2025-08-15T12:34:43-05:00 2024-09-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 26204 990 2023-10-01 222667354 BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC BETH 5087462000 CO BILH TAX 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 RAFAEL HERNANDEZ VP, BILH CORPORATE TREASURER 5087462000 2025-08-14 0 1 ANGELA M MOORE P00244342 3174648600 2025-08-12 2023 2025-03-06 01:10:19Z X KEVIN TABB MD C/O BILH TAX 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 389851554 0 X WWW.BIDPLYMOUTH.ORG X 1985 MA SEE SCHEDULE O. 19 15 2207 160 1317666 0 4388076 3488824 360314619 378829624 170922 1197609 4244782 6050060 369118399 389566117 0 92395 0 0 158716757 165686481 31848 44978 1281721 206261702 228052620 365010307 393876474 4108092 -4310357 214499502 226989595 117122090 143000706 97377412 83988889 X SEE SCHEDULE O. 0 0 342731051 92395 186892568 OUTPATIENT CLINICS AND SERVICES- SEE SCHEDULE O. 167430821 INPATIENT MEDICAL/ SURGINCAL AND INTENSIVE CARE- SEE SCHEDULE O. 28177857 EMERGENCY DEPARTMENT- SEE SCHEDULE O. 342731051 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 X 388 0 1 2207 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 19 15 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 0 FL MA NC NH NY SC X KAREN WOLFSON AVP TAXATION 7817448924 BILH SCHRAFFTS CITY CENTER 4TH CHARLESTOWN MA 02129 ROWAN MICHAEL TTEE(EXO)(CEO DESIG)EVP HOS&AMB BILH 1.00 64.00 X 0 2302117 2401778 SHORETT PETER TTEE(CEO DESIG) (SR EVP & COO, BILH) 1.00 64.00 X 0 1559476 48246 COUGHLIN KEVIN PRESIDENT & TRUSTEE (EX-OFFICIO) 55.00 2.00 X X 770656 0 53764 BURNS ERIN TRUSTEE 55.00 2.00 X 610111 0 80531 KELLY MD DAVID TRUSTEE & VICE CHAIR 55.00 2.00 X X 602450 0 83362 MCGILL KRISTINA TRUSTEE; PHARMACY MANAGER (PER DIEM) 55.00 2.00 X 6465 0 0 KAPELL JEFF TRUSTEE & CHAIR 1.00 2.00 X X 0 0 0 BLAIR RAYMOND TRUSTEE 1.00 2.00 X 0 0 0 CARR ALLISON GILLMORE TRUSTEE 1.00 2.00 X 0 0 0 CARUCCI DEAN TTEE (EXO) (BILH DIV PRES COMMUNITY) 1.00 12.00 X 0 0 0 HEWITT CHARLES TRUSTEE 1.00 2.00 X 0 0 0 HORWITZ-WILLIS NATE TRUSTEE 1.00 3.00 X 0 0 0 JOHNSON JOHN TRUSTEE 1.00 2.00 X 0 0 0 KENNISTON MD JULIA TTEE (EX-OFF) (PRES, MEDICAL STAFF) 1.00 2.00 X 0 0 0 KOWALOFF MD HARVEY TRUSTEE 1.00 2.00 X 0 0 0 MARBLE MEGAN VAYO TRUSTEE 1.00 2.00 X 0 0 0 MARINI ANNA TRUSTEE 1.00 2.00 X 0 0 0 MCGRATH JOHN TRUSTEE 1.00 2.00 X 0 0 0 MCKENNA CATHERINE TRUSTEE 1.00 2.00 X 0 0 0 SHIELDS MARY TRUSTEE 1.00 2.00 X 0 0 0 SPENCER LUIS TRUSTEE 1.00 2.00 X 0 0 0 TABB MD KEVIN CEO (EX-OFF) (CEO, BILH) 1.00 64.00 X 0 4313387 1097028 RIOS CINDY TREAS (EX-OFF) (EXEC VP & CFO, BILH) 1.00 64.00 X 0 1471427 217736 KATZ ESQ JAMIE CLERK (EX-OFF); GENERAL COUNSEL BILH 1.00 63.00 X 0 1270175 32002 JENKINS JIM ASST TREAS (EX-OFF), CFO 55.00 2.00 X 404337 0 30468 RANGAVIZ SHEILAH ASST TREAS (EX-OFF), CFO 1.00 60.00 X 0 336544 16067 ARMSTRONG ESQ EMILY ASST CLERK (DIV VP DEP GC BOS, BILH) 1.00 61.00 X 0 309666 41550 GEE ESQ CARROLL ASST CLERK (ASSOC GEN COUNSEL, BILH) 1.00 60.00 X 0 180814 41396 THOMAS MD TENNY CHIEF MEDICAL OFFICER 55.00 0.00 X 647621 0 77006 TIERNEY MD MATT CHIEF OF SURGERY 1.00 55.00 X 0 594170 74037 CHAPIN RN MS MARY VP, AMBUL SVCS & PROCESS IMPROVEMT 55.00 0.00 X 353971 0 303507 RUTHERFORD RON VP, CIO, & VP, SUPPORT SERVICES 55.00 1.00 X 314016 0 259447 DOHERTY RN DONNA CNO & SVP, PATIENT CARE SERVICES 55.00 0.00 X 398271 0 35668 ABOU RJEILY MD CHARBEL CHIEF OF MEDICINE 55.00 0.00 X 325756 0 67863 BAKER WENDY VP, HUMAN RESOURCES BUSINESS PARTNER 55.00 0.00 X 272222 0 23087 BETTERIDGE MD DAVID R DIAGNOSTIC RADIOLOGIST 55.00 0.00 X 661466 0 63021 OLIWA MD NEIL ANESTHESIOLOGIST 55.00 0.00 X 622967 0 74295 MASSENGALE MD JUSTIN CARDIOLOGIST 55.00 0.00 X 606240 0 61568 FINE MD COLLEEN W RADIOLOGIST 55.00 0.00 X 603503 0 47650 GALVIN MD JAMES M RADIOLOGIST 55.00 0.00 X 597215 0 46443 DWYER MARY CONTROLLER; FMR INT ASST TREAS &CFO 0.00 0.00 X 212529 0 28810 BROWNING MD THOMAS FORMER CHIEF OF MEDICINE 0.00 55.00 X 0 244869 54502 8009796 12582645 5360832 630 1 1 0 BETH ISRAEL LAHEY HEALTH INC 529 MAIN STREET CHARLESTOWN MA 02129 PROFESSIONAL & OTHER SERVICES 167609683 AMERISOURCEBERGEN DRUG CORP PO BOX 29808 NEW YORK NY 10087 PHARMACEUTICAL & HEALTHCARE SVCS 46996160 VAYA WORKFORCE SOLUTIONS LLC 5930 CORNERSTONE COURT WEST SAN DIEGO CA 92121 STAFFING SERVICES 18950456 ASSOCIATED PHYSICIANS OF HMFP 375 LONGWOOD AVENUE BOSTON MA 02215 LEASED PHYSICIAN SERVICES 11446882 CARDINAL HEALTH INC PO BOX 13862 NEWARK NJ 07188 HEALTHCARE SERVICES 5801018 151 23315 3465509 9333 3488824 OUTPATIENT CARE 621400 182664876 182664876 INPATIENT CARE 621400 167430821 167430821 EMERGENCY DEPT 621910 28177857 28177857 SERVICES TO AFFILIATES 622110 556070 556070 378829624 908551 100407 808144 151783 64495 87288 87288 27434 59854 510000 220942 289058 289058 56667 232391 0 23315 0 0 REBATES AND REFUNDS 622110 2557487 2557487 CAFETERIA & GIFT SHOP 722514 1204197 1204197 FEDERAL RECOVERY 923000 1067020 1067020 1134068 47115 1133158 -46205 5962772 389566117 382501246 1317666 2258381 X 92395 92395 5719542 5464918 254624 241339 230553 10786 125016055 119428911 5587144 3517937 3360715 157222 20192808 19289372 903436 10998800 10507248 491552 50894767 11486949 38171075 1236743 87626 87626 44978 44978 52061482 51560007 501475 1019988 982557 37431 10674576 9115571 1559005 286500 286500 1645603 1645603 9309499 7554320 1755179 424370 424370 PHARMACEUTICALS 47137340 47137340 MEDICAL SUPPLIES 40975318 40975318 MEDICAID ASSESSMENT 5395824 5395824 MAINTENANCE CONTRACTS 3810322 3810322 4329405 3982258 347147 393876474 342731051 49863702 1281721 640465 14934 34064 522101 1329849 34029259 41625894 150000 4199878 3402657 1297853 1279007 223566968 98375718 125106032 125191250 37378560 30789123 11175354 23322817 214499502 226989595 31902851 31239282 24115 42494423 35774206 42724816 75963103 117122090 143000706 X 82823072 65174838 14554340 18814051 97377412 83988889 214499502 226989595 X -4310357 4071418 -13149584 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1 0 0 0 1 0 1 87626 87626 0 PART II-B, LINE 1: BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER NETWORK AFFILIATES AND/OR PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $87,626 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES. 14554340 3267732 1026219 34240 18814051 12649667 3303153 919841 2315664 2657 14554340 14345173 1544783 -2782405 457884 12649667 12645124 1044499 1771932 1116382 14345173 12296225 906502 357015 914618 12645124 0.03000 0.97000 1 1 1 385907 385907 140317297 41020915 99296382 74206609 56089145 18117464 8657155 1265658 7391497 125191250 INVESTMENT IN BILHIP 30404686 C INVESTMENTS IN JOINT VENTURES 384437 C 30789123 DEPOSITS 505047 DEFERRED COMPENSATION 245127 LEASED ASSETS 3219223 PROFESSIONAL LIABILITY REINSURANCE RECOVERIES 8161972 OTHER 275227 ASSETS IN PERPETUAL TRUSTS 10916221 23322817 DUE TO AFFILIATES 54003439 ASSET RETIREMENT OBLIGATIONS 745860 PROFESSIONAL LIABILITY RESERVES 8473984 OTHER LIABILITIES 279956 ESTIMATED THIRD PARTY SETTLEMENTS 6075759 OPERATING LEASED LIABILITIES 3998060 DEFERRED COMPENSATION 245127 WORKERS COMPENSATION 2140918 75963103 X PART V, LINE 4: BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC.'S ENDOWMENT FUNDS ARE INTENDED TO ENSURE THAT BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. ACCOMPLISHES ITS CHARITABLE MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF ITS PATIENTS AND COMMUNITY BY PROVIDING A FULL CONTINUUM OF HEALTHCARE SERVICES. BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. DELIVERS THESE SERVICES WITH EXCELLENCE AND COMPASSION AND PROVIDES ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. THE SPECIFIC USES OF THE ENDOWMENT VARY DEPENDING ON THE NATURE OF RESTRICTIONS, IF ANY, IMPOSED BY DONORS. BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC.'S ENDOWMENT CONSISTS OF APPROXIMATELY FORTY FUNDS. INVESTMENT INCOME EARNED IS USED FOR HOSPITAL CAPITAL NEEDS, FREE CARE, AND FOR OTHER OPERATING EXPENSES AT THE DIRECTION OF THE DONORS. UNDER BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC.'S CURRENT INVESTMENT SPENDING POLICY, WHICH IS WITHIN THE GUIDELINES SPECIFIED UNDER MASSACHUSETTS STATE LAW, 5% OF THE AVERAGE OF THE FAIR VALUE OF QUALIFYING LONG-TERM INVESTMENTS APPLIED TO A THREE-YEAR MOVING AVERAGE WITH A ONE-YEAR LAG IS APPROPRIATED AS STATED BY THE DONOR WITH THE EXCEPTION OF ONE FUND, WHICH REMAINS AT 4%. IN ESTABLISHING THIS POLICY, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. CONSIDERED THE EXPECTED RETURN ON ITS ENDOWMENT AND ITS PROGRAMMING NEEDS. ACCORDINGLY, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. EXPECTS THE CURRENT SPENDING POLICY TO ALLOW ITS ENDOWMENT TO MAINTAIN ITS PURCHASING POWER AND TO PROVIDE A PREDICTABLE AND STABLE SOURCE OF REVENUE FOR THE ANNUAL OPERATING BUDGET. ADDITIONAL REAL GROWTH WILL BE PROVIDED THROUGH NEW GIFTS OR EXCESS INVESTMENT RETURN. PART X, LINE 2: BETH ISRAEL LAHEY HEALTH, INC., WHICH SERVES AS THE PARENT OF THE SYSTEM, HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE AN ORGANIZATION DESCRIBED UNDER INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ALSO DETERMINED THAT THE OTHER ENTITIES IN THE SYSTEM, EXCLUDING ITS FOR-PROFIT SUBSIDIARIES, QUALIFY AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, MEET THE CODE'S REQUIREMENTS UNDER SECTION 509(A), AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION HAS BEEN RECORDED FOR INCOME TAXES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS FOR THE YEARS ENDED SEPTEMBER 30, 2024 AND 2023, RESPECTIVELY. X X X X X X 1 DOING GOOD DIGITAL LLC 668 N COAST HWY 224 LAGUNA BEACH CA 92651 DIGITAL MARKETING 0 0 7862 -7862 RAISE THE BAR LLC 36 RANGELEY ROAD NEWTON MA 02465 REPORTING CONSULTING 0 0 11806 -11806 ZURI GROUP LLC 328 NW BOND STREET STE 204 BEND OR 97703 STRATEGY CONSULTING 0 0 22327 -22327 41995 -41995 FL MA NC NH NY SC BOSTON MARATHON 23315 23315 23315 23315 SCHEDULE G PART II THE BOSTON MARATHON EVENT REPORTED IN THIS FORM 990 SCHEDULE G IS COORDINATED BY THE BETH ISRAEL LAHEY HEALTH ("BILH") DEVELOPMENT TEAM AS AN EVENT FOR THE BILH HEALTHCARE SYSTEM. RUNNERS PARTICIPATE IN THE MARATHON AND RAISE FUNDS FOR A SPECIFIC ENTITY WITHIN THE BILH SYSTEM. BILH REPORTS ALL EXPENSES FOR THE MARATHON ON ITS FORM 990, WHILE CONTRIBUTIONS RAISED BY RUNNERS ARE REPORTED AS REVENUE ON THE FORM 990 FOR EACH HOSPITAL OR OTHER HEALTHCARE ORGANIZATION DESIGNATED BY PARTICIPATING RUNNERS. 1 1 X 1 X 400.000000000000 1 X 1 1 1 0 1 1 2335413 406810 1928603 0.00490 52610583 43040002 9570581 0.02430 54945996 43446812 11499184 0.02920 324848 324848 0.00080 235611327 194903990 40707337 0.10340 113821 113821 0.00030 236049996 194903990 41146006 0.10450 290995992 238350802 52645190 0.13370 28293 28293 0.00010 28293 28293 0.00010 1 3237797 205610378 222772739 -17162361 X 1 1 1 1 BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH INC 275 SANDWICH STREET PLYMOUTH MA 023602183 WWW.BIDPLYMOUTH.ORG MA STATE LICENSE #2082 X X X X COMMUNITY HOSPITAL BETH ISRAEL DEACONESS HOSPITAL - PLYMOUT 1 0 0 1 X X X X X X X 21 1 1 0 1 X SEE PART VI 1 21 1 SEE PART VI 0 1 X 400.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART VI X SEE PART VI X SEE PART VI X X X X X 1 X 0 X X X X 1 X 0 0 BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. PART V, SECTION B, LINE 5: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. PART V, SECTION B, LINE 11: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION. 3 1 - BID-PLYMOUTH REHABILITATION CENTER 10 CORDAGE PARK CIRCLE SUITE 225 PLYMOUTH MA 02360 OTHER LOCATIONS 2 - BID-PLYMOUTH REHABILITATION CENTER 3 VILLAGE GREEN NORTH SUITE 331 PLYMOUTH MA 02360 OTHER LOCATIONS 3 - BETH ISRAEL DEACONESS IMAGING THE PARK 45 RESNIK ROADSUITE 104-B106201 PLYMOUTH MA 02360 OTHER LOCATIONS PART III, LINE 2: THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUTSUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS$3,237,797. FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS-COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSBETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BID-PLYMOUTH) AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH (BID PLYMOUTH). THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND PARTS OF SOUTHERN NEW HAMPSHIRE AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,700 PHYSICIANS AND 39,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES.BILH'S PURPOSE STATEMENT ARTICULATES THE IMPACT BILH AND EACH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. BILH'S SHARED VALUES GUIDE DAILY EFFORTS, KEEP BILH AND EACH AFFILIATE ALIGNED IN THE PURSUIT OF PURPOSE AND SHOW HOW BILH CARES FOR PATIENTS, EACH OTHER AND OUR COMMUNITIES.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BID PLYMOUTH COMMUNITY BENEFITS MISSION STATEMENT UTILIZING THE INTEGRATED RESOURCES OF THE BETH ISRAEL LAHEY HEALTH SYSTEM, BETH ISRAEL DEACONESS HOSPITALPLYMOUTH DELIVERS THE FULL CONTINUUM OF WORLD-CLASS HEALTHCARE SERVICES TO ALL THE COMMUNITIES OF SOUTHEASTERN MASSACHUSETTS. BID-PLYMOUTH'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: - INVOLVING BID-PLYMOUTH STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE THREE-YEAR IMPLEMENTATION STRATEGY; - ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT THE HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; - ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL AND ECONOMIC FACTORS; - IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN BID-PLYMOUTH'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED; - PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND - FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTHCARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES. COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, BID-PLYMOUTH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $438,669 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMBID-PLYMOUTH'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS CBSA AND BEYOND. TO ACCOMPLISH THIS BY PROVIDING A FULL CONTINUUM OF HEALTHCARE SERVICES WITH EXCELLENCE AND COMPASSION ARE PRIMARY TENETS OF ITS MISSION. BID-PLYMOUTH'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF BID-PLYMOUTH'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF BID-PLYMOUTH'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. THE BID-PLYMOUTH COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE MANAGER OF COMMUNITY BENEFITS & COMMUNITY RELATIONS. THE MANAGER HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE BID-PLYMOUTH PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT.THE BID-PLYMOUTH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH BID-PLYMOUTH'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT BID-PLYMOUTH'S COMMUNITY BENEFITS MISSION TO ASSESS ROOT CAUSES OF HEALTH DISPARITIES AND TO ASSIST IN IMPROVING HEALTHCARE FOR THE DISADVANTAGED AND UNDERSERVED. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF BID-PLYMOUTH'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF BID-PLYMOUTH'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF BID-PLYMOUTH'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY BID-PLYMOUTH'S PROGRAMMATIC ENDEAVORS, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. BID-PLYMOUTH'S CBAC MEMBERS INCLUDE: - MIKE BABINI, PLYMOUTH COMMUNITY MEMBER & FORMER BID-PLYMOUTH BOARD OF TRUSTEES - LYLE BAZZINOTTI, PLYMOUTH COMMUNITY MEMBER & FORMER BID-PLYMOUTH BOARD OF TRUSTEES - CHRIS CAMPBELL, SUPERINTENDENT, PLYMOUTH SCHOOLS- DENNIS CARMAN, EXECUTIVE DIRECTOR, UNITED WAY OF GREATER PLYMOUTH - SARAH CLOUD, DIRECTOR OF SOCIAL WORK, BID-PLYMOUTH - KEVIN COUGHLIN, PRESIDENT, BID PLYMOUTH- BETTY DEBENEDICTIS, LEGISLATIVE DIRECTOR FOR REPRESENTATIVE MATT MURATORE, COMMONWEALTH OF MASSACHUSETTS - CHRISTINA DEGAZON, PRACTICE MANAGER, BID-PLYMOUTH - ALISA DELAGE, CHIEF PROGRAMS OFFICER, OLD COLONY ELDER SERVICES - MARC DUPHILY, CHIEF, CARVER POLICE DEPARTMENT- PETER FORMAN, EXECUTIVE DIRECTOR, SOUTH SHORE CHAMBER OF COMMERCE - NIKKI GALIBOIS, DIRECTOR OF PLANNING & DEVELOPMENT, SOUTH SHORE COMMUNITY ACTION COUNCIL- SUE GIOVANETTI, EXECUTIVE DIRECTOR, PLYMOUTH AREA COALITION FOR THE HOMELESS - MEAGHAN GROVES, PRACTICE MANAGER, HARBOR COMMUNITY HEALTH- ANGELA HARRINGTON, INTERPRETER SERVICES, BID PLYMOUTH- VEDNA HEYWOOD, PLYMOUTH COMMUNITY MEMBER - NATE HORWITZ-WILLIS, EXECUTIVE DIRECTOR OF ADVOCACY FUND AND EXECUTIVE VICE PRESIDENT OF EXTERNAL AFFAIRS, PLANNED PARENTHOOD LEAGUE OF MASSACHUSETTS - MIKE JACKMAN, CHAIR, SOUTH SHORE COMMUNITY PARTNERS FOR PREVENTION - KAREN KEANE, DIRECTOR, PLYMOUTH PUBLIC HEALTH DEPARTMENT - MALISSA KENNEY, PRESIDENT/CEO, HEALTHY PLYMOUTH - ANNA MARINI, BID PLYMOUTH BOARD OF DIRECTORS- AMY NAPLES, EXECUTIVE DIRECTOR, PLYMOUTH CHAMBER OF COMMERCE- DEREK PAIVA, VICE PRESIDENT, OLD COLONY YMCA - MARCIA RICHARDS, COMMUNITY DIETICIAN, BID PLYMOUTH- MINHTRAM TRAN, DEI LEGAL COUNSEL, PLYMOUTH COUNTY DA'S OFFICE- KERRI VICTORIO, DIRECTOR, CUSTOMER RELATIONS, GREATER ATTLEBORO TAUNTON REGIONAL TRANSIT AUTHORITY (GATRA)- DEEDEE WINTERSON, DIRECTOR OF RESIDENT SERVICES, ALGONQUIN HEIGHTS FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY (IS OR CHIP) PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. BID PLYMOUTH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE BID PLYMOUTH BOARD OF TRUSTEES ON SEPTEMBER 13, 2023. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 13, 2023, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE CHNA AND THE ASSOCIATED IS REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF BID PLYMOUTH'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA (CBSA) WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BID PLYMOUTH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BID PLYMOUTH, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.COMMUNITY HEALTH NEEDS ASSESSMENT-PRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, BID PLYMOUTH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF BID PLYMOUTH 'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES CARVER, DUXBURY, KINGSTON AND PLYMOUTH.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR BID PLYMOUTH'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).BID PLYMOUTH'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCED POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN IN THE COMMUNITIES OF CARVER, DUXBURY, KINGSTON AND PLYMOUTH IN ITS CBSA, PRIORITY COHORTS AS FOLLOWS: - YOUTH - OLDER ADULTS - LOW-RESOURCED POPULATIONS - INDIVIDUALS WITH DISABILITIES - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS. COMMUNITY HEALTH NEEDS ASSESSMENT-SUMMARY OF APPROACH AND METHODSBID PLYMOUTH'S CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING BID PLYMOUTH'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. BID PLYMOUTH'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, BID-PLYMOUTH CONDUCTED 17 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED 4 FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 460 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 600 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY.COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-DETAIL OF APPROACH AND METHODSBID-PLYMOUTH RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. BID-PLYMOUTH COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT BID-PLYMOUTH LEVERAGED INCLUDED: - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020) - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020) - U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021) - BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2019) - MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) FBI UNIFORM CRIME REPORTS (2019) - MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021) - MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) - MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019) - MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020) - MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018) - ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021) COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, BID-PLYMOUTH WORKED WITH COLLABORATORS TO CONDUCT 17 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT BID-PLYMOUTH'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON BID-PLYMOUTH'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN BID-PLYMOUTH'S CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS. FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)BID-PLYMOUTH CONDUCTED 4 COMMUNITY FOCUS GROUPS AND HELD TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED 226 RESIDENTS IN BID-PLYMOUTH'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH THE SOUTH SHORE COMMUNITY PARTNERS IN PREVENTION (CHNA 23), ALGONQUIN HEIGHTS, NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) PLYMOUTH AND THE HEALING STUDY WORKGROUP. BID-PLYMOUTH HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF BID-PLYMOUTH'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SENIOR CENTERS, PARTNER NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES AND TARGETED OUTREACH TO POPULATIONS NEVER BEFORE ENGAGED TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE BID-PLYMOUTH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES. COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: - REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS WITH THE BID-PLYMOUTH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS. - IDENTIFY BID-PLYMOUTH'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. - ANALYZE BID-PLYMOUTH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY BID-PLYMOUTH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). - DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-KEY FINDINGS THE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDING SEPTEMBER 30, 2022, WERE: - YOUTH - OLDER ADULTS - LOW-RESOURCED POPULATIONS - INDIVIDUALS WITH DISABILITIES - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS BID-PLYMOUTH'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTHCARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. - SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY. - HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). - HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM BID-PLYMOUTH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025. COMMUNITY HEALTH NEEDS ASSESSMENT-MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLE BID-PLYMOUTH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY. AS NOTED ABOVE, BID-PLYMOUTH COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE BID-PLYMOUTH WEBSITE AT: IN ADDITION TO THE CHNA, BID-PLYMOUTH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE BID-PLYMOUTH WEBSITE AT: HTTPS://BIDPLYMOUTH.ORG/-/MEDIA/FILES/PLYMOUTH/BID-PLYMOUTH-2022-CHNA-IMPLEMENTATION-093022.PDF BID-PLYMOUTH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 20192 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE BID-PLYMOUTH WEBSITE AT: HTTPS://BIDPLYMOUTH.ORG/-/MEDIA/FILES/PLYMOUTH/BID-PLYMOUTH-2019-CHNA-REPORT-FINAL-092519.PDF FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING BID-PLYMOUTH'S FISCAL YEAR ENDED SEPTEMBER 30, 20193 (TAX YEAR 2018) IS AVAILABLE ON THE BID-PLYMOUTH WEBSITE AT: HTTPS://BIDPLYMOUTH.ORG/-/MEDIA/FILES/PLYMOUTH/BID-PLYMOUTH-2020-2022-IMPLENTATION-STRATEGY-REVISED.PDF EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A). FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION COMMUNITY HEALTH NEEDS ASSESSMENT-ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11) AS NOTED ABOVE, BID-PLYMOUTH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND A SUMMARY OF BID-PLYMOUTH'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THAT CHNA AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, BID-PLYMOUTH HAS BEEN STRATEGIC IN IDENTIFYING ITS COMMUNITY HEALTH PRIORITIES TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW. PRIORITY AREA 1: EQUITABLE ACCESS TO CARE - PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC, AND ECONOMIC BARRIERS. PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH - ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY OF LIFE OUTCOMES. PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE - PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE. PRIORITY AREA 4: CHRONIC AND COMPLEX CONDITIONS - IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS-AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES. COMMUNITY HEALTH NEEDS ASSESSMENT-APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)BID-PLYMOUTH HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES BID-PLYMOUTH OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES AMONG THEIR FOCUS COHORTS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS. BID-PLYMOUTH HAS BEEN A LEADER IN CREATING MANY COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. DUE TO THE INCREASE IN HOMELESSNESS AND HOUSING INSECURITY, BID-PLYMOUTH HAS SUPPORTED OVERNIGHTS OF HOSPITALITY THROUGH FATHER BILL'S & MAINSPRING. IN FY24, THIS SEASONAL SHELTER PROVIDED SAFE SHELTER, HOT MEALS, AND WRAPAROUND SUPPORT SERVICES TO 84 UNIQUE INDIVIDUALS EXPERIENCING HOMELESSNESS. FOOD INSECURITY AND THE RISING COST OF HEALTHY FOODS HAS MADE IT CHALLENGING FOR PEOPLE EXPERIENCING FOOD INSECURITY TO EAT HEALTHY. IN RESPONSE, IN FY24, THE COMMUNITY DIETICIAN FOR BID-PLYMOUTH ENGAGED 858 ADULTS AND FAMILIES PRESENTING WITH FOOD INSECURITY THROUGH PROGRAMS TO LEARN ABOUT LOW-COST, HEALTHY NUTRITION RESOURCES AND OFFERED FREE TOOLS FOR FOOD PREPARATION. OTHER EXAMPLES OF SUCCESS ARE LISTED IN THE SUBSEQUENT SCHEDULE H IMPLEMENTATION STRATEGY UPDATE. BID-PLYMOUTH IS ROOTED IN PROVIDING HEALTHCARE TO POPULATIONS WHO HAVE HISTORICALLY NOT HAD ADEQUATE ACCESS TO CARE. LOCATED IN A SUBURBAN AREA, TWO OF THE MORE SIGNIFICANT BARRIERS TO ACCESS ARE TRANSPORTATION AND LANGUAGE. BID-PLYMOUTH RESPONDED TO THE TRANSPORTATION CHALLENGES THROUGH AN INNOVATIVE COMMUNITY PROGRAM CALLED TAKING PEOPLE PLACES. THIS PROGRAM UTILIZES LYFT AND RECEIVES PARTIAL STATE MATCHING FUNDS FOR ADULTS AGED 60 AND OVER, AND THOSE PRESENTING WITH A DISABILITY. IN FY24, 345 RIDES WERE PROVIDED;117 OF WHICH WERE FOR ADULTS AGED 60 AND OLDER AND 228 WERE FOR THOSE WITH A DISABILITY WHO NEEDED ACCESS TO MEDICAL CARE AND WHO DID NOT HAVE ANY OTHER RESOURCES. AS FOR THE INCREASE IN THE NEED FOR INTERPRETER SERVICES, BID-PLYMOUTH MET THE DEMAND USING IN-PERSON/ON-SITE INTERPRETERS, TELEPHONIC/OVER THE PHONE (OPI) AND VIDEO REMOTE INTERPRETATION (VRI) SYSTEM, RESULTING IN 12,303 ENCOUNTERS IN FY24 COMPARED TO 8,723 IN FY23. BID-PLYMOUTH HAS FOCUSED ITS EFFORTS ON CREATING FOCUSED PROGRAMS THAT ADDRESS CHRONIC DISEASES SUCH AS CANCER AND HIV. THESE PROGRAMS INCLUDE THE CANCER SUPPORT PROGRAM FOR THOSE LIVING WITH CANCER AND THE ACCESS PROGRAM FOR THOSE LIVING WITH HIV AND/OR AIDS. THE CANCER SUPPORT PROGRAM ENGAGES PATIENTS WITH EMOTIONAL AND/OR FINANCIAL HARDSHIP AND PROVIDES COUNSELING, TRANSPORTATION, WIGS AND ANY OTHER NEEDED RESOURCES TO ALLEVIATE STRESS. THE ACCESS PROGRAM PROVIDES PRIMARY MEDICAL CARE TO HIV/AIDS CLIENTS. CARE INCLUDES PHYSICAL EXAMINATIONS; ADHERENCE AND TREATMENT COUNSELING; LABORATORY TESTING; IMMUNIZATIONS AND SCREENING; REFERRALS TO SPECIALTY CARE AND CLINICAL TRIALS; MEDICAL NUTRITION THERAPY, AND MEDICAL CASE MANAGEMENT. IN FY24, 100% OF THE PATIENTS WERE VIRALLY SUPPRESSED. DETAILS OF THESE AND OTHER BID-PLYMOUTH PROGRAMS ADDRESSING CHRONIC DISEASE MANAGEMENT ARE INCLUDED IN THE IMPLEMENTATION STRATEGY UPDATE BELOW. AMONG THE MANY WAYS BID-PLYMOUTH AND ITS COMMUNITY PARTNERS ADDRESS BEHAVIORAL HEALTH NEEDS IS BY GROWING ITS BEHAVIORAL HEALTH INTEGRATED CARE INITIATIVE. SOCIAL WORK CONNECTS WITH PRIMARY CARE PROVIDERS, AN ADVANCED PRACTICE NURSE PRACTITIONER WITH MENTAL HEALTH TRAINING, AND A PSYCHIATRIST TO INTEGRATE BEHAVIORAL HEALTH SCREENING, ASSESSMENT, AND TREATMENT SERVICES INTO THE PRIMARY CARE PRACTICES. RESULTS OF THE BEHAVIORAL HEALTH INTEGRATED CARE INITIATIVE SHOW THAT MORE PATIENTS WITH UNMET HEALTH NEEDS ARE ACCESSING MENTAL HEALTH SERVICES. RESULTS IN FY24 ALSO SHOW THAT DEPRESSIVE SYMPTOMS (PHQ9) DECREASED BY 59% AND ANXIETY SCORE (GAD7) DECREASED BY 60%. A FULL UPDATE ON BID-PLYMOUTH'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW. FY23 SCHEDULE H-IMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: EQUITABLE ACCESS TO CARE IN THE FY22 CHNA, INDIVIDUALS IDENTIFIED SEVERAL BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THE ISSUES STEM FROM HOW THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM-LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL-LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FORGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. FINALLY, TRANSPORTATION WAS ALSO IDENTIFIED AS A SIGNIFICANT BARRIER, RATHER A BROAD ARRAY OF INTERRELATED ISSUES INCLUDING ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION. GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC, AND ECONOMIC BARRIERS. STRATEGIES: 1. PROMOTE ACCESS TO HEALTH CARE, HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICATIONS FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED. 2. PROMOTE EQUITABLE CARE, HEALTH EQUITY, HEALTH LITERACY FOR PATIENTS, ESPECIALLY THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS. COHORTS: LOW-RESOURCED POPULATIONS AND RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INITIATIVES: - BID-PLYMOUTH'S FINANCIAL ASSISTANCE PROGRAM - BID-PLYMOUTH'S ENROLLMENT COUNSELING/ASSISTANCE & PATIENT NAVIGATION SUPPORT - PRIMARY CARE SUPPORT - INTERPRETER SERVICES METRICS AND STATUS UPDATE: - NUMBER OF PATIENTS SERVED THROUGH FINANCIAL ASSISTANCE (BASELINE: 4,582 PATIENTS SCREENED FOR FINANCIAL ASSISTANCE; YEAR 1: 3,458 PATIENTS SCREENED FOR FINANCIAL ASSISTANCE)- NUMBER OF PATIENTS SERVED THROUGH ENROLLMENT COUNSELING (BASELINE: 140 PATIENTS ENROLLED IN STATE ASSISTANCE PROGRAM AND 235 UNINSURED PATIENTS ENROLLED IN HEALTH SAFETY NET; YEAR 1: 218 PATIENTS ENROLLED IN STATE ASSISTANCE PROGRAM AND 203 UNINSURED PATIENTS ENROLLED IN HEALTH SAFETY NET)- NUMBER OF PATIENTS SERVED THROUGH PRIMARY CARE (BASELINE: 6,899 NEW PATIENTS IN PRIMARY CARE OFFICES IN CBSA; YEAR 1: 1,584 NEW PATIENTS IN PRIMARY CARE OFFICES IN THE CBSA)- NUMBER OF PATIENTS ASSISTED, AND NUMBER OF LANGUAGES PROVIDED THROUGH INTERPRETER SERVICES (BASELINE: 8,723 INTERPRETER SESSIONS PROVIDED; YEAR 1: 12,303 INTERPRETER SESSIONS PROVIDED) FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH THE SOCIAL DETERMINANTS OF HEALTH ARE "THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING AND QUALITY-OF-LIFE OUTCOMES AND RISKS." THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/ NAVIGATION ISSUES AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA ON SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND THE BID-PLYMOUTH COMMUNITY HEALTH SURVEY REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, ECONOMIC INSTABILITY, TRANSPORTATION, AND FOOD INSECURITY/NUTRITION, TRANSPORTATION. GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES. STRATEGIES: 1. SUPPORT IMPACTFUL PROGRAMS THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSING. 2. SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE HEALTHY EATING AND ACCESS TO AFFORDABLE, HEALTHY FOODS. 3. SUPPORT EXISTING PARTNERSHIPS AND EXPLORE NEW ONES WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION. 4. PROVIDE COMMUNITY HEALTH GRANTS TO SUPPORT EVIDENCE-BASED PROGRAMS. 5. SUPPORT IMPACTFUL PROGRAMS AND EVIDENCE-BASED STRATEGIES TO INCREASE EMPLOYMENT AND EARNINGS AND INCREASE FINANCIAL SECURITY. 6. COLLABORATE TO ENHANCE ACCESS TO COORDINATED HEALTH AND SUPPORT SERVICES AND RESOURCES TO SUPPORT OVERALL HEALTH AND AGING IN PLACE. COHORTS: LOW-RESOURCED POPULATIONS, YOUTH, OLDER ADULTS, INDIVIDUALS WITH DISABILITIES AND RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INITIATIVES: - GRANT SUPPORT FOR FATHER BILL'S AND MAINSPRING (FBMS) FOR TEMPORARY SHELTER - NUTRITION EDUCATION AND COOKING TIPS IN THE COMMUNITY THROUGH BID-PLYMOUTH REGISTERED DIETICIAN (RD) - TAKING PEOPLE PLACES (TPP) TRANSPORTATION PROGRAM - COMMUNITY HEALTH GRANT PROGRAM GRANT FUNDING PROGRAM FOR COMMUNITY ORGANIZATIONS AND MUNICIPALITIES - PROVIDE OPPORTUNITIES FOR GRANT FUNDING - CAREER AND ACADEMIC ADVISING - HOSPITAL SPONSORED COMMUNITY COLLEGE COURSES - HOSPITAL SPONSORED ENGLISH SPEAKERS OF OTHER LANGUAGES (ESOL) CLASSES - PLYMOUTH SENIOR TASK FORCE: AGE AND DEMENTIA FRIENDLY DESIGNATION PROCESS METRICS AND STATUS UPDATE: - NUMBER OF PARTICIPANTS AND THEIR DEMOGRAPHICS PROVIDED WITH SHELTER SERVICES AND NUMBER OF FAMILIES PREVENTED FROM EXPERIENCING HOMELESSNESS (BASELINE: SHELTER SERVICES PROVIDED TO 72 UNIQUE INDIVIDUALS; 98% OF RESIDENTS MAINTAINED HOUSING; YEAR 1: SHELTER SERVICES PROVIDED TO 84 UNIQUE INDIVIDUALS; 99% OF RESIDENTS MAINTAINED HOUSING)- NUTRITION PROGRAM: NUMBER OF RECIPES, NUMBER OF PARTICIPANTS AND THEIR DEMOGRAPHICS, NUMBER OF WORKSHOPS AND PARTICIPANT RESPONSES TO PRE/POST SURVEYS (BASELINE: 18 RECIPES WERE SHARED WITH 889 PARTICIPANTS ATTENDED 25 NUTRITION PROGRAMS FOR ADULTS AND FAMILIES LIVING IN THE CBSA AND PRESENTING WITH FOOD INSECURITY; 25 PROGRAMS FOR YOUTH & FAMILIES LIVING IN THE CBSA SEEKING ACCESS TO HEALTHY AND AFFORDABLE FOOD OPTIONS AND THEY ALL REPORTED AN INCREASED CONFIDENCE IN PREPARING HEALTHY FOOD ON A BUDGET; YEAR 1: 17 RECIPES WERE SHARED WITH 858 PARTICIPANTS ATTENDED 20 NUTRITION PROGRAMS FOR ADULTS AND FAMILIES LIVING IN THE CBSA AND PRESENTING WITH FOOD INSECURITY; 20 PROGRAMS FOR YOUTH & FAMILIES LIVING IN THE CBSA SEEKING ACCESS TO HEALTHY AND AFFORDABLE FOOD OPTIONS AND THEY ALL REPORTED AN INCREASED CONFIDENCE IN PREPARING HEALTHY FOOD ON A BUDGET ). - NUMBER OF PEOPLE SERVED THROUGH TAKING PEOPLE PLACES: (BASELINE: 388 RIDES PROVIDED, OF WHICH 83 WERE FOR ADULTS AGED 60 AND OLDER AND 305 WERE FOR THOSE WITH A DISABILITY: YEAR 1: 345 RIDES PROVIDED, OF WHICH 117 WERE FOR ADULTS AGED 60 AND OLDER AND 228 WERE FOR THOSE WITH A DISABILITY)- NUMBER SERVED AND POSITIVE OUTCOMES REPORTED: - SOUTH SHORE COMMUNITY ACTION COUNCIL HOUSING ASSISTANCE AND EMERGENCY FOOD (BASELINE: PROVIDED REFERRALS, CASE MANAGEMENT, AND FINANCIAL ASSISTANCE WITH RENT OR MORTGAGE ARREARAGES FOR 61 HOUSEHOLDS (181 HOUSEHOLD MEMBERS), WITH 14 HOUSEHOLDS (37 HOUSEHOLD MEMBERS) AVOIDING EVICTION, 58 HOUSEHOLDS RECEIVING FINANCIAL ASSISTANCE WITH RENT OR MORTGAGE MAINTAINING STABLE HOUSING FOR 3 MONTHS, 4 HOUSEHOLDS (11 HOUSEHOLD MEMBERS) RECEIVING FINANCIAL ASSISTANCE WITH UTILITY BILLS AND AVOIDING A UTILITY SHUT-OFF, 34 HOUSEHOLDS (51 HOUSEHOLD MEMBERS) ACCESSING EMERGENCY FOOD; YEAR 1: PROVIDED REFERRALS, CASE MANAGEMENT, AND FINANCIAL ASSISTANCE WITH RENT OR MORTGAGE ARREARAGES FOR 63 HOUSEHOLDS WITH 25% OF APPLICANTS AVOIDING EVICTION, 27 HOUSEHOLDS RECEIVING FINANCIAL ASSISTANCE WITH RENT OR MORTGAGE MAINTAINING STABLE HOUSING FOR 3 MONTHS, 1 HOUSEHOLD RECEIVING FINANCIAL ASSISTANCE WITH UTILITY BILLS AND AVOIDING A UTILITY SHUT-OFF, 36 HOUSEHOLDS ACCESSING EMERGENCY FOOD) - NEIGHBORWORKS HOUSING SOLUTIONS - FAMILY SELF SUFFICIENCY PROGRAM AND FAMILY SHELTER PROGRAM (BASELINE: 29 FAMILIES ACCUMULATED AN AVERAGE SAVINGS OF $7,446, WITH 2 FAMILIES NO LONGER NEEDING HOUSING ASSISTANCE PAYMENTS AND WERE PAYING MARKET RENT AND 30 FAMILIES RECEIVED WEEKLY ONE- ON-ONE CASE MANAGEMENT AND ASSISTANCE IN ACCESSING HEALTH BENEFITS, HEALTH CARE, SCHOOL ENROLLMENT, TRANSPORTATION, AS WELL AS ESOL AND BUDGETING CLASSES; YEAR 1: NO DATA AS THIS WAS A ONE-YEAR FUNDED PROGRAM) - PLYMOUTH COUNTY SHERIFF'S DEPARTMENT AQUAPONICS/HYDROPONICS PROGRAM: (BASELINE: 21,629 LBS. OF FOOD DONATED AND A NEW ENVIRONMENTAL JUSTICE EDUCATION CENTER EDUCATION AND TRAINING PROGRAM DEVELOPED ON AQUAPONICS ~ HYDROPONICS ~ VERTICAL GROWING SYSTEMS; YEAR 1: NO DATA AS THIS WAS A ONE-YEAR FUNDED PROGRAM) - GREATER PLYMOUTH COMMUNITY HEALTH NETWORK ALLIANCE (CHNA): ORGANIZATIONAL SUPPORT PROVIDED (BASELINE: NO DATA AS THIS GRANT STARTED IN FY24; YEAR 1: 8 EDUCATION & SKILL-BUILDING SESSIONS SERVED AN AVERAGE OF 28 PARTICIPANTS PER SESSION, 4 MINI-GRANTS WERE PROVIDED TO AREA NON-PROFITS, THE STEERING COMMITTEE REPRESENTS 12 COMMUNITY & MUNICIPAL ORGANIZATIONS, THERE ARE 341 UNDUPLICATED COMMUNITY REPRESENTATIVES ON THE MEMBER EMAIL LIST) - DIRECTORS OF PERSONAL ECONOMY: (BASELINE: NO DATA AS THIS GRANT STARTED IN FY24; YEAR 1: FUNDING WAS PROVIDED TO SUPPORT WORKFORCE DEVELOPMENT FOR THOSE IN RECOVERY)- NUMBER OF PARTICIPANTS AND ORGANIZATIONS SERVED: - COMMUNITY GRANT WORKSHOPS (BASELINE:118 PARTICIPANTS; YEAR 1: 19 COMMUNITY ORGANIZATIONS REPRESENTED) - GRANT CONSULTATION SERVICES (BASELINE: 2 ORGANIZATIONS ONE WHO PROVIDES ACCESS TO FOOD AND ONE WHO PROVIDES TRANSPORTATION SERVICES TO 11 SOCIAL SERVICE ORGANIZATIONS; YEAR 1: 2 COMMUNITY ORGANIZATIONS SERVING THE CBSA WERE GIVEN GRANT WRITING SUPPORT)- NUMBER OF PEOPLE TRAINED THROUGH CAREER AND ACADEMIC ADVISING: (BASELINE: 89 COMMUNITY MEMBERS TRAINED ACROSS BILH - BID-PLYMOUTH PARTICIPATED IN THESE TRAININGS; YEAR 1:1,044 BILH EMPLOYEES RECEIVED CAREER DEVELOPMENT SERVICES) - NUMBER OF PEOPLE SERVED THROUGH COMMUNITY COLLEGE COURSES: (BASELINE: NO DATA FOR COMMUNITY COLLEGE COURSES; YEAR 1: NO DATA FOR COMMUNITY COLLEGE COURSES) - NUMBER OF PEOPLE SERVED THROUGH ESOL CLASSES: (BASELINE: 20 PARTICIPANTS PER WEEKLY ESOL CLASS; YEAR 1: NO DATA) PLYMOUTH SENIOR TASK FORCE: SECTORS REPRESENTED, NUMBER OF NEW PARTNERSHIPS AND NUMBER OF NEW PROTOCOLS/POLICIES IMPLEMENTED: (BASELINE: 10 SECTORS REPRESENTED, 3 NEW PARTNERSHIPS AND AGE & DEMENTIA FRIENDLY NEEDS ASSESSMENT COMPLETED; YEAR 1: 10 SECTORS REPRESENTED, 2 NEW PARTNERSHIPS AND WORKING TOWARDS SUSTAINABILITY FOR THE GREATER PLYMOUTH CHNA) FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE ANXIETY, CHRONIC STRESS, DEPRESSION AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES ON YOUTH AND YOUNG ADULTS AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. YOUTH MENTAL HEALTH WAS A CRITICAL CONCERN IN THE CBSA, INCLUDING THE SIGNIFICANT PREVALENCE OF CHRONIC STRESS, ANXIETY, AND BEHAVIORAL ISSUES. THESE CONDITIONS WERE EXACERBATED OVER THE PANDEMIC, DUE TO ISOLATION, UNCERTAINTY, REMOTE LEARNING, AND FAMILY DYNAMICS. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE BID-PLYMOUTH CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES (MENTAL HEALTH, HOUSING, AND HOMELESSNESS). INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE. STRATEGIES: 1. ENHANCE AND EXPLORE RELATIONSHIPS WITH SCHOOLS, YOUTH SERVING ORGANIZATIONS, AND OTHER COMMUNITY PARTNERS TO BUILD RESILIENCY, COPING, AND PREVENTION SKILLS. 2. PARTICIPATE IN MULTI-SECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS AND ENVIRONMENTAL CHANGES TO INCREASE RESILIENCY, REDUCE SUBSTANCE USE, OVERDOSES & DEATHS. 3. BUILD THE CAPACITY OF COMMUNITY MEMBERS AND EMERGENCY SERVICES TO UNDERSTAND THE IMPORTANCE OF MENTAL HEALTH, AND REDUCE NEGATIVE STEREOTYPES, BIAS, AND STIGMA AROUND MENTAL ILLNESS AND SUBSTANCE USE. 4. PROVIDE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION, AND TREATMENT. COHORTS: YOUTH, OLDER ADULTS, INDIVIDUALS WITH DISABILITIES, LOW-RESOURCED POPULATIONS AND RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INITIATIVES: - PROVIDE AN OPPORTUNITY FOR GRANT FUNDING - PCO HOPE: HIDDEN IN PLAIN SITE MOBILE DISPLAY - ADULT AND YOUTH MENTAL HEALTH FIRST AID - MEMBER OF MANY COMMUNITY INITIATIVES AND OUTREACH PROGRAMS - RESILIENCY LIBRARY - GRANT-FUNDED TRAINING FOR EMERGENCY MEDICAL SERVICE (EMS) PROVIDERS TO IDENTIFY AND INTERVENE AROUND SUICIDE AND SUICIDAL IDEATION - GOSNOLD RECOVERY NAVIGATORS - EXPLORE OTHER POTENTIAL HOSPITAL-BASED PROGRAMMING METRICS AND STATUS UPDATE: - GRANT TRAININGS: NUMBER OF PARTICIPANTS, PERCENT REPORTING INCREASED SKILLS AND CONFIDENCE IN APPLYING SKILLS: (BASELINE: 5 ORGANIZATIONS WHO PROVIDE SERVICES TO INDIVIDUALS EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE ISSUES; 100% REPORTED IMPROVED SKILLS IN BECOMING GRANT READY AND GRANT WRITING, AS WELL AS A SIGNIFICANT INCREASE IN CONFIDENCE IN USING THESE SKILLS; YEAR 1: 8 COMMUNITY BASED ORGANIZATIONS PARTICIPATING IN GRANT WORKSHOPS REPORTED A SIGNIFICANT INCREASE IN CONFIDENCE USING THESE SKILLS) - PCO HOPE: NUMBER OF PARTICIPANTS AND DEMOGRAPHICS, NUMBER SCREENED AND RESULTS AND NUMBER COMPLETING PROGRAM: (BASELINE: PCO HOPE HIDDEN IN PLAIN SITE NO LONGER NEEDED FUNDING FOR THIS PROGRAM; YEAR 1: PCO HOPE IS NO LONGER IN OPERATION) - MENTAL HEALTH FIRST AID: NUMBER OF PARTICIPANTS AND DEMOGRAPHICS, INCREASED SKILLS AND INCREASED CONFIDENCE IN USING SKILLS: (BASELINE: NO DATA AVAILABLE FOR MENTAL HEALTH FIRST AID; YEAR 1: 24 PARTICIPANTS ATTENDED ADULT MHFA - COMMUNITY INITIATIVES: SECTORS REPRESENTED, NUMBER OF RESOURCES OBTAINED, NUMBER OF PARTNERSHIPS DEVELOPED, SKILL-BUILDING/EDUCATION SHARED AND NUMBER OF NEW POLICIES/PROTOCOLS IMPLEMENTED THROUGH COMMUNITY INITIATIVES AND OUTREACH PROGRAMS: (BASELINE: 5 SECTORS REPRESENTED, 6 NEW PARTNERSHIPS DEVELOPED, MULTIPLE RESOURCES AND EDUCATION GAINED AND SHARED; YEAR 1: 8 SECTORS REPRESENTED, 2 NEW PARTNERSHIPS DEVELOPED, MULTIPLE RESOURCES AND EDUCATION GAINED AND SHARED) - RESILIENCY LIBRARY: NUMBER OF COMMUNITY MEMBERS TRAINED/EDUCATED, INCREASED SKILLS AND INCREASED CONFIDENCE IN THE ABILITY TO USE SKILLS: (BASELINE AND YEAR 1: RESILIENCY LIBRARY NO LONGER NEEDED FUNDING FOR THE PROGRAM)- SUICIDE PREVENTION FOR FIRST RESPONDERS: NUMBER OF COMMUNITY MEMBERS TRAINED/EDUCATED, INCREASED SKILLS AND INCREASED CONFIDENCE IN THE ABILITY TO USE SKILLS: (BASELINE: 38 FIRST RESPONDERS WERE TRAINED ON SUICIDE PREVENTIONS; YEAR 1: 57 FIRST RESPONDERS WERE TRAINED ON SUICIDE PREVENTION, INTERVENTION AND POST-VENTION) - RECOVERY COACH PROGRAM: NUMBER OF PATIENTS ASSISTED AND THEIR DEMOGRAPHICS: (BASELINE: NO DATA AVAILABLE FOR GOSNOLD AS FUNDING IS THROUGH A THIRD PARTY, THIS WILL BE EVALUATED IN FY24 AND POTENTIALLY ADDED IN; YEAR 1: 2,074 CONSULTS IN THE ED RESULTED IN 1,277 REFERRALS TO TREATMENT AND 1,659 CONSULTS ON MEDICAL FLOORS RESULTED IN 892 REFERRALS TO TREATMENT)- MENTAL HEALTH AND SUBSTANCE USE: NUMBER OF PATIENTS ASSISTED AND THEIR DEMOGRAPHICS, POSITIVE OUTCOMES REPORTED, NUMBER TRAINED, AMOUNT OF UNUSED PRESCRIPTION DRUGS COLLECTED AND REFERRALS. - BEHAVIORAL HEALTH INTEGRATED CARE INITIATIVE (BASELINE: 1,478 WITH DEPRESSIVE SYMPTOMS (PHQ9) DECREASING BY 59% AND ANXIETY SCORE (GAD7) DECREASING BY 66%; YEAR 1: PHQ9 SCORES DECREASED BY 59% AND GAD7 SCORES DECREASED BY 60%) - PLYMOUTH COUNTY OUTREACH (BASELINE: 960 WITH 58% OF PATIENTS ACCEPTING TREATMENT IN THE EMERGENCY DEPARTMENT AND 48% PATIENTS ACCEPTING TREATMENT WHO WERE ADMITTED TO INPATIENT BEDS; YEAR 1: 60% OF PATIENTS IN ED ACCEPTED TREATMENT AND 76% OF FRIENDS AND FAMILY ACCEPTED SUPPORT SERVICES) - PLYMOUTH COUNTY OUTREACH HOPE (BASELINE: 958 PEOPLE WERE TRAINED IN HOW TO ADMINISTER NARCAN AND 366 GALLONS OF UNUSED PRESCRIPTION DRUGS WERE COLLECTED; YEAR 1: PCO HOPE IS NO LONGER IN OPERATION. PRESCRIPTION DRUG TAKEBACK RESULTED IN 395 GALLONS OF UNUSED PRESCRIPTION DRUGS COLLECTED) - PLYMOUTH COUNTY OUTREACH HUB (BASELINE: 50% OF REFERRALS THROUGH A WERE CLOSED DUE TO CONNECTION TO SERVICES; YEAR 1: BID PLYMOUTH DID NOT PARTICIPATE IN HUB MEETINGS DUE TO STAFFING CHANGES) PRIORITY AREA 4: CHRONIC AND COMPLEX CONDITIONS CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN MASSACHUSETTS AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY. INPATIENT DISCHARGE RATES VARY ACROSS CONDITIONS AND COMMUNITIES. RATES ARE LOWER IN DUXBURY COMPARED TO THE COMMONWEALTH OVERALL. RATES IN CARVER ARE HIGHER THAN THE COMMONWEALTH IN ALL CATEGORIES, EXCEPT FOR DIABETES. GOAL: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES. STRATEGIES: 1. PROVIDE PREVENTATIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMS. 2. ENSURE CANCER PATIENTS AND THEIR FAMILIES HAVE ACCESS TO COORDINATED HEALTH & SUPPORT SERVICES AND RESOURCES TO SUPPORT THEM. 3. ADDRESS CHRONIC DISEASE MANAGEMENT THROUGH HEALTH AND NUTRITION EDUCATION. COHORTS: ALL PRIORITY COHORTS WITH IDENTIFIED CHRONIC DISEASE RISK, OLDER ADULTS, PATIENTS DIAGNOSED WITH CANCER AND THEIR FAMILIES/CAREGIVERS AND RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INITIATIVES: - BID-PLYMOUTH AIDS COMPREHENSIVE, CARE, EDUCATION AND SUPPORT SERVICES (ACCESS) PROGRAM FOR HIV/AIDS - KEEP THE BEAT POST- CARDIAC PROGRAM - CHRONIC DISEASE & NUTRITION EDUCATION - HOUSECALLS PROGRAM - STROKE EDUCATION - CANCER PATIENT SUPPORT PROGRAM - COMMUNITY EDUCATION - HEALTHY RECIPES FOR FOOD PANTRIES - NUTRITION EDUCATION AT LOCAL COUNCILS ON AGING (COAS), LIBRARIES AND SCHOOLS - NUTRITION ARTICLES DISTRIBUTED TO AREA NEWSLETTERS - NUTRITION EDUCATION AND COOKING TIPS FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION METRICS AND STATUS UPDATE: - ACCESS PROGRAM FOR AIDS & HIV: NUMBER OF PARTICIPANTS AND THEIR DEMOGRAPHICS: (BASELINE:14 CLIENTS WERE ENROLLED IN ACCESS CARE, WITH 100% TAKING ANTIRETROVIRAL TREATMENT (ART) AND 100% VIRALLY SUPPRESSED; YEAR 1: 15 CLIENTS WERE ENROLLED IN ACCESS CARE, WITH 100% TAKING ANTIRETROVIRAL TREATMENT (ART) AND 100% VIRALLY SUPPRESSED) - KEEP THE BEAT POST CARDIAC REHABILITATION: NUMBER OF PARTICIPANTS AND THEIR DEMOGRAPHICS:(BASELINE: 11; YEAR 1: 17) - NUTRITION PROGRAM: NUMBER OF PARTICIPANTS AND THEIR DEMOGRAPHICS: (BASELINE: 1,428 PARTICIPANTS ATTENDED NUTRITION PROGRAMS; 2,663 PEOPLE WERE REACHED INDIRECTLY THROUGH VIDEO AND RADIO; 22 AGENCIES SERVING RECEIVED NUTRITION NOTES FOR THEIR NEWSLETTERS AND 32 VENDORS EDUCATED 250 PARTICIPANTS THROUGH A HEALTH & WELLNESS FAIR SUPPORTED BY BID-PLYMOUTH; YEAR 1: 1,407 PARTICIPANTS ATTENDED NUTRITION PROGRAMS; 20 AGENCIES SERVING THE COMMUNITY RECEIVED NUTRITION NOTES FOR THEIR NEWSLETTERS AND SENT THEM OUT TO OVER 15,000 CONSTITUENTS, AND 35 VENDORS EDUCATED 300 PARTICIPANTS THROUGH A HEALTH & WELLNESS FAIR SUPPORTED BY BID-PLYMOUTH) - HOUSECALLS COMMUNITY LECTURE SERIES: NUMBER OF PARTICIPANTS AND THEIR DEMOGRAPHICS: (BASELINE: 2 PROGRAMS EDUCATED 47 OLDER ADULTS AROUND JOINT HEALTH AND 65 PARTICIPANTS EDUCATED ON BEHAVIORAL HEALTH AND COMMUNITY PROGRAMS; YEAR 1: 3 PROGRAMS EDUCATED A TOTAL OF 120 OLDER ADULTS AROUND JOINT HEALTH, THE FUTURE OF HEALTHCARE ON THE SOUTH SHORE AND THE NEED FOR EXPANDED EMERGENCY SERVICES)- COMMUNITY STROKE EDUCATION: NUMBER OF PARTICIPANTS AND THEIR DEMOGRAPHICS: (BASELINE: 29 PARTICIPANTS WERE EDUCATED THROUGH 2 COMMUNITY EVENTS ON STROKE SYMPTOMS AND EARLY NOTIFICATION; YEAR 1: STROKE EDUCATION WAS SHARED WITH STAFF AND VISITORS AT THE HOSPITAL ON THE TV MONITORS FOR STROKE AWARENESS, A PSA ON HOW TO RECOGNIZE AND TREAT A STROKE WAS TAPED AND SHOWN IN PLYMOUTH, AND 25 OLDER ADULTS WERE EDUCATED AT THE PLYMOUTH HEALTH & SAFETY FAIR )- CANCER SUPPORT PROGRAM: NUMBER OF PARTICIPANTS AND THEIR DEMOGRAPHICS: (BASELINE: 400 RIDES WERE GIVEN TO PATIENTS NEEDING RIDES TO AND FROM TREATMENT 50 WIGS WERE PROVIDED TO PATIENTS, 35 PARTICIPANTS TOOK PART IN THE BRIDGE TO WELLNESS PROGRAM AND 4 CANCER SURVIVORS WERE TRAINED TO WORK WITH PATIENTS AS MENTORS TO PROVIDE SUPPORT THROUGH THE TREATMENT PROCESS; YEAR 1: 610 RIDES WERE GIVEN TO PATIENTS NEEDING RIDES TO AND FROM TREATMENT 45 WIGS WERE PROVIDED TO PATIENTS, 19 PARTICIPANTS TOOK PART IN THE BRIDGE TO WELLNESS PROGRAM AND 4 CANCER SURVIVORS WERE TRAINED TO WORK WITH PATIENTS AS MENTORS TO PROVIDE SUPPORT THROUGH THE TREATMENT PROCESS) - NUTRITION PROGRAM: NUMBER OF RECIPES, NUMBER OF PARTICIPANTS AND THEIR DEMOGRAPHICS, NUMBER OF NUTRITION ARTICLES, NUMBER OF WORKSHOPS AND INCREASED KNOWLEDGE OF NUTRITION: (BASELINE: 8 DELICIOUS & NUTRITIOUS SHOWS WERE AIRED WITH RECIPE DEMONSTRATIONS, OVER 4,000 COMMUNITY PARTICIPANTS WERE REACHED DIRECTLY AND INDIRECTLY WITH NUTRITION EDUCATION,12 NUTRITION ARTICLES WERE SENT OUT THE COMMUNITY AND 99% OF PARTICIPANTS SURVEYED REPORTED THAT THEIR KNOWLEDGE HAD INCREASED; YEAR 1: 9 DELICIOUS & NUTRITIOUS SHOWS WERE AIRED WITH RECIPE DEMONSTRATIONS, OVER 2,663 COMMUNITY PARTICIPANTS WERE REACHED DIRECTLY AND INDIRECTLY WITH NUTRITION EDUCATION,12 NUTRITION ARTICLES WERE SENT OUT THE COMMUNITY AND 99% OF PARTICIPANTS SURVEYED REPORTED THAT THEIR KNOWLEDGE HAD INCREASED) COMMUNITY PARTNERSBID PLYMOUTH IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE:- ALGONQUIN HEIGHTS- BAY STATE COMMUNITY SERVICES, INC.- BID-PLYMOUTH COMMUNITY BUSINESS PARTNERS (APPROXIMATELY 69 BUSINESSES)- BRAZILIAN CHURCH- BRAZILIAN MARKET (UAI BRAZIL)- CARVER CARES COALITION- CLEANSLATE CENTERS- CHILD & FAMILY SERVICES- COMMUNITY HEALTH NETWORK AREA (CHNA 23)- COUNCILS ON AGING IN THE CBSA- COMMUNITY SERVINGS- DUXBURY FREE LIBRARY- EMS PROVIDERS IN THE CBSA- FATHER BILLS & MAINSPRING- FOOD PANTRIES IN THE CBSA- GOSNOLD BEHAVIORAL HEALTH- GREATER ATTLEBORO TAUNTON REGIONAL TRANSIT AUTHORITY (GATRA)- GREATER PLYMOUTH COMMUNITY HEALTH NETWORK ALLIANCE (CHNA 23)- HARBOR HEALTH SERVICES, INC.- HEALTH IMPERATIVES- HEALTH RESOURCE & SERVICES ADMINISTRATION (HRSA)-RYAN WHITE PART C- HERRING POND WAMPANOAG TRIBE- HIGH POINT TREATMENT CENTER- JETT FOUNDATION- LAURELWOOD AT THE PINEHILLS- LIBRARIES IN THE CBSA- MARSHFIELD COUNCIL ON AGING- NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) - PLYMOUTH- NEIGHBORWORKS HOUSING SOLUTIONS- NEW HOPE CHAPEL- OLD COLONY ELDER SERVICES- OLD COLONY YMCA- PLYMOUTH AREA COMMUNITY ACCESS TELEVISION (PAC TV)- PLYMOUTH AREA CHAMBER OF COMMERCE- PLYMOUTH AREA COALITION FOR THE HOMELESS- PLYMOUTH BOYS & GIRLS CLUB- PLYMOUTH CENTER FOR ACTIVE LIVING- PLYMOUTH COUNTY DISTRICT ATTORNEY'S OFFICE- PLYMOUTH COUNTY SHERIFF'S OFFICE- PLYMOUTH COUNTY SUICIDE PREVENTION COALITION- PLYMOUTH COUNTY HUB- PLYMOUTH COUNTY OUTREACH- PLYMOUTH DEPARTMENT OF DEVELOPMENTAL SERVICES- PLYMOUTH ECONOMIC DEVELOPMENT CORP.- PLYMOUTH FAMILY NETWORK- PLYMOUTH FAMILY RESOURCE CENTER- PLYMOUTH FITNESS CENTER- PLYMOUTH HEALTH AND HUMAN SERVICES- PLYMOUTH PRIDE- PLYMOUTH PUBLIC LIBRARY- PLYMOUTH RECOVERY CENTER- PLYMOUTH YOUTH DEVELOPMENT COLLABORATIVE (PYDC)- POLICE DEPARTMENTS IN THE CBSA- PUBLIC HEALTH DEPARTMENTS IN THE CBSA- ROTARY CLUB OF PLYMOUTH- SALVATION ARMY- SCHOOLS IN THE CBSA- SENIOR HOUSING IN THE CBSA- SOUTH SHORE CHAMBER OF COMMERCE- SOUTH SHORE COMMUNITY ACTION COUNCIL- TAKING PEOPLE PLACES/THE ALTERNATIVE BOARD- TERRA CURA, INC.- THE FARMHOUSE- TO THE MOON AND BACK- TOWN OF PLYMOUTH- QUINCY ASIAN RESOURCES, INC. (QARI)- U-MASS EXTENSION- UNITED WAY GREATER PLYMOUTHAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, BID-PLYMOUTH IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY IN THE FY 2023 - 2025 IS, WHICH WILL GUIDE THE BID-PLYMOUTH'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025, EXAMPLES OF IDENTIFIED NEEDS THAT WILL NOT BE MET IN THESE YEARS ARE SUPPORTING EDUCATION ACROSS THE LIFESPAN AND STRENGTHENING THE BUILT ENVIRONMENT (IEI.E.,. IMPROVING ROADS/SIDEWALKS AND ENHANCING ACCESS TO SAFE RECREATIONAL SPACES/ACTIVITIES). IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE 2019 CHNA THAT ARE NOT INCLUDED IN THE 2019 IS AND WHICH HAVE GUIDED THE BID-PLYMOUTH'S COMMUNITY BENEFITS ACTIVITIES THE PERIOD FOR THE FISCAL PERIOD COVERED BY THIS FILING DUE TO LIMITED FINANCIAL RESOURCES COMMUNITY NEEDS DEEMED BY THE CBAC AND SLT TO BE OUTSIDE OF BID-PLYMOUTH'S PRIMARY SPHERE OF INFLUENCE AND HAVE OPTED TO ALLOW OTHERS IN ITS CBSA AND THE COMMONWEALTH TO FOCUS ON THESE ISSUES. BID-PLYMOUTH IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES AND OTHER IDENTIFIED RESOURCES IN THE COMMUNITY. AS NOTED IN DETAIL ABOVE, BID-PLYMOUTH 'S PRIMARY TOOL FOR ASSESSING THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2). FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BID PLYMOUTH CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 13.37% OF BID PLYMOUTH'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS-ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, BID PLYMOUTH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://BIDPLYMOUTH.ORG/ABOUT/COMMUNITY-BENEFITS-NEEDS THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT BID PLYMOUTH FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BID PLYMOUTH IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS-CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBID PLYMOUTH'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $1,928,603 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 20243 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, BID PLYMOUTH IS ONE OF ELEVEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE MASSACHUSETTS HEALTH SAFETY NET TRUST, WAS $52 MILLION FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, FOR THE PERIOD COVERED BY THIS FILING, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CARE-MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BID PLYMOUTH ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BID PLYMOUTH GENERATED $43,040,002 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY BID PLYMOUTH FOR SUCH SERVICES BY $9,570,581 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 13.8% OR 45,043 OF BID PLYMOUTH'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 50.3% OR 163,457 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS.DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICAID PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL EXCEEDING $35.5 MILLION RELATED TO TREATING MEDICAID PATIENTS.MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND BID PLYMOUTH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BID PLYMOUTH GENERATED $205,610,378 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY. OF THESE AMOUNTS, REVENUE OF $84,658,214 IS RELATED TO THE PROVISION OF OB/GYN, ENDOCRINE, PULMONOLOGY, NEUROSCIENCES, CARDIOLOGY, INFECTIOUS DISEASE, BEHAVIORAL HEALTH, CANCER (INCLUDING HEMATOLOGY), AND NEPHROLOGY SERVICES AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $40,707,337. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH BID PLYMOUTH CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, BID PLYMOUTH HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 16.9%.BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BID PLYMOUTH ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. COSTS FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $3,237,797 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), EXETER HEALTH RESOURCES, INC. (EHRI), EXETER HOSPITAL (EH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER AND THEIR AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP). FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION FINANCIAL STATEMENT FOOTNOTES: REVENUE RECOGNITIONTHE SYSTEM'S PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING MANAGED CARE PAYORS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDE AN ESTIMATE OF VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE SYSTEM BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE SYSTEM'S FACILITY.REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE SYSTEM. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED (OR ACTUAL) CHARGES. THE SYSTEM BELIEVES THAT THIS METHOD PROVIDES A REASONABLE REPRESENTATION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO INPATIENT SERVICES. THE SYSTEM MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL, OR COMMENCEMENT OF A PATIENT SERVICE, TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TO THAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE OR COMPLETION OF THE OUTPATIENT SERVICES. PATIENT ENCOUNTERS AND RELATED EPISODES OF CARE AND PROCEDURES QUALIFY AS DISTINCT GOODS AND SERVICES, PROVIDED SIMULTANEOUSLY TOGETHER WITH OTHER READILY AVAILABLE RESOURCES, IN A SINGLE INSTANCE OF SERVICE, AND THEREBY CONSTITUTE A SINGLE PERFORMANCE OBLIGATION FOR EACH PATIENT ENCOUNTER AND, IN MOST INSTANCES, OCCUR AT READILY DETERMINABLE TRANSACTION PRICES. ALL SERVICES PROVIDED ARE EXPECTED TO RESULT IN CASH FLOWS AND ARE THEREFORE REFLECTED AS NET REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS.THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. THE ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS ARE BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES AND HISTORICAL CASH COLLECTION EXPERIENCE. DIFFERENCES BETWEEN STANDARD CHARGES AND ESTIMATED TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE AND ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. ADJUSTMENTS ARISING FROM A CHANGE IN THE TRANSACTION PRICE WERE NOT SIGNIFICANT DURING THE YEARS ENDED SEPTEMBER 30, FOR 2024 OR 2023. REVENUES UNDER THE TRADITIONAL FEE FOR SERVICE MEDICARE AND MEDICAID PROGRAMS ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS. RETROSPECTIVELY DETERMINED COST-BASED REVENUES UNDER THESE PROGRAMS, WHICH WERE MORE PREVALENT IN EARLIER PERIODS, AND CERTAIN OTHER PAYMENTS, SUCH AS DISPROPORTIONATE SHARE HOSPITAL AND BAD DEBT EXPENSE REIMBURSEMENT, WHICH ARE BASED ON OUR HOSPITALS COST REPORTS, ARE ESTIMATED USING HISTORICAL TRENDS AND CURRENT FACTORS. COST REPORT SETTLEMENTS UNDER THESE PROGRAMS ARE SUBJECT TO AUDIT BY MEDICARE AND MEDICAID AUDITORS AND ADMINISTRATIVE AND JUDICIAL REVIEW, AND IT CAN TAKE SEVERAL YEARS UNTIL FINAL SETTLEMENT OF SUCH MATTERS IS DETERMINED AND COMPLETELY RESOLVED. THE SYSTEM RECORDS ACCRUALS TO REFLECT THE EXPECTED FINALSETTLEMENTS ON COST REPORTS. FOR FILED COST REPORTS, THE ACCRUAL IS RECORDED BASED ON THOSE COST REPORTS AND SUBSEQUENT ACTIVITY. THE ACCRUAL FOR PERIODS FOR WHICH A COST REPORT IS YET TO BE FILED IS RECORDED BASED ON ESTIMATES OF WHAT THE SYSTEM EXPECTS TO REPORT ON THE FILED COST REPORTS. AFTER THE COST REPORT IS FILED, THE ACCRUAL MAY NEED TO BE ADJUSTED. SETTLEMENTS WITH THIRD-PARTY PAYORS FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS OR INVESTIGATIONS ARE CONSIDERED VARIABLE CONSIDERATION AND ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE USING THE MOST LIKELY OUTCOME METHOD. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE PAYMENT AGREEMENT WITH THE PAYOR, CORRESPONDENCE FROM THE PAYOR AND HISTORICAL SETTLEMENT ACTIVITY, INCLUDING AN ASSESSMENT TO ENSURE THAT IT IS PROBABLE THAT A SIGNIFICANT REVERSAL IN THE AMOUNT OF CUMULATIVE REVENUE RECOGNIZED WILL NOT OCCUR WHEN THE UNCERTAINTY ASSOCIATED WITH THE RETROACTIVE ADJUSTMENT IS SUBSEQUENTLY RESOLVED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN, OR AS YEARS ARE SETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS.THE SYSTEM IS NOT AWARE OF ANY MATERIAL CLAIMS, DISPUTES, OR UNSETTLED MATTERS WITH ANY PAYORS THAT WOULD AFFECT REVENUES THAT HAVE NOT BEEN ADEQUATELY PROVIDED FOR AND DISCLOSED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. BECAUSE THE LAWS, REGULATIONS, INSTRUCTIONS AND RULE INTERPRETATIONS GOVERNING MEDICARE AND MEDICAID REIMBURSEMENT ARE COMPLEX, SUBJECT TO INTERPRETATION AND CAN CHANGE FREQUENTLY, THE ESTIMATES RECORDED COULD CHANGE BY MATERIAL AMOUNTS.CONSISTENT WITH THE SYSTEM'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (E.G., COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. PATIENTS WHO MEET THE SYSTEM'S CRITERIA FOR CHARITY CARE ARE PROVIDED CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE SYSTEM HAS DETERMINED THAT IT HAS PROVIDED SUFFICIENT IMPLICIT PRICE CONCESSIONS FOR THESE ACCOUNTS. PRICE CONCESSIONS, INCLUDING CHARITY CARE, ARE NOT REPORTED AS REVENUE.PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED CO-PAYS, CO-INSURANCE AND DEDUCTIBLES, WHICH VARY IN AMOUNT. THE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH CO-PAYS, CO-INSURANCE AND DEDUCTIBLES AND FOR THOSE WHO ARE UNINSURED BASED ON HISTORICAL COLLECTION EXPERIENCE AND CURRENT MARKET CONDITIONS. THE DISCOUNT OFFERED TO CERTAIN UNINSURED PATIENTS IS RECOGNIZED AS A CONTRACTUAL ALLOWANCE, WHICH REDUCES NET OPERATING REVENUES AT THE TIME THE SELF-PAY ACCOUNTS ARE RECORDED. THE UNINSURED PATIENT ACCOUNTS, NET OF CONTRACTUAL ALLOWANCES RECORDED, ARE FURTHER REDUCED TO THEIR NET REALIZABLE VALUE AT THE TIME THEY ARE RECORDED THROUGH IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION TRENDS FOR SELF-PAY ACCOUNTS AND OTHER FACTORS THAT AFFECT THE ESTIMATION PROCESS. ALTHOUGH OUTCOMES VARY, THE SYSTEM'S POLICY IS TO ATTEMPT TO COLLECT AMOUNTS DUE FROM PATIENTS, INCLUDING CO-PAYS, CO-INSURANCE AND DEDUCTIBLES DUE FROM PATIENTS WITH INSURANCE, AT THE TIME OF SERVICE WHILE COMPLYING WITH ALL FEDERAL AND STATE STATUTES AND REGULATIONS.OTHER REVENUE INCLUDES CONTRIBUTIONS AND NET ASSETS RELEASED FROM RESTRICTIONS AS WELL AS CAFETERIA AND PARKING INCOME. ADDITIONALLY, PHARMACY SALES AND OTHER CONTRACTS RELATED TO HEALTH CARE SERVICES ARE INCLUDED IN OTHER REVENUE AND CONSIST OF CONTRACTS WHICH VARY IN DURATION AND IN PERFORMANCE. REVENUE IS RECOGNIZED WHEN THE PERFORMANCE OBLIGATIONS IDENTIFIED WITHIN THE INDIVIDUAL CONTRACTS ARE SATISFIED AND COLLECTIONS ARE PROBABLE. OTHER REVENUE FOR THE YEARS ENDED SEPTEMBER 30, 2024 AND 2023 ALSO INCLUDED FUNDING RECEIVED FROM FEDERAL AND STATE SOURCES RELATED TO THE COVID-19 PANDEMIC AMOUNTING TO $17,500 AND $6,100, RESPECTIVELY.EMERGENCY CARE ACCESSAS PREVIOUSLY NOTED IN THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, BIDMC SERVED AS THE SOLE MEMBER OF BID PLYMOUTH. THE MEDICAL CENTER IS A NATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER AND TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) IS AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BIDMC AND IS ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BID PLYMOUTH EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. THE BID PLYMOUTH DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR. FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION FINANCIAL ASSISTANCE POLICY-INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE BID PLYMOUTH IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE FROM BID PLYMOUTH AS WELL AS PROVIDERS WHO FOLLOW BID PLYMOUTH'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN BID PLYMOUTH AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW BID PLYMOUTH'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. BID PLYMOUTH DOES NOT DISCRIMINATE WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONS EFFECTIVE ON OR ABOUT APRIL 24, 2024.FINANCIAL ASSISTANCE POLICY-APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY-ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE-PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY-TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: CHINESE (TRADITIONAL), SPANISH (ESPAOL), PORTUGUESE (PORTUGUS), AND VIETNAMESE (TIENG VIET) (SCHEDULE H PART V SECTION B QUESTION 16I).FINANCIAL ASSISTANCE POLICY-WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://BIDPLYMOUTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/ASSISTANCE. IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION FINANCIAL ASSISTANCE POLICY-PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE BID PLYMOUTH FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. - CREDIT AND COLLECTION POLICY- APPLICATION FOR FINANCIAL ASSISTANCE- MEDICAL HARDSHIP APPLICATION- FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, CHINESE, SPANISH, PORTUGUESE, AND VIETNAMESE, CAN BE FOUND ON THE BID PLYMOUTH WEBSITE AT: HTTPS://BIDPLYMOUTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/ASSISTANCE. LIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED-LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. THE HOSPITAL MAY DEFER OR REQUIRE PAYMENT BEFORE PROVIDING MEDICALLY NECESSARY SERVICES (OTHER THAN EMERGENCY MEDICAL SERVICES) TO PATIENTS WITH UNPAID BALANCES WHO HAVE FAILED TO PROVIDE REQUESTED INFORMATION FOR PROCESSING A FINANCIAL ASSISTANCE APPLICATION OR WITH RESPECT TO A PAYMENT PLAN. THE HOSPITAL DOES NOT PROVIDE A 30-DAY WRITTEN NOTICE IN ADVANCE OF TAKING SUCH ACTION, AS SUCH NOTICE IS NOT REQUIRED BY THE SECTION 501(R) REGULATIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS NOTED THROUGHOUT THIS FORM 990, BID PLYMOUTH IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH BID PLYMOUTH DOES NOT DIRECTLY ENGAGE IN RESEARCH, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC, NEW ENGLAND BAPTIST HOSPITAL AND JOSLIN DIABETES CENTER ALL ENGAGE IN RESEARCH ACTIVITIES DESIGNED TO CARE FOR PATIENTS NOT ONLY AT THESE HOSPITALS, BUT ACROSS THE COMMUNITIES SERVED BY BILH AND BEYOND. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $370 MILLION IN RESEARCH EXPENSES, MORE THAN $91 MILLION OF WHICH WERE INTERNALLY FUNDED. ALTHOUGH THE RESEARCH ACTIVITIES OF THESE BIDMC AND OTHER BILH AFFILIATES ARE NOT QUANTIFIED HERE IN BID PLYMOUTH'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY BID PLYMOUTH, BILH AND BEYOND. INFORMATION ON THE RESEARCH ENGAGED IN AT BIDMC AND JOSLIN, SISTER ENTITIES TO BID PLYMOUTH, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION. TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:- ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE - EMERGENCY MEDICINE - MEDICINE - ALLERGY AND INFLAMMATION - CARDIOVASCULAR MEDICINE - CENTER FOR VASCULAR BIOLOGY RESEARCH - CLINICAL INFORMATICS - CLINICAL NUTRITION - ENDOCRINOLOGY - EXPERIMENTAL MEDICINE - GASTROENTEROLOGY - GENERAL MEDICINE AND PRIMARY CARE - GENETICS - GERONTOLOGY - HEMATOLOGY AND ONCOLOGY - HEMOSTASIS AND THROMBOSIS - IMMUNOLOGY - INFECTIOUS DISEASE - INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY - MOLECULAR AND VASCULAR MEDICINE - NEPHROLOGY - PULMONOLOGY - RHEUMATOLOGY - SIGNAL TRANSDUCTION - TRANSLATIONAL RESEARCH - TRANSPLANT IMMUNOLOGY-NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY - CARDIAC SURGERY - CENTER FOR MINIMALLY INVASIVE SURGERY - NEUROSURGERY - PLASTIC AND RECONSTRUCTIVE SURGERY - VASCULAR SURGERY- TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $370 MILLION IN RESEARCH EXPENSES, MORE THAN $91 MILLION OF WHICH WERE INTERNALLY FUNDED AND REPORTED ON THE BIDMC SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE.RESEARCH ENGAGED IN AT THE MEDICAL CENTERTHE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. DETAIL ON RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. 1. FIRST-OF-ITS-KIND STUDY FINDS HIDDEN CLUES TO RARE TYPE OF PANCREATIC CANCER, OPENS DOORS TO NEW THERAPIESPANCREATIC NEUROENDOCRINE TUMORS (PANNETS) ARE A RARE KIND OF CANCER THAT FORMS IN THE PANCREAS. PHYSICIANS STILL HAVE DIFFICULTY PREDICTING HOW THE DISEASE WILL AFFECT INDIVIDUAL PATIENTS AND HOW BEST TO TREAT IT.BIDMC SCIENTISTS USED PROTEOGENOMICS, THE INTEGRATED LARGE-SCALE STUDY OF GENES AND PROTEINS IN CANCER CELLS, TO LEARN MORE ABOUT THESE TUMORS. USING 37 TUMOR SAMPLES, THE TEAM DISCOVERED FOUR PREVIOUSLY UNDESCRIBED PANNETS. TWO OF THESE SUBTYPES SHOWED HIGH RECURRENCE RATES, SUGGESTING A PREVIOUSLY UNRECOGNIZED CLINICAL AGGRESSIVENESS. THESE TUMORS ALSO SHOWED SIGNS OF LOW OXYGEN LEVELS AND INFLAMMATIONBOTH LINKED TO MORE AGGRESSIVE CANCERS.THE SCIENTISTS ALSO FOUND CHANGES IN HOW THE CANCER CELLS USE ENERGY AND HOW THEY HIDE FROM THE IMMUNE SYSTEM, FINDINGS WHICH COULD HELP RESEARCHERS DEVELOP NEW TREATMENTS.IMPORTANTLY, THE RESEARCHERS ADD, THESE PROTEOMIC SUBTYPES WOULD NOT HAVE BEEN DISCOVERABLE USING PRIOR GENOMICS-BASED APPROACHES TO PANNETS OR CURRENT STATE-OF-THE-ART CLINICOPATHOLOGICAL PANNET SUBTYPING. LEAD AUTHOR MICHAEL ROEHRL, CHIEF OF THE DEPARTMENT OF PATHOLOGY AND PI AT BIDMC SAID: "PROTEOGENOMICS REPRESENTS A SIGNIFICANT STEP FORWARD IN UNDERSTANDING PANCREATIC NEUROENDOCRINE TUMORS, AND OUR PUBLICLY AVAILABLE PROTEOMIC PANNET DATASET SHOULD BE OF IMMEDIATE INTEREST TO SCIENTISTS AND PHYSICIANS AROUND THE WORLD." 2. RESEARCHERS HALT PROGRESSION IN PARKINSON'S DISEASE MOUSE MODEL, OPENING THE DOOR TO POTENTIAL DISEASE-MODIFYING TREATMENT FOR PATIENTS WITH PARKINSON'S DISEASEINVESTIGATORS AT BIDMC SHED NEW LIGHT ON KEY CELLULAR PROCESSES INVOLVED IN THE PROGRESSION OF PARKINSON'S DISEASE (PD). AFFECTING AROUND 10 MILLION PEOPLE WORLDWIDE, PARKINSON'S DISEASE IS A NEURODEGENERATIVE DISORDER CAUSED BY THE PROGRESSIVE LOSS OF THE GROUP OF BRAIN CELLS RESPONSIBLE FOR PRODUCING DOPAMINE, A NEUROTRANSMITTER THAT PLAYS A CRITICAL ROLE IN REGULATING MOVEMENT AND COORDINATION. AS THESE NEURONS DEGENERATE AND DOPAMINE LEVELS DECREASE, INDIVIDUALS WITH PARKINSON'S DISEASE EXPERIENCE A WIDE RANGE OF SYMPTOMS, INCLUDING TREMORS, STIFFNESS AND DIFFICULTIES WITH BALANCE AND COORDINATION.RESEARCHERS IN THE LAB OF SENIOR AUTHOR DAVID K. SIMON, MD, PHD, DIRECTOR OF THE PARKINSON'S DISEASE & MOVEMENT DISORDERS CENTER, IN COLLABORATION WITH COLLEAGUES AT THE UNIVERSITY OF CAMBRIDGE AND MISSION THERAPEUTICS, PERFORMED TWO SETS OF COMPLEMENTARY EXPERIMENTS SHOWING THAT INHIBITING A SPECIFIC ENZYME IN A MOUSE MODEL PROTECTS THE DOPAMINE-PRODUCING NEURONS THAT ARE NORMALLY LOST AS PD PROGRESSES, EFFECTIVELY HALTING THE PROGRESSION OF THE DISEASE. THE FINDINGS OPEN THE DOOR TO THE DEVELOPMENT OF NOVEL THERAPEUTICS TARGETING THE ENZYME THAT MAY SLOW OR PREVENT THE PROGRESSION OF PARKINSON'S DISEASE IN PEOPLEA MAJOR UNMET NEED. "OUR LAB IS FOCUSED ON WORKING OUT THE ORIGINS OF PARKINSON'S DISEASE AND IT IS OUR HOPE THATONE DAYWE WILL BE ABLE TO SLOW DOWN OR EVEN PREVENT DISEASE PROGRESSION IN PATIENTS," SAID FIRST AUTHOR TRACY-SHI ZHANG FANG, PHD, AN INSTRUCTOR IN SIMON'S LAB. "THE CURRENT STUDY'S FINDINGS PAVE THE WAY TOWARD THAT FUTURE." FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION 3. AI CHATBOT SHOWS POTENTIAL AS DIAGNOSTIC PARTNER, RESEARCHERS FINDPHYSICIAN-INVESTIGATORS AT BIDMC COMPARED A CHATBOT'S PROBABILISTIC REASONING TO THAT OF HUMAN CLINICIANS. THE FINDINGS, PUBLISHED IN JAMA NETWORK OPEN, SUGGEST THAT ARTIFICIAL INTELLIGENCE COULD SERVE AS USEFUL CLINICAL DECISION SUPPORT TOOLS FOR PHYSICIANS.BASING THEIR STUDY ON A PREVIOUSLY PUBLISHED NATIONAL SURVEY OF MORE THAN 550 PRACTITIONERS PERFORMING PROBABILISTIC REASONING ON FIVE MEDICAL CASES, ADAM RODMAN, MD, AN INTERNAL MEDICINE PHYSICIAN AND INVESTIGATOR IN THE DEPARTMENT OF MEDICINE, AND COLLEAGUES FED THE PUBLICLY AVAILABLE LARGE LANGUAGE MODEL (LLM), CHAT GPT-4, THE SAME SERIES OF CASES AND RAN AN IDENTICAL PROMPT 100 TIMES TO GENERATE A RANGE OF RESPONSES.THE CHATBOTJUST LIKE THE PRACTITIONERS BEFORE THEMWAS TASKED WITH ESTIMATING THE LIKELIHOOD OF A GIVEN DIAGNOSIS BASED ON PATIENTS' PRESENTATION. THEN, GIVEN TEST RESULTS SUCH AS CHEST RADIOGRAPHY FOR PNEUMONIA, MAMMOGRAPHY FOR BREAST CANCER, STRESS TEST FOR CORONARY ARTERY DISEASE AND A URINE CULTURE FOR URINARY TRACT INFECTION, THE CHATBOT PROGRAM UPDATED ITS ESTIMATES.WHEN TEST RESULTS WERE POSITIVE, IT WAS SOMETHING OF A DRAW; THE CHATBOT WAS MORE ACCURATE IN MAKING DIAGNOSES THAN THE HUMANS IN TWO CASES, SIMILARLY ACCURATE IN TWO CASES AND LESS ACCURATE IN ONE CASE. BUT WHEN TESTS CAME BACK NEGATIVE, THE CHATBOT SHONE, DEMONSTRATING MORE ACCURACY IN MAKING DIAGNOSES THAN HUMANS IN ALL FIVE CASES.BUT RODMAN IS LESS INTERESTED IN HOW CHATBOTS AND HUMANS PERFORM TOE-TO-TOE THAN IN HOW HIGHLY SKILLED PHYSICIANS' PERFORMANCE MIGHT CHANGE IN RESPONSE TO HAVING THESE NEW SUPPORTIVE TECHNOLOGIES AVAILABLE TO THEM IN THE CLINIC, ADDED RODMAN."HUMANS STRUGGLE WITH PROBABILISTIC REASONING, THE PRACTICE OF MAKING DECISIONS BASED ON CALCULATING ODDS," SAID RODMAN. "WE CHOSE TO EVALUATE PROBABILISTIC REASONING IN ISOLATION BECAUSE IT IS A WELL-KNOWN AREA WHERE HUMANS COULD USE SUPPORT. HUMANS SOMETIMES FEEL THE RISK IS HIGHER THAN IT IS AFTER A NEGATIVE TEST RESULT, WHICH CAN LEAD TO OVERTREATMENT, MORE TESTS AND TOO MANY MEDICATIONS."4. BIDMC'S COMPLEX HYPERTENSION CENTER IS THE REGION'S ONLY AMERICAN HEART ASSOCIATION-CERTIFIED COMPREHENSIVE CARE CENTER PHYSICIAN-SCIENTISTS AT BIDMC, LED BY ERIC A. SECEMSKY, MD, ARE AT THE FOREFRONT OF A BREAKTHROUGH TREATMENT FOR PATIENTS WITH TREATMENT-RESISTANT HYPERTENSIONDANGEROUSLY HIGH BLOOD PRESSURE THAT PERSISTS DESPITE TAKING THREE OR MORE MEDICATIONS. FOR THESE HIGH-RISK PATIENTS, BIDMC IS AMONG THE FIRST IN THE NATION TO OFFER RENAL DENERVATION (RDN), A MINIMALLY INVASIVE PROCEDURE THAT TARGETS OVERACTIVE NERVES NEAR THE KIDNEYS TO HELP LOWER BLOOD PRESSURE.SECEMSKY, DIRECTOR OF VASCULAR INTERVENTION AT BIDMC, PIONEERED THE USE OF RDN AT THE MEDICAL CENTER AND SERVES AS SITE PRINCIPAL INVESTIGATOR ON MAJOR CLINICAL TRIALS THAT HELPED SECURE FDA APPROVAL FOR TWO CATHETER-BASED RDN DEVICES. THE PROCEDURE INVOLVES THREADING A DEVICE THROUGH THE GROIN TO REACH THE RENAL ARTERIES. ONE USES HEAT-FILLED BALLOONS; THE OTHER, RADIOFREQUENCY ABLATIONBOTH DESIGNED TO DISRUPT NERVE SIGNALS THAT RAISE BLOOD PRESSURE.SO FAR, SECEMSKY AND HIS TEAM HAVE PERFORMED RDN ON SIX PATIENTS THROUGH BIDMC'S COMPLEX HYPERTENSION CLINIC, WHICH BRINGS TOGETHER A MULTIDISCIPLINARY TEAM TO CARE FOR PATIENTS WITH THE MOST DIFFICULT-TO-CONTROL BLOOD PRESSURE. ON AVERAGE, PATIENTS CAN EXPECT A 710 MMHG DROP IN BLOOD PRESSUREENOUGH TO MEANINGFULLY REDUCE THE RISK OF HEART ATTACK AND STROKE OVER TIME."THIS DEVICE IS NOVEL AND STATE-OF-THE ART, BUT MORE IMPORTANTLY, HAVING SOMETHING TO OFFER PEOPLE WITH TREATMENT RESISTANT BLOOD PRESSURE REPRESENTS ONE PART OF OUR OPPORTUNITY TO BUILD ONE OF THE LARGEST HYPERTENSION CENTERS IN NEW ENGLAND.5. NEW AI MODEL FLAGS 3.5 TIMES AS MANY PATIENTS AT RISK FOR PANCREATIC CANCER AS CURRENT SCREENING GUIDELINES; COULD LEAD TO EARLIER DETECTION OF PANCREATIC CANCERHOVERING AT JUST 11 PERCENT, PANCREATIC CANCER HAS THE LOWEST FIVE-YEAR RELATIVE SURVIVAL RATE OF ANY CANCER DIAGNOSIS, LARGELY BECAUSE THE DISEASE IS TYPICALLY CAUGHT IN ITS ADVANCED STAGES. IF CAUGHT IN ITS EARLIEST STAGES, FIVE-YEAR SURVIVAL RATES CAN REACH AS HIGH AS 80 PERCENT; HOWEVER, CURRENT SCREENING GUIDELINES APPLY ONLY TO ABOUT 10 PERCENT OF THE 62,000 PANCREATIC CANCER CASES THAT ARE DIAGNOSED EACH YEAR IN THE UNITED STATES. INVESTIGATORS AT BIDMC BUILT AND VALIDATED A RISK PREDICTION MODEL TO HELP PHYSICIANS IDENTIFY PATIENTS WHO ARE AT HIGH RISK FOR DEVELOPING PANCREATIC CANCER. THE TEAM'S MODEL, A NEURAL NETWORK TRAINED ON DE-IDENTIFIED DATA FROM ELECTRONIC HEALTH RECORDS FROM 55 U.S. HEALTH CARE ORGANIZATIONS, FLAGGED PATIENTS AS AT RISK OF DEVELOPING PANCREATIC CANCER UP TO 18 MONTHS BEFORE DIAGNOSIS IN PATIENTS 40 YEARS OR OLDER AND CAUGHT 3.5 TIMES AS MANY CASES THAN CURRENT SCREENING GUIDELINES WOULD IF APPLIED TO THE SAME GROUP. THEIR FINDINGS APPEAR IN EBIOMEDICINE, PART OF LANCET DISCOVERY SCIENCE.NAMED PRISMNN, THE TEAM'S MACHINE LEARNING MODEL WAS TRAINED ON DATA FROM MORE THAN 1.5 MILLION EHR PROVIDED BY INDUSTRY PARTNER TRINETX. THE DATA SET INCLUDED AN AVERAGE OF 13 YEARS OF HISTORICAL DATA ABOUT DEMOGRAPHICS, DOCTOR'S VISITS, DIAGNOSES, LAB WORK, PROCEDURES AND MEDICATIONS FOR MORE THAN 35,000 PATIENTS WHO EVENTUALLY DEVELOPED PANCREATIC CANCER AND MORE THAN 1.5 MILLION CONTROLS. THE MODEL FLAGGED PATIENTS AT HIGH RISK FOR DEVELOPING CANCER BASED ON 87 FEATURES IT AUTOMATICALLY SELECTED BASED ON THE INPUT TRAINING DATA."THERE ARE SIGNALS IN THE DATA THAT'S BEING ROUTINELY COLLECTED ALREADY WHEN PEOPLE SEE THEIR PRIMARY CARE PHYSICIAN OR GO TO THE ED WITH A BROKEN ANKLESYMPTOMS THAT SHOW UP, SUCH AS CERTAIN MEDICATIONS OR CHANGES IN LAB VALUES," LIMOR APPELBAUM, AN INVESTIGATOR AT BIDMC, SAID. "TAKEN TOGETHER, THESE ARE ALL SIGNALS THAT CAN PREDICT PANCREATIC CANCER BEFORE THE CANCER IS ACTUALLY DETECTED, AND THAT GIVES US THE OPPORTUNITY TO CATCH THOSE CANCERS EARLY, BEFORE IT HAS SPREAD."6. PLASMA PROTEIN CLUES COULD HELP PREDICT WHO WILL DEVELOP HYPERTENSIONEXERCISE TESTING CAN SERVE AS A POWERFUL PHYSIOLOGIC PROBE TO UNMASK SUBCLINICAL CARDIOVASCULAR ABNORMALITIES WELL BEFORE DISEASE ONSET. FOR EXAMPLE, BLOOD PRESSURE CHANGES DURING EXERCISE (EBP) CAN REVEAL A LATENT TENDENCY TOWARD FUTURE DEVELOPMENT OF HYPERTENSION. AT PRESENT, THERE IS NO RELIABLE CIRCULATING BIOMARKERA PROTEIN OR OTHER MOLECULE PRESENT IN THE BLOOD STREAMINDICATIVE OF FUTURE RISK OF HYPERTENSION.INVESTIGATORS AT BIDMC IDENTIFIED UNIQUE CIRCULATING PROTEINS THAT REFLECT EBP AND THAT MAY, IN TURN, BE EARLY INDICATORS OF FUTURE RISK OF HYPERTENSION. LED BY ROBERT E. GERSZTEN, MD, DIRECTOR OF BIDMC'S NATIONALLY RECOGNIZED PROGRAM IN PERSONAL GENOMICS AND CARDIOMETABOLIC DISEASE, JEREMY ROBBINS, MD, AND MARK SARZYNSKI, PHD, THE SCIENTISTS PERFORMED LARGE-SCALE PROTEOMIC PROFILING AND EBP MEASUREMENTS AMONG 681 HEALTHY ADULTS WHO UNDERWENT CARDIOPULMONARY EXERCISE TESTING BEFORE AND AFTER 20 WEEKS OF ENDURANCE EXERCISE TRAINING.THE STUDY TEAM, INCLUDING LEAD AUTHOR PRASHANT RAO, MBBS, IDENTIFIED 37 PROTEINS ASSOCIATED WITH EBP, MANY OF WHICH WOULD NOT HAVE BEEN IDENTIFIED THROUGH PROFILING RESTING BP ALONE. SEVERAL OF THESE PROTEINS WERE RELEVANT TO VASCULAR BIOLOGY.THE INVESTIGATORS DEMONSTRATED THAT THE EBP-ASSOCIATED PLASMA PROTEIN KNOWN AS TGFBR3 IS A NOVEL CIRCULATING BIOMARKER ASSOCIATED WITH A LOWER RISK OF INCIDENT HYPERTENSION. GENETICALLY PREDICTED LEVELS OF THIS PLASMA PROTEIN WERE INVERSELY ASSOCIATED WITH FUTURE HYPERTENSION RISK IN A DIVERSE POPULATION AND MAY PROTECT AGAINST THE DEVELOPMENT OF CVD. THIS WORK MAY HELP IN DETERMINING WHICH PATIENTS MIGHT BENEFIT FROM EARLY CLINICAL INTERVENTIONS TO REDUCE THE IMPACT OF CARDIOVASCULAR DISEASE. FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION 7. DYNAMIC DUO: COMBINING CHOLESTEROL-LOWERING STATINS WITH EXISTING CANCER DRUG SHOWS POTENT EFFECT AGAINST AGGRESSIVE SUBTYPE OF BREAST CANCER IN PRE-CLINICAL MODELSIN A NEW TRANSLATIONAL RESEARCH STUDY, INVESTIGATORS AT BIDMC EXPLORED THE POTENTIAL OF STATINS COMMONLY USED MEDICATIONS FOR MANAGING CHOLESTEROL LEVELS TO WORK IN CONJUNCTION WITH AKT INHIBITORS, A CLASS OF DRUGS THAT TARGET A KEY PATHWAY INVOLVED IN CANCER CELL SURVIVAL AND GROWTH. RESEARCHERS DISCOVERED THAT THIS DRUG COMBINATION POTENTLY KILLED TRIPLE NEGATIVE BREAST CANCER (TNBC) CELLS IN PRECLINICAL MODELS. THE FINDINGS SUGGEST THE DRUG COMBINATION MAY PROVIDE A NEW, EFFECTIVE TREATMENT FOR TNBC, A SUBTYPE OF BREAST CANCER KNOWN FOR ITS AGGRESSIVENESS AND LIMITED TREATMENT OPTIONS AND THAT AFFECTS UP TO 15 PERCENT OF BREAST CANCER PATIENTS.THE BIDMC INVESTIGATORS AND THEIR COLLEAGUES USED A CRISPR-BASED SCREENING APPROACH IN TNBC TO IDENTIFY GENES THAT COULD BE TARGETED IN COMBINATION WITH A RECENTLY FDA-APPROVED AKT-INHIBITOR CALLED CAPIVASERTIB. THE SCREEN IDENTIFIED GENES IN CHOLESTEROL METABOLISM AS CANDIDATES, REVEALING A TNBC-SPECIFIC VULNERABILITY TO THE COMBINATION OF STATINSCHOLESTEROL-LOWERING DRUGS THAT TARGET CELLS' CHOLESTEROL METABOLISMAND AKT INHIBITORS.AS THE SCIENTISTS EXPECTED, THE COMBINATION KILLED TNBC CELLS IN A PANEL OF CELL LINES, PATIENT-DERIVED ORGANOIDS AND MOUSE MODELS. THE FINDINGS PAVE THE WAY FOR CLINICAL TRIALS TO DETERMINE THE SAFETY AND EFFECTIVENESS OF THIS COMBINATION IN PATIENTS. IF SUCCESSFUL, THIS BASIC, DISCOVERY SCIENCE APPROACH COULD LEAD TO A NEW TREATMENT OPTION FOR PATIENTS WITH TNBC, PROVIDING A MUCH-NEEDED ADVANCEMENT IN THE FIGHT AGAINST THIS AGGRESSIVE CANCER.RESEARCH AT JOSLIN DIABETES CENTERTHE JOSLIN DIABETES CENTER (JDC), IN CONJUNCTION WITH ITS AFFILIATE THE JOSLIN CLINIC, PROVIDES WORLD CLASS LEADING EDGE PATIENT CARE IN THE SPECIALTY AREA OF DIABETES AND CARING FOR PATIENTS THROUGH A RELENTLESS TEAM OF CLINICIANS, SKILLED HEALTH EDUCATORS, AND ACCESS TO PIONEERING DIABETES RESEARCH. JOSLIN IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND OFFERS A RICH EDUCATIONAL ENVIRONMENT INVOLVING COURSES, LECTURES, FELLOWSHIP OPPORTUNITIES AND CME COURSES. JDC ALSO PROVIDES INFRASTRUCTURE, MANAGEMENT AND SUPPORT SERVICES TO ITS AFFILIATE, THE JOSLIN CLINIC. IN ADDITION, JOSLIN'S MISSION IS NOT ONLY TO PROVIDE OUTSTANDING PATIENT CARE, BUT ALSO TO BRING BEST PRACTICES TO THE LARGER MEDICAL COMMUNITY. JOSLIN ENGAGES IN RESEARCH RELATED TO BETTER UNDERSTANDING DIABETES, HOW TO TREAT IT AND HOW TO HELP PATIENTS MANAGE AND LIVE HEALTHIER LIVES WITH THE DISEASE. JOSLIN DIABETES RESEARCH CENTER IS ONE OF ONLY 16 NIH-DESIGNATED DIABETES RESEARCH CENTERS IN THE UNITED STATES. JOSLIN'S RESEARCH TEAM IS WORLD-RENOWNED AND PASSIONATE ABOUT IMPROVING THE LIVES OF PEOPLE WITH DIABETES.MILLIONS OF PEOPLE WITH DIABETES THROUGHOUT THE WORLD BENEFIT DIRECTLY FROM BASIC AND CLINICAL RESEARCH CONDUCTED AT THE CENTER. APPROXIMATELY 300 RESEARCHERS EMPLOYED AT THE JOSLIN DIABETES CENTER ARE WORKING ON VARIOUS ASPECTS OF DIABETES, SEARCHING FOR WAYS TO PREVENT AND TREAT DIABETES IN ALL ITS FORMS AND ULTIMATELY FIND A CURE FOR THE DISEASE.THE RESEARCH ENGAGED IN AT JDC HELPS IMPROVES THE LIVES AT JDC, ACROSS BILH AND IN THE WIDER COMMUNITY BEYOND EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE COMMUNITIES. AS NOTED ABOVE RELATED TO BIDMC, ALTHOUGH JOSLIN'S RESEARCH ACTIVITIES ARE NOT QUANTIFIED HERE IN THIS HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY THIS HOSPITAL, ALL OF BILH AND BEYOND. SOME EXAMPLES OF RESEARCH ENGAGED IN BY JOSLIN DURING THE PERIOD COVERED BY THIS FILING ARE BELOW. 1. MORE THAN HALF OF PATIENTS WITH VISION-THREATENING CONDITION UNAWARE THEY HAVE ITA LONG-RUNNING STUDY OF 27,000 PEOPLE WITH DIABETES SUGGESTS THERE'S A MAJOR COMMUNICATION GAP BETWEEN PATIENTS AND THEIR EYE CARE PROVIDERS. IN A TEN-YEAR OBSERVATIONAL STUDY, INVESTIGATORS AT JOSLIN DIABETES CENTER ASSESSED THE SELF-REPORTED AWARENESS OF THE PRESENCE OF DIABETIC RETINOPATHYA SERIOUS COMPLICATION OF BOTH TYPE 1 AND TYPE 2 DIABETESIN 26,876 PATIENTS WITH DIABETES WHO UNDERWENT RETINAL IMAGING DURING AN ENDOCRINOLOGY VISIT. THESE PARTICIPANTS WERE NOT RECEIVING EYE CARE AT JOSLIN. WITH PREVIOUS DIAGNOSTIC INFORMATION AVAILABLE FOR MORE THAN 94 PERCENT OF PARTICIPANTS, THE INVESTIGATORS FOUND SUBSTANTIAL DISCREPANCIESWHAT THEY CALL "LOW CONCORDANCE"BETWEEN PARTICIPANTS' CURRENT EYE HEALTH STATUS AND THEIR SELF-REPORTED EYE HEALTH. WHILE NEARLY ALL PATIENTS WITHOUT DIABETIC RETINOPATHY REPORTED NOT HAVING ANY EYE DISEASE, 89 PERCENT OF PATIENTS WITH MILD CASES AND 55 PERCENT OF PATIENTS WITH VISION-THREATENING DIABETIC RETINOPATHY ALSO REPORTED THAT THEY WERE UNAWARE OF ANY EYE DISEASE. A QUARTER OF THOSE WITH VISION-THREATENING DISEASE ALSO DID NOT REPORT PLANNED FOLLOWUP IN ACCORDANCE WITH NATIONAL GUIDELINES.INCREASING AWARENESS OF DIABETIC RETINOPATHY WAS LINKED TO INCREASING EYE CARE PROVIDER SPECIALIZATION. AMONG THOSE WITH VISION-THREATENING DIABETIC RETINOPATHY, PATIENTS WHO SAW A RETINA PHYSICIAN HAD HIGHEST AWARENESS OF THEIR DIABETIC RETINOPATHY AND THE HIGHEST CONCORDANCE WITH FOLLOW UP.2. PREVENTING BETA CELL DYSFUNCTIONDIABETES RESULTS FROM FAILURE OF BETA () CELLS IN PANCREATIC ISLETS TO RELEASE SUFFICIENT INSULIN TO REGULATE BLOOD SUGAR IN THE BODY. RESEARCHERS AT JOSLIN DIABETES CENTER REVEALED THAT THE CHRONICALLY HIGH SUGAR LEVELS THAT OCCUR EARLY DURING THE DEVELOPMENT OF DIABETES FURTHER UNDERMINE THE ABILITY OF BETA CELLS TO PRODUCE INSULIN BY REDUCING TRANSLATION OF SPECIFIC MRNAS THAT CONTAIN THE CELL'S GENETIC INSTRUCTIONS FOR MAKING AND SECRETING INSULIN. BLOCKING THIS RESPONSE TO HIGH SUGAR LEVELS COULD BE A NEW WAY TO PREVENT PROGRESSION OF EARLY DIABETES OR EVEN AN EFFECTIVE STRATEGY TO IMPROVE THE FUNCTION OF BETA CELLS IMPLANTED IN PATIENTS TO CURE DIABETES.THE TEAM LOOKED AT THE IMPACT OF SUSTAINED ELEVATED GLUCOSE LEVELS ON CELL MRNA TRANSLATION ACROSS THE ENTIRE GENOME USING HIGH-THROUGHPUT RIBOSOME PROFILING AND NASCENT PROTEOMICS IN MIN6 INSULINOMA CELLS AND THEN VERIFIED SPECIFIC CHANGES IN HUMAN ISLETS. THEY DEMONSTRATED THAT SUSTAINED HIGH GLUCOSE SELECTIVELY IMPAIRS TRANSLATION OF GENES THAT SERVE CRITICAL ROLES AT ALMOST EVERY STEP OF GLUCOSE METABOLISMCOUPLED INSULIN SECRETION IN PANCREATIC CELLS.THE RESEARCH UNCOVERED A TRANSLATIONAL REGULATORY CIRCUIT DURING CELL GLUCOSE TOXICITY THAT IMPAIRS EXPRESSION OF PROTEINS WITH CRITICAL ROLES IN CELL FUNCTION THAT MAY BE LEVERAGED TO DEVELOP NEW THERAPEUTIC STRATEGIES FOR THE TREATMENT OF DIABETES. 3. STUDY COMPARES THE EFFECTS OF BARIATRIC SURGERY VERSUS MEDICAL MANAGEMENT FOR PEOPLE WITH TYPE 2 DIABETES A LANDMARK STUDY CONDUCTED AT FOUR SITES, INCLUDING JOSLIN DIABETES CENTER, REPORTS THAT PEOPLE WITH TYPE 2 DIABETES WHO UNDERWENT BARIATRIC SURGERY ACHIEVED BETTER LONG-TERM BLOOD GLUCOSE CONTROL COMPARED TO PEOPLE WHO RECEIVED MEDICAL MANAGEMENT PLUS LIFESTYLE INTERVENTIONS. PARTICIPANTS WHO UNDERWENT BARIATRIC SURGERY, ALSO CALLED METABOLIC OR WEIGHT-LOSS SURGERY, WERE ALSO MORE LIKELY TO STOP NEEDING DIABETES MEDICATIONS AND HAD HIGHER RATES OF DIABETES REMISSION UP TO 12 YEARS POST-SURGERY. THE FINDINGS, PUBLISHED IN JAMA, SUGGEST THAT WEIGHT LOSS SURGERY MAY CARRY BENEFITS FOR PEOPLE WITH DIABETES, EVEN THOSE WHO ARE BELOW THE TRADITIONAL BMI THRESHOLD OF 35 FOR BARIATRIC SURGERY. AMONG THE FINDINGS, THE STUDY SHOWED THAT:- THE SURGERY GROUP EXPERIENCED AN AVERAGE 20 PERCENT WEIGHT LOSS COMPARED TO 8 PERCENT IN THE MEDICAL/LIFESTYLE GROUP.- THE PERCENT OF PARTICIPANTS USING MEDICATIONS TO TREAT DIABETES IN THE SURGERY GROUP DECREASED FROM 98 PERCENT TO 61 PERCENT YET REMAINED LARGELY UNCHANGED IN THE MEDICATION/LIFESTYLE GROUP.- 18 PERCENT OF PARTICIPANTS IN THE SURGERY GROUP WERE IN REMISSIONMEANING THEY NO LONGER REQUIRED MEDICATIONS TO CONTROL THEIR BLOOD GLUCOSE LEVELSFROM DIABETES, COMPARED TO 6 PERCENT OF PARTICIPANTS IN THE MEDICATION/LIFESTYLE GROUP.- THE RESULTS AND DIFFERENCES BETWEEN GROUPS REMAINED SIGNIFICANT AT 12 YEARS."WHEN WE TREAT DIABETES, WE'RE REALLY TRYING TO PREVENT COMPLICATIONS LIKE HEART DISEASE, KIDNEY DISEASE, STROKE, NERVE DAMAGE AND EYE DAMAGE," SAID SITE PI M. E. PATTI, ENDOCRINOLOGIST IN THE ADULT DIABETES SECTION, AND DIRECTOR OF THE HYPOGLYCEMIA CLINIC AT JOSLIN DIABETES CENTER. "WE AREN'T JUST LOOKING TO REDUCE BODY WEIGHT, WE ALSO WANT TO IMPROVE OVERALL HEALTH. THIS RANDOMIZED STUDY IS AN IMPORTANT MILESTONE SHOWING SURGERY PROVIDES SUSTAINED IMPROVEMENTS IN DIABETES CONTROL." FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION 4. SHIFTING FOCUS: INVESTIGATORS DESCRIBE CHANGES TO PANCREATIC CELL AT ONSET OF TYPE 1 DIABETESABOUT EIGHT MILLION PEOPLE LIVE WITH TYPE 1 DIABETES (T1D) WORLDWIDE, A CHRONIC AUTOIMMUNE CONDITION IN WHICH THE BODY ATTACKS AND DESTROYS ITS OWN INSULIN-PRODUCING -CELLS (PRONOUNCED "BETA") IN THE PANCREAS, LEADING TO A LACK OF INSULIN AND INABILITY TO REGULATE BLOOD SUGAR. IT'S NOT KNOWN WHY THE BODY SUDDENLY PERCEIVES ITS OWN -CELLS AS THE ENEMY; SOME LINES OF EVIDENCE SUGGEST ENVIRONMENTAL FACTORS SUCH AS VIRAL INFECTIONS MAY TRIGGER THE ONSET OF T1D, OTHERS SUGGEST GENETICS MAY ALSO PLAY SOME ROLE.GROUNDBREAKING RESEARCH BY INVESTIGATORS AT JOSLIN DIABETES CENTER SHEDS NEW LIGHT ON THE SPECIFIC CHANGES -CELLS GO THROUGH AT THE ONSET OF T1D. THEIR FINDINGSPUBLISHED IN NATURE CELL BIOLOGYOFFER NEW AVENUES FOR TARGETED INTERVENTIONS FOR THE CHRONIC AUTOIMMUNE CONDITION."IN THE FIELD OF TYPE 1 DIABETES, RESEARCH HAS LARGELY FOCUSED ON UNDERSTANDING THE IMMUNE COMPONENT, BUT OUR STUDY ARGUES THAT THE -CELL IS A SIGNIFICANT PLAYER," SAID ROHIT N. KULKARNI, MD, PHD, MARGARET A. CONGLETON CHAIR AND CO-HEAD OF THE SECTION ON ISLET & REGENERATIVE BIOLOGY AT JOSLIN DIABETES CENTER. "OUR FINDINGS SUGGEST THAT THE -CELL COULD BE INITIATING KEY EVENTS WHICH THEN PROMOTE THE AUTOIMMUNE MECHANISM TO GO AWRY. IT'S A PARADIGM SHIFTING APPROACH."5. JOSLIN EXPERTS' PILOT STUDY SHOWS HYBRID CARE LEADS TO BETTER OUTCOMES FOR SOME WITH T1DFOR MOST YOUNG PEOPLE, LEAVING HOME AND LIVING INDEPENDENTLY FOR THE FIRST TIME MEANS SUDDENLY HAVING TO MANAGE THEIR OWN HEALTH, FROM SCHEDULING REGULAR DOCTOR APPOINTMENTS TO PREPARING HEALTHY MEALS. FOR YOUNG ADULTS WITH TYPE 1 DIABETES (T1D) WHO MUST MANAGE THEIR BLOOD SUGAR LEVELS 24/7 ON THEIR OWN, THE STAKES ARE ESPECIALLY HIGH. EVIDENCE SUGGESTS YOUNG ADULTS WITH T1D WITH SUBOPTIMAL GLYCEMIC CONTROL ARE AT HIGH RISK OF HOSPITALIZATION AND LONG-TERM COMPLICATIONS.TO ADDRESS MANY OF THE CHALLENGES TO DIABETES MANAGEMENT FACED BY YOUNG ADULTS WITH T1D, RESEARCHERS AT JOSLIN DIABETES CENTER DEVELOPED A PROGRAM THAT LEVERAGES TELEHEALTH AND PROVIDES SUPPORT FROM DEDICATED CASE MANAGERS WHO SERVE AS LIAISONS BETWEEN PATIENTS AND THEIR CARE TEAMS. IN A PAPER PUBLISHED IN ENDOCRINE PRACTICE, THE RESEARCHERS REPORTED THAT THEIR PILOT PROGRAM, KNOWN AS LEVERAGING INTENSIVE FOLLOW-UP TREATMENT IN YOUNG ADULTS (LIFT-YA) WAS ASSOCIATED WITH IMPROVED GLYCEMIC CONTROL AND AN INCREASE IN ADOPTION OF CONTINUOUS GLUCOSE MONITORS (CGM)TWO KEYS TO IMPROVED OUTCOMES FOR YOUNG ADULTS WITH DIABETES.AT THE END OF THE PILOT STUDY, THE RESEARCHERS COMPARED OUTCOMES OF THOSE ABLE TO COMPLETE THE PROGRAM AND THOSE ABLE TO ATTEND FEWER THAN HALF THE MEETINGS, AS WELL AS 33 PEOPLE WHO DID NOT PARTICIPATE. AS EXPECTED, THE "COMPLETERS" HAD A SIGNIFICANTLY HIGHER NUMBER OF TOTAL VISITS THAN THE OTHER TWO GROUPS.SIMILARLY, THE NUMBER OF CGM USERS INCREASED DRAMATICALLY BY 70 PERCENT AMONG THE COMPLETERS BUT REMAINED UNCHANGED IN THE OTHER TWO GROUPS. LIKEWISE, THE COMPLETERS SAW SIGNIFICANT REDUCTION IN THEIR HBA1C LEVELS, A MEASURE OF BLOOD SUGAR, WITHIN THEIR GROUP. "WE BELIEVE THE EFFORTS OF THE CASE MANAGERS TO OVERCOME OPERATIONAL HURDLES AND OTHER CLINICAL CHALLENGES BY COORDINATING EFFECTIVE COMMUNICATION BETWEEN PARTICIPANTS AND THE MULTIDISCIPLINARY CARE TEAM WERE PART OF THE REASON WE SAW THESE POSITIVE OUTCOMES," TOSCHI SAID. "LEVERAGING FREQUENT TELEHEALTH-BASED VISITS AND THE ANCHORING ROLE OF THE CASE MANAGERS PROVIDED ACTIONABLE SOLUTIONS FOR AT LEAST SOME OF THE SELF-REPORTED BARRIERS TO DIABETES CARE IN YOUNG ADULTS WITH T1D.SELECTED JOSLIN PUBLICATIONS FYE 9/30/24HYBRID CARE MODEL: COMBINING TELEMEDICINE AND OFFICE VISITS FOR DIABETES MANAGEMENT IN OLDER ADULTS WITH TYPE 1 DIABETESMED RES ARCH / SEP 30 2024BILH AUTHORS ELENA TOSCHI, ATIF ADAM, REBECCA HURLBERT, CHRISTINE SLYNE, LORI LAFFEL, MEDHA MUNSHI ROLE OF DIVALENT CATIONS IN INFECTIONS IN HOST-PATHOGEN INTERACTIONINT J MOL SCI / SEP 10 2024BILH AUTHORS JOHN A D'ELIA, LARRY A WEINRAUCHCHARACTERIZING VASCULAR WALL AND LUMEN CALIBER IN EYES WITH DIABETIC RETINOPATHY BASED ON ADAPTIVE OPTICS SCANNING LASER OPHTHALMOSCOPYDIAGNOSTICS (BASEL) / SEP 12 2024BILH AUTHORS KONSTANTINA SAMPANI, JENNIFER K SUNCAN INTRANASAL NALOXONE PREVENT HYPOGLYCEMIA-ASSOCIATED AUTONOMIC FAILURE?J CLIN ENDOCRINOL METAB / SEP 27 2024BILH AUTHORS HAMAYLE SAEED, MARY-ELIZABETH PATTIM6A MRNA METHYLATION BY METTL14 REGULATES EARLY PANCREATIC CELL DIFFERENTIATIONEMBO J / SEP 25 2024BILH AUTHORS SEVIM KAHRAMAN, DARIO F DE JESUS, NATALIE K BROWN, JIANG HU, ROHIT N KULKARNIEXERCISE ACTIVATES AMPK IN MOUSE AND HUMAN PANCREATIC ISLETS TO DECREASE SENESCENCENAT METAB / SEP 24 2024BILH AUTHORS PRISCILA CARAPETO, KANAKO IWASAKI, FRANCESKO HELA, JIHO KAHNG, ANA B ALVES-WAGNER, ROELAND J W MIDDELBEEK, MICHAEL F HIRSHMAN, LAURIE J GOODYEAR, CRISTINA AGUAYO-MAZZUCATOPOSTPRANDIAL METABOLOMICS ANALYSIS REVEALS DISORDERED SEROTONIN METABOLISM IN POST-BARIATRIC HYPOGLYCEMIAJ CLIN INVEST / SEP 12 2024BILH AUTHORS RAFAEL FERRAZ-BANNITZ, BERKCAN OZTURK, CAMERON CUMMINGS, VISSARION EFTHYMIOU, PILAR CASANOVA QUEROL, LINDSAY POULOS, HANNA WANG, VALERIE NAVARRETE, HAMAYLE SAEED, CHRISTOPHER M MULLA, HUI PAN, JONATHAN M DREYFUSS, MARY-ELIZABETH PATTI CIRCULATING METABOLITE BIOMARKERS OF GLYCEMIC CONTROL IN YOUTH-ONSET TYPE 2 DIABETESJAMA OPHTHALMOL / SEP 1 2024BILH AUTHORS CHANG LU, JONATHAN M DREYFUSS, SHUNING ZHENG, DANIELLE WOLFS, ELVIRA ISGANAITISULTRA-WIDEFIELD AND EARLY TREATMENT DIABETIC RETINOPATHY STUDY 7-FIELD GRADING OF DIABETIC RETINOPATHYJAMA OPHTHALMOL / SEP 2 2024BILH AUTHORS LLOYD PAUL AIELLO, JENNIFER K SUNASSESSMENT OF BASELINE ULTRAWIDEFIELD FLUORESCEIN ANGIOGRAPHIC QUANTITATIVE LEAKAGE PARAMETERS WITH ULTRAWIDEFIELD FUNDUS FEATURES AND CLINICAL PARAMETERS IN DIABETIC RETINOPATHY IN PROTOCOL AAOPHTHALMOL RETINA / AUG 30 2024BILH AUTHORS JENNIFER K SUNNEURODEGENERATIVE BIOMARKERS IN DIFFERENT CHAMBERS OF THE EYE RELATIVE TO PLASMA: AN AGREEMENT VALIDATION STUDYALZHEIMERS RES THER / AUG 26 2024BILH AUTHORS KONSTANTINA SAMPANIWHAT REALLY MATTERS?: HOW INSULIN DOSE, TIMING, AND DISTRIBUTION RELATE TO MEAL COMPOSITION IN FREE-LIVING PEOPLE WITH TYPE 1 DIABETESDIABETES TECHNOL THER / AUG 22 2024BILH AUTHORS ELENA TOSCHI, ASTRID ATAKOV-CASTILLO ENDOTHELIN 3/EDNRB SIGNALING INDUCES THERMOGENIC DIFFERENTIATION OF WHITE ADIPOSE TISSUENAT COMMUN / AUG 22 2024BILH AUTHORS CHIH-HAO WANG, TADATAKA TSUJI, TIAN LIAN HUANG, MARI SATO, FARNAZ SHAMSI, YU-HUA TSENGSCREENDMT REVEALS DIHOMES ARE REPLICABLY INVERSELY ASSOCIATED WITH BMI AND STIMULATE ADIPOCYTE CALCIUM INFLUXCOMMUN BIOL / AUG 14 2024BILH AUTHORS JONATHAN M DREYFUSS, HUI PAN LIGHT-RESPONSIVE ADIPOSE-HYPOTHALAMUS AXIS CONTROLS METABOLIC REGULATIONNAT COMMUN / AUG 8 2024BILH AUTHORS TADATAKA TSUJI, YANG ZHANG, TIAN LIAN HUANG, HENRIQUE CAMARA, MEGHAN HALPIN, MATTHEW D LYNESMATRISOME PROTEOMICS REVEALS NOVEL MEDIATORS OF MUSCLE REMODELING WITH AEROBIC EXERCISE TRAININGMATRIX BIOL PLUS / AUG 7 2024BILH AUTHORS PATTARAWAN PATTAMAPRAPANONT, EILEEN M COONEY, TARA L MACDONALD, HUI PAN, JONATHAN M DREYFUSS, SARAH J LESSARDLIGNAN INTAKE AND TYPE 2 DIABETES INCIDENCE AMONG US MEN AND WOMENJAMA NETW OPEN / AUG 1 2024BILH AUTHORS QI SUNEVERYTHING YOU WANTED TO KNOW ABOUT PANCREATIC DUCTS BUT DIDN'T KNOW WHERE TO LOOKGASTROENTEROLOGY / JUL 31 2024BILH AUTHORS ROHIT KULKARNIFENOFIBRATE SHOWS PROMISE IN SLOWING DIABETIC RETINOPATHY PROGRESSIONNEJM EVID / JUL 23 2024BILH AUTHORS PAOLO S SILVA, LLOYD PAUL AIELLOTHE ARDUOUS PATH TOWARD EQUITABLE ACCESS TO ENDOCRINOLOGY CAREJ ENDOCR SOC / JUL 15 2024BILH AUTHORS GIULIO R ROMEO, TIZIANA CAPUTOEXPRESSION PROFILING BY HIGH-THROUGHPUT SEQUENCING REVEALS GADD45, SMAD7, EGR-1 AND HOXA3 ACTIVATION IN MYOSTATIN (MSTN) AND GDF11 TREATED MYOBLASTSGENET MOL BIOL / JUL 15 2024BILH AUTHORS AMY J WAGERSEXERCISE TRAINING AND COLD EXPOSURE TRIGGER DISTINCT MOLECULAR ADAPTATIONS TO INGUINAL WHITE ADIPOSE TISSUECELL REP / JUL 13 2024BILH AUTHORS MARIA VAMVINI, PASQUALE NIGRO, TIZIANA CAPUTO, KRISTIN I STANFORD, MICHAEL F HIRSHMAN, ROELAND J W MIDDELBEEK, LAURIE J GOODYEARMULTI-STEP REGULATION OF MICRORNA EXPRESSION AND SECRETION INTO SMALL EXTRACELLULAR VESICLES BY INSULINCELL REP / JUL 13 2024BILH AUTHORS MARSEL LINO, RUBEN GARCIA-MARTIN, VITOR ROSETTO MUOZ, GABRIEL PALERMO RUIZ, ALLAH NAWAZ, BRUNA BRASIL BRANDO, JONATHAN DREYFUS, HUI PAN, C RONALD KAHNIMPACT OF A TUBELESS, DISPOSABLE INSULIN PUMP ON EMERGENCY DEPARTMENT VISITS AND INPATIENT ADMISSIONS AMONG A MEDICARE POPULATIONJ MANAG CARE SPEC PHARM / JUN 17 2024BILH AUTHORS MEDHA N MUNSHI FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION RATIONALE OF BASIC AND CELLULAR MECHANISMS CONSIDERED IN UPDATING THE STAGING SYSTEM FOR DIABETIC RETINAL DISEASEOPHTHALMOL SCI / MAR 27 2024BILH AUTHORS WARD FICKWEILER, GEORGE KING, LLOYD PAUL AIELLO FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS- GRADUATE MEDICAL EDUCATION AS NOTED THROUGHOUT THIS FORM 990, BID PLYMOUTH IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH BID PLYMOUTH DOES NOT DIRECTLY ENGAGE IN HEALTH PROFESSIONS EDUCATION / GRADUATE MEDICAL EDUCATION, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND MOUNT AUBURN HOSPITAL ALL ENGAGE IN EDUCATIONAL ACTIVITIES DESIGNED TRAIN FUTURE PHYSICIANS AND OTHER FUTURE HEALTHCARE PRACTITIONERS. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $210 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $67 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $143 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW. ALTHOUGH THE EDUCATIONAL ACTIVITIES OF THESE BILH AFFILIATES ARE NOT QUANTIFIED HERE IN BID PLYMOUTH'S FORM 990 SCHEDULE H, PART I, 7F, AS ALREADY NOTED THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY BID PLYMOUTH AND BEYOND. IN ADDITION, INFORMATION ON THE TEACHING ACTIVITIES AT BIDMC, A SISTER ENTITY TO BID PLYMOUTH, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 63 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 736 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 43 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 47 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS:- ANESTHESIOLOGY- EMERGENCY MEDICINE- EAR, NOSE AND THROAT (OTOLARYNGOLOGY)- INTERNAL MEDICINE- NEUROLOGY- NEUROSURGERY- OBSTETRICS AND GYNECOLOGY- PATHOLOGY- PLASTIC SURGERY - PSYCHIATRY- RADIOLOGY- SURGERY- TRANSITIONAL YEAR- UROLOGYRESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. MORE THAN HALF OF THESE PROGRAMS (47 OF 91) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS:- ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA, ANESTHESIA MEDICAL EDUCATION, ADVANCED CRITICAL CARE AND ULTRASOUND- DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS)- EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, MEDICAL EDUCATION IN EMERGENCY MEDICINE- INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY- NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY, NEURO CRITICAL CARE- OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY, UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY.- PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY - PSYCHIATRY: EARLY PSYCHOSIS, CONSULT LIAISON PSYCHIATRY- RADIOLOGY: DIAGNOSTIC, ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING (MSK), NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, ADVANCED CROSS-SECTIONAL IMAGING. - RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC- SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, LYMPHATIC SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, OTOLARYNGOLOGY FELLOWSHIP, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATED, JOINTS FELLOWSHIPADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS -- EXAMPLESBELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER: FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HEALTH ALLIANCE, TUFTS MEDICAL CENTER, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL, SOUTH SHORE HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: - RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE.- DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: - DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: - DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC.- ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS.PROGRAM OBJECTIVES - INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS - CONTRIBUTE TO THE HEALTH AND WELL-BEING OF POPULATIONS AROUND THE WORLD - ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS - EXPAND RESEARCH OPPORTUNITIES - ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION SITE LOCATIONS - BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. - VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. - ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH. NEUROLOGY EDUCATION AT BIDMCTHE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. PATHOLOGY EDUCATION AT BIDMCTHE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING. FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION RADIOLOGY EDUCATION AT BIDMCTHE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE:- THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR.- FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR.- ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.OUR UNIQUE EDUCATIONAL TRACKSCURRENTLY, SIX TRACKS ARE OFFERED:- CLINICAL- EDUCATION- RESEARCH- GLOBAL HEALTH- QUALITY IMPROVEMENT- HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.SURGERY EDUCATION AT BIDMCTHE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, NEUROSURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, UROLOGY, AND VASCULAR SURGERY. RESIDENTS AND FELLOWS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. RESIDENTS AND FELLOWS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE:- RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB - SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS - COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.IRC 501(R) REPORTING UNDER REVENUE PROCEDURE 2015-21DURING A REVIEW OF BID PLYMOUTH'S SECTION 501(R) COMPLIANCE IN FY24, IT WAS DETERMINED THAT HOSPITAL WAS NOT CONSISTENTLY OFFERING A COPY OF ITS FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY (PLS) AS PART OF PATIENT INTAKE OR DISCHARGE. THE HOSPITAL HAS WORKED AND IS CONTINUING TO WORK ON TRAINING ITS INTAKE AND DISCHARGE TEAMS TO ENSURE THAT A COPY OF THE PLS IS OFFERED. THE HOSPITAL IS NOT AWARE OF ANY PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE THAT WERE ADVERSELY AFFECTED BY NOT BEING OFFERED A COPY OF THE PLS AT EITHER INTAKE OR DISCHARGE. BID PLYMOUTH HAS ADOPTED PROCEDURES THAT REQUIRE IT TO REVIEW, ON A REGULAR BASIS, ITS POLICIES AND PROCEDURE TO ENSURE COMPLIANCE WITH THE REQUIREMENTS OF SECTION 501(R) AND THE REGULATIONS ISSUED THEREUNDER. THOSE PROCEDURES INCLUDE REVIEWING A SECTION 501(R) COMPLIANCE CHECKLIST. FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. AFFILIATED HEALTH CARE SYSTEM AND ACCOMPLISHMENTSAS NOTED THROUGHOUT THIS FORM 990, BID PLYMOUTH IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.THE BILH CORE VALUES AND PRINCIPALS ARE LISTED HERE AS WELL AS NETWORK-WIDE ACCOMPLISHMENTS DURING THE FISCAL PERIOD COVERED BY THIS FILING. THE BILH NETWORK IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. THE BILH PURPOSE STATEMENT ARTICULATES THE IMPACT THAT EACH BILH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. THESE SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS.EQUITY. EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.BILH IS ACCOMPLISHING THIS MISSION BY PROVIDING SUPPORT TO ITS AFFILIATES WHICH INCLUDE:1. A PHYSICIAN ENTERPRISE THAT ENCOMPASSES THE SYSTEM'S NETWORK OF EMPLOYED PRIMARY CARE AND SPECIALTY PHYSICIANS LOCATED THROUGHOUT OUR REGION;2. A HOSPITAL AND AMBULATORY SERVICES GROUP THAT INCLUDES WORLD-CLASS ACADEMIC MEDICAL CENTERS AND TEACHING HOSPITALS WITH AFFILIATIONS WITH HARVARD MEDICAL SCHOOL, UM AND TUFTS UNIVERSITY SCHOOL OF MEDICINE; LEADING COMMUNITY HOSPITALS; A RENOWNED ORTHOPEDICS HOSPITAL; AND COMPREHENSIVE AMBULATORY CENTERS;3. A POPULATION HEALTH ENTERPRISE THAT EMBRACES A MODEL OF CARE TO IMPROVE THE HEALTH OF ALL THOSE SERVED BY BILH; THE POPULATION HEALTH DOMAIN INCLUDES THE SYSTEM'S CLINICALLY INTEGRATED NETWORK OF AFFILIATED PROVIDERS AND VITAL SERVICES, INCLUDING BEHAVIORAL HEALTH AND HOME CARE SERVICES; 4. A ROBUST NETWORK OF ADMINISTRATIVE AND OPERATIONAL SERVICES TO ADVANCE STRATEGIC GOALS, BOTH LOCALLY AND AT THE SYSTEM LEVEL, THAT OFFERS EXPERTISE AND STANDARDIZED RESOURCES BASED ON BEST PRACTICES.DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), THE JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC (EHRI) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND LHSS IN TURN SERVED AS THE SOLE MEMBER OF BETH ISRAEL LAHEY HEALTH PRIMARY CARE. THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. SEE FORM 990 SCHEDULE R FOR ADDITIONAL AFFILIATED ENTITIES. BILH PROVIDES CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS. BILH SUPPORT INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING SERVICES: DEVELOPMENT AND FUNDRAISING, STRATEGIC PLANNING, COMPLIANCE, GOVERNANCE AND LEGAL SUPPORT, HUMAN RESOURCES, PATIENT CARE PAYOR CONTRACTING, OPERATIONAL SUPPORT SUCH AS PROCESSING PAYROLL AND ACCOUNTS PAYABLE, NETWORK-WIDE BENEFIT PLAN STRUCTURING AND NETWORK-WIDE CASH MANAGEMENT. BILH OVERSEES THE FINANCIAL WELL-BEING OF ITS AFFILIATES, INCLUDING PROVIDING MANAGEMENT, LEADERSHIP, DEBT STRUCTURING SUPPORT, FINANCING OF CAPITAL PROJECTS THROUGH ITS OBLIGATED GROUP DEBT AND FINANCIAL SUPPORT SERVICES, INCLUDING INTERNAL AND EXTERNAL AUDIT, TREASURY, INSURANCE AND TAX SERVICES. FOR THE FISCAL PERIOD COVERED BY THIS FILING BILH, INC. PROVIDED SERVICES AND SUPPORT TO ITS AFFILIATES, IN THE AMOUNT OF $15,835,226,845.ADDITIONAL DETAIL ABOUT ACCOMPLISHMENTS ACROSS BILH ARE BELOW. FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES - FISCAL YEAR ENDED SEPTEMBER 30, 2024BILH'S SUPPORT OF ITS AFFILIATES ENABLES THE NETWORK AS A WHOLE TO ACCOMPLISH ITS PRIMARY MISSION OF IMPROVING THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. AS NOTED PREVIOUSLY IN THIS FILING, BILH STRIVES TO ACCOMPLISH THIS MISSION BY DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO USE SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE AND BILH IS ACCOMPLISHING THIS GOAL BY PROVIDING SUPPORT TO EACH OF ITS AFFILIATES, PROVIDING AN ORGANIZATIONAL STRUCTURE AND OPERATING MODEL WHICH IS DRIVEN BY FOUR DEEPLY INTERCONNECTED DOMAINS DESIGNED TO ADVANCE MEANINGFUL PARTNERSHIPS ACROSS ORGANIZATIONS, CARE SETTINGS, SPECIALTIES, AND GEOGRAPHIES TO ENSURE BILH PATIENTS RECEIVE THE CARE THEY NEED IN THE COMMUNITIES WHERE THEY LIVE AND WORK.PATIENT CARE DELIVERY ACROSS THE BILH NETWORK - FISCAL YEAR ENDED SEPTEMBER 30, 2024HOSPITAL CARE:DURING THE PERIOD COVERED BY THIS FILING, THE BILH HOSPITALS PROVIDED CARE TO PATIENTS IN A FULL SPECTRUM OF SPECIALTIES AND UTILIZING A WIDE RANGE OF MODALITIES. BELOW ARE A SAMPLE OF THE HOSPITAL CARE PROVIDED TO BILH PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING, BILH HOSPITALS HAD APPROXIMATELY 4.9 MILLION OUTPATIENT ENCOUNTERS. APPROXIMATELY 80,000 OUTPATIENT/AMBULATORY SURGERIES AND OVER 100,000 ENDOSCOPIES WERE PERFORMED, IN ADDITION, ACROSS BILH HOSPITALS PATIENTS HAD MORE THAN 141,000 ONCOLOGY VISITS AND ALMOST 111,000 ONCOLOGY INFUSIONS, 268,000 EKGS, OVER 59,000 ORTHOPEDIC PROCEDURES, MORE THAN 758,000 RADIOLOGY EXAMS, OVER 312,000 CT EXAMS, MORE THAN 177,000 ULTRASOUND PROCEDURES, OVER 142,000 MRIS, OVER 221,000 OUTPATIENT BREAST IMAGING EXAMS, APPROXIMATELY 312,000 OUTPATIENT REHABILITATION AND PHYSICAL THERAPY VISITS AND MORE THAN 11.7 MILLION OUTPATIENT LAB TESTS WERE PERFORMED. THE BILH HOSPITALS ALSO HAD APPROXIMATELY 432,000 EMERGENCY DEPARTMENT VISITS, MORE THAN 35,000 OBSERVATION CASES AND MORE THAN 137,000 INPATIENT DISCHARGES WITH APPROXIMATELY 729,000 INPATIENT DAYS, INCLUDING MORE THAN 44,000 INPATIENT PSYCH DAYS. DURING THIS PERIOD MORE THAN 31,000 INPATIENT SURGERIES WERE PERFORMED AND APPROXIMATELY 14,000 NEWBORNS WERE DELIVERED AND THERE WERE APPROXIMATELY 52,000 PAIN CLINIC VISITS. BILH HOSPITALS ALSO HAD MORE THAN 75,000 URGENT CARE VISITS DURING THIS PERIOD. NON-HOSPITAL PHYSICIAN CARE:DURING THE PERIOD COVERED BY THIS FILING, THE BILH PHYSICIANS PROVIDED CARE TO PATIENTS OUTSIDE OF THE HOSPITALS AND IN PHYSICIAN OFFICE OR OTHER CLINICAL SETTINGS. BELOW ARE A SAMPLE OF THE NON-HOSPITAL PHYSICIAN SERVICES PROVIDED TO BILH PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING, MORE THAN 470 PRIMARY CARE AND FAMILY PRACTICE PROVIDERS HAD APPROXIMATELY 843,000 PATIENT VISITS AND PROVIDERS ACROSS THE FULL SPECTRUM OF SPECIALTIES HAD MORE THAN 624,000 PATIENT VISITS. IN ADDITION, JOSLIN DIABETES CENTER HAD MORE THAN 27,000 PATIENT VISITS RELATED TO DIABETES CARE AND THERE WERE MORE THAN 53,000 URGENT CARE VISITS TO NON-HOSPITAL URGENT CARE LOCATIONS. COMMUNITY BENEFITS, UNCOMPENSATED CARE, COSTS TO PROVIDE CARE TO MEDICAID AND MEDICARE PATIENTS - FISCAL YEAR ENDED SEPTEMBER 30, 2024DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED MORE THAN $52 MILLION IN NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST.IN ADDITION TO THE CHARITY CARE REPORTED ABOVE, EACH OF THE BILH HOSPITALS ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT ENSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICAID PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL EXCEEDING $35.5 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS. PAYMENTS FROM MEDICARE DO NOT COVER THE COST OF SERVICES PROVIDED. ALL BILH HOSPITALS PROVIDE CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICARE PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE, RESULTING IN A COMBINED SHORTFALL EXCEEDING $161 MILLION RELATED TO TREATING MEDICARE PATIENTS. IN ADDITION TO THE COSTS NOTED ABOVE, DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED COMBINED COMMUNITY BENEFITS, COMMUNITY HEALTH IMPROVEMENT SERVICES, CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY HEALTH CENTERS AND OTHER GROUPS AS WELL AS COSTS INCURRED RELATED TO SUBSIDIES FOR PRIMARY AND SPECIALTY CARE ACCESS, BEHAVIORAL HEALTH CARE AND OTHER CARE PROVIDED AT A LOSS TOTALING OVER $150 MILLION. FOR ADDITIONAL INFORMATION ON THESE ACTIVITIES AS WELL AS EACH HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY, PLEASE SEE FORM 990 SCHEDULE H FOR EACH OF THE BILH HOSPITALS. EDUCATION AND RESEARCH - FISCAL YEAR ENDED SEPTEMBER 30, 2024RESEARCH ACTIVITIES ACROSS BILH SERVE PATIENT CARE BOTH AT BILH AND BEYOND AS PART OF THE ADVANCEMENT OF SCIENCE. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION AND TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $370 MILLION IN RESEARCH EXPENSES, MORE THAN $91 MILLION OF WHICH WERE INTERNALLY FUNDED.ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $210 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $67 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $143 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW.ADDITIONAL BILH NETWORK ACTIVITIES - EXPANDING ACCESS AND SERVICES; CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST; BEHAVIORAL HEALTH; COMMUNITY INVESTMENTS - FISCAL YEAR ENDED SEPTEMBER 30, 2024THROUGHOUT THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH ("BILH") REMAINED COMMITTED TO DELIVERING HIGH-QUALITY CARE AT A LOWER COST BY LEVERAGING COMMUNITY SETTINGS AND MAINTAINING CARE WITHIN THE BILH PERFORMANCE NETWORK ("BILHPN"), WHEN APPROPRIATE. THE FOLLOWING HIGHLIGHTS SOME OF THESE ONGOING EFFORTS. IN ADDITIONAL TO THE ACCOMPLISHMENTS NOTED ABOVE, BILH CONTINUED THIS COMMITMENT WITH THE FOLLOWING ACTIVITIES: ENHANCING THE BILHPN OPERATING MODELBILH PERFORMANCE NETWORK ("BILHPN") IS BILH'S CLINICALLY INTEGRATED NETWORK OF PHYSICIANS, CLINICIANS, AND HOSPITALS THAT WORK TOGETHER TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE CARE FOR PATIENTS. BILHPN ACHIEVED ITS GOAL OF BECOMING A FULLY INTEGRATED CLINICALLY INTEGRATED NETWORK ("CIN") IN FY 2024. THIS MOVE POSITIONED ITS PROVIDERS TO IMPROVE CARE QUALITY AND SUCCEED IN A VALUE-BASED DELIVERY SYSTEM. ALONGSIDE THIS TRANSFORMATION, BILHPN HAS REDEFINED ITS OPERATING MODEL TO PRIORITIZE HIGH-QUALITY CARE, IMPROVE THE HEALTH OF THE POPULATIONS BILH SERVES, ENHANCE PERFORMANCE, AND PROMOTE WELL-BEING ACROSS ITS NETWORK. THROUGHOUT FY 2024, BILHPN CONCENTRATED ON QUALITY IMPROVEMENT INITIATIVES, SUCH AS REDUCING DISPARITY GAPS, LOWERING READMISSION RATES, IMPROVING DIABETES AND HYPERTENSION MANAGEMENT, AND ENHANCING SKILLED NURSING CARE VISITS. FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION IMPROVING PHARMACY ACCESSTHROUGHOUT FY 2024, BILH PHARMACY EXPERIENCED SIGNIFICANT EXPANSION THAT REFLECTS ITS ONGOING COMMITMENT TO IMPROVING ACCESS TO CARE AND REDUCING THE COST OF CARE. ITS ACHIEVEMENTS INCLUDE:- EXPANDED ACCESS TO 8,000 ADDITIONAL PATIENTS, INCLUDING 5,700 MEDICAID PATIENTS;- IMPROVED PATIENT FINANCIAL ASSISTANCE SERVICES;- LAUNCHED CLINICS FOCUSED ON WEIGHT LOSS AND IRRITABLE BOWEL SYNDROME AND EXPANDED ACCESS TO ANTICOAGULATION MANAGEMENT THROUGH THE CENTRALIZED ANTICOAGULATION MANAGEMENT PROGRAM;- LAUNCHED INSCRIPT TO PROVIDE PHARMACY BENEFIT MANAGEMENT ("PBM") SERVICES TO FULLY INSURED AND SELF-FUNDED HEALTH PLANS, RESULTING IN HEALTH PLAN MEMBERS SAVING OVER 20% IN OUT-OF-POCKET COSTS AND GREATER ACCESS TO MEDICATION; AND, - EXPANDED PHARMACY PRESENCE IN CLINICS TO IMPROVE ACCESS TO MEDICATIONS FOR TREATING DIABETES AND CARDIOVASCULAR DISEASES.INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICESIN FY 2024, BILH AWARDED $1.2 MILLION TO FOUR COMMUNITY-BASED ORGANIZATIONS TO IMPLEMENT BEHAVIORAL HEALTH NAVIGATOR PROGRAMS THAT WILL FUND THE HIRING, TRAINING, AND SUPPORT OF COMMUNITY-BASED BEHAVIORAL HEALTH NAVIGATORS WHO WILL WORK TO IDENTIFY, UNDERSTAND, AND EFFECTIVELY CONNECT RESIDENTS EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE ISSUES TO APPROPRIATE SUPPORT AND ASSISTANCE. THE FOUR NONPROFIT ORGANIZATIONS IN THE GATEWAY MUNICIPALITIES OF HAVERHILL, LYNN, PEABODY, AND QUINCY HAVE BEEN GIVEN $300,000 EACH FROM FY 2024 TO 2027 TO LAUNCH THESE PROGRAMS IN THEIR COMMUNITIES. LABORATORY SERVICES EXPANSION AND OPTIMIZATIONBILH TRANSITIONED TO CENTRALIZED OVERSIGHT OF ALL LABORATORY DRAW SITES IN FY 2024 AND CREATED 11 NEW COMMUNITY-BASED LAB DRAW STATIONS, WHICH INCREASES PATIENT ACCESS TO LAB SERVICES AND IMPROVES BOTH PATIENT AND PROVIDER SATISFACTION. THE CENTRALIZED OVERSIGHT MODEL BETTER ENABLES BILH TO FOCUS ON QUALITY, SERVICE, AND PHLEBOTOMIST RECRUITMENT. IN ADDITION, BILH CONTINUES TO REFINE TRANSPORTATION ROUTES FOR LAB SPECIMENS, MAINTAINING HIGH STANDARDS FOR TURNAROUND TIMES AND EFFICIENCY, WHICH FURTHER IMPROVES THE OVERALL QUALITY OF LABORATORY SERVICES.ENHANCEMENT OF CARE DELIVERY ACROSS PRIMARY CARE PRACTICESBILH PRIMARY CARE ("BILHPC") CONTINUED TO ENHANCE CARE DELIVERY AND ELEVATE THE QUALITY OF CARE THROUGHOUT ITS PRACTICES, AS DEMONSTRATED BY THE FOLLOWING INITIATIVES:- PARTNERED WITH A BILHPN PHARMACIST AND LOCAL DIABETES NURSE EDUCATORS TO LAUNCH A DIABETES HUB AND SPOKE MODEL IN THE MILTON AND NEEDHAM PRIMARY CARE REGIONS, WHERE A DIABETES-SPECIALIZED ADVANCED PRACTICE PRACTITIONER IS EMBEDDED IN THE PRACTICE; - COLLABORATED WITH BILH PHARMACY TO PLAN THE EXPANSION OF REMOTE BLOOD PRESSURE MONITORING FOR IMPROVED HYPERTENSION MANAGEMENT;- EXPANDED THE VIRTUALIST PROGRAM, ENHANCING ACCESS TO ACUTE AND OVERFLOW CARE; AND - INTRODUCED A SELF-SCHEDULING TOOL FOR NEW PATIENTS SEEKING TO ESTABLISH CARE WITH A PRIMARY CARE PROVIDER.EDUCATION AND AWARENESS EFFORTS TO PROMOTE ACCESS TO CAREIN FY 2024, BILH WORKED TO IMPROVE ACCESS FOR MASSHEALTH PATIENTS IN EASTERN MASSACHUSETTS THROUGH VARIOUS COMMUNICATIONS INITIATIVES. A KEY EFFORT WAS LAUNCHING A MONTHLY NEWSLETTER, AVAILABLE IN SEVEN LANGUAGES, TO ENGAGE PATIENTS AND SHARE HEALTH INFORMATION. NEW ENGLAND BAPTIST HOSPITAL ("NEBH") HOSTED INFORMATION SESSIONS TO EDUCATE UNDERSERVED POPULATIONS ABOUT ITS SERVICES. NEBH ALSO PERFORMED OUTREACH TO COMMUNITY HOUSING FACILITIES, PARTICIPATED IN BOSTON MAYOR WU'S HISPANIC HERITAGE MONTH LUNCHEON, AND PARTNERED WITH NEIGHBORHOOD ASSOCIATIONS AND MAIN STREET BOARDS. 1 FATHER BILLS AND MAINSPRING INC 430 BELMONT ST BROCKTON MA 023014921 222538039 501(C)(3) 12500 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS SOUTH SHORE COMMUNITY ACTION COUNCIL INC 71 OBERY ST PLYMOUTH MA 023602181 046125732 501(C)(3) 7500 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS TAKING PEOPLE PLACES INC 62 MAIN ST STE 107 KINGSTON MA 023643046 881693722 501(C)(3) 12661 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS PLYMOUTH COUNTY SHERIFF'S DEPARTMENT 24 LONG POND ROAD PLYMOUTH MA 02360 271278951 GOVERNMENT ENTITY 20234 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS UNITED WAY OF GREATER PLYMOUTH COUNTY 934 WEST CHESTNUT STREET BROCKTON MA 02301 042103940 501(C)(3) 24500 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS PLYMOUTH REGIONAL ECONOMIC DEV FOUNDATION 32 COURT STREET PLYMOUTH MA 02360 043575807 501(C)(3) 15000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS MEDICAL CARE OF BOSTON MANAGEMENT CORP 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 042810972 501(C)(3) 1911966 0 ACCESS TO PRIMARY AND/OR SPECIALTY CARE 7 0 PART I, LINE 2: AS PREVIOUSLY NOTED IN THE FILING BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS. PART IV, SUPPLEMENTAL INFORMATION - ACCESS TO PRIMARY AND/OR SPECIALTY CARE AS PREVIOUSLY NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. THE BILH NETWORK IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. TO THAT END, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. PROVIDED GRANTS AND OTHER ASSISTANCE IN THE FORM OF CASH ALLOCATIONS FOR PRIMARY AND/OR SPECIALTY CARE OPERATIONS IN THE COMMUNITIES SERVED BY BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. THESE AMOUNTS ARE REPORTED IN THIS FORM 990 SCHEDULE I AND MAY NOT BE REFLECTED IN FORM 990 PART IX DEPENDING ON HOW THESE AMOUNTS WERE REPORTED IN THE AUDITED FINANCIAL STATEMENTS. X 1 1 1 1 0 0 0 0 0 1 0 TABB MD KEVIN CEO (EX-OFF) (CEO, BILH) 0 2183284 0 1588566 0 541537 0 1052595 0 44433 0 5410415 0 0 ROWAN MICHAEL TTEE(EXO)(CEO DESIG)EVP HOS&AMB BILH 0 1190402 0 617208 0 494507 0 2372445 0 29333 0 4703895 0 0 RIOS CINDY TREAS (EX-OFF) (EXEC VP & CFO, BILH) 0 926412 0 523188 0 21827 0 182509 0 35227 0 1689163 0 0 SHORETT PETER TTEE(CEO DESIG) (SR EVP & COO, BILH) 0 902677 0 453262 0 203537 0 14020 0 34226 0 1607722 0 0 KATZ ESQ JAMIE CLERK (EX-OFF); GENERAL COUNSEL BILH 0 820540 0 322850 0 126785 0 23170 0 8832 0 1302177 0 0 COUGHLIN KEVIN PRESIDENT & TRUSTEE (EX-OFFICIO) 534516 0 139415 0 96725 0 17070 0 36694 0 824420 0 0 0 THOMAS MD TENNY CHIEF MEDICAL OFFICER 465687 0 175782 0 6152 0 33000 0 44006 0 724627 0 0 0 BETTERIDGE MD DAVID R DIAGNOSTIC RADIOLOGIST 609438 0 35864 0 16164 0 39600 0 23421 0 724487 0 0 0 OLIWA MD NEIL ANESTHESIOLOGIST 566862 0 34418 0 21687 0 33000 0 41295 0 697262 0 0 0 BURNS ERIN TRUSTEE 566922 0 34418 0 8771 0 33000 0 47531 0 690642 0 0 0 KELLY MD DAVID TRUSTEE & VICE CHAIR 559554 0 36716 0 6180 0 39600 0 43762 0 685812 0 0 0 TIERNEY MD MATT CHIEF OF SURGERY 0 513412 0 50000 0 30758 0 33000 0 41037 0 668207 0 0 MASSENGALE MD JUSTIN CARDIOLOGIST 599646 0 0 0 6594 0 24750 0 36818 0 667808 0 0 0 CHAPIN RN MS MARY VP, AMBUL SVCS & PROCESS IMPROVEMT 236799 0 72842 0 44330 0 272643 0 30864 0 657478 0 0 0 FINE MD COLLEEN W RADIOLOGIST 538048 0 37158 0 28297 0 39600 0 8050 0 651153 0 0 0 GALVIN MD JAMES M RADIOLOGIST 550816 0 38299 0 8100 0 39600 0 6843 0 643658 0 0 0 RUTHERFORD RON VP, CIO, & VP, SUPPORT SERVICES 190139 0 64376 0 59501 0 236246 0 23201 0 573463 0 0 0 JENKINS JIM ASST TREAS (EX-OFF), CFO 326137 0 51574 0 26626 0 642 0 29826 0 434805 0 0 0 DOHERTY RN DONNA CNO & SVP, PATIENT CARE SERVICES 299162 0 78880 0 20229 0 12172 0 23496 0 433939 0 0 0 ABOU RJEILY MD CHARBEL CHIEF OF MEDICINE 297786 0 5499 0 22471 0 30989 0 36874 0 393619 0 0 0 RANGAVIZ SHEILAH ASST TREAS (EX-OFF), CFO 0 270890 0 41723 0 23931 0 9392 0 6675 0 352611 0 0 ARMSTRONG ESQ EMILY ASST CLERK (DIV VP DEP GC BOS, BILH) 0 250852 0 52448 0 6366 0 11084 0 30466 0 351216 0 0 BROWNING MD THOMAS FORMER CHIEF OF MEDICINE 0 235073 0 0 0 9796 0 24650 0 29852 0 299371 0 0 BAKER WENDY VP, HUMAN RESOURCES BUSINESS PARTNER 188346 0 61686 0 22190 0 8842 0 14245 0 295309 0 0 0 DWYER MARY CONTROLLER; FMR INT ASST TREAS &CFO 196982 0 3600 0 11947 0 8063 0 20747 0 241339 0 0 0 GEE ESQ CARROLL ASST CLERK (ASSOC GEN COUNSEL, BILH) 0 169811 0 10860 0 143 0 5609 0 35787 0 222210 0 0 PART I, LINE 1A FROM TIME TO TIME AND UNDER CERTAIN CIRCUMSTANCES, ENTITY OR ONE OF IT'S AFFILIATES MAY CHOOSE TO GROSS-UP A PAYMENT TO MAKE THE EMPLOYEE WHOLE FROM A TAX PERSPECTIVE. AS EXPLAINED FURTHER BELOW, ACROSS BILH THESE SITUATIONS ARE REVIEWED ON A CASE-BY-CASE BASIS AND THE COST OF ANY GROSS-UP IS CONSIDERED WHEN REVIEWING AN EMPLOYEE'S OVERALL COMPENSATION PACKAGE FOR REASONABLENESS. EXAMPLES OF THE TYPES OF EXPENSES WHICH MAY FALL INTO THIS CATEGORY ARE REIMBURSEMENT FOR RELOCATION AND TEMPORARY HOUSING. A HOUSING ALLOWANCE WAS PROVIDED TO ONE OFFICER DURING THE YEAR. THIS BENEFIT WAS TREATED AS PART OF THEIR TAXABLE COMPENSATION. PART I, LINE 3 BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S CHIEF EXECUTIVE OFFICER AND PRESIDENT ARE EMPLOYED THROUGH BETH ISRAEL LAHEY HEALTH (BILH), WHICH AS NOTED THROUGHOUT THIS FILING, IS THE DIRECT OR INDIRECT SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. IN THIS CAPACITY, THE BILH COMPENSATION COMMITTEE SETS COMPENSATION FOR THE CEO AND PRESIDENT OF BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. AS NOTED IN RESPONSE TO THIS FORM 990 PART VI QUESTIONS 15A AND 15B, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER SENIOR EXECUTIVES IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO AS VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BILH BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS FOR BOTH THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES ARE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION. PART I, LINES 4A-B ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, RECEIVED SEVERANCE PAYMENTS. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. BILH AND ITS AFFILIATES MAINTAIN CERTAIN SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING PLANS, WHICH UNDER THE DEFINITION TO THIS FORM 990 ARE SUPPLEMENTAL NONQUALIFIED PLANS: BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM, BETH ISRAEL LAHEY HEALTH, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, LAHEY CLINIC FOUNDATION, INC. 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN PHYSICIANS, SENIOR MANAGEMENT AND DEFINED MEDICAL STAFF, THE JORDAN HEALTH SYSTEMS, INC. 457(F) DEFERRED COMPENSATION PLAN. IN ADDITION, DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THESE ADDITIONAL IRC 457(B) PLANS AND BENEFITS FROM PARTICIPATING IN ONE OF THESE PLANS IS ALSO REPORTED IN THIS FORM 990: ANNA JAQUES HOSPITAL SELECT GROUP 457(B) DEFERRED COMPENSATION PLAN, BETH ISRAEL DEACONESS HOSPITAL MILTON 457(B) PLAN, BETH ISRAEL DEACONESS MEDICAL CENTER 457(B) PLAN, BETH ISRAEL LAHEY HEALTH, INC. 457(B) DEFERRED COMPENSATION PLAN, LAHEY CLINIC FOUNDATION, INC. 457(B) NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN PHYSICIANS, SENIOR MANAGEMENT AND DEFINED MEDICAL STAFF, MOUNT AUBURN HOSPITAL 457(B) DEFERRED COMPENSATION PLAN, NEW ENGLAND BAPTIST HOSPITAL 457(B) PLAN, THE JORDAN HEALTH SYSTEMS, INC. ELIGIBLE DEFERRED COMPENSATION PLAN, WINCHESTER HOSPITAL SELECT GROUP 457(B) DEFERRED COMPENSATION PLAN, EXETER HEALTH RESOURCES, INC. 457(B) RETIREMENT SAVINGS PLAN, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. 457(B) DEFERRED COMPENSATION PLAN. THESE PLANS ARE NON-QUALIFIED DEFERRED COMPENSATION PLANS AND PURSUANT TO THE PLANS, ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS AND/OR CAN MAKE THEIR OWN EMPLOYEE DEFERRALS. AMOUNTS RECEIVED BY PARTICIPANTS AND DEFERRED BY PARTICIPANTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. PART I, LINE 7 AS NOTED ABOVE, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES. DURING THE 2023 CALENDAR YEAR, BILH MAINTAINED EXECUTIVE COMPENSATION PACKAGES WHICH INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF VARIOUS FACTORS, INCLUDING BUT NOT LIMITED TO, MEETING OR EXCEEDING THE EMPLOYING ENTITY'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, BUDGETED CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. IN EACH CASE, INCENTIVE COMPENSATION WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, AND FOR THE BILH CEO AS NOTED ABOVE, THE FULL BILH BOARD OF TRUSTEES. ADDITIONAL INFORMATION IS INCLUDED IN THE EXPLANATORY NOTES TO THIS SCHEDULE J. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES: DIRECTORS AND TRUSTEES SERVE WITHOUT COMPENSATION: ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES IN THE NOTES BELOW. REPORTING PERIOD: AS REQUIRED BY FORM 990, COMPENSATION REPORTED IN THE FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024 IS CALENDAR YEAR 2023 COMPENSATION. COMPENSATION SOURCES: COMPENSATION REPORTED FOR INDIVIDUALS MAY INCLUDE COMPENSATION PAID BY THE REPORTING ENTITY, AN AFFILIATE OF THE REPORTING ENTITY AND IN SOME CASES UNRELATED ENTITIES AS REQUIRED BY FORM 990. REPORTABLE COMPENSATION: REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION: OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: ORDINARY WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN. OTHER REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER SUBSIDIZED PARKING; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE. DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401(K) RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403(B) RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT. NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE, AMONG OTHER THINGS, AMOUNTS FROM ONE OR MORE OF THE FOLLOWING NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, AND DISABILITY INSURANCE. ADDITIONAL INDIVIDUAL SPECIFIC INFORMATION IS INCLUDED BELOW. COMPLETE TITLES AND ADDITIONAL EXPLANATORY INFORMATION FOR OFFICERS, DIRECTOR/TRUSTEES, KEY EMPLOYEES AND THE ENTITIES FIVE HIGHEST PAID EMPLOYEES OTHER THAN ODTKE ARE LISTED BELOW ALPHABETICALLY: SCHEDULE J FOOTNOTES (CONTINUED): ABOU RJEILY, M.D., CHARBEL - CHIEF OF MEDICINE- BETH ISRAEL DEACONESS HOSPITAL -PLYMOUTH, INC. ARMSTRONG, ESQ., EMILY UNLESS OTHERWISE NOTED, MS. ARMSTRONG SERVED IN THE POSITIONS BELOW FOR THE FULL FISCAL YEAR ENDED SEPTEMBER 30, 2024: DIVISIONAL VICE PRESIDENT, DEPUTY GENERAL COUNSEL FOR METRO BOSTON - BETH ISRAEL LAHEY HEALTH - ASSISTANT CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - ASSISTANT CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. -TERM ENDED ON AUGUST 31, 2024 - ASSISTANT CLERK (EX-OFFICIO) - JOSLIN CLINIC, INC. -TERM ENDED ON SEPTEMBER 30, 2024 - ASSISTANT CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. -TERM ENDED ON SEPTEMBER 30, 2024 - ASSISTANT CLERK - THE JORDAN HEALTH SYSTEMS, INC. -TERM ENDED ON AUGUST 31, 2024 - ASSISTANT CLERK - JORDAN PHYSICIAN ASSOCIATES, INC. -TERM ENDED AUGUST 31, 2024 - CLERK (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP -TERM ENDED MARCH 30, 2023 - CLERK (EX-OFFICIO) - BAIM INSTITUTE FOR CLINICAL RESEARCH, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. -TERM ENDED MARCH 30, 2023 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. BAKER, WENDY - VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. MS. BAKER SERVED IN THIS POSITION DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. BETTERIDGE, M.D., DAVID R - DIAGNOSTIC RADIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR A TAXABLE INSURANCE BENEFIT IN THE AMOUNT OF $16,164. BROWNING, M.D., THOMAS - FORMER CHIEF OF MEDICINE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., INC. BURNS, ERIN - TRUSTEE - JORDAN HEALTH SYSTEMS, INC. - TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., INC. - TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. CARUCCI, DEAN MR. CARUCCI BEGAN SERVING IN THE FOLLOWING ROLES ON AUGUST 5, 2024, UNLESS OTHERWISE NOTED BELOW: - DIVISIONAL PRESIDENT, COMMUNITY - BETH ISRAEL LAHEY HEALTH, INC. -TERM BEGAN ON JULY 29, 2024 TRUSTEE - WINCHESTER HEALTHCARE MANAGEMENT, INC. -TERM BEGAN ON AUGUST 4, 2024 - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC - TRUSTEE - BID - MILTON PHYSICIAN ASSOCIATES, INC. - TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - EXETER HEALTH RESOURCES, INC. - TRUSTEE - EXETER HOSPITAL, INC. - TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE - WINCHESTER HEALTHCARE MANAGEMENT, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - WINCHESTER HOSPITAL AS NOTED, MR. CARUCCI SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. ACCORDINGLY, SINCE MR. CARUCCI DID NOT BEGIN SERVING IN HIS POSITIONS UNTIL CALENDAR YEAR 2024, THERE IS NO COMPENSATION TO REPORT IN THIS FILING. CHAPIN, RN, MS, MARY MS. CHAPIN SERVED IN THE FOLLOWING ROLE THROUGH NOVEMBER 3, 2023: - VICE PRESIDENT, AMBULATORY SERVICES & PROCESS IMPROVEMENT - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. OTHER REPORTABLE COMPENSATION FOR MS. CHAPIN INCLUDES SEVERANCE PAYMENTS RECEIVED IN 2023 IN THE AMOUNT OF $26,656. OTHER REPORTABLE COMPENSATION FOR MS. CHAPIN INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $16,633. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. DEFERRED COMPENSATION INCLUDES AN UNVESTED CONTRIBUTION TO A NONQUALIFIED PLAN IN THE AMOUNT OF $260,666. COUGHLIN, KEVIN - PRESIDENT AND TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH, INC. - PRESIDENT AND TRUSTEE - THE JORDAN HEALTH SYSTEMS, INC. - PRESIDENT AND TRUSTEE - JORDAN PHYSICIAN ASSOCIATES MR. COUGHLIN SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. COUGHLIN INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $70,859. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. DOHERTY, R.N., DONNA - CHIEF NURSING OFFICER AND SENIOR VICE PRESIDENT, PATIENT CARE SERVICES - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. OTHER REPORTABLE COMPENSATION FOR MS. DOHERTY INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $18,217. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. DWYER, MARY MS. DWYER SERVED IN THE FOLLOWING ROLE THROUGH MAY 15, 2022: - FORMER INTERIM ASSISTANT TREASURER (EX-OFFICIO), CHIEF FINANCIAL OFFICER, CONTROLLER - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR TO CASH OUT PTO IN THE AMOUNT OF $10,082. FINE, M.D., COLLEEN W - RADIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. GALVIN, M.D., JAMES M - RADIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. GEE, ESQ., CARROLL - ASSOCIATE GENERAL COUNSEL BETH ISRAEL LAHEY HEALTH MS. GEE BEGAN SERVING IN THE FOLLOWING ROLES AS OF SEPTEMBER 1, 2024: - ASSISTANT CLERK- BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - ASSISTANT CLERK THE JORDAN HEALTH SYSTEMS, INC. - ASSISTANT CLERK JORDAN PHYSICIAN ASSOCIATES, INC. - ASSISTANT CLERK COMMUNITY PHYSICIANS ASSOCIATES, INC. - ASSISTANT CLERK BID-MILTON PHYSICIAN ASSOCIATES, INC. - ASSISTANT CLERK BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. SCHEDULE J FOOTNOTES (CONTINUED): JENKINS, JIM UNLESS OTHERWISE NOTED, MR. JENKINS SERVED IN THE FOLLOWING POSITIONS DURING THE PERIOD ENDED SEPTEMBER 30, 2024: - ASSISTANT TREASURER (EX OFFICIO) AND CHIEF FINANCIAL OFFICER- THE JORDAN HEALTH SYSTEMS, INC. - ASSISTANT TREASURER (EX OFFICIO) AND CHIEF FINANCIAL OFFICER - JORDAN PHYSICIAN ASSOCIATES, INC. - ASSISTANT TREASURER (EX OFFICIO) AND CHIEF FINANCIAL OFFICER - BETH ISRAEL DEACONESS HOSPITAL- PLYMOUTH, INC. MR. JENKINS'S TERM ENDED IN THE ABOVE POSITIONS ON MARCH 29, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. MR. JENKINS OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR TEMPORARY HOUSING IN THE AMOUNT OF $14,236. KATZ, J.D., JAMIE UNLESS OTHERWISE NOTED BELOW, MR. KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2024: - GENERAL COUNSEL AND CLERK (EX-OFFICIO), - BETH ISRAEL LAHEY HEALTH, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - CLERK (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - CLERK (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - CLERK - COMMUNITY PHYSICIANS ASSOCIATES, INC. - CLERK - BID - MILTON PHYSICIAN ASSOCIATES, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - CLERK - JORDAN PHYSICIAN ASSOCIATES, INC. - CLERK - THE JORDAN HEALTH SYSTEMS, INC. - CLERK (EX-OFFICIO) - ANNA JAQUES HOSPITAL - CLERK - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. - TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TRUSTEE AND CLERK (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - CLERK - WINCHESTER HEALTHCARE MANAGEMENT, INC. - CLERK (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - CLERK - LAHEY CLINIC, INC. - CLERK - LAHEY CLINIC HOSPITAL, INC.D/B/A LAHEY HOSPITAL & MEDICAL CENTER - CLERK (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE AND CLERK (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - TRUSTEE AND CLERK - CAB HEALTH AND RECOVERY SERVICES, INC. - TRUSTEE AND CLERK - HEALTH AND EDUCATION HOUSING SERVICES, INC. - CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL - CLERK - JOSLIN CLINIC, INC. - CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - CLERK (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - CLERK - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - CLERK (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - CLERK - EXETER HOSPITAL, INC. - CLERK (EX-OFFICIO) - CORE PHYSICIANS, LLC AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $76,930. IN ADDITION, MR. KATZ OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR GROUP TERM LIFE INSURANCE IN THE AMOUNTS OF $29,355. KELLY, M.D., DAVID - TRUSTEE & VICE CHAIR - JORDAN HEALTH SYSTEMS, INC. - TRUSTEE & VICE CHAIR - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH - TRUSTEE & VICE CHAIR - JORDAN PHYSICIAN ASSOCIATES, INC. MASSENGALE, M.D., JUSTIN - CARDIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. MCGILL, KRISTINA MS. MCGILL BEGAN SERVING IN HER ROLE ON OCTOBER 1, 2023. - PHARMACY MANAGER (PER DIEM) BETH ISRAEL DEACONESS PLYMOUTH INC. - TRUSTEE THE JORDAN HEALTH SYSTEMS, INC, - TRUSTEE JORDAN PHYSICIAN ASSOCIATES, INC. OLIWA, M.D., NEIL - ANESTHESIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR PAYMENT TO CASH OUT PTO IN THE AMOUNTS OF $16,275. SCHEDULE J FOOTNOTES (CONTINUED): RANGAVIZ, SHEILAH - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER COMMUNITY PHYSICIANS ASSOCIATES, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER - BID-MILTON PHYSICIAN ASSOCIATES, INC. UNLESS OTHERWISE NOTED BELOW, MS. RANGAVIZ'S SERVED IN THE FOLLOWING ROLES BEGINNING MARCH 30, 2024: - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. -TERM BEGAN ON MARCH 10, 2024 - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER - THE JORDAN HEALTH SYSTEMS, INC. MS. RANGAVIZ SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. RIOS, CINDY MS. RIOS SERVED IN THE FOLLOWING POSITIONS FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2024: - EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER & TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. - TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - TREASURER - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. - TRUSTEE & TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. - TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TREASURER - BID - MILTON PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TREASURER - JOSLIN CLINIC, INC. - TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - TREASURER - THE JORDAN HEALTH SYSTEMS, INC. - TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TREASURER - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER - TREASURER - LAHEY CLINIC, INC. - TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TREASURER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - TREASURER - WINCHESTER HEALTHCARE MANAGEMENT, INC. - TRUSTEE & TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. - TRUSTEE & TREASURER - HEALTH AND EDUCATION HOUSING SERVICES, INC. - TRUSTEE & TREASURER - LAHEY HEALTH SHARED SERVICES, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE, INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - SEACOAST NURSING & REHABILITATION CENTER, INC. - TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL - TREASURER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - TREASURER - EXETER HOSPITAL, INC. - TREASURER - EXETER MED REAL, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOC AND HOSPICE - TREASURER (EX-OFFICIO) - CORE PHYSICIANS, LLC AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. DEFERRED COMPENSATION IN THE AMOUNT OF $125,000 RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2023, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. IN ADDITION, DEFERRED COMPENSATION INCLUDES AN UNVESTED CONTRIBUTION TO A NONQUALIFIED PLAN IN THE AMOUNT OF $52,757. ROWAN, MICHAEL MR. ROWAN SERVED IN THE FOLLOWING POSITIONS THROUGH HIS RETIREMENT ON DECEMBER 31, 2023: - EXECUTIVE VICE PRESIDENT, HOSPITAL AND AMBULATORY SERVICES - BETH ISRAEL LAHEY HEALTH, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - TRUSTEE (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - NEW ENGLAND BAPTIST HOSPITAL - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TRUSTEE - THE JORDAN HEALTH SYSTEMS, INC. - TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. - TRUSTEE - BID - MILTON PHYSICIAN ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JOSLIN CLINIC, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JOSLIN DIABETES CENTER, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - ANNA JAQUES HOSPITAL, INC. - TRUSTEE (CEO DESIGNEE) - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HOSPITAL - TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HEALTHCARE MANAGEMENT, INC. - TRUSTEE (CEO DESIGNATE) - EXETER HOSPITAL, INC - TRUSTEE (CEO DESIGNATE) - EXETER HEALTH RESOURCES, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. ROWAN INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $429,049. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. IN ADDITION, MR. ROWAN'S OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR GROUP TERM LIFE INSURANCE IN THE AMOUNTS OF $44,958. DEFERRED COMPENSATION FOR MR. ROWAN INCLUDES DEFERRED SEVERANCE PAYMENTS IN THE AMOUNT OF $2,353,850 TO BE PAID AFTER DECEMBER 31, 2023. SCHEDULE J FOOTNOTES (CONTINUED): RUTHERFORD, RON MR. RUTHERFORD'S TERM ENDED IN THE FOLLOWING POSITIONS ON NOVEMBER 3, 2023 DURING THE YEAR ENDED SEPTEMBER 30, 2024: - VICE PRESIDENT, CIO, VICE PRESIDENT SUPPORT SERVICES - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - VICE PRESIDENT, CIO, VICE PRESIDENT SUPPORT SERVICES - JORDAN PHYSICIAN ASSOCIATES, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. RUTHERFORD INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $14,700. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. IN ADDITION, OTHER REPORTABLE COMPENSATION FOR MR. RUTHERFORD INCLUDES SEVERANCE PAYMENTS RECEIVED IN 2023 IN THE AMOUNT OF $23,558. DEFERRED COMPENSATION FOR MR. RUTHERFORD INCLUDES DEFERRED SEVERANCE PAYMENTS IN THE AMOUNT OF $226,152 TO BE PAID AFTER DECEMBER 31, 2023. SHORETT, PETER - SENIOR EXECUTIVE VICE PRESIDENT AND CHIEF OPERATING OFFICER - BETH ISRAEL LAHEY HEALTH, INC. -TERM BEGAN DECEMBER 10, 2023 - EXECUTIVE VICE PRESIDENT AND CHIEF STRATEGY OFFICER - BETH ISRAEL LAHEY HEALTH, INC. -TERM ENDED DECEMBER 9, 2023 - TRUSTEE (EX-OFFICIO, CEO DESIGNATE) - MOUNT AUBURN HOSPITAL -TERM ENDED ON JANUARY 31, 2024. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - ANNA JAQUES HOSPITAL, INC. -TERM BEGAN ON JANUARY 1, 2024 - TRUSTEE - SEACOAST AFFILIATED GROUP PRACTICE, INC. -TERM BEGAN ON JANUARY 1, 2024 - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. -TERM BEGAN ON FEBRUARY 1, 2024 - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - LAHEY CLINIC FOUNDATION, INC. -TERM BEGAN ON FEBRUARY 1, 2024 - TRUSTEE - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER -TERM BEGAN ON FEBRUARY 1, 2024 - TRUSTEE - LAHEY CLINIC, INC. -TERM BEGAN ON FEBRUARY 1, 2024 - TRUSTEE (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. -TERM ENDED ON MARCH 29, 2024. - TRUSTEE - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP -TERM ENDED ON MARCH 29, 2024. IN ADDITION, MR. SHORETT SERVED IN THE FOLLOWING ROLES TERM DURING THE PERIOD JANUARY 1, 2024 AND ENDED AUGUST 4, 2024: - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - TRUSTEE - BID - MILTON PHYSICIAN ASSOCIATES, INC. - TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - EXETER HEALTH RESOURCES, INC. - TRUSTEE - EXETER HOSPITAL, INC. - TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE - THE JORDAN HEALTH SYSTEMS, INC. - TRUSTEE - WINCHESTER HEALTHCARE MANAGEMENT, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - WINCHESTER HOSPITAL MR. SHORETT SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. SHORETT INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $179,843. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. SCHEDULE J FOOTNOTES (CONTINUED): TABB, M.D., KEVIN UNLESS OTHERWISE NOTED BELOW, DR. TABB HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2024: - PRESIDENT AND CHIEF EXECUTIVE OFFICER; TRUSTEE (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. - CHIEF EXECUTIVE OFFICER AND TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TRUSTEE (EX-OFFICIO) ROLE ENDED ON JANUARY 31, 2024 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE - TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER -TRUSTEE (EX-OFFICIO) ROLE ENDED ON JANUARY 31, 2024 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE - TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC, INC. -TRUSTEE (EX-OFFICIO) ROLE ENDED ON JANUARY 31, 2024 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE - TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. -TRUSTEE (EX-OFFICIO) ROLE ENDED ON JANUARY 31, 2024 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE - TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - PRESIDENT (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. - TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE, BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HOSPITAL - TRUSTEE AND PRESIDENT (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - CHIEF EXECUTIVE OFFICER - WINCHESTER HEALTHCARE MANAGEMENT, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION -TRUSTEE (EX-OFFICIO) ROLE ENDED ON OCTOBER 31, 2023 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE - CHIEF EXECUTIVE OFFICER AND TRUSTEE - CAB HEALTH AND RECOVERY SERVICES, INC. -TRUSTEE ROLE ENDED ON OCTOBER 31, 2023 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE - CHIEF EXECUTIVE OFFICER AND TRUSTEE - HEALTH AND EDUCATION HOUSING SERVICES, INC. -TRUSTEE ROLE ENDED ON OCTOBER 31, 2023 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - CHIEF EXECUTIVE OFFICER - BID - MILTON PHYSICIAN ASSOCIATES, INC. - CHIEF EXECUTIVE OFFICER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - CHIEF EXECUTIVE OFFICER - THE JORDAN HEALTH SYSTEMS, INC. - CHIEF EXECUTIVE OFFICER - JORDAN PHYSICIAN ASSOCIATES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - CHIEF EXECUTIVE OFFICER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - CHIEF EXECUTIVE OFFICER - JOSLIN CLINIC, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - CHIEF EXECUTIVE OFFICER - EXETER HOSPITAL, INC. IN ADDITION TO THE POSITIONS NOTED ABOVE, DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNEE WHO THEN BECAME THE VOTING TRUSTEE IN HIS PLACE: - TRUSTEE (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION - TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, BID-MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATES - TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM - TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, THE JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL - TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL - TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL AND WINCHESTER HEALTHCARE MANAGEMENT - TRUSTEE (EX-OFFICIO) ANNA JAQUES HOSPITAL, INC. AND SEACOAST AFFILIATED GROUP PRACTICE - TRUSTEE (EX-OFFICIO) JOSLIN DIABETES CENTER - TRUSTEE (EX-OFFICIO) JOSLIN CLINIC - TRUSTEE (EX-OFFICIO) EXETER HEALTH RESOURCES, INC. - TRUSTEE (EX-OFFICIO) EXETER HOSPITAL, INC. - TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TRUSTEE (EX-OFFICIO) LAHEY CLINIC FOUNDATION, INC. - TRUSTEE (EX-OFFICIO) LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER - TRUSTEE (EX-OFFICIO) LAHEY CLINIC, INC. - TRUSTEE (EX-OFFICIO) CAB HEALTH AND RECOVERY SERVICES, INC. - TRUSTEE (EX-OFFICIO) HEALTH AND EDUCATION HOUSING SERVICES, INC. - TRUSTEE (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $497,673. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. IN ADDITION, DR. TABB'S OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR GROUP TERM LIFE INSURANCE IN THE AMOUNTS OF $23,364. DEFERRED COMPENSATION IN THE AMOUNT OF $1,034,000 IS INCLUDED IN THIS FILING FOR DR. TABB. THIS AMOUNT RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2023, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. THOMAS, M.D., TENNY - CHIEF MEDICAL OFFICER - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. DR. TENNY SERVED IN THIS POSITION DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. TIERNEY, M.D., MATT - CHIEF OF SURGERY - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. YALE, ERIN - CHIEF OPERATING OFFICER - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. AS NOTED, MS. YALE SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. ACCORDINGLY, SINCE MS. YALE DID NOT BEGIN SERVING IN THIS POSITION UNTIL CALENDAR YEAR 2024, THERE IS NO COMPENSATION TO REPORT IN THIS FILING. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584Y7K9 2023-12-12 442970000 MDFA - SERIES 2023M - SEE PART VI 0 0 0 B MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584YTK5 2019-07-31 211922775 MDFA - SERIES 2019K - SEE PART VI 0 0 0 C MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584YJW0 2018-06-26 479594374 MDFA - SERIES 2018J-1,J-2 - SEE PART VI 0 0 0 D MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584XMT5 2016-05-12 257611877 MDFA - SERIES 2016I - SEE PART VI 0 0 0 A 452893704 3559000 305961081 143373623 0 0 0 1 B 33635000 211922775 2931137 19714020 189277618 2019 0 0 1 1 C 17085000 504358641 4594374 499764267 2021 0 0 1 1 D 61215000 257618370 2515889 19006493 236095988 2016 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 D 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 0 1 1 0 0 0 0 1 C 0 0 0 1 0 0 0 1 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 BOND A, ENTITY 1: PART I, ROW A, COLUMN F: THE ISSUE'S PROCEEDS WILL BE USED TO FINANCE PROJECTS AND PAY ISSUANCE COSTS. BOND B, ENTITY 1: PART I, ROW B, COLUMN F: FOR TAX PURPOSES (PURSUANT TO PROPOSED TREASURY REGULATIONS SECTION 1.150-1(D)(2)(II)(C)), THE ISSUE'S PROCEEDS OTHER THAN THOSE ALLOCATED TO COSTS OF ISSUANCE WERE ALLOCATED TO CAPITAL EXPENDITURES ON THE DATE OF CLOSING. THE PRESENTATION SHOWN HERE DEPARTS FROM THE TAX TREATMENT, REFLECTING THE CHARACTERIZATION OF THE TRANSACTION FOR OTHER PURPOSES, AND IS MORE IN ACCORDANCE TO THE FINANCIAL ACCOUNTING PRESENTATION. PART IV, COLUMN B, LINE 2C: ARBITRAGE REBATE CALCULATION PERFORMED ON 11/12/2024 BOND C, ENTITY 1: PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $24,764,267 OF INVESTMENT EARNINGS. PART IV, COLUMN C, LINE 2C: FINAL REBATE CALCULATION SHOWING NO REBATE DUE COMPLETED ON 09/30/2023. BOND D, ENTITY 1: PART I, ROW D, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998. PART II, COLUMN D, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. PART IV, COLUMN D, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021. BOND A, ENTITY 2: PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 08/17/2007 AND 07/14/2005. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $125,030 OF INVESTMENT EARNINGS. PART IV, COLUMN A, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021. BOND B, ENTITY 2: PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES (DATED 06/09/2008; 11/30/2005; 07/16/2003; AND 06/04/1998), FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART II, COLUMN B, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW PART IV, COLUMN B, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019. BOND C, ENTITY 2: PART I, ROW C, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW C, COLUMN F: REFINANCING AND REFUNDING PRIOR BONDS ISSUED ON 11/20/2003 AND 12/19/2001. PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. BOND D, ENTITY 2: PART I, ROW D, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW D, COLUMN F: REFINANCING AND REFUNDING PRIOR BOND ISSUANCE 12/19/2001. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. BOND A, ENTITY 3: PART I, ROW A, COLUMN A: MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PART I, ROW A, COLUMN F: DESCRIPTION OF PURPOSE - REFUND ISSUE DATED 06/28/2000. PART II, COLUMN A, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. PART IV, ROW 2C, COLUMN A: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 10, 2009. PART III, LINE 9 AND PART IV, LINE 7: THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS ORIGINALLY FORMED IN JUNE 2020 AND EXPANDED WITH THE ADDITION OF EXETER HOSPITAL (EIN: 22-2674014) IN JULY 2024. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC) SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH NOT EVERY MEMBER OF THE BILH OBLIGATED GROUP HAS FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, THOSE THAT HAVE NOT NEVERTHELESS FOLLOW THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS. THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP. THE OBLIGATED GROUP INCLUDES THE FOLLOWING ENTITIES: BETH ISRAEL DEACONESS MEDICAL CENTER, INC., MOUNT AUBURN HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., NEW ENGLAND BAPTIST HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL MILTON, INC., BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC., MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, MOUNT AUBURN PROFESSIONAL SERVICES, INC., LAHEY CLINIC FOUNDATION, INC., LAHEY CLINIC, INC., LAHEY CLINIC HOSPITAL, INC., NORTHEAST HOSPITAL CORPORATION, WINCHESTER HOSPITAL, ANNA JAQUES HOSPITAL AND EXETER HOSPITAL. THE OBLIGATED GROUP IS AWARE OF THE INSTRUCTIONS TO SCHEDULE K THAT STATE THAT "IF THE ORGANIZATION HAS ONE OR MORE RELATED ORGANIZATIONS (FOR EXAMPLE, PARENT AND SUBSIDIARY RELATIONSHIP), IT MUST COMPLETE SCHEDULE K (FORM 990) CONSISTENT WITH THE FILINGS(S) OF ITS RELATED ORGANIZATION(S). THE SAME LIABILITY SHOULDN'T BE REPORTED BY MORE THAN ONE OF THE RELATED ORGANIZATIONS." THE OBLIGATED GROUP IS CURRENTLY WORKING TOWARD A DETERMINATION REGARDING THE REPORTING OF TAX-EXEMPT DEBT AMONG ITS MEMBERS WITH RESPECT TO SCHEDULE K. IN THE ABSENCE OF SUCH A DETERMINATION, FOR THE REPORTING PERIOD ENDING ON 09/30/2024, THE OBLIGATED GROUP HAS INCLUDED ALL TAX-EXEMPT BOND ISSUES ON EACH OF ITS MEMBER'S FORM 990 SCHEDULES K, WHICH IS CONSISTENT WITH THE APPROACH THAT HAS BEEN TAKEN SINCE THE OBLIGATED GROUP'S FORMATION. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584XFW6 2015-10-21 262828878 MDFA - LAHEY SERIES F - SEE PART VI 0 0 0 B MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584XDH1 2015-09-02 203702204 MDFA - SERIES 2015 H-1 - SEE PART VI 0 0 0 C NH HEALTH AND EDUCATION FACILITIES AUTHORITY 020279866 000000000 2015-03-02 24020000 EXETER SERIES 2015 - SEE PART VI 0 0 0 D NH HEALTH AND EDUCATION FACILITIES AUTHORITY 020279866 000000000 2012-03-09 32565000 EXETER SERIES 2012 - SEE PART VI 0 0 0 A 35800000 262953908 4857465 3129474 94764737 160202232 2021 1 1 1 1 B 122805000 203702204 2348479 201353725 1 1 1 1 C 14435000 24020000 162154 23857846 2015 1 0 1 1 D 14885000 32565000 215404 32349596 2012 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 0 0.00100 0.00000 0.00100 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 1 1 B 0 0 0 1 0 0 0 0 1 C 1 1 0 0 0 1 D 1 1 0 0 0 1 A 1 B 1 C 1 D 1 A MASS HEALTH & EDUCATIONAL FACILITIES AUTHORITY 042456011 57586CDD4 2004-07-08 30340000 MHEFA - WINCHESTER F - ADV REFUND 0 0 0 A 10595000 30340000 365445 47003 29927552 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 MORGAN STANLEY 20.000000000000 0 0 0 0 1 A 1 SUBSTANTIAL CONTRIBUTOR INDEPENDENT CONTRACTOR 612022 FROM TIME TO TIME, BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC.'S SERVICE PROVIDERS AND/OR VENDORS MAY MAKE A CHARITABLE CONTRIBUTION TO BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. AND TO SUPPORT BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC.'S TAX EXEMPT MISSION. ALL OF BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC.'S AGREEMENTS WITH VENDORS AND SERVICE PROVIDERS ARE REVIEWED BY THE BETH ISRAEL LAHEY HEALTH (BILH) OFFICE OF GENERAL COUNSEL AND OTHER BILH FUNCTIONS AS RELEVANT DEPARTMENTS REVIEW BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC.'S AGREEMENTS BEFORE THEY ARE SIGNED. NO AGREEMENTS INCLUDE QUID PRO QUO PROVISIONS REQUIRING SERVICE PROVIDERS AND/OR VENDORS TO MAKE CONTRIBUTIONS TO BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. NOR ARE ANY CONTRIBUTIONS TAKEN INTO ACCOUNT AS AN INDUCEMENT TO SIGN AN AGREEMENT. ALL SUCH CONTRIBUTIONS ARE GIFTS MADE OUT OF GENEROSITY OF THE SERVICE PROVIDER/VENDOR. TRANSACTIONS WITH THOSE DONORS ARE REPORTED IN THIS FORM 990 SCHEDULE L 0 FORM 990, PART I, LINE 1 THE MISSION OF THE BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH, INC. (BID-PLYMOUTH OR HOSPITAL) IS TO IMPROVE THE HEALTH AND WELL-BEING OF ITS PATIENTS AND COMMUNITIES BY PROVIDING A FULL CONTINUUM OF HEALTHCARE SERVICES WITH EXCELLENCE AND COMPASSION AS WELL AS ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH BETH ISRAEL LAHEY HEALTH AND ITS AFFILIATES, REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: THE MISSION OF THE BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH, INC. (BID-PLYMOUTH OR HOSPITAL) IS TO IMPROVE THE HEALTH AND WELL-BEING OF ITS PATIENTS AND COMMUNITIES BY PROVIDING A FULL CONTINUUM OF HEALTHCARE SERVICES WITH EXCELLENCE AND COMPASSION AS WELL AS ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH BETH ISRAEL LAHEY HEALTH AND ITS AFFILIATES, REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. SERVING THE GREATER PLYMOUTH REGION, BID-PLYMOUTH AND ITS AFFILIATES COLLABORATE WITH COMMUNITY LEADERS, PUBLIC AND PRIVATE AGENCIES AND BUSINESSES, TO PROVIDE HEALTH PROMOTION, HEALTH PROTECTION, AND PREVENTIVE SERVICES TO MEET THE BROAD RANGE OF THE COMMUNITY'S HEALTH AND WELLNESS NEEDS AS IDENTIFIED THROUGH COMMUNITY FEEDBACK AND FORMAL COMMUNITY NEEDS ASSESSMENTS. AS PART OF ITS MISSION TO SUPPORT COMMUNITY HEALTH, THE HOSPITAL IS COMMITTED TO ASSESSING ROOT CAUSES OF HEALTH DISPARITIES AND TO ASSISTING IN IMPROVING HEALTH CARE FOR THE DISADVANTAGED AND UNDERSERVED. BID-PLYMOUTH IS A 170-BED ACUTE CARE HOSPITAL SERVING MORE THAN 535,000 RESIDENTS IN PLYMOUTH AND BARNSTABLE COUNTIES, INCLUDING THE COMMUNITIES OF BOURNE, CARVER, DUXBURY, HALIFAX, KINGSTON, LAKEVILLE, PEMBROKE, PLYMPTON, PLYMOUTH, MARSHFIELD, MIDDLEBORO, SANDWICH AND WAREHAM. THE HOSPITAL IS THE REGION'S LEADING PROVIDER OF HIGH-QUALITY HEALTHCARE, PROVIDING COMPREHENSIVE HEALTHCARE RANGING FROM PRIMARY AND PREVENTIVE CARE TO SPECIALTY SERVICES. THROUGHOUT BID-PLYMOUTH, QUALITY IMPROVEMENT IS PARAMOUNT AND ENCOMPASSES BOTH CLINICAL OUTCOMES AND THE SERVICE COMPONENTS OF ALL INTERACTIONS WITH PATIENTS AND THEIR FAMILIES. WHEN NEEDED, BID-PLYMOUTH PATIENTS HAVE ACCESS TO THE HOSPITAL'S SISTER ENTITY, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), WHICH IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER AND IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. BIDMC IS EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS RECOGNIZED NATIONALLY FOR THE CLINICAL EXCELLENCE OF ITS FACULTY AND THE PATIENT CARE PROVIDED, AS WELL AS FOR THE MAGNITUDE AND BREADTH OF ITS RESEARCH AND FOR ITS COMMITMENT TO MEDICAL EDUCATION. MANY BID-PLYMOUTH PHYSICIANS ALSO HOLD APPOINTMENTS AT HARVARD OR OTHER MAJOR MEDICAL SCHOOLS AND ARE TIED CLOSELY WITH THEIR COLLEAGUES AT OTHER ACADEMIC MEDICAL CENTERS. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), EXETER HEALTH RESOURCES INC. (EHRI) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC) AND EXETER HEALTH RESOURCES INC SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL. EACH OF THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,700 PHYSICIANS AND 39,000 EMPLOYEES. FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: OUTPATIENT CLINICS AND SERVICES BID-PLYMOUTH PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES ENCOMPASSING GENERAL INTERNAL MEDICINE AND ALL THE SUBSPECIALTIES OF INTERNAL MEDICINE, COVERING THE GAMUT OF SERVICES FROM PRIMARY TO TERTIARY CARE AS WELL AS PROVIDING SURGICAL SERVICES ON AN OUTPATIENT BASIS. THE HOSPITAL'S MEDICAL STAFF BLENDS EXPERIENCED PRIMARY CARE PHYSICIANS AND SPECIALISTS IN A WIDE VARIETY OF DISCIPLINES. BID-PLYMOUTH'S SERVICES AND CENTERS OF EXCELLENCE INCLUDE: - AIDS/HIV CARE, EDUCATION, AND SUPPORT ANTICOAGULATION CLINIC - BREAST CENTER - CANCER CARE SERVICES: RADIATION AND MEDICAL ONCOLOGY, ONCOLOGY SOCIAL WORK, GENETIC COUNSELING AND TESTING, AND SURGERY - CARDIOVASCULAR SERVICES: DIAGNOSTIC AND INTERVENTIONAL CARDIAC & PULMONARY REHABILITATION - DIABETES/ENDOCRINOLOGY - ENDOSCOPY - HOSPICE AND PALLIATIVE CARE - IMAGING/RADIOLOGY SERVICES: DIGITAL MAMMOGRAPHY, MRI, BREAST MRI, CT, PET/CT, ULTRASOUND, NUCLEAR MEDICINE, GENERAL X-RAY - LUNG CANCER PROGRAM NEUROLOGY OCCUPATIONAL HEALTH - OBSTETRICS, GYNECOLOGY, AND MIDWIFERY - ORTHOPEDICS - PATHOLOGY - PAIN MANAGEMENT PODIATRY - PRIMARY & FAMILY CARE PHYSICAL THERAPY /REHAB SLEEP CENTER - SPINE CARE STROKE SERVICES - SUBSTANCE ABUSE & BEHAVIORAL HEALTH - SURGERY: GENERAL, LAPAROSCOPIC, NEUROSURGERY, OTOLARYNGOLOGY, THORACIC, VASCULAR - UROLOGY VEIN CENTER - WOUND HEALING & HYPERBARIC CENTER IN ADDITION, DIAGNOSTIC FACILITIES INCLUDE A COMPLETE 24-HOUR HISTOPATHOLOGY LABORATORY AND BLOOD BANKING SERVICES AS WELL AS DIAGNOSTIC IMAGING INCLUDING CT SCANNING, ULTRASOUND, ULTRASONIC CARDIOGRAPHY, BONE DENSITOMETRY, NUCLEAR MEDICINE, PLAIN FILM RADIOLOGY AND FLUOROSCOPY. IN ADDITION, THE HOSPITAL'S PICTURE ARCHIVAL AND COMMUNICATION SYSTEM (PACS) CAN INSTANTANEOUSLY TRANSMIT RADIOLOGIC IMAGES BETWEEN BID-PLYMOUTH AND BIDMC, MEANING THAT PATIENTS IN PLYMOUTH HAVE ACCESS TO THE SAME WORLD-CLASS SPECIALISTS AS PATIENTS AT BIDMC IN BOSTON. THE SYSTEM FACILITATES, WHEN NECESSARY, MULTI-DISCIPLINARY EVALUATION OF IMAGES, RESULTING IN IMPROVED TECHNICAL PERFORMANCE AND FEEDBACK AND DIAGNOSES WITH GREATER DIAGNOSTIC ACCURACY. DURING THE PERIOD COVERED BY THIS FILING, BID-PLYMOUTH HAD 293,943 OUTPATIENT ENCOUNTERS. THIS INCLUDED 487 HOSPITAL CLINIC ENCOUNTERS, 6,142 OBSERVATION CASES, 2,713 PAIN CLINIC VISITS, 2,725 WOUND CENTER VISITS, 6,152 OUTPATIENT AMBULATORY SURGERIES, 11,522 OUTPATIENT ENDOSCOPY VISITS, 10,170 OUTPATIENT ONCOLOGY VISITS, 12,620 OUTPATIENT ONCOLOGY INFUSIONS, 17,187 OUTPATIENT EKG EXAMS, 2,330 OUTPATIENT ORTHOPEDIC PROCEDURES, 34,530 OUTPATIENT RADIOLOGY EXAMS, 36,928 OUTPATIENT CT SCANS, 13,760 OUTPATIENT ULTRASOUNDS, 9,298 OUTPATIENT MRIS, 2,646 OTHER NUCLEAR MEDICINE TESTS, 83 BREAST IMAGING EXAMS, 682,417 OUTPATIENT LAB TESTS, 17,639 OUTPATIENT REHABILITATION/PHYSICAL THERAPY VISITS, AND 95,231 OTHER TESTS AND PROCEDURES. FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICE: INPATIENT MEDICAL / SURGICAL AND INTENSIVE CARE BID-PLYMOUTH PROVIDES A WIDE RANGE OF INPATIENT CARE INCLUDING SURGICAL SERVICES, INTENSIVE AND CARDIAC CARE, OBSTETRICS, SENIOR BEHAVIORAL HEALTH, AND COMPLETE DIAGNOSTIC FACILITIES. THE HOSPITAL'S INPATIENT UNITS INCLUDE 120 GENERAL MEDICAL/SURGICAL BEDS, 13 CRITICAL CARE BEDS, 18 OBSTETRICS BEDS, 19 PSYCHIATRIC BEDS, AND 13 NURSERY BASSINETS IN THE BIRTHPLACE. SURGICAL SERVICES ARE AVAILABLE 24 HOURS A DAY FOR CRITICALLY ILL OR INJURED PATIENTS REQUIRING IMMEDIATE SURGICAL INTERVENTION, OR FOR OTHER PATIENTS ON A NON-EMERGENT OR ELECTIVE BASIS. BID-PLYMOUTH'S HIGHLY QUALIFIED SURGEONS PERFORM ORTHOPEDIC PROCEDURES AND IMPLANTS, NEUROSURGERY, PLASTIC RECONSTRUCTION, GASTROINTESTINAL, GENERAL SURGICAL (INCLUDING BREAST), GYNECOLOGICAL, OPHTHALMOLOGIC, OTOLARYNGOLOGIC, PODIATRIC, AND UROLOGICAL PROCEDURES. LIMITED VASCULAR AND THORACIC SURGERY IS ALSO PERFORMED. PATIENTS ARE UNDER THE CARE OF THE HOSPITAL'S MEDICAL STAFF, HOSPITALISTS, MID-LEVEL PROVIDERS AND SURGEONS IN GENERAL AND SPECIALTY PRACTICE. THE NURSING CARE TEAM CONSISTS OF REGISTERED NURSES AND QUALIFIED ANCILLARY CLINICIANS WORKING COLLABORATIVELY WITH SURGICAL AND ANESTHESIA PHYSICIANS. THE SCOPE OF NURSING PRACTICE IN THE PERIOPERATIVE AREA INCLUDES PREOPERATIVE ASSESSMENT AND PLANNING, INTRA-OPERATIVE INTERVENTION, POSTOPERATIVE ASSESSMENT AND INTERVENTION, DISCHARGE PLANNING AND DOCUMENTATION TO ENSURE HIGH QUALITY PATIENT CARE AND SAFETY. THE INPATIENT POPULATION THAT IS SERVED INCLUDES CHILDREN UNDER 15 YEARS OF AGE REQUIRING MINOR OUTPATIENT SURGERY AND ANY INDIVIDUALS WHO ARE 15 YEARS AND OLDER WHO REQUIRE MINOR OR MAJOR SURGICAL INTERVENTION. DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2024 BIDNP HAD 12,683 INPATIENT DISCHARGES WITH 62,115 PATIENT DAYS, PERFORMED 1,930 INPATIENT SURGERIES, HAD 3,989 INPATIENT PSYCH DAYS,, AND 962 NEWBORN DELIVERIES. FORM 990, PART III, LINE 4C, DESCRIPTION OF PROGRAM SERVICE: EMERGENCY DEPARTMENT BIDP OPERATES AN EMERGENCY DEPARTMENT (ED) WHICH IS OPEN TO ALL PATIENTS IN NEED OF EMERGENT CARE, REGARDLESS OF ABILITY TO PAY. THE ED IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR. DURING THE FISCAL YEAR COVERED BY THIS FILING, BIDN HAD 44,939 EMERGENCY DEPARTMENT VISITS. IN ADDITION TO THE PROGRAM SERVICE ACCOMPLISHMENTS NOTED ABOVE, THE BILH NETWORK HAD SIGNIFICANT ACTIVITIES ACROSS ENTITIES RELATED TO BOTH BEHAVIORAL HEALTH AND OTHER HEALTHCARE INITIATIVES. SEE THE NARRATIVE SUPPORT FOR SCHEDULE H FOR ADDITIONAL DETAILS. FORM 990, PART IV, LINE 12: THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2024. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), THE JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC. (EHRI) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND OTHER AFFILIATES OF EHRI. EACH OF THESE BILH AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. IN ADDITION, THE BILH FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. THE ACCOUNTS OF THE ENTITIES FOR WHICH HMFP SERVES AS MEMBER ARE ALSO INCLUDED IN THE HMFP AND BILH AUDITED FINANCIAL STATEMENTS. THE AUDIT AND COMPLIANCE COMMITTEE OF BILH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE CONSOLIDATED AUDIT FOR THE NETWORK AS A WHOLE. FORM 990, PART IV, LINE 24A: AS DESCRIBED IN THIS FORM 990 AND FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND SERVED AS A SUPPORT ORGANIZATION OF AND DIRECT OR INDIRECT SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.. DURING THIS SAME PERIOD, BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. WAS A MEMBER OF THE BILH OBLIGATED GROUP WHICH HAS ISSUED TAX-EXEMPT BOND FINANCING THROUGH EITHER THE BILH OBLIGATED GROUP OR THROUGH A PREVIOUS OBLIGATED GROUP WHICH IS NOW A PART OF THE BILH OBLIGATED GROUP. THE SCHEDULE K AS INCLUDED IN THIS FORM 990 INCLUDES ALL OF THE BILH OBLIGATED GROUP OUTSTANDING TAX-EXEMPT DEBT FOR BONDS ISSUED AFTER DECEMBER 31, 2002, ONLY A PORTION OF WHICH IS ALLOCABLE TO AND REPORTED ON BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S BALANCE SHEET. FORM 990, PART IV, LINE 24B: AS REPORTED ON THE FORM 990 SCHEDULE K, THE LAHEY HEALTH SYSTEM INC. (LHSI) SERIES F BONDS WHICH WERE ISSUED IN 2015 ARE NOW PART OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP DEBT. THE BONDS WERE ISSUED IN 2015 AND AS OF SEPTEMBER 30, 2023 THERE WAS A BALANCE REMAINING IN THE CONSTRUCTION FUND. PROCEEDS IN THE CONSTRUCTION FUND WERE UNEXPECTEDLY HELD BEYOND THE THREE-YEAR TEMPORARY PERIOD, AND WERE YIELD RESTRICTED IN COMPLIANCE WITH FEDERAL TAX REQUIREMENTS. ALTHOUGH THESE BONDS ARE NOT ON THE BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S BALANCE SHEET, BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. IS INCLUDING THIS DISCLOSURE IN ITS FORM 990 BECAUSE BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. IS A MEMBER OF THE BILH OBLIGATED GROUP. PART V, LINE 1A AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS A SUPPORT ORGANIZATION AND THE DIRECT OR INDIRECT SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL- PLYMOUTH, INC. AS PART OF THAT RELATIONSHIP, BILH PROVIDED CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS, INCLUDING AMONG OTHER THINGS, OPERATIONAL SUPPORT SUCH AS PROCESSING PAYROLL AND ACCOUNTS PAYABLE. IN THIS CAPACITY BILH ISSUED ALL FORMS 1099 TO NOT ONLY ITS OWN VENDORS AND SERVICE PROVIDERS, BUT ALSO TO THOSE WHO PROVIDED SERVICES TO {{ENTITY-NAME}}. FORMS 1099 WERE ALL ISSUED IN THE BILH NAME AND UNDER THE BILH EIN. HOWEVER, IN ACCORDANCE WITH INSTRUCTIONS TO THIS FORM 990, BETH ISRAEL DEACONESS HOSPITAL- PLYMOUTH, INC. IS REPORTING THE NUMBER OF FORMS 1099 RELATED TO SERVICES PERFORMED FOR AND PAYMENTS RELATED TO, ITS SERVICE PROVIDERS AS IF THEY WERE PROCESSED DIRECTLY BY BETH ISRAEL DEACONESS HOSPITAL- PLYMOUTH, INC. EACH OTHER AFFILIATE IS SIMILARLY REPORTING THE NUMBER OF FORMS 1099 WHICH ARE ATTRIBUTABLE TO THEIR OWN SERVICE PROVIDERS. PART V, LINE 7G: BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899. PART V, LINE 7H: BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 1098-C. FORM 990, PART VI, SECTION A, LINE 2 FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS DIRECT OR INDIRECT SOLE MEMBER OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC. (EHRI) AND EXETER HOSPITAL. EACH OF THESE AFFILIATES MAY HAVE, IN TURN, SERVED AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE BILH NETWORK OF AFFILIATES. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. FOR THIS SAME PERIOD HMFP SERVED AS THE SOLE MEMBER OF AFFILIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) AS WELL AS THE DIRECT OR INDIRECT MEMBER OF SEVERAL ADDITIONAL ENTITIES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE NETWORK OF THE AFFILIATED ORGANIZATIONS NOTED ABOVE. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. FORM 990, PART VI, SECTION A, LINE 6 FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS DIRECT OR INDIRECT SOLE MEMBER OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC. (EHRI), EXETER HOSPITAL AND TO AFFILIATES OF THESE ENTITIES. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE EXCLUSIVE AUTHORITY TO (A) APPOINT AND REAPPOINT TRUSTEES, (B) FILL ANY VACANCIES IN THE OFFICES OF TRUSTEES, AND (C) ACTING BY VOTE OF NOT LESS THAN THREE QUARTERS (3/4) OF THE MEMBER'S TRUSTEES THEN IN OFFICE, REMOVE, WITH OR WITHOUT CAUSE, A TRUSTEE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. HAS THE FOLLOWING RIGHTS, AS DESIGNATED IN BETH ISRAEL DEACONESS HOSPITAL -PLYMOUTH, INC.'S BY-LAWS: SUBJECT TO THE PROVISIONS OF THE ARTICLES OF ORGANIZATION AND THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, BOTH POSITIVE AND NEGATIVE, CONFERRED BY MASSACHUSETTS GENERAL LAWS ("M.G.L.") CHAPTER 180, AS AMENDED, ON MEMBERS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. IN ADDITION, EXCEPT AS ARE EXPRESSLY GRANTED TO THE BOARD OF TRUSTEES OF THE CORPORATION ("BOARD") IN THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, POSITIVE AND NEGATIVE, CONFERRED BY M.G.L. CHAPTER 180 ON BOARDS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. NOT WITHSTANDING THE FOREGOING, THE MEMBER MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE BOARD: (A) APPROVE OR REQUIRE ANY CHANGE IN, OR CONSOLIDATION OF PHILANTHROPIC GIFTS, ASSETS, AND PROGRAMS OF THE CORPORATION, WHICH SHALL REMAIN UNDER THE CORPORATION'S CONTROL AND BE USED FOR THE BENEFIT OF THE CORPORATION AND NOT FOR OTHER COMPONENTS OF THE MEMBER'S SYSTEM, EXCEPT TO THE EXTENT THAT SUCH CHANGES INVOLVE BACK-OFFICE CONSOLIDATION WITH OTHER DIRECT OR INDIRECT SUBSIDIARIES OF THE MEMBER; (B) APPROVE OR REQUIRE ANY CHANGE IN THE NAME, BRAND, OR TRADEMARK OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES, EXCEPT SUCH COMPLEMENTARY CHANGES AS THE MEMBER MAY DETERMINE ARE REASONABLY APPROPRIATE IN ESTABLISHING A SYSTEM-WIDE IDENTITY FOR THE AFFILIATED ENTITIES; OR (C) AMEND OR RESTATE THESE BYLAWS TO CHANGE OR ELIMINATE EITHER OF THE FOREGOING LIMITATIONS ON ITS POWERS. FOR THE PERIOD ENDING ON THE THIRD ANNIVERSARY OF THE DATE THE MEMBER BECOMES THE SOLE CORPORATE MEMBER OF THE CORPORATION, THE MEMBER'S AUTHORITY TO CHANGE THE MEDICAL SCHOOL AFFILIATION OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES IS SUBJECT TO THE REQUIREMENT THAT IT OBTAIN THE UNANIMOUS CONSENT OF THE CORPORATION'S DESIGNATED TRUSTEES (AS DEFINED IN THE BYLAWS OF THE MEMBER) AND THE APPROVAL OF THE MEMBER'S BOARD OF TRUSTEES (THE "MEMBER'S BOARD"). THE MEMBER MAY NOT CAUSE THE CORPORATION TO CEASE OPERATING A SEPARATELY LICENSED HOSPITAL FACILITY, OR CLOSE ANY ESSENTIAL SERVICE OF SUCH HOSPITAL FACILITY, WITHOUT CONSULTING WITH THE BOARD PRIOR TO TAKING SUCH ACTION. THE POWERS AND RESPONSIBILITIES OF THE BOARD INCLUDE THE FOLLOWING: PROVIDING RECOMMENDATIONS TO THE MEMBER REGARDING (I) APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES, (II) THE ESTABLISHMENT OF THE CORPORATION'S POLICIES, (III) THE MAINTENANCE OF PATIENT CARE QUALITY, AND (IV) THE PROVISION OF CLINICAL SERVICES AND COMMUNITY SERVICE PLANNING IN A MANNER RESPONSIVE TO LOCAL COMMUNITY NEEDS; (B) ENSURING COMPLIANCE WITH ALL LICENSURE AND ACCREDITATION REQUIREMENTS, INCLUDING CREDENTIALING AND OTHER MEDICAL STAFF MATTERS; (C) PROVIDING OVERSIGHT FOR INSTITUTIONAL PLANNING, MAKING RECOMMENDATIONS FOR NEW CLINICAL SERVICES, AND PARTICIPATING IN AN ANNUAL REVIEW OF THE CORPORATION'S STRATEGIC ANDFINANCIAL PLAN AND GOALS. (D) REVIEWING AND RECOMMENDING APPROVAL OF OPERATING AND CAPITAL BUDGETS AS WELL AS MAKING RECOMMENDATIONS WITH RESPECT TO CAPITAL EXPENDITURES; (E) MAKING RECOMMENDATIONS WITH RESPECT TO QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS; (F) PROVIDING OVERSIGHT OF RISK MANAGEMENT PROGRAMS RELATING TO PATIENT CARE AND SAFETY; (G) REVIEWING DISASTER PLANS THAT DEAL WITH BOTH INTERNAL (E.G., FIRE) AND EXTERNAL DISASTERS; AND (H) EVALUATING RECRUITMENT NEEDS TO ENSURE ADEQUATE MEDICAL STAFF CAPACITY TO CONTINUE TO MEET COMMUNITY NEEDS. EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, THE BOARD SHALL ACT IN AN ADVISORY CAPACITY AND CONSISTENT THERE WITH SHALL HAVE ONLY THE FOLLOWING POWERS: (A) POWERS EXPRESSLY GRANTED BY THE MEMBER FROM TIME TO TIME; (B) POWER TO EXERCISE ITS AUTHORITY AS A MEMBER OF OTHER CORPORATIONS; (C) POWER TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THE BYLAWS OF THE MEMBER (AS DEFINED UNDER THE BYLAWS OF THE MEMBER) OR UNDER THESE BYLAWS WITH RESPECT TO THE MEMBER; AND (D) POWERS TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THAT AGREEMENT DATED JUNE 30, 2017 BY AND AMONG LAHEY HEALTH SYSTEM, INC., BETH ISRAEL DEACONESS MEDICAL CENTER, INC., NEW ENGLAND BAPTIST HOSPITAL, INC., MOUNT AUBURN HOSPITAL, CAREGROUP,INC., AND SEACOAST REGIONAL HEALTH SYSTEMS, INC. THE POWERS OF THE BOARD IN CLAUSES (A) AND (B) OF THE PRECEDING SENTENCE SHALL BE SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. THE POWERS OF THE BOARD IN CLAUSE (C) AND (D) OF THE FIRST SENTENCE OF THIS PARAGRAPH SHALL BE INDEPENDENT OF THE MEMBER AND NOT SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. NOT WITHSTANDING CLAUSE (B) ABOVE, THE POWER OF THE CORPORATION TO EXERCISE ITS AUTHORITY AS A MEMBER OF ANOTHER CORPORATION SHALL BE SUBJECT TO THE FOLLOWING LIMITATIONS: (X) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED BY THE CORPORATION ONLY AT THE EXPRESS AND EXPLICIT DIRECTION OF, AND WITH THE APPROVAL OF, THE MEMBER; (Y) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED DIRECTLY BY THE MEMBER AFTER CONSULTATION WITH THE CHAIR BUT OTHERWISE WITHOUT THE APPROVAL OR PARTICIPATION OF THE CORPORATION; AND (Z) OTHER THAN STATUTORY POWERS, THE CORPORATION SHALL HAVE ONLY THOSE POWERS AND AUTHORITIES OVER AND WITH RESPECT TO THE CORPORATIONS OF WHICH IT IS A MEMBER AS ARE EXPRESSLY AND EXPLICITLY DELEGATED OR DIRECTED TO THE CORPORATION BY ACTION OF THE MEMBER'S BOARD. FORM 990, PART VI, SECTION B, LINE 11B AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE DIRECT OR INDIRECT SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.. THIS FORM 990 IS PREPARED BY THE BILH TAX DEPARTMENT IN CONJUNCTION WITH DELOITTE TAX, LLP (DELOITTE). AS PART OF THIS PROCESS, THE BILH TAX DEPARTMENT WORKS WITH OTHER DISCIPLINES AND FUNCTIONS WITHIN BILH AND BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. TO ENSURE THAT ALL FINANCIAL AND NON-FINANCIAL DISCLOSURES ARE COMPLETE AND ACCURATE. EXAMPLES OF SUCH DEPARTMENTS INCLUDE BUT ARE NOT LIMITED TO: FINANCE AND ACCOUNTING, HUMAN RESOURCES AND PAYROLL, TREASURY, COMPLIANCE, LEGAL, COMMUNITY BENEFITS, FINANCIAL ASSISTANCE AND REIMBURSEMENT, GOVERNANCE, DEVELOPMENT, GRADUATE MEDICAL EDUCATION, GOVERNMENT RELATIONS, RESEARCH AND/OR RESEARCH FINANCE. BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S FORM 990 IS REVIEWED INTERNALLY BY THE BILH ASSISTANT VICE PRESIDENT, TAXATION AND EXTERNALLY BY DELOITTE. BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S FORM 990, ALONG WITH THE FORMS 990 OF ALL ENTITIES IN THE BILH NETWORK, ARE DISCUSSED WITH THE BILH AUDIT AND COMPLIANCE COMMITTEE. DELOITTE SIGNS THE FINAL RETURNS. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) SYSTEM OF AFFILIATES. ALL ENTITIES IN THE BILH NETWORK ADHERE TO THE BILH CONFLICT OF INTEREST POLICY AND MAINTAIN A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY AT THE ENTITY LEVEL. PURSUANT TO THESE POLICIES, BILH ENTITIES' OFFICERS, TRUSTEES AND KEY EMPLOYEES AS WELL AS CERTAIN OTHER INDIVIDUALS ARE REQUIRED TO COMPLETE THE ANNUAL CONFLICT OF INTEREST AND TAX QUESTIONNAIRE (COI-TQ). THE COI-TQ IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS AND FAMILY RELATIONSHIPS AND AFFILIATIONS MAINTAINED BY OFFICERS, TRUSTEES, OR KEY EMPLOYEES AND THEIR FAMILY MEMBERS AND WHICH MAY RESULT IN A REAL OR PERCEIVED CONFLICT OF INTEREST. THE BILH OFFICE OF INTEGRITY AND COMPLIANCE, IN CONJUNCTION WITH THE BILH TAX DEPARTMENT, ADMINISTERS THE COI-TQ PROCESS ANNUALLY. BILH INTEGRITY AND COMPLIANCE COLLECTS AND REVIEWS ALL DISCLOSURES. DISCLOSURES FOR BILH EXECUTIVES AND KEY EMPLOYEES ARE ASSIGNED APPROPRIATE FOLLOW-UP ACTION IN ACCORDANCE WITH THE BILH POLICY. A SUMMARY OF POSITIVE RESPONSES FOR EACH BILH AFFILIATE IS PROVIDED TO THE COMPLIANCE OFFICER FOR THAT ENTITY FOR REVIEW FINAL DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. ANY ACTIVITY THAT REQUIRES ACTION UNDER THE CONFLICT OF INTEREST POLICIES IS SUBJECT TO ONGOING REVIEW BY BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. AS WELL AS THE BILH INTEGRITY AND COMPLIANCE OFFICE. PURSUANT TO THE BILH CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A MANAGEMENT PLAN TO REQUIRE DISCLOSURE AND RECUSAL, INCLUDING APPROPRIATE DOCUMENTATION IN THE MINUTES. IN ADDITION, AS NOTED ABOVE, THE ANNUAL COI-TQ PROCESS OUTLINED ABOVE IS JOINTLY ISSUED BY THE BILH TAX DEPARTMENT, TO ENSURE THAT THE QUESTIONNAIRE IS DISTRIBUTED TO ALL CURRENT AND FORMER MEMBERS OF THE BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. BOARD OF TRUSTEES AS WELL AS FORMER OFFICERS AND KEY EMPLOYEES. THE COI-TQ PROCESS IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. TO COMPLETELY AND ACCURATELY COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. IN THIS ROLE BILH MAINTAINS THE RESPONSIBILITY FOR SETTING COMPENSATION FOR EXECUTIVES AND SENIOR MANAGEMENT OF THE ENTITIES WHICH COMPRISED THE BETH ISRAEL LAHEY HEALTH NETWORK. THE BILH COMPENSATION COMMITTEE IS THEREFORE RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES, THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES AND EXCEPT AS OTHERWISE NOTED BELOW OR IN FORM 990 SCHEDULE J, THE COMPENSATION REPORTED IN THIS FORM 990 FOR BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S OFFICERS, TRUSTEES AND KEY EMPLOYEES WAS SET BY THE BILH COMPENSATION COMMITTEE. THE BILH COMPENSATION COMMITTEE PROCESS FOR SETTING COMPENSATION IS BELOW. THE BETH ISRAEL LAHEY HEALTH (BILH) COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER SENIOR EXECUTIVES IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO AS VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS FOR BOTH THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES ARE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION. FORM 990, PART VI, LINE 16B AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVES AS THE DIRECT OR INDIRECT SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. ALTHOUGH BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S BOARD HAS NOT FORMALLY ADOPTED A WRITTEN POLICY REGARDING INVESTMENT IN, CONTRIBUTION OF ASSETS TO AND/OR PARTICIPATION IN A JOINT VENTURE WITH A TAXABLE ENTITY, PROCEDURALLY IF/WHEN ANY SUCH TRANSACTION IS CONTEMPLATED BY ANY BILH AFFILIATE, BOTH THE BILH OFFICE OF GENERAL COUNSEL AND BILH TAX DEPARTMENT ARE INVOLVED TO EVALUATE PARTICIPATION. OUTSIDE COUNSEL IS ALSO CONSULTED WHERE NEEDED. THESE STEPS ARE TAKEN TO ENSURE THAT PARTICIPATION IN ANY JOINT VENTURE ARRANGEMENT HAS BEEN REVIEWED UNDER APPLICABLE FEDERAL TAX LAW AND TO ENSURE THAT BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S EXEMPT STATUS IS SAFEGUARDED. FORM 990, PART VI, SECTION C, LINE 19 AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL LAHEY HEALTH TAX DEPARTMENT SCHRAFFT'S CITY CENTER, 4TH FLOOR, 529 MAIN STREET CHARLESTOWN, MA 02129 FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 23,632,598. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,632,598. CLINICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 983. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 983. OUTSIDE LABOR: PROGRAM SERVICE EXPENSES 13,774,261. MANAGEMENT AND GENERAL EXPENSES 60,282. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,834,543. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 11,649,601. MANAGEMENT AND GENERAL EXPENSES 335,301. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,984,902. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,502,564. MANAGEMENT AND GENERAL EXPENSES 105,892. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,608,456. FORM 990, PART XI, LINE 9: INVESTMENT EXPENSES -4,238. NET ASSETS RELEASED FROM RESTRICTIONS 34,240. PENSION ADJUSTMENT -132,033. CHANGE IN FUNDED STATUS OF BENEFITS 2,395,436. TRANSFER OF NET ASSETS TO AFFILIATES -15,671,143. TRUST AND PLEDGE ADJUSTMENTS 228,154. RESTRICTED FUND ADJUSTMENTS 0. PART XII, LINE 2C: AS NOTED THROUGHOUT THIS FORM 990, BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL LAHEY HEALTH (BILH) SERVES AS THE DIRECT OR INDIRECT MEMBER OF BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. AND BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC. IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF BETH ISRAEL LAHEY HEALTH. THE AUDIT AND COMPLIANCE COMMITTEE OF BILH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE CONSOLIDATED AUDIT FOR THE NETWORK AS A WHOLE. 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INACTIVE MA 501(C)(3) 12A, I WINCHESTER HEALTHCARE MANAGEMENT INC 1 WINCHESTER HEALTHCARE MANAGEMENT INC 41 HIGHLAND AVE WINCHESTER MA 01890 222701817 MANAGEMENT MA 501(C)(3) 12A, I LAHEY HEALTH SHARED SERVICES INC 1 WINCHESTER HOSPITAL 41 HIGHLAND AVE WINCHESTER MA 01890 042104434 HEALTHCARE MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 WINCHESTER HOSPITAL FOUNDATION INC 41 HIGHLAND AVE WINCHESTER MA 01890 043399570 PROFESSIONAL SERVICES & FINANCIAL SUPPORT MA 501(C)(3) 12A, I WINCHESTER HEALTHCARE MANAGEMENT INC 1 BETH ISRAEL LAHEY HEALTH SURGERY CENTER PLYMOUTH LLC 41 RESNIK ROAD PLYMOUTH MA 02360 883871838 SURGERY CENTER MA BETH ISRAEL DEACONESS MEDICAL CENTER- PLYMOUTH EXCLUDED 0 0 0.51000 BIDCO HOSPITAL LLC 247 STATION DRIVE NORTHWEST 1 WESTWOOD MA 02090 461643790 COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC MA BETH ISRAEL DEACONESS MEDICAL CENTER EXCLUDED 0 0 0.00900 BIDCO PHYSICIAN LLC 600 UNICORN PARK DRIVE 4TH FL WOBURN MA 01801 461589743 COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BILH MA N/A 0 0 BILH INVESTMENT PARTNERSHIP LLP 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 043278109 INVESTMENT PARTNERSHIP MA BETH ISRAEL DEACONESS MEDICAL CENTER EXCLUDED 2132142 36265828 0 157133 0 0.02920 NEBSC HOSPITAL HOLDINGS LLC 125 PARKER HILL AVE BOSTON MA 02120 874293833 INVESTMENT PARTNERSHIP MA N/A 0 0 NEW ENGLAND BAPTIST SURGERY CENTER LLC 100 AVON MEADOW LANE AVON MA 06001 874311329 AMBULATORY SURGERY CENTER MA N/A 0 0 PHYSICIANS PROFESSIONAL SERVICES LLP 200 RIVERS EDGE DRIVE MEDFORD MA 02155 043275078 TO PROVIDE MEDICAL BILLING SERVICES MA N/A 0 0 SHIELDS IMAGING AT ANNA JAQUES HOSPITAL LLC 700 CONGRESS ST STE 204 QUINCY MA 02169 383989358 MRI SERVICES MA N/A 0 0 WINCHESTER HOSPITALSHIELDS MRI LLC 700 CONGRESS ST STE 204 QUINCY MA 02169 462523117 MRI SERVICES MA N/A 0 0 GREATER NEWBURYPORT MANAGEMENT SERVICES ORGANIZATION INC 25 HIGHLAND AVE NEWBURYPORT MA 01950 161744477 MANAGEMENT SERVICES MA N/A C 0 HUNTINGFIELD CORPORATION C/O LCF 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 520717412 TO HOLD OWNERSHIP OF SUBTERRANEAN RIGHTS DE N/A C 0 LAHEY CLINIC INSURANCE CO LTD CRAIG APPIN HOUSE PO BOX HM 2450 HAMILTON BD INSURANCE BD N/A C 0 LEDGEWOOD HEALTH CARE CORPORATION 87 HERRICK STREET BEVERLY MA 01915 042855189 NURSING HOME MA N/A C 0 NORTHEAST PROPRIETARY CORP 85 HERRICK STREET BEVERLY MA 01915 042855191 MEDICAL SERVICES MA N/A C 0 WINCHESTER HEALTHCARE ENTERPRISES INC 41 HIGHLAND AVE WINCHESTER MA 01890 042932059 MANAGEMENT SERVICES MA N/A C 0 WINCHESTER PHYSICIAN ASSOCIATES INC 41 HIGHLAND AVE WINCHESTER MA 01890 043262963 MANAGEMENT SERVICES MA N/A C 0 1 1 0 1 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 SEE PART VII J 375041 FMV SEE PART VII L 527726 FMV SEE PART VII M 17647543 FMV SEE PART VII Q 305723 FMV SEE PART VII M 109600 FMV SEE PART VII Q 262967 FMV SEE PART VII M 349230817 FMV SEE PART VII O 6774001 FMV SEE PART VII R 409613452 FMV SEE PART VII L 471590 FMV SEE PART VII M 2823323 FMV SEE PART VII M 2340033 FMV SEE PART VII O 986303 FMV SEE PART VII S 780591 FMV SEE PART VII M 4453236 FMV SEE PART VII O 7354411 FMV SEE PART VII Q 2502118 FMV SEE PART VII R 16451734 FMV SEE PART VII M 1384920 FMV SEE PART VII D 2105559000 FMV SEE PART VII E 35774000 FMV FORM 990, SCH R, PART V, LN 1D LOANS/LOAN GUARANTEES TO/FOR RO BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH ("BIDP") IS A MEMBER OF THE BILH OBLIGATED GROUP AND AS SUCH IS JOINTLY AND SEVERALLY LIABLE FOR ALL DEBT OF THE OBLIGATED GROUP. IN THIS CAPACITY, BIDP HAS MADE LOAN GUARANTEES TO THE FOLLOWING OTHER MEMBERS OF THE OBLIGATED GROUP TOTALING $2,105,559,000: ANNA JAQUES HOSPITAL BETH ISRAEL DEACONESS MEDICAL CENTER LAHEY CLINIC FOUNDATION LAHEY CLINIC HOSPITAL LAHEY CLINIC MOUNT AUBURN HOSPITAL NORTHEAST HOSPITAL CORP WINCHESTER HOSPITAL NEW ENGLAND BAPTIST HOSPITAL BETH ISRAEL DEACONESS HOSPITAL MILTON BETH ISRAEL DEACONESS HOSPITAL NEEDHAM EXETER HOSPITAL FORM 990, SCH R, PART V, LN 1E LOANS/LOAN GUARANTEES BY RO BIDP IS A MEMBER OF THE BILH OBLIGATED GROUP AND AS SUCH ALL OTHER MEMBERS OF THE BILH OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR THE OBLIGATED GROUP DEBT OUTSTANDING AT BIDP. IN THIS CAPACITY, THE ENTITIES LISTED BELOW HAVE LOAN GUARANTEES TO BIDP TOTALING $35,774,000: ANNA JAQUES HOSPITAL BETH ISRAEL DEACONESS MEDICAL CENTER LAHEY CLINIC FOUNDATION LAHEY CLINIC HOSPITAL LAHEY CLINIC, INC. MOUNT AUBURN HOSPITAL MOUNT AUBURN PROFESSIONAL SERVICES NORTHEAST HOSPITAL CORP. WINCHESTER HOSPITAL NEW ENGLAND BAPTIST HOSPITAL BETH ISRAEL DEACONESS HOSPITAL - MILTON BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM EXETER HOSPITAL MEDICAL CARE OF BOSTON MANAGEMENT CORP. D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE FORM 990, SCH R, PART V, LN 1J - LEASE OF FAC/EQUIP/OTHER ASSETS TO RO AS NOTED THROUGHOUT THIS FILING, BIDP IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THE CLOSE CONNECTION BETWEEN BIDP AND MEDICAL CARE OF BOSTON MANAGEMENT CORP DBA BILH PRIMARY CARE ("APG," A RELATED ENTITY EXEMPT UNDER IRC 501(C)(3)), APG LEASES SPACE FROM BIDP TO USE IN FURTHERANCE OF THE BIDP, APG, AND BILH TAX-EXEMPT PURPOSES. APG PAID BIDP $375,041 FOR SPACE RENTAL. FORM 990, SCH R, PART V, LN 1L PERF OF SVCS/MEMBERSHIP/FUNDRAISING FOR RO AS NOTED THROUGHOUT THIS FILING, BIDP IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, BIDP PROVIDES SERVICES TO OTHER NETWORK ENTITIES IN FURTHERANCE OF ITS EXEMPT PURPOSE AND IN FURTHERANCE OF THE EXEMPT PURPOSE OF ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, BIDP PROVIDED THE FOLLOWING SERVICES TO ITS TAX-EXEMPT AFFILIATES: 1. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - PHYSICIAN SERVICES: $527,726 2. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - PHYSICIAN SERVICES: $471,590 FORM 990, SCH R, PART V, LN 1M - PERF OF SVCS/MEMBERSHIP/FUNDRAISING BY RO AS NOTED THROUGHOUT THIS FILING, BIDP IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, ONE OR MORE OF BIDP'S AFFILIATES PROVIDED SERVICES TO BIDP IN FURTHERANCE OF THE EXEMPT PURPOSE OF BIDP AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, BIDP RECEIVED THE FOLLOWING SERVICES FROM ITS TAX-EXEMPT AFFILIATES: 1. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - PHYSICIAN SERVICES: $17,647,543 2. BETH ISRAEL DEACONESS MEDICAL CENTER - PHYSICIAN SERVICES: $109,600 3. BETH ISRAEL LAHEY HEALTH, INC. AS A SUPPORT ORGANIZATION OF BIDP, BILH PROVIDES CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS. BILH SUPPORT INCLUDES THE FOLLOWING SERVICES: DEVELOPMENT AND FUNDRAISING, STRATEGIC PLANNING, COMPLIANCE, GOVERNANCE AND LEGAL SUPPORT, PAYOR CONTRACTING, OPERATIONAL SUPPORT SUCH AS PROCESSING PAYROLL AND ACCOUNTS PAYABLE, NETWORK-WIDE BENEFIT PLAN STRUCTURING AND NETWORK-WIDE CASH MANAGEMENT. BILH OVERSEES THE FINANCIAL WELL-BEING OF ITS AFFILIATES, INCLUDING MANAGEMENT, LEADERSHIP, DEBT STRUCTURING SUPPORT, FINANCING OF CAPITAL PROJECTS THROUGH ITS OBLIGATED GROUP DEBT AND FINANCIAL SUPPORT SERVICES, INCLUDING INTERNAL AND EXTERNAL AUDIT, INSURANCE AND TAX SERVICES: A. NETWORK ASSESSMENT FEE: $51,803,050 B. OPERATION OF PAYROLL AND PROVISION OF EMPLOYEE BENEFITS: $116,628,582 C. OPERATION OF ACCOUNTS PAYABLE AND PAYMENT FOR THIRD PARTY SERVICES: 180,799,185 4. JORDAN HEALTH SYSTEMS, INC - MANAGEMENT SERVICES: $2,340,033 5. JORDAN PHYSICIAN ASSOCIATES A. MANAGEMENT SERVICES: $4,232,212 B. PATHOLOGY SERVICES: $221,024 6. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - PHYSICIAN SERVICES: $2,823,323 7. NORTHEAST BEHAVIORAL HEALTH CORP - PSYCH SERVICES: $1,384,920 FORM 990, SCH R, PART V, LN 1O SHARING OF PAID EMPLOYEES WITH RO 1. BETH ISRAEL LAHEY HEALTH-SEE NOTE ABOVE IN CODE M: $6,774,001 2. JORDAN HEALTH SYSTEMS, INC: $986,303 3. JORDAN PHYSICIAN ASSOCIATES: $7,354,411 FORM 990, SCH R, PART V, LN 1Q - REIMB. PAID BY RO FOR EXPENSES AS NOTED THROUGHOUT THIS FILING, BIDP IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, BIDP WAS REIMBURSED BY ONE OR MORE OF ITS AFFILIATED ENTITIES FOR EXPENSES INCURRED IN FURTHERANCE OF THE EXEMPT PURPOSE OF BIDP AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, BIDP RECEIVED THE FOLLOWING REIMBURSEMENTS FOR EXPENSES FROM ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL DEACONESS HOSPITAL-MILTON HISTO/LAB EXPENSE REIMBURSEMENTS: $305,723 2. BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM HISTO/LAB EXPENSE REIMBURSEMENTS: $262,967 3. JORDAN PHYSICIAN ASSOCIATES - EXPENSE REIMBURSEMENT (MALPRACTICE AND FRINGE): $2,502,118 FORM 990, SCH R, PART V, LN 1R OTHER TRANSFER OF CASH/PROP TO RO AS NOTED THROUGHOUT THIS FILING, BIDP IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, BIDP TRANSFERRED CASH TO ONE OR MORE OF ITS AFFILIATED ENTITIES AS PART OF NETWORK-WIDE CASH MANAGEMENT AND IN FURTHERANCE OF THE EXEMPT PURPOSE OF BIDP AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, BIDP TRANSFERRED THE FOLLOWING CASH OR PROPERTY TO ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH - CASH TRANSFERS: $409,613,452 2. JORDAN PHYSICIAN ASSOCIATES SUPPORT OF PRIMARY AND SPECIALTY CARE IN THE COMMUNITY: $ 15,671,143 3. MEDICAL CARE OF BOSTON MGMT CORP DBA BILH PRIMARY CARE SUPPORT OF PRIMARY AND SPECIALTY CARE IN THE COMMUNITY: $1,911,966