2025-08-15T10:51:53-05:00 2024-09-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2023-10-01 042297845 SOUTH SHORE MEDICAL CENTER INC SOUT 7818785200 143 LONGWATER DRIVE NORWELL MA 02061 STEPHEN JENNEY SVP & CFO 7816248000 2025-08-15 1 1 SHAWNA M JANSONS P01222873 3174648600 2023 2025-03-06 01:10:19Z STEPHEN JENNEY 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 86274843 0 X WWW.SOUTHSHOREHEALTH.ORG X 2004 MA SOUTH SHORE MEDICAL CENTER CARES FOR PATIENTS COMPASSIONATELY AND EFFECTIVELY, WITH THE HIGHEST MEDICAL AND ETHICAL STANDARDS. WE BUILD A BETTER FUTURE FOR THE COMMUNITIES WE SERVE THROUGH TEACHING, LEADERSHIP IN HEALTH CARE INNOVATION AND PHILANTHROPY. 13 8 756 8 0 0 0 0 80599616 74349554 0 -45088 8075468 11925289 88675084 86229755 0 0 0 0 69105497 70845240 0 0 0 27861449 27478378 96966946 98323618 -8291862 -12093863 59822242 53005476 62532959 67809355 -2710717 -14803879 X SOUTH SHORE MEDICAL CENTER DELIVERS EFFECTIVE AND COMPASSIONATE PATIENT CARE WITH THE HIGHEST MEDICAL AND ETHICAL STANDARDS. WE BUILD A BETTER FUTURE FOR THE COMMUNITIES WE SERVE THROUGH TEACHING AND LEADERSHIP IN HEALTHCARE INNOVATION. YOUR HEALTH, OUR PASSION, ONE COMMUNITY. 0 0 84933657 86253468 SOUTH SHORE MEDICAL CENTER PROVIDED MEDICAL, PREVENTATIVE AND OTHER CLINICAL SERVICES TO ITS PATIENTS. THE ORGANIZATION WORKS TO IMPROVE THE QUALITY OF HEALTH CARE SERVICES PROVIDED TO PATIENTS IN SOUTHEASTERN MASSACHUSETTS THROUGH CLINICAL INTEGRATION AND THE IMPLEMENTATION OF A UNIFIED ELECTRONIC MEDICAL RECORDS SYSTEM. SOUTH SHORE MEDICAL CENTER PARTICIPATED IN EDUCATIONAL AND TRAINING PROGRAMS FOR MEDICAL STUDENTS AND MEDICAL RESIDENTS AND FOR OTHER HEALTHCARE PROFESSIONALS INCLUDING PHYSICIAN ASSISTANTS AND NURSES. 84933657 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 37 0 1 756 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 8 1 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 1 0 MA X STEPHEN JENNEY 7816248000 55 FOGG RD SOUTH WEYMOUTH MA 01290 ALLEN SMITH MD PRESIDENT & CEO 0.50 44.00 X X 0 1263309 183307 KIMBERLY DEVER MD DIRECTOR, CHIEF OB/GYN 0.50 43.00 X 0 790024 41762 AMANDA MARCHICA DO DIRECTOR AS OF 10/1/2023 0.50 43.00 X 0 285142 31720 BRADFORD SAMPSON DIRECTOR 0.50 4.00 X 0 80000 0 PAMELA O'LEARY CHAIR 0.50 4.00 X X 0 0 0 THOMAS MCCARTHY VICE CHAIR 0.50 4.00 X X 0 0 0 ALAN MCKIM DIRECTOR 0.50 4.00 X 0 0 0 CHRISTOPHER ODDLEIFSON DIRECTOR THRU 12/31/2023 0.50 4.00 X 0 0 0 ELLEN ESSENFELD DIRECTOR 0.50 4.00 X 0 0 0 GRACE LEE DIRECTOR AS OF 10/1/2023 0.50 4.00 X 0 0 0 HELEN GARVEY DIRECTOR THRU 12/31/2023 0.50 4.00 X 0 0 0 KENNETH QUIGLEY JR DIRECTOR AS OF 10/1/2023 0.50 4.00 X 0 0 0 MICHAEL SHEEHAN DIRECTOR 0.50 4.00 X 0 0 0 PAMELA WHELTON DIRECTOR THRU 12/31/2023 0.50 4.00 X 0 0 0 PAUL WANTANABE PHD DIRECTOR 0.50 4.00 X 0 0 0 PAULA L BECKER DIRECTOR 0.50 4.00 X 0 0 0 JOSEPH R DRISCOLL ESQ SECRETARY 0.50 44.00 X 0 571479 36056 STEPHEN JENNEY CFO & TREAS. AS OF 10/1/23 0.50 44.00 X 0 293418 20403 DAVID HALLE MD AMBULATORY MEDICAL DIRECTOR 40.00 1.00 X 594728 0 36056 LINDA OLIVER VP AMBULATORY SERV. 40.00 0.00 X 383107 0 9900 MATTHEW HJORT MD PHYSICIAN 40.00 0.00 X 726549 0 36056 SERGIO FEFER MD PHYSICIAN 40.00 0.00 X 621620 0 31227 STEVEN STARR MD PHYSICIAN 40.00 0.00 X 555478 0 29559 TEJASH SHAH PHYSICIAN 40.00 0.00 X 540972 0 9900 MOHAMMED SHARAF MD PHYSICIAN 40.00 0.00 X 508342 0 14774 JUSTIN CAMPBELL DIRECTOR THRU 9/30/2023 0.00 1.00 X 0 91600 0 MICHAEL AYERS MD DIRECTOR THRU 9/30/2023 0.50 5.00 X 0 29133 0 KRISTINE HANSCOM CPA MST CGMA FORMER TREAS. & CFO (THRU 5/31/23) 0.50 44.00 X 0 907550 18546 3930796 4311655 499266 119 1 1 0 FOXROCK LONGWATER II REALTY LLC 350 GRANITE STREET SUITE 2205 BRAINTREE MA 02184 MANAGEMENT COMPANY 4003059 SOUTH SUBURBAN GASTROENTEROLOGY PC 1085 MAIN STREET SOUTH WEYMOUTH MA 02190 PHYSICIAN SERVICES 1508571 BOSTON UNIVERSITY DERMATOLOGY 609 ALBANY STREET ROOM J-100 BOSTON MA 02118 PHYSICIAN SERVICES 571083 HANCOCK FLAG REALTY LLC PO BOX 690528 QUINCY MA 02169 MANAGEMENT COMPANY 520478 BEALE'S LLC PO BOX 143 ACCORD MA 02018 CLEANING SERVICES 339869 9 NET PATIENT SVCS. REV. 621110 68776930 68776930 PREMIUM REVENUE 621110 5572624 5572624 74349554 21375 0 21375 21375 21375 45088 -45088 -45088 -45088 HOSPITAL SALARY SUPPOR 900099 11006218 11006218 BMC HEALTHNET PAYMENTS 900099 434105 434105 MACRA MEDICARE PAYMENT 900099 215179 215179 248412 248412 11903914 86229755 86253468 0 -23713 375687 327582 48105 58019649 50590422 7429227 12449904 10855734 1594170 2596241 2251925 344316 25255 25255 7685592 6152286 1533306 2923966 2548504 375462 7229608 5871295 1358313 160574 160424 150 1197366 768522 428844 1318625 1294816 23809 DRUGS & MED. SUPPLIES 4498372 4498372 EQUIP. MAINT. CONTRACT 359539 311193 48346 DUES 332165 87161 245004 ANSWERING SERVICE 95859 52525 43334 -944784 -837104 -107680 98323618 84933657 13389961 0 5984918 2394049 5310531 5107065 738981 410602 1312021 1607287 15723880 11188036 5012867 4535844 5794049 5249084 35668875 33701545 59822242 53005476 7404515 7782587 4011 4011 55124433 60022757 62532959 67809355 X -2710717 -14803879 -2710717 -14803879 59822242 53005476 -12093863 701 0 X 0 1 X 1 0 X 7511397 5939950 0 0 0 13451347 67914644 76000277 81787293 88653709 86253468 400609391 75426041 81940227 81787293 88653709 86253468 414060738 0 0 0 414060738 593905 1108805 21375 21375 22076 1767536 593905 1108805 21375 21375 22076 1767536 76019946 83049032 81808668 88675084 86275544 415828274 0.99570 0.99510 0.00430 0.00490 X 271208 47148 224060 5597242 3527476 2069766 9564017 7613412 1950605 291413 291413 4535844 A/R - OTHER 136820 SECURITY DEPOSITS 160667 DUE FROM THIRD PARTIES 5128095 ROU ASSETS 28275963 33701545 DUE TO AFFILIATES 24081791 DUE TO THIRD PARTY 50784 PHYSICIAN BENEFITS PAYABLE 5229396 ROU LEASE LIABILITY 30660786 60022757 X PART X, LINE 2: THE CORPORATION FOLLOWS THE PROVISIONS OF FASB ASC 740, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. ASC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. IT PRESCRIBES AN UNCERTAINTY THRESHOLD AND MEASUREMENT ATTRIBUTES FOR FINANCIAL STATEMENT DISCLOSURE OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. 1 0 0 0 0 0 0 1 0 ALLEN SMITH MD PRESIDENT & CEO 0 1082002 0 175763 0 5544 0 159900 0 23407 0 1446616 0 0 KRISTINE HANSCOM CPA MST CGMA FORMER TREAS. & CFO (THRU 5/31/23) 0 275823 0 0 0 631727 0 9900 0 8646 0 926096 0 0 KIMBERLY DEVER MD DIRECTOR, CHIEF OB/GYN 0 671901 0 90317 0 27806 0 9900 0 31862 0 831786 0 0 MATTHEW HJORT MD PHYSICIAN 604193 0 115855 0 6501 0 9900 0 26156 0 762605 0 0 0 SERGIO FEFER MD PHYSICIAN 592114 0 26450 0 3056 0 9900 0 21327 0 652847 0 0 0 DAVID HALLE MD AMBULATORY MEDICAL DIRECTOR 526850 0 64266 0 3612 0 9900 0 26156 0 630784 0 0 0 JOSEPH R DRISCOLL ESQ SECRETARY 0 514628 0 34015 0 22836 0 9900 0 26156 0 607535 0 0 STEVEN STARR MD PHYSICIAN 548869 0 1065 0 5544 0 9900 0 19659 0 585037 0 0 0 TEJASH SHAH PHYSICIAN 535910 0 4390 0 672 0 9900 0 0 0 550872 0 0 0 MOHAMMED SHARAF MD PHYSICIAN 502112 0 5390 0 840 0 9900 0 4874 0 523116 0 0 0 LINDA OLIVER VP AMBULATORY SERV. 326250 0 47675 0 9182 0 9900 0 0 0 393007 0 0 0 AMANDA MARCHICA DO DIRECTOR AS OF 10/1/2023 0 172732 0 112121 0 289 0 7641 0 24079 0 316862 0 0 STEPHEN JENNEY CFO & TREAS. AS OF 10/1/23 0 233482 0 56875 0 3061 0 5960 0 14443 0 313821 0 0 JUSTIN CAMPBELL DIRECTOR THRU 9/30/2023 0 91600 0 0 0 0 0 0 0 0 0 91600 0 0 MICHAEL AYERS MD DIRECTOR THRU 9/30/2023 0 29133 0 0 0 0 0 0 0 0 0 29133 0 0 PART I, LINE 3 THE VICE PRESIDENT OF AMBULATORY CARE RECEIVES COMPENSATION FOR SERVICES PERFORMED FOR A RELATED ORGANIZATION. THE COMPENSATION COMMITTEE OF SOUTH SHORE HEALTH SYSTEM, A RELATED ORGANIZATION, DETERMINES THE PRESIDENT'S COMPENSATION. THE COMPENSATION COMMITTEE MEETS PERIODICALLY AND ENGAGES AN INDEPENDENT EXTERNAL COMPENSATION CONSULTING FIRM TO ESTABLISH THE COMPENSATION OF KEY SYSTEM EMPLOYEES. THE CONSULTING FIRM DEVELOPS AND PRESENTS ALL MATERIALS INCLUDING MARKET TRENDS, COMPENSATION STUDIES AND SURVEYS, AND ADHERES TO BEST PRACTICE GUIDELINES. THE FINAL RECOMMENDATION FOR COMPENSATION CHANGES IS PRESENTED AND APPROVED BY THE ENTIRE INDEPENDENT COMMUNITY OF THE BOARD OF DIRECTORS. PART I, LINE 4A KRISTINE HANSCOM, THE FORMER CFO & TREASURER RECEIVED SEPARATION COMPENSATION IN THE AMOUNT OF $586,000 FROM SOUTH SHORE HOSPITAL, A RELATED ORGANIZATION. PART I, LINE 7 THE NON-FIXED PAYMENTS PROVIDED CONSIST OF STIPENDS. FORM 990, PART VI, SECTION A, LINE 2 MANY OF THE PERSONS LISTED IN PART VII HAVE A "BUSINESS RELATIONSHIP" WITH ONE ANOTHER DUE TO THE OVERLAPPING BOARD STRUCTURE OF SOUTH SHORE HEALTH SYSTEM AND ITS RELATED ENTITIES. FORM 990, PART VI, SECTION A, LINE 6 COASTAL MEDICAL ASSOCIATES, INC. D/B/A SOUTH SHORE PHYSICIAN AMBULATORY ENTERPRISE IS THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A OFFICERS AND DIRECTORS ARE ELECTED ANNUALLY BY A BOARD VOTE OF THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS PREPARED INTERNALLY AND REVIEWED BY THE TAX PRACTICE OF ITS INDEPENDENT AUDITORS. THE RETURN IS THEN REVIEWED BY THE CFO/TREASURER. FORM 990 IS UPLOADED TO THE GOVERNING BOARD'S WEB PORTAL FOR ALL BOD MEMBERS TO REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST FORM ANNUALLY. THE FORMS ARE THEN REVIEWED FOR CONFLICTS OR POTENTIAL CONFLICTS. BOARD MEMBERS ABSTAIN FROM VOTING ON MATTERS THAT PRESENT A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15B THE PRESIDENT AND/OR THE VICE PRESIDENT OF AMBULATORY CARE, IS CONSIDERED A SOUTH SHORE HEALTH SYSTEM EXECUTIVE; ALL EXECUTIVE COMPENSATION DECISIONS ARE MADE BY THE SSHS PRESIDENT/CEO, USING THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTOR'S APPROVED PHILOSOPHY AND PAY APPROACH FOR THE EXECUTIVE TEAM. THE COMPENSATION COMMITTEE IS INDEPENDENT AND CONSISTS SOLELY OF MEMBERS WHO DO NOT HAVE A CONFLICT OF INTEREST WITH REGARDS TO COMPENSATION MATTERS. ANNUAL COMPENSATION DECISIONS FOR COASTAL (SSPAE) PHYSICIANS AND ADVANCED PRACTICE CLINICIAN EMPLOYEES ARE ALSO MADE BY SSHS AND ARE BASED ON A COMBINATION OF ADVICE AND RESEARCH PROVIDED BY OUTSIDE CONSULTANTS, REVIEW OF COMPARABLE INDUSTRY DATA AND MARKET CONDITIONS. FORM 990, PART VI, SECTION C, LINE 19 SOUTH SHORE MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR INSPECTION AT THE CORPORATION'S OFFICE. COPIES OF THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. IN ADDITION, CERTAIN GOVERNING DOCUMENTS ARE ALSO AVAILABLE THROUGH THE MASSACHUSETTS SECRETARY OF THE COMMONWEALTH'S CORPORATIONS DIVISION DATABASE. SOUTH SHORE HOSPITAL INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 042769210 HOSPITAL MA 501(C)(3) 3 SOUTH SHORE HEALTH SYSTEM INC 0 SOUTH SHORE PROPERTY INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 050398822 DEVELOPS AND MANAGES REAL PROPERTY FOR SOUTH SHORE HOSPITAL AND AFFILIATES MA 501(C)(3) 12A, I SOUTH SHORE HEALTH SYSTEM INC 0 COASTAL MEDICAL ASSOCIATES INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 043170333 PROVIDES SPECIALIZED MEDICAL CARE MA 501(C)(3) 3 SOUTH SHORE HEALTH SYSTEM INC 0 METROSOUTH OBSTETRICS & GYNECOLOGY INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 330998957 PROVIDES SPECIALIZED MEDICAL CARE MA 501(C)(3) 3 SOUTH SHORE HOSPITAL INC 0 ATLANTIC WOMEN'S HEALTH INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 200156651 PROVIDES SPECIALIZED MEDICAL CARE MA 501(C)(3) 3 SOUTH SHORE HOSPITAL INC 0 SOUTH SHORE HEALTH EXPRESS INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 452385865 OPERATES MEDICAL URGENT CARE CENTERS MA 501(C)(3) 10 COASTAL MEDICAL ASSOCIATES INC 1 CONNECTED CARE OF SOUTHEASTERN MASSACHUSETTS INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 823503666 OPERATE AN ACCOUNTABLE CARE ORGANIZATION MA 501(C)(3) 10 SOUTH SHORE HEALTH SYSTEM INC 0 SOUTH SHORE HEALTH SYSTEM INC 55 FOGG ROAD SOUTH WEYMOUTH MA 02190 042105926 SUPPORTS THE CHARITABLE MISSION OF SOUTH SHORE HOSPITAL AND ITS AFFILIATES MA 501(C)(3) 12B, II N/A 0 SOUTH SHORE HEALTH INTEGRATED DELIVERY NETWORK INC 55 FOGG RD SOUTH WEYMOUTH MA 02190 852785921 TO DEVELOP & MAINTAIN A NETWORK OF PROVIDERS FOR DELIVERY OF HEALTHCARE SERV MA N/A C 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0