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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 NEW ENGLAND BAPTIST HOSPITAL IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED IN MUSCULOSKELETAL DISEASE AND COLLABORATE ON PROGRAMS TO ADDRESS THESE NEEDS, WITH SPECIAL FOCUS ON UNDERSERVED POPULATIONS THROUGH OUTREACH, EDUCATION AND PROVISION OF SERVICES TO ADDRESS MUSCULOSKELETAL HEALTH.AS NOTED THROUGHOUT THIS NARRATIVE, NEW ENGLAND BAPTIST HOSPITAL'S (NEBH OR HOSPITAL) PRIMARY PURPOSE IS THE OPERATION AND MAINTENANCE OF AN ACUTE CARE, ORTHOPEDIC SPECIALTY HOSPITAL AND PROVISION OF ALL SERVICES RELATED THERETO FOR THE BENEFIT OF PATIENTS. THE HOSPITAL OPERATES AS AN ADULT MEDICAL / SURGICAL HOSPITAL WITH A NATIONAL REPUTATION IN ORTHOPEDIC CARE. PATIENTS ARE OFFERED A FULL RANGE OF SERVICES IN ORTHOPEDICS AND RHEUMATOLOGY, JOINT REPLACEMENT, SPINE CARE, FOOT AND ANKLE CARE, HAND SURGERY, OCCUPATIONAL MEDICINE AND SPORTS MEDICINE. COMMUNITY BENEFITS PHILOSOPHY NEBH IS COMMITTED TO ITS COMMUNITY. THE HOSPITAL'S PHILOSOPHY IS TO PARTNER DIRECTLY WITH LOCAL ORGANIZATIONS TO PROVIDE DIRECT SERVICES IN OUR PRIORITY AREAS, TO STREAMLINE AND REDUCE DUPLICATION AND TO BUILD POSITIVE RELATIONSHIPS IN THE SURROUNDING NEIGHBORHOODS. DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $742,752 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I, COLUMN C.COMMUNITY BENEFITS LEADERSHIP AND PROCESSCOMMUNITY BENEFITS LEADERSHIPTHE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT ARE RESPONSIBLE FOR OVERSEEING THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY BENEFITS PLAN BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH IMPLEMENTATION STRATEGY/PLAN (CHIP). COMMUNITY PLANNING IS DONE IN CONJUNCTION WITH MEMBERS OF THE DESIGNATED HOSPITAL COMMUNITY, WHO MAY PROVIDE INSIGHT AND RECOMMENDATIONS ON COMMUNITY HEALTH ISSUES. THE BOARD IS RESPONSIBLE FOR DEVELOPING POLICY TO IMPLEMENT AND EVALUATING THE HOSPITAL'S CURRENT AND FUTURE COMMUNITY PROGRAMS. THE DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS REPORTS TO SENIOR MANAGEMENT AND TO THE PRESIDENT OF THE HOSPITAL ON COMMUNITY BENEFIT ACTIVITIES AND PLANS. DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS, RESPONSIBILITIES INCLUDE:- PLANNING, ORGANIZING AND EVALUATING THE COMMUNITY BENEFITS PROGRAMMING IN COLLABORATION WITH HOSPITAL ADMINISTRATION, NEBH STAFF AND THE KEY STAKEHOLDERS WITHIN THE COMMUNITY.- COORDINATING THROUGH THE HOSPITAL'S COMMUNITY BENEFITS COMMITTEE, WHOSE MEMBERS INCLUDE EMPLOYEES AMONG THROUGHOUT THE HOSPITAL AND NUMEROUS EVENTS AND ACTIVITIES OPEN TO ALL NEBH EMPLOYEES.COMMUNITY BENEFITS COMMITTEE- ELAINE ADAMS, RN. REGISTERED NURSE AND COMMUNITY MEMBER.- LAURA ADAMS, SENIOR PROGRAM COORDINTOR, ROXBURY TENANTS OF HARVARS, AND COMMUNITY MEMBER.- LEON BRASFIELD, CAST TECHNICIAN, REHAB SERVICES.- BETH DONATO, MSPT, DIRECTOR OF INPATIENT REHABILITATIVE SERVICES.- ASHLEY DUBOIS, HRIS COORDINATOR, HUMAN RESOURCES.- CHRISTINE DWYER, DIRECTOR, PUBLIC AFFAIRS AND COMMUNITY RELATIONS.- DUANE GOSLEY, SR. PROJECT MANAGER, INFORMATION TECHNOLOGY.- KATHLEEN HAYES, RN, REGISTERED NURSE.- MICHAEL HOWE, EXECUTIVE ASSISTANT- JOHN JACKSON, ADMINISTRATIVE COORDINATOR, TOBIN COMMUNITY CENTER, BCYF.- EILEEN O'DONNELL, RN, CLINICAL LEADER, EMPLOYEE HEALTH.- HALEY OH, DIRECTOR RESEARCH & FINANCIAL ADMINISTRATION- PAIGE LEGASSIE, BUSINESS PARTNER, HUMAN RESOURCES.- JANET MCCARTHY, RN, REGISTERED NURSE AND COMMUNITY MEMBER.- DAVID PASSAFRO, SR. VICE PRESIDENT, EXTERNAL AFFAIRS.- JARLIN RIZIK, MANAGER, CENTRAL TRANSPORTATION.- LYNN STEWART, MANAGER, AMENITIES AND STUDENT SERVICES.
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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 (ACA), 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. NEBH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016. THAT CHNA WAS APPROVED BY THE BOARD OF TRUSTEES IN SEPTEMBER 2016. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD OF TRUSTEES IN SEPTEMBER 2016 WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER IRC SECTION 501(R). THE PREVIOUS NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE NEBH BOARD OF TRUSTEES IN SEPTEMBER 2013 AND INFORMED NEBH'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. DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2013 (TAX YEAR 2012), NEBH CONDUCTED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSING ON THE MISSION HILL AND ROXBURY NEIGHBORHOODS IN BOSTON WHICH, AS PREVIOUSLY NOTED, ARE THE HOSPITAL'S PRIMARY COMMUNITY BENEFITS SERVICE AREAS. THE OVERALL GOAL OF THE ASSESSMENT WAS TO COMPILE INFORMATION FROM A RANGE OF QUANTITATIVE AND QUALITATIVE SOURCES TO CLARIFY THE HEALTH CARE NEEDS AND PRIORITIES OF COMMUNITY RESIDENTS AND ASSESS THE OVERALL STRENGTHS AND WEAKNESSES OF THE HEALTH AND SOCIAL SERVICE SYSTEMS. THE PROJECT ALSO FULFILLED BOTH THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT THE HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW THE HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WOULD ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT. AS NOTED BELOW, THE 2016 CHNA PROCESS WAS BORNE FROM THE SAME COMMITMENTS AND WITH THE SAME GOALS. THE 2013 CHNA CONCLUDED THAT THE MOST SIGNIFICANT HEALTH-RELATED ISSUE FACING THE COMMUNITIES SURROUNDING NEBH WERE THE BROADER SOCIAL AND ECONOMIC DETERMINANTS, INCLUDING, POVERTY, UNEMPLOYMENT, FOOD INSECURITY, VIOLENCE AND TRANSPORTATION. IN ADDITION TO THIS UNDERLYING PRIORITY, ISSUES RELATED TO OBESITY, LACK OF PHYSICAL EXERCISE, AND POOR NUTRITION AS WELL AS THE CHRONIC DISEASES THAT ARE OFTEN ASSOCIATED WITH THESE FACTORS WERE SEEN AS ANOTHER PRIORITY. IN ADDITION, ISSUES RELATED TO OLDER ADULT HEALTH, SUCH AS GENERAL HEALTH AND WELLNESS, FALLS PREVENTION, ISOLATION/DEPRESSION, OSTEOPOROSIS, CHRONIC DISEASE, WERE ALSO IDENTIFIED AS A PRIORITY. THE CHNA CONDUCTED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016, SIMILARLY FOCUSED ON THE BOSTON NEIGHBORHOODS OF MISSION HILL AND ROXBURY, WHICH AS NOTED ABOVE, ARE NEBH'S PRIMARY SERVICE AREA WITH RESPECT TO ITS COMMUNITY BENEFIT INITIATIVES. AS REQUIRED UNDER THE LAW, THE OVERALL GOAL OF THE ASSESSMENT WAS TO COMPILE INFORMATION FROM A RANGE OF QUANTITATIVE AND QUALITATIVE SOURCES TO CLARIFY THE HEALTH CARE NEEDS AND PRIORITIES OF COMMUNITY RESIDENTS AND ASSESS THE OVERALL STRENGTHS AND WEAKNESSES OF THE AREA'S HEALTH AND SOCIAL SERVICE SYSTEMS. ULTIMATELY, THE PURPOSE OF THE ASSESSMENT WAS TO FACILITATE THE DEVELOPMENT OF A STRATEGIC PLAN/IMPLEMENTATION STRATEGY THAT WOULD GUIDE HOW NEBH WILL WORK WITH STAKEHOLDERS IN MISSION HILL AND ROXBURY TO STRENGTHEN THE COMMUNITY AND IMPROVE HEALTH STATUS DURING THE FISCAL YEARS ENDING SEPTEMBER 30, 2017, SEPTEMBER 30, 2018 AND SEPTEMBER 30, 2019.THE IDENTIFIED NEEDS IN THE CHNA WHICH WILL INFORM NEBH'S COMMUNITY BENEFIT OPERATIONS FOR THE NEXT THREE FISCAL YEARS AS NOTED ABOVE ARE: MUSCULOSKELETAL HEALTH, OBESITY PREVENTION, VIOLENCE PREVENTION, WORKFORCE DEVELOPMENT, ELDER ISOLATION, ACCESS TO HEALTHY AFFORDABLE FOOD, FOOD INSECURITY/HUNGER AND MOBILITY AND TRANSPORTATION FOR THE ELDERLY AS WELL AS IMPROVING THE HEALTH, FUNCTION, AND QUALITY OF LIFE OF OLDER ADULTS. AS NOTED ABOVE, ACCOMPLISHMENTS RELATED TO THESE IDENTIFIED NEEDS WILL BE REPORTED IN THE HOSPITAL'S 2016 FORM 990 SCHEDULE H. COMMUNITY HEALTH NEEDS ASSESSMENT - COMMUNITY INFORMATIONAS NOTED ABOVE, THE TWO MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTS CONDUCTED BY NEBH FOCUSED ON THE MISSION HILL AND ROXBURY NEIGHBORHOODS IN BOSTON WHICH, AS PREVIOUSLY NOTED, ARE THE HOSPITAL'S PRIMARY COMMUNITY BENEFITS SERVICE AREAS. (SCHEDULE H PART VI QUESTION 4)
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COMMUNITY HEALTH NEEDS ASSESSMENT -- APPROACH AND METHODS
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NEBH IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS FROM ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED AND IMPROVE THE OVERALL HEALTH OF THE REGION. NEBH WORKS WITH ALL SEGMENTS OF THE POPULATION BUT IN RECOGNITION OF ITS STRONG TIES TO ITS SURROUNDING COMMUNITY AND ITS SPECIFIC CLINICAL EXPERTISE, NEBH FOCUSES ITS COMMUNITY BENEFIT EFFORTS ON IMPROVING THE HEALTH AND WELL-BEING OF THE LOW INCOME, UNDERSERVED POPULATIONS LIVING IN MISSION HILL AND ROXBURY AND ON MUSCULOSKELETAL HEALTH. NEBH CURRENTLY OPERATES NUMEROUS EDUCATIONAL, OUTREACH, AND COMMUNITY-STRENGTHENING INITIATIVES, COLLABORATES WITH MANY OF THE COMMUNITY'S LEADING SERVICE ORGANIZATIONS. THE HOSPITAL CONTRIBUTES OVER $2.0 MILLION ANNUALLY TO SUPPORT ITS COMMUNITY BENEFIT COMMITMENTS AND THE MASSACHUSETTS UNCOMPENSATED CARE POOL. NEBH IS ALWAYS EAGER TO EXPLORE WAYS THAT IT CAN FURTHER ENGAGE AND ENRICH ITS CONNECTIONS TO THE COMMUNITY.THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED COMMUNITY HEALTH IMPROVEMENT PLAN WERE THE CULMINATION OF SEVERAL MONTHS OF WORK. THIS PROJECT WAS BORNE LARGELY OUT OF NEBH'S DESIRE TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS SURROUNDING COMMUNITY. THE PROCESS IS ALSO DESIGNED TO MEET THE REQUIREMENTS OF THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REQUIREMENTS UNDER INTERNAL REVENUE CODE SECTION 501(R), WHICH MANDATE THAT ALL NONPROFIT HOSPITALS CONDUCT A PERIODIC COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND STRATEGIC PLANNING PROCESS. THE COMMONWEALTH REQUIRES NONPROFIT HOSPITALS AND MANAGED CARE ORGANIZATIONS TO UPDATE THEIR CHNAS EVERY YEAR AND THE IRS REQUIRES THAT A CHNA BE CONDUCTED EVERY THREE YEARS. MORE SPECIFICALLY, THE COMMONWEALTH AND IRS REGULATIONS REQUIRE THAT NEBH ASSESS COMMUNITY HEALTH NEED, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW THE HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT.IN LIGHT OF THESE REQUIREMENTS, NEBH HIRED JOHN SNOW, INC. (JSI), A NATIONALLY RECOGNIZED PUBLIC HEALTH CONSULTING FIRM, TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSING ON MISSION HILL AND ROXBURY, ITS PRIMARY SERVICE AREA WITH RESPECT TO ITS COMMUNITY BENEFIT INITIATIVES. THE OVERALL GOAL OF THE ASSESSMENT WAS TO COMPILE INFORMATION FROM A RANGE OF QUANTITATIVE AND QUALITATIVE SOURCES TO CLARIFY THE HEALTH CARE NEEDS AND PRIORITIES OF COMMUNITY RESIDENTS AND ASSESS THE OVERALL STRENGTHS AND WEAKNESSES OF THE AREA'S HEALTH AND SOCIAL SERVICE SYSTEMS. THE CHNA PROCESS WAS CONDUCTED IN THREE PHASES:- PHASE I: THE JSI PROJECT TEAM CONDUCTED A PRELIMINARY NEEDS ASSESSMENT THAT RELIED HEAVILY ON QUANTITATIVE HEALTH-RELATED DATA DRAWN FROM THE MASSACHUSETTS COMMUNITY HEALTH INFORMATION PROFILE (MASSCHIP) SYSTEM AS WELL AS OTHER NATIONAL, STATE, AND LOCAL SOURCES. THESE DATA ALLOWED THE JSI PROJECT TEAM TO UNDERSTAND THE UNDERLYING CHARACTERISTICS OF AREA RESIDENTS AND IDENTIFY THE SPECIFIC SEGMENTS OF THE COMMUNITY MOST AT-RISK. - PHASE II: JSI CONDUCTED A SERIES OF INTERVIEWS WITH KEY STAKEHOLDERS AND TWO FOCUS GROUPS WITH COMMUNITY MEMBERS. THE FOCUS GROUPS HELPED THE JSI PROJECT TEAM TO ENGAGE THE COMMUNITY AND BETTER UNDERSTAND THEIR HEALTH STATUS, HEALTH-SEEKING BEHAVIORS, SERVICE GAPS, HEALTH-RELATED CHALLENGES, AND PRIORITIES. - PHASE III: CHRISTINE DWYER, DIRECTOR OF PUBLIC AFFAIRS AND COMMUNITY RELATIONS, AND BETH GREENSPAN, VICE PRESIDENT, CHIEF STRATEGY OFFICER, WORKED WITH JSI TO INTEGRATE THE CHNA'S FINDINGS, INCLUDING FEEDBACK FROM NEBH STAFF AND THE COMMUNITY, AND DEVELOPED NEBH'S COMMUNITY HEALTH IMPROVEMENT PLAN. IN PHASE III, JSI ALSO DEVELOPED A FINAL CHNA REPORT, OBTAINED APPROVAL FOR ITS COMMUNITY HEALTH IMPROVEMENT PLAN FROM NEBH'S BOARD OF TRUSTEES, AND DISSEMINATED THE RESULTS OF THE PROJECT TO INTERNAL AND EXTERNAL STAKEHOLDERS.THE CHNA UTILIZED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. AS NOTED ABOVE, THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS IN THE REGION AS WELL AS INFORMATION FROM COMMUNITY DIALOGUES CONDUCTED WITH COMMUNITY RESIDENTS, AND INTERVIEWS WITH COMMUNITY STAKEHOLDERS. (SCHEDULE H, PART V, SECTION B, QUESTION 5). NEBH CONDUCTED THIS CHNA PROCESS INDEPENDENTLY AS REPORTED IN (SCHEDULE H, PART V, SECTION B, QUESTIONS 6A AND 6B). THE 2016 CHNA AND IMPLEMENTATION STRATEGY PROCESS WAS BORNE FROM THE SAME COMMITMENTS AND WITH THE SAME GOALS AND WILL GUIDE HOW NEBH WILL WORK WITH STAKEHOLDERS IN MISSION HILL AND ROXBURY TO STRENGTHEN THE COMMUNITY AND IMPROVE HEALTH STATUS DURING THE FISCAL YEARS ENDING SEPTEMBER 30, 2017, SEPTEMBER 30, 2018 AND SEPTEMBER 30, 2019.
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2013 COMMUNITY HEALTH NEEDS ASSESSMENT - SUMMARY OF FINDINGS
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THE FOLLOWING ARE KEY FINDINGS RELATED TO COMMUNITY CHARACTERISTICS AND THE DETERMINANTS OF HEALTH FOR NEBH'S COMMUNITY BENEFIT SERVICE AREA. SINCE MISSION HILL IS THE DOMINANT GEOGRAPHY IN NEBH'S COMMUNITY BENEFIT SERVICE AREA, THE FOCUS OF THIS SUMMARY IS ON MISSION HILL AS COMPARED TO ROXBURY AND BOSTON OVERALL.- AGE: MISSION HILL'S POPULATION HAS LARGER PROPORTIONS OF OLDER ADULTS (65+) AND SMALLER PROPORTIONS OF CHILDREN (<18) THAN THE POPULATIONS IN ROXBURY AND BOSTON OVERALL. WITH RESPECT TO AGE, THE MOST STRIKING FINDING IS THE EXTREMELY LARGE PROPORTION OF YOUNG ADULTS (COLLEGE STUDENTS) THAT RESIDE IN MISSION HILL COMPARED TO ROXBURY AND BOSTON OVERALL, WHICH SKEWS THE AGE DISTRIBUTION. MORE THAN 40% (40.2%) OF MISSION HILL'S POPULATION IS BETWEEN 18 AND 24 YEARS OLD, COMPARED TO 16.4 FOR ROXBURY AND 19.0% FOR BOSTON OVERALL.- RACE/ETHNICITY, FOREIGN BORN STATUS, AND LANGUAGE: THE PROPORTION OF RACIAL/ETHNIC MINORITY POPULATIONS IN MISSION HILL IS HIGH RELATIVE TO THE COMMONWEALTH OF MASSACHUSETTS OVERALL BUT MIRRORS THE PROPORTIONS IN BOTH ROXBURY AND BOSTON OVERALL. HOWEVER, THE SPECIFIC CHARACTERISTICS OF THE RACIAL/ETHNIC MINORITY POPULATION IN MISSION HILL ARE VERY DIFFERENT. IN MISSION HILL THERE ARE MUCH LARGER PERCENTAGES OF ASIAN RESIDENTS AND SMALLER PROPORTIONS OF AFRICAN AMERICAN AND HISPANIC RESIDENTS COMPARED TO ROXBURY. ACROSS MISSION HILL, ROXBURY, AND BOSTON OVERALL, MORE THAN ONE-THIRD OF THE POPULATIONS ARE FOREIGN BORN AND MORE THAN ONE-THIRD OF THE POPULATIONS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THERE ARE CLEAR AND WELL-RECOGNIZED HEALTH DISPARITIES AMONG RACIAL/ETHNIC MINORITY AND FOREIGN POPULATIONS COMPARED TO THE MAJORITY NON-HISPANIC WHITE POPULATION. IN ADDITION, THERE ARE SIGNIFICANT HEALTH LITERACY ISSUES AMONG RACIAL/ETHNIC MINORITIES, PARTICULARLY WITH FOREIGN-BORN POPULATIONS AND FOR THOSE WITH LIMITED ABILITY TO SPEAK ENGLISH. - INCOME/POVERTY: LARGE PROPORTIONS OF THE POPULATIONS IN MISSION HILL AND ROXBURY LIVE IN POVERTY (< 100% OF THE FEDERAL POVERTY LEVEL - FPL) OR LOW-INCOME HOUSEHOLDS (< 200% FPL) AND STRUGGLE TO PAY FOR FOOD AND OTHER BASIC HOUSEHOLD ITEMS. IN MISSION HILL 39% OF THE HOUSEHOLDS ARE LIVING IN POVERTY, COMPARED TO 35% IN ROXBURY, AND 21% IN BOSTON OVERALL. THE SIGNIFICANT AND NEGATIVE IMPACTS OF POVERTY WERE ALSO DISCUSSED IN NEARLY ALL OF INTERVIEWS AND IN EACH FOCUS GROUP. THE MISSION HILL FIGURES ARE SOMEWHAT SKEWED BY THE LARGE NUMBERS OF COLLEGE STUDENTS THAT LIVE IN THE AREA AND DO NOT HAVE A REGULAR INCOME. IF THESE YOUNG ADULTS LIVING IN NON-FAMILY HOUSEHOLDS ARE TAKEN OUT OF THE ANALYSIS, MISSION HILL FAIRS SLIGHTLY BETTER THAN ROXBURY. HOWEVER, POVERTY AND ITS IMPACTS ARE STILL MAJOR ISSUE FOR MISSION HILL'S FAMILIES AND OTHER MORE PERMANENT RESIDENTS. - EDUCATION: COMPARED TO BOSTON, RESIDENTS OF MISSION HILL ARE LESS LIKELY TO HAVE A HIGH SCHOOL DIPLOMA. COMPARED TO ROXBURY, HOWEVER, MISSION HILL RESIDENTS ARE MORE LIKELY TO HAVE A HIGH SCHOOL DIPLOMA. ONCE AGAIN, THIS DATA IS SKEWED BY THE HIGH NUMBER OF TRANSIENT YOUNG ADULT RESIDENTS WHO ATTEND BOSTON'S MANY UNIVERSITIES AND COLLEGES AND LIVE IN MISSION HILL.- LACK OF EMPLOYMENT, THE ECONOMIC DOWNTURN, AND ITS IMPACTS: WHILE MISSION HILL RESIDENTS APPEAR BETTER OFF THAN RESIDENTS OF ROXBURY ON THIS ISSUE, A LARGE PROPORTION OF THE MISSION HILL POPULATION ARE EITHER UNEMPLOYED OR DO NOT CONSIDER THEMSELVES PART OF THE WORKFORCE. THE UNEMPLOYMENT RATE IN MISSION HILL FOR PEOPLE OVER THE AGE OF 16 YEARS OLD IS JUST 8.1%, COMPARED TO 16.5% IN ROXBURY AND 10.2% IN BOSTON OVERALL. HOWEVER, IN ORDER TO GET A CLEAR PICTURE OF THIS ISSUE ONE MUST ALSO CONSIDER THE NUMBER AND PROPORTION OF THE POPULATION WHO DO NOT CONSIDER THEMSELVES PART OF THE WORKFORCE. IN MISSION HILL NEARLY 40% (5,873) OF THE 16-YEAR-OLD-AND-OVER POPULATION DOES NOT CONSIDER ITSELF TO BE PART OF LABOR FORCE, WHICH MEANS THAT 41% (5,873) OF THE TOTAL POPULATION IS NOT EMPLOYED. VIEWED IN THIS MANNER, MISSION HILL IS STILL BETTER OFF THAN ROXBURY BUT NOT NEARLY TO THE EXTENT THAT UNEMPLOYMENT FIGURES ALONE SUGGEST. IN ROXBURY, 51% (17,837) OF THE POPULATION IS NOT EMPLOYED AND IN BOSTON OVERALL THE FIGURE, NOT SURPRISINGLY, IS MUCH LOWER AT 38% (199,006). UNEMPLOYMENT AND THE IMPACT THAT THE ECONOMIC DOWNTURN HAS HAD ON THE MISSION HILL COMMUNITY OVER THE PAST 3-5 YEARS WAS ONE OF THE DOMINANT, IF NOT THE MOST DOMINANT, THEMES IN THE INTERVIEWS AND FOCUS GROUPS. LACK OF EMPLOYMENT OPPORTUNITIES FOR MISSION HILL'S YOUTH AND ADULTS HAS GREATLY IMPACTED THEIR ABILITY TO PROVIDE FOOD AND OTHER BASIC HOUSEHOLD ITEMS, TO SAY NOTHING OF OTHER COMFORTS THAT MANY TAKE FOR GRANTED. THESE ISSUES HAVE ALSO IMPACTED PEOPLE'S EMOTIONAL HEALTH AND LED TO ISOLATION, PARTICULARLY FOR OLDER ADULTS ON LIMITED FIXED INCOMES. CERTAINLY, POVERTY, UNEMPLOYMENT, ISOLATION, AND EMOTIONAL WELL-BEING ARE IMPORTANT DETERMINANTS OF HEALTH AND WELLNESS. - FOOD INSECURITY: ANOTHER DOMINANT THEME FROM THE INTERVIEWS AND FOCUS GROUPS WAS THE LACK OF ACCESS TO AFFORDABLE, HEALTHY FOODS. INTERVIEWEES AND FOCUS GROUP PARTICIPANTS DISCUSSED THE FACT THAT THERE ARE FEW PLACES FOR RESIDENTS OF MISSION HILL AND ROXBURY TO BUY REASONABLY PRICED FRESH VEGETABLES AND OTHER NUTRITIONAL FOODS. PARTICIPANTS ALSO SPOKE OF THE HIGH PRICES AND LACK OF FRESH VEGETABLES AT THE LARGE, LOCAL GROCERY STORES IN THE AREA AND THE LONG DISTANCES THAT THEY HAD TO TRAVEL TO ACCESS MORE AFFORDABLE HEALTHY FOOD OPTIONS.- TRANSPORTATION: GIVEN THE STEEP AND HILLY LANDSCAPE OF MISSION HILL, TRANSPORTATION WAS SEEN AS A MAJOR BARRIER AND DETERMINANT OF HEALTH AND WELL-BEING. LACK OF TRANSPORTATION WAS A LEADING THEME FROM THE ASSESSMENT INTERVIEWEES AND FOCUS GROUP PARTICIPANTS, ESPECIALLY FOR OLDER ADULT AND LOW-INCOME RESIDENTS LACKING A PERSONAL VEHICLE. INTERVIEWEES AND FOCUS GROUP PARTICIPANTS DISCUSSED CHALLENGES RELATED TO NAVIGATING THE HILLY TERRAIN ON MISSION HILL, THE ISOLATION THAT THOSE WITHOUT A PERSONAL CAR EXPERIENCED, THE NECESSITY FOR MANY TO TRAVEL OUTSIDE THE MISSION HILL AREA TO FIND AFFORDABLE FOOD AND OTHER BASIC ITEMS, AND THE IMPORTANCE OF THE MISSION LINK PUBLIC TRANSPORTATION SERVICE. - ACCESS TO RECREATIONAL FACILITIES: DESPITE THE DENSITY OF THE MISSION HILL COMMUNITY, ACCESS TO RECREATIONAL FACILITIES AND OPEN SPACES IS ONE OF MISSION HILL'S ASSETS. THERE ARE A NUMBER OF PARKS, RECREATIONAL AREAS, AND INDOOR COMMUNITY CENTERS. AS WILL BE DISCUSSED LATER IN THE REPORT, A HIGH PROPORTION OF THE POPULATION IS OVERWEIGHT AND DOES NOT GET REGULAR PHYSICAL EXERCISE, BUT NOT NECESSARILY BECAUSE RECREATIONAL FACILITIES OR OPEN SPACES ARE IN SHORT SUPPLY. - VIOLENCE: RATES OF HOMICIDE AND NON-FATAL GUNSHOT WOUNDS SEEN IN THE CITY'S HOSPITAL EMERGENCY DEPARTMENTS ARE CONSIDERABLY HIGHER IN ROXBURY (INCLUDING MISSION HILL) THAN IN BOSTON OVERALL. WHILE THERE WAS A CLEAR CONSENSUS AMONG INTERVIEWEES AND FOCUS GROUP PARTICIPANTS THAT THIS ISSUE HAD IMPROVED DRAMATICALLY OVER THE PAST 2 DECADES AND THAT MISSION HILL WAS CONSIDERABLY SAFER THAN ROXBURY OVERALL, THIS GROUP AGREED THAT VIOLENCE STILL HAD A MAJOR IMPACT ON THE COMMUNITY. VIOLENCE NEGATIVELY AFFECTS THE HEALTH OF THOSE DIRECTLY INVOLVED BUT ALSO HAS MAJOR NEGATIVE EMOTIONAL EFFECTS ON THOSE WHO ARE INDIRECTLY INVOLVED AND THE COMMUNITY MORE BROADLY. THESE IMPACTS INCLUDE MENTAL HEALTH ISSUES, ISOLATION, AND LACK OF COMMUNITY COHESION. NEARLY EVERYONE WHO WAS INTERVIEWED OR INVOLVED IN FOCUS GROUPS DISCUSSED THE IMPACTS OF VIOLENCE AND ITS ASSOCIATED TRAUMA, PARTICULARLY ON THE AREA'S YOUTH AND THEIR FAMILIES. NEARLY EVERYONE WE TALKED WITH SAID THAT THEY KNEW SOMEONE WHO HAD BEEN IMPACTED DIRECTLY BY VIOLENCE AND UNDERSTOOD FIRST-HAND THE TOLL IT TOOK ON THE COMMUNITY.
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COMMUNITY HEALTH NEEDS ASSESSMENT - ADDRESSING COMMUNITY HEALTH NEEDS
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DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016 LARGE PROPORTIONS OF INDIVIDUALS RESIDING WITHIN BOSTON AND NEBH'S COMMUNITY BENEFITS SERVICE AREA LIVE IN POVERTY, HAVE LIMITED FORMAL EDUCATION, ARE UNEMPLOYED, AND STRUGGLE TO AFFORD FOOD AND OTHER ESSENTIAL HOUSEHOLD ITEMS. THESE POPULATIONS ARE DISPROPORTIONATELY FROM RACIAL/ETHNIC MINORITY GROUPS AND, PARTLY AS A RESULT OF THEIR POVERTY, FACE DISPARITIES IN HEALTH AND ACCESS TO CARE OUTCOMES. IT IS CRITICAL TO NOTE THAT THERE IS A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. IT IS INSUFFICIENT TO TALK SOLELY ABOUT RACE/ETHNICITY, FOREIGN BORN STATUS, OR LANGUAGE AS THE UNDERLYING AND CORRELATIVE ISSUES RELATED TO HEALTH AND WELL-BEING INVOLVE ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION. NEBH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY WHICH ARE AVAILABLE ON THE HOSPITAL'S WEBSITE. AS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, NEBH'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 NEBH WEBSITE AT:HTTPS://WWW.NEBH.ORG/ABOUT-NEBH/OUR-COMMUNITY/IN ADDITION, THE CHNA WHICH WAS COMPLETED 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 NEBH WEBSITE AT: HTTPS://WWW.NEBH.ORG/ABOUT-NEBH/OUR-COMMUNITY/BOTH SETS OF DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST. (SCHEDULE H, PART V, SECTION B, LINE 7A)A SUMMARY OF NEBH'S COMMUNITY BENEFIT ACTIVITIES WHICH ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013 AND PRIORITIZED IN THE RELATED CHIP ARE PROVIDED HERE ALONG WITH THE ENTITIES WITH WHICH THE HOSPITAL PARTNERS RELATED TO THESE EFFORTS. PRIORITY AREA # 1 : SOCIAL & ECONOMIC DETERMINANTS OF HEALTHA. INCREASE ACCESS TO HEALTHY FOODS AND OTHER BASIC HOUSEHOLD NEEDS - TARGET POPULATION: LOW-INCOME INDIVIDUALS AND FAMILIES - PROGRAMMATIC OBJECTIVES: I. EDUCATE INDIVIDUALS AND FAMILIES ABOUT HEALTHY EATING, MEAL PLANNIG, HOUSEHOLD BUDGETING, ETC. II. DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITY AND/OR LACK BASIC HOUSEHOLD ITEMS. - COMMUNITY ACTIVITIES: I. SUPPORT COMMUNITY FOOD PANTRIES II. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS, COOKING CLASSES, AND EDUCATIONAL SESSIONS III. PROMOTE A MOBILE FARMERS' MARKET TO THE COMMUNITY AT A DISCOUNTED RATE. - COMMUNITY PARTNERS: - ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD) - PARKER HILL/FENWAY AND JAMAICA PLAIN - MISSION HILL ELEMENTARY SCHOOL TO COMBAT HUNGER - ROXBURY TENANTS OF HARVARD (RTH) - MISSION MAINB. INCREASE JOB OPPORTUNITIES FOR YOUTH AND ADULTS - TARGET POPULATION: YOUTH AND ADULTS - PROGRAMMATIC OBJECTIVES: I. PROVIDE SUMMER INTERNSHIP AND EMPLOYMENT OPPORTUNITIES FOR YOUTH II. PROVIDE CAREER TRAINING AND EMPLOYMENT OPPORTUNITIES FOR ADULTS INTERESTED IN HEALTH CAREERS. - COMMUNITY ACTIVITIES: I. SUPPORT THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP II. PROMOTE HOSPITAL JOB OPPORTUNITIES TO MISSION HILL RESIDENTS - COMMUNITY PARTNERS: - ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD) - SOCIEDAD LATINA - ROXBURY TENANTS OF HARVARD (RTH) - MISSION MAINC. IMPROVE ACCESS AND SAFETY TO ESSENTIAL COMMUNITY VENUES FOR MISSION HILL RESIDENTS - TARGET POPULATION: MISSION HILL COMMUNITY - PROGRAMMATIC OBJECTIVES: I. INCREASE THE NUMBER OF MISSION HILL RESIDENTS WHO HAVE ACCESS TO AFFORDABLE TRANSPORTATION TO ENSURE ACCESS TO BASIC NEEDS AND REDUCE ISOLATION II. IMPROVE ACCESSIBILITY AND BEAUTIFY COMMUNITY PARKS AND OTHER AREAS III. REMOVE TRASH AND PROVIDE CLEANING SERVICES IN COMMUNITY - COMMUNITY ACTIVITIES: I. SUPPORT MISSION LINK II. MAINTAIN MCLAUGHLIN FIELD III. MAKE COMMUNITY IMPROVEMENTS TO WALKWAYS AND OTHER PUBLIC AREAS IV. PROVIDE TRASH TRUCK AND CLEAN PUBLIC AREAS AFTER MOVE-IN DAY - COMMUNITY PARTNERS: - MISSION LINK - FRIENDS OF MCLAUGHLIN PARK - CITY OF BOSTON - PROBLEM PROPERTIES TASK FORCE ******PRIORITY AREA # 2 : OBESITY, FITNESS, NUTRITION, AND CHRONIC DISEASEA. PROMOTE GENERAL HEALTH AND WELLNESS - TARGET POPULATION: CHILDREN, YOUTH, AND ADULTS - PROGRAMMATIC OBJECTIVES: I. EDUCATE THE PUBLIC ABOUT HEALTH RISK FACTORS, HEALTH PROMOTION, AND BASIC WELLNESS - COMMUNITY ACTIVITIES: I. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS AND EDUCATIONAL SESSIONS ON KEY HEALTH ISSUES IN COMMUNITY VENUES B. INCREASE PHYSICAL ACTIVITY - TARGET POPULATION: CHILDREN, YOUTH, AND ADULTS - PROGRAMMATIC OBJECTIVES: I. EDUCATE ON HEALTHY EATING AND ACTIVE LIVING II. INCREASE THE NUMBER OF CHILDREN AND ADULTS WHO ARE PHYSICALLY ACTIVE III. IMPROVE ACCESSIBILITY AND BEAUTIFY OF WALKWAYS, COMMUNITY PARKS, AND RECREATION AREAS - COMMUNITY ACTIVITIES: I. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS AND EDUCATIONAL SESSIONS II. SUPPORT AND PROMOTE THE DEVELOPMENT OF WALKING AND OTHER PHYSICAL ACTIVITY GROUPS IN COMMUNITY VENUES III. SUPPORT AND COLLABORATE WITH BOSTON FOOD AND FITNESS COLLABORATIVE IV. MAINTAIN MCLAUGHLIN FIELD V. MAKE COMMUNITY IMPROVEMENTS TO WALKWAYS AND OTHER PUBLIC AREAS VI. SUPPORT LITTLE LEAGUE VII. SUPPORT SUMMER CAMP AT THE TOBIN COMMUNITY CENTERC. INCREASE HEALTHY EATING - TARGET POPULATION: CHILDREN, YOUTH & ADULTS - PROGRAMMATIC OBJECTIVES: I. EDUCATE ON HEALTHY EATING AND ACTIVE LIVING II. DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITY III.INCREASING ACCESS TO HEALTHY FOODS, FRUITS, AND VEGETABLES - COMMUNITY ACTIVITIES: I. SUPPORT COMMUNITY FOOD PANTRIES II. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS, COOKING CLASSES, AND EDUCATION SESSIONS III. PROMOTE PARTICIPATION IN MOBILE FARMERS' MARKETS IV. SUPPORT AND COLLABORATE WITH BOSTON FOOD & FITNESS COLLABORATIVED. INCREASING SCREENING, IDENTIFICATION AND REFERRAL FOR PEOPLE WITH CHRONIC DISEASE AND / OR ASSOCIATED RISK FACTORS - TARGET POPULATION: CHILDREN, YOUTH & ADULTS - PROGRAMMATIC OBJECTIVES: I. PROMOTE OBESITY SCREENING FOR CHILDREN AND YOUTH IN COMMUNITY BASED SETTING II. LINK CHILDREN AND YOUTH WHO ARE OVERWEIGHT OR OBESE TO EVIDENCE BASED PROGRAMS THAT PROMOTE HEALTHY EATING AND ACTIVE LIVING III. INCREASE THE NUMBER OF ADULTS SCREENED FOR HYPERTENSION, DIABETES, DEPRESSION, HIGH CHOLESTEROL, AND OTHER LEADING CHRONIC DISEASES IV. LINK THOSE WHO HAVE CHRONIC DISEASE OR ITS ASSOCIATED RISK FACTORS TO PRIMARY CARE AND/OR EVIDENCE-BASED CHRONIC DISEASE MANAGEMENT PROGRAMS. - COMMUNITY ACTIVITIES: I. SUPPORT AND PROMOTE COMMUNITY HEALTH FAIRS AND SCREENING/REFERRAL EVENTS II. DEVELOP PRIMARY AND SPECIALTY CARE REFERRAL NETWORKS FOR THOSE IN NEED SUPPORT AND COLLABORATE WITH BOSTON FOOD & FITNESS COLLABORATIVE - OBESITY, FITNESS, NUTRITION, AND CHRONIC DISEASE - COMMUNITY PARTNERS: - BOSTON PUBLIC HEALTH COMMISSION - SOCIEDAD LATINA - ROXBURY TENANTS OF HARVARD (RTH) - MISSION MAIN - TOBIN COMMUNITY CENTER - MISSION HILL HEALTH MOVEMENT - ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD) - PUBLIC HOUSING FACILITIES - BOSTON FOOD AND FITNESS COLLABORATIVE - LITTLE LEAGUE *****
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PRIORITY AREA # 3 : ELDER HEALTH
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A. PROMOTE GENERAL HEALTH AND WELLNESS FOR ELDERS - TARGET POPULATION: ELDERS - PROGRAMMATIC OBJECTIVES: I. INCREASE GENERAL KNOWLEDGE ABOUT CHRONIC DISEASE, PHYSICAL ACTIVITY, NUTRITION, BEHAVIORAL HEALTH, AND FALLS PREVENTION - COMMUNITY ACTIVITIES: I. SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS AND EDUCATIONAL SESSIONS II. CREATE AN ELDER HEALTH EDUCATION AND PREVENTION CENTER III. PARTICIPATE IN MA DEPARTMENT OF PUBLIC HEALTH STANFORD SELF- MANAGEMENT SUPPORT PROGRAM INITIATIVEB. REDUCE FALLS FOR ELDERS - TARGET POPULATION: ELDERS - PROGRAMMATIC OBJECTIVES: I. INCREASE BALANCE TRAINING AND PHYSICAL ACTIVITY; MEDICAL MANAGEMENT OF EXISTING ILLNESS; AND ENVIRONMENTAL/HOME MODIFICATIONS - COMMUNITY ACTIVITIES: I. PARTICIPATE IN MA DEPARTMENT OF PUBLIC HEALTH STANFORD SELF- MANAGEMENT SUPPORT PROGRAM INITIATIVEC. DECREASE DEPRESSION AND SOCIAL ISOLATION IN ELDERS - TARGET POPULATION: ELDERS - PROGRAMMATIC OBJECTIVES: I. INCREASE THE NUMBER OF MISSION HILL RESIDENTS WHO HAVE ACCESS TO AFFORDABLE TRANSPORTATION II. REDUCE ISOLATION III. INCREASE SCREENING, IDENTIFICATION, AND REFERRAL FOR ELDERS WITH DEPRESSION - COMMUNITY ACTIVITIES: I. SUPPORT MISSION LINK II. DEVELOP OR SUPPORT COMMUNAL ACTIVITIES THAT BRING ELDERS TOGETHER III. SUPPORT ACTIVITIES SPONSORED BY LEGACY PROJECT IV. DEVELOP OR SUPPORT ELDER HEALTH SCREENING INITIATIVES THAT INCLUDE DEPRESSION SCREENINGD. INCREASE SCREENING, IDENTIFICATION AND REFERRAL FOR HEALTH ISSUES SUCH AS OSTEOPOROSIS, ARTHRITIS / LUPUS, AND DEPRESSION - TARGET POPULATION: ELDERS - PROGRAMMATIC OBJECTIVES: I. INCREASE THE NUMBER OF ELDERS SCREENED FOR OSTEOPOROSIS, ARTHRITIS/LUPUS, DEPRESSION, JOINT ISSUES, AND OTHER LEADING ELDER HEALTH ISSUES/CONDITIONS II. LINK THOSE WHO HAVE CHRONIC DISEASE OR OTHER HEALTH ISSUES TO APPROPRIATE PRIMARY AND SPECIALTY CARE - COMMUNITY ACTIVITIES: I. DEVELOP OR SUPPORT ELDER HEALTH SCREENING INITIATIVES II. DEVELOP PRIMARY CARE AND SPECIALTY CARE REFERRAL NETWORKS FOR THOSE IN NEED - ELDER CARE - COMMUNITY PARTNERS - BOSTON PUBLIC HEALTH COMMISSION - MISSION HILL HEALTH MOVEMENT - ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD) - ROXBURY TENANTS OF HARVARD (RTH) - LEGACY PROJECT - PUBLIC HOUSING FACILITIES - MA DEPARTMENT OF PUBLIC HEALTH - NEBH AND CAREGROUP MEMBER ORGANIZATIONS ******IN ADDITION TO THE PROGRAMS NOTED ABOVE, NEBH ENGAGED IN AND/OR PARTICIPATED IN THE COMMUNITY BENEFIT ACTIVITIES LISTED BELOW:MUSCULOSKELETAL HEALTH ARTHRITIS AND LUPUS SUPPORT GROUPTHE GOAL OF THIS INITIATIVE IS TO ADDRESS ACCESS, EDUCATION, TREATMENT, AND SUPPORT NEEDS OF PEOPLE WITH ARTHRITIS AND LUPUS, ESPECIALLY UNDER-SERVED POPULATIONS IN THE CITY OF BOSTON, TARGETING WOMEN OF COLOR. THE LONG-TERM GOAL IS TO MEET THE IDENTIFIED NEEDS OF MORE SUPPORT AND EDUCATION. ARTHRITIS FOUNDATIONTHE ARTHRITIS FOUNDATION'S WALK TO CURE ARTHRITIS ENCOURAGES PEOPLE TO MOVE TO PREVENT OR TREAT ARTHRITIS. THERE ARE 27 MILLION PEOPLE WITH OSTEOARTHRITIS, THE MOST COMMON FORM OF ARTHRITIS, 1.3 MILLION PEOPLE WITH RHEUMATOID ARTHRITIS, AN AUTOIMMUNE DISEASE THAT CAN LEAD TO CHRONIC PAIN, LOSS OF FUNCTION AND DEFORMITY AND 300,000 CHILDREN (OR ONE IN 250) WITH JUVENILE ARTHRITIS, WHICH AFFECTS CHILDREN BETWEEN THE AGES OF INFANCY AND 18. BY 2030, AN ESTIMATED 67 MILLION AMERICANS AGES 18 YEARS OR OLDER ARE PROJECTED TO HAVE DOCTOR-DIAGNOSED ARTHRITIS. NEW ENGLAND BAPTIST HOSPITAL (NEBH) HAS PARTNERED WITH THE ARTHRITIS FOUNDATION'S, GREATER BOSTON CHAPTER ON THEIR WALK TO CURE ARTHRITIS, IN THE FIGHT AGAINST ARTHRITIS BY RAISING AWARENESS AND REDUCING THE IMPACT OF ARTHRITIS, WHICH IS THE NATION'S LEADING CAUSE OF DISABILITY. OSTEOPOROSIS OSTEOPOROSIS IS A MAJOR PUBLIC HEALTH THREAT FOR AN ESTIMATED 54 MILLION AMERICANS AGE 50 AND OLDER. TWENTY PERCENT OF NON-HISPANIC CAUCASIAN AND ASIAN WOMEN AGED 50 AND OLDER ARE ESTIMATED TO HAVE OSTEOPOROSIS, AND 52 PERCENT ARE ESTIMATED TO HAVE LOW BONE MASS. THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (DPH) HAS IDENTIFIED OSTEOPOROSIS AS A PUBLIC HEALTH ISSUE AND ESTABLISHED THE OSTEOPOROSIS AWARENESS PROGRAM. PHYSICAL ACTIVITY CAN IMPROVE THE OVERALL HEALTH AND WELL-BEING OF OLDER ADULTS. EVEN MODEST LEVELS OF ACTIVITY, DONE EACH DAY FOR A TOTAL OF 30 MINUTES, CAN PREVENT OR CONTROL OSTEOPOROSIS AND WEIGHT GAIN. NEBH SUPPORTS TWO WALKING GROUPS AT ROXBURY TENANTS OF HARVARD: A WALKING/EXERCISE PROGRAM HELD IN MISSION HILL, SERVING BETWEEN 20-40 WOMEN AND MEN BETWEEN THE AGES OF 40 AND 90 FROM ALL ETHNIC BACKGROUNDS AT EACH SESSION. THE HOSPITAL ALSO OFFERS EDUCATIONAL PROGRAMS SUCH AS STRETCHING, EATING HEALTHY, ETC. TO THIS GROUP.
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GREATER BOSTON SENIOR GAMES
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SINCE 2001, NEBH HAS BEEN A SPONSOR OF THE GREATER BOSTON SENIOR GAMES. THE GAMES PROVIDE OLDER ADULTS (50 YEARS AND OLDER) THE OPPORTUNITY TO PARTICIPATE IN ATHLETIC COMPETITIONS, PROMOTING WELLNESS, AND KEEPING THEM ACTIVE. BENEFITS INCLUDE: MAINTAINING PHYSICAL, MENTAL AND EMOTIONAL FITNESS, SOCIALIZATION, KEEPING AN ACTIVE LIFESTYLE, REDUCING ISOLATION, PARTICIPATING IN COMMUNITY ACTIVITIES, MEETING PEOPLE WITH DIFFERENT CULTURES, LANGUAGES AND CUSTOMS AND MAINTAINING ENERGY AND ENTHUSIASM. DURING THE FIVE-DAY GAMES, SENIOR ATHLETES PARTICIPATE IN THEIR CHOICE OF EVENTS INCLUDING BILLIARDS, BOCCE, BOWLING, GOLF, HALF-COURT BASKETBALL, HORSESHOES, SOCCER KICK, SOFTBALL THROW, SWIMMING, TENNIS, TRACK AND A NON-COMPETITIVE WALK. BETWEEN 80-100 ELDERS FROM THE MISSION HILL/ROXBURY COMMUNITY ATTEND THE EVENTS EACH YEAR.JR. CELTICS PROGRAMTHE JR. CELTICS PROGRAM, PRESENTED BY NEW ENGLAND BAPTIST HOSPITAL, CHALLENGES OVER 350 3RD TO 5TH GRADERS TO DEVELOP THEIR BASKETBALL GAME THROUGH SKILLS, DRILLS AND LEADERSHIP TRAINING AND LSO KEEPING THEM ACTIVE WITH PHYSICAL EXERCISE. THE JR. CELTICS HELD 2 PROGRAMS IN THE MISSION HILL AREA THAT BENEFITTED YOUTH IN MISSION HILL.MOBILITY AND ELDERLY TRANSPORTATION - THE MISSION LINKBECAUSE THE NEIGHBORHOOD OF MISSION HILL IS LOCATED ON A STEEP HILL, AT THE HIGHEST ELEVATION IN BOSTON, IT PRESENTS A SIGNIFICANT ISSUE TO MOBILITY FOR THE ELDERLY POPULATION. THE NEED FOR REGULAR TRANSPORTATION TO AVOID SOCIAL ISOLATION OF THOSE SENIORS IN THE MISSION HILL COMMUNITY WAS IDENTIFIED AS A CRITICAL ISSUE DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT. NEBH HAS BEEN A MAJOR SPONSOR OF THE MISSION LINK BUS FOR MANY YEARS TO INCREASE ACCESS TO HEALTHY FOOD OPTIONS, MEDICAL CARE, AND PUBLIC TRANSPORTATION. ELDER ISOLATIONTHE MISSION HILL LEGACY PROJECT BRINGS SENIORS FROM THROUGHOUT THE MISSION HILL NEIGHBORHOOD TOGETHER FOR SOCIAL AND EDUCATIONAL EVENTS. IT IS EVIDENT THAT THERE ARE MANY ISSUES RELATED TO OLDER ADULT HEALTH IN THE MISSION HILL COMMUNITY. NEBH IS COMMITTED TO THE MISSION HILL LEGACY PROJECT TO HELP WITH ELDER ISOLATION. NEBH PROVIDES AN EXERCISE PROGRAM AND A BIRTHDAY CELEBRATION PROGRAM THAT TRAVELS THROUGHOUT HOUSING DEVELOPMENTS IN MISSION HILL ON A QUARTERLY BASIS. OBESITY PREVENTION OBESITY HAS REACHED EPIDEMIC PROPORTIONS IN THE UNITED STATES. OBESITY IS BECOMING A MAJOR ISSUE IN MASSACHUSETTS AND HAS A SIGNIFICANT NEGATIVE IMPACT ON THE MUSCULOSKELETAL SYSTEM. NEBH HAS A LONG-STANDING COMMITMENT TO IMPROVING THE HEALTH STATUS OF BOSTON RESIDENTS, WITH A FOCUS ON MOVEMENT AND PREVENTION OF OBESITY. THE HOSPITAL SUPPORTS THE MISSION HILL LITTLE LEAGUE, MISSION HILL SOFTBALL LEAGUE, MAURICE J. TOBIN COMMUNITY CENTER, ROXBURY TENANTS OF HARVARD AND SOCIEDAD LATINA FOR THE PROGRAMS IN PHYSICAL ACTIVITY. THE HOSPITAL SUPPORTS THE GYM, LEAGUES, AND SUMMER CAMP AT THE MAURICE J. TOBIN COMMUNITY CENTER AS WELL AS THE HEALTH EDUCATORS IN ACTION PROGRAM AT SOCIEDAD LATINA. FOR MANY YEARS, NEBH HAS MAINTAINED AND IS A MAJOR CONTRIBUTOR TO THE LIGHTING AT MCLAUGHLIN FIELD AT NIGHT TO FOSTER ITS USE FOR PHYSICAL ACTIVITY. VIOLENCE PREVENTION CREATING A STRONG FEELING OF COMMUNITY AND FOCUSING ON YOUTH EDUCATION ARE TWO IMPORTANT ASPECTS OF VIOLENCE PREVENTION. NEBH WORKS WITH COMMUNITY GROUPS SUCH AS THE MISSION HILL YOUTH COLLABORATIVE (MHYC), THE MISSION HILL CRIME COMMITTEE AND THE BOSTON POLICE TO HELP EDUCATE OUR COMMUNITY AND TO KEEP OUR YOUTH ENGAGED IN PRODUCTIVE ACTIVITIES TO PREVENT VIOLENCE IN OUR COMMUNITY. THE MHYC SERVES OVER 1,500 YOUTH AND FAMILIES LIVING IN THE MISSION HILL AREA BY HOSTING EDUCATIONAL AND FUN EVENTS, SUCH AS HALLOWEEN ON THE HILL. SECURITY CAMERA'S AND ROUNDS NEBH PERFORMS SECURITY ROUNDS THROUGHOUT THE MISSION HILL AREA 7 DAYS A WEEK 24 HOURS A DAY AT SCHEDULED AND UNSCHEDULED INTERVALS. THIS SERVICE PROVIDES VIOLENCE DETERRENCE IN THE NEIGHBORHOOD. NEBH IN CONJUNCTION WITH COMMUNITY LEADERS REVIEWED AND UPGRADED ITS VIDEO SYSTEM TO ENHANCE NEIGHBORHOOD SECURITY. NEBH ALSO WORKS WITH THE MISSION HILL PROBLEM PROPERTIES TASK FORCES TO IMPROVE SAFETY AND SECURITY OF THE COMMUNITY. FOOD INSECURITY/HUNGER MISSION HILL ELEMENTARY SCHOOL, MISSION HILL LEGACY PROJECT AND BOSTONCANSHARE HUNGER IS ON THE RISE IN MASSACHUSETTS. FOOD IS NEEDED TO SUSTAIN FAMILIES DURING THE HOLIDAYS, SCHOOL VACATIONS AND WHEN THE CHILDREN ARE NOT ATTENDING SCHOOL. NEBH PARTNERED THE MISSION HILL ELEMENTARY SCHOOL AND THE MISSION HILL LEGACY PROJECT TO COMBAT HUNGER. NEBH IS COMMITTED TO COMBATING HUNGER IN OUR LOCAL NEIGHBORHOODS. EACH YEAR, MUCH NEEDED FOOD IS GIVEN DURING THE THANKSGIVING AND CHRISTMAS HOLIDAYS AND DURING SCHOOL VACATIONS. FOOD IS PROVIDED TO SUPPLEMENT STUDENT AND FAMILY FOOD NEEDS, AS MEALS ARE NOT SERVED BY THE SCHOOL SYSTEM DURING VACATIONS. LUNCH IS ALSO PROVIDED DURING THE WINTER MONTHS FOR CHILDREN PARTICIPATING IN THE YMCA AND THE CHILL FOUNDATION'S SKI PROGRAM. DURING THE HOLIDAYS, FOOD IS GIVEN TO SENIORS IN NEED THROUGH THE MISSION HILL LEGACY PROGRAM. NEBH DONATED TO THE BOSTON CAN SHARE PROGRAM WHICH IS THE ANNUAL FOOD DRIVE SPONSORED BY THE MAYOR'S OFFICE OF FOOD INITIATIVES.INCREASE ACCESS TO HEALTHY FOODS -- ACCESS TO HEALTHY FRUITS AND VEGETABLESAS IDENTIFIED IN THE CHNA, THERE IS A NEED IN MISSION HILL FOR ACCESS TO AFFORDABLE HEALTHY FOOD. NEBH IS COMMITTED TO PROVIDING ACCESS TO AFFORDABLE HEALTHY FOOD BY PARTNERING WITH THE MISSION HILL HEALTH MOVEMENT AND THE MISSION HILL FARMERS MARKET. NEBH OFFERED $2 COUPONS TO THE FARMERS MARKET EACH WEEK DURING THE SUMMER AND FALL TO MISSION HILL/ROXBURY RESIDENTS SO THAT THEY MAY PURCHASE FRESH FRUIT AND VEGETABLES AT A DISCOUNTED RATE. OVER 3,950 COUPONS WERE GIVEN OUT TO COMMUNITY RESIDENTS.
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2013 COMMUNITY HEALTH IMPLEMENTATION STRATEGY/PLAN - ISSUES NOT ADDRESSED
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AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, NEBH IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, AS NOTED IN SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE CHIP. IN THE 2013 CHIP WHICH GUIDED THE NEBH COMMUNITY BENEFIT ACTIVITIES FOR THE FISCAL PERIOD COVERED BY THIS FILING, EXAMPLES OF IDENTIFIED NEEDS THAT WERE NOT MET ARE CHRONIC DISEASE, BEHAVIORAL HEALTH AND MATERNAL AND CHILD HEALTH. IN ADDITION, THE MOST RECENTLY COMPLETED CHIP WHICH, AS NOTED PREVIOUSLY WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016 AND WHICH WILL GUIDE THE MEDICAL CENTER'S COMMUNITY BENEFIT ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2017, SEPTEMBER 30, 2018 AND SEPTEMBER 30, 2019, DOES NOT INCLUDE SOME NEEDS IDENTIFIED IN THE CHNA THAT WAS ALSO COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016. NEBH WILL NOT BE ADDRESSING CHRONIC DISEASE, BEHAVIORAL HEALTH AND MATERNAL AND CHILD HEALTH UNDER THIS MOST RECENTLY COMPLETED CHNA.NEBH IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES. IN ADDITION, THE HOSPITAL IS AN ORTHOPEDIC SPECIALTY-REFERRAL HOSPITAL FOR THE NEW ENGLAND REGION. IT IS NOT A FULL-SERVICE COMMUNITY HOSPITAL. BECAUSE OF THIS, AND TO AVOID DUPLICATION OF SERVICES, THE HOSPITAL IDENTIFIED RESOURCES AND STRENGTHS IN ITS SPECIALTY AREAS WHEN DETERMINING ITS PRIORITIES IN ITS IMPLEMENTATION STRATEGY/PLAN. (SCHEDULE H PART V SECTION B QUESTION 11)AS NOTED IN DETAIL ABOVE, NEBH'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND CHIP (SCHEDULE H PART VI QUESTION 2). ISSUES NOT ADDRESSED: CHRONIC DISEASE NEW ENGLAND BAPTIST HOSPITAL IS FULLY ENGAGED THROUGH ITS AFFILIATIONS WITH OTHER HOSPITALS, CLINICS AND PHYSICIAN GROUPS WHO HAVE SIGNIFICANT EXPERTISE IN CHRONIC DISEASE MANAGEMENT TO ENSURE THAT THE NEEDS OF OUR COMMUNITY ASSOCIATED WITH DIABETES, CONGESTIVE HEART FAILURE, ETC., ARE MET. BEHAVIORAL HEALTH SUPPORT PROGRAMS IN NEARBY CLINICS AND HOSPITALS HAVE BEEN ESTABLISHED TO PROVIDE BEHAVIORAL HEALTH MANAGEMENT TO BETTER ASSESS, MONITOR AND TREAT PATIENTS WITH MOOD DISORDER, SUBSTANCE ABUSE, ETC., IN OUR COMMUNITY. MATERNAL AND CHILD HEALTH NEW ENGLAND BAPTIST DOES NOT PROVIDE MATERNAL AND CHILD HEALTH. THE COMMUNITY IS SURROUNDED BY MEDICAL INSTITUTIONS THAT OFFER THESE SERVICES.
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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 NEBH CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AS WELL AS COMMUNITY BUILDING ACTIVITIES. AS DEMONSTRATED IN THIS SCHEDULE H, DURING THE PERIOD COVERED BY THIS FILING, 3.53% OF THE NEBH'S TOTAL EXPENSES WERE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. IN ADDITION AS NOTED IN THE NARRATIVE BELOW, THERE ARE ADDITIONAL ACTIVITIES AND EXPENDITURES WHICH NEBH CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. UNDER THE INSTRUCTIONS TO THIS SCHEDULE H QUESTION 7 THESE ITEMS ARE NOT QUANTIFIED IN SCHEDULE H QUESTION 7, BUT IT IS WORTH NOTING THAT IF NEBH HAD INCLUDED THESE IN SCHEDULE H QUESTION 7, THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WOULD BE 9.47% FOR THE PERIOD COVERED BY THIS FILING. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AT COST AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990.
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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FINANCIAL ASSISTANCE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEAS REPORTED IN THE NEBH CONSOLIDATED FINANCIAL STATEMENT AND IN THIS FORM 990, SCHEDULE H, NEBH'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND PAYMENTS TO AND RECEIPTS FROM THE HEALTH SAFETY NET TRUST, WAS $1,656,133 IN FISCAL YEAR ENDED SEPTEMBER 30, 2016 AND HAS BEEN REPORTED AS PART OF THE FINANCIAL ASSISTANCE AND CHARITY CARE REPORTED IN THIS SCHEDULE H, PART I, LINE 7A. OTHER UNCOMPENSATED CHARITY CARE - MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, NEW ENGLAND BAPTIST HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW INCOME FAMILIES, INCLUDING 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. CHARITY CARE & EXPENSES DIRECT OFFSETTING NET COMMUNITYMEANS TESTED GOV'T REVENUE BENEFITPROGRAMS EXPENSE A) CHARITY CARE AT COST $198,000 - $198,000 HEALTH SAFETY NET PAYMENTS 1,656,133 - 1,656,133 TOTAL 1,854,133 - 1,854,133B) UNREIMBURSED MEDICAID 856,149 (491,874) 364,275DURING THE FISCAL PERIOD COVERED BY THIS FILING, NEBH COLLECTED $491,874IN MEDICAID REVENUE WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY NEBH FOR SUCH SERVICES BY $364,275, AS REPORTED ON THIS SCHEDULE H, PART I, LINE 7B. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND THE HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 35.54% OR 45,801 OF NEBH'S PATIENT ENCOUNTERS WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO MEDICARE REVENUE OF $68,478,496. 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 $14,289,150. OF THIS AMOUNT, $4,231 IS INCLUDED IN FORM 990 SCHEDULE H PART I, LINE 7G AND RELATED TO THE PROVISION OF SUBSIDIZED HEALTH SERVICES FOR PROVIDING TO PATIENTS. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH NEBH CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE ADDITIONAL MEDICARE SHORTFALL OF $14,284,918 IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, NEBH HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. IF NEBH HAD INCLUDED THE FULL MEDICARE SHORTFALL IN SCHEDULE H QUESTION 7, THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WOULD BE 9.47% FOR THE PERIOD COVERED BY THIS FILING.BAD DEBTSAS REPORTED IN THE NEBH AUDITED FINANCIAL STATEMENT FOR THE PERIOD COVERED BY THIS FILING, IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, NEBH 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 WERE $134,332 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND IN THIS FORM 990 SCHEDULE H, PART III AS REQUIRED.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 NEBH AUDITED FINANCIAL STATEMENTS. AS PREVIOUSLY NOTED IN THIS FORM 990, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF NEBH AND AFFILIATES FOR FISCAL YEAR ENDED SEPTEMBER 30, 2016 INCLUDE THE ACCOUNTS OF THE NEW ENGLAND BAPTIST MEDICAL ASSOCIATES AN ENTITY INTEGRALLY RELATED TO HELPING NEBH ACCOMPLISH ITS CHARITABLE PURPOSES. THE NEBH FORM 990 IS PREPARED FOR NEBH ONLY AND AS SUCH, THE METRICS INCLUDED IN THESE FOOTNOTES WILL NOT TIE TO THE FACE OF THE NEBH FORM 990, SCHEDULE H.
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FINANCIAL STATEMENT FOOTNOTES:
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BAD DEBTSTHE AUDITED FINANCIAL STATEMENTS OF NEW ENGLAND BAPTIST HOSPITAL (HOSPITAL) INCLUDE THE HOSPITAL AND NEW ENGLAND BAPTIST MEDICAL ASSOCIATES, OF WHICH NEBH IS ITS SOLE MEMBER. FOOTNOTE 3 (INCLUDED IN ITS ENTIRETY BELOW) OF THOSE STATEMENTS DESCRIBE AND DETAIL FY 2016 BAD DEBT EXPENSE. IN ADDITION, AS NOTED IN SCHEDULE H PART III SECTION A QUESTION 1, THE HOSPITAL RECORDS BAD DEBTS IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. AS SUCH, THE EXPENSE REPRESENTS THE EXPECTED LOST REVENUE RATHER THAN THE FULL CHARGES OR AT COST.(3) COMMUNITY SERVICE AND UNCOMPENSATED CARETHE COST OF THE CORPORATION'S UNREIMBURSED CHARITY AND OTHER UNCOMPENSATED CARE CONSISTED OF THEFOLLOWING (IN THOUSANDS): YEAR ENDED SEPTEMBER 30 2016 2015UNREIMBURSED CHARITY CARE-AT COST $198 $250UNCOMPENSATED CARE EXPENSE $2,473 $3,477 TOTAL $2,671 $3,727 (A) UNREIMBURSED CHARITY CARETHE CORPORATION PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES, TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE CORPORATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE EXCEPT TO THE EXTENT REIMBURSED BY THE STATEWIDE HEALTH SAFETY NET (HSN).THE AMOUNT OF CHARITY CARE AT ESTABLISHED CHARGES, AND THE COST OF UNREIMBURSED CHARITY CARE AS ESTIMATED USING AN OVERALL RATIO OF COST TO CHARGE PROVIDED BY THE CORPORATION, IS COMPRISED OF THECOMPONENTS LISTED BELOW (IN THOUSANDS): YEAR ENDED SEPTEMBER 30 2016 2015CHARITY CARE-AT ESTABLISHED CHARGES $343 $407ESTIMATED COST OF CHARITY CARE $198 $250 (B) UNCOMPENSATED CARETHE CORPORATION ALSO PROVIDES FOR THE DELIVERY OF CHARITY CARE TO THE INDIGENT STATEWIDE THROUGH PAYMENTS TO THE HSN THAT IS OPERATED BY THE COMMONWEALTH OF MASSACHUSETTS. IN ADDITION, THE CORPORATION PROVIDES SERVICES THAT WERE NOT PAID BY PATIENTS AND, THEREFORE, ARE RECORDED AS BAD DEBTS. THE CORPORATION HAS REPORTED ITS GROSS OBLIGATION TO THE HSN FOR THE DELIVERY OF CHARITY CARE TO THE INDIGENT STATEWIDE AND BAD DEBTS AMOUNTING TO $1,656 AND $1,750 AT SEPTEMBER 30, 2016 AND 2015, RESPECTIVELY, WHICH IS REFLECTED AS UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED STATEMENTSOF OPERATIONS.PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSPATIENTS ACCOUNTS RECEIVABLE ARE REFLECTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS ACCOUNTS RECEIVABLE, THE CORPORATION 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 PAYER 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 CORPORATION, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, WILL WRITE OFF THE DIFFERENCE BETWEEN THE STANDARD RATES (OR DISCOUNTED RATES IF APPLICABLE) AND THE AMOUNT ACTUALLY COLLECTED 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 ACCOUNTSCREDIT AND COLLECTION POLICY GUIDING PRINCIPLESNEBH ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, THE HOSPITAL MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. THE HOSPITAL'S CREDIT AND COLLECTION POLICY, 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" REQUIREMENTS. 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 NEW ENGLAND BAPTIST HOSPITAL 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. NEBH 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, IN ITS DETERMINATION THAT A PATIENT IS LOW-INCOME, OR IN ITS BILLING AND COLLECTION PRACTICES.
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CREDIT AND COLLECTION POLICY - NOTICE OF AVAILABILITY OF FINANCIAL
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ASSISTANCE AND OTHER COVERAGE OPTIONS FINANCIAL ASSISTANCE IS INTENDED TO ASSIST LOW-INCOME PATIENTS WHO DO NOT OTHERWISE HAVE THE ABILITY TO PAY FOR THEIR HEALTH CARE SERVICES. SUCH ASSISTANCE TAKES INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL PROVIDES THIS ASSISTANCE FOR BOTH RESIDENTS AND NON-RESIDENTS OF MASSACHUSETTS; HOWEVER, THERE MAY NOT BE COVERAGE IN A STATE PUBLIC ASSISTANCE PROGRAM FOR A MASSACHUSETTS HOSPITAL'S SERVICES THROUGH AN OUT-OF STATE RESIDENT. IN ORDER FOR THE HOSPITAL TO ASSIST UNINSURED AND UNDERINSURED PATIENTS FIND THE MOST APPROPRIATE COVERAGE OPTIONS AS WELL AS DETERMINE IF THE PATIENT IS FINANCIALLY ELIGIBLE FOR ANY DISCOUNTS IN PAYMENTS, PATIENTS MUST ACTIVELY WORK WITH HOSPITALS TO VERIFY THE PATIENT'S DOCUMENTED FAMILY INCOME, OTHER INSURANCE COVERAGE, AND ANY OTHER INFORMATION THAT COULD BE USED IN DETERMINING ELIGIBILITY. THE HOSPITAL POSTS NOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE IN THE FOLLOWING LOCATIONS:- INPATIENT, CLINICS, URGENT CARE DEPARTMENT, ADMISSION AND/OR REGISTRATION AREAS;- PATIENT FINANCIAL COUNSELOR AREAS;- CENTRAL ADMISSION/REGISTRATION AREAS; AND/OR, - BUSINESS OFFICE AREAS THAT ARE OPEN TO PATIENTS.PLAIN LANGUAGE SUMMARIES OF THE FINANCIAL ASSISTANCE POLICY AND HOW TO APPLY FOR ASSISTANCE ARE ALSO INCLUDED IN BILLING STATEMENTS AND ARE ON THE HOSPITAL'S WEBSITE HTTPS://WWW.NEBH.ORG/MEDIA/235478/FINANCIAL_ASSISTANCE_POLICY_9.22.2016.PDF. IN ACCORDANCE WITH THE REGULATIONS UNDER IRC SECTION 501(R), NEBH HAS REVIEWED ITS COMMUNITY AND DETERMINED THAT NO FOREIGN SPEAKING POPULATION EXCEEDS THE LESSER OF 1000 OR 5% OF PATIENTS. AS SUCH, THE NEBH FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARIES ARE ONLY AVAILABLE IN ENGLISH. HOWEVER, ALTHOUGH NOT REQUIRED UNDER IRC SECTION 501(R), AS A SERVICE TO THE COMMUNITY NEBH'S PATIENT RIGHTS NOTICE IS AVAILABLE IN SPANISH, RUSSIAN AND GREEK. IN ADDITION, NEBH HAS INTERPRETERS AVAILABLE TO HELP PATIENTS WHOSE PRIMARY LANGUAGE IS NOT ENGLISH. (SCHEDULE H PART VI QUESTION 3).THE HOSPITAL WILL TRY TO IDENTIFY AVAILABLE COVERAGE OPTIONS FOR PATIENTS WHO MAY BE UNINSURED OR UNDERINSURED WITH THEIR CURRENT INSURANCE PROGRAM WHEN THE PATIENT IS SCHEDULING SERVICES, WHILE THE PATIENT IS AT NEBH, UPON DISCHARGE, AND/OR FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THE HOSPITAL WILL DIRECT ALL PATIENTS SEEKING INFORMATION ON AVAILABLE COVERAGE OPTIONS OR THOSE THAT THE HOSPITAL DETERMINES MAY BE ELIGIBLE TO THE HOSPITAL'S CERTIFIED APPLICATION COUNSELOR FOR HELP SCREENING 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.HOSPITALS HAVE NO ROLE IN SPECIFICALLY DETERMINING THE ELIGIBILITY FOR ENROLLMENT WITHIN A PUBLIC ASSISTANCE PROGRAM. IN MASSACHUSETTS, INDIVIDUALS WHO APPLY FOR COVERAGE IN MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP MUST DO SO THROUGH A SINGLE UNIFORM APPLICATION THAT IS SUBMITTED THROUGH THE STATE'S ENROLLMENT SYSTEM CALLED THE HEALTH INSURANCE EXCHANGE (HIX). THROUGH THIS PROCESS, THE INDIVIDUAL SUBMITS AN APPLICATION USING AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), SUBMITS A PAPER APPLICATION, OR COMPLETES THE APPLICATION OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. THE HOSPITAL ALSO HAS A CERTIFIED APPLICATION COUNSELOR WHO IS AVAILABLE TO HELP INDIVIDUALS WITH SUBMITTING THEIR APPLICATION EITHER ON THE WEBSITE OR ON PAPER.
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CREDIT AND COLLECTION POLICY - ENROLLMENT IN PUBLIC ASSISTANCE PROGRAMS
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HOSPITALS HAVE NO ROLE IN SPECIFICALLY DETERMINING THE ELIGIBILITY FOR ENROLLMENT WITHIN A PUBLIC ASSISTANCE PROGRAM. IN MASSACHUSETTS, INDIVIDUALS APPLING FOR COVERAGE IN MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP MUST DO SO THROUGH A SINGLE UNIFORM APPLICATION THAT IS SUBMITTED THROUGH THE STATE'S ENROLLMENT SYSTEM CALLED THE HEALTH INSURANCE EXCHANGE (HIX). THROUGH THIS PROCESS, THE INDIVIDUAL CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM THE HOSPITAL'S FINANCIAL COUNSELORS (CAC -"CERTIFIED APPLICATION COUNSELOR") WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION. IN ORDER TO APPLY FOR COVERAGE, THE FOLLOWING PROCESS OCCURS:1. AN INDIVIDUAL IS REQUESTED TO DEVELOP AN ONLINE ACCOUNT FOR USE BY THE STATE TO CONDUCT AN IDENTITY VERIFICATION OF THE INDIVIDUAL. ONCE THIS IS COMPLETED, THE INDIVIDUAL IS THEN ABLE TO SUBMIT A COMPLETED APPLICATION THROUGH THE HCENTIVE SYSTEM ON THE CONNECTOR WEBSITE. IF THE INDIVIDUAL DOES NOT WANT TO GO THROUGH THE ONLINE IDENTITY VERIFICATION SYSTEM, THEY CAN SUBMIT A PAPER APPLICATION. OTHER VERIFICATION MAY STILL BE NEEDED, INCLUDING PROOF OF INCOME, RESIDENCY, AND CITIZENSHIP. 2. ONCE THE APPLICATION IS RECEIVED, THE STATE WILL VERIFY THE ELIGIBILITY BY COMPARING THE INDIVIDUALS FINANCIAL AND OTHER DEMOGRAPHIC INFORMATION TO A FEDERAL DATA SITE AS WELL AS CONDUCTING AN INCOME REVIEW USING A MODIFIED ADJUSTED GROSS INCOME REVIEW. IF NECESSARY, THE INDIVIDUAL WILL ALSO SUBMIT ADDITIONAL VERIFICATION AS REQUESTED BY THE SYSTEM. ONCE THIS OCCURS, THE INDIVIDUAL IS DEEMED: A. ELIGIBLE FOR MASSHEALTH COVERAGE, UPON WHICH THE INDIVIDUAL IS NOTIFIED BY MAIL FROM MASSHEALTH, WHICH INCLUDES ELIGIBILITY INFORMATION INCLUDING START DATE AND OTHER PERTINENT INFORMATION; OR B. IF THE INDIVIDUAL IS ELIGIBLE FOR A QUALIFIED HEALTH PLAN THROUGH THE HEALTH CONNECTOR PROGRAM, THEY ARE NOTIFIED OF THEIR ELIGIBILITY AND DIRECTED TO TAKE ADDITIONAL STEPS. THIS INCLUDES: (1) CHOOSING A PLAN, (2) PAYING THEIR MONTHLY PREMIUM, (3) ENROLLING AND RECEIVING THEIR PROOF OF COVERAGE.CREDIT AND COLLECTION POLICY - ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMSAS NOTED IN THIS SCHEDULE H, PART III, SECTION C, QUESTION 9B, THE HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR THROUGH THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM, WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. FOR THOSE PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS PATIENTS BY SCREENING THEM FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. THESE INCLUDE, BUT ARE NOT LIMITED TO, PROGRAMS OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR OTHERS. WHEN APPLICABLE, THE HOSPITAL MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP THROUGH A SINGLE UNIFORM APPLICATION THAT IS SUBMITTED THROUGH THE STATE'S NEW ENROLLMENT SYSTEM CALLED THE HEALTH INSURANCE EXCHANGE (HIX). IT IS THE PATIENT'S OBLIGATION TO PROVIDE THE HOSPITAL AND ITS 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 EITHER THE VIRTUAL GATEWAY, 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 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. 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 PROGRAMS OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM OR MEDICAL HARDSHIP 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 APPLICATIONS FOR ASSISTANCE ARE REVIEWED AND PROCESSED BY THE MASSACHUSETTS OFFICE OF MEDICAID 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. AS PREVIOUSLY NOTED, THE HOSPITAL HAS NO ROLE IN THE DETERMINATION OF PROGRAM ELIGIBILITY MADE BY THE COMMONWEALTH, BUT MAY TAKE A DIRECT ROLE IN APPEALING OR SEEKING INFORMATION RELATED TO THE COVERAGE DECISIONS AT THE PATIENT'S REQUEST. 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.
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CREDIT AND COLLECTION POLICY - NEBH STANDARD COLLECTION PRACTICES
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AS PREVIOUSLY NOTED IN THE NARRATIVE TO THIS FORM 990, SCHEDULE H, NEW ENGLAND BAPTIST HOSPITAL 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, THE HOSPITAL HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. THE HOSPITAL MAKES THE SAME REASONABLE EFFORT AND FOLLOWS THE SAME REASONABLE PROCESS FOR COLLECTING ON BILLS OWED BY AN UNINSURED PATIENT AS IT DOES FOR ALL OTHER PATIENTS. THE HOSPITAL WILL FIRST SHOW THAT IT HAS A CURRENT UNPAID BALANCE THAT IS RELATED TO SERVICES PROVIDED TO THE PATIENT AND NOT COVERED BY A PRIVATE INSURER OR A FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL ALSO HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. THE HOSPITAL AND/OR ITS AGENTS DO NOT CHARGE INTEREST ON AN OVERDUE BALANCE FOR A LOW INCOME PATIENT OR ANY OTHER PATIENT. THE HOSPITAL FOLLOWS THE MASSACHUSETTS MEDICAL HARDSHIP INCOME LEVELS AND PERCENTAGES IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY. THERE ARE NO INCOME LIMITS FOR MEDICAL HARDSHIP. MASSACHUSETTS RESIDENTS AT ALL INCOME LEVELS ARE ELIGIBLE IF A PATIENT'S FAMILY ALLOWED MEDICAL BILLS ARE HIGHER THAN A SPECIFIED SLIDING SCALE PERCENTAGE OF FAMILY INCOME.IN ADDITION TO PUBLICIZING THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION B, QUESTION 16A-F, THERE IS MULTI-LANGUAGE SIGNAGE IN THE FINANCIAL COUNSELING OFFICE STATING THAT A COPY OF THE POLICY IS AVAILABLE UPON REQUEST.CREDIT AND COLLECTION POLICY - OUTSIDE COLLECTION AGENCIESTHE HOSPITAL 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 HOSPITAL'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.THE HOSPITAL 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 THIS CREDIT AND COLLECTION POLICY. ALL OUTSIDE COLLECTION AGENCIES HIRED BY THE HOSPITAL WILL PROVIDE THE PATIENT WITH AN OPPORTUNITY TO FILE A GRIEVANCE AND WILL FORWARD TO THE HOSPITAL THE RESULTS OF SUCH PATIENT GRIEVANCES. THE HOSPITAL REQUIRES THAT ANY OUTSIDE COLLECTION AGENCY THAT IT USES IS LICENSED BY THE COMMONWEALTH OF MASSACHUSETTS AND THAT THE OUTSIDE COLLECTION AGENCY ALSO IS IN COMPLIANCE WITH THE MASSACHUSETTS ATTORNEY GENERAL'S DEBT COLLECTION REGULATIONS.CREDIT AND COLLECTION POLICY - EXEMPTION FROM NEBH COLLECTION PRACTICES AND DISCOUNT FOR UNINSUREDTHE HOSPITAL EXEMPTS PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, 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.
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CREDIT AND COLLECTION POLICY - HOSPITAL FINANCIAL ASSISTANCE PROGRAMS
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NEW ENGLAND BAPTIST 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.(SCHEDULE H PART I QUESTION 3C).AS PREVIOUSLY NOTED IN THIS FILING, NEBH 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 NEBH 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 NEBH. 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 NEBH.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 NEBH.MEDICAL HARDSHIP: NEBH FOLLOWS THE COMMONWEALTH OF MASSACHUSETTS GUIDELINES FOR MEDICAL HARDSHIP BASED ON AN INDIVIDUAL'S HOUSEHOLD INCOME, ASSETS, FAMILY SIZE, EXPENSES AND MEDICAL NEEDS.(SCHEDULE H PART I QUESTION 3C.)AMOUNT GENERALLY BILLED (AGB): THE FINANCIAL ASSISTANCE POLICY ESTABLISHES A LIMIT ON THE AMOUNT CHARGED (AMOUNT GENERALLY BILLED OR AGB) FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. THE AGB IS CALCULATED BASED ON ALL CLAIMS THAT HAVE BEEN PAID IN FULL FOR MEDICALLY NECESSARY CARE BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS OVER THE PREVIOUS TWELVE MONTH PERIOD. AT THE TIME OF FILING, NEBH'S AGB IS 72% AND 60% FOR INPATIENT AND OUTPATIENT SERVICES RESPECTIVELY.BILLING AND COLLECTIONS BEFORE REASONABLE EFFORTSNEITHER NEBH 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.FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLANDETAIL RELATED TO THE NEBH COMMUNITY HEALTH NEEDS ASSESSMENT, IMPLEMENTATION STRATEGY AND COMMUNITY BENEFITS ACTIVITIES HAS BEEN PROVIDED IN FORM 990, SCHEDULE H, PART V, SECTION C ABOVE.COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, THE MEDICAL CENTER'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 MEDICAL CENTER'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 TO THE NEBH COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) WHICH WERE APPROVED BY BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, NEBH PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL. THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND AT THE HOSPITAL UPON REQUEST. 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 HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - RESEARCHTHE NEBH DIVISION OF RESEARCH SUPPORTS EXISTING RESEARCH GROUPS WITHIN AND OUTSIDE OF THE HOSPITAL IN CLINICAL, TRANSACTIONAL, AND PATIENT-CENTERED RESEARCH, WITH A FOCUS ON THREE KEY AREAS: JOINT REPLACEMENT, OSTEOARTHRITIS, AND SPINE RESEARCH. EACH YEAR, THE DIVISION OF RESEARCH HOSTS A SYMPOSIUM WHERE RESEARCH PRINCIPAL INVESTIGATORS SHARE THEIR KNOWLEDGE TO THE PUBLIC. NEBH RESEARCH IS PREDOMINANTLY SELF-FUNDED. DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH REPORTED $1,884,334 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE. EXPENSE DIRECT OFFSETTING NET COMMUNITY REVENUE BENEFIT EXPENSEH)RESEARCH SELF-FUNDED(TOTAL EXPENSE LESS INDUSRTY REIMBURS) 1,990,367 (106,033) 1,884,334
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.