2024-08-05T14:56:44+00:00 2023-09-30 440160260 Forvis Mazars LLP 500 Ridgefield Court Asheville NC 28806 990 2022-10-01 042104298 Hebrew Rehabilitation Center HEBR 6173638000 1200 Centre Street Boston MA 02131 STEVEN LANDERS President & CEO 2024-08-05 true true Amy Bibby P00445891 8282542254 2024-07-17 2022 2024-08-08 14:25:15Z STEVEN LANDERS 1200 Centre Street Boston MA 02131 156052931 false X WWW.HEBREWSENIORLIFE.ORG X 1903 MA See Schedule O. 4 2 1668 375 356955 40702 23626733 20676200 133055190 133911964 1184771 1107812 401489 356955 158268183 156052931 0 0 0 0 94382918 98776790 0 0 0 65648678 60201056 160031596 158977846 -1763413 -2924915 53393379 47730142 152629018 149726695 -99235639 -101996553 To operate its Harvard Medical Schools affiliated chronic care hospital that provides seniors with compassionate long-term care, post-acute care, outpatient services and adult day health care. false false 145432676 131800971 See Schedule O. 2329325 2110993 Other program service revenue is made up of miscellaneous non-patient service revenue and expenses, including department of medicine teaching, fellowships & other support, food service, variety of ancillary programs, and space leased by HSL. 147762001 true true false true false false false true false true true false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 0 0 1668 true true true false false false false false false false false false false false X 4 2 false false false false true true true true true false false true true true true true true false true false MA X X Jonathan Allia 6173638000 1200 CENTRE STREET BOSTON MA 02131 JAMES D HART SECRETARY & CHIEF FIN. OFFICER 5.0 45.0 X X 0 484124 67645 LOUIS J WOOLF PRESIDENT AND CEO (end 07/2023) 5.0 45.0 X X 0 1199018 89270 MARSHA COHEN TREASURER 0.1 3.0 X X 0 0 0 MELISSA BAYER TEARNEY BOARD CHAIR 0.1 3.0 X X 0 0 0 STEVEN LANDERS PRESIDENT AND CEO (start 07/2023) 5.0 45.0 X X 0 0 0 ERIC ROGERS CHIEF INFORMATION OFFICER 5.0 45.0 X 0 329641 71139 HELEN CHEN MD CHIEF MEDICAL OFFICER 25.0 25.0 X 472975 0 45446 KATELYN QUYNN CHIEF DEV OFF & VP BOARD REL. 5.0 45.0 X 0 528155 55744 KATHYRN W TASKER CHIEF SPONSORED AWARDS OFFICER 35.0 15.0 X 234545 0 68053 KIMBERLY J BROOKS CHIEF OP. OFFICER, SEN LIVING 1.0 49.0 X 0 494589 64841 LEWIS LIPSITZ MD DIR, HMIFAR & CHIEF ACAD. OFF 30.0 20.0 X 429317 0 88772 LINDA THOMPSON CHIEF PEOPLE OFFICER 5.0 45.0 X 0 300779 34435 MANDEL I ERNEST MD CHIEF MEDICAL OFFICER 25.0 25.0 X 226591 0 15535 MARY MOSCATO FACHE PRESIDENT, HSL HC SVCS. & HRC 25.0 25.0 X 526978 0 46116 RACHEL LERNER ESQUIRE GEN. CNSL. & CHIEF COMP. OFF. 5.0 45.0 X 0 256070 57898 RACHEL WHITEHOUSE CHIEF COMM. & PLAN OFFICER 5.0 45.0 X 0 313193 69029 SARAH L SYKORA CHIEF COMM. & PLAN OFFICER 5.0 45.0 X 0 247473 63258 TAMMY B RETALIC MS RN CHIEF NURSING OFF. & VP PCS 25.0 25.0 X 342266 0 69446 ALVARO PASCUAL-LEONE SR. SCIENTIST/DIRECTOR 45.0 0 X 344313 0 57612 ERAN D METZGER MEDICAL DIRECTOR, HSL PSYCH. 45.0 0 X 304145 0 44207 INNOKENTIY BAKAEV MEDICAL DIRECTOR, RSU AND LTCH 45.0 0 X 290497 0 48631 RASHMI KAURA MEDICAL DIRECTOR OF HOSPICE AND PALLIATIVE CARE 45.0 0 X 285151 0 32689 SHARON K INOUYE SR. SCIENTIST/DIRECTOR 45.0 0 X 364300 0 37281 3821078 4153042 1127047 0 false true false 0 17544220 3131980 20676200 Patient Service Revenue 623000 131800971 131800971 All Oher Program Services 623000 2110993 2110993 0 0 0 0 133911964 1079630 1079630 0 0 28182 28182 0 28182 28182 Cell Tower Rental 540000 30905 30905 Fee From Houseworks 810000 326050 326050 0 0 0 0 356955 156052931 133911964 356955 1107812 2232672 2232672 78254698 77191595 1063103 1144205 1029784 114421 10786453 9707807 1078646 6358762 5722886 635876 88051 24648 63403 66414 23019 43395 3724 3724 5551842 4988848 562994 0 348944 314050 34894 710168 454855 255313 1948307 1753475 194832 8800812 8409344 391468 61539 59263 2276 73232 63929 9303 14244 12820 1424 3529583 3529583 3354739 3019265 335474 1083781 802761 281020 Research 15396133 15396133 Culinary and Food Services 4104096 4104096 Medial Supplies and PPE 3100057 2995956 104101 Housekeeping Services 2532897 2532897 9432493 9150846 281647 0 158977846 147762001 11215845 0 4041602 2127150 3008053 451212 1348481 -2752464 9253928 12563704 0 0 1125154 1340735 2456444 2392951 157201829 128929318 28877629 28272511 2848557 3216458 0 433531 117885 53393379 47730142 19029217 15885065 1382803 2278233 148848 39800 313082 332820 0 131755068 131190777 152629018 149726695 X -124301973 -129320565 25066334 27324012 -99235639 -101996553 53393379 47730142 X -2924915 326826 -162825 X false true X true true true X 12030776 22500979 24607736 23626733 20676200 103442424 0 0 12030776 22500979 24607736 23626733 20676200 103442424 0 103442424 1588680 2625298 1235004 1012197 1079630 7540809 339181 261554 367507 401489 356955 1726686 0 0 0 0 0 0 112709919 0 0.9178 0.9082 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 9470 9470 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY HEBREW REHABILITATION CENTER MAINTAINS MEMBERSHIPS WITH CERTAIN ASSOCIATIONS, OF THE TOTAL DUES PAID, $9,470 WAS USED FOR LOBBYING FOR ELDER CARE. false true X 202364 202364 79800501 60711511 19088990 76577472 68217807 8359665 621492 621492 28272511 Parent Investment Pool 3216458 F 3216458 Due to Affiliates 131190777 Operating Lease 131190777 Schedule D, Part IV, Line 2b Explanation of escrow agreement DEPOSITS CONSIST OF FUNDS HELD FOR PATIENTS FOR THEIR PERSONAL USE. IT IS REFERRED TO AS THE PATIENTS' BANK, AS ALLOWED BY MEDICAID. EACH MONTH, $75 OF A PATIENT'S SOCIAL SECURITY PAYMENT WILL GO TO THE PATIENTS' BANK FOR HIS/HER PERSONAL USE. THE REMAINDER GOES TO PAY FOR HIS/HER CARE. true true X true X true X true false false 0 0 0 0.0 102475013 90131821 12343192 0.0776 0 0 0 0.0 0 0 102475013 90131821 12343192 0.0776 1811898 706232 1105666 0.0069 1819563 1500 1818063 0.0114 2559596 2240350 319246 0.0020 21902962 16358792 5544170 0.0348 0 0 0 0.0 0 0 28094019 19306874 8787145 0.0552 0 0 130569032 109438695 21130337 0.1328 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1811898 706323 1105575 0.0069 0 0.0 0 0.0 0 0 1811898 706323 1105575 0.0069 true 1329426 0 15246896 12248639 2998257 X true true 1 1 HEBREW REHABILITATION CENTER 1200 CENTRE STREET Boston MA 02131 WWW.HEBREWSENIORLIFE.ORG 2290 X X X X HEBREW REHABILITATION CENTER 1 false false true X X X X X X X X X 21 true false true true X HTTPS://WWW.HEBREWSENIORLIFE.ORG/SITES/DEFAULT/FILES/2019- 11/COMMUNITY_HEALTH_NEEDS_ASSESSMENT_2019 true 21 true https://www.hebrewseniorlife.org/sites/default/files/2019-11/Community_Health_Needs_Assessment_2019. false true X 200.0 400.0 X X X true true X X X true X SEE PART VI - SUPPLEMENTAL INFORMATION X SEE PART VI - SUPPLEMENTAL INFORMATION X SEE PART VI - SUPPLEMENTAL INFORMATION X X X X X true X false X X X X false X X false false Schedule H, Part V, Section B, Line 3E Hebrew Rehabilitation Center's (HRC) 2022 Community Health Needs Assessment (CHNA) provides a prioritized description of the significant health needs of the community identified in the CHNA. The CHNA can be found at https://www.hebrewseniorlife.org/sites/default/files/2019-11/Community_Health_Needs_Assessment_2019.pdf. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HEBREW REHABILITATION CENTER. IN SUPPORT OF OUR MISSION TO HONOR OUR ELDERS, HRC IS FOCUSED ON THE MOST VULNERABLE AND UNDER-SERVED SENIORS, E.G. THE MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS IN THE COMMUNITY. OF SPECIAL IMPORTANCE TO HRC ARE SENIORS AT RISK FOR ELDER ABUSE AND NEGLECT. THE PRIMARY VEHICLE FOR GATHERING COMMUNITY INPUT WAS THE BOSTON CHNA-CHIP COLLABORATIVE SURVEY. OVER 100 GROUPS AND ORGANIZATIONS WERE INVOLVED IN DATA GATHERING ACROSS SECTORS, INCLUDING REPRESENTATIVES FROM HOUSING, TRANSPORTATION, FAITH COMMUNITY, EDUCATION, PUBLIC HEALTH, AND HEALTH CARE; ORGANIZATIONS THAT WORK WITH SPECIFIC POPULATIONS; FOCUS GROUPS WITH COMMUNITY MEMBERS NOT TYPICALLY REPRESENTED IN THESE PROCESSES (E.G., LGBTQ YOUTH, LOW-WAGE WORKERS, FAMILY MEMBERS AFFECTED BY VIOLENCE, SPECIFIC IMMIGRANT POPULATIONS, ETC.). WE LEVERAGED SEVERAL COMMUNITY PARTNERSHIPS TO COMPLETE THE SURVEY, E.G., FORMER MEMBERS OF THE MULTICULTURAL COALITION ON AGING, WHICH REPRESENTED BOSTON AND ITS IMMEDIATE SUBURBS, 2LIFE COMMUNITIES, LOCAL CHURCHES, SENIOR CENTERS, AND THE LIKE. MEMBERS OF THESE GROUPS INCLUDED SENIOR HEALTH FOCUSED GOVERNMENTAL AGENCIES AND OTHER ORGANIZATIONS THAT SERVE AND REPRESENT MEMBERS OF THE MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS IN THE COMMUNITY. THESE INCLUDE LOW- INCOME SENIORS, DISABLED SENIORS, SENIORS WITH MEMORY HEALTH CHALLENGES, SENIORS WITH CHRONIC DISEASES SUCH AS DIABETES AND HEART DISEASES, AND SENIORS WITH MOBILITY CHALLENGES AND FALL RISKS. ALSO REPRESENTED WERE SENIORS OF UNDERSERVED ETHNIC MINORITIES FOR WHOM ENGLISH IS NOT THEIR FIRST LANGUAGE, MANY OF WHOM ARE CHALLENGED BY LOW HEALTH LITERACY, CULTURAL BARRIERS, AND LIMITED ENGLISH PROFICIENCY. THE SURVEYS WERE IN THE FIELD FOR ONE MONTH. IN ADDITION TO THE SURVEY, HRC TOOK INTO ACCOUNT PUBLICLY AVAILABLE DATA SETS IN CONDUCTING ITS 2019 CHNA, INCLUDING: *2019 BOSTON CHNA - CHIP *BOSTON PUBLIC HEALTH COMMISSION "HEALTH OF BOSTON 2016-2017" *2018 MASSACHUSETTS HEALTHY AGING COMMUNITY PROFILE *THE MASSACHUSETTS DPH WEST SUBURBAN COMMUNITY NETWORK AREA (CHNA 18) THAT CONSISTS OF BROOKLINE, DEDHAM, DOVER, NEEDHAM, NEWTON, WALTHAM, WELLESLEY, AND WESTON. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - HEBREW REHABILITATION CENTER. OTHER ORGANIZATIONS WITH WHOM THE ORGANIZATION CONDUCTED ITS CHNA AS PART OF THE PROCESS FOR ITS MOST RECENT CHNA, HRC PARTICIPATED IN THE BOSTON CHNA-CHIP COLLABORATIVE, WHICH GATHERED COMMUNITY INPUT BASED ON THE COLLABORATIVE'S SURVEY. HRC'S SURVEY RESULTS, ALONG WITH THE OTHER MEMBERS OF THE COLLABORITVE WHO SERVE THE SAME COMMUNITY, WERE USED BY HRC AS THE BASIS FOR THE CHNA AND IMPLEMENTATION STRATEGY. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HEBREW REHABILITATION CENTER. THE HRC 2022 CHNA IDENTIFIES THE FOLLOWING SIGNIFICANT HEALTH NEEDS OF SENIORS IN OUR COMMUNITY: *GERIATRIC SPECIALISTS AND SERVICES *BEHAVIORAL/MENTAL HEALTH HEALTH *IN-HOME HEALTH *SOCIAL DETERMINANTS OF HEALTH DETAILS ON HOW HRC IS WORKING TO INCREASE THE AVAILABILITY, ACCESSIBILITY, AND VISIBILITY OF SPECIALIZED GERIATRIC CARE ARE DETAILED EXTENSIVELY IN THE HRC 2022 CHNA IMPLEMENTATION PLAN. IN DETERMINING HOW HRC WOULD ADDRESS THE NEEDS IDENTIFIED IN ITS CHNA, HRC CONSIDERED THE DEGREE OF COMMUNITY NEED FOR ADDITIONAL RESOURCES, ITS ABILITY TO MEET THE NEED THROUGH ITS EXPERIENCE, EXPERTISE AND PROGRAMMING, AND THE CAPABILITY OF OTHER ORGANIZATIONS TO MEET THAT SAME NEED. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - HEBREW REHABILITATION CENTER. HEBREW REHABILITATION CENTER ALSO USES MEDICAID ELIGIBILITY TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - HEBREW REHABILITATION CENTER. IN ADDITION TO HAVING THE FAP LISTED ON THE WEBSITE, NURSING UNIT COORDINATORS HAVE COPIES OF THE FAP AND APPLICATION IN THEIR OFFICES WHERE THEY ADMIT PATIENTS. FOR THE LONG-TERM CHRONIC CARE UNIT, FINANCIAL ASSISTANCE IS DISCUSSED BY THE FISCAL STAFF AT MEETINGS WITH PATIENTS AND FAMILIES. 1 HSL MEDICAL GROUP HRC (DEDHAM) 7000 GREAT MEADOW ROAD Dedham MA 02026 Outpatient Clinic HEBREW SENIORLIFE MEDICAL GROUP AT OC ONE DEL POND DRIVE Canton MA 02021 Outpatient Clinic HEBREW SENIORLIFE MEDICAL GROUP AT CCB 100 CENTRE STREET Brookline MA 02446 Outpatient Clinic GREAT DAYS FOR SENIORS (BRIGHTON) 30 WALLINGFORD ROAD Brighton MA 02135 ADULT DAY HEALTH Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM HRC is part of a group of not-for-profit affiliated entities whose sole member is Hebrew SeniorLife, Inc. HSL's coordinated system of care is based on the premise that research, training of geriatric health-care professionals, senior living and health care must be integrated in such a way to promote independence for all adults as they age. HSL is working to chart the course for senior life. Through our unparalleled combination of experience, optimism, vision and determination, we are working to improve the quality of life for people as they age and dispelling the notion that growing old has to mean growing frail. HRC's affiliates include senior supportive housing communities, which help keep seniors independent in their homes with supportive services including wellness and fitness programs, social service supports, access to health and home care, dining programs, and recreational activities. Coordinated services throughout the HSL network support seniors in their independence as well as provide for successful transitions between care settings. HSL's Department of Volunteer, Youth and Community Engagement involved 200 consistent volunteers through in person and remote engagement, and an additional 300 student volunteers through our multigenerational programs. These volunteers support the Hebrew SeniorLife staff and enrich the lives of our residents and patients with program facilitation, one-on-one support and specialized initiatives. HRC's Roslindale campus makes Kosher meals, an important service to many in the Jewish community, and its kitchen provides Kosher meals for Combined Jewish Philanthropies, Ethos, and Springwell as part of their Home-Delivered Meals program. The Deanna and Sidney Wolk Center for Memory Health at Hebrew SeniorLife provides comprehensive outpatient care related to brain health, cognitive and behavioral concerns, and memory loss. We are committed to providing families and patients with answers, hope, and personalized interventions designed to preserve brain health, minimize disability, slow the progression of symptoms, and maximize quality of life. The Center for the Prevention of Elder Abuse and Neglect at Hebrew SeniorLife (CPEAN) provides safe shelter and services for older people suffering from abuse, neglect, or financial exploitation. CPEAN's work focuses in four areas: (1) physical shelter for older adults who are in an unsafe situation due to abuse; (2) supportive services to seniors experiencing abuse; (3) training and education; and (4) community awareness-building. CPEAN utilizes multiple Hebrew SeniorLife sites to provide direct client services, including the Roslindale campus. Seniors and the professional community are served through sponsored events such as various support groups and healthy aging programs, and professional sponsorships. There were 55 programs reaching 16,038 people in FY23. Through its blogs, HSL provides a wealth of free information on healthy aging to the general public, covering topics such as fighting seasonal depression and anxiety; the hazards of hoarding among seniors; what vaccines do seniors need; and tips to protect seniors from being scammed. HRC collaborates with area providers to promote the health of seniors and is a preferred provider with Beth Israel Lahey Health for both its Beth Israel Deaconess Medical Center Hospital and its New England Baptist Hospital. HRC works with these hospitals to provide the highest quality, cost-effective hospital and post-hospital care. Driven by a commitment to reduce avoidable hospitalizations and readmissions, the goals of these agreements are to improve transitions of care for patients, access, communications, and information sharing, and ensure the best possible patient outcomes. HRC's Hinda and Arthur Marcus Institute for Aging Research described in general in the 990 Schedule O Part III Line 4A, is a worldwide leader in aging research, affiliated with Harvard Medical School. Through the HSL website, the Marcus Institute provides a wealth of free information on its latest findings in a series of guides that address issues faced by older adults and their families. These guides include Preventing Falls in Older Adults, the Delirium Guide, and Advanced Dementia, a Guide for Families. Marcus Institute researchers have several important findings that will directly improve the health of seniors, which include: 1. A video education tool for family members improved alignment between preferences for comfort-focused care and advance directives among patients with late-stage dementia. 2. Recognizing calcification of the abdominal aorta on bone density scans can be an important contributor to heart attack risk. Doctors should pay attention to this when receiving bone density scans 3. We have found abnormalities in brain networks associated with alterations in gait that can lead to falls and associated injuries. This information is leading to therapeutic interventions with transcranial direct current stimulation that stimulates these networks and improves gait and cognition. 4. More than one-third of women and men age 65+ cohort members of the Framingham Heart Study had CT imaging evidence of new or worsening moderate-to-severe disc and facet joint degeneration over 6 years; the high frequency of degenerative findings in asymptomatic older adults suggests cautious interpretation of imaging results. 5. Both long-term and recent weight loss in older adults increase deterioration in bone microarchitecture, especially at the weight-bearing skeleton; attention to fracture risk in older adults with recent weight loss as well as in those with weight loss over adulthood is warranted. 6. Older adults with smaller size and lower density trunk muscles as seen on CT images have greater risk of excessive forward thoracic curvature (hyperkyphosis); strengthening mid-back musculature may improve muscle properties and prevent spinal deformity with aging. 7. Older adults with diabetes have deficits in cortical bone microarchitecture that may increase risk of fracture, whereas levels of bone mineral density are normal as defined by clinical DXA. 8. Promising new imaging method aids fracture prediction: Deterioration in bone microstructure is an independent risk factor for fracture in older women and men. 9. We have demonstrated that noninvasive transcranial electrical brain stimulation (tES) may improve gait and mobility in patients with Parkinson's disease, and separately, enhance both memory and balance outcomes in older adults with cognitive impairment. 10. We have developed a telemedicine platform and a formal training program to enable remotely-supervised, caregiver-led administration of transcranial electrical stimulation (tES) interventions. 11. A study of older adults (average age 71) showed that knee hypermobility was linked up to 4-fold higher odds of ankle & foot pain, aching or stiffness as well as foot osteoarthritis. Knee hypermobility reduces the stability of the knee (and other lower body joints), and it is thought that this alters knee joint loads and contributes to joint pain. These data suggest that therapeutic interventions targeting mechanical factors, particularly for knee hypermobility, may be needed to prevent ankle and foot symptoms. 12. We evaluated the known risk factors for Parkinson disease (PD) as well as family history to examine how these factors may combine to determine overall Parkinson's risk. Additive interaction was present between no family history of PD and caffeine in men and between caffeine and physical activity in women. Having multiple known protective factors for PD had additive or super-additive effects, so that PD risk is very low in these individuals with multiple protective risk factors. 13. Higher protein intake is beneficial for maintenance of physical function in middle-aged Americans over the span of two decades. This association was particularly evident in women. 14. Men with higher intakes of milk, milk+yogurt, and milk+yogurt+cheese have higher trabecular and integral volumetric bone mineral density and vertebral compressive strength. Dairy intake seems to be most beneficial for older men irrespective of serum vitamin D levels. 15. Higher dietary fiber may modestly reduce bone loss in men at the hip. 16. Among Puerto Rican adults residing in Boston, dairy food intakes were associated with higher bone mineral density, particularly those with sufficient vitamin D status. 17. Frailty is associated with major respiratory complications, particularly respiratory failure after tracheobronchoplasty. Preoperative identification of frailty may help guide decision making for patients. 18. Deficit-accumulation frailty index provides better prediction of death or poor recovery than frailty phenotype in older patients undergoing aortic valve replacement. Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM 19. Considering both multimorbidity patterns and frailty is important for identifying older adults at greater risk of mortality. Of the five patterns identified, the neuropsychiatric class was associated with lower survival across all frailty levels. 20. Older individuals treated with pravastatin could live free of coronary heart disease, on average, for an additional 18.7 days in 6 years, yet their overall survival was 33.7 days shorter than those who received usual care. 21. A 24-week multicomponent program had sustained beneficial effects up to 1 year on physical function, frailty, sarcopenia, depressive symptoms, and nutritional status in socioeconomically vulnerable older adults in rural communities. 22. In hospitalized individuals who underwent cardiac surgery, there are highly variable prescribing cultures of antipsychotics across hospitals, and a short-term use of typical antipsychotics was associated with risks of adverse events similar to those with atypical antipsychotics. 23. One in 3 older adults undergoing aortic valve replacement had depressive symptoms at baseline and a higher risk of short-term and midterm mortality. 24. A randomized trial found an advance care planning education video promotes care that is more aligned with the personal preferences of people living with advanced dementia. 25. Over the last decade, the rate of tube-feeding in advanced dementia has declined by 50% in the US. 26. Black nursing home residents with advanced dementia receive more aggressive care at the end-of-life compared to white residents 27. Development of new tools for measurement of delirium-which have helped to improve identification and management of delirium: 1. Delirium severity (CAM-S, DEL-S) 2. Burden of delirium (DEL-B) 3. Ultrabrief screening tools (UB-CAM) 28. We have found Identification of biomarkers for delirium, including inflammatory, neurodegenerative, imaging-based, and EEG-based. Specifically, abnormalities in resting-state EEG spectral power or TMS-plasticity may indicate a sub-clinical risk for post-surgery delirium. (Ross, et al. Neurophysiologic predictors...) 29. Provision of new resources to advance the field of delirium research through the NIDUS (Network for Investigation of Delirium: Unifying Scientists)-including a Research Hub of 1,751 indexed human and animal studies, 46 measurement information cards, harmonization tools, delirium bibliography (>5500 articles), NIDUS University, pilot grants, and mentorship resources. 30. High resolution peripheral quantitative computed tomography scans predict the risk for fracture even after accounting for more commonly used ways to predict fractures. 31. The number of mitochondria in older adults' muscle is associated with walking speed. 32. Drugs used to treat osteoporosis, when given to NH residents, also prevent fractures. 33. Genetic risk scores can identify which older adults do not need to undergo bone density testing for fracture risk. 34. The largest genome wide association study for bone status in 426,824 individuals, identified 518 genome-wide significant loci of which 301 were never before described. 35. A deficit accumulation frailty index captures both improvements and worsening frailty over 1 year, with measurable changes in mortality. 36. Frailty index is associated with functional decline, and predicts mortality as well as standard mortality prognostic indices. 37. COVID-19 risk factors among nursing home patients included need for high levels of care such as bowel incontinence. 38. Older adults admitted to a SNF for post-acute care with COVID-19 returned to the community and had functional improvement comparable to a COVID-19 negative group. However, those who are frailer at admission tended to have lower function at discharge. 39. Establishing and leading a National Institute of Aging-funded national infrastructure to enable pragmatic trials evaluation interventions in health care systems will improve care of persons living with dementia and their care partners. 40. A multicomponent intervention can improve appropriate prescribing of antibiotics to nursing home residents with advanced dementia and reduce the spread of antibiotic resistant bacteria 41. Disparities in care for nursing home residents with dementia can be achieved by improving the cultural competence of nursing home staff, enhancing support for low-resource facilities, standardizing advance care planning, and educating staff about evidenced-based care and shared decision-making. 42. Little population data exist for foot osteoarthritis (OA), unlike readily available information on hand, knee or hip OA. By examining the UK population for patterns of foot OA, knee OA, hand OA and hip OA and it was found that incidence of foot OA exceeded that of even knee OA, particularly so in people 75 years and older. Hip OA had a significant increased occurrence in younger adults, which is concerning for occupational demands and surgical burden. The levels of OA represent significant socioeconomic burden in the UK that may be modifiable, especially in older age groups. 43. The largest genome-wide association study (GWAS) of hallux valgus, a common structural foot disorder known as bunions that we previously showed to be highly heritable. This study identified a new GWAS locus for hallux valgus shown to be related to collagen genes. 44. The occurrence of hip fractures in the US has decreased over the past 40 years, even after taking age changes across that timeframe into account. Some have postulated that treatment for osteoporosis is the reason for this reduction in hip fractures. However, this study showed that the cause of the decline in fractures is more closely related to reductions in smoking and heavy drinking across the past 40 years. Thus, in addition to treatment of osteoporosis, these data emphasize the need to encourage public health interventions for smoking cessation and heavy drinking. 45. Foot arthritis and foot pain were common in this community sample but not as often simultaneously. Metabolic and biomechanical factors (eg, obesity, load, previous foot injury) were linked to symptomatic foot arthritis. Radiographic foot arthritis (but not symptomatic) was more common in Black than White participants. This study has prompted further work on the effects of occupation as well as gait adaptations for foot arthritis. 46. We evaluated whether increasing serum vitamin D and dietary calcium intake in older women with low vitamin D levels had a positive effect on muscle, strength, balance and function. This pilot study showed positive effects for muscle and physical function after 6-months, as well as with balance. Strength was not affected. Larger studies are planned to examine specific muscle groups and more aspects of physical function. 47. We addressed whether social networks size affected the link between a person's fear of falling and safety modifications to bathrooms to prevent falls. While it was known that fear of falling encouraged safety modifications, this work showed that social isolation reduced the likelihood of having safety modifications done, even among those older adults with fear of falling. This publication was received the graduation student award from Harvard TH Chan School of Public Health for expanding the focus on safety modifications in older adults. 48. The current medical evidence for foot and ankle osteoarthritis for the diagnosis, patterns of disease, societal burden, outcome assessment and treatments was summarized. We proposed an agenda to guide future research not only in U.S. but also to guide global work, especially among older adults. 49. Improving end of life symptom assessment and management among critically ill older adults. NIH funded studies from the Marcus Institute have provided further evidence to guide symptom palliation at end of life. A publication from this work is now required reading for maintenance of board certification in Neurocritical Care by the United Council for Neurological Subspecialties. 50. Prior falls, fractures, low grip strength, and elevated HbA1c are risk factors for fractures in older adults with type 2 diabetes; evaluation of these factors may improve opportunities for early intervention and reduce fractures in this high-risk group. 51. Vascular dysfunction with aging contributes to the deficits specifically in cortical bone density and microarchitecture. 52. More than one-third of women and men age 65+ cohort members of the Framingham Heart Study had CT imaging evidence of new or worsening moderate-to-severe disc and facet joint degeneration over 6 years; the high frequency of degenerative findings in asymptomatic older adults suggests cautious interpretation of imaging results. Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM 53. More than 50% of the variation in thoracic spine curvature in older adults is under genetic control and shares genetic factors with other age-related spine traits including trunk muscle size, vertebral fracture, and bone mineral density. 54. Consumption of an anti-inflammatory diet (e.g., a diet consisting of nutrients like fiber, vitamin A, and vitamin C) is associated with reduced odds of frailty onset. 55. The home air temperature influences sleep, mood, cognitive function, and subjective wellbeing of older adults. The specific relationships between temperature and these health outcomes can be used to optimize the home environment based on older adults' unique and ever-changing physiology. 56. We developed a fracture prediction model to predict fracture in nursing home residents, and made it publically available on a website. The model is being used to identify nursing home residents at greatest risk for injury and target interventions to reduce the risk of injury. The model is comprised entirely from data that is already collected on every nursing home resident in the United States, and thus, it has the potential to be used more broadly to prevent fracture in high risk residents. 57. We conducted a series of studies including a pragmatic randomized control trial and sampling survey to identify effective strategies to increase COVID-19 vaccination rates in nursing home staff. Results have been disseminated through peer reviewed journals and also through the American Health Care Association. 58. We developed a novel remote injury prevention service that could provide recommendations to deprescribe medications associated with falls and consideration of osteoporosis medications for high risk nursing home residents. This model could be readily adopted by a nursing home chain. 59. A multifaceted state-wide COVID-19 prevention program in Massachusetts Nursing Homes reduced the incidence of COVID-19 infection, and was equally effective in Black residents or residents with dementia, who were at the highest risk of infection and its complications. 60. The Marcus Institute's data coordinating center currently supports 15 randomized clinical trials testing novel interventions for the promotion of functional independence, amelioration of lethargy and fatigue, management of chronic pain, prevention of cognitive decline, and other outcomes relevant to the health of older adults. 61. In a study of forty older adults living in nursing homes, delirium was identified in 10% of residents the day after COVID-19 vaccination. Delirium after COVID-19 vaccination all resolved without complications, which contrasts with complications of COVID-19 itself. Therefore, the risk-benefit ratio strongly supports vaccination in this population. (Mak, et al. Delirium after COVID-19 vaccination) 62. We collected and compiled a database of various measurements from 560 older adults aged 70 and older undergoing major non-cardiac surgery. With this as our source, we found that the administration of benzodiazepines to older adults hospitalized after major surgery is associated with increased post-operative delirium. Additionally, a novel and important independent risk factor for delirium was uncovered: lack of private insurance, a social determinant of health reflecting socioeconomic status. Delirium is associated with an acceleration in cognitive decline out to six years following elective surgery. (Duprey, et al. Association between perioperative medication...; Arias, et al. Social determinants of health...; Kunicki, et al. Six-Year Trajectory...) 63. Through interviews done with older adults between July - December 2020, we found that resilience factors may mitigate adverse health outcomes associated with loneliness. Larger social network size moderates the effect of loneliness on physical function, and activity engagement moderates the effect of loneliness on mental health. (Liu, et al. Association of loneliness...) 64. The Marcus Institute Health Care Services Area continues to participate in the project, Individualized Care for Older Persons with Complex Chronic Conditions (I-CARE4OLD), funded by the European Union's Horizon 2020 research and innovation program under grant agreement No. 965341. Activities include a secondary analysis of existing data from the interRAI Home Care and MDS tools to create prediction/risk models for the following outcomes: functional decline, cognitive decline, increase frailty, death, hospitalization, and decreased health-related quality of life. The profiles are examined, evaluated and validated through a longitudinal analysis of cross-national cohorts of home care and nursing home admissions from across the globe. 65. Among 59 genomic loci for skull bone mineral density, four novel loci were also implicated in a condition called craniosynostosis, which is a birth defect where sutures between bones in a child's skull close too soon Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT THIS IS NOT APPLICABLE AS IN MASSACHUSETTS ONLY ACUTE HOSPITALS FILE COMMUNITY BENEFIT REPORTS WITH THE STATE. HRC PROVIDES ITS SCHEDULE H FILING TO THE STATE VIA THE MASSACHUSETTS HOSPITAL ASSOCIATION. Schedule H, Part I, Line 7g Subsidized Health Services The reported subsidized health services include costs of Great Days for Seniors Adult Day Health programs based at Hebrew Rehabilitation Center in Roslindale and at 2Life on Wallingford Road in Brighton. Due to the Public Health Emergency (PHE), the two centers were closed during the second half of FY2020. We expect to resume services in August 2021. The service is funded by Medicaid and self-pay. The Medicaid loss is included with Medicaid in line 7b. The service is priced for affordability and operates at a loss when total costs are included. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 1329426 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The costing methodology used is based primarily on the standard cost accounting methods of the Massachusetts State Center for Health Information and Analysis (CHIA) Cost Report, which follows the standard Medicare cost accounting principles of the Medicare Cost Report. To cost some specific programs, a cost to charges ratio specific to each program was developed. Schedule H, Part II Community Building Activities Founded in 1903 with the promise to honor our elders, Hebrew Rehabilitation Center (HRC) is an essential member of the Greater Boston health care community. The HRC Roslindale campus, a long-time cultural touchstone in the area, opened in 1963. HRC opened a satellite in Dedham at NewBridge on the Charles in 2009. At HRC patients and families receive industry-leading care, and our staff do incredible work that reverberates globally. HRC is committed to caring for the underserved, as 90% of the seniors served are low-income. As a chronic care hospital that primarily serves a community of older adult, it is our priority to keep people healthy, safe, and independent in their homes for as long as possible. HRC places great emphasis on educating older people and their loved ones on the necessary steps and care needed to remain independent. HRC does this through outpatient care at its satellite clinics in supportive senior housing, adult day health programs that help at-risk seniors stay at home, outpatient rehabilitative care designed to prevent re-hospitalizations, and many supportive programs and services that improve the physical and mental health and lives of older people. As such, HRC community activities are designed to improve the health of our inpatients and ambulatory patients, as well as older residents in the communities in which we operate. HRC's community activities are also designed to teach the next generation of caregivers, which includes our own staff and external learners across Boston. HRC contributed $160,000 to Workforce Development through career development programs, including a Certified Nurse Assistants (CNAs) Training program and dietetic internship, enabling employees to move into higher wage positions in healthcare support positions. The Nurse Assistant Training Program at Hebrew Rehabilitation Center prepares learners for continued employment as entry-level certified nurse assistants (CNA) through a combination of classroom and clinical education. This program is approved by the Massachusetts Department of Public Health (MA DPH) and emphasizes basic nursing assistant skills and related knowledge. The program includes costs of software and remedial support for English as a Second Language (ESOL), pays the candidates to attend class, and covers the certification exam, scrubs, and transportation. Upon successful completion of the MA State Competency Exam, administered through HDMaster, the CNA will be recognized on the Massachusetts Health and Human Services Licensed Professionals Registry. Twenty-one students have successfully completed the program in 2023. The Hebrew Rehabilitation Center (HRC) Dietetic Internship is a 9-month, full-time program running from September to May. We provide training in a long-term chronic care hospital with a focus on the aging population and clinical rehabilitation through a supervised practice experience designed to provide a strong theoretical knowledge base with practical experiences in sub-acute clinical nutrition, outpatient nutrition services, community nutrition, food service management, skilled nursing, and long-term medical care. Graduates of the program are eligible to sit for the Commission of Dietetic Registration credentialing examination for Registered Dietitians (RD). Upon completion of the program, dietetic interns receive a signed Verification Statement. Once dietetic interns have both a graduate degree and the DI verification statement, they are eligible to take the registration examination for dietitians as administered by the Commission on Dietetic Registration (www.cdrnet.org). HRC offers several opportunities for employees to receive scholarships to pursue their educational goals: * The Hebrew SeniorLife Scholarship Program provides employees and their families the opportunity to increase their education and skills at area programs towards any type of education advancement. In 2023, 26 scholarships for a total of $112,350. * Career Development offers scholarships to employees who are pursuing an LPN, RN, NP, or DNP pathway. In 2023, there were 8 scholarships in progress (those are recurrent annually) and 5 new scholarships awarded for a grand total of 103,043. * The NewBridge Scholarship Fund offers scholarships to support educational opportunities for qualifying employees. In 2023 $158,584.00 was disbursed to 28 NewBridge Scholars. * Orchard Cove maintains a scholarship program designed to provide qualifying employees with financial assistance to further their education, improve work performance and increase staff retention. In 2023 Orchard Cove granted 13 scholarships totaling $40,500. * The Jamie and Harold Kotler HELP Fund provides employees tangible and meaningful support through some of life's most challenging and emotional transitions. HELP (HSL's Employee Lifeline Program) was designed by a group of employees and is funded through employee and Development efforts. In 2023, The Kotler HELP Fund made grants to 17 HSL employees for a total of $11,928.32 disbursed. HRC serves as a primary training facility for 48 affiliate academic institutions in the Greater Boston area, including: Harvard Medical School, Northeastern University, Simmons University, among others. In 2023 HRC trained more than 400 students in a wide variety of health professions including: medicine, nursing; pharmacy; dentistry; physical, occupational, speech, and expressive therapies; clinical pastoral and social work. HRC seniors actively participate in the education of 164 Harvard Medical School students annually through role-playing sessions that allow our seniors to provide important and vital feedback to the next generation of doctors on how to effectively communicate and treat older adults. In 2023 HRC served as the nurse aide training facility for several long-term care facilities in the Boston area including; Sherrill House, The Boston Home, CareOne Brookline, and the Neville Center to help their sites overcome the nurse aide workforce challenges. In 2023, HRC's Department of Medicine's 29 physicians, 1 PhD, and 21 NPs devote 2,582 hours, the equivalent of $352,656 to teaching geriatric medicine . An additional 91 researchers and allied clinical and specialty support educators provide 26,055 hours of instruction, the equivalent of $1,129,306 annually . HRC reestablished their partnership with Edward M. Kennedy Academy for Health Careers, which opened the door for 28 high school students to gain clinical experience and hours needed to be eligible for the state certified nursing exam. HRC is currently in the process of onboarding an additional 30 students from EMK to complete their clinical rotation. The partnership has also expanded to include a summer internship to help students explore careers in healthcare. HRC also trained three dental residents from Boston University School of Dental Medicine on geriatric dental medicine. HSL's Chaplaincy Institute is a nationally respected leader in chaplaincy education with expertise in Jewish spiritual care, geriatrics, dementia, trauma-informed care, the nonreligious, and LGBTQ aging. The Institute trains 20 graduate level students in spiritual care (Clinical Pastoral Education, accredited by The Association for Clinical Pastoral Education) over the course of a year. Other economic development, physical improvements, and environmental benefits were identified but not specifically costed in Part II. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount HRC RECORDS PROVISION FOR DOUBTFUL ACCOUNTS AS THE AMOUNT NEEDED TO ADJUST THE RESERVE, WHICH IS BASED ON ESTIMATED PERCENTAGES OF ACCOUNTS RECEIVABLE BY PAYOR AND AGING CATEGORY. IF NOT ALREADY ADJUSTED BY CONTRACTUAL ALLOWANCE, THE CHARGE FIGURE IS ADJUSTED TO COST USING HRC'S OVERALL COST TO CHARGE RATIO. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote HRC ESTIMATES AN ALLOWANCE FOR UNCOLLECTIBLE PATIENT ACCOUNTS. GENERALLY, NO FINANCE CHARGES ARE ASSESSED ON RECEIVABLES. ONCE AN ACCOUNT HAS BEEN DETERMINED TO BE UNCOLLECTIBLE, IT IS CHARGED-OFF. PLEASE SEE FOOTNOTE ON PAGE 17 OF THE AUDITED FINANCIALSTATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE HOSPITAL ACHIEVED A SLIGHT MARGIN ON MEDICARE THAT HELPS DEFRAY THE LOSS ON MEDICAIDLONG TERM CHRONIC CARE. THE GAIN IS DUE IN PART TO THE SITE NEUTRAL PAYMENT PROVISION THAT WERE TEMPORARILY WAIVED DURING THE PHE. ALSO, THE LTAC VENT PROGRAM WAS ENDED, AND VENTWEANED PATIENTS WERE MOVED TO LONG TERM CHRONIC FLOORS. HRC CONTINUES TO TREAT ACUTE CASES, BUT THE LENGTH OF STAY IS NOW IN LINE WITH THE DRG GEOMETRIC MEAN LENGTH OF STAY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance PATIENTS FOUND TO BE ELIGIBLE FOR ASSISTANCE THROUGH MASSACHUSETTS MEDICAID (KNOWN AS MASSHEALTH) OR OTHER PROGRAM ARE NOT PURSUED THROUGH COLLECTION EFFORTS BUT RATHER ARE ASSISTED FREE-OF-CHARGE WITH THE MASSHEALTH APPLICATION AND ELIGIBILITY PROCESS THROUGH TO COMPLETION, INCLUDING ANY NECESSARY APPEALS. Schedule H, Part V, Section B, Line 16a FAP website - HEBREW REHABILITATION CENTER: Line 16a URL: SEE PART VI - SUPPLEMENTAL INFORMATION; Schedule H, Part V, Section B, Line 16b FAP Application website - HEBREW REHABILITATION CENTER: Line 16b URL: SEE PART VI - SUPPLEMENTAL INFORMATION; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - HEBREW REHABILITATION CENTER: Line 16c URL: SEE PART VI - SUPPLEMENTAL INFORMATION; Schedule H, Part VI, Line 2 Needs assessment In 2022, HRC updated its 2019 Community Health Needs Assessment (CHNA). We re-evaluated the needs of our community and the services we offer as well as those offered by others within and around the communities we serve. Our CHNA findings show that seniors in our communities need assistance with Geriatric Specialists and Services, Behavioral/Mental Health, In-Home Health, and Social Determinants of Health. In response to these findings, HRC developed an implementation plan documenting goals, our current services, and our action plan and timeline. HRC completed its 2022 Community Health Needs Assessment (CHNA) in September 2022, which may be found at https://www.hebrewseniorlife.org/about-us/community-partnerships Schedule H, Part VI, Line 3 Patient education of eligibility for assistance ALL PATIENTS ADMITTED TO HRC ARE COUNSELED BY AN ADMISSIONS COORDINATOR ABOUT SERVICES RENDERED, BILLING PROCEDURES, PATIENT RIGHTS AND RESPONSIBILITIES, INSURANCE COVERAGE, AND ELIGIBILITY FOR ASSISTANCE AS REQUIRED BY GUIDELINES ESTABLISHED BY THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES AND THE COMMONWEALTH OF MASSACHUSETTS' DEPARTMENT OF PUBLIC HEALTH. IN ADDITION TO THE ADMISSIONS COORDINATOR, A FISCAL AGENT FOR HRC ALSO PROVIDES EDUCATION ON ELIGIBILITY UNDER FEDERAL, STATE AND LOCAL PROGRAMS. ALL ADMISSIONS DOCUMENTATION IS REVIEWED AND SIGNED BY THE PATIENT OR RESPONSIBLE PARTY ON BEHALF OF THE PATIENT AT THE TIME OF ADMISSION AND RETAINED ON FILE. Schedule H, Part VI, Line 4 Community information HRC honors diversity and provides health care services to all without regard to religion, culture, race, color, national origin, class background, gender, sexual orientation, gender expression, marital status, political persuasion, or qualified handicap. HRC provides patient care and services in Roslindale, at the HRC satellite on the NewBridge on the Charles campus in Dedham, and at the outpatient clinics in Dedham and Canton. 95% of the patients of Hebrew Rehabilitation Center and its satellite medical clinics are on Medicare and are older than 65. In summary, our primary community is comprised of seniors and low-income 65+, in certain neighborhoods of Boston and the towns of Brookline, Chestnut Hill, Dedham, Needham, Newton, Wellesley, Weston, and Westwood. Schedule H, Part VI, Line 5 Promotion of community health Hebrew Rehabilitation Center (HRC) operates a 675-bed licensed chronic care hospital consisting of a 455-bed facility in the Roslindale section of Boston, MA and a 220-bed satellite facility in Dedham, MA (also known as the HRC-NewBridge, on the campus of the continuing care retirement community operated by NewBridge on the Charles, Inc.). HRC-NewBridge leases space from NewBridge on the Charles, Inc., an affiliated entity, to operate the 220-bed satellite. HRC also operates two outpatient clinic satellites on Hebrew SeniorLife campuses: NewBridge on the Charles, Dedham, MA, and Orchard Cove, Canton, MA. HRC is accredited by CARF (Commission on Accreditation of Rehabilitation Facilities) and is the only geriatric specialist affiliated with Harvard Medical School. Services provided by HRC include long-term chronic care, medically complex care, post-acute rehabilitative care, primary and specialty care, outpatient clinics, outpatient therapy services, and adult day care. HRC is part of the Hebrew SeniorLife health care continuum, which includes home health care and private care, hospice care, and community palliative care. Hebrew SeniorLife, Inc., is HRC's sole member and also provides management services to HRC. Hebrew SeniorLife is a Harvard Medical School affiliate and a national thought leader in aging, senior health care, senior living, research and teaching, HSL is governed by a large and active community board comprised entirely of independent persons from the community. HRC, as a subsidiary of HSL, has a board comprised of three employees (President, CEO, CFO) and two independent directors who are also members of HSL's Board of Directors (including the Board Chair). Surplus funds, should they exist, are reinvested in HRC as capital investment, for upkeep of the facility and for growing patient medical equipment and technology needs. Schedule H, Part VI, Line 7 State filing of community benefit report MA X X X X X X false false false false false false false false false JAMES D HART SECRETARY & CHIEF FIN. OFFICER 0 372217 0 111480 0 427 0 5800 0 61845 0 551769 0 0 LOUIS J WOOLF PRESIDENT AND CEO (end 07/2023) 0 702834 0 496184 0 0 0 5800 0 83470 0 1288288 0 0 KATELYN QUYNN CHIEF DEV OFF & VP BOARD REL. 0 364873 0 162871 0 411 0 5800 0 49944 0 583899 0 0 ERIC ROGERS CHIEF INFORMATION OFFICER 0 275309 0 54184 0 148 0 5800 0 65339 0 400780 0 0 KIMBERLY J BROOKS CHIEF OP. OFFICER, SEN LIVING 0 304647 0 189799 0 143 0 5800 0 59041 0 559430 0 0 SARAH L SYKORA CHIEF COMM. & PLAN OFFICER 0 224300 0 23076 0 97 0 3728 0 59530 0 310731 0 0 RACHEL LERNER ESQUIRE GEN. CNSL. & CHIEF COMP. OFF. 0 256008 0 0 0 62 0 5800 0 52098 0 313968 0 0 LINDA THOMPSON CHIEF PEOPLE OFFICER 0 245398 0 55000 0 381 0 0 0 34435 0 335214 0 0 LEWIS LIPSITZ MD DIR, HMIFAR & CHIEF ACAD. OFF 378332 0 50985 0 0 0 5800 0 82972 0 518089 0 0 0 TAMMY B RETALIC MS RN CHIEF NURSING OFF. & VP PCS 283604 0 58394 0 268 0 4853 0 64593 0 411712 0 0 0 MANDEL I ERNEST MD CHIEF MEDICAL OFFICER 226591 0 0 0 0 0 4532 0 11003 0 242126 0 0 0 KATHYRN W TASKER CHIEF SPONSORED AWARDS OFFICER 234389 0 0 0 156 0 4889 0 63164 0 302598 0 0 0 RACHEL WHITEHOUSE CHIEF COMM. & PLAN OFFICER 0 273238 0 39677 0 278 0 5460 0 63569 0 382222 0 0 MARY MOSCATO FACHE PRESIDENT, HSL HC SVCS. & HRC 399445 0 127533 0 0 0 5800 0 40316 0 573094 0 0 0 HELEN CHEN MD CHIEF MEDICAL OFFICER 361383 0 111354 0 238 0 5800 0 39646 0 518421 0 0 0 SHARON K INOUYE SR. SCIENTIST/DIRECTOR 350084 0 13396 0 820 0 5800 0 31481 0 401581 0 0 0 ALVARO PASCUAL-LEONE SR. SCIENTIST/DIRECTOR 343902 0 0 0 411 0 5800 0 51812 0 401925 0 0 0 ERAN D METZGER MEDICAL DIRECTOR, HSL PSYCH. 303703 0 0 0 442 0 4926 0 39281 0 348352 0 0 0 INNOKENTIY BAKAEV MEDICAL DIRECTOR, RSU AND LTCH 290441 0 0 0 56 0 4177 0 44454 0 339128 0 0 0 RASHMI KAURA MEDICAL DIRECTOR OF HOSPICE AND PALLIATIVE CARE 285008 0 0 0 143 0 5700 0 26989 0 317840 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Hebrew Seniorlife, Inc. (HSL), the parent organization, establishes compensation of the organization's President/CEO and CFO. HSL utilizes the following in establishing such compensation: compensation committee, written employment contract, independent compensation consultant, compensation survey or study, & approval by the board or compensation committee. Form 990, Part VI, Line 6 Classes of members or stockholders HSL is the sole member of the organization. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The HSL board chair appoints the members of the HRC board of directors with the advice and consent of the HSL board members. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Classes of persons, decisions requiring approval and type of voting rights decisions involving major changes in organization, debt placement, sale of assets, etc. are also subject to approval by HSL's board. Ultimately, governance of the corporation rests with the board of directors of the company's sole corporate member, HSL. Form 990, Part VI, Line 11b Review of form 990 by governing body Preparation of the Form 990 begins internally with HSL staff and Forvis Mazars preparing the form with information from HSL staff and the HSL audit. All forms 990 and 990-T of the affiliates of HSL (HSL is the sole corporate member of each affiliate) will be reviewed prior to filing by the audit & compliance committee of HSL. Subsequent to such review, and prior to filing, copies will be provided to the appropriate governing board of directors for each affiliate. The governing boards will have five days time in which to view the full returns prior to their filing. Form 990, Part VI, Line 12c Conflict of interest policy The board of HRC voted to adopt the HSL conflict of interest policy. Monitoring and dealing with potential or actual conflicts: Individuals covered under the conflict of interest policy have an affirmative duty to disclose the existence or possibility of a conflict of interest and shall be given the opportunity to disclose all material facts to the HSL conflicts committee. The organization's conflict of interest policy provides that annually, each covered person shall sign a statement affirming that such person received a copy of the conflict of interest policy, read and understands the policy and agrees to comply with the policy. The signed statement affirms that the person understands HRC is a charitable organization and that in order to maintain its tax-exempt status, HRC must engage in activities which accomplish one or more of its tax-exempt purposes. Who is covered: The conflict of interest policy covers all directors, officers, members of committees with board delegated powers, persons serving in senior staff positions outlined in an exhibit attached to the conflict of interest policy, and any other person who is in a position to exercise substantial influence over the affairs of any of the organization or any of its affiliates. Level at which determinations of conflict are made and which actual conflicts are reviewed: The HSL conflicts committee is responsible or determining if a conflict of interest exists and evaluating whether the organization can obtain with reasonable efforts a more advantageous transaction or arrangement from a transaction that would not give rise to a conflict of interest. The conflicts committee reports its findings to the board of directors who are responsible for making a final determination on the conflict. Restrictions on conflicted persons: All covered persons are restricted from entering into a transaction without disclosing the actual or potential conflict to the HSL conflict committee and obtaining approval of the board of directors. Covered persons with a conflict must leave the room when transactions giving rise to the conflict are under discussion by the board of directors. Form 990, Part VI, Line 15b Process to establish compensation of other employees The compensation committee of the HSL board, with the assistance of data provided by an independent, expert consultant, has reviewed the president/CEO's total compensation and the compensation of all officers and key employees as well as highly compensated employees (> $150,000) of HSL and its affiliates. The full HSL board further reviewed and approved the compensation of the officers, key employees and highly compensated employees of HSL and its affiliates. The review and approval procedures outlined above were last completed in 2018. Additionally, the organization completed a walk through of senior leadership compensation with an independent, expert consultant, during 2019. All of these committee members are independent directors. Independent consultants were hired by the compensation committee and assisted with the compensation review. Documentation and records of compensation committee meetings are maintained with respect to deliberations and compensation decisions. Form 990, Part VI, Line 19 Required documents available to the public The organization's tax returns are available at www.guidestar.org. Governing documents are available at the Commonwealth of Massachusetts' website. The tax returns, conflict of interest policy, and financial statements are also available upon request at the offices of HSL at 1200 Centre Street, Boston MA, 02131 or by telephone and e-mail. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfers to Affiliates - -162825; Form 990, Part I, Line 1 Organization's Mission As an affiliate of Hebrew Seniorlife, Inc. (HSL), the mission of the Hebrew Rehabilitation Center (HRC) is to honor our elders, by respecting and promoting their independence, spiritual vigor, dignity and choice, and by recognizing that they are a resource to be cherished. As part of our mission, we accept special responsibility for the frailest and neediest members of or community who are most dependent on our care. We seek to fulfill our mission by operating programs in: - Memory Care - Rehabilitative Therapy - Expressive Therapy - Palliative Care - Life Enhancement - Spiritual Care - Russian Language Form 990, Part III, Line 4a Three Largest Program Services HRC offers long-term care management, rehabilitative, and extended medical care that meets the chronic and acute medical needs of older adult patients in a therapeutic and healing environment. Care is provided in a home-like setting and tailored to the individual needs of each patient. In addition to expert geriatric medical care provided by physicians and nurse practitioners from our onsite department of medicine, a multidisciplinary team offers a wide range of therapeutic programs that maximize function with the goal of helping our patients maintain independence for as long as possible. Examples of our program services are as follows: 1. Memory Care: HRC has memory care units in two locations to serve seniors with moderate to advanced memory loss who need special services and accommodations to keep them safe and engaged. We provide to our long-term chronic memory care patients services such as expressive therapies involving music and art, which build on and support their abilities, talents, and interests. We will focus on what residents can still do, rather than on what they can't, thereby offering opportunities for accomplishment, success, and joy each day. 2. Expressive Therapy: Expressive therapy is a dynamic, multimodal approach to integrating the arts into the healing process. Used within the context of a health care or rehabilitation setting, expressive therapies like music, art, and dance can foster healing and provide an overall sense of well-being and connection to others. HRC employs expressive therapists who function as members of the multidisciplinary health care team to provide treatment to seniors. Therapists are masters-level mental health counselors who are also professionally trained in their respective disciplines (e.g., art, music, etc.). The overall goals of treatment are to provide a safe, secure setting in which patients can express themselves on both verbal and non-verbal levels. Patients also feel an increased connection to others that in turn decreases their level of distress and psychological discomfort. 3. Palliative Care: Since 2007, the HRC palliative care program has been helping patients maximize the quality of life while maintaining dignity and control as they navigate the journey of serious and terminal illness. The palliative team comprising of counselors, doctors, nurses, health aides, and therapists, accomplish this by providing medical information, asking questions, and supporting the patient and family's decisions. The palliative care team also takes measures to provide medical help, massage, music therapy, and other interventions to make the patient's journey as comfortable as possible. Form 990, Part I, Line 22 Description of Negative Net Assets THE DECREASE IN UNRESTRICTED NET ASSETS AND UNRESTRICTED NET DEFICIT AT HRC FOR FISCAL YEAR 2023 REFLECTS THE INCLUSION OF EXPENSES THAT ARE SUPPORTED BY HRC'S PARENT, HSL. HSL BENEFITS FROM BOTH MANAGEMENT FEES AND PHILANTHROPIC INCOME THAT ARE AVAILABLE TO FUND HRC'S OPERATING, PENSION FUND, AND OTHER EXPENSES. AS SUCH, HSL'S MANAGEMENT, BOARD OF DIRECTORS, AND LENDERS VIEW THE ORGANIZATION'S FINANCIAL CONDITION AS HSL AND HRC'S COMBINED BALANCE SHEET, WITH $304.2 MILLION IN UNRESTRICTED NET ASSETS AT 9/30/23. Hebrew Seniorlife Hospice Care Inc 1200 Centre Street Boston MA 02131 461309228 Elder Housing MA 501(c)(3) 10 HSL true Newbridge on The Charles Inc 1200 Centre Street Boston MA 02131 383707573 Elder Housing MA 501(c)(3) 10 HSL true Orchard Cove Inc One Del Pond Drive Canton MA 02021 223080006 Cont. Car MA 501(c)(3) 10 HSL true HRCA Senior Housing Inc 1200 Centre Street Boston MA 02131 042765428 Elder Housing MA 501(c)(3) 10 HSL true CTR Communities of Brookline Inc 1200 Centre Street Boston MA 02131 010569404 Elder Housing MA 501(c)(3) 10 HSL true HRCA Brookline Housing 112-120 Centre Court Inc 1200 Centre Street Boston MA 02131 030372998 Elder Housing MA 501(c)(3) 10 HSL true HRCA Housing for Elderly Inc 1200 Centre Street Boston MA 02131 042543731 Elder Housing MA 501(c)(3) 10 HSL true HRCA Brookline Housing 108 Centre Street Inc 1200 Centre Street Boston MA 02131 810612222 Elder Housing MA 501(c)(3) Type II HSL true Hebrew Seniorlife Inc 1200 Centre Street Boston MA 02131 900183119 Mgmt Services MA 501(c)(3) 7 NA false Hebrew Seniorlife Affiliated Medical Group Inc 1200 Centre Street Boston MA 02131 823654673 Physician Svc MA 501(c)(3) 10 HSL true HRCA Brookline Housing 1550 Beacon Plaza Inc 1201 Centre Street Boston MA 02131 010569403 Elder Housing MA 501(c)(3) 10 HSL true CCB Cohen 112 Centre MM LLC 1200 Centre St Boston MA 02131 821763395 Elder Housing MA NA N/A 0 0 false 0 false 0 HSL Fireman Operating LP 640 N Main St Randolph MA 02368 844212813 Elder Housing MA NA N/A 0 0 false 0 false 0 HSL Payroll Services Inc 100 Centre Street Brookline MA 02446 042684823 Payroll Services MA NA C Corporation 0 0 0 false Hebrew Seniorlife Reage Solutions Inc 1200 Centre Street Boston MA 02131 814906048 Mgmt & Cons. Svcs DE NA C Corporation 0 0 0 false false false false false false false false false false true true true true false false true true true true