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FORM 990 SCHEDULE H PART V, SECTION C:
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SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENT BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BIDN OR HOSPITAL) IS COMMITTED TO WORKING IN PARTNERSHIP WITH RESIDENTS AND COMMUNITY LEADERS AS WELL AS CIVIC, SOCIAL AND MEDICAL ORGANIZATIONS FROM THE COMMUNITIES SERVED. THE HOSPITAL IS DEDICATED TO THE PLANNING, DEVELOPMENT, IMPLEMENTATION, AND MONITORING OF PROGRAMS THAT ADDRESS THE HEALTH CARE NEEDS OF OUR COMMUNITY. BIDN HAS MAINTAINED A TRADITION OF EXTENSIVE COMMUNITY SERVICE PROGRAMMING THROUGHOUT ITS HISTORY. THROUGH THE HOSPITAL'S COMMUNITY BENEFIT PROGRAMS, BIDN OFFERS CLINICAL, EDUCATIONAL AND FINANCIAL RESOURCES. THESE PROGRAMS ARE DESIGNED TO IMPROVE AWARENESS OF COMMUNITY HEALTHCARE ISSUES AND INCREASE PARTICIPATION IN WELLNESS AND PREVENTATIVE HEALTH ACTIVITIES. THE HOSPITAL'S COMMITMENT TO THE COMMUNITY BENEFIT IDEALS ALSO INCLUDES CONDUCTING PERIODIC COMMUNITY HEALTH NEEDS ASSESSMENTS AND PROVIDING EXTENSIVE OPPORTUNITIES FOR PUBLIC INPUT AND PARTICIPATION IN ONGOING EVALUATIVE PROCESSES. BIDN BELIEVES THAT THE COOPERATIVE AND COLLABORATIVE PARTNERSHIPS DEVELOPED THROUGH COMMUNITY BENEFIT PROGRAMS WILL HELP ADDRESS THE HEALTH AND WELFARE NEEDS OF THE COMMUNITY. 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, BIDN PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $390,061 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. 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-NEEDHAM'S PRESIDENT AND CEO, LEADERSHIP STAFF AND MEMBERS OF THE BOARD OF TRUSTEES, IN COLLABORATION WITH COMMUNITY BENEFITS STAFF, INCLUDING THE COMMUNITY RELATIONS COORDINATOR AND CHIEF EXTERNAL RELATIONS OFFICER, ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITAL'S COMMUNITY BENEFIT MANDATE IS EXECUTED EFFECTIVELY.
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COMMUNITY HEALTH NEEDS ASSESSMENT
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COMMUNITY HEALTH NEEDS ASSESSMENT - INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. BID-NEEDHAM COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2016 AND WAS COMPLETED IN CONJUNCTION WITH BETH ISRAEL DEACONESS MEDICAL CENTER WHICH SERVES AS BID-NEEDHAM'S SOLE MEMBER AND THE OTHER COMMUNITY HOSPITALS FOR WHICH BIDMC SERVES AS SOLE MEMBER (BID-MILTON AND BID-PLYMOUTH). THAT CHNA WAS APPROVED BY THE BID-NEEDHAM BOARD OF TRUSTEES ON SEPTEMBER 1, 2016. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS APPROVED BY THE BOARD ON SEPTEMBER 1, 2016 WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER IRC SECTION 501(R). DETAIL RELATED TO THIS PROCESS WILL BE INCLUDED IN BIDN'S FORM 990 SCHEDULE H FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2017. THE PREVIOUS NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE BID-NEEDHAM BOARD OF TRUSTEES IN SEPTEMBER 2013 AND INFORMED BID-NEEDHAM'S COMMUNITY BENEFIT PROCESS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2014, SEPTEMBER 30, 2015 AND SEPTEMBER 30, 2016. AS SUCH, THE ACCOMPLISHMENTS AND ACTIVITIES INCLUDED IN THIS FILING RELATE TO THE DOCUMENTS APPROVED AS OF SEPTEMBER 30, 2013. THE 2013 BID-NEEDHAM COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP OR IMPLEMENTATION STRATEGY) WERE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OUT OF BID-NEEDHAM'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 WAS DESIGNED TO FULFILL THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BID-NEEDHAM ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BID-NEEDHAM, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT.COMMUNITY HEALTH NEEDS ASSESSMENT - TARGETED GEOGRAPHY AND POPULATIONTHE 2013 COMMUNITY HEALTH ASSESSMENT (CHNA) FOCUSED ON THE FOUR TOWNS THAT COMPRISE THE HOSPITAL'S PRIMARY SERVICE AREA. THESE COMMUNITIES INCLUDE DEDHAM, DOVER, NEEDHAM, AND WESTWOOD (REFERRED TO AS THE NEEDHAM REGION). WHILE THE CHNA PROCESS AIMED TO EXAMINE THE HEALTH CONCERNS ACROSS THE ENTIRE REGION, THERE WAS A PARTICULAR FOCUS ON IDENTIFYING THE NEEDS OF THE MOST UNDERSERVED POPULATION GROUPS OF THE REGION, INCLUDING YOUTH, SENIORS AND IMMIGRANTS. COMMUNITY HEALTH NEEDS ASSESSMENT -- APPROACH AND METHODSBIDN ENGAGED HEALTH RESOURCES IN ACTION, A NON-PROFIT HEALTH ORGANIZATION, TO CONDUCT ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE PURPOSE OF THE CHNA WAS TO PROVIDE AN EMPIRICAL FOUNDATION FOR FUTURE HEALTH PLANNING AS WELL AS FULFILL THE CHNA REQUIREMENT FOR BOTH THE MASSACHUSETTS ATTORNEY GENERAL AND IRS. THE RESULTS OF THIS PROCESS HELP GUIDE THE HOSPITAL'S EFFORTS TO IMPROVE THE HEALTH OF THE POPULATION SERVED. THE PROCESS INCLUDED BOTH QUALITATIVE AND QUANTITATIVE REVIEW OF COMMUNITY DATA AND THE CHNA EVALUATED HEALTH NEEDS OF DISADVANTAGED POPULATIONS, AMONG OTHER COMMUNITY HEALTH NEEDS.QUANTITATIVE DATA: REVIEWING EXISTING SECONDARY DATAEXISTING DATA WAS DRAWN FROM STATE, HEALTH NETWORK AREA (HNA) AND LOCAL SOURCES IN ORDER TO DEVELOP A SOCIAL, ECONOMIC, AND HEALTH PORTRAIT OF THE NEEDHAM REGION, THROUGH A "SOCIAL DETERMINANTS OF HEALTH FRAMEWORK." SOURCES OF DATA INCLUDED, BUT WERE NOT LIMITED TO, THE U.S. CENSUS, CENTERS FOR DISEASE CONTROL AND PREVENTION, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, AND F.B.I. UNIFORM CRIME REPORTS. OTHER TYPES OF DATA INCLUDED SELF-REPORT OF HEALTH BEHAVIORS FROM LARGE, POPULATION-BASED SURVEYS SUCH AS THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VITAL STATISTICS BASED ON BIRTH AND DEATH RECORDS. IT SHOULD BE NOTED THAT ASIDE FROM POPULATION COUNTS, AGE AND RACIAL/ETHNIC DISTRIBUTION, OTHER DATA FROM THE U.S. CENSUS DERIVE FROM THE AMERICAN COMMUNITY SURVEY, WHICH IS COMPRISED OF DATA FROM A SAMPLE OF A GIVEN GEOGRAPHIC AREA. QUALITATIVE DATA: COMMUNITY DIALOGUES WHILE RESIDENTS FROM THE NEEDHAM REGION PARTICIPATED IN THE COMMUNITY DIALOGUES, THE COMMUNITIES OF NEEDHAM AND WESTWOOD WERE SPECIFICALLY THE FOCUS. THESE TOWNS WERE SELECTED IN ORDER TO BETTER UNDERSTAND THEIR SPECIFIC NEEDS, AND BECAUSE THEY REPRESENT DIFFERENT GEOGRAPHIC REGIONS OF THE BIDN SERVICE AREA. PARTICIPANTS REPRESENTED A RANGE OF POPULATION GROUPS, SENIORS, LEADERS AND HEALTH PROVIDERS IN THE SPECIFIC COMMUNITIES, AND SPECIAL INTEREST POPULATIONS. COMMUNICATION ABOUT THE EVENTS WAS DISTRIBUTED THROUGH BID-NEEDHAM CONTACTS IN EACH AREA, INCLUDING THE LOCAL HEALTH DEPARTMENTS, PUBLIC SCHOOLS, AND COUNCILS ON AGING. CONTACTS HELPED DISSEMINATE INFORMATION THROUGH A WIDER NETWORK OF ORGANIZATIONS AND AGENCIES TO PROVIDE A CROSS-SECTION OF RESIDENTS TO EACH EVENT, DRAWN FROM THE GENERAL POPULATION AS WELL AS LEADERS IN THE PUBLIC SCHOOLS, THE COUNCIL ON AGING, AND LOCAL GOVERNMENT. THE DISCUSSIONS AIMED TO EXPLORE PARTICIPANTS' PERCEPTIONS OF THEIR COMMUNITIES, WHAT ASPECTS OF THE COMMUNITIES MAKE IT EASIER OR HARDER TO BE HEALTHY, AND THEIR SUGGESTIONS FOR FUTURE PROGRAMMING AND SERVICES TO ADDRESS THEIR PERCEIVED HEALTH ISSUES AND WERE MODERATED BY TRAINED HRIA PERSONNEL. KEY INFORMANT INTERVIEWS INTERVIEWS WERE CONDUCTED WITH TEN INDIVIDUALS REPRESENTING A RANGE OF SECTORS, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE, AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., SENIORS). THE INTERVIEWS EXPLORED PARTICIPANTS' PERCEPTIONS OF THEIR COMMUNITIES, PRIORITY HEALTH CONCERNS AND SOLICITED SUGGESTIONS FOR FUTURE PROGRAMMING AND SERVICES TO ADDRESS THEIR PERCEIVED HEALTH ISSUES. A SEMI-STRUCTURED INTERVIEW GUIDE WAS USED ACROSS ALL DISCUSSIONS TO ENSURE CONSISTENCY IN THE TOPICS COVERED. ANALYSES THE COLLECTED QUALITATIVE INFORMATION WAS MANUALLY CODED AND THEN ANALYZED THEMATICALLY FOR MAIN CATEGORIES AND SUB-THEMES. DATA ANALYSTS IDENTIFIED KEY THEMES THAT EMERGED ACROSS ALL GROUPS AND INTERVIEWS AS WELL AS THE UNIQUE ISSUES THAT WERE NOTED FOR SPECIFIC POPULATIONS. FREQUENCY AND INTENSITY OF DISCUSSIONS ON A SPECIFIC TOPIC WERE KEY INDICATORS USED FOR EXTRACTING MAIN THEMES. WHILE MUNICIPALITY DIFFERENCES ARE NOTED WHERE APPROPRIATE, ANALYSES EMPHASIZED FINDINGS COMMON ACROSS THE NEEDHAM REGION.THE CHNA UTILIZED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. AS NOTED ABOVE, THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS IN THE REGION AS WELL AS INFORMATION FROM COMMUNITY DIALOGUES CONDUCTED WITH COMMUNITY RESIDENTS, AND INTERVIEWS WITH COMMUNITY STAKEHOLDERS. (SCHEDULE H, PART V, SECTION B, QUESTION 5). BIDN CONDUCTED THIS CHNA PROCESS INDEPENDENTLY AS REPORTED IN SCHEDULE H, PART V, SECTION B, QUESTION 6A AND 6B.COMMUNITY HEALTH NEEDS ASSESSMENT - KEY FINDINGSBIDN'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 NEEDHAM 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 NEEDHAM REGION WORKING TO MEET THE HEALTH AND SOCIAL SERVICE NEEDS OF RESIDENTS.
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COMMUNITY HEALTH NEEDS ASSESSMENT - ADDRESSING COMMUNITY HEALTH NEEDS
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BID-NEEDHAM STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY WHICH ARE AVAILABLE ON THE BID-NEEDHAM WEBSITE. AS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, BID-NEEDHAM'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.BIDNEEDHAM.ORG/WRITABLE/FILES/NEEDHAM-CHNA-REPORT-FINAL.PDF IN ADDITION, THE CHNA AND CHIP WHICH WERE 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.BIDNEEDHAM.ORG/WRITABLE/FILES/BID-NEEDHAM-CB-PLAN-FINAL-9-6-13-AK.PDFHTTP://WWW.BIDNEEDHAM.ORG/WRITABLE/FILES/BID-NEEDHAM-FINAL-CHNA-REPORT_8.15.13.PDFBOTH DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST. (SCHEDULE H, PART V, SECTION B, LINE 7A.) A SUMMARY OF BID-NEEDHAM'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 BID-NEEDHAM PARTNERS RELATED TO THESE EFFORTS. 1A. ACCESS TO CARE - PRIMARY AND SPECIALTY CARE SERVICES BID-NEEDHAM STRIVES TO ENSURE ACCESS TO PRIMARY CARE AND SPECIALTY CARE SERVICES IN THE AREAS SERVED BY BID-NEEDHAM AND TO THAT END, THE HOSPITAL ALSO PROVIDES FINANCIAL SUPPORT TO HELP THE COMMUNITY ACCESS THAT CARE. THE HOSPITAL'S CERTIFIED APPLICATION COUNSELORS ASSISTED 240 PEOPLE WITH THE INSURANCE ENROLLMENT PROCESS AND SUCCESSFULLY ENROLLED 260 PATIENTS IN MASSHEALTH. 1B. ACCESS TO CARE - PRIMARY, SPECIALTY AND HOSPITALIST CARE SERVICESADDITIONALLY, DURING THE PERIOD COVERED BY THIS FILING, BID-NEEDHAM PROVIDED SUBSIDIZED PRIMARY, SPECIALTY AND HOSPITALIST CARE SERVICES AT A COST OF $1,906,648 AS REPORTED IN THIS FORM 990 SCHEDULE H PART I LINE 7G. IN ADDITION, AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) SERVES AS THE SOLE MEMBER OF BID-NEEDHAM AND MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP (APG). APG WORKS WITH BID-NEEDHAM TO PROVIDE ACCESS TO PRIMARY CARE IN THE COMMUNITIES SERVED BY BID-NEEDHAM AND DURING THE PERIOD COVERED BY THIS FILING, THE MEDICAL CENTER PROVIDED AN ADDITIONAL $ 1,098,693 OF SUPPORT RELATED TO THESE ACTIVITIES, BUT AS REQUIRED BY THIS FORM 990 SCHEDULE H, THIS AMOUNT HAS NOT BEEN REPORTED ON EITHER BID-NEEDHAM OR THE MEDICAL CENTER'S SCHEDULE H PART I LINE 7G.
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2. MENTAL HEALTH
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IN THE AREA OF MENTAL HEALTH, BID-NEEDHAM CONTINUES TO STRENGTHEN THE RELATIONSHIP WITH RIVERSIDE COMMUNITY CARE, A LOCAL INTEGRATED BEHAVIORAL HEALTH AND HUMAN SERVICES ORGANIZATION. WHEN A PATIENT WITH PSYCHIATRIC DISORDERS OR SUBSTANCE ABUSE PRESENTS IN THE EMERGENCY DEPARTMENT (ED) AT BID-NEEDHAM, RIVERSIDE IS CONTACTED. RIVERSIDE STAFF COME TO THE ED, EVALUATE THE PATIENT, AND MAKE RECOMMENDATIONS FOR PLACEMENT OR OUTPATIENT SERVICES. IF BED PLACEMENT IS REQUIRED, RIVERSIDE DOES A SEARCH FOR A BED AND PROVIDES ASSISTANCE IN THE ED UNTIL A BED CAN BE FOUND. ADDITIONALLY DURING THE PERIOD COVERED BY THIS FILING, BID-NEEDHAM CONTINUED TO UPDATE AND IMPLEMENT THE SUICIDE SCREENING GUIDELINES AND SHARED WITH RIVERSIDE.THE NEEDHAM DEPARTMENT OF PUBLIC HEALTH'S "NEEDHAM COALITION FOR SUICIDE PREVENTION" CONTINUED WITH THE INTEGRATION OF THE NATIONAL GOALS BASED ON THE U.S. SURGEON GENERAL'S CALL TO ACTION TO PREVENT SUICIDE. A BID-NEEDHAM STAFF MEMBER PARTICIPATES ON THE COALITION. WORKING WITHIN THE FABRIC OF THE COMMUNITY, THE COALITION REINFORCES THE ABILITY OF FAMILIES, SCHOOLS, RELIGIOUS INSTITUTIONS, AND PEER NETWORKS TO HELP DISTRESSED INDIVIDUALS NOT TO FEEL ALONE, TO SEE OPTIONS IN THEIR LIVES AND TO KNOW THEY HAVE A FUTURE. WORKING TOGETHER, THE COALITION HAS FOCUSED ON THE PUBLIC HEALTH APPROACH (BASED ON SCIENTIFIC EVIDENCE) TO PREVENT SUICIDE AND HAS CONTINUED TO TRY TO COMBINE THESE METHODS WITH WHAT WE KNOW ABOUT NEEDHAM'S UNIQUE TRAITS AND VALUES AS A COMMUNITY. BID-NEEDHAM PROVIDED FUNDING FOR THE WILLIAM JAMES INTERFACE REFERRAL SERVICE. THE PRIMARY GOAL OF THIS SERVICE IS TO ENHANCE, IMPROVE, OR DEVELOP COLLABORATIVE EFFORTS BETWEEN COMMUNITY-BASED MENTAL HEALTH SERVICES AND COMMUNITY MENTAL HEALTH SYSTEMS AND SERVICES. INTERFACE PROVIDES PERSONALIZED COUNSELING REFERRALS MATCHED FOR LOCATION, SPECIALTY AND INSURANCE OR FEE REQUIREMENTS. MEMBERS OF THE COMMUNITY CAN CALL THE COMPLIMENTARY REFERRAL HELPLINE TO CONSULT WITH A RESOURCE AND REFERRAL COUNSELOR TO RECEIVE SERVICES. AS PART OF BID-NEEDHAM'S FUNDING, INTERFACE ESTABLISHED A WEBSITE WITH INFORMATION ON ANXIETY, GRIEF/LOSS, AND MENTAL HEALTH AND WELLNESS ISSUES IMPACTING CHILDREN AND FAMILIES (HTTPS://INTERFACE.WILLIAMJAMES.EDU/). BY ENHANCING COMMUNICATION BETWEEN SCHOOLS AND AGENCIES, PROVIDING EDUCATION, TRAINING AND SUPPORT, INTERFACE REFERRAL SERVICE ALLOWS BID-NEEDHAM, AS WELL AS EACH ORGANIZATION AND SYSTEM, TO WORK MORE EFFECTIVELY ON BEHALF OF THE INDIVIDUALS AND FAMILIES IT SERVES. ALONG WITH PROVIDING FUNDING FOR THE SERVICE, THE HOSPITAL ALSO DISTRIBUTES INFORMATION TO PATIENTS THAT DIRECT THEM TO THE SERVICE, TO CONNECT THEM WITH MENTAL HEALTH RESOURCES. THE HOSPITAL ALSO WORKED WITH WALKER AND SOUTH SHORE HOSPITAL TO PROVIDE MENTAL HEALTH FIRST AID TRAINING TO THE COMMUNITY.3. SUBSTANCE ABUSEIN A PARTNERSHIP WITH THE NEEDHAM DEPARTMENT OF PUBLIC HEALTH AND NEEDHAM PUBLIC SCHOOLS, THE HOSPITAL ACTIVELY PARTICIPATES ON THE NEEDHAM COALITION FOR YOUTH SUBSTANCE ABUSE PREVENTION (NCYSAP). THIS COALITION, WHICH IS COMPRISED OF LEADERS AND STAKE HOLDERS FROM KEY SECTORS OF THE COMMUNITY, ADDRESSES THE BIOLOGICAL, PSYCHOLOGICAL, AND LEGAL CONSEQUENCES OF UNDERAGE SUBSTANCE USE, AND ITS PREVENTION FOR LOCAL ADULTS AND YOUTH. RESEARCH SHOWS THAT MULTI-SECTOR, MULTI STRATEGY APPROACHES TO SUBSTANCE ABUSE PREVENTION, IMPLEMENTED BY COMMUNITY COALITIONS, REDUCE ALCOHOL AND OTHER DRUG USE SIGNIFICANTLY. MEMBERS ARE COMMITTED TO IMPLEMENTING ENVIRONMENTAL PREVENTION STRATEGIES THAT IMPACT ACCESS AND AVAILABILITY, POLICY AND ENFORCEMENT, MEDIA ADVOCACY AND COMMUNITY NORMS. THE COALITION DEVELOPS RESOURCES, INFORMATIONAL EDUCATION, AND HOLDS COMMUNITY FORUMS. THE HOSPITAL SUPPORTS THE COALITION BOTH FINANCIALLY AND WITH STAFF RESOURCES.- BID-NEEDHAM FUNDED AND PROVIDED VOLUNTEERS FOR NEEDHAM HIGH SCHOOL'S AND DOVER HIGH SCHOOL'S 5TH QUARTER EVENTS, A SUBSTANCE-FREE ACTIVITY FOR HIGH SCHOOL STUDENTS ON FRIDAY EVENINGS DURING FOOTBALL SEASON. - THE HOSPITAL FUNDED THE SALSA SUBSTANCE ABUSE PREVENTION CURRICULUM FOR 8TH GRADE STUDENTS IN NEEDHAM. - HOSPITAL STAFF PARTICIPATED AND PROVIDED SUBSTANCE ABUSE PREVENTION MATERIALS AT THE NEEDHAM HIGH SCHOOL REALITY FAIR.4. TRANSPORTATIONTO ADDRESS ISSUES RELATED TO TRANSPORTATION AND REDUCE HEALTH DISPARITY, BID-NEEDHAM DISTRIBUTED BROCHURES AND PROVIDED INFORMATION ON THE WEBSITE, TO PROMOTE AVAILABLE PUBLIC TRANSPORTATION RESOURCES AND TRANSPORTATION OPTIONS FOR THE GERIATRIC POPULATION. - THE HOSPITAL ALSO ISSUED TAXI VOUCHERS TO THOSE PATIENTS WHO COULD NOT PAY FOR TRANSPORTATION DUE TO HARDSHIPS, BUT NEEDED A RIDE HOME FROM THE HOSPITAL. 195 VOUCHERS WERE PROVIDED AT A VALUE OF $3,200.- BID-NEEDHAM PROVIDED FUNDING TO THE ELLIE FUND, TO PAY FOR TAXI RIDES OR GAS GIFT CARDS FOR CANCER PATIENTS WHO COULD NOT AFFORD THEIR OWN RIDES. THE DONATION OF $1,500 PROVIDED GAS ASSISTANCE, TAXI RIDES AND TRANSPORTATION SERVICE BY THE RIDE FOR 17 PATIENTS.- FINALLY, BID-NEEDHAM SPONSORED A NEW TRANSPORTATION PROGRAM PROVIDED BY THE NEEDHAM COMMUNITY COUNCIL, WITH $1,000 TO PROVIDE UBER AND LYFT SERVICE TO NEEDHAM RESIDENTS GOING TO MEDICAL APPOINTMENTS. 5. INJURY PREVENTION - SENIOR POPULATIONTHE HOSPITAL CONTINUED THE WORK OF THE FALLS COMMITTEE, WHICH DEVELOPS EDUCATION AND STRATEGIES TO REDUCE INJURIES FROM FALLS. THE COMMITTEE WORKED ON FALL PREVENTION PROGRAMS, CONDUCTED POST-FALL ANALYSIS, DEVELOPED EDUCATIONAL/COLLATERAL MATERIALS FOR PATIENTS AND FAMILY MEMBERS, AND OFFERED DIVERSIONARY ACTIVITIES FOR PATIENTS AT RISK OF FALLING. THE HOSPITAL CONTINUED TO USE THEIR STANDARDIZED FALL ASSESSMENT SCALE TO DETERMINE WHICH PATIENTS ARE AT RISK. PATIENTS SCREENED POSITIVE WEAR A YELLOW WRIST BAND AND ARE PLACED ON THE BID-NEEDHAM FALL PRECAUTION WHILE IN THE HOSPITAL. THESE PATIENTS ARE ALSO PROVIDED WITH EDUCATIONAL MATERIALS AND HOSPITAL STAFF DISCUSSES WHAT CAN BE DONE AT HOME TO PREVENT FALLS.IN CONJUNCTION WITH THE NEEDHAM BOARD OF HEALTH, TO PREVENT INJURY DUE TO BURNS AND TO PROMOTE OVERALL HEALTH AND NUTRITION FOR THE SENIOR POPULATION, BID-NEEDHAM CONTINUED THE TRAVELING MEALS PROGRAM FOR SENIORS AND THOSE UNABLE TO PROVIDE FOOD FOR THEMSELVES. NEARLY 8,500 MEALS WERE DELIVERED TO RESIDENTS THROUGHOUT THE COMMUNITY. THE HOSPITAL'S NUTRITIONISTS AND PHYSICAL THERAPISTS ALSO VISITED LOCAL SENIOR LIVING CENTERS, COUNCIL ON AGING, YMCA AND JCC TO DISCUSS HEALTHY FOOD, ACTIVE LIFESTYLES, HEALTHY AGING AND FALL PREVENTION FOR SENIORS. THE HOSPITAL PARTNERED WITH THE NEEDHAM COUNCIL ON AGING TO HOST A SERIES OF TALKS AT THE SENIOR CENTER ON HEALTHY AGING. FINALLY, THE HOSPITAL DONATED $1,000 TO THE NEEDHAM COUNCIL ON AGING AND $500 TO THE DOVER COUNCIL ON AGING, TO BE USED FOR SENIOR PROGRAMMING ON HEALTHY AGING.6. OTHER COMMUNITY HEALTH AND SUPPORT INITIATIVESSTROKE EDUCATION:BID-NEEDHAM CONTINUED TO EDUCATE THE COMMUNITY ABOUT THE SIGNS OF A STROKE AND THE IMPORTANCE OF GETTING A STROKE PATIENT TO AN EMERGENCY DEPARTMENT AS QUICKLY AS POSSIBLE. MAGNETS AND FLYERS WERE DISTRIBUTED AT COMMUNITY EVENTS TO EDUCATE THE PUBLIC ON THE SIGNS OF A STROKE AND THE URGENCY REQUIRED TO GET MEDICAL TREATMENT. THE HOSPITAL ALSO HAD INFORMATION AT TABLES THROUGHOUT THE HOSPITAL DURING STROKE MONTH IN MAY, AND HAD A PHYSICIAN SPEAK IN THE COMMUNITY. CANCER AWARENESS:THE MAMMOGRAPHY DEPARTMENT SUPPORTED BREAST CANCER AWARENESS MONTH AND MADE EFFORTS TO EMPHASIZE THE IMPORTANCE OF HAVING AN ANNUAL SCREENING MAMMOGRAM. IN ADDITION, THE HOSPITAL SUPPORTED THE COMMUNITY-WIDE "NEEDHAM GOES PINK" EVENT TO INCREASE BREAST CANCER AWARENESS, BY DONATING PINK SOCKS AND RIBBONS TO NEEDHAM JUNIOR FOOTBALL AND CHEER TO WEAR THROUGHOUT THE MONTH OF OCTOBER. THE HOSPITAL ALSO SUPPORTED THE SEAN D. BIGGS "BIGGSTEPS 5K" RACE TO SUPPORT CANCER RESEARCH, BY ATTENDING THE RACE AND DISTRIBUTING CANCER-RELATED RESOURCES. FINALLY, THE HOSPITAL EXECUTED A COMMUNITY-WIDE INITIATIVE TO PROMOTE THE IMPORTANCE OF SCREENING FOR CHRONIC DISEASE PREVENTION, CALLED "BE SEEN, GET SCREENED." THIS MESSAGE WAS PROMOTED AT SEVERAL COMMUNITY EVENTS AND ON SOCIAL MEDIA.DIABETES EDUCATION:DIABETES IS A KNOWN HEALTH RISK AND ILLNESS AMONG BID-NEEDHAM PATIENTS AND THE COMMUNITY AT LARGE. THE DIABETES CENTER STAFF INCLUDES A LICENSED DIETITIAN/NUTRITIONIST WHO CONDUCTS EDUCATIONAL SEMINARS ON DIABETES-RELATED NUTRITION, AND CONDUCTS BLOOD SUGAR SCREENINGS AT COMMUNITY HEALTH FAIRS.
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COMMUNITY PARTNERS
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BID-NEEDHAM PARTNERS WITH A WIDE RANGE OF COMMUNITY LEADERS AND LOCAL GROUPS TO IMPROVE THE HEALTH STATUS OF THE PEOPLE LIVING IN THE HOSPITAL'S COMMUNITIES AND TO PROVIDE CARE FOR THEM AT THE RIGHT PLACE, AT THE RIGHT TIME. BID-NEEDHAM IS AN IMPORTANT MEMBER OF LOCAL PUBLIC HEALTH TEAMS ADDRESSING THE NEEDS OF AREA COMMUNITIES. BID-NEEDHAM CRAFTS ITS COMMUNITY BENEFITS INITIATIVES WITH AREA BOARDS OF HEALTH, PUBLIC SAFETY, COUNCILS ON AGING, AND SCHOOLS TO COLLECTIVELY PROMOTE THE HEALTH AND WELLBEING OF THE BID-NEEDHAM COMMUNITY. AS NOTED IN THIS NARRATIVE SUPPORT TO FORM 990 SCHEDULE H, BOTH WITHIN AND BEYOND ITS WALLS, BID-NEEDHAM PLAYS AN ACTIVE ROLE IN COALITION BUILDING, WORKING TO EMPOWER A RANGE OF COMMUNITY LEADERS TO FOSTER SUSTAINABLE, HEALTHY LIFESTYLES THAT LEAD TO BETTER HEALTH FOR ALL MEMBERS OF THE COMMUNITY.BID-NEEDHAM WORKS CLOSELY WITH SEVERAL COMMUNITY PARTNERS TO SUPPORT EXISTING PROGRAMMING AND TO PROVIDE HEALTH EDUCATION AND INFORMATION TO AREA RESIDENTS. WE WORK CLOSELY WITH THE PUBLIC HEALTH DEPARTMENTS IN THE AREA, AS WELL AS LOCAL COUNCILS ON AGING, TO ADDRESS SUBSTANCE ABUSE PREVENTION, MENTAL HEALTH, HEALTHY AGING AND TRANSPORTATION. WE ALSO SUPPORT LOCAL FITNESS FACILITIES THAT PROVIDE HEALTHY OPPORTUNITIES FOR THE UNDERSERVED, SUCH AS THE COUNCIL ON AGING, THE BOSTON JCC AND THE CHARLES RIVER YMCA. THE HOSPITAL PROVIDES FUNDING TO AND PROGRAMMING WITH MENTAL HEALTH ORGANIZATIONS SUCH AS CHARLES RIVER CENTER, WALKER AND RIVERSIDE. WE SERVE ON COALITIONS AND PROVIDE FUNDING FOR PROGRAMS FOR LOCAL SUBSTANCE PREVENTION COALITIONS AND SUBSTANCE PREVENTION CURRICULUM IN THE SCHOOLS. THE HOSPITAL SUPPORTS ORGANIZATIONS THAT PROVIDE FOOD AND OTHER BASIC NECESSITIES TO THE UNDERSERVED, SUCH AS RIPPLES OF HOPE, THREE SQUARES RIDE FOR FOOD, DEDHAM HOUSING AUTHORITY, HEALTHCARE FOR HOMELESS, NEEDHAM COMMUNITY COUNCIL, NEEDHAM STEPS UP AND THE ELLIE FUND. WE PROVIDE EDUCATION TO THE AGING POPULATION WITH FOX HILL, NORTH HILL, AVITA, THE NEWTON NEEDHAM REGIONAL CHAMBER AND THE UNITED INDIA ASSOCIATION. BID-NEEDHAM ALSO PROMOTES HEALTH AND WELLNESS THROUGH PARTNERSHIPS WITH COMMUNITY GROUPS THAT ADVOCATE FOR HEALTHY LIFESTYLES, EXERCISE, SOCIALIZING AND MENTAL WELLNESS SUCH AS NEEDHAM JUNIOR FOOTBALL AND CHEER, NEEDHAM TRACK CLUB, GREAT HALL CONCERT SERIES AND RELIGIOUS ORGANIZATIONS.THE HOSPITAL WORKS WITH SEVERAL AREA GROUPS INCLUDING: -AA-AMERICAN CANCER SOCIETY-AMERICAN LUNG ASSOCIATION-AMERICAN HEART ASSOCIATION-AVITA OF NEEDHAM-CHARLES RIVER CENTER-CHARLES RIVER YMCA-CHNA 18-DEDHAM FOOD PANTRY-DEDHAM HOUSING AUTHORITY-DEDHAM PARKS AND RECREATION-DOVER COUNCIL ON AGING-DOVER PARKS AND RECREATION-EVERETT HIGH SCHOOL CULINARY SCHOOL-SPAN-DS-FOX HILL VILLAGE-GLOBAL INITIATIVE FOR COPD (GOLD)-GREAT HALL CONCERT SERIES-HEALTHCARE FOR HOMELESS-JEWISH COMMUNITY CENTERS OF GREATER BOSTON-JOSLIN DIABETES CENTER-KYLE W. SHAPIRO FOUNDATION-MEDFIELD EMPLOYERS AND MERCHANTS ASSOCIATION-NEEDHAM BUSINESS ASSOCIATION-NEEDHAM COALITION FOR YOUTH SUBSTANCE ABUSE PREVENTION-NEEDHAM COALITION FOR SUICIDE PREVENTION-NEEDHAM COMMUNITY COUNCIL-NEEDHAM COMMUNITY EDUCATION-NEEDHAM COUNCIL ON AGING-NEEDHAM DEPARTMENT OF PUBLIC HEALTH-NEEDHAM EDUCATION FOUNDATION-NEEDHAM EXCHANGE CLUB-NEEDHAM FARMERS MARKET-NEEDHAM FIREFIGHTERS ASSOCIATION-NEEDHAM JUNIOR FOOTBALL AND CHEER-NEEDHAM PUBLIC SCHOOLS-NEEDHAM ROTARY CLUB-NEEDHAM STEPS UP-NEEDHAM TOUCHDOWN CLUB-NEEDHAM TRACK CLUB-NEW ENGLAND DEVELOPMENT-NEW YEAR'S NEEDHAM-NEWTON NEEDHAM CHAMBER OF COMMERCE-NORTH HILL-PARENT TALK-RIPPLES OF HOPE-RIVERSIDE COMMUNITY CARE-SAINT SUSANNA NEEDHAM-SEAN D. BIGGS FOUNDATION-ST. JOSEPH'S PARISH NEEDHAM-SOUTH SHORE MENTAL HEALTH-TAKE BACK THE NIGHT-THE ELLIE FUND-TEMPLE BETH SHALOM-THREE SQUARES NEW ENGLAND-TOWN OF DOVER-TOWN OF NEEDHAM-UNITED INDIA ASSOCIATION OF NEW ENGLAND-VNA CARE NETWORK-WALKER SCHOOL-WE BEAT CANCER-WILLIAM JAMES COLLEGEAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, BID-NEEDHAM IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. DUE TO LIMITED FINANCIAL AND STAFF RESOURCES, THE HOSPITAL'S COMMUNITY BENEFITS EFFORTS WERE DEVOTED TO THE PRIORITY AREAS IDENTIFIED BY THE CHNA AND THE HOSPITAL DID NOT IMPLEMENT SPECIFIC COMMUNITY BENEFITS PROGRAMMING FOR ISSUES THAT WERE NOT CITED AS PRESSING HEALTH CONCERNS, ISSUES WHERE THE REGIONAL RATES OF OCCURRENCE FELL BELOW THE STATEWIDE AVERAGE, OR THOSE ISSUES WHERE THE CONCERN WAS BEING ADDRESSED BY OTHER COMMUNITY PARTNERS. THESE AREAS INCLUDE OBESITY, HEALTHY EATING AND PHYSICAL ACTIVITY, CHRONIC DISEASES, REPRODUCTIVE AND MATERNAL HEALTH, AND COMMUNICABLE DISEASE. HOWEVER, SOME OF THESE TOPICS WERE ADDRESSED THROUGH EXISTING PROGRAMMING SUPPORTED BY THE HOSPITAL OR BY INDIVIDUAL BID-NEEDHAM DEPARTMENTS, AND ARE WORTH NOTING FOR THEIR BENEFIT TO THE COMMUNITY AND WERE LISTED ABOVE IN OTHER COMMUNITY HEALTH AND SUPPORT INITIATIVES. IN ADDITION, EFFORTS TO IMPROVE TRANSPORTATION SYSTEMS ARE NOT PART OF THE HOSPITAL'S MISSION AND UNLIKE THE MANY PROGRAMS DESCRIBED HEREIN WHERE BID-NEEDHAM IS UNIQUELY SITUATED TO IMPLEMENT OR PARTICIPATE IN SUCH PROGRAMS, IMPROVING TRANSPORTATION SYSTEMS IS OUTSIDE THE SCOPE OF THE HOSPITAL'S EXPERTISE, AS REFLECTED IN THE EFFORTS DEVOTED TO THAT NEED. (SCHEDULE H, PART V, SECTION B, QUESTION 11). AS NOTED IN DETAIL ABOVE, THE BID-NEEDHAM'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 - NEEDHAM (BIDN OR HOSPITAL) CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS REPORTED IN THIS SCHEDULE H, 4.38% OF BIDN'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 BIDN 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 BIDN HAD INCLUDED THESE IN SCHEDULE H QUESTION 7, THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WOULD BE 9.38% 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 BIDN. 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 BIDN SCHEDULE H PER THE INSTRUCTIONS TO THE FORM 990, THOSE ACTIVITIES ARE RELEVANT IN EVALUATING THE TOTAL COMMUNITY BENEFIT PROVIDED. BIDMC REPORTED APPROXIMATELY 17% 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 BENEFITS - EMERGENCY ROOM OPERATIONIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BID-NEEDHAM 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 ASSISTANCEBIDN'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 $868,776 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 BIDN, 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 BIDN. 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.
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OTHER UNCOMPENSATED CHARITY CARE - MEDICAID AND MEDICARE
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IN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BIDN 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 BIDN 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 $5,277,069 IN REVENUE, THIS AMOUNT WAS LESS THAN THE COST OF CARE PROVIDED BY BIDN FOR SUCH SERVICES BY $283,232 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 7.56% OR 11,455 OF BID-NEEDHAM'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, THE MEDICAL CENTER IS THE SOLE MEMBER OF BID-NEEDHAM AND THIS ADDITIONAL BIDMC COST IS NOT QUANTIFIED IN THE BID-NEEDHAM SCHEDULE H. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND BIDN PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. PAYMENTS TO HOSPITALS THROUGH THIS GOVERNMENT SPONSORED PROGRAM HAVE ALSO NOT KEPT PACE WITH INFLATION AND ALTHOUGH THE PROVISION OF HEALTH CARE TO THESE PATIENTS GENERATED $26,919,672 IN REVENUE, THIS AMOUNT WAS LESS THAN THE COST OF CARE PROVIDED BY BIDN FOR SUCH SERVICES BY $2,980,095. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 44,852 OR 29.59% OF BID-NEEDHAM'S PATIENT ENCOUNTERS WERE WITH MEDICARE PATIENTS. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH BIDN CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THIS MEDICARE SHORTFALL IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, BIDN HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. BIDMC SIMILARLY PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 24.01% OR 279,319 OF THE MEDICAL CENTER'S PATIENT ENCOUNTERS WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO MEDICARE REVENUE OF $386,024,402. HOWEVER, BECAUSE PAYMENTS TO HOSPITALS THROUGH THIS GOVERNMENT SPONSORED PROGRAM HAVE NOT KEPT PACE WITH INFLATION, REVENUE COLLECTED WAS LESS THAN THE COST OF SERVICES BY $20,805,001. THIS ADDITIONAL BIDMC COST IS NOT QUANTIFIED IN THE BID-NEEDHAM 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, BIDN 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 $1,381,634 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 IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. 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, 2015 INCLUDE THE ACCOUNTS OF THE MEDICAL CENTER AND ITS SUBSIDIARIES, (BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BIDN), MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP (APG)), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BID-PLYMOUTH), JORDAN HEALTH SYSTEMS, INC., BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON)) 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 BIDN FORM 990 IS PREPARED FOR BIDN ONLY AND AS SUCH, THE METRICS INCLUDED IN THESE FOOTNOTES WILL NOT TIE TO THE FACE OF THE BIDN 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 BIDN. 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 BIDN EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. THE BIDN 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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BIDN ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, BIDN MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. THE BIDN 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 BIDN FINALIZED THIS POLICY. AS PREVIOUSLY NOTED THE FISCAL YEAR COVERED BY THIS FILING IS OCTOBER 1, 2015 TO SEPTEMBER 30, 2016. THE TREASURY ISSUED FINAL REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R) ON DECEMBER 29, 2014 WITH AN EFFECTIVE DATE FOR THE HOSPITAL AS OF OCTOBER 1, 2016. AS SUCH, THE DETAIL INCLUDED IN THIS FORM 990 SCHEDULE H RELATES TO THE CREDIT AND COLLECTION POLICY AND THE FINANCIAL ASSISTANCE POLICY IN EFFECT FOR THE PERIOD COVERED BY THIS FILING, UNLESS OTHERWISE NOTED. BIDN 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 OFFICE OF MEDICAID, DETERMINATION THAT A PATIENT IS LOW-INCOME, OR IN ITS BILLING AND COLLECTION PRACTICES. CREDIT AND COLLECTION POLICY - NOTICE 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, BIDN WILL ASSIST THEM IN APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.BIDN 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 BIDN 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. BIDN ADVISES PATIENTS OF THEIR RIGHT TO (I) APPLY FOR MASSHEALTH AND LOW INCOME PATIENT DETERMINATION AND (II) A PAYMENT PLAN. BIDN'S FINANCIAL COUNSELORS 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. PLAIN LANGUAGE SUMMARIES OF THE FINANCIAL ASSISTANCE POLICY AND HOW TO APPLY FOR ASSISTANCE ARE INCLUDED IN BILLING STATEMENTS, POSTED IN THE EMERGENCY DEPARTMENT AND ADMISSIONS, AND FULL COPIES OF THE POLICY ARE AVAILABLE IN MULTIPLE LOCATIONS THROUGHOUT THE HOSPITAL AND ON THE HOSPITAL'S PUBLIC WEBSITE HTTP://WWW.BIDNEEDHAM.ORG/YOUR-VISIT/INSURANCE-AND-FINANCIAL-INFORMATION WITH ADDITIONAL LINKS FROM THE HOSPITAL'S PATIENT ONLINE PAYMENT PORTAL. FINANCIAL ASSISTANCE POLICIES, APPLICATIONS AND PLAIN LANGUAGE SUMMARIES ARE AVAILABLE IN ENGLISH, SPANISH, CHINESE AND RUSSIAN AT NO COST TO THE PATIENT. ADDITIONAL HELP AND SUPPORT ARE PROVIDED BY ON-SITE FINANCIAL COUNSELORS.(SCHEDULE H PART VI QUESTION 3).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, BIDN 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.BIDN 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. BIDN WILL DIRECT ALL PATIENTS SEEKING INFORMATION ON AVAILABLE COVERAGE OPTIONS, OR THOSE THAT THE HOSPITAL DETERMINES MAY BE ELIGIBLE, TO THE HOSPITAL'S FINANCIAL COUNSELORS 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 HEALTH INFORMATION EXCHANGE (HIX) APPLICATION, THE HOSPITAL WILL ASSIST THE PATIENT IN COMPLETING THE APPLICATION FOR MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR OTHER FORMS OF FINANCIAL ASSISTANCE PROGRAMS AS THEY BECOME PART OF THE VIRTUAL GATEWAY PROGRAM, 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 - ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS
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AS NOTED IN THIS FORM 990, SCHEDULE H, PART III, SECTION C, QUESTION 9B, BIDN 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, 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. (SCHEDULE H PART I QUESTION 3C)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 INDIVIDUALS APPLYING DUE TO A MEDICAL HARDSHIP.ALL HEALTH 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. BIDN 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 FINANCIAL ASSISTANCE ELIGIBLE PATIENTS IS DETERMINED BY THE SPECIFIC CONNECTOR PLAN FOR WHICH THEY QUALIFY. IN ADDITION, THE BIDN POLICY PROVIDES FOR INDIVIDUALS WHO ARE UNABLE TO AFFORD THEIR CARE BECAUSE OF MEDICAL HARDSHIP AND PROVIDES FEES BASED ON A SLIDING SCALE RELATIVE TO PERCENTAGES OF THE FEDERAL POVERTY GUIDELINES (SCHEDULE H, PART V, SECTION B, QUESTION 22D). BIDN 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 BIDN'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 BIDN CREDIT AND COLLECTION POLICY IS AVAILABLE FROM BIDN FINANCIAL COUNSELORS AS NOTED IN FORM 990, SCHEDULE H, PART V, SECTION B, QUESTIONS 16A-F). IN ADDITION, ONCE BIDN 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).
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CREDIT AND COLLECTION POLICY - BIDN STANDARD COLLECTION PRACTICES
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AS PREVIOUSLY NOTED IN THE NARRATIVE TO THIS FORM 990 SCHEDULE H, PART III, SECTION C, LINE 9A AND 9B, BIDN 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, BIDN HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. BIDN 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. BIDN ALSO HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. BIDN AND/OR ITS AGENTS DO NOT CHARGE INTEREST ON AN OVERDUE BALANCE FOR A LOW INCOME PATIENT OR ANY OTHER PATIENT. BIDN 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.CREDIT AND COLLECTION POLICY - OUTSIDE COLLECTION AGENCIESBIDN 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 BIDN'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 HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM.BIDN 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.CREDIT AND COLLECTION POLICY - EXEMPTION FROM BIDN COLLECTION PRACTICESBIDN 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. (SCHEDULE H PART I QUESTION 3C).AS PREVIOUSLY NOTED IN THIS FILING, THE HOSPITAL 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 PERIOD: THE 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 PERIOD: APPLICANTS 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 ASSISTANCE: FINANCIAL 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 ASSISTANCE: PATIENTS, 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 ASSISTANCE: PATIENTS, 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 HARDSHIP: FINANCIAL ASSISTANCE IS AVAILABLE TO ELIGIBLE PATIENTS WHOSE MEDICAL BILLS ARE GREATER THAN OR EQUAL TO 25% OF THEIR GROSS INCOME. (SCHEDULE H PART I QUESTION 3C).AMOUNTS 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 46% OF CHARGES. CREDIT AND COLLECTION POLICY - DISCOUNT FOR UNINSURED PATIENTSIN ADDITION TO THE FINANCIAL ASSISTANCE INFORMATION PROVIDED ABOVE, THE BIDN 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 BIDN 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 COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLANDETAIL TO BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM'S (BIDN 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. CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS - GRADUATE MEDICAL EDUCATION AS NOTED THROUGHOUT THIS FORM 990, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BID-NEEDHAM). AS REPORTED IN THIS FORM 990 SCHEDULE H PART I LINE 7, BIDN PARTICIPATES IN SOME OF THE RESIDENT AND FELLOW TRAINING PROGRAMS WHICH ARE OPERATED AT BIDMC, WITH BIDMC RESIDENTS ROTATING THROUGH BIDN. IN ADDITION TO THE GRADUATE MEDICAL EDUCATION ACTIVITIES REPORTED ON THE BIDN SCHEDULE H, BIDMC'S PROVISION OF GRADUATE MEDICAL EDUCATION IS AN IMPORTANT COMMUNITY BENEFIT PROVIDED BY BID-NEEDHAM'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 - RESEARCH
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AS PREVIOUSLY NOTED IN THROUGHOUT THIS FORM 990, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS THE SOLE MEMBER OF BID-NEEDHAM. ALTHOUGH BID-NEEDHAM 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 6450 ACTIVE CLINICAL TRIALS DURING THE FISCAL PERIOD COVERED BY THIS FILING. THIS RESEARCH IS LED BY 568 PRINCIPAL INVESTIGATORS, 416 OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY WHO 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 O ALLERGY AND INFLAMMATION O CARDIOVASCULAR MEDICINE O CENTER FOR VASCULAR BIOLOGY RESEARCH O CENTER FOR VIROLOGY AND VACCINE RESEARCH O CLINICAL INFORMATICS O CLINICAL NUTRITION O ENDOCRINOLOGY O EXPERIMENTAL MEDICINE O GASTROENTEROLOGY O GENERAL MEDICINE AND PRIMARY CARE O GENETICS O GERONTOLOGY O HEMATOLOGY AND ONCOLOGY O HEMOSTASIS AND THROMBOSIS O IMMUNOLOGY O INFECTIOUS DISEASE O INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY O MOLECULAR AND VASCULAR MEDICINE O NEPHROLOGY O PULMONOLOGY O RHEUMATOLOGY O SIGNAL TRANSDUCTION O TRANSLATIONAL RESEARCH O TRANSPLANT IMMUNOLOGY-NEONATOLOGY -NEUROLOGY -OBSTETRICS AND GYNECOLOGY -ORTHOPAEDIC SURGERY -PATHOLOGY -PSYCHIATRY -RADIOLOGY -SURGERY O CARDIAC SURGERY O CENTER FOR MINIMALLY INVASIVE SURGERY O NEUROSURGERY O PLASTIC AND RECONSTRUCTIVE SURGERY O 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 THIS SCHEDULE H, PART I, LINE 7H TO 17.37%.
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RESEARCH ENGAGED IN AT THE MEDICAL CENTER
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VIKAS P. SUKHATME, M.D., SCD, THE MEDICAL CENTER'S CHIEF ACADEMIC OFFICER, HAS SAID THAT THIS IS PERHAPS THE MOST VIGOROUS AND TRANSFORMING PERIOD IN THE HISTORY OF BIOMEDICAL RESEARCH, A TIME WHEN SOPHISTICATED TECHNOLOGIES ARE ENABLING THE PURSUIT OF HIGHLY ORIGINAL INVESTIGATIONS AND RAPIDLY EVOLVING GENOMIC DISCOVERIES ARE UNCOVERING IMPORTANT INSIGHTS INTO HUMAN HEALTH.THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H, DEPENDING ON FUNDING SOURCE. GROUNDBREAKING GENETICS DISCOVERIES CHALLENGE SCIENTIFIC DOGMAIN THE HALF-CENTURY OLD CENTRAL DOGMA OF MOLECULAR BIOLOGY, IT WAS UNDERSTOOD AND ACCEPTED THAT DNA INSTRUCTS THE BODY ON HOW TO CONSTRUCT PROTEINS, THE BUILDING BLOCKS OF LIFE. PACKAGED IN GENES, THESE INSTRUCTIONS WERE TRANSPORTED TO CELLS' PROTEIN-MAKING MACHINERY BY WAY OF DNA'S CHEMICAL COUSIN RNA. IN BETWEEN THE GENES WERE LONG STRETCHES OF NONCODING RNA, WHICH WERE BELIEVED TO SERVE NO PURPOSE, AND WERE OFTEN REFERRED TO AS "JUNK DNA." BUT INVESTIGATORS AT BIDMC HAVE MADE KEY DISCOVERIES DEMONSTRATING THAT THIS "JUNK" MAY ACTUALLY BE HIDDEN TREASURE, REVEALING THAT NONCODING RNA PLAYS KEY ROLES IN HEALTH AND DISEASE, PARTICULARLY CANCER. RECOGNIZING THESE INSIGHTS INTO THE WORLD OF NON-CODING RNAS, BIDMC HAS SET UP THE INSTITUTE FOR RNA MEDICINE WITHIN THE BIDMC CANCER CENTER AND FRANK SLACK, PHD, FORMERLY OF YALE UNIVERSITY, JOINED AS ITS DIRECTOR DURING THE PERIOD COVERED BY THIS FILING THIS FLAGSHIP PROGRAM WILL FURTHER ENHANCE BIDMC'S VISIBILITY IN THE WORLD OF SCIENCE AND IS ENTIRELY CONSISTENT WITH ITS BENCH TO BEDSIDE PHILOSOPHY."FIFTY PERCENT OF THE GENOME IS TRANSCRIBED, BUT ONLY TWO PERCENT MAKES PROTEIN, AND THERE WAS NO CODE, NO LANGUAGE FOR UNDERSTANDING THE REST," EXPLAINS CANCER CENTER DIRECTOR PIER PAOLO PANDOLFI, MD, PHD. "IN TERMS OF BIOMEDICAL RESEARCH, THE IMPACT IS IMMENSE, BECAUSE NOW [THERE ARE] ALL OF THESE NEW ENTITIES, PSEUDOGENES, LINCRNAS, CERNAS THAT HAVE BEEN GIVEN A FUNCTION. WE HAVE NOW ALMOST TRIPLED THE SIZE OF THE FUNCTIONAL GENOME AND THIS IS CRITICALLY IMPORTANT FOR CANCER GENETICS." A BIDMC RESEARCH TEAM LED BY PANDOLFI RECENTLY DISCOVERED THAT CIRCULAR RNAS - A CLASS OF NON-CODING RNAS - ARE AFFECTED BY GENOMIC REARRANGEMENTS IN CANCER, JUST LIKE THEIR PROTEIN COUNTERPARTS. THEY ALSO FOUND THAT CIRCULAR RNAS PROMOTE TUMOR GROWTH AND PROGRESSION. THE GROUP'S WORK PAVES THE WAY FOR THE DISCOVERY OF MANY MORE OF THESE UNUSUAL RNAS AND HOW THEY CONTRIBUTE TO CANCER, WHICH COULD REVEAL NEW MECHANISMS AND DRUGGABLE PATHWAYS INVOLVED IN THE PROGRESSION OF CANCER.*****THE CO-CLINICAL TRIAL SPEEDS TESTING OF CANCER DRUGSCLINICAL TRIALS TO TEST NEW CANCER DRUGS ARE LENGTHY AND COMPLEX. AS A RESULT, THERE IS A BACKLOG OF MORE THAN 800 NEW TARGETED CANCER THERAPIES AWAITING CLINICAL TESTING. "THE CURRENT SYSTEM CAN'T KEEP PACE," SAYS PIER PAOLO PANDOLFI, MD, PHD. "THERE ISN'T ENOUGH TIME OR RESOURCES TO TEST EACH ONE OF THESE NEW DRUGS IN HUMAN SUBJECTS AS SINGLE AGENTS - LET ALONE IN COMBINATIONS." DR. PANDOLFI CONCEIVED AND DEVELOPED A REVOLUTIONARY NEW STREAMLINED TESTING METHOD KNOWN AS THE CO-CLINICAL TRIAL. IN THIS BIT OF SCIENTIFIC MULTITASKING, A HUMAN CLINICAL TRIAL IS SIMULTANEOUSLY PARTNERED WITH ANIMAL STUDIES OF MICE TO HELP DOCTORS LEARN MUCH MORE QUICKLY WHICH PATIENTS WITH WHICH MUTATIONS ARE BEING HELPED - OR NOT BEING HELPED - BY TARGETED CANCER DRUGS. PANDOLFI WAS AWARDED $4.2 MILLION IN AMERICAN REINVESTMENT AND RECOVERY ACT (ARRA) FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH (NIH) FOR THE CO-CLINICAL TRIAL INVESTIGATIONS. THE NEW MODEL TAKES ADVANTAGE OF THE TREMENDOUS TECHNOLOGICAL ADVANCES THAT ARE PROVIDING SCIENTISTS WITH VALUABLE NEW INFORMATION ABOUT CANCER'S GENETIC UNDERPINNINGS. IN MARCH 2012, THE FIRST FINDINGS USING THE CO-CLINICAL STRATEGY WERE PUBLISHED IN NATURE, REVEALING KEY INSIGHTS INTO NEW LUNG CANCER THERAPIES. NATURE DESCRIBED THIS PROCESS AS ONE OF "FOUR WAYS TO FIX THE CLINICAL TRIAL" STATING THAT "THE CO-CLINICAL MODEL .[BRINGS] FUNDAMENTAL CHANGES TO THE CLINICAL TRIAL SYSTEM TO MAKE IT FASTER, CHEAPER, MORE ADAPTABLE AND MORE IN TUNE WITH MODERN MOLECULAR MEDICINE." THE " ULTIMATE GOAL IS TO FIND OUT EXACTLY WHY DIFFERENT PATIENTS RESPOND TO DIFFERENT TREATMENTS SO THAT DRUGS ARE GIVEN ONLY TO THE PATIENTS WHO WILL RESPOND," SAYS DR. PANDOLFI. IN ADDITION, SENTHIL MUTHUSWAMY, PHD, DIRECTOR OF THE CELL BIOLOGY PROGRAM IN THE CANCER RESEARCH INSTITUTE AT THE MEDICAL CENTER, HAS PIONEERED WAYS OF PRESERVING TUMOR TISSUE IN VITRO IN SO-CALLED ORGANOIDS THAT MAINTAIN CHARACTERISTICS OF THE CANCER AND CAN BE RAPIDLY TESTED FOR SUSCEPTIBILITY TO DRUG TREATMENTS. THIS NEW ORGANOID APPROACH NOW PROVIDES A 'LIVE' BIOBANK OF TISSUE FOR DISCOVERY AND VALIDATION OF NEW DRUGS AND TARGETS AND MODELING RESISTANCE TO THERAPY. BY USING A COHORT OF PATIENT SAMPLES FROM WHICH THEY CAN SCREEN FOR DRUGS AND MUTATIONS, MUTHUSWAMY AND TEAM CAN BEGIN TO UNDERSTAND WHY SOME PATIENTS RESPOND TO A TREATMENT WHILE OTHERS DO NOT, AND CAN THEREBY AVOID GIVING PATIENTS UNNECESSARY OR INEFFECTIVE TREATMENTS. THIS APPROACH COULD ALSO HELP PATIENTS AND THEIR ONCOLOGISTS MAKE TREATMENT DECISIONS.*****PIONEERS IN THE QUEST FOR VACCINES FOR HIV AND ZIKA BETH ISRAEL DEACONESS MEDICAL CENTER SCIENTISTS HAVE DISTINGUISHED THEMSELVES AS INTERNATIONAL LEADERS IN THE DEVELOPMENT OF VACCINES FOR HIV AND ZIKA. DR. DAN BAROUCH, CHIEF OF THE DIVISION OF VIROLOGY AND VACCINE RESEARCH IN BIDMC'S DEPARTMENT OF MEDICINE, AND A TEAM OF 50 SCIENTISTS AT BIDMC ARE TESTING AN ANTIBODY THAT HAS PROVEN TO REDUCE THE HIV VIRUS IN MONKEYS, WITH A $20 MILLION DOLLAR GRANT FROM THE BILL AND MELINDA GATES FOUNDATION. THE FOUR YEAR GRANT WILL FUND FURTHER TESTING ON MONKEY MODELS AS WELL AS OBSERVING IF THE ANTIBODY HAS A SIMILAR EFFECT ON HIV-INFECTED HUMANS. THE GOAL OF THIS WORK IS TO POTENTIALLY ATTACK THE VIRAL RESERVOIRS WITH THIS ANTIBODY IN THE HOPES OF REDUCING OR ELIMINATING THE VIRUS. THIS IS A MOST NOVEL APPROACH IN WHICH BIDMC IS A WORLD LEADER. BAROUCH AND HIS TEAM ARE ALSO RACING TO DEVELOP SAFE AND EFFECTIVE MEASURES TO PREVENT THE ZIKA VIRUS. IN FEBRUARY 2016, THE WORLD HEALTH ORGANIZATION HAD DECLARED THE ZIKA EPIDEMIC A GLOBAL PUBLIC HEALTH EMERGENCY, BASED LARGELY ON THE VIRUS' NEWLY-ESTABLISHED LINK TO MICROCEPHALY AND OTHER MAJOR BIRTH DEFECTS IN BABIES BORN TO INFECTED MOTHERS. THE VIRUS HAS ALSO BEEN ASSOCIATED WITH THE NEUROLOGIC DISORDER GUILLAIN-BARR SYNDROME IN ADULTS. BAROUCH AND COLLEAGUES HAVE DEMONSTRATED THAT THREE DIFFERENT VACCINE CANDIDATES PROVIDED ROBUST PROTECTION AGAINST ZIKA VIRUS IN BOTH MICE AND RHESUS MONKEYS. SEVERAL HUMAN CLINICAL TRIALS BEGAN LAST FALL AT TEST SITES INCLUDING BIDMC, WALTER REED ARMY INSTITUTE OF RESEARCH AND NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES AFFILIATED CLINICAL TRIAL SITES.*****SCIENTISTS UNCOVER THE EARLIEST STAGES OF ALZHEIMER'S DISEASEALZHEIMER'S DISEASE (AD) CURRENTLY AFFLICTS 5.4 MILLION AMERICANS AND 30 MILLION INDIVIDUALS WORLDWIDE. IT IS ESTIMATED THAT BY 2050, MEDICAL COSTS OF CARING FOR AD PATIENTS WILL SOAR TO OVER $1 TRILLION IN THE U.S. ALONE. MEDICAL CENTER INVESTIGATORS KUN PING LU, MD, PHD, AND XIAO ZHEN ZHOU, MD, PHD, HAVE IDENTIFIED THE FIRST, EARLY STEP IN WHICH THE TAU PROTEIN IS TRANSFORMED FROM ITS BENEFICIAL FUNCTION AS A MEANS OF NEURONAL SUPPORT AND TURNED INTO A TWISTED, MISSHAPEN VILLAIN RESPONSIBLE FOR DEBILITATING MEMORY LOSS. THE DISCOVERY OFFERS A PROMISING NEW DIRECTION FOR THE DEVELOPMENT OF THERAPEUTIC ANTIBODIES AND VACCINES, AND HINGES ON AN ENZYME CALLED PIN1 (PROLYL ISOMERASE), WHICH CAN UNTANGLE THE TWISTED TAU. PIN1 WAS CO-DISCOVERED BY LU IN 1995. A NEW ANTIBODY TECHNOLOGY DEVELOPED BY DR. LU AND DR. ZHOU HAS MADE IT POSSIBLE TO DISTINGUISH BETWEEN HEALTHY AND DISEASE-CAUSING TAU PROTEIN. THEIR WORK HAS DEMONSTRATED THAT THE PROTEIN'S PATHOGENIC FORM APPEARS IN THE BRAIN CELLS OF PATIENTS WITH EARLY DEMENTIA AND AS IT PROGRESSES TO ALZHEIMER'S RAPIDLY ACCUMULATES AT THE BRAIN LOCATION THAT IS CRITICAL FOR MEMORY.*****
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TEAMING UP TO TACKLE SEPSIS - FROM BENCH TO BEDSIDE
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SEPSIS IS ONE OF THE MOST COMMON - AND MOST TERRIFYING - OF CONDITIONS TO BE FOUND IN HOSPITAL EMERGENCY DEPARTMENTS AND INTENSIVE CARE UNITS. SOMETIMES KNOWN AS BLOOD POISONING, SEPSIS OCCURS WHEN THE BODY OVERREACTS TO WHAT IS OFTEN A SIMPLE INFECTION, AND CAN RAPIDLY ESCALATE TO LIFE-THREATENING ORGAN SHUTDOWN. EACH YEAR, SEPSIS IS RESPONSIBLE FOR MORE THAN 200,000 DEATHS, MAKING IT A LEADING CAUSE OF HOSPITAL MORTALITY. AT THE MEDICAL CENTER, INTERDISCIPLINARY RESEARCH TEAMS HAVE MADE SEPSIS A PRIMARY FOCUS OF THEIR ATTENTION. BY LITERALLY BRINGING KEY SCIENTIFIC FINDINGS FROM THE LAB BENCH TO THE PATIENT BEDSIDE, EMERGENCY ROOM PHYSICIAN NATHAN SHAPIRO, MD, PHD, HAS BEEN INSTRUMENTAL IN LEADING INVESTIGATIONS INTO THE ORIGINS OF THIS EXTREMELY DANGEROUS CONDITION, ESTIMATED TO COST $17 BILLION PER YEAR, NATIONWIDE. AS A MEMBER OF THE CENTER FOR VASCULAR BIOLOGY RESEARCH (CVBR) DR. SHAPIRO HAS PARTNERED WITH BASIC SCIENTISTS SAMIR PARIKH, MD, AND WILLIAM AIRD, MD, TO EXPLORE THE ROLE THAT BLOOD VESSELS PLAY IN THE ONSET OF SEPSIS AND IN ITS ESCALATION TO A LIFE-THREATENING CONDITION. THEIR WORK INVESTIGATING THE ENDOTHELIUM LAYER, WHICH LINES THE BLOOD CELLS, IS UNCOVERING VITALLY IMPORTANT CLUES, INCLUDING THE ROLE THAT THE VEGF (VASCULAR ENDOTHELIAL GROWTH FACTOR) PROTEIN MAY PLAY IN THE ONSET OF THIS PROGRESSIVELY SEVERE ILLNESS. THE EMERGENCY-ROOM-AS-LABORATORY IS A UNIQUE AND VALUABLE APPROACH TO STUDYING SEPSIS, AND AS AN ATTENDING PHYSICIAN, DR. SHAPIRO HAS BEEN PRINCIPAL INVESTIGATOR OF NUMEROUS ER-BASED CLINICAL TRIALS TO HELP ASCERTAIN THE MOST EFFECTIVE AND PRUDENT MANAGEMENT OF THE CONDITION IN CASES IN WHICH SEPSIS HAS TAKEN HOLD.*****TRACING THE NEURAL CIRCUITRY OF APPETITE AND HUNGERIF YOU'VE EVER SKIPPED MEALS FOR A WHOLE DAY OR GONE ON A STRICT, LOW-CALORIE DIET, YOU KNOW JUST HOW POWERFUL AND UNCOMFORTABLE THE FEELING OF HUNGER CAN BE. HUNGER IS A COMPLEX MOTIVATION GOVERNED BY THE BRAIN AND BIDMC INVESTIGATOR BRADFORD LOWELL, MD, PHD, OF THE DIVISION OF ENDOCRINOLOGY, DIABETES AND METABOLISM IN BIDMC'S DEPARTMENT OF MEDICINE IS UNCOVERING THE INTRICATE NEUROCIRCUITRY THAT UNDERLIE THESE FEELINGS. IN A RECENT REPORT PUBLISHED IN NATURE NEUROSCIENCE, THE LOWELL LABORATORY MADE IMPORTANT PROGRESS IN UNDERSTANDING THE NEURAL BASIS OF APPETITE. USING A VARIETY OF INNOVATIVE TECHNOLOGIES TO CONTROL THE ACTIVITY IN THE BRAINS OF LIVING MICE, LOWELL AND HIS TEAM HAVE IDENTIFIED ONE PARTICULAR CIRCUIT THAT INVOLVES A GROUP OF MELANOCORTIN-4 RECEPTOR (MC4R) NEURONS THAT APPEARS TO SWITCH HUNGER OFF AND ON AND PROVIDED A HIGHLY PROMISING NEW STRATEGY FOR THE DEVELOPMENT OF WEIGHT LOSS DRUGS TO HELP COMBAT THE EPIDEMIC OF OBESITY. SCIENTISTS IN LOWELL'S LAB ALSO RECENTLY CATALOGUED A "PARTS LIST" OF BRAIN CELL TYPES IN ONE REGION OF THE MOUSE HYPOTHALAMUS. THEY FOUND SOME 50 DISTINCT CELL TYPES, INCLUDING A PREVIOUSLY UNDESCRIBED NEURON TYPE THAT MAY UNDERLIE SOME OF THE GENETIC RISK OF HUMAN OBESITY. THIS CATALOG OF CELL TYPES MARKS THE FIRST TIME NEUROSCIENTISTS HAVE ESTABLISHED A COMPREHENSIVE "PARTS LIST" FOR THIS AREA OF THE BRAIN. THE NEW INFORMATION WILL ALLOW RESEARCHERS TO ESTABLISH WHICH CELLS PLAY WHAT ROLE IN THIS REGION OF THE BRAIN.*****NEW CLASS OF FATTY MOLECULES BATTLES DIABETES IN MICELIPIDS, THE CHEMICAL FAMILY THAT INCLUDES FATS AND RELATED MOLECULES, GET BLAMED FOR CLOGGED ARTERIES AND HEART ATTACKS. BUT RESEARCHERS LED BY BIDMC'S BARBARA KAHN, MD, HAVE MADE A SURPRISING DISCOVERY OF A PREVIOUSLY UNIDENTIFIED CLASS OF LIPID MOLECULES THAT ACTUALLY ENHANCE INSULIN SENSITIVITY AND BLOOD SUGAR CONTROL. THESE NEW FINDINGS, RECENTLY PUBLISHED IN THE JOURNAL CELL, OFFER A PROMISING NEW AVENUE FOR THE PREVENTION AND TREATMENT OF TYPE 2 DIABETES. NAMED FATTY ACID HYDROXYL FATTY ACIDS, OR FAHFAS, THESE NEW MOLECULES ARE IN FAT CELLS AS WELL AS OTHER CELLS THROUGHOUT THE BODY, AND NOW JOIN A SMALL GROUP OF FATTY ACIDS KNOWN TO BENEFIT HEALTH, WHICH ALSO INCLUDES OMEGA-3 FATTY ACIDS FOUND IN FISH OIL. THE DISCOVERY OF FAHFAS PROVIDES IMPORTANT NEW INSIGHTS UNDERLYING METABOLIC AND INFLAMMATORY DISEASES, AND OFFERS VIABLE NEW TREATMENT AVENUES THAT KAHN AND HER TEAM HOPE TO BE ABLE TO TEST IN CLINICAL TRIALS. "THIS IS OF CRITICAL IMPORTANCE AS RATES OF OBESITY AND TYPE 2 DIABETES REMAIN AT EPIDEMIC PROPORTIONS WORLDWIDE," SAYS KAHN, AN INVESTIGATOR IN BIDMC'S DIVISION OF ENDOCRINOLOGY, DIABETES AND METABOLISM IN THE DEPARTMENT OF MEDICINE. ATTEMPTS ARE NOW IN PROGRESS TO TEST FAHFAS IN DIABETIC PATIENTS. FOR THIS AND OTHER PIONEERING WORK, DR. KAHN WAS AWARDED THE 2016 BANTING MEDAL FOR SCIENTIFIC ACHIEVEMENT FROM THE AMERICAN DIABETES ASSOCIATION. *****UNCOVERING DRUGS THAT MAY COMBAT DEADLY ANTIBIOTIC-RESISTANT BACTERIAIN RECENT YEARS, HOSPITALS HAVE REPORTED DRAMATIC INCREASES IN THE NUMBER OF CASES OF THE HIGHLY CONTAGIOUS, DIFFICULT-TO-TREAT, AND OFTEN DEADLY ANTIBIOTIC-RESISTANT BACTERIA CARBAPENEM-RESISTANT ENTEROBACTERIACEAE (CRE). RESEARCHERS AT THE MEDICAL CENTER HAVE DEVELOPED A PROMISING NEW METHOD OF IDENTIFYING NEW ANTIMICROBIALS THAT TARGET THESE ORGANISMS. WHILE THERE IS A CRITICAL NEED FOR NEW ANTIMICROBIAL AGENTS AGAINST CRE AND OTHER EMERGING ANTIBIOTIC-RESISTANT BACTERIA, THE NUMBER OF NEW ANTIBIOTICS THAT HAVE BEEN DEVELOPED AND APPROVED HAS STEADILY DECREASED IN RECENT DECADES. TO IDENTIFY NEW OR EXISTING DRUGS THAT CAN DESTROY MULTIDRUG-RESISTANT CRE, BIDMC RESEARCHERS JAMES KIRBY AND KENNETH SMITH EXAMINED APPROXIMATELY 10,000 COMPOUNDS WITH KNOWN ACTIVITY-SO CALLED KNOWN BIOACTIVE MOLECULES-INCLUDING MOST PREVIOUSLY FDA-APPROVED DRUGS, VETERINARY DRUGS AND INHIBITORS OF VARIOUS CELLULAR PROCESSES NOT CURRENTLY USED AS THERAPEUTICS. THROUGH A PROCESS CALLED HIGH THROUGHPUT SCREENING, THE INVESTIGATORS LOOKED TO SEE WHETHER ANY OF THESE COMPOUNDS COULD EITHER DIRECTLY INHIBIT THE GROWTH OF CRE OR RESTORE THE EFFECTIVENESS OF CARBAPENEM AGAINST THESE ORGANISMS. THEY FOUND THAT 79 COMPOUNDS INHIBITED CRE. OF THESE, THREE HAD ALREADY BEEN APPROVED FOR HUMAN AND VETERINARY USE. THESE ANTIMICROBIALS CURRENTLY HAVE OTHER INTENDED USES AND ARE NOT CURRENTLY CONSIDERED AS TREATMENTS FOR CRE, HOWEVER KIRBY AND SMITH'S FINDINGS SUGGEST THEY COULD POTENTIALLY BE REPURPOSED FOR CRE TREATMENT*****BIDMC-DESIGNED PORTABLE DIAGNOSTIC TOOL COULD IMPROVE GLOBAL HEALTH, SAVE MONEY IN THE FIFTY YEARS SINCE THE FICTIONAL DEVICE MADE ITS DEBUT ON STAR TREK FIFTY YEARS AGO, SCIENTISTS HAVE BEEN WORKING TO BUILD A REAL TRICORDER - A HANDHELD, USER-FRIENDLY MEDICAL DIAGNOSTIC DEVICE THAT COULD CHANGE THE WAY HEALTH CARE IS DELIVERED IN THE UNITED STATES AND ABROAD. THIS YEAR, A TEAM LED BY CHUNG-KANG PENG, PHD, CO-DIRECTOR OF THE REY INSTITUTE FOR NONLINEAR DYNAMICS IN MEDICINE AT BIDMC, DEVELOPED JUST SUCH A DEVICE. THE PORTABLE MACHINE TOOK HOME A $1 MILLION IN THE $10M QUALCOMM TRICORDER XPRIZE, PLACING SECOND OUT OF THREE HUNDRED ENTRANTS. WEIGHING IN AT LESS THAN FIVE POUNDS, THE DEVICE MONITORS FIVE VITAL SIGNS - BLOOD PRESSURE, HEART RATE, OXYGEN SATURATION, RESPIRATORY RATE, TEMPERATURE - AND TESTS FOR 13 COMMON CONDITIONS, PROVIDING A DIAGNOSIS IN MINUTES FOR AILMENTS SUCH AS EAR INFECTION, HYPERTENSION AND DIABETES. EQUIPPED WITH A SMART PHONE-BASED USER INTERFACE, THE MACHINE IS DESIGNED FOR USE BY PEOPLE WITH LITTLE TO NO MEDICAL TRAINING. PENG, AN EXPERT IN STATISTICAL PHYSICS AND ITS APPLICATION TO THE STUDY OF PHYSIOLOGICAL MEASURES, AND HIS TEAM BEGAN WORK ON THE DEVICE IN 2012. ITS EVENTUAL CONSUMER-USE COULD MEAN EARLIER DIAGNOSES OF AND BETTER CONTROL OF CHRONIC DISEASE, LIKE DIABETES. IT COULD ALSO REDUCE OFFICE VISITS FOR LESS SERIOUS CONDITIONS, REPRESENTING SIGNIFICANT HEALTH CARE SAVINGS. THE DIAGNOSTIC TOOL COULD ALSO BE DEPLOYED IN DEVELOPING REGIONS, SUCH AS RURAL CHINA, WHERE UP TO 800 MILLION PEOPLE LACK ACCESS TO BASIC HEALTH CARE, SAYS PENG, WHO IS ALSO A PROFESSOR AT NATIONAL CENTRAL UNIVERSITY IN TAIWAN, AS WELL AS AN ASSOCIATE PROFESSOR AT HARVARD MEDICAL SCHOOL.*****NEW INSIGHT INTO GENETICS AND BRAIN CIRCUITRY OF IMPAIRED SOCIABILITY IN AUTISMAMONG THE BROAD CATEGORY OF COGNITIVE DEVELOPMENTAL DISABILITIES LIKE DOWN SYNDROME, AUTISM IS MARKED BY ITS SOCIAL IMPAIRMENTS. PEOPLE WITH THE DISORDER OFTEN HAVE DIFFICULTY MAKING EYE CONTACT, RECOGNIZING SOCIAL CUES OR FOCUSING ON OTHER PEOPLE. RESEARCHERS AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) HAVE GAINED NEW INSIGHT INTO THE GENETIC AND NEURONAL CIRCUIT MECHANISMS THAT MAY CONTRIBUTE TO THIS IMPAIRED SOCIABILITY IN SOME FORMS OF AUTISM SPECTRUM DISORDER. LED BY MATTHEW P. ANDERSON, MD, PHD, DIRECTOR OF NEUROPATHOLOGY AT BIDMC, THE SCIENTISTS DETERMINED HOW A GENE LINKED TO ONE COMMON FORM OF AUTISM WORKS IN A SPECIFIC POPULATION OF BRAIN CELLS TO IMPAIR SOCIABILITY. THE RESEARCH, PUBLISHED IN THE JOURNAL NATURE, REVEALS THE NEUROBIOLOGICAL CONTROL OF SOCIABILITY AND COULD REPRESENT IMPORTANT FIRST STEPS TOWARD INTERVENTIONS FOR PATIENTS WITH AUTISM.ANDERSON AND COLLEAGUES FOCUSED ON THE GENE UBE3A, MULTIPLE COPIES OF WHICH
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SCHEDULE H PART VI QUESTIONS 5 AND 6
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ADDITIONAL PROMOTION OF COMMUNITY HEALTH AND AFFILIATED HEALTH CARE SYSTEMBIDN MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. IN ADDITION, AS NOTED THROUGHOUT THIS NARRATIVE SUPPORT TO THE BIDN FORM 990 AND SCHEDULES, THE MEDICAL CENTER IS PART OF THE CAREGROUP NETWORK OF AFFILIATES AND CAREGROUP SERVES AS THE MEDICAL CENTER'S SOLE MEMBER. THE MEDICAL CENTER SERVES AS THE SOLE MEMBER TO BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, BETH ISRAEL DEACONESS HOSPITAL - MILTON, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP AND JORDAN HEALTH SYSTEMS, INC. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC. EACH OF THESE ENTITIES MAY, IN TURN, SERVE AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. BIDN, THE MEDICAL CENTER AND EACH OF ITS AFFILIATES IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES THEY SERVE.
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SCHEDULE H PART VI QUESTION 7
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MA
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.