TY 2019 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) Dianne J Anderson...................................................................... President & CEO (Until 10/19)	50.0 ................. 1.0	X	X		872,489	44,936
(2) Jason D Reid...................................................................... Physician (Ortho Trauma)	40.0 ................. 0.0			X	537,287	18,025
(3) Ziad Alfarah MD...................................................................... Senior VP Medical Affairs	40.0 ................. 0.0			X	462,643	38,342
(4) Deborah J Wilson...................................................................... President & CEO (11/19 - On)	50.0 ................. 1.0	X	X		470,654	27,807
(5) John J Brady...................................................................... Physician	40.0 ................. 0.0			X	474,830	18,762
(6) George Kondylis MD...................................................................... Physician (Ed Chief)	40.0 ................. 0.0			X	417,194	22,495
(7) Karen Moore...................................................................... Senior VP Operations	40.0 ................. 0.0			X	395,769	26,671
(8) Felix Mercado...................................................................... CFO (Until 10/20)	50.0 ................. 1.0		X		290,320	36,762
(9) Cynthia Phelan...................................................................... CORP. ASSISTANT SECRETARY & VP	50.0 ................. 1.0	X	X		287,400	37,708
(10) Robert Gilbert ESQ...................................................................... Chairman	1.0 ................. 1.0	X			0	0
(11) Dana J Marks...................................................................... Treasurer	1.0 ................. 1.0	X			0	0
(12) Dennis Conlin...................................................................... Secretary/Clerk	1.0 ................. 1.0	X			0	0
(13) Eduardo Haddad MD...................................................................... Trustee	1.0 ................. 1.0	X			0	0
(14) Jonathan Isaacson...................................................................... Trustee	1.0 ................. 1.0	X			0	0
(15) Norman Rogers...................................................................... Trustee	1.0 ................. 1.0	X			0	0
(16) Richard Santagati...................................................................... TRUSTEE	1.0 ................. 1.0	X			0	0
(17) William Wall...................................................................... Trustee	1.0 ................. 1.0	X			0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Greater Lawrence Family Health Cent, 1 Griffin Brook Drive METHUEN,MA01844	Resident Services	4,208,333
Gre Andover Medical Center LLC, 280 Merrimack Street LAWRENCE,MA01843	Prop. Rental Svcs.	4,060,368
Lawrence Anesthesia Services Inc, 7111 Fairway Drive Suite 450 PAL BEACH GARDENS,FL33418	Anesthesia Svcs.	3,623,849
Freedom Healthcare Staffing, 2851 S Parker Road Suite 1100 AURORA,CO80014	Nursing Services	2,372,248
Medicus Hospitalists LLC, 22 Roulston Road WINDHAM,NH03087	Hospitalist Services	2,241,870
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 95

- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Lawrence General Hospital

Employer identification number

04-2103586

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Lawrence General Hospital

Employer identification number

04-2103586

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Yes

66,569

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

66,569

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B Line 1F, LOBBYING ACTIVITIES:	Represents (A) 11.08% of Massachusetts Hospital Association ("MHA") annual dues/fees that is deemed to be used for lobbying expenditures ($16,354); (B) 11.08% of American Hospital Associatoin ("AHA") annual dues/fees that is deemed to be used for lobbying expenditures ($5,215); and (C) consultant expenses deemed to be used for lobbying expenditures ($45,000) in FY 2020.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Lawrence General Hospital

Employer identification number

04-2103586

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	1,100,000	1,100,000	1,100,000	1,100,000	1,100,000
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	1,100,000	1,100,000	1,100,000	1,100,000	1,100,000

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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" on 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 .....	1,915,045		1,915,045
b	Buildings ....	109,420,512	66,342,497	43,078,015
c	Leasehold improvements	21,757,351	5,108,292	16,649,059
d	Equipment ....	112,531,366	70,265,684	42,265,682
e	Other .....	7,598,736	2,043,632	5,555,104
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				109,462,905

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on 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........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)OTHER ASSETS				10,230,586
(2)FUNDS HELD BY TRUSTEE				11,157,325
(3)INTEREST LGH CHARITABLE TRUST				17,597,630
(4)OTHER RECEIVABLES				7,714,132
(5)DUE FROM AFFILIATES				13,444,113
(6)EST. SETTLEMENTS W/THIRD PARTY				1,219,596
(7)RIGHTS OF USED ASSETS - OP LEA				45,958,794
(8)TEMPORARILY RESTRICTED CASH				1,140,782
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				108,462,958

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	115,301,580
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) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	288,258,852
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	483,000
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	483,000
3	Subtract line 2e from line 1..................			3	287,775,852
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
c	Add lines 4a and 4b....................			4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	287,775,852

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	299,696,926
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
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3	299,696,926
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
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	299,696,926

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 X, LINE 2:

THE ORGANIZATION ANNUALLY EVALUATES ITS TAX STATUS AND TAX POSITIONS TAKEN WITH RESPECT TO ITS OPERATIONS AND FINANCIALS POSITION. UNDER ASC 740, AN ORGANIZATION MUST RECOGNIZE THE FINANCIAL STATEMENT EFFECTS OF A TAX POSITION TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL NOT BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY. THE ORGANIZATION DOES NOT BELIEVE IT HAS TAKEN ANY MATERIAL UNCERTAIN TAX POSITIONS, AND, ACCORDINGLY, IT HAS NOT RECORDED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Lawrence General Hospital

Employer identification number

04-2103586

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	12,831,463	3,334,373	9,497,090	0.030 %
b	Medicaid (from Worksheet 3, column a) . . . . .	29,600,718	23,976,932	5,623,786	0.020 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	50,319,087	42,144,920	8,174,167	0.030 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	92,751,268	69,456,225	23,295,043	0.080 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	537,287	49,494	487,793
f	Health professions education (from Worksheet 5) . . .	4,170,833	1,258,071	2,912,762	0.010 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	338,501	0	338,501
j	Total. Other Benefits . .	5,046,621	1,307,565	3,739,056	0.010 %
k	Total. Add lines 7d and 7j .	97,797,889	70,763,790	27,034,099	0.090 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

15,083,661

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

58,793,699

Enter Medicare allowable costs of care relating to payments on line 5.....

72,552,749

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-13,759,050

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	LAWRENCE GENERAL HOSPITAL 1 GENERAL STREET LAWRENCE,MA01841	X	X	X	X

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Lawrence General Hospital
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): www.lawrencegeneral.org

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Lawrence General Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 400.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

The FAP application form was widely available on a website (list url):

A plain language summary of the FAP was widely available on a website (list url):

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	Lawrence General Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Lawrence General Hospital
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

Yes

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Part V, Section B, Line 5	THE HOSPITALS MOST RECENT CHNA (TAX YEAR 2019) CHNA UTILIZIED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED: SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, & HEALTH INDICATORS IN THE REGION; ADMINISTERING A PUBLIC SURVEY COMPLETED BY 630 RESIDENTS AND 473 HEALTH OR SOCIAL SERVICE PROVIDERS; AND CONDUCTING TWO FOCUS GROUPS AND 5 KEY INFORMANT INTERVIEWS TO IDENTIFY THE PERCEIVED HEALTH NEEDS, CHALLENGES TO ACCESSING SERVICES, CURRENT STRENGTHS AND ASSETS, AND OPPORTUNITIES FOR ACTION IN THE COMMUNITY. THE CNHA ENGAGED OVER 1100 PARTICIPANTS, GUIDED BY AN ADVISORY COMMITTEE OF 50 COMMUNITY PROVIDER STAKEHOLDERS. IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL INCLUDED MEMBERS FROM THE COMMUNITY WHO HAVE EXTENSIVE EXPERIENCE IN MATTERS OF PUBIC HEALTH. THIS INCLUDED MEMBERS FROM THE GREATER LAWRENCE FAMILY HEALTH CENTER, WITH ADVISORY GUIDANCE FROM THE CITY OF LAWRENCES MAYORS HEALTH TASK FORCE AND THE DEPARTMENTS OF PUBLIC HEALTH OF THE CITIES OF METHUEN AND NORTH ANDOVER, ALONG WITH REPRESENTATIVES FROM LAW ENFORCEMENT AND FIRST RESPONDERS, LOCAL SCHOOL SYSTEMS, FAITH COMMUNITY, AND OTHER SOCIAL AND GOVERNMENT SERVICES.
Part V, Section B, Line 11	THE HOSPITAL IS STILL IN THE PROCESS OF ADDRESSING ALL THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.
Part V, Section B, Line 24	THE HOSPITAL CHARGES SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE AN AMOUNT EQUAL TO THE GROSS CHARGE AMOUNT.

Schedule H (Form 990) 2019

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 6A:	THE HOSPITAL FILES A REPORT EACH AND EVERY TAX YEAR WITH THE ATTORNEY GENERAL. THIS REPORT IS PUBLICALLY AVAILABLE.
PART I, LINE 7:	THE COST-TO-CHARGE RATIO WAS USED AS THE COSTING METHODOLOGY TO CALCULATE THE AMOUNT USED TO CALCULATE THE AMOUNTS IN THE TABLE OF LINE 7.
PART III, SECTION A, LINE 2:	AMOUNT REPRESENTS BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE IS THE SUM OF (A) ACTUAL BAD DEBT WRITE-OFFS DURING THE YEAR (B) LESS RECOVERIES MADE DURING THE YEAR AND (C) ADJUSTMENTS FOR ALLOWANCES MADE AT FISCAL YEAR-END.
PART III, SECTION A, LINE 4:	AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS RECORDED TO REPORT ACCOUNTS RECEIVABLE AT THEIR NET REALIZABLE VALUE. THE ESTIMATED LOSSES ARE BASED UPON HISTORICAL COLLECTION EXPERIENCE TOGETHER WITH A REVIEW OF THE CURRENT STATUS OF THE EXISTING RECEIVABLES.
PART III, SECTION B, LINE 8:	THE HOSPITALS OPERATIONS IN ITS FISCAL YEAR 2020 WERE SIGNIFICANTLY AND NEGATIVELY IMPACTED BY THE COVID 19 PANDEMIC. WHILE THE HOSPITAL PROVIDED A SIGNIFICANT LEVEL OF INPATIENT AND EMERGENCY CARE TO PATIENTS STRICKEN BY THE DISEASE, IT REALIZED A SUBSTANTIAL LOSS FROM OPERATIONS DUE TO THE SUSPENSION OF ELECTIVE/NON - EMERGENT CARE AND A COLLATERAL LOSS OF OUTPATIENT REVENUE DUE TO DECLINES IN VOLUME IN AREAS SUCH AS PHYSICAL AND OCCUPATIONAL THERAPY, ENDOSCOPY AND IMAGING. IN TOTAL, THE HOSPITAL INCURRED A LOSS OF MORE THAN $13 MILLION IN PROVIDING CARE TO MEDICARE PATIENTS AND AN ESTIMATED LOSS OF APPROXIMATELY $6 MILLION PROVIDING CARE TO MEDICAID PATIENTS. THE HOSPITAL NOTES THE FOLLOWING SPECIFIC ITEMS OF COMMUNITY BENEFIT INCLUDED IN THIS LOSS : OF THE CLAIMED REIMBURSEMENT FOR MEDICARE BAD DEBTS ON THE AS FILED FY 2020 COST REPORT, APPROXIMATELY $1.92 MILLION ARE ASSOCIATED WITH UNPAID COINSURANCE AND DEDUCTIBLES FOR SERVICES PROVIDED TO PATIENTS WHO ARE DUALLY ELIGIBLE FOR MEDICARE AND MEDICAID. OF THIS AMOUNT, $672,556 WILL NOT BE REIMBURSED OWING TO THE STATUTORY THIRTY FIVE PERCENT (35%) MANDATED BY THE BALANCED BUDGET ACT OF 1997. EFFECTIVELY THIS REPRESENTS A HOSPITAL SUBSIDY OF SERVICES PROVIDED TO PATIENTS WHOSE INSURANCE COVERAGE IS PARTLY THE RESPONSIBILITY OF TITLE XIX. GIVEN THE HIGH NUMBER OF DUAL ELIGIBLE PATIENTS WHO RECEIVE CARE AT LAWRENCE GENERAL HOSPITAL, VARIOUS ELEMENTS OF THE FEDERAL GOVERNMENTS BUDGET ACTIONS AND CMSS PAYMENT POLICIES FOR MEDICARE HAVE A DISPROPORTIONATE IMPACT ON THIS ORGANIZATION. HISTORICALLY THE MEDICARE PROGRAM RECOGNIZED THE ADDITIONAL COSTS ASSOCIATED WITH TREATING SUCH PATIENTS THROUGH THE DISPROPRORTIONATE SHARE HOSPITAL (DSH) ADJUSTMENT TO INPATIENT MS-DRG PAYMENTS. HOWEVER, CHANGES MANDATED BY VARIOUS PROVISIONS OF THE AFFORDABLE CARE ACT AND THE HEALTH CARE AND EDUCATION RECONCILIATION ACT OF 2010 RESULTED IN REDUCTIONS IN REIMBURSEMENT FOR HOSPITALS IN STATES WHICH EXPANDED MEDICAID ELIGIBILITY AND BENEFITED HOSPITALS IN STATES WHICH DID NOT. IN THE HOSPITALS FY 2020 IT IS ESTIMATED THAT THESE CHANGES RESULTED IN A REIMBURSEMENT LOSS OF $4.97 MILLION FROM PRE-2104 LEVELS.
PART III, SECTION B, LINE 6	THE HOSPITAL USES THE SAME COST FINDING METHOD EMPLOYED IN THE MEDICARE COST REPORT, WHICH IS A BLEND OF RATIO OF COSTS TO CHARGES (RCC) AND PER DIEM METHODOLOGIES.
PART III, SECTION C, LINE 9B:	SECTION V OF THE ORGANIZATIONS CREDIT AND COLLECTION POLICY OUTLINES THE COLLECTION PRACTICES OF THE ORGANIZATION.
PART VI, LINE 2 - Needs Assessment:	LAWRENCE GENERAL HOSPITAL IDENTIFIES THE HEALTH CARE NEEDS IN OUR COMMUNITIES USING A NUMBER OF SOURCES, COMMUNITY AGENCIES, AND PARTNERS. WE USE FINDINGS AND REPORTS FROM THE MAYORS HEALTH TASK FORCE OF LAWRENCE, WHICH IS COMPRISED OF 100 PLUS LOCAL COMMUNITY & SOCIAL SERVICE AGENCIES; THE DEPARTMENT OF PUBLIC HEALTH; COMMUNITY NEEDS ASSESSMENT REPORTS ON HEALTH CARE ACCESS, DEMOGRAPHIC PROFILE OF ADULTS; HEALTH INDICATORS FOR LAWRENCE, MA; DEMOGRAPHIC INDICATORS; BREAST HEALTH REPORTS ON BREAST CANCER MORTALITY; BEHAVIORAL RISK FACTORS; DEMOGRAPHIC PROFILE OF ADULTS FOR THE REGION; AND CHRONIC ILLNESS REPORT FOR LAWRENCE, MA. IN ADDITION, WE CONDUCT INTERNAL PATIENT SURVEYS AND CONTINUALLY ASSESS THIS DATA, AS WELL AS DATA AVAILABLE THROUGH SOURCES SUCH AS MASSCHIP, BEHAVIORAL RISK FACTOR SURVEY DATA, QUALITY BENCHMARKING DATA, DPH REPORTS ON RACIAL AND ETHNIC HEALTH DISPARITIES OR PERIODIC BIRTH STATISTICS AND MARKET DATA. WE ALSO SOLICIT COMMUNITY INPUT THROUGH COMMUNITY SURVEYS, WEB AND SOCIAL NETWORKING SITE COMMUNICATIONS AND A LARGE NETWORK OF NEARLY 30 COMMUNITY CONTACTS VIA OUR VERY ACTIVE PATIENT-FAMILY ADVISORY COUNCIL. OTHER MEANS OF FEEDBACK AND INPUT INCLUDE COMMUNITY FOCUS GROUPS, INFORMATION SUPPLIED BY PUBLIC HEALTH PERSONNEL, LGH VOLUNTEERS AND TRUSTEES, AND FEEDBACK FROM LGH STAFF. COMMUNITY HEALTH NEEDS ASSESSMENT: TO VERIFY THAT LAWRENCE GENERAL IS ACHIEVING ITS MISSION AND MEETING THE NEEDS OF THE COMMUNITY, THE HOSPITAL UNDERTOOK A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN THE SPRING AND SUMMER OF 2019 (TAX YEAR 2018). THE LAWRENCE GENERAL HOSPITAL CHNA FOCUSED ON THE HOSPITALS PRIMARY AND SECONDARY MARKETS, WHICH INCLUDE THE TOWNS OF: (PRIMARY) LAWRENCE, METHUEN, NORTH ANDOVER, HAVERHILL, AND ANDOVER IN MASSACHUSETTS (MA) AS WELL AS (SECONDARY) MIDDLETON (MA), GEORGETOWN (MA), SALEM (NH), PLAISTOW (NH), ATKINSON (NH), BOXFORD (MA), AND TEWKSBURY (MA). LGH ENGAGED HEALTH RESOURCES IN ACTION (HRIA), A NON-PROFIT PUBLIC HEALTH CONSULTANCY ORGANIZATION, TO CONDUCT THE CHNA. THE CHNA INCLUDED REVIEWING EXISTING SOCIAL, ECONOMIC, AND HEALTH DATA OF THE MERRIMACK VALLEY REGION AS WELL AS CONDUCTING A PUBLIC SURVEY AND IN DEPTH DISCUSSIONS WITH PROVIDERS, COMMUNITY-BASED ORGANIZATIONAL LEADERS, AND RESIDENTS TO IDENTIFY THE PERCEIVED HEALTH NEEDS OF THE COMMUNITY, CHALLENGES TO ACCESS SERVICES, THE CURRENT STRENGTHS AND ASSETS, AND OPPORTUNITIES FOR ACTION. THE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED: SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS IN THE REGION; ADMINISTERING A PUBLIC SURVEY COMPLETED BY 450 RESIDENTS AND 521 HEALTH OR SOCIAL SERVICE PROVIDERS; AND CONDUCTING FOCUS GROUPS AND 5 INTERVIEWS WITH PROVIDERS, COMMUNITY-BASED ORGANIZATIONAL STAFF, AND RESIDENTS TO IDENTIFY THE PERCEIVED HEALTH NEEDS, CHALLENGES TO ACCESSING SERVICES, CURRENT STRENGTHS AND ASSETS, AND OPPORTUNITIES FOR IMPROVEMENT IN THE COMMUNITY. THE 2019 CHNA ENGAGED MORE THAN 1100 INDIVIDUALS THE LAWRENCE GENERAL CHNA INCORPORATES DATA ON IMPORTANT SOCIAL, ECONOMIC, AND HEALTH INDICATORS PULLED FROM VARIOUS SOURCES, INCLUDING THE MA DEPARTMENT OF PUBLIC HEALTH (MASSCHIP), U.S. CENSUS, CENTERS FOR DISEASE CONTROL AND PREVENTION, AND U.S. BUREAU OF LABOR. TYPES OF DATA INCLUDED SELF-REPORT OF HEALTH BEHAVIORS FROM LARGE, POPULATION-BASED SURVEYS SUCH AS THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VITAL STATISTICS BASED ON BIRTH AND DEATH RECORDS. ALL TABLES AND GRAPHS NOTE THE SPECIFIC DATA SOURCE. THE LAWRENCE GENERAL HOSPITAL (LGH) PRIMARY AND SECONDARY SERVICE AREAS ARE COMPRISED OF A TOTAL OF 12 COMMUNITIES THAT CROSS STATE LINES (MASSACHUSETTS AND NEW HAMPSHIRE), COUNTY LINES (ESSEX COUNTY MA, MIDDLESEX COUNTY MA, AND ROCKINGHAM COUNTY NH), AND COMMUNITY HEALTH NETWORK AREAS. KEY HEALTH ISSUES EMERGED AS AREAS OF POTENTIAL CONCERN IN THE ASSESSMENT, BOTH FROM AN EPIDEMIOLOGICAL PERSPECTIVE AND RESIDENT/PROVIDER AREAS OF INTEREST. THESE MAY ALSO BE THE AREAS WHERE THERE IS THE MOST GROUNDSWELL OF SUPPORT FOR ACTION: - SOCIAL DETERMINANTS OF HEALTH (HOUSING AND TRANSPORTATION) - CHRONIC DISEASE (DIABETES AND OBESITY) AGING POPULATION - BEHAVIORAL HEALTH (SUBSTANCE USE DISORDER) - HEALTH CARE ACCESS OVERARCHING CONCLUSIONS THAT CUT ACROSS MULTIPLE TOPIC AREAS INCLUDE THE FOLLOWING: THE SERVICE AREA IS DEMOGRAPHICALLY AND ECONOMICALLY DIVERSE AND IN THE PAST THREE YEARS THE SERVICE AREA HAS GROWN MODESTLY. WHILE SEVERAL COMMUNITIES IN THE REGION SUCH AS ANDOVER AND NORTH ANDOVER ARE HIGHLY AFFLUENT, COMMUNITIES SUCH AS LAWRENCE AND TO A LESSER EXTENT METHUEN EXPERIENCE LOWER MEDIAN INCOMES, HIGHER RATES OF POVERTY AND UNEMPLOYMENT, AND LOWER LEVELS OF EDUCATION. THESE FACTORS ALL HAVE A SIGNIFICANT IMPACT ON PEOPLES HEALTH PRIORITIES, THEIR ABILITY TO SEEK SERVICES, ACCESS TO RESOURCES, RELIANCE ON SUPPORT NETWORKS, STRESS LEVEL, AND OPPORTUNITIES TO ENGAGE IN HEALTHFUL LIVES. INCREASED CULTURAL AND LINGUISTIC DIVERSITY DRIVEN BY AN INFLUX IN IMMIGRANTS ALONG WITH ECONOMIC INEQUITIES ACROSS THE REGION PRESENT SIGNIFICANT CHALLENGES WHEN DELIVERING SERVICES AND CARE THAT AIM TO MEET THE MULTITUDE OF NEEDS ACROSS THE REGION. ALL COMMUNITIES IN THE HOSPITALS SERVICE AREA SAW MODEST POPULATION GROWTH SINCE 2016 AND DECREASES IN BOTH THE PERCENTAGE OF FAMILIES LIVING BELOW POVERTY LEVEL AND RATES OF UNEMPLOYMENT. HOUSING AND TRANSPORTATION WERE HIGHLIGHTED AS BARRIERS TO INDIVIDUALS HEALTH STATUS. CHRONIC DISEASE, INCLUDING DIABETES AND OBESITY, WERE IDENTIFIED AS INDIVIDUAL OR FAMILY CONCERNS BY PROVIDERS AND RESIDENTS. OBESITY, LACK OF PROPER NUTRITION, AND SEDENTARY LIFESTYLE CONTINUE TO BE CONCERNS AMONG RESIDENTS, ORGANIZATIONAL LEADERS, AND HEALTH CARE PROVIDERS. FOOD INSECURITY REMAINS A TOP CONCERN, EVIDENCED BY HIGH UTILIZATION OF COMMUNITY AND SCHOOL-BASED NUTRITION PROGRAMS OF PARTICULAR CONCERN IS LACK OF ACCESS TO AND AFFORDABILITY OF HEALTHY FOODS. DIABETES AND HEART DISEASE ARE CONDITIONS OF PARTICULAR CONCERN TO RESIDENTS THAT ARE DIRECTLY RELATED TO DIET, LIFESTYLE, AND OBESITY OVER THE LAST DECADE THE PROPORTION OF THE POPULATION 65 YEARS OLD AND OVER HAS INCREASED ACROSS THE SERVICE ARE AND THE UNIQUE HEALTH NEEDS OF THE AGING POPULATION WERE NOTED BY RESIDENTS AND PROVIDERS. LIKE COMMUNITIES ACROSS THE STATE OF MA, ALL COMMUNITIES IN THE SERVICE AREA HAVE SEEN AN INCREASE IN THE PROPORTION OF THEIR POPULATION 65 YEARS AND OVER. ISSUES OF CONCERN INCLUDE COST OF HEALTH CARE AND PRESCRIPTION MEDICATIONS, AFFORDABLE HOUSING, SOCIAL ISOLATION, AND CHRONIC CONDITIONS; SPECIFICALLY, ALZHEIMERS AND DEMENTIA WERE IDENTIFIED AS GROWING CONCERNS FOR ELDERS IN THE COMMUNITY. AGING IN PLACE IS DESIRED BUT IT CAN BE DIFFICULT FOR FAMILIES TO EQUIP HOMES WITH NECESSARY ACCOMMODATIONS. BEHAVIORAL HEALTH, SPECIFICALLY ACCESS TO MENTAL HEALTH PROVIDERS AND SUBSTANCE USE DISORDERS CONTINUE TO BE CONCERNS IN THE COMMUNITY. BEHAVIORAL HEALTH REMAINED A KEY CONCERN AMONG PARTICIPANTS. RISING RATES OF STRESS HAVE BEEN COMPOUNDED BY THE OPIOID EPIDEMIC, 2018 GAS EXPLOSIONS, AND AMONG LOW-INCOME RESIDENTS, THE ADDITIONAL STRESSORS OF HOMELESSNESS AND FOOD INSECURITY. LIMITED ACCESS TO BEHAVIORAL HEALTH PROVIDERS (INCLUDING PSYCHIATRISTS), DRIVEN BY LOW INSURANCE REIMBURSEMENTS FOR BEHAVIORAL HEALTH SERVICES AND NOT ENOUGH PROVIDERS TO MEET SERVICE AREA DEMAND, LEAD TO LONG WAITS FOR BEHAVIORAL HEALTH SERVICES AND MEDICATION ADJUSTMENTS. SUBSTANCE USE DISORDER CONTINUES TO BE A SUBSTANTIAL CONCERN AMONG PARTICIPANTS, WHILE DETOX FACILITIES ARE LIMITED. VAPING, MARIJUANA, OPIOID AND ALCOHOL USE AMONG YOUTH WAS DESCRIBED AS A GROWING ISSUE. TRAUMA RELATED TO DRUGS, GUNS, DOMESTIC AND GANG VIOLENCE WAS A NEW THEME THAT EMERGED IN THE 2019 CHNA REPORT, RESIDENTS CONTINUE TO EXPRESS CONCERNS AROUND EQUITABLE ACCESS TO HEALTH CARE DUE TO AFFORDABILITY, AVAILABILITY OF PROVIDERS, AND INSURANCE COVERAGE. RESPONDENTS NOTED A NUMBER OF CHALLENGES TO ACCESSING HEALTHCARE INCLUDING: DIFFICULTIES OBTAINING HEALTH INSURANCE FOR IMMIGRANT POPULATIONS, LIMITED PHYSICIAN NETWORKS FOR THOSE WITH PUBLIC INSURANCE, COST OF CARE AND AFFORDABILITY OF PRESCRIPTION MEDICATIONS (PARTICULARLY FOR SENIORS), FEWER HEALTH CARE ACCESS POINTS DUE TO PRACTICE CLOSURES AND MERGERS, LOSS OF INSURANCE COVERAGE DURING PERIODS OF INCARCERATION, AND HOMELESSNESS. THE SERVICE AREA HAS A STRONG SENSE OF COMMUNITY, WITH PARTICIPANTS NAMING RESILIENCY, STRONG FAMILY AND COMMUNITY VALUES, AND SUPPORT FOR SOCIAL SERVICE ORGANIZATIONS AS STRENGTHS OF THE SERVICE AREA. PARTICIPANTS CITED MULTIPLE ASSETS OF THE REGION INCLUDING THE STRENGTH OF RESILIENCY, DIVERSITY, FAMILY AND COMMUNITY VALUES, LOCAL ACCESS TO HIGH-QUALITY HEALTHCARE SERVICES, AND THE MANY CLOSE COLLABORATIVE PARTNERSHIPS BETWEEN HEALTHCARE PROVIDERS, COMMUNITY ORGANIZATIONS, AND GOVERNMENT.
PART VI, LINE 3 - Patient education of eligibility for assistance:	FOR THOSE PATIENTS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL PROVIDES PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS AS WELL AS GENERAL NOTICES POSTED THROUGOUT THE HOSPITAL. THE GOAL OF THESE NOTICES IS TO ASSIST PATIENTS IN APPLYING FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM, SUCH AS MASSHEALTH, CAREPLUS, MASSHEALTH STANDARD, AND HEALTH SAFETY NET. WHEN APPLICABLE, THE HOSPITAL MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THAT PATIENTS DOCUMENTED INCOME AND ALLOWABLE MEDICAL EXPENSES. THE HOSPITAL WILL PROVIDE, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE A LOW INCOME PATIENT UNDER EITHER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT AVAILABLE PAYMENT PLANS THAT MAY BE AVAILABLE TO THEM BASED ON THEIR FAMILY SIZE AND INCOME. THE HOSPITAL MAKES A REASONABLE EFFORT TO IDENTIFY AVAILABLE COVERAGE OPTIONS FOR PATIENTS WHO MAY BE UNINSURED AND UNDERINSURED WITH THEIR CURRENT INSURANCE PROGRAM WHEN THE PATIENT IS SCHEDULING THEIR SERVICES, WHILE THE PATIENT IS IN THE HOSPITAL, UPON DISCHARGE, AND FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THE HOSPITAL WILL DIRECT ALL PATIENTS SEEKING AVAILABLE COVERAGE OPTIONS, OR THOSE THAT THE HOSPITAL DETERMINES MAY BE ELIGIBLE, TO THE HOSPITALS PATIENT FINANCIAL COUNSELING SERVICES TO SCREEN FOR ELIGILBITY IN AN APPROPRIATE COVERAGE OPTION. THE HOSPITAL WILL THEN ASSIST THE PATIENT IN APPLYING FOR THE APPROPRIATE COVERAGE OPTIONS THAT ARE AVAILABLE OR NOTIFY THEM OF THE AVAILABILTY OF FINANCIAL ASSISTANCE THROUGH THE HOSPITALS OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL WILL ALSO PROVIDE INFORMATION ON HOW TO CONTACT APPROPROPRIATE STAFF WITHIN THE HOSPITALS FINANCE OFFICE TO VERIFY THE ACCURACY OF THE HOSPITAL BILL OR TO DISPUTE CERTAIN CHARGES.
PART VI, LINE 4 - Community information:	LAWRENCE GENERAL HOSPITAL IS LOCATED IN LAWRENCE, MASSACHUSETTS, BUT SERVES THE ENTIRE MERRIMACK VALLEY REGION. THE VALLEY IS A BI-STATE REGION ALONG THE MERRIMACK RIVER IN THE STATES OF NEW HAMPSHIRE AND MASSACHUSETTS, WITH LAWRENCE GENERAL SERVING THE SOUTHERN TIP OF THE NH VALLEY, AND ALL OF THE MA VALLEY AREA. THE MERRIMACK RIVER IS ONE OF THE LARGER WATERWAYS IN THE NEW ENGLAND REGION AND HAS HELPED DEFINE THE LIVELIHOOD AND CULTURE OF THOSE LIVING ALONG IT SINCE NATIVE TIMES. MAJOR CITIES IN THE MERRIMACK VALLEY INCLUDE LOWELL, LAWRENCE, HAVERHILL, METHUEN AND NEWBURYPORT IN MASSACHUSETTS. THE MERRIMACK VALLEY WAS A MAJOR CENTER OF THE TEXTILE INDUSTRY IN AMERICA DURING THE 19TH CENTURY. LAWRENCE HAS ALWAYS BEEN A MULTI-ETHNIC AND MULTICULTURAL GATEWAY CITY WITH A HIGH PERCENTAGE OF FOREIGN-BORN RESIDENTS. THE SUCCESSIVE WAVES OF IMMIGRANTS COMING TO LAWRENCE TO WORK IN THE MILLS BEGAN WITH THE IRISH, FOLLOWED BY THE FRENCH CANADIANS, ENGLISHMEN, AND GERMANS IN THE LATE 1800'S. AROUND THE TURN OF THE CENTURY AND EARLY 1900'S, ITALIANS, POLES, LITHUANIANS, AND SYRIANS BEGAN ARRIVING. THE WAVE OF PUERTO RICANS AND DOMINICANS STARTED IN THE MID TO LATE 1900'S, AND THE NEWEST ARRIVALS HAVE ORIGINATED FROM VIETNAM AND CAMBODIA. THE CURRENT POPULATION IS LARGELY HISPANIC AND HAS GIVEN A LATINO SLANT TO THE LOCAL ECONOMY AND CULTURE. CURRENTLY, LAWRENCES TOTAL POPULATION IS APPROXIMATELY 80,028 (CENSUS BUREAU 2019 ESTIMATE), OF WHICH ROUGHLY 60% ARE OF LATINO DESCENT, MAINLY FROM THE DOMINICAN REPUBLIC AND PUERTO RICO. TODAY, LAWRENCE REMAINS AN URBAN CENTER WITH A SIGNIFICANT PART OF ITS ECONOMY STILL MANUFACTURING-BASED. DESPITE GLOBAL TRENDS THAT HAVE SEEN MANUFACTURING INDUSTRIES MOVE SOUTH AND OVERSEAS, THE CITY IS STILL A HUB OF TEXTILE, APPAREL AND SHOE COMPANIES SUCH AS MALDEN MILLS, KGR INC., GRIECO BROTHERS, NEW BALANCE AND CARDINAL SHOE. WITH THE AFFORDABLE SPACE AND CLOSE PROXIMITY TO I-93 AND I-95, NEWER COMPANIES IN TECHNOLOGY, HEALTH CARE AND MANUFACTURING SUCH AS NEW ENGLAND AFFILIATED TECHNOLOGY, THE ROBERT ABLE COMPANY AND THE GEM GROUP, HAVE CHOSEN TO LOCATE IN LAWRENCE. LAWRENCE, MA IS A COLORFUL CITY WITH SIGNIFICANT CHALLENGES. ONCE A THRIVING CITY AND THE HUB OF THE U.S. TEXTILE INDUSTRY, THE CITY OF LAWRENCE IS STILL STRUGGLING TO RECOVER FROM THE DEVASTATING ECONOMIC DECLINE IT SUFFERED WHEN THE MILLS BEGAN TO CLOSE IN THE 1960'S. TODAY, THE CITY IS A DENSELY POPULATED, IMPOVERISHED AREA WITH HIGH LEVELS OF UNEMPLOYMENT, HIGH RATES OF CRIME, ILLITERACY, AND AGING HOUSING, AS WELL AS DRUG USE AND ITS RELATED VIOLENCE. JUST OVER ONE QUARTER OF THE HOUSEHOLDS IN LAWRENCE CAN BE CLASSIFIED AS POOR, BASED ON THE FEDERAL POVERTY LEVEL. THE MA DEPARTMENT OF PUBLIC HEALTH HAS IDENTIFIED LAWRENCE PUBLIC SCHOOLS AS HAVING THE HIGHEST STUDENT RATES OF OBESITY IN THE STATE, AT 47%. AS THE PREVALENCE OF OBESITY HAS BEEN LINKED TO THE ECONOMIC HARDSHIP OF A COMMUNITY, THE CITY OF LAWRENCE CONTINUES TO BE AT RISK. THESE FINDINGS INDICATE THAT LAWRENCES CONSIDERABLE POPULATION OF LOW-INCOME, LATINO CHILDREN ARE MORE LIKELY TO SUFFER FROM OBESITY BECAUSE OF THE MANY BARRIERS TO HEALTHY EATING AND ACTIVE LIFESTYLES. FOR INSTANCE, URBAN RESIDENTS OFTEN LACK CONSISTENT ACCESS TO HEALTHY FOOD CHOICES AND SAFE PLACES FOR PHYSICAL ACTIVITY IN THEIR NEIGHBORHOODS. ADDITIONALLY, MANY LAWRENCE PUBLIC SCHOOLS HAVE LIMITED SPACE AND NO DESIGNATED GYMNASIUM, AND THEREFORE, NO FORMAL PHYSICAL EDUCATION PROGRAMS FOR THEIR STUDENTS. APPROXIMATELY 40% OF THE PATIENTS THAT LAWRENCE GENERAL TREATS ARE ON SOME TYPE OF GOVERNMENT ASSISTANCE PROGRAM OR NEED FINANCIAL ASSISTANCE WITH THEIR MEDICAL COSTS. AS A RESULT, LAWRENCE GENERAL PROVIDED OVER $31.2M IN CHARITABLE CARE AND COMMUNITY BENEFITS TO PERSONS WHO WOULD NOT OTHERWISE BE ABLE TO AFFORD QUALITY HEALTHCARE IN FY2020.
PART VI, LINE 5 - promotion for community health:	LAWRENCE GENERAL HOSPITAL HAS A STRONG HISTORY OF ASSISTING CHILDREN AND FAMILIES IN NEED. PROUDLY RECOGNIZED AS THE ONLY NOT-FOR-PROFIT COMMUNITY HOSPITAL SERVING THIS REGION, THE INSTITUTION REMAINS TRUE TO ITS ORIGINAL MISSION. FOR MORE THAN 140 YEARS, LGH HAS CARED FOR AND IMPROVED THE HEALTH STATUS OF THE RESIDENTS OF THE MERRIMACK VALLEY REGION, PARTICULARLY LAWRENCE, ONE OF THE POOREST CITIES IN MASSACHUSETTS. IN A CITY WITH SO MUCH NEED, LGH HAS BUILT AN IMPRESSIVE TRADITION OF QUALITY AND EXCELLENCE IN HEALTH CARE WHILE CONTINUING ITS COMMITMENT TO PROVIDE CARE TO EVERYONE WHO ENTERS ITS DOORS IN SPITE DECLINING REIMBURSEMENTS. IN THE PAST 5 YEARS, LGH HAS INCREASED THE QUALITY OF ITS CARE AND EXPANDED ITS BREADTH OF SERVICES AVAILABLE LOCALLY, WHILE ENSURING THE AFFORDABILITY OF THAT CARE. EVEN DURING A YEAR IN WHICH COVID NEGATIVELY IMPACTED VOLUME WITH THE SUSPENSION OF ELECTIVE PROCEDURES AND SOME OUTPATIENT SERVICES, THE HOSPITAL PROVIDED 277,171 INPATIENT ADMISSIONS, OBSERVATION STAYS AND OUTPATIENT VISITS. LGH IS NOW THE ONLY LOCALLY-CONTROLLED, NOT-FOR-PROFIT HOSPITAL IN THE CENTRAL MERRIMACK VALLEY WITH A BOARD OF TRUSTEES FROM OUR REGION. AS THE LARGEST PRIVATE EMPLOYER IN LAWRENCE, LGH IS LICENSED FOR 186 BEDS AND IS STAFFED BY NEARLY 2000 EMPLOYEES AND MORE THAN 500 PHYSICIANS REPRESENTING OVER 40 SPECIALTIES. THE HOSPITALS CLINICAL STRENGTHS INCLUDE A 24-HOUR EMERGENCY DEPARTMENT AND LEVEL III TRAUMA CENTER; A DEDICATED INTENSIVE CARE UNIT; ADVANCED SURGICAL CENTER; INPATIENT PEDIATRIC CENTER; WOMENS HEALTH SERVICES; IMAGING CENTER; CARDIAC SERVICES; SLEEP CENTER; BIRTHING CENTER; DAY SURGERY CENTER; BARIATRIC CENTER; COMMUNITY CANCER PROGRAM; OUTPATIENT PHYSICAL THERAPY CENTER; AND AN ADVANCED LIFE SUPPORT EMS PROGRAM. ALL OF THESE SERVICES CREATE A HEALTH SAFETY NET FOR THE CITY OF LAWRENCE AND THE SURROUNDING COMMUNITIES. LGH HAS CONTINUALLY EXPANDED ITS AFFILIATION WITH BETH ISRAEL DEACONESS MEDICAL CENTER. THIS CLINICAL AFFILIATION WAS DEVELOPED TO ENHANCE PROGRAMS AND SERVICES AVAILABLE IN THE GREATER MERRIMACK VALLEY, INCREASE LOCAL ACCESS TO SPECIALTIES OF A HARVARD-AFFILIATED TEACHING HOSPITAL, AND IMPROVE THE COORDINATION OF CARE. IN RECENT YEARS, THE HOSPITAL HAS ADDED MANY NEW SPECIALISTS AND/OR SPECIALTY CLINICS TO BETTER SERVE THE MERRIMACK VALLEY REGION. THE HOSPITAL WORKS CLOSELY WITH PRIVATE PRACTICE PHYSICIANS AND GREATER LAWRENCE FAMILY HEALTH CENTER TO INCREASE THE BREADTH OF SERVICES AVAILABLE LOCALLY, WHILE DECREASING OVERALL HEALTH CARE COSTS. IN ORDER TO FACILITATE BETTER ACCESS TO CHILDRENS MEDICAL SERVICES, WE HAVE AN ONGOING CLINICAL AFFILIATION WITH FLOATING HOSPITAL FOR CHILDREN AT TUFTS MEDICAL CENTER. IN AN EFFORT TO EASE THE STRESS AND HARDSHIP OF FAMILIES WITH SICK CHILDREN AND TO PROVIDE THE BEST IN PEDIATRIC CARE, OUR PEDIATRIC CARE CENTER IS STAFFED BY FLOATING HOSPITAL HOSPITALISTS WHO OVERSEE INPATIENT PEDIATRIC CARE. HIGHLY-TRAINED PEDIATRIC SPECIALISTS FROM BOSTONS TUFTS FLOATING ARE ALSO AVAILABLE AT A PEDIATRIC SPECIALTY CLINIC IN LAWRENCE THROUGH OUR AFFILIATION AGREEMENT. LAWRENCE GENERAL MAINTAINS AN ACTIVE AND ENTHUSIASTIC PATIENT FAMILY ADVISORY COMMITTEE TO FURTHER INCORPORATE THE COMMUNITY VOICE INTO OUR HOSPITAL OPERATIONS. THE HOSPITAL BOARD OF TRUSTEES, WHO LIVE AND WORK IN THE LOCAL COMMUNITY ALSO PARTICIPATE, AND THE SENIOR MANAGEMENT OF THE HOSPITAL ENSURES IMPLEMENTATION OF PLANS AND MONITORS PROGRESS. THE HOSPITALS CONTINUOUS AND ENHANCED QUALITY IMPROVEMENT PROCESS ALSO PROVIDES ANOTHER SOURCE FOR THE IDENTIFICATION OF NEEDS. OPPORTUNITIES FOR IMPROVEMENT ARE IDENTIFIED THROUGHOUT THE ORGANIZATION, AND THE BOARD OF TRUSTEES HELPS DETERMINE ANNUAL PRIORITIES. LAWRENCE GENERAL HAS MANY ENGAGED AND ENTHUSIASTIC PARTNERS IN THE COMMUNITY, AND BY WORKING WITH THE ONES LISTED BELOW (AS WELL AS OTHERS), LAWRENCE GENERAL HOSPITAL IS ABLE TO PROMOTE, FOSTER AND DELIVER IMPROVED HEALTH AND WELLNESS TO THE ENTIRE MERRIMACK VALLEY REGION: American Cancer Society American College of Radiology (ACR) American Heart Association American Red Cross American Training Andover Coalition for Public Education Andover Public Schools Asthma & Allergy Foundation Baldpate Hospital: Detox/Residential/Outpatient Substance Abuse Services Beth Israel Deaconess Medical Center (BIDMC) Boys & Girls Club of Greater Lawrence Childrens Hospital of Boston City of Lawrence Community Cancer Program Dana Farber Cancer Institute/Commonwealth Hematology & Oncology Danvers Treatment Center/Lahey Behavioral Health Clinical Stabilization Services Daybreak Shelter Diabetes Today Coalition Edgewood Retirement Community Elder Services of the Merrimack Valley, Inc. Essex County Community Foundation Family Services Floating Hospital for Children at Tufts Medical Center Foster Kids of Merrimack Valley Genesis Healthcare Corporation Greater Lawrence Family Health Center (GLFHC) Greater Lawrence Family Residency Groundwork Lawrence Habit OPCO Hampstead Hospital: Detox/Residential/Outpatient Substance Abuse Services Health Care For All Home Health Foundation/VNA Housing Families Ironstone Farm Jackson Lumber Work Health Initiative Kiwanis Club of Lawrence L&M Radiology Lawrence Community Works Lawrence Council on Aging Lawrence Family Development Charter School Lawrence Farmers Market Lawrence Fire Department Lawrence High School Lawrence History Center Lawrence Public Schools Lawrence Rotary Club Lawrence Senior Center Lazarus House Lynn Transitional Support Services/Lahey Behavioral Health March of Dimes Mary Immaculate Health Care Services Massachusetts Department of Public Health Mass General Hospital (Pediatric Cardiology) MassCONNECT Collaborators Mayor's Health Task Force The Office of Mayor Daniel Rivera, City of Lawrence Merrimack College Merrimack Valley Assisted Living Facilities Merrimack Valley Chamber of Commerce Merrimack Valley Community Development Committee Merrimack Valley Food Bank Merrimack Valley Habitat for Humanity Merrimack Valley Health Services Merrimack Valley Senior Centers Merrimack Valley Skilled Nursing Facilities Merrimack Valley YMCA Methuen Health and Rehab Center Nevins Family Services Northern Essex Community College Notre Dame High School North Andover Athletic Association North Andover Public Schools Northeast Center for Healthy Communities Northeast Independent Living Northeast Rehabilitation NeuroCare Option Care/ Walgreens Patient Family Advisory Council Penacook Place Pentucket Medical Associates Professional Center for Child Development Psychological Center Schwartz Center for Compassionate Healthcare Tobacco Free Community Partnership Transitions Program/Lahey Behavioral Health Post Detox/Pre-Recovery/Tewksbury Tufts Medical Center United Way of the Merrimack Valley Whittier Rehab Hospital Wingate Healthcare Services YWCA of Lawrence
PART VI, LINE 6 - affiliated health care system:	LAWRENCE GENERAL HOSPITAL IS PART OF LAWRENCE GENERAL HOSPITAL & AFFILIATES. THERE ARE SEVEN AFFILIATES WITHIN THIS SYSTEM AS OF 9-30-2020, INCLUDING: LGH HEALTH ENTERRISES, INC. THIS ENTITY IS A FOR-PROFIT HEALTHCARE MANAGEMENT COMPANY LOCATED IN LAWRENCE, MASSACHUSETTS. THIS ENTITY PROVIDES HEALTHCARE MANAGEMENT SERVICES. COMMUNITY MEDICAL ASSOCIATES, INC. THIS ENTITY IS A NOT-FOR-PROFIT MULTI-SPECIALITY CARE PHYSICIAN PRACTICE GROUP LOCATED IN LAWRENCE, MASSACHUSETTS. LGH PHYSICIAN ASSOCIATES, P.C. THIS ENTITY IS A FOR-PROFIT MANAGEMENT COMPANY LOCATED IN LAWRENCE, MASSACHUSETTS. THIS ENTITY PROVIDES MANAGEMENT SERVICES TO LOCAL AREA PHYSICIAN GROUPS. LGH CHARITABLE TRUST, INC. THIS ENTITY IS A NOT-FOR-PROFIT CHARITABLE FOUNDATION LOCATED IN LAWRENCE, MASSACHUSETTS. THIS ENTITY ACTS ON BEHALF OF THE HOSPITAL FOR ALL OF ITS FUNDRAISING INITIATIVES. LGH ADMINISTRATIVE SERVICES, INC. THIS ENTITY IS A NOT-FOR PROFIT QUALIFED ACTIVE LOW INCOME COMMUNITY BUSINESS (QALICB) LOCATED IN LAWRENCE, MASSACHUSETTS. THIS ENTITY WAS CREATED FOR PURPOSES OF NEW MARKET TAX CREDIT TRANSACTION THAT FUNDED THE CONSTRUCTION OF A SURGICAL BUILDING. MERRIMACK VALLEY HEALTH SERVICES, INC. THIS ENTITY IS A NOT-FOR PROFIT PROVIDES MEDICAL IMAGING SERVICES AT AN OFFSITE LOCATION IN ANDOVER AND ALSO AT LAWRENCE GENERAL HOSPITAL IN LAWRENCE, MASSACHUSETTS. MERRIMACK VALLEY IN MOTION, LLC THIS ENTITY IS A FOR-PROFIT LIMITED LIABILITY COMPANY (LLC) LOCATED IN LAWRENCE, MASSACHUSETTS. THIS ENITY PROVIDES MANAGEMENT AND PROFESSIONAL SERVICES TO LGH IN CONNECTION WITH CERTAIN OUTPATIENT REHABILITATION CLINICS.
PART VI, LINE 7 - state filing of community benefit report:	THE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF MASSACHUSETTS ONLY.
PART I, LINE 3C:	NOT APPLICABLE
PART I, LINE 7G:	NOT APPLICABLE
PART I, LN 7 COL(F):	NOT APPLICABLE
PART III, LINE 3:	NOT APPLICABLE
SECTION B, LINE 5	THE HOSPITALS MOST RECENT CHNA (TAX YEAR 2019) CHNA UTILIZIED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED: SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, & HEALTH INDICATORS IN THE REGION; ADMINISTERING A PUBLIC SURVEY COMPLETED BY 630 RESIDENTS AND 473 HEALTH OR SOCIAL SERVICE PROVIDERS; AND CONDUCTING TWO FOCUS GROUPS AND 5 KEY INFORMANT INTERVIEWS TO IDENTIFY THE PERCEIVED HEALTH NEEDS, CHALLENGES TO ACCESSING SERVICES, CURRENT STRENGTHS AND ASSETS, AND OPPORTUNITIES FOR ACTION IN THE COMMUNITY. THE CNHA ENGAGED OVER 1100 PARTICIPANTS, GUIDED BY AN ADVISORY COMMITTEE OF 50 COMMUNITY PROVIDER STAKEHOLDERS. IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL INCLUDED MEMBERS FROM THE COMMUNITY WHO HAVE EXTENSIVE EXPERIENCE IN MATTERS OF PUBIC HEALTH. THIS INCLUDED MEMBERS FROM THE GREATER LAWRENCE FAMILY HEALTH CENTER, WITH ADVISORY GUIDANCE FROM THE CITY OF LAWRENCES MAYORS HEALTH TASK FORCE AND THE DEPARTMENTS OF PUBLIC HEALTH OF THE CITIES OF METHUEN AND NORTH ANDOVER, ALONG WITH REPRESENTATIVES FROM LAW ENFORCEMENT AND FIRST RESPONDERS, LOCAL SCHOOL SYSTEMS, FAITH COMMUNITY, AND OTHER SOCIAL AND GOVERNMENT SERVICES.
SECTION B, LINE 11	THE HOSPITAL IS STILL IN THE PROCESS OF ADDRESSING ALL THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.
SECTION B, LINE 24	THE HOSPITAL CHARGES SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE AN AMOUNT EQUAL TO THE GROSS CHARGE AMOUNT.

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Lawrence General Hospital

Employer identification number

04-2103586

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Deborah J Wilson President & CEO (11/19 - On)	(i) (ii)	395,159 ------------- 0	45,745 ------------- 0	29,750 ------------- 0	21,000 ------------- 0	6,807 ------------- 0	498,461 ------------- 0	0 ------------- 0
2Dianne J Anderson President & CEO (Until 10/19)	(i) (ii)	570,041 ------------- 0	146,448 ------------- 0	156,000 ------------- 0	21,500 ------------- 0	23,436 ------------- 0	917,425 ------------- 0	0 ------------- 0
3Cynthia Phelan CORP. ASSISTANT SECRETARY & VP	(i) (ii)	256,501 ------------- 0	23,451 ------------- 0	7,448 ------------- 0	22,000 ------------- 0	15,708 ------------- 0	325,108 ------------- 0	0 ------------- 0
4Felix Mercado CFO (Until 10/20)	(i) (ii)	246,355 ------------- 0	37,413 ------------- 0	6,552 ------------- 0	19,000 ------------- 0	17,762 ------------- 0	327,082 ------------- 0	0 ------------- 0
5Jason D Reid Physician (Ortho Trauma)	(i) (ii)	487,287 ------------- 0	50,000 ------------- 0	0 ------------- 0	1,000 ------------- 0	17,025 ------------- 0	555,312 ------------- 0	0 ------------- 0
6John J Brady Physician	(i) (ii)	454,830 ------------- 0	20,000 ------------- 0	0 ------------- 0	1,000 ------------- 0	17,762 ------------- 0	493,592 ------------- 0	0 ------------- 0
7Ziad Alfarah MD Senior VP Medical Affairs	(i) (ii)	392,373 ------------- 0	49,100 ------------- 0	21,170 ------------- 0	21,000 ------------- 0	17,342 ------------- 0	500,985 ------------- 0	0 ------------- 0
8George Kondylis MD Physician (Ed Chief)	(i) (ii)	355,201 ------------- 0	61,993 ------------- 0	0 ------------- 0	3,000 ------------- 0	19,495 ------------- 0	439,689 ------------- 0	0 ------------- 0
9Karen Moore Senior VP Operations	(i) (ii)	336,367 ------------- 0	44,402 ------------- 0	15,000 ------------- 0	20,000 ------------- 0	6,671 ------------- 0	422,440 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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 II:	PAYROLL RECORDS ARE FOR THE 1/1/2019 - 12/31/2019 CALENDAR YEAR.
PART I, LINE 3:	THE CEO'S COMPENSATION IS ESTABLISHED BY THE FOLLOWING METHODS: (A) COMPENSATION COMMITTEE, (B) INDEPENDENT COMPENSATION CONSULTANT, (C) FORM 990 OF OTHER ORGANIZATIONS (D) WRITTEN EMPLOYMENT CONTRACT, (E) COMPENSATION SURVEY AND (F) APPROVAL BY AN EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES.
PART I, LINE 4A:	Dianne J. Anderson, the President & CEO of the organization until October 2019 received a severance payment of $67,500.
Part I, Line 4B:	AS PART OF ITS TOTAL COMPENSATION PACKAGE FOR EXECUTIVE-LEVEL STAFF, LAWRENCE GENERAL HOSPITAL OFFERS 403(B), 457(B) AND 457(F) NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLANS. FOR THE 2019 CALENDAR YEAR, LAWRENCE GENERAL HOSPITAL CONTRIBUTED THESE AMOUNTS TO THE FOLLOWING EMPLOYEES LISTED ON FORM 990, SCHEDULE J, PART II: DIANNE J. ANDERSON, 403B PLAN ($2,500), 457B PLAN ($19,000), 457F PLAN($88,500); DEBORAH J. WILSON, 403B PLAN ($2,000), 457B PLAN ($19,000), 457F PLAN($29,750); CYNTHIA PHELAN, 403B PLAN ($3,000), 457B PLAN ($19,000), 457F PLAN($7,448); FELIX MERCADO, 403B ($0), 457B ($19,000), 457F PLAN ($6,552); JASON REID, 403B PLAN ($1,000), 457B PLAN ($0), 457F PLAN ($0); JOHN BRADY, 403B PLAN ($1,000), 457B PLAN ($0), 457F PLAN ($0); GEORGE KONDYLIS, MD, 403B PLAN ($3,000), 457B PLAN ($0), 457F PLAN ($0); KAREN MOORE, 403B PLAN ($1,000), 457B PLAN ($19,000), 457F PLAN ($15,000); ZIAD ALFARAH, MD, 403B PLAN ($2,000), 457B PLAN ($19,000), 457F PLAN ($21,170).
Part II, Column C:	The retirement and deferred compensation numbers consist of the following plans: 403(B) Employer Paid Match 457(B) SERP Plan #5 Employer Paid 457(F) Employer Paid Match
Part II, Column D:	The nontaxable benefits numbers consist of the following: Health Insurance Dental Insurance Standard Insurance - LTD Insurance Principal/Principal Financial Group - LTD Insurance The Hartford - Ltd Insurance Nationwide - Life Insurance

Schedule J (Form 990) 2019

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
Lawrence General Hospital

Employer identification number
04-2103586

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	REFINANCING & CAPITAL EXPENDITURES	99-9999999	noneavail	11-07-2017	65,665,000	REFINANCING & CAPTIAL EXPENDITURES		X		X		X
B	MASS DEVELOPMENT SERIES 2013B	99-9999999	noneavail	02-02-2014	43,490,000	MASS DEVELOPMENT, SERIES 2013B		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	0		0
2 Amount of bonds legally defeased ..............	0		0
3 Total proceeds of issue ..................	65,665,000		43,490,000
4 Gross proceeds in reserve funds .............	6,664,973		4,492,351
5 Capitalized interest from proceeds .............	0		0
6 Proceeds in refunding escrows ...............	0		0
7 Issuance costs from proceeds ...............	1,546,549		1,458,644
8 Credit enhancement from proceeds .............	0		0
9 Working capital expenditures from proceeds .............	0		0
10 Capital expenditures from proceeds .............	20,167,564		42,031,356
11 Other spent proceeds .............	0		0
12 Other unspent proceeds .............	0		0
13 Year of substantial completion .............	2020		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........	X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
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 ....	0 %		0 %
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 .........	0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		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		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..	0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X
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		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........		X		X
c No rebate due? .........		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........	0		0
c Term of hedge .........
d Was the hedge superintegrated? ......		X		X
e Was the hedge terminated? ........		X		X

Schedule K (Form 990) 2019

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
b Name of provider ..........	0		0
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
7 Has the organization established written procedures to monitor the requirements of section 148? ...		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

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Lawrence General Hospital

Employer identification number

04-2103586

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2019

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) DR EDUARDO HADDAD MEDICAL DIRECT	TRUSTEE	182,000	PHYSICIAN SERVICES		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
PART IV, LINE 1:	PAYMENTS OF $182,000 LISTED FOR EDUARDO HADDAD, MD WERE PAID DIRECTLY TO HIM AS PART OF A MEDICAL DIRECTORSHIP.

Schedule L (Form 990 or 990-EZ) 2019

Additional Data

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Software Version:

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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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

Lawrence General Hospital

Employer identification number

04-2103586

Return Reference	Explanation
FORM 990, PART III, Line 4D:	OTHER PROGRAM SERVICE REVENUE PRIMARILY CONSISTS OF CAFETERIA RECEIPTS, INTERCOMPANY REIMBURSEMENTS, DSTI WAIVER FUNDS, DSRIP FUNDS, AND OCCUPATIONAL HEALTH CLINIC REVENUE.
FORM 990, PART VI, SECTION B, LINE 11:	FORM 990 IS PREPARED AND REVIEWED BY THE ORGANIZATION'S EXTERNAL CONSULTANT AND SUBSEQUENTLY REVIEWED BY THE CONTROLLER AND ORGANIZATION'S CFO. ONCE COMPLETE, THE FORM AND ALL SCHEDULES ARE MADE AVAILABLE TO THE BOARD OF TRUSTEES VIA A SECURE INTERNET PORTAL FOR REVIEW. THE ORGANIZATION'S CFO AND SENIOR VICE PRESIDENT ARE AVAILABLE TO FACILITATE THE REVIEW AS WELL AS ANSWER ANY QUESTIONS REGARDING THE FORM.
FORM 990, PART VI, SECTION B, LINE 12C:	ON AN ANNUAL BASIS, THE HOSPITAL DISTRIBUTES A CONFLICT OF INTEREST POLICY TO THE BOARD OF TRUSTEES. THE TRUSTEES ARE REQURED TO DISCLOSE, IN WRITING, ANY POTENTIAL CONFLICT THAT THEY ARE AWARE OF. ALL KNOWN INTERESTS HAVE BEEN DISCLOSED IN SCHEDULE L.
FORM 990, PART VI, SECTION B, LINE 15:	THE CEO'S ANNUAL COMPENSATION IS REVIEWED AND APPROVED BY AN EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE COMPENSATION FOR THE CFO, EVP, AND SENIOR MANAGEMENT ARE DETERMINED BY THE CEO AND REVIEWED BY THE BOARD OF TRUSTEES. INDEPENDENT SURVEYS ARE ALSO PERFORMED TO DETERMINE SALARY RESONABLENESS.
FORM 990, PART VI, SECTION C, LINE 18:	THE HOSPITAL MAKES THE FORM 990 AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19:	THE HOSPITAL MAKES ALL DOCUMENTS, INCLUDING COPIES OF ITS BY-LAWS, CONFLICT-OF-INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST.
FORM 990, PART VII, BOARD OF DIRECTORS:	SUBSEQUENT TO THE END OF FISCAL YEAR 2019 AND AFTER THE FILING OF THE 2018 TAX RETURNS, FELIX. MERCADO, CFO WENT INTO A NEW POSITION, SENIOR VICE PRESIDENT OF BUSINESS/OPERATIONAL PERFORMANCE & CHIEF COMPLIANCE OFFICER WITH THE HOSPITAL ON 10/1/2020. MICHAEL S. TURILLI WAS HIRED AS THE NEW SENIOR VICE PRESIDENT/CFO IN APRIL 2021 AND WILL BE SIGNING THIS TAX FILING, ALTHOUGH HE WAS NOT ON THE BOARD OF DIRECTORS FOR THE FISCAL YEAR IN WHICH THIS FORM 990 COVERS.
FORM 990, PART VIII, LINE 11A:	During the Hospitals fiscal year 2020 Lawrence General Hospital and the Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid Services (EOHHS) entered into an Amended and Restated fiscal year 2018-2022 Safety Net Provider Agreement. This Agreement calls for payment of the following amounts to the Hospital: a total of $13,200,000 for state fiscal year (SFY) 2018; $12,900,000 for SFY 201919; $11,360,000 for SFY 2020; $11,090,000 for SFY 2021; and $10,420,000 for SFY 2022. Payment of these amounts is subject to determination by EOHHS that the Hospital meaningfully participates in MassHealths ACO program; determination by EOHHS that the Hospital meaningfully participates in MassHealths managed care networks by accepting appropriate contracting rates to the extent such arrangements have been offered by any MassHealth Managed Care Organizations; (c) satisfaction of all other requirements as set forth by MassHealth; appropriation to, and availability of funds in, the Safety Net Provider Trust Fund established under M.G.L. c. 29, 2AAAAA (Safety Net Provider Trust Fund); all other necessary state approvals; and federal approval and the availability of full federal financial participation. In all years covered in the Agreement, these amounts are reflected in "other operating revenue" on the Hospital's financial statements and IRS Form 990.
FORM 990, PART XI LINE 9, RECONCILIATION OF NET ASSETS:	CHANGE IN THE VALUE OF NET ASSETS HELD BY LGH CHARITABLE TRUST, INC. $2,837,000; NET ASSET TRANSFER TO COMMUNITY MEDICAL ASSOCIATES, INC. ($5,500,000); NET ASSET TRANSFER FROM LGH CHARITABLE TRUST, INC. $1,406,000; LOSS ON RETIREMENT OF LONG-TERM DEBT ($25,000); CAPITAL GRANT TO LGHCT $104,000; OTHER $583; EQUALS: TOTAL OTHER CHANGES IN NET ASSETS ($1,177,417).
Form 990, COVID-19 Disclosure:	On January 30, 2020, the World Health Organization ("WHO") announced a global health emergency because of a new strain of coronavirus (the "COVID-19 outbreak") and the risks to the international community as the virus spreads globally beyond its point of origin. In March 2020, the WHO classified the COVID-19 outbreak as a pandemic, based on the rapid increase in exposure globally. As a result of the COVID-19 outbreak, the Organization has incurred, and is expected to incur for the foreseeable future, incremental and other COVID-19 pandemic related expenses. COVID-19 related expenses consist of additional costs that the Organization is incurring to protect its employees, contractors, and customers, and to support social-distancing requirements resulting from the COVID-19 pandemic. These costs include, but are not limited to, new or added benefits provided to employees, the use of temporary staffing, the purchase of additional personal protection equipment and disinfecting supplies, additional facility cleaning services, and increased technology expenses to support remote working, where possible. The full impact of the COVID-19 outbreak continues to evolve as of the date of this report. As such, it is uncertain as to the full impact that the pandemic will have on the Organization's financial condition, liquidity, and future results of operations. Management is actively monitoring the global situation on its financial condition, liquidity, operations, suppliers, industry, and workforce. On March 27, 2020, the Coronavirus Aid, Relief and Economic Security Act (the "CARES" Act) was enacted. The CARES Act, among other things, has apportioned funds for the United States Small Business Administartion Paycheck Protection Program ("PPP") loans that are forgivable in certain situations to promote continued employement, as well as Economic INjury Disaster Loan. The CARES Act also established funding to hospitals and other healthcare providers to be distributed through the Provider Relief Fund. These funds are not required to be repaid provided the recipients attest to, and comply with, certain terms and conditoins, including among other things, that the funds are being used for lost operating revenues and COVID-19 related expenses. During 2020, the Organization received approximately $44,294,000 of federal provider relief funding, which has been recorded as other revenue at September 30, 2020. Management continues to examine the impact that the COVID-19 outbreak and CARES Act may have on its business. Management is currently unable to determine any additional impact on its financial condition, results of operation, or liquidity. Although the Organization cannot estimate the length or gravity of the impact of the COVID-19 outbreak at this time, if the pandemic continues, it may have a material adverse effect on the Organization's results of future operations, financial position, and liquidity in fiscal year 2021.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

Lawrence General Hospital

Employer identification number

04-2103586

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?
(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	Yes	No
(1)LGH CHARITABLE TRUST INC 1 GENERAL STREET LAWRENCE,MA01841 22-2586814	FUNDRAISING	MA	501(C)3	7	LGH INC	Yes
(2)COMMUNITY MEDICAL ASSOCIATES INC I GENERAL STREET LAWRENCE,MA01841 27-2142635	PRIMARY CARE	MA	501(C)3	3	LGH INC	Yes
(3)LGH ADMINISTRATIVE SERVICES INC 1 GENERAL STREET LAWRENCE,MA01841 32-0423203	QALICB	MA	501(C)3	12A	LGH INC	Yes
(4)MERRIMACK VALLEY HEALTH SERVICES INC 600 FEDERAL STREET ANDOVER,MA01840 22-2604915	MEDICAL IMAGI	MA	501(C)3	10	LGH INC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Merrimack Valley in Motion LLC 1 General Street Lawrence,MA01841 32-0578008	Management Se	MA	LGH	RELATED	248,230	846,986		No	0		No	51.000 %

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?
(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		Yes	No
(1) LGH HEALTH ENTERPRISES INC 38 PROSPECT STREET LAWRENCE,MA01842 04-2869696	HEALTHCARE MG	MA	LGH INC	C-CORP	0	2,181,096	100.000 %	Yes
(2) LGH PHYSICIAN ASSOCIATES PC 38 PROSPECT STREET LAWRENCE,MA01842 04-3174041	HEALTHCARE MG	MA	LGH INC	C-CORP	0	2,279,087	100.000 %	Yes

Schedule R (Form 990) 2019

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

Yes

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
(1) COMMUNITY MEDICAL ASSOCIATES INC	B	5,500,000	REVIEW OF RECOR
(2) LGH HEALTH ENTERPRISES INC	O	13,649	REVIEW OF RECOR
(3) LGH PHYSICIAN ASSOCIATES PC	O	34,983	REVIEW OF RECOR
(4) LGH CHARITABLE TRUST INC	O	607,058	REVIEW OF RECOR
(5) LGH CHARITABLE TRUST INC	S	1,406,000	REVIEW OF RECOR
(6) COMMUNITY MEDICAL ASSOCIATES	P	147,368	REVIEW OF RECOR
(7) LGH PHYSICIAN ASSOCIATES PC	P	2,126,937	REVIEW OF RECOR
(8) COMMUNITY MEDICAL ASSOCIATES	O	1,022,046	REVIEW OF RECOR
(9) LGH CHARITABLE TRUST INC	N	4,631	REVIEW OF RECOR
(10) MERRIMACK VALLEY HEALTH SERVICES	E	2,655,000	REVIEW OF RECOR
(11) LGH CHARITABLE TRUST INC	D	8,836,000	REVIEW OF RECOR
(12) MERRIMACK VALLEY HEALTH SERVICES	E		REVIEW OF RECOR

Schedule R (Form 990) 2019

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: ACUTE CARE COMMUNITY HOSPITAL PROVIDING INPATIENT AND OUTPATIENT HEALTH SERVICES TO THE GENERAL PUBLIC.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	2,447
6	Total number of volunteers (estimate if necessary) .............	6	416
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,008,704
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	-11,419

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	101,579	44,640,608
9	Program service revenue (Part VIII, line 2g) .........	232,996,159	219,838,831
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	821,614	1,220,615
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	27,979,379	22,075,798
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	261,898,731	287,775,852
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	150,210,585	159,935,407
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 192,942
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	115,798,789	139,761,519
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	266,009,374	299,696,926
19	Revenue less expenses. Subtract line 18 from line 12.......	-4,110,643	-11,921,074
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	264,797,940	322,203,722
21	Total liabilities (Part X, line 26).............	157,357,828	228,345,101
22	Net assets or fund balances. Subtract line 21 from line 20.....	107,440,112	93,858,621

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 86,790,443 including grants of $ 0 ) (Revenue $ 111,597,153 )
	INPATIENT HEALTHCARE SERVICES - PROVIDING INPATIENT SERVICES CONSISTENT WITH OUR CORE VALUES BY PROVIDING ACCESS TO COMPREHENSIVE, HIGH QUALITY, COMPASSIONATE, AND EFFICIENT HEALTHCARE SERVICES. LAWRENCE GENERAL HOSPITAL IS A 186 BED HOSPITAL THAT PROVIDED 41,717 PATIENT DAYS OF INPATIENT SERVICES WITH 10,908 DISCHARGES DURING FY 2020.

4b	(Code: ) (Expenses $ 84,180,850 including grants of $ 0 ) (Revenue $ 108,241,678 )
	OUTPATIENT HEALTHCARE SERVICES - PROVIDING OUTPATIENT SERVICES CONSISTENT WITH OUR CORE VALUES BY PROVIDING ACCESS TO COMPREHENSIVE, HIGH QUALITY, COMPASSIONATE, AND EFFICIENT HEALTHCARE SERVICES. DURING FY 2020, LAWRENCE GENERAL HOSPITAL HAD 242,379 OUTPATIENT VISITS.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ 37,430,605 including grants of $ 0 ) (Revenue $ 22,074,298 )
4e	Total program service expenses208,401,898

(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
(A) Name and title
(18) Mark Johnson........................................................................ Trustee	1.0 .......................1.0	X	0	0	0
(19) Michael Mancuso........................................................................ TRUSTEE	1.0 .......................1.0	X	0	0	0
(20) Laurel Sweeney........................................................................ Trustee	1.0 .......................1.0	X	0	0	0
(21) Rosemarie Day........................................................................ Trustee (6/20 - On)	1.0 .......................1.0	X	0	0	0
(22) Marianne Paley Nadel........................................................................ Trustee (6/20 - On)	1.0 .......................1.0	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	4,208,586	0	271,508

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	44,640,608

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		44,640,608

		Business Code
2a	NET PATIENT REVENUE	621110	218,831,627	218,831,627
b	NET PATIENT REVENUE (LAB RECEIPTS)	621500	1,007,204		1,007,204
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		219,838,831

3 Investment income (including dividends, interest, and othersimilar amounts) ......			300,173			300,173
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	0	6c
d	Net rental income or (loss).......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	8,622,270		7a
b	Less: cost or other basis and sales expenses	7,701,828		7b
c	Gain or (loss)	920,442		7c
d	Net gain or (loss).........			920,442			920,442
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	WAIVER/DSTI RECEIPTS		621110	13,615,745	13,615,745
b	DSRIP		621110	1,653,697	1,653,697
c	MEALS		621110	467,260	467,260
d	All other revenue ....			6,339,096	6,337,596	1,500
e	Total. Add lines 11a–11d ......			22,075,798
12	Total revenue. See instructions.....			287,775,852	240,905,925	1,008,704	1,220,615

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	2,043,621		2,043,621
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	132,304,563	104,451,595	27,692,418	160,550
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,621,323	1,283,966	335,383	1,974
9	Other employee benefits .......	14,784,146	11,707,933	3,058,217	17,996
10	Payroll taxes ...........	9,181,754	7,271,259	1,899,318	11,177
11	Fees for services (non-employees):
a	Management ......	35,376,316	19,364,646	16,011,670
b	Legal .........	745,862		745,862
c	Accounting ...........	744,688		744,688
d	Lobbying ...........	66,569		66,569
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	15,000		15,000
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	0
12	Advertising and promotion ....	382,731		382,731
13	Office expenses .......	874,938	598,588	276,080	270
14	Information technology ......	5,200,797	90,140	5,110,657
15	Royalties ..	0
16	Occupancy ...........	6,916,613	2,435,245	4,481,368
17	Travel ............	163,828	89,933	73,895
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	12,541		12,541
20	Interest ...........	4,674,954		4,674,954
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	11,986,327		11,986,327
23	Insurance ...	859,930		859,930
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	SUPPLIES AND EQUIPMENT	36,021,171	36,014,009	7,162
b	MISCELLANEOUS	35,719,254	25,094,584	10,623,695	975
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	299,696,926	208,401,898	91,102,086	192,942
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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			7,995,888	1	44,373,449
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			46,497,181	4	34,129,035
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			7,585,000	7	7,585,000
8	Inventories for sale or use ............			8,936,727	8	10,353,124
9	Prepaid expenses and deferred charges ......			839,400	9	1,227,146
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	253,223,010
b	Less: accumulated depreciation	10b	143,760,105	115,300,248	10c	109,462,905
11	Investments—publicly traded securities .			16,017,658	11	6,610,105
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			61,625,838	15	108,462,958
16	Total assets. Add lines 1 through 15 (must equal line 33)...			264,797,940	16	322,203,722

17	Accounts payable and accrued expenses .....	37,403,725	17	38,186,313
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	483,448
20	Tax-exempt bond liabilities .........	75,600,336	20	74,355,504
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	90,008	24	18,256
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	44,263,759	25	115,301,580
26	Total liabilities. Add lines 17 through 25..	157,357,828	26	228,345,101

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	106,340,112	27	92,758,621
28	Net assets with donor restrictions ...........	1,100,000	28	1,100,000
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	107,440,112	32	93,858,621
33	Total liabilities and net assets/fund balances ........	264,797,940	33	322,203,722