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DISCLOSURES FOR FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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WILL FOLLOW THOSE DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B
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FORM 990 SCHEDULE H PART V, SECTION C:
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SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BCOMMUNITY BENEFITS MISSION STATEMENT BETH ISRAEL DEACONESS HOSPITAL-MILTON'S (BID-MILTON OR HOSPITAL) COMMUNITY BENEFITS MISSION IS: "TO PROVIDE FREE OR LOW-COST PROGRAMS THAT ADDRESS UNMET HEALTH AND WELLNESS NEEDS OF RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE COMMUNITIES OF MILTON, RANDOLPH, QUINCY, DORCHESTER, HYDE PARK, BRAINTREE AND CANTON, IN A MANNER SHAPED BY COMMUNITY INPUT, ALIGNED WITH HOSPITAL RESOURCES, AND GUIDED BY OUR OBJECTIVE TO DELIVER HIGH-QUALITY CARE WITH COMPASSION, DIGNITY AND RESPECT." THIS MISSION IS ACHIEVED BY IDENTIFYING EXISTING AND FUTURE HEALTH NEEDS IN THE COMMUNITY AND ADDRESSING THEM THROUGH HEALTH INITIATIVES, INCLUDING EDUCATION, PREVENTION AND SCREENING PROGRAMS. AS NOTED THROUGHOUT THIS NARRATIVE, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER, IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS THE SOLE MEMBER OF BID-MILTON. THE MEDICAL CENTER IS COMMITTED TO ITS COMMUNITY. THE MEDICAL CENTER'S MISSION IS TO SERVE PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM AND THEIR FAMILIES. THAT MISSION IS SUPPORTED BY THE MEDICAL CENTER'S COMMITMENT TO PERSONALIZED, EXCELLENT CARE FOR OUR PATIENTS; A WORKFORCE COMMITTED TO INDIVIDUAL ACCOUNTABILITY, MUTUAL RESPECT AND COLLABORATION; AND A COMMITMENT TO MAINTAINING OUR FINANCIAL HEALTH. THE MEDICAL CENTER IS COMMITTED TO BEING ACTIVE IN THE COMMUNITY AS WELL. SERVICE TO COMMUNITY IS AT THE CORE AND AN IMPORTANT PART OF THE MEDICAL CENTER'S MISSION. BIDMC HAS A COVENANT TO CARE FOR THE UNDERSERVED AND TO WORK TO CHANGE DISPARITIES IN ACCESS TO CARE. THE MEDICAL CENTER KNOWS THAT TO BE SUCCESSFUL WE NEED TO LEARN FROM THOSE WE SERVE. THIS COMMUNITY BENEFIT MISSION IS FULFILLED BY:- IMPLEMENTING PROGRAMS AND SERVICES IN GREATER BOSTON AND OUTER CAPE COD TO IMPROVE THE CURRENT AND FUTURE HEALTH STATUS OF MEDICALLY UNDERSERVED COMMUNITIES WHICH ARE CHALLENGED BY BARRIERS IN ACCESSING AND INTERACTING EFFECTIVELY WITH THE HEALTHCARE SYSTEM AND IMPACTED BY OTHER SOCIAL DETERMINANTS OF HEALTH.- ENSURING THAT ALL PATIENTS RECEIVE EQUITABLE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE AND THAT THE MEDICAL CENTER IS WELCOMING AND INCLUSIVE; AND- ENCOURAGING COLLABORATIVE RELATIONSHIPS WITH OTHER PROVIDERS AND GOVERNMENT ENTITIES TO SUPPORT AND ENHANCE RATIONAL AND EFFECTIVE HEALTH POLICIES AND PROGRAMS. DURING THE FISCAL YEAR COVERED BY THIS FILING, BID-MILTON PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF 1,059,201 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I, COLUMN C. AS NOTED IN THE NARRATIVE DETAIL TO SCHEDULE H BELOW, BID-MILTON HAS PARTNERED WITH THE COMMONWEALTH OF MASSACHUSETTS ON SOME OF THESE EFFORTS BECAUSE THE HOSPITAL IS UNIQUELY QUALIFIED IN ITS COMMUNITIES, TO PROVIDE CERTAIN SERVICES, AND GRANT FUNDING RECEIVED OF $854,156 HAS SIMILARLY BEEN REPORTED IN THIS SCHEDULE H, PART I, LINES 7E AND 7I, COLUMN D. IN ADDITION, DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER PROVIDED NET COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF 13,930,047 AS REPORTED ON THE MEDICAL CENTER'S SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIPBID-MILTON'S COMMUNITY BENEFITS LEADERSHIP TEAM INCLUDES REPRESENTATION FROM THE HOSPITAL'S SENIOR ADMINISTRATION, PATIENT FAMILY AND ADVISORY COUNCIL AND COMMUNITY SERVICE PROVIDERS, ALL OF WHOM ARE MEMBERS OF THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE. DAY-TO-DAY OPERATIONS OF THE COMMUNITY BENEFITS PROGRAM IS OVERSEEN BY THE HOSPITAL'S PUBLIC RELATIONS DEPARTMENT, WITH GUIDANCE FROM HOSPITAL LEADERSHIP AND FINANCE DEPARTMENT AND COMMUNITY BENEFITS ADVISORY COMMITTEE.
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FORM 990 SCHEDULE H PART V, SECTION B, LINE 1 - 8
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COMMUNITY HEALTH NEEDS ASSESSMENTCOMMUNITY HEALTH NEEDS ASSESSMENT - INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE (IRC) SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BID-MILTON COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2016. THAT CHNA WAS APPROVED BY THE BID-MILTON BOARD OF DIRECTORS ON SEPTEMBER 30, 2016. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS APPROVED BY THE BOARD ON SEPTEMBER 30, 2016 WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE PREVIOUS NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE BID-MILTON BOARD OF DIRECTORS ON OR BEFORE SEPTEMBER 30, 2013 AS REQUIRED AND THE ACCOMPLISHMENTS AND ACTIVITIES INCLUDED IN THIS FILING RELATE TO THE DOCUMENTS APPROVED AS OF SEPTEMBER 30, 2013. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP OR IMPLEMENTATION STRATEGY) ARE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WAS BORNE LARGELY OUT OF BID-MILTON'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BID-MILTON ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW THE BID-MILTON, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT.COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHYTHE 2013 COMMUNITY HEALTH ASSESSMENT (CHNA) ENCOMPASSED BRAINTREE, MILTON, AND RANDOLPH (REFERRED TO AS THE MILTON REGION). FOCUSING BID-MILTON'S CHNA ON THIS GEOGRAPHIC AREA FACILITATED THE ALIGNMENT OF THE HOSPITAL'S EFFORTS WITH COMMUNITY AND GOVERNMENTAL PARTNERS, AND SEVERAL COMMUNITY-BASED ORGANIZATIONS. THIS FOCUS ALSO FACILITATES COLLABORATION WITH THE ADVISORY COMMITTEE, WHICH AS DESCRIBED ABOVE, IS INVOLVED IN IMPLEMENTING KEY STRATEGIES OF THE CHNA SO THAT FUTURE INITIATIVES CAN BE DEVELOPED IN A MORE COORDINATED APPROACH. BID-MILTON COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2016. WITH THE CLOSING OF QUINCY MEDICAL CENTER, THE GEOGRAPHICAL FOCUS OF BID-MILTON'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES MILTON, QUINCY AND RANDOLPH.COMMUNITY HEALTH NEEDS ASSESSMENTTARGET POPULATIONSTARGET POPULATIONS FOR BID-MILTON'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS, AND A CHNA WHICH IS CONDUCTED EVERY THREE YEARS, IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).BID-MILTON'S TARGET POPULATIONS FOCUS ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN THE MILTON REGION, AS FOLLOWS:- CHILDREN AND YOUTH AT RISK- SENIORS/SOCIALLY ISOLATED ELDERS/ELDERS LIVING IN PUBLIC HOUSING INDIVIDUALS WHO ARE OBESE/OVERWEIGHT- LOW INCOME NEIGHBORHOODS/ETHNIC & LINGUISTIC MINORITIES- UNDERINSURED/UNINSURED - INDIVIDUALS WITH CHRONIC DISEASE- INDIVIDUALS WITH BEHAVIORAL HEALTH PROBLEMSBID-MILTON'S PROGRAMS MIRROR THE FIVE CORE PRINCIPLES OUTLINED BY THE PUBLIC HEALTH INSTITUTE IN TERMS OF THE "EMPHASIS ON COMMUNITIES WITH DISPROPORTIONATE UNMET HEALTH-RELATED NEEDS; EMPHASIS ON PRIMARY PREVENTION; BUILDING A SEAMLESS CONTINUUM OF CARE; BUILDING COMMUNITY CAPACITY; AND COLLABORATIVE GOVERNANCE." COMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH AND METHODSTHE CHNA UTILIZED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS IN THE REGION AS WELL AS INFORMATION FROM TWO COMMUNITY DIALOGUES CONDUCTED WITH COMMUNITY RESIDENTS, AND TEN INTERVIEWS WITH COMMUNITY STAKEHOLDERS. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE THREE MUNICIPALITIES THAT COMPRISE THE MILTON REGION, AND WITH A RANGE OF PEOPLE REPRESENTING DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE, AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., SENIORS) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 30 PEOPLE. BID-MILTON CONDUCTED THIS CHNA PROCESS INDEPENDENTLY AS REPORTED IN SCHEDULE H, PART V, SECTION B, QUESTIONS 6A AND 6B.THE BID-MILTON COMMUNITY BENEFITS PLAN WAS DEVELOPED BY A TEAM COMPRISED OF HOSPITAL LEADERSHIP, PATIENT ADVOCACY, MEDICAL STAFF, PUBLIC RELATIONS, AND COMMUNITY REPRESENTATION. THE GROUP REVIEWED PROGRESS TOWARDS GOALS AND OBJECTIVES OF THE PRIOR THREE YEAR PERIOD, AS WELL AS THE CURRENT DATA COLLECTED THROUGH THE CHNA, TO HELP ENVISION AND DEFINE PRIORITY AREAS FOR THE FUTURE. PRIORITY AREAS WERE IDENTIFIED AND GOALS WERE DEFINED, ALONG WITH OBJECTIVES FOR EACH GOAL AND DRAFTED STRATEGIES TO OPERATIONALIZE THESE OBJECTIVES. COMMUNITY HEALTH NEEDS ASSESSMENTKEY FINDINGSBID-MILTON'S CHNA RESULTED IN KEY FINDINGS RELATED TO DEMOGRAPHICS, SOCIAL AND PHYSICAL ENVIRONMENT, RISK AND PROTECTIVE LIFESTYLE BEHAVIORS, HEALTH OUTCOMES, ACCESS TO CARE, COMMUNITY ASSETS AND PROGRAMS AND COMMUNITY SUGGESTIONS FOR FUTURE PROGRAMS AND SERVICES. SEVERAL OVERARCHING THEMES EMERGED FROM THIS SYNTHESIS OF DATA, INCLUDING: LACK OF TRANSPORTATION SERVICES IN THE REGION PREVENTS RESIDENTS FROM ACCESSING SERVICES; HEALTHY EATING, PHYSICAL ACTIVITY AND OBESITY ARE ISSUES AFFECTING RESIDENTS IN THE MILTON REGION AS THEY ARE SEEN NATIONALLY; SUBSTANCE ABUSE AND MENTAL HEALTH ARE PRESSING HEALTH CONCERNS IN THE COMMUNITY, FOR WHICH THE CURRENT SYSTEM WAS PERCEIVED AS INSUFFICIENT; AND, DESPITE STRONG HEALTH CARE SERVICES IN THE REGION, VULNERABLE POPULATIONS ENCOUNTER CONTINUED DIFFICULTIES IN ACCESSING RESOURCES. IN RESPONSE, THERE ARE SEVERAL EFFORTS CURRENTLY UNDERWAY IN THE MILTON REGION WORKING TO MEET THE HEALTH AND SOCIAL SERVICE NEEDS OF RESIDENTS.
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FORM 990 SCHEDULE H PART V, SECTION B, LINE 1 - 8 (CONTINUED)
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COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDSBID-MILTON STRIVES TO ADDRESS THE PRIORITY AREAS AND IN ITS CHNA AND IMPLEMENTATION STRATEGY WHICH ARE AVAILABLE UPON REQUEST AND ON THE BID-MILTON WEBSITE. AS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, BID-MILTON'S MOST RECENTLY COMPLETED CHNA WAS COMPLETED DURING THE FISCAL YEAR ENDED 2016 AND THE FIRST YEAR OF ACCOMPLISHMENTS UNDER THAT CHNA AND IMPLEMENTATION STRATEGY (CHIP) WILL BE REPORTED IN THE FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2017. THAT CHNA AND CHIP ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT:HTTP://WWW.MILTONHOSPITAL.ORG/ASSETS/UPLOADS/COMMUNITY-BENEFITS/MILTON-CHNA-FINAL-SEPTEMBER-2016.PDF IN ADDITION, THE CHNA WHICH WAS PREVIOUSLY COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013 AND UNDER WHICH COMMUNITY BENEFITS ACTIVITIES WERE GUIDED FOR THE PERIOD COVERED BY THIS FILING IS AVAILABLE ON THE HOSPITAL'S WEBSITE AT: HTTP://WWW.MILTONHOSPITAL.ORG/ASSETS/UPLOADS/COMMUNITY-BENEFITS/BID-MILTON-CHNAIS-FINAL-12-20-13.PDF BOTH DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST. (SCHEDULE H, PART V, SECTION B, LINE 7A.)A SUMMARY OF BID-MILTON'S COMMUNITY BENEFIT ACTIVITIES WHICH ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013 AND PRIORITIZED IN THE RELATED CHIP ARE PROVIDED HERE ALONG WITH THE ENTITIES WITH WHICH THE HOSPITAL PARTNERS RELATED TO THESE EFFORTS. IMPROVING ACCESS TO AFFORDABLE PREVENTIVE HEALTH CARE SCREENINGSEACH YEAR, BID-MILTON OFFERS COMMUNITY MEMBERS ACCESS TO FREE OR LOW COST PREVENTIVE SCREENINGS TO ADDRESS HEART HEALTH AND CANCER CONCERNS BEFORE THEY ARISE. IN PARTNERSHIP WITH COMMUNITY PHYSICIANS, FREE SKIN CANCER SCREENINGS WERE PROVIDED TO 53 COMMUNITY MEMBERS AT NO COST IN MAY 2016. BY PROVIDING ACCESS TO THESE FREE SCREENINGS, THE HOSPITAL EMPOWERED PATIENTS TO DETECT POTENTIALLY HARMFUL MELANOMAS IN THE EARLY STAGES WHEN THE CURE RATE IS NEARLY 100 PERCENT.IN ADDITION, BID-MILTON HOSTED TWO, LOW-COST BLOOD SCREENING FAIRS. PARTICIPANTS' BLOOD WAS TESTED FOR GLUCOSE, CALCIUM, PROTEIN AND KIDNEY AND LIVER FUNCTION. THESE TYPES OF TESTS PROVIDED SCREENING FOR MANY HEALTH ISSUES, INCLUDING DIABETES. ADDITIONALLY, A COMPLETE "LIPID PROFILE" TESTED BLOOD FOR CHOLESTEROL, TRIGLYCERIDES, HDL AND LDL ("GOOD AND "BAD" CHOLESTEROL), AND THESE TESTS CAN BE DIRECT INDICATORS OF HEART DISEASE. THESE BI-ANNUAL BLOOD SCREENING EVENTS PROVIDED ACCESS TO VALUABLE HEALTH CARE SCREENINGS TO 75 COMMUNITY MEMBERS AT A LOW COST. THE SCREENINGS ATTRACTED MANY REGULAR ATTENDEES WHO TAKE ADVANTAGE OF THE OPPORTUNITY TO REGULARLY TRACK TEST RESULTS OVER TIME.FOCUS ON CHRONIC DISEASE PREVENTION AND EDUCATIONIN APRIL, 2016, BID-MILTON HELD ITS SEVENTH ANNUAL DIABETES FAIR. DUE TO THE POPULARITY OF THIS EVENT, THE HOSPITAL OUTGREW ITS SPACE AND FOR THE FIRST TIME HAD TO MOVE THIS EVENT OFF THE HOSPITAL CAMPUS. MORE THAN 90 INDIVIDUALS SUFFERING FROM DIABETES ATTENDED THIS FREE EVENT HELD AT THE LANTANA IN RANDOLPH AND RECEIVED VALUABLE INFORMATION FOR MANAGING DIABETES FROM A TEAM OF CLINICAL EXPERTS. TOPICS INCLUDED NEW DIABETES MEDICATIONS, MAINTAINING A HEALTHY HEART, EYE HEALTH AND IMPORTANT DIETARY RECOMMENDATIONS. ATTENDEES WERE ALSO ABLE TO WITNESS A HEALTHY COOKING DEMONSTRATION LED BY THE HOSPITAL'S CERTIFIED DIABETES EDUCATOR AND WERE SERVED A DIABETIC-FRIENDLY LUNCH. THE FAIR ALSO INCLUDED EXHIBITOR DISPLAYS AS WELL AS FREE BLOOD PRESSURE AND FOOT SCREENINGS.HELD EACH SPRING AND FALL, BID-MILTON'S COMMUNITY EDUCATION LECTURE SERIES PROVIDED ACCESS TO FREE HEALTH EDUCATION OPPORTUNITIES FOR PEOPLE OF ALL AGES. SELECTED BASED ON NEEDS ASSESSMENT DATA AND DISEASE PREVALENCE, TOPICS INCLUDED EAR DISEASE AND HEARING LOSS, STROKE, HORMONES AND MENOPAUSE, OBSTRUCTIVE SLEEP APNEA, KIDNEY STONES AND COPING WITH GRIEF AND STRESS.EDUCATING SENIORSBID-MILTON CONTINUED ITS PARTNERSHIP WITH THE MILTON COUNCIL ON AGING IN EDUCATING COMMUNITY SENIORS ON IMPORTANT HEALTH TOPICS THROUGH THE HOSPITAL'S "LUNCH AND LEARN" LECTURES SERIES AT THE MILTON SENIOR CENTER ON SLEEP AND PULMONARY FUNCTION, PNEUMONIA, VACCINES, MAINTAINING A HEALTHY BLOOD PRESSURE, MACULAR DEGENERATION AND SKIN CANCER. IN ADDITION TO THE TOWN OF MILTON, THE HOSPITAL HAS EXPANDED ITS LECTURE SERIES TO THE RANDOLPH SENIOR CENTER. LECTURES AT THE RANDOLPH SENIOR CENTER WERE CONDUCTED IN ENGLISH AND HAITIAN CREOLE, EDUCATING SENIORS IN THEIR NATIVE LANGUAGE ON DIABETES. THE HOSPITAL ALSO EXPANDED THIS PROGRAM TO INCLUDE FULLER VILLAGE, A RETIREMENT COMMUNITY IN MILTON. LECTURES AT FULLER VILLAGE FOCUSED ON PROPER NUTRITION AS YOU AGE AND STRESS AND ANXIETY.ENHANCE COMMUNITY RESOURCES ON NUTRITION COUNSELING AND EDUCATIONIN ADDITION TO PROVIDING NUTRITION COUNSELING ON AN INPATIENT AND OUTPATIENT BASIS, BID-MILTON HELD ITS SEVENTH ANNUAL COMMUNITY HEALTH WALK IN JUNE 2016. IN ADDITION TO HIGHLIGHTING THE BENEFITS OF WALKING AS A CARDIOVASCULAR EXERCISE AND SPONSORING FREE HEALTH EXHIBITORS AND SCREENINGS, THE WALK SERVES AS BID-MILTON'S OUTLET FOR DISTRIBUTING MINI-GRANTS TO LOCAL ORGANIZATIONS SUPPORTING COMMUNITY HEALTH INITIATIVES. BID-MILTON AWARDED $4,500 TO FIVE LOCAL ORGANIZATIONS INCLUDING OLD COLONY HOSPICE, SOUTH SHORE YMCA, JOANNA'S PLACE, LET IT OUT AND GIRL POWER. GRANT FUNDING WILL BE USED TO SUPPORT INITIATIVES SUCH AS SAFE MEDICATION DISPOSAL, COPING SERVICES AND PROGRAMS FOR FAMILIES GRIEVING THE LOSS OF A LOVED ONE FROM SUBSTANCE ABUSE, EXERCISE AND EMPOWERMENT PROGRAMS FOR CHILDREN AND NUTRITION ACCESS TO DISADVANTAGED WOMEN AND YOUNG FAMILIES.FINALLY, THE HOSPITAL SPONSORS BOTH A MONTHLY BARIATRIC SURGERY INFORMATION SESSION ALONG WITH A BARIATRIC SURGERY SUPPORT GROUP AS AN OPTION FOR CHRONICALLY OBESE INDIVIDUALS WHO HAVE FAILED OTHER WEIGHT LOSS ATTEMPTS TO ENJOY THE HEALTH BENEFITS THAT COME FROM SUBSTANTIAL AND SUSTAINED WEIGHT LOSS.INCREASE COMMUNITY AWARENESS ON BEHAVIORAL HEALTH AND SUBSTANCE ABUSEBEHAVIORAL HEALTH AND SUBSTANCE ABUSE CONTINUES TO BE A MAJOR CONCERN ACROSS THE COMMONWEALTH. TO ADDRESS THESE ISSUES, BID-MILTON BECAME AN ACTIVE PARTNER IN THE MILTON SUBSTANCE PREVENTION COALITION, HOSTING SEVERAL COALITION MEETINGS AND SERVING AS A FISCAL AGENT FOR THE COALITION'S MULTI-YEAR GRANT FROM THE BLUE HILLS REGIONAL HEALTH ALLIANCE. BID-MILTON OFFERED FREE MENTAL HEALTH FIRST AID TRAININGS TO THE COMMUNITY IN THE FALL OF 2015 AND SPRING OF 2016. THE CLASS PREPARES INDIVIDUALS ON HOW TO ASSIST SOMEONE EXPERIENCING A MENTAL-HEALTH RELATED CRISIS. COMMUNITY MEMBERS WERE TAUGHT HOW TO IDENTIFY RISK FACTORS AND WARNING SIGNS FOR MENTAL HEALTH AND ADDICTION CONCERNS, STRATEGIES FOR BOTH CRISIS AND NON-CRISIS SITUATIONS AND WHERE TO TURN FOR HELP. A TOTAL OF 47 COMMUNITY MEMBERS WERE TRAINED.BID-MILTON ALSO ARRANGED FOR NATIONALLY NOTED SPEAKER AND AUTHOR MARIA TROZZI, M.ED TO CONDUCT A PROGRAM FOR PARENTS OF YOUNG CHILDREN ON HOW TO DEVELOP RESILIENCY - THE ABILITY TO ADAPT WELL TO ADVERSITY, TRAUMA, TRAGEDY AND SIGNIFICANT SOURCES OF STRESS- TO HELP CHILDREN BETTER MANAGE THEIR STRESS AND ANXIETY. THIS POPULAR PROGRAM WAS ATTENDED NOT ONLY BY PARENTS AND CAREGIVERS, BUT ALSO TEACHERS AND GUIDANCE COUNSELORS. IN ADDITION, BID-MILTON ORGANIZED A SUBSTANCE ABUSE TREATMENT FORUM FOR COMMUNITY MEMBERS AND HEALTHCARE PROFESSIONALS. THE FORUM ADDRESSED SUCH TOPICS AS INTEGRATED PRIMARY CARE AND BEHAVIORAL HEALTH PROGRAMS, RESOURCES FOR FAMILY MEMBERS, OUTPATIENT AND INPATIENT RECOVERY OPTIONS, AND HOW AND WHEN TO FILE FOR A SECTION 35.CHART 2 BEHAVIORAL HEALTH PROGRAMMINGIN RESPONSE TO AN INCREASE IN PATIENTS PRESENTING TO THE HOSPITAL'S EMERGENCY DEPARTMENT IN BEHAVIORAL HEALTH CRISIS, WHICH PERPETUATES AND CONTRIBUTES TO BEHAVIORAL HEALTH PATIENT BOARDING, BETH ISRAEL DEACONESS HOSPITAL-MILTON AND SOUTH SHORE MENTAL HEALTH ARE COLLABORATING ON A $2 MILLION CHART 2 (COMMUNITY HOSPITAL ACCELERATION, REHABILITATION AND TRANSFORMATION) GRANT TO PROVIDE CO-LOCATED BEHAVIORAL HEALTH SERVICES IN THE BID-MILTON ED WITH POST-DISCHARGE COMMUNITY FOLLOW UP. THE PROGRAM MODEL IS COMPRISED OF A CARE TEAM OF MEDICAL, CLINICAL AND NON-TRADITIONAL PROFESSIONALS, INCLUDING A MASTERS-PREPARED RN DIRECTOR OF CARE INTEGRATION, A FULL TIME LICSW, AN MD AND RN "CHAMPION", A LICENSED MUSIC THERAPIST, A PEER SPECIALIST, A CHAPLAIN AND AN LICSW WHO SERVES AS A COMMUNITY NAVIGATOR TO FOLLOW PATIENTS ONCE THEY ARE DISCHARGED FROM THE ED.
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FORM 990 SCHEDULE H PART V, SECTION B, LINE 1 - 8 (CONTINUED)
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KEY COMPONENTS OF THE MODEL INCLUDE: IMPROVING CARE WHILE THE PATIENT IS PHYSICALLY IN THE ED AND PROVIDING EDUCATION AND SUPPORT TO ED STAFF IN WORKING WITH BH PATIENTS; FORMING THE BEGINNING OF THE THERAPEUTIC RELATIONSHIP WITH THE PATIENTS AND FAMILIES TO EDUCATE, INTERVENE IN CRISIS SITUATIONS, DEESCALATE AND FORM A WORKING ALLIANCE FOR POST DISCHARGE FOLLOW UP; PROVIDING WARM HANDOFFS BETWEEN THE HOSPITAL AND THE DISCHARGE PROGRAM TO PROMOTE CONTINUITY OF CARE AND REDUCTION OF REVISITS; FACILITATING LINKAGES TO THE ARRAY OF BEHAVIORAL HEALTH SERVICES PROVIDED BY SSMH IN THE COMMUNITY (E.G.: A PEER ACTIVITY CENTER AND ONGOING CASE MANAGEMENT); AND INTEGRATING CARE STRATEGIES WHICH ARE BASED ON EVIDENCE BASED PRACTICES TO MORE EFFECTIVELY MANAGE THE NEEDS OF BEHAVIORAL HEALTH PATIENTS IN CRISIS IN THE ED.COMMUNITY PARTNERSBID-MILTON IS AN IMPORTANT MEMBER OF LOCAL PUBLIC HEALTH TEAMS ADDRESSING THE NEEDS OF AREA COMMUNITIES. BID-MILTON WORKS WITH SEVERAL AREA GROUPS INCLUDING:- AARP- AL-ANON- ALATEEN- ALCOHOLICS ANONYMOUS- AMERICAN ACADEMY OF DERMATOLOGY- AMERICAN CANCER SOCIETY- AMERICAN HEART ASSOCIATION- AMERICAN RED CROSS- BAY STATE COMMUNITY SERVICES- BOSTON HIGASHI SCHOOL- CANTON BOARD OF HEALTH- CHADD (CHILDREN AND ADULTS WITH ATTENTION DEFICIT DISORDER)- CURRY COLLEGE- FULLER VILLAGE- GREATER BOSTON UROLOGY- INTERFAITH SOCIAL SERVICES- MANET COMMUNITY HEALTH CENTERS- MILTON BOARD OF HEALTH- MILTON COUNCIL ON AGING- MILTON FOUNDATION FOR EDUCATION- MILTON LOCAL EMERGENCY PLANNING COMMITTEE- MILTON SUBSTANCE ABUSE PREVENTION COALITION- MILTON PUBLIC SCHOOLS- NICOTINE ANONYMOUS- OLD COLONY HOSPICE- OVEREATERS ANONYMOUS- QUINCY BOARD OF HEALTH- QUINCY COMMUNITY ACTION PROGRAMS- QUINCY PUBLIC SCHOOLS- RANDOLPH BOARD OF HEALTH- RANDOLPH PUBLIC SCHOOLS- RANDOLPH SENIOR CENTER- SOUTH SHORE DERMATOLOGY- SOUTH SHORE ELDER SERVICES- SOUTH SHORE MENTAL HEALTH- SOUTH SHORE YMCA/GERMANTOWN NEIGHBORHOOD ASSOCIATION- WORK, INC.AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, THE BID-MILTON IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, AS NOTED IN SCHEDULE H, PART V, SECTION B, QUESTION 11, BID-MILTON IS UNABLE TO ADDRESS ALL NEEDS. DURING THE PERIOD COVERED BY THIS FILING, BID-MILTON WAS UNABLE TO ADDRESS THE NEED FOR TRANSPORTATION IDENTIFIED IN THE CHNA AND THE CHIP DUE TO LIMITED FINANCIAL RESOURCES. AS NOTED IN DETAIL ABOVE, THE BID-MILTON'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND CHIP (SCHEDULE H PART VI QUESTION 2).
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BETH ISRAEL DEACONESS HOSPITAL - MILTON (BID-MILTON OR HOSPITAL) CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 8.28% OF BID-MILTON'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. IN ADDITION AS NOTED THROUGHOUT THIS SCHEDULE H NARRATIVE, THERE ARE SIGNIFICANT ADDITIONAL ACTIVITIES AND EXPENDITURES WHICH BID-MILTON CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. UNDER THE INSTRUCTIONS TO THIS SCHEDULE H QUESTION 7 THESE ITEMS ARE NOT QUANTIFIED IN SCHEDULE H QUESTION 7, BUT IT IS WORTH NOTING THAT IF BID-MILTON HAD INCLUDED THESE IN SCHEDULE H QUESTION 7, THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WOULD BE 9.69% FOR THE PERIOD COVERED BY THIS FILING. IN ADDITION, IT IS IMPORTANT TO NOTE IN THIS CONTEXT THAT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER, ENTITY EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND THE SOLE MEMBER OF BID-MILTON. THE FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS PROVIDED BY BIDMC ARE PROVIDED BY THE SAME HEALTH CARE SYSTEM, AND ALTHOUGH THOSE ACTIVITIES ARE NOT QUANTIFIED ON THE BID-MILTON SCHEDULE H PER THE INSTRUCTIONS TO THE FORM 990, THOSE ACTIVITIES ARE RELEVANT IN EVALUATING THE TOTAL COMMUNITY BENEFIT PROVIDED. BIDMC REPORTED APPROXIMATELY 16% OF TOTAL EXPENSES INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST.
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COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORT
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AS PREVIOUSLY NOTED IN THIS FILING, HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) WERE APPROVED BY THE COMMUNITY BENEFITS COMMITTEE AND BOARD OF DIRECTORS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013 AND RELATE TO THE COMMUNITY BENEFIT ACTIVITIES REPORTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H. THE HOSPITAL'S MOST RECENT CHNA AND CHIP WERE COMPLETED AND APPROVED BY THE COMMUNITY BENEFITS COMMITTEE AND BOARD OF DIRECTORS DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2016 AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). ACTIVITIES RELATED TO THESE LATTER DOCUMENTS WILL BE REPORTED BEGINNING WITH THE FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2017. IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL. (SCHEDULE H, PART VI, LINE 7) THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND UPON REQUEST AT THE HOSPITAL. THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT THE MEDICAL CENTER FILED WITH THE ATTORNEY GENERAL'S OFFICE. COMMUNITY BENEFITSEMERGENCY ROOM OPERATIONIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BID-MILTON IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY.
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBID-MILTON'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $1,297,349 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2016 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A. THE MEDICAL CENTER, WHICH AS PREVIOUSLY NOTED IS THE SOLE MEMBER OF BID-MILTON, PROVIDED AN ADDITIONAL $20,063,870 OF FINANCIAL ASSISTANCE AND CHARITY CARE AT COST WHICH IS REPORTED ON THE MEDICAL CENTER FORM 990, SCHEDULE H, PART I, LINE 7A FOR THE SAME FISCAL PERIOD. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. HMFP IS THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER. THE OPERATIONS OF HMFP AND THE ENTITIES FOR WHICH HMFP SERVES AS MEMBER ARE INTEGRALLY RELATED TO THE MEDICAL CENTER'S ACCOMPLISHMENTS OF ITS PURPOSES. HMFP AND ITS AFFILIATES ARE INTEGRALLY RELATED TO BIDN AND TO SERVING THE COMMUNITIES SERVED BY BID-MILTON. AS PART OF THIS RELATIONSHIP, HMFP PATIENTS WHO MEET THE FREE CARE CRITERIA OF THE MEDICAL CENTER ARE PROVIDED FREE CARE AT HMFP AND ITS AFFILIATED ENTITIES. DURING THE FISCAL PERIOD COVERED BY THIS FILING, HMFP AND ITS AFFILIATED ENTITIES PROVIDED ADDITIONAL NET FREE CARE TO PATIENTS IN THE AMOUNT OF $4,015,379. SEE ADDITIONAL INFORMATION BELOW IN THIS SCHEDULE H NARRATIVE. OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BID-MILTON ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS WHICH INSURE LOW INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. MEDICAID IS A GOVERNMENT INSURANCE PROGRAM FOR INDIVIDUALS WITH LIMITED INCOME AND RESOURCES, AND BID-MILTON PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICAID PROGRAM. PAYMENTS TO HOSPITALS THROUGH THIS GOVERNMENT SPONSORED PROGRAM HAVE NOT KEPT PACE WITH INFLATION AND ALTHOUGH THE PROVISION OF HEALTH CARE TO THESE PATIENTS GENERATED $9,734,002 IN MEDICAID REVENUE WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY BID-MILTON FOR SUCH SERVICES BY $2,201,223 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 14.17% OR 19,892 OF BID-MILTON'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION 22.28% OR 259,205 OF THE MEDICAL CENTER'S PATIENT CASES WERE WITH MEDICAID PATIENTS. THIS TRANSLATED TO AN ADDITIONAL $44,357,335 IN UNCOVERED COST BORNE BY BIDMC IN PROVIDING CARE TO MEDICAID PATIENTS. AS PREVIOUSLY NOTED, THIS ADDITIONAL BIDMC COST IS NOT QUANTIFIED IN THE BID-MILTON SCHEDULE H.
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BAD DEBTS
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IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BID-MILTON ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS, AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $3,386,312 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. BIDMC SIMILARLY INCURS BAD DEBT LOSSES AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE IN ITS FINANCIAL STATEMENTS. BIDMC CHARGES FOR THOSE SERVICES WERE $21,621,241 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND AS REPORTED ON THE BIDMC FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER THE AMOUNT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. AS REQUIRED BY THIS FORM 990, SCHEDULE H, PART III, LINE 4, BELOW ARE THE BAD DEBT AND ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTES FROM THE BETH ISRAEL DEACONESS MEDICAL CENTER'S (BIDMC OR MEDICAL CENTER) AUDITED FINANCIAL STATEMENTS. AS PREVIOUSLY NOTED IN THIS FORM 990, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE MEDICAL CENTER AND AFFILIATES FOR FISCAL YEAR ENDED SEPTEMBER 30, 2016 INCLUDE THE ACCOUNTS OF THE MEDICAL CENTER AND ITS SUBSIDIARIES, (MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP (APG)), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC,, JORDAN HEALTH SYSTEMS, INC. AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER. THE BID-MILTON FORM 990 IS PREPARED FOR BID-MILTON ONLY AND AS SUCH, THE METRICS INCLUDED IN THESE FOOTNOTES WILL NOT TIE TO THE FACE OF THE BID-MILTON FORM 990, SCHEDULE H.FINANCIAL STATEMENT FOOTNOTES:BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, THE MEDICAL CENTER ALSO INCURS LOSSES RELATED TO SELF PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBTS ARE INCLUDED AS A COMPONENT OF NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS, AND INCLUDE THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. THE ESTIMATED COST OF PROVIDING SUCH SERVICES WAS $16,257,000 AND $14,059,000 IN 2016 AND 2015, RESPECTIVELY.PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSPATIENT ACCOUNTS RECEIVABLE ARE REFLECTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST COLLECTION HISTORY, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN GOVERNMENTAL AND EMPLOYEE HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS FOR EACH OF ITS MAJOR CATEGORIES OF REVENUE BY PAYOR TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR CATEGORIES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THROUGHOUT THE YEAR, THE MEDICAL CENTER, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, WILL WRITE OFF PATIENTS' UNMET OR UNCOLLECTED RESPONSIBILITY AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN ADDITION TO THE REVIEW OF THE CATEGORIES OF REVENUE, MANAGEMENT MONITORS THE WRITE OFFS AGAINST ESTABLISHED ALLOWANCES TO DETERMINE THE APPROPRIATENESS OF THE UNDERLYING ASSUMPTIONS USED IN ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE MEDICAL CENTER'S METHODOLOGY FOR VALUING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE REMAINED SUBSTANTIALLY CONSISTENT IN 2016 AND 2015. THE MEDICAL CENTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS REPRESENTED APPROXIMATELY 11.3% OF PATIENT ACCOUNTS RECEIVABLE NET OF CONTRACTUAL ALLOWANCES IN 2016 AND 12.6% IN 2015.
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EMERGENCY CARE ACCESS
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AS PREVIOUSLY NOTED IN THIS FILING, BIDMC IS THE SOLE MEMBER OF BID-MILTON. THE MEDICAL CENTER IS A NATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER AND TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) IS AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BIDMC AND IS ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BID-MILTON EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. THE BID-MILTON DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR.
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CREDIT AND COLLECTION POLICY GUIDING PRINCIPLES
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BID-MILTON ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, BID-MILTON MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. THE BID-MILTON CREDIT AND COLLECTION POLICY WHICH APPLIES TO THE HOSPITAL IS DESIGNED TO COMPLY WITH BOTH THE MASSACHUSETTS HEALTH SAFETY NET REGULATIONS ON CREDIT AND COLLECTION POLICIES, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES MEDICARE BAD DEBT REQUIREMENTS, THE MEDICARE PROVIDER REIMBURSEMENT MANUAL AND THE FEDERAL HEALTHCARE REFORM LAW'S "FINANCIAL ASSISTANCE POLICY" FOR WHICH THE IRS HAD PROVIDED PRELIMINARY GUIDANCE AT THE TIME THE BID-MILTON FINALIZED THIS POLICY. BID-MILTON CONTINUES TO MONITOR GUIDANCE FROM THE IRS AS IT IS ISSUED. BID-MILTON DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, CITIZENSHIP, ALIENAGE, RELIGION, CREED, SEX, SEXUAL ORIENTATION, DISABILITY, OR AGE IN ITS POLICIES OR IN ITS APPLICATION OF POLICIES CONCERNING THE ACQUISITION AND VERIFICATION OF FINANCIAL INFORMATION, PRE-ADMISSION OR PRE-TREATMENT DEPOSITS, PAYMENT PLANS, DEFERRED OR REJECTED ADMISSIONS, LOW INCOME PATIENT STATUS AS DETERMINED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES, DETERMINATION THAT A PATIENT IS LOW-INCOME, OR IN ITS BILLING AND COLLECTION PRACTICES. CREDIT AND COLLECTION POLICYNOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE AND OTHER COVERAGE OPTIONSFINANCIAL ASSISTANCE IS INTENDED TO ASSIST LOW-INCOME PATIENTS WHO DO NOT OTHERWISE HAVE THE ABILITY TO PAY FOR THEIR HEALTH CARE SERVICES. SUCH ASSISTANCE TAKES INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR PATIENTS THAT ARE UNINSURED OR UNDERINSURED, BID-MILTON WILL ASSIST THEM IN APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.BID-MILTON PROVIDES THIS ASSISTANCE FOR BOTH RESIDENTS AND NON-RESIDENTS OF MASSACHUSETTS; HOWEVER, THERE MAY NOT BE COVERAGE FOR A MASSACHUSETTS HOSPITAL'S SERVICES THROUGH AN OUT-OF STATE PROGRAM. IN ORDER FOR BID-MILTON TO ASSIST UNINSURED AND UNDERINSURED PATIENTS FIND THE MOST APPROPRIATE COVERAGE OPTIONS, PATIENTS MUST ACTIVELY WORK WITH THE HOSPITAL'S FINANCIAL COUNSELORS TO VERIFY THEIR FINANCIAL AND OTHER INFORMATION THAT COULD BE USED IN DETERMINING ELIGIBILITY. BID-MILTON ADVISES PATIENTS OF THEIR RIGHT TO (I) APPLY FOR MASSHEALTH AND LOW INCOME PATIENT DETERMINATION AND (II) A PAYMENT PLAN. BID-MILTON'S FINANCIAL CLEARANCE UNIT (FCU) WILL ASSIST PATIENTS IN FULFILLING THEIR RIGHT TO APPLY FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM INCLUDING MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET, HEALTH SAFETY NET AND/OR OTHER FINANCIAL PROGRAMS AS AVAILABLE AND APPROPRIATE.THE HOSPITAL ALSO WILL ASSIST UNINSURED OR UNDERINSURED PATIENTS, WHEN REQUESTED OR AS IDENTIFIED THROUGH INTERNAL SCREENING PROCEDURES, IN APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, BID-MILTON WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS WHO HAVE A FINANCIAL LIABILITY AS WELL AS IN GENERAL NOTICES THAT ARE POSTED THROUGHOUT THE HOSPITAL.BID-MILTON WILL TRY TO IDENTIFY AVAILABLE COVERAGE OPTIONS FOR PATIENTS WHO MAY BE UNINSURED OR UNDERINSURED WITH THEIR CURRENT INSURANCE PROGRAM WHEN THE PATIENT IS SCHEDULING SERVICES, WHILE THE PATIENT IS AT THE HOSPITAL, UPON DISCHARGE, AND/OR FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. BID-MILTON WILL DIRECT ALL PATIENTS SEEKING INFORMATION ON AVAILABLE COVERAGE OPTIONS, OR THOSE THAT THE HOSPITAL DETERMINES MAY BE ELIGIBLE, TO THE HOSPITAL'S FCU WHERE PATIENT FINANCIAL COUNSELORS CAN SCREEN PATIENTS FOR ELIGIBILITY IN AN APPROPRIATE COVERAGE OPTION. THE HOSPITAL WILL THEN ASSIST THE PATIENT IN APPLYING FOR APPROPRIATE COVERAGE OPTIONS THAT ARE AVAILABLE TO THEM.WHEN REQUESTED, THE HOSPITAL WILL ALSO PROVIDE INFORMATION ON HOW TO CONTACT THE APPROPRIATE STAFF WITHIN THE HOSPITAL'S FINANCE OFFICE TO VERIFY THE ACCURACY OF THE HOSPITAL BILL OR TO DISPUTE CERTAIN CHARGES. CONTACT INFORMATION IS PRINTED ON ALL PATIENT STATEMENTS.FOR CASES WHERE THE HOSPITAL IS USING THE HEATH INFORMATION EXCHANGE APPLICATION, THE HOSPITAL WILL ASSIST THE PATIENT IN COMPLETING THE APPLICATION FOR MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR OTHER FORMS OF FINANCIAL ASSISTANCE PROGRAMS AS THEY BECOME PART OF THE HEATH INFORMATION EXCHANGE PROGRAM, WHICH IS AN INTERNET PORTAL DESIGNED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES IN ORDER TO PROVIDE THE GENERAL PUBLIC, MEDICAL PROVIDERS, AND COMMUNITY-BASED ORGANIZATIONS WITH AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE COMMONWEALTH.
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CREDIT AND COLLECTION POLICY
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ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMSAS NOTED IN THIS FORM 990, SCHEDULE H, PART III, SECTION C QUESTION 9B, BID-MILTON PROVIDES PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR OTHER AVAILABLE PROGRAMS FOR WHICH THE PATIENT MAY BE ELIGIBLE AND WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. FOR PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS THEM BY SCREENING FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. THESE PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO: MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, AND OTHERS. WHEN APPLICABLE THE HOSPITAL MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED FAMILY INCOME, CURRENT AND PRIOR INSURANCE COVERAGE AND ALLOWABLE MEDICAL EXPENSES. IT IS THE PATIENT'S OBLIGATION TO PROVIDE THE FINANCIAL COUNSELORS WITH ACCURATE AND TIMELY INFORMATION REGARDING THEIR FULL NAME, ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, INCLUDING OTHER INSURANCE OR COVERAGE OPTIONS (SUCH AS MOTOR VEHICLE POLICY OR WORKER'S COMPENSATION POLICY) THAT CAN COVER THE COST OF THE CARE RECEIVED AND ANY OTHER APPLICABLE FINANCIAL RESOURCES, AND CITIZENSHIP AND RESIDENCY INFORMATION. THIS INFORMATION IS USED TO DETERMINE IF THE PATIENT IS ELIGIBLE TO APPLY FOR CERTAIN HEALTH INSURANCE PROGRAMS. IF THERE IS NO SPECIFIC COVERAGE FOR THE SERVICES PROVIDED, THE HOSPITAL WILL USE THE INFORMATION TO DETERMINE IF THE SERVICES MAY BE COVERED BY AN APPLICABLE PROGRAM THAT WILL COVER CERTAIN SERVICES DEEMED BAD DEBT. IN ADDITION, THE HOSPITAL WILL USE THIS INFORMATION TO DISCUSS ELIGIBILITY FOR CERTAIN HEALTH INSURANCE PROGRAMS. THE SCREENING AND APPLICATION PROCESS FOR A PUBLIC HEALTH INSURANCE PROGRAM IS DONE THROUGH THE HEALTH INFORMATION EXCHANGE (HIX), WHICH IS AN INTERNET PORTAL DESIGNED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES IN ORDER TO PROVIDE THE GENERAL PUBLIC, MEDICAL PROVIDERS, AND COMMUNITY-BASED ORGANIZATIONS WITH AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE STATE OR THROUGH A STANDARD PAPER APPLICATION THAT IS COMPLETED BY THE PATIENT AND ALSO SUBMITTED DIRECTLY TO THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR PROCESSING AS THIS OFFICE SOLELY MANAGES THE APPLICATION PROCESS LISTED ABOVE, WHICH IS AVAILABLE FOR CHILDREN, ADULTS, SENIORS, VETERANS, HOMELESS, AND DISABLED INDIVIDUALS. IN SPECIAL CIRCUMSTANCES, THE HOSPITAL MAY APPLY FOR THE PATIENT USING A SPECIFIC FORM DESIGNED BY THE MASSACHUSETTS DIVISION OF HEALTH CARE FINANCE AND POLICY. SPECIAL CIRCUMSTANCES INCLUDE INDIVIDUALS SEEKING FINANCIAL ASSISTANCE COVERAGE DUE TO BEING INCARCERATED, VICTIMS OF SPOUSAL ABUSE, OR APPLYING DUE TO A MEDICAL HARDSHIP. IN SPECIAL CIRCUMSTANCES, THE HOSPITAL MAY APPLY FOR THE PATIENT FOR ELIGIBILITY IN THE HEALTH SAFETY NET PROGRAM USING A SPECIFIC FORM DESIGNED BY THE MASSACHUSETTS DIVISION OF HEALTH CARE FINANCE AND POLICY. SPECIAL CIRCUMSTANCES INCLUDE INDIVIDUALS SEEKING FINANCIAL ASSISTANCE COVERAGE DUE TO BEING INCARCERATED, VICTIMS OF SPOUSAL ABUSE, OR APPLYING DUE TO A MEDICAL HARDSHIP.THE HOSPITAL SPECIFICALLY ASSISTS THE PATIENT IN COMPLETING THE APPLICATION AND SECURING THE NECESSARY DOCUMENTATION REQUIRED BY THE APPLICABLE FINANCIAL ASSISTANCE PROGRAM. NECESSARY DOCUMENTATION INCLUDES PROOF OF: (1) ANNUAL HOUSEHOLD INCOME (PAYROLL STUBS, RECORD OF SOCIAL SECURITY PAYMENTS, AND A LETTER FROM THE EMPLOYER, TAX RETURNS, OR BANK STATEMENTS), (2) CITIZENSHIP AND IDENTITY, AND (3) IMMIGRATION STATUS FOR NON-CITIZENS (IF APPLICABLE), AND (4) ASSETS OF THOSE INDIVIDUALS WHO ARE ALSO ENROLLED IN THE MEDICARE PROGRAM. THE HOSPITAL WILL THEN SUBMIT THIS DOCUMENTATION TO THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES AND ASSIST THE PATIENT IN SECURING ANY ADDITIONAL DOCUMENTATION IF SUCH IS REQUESTED BY THE COMMONWEALTH AFTER COMPLETING THE APPLICATION. THE COMMONWEALTH PLACES A THREE DAY TIME LIMITATION ON SUBMITTING ALL NECESSARY DOCUMENTATION FOLLOWING THE SUBMISSION OF THE APPLICATION FOR A PROGRAM. FOLLOWING THIS THREE DAY PERIOD, THE PATIENT MUST WORK WITH THE MASSHEALTH ENROLLMENT CENTERS TO SECURE THE ADDITIONAL DOCUMENTATION NEEDED FOR ENROLLMENT IN THE APPLICABLE FINANCIAL ASSISTANCE PROGRAM.IN SPECIAL CIRCUMSTANCES, THE HOSPITAL MAY APPLY FOR THE PATIENT FOR ELIGIBILITY IN THE HEALTH SAFETY NET PROGRAM USING A SPECIFIC FORM DESIGNED BY THE MASSACHUSETTS DIVISION OF HEALTH CARE FINANCE AND POLICY. SPECIAL CIRCUMSTANCES INCLUDE INDIVIDUALS SEEKING FINANCIAL ASSISTANCE COVERAGE DUE TO BEING INCARCERATED, VICTIMS OF SPOUSAL ABUSE, OR APPLYING DUE TO A MEDICAL HARDSHIP.ALL HEATH INFORMATION EXCHANGE APPLICATIONS ARE REVIEWED AND PROCESSED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES WHICH USES THE FEDERAL POVERTY GUIDELINES, ASSET INFORMATION AS WELL AS NECESSARY DOCUMENTATION LISTED ABOVE AS THE BASIS FOR DETERMINING ELIGIBILITY FOR STATE SPONSORED PUBLIC ASSISTANCE PROGRAMS. BID-MILTON HAS NO ROLE IN THE DETERMINATION OF PROGRAM ELIGIBILITY MADE BY THE COMMONWEALTH, BUT AT THE PATIENT'S REQUEST MAY TAKE A DIRECT ROLE IN APPEALING OR SEEKING INFORMATION RELATED TO THE COVERAGE DECISIONS. IT IS STILL THE PATIENT'S RESPONSIBILITY TO INFORM THE HOSPITAL OF ALL COVERAGE DECISIONS MADE BY THE COMMONWEALTH TO ENSURE ACCURATE AND TIMELY ADJUDICATION OF ALL HOSPITAL BILLS AND THE AMOUNTS ULTIMATELY CHARGED TO THE FINANCIAL ASSISTANCE ELIGIBLE PATIENTS IS DETERMINED BY THE SPECIFIC CONNECTOR PLAN FOR WHICH THE PATIENT QUALIFIES. IN ADDITION, BID-MILTON'S POLICY PROVIDES FOR INDIVIDUALS WHO ARE UNABLE TO AFFORD THEIR CARE BECAUSE OF MEDICAL HARDSHIP AND PROVIDES FOR FEES BASED ON A SLIDING SCALE RELATIVE TO PERCENTAGES OF THE FEDERAL POVERTY GUIDELINES (SCHEDULE H, PART V, SECTION B, QUESTION 22D). IN ADDITION, BID-MILTON BECOMES AWARE OF A PATIENT'S HSN OR FINANCIAL ELIGIBILITY STATUS, ALL INVOICES ARE ADJUSTED ACCORDINGLY (SCHEDULE H, PART V, SECTION B, QUESTIONS 23 AND 24). BID-MILTON NOTIFIES ITS PATIENTS ABOUT ITS FINANCIAL ASSISTANCE POLICY THROUGH SUMMARY POSTINGS IN THE EMERGENCY DEPARTMENT AND WITHIN PATIENT FINANCIAL SERVICES. IN ADDITION, EACH PATIENT'S STATEMENT INCLUDES INFORMATION REFERRING PATIENTS TO BID-MILTON'S FINANCIAL COUNSELORS FOR SUPPORT IN APPLYING FOR FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR OTHER AVAILABLE PROGRAMS FOR WHICH THE PATIENT MAY BE ELIGIBLE, INCLUDING MEDICAL HARDSHIP, AND WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. THE FULL BID-MILTON CREDIT AND COLLECTION POLICY IS AVAILABLE FROM BID-MILTON FINANCIAL COUNSELORS.
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CREDIT AND COLLECTION POLICY
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BID-MILTON STANDARD COLLECTION PRACTICESAS PREVIOUSLY NOTED IN THIS FORM 990 SCHEDULE H, BID-MILTON ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. ADDITIONALLY, TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, THE HOSPITAL MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. AS SUCH, THE HOSPITAL HAS A FIDUCIARY DUTY TO SEEK REIMBURSEMENT FOR SERVICES IT HAS PROVIDED FROM INDIVIDUALS WHO ARE ABLE TO PAY, FROM THIRD PARTY INSURERS WHO COVER THE COST OF CARE, AND FROM OTHER PROGRAMS OF ASSISTANCE FOR WHICH THE PATIENT IS ELIGIBLE. TO DETERMINE WHETHER A PATIENT IS ABLE TO PAY FOR THE SERVICES PROVIDED AS WELL AS TO ASSIST THE PATIENT IN FINDING ALTERNATIVE COVERAGE OPTIONS IF THEY ARE UNINSURED OR UNDERINSURED, BID-MILTON HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. BID-MILTON MAKES THE SAME REASONABLE EFFORT AND FOLLOWS THE SAME REASONABLE PROCESS FOR COLLECTING ON BILLS OWED BY AN UNINSURED PATIENT AS IT DOES FOR ALL OTHER PATIENTS. THE HOSPITAL WILL FIRST SHOW THAT IT HAS A CURRENT UNPAID BALANCE THAT IS RELATED TO SERVICES PROVIDED TO THE PATIENT AND NOT COVERED BY A PRIVATE INSURER OR A FINANCIAL ASSISTANCE PROGRAM. BID-MILTON ALSO HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. BID-MILTON AND/OR ITS AGENTS DO NOT CHARGE INTEREST ON AN OVERDUE BALANCE FOR A LOW INCOME PATIENT OR ANY OTHER PATIENT. BID-MILTON FOLLOWS THE MASSACHUSETTS MEDICAL HARDSHIP INCOME LEVELS AND PERCENTAGES IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY. THERE ARE NO INCOME LIMITS FOR MEDICAL HARDSHIP. MASSACHUSETTS RESIDENTS AT ALL INCOME LEVELS ARE ELIGIBLE IF A PATIENT'S FAMILY ALLOWED MEDICAL BILLS ARE HIGHER THAN A SPECIFIED SLIDING SCALE PERCENTAGE OF FAMILY INCOME.IN ADDITION TO PUBLICIZING THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION B QUESTION 16A-F, THERE IS MULTI-LANGUAGE SIGNAGE IN THE FINANCIAL COUNSELING OFFICE STATING THAT A COPY OF THE POLICY IS AVAILABLE UPON REQUEST. CREDIT AND COLLECTION POLICY - OUTSIDE COLLECTION AGENCIESBID-MILTON CONTRACTS WITH OUTSIDE COLLECTION AGENCIES TO ASSIST IN THE COLLECTION OF CERTAIN ACCOUNTS, INCLUDING PATIENT RESPONSIBLE AMOUNTS NOT RESOLVED AFTER ISSUANCE OF HOSPITAL BILLS OR FINAL NOTICES. HOWEVER, AS DETERMINED THROUGH THE BID-MILTON'S CREDIT AND COLLECTION POLICY, THE HOSPITAL MAY ASSIGN SUCH DEBT AS BAD DEBT OR CHARITY CARE (OTHERWISE DEEMED AS UNCOLLECTIBLE) PRIOR TO 120 DAYS IF IT IS ABLE TO DETERMINE THAT THE PATIENT WAS UNABLE TO PAY FOLLOWING THE HOSPITALS' OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM.BID-MILTON HAS A SPECIFIC AUTHORIZATION OR CONTRACT WITH ITS OUTSIDE COLLECTION AGENCIES AND REQUIRES SUCH AGENCIES TO ABIDE BY THE HOSPITAL'S CREDIT AND COLLECTION POLICIES FOR DEBTS THAT THE AGENCY IS PURSUING, INCLUDING THE OBLIGATION TO REFRAIN FROM "EXTRAORDINARY COLLECTION ACTIVITIES" UNTIL SUCH TIME AS THE HOSPITAL HAS MADE A REASONABLE EFFORT AND FOLLOWED A REASONABLE PROCESS FOR DETERMINING THAT A PATIENT IS ENTITLED TO ASSISTANCE OR EXEMPTION FROM ANY COLLECTION OR BILLING PROCEDURES UNDER THE HOSPITAL'S CREDIT AND COLLECTION POLICY. ALL OUTSIDE COLLECTION AGENCIES HIRED BY THE HOSPITAL WILL PROVIDE THE PATIENT WITH AN OPPORTUNITY TO FILE A GRIEVANCE AND WILL FORWARD TO THE HOSPITAL THE RESULTS OF SUCH PATIENT GRIEVANCES. THE HOSPITAL REQUIRES THAT ANY OUTSIDE COLLECTION AGENCY THAT IT USES IS LICENSED BY THE COMMONWEALTH OF MASSACHUSETTS AND THAT THE OUTSIDE COLLECTION AGENCY ALSO IS IN COMPLIANCE WITH THE MASSACHUSETTS ATTORNEY GENERAL'S DEBT COLLECTION REGULATIONS.
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CREDIT AND COLLECTION POLICY
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EXEMPTION FROM BID-MILTON COLLECTION PRACTICESBID-MILTON EXEMPTS PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN AND "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID, SUBJECT TO SOME EXCEPTIONS, FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS.CREDIT AND COLLECTION POLICY - HOSPITAL FINANCIAL ASSISTANCE PROGRAMSTHE HOSPITAL, WHEN REQUESTED BY THE PATIENT AND BASED ON INTERNAL REVIEW OF EACH PATIENT'S FINANCIAL STATUS, MAY OFFER 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. ANY DISCOUNT THAT IS PROVIDED BY THE HOSPITAL IS CONSISTENT WITH FEDERAL AND STATE REQUIREMENTS, AND DOES NOT INFLUENCE A PATIENT'S ABILITY TO RECEIVE SERVICES FROM THE HOSPITAL. SUCH PROGRAMS INCLUDE: PROMPT PAY DISCOUNTS FOR UNINSURED PATIENTS, ONE TIME OR SPECIAL CIRCUMSTANCE SITUATIONS AND PAYMENT PLANS.AS PREVIOUSLY NOTED IN THIS FILING, BID-MILTON IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THE HOSPITAL'S CURRENT FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR THE HOSPITAL'S SERVICE AREA, INCLUDING THE FEDERAL TREASURY REGULATIONS IN EFFECT AS OF OCTOBER 1, 2016. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE RECEIVED FROM QUALIFYING HOSPITAL PROVIDERS.THE HOSPITAL WILL NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.APPLICATION PERIODTHE PERIOD IN WHICH APPLICATIONS WILL BE ACCEPTED AND PROCESSED FOR FINANCIAL ASSISTANCE. THE APPLICATION PERIOD BEGINS ON THE DATE THAT THE FIRST POST-DISCHARGE BILLING STATEMENT IS PROVIDED AND ENDS ON THE 240TH DAY AFTER THAT DATE.QUALIFICATION PERIODAPPLICANTS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE GRANTED ASSISTANCE FOR A PERIOD OF SIX MONTHS. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE MAY ATTEST THAT THERE HAVE BEEN NO CHANGES TO THEIR FINANCIAL SITUATION AT THE END OF THE SIX (6) MONTH QUALIFICATION PERIOD TO EXTEND ELIGIBILITY FOR ANOTHER SIX (6) MONTHS. FINANCIAL ASSISTANCEFINANCIAL ASSISTANCE IS PROVIDED TO ELIGIBLE PATIENTS, WHO WOULD OTHERWISE EXPERIENCE FINANCIAL HARDSHIP, TO RELIEVE THEM OF ALL OR PART OF THEIR FINANCIAL OBLIGATION FOR EMERGENCY OR MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL. FULL ASSISTANCEPATIENTS, OR THEIR GUARANTORS, WITH ANNUALIZED FAMILY INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL (FPL) WILL RECEIVE A 100% WAIVER OF PATIENT FINANCIAL OBLIGATION FOR ELIGIBLE MEDICAL SERVICES PROVIDED BY THE HOSPITAL.PARTIAL ASSISTANCEPATIENTS, OR THEIR GUARANTORS, WITH ANNUALIZED FAMILY INCOMES BETWEEN 201% AND 400% OF THE FPL MAY RECEIVE FINANCIAL ASSISTANCE THAT PROVIDES A DISCOUNT, FOR ELIGIBLE MEDICAL SERVICES PROVIDED BY THE HOSPITAL.MEDICAL HARDSHIPFINANCIAL ASSISTANCE IS AVAILABLE TO ELIGIBLE PATIENTS WHOSE MEDICAL BILLS ARE GREATER THAN OR EQUAL TO 25% OF THEIR GROSS INCOME.AMOUNT GENERALLY BILLED (AGB)THE FINANCIAL ASSISTANCE POLICY ESTABLISHES A LIMIT ON THE AMOUNT CHARGED (AMOUNT GENERALLY BILLED OR AGB) FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. THE AGB IS A BLENDED RATE OF MEDICARE AND COMMERCIAL PAYER REIMBURSEMENT THAT AMOUNTS TO APPROXIMATELY 38% OF CHARGES. CREDIT AND COLLECTION POLICYDISCOUNT FOR UNINSURED PATIENTSIN ADDITION TO THE FINANCIAL ASSISTANCE INFORMATION PROVIDED ABOVE, THE BID-MILTON MAY GIVE A SELF-PAY DISCOUNT TO PATIENTS WHO ARE UNINSURED.
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BILLING AND COLLECTIONS BEFORE REASONABLE EFFORTS
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NEITHER BID-MILTON NOR ANY AUTHORIZED THIRD PARTY TOOK ANY OF THE ACTIONS LISTED IN FORM 990, SCHEDULE H, PART V, SECTION B, QUESTIONS 18, 19 OR 20.
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS
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COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLAN
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DETAIL TO BETH ISRAEL DEACONESS HOSPITAL-MILTON'S (BID-MILTON OR HOSPITAL) COMMUNITY HEALTH NEEDS ASSESSMENT, IMPLEMENTATION STRATEGY AND COMMUNITY BENEFITS ACTIVITIES HAVE BEEN PROVIDED IN FORM 990, SCHEDULE H,PART V SECTION C ABOVE.
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CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS
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GRADUATE MEDICAL EDUCATIONAS NOTED THROUGHOUT THIS FORM 990, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON (BID-MILTON). ALTHOUGH BID-MILTON DOES NOT PARTICIPATE DIRECTLY IN RESIDENT AND FELLOW TRAINING PROGRAMS WHICH ARE OPERATED AT BIDMC, THE PROVISION OF GRADUATE MEDICAL EDUCATION IS AN IMPORTANT COMMUNITY BENEFIT PROVIDED BY BID-MILTON'S NETWORK OF AFFILIATED ENTITIES. THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 48 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 611 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 42 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 62 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS:- ANESTHESIOLOGY- EMERGENCY MEDICINE- INTERNAL MEDICINE- NEUROLOGY- NEUROSURGERY- OBSTETRICS AND GYNECOLOGY- PATHOLOGY- PSYCHIATRY- RADIOLOGY- SURGERY- TRANSITIONAL YEARDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER HAD NET EXPENDITURES OF $72,842,238 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE MEDICAL CENTER'S TEACHING FUNCTION WHICH REPRESENTED 4.62% OF THE MEDICAL CENTER'S TOTAL EXPENSES.RESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. OVER HALF OF THESE PROGRAMS (55 OF 90) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS:- ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, CRITICAL CARE MEDICINE, NEUROANESTHESIA, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA- EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, ACADEMIC EMERGENCY MEDICINE AND FACULTY FELLOWSHIP- INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOSCOPY, CARDIAC MAGNETIC RESONANCE IMAGING CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND ONCOLOGY, HEPATOLOGY, HOSPITAL AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY- NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY- OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, MATERNAL FETAL MEDICINE, MINIMALLY INVASIVE GYNECOLOGIC SURGERY, REPRODUCTIVE ENDOCRINOLOGY- PATHOLOGY: CYTOPATHOLOGY, HEMATOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY - CPEP, SELECTIVE PATHOLOGY - RADIOLOGY-DIAGNOSTIC: ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED MRI, MUSCULOSKELETAL IMAGING - MSK, NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, VASCULAR AND INTERVENTIONAL RADIOLOGY, RADIATION ONCOLOGY- SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, COLORECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, INTERDISCIPLINARY BREAST SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, NEUROSURGICAL ONCOLOGY & STERIOTACTIC NEUROSURGERY, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, PLASTIC HAND SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATED
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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RESEARCHAS PREVIOUSLY NOTED IN THROUGHOUT THIS FORM 990, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS THE SOLE MEMBER OF BID-MILTON. ALTHOUGH BID-MILTON DOES NOT ENGAGE IN DIRECT RESEARCH, IT IS PART OF BIDMC'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE BIDMC RESEARCH PROGRAM STRIVES TO BE, AND IS, RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS THAT IMPROVE THE QUALITY OF LIFE. THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. MEDICAL CENTER INVESTIGATORS LEAD MORE THAN 1,285 ACTIVE FEDERAL AND INDUSTRY SPONSORED PROJECTS AND MORE THAN 1500 ACTIVE CLINICAL TRIALS DURING THE FISCAL PERIOD COVERED BY THIS FILING. THIS RESEARCH IS LED BY 568 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, AND CARDIOLOGY/CARDIAC SURGERY.AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:- ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE - EMERGENCY MEDICINE - MEDICINE - ALLERGY AND INFLAMMATION- CARDIOVASCULAR MEDICINE- CENTER FOR VASCULAR BIOLOGY RESEARCH- CENTER FOR VIROLOGY AND VACCINE RESEARCH- CLINICAL INFORMATICS- CLINICAL NUTRITION- ENDOCRINOLOGY- EXPERIMENTAL MEDICINE- GASTROENTEROLOGY- GENERAL MEDICINE AND PRIMARY CARE- GENETICS- GERONTOLOGY- HEMATOLOGY AND ONCOLOGY- HEMOSTASIS AND THROMBOSIS- IMMUNOLOGY- INFECTIOUS DISEASE- INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY- MOLECULAR AND VASCULAR MEDICINE- NEPHROLOGY- PULMONOLOGY- RHEUMATOLOGY- SIGNAL TRANSDUCTION- TRANSLATIONAL RESEARCH- TRANSPLANT IMMUNOLOGY- NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY - CARDIAC SURGERY- CENTER FOR MINIMALLY INVASIVE SURGERY- NEUROSURGERY- PLASTIC AND RECONSTRUCTIVE SURGERY- VASCULAR SURGERY- TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $73,240,411 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 4.64% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $200,837,860 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS WHICH, IF INCLUDED IN THE SCHEDULE H, PART I, LINE 7H CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THE MEDICAL CENTER'S SCHEDULE H, PART I, LINE 7H TO 17.37%.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.