHAIR, DEPT. OF SURGERY (i)
(ii)
70,481
281,922
15,330
61,320
635
2,538
24,885
99,540
5,646
22,587
116,977
467,907
0
0
(13)IMPERATO MD JOHNMD, EMERG DEPT (i)
(ii)
301,134
0
29,184
0
58,027
0
12,750
0
5,676
0
406,771
0
0
0
(14)KAWADA MD CHARLESFRMR TEE & CHAIR OB/GYN (i)
(ii)
124,681
0
0
0
36,897
0
10,000
0
21,793
0
193,371
0
0
0
(15)SEMENZA PETERFORMER CFO (i)
(ii)
0
132,480
0
0
0
26,491
0
0
0
6,256
0
165,227
0
0
(16)ZINNER MD STEPHENFRMR TEE,CHAIR DEPT MED (i)
(ii)
64,628
366,223
0
0
1,388
7,867
2,678
15,173
1,588
9,003
70,282
398,266
0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: DURING THE 2013 CALENDAR YEAR, MOUNT AUBURN HOSPITAL MAINTAINED AN IRC SECTION 457(B) PLAN PURSUANT TO WHICH ELIGIBLE EMPLOYEE COULD DEFER PART OF THEIR COMPENSATION. THIS PLAN IS STRICTLY EMPLOYEE FUNDED WITH NO EMPLOYER DEFERRALS AND ONE OR MORE INDIVIDUALS LISTED ON THE MAPS FORM 990 PART VII AND SCHEDULE J WERE ELIGIBLE TO PARTICIPATE IN THE PLAN. UNDER THE DEFINITIONS TO THIS FORM 990, THIS PLAN IS CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. AMOUNTS DEFERRED AND INCREASES IN THE VALUE OF THE NON-QUALIFIED PLAN ACCOUNTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990 SCHEDULE J, PART II, COLUMN C, DEFERRED INCOME, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. IN ADDITION, AS PREVIOUSLY NOTED, CAREGROUP, INC. (CAREGROUP) IS THE SOLE MEMBER OF MOUNT AUBURN HOSPITAL. DURING THE PERIOD COVERED BY THIS FILING, THE CEO OF MAH/MAPS WAS PAID BY CAREGROUP WHICH IS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER ANNUITY RETIREMENT PLAN (ARP). UNDER THE DEFINITIONS TO THIS FORM 990, THE ARP IS CONSIDERED A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. PARTICIPANTS RECEIVE BOTH CURRENTLY TAXABLE AND DEFERRED BENEFITS FROM THIS PLAN. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW.
PART I, LINE 7 NON-FIXED PAYMENTS: THE PRESIDENT/CEO, VICE PRESIDENTS, DEPARTMENT CHAIRS AND OTHER SENIOR MANAGEMENT ARE ELIGIBLE TO RECEIVE ANNUAL INCENTIVE COMPENSATION PAYMENTS BASED ON COMPARISON OF ACTUAL ACCOMPLISHMENTS WITH PRE-DETERMINED GOALS.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. OTHER REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED FULLY VESTED 457(B) PLAN; TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AND OTHER TAXABLE RETIREMENT BENEFITS. DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401K RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403B RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN. NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THE NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE. ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES. MOUNT AUBURN HOSPITAL, MOUNT AUBURN PROFESSIONAL SERVICES AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM AND CAREGROUP MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS MAH, MAPS AND BIDN RESPECTIVELY. IN ADDITION, THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL MAY BE REFERRED TO AS PFHC, HMS OR PFHC/HMS. BALESTRERO, M.D., LORI TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES HOSPITALIST - MOUNT AUBURN PROFESSIONAL SERVICES DIRECTOR, HOSPITALIST SERVICE - MOUNT AUBURN HOSPITAL INSTRUCTOR IN MEDICINE - HARVARD MEDICAL SCHOOL DR. BALESTRERO RESIGNED HER POSITION ON THE MAPS BOARD AS OF JANUARY 28, 2014. DR. BALESTRERO DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. IN HER ROLE AS A HOSPITALIST, DR. BALESTRERO PERFORMS SERVICES FOR BOTH MOUNT AUBURN PROFESSIONAL SERVICES AND MOUNT AUBURN HOSPITAL. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. BALESTRERO IS PAID DIRECTLY BY MOUNT AUBURN PROFESSIONAL SERVICES, THE PORTION OF DR. BALESTRERO'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 141,092 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 459 DEFERRED COMPENSATION: 8,925 NON-TAXABLE BENEFITS: 5,268 PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 141,092 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 459 DEFERRED COMPENSATION: 8,925 NON-TAXABLE BENEFITS: 5,267 BINDER, M.D., DAVID TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES EMERGENCY MEDICINE PHYSICIAN - MOUNT AUBURN PROFESSIONAL SERVICES INSTRUCTOR IN MEDICINE - HARVARD MEDICAL SCHOOL DR. BINDER RESIGNED HIS POSITION ON THE MAPS BOARD AS OF JANUARY 28, 2014. DR. BINDER DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 302,057 INCENTIVE COMPENSATION: 24,159 OTHER REPORTABLE COMPENSATION: 3,325 DEFERRED COMPENSATION: 20,400 NON-TAXABLE BENEFITS: 20,243 CANEPA, JOHN J. TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES TRUSTEE AND BOARD VICE-CHAIR - MOUNT AUBURN HOSPITAL MR. CANEPA BEGAN HIS TERM ON MAPS' BOARD ON JANUARY 28, 2014 AND DEVOTES, ON AVERAGE, A COMBINED 6 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. CLOUGH, JEANETTE G. TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER - MOUNT AUBURN PROFESSIONAL SERVICES TRUSTEE (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER - MOUNT AUBURN HOSPITAL MS. CLOUGH DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. IN HER POSITIONS AS PRESIDENT AND CHIEF EXECUTIVE OFFICER FOR MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) AND MOUNT AUBURN HOSPITAL (MAH), MS. CLOUGH RECEIVES PAYMENTS DIRECTLY FROM MAH AS WELL AS FROM CAREGROUP, THE SOLE MEMBER OF MAH, AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND A SUPPORT ORGANIZATION OF MAH. ADDITIONALLY, MS. CLOUGH PERFORMS SERVICES FOR BOTH MAH AND MAPS BUT NOT DIRECTLY FOR CAREGROUP. AS SUCH AND AS REQUIRED BY THIS FORM 990, MS. CLOUGH'S COMPENSATION IS REPORTED HERE AS IF PAID BY MAH AND MAPS. THE COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 79,877 INCENTIVE COMPENSATION: 64,875 OTHER REPORTABLE COMPENSATION: 16,729 DEFERRED COMPENSATION: 166,809 NON-TAXABLE BENEFITS: 2,872 PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 452,634 INCENTIVE COMPENSATION: 367,625 OTHER REPORTABLE COMPENSATION: 94,797 DEFERRED COMPENSATION: 945,253 NON-TAXABLE BENEFITS: 16,274 INCENTIVE COMPENSATION REPORTED FOR THE 2013 CALENDAR YEAR INCLUDES 1) PAYMENTS IN 2013 PURSUANT TO A LONG TERM INCENTIVE PLAN RELATED TO MOUNT AUBURN HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2012 IN THE AMOUNT OF $225,000 AND 2) A PAYMENT PURSUANT TO AN ANNUAL INCENTIVE PLAN RELATED TO THE FISCAL YEAR ENDED SEPTEMBER 30, 2012 IN THE AMOUNT OF $225,000. AS REQUIRED BY THIS FORM 990, THESE INCENTIVE COMPENSATION PAYMENTS WERE REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL FOR THE 2013 CALENDAR YEAR INCLUDES AN ACTUARIAL CHANGE IN THE PROJECTED BENEFIT OBLIGATION OF MS. CLOUGH'S SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) OF $698,500. THE SERP DOES NOT VEST UNTIL MS. CLOUGH REACHES AGE 62. DEFERRED COMPENSATION REPORTED FOR THE 2013 CALENDAR YEAR ALSO INCLUDES TWO INCENTIVE PAYMENTS RELATED TO THE SERVICES MS. CLOUGH PERFORMED DURING MOUNT AUBURN'S FISCAL YEAR ENDED SEPTEMBER 30, 2013 BUT WHICH WERE NOT PAID TO MS. CLOUGH UNTIL AFTER MARCH 15, 2014 -- ONE IN THE AMOUNT OF $200,000 RELATED TO AN ANNUAL INCENTIVE PLAN, AND ANOTHER FOR $200,000 RELATED TO A LONG TERM INCENTIVE PLAN. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. CLOUGH INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $60,562. ADDITIONALLY, OTHER REPORTABLE COMPENSATION IN THE AMOUNT OF $18,950 WAS REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990, AS REQUIRED.
SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) HUANG, M.D., EDWIN TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES CHAIR, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY - MOUNT AUBURN PROFESSIONAL SERVICES CHAIR, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY - MOUNT AUBURN HOSPITAL ASSISTANT PROFESSOR OF OBSTETRICS, GYNECOLOGY AND REPRODUCTIVE BIOLOGY - HARVARD MEDICAL SCHOOL DR. HUANG JOINED THE BOARD OF MOUNT AUBURN PROFESSIONAL SERVICES ON JANUARY 28, 2014. DR. HUANG DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. HUANG PERFORMS SERVICES FOR BOTH MOUNT AUBURN PROFESSIONAL SERVICES AND MOUNT AUBURN HOSPITAL. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. HUANG IS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF DR. HUANG'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 162,139 INCENTIVE COMPENSATION: 44,800 OTHER REPORTABLE COMPENSATION: 2,960 DEFERRED COMPENSATION: 7,000 NON-TAXABLE BENEFITS: 9,273 PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 243,208 INCENTIVE COMPENSATION: 67,200 OTHER REPORTABLE COMPENSATION: 4,441 DEFERRED COMPENSATION: 10,500 NON-TAXABLE BENEFITS: 13,909 OTHER REPORTABLE AND DEFERRED COMPENSATION INCLUDE COMBINED 457(B) DEFERRALS AND AN INCREASE IN DR. HUANG'S PLAN VALUE OF $23,668. LUCCHINO, DAVID TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES TRUSTEE - MOUNT AUBURN HOSPITAL MR. LUCCHINO'S TERM ON THE MAPS BOARD ENDED JANUARY 28, 2014. MR. LUCCHINO DEVOTED, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. MACDONALD, M.D., LESLIE TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES PHYSICIAN, OBSTETRICS AND GYNECOLOGY - MOUNT AUBURN PROFESSIONAL SERVICES CLINICAL INSTRUCTOR IN OBSTETRICS, GYNECOLOGY AND REPRODUCTIVE BIOLOGY - HARVARD MEDICAL SCHOOL DR. MACDONALD DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 237,484 INCENTIVE COMPENSATION: 50,821 OTHER REPORTABLE COMPENSATION: 887 DEFERRED COMPENSATION: 36,476 NON-TAXABLE BENEFITS: 23,768 AS REQUIRED BY THIS FORM 990, OF THE AMOUNT INCLUDED IN BONUS AND INCENTIVE COMPENSATION FOR THE 2013 CALENDAR YEAR, $38,875 WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES FOR THE 2013 CALENDAR YEAR INCLUDES AN INCENTIVE PAYMENT OF $18,626 RELATED TO DR. MACDONALD'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2013, BUT NOT PAID TO DR. MACDONALD UNTIL AFTER MARCH 15, 2014. SETNIK, M.D., GARY S. TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES CHAIR, DEPARTMENT OF EMERGENCY MEDICINE - MOUNT AUBURN PROFESSIONAL SERVICES CHAIR, DEPARTMENT OF EMERGENCY MEDICINE - MOUNT AUBURN HOSPITAL ASSISTANT PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. SETNIK'S TERM ON MOUNT AUBURN PROFESSIONAL SERVICES' BOARD BEGAN ON JANUARY 28, 2014. DR. SETNIK DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. SETNIK PERFORMS SERVICES FOR BOTH MOUNT AUBURN PROFESSIONAL SERVICES AND MOUNT AUBURN HOSPITAL. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. SETNIK IS PAID DIRECTLY BY MOUNT AUBURN PROFESSIONAL SERVICES, THE PORTION OF DR. SETNIK'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 131,400 INCENTIVE COMPENSATION: 26,400 OTHER REPORTABLE COMPENSATION: 1,980 DEFERRED COMPENSATION: 14,160 NON-TAXABLE BENEFITS: 8,292 PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 197,101 INCENTIVE COMPENSATION: 39,600 OTHER REPORTABLE COMPENSATION: 2,970 DEFERRED COMPENSATION: 21.240 NON-TAXABLE BENEFITS: 12,437 AS REQUIRED BY THIS FORM 990, BONUS AND INCENTIVE COMPENSATION FOR THE 2013 CALENDAR YEAR IN THE AMOUNT OF $13,500 WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. OTHER REPORTABLE AND DEFERRED COMPENSATION INCLUDE COMBINED 457(B) DEFERRALS AND AN INCREASE IN DR. SETNIK'S PLAN VALUE OF $13,713. SIMONS, TOM TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES TRUSTEE AND BOARD CHAIR - MOUNT AUBURN HOSPITAL DIRECTOR (EX-OFFICIO) - CAREGROUP, INC. MR. SIMONS' TERM ON THE MAPS BOARD BEGAN JANUARY 28, 2014. MR. SIMONS DEVOTES, ON AVERAGE, A COMBINED 6 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. STEVENSON, HOWARD H. TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES TRUSTEE - MOUNT AUBURN HOSPITAL DIRECTOR - CAREGROUP, INC. MR. STEVENSON DEVOTES, ON AVERAGE, A COMBINED 3 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. LUKASIK, CHARLES CHIEF OPERATING OFFICER AND CLERK - MOUNT AUBURN PROFESSIONAL SERVICES IN HIS ROLE AS CHIEF OPERATING OFFICER OF MAPS, MR. LUKASIK PERFORMS SERVICES FOR BOTH MOUNT AUBURN PROFESSIONAL SERVICES AND MOUNT AUBURN HOSPITAL. AS REQUIRED BY THIS FORM 990, ALTHOUGH MR. LUKASIK IS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF MR. LUKASIK'S COMPENSATION ATTRIBUTABLE TO SERVICES PROVIDED TO EACH ENTITY HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. MR. LUKASIK DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 241,618 INCENTIVE COMPENSATION: 59,863 OTHER REPORTABLE COMPENSATION: 2,456 DEFERRED COMPENSATION: 19,380 NON-TAXABLE BENEFITS: 23,686 PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 12,717 INCENTIVE COMPENSATION: 3,151 OTHER REPORTABLE COMPENSATION: 129 DEFERRED COMPENSATION: 1,020 NON-TAXABLE BENEFITS: 1,246 AS REQUIRED BY THIS FORM 990, BONUS AND INCENTIVE COMPENSATION FOR THE 2013 CALENDAR YEAR IN THE AMOUNT OF $63,014 WAS ALSO PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. SULLIVAN, WILLIAM VICE PRESIDENT, FINANCE AND TREASURER - MOUNT AUBURN PROFESSIONAL SERVICES VICE PRESIDENT AND CHIEF FINANCIAL OFFICER - MOUNT AUBURN HOSPITAL MR. SULLIVAN DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. IN HIS ROLES AS CHIEF FINANCIAL OFFICER OF MOUNT AUBURN HOSPITAL AND VICE PRESIDENT OF FINANCE OF MOUNT AUBURN PROFESSIONAL SERVICES, MR. SULLIVAN PERFORMS SERVICES FOR BOTH ENTITIES. AS REQUIRED BY FORM 990, ALTHOUGH MR. SULLIVAN WAS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF MR. SULLIVAN'S COMPENSATION ATTRIBUTABLE TO SERVICES PROVIDED TO EACH ENTITY HAS BEEN SEPARATELY REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 44,247 INCENTIVE COMPENSATION: 10,710 OTHER REPORTABLE COMPENSATION: 185 DEFERRED COMPENSATION: 2,125 NON-TAXABLE BENEFITS: 3,340 PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 250,734 INCENTIVE COMPENSATION: 60,691 OTHER REPORTABLE COMPENSATION: 1,048 DEFERRED COMPENSATION: 10,625 NON-TAXABLE BENEFITS: 18,928 AS REQUIRED BY THIS FORM 990, BONUS AND INCENTIVE COMPENSATION FOR THE 2013 CALENDAR YEAR IN THE AMOUNT OF $71,401 WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. BIRJINIUK, M.D., VLADIMIR CHIEF, CARDIOVASCULAR SURGERY - MOUNT AUBURN PROFESSIONAL SERVICES ASSISTANT PROFESSOR OF SURGERY - HARVARD MEDICAL SCHOOL DR. BIRJINIUK DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 970,906 INCENTIVE COMPENSATION: 1,600 OTHER REPORTABLE COMPENSATION: 74,272 DEFERRED COMPENSATION: 41,550 NON-TAXABLE BENEFITS: 28,233 DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES FOR THE 2013 CALENDAR YEAR INCLUDES AN INCENTIVE PAYMENT OF $28,800 RELATED TO DR. BIRJINIUK'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2013, BUT NOT PAID TO DR. BIRJINIUK UNTIL AFTER MARCH 15, 2014.
SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) ABNER, M.D., ANTHONY RADIATION ONCOLOGIST - MOUNT AUBURN PROFESSIONAL SERVICES INSTRUCTOR IN RADIOLOGY - HARVARD MEDICAL SCHOOL DR. ABNER DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 248,239 INCENTIVE COMPENSATION: 414,871 OTHER REPORTABLE COMPENSATION: 1,614 DEFERRED COMPENSATION: 12,750 NON-TAXABLE BENEFITS: 28,397 ROSENBLATT, M.D., PETER UROGYNECOLOGIC AND RECONSTRUCTIVE SURGEON - MOUNT AUBURN PROFESSIONAL SERVICES INSTRUCTOR, GRADUATE MEDICAL EDUCATION - MOUNT AUBURN HOSPITAL ASSISTANT PROFESSOR OF OBSTETRICS, GYNECOLOGY AND REPRODUCTIVE BIOLOGY - HARVARD MEDICAL SCHOOL DR. ROSENBLATT DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DR. ROSENBLATT PERFORMS SERVICES FOR BOTH MOUNT AUBURN PROFESSIONAL SERVICES AND MOUNT AUBURN HOSPITAL. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ROSENBLATT IS PAID DIRECTLY BY MOUNT AUBURN PROFESSIONAL SERVICES, THE PORTION OF DR. ROSENBLATT'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 444,371 INCENTIVE COMPENSATION: 36,689 OTHER REPORTABLE COMPENSATION: 1,164 DEFERRED COMPENSATION: 16,065 NON-TAXABLE BENEFITS: 20,042 PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 49,375 INCENTIVE COMPENSATION: 4,077 OTHER REPORTABLE COMPENSATION: 129 DEFERRED COMPENSATION: 1,785 NON-TAXABLE BENEFITS: 2,226 NAUTA, M.D., RUSSELL CHAIR, DEPARTMENT OF SURGERY - MOUNT AUBURN PROFESSIONAL SERVICES CHAIR, DEPARTMENT OF SURGERY - MOUNT AUBURN HOSPITAL FORMER TRUSTEE - MOUNT AUBURN HOSPITAL PROFESSOR OF SURGERY - HARVARD MEDICAL SCHOOL DR. NAUTA DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. NAUTA PERFORMS SERVICES FOR BOTH MOUNT AUBURN PROFESSIONAL SERVICES AND MOUNT AUBURN HOSPITAL. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. NAUTA IS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF DR. NAUTA'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 70,481 INCENTIVE COMPENSATION: 15,330 OTHER REPORTABLE COMPENSATION: 635 DEFERRED COMPENSATION: 24,885 NON-TAXABLE BENEFITS: 5,646 PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 281,922 INCENTIVE COMPENSATION: 61,320 OTHER REPORTABLE COMPENSATION: 2,538 DEFERRED COMPENSATION: 99,540 NON-TAXABLE BENEFITS: 22,587 AS REQUIRED BY THIS FORM 990, BONUS AND INCENTIVE COMPENSATION FOR THE 2013 CALENDAR YEAR IN THE AMOUNT OF $76,650 WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN THE PRIOR YEAR FORM 990. DEFERRED COMPENSATION REPORTED BY MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES FOR THE 2013 CALENDAR YEAR INCLUDES AN INCENTIVE PAYMENT OF $106,575 RELATED TO DR. NAUTA'S PERFORMANCE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2013, BUT NOT PAID TO DR. NAUTA UNTIL AFTER MARCH 15, 2014. IMPERATO, M.D., JOHN PHYSICIAN, EMERGENCY MEDICINE - MOUNT AUBURN PROFESSIONAL SERVICES DR. IMPERATO DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 301,134 INCENTIVE COMPENSATION: 29,184 OTHER REPORTABLE COMPENSATION: 58,027 DEFERRED COMPENSATION: 12,750 NON-TAXABLE BENEFITS: 5,676 OTHER REPORTABLE AND DEFERRED COMPENSATION INCLUDE COMBINED 457(B) DEFERRALS AND AN INCREASE IN DR. IMPERATO'S PLAN VALUE OF $57,220. KAWADA, M.D., CHARLES FORMER TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES PHYSICIAN, OBSTETRICS AND GYNECOLOGY - MOUNT AUBURN PROFESSIONAL SERVICES FORMER CHAIR, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY - MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES ASSISTANT CLINICAL PROFESSOR OF OBSTETRICS, GYNECOLOGY AND REPRODUCTIVE BIOLOGY - HARVARD MEDICAL SCHOOL DR. KAWADA SERVED ON THE MOUNT AUBURN PROFESSIONAL SERVICES BOARD THROUGH DECEMBER 31, 2011. DR. KAWADA DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 124,681 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 36,897 DEFERRED COMPENSATION: 10,000 NON-TAXABLE BENEFITS: 21,793 AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES FOR THE 2013 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. KAWADA'S POSITION AS ASSISTANT CLINICAL PROFESSOR OF OBSTETRICS, GYNECOLOGY AND REPRODUCTIVE BIOLOGY, HARVARD MEDICAL SCHOOL: $23,923 BASE AND OTHER REPORTABLE COMPENSATION, $3,000 DEFERRED COMPENSATION AND $21,702 NON-TAXABLE BENEFITS. OTHER REPORTABLE AND DEFERRED COMPENSATION INCLUDE COMBINED 457(B) DEFERRALS AND AN INCREASE IN DR. KAWADA'S PLAN VALUE OF $36,136. SEMENZA, PETER FORMER CHIEF FINANCIAL OFFICER - MOUNT AUBURN HOSPITAL FORMER CHIEF FINANCIAL OFFICER - MOUNT AUBURN PROFESSIONAL SERVICES FORMER INTERIM CHIEF FINANCIAL OFFICER - BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM MR. SEMENZA SERVED AS THE INTERIM CHIEF FINANCIAL OFFICER OF BIDN FROM DECEMBER 3, 2012 TO APRIL 30, 2013 AND DEVOTED, ON AVERAGE, 60 HOURS PER WEEK TO THAT ENTITY. PAYMENTS REPORTED BY MAH: BASE COMPENSATION: 0 BONUS AND INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 26,491 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 PAYMENTS REPORTED BY BIDN: BASE COMPENSATION: 132,480 BONUS AND INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 6,256 MR. SEMENZA RETIRED FROM HIS POSITIONS OF CHIEF FINANCIAL OFFICER OF MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES ON AUGUST 15, 2011. AMOUNTS REPORTED HERE AS OTHER REPORTABLE COMPENSATION RELATE TO CONTRIBUTIONS TO AND, THE CHANGE IN VALUE OF, NON-QUALIFIED RETIREMENT PLAN BALANCE. ZINNER, M.D., STEPHEN FORMER TRUSTEE - MOUNT AUBURN PROFESSIONAL SERVICES CHAIR DEPARTMENT OF MEDICINE - MOUNT AUBURN PROFESSIONAL SERVICES FORMER TRUSTEE - MOUNT AUBURN HOSPITAL CHAIR DEPARTMENT OF MEDICINE - MOUNT AUBURN HOSPITAL CHARLES S. DAVIDSON PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. ZINNER SERVED AS THE CHAIR IN THE DEPARTMENT OF MEDICINE UNTIL SEPTEMBER 30, 2014 AND DEVOTED, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. ZINNER PERFORMS SERVICES FOR BOTH MOUNT AUBURN PROFESSIONAL SERVICES AND MOUNT AUBURN HOSPITAL. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ZINNER IS PAID DIRECTLY BY MOUNT AUBURN HOSPITAL, THE PORTION OF DR. ZINNER'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY MOUNT AUBURN PROFESSIONAL SERVICES: BASE COMPENSATION: 64,628 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 1,388 DEFERRED COMPENSATION: 2,678 NON-TAXABLE BENEFITS: 1,588 PAYMENTS REPORTED BY MOUNT AUBURN HOSPITAL: BASE COMPENSATION: 366,223 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,867 DEFERRED COMPENSATION: 15,173 NON-TAXABLE BENEFITS: 9,003
Schedule J (Form 990) 2013

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.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
MOUNT AUBURN PROFESSIONAL SERVICES INC
 
Employer identification number
04-3026897
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 NONEAVAIL 07-11-2012 49,910,000 REFUND ISSUES DATED 2/11/1998   X   X   X
B MA DEVELOPMENT FINANCE AGENCY
 
04-3431814 NONEAVAIL 09-15-2011 120,280,000 REFUND ISSUES DATED 2/11/1998   X   X   X
C MA HLTH & ED FAC AUTH
 
04-2456011 57586C3S2 06-09-2008 377,527,010 REFUND ISSUES DATED 1/19/1989; 9/23/1992; 8/12/2004; & CAPITAL PROJECTS   X   X   X
D MA HLTH & ED FAC AUTH
 
04-2456011 57586CDK8 08-12-2004 187,125,000 REFUND ISSUES DATED 9/23/1992, 11/9/1994   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 29,700,000 29,700,000 75,420,000 154,175,000
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 49,910,000 120,280,000 378,911,689 187,125,000
4 Gross proceeds in reserve funds . . . . . . . . . . . . 27,356,617   27,356,617  
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 368,094 290,672 3,929,290 1,796,643
8 Credit enhancement from proceeds . . . . . . . . . . . 7,991,727     7,991,727
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 134,556,855   134,556,855  
11 Other spent proceeds . . . . . . . . . . . . . . 49,541,906 119,989,328 213,068,927 177,336,630
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2011 2011
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X   X   X   X  
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X              
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
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              
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            
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?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.600 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.100 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.700 %      
7 Does the bond issue meet the private security or payment test? . . . . .   X            
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 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              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X   X   X
b Exception to rebate? . . . . . . . . X   X     X X  
c No rebate due? . . . . . . . .   X   X X     X
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X   X   X X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X X  
b Name of provider . . . . . . . . . CITIBANK
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . . 21.000000000000     21.000000000000
d Was the hedge superintegrated? . . . .   X           X
e Was the hedge terminated? . . . . . . X           X  
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
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? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K - EXPLANATORY STATEMENT CAREGROUP, INC., (CAREGROUP) IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED THAT SERVES AS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, BETH ISRAEL DEACONESS HOSPITAL - MILTON, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND THESE ENTITIES' PHYSICIAN GROUPS AND OTHER AFFILIATED ENTITIES. CAREGROUP'S PURPOSE IS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MAKE UP THE CAREGROUP SYSTEM. CAREGROUP AND SOME OF ITS AFFILIATES JOINTLY BORROW DEBT AS AN OBLIGATED GROUP. THE OBLIGATED GROUP MEMBERS ARE: CAREGROUP, BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS - NEEDHAM (BID-NEEDHAM), MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) AND MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP (APG). THE INFORMATION REPORTED ON SCHEDULE K FOR BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER) REFLECTS THE COMBINED CAREGROUP OBLIGATED GROUP DEBT ISSUED AFTER DECEMBER 31, 2002 WITH AN OUTSTANDING PRINCIPAL BALANCE IN EXCESS OF $100,000.
SCHEDULE K PART 1F - DESCRIPTION OF TAX-EXEMPT DEBT PURPOSE PURPOSES OF CAREGROUP SERIES E BONDS: - TO FINANCE OR REFINANCE VARIOUS RENOVATION AND CONSTRUCTION PROJECTS AND CAPITAL EQUIPMENT ACQUISITIONS FOR THE MEDICAL CENTER - TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR MAH'S NEW AND EXPANDED FACILITIES WITH APPROXIMATELY 250,000 SQUARE FEET OF NEW AND RENOVATED SPACE TO INCLUDE: A NEW SIX-STORY ACUTE CARE FACILITY TO SUPPORT ADDITIONAL CRITICAL CARE AND MEDICAL /SURGICAL BEDS, EXPANDED OPERATING ROOMS AND INTERVENTIONAL RADIOLOGY ROOMS AND A NEW PARKING GARAGE - TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR NEBH'S MASTER FACILITY PLAN, INCLUDING A NEW ATRIUM OF APPROXIMATELY 2,740 SQUARE FEET, A PRE-OPERATIVE AND POST ANESTHESIA UNIT OF APPROXIMATELY 14,310 SQUARE FEET, CONSTRUCTION OF A CENTRAL STERILE SUPPLY AREA OF APPROXIMATELY 8,290 SQUARE FEET AND CONSTRUCTION OF NEW OPERATING ROOMS OF APPROXIMATELY 18,615 SQUARE FEET; - TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR BID-NEEDHAM'S NEW AND EXPANDED FACILITIES INCLUDING AN APPROXIMATELY 59,000 SQUARE FOOT PROJECT ON TWO FLOORS TO RENOVATE AND EXPAND SERVICES IN THE EMERGENCY DEPARTMENT, INPATIENT UNITS, RADIOLOGY DEPARTMENT AND ASSOCIATED SUPPORT SERVICES; - TO REFINANCE $201,975,000 OF DEBT PREVIOUSLY ISSUED BY MEMBERS OF THE OBLIGATED GROUP, INCLUDING $138,075,000 OF THE CAREGROUP SERIES C BONDS DESCRIBED BELOW. PURPOSES OF CAREGROUP SERIES D BONDS: - REFUNDING OF THE OUTSTANDING PRINCIPAL BALANCE OF THE MAH SERIES B BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED JULY 13, 2004 PURPOSES OF CAREGROUP SERIES C BONDS: - REFUNDING OF THE OUTSTANDING PRINCIPAL BALANCE OF THE BETH ISRAEL HOSPITAL ASSOCIATION SERIES G BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED JULY 13, 2004 PURPOSES OF CAREGROUP SERIES F BONDS: - REFUNDING OF A PORTION OF THE OUTSTANDING PRINCIPAL BALANCE OF THE CAREGROUP SERIES A BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED SEPTEMBER 1, 2011 PURPOSES OF CAREGROUP SERIES G BONDS: - REFUNDING THE REMAINING PORTION OF THE OUTSTANDING PRINCIPAL BALANCE OF THE CAREGROUP SERIES A BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED JULY 1, 2012
SCHEDULE K PART II, COLUMN C, LINE 3 THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE DUE TO THE INVESTMENT EARNINGS ON THE PROJECT FUND. SCHEDULE K PART II, COLUMNS A, B AND D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE PROCEEDS USED TO REFUND PRIOR ISSUE(S). THE AMOUNTS ARE NOT LISTED ON LINE 6 BECAUSE THEY ARE NO LONGER IN ESCROW. SCHEDULE K PART II, COLUMN C, LINE 11: OF THE PROCEEDS LISTED, $8,993,760 WERE USED FOR TERMINATION OF THE HEDGE AGREEMENT, WITH THE REMAINDER USED FOR REFUNDING PURPOSES OF THE ISSUE. SCHEDULE K PART III QUESTIONS 2 AND 3: FACILITIES FINANCED WITH TAX-EXEMPT BONDS ARE PRIMARILY OCCUPIED BY CAREGROUP AND ITS AFFILIATED TAX-EXEMPT ENTITIES, INCLUDING BUT NOT LIMITED TO THE MEDICAL CENTER, BID-NEEDHAM, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER NEBH, NEW ENGLAND BAPTIST MEDICAL ASSOCIATES, MAH, MAPS AND APG. SOME FINANCED SPACE MAY CONTAIN LEASE ARRANGEMENTS, AND THE AFFILIATES WHICH OWN THE DEBT FINANCED SPACE MAY OPT TO ENGAGE A MANAGEMENT SERVICES COMPANY (I.E. CLEANING, PATIENT TRANSPORT, AND FOOD SERVICES) OR ENGAGE IN RESEARCH PURSUANT TO RESEARCH AGREEMENTS WITHIN TAX EXEMPT DEBT FINANCED SPACE. ANY SUCH AGREEMENTS IN PLACE AS OF SEPTEMBER 30, 2014 WERE REVIEWED TO ENSURE PROPER ACCOUNTING OF ANY PRIVATE USE GENERATED FROM SUCH ACTIVITIES. IN ADDITION, SUCH AGREEMENTS ARE GENERALLY REVIEWED BY INSIDE COUNSEL PRIOR TO FINALIZING.
PART IV, COLUMN C, LINE 2C AN ARBITRAGE REBATE CALCULATION WAS COMPLETED AS OF SEPTEMBER 30, 2012.
PART IV, COLUMN D, LINE 2C AN ARBITRAGE REBATE CALCULATION WAS COMPLETED AS OF SEPTEMBER 30, 2013. SCHEDULE K PART IV, COLUMN D, LINE 4C: AT THE TIME OF ISSUE, THE CAREGROUP OBLIGATED GROUP ENTERED INTO THREE FLOATING-TO-FIXED INTEREST RATE SWAPS, TWO OF WHICH HAD 21 YEAR MATURITY DATES AND THE THIRD HAD A 20 YEAR MATURITY. THESE HEDGES WERE TERMINATED IN 2008.
Schedule K (Form 990) 2013

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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
MOUNT AUBURN PROFESSIONAL SERVICES INC
 
Employer identification number

04-3026897
Return Reference Explanation
FORM 990, PART I, LINE 1 & PART III, LINE 1 MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) IS A PHYSICIAN GROUP PRACTICE PROVIDING PATIENT CARE AND TEACHING SERVICES IN THE AREAS OF PRIMARY CARE, OBSTETRICS/GYNECOLOGY, EMERGENCY MEDICINE AND OTHER SPECIALTIES.
FORM 990, PART III, LINE 4A AS A SUPPORT ORGANIZATION TO MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL), A HOSPITAL EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986 AS AMENDED, DURING THE FISCAL PERIOD COVERED BY THIS RETURN, MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) PROVIDED DIRECT PATIENT CARE SERVICES THROUGH MORE THAN 321,000 PATIENT ENCOUNTERS WITH A VARIETY OF MEDICAL ISSUES IN THE AREA OF PRIMARY CARE. IN ADDITION, MAPS PROVIDED APPROXIMATELY $124,000 OF FREE CARE TO PATIENTS IN NEED, WHICH IS IN DIRECT FURTHERANCE OF MAPS' EXEMPT PURPOSE OF FURTHERING THE EXEMPT FUNCTIONS OF MAH. MAPS ALSO PROVIDED SUPPORT TO THE MEDICAL EDUCATION AND CLINICAL PROGRAMS OF MAH WHICH IS IN DIRECT FURTHERANCE OF ITS SUPPORT OF MAH'S EXEMPT FUNCTION. SECTIONS OF THE MOUNT AUBURN HOSPITAL FORM 990 SCHEDULE H, HOSPITALS, NARRATIVE DISCLOSURES RELATED TO COMMUNITY BENEFIT HAS BEEN INCLUDED IN THESE MOUNT AUBURN PROFESSIONAL SERVICES NARRATIVE TO PROVIDE ADDITIONAL DETAIL.
FORM 990, PART III, LINE 4B AS A SUPPORT ORGANIZATION TO MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL), A HOSPITAL EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986 AS AMENDED, DURING THE FISCAL PERIOD COVERED BY THIS RETURN, MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) PROVIDED DIRECT PATIENT CARE SERVICES THROUGH MORE THAN 54,000 PATIENT ENCOUNTERS IN VARIOUS SPECIALTY AREAS INCLUDING EMERGENCY MEDICINE, VASCULAR MEDICINE, NEUROLOGY, RHEUMATOLOGY AND CARDIAC SURGERY. IN ADDITION, MAPS PROVIDED APPROXIMATELY $246,000 OF FREE CARE TO PATIENTS IN NEED, ALL OF WHICH IS IN DIRECT FURTHERANCE OF MAPS' EXEMPT PURPOSE OF FURTHERING THE EXEMPT FUNCTIONS OF MAH. MAPS ALSO PROVIDED SUPPORT TO THE MEDICAL EDUCATION AND CLINICAL PROGRAMS OF MAH WHICH IS IN DIRECT FURTHERANCE OF ITS SUPPORT OF MAH'S EXEMPT FUNCTION. SECTIONS OF THE MOUNT AUBURN HOSPITAL FORM 990 SCHEDULE H, HOSPITALS, NARRATIVE DISCLOSURES RELATED TO COMMUNITY BENEFIT HAS BEEN INCLUDED IN THESE MOUNT AUBURN PROFESSIONAL SERVICES NARRATIVE TO PROVIDE ADDITIONAL DETAIL.
FORM 990, PART III, LINE 4C AS A SUPPORT ORGANIZATION TO MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL), A HOSPITAL EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986 AS AMENDED, DURING THE FISCAL PERIOD COVERED BY THIS RETURN, MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) PROVIDED DIRECT PATIENT CARE SERVICES THROUGH MORE THAN 62,000 PATIENT ENCOUNTERS IN THE AREA OF OBSTETRICS/GYNECOLOGY. IN ADDITION, MAPS PROVIDED APPROXIMATELY $110,000 OF FREE CARE TO PATIENTS IN NEED, WHICH IS IN DIRECT FURTHERANCE OF MAPS' EXEMPT PURPOSE OF FURTHERING THE EXEMPT FUNCTIONS OF MAH. MAPS ALSO PROVIDED SUPPORT TO THE MEDICAL EDUCATION AND CLINICAL PROGRAMS OF MAH WHICH IS IN DIRECT FURTHERANCE OF ITS SUPPORT OF MAH'S EXEMPT FUNCTION. SECTIONS OF THE MOUNT AUBURN HOSPITAL FORM 990 SCHEDULE H, HOSPITALS, NARRATIVE DISCLOSURES RELATED TO COMMUNITY BENEFIT HAS BEEN INCLUDED IN THESE MOUNT AUBURN PROFESSIONAL SERVICES NARRATIVE TO PROVIDE ADDITIONAL DETAIL.
PART IV, QUESTION 12A AS DESCRIBED IN THIS FILING, MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) IS A PUBLIC CHARITY AND TAX EXEMPT AFFILIATE OF MOUNT AUBURN HOSPITAL, (MAH OR HOSPITAL), A REGIONAL TEACHING HOSPITAL, EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THE FINANCIAL RECORDS OF MAPS ARE AUDITED EACH YEAR AS PART OF THE MAH CONSOLIDATED AUDITED FINANCIAL STATEMENT PROCESS AND FOR THE FISCAL PERIOD COVERED BY THIS FILING, THE BOSTON, MA OFFICE OF KPMG ISSUED AND UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MAH AND AFFILIATE.
PART IV, LINE 24A MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) IS A MEMBER OF THE CAREGROUP OBLIGATED GROUP. THE ENTITIES THAT COMPRISE THIS OBLIGATED GROUP ARE ALL JOINTLY AND SEVERALLY LIABLE ON THE TAX-EXEMPT DEBT ISSUED TO THE OBLIGATED GROUP. AS SUCH, ALTHOUGH MAPS DOES NOT REFLECT ANY OF THIS DEBT ON ITS INDIVIDUAL BALANCE SHEET, MAPS HAS ATTACHED A COMPLETED COPY OF SCHEDULE K, SUPPLEMENTAL INFORMATION ON TAX-EXEMPT BONDS, TO THIS FORM 990.
FORM 990, PART IV, QUESTION 24B PROCEEDS IN THE PROJECT FUND WERE UNEXPECTEDLY HELD BEYOND THE THREE-YEAR TEMPORARY PERIOD, BUT WERE YIELD RESTRICTED IN COMPLIANCE WITH FEDERAL TAX REQUIREMENTS.
FORM 990, PART VI, SECTION A, LINE 2 AS NOTED IN VARIOUS NARRATIVE DISCLOSURES WHICH SUPPORT THIS FORM 990 AND RELATED SCHEDULES, CAREGROUP, INC. (CAREGROUP) IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CAREGROUP'S PURPOSE IS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MAKE UP THE CAREGROUP SYSTEM. CAREGROUP SERVES AS THE SOLE MEMBER AND A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER). BIDMC IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BIDN), MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A AFFILIATED PHYSICIANS GROUP (APG), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH) AND JORDAN HEALTH SYSTEMS INC. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES. CAREGROUP ALSO SERVES AS THE SOLE MEMBER AND A SUPPORT ORGANIZATION OF NEW ENGLAND BAPTIST HOSPITAL (NEBH) AND MOUNT AUBURN HOSPITAL (MAH), WHICH IN TURN SERVE AS THE SOLE MEMBER OF NEW ENGLAND BAPTIST MEDICAL ASSOCIATES (NEBMA) AND MOUNT AUBURN PROFESSIONAL SERVICES (MAPS), RESPECTIVELY. EACH OF THE ENTITIES LISTED IN THIS PARAGRAPH MAY, IN TURN, SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE CAREGROUP NETWORK OF AFFILIATES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE CAREGROUP NETWORK OF AFFILIATED ORGANIZATIONS. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J.
FORM 990, PART VI, SECTION A, LINE 6 MOUNT AUBURN HOSPITAL INC. (MAH) IS A REGIONAL TEACHING HOSPITAL CLOSELY AFFILIATED WITH THE HARVARD MEDICAL SCHOOL WITH A MISSION TO IMPROVE THE HEALTH OF THE RESIDENTS OF CAMBRIDGE, MASSACHUSETTS AND THE SURROUNDING COMMUNITIES. MAH IS DEDICATED TO DELIVERING HIGH QUALITY HEALTHCARE SERVICES IN A PERSONABLE, CONVENIENT, AND COMPASSIONATE MANNER, WITH RESPECT FOR THE DIGNITY OF PATIENTS AND THEIR FAMILIES. MAH IS A HOSPITAL EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AS AMENDED, AND ACTING THROUGH ITS BOARD OF TRUSTEES, IS THE SOLE MEMBER OF MOUNT AUBURN PROFESSIONAL SERVICES.
FORM 990, PART VI, SECTION A, LINE 7A AS NOTED ABOVE, MOUNT AUBURN HOSPITAL INC. (MAH) IS THE SOLE MEMBER OF MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) AND THE MEMBER ELECTS A BOARD OF TRUSTEES TO SERVE AS THE GOVERNING BODY OF THE CORPORATION OF MAPS.
FORM 990, PART VI, SECTION A, LINE 7B ACCORDING TO THE MAPS'S BYLAWS, AS SOLE MEMBER, MAH HAS THE FOLLOWING RIGHTS: - ESTABLISHMENT OR MODIFICATION OF COMPENSATION OF OR REMOVAL OF THE CHIEF EXECUTIVE OFFICER, IF ANY, OR PRESIDENT OF THE CORPORATION; - ENTERING INTO OF CONTRACTS WHICH BIND THE CORPORATION AND WHICH ARE MANAGED CARE CONTRACTS, EXCLUSIVE CONTRACTS, AGREEMENTS-NOT-TO-COMPETE OR USE SIMILAR ARRANGEMENTS, CONTRACTS FOR MANAGEMENT SERVICES OR OTHER MULTI-YEAR SERVICE CONTRACTS WITH POTENTIALLY SIGNIFICANT MULTI-YEAR BUDGETARY IMPACT; - ADOPTION OF A MISSION STATEMENT AND STRATEGIC, FINANCIAL AND OPERATIONAL PLAN FOR THE CORPORATION; - ADOPTION OF AN ANNUAL OPERATING BUDGET AND ALL CAPITAL BUDGETS;THE BORROWING OF, OR INCIDENCE OF DEBT IN, ANY AMOUNT OTHER THAN (I) FOR PURPOSE OF SECURING WORKING CAPITAL FROM A LENDER WHICH SHALL HAVE BEEN APPROVED BY THE MEMBER AND PURSUANT TO THEN EXISTING AND PROVISIONS RELATING TO SUCH BORROWING WHICH SHALL HAVE BEEN APPROVED BY THE MEMBER, AND (II) DEBT INCURRED IN THE ORDINARY COURSE OF BUSINESS WHICH IS ANTICIPATED IN AND CONSISTENT WITH THE ANNUAL OPERATING BUDGET OR A CAPITAL BUDGET WHICH SHALL HAVE BEEN APPROVED BY THE MEMBER FOR THE YEAR IN WHICH INCURRED; - ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE CORPORATION, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION OR THE ADDITION OR ELIMINATION OF ANY CLINICAL DEPARTMENT OR PROGRAM, WHICH DEPARTMENT OR PROGRAM COULD REASONABLY BE ANTICIPATED WOULD MATERIALLY AFFECT THE FINANCIAL STATUS OF THE CORPORATION, OR ITS ABILITY TO CONDUCT ITS BUSINESS, OR THE ENTERING INTO OF ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE ENTITY; AND, - INITIATION OF ANY BANKRUPTCY OR INSOLVENCY ACTION ON BEHALF OF THE CORPORATION OR ANY SUBSIDIARY THEREOF.
FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER OF MOUNT AUBURN HOSPITAL (MAH), THE TAX DIRECTOR OF CAREGROUP, WHICH IS THE MEMBER OF MAH AND DELOITTE TAX, LLP. THE COMPLETE FORM 990 IS PRESENTED TO THE AUDIT COMMITTEE OF MAH FOR REVIEW AND DISCUSSION. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF THE MAPS BOARD OF TRUSTEES OF THE FILING ENTITY PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C AS NOTED ABOVE, MOUNT AUBURN HOSPITAL (MAH) IS THE SOLE MEMBER OF MOUNT AUBURN PROFESSIONAL SERVICES (MAPS). MAH HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO BOTH MAH AND MAPS. PURSUANT TO THAT POLICY, ALL OFFICERS, TRUSTEES AND KEY EMPLOYEES OF BOTH ENTITIES ARE ASKED TO COMPLETE AN ANNUAL CONFLICT DISCLOSURE STATEMENT WHICH IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS RELATIONSHIPS MAINTAINED BY OFFICERS, TRUSTEES OR KEY EMPLOYEES AND THEIR FAMILY MEMBERS WHICH MAY RESULT IN A CONFLICT OF INTEREST. IN ADDITION, ANY INDIVIDUAL WHO COMMENCES A TERM AS AN OFFICER, DIRECTOR, TRUSTEE OR KEY EMPLOYEE IS REQUIRED TO COMPLETE THE ANNUAL CONFLICT DISCLOSURE AT THE TIME SUCH POSITION COMMENCES. ALL ANNUAL DISCLOSURES ARE REVIEWED BY THE MAH OFFICE OF GENERAL COUNSEL FOR DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT AND ANY ACTIVITY THAT REQUIRES ACTION UNDER THE CONFLICT OF INTEREST POLICY IS SUBJECT TO ONGOING REVIEW AND ACTION THROUGH THE GENERAL COUNSEL'S OFFICE. PURSUANT TO THE CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A PLAN TO REQUIRE DISCLOSURE AND RECUSAL, INCLUDING APPROPRIATE DOCUMENTATION IN THE MINUTES. CAREGROUP, INC. IS THE SOLE MEMBER OF MAH. IN ADDITION TO THE CONFLICT OF INTEREST PROCESS OUTLINED ABOVE, THE MAH OFFICE OF THE GENERAL COUNSEL AND THE CAREGROUP TAX DEPARTMENT JOINTLY ISSUE A TAX QUESTIONNAIRE TO ALL CURRENT AND FORMER MEMBERS OF THE BOARD OF TRUSTEES AS WELL AS CURRENT AND FORMER OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR MAH TO COMPLETELY AND ACCURATELY PROCESS AND COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES.
FORM 990, PART VI, SECTION B, LINE 15 AS PREVIOUSLY NOTED, MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) IS THE SOLE MEMBER OF MAPS. THE HOSPITAL HAS A COMPENSATION COMMITTEE (THE "COMMITTEE") THAT IS COMPRISED OF SIX MEMBERS OF THE BOARD OF TRUSTEES INCLUDING THE CURRENT CHAIRMAN OF THE BOARD OF TRUSTEES AND THE MAH/MAPS CEO, WHO SERVES ON THE COMMITTEE AS AN "EX OFFICIO" MEMBER WITHOUT VOTING RIGHTS. ALL OTHER MEMBERS OF THE COMMITTEE ARE INDEPENDENT. THE COMMITTEE OPERATES TO FULFILL THE FOLLOWING RESPONSIBILITIES: - TO REVIEW AND APPROVE THE TOTAL COMPENSATION OF EACH MEMBER OF THE HOSPITAL'S SENIOR MANAGEMENT TEAM SO AS TO ENSURE THAT SUCH COMPENSATION REMAINS COMPETITIVE IN THE MARKETPLACE, REPRESENTS GOOD VALUE TO THE HOSPITAL FOR THE QUALITY AND QUANTITY OF SERVICES PROVIDED AND CONSTITUTES REASONABLE TOTAL COMPENSATION TO THE EMPLOYEE IN LIGHT OF THE EMPLOYEE'S POSITION, RESPONSIBILITIES, QUALIFICATIONS AND PERFORMANCE IN ACCORDANCE WITH INTERNAL AND EXTERNAL REASONABLE COMPENSATION STANDARDS APPLICABLE TO THIS TAX EXEMPT HOSPITAL; - TO RECOMMEND TO THE BOARD OF TRUSTEES THE TERMS AND CONDITIONS OF ANY EMPLOYMENT AGREEMENTS BETWEEN THE HOSPITAL AND ITS PRESIDENT/CHIEF EXECUTIVE OFFICER INCLUDING BASE SALARIES, INCENTIVE COMPENSATION, SUPPLEMENTAL EMPLOYEE RETIREMENT PLANS, BENEFITS AND OTHER LAWFUL METHODS OF REASONABLE COMPENSATION; - TO RECOMMEND TO THE BOARD OF TRUSTEES FOR THE BOARD'S APPROVAL THE TERMS AND CONDITIONS OF ANY SUPPLEMENTAL EMPLOYEE RETIREMENT PLANS FOR HOSPITAL EXECUTIVES; - TO REVIEW AND APPROVE THOSE PORTIONS OF THE FEDERAL FORM 990 AND THE MASSACHUSETTS FORM PC, OR THEIR EQUIVALENTS, PERTAINING TO THE COMPENSATION OF HOSPITAL EMPLOYEES PRIOR TO THE HOSPITAL'S FILING OF SUCH FORMS WITH THE REGULATORY AUTHORITIES; - AS DETERMINED TO BE ADVISABLE BY THE COMMITTEE FROM TIME TO TIME, TO ENGAGE OUTSIDE COMPENSATION CONSULTANTS AND LEGAL AND OTHER ADVISORS TO PROVIDE TO THE COMMITTEE APPROPRIATE AND RELIABLE COMPARABLE COMPENSATION DATA FOR SIMILARLY SITUATED EMPLOYEES OF NATIONAL, REGIONAL AND LOCAL PEER INSTITUTIONS AND OTHER EXPERT ADVICE TO ASSIST THE COMMITTEE IN FULFILLING ITS RESPONSIBILITIES; - TO WORK WITH THE HOSPITAL'S MANAGEMENT AND AUDITORS TO RESOLVE, OR TO RECOMMEND TO THE BOARD OF TRUSTEES RESOLUTION OF, ANY ISSUES OF CONCERN PERTAINING TO THE COMPENSATION OF HOSPITAL EMPLOYEES THAT MAY ARISE DURING THE COURSE OF THE HOSPITAL'S INDEPENDENT AUDIT OR MAY BE PRESENTED IN THE INDEPENDENT AUDITOR'S MANAGEMENT LETTER TO THE HOSPITAL; - TO REVIEW AND APPROVE EMPLOYEE BENEFITS PROGRAMS INCLUDING WELFARE, FRINGE AND RETIREMENT PLANS AND PROGRAMS, AND ANY MATERIAL AMENDMENTS THERETO; - TO ADOPT SUCH POLICIES AND PROCEDURES AS THE COMMITTEE MAY DETERMINE FROM TIME TO TIME TO BE NECESSARY OR USEFUL TO ENSURE THAT THE HOSPITAL PAYS REASONABLE AND COMPETITIVE COMPENSATION TO ITS MANAGEMENT TEAM WHILE PRESERVING THE TAX EXEMPT STATUS OF THE HOSPITAL; AND - TO REVIEW AND REASSESS THE COMMITTEE'S CHARTER FROM TIME TO TIME AND TO RECOMMEND ANY PROPOSED CHANGES TO THE HOSPITAL'S BOARD OF TRUSTEES FOR ITS CONSIDERATION AND APPROVAL. THE COMMITTEE MEETS SEVERAL TIMES DURING THE YEAR TO REVIEW AND APPROVE INDIVIDUAL PERFORMANCE GOALS FOR MANAGEMENT AND THE CEO, TO REVIEW PERFORMANCE AGAINST SUCH GOALS, TO APPROVE INCENTIVE COMPENSATION PAYMENTS TO MANAGEMENT, TO RECOMMEND COMPENSATION PAYMENTS TO THE CEO FOR APPROVAL BY THE TRUSTEES AND TO APPROVE SALARY ADJUSTMENTS FOR THE NEXT YEAR. FURTHER, THE COMMITTEE WILL ADDRESS AS REQUIRED ANY CHANGES IN INDIVIDUAL OR GROUP COMPENSATION ARRANGEMENTS AT SUCH MEETINGS. THE COMMITTEE UNDERSTANDS THAT ONE OF ITS CORE RESPONSIBILITIES IS TO ENSURE THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT ALL ARRANGEMENTS COMPLY WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE COMPENSATION COMMITTEE HAS HISTORICALLY RELIED UPON GUIDANCE OUTLINED IN WRITTEN COMPENSATION SURVEYS/STUDIES PRODUCED UNDER AN ARRANGEMENT WITH AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF ORGANIZATIONS SIMILAR TO MAH. THE COMMITTEE HAS HISTORICALLY HAD A FULL STUDY CONDUCTED BY SUCH FIRM EVERY OTHER YEAR WITH AN UPDATED STUDY IN THE OTHER YEARS. THIS SURVEY HAS FORMED THE BASIS FOR THE COMMITTEE FULFILLING ITS RESPONSIBILITY IN THIS REGARD. FOR THE PERIODS COVERED IN THIS FORM 990, THE COMMITTEE MET SEVERAL TIMES TO REVIEW THE COMPENSATION OF EACH OF THE INDIVIDUALS DESCRIBED ABOVE. TOOLS UTILIZED FOR THIS REVIEW INCLUDED THE COMPENSATION STUDY PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM CONTRACTED BY THE COMMITTEE. FURTHER, PERFORMANCE OF EACH INDIVIDUAL WAS MEASURED AGAINST PREVIOUS APPROVED GOALS AND OBJECTIVES IN DETERMINING INCENTIVE COMPENSATION PAYMENTS. AFTER DISCUSSION AND ANALYSIS AT SEVERAL MEETINGS, THE COMPENSATION COMMITTEE VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE CEO. UPON EXCUSING THE CEO FROM ITS MEETING, THE COMPENSATION COMMITTEE DISCUSSED THE COMPENSATION OF THE CEO AND THE PERFORMANCE OF THE CEO AGAINST PREVIOUSLY APPROVED GOALS AND OBJECTIVES AND WITH THE INPUT OF THE COMPENSATION STUDY AND VOTED TO RECOMMEND FOR APPROVAL BY THE BOARD OF TRUSTEES THE COMPENSATION ARRANGEMENT OF THE CEO. AT A FUTURE BOARD OF TRUSTEES MEETING, THE COMMITTEE CHAIRMAN MADE A FULL REPORT TO THE INDEPENDENT TRUSTEES OF THE COMMITTEES ANALYSIS OF CEO COMPENSATION AND AFTER DISCUSSION RECOMMENDED THAT THE TRUSTEES APPROVE THE CEO COMPENSATION. THE TRUSTEES VOTED AND APPROVED THE COMPENSATION. ALL DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION OF THE MAH CEO WAS THEN ALSO APPROVED BY THE CAREGROUP COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: MOUNT AUBURN HOSPITAL OFFICES 330 MOUNT AUBURN ST CAMBRIDGE, MA 02138
FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATE 11,500,180.
FORM 990, PART XII QUESTION 2B AND 2C AS PREVIOUSLY REPORTED IN THIS FILING, MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) IS A PUBLIC CHARITY AND TAX EXEMPT AFFILIATE OF MOUNT AUBURN HOSPITAL, (MAH), A REGIONAL TEACHING HOSPITAL, EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THE FINANCIAL RECORDS OF MAPS ARE AUDITED EACH YEAR AS PART OF THE MAH CONSOLIDATED AUDITED FINANCIAL STATEMENT PROCESS AND FOR THE FISCAL PERIOD COVERED BY THIS FILING, THE AUDIT WAS PREPARED AND SIGNED BY THE BOSTON, MA OFFICE OF KPMG. THIS PROCESS IS MONITORED AND REVIEWED INTERNALLY BY THE MAH AUDIT COMMITTEE
FORM 990, SCHEDULE L, PART IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR. MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) MAINTAINS AN ACCOUNTABLE BUSINESS EXPENSE REIMBURSEMENT PLAN. FROM TIME TO TIME, MAPS MAY REIMBURSE ITS OFFICERS, DIRECTORS/TRUSTEES AND/OR KEY EMPLOYEES FOR EXPENSES THEY INCURRED AND WHICH ARE PROPERLY ORDINARY AND NECESSARY BUSINESS EXPENSES OF THE REPORTING ENTITY. THE POLICIES AND PROCEDURES REQUIRED BY THE ACCOUNTABLE BUSINESS PLAN MUST BE FOLLOWED IN ORDER TO RECEIVE REIMBURSEMENT FOR SUCH EXPENSES AND IT IS POSSIBLE THAT ONE OR MORE INDIVIDUALS RECEIVED NON-TAXABLE REIMBURSEMENTS WHICH TOTALED $10,000 OR MORE DURING THE FISCAL PERIOD COVERED BY THIS FILING. ALL OF THE ABOVE TRANSACTIONS WERE NEGOTIATED AT ARMS LENGTH AND IN ACCORDANCE WITH THE MAPS CONFLICT OF INTEREST POLICY AND REFLECT FAIR MARKET PAYMENTS AND RATES.
FORM 990, SCHEDULE H, PART VI - SUPPLEMENTAL INFORMATION WILL FOLLOW THOSE DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B. FORM 990 SCHEDULE H PART V, SECTION C: SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION B. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS COMMUNITY BENEFITS MISSION STATEMENT MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF COMMUNITY MEMBERS BY COLLABORATING WITH COMMUNITY PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $1,945,626 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I, COLUMN C. COMMUNITY BENEFITS LEADERSHIP/TEAM THE DIRECTOR OF COMMUNITY HEALTH IS RESPONSIBLE FOR THE DEVELOPMENT AND IMPLEMENTATION OF MAH'S COMMUNITY BENEFITS PROGRAM. AS SUPERVISOR TO THE METROWEST REGIONAL CENTER FOR HEALTHY COMMUNITIES (RCHC) STAFF, THE DIRECTOR HAS CONTINUOUS DIALOGUES WITH THOSE WHO WORK CLOSELY WITH LOCAL COMMUNITY HEALTH NETWORK AREAS. THE DIRECTOR REPORTS TO THE VICE PRESIDENT OF MARKETING AND STRATEGIC PLANNING, WHO ENSURES THAT COMMUNITY BENEFIT PRIORITIES ARE MONITORED BY SENIOR MANAGEMENT. THE HOSPITAL CEO IS ACTIVELY INVOLVED IN INITIATING ACTIVITIES AND RELATIONSHIPS WITH COMMUNITY PARTNERS. ONLY THE COSTS THAT RELATE DIRECTLY TO THE COMMUNITY BENEFIT PORTION OF PROGRAMS ARE COUNTED AS EXPENDITURES. COMMUNITY BENEFITS TEAM MEETINGS ANNUALLY THE BOARD OF TRUSTEES APPROVES THE COMMUNITY BENEFIT'S MISSION STATEMENT AND PLAN. THE VICE PRESIDENT OF MARKETING AND STRATEGIC PLANNING AND THE DIRECTOR OF COMMUNITY HEALTH MEET REGULARLY TO DISCUSS COMMUNITY BENEFIT PROGRAMMING. AMENDMENTS TO THE PLAN DURING THE YEAR ARE APPROVED BY THE VICE PRESIDENT OF MARKETING AND STRATEGIC PLANNING. A HOSPITAL-WIDE DIVERSITY COMMITTEE, AIMED AT KEEPING THE ORGANIZATION FOCUSED ON THE NEEDS OF PATIENTS AND EMPLOYEES FROM DIFFERENT CULTURAL AND LINGUISTIC BACKGROUNDS, IS CHAIRED BY THE DIRECTOR OF COMMUNITY HEALTH AND INCLUDES REPRESENTATIVES FROM MANY HOSPITAL DISCIPLINES. THE COMMUNITY BENEFITS PLAN WAS PRESENTED TO THE PATIENT AND FAMILY ADVISORY COUNCIL. COPIES OF THE COMMUNITY BENEFITS PLAN WERE SENT TO EVERYONE INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. COMMUNITY HEALTH STAFF MEMBERS MEET MONTHLY TO REVIEW COMMUNITY PROGRAMS. COMMUNITY MEMBERS ARE INVITED TO AN OPEN COMMUNITY BENEFITS MEETING. THE METROWEST REGIONAL CENTER FOR HEALTHY COMMUNITIES, A MOUNT AUBURN HOSPITAL PROGRAM, HAS A COMMUNITY ADVISORY BOARD THAT PROVIDES SUGGESTIONS AND FEEDBACK. COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY HEALTH NEEDS ASSESSMENT - INTERNAL REVENUE CODE SECTION 501(R) INTERNAL REVENUE CODE (IRC) SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. MAH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2012. THE NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE MAH BOARD OF TRUSTEES ON OR BEFORE SEPTEMBER 30, 2012. THE MAH COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP OR IMPLEMENTATION STRATEGY) WERE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OUT OF MAH'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLED THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT MAH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW MAH, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT. COMMUNITY HEALTH NEEDS ASSESSMENT - TARGETED GEOGRAPHY AND POPULATION MAH COMMUNITY BENEFITS ARE AIMED AT SERVING COMMUNITY MEMBERS WHO LIVE ARLINGTON, BELMONT, CAMBRIDGE, WALTHAM, WATERTOWN AND SOMERVILLE, UNDERSERVED COMMUNITY MEMBERS SERVED BY JOSEPH M. COMMUNITY HEALTH CENTER AND MASSACHUSETTS COMMUNITY HEALTH NETWORK AREAS 7, 15, 17, 18 AND 20. THIS DECISION WAS MADE BY REVIEWING MAH PRIMARY DISCHARGE DATA, THE NEEDS OF THE MASSACHUSETTS COMMUNITY HEALTH NETWORK AREAS NOTED ABOVE, THE UNIQUE EXPERTISE OF THE MOUNT AUBURN HOSPITAL REGIONAL CENTER FOR HEALTHY COMMUNITIES STAFF (MAHRCHC), AND THE NEEDS OF THE CLOSEST FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER-JOSEPH M. SMITH COMMUNITY HEALTH CENTER (JMSCHC). COMMUNITY HEALTH NEEDS ASSESSMENT - APPROACH AND METHODS MAH COMMUNITY HEALTH DEPARTMENT STAFF MET WITH COMMUNITY MEMBERS INCLUDING THOSE WHO WORK IN PUBLIC HEALTH. TO REACH COMMUNITY MEMBERS IN MAH'S TARGET AREA MAH CONCENTRATED ITS EFFORTS WITH MEMBERS FROM THE LOCAL COMMUNITY HEALTH NETWORK AREAS (NETWORK AREA). A COMMUNITY HEALTH NETWORK IS A LOCAL COALITION OF PUBLIC, NON-PROFIT, AND PRIVATE SECTOR ORGANIZATIONS WORKING TOGETHER TO BUILD HEALTHIER COMMUNITIES IN MASSACHUSETTS THROUGH COMMUNITY-BASED PREVENTION PLANNING AND HEALTH PROMOTION. THESE NETWORK AREAS WERE ESTABLISHED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH IN 1992. MOUNT AUBURN HOSPITAL'S REGIONAL CENTER FOR HEALTHY COMMUNITIES (MAHRCHC OR CENTER) STAFF WORKED DIRECTLY WITH COMMUNITY HEALTH NETWORK AREAS TO HELP COMMUNITIES REALIZE THEIR VISION FOR A HEALTHIER PLACE TO LIVE. THE CENTER DID THIS BY 1) SUPPORTING AND ENCOURAGING NETWORK AREAS TO DESIGN AND IMPLEMENT INCLUSIVE COMMUNITY HEALTH PLANNING AND ASSESSMENT PROCESSES; AND 2) PROVIDING TOOLS AND TEMPLATES, TRAINING, FACILITATION, AND OPPORTUNITIES FOR SHARING AND COLLABORATION AMONG THE NETWORK AREAS. THE MAHRCHC LEAD REGIONAL HEALTH PLANNING THROUGH ITS WORK WITH FIVE NETWORK AREAS (AREAS 7, 15, 17, 18, AND 20). MAH COMMUNITY BENEFITS STAFF WORKED CLOSELY WITH THE LEADERS OF NETWORK AREA 17 TO REVIEW THE ASSESSMENT, AND TO PRIORITIZE THE AREAS FOR IMPLEMENTATION OF COMMUNITY HEALTH INITIATIVES WITHIN THE NETWORK AREA. MAH THEN REVIEWED THE CURRENT COMMUNITY BENEFIT PLAN WITH 1) COMMUNITY BASED ORGANIZATION PARTNERS, 2) MAH STAFF AND 3) THE MAH PATIENT AND FAMILY ADVISORY BOARD. THE RESULTS OF ALL OF THESE THOUGHTFUL PLANNING PROCESSES WERE REVIEWED WITH SENIOR MANAGEMENT AND THE BOARD OF TRUSTEES ON JULY 24TH, 2012. THE BOARD OF TRUSTEES APPROVED AN ANNUAL PROGRAM BUDGET OF OVER ONE MILLIONS DOLLARS. COMMUNITY HEALTH NEEDS ASSESSMENT - MAJOR HEALTH NEEDS AND HOW PRIORITIES WERE DETERMINED TO DETERMINE PRIORITIES FOR COMMUNITY BENEFIT PROGRAMMING MAH GROUPED ASSESSMENT INFORMATION INTO THREE AREAS: 1. SUPPORT FOR LOCAL COMMUNITY HEALTH NETWORK AREAS 2. COMMUNITY HEALTH INITIATIVES IN COMMUNITY HEALTH NETWORK AREA 17 3. DIRECT AND INDIRECT PROGRAMMING MAHRCHC STAFF WORKED WITH THE STEERING COMMITTEES OF THE NETWORK AREAS TO CHOOSE ACTIVITIES THAT: 1. HAVE BEEN RIGOROUSLY EVALUATED AND ARE SHOWN TO BE EFFECTIVE. 2. ARE DEVELOPED TO REDUCE 'RISK' FACTORS AND ENHANCE 'PROTECTIVE' FACTORS FOR COMMUNITY MEMBERS. 3. BUILD UPON THE STRENGTHS AND RESOURCES OF DIVERSE COMMUNITY MEMBERS. EACH NETWORK AREA THEN WORKED INTERNALLY TO IDENTIFY AND CHOOSE THE SUPPORT THEY WOULD RECEIVE FROM THE MAH REGIONAL CENTER STAFF. COMMUNITY HEALTH NEEDS ASSESSMENT - COMMUNITY HEALTH INITIATIVES IN NETWORK AREA 17 WITH THE GUIDANCE OF MAHRCHC, NETWORK AREA 17 CARRIED OUT A BROAD COMMUNITY HEALTH NEEDS ASSESSMENT TO IDENTIFY SHARED HEALTH PRIORITIES. THE NETWORK AREA IS FOUNDED ON THE CONCEPT THAT GOOD HEALTH REQUIRES THE BROAD AND ENGAGED PARTICIPATION OF ALL MEMBERS OF A COMMUNITY. THROUGHOUT THE ASSESSMENT PROCESS, THE NETWORK AREA MADE AN EFFORT TO THINK ABOUT HEALTH NOT ONLY AS THE PHYSICAL HEALTH OF THE PEOPLE WHO LIVE IN ITS MEMBER COMMUNITIES, BUT ALSO AS THE SPIRITUAL, SOCIAL, PHYSICAL AND EMOTIONAL WELL-BEING OF COMMUNITY MEMBERS AND OF THE COMMUNITY AS A WHOLE. IMPLICIT IN THIS APPROACH IS AN UNDERSTANDING THAT HEALTH IS NOT DETERMINED BY HEALTHCARE, BUT BY THE SOCIAL SUPPORTS, ENVIRONMENTAL OPPORTUNITIES, POLICIES AND NORMS OF THE COMMUNITY AND BY THE UNDERLYING ECONOMIC FACTORS AND WELL-BEING OF WHERE PEOPLE LIVE.
THIS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS INCLUDED FACILITATORS AND CONSULTANT EVALUATORS TO MAKE LANGUAGE AND PROCESSES AS ACCESSIBLE, PRACTICAL AND SIMPLE AS POSSIBLE. THIS, IN TURN, MADE THE RESULTS MORE COMPREHENSIBLE AND ALLOWED ALL MEMBERS OF THE PROCESS TO BE HEARD AND TO OWN THE DECISIONS THAT FOLLOWED FROM THE ASSESSMENT. IN TERMS OF DATA COLLECTION, THE INSTITUTE FOR COMMUNITY HEALTH RELIED HEAVILY ON MASSCHIP AND YOUTH BEHAVIOR RISK SURVEY DATA. THE PROCESS DESIGN EVOLVED AS THE PROJECT PROGRESSED, TAKING INTO CONSIDERATION NEW FINDINGS, THE INTERESTS OF NEW MEMBERS AND IDEAS ABOUT HOW TO BETTER ENGAGE THE COMMUNITY IN THE ASSESSMENT PROCESS. (SCHEDULE H, PART V, SECTION B, QUESTION 3). AS A RESULT OF THE ASSESSMENT PROCESS NETWORK AREA 17 HAS A SHARED AND ARTICULATED DIRECTION AND MEMBERS ARE MORE AWARE OF THEIR COMMUNITIES' SIMILARITIES AND DIFFERENCES. THE STEERING COMMITTEE OF NETWORK AREA 17 HAS GROWN TO INCLUDE REPRESENTATIVES FROM COMMUNITIES THAT HAD TRADITIONALLY BEEN LESS INVOLVED AND THE WHOLE NETWORK AREA 17 IS ACTIVELY ENGAGED IN THE PROCESS OF DECIDING HOW THE FUNDS THAT WILL BE COMING TO NETWORK AREA SHOULD BE SPENT. COMMUNITY HEALTH NEEDS ASSESSMENT - KEY FINDINGS MAH'S CHNA RESULTED IN THE FOLLOWING KEY FINDINGS RELATED TO COMMUNITY HEALTH NEEDS: 1. YOUTH SUBSTANCE ABUSE 2. YOUTH ACCESS TO SERVICES 3. YOUTH MENTAL HEALTH 4. ADULT MENTAL HEALTH 5. OBESITY AND ACTIVE LIVING 6. CRIME AND SAFETY COMMUNITY HEALTH NEEDS ASSESSMENT - ADDRESSING COMMUNITY HEALTH NEEDS MAH STRIVES TO ADDRESS THE PRIORITY AREAS AND IN ITS CHNA AND IMPLEMENTATION STRATEGY WHICH ARE AVAILABLE ON THE MAH WEBSITE (HTTP://WWW.MOUNTAUBURNHOSPITAL.ORG/BODY.CFM?ID=13) AND UPON REQUEST. A SUMMARY OF MAH'S COMMUNITY BENEFIT ACTIVITIES FOR THE FISCAL YEAR COVERED BY THIS FILING AND WHICH ADDRESS THE UNMET NEEDS IDENTIFIED IN THE MOST RECENT CHNA AND PRIORITIZED IN THE MOST RECENT CHIP ARE PROVIDED HERE ALONG WITH THE ENTITIES WITH WHICH THE HOSPITAL PARTNERS RELATED TO THESE EFFORTS. YOUTH SUBSTANCE ABUSE - CANCER PREVENTION PEER LEADER DEVELOPMENT-A SOCIAL NORMS APPROACH MOUNT AUBURN HOSPITAL WORKS CLOSELY WITH THE ARLINGTON ENRICHMENT COLLABORATIVE (AEC) AND THE ARLINGTON YOUTH HEALTH AND SAFETY COALITION (AYHSC) TO BRING CANCER PREVENTION AWARENESS AS WELL AS EDUCATIONAL TOOLS AND MATERIALS TO DEVELOP MIDDLE SCHOOL PEER LEADER EDUCATORS, BUILDING ESSENTIAL STEPS IN DEVELOPING AN ONGOING TOBACCO-FREE AND SUN SAFETY SOCIAL NORMS FOR MIDDLE AND HIGH SCHOOL STUDENTS. YOUTH SUBSTANCE ABUSE, ACCESS TO SERVICES AND MENTAL HEALTH ADDRESSING YOUTH ISSUES, IN PARTICULAR MENTAL HEALTH, SUBSTANCE ABUSE, DATING VIOLENCE, BULLYING, AND ACCESS TO SERVICES FOR YOUTH, WERE SOME OF THE TOP ISSUES IDENTIFIED IN THE COMMUNITY NEEDS ASSESSMENT. MAH HAS WORKED WITH THE MEMBERS OF NETWORK AREA 17 TO MAKE FUNDS AVAILABLE TO ADDRESS THESE ISSUES. DURING THE PERIOD COVERED BY THIS FILING, FIVE GRANTEES COMPLETED THREE YEARS OF FUNDING. IN ADDITION TO PROVIDING TECHNICAL SUPPORT FOR INDIVIDUAL GRANTEES, MOUNT AUBURN HOSPITAL STAFF ORGANIZES AND FACILITATES COMMUNITIES OF LEARNING FOR THE GRANTEES. THESE MEETINGS PROVIDE OPPORTUNITIES FOR REPRESENTATIVES FROM DIFFERENT ORGANIZATIONS TO SHARE SUCCESSES AND PROBLEM SOLVE CHALLENGES. YOUTH MENTAL HEALTH AS NOTED IN MORE DETAIL BELOW RELATED TO ADULT MENTAL HEALTH, MAH HAS WORKED WITH NETWORK AREA 17 MEMBERS TO CREATE A SCHOLARSHIP PROGRAM TO TRAIN COMMUNITY MEMBERS IN MENTAL HEALTH FIRST AID. DURING THE PERIOD COVERED BY THIS FILING, MAH EXPANDED THIS PROGRAM TO INCLUDE YOUTH MENTAL HEALTH FIRST AID TRAINING AND REACHED OUT TO LOCAL SCHOOL DEPARTMENTS TO OFFER THE INSTRUCTOR TRAINING OPPORTUNITY. ADULT MENTAL HEALTH MAH HAS WORKED WITH NETWORK AREA 17 MEMBERS TO CREATE A SCHOLARSHIP PROGRAM TO TRAIN COMMUNITY MEMBERS IN MENTAL HEALTH FIRST AID. SCHOLARSHIPS ARE OFFERED AT THREE LEVELS: INDIVIDUAL-FOR A COMMUNITY MEMBER TO ATTEND TRAINING, COMMUNITY--FOR AN ORGANIZATION TO HAVE TRAINING FOR THEIR STAFF, AND INSTRUCTOR-FOR A REPRESENTATIVE FROM A COMMUNITY ORGANIZATION TO BECOME AN INSTRUCTOR. OBESITY AND ACTIVE LIVING THROUGH THE MOST RECENT COMMUNITY NEEDS ASSESSMENT, OBESITY, ACCESS TO HEALTHY FOODS, AND OPPORTUNITIES FOR ACTIVE LIVING WERE IDENTIFIED AS A COMBINED PRIORITY AREA FOR THE NETWORK AREA. MAH HAS WORKED WITH MEMBERS OF THE NETWORK AREA TO MAKE FUNDS AVAILABLE TO PROMOTE POLICY CHANGE. DURING THE PERIOD COVERED BY THIS FILING, THREE GRANTEES COMPLETED TWO YEARS OF FUNDING AS FOOD AND ACTIVITY POLICY COUNCILS. ANOTHER REQUEST FOR PROPOSAL WAS CRAFTED AND FIVE ADDITIONAL GRANTEES WERE FUNDED. THREE OF THESE FIVE ARE NEW PROGRAMS. EACH GRANTEE IS OFFERED TECHNICAL ASSISTANCE BY MOUNT AUBURN HOSPITAL COMMUNITY HEALTH SPECIALISTS. THE GROUP IS CONVENED AT A COMMUNITY OF LEARNING THROUGHOUT THE YEAR. MOUNT AUBURN HOSPITAL COMMUNITY HEALTH SPECIALISTS PLAN AND FACILITATE THESE EVENTS WHERE GRANTEES FROM DIFFERENT TOWNS SHARE SUCCESSES AND CHALLENGES. OBESITY AND ACTIVE LIVING HEALTHY WALTHAM FILLS A VITAL ROLE FOR THE HEALTH AND WELL-BEING OF WALTHAM COMMUNITY MEMBERS. LONG TERMS GOALS INCLUDE IMPROVING NUTRITION AND EXERCISE AMONG COMMUNITY MEMBERS TO PREVENT ILLNESS. DURING THE PERIOD COVERED BY THIS FILING, HEALTHY WALTHAM PARTNERED WITH JOSEPH M. SMITH COMMUNITY HEALTH CENTER AND MOUNT AUBURN HOSPITAL TO INCREASE AWARENESS OF THE LINK BETWEEN OBESITY AND CANCER IN PARTICULAR COLORECTAL CANCER. EFFORTS HAVE FOCUSED ON PREVENTION AND SCREENING. RECOGNIZING THAT HEALTH INCLUDES FEELING SAFE AND SECURE IN THE COMMUNITY YOU LIVE, MOUNT AUBURN HOSPITAL ALSO SUPPORTED HEALTHY WALTHAM'S WORK WITH YOUTH TO IDENTIFY SAFE AND UNSAFE PLACES IN THE COMMUNITY AND THOUGHTS ABOUT HOW TO IMPROVE THE OVERALL WELL-BEING OF THE WALTHAM COMMUNITY. CRIME AND SAFETY DURING THE MOST RECENT COMMUNITY NEEDS ASSESSMENT CRIME AND SAFETY WAS PRIORITIZED AS AN AREA OF CONCERN. WITHOUT A CLEAR CONSENSUS ON WHICH ACTIVITIES WOULD BE MOST BENEFICIAL THE NETWORK AREA DECIDED TO CONDUCT FOCUS GROUPS IN EACH TOWN. BASED ON THE RESULTS OF THOSE FOCUS GROUPS A REQUEST FOR PROPOSAL WAS DEVELOPED TO FOSTER PROMISING PRACTICES AND COLLABORATIONS ACROSS NON-TRADITIONAL PARTNERS. THREE PROGRAMS WERE FUNDED--TWO ADDRESS DOMESTIC VIOLENCE AND ONE ADDRESSED THE INTERSECTION BETWEEN PETTY THEFT AND SUBSTANCE ABUSE. AS WITH OTHER FUNDING PROGRAMS, MOUNT AUBURN HOSPITAL STAFF PROVIDES TECHNICAL ASSISTANCE TO THE GRANTEES AS WELL AS DESIGN AND FACILITATE COMMUNITIES OF LEARNING FOR THE GRANTEES TO SHARE SUCCESSES AND CHALLENGES. COMMUNITY PARTNERS MAH SUPPORTS NETWORK AREA 17'S MISSION TO HELP BUILD HEALTHIER PEOPLE AND BETTER CONNECTED COMMUNITIES ACROSS. MAH CURRENTLY PROVIDES 100% OF NETWORK AREA 17'S FUNDING. IN ADDITION TO THE DEDICATED COMMUNITY HEALTH INITIATIVES THE NETWORK AREA HOSTS GENERAL MEETINGS, TRAININGS, AND PATHWAYS FOR NETWORK AREA MEMBERS TO COMMUNICATE WHICH INCLUDE EMAILS, NEWSLETTERS, A WEBSITE AND DEDICATED TIME AT GENERAL MEETINGS. NETWORK AREA 17 CONSISTS OF OVER 60 MEMBERS. THE FOLLOWING AGENCIES ARE REPRESENTED: - AIDS ACTION COMMITTEE - ARLINGTON DIVERSION - ARLINGTON YOUTH COALITION - BOSTON AREA GLEANERS - CAMBRIDGE AND SOMERVILLE EARLY INTERVENTION - CAMBRIDGE COMMUNITY CENTER - CAMBRIDGE ECONOMIC OPPORTUNITY COUNCIL - CAMBRIDGE HEALTH ALLIANCE - CAMBRIDGE PREVENTION COALITION - CAMBRIDGE PUBLIC HEALTH DEPARTMENT - CASPAR - COMMUNITY DAY CENTER OF WALTHAM - CHILD CARE RESOURCE CENTER - EAST END HOUSE - FOOD FOR FREE - GREATER WALTHAM ARC - HEALTHY WALTHAM - INSTITUTE FOR COMMUNITY HEALTH WIC - MASSACHUSETTS ALLIANCE OF PORTUGUESE SPEAKERS - MARGARET FULLER HOUSE - MINUTE MAN SENIOR SERVICES SHINE - PAINE SENIOR SERVICES - PARENTS HELPING PARENTS - REACH - SOMERVILLE CARES ABOUT PREVENTION - SOMERVILLE COMMUNITY HEALTH AGENDA - SOMERVILLE EARLY INTERVENTION - SOMERVILLE HOMELESS COALITION - SOMERVILLE POLICE DEPARTMENT - SPRINGWELL - ST. ELIZABETH'S MEDICAL CENTER - THOM CHARLES RIVER EARLY INTERVENTION - TITLE IX RUNNING CLUB - TRANSITION HOUSE - WATERTOWN COMMUNITY FOUNDATION - WATERTOWN HEALTH DEPARTMENT - WATERTOWN YOUTH COALITION - YOUTH ON FIRE COMMUNITY HEALTH NEEDS - OTHER INITIATIVES IMMIGRANT HEALTH - LISTEN AND LEARN THE LISTEN AND LEARN PROGRAMS BRING CLINICIANS AND COMMUNITY MEMBERS TOGETHER TO "LISTEN AND LEARN" FROM EACH OTHER ABOUT BARRIERS TO THE PREVENTION AND EARLY DETECTION OF ILLNESS. HEALTH EDUCATION IS PROVIDED IN LOCATIONS CONVENIENT TO UNDERSERVED COMMUNITY MEMBERS SUCH AS ENGLISH SPEAKERS OF OTHER LANGUAGES (ESOL) PROGRAMS AND SENIOR CENTERS. COMMUNITY MEMBERS ARE ENCOURAGED TO SHARE THEIR BELIEFS ABOUT ILLNESS AND BARRIERS TO PREVENTION AND EARLY DETECTION GUIDELINES. INFORMATION LEARNED IS SHARED WITH APPROPRIATE CLINICAL TEAMS AT MOUNT AUBURN HOSPITAL.
IMMIGRANT HEALTH - BREASTFEEDING THIS PROGRAM BRINGS MOUNT AUBURN HOSPITAL, JOSEPH M. SMITH COMMUNITY HEALTH CENTER AND WALTHAM'S WOMEN'S INFANTS AND CHILDREN TOGETHER TO PROMOTE COORDINATION AND COMMUNICATION ABOUT INCREASING BREAST FEEDING SUCCESS AMONG IMMIGRANT WOMEN. HEALTH EDUCATION FOR THE HOMELESS MAH STAFF GOES TO HOMELESS SHELTERS TO TEACH BASIC HEALTH EDUCATION. THE FOCUS IS ON PREVENTION AND EARLY DETECTION OF ILLNESS. BY GOING WHERE VULNERABLE COMMUNITY MEMBERS ARE THESE ENCOUNTERS FOSTER RELATIONSHIPS WITH HEALTH CARE PROVIDERS AND IMPROVE HEALTH SEEKING BEHAVIORS. HUNGER IN AN EFFORT TO ADDRESS HUNGER THIS PROGRAM CONDUCTS FOOD DRIVES, AND PROVIDES OPPORTUNITIES FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP). ENROLLMENT TO IMPROVE NUTRITIONAL STATUS IN VULNERABLE POPULATIONS. FINANCIAL COUNSELORS HAVE BEEN TRAINED TO BE ABLE TO ENROLL COMMUNITY MEMBERS IN SNAP AS THEY ENROLL IN PUBLIC ASSISTANCE PROGRAMS. CHRONIC DISEASE SELF-MANAGEMENT - HOUSE CALLS PROGRAM MOUNT AUBURN HOSPITAL STRIVES TO IMPROVE THE HEALTH OF ELDERS THROUGH MANY COMMUNITY BASED INITIATIVES. THE FIRST IS A HOUSE CALLS PROGRAM. THIS PROGRAM WAS DEVELOPED IN RESPONSE TO A WORKING GROUP CONSISTING OF HOMECARE PROVIDERS, HOME BOUND ELDERS AND THEIR FAMILIES, AND GERIATRICIANS. THE HOUSE CALLS PROGRAM ADDRESSES BARRIERS TO HEALTH CARE BY TAKING GERIATRICIANS OUT OF THE OFFICE TO CARE FOR VULNERABLE ELDERS IN THEIR OWN HOMES. THESE SERVICES ARE PROVIDED IN-KIND. SECOND, MOUNT AUBURN HOSPITAL SOCIAL WORKERS ATTEND COMMUNITY MEETINGS TO SHARE BEST PRACTICES, IDENTIFY OPPORTUNITIES TO IMPROVE AND ADDRESS CHALLENGES TO ELDER CARE. MOUNT AUBURN ALSO PROVIDES DIRECT FINANCIAL SUPPORT FOR COMMUNITY BASED ORGANIZATIONS THAT SERVE ELDERS. CHRONIC DISEASE SELF-MANAGEMENT - FALL PREVENTION STRATEGIES FOR SENIORS TO IMPROVE THE HEALTH OF SENIORS, MOUNT AUBURN HOSPITAL OFFERS THIS EVIDENCED BASED PROGRAM TO SENIOR COMMUNITY MEMBERS AT RISK FOR FALLS. THIS PROGRAM CONTINUES TO BE IN HIGH DEMAND AND WE CONTINUE TO BE ABLE TO MEET THAT DEMAND BY ADDING NEW CLASSES. DURING THE PERIOD COVERED BY THIS FILING, MAH WE PILOTED THIS PROGRAM AT ELDER HOUSING IN ARLINGTON. BY REACHING SENIORS WHERE THEY LIVE WITH THESE IMPORTANT FALL PREVENTION STRATEGIES WE HOPE TO ENCOURAGE THEM TO ATTENDED OTHER HEALTH PROMOTION ACTIVITIES AT THE LOCAL COUNCIL ON AGING. CHRONIC DISEASE SELF-MANAGEMENT - BLOOD PRESSURE MONITORING FOR SENIORS IN THIS PROGRAM MAH NURSES GO TO COMMUNITY SETTINGS AND PROVIDE FREE BLOOD PRESSURE SCREENINGS. SENIORS ARE SEEN IN COUNCILS ON AGING OR ELDER HOUSING COMPLEXES. IN ADDITION TO PROVIDING COMMUNITY MEMBERS WITH A RECORD OF THEIR BLOOD PRESSURE READING TO SHARE WITH THEIR PROVIDERS; THE NURSES TAKE THIS OPPORTUNITY TO REVIEW WARNING SIGNS OF HEART ATTACK AND STROKE. CHRONIC DISEASE SELF-MANAGEMENT - LIVING WITH DIABETES TO IMPROVE THE HEALTH OF COMMUNITY MEMBERS WITH CHRONIC DISEASE, MOUNT AUBURN HOSPITAL OFFERS THESE EVIDENCED BASED PROGRAMS TO ALL COMMUNITY MEMBERS. DEVELOPED AT STANFORD UNIVERSITY THESE PROGRAMS BUILD THE CAPACITY FOR INDIVIDUALS TO BETTER MANAGE THEIR OWN HEALTH. PARTICIPANTS RECEIVE THE BOOK "LIVING A HEALTHY LIFE WITH CHRONIC CONDITIONS" AND A RELAXATION CD. ALL PROGRAMS ARE OFFERED FREE OF CHARGE. THERE IS NO COST FOR PARKING. CHRONIC DISEASE - POWERFUL TOOLS FOR CAREGIVERS RECOGNIZING THAT THE ROLE OF CAREGIVING CAN BE STRESSFUL AND NEGATIVELY IMPACT THE HEALTH OF THE CAREGIVER, MAH CONDUCTED AN ASSESSMENT OF CAREGIVER NEED IN FY 13. BASED ON THE RESULTS OF THAT ASSESSMENT MAH ADDED THE POWERFUL TOOLS FOR CAREGIVERS EVIDENCED BASED PROGRAM TO OUR ARRAY OF HEALTHY AGING PROGRAMMING. MAH STAFF HAS BEEN TRAINED AS LEADERS OF THE POWERFUL TOOLS FOR CAREGIVERS PROGRAM WHICH PROVIDES THE TOOLS FOR CAREGIVERS TO CARE FOR THEMSELVES. CHRONIC DISEASE - LYME DISEASE AWARENESS AT MOUNT AUBURN HOSPITAL WE ARE WORKING TO INCREASE AWARENESS OF LYME DISEASE IN THE COMMUNITIES WE SERVE. MASSACHUSETTS IS ONE OF THE STATES WHERE LYME DISEASE IS PREVALENT. THERE WERE OVER 25000 CONFIRMED CASES OF LYME DISEASE IN MIDDLESEX COUNTY, MASSACHUSETTS IN 2012. THIS PROGRAM PROVIDED COMMUNITY EDUCATION ABOUT PREVENTION AND EARLY DETECTION OF LYME DISEASE. EFFORTS WERE MADE TO REACH LANDSCAPERS AND OTHER SEASONAL WORKERS WHO ARE AT RISK. VULNERABLE COMMUNITY MEMBERS IN WATERTOWN MAH SUPPORTS WATERTOWN'S SOCIAL SERVICE RESOURCE SPECIALIST PILOT PROGRAM. WATERTOWN ORGANIZATIONS HAD IDENTIFIED A GAP IN SUPPORT FOR ADULT COMMUNITY MEMBERS AND HAVE WORKED TOGETHER TO STRUCTURE THIS TWO YEAR PILOT. MAH SOCIAL WORKERS ALSO ATTEND COMMUNITY MEETINGS WITH WATERTOWN DEPARTMENT OF PUBLIC HEALTH AND OTHER COMMUNITY BASED ORGANIZATIONS. THESE MEETINGS PROVIDE FORUMS FOR COMMUNICATION ABOUT THE NEEDS OF WATERTOWN COMMUNITY MEMBERS. LACK OF TRANSPORTATION TRANSPORTATION IS TOO OFTEN A BARRIER TO MEDICAL CARE. MOUNT AUBURN STAFF PARTICIPATED IN CAMBRIDGE'S COMMUNITY WIDE TASK FORCE ADDRESSING TRANSPORTATION. DURING THE PERIOD COVERED BY THIS FILING, MAH CO-HOSTED A FOCUS GROUP OF ELDERS WHO UTILIZE PUBLIC TRANSPORTATION WITH THE CITY OF CAMBRIDGE AND MOUNT AUBURN CLINICIANS WORK WITH PATIENTS WHO REQUIRE TRANSPORTATION TO IDENTIFY SOLUTIONS AND WHEN NECESSARY PROVIDE ASSISTANCE. ACCESS TO SERVICES FOR IMMIGRANTS THIS COMPREHENSIVE PROGRAM IMPROVES BIRTH OUTCOMES BY IMPROVING ACCESS TO PERINATAL CARE. FOR EASE OF ACCESS, MOUNT AUBURN MIDWIVES AND OBSTETRICIANS WORK ON-SITE AT JOSEPH M. SMITH COMMUNITY HEALTH CENTER (JMSCHC). TWENTY PERCENT OF THE WOMEN WERE IDENTIFIED AS HAVING LIMITED SUPPORTS AND WERE PROVIDED DOULAS. THESE "BIRTH COUCHES" PROVIDE ONE TO ONE SUPPORT DURING LABOR. IN ADDITION A GROUP PREGNANCY SUPPORT GROUP FOR LATINAS HELPS TO BUILD EACH WOMAN'S CAPACITY TO PREPARE FOR DELIVERY AND CARE FOR HER CHILD AND HERSELF. MAH HELPS TO PROVIDES UROLOGICAL HEALTH SERVICES TO MEN WHO OTHERWISE WOULD NOT HAVE ACCESS TO THESE SERVICES. OPEN TO ALL COMMUNITY MEMBERS, THIS CLINIC MOSTLY SERVES PATIENTS FROM THE JOSEPH M. SMITH COMMUNITY HEALTH CENTER. THERE ARE NO HOSPITAL OR PROFESSIONAL CHARGES ASSOCIATED WITH THE CLINIC VISIT. ADULT SUBSTANCE ABUSE DESPITE OVERWHELMING PUBLIC AWARENESS ABOUT THE HEALTH RISKS ASSOCIATED WITH SMOKING; MANY COMMUNITY MEMBERS, IN PARTICULAR UNDERSERVED COMMUNITY MEMBERS; CONTINUE TO BE UNSUCCESSFUL IN THEIR ATTEMPTS TO STOP SMOKING. DURING THE PERIOD COVERED BY THIS FILING, MAH REORGANIZED THIS FREE PROGRAM WHICH PROVIDES SMOKING CESSATION EDUCATION TO THOSE IN NEED OF QUITTING. WITH AN EMPHASIS ON FIRST HELPING SMOKERS UNDERSTAND WHY SMOKING IS SO ADDICTING AND HOW THE TOBACCO INDUSTRY MARKETS SMOKING, THE GOAL OF THIS PROGRAM IS TO HELP COMMUNITY MEMBERS SET REALISTIC PLANS TO STOP SMOKING. ADULT SUBSTANCE ABUSE MAH PROVIDES HANDICAPPED ACCESSIBLE SPACE FOR MULTIPLE SCLEROSIS, AA AND SMART RECOVERY GROUPS TO MEET. COMMUNITY SUPPORT - BEREAVEMENT THIS SUPPORT GROUP PROVIDES PEOPLE THE OPPORTUNITY, IN A SAFE AND SUPPORTIVE ENVIRONMENT, TO SHARE THEIR FEELING AND STORIES WITH OTHERS THAT ARE GOING, OR HAVE GONE, THROUGH THE LOSS OF A LOVED ONE. IT IS OPEN TO ANY ADULT COMMUNITY MEMBER WHO HAS EXPERIENCED THE DEATH OF SOMEONE SIGNIFICANT IN THEIR LIFE. COMMUNITY SUPPORT - LIVING WITH CANCER THIS PROGRAM WORKS WITH CANCER PATIENTS TO CREATE A SENSE OF SUPPORT, CONFIDENCE, COURAGE, AND COMMUNITY AMONG CANCER PATIENTS. IN ADDITION TO OUR COLLABORATION WITH THE AMERICAN CANCER SOCIETY, DURING THE PERIOD COVERED BY THIS FILING, MOUNT AUBURN HOSPITAL STAFF WAS TRAINED TO LEAD THE EVIDENCED BASED PROGRAM- "CANCER THRIVING AND SURVIVING". THE HOSPITAL ALSO OFFERS AN EIGHT WEEK MIND-BODY PROGRAM FOR CANCER SURVIVORS. ALL THESE PROGRAMS ARE AIMED AT INCREASING HOPE AND EMPOWERMENT FOR THOSE AFFECTED BY CANCER. COMMUNITY SUPPORT - LIVING WITH POST-PARTUM DEPRESSION THIS FREE GROUP IS OPEN TO COMMUNITY MEMBERS AND PROVIDES THE NECESSARY SUPPORT AND EDUCATION TO NEW MOTHERS. MAH CLINICIANS MAY ALSO IDENTIFY AT RISK WOMEN WHO WOULD LIKELY BENEFIT FROM INCREASED SUPPORT AND SUGGEST THEY PARTICIPATE. SENIOR ACCESS TO CARE - LIFELINE THIS PROGRAM PROVIDES PERSONAL EMERGENCY RESPONSE SERVICES (LIFELINE) TO UNDERSERVED ELDERS AND DISABLED ADULTS. MAH WORKED CLOSELY WITH LOCAL AGING SERVICE ACTION POINTS AND PROVIDED THE EMERGENCY RESPONSE SYSTEMS BELOW COST TO OVER 1,000 COMMUNITY MEMBERS WHO ARE IN NEED. SENIOR ACCESS TO CARE - WHEN A CAREGIVER IS ILL MAH WORKS WITH LOCAL SOCIAL SERVICE AGENCIES TO ENSURE THAT WHEN A CAREGIVER OF AN ELDER IS ADMITTED AS A PATIENT, THE ELDER IS ALSO ADMITTED UNTIL SAFE CARE CAN BE ARRANGED.
DOMESTIC VIOLENCE IN PARTNERSHIP WITH THE LOCAL POLICE DEPARTMENTS MOUNT AUBURN HOSPITAL PROVIDES TEMPORARY "SAFE BEDS" FOR VICTIMS OF DOMESTIC VIOLENCE. AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, MAH IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. HOWEVER, AS NOTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE CHIP. THE FOLLOWING IDENTIFIED NEEDS WERE NOT ADDRESSED IN THE CHIP: SENIOR ACCESS TO SERVICES, CHRONIC HEALTH CONDITIONS, IMMIGRANT ACCESS TO SERVICES, HOMELESSNESS AFFORDABLE HOUSING, DOMESTIC VIOLENCE, SUBSTANCE ABUSE ADULTS, POVERTY/ HUNGER ACCESS TO FOOD, SEXUAL HEALTH AND GENERAL POPULATION ACCESS TO SERVICES. HOWEVER, AS NOTED WITHIN THIS NARRATIVE, THE HOSPITAL CAN AND DOES PROACTIVELY SUPPORT SOME OF THESE ADDITIONAL COMMUNITY HEALTH NEEDS WITHIN THE BROADER MAH PLAN. IN ADDITION, WHERE THE HOSPITAL IS UNABLE TO ADDRESS NEEDS BECAUSE OF LIMITED FINANCIAL RESOURCES, THE HOSPITAL EXPLORES A RANGE OF OTHER FUNDING OPPORTUNITIES TO MEET HELP MEET COMMUNITY NEEDS. AS NOTED IN DETAIL ABOVE, THE MAH'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND CHIP (SCHEDULE H PART VI QUESTION 2).
FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 8.2% OF MAH'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. AS NOTED THROUGHOUT THIS FILING, MOUNT AUBURN PROFESSIONAL SERVICES IS A SUPPORT ORGANIZATION OF MOUNT AUBURN HOSPITAL. AS SUCH, IT ALSO PROVIDES ADDITIONAL DETAIL ON THE ACTIVITIES IN WHICH MAPS IS ENGAGED, IN SUPPORT OF THE HOSPITAL'S MISSIONS. COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORT IN ADDITION TO MAH'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) WHICH WERE APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2012, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, MAH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL. THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND AT MAH UPON REQUEST. THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT MAH FILED WITH THE ATTORNEY GENERAL'S OFFICE. IN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, MAH IS A GENERAL MEDICAL AND SURGICAL HOSPITAL AND TEACHING HOSPITAL, PROVIDING 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMS FINANCIAL ASSISTANCE MAH'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $4,142,727 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2014 AND HAS BEEN REPORTED ON THIS SCHEDULE H,PART I,LINE 7A. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINES 10 AND 11, ELIGIBILITY FOR FREE CARE TO LOW INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 200% FOR FULL FREE CARE AND 201%-400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS,FAMILY SIZE AND MONTHLY EXPENSES,INCLUDING MEDICAL HARDSHIP REVIEW. SEE ADDITIONAL INFORMATION IN THIS SCHEDULE H NARRATIVE. OTHER UNCOMPENSATED CHARITY CARE -MEDICAID AND MEDICARE IN ADDITION TO THE CHARITY CARE REPORTED ABOVE,MAH ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS WHICH INSURE LOW INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MAH GENERATED $12,060,577 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY MAH FOR SUCH SERVICES BY $698,803 AS REPORTED ON THIS SCHEDULE H,PART I LINE 7B. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS,AND MAH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MAH GENERATED $95,034,198 RELATED TO TREATING MEDICARE PATIENTS. OF THIS AMOUNT, REVENUE OF $6,076,219 IS RELATED TO THE PROVISION OF PSYCHIATRIC CARE AND CARE IN THE EMERGENCY DEPARTMENT AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8,ALTHOUGH MAH CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, MAH HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. BAD DEBTS IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, MAH ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS, AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $4,059,502 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. AS REQUIRED BY THIS FORM 990, SCHEDULE H, PART III, LINE 4, BELOW ARE THE BAD DEBT AND ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTES FROM THE MOUNT AUBURN HOSPITAL AND AFFILIATE AUDITED FINANCIAL STATEMENTS. AS PREVIOUSLY NOTED IN THIS FORM 990, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE HOSPITAL AND ITS AFFILIATE FOR FISCAL YEAR ENDED SEPTEMBER 30, 2014 INCLUDE THE ACCOUNTS OF MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES (MAPS). THE MAH FORM 990 IS PREPARED FOR MAH ONLY AND AS SUCH, THE METRICS INCLUDED IN THESE FOOTNOTES WILL NOT TIE TO THE FACE OF THE MAH FORM 990, SCHEDULE H. FINANCIAL STATEMENT FOOTNOTES: UNCOMPENSATED CARE AND PROVISION FOR BAD DEBTS THE HOSPITAL PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. ESSENTIALLY, THE POLICY DEFINES CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO PAYMENT IS ANTICIPATED. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE EXCEPT TO THE EXTENT REIMBURSED BY THE STATEWIDE HEALTH SAFETY NET (HSN). THE HOSPITAL GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY AGREEMENTS. ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTION, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTS PATIENT ACCOUNTS RECEIVABLE ARE REFLECTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST COLLECTION HISTORY, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN GOVERNMENTAL AND EMPLOYEE HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS FOR EACH OF ITS MAJOR CATEGORIES OF REVENUE BY PAYOR TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR CATEGORIES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THROUGHOUT THE YEAR, THE HOSPITAL, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, WILL WRITE OFF THE DIFFERENCE BETWEEN THE STANDARD RATES (OR DISCOUNTED RATES IF APPLICABLE) AND THE AMOUNTS ACTUALLY COLLECTED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN ADDITION TO THE REVIEW OF THE CATEGORIES OF REVENUE, MANAGEMENT MONITORS THE WRITE OFFS AGAINST ESTABLISHED ALLOWANCES TO DETERMINE THE APPROPRIATENESS OF THE UNDERLYING ASSUMPTIONS USED IN ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S METHODOLOGY FOR VALUING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE REMAINED SUBSTANTIALLY CONSISTENT IN 2014 AND 2013. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS REPRESENTED APPROXIMATELY 11% AND 12% OF PATIENT ACCOUNTS RECEIVABLE NET OF CONTRACTUAL ALLOWANCES IN 2014 AND 2013, RESPECTIVELY.
EMERGENCY CARE ACCESS MOUNT AUBURN HOSPITAL EMERGENCY DEPARTMENT (ED) IS A FULL SERVICE ED STAFFED BY PROFESSIONAL NURSES AND PHYSICIANS SPECIALIZING IN EMERGENCY MEDICINE. THE ED'S MISSION IS TO PROVIDE EXPERT EMERGENCY MEDICAL CARE WHILE MAINTAINING COMPASSIONATE CONCERN FOR ALL PATIENTS AND THEIR FAMILIES. THE MOUNT AUBURN HOSPITAL EMERGENCY DEPARTMENT STAFF PHYSICIANS ARE EMERGENCY MEDICINE BOARD CERTIFIED AND ARE ON THE HARVARD SCHOOL FACULTY. THE MAH DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR. MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY GUIDING PRINCIPLES THE HOSPITAL ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, MOUNT AUBURN HOSPITAL MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. THE MOUNT AUBURN HOSPITAL'S CREDIT AND COLLECTION POLICY, WHICH APPLIES TO THE HOSPITAL AND ANY OTHER ENTITY WHICH IS PART OF THE HOSPITAL'S LICENSE OR TAX IDENTIFICATION NUMBER, IS DESIGNED TO COMPLY WITH BOTH THE MASSACHUSETTS HEALTH SAFETY NET REGULATIONS ON CREDIT AND COLLECTION POLICIES, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES MEDICARE BAD DEBT REQUIREMENTS, THE MEDICARE PROVIDER REIMBURSEMENT MANUAL AND THE FEDERAL HEALTHCARE REFORM LAW'S "FINANCIAL ASSISTANCE POLICY" FOR WHICH THE IRS HAD PROVIDED PRELIMINARY GUIDANCE AT THE TIME THE HOSPITAL FINALIZED THIS POLICY. THE HOSPITAL CONTINUES TO MONITOR GUIDANCE FROM THE IRS AS IT IS ISSUED. MOUNT AUBURN HOSPITAL DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, CITIZENSHIP, ALIENAGE, RELIGION, CREED, SEX, SEXUAL ORIENTATION, DISABILITY, OR AGE IN ITS POLICIES OR IN ITS APPLICATION OF POLICIES CONCERNING THE ACQUISITION AND VERIFICATION OF FINANCIAL INFORMATION, PRE-ADMISSION OR PRE-TREATMENT DEPOSITS, PAYMENT PLANS, DEFERRED OR REJECTED ADMISSIONS, LOW INCOME PATIENT STATUS AS DETERMINED BY THE MASSACHUSETTS OFFICE OF MEDICAID, DETERMINATION THAT A PATIENT IS LOW-INCOME, OR IN ITS BILLING AND COLLECTION PRACTICES. MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY - NOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE AND OTHER COVERAGE OPTIONS FINANCIAL ASSISTANCE IS INTENDED TO ASSIST LOW-INCOME PATIENTS WHO DO NOT OTHERWISE HAVE THE ABILITY TO PAY FOR THEIR HEALTH CARE SERVICES. SUCH ASSISTANCE TAKES INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS. MOUNT AUBURN HOSPITAL PROVIDES THIS ASSISTANCE FOR BOTH RESIDENTS AND NON-RESIDENTS OF MASSACHUSETTS; HOWEVER, THERE MAY NOT BE COVERAGE FOR A MASSACHUSETTS HOSPITAL'S SERVICES THROUGH AN OUT-OF STATE PROGRAM. IN ORDER FOR THE HOSPITAL TO ASSIST UNINSURED AND UNDERINSURED PATIENTS FIND THE MOST APPROPRIATE COVERAGE OPTIONS, AS WELL AS TO DETERMINE IF THE PATIENT IS FINANCIALLY ELIGIBLE FOR ANY PAYMENT DISCOUNTS, PATIENTS MUST ACTIVELY WORK WITH THE HOSPITAL TO VERIFY THEIR FINANCIAL AND OTHER INFORMATION THAT COULD BE USED IN DETERMINING ELIGIBILITY. THE HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR THROUGH THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM, WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. FOR THOSE PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS PATIENTS BY SCREENING THEM FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. THESE PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO: MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START AND HEALTH SAFETY NET. WHEN APPLICABLE, THE HOSPITAL MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED FAMILY INCOME, CURRENT AND PRIOR INSURANCE COVERAGE AND ALLOWABLE MEDICAL EXPENSES. IN ADDITION, IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS WHO HAVE A FINANCIAL LIABILITY AS WELL AS IN GENERAL NOTICES THAT ARE POSTED THROUGHOUT THE HOSPITAL. THE HOSPITAL WILL TRY TO IDENTIFY AVAILABLE COVERAGE OPTIONS FOR PATIENTS WHO MAY BE UNINSURED OR UNDERINSURED WITH THEIR CURRENT INSURANCE PROGRAM WHEN THE PATIENT IS SCHEDULING SERVICES, WHILE THE PATIENT IS IN THE HOSPITAL, UPON DISCHARGE, AND/OR FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THE HOSPITAL WILL DIRECT ALL PATIENTS SEEKING INFORMATION ON AVAILABLE COVERAGE OPTIONS OR FINANCIAL ASSISTANCE TO THE HOSPITAL'S PATIENT FINANCIAL COUNSELING OFFICE TO DETERMINE IF THEY ARE ELIGIBLE AND THEN TO SCREEN PATIENTS FOR ELIGIBILITY IN AN APPROPRIATE COVERAGE OPTION. THE HOSPITAL WILL THEN ASSIST THE PATIENT IN APPLYING FOR APPROPRIATE COVERAGE OPTIONS THAT ARE AVAILABLE TO THEM OR NOTIFY THEM OF THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. FOR CASES WHERE THE HOSPITAL IS USING THE VIRTUAL GATEWAY APPLICATION, THE HOSPITAL WILL ASSIST THE PATIENT IN COMPLETING THE APPLICATION FOR MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR OTHER FORMS OF FINANCIAL ASSISTANCE PROGRAMS AS THEY BECOME PART OF THE VIRTUAL GATEWAY PROGRAM, WHICH IS AN INTERNET PORTAL DESIGNED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES IN ORDER TO PROVIDE THE GENERAL PUBLIC, MEDICAL PROVIDERS, AND COMMUNITY-BASED ORGANIZATIONS WITH AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE COMMONWEALTH. MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY - ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AS NOTED IN THIS, SCHEDULE H, PART III, SECTION C, QUESTION 9B, MOUNT AUBURN HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR THROUGH THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. FOR PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS THEM BY SCREENING FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. THESE PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO: MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START AND HEALTH SAFETY NET. WHEN APPLICABLE THE HOSPITAL MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED FAMILY INCOME, CURRENT AND PRIOR INSURANCE COVERAGE AND ALLOWABLE MEDICAL EXPENSES. IT IS THE PATIENT'S OBLIGATION TO PROVIDE THE HOSPITAL WITH ACCURATE AND TIMELY INFORMATION REGARDING THEIR FULL NAME, ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, INCLUDING OTHER INSURANCE OR COVERAGE OPTIONS (SUCH AS MOTOR VEHICLE POLICY OR WORKER'S COMPENSATION POLICY) THAT CAN COVER THE COST OF THE CARE RECEIVED AND ANY OTHER APPLICABLE FINANCIAL RESOURCES, AND CITIZENSHIP AND RESIDENCY INFORMATION - ALL TO DETERMINE IF THE PATIENT IS ELIGIBLE TO APPLY FOR CERTAIN HEALTH INSURANCE PROGRAMS. IF THERE IS NO SPECIFIC COVERAGE FOR THE SERVICES PROVIDED, THE HOSPITAL WILL USE THE INFORMATION TO DETERMINE IF THE SERVICES MAY BE COVERED BY AN APPLICABLE PROGRAM THAT WILL COVER CERTAIN SERVICES DEEMED BAD DEBT. IN ADDITION, THE HOSPITAL WILL USE THIS INFORMATION TO DISCUSS ELIGIBILITY FOR CERTAIN HEALTH INSURANCE PROGRAMS. THE SCREENING AND APPLICATION PROCESS FOR A PUBLIC HEALTH INSURANCE PROGRAM IS DONE THROUGH THE VIRTUAL GATEWAY, WHICH IS AN INTERNET PORTAL DESIGNED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES IN ORDER TO PROVIDE THE GENERAL PUBLIC, MEDICAL PROVIDERS, AND COMMUNITY-BASED ORGANIZATIONS WITH AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE STATE OR THROUGH A STANDARD PAPER APPLICATION THAT IS COMPLETED BY THE PATIENT AND ALSO SUBMITTED DIRECTLY TO THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR PROCESSING AS THIS OFFICE SOLELY MANAGES THE APPLICATION PROCESS LISTED ABOVE, WHICH IS AVAILABLE FOR CHILDREN, ADULTS, SENIORS, VETERANS, HOMELESS, AND DISABLED INDIVIDUALS.
THE HOSPITAL SPECIFICALLY ASSISTS THE PATIENT IN COMPLETING THE APPLICATION AND SECURING THE NECESSARY DOCUMENTATION REQUIRED BY THE APPLICABLE FINANCIAL ASSISTANCE PROGRAM. NECESSARY DOCUMENTATION INCLUDES PROOF OF: (1) ANNUAL HOUSEHOLD INCOME (PAYROLL STUBS, RECORD OF SOCIAL SECURITY PAYMENTS, AND A LETTER FROM THE EMPLOYER, TAX RETURNS, OR BANK STATEMENTS), (2) CITIZENSHIP AND IDENTITY, AND (3) IMMIGRATION STATUS FOR NON-CITIZENS (IF APPLICABLE), AND (4) ASSETS OF THOSE INDIVIDUALS WHO ARE ALSO ENROLLED IN THE MEDICARE PROGRAM. THE HOSPITAL WILL THEN SUBMIT THIS DOCUMENTATION TO THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES AND ASSIST THE PATIENT IN SECURING ANY ADDITIONAL DOCUMENTATION IF SUCH IS REQUESTED BY THE COMMONWEALTH AFTER COMPLETING THE APPLICATION. THE COMMONWEALTH PLACES A THREE DAY TIME LIMITATION ON SUBMITTING ALL NECESSARY DOCUMENTATION FOLLOWING THE SUBMISSION OF THE APPLICATION FOR A PROGRAM. FOLLOWING THIS THREE DAY PERIOD, THE PATIENT MUST WORK WITH THE MASSHEALTH ENROLLMENT CENTERS TO SECURE THE ADDITIONAL DOCUMENTATION NEEDED FOR ENROLLMENT IN THE APPLICABLE FINANCIAL ASSISTANCE PROGRAM. IN SPECIAL CIRCUMSTANCES, THE HOSPITAL MAY APPLY FOR THE PATIENT USING A SPECIFIC FORM DESIGNED BY THE MASSACHUSETTS DIVISION OF HEALTH CARE FINANCE AND POLICY. SPECIAL CIRCUMSTANCES INCLUDE INDIVIDUALS SEEKING FINANCIAL ASSISTANCE COVERAGE DUE TO BEING INCARCERATED, VICTIMS OF SPOUSAL ABUSE, OR APPLYING DUE TO A MEDICAL HARDSHIP. ALL VIRTUAL GATEWAY APPLICATIONS ARE REVIEWED AND PROCESSED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES, WHICH USES THE FEDERAL POVERTY GUIDELINES, ASSET INFORMATION AS WELL AS NECESSARY DOCUMENTATION LISTED ABOVE AS THE BASIS FOR DETERMINING ELIGIBILITY FOR STATE SPONSORED PUBLIC ASSISTANCE PROGRAMS. MOUNT AUBURN HOSPITAL HAS NO ROLE IN THE DETERMINATION OF PROGRAM ELIGIBILITY MADE BY THE COMMONWEALTH, BUT AT THE PATIENT'S REQUEST MAY TAKE A DIRECT ROLE IN APPEALING OR SEEKING INFORMATION RELATED TO THE COVERAGE DECISIONS. IT IS STILL THE PATIENT'S RESPONSIBILITY TO INFORM THE HOSPITAL OF ALL COVERAGE DECISIONS MADE BY THE COMMONWEALTH TO ENSURE ACCURATE AND TIMELY ADJUDICATION OF ALL HOSPITAL BILLS. IN ADDITION, THE HOSPITAL'S POLICY PROVIDES FOR INDIVIDUALS WHO ARE UNABLE TO AFFORD THEIR CARE BECAUSE OF MEDICAL HARDSHIP AND PROVIDES FOR FEES BASED ON A SLIDING SCALE RELATIVE TO PERCENTAGES OF THE FEDERAL POVERTY GUIDELINES (SCHEDULE H, PART V, SECTION B, QUESTION 20D). IN ADDITION, ALL HOSPITAL PATIENTS WHO PRESENT WITHOUT PRIVATE INSURANCE ARE SCREENED FOR PRIOR HSN ELIGIBILITY AND/OR FINANCIAL ASSISTANCE BEFORE ANY BILLS ARE SENT TO THE PATIENT AND ONCE THE HOSPITAL BECOMES AWARE OF A PATIENT'S HSN OR FINANCIAL ELIGIBILITY STATUS, ALL INVOICES ARE ADJUSTED ACCORDINGLY (SCHEDULE H, PART V, SECTION B, QUESTIONS 21 AND 22). MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY: STANDARD COLLECTION PRACTICES AS PREVIOUSLY NOTED IN THE NARRATIVE TO THIS FORM 990 SCHEDULE H, MOUNT AUBURN HOSPITAL ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. ADDITIONALLY, TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, THE HOSPITAL MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. AS SUCH, THE HOSPITAL HAS A FIDUCIARY DUTY TO SEEK REIMBURSEMENT FOR SERVICES IT HAS PROVIDED FROM INDIVIDUALS WHO ARE ABLE TO PAY, FROM THIRD PARTY INSURERS WHO COVER THE COST OF CARE, AND FROM OTHER PROGRAMS OF ASSISTANCE FOR WHICH THE PATIENT IS ELIGIBLE. TO DETERMINE WHETHER A PATIENT IS ABLE TO PAY FOR THE SERVICES PROVIDED AS WELL AS TO ASSIST THE PATIENT IN FINDING ALTERNATIVE COVERAGE OPTIONS IF THEY ARE UNINSURED OR UNDERINSURED, THE HOSPITAL HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. THE HOSPITAL MAKES THE SAME REASONABLE EFFORT AND FOLLOWS THE SAME REASONABLE PROCESS FOR COLLECTING ON BILLS OWED BY AN UNINSURED PATIENT AS IT DOES FOR ALL OTHER PATIENTS. THE HOSPITAL WILL FIRST SHOW THAT IT HAS A CURRENT UNPAID BALANCE THAT IS RELATED TO SERVICES PROVIDED TO THE PATIENT AND NOT COVERED BY A PRIVATE INSURER OR A FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL ALSO HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY: OUTSIDE COLLECTION AGENCIES THE HOSPITAL CONTRACTS WITH AN OUTSIDE COLLECTION AGENCY TO ASSIST IN THE COLLECTION OF CERTAIN ACCOUNTS, INCLUDING PATIENT RESPONSIBLE AMOUNTS NOT RESOLVED AFTER ISSUANCE OF HOSPITAL BILLS OR FINAL NOTICES. HOWEVER, AS DETERMINED THROUGH THE HOSPITAL'S CREDIT AND COLLECTION POLICY, THE HOSPITAL MAY ASSIGN SUCH DEBT AS BAD DEBT OR CHARITY CARE (OTHERWISE DEEMED AS UNCOLLECTIBLE) PRIOR TO 120 DAYS IF IT IS ABLE TO DETERMINE THAT THE PATIENT WAS UNABLE TO PAY FOLLOWING THE HOSPITALS' OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. MOUNT AUBURN HOSPITAL HAS A SPECIFIC AUTHORIZATION OR CONTRACT WITH ITS OUTSIDE COLLECTION AGENCY AND REQUIRES SUCH AGENCY TO ABIDE BY THE HOSPITAL'S CREDIT AND COLLECTION POLICIES FOR DEBTS THAT THE AGENCY IS PURSUING. IN ADDITION, THE HOSPITAL REQUIRES THAT ANY OUTSIDE COLLECTION AGENCY THAT IT USES MUST BE LICENSED BY THE COMMONWEALTH OF MASSACHUSETTS AND BE IN COMPLIANCE WITH THE MASSACHUSETTS ATTORNEY GENERAL'S DEBT COLLECTION REGULATIONS. FINALLY, ANY OUTSIDE COLLECTION AGENCY HIRED BY THE HOSPITAL WILL PROVIDE THE PATIENT WITH AN OPPORTUNITY TO FILE A GRIEVANCE AND WILL FORWARD TO THE HOSPITAL THE RESULTS OF ANY SUCH PATIENT GRIEVANCE. MOUNT AUBURN HOSPITAL - CREDIT AND COLLECTION POLICY: EXEMPTION FROM HOSPITAL COLLECTION PRACTICES MOUNT AUBURN HOSPITAL EXEMPTS PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN AND "LOW INCOME PATIENTS" AS DETERMINED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES, SUBJECT TO SOME EXCEPTIONS, FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS. CREDIT AND COLLECTION POLICY - DISCOUNT FOR UNINSURED PATIENTS IN ADDITION TO THE FINANCIAL ASSISTANCE INFORMATION PROVIDED ABOVE, THE MEDICAL CENTER GIVES A SELF-PAY DISCOUNT TO PATIENTS WHO ARE UNINSURED. BILLING AND COLLECTIONS BEFORE REASONABLE EFFORTS NEITHER THE HOSPITAL NOR ANY AUTHORIZED THIRD PARTY TOOK ANY OF THE ACTIONS LISTED IN FORM 990, SCHEDULE H, PART V, SECTION B, QUESTION 17 OR 18. CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS - HEALTH PROFESSIONS EDUCATION MAH'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES, AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE MAH A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE HOSPITAL TRAINS MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS. MAH HAS FOUR APPROVED RESIDENCY PROGRAMS WITH APPROXIMATELY 42 INTERNAL MEDICINE RESIDENTS, APPROXIMATELY 12 RADIOLOGY RESIDENTS, AND NEWLY INITIATED PODIATRY AND PHARMACY PRACTICE RESIDENCY PROGRAM WITH 6 AND 2 RESIDENTS ENROLLED RESPECTIVELY DURING 2013. STAFF PHYSICIANS AT MAH WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. AS PART OF THE HOSPITAL'S COMMITMENT TO MEDICAL STUDENT EDUCATION AND AFFILIATION WITH HARVARD MEDICAL SCHOOL, MAH IS A CORE SITE FOR THE HARVARD MEDICAL SCHOOL SUB-INTERNSHIP IN MEDICINE. THE HOSPITAL ALSO PARTICIPATES IN THE INTRODUCTORY COURSES IN CLINICAL MEDICINE FOR FIRST AND SECOND-YEAR HARVARD MEDICAL STUDENTS AND THE BIOMEDICAL DOCTORAL STUDENTS FROM THE MASSACHUSETTS INSTITUTE OF TECHNOLOGY'S HEALTH SCIENCES AND TECHNOLOGY PROGRAM. ADDITIONALLY, MEDICAL STUDENTS FROM MANY OTHER MEDICAL SCHOOLS CHOOSE TO DO SUB-INTERNSHIPS AND SUBSPECIALTY ELECTIVES DURING THEIR FOURTH YEAR. IN ADDITION TO THE INTERNAL MEDICINE TRAINING PROGRAM, MOUNT AUBURN HOSPITAL IS A SITE FOR OTHER POST-GRADUATE MEDICAL EDUCATION DISCIPLINES. THE HOSPITAL'S RESIDENTS BENEFIT FROM THE MAH RESIDENCY PROGRAM IN DIAGNOSTIC RADIOLOGY, ITS PARTICIPATION AS A CORE SITE FOR THE BETH ISRAEL DEACONESS MEDICAL CENTER SURGICAL TRAINING PROGRAM, AND IN THE HARVARD-AFFILIATED EMERGENCY MEDICINE RESIDENCY. MAH ALSO WELCOMES ROTATING INTERNS FROM THE HARVARD / LONGWOOD PSYCHIATRY RESIDENCY, GERIATRIC FELLOWS FROM THE BETH ISRAEL DEACONESS / HARVARD MEDICAL SCHOOL DIVISION ON AGING FELLOWSHIP PROGRAM, AND PEDIATRIC / NEONATOLOGY RESIDENTS FROM MASSACHUSETTS GENERAL HOSPITAL / CAMBRIDGE HOSPITAL PROGRAM IN NEONATOLOGY. THE TRACKS OF TRAINING IN INTERNAL MEDICINE MOUNT AUBURN HOSPITAL OFFERS A THREE-YEAR CATEGORICAL MEDICINE TRACK AND A ONE-YEAR PRELIMINARY MEDICINE TRACK.
THE CATEGORICAL TRACK MAH'S THREE-YEAR CATEGORICAL INTERNAL MEDICINE TRACK PREPARES RESIDENT TRAINEES FOR BOARD CERTIFICATION BY THE AMERICAN BOARD OF INTERNAL MEDICINE AND CAREERS THAT COVER THE FULL SPECTRUM OF OPPORTUNITIES IN BOTH GENERAL INTERNAL MEDICINE AND MEDICINE SUB-SPECIALTIES. RESIDENT TRAINEES ARE ABLE TO TAILOR THEIR FLOW OF THE 36 MONTHS OF TRAINING TO OBTAIN THE STRONG BACKGROUND AND EXCELLENT CLINICAL SKILLS TO PURSUE SUBSEQUENT CAREERS IN PRIMARY CARE PRACTICE, HOSPITALIST MEDICINE, AND PLACEMENT IN COMPETITIVE SUB-SPECIALTY FELLOWSHIP TRAINING PROGRAMS. ONE WAY MAH SUPPORTS TRAINEES IN THEIR INTENDED CAREER GOALS IS THROUGH THE USE OF DEFINED PATHWAYS. THESE PATHWAYS, IN SUB-SPECIALTY FELLOWSHIP, PRIMARY CARE, HOSPITALIST MEDICINE, AND MEDICAL EDUCATION, OUTLINE FOR THE TRAINEE THE MILESTONES THAT SHOULD BE MET THROUGHOUT THE COURSE OF TRAINING. THE PRELIMINARY TRACK THE PRELIMINARY MEDICINE INTERNSHIP TRACK OFFERS ONE YEAR OF TRAINING IN MEDICINE FOR PHYSICIANS WHO WILL CONTINUE THEIR TRAINING IN SPECIALTIES OTHER THAN INTERNAL MEDICINE, SUCH AS RADIOLOGY, OPHTHALMOLOGY, ANESTHESIOLOGY, RADIATION ONCOLOGY, NEUROLOGY, DERMATOLOGY, PHYSICAL MEDICINE & REHABILITATION, AND OTHERS. THIS TRACK'S MAJOR STRENGTH, AS WELL AS ITS MAJOR ATTRACTION, IS THAT THE YEAR IS VIRTUALLY IDENTICAL IN STRUCTURE AND CONTENT TO THE FIRST YEAR FOR PHYSICIANS WHO TRAIN AT MOUNT AUBURN HOSPITAL FOR THREE YEARS IN THE CATEGORICAL INTERNAL MEDICINE TRACK. THE ONLY DIFFERENCE BEING THE QUANTITY OF AMBULATORY MEDICINE EXPERIENCE, BECAUSE PRELIMINARY INTERNS ARE NOT ASSIGNED A CONTINUITY CLINIC DURING THEIR YEAR. RADIOLOGY RESIDENCY PROGRAM RESIDENTS ARE TYPICALLY ASSIGNED IN ONE MONTH BLOCKS TO ONE OF THE DIFFERENT MODALITIES. EARLY IN TRAINING, RESIDENTS ARE EXPECTED TO READ EXTENSIVELY, MASTER ANATOMY, PARTICIPATE IN THE PROTOCOLLING AND INTERPRETATION OF PATIENT EXAMINATIONS, AND TO PARTICIPATE IN DISCUSSIONS CONCERNING DIAGNOSTIC PROBLEMS. RESIDENTS ADVANCE TO INCREASED LEVELS OF RESPONSIBILITY, AND SOUND JUDGMENT AS A RADIOLOGIST IS ESTABLISHED DURING OVERNIGHT CALL. - ROTATIONS AVAILABLE: CT AND MR WHICH INCLUDES NEURO, HEAD AND NECK, ,CARDIOTHORACIC, GI, GU AND MUSCULOSKELETAL RADIOLOGY - SPECIAL PROCEDURES (INTERVENTIONAL RADIOLOGY) WHICH INCLUDES VASCULAR RADIOLOGY AND INTERVENTION, THORACIC PROCEDURES, ABDOMINAL PROCEDURES, UTERINE FIBROID EMBOLIZATION PROGRAM, VERTEBROPLASTY - FLUOROSCOPY WHICH INCLUDES GI, GU AND MUSCULOSKELETAL PROCEDURES - ULTRASOUND, INCLUDING OBSTETRIC ULTRASOUND - NUCLEAR MEDICINE, INCLUDING CARDIAC - BREAST IMAGING, INCLUDING MAMMOGRAPHY, MR, AND PROCEDURES - EMERGENCY RADIOLOGY (2ND YEAR, 3 MONTHS PERFORMED AT MASSACHUSETTS GENERAL HOSPITAL) - PEDIATRIC RADIOLOGY (2ND YEAR, 3 MONTHS PERFORMED AT BOSTON CHILDREN'S HOSPITAL) - ARMED FORCES INSTITUTE OF PATHOLOGY (3RD YEAR, 4 WEEK COURSE, WASHINGTON, D.C.) - ROTATIONS IN CARDIAC RADIOLOGY AND CAROTID ULTRASOUND ARE ALSO INCLUDED IN CONJUNCTION WITH THE DEPARTMENTS OF CARDIOLOGY AND VASCULAR SURGERY. - ONE MONTH OF RESEARCH OR OTHER SCHOLARLY ACTIVITY DURING THE THIRD YEAR - THREE MONTHS OF THE 4TH YEAR IS SET ASIDE FOR AN ELECTIVE, ALLOWING THE RESIDENT TO DEVELOP IN-DEPTH KNOWLEDGE IN A SPECIFIC AREA OF INTEREST. THREE RESIDENTS ARE CHOSEN EACH YEAR FOR A FOUR-YEAR PROGRAM AND APPOINTED AS CLINICAL FELLOWS AT HARVARD MEDICAL SCHOOL. THE RATIO OF STAFF RADIOLOGISTS TO RESIDENTS RESULTS IN CLOSE CONTACT BETWEEN THE STAFF AND RESIDENTS THROUGHOUT THE TRAINING PROGRAM. AFTER THE RESIDENT HAS OBTAINED THE NECESSARY FIRM FOUNDATIONS IN THE FUNDAMENTALS OF RADIOLOGY, HE OR SHE IS ENCOURAGED TO TAKE INCREASING RESPONSIBILITY IN BOTH ROUTINE AND SPECIALIZED EXAMINATIONS AND PROCEDURES. THE MAJORITY OF OUR RESIDENTS PURSUE SUBSPECIALTY FELLOWSHIP TRAINING. HOWEVER, THE GOAL OF THE RADIOLOGY RESIDENCY PROGRAM IS TO TRAIN RESIDENTS TO BE FULLY QUALIFIED IN DIAGNOSTIC RADIOLOGY AND SPECIAL PROCEDURES BY THE TIME THEY HAVE COMPLETED THE FOUR-YEAR PROGRAM. GRADUATES HAVE PURSUED CAREERS IN ACADEMIA AND PRIVATE PRACTICE. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $6,404,751 REPORTED ON THIS SCHEDULE H RELATED TO MAH'S TEACHING FUNCTION. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - RESEARCH MOUNT AUBURN HOSPITAL PARTICIPATES IN THE EASTERN COOPERATIVE ONCOLOGY GROUP (ECOG), WHICH IS A LARGE NETWORK OF RESEARCHERS, PHYSICIANS, AND HEALTH CARE PROFESSIONALS AT PUBLIC AND PRIVATE INSTITUTIONS ACROSS THE COUNTRY INVOLVED IN ONCOLOGY CLINICAL RESEARCH, AND FUNDED PRIMARILY BY THE NATIONAL CANCER INSTITUTE (NCI). PARTICIPATING ENTITIES WORK TOWARD THE COMMON GOAL OF CONTROLLING, EFFECTIVELY TREATING, AND ULTIMATELY CURING CANCER. RESEARCH RESULTS ARE PROVIDED TO THE WORLD-WIDE MEDICAL COMMUNITY THROUGH SCIENTIFIC PUBLICATIONS AND PROFESSIONAL MEETINGS. DURING THE FISCAL YEAR COVERED BY THIS FILING, THE HOSPITAL PROVIDED ONCOLOGY NURSING SUPPORT DIRECTED TOWARD THIS RESEARCH. IN ADDITION, DURING THE PERIOD COVERED BY THIS FILING, THE HOSPITAL ENGAGED IN DISPARITIES RESEARCH, FOCUSED ON ASSESSING THE NEEDS OF CAREGIVERS OF ELDERS IN CAMBRIDGE. RESEARCH RESULTS WERE SHARED BROADLY WITH THE COMMUNITY. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $24,150 REPORTED ON THIS SCHEDULE H RELATED TO RESEARCH. MOUNT AUBURN HOSPITAL- ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY MOUNT AUBURN HOSPITAL IS GOVERNED BY A MAXIMUM OF 28 MEMBERS OF THE BOARD OF TRUSTEES, MANY OF WHOM LIVE AND WORK IN THE COMMUNITY AND SERVE TO SUPPORT THE MISSION AND VALUES OF THE HOSPITAL. MAH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY AND ENDEAVORS TO PROVIDE THEM WITH THE SAFEST AND MOST TECHNOLOGICALLY ADVANCED ENVIRONMENT POSSIBLE THROUGH THE EFFECTIVE USE OF SURPLUS FUNDS. SOME OF MAH'S SURPLUS FUNDS HAVE BEEN USED TO FUND CONTINUING RENOVATION OF EXISTING FACILITIES, INCLUDING INPATIENT UNITS AND OTHER CLINICAL AREAS. MAH STRIVES TO FULLY SERVE THE COMMUNITY THROUGH PARTICIPATION IN GOVERNMENT SPONSORED HEALTHCARE PROGRAMS SUCH AS MEDICARE, MEDICAID, CHAMPUS AND TRICARE. AS PREVIOUSLY NOTED MAH ALSO SERVES AS A TEACHING HOSPITAL AFFILIATED WITH THE HARVARD MEDICAL SCHOOL AND MAINTAINS TWO RESIDENCY PROGRAMS SPECIALIZING IN PRIMARY CARE AND RADIOLOGY. MOUNT AUBURN HOSPITAL- AFFILIATED HEALTH CARE SYSTEM AS NOTED IN VARIOUS NARRATIVE DISCLOSURES WHICH SUPPORT THIS FORM 990 AND RELATED SCHEDULES, CAREGROUP, INC. (CAREGROUP) IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CAREGROUP'S PURPOSE IS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MAKE UP THE CAREGROUP SYSTEM. CAREGROUP SERVES AS THE SOLE MEMBER AND A SUPPORT ORGANIZATION OF MOUNT AUBURN HOSPITAL (MAH) AND NEW ENGLAND BAPTIST HOSPITAL (NEBH) WHICH IN TURN EACH SERVE AS THE SOLE MEMBER OF MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) AND NEW ENGLAND BAPTIST MEDICAL ASSOCIATES (NEBMA) AND RESPECTIVELY. CAREGROUP SERVES AS THE SOLE MEMBER AND A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER). BIDMC IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BIDN), MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A AFFILIATED PHYSICIANS GROUP (APG), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH) AND JORDAN HEALTH SYSTEMS, INC. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES. EACH OF THE ENTITIES LISTED IN THIS PARAGRAPH MAY, IN TURN, SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE CAREGROUP NETWORK OF AFFILIATES. COMBINED THESE ENTITIES FORM A REGIONAL HEALTHCARE DELIVERY SYSTEM COMPRISED OF TEACHING AND COMMUNITY HOSPITALS, PHYSICIAN GROUPS, AND OTHER CAREGIVERS. THESE ENTITIES ARE COMMITTED TO PROVIDING PERSONALIZED, PATIENT CENTERED CARE WITHIN THE COMMUNITIES THEY SERVE, ENSURING ACCESS TO A WIDE RANGE OF SPECIALTY SERVICES AND A BROAD SPECTRUM OF COMPREHENSIVE HEALTH SERVICES RANGING FROM WELLNESS PROGRAMS TO HOME CARE AS WELL AS TO FURTHERING EXCELLENCE IN MEDICAL EDUCATION AND RESEARCH.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MOUNT AUBURN PROFESSIONAL SERVICES INC
 
Employer identification number

04-3026897
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) 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 entity?
Yes No
(1) ASSOC PHYS HARVARD MED FAC PHY AT BIDMC

375 LONGWOOD AVE

BOSTON,MA02215
32-0058309
TO PROVIDE EMERGENCY MEDICAL SERVICES MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(2) BI ANAESTHESIA FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
04-2997215
SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(3) BI COMMUNITY FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
04-2776678
INACTIVE CORPORATION MA 501(C)(3) LINE 7 N/A
 
No
(4) BI DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
04-3079630
SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(5) BI DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
20-8253452
SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(6) BI DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
04-3030397
SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(7) BI DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC

330 BROOKLINE AVE

BOSTON,MA02215
20-4974585
SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(8) BI DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC

110 FRANCIS STREET

BOSTON,MA02215
02-0671240
SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(9) BI DEACONESS HOSPITAL - NEEDHAM INC

148 CHESTNUT ST

NEEDHAM,MA00000
04-3229679
HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. MA 501(C)(3) LINE 3 BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(10) BETH ISRAEL DEACONESS MEDICAL CENTER

330 BROOKLINE AVE

BOSTON,MA02215
04-2103881
THE OPERAION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA MA 501(C)(3) LINE 3 CAREGROUP INC
 
 
No
(11) BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP

300 LONGWOOD AVE

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

330 BROOKLINE AVE

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

330 BROOKLINE AVE

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

330 BROOKLINE AVE

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

330 BROOKLINE AVE

BOSTON,MA02215
04-2571853
SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(16) LONGWOOD MEDICAL INTL FOUNDATION

185 PILGRIM ROAD BOST

BOSTON,MA02215
04-3208878
INACTIVE CORPORATION MA 501(C)(3) LINE 11A, I HMFP AT BIDMC
 
 
No
(17) CAREGROUP INC

109 BROOKLINE AVE

BOSTON,MA02215
22-2629185
OVERSEE FINCIAL HEALTH OF AFFILIATES MA 501(C)(3) LINE 11D, III-O N/A
 
No
(18) CARL J SHAPIRO INSTITUTE

330 BROOKLINE AVE

BOSTON,MA02215
04-3326928
DEVELOP INNOVATIVE PROG AND MODELS FOR TEACHING AND RESEARCH MA 501(C)(3) LINE 11A, I N/A
 
No
(19) CONTINUING EDU PROGRAM DBA BID DEPT OF PSYCH FDN

C/O HARVARD MED SCH 401 PARK DR

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

400 HUNNEWELL ST

NEEDHAM,MA02494
04-2810972
OUTPATIENT, PRIMARY CARE AND SPECIALTY SERVICES MA 501(C)(3) LINE 9 BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(21) MOUNT AUBURN HOSPITAL

330 MOUNT AUBURN ST

CAMBRIDGE,MA02138
04-2103606
HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS MA 501(C)(3) LINE 3 CAREGROUP INC
 
 
No
(22) MOUNT AUBURN PROFESSIONAL SERVICES INC

330 MOUNT AUBURN ST

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

125 PARKER HILL AVE

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

125 PARKER HILL AVE

BOSTON,MA02120
04-3235796
OUTPATIENT MEDICAL SERVICES TO THE VARIOUS COMMUNITIES SERVICED BY NEBH MA 501(C)(3) LINE 3 NEW ENGLAND BAPTIST HOSPITAL INC
 
 
No
(25) RIVERBROOK CORPORATION

109 BROOKLINE AVE

BOSTON,MA02215
04-2828955
TO HOLD TITLE TO PROPERTY FOR CAREGROUP, INC. MA 501(C)(2)   CAREGROUP INC
 
 
No
(26) HARVARD MEDICAL COLLABORATIVE INC

25 SHATTUCK ST

BOSTON,MA02115
04-3476764
COORDINATE AND PROVIDE STATEGIC PLANNING OPP FOR HMS MA 501(C)(3) LINE 11A, I N/A
 
No
(27) HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC

375 LONGWOOD AVE

BOSTON,MA02215
22-2768204
GENERAL AND SPECIALIZED MEDICAL SERVICES TO THE PATIENTS OF BIDMC AND OTHERS MA 501(C)(3) LINE 9 N/A
 
No
(28) BETH ISRAEL DEACONESS HOSPITAL - MILTON INC

199 REEDSDALE RD

MILTON,MA02186
04-2103604
HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. MA 501(C)(3) LINE 3 BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(29) COMMUNITY PHYSICIAN ASSOCIATES INC

199 REEDSDALE RD

MILTON,MA02186
04-3243146
OUTPATIENT AND PRIMARY CARE SERVICES MA 501(C)(3) LINE 3 MILTON HOSPITAL FOUNDATION INC
 
 
No
(30) MILTON HOSPITAL FOUNDATION INC

199 REEDSDALE RD

MILTON,MA02186
22-2566792
PROMOTE HEALTHCARE MA 501(C)(3) LINE 11A, I BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(31) BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH INC

275 SANDWICH ST

PLYMOUTH,MA02186
22-2667354
HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. MA 501(C)(3) LINE 3 BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(32) JH REALTY CORP

275 SANDWICH ST

PLYMOUTH,MA02360
22-2677673
REAL ESTATE MA 501(C)(3) LINE 11A, I BETH ISRAEL DEACONESS-PLYMOUTH
 
 
No
(33) JORDAN AMBULATORY HEALTH CARE

36 CORDAGE PARK CIRCLE

PLYMOUTH,MA02360
22-2667348
PROVIDE MEDICAL SERVICES MA 501(C)(3) LINE 11A, I BETH ISRAEL DEACONESS-PLYMOUTH
 
 
No
(34) JORDAN HEALTH FOUNDATION

175 SANDWICH ST

PLYMOUTH,MA02360
51-0432984
PROMOTE HEALTHCARE MA 501(C)(3) LINE 11A, I BETH ISRAEL DEACONESS-PLYMOUTH
 
 
No
(35) JORDAN HEALTH SYSTEMS INC

275 SANDWICH ST

PLYMOUTH,MA02360
04-2103805
PROMOTE HEALTHCARE MA 501(C)(3) LINE 11A, I BETH ISRAEL DEACONESS MEDICAL CENTER INC
 
 
No
(36) JORDAN PHYSICIANS ASSOCIATES INC

275 SANDWICH ST

PLYMOUTH,MA02360
04-3228556
OUTPATIENT AND PRIMARY CARE SERVICES MA 501(C)(3) LINE 9 JORDAN HEALTH SYSTEMS INC
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) ADVANCED VASCULAR CARE LLC

375 LONGWOOD AVE
BOSTON,MA02215
26-1647880
TO PROVIDE MEDICAL SUPPORT SERVICES MA N/A
                 
(2) BETH ISRAEL DEACONESS PHYS ORG LLC DBA BIDCO

ONE UNIVERSITY AVE NORTH ENTRANCE
WESTWOOD,MA02090
04-3426253
COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC MA N/A
                 
(3) BIDCO PHYSICIAN LLC

ONE UNIVERSITY AVE NORTH ENTRANCE
WESTWOOD,MA02090
04-3426253
COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC MA N/A
                 
(4) BIDCO HOSPITAL LLC

ONE UNIVERSITY AVE NORTH ENTRANCE
WESTWOOD,MA02090
46-1643790
COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC MA N/A
                 
(5) CAREGROUP CLINICAL RESEARCH LLC

109 BROOKLINE AVENUE
BOSTON,MA02215
30-0228711
TO PARTICIPATE IN A CLINICAL RESEARCH PARTNERSHIP MA N/A
                 
(6) CAREGROUP INVESTMENT PARTNERSHIP LLP

109 BROOKLINE AVENUE
BOSTON,MA02215
04-3278109
INVESTMENT PARTNERSHIP MA N/A
                 
(7) CHARLTON MRI SERVICES LLC

330 BROOKLINE AVENUE
BOSTON,MA02215
26-4662778
PROVISION OF PATIENT CARE SERVICES MA N/A
                 
(8) PHYSICIAN PROFESSIONAL SERVICES LLP

10 CABOT ROAD
MEDFORD,MA02215
04-3275078
TO PROVIDE MEDICAL BILLING SERVICES MA N/A
                 
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
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) MILTON PHYSICIAN-HOSPITAL ORGANIZATION INC

199 REEDSDALE ROAD
MILTON,MA02186
04-3213042
PHYSICIAN/HOSPITAL ORGANIZATION MA N/A
C         No
(2) ANESTHESIA FINANCIAL SOLUTIONS INC

330 BROOKLINE AVE
BOSTON,MA02215
04-3571311
INACTIVE CORPORATION MA N/A
C         No
(3) JORDON COMMUNITY ACO INC

275 SANDWICH ST
PLYMOUTH,MA02360
45-4047430
COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BID-PLYMOUTH MA N/A
C         No
(4) ATLANTIC MEDICAL MANAGEMENT INC

275 SANDWICH ST
PLYMOUTH,MA02360
04-3161451
INACTIVE CORPORATION MA  
C         No






Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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 or (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
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
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 related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
FORM 990, SCHEDULE R, PART III THE PARTNERSHIP IS CONTROLLED 50% BY THE BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION, INC. AND 50% BY THE BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS DO GYNECOLOGY FOUNDATION, INC.
Schedule R (Form 990) 2013
Additional Data


Software ID:  
Software Version: