TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) ELEANOR CLAUS...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(2) HOWARD CROW JR...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(3) PHILIP MCLOUGHLIN...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(4) MICHAEL K LAUF...................................................................... PRESIDENT/CEO/TRUSTEE	55.0 ................. 5.0	X	X	0	1,726,957	238,606
(5) NATE RUDMAN MD...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(6) JOEL CROWELL...................................................................... TREAS/CLERK AS OF 5/16/TRUSTEE	2.0 ................. 2.0	X	X	0	0	0
(7) SUZANNE FAY GLYNN ESQ...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(8) PATRICK M FLYNN MD...................................................................... TRUSTEE	40.0 ................. 2.0	X		44,332	0	919
(9) DEWITT DAVENPORT...................................................................... VICE CHAIRMAN/TRUSTEE	2.0 ................. 2.0	X	X	0	0	0
(10) DIANE COLETTI...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(11) WILLIAM ZAMMER Jr...................................................................... CHAIRMAN/TRUSTEE	2.0 ................. 2.0	X	X	0	0	0
(12) SUMNER B TILTON JR...................................................................... TREASURER UNTIL 5/16 / TRUSTEE	2.0 ................. 2.0	X	X	0	0	0
(13) PAUL EVANS MD...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(14) JAMES MULCAHY MD...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(15) GARY VACON MD...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(16) ROBERT TALERMAN...................................................................... TRUSTEE AS OF 5/16	2.0 ................. 2.0	X		0	0	0
(17) ROBERT WILSTERMAN MD...................................................................... TRUSTEE AS OF 1/16	40.0 ................. 2.0	X		91,572	0	2,810

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) GROVER BAXLEY MD........................................................................ TRUSTEE UNTIL 1/16	40.0 .......................2.0	X					200,278	0	9,380
(19) ROBERT BIRMINGHAM........................................................................ TRUSTEE UNTIL 5/16	2.0 .......................2.0	X					0	0	0
(20) MICHAEL G JONES........................................................................ Sr VP Chief Legal OffICER	55.0 .......................5.0		X				0	406,684	78,218
(21) MICHAEL L CONNORS........................................................................ SENIOR VP FINANCE/CFO	55.0 .......................5.0		X				0	526,685	89,857
(22) DIANNE C KOLB........................................................................ President VNA	45.0 .......................5.0			X			0	267,984	61,715
(23) EMILY SCHORER........................................................................ SVP HUMAN RESOURCES	45.0 .......................5.0			X			0	313,078	56,834
(24) JEANNE FALLON........................................................................ SR VP & CIO	45.0 .......................5.0			X			0	306,361	69,235
(25) JEFFREY S DYKENS........................................................................ SEE SCHEDULE O	45.0 .......................5.0			X			0	292,218	63,044
(26) PATRICK KANE........................................................................ SVP OF MRKTG, COMMUN & DEVLP	45.0 .......................5.0			X			0	397,702	68,813
(27) ARTHUR MOMBOURQUETTE........................................................................ COO UNTIL 1/15	45.0 .......................5.0			X			0	458,522	10,775
(28) THERESA M AHERN........................................................................ SVP, STRAT, COMMUNITY/GOV REL.	45.0 .......................5.0			X			0	306,017	48,236
(29) VICTOR OLIVEIRA........................................................................ VP PATIENT SERVICES	45.0 .......................5.0			X			0	308,464	72,433
(30) JOHN LIPOMI........................................................................ SR VP MANAGED CARE UNT 12/15	45.0 .......................5.0			X			0	452,903	74,119
(31) DONALD GUADAGNOLI MD........................................................................ CMO CAPE COD HOSPITAL	45.0 .......................5.0			X			0	530,387	91,519
(32) KEVIN J MULROY........................................................................ See Sch O for title	45.0 .......................5.0			X			0	466,062	73,555
(33) CARTER HUNT........................................................................ SEE SCHEDULE O FOR TITLE	45.0 .......................5.0			X			0	200,307	59,015
(34) ALEXANDER HEARD MD........................................................................ CMO FALMOUTH HOSPITAL	45.0 .......................5.0			X			37,655	179,951	3,737
(35) CHRISTIAN BROWN........................................................................ SR VP MANAGED CARE AS OF 11/15	45.0 .......................5.0			X			0	320,333	76,339
(36) KEVIN RALPH........................................................................ SVP DEVELOPMENT	45.0 .......................5.0			X			0	302,145	47,865
(37) EMILY TIERNEY MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,724,614	0	41,609
(38) RICHARD B ZELMAN MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,410,820	0	47,724
(39) ACHILLE PAPAVASILIOU MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		968,348	0	64,724
(40) PAUL HOULE MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		856,626	0	64,724
(41) NICHOLAS COPPA MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		852,907	0	39,192
(42) MARY FRANCO........................................................................ FORMER SVP DEVELOPMENT	0.0 .......................0.0					X	0	119,475	1,525

(A) Name and business address	(B) Description of services	(C) Compensation
CAPE COD HEALTHCARE INC, 25 COMMUNICATION WAY HYANNIS,MA02601	PURCHASED SERVICES	52,647,895
CORE MEDICAL GROUP, 2 KEEWAYDIN DRIVE SALEM,NH03079	CONTRACT RN, PT, OT	586,232
QUALITY IN REAL TIME, 49S CASS STREET BATTLECREEK,MI49037	CODING REVIEW SVCS	439,340
DELTA HEALTH, 400 LAKEMOUNT PARK BOULEVARD ALTOONA,PA06602	MIS-SUPPORT	264,591
CARDIOCOM, EB 113 PO BOX 1691 MINNEAPOLIS,MN55480	TELEMEDICINE SVCS	225,780
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 11

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....	13,524,136	17,223,613	9,458,675	15,572,146	13,584,232	69,362,802
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......						0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
4	Total. Add lines 1 through 3	13,524,136	17,223,613	9,458,675	15,572,146	13,584,232	69,362,802
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..						1,610,927
6	Public support. Subtract line 5 from line 4.						67,751,875

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..	13,524,136	17,223,613	9,458,675	15,572,146	13,584,232	69,362,802
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	2,203,229	680,260	3,486,933	4,951,524	5,368,273	16,690,219
9	Net income from unrelated business activities, whether or not the business is regularly carried on..	814,019	187,290	1,059,076	1,000,152	798,057	3,858,594
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	2,261,728	2,163,050	2,189,718	2,271,023	2,353,977	11,239,496
11	Total support. Add lines 7 through 10.						101,151,111

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

3,703,439,578

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

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

66.981 %

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

69.034 %

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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

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

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

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

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

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

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

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

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

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

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1	0
2	Recoveries of prior-year distributions	2	0
3	Other gross income (see instructions)	3	0
4	Add lines 1 through 3	4	0
5	Depreciation and depletion	5	0
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6	0
7	Other expenses (see instructions)	7	0
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8	0

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a	0
b	Average monthly cash balances	1b	0
c	Fair market value of other non-exempt-use assets	1c	0
d	Total (add lines 1a, 1b, and 1c)	1d	0
e	Discount claimed for blockage or other factors (explain in detail in Part VI): 0
2	Acquisition indebtedness applicable to non-exempt use assets	2	0
3	Subtract line 2 from line 1d	3	0
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4	0
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5	0
6	Multiply line 5 by .035	6	0
7	Recoveries of prior-year distributions	7	0
8	Minimum Asset Amount (add line 7 to line 6)	8	0

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1	0
2	Enter 85% of line 1	2	0
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3	0
4	Enter greater of line 2 or line 3	4	0
5	Income tax imposed in prior year	5	0
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6	0

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

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

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

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes		0
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity		0
3 Administrative expenses paid to accomplish exempt purposes of supported organizations		0
4 Amounts paid to acquire exempt-use assets		0
5 Qualified set-aside amounts (prior IRS approval required)		0
6 Other distributions (describe in Part VI). See instructions		0
7Total annual distributions. Add lines 1 through 6.		0
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions		0
9 Distributable amount for 2015 from Section C, line 6		0
10 Line 8 amount divided by Line 9 amount		0 %

Section E - Distribution Allocations (see instructions)	(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6			0
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)		0
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......0
e From 2014.......0
fTotal of lines 3a through e	0
g Applied to underdistributions of prior years		0
h Applied to 2015 distributable amount			0
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.	0
4Distributions for 2015 from Section D, line 7:
$ 0
a Applied to underdistributions of prior years		0
b Applied to 2015 distributable amount			0
c Remainder. Subtract lines 4a and 4b from 4.	0
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)		0
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)			0
7 Excess distributions carryover to 2016. Add lines 3j and 4c.	0
8 Breakdown of line 7:
a
b
c Excess from 2013.......0
d From 2014.......0
e From 2015.......0

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization CAPE COD HEALTHCARE INC & AFFILIATES

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization CAPE COD HEALTHCARE INC & AFFILIATES		Employer identification number 90-0054984

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization CAPE COD HEALTHCARE INC & AFFILIATES			Employer identification number 90-0054984
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

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

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

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

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

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

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

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

Yes

107,025

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

107,025

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

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

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1I	Cape Cod Hospital and Falmouth Hospital Association, Inc. pay membership dues to the Massachusetts Hospital Association which engages in lobbying purposes as defined by Medicare. Per the MHA advisory, 32.43% of dues paid should be allocated to lobbying activity. For FY16 for Cape Cod Hospital and Falmouth Hospital Association, Inc. combined, the lobbying portion equals $ 107,025.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

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

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

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

1a	Beginning of year balance ....	37,495,620	38,872,003	36,060,986	35,475,473	32,638,639
b	Contributions ...	57,261	1,523,222	1,925,651	60,508	435,091
c	Net investment earnings, gains, and losses	2,000,285	-2,217,064	1,613,999	1,238,094	3,092,757
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	744,077	682,541	728,633	713,089	691,014
f	Administrative expenses ....
g	End of year balance ......	38,809,089	37,495,620	38,872,003	36,060,986	35,475,473

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

82.350 %

Temporarily restricted endowment SchDMd Bullet

17.650 %

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

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

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

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

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	23,303,713		23,303,713
b	Buildings	386,317,293	168,293,309	218,023,984
c	Leasehold improvements	4,915,703	2,473,914	2,441,789
d	Equipment ...	201,826,031	155,444,164	46,381,867
e	Other ...	4,062,037	1,520,696	2,541,341
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				292,692,694

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other (A) LONG-TERM INVESTMENTS	334,413,841	F
(B) AGREEMENT / INDENTURE	9,986,822	F
(C) TEMP RESTRICTED INVESTMENTS	23,909,957	F
(D) PERM RESTRICTED INVESTMENTS	31,900,830	F
(E) SHORT TERM INVESTMENTS - FDN	768,038	F
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	400,979,488

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
DUE TO AFFILIATES	17,308,147
EST. SETTLEMENTS W 3RD PARTIES	20,661,410
ABANDONED PROPERTY	69,069
OTHER CURRENT LIABILITIES	462,222
INTEREST RATE SWAPS	2,309,121
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	40,809,969
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PART V, LINE 4	THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO FURTHER THE HEALTHCARE MISSION OF CAPE COD HEALTHCARE INC., AND ITS AFFILIATES.
SCHEDULE D, PART X, LINE 2	THE ORGANIZATION DOES NOT HAVE A FIN 48 FOOTNOTE AS ANY UNCERTAIN TAX POSITIONS WERE DEEMED IMMATERIAL.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions. Right pointing arrow large image

Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers.Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	Central America and the Caribbean	1	0	Program Services	CAPTIVE INSURANCE	6,164,733
















3a	Sub-total .....	1	0			6,164,733
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	1	0			6,164,733

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015

Schedule F (Form 990) 2015

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(a)(c) Region	(b)(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2015

Schedule F (Form 990) 2015Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2015

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2015

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation
SCHEDULE F, PART I, COLUMN F	EXPENSES ARE CODED IN THE GENERAL LEDGER TO THE CAPTIVE INSURANCE COMPANY.

Schedule F (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)		(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
			Yes	No
	Borns GroupVDM	DIRECT MAIL Solicitatio		No	275,292	120,968	154,324









Total . . . . . . . . . . . . . . . . . . . .					275,292	120,968	154,324

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

CT, FL, ME, MA, SC

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2015

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 GALA EVENT (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	359,991	359,991
2	Less: Contributions . . . .	92,441	92,441
3	Gross income (line 1 minus line 2) . . . . . .	267,550	267,550

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	2,625	2,625
7	Food and beverages . . .	50,158	50,158
8	Entertainment . . . .	7,500	7,500
9	Other direct expenses . . .	100,152	100,152
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		160,435
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		107,115

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .	100,152	100,152

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2015

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	8,724,617	3,664,469	5,060,148	0.650 %
b	Medicaid (from Worksheet 3, column a) . . . . .	93,588,894	76,642,185	16,946,709	2.180 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	9,261,877	7,402,574	1,859,303	0.240 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	111,575,388	87,709,228	23,866,160	3.070 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	2,422,471		2,422,471	0.310 %
f	Health professions education (from Worksheet 5) . . .	1,668,101	114,244	1,553,857	0.200 %
g	Subsidized health services (from Worksheet 6) . . . .	203,145,714	186,241,020	16,904,694	2.180 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	4,481,085		4,481,085	0.580 %
j	Total. Other Benefits . .	211,717,371	186,355,264	25,362,107	3.270 %
k	Total. Add lines 7d and 7j .	323,292,759	274,064,492	49,228,267	6.340 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

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

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	28,368	28,368
7	Community health improvement advocacy
8	Workforce development	861,711	861,711	0.110 %
9	Other
10	Total	890,079	890,079	0.110 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

7,491,768

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

4,121,932

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

Section B. Medicare

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

263,277,213

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

262,002,490

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

1,274,723

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)					Facility reporting group
1	CAPE COD HOSPITAL 27 PARK STREET HYANNIS,MA02601 SEE PART V, SECTION C 2135	X	X	X	A
2	FALMOUTH HOSPITAL ASSOCIATION INC 100 TER HEUN DRIVE FALMOUTH,MA02540 SEE PART V, SECTION C 2289	X	X	X	A

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	A
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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

Yes

6 a

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url): SEE PART V, SECTION C

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

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

Yes

If "Yes" (list url): SEE PART V, SECTION C

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

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

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

SEE PART V, SECTION C

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

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

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

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

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

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

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

Other (describe in Section C)

Billing and Collections

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

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

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION A	WEBSITES PART V, SECTION A, LINE 1 - CAPE COD HOSPITAL WWW.CAPECODHEALTH.ORG/LOCATIONS/CAPE-COD-HOSPITAL PART V, SECTION A, LINE 2 - FALMOUTH HOSPITAL WWW.CAPECODHEALTH.ORG/LOCATIONS/FALMOUTH-HOSPITAL PART V, SECTION B, LINE 5 Over 20 data sources were utilized to collect Barnstable County and town-level health statistics on disease incidence and prevalence, hospital utilization, morbidity and mortality, barriers to accessing care, and behavioral risk factors. Regional statistics were analyzed and compared to state and national statistics to identify where demographic and health disparities exist. Once collected, statistical data was vetted and augmented with community input. Cape Cod Hospital and Falmouth Hospital selected John Snow, Inc. (JSI) a public health research firm, to conduct primary research including health data research, key informant interviews and facilitation of community and provider forums. JSI interviewed over 25 regional leaders representing the broad interests of the community and who offer information or expertise relative to the significant health needs of vulnerable populations. They included such entities as municipal public health departments, human service agencies, schools and law enforcement agencies, federally qualified health centers, community organizations serving low-income, vulnerable and medically underserved populations, elected officials, and hospital clinicians and administrators. Five community input forums were held across Barnstable County. More than 140 individuals and 90 community organizations attended. These forums provided an opportunity to present statistical health findings to participants and identify gaps in services. Additionally, the forums facilitated dialogue on issues not identified and target populations most impacted by health issues. A post-forum survey was provided to participants to identify and rank health priorities in the region. Feedback and input from the key informant interviews and from attendees of the community and provider forums was used to inform the selection and prioritization of significant health needs. The following organizations participated in the community input activities throughout the phases of the project: Public health experts, health care providers and health service organizations AIDS Support Group of Cape Cod Alzheimers Family Support Center of Cape Cod Arbor Counseling Services Barnstable County Department of Health and Environment Barnstable County Department of Human Services Barnstable County Public Nursing Division CCHC Emergency Services CCHC Centers for Behavioral Health Cape & Islands Emergency Medical Services System Caron Treatment Center Community Health Center of Cape Cod Duffy Health Center Emerald Physicians Falmouth Human Services Gosnold on Cape Cod Harbor Community Health Center-Hyannis Hope Health HOPE Dementia & Alzheimers Services of Cape Cod Mashpee Wampanoag Health Service Unit Outer Cape Health Services Spaulding Rehabilitation Hospital Cape Cod Specialty Network for the Uninsured Town of Brewster Health Department Town of Falmouth Health Department Town of Mashpee Human Services Vinfen Visiting Nurse Association of Cape Cod Organizations serving low-income, medically underserved or vulnerable populations: Barnstable Public School System Boys & Girls Club of Cape Cod Cape Cod Center for Women Cape Cod Child Development Cape Cod Council of Churches Cape Cod WIC Cape Cod Neighborhood Support Coalition Child and Family Services Coalition for Children Community Action Committee of Cape Cod & the Islands Childrens Cove Community Development Partnership Elder Services of Cape Cod & the Islands Falmouth Public School System Falmouth Service Center Falmouth Together We Can Falmouth Volunteers in Public Schools The Family Pantry of Cape Cod Glenna Kohl Fund for Hope Health Imperatives Healthy Living Cape Cod Helping Our Women Homeless Prevention Council Housing Assistance Corporation Independence House Justice Resource Institute Lyme Awareness of Cape Cod Outer Cape Women Infants and Children (WIC) Mother and Infant Recovery Network National Alliance on Mental Illness Cape Cod Samaritans on Cape Cod and the Islands Sandpiper Nursery School Sandwich Public School System SHINE (Serving Health Information Needs of Everyone) Sight Loss Services Town of Falmouth Council on Aging Town of Mashpee Council on Aging Town of Provincetown Council on Aging Town of Sandwich Council on Aging Town of Truro Council on Aging WE CAN YMCA of Cape Cod County, town, or municipal entities and regional task forces: Cape & Islands United Way Cape Cod Community College Cape Cod District Attorneys Office Cape Cod Foundation Cape & Islands Suicide Prevention Coalition Yarmouth Police Department MA Department of Mental Health MA Department of Public Health Mashpee Wampanoag Tribe Health Services Community Health Network Area 27 Behavioral Health Provider Coalition of Cape Cod & the Islands Barnstable County Regional Substance Abuse Council Barnstable Town Council Substance Use in Pregnancy Task Force
PART V, SECTION B, LINE 6(A)	Cape Cod Hospital and Falmouth Hospital jointly conducted the most recent Community Health Needs Assessment Report. PART V, SECTION B, LINE 7(A) http://www.capecodhealth.org/app/files/public/3927/community-health-needs- ASSESSMENT-2017-2019.PDF PART V, SECTION B, LINE 7(B) http://www.bchumanservices.net/publications-data/related-local-publica TIONS-DATA/ PART V, SECTION B, LINE 10(A) http://www.capecodhealth.org/app/files/public/3927/community-health-needs- ASSESSMENT-2017-2019.PDF PART V, SECTION B, LINE 11 The significant health needs identified in the CHNA include chronic and infectious disease, behavioral health, access to care and disease prevention and wellness. Cape Cod Hospital (CCH) and Falmouth Hospital (FH) will address these specific issues through a comprehensive set of implementation strategies that include hospital-based programs, collaborative efforts with numerous regional health partners and providing grants to community based organizations with initiatives that align with community health improvement strategies. Three specific issues identified through the assessment fall outside of the core competencies of the hospitals and were not included in the CCH and FH implementation strategies. The issues are transportation, housing and homelessness, and employment. These issues are long-standing regional challenges and were identified in the previous CHNA as issues outside the scope of significant health needs that the hospitals can reasonably address. Residents impacted by these issues will be served by the hospitals since it is their mission to serve all without regard to sex, race, creed, residence, national origin, sexual orientation, or ability to pay. Cape Cod Hospital and Falmouth Hospital recognize that there are regional entities with the core competencies, knowledge, staff and funding sources to specifically address the issues of transportation, housing and homelessness, and employment. The hospitals will collaborate on activities that are led by the appropriate agencies.
PART V, SECTION B, LINE 13(B)	IN SOME CASES, THE MASSACHUSETTS HEALTHCONNECTOR CALCULATOR OR MODIFIED ADJUSTED GROSS INCOME IS USED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. PART V, SECTION B, LINE 13(H) STATE REGULATIONS PART V, SECTION B, LINE 16(A) https://www.capecodhealth.org/app/files/public/3908/fap-policy-cchc-8-29-2 016.PDF PART V, SECTION B, LINE 16(B) HTTPS://WWW.CAPECODHEALTH.ORG/PATIENTS-VISITORS PART V, SECTION B, LINE 16(C) https://www.capecodhealth.org/app/files/public/3910/plain-language-summary -9-15-2016.PDF
PART V, SECTION B, LINE 22(d)	THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IS 110% OF THE MEDICARE FEE SCHEDULE. THIS APPLIES TO BOTH CAPE COD HOSPITAL AND FALMOUTH HOSPITAL.

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?70
Name and address		Type of Facility (describe)
1	Visiting Nurse Association of Cape Cod 255 Independence Drive Hyannis,MA02601	home health
2	CAPE COD HEALTHCARE CORP 88 LEWIS BAY RD HYANNIS,MA02601	ADMINISTRATIVE
3	Dermatology and Skin Surgery of Cape Cod 35 Wilkens Lane Suite A Hyannis,MA02601	medical group practice
4	FONTAINE MEDICAL CENTER 525 LONG POND DRIVE HARWICH,MA02645	Medical Group Practice
5	BOURNE HEALTH CENTER 1 Trowbridge Road BOURNE,MA02532	medical group practice
6	Bramblebush Medical Group 21 Bramblebush Park FALMOUTH,MA02540	medical group practice
7	Seaside Pediatrics 150 Ansel Hallet Road West Yarmouth,MA02673	medical group practice
8	Manning Jr William J MD 700 Attucks Lane Suite 1A HYANNIS,MA02601	medical group practice
9	Fontaine OUTPATIENT CENTER 525 Long Pond Drive Harwich,MA02645	medical group practice
10	Guo X Y David MD PhD 90 TER HEUN DRIVE SUITE 302 FALMOUTH,MA02540	Medical Group Practice
11	BAYSIDE INTERNAL MEDICINE 2 JAN SEBASTIAN WAY SANDWICH,MA02563	Medical Group Practice
12	Shapiro Gary MD 700 ATTUCKS LANE SUITE 1C Hyannis,MA02601	Medical Group Practice
13	THEODORE A CALIANOS II MD 5 INDUSTRIAL DRIVE SUITE 107 MASHPEE,MA02649	MEDICAL GROUP PRACTICE
14	VASCULAR AND VEIN CENTER OF CAPE COD 90 TER HEUN DRIVE SUITE 303 FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
15	YARMOUTH INTERNISTS 257 STATION AVENUE SOUTH YARMOUTH,MA02664	MEDICAL GROUP PRACTICE
16	CHATHAM MEDICAL GROUP 1629 MAIN STREET CHATHAM,MA02633	MEDICAL GROUP PRACTICE
17	ENDOCRINE CENTER OF CAPE CODE 40 QUINLAN WAY 2ND FL SUITE 206 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
18	MALAQUIAS STEPHEN MD 257 STATION AVENUE SOUTH YARMOUTH,MA02664	MEDICAL GROUP PRACTICE
19	FAL SPECIALTY CARE PRACTICE 90 TER HEUN DRIVE SUITE 302 FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
20	MACC NEUROLOGY - CCHC 46 NORTH STREET SUITE 7 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
21	CAPE COD PEDIATRICS 55 ROUTE 130 FORESTDALE,MA02644	MEDICAL GROUP PRACTICE
22	NAUSET FAMILY PRACTICE 81 OLD COLONY WAY STE D ORLEANS,MA02653	MEDICAL GROUP PRACTICE
23	JAMES O'CONNOR MD PRACTICE 107 COUNTY ROAD NORTH FALMOUTH,MA02556	MEDICAL GROUP PRACTICE
24	DEVIN MCMANUS MEDICAL PRACTICE 10 BRAMBLEBUSH DRIVE FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
25	BAXLEY PRACTICE 51A OCEAN AVENUE CATAUMET,MA02534	MEDICAL GROUP PRACTICE
26	ARTHUR CRAGO MD PRACTICE 315 PALMER AVENUE FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
27	CAPE HEALTH INSURANCE COMPANY - FOREIGN C/O CCHC 25 COMMUNICATION WAY HYANNIS,MA02601	ADMINISTRATIVE
28	HEALTHCARE FOUNDATION 0NE FINANCIAL PLACE 297 NORTH STRE HYANNIS,MA02601	ADMINISTRATIVE
29	HEALTHCARE FOUNDATION HOMEPORT 348C GIFFORD STREET FALMOUTH,MA02540	ADMINISTRATIVE
30	JML CARE CENTER 184 TER HEUN DRIVE FALMOUTH,MA02540	SKILLED NUR & REHAB
31	Cape & Islands Health Services II 14 YELLOW BRICK ROAD HYANNIS,MA02601	COLLECTION CENTER
32	CAPE & ISLANDS HEALTH SERVICES II 5 INDUSTRIAL DRIVE SUITE 102 MASHPEE,MA02649	COLLECTION CENTER
33	CAPE & ISLANDS HEALTH SERVICES II 200 JONES ROAD FALMOUTH,MA02540	COLLECTION CENTER
34	CAPE & ISLANDS HEALTH SERVICES II 525 LONG POND DRIVE HARWICH,MA02645	COLLECTION CENTER
35	CAPE & ISLANDS HEALTH SERVICES II 81 OLD COLONY WAY ORLEANS,MA02653	COLLECTION CENTER
36	CAPE & ISLANDS HEALTH SERVICES II 2 JAN SEBASTIAN WAY ROUTE 130 SANDWICH,MA02653	COLLECTION CENTER
37	CAPE & ISLANDS HEALTH SERVICES II 860 ROUTE 134 UNIT 2 SOUTH DENNIS,MA02660	COLLECTION CENTER
38	CAPE & ISLANDS HEALTH SERVICES II 1 TROWBRIDGE ROAD BOURNE,MA02532	COLLECTION CENTER
39	CAPE & ISLANDS HEALTH SERVICES II 68B ROUTE 6A SANDWICH,MA02563	COLLECTION CENTER
40	CAPE & ISLANDS HEALTH SERVICES II 1629 MAIN STREET CHATHAM,MA02633	COLLECTION CENTER
41	CAPE & ISLANDS HEALTH SERVICES II 27 PARK STREET HYANNIS,MA02601	COLLECTION CENTER
42	CAPE & ISLANDS HEALTH SERVICES II 30 SHANKPAINTER ROAD PROVINCETOWN,MA02657	COLLECTION CENTER
43	HERITAGE AT FALMOUTH 140 TER HEUN DRIVE FALMOUTH,MA02540	ASSISTED LIVING
44	CAPE COD HUMAN SERVICES 460 WEST MAIN STREET HYANNIS,MA02601	OUTPATIENT CLINIC
45	CAPE COD HUMAN SERVICES 525 LONG POND DRIVE HARWICH,MA02645	OUTPATIENT CLINIC
46	CAPE COD MEDICAL OFFICE BUILDING INC 20 GLEASON STREET HYANNIS,MA02601	ADMINISTRATIVE
47	ORLEANS MEDICAL CENTER 204 MAIN STREET ORLEANS,MA02653	MEDICAL GROUP PRACTICE
48	CAPE COD DERMATOLOGY 134 ANSEL HALLETT ROAD W YARMOUTH,MA02673	MEDICAL GROUP PRACTICE
49	CAPE COD RHEUMATOLOGY CENTER 40 QUINLAN WAY 2ND FL SUITE 206 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
50	CCHC CARDIOVASCULAR CENTER 25 MAIN STREET HYANNIS,MA02601	MEDICAL GROUP PRACTICE
51	ZIAD FARAH MD-FONTAINE MEDICAL CENTER 525 LONG POND DRIVE HARWICH,MA02645	MEDICAL GROUP PRACTICE
52	FONTAINE URGENT CARE CENTER 525 LONG POND DRIVE HARWICH,MA02645	MEDICAL GROUP PRACTICE
53	NEUROLOGY CENTER OF CAPE COD 40 QUINLAN WAY 2ND FL SUITE 206 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
54	PARK STREET PRIMARY CARE 62 PARK STREET HYANNIS,MA02601	MEDICAL GROUP PRACTICE
55	SANDWICH MEDICAL GROUP STONEHMAN OUTPATIENT2 JAN SEBASTIA SANDWICH,MA02563	MEDICAL GROUP PRACTICE
56	SANDWICH PRIMARY CARE 441 RT 130 SANDWICH,MA02563	MEDICAL GROUP PRACTICE
57	UPPER CAPE ORTHOPEDICS 26 EDGERTON DRIVE SUITE C NORTH FALMOUTH,MA02556	MEDICAL GROUP PRACTICE
58	MICHAEL BARNETT MD PRACTICE 348 GIFFORD STREET FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
59	ALL CAPE UROLOGY PRACTICE 20 GLEASON STREET HYANNIS,MA02601	MEDICAL GROUP PRACTICE
60	NEUROSURGEONS OF CAPE COD 46 NORTH STREET SUITE 4 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
61	MDVIP YARMOUTH 257 STATION AVE SOUTH YARMOUTH,MA02664	MEDICAL GROUP PRACTICE
62	MASHPEE SURGICAL CENTER 160 FALMOUTH ROAD MASHPEE,MA02649	MEDICAL GROUP PRACTICE
63	CAPE COD HEALTHCARE WOUND CARE 905 ATTUCKS LANE HYANNIS,MA02601	MEDICAL GROUP PRACTICE
64	CAPE COD OBSTETRICS AND GYNECOLOGY 90 TER HEUN DRIVE FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
65	SOUTHEASTERN SURGICAL ASSOCIATES 100 CAMP STREET HYANNIS,MA02601	MEDICAL GROUP PRACTICE
66	FALMOUTH URGENT CARE 273 TEATICKET HIGHWAY FALMOUTH,MA02536	MEDICAL GROUP PRACTICE
67	HYANNIS URGENT CARE 1220 IYANNOUGH ROAD HYANNIS,MA02601	MEDICAL GROUP PRACTICE
68	UPPER CAPE EAR NOSE THROAT 200 A JONES ROAD FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
69	ORTHOPEDIC SPECIALISTS 5 BRAMBLEBUSH DRIVE FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
70	PATIENT SERVICE CENTER 35 WILKENS LANE BARNSTABLE,MA02601	MEDICAL GROUP PRACTICE

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 3C	N/A PART I, LINE 6A N/A
PART I, LINE 7, COLUMN F	THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F WAS $7,491,768. The amounts reported in the table were calculated using the ratio of patient care cost to charges and by following the Form 990, Schedule H instructions. The total percentage of charity care and certain other community benefits at cost in the table was calculated on a group return basis as required by the Form 990 instructions, and not on a hospital-only basis.
PART II, LINE 6	Cape Cod Healthcare clinical, community benefits and support staff participated in a variety of coalition building activities within the service area to address and improve care related to womens health, behavioral health, chronic disease self management and substance use disorders. Coalition activities ranged from new program development to reach medically underserved populations to the expansion of existing activities to strengthen collaboration between regional health care providers and human service agencies. PART II, LINE 8 WORKFORCE DEVELOPMENT Cape Cod Healthcare's Physician Recruitment program strives to identify areas of unmet need and improve access to primary and specialty care for vulnerable populations, especially those over 65 with public health insurance coverage. Through rigorous efforts highly qualified physicians and physician extenders are recruited and retained to meet the health care needs of residents of Cape Cod. PART III, LINES 2-3 The organization is reporting $4,121,932 of bad debt expense that meets its financial assistance policy. This amount is related to bad debt from both hospitals during FY16 of uninsured patients who were seen in the ER and received medically necessary services. Cape Cod Healthcare receives payments for services rendered from federal and state agencies (under the Medicare and Medicaid programs), managed care payors, commercial insurance companies, and patients. Patient accounts receivable are reported net of contractual allowances and reserves for denials, uncompensated care, and doubtful accounts. The level of reserves is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in Federal and state governmental and private employer health care coverage and other collection indicators. IF A PATIENT IS INELIGIBLE FOR CHARITY CARE BECAUSE HIS OR HER INCOME EXCEEDS THE ELIGIBILITY GUIDELINES, ANY UNCOLLECTIBLE ACCOUNTS RECEIVABLE BALANCE IS WRITTEN OFF TO BAD DEBT AS REPORTED IN PART III, LINE 2.
PART III, LINE 4	REFER TO PAGE 15 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR FOOTNOTES RELATED TO ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BAD DEBT.
PART III, LINE 9(B)	Hospital Financial Assistance Programs Patients who are eligible for enrollment in a state public assistance program, like the Massachusetts MassHealth or Health Safety Net programs, 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 payment amount will be set at the hospital, when requested by the patient and based on an internal review of each patients 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 patients documented financial situation and the patients 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. Populations Exempt from Collection Activities: There are several situations where a patient can be exempted from further billing and collection procedures once the determination is made that the patient is exempt pursuant to State regulations: a) Patients enrolled in a public health insurance program, including but not limited to, MassHealth, Emergency Aid to the Elderly, Disabled and Children, Healthy Start, Childrens Medical Security Plan, or designated a "Low Income Patient" by the Office of Medicaid, subject to the following exceptions: (i) The hospital may seek to bill and collect the co-payments and deductibles that are set forth by each specific program. (ii) The hospital may also initiate billing and collection efforts 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 the signed application) the hospital shall cease its billing and collection activities. (iii) The hospital will not continue collection action on any Low Income Patient for services rendered by the hospital during the period for which he or she has been determined to be a Low Income Patient by the Office of Medicaid. However, the hospital may continue collection action on a 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 States Virtual Gateway or Recipient Eligibility Verification System. Once a Low Income Patient is determined eligible and enrolled in the Health Safety Net, MassHealth, or certain Commonwealth Care programs, the hospital will cease its billing and collection efforts for services provided prior to the beginning of their eligibility. (iv) 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 patients prior written consent to be billed for the service.
PART VI, LINE 2	NEEDS ASSESSMENT: THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT (CHNA REPORT) AND IMPLEMENTATION PLAN WAS RELEASED AND MADE WIDELY AVAILABLE TO THE PUBLIC ON SEPTEMBER 30, 2016. THE GOALS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROJECT ARE TO MONITOR REGIONAL HEALTH DATA, ENGAGE HOSPITAL STAKEHOLDERS, PROMOTE PARTNERSHIPS BETWEEN THE HOSPITALS AND COMMUNITY ORGANIZATIONS AND DEVELOP MULTI-YEAR IMPLEMENTATION STRATEGIES TO GUIDE HOSPITAL INITIATIVES TO IMPROVE THE HEALTH OF BARNSTABLE COUNTY RESIDENTS. THE METHODOLOGY FOR CONDUCTING THE ASSESSMENT INCLUDED THE COLLECTION AND ANALYSIS OF PRIMARY AND SECONDARY HEALTH DATA, GATHERING SIGNIFICANT INPUT FROM THE COMMUNITY, AND THE IDENTIFICATION AND PRIORITIZATION OF KEY HEALTH NEEDS FOR THE REGION. OVER 20 DATA SOURCES WERE UTILIZED TO COLLECT BARNSTABLE COUNTY AND TOWN-LEVEL HEALTH STATISTICS ON DISEASE INCIDENCE AND PREVALENCE, HOSPITAL UTILIZATION, MORBIDITY AND MORTALITY, BARRIERS TO ACCESSING CARE, AND BEHAVIORAL RISK FACTORS. REGIONAL STATISTICS WERE ANALYZED AND COMPARED TO STATE AND NATIONAL STATISTICS TO IDENTIFY WHERE DEMOGRAPHIC AND HEALTH DISPARITIES EXIST. ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS REPRESENTING LOW-INCOME, MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS PROVIDED CRITICAL INSIGHT AND FEEDBACK ON THE REGIONAL HEALTH NEEDS THROUGH KEY INFORMATION INTERVIEWS AND COMMUNITY INPUT FORUMS. THROUGH THIS COLLECTION OF DATA AND COMMUNITY INPUT THE SIGNIFICANT HEALTH NEEDS OF BARNSTABLE COUNTY RESIDENTS WERE DISTINGUISHED AND PRIORITIZED BASED ON THE FREQUENCY, URGENCY, SCOPE, SEVERITY AND MAGNITUDE OF THE IDENTIFIED ISSUES. THE SIGNIFICANT HEALTH NEEDS AND ASSOCIATED TARGET POPULATIONS IDENTIFIED THROUGH THE CHNA REPORT WILL SERVE AS THE FOUNDATION FOR COMMUNITY BENEFITS AND HOSPITAL PLANNING SPANNING FISCAL YEARS 2017-2019. THE FOLLOWING SOURCES WERE UTILIZED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTS: - CAPE COD HOSPITAL AND FALMOUTH HOSPITAL UTILIZATION DATA - BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES: ANALYSIS OF SUBSTANCE ABUSE ON CAPE COD, A BASELINE ASSESSMENT, BARNSTABLE COUNTY BEHAVIORAL HEALTH WEB PORTAL, BARNSTABLE COUNTY PUBLIC HEALTH AND WELLNESS WEB PORTAL - CAPE COD FOUNDATION CONNECT CAPE COD - UNIVERSITY OF MASSACHUSETTS (UMASS) DONAHUE INSTITUTE LONG-TERM PROJECTIONS FOR MASSACHUSETTS REGIONAL AND MUNICIPALITIES - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH: MASSACHUSETTS COMMUNITY HEALTH INFORMATION PROFILE (MASS CHIP), MASSACHUSETTS BEHAVIORAL HEALTH RISK FACTOR SURVEILLANCE SYSTEM - US CENSUS BUREAU: US CENSUS 2010, AMERICAN COMMUNITY SURVEY ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL SELECTED JOHN SNOW, INC. (JSI) A PUBLIC HEALTH RESEARCH FIRM, TO CONDUCT PRIMARY RESEARCH INCLUDING HEALTH DATA RESEARCH, KEY INFORMANT INTERVIEWS AND FACILITATION OF COMMUNITY AND PROVIDER FORUMS. JSI INTERVIEWED OVER 25 REGIONAL LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY AND WHO OFFER INFORMATION OR EXPERTISE RELATIVE TO THE SIGNIFICANT HEALTH NEEDS OF VULNERABLE POPULATIONS. THEY INCLUDED SUCH ENTITIES AS MUNICIPAL PUBLIC HEALTH DEPARTMENTS, HUMAN SERVICE AGENCIES, SCHOOLS AND LAW ENFORCEMENT AGENCIES, FEDERALLY QUALIFIED HEALTH CENTERS, COMMUNITY ORGANIZATIONS SERVING LOW-INCOME, VULNERABLE AND MEDICALLY UNDERSERVED POPULATIONS, ELECTED OFFICIALS, AND HOSPITAL CLINICIANS AND ADMINISTRATORS. FIVE COMMUNITY INPUT FORUMS WERE HELD ACROSS BARNSTABLE COUNTY. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS ATTENDED. THESE FORUMS PROVIDED AN OPPORTUNITY TO PRESENT STATISTICAL HEALTH FINDINGS TO PARTICIPANTS AND IDENTIFY GAPS IN SERVICES. ADDITIONALLY, THE FORUMS FACILITATED DIALOGUE ON ISSUES NOT IDENTIFIED AND TARGET POPULATIONS MOST IMPACTED BY HEALTH ISSUES. A POST-FORUM SURVEY WAS PROVIDED TO PARTICIPANTS TO IDENTIFY AND RANK HEALTH PRIORITIES IN THE REGION. FEEDBACK AND INPUT FROM THE KEY INFORMANT INTERVIEWS AND FROM ATTENDEES OF THE COMMUNITY AND PROVIDER FORUMS WAS USED TO INFORM THE SELECTION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: 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 THEIR UNPAID HOSPITAL BILLS. IN ORDER TO ASSIST UNINSURED AND UNDERINSURED PATIENTS IN FINDING AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES POSTED THROUGHOUT THE HOSPITAL. THE GOAL OF THESE NOTICES IS TO INFORM PATIENTS THAT THEY MAY BE ELIGIBLE TO APPLY FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM, SUCH AS, BUT NOT LIMITED TO, MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET. THE HOSPITAL WILL PROVIDE, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE DESIGNATED A LOW INCOME PATIENT UNDER EITHER THE STATE HEALTH SAFETY NET PROGRAM OR THROUGH THE HOSPITAL'S OWN INTERNAL CHARITY CARE PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT PAYMENT PLANS THAT MAY BE AVAILABLE TO HIM OR HER BASED ON THE SIZE OF HIS OR HER FAMILY AND FAMILY INCOME.
PART VI, LINE 4	DEMOGRAPHICS OF THE SERVICE AREA CAPE COD HEALTHCARE IS THE COMMUNITY SAFETY-NET PROVIDER OF HEALTH CARE SERVICES FOR THE YEAR-ROUND RESIDENTS AND MILLIONS OF ANNUAL VISITORS TO BARNSTABLE COUNTY, ALSO KNOWN AS "CAPE COD." CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, THE ONLY TWO ACUTE-CARE, NON-PROFIT HOSPITALS IN THE REGION, TOGETHER SHARE THE 15 TOWNS OF BARNSTABLE COUNTY AS THEIR PRIMARY SERVICE AREA. THE UPPER CAPE REGION INCLUDES THE MASHPEE WAMPANOAG TRIBAL REGION. CAPE COD HOSPITAL, LOCATED IN HYANNIS, MA, IS A 259-BED ACUTE-CARE, NON-PROFIT HOSPITAL. FALMOUTH HOSPITAL, LOCATED IN FALMOUTH, MA, IS A 95-BED ACUTE-CARE, NON-PROFIT HOSPITAL. BARNSTABLE COUNTY IS A GEOGRAPHICALLY ISOLATED REGION LOCATED ON THE EASTERN SEABOARD OF MASSACHUSETTS. THE NARROW PENINSULA SPANS OVER 70 MILES IN LENGTH AND HOSTS A YEAR-ROUND POPULATION OF 215,449 RESIDENTS. BARNSTABLE COUNTY CONSISTS OF 15 TOWNS THAT VARY IN YEAR-ROUND POPULATION SIZE FROM ABOUT 45,000 RESIDENTS (BARNSTABLE) TO SLIGHTLY MORE THAN 1,700 RESIDENTS (TRURO). IN ADDITION TO SERVING YEAR-ROUND RESIDENTS, THE REGIONAL COMMUNITY INFRASTRUCTURE, INCLUDING CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, MUST MEET THE DEMANDS OF A SIGNIFICANT INFLUX OF SEASONAL RESIDENTS AND VISITORS EACH YEAR. THE CAPE COD COMMISSION PRODUCED ESTIMATES, USING SURVEY DATA FROM SECOND HOMEOWNERS TO INDICATE THAT THE POPULATION OF SUMMER RESIDENTS ON CAPE COD, WHEN AVERAGED OVER A FULL YEAR, IS EQUIVALENT TO AN ADDITIONAL 68,856 FULL-TIME RESIDENTS. THIS COUPLED WITH DAY VISITORS AND SHORT TERM TRAVELER VOLUME RESULTS IN AN ESTIMATED 7 MILLION VISITORS AND RESIDENTS ON CAPE COD IN A GIVEN SUMMER SEASON. THIS SEASONAL POPULATION EXPANSION AND CONTRACTION CREATES UNIQUE CHALLENGES FOR THE CAPES HEALTH CARE SYSTEM, TRANSPORTATION NETWORK, WORKFORCE, BUSINESS COMMUNITY, AND HOUSING MARKET. POPULATION TRENDS AND AGE DEMOGRAPHIC ANALYSIS REVEALS TWO STRIKING TRENDS THAT WILL IMPACT BARNSTABLE COUNTY IN THE NEAR FUTURE. CURRENT DATA AND FUTURE DEMOGRAPHIC PREDICTIONS FOR THE REGION DEMONSTRATE THAT BARNSTABLE COUNTYS OVERALL POPULATION IS DECLINING AND INCREASING IN AGE. ACCORDING TO THE LONG-TERM POPULATION PROJECTIONS FOR MASSACHUSETTS REGIONS AND MUNICIPALITIES, A PUBLICATION BY THE UMASS DONAHUE INSTITUTE, ALL REGIONS IN MA WILL EXPERIENCE POSITIVE POPULATION GROWTH FROM 2010-2035 EXCEPT FOR BARNSTABLE COUNTY AND THE ISLANDS OF NANTUCKET AND MARTHAS VINEYARD. A PROJECTED NET LOSS OF 13% OF THE OVERALL POPULATION OF BARNSTABLE COUNTY IS PREDICTED BETWEEN 2010 AND 2035. BY 2035, THE TOTAL YEAR-ROUND POPULATION IS EXPECTED TO DECREASE TO APPROXIMATELY 188,000 RESIDENTS, A POPULATION SIMILAR TO HISTORIC 1990 NUMBERS. THIS DECLINE IS ATTRIBUTED TO TWO FACTORS, AN OUTFLOW OF YOUNG PEOPLE FROM THE REGION, AND DEATHS CONTINUING TO OUTNUMBER BIRTHS. IN ADDITION TO THE DECLINING POPULATION, THE YEAR-ROUND POPULATION OF BARNSTABLE COUNTY WILL CONTINUE TO HAVE A SIGNIFICANTLY LARGER PROPORTION OF SENIORS OVER THE AGE OF 65 THAN THE STATE OF MASSACHUSETTS (MA) AND THE UNITED STATES (U.S.). ACCORDING TO 2009-2013 AMERICAN COMMUNITY SURVEY ESTIMATES, NEARLY 26% OF THE YEAR-ROUND POPULATION OF BARNSTABLE COUNTY IS OVER THE AGE OF 65 COMPARED TO 14% IN MA AND 13% IN THE U.S. IT IS PREDICTED THAT BY THE YEAR 2035, NEARLY 35% OF THE POPULATION OF BARNSTABLE COUNTY WILL BE OVER THE AGE OF 65.4 IN MA, 58% OF THE OVERALL POPULATION IS COMPRISED OF RESIDENTS BETWEEN THE AGES OF 044 YEARS COMPARED TO ONLY 42% IN BARNSTABLE COUNTY. 'BABY BOOMERS', WHO ARE CURRENTLY INCLUDED IN THE AGE BRACKET OF 45 TO 64 YEAR-OLD RESIDENTS, REPRESENT AN ADDITIONAL 32% OF THE CAPES POPULATION. THESE COMBINED POPULATION STATISTICS SKEW BARNSTABLE COUNTYS MEDIAN AGE TO OVER 50 YEARS OLD, THE HIGHEST FOR ALL COUNTIES IN MASSACHUSETTS. THIS IS MORE THAN A DECADE OLDER THAN THE MA MEDIAN AGE OF 39 YEARS AND THE U.S. MEDIAN AGE OF 37 YEARS. A COMMON THEME DISCUSSED IN STAKEHOLDER INTERVIEWS AND COMMUNITY/PROVIDER FORUMS WAS THAT PERSONS OVER THE AGE OF 65 AND YOUTH (15-24 YEARS OLD) REPRESENTED TWO OF THE MOST VULNERABLE POPULATIONS IN THE SERVICE AREA. YOUTH WERE IDENTIFIED AS A TARGET POPULATION DUE TO CONCERNS RELATED TO EARLY ONSET OF MENTAL HEALTH CONDITIONS, SUBSTANCE USE AND RISKY HEALTH BEHAVIORS. BARNSTABLE COUNTYS GENDER DEMOGRAPHICS MIRROR THOSE OF MA; 52% OF RESIDENTS ARE FEMALE AND 48% ARE MALE. NEARLY 12% OF BARNSTABLE COUNTY RESIDENTS OVER THE AGE OF 18 ARE VETERANS WHICH IS HIGHER THAN THE PERCENTAGE IN BOTH MA (7%) AND THE U.S. (9%). IN BARNSTABLE COUNTY, 13% OF RESIDENTS REPORT THAT THEY ARE LIVING WITH A DISABILITY COMPARED TO 11% IN MA. BARNSTABLE COUNTY MUST MEET THE UNIQUE HEALTH NEEDS OF VETERANS AND PERSONS LIVING WITH DISABILITIES WHO MAY BE AT A GREATER RISK OF DEVELOPING COMORBID CONDITIONS AND OFTEN ENCOUNTER LIMITED ACCESS OR BARRIERS TO CARE. INCOME AND POVERTY ALTHOUGH BARNSTABLE COUNTY HAS A LOWER PROPORTION OF LOW-INCOME RESIDENTS THAN DOES MA (9% VS. 11%), REPRESENTATIVES OF ORGANIZATIONS THAT SERVE VULNERABLE, LOW-INCOME AND MEDICALLY UNDERSERVED POPULATIONS REPORT A GROWING NUMBER OF RESIDENTS WHO STRUGGLE TO SECURE AND MAINTAIN STABLE EMPLOYMENT. THEY ALSO RELY ON PUBLIC ASSISTANCE PROGRAMS TO AFFORD HEALTH INSURANCE, FOOD AND HOUSING. ACCORDING TO FIVE-YEAR CENSUS ESTIMATES (2009-2013), THE MEDIAN HOUSEHOLD INCOME OF BARNSTABLE COUNTY RESIDENTS WAS $60,526 COMPARED TO $66,866 FOR ALL MASSACHUSETTS RESIDENTS. IN 2014, A HIGHER PERCENT OF PER CAPITA INCOME WAS DERIVED FROM TRANSFER PAYMENTS (SOCIAL SECURITY, DISABILITY PENSIONS, HOUSING AND FOOD SUBSIDY PROGRAMS, AND UNEMPLOYMENT BENEFITS) IN BARNSTABLE COUNTY (19%) COMPARED TO MA (15%) AND THE U.S. (17%). VULNERABLE POPULATIONS ARE FURTHER CHALLENGED BY EMPLOYMENT OPPORTUNITIES ON CAPE COD WHICH DECREASE DURING WINTER MONTHS DUE TO CHARACTERISTICS INHERENT IN A SEASONAL ECONOMY DEPENDENT ON TOURISM AND OTHER FACTORS. IN 2015, THE UNEMPLOYMENT RATE IN BARNSTABLE COUNTY RANGED FROM 9% IN JANUARY TO 5% IN JULY COMPARED TO A STEADY ANNUAL RATE OF 6% UNEMPLOYMENT FOR MA OVERALL. ACCORDING TO FIVE-YEAR ESTIMATES (2009-2013) OF THE AMERICAN COMMUNITY SURVEY: * MORE THAN 48% OF BARNSTABLE COUNTY RESIDENT WHO RENT AND 38% WHO OWN A HOUSING UNIT ARE COST-BURDENED, SPENDING 35% OR MORE OF THEIR TOTAL INCOME ON HOUSING. ACCORDING TO THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, FAMILIES WHO PAY MORE THAN 30% OF THEIR INCOME FOR HOUSING ARE CONSIDERED COST-BURDENED AND MAY HAVE DIFFICULTY AFFORDING NECESSITIES SUCH AS FOOD, CLOTHING, TRANSPORTATION AND MEDICAL CARE. * 42% OF BARNSTABLE COUNTY RESIDENTS RECEIVE PUBLICILY-FUNDED HEALTH INSURANCE COVERAGE COMPARED TO 32% OF RESIDENTS IN MA OVERALL, AND * 42% OF RESIDENT RECEIVE SOCIAL SECURITY PAYMENTS COMPARED TO 28% IN MA OVERALL. COMBINED TOGETHER, THESE INDICATORS PAINT A PICTURE OF MANY RESIDENTS IN NEED. THE COMMUNITY INPUT COLLECTION PHASE OF THE PROJECT IDENTIFIED NUMEROUS TARGET POPULATIONS IN NEED OF HEALTH INTERVENTIONS. THESE INCLUDED FINANCIALLY DISADVANTAGED POPULATIONS, INCLUDING INDIVIDUALS WITH TRANSITIONAL EMPLOYMENT, CHILDREN UNDER THE AGE OF 18, INDIVIDUALS/FAMILIES WITH HOUSING INSECURITIES, AND THOSE LIVING ON FIXED INCOMES. RACE, ETHNICITY AND LANGUAGE IN ADDITION TO AGE AND INCOME, RACE, ETHNICITY, AND LANGUAGE PLAY A ROLE IN DETERMINING HEALTH OUTCOMES FOR RESIDENTS. COMPARED TO MA, BARNSTABLE COUNTY HAS A RELATIVELY HOMOGENEOUS POPULATION WITH 92% IDENTIFYING AS CAUCASIAN IN 2009-2013 CENSUS ESTIMATES. MASSACHUSETTS IS MORE RACIALLY DIVERSE WITH ONLY 76% OF RESIDENTS IDENTIFYING AS CAUCASIAN. ACCORDING TO FIVE-YEAR ESTIMATES OF THE AMERICAN COMMUNITY SURVEY (2009-2013) THE LARGEST RACIAL/ETHNIC MINORITY GROUPS ON CAPE COD ARE HISPANICS/LATINOS AND AFRICAN-AMERICAN RESIDENTS WITH EACH GROUP REPRESENTING ABOUT 2% OF THE POPULATION. IN THAT SAME TIME PERIOD, 7% OF THE POPULATION LIVING IN BARNSTABLE COUNTY WAS FOREIGN-BORN, COMPARED TO 15% FOR THE COMMONWEALTH OF MASSACHUSETTS. SLIGHTLY MORE THAN 8% OF THE POPULATION FIVE YEARS OR OLDER IN BARNSTABLE COUNTY SPEAKS A LANGUAGE OTHER THAN ENGLISH AT HOME COMPARED TO 22% IN THE COMMONWEALTH. WHILE DIVERSITY MAY BE LOW COMPARATIVELY, PUBLIC HEALTH EXPERTS AND INDIVIDUALS REPRESENTING LOW-INCOME, VULNERABLE, AND MEDICALLY UNDERSERVED POPULATIONS ON CAPE COD CITE THAT FOREIGN-BORN RESIDENTS AND RACIAL/ETHNIC MINORITIES ON CAPE COD (E.G., HISPANICS, AFRICAN AMERICANS, AND PORTUGUESE-SPEAKING BRAZILIANS) WERE MOST LIKELY TO EXPERIENCE BARRIERS TO ACCESSING CARE AND ARE DISPROPORTIONALLY IDENTIFIED WITHIN HIGH NEEDS POPULATIONS AS COMPARED TO OTHERS.
INSURANCE STATUS	MASSACHUSETTS LEADS THE NATION AS THE STATE WITH THE LOWEST RATE OF UNINSURED RESIDENTS. IN 2014, ONLY 4% OF RESIDENTS IN THE COMMONWEALTH LACKED MEDICAL HEALTH INSURANCE, COMPARED TO 10% NATIONALLY, DUE TO THE STATES EARLY HEALTH REFORM EFFORTS WHICH BEGAN IN 2006. HOWEVER, THERE IS VARIATION IN INSURED POPULATIONS ACROSS THE STATE OF MA ACCORDING TO THE GEOGRAPHY OF UNINSURANCE IN MASSACHUSETTS 2009-2013, A PUBLICATION BY THE BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION AND THE URBAN INSTITUTE. ACCORDING TO THE STUDY, BARNSTABLE COUNTY, AT 3.4%, HAS THE HIGHEST PERCENTAGE OF UNINSURED CHILDREN (0-17 YEARS) IN THE STATE COMPARED TO ALL OTHER COUNTIES. BARNSTABLE COUNTY, WITH AN OVERALL 5% UNINSURED RATE (ADULTS AND CHILDREN), IS ALSO THE 4TH HIGHEST RANKING COUNTY IN MA FOR THE NUMBER OF UNINSURED PERSONS OF ALL AGES. INPUT FROM PUBLIC HEALTH EXPERTS AND INDIVIDUALS REPRESENTING LOW-INCOME, VULNERABLE, AND MEDICALLY-UNDERSERVED POPULATIONS ON CAPE COD NOTE THAT BEYOND INDIVIDUALS AND CHILDREN WHO ARE UNINSURED, THERE ARE MANY RESIDENTS WHO ARE 'UNDER-INSURED'. THIS POPULATION STRUGGLES WITH THE COST OF PUBLICLY AVAILABLE HEALTH PLANS, COVERAGE OF DEDUCTIBLES AND PRESCRIPTIONS, AND WITH MAINTAINING INSURANCE COVERAGE UNDER CONTINUOUS ENROLLMENT CHANGES. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL DERIVE APPROXIMATELY 67% OF PATIENT SERVICE REVENUES FROM PUBLIC PAYERS. FROM FY2013 TO FY2015 THE HOSPITALS PERCENTAGE OF MEDICAID AND MEDICARE STEADILY INCREASED WHILE THE PERCENTAGE FROM NON-GOVERNMENT SOURCES STEADILY DECREASED. AS BOTH STATE AND FEDERAL PAYERS FACE BUDGETING CONCERNS, PUBLIC PAYER REIMBURSEMENT IS FORECASTED TO REMAIN FLAT OR DECLINE. MANY OF THE KEY SERVICES USED BY VULNERABLE POPULATIONS SUCH AS BEHAVIORAL HEALTH ARE POORLY REIMBURSED. THESE TRENDS DEMONSTRATE CONTINUED RELIANCE ON SOURCES OF PUBLIC HEALTH COVERAGE AS THE AREA DEMOGRAPHICS BECOME MORE CHALLENGING. CONCLUSION UNDERSTANDING THE COMMUNITY NEED AND HEALTH STATUS OF BARNSTABLE COUNTY RESIDENTS BEGINS WITH IDENTIFYING THE DEMOGRAPHIC PROFILE AND UNDERLYING SOCIO-ECONOMIC DRIVERS THAT IMPACT HEALTH AND HEALTH EQUITY. ASSESSING SOCIAL DETERMINANTS OF HEALTH SUCH AS AGE, INCOME, RACE/ETHNICITY, LANGUAGE, INCOME, POVERTY, UNEMPLOYMENT, INSURANCE COVERAGE, AND HOUSING STATUS PROVIDES CRITICAL INFORMATION FOR IDENTIFYING TARGET POPULATIONS AND COMMUNITY SETTINGS FOR HEALTH IMPROVEMENT INTERVENTIONS AND ACTIVITIES.
PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: Cape Cod Healthcare conducts a Community Health Needs Assessment every three years to determine the significant health care needs of the residents of Barnstable County. The objective of the assessment is to gather statistically valid information and accurate comparisons to state and national benchmarks of health and quality of life measures for residents of Barnstable County. The target populations, significant health needs and available resources to address those health needs are integrated into community benefit and hospital planning activities including direct clinical programs, health education, wellness promotion, financial support and community engagement activities. The following is a list of FY16 target populations: - INDIVIDUALS MANAGING OR AT RISK OF DEVELOPING CHRONIC AND INFECTIOUS DISEASES SUCH AS CANCER, CARDIOVASCULAR DISEASE, ALZHEIMER'S DISEASE, HEPATITIS C, OR TICK-BORNE DISEASE. - RESIDENTS FACING BARRIERS TO CARE DUE TO LANGUAGE, COST, OR AGE, INCLUDING THOSE WHO ARE UNINSURED OR UNDER-INSURED. - INDIVIDUALS WITH MENTAL HEALTH DISORDERS AND CO-OCCURRING DISORDERS. - INDIVIDUALS WITH SUBSTANCE USE DISORDERS. - SENIOR POPULATION, AGES 65 AND OLDER. - YOUTH AND YOUNG ADULTS, AGES 15 TO 24 YEARS OLD. Cape Cod Healthcare and the Cape Cod Healthcare Community Benefits department supported the following programs in FY16: INTERPRETER SERVICES FOR COMMUNITY-BASED PHYSICIAN OFFICES CCHC COMMUNITY BENEFITS PROVIDES ANNUAL SUPPORT TO IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE FOR INDIVIDUALS WHO FACE BARRIERS TO CARE DUE TO LANGUAGE THROUGH THE COMMUNITY BASED INTERPRETER SERVICES PROGRAM. THE PROGRAM DISPATCHES FREE MEDICAL LANGUAGE INTERPRETERS TO COMMUNITY-BASED PHYSICIAN PRACTICES TO ASSIST LIMITED AND NON-ENGLISH SPEAKING PATIENTS AND THEIR FAMILIES. THE AVAILABILITY OF PROFICIENT AND PROFESSIONAL INTERPRETER SERVICES ENSURES THE DELIVERY OF SAFE, QUALITY HEALTH CARE AND POSITIVE CLINICAL OUTCOMES. Specialty Network for the Uninsured CAPE COD HEALTHCARE COMMUNITY BENEFITS PROVIDES ANNUAL GRANT SUPPORT TO HARBOR COMMUNITY HEALTH CENTER - HYANNIS TO COORDINATE THE SPECIALTY NETWORK FOR THE UNINSURED (SNU). THE SNU PROGRAM INCREASES ACCESS TO SPECIALTY CARE FOR UNINSURED AND UNDER-INSURED RESIDENTS OF BARNSTABLE COUNTY THROUGH MANAGING A NETWORK OF MEDICAL SPECIALISTS WHO WILL PROVIDE FREE OR SIGNIFICANTLY REDUCED SLIDING-SCALE FEES FOR OFFICE VISITS, PROCEDURES AND CONTINUED CARE OF UNINSURED AND UNDER-INSURED INDIVIDUALS. Prescription Assistance Program THE PRESCRIPTION ASSISTANCE PROGRAM IS AN INITIATIVE OF CAPE COD HOSPITAL AND FALMOUTH HOSPITAL EMERGENCY, BEHAVIORAL HEALTH AND PHARMACY DEPARTMENTS AS A COMMUNITY BENEFIT TO ASSIST UNINSURED, UNDER-INSURED AND FINANCIALLY DISADVANTAGED PATIENTS WHO HAVE NO OTHER VIABLE MEANS TO PAY FOR MEDICATIONS UPON DISCHARGE FROM HOSPITAL FACILITIES. Transportation Assistance Program IN AN EFFORT TO ASSIST LOW-INCOME AND VULNERABLE POPULATIONS, CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROVIDE TRANSPORTATION UPON DISCHARGE FROM EMERGENCY AND BEHAVIORAL HEALTH DEPARTMENTS, TO THOSE PATIENTS WITHOUT RESOURCES FOR TRANSPORTATION. DUFFY HEALTH CENTER: SUPPORTING BEHAVIORAL HEALTH SERVICES FOR HOMELESS AND AT RISK ADULTS THE DUFFY HEALTH CENTER PROVIDES PRIMARY CARE AND BEHAVIORAL HEALTH CARE TO HOMELESS ADULTS AND THOSE AT-RISK FOR HOMELESSNESS IN BARNSTABLE COUNTY. IN FY16, COMMUNITY BENEFITS FUNDING FROM CAPE COD HEALTHCARE SUPPORTED THE DUFFY HEALTH CENTERS BEHAVIORAL HEALTH SERVICES INCLUDING THERAPY, PSYCHIATRY AND CASE MANAGEMENT SUPPORT FOR HEALTH CENTER PATIENTS. SUPPORT GROUPS AND HEALTH EDUCATION CLASSES AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL AT CAPE COD AND FALMOUTH HOSPITAL, SUPPORT GROUPS FOR BEREAVEMENT AND CANCER SURVIVORSHIP, CLASSES AND COUNSELING FOCUSED ON BREASTFEEDING AND FATHERHOOD AND HOLISTIC SERVICES TO COMPLEMENT TRADITIONAL MEDICAL CARE ARE CONDUCTED ON A REGULAR BASIS AND OPEN TO ALL MEMBERS OF THE COMMUNITY. CLASSES AND GROUPS ARE AVAILABLE TO INDIVIDUALS, FAMILIES AND CAREGIVERS INCLUDE IN-PERSON MEETINGS AND CONTACTS TO OFFER SUPPORT AND REASSURANCE THROUGH THEIR SPECIFIC DISEASE/HEALTH CARE SITUATION. WORKFORCE AND CAREER DEVELOPMENT INITIATIVES: CAPE COD HEALTHCARE RECOGNIZES THE IMPORTANCE OF WORKFORCE DEVELOPMENT AND SUPPORTS THE OPPORTUNITY FOR STUDENTS FROM HIGH SCHOOL THROUGH GRADUATE SCHOOL TO HAVE A POSITIVE AND PROFESSIONAL EXPERIENCE THROUGH INTERNSHIPS, JOB SHADOWING AND TRAINING WITH HEALTH CARE PROVIDERS IN SEVERAL HOSPITAL DEPARTMENTS. BY TRAINING AND MENTORING STUDENTS FOR FUTURE EMPLOYMENT, WE HOPE TO SUCCESSFULLY ENGAGE INDIVIDUALS SO THEY SELECT HEALTH CARE AS A VIABLE AND ADMIRABLE VOCATION, THUS DECREASING THE POTENTIAL RISK FOR PREDICTED FUTURE SHORTAGES IN THE WORKPLACE. SUPPORTING THE HEALTH INSURANCE NEEDS OF EVERYONE (SHINE): CAPE COD HEALTHCARE COMMUNITY BENEFITS PROVIDED A GRANT TO THE REGIONAL SHINE PROGRAM TO EXPAND INFORMATION, COUNSELING AND ASSISTANCE TO BARNSTABLE COUNTY RESIDENTS WITH MEDICARE AND THEIR CAREGIVERS. Growing a dementia friendly community: hope dementia and Alzheimers services: Cape Cod healthcare community benefits awarded a grant to hope dementia and Alzheimers services to offer community trainings for caregivers and emergency responders titled Alzheimers disease: what you need to know. FOODS TO ENCOURAGE - NUTRITION'S ROLE IN DIABETES AND HYPERTENSION TREATMENT AND PREVENTION PILOT PROGRAM: CAPE COD HUNGER NETWORK FOODS TO ENCOURAGE IS A PROGRAM TO MONITOR AND IMPROVE DIABETES AND HYPERTENSION DISEASE OUTCOMES IN LOW TO MODERATE INCOME RESIDENTS WHO ACCESS FOOD FROM CAPE FOOD PANTRIES. The FY16 community benefits grant from cape cod healthcare allowed the program to expand from one location to four food pantries across cape cod. Cape cod cooperative extension tick testing and disease surveillance project: Cape cod healthcare provided community benefits funding to the Cape Cod cooperative extension to subsidize a tick testing and tick-borne disease surveillance program for Barnstable county residents. HEALTHY PARKS, HEALTHY PEOPLE: A WELLNESS COLLABORATION BETWEEN CAPE COD HEALTHCARE AND THE CAPE COD NATIONAL SEASHORE CAPE COD HEALTHCARE COLLABORATED WITH THE CAPE COD NATIONAL SEASHORE TO PROMOTE WELLNESS, EXERCISE AND PHYSICAL ACTIVITY TO IMPROVE THE HEALTH OF CAPE COD RESIDENTS AND VISITORS. Living fit for you! Cancer wellness program at Falmouth hospital: Living fit for you is a free, structured, and medically-supervised exercise and education program that assists individuals undergoing treatment for cancer to manage fatigue, deconditioning, and a loss of physical function.
PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEMS ROLES: THE HOSPITALS ARE PART OF AN AFFILIATED HEALTHCARE SYSTEM AND THEIR RESPECTIVE ROLES ARE: CAPE COD HOSPITAL - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN HYANNIS, MASSACHUSETTS FALMOUTH HOSPITAL ASSOCIATION, INC. - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN FALMOUTH, MASSACHUSETTS CAPE COD HEALTHCARE, INC. - A NOT-FOR-PROFIT CORPORATION THAT SERVES AS THE PARENT COMPANY OF VARIOUS ENTITIES PROVIDING HEALTH CARE SERVICES TO THE POPULATION OF CAPE COD, MASSACHUSETTS CAPE COD HEALTHCARE FOUNDATION, INC. - A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE DEVELOPMENT AND FUNDRAISING SUPPORT TO CAPE COD HEALTHCARE CAPE AND ISLANDS HEALTH SERVICES II, INC. - A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE VARIOUS NONHOSPITAL HEALTH CARE SERVICES MEDICAL AFFILIATES OF CAPE COD, INC. - A NOT-FOR-PROFIT MEDICAL GROUP PRACTICE VISITING NURSE ASSOCIATION OF CAPE COD - A NOT-FOR-PROFIT PROVIDER OF HOME HEALTH SERVICES CAPE COD HUMAN SERVICES, INC. - A NOT-FOR-PROFIT PROVIDER OF OUTPATIENT MENTAL HEALTH SERVICES FALMOUTH ASSISTED LIVING, INC., D/B/A HERITAGE AT FALMOUTH - A NOT-FOR-PROFIT CORPORATION THAT OWNS AN ASSISTED LIVING FACILITY JML CARE CENTER, INC. - A NOT-FOR-PROFIT SKILLED NURSING AND REHABILITATION FACILITY CAPE HEALTH INSURANCE COMPANY - A CAPTIVE INSURANCE COMPANY THAT PROVIDES MEDICAL PROFESSIONAL AND GENERAL LIABILITY INSURANCE TO CAPE COD HEALTHCARE CAPE COD HOSPITAL MEDICAL OFFICE BUILDING - A PROVIDER OF LEASED AND SUBLEASED SPACE TO CAPE COD HOSPITAL AND RELATED AFFILIATIONS PART VI, LINE 7 ALL STATES WHERE ORGANIZATION FILES A COMMUNITY BENEFITS REPORT: MA

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

Any related organization?

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

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

The organization?

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1DIANNE C KOLBPresident VNA	(i) (ii)	0 ------------- 205,082	0 ------------- 42,651	0 ------------- 20,251	0 ------------- 37,418	0 ------------- 24,297	0 ------------- 329,699	0 ------------- 10,403
2MICHAEL G JONESSr VP Chief Legal OffICER	(i) (ii)	0 ------------- 311,755	0 ------------- 73,106	0 ------------- 21,823	0 ------------- 41,844	0 ------------- 36,374	0 ------------- 484,902	0 ------------- 15,965
3MICHAEL K LAUFPRESIDENT/CEO/TRUSTEE	(i) (ii)	0 ------------- 846,278	0 ------------- 700,125	0 ------------- 180,554	0 ------------- 198,300	0 ------------- 40,306	0 ------------- 1,965,563	0 ------------- 146,200
4MICHAEL L CONNORSSENIOR VP FINANCE/CFO	(i) (ii)	0 ------------- 391,729	0 ------------- 102,000	0 ------------- 32,956	0 ------------- 52,735	0 ------------- 37,122	0 ------------- 616,542	0 ------------- 18,911
5EMILY TIERNEY MDPHYSICIAN	(i) (ii)	829,254 ------------- 0	825,863 ------------- 0	69,497 ------------- 0	28,454 ------------- 0	13,155 ------------- 0	1,766,223 ------------- 0	0 ------------- 0
6EMILY SCHORERSVP HUMAN RESOURCES	(i) (ii)	0 ------------- 251,483	0 ------------- 60,965	0 ------------- 630	0 ------------- 22,402	0 ------------- 34,432	0 ------------- 369,912	0 ------------- 0
7JEANNE FALLONSR VP & CIO	(i) (ii)	0 ------------- 246,997	0 ------------- 49,335	0 ------------- 10,029	0 ------------- 41,561	0 ------------- 27,674	0 ------------- 375,596	0 ------------- 8,625
8JEFFREY S DYKENSSEE SCHEDULE O	(i) (ii)	0 ------------- 236,355	0 ------------- 37,200	0 ------------- 18,663	0 ------------- 26,862	0 ------------- 36,182	0 ------------- 355,262	0 ------------- 10,620
9RICHARD B ZELMAN MDPHYSICIAN	(i) (ii)	1,191,706 ------------- 0	125,000 ------------- 0	94,114 ------------- 0	10,600 ------------- 0	37,124 ------------- 0	1,458,544 ------------- 0	0 ------------- 0
10ACHILLE PAPAVASILIOU MDPHYSICIAN	(i) (ii)	592,722 ------------- 0	374,996 ------------- 0	630 ------------- 0	28,600 ------------- 0	36,124 ------------- 0	1,033,072 ------------- 0	0 ------------- 0
11PAUL HOULE MDPHYSICIAN	(i) (ii)	592,722 ------------- 0	263,274 ------------- 0	630 ------------- 0	28,600 ------------- 0	36,124 ------------- 0	921,350 ------------- 0	0 ------------- 0
12PATRICK KANESVP OF MRKTG, COMMUN & DEVLP	(i) (ii)	0 ------------- 301,455	0 ------------- 71,715	0 ------------- 24,532	0 ------------- 32,439	0 ------------- 36,374	0 ------------- 466,515	0 ------------- 15,450
13ARTHUR MOMBOURQUETTECOO UNTIL 1/15	(i) (ii)	0 ------------- 30,541	0 ------------- 0	0 ------------- 427,981	0 ------------- 8,808	0 ------------- 1,967	0 ------------- 469,297	0 ------------- 23,333
14THERESA M AHERNSVP, STRAT, COMMUNITY/GOV REL.	(i) (ii)	0 ------------- 234,628	0 ------------- 59,900	0 ------------- 11,489	0 ------------- 23,939	0 ------------- 24,297	0 ------------- 354,253	0 ------------- 9,188
15VICTOR OLIVEIRAVP PATIENT SERVICES	(i) (ii)	0 ------------- 240,705	0 ------------- 48,360	0 ------------- 19,399	0 ------------- 36,309	0 ------------- 36,124	0 ------------- 380,897	0 ------------- 11,375
16JOHN LIPOMISR VP MANAGED CARE UNT 12/15	(i) (ii)	0 ------------- 350,609	0 ------------- 79,875	0 ------------- 22,419	0 ------------- 48,782	0 ------------- 25,337	0 ------------- 527,022	0 ------------- 17,253
17DONALD GUADAGNOLI MDCMO CAPE COD HOSPITAL	(i) (ii)	0 ------------- 411,719	0 ------------- 94,500	0 ------------- 24,168	0 ------------- 54,395	0 ------------- 37,124	0 ------------- 621,906	0 ------------- 12,722
18KEVIN J MULROYSee Sch O for title	(i) (ii)	0 ------------- 361,965	0 ------------- 84,375	0 ------------- 19,722	0 ------------- 37,163	0 ------------- 36,392	0 ------------- 539,617	0 ------------- 9,750
19CARTER HUNTSEE SCHEDULE O FOR TITLE	(i) (ii)	0 ------------- 184,627	0 ------------- 15,096	0 ------------- 584	0 ------------- 24,860	0 ------------- 34,155	0 ------------- 259,322	0 ------------- 0
20ALEXANDER HEARD MDCMO FALMOUTH HOSPITAL	(i) (ii)	37,655 ------------- 179,887	0 ------------- 0	0 ------------- 64	557 ------------- 3,180	0 ------------- 0	38,212 ------------- 183,131	0 ------------- 0
21CHRISTIAN BROWNSR VP MANAGED CARE AS OF 11/15	(i) (ii)	0 ------------- 255,778	0 ------------- 48,300	0 ------------- 16,255	0 ------------- 42,447	0 ------------- 33,892	0 ------------- 396,672	0 ------------- 8,025
22KEVIN RALPHSVP DEVELOPMENT	(i) (ii)	0 ------------- 240,975	0 ------------- 60,750	0 ------------- 420	0 ------------- 10,491	0 ------------- 37,374	0 ------------- 350,010	0 ------------- 0
23NICHOLAS COPPA MDPHYSICIAN	(i) (ii)	609,218 ------------- 0	243,269 ------------- 0	420 ------------- 0	5,300 ------------- 0	33,892 ------------- 0	892,099 ------------- 0	0 ------------- 0
24MARY FRANCOFORMER SVP DEVELOPMENT	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 119,475	0 ------------- 0	0 ------------- 1,525	0 ------------- 121,000	0 ------------- 0
25GROVER BAXLEY MDTRUSTEE UNTIL 1/16	(i) (ii)	179,880 ------------- 0	0 ------------- 0	20,398 ------------- 0	7,855 ------------- 0	1,525 ------------- 0	209,658 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

SCHEDULE J, PART I, LINE 4A

MARY FRANCO, FORMER SVP OF DEVELOPMENT (FROM 1/14-5/14), RECEIVED SEVERANCE PAYMENTS OF $119,475 DURING CALENDAR YEAR 2015. THE ARRANGEMENT PROVIDES FOR CONTINUED PAYMENT OF THE INDIVIDUAL'S SALARY AND BENEFIT FOR A PERIOD OF 15 MONTHS, INCLUDING MEDICAL AND DENTAL INSURANCE COVERAGE. ARTHUR MOMBOURQUETTE, COO CCHC (FROM 11/12-1/15), RECEIVED SEVERANCE PAYMENTS OF $369,231 DURING CALENDAR YEAR 2015. THE ARRANGEMENT PROVIDES FOR CONTINUED PAYMENT OF THE INDIVIDUAL'S SALARY AND BENEFITS FOR A PERIOD OF 12 MONTHS, INCLUDING MEDICAL AND DENTAL INSURANCE COVERAGE. SCHEDULE J, PART I, LINE 4B - 457(F) CAPE COD HEALTHCARE, INC. AND AFFILIATES SPONSORS A 457(F) VOLUNTARY PERSONAL DEFERRAL PLAN ("THE PLAN") FOR KEY EXECUTIVES. VESTING IS DEFERRED FOR AT LEAST TWO YEARS FROM THE DATE OF THE AWARD. THE PLAN OFFERS PARTICIPATING EMPLOYEES AN ANNUAL DEFERRAL OF CASH COMPENSATION. AMOUNTS DEFERRED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND AMOUNTS PAID UNDER THE PLAN DURING CALENDAR YEAR 2015 WERE AS FOLLOWS: - MICHAEL K. LAUF - $65,637 - MICHAEL L. CONNORS - $23,876 - MICHAEL G. JONES - $20,017 - VICTOR OLIVEIRA - $13,664 - JEFFREY S. DYKENS - $11,276 - DIANNE C. KOLB - $11,599 - JOHN LIPOMI - $19,096 - KEVIN MULROY - $10,245 - THERESA AHERN - $9,683 - JEANNE FALLON - $9,063 - DONALD GUADAGNOLI, MD - $13,319 - PATRICK KANE - $15,817 - ARTHUR MOMBOURQUETTE - $27,226 - CHRISTIAN BROWN - $8,482 CAPE COD HEALTHCARE, INC. AND AFFILIATES ALSO SPONSOR A NONQUALIFIED PENSION RESTORATION ACCOUNT PLAN FOR KEY EXECUTIVES. THE ORGANIZATION MAKES CONTRIBUTIONS OF TWO PERCENT OF THE INDIVIDUAL'S ANNUAL SALARY (INCLUDING BONUS) THROUGHOUT THE PLAN YEAR. AMOUNTS DEFERRED ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND UNDER THE PLAN, PARTICIPANTS ARE ENTITLED TO CERTAIN BENEFITS UPON RETIREMENT, TERMINATION, OR DEATH. During calendar year 2015, Michael Lauf also participated in a Section 457(f) plan. Twelve percent of his base salary was contributed and each contribution is subject to a three year vesting schedule. The amount deferred in calendar year 2015 was $102,000 and is included in Schedule J, Part II, Column (C). IN ADDITION, $95,087 WAS PAID OUT FROM HIS CEO SUPPLEMENTAL PLAN, AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN B(III).

SCHEDULE J, PART I, LINE 7

Discretionary bonuses are awarded annually based upon both the performance of the organization and the individual. Bonuses are reflected in Schedule J, Part II, Column B(ii). THE INDIVIDUALS REPORTED IN SCHEDULE J, PART II REPORTED AS BEING PAID FROM A RELATED ORGANIZATION WERE EMPLOYEES OF, AND COMPENSATED BY CAPE COD HEALTHCARE, INC., THE PARENT CORPORATION.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number
90-0054984

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MHEFA REVENUE BONDS SERIES D	04-2456011	57586ERM5	02-16-2010	63,314,516	Reissue of Series D (12/23/2004)		X		X		X
B	MHEFA REVENUE BONDS SERIES E	04-2456011	000000000	01-12-2012	29,440,000	Reissue of Ser E(6/18/08)&(2/12/09		X		X		X
C	MDFA REVENUE BONDS SERIES 2012A	04-3431814	000000000	02-24-2012	25,800,000	REFUND SER.B(8/15/98)&C(11/15/01)		X		X		X
D	MDFA REVENUE BONDS SERIES 2013	04-3431814	57584VAH8	07-11-2013	50,831,729	REFUND SER C(10/9/01)& CAPITAL IMP		X		X		X
	MDFA REVENUE BONDS SERIES 2014	04-3431814	000000000	09-29-2014	24,000,000	RENOVATION & REAL ESTATE PURCHASE		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	9,185,000		13,738,666		10,320,000		0
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	63,314,516		29,440,000		25,800,000		50,834,109
4 Gross proceeds in reserve funds .............	3,986,259		0		0		519,529
5 Capitalized interest from proceeds .............	0		0		0		1,295,804
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	914,516		0		336,100		803,269
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		0		0		27,999,812
11 Other spent proceeds .............	62,400,000		29,440,000		25,463,900		20,735,223
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2010		2012		2012		2014
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X		X		X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part III

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2015

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X						X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X						X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X						X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X						X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X						X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part IV

Arbitrage

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

Schedule K (Form 990) 2015

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

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

Return Reference	Explanation
PART IV, LINE 2(C)	MHEFA, REVENUE BONDS, SERIES D - THE DATE THE REBATE COMPUTATION WAS LAST PERFORMED WAS 6/30/2014. MHEFA, REVENUE BONDS, SERIES E - THE DATE THE REBATE COMPUTATION WAS LAST PERFORMED WAS 7/12/2012. MDFA REVENUE BONDS, SERIES 2012A- THE DATE THE REBATE COMPUTATION WAS LAST PERFORMED WAS 01/31/16. MDFA, REVENUE BONDS, SERIES 2014 - THE DATE THE REBATE COMPUTATION WAS LAST PERFORMED WAS 08/31/15.

Schedule K (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number
90-0054984

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MHEFA REVENUE BONDS SERIES D	04-2456011	57586ERM5	02-16-2010	63,314,516	Reissue of Series D (12/23/2004)		X		X		X
B	MHEFA REVENUE BONDS SERIES E	04-2456011	000000000	01-12-2012	29,440,000	Reissue of Ser E(6/18/08)&(2/12/09		X		X		X
C	MDFA REVENUE BONDS SERIES 2012A	04-3431814	000000000	02-24-2012	25,800,000	REFUND SER.B(8/15/98)&C(11/15/01)		X		X		X
D	MDFA REVENUE BONDS SERIES 2013	04-3431814	57584VAH8	07-11-2013	50,831,729	REFUND SER C(10/9/01)& CAPITAL IMP		X		X		X
	MDFA REVENUE BONDS SERIES 2014	04-3431814	000000000	09-29-2014	24,000,000	RENOVATION & REAL ESTATE PURCHASE		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	9,185,000		13,738,666		10,320,000		0
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	63,314,516		29,440,000		25,800,000		50,834,109
4 Gross proceeds in reserve funds .............	3,986,259		0		0		519,529
5 Capitalized interest from proceeds .............	0		0		0		1,295,804
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	914,516		0		336,100		803,269
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		0		0		27,999,812
11 Other spent proceeds .............	62,400,000		29,440,000		25,463,900		20,735,223
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2010		2012		2012		2014
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X		X		X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part III

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2015

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X						X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X						X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X						X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X						X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X						X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part IV

Arbitrage

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

Schedule K (Form 990) 2015

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part VI

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

Return Reference	Explanation
PART IV, LINE 2(C)	MHEFA, REVENUE BONDS, SERIES D - THE DATE THE REBATE COMPUTATION WAS LAST PERFORMED WAS 6/30/2014. MHEFA, REVENUE BONDS, SERIES E - THE DATE THE REBATE COMPUTATION WAS LAST PERFORMED WAS 7/12/2012. MDFA REVENUE BONDS, SERIES 2012A- THE DATE THE REBATE COMPUTATION WAS LAST PERFORMED WAS 01/31/16. MDFA, REVENUE BONDS, SERIES 2014 - THE DATE THE REBATE COMPUTATION WAS LAST PERFORMED WAS 08/31/15.

Schedule K (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

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

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

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

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

Part II

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

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










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

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) DR KATIE RUDMAN	SPOUSE OF TRUSTEE	131,903	MACC EMPLOYEE		No
(2) DR DALE WELDON	SPOUSE OF OFFICER	122,962	HOSPITAL EMPLOYEE		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	25	211,039	VALUE OF STOCK REC'D
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

Yes

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2015)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE M, PART I, COLUMN (B)	THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED. SCHEDULE M, PART I, LINE 32(A) ON OCCASION THE ORGANIZATION UTILIZES A BROKER TO DISPOSE OF NONCASH CONTRIBUTIONS (OTHER THAN PUBLICLY TRADED SECURITIES).

Schedule M (Form 990) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Return Reference	Explanation
FORM 990, PART I, LINE 1 AND PART III, LINE 1	WE WILL BE THE HEALTH SERVICE PROVIDER OF CHOICE FOR CAPE COD RESIDENTS BY ACHIEVING AND MAINTAINING THE HIGHEST STANDARDS IN HEALTH CARE DELIVERY AND SERVICE QUALITY. TO DO SO, WE WILL PARTNER WITH OTHER HEALTH AND HUMAN SERVICE PROVIDERS AS WELL AS INVEST IN NEEDED MEDICAL TECHNOLOGIES, HUMAN RESOURCES AND CLINICAL SERVICES. ABOVE ALL, WE WILL HELP IDENTIFY AND RESPOND TO THE NEEDS OF OUR COMMUNITY. COMMUNITY BENEFITS MISSION STATEMENT CAPE COD HEALTHCARE, INC., (CCHC) THROUGH ITS COMMUNITY BENEFITS INITIATIVE, IS COMMITTED TO ENHANCING THE QUALITY OF AND ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES FOR ALL RESIDENTS OF CAPE COD. THROUGH CONTINUOUS ASSESSMENT OF COMMUNITY NEEDS, COORDINATED PLANNING AND THE ALLOCATION OF RESOURCES, THIS COMMITMENT INCLUDES A SPECIAL FOCUS ON THE UNMET NEEDS OF THE FINANCIALLY DISADVANTAGED AND UNDERSERVED POPULATIONS. WE WILL TAKE A LEADERSHIP ROLE IN COLLABORATIVE EFFORTS JOINING OUR RESOURCES, TALENT, AND COMMITMENT WITH THAT OF OTHER PROVIDERS, ORGANIZATIONS AND COMMUNITY MEMBERS. THE COMMUNITY BENEFITS MISSION STATEMENT WAS AFFIRMED BY THE CCHC COMMUNITY HEALTH COMMITTEE AND THE BOARD OF TRUSTEES IN 2000 AND REMAINS IN EFFECT. TARGET POPULATIONS 1. NAME OF TARGET POPULATION: INDIVIDUALS MANAGING OR AT RISK OF DEVELOPING CHRONIC AND INFECTIOUS DISEASES SUCH AS CANCER, CARDIOVASCULAR DISEASE, ALZHEIMERS DISEASE, HEPATITIS C OR TICK-BORNE DISEASE. BASIS FOR SELECTION: ALIGNED WITH STATE AND NATIONAL HEALTH PRIORITIES, BARNSTABLE COUNTY RESIDENTS MANAGING CHRONIC DISEASES ARE AT THE GREATEST RISK OF DECLINED HEALTH AND DEATH. CANCER, CARDIOVASCULAR DISEASE, ALZHEIMERS DISEASE, HEPATITIS C AND TICK-BORNE DISEASES ARE HIGHLY REPRESENTED AMONG RESIDENTS OF BARNSTABLE COUNTY. THIS TARGET POPULATION WAS IDENTIFIED AND SELECTED IN THE 2014-2016 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. 2. NAME OF TARGET POPULATION: RESIDENTS FACING BARRIERS TO CARE DUE TO LANGUAGE, COST, OR AGE, INCLUDING THOSE WHO ARE UNINSURED OR UNDER-INSURED. BASIS FOR SELECTION: BARRIERS TO CARE EXIST IN BARNSTABLE COUNTY DESPITE HIGH RATES OF RESIDENTS WITH HEALTH INSURANCE COVERAGE. THIS SPECIFIC TARGET POPULATION WAS IDENTIFIED IN THE 2014-2016 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. THE REPORT IDENTIFIED THE AVAILABILITY OF PRIMARY CARE AND SPECIALTY CARE PROVIDERS, OUT-OF-POCKET EXPENSES, AND LINGUISTIC CHALLENGES AS SPECIFIC BARRIERS FOR THIS TARGET POPULATION. 3. NAME OF TARGET POPULATION: INDIVIDUALS WITH MENTAL HEALTH DISORDERS AND CO-OCCURRING DISORDERS. BASIS FOR SELECTION: ACCESS TO ADEQUATE MENTAL HEALTH CARE IN BARNSTABLE COUNTY IS AN AREA OF CONCERN, AS EVIDENCED BY HIGH RATES OF PATIENTS PRESENTING WITH MENTAL HEALTH DISORDERS IN HOSPITAL EMERGENCY DEPARTMENTS AND INCREASING RATES OF SUICIDE. SPECIFIC CHALLENGES IDENTIFIED FOR RESIDENTS WITH MENTAL HEALTH DISORDER INCLUDE ACCESS BARRIERS DUE TO A SHORTAGE OF PSYCHIATRIC PROVIDERS, LONG WAIT TIMES FOR OUTPATIENT APPOINTMENTS AND LIMITED ACUTE CARE INSTITUTIONAL OPTIONS FOR SPECIAL POPULATIONS. THIS SPECIFIC TARGET POPULATION WAS IDENTIFIED IN THE 2014-2016 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. 4. NAME OF TARGET POPULATION: INDIVIDUALS WITH SUBSTANCE USE DISORDERS.BASIS FOR SELECTION: THE IMPACT OF SUBSTANCE USE DISORDERS IS A CRITICAL HEALTH CHALLENGE FOR THE HEALTH SYSTEM AND COMMUNITY IN BARNSTABLE COUNTY. THE OVERALL RATES OF SUBSTANCE USE TREATMENT ADMISSIONS ARE HIGHER IN BARNSTABLE COUNTY THAN MA, SPECIFICALLY FOR ALCOHOL AS A PRIMARY SUBSTANCE. IN ADDITION, TREATMENT ADMISSIONS FOR OPIATES AS A PRIMARY SUBSTANCE OF USE MORE THAN DOUBLED FROM 2007 TO 2011. CHALLENGES CITED INCLUDE THE AVAILABILITY OF ACUTE DETOX AND TREATMENT OPTIONS, AND NAVIGATION OF EXISTING SERVICES. THIS SPECIFIC TARGET POPULATION WAS IDENTIFIED IN THE 2014-2016 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. 5. NAME OF TARGET POPULATION: SENIOR POPULATION, AGES 65 AND OLDER. BASIS FOR SELECTION: BARNSTABLE COUNTYS MEDIAN AGE OF 49.9 YEARS IS MORE THAN A DECADE OLDER THAN MA AND U.S. MEDIAN AGE AVERAGES. ACCORDING TO THE 2010 U.S. CENSUS, THE POPULATION OF INDIVIDUALS OF THE AGE 65 AND OLDER REPRESENT 25% OF THE YEAR ROUND POPULATION IN BARNSTABLE COUNTY WITH A SIGNIFICANT INCREASE OF RESIDENTS OVER THE AGE OF 85 BETWEEN 2000 AND 2010. NEARLY 40% OF ALL HOUSEHOLDS REPORT A RESIDENT OVER THE AGE OF 65. HIGH UTILIZATION RATES OF HEALTH SERVICES, ISOLATION, AND CHALLENGES RELATED TO NAVIGATION OF SERVICES WERE IDENTIFIED IN THE 2014-2016 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. 6. NAME OF TARGET POPULATION: YOUTH AND YOUNG ADULTS, AGES 15 TO 24 YEARS OLD. BASIS FOR SELECTION: YOUTH AND YOUNG ADULTS, AGES 1524 YEARS OLD, WERE IDENTIFIED IN THE 2014-2016 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AS A SPECIFIC AT-RISK POPULATION DUE TO INCREASING RATES OF SUBSTANCE ABUSE TREATMENT ADMISSIONS, SEXUALLY TRANSMITTED DISEASES AND MOTOR VEHICLE ACCIDENTS. CAPE COD HEALTHCARE COLLABORATES WITH A BROAD RANGE OF HEALTH AND HUMAN SERVICE AGENCIES TO ADDRESS THE NEEDS OF AT-RISK YOUTH AND YOUNG ADULTS. PUBLICATION OF TARGET POPULATIONS NOT SPECIFIED, OTHER- COMMUNITY HEALTH NEEDS ASSESSMENT REPORT HOSPITAL/HMO WEB PAGE PUBLICIZING TARGET POP. HTTP://WWW.CAPECODHEALTH.ORG/ABOUT/CARING-FOR-OUR-COMMUNITY/
KEY ACCOMPLISHMENTS OF REPORTING YEAR	CAPE COD HEALTHCARE CONTINUED TO STAND OUT IN THE AREA OF QUALITY, INNOVATION AND PATIENT APPRECIATION IN FY2016. CAPE COD HOSPITAL AND FALMOUTH HOSPITALS GARNERED SEVERAL IMPORTANT AWARDS AND RECOGNITIONS, INCLUDING: * AMERICA'S 100 GREAT COMMUNITY HOSPITALS: CAPE COD HOSPITAL WAS NAMED TO THE LIST OF AMERICAS 100 GREAT COMMUNITY HOSPITALS BY BECKERS HOSPITAL REVIEW FOR THE FIFTH CONSECUTIVE YEAR. THIS RECOGNITION IS BASED ON QUALITY OF CARE AND SERVICE TO OUR COMMUNITY, AND DEMONSTRATES THAT THE HOSPITAL IS SUCCESSFULLY AND CONSISTENTLY ACHIEVING TOP RESULTS IN PATIENT CARE AND SATISFACTION. * AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION GET WITH THE GUIDELINES: FALMOUTH HOSPITAL EARNED THE GET WITH THE GUIDELINES-STROKE GOLD-PLUS QUALITY ACHIEVEMENT AWARD FOR THE SEVENTH CONSECUTIVE YEAR. THIS ACHIEVEMENT RECOGNIZES THE HOSPITALS COMMITMENT AND SUCCESS IN IMPLEMENTING SPECIFIC QUALITY IMPROVEMENT MEASURES OUTLINE BY THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION FOR THE TREATMENT OF STROKE PATIENTS. * DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE: HEALTHGRADES RECOGNIZED BOTH CAPE COD HOSPITAL AND FALMOUTH HOSPITAL WITH ITS 2016 DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE. THE HONOR RECOGNIZED HOSPITALS PERFORMING IN THE TOP 5 PERCENT NATIONWIDE BASED ON RISK-ADJUSTED CLINICAL OUTCOMES FOR DOZENS OF COMMON PROCEDURES AND CONDITIONS. * BLUE DISTINCTION AWARDS: BLUE CROSS BLUE SHIELD RECOGNIZES HOSPITALS FOR DEMONSTRATED EXPERTISE IN SPECIALTY SERVICES AND QUALITY MEASURES FOR PATIENTS. CAPE COD HOSPITAL WAS RECOGNIZED FOR THE FOLLOWING SPECIALTIES: TOTAL HIP REPLACEMENT, TOTAL KNEE REPLACEMENT, MATERNITY, AND CARDIAC AND SPINE SURGERY. FALMOUTH HOSPITAL WAS RECOGNIZED FOR THE FOLLOWING SPECIALTIES: TOTAL HIP REPLACEMENT AND MATERNITY. * CENTER OF NAS EXCELLENCE: CAPE COD HOSPITAL WAS DESIGNATED A CENTER OF EXCELLENCE FOR EDUCATION AND TRAINING FOR INFANTS AND FAMILIES IMPACTED BY NEONATAL ABSTINENCE SYNDROME BY THE VERMONT OXFORD NETWORK. THE DESIGNATION IS AWARDED TO HEALTH CENTERS THAT SUCCESSFULLY TRAIN AT LEAST 85 PERCENT OF THEIR DESIGNATED CARE TEAM USING A NOVEL ONLINE TRAINING PLATFORM TO COMPLETE 17 CRITICAL, EVIDENCE-BASED LEARNING LESSONS. * LEAPFROG HOSPITAL SAFETY SCORE: CAPE COD HOSPITAL WAS ONE OF ONLY 182 HOSPITALS IN THE ENTIRE COUNTRY TO ACHIEVE STRAIGHT AS IN THE ANNUAL HOSPITAL SAFETY SCORE SINCE THE INITIATIVE WAS LAUNCHED IN 2012. FALMOUTH HOSPITAL WAS RECOGNIZED WITH A B HOSPITAL SAFETY SCORE. THE HOSPITAL SAFETY SCORE IS THE GOLD STANDARD RATING FOR PATIENT SAFETY AND IS COMPILED BY THE LEAPFROG GROUP, A NON-PROFIT HOSPITAL SAFETY WATCHDOG. * READMISSION RATES: CAPE COD HOSPITAL WAS RECOGNIZED AS AMONG THE TOP THREE HOSPITALS IN THE STATE WITH THE LOWEST READMISSION RATES IN A REPORT BY THE STATE CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA) IN 2016. THE REPORT EXAMINED RATES AT SPECIFIC HOSPITALS AND REGIONS IN THE STATE. CCH HAS CONSISTENTLY BEEN WITHIN THE LOWEST QUARTILE FOR READMISSION RATES OVER THE PAST SEVERAL YEARS. * STANDARD & POORS RAISES CCHC BOND RATING: STANDARD & POORS RATINGS SERVICES REAFFIRMED ITS LONG-TERM "A" RATING FOR CAPE COD HEALTHCARE. THE RATING OUTLOOK REMAINED "STABLE." S&P ATTRIBUTED THE POSITIVE RATING TO CCHC'S FINANCIAL PROFILE AS "STRONG, WITH CONSISTENTLY HEALTHY FINANCIAL OPERATING PERFORMANCE IN RECENT YEARS." STANDARD & POOR'S IS A NATIONALLY RECOGNIZED STATISTICAL RATING ORGANIZATION DESIGNATED BY THE SECURITIES AND EXCHANGE COMMISSION. IN ADDITION TO CLINICAL ACHIEVEMENTS, HOSPITAL-BASED AND COMMUNITY-BASED HEALTH IMPROVEMENT ACTIVITIES CONTINUED IN AN EFFORT TO ADDRESS THE HEALTH NEEDS OF BARNSTABLE COUNTY RESIDENTS. THE 2014-2016 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION PLAN GUIDED HEALTH IMPROVEMENT AND COMMUNITY BENEFITS ACTIVITIES TO FOCUS ON FOUR KEY HEALTH PRIORITIES IDENTIFIED IN THE REPORT: CHRONIC AND INFECTIOUS DISEASE, ACCESS TO CARE, MENTAL HEALTH AND SUBSTANCE USE DISORDERS. THESE PRIORITIES WERE ADDRESSED THROUGH NEW AND EXISTING HOSPITAL PROGRAMS, COLLABORATION WITH FEDERALLY QUALIFIED HEALTH CENTERS, INVESTMENTS IN COMMUNITY-BASED HEALTH AND HUMAN SERVICE ORGANIZATIONS, AND EXPANDED REGIONAL COALITIONS AND TASK FORCE EFFORTS. CHRONIC AND INFECTIOUS DISEASE MANAGEMENT, PREVENTION, SCREENING, AND DETECTION EFFORTS WERE SUPPORTED THROUGH A VARIETY OF CCHC COMMUNITY BENEFITS ACTIVITIES. HOSPITAL EFFORTS INCLUDED CANCER SURVIVORSHIP SERVICES, ONCOLOGY SUPPORT GROUPS, PHYSICIAN-LED CANCER PREVENTION WORKSHOPS AND HEALTH FAIRS, AND CLINICAL-COMMUNITY LINKAGES FOR PATIENTS TO ACCESS COMPLEMENTARY SERVICES SUCH AS MASSAGE, ACUPUNCTURE AND NUTRITIONAL COUNSELING. CCHC INFECTIOUS DISEASE CLINICAL SERVICES COORDINATED HEPATITIS C AND HIV/AIDS SCREENING, TESTING AND DISEASE MANAGEMENT SERVICES FOR THE REGION. CCHC COMMUNITY BENEFITS PROVIDED GRANTS FOR PROJECTS INCLUDING A HPV AWARENESS CAMPAIGN FOR YOUTH, MELANOMA PREVENTION EDUCATION AT BEACHES, AND A TICK TESTING AND TICK-BORNE DISEASE SURVEILLANCE PROGRAM. CAPE COD HEALTHCARE PARTNERED WITH THE CAPE COD HUNGER NETWORK TO EXPAND A PROGRAM FOR CLIENTS OF LOCAL FOOD PANTRIES TO HELP MONITOR THEIR DIABETES AND HEART DISEASE AND ENCOURAGE NUTRITIONAL IMPROVEMENT THROUGH EDUCATION AND DISTRIBUTION OF FRESH FOOD AND VEGETABLES. THE FLAVORX PILOT PROJECT ENCOURAGED PATIENTS TO PURSUE PLANT-BASED DIETS AND OFFERED INCENTIVES TO SHOP AT LOCAL FARMERS MARKETS. HEALTHY PARKS, HEALTHY PEOPLE, A WALKING PROGRAM TO PROMOTE HEALTH AND WELLNESS FOR YEAR-ROUND AND SEASONAL RESIDENTS, AS WELL AS VISITORS TO THE CAPE, WAS CONTINUED THROUGH A PARTNERSHIP BETWEEN THE US NATIONAL PARK SERVICE, THE CAPE COD NATIONAL SEASHORE, AND CAPE COD HEALTHCARE. IMPROVING ACCESS TO CARE FOR TARGET POPULATIONS WAS SUPPORTED THROUGH NEW ACTIVITIES AND EXISTING PROGRAMS IN FY2016. IN PARTNERSHIP WITH THE CAPE AND ISLANDS EMERGENCY MEDICAL SERVICES SYSTEM, CCHC EXPANDED MEDICAL INTERPRETER SERVICES FOR LIMITED-ENGLISH SPEAKING PATIENTS IN PRE-HOSPITAL SETTINGS. THE NEW PROGRAM PROVIDES PHONE BASED INTERPRETER SERVICES TO PARAMEDICS AND FIRST RESPONDERS TO IMPROVE COMMUNICATION WITH PATIENTS UPON ARRIVAL TO A 911 CALL AND DURING TRANSPORT TO THE HOSPITAL. CCHC INTERPRETER SERVICES ALSO PROVIDED FREE MEDICAL INTERPRETER SERVICES FOR LIMITED ENGLISH SPEAKING PATIENTS IN COMMUNITY-BASED PRIMARY AND SPECIALTY CARE OFFICES ACROSS THE REGION. A CCHC GRANT TO THE BARNSTABLE COUNTY HUMAN SERVICES DEPARTMENT SUPPORTED EFFORTS TO INCREASE THE NETWORK OF VOLUNTEERS FOR THE SHINE (SERVING THE HEALTH INSURANCE NEEDS OF EVERYONE) PROGRAM ACROSS ALL 15 TOWNS IN BARNSTABLE COUNTY. IN AN EFFORT TO ENSURE A STRONG AND SKILLED WORKFORCE IN THE REGION, CAPE COD HEALTHCARE AWARDED CAPE COD COMMUNITY COLLEGE A $1 MILLION GRANT TO EXPAND LOCAL NURSING AND ALLIED HEALTH PROGRAMS. CCHC CENTERS FOR BEHAVIORAL HEALTH EXPANDED SERVICES TO INCLUDE A BEHAVIORAL HEALTH TELEMEDICINE PROGRAM AT FALMOUTH HOSPITAL, ADDICTION ASSESSMENT AND DETOX PROTOCOL CONSULTATION AT BOTH HOSPITALS AND A NEW COLLABORATIVE CASE MANAGEMENT MODEL WITH DUFFY HEALTH CENTER TO CARE FOR PATIENTS WHO ARE HOMELESS OR AT RISK OF HOMELESSNESS. CCHCS SUPPORT OF THE BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS RESULTED IN TRAINING 40 LOCAL LAW ENFORCEMENT OFFICERS IN MENTAL HEALTH FIRST AID AND HOSTING A BEHAVIORAL HEALTH SUMMIT ATTENDED BY MORE THAN 250 HEALTH, BUSINESS AND COMMUNITY LEADERS. SEVERAL COMMUNITY BENEFITS GRANTS WERE MADE TO EXPAND BEHAVIORAL HEALTH SERVICES IN THE COMMUNITY, INCLUDING A MENTAL HEALTH PROGRAM FOR YOUNG ADULTS AT CAPE COD COMMUNITY COLLEGE, SUPPORT GROUPS FOR SUICIDE ATTEMPT SURVIVORS, AND COUNSELING SUPPORT FOR CAREGIVERS OF INDIVIDUALS WITH ALZHEIMERS DISEASE AND DEMENTIA.
CAPE COD HEALTHCARE LEADERSHIP EFFORTS IN ADDRESSING SUBSTANCE	USE DISORDERS CONTINUED THROUGH A PLEDGE OF $2.5 MILLION IN GRANT SUPPORT TO EXPAND ACCESS TO MEDICATION ASSISTED TREATMENT AT FEDERALLY QUALIFIED HEALTH CENTERS, INCREASE CASE MANAGEMENT SUPPORT, AND IMPROVE TREATMENT NAVIGATION EFFORTS IN THE REGION. CAPE COD HOSPITAL WAS ONE OF TWO SITES AWARDED A MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH GRANT TO PILOT THE MOMS DO CARE PROGRAM. THE PROGRAM PROVIDES INTEGRATED PRENATAL AND SUBSTANCE USE TREATMENT AND PEER RECOVERY SERVICES FOR PREGNANT WOMEN WITH OPIOID USE DISORDERS. PHYSICIAN AND CLINICAL LEADERSHIP IN THE MATERNITY AND PEDIATRIC DEPARTMENT AT CAPE COD HOSPITAL ALSO LED THE EFFORT TO BECOME A DESIGNATED CENTER OF EXCELLENCE FOR EDUCATION AND TRAINING FOR INFANTS AND FAMILIES IMPACTED BY NEONATAL ABSTINENCE SYNDROME BY THE VERMONT OXFORD NETWORK. IN ADDITION, CCHC COMMUNITY BENEFITS ALSO PROVIDED GRANT FUNDING FOR YOUTH PREVENTION PROGRAMS, PARENTING IN RECOVERY CLASSES AND PEER-LED RECOVERY SUPPORT GROUPS FOR MOTHERS. CCHC STRATEGIC PARTNERSHIPS WITH THE FOUR REGIONAL FEDERALLY QUALIFIED HEALTH CENTERS FOCUSED ON ALL HEALTH PRIORITIES. GRANTS SUPPORTED EFFORTS TO EXPAND PSYCHIATRIC SERVICES AND PRIMARY CARE ACCESS, DEVELOP COMPLEX CARE MANAGEMENT PROGRAMS FOR HIGH-RISK PATIENTS AND INCREASE ACCESS FOR OFFICE-BASED OPIOID TREATMENT PROGRAMS FOR INDIVIDUALS WITH SUBSTANCE USE DISORDERS. IN ADDITION TO HOSPITAL-BASED PROGRAMS AND GRANT FUNDED COMMUNITY-BASED PROJECTS, COMMUNITY BENEFITS AND HOSPITAL STAFF CONTINUED TO PLAY LEADERSHIP ROLES IN HEALTH AND HUMAN SERVICE ORGANIZATIONS AND COALITIONS ACROSS BARNSTABLE COUNTY INCLUDING THE CAPE & ISLANDS COMMUNITY HEALTH AREA NETWORK (CHNA 27) STEERING COMMITTEE, BARNSTABLE COUNTY HUMAN SERVICES ADVISORY COUNCIL, BARNSTABLE COUNTY REGIONAL SUBSTANCE USE COUNCIL, BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS, QUALITY OF LIFE INITIATIVE AND THE SUBSTANCE USE IN PREGNANCY TASK FORCE. PLANS FOR NEXT REPORTING YEAR ANNUAL COMMUNITY BENEFITS PLANS FOR CAPE COD HOSPITAL, FALMOUTH HOSPITAL AND CAPE COD HEALTHCARE REFLECT THE PRIORITIES, GOALS AND OBJECTIVES OF THE THREE-YEAR IMPLEMENTATION STRATEGIES INCLUDED IN THE 20172019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION PLAN. COMMUNITY BENEFITS FY2017FY2019 GOALS: 1. IMPROVE CHRONIC AND INFECTIOUS DISEASE PREVENTION AND MANAGEMENT TO MEET THE GROWING NEEDS OF AN AGING AND AT-RISK POPULATION. 2. STRENGTHEN REGIONAL HEALTH SERVICES AND COMMUNITY RESOURCES FOR INDIVIDUALS WITH MENTAL HEALTH CONDITIONS, SUBSTANCE USE, CO-OCCURRING DISORDERS, AND COMORBIDITIES. 3. REDUCE BARRIERS TO CARE AND STRENGTHEN THE REGIONAL HEALTH SAFETY NET FOR VULNERABLE POPULATIONS. 4. IMPROVE THE HEALTH AND DISEASE PREVENTION OF ALL RESIDENTS OF BARNSTABLE COUNTY AND SUSTAIN THE WELLNESS OF SENIORS AND CAREGIVERS. 5. SUPPORT REGIONAL HEALTH EFFORTS THROUGH DIRECT GRANT FUNDING AND A COMPETITIVE RFP GRANTS PROGRAM WITH FUNDING GUIDELINES THAT ARE ALIGNED WITH COMMUNITY BENEFITS PRIORITIES. 6. MAINTAIN AND DEVELOP COMMUNITY LEADERSHIP OPPORTUNITIES TO IMPROVE THE HEALTH STATUS OF THE RESIDENTS OF BARNSTABLE COUNTY INCLUDING PARTICIPATION WITH THE COMMUNITY HEALTH AREA NETWORK (CHNA 27) STEERING COMMITTEE, BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS, THE BARNSTABLE COUNTY HUMAN SERVICES ADVISORY COUNCIL, AND THE BARNSTABLE COUNTY REGIONAL SUBSTANCE ABUSE COUNCIL. COMMUNITY BENEFITS LEADERSHIP/TEAM CAPE COD HEALTHCARE, CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, ALONG WITH OUR AFFILIATES, STRIVE TO BE THE HEALTH SERVICE PROVIDER OF CHOICE FOR BARNSTABLE COUNTY RESIDENTS BY ACHIEVING AND MAINTAINING THE HIGHEST STANDARDS IN HEALTHCARE DELIVERY AND SERVICE QUALITY. TO DO SO, WE PARTNER WITH OTHER HEALTH AND HUMAN SERVICE PROVIDERS AS WELL AS INVEST IN NEEDED MEDICAL TECHNOLOGIES, HUMAN RESOURCES AND CLINICAL SERVICES. ABOVE ALL, WE ARE THE SAFETY NET HEALTH CARE PROVIDER FOR RESIDENTS OF BARNSTABLE COUNTY. THE DEVELOPMENT OF CAPE COD HEALTHCARES STRATEGIC INITIATIVES AND COMMUNITY COLLABORATIONS, INCLUDING THE COMMUNITY BENEFITS PROGRAM, IS LED BY MICHAEL K. LAUF, CHIEF EXECUTIVE OFFICER AND THERESA M. AHERN, SENIOR VICE PRESIDENT, STRATEGY, COMMUNITY AND GOVERNMENTAL AFFAIRS. MANAGEMENT OF THE PROGRAM IS THE RESPONSIBILITY OF LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS AND GRANTS ADMINISTRATION. THE COMMUNITY HEALTH COMMITTEE, A DESIGNATED SUBCOMMITTEE OF CAPE COD HEALTHCARES BOARD OF TRUSTEES, PROVIDES STRATEGIC OVERSIGHT TO THE COMMUNITY BENEFITS PROGRAM. THE COMMITTEE IS COMPRISED OF LEADERS OF HEALTH AND HUMAN SERVICES ORGANIZATIONS, COMMUNITY ADVOCACY GROUPS AND COUNTY GOVERNMENT, AS WELL AS TWO CURRENT MEMBERS OF THE CCHC BOARD OF TRUSTEES. THE COMMITTEE DEVELOPS AND RECOMMENDS POLICIES TO THE CAPE COD HEALTHCARE BOARD OF TRUSTEES REGARDING COMMUNITY BENEFITS PROGRAMS, SETS PRIORITIES, AWARDS PRIORITY GRANT FUNDING TO COMMUNITY ORGANIZATIONS, AND ADVISES ON COMMUNITY HEALTH ISSUES AND INITIATIVES.
FY 16 COMMUNITY HEALTH COMMITTEE MEMBERS:	ELEANOR CLAUS (CHAIR) CCHC BOARD MEMBER KINLIN GROVER REAL ESTATE 927 ROUTE 6A, YARMOUTHPORT, MA 02675 508.362.3000 X203 ECLAUS@KINLINGROVER.COM REPRESENTING: CCHC BOARD OF TRUSTEES SUZANNE FAY GLYNN, ESQ. CCHC BOARD MEMBER GLYNN LAW OFFICES 49 LOCUST STREET, FALMOUTH, MA 02540 508.548.8282 LJARVIS@GLYNNLAWOFFICES.COM REPRESENTING: CCHC BOARD OF TRUSTEES ELIZABETH ALBERT DIRECTOR BARNSTABLE COUNTY HUMAN SERVICES P.O. BOX 427, BARNSTABLE, MA 02630 508.375.6626 BALBERT@BARNSTABLECOUNTY.ORG REPRESENTING: COMMUNITY AT LARGE & COUNTY DEPARTMENTS KAREN CARDEIRA DIRECTOR FALMOUTH HUMAN SERVICES 65 TOWN HALL SQUARE, FALMOUTH, MA 02540 508.548.0533 KCARDEIRA@FALMOUTHHUMANSERVICES.ORG REPRESENTING: COMMUNITY AT LARGE & UPPER CAPE REGION MARY DEVLIN PUBLIC HEALTH AND WELLNESS DIVISION MANAGER VISITING NURSE ASSOCIATION OF CAPE COD 255 INDEPENDENCE DRIVE, HYANNIS, MA 02601 508.957.7619 MDEVLIN@VNACAPECOD.ORG REPRESENTING: PROVINCETOWN TO PLYMOUTH WITH EMPHASIS ON CHRONIC DISEASE AND HEALTHY AGING OF THE SENIOR POPULATION KAREN GARDNER CHIEF EXECUTIVE OFFICER COMMUNITY HEALTH CENTER OF CAPE COD 107 COMMERCIAL ST., MASHPEE, MA 02649 508.477.7090 KGARDNER@CHCOFCAPECOD.ORG REPRESENTING: COMMUNITY HEALTH CENTER NETWORK & UPPER CAPE RON HOLMES 39 WADING PLACE PATH CHATHAM, MA 02663 508.726.3931 RON.HOLMES@VERIZON.COM REPRESENTING: REGIONAL BEHAVIORAL HEALTH PROVIDERS AND INITIATIVES STACIE PEUGH CHIEF EXECUTIVE OFFICER YMCA CAPE COD 2245 IYANNOUGH RD, WEST BARNSTABLE, MA 02668 508-362-6500 SPEUGH@YMCACAPECOD.ORG REPRESENTING: YOUTH DEVELOPMENT, WELLNESS, DISEASE MANAGEMENT AND PREVENTION SUSAN TRAVERS DIRECTOR TRURO COUNCIL ON AGING 7 STANDISH WAY, NORTH TRURO 02652 508-487-2462 STRAVERS@TRURO-MA.GOV REPRESENTING: SENIOR POPULATIONS & OUTER CAPE CAPE COD HEALTHCARE MEMBER: THERESA M. AHERN SENIOR VICE PRESIDENT, STRATEGY, COMMUNITY AND GOVERNMENTAL AFFAIRS CAPE COD HEALTHCARE 88 LEWIS BAY ROAD HYANNIS, MA 02601 508-862-5077 TAHERN@CAPECODHEALTH.ORG COMMUNITY BENEFITS TEAM MEETINGS THE FY2016 COMMUNITY HEALTH COMMITTEE MEETINGS WERE HELD ON THE FOLLOWING DATES: NOVEMBER 5, 2015 9:00 11:00 AM APRIL 5, 2016 4:00-5:00 PM JUNE 7, 2016 4:00-5:00 PM JULY 26, 2016 4:00-5:00 PM
COMMUNITY PARTNERS	ALZHEIMERS FAMILY CAREGIVER SUPPORT CENTER BARNSTABLE COUNTY CAPE COD COOPERATIVE EXTENSION SERVICES BARNSTABLE COUNTY HUMAN SERVICES BARNSTABLE COUNTY REGIONAL SUBSTANCE ABUSE COUNCIL BARNSTABLE COUNTY SHERIFF BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS BIG BROTHERS BIG SISTERS OF CAPE COD & THE ISLANDS BOYS & GIRLS CLUB OF CAPE COD CALMER CHOICE CAPE & ISLANDS EMS SYSTEMS, INC CAPE & ISLANDS UNITED WAY CAPE COD CHILD DEVELOPMENT CAPE COD CHILDRENS MUSEUM CAPE COD CHILDRENS PLACE CAPE COD COMMUNITY COLLEGE CAPE COD FOUNDATION CAPE COD HUNGER NETWORK CHILDRENS COVE COALITION FOR CHILDREN COMMUNITY DEVELOPMENT PARTNERSHIP COMMUNITY HEALTH CENTER OF CAPE COD COMMUNITY HEALTH NETWORK AREA 27 CAPE COD & ISLANDS (CHNA 27) DUFFY HEALTH CENTER FALMOUTH SERVICE CENTER FAMILY PANTRY OF CAPE COD GANDARA MENTAL HEALTH GLENNA KOHL FUND FOR HOPE GOSNOLD ON CAPE COD HARBOR COMMUNITY HEALTH CENTER - HYANNIS HELPING OUR WOMEN HOPE DEMENTIA & ALZHEIMERS SERVICES INDEPENDENCE HOUSE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH MOTHERS AND INFANTS RECOVERY NETWORK NATIONAL ALLIANCE ON MENTAL ILLNESS CAPE COD OPEN DOORWAY OF CAPE COD OUTER CAPE HEALTH SERVICES PARKINSON SUPPORT NETWORK OF CAPE COD SAIL CAPE COD SAMARITANS ON CAPE COD AND THE ISLANDS SHEAS YOUTH BASKETBALL ASSOCIATION SPECIALTY NETWORK FOR THE UNINSURED TOWN OF BARNSTABLE YOUTH COMMISSION TOWN OF YARMOUTH PARK AND RECREATIONS DEPARTMENT UNITED STATES NATIONAL PARK SERVICE AND CAPE COD NATIONAL SEASHORE UPPER CAPE SPARTANS WE CAN YMCA CAPE COD COMMUNITY HEALTH NEEDS ASSESSMENT DATE LAST ASSESSMENT COMPLETED AND CURRENT STATUS THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT (CHNA REPORT) AND IMPLEMENTATION PLAN WAS RELEASED AND MADE WIDELY AVAILABLE TO THE PUBLIC ON SEPTEMBER 30, 2016. THE GOALS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROJECT ARE TO MONITOR REGIONAL HEALTH DATA, ENGAGE HOSPITAL STAKEHOLDERS, PROMOTE PARTNERSHIPS BETWEEN THE HOSPITALS AND COMMUNITY ORGANIZATIONS AND DEVELOP MULTI-YEAR IMPLEMENTATION STRATEGIES TO GUIDE HOSPITAL INITIATIVES TO IMPROVE THE HEALTH OF BARNSTABLE COUNTY RESIDENTS. THE METHODOLOGY FOR CONDUCTING THE ASSESSMENT INCLUDED THE COLLECTION AND ANALYSIS OF PRIMARY AND SECONDARY HEALTH DATA, GATHERING SIGNIFICANT INPUT FROM THE COMMUNITY, AND THE IDENTIFICATION AND PRIORITIZATION OF KEY HEALTH NEEDS FOR THE REGION. OVER 20 DATA SOURCES WERE UTILIZED TO COLLECT BARNSTABLE COUNTY AND TOWN-LEVEL HEALTH STATISTICS ON DISEASE INCIDENCE AND PREVALENCE, HOSPITAL UTILIZATION, MORBIDITY AND MORTALITY, BARRIERS TO ACCESSING CARE, AND BEHAVIORAL RISK FACTORS. REGIONAL STATISTICS WERE ANALYZED AND COMPARED TO STATE AND NATIONAL STATISTICS TO IDENTIFY WHERE DEMOGRAPHIC AND HEALTH DISPARITIES EXIST. ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS REPRESENTING LOW-INCOME, MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS PROVIDED CRITICAL INSIGHT AND FEEDBACK ON THE REGIONAL HEALTH NEEDS THROUGH KEY INFORMATION INTERVIEWS AND COMMUNITY INPUT FORUMS. THROUGH THIS COLLECTION OF DATA AND COMMUNITY INPUT THE SIGNIFICANT HEALTH NEEDS OF BARNSTABLE COUNTY RESIDENTS WERE DISTINGUISHED AND PRIORITIZED BASED ON THE FREQUENCY, URGENCY, SCOPE, SEVERITY AND MAGNITUDE OF THE IDENTIFIED ISSUES. THE SIGNIFICANT HEALTH NEEDS AND ASSOCIATED TARGET POPULATIONS IDENTIFIED THROUGH THE CHNA REPORT WILL SERVE AS THE FOUNDATION FOR COMMUNITY BENEFITS AND HOSPITAL PLANNING SPANNING FISCAL YEARS 2017-2019.
CONSULTANTS/OTHER ORGANIZATIONS	THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE 2017 - 2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT PROJECT: AIDS SUPPORT GROUP OF CAPE COD ALZHEIMERS FAMILY SUPPORT CENTER OF CAPE COD ARBOR COUNSELING SERVICES BARNSTABLE COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENT BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES BARNSTABLE COUNTY PUBLIC NURSING DIVISION BARNSTABLE COUNTY REGIONAL SUBSTANCE ABUSE COUNCIL BARNSTABLE PUBLIC SCHOOL SYSTEM BARNSTABLE TOWN COUNCIL BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS BOYS & GIRLS CLUB OF CAPE COD CAPE & ISLANDS EMERGENCY MEDICAL SERVICES SYSTEM CAPE & ISLANDS SUICIDE PREVENTION COALITION CAPE & ISLANDS UNITED WAY CAPE COD CENTER FOR WOMEN CAPE COD CHILD DEVELOPMENT CAPE COD COMMUNITY COLLEGE CAPE COD COUNCIL OF CHURCHES CAPE COD DISTRICT ATTORNEYS OFFICE CAPE COD FOUNDATION CAPE COD NEIGHBORHOOD SUPPORT COALITION CAPE COD WIC CARON TREATMENT CENTER CCHC CENTERS FOR BEHAVIORAL HEALTH CCHC EMERGENCY SERVICES CHILD AND FAMILY SERVICES CHILDRENS COVE COALITION FOR CHILDREN COMMUNITY ACTION COMMITTEE OF CAPE COD & THE ISLANDS COMMUNITY DEVELOPMENT PARTNERSHIP COMMUNITY HEALTH CENTER OF CAPE COD COMMUNITY HEALTH NETWORK AREA 27 DUFFY HEALTH CENTER ELDER SERVICES OF CAPE COD & THE ISLANDS EMERALD PHYSICIANS FALMOUTH HUMAN SERVICES FALMOUTH PUBLIC SCHOOL SYSTEM FALMOUTH SERVICE CENTER FALMOUTH TOGETHER WE CAN FALMOUTH VOLUNTEERS IN PUBLIC SCHOOLS GLENNA KOHL FUND FOR HOPE GOSNOLD ON CAPE COD HARBOR COMMUNITY HEALTH CENTER-HYANNIS HEALTH IMPERATIVES HEALTHY LIVING CAPE COD HELPING OUR WOMEN HOMELESS PREVENTION COUNCIL HOPE DEMENTIA & ALZHEIMERS SERVICES OF CAPE COD HOPE HEALTH HOUSING ASSISTANCE CORPORATION INDEPENDENCE HOUSE JOHN SNOW, INC. JUSTICE RESOURCE INSTITUTE LYME AWARENESS OF CAPE COD MA DEPARTMENT OF MENTAL HEALTH MA DEPARTMENT OF PUBLIC HEALTH MASHPEE WAMPANOAG HEALTH SERVICE UNIT MASHPEE WAMPANOAG TRIBE HEALTH SERVICES MOTHER AND INFANT RECOVERY NETWORK NATIONAL ALLIANCE ON MENTAL ILLNESS CAPE COD OUTER CAPE HEALTH SERVICES OUTER CAPE WOMEN INFANTS AND CHILDREN (WIC) SAMARITANS ON CAPE COD AND THE ISLANDS SANDPIPER NURSERY SCHOOL SANDWICH PUBLIC SCHOOL SYSTEM SHINE (SERVING HEALTH INFORMATION NEEDS OF EVERYONE) SIGHT LOSS SERVICES SPAULDING REHABILITATION HOSPITAL CAPE COD SPECIALTY NETWORK FOR THE UNINSURED SUBSTANCE USE IN PREGNANCY TASK FORCE THE FAMILY PANTRY OF CAPE COD TOWN OF BREWSTER HEALTH DEPARTMENT TOWN OF FALMOUTH COUNCIL ON AGING TOWN OF FALMOUTH HEALTH DEPARTMENT TOWN OF MASHPEE COUNCIL ON AGING TOWN OF MASHPEE HUMAN SERVICES TOWN OF PROVINCETOWN COUNCIL ON AGING TOWN OF SANDWICH COUNCIL ON AGING TOWN OF TRURO COUNCIL ON AGING VINFEN VISITING NURSE ASSOCIATION OF CAPE COD WE CAN YARMOUTH POLICE DEPARTMENT YMCA OF CAPE COD DATA SOURCES COMMUNITY FOCUS GROUPS, HOSPITAL, INTERVIEWS, MASSCHIP, PUBLIC HEALTH PERSONNEL, SURVEYS, CHNA
COMMUNITY BENEFITS PROGRAMS	INTERPRETER SERVICES FOR COMMUNITY-BASED PHYSICIAN OFFICES PROGRAM TYPE: OUTREACH TO UNDERSERVED STATEWIDE PRIORITY: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS, REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORM BRIEF DESCRIPTION OR OBJECTIVE: CCHC COMMUNITY BENEFITS PROVIDES ANNUAL SUPPORT TO IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE FOR INDIVIDUALS WHO FACE BARRIERS TO CARE DUE TO LANGUAGE THROUGH THE COMMUNITY BASED INTERPRETER SERVICES PROGRAM. THE PROGRAM DISPATCHES FREE MEDICAL LANGUAGE INTERPRETERS TO COMMUNITY-BASED PHYSICIAN PRACTICES TO ASSIST LIMITED AND NON-ENGLISH SPEAKING PATIENTS AND THEIR FAMILIES. THE AVAILABILITY OF PROFICIENT AND PROFESSIONAL INTERPRETER SERVICES ENSURES THE DELIVERY OF SAFE, QUALITY HEALTH CARE AND POSITIVE CLINICAL OUTCOMES. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: ARTHRITIS, OTHER: ASTHMA/ALLERGIES, OTHER: CANCER, OTHER: CARDIAC DISEASE, OTHER: CHRONIC PAIN , OTHER: COLITIS/CROHN DISEASE, OTHER: CULTURAL COMPETENCY, OTHER: DIABETES, OTHER: FAMILY PLANNING, OTHER: HEPATITIS, OTHER: HIV/AIDS, OTHER: HYPERTENSION, OTHER: LYME DISEASE, OTHER: NUTRITION, OTHER: OSTEOPOROSIS/MENOPAUSE, OTHER: PARKINSONS DISEASE, OTHER: PREGNANCY, OTHER: PULMONARY DISEASE/TUBERCULOSIS, OTHER: SAFETY - HOME, OTHER: SEXUALLY TRANSMITTED DISEASES, OTHER: SICKLE CELL DISEASE, OTHER: SMOKING/TOBACCO, OTHER: STROKE, OTHER: UNINSURED/UNDERINSURED, OVERWEIGHT AND OBESITY, PHYSICAL ACTIVITY, RESPONSIBLE SEXUAL BEHAVIOR, SUBSTANCE ABUSE, TOBACCO USE SEX: ALL AGE GROUP: ALL ADULTS ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: REDUCE LANGUAGE BARRIERS TO CARE BY PROVIDING MEDICAL INTERPRETATIONS IN COMMUNITY-BASED PRIMARY CARE AND SPECIALTY SETTINGS. GOAL STATUS: COLLABORATION WITH COMMUNITY HEALTH CENTERS AND PHYSICIAN OFFICES RESULTED IN 816 LANGUAGE INTERPRETATIONS IN FY16. APPROXIMATELY, 82 % OF REQUESTED INTERPRETATIONS WERE FOR RESIDENTS SPEAKING PORTUGUESE AND 18% FOR RESIDENTS SPEAKING SPANISH. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS COMMUNITY-BASED MEDICAL OFFICES ON CAPE COD: VARIOUS HARBOR COMMUNITY HEALTH CENTER-HYANNIS: HTTP://WWW.HHSI.US/CAPE-COD/HARBOR-COMMUNITY-HEALTH-CENTER-HYANNIS/ COMMUNITY HEALTH CENTER OF CAPE COD: WWW.CHCOFCAPECOD.ORG CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED SPECIALITY NETWORK FOR THE UNINSURED: HARBOR COMMUNITY HEALTH CENTER HYANNIS PROGRAM TYPE: OUTREACH TO UNDERSERVED STATEWIDE PRIORITY: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS BRIEF DESCRIPTION OR OBJECTIVE: CAPE COD HEALTHCARE COMMUNITY BENEFITS PROVIDES ANNUAL GRANT SUPPORT TO HARBOR COMMUNITY HEALTH CENTER HYANNIS TO COORDINATE THE SPECIALTY NETWORK FOR THE UNINSURED (SNU). THE SNU PROGRAM INCREASES ACCESS TO SPECIALTY CARE FOR UNINSURED AND UNDER-INSURED RESIDENTS OF BARNSTABLE COUNTY THROUGH MANAGING A NETWORK OF MEDICAL SPECIALISTS WHO WILL PROVIDE FREE OR SIGNIFICANTLY REDUCED SLIDING-SCALE FEES FOR OFFICE VISITS, PROCEDURES AND CONTINUED CARE OF UNINSURED AND UNDER-INSURED INDIVIDUALS. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: ARTHRITIS, OTHER: ASTHMA/ALLERGIES, OTHER: CANCER, OTHER: CARDIAC DISEASE, OTHER: CHRONIC PAIN , OTHER: DIABETES, OTHER: FAMILY PLANNING, OTHER: HEARING, OTHER: HEPATITIS, OTHER: HYPERTENSION, OTHER: LYME DISEASE, OTHER: OSTEOPOROSIS/MENOPAUSE, OTHER: PARKINSONS DISEASE, OTHER: PREGNANCY, OTHER: PULMONARY DISEASE/TUBERCULOSIS, OTHER: STROKE, OTHER: UNINSURED/UNDERINSURED, OTHER: VISION SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: INCREASE ACCESS TO SPECIALTY CARE FOR LOW-INCOME, UNINSURED AND UNDER-INSURED INDIVIDUALS. GOAL STATUS: THE SNU PROGRAM PROVIDED 681 PATIENT APPOINTMENTS WITH SPECIALISTS IN FY16. THE MOST UTILIZED SPECIALTIES INCLUDED UROLOGY, OPHTHALMOLOGY, EARS, NOSE AND THROAT (ENT), ORTHOPEDICS AND PODIATRY. GOAL DESCRIPTION: PROVIDE ACCESS TO SPECIALISTS FOR UNINSURED OR UNDER-INSURED RESIDENTS WHO FACE LANGUAGE BARRIERS TO CARE. GOAL STATUS: SIXTEEN PERCENT (16%) OF SNU PATIENTS REQUESTED A MEDICAL INTERPRETER. NINETY-FOUR PERCENT (94%) OF THOSE PATIENTS REQUIRED INTERPRETATION FOR PORTUGUESE AND 6% REQUIRED INTERPRETATION FOR SPANISH. GOAL DESCRIPTION: MAINTAIN REFERRAL RELATIONSHIP BETWEEN SNU PROGRAM AND FEDERALLY QUALIFIED HEALTH CENTERS IN THE REGION. GOAL STATUS: NEARLY ALL (99%) PROGRAM REFERRALS WERE MADE BY REGIONAL FEDERALLY QUALIFIED HEALTH CENTERS INCLUDING HARBOR COMMUNITY HEALTH CENTER-HYANNIS, COMMUNITY HEALTH CENTER OF CAPE COD, DUFFY HEALTH CENTER AND ISLAND HEALTH CARE. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS COMMUNITY HEALTH CENTER OF CAPE COD: HTTP://WWW.CHCOFCAPECOD.ORG/ HARBOR COMMUNITY HEALTH CENTER- HYANNIS: WWW.HHSI.US DUFFY HEALTH CENTER: WWW.DUFFYHEALTHCENTER.ORG ISLAND HEALTH CARE: WWW.IHIMV.ORG CAPE COD HEALTHCARE: WWW.CAPECODHEALTH.ORG CONTACT INFORMATION: LISA GUYON, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA, 02601, PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED
PRESCRIPTION ASSISTANCE PROGRAM FOR VULNERABLE POPULATIONS:	CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROGRAM TYPE: DIRECT SERVICES STATEWIDE PRIORITY: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, REDUCING HEALTH DISPARITY BRIEF DESCRIPTION OR OBJECTIVE: THE PRESCRIPTION ASSISTANCE PROGRAM IS AN INITIATIVE OF CAPE COD HOSPITAL AND FALMOUTH HOSPITAL EMERGENCY, BEHAVIORAL HEALTH AND PHARMACY DEPARTMENTS AS A COMMUNITY BENEFIT TO ASSIST UNINSURED, UNDER-INSURED AND FINANCIALLY DISADVANTAGED PATIENTS WHO HAVE NO OTHER VIABLE MEANS TO PAY FOR MEDICATIONS UPON DISCHARGE FROM HOSPITAL FACILITIES. TARGET POPULATION REGIONS SAVED: COUNTY- BARNSTABLE HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: UNINSURED/UNDERINSURED SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: ASSIST RESIDENTS WHO ARE UNABLE TO AFFORD MEDICATIONS TO ENSURE COMPLIANCE WITH HOSPITAL DISCHARGE PLANNING. GOAL STATUS: CAPE COD HOSPITAL AND FALMOUTH HOSPITAL EMERGENCY AND BEHAVIORAL HEALTH DEPARTMENTS PROVIDED PHARMACY VOUCHERS AND PRESCRIPTION ASSISTANCE TOTALING MORE THAN $15,500 FOR UNINSURED, UNDER-INSURED OR FINANCIALLY CHALLENGED PATIENTS. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS LOCAL PHARMACIES: N/A CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601 PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED TRANSPORTATION ASSISTANCE PROGRAM FOR VULNERABLE POPULATIONS: CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROGRAM TYPE: DIRECT SERVICES STATEWIDE PRIORITY: REDUCING HEALTH DISPARITY BRIEF DESCRIPTION OR OBJECTIVE: IN AN EFFORT TO ASSIST LOW-INCOME AND VULNERABLE POPULATIONS, CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROVIDE TRANSPORTATION UPON DISCHARGE FROM EMERGENCY AND BEHAVIORAL HEALTH DEPARTMENTS, TO THOSE PATIENTS WITHOUT RESOURCES FOR TRANSPORTATION. TARGET POPULATION REGIONS SAVED: COUNTY- BARNSTABLE HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: UNINSURED/UNDERINSURED SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: ASSIST RESIDENTS WHO ARE UNABLE TO AFFORD OR ACCESS TRANSPORTATION TO ENSURE COMPLIANCE WITH THEIR DISCHARGE PLAN. GOAL STATUS: CAPE COD HOSPITAL AND FALMOUTH HOSPITAL EMERGENCY AND BEHAVIORAL HEALTH DEPARTMENTS PROVIDED TAXI VOUCHERS TOTALING MORE THAN $37,500 FOR UNINSURED, UNDER-INSURED OR FINANCIALLY DISADVANTAGED PATIENTS UPON DISCHARGE. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS LOCAL TAXI COMPANIES: N/A CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA, 02601 PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED
DUFFY HEALTH CENTER: SUPPORTING BEHAVIORAL HEALTH SERVICES FOR	HOMELESS AND AT RISK ADULTS PROGRAM TYPE: SCHOOL/HEALTH CENTER PARTNERSHIP STATEWIDE PRIORITY: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS BRIEF DESCRIPTION OR OBJECTIVE: THE DUFFY HEALTH CENTER PROVIDES PRIMARY CARE AND BEHAVIORAL HEALTH CARE TO HOMELESS ADULTS AND THOSE AT-RISK FOR HOMELESSNESS IN BARNSTABLE COUNTY. IN FY16, COMMUNITY BENEFITS FUNDING FROM CAPE COD HEALTHCARE SUPPORTED THE DUFFY HEALTH CENTERS BEHAVIORAL HEALTH SERVICES INCLUDING THERAPY, PSYCHIATRY AND CASE MANAGEMENT SUPPORT FOR HEALTH CENTER PATIENTS. TARGET POPULATION REGIONS SAVED: COUNTY- BARNSTABLE HEALTH INDICATOR: ACCESS TO HEALTH CARE, MENTAL HEALTH, OTHER: ALCOHOL AND SUBSTANCE ABUSE, OTHER: HOMELESSNESS, OTHER: UNINSURED/UNDERINSURED, SUBSTANCE ABUSE SEX: ALL AGE GROUP: ADULT, ADULT-ELDER, ADULT-YOUNG ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: TO PROVIDE BEHAVIORAL HEALTH SERVICES TO 1,200 PATIENTS. GOAL STATUS: BEHAVIORAL HEALTH SERVICES WERE PROVIDED TO MORE THAN 1,300 DUFFY HEALTH CENTER PATIENTS THROUGH 10,000 VISITS. GOAL DESCRIPTION: DUFFY HEALTH CENTER WILL PROVIDE PSYCHIATRIC SERVICES, PRIMARILY MEDICATION PRESCRIBING AND MONITORING, TO APPROXIMATELY 300 PATIENTS. GOAL STATUS: PSYCHIATRIC SERVICES, INCLUDING MEDICATION PRESCRIBING AND MONITORING, WERE PROVIDED TO 596 PATIENTS. GOAL DESCRIPTION: 100% OF ALL NEW DUFFY HEALTH CENTER PATIENTS WILL BE SCREENED FOR BEHAVIORAL HEALTH NEEDS. GOAL STATUS: APPROXIMATELY 75% OF NEW PATIENTS WERE SCREENED IN FY16. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS THE DUFFY HEALTH CENTER : WWW.DUFFYHEALTHCENTER.ORG CATHOLIC SOCIAL SERVICES: HTTPS://WWW.CSSDIOC.ORG/ CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED SUPPORT GROUPS AND HEALTH EDUCATION CLASSES AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROGRAM TYPE: COMMUNITY EDUCATION SUPPORT GROUP STATEWIDE PRIORITY: CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS BRIEF DESCRIPTION OR OBJECTIVE: AT CAPE COD AND FALMOUTH HOSPITAL, SUPPORT GROUPS FOR BEREAVEMENT AND CANCER SURVIVORSHIP, CLASSES AND COUNSELING FOCUSED ON BREASTFEEDING AND FATHERHOOD AND HOLISTIC SERVICES TO COMPLEMENT TRADITIONAL MEDICAL CARE ARE CONDUCTED ON A REGULAR BASIS AND OPEN TO ALL MEMBERS OF THE COMMUNITY. CLASSES AND GROUPS ARE AVAILABLE TO INDIVIDUALS, FAMILIES AND CAREGIVERS AND INCLUDE IN-PERSON MEETINGS TO OFFER SUPPORT AND REASSURANCE THROUGH THEIR SPECIFIC DISEASE/HEALTH CARE SITUATION. TARGET POPULATION REGIONS SAVED: COUNTY- BARNSTABLE HEALTH INDICATOR: OTHER: ARTHRITIS, OTHER: BEREAVEMENT, OTHER: CANCER, OTHER: CHILD CARE, OTHER: CHRONIC PAIN , OTHER: DIABETES, OTHER: HOSPICE, OTHER: HYPERTENSION, OTHER: NUTRITION, OTHER: PARENTING SKILLS, OTHER: PREGNANCY, OTHER: STRESS MANAGEMENT SEX: ALL AGE GROUP: ADULT, ADULT-ELDER, ADULT-YOUNG ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: PROVIDE SUPPORT GROUPS AND EDUCATIONAL ACTIVITIES FOR PATIENTS, FAMILIES AND CAREGIVERS ON A CONTINUUM OF ISSUES INCLUDING CANCER SURVIVORSHIP, PRENATAL/NEW MOTHERS AND FATHERS GROUPS, BEREAVEMENT AND CHRONIC DISEASE SELF-MANAGEMENT. GOAL STATUS: IN FY16, OVER 4,300 HOURS OF SUPPORT GROUPS AND CLASSES WERE OFFERED AND FACILITATED FOR INDIVIDUALS AND FAMILIES. INFORMATION AND RESOURCES WERE INCLUDED TO ASSIST THEM WITH THEIR SPECIFIC DISEASE OR HEALTH RELATED CIRCUMSTANCE. PARTNERS PARTNER NAME, DESCRIPTION, PARTNER WEB ADDRESS VISITING NURSES ASSOCIATION HTTP://WWW.VNACAPECOD.ORG AMERICAN CANCER SOCIETY: WWW.CANCER.ORG YMCA CAPE COD: HTTP://YMCACAPECOD.ORG/ CAPE COD HEALTHCARE: HTTP://WWW.CAPECODHEALTH.ORG/CLASSES-EVENTS/ CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED
WORKFORCE AND CAREER DEVELOPMENT INITIATIVES: CAPE COD HEALTHCARE	PROGRAM TYPE: MENTORSHIP/CAREER TRAINING/INTERNSHIP STATEWIDE PRIORITY: REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORM BRIEF DESCRIPTION OR OBJECTIVE: CAPE COD HEALTHCARE RECOGNIZES THE IMPORTANCE OF WORKFORCE DEVELOPMENT AND SUPPORTS THE OPPORTUNITY FOR STUDENTS FROM HIGH SCHOOL THROUGH GRADUATE SCHOOL TO HAVE A POSITIVE AND PROFESSIONAL EXPERIENCE THROUGH INTERNSHIPS, JOB SHADOWING AND TRAINING WITH HEALTH CARE PROVIDERS IN SEVERAL HOSPITAL DEPARTMENTS. BY TRAINING AND MENTORING STUDENTS FOR FUTURE EMPLOYMENT, WE HOPE TO SUCCESSFULLY ENGAGE INDIVIDUALS SO THEY SELECT HEALTH CARE AS A VIABLE AND ADMIRABLE VOCATION, THUS DECREASING THE POTENTIAL RISK FOR PREDICTED FUTURE SHORTAGES IN THE WORKPLACE. TARGET POPULATION REGIONS SAVED: COUNTY- BARNSTABLE HEALTH INDICATOR: ACCESS TO HEALTH CARE SEX: ALL AGE GROUP: ADULT, ADULT-YOUNG ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: INCREASE THE SUPPLY OF QUALIFIED HEALTH PROFESSIONALS THROUGH OFFERING WORKFORCE AND CAREER DEVELOPMENT PARTNERSHIPS. GOAL STATUS: IN FY16, OVER 22,000 HOURS OF WORKFORCE AND CAREER DEVELOPMENT EFFORTS TOOK PLACE INCLUDING STUDENT TRAINING, MENTORING, AND JOB SHADOWING. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS CAPE COD COMMUNITY COLLEGE: WWW.CAPECOD.EDU/ UPPER CAPE REGIONAL TECHNICAL SCHOOL: WWW.UPPERCAPETECH.COM/ COD REGIONAL TECHNICAL HIGH SCHOOL: HTTP://WWW.CAPETECH.US/ MA COLLEGE OF PHARMACY AND HEALTH SCIENCES: WWW.MCPHS.EDU THE RIVERVIEW SCHOOL: WWW.RIVERVIEWSCHOOL.ORG UNIVERSITY OF MASSACHUSETTS: WWW.MASSACHUSETTS.EDU CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED INTEGRATING BEHAVIORAL HEALTH SERVICES WITH COMPLEX CARE MANAGEMENT AT OUTER CAPE HEALTH SERVICES PROGRAM TYPE: GRANT/DONATION/FOUNDATION/SCHOLARSHIP STATEWIDE PRIORITY: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS, REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORM BRIEF DESCRIPTION OR OBJECTIVE: CAPE COD HEALTHCARE COMMUNITY BENEFITS PROVIDED GRANT SUPPORT TO OUTER CAPE HEALTH SERVICES FOR THE EXPANSION OF COMPLEX CARE MANAGEMENT SERVICES AND INTEGRATION OF BEHAVIORAL HEALTH COUNSELING FOR HIGH-RISK PATIENTS ON THE LOWER AND OUTER CAPE. THE PROGRAM FEATURES IN-HOME VISITS FOR PATIENTS WHO ARE GEOGRAPHICALLY AND SOCIALLY ISOLATED, IMMOBILE OR WOULD OTHERWISE RELY UPON EMERGENCY MEDICAL SERVICE PROVIDERS EVEN FOR NON-URGENT CARE. TARGET POPULATION REGIONS SAVED: COUNTY- BARNSTABLE HEALTH INDICATOR: ACCESS TO HEALTH CARE, MENTAL HEALTH, OTHER: ALCOHOL AND SUBSTANCE ABUSE, OTHER: ALZHEIMER DISEASE, OTHER: CANCER, OTHER: CARDIAC DISEASE, OTHER: DENTAL HEALTH, OTHER: DIABETES, OTHER: ELDER CARE, OTHER: HEPATITIS, OTHER: HIV/AIDS, OTHER: HOMEBOUND, OTHER: HOSPICE, OTHER: HYPERTENSION, OTHER: PARKINSONS DISEASE, OTHER: PULMONARY DISEASE/TUBERCULOSIS, OTHER: SAFETY, OTHER: STRESS MANAGEMENT, OTHER: UNINSURED/UNDERINSURED, SUBSTANCE ABUSE SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: DEFINE AND IDENTIFY A HIGH-RISK POPULATION OF PATIENTS TO BENEFIT FROM INTENSIVE CASE MANAGEMENT INCLUDING HOME VISITS. GOAL STATUS: IN FY16, 110 PATIENTS WERE IDENTIFIED AND ENROLLED IN COMPLEX CASE MANAGEMENT SERVICES INCLUDING HOME VISITS. THE MAJORITY OF ENROLLED PATIENTS ARE MANAGING CHRONIC DISEASES SUCH AS DIABETES, HEART DISEASE AND COPD. GOAL DESCRIPTION: DEVELOP A MULTI-DISCIPLINARY TEAM TO MANAGE PATIENTS ENROLLED IN COMPLEX CARE MANAGEMENT SERVICES INCLUDING THE ADDITION OF A BEHAVIORAL HEALTH CASE MANAGER. GOAL STATUS: IN FY16, 35% OF ALL PATIENTS ENROLLED IN THE PROGRAM RECEIVED COORDINATION OF CARE FOR BEHAVIORAL HEALTH CONCERNS. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS OUTER CAPE HEALTH SERVICES WWW.OUTERCAPE.ORG CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED
SUPPORTING THE HEALTH INSURANCE NEEDS OF EVERYONE (SHINE):	BARNSTABLE DEPARTMENT OF HUMAN SERVICES PROGRAM TYPE: GRANT/DONATION/FOUNDATION/SCHOLARSHIP STATEWIDE PRIORITY: REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORM BRIEF DESCRIPTION OR OBJECTIVE: CAPE COD HEALTHCARE COMMUNITY BENEFITS PROVIDED A GRANT TO THE REGIONAL SHINE PROGRAM TO EXPAND INFORMATION, COUNSELING AND ASSISTANCE TO BARNSTABLE COUNTY RESIDENTS WITH MEDICARE AND THEIR CAREGIVERS. TARGET POPULATION REGIONS SAVED: COUNTY- BARNSTABLE HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: ELDER CARE, OTHER: UNINSURED/UNDERINSURED SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: INCREASE THE NUMBER OF REGIONAL MEDICARE BENEFICIARIES ASSISTED BY THE SHINE PROGRAM. GOAL STATUS: IN FY16, SHINE SERVED 7,300 INDIVIDUALS IN BARNSTABLE COUNTY, A 13% INCREASE COMPARED TO THE PREVIOUS YEAR. GOAL DESCRIPTION: INCREASE THE NUMBER OF TRAINED SHINE VOLUNTEER COUNSELORS AVAILABLE IN COUNCIL ON AGING OFFICES AND OTHER ORGANIZATIONS. GOAL STATUS: SHINE INCREASED THE NUMBER OF TRAINED COUNSELORS IN THE REGION BY 18% IN FY16. GOAL DESCRIPTION: INCREASE THE NUMBER OF HOURS THE SHINE PROGRAM CONDUCTS OF COMMUNITY OUTREACH AND PRESENTATIONS IN THE COMMUNITY. GOAL STATUS: SHINE INCREASED THE NUMBER OF HOURS CONDUCTING OUTREACH IN THE COMMUNITY BY MORE THAN 27% COMPARED TO THE PREVIOUS YEAR. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS BARNSTABLE COUNTY HUMAN SERVICES: WWW.BCHUMANSERVICES.NET/INITIATIVES/SHINE/ CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED GROWING A DEMENTIA FRIENDLY COMMUNITY: HOPE DEMENTIA AND ALZHEIMERS SERVICES PROGRAM TYPE: GRANT/DONATION/FOUNDATION/SCHOLARSHIP STATEWIDE PRIORITY: CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS, REDUCING HEALTH DISPARITY BRIEF DESCRIPTION OR OBJECTIVE: CAPE COD HEALTHCARE COMMUNITY BENEFITS AWARDED A GRANT TO HOPE DEMENTIA AND ALZHEIMERS SERVICES TO OFFER COMMUNITY TRAININGS FOR CAREGIVERS AND EMERGENCY RESPONDERS TITLED ALZHEIMERS DISEASE: WHAT YOU NEED TO KNOW. TARGET POPULATION REGIONS SAVED: COUNTY- BARNSTABLE HEALTH INDICATOR: MENTAL HEALTH, OTHER: ALZHEIMER DISEASE, OTHER: ELDER CARE SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: TRAIN 150-200 COMMUNITY FRONTLINE PROFESSIONALS WITH THE KNOWLEDGE AND RESOURCES TO CARE FOR AN INDIVIDUAL WITH ALZHEIMERS DISEASE OR AGE-RELATED DEMENTIA (ADRD). GOAL STATUS: IN FY16, 160 INDIVIDUAL PARTICIPATED IN THE HALF-DAY TRAININGS. GOAL DESCRIPTION: INCREASE THE KNOWLEDGE AND IDENTIFICATION OF RESOURCES FOR INDIVIDUALS THAT PARTICIPATED IN TRAININGS. GOAL STATUS: POST TRAINING SURVEYS DEMONSTRATED: 58% INCREASE IN UNDERSTANDING ADRD, 52% INCREASE IN UNDERSTANDING ADRD DISEASE PROGRESSION, 53% INCREASE IN KNOWLEDGE AND ABILITY TO APPLY EFFECTIVE COMMUNICATION WITH ARDRD POPULATION AND 54% INCREASED ABILITY TO MORE EFFECTIVELY HELP ADRD INDIVIDUALS AND FAMILIES MINIMIZE CRISES AND AVOID HOSPITALIZATION/READMISSIONS. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS HOPE DEMENTIA & ALZHEIMER'S SERVICES: WWW. HOPEHEALTHMA.ORG/SERVICES/DEMENTIA-ALZHEIMERS-SERVICES CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02668, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED
FOODS TO ENCOURAGE - NUTRITION'S ROLE IN DIABETES AND	HYPERTENSION TREATMENT AND PREVENTION PILOT PROGRAM: CAPE COD HUNGER NETWORK PROGRAM TYPE: GRANT/DONATION/FOUNDATION/SCHOLARSHIP STATEWIDE PRIORITY: CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS, SUPPORTING HEALTHCARE REFORM BRIEF DESCRIPTION OR OBJECTIVE: FOODS TO ENCOURAGE IS A PROGRAM TO MONITOR AND IMPROVE DIABETES AND HYPERTENSION DISEASE OUTCOMES IN LOW TO MODERATE INCOME RESIDENTS WHO ACCESS FOOD FROM CAPE FOOD PANTRIES. THE FY16 COMMUNITY BENEFITS GRANT FROM CAPE COD HEALTHCARE ALLOWED THE PROGRAM TO EXPAND FROM ONE LOCATION TO FOUR FOOD PANTRIES ACROSS CAPE COD. TARGET POPULATION REGIONS SAVED: COUNTY- BARNSTABLE HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: CARDIAC DISEASE, OTHER: DIABETES, OTHER: HYPERTENSION, OTHER: NUTRITION, OVERWEIGHT AND OBESITY SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: THE PROGRAM WILL EXPAND ENROLLMENT FROM 100 TO 200 PARTICIPANTS. GOAL STATUS: IN FY16, A TOTAL OF 222 PARTICIPANTS WERE REGISTERED IN THE PROGRAM. NEW PROGRAM LOCATIONS PROVIDED AN OPPORTUNITY TO REACH A BROAD DEMOGRAPHIC OF INDIVIDUALS FROM AGES 35 TO 80 YEARS OLD. GOAL DESCRIPTION: BLOOD SUGAR AND BLOOD PRESSURE MONITORING WILL SHOW IMPROVEMENTS OVER TIME WITH INCREASED INTAKE OF FRESH FRUITS AND VEGETABLES AND NUTRITION EDUCATION. GOAL STATUS: OVER 35% OF PARTICIPANTS WHO ATTENDED WEEKLY PROGRAM ACTIVITIES DEMONSTRATED IMPROVED BLOOD SUGAR LEVELS AND 2% SHOWED IMPROVEMENT IN BLOOD PRESSURE. IMPROVEMENT IN BOTH HEALTH INDICATORS VARIED BY INDIVIDUAL BUT THERE WAS A STRONG CORRELATION BETWEEN NUMBER OF ATTENDED ACTIVITIES AND A PARTICIPANTS IMPROVED HEALTH INDICATORS. PARTNERS PARTNER NAME, DESCRIPTION PARTNER WEB ADDRESS CC HUNGER NETWORK: WWW.CAPECODHUNGERNETWORK.ORG FALMOUTH SERVICE CENTER: WWW.FALMOUTHSERVICECENTER.ORG BARNSTABLE COUNTY HEALTH DEPARTMENT: WWW.BARNSTABLECOUNTYHEALTH.ORG/PROGRAMS-AND.../PUBLIC-HEALTH-NURSE CAPE COD COOPERATIVE EXTENSION: WWW.CAPECODEXTENSION.ORG CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED CAPE COD COOPERATIVE EXTENSION TICK TESTING AND DISEASE SURVEILLANCE PROJECT PROGRAM TYPE: GRANT/DONATION/FOUNDATION/SCHOLARSHIP STATEWIDE PRIORITY: CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS BRIEF DESCRIPTION OR OBJECTIVE: CAPE COD HEALTHCARE PROVIDED COMMUNITY BENEFITS FUNDING TO THE CAPE COD COOPERATIVE EXTENSION TO SUBSIDIZE A TICK TESTING AND TICK-BORNE DISEASE SURVEILLANCE PROGRAM FOR BARNSTABLE COUNTY RESIDENTS. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE HEALTH INDICATOR: OTHER: LYME DISEASE SEX: ALL AGE GROUP: ADULT ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: PROMOTE TICK TESTING SERVICES TO LOCAL RESIDENTS. RESIDENTS WILL MAIL TICK TO UMASS LABORATORY OF MEDICAL ZOOLOGY AND RECEIVE EPIDEMIOLOGICAL AND INFECTION STATUS OF TICK TO SHARE WITH HEALTH CARE PROVIDER. GOAL STATUS: IN TOTAL, 309 TICKS WERE SUBMITTED BY RESIDENTS FOR TESTING. THE GREATEST NUMBER OF TICKS SUBMITTED FOR TESTING WAS DURING THE MONTHS OF MAY, JUNE AND JULY. GOAL DESCRIPTION: IDENTIFY THE EPIDEMIOLOGICAL AND INFECTION STATUS OF TICKS TESTED FROM BARNSTABLE COUNTY. GOAL STATUS: OF THE 309 TICKS TESTED, 25% TESTED POSITIVE FOR LYME DISEASE, 8% TESTED POSITIVE FOR BABESIOSIS AND 6% TESTED POSITIVE FOR ANAPLASMOSIS. PARTNERS PARTNER NAME, DESCRIPTION, PARTNER WEB ADDRESS CAPE COD COOPERATIVE EXTENSION WWW.CAPECODEXTENSION.ORG UMASS LABORATORY OF MEDICAL ZOOLOGY WWW.TICKDISEASES.ORG CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED
HEALTHY PARKS, HEALTHY PEOPLE: A WELLNESS COLLABORATION BETWEEN	CAPE COD HEALTHCARE AND THE CAPE COD NATIONAL SEASHORE PROGRAM TYPE: PREVENTION STATEWIDE PRIORITY: CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS BRIEF DESCRIPTION OR OBJECTIVE: CAPE COD HEALTHCARE COLLABORATED WITH THE CAPE COD NATIONAL SEASHORE TO PROMOTE WELLNESS, EXERCISE AND PHYSICAL ACTIVITY TO IMPROVE THE HEALTH OF CAPE COD RESIDENTS AND VISITORS. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE HEALTH INDICATOR: HYPERTENSION, OTHER: STROKE, OVERWEIGHT AND OBESITY, PHYSICAL ACTIVITY SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: ENGAGE INDIVIDUALS IN SEASONAL WALKING AND WELLNESS PROGRAMS AIMED AT IMPROVING HEALTH OUTCOMES. GOAL STATUS: OVER 120 INDIVIDUALS PARTICIPATED IN THE SUMMER WALKING PROGRAM AT THE CAPE COD NATIONAL SEASHORE AND THE WINTER WALKING PROGRAM AT THE CAPE COD MALL. GOAL DESCRIPTION: IMPACT WELLNESS AND REDUCE BLOOD PRESSURE READINGS TO HEALTHY LEVELS FOR PROGRAM PARTICIPANTS. GOAL STATUS: THE SUMMER PROGRAM ENGAGED 61 PARTICIPANTS. THE PRE-PROGRAM AVERAGE BLOOD PRESSURE WAS 131/78 COMPARED TO THE POST-PROGRAM AVERAGE BLOOD PRESSURE OF 121/72. PARTNERS PARTNER NAME, DESCRIPTION, PARTNER WEB ADDRESS NATIONAL PARK SERVICE: WWW.NPS.GOV/.../HEALTHY-PARKS-HEALTHY-PEOPLE CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED LIVING FIT FOR YOU! CANCER WELLNESS PROGRAM AT FALMOUTH HOSPITAL PROGRAM TYPE: DIRECT SERVICES STATEWIDE PRIORITY: CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS BRIEF DESCRIPTION OR OBJECTIVE: LIVING FIT FOR YOU IS A FREE, STRUCTURED, AND MEDICALLY-SUPERVISED EXERCISE AND EDUCATION PROGRAM THAT ASSISTS INDIVIDUALS UNDERGOING TREATMENT FOR CANCER TO MANAGE FATIGUE, DE-CONDITIONING AND A LOSS OF PHYSICAL FUNCTION. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE HEALTH INDICATOR: MENTAL HEALTH, OTHER: CANCER, OTHER: CANCER - BREAST, OTHER: CANCER - CERVICAL, OTHER: CANCER - COLO-RECTAL, OTHER: CANCER - LUNG, OTHER: CANCER - MULTIPLE MYELOMA, OTHER: CANCER - OTHER, OTHER: CANCER - OVARIAN, OTHER: CANCER - PROSTATE, OTHER: CANCER - SKIN, OTHER: CHRONIC PAIN , OTHER: NUTRITION, PHYSICAL ACTIVITY SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION: PROVIDE FREE EXERCISE AND EDUCATION CLASSES FOR CANCER SURVIVORS OF ALL AGES. GOAL STATUS: IN FY16, 253 EXERCISE AND EDUCATION CLASSES WERE OFFERED. GOAL DESCRIPTION: PROVIDE ONE-TO-ONE WELLNESS CONSULTATIONS FOR INDIVIDUALS UNABLE TO ATTEND THE STRUCTURED EXERCISE AND EDUCATION CLASSES. GOAL STATUS: IN FY16, 68 ONE-ON-ONE EXERCISE AND EDUCATION CONSULTATIONS WERE PROVIDED TO INDIVIDUALS. PARTNERS PARTNER NAME, DESCRIPTION, PARTNER WEB ADDRESS CAPE COD HEALTHCARE: WWW.CAPECODHEALTH.ORG/CLASSES-EVENTS CAPE WELLNESS COLLABORATIVE: WWW.CAPEWELLNESS.ORG CONTACT INFORMATION: LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION: NOT SPECIFIED
FUNCTIONAL EXPENSE NOTE	FORM 990 PART I AND PART IX FUNDRAISING IS CONDUCTED ON BEHALF OF CAPE COD HEALTHCARE, INC. BY CAPE COD HEALTHCARE FOUNDATION, INC. CERTAIN OFFICERS ARE COMPENSATED BY CAPE COD HEALTHCARE, INC. FUNDS RAISED ARE REPORTED AT CAPE COD HEALTHCARE, INC. AND AFFILIATES. FORM 990, PART I, LINE 6 CAPE COD HEALTHCARE, INC.'S VOLUNTEERS INCLUDE ITS TRUSTEES. FORM 990, PART VI, LINE 2 TRUSTEES SIT ON THE BOARD OF THE FOLLOWING: EMERALD PHYSICIAN MEMBER TRUST: PHILIP MCLOUGHLIN JOEL CROWELL CAPE HEALTH INSURANCE COMPANY: MICHAEL K LAUF PATRICK J FLYNN, MD PHILIP MCLOUGHLIN SUMNER B TILTON, JR THE MEMBERS OF CAPE COD HEALTHCARE, INC.'S BOARD ALSO SIT ON THE BOARD OF CAPE COD MEDICAL OFFICE BUILDING, A FOR-PROFIT RELATED ORGANIZATION. FORM 990, PART VI, LINES 6 & 7(A) THE ORGANIZATION HAS MEMBERS/INCORPORATORS WHO ELECT THE ORGANIZATION'S TRUSTEES. FORM 990, PART VI, LINE 7(B) THE DECISIONS OF THE GOVERNING BODY THAT NEED APPROVAL BY ITS MEMBERS/INCORPORATORS INCLUDE APPROVAL OF CHANGES MADE TO THE CORPORATION'S BYLAWS AND APPROVAL WHEN THERE IS A DIVESTING OF ONE OF THE MAJOR AFFILIATES OF THE ORGANIZATION. FORM 990, PART VI, LINE 11 THE ORGANIZATION'S FORM 990 IS REVIEWED AT SEVERAL LEVELS. THE ORGANIZATION ENGAGES A PUBLIC ACCOUNTING FIRM TO ASSIST IN THE PREPARATION AND REVIEW OF ITS FORM 990 AND WHO SIGNS AS PAID PREPARER. SENIOR MANAGEMENT OF THE ORGANIZATION IS RESPONSIBLE FOR THE TIMELY PREPARATION OF FORM 990. THE COMPLETED FORM 990 IS PROVIDED TO THE FINANCE COMMITTEE AND THE ENTIRE BOARD IN ADVANCE OF THE FILING DEADLINE. FORM 990, PART VI, LINE 12 THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY AND REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THIS POLICY. ON AN ANNUAL BASIS, EACH TRUSTEE, OFFICER AND EMPLOYEE AT THE SENIOR MANAGEMENT LEVEL COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM. THE FORMS ARE REVIEWED BY CAPE COD HEALTHCARE, INC.'S ("CCHC") DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE WHO PREPARES A SUMMARY FOR CCHC'S COMPLIANCE OFFICER. ANY MATERIAL INTERESTS SO DISCLOSED ARE PRESENTED TO THE CORPORATION'S GOVERNANCE COMMITTEE FOR REVIEW AND RESOLUTION. ALL DISCLOSURE STATEMENTS SUBMITTED BY EMPLOYEES WILL BE REVIEWED BY HUMAN RESOURCES AND/OR CCHC'S DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE. FOR ANY DISCLOSURE THAT IS CONSIDERED SUBSTANTIVE THE EMPLOYEE'S AREA MANAGER WILL BE CONSULTED TO DETERMINE IF THE SITUATION IS GENERALLY ACCEPTABLE, REQUIRES FURTHER EXAMINATION AND POSSIBLE ACTION OR IS GENERALLY NOT ACCEPTABLE. ANY ACTION PLAN CREATED TO MANAGE A CONFLICT OF INTEREST WILL BE MONITORED BY THE EMPLOYEE'S AREA MANAGER OR SUPERVISOR.
FORM 990, PART VI, LINE 15	THE ANNUAL PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, OFFICERS, EXECUTIVES AND KEY EMPLOYEES INCLUDE THE FOLLOWING: CEO - COMPENSATION WILL BE DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, AND WILL INCLUDE CONSIDERATION OF RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. OFFICERS, EXECUTIVES AND KEY EMPLOYEES - OFFICER, EXECUTIVE AND KEY EMPLOYEE COMPENSATION WILL BE DETERMINED BY THE CEO AND WILL INCLUDE CONSIDERATION OF RECENT RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. THE CEO'S DETERMINATION OF SUCH COMPENSATION WILL BE SUBJECT TO THE APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED IN THE MEETING MINUTES.
FORM 990, PART VI, LINE 19	THE ORGANIZATION MAKES ITS BYLAWS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THE ANNUALLY FILED FORM PC, A PUBLICLY DISCLOSED TAX-EXEMPT ORGANIZATION FILING FOR THE STATE OF MASSACHUSETTS.
FORM 990, PART VII, COLUMN (B)	THE INDIVIDUALS REPORTED AS RECEIVING COMPENSATION FROM A RELATED ORGANIZATION IN COLUMNS (E) AND (F) IN PART VII ARE EMPLOYEES AT CAPE COD HEALTHCARE, INC., A TAX-EXEMPT RELATED ORGANIZATION. FORM 990, Part VII, Section A Title for Carter Hunt: Executive Director - Hospital/Medical/Surgical Practices Title for Kevin Mulroy: Chief Medical Info Officer and Chief Quality & Safety Officer until 2/15, COO starting 2/15 TITLE FOR JEFFREY S DYKENS: COO FALMOUTH HOSPITAL UNTIL 6/16, VP FINANCE & OPS STARTING 6/16 FORM 990, PART VII, SECTION B WITH THE EXCEPTION OF REPORTING FOR VISITING NURSE ASSOCIATION OF CAPE COD, INC, CAPE COD HEALTHCARE, INC. PAYS INDEPENDENT CONTRACTORS ON BEHALF OF ITS AFFILIATES WHO FILE AS PART OF A GROUP FORM 990 AS CAPE COD HEALTHCARE, INC. AND AFFILIATES.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS OR FUND BALANCES NET ASSETS RELEASED FROM RESTRICTION ($5,201,035) TRANSFERS TO/FROM AFFILIATES (3,127,980) CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT 905,365 CHANGE IN VALUE OF BENEFICIAL INTEREST 567,015 TRANSFER OF NET ASSETS (22,000) OTHER CHANGES TO NET ASSETS (1,805,955) ------------- ($8,684,590)
AFFILIATES INCLUDED IN GROUP RETURN	CAPE COD HOSPITAL 04-2103600 CAPE COD HUMAN SERVICES, INC. 04-2323506 CAPE & ISLANDS HEALTH SERVICES II, INC. 04-3572408 FALMOUTH HOSPITAL ASSOCIATION, INC. 04-2220716 JML CARE CENTER, INC. 04-2995795 FALMOUTH ASSISTED LIVING, INC. 22-3379395 VNA OF CAPE COD, INC. 04-2104159 CAPE COD HEALTHCARE FOUNDATION, INC. 04-3475950 MEDICAL AFFILIATES OF CAPE COD, INC. 04-3187299 ALL OF THE ABOVE ENTITIES, EXCEPT THE VNA OF CAPE COD, INC., CAN BE REACHED AT: 25 COMMUNICATION WAY HYANNIS, MA 02601 THE VNA OF CAPE COD, INC. CAN BE REACHED AT: 255 INDEPENDENCE DRIVE HYANNIS, MA 02601

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	5,511
6	Total number of volunteers (estimate if necessary) .............	6	806
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,632,584
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	798,057

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	15,572,146	13,584,232
9	Program service revenue (Part VIII, line 2g) .........	769,456,161	813,097,623
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	6,228,163	10,134,688
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,124,349	2,193,542
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	793,380,819	839,010,085
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	412,045,456	421,295,177
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	107,645	120,968
b	Total fundraising expenses (Part IX, column (D), line 25) 3,319,958
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	332,632,591	362,645,424
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	744,785,692	784,061,569
19	Revenue less expenses. Subtract line 18 from line 12.......	48,595,127	54,948,516
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	858,605,441	904,223,714
21	Total liabilities (Part X, line 26).............	290,745,257	270,275,550
22	Net assets or fund balances. Subtract line 21 from line 20.....	567,860,184	633,948,164

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 705,647,856 including grants of $ 0 ) (Revenue $ 813,097,623 )
	PATIENT SERVICES - SEE SCHEDULES H AND O

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses705,647,856

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	6,187,152	7,882,235	1,556,522

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	92,441
d	Related organizations		1d
e	Government grants (contributions)		1e	1,338,433

f	All other contributions, gifts, grants, and similar amounts not included above		1f	12,153,358

g	Noncash contributions included in lines 1a-1f:$ 211,039
h Total.Add lines 1a-1f.......		13,584,232

		Business Code
2a	PATIENT SERVICE REVENUE	900099	787,513,020	787,513,020
b	LABORATORY SERVICES	621500	9,388,292	6,809,458	2,578,834
c	QUALITY EARNED PAYMENTS	900099	5,518,314	5,518,314
d	PROGRAM RELATED RENTAL INCOME	900099	3,430,917	3,377,167	53,750
e	MEANINGFUL USE	900099	1,322,528	1,322,528
f	All other program service revenue.			5,924,552	5,924,552
g Total.Add lines 2a–2f.....			813,097,623

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			5,368,273			5,368,273
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		4,766,415
b	Less: cost or other basis and sales expenses
c	Gain or (loss)		4,766,415
d	Net gain or (loss).....			4,766,415			4,766,415
8a	Gross income from fundraising events (not including $ 92,441of contributions reported on line 1c). See Part IV, line 18 ....
	a		267,550
b	Less: direct expenses ...b		160,435
c	Net income or (loss) from fundraising events..			107,115			107,115
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA INCOME		900099	1,672,825			1,672,825
b	MEDICAL RECORDS		900099	99,634			99,634
c	EMPLOYEE PHARMACY		900099	313,968			313,968
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,086,427
12	Total revenue. See Instructions......			839,010,085	810,465,039	2,632,584	12,328,230

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,260,126	1,260,126
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	254,865	254,865
7	Other salaries and wages	333,962,413	297,636,401	34,991,608	1,334,404
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	9,910,482	8,457,442	1,399,664	53,376
9	Other employee benefits .......	53,623,678	47,606,809	5,790,932	225,937
10	Payroll taxes ...........	22,283,613	19,504,673	2,676,858	102,082
11	Fees for services (non-employees):
a	Management ......	5,958,411	2,688,718	3,269,693
b	Legal .........	221,757	6,312	215,445
c	Accounting ...........	771,341	131,369	639,972
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	120,968			120,968
f	Investment management fees ......	855,829	81,349	774,480
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	31,442,411	31,039,486	402,925
12	Advertising and promotion ....	796,453	740,512	55,941
13	Office expenses .......	4,831,522	4,432,492	312,847	86,183
14	Information technology ......	9,390,988	8,484,763	906,225
15	Royalties ..	0
16	Occupancy ...........	16,163,877	14,873,706	1,148,685	141,486
17	Travel ............	5,021,326	4,719,633	301,693
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	8,473,081	7,638,755	834,326
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	28,190,506	25,583,774	2,589,965	16,767
23	Insurance ...	6,233,738	5,698,255	535,483
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	106,706,765	106,706,765
b	PURCHASED SERVICES	49,509,047	46,213,469	3,269,036	26,542
c	ADMINISTRATION OFFICE	53,438,306	40,217,841	12,674,377	546,088
d	REPAIRS AND MAINTENANCE	12,836,965	11,655,692	1,181,273
e	All other expenses	21,803,101	20,014,649	1,122,327	666,125
25	Total functional expenses. Add lines 1 through 24e	784,061,569	705,647,856	75,093,755	3,319,958
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			48,422,773	1	41,486,722
2	Savings and temporary cash investments .........			1,401,964	2	1,407,662
3	Pledges and grants receivable, net ......			11,419,529	3	13,712,338
4	Accounts receivable, net .............			70,183,932	4	88,033,760
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net ....			5,956,495	7	5,375,686
8	Inventories for sale or use ........			10,858,391	8	11,108,863
9	Prepaid expenses and deferred charges ......			6,857,352	9	7,950,467
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	620,424,777
b	Less: accumulated depreciation	10b	327,732,083	298,319,535	10c	292,692,694
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			363,963,703	12	400,979,488
13	Investments—program-related. See Part IV, line 11 ..			11,118,346	13	9,294,601
14	Intangible assets ...............			9,157,829	14	9,346,552
15	Other assets. See Part IV, line 11 ...........			20,945,592	15	22,834,881
16	Total assets. Add lines 1 through 15 (must equal line 34)...			858,605,441	16	904,223,714

17	Accounts payable and accrued expenses .....	67,214,459	17	57,125,221
18	Grants payable ...	0	18	0
19	Deferred revenue .........	719,573	19	781,816
20	Tax-exempt bond liabilities .........	166,678,346	20	156,420,826
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	16,874,390	23	15,137,718
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	39,258,489	25	40,809,969
26	Total liabilities. Add lines 17 through 25..	290,745,257	26	270,275,550

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	497,943,893	27	564,517,008
28	Temporarily restricted net assets ...........	38,531,451	28	37,490,718
29	Permanently restricted net assets	31,384,840	29	31,940,438
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	567,860,184	33	633,948,164
34	Total liabilities and net assets/fund balances ........	858,605,441	34	904,223,714

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CAPE COD HEALTHCARE INC 25 COMMUNICATION WAY HYANNIS,MA02601 22-2600704	PARENT CORP	MA	501(c)(3)	13b	NA	Yes

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Name	Address	EIN	Name control
CAPE COD HOSPITAL	25 COMMUNICATION WAY HYANNIS, MA 02601	04-2103600	CAPE
VISITING NURSE ASSN OF CAPE COD INC	25 COMMUNICATION WAY HYANNIS, MA 02601	04-2104159	CAPE
FALMOUTH HOSPITAL ASSOCIATION INC	25 COMMUNICATION WAY HYANNIS, MA 02601	04-2220716	CAPE
CAPE COD HUMAN SERVICES INC	25 COMMUNICATION WAY HYANNIS, MA 02601	04-2323506	CAPE
MEDICAL AFFILIATES OF CAPE COD INC	25 COMMUNICATION WAY HYANNIS, MA 02601	04-3187299	CAPE
CAPE COD HEALTHCARE FOUNDATION INC	25 COMMUNICATION WAY HYANNIS, MA 02601	04-3475950	CAPE
CAPE & ISLANDS HEALTH SERVICES II	25 COMMUNICATION WAY HYANNIS, MA 02601	04-3572408	CAPE
FALMOUTH ASSISTED LIVING INC	25 COMMUNICATION WAY HYANNIS, MA 02601	22-3379395	CAPE
JML CARE CENTER INC	25 COMMUNICATION WAY HYANNIS, MA 02601	04-2995795	CAPE