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SCHEDULE H, PART VI, LINE 1: PART I, LINE 3(C):
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FEDERAL POVERTY GUIDELINES AND PATIENT ELIGIBILITYFREE CAREFREE CARE IS PROVIDED FOR MEDICALLY NECESSARY SERVICE TO PATIENTS WHO HAVE BEEN DEEMED FINANCIALLY UNABLE TO PAY FOR ALL OR PART OF THE HOSPITAL CARE PURSUANT TO THE HOSPITAL'S CREDIT AND COLLECTION POLICY. ELIGIBILITY IS AVAILABLE TO MASSACHUSETTS RESIDENTS WHOSE FAMILY INCOME IS EQUAL TO OR LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES (FPG). THE FPG IS UPDATED ANNUALLY AND IS POSTED ON THE STATE'S DIVISION OF HEALTH CARE FINANCE AND POLICY WEBSITE:HTTP://WWW.MASS.GOV/EOHHS/DOCS/MASSHEALTH/DESKGUIDES/FPL-DESKGUIDE.PDF DISCOUNTED CAREDISCOUNTED CARE IS PROVIDED TO LOW INCOME PATIENTS WHO MEET THE CRITERIA UNDER 114.6 CMR 13.04(1). IN ORDER TO BE DETERMINED A LOW INCOME PATIENT, AN INDIVIDUAL MUST BE A RESIDENT OF THE COMMONWEALTH AND DOCUMENT FAMILY INCOME EQUAL TO OR LESS THAN 400% OF THE FPG, SUBJECT TO THE FOLLOWING CONDITIONS.THE FOLLOWING INDIVIDUALS ARE NOT ELIGIBLE FOR LOW INCOME PATIENT STATUS:- INDIVIDUALS ENROLLED IN MASSHEALTH STANDARD AND MASSHEALTH FAMILY ASSISTANCE/DIRECT COVERAGE PROGRAMS;- INDIVIDUALS WHO HAVE BEEN DETERMINED ELIGIBLE FOR ANY MASSHEALTH PROGRAM INCLUDING MASSHEALTH PREMIUM ASSISTANCE BUT WHO HAVE FAILED TO ENROLL; AND- INDIVIDUALS WHOSE ENROLLMENT IN MASSHEALTH OR COMMONWEALTH CARE HAS BEEN TERMINATED DUE TO FAILURE TO PAY PREMIUMS.
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SCHEDULE H, PART VI, LINE 6(A) AND 6(B):
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STATE FILINGS OF THE COMMUNITY BENEFIT REPORTNEW ENGLAND BAPTIST HOSPITAL (NEBH OR HOSPITAL) PREPARES AND FILES AN ANNUAL NON-PROFIT HOSPITAL COMMUNITY BENEFIT REPORT WITH THE STATE OF MASSACHUSETTS OFFICE OF ATTORNEY GENERAL. 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 NEBH FILED WITH THE ATTORNEY GENERAL'S OFFICE. CURRENT AND PAST FILINGS OF THE HOSPITAL'S COMMUNITY BENEFIT REPORT ARE MADE PUBLIC ON BOTH THE HOSPITAL'S PUBLIC WEBSITE AND THAT OF THE MASSACHUSETTS OFFICE OF ATTORNEY GENERAL:HTTP://WWW.NEBH.ORG/ABOUT-NEBH/OUR-COMMUNITY/HTTP://WWW.CBSYS.AGO.STATE.MA.US/HEALTHCARE/HCCBAR.ASP
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SCHEDULE H, PART VI, SUPPLEMENTAL INFORMATION
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THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW NEBH CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AS WELL AS COMMUNITY BUILDING ACTIVITIES. AS DEMONSTRATED IN THIS SCHEDULE H, DURING THE PERIOD COVERED BY THIS FILING, 3.96% OF THE NEBH'S TOTAL EXPENSES WERE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. IN ADDITION AS NOTED IN THE NARRATIVE BELOW AND THROUGHOUT THIS RETURN, THERE ARE ADDITIONAL ACTIVITIES AND EXPENDITURES WHICH NEBH CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. UNDER THE INSTRUCTIONS TO THIS SCHEDULE H QUESTION 7 THESE ITEMS ARE NOT QUANTIFIED IN SCHEDULE H QUESTION 7, BUT IT IS WORTH NOTING THAT IF NEBH HAD INCLUDED THESE IN SCHEDULE H QUESTION 7, THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WOULD BE 5.10% FOR THE PERIOD COVERED BY THIS FILING.
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SCHEDULE H, PART VI, LINE 1: PART I, LINE 7(A-D):
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CHARITY CARE AND MEANS-TESTED PROGRAMSCHARITY CARE AT COST IS CALCULATED USING AN INTERNAL COST TO CHARGE RATIO CALCULATION. UNREIMBURSED MEDICAID COSTS ARE CALCULATED BY APPLYING THE COST TO CHARGE RATIO TO MEDICAID GROSS CHARGES AND SUBTRACTING MEDICAID NET REIMBURSEMENT. OTHER BENEFITS INCLUDE THE HOSPITAL'S GROSS OBLIGATION INTO THE MASSACHUSETTS HEALTH SAFETY NET POOL. PLEASE SEE THE NOTES TO THE AUDITED FINANCIALS FOR BAD DEBTS INCLUDED IN THIS SCHEDULE H DISCLOSURE (PART III, LINE 4) AND THE FOLLOWING SUMMARY:CHARITY CARE & EXPENSES DIRECT OFFSETTING NET COMMUNITYMEANS TESTED GOVT. REVENUE BENEFITPROGRAMS EXPENSEA) CHARITY CARE AT COST $250,000 - $250,000 HEALTH SAFETY NET PAYMENTS 1,750,164 - 1,750,164 TOTAL 2,000,164 - 2,000,164B) UNREIMBURSED MEDICAID 1,079,018 (622,484) 456,534 NEBH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN PROGRAMS DESIGNED TO SUPPORT LOW INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS WHICH INSURE LOW INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 1.3% OR 2,203 OF NEBH'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. THIS TRANSLATED TO $1,079,018 IN MEDICAID REVENUE WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY NEBH FOR SUCH SERVICES BY $456,534, AS REPORTED WITHIN SCHEDULE H, PART I, LINE 7B. NEBH ALSO MADE PAYMENTS TO THE HEALTH SAFETY NET TRUST (HSN) TO SUPPORT THE DELIVERY OF CHARITY CARE TO PATIENTS THROUGHOUT MASSACHUSETTS. THE HOSPITAL'S TOTAL PAYMENTS TO THE HSN WERE $1,750,164 FOR THE PERIOD COVERED BY THIS FILING AND QUANTIFIED AS PART OF CHARITY CARE REPORTED IN THIS SCHEDULE H, PART I LINE 1A. THIS AMOUNT IS ALSO REPORTED AS A COMPONENT OF UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS.
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SCHEDULE H, PART VI, LINE 1: PART I, LINE 7(E):
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COMMUNITY HEALTH IMPROVEMENT SERVICESSCHEDULE H, PART VI, LINE 1: PART I, LINE 7(I): CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENT NEW ENGLAND BAPTIST HOSPITAL IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED IN MUSCULOSKELETAL DISEASE AND COLLABORATE ON PROGRAMS TO ADDRESS THESE NEEDS, WITH SPECIAL FOCUS ON UNDERSERVED POPULATIONS THROUGH OUTREACH, EDUCATION AND PROVISION OF SERVICES TO ADDRESS MUSCULOSKELETAL HEALTH.AS NOTED THROUGHOUT THIS NARRATIVE, NEW ENGLAND BAPTIST HOSPITAL'S (NEBH OR HOSPITAL) PRIMARY PURPOSE IS THE OPERATION AND MAINTENANCE OF AN ACUTE CARE, ORTHOPEDIC SPECIALTY HOSPITAL AND PROVISION OF ALL SERVICES RELATED THERETO FOR THE BENEFIT OF PATIENTS. THE HOSPITAL OPERATES AS AN ADULT MEDICAL / SURGICAL HOSPITAL WITH A NATIONAL REPUTATION IN ORTHOPEDIC CARE. PATIENTS ARE OFFERED A FULL RANGE OF SERVICES IN ORTHOPEDICS AND RHEUMATOLOGY, JOINT REPLACEMENT, SPINE CARE, FOOT AND ANKLE CARE, HAND SURGERY, OCCUPATIONAL MEDICINE AND SPORTS MEDICINE. COMMUNITY BENEFITS PHILOSOPHY NEBH IS COMMITTED TO ITS COMMUNITY. OUR PHILOSOPHY IS TO PARTNER DIRECTLY WITH LOCAL ORGANIZATIONS TO PROVIDE DIRECT SERVICES IN OUR PRIORITY AREAS, TO STREAMLINE AND REDUCE DUPLICATION AND TO BUILD POSITIVE RELATIONSHIPS IN THE NEIGHBORHOOD DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $883,741 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I, COLUMN C. EXPENSE DIRECT NET OFFSETTING COMMUNITY REVENUE BENEFIT EXPENSEE) COMMUNITY HEALTH IMPRO- -VEMENT SERVICES7E NEBH COMMUNITY RELATIONS 131,693 - 131,693 STAFF COSTS 7E COMMUNITY BENEFITS 317,679 - 317,679 (SEE CB REPORT) TOTAL 449,372 - 449,372 I) CASH & IN-KIND CONTRI- 434,369 - 434,369 -BUTIONS TO COMMUNITY GROUPS TOTAL 7E & 7I 883,741 - 883,741 COMMUNITY BENEFITS LEADERSHIP THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT ARE RESPONSIBLE FOR OVERSEEING THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY BENEFITS PLAN. COMMUNITY PLANNING IS DONE IN CONJUNCTION WITH MEMBERS OF THE DESIGNATED HOSPITAL COMMUNITY, WHO MAY PROVIDE INSIGHT AND RECOMMENDATIONS ON COMMUNITY HEALTH ISSUES. THE BOARD IS RESPONSIBLE FOR DEVELOPING POLICY TO IMPLEMENT AND EVALUATING THE HOSPITAL'S CURRENT AND FUTURE COMMUNITY PROGRAMS. THE DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS REPORTS TO SENIOR MANAGEMENT AND TO THE PRESIDENT OF THE HOSPITAL ON COMMUNITY BENEFIT ACTIVITIES AND PLANS. DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS, RESPONSIBILITIES INCLUDE:- PLANNING, ORGANIZING AND EVALUATING THE COMMUNITY BENEFITS PROGRAMMING IN COLLABORATION WITH HOSPITAL ADMINISTRATION, NEBH STAFF AND THE KEY STAKEHOLDERS WITHIN THE COMMUNITY.- COORDINATING THE HOSPITAL'S CURRENT COMMUNITY BENEFIT PROGRAM WITH NUMEROUS DEPARTMENTS THROUGHOUT THE HOSPITALCOMMUNITY HEALTH NEEDS ASSESSMENT 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 PURSUANT TO FEDERAL GUIDELINES, IN ORDER MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2013 (TAX YEAR 2012). NEBH CONDUCTED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSING ON MISSION HILL AND ROXBURY, ITS PRIMARY SERVICE AREA WITH RESPECT TO ITS COMMUNITY BENEFIT INITIATIVES. THE OVERALL GOAL OF THE ASSESSMENT WAS TO COMPILE INFORMATION FROM A RANGE OF QUANTITATIVE AND QUALITATIVE SOURCES TO CLARIFY THE HEALTH CARE NEEDS AND PRIORITIES OF COMMUNITY RESIDENTS AND ASSESS THE OVERALL STRENGTHS AND WEAKNESSES OF THE AREA'S HEALTH AND SOCIAL SERVICE SYSTEMS. ULTIMATELY, THE PURPOSE OF THE ASSESSMENT WAS TO FACILITATE THE DEVELOPMENT OF A STRATEGIC PLAN THAT WOULD GUIDE HOW NEBH WOULD WORK WITH STAKEHOLDERS IN MISSION AND HILL AND ROXBURY TO STRENGTHEN THE COMMUNITY AND IMPROVE HEALTH STATUS MOVING FORWARD. THE MOST SIGNIFICANT HEALTH-RELATED ISSUE FACING THE COMMUNITIES SURROUNDING NEBH ARE THE BROADER SOCIAL AND ECONOMIC DETERMINANTS (E.G., POVERTY, UNEMPLOYMENT, FOOD INSECURITY, VIOLENCE, TRANSPORTATION). IN ADDITION TO THIS UNDERLYING PRIORITY, ISSUES RELATED OBESITY, LACK OF PHYSICAL EXERCISE, AND POOR NUTRITION AS WELL AS THE CHRONIC DISEASES THAT ARE OFTEN ASSOCIATED WITH THESE FACTORS ARE SEEN AS ANOTHER PRIORITY. ALSO, ISSUES RELATED TO OLDER ADULT HEALTH (E.G., GENERAL HEALTH AND WELLNESS, FALLS PREVENTION, ISOLATION/DEPRESSION, OSTEOPOROSIS, CHRONIC DISEASE) ARE ALSO A PRIORITY. THE EXPRESSED NEEDS FROM THE CHNA, LED TO NEBH'S FOCUS ON THE FOLLOWING AREAS: MUSCULOSKELETAL HEALTH, OBESITY PREVENTION, VIOLENCE PREVENTION, WORKFORCE DEVELOPMENT, ELDER ISOLATION, ACCESS TO HEALTHY AFFORDABLE FOOD, FOOD INSECURITY/HUNGER AND MOBILITY AND TRANSPORTATION FOR THE ELDERLY. AS NOTED IN SCHEDULE H PART V SECTION B QUESTION 7A, NEBH'S CHNA CAN BE FOUND ON THE NEBH WEBSITE AT: HTTP://WWW.NEBH.ORG/ABOUT-NEBH/OUR-COMMUNITY/NEBH IS COMMITTED TO IMPROVING THE HEALTH STATUS AND WELL-BEING OF THOSE LIVING THROUGHOUT ITS COMMUNITY BENEFIT SERVICE AREA. NEBH'S COMMUNITY HEALTH IMPROVEMENT PLAN, INCLUDES MANY ACTIVITIES THAT WILL IMPACT ALL RESIDENTS. AS NOTED IN SCHEDULE H PART V SECTION B QUESTION 10A, NEBH'S IMPLEMENTATION STRATEGY/CHIP CHNA CAN BE FOUND ON THE NEBH WEBSITE AT: HTTP://WWW.NEBH.ORG/ABOUT-NEBH/OUR-COMMUNITY/THE INFORMATION GATHERED AS PART OF THIS EFFORT ALLOWED NEBH TO ENGAGE THE COMMUNITY AND GAIN A BETTER UNDERSTANDING OF THE HEALTH STATUS, HEALTH CARE NEEDS, SERVICE GAPS, AND BARRIERS TO CARE OF THOSE LIVING IN MISSION HILL AND ROXBURY, NEBH'S PRIMARY SERVICE FOR ITS COMMUNITY BENEFIT EFFORTS. THE IMPLEMENTATION PLAN STARTED IN SEPTEMBER 2013. ADDITIONALLY, IN COMPLIANCE WITH INTERNAL REVENUE CODE SECTION 501(R), NEBH HAS COMMENCED ITS NEXT CHNA PROCESS AND WILL HAVE A NEW CHNA COMPLETED AND VOTED BY THE NEBH BOARD OF TRUSTEES, OR AND AUTHORIZED SUBCOMMITTEE OF THE BOARD, ON OR BEFORE SEPTEMBER 30, 2016. A NEW IMPLEMENTATION STRATEGY/CHIP WILL BE ADOPTED AFTER THE CHNA PROCESS HAS BEEN COMPLETED. SEVERAL COMMUNITY PROGRAMS AND EVENTS IN WHICH NEBH PLAYS A LEADERSHIP ROLE INCLUDE:MUSCULOSKELETAL HEALTH ARTHRITIS AND LUPUS SUPPORT GROUPTHE GOAL OF THIS INITIATIVE IS TO ADDRESS ACCESS, EDUCATION, TREATMENT, AND SUPPORT NEEDS OF PEOPLE WITH ARTHRITIS AND LUPUS, ESPECIALLY UNDER-SERVED POPULATIONS IN THE CITY OF BOSTON, TARGETING WOMEN OF COLOR. THE LONG-TERM GOAL IS TO MEET THE IDENTIFIED NEEDS OF MORE SUPPORT AND EDUCATION. ARTHRITIS FOUNDATIONTHE ARTHRITIS FOUNDATION'S WALK TO CURE ARTHRITIS ENCOURAGES PEOPLE TO MOVE TO PREVENT OR TREAT ARTHRITIS. THERE ARE 27 MILLION PEOPLE WITH OSTEOARTHRITIS, THE MOST COMMON FORM OF ARTHRITIS, 1.3 MILLION PEOPLE WITH RHEUMATOID ARTHRITIS, AN AUTOIMMUNE DISEASE THAT CAN LEAD TO CHRONIC PAIN, LOSS OF FUNCTION AND DEFORMITY AND 300,000 CHILDREN (OR ONE IN 250) WITH JUVENILE ARTHRITIS, WHICH AFFECTS CHILDREN BETWEEN THE AGES OF INFANCY AND 18. BY 2030, AN ESTIMATED 67 MILLION AMERICANS AGES 18 YEARS OR OLDER ARE PROJECTED TO HAVE DOCTOR-DIAGNOSED ARTHRITIS. NEW ENGLAND BAPTIST HOSPITAL (NEBH) HAS PARTNERED WITH THE ARTHRITIS FOUNDATION'S, GREATER BOSTON CHAPTER ON THEIR WALK TO CURE ARTHRITIS, IN THE FIGHT AGAINST ARTHRITIS BY RAISING AWARENESS AND REDUCING THE IMPACT OF ARTHRITIS, WHICH IS THE NATION'S LEADING CAUSE OF DISABILITY.
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SCHEDULE H, PART VI, LINE 1: PART I, LINE 7(E)& 7(I):
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OSTEOPOROSIS OSTEOPOROSIS IS A MAJOR PUBLIC HEALTH THREAT FOR AN ESTIMATED 54 MILLION AMERICANS AGE 50 AND OLDER. TWENTY PERCENT OF NON-HISPANIC CAUCASIAN AND ASIAN WOMEN AGED 50 AND OLDER ARE ESTIMATED TO HAVE OSTEOPOROSIS, AND 52 PERCENT ARE ESTIMATED TO HAVE LOW BONE MASS. THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (DPH) HAS IDENTIFIED OSTEOPOROSIS AS A PUBLIC HEALTH ISSUE AND ESTABLISHED THE OSTEOPOROSIS AWARENESS PROGRAM. PHYSICAL ACTIVITY CAN IMPROVE THE OVERALL HEALTH AND WELL-BEING OF OLDER ADULTS. EVEN MODEST LEVELS OF ACTIVITY, DONE EACH DAY FOR A TOTAL OF 30 MINUTES, CAN PREVENT OR CONTROL OSTEOPOROSIS AND WEIGHT GAIN. NEBH SUPPORTS TWO WALKING GROUPS AT ROXBURY TENANTS OF HARVARD: A WALKING/EXERCISE PROGRAM HELD IN MISSION HILL, SERVING BETWEEN 20-40 WOMEN AND MEN BETWEEN THE AGES OF 40 AND 90 FROM ALL ETHNIC BACKGROUNDS AT EACH SESSION. THE HOSPITAL ALSO OFFERS EDUCATIONAL PROGRAMS SUCH AS STRETCHING, EATING HEALTHY, ETC. TO THIS GROUP.GREATER BOSTON SENIOR GAMESSINCE 2001, NEBH HAS BEEN A SPONSOR OF THE GREATER BOSTON SENIOR GAMES. THE GAMES PROVIDE OLDER ADULTS (50 YEARS AND OLDER) THE OPPORTUNITY TO PARTICIPATE IN ATHLETIC COMPETITIONS, PROMOTING WELLNESS, AND KEEPING THEM ACTIVE. BENEFITS INCLUDE: MAINTAINING PHYSICAL, MENTAL AND EMOTIONAL FITNESS, SOCIALIZATION, KEEPING AN ACTIVE LIFESTYLE, REDUCING ISOLATION, PARTICIPATING IN COMMUNITY ACTIVITIES, MEETING PEOPLE WITH DIFFERENT CULTURES, LANGUAGES AND CUSTOMS AND MAINTAINING ENERGY AND ENTHUSIASM. DURING THE FIVE-DAY GAMES, SENIOR ATHLETES PARTICIPATE IN THEIR CHOICE OF EVENTS INCLUDING BILLIARDS, BOCCE, BOWLING, GOLF, HALF-COURT BASKETBALL, HORSESHOES, SOCCER KICK, SOFTBALL THROW, SWIMMING, TENNIS, TRACK AND A NON-COMPETITIVE WALK. BETWEEN 80-100 ELDERS FROM THE MISSION HILL/ROXBURY COMMUNITY ATTEND THE EVENTS EACH YEAR.JR. CELTICS PROGRAMTHE JR. CELTICS PROGRAM, PRESENTED BY NEW ENGLAND BAPTIST HOSPITAL, CHALLENGES OVER 350 3RD TO 5TH GRADERS TO DEVELOP THEIR BASKETBALL GAME THROUGH SKILLS, DRILLS AND LEADERSHIP TRAINING AND LSO KEEPING THEM ACTIVE WITH PHYSICAL EXERCISE. THE JR. CELTICS HELD 2 PROGRAMS IN THE MISSION HILL AREA THAT BENEFITTED YOUTH IN MISSION HILL.MOBILITY AND ELDERLY TRANSPORTATION - THE MISSION LINKBECAUSE THE NEIGHBORHOOD OF MISSION HILL IS LOCATED ON A STEEP HILL, AT THE HIGHEST ELEVATION IN BOSTON, IT PRESENTS A SIGNIFICANT ISSUE TO MOBILITY FOR THE ELDERLY POPULATION. THE NEED FOR REGULAR TRANSPORTATION TO AVOID SOCIAL ISOLATION OF THOSE SENIORS IN THE MISSION HILL COMMUNITY WAS IDENTIFIED AS A CRITICAL ISSUE DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT. NEBH HAS BEEN A MAJOR SPONSOR OF THE MISSION LINK BUS FOR MANY YEARS TO INCREASE ACCESS TO HEALTHY FOOD OPTIONS, MEDICAL CARE, AND PUBLIC TRANSPORTATION. ELDER ISOLATIONTHE MISSION HILL LEGACY PROJECT BRINGS SENIORS FROM THROUGHOUT THE MISSION HILL NEIGHBORHOOD TOGETHER FOR SOCIAL AND EDUCATIONAL EVENTS. IT IS EVIDENT THAT THERE ARE MANY ISSUES RELATED TO OLDER ADULT HEALTH IN THE MISSION HILL COMMUNITY. NEBH IS COMMITTED TO THE MISSION HILL LEGACY PROJECT TO HELP WITH ELDER ISOLATION. NEBH PROVIDES AN EXERCISE PROGRAM AND A BIRTHDAY CELEBRATION PROGRAM THAT TRAVELS THROUGHOUT HOUSING DEVELOPMENTS IN MISSION HILL ON A QUARTERLY BASIS. OBESITY PREVENTION OBESITY HAS REACHED EPIDEMIC PROPORTIONS IN THE UNITED STATES. OBESITY IS BECOMING A MAJOR ISSUE IN MASSACHUSETTS AND HAS A SIGNIFICANT NEGATIVE IMPACT ON THE MUSCULOSKELETAL SYSTEM. NEBH HAS A LONG-STANDING COMMITMENT TO IMPROVING THE HEALTH STATUS OF BOSTON RESIDENTS, WITH A FOCUS ON MOVEMENT AND PREVENTION OF OBESITY. THE HOSPITAL SUPPORTS THE MISSION HILL LITTLE LEAGUE, MISSION HILL SOFTBALL LEAGUE, MAURICE J. TOBIN COMMUNITY CENTER, ROXBURY TENANTS OF HARVARD AND SOCIEDAD LATINA FOR THE PROGRAMS IN PHYSICAL ACTIVITY. THE HOSPITAL SUPPORTS THE GYM, LEAGUES, AND SUMMER CAMP AT THE MAURICE J. TOBIN COMMUNITY CENTER AS WELL AS THE HEALTH EDUCATORS IN ACTION PROGRAM AT SOCIEDAD LATINA. FOR MANY YEARS, NEBH HAS MAINTAINED AND IS A MAJOR CONTRIBUTOR TO THE LIGHTING AT MCLAUGHLIN FIELD AT NIGHT TO FOSTER ITS USE FOR PHYSICAL ACTIVITY. VIOLENCE PREVENTION CREATING A STRONG FEELING OF COMMUNITY AND FOCUSING ON YOUTH EDUCATION ARE TWO IMPORTANT ASPECTS OF VIOLENCE PREVENTION. NEBH WORKS WITH COMMUNITY GROUPS SUCH AS THE MISSION HILL YOUTH COLLABORATIVE (MHYC), THE MISSION HILL CRIME COMMITTEE AND THE BOSTON POLICE TO HELP EDUCATE OUR COMMUNITY AND TO KEEP OUR YOUTH ENGAGED IN PRODUCTIVE ACTIVITIES TO PREVENT VIOLENCE IN OUR COMMUNITY. THE MHYC SERVES OVER 1,500 YOUTH AND FAMILIES LIVING IN THE MISSION HILL AREA BY HOSTING EDUCATIONAL AND FUN EVENTS, SUCH AS HALLOWEEN ON THE HILL. SECURITY CAMERA'S AND ROUNDS NEBH PERFORMS SECURITY ROUNDS THROUGHOUT THE MISSION HILL AREA 7 DAYS A WEEK 24 HOURS A DAY AT SCHEDULED AND UNSCHEDULED INTERVALS. THIS SERVICE PROVIDES VIOLENCE DETERRENCE IN THE NEIGHBORHOOD. NEBH IN CONJUNCTION WITH COMMUNITY LEADERS REVIEWED AND UPGRADED ITS VIDEO SYSTEM TO ENHANCE NEIGHBORHOOD SECURITY. NEBH ALSO WORKS WITH THE MISSION HILL PROBLEM PROPERTIES TASK FORCES TO IMPROVE SAFETY AND SECURITY OF THE COMMUNITY. FOOD INSECURITY/HUNGER MISSION HILL ELEMENTARY SCHOOL, MISSION HILL LEGACY PROJECT AND BOSTONCANSHARE HUNGER IS ON THE RISE IN MASSACHUSETTS. FOOD IS NEEDED TO SUSTAIN FAMILIES DURING THE HOLIDAYS, SCHOOL VACATIONS AND WHEN THE CHILDREN ARE NOT ATTENDING SCHOOL. NEBH PARTNERED THE MISSION HILL ELEMENTARY SCHOOL AND THE MISSION HILL LEGACY PROJECT TO COMBAT HUNGER. NEBH IS COMMITTED TO COMBATING HUNGER IN OUR LOCAL NEIGHBORHOODS. EACH YEAR, MUCH NEEDED FOOD IS GIVEN DURING THE THANKSGIVING AND CHRISTMAS HOLIDAYS AND DURING SCHOOL VACATIONS. FOOD IS PROVIDED TO SUPPLEMENT STUDENT AND FAMILY FOOD NEEDS, AS MEALS ARE NOT SERVED BY THE SCHOOL SYSTEM DURING VACATIONS. LUNCH IS ALSO PROVIDED DURING THE WINTER MONTHS FOR CHILDREN PARTICIPATING IN THE YMCA AND THE CHILL FOUNDATION'S SKI PROGRAM. DURING THE HOLIDAYS, FOOD IS GIVEN TO SENIORS IN NEED THROUGH THE MISSION HILL LEGACY PROGRAM. NEBH DONATED TO THE BOSTON CAN SHARE PROGRAM WHICH IS THE ANNUAL FOOD DRIVE SPONSORED BY THE MAYOR'S OFFICE OF FOOD INITIATIVES.INCREASE ACCESS TO HEALTHY FOODS ACCESS TO HEALTHY FRUITS AND VEGETABLESAS IDENTIFIED IN THE CHNA, THERE IS A NEED IN MISSION HILL FOR ACCESS TO AFFORDABLE HEALTHY FOOD. NEBH IS COMMITTED TO PROVIDING ACCESS TO AFFORDABLE HEALTHY FOOD BY PARTNERING WITH THE MISSION HILL HEALTH MOVEMENT AND THE MISSION HILL FARMERS MARKET. NEBH OFFERED $2 COUPONS TO THE FARMERS MARKET EACH WEEK DURING THE SUMMER AND FALL TO MISSION HILL/ROXBURY RESIDENTS SO THAT THEY MAY PURCHASE FRESH FRUIT AND VEGETABLES AT A DISCOUNTED RATE. OVER 3,950 COUPONS WERE GIVEN OUT TO COMMUNITY RESIDENTS.IN ADDITION TO THE COMMUNITY BENEFIT ACTIVITIES LISTED ABOVE, NEBHENGAGES IS OTHER COMMUNITY ACTIVITIES WHICH NEBH CONSIDERS PART OF ITS COMMUNITY BENEFIT, BUT WHICH ARE REPORTED IN THIS FORM 990 SCHEDULE H PART II AS COMMUNITY BUILDING AS REQUIRED. DETAIL RELATED TO SOME OF THESE ACTIVITIES IS BELOW.
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WORKFORCE DEVELOPMENT
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MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP NEW ENGLAND BAPTIST HOSPITAL MADE AN IMPORTANT COMMITMENT TO OUR COMMUNITY BY CREATING THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP, NAMED AFTER A LONG SERVICE HOSPITAL EMPLOYEE WHO PASSED AWAY IN 2009.THE GOAL OF THIS PROGRAM IS TO OFFER TWELVE TO FIFTEEN HIGH SCHOOL AND COLLEGE STUDENTS WHO PERMANENTLY RESIDE IN THE MISSION HILL/ROXBURY COMMUNITY AN 8 TO 10 WEEK PAID SUMMER EMPLOYMENT IN POSITIONS THAT WILL BE ENGAGING, ENRICHING AND REWARDING WHILE PROVIDING EXPOSURE TO HEALTH AND SCIENCE RELATED CAREER PATHS. THESE JOBS ARE IN CLINICAL AREAS THAT ALLOW THE STUDENTS TO OBSERVE/BECOME FAMILIAR WITH PATIENT CARE WHILE THEY PERFORM ANCILLARY FUNCTIONS OR IN DEPARTMENTS THAT SUPPORT OUR PATIENT CARE EFFORTS INVOLVING SOME EXPOSURE TO SCIENCE/HEALTH CARE CAREERS. NEBH WORKS WITH HIGH SCHOOL AND COLLEGE STUDENTS THROUGH EXISTING PARTNERSHIPS WITH THE ROXBURY TENANTS OF HARVARD, ABCD PARKER HILL/ FENWAY NEIGHBORHOOD SERVICE CENTER AND SOCIEDAD LATINA, A YOUTH AGENCY IN MISSION HILL. IN 2015, NINE STUDENTS WERE GAINFULLY EMPLOYED FOR THE SUMMER. FOUR OF THE NINE WERE HIRED AS PERMANENT PART TIME EMPLOYEES.ABCD SUMMERWORKS PROGRAM NEBH HAS BEEN A SPONSOR OF THE SUMMERWORKS PROGRAM FOR MANY YEARS. THE PROGRAM OFFERS YOUTH LIVING IN MISSION HILL A MEANINGFUL WORK EXPERIENCE AT LOCAL NON-PROFIT, ACADEMIC, AND MEDICAL INSTITUTIONS DURING THE SUMMER. CRISTO REY BOSTON HIGH SCHOOL CORPORATE WORK STUDY THE SIGNATURE COMPONENT OF CRISTO REY BOSTON HIGH SCHOOL IS THE CORPORATE WORK STUDY PROGRAM. THE SCHOOL SERVES FAMILIES WITH LIMITED FINANCIAL RESOURCES. EVERY ONE OF THEIR STUDENTS WORKS FIVE FULL DAYS PER MONTH TO PAY FOR MOST OF THE COST OF THEIR EDUCATION AND TO GAIN PROFESSIONAL EXPERIENCE. BY WORKING, STUDENTS LEARN ABOUT THE CORPORATE WORLD, CONNECT ACADEMIC COURSEWORK TO THE WORK THEY DO AT THEIR CORPORATE PLACEMENTS, AND GAIN SKILLS THAT WILL SERVE THEM BEYOND HIGH SCHOOL. APPRENTICESHIP LEARNINGAPPRENTICE LEARNING IS A BOSTON-BASED NON-PROFIT WHICH PROVIDES 8TH GRADERS IN URBAN PUBLIC SCHOOLS THE OPPORTUNITY TO EXPERIENCE FIRSTHAND THE ADULT WORLD OF WORK AS PART OF THEIR SCHOOL DAY. STUDENTS SPEND 2 HOURS PER WEEK FOR 6 WEEKS AT THE HOSPITAL WITH VARIOUS STAFF MEMBERS.ISSUES NOT ADDRESSED: THE HOSPITAL IS AN ORTHOPEDIC SPECIALTY-REFERRAL HOSPITAL FOR THE NEW ENGLAND REGION. IT IS NOT A FULL-SERVICE COMMUNITY HOSPITAL. BECAUSE OF THIS, AND TO AVOID DUPLICATION OF SERVICES, THE HOSPITAL IDENTIFIED RESOURCES AND STRENGTHS IN ITS SPECIALTY AREAS. SIMILAR TO THE COMMUNITY NEEDS ASSESSMENT PROCESS, THE HOSPITAL EVALUATED RESOURCES AND STRENGTHS OF ITS SPECIALTY AREAS AND THEN SOUGHT OUT COMMUNITY PARTNERS FOR EACH AREA TO HELP DEVELOP AND IMPLEMENT PLANS AND PROJECTS ACCORDING TO COMMUNITY NEED. (FORM 990 SCHEDULE H PART V SECTION B QUESTION 11)CHRONIC DISEASE NEW ENGLAND BAPTIST HOSPITAL IS FULLY ENGAGED THROUGH ITS AFFILIATIONS WITH OTHER HOSPITALS, CLINICS AND PHYSICIAN GROUPS WHO HAVE SIGNIFICANT EXPERTISE IN CHRONIC DISEASE MANAGEMENT TO ENSURE THAT THE NEEDS OF OUR COMMUNITY ASSOCIATED WITH DIABETES, CONGESTIVE HEART FAILURE, ETC., ARE MET. BEHAVIORAL HEALTH SUPPORT PROGRAMS IN NEARBY CLINICS AND HOSPITALS HAVE BEEN ESTABLISHED TO PROVIDE BEHAVIORAL HEALTH MANAGEMENT TO BETTER ASSESS, MONITOR AND TREAT PATIENTS WITH MOOD DISORDER, SUBSTANCE ABUSE, ETC., IN OUR COMMUNITY. MATERNAL AND CHILD HEALTH NEW ENGLAND BAPTIST DOES NOT PROVIDE MATERNAL AND CHILD HEALTH. THE COMMUNITY IS SURROUNDED BY MEDICAL INSTITUTIONS THAT OFFER THESE SERVICES.SCHEDULE H, PART VI, LINE 1: PART I, LINE 7(F):HEALTH PROFESSIONS EDUCATIONNEW ENGLAND BAPTIST HOSPITAL (NEBH) SERVES AS A TEACHING HOSPITAL AFFILIATED WITH THE TUFTS UNIVERSITY SCHOOL OF MEDICINE AND PHILADELPHIA COLLEGE OF MEDICINE AND MAINTAINS RESIDENCY PROGRAMS SPECIALIZING IN ORTHOPEDICS AND RADIOLOGY. ALSO, NEBH CONDUCTS TEACHING PROGRAMS IN COLLABORATION WITH THE HARVARD SCHOOL OF PUBLIC HEALTH AND THE HARVARD MEDICAL SCHOOL. RESIDENTS IN THESE PROGRAMS OBTAIN EDUCATION NECESSARY TO BE LICENSED AS A HEALTH PROFESSIONAL, AND THEIR SELECTION AND ROTATION BEYOND THE NEBH PROGRAM IS IN NO WAY RESTRICTED. IN FY 2015, NEBH HAD A TOTAL OF 41 ROTATING ORTHOPEDIC AND RADIOLOGY RESIDENTS.
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SCHEDULE H, PART VI, LINE 1: PART I, LINE 7(G):
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SUBSIDIZED HEALTH SERVICESNEW ENGLAND BAPTIST HOSPITAL (NEBH) PROVIDES CERTAIN HEALTH IMPROVEMENT SERVICES WITH THE PURPOSE OF IMPROVING COMMUNITY HEALTH. THESE SERVICES ARE PROVIDED FOR THE BENEFIT OF OUR COMMUNITY, AND SUBSIDIZED BY THE ORGANIZATION: IF NEBH DISCONTINUED THESE SERVICES, THEN OTHER COMMUNITY NOT-FOR-PROFIT ORGANIZATIONS OR GOVERNMENT AGENCIES WOULD BEAR THE ADDITIONAL BURDEN OF COVERAGE AND SERVICE. THE FOLLOWING IS A LIST OF THE PROGRAMS (PLEASE SEE DESCRIPTIONS OF THE PROGRAMS BELOW) THAT WERE SUBSIDIZED BY THE HOSPITAL IN FY 2015: EXPENS DIRECT NET OFFSETTING COMMUNITY REVENUE BENEFIT EXPENSEG) SUBSIDIZED HEALTH SERVICES7G) ORTHOPEDIC BRACES 439,363 - 439,363 TO PATIENTS AT NO COST7G) COMMUNITY HEALTH SERVICES IN MISSION HILL BY 531,357 (317,872) 213,485 DR.TSIKITAS7G) COMMUNITY HEALTH SERVICES BY DR. TALALAYEVSKY 504,237 (389,972) 114,2657G) NEBH HOSPITALISTS 3,249,326 (1,956,228) 1,293,0987G) NEBH SURGICAL 460,039 (12,783) 447,256 HOUSE OFFICER7G) PSYCHIATRIC CARE & COUNSELING 116,243 - 116,2437G) AMBULATORY 1,960,743 (974,942) 985,801 TOTAL 7,261,308 (3,651,797) 3,609,511 ORTHOPEDIC BRACES PROVIDED TO PATIENTS AT NO COSTAS A CENTER OF ORTHOPEDIC EXCELLENCE, NEBH IS A PLACE WHERE THE CARE AND COMFORT OF OUR PATIENTS EXTENDS BEYOND THEIR HOSPITAL VISIT. THE NEBH BRACE PROGRAM PROVIDES PATIENTS WITH THE CUSTOM DURABLE MEDICAL EQUIPMENT (DME) THEY NEED AFTER SURGERY OR HOSPITAL VISIT. EACH PATIENT NEED IS DIFFERENT AND THE PROGRAM IS DESIGNED TO BEST PROTECT, SUPPORT, AND REHABILITATE PATIENTS IN OUR COMMUNITY. COMMON NEEDS INCLUDE: AN AMBULATORY PATIENT NEEDING A CUSTOM CAST, WALKING BOOT, WALKER OR BRACE AFTER A FALL; A PATIENT REQUIRING A CUSTOMIZED ORTHOTIC FOR PROTECTION BEFORE GOING HOME AFTER SURGERY; OR A PATIENT CONTINUING REHABILITATION USING A CONTINUOUS PASSIVE MOTION DEVICES (CPM'S). THIS PROGRAM IS DESIGNED TO ALLOW OUR PATIENTS TO SAFELY EXIT THE HOSPITAL AND SUPPORT THEM AS THEY RETURN TO THEIR DAILY ROUTINES. IN FY 2015, THE BRACE PROGRAM REQUIRED A NET SUBSIDY OF $439,363COMMUNITY HEALTH SERVICES NEBH IS A REFERRAL AND APPOINTMENT BASED ORTHOPEDIC SPECIALTY HOSPITAL. IN FY 2015 TOTAL INPATIENT HOSPITAL ADMISSIONS WERE 8,214, OF WHICH 99% WERE FOR SURGICAL PROCEDURES - PRIMARILY HIP, KNEE, AND OTHER MUSCULOSKELETAL PROCEDURES; AND OUTPATIENT ACTIVITY WERE PREDOMINANTLY APPOINTMENT SURGERIES AND RELATED ANCILLARY VISITS TO RADIOLOGY, LAB, AND PHYSICAL THERAPY CLINICS. IN FY 2009, THE HOSPITAL HIRED A PRIMARY CARE PHYSICIAN WITH OFFICES ON MISSION HILL, DR. BILL TSIKITAS, TO PROVIDE THOSE IN THE MISSION HILL COMMUNITY WITH A PRIMARY CARE FIRST CONTACT FOR UNDIAGNOSED HEALTH CONCERNS OR PREVENTIVE CARE NEEDS THAT IS OTHERWISE NOT READILY AVAILABLE. IN FY 2015, DR. TSIKITAS' PRACTICE REQUIRED A SUBSIDY $213,485 AND THE HOSPITAL EXPECTS A SIMILAR FINANCIAL LOSS IN FUTURE YEARS. BOSTON'S FOREIGN-BORN POPULATION HAS INCREASED BY ALMOST 50% OVER THE PAST TWENTY YEARS AND NOW MAKES UP AN ESTIMATED 28% OF THE POPULATION, WELL ABOVE THE STATE AND NATIONAL AVERAGES MAKING BOSTON ONE OF THE MOST DIVERSE CITIES IN THE UNITED STATES. THE ORIGIN OF THESE RECENT IMMIGRANTS IS INCREDIBLY DIVERSE: NO SINGLE COUNTRY OF ORIGIN REPRESENTS MORE THAN 10% OF THIS FOREIGN-BORN POPULATION AND IT IS ESTIMATED THAT THERE ARE OVER 140 DIFFERENT LANGUAGES SPOKEN IN BOSTON HOMES. SETTLEMENT OF RECENT IMMIGRANTS IS SIMILARLY DIVERSE, AS EVERY BOSTON NEIGHBORHOOD HAS SEEN ITS FOREIGN-BORN POPULATION GROW AT HIGHER RATES THAN THE GENERAL POPULATION. NEBH HAS SINCE FY 2005 SUBSIDIZED THE PRACTICE OF DR. GREGORY TALALAYEVSKY, A RUSSIAN-SPEAKING PRIMARY CARE PHYSICIAN, TO THE MEET THE UNIQUE NEEDS OF THAT COMMUNITY. DR. TALALAYEVSKY'S SMALL PRACTICE HAS A STEADY PATIENT BASE OF THE ELDERLY AND RUSSIAN-SPEAKING POPULATION IN BOSTON. THESE PATIENTS AND OTHER NON-PROFITS OR GOVERNMENT AGENCIES WOULD SUFFER UNWANTED BURDENS IF HIS PRACTICE WERE TO CLOSE. IN FY 2015, DR. TALALAYEVSKY'S PRACTICE REQUIRED A SUBSIDY $114,265 AND THE HOSPITAL EXPECTS A SIMILAR FINANCIAL LOSS IN FUTURE YEARS.IN ADDITION, HOSPITALISTS AND SURGICAL HOUSE OFFICERS OVERSEE THE CARE OF EVERY PATIENT ADMITTED REGARDLESS OF THEIR ABILITY TO PAY. THEY ARE AVAILABLE 24 HOURS A DAY AND SEVEN DAYS A WEEK. IN FY 2015, THE HOSPITALISTS REQUIRED A SUBSIDY $1,293,098, AND SURGICAL HOUSE OFFICER REQUIRED A SUBSIDY $447,256. THE HOSPITAL EXPECTS A SIMILAR FINANCIAL LOSS IN FUTURE YEARS.PSYCHIATRIC CARE & COUNSELINGNEBH OFFERS MINISTRY SERVICES AND IS FULLY ACCREDITED THROUGH THE ASSOCIATION OF CLINICAL PASTORAL EDUCATION. CHAPLAINS, LED BY DR. KEN LARSEN, PROVIDE SPIRITUAL COUNSELING UPON REQUEST. DR. LARSEN AND HIS STAFF OFFER PSYCHIATRIC CARE AND COUNSELING TO PATIENTS AND FAMILIES, SUPPORTING THEIR EMOTIONAL WELL-BEING WHILE THEY RECOVER PHYSICALLY, AT NO COST. NEBH STANDARD PSYCHIATRIC CARE INCLUDES EVALUATIONS DURING PRE-ADMISSION SCREENING, MONITORING OF PATIENTS DURING PRE & POST-OPERATIVE PERIODS, AND FOR CERTAIN PATIENTS, SUPPORT DURING DETOXIFICATION AND MANAGEMENT OF PAIN. THE HOSPITAL OFFERS THESE PSYCHIATRIC CARE AND COUNSELING FOR THE WELL-BEING OF ITS PATIENTS, THEIR FAMILIES, AND OUR COMMUNITY. ADDITIONALLY, A FULL CHAPEL IS OPEN TO ALL VISITORS, PATIENTS, AND EMPLOYEES, AS WELL AS PRAYER ROOM LOCATED NEXT TO THE INTENSIVE CARE UNIT (ICU). IN FY 2015, THESE SERVICES REQUIRED A SUBSIDY $116,243 AND THE HOSPITAL EXPECTS A SIMILAR FINANCIAL LOSS IN FUTURE YEARS.COMMUNITY WALK-IN CLINIC/ AMBULATORY / EMERGENT CARE:A NEW PATIENT CARE DELIVERY SYSTEM WAS IMPLEMENTED IN MARCH 2016 FOR THE COORDINATION OF CARE OF AMBULATORY PATIENTS WHO REQUIRE NON-SCHEDULED MEDICAL EVALUATION OR TRANSFER TO ANOTHER FACILITY. THE GOAL OF THIS CHANGE WAS TO CREATE A MORE EFFICIENT DELIVERY MODEL WHERE PATIENTS ARE TRIAGED FOR THEIR CARE DEPENDING UPON THEIR CLINICAL PRESENTATION. AS NOTED ELSEWHERE IN THIS RETURN, NEBH IS NOT LICENSED TO OPERATE AN EMERGENCY ROOM, BUT WILL TRIAGE AND/OR TREAT ANY PATIENT IN NEED OF CARE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. A CLINICAL RESOURCE NURSE AND HOSPITALIST COLLABORATE TO IDENTIFY VENUE PRIOR TO THE ARRIVAL OF PATIENT WHEN ABLE. THE HOSPITALIST WILL MAKE A DETERMINATION AS TO THE BEST PATIENT DISPOSITION. CLINICAL SITUATIONS RECEIVED BY PHONE OR WALK-IN REQUIRING EMERGENCY MANAGEMENT ARE DIRECTED TO THE NEAREST EMERGENCY DEPARTMENT, SUCH AS BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A RELATED AFFILIATE AND TERTIARY CARE ACADEMIC MEDICAL CENTER WHICH OPERATES A LEVEL 1 TRAUMA EMERGENCY DEPARTMENT 24 HOURS A DAY, 7 DAYS A WEEK.ALL PATIENTS WHO COME TO NEBH, AND WHO CAN BE ADEQUATELY TREATED AT NEBH, ARE TREATED AND NOT TRANSFERRED, REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR CARE. IN FY 2015, THE NET COST TO PROVIDE ACCESS TO EMERGENCY CARE, EMERGENCY TRIAGE, URGENT CARE AND UNSCHEDULED COMMUNITY WALK-IN CARE WAS $1,173,477.
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SCHEDULE H, PART VI, LINE 1: PART I, LINE 7(H):
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RESEARCHTHE NEBH DIVISION OF RESEARCH SUPPORTS EXISTING RESEARCH GROUPS WITHIN AND OUTSIDE OF THE HOSPITAL IN CLINICAL, TRANSACTIONAL, AND PATIENT-CENTERED RESEARCH, WITH A FOCUS ON THREE KEY AREAS: JOINT REPLACEMENT, OSTEOARTHRITIS, AND SPINE RESEARCH. EACH YEAR, THE DIVISION OF RESEARCH HOSTS A SYMPOSIUM WHERE RESEARCH PRINCIPAL INVESTIGATORS SHARE THEIR KNOWLEDGE TO THE PUBLIC. NEBH RESEARCH IS PREDOMINANTLY SELF-FUNDED.
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SCHEDULE H, PART VI, LINE 1: PART III, LINE 4:
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AUDITED FINANCIALS FOOTNOTE FOR BAD DEBT EXPENSETHE AUDITED FINANCIAL STATEMENTS OF NEW ENGLAND BAPTIST HOSPITAL (HOSPITAL) INCLUDE THE HOSPITAL AND NEW ENGLAND BAPTIST MEDICAL ASSOCIATES, OF WHICH NEBH IS ITS SOLE MEMBER. FOOTNOTE 3 (INCLUDED IN ITS ENTIRETY BELOW) OF THOSE STATEMENTS DESCRIBE AND DETAIL FY 2015 BAD DEBT EXPENSE.THE HOSPITAL RECORDS BAD DEBTS IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. AS SUCH, THE EXPENSE REPRESENTS THE EXPECTED LOST REVENUE RATHER THAN THE FULL CHARGES OR AT COST.(3) COMMUNITY SERVICE AND UNCOMPENSATED CARETHE COST OF THE CORPORATION'S UNREIMBURSED CHARITY AND OTHER UNCOMPENSATED CARE CONSISTED OF THE FOLLOWING (IN THOUSANDS): YEAR ENDED SEPTEMBER 30 2015 2014UNREIMBURSED CHARITY CARE-AT COST $250 $166UNCOMPENSATED CARE EXPENSE $3,477 $2,607TOTAL $3,727 $2,773(A) UNREIMBURSED CHARITY CARETHE CORPORATION PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY.BECAUSE THE CORPORATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE EXCEPT TO THE EXTENT REIMBURSED BY THE STATEWIDE HEALTH SAFETY NET (HSN).THE AMOUNT OF CHARITY CARE AT ESTABLISHED CHARGES, AND THE ESTIMATED COST OF UNREIMBURSED CHARITY CARE PROVIDED BY THE CORPORATION, IS COMPRISED OF THE COMPONENTS LISTED BELOW (IN THOUSANDS): YEAR ENDED SEPTEMBER 30 2015 2014CHARITY CARE- AT ESTABLISHED CHARGES $407 $280ESTIMATED COST OF CHARITY CARE $250 $166THE CORPORATION ALSO PROVIDES FOR THE DELIVERY OF CHARITY CARE TO THE INDIGENT STATEWIDE THROUGH PAYMENTS TO THE HSN THAT IS OPERATED BY THE COMMONWEALTH OF MASSACHUSETTS. IN ADDITION, THE CORPORATION PROVIDES SERVICES THAT WERE NOT PAID BY PATIENTS AND, THEREFORE, ARE RECORDED AS BAD DEBTS. THE CORPORATION HAS REPORTED ITS GROSS OBLIGATION TO THE HSN FOR THE DELIVERY OF CHARITY CARE TO THE INDIGENT STATEWIDE AND BAD DEBTS AMOUNTING TO $1,750 AND $1,672 AT SEPTEMBER 30, 2015 AND 2014, RESPECTIVELY, WHICH IS REFLECTED AS UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS.
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SCHEDULE H, PART V, LINE 1: PART III, SECTION B., LINE 8:
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MEDICARE SHORTFALL AND COSTING METHODOLOGYMEDICARE SHORTFALLTHE HOSPITAL MAY ON OCCASION REPORT A SHORTFALL RELATED TO ITS CARE OF MEDICARE PATIENTS. ALTHOUGH NEBH CONSIDERS SUCH MEDICARE SHORTFALL PART OF ITS COMMUNITY BENEFIT FOR THE REASONS LISTED BELOW, AS REQUIRED BY THE FORM 990, OTHER THAN AMOUNTS RELATED TO SUBSIDIZED HEALTH SERVICES REPORTED IN SCHEDULE H, PART I, LINE 7G, THE SHORTFALL HAS NOT BEEN QUANTIFIED IN PART I LINE 7, AND HAS BEEN SEPARATELY STATED IN PART III LINE 7 AS REQUIRED. - IRS REV. RUL. 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT.- MEDICARE IS THE LARGEST PAYER FOR THE HOSPITAL AND ITS COMMUNITY. THE HOSPITAL MUST ACCEPT THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SUCH SERVICES. IF THE MEDICARE PARTICIPATION IS PREMISED ON THIS FACT, THEN PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A COMMUNITY BENEFIT.- IN OUR COMMUNITY, MANY LOW INCOME INDIVIDUALS RECEIVE MEDICARE BENEFITS.- THE ELDERLY ARE OFTEN AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE SERVICES, CMS WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY.MEDICARE COSTING METHODOLOGYTHE HOSPITAL USES THE COST TO CHARGE RATIO AS COMPUTED IN ITS FY 2015 MEDICARE COST REPORT FILING FOR AMOUNTS REPORTED IN PART III, SECTION B, QUESTION 8 OF THIS TAX RETURN.
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SCHEDULE H, PART VI: LINE 1: PART III, SECTION C., LINE 9B:
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BILLING & COLLECTION PRACTICESDOES THE ORGANIZATIONS COLLECTION POLICY CONTAIN PROVISIONS FOR PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OF FINANCIAL ASSISTANCE?YES. PLEASE SEE SECTION IV OF THE HOSPITAL'S CREDIT & COLLECTION POLICY, INCLUDED IN ITS ENTIRETY IN THE RESPONSE TO PART V, SECTION B, LINES 17-20. THIS SECTION DESCRIBES THE OVERALL HOSPITAL POLICIES AND PRACTICES, INCLUDING SPECIFIC GUIDANCE FOR LOW INCOME AND CHARITY CARE PATIENTS.
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SCHEDULE H, PART VI, LINE 1: PART V, SECTION A:
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FACILITY INFORMATION: NEW ENGLAND BAPTIST HOSPITAL IS AN ACUTE CARE MEDICAL / SURGICAL HOSPITAL AND A TEACHING AFFILIATE OF TUFTS UNIVERSITY MEDICAL SCHOOL IN THE AREAS OF ORTHOPEDICS AND RADIOLOGY. ALTHOUGH NEBH IS NOT LICENSED TO OPERATE AN EMERGENCY DEPARTMENT, NEBH STILL PROVIDES CARE TO ALL WHO NEED URGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY.
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SCHEDULE H, PART VI, LINES 1 & 2, PART V, SECTION B, LINES 1-9:
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NEEDS ASSESSMENTCOMMUNITY HEALTH NEEDS ASSESSMENT - INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE (IRC) SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY (COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP)) PURSUANT TO FEDERAL GUIDELINES, IN ORDER MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AS NOTED PREVIOUSLY IN THIS FILING, NEW ENGLAND BAPTIST HOSPITAL COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN JUNE 2013. THE NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE NEBH BOARD OF TRUSTEES ON OR BEFORE SEPTEMBER 30, 2016. AS NOTED IN DETAIL ABOVE, THE NEBH'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND CHIP (SCHEDULE H PART VI QUESTION 2), HEREIN DESCRIBED. COMMUNITY HEALTH NEEDS ASSESSMENT - TARGETED GEOGRAPHY & POPULATION- NEBH'S PRIMARY SERVICE AREA SPANS GREATER BOSTON AND BEYOND- NEBH'S COMMUNITY BENEFIT SERVICE AREA INCLUDES MISSION HILL AND PARTS OF ROXBURY AND JAMAICA PLAINCOMMUNITY HEALTH NEEDS ASSESSMENT - APPROACH & METHODS (SCHEDULE H PART V SECTION B QUESTION 3)NEBH IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS FROM ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED AND IMPROVE THE OVERALL HEALTH OF THE REGION. NEBH WORKS WITH ALL SEGMENTS OF THE POPULATION BUT IN RECOGNITION OF ITS STRONG TIES TO ITS SURROUNDING COMMUNITY AND ITS SPECIFIC CLINICAL EXPERTISE, NEBH FOCUSES ITS COMMUNITY BENEFIT EFFORTS ON IMPROVING THE HEALTH AND WELL-BEING OF THE LOW INCOME, UNDERSERVED POPULATIONS LIVING IN MISSION HILL AND ROXBURY AND ON MUSCULOSKELETAL HEALTH. NEBH CURRENTLY OPERATES NUMEROUS EDUCATIONAL, OUTREACH, AND COMMUNITY-STRENGTHENING INITIATIVES, COLLABORATES WITH MANY OF THE COMMUNITY'S LEADING SERVICE ORGANIZATIONS. THE HOSPITAL CONTRIBUTES OVER $2.5 MILLION ANNUALLY TO SUPPORT ITS COMMUNITY BENEFIT COMMITMENTS AND THE MASSACHUSETTS UNCOMPENSATED CARE POOL. NEBH IS EAGER TO EXPLORE WAYS THAT IT CAN FURTHER ENGAGE AND ENRICH ITS CONNECTIONS TO THE COMMUNITY.THIS REPORT AND ASSOCIATED COMMUNITY HEALTH IMPROVEMENT PLAN IS THE CULMINATION OF FOUR MONTHS OF WORK. THIS PROJECT WAS BORNE LARGELY OUT OF NEBH'S DESIRE TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS SURROUNDING COMMUNITY. HOWEVER, THE PROJECT ALSO FULFILLS LONG-STANDING REQUIREMENTS OF THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE AND A NEW FEDERAL INTERNAL REVENUE SERVICE (IRS) REQUIREMENTS, WHICH MANDATE THAT ALL NONPROFIT HOSPITALS CONDUCT A PERIODIC COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND STRATEGIC PLANNING PROCESS. THE COMMONWEALTH REQUIRES NONPROFIT HOSPITALS AND MANAGED CARE ORGANIZATIONS TO UPDATE THEIR CHNAS EVERY YEAR AND THE IRS REQUIRES THAT A CHNA BE CONDUCTED EVERY THREE YEARS. MORE SPECIFICALLY, THE COMMONWEALTH AND IRS REGULATIONS REQUIRE THAT NEBH ASSESS COMMUNITY HEALTH NEED, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW THE HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT.IN LIGHT OF THESE REQUIREMENTS, NEBH HIRED JOHN SNOW, INC. (JSI), A NATIONALLY RECOGNIZED PUBLIC HEALTH CONSULTING FIRM, TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSING ON MISSION HILL AND ROXBURY, ITS PRIMARY SERVICE AREA WITH RESPECT TO ITS COMMUNITY BENEFIT INITIATIVES. THE OVERALL GOAL OF THE ASSESSMENT WAS TO COMPILE INFORMATION FROM A RANGE OF QUANTITATIVE AND QUALITATIVE SOURCES TO CLARIFY THE HEALTH CARE NEEDS AND PRIORITIES OF COMMUNITY RESIDENTS AND ASSESS THE OVERALL STRENGTHS AND WEAKNESSES OF THE AREA'S HEALTH AND SOCIAL SERVICE SYSTEMS. ULTIMATELY, THE PURPOSE OF THE ASSESSMENT WAS TO FACILITATE THE DEVELOPMENT OF A STRATEGIC PLAN THAT WOULD GUIDE HOW NEBH WOULD WORK WITH STAKEHOLDERS IN MISSION AND HILL AND ROXBURY TO STRENGTHEN THE COMMUNITY AND IMPROVE HEALTH STATUS MOVING FORWARD. THE CHNA WAS CONDUCTED IN THREE PHASES:- PHASE I: THE JSI PROJECT TEAM CONDUCTED A PRELIMINARY NEEDS ASSESSMENT THAT RELIED HEAVILY ON QUANTITATIVE HEALTH-RELATED DATA DRAWN FROM THE MASSACHUSETTS COMMUNITY HEALTH INFORMATION PROFILE (MASSCHIP) SYSTEM AS WELL AS OTHER NATIONAL, STATE, AND LOCAL SOURCES. THESE DATA ALLOWED THE JSI PROJECT TEAM TO UNDERSTAND THE UNDERLYING CHARACTERISTICS OF AREA RESIDENTS AND IDENTIFY THE SPECIFIC SEGMENTS OF THE COMMUNITY MOST AT-RISK. - PHASE II: JSI CONDUCTED A SERIES OF INTERVIEWS WITH KEY STAKEHOLDERS AND TWO FOCUS GROUPS WITH COMMUNITY MEMBERS. THE FOCUS GROUPS HELPED THE JSI PROJECT TEAM TO ENGAGE THE COMMUNITY AND BETTER UNDERSTAND THEIR HEALTH STATUS, HEALTH-SEEKING BEHAVIORS, SERVICE GAPS, HEALTH-RELATED CHALLENGES, AND PRIORITIES. - PHASE III: CHRISTINE DWYER, DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS, AND BETH GREENSPAN, VICE PRESIDENT, CHIEF STRATEGY OFFICER, WORKED WITH JSI TO INTEGRATE THE CHNA'S FINDINGS, INCLUDING FEEDBACK FROM NEBH STAFF AND THE COMMUNITY, AND DEVELOPED NEBH'S COMMUNITY HEALTH IMPROVEMENT PLAN. IN PHASE III, JSI ALSO DEVELOPED A FINAL CHNA REPORT, OBTAINED APPROVAL FOR ITS COMMUNITY HEALTH IMPROVEMENT PLAN FROM NEBH'S BOARD OF TRUSTEES, AND DISSEMINATED THE RESULTS OF THE PROJECT TO INTERNAL AND EXTERNAL STAKEHOLDERS.THE CHNA UTILIZED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. AS NOTED ABOVE, THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS IN THE REGION AS WELL AS INFORMATION FROM COMMUNITY DIALOGUES CONDUCTED WITH COMMUNITY RESIDENTS, AND INTERVIEWS WITH COMMUNITY STAKEHOLDERS. (SCHEDULE H, PART V, SECTION B, QUESTION 5). NEBH CONDUCTED THIS CHNA PROCESS INDEPENDENTLY AS REPORTED IN SCHEDULE H, PART V, SECTION B, QUESTIONS 6A AND 6B.COMMUNITY HEALTH NEEDS ASSESSMENT - KEY FINDINGSTHE FOLLOWING ARE KEY FINDINGS RELATED TO COMMUNITY CHARACTERISTICS AND THE DETERMINANTS OF HEALTH FOR NEBH'S COMMUNITY BENEFIT SERVICE AREA. SINCE MISSION HILL IS THE DOMINANT GEOGRAPHY IN NEBH'S COMMUNITY BENEFIT SERVICE AREA, THE FOCUS OF THIS SUMMARY IS ON MISSION HILL AS COMPARED TO ROXBURY AND BOSTON OVERALL- AGE: MISSION HILL'S POPULATION HAS LARGER PROPORTIONS OF OLDER ADULTS (65+) AND SMALLER PROPORTIONS OF CHILDREN (<18) THAN THE POPULATIONS IN ROXBURY AND BOSTON OVERALL. WITH RESPECT TO AGE, THE MOST STRIKING FINDING IS THE EXTREMELY LARGE PROPORTION OF YOUNG ADULTS (COLLEGE STUDENTS) THAT RESIDE IN MISSION HILL COMPARED TO ROXBURY AND BOSTON OVERALL, WHICH SKEWS THE AGE DISTRIBUTION. MORE THAN 40% (40.2%) OF MISSION HILL'S POPULATION IS BETWEEN 18 AND 24 YEARS OLD, COMPARED TO 16.4 FOR ROXBURY AND 19.0% FOR BOSTON OVERALL.
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SCHEDULE H, PART VI, LINES 1 & 2, PART V, SECTION B, LINES 1-9:
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NEEDS ASSESSMENT CONTINUED- RACE/ETHNICITY, FOREIGN BORN STATUS, AND LANGUAGE: THE PROPORTION OF RACIAL/ETHNIC MINORITY POPULATIONS IN MISSION HILL IS HIGH RELATIVE TO THE COMMONWEALTH OF MASSACHUSETTS OVERALL BUT MIRRORS THE PROPORTIONS IN BOTH ROXBURY AND BOSTON OVERALL. HOWEVER, THE SPECIFIC CHARACTERISTICS OF THE RACIAL/ETHNIC MINORITY POPULATION IN MISSION HILL ARE VERY DIFFERENT. IN MISSION HILL THERE ARE MUCH LARGER PERCENTAGES OF ASIAN RESIDENTS AND SMALLER PROPORTIONS OF AFRICAN AMERICAN AND HISPANIC RESIDENTS COMPARED TO ROXBURY. ACROSS MISSION HILL, ROXBURY, AND BOSTON OVERALL, MORE THAN ONE-THIRD OF THE POPULATIONS ARE FOREIGN BORN AND MORE THAN ONE-THIRD OF THE POPULATIONS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THERE ARE CLEAR AND WELL-RECOGNIZED HEALTH DISPARITIES AMONG RACIAL/ETHNIC MINORITY AND FOREIGN POPULATIONS COMPARED TO THE MAJORITY NON-HISPANIC WHITE POPULATION. IN ADDITION, THERE ARE SIGNIFICANT HEALTH LITERACY ISSUES AMONG RACIAL/ETHNIC MINORITIES, PARTICULARLY WITH FOREIGN-BORN POPULATIONS AND FOR THOSE WITH LIMITED ABILITY TO SPEAK ENGLISH. - INCOME/POVERTY: LARGE PROPORTIONS OF THE POPULATIONS IN MISSION HILL AND ROXBURY LIVE IN POVERTY (< 100% OF THE FEDERAL POVERTY LEVEL - FPL) OR LOW-INCOME HOUSEHOLDS (< 200% FPL) AND STRUGGLE TO PAY FOR FOOD AND OTHER BASIC HOUSEHOLD ITEMS. IN MISSION HILL 39% OF THE HOUSEHOLDS ARE LIVING IN POVERTY, COMPARED TO 35% IN ROXBURY, AND 21% IN BOSTON OVERALL. THE SIGNIFICANT AND NEGATIVE IMPACTS OF POVERTY WERE ALSO DISCUSSED IN NEARLY ALL OF INTERVIEWS AND IN EACH FOCUS GROUP. THE MISSION HILL FIGURES ARE SOMEWHAT SKEWED BY THE LARGE NUMBERS OF COLLEGE STUDENTS THAT LIVE IN THE AREA AND DO NOT HAVE A REGULAR INCOME. IF THESE YOUNG ADULTS LIVING IN NON-FAMILY HOUSEHOLDS ARE TAKEN OUT OF THE ANALYSIS, MISSION HILL FAIRS SLIGHTLY BETTER THAN ROXBURY. HOWEVER, POVERTY AND ITS IMPACTS ARE STILL MAJOR ISSUE FOR MISSION HILL'S FAMILIES AND OTHER MORE PERMANENT RESIDENTS. - EDUCATION: COMPARED TO BOSTON, RESIDENTS OF MISSION HILL ARE LESS LIKELY TO HAVE A HIGH SCHOOL DIPLOMA. COMPARED TO ROXBURY, HOWEVER, MISSION HILL RESIDENTS ARE MORE LIKELY TO HAVE A HIGH SCHOOL DIPLOMA. ONCE AGAIN, THIS DATA IS SKEWED BY THE HIGH NUMBER OF TRANSIENT YOUNG ADULT RESIDENTS WHO ATTEND BOSTON'S MANY UNIVERSITIES AND COLLEGES AND LIVE IN MISSION HILL.- LACK OF EMPLOYMENT, THE ECONOMIC DOWNTURN, AND ITS IMPACTS: WHILE MISSION HILL RESIDENTS APPEAR BETTER OFF THAN RESIDENTS OF ROXBURY ON THIS ISSUE, A LARGE PROPORTION OF THE MISSION HILL POPULATION ARE EITHER UNEMPLOYED OR DO NOT CONSIDER THEMSELVES PART OF THE WORKFORCE. THE UNEMPLOYMENT RATE IN MISSION HILL FOR PEOPLE OVER THE AGE OF 16 YEARS OLD IS JUST 8.1%, COMPARED TO 16.5% IN ROXBURY AND 10.2% IN BOSTON OVERALL. HOWEVER, IN ORDER TO GET A CLEAR PICTURE OF THIS ISSUE ONE MUST ALSO CONSIDER THE NUMBER AND PROPORTION OF THE POPULATION WHO DO NOT CONSIDER THEMSELVES PART OF THE WORKFORCE. IN MISSION HILL NEARLY 40% (5,873) OF THE 16-YEAR-OLD-AND-OVER POPULATION DOES NOT CONSIDER ITSELF TO BE PART OF LABOR FORCE, WHICH MEANS THAT 41% (5,873) OF THE TOTAL POPULATION IS NOT EMPLOYED. VIEWED IN THIS MANNER, MISSION HILL IS STILL BETTER OFF THAN ROXBURY BUT NOT NEARLY TO THE EXTENT THAT UNEMPLOYMENT FIGURES ALONE SUGGEST. IN ROXBURY, 51% (17,837) OF THE POPULATION IS NOT EMPLOYED AND IN BOSTON OVERALL THE FIGURE, NOT SURPRISINGLY, IS MUCH LOWER AT 38% (199,006). UNEMPLOYMENT AND THE IMPACT THAT THE ECONOMIC DOWNTURN HAS HAD ON THE MISSION HILL COMMUNITY OVER THE PAST 3-5 YEARS WAS ONE OF THE DOMINANT, IF NOT THE MOST DOMINANT, THEMES IN THE INTERVIEWS AND FOCUS GROUPS. LACK OF EMPLOYMENT OPPORTUNITIES FOR MISSION HILL'S YOUTH AND ADULTS HAS GREATLY IMPACTED THEIR ABILITY TO PROVIDE FOOD AND OTHER BASIC HOUSEHOLD ITEMS, TO SAY NOTHING OF OTHER COMFORTS THAT MANY TAKE FOR GRANTED. THESE ISSUES HAVE ALSO IMPACTED PEOPLE'S EMOTIONAL HEALTH AND LED TO ISOLATION, PARTICULARLY FOR OLDER ADULTS ON LIMITED FIXED INCOMES. CERTAINLY, POVERTY, UNEMPLOYMENT, ISOLATION, AND EMOTIONAL WELL-BEING ARE IMPORTANT DETERMINANTS OF HEALTH AND WELLNESS. - FOOD INSECURITY: ANOTHER DOMINANT THEME FROM THE INTERVIEWS AND FOCUS GROUPS WAS THE LACK OF ACCESS TO AFFORDABLE, HEALTHY FOODS. INTERVIEWEES AND FOCUS GROUP PARTICIPANTS DISCUSSED THE FACT THAT THERE ARE FEW PLACES FOR RESIDENTS OF MISSION HILL AND ROXBURY TO BUY REASONABLY PRICED FRESH VEGETABLES AND OTHER NUTRITIONAL FOODS. PARTICIPANTS ALSO SPOKE OF THE HIGH PRICES AND LACK OF FRESH VEGETABLES AT THE LARGE, LOCAL GROCERY STORES IN THE AREA AND THE LONG DISTANCES THAT THEY HAD TO TRAVEL TO ACCESS MORE AFFORDABLE HEALTHY FOOD OPTIONS.- TRANSPORTATION: GIVEN THE STEEP AND HILLY LANDSCAPE OF MISSION HILL, TRANSPORTATION WAS SEEN AS A MAJOR BARRIER AND DETERMINANT OF HEALTH AND WELL-BEING. LACK OF TRANSPORTATION WAS A LEADING THEME FROM THE ASSESSMENT INTERVIEWEES AND FOCUS GROUP PARTICIPANTS, ESPECIALLY FOR OLDER ADULT AND LOW-INCOME RESIDENTS LACKING A PERSONAL VEHICLE. INTERVIEWEES AND FOCUS GROUP PARTICIPANTS DISCUSSED CHALLENGES RELATED TO NAVIGATING THE HILLY TERRAIN ON MISSION HILL, THE ISOLATION THAT THOSE WITHOUT A PERSONAL CAR EXPERIENCED, THE NECESSITY FOR MANY TO TRAVEL OUTSIDE THE MISSION HILL AREA TO FIND AFFORDABLE FOOD AND OTHER BASIC ITEMS, AND THE IMPORTANCE OF THE MISSION LINK PUBLIC TRANSPORTATION SERVICE. - ACCESS TO RECREATIONAL FACILITIES: DESPITE THE DENSITY OF THE MISSION HILL COMMUNITY, ACCESS TO RECREATIONAL FACILITIES AND OPEN SPACES IS ONE OF MISSION HILL'S ASSETS. THERE ARE A NUMBER OF PARKS, RECREATIONAL AREAS, AND INDOOR COMMUNITY CENTERS. AS WILL BE DISCUSSED LATER IN THE REPORT, A HIGH PROPORTION OF THE POPULATION IS OVERWEIGHT AND DOES NOT GET REGULAR PHYSICAL EXERCISE, BUT NOT NECESSARILY BECAUSE RECREATIONAL FACILITIES OR OPEN SPACES ARE IN SHORT SUPPLY. - VIOLENCE: RATES OF HOMICIDE AND NON-FATAL GUNSHOT WOUNDS SEEN IN THE CITY'S HOSPITAL EMERGENCY DEPARTMENTS ARE CONSIDERABLY HIGHER IN ROXBURY (INCLUDING MISSION HILL) THAN IN BOSTON OVERALL. WHILE THERE WAS A CLEAR CONSENSUS AMONG INTERVIEWEES AND FOCUS GROUP PARTICIPANTS THAT THIS ISSUE HAD IMPROVED DRAMATICALLY OVER THE PAST 2 DECADES AND THAT MISSION HILL WAS CONSIDERABLY SAFER THAN ROXBURY OVERALL, THIS GROUP AGREED THAT VIOLENCE STILL HAD A MAJOR IMPACT ON THE COMMUNITY. VIOLENCE NEGATIVELY AFFECTS THE HEALTH OF THOSE DIRECTLY INVOLVED BUT ALSO HAS MAJOR NEGATIVE EMOTIONAL EFFECTS ON THOSE WHO ARE INDIRECTLY INVOLVED AND THE COMMUNITY MORE BROADLY. THESE IMPACTS INCLUDE MENTAL HEALTH ISSUES, ISOLATION, AND LACK OF COMMUNITY COHESION. NEARLY EVERYONE WHO WAS INTERVIEWED OR INVOLVED IN FOCUS GROUPS DISCUSSED THE IMPACTS OF VIOLENCE AND ITS ASSOCIATED TRAUMA, PARTICULARLY ON THE AREA'S YOUTH AND THEIR FAMILIES. NEARLY EVERYONE WE TALKED WITH SAID THAT THEY KNEW SOMEONE WHO HAD BEEN IMPACTED DIRECTLY BY VIOLENCE AND UNDERSTOOD FIRST-HAND THE TOLL IT TOOK ON THE COMMUNITY. - COMMUNITY HEALTH NEEDS ASSESSMENT - COMMUNITY HEALTH PRIORITIESTHE CHNA'S APPROACH PROVIDED AMPLE OPPORTUNITY TO VET THE QUANTITATIVE AND QUALITATIVE DATA COMPILED DURING THE ASSESSMENT. IN ADDITION, INTERVIEW AND FOCUS GROUP PARTICIPANTS WERE ASKED WHAT THEY PERCEIVED TO BE THE LEADING COMMUNITY HEALTH PRIORITIES. ULTIMATELY, THERE WAS LITTLE DEBATE THAT THE MOST SIGNIFICANT HEALTH-RELATED ISSUE FACING THE COMMUNITIES SURROUNDING NEBH WAS THE BROADER 1) SOCIAL AND ECONOMIC DETERMINANTS (E.G., POVERTY, UNEMPLOYMENT, FOOD INSECURITY, VIOLENCE, TRANSPORTATION), WHICH PREVENT MANY RESIDENTS, PARTICULARLY LOW INCOME, RACIAL/ETHNIC MINORITY, AND OLDER ADULT RESIDENTS FROM MAINTAINING A HEALTHY LIFESTYLE AND/OR ACCESSING THE REGULAR PREVENTIVE AND ACUTE HEALTH SERVICES THEY NEED. IN ADDITION TO THIS UNDERLYING PRIORITY, 2) ISSUES RELATED OBESITY, LACK OF PHYSICAL EXERCISE, AND POOR NUTRITION AS WELL AS THE CHRONIC DISEASES THAT ARE OFTEN ASSOCIATED WITH THESE FACTORS WERE SEEN AS ANOTHER PRIORITY. FINALLY, ISSUES RELATED TO 3) ELDER HEALTH (E.G., GENERAL HEALTH AND WELLNESS, FALLS PREVENTION, ISOLATION/DEPRESSION, OSTEOPOROSIS, CHRONIC DISEASE) WERE ALSO A PRIORITY. THIS IS PARTICULARLY TRUE IF ONE PRIORITIZES THE MORE PERMANENT RESIDENTS OF THE COMMUNITY, WHO ARE DISPROPORTIONATELY OLDER THAN THE COMMUNITY OVERALL.
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SCHEDULE H, PART VI: LINE 1 & 2, PART V, SECTION B, LINES 1-9
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COMMUNITY HEALTH NEEDS ASSESSMENT - IMPROVEMENT PLAN - PRIORITY AREA # 1 : SOCIAL & ECONOMIC DETERMINANTS OF HEALTHA. INCREASE ACCESS TO HEALTHY FOODS AND OTHER BASIC HOUSEHOLD NEEDS- TARGET POPULATION: LOW-INCOME INDIVIDUALS AND FAMILIES- PROGRAMMATIC OBJECTIVES: I. EDUCATE INDIVIDUALS AND FAMILIES ABOUT HEALTHY EATING, MEAL PLANNING, HOUSEHOLD BUDGETING, ETC. II. DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITY AND/OR LACK BASIC HOUSEHOLD ITEMS- COMMUNITY ACTIVITIES:I. SUPPORT COMMUNITY FOOD PANTRIESII. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS, COOKING CLASSES, AND EDUCATIONAL SESSIONSIII. PROMOTE A MOBILE FARMERS' MARKET TO THE COMMUNITY AT A DISCOUNTED RATE- COMMUNITY PARTNERS:- ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD)- PARKER HILL/FENWAY AND JAMAICA PLAIN- MISSION HILL ELEMENTARY SCHOOL TO COMBAT HUNGER- ROXBURY TENANTS OF HARVARD (RTH)- MISSION MAINB. INCREASE JOB OPPORTUNITIES FOR YOUTH AND ADULTS - TARGET POPULATION: YOUTH AND ADULTS- PROGRAMMATIC OBJECTIVES: I. PROVIDE SUMMER INTERNSHIP AND EMPLOYMENT OPPORTUNITIES FOR YOUTHII. PROVIDE CAREER TRAINING AND EMPLOYMENT OPPORTUNITIES FOR ADULTS INTERESTED IN HEALTH CAREERS - COMMUNITY ACTIVITIES:I. SUPPORT THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIPII. PROMOTE HOSPITAL JOB OPPORTUNITIES TO MISSION HILL RESIDENTS - COMMUNITY PARTNERS:- ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD)- SOCIEDAD LATINA- ROXBURY TENANTS OF HARVARD (RTH) - MISSION MAINC. IMPROVE ACCESS AND SAFETY TO ESSENTIAL COMMUNITY VENUES FOR MISSION HILL RESIDENTS - TARGET POPULATION: MISSION HILL COMMUNITY- PROGRAMMATIC OBJECTIVES: I. INCREASE THE NUMBER OF MISSION HILL RESIDENTS WHO HAVE ACCESS TO AFFORDABLE TRANSPORTATION TO ENSURE ACCESS TO BASIC NEEDS AND REDUCE ISOLATIONII. IMPROVE ACCESSIBILITY AND BEAUTIFY COMMUNITY PARKS AND OTHER AREASIII. REMOVE TRASH AND PROVIDE CLEANING SERVICES IN COMMUNITY - COMMUNITY ACTIVITIES:I. SUPPORT MISSION LINKII. MAINTAIN MCLAUGHLIN FIELDIII. MAKE COMMUNITY IMPROVEMENTS TO WALKWAYS AND OTHER PUBLIC AREASIV. PROVIDE TRASH TRUCK AND CLEAN PUBLIC AREAS AFTER MOVE-IN DAY - COMMUNITY PARTNERS:- MISSION LINK- FRIENDS OF MCLAUGHLIN PARK- CITY OF BOSTON- PROBLEM PROPERTIES TASK FORCE PRIORITY AREA # 2 : OBESITY, FITNESS, NUTRITION, AND CHRONIC DISEASEA. PROMOTE GENERAL HEALTH AND WELLNESS- TARGET POPULATION: CHILDREN, YOUTH, AND ADULTS- PROGRAMMATIC OBJECTIVES: I. EDUCATE THE PUBLIC ABOUT HEALTH RISK FACTORS, HEALTH PROMOTION, AND BASIC WELLNESS - COMMUNITY ACTIVITIES:I. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS AND EDUCATIONAL SESSIONS ON KEY HEALTH ISSUES IN COMMUNITY VENUES B. INCREASE PHYSICAL ACTIVITY - TARGET POPULATION: CHILDREN, YOUTH, AND ADULTS- PROGRAMMATIC OBJECTIVES: I. EDUCATE ON HEALTHY EATING AND ACTIVE LIVINGII. INCREASE THE NUMBER OF CHILDREN AND ADULTS WHO ARE PHYSICALLY ACTIVEIII. IMPROVE ACCESSIBILITY AND BEAUTIFY OF WALKWAYS, COMMUNITY PARKS, AND RECREATION AREAS- COMMUNITY ACTIVITIES:I. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS AND EDUCATIONAL SESSIONSII. SUPPORT AND PROMOTE THE DEVELOPMENT OF WALKING AND OTHER PHYSICAL ACTIVITY GROUPS IN COMMUNITY VENUESIII. SUPPORT AND COLLABORATE WITH BOSTON FOOD AND FITNESS COLLABORATIVEIV. MAINTAIN MCLAUGHLIN FIELDV. MAKE COMMUNITY IMPROVEMENTS TO WALKWAYS AND OTHER PUBLIC AREASVI. SUPPORT LITTLE LEAGUEVII. SUPPORT SUMMER CAMP AT THE TOBIN COMMUNITY CENTERC. INCREASE HEALTHY EATING- TARGET POPULATION: CHILDREN, YOUTH & ADULTS- PROGRAMMATIC OBJECTIVES: I. EDUCATE ON HEALTHY EATING AND ACTIVE LIVINGII. DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITYIII. INCREASING ACCESS TO HEALTHY FOODS, FRUITS, AND VEGETABLES- COMMUNITY ACTIVITIES:I. SUPPORT COMMUNITY FOOD PANTRIESII. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS, COOKING CLASSES, AND EDUCATION SESSIONSIII. PROMOTE PARTICIPATION IN MOBILE FARMERS' MARKETSIV. SUPPORT AND COLLABORATE WITH BOSTON FOOD & FITNESS COLLABORATIVED. INCREASING SCREENING, IDENTIFICATION AND REFERRAL FOR PEOPLE WITH CHRONIC DISEASE AND / OR ASSOCIATED RISK FACTORS- TARGET POPULATION: CHILDREN, YOUTH & ADULTS- PROGRAMMATIC OBJECTIVES: I. PROMOTE OBESITY SCREENING FOR CHILDREN AND YOUTH IN COMMUNITY BASED SETTINGII. LINK CHILDREN AND YOUTH WHO ARE OVERWEIGHT OR OBESE TO EVIDENCE BASED PROGRAMS THAT PROMOTE HEALTHY EATING AND ACTIVE LIVINGIII. INCREASE THE NUMBER OF ADULTS SCREENED FOR HYPERTENSION, DIABETES, DEPRESSION, HIGH CHOLESTEROL, AND OTHER LEADING CHRONIC DISEASESIV. LINK THOSE WHO HAVE CHRONIC DISEASE OR ITS ASSOCIATED RISK FACTORS TO PRIMARY CARE AND/OR EVIDENCE-BASED CHRONIC DISEASE MANAGEMENT PROGRAMS- COMMUNITY ACTIVITIES:I. SUPPORT AND PROMOTE COMMUNITY HEALTH FAIRS AND SCREENING/REFERRAL EVENTSII. DEVELOP PRIMARY AND SPECIALTY CARE REFERRAL NETWORKS FOR THOSE IN NEED SUPPORT AND COLLABORATE WITH BOSTON FOOD & FITNESS COLLABORATIVEOBESITY, FITNESS, NUTRITION, AND CHRONIC DISEASE - COMMUNITY PARTNERS: - BOSTON PUBLIC HEALTH COMMISSION - SOCIEDAD LATINA- ROXBURY TENANTS OF HARVARD (RTH)- MISSION MAIN- TOBIN COMMUNITY CENTER- MISSION HILL HEALTH MOVEMENT- ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD)- PUBLIC HOUSING FACILITIES- BOSTON FOOD AND FITNESS COLLABORATIVE- LITTLE LEAGUEPRIORITY AREA # 3 : ELDER HEALTHA. PROMOTE GENERAL HEALTH AND WELLNESS FOR ELDERS- TARGET POPULATION: ELDERS- PROGRAMMATIC OBJECTIVES: I. INCREASE GENERAL KNOWLEDGE ABOUT CHRONIC DISEASE, PHYSICAL ACTIVITY, NUTRITION, BEHAVIORAL HEALTH, AND FALLS PREVENTION - COMMUNITY ACTIVITIES:I. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS AND EDUCATIONAL SESSIONS II. CREATE AN ELDER HEALTH EDUCATION AND PREVENTION CENTERIII. PARTICIPATE IN MA DEPARTMENT OF PUBLIC HEALTH STANFORD SELF-MANAGEMENT SUPPORT PROGRAM INITIATIVEB. REDUCE FALLS FOR ELDERS- TARGET POPULATION: ELDERS- PROGRAMMATIC OBJECTIVES: I. INCREASE BALANCE TRAINING AND PHYSICAL ACTIVITY; MEDICAL MANAGEMENT OF EXISTING ILLNESS; AND ENVIRONMENTAL/HOME MODIFICATIONS - COMMUNITY ACTIVITIES:I. PARTICIPATE IN MA DEPARTMENT OF PUBLIC HEALTH STANFORD SELF-MANAGEMENT SUPPORT PROGRAM INITIATIVEC. DECREASE DEPRESSION AND SOCIAL ISOLATION IN ELDERS- TARGET POPULATION: ELDERS- PROGRAMMATIC OBJECTIVES: I. INCREASE THE NUMBER OF MISSION HILL RESIDENTS WHO HAVE ACCESS TO AFFORDABLE TRANSPORTATIONII. REDUCE ISOLATIONIII. INCREASE SCREENING, IDENTIFICATION, AND REFERRAL FOR ELDERS WITH DEPRESSION - COMMUNITY ACTIVITIES:I. SUPPORT MISSION LINKII. DEVELOP OR SUPPORT COMMUNAL ACTIVITIES THAT BRING ELDERS TOGETHERIII. SUPPORT ACTIVITIES SPONSORED BY LEGACY PROJECTIV. DEVELOP OR SUPPORT ELDER HEALTH SCREENING INITIATIVES THAT INCLUDE DEPRESSION SCREENINGD.INCREASE SCREENING, IDENTIFICATION AND REFERRAL FOR HEALTH ISSUES SUCH AS OSTEOPOROSIS, ARTHRITIS / LUPUS, AND DEPRESSION- TARGET POPULATION: ELDERS- PROGRAMMATIC OBJECTIVES: I. INCREASE THE NUMBER OF ELDERS SCREENED FOR OSTEOPOROSIS, ARTHRITIS/LUPUS, DEPRESSION, JOINT ISSUES, AND OTHER LEADING ELDER HEALTH ISSUES/CONDITIONSII. LINK THOSE WHO HAVE CHRONIC DISEASE OR OTHER HEALTH ISSUES TO APPROPRIATE PRIMARY AND SPECIALTY CARE - COMMUNITY ACTIVITIES:I. DEVELOP OR SUPPORT ELDER HEALTH SCREENING INITIATIVESII. DEVELOP PRIMARY CARE AND SPECIALTY CARE REFERRAL NETWORKS FOR THOSE IN NEED ELDER CARE - COMMUNITY PARTNERS- BOSTON PUBLIC HEALTH COMMISSION- MISSION HILL HEALTH MOVEMENT- ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD)- ROXBURY TENANTS OF HARVARD (RTH)- LEGACY PROJECT- PUBLIC HOUSING FACILITIES- MA DEPARTMENT OF PUBLIC HEALTH- NEBH AND CAREGROUP MEMBER ORGANIZATIONS
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SCHEDULE H, PART VI, LINE 1: PART V, SECTION B, LINES -13-24
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THE RESPONSE TO PART V, SECTION B, LINES 13-24 CORRESPONDS TO APPLICABLE SECTIONS OF OUR PUBLISHED CREDIT & COLLECTION POLICY. THAT POLICY IS ORGANIZED AS FOLLOWS IN RELATION TO THE SCHEDULE H NARRATIVE REQUESTS: I. ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS: PART V, SECTION B, LINES, -13-16II. HOSPITAL COLLECTION PRACTICES & POLICIES PART V, SECTION B, LINES, 17-20III. DEPOSITS AND INSTALLMENT PLANS: PART V, SECTION B, LINES, 17-20IV. DELIVERY OF HEALTH CARE SERVICES: PART V, SECTION B, LINE 21 V. NOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE AND OTHER COVERAGE OPTIONS: PART V, SECTION B, LINES, 22-24CREDIT & COLLECTION POLICY, EFFECTIVE JANUARY 1, 2015INTRODUCTIONNEW ENGLAND BAPTIST HOSPITAL (NEBH OR HOSPITAL) IS THE FRONTLINE CAREGIVER PROVIDING MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO OUR FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR. THE HOSPITAL ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, THE HOSPITAL MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. IT IS IMPORTANT TO NOTE THAT WHILE THE FEDERAL AND STATE GOVERNMENT USES DIFFERENT NAMES FOR THE POLICIES THAT HOSPITAL MUST FOLLOW TO SHOW HOW THEY ARE PROVIDING FINANCIAL ASSISTANCE TO PATIENTS; THE OVERALL REQUIREMENTS ARE THE SAME. AS A RESULT, NEBH'S POLICY IS DESIGNED TO COMPLY WITH BOTH THE STATE HEALTH SAFETY NET REGULATIONS ON "CREDIT AND COLLECTION POLICIES AND THE FEDERAL HEALTHCARE REFORM LAW'S "FINANCIAL ASSISTANCE POLICY" REQUIREMENTS. TO THAT END, NEBH HAS REVIEWED THE FINAL REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R) ISSUED BY THE TREASURY ON DECEMBER 29, 2015 AND IS, OR WILL BE, IN COMPLIANCE WITH THOSE REGULATIONS ON OR BEFORE OCTOBER 1, 2016 AS REQUIRED. THE HOSPITAL DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, CITIZENSHIP, ALIENAGE, RELIGION, CREED, SEX, SEXUAL PREFERENCE, AGE, OR DISABILITY IN ITS POLICIES OR IN ITS APPLICATION OF POLICIES, CONCERNING THE ACQUISITION AND VERIFICATION OF FINANCIAL INFORMATION, PRE-ADMISSION OR PRE-TREATMENT DEPOSITS, PAYMENT PLANS, DEFERRED OR REJECTED ADMISSIONS, LOW INCOME PATIENT STATUS AS DETERMINED BY THE MASSACHUSETTS OFFICE OF MEDICAID, DETERMINATION THAT A PATIENT IS LOW-INCOME, OR IN ITS BILLING AND COLLECTION PRACTICES.THIS CREDIT AND COLLECTION POLICY IS DEVELOPED TO ENSURE COMPLIANCE WITH APPLICABLE CRITERIA REQUIRED UNDER (1) THE HEALTH SAFETY NET ELIGIBLE SERVICES REGULATION (101 CMR 613.00), (2) THE CENTERS FOR MEDICARE AND MEDICAID SERVICES MEDICARE BAD DEBT REQUIREMENTS (42 CFR 413.89), (3) THE MEDICARE PROVIDER REIMBURSEMENT MANUAL (PART 1, CHAPTER 3), AND (4) THE INTERNAL REVENUE CODE SECTION 501(R) AS REQUIRED UNDER THE SECTION 9007(A) OF THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT (PUB. L. NO. 111-148).
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SCHEDULE H, PART VI, LINE 1: PART V, SECTION B, LINE 13:
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USING FPG FOR FREE CARE AND DISCOUNTED CAREFREE CAREFREE CARE IS PROVIDED FOR MEDICALLY NECESSARY SERVICE TO PATIENTS WHO HAVE BEEN DEEMED FINANCIALLY UNABLE TO PAY FOR ALL OR PART OF THE HOSPITAL CARE PURSUANT TO THE HOSPITAL'S CREDIT AND COLLECTION POLICY. ELIGIBILITY IS AVAILABLE TO MASSACHUSETTS RESIDENTS WHOSE FAMILY INCOME IS EQUAL TO OR LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES (FPG). THE FPG IS UPDATED ANNUALLY AND IS POSTED ON THE STATE'S DIVISION OF HEALTH CARE FINANCE AND POLICY WEBSITE:HTTP://WWW.MASS.GOV/EOHHS/DOCS/MASSHEALTH/DESKGUIDES/FPL-DESKGUIDE.PDF DISCOUNTED CAREDISCOUNTED CARE IS PROVIDED TO LOW INCOME PATIENTS WHO MEET THE CRITERIA UNDER 114.6 CMR 13.04(1). IN ORDER TO BE DETERMINED A LOW INCOME PATIENT; AN INDIVIDUAL MUST BE A RESIDENT OF THE COMMONWEALTH AND DOCUMENT FAMILY INCOME EQUAL TO OR LESS THAN 400% OF THE FPG, SUBJECT TO THE LIMITED EXCEPTIONS.
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SCHEDULE H, PART VI, LINE 1: PART V, SECTION B, LINES 13 - 16:
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FINANCIAL ASSISTANCE PROGRAM I. DOCUMENTING ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS1. GENERAL PRINCIPLESFINANCIAL ASSISTANCE IS INTENDED TO ASSIST LOW-INCOME PATIENTS WHO DO NOT OTHERWISE HAVE THE ABILITY TO PAY FOR THEIR HEALTH CARE SERVICES. SUCH ASSISTANCE TAKES INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS. THE HOSPITAL PROVIDES THIS ASSISTANCE FOR BOTH RESIDENTS AND NON-RESIDENTS OF MASSACHUSETTS; HOWEVER, THERE MAY NOT BE COVERAGE IN A STATE PUBLIC ASSISTANCE PROGRAM FOR A MASSACHUSETTS HOSPITAL'S SERVICES THROUGH AN OUT-OF STATE RESIDENT. IN ORDER FOR THE HOSPITAL TO ASSIST UNINSURED AND UNDERINSURED PATIENTS FIND THE MOST APPROPRIATE COVERAGE OPTIONS AS WELL AS DETERMINE IF THE PATIENT IS FINANCIALLY ELIGIBLE FOR ANY DISCOUNTS IN PAYMENTS, PATIENTS MUST ACTIVELY WORK WITH HOSPITALS TO VERIFY THE PATIENT'S DOCUMENTED FAMILY INCOME, OTHER INSURANCE COVERAGE, AND ANY OTHER INFORMATION THAT COULD BE USED IN DETERMINING ELIGIBILITY. 2. ENROLLMENT IN A PUBLIC ASSISTANCE PROGRAMHOSPITALS HAVE NO ROLE IN SPECIFICALLY DETERMINING THE ELIGIBILITY FOR ENROLLMENT WITHIN A PUBLIC ASSISTANCE PROGRAM. IN MASSACHUSETTS, INDIVIDUALS APPLY FOR COVERAGE IN MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP MUST DO SO THROUGH A SINGLE UNIFORM APPLICATION THAT IS SUBMITTED THROUGH THE STATE'S NEW ENROLLMENT SYSTEM CALLED THE HEALTH INSURANCE EXCHANGE (HIX). THROUGH THIS PROCESS, THE INDIVIDUAL 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 THE HOSPITAL'S FINANCIAL COUNSELORS (CAC -"CERTIFIED APPLICATION COUNSELOR") WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION. IN ORDER TO APPLY FOR COVERAGE, THE FOLLOWING PROCESS OCCURS:1. AN INDIVIDUAL IS REQUESTED TO DEVELOP AN ONLINE ACCOUNT FOR USE BY THE STATE TO CONDUCT AN IDENTITY VERIFICATION OF THE INDIVIDUAL. ONCE THIS IS COMPLETED, THE INDIVIDUAL IS THEN ABLE TO SUBMIT A COMPLETED APPLICATION THROUGH THE HCENTIVE SYSTEM ON THE CONNECTOR WEBSITE. IF THE INDIVIDUAL DOES NOT WANT TO GO THROUGH THE ONLINE IDENTITY VERIFICATION SYSTEM, THEY CAN SUBMIT A PAPER APPLICATION. OTHER VERIFICATION MAY STILL BE NEEDED, INCLUDING PROOF OF INCOME, RESIDENCY, AND CITIZENSHIP. 2. ONCE THE APPLICATION IS RECEIVED, THE STATE WILL VERIFY THE ELIGIBILITY BY COMPARING THE INDIVIDUALS FINANCIAL AND OTHER DEMOGRAPHIC INFORMATION TO A FEDERAL DATA SITE AS WELL AS CONDUCTING AN INCOME REVIEW USING A MODIFIED ADJUSTED GROSS INCOME REVIEW. IF NECESSARY, THE INDIVIDUAL WILL ALSO SUBMIT ADDITIONAL VERIFICATION AS REQUESTED BY THE SYSTEM. ONCE THIS OCCURS, THE INDIVIDUAL IS DEEMED:A. ELIGIBLE FOR MASSHEALTH COVERAGE, UPON WHICH THE INDIVIDUAL IS NOTIFIED BY MAIL FROM MASSHEALTH, WHICH INCLUDES ELIGIBILITY INFORMATION INCLUDING START DATE AND OTHER PERTINENT INFORMATION; ORB. IF THE INDIVIDUAL IS ELIGIBLE FOR A QUALIFIED HEALTH PLAN THROUGH THE HEALTH CONNECTOR PROGRAM, THEY ARE NOTIFIED OF THEIR ELIGIBILITY AND DIRECTED TO TAKE ADDITIONAL STEPS. THIS INCLUDES: (1) CHOOSING A PLAN, (2) PAYING THEIR MONTHLY PREMIUM, (3) ENROLLING AND RECEIVING THEIR PROOF OF COVERAGE.MORE INFORMATION REGARDING THE MASSHEALTH AND CONNECTOR PROGRAM BENEFITS AND APPLICATION PROCESS CAN BE FOUND AT WWW.MASS.GOV/MASSHEALTH AND WWW.MAHEALTHCONNECTOR.ORG.3. HOSPITAL SCREENING AND ELIGIBILITY APPROVAL PROCESSTHE HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR THROUGH THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM, WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. FOR THOSE PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS PATIENTS BY SCREENING THEM FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. THESE INCLUDE, BUT ARE NOT LIMITED TO, PROGRAMS OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP MUST DO SO THROUGH A SINGLE UNIFORM APPLICATION THAT IS SUBMITTED THROUGH THE STATE'S NEW ENROLLMENT SYSTEM CALLED THE HEALTH INSURANCE EXCHANGE (HIX). IT IS THE PATIENT'S OBLIGATION TO PROVIDE THE HOSPITAL WITH ACCURATE AND TIMELY INFORMATION REGARDING THEIR FULL NAME, ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS (INCLUDING ANY OTHER INSURANCE OR COVERAGE OPTIONS (LIKE A MOTOR VEHICLE POLICY OR WORKER'S COMPENSATION POLICY) THAT CAN COVER THE COST OF THE CARE RECEIVED), ANY OTHER APPLICABLE FINANCIAL RESOURCES, AND CITIZENSHIP AND RESIDENCY INFORMATION. THIS INFORMATION WILL BE USED TO DETERMINE COVERAGE FOR THE SERVICES PROVIDED TO THE PATIENT. IF THERE IS NO SPECIFIC COVERAGE FOR THE SERVICES PROVIDED, THE HOSPITAL WILL USE THE INFORMATION TO DETERMINE IF THE SERVICES MAY BE COVERED BY AN APPLICABLE PROGRAM THAT WILL COVER CERTAIN SERVICES DEEMED BAD DEBT. IN ADDITION, THE HOSPITAL WILL USE THIS INFORMATION TO DISCUSS ELIGIBILITY FOR CERTAIN HEALTH INSURANCE PROGRAMS. IF THE PATIENT OR GUARANTOR IS UNABLE TO PROVIDE THE NECESSARY INFORMATION, THE HOSPITAL MAY (AT THE PATIENT'S REQUEST) MAKE REASONABLE EFFORTS TO OBTAIN ANY ADDITIONAL INFORMATION FROM OTHER SOURCES. THIS WILL OCCUR WHEN THE PATIENT IS SCHEDULING THEIR SERVICES, DURING PRE-REGISTRATION, WHILE THE PATIENT IS ADMITTED IN THE HOSPITAL, UPON DISCHARGE, OR FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. INFORMATION THAT THE HOSPITAL OBTAINS WILL BE MAINTAINED IN ACCORDANCE WITH APPLICABLE FEDERAL AND STATE PRIVACY AND SECURITY LAWS.THE SCREENING AND APPLICATION PROCESS FOR A PUBLIC HEALTH INSURANCE PROGRAMS IS DONE THROUGH EITHER THE VIRTUAL GATEWAY (WHICH IS AN INTERNET PORTAL DESIGNED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES TO PROVIDE THE GENERAL PUBLIC, MEDICAL PROVIDERS, AND COMMUNITY-BASED ORGANIZATIONS WITH AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE STATE) OR THROUGH A STANDARD PAPER APPLICATION THAT IS COMPLETED BY THE PATIENT AND ALSO SUBMITTED DIRECTLY TO THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR PROCESSING. THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES SOLELY MANAGES THE APPLICATION PROCESS FOR THE PROGRAMS LISTED ABOVE, WHICH IS AVAILABLE FOR CHILDREN, ADULTS, SENIORS, VETERANS, HOMELESS, AND DISABLED INDIVIDUALS. ALL APPLICATIONS ARE REVIEWED AND PROCESSED BY THE MASSACHUSETTS OFFICE OF MEDICAID, WHICH USES THE FEDERAL POVERTY GUIDELINES, ASSET INFORMATION, AS WELL AS THE NECESSARY DOCUMENTATION LISTED ABOVE AS THE BASIS FOR DETERMINING ELIGIBILITY FOR STATE SPONSORED PUBLIC ASSISTANCE PROGRAMS. A COPY OF THE FEDERAL POVERTY GUIDELINES THAT ARE USED BY THE STATE IS ATTACHED TO THE NEBH POLICY.HOSPITALS HAVE NO ROLE IN THE DETERMINATION OF PROGRAM ELIGIBILITY MADE BY THE STATE, BUT AT THE PATIENT'S REQUEST MAY TAKE A DIRECT ROLE IN APPEALING OR SEEKING INFORMATION RELATED TO THE COVERAGE DECISIONS. IT IS STILL THE PATIENT'S RESPONSIBILITY TO INFORM THE HOSPITAL OF ALL COVERAGE DECISIONS MADE BY THE STATE TO ENSURE ACCURATE AND TIMELY ADJUDICATION OF ALL HOSPITAL BILLS.
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SCHEDULE H, PART VI, LINE 1: PART V, SECTION B, LINES 17-20:
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HOSPITAL COLLECTIONS PRACTICESTHE HOSPITAL HAS A WRITTEN FINANCIAL ASSISTANCE POLICY THAT EXPLAINS THE ACTIONS IT MAY TAKE UPON NON-PAYMENT IN THE CREDIT AND COLLECTION POLICY. II. HOSPITAL BILLING AND COLLECTION PRACTICESTHE HOSPITAL HAS A FIDUCIARY DUTY TO SEEK REIMBURSEMENT FOR SERVICES IT HAS PROVIDED FROM INDIVIDUALS WHO ARE ABLE TO PAY, FROM THIRD PARTY INSURERS WHO COVER THE COST OF CARE, AND FROM OTHER PROGRAMS OF ASSISTANCE FOR WHICH THE PATIENT IS ELIGIBLE. TO DETERMINE WHETHER A PATIENT IS ABLE TO PAY FOR THE SERVICES PROVIDED AS WELL AS TO ASSIST THE PATIENT IN FINDING ALTERNATIVE COVERAGE OPTIONS IF THEY ARE UNINSURED OR UNDERINSURED, THE HOSPITAL FOLLOWS THE FOLLOWING CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. FOR UNINSURED OR UNDERINSURED PATIENTS, A QUOTATION WILL BE PROVIDED BASED ON THE REQUESTED/PHYSICIAN ORDERED PROCEDURES BASED ON THE DISCOUNTED RATES ACCORDING TO THE HOSPITAL'S BLUE CROSS HMO CONTRACTED RATE AND BILLED PRIOR TO SERVICES. THE QUOTATION IS FOR HOSPITAL SERVICES AND DOES NOT INCLUDE PROFESSIONAL PHYSICIAN FEES. LOW INCOME PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AS OUTLINED IN SECTIONS II AND III OF THE CREDIT AND COLLECTION POLICY.A. COLLECTING INFORMATION ON PATIENT FINANCIAL RESOURCES AND INSURANCE COVERAGE1) PATIENT OBLIGATIONS:PRIOR TO THE DELIVERY OF ANY HEALTH CARE SERVICES (EXCEPT FOR CASES THAT ARE AN EMERGENCY OR URGENT CARE SERVICE LEVEL), THE PATIENT IS EXPECTED TO PROVIDE TIMELY AND ACCURATE INFORMATION ON THEIR INSURANCE STATUS, DEMOGRAPHIC INFORMATION, CHANGES TO THEIR FAMILY INCOME OR INSURANCE STATUS, AND INFORMATION ON ANY DEDUCTIBLES OR CO-PAYMENTS THAT ARE OWED BASED ON THEIR EXISTING INSURANCE OR FINANCIAL PROGRAM'S PAYMENT OBLIGATIONS. THE DETAILED INFORMATION WILL INCLUDE:A) FULL NAME, ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, CITIZENSHIP AND RESIDENCY INFORMATION, AND THE PATIENT'S APPLICABLE FINANCIAL RESOURCES THAT MAY BE USED TO PAY THEIR BILL;B) FULL NAME OF THE PATIENT'S GUARANTOR, THEIR ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, AND THEIR APPLICABLE FINANCIAL RESOURCES THAT MAY BE USED TO PAY FOR THE PATIENT'S BILL; ANDC) OTHER RESOURCES THAT MAY BE USED TO PAY THEIR BILL, INCLUDING OTHER INSURANCE PROGRAMS, MOTOR VEHICLE OR HOMEOWNERS INSURANCE POLICIES IF THE TREATMENT WAS DUE TO AN ACCIDENT, WORKER'S COMPENSATION PROGRAMS, STUDENT INSURANCE POLICIES, AND ANY OTHER FAMILY INCOME SUCH AS AN INHERITANCES, GIFTS, OR DISTRIBUTIONS FROM AN AVAILABLE TRUST, AMONG OTHERS.IT IS ULTIMATELY THE PATIENT'S OBLIGATION TO KEEP TRACK OF AND TIMELY PAY THEIR UNPAID HOSPITAL BILL, INCLUDING ANY EXISTING CO-PAYMENTS, CO-INSURANCE, AND DEDUCTIBLES. THE PATIENT IS FURTHER REQUIRED TO INFORM EITHER THEIR CURRENT HEALTH INSURER (IF THEY HAVE ONE) OR THE AGENCY THAT DETERMINED THE PATIENT'S ELIGIBILITY STATUS IN A PUBLIC PROGRAM OF ANY CHANGES IN FAMILY INCOME OR INSURANCE STATUS. THE HOSPITAL MAY ALSO ASSIST THE PATIENT WITH UPDATING THEIR ELIGIBILITY IN A PUBLIC PROGRAM WHEN THERE ARE ANY CHANGES IN FAMILY INCOME OR INSURANCE STATUS, BUT ONLY IF THE HOSPITAL IS MADE AWARE BY THE PATIENT OF FACTS THAT MAY INDICATE A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS.PATIENTS ARE REQUIRED TO NOTIFY THE APPLICABLE PUBLIC PROGRAM IN WHICH THEY ARE ENROLLED OF ANY INFORMATION RELATED TO A CHANGE IN FAMILY INCOME OR ANY LAWSUIT OR INSURANCE CLAIM THAT MAY COVER THE COST OF THE SERVICES PROVIDED BY THE HOSPITAL. A PATIENT IS FURTHER REQUIRED TO ASSIGN THE RIGHT TO A THIRD PARTY PAYMENT THAT WILL COVER THE COSTS OF THE SERVICES PAID BY THE APPLICABLE PUBLIC PROGRAM. 2) HOSPITAL OBLIGATIONS:THE HOSPITAL WILL MAKE ALL REASONABLE AND DILIGENT EFFORTS TO COLLECT THE PATIENT'S INSURANCE AND OTHER INFORMATION TO VERIFY COVERAGE FOR THE HEALTH CARE SERVICES TO BE PROVIDED BY THE HOSPITAL. THESE EFFORTS MAY OCCUR WHEN THE PATIENT IS SCHEDULING THEIR SERVICES, DURING PRE-REGISTRATION, WHILE THE PATIENT IS ADMITTED IN THE HOSPITAL, UPON DISCHARGE, OR DURING THE COLLECTION PROCESS WHICH MAY OCCUR FOR A REASONABLE TIME FOLLOWING DISCHARGE. THE HOSPITAL WILL DELAY ANY ATTEMPT TO OBTAIN THIS INFORMATION DURING THE DELIVERY OF ANY EMTALA LEVEL EMERGENCY OR URGENT CARE SERVICES, IF THE PROCESS TO OBTAIN THIS INFORMATION WILL DELAY OR INTERFERE WITH EITHER THE MEDICAL SCREENING EXAMINATION OR THE SERVICES UNDERTAKEN TO STABILIZE AN EMERGENCY MEDICAL CONDITION. THE HOSPITAL'S REASONABLE AND DILIGENT EFFORTS WILL INCLUDE, BUT IS NOT LIMITED TO, REQUESTING INFORMATION ABOUT THE PATIENT'S INSURANCE STATUS, CHECKING ANY AVAILABLE PUBLIC OR PRIVATE INSURANCE DATABASES, AND FOLLOWING THE BILLINGS RULES OF A KNOWN THIRD PARTY PAYER. WHEN HOSPITAL REGISTRATION OR ADMISSION STAFF ARE MADE AWARE OF ANY SUCH INFORMATION, THEY SHALL ALSO INFORM PATIENTS OF THEIR RESPONSIBILITY TO INFORM IN WRITING WITHIN 10 DAYS THE HEALTH SAFETY NET OR MASSHEALTH OF ANY CHANGES TO FAMILY INCOME OR INSURANCE STATUS, INCLUDING ANY LAWSUIT OR INSURANCE CLAIM, CIVIL ACTION, OR OTHER PROCEEDING THAT MAY COVER THE COST OF THE SERVICES PROVIDED BY THE HOSPITAL AND INFORM THE PATIENT OF THEIR RESPONSIBILITY TO REPAY HEALTH SAFETY NET FOR APPLICABLE SERVICES REIMBURSED TO THE PATIENT FROM THIRD PARTY LIABILITY CLAIMS OR LAWSUITS.IF THE PATIENT OR GUARANTOR/GUARDIAN IS UNABLE TO PROVIDE THE INFORMATION NEEDED, AND THE PATIENT CONSENTS, THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO CONTACT RELATIVES, FRIENDS, GUARANTOR/GUARDIAN, AND/OR OTHER APPROPRIATE THIRD PARTIES FOR ADDITIONAL INFORMATION. THE HOSPITAL WILL ALSO MAKE REASONABLE AND DILIGENT EFFORTS TO INVESTIGATE WHETHER A THIRD PARTY RESOURCE MAY BE RESPONSIBLE FOR THE SERVICES PROVIDED BY THE HOSPITAL, INCLUDING BUT NOT LIMITED TO: (1) A MOTOR VEHICLE OR HOME OWNER'S LIABILITY POLICY, (2) GENERAL ACCIDENT OR PERSONAL INJURY PROTECTION POLICIES, (3) WORKER'S COMPENSATION PROGRAMS, (4) STUDENT INSURANCE POLICIES, AMONG OTHERS AND 5) APPEALING A DENIED CLAIM WHEN THE SERVICE IS PAYABLE IN WHOLE OR IN PART BY AN INSURER; AND 6) IMMEDIATELY RETURNING ANY PAYMENT RECEIVED FROM THE OFFICE WHEN ANY AVAILABLE THIRD-PARTY RESOURCE HAS BEEN IDENTIFIED. IN ACCORDANCE WITH APPLICABLE STATE REGULATIONS OR THE INSURANCE CONTRACT, FOR ANY CLAIM WHERE THE HOSPITAL'S REASONABLE AND DILIGENT EFFORTS RESULTED IN A PAYMENT FROM A PRIVATE INSURER OR PUBLIC PROGRAM, THE HOSPITAL WILL REPORT THE PAYMENT AND OFFSET IT AGAINST ANY CLAIM THAT MAY HAVE BEEN PAID BY THE PRIVATE INSURER OR PUBLIC PROGRAM. FOR STATE PUBLIC ASSISTANCE PROGRAMS, THE HOSPITAL IS NOT REQUIRED TO SECURE ASSIGNMENT ON A PATIENT'S RIGHT TO A THIRD PARTY COVERAGE ON SERVICES PROVIDED DUE TO AN ACCIDENT. IN THESE CASES THE STATE OF MASSACHUSETTS WILL ATTEMPT TO SEEK ASSIGNMENT ON THE COSTS OF THE SERVICES PROVIDED TO THE PATIENT AND WHICH WAS PAID FOR BY EITHER THE OFFICE OF MEDICAID OR PROGRAMS OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP.THE HOSPITAL FURTHER MAINTAINS ALL INFORMATION IN ACCORDANCE WITH APPLICABLE FEDERAL AND STATE PRIVACY, SECURITY, AND ID THEFT LAWS.
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B. HOSPITAL BILLING PRACTICES
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THE HOSPITAL MAKES THE SAME REASONABLE EFFORT AND FOLLOWS THE SAME REASONABLE PROCESS FOR COLLECTING ON BILLS OWED BY AN UNINSURED PATIENT AS IT DOES FOR ALL OTHER PATIENTS. THE HOSPITAL WILL FIRST SHOW THAT IT HAS A CURRENT UNPAID BALANCE THAT IS RELATED TO SERVICES PROVIDED TO THE PATIENT AND NOT COVERED BY A PRIVATE INSURER OR A FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL FOLLOWS REASONABLE COLLECTION/BILLING PROCEDURES, WHICH INCLUDE: 1) AN INITIAL BILL SENT TO THE PATIENT OR THE PARTY RESPONSIBLE FOR THE PATIENT'S PERSONAL FINANCIAL OBLIGATIONS, THE INITIAL BILL WILL INCLUDE INFORMATION ABOUT THE AVAILABILITY OF A FINANCIAL ASSISTANCE PROGRAM THAT MIGHT BE ABLE TO COVER THE COST OF THE HOSPITAL'S BILL;2) SUBSEQUENT BILLINGS, TELEPHONE CALLS, COLLECTION LETTERS, PERSONAL CONTACT NOTICES, COMPUTER NOTIFICATIONS, OR ANY OTHER NOTIFICATION METHOD THAT CONSTITUTES A GENUINE EFFORT TO CONTACT THE PARTY RESPONSIBLE FOR THE OBLIGATION AND INFORMS THE PATIENT OF THE AVAILABILITY OF FINANCIAL ASSISTANCE;3) IF POSSIBLE, DOCUMENTATION OF ALTERNATIVE EFFORTS TO LOCATE THE PARTY RESPONSIBLE FOR THE OBLIGATION OR THE CORRECT ADDRESS ON BILLINGS RETURNED BY THE POSTAL SERVICE SUCH AS "INCORRECT ADDRESS OR "UNDELIVERABLE;"4) SENDING A FINAL NOTICE BY CERTIFIED MAIL FOR UNINSURED PATIENTS (THOSE WHO ARE NOT ENROLLED IN A PUBLIC PROGRAM SUCH AS THE HEALTH SAFETY NET OR MASSHEALTH) WHO INCUR AN EMERGENCY BAD DEBT BALANCE OVER $1,000 ON EMERGENCY LEVEL SERVICES ONLY, WHERE NOTICES HAVE NOT BEEN RETURNED AS "INCORRECT ADDRESS OR "UNDELIVERABLE AND ALSO NOTIFYING THE PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE COMMUNICATION;5) DOCUMENTATION OF CONTINUOUS BILLING OR COLLECTION ACTION UNDERTAKEN ON A REGULAR, FREQUENT BASIS IS MAINTAINED. SUCH DOCUMENTATION IS MAINTAINED UNTIL AUDIT REVIEW BY A FEDERAL AND/OR STATE AGENCY OF THE FISCAL YEAR COST REPORT IN WHICH THE BILL OR ACCOUNT IS REPORTED. THE FEDERAL MEDICARE PROGRAM AND THE STATE DIVISION OF HEALTH CARE FINANCE AND POLICY FOR PURPOSES OF THE HEALTH SAFETY NET PROGRAM, DEEMS 120 DAYS AS APPROPRIATE FOR PERIOD OF TIME REPRESENTING CONTINUOUS BILLING OR COLLECTION ACTIONS.6) CHECKING THE MASSACHUSETTS ELIGIBILITY VERIFICATION SYSTEM (EVS) TO ENSURE THAT THE PATIENT IS NOT A LOW INCOME PATIENT AS DETERMINED BY THE OFFICE OF MEDICAID AND HAS NOT SUBMITTED AN APPLICATION TO THE VIRTUAL GATEWAY SYSTEM FOR COVERAGE OF THE SERVICES UNDER A PUBLIC PROGRAM, PRIOR TO SUBMITTING CLAIMS TO THE HEALTH SAFETY NET OFFICE FOR EMERGENCY BAD DEBT COVERAGE OF AN EMERGENCY LEVEL OR URGENT CARE SERVICE.C. HOSPITAL FINANCIAL ASSISTANCE PROGRAMSPATIENTS WHO ARE ELIGIBLE FOR ENROLLMENT IN A STATE PUBLIC ASSISTANCE PROGRAM, LIKE THE MASSACHUSETTS PROGRAMS OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP, ARE DEEMED ENROLLED IN A FINANCIAL ASSISTANCE PROGRAM. FOR ALL PATIENTS THAT ARE ENROLLED IN THESE STATE PUBLIC ASSISTANCE PROGRAMS, THE HOSPITAL MAY ONLY BILL THOSE PATIENTS FOR THE SPECIFIC CO-PAYMENT, CO-INSURANCE, OR DEDUCTIBLE THAT IS OUTLINED IN THE APPLICABLE STATE REGULATIONS AND WHICH MAY FURTHER BE INDICATED ON THE STATE MEDICAID MANAGEMENT INFORMATION SYSTEM. THE HOSPITAL WILL SEEK A SPECIFIED PAYMENT FOR THOSE PATIENTS THAT DO NOT QUALIFY FOR ENROLLMENT IN A MASSACHUSETTS STATE PUBLIC ASSISTANCE PROGRAM, SUCH AS OUT-OF-STATE RESIDENTS, BUT WHO MAY OTHERWISE MEET THE GENERAL FINANCIAL ELIGIBILITY CATEGORIES OF A STATE PUBLIC ASSISTANCE PROGRAM. FOR THESE PATIENTS, THE DISCOUNTED PAYMENT AMOUNT WILL BE SET AT THE PROSPECTIVE MEDICARE FEE FOR SERVICE RATE.THE HOSPITAL, WHEN REQUESTED BY THE PATIENT AND BASED ON AN INTERNAL REVIEW OF EACH PATIENT'S FINANCIAL STATUS, MAY OFFER A PATIENT AN ADDITIONAL DISCOUNT ON AN UNPAID BILL. ANY SUCH REVIEW SHALL BE PART OF A SEPARATE HOSPITAL FINANCIAL ASSISTANCE PROGRAM THAT IS APPLIED ON A UNIFORM BASIS TO PATIENTS, AND WHICH TAKES INTO CONSIDERATION THE PATIENT'S DOCUMENTED FINANCIAL SITUATION AND THE PATIENT'S INABILITY TO MAKE A PAYMENT AFTER REASONABLE COLLECTION ACTIONS. ANY DISCOUNT THAT IS PROVIDED BY THE HOSPITAL IS CONSISTENT WITH FEDERAL AND STATE REQUIREMENTS, AND DOES NOT INFLUENCE A PATIENT TO RECEIVE SERVICES FROM THE HOSPITAL. D. POPULATIONS EXEMPT FROM COLLECTION ACTIVITIESTHE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES PURSUANT TO STATE REGULATIONS AND POLICIES:1) PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, PROGRAMS OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP, "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID - SUBJECT TO THE FOLLOWING EXCEPTIONS:A. THE HOSPITAL MAY SEEK COLLECTION ACTION AGAINST ANY PATIENT ENROLLED IN THE ABOVE MENTIONED PROGRAMS FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM;B. THE HOSPITAL MAY ALSO INITIATE BILLING OR COLLECTION FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, (INCLUDING RECEIPT OR VERIFICATION OF SIGNED APPLICATION) THE HOSPITAL SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES; C. THE HOSPITAL MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED, EXPIRED, OR NOT OTHERWISE IDENTIFIED ON THE STATE VIRTUAL GATEWAY OR ELIGIBILITY VERIFICATION SYSTEM. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED INPROGRAMS OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP, THE HOSPITAL WILL CEASE COLLECTION ACTIVITY FOR SERVICES PROVIDED PRIOR TO THE BEGINNING OF THEIR ELIGIBILITY.D. AT THE REQUEST OF THE PATIENT, A PROVIDER MAY BILL A LOW INCOME PATIENT IN ORDER TO ALLOW THE PATIENT TO MEET THE REQUIRED COMMONHEALTH ONE-TIME DEDUCTIBLE. E. THE HOSPITALS MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE.
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F. STANDARD COLLECTION ACTIONS
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1) THE HOSPITAL WILL NOT UNDERTAKE ANY "EXTRAORDINARY COLLECTION ACTIVITIES" UNTIL SUCH TIME AS THE HOSPITAL HAS MADE A REASONABLE EFFORT AND FOLLOWED A REASONABLE REVIEW OF THE PATIENT'S FINANCIAL STATUS, WHICH WILL DETERMINE THAT A PATIENT IS ENTITLED TO FINANCIAL ASSISTANCE OR EXEMPTION FROM ANY COLLECTION OR BILLING ACTIVITIES UNDER THIS CREDIT AND COLLECTION POLICY. THE HOSPITAL WILL KEEP ANY AND ALL DOCUMENTATION THAT WAS USED IN THIS DETERMINATION PURSUANT TO THE HOSPITAL'S APPLICABLE RECORD RETENTION POLICY. EXTRAORDINARY COLLECTION ACTIVITIES MAY INCLUDE LAWSUITS, LIENS ON RESIDENCES, ARRESTS, BODY ATTACHMENTS, OR AS OTHERWISE DESCRIBED BELOW IN COMPLIANCE WITH STATE REQUIREMENTS.2) THE HOSPITAL WILL NOT UNDERTAKE COLLECTION ACTION AGAINST AN INDIVIDUAL THAT HAS BEEN APPROVED FOR MEDICAL HARDSHIP UNDER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM WITH RESPECT TO THE AMOUNT OF THE BILL THAT EXCEEDS THE MEDICAL HARDSHIP CONTRIBUTION. THE HOSPITAL WILL FURTHER CEASE ANY COLLECTION EFFORTS AGAINST AN EMERGENCY BAD DEBT CLAIM THAT IS APPROVED FOR MEDICAL HARDSHIP UNDER THE HEALTH SAFETY NET PROGRAM.IF THE HOSPITAL IS ASSISTING THE APPLICANT AND FAILS TO SUBMIT THE COMPLETED APPLICATION TO THE HEALTH SAFETY NET OFFICE WITHIN THAT TIME FRAME, THE HOSPITAL WILL NOT UNDERTAKE A COLLECTION ACTION AGAINST THE APPLICANT WITH RESPECT TO ANY BILLS THAT WOULD HAVE BEEN ELIGIBLE FOR MEDICAL HARDSHIP PAYMENT HAD THE APPLICATION BEEN SUBMITTED AND APPROVED.3) THE HOSPITAL WILL NOT GARNISH A LOW INCOME PATIENT'S (AS DETERMINED BY THE OFFICE OF MEDICAID) OR THEIR GUARANTOR'S WAGES OR EXECUTE A LIEN ON THE LOW INCOME PATIENT'S OR THEIR GUARANTOR'S PERSONAL RESIDENCE OR MOTOR VEHICLE UNLESS: (1) THE HOSPITAL CAN SHOW THE PATIENT OR THEIR GUARANTOR HAS THE ABILITY TO PAY, (2) THE PATIENT/GUARANTOR DID NOT RESPOND TO HOSPITAL REQUESTS FOR INFORMATION OR THE PATIENT/GUARANTOR REFUSED TO COOPERATE WITH THE HOSPITAL TO SEEK AN AVAILABLE FINANCIAL ASSISTANCE PROGRAM, AND (3) FOR PURPOSES OF THE LIEN, IT WAS APPROVED BY THE HOSPITAL'S BOARD OF TRUSTEES ON AN INDIVIDUAL CASE BY CASE BASIS.4) THE HOSPITAL AND ITS AGENTS SHALL NOT CONTINUE COLLECTION OR BILLING ON A PATIENT WHO IS A MEMBER OF A BANKRUPTCY PROCEEDING EXCEPT TO SECURE ITS RIGHTS AS A CREDITOR IN THE APPROPRIATE ORDER, PROVIDED THAT THE STATE OF MASSACHUSETTS WILL FILE ITS OWN RECOVERY ACTION FOR THOSE PATIENTS ENROLLED IN PROGRAMS OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP. THE HOSPITAL AND ITS AGENTS WILL ALSO NOT CHARGE INTEREST ON AN OVERDUE BALANCE FOR A LOW INCOME PATIENT OR FOR PATIENTS WHO ARE LOW INCOME BASED ON THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. 5) THE HOSPITAL MAINTAINS COMPLIANCE WITH APPLICABLE BILLING REQUIREMENTS, INCLUDING THE DEPARTMENT OF PUBLIC HEALTH REGULATIONS (105 CMR 130.332) FOR NON-PAYMENT OF SPECIFIC SERVICES OR READMISSIONS THAT THE HOSPITAL DETERMINES WAS THE RESULT OF A SERIOUS REPORTABLE EVENTS (SRE). SRES THAT DO NOT OCCUR AT THE HOSPITAL ARE EXCLUDED FROM THIS DETERMINATION OF NON-PAYMENT. THE HOSPITAL ALSO DOES NOT SEEK PAYMENT FROM A LOW INCOME PATIENT DETERMINED ELIGIBLE FOR THE PUBLIC ASSISTANT PROGRAM WHOSE CLAIMS WERE INITIALLY DENIED BY AN INSURANCE PROGRAM DUE TO AN ADMINISTRATIVE BILLING ERROR BY THE HOSPITAL.G. OUTSIDE COLLECTION AGENCIESTHE HOSPITAL CONTRACTS WITH AN OUTSIDE COLLECTION AGENCY TO ASSIST IN THE COLLECTION OF CERTAIN ACCOUNTS, INCLUDING PATIENT RESPONSIBLE AMOUNTS NOT RESOLVED AFTER ISSUANCE OF HOSPITAL BILLS OR FINAL NOTICES. HOWEVER, AS DETERMINED THROUGH THIS CREDIT AND COLLECTION POLICY, THE HOSPITAL MAY ASSIGN SUCH DEBT AS BAD DEBT OR CHARITY CARE (OTHERWISE DEEMED AS UNCOLLECTIBLE) PRIOR TO 120 DAYS IF IT IS ABLE TO DETERMINE THAT THE PATIENT WAS UNABLE TO PAY FOLLOWING THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL HAS A SPECIFIC AUTHORIZATION OR CONTRACT WITH THE OUTSIDE COLLECTION AGENCY AND REQUIRES SUCH AGENCIES TO ABIDE BY THE HOSPITAL'S CREDIT AND COLLECTION POLICIES FOR THOSE DEBTS THAT THE AGENCY IS PURSUING, INCLUDING THE OBLIGATION TO REFRAIN FROM "EXTRAORDINARY COLLECTION ACTIVITIES" UNTIL SUCH TIME AS THE HOSPITAL HAS MADE A REASONABLE EFFORT AND FOLLOWED A REASONABLE PROCESS FOR DETERMINING THAT A PATIENT IS ENTITLED TO ASSISTANCE OR EXEMPTION FROM ANY COLLECTION OR BILLING PROCEDURES UNDER THIS CREDIT AND COLLECTION POLICY. ALL OUTSIDE COLLECTION AGENCIES HIRED BY THE HOSPITAL WILL PROVIDE THE PATIENT WITH AN OPPORTUNITY TO FILE A GRIEVANCE AND WILL FORWARD TO THE HOSPITAL THE RESULTS OF SUCH PATIENT GRIEVANCES. THE HOSPITAL REQUIRES THAT ANY OUTSIDE COLLECTION AGENCY THAT IT USES IS LICENSED BY THE COMMONWEALTH OF MASSACHUSETTS AND THAT THE OUTSIDE COLLECTION AGENCY ALSO IS IN COMPLIANCE WITH THE MASSACHUSETTS ATTORNEY GENERAL'S DEBT COLLECTION REGULATIONS AT 940 C.M.R. 7.00.III. DEPOSITS AND INSTALLMENT PLANSPURSUANT TO THE MASSACHUSETTS HEALTH SAFETY NET REGULATIONS PERTAINING TO PATIENTS THAT ARE EITHER: (1) DETERMINED TO BE A "LOW INCOME PATIENT OR (2) QUALIFY FOR MEDICAL HARDSHIP, THE HOSPITAL WILL PROVIDE THE PATIENT WITH INFORMATION ON DEPOSITS AND PAYMENT PLANS BASED ON THE PATIENT'S DOCUMENTED FINANCIAL SITUATION. ANY OTHER PLAN WILL BE BASED ON THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM, AND WILL NOT APPLY TO PATIENTS WHO HAVE THE ABILITY TO PAY.A. EMERGENCY SERVICES A HOSPITAL MAY NOT REQUIRE PRE-ADMISSION AND/OR PRE-TREATMENT DEPOSITS FROM INDIVIDUALS THAT REQUIRE EMERGENCY LEVEL SERVICES OR THAT ARE DETERMINED TO BE LOW INCOME PATIENTS. B. LOW INCOME PATIENT DEPOSITSA HOSPITAL MAY REQUEST A DEPOSIT FROM INDIVIDUALS DETERMINED TO BE LOW INCOME PATIENTS. SUCH DEPOSITS MUST BE LIMITED TO 20% OF THE DEDUCTIBLE AMOUNT, UP TO $500. ALL REMAINING BALANCES ARE SUBJECT TO THE PAYMENT PLAN CONDITIONS ESTABLISHED IN 101 CMR 613.08.C. DEPOSITS FOR MEDICAL HARDSHIP PATIENTSA HOSPITAL MAY REQUEST A DEPOSIT FROM PATIENTS ELIGIBLE FOR MEDICAL HARDSHIP. DEPOSITS WILL BE LIMITED TO 20% OF THE MEDICAL HARDSHIP CONTRIBUTION UP TO $1,000. ALL REMAINING BALANCES WILL BE SUBJECT TO THE PAYMENT PLAN CONDITIONS ESTABLISHED IN 101 CMR 613.08.D. PAYMENT PLANS FOR LOW INCOME PATIENTS PURSUANT TO THE MASSACHUSETTS HEALTH SAFETY NET PROGRAMAN INDIVIDUAL WITH A BALANCE OF $1,000 OR LESS, AFTER INITIAL DEPOSIT, MUST BE OFFERED AT LEAST A ONE-YEAR PAYMENT PLAN INTEREST FREE WITH A MINIMUM MONTHLY PAYMENT OF NO MORE THAN $25. A PATIENT THAT HAS A BALANCE OF MORE THAN $1,000, AFTER INITIAL DEPOSIT, MUST BE OFFERED AT LEAST A TWO-YEAR INTEREST FREE PAYMENT PLAN.E. PAYMENT PLANS FOR HSN PARTIAL LOW INCOME PATIENTS.PURSUANT TO THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM, SERVICES RENDERED IN A HOSPITAL LICENSED HEALTH CENTER MUST BE OFFERED THE SAME PAYMENT PLANS AS THE MAIN CAMPUS.THE HOSPITAL ALSO OFFERS THE HEALTH SAFETY NET PARTIAL LOW INCOME PATIENT A CO-INSURANCE PLAN, THAT ALLOWS THE PATIENT TO PAY 20% OF THE HEALTH SAFETY NET PAYMENT FOR EACH VISIT UNTIL THE PATIENT MEETS THEIR ANNUAL DEDUCTIBLE. THE REMAINING BALANCE WILL BE WRITTEN OFF TO THE HEALTH SAFETY NET.SCHEDULE H, PART VI, LINE 1: PART V, SECTION B, LINES 17 OR 18: ACTIONS ON COLLECTIONSNEITHER THE NEW ENGLAND BAPTIST HOSPITAL NOR ANY AUTHORIZED THIRD PARTY TOOK ANY OF THE ACTIONS LISTED IN FORM 990, SCHEDULE H, PART V, SECTION B, QUESTION 18 OR 19.
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SCHEDULE H, PART VI, LINE 1: PART V, SECTION B, LINE 21:
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POLICY RELATING TO EMERGENCY MEDICAL CARE IV. DELIVERY OF HEALTH CARE SERVICESTHE HOSPITAL EVALUATES THE DELIVERY OF HEALTH CARE SERVICES FOR ALL PATIENTS WHO PRESENT FOR SERVICES REGARDLESS OF THEIR ABILITY TO PAY. HOWEVER, NON-EMERGENT OR NON-URGENT HEALTH CARE SERVICES (I.E., ELECTIVE OR PRIMARY CARE SERVICES) MAY BE DELAYED OR DEFERRED BASED ON THE CONSULTATION WITH THE HOSPITAL'S CLINICAL STAFF AND, IF NECESSARY AND, IF AVAILABLE, THE PATIENT'S PRIMARY CARE PROVIDER. THE HOSPITAL MAY DECLINE TO PROVIDE A PATIENT WITH NON-EMERGENT, NON-URGENT SERVICES IN THOSE CASES WHEN THE HOSPITAL IS UNABLE TO IDENTIFY A PAYMENT SOURCE OR ELIGIBILITY IN A FINANCIAL ASSISTANCE PROGRAM. SUCH PROGRAMS INCLUDE MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, AND OTHERS. CHOICES RELATED TO THE DELIVERY AND ACCESS TO CARE IS OFTEN DEFINED IN EITHER THE INSURANCE CARRIER'S OR THE FINANCIAL ASSISTANCE PROGRAM'S COVERAGE MANUAL. THE URGENCY OF TREATMENT ASSOCIATED WITH EACH PATIENT'S PRESENTING CLINICAL SYMPTOMS WILL BE DETERMINED BY A MEDICAL PROFESSIONAL AS DETERMINED BY LOCAL STANDARDS OF PRACTICE, NATIONAL AND STATE CLINICAL STANDARDS OF CARE, AND THE HOSPITAL MEDICAL STAFF POLICIES AND PROCEDURES. FURTHER, ALL HOSPITALS FOLLOW THE FEDERAL EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA) REQUIREMENTS BY CONDUCTING A MEDICAL SCREENING EXAMINATION TO DETERMINE WHETHER AN EMERGENCY MEDICAL CONDITION EXISTS. IT IS IMPORTANT TO NOTE THAT CLASSIFICATION OF PATIENTS' MEDICAL CONDITION IS FOR CLINICAL MANAGEMENT PURPOSES ONLY, AND SUCH CLASSIFICATIONS ARE INTENDED FOR ADDRESSING THE ORDER IN WHICH PHYSICIANS SHOULD SEE PATIENTS BASED ON THEIR PRESENTING CLINICAL SYMPTOMS. THESE CLASSIFICATIONS DO NOT REFLECT EVALUATION OF THE PATIENT'S MEDICAL CONDITION REFLECTED IN FINAL DIAGNOSIS. FOR THOSE PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST WITH FINDING A FINANCIAL ASSISTANCE PROGRAM THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILL(S). FOR THOSE PATIENTS WITH PRIVATE INSURANCE, THE HOSPITAL MUST WORK THROUGH THE PATIENT AND THE INSURER TO DETERMINE WHAT MAY BE COVERED UNDER THE PATIENT'S INSURANCE POLICY. AS THE HOSPITAL IS OFTEN NOT ABLE TO GET THIS INFORMATION FROM THE INSURER IN A TIMELY MANNER, IT IS THE PATIENT'S OBLIGATION TO KNOW WHAT SERVICES WILL BE COVERED PRIOR TO SEEKING NON-EMERGENCY LEVEL AND NON-URGENT CARE SERVICES. DETERMINATION OF TREATMENT BASED ON MEDICAL CONDITIONS IS MADE ACCORDING TO THE FOLLOWING DEFINITIONS: 1. EMERGENCY AND URGENT CARE SERVICESANY PATIENT WHO COMES TO THE HOSPITAL WILL BE EVALUATED AS TO THE LEVEL OF EMERGENCY LEVEL OR URGENT CARE SERVICES WITHOUT REGARD TO THE PATIENT'S IDENTIFICATION, INSURANCE COVERAGE, OR ABILITY TO PAY. THE EVALUATION OF EMERGENCY LEVEL OR URGENT CARE SERVICES AS DEFINED BELOW IS FURTHER USED BY THE HOSPITAL FOR PURPOSES OF DETERMINING ALLOWABLE EMERGENCY AND URGENT BAD DEBT COVERAGE UNDER THE HEALTH SAFETY NET FUND.A) EMERGENCY LEVEL SERVICES INCLUDES:I. MEDICALLY NECESSARY SERVICES PROVIDED AFTER THE ONSET OF A MEDICAL CONDITION, WHETHER PHYSICAL OR MENTAL, MANIFESTING ITSELF BY SYMPTOMS OF SUFFICIENT SEVERITY INCLUDING SEVERE PAIN, THAT THE ABSENCE OF PROMPT MEDICAL ATTENTION COULD REASONABLY BE EXPECTED BY A PRUDENT LAYPERSON WHO POSSESSES AN AVERAGE KNOWLEDGE OF HEALTH AND MEDICINE TO RESULT IN PLACING THE HEALTH OF THE PERSON OR ANOTHER PERSON IN SERIOUS JEOPARDY, SERIOUS IMPAIRMENT TO BODY FUNCTION OR SERIOUS DYSFUNCTION OF ANY BODY ORGAN OR PART OR, WITH RESPECT TO A PREGNANT WOMAN, AS FURTHER DEFINED IN SECTION 1867(E) (1) (B) OF THE SOCIAL SECURITY ACT, 42 U.S.C. 1295DD(E)(1)(B). A MEDICAL SCREENING EXAMINATION AND ANY SUBSEQUENT TREATMENT FOR AN EXISTING EMERGENCY MEDICAL CONDITIONS OR ANY OTHER SUCH SERVICE RENDERED TO THE EXTENT REQUIRED PURSUANT TO THE FEDERAL EMTALA (42 USC 1395(DD) QUALIFIES AS AN EMERGENCY LEVEL SERVICE.B) URGENT CARE SERVICES INCLUDE:I. MEDICALLY NECESSARY SERVICES PROVIDED AFTER SUDDEN ONSET OF A MEDICAL CONDITION, WHETHER PHYSICAL OR MENTAL, MANIFESTING ITSELF BY ACUTE SYMPTOMS OF SUFFICIENT SEVERITY (INCLUDING SEVERE PAIN) THAT A PRUDENT LAYPERSON WOULD BELIEVE THAT THE ABSENCE OF MEDICAL ATTENTION WITHIN 24 HOURS COULD REASONABLY EXPECT TO RESULT IN: PLACING THE PATIENT'S HEALTH IN JEOPARDY, IMPAIRMENT TO BODILY FUNCTION, OR DYSFUNCTION OF ANY BODILY ORGAN OR PART. URGENT CARE SERVICES ARE PROVIDED FOR CONDITIONS THAT ARE NOT LIFE THREATENING AND DO NOT POSE A HIGH RISK OF SERIOUS DAMAGE TO AN INDIVIDUAL'S HEALTH, BUT PROMPT MEDICAL SERVICES ARE NEEDED.C) EMTALA LEVEL REQUIREMENTS:I. AS NOTED IN THIS FILING, NEW ENGLAND BAPTIST HOSPITAL IS NOT LICENSED FOR AND DOES NOT HAVE AN EMERGENCY ROOM AND THEREFORE DOES NOT ANTICIPATE THE UNSCHEDULED PRESENTATION OF PATIENTS REQUIRING EMERGENCY SERVICES. IF AND WHEN APPROPRIATE, EMERGENCY AND URGENT SERVICES WILL BE PROVIDED WITHOUT REGARD TO A PATIENT'S IDENTIFICATION, INSURANCE COVERAGE, OR ABILITY TO PAY. IN ACCORDANCE WITH FEDERAL REQUIREMENTS, EMTALA IS TRIGGERED FOR ANYONE WHO COMES TO THE HOSPITAL PROPERTY REQUESTING EXAMINATION OR TREATMENT OF AN EMERGENCY LEVEL SERVICE (EMERGENCY MEDICAL CONDITION) OR TREATMENT FOR A MEDICAL CONDITION. MOST COMMONLY, UNSCHEDULED PERSONS PRESENT THEMSELVES AT THE HOSPITAL SEEKING URGENT CARE. HOWEVER, UNSCHEDULED PERSONS REQUESTING SERVICES FOR AN EMERGENCY MEDICAL CONDITION WHILE PRESENTING AT ANOTHER INPATIENT UNIT, CLINIC, OR OTHER ANCILLARY AREA MAY ALSO BE SUBJECT TO AN EMERGENCY MEDICAL SCREENING EXAMINATION IN ACCORDANCE WITH EMTALA. EXAMINATION AND TREATMENT FOR EMERGENCY MEDICAL CONDITIONS OR ANY SUCH OTHER SERVICE RENDERED TO THE EXTENT REQUIRED UNDER EMTALA, WILL BE PROVIDED TO THE PATIENT AND WILL QUALIFY AS EMERGENCY CARE. THE DETERMINATION THAT THERE IS AN EMERGENCY MEDICAL CONDITION IS MADE BY THE EXAMINING PHYSICIAN OR OTHER QUALIFIED MEDICAL PERSONNEL OF THE HOSPITAL AS DOCUMENTED IN THE MEDICAL RECORD. THE DETERMINATION THAT THERE IS AN URGENT OR PRIMARY MEDICAL CONDITION IS ALSO MADE BY THE EXAMINING PHYSICIAN OR OTHER QUALIFIED MEDICAL PERSONNEL OF THE HOSPITAL AS DOCUMENTED IN THE MEDICAL RECORD.2. NON-EMERGENT, NON-URGENT SERVICES: FOR PATIENTS WHO EITHER (1) ARRIVE TO THE HOSPITAL SEEKING NON-EMERGENT OR NON-URGENT LEVEL CARE OR (2) SEEK ADDITIONAL CARE FOLLOWING STABILIZATION OF AN EMERGENCY MEDICAL CONDITION, THE HOSPITAL MAY PROVIDE ELECTIVE SERVICES AFTER CONSULTING WITH THE HOSPITAL'S CLINICAL STAFF AND REVIEWING THE PATIENT'S COVERAGE OPTIONS. A) ELECTIVE SERVICES: SERVICES THAT DO NOT MEET THE DEFINITION OF EMERGENT OR URGENT ABOVE. TYPICALLY, THESE SERVICES ARE EITHER PRIMARY CARE SERVICES OR MEDICAL PROCEDURES SCHEDULED IN ADVANCE BY THE PATIENT OR BY THE HEALTH CARE PROVIDER (HOSPITAL, PHYSICIAN OFFICE, OTHER). 3. LOCATIONS WHERE PATIENTS MAY PRESENT:PATIENTS ARE ABLE TO SEEK EMERGENCY LEVEL SERVICES AND URGENT CARE SERVICES WHEN THEY COME TO THE HOSPITAL'S DESIGNATED URGENT CARE AREA. NEBH IS NOT LICENSED FOR AN EMERGENCY ROOM. HOWEVER, PATIENTS WITH EMERGENT AND URGENT CONDITIONS MAY ALSO PRESENT IN A VARIETY OF OTHER LOCATIONS, INCLUDING BUT NOT LIMITED TO ANCILLARY DEPARTMENTS SUCH AS RADIOLOGY AND LABORATORY, HOSPITAL CLINICS AND OTHER AREAS. THE HOSPITAL ALSO PROVIDES OTHER ELECTIVE SERVICES AT THE MAIN HOSPITAL, CLINICS AND OTHER OUTPATIENT LOCATIONS.SCHEDULE H, PART VI, LINE 1: PART V, SECTION B, LINE -22-24:INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCENEW ENGLAND BAPTIST HOSPITAL (NEBH) NOTIFIES ITS PATIENTS ABOUT ITS FINANCIAL ASSISTANCE POLICY THROUGH ITS FINANCIAL COUNSELORS AND PUBLIC DISCLOSURES, AS DESCRIBED HERE WITHIN. IN ADDITION, ONCE NEBH BECOMES AWARE OF A PATIENT'S HSN OR FINANCIAL ELIGIBILITY STATUS, ALL INVOICES ARE ADJUSTED ACCORDINGLY. THE NEBH CREDIT & COLLECTION POLICY FURTHER DESCRIBES ITS PRACTICES AND NOTIFICATIONS FOR INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE:
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V. NOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE AND OTHER COVERAGE
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OPTIONS1. GENERAL PRINCIPLESFOR THOSE PATIENTS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE BILLS THAT ARE SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES THAT ARE POSTED THROUGHOUT THE HOSPITAL.THE GOAL OF THESE NOTICES IS TO ASSIST PATIENTS IN APPLYING FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP MUST DO SO THROUGH A SINGLE UNIFORM APPLICATION THAT IS SUBMITTED THROUGH THE STATE'S NEW ENROLLMENT SYSTEM CALLED THE HEALTH INSURANCE EXCHANGE (HIX). THE HOSPITAL WILL PROVIDE, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE A LOW INCOME PATIENT UNDER EITHER THE MASSACHUSETTS PUBLIC ASSISTANCE PROGRAM OR ADDITIONAL ASSISTANCE FOR PATIENTS WHO ARE LOW INCOME THROUGH THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT AVAILABLE PAYMENT PLANS THAT MAY BE AVAILABLE TO THEM BASED ON THEIR FAMILY SIZE AND INCOME.2. ROLE OF HOSPITAL PATIENT FINANCIAL COUNSELORS AND OTHER FINANCE STAFFTHE HOSPITAL WILL TRY TO IDENTIFY AVAILABLE COVERAGE OPTIONS FOR PATIENTS WHO MAY BE UNINSURED OR UNDERINSURED WITH THEIR CURRENT INSURANCE PROGRAM WHEN THE PATIENT IS SCHEDULING THEIR SERVICES, WHILE THE PATIENT IS IN THE HOSPITAL, UPON DISCHARGE, AND FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THE HOSPITAL REGISTRATION AND ADMISSION STAFF WILL DIRECT ALL PATIENTS SEEKING AVAILABLE COVERAGE OPTIONS OR FINANCIAL ASSISTANCE TO THE HOSPITAL'S PATIENT FINANCIAL COUNSELING OFFICE TO DETERMINE IF THEY ARE ELIGIBLE AND THEN TO SCREEN FOR ELIGIBILITY IN AN APPROPRIATE COVERAGE OPTION. THE HOSPITAL WILL THEN ASSIST THE PATIENT IN APPLYING FOR THE APPROPRIATE COVERAGE OPTIONS THAT ARE AVAILABLE OR NOTIFY THEM OF THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM.THE HOSPITAL WILL ALSO PROVIDE INFORMATION ON HOW TO CONTACT THE APPROPRIATE STAFF WITHIN THE HOSPITAL'S FINANCE OFFICE TO VERIFY THE ACCURACY OF THE HOSPITAL BILL OR TO DISPUTE CERTAIN CHARGES.3. NOTIFICATION PRACTICES:THE HOSPITAL WILL POST A NOTICE (SIGNS) OF AVAILABILITY OF FINANCIAL ASSISTANCE AS OUTLINED IN THIS CREDIT AND COLLECTION POLICY IN THE FOLLOWING LOCATIONS:A) INPATIENT, CLINICS, URGENT CARE DEPARTMENT ADMISSION AND/OR REGISTRATION AREAS;B) PATIENT FINANCIAL COUNSELOR AREAS;C) CENTRAL ADMISSION/REGISTRATION AREAS; AND/ORD) BUSINESS OFFICE AREAS THAT IS OPEN TO PATIENTS.E) POSTED SIGNS WILL BE CLEARLY VISIBLE AND LEGIBLE TO PATIENTS VISITING THESE AREAS. THE HOSPITAL WILL ALSO INCLUDE A NOTICE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ALL INITIAL BILLS.WHEN THE PATIENT CONTACTS THE HOSPITAL, THE HOSPITAL FINANCE STAFF WILL ATTEMPT TO IDENTIFY IF A PATIENT QUALIFIES FOR A PUBLIC FINANCIAL ASSISTANCE PROGRAM OR A PAYMENT PLAN. A PATIENT WHO IS ENROLLED IN A PUBLIC FINANCIAL ASSISTANCE PROGRAM (E.G., MASSHEALTH OR THE HEALTH SAFETY NET) MAY QUALIFY FOR CERTAIN PLANS. PATIENTS MAY ALSO QUALIFY FOR ADDITIONAL ASSISTANCE BASED ON THE HOSPITAL'S OWN INTERNAL CRITERIA FOR FINANCIAL ASSISTANCE, OR QUALIFY FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED INCOME AND ALLOWABLE MEDICAL EXPENSES.FOR CASES WHERE THE HOSPITAL IS USING THE VIRTUAL GATEWAY APPLICATION, THE HOSPITAL WILL ASSIST THE PATIENT IN COMPLETING THE APPLICATION FOR MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR OTHER FORMS OF FINANCIAL ASSISTANCE PROGRAMS AS THEY BECOME PART OF THE VIRTUAL GATEWAY PROGRAM.SCHEDULE H, PART VI, LINE 3:PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCENEW ENGLAND BAPTIST HOSPITAL INFORMS AND EDUCATES ITS PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS AS DESCRIBED IN ITS CREDIT & COLLECTIONS POLICY:DOCUMENTING ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS1. GENERAL PRINCIPLESFINANCIAL ASSISTANCE IS INTENDED TO ASSIST LOW-INCOME PATIENTS WHO DO NOT OTHERWISE HAVE THE ABILITY TO PAY FOR THEIR HEALTH CARE SERVICES. SUCH ASSISTANCE TAKES INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS. THE HOSPITAL PROVIDES THIS ASSISTANCE FOR BOTH RESIDENTS AND NON-RESIDENTS OF MASSACHUSETTS; HOWEVER, THERE MAY NOT BE COVERAGE IN A STATE PUBLIC ASSISTANCE PROGRAM FOR A MASSACHUSETTS HOSPITAL'S SERVICES THROUGH AN OUT-OF STATE RESIDENT. IN ORDER FOR THE HOSPITAL TO ASSIST UNINSURED AND UNDERINSURED PATIENTS FIND THE MOST APPROPRIATE COVERAGE OPTIONS AS WELL AS DETERMINE IF THE PATIENT IS FINANCIALLY ELIGIBLE FOR ANY DISCOUNTS IN PAYMENTS, PATIENTS MUST ACTIVELY WORK WITH HOSPITALS TO VERIFY THE PATIENT'S DOCUMENTED FAMILY INCOME, OTHER INSURANCE COVERAGE, AND ANY OTHER INFORMATION THAT COULD BE USED IN DETERMINING ELIGIBILITY.
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2. HOSPITAL SCREENING AND ELIGIBILITY APPROVAL PROCESS
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THE HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR THROUGH THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM, WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. FOR THOSE PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS PATIENTS BY SCREENING THEM FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. FOR THOSE PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS PATIENTS BY SCREENING THEM FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. THESE INCLUDE, BUT ARE NOT LIMITED TO, PROGRAMS OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP MUST DO SO THROUGH A SINGLE UNIFORM APPLICATION THAT IS SUBMITTED THROUGH THE STATE'S NEW ENROLLMENT SYSTEM CALLED THE HEALTH INSURANCE EXCHANGE (HIX). IT IS THE PATIENT'S OBLIGATION TO PROVIDE THE HOSPITAL WITH ACCURATE AND TIMELY INFORMATION REGARDING THEIR FULL NAME, ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS (INCLUDING ANY OTHER INSURANCE OR COVERAGE OPTIONS (LIKE A MOTOR VEHICLE POLICY OR WORKER'S COMPENSATION POLICY) THAT CAN COVER THE COST OF THE CARE RECEIVED), ANY OTHER APPLICABLE FINANCIAL RESOURCES, AND CITIZENSHIP AND RESIDENCY INFORMATION. THIS INFORMATION WILL BE USED TO DETERMINE COVERAGE FOR THE SERVICES PROVIDED TO THE PATIENT. IF THERE IS NO SPECIFIC COVERAGE FOR THE SERVICES PROVIDED, THE HOSPITAL WILL USE THE INFORMATION TO DETERMINE IF THE SERVICES MAY BE COVERED BY AN APPLICABLE PROGRAM THAT WILL COVER CERTAIN SERVICES DEEMED BAD DEBT. IN ADDITION, THE HOSPITAL WILL USE THIS INFORMATION TO DISCUSS ELIGIBILITY FOR CERTAIN HEALTH INSURANCE PROGRAMS. IF THE PATIENT OR GUARANTOR IS UNABLE TO PROVIDE THE NECESSARY INFORMATION, THE HOSPITAL MAY (AT THE PATIENT'S REQUEST) MAKE REASONABLE EFFORTS TO OBTAIN ANY ADDITIONAL INFORMATION FROM OTHER SOURCES. THIS WILL OCCUR WHEN THE PATIENT IS SCHEDULING THEIR SERVICES, DURING PRE-REGISTRATION, WHILE THE PATIENT IS ADMITTED IN THE HOSPITAL, UPON DISCHARGE, OR FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. INFORMATION THAT THE HOSPITAL OBTAINS WILL BE MAINTAINED IN ACCORDANCE WITH APPLICABLE FEDERAL AND STATE PRIVACY AND SECURITY LAWS.THE SCREENING AND APPLICATION PROCESS FOR A PUBLIC HEALTH INSURANCE PROGRAMS IS DONE THROUGH EITHER THE VIRTUAL GATEWAY (WHICH IS AN INTERNET PORTAL DESIGNED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES TO PROVIDE THE GENERAL PUBLIC, MEDICAL PROVIDERS, AND COMMUNITY-BASED ORGANIZATIONS WITH AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE STATE) OR THROUGH A STANDARD PAPER APPLICATION THAT IS COMPLETED BY THE PATIENT AND ALSO SUBMITTED DIRECTLY TO THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR PROCESSING. THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES SOLELY MANAGES THE APPLICATION PROCESS FOR THE PROGRAMS LISTED ABOVE, WHICH IS AVAILABLE FOR CHILDREN, ADULTS, SENIORS, VETERANS, HOMELESS, AND DISABLED INDIVIDUALS. VIRTUAL GATEWAY AND PAPER APPLICATIONS ARE REVIEWED AND PROCESSED BY THE MASSACHUSETTS OFFICE OF MEDICAID, WHICH USES THE FEDERAL POVERTY GUIDELINES, ASSET INFORMATION, AS WELL AS THE NECESSARY DOCUMENTATION LISTED ABOVE AS THE BASIS FOR DETERMINING ELIGIBILITY FOR STATE SPONSORED PUBLIC ASSISTANCE PROGRAMS. THE ELIGIBILITY FOR ENROLLMENT INTO THE HEALTH SAFETY NET PROGRAM FOR FULL OR PARTIAL HEALTH SAFETY NET COVERAGE IS ALSO DETERMINED THROUGH THE VIRTUAL GATEWAY. THE HOSPITAL WILL ALSO ASSIST OTHER PATIENTS, SUCH AS MINORS RECEIVING CONFIDENTIAL SERVICES OR INDIVIDUALS WHO HAVE BEEN BATTERED OR ABUSED, OBTAIN COVERAGE THROUGH THE HEALTH SAFETY NET BY USING THE MASSACHUSETTS DIVISION OF HEALTH CARE FINANCE AND POLICY SPECIAL CIRCUMSTANCE APPLICATION. A COPY OF THE FEDERAL POVERTY GUIDELINES THAT ARE USED BY THE STATE IS ATTACHED TO THIS POLICY. HOSPITALS HAVE NO ROLE IN THE DETERMINATION OF PROGRAM ELIGIBILITY MADE BY THE STATE, BUT AT THE PATIENT'S REQUEST MAY TAKE A DIRECT ROLE IN APPEALING OR SEEKING INFORMATION RELATED TO THE COVERAGE DECISIONS. IT IS STILL THE PATIENT'S RESPONSIBILITY TO INFORM THE HOSPITAL OF ALL COVERAGE DECISIONS MADE BY THE STATE TO ENSURE ACCURATE AND TIMELY ADJUDICATION OF ALL HOSPITAL BILLS.SCHEDULE H, PART VI, LINE 4:COMMUNITY INFORMATIONTHE COMMUNITY SERVED BY NEW ENGLAND BAPTIST HOSPITAL (NEBH) IS DETERMINED BY PROXIMITY TO THE HOSPITAL AND AN EVALUATION OF DISCHARGE DATA. ITS PRIMARY COMMUNITY SERVICE AREA IS THE BOSTON NEIGHBORHOOD OF MISSION HILL; HOWEVER, THE HOSPITAL'S PATIENT BASE AND SERVICES EXTEND TO OTHER BOSTON NEIGHBORHOODS AND SURROUNDING TOWNS. PRIMARY COMMUNITY SERVICE AREAMISSION HILL IS A ONE SQUARE MILE NEIGHBORHOOD LOCATED APPROXIMATELY ONE MILE FROM BOSTON'S DOWNTOWN BUSINESS DISTRICT. APPROXIMATELY THREE QUARTERS OF THE NEIGHBORHOOD IS RESIDENTIAL MADE-UP OF PRIVATELY OWNED ONE TO THREE FAMILY BUILDINGS AND A NUMBER OF MULTI-FAMILY BUILDINGS. MISSION HILL'S POPULATION OF AROUND 19,000 PEOPLE IS RACIALLY AND ECONOMICALLY DIVERSE. ATOP THE HILL IS NEW ENGLAND BAPTIST HOSPITAL AND MCLAUGHLIN PLAYGROUND, WHICH EXTENDS FROM THE HOSPITAL GROUNDS DOWN PARKER HILL AVENUE. MCLAUGHLIN PLAYGROUND, IS ONE OF THE HIGHEST POINTS IN THE CITY WHERE YOU CAN OBSERVE A PANORAMIC VIEW OF DOWNTOWN BOSTON, BOSTON HARBOR, AND THE BLUE HILLS.
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SCHEDULE H, PART VI, LINE 5 & 6:
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PROMOTION OF COMMUNITY HEALTH ACTIVITIES AND AFFILIATED NETWORKSSCHEDULE H PART VI QUESTIONS 5 AND 6 - ADDITIONAL PROMOTION OF COMMUNITY HEALTH AND AFFILIATED HEALTH CARE SYSTEMNEW ENGLAND BAPTIST HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF THE BOARD OF TRUSTEES ARE INDEPENDENT COMMUNITY MEMBERS. NEW ENGLAND BAPTIST HOSPITAL IS THE SOLE MEMBER OF ITS AFFILIATED ENTITY NEW ENGLAND BAPTIST MEDICAL ASSOCIATES.IN ADDITION, AS NOTED, NEBH IS PART OF THE CAREGROUP NETWORK OF AFFILIATES, WHICH INCLUDES MOUNT AUBURN HOSPITAL, BETH ISRAEL DEACONESS MEDICAL CENTER AND ITS NETWORK OF AFFILIATES INCLUDING BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, BETH ISRAEL DEACONESS HOSPITAL - MILTON, AND BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, EACH OF THESE ENTITIES MAY, IN TURN, SERVE AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. NEW ENGLAND BAPTIST HOSPITAL AND EACH OF ITS AFFILIATES IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES THEY SERVE.
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SCHEDULE H, PART VI:
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OTHER INFORMATIONNEW ENGLAND BAPTIST HOSPITAL (NEBH OR HOSPITAL) IS GOVERNED BY A BOARD OF TRUSTEES GENERALLY COMPOSED OF UP TO 28 VOLUNTEERS, MANY OF WHOM LIVE AND WORK IN THE COMMUNITY AND ALL OF WHOM SERVE TO SUPPORT THE MISSION AND VALUES OF THE HOSPITAL. NEBH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY AND ENDEAVORS TO PROVIDE THEM WITH THE SAFEST AND MOST TECHNOLOGICALLY ADVANCED ENVIRONMENT POSSIBLE THROUGH THE EFFECTIVE USE OF SURPLUS FUNDS. SOME OF OUR SURPLUS FUNDS HAVE BEEN USED TO FUND THE CONTINUING RENOVATION OR OUR EXISTING FACILITIES, INCLUDING INPATIENT UNITS AND OTHER CLINICAL AREAS. NEBH STRIVES TO FULLY SERVE THE COMMUNITY THROUGH PARTICIPATION IN GOVERNMENT SPONSORED HEALTHCARE PROGRAMS SUCH AS MEDICARE, MEDICAID, MASSHEALTH AND COMMONWEALTH CARE. NEBH ALSO SERVES AS A TEACHING HOSPITAL AFFILIATED WITH TUFTS UNIVERSITY MEDICAL SCHOOL AND MAINTAINS RESIDENCY PROGRAMS SPECIALIZING IN ORTHOPEDICS AND RADIOLOGY. COMMUNITY MEMBERS ALSO USE NEBH AS A CONDUIT FOR VOLUNTEERING AS EVIDENCED BY MORE THAN 50 VOLUNTEERS WHO ASSIST WITH PATIENT SERVICES AND ADMINISTRATIVE ROLES.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.