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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 BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENT LAHEY CLINIC HOSPITAL, INC. INCLUDES BOTH LAHEY HOSPITAL & MEDICAL CENTER (LHMC) AND LAHEY MEDICAL CENTER-PEABODY. TOGETHER, THEY ARE REFERRED TO AS LHMC/LMCP THROUGHOUT THIS REPORT. BOTH HOSPITALS ARE PART OF THE BETH ISRAEL LAHEY HEALTH (BILH) SYSTEM. BILH WAS ESTABLISHED WITH AN APPRECIATION FOR THE IMPORTANCE OF CARING FOR PATIENTS AND COMMUNITIES IN NEW AND BETTER WAYS. BILH BRINGS TOGETHER AN EXCEPTIONAL ARRAY OF CLINICAL ORGANIZATIONS SPANNING THE FULL CONTINUUM OF HEALTH CARE DELIVERYACADEMIC AND TEACHING HOSPITALS, COMMUNITY HOSPITALS, AMBULATORY AND URGENT CARE CENTERS, BEHAVIORAL HEALTH PROGRAMS AND HOME CAREIN A SHARED MISSION TO EXPAND ACCESS TO GREAT CARE AND ADVANCE THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. LHMC/LMCP AFFIRMS ITS COMMITMENT TO IDENTIFYING AND SERVING THE HEALTH AND WELLNESS NEEDS OF ITS COMMUNITY THROUGH A COMMUNITY BENEFITS PROGRAM. THE FOUNDATION OF THIS PROGRAM IS A COLLABORATIVE INITIATIVE BETWEEN COLLEAGUES, COMMUNITY LEADERS, REPRESENTATIVES OF COMMUNITY AGENCIES AND COMMUNITY RESIDENTS. THROUGH COLLABORATIVE PLANNING AND COALITION BUILDING, LHMC/LMCP SERVES AS A CATALYST AND COMMUNITY LEADER STRIVING TO IMPROVE THE HEALTH STATUS OF COMMUNITY MEMBERS.MORE BROADLY, LHMC/LMCP'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING THE LHMC/LMCP'S STAFF, INCLUDING ITS LEADERSHIP, AND DOZENS OF COMMUNITY PARTNERS IN THE COMMUNITY HEALTH ASSESSMENT PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY; ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT LHMC/LMCP'S SERVICE AREA IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. IN THIS REGARD, SPECIAL ATTENTION IS GIVEN TO ENGAGING DIVERSE PERSPECTIVES OF THOSE WHO ARE NOT PATIENTS OF LHMC/LMCP AND THOSE WHO ARE OFTEN LEFT OUT OF THESE ASSESSMENT, PLANNING, AND PROGRAM IMPLEMENTATION PROCESSES; ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN LHMC/LMCP'S CBSA THAT ARE GEARED TOWARD IMPROVING THE CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTH CARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF LEADING HEALTH ISSUES; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., PUBLIC HEALTH, HEALTH CARE, SOCIAL SERVICES, BUSINESS, ACADEMIC, AND COMMUNITY HEALTH) TO ADVOCATE FOR, SUPPORT, AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS SUMMARYDURING THE FISCAL YEAR COVERED BY THIS FILING, LHMC/LMCP PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $1,919,625 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMLHMC/LMCP IS A MEMBER OF BILH. WHILE LHMC/LMCP OVERSEES LOCAL COMMUNITY BENEFITS PROGRAMMING AND COMMUNITY ENGAGEMENT EFFORTS, COMMUNITY BENEFITS IS UNDER THE PURVIEW OF THE BILH CHIEF STRATEGY OFFICER. THIS STRUCTURE ENSURES THAT COMMUNITY BENEFITS EFFORTS, PRIORITIZATION, PLANNING AND STRATEGY ALIGN AND/OR ARE INTEGRATED WITH LOCAL AND SYSTEM STRATEGIC AND REGULATORY PRIORITIES. THE LHMC/LMCP COMMUNITY BENEFITS PROGRAM IS LED BY A REGIONAL MANAGER OF COMMUNITY BENEFITS/COMMUNITY RELATIONS. THE REGIONAL MANAGER HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE LHMC/LMCP PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS/COMMUNITY RELATIONS, THE LATTER OF WHOM REPORTS DIRECTLY TO THE BILH CHIEF STRATEGY OFFICER. IT IS THE RESPONSIBILITY OF THESE SENIOR MANAGERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF THE UNDERSERVED POPULATIONS ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE (IRC) SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. LHMC/LMCP COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN 2019. THAT CHNA WAS APPROVED BY THE LHMC/LMCP BOARD OF TRUSTEES ON SEPTEMBER 16, 2019. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 16, 2019, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE MOST RECENT CHNA AND THE ASSOCIATED IMPLEMENTATION STRATEGY ARE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OF LHMC/LMCP'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS COMMONWEALTH ATTORNEY GENERAL'S OFFICE (AGO) AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT LHMC/LMCP ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW LHMC/LMCP, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONSLHMC/LMCP'S CBSA INCLUDES EIGHT COMMUNITIES: ARLINGTON, BEDFORD, BILLERICA, BURLINGTON, LEXINGTON, LOWELL, LYNNFIELD, AND PEABODY. GIVEN THAT LHMC/LMCP OPERATES MULTIPLE BUILDINGS UNDER A SINGLE STATE LICENSE AND SERVES DIFFERENT GEOGRAPHIC AREAS AND POPULATIONS, THE COMMUNITIES THAT ARE PART OF THE CBSA ARE AN AGGREGATE OF THESE AREAS AND POPULATIONS. THE CBSA DOES NOT EXCLUDE MEDICALLY UNDERSERVED, LOW-INCOME, OR MINORITY POPULATIONS. FOR THIS ASSESSMENT, LHMC/LMCP MADE EVERY EFFORT TO IDENTIFY THE HEALTH NEEDS OF ALL RESIDENTS WITHIN ITS CBSA, REGARDLESS OF WHETHER THEY USE OR HAVE USED SERVICES AT ITS FACILITIES. TARGET POPULATIONS FOR LHMC/LMCP'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).LHMC/LMCP'S'S TARGET POPULATIONS FOCUS ON MEDICALLY UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN THE CBSA, AS FOLLOWS: LOW-RESOURCE INDIVIDUALS AND FAMILIES OLDER ADULTS YOUTH/ADOLESCENTS INDIVIDUALS AND FAMILIES WITH CHRONIC/COMPLEX CONDITIONSLHMC/LMCP'S PROGRAMS MIRROR THE FIVE CORE PRINCIPLES OUTLINED BY THE PUBLIC HEALTH INSTITUTE IN TERMS OF THE "EMPHASIS ON COMMUNITIES WITH DISPROPORTIONATE UNMET HEALTH-RELATED NEEDS; EMPHASIS ON PRIMARY PREVENTION; BUILDING A SEAMLESS CONTINUUM OF CARE; BUILDING COMMUNITY CAPACITY; AND COLLABORATIVE GOVERNANCE." PROGRAMS DEVELOPED WILL AIM TO ADDRESS AND IMPROVE UPON THE FOLLOWING PRIORITY AREAS: CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS MENTAL HEALTH DISORDERS AND SUBSTANCE USE DISORDERS SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE ASSESSMENT BEGAN WITH THE CREATION OF A STEERING COMMITTEE COMPOSED OF REPRESENTATIVES FROM THE FORMER LAHEY HEALTH SYSTEM, INCLUDING LHMC/LMCP, WINCHESTER HOSPITAL, AND BEVERLY HOSPITAL-ADDISON GILBERT HOSPITAL. THE HOSPITAL HIRED JSI, A PUBLIC HEALTH RESEARCH AND CONSULTING FIRM IN BOSTON, TO COMPLETE THE CHNA AND IMPLEMENTATION STRATEGY. THE STEERING COMMITTEE PROVIDED VITAL OVERSIGHT OF THE CHNA APPROACH, METHODS, AND REPORTING PROCESS. LHMC/LMCP ENGAGED ITS CBAC, MADE UP OF HOSPITAL LEADERSHIP AND CLINICAL STAFF, LOCAL SERVICE PROVIDERS, AND KEY COMMUNITY STAKEHOLDERS, EXTENSIVELY THROUGHOUT THIS PROCESS. THIS GROUP MET THREE TIMES OVER THE COURSE OF THE ASSESSMENT AND PROVIDED INPUT ON THE ASSESSMENT APPROACH, VETTED PRELIMINARY FINDINGS, AND HELPED PRIORITIZE COMMUNITY HEALTH ISSUES AND VULNERABLE POPULATIONS. THE CBAC ALSO REVIEWED AND PROVIDED FEEDBACK ON THE ASSOCIATED IMPLEMENTATION STRATEGY.
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FORM 990 SCHEDULE H PART V, SECTION C:
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FINALLY, THE PROJECT ADVISORY COMMITTEE (PAC) WAS CONVENED TO PROVIDE INPUT AND FEEDBACK FROM A SYSTEM WIDE PERSPECTIVE. THE PAC WAS COMPOSED OF REPRESENTATIVES FROM CLINICAL AND ADMINISTRATIVE LEADERSHIP AND LOCAL PUBLIC HEALTH OFFICIALS, ALONG WITH COMMUNITY RELATIONS STAFF. THE PAC MET THREE TIMES OVER THE COURSE OF THE PROJECT, PROVIDED BROAD-BASED FEEDBACK ON THE APPROACH, AND VETTED PRELIMINARY FINDINGS RELATIVE TO PRIORITY COMMUNITY HEALTH ISSUES AND VULNERABLE POPULATIONS. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSQUANTITATIVE DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN LHMC/LMCP'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF THE HEALTH-RELATED ISSUES. SOURCES INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017 AND 2018-2019) FBI UNIFORM CRIME REPORTS (2017) MDPH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015) MDPH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017) MDPH, ANNUAL REPORTS ON BIRTHS (2016) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY2013-2017) MASSACHUSETTS CHIA HOSPITAL DISCHARGES (2017) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018) YOUTH RISK BEHAVIOR SURVEYS (2017 AND 2018)TO AUGMENT THE QUANTITATIVE DATA FROM MDPH, JSI WORKED WITH THE MASSACHUSETTS CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA) TO OBTAIN 2018 INPATIENT HOSPITAL DISCHARGE DATA FOR ALL OF THE MUNICIPALITIES IN THE SERVICE AREA.THE IMPACT OF ANY ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE HOSPITAL FACILITY'S PRIOR CHNA(S) WAS NOT INCLUDED IN THIS MOST RECENTLY CONDUCTED CHNA.
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SCHEDULE H, PART V, SECTION B, LINE 5:
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2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS LHMC/LMCP WITH THE HELP OF JOHN SNOW, INC., CONDUCTED 28 KEY INFORMANT INTERVIEWS WITH COMMUNITY STAKEHOLDERS, INCLUDING REPRESENTATIVES FROM HOSPITAL AND MUNICIPAL LEADERSHIP, THE BUSINESS COMMUNITY, PUBLIC HEALTH DEPARTMENTS, SOCIAL SERVICE PROVIDERS, SCHOOLS, AND COMMUNITY HEALTH COALITIONS. JSI ALSO FACILITATED FIVE FOCUS GROUPS. APPENDIX A IN THE LHMC/LMCP CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.2019 COMMUNITY HEATH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS FIVE FOCUS GROUPS WITH IDENTIFIED UNDERSERVED POPULATIONS WERE ALSO HELD. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE CITY AND TOWNS THAT COMPRISE THE LHMC/LMCP REGION. PARTICIPANTS REPRESENTED DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., YOUTH, SENIORS, MINORITY GROUPS AND FOREIGN-LANGUAGE SPEAKERS) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 500 PEOPLE. APPENDIX A IN THE LHMC CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTS THE LHMC/LMCP COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS DEVELOPED BY A TEAM COMPRISED OF HOSPITAL LEADERSHIP, MEDICAL STAFF, COMMUNITY BENEFITS STAFF AND COMMUNITY REPRESENTATION. THE GROUP REVIEWED PROGRESS TOWARD GOALS AND OBJECTIVES OF THE PRIOR THREE-YEAR PERIOD, AS WELL AS THE CURRENT DATA COLLECTED THROUGH THE CHNA, TO HELP ENVISION AND DEFINE PRIORITY AREAS FOR THE FUTURE. THE IMPLEMENTATION STRATEGY IDENTIFIED PRIORITY AREAS AND DEFINED GOALS, ALONG WITH OBJECTIVES FOR EACH GOAL AND DRAFTED STRATEGIES TO OPERATIONALIZE THESE OBJECTIVES. 2019 COMMUNITY HEALTH NEEDS ASSESSMENTKEY FINDINGSBELOW IS A HIGH-LEVEL SUMMARY OF HEALTH-RELATED FINDINGS THAT WERE IDENTIFIED AFTER A COMPREHENSIVE REVIEW OF ALL THE QUANTITATIVE AND QUALITATIVE INFORMATION THAT WAS COLLECTED AS PART OF THE CHNA. A DETAILED AND IN-DEPTH DISCUSSION OF KEY FINDINGS IS INCLUDED IN THE FULL CHNA REPORT. SOCIAL DETERMINANTS OF HEALTH (E.G., TRANSPORTATION, ECONOMIC STABILITY, ACCESS TO CARE, HOUSING, FOOD INSECURITY) AFFECT MANY SEGMENTS OF THE POPULATION. A KEY THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND COMMUNITY HEALTH SURVEY WAS THE CONTINUED IMPACT THAT SOCIAL DETERMINANTS OF HEALTH HAVE ON RESIDENTS OF LHMC/LMCP'S SERVICE AREA, ESPECIALLY THOSE WHO ARE LOW TO MODERATE INCOME, ARE FRAIL OR HOMEBOUND, HAVE MENTAL HEALTH OR SUBSTANCE USE ISSUES, OR LACK A CLOSE SUPPORT SYSTEM. CERTAIN POPULATIONS ARE MORE VULNERABLE TO HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE ENROLLMENT AND THE COMMUNITIES THAT MAKE UP LHMC/LMCP'S SERVICE AREA HAVE STRONG, ROBUST SAFETY-NET SYSTEMS, THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW-INCOME, MEDICAID-COVERED, UNINSURED, AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL AND BEHAVIORAL SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE, AND IMPROVE THE QUALITY OF PRIMARY MEDICAL CARE, MEDICAL SPECIALTY, AND BEHAVIORAL HEALTH SERVICES. MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY/STRESS, ACCESS TO TREATMENT, STIGMA) UNDERLIE MANY HEALTH AND SOCIAL CONCERNS. NEARLY EVERY KEY INFORMANT INTERVIEW, FOCUS GROUP, AND LISTENING SESSION INCLUDED DISCUSSIONS ON THE IMPACT OF MENTAL HEALTH ISSUES. A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION INDICATED THAT DEPRESSION, ANXIETY/STRESS, AND SOCIAL ISOLATION WERE THE LEADING CONCERNS. THERE WERE PARTICULAR CONCERNS ABOUT THE IMPACT OF DEPRESSION, ANXIETY, AND E-CIGARETTES/VAPING ON YOUTH AND SOCIAL ISOLATION AMONG OLDER ADULTS. SUBSTANCE DEPENDENCY CONTINUES TO AFFECT INDIVIDUALS, FAMILIES, AND COMMUNITIES. THE OPIOID EPIDEMIC CONTINUES TO BE AN AREA OF FOCUS. BEYOND OPIOIDS, KEY INFORMANTS WERE ALSO CONCERNED ABOUT ALCOHOL MISUSE, CHANGING COMMUNITY NORMS IN LIGHT OF THE LEGALIZATION OF RECREATIONAL MARIJUANA USE, AND E-CIGARETTES/VAPING AMONG ADOLESCENTS. CHRONIC DISEASES (E.G., CARDIOVASCULAR DISEASE, CANCER, DIABETES, ASTHMA) REQUIRE MORE EDUCATION, SCREENING/EARLY INTERVENTION, AND MANAGEMENT AND A FOCUS ON RISK FACTORS. ALTHOUGH THERE WAS MAJOR EMPHASIS ON BEHAVIORAL HEALTH ISSUES, MANY KEY INFORMANTS, FOCUS GROUP PARTICIPANTS, AND LISTENING SESSION PARTICIPANTS IDENTIFIED A NEED TO ADDRESS THE MANY RISK FACTORS ASSOCIATED WITH CHRONIC AND COMPLEX HEALTH CONDITIONS. PHYSICAL INACTIVITY AND POOR NUTRITION/LIFESTYLE WERE DISCUSSED BY MANY, WITH SOME OF THESE ISSUES BEING ASSOCIATED WITH AGE (MOBILITY ISSUES AMONG OLDER ADULTS), EDUCATION/HEALTH LITERACY (LACK OF UNDERSTANDING ABOUT HEALTHY EATING), AND SOCIOECONOMIC STATUS (FRESH FOODS BEING EXPENSIVE AND GYMS AND HEALTH CENTERS BEING UNAFFORDABLE). ADDRESSING THE LEADING RISK FACTORS IS AT THE ROOT OF MANY CHRONIC DISEASE PREVENTION AND MANAGEMENT STRATEGIES.COMMUNITY HEALTH NEEDS ASSESSMENT AND ACTIVITIES REPORTED IN THIS FILINGTHE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, WILL INFORM LHMC'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022.COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDSLHMC/LMCP STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY THAT ARE AVAILABLE UPON REQUEST AND ON THE HOSPITAL'S WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/WP-CONTENT/UPLOADS/SITES/2/2019/09/LHMC-FINAL-CHNA-PDF.PDF.IN ADDITION, THE CHNA THAT WAS PREVIOUSLY COMPLETED DURING THE FISCAL YEAR ENDED FY16 IS AVAILABLE ON THE HOSPITAL'S WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/WP-CONTENT/UPLOADS/SITES/2/2019/08/LHMC-MASTER-REPORT-AND-APPENDICES.PDF.BOTH DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A). COMMUNITY HEALTH NEEDS ASSESSMENT AND ACTIVITIES REPORTED IN THIS FILINGTHE PREVIOUS NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE LHMC BOARD OF TRUSTEES ON FEBRUARY 22, 2016 AND INFORMED LHMC'S COMMUNITY BENEFITS PROCESS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2017; SEPTEMBER 30, 2018; AND SEPTEMBER 30, 2019. AS SUCH, THE ACCOMPLISHMENTS AND ACTIVITIES INCLUDED IN THIS FILING AND REPORTED BELOW RELATE TO THE DOCUMENTS APPROVED AS OF SEPTEMBER 30, 2015. 2016 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYIN FY16, LAHEY HOSPITAL & MEDICAL CENTER, IN CONJUNCTION WITH ALL FOUR HOSPITALS IN THE LAHEY HEALTH SYSTEM, COMPLETED THE REQUIRED TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). 2016 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONSLHMC'S COMMUNITY BENEFITS INVESTMENTS ARE FOCUSED ON EXPANDING ACCESS, ADDRESSING BARRIERS TO CARE AND IMPROVING THE HEALTH STATUS OF RESIDENTS LIVING IN THE FOLLOWING 13, MOSTLY CONTIGUOUS, MUNICIPALITIES LOCATED IN MIDDLESEX AND ESSEX COUNTIES ARLINGTON, BEDFORD, BILLERICA, BURLINGTON, LEXINGTON, PEABODY, READING, STONEHAM, TEWKSBURY, WAKEFIELD, WILMINGTON, WINCHESTER AND WOBURN. PRIORITY TARGET POPULATIONS LHMC FOCUSES ITS ACTIVITIES TO MEET THE NEEDS OF ALL SEGMENTS OF THE POPULATION WITH RESPECT TO AGE, RACE, ETHNICITY, INCOME, GENDER IDENTITY AND SEXUAL ORIENTATION TO ENSURE THAT ALL RESIDENTS HAVE THE OPPORTUNITY TO LIVE HEALTHY LIVES. HOWEVER, BASED ON THE ASSESSMENT'S QUANTITATIVE AND QUALITATIVE FINDINGS, THERE WAS BROAD AGREEMENT THAT LHMC'S CHIP SHOULD TARGET LOW-INCOME POPULATIONS (LOW-INCOME INDIVIDUALS/FAMILIES, OLDER ADULTS ON FIXED INCOMES, AND HOMELESS), OLDER ADULT POPULATIONS (FRAIL, ISOLATED OLDER ADULTS), YOUTHS/ADOLESCENTS (13-18-YEAR-OLDS, THOSE IN MIDDLE SCHOOL AND HIGH SCHOOL) AND OTHER VULNERABLE POPULATIONS (DIVERSE RACIAL/ETHNIC MINORITY AND LINGUISTICALLY ISOLATED POPULATIONS) THAT ARE MORE IIKELY THAN OTHER COHORTS TO FACE DISPARITIES IN ACCESS AND HEALTH OUTCOMES.2016 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE CHNA WAS CONDUCTED IN THREE PHASES, ALLOWING LHMC TO COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA, ENGAGE AND INVOLVE KEY INTERNAL AND EXTERNAL STAKEHOLDERS, DEVELOP A REPORT AND DETAILED CHIP AND COMPLY WITH ALL STATE AND FEDERAL IRS COMMUNITY BENEFITS REQUIREMENTS. DATA SOURCES INCLUDED A BROAD ARRAY OF PUBLICLY AVAILABLE SECONDARY DATA, KEY INFORMANT INTERVIEWS, COMMUNITY AND FORUMS AND THE 2015 LHMC COMMUNITY HEALTH SURVEY, WHICH CAPTURED INFORMATION FROM HUNDREDS OF RANDOM HOUSEHOLDS IN LHMC'S PRIMARY SERVICE AREA.
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SCHEDULE H, PART V, SECTION B, LINE 5:
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2016 COMMUNITY HEALTH NEEDS ASSESSMENTMAJOR HEALTH NEEDS AND HOW PRIORITIES WERE DETERMINEDIN RESPONSE TO THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2016 CHNA, LHMC DEVELOPED A THREE YEAR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE CHIP WAS DEVELOPED WITH INPUT FROM THE LHMC COMMUNITY BENEFITS ADVISORY BOARD AND APPROVED BY THE LHMC BOARD OF DIRECTORS. IN ADDITION, FEEDBACK FROM COMMUNITY REPORT OUT SESSIONS WAS TAKEN INTO CONSIDERATION WHEN DEVELOPING THE PLAN.THE COMMUNITY BENEFITS PROGRAMS OFFERED IN FY16 WERE DESIGNED TO ADDRESS THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2016 CHNA, ALONG WITH THE MASSACHUSETTS STATEWIDE HEALTH PRIORITIES IDENTIFIED BY THE EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES.HEALTH NEEDS IDENTIFIED IN THE 2016 CHNA: BEHAVIORAL HEALTH/SUBSTANCE ABUSE ELDER HEALTH SOCIAL ISOLATION DEPRESSION CARE MANAGEMENT WELLNESS PREVENTION AND CHRONIC DISEASE MANAGEMENT2016 COMMUNITY HEALTH NEEDS ASSESSMENTKEY FINDINGS SOCIAL DETERMINANTS OF HEALTH HAVE A MAJOR IMPACT ON MANY SEGMENTS OF THE SERVICE AREA'S POPULATION. RELATIVE TO THE COMMONWEALTH OVERALL, MOST OF THE COMMUNITIES IN LHMC'S PRIMARY SERVICE AREA ARE AFFLUENT AND FARE WELL WITH RESPECT TO THE LEADING HEALTH INDICATORS. HOWEVER, THERE ARE SEGMENTS OF THE POPULATION THAT STRUGGLE TO ACCESS NEEDED HEALTH SERVICES AND EXPERIENCE DISPARITIES IN HEALTH OUTCOMES. ONE OF THE DOMINANT THEMES FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH HAVE ON THE PRIMARY SERVICE AREA, PARTICULARLY ON LOW-INCOME, RACIALLY/ETHNICALLY DIVERSE, AND OLDER ADULT COHORTS. SOCIAL DETERMINANTS SUCH AS POVERTY, LACK OF EMPLOYMENT OPPORTUNITIES, LIMITED TRANSPORTATION, LIMITED HEALTH LITERACY, LINGUISTIC BARRIERS, LACK OF SOCIAL SUPPORT, AND DOMESTIC VIOLENCE LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND THEIR FAMILY'S HEALTH. LIMITED ACCESS TO PRIMARY CARE, ORAL HEALTH, AND BEHAVIORAL HEALTH SERVICES FOR LOW-INCOME, MEDICAID-INSURED, UNINSURED, AND OTHER VULNERABLE POPULATION SEGMENTS. MASSACHUSETTS HAS ONE OF THE HIGHEST RATES OF HEALTH INSURANCE COVERAGE AND ONE OF THE STRONGEST, MOST ROBUST HEALTH SERVICE SYSTEMS IN THE NATION. NONETHELESS, THERE ARE STILL POCKETS OF LOW-INCOME, MEDICAID-INSURED, UNINSURED, AND UNDERINSURED RESIDENTS IN THE SERVICE AREA WHO HAVE LIMITED ACCESS TO NEEDED SERVICES AND/OR ARE NOT PROPERLY ENGAGED IN ESSENTIAL MEDICAL, ORAL, AND BEHAVIORAL HEALTH SERVICES. BEHAVIORAL HEALTH AND ORAL HEALTH SERVICES ARE A PARTICULAR CONCERN. AS WILL BE DISCUSSED BELOW, THESE POPULATIONS ARE, IN TURN, MORE LIKELY TO USE THE EMERGENCY ROOM AND MORE LIKELY TO HAVE HEALTH RISK FACTORS SUCH AS OBESITY, POOR FITNESS, AND RISKY ALCOHOL USE, AND BE MORE PRONE TO DIABETES, HYPERTENSION, AND ASTHMA. HIGH RATES OF THE LEADING HEALTH RISK FACTORS. ANOTHER LEADING FINDING DRAWN FROM THE ASSESSMENT'S QUANTITATIVE DATA WAS THE FACT THAT MANY CITIES AND TOWNS IN LHMC'S PRIMARY SERVICE AREA HAVE RATES OF CHRONIC PHYSICAL AND BEHAVIORAL HEALTH CONDITIONS THAT ARE HIGHER THAN COMMONWEALTH AVERAGES. IN SOME PEOPLE, THESE CONDITIONS HAVE UNDERLYING GENETIC AND BIOLOGICAL CAUSES THAT ARE DIFFICULT TO COUNTER. HOWEVER, MOST OF THESE CONDITIONS ARE CONSIDERED PREVENTABLE OR AT LEAST MANAGEABLE. ADDRESSING THE LEADING HEALTH RISK FACTORS (I.E., OBESITY, LACK OF FITNESS, POOR NUTRITION, TOBACCO USE, AND ALCOHOL ABUSE) IS CRITICAL TO CHRONIC DISEASE PREVENTION AND MANAGEMENT EFFORTS. IT SHOULD BE NOTED THAT MOST CITIES AND TOWNS IN LHMC'S PRIMARY SERVICE AREA FARE WELL AS A WHOLE COMPARED WITH COMMONWEALTH AVERAGES FOR THESE RISK FACTORS. HOWEVER, THERE ARE CITIES/TOWNS WHOSE RATES ARE NOT AS FAVORABLE AND SEGMENTS OF POPULATIONS IN ALL MUNICIPALITIES THAT DO NOT FARE AS WELL AND HAVE MAJOR RISK FACTORS. AS STATED ABOVE, THOSE AT RISK ARE MORE LIKELY TO BE LOW INCOME, OLDER ADULTS, OR FOREIGN BORN. HIGH RATES OF SUBSTANCE USE AND MENTAL HEALTH ISSUES. ONE OF THE LEADING FINDINGS FROM THE ASSESSMENT WAS THE PROFOUND IMPACT THAT SUBSTANCE USE AND MENTAL HEALTH ARE HAVING ON INDIVIDUALS, FAMILIES AND COMMUNITIES THROUGHOUT LHMC'S PRIMARY SERVICE AREA. DEPRESSION/ANXIETY, SUICIDE, ALCOHOL ABUSE, OPIOID AND PRESCRIPTION DRUG ABUSE, AND MARIJUANA USE AMONG YOUTHS ARE MAJOR HEALTH ISSUES. NUMEROUS RESIDENTS AND AREA SERVICE PROVIDERS SPOKE PASSIONATELY DURING INTERVIEWS AND COMMUNITY FORUMS ABOUT THE TREMENDOUS IMPACT THAT THESE ISSUES HAVE ON MANY INDIVIDUALS AND FAMILIES IN THE PRIMARY SERVICE AREA. OPIOID ABUSE WAS A PARTICULAR CONCERN FOR RESIDENTS AND SERVICE PROVIDERS IN LHMC'S PRIMARY SERVICE AREA, AND ALL SEGMENTS OF THE POPULATION (BY AGE AND INCOME) CALLED FOR GREATER OUTREACH, EDUCATION, SCREENING, AND TREATMENT SERVICES. HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS, PARTICULARLY FOR LOW-INCOME POPULATIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER AND ASTHMA). THE ASSESSMENT'S QUANTITATIVE DATA SHOW THAT LHMC'S SERVICE AREA FARES BETTER THAN THE COMMONWEALTH OVERALL WITH RESPECT TO CHRONIC DISEASE RATES, BUT A NUMBER OF TOWNS FARE LESS FAVORABLY, AND THE RATES FOR LOW-INCOME AND OLDER ADULT POPULATIONS ARE VERY HIGH. IT SHOULD BE NOTED THAT EVEN FOR THOSE COMMUNITIES THAT DO NOT HAVE RATES THAT ARE STATISTICALLY HIGHER THAN THE COMMONWEALTH'S, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH. HIGH RATES OF CANCER, PARTICULARLY FOR LOW-INCOME, RACIALLY/ETHNICALLY DIVERSE AND OTHERWISE AT-RISK POPULATION SEGMENTS. MANY OF THE COMMUNITIES THAT ARE PART OF LHMC'S PRIMARY SERVICE AREA HAVE HIGH CANCER INCIDENCE, HOSPITALIZATION, OR MORTALITY RATES. THIS IS PARTICULARLY TRUE FOR CERTAIN CANCERS IN SPECIFIC COMMUNITIES. MYRIAD FACTORS ARE ASSOCIATED WITH CANCER, AND MANY OF THEM ARE VERY DIFFICULT TO ASSESS COMPLETELY OR TO ADDRESS. HOWEVER, AT THE ROOT OF ADDRESSING CANCER AND HIGH MORTALITY ARE SCREENING, EARLY DETECTION, PEER SUPPORT, AND ACCESS TO TIMELY, SUPPORTIVE, QUALITY TREATMENT. COMMUNITY HEALTH NEEDS ASSESSMENTMAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLELHMC/LMCP STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY. THE FINDINGS WERE SHARED AT VARIOUS COMMUNITY MEETINGS. COPIES OF THE REPORT ARE AVAILABLE UPON REQUEST AND ON THE HOSPITAL'S WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/WP-CONTENT/UPLOADS/SITES/2/2019/08/LHMC-MASTER-REPORT-AND-APPENDICES.PDFIN ADDITION, THE MOST RECENT CHNA HAS ALSO BEEN SHARED PUBLICLY AND COPIES ARE AVAILABLE UPON REQUEST AND ON THE HOSPITAL'S WEBSITE ATHTTPS://WWW.LAHEY.ORG/LHMC/WP-CONTENT/UPLOADS/SITES/2/2019/09/LHMC-FINAL-CHNA-PDF.PDF.BOTH DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).
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SCHEDULE H, PART V, SECTION B, LINE 11:
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COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDSFY19 SCHEDULE HIMPLEMENTATION STRATEGY UPDATETHE COMMUNITY BENEFITS PROGRAMS THAT LHMC/LMCP OFFERED TO MEET THESE MOST PRESSING HEALTH CARE NEEDS INCLUDE THE FOLLOWING:FOCUS ON COLLABORATIVE CARE MODELTHE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) REPORTS THAT ONE IN FOUR INDIVIDUALS EXPERIENCES A MENTAL ILLNESS EACH YEAR, UNDERSCORING A CRITICAL NEED FOR MENTAL HEALTHCARE ACCESS ACROSS ALL PATIENT POPULATIONS. IN THE FY19 LHMC/LMCP CHNA, MENTAL HEALTHINCLUDING DEPRESSION, ANXIETY, STRESS, SERIOUS MENTAL ILLNESS AND OTHER CONDITIONSWAS OVERWHELMINGLY IDENTIFIED AS ONE OF THE LEADING HEALTH ISSUES FOR RESIDENTS OF THE SERVICE AREA. FURTHER, INDIVIDUALS FROM ACROSS THE HEALTH SERVICE SPECTRUM DISCUSSED THE BURDEN OF MENTAL HEALTH ISSUES FOR ALL SEGMENTS OF THE POPULATION, SPECIFICALLY THE PREVALENCE OF DEPRESSION AND ANXIETY.IN AN EFFORT TO MEET THIS NEED, LHPC ADOPTED THE COLLABORATIVE CARE MODEL (COCM). THE MODEL WILL BE EXPANDED TO ADDITIONAL COMMUNITIES THROUGHOUT THE BETH ISRAEL LAHEY HEALTH SERVICE AREA. COLLABORATIVE CARE IS A NATIONALLY RECOGNIZED, PRIMARY CARE-LED PROGRAM THAT SPECIALIZES IN PROVIDING BEHAVIORAL HEALTH SERVICES IN THE PRIMARY CARE SETTING. THE SERVICES ARE PROVIDED BY A LICENSED BEHAVIORAL HEALTH CLINICIAN AND INCLUDE COUNSELING SESSIONS, PHONE CONSULTATIONS WITH A PSYCHIATRIST, COORDINATION AND FOLLOW UP CARE. THE BEHAVIORAL HEALTH CLINICIAN WORKS CLOSELY WITH THE PRIMARY CARE PROVIDER IN AN INTEGRATIVE TEAM APPROACH TO TREATING A VARIETY OF MEDICAL AND MENTAL HEALTH CONDITIONS.THE PRIMARY CARE PROVIDER AND THE BEHAVIORAL HEALTH CLINICIAN DEVELOP A TREATMENT PLAN THAT IS SPECIFIC TO THE PATIENT'S PERSONAL GOALS. THE BEHAVIORAL HEALTH CLINICIAN USES THERAPIES THAT ARE PROVEN TO WORK IN PRIMARY CARE. A CONSULTING PSYCHIATRIST MAY ADVISE THE PRIMARY CARE PROVIDER ON MEDICATIONS THAT MAY BE HELPFUL. IN FY19 LHMC REACHED HIRED AND TRAINED BEHAVIORAL HEALTH CLINICIANS AND REACHED 3,501 PATIENTS ACROSS 4 PRIMARY CARE PRACTICES.FOCUS ON WELLNESS, PREVENTION AND CHRONIC DISEASE MANAGEMENTTHE WOMEN'S LEADERSHIP COUNCIL (WLC) AT LHMC WAS FOUNDED IN 2004 BY A GROUP OF FEMALE COMMUNITY LEADERS AND PHYSICIANS WITH THE GOAL OF EDUCATING AND EMPOWERING WOMEN TO BE THEIR OWN HEALTH CARE ADVOCATES. ONE OF THE WAYS THEY ACHIEVE THAT MISSION IS THROUGH THE WOMEN'S HEALTH LECTURE SERIES, A FORUM THAT SUPPORTS EDUCATION AND HEALTH CARE ADVOCACY FOR WOMEN OF ALL AGES. THE LECTURE TOPICS ARE DERIVED DIRECTLY FROM THE LHMC/LMCP CHNA AND ARE CHOSEN BY THE WLC EDUCATION COMMITTEE WITH INPUT FROM THE CLINICAL ADVISORY COMMITTEE. THE LECTURES ARE FREE AND OPEN TO THE PUBLIC. IN FY19, THE WLC HOSTED THREE LECTURES AND SERVED APPROXIMATELY 480 PEOPLE. IN FY19, LHMC ALSO PARTNERED WITH THE MERRIMACK VALLEY FOOD BANK (MVFB) TO PROVIDE $10,000 FUNDING TO SUPPORT ITS COMMUNITY MARKET PROGRAM, WHICH SERVED 1,194 RESIDENTS OF FOUR LOWELL HOUSING AUTHORITY (LHA) PROPERTIES, OFFERING THEM THE OPPORTUNITY TO SUPPLEMENT THEIR FOOD BY ENJOYING FRESH PRODUCE AT NO COST. IN ADDITION TO THE FRESH PRODUCE, THE MARKET FREQUENTLY OFFERS BOTTLED WATER, JUICE, AND OTHER ITEMS. THE MARKET OPERATES IN ONE LOCATION EACH FRIDAY SO THAT RESIDENTS OF EACH COMPLEX ARE ABLE TO ATTEND ONCE PER MONTH. THERE ARE INTERPRETERS AT THE MARKETS, WHERE MOST GUESTS ARE SPEAKERS OF OTHER LANGUAGES, AND OUTREACH MATERIALS ARE TRANSLATED INTO SPANISH AND KHMER FOR ALL PARTNER SITES. IN FY18, LHMC PROVIDED FUNDING TO MILL CITY GROWS (MCG) TO SUPPORT A MOBILE MARKET IN LOWELL THAT INCREASED ACCESS TO FRESH FRUITS AND VEGETABLES FOR OVER 1,400 LOW-INCOME SENIORS. THIS WORK CONTINUED INTO FY19 WHEN LHMC CONTINUED THE PARTNERSHIP WITH MILL CITY GROWS TO PROVIDE FUNDING FOR IMPROVEMENTS TO ITS COMMUNITY-BASED GARDEN PROGRAM. MCG, A LONGTIME PARTNER OF LHMC, HAS DESIGNED AND BUILT AND NOW OVERSEES 20 COMMUNITY AND SCHOOL GARDENS IN LOWELL THAT ARE USED BY OVER 6,500 LOWELL RESIDENTS. IN THIS URBAN ENVIRONMENT WITH NUMEROUS LOW-INCOME NEIGHBORHOODS, ENVIRONMENTAL CHALLENGES EXIST THAT CONTRIBUTE TO HEALTH INEQUITIES AMONG LOW-INCOME FAMILIES, ELDERS, IMMIGRANTS AND REFUGEE RESIDENTS. MCG'S SEVEN COMMUNITY GARDENS INCLUDE 199 GARDEN BEDS. THESE GARDEN BEDS ARE ASSIGNED TO LOCAL RESIDENTS FOR THEIR PERSONAL USE FROM APRIL TO NOVEMBER EACH YEAR TO GROW AND HARVEST PRODUCE. SCHOOL GARDENS ARE AVAILABLE AT 13 OF LOWELL'S PUBLIC SCHOOLS (LPS), WHERE OVER 6,000 STUDENTS CAN PARTICIPATE IN GARDENING THROUGH IN-CLASSROOM, AFTERSCHOOL AND OUT-OF-SCHOOL ACTIVITIES. MCG'S EDUCATION TEAM PROVIDES IN-SCHOOL LESSONS AT TWO TO FOUR HIGH-NEEDS SCHOOLS IN LOWELL, AFTERSCHOOL PROGRAMMING AT FOUR SCHOOLS, SCHOOLWIDE TASTE TESTS OF LOCAL PRODUCE FOR UP TO 2,000 STUDENTS, AND FAMILY COOKING CLASSES FOR UP TO 20 FAMILIES PER YEAR.LHMC ALSO PARTNERED WITH THE BURLINGTON RECREATION DEPARTMENT AND THE NATIONAL FITNESS CAMPAIGN (NFC) TO FUND AN OUTDOOR FITNESS COURT, MAKING WHO $40,000 PAYMENTS, ONE IN FY18 AND THE SECOND IN FY19. THE NFC FITNESS COURT IS A FULL-BODY CIRCUIT-TRAINING SYSTEM DESIGNED FOR ADULTS OF ALL AGES AND FITNESS LEVELS. EACH FITNESS COURT FEATURES 30 INDIVIDUAL PIECES OF EQUIPMENT AND SHOCK-RESISTANT SPORTS FLOORING AND INCLUDES EXERCISE STATIONS THAT ALLOW FOR UP TO 28 INDIVIDUALS TO USE THE COURT AT THE SAME TIME. WORKOUTS ARE APP DRIVEN AND CAN BE TAILORED FOR EACH PARTICIPANT. RESEARCH IS INCREASINGLY DEMONSTRATING LINKS BETWEEN SPECIFIC COMMUNITY FACTORS, SUCH AS THE AVAILABILITY OF PARKS, ACCESSIBILITY OF HEALTHY FOODS, AND WALKABILITY OF NEIGHBORHOODS, AND THE CHOICES PEOPLE MAKE IN THEIR DAILY LIVES. THE FITNESS COURT OPENED IN JUNE 2019, AND THE BURLINGTON RECREATION DEPARTMENT HAS HOSTED SEVERAL FREE PILOT CLASSES, HIRED A FITNESS COURT COORDINATOR, AND IS PLANNING FOR A SCHEDULED BIWEEKLY CLASS IN FY20. THE BURLINGTON SITE WAS ALSO SELECTED BY NFC AS A PILOT STUDY SITE AND IS BEING CLOSELY MONITORED FOR USERS AND TOTAL IMPACT.FOCUS ON ELDER HEALTHLHMC CONTINUED OUR EXTREMELY SUCCESSFUL PARTNERSHIP WITH MINUTEMAN SENIOR SERVICES IN FY19 TO CONTINUE TO PROVIDE SHINE COUNSELORS AT THE ARLINGTON AND BURLINGTON COUNCILS ON AGING AND AT A DESIGNATED SITE ON THE LHMC CAMPUS AT 41 MALL ROAD. THE CONSUMERS SERVED IN THE LHMC REGION RECEIVED NO-COST, ONE-ON-ONE INSURANCE BENEFITS COUNSELING PROVIDED BY STATE-CERTIFIED SHINE VOLUNTEERS OR STAFF MEMBERS. LHMC IS THE ONLY ACUTE CARE HEALTH SYSTEM SERVING AS A SHINE COUNSELING SITE IN MASSACHUSETTS. THE COLLABORATION INCLUDES PRIVATE, IN-KIND SPACE SO SHINE COUNSELORS CAN BE ACCESSIBLE TO THE HOSPITAL COMMUNITY, VOLUNTEER SUPPORT PROVIDED BY THE LHMC VOLUNTEER SERVICES DEPARTMENT, AND RELATED SERVICES. THE PROGRAM SERVED 672 INDIVIDUALS OVER THE COURSE OF THE YEAR AND 25% OF CONSUMERS WERE BELOW THE FEDERAL POVERTY THRESHOLD, MEANING THESE INDIVIDUALS RECEIVED ADDITIONAL COUNSELING REGARDING MASSHEALTH, HEALTH SAFETY NET AND THE MEDICARE SAVINGS PROGRAM.LHMC HAS A ROBUST, DEDICATED TRAUMA DEPARTMENT COMMITTED TO COMMUNITY-BASED INJURY PREVENTION FOR OLDER ADULTS. ACCORDING TO THE AMERICAN ORTHOPAEDIC ASSOCIATION, FRAGILITY FRACTURES HAVE BECOME NEARLY EPIDEMIC IN THE UNITED STATES AMONG OLDER ADULTS, WITH OVER 2 MILLION FRACTURES OCCURRING EACH YEARMORE THAN THE TOTAL NUMBER OF HEART ATTACKS, STROKES AND BREAST CANCER COMBINED. BASED ON THIS DATA AND COMMUNITY FEEDBACK IN THE MOST RECENT CHNA, MOBILITY AND FALLS PREVENTION FOR OLDER ADULTS CONTINUES TO BE A PRIORITY FOR LHMC'S INJURY PREVENTION PROGRAM. IN FY19, LHMC CONTINUED IS EXTREMELY SUCCESSFUL EVIDENCE-BASED A MATTER OF BALANCE FALLS PREVENTION PROGRAM. LHMC HOSTED FIVE EIGHT-WEEK SESSIONS OF THE PROGRAM AND EXPANDED CAPACITY FOR THE PROGRAM IN THE COMMUNITY BY TRAINING 17 COMMUNITY-BASED COACHES. LHMC ALSO FOCUSED ITS ANNUAL INJURY PREVENTION & COMMUNITY OUTREACH CONFERENCE IN FY19 ON FALLS PREVENTION. A TOTAL OF 70 PARTICIPANTS ENROLLED IN THE PROGRAM (SOME HAD STARTED THE PROGRAM DURING FY18; 54 COMPLETED FIVE OR MORE SESSIONS). AGES RANGED FROM 60 TO 95, WITH TWO INDIVIDUALS REPORTING AN AGE LESS THAN 60; THE TOP FOUR AGE GROUPS WERE 80-84 (28%), 75-79 (24%), 85-89 (14%), AND 65-69 (14%). OF THE PARTICIPANTS, 74% WERE FEMALES, 26% MALES, AND 5% WERE NON-RESPONDERS. THIRTY-ONE PERCENT OF PARTICIPANTS REPORTED THAT THEY LIVE ALONE.
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SCHEDULE H, PART V, SECTION B, LINE 11:
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GOOD NUTRITION HELPS PREVENT DISEASE AND IS ESSENTIAL FOR THE HEALTHY GROWTH AND DEVELOPMENT OF CHILDREN AND ADOLESCENTS. SURVEY DATA FROM THE CDC'S STATE INDICATOR REPORT ON FRUITS AND VEGETABLES SHOWS THAT IN 2018, ONLY 14% OF ADULTS MEET THE DAILY FRUIT INTAKE RECOMMENDATION AND ONLY 11.1% OF ADULTS MEET THE VEGETABLE RECOMMENDATION (CDC, 2018). MOREOVER, ACCORDING TO A RECENT SURVEY CONDUCTED BY THE MASSACHUSETTS HEALTHY AGING COLLABORATIVE, IN ARLINGTON ONLY 32%, IN BURLINGTON ONLY 38%, AND IN BILLERICA ONLY 19% OF SENIORS ARE GETTING THE RECOMMENDED FIVE SERVINGS OF FRUITS AND VEGETABLES PER DAY. ISSUES OF ACCESS TO INFORMATION AS WELL AS EQUITABLE ACCESS TO HEALTHY FOODS BOTH PLAY A ROLE IN THESE LOW FIGURES. TO ADDRESS THIS NEED, LHMC PARTNERED WITH THE NEW ENTRY SUSTAINABLE FARMING PROJECT, AN ORGANIZATION THAT GROWS ORGANIC PRODUCE LOCALLY FOR MIDDLESEX COUNTY, AND RAN FARMERS MARKETS FOR A TOTAL OF 20 WEEKS. THIS IS THE SIXTH YEAR OF A PARTNERSHIP THAT SERVES SENIORS AT THE BURLINGTON, ARLINGTON, AND BILLERICA COUNCILS ON AGING. DEPENDING ON LOCATION, THE PROGRAM SERVED 50-70 SENIORS PER WEEK FROM JUNE THROUGH OCTOBER, AND ON AVERAGE, PARTICIPANTS TOOK HOME SIX VARIETIES OF FRESH, LOCAL PRODUCE EACH WEEK. IN TOTAL, THE PROGRAM DISTRIBUTED MORE THAN 40,000 POUNDS OF PRODUCE TO THE COMMUNITY. OVERALL FITNESS AND PHYSICAL ACTIVITY REDUCE THE RISK FOR MANY CHRONIC DISEASES, ARE LINKED TO GOOD EMOTIONAL HEALTH AND HELP PREVENT DISEASE. ONE WAY THAT LHMC IS ADDRESSING THIS HEALTH NEED IS THROUGH OUR PARTNERSHIP WITH THE METRO NORTH YMCA TO OFFER FREE ENHANCE FITNESS CLASSES IN THE COMMUNITY. ENHANCE FITNESS IS A NATIONALLY OFFERED PROGRAM AT YMCAS ACROSS THE COUNTRY. IT IS AN EVIDENCE-BASED HEALTH INTERVENTION, OFFSETTING THE EFFECTS OF AGING AND CHRONIC ILLNESS AS WELL AS MINIMIZING FALL RISK. PARTICIPANTS WORK ON CARDIO AND MUSCULAR STRENGTH, BALANCE, AND STABILITY, ALL WHILE FOSTERING A SUPPORTIVE SOCIAL COMMUNITY. CLASSES MEET THREE DAYS PER WEEK AND SESSIONS RUN FOR EIGHT WEEKS. FITNESS CHECKS ARE DONE AT THE BEGINNING AND END OF EACH EIGHT-WEEK SESSION. IN FY19, THE YMCA WAS ABLE TO OFFER TWO SESSIONS OF ENHANCE FITNESS AT THE PEABODY YMCA AND PEABODY SENIOR CENTER, AND THIS PARTNERSHIP WILL CONTINUE INTO FY20 AND WILL EXPAND TO THE LYNNFIELD SENIOR CENTER AS WELL. THE PROGRAM SERVED 103 PEOPLE OVER THE COURSE OF THE TWO CLASSES. FOCUS ON SUBSTANCE USE AND MENTAL HEALTHIN FY19, LHMC SUPPORTED THE YOUTH RISK BEHAVIOR SURVEY (YRBS) IN THE LYNNFIELD PUBLIC SCHOOL DISTRICT AND FOR THE MIDDLESEX LEAGUE COLLABORATIVE WHICH INCLUDES THE TOWNS OF ARLINGTON, WAKEFIELD, BELMONT, WATERTOWN, BURLINGTON, WILMINGTON, MELROSE, WINCHESTER, READING, WOBURN, AND STONEHAM. THE YRBS CAN DETERMINE THE PREVALENCE OF HEALTH BEHAVIORS; ASSESS WHETHER HEALTH BEHAVIORS INCREASE, DECREASE, OR STAY THE SAME OVER TIME; EXAMINE THE CO-OCCURRENCE OF HEALTH BEHAVIORS; PROVIDE COMPARISON DATA FOR GEOGRAPHIES AND SUBPOPULATIONS; AND MONITOR PROGRESS TOWARD ACHIEVING HEALTHY PEOPLE OBJECTIVES AND PROGRAM INDICATORS. THE YRBS ALLOWS THE SCHOOLS TO BETTER UNDERSTAND THE EXTENT TO WHICH MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS IN THE DISTRICT ENGAGE IN RISKY BEHAVIORS. LHMC'S SUPPORT HAS ALLOWED BOTH THE MIDDLESEX LEAGUE AND LYNNFIELD PUBLIC SCHOOL DISTRICT TO CREATE AN ONLINE, STANDARDIZED TEST THAT ALLOWS FOR THE DATA TO BE PROCESSED IN A TIMELY MANNER AND SYNTHESIZED INTO A REGIONAL REPORT.LHMC ALSO SUPPORTED THE PEABODY VETERANS MEMORIAL HIGH SCHOOL (PVMHS) STUDENT HEALTH CENTER (SHC) WITH FUNDING FOR SERVICES NOT CURRENTLY COVERED BY INSURANCE. THIS YEAR, 352 INDIVIDUALS WERE SERVED IN 932 MEDICAL VISITS AND 1,284 BEHAVIORAL HEALTH VISITS. THE MISSION OF THE SHC IS TO PROVIDE HIGH-QUALITY COMPREHENSIVE HEALTH CARE TO STUDENTS IN ORDER TO SUPPORT OPTIMAL HEALTH AND ACADEMIC OUTCOMES. THE MISSION OF THE SHC ALIGNS CLOSELY WITH THE PRIORITIES IDENTIFIED BY LHMC IN ITS MOST RECENT CHNA. FOR EXAMPLE, THE SHC IMPROVES ACCESS TO BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES BY OFFERING THESE SERVICES ON-SITE, AND IT INTEGRATES THOSE SERVICES INTO PRIMARY MEDICAL CARE. THE SHC ALSO IDENTIFIES STUDENTS WITH CHRONIC CONDITIONS AND HELPS THEM IMPROVE SELF-MANAGEMENT OF THESE CONDITIONS. IN ADDITION, THE SHC, THROUGH ITS PARTNERSHIP WITH HAVEN FROM HUNGER, HELPS PROMOTE WELLNESS THROUGH HEALTH EDUCATION AND HEALTHY EATING.IN FY19, LHMC PARTNERED WITH LEXINGTON YOUTH & FAMILY SERVICES (LYFS) ON ITS CRISIS COUNSELING PROGRAM AT LEXINGTON HIGH SCHOOL. THE PURPOSE OF THE COUNSELING PROGRAM IS TO PROVIDE CRISIS COUNSELING TO AT-RISK LEXINGTON TEENS AND THEIR FAMILIES. YRBS RESULTS FROM LEXINGTON SHOW THAT 27.1% OF HIGH SCHOOL STUDENTS FELT SAD OR HOPELESS FOR TWO OR MORE WEEKS PER YEAR, 17.2% HAD SERIOUSLY CONSIDERED SUICIDE, 10.4% MADE A SUICIDE PLAN, 4% HAD ACTUALLY ATTEMPTED SUICIDE, AND 12.5% HAD ENGAGED IN SELF-INJURY. FOCUSING JUST ON THOSE WHO REPORTED CONSIDERING SUICIDE, 17.2% OF 1,700 HIGH SCHOOL STUDENTS IS ABOUT 290 STUDENTS. FUNDING PROVIDED BY LHMC IN FY19 ENABLED LYFS TO MAINTAIN ITS CURRENT DROP-IN COUNSELING HOURS AND INCREASE THE NUMBER OF COUNSELING SESSIONS PROVIDED TO OVER SIXTY. OUTREACH EFFORTS ALSO FOCUSED ON LEXINGTON'S FAST-GROWING ASIAN POPULATION AND LGBTQ+ COMMUNITY. COMMUNITY PARTNERSLHMC/LMCP IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE: A HEALTHY LYNNFIELD COALITION AMERICAN CANCER SOCIETY ARLINGTON HOUSING CORPORATION BURBANK YMCA BURLINGTON RECREATION DEPARTMENT BURLINGTON SCHOOL DEPARTMENT COMMUNITY HEALTH NETWORK AREA 13/14 COMMUNITY HEALTH NETWORK AREA 15 CITY OF PEABODY LYNNFIELD PUBLIC SCHOOLS MERRIMACK VALLEY FOOD BANK METRO NORTH YMCA MILL CITY GROWS MINUTEMAN SENIOR SERVICES NEW ENTRY SUSTAINABLE FARMING PROJECT NORTH SHORE COMMUNITY HEALTH NORTH SUBURBAN YMCA TOWN OF ARLINGTON TOWN OF BEDFORD TOWN OF BILLERICA TOWN OF BURLINGTON TOWN OF LEXINGTON TOWN OF LYNNFIELDIT IS IMPORTANT TO NOTE THAT THERE ARE COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED THROUGH LHMC/LMCP'S ASSESSMENT THAT WERE NOT PRIORITIZED FOR INCLUSION IN THE IMPLEMENTATION STRATEGY FOR A NUMBER OF REASONS: FEASIBILITY OF LHMC/LMCP HAVING AN IMPACT IN THE SHORT OR LONG TERM CLINICAL EXPERTISE OF THE ORGANIZATION LIMITED BURDEN ON RESIDENTS OF THE SERVICE AREA ISSUE IS BEING ADDRESSED BY COMMUNITY PARTNERS IN A WAY THAT DOES NOT WARRANT ADDITIONAL SUPPORTTHOUGH MATERNAL AND CHILD HEALTH IS NOT A PRIORITY AREA INCLUDED IN LHMC/LMCP'S IMPLEMENTATION STRATEGY, LHMC/LMCP PARTNERS WITH ITS AFFILIATED LOCAL COMMUNITY HOSPITALS WITH CLINICAL EXPERTISE IN THIS AREA TO ADDRESS ISSUES IN THIS DOMAIN. AS NOTED IN DETAIL ABOVE, LHMC/LMCP'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IMPLEMENTATION STRATEGY (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 LHMC/LMCP CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 7.37% OF LHMC/LMCP'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, THERE ARE ADDITIONAL ACTIVITIES AND EXPENDITURES WHICH NEBH CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. ALTHOUGH THOSE ACTIVITIES ARE NOT QUANTIFIED ON THE LHMC/LMCP SCHEDULE H PER THE INSTRUCTIONS TO THE FORM 990, THOSE ACTIVITIES ARE RELEVANT IN EVALUATING THE TOTAL COMMUNITY BENEFITS PROVIDED. IF LHMC/LMCP HAD INCLUDED THESE IN SCHEDULE H, QUESTION 7, LHMC/LMCP WOULD HAVE REPORTED OVER $76,667,927 IN NET EXPENDITURES AT COST, WHICH REPRESENTED APPROXIMATELY 7.84% OF TOTAL EXPENSES INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST FOR THE FISCAL PERIOD COVERED BY THIS FILING. COMMUNITY BENEFITSANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, LHMC/LMCP'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE COMMUNITY BENEFITS ADVISORY COMMITTEE AND BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT 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 ON THE HOSPITAL WEBSITE AT:HTTPS://WWW.LAHEY.ORG/LHMC/LAHEY-PROMISE/IN-THE-COMMUNITY/HEALTH-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION-STRATEGIES/. 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 THAT LHMC/LMCP FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, LHMC/LMCP IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCELHMC/LMCP'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 $9,403,815 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A. OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, LHMC/LMCP 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 THAT 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 LHMC/LMCP 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 $79,167,630 IN MEDICAID REVENUE THIS WAS LESS THAN THE COST OF CARE PROVIDED BY LAHEY CLINIC HOSPITAL FOR SUCH SERVICES BY $8,519,019 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 7.9% OR 69,646 OF LAHEY CLINIC HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 45.1% OR 397,123 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO AN ADDITIONAL $3,890,722 IN UNCOVERED COST BORNE BY LHMC/LMCP IN PROVIDING CARE TO MEDICARE PATIENTS. AS PREVIOUSLY NOTED, THIS ADDITIONAL COST IS NOT QUANTIFIED IN THE LHMC/LMCP SCHEDULE H. BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, LHMC/LMCP 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 $27,684,746 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. LHMC/LMCP SIMILARLY INCURS BAD DEBT LOSSES AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE IN ITS FINANCIAL STATEMENTS. LHMC/LMCP CHARGES FOR THOSE SERVICES WERE $27,684,746 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND AS REPORTED ON THE LHMC/LMCP FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER THE AMOUNT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F, WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE SEVEN MONTHS ENDED SEPTEMBER 30, 2019 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE LHMC/LMCP 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. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE RECEIVED FROM QUALIFYING LHMC/LMCP PROVIDERS.LHMC/LMCP DOES 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.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION:
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FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) WHICH APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE (SCHEDULE H PART V SECTION B QUESTION 15).FINANCIAL ASSISTANCE POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION MAY BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HER OR HIS CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS 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 HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICYTRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: CHINESE-TRADITIONAL, CHINESE-MANDARIN, SPANISH AND PORTUGUESE (SCHEDULE H PART V SECTION B QUESTION 16I).FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND ON THE HOSPITAL'S WEBSITE AT (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT:HTTPS://WWW.LAHEY.ORG/LHMC/YOUR-VISIT/INSURANCE-BILLING-RECORDS/FINANCIAL-COUNSELING-ASSISTANCE/IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICYPLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS' APPROVAL UNDER THE FAP WILL APPLY. LIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLEDLOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS, MEDICAID AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22).
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION:
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PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAT EXCEED THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED AND FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS NOTED IN THIS FILING, THE LAHEY CLINIC INC. (LCI) IS A SISTER ENTITY TO THE LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). EACH IS AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND EACH IS INTEGRALLY RELATED TO ACCOMPLISHING THEIR COMBINED MISSIONS OF PATIENT CARE, EDUCATION AND RESEARCH. THE EXPENSES ASSOCIATED WITH RESEARCH ARE NOT INCLUDED IN COSTS REPORTED IN THIS FORM 990 SCHEDULE H PART I LINE 7H, BECAUSE THEY ARE ACCOUNTED FOR AS COSTS OF LAHEY CLINIC INC., THESE ACTIVITIES ARE IMPORTANT TO THE COMBINED MISSIONS OF BOTH ENTITIES AND TO THE COMMUNITIES SERVED BY THE HOSPITAL, AND AS SUCH, DETAIL SUPPORTING THESE ACCOMPLISHMENTS ARE INCLUDED IN THE NARRATIVE SUPPORT TO THIS FILING. SINCE LAHEY CLINIC'S INCEPTION, OUR CLINICIANS HAVE ENTHUSIASTICALLY ENGAGED IN FURTHERING RESEARCH IN ORDER TO ADVANCE THE PRACTICE OF MEDICINE, NOT ONLY FOR LAHEY PATIENTS BUT FOR ALL PATIENTS. ADVANCING MEDICINE THROUGH RESEARCH AND THE EDUCATION OF TOMORROW'S HEALTH CARE LEADERS IS A LONGSTANDING, CORE COMPONENT OF THE LAHEY CLINIC MISSION. WHETHER WORKING IN THE LABORATORY SETTING OR PARTICIPATING IN CLINICAL TRIALS TO TREAT PATIENTS AND ADVANCE CLINICAL MEDICINE, THEY ARE HELPING TO SHAPE THE NEW TREATMENTS THAT IMPROVE QUALITY CARE FOR PATIENTS, BOTH SAFELY AND EFFECTIVELY.THE MAJORITY OF THE RESEARCH CONDUCTED AT LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC) CONSISTS OF CLINICAL TRIALS THAT HAVE A DIRECT IMPACT ON THE LIVES OF OUR PATIENTS. DURING THE FISCAL PERIOD COVERED BY THIS FILING, LHMC WAS ENGAGED IN MORE THAN 179 ACTIVE FEDERAL, CORPORATE, NON-PROFIT, AND INTERNALLY SPONSORED PROJECTS, AND MORE THAN 400 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL STUDIES. DURING THE SAME TIME, LHMC HAD OVER 140 PRINCIPAL INVESTIGATORS, MANY WHO ARE TUFTS UNIVERSITY SCHOOL OF MEDICINE FACULTY, AND NEARLY THE SAME NUMBER OF CO-INVESTIGATORS DEMONSTRATING A ROBUST CULTURE OF RESEARCH ENGAGEMENT AMONG PHYSICIANS AND CLINICAL DISCIPLINES. THIS BROAD ENGAGEMENT RESULTED IN OVER 1,500 PATIENTS RECEIVING MEDICAL CARE AS HUMAN SUBJECTS. THE KEY AREAS OF RESEARCH INCLUDE THERAPEUTIC INVESTIGATIONAL DRUG AND MEDICAL DEVICE CLINICAL TRIALS, COMPARATIVE EFFECTIVENESS RESEARCH, AND TRANSLATIONAL RESEARCH ALL OF WHICH SERVE THE GOAL OF TREATING PATIENTS AND PROVIDING THE CUTTING EDGE CARE OF TOMORROW. AS NOTED IN THIS FILING, LHMC IS A TEACHING HOSPITAL OF THE TUFTS UNIVERSITY SCHOOL OF MEDICINE, AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE WITH TUFTS AS WELL AS OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED BOSTON TEACHING HOSPITALS. LHMC ALSO PARTICIPATES IN THE TUFTS CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE (TUFTS CTSI), WHICH PROMOTES COLLABORATIVE, CROSS-DISCIPLINARY, FULL-SPECTRUM TRANSLATIONAL RESEARCH AMONG ITS MULTIPLE HOSPITALS AND HEALTH PLANS, INDUSTRY LEADERS, COMMUNITY ORGANIZATIONS, AND OTHER PARTICIPANTS WHO PLACE A UNIQUE EMPHASIS ON ENGAGING THEIR LOCAL COMMUNITIES IN BIOMEDICAL RESEARCH. THE COLLABORATIVE NATURE OF THE RESEARCH CONDUCTED AT LHMC RESULTED IN THEIR PUBLISHING OVER 200 PEER-REVIEWED JOURNAL ARTICLES DURING THE PERIOD COVERED BY THIS FILING. LHMC ENGAGES IN RESEARCH IN NEARLY ALL DISCIPLINES: ALLERGY AND IMMUNOLOGY ANESTHESIOLOGY CARDIOVASCULAR AND THORACIC SURGERY CARDIOVASCULAR MEDICINE CELL AND MOLECULAR BIOLOGY RESEARCH LABORATORY COLON AND RECTAL SURGERY DERMATOLOGY DIAGNOSTIC RADIOLOGY FOOD & NUTRITION SERVICES GASTROENTEROLOGY GENERAL INTERNAL MEDICINE GENERAL SURGERY GYNECOLOGY HEMATOLOGY AND ONCOLOGY HOSPITAL MEDICINE INFECTIOUS DISEASES LABORATORY MEDICINE NEUROLOGY NEUROSURGERY NURSING OPHTHALMOLOGY ORTHOPAEDIC SURGERY OTOLARYNGOLOGY/HEAD & NECK SURGERY PATHOLOGY PHYSICAL THERAPY PLASTIC AND RECONSTRUCTIVE SURGERY PROFESSIONAL DEVELOPMENT AND SIMULATION PSYCHIATRY AND BEHAVIORAL HEALTH PULMONARY AND CRITICAL CARE MEDICINE RADIATION ONCOLOGY SURGICAL CRITICAL CARE TRANSPLANTATION TRAUMA CENTER TRAVEL AND TROPICAL MEDICINE UROLOGYDURING THE FISCAL YEAR COVERED BY THIS FILING, LCI REPORTED $1,256,206 OF NET INTERNALLY FUNDED RESEARCH AND AN ADDITIONAL $1,359,659 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS. AS NOTED PREVIOUSLY, THESE AMOUNT IS NOT REPORTED ON SCHEDULE H, PART I, LINE 7H FOR LHMC BECAUSE THE EXPENSES AND ACTIVITIES ARE REPORTED ON THE BOOKS AND RECORDS OF LCI RATHER THAN LHMC. HOWEVER, IT IS WORTH NOTING THAT IF THESE AMOUNTS WERE INCLUDED ON THE HOSPITAL'S SCHEDULE H, PART I LINE 7H, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED ON THIS SCHEDULE H, PART I, LINE 7H TO 8.11%.RESEARCH ENGAGEMENT AT LHMCADVANCING MEDICINE THROUGH DISCOVERY, RESEARCH AND INNOVATION IS THE MISSION OF THE RESEARCH PROGRAM AT LHMC. ITS FOCUS CENTERS ON BRINGING THE LATEST THERAPEUTICS TO THE CLINIC, EVALUATING AND IMPLEMENTING PREVENTATIVE INTERVENTIONS FOR THE PURPOSE OF IMPROVING HEALTH OUTCOMES, ASSESSING THE QUALITY AND EFFECTIVENESS OF MEDICAL CARE, AND TRANSFORMING THE PRACTICE OF MEDICINE THROUGH SCIENTIFIC DISCOVERY. EXAMPLES OF RESEARCH ENGAGEMENT AT LHMCHIGHLIGHTED BELOW ARE A FEW EXAMPLES OF THE TRANSFORMATIVE RESEARCH CONDUCTED AT LHMC. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS LHMC IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPLORING REAL WORLD DATA TO CHANGE MEDICAL PRACTICEUNDER THE LEADERSHIP OF DRS. FREDERIC RESNIC AND ZOHAR GHOGAWALA, THE LAHEY COMPARATIVE EFFECTIVENESS RESEARCH INSTITUTE (CERI) IS UTILIZING REAL-WORLD CLINICAL DATA TO EVALUATE THE IMPACT OF ALTERNATIVE TREATMENTS USED IN THE TREATMENT OF CARDIOVASCULAR DISEASE AND NEUROSURGICAL DEVICES. THEIR PARTICULAR RESEARCH FOCUS IS ON THE SAFETY AND OUTCOMES OF MEDICAL DEVICES, AND HAS BEEN THE RECIPIENT OF NUMEROUS FEDERAL AWARDS TO STUDY THE PERFORMANCE OF IMPLANTABLE MEDICAL DEVICES, AND THEIR SAFETY OVER TIME.NATIONAL CANCER INSTITUTE (NCI) HIGH PERFORMING SITETHE LHMC ONCOLOGY RESEARCH PROGRAM HAS RECEIVED NATIONAL RECOGNITION FOR THEIR HIGH QUALITY RESEARCH, INCLUDING BEING CONSISTENTLY RECOGNIZED AS A NATIONAL CANCER INSTITUTE (NCI) HIGH PERFORMING SITE. FOUNDED AFTER THE NATIONAL CLINICAL TRIALS NETWORK (NCTN) WAS FORMED IN 2013, THE HIGH PERFORMING SITE INITIATIVE (HPSI) RECOGNIZES SITES THAT ENROLL VERY LARGE NUMBERS OF PATIENTS ONTO NCTN TRIALS WHILE MAINTAINING EXCELLENT TRIAL DATA QUALITY. HIGH PERFORMING SITES RECEIVE SUPPLEMENTAL AWARDS FROM NCI TO RECOGNIZE, REWARD AND SUPPORT SITES THAT, DESPITE NOT HAVING THE INFRASTRUCTURE SUPPORT AVAILABLE THROUGH OTHER DEDICATED NCI GRANTS, OUTPERFORM MANY OTHER LARGER RESEARCH PROGRAMS.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION:
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TRANSLATING DISCOVERY RESEARCH INTO CLINICAL SOLUTIONS THE IAN C. SUMMERHAYES CELL AND MOLECULAR BIOLOGY (ICSCMB) LAB AT LHMC PERFORMS TRANSLATIONAL RESEARCH PRIMARILY FOCUSED ON MOLECULAR ONCOLOGY, AND COLLABORATES WITH THE NIH CANCER GENOME ATLAS PROJECT AND HIGH-TECH CORPORATIONS TO ACCELERATE OUR UNDERSTANDING OF THE MOLECULAR BASIS OF CANCER THROUGH THE APPLICATION OF GENOME ANALYSIS TECHNOLOGIES, AND PIONEER METHODS OF EARLY DETECTION OF CANCER. A RECENT STUDY IDENTIFIED MICRORNA (MIRNA) BIOMARKERS OF SMALL, PATHOLOGICALLY CONFIRMED STAGE 1 CLEAR CELL RENAL CELL CARCINOMA (CCRCC) TUMORS THAT ARE ASSOCIATED WITH PROGRESSION TO METACHRONOUS METASTATIC DISEASE. THROUGH ICSCMB COLLABORATIONS, THE RECENTLY DISCOVERED MIRNA BIOMARKERS PROFILED IN THIS STUDY ARE NOW BEING TRANSLATED INTO CLINICAL DIAGNOSTICS AND PREDICTIVE MODELS THAT HAVE THE POTENTIAL TO IDENTIFY PATIENTS WITH SMALL RENAL MASSES WHO ARE LIKELY TO HAVE PROGRESSIVE CCRCC, AND ENABLE CLINICIANS TO MAKE CRITICAL TREATMENT DECISIONS EARLIER IN THE DISEASE PROCESS. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS MEDICAL EDUCATION LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC OR HOSPITAL) IS COMMITTED TO THE HIGHEST QUALITY MEDICAL CARE. THE ENTIRE LAHEY COMMUNITY RECOGNIZES THAT THIS GOAL CANNOT BE ACCOMPLISHED WITHOUT A COMMITMENT TO EDUCATION. EDUCATIONAL PROGRAMS HAVE BEEN AN INTEGRAL PART OF LAHEY'S MISSION ADVANCING QUALITY PATIENT CARE SINCE ITS FOUNDING IN 1923. LHMC IS A MAJOR AFFILIATE FOR TUFTS MEDICAL SCHOOL AND TEACHING PHYSICIANS WHO HOLD FACULTY APPOINTMENTS AT TUFTS INSTRUCT THE DOCTORS OF TOMORROW. THE INSTITUTIONAL COMMITMENT TO EDUCATION SUPPORTS PROFESSIONAL GROWTH OPPORTUNITIES AND CONTRIBUTES TO THE GOAL OF PROVIDING OPTIMAL PATIENT CARE.THE MEDICAL EDUCATION DEPARTMENT OVERSEES THE ADMINISTRATIVE FUNCTIONS FOR GRADUATE, UNDERGRADUATE AND ADVANCED PRACTITIONER TRAINING PROGRAMS AND ITS CONTINUING MEDICAL EDUCATION (CME) PROGRAM HOLDS ACCREDITATION WITH COMMENDATION FROM THE ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION. INTELLECTUAL STIMULATION PRODUCED IN AN ENVIRONMENT OF TEACHING AND LEARNING ENHANCES THE HOSPITAL'S ABILITY TO ENSURE THAT THE REQUIREMENTS FOR CURRICULA, SCHOLARLY ACTIVITY AND THE GENERAL COMPETENCIES CAN BE MET. DURING THE FISCAL YEAR COVERED BY THIS FILING, LHMC HAD NET EXPENDITURES OF $25,360,565 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE HOSPITAL'S TEACHING FUNCTION WHICH REPRESENTED 2.59% OF THE HOSPITAL'S TOTAL EXPENSES. ACGME ACCREDITED GME PROGRAMS -- RESIDENCYLAHEY CLINIC HOSPITAL, INC. SPONSORS SEVEN RESIDENCY AND TEN FELLOWSHIP PROGRAMS THAT TRAINS 158 RESIDENTS AND FELLOWS. THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED THESE PROGRAMS LISTED BELOW. ACGME ACCREDITED RESIDENCY PROGRAMS ANESTHESIOLOGY, COLON RECTAL SURGERY, DIAGNOSTIC RADIOLOGY, GENERAL SURGERY, INTERNAL MEDICINE, PLASTIC SURGERY AND UROLOGY. ACGME ACCREDITED FELLOWSHIP PROGRAMS: CARDIOVASCULAR MEDICINE, CARDIOLOGY ELECTROPHYSIOLOGY, INTERVENTIONAL CARDIOLOGY, MICROGRAPHIC DERMATOLOGIC SURGERY, ENDOCRINOLOGY, GASTROENTEROLOGY, PULMONARY AND CRITICAL CARE MEDICINE, TRANSPLANT HEPATOLOGY AND ORTHOPAEDIC HAND SURGERY. LHMC ALSO SERVES AS THE TEACHING SITE FOR A CLINICAL NEUROPHYSIOLOGY PROGRAM UNDER THE SPONSORSHIP OF TUFTS MEDICAL CENTER.ADDITIONAL INFORMATION ON LHMC'S CORE RESIDENCY PROGRAMS IS BELOW.ACGME ACCREDITED GME PROGRAMS -- FELLOWSHIPSADDITIONAL TRAINING OPPORTUNITIES FOR UP TO 15 TRAINEES ARE OFFERED IN MULTIPLE SPECIALTIES THAT INCLUDE FELLOWSHIPS IN ANESTHESIOLOGY TRANSPLANT, BARIATRIC SURGERY, ADVANCED CARDIOLOGY, HEPATOBILIARY SURGICAL TRANSPLANTATION, RADIOLOGY WOMEN'S HEALTH AND BREAST IMAGING, NEUROSURGERY, INTERVENTIONAL PULMONOLOGY, GYNECOLOGIC PELVIC FLOOR, AND OPHTHALMOLOGY RETINAL SURGERY. THE HOSPITAL ALSO THE HOSPITAL ALSO HOSTS ROTATING RESIDENTS AND FELLOWS IN ANESTHESIOLOGY, DERMATOLOGY, EMERGENCY MEDICINE, GYNECOLOGY, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASE, INTERNAL MEDICINE, NEUROLOGY, NEUROSURGERY, OPHTHALMOLOGY, OTOLARYNGOLOGY, ORTHOPAEDIC SURGERY, CARDIOTHORACIC SURGERY AND SURGICAL TRANSPLANT AND SERVES AS A ROTATION SITE FOR RESIDENTS AND FELLOWS FROM MULTIPLE LOCAL HOSPITALS INCLUDING, TUFTS MEDICAL CENTER, MASSACHUSETTS GENERAL HOSPITAL, BOSTON MEDICAL CENTER, ST. ELIZABETH'S HOSPITAL AND LEMUEL SHATTUCK HOSPITAL. THESE ACCOUNT FOR OVER 200 ROTATIONS PER YEAR.CORE ACGME ACCREDITED RESIDENCY PROGRAMSINTERNAL MEDICINETHE INTERNAL MEDICINE PROGRAM IS THE LARGEST RESIDENCY PROGRAM WITH 42 RESIDENTS, INCLUDING 12 CATEGORICAL AND 6 PRELIMINARY INTERNS.AS HEALTHCARE IS RAPIDLY CHANGING AND INTERNISTS CARE FOR PATIENTS IN A VARIETY OF SETTINGS WITH A WIDE-RANGE OF MEDICAL CONDITIONS, THE HOSPITAL'S TRAINING PROGRAM'S MISSION IS TO PROVIDE RESIDENTS WITH THE SKILLS NECESSARY TO THRIVE IN THIS CHANGING MEDICAL ENVIRONMENT. RESIDENTS CARE FOR PATIENTS ACROSS A WIDE SPECTRUM OF DISEASE IN AN EFFICIENT SYSTEM INCLUSIVE OF ACTIVE FACULTY MEMBERS, SUPPORTIVE ADMINISTRATION, AND CONSCIENTIOUS ANCILLARY STAFF. THE PROGRAM ALSO OFFERS RESIDENTS THE OPPORTUNITY TO PARTICIPATE IN OTHER ASPECTS OF HOSPITAL AND AMBULATORY CLINIC ACTIVITIES, INCLUDING SERVING ON COMMITTEES, FUNCTIONING AS EDITORS OF LAHEY'S INTERNAL MEDICINE NEWSLETTER, AND PARTICIPATING IN QUALITY IMPROVEMENT PROJECTS.GENERAL SURGERYLHMC'S DIVISION OF SURGERY HAS 80 FULL-TIME FACULTY WHO CONTRIBUTE TO THE TRAINING OF FIVE CATEGORICAL GENERAL SURGERY RESIDENTS PER YEAR. IN EACH SPECIALTY, INCLUDING GENERAL SURGERY, RESIDENTS ACQUIRE THE SKILLS AND KNOWLEDGE NECESSARY TO BECOME COMPETENT AND SKILLED INDEPENDENT GENERAL SURGEONS.SURGICAL SPECIALTIES ARE WELL ESTABLISHED, WITH FACULTY COMBINING BUSY CLINICAL PRACTICES WITH STRONG ACADEMIC CREDENTIALS. IN FIELDS WHERE REGIONAL CENTERS CONCENTRATE ON PARTICULAR TYPES OF DISEASESUCH AS PENETRATING TRAUMA AND PEDIATRIC SURGERYLHMC'S RESIDENTS ROTATE TO THESE REGIONAL CENTERS TO BROADEN THEIR EXPOSURE. LHMC'S OUTPATIENT CLINICS, HOSPITAL AND OPERATING ROOMS ARE UNDER ONE ROOF, SO RESIDENTS CAN READILY PARTICIPATE IN OUTPATIENT EVALUATION, OPERATIVE PROCEDURES, POSTOPERATIVE CARE AND POST-HOSPITAL FOLLOW-UP.UNDER THE SUPERVISION OF ATTENDING STAFF, RESIDENTS ASSUME INCREASED RESPONSIBILITY AS THEY PROGRESS THROUGH THE PROGRAM, INCLUDING TEACHING JUNIOR RESIDENTS AND MEDICAL STUDENTS. THE COMBINATION OF AN ACTIVE EMERGENCY SERVICE WITH 2,400 ANNUAL VISITS, A COMMUNITY-BASED PRACTICE AND WIDE TERTIARY REFERRAL ENSURES EACH RESIDENT WILL SEE A BROAD RANGE OF CASES. ANESTHESIOLOGYTHIS FOUR-YEAR RESIDENCY HAS UP TO SIX RESIDENTS PER ANNUAL COHORT. TRAINING OCCURS IN A COLLABORATIVE ENVIRONMENT. OPERATIVE CASES RANGE FROM ROUTINE AMBULATORY PROCEDURES TO COMPLEX NEUROSURGICAL, VASCULAR, CARDIOTHORACIC AND TRANSPLANT SURGERIES. CASE ASSIGNMENTS ARE INDIVIDUALIZED TO EACH RESIDENT'S ABILITY AND LEVEL OF TRAINING. THE DEPARTMENT OF ANESTHESIOLOGY AT LHMC AND THE AMBULATORY SURGERY CENTER, LAHEY MEDICAL CENTER PEABODY, COMBINED ADMINISTER MORE THAN 25,000 ANESTHETICS ANNUALLY AND THE VARIETY AND COMPLEXITY OF CASES PROVIDE A RICH ENVIRONMENT FOR RESIDENCY TRAINING.DIAGNOSTIC RADIOLOGYLHMC IN BURLINGTON IS A LEVEL II TRAUMA CENTER. RESIDENTS BECOME ACCOMPLISHED IN THE TECHNIQUES OF BASIC RADIOGRAPHY, FLUOROSCOPY, FILM INTERPRETATION, AND RADIATION PROTECTION AS WELL AS ROUTINE CT STUDIES INCLUDING BRAIN, SPINE, EXTREMITIES, CHEST AND ABDOMINAL CASES. LHMC PERFORMS STATE-OF-THE-ART CT AND MR ANGIOGRAPHY (NEUROVASCULAR, CARDIAC, AND PERIPHERAL VASCULAR IMAGING). A DEDICATED 3-D IMAGING LABORATORY ALLOWS FOR THE MANIPULATION OF IMAGES TO BETTER INTERPRET STUDIES, ALL OF WHICH INCREASE THE HOSPITAL'S RESIDENTS' LEVEL OF KNOWLEDGE AND EXPERIENCE. LHMC HAS INSTALLED SIMILAR SOFTWARE AT ALL RADIOLOGY PACS STATIONS WHICH PROVIDES RESIDENTS WITH TREMENDOUS HANDS ON TRAINING IN THE USE OF 3-D POST-PROCESSING SOFTWARE. RESIDENTS ALSO HAVE THE OPPORTUNITY TO TRAIN IN ADVANCED SUBSPECIALTY IMAGING, OFTEN RESERVED FOR FELLOWS IN OTHER DEPARTMENTS (I.E., CT COLONOGRAPHY, BREAST MRI, LUNG SCREENING, ETC.).
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION:
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UROLOGYTHE UROLOGY PROGRAM CONSISTS OF FIVE CLINICAL YEARS VERTICALLY INTEGRATED WITH GRADED RESPONSIBILITY FOR PATIENT CARE. IN ADDITION TO ACGME ACCREDITATION, THIS TRAINING PROGRAM MEETS ALL THE REQUIREMENTS OF THE AMERICAN BOARD OF UROLOGY (ABU) RESIDENTS BECOME FAMILIAR WITH THE PHYSIOLOGY AND PATHOPHYSIOLOGY OF UROLOGIC DISEASES AND HAVE A DEDICATED ROTATION IN THE BASIC SCIENCE RESEARCH LAB AS WELL AS CLINICAL TRAINING FOCUSING INITIALLY ON BASIC UROLOGY INCLUDING ENDOSCOPY, INPATIENT CONSULTS AND EARLY EXPOSURE TO ROBOTICS AND PROGRESSES TO EXPERIENCE WITH MORE COMPLEX ENDOSCOPIC PROCEDURES AS WELL AS PERFORMING MAJOR AND MINOR OPERATIVE PROCEDURES. THE FIFTH YEAR OF THIS PROGRAM IS SPENT AS A CHIEF RESIDENT WITH EXPERIENCE AT EXPOSURE BOTH AT LHMC AND A BETH ISRAEL DEACONESS MEDICAL CENTER, A TERTIARY CARE ACADEMIC MEDICAL CENTER IN BOSTON, MASSACHUSETTS AND A SISTER ENTITY TO LHMC. THE CHIEF RESIDENT SPENDS THE YEAR BECOMING PROFICIENT IN MAJOR OPERATIVE PROCEDURES AND IS RESPONSIBLE FOR ORGANIZING CONFERENCES AT BOTH TEACHING HOSPITALS. THE CHIEF RESIDENTS SUPERVISE AND COORDINATE THE JUNIOR RESIDENTS AS WELL AS MEDICAL STUDENTS. THIS INCREASING LEVEL OF INDEPENDENCE PREPARES THE CHIEF RESIDENTS FOR THE TRANSITION TO FELLOWSHIP OR INDEPENDENT PRACTICE.EXAMPLES OF THE HOSPITAL'S ACGME ACCREDITED FELLOWSHIP PROGRAMS GASTROENTEROLOGY FELLOWSHIPTHE GASTROENTEROLOGY FELLOWSHIP IS A THREE-YEAR WHERE FELLOWS GAIN PROFICIENCY IN ALL AREAS OF GASTROENTEROLOGY AND HEPATOLOGY. APPROXIMATELY EIGHTEEN MONTHS ARE SPENT ON THE GASTROENTEROLOGY SERVICE, WHICH COMPRISES THE INPATIENT SERVICE FOR PATIENTS ADMITTED WITH PRIMARY GASTROINTESTINAL DISORDERS, AS WELL AS THE CONSULTATION SERVICE. THE HOSPITAL IS A BUSY LIVER TRANSPLANT CENTER, AND TRAINEES SPEND A TOTAL OF SIX MONTHS ON THE INPATIENT LIVER SERVICE CARING FOR PATIENTS WITH COMPLICATED LIVER DISEASE. FELLOWS MAINTAIN THEIR OWN CONTINUITY CLINIC, WHICH MEETS WEEKLY FOR THREE YEARS. FELLOWS ALSO ROTATE INTO IBD AND HEPATOLOGY OUTPATIENT CLINICS DURING THEIR THIRD YEAR. ROTATIONS IN ENDOSCOPY, CLINICAL RESEARCH, MOTILITY AND NUTRITION ARE ALSO PART OF THE EDUCATIONAL EXPERIENCE. THERE IS A RICH CONFERENCE SCHEDULE INCLUDING DIDACTIC LECTURES, INSTRUCTION IN PATHOLOGY AND RADIOLOGY, AND CASE DISCUSSIONS AND FELLOWS HAVE MULTIPLE OPPORTUNITIES FOR TEACHING OF RESIDENTS AND MEDICAL STUDENTS. GRADUATING FELLOWS ARE WELL SUITED FOR A CAREER IN ACADEMIC CLINICAL GASTROENTEROLOGY.PULMONARY AND CRITICAL CARE MEDICINE FELLOWSHIPPULMONARY AND CRITICAL CARE MEDICINE FELLOWSHIP INCLUDES TRAINING IN INTERVENTIONAL PULMONOLOGY AND PREPARATION FOR CERTIFICATION IN BOTH PULMONARY MEDICINE AND CRITICAL CARE MEDICINE. ROTATIONS ARE SCHEDULED IN THE MEDICAL AND SURGICAL INTENSIVE CARE UNITS.FELLOWS WORK DIRECTLY WITH PULMONARY AND CRITICAL CARE MEDICINE PROFESSIONALS AND ALSO INTERACT WITH PHYSICIANS AND TRAINEES IN ANESTHESIOLOGY, CARDIOTHORACIC SURGERY, GENERAL SURGERY, INTERNAL MEDICINE AND ITS SUBSPECIALTIES, NEUROLOGY, NEUROSURGERY, ORTHOPAEDIC SURGERY AND UROLOGY. RESEARCH OPPORTUNITIES ARE AN ESSENTIAL PART OF THE TRAINING AND SIX MONTHS SPACED THROUGHOUT THE FELLOWSHIP ARE SET ASIDE SPECIFICALLY FOR RESEARCH. ADVANCED PRACTITIONER PROGRAMPHYSICIAN ASSISTANT AND NURSE PRACTITIONER STUDENTS FROM SEVERAL LOCAL COLLEGES AND UNIVERSITIES ROTATE TO MULTIPLE DEPARTMENTS THROUGHOUT THE LHMC AS PART OF THEIR EDUCATIONAL EXPERIENCE.ADVANCED PRACTICE EDUCATION IS INTRINSIC TO LHMC'S TRADITION OF PATIENT-CENTERED CARE. THE ADVANCED PRACTICE COUNCIL OVERSEES THE PROFESSIONAL PRACTICE AND DEVELOPMENT OF THE ADVANCE PRACTITIONERS WHILE LEARNING AND TRAINING AT LHMC AND ASSURES THAT THE MEDICAL STAFF, NURSING DEPARTMENT, HOSPITAL ADMINISTRATION, AND PHYSICIAN LEADERS ARE CONNECTED IN THEIR SUPPORT OF OUR ADVANCED PRACTICE PROVIDERS AND THEIR STUDENTS. OUR TEAM MODEL ENSURES A SEAMLESS, COORDINATED APPROACH TO PATIENT CARE.ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. ON MARCH 1, 2019, THE BETH ISRAEL LAHEY HEALTH SYSTEM WAS FORMED THROUGH THE COMBINATION OF THE HOSPITALS AND OTHER AFFILIATES OF THREE LEGACY HEALTH CARE SYSTEMS BASED PRIMARILY IN EASTERN MASSACHUSETTS, INCLUDING THE FORMER CAREGROUP HEALTH SYSTEM, THE FORMER LAHEY HEALTH SYSTEM, AND THE SEACOAST HEALTH SYSTEM. BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS NOW THE SOLE MEMBER OF THE HOSPITAL AND NINE ADDITIONAL AFFILIATED HOSPITALS. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE BILH HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. AFFILIATED HEALTH CARE SYSTEMAS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. BILH SERVES AS SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). LAHEY CLINIC FOUNDATION SERVES AS THE SOLE MEMBER OF LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES.IRC 501(R) REPORTING UNDER REVENUE PROCEDURE 2015-21:DURING A REVIEW OF LAHEY CLINIC HOSPITAL, INC.'S SECTION 501(R) COMPLIANCE IN FY19, IT WAS DETERMINED THAT CERTAIN INFORMATION IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP), PLAIN LANGUAGE SUMMARY (PLS) AND CREDIT AND COLLECTIONS POLICY (CCP) REQUIRED CLARIFICATION OR CORRECTION. IN ACCORDANCE WITH THE PROCEDURES SET FORTH IN REVENUE PROCEDURE 2015-21, EACH OF THOSE ITEMS IS LISTED ALONG WITH THE METHOD OF CORRECTION. CORRECTION OCCURRED BY ADOPTION OF A REVISED FAP, PLS AND CCP BY THE HOSPITAL'S AUTHORIZED BODY PRIOR TO FILING THIS RETURN.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION:
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(1) WHILE THE FAP SPECIFIED THE PERCENTAGE OF DISCOUNTS AVAILABLE, IT DID NOT SPECIFICALLY REFER TO WHAT CHARGES THOSE DISCOUNTS WOULD BE APPLIED. THE FAP HAS BEEN REVISED TO CLARIFY THAT THE DISCOUNTS ARE APPLIED TO PATIENT GROSS CHARGES. (2) THE FAP DID NOT SPECIFY THE AMOUNTS GENERALLY BILLED (AGB) BY THE HOSPITAL OR SPECIFY THE METHODOLOGY FOR CALCULATING THE AGB. THIS INFORMATION WAS POSTED ON THE HOSPITAL'S WEBSITE BUT WAS NOT SPECIFICALLY INCLUDED IN THE FAP. THE FAP HAS BEEN REVISED TO INCLUDE THIS INFORMATION. (3) THE FAP DID NOT CLEARLY DESCRIBE INFORMATION OBTAINED FROM SOURCES OTHER THAN THE INDIVIDUAL SEEKING FINANCIAL ASSISTANCE TO PRESUMPTIVELY DETERMINE THAT THE INDIVIDUAL IS FAP-ELIGIBLE. THE FAP HAS BEEN REVISED TO CLARIFY SUCH INFORMATION. (4) THE LIST OF PROVIDERS OF EMERGENCY AND MEDICALLY NECESSARY CARE AT THE HOSPITAL DID NOT INCLUDE ALL PROVIDERS. THE LIST HAS BEEN UPDATED AND NOW REFLECTS ALL PROVIDERS. (5) THE PLS DID NOT INCLUDE INSTRUCTIONS ON HOW AN INDIVIDUAL CAN OBTAIN A FREE COPY OF THE FAP AND FAP INSTRUCTIONS BY MAIL AND DID NOT INCLUDE THE CONTACT INFORMATION, INCLUDING TELEPHONE NUMBER AND PHYSICAL LOCATION OF THE HOSPITAL'S OFFICE OR DEPARTMENT THAT CAN PROVIDE ASSISTANCE WITH THE FAP APPLICATION PROCESS. THE PLS HAS BEEN REVISED TO INCLUDE THIS INFORMATION. (6) THE HOSPITAL HAD NOT YET MADE EFFORTS TO INFORM MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL ABOUT THE FAP IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. THE HOSPITAL HAS SINCE MADE SUCH EFFORTS, INCLUDING BY DISTRIBUTING COPIES OF ITS FAP AND FAP APPLICATION TO REFERRING STAFF PHYSICIANS AND TO COMMUNITY HEALTH CENTERS SERVING THE HOSPITAL'S COMMUNITY. (7) THE HOSPITAL HAD NOT BEEN OFFERING A PAPER COPY OF ITS PLS TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS. THE HOSPITAL HAS NOW ENSURED THAT IT IS DOING SO. (8) WHILE THE HOSPITAL HAD NOT BEEN ENGAGING IN ANY EXTRAORDINARY COLLECTION ACTIONS (ECAS), ITS CCP DID NOT INCLUDE A DESCRIPTION OF THE OFFICE, DEPARTMENT OR COMMITTEE WITH FINAL AUTHORITY FOR DETERMINING THAT REASONABLE EFFORTS HAD BEEN MADE TO DETERMINE FAP ELIGIBILITY BEFORE ENGAGING IN ANY ECAS. THE CCP HAS BEEN REVISED TO [EXPLICITLY PROHIBIT THE HOSPITAL FROM ENGAGING IN ECAS / INCLUDE SUCH A DESCRIPTION].FINALLY, THE HOSPITAL HAS ADOPTED PROCEDURES THAT REQUIRE THE HOSPITAL TO REVIEW, ON A REGULAR BASIS, THE HOSPITAL'S POLICIES AND PROCEDURE TO ENSURE COMPLIANCE WITH THE REQUIREMENTS OF SECTION 501(R) AND THE REGULATIONS ISSUED THEREUNDER. THOSE PROCEDURES INCLUDE REVIEWING A SECTION 501(R) COMPLIANCE CHECKLIST.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.