TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) ADLER MD JOHNATHAN...................................................................... TRUSTEE	1.00 ................. 1.00	X		7,489	0
(2) ANDREWS PAUL...................................................................... TRUSTEE, CHAIR	1.00 ................. 1.00	X	X	0	0
(3) BERTOCHI MARGARET...................................................................... TTEE (EX-OFF) PRES WINS. CLUB	1.00 ................. 1.00	X		0	0
(4) CONWAY JAMES...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0
(5) DEROSA CINDY...................................................................... TTEE (EX-OFF), PRES FRND OF WH	1.00 ................. 1.00	X		0	0
(6) FICOCIELLO DDS JAMES...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0
(7) FORTUNATO MD ROBERT...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0
(8) FULLER MD ARLAN...................................................................... TRUSTEE	1.00 ................. 1.00	X		84,113	0
(9) HAYDEN ERIC W...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0
(10) HOUGHTON JANICE...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0
(11) HUTCHESON MD JOHN J...................................................................... TTEE (EX-OFF) - MED STAFF PRES	1.00 ................. 1.00	X		0	0
(12) LITTLE MD ARTHUR...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0
(13) MARTINI JOHN C...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0
(14) MCCANCE WILLIAM...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0
(15) MCDONOUGH DEBORAH...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0
(16) NESTO MD RICHARD...................................................................... PRESIDENT, TRUSTEE (EX-OFF)	1.00 ................. 65.00	X	X	862,978	68,437
(17) OCKERBLOOM RICHARD...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) ROTOLO MD PETER J........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(19) SAYRE RICHARD........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(20) SMITH KEVIN F........................................................................ TRUSTEE, VICE CHAIR	1.00 .......................1.00	X	X				31,198	0	0
(21) TABB MD KEVIN........................................................................ TRUSTEE (EX-OFF), CEO	1.00 .......................64.00	X	X				0	1,756,953	143,704
(22) TARBY JD JOSEPH III........................................................................ TRUSTEE, ASST. CLERK	1.00 .......................1.00	X	X				0	0	0
(23) TAYLOR MD JOSEPH........................................................................ TRUSTEE	1.00 .......................1.00	X					0	69,045	6,018
(24) WALSH JANE........................................................................ TRUSTEE, VICE CHAIR	1.00 .......................61.00	X	X				0	0	0
(25) WEINER MD RICHARD........................................................................ TRUSTEE, CEO	40.00 .......................2.00	X	X				359,635	0	45,843
(26) FISCHER STEVEN P........................................................................ TREASURER (EX-OFF)	1.00 .......................61.00		X				0	770,210	75,762
(27) KATZ JAMIE........................................................................ CLERK (EX-OFF)	1.00 .......................59.00		X				0	560,463	44,008
(28) O'CONNOR TIMOTHY........................................................................ EVP, CFO & TREASURER	1.00 .......................57.00		X				0	1,108,721	197,547
(29) SPACKMAN JD DAVID G........................................................................ SVP GOV AFFAIRS, GC AND CLERK	1.00 .......................57.00		X				0	323,729	41,403
(30) WOODS MATTHEW J........................................................................ VP FINANCE, ASSISTANT CLERK	1.00 .......................42.00		X				0	375,014	56,877
(31) SCHULER KATHY ANN........................................................................ COO & CNO - WH	40.00 .......................2.00			X			343,127	0	39,860
(32) ZITKOVSKY DANA........................................................................ CHIEF MEDICAL OFFICER	40.00 .......................1.00			X			176,022	0	0
(33) ACKER DAVID........................................................................ QUALITY SAFETY ADVISOR & PHYS	40.00 .......................0.00				X		213,194	0	1,364
(34) BEYERMAN KATHLEEN........................................................................ ACNO NURSING STAFF DEVELOPMENT	40.00 .......................0.00				X		199,190	0	34,559
(35) GREGA JOANNE M........................................................................ ADMINISTRATIVE DIR, RADIOLOGY	40.00 .......................0.00				X		217,661	0	38,101
(36) ROBERTSON CATHERINE A........................................................................ VP, PHYSICIAN SERVICES	40.00 .......................0.00				X		258,462	0	9,062
(37) SACHETTI NANCY L........................................................................ DIRECTOR, HIGHLAND HEALTH IPA	40.00 .......................0.00				X		232,757	0	41,698
(38) GRANT MD JD HOWARD R........................................................................ FMR TTEE, PRESIDENT & CEO	0.00 .......................5.00					X	0	4,442,870	248,265
(39) ISEKE MD RICHARD........................................................................ FMR CMO	40.00 .......................1.00					X	343,507	65,347	24,693

(A) Name and business address	(B) Description of services	(C) Compensation
SODEXHO OPERATIONS LLC PO BOX 360170 PITTSBURGH,PA152516170	MANAGEMENT	1,663,814
NEW ENGLAND INPATIENT SPECIALISTS 47 HIGH STREET SUITE 101 NORTH ANDOVER,MA01845	HOSPITALISTS	1,654,299
CLINICAL FINANCIAL RESOURCE INC PO BOX 100 SEEKONK,MA02771	CODING/BILLING SERVICES	1,323,640
DIVURGENT LLC 4445 CORPORATION LANE SUITE 228 VIRGINIA BEACH,VA23462	CONSULTING	1,299,181
STRATA PATHOLOGY SERVICESINC 1 CRANBERRY HILL LEXINGTON,MA02421	LAB SERVICES	1,228,322
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 57

Section D - Distributions	Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Return Reference	Explanation
PART II-B, LINE 1:	AS NOTED THROUGHOUT THIS FILING, ON MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF, AMONG OTHER ENTITIES, LAHEY HEALTH SHARED SERVICES (LHSS), NORTHEAST HOSPITAL CORP (NHC) D/B/A/ BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL AND BAYRIDGE HOSPITALS, WINCHESTER HOSPITAL AND THE LAHEY CLINIC FOUNDATION (LCF). LCF IN TURN SERVES AS THE SOLE MEMBER OF LAHEY CLINIC INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. PRIOR TO MARCH 1, 2019 ALL OF THESE ENTITIES WERE PART OF THE LAHEY HEALTH NETWORK. IN ADDITION, ALL OF THESE ENTITIES ARE EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. AS PART OF ITS NETWORK SUPPORT FUNCTION LHSS PROVIDES GOVERNMENT RELATION SERVICES TO THE ENTITIES NOTED ABOVE AND OTHER NETWORK AFFILIATES. COSTS INCURRED BY LHSS ON BEHALF OF THESE AFFILIATES ARE CHARGED BACK TO AND ARE INCLUDED WITH OTHER COSTS REPORTED BY THE RESPECTIVE ORGANIZATIONS IN FORM 990, SCHEDULE C, POLITICAL CAMPAIGN AND LOBBYING ACTIVITIES, PART II-B. WINCHESTER HOSPITAL ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER NETWORK AFFILIATES AND/OR PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $265,290 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES.

	(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d


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

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(3) Other (A) INVESTMENTS, OTHER 457B	914,354	F
(B) AWUL TEMP RESTR INVESTMENTS	14,607,903	F
(C) AWUL PERM RESTR INVESTMENTS	1,790,975	F
(D) TRUST - PERM RESTR IRREV TRUST	4,305,492	F
(E) LT INVESTMENTS - OTHER	168,636,828	F
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	190,255,552

(a) Description	(b) Book value
(1) NOTES RECEIVABLE INTERNATIONAL FAMILY	2,500,000
(2) RESERVE-NOTES RECEIVABLE	-2,500,000
(3) SPLIT-DOLLAR LIFE EQUITIES	1,084,826
(4) INVESTMENT IN CAPTIVE INSURANCE	894,158
(5) BENE. INT. IN NET ASSETS	5,418,124
(6) RADIATION THERAPY OF WIN	682,500
(7) RAD. THERAPY OF WIN-VAL. ADJ.	2,020,000
(8) INVESTMENT IN JP-SHIELDS-MRI	7,688,100
(9) SHIELD-MRI-VALUATION ADJ	-1,368,800
(10) INVESTMENT IN YANKEE ALLIANCE	470,900
(11) INDEPENDENT PHYSICIAN NETWORK	2,660,000
(12) CERTIFICATE OF NEED-VALUATION	7,000,000
(13) CLINICAL RELATIONSHIP-BCH	902,215
(14) TRADE NAME-VALUATION	5,700,000
(15) PROFESSIONAL INSURANCE RECEIVABLE	11,776,071
(16) LEASEHOLD VALUATION	1,279,812
(17) MORTGAGE RECEIVABLE	65,471
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........	46,273,377

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......	1	3,697,428,000
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	1,345,571
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	3,525,310,360
e	Add lines 2a through 2d .....................	2e	3,526,655,931
3	Subtract line 2e from line 1..................	3	170,772,069
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	-467,005
b	Other (Describe in Part XIII.) ...........	4b	117,527,902
c	Add lines 4a and 4b....................	4c	117,060,897
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......	5	287,832,966

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	3,162,285		3,162,285	1.130 %
b	Medicaid (from Worksheet 3, column a) . . . . .	24,093,522	19,482,938	4,610,584	1.650 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	27,255,807	19,482,938	7,772,869	2.780 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,468,347	223,567	1,244,780	0.450 %
f	Health professions education (from Worksheet 5) . . .	174,208	650	173,558	0.060 %
g	Subsidized health services (from Worksheet 6) . . . .	26,590,155	14,697,090	11,893,065	4.250 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	272,550		272,550	0.100 %
j	Total. Other Benefits . .	28,505,260	14,921,307	13,583,953	4.860 %
k	Total. Add lines 7d and 7j .	55,761,067	34,404,245	21,356,822	7.640 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

6,359,770

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

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

Section B. Medicare

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

94,774,537

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

108,341,508

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

-13,566,971

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)			Other (describe)
1	WINCHESTER HOSPITAL 41 HIGHLAND AVENUE WINCHESTER,MA01890 WWW.WINCHESTERHOSPITAL.ORG	X	ACUTE CARE FACILITY

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	WINCHESTER HOSPITAL
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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

Yes

6 a

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): SEE PART VI

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

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

Yes

If "Yes" (list url): SEE PART VI

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	WINCHESTER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000% and FPG family income limit for eligibility for discounted care of 200.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

SEE PART VI

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

SEE PART VI

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

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

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

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

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	WINCHESTER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	WINCHESTER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
WINCHESTER HOSPITAL	PART V, SECTION B, LINE 5: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
WINCHESTER HOSPITAL	PART V, SECTION B, LINE 11: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION.

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?22
Name and address		Type of Facility (describe)
1	1 - WINCHESTER HOSPITAL 1021 MAIN STREET WINCHESTER,MA01890	ADMIN OFFICES, BILLING, DOCTOR OFFICES
2	2 - WINCHESTER HOSPITAL 200 UNICORN PARK WOBURN,MA01801	COMMUNITY HEALTH, MRI, BREAST CANCER CENTER
3	3 - WINCHESTER HOSPITAL 620 WASHINGTON STREET WINCHESTER,MA01890	RADIOLOGY/ONCOLOGY SERVICES FACILITY
4	4 - WINCHESTER HOSPITAL - BALDWIN PARK I 12 ALFRED STREET WOBURN,MA01801	COMMUNITY HEALTH INST., SLEEP CARE & ADMIN OFFICES
5	5 - WINCHESTER HOSPITAL - BALDWIN PARK II 12 ALFRED STREET WOBURN,MA01801	BREAST CARE, IMAGING HEMOTOLOGY/ONCOLOGY LAB, PHARMACY, CHIRO
6	6 - FAMILY MEDICAL SERVICES 500 SALEM STREET WILMINGTON,MA01887	AUDIOLOGY, OB/GYN, CARDIO-PUL, LAB, PT, URGENT CARE, PEDI
7	7 - WINCHESTER HOSPITAL 262/264 W CUMMINGS PARK WOBURN,MA01801	LAB & HOME CARE SERVICE
8	8 - WINCHESTER HOSPITAL RUSSELL HILL BUILDINGS 955 MAIN STREET WINCHESTER,MA01890	LAB, RADIOLOGY & PHYSICAL THERAPY
9	9 - WINCHESTER HOSPITAL 150 PRUDENTIAL WAY WOBURN,MA01801	MRI SERVICE
10	10 - READING HEALTH CENTER 20 POND MEADOW DRIVE READING,MA01867	LAB
11	11 - PATIENT SPECIMEN COLLECTION & SERV CT 3 WOODLAND ROAD STONEHAM,MA02180	LAB
12	12 - MONTVALE DIAGNOSTIC CENTER 88 MONTVALE AVENUE STONEHAM,MA02180	LAB
13	13 - WINCHESTER HOSPITAL 790 BOSTON POST ROAD BILLERICA,MA01821	LAB
14	14 - WINCHESTER HOSPITAL 100 BYPASS ROAD NORTH ANDOVER,MA01845	LAB
15	15 - WINCHESTER HOSPITAL 101 CAMBRIDGE STREET BURLINGTON,MA01803	LAB
16	16 - WINCHESTER HOSPITAL 11 SHORE ROAD WINCHESTER,MA01890	LAB
17	17 - WINCHESTER HOSPITAL 75 RIVERSIDE AVENUE MEDFORD,MA02155	LAB, WEIGHT MGMT, WOUND CARE CENTER
18	18 - WINCHESTER HOSPITAL 10P COMMERCE WAY WOBURN,MA01801	ENDOSCOPY CENTER
19	19 - WINCHESTER HOSPITAL 21 MAIN STREET NORTH READING,MA01864	DIAGNOSTIC CENTER
20	20 - PAIN MANAGEMENT CENTER 444 WASHINGTON STREET WOBURN,MA01801	PAIN CLINIC CENTER
21	21 - CHOATE MEDICAL CENTER 23 WARREN AVENUE WOBURN,MA01801	PHYSICAL THERAPY
22	22 - WINCHESTER HOSPITAL 95 MAPLE STREET STONEHAM,MA02180	STOREROOM/WAREHOUSE

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
FORM 990, SCHEDULE H, PART V, SECTION C:	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 WINCHESTER HOSPITAL IS A MEMBER OF BETH ISRAEL LAHEY HEALTH (BILH). AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES BILH TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES IT SERVES. BILH'S COMMUNITY BENEFITS STAFF IS COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES.IN 2013 THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND BOARD OF TRUSTEES LAID OUT THE COMMUNITY BENEFITS MISSION: "WINCHESTER HOSPITAL IS COMMITTED TO BENEFIT ALL OF THE COMMUNITIES WE SERVE BY COLLABORATING WITH COMMUNITY PARTNERS TO IDENTIFY HEALTH NEEDS, IMPROVE THE HEALTH STATUS OF COMMUNITY RESIDENTS, ADDRESS HEALTH DISPARITIES, AND EDUCATE COMMUNITY MEMBERS ABOUT PREVENTION AND SELF-CARE". WINCHESTER HOSPITAL FULFILLS THIS MISSION BY: INVOLVING WINCHESTER HOSPITAL'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY; ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. SPECIAL ATTENTION IS FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR 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 WINCHESTER HOSPITAL'S SERVICE AREA GEARED TOWARD IMPROVING CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES; PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS SUMMARYDURING THE FISCAL YEAR COVERED BY THIS FILING, WINCHESTER HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $1,517,330, AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMWINCHESTER HOSPITAL IS A MEMBER OF BILH. WHILE WINCHESTER HOSPITAL OVERSEES LOCAL COMMUNITY BENEFITS PROGRAMMING AND COMMUNITY ENGAGEMENT EFFORTS, AND 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 WINCHESTER HOSPITAL 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 WINCHESTER HOSPITAL 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. COMMUNITY HEALTH NEEDS ASSESSMENTMOST 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. WINCHESTER HOSPITAL COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN AUGUST 2019. THAT CHNA WAS APPROVED BY THE WINCHESTER HOSPITAL BOARD OF TRUSTEES ON SEPTEMBER 17, 2019. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 17, 2019, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE 2019 CHNA AND THE ASSOCIATED IMPLEMENTATION STRATEGY ARE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OF WINCHESTER HOSPITAL'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 WINCHESTER HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW WINCHESTER HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY2019 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONSTHE GEOGRAPHICAL FOCUS OF THE 2019 CHNA ENCOMPASSES WINCHESTER HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA), COMPRISED OF NINE CITIES AND TOWNS INCLUDING MEDFORD, NORTH READING, READING, STONEHAM, WILMINGTON, WINCHESTER, WOBURN, AND TEWKSBURY. TARGET POPULATIONS FOR WINCHESTER HOSPITAL'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). WHILE WINCHESTER HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH STATUS AND WELL-BEING OF THOSE LIVING THROUGHOUT ITS ENTIRE SERVICE AREA, PER THE COMMONWEALTH'S UPDATED COMMUNITY BENEFITS GUIDELINES, WINCHESTER HOSPITAL'S IMPLEMENTATION STRATEGY WILL FOCUS ON POPULATIONS THAT ARE MOST AT-RISK. THE CHNA SHOWED THAT ALTHOUGH ALL GEOGRAPHIC, DEMOGRAPHIC, AND SOCIO-ECONOMIC SEGMENTS OF THE POPULATION FACE CHALLENGES THAT CAN HINDER THE ABILITY TO ACCESS CARE OR MAINTAIN GOOD HEALTH, THE POPULATIONS LISTED BELOW WERE IDENTIFIED AS FACING THE GREATEST HEALTH DISPARITIES AND BEING THE MOST AT RISK. - YOUTH AND ADOLESCENTS- OLDER ADULTS- LOW-RESOURCE INDIVIDUALS AND FAMILIES- INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS WINCHESTER HOSPITAL'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." IN RESPONSE TO THE FY19 CHNA, WINCHESTER HOSPITAL WILL FOCUS ITS FY20-22 IMPLEMENTATION STRATEGY ON THE FOLLOWING PRIORITY AREAS THAT ADDRESS THE BROAD RANGE OF HEALTH AND SOCIAL ISSUES FACING RESIDENTS WHO HAVE THE GREATEST HEALTH DISPARITIES: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS MENTAL HEALTH AND SUBSTANCE USE DISORDERS2019 COMMUNITY HEALTH NEEDS ASSESSMENT - SUMMARY OF APPROACH AND METHODSTHE ASSESSMENT BEGAN WITH THE CREATION OF A STEERING COMMITTEE COMPOSED OF REPRESENTATIVES FROM THE FORMER LAHEY HEALTH SYSTEM, INCLUDING WINCHESTER HOSPITAL, LAHEY HOSPITAL AND MEDICAL CENTER 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.
FORM 990, SCHEDULE H, PART V, SECTION C:	WINCHESTER HOSPITAL 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. 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 METHODSTHE QUANTITATIVE ASSESSMENT INCLUDED AN EXTENSIVE ANALYSIS OF DEMOGRAPHIC AND SOCIOECONOMIC DATA, HEALTH STATUS, UTILIZATION RATES, AND BEHAVIORAL RISK SURVEY DATA. DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN WINCHESTER HOSPITAL'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF HEALTH-RELATED ISSUES. - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017)- MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES- FBI UNIFORM CRIME REPORTS (2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, OPIOID RELATED EMS INCIDENTS (2018)- MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY2013-2017)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2017)- MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018)- MIDDLESEX LEAGUE YOUTH RISK BEHAVIOR SURVEY (2019)- CHANGING FACES OF GREATER BOSTON, BOSTON FOUNDATION (2019)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. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)WINCHESTER HOSPITAL 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 FOUR FOCUS GROUPS. APPENDIX A IN THE WINCHESTER HOSPITAL CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.2019 COMMUNITY HEATH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)FOUR FOCUS GROUPS AND TWO COMMUNITY LISTENING SESSIONS 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 WINCHESTER HOSPITAL 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 1200 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 WINCHESTER HOSPITAL 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 AND ACCESS TO CARE (E.G., ECONOMIC STABILITY, TRANSPORTATION, ACCESS TO CARE, HOUSING, FOOD INSECURITY) IMPACT 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 THE SOCIAL DETERMINANTS OF HEALTH HAVE ON RESIDENTS OF WH'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. THE INCREASING COST OF HOUSING IN AREAS OUTSIDE BOSTON WAS ALSO NOTED AS CONTRIBUTING TO HOUSING/FINANCIAL INSTABILITY. CERTAIN POPULATIONS ARE MORE VULNERABLE TO HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACTS THAT MASSACHUSETTS HAS ONE OF THE HIGHEST RATES OF HEALTH INSURANCE ENROLLMENT AND THE COMMUNITIES THAT MAKE UP WH'S CBSA ARE GENERALLY INSURED AND EMPLOYED, THERE WAS CONCERN THAT FAMILIES FACE FINANCIAL STRESS BECAUSE OF HIGH OUT-OF-POCKET COSTS FOR HEALTH CARE SERVICES AND NOT BEING ELIGIBLE FOR PUBLIC BENEFITS, OR, IF THEY ARE ELIGIBLE, THEY ARE NOT ENROLLING BECAUSE OF THE STIGMA OF ACCEPTING PUBLIC ASSISTANCE. IN ADDITION, THERE ARE GROUPS THAT FACE LANGUAGE AND CULTURAL BARRIERS TO ACCESSING 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. FROM A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION, 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 OF SOCIAL ISOLATION AMONG OLDER ADULTS. ACCESS TO MENTAL HEALTH SERVICES WAS LIMITED BY THE GENERAL LACK OF PROVIDERS AND THE LOW NUMBER ACCEPTING EVEN PRIVATE HEALTH INSURANCE. SUBSTANCE DEPENDENCY CONTINUES TO IMPACT INDIVIDUALS, FAMILIES, AND COMMUNITIES. THE OPIOID EPIDEMIC CONTINUES TO BE AN AREA OF FOCUS. BEYOND OPIOIDS, KEY INFORMANTS WERE ALSO CONCERNED WITH ALCOHOL MISUSE, CHANGING COMMUNITY NORMS IN LIGHT OF THE LEGALIZATION OF RECREATIONAL MARIJUANA USE, AND E-CIGARETTES/VAPING AMONG ADOLESCENTS. CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS: CHRONIC DISEASES SUCH AS CARDIOVASCULAR DISEASE, CANCER, DIABETES, ASTHMA, ETC. 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), EASE OF ACCESS TO HIGH- CALORIE/UNHEALTHY FOOD CHOICES, AND A LACK OF WALKABLE STREETS IN NEIGHBORHOODS. ADDRESSING THE LEADING RISK FACTORS IS AT THE ROOT OF MANY CHRONIC DISEASE PREVENTION AND MANAGEMENT STRATEGIES.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, WILL INFORM MAH'S COMMUNITY BENEFIT INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022.
SCHEDULE H, PART V, SECTION B, LINE 5:	COMMUNITY HEALTH NEEDS ASSESSMENT AND ACTIVITIES REPORTED IN THIS FILINGTHE PREVIOUS NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE WINCHESTER HOSPITAL BOARD OF TRUSTEES AND INFORMED WINCHESTER HOSPITAL'S COMMUNITY BENEFITS PROCESS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2017; SEPTEMBER 30, 2018; AND SEPTEMBER 30, 2019. 2016 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYIN FY16, WINCHESTER HOSPITAL, IN CONJUNCTION WITH ALL FOUR HOSPITALS IN THE LAHEY HEALTH SYSTEM, COMPLETED ITS TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA AND THE ASSOCIATED IMPLEMENTATION STRATEGY WERE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OUT OF THE HOSPITAL'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. 2016 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONSTHE HOSPITAL'S COMMUNITY BENEFITS WORK IS FOCUSED ON EXPANDING ACCESS, ADDRESSING BARRIERS TO CARE AND IMPROVING THE HEALTH STATUS OF RESIDENTS LIVING IN EIGHT MUNICIPALITIES LOCATED IN MIDDLESEX COUNTY: NORTH READING, READING, STONEHAM, TEWKSBURY, WAKEFIELD, WILMINGTON, WINCHESTER AND WOBURN. DEMOGRAPHICALLY AND SOCIOECONOMICALLY, WINCHESTER HOSPITAL FOCUSES ACTIVITIES TO MEET THE NEEDS OF ALL SEGMENTS OF THE POPULATION WITH RESPECT TO AGE, RACE/ETHNICITY, INCOME AND THE BROAD RANGE OF OTHER WAYS THAT POPULATIONS CHARACTERIZE THEMSELVES, TO ENSURE THAT ALL RESIDENTS HAVE THE OPPORTUNITY TO LIVE HEALTHY, HAPPY AND FULFILLING LIVES. HOWEVER, IN ACCORDANCE WITH FEDERAL AND COMMONWEALTH GUIDELINES, WINCHESTER HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES ARE FOCUSED PARTICULARLY ON THOSE POPULATION SEGMENTS IDENTIFIED BY THE NEEDS ASSESSMENT AS BEING MOST AT RISK: LOW-INCOME INDIVIDUALS AND FAMILIES, RACIAL/ETHNIC MINORITIES, YOUTH AND ADOLESCENTS, OLDER ADULTS, AND THOSE WHO ARE GEOGRAPHICALLY OR OTHERWISE ISOLATED.2016 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE CHNA WAS CONDUCTED IN THREE PHASES, ALLOWING WINCHESTER HOSPITAL 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 WINCHESTER HOSPITAL COMMUNITY HEALTH SURVEY, WHICH CAPTURED INFORMATION FROM HUNDREDS OF RANDOM HOUSEHOLDS IN PRIMARY SERVICE AREA.2016 COMMUNITY HEALTH NEEDS ASSESSMENTMAJOR HEALTH NEEDS AND HOW PRIORITIES WERE DETERMINEDIN RESPONSE TO THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2016 CHNA, WINCHESTER HOSPITAL DEVELOPED A THREE-YEAR IMPLEMENTATION STRATEGY WITH INPUT FROM THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY BOARD AND APPROVED BY THE BOARD OF DIRECTORS. FEEDBACK FROM COMMUNITY SESSIONS WAS ALSO 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 INCLUDED: BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE ABUSE) ELDER HEALTH WELLNESS, PREVENTION AND CHRONIC DISEASE MANAGEMENT 2016 COMMUNITY HEALTH NEEDS ASSESSMENT KEY 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 WH'S SERVICE AREA ARE AFFLUENT AND FARE WELL WITH RESPECT TO THE LEADING HEALTH INDICATORS. HOWEVER, SEGMENTS OF THE POPULATION 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 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, YET THERE ARE STILL POCKETS OF LOW-INCOME, MEDICAID-INSURED, UNINSURED AND UNDERINSURED RESIDENTS 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. PER THE COMMUNITY HEALTH SURVEY, 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 DEVELOPING DIABETES, HYPERTENSION AND ASTHMA. HIGH RATES OF THE LEADING HEALTH RISK FACTORS. ANOTHER SIGNIFICANT FINDING DRAWN FROM THE ASSESSMENT'S QUANTITATIVE DATA WAS THE FACT THAT MANY CITIES AND TOWNS IN WH'S 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, FOR MOST, THESE CONDITIONS ARE CONSIDERED PREVENTABLE OR AT LEAST MANAGEABLE. ADDRESSING THE LEADING HEALTH RISK FACTORS (E.G., 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 THE SERVICE AREA FARE WELL AS A WHOLE COMPARED WITH COMMONWEALTH AVERAGES ON 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 WH'S SERVICE AREA. DEPRESSION/ANXIETY, SUICIDE, ALCOHOL ABUSE, OPIOID AND PRESCRIPTION DRUG ABUSE, AND MARIJUANA USE AMONG YOUTH 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 SERVICE AREA. OPIOID ABUSE WAS A PARTICULAR CONCERN FOR RESIDENTS AND SERVICE PROVIDERS IN THE SERVICE AREA, AND THERE WERE CALLS FOR GREATER OUTREACH, EDUCATION, SCREENING AND TREATMENT SERVICES FOR ALL SEGMENTS OF THE POPULATION BY AGE AND INCOME. 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 SHOWS THAT WH'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 WH'S 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 AND SUPPORTIVE QUALITY TREATMENT.COMMUNITY HEALTH NEEDS ASSESSMENT - MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEWINCHESTER HOSPITAL 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.WINCHESTERHOSPITAL.ORG/OUR-PROMISE/SUPPORTING-OUR-COMMUNITY
SCHEDULE H, PART V, SECTION B, LINE 11	IN ADDITION, THE MOST RECENT CHNA HAS ALSO BEEN SHARED PUBLICALLY AND COPIES ARE AVAILABLE UPON REQUEST AND ON THE HOSPITAL'S WEBSITE ATHTTPS://WWW.WINCHESTERHOSPITAL.ORG/OUR-PROMISE/SUPPORTING-OUR-COMMUNITYBOTH DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A). COMMUNITY HEALTH NEEDS ASSESSMENT ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)FY19 SCHEDULE HIMPLEMENTATION STRATEGY UPDATETHE IMPLEMENTATION STRATEGY DEVELOPED TO MEET THESE PRESSING HEALTH CARE NEEDS FOCUSES ON THE FOLLOWING AREAS: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 WINCHESTER HOSPITAL 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 LAHEY HEALTH PRIMARY CARE 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 THEY INCLUDE COUNSELING SESSIONS, PHONE CONSULTATIONS WITH A PSYCHIATRIST, AND 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, AND 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. FY19 SUCCESS INCLUDED HIRING AND TRAINING BEHAVIORAL HEALTH CLINICIANS, LAUNCHING THE FIRST PRACTICE IN AUGUST AND REACHING 49 PATIENTS ACROSS 3 PRIMARY CARE SITES. BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDERWINCHESTER HOSPITAL PROVIDED A GRANT TO THE BOYS & GIRLS CLUB TO IMPLEMENT THIS INNOVATIVE APPROACH TO SCREEN AND IDENTIFY YOUTH WHO HAVE OR ARE AT RISK OF DEVELOPING MENTAL HEALTH OR SUBSTANCE USE DISORDERS AND DELIVER IMMEDIATE INTERVENTION AND/OR REFERRAL TO TREATMENT.WHAT DIFFERENTIATES THE PROGRAM FROM OTHER SCREENING EFFORTS IS THAT IT IS DELIVERED ON-SITE AT THE BOYS & GIRLS CLUB BY STAFF MEMBERS WHO KNOW THE PARTICIPANTS AND SEE THEM ON A REGULAR BASIS. THE STAFF MEMBERS ARE THE PARTICIPANTS' MENTORS AND ARE HIGHLY LIKED AND RESPECTED. ADMINISTERING THE PROGRAM IN THIS NON-AUTHORITARIAN, SAFE ENVIRONMENT RESULTS IN MORE NATURAL, OPEN, AND HONEST DIALOGUE. IN FY19 317 YOUTH MEMBERS WERE SCREENED AND 20 WERE REFERRED FOR FOLLOW UP CONSULTATIONS AND TWO WERE REFERRED FOR TREATMENT. IN ADDITION, 10 STAFF MEMBERS WERE TRAINED IN SCREENING AND INTERVIEWING TECHNIQUES.WINCHESTER HOSPITAL COLLABORATED WITH MYSTIC VALLEY ELDER SERVICES TO SUPPORT THE MOBILE MENTAL HEALTH PROGRAM IN PROVIDING HOME-BASED MENTAL HEALTH SERVICES TO OLDER ADULTS IN MEDFORD, READING, STONEHAM, AND WAKEFIELD. THE PROGRAM ADDRESSES A VARIETY OF ISSUES AFFECTING OLDER ADULTS' EMOTIONAL WELL-BEING AND QUALITY OF LIFE SUCH AS HOARDING, DEPRESSION, ANXIETY, ADJUSTMENT TO LOSS, AND SUBSTANCE USE. THE GOAL IS TO IMPROVE THE MENTAL HEALTH AND EMOTIONAL WELL-BEING OF OLDER ADULTS AND INCREASE ACCESS TO MENTAL HEALTH CARE BY PROVIDING HOME-BASED MENTAL HEALTH COUNSELING AND DIRECT CARE SERVICES INCLUDING DIAGNOSIS, PRESCRIPTION MEDICATION, AND THERAPY GET TRAINED PROFESSIONALS TO CLIENTS AS SOON AS POSSIBLE TO ENSURE RECOVERY. IN FY19, THE MOBILE MENTAL HEALTH PROGRAM PROVIDED SERVICES TO 371 COMMUNITY MEMBERS, 128 (35%) OF WHOM WERE SERVED SPECIFICALLY THROUGH FUNDING RECEIVED BY WINCHESTER HOSPITAL. PARTICIPANTS REPORTED IMPROVED HEALTH AND LEVEL OF HAPPINESS, AND AN INCREASE IN THE NUMBER OF HEALTHY BEHAVIORS THEY ENGAGED IN. DATA RELEASED IN OCTOBER 2019 BY THE NATIONAL CENTER FOR HEALTH STATISTICS AND THE CDC SHOWS THAT SUICIDE WAS THE SECOND LEADING CAUSE OF DEATH AMONG AMERICANS AGES 15 TO 24 IN2017. THIS COMBINED WITH AN INCREASED NUMBER OF WOBURN PUBLIC SCHOOLS STUDENTS RECEIVING COUNSELING SUPPORTED A GROWING NEED FOR SCHOOL BASED MENTAL HEALTH SERVICES. IN RESPONSE, WINCHESTER HOSPITAL PROVIDED FUNDING FOR TCI "TRAIN THE TRAINER" SESSIONS, CONDUCTED BY PERSONNEL FROM CORNELL UNIVERSITY, FOR STAFF MEMBERS OF WOBURN PUBLIC SCHOOLS, THE WOBURN BOYS & GIRLS CLUB, AND THE WOBURN YMCA. TCI TRAINING PRESENTS A CRISIS PREVENTION AND INTERVENTION MODEL THAT TEACHES STAFF TO HELP CHILDREN LEARN CONSTRUCTIVE WAYS TO HANDLE CRISIS SITUATIONS AND HELP MANAGE STRESSFUL SITUATIONS, ALLOWING LICENSED CLINICIANS TO CONDUCT GOALS-BASED COUNSELING USING A MODULAR APPROACH TO THERAPY FOR ANXIETY, DEPRESSION, TRAUMA, AND CONDUCT DISORDERS. THE SKILLS, KNOWLEDGE, AND PROFESSIONAL JUDGMENT OF STAFF IN RESPONDING TO CRISES ARE CRITICAL FACTORS IN HELPING YOUNG PEOPLE LEARN CONSTRUCTIVE AND ADAPTIVE WAYS TO DEAL WITH FRUSTRATION. IN FY19, TCI TRAINING WAS COMPLETED BY 13 STAFF MEMBERS FROM WOBURN SCHOOLS, TWO STAFF MEMBERS FROM THE WOBURN BOYS & GIRLS CLUB, AND TWO STAFF MEMBERS FROM THE YMCA, WHO THEN IMPLEMENTED THE TRAINING FOR MORE THAN 350 STAFF MEMBERS AT THEIR RESPECTIVE SITES. AFTER IMPLEMENTING THE TRAINING, TEACHERS AND STAFF FROM THE SCHOOLS REPORTED A 25% REDUCTION IN THE NUMBER OF SUSPENSIONS AND INCIDENCES OF STUDENTS BEING SENT TO THE OFFICE, AND REPORTED THEY WERE LESS LIKELY TO ENGAGE IN POWER STRUGGLES WITH STUDENTS.THE NAN PROJECT BUILT ON PARTNERSHIPS WITH GALVIN MIDDLE SCHOOL AND THE WAKEFIELD SUICIDE PREVENTION COALITION TO REDUCE THE STIGMA AND INCREASE UNDERSTANDING OF MENTAL HEALTH AND SUICIDE. WITH SUPPORT FROM WINCHESTER HOSPITAL, THE NAN PROJECT EDUCATED STUDENTS, STAFF, AND PARENTS ABOUT YOUTH MENTAL HEALTH ISSUES THROUGH A SERIES OF TRAINING AND EDUCATIONAL SESSIONS. THE OVERALL GOAL WAS TO HELP TEACHERS, PARENTS, AND STUDENTS REDUCE THE STIGMA OF AND INCREASE UNDERSTANDING ABOUT MENTAL HEALTH ISSUES AND SUICIDE. IN FY19, 25 STAFF MEMBERS, INCLUDING GUIDANCE COUNSELORS, TEACHERS, SCHOOL NURSES, AND ADJUSTMENT COUNSELORS, RECEIVED QPR SOCIAL EMOTIONAL BEHAVIORAL HEALTH TRAINING TO LEARN ABOUT THE SIGNS OF DEPRESSION, OTHER MENTAL ILLNESSES, AND SUICIDE RISK; RESOURCES AVAILABLE IN THEIR COMMUNITY; AND HOW TO RESPOND TO YOUTH IN DISTRESS. IN ADDITION, ALL STAFF MEMBERS AT WAKEFIELD HIGH SCHOOL AND SEEM COLLABORATIVE PARTICIPATED IN A PROFESSIONAL DEVELOPMENT TRAINING SESSION ON ANXIETY AND DEPRESSION AND MORE THAN 100 PARENTS ATTENDED A COMMUNITY HEALTH FORUM/RESOURCE FAIR. AS A RESULT, TEACHERS AND STAFF REPORTED THAT STUDENTS DEMONSTRATED INCREASED AWARENESS OF HOW TO ASK FOR AND WHERE TO FIND HELP FOR THEMSELVES AND OTHERS WHO ARE STRUGGLING WITH MENTAL ILLNESS AND PARENTS LEARNED ABOUT SIGNS OF DEPRESSION, OTHER MENTAL ILLNESSES, AND SUICIDE RISK; RESOURCES AVAILABLE IN THEIR COMMUNITY; AND HOW TO RESPOND TO YOUTH IN DISTRESS. FOCUS ON ELDER HEALTHTHE SENIOR POPULATION IS THE FASTEST-GROWING DEMOGRAPHIC GROUP IN THE UNITED STATES, WITH MORE THAN 33 MILLION AMERICANS OVER THE AGE OF 65, AND THIS NUMBER IS EXPECTED TO DOUBLE BY THE YEAR 2030. IN ADDITION, THE HEALTH NEEDS OF THIS POPULATION ARE COMPLEX. WITH THIS IN MIND, WINCHESTER HOSPITAL LAUNCHED THE "AGING ON YOUR OWN TERMS" SENIOR OUTREACH INITIATIVE IN SEPTEMBER 2001. THIS SERIES OF PROGRAMS EDUCATES ACTIVE AGING ADULTS ON HOW TO MEET THEIR HEALTH NEEDS AND PROVIDES EVENTS AND ACTIVITIES TO ENHANCE THEIR SOCIAL WELL-BEING AND QUALITY OF LIFE. WINCHESTER HOSPITAL WORKS WITH SENIOR CENTERS AND ELDER CARE AGENCIES TO OFFER A VARIETY OF PROGRAMS AND SERVICES AT NO COST TO AREA SENIORS. EVENTS ARE HELD AT LOCATIONS THROUGHOUT THE COMMUNITY THAT ARE ACCESSIBLE VIA PUBLIC TRANSPORTATION. THE EDUCATIONAL PROGRAMS ALIGN WITH THE HEALTH NEEDS IDENTIFIED THROUGH THE FY16 CHNA AND FEEDBACK FROM PARTICIPANTS AND COMMUNITY PARTNERS. A DISTINGUISHING COMPONENT OF THE PROGRAM IS THE INTEGRATION OF SOCIAL PROGRAMMING TO ADDRESS ISOLATION, DEPRESSION, AND SOCIAL WELL-BEING.
SCHEDULE H, PART V, SECTION B, LINE 11	WINCHESTER HOSPITAL'S AGING ON YOUR OWN TERMS SENIOR OUTREACH INITIATIVE INCLUDES EDUCATIONAL PROGRAMS DESIGNED TO MEET THE HEALTH NEEDS OF ACTIVE AGING ADULTS AND INCLUDES SOCIAL EVENTS AND ACTIVITIES TO ENHANCE THEIR SOCIAL WELL-BEING AND QUALITY OF LIFE. IN FY19, WINCHESTER HOSPITAL PARTNERED WITH LOCAL SENIOR CENTERS TO PROVIDE FIVE SOCIAL EVENTS AND THREE EDUCATIONAL PROGRAMS TO 1,500 SENIORS IN WINCHESTER HOSPITAL'S SERVICE AREA. THE EDUCATIONAL SESSIONS ADDRESSED EATING HEALTHY TO AGE WELL, HIGHS & LOWS OF BLOOD PRESSURE AND ALLERGIES & AGING. SENIORS LEARN ABOUT WELLNESS, MAKE NEW FRIENDS, STAY CONNECTED AND LEARN ABOUT COMMUNITY RESOURCES.THE WINCHESTER HOSPITAL HOME BLOOD DRAW PROGRAM WAS DEVELOPED TO ENHANCE ACCESS TO PHLEBOTOMY SERVICES FOR HOMEBOUND PATIENTS WHO HAVE DIFFICULTY GETTING TO A LABORATORY OR DRAWING STATION. HOMEBOUND PATIENTS ARE DEFINED AS PEOPLE WITH A CONDITION DUE TO SURGERY, ILLNESS, OR INJURY THAT PRECLUDES THEM FROM ACCESSING MEDICAL CARE OUTSIDE THEIR HOME. THE GOAL IS TO INCREASE ACCESS TO PHLEBOTOMY SERVICES FOR HOMEBOUND PATIENTS WHO HAVE DIFFICULTY GETTING TO A LABORATORY/DRAWING STATION DUE TO ILLNESS OR INJURY. IN FY19, WINCHESTER HOSPITAL LAB SERVICES PROVIDED 9,969 FREE IN-HOME BLOOD DRAWS. IN ADDITION TO APPRECIATING THE CONVENIENCE OF THE HOME BLOOD DRAW, PATIENTS HAVE REPORTED REDUCED FEELINGS OF ISOLATION BECAUSE THE VISIT WITH THE PHLEBOTOMIST PROVIDES THEM WITH A SOCIAL OPPORTUNITY.RECOGNIZING ELDER HEALTH AS ONE OF THE LEADING PRIORITIES IDENTIFIED IN THE FY16 CHNA, WINCHESTER HOSPITAL AWARDED A GRANT TO THE WOBURN COUNCIL ON AGING TO SUPPORT A SAFE HOME INITIATIVE. THE INITIATIVE WAS COMMUNITY COLLABORATION BETWEEN THE COUNCIL ON AGING, THE WOBURN POLICE AND FIRE DEPARTMENTS, NEW ENGLAND REHAB, MINUTEMAN SENIOR SERVICES, AND THE WOBURN BOARD OF HEALTH. THE OVERALL GOAL OF THE PROGRAM WAS TO IMPROVE HOME SAFETY AND REDUCE THE NUMBER OF FALLS BY INCREASING AWARENESS ABOUT COMMON HOME SAFETY HAZARDS. THE PROGRAM TARGETED OLDER ADULTS IN WOBURN AND NEARBY CITIES AND TOWNS, AND INCLUDED A FULL ARRAY OF WORKSHOPS, CLASSES, AND LEARNING OPPORTUNITIES DESIGNED TO INCREASE THE LEVEL OF HOME SAFETY. IN FY19 MORE THAN 500 SENIORS PARTICIPATED IN THE PROGRAM, REPORTING THE FOLLOWING CHANGES:O 17% DECREASED CLUTTER IN THEIR HOMEO 13% REMOVED RUGS TO REDUCE THEIR RISK OF FALLSO 14% ORGANIZED AND/OR CLEARED WALKWAYS OF OBSTRUCTIONSO 7% ADDED AND/OR IMPROVED LIGHTING IN THEIR HOMERECOGNIZING ELDER HEALTH AS ONE OF THE LEADING PRIORITIES IDENTIFIED IN THE FY16 CHNA, WINCHESTER HOSPITAL COLLABORATED WITH THE STONEHAM COUNCIL ON AGING TO HOLD FREE CHAIR YOGA CLASSES FOR OLDER ADULTS IN STONEHAM AND NEARBY CITIES AND TOWNS. THE PRACTICE OF YOGA INCREASES MENTAL FOCUS, ENHANCES FLEXIBILITY, DECREASES STRESS, AND IMPROVES BRAIN FUNCTION AND RESPIRATION. OFFERING A YOGA CLASS IN WHICH YOU CAN PARTICIPATE FROM THE COMFORT OF A CHAIR HELPS REDUCE BARRIERS TO EXERCISE FOR PEOPLE WITH PHYSICAL LIMITATIONS, MOBILITY ISSUES, OR DISABILITIES, AND ALLOWS THEM TO ACHIEVE THE BENEFITS OF YOGA IN A COMFORTABLE AND SAFE WAY. THE OVERALL GOALS OF THE PROGRAM WERE TO HELP PARTICIPANTS REDUCE PAIN AND IMPROVE MOBILITY AND EMOTIONAL WELL-BEING. IN FY19 39 CLASSES WERE HELD REACHING 54 PARTICIPANTS. PER A SURVEY COMPLETED BY ALL 54 PARTICIPANTS, MORE THAN 85% EXPERIENCED THE FOLLOWING CHANGES AS A RESULT OF PARTICIPATING IN THE CLASSES:O INCREASED STRENGTH/IMPROVED FITNESS AND BALANCEO FELT MORE RELAXED/REDUCED STRESSO IMPROVED SOCIAL LIFEO REDUCED FEELINGS OF ISOLATIONO INCREASED CONNECTIONS WITH NEIGHBORS OR MADE NEW FRIENDSO IMPROVED OVERALL SENSE OF HAPPINESS AND WELL-BEING WELLNESS, PREVENTION AND MANAGEMENT OF CHRONIC DISEASEACCORDING TO THE AMERICAN ACADEMY OF PEDIATRICS, PEDIATRIC ASTHMA CONTINUES TO BE A LEADING CAUSE OF HOSPITAL ADMISSIONS IN THE U.S., WITH READMISSION RATES OF BETWEEN 10% AND 40%. ASTHMA IS THE LEADING CHRONIC DISEASE IN CHILDREN, AFFECTING ABOUT 10% OF THOSE UNDER AGE 18. IN ADDITION, IT IS THE PRIMARY REASON FOR MISSED SCHOOL DAYS. ACCORDING TO WINCHESTER HOSPITAL'S 2016 CHNA, HOSPITAL ADMISSIONS RATES FOR ASTHMA PATIENTS UNDER THE AGE OF 20 WERE SIGNIFICANTLY HIGHER IN CERTAIN TOWNS IN ITS SERVICE AREA, SUCH AS WOBURN (35% HIGHER THAN THE COUNTY AND 16% HIGHER THAN THE STATE) AND MEDFORD (29% HIGHER THAN THE COUNTY AND 20% HIGHER THAN THE STATE). ACCORDING TO THE CDC'S VITAL SIGNS REPORT ON PEDIATRIC ASTHMA, ACTION PLANS CAN DECREASE THE RATE OF ASTHMA-RELATED HOSPITALIZATIONS BY MORE THAN 5%. AS A RESULT, WINCHESTER HOSPITAL'S CENTER FOR HEALTHY LIVING DEVELOPED AND LAUNCHED CHAMP, A MODEL OF CARE THAT USES A TEAM APPROACH PROVEN TO HELP CHILDREN WITH ASTHMA MANAGE THE CONDITION MORE EFFECTIVELY. THE TEAM CONSISTS OF FAMILY MEMBERS, CAREGIVERS, THE CHILD'S PEDIATRICIAN AND/OR PRIMARY CARE PHYSICIAN, CLINICAL STAFF FROM WINCHESTER HOSPITAL, THE CHILD'S SCHOOL NURSE, CHILDCARE PERSONNEL, CLASSROOM TEACHERS, AND ANYONE ELSE WHO MAY BE IN A POSITION TO ADVISE THE CHILD AND HIS/HER PARENTS ABOUT ASTHMA MANAGEMENT. THE GOAL OF THE PROGRAM IS TO REDUCE EMERGENCY DEPARTMENT VISITS FOR PEDIATRIC ASTHMA PATIENTS BY ENSURING EFFECTIVE CONTROL OF THE DISEASE THROUGH TREATMENT AND THROUGH EDUCATION OF PATIENTS, FAMILIES, PHYSICIANS, AND OTHER HEALTH PROFESSIONALS. IN FY19, 104 CHILDREN PARTICIPATED IN CHAMP, RESULTING IN A 50% DECREASE IN HOSPITAL ADMISSIONS COMPARED TO FY18, AND 32% LOWER THAN THE STATE AVERAGE. IN ADDITION, HOSPITAL DISCHARGES AT WINCHESTER HOSPITAL DECREASED 11.11% AND EMERGENCY DEPARTMENT VISITS DECREASED 20%.THE HIGH-RISK INTERVENTION PROGRAM HELPS ADULTS WITH CHRONIC DISEASE MANAGE AND IMPROVE THEIR HEALTH AND ENHANCE THEIR OVERALL QUALITY OF LIFE BY ADDRESSING THE PHYSICAL AND PSYCHOLOGICAL EFFECTS OF CHRONIC DISEASE AND IMPROVING COORDINATION OF CARE. THE PROGRAM CONSISTS OF A CONSULTATION WITH A NURSE FROM THE CENTER FOR HEALTHY LIVING, FOLLOWED BY AT LEAST TWO PHONE CONSULTATIONS TO HELP THE PATIENT MANAGE THEIR CARE AND MEDICATIONS, TO ASSIST WITH MEDICAL APPOINTMENTS, AND TO FACILITATE COMMUNICATION AMONG ALL MEMBERS OF THE PATIENT'S CARE TEAM. THE TEAM ALSO WORKS TO IDENTIFY AND ADDRESS ANY SOCIAL DETERMINANTS OF HEALTH THAT COULD BE NEGATIVELY IMPACTING THE PATIENT'S HEALTH. CONVERSATIONS REGARDING END-OF-LIFE AND PALLIATIVE CARE ARE ALSO INITIATED WHEN APPROPRIATE. THE PROGRAM IS OFFERED UPON DISCHARGE TO AT-RISK PATIENTS WHO HAVE MULTIPLE HEALTH CONDITIONS AND/OR SOCIAL DETERMINANTS OF HEALTH THAT COULD PUT THEIR HEALTH AND SAFETY AT RISK, SUCH AS LOWER INCOME, PROBLEMS WITH THEIR PHYSICAL HOME ENVIRONMENT, LACK OF FAMILY SUPPORT, AND LACK OF ACCESS TO CARE.IN FY19, 1,105 PATIENTS RECEIVED HOSPITAL VISITS AND FOLLOW-UP CONSULTATIONS WITH NURSES FROM WINCHESTER HOSPITAL. IN ADDITION, 92% OF THE PARTICIPANTS BEING TREATED WITH PREDNISONE SUCCESSFULLY TAPERED DOWN AFTER DISCHARGE.ACCORDING TO WINCHESTER HOSPITAL'S FY16 CHNA, SEVEN OF THE NINE TOWNS IN THE HOSPITAL'S SERVICE AREA EXPERIENCED HIGHER INCIDENCE RATES OF CANCER THAN THOSE OF THE STATE, WITH THE HIGHEST RATES OCCURRING IN WILMINGTON (588). THE RATES SPECIFICALLY FOR BREAST CANCER WERE ALSO HIGHER THAN THOSE OF THE STATE (134) AND COUNTY (143) IN THREE OF THESE TOWNSREADING (179), WILMINGTON (169), AND NORTH READING (155)AND THE BREAST CANCER DEATH RATES IN READING (34) AND WILMINGTON (30) WERE SIGNIFICANTLY HIGHER THAN THE STATE (20) AND COUNTY (19.4) RATES. IN ADDITION, ACCORDING TO THE COMMUNITY HEALTH SURVEY CONDUCTED AS PART OF THE CHNA, RATES OF MAMMOGRAPHY SCREENING FOR WOMEN AGE 40 AND UP WERE LOWER THAN REPORTED IN THE PAST. RECOGNIZING THAT BREAST CANCER RISK VARIES AND SOME WOMEN NEED SCREENING BEYOND THE STANDARD RECOMMENDATIONS, WINCHESTER HOSPITAL IMPLEMENTED A CONFIDENTIAL SURVEY TO HELP RESIDENTS ASSESS THEIR LIFETIME RISK OF BREAST CANCER. ASSESSMENT, EVALUATION, AND FOLLOW-UP ARE ALL PROVIDED AT NO COST TO PARTICIPANTS. RESULTS ARE SHARED WITH THE PARTICIPANT'S PHYSICIANS, WHO CAN HELP HER DETERMINE WHETHER SHE MIGHT BENEFIT FROM SCREENING BEYOND REGULAR CHECKUPS AND MAMMOGRAMS. IN ADDITION, GENETIC COUNSELORS PROVIDE INFORMATION AND ANSWER QUESTIONS ABOUT THE BENEFITS AND LIMITATIONS OF GENETIC TESTING. IN FY19, WINCHESTER HOSPITAL CONDUCTED 8,528 FREE SCREENINGS, IDENTIFYING THE FOLLOWING:O 256 PATIENTS WITH A HIGH-RISK MUTATIONO 850 PATIENTS WITH A HIGH LIFETIME RISK OF BREAST CANCERO 768 PATIENTS WITH A MODERATE LIFETIME RISK OF BREAST CANCERFOLLOW-UP CONSULTATIONS WERE PROVIDED AFTER EACH SCREENING, AND RESULTS WERE SHARED WITH THE PARTICIPANT'S PHYSICIANS SO THEY COULD DISCUSS THE RECOMMENDED FOLLOW-UP EVALUATION AND CARE.
FORM 990, SCHEDULE H, PART VI:	NUMEROUS STUDIES SHOW THAT EXERCISE CAN REDUCE THE CHANCE OF REOCCURRENCE OF CANCER AND HELP SURVIVORS REDUCE DISABILITY. AT THE RENO CENTER FOR CANCER CARE AT WINCHESTER HOSPITAL, MORE THAN 500 PATIENTS WERE ASSESSED USING THE NATIONAL COMPREHENSIVE CANCER NETWORK DISTRESS THERMOMETER, IN WHICH PATIENTS ARE ASKED TO RATE THEIR DISTRESS OVER PRACTICAL, FAMILY, EMOTIONAL, PHYSICAL, AND SPIRITUAL PROBLEMS. FINDINGS FROM THE STUDY INDICATED FATIGUE WAS OVERWHELMINGLY THE NUMBER ONE CONCERN. AS A RESULT, PHYSICAL THERAPISTS FROM WINCHESTER HOSPITAL DEVELOPED AND LAUNCHED THE FIGHTING FATIGUE PROGRAM. FACILITATED BY A PHYSICAL THERAPIST AND A FITNESS SPECIALIST, THE PROGRAM SUPPORTS PATIENTS BEFORE, DURING, AND AFTER CANCER TREATMENT. THE PROGRAM INCLUDES AN INITIAL SCREENING FOLLOWED BY 12 WEEKS OF FITNESS SESSIONS TAILORED TO EACH PARTICIPANT'S ABILITY. THE SESSIONS INCORPORATE RELAXATION TECHNIQUES SUCH AS BREATHING AND MEDITATION EXERCISES. WITHOUT THIS PROGRAM, MOST PATIENTS WOULD NOT BE ABLE TO EXERCISE INDEPENDENTLY DUE TO IMPAIRMENT FROM THEIR ILLNESS OR SIDE EFFECTS FROM TREATMENT.THE OVERALL GOAL OF THE PROGRAM WAS TO ENABLE CANCER PATIENTS TO GAIN CONFIDENCE IN SELF-CARE INDEPENDENCE, ESTABLISH AN EXERCISE PROGRAM TO COMBAT THE EFFECTS OF CANCER TREATMENT, AND MAINTAIN OR REGAIN A HEALTHY SENSE OF WELL-BEING. IN FY19, 25 PARTICIPANTS COMPLETED THE PROGRAM, WITH THE FOLLOWING REPORTED RESULTS:O 100% INCREASED THEIR CONFIDENCE IN THEIR ABILITY TO PERFORM DAILY ACTIVITIES.O 100% INCREASED THEIR ENERGY LEVELS.O 100% ACHIEVED THE ABILITY TO EXERCISE INDEPENDENTLY AT HOME. O 100% REDUCED THEIR FATIGUE AND STRESS USING BREATHING TECHNIQUES.O 90% FOUND MEDITATION HELPFUL IN REDUCING FATIGUE AND/OR STRESS.O 90% IMPROVED THEIR FLEXIBILITY.O 67% IMPROVED THEIR SLEEP.COMMUNITY PARTNERSWINCHESTER HOSPITAL 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. LISTED BELOW IS A LIST OF THE COMMUNITY PARTNERS WE HAVE JOINED WITH IN ASSESSING COMMUNITY NEED AS WELL AS PLANNING, EXECUTING, AND OVERSEEING OUR IMPLEMENTATION STRATEGY: BOYS & GIRLS CLUB OF STONEHAM & WAKEFIELD CHNA15 CITY OF MEDFORD CITY OF WOBURN COUNCIL OF SOCIAL CONCERN, WOBURN MASSACHUSETTS DEPT. OF MENTAL HEALTH METRO HOUSING BOSTON MIDDLESEX COUNTY DISTRICT ATTORNEY MINUTEMAN SENIOR SERVICES MYSTIC VALLEY ELDER SERVICES MYSTIC VALLEY PUBLIC HEALTH COALITION MYSTIC VALLEY SUBSTANCE USE PREVENTION COALITION NAN PROJECT STONEHAM SUBSTANCE ABUSE COALITION TEWKSBURY SUBSTANCE ABUSE PREVENTION COALITION TOWN OF NORTH READING TOWN OF READING TOWN OF STONEHAM TOWN OF WAKEFIELD TOWN OF WILMINGTON TOWN OF WINCHESTER TOWN OF WOBURN TOWN OF TEWKSBURY WINCHESTER HOUSING AUTHORITY WINCHESTER SAFER COALITION AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, WINCHESTER HOSPITAL IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. WH COMMITS DIRECT COMMUNITY HEALTH PROGRAM INVESTMENTS AND IN-KIND RESOURCES OF STAFF TIME AND MATERIALS. WH ALSO GENERATES LEVERAGED FUNDS THROUGH GRANTS FROM PUBLIC AND PRIVATE SOURCES ON BEHALF OF ITS OWN PROGRAMS OR SERVICES, AS WELL AS ON BEHALF OF ITS COMMUNITY PARTNERS. HOWEVER, AS NOTED IN SCHEDULE H, PART V, SECTION B, QUESTION 11, WINCHESTER HOSPITAL IS UNABLE TO ADDRESS ALL NEEDS IDENTIFIED IN THE CHNA AND THE IMPLEMENTATION STRATEGY BECAUSE OF LIMITED FINANCIAL RESOURCES DURING THE PERIOD COVERED BY THIS FILING. AS NOTED IN DETAIL ABOVE, WINCHESTER HOSPITAL'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).
FORM 990, SCHEDULE H, PART VI	SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW WINCHESTER HOSPITAL CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 7.64% OF WINCHESTER HOSPITAL'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 WINCHESTER HOSPITAL CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. ALTHOUGH THOSE ACTIVITIES ARE NOT QUANTIFIED ON THE WINCHESTER HOSPITAL SCHEDULE H PER THE INSTRUCTIONS TO THE FORM 990, THOSE ACTIVITIES ARE RELEVANT IN EVALUATING THE TOTAL COMMUNITY BENEFITS PROVIDED. IF WINCHESTER HOSPITAL HAD INCLUDED THESE IN SCHEDULE H, QUESTION 7, WINCHESTER HOSPITAL WOULD HAVE REPORTED OVER $34,923,793 IN NET EXPENDITURES AT COST, WHICH REPRESENTED APPROXIMATELY 12.49% 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, WINCHESTER HOSPITAL'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.WINCHESTERHOSPITAL.ORG/FILE%20LIBRARY/UNASSIGNED/WH-FY18-COMMUNITY-BENEFITS-REPORT.PDFTHERE 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 WINCHESTER HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, WINCHESTER HOSPITAL 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 ASSISTANCEWINCHESTER HOSPITAL'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 $3,162,285 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, WINCHESTER HOSPITAL 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 WINCHESTER HOSPITAL 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 $19,482,938 IN MEDICAID REVENUE THIS WAS LESS THAN THE COST OF CARE PROVIDED BY WINCHESTER HOSPITAL FOR SUCH SERVICES BY $4,610,584 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 6.9% OR 19,938 OF WINCHESTER HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 30.9% OR 89,913 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO AN ADDITIONAL $13,566,971 IN UNCOVERED COST BORNE BY WINCHESTER HOSPITAL IN PROVIDING CARE TO MEDICARE PATIENTS. AS PREVIOUSLY NOTED, THIS ADDITIONAL COST IS NOT QUANTIFIED IN THE WINCHESTER HOSPITAL SCHEDULE H. BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, WINCHESTER HOSPITAL 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 $6,359,770 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. WINCHESTER HOSPITAL SIMILARLY INCURS BAD DEBT LOSSES AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE IN ITS FINANCIAL STATEMENTS. WINCHESTER HOSPITAL CHARGES FOR THOSE SERVICES WERE $6,359,770 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND AS REPORTED ON THE BIDMC FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER THE AMOUNT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F, WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY 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.
FORM 990 SCHEDULE H PART VI:	FINANCIAL ASSISTANCE POLICY INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE WINCHESTER HOSPITAL IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. 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 WINCHESTER HOSPITAL PROVIDERS.WINCHESTER HOSPITAL 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.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 POLICY APPLYING 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 POLICY ELIGIBILITY 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 ASSISTANCE PUBLIC 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 POLICY TRANSLATIONS 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: SPANISH, PORTUGUESE, CHINESE-TRADITIONAL, CHINESE-MANDARIN (SCHEDULE H PART V SECTION B QUESTION 16I).FINANCIAL ASSISTANCE POLICY WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE AT THE HOSPITAL OR 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.WINCHESTERHOSPITAL.ORG/MY-VISIT/INSURANCE-BILLING--RECORDS/FINANCIAL-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 POLICY PLAIN 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.
SCHEDULE H, PART VI	LIMITATION ON CHARGES INTERNAL 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 BILLED LOOK 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). 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 COLLECTIONS 501(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. ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. 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.
SCHEDULE H, PART VI	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 WINCHESTER HOSPITAL'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. (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 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 FAP HAS BEEN REVISED TO INCLUDE THIS INFORMATION. (4) 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. (5) 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. (6) 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. (7) 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. (8) 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. (9) 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.

Schedule H (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
WINCHESTER HOSPITAL

Employer identification number
04-2104434

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) BOYS & GIRLS CLUB OF STONEHAM & WAKEFIELD 15 DALE COURT STONEHAM,MA02180	23-7025777	501(C)(3)	5,000	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(2) CITY OF WOBURN WOBURN PUBLIC SCHOOLS 55 LOCUST STREET WOBURN,MA01801	04-6001417	GOVERNMENT ENTITY	30,450	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(3) COUNCIL OF SPECIAL CONCERN WOBURN 2 MERRIMAC STREET WOBURN,MA01801	04-2494773	501(C)(5)	5,000	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(4) ELIOT HUMAN SERVICES INC 125 HARTWELL AVENUE LEXINGTON,MA02421	04-2316924	501(C)(3)	10,500	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(5) MEDFORD HEALTH MATTERS INC 85 GEORGE P HASSETT DRIVE MEDFORD,MA02155	02-0586758	GOVERNMENT ENTITY	7,000	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(6) METROPOLITAN BOSTON HOUSING PARTNERSHIP INC 1411 TREMONT STREET BOSTON,MA021203401	04-2775991	501(C)(3)	34,860	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(7) MISSION OF DEEDS INC 6 CHAPIN AVENUE READING,MA01867	22-3252651	501(C)(3)	10,833	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(8) MYSTIC VALLEY ELDER SERVICES (MVES) 300 COMMERCIAL STREET MALDEN,MA02148	04-2562646	501(C)(3)	17,500	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(9) REGIONAL CENTER FOR POISON CONTROL MAILSTOP 3025 300 LONGWOOD AVENUE BOSTON,MA02115		GOVERNMENT ENTITY	21,100	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(10) TOWN OF NORTH READING 235 NORTH STREET NORTH READING,MA01864	04-6001248	GOVERNMENT ENTITY	8,411	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(11) WINCHESTER BOARD OF HEALTH 71 MOUNT VERNON STREET WINCHESTER,MA01890		GOVERNMENT ENTITY	5,000	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.
(12) WINCHESTER GOT LUNCH PO BOX 322 WINCHESTER,MA01890	45-4480474	501(C)(3)	14,655	AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

AS PREVIOUSLY NOTED IN THE FILING WINCHESTER HOSPITAL, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.

Schedule I (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1NESTO MD RICHARD PRESIDENT, TRUSTEE (EX-OFF)	(i) (ii)	0 ------------- 742,043	0 ------------- 0	0 ------------- 120,935	0 ------------- 36,500	0 ------------- 31,937	0 ------------- 931,415	0 ------------- 0
2TABB MD KEVIN TRUSTEE (EX-OFF), CEO	(i) (ii)	0 ------------- 1,184,747	0 ------------- 552,000	0 ------------- 20,206	0 ------------- 93,674	0 ------------- 50,030	0 ------------- 1,900,657	0 ------------- 0
3WEINER MD RICHARD TRUSTEE, CEO	(i) (ii)	356,699 ------------- 0	0 ------------- 0	2,936 ------------- 0	11,984 ------------- 0	33,859 ------------- 0	405,478 ------------- 0	0 ------------- 0
4FISCHER STEVEN P TREASURER (EX-OFF)	(i) (ii)	0 ------------- 565,045	0 ------------- 151,691	0 ------------- 53,474	0 ------------- 18,750	0 ------------- 57,012	0 ------------- 845,972	0 ------------- 0
5KATZ JAMIE CLERK (EX-OFF)	(i) (ii)	0 ------------- 415,671	0 ------------- 111,276	0 ------------- 33,516	0 ------------- 17,792	0 ------------- 26,216	0 ------------- 604,471	0 ------------- 0
6O'CONNOR TIMOTHY EVP, CFO & TREASURER	(i) (ii)	0 ------------- 671,616	0 ------------- 0	0 ------------- 437,105	0 ------------- 164,700	0 ------------- 32,847	0 ------------- 1,306,268	0 ------------- 0
7SPACKMAN JD DAVID G SVP GOV AFFAIRS, GC AND CLERK	(i) (ii)	0 ------------- 318,145	0 ------------- 0	0 ------------- 5,584	0 ------------- 29,398	0 ------------- 12,005	0 ------------- 365,132	0 ------------- 0
8WOODS MATTHEW J VP FINANCE, ASSISTANT CLERK	(i) (ii)	0 ------------- 366,293	0 ------------- 0	0 ------------- 8,721	0 ------------- 22,570	0 ------------- 34,307	0 ------------- 431,891	0 ------------- 0
9SCHULER KATHY ANN COO & CNO - WH	(i) (ii)	340,193 ------------- 0	0 ------------- 0	2,934 ------------- 0	11,531 ------------- 0	28,329 ------------- 0	382,987 ------------- 0	0 ------------- 0
10ZITKOVSKY DANA CHIEF MEDICAL OFFICER	(i) (ii)	175,147 ------------- 0	0 ------------- 0	875 ------------- 0	0 ------------- 0	0 ------------- 0	176,022 ------------- 0	0 ------------- 0
11ACKER DAVID QUALITY SAFETY ADVISOR & PHYS	(i) (ii)	211,016 ------------- 0	0 ------------- 0	2,178 ------------- 0	0 ------------- 0	1,364 ------------- 0	214,558 ------------- 0	0 ------------- 0
12BEYERMAN KATHLEEN ACNO NURSING STAFF DEVELOPMENT	(i) (ii)	193,835 ------------- 0	0 ------------- 0	5,355 ------------- 0	7,633 ------------- 0	26,926 ------------- 0	233,749 ------------- 0	0 ------------- 0
13GREGA JOANNE M ADMINISTRATIVE DIR, RADIOLOGY	(i) (ii)	215,686 ------------- 0	0 ------------- 0	1,975 ------------- 0	8,350 ------------- 0	29,751 ------------- 0	255,762 ------------- 0	0 ------------- 0
14ROBERTSON CATHERINE A VP, PHYSICIAN SERVICES	(i) (ii)	257,831 ------------- 0	0 ------------- 0	631 ------------- 0	8,746 ------------- 0	316 ------------- 0	267,524 ------------- 0	0 ------------- 0
15SACHETTI NANCY L DIRECTOR, HIGHLAND HEALTH IPA	(i) (ii)	229,800 ------------- 0	0 ------------- 0	2,957 ------------- 0	9,125 ------------- 0	32,573 ------------- 0	274,455 ------------- 0	0 ------------- 0
16GRANT MD JD HOWARD R FMR TTEE, PRESIDENT & CEO	(i) (ii)	0 ------------- 842,784	0 ------------- 0	0 ------------- 3,600,086	0 ------------- 219,222	0 ------------- 29,043	0 ------------- 4,691,135	0 ------------- 0
17ISEKE MD RICHARD FMR CMO	(i) (ii)	322,345 ------------- 62,262	0 ------------- 0	21,162 ------------- 3,085	9,160 ------------- 0	11,636 ------------- 3,897	364,303 ------------- 69,244	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
SCHEDULE J PART I QUESTION 4A:	SEVERANCE AND CHANGE OF CONTROL PAYMENTS AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN WINCHESTER HOSPITAL 'S (WH) FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 DETAIL. DURING THE 2018 CALENDAR YEAR, HOWARD GRANT, MD, JD BECAME ELIGIBLE FOR SEVERANCE. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. SCHEDULE J PART I QUESTION 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN WINCHESTER HOSPITAL 'S (WH) FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 DETAIL. DURING THE 2018 CALENDAR YEAR, WH WAS A PARTICIPATING EMPLOYER IN THE LAHEY CLINIC 457(F) NON-QUALIFIED DEFINED CONTRIBUTION PLAN. PURSUANT TO THIS PLAN, ELIGIBLE EMPLOYEES RECEIVED CERTAIN RETIREMENT BENEFITS AND UNDER THE DEFINITIONS TO THIS FORM 990, THIS PLAN IS CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. CONTRIBUTIONS RECEIVED BY PARTICIPANTS AND RELATED TO THESE PLANS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW.
SCHEDULE J PART I QUESTION 7:	THE WH EXECUTIVE COMPENSATION PACKAGES AND CERTAIN EMPLOYEE COMPENSATION PACKAGES INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING PRE-DETERMINED GOALS. FOR CALENDAR YEAR 2018 WHICH IS THE PERIOD FOR WHICH COMPENSAITON IS REPORTED IN THIS FILING, LAHEY HEALTH SYSTEM, INC. (LHSI) SERVED AS THE PARENT TO THE LAHEY HEALTH SYSTEM AND SERVED AS THE SOLE MEMBER OF WINCHESTER HOSPITAL. AS REPORTED IN THIS FORM 990, LHSI MAINTAINED A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD. INCENTIVE COMPENSATION FOR EACH EXECUTIVE REPORTED IN THIS FORM 990 WAS REVIEWED AND APPROVED BY THE LHSI COMPENSATION COMMITTEE.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES:	THE FILING ORGANIZATION HAS PROVIDED DETAILED NARRATIVE DISCLOSURE FOR EACH INDIVIDUAL LISTED IN PART VII. NOTE, HOWEVER, THAT THE ORDER OF THE NARRATIVE DISCLOSURE INCLUDED BELOW MAY NOT COINCIDE WITH THE ORDER OF THE INDIVIDUALS LISTED IN PART VII. AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN THIS SHORT PERIOD FORM 990 FOR WINCHESTER HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 DETAIL. REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: REGULAR WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS QUANTIFIED IN OTHER REPORTABLE COMPENSATION WHICH MAY NOT BE SEPARATELY NOTED IN THIS FILING INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; DISTRIBUTIONS FROM A 457(B) PLAN; AMOUNTS INCLUDIBLE IN INCOME UNDER A 457(F) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED RETIREMENT BENEFITS; OTHER TAXABLE RETIREMENT BENEFITS DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401K RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403B RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT, UNFUNDED AND UNVESTED AMOUNTS DEFERRED UNDER 457(F) PLAN NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THE NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ALL TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF TRUSTEE, AS DENOTED BY THE LISTED TITLES. LAHEY HEALTH SYSTEM, INC., LAHEY CLINIC, INC., LAHEY HEALTH SHARED SERVICES, INC., NORTHEAST MEDICAL PRACTICE, INC., WINCHESTER PHYSICIAN ASSOCIATES, INC., AND WINCHESTER HOSPITAL MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS LHSI, LC, LHSS, NMP, WPA, AND WH RESPECTIVELY. ADLER, M.D., JOHNATHAN TRUSTEE WINCHESTER HOSPITAL TRUSTEE AND PHYSICIAN WINCHESTER HEALTHCARE MANAGEMENT, INC. PAYMENTS REPORTED BY WINCHESTER PHYSICIANS ASSOCIATES: BASE COMPENSATION: 7,489 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 ANDREWS, PAUL TRUSTEE AND CHAIR WINCHESTER HOSPITAL TRUSTEE AND CHAIR WINCHESTER HEALTHCARE MANAGEMENT, INC. BERTOCHI, MARGARET TRUSTEE (EX-OFFICIO), PRESIDENT WINSTON CLUB WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO), PRESIDENT WINSTON CLUB WINCHESTER HEALTHCARE MANAGEMENT, INC. CONWAY, JAMES TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. DEROSA, CINDY TRUSTEE (EX-OFFICIO), PRESIDENT FRIENDS OF WINCHESTER HOSPITAL - WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO), PRESIDENT FRIENDS OF WINCHESTER HOSPITAL - WINCHESTER HEALTHCARE MANAGEMENT, INC. FICOCIELLO, D.D.S., JAMES TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. FISCHER, STEVEN EFFECTIVE MARCH 1, 2019 MR. FISCHER HELD THE FOLLOWING POSITIONS: TREASURER (EX-OFFICIO) WINCHESTER HOSPITAL EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. TREASURER BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR AND TREASURER BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY, INC. TREASURER (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER BETH ISRAEL DEACONESS HOSPITAL MILTON TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH TRUSTEE (EX-OFFICIO) AND TREASURER BETH ISRAEL DEACONESS MILTON PHYSICIANS ASSOCIATES F/K/A MILTON HOSPITAL FOUNDATION TREASURER (EX-OFFICIO) MOUNT AUBURN HOSPITAL TREASURER (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE AND TREASURER COMMUNITY PHYSICIANS ASSOCIATES TRUSTEE AND TREASURER JORDAN PHYSICIAN ASSOCIATES DIRECTOR AND TREASURER JORDAN HEALTH SYSTEMS, INC. TREASURER (EX-OFFICIO) ANNA JACQUES HOSPITAL TREASURER (EX-OFFICIO) SEACOAST AFFILIATED GROUP PRACTICE, INC TRUSTEE AND TREASURER LAHEY HEALTH SHARED SERVICES, INC. TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. F/K/A LAHEY PHYSICIAN COMMUNITY ORGANIZATION I, INC. TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND TREASURER NORTHEAST HEALTH SYSTEM, INC. TREASURER NORTHEAST PROFESSIONAL REGISTRY OF NURSES TRUSTEE (EX-OFFICIO) AND TREASURER NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND TREASURER SEACOAST NURSING & REHABILITATION CENTER, INC. TRUSTEE (EX-OFFICIO) AND TREASURER WINCHESTER HOSPITAL FOUNDATION, INC. TREASURER WINCHESTER HEALTHCARE MANAGEMENT, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL AND MEDICAL CENTER TREASURER (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND TREASURER NORTHEAST MEDICAL PRACTICE, INC. TRUSTEE (EX-OFFICIO) AND TREASURER NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND TREASURER CAB HEALTH & RECOVERY SERVICES, INC. TRUSTEE AND TREASURER HEALTH & EDUCATION HOUSING SERVICES, INC. ASSISTANT TREASURER MEDICAL CARE OF BOSTON MANAGEMENT CORP A/K/A AFFILIATED PHYSICIANS GROUP TREASURER LEDGEWOOD HEALTH CARE CORP. MR. FISCHER HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: ASSISTANT TREASURER BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR AND TREASURER BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY, INC. DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH DIRECTOR JORDAN PHYSICIAN ASSOCIATES DIRECTOR JORDAN HEALTH SYSTEMS, INC. AS NOTED IN THIS FILING, AND AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 COMPENSATION. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 565,046 INCENTIVE COMPENSATION: 151,691 OTHER REPORTABLE COMPENSATION: 53,474 DEFERRED COMPENSATION: 18,750 NON-TAXABLE BENEFITS: 57,012 OTHER REPORTABLE COMPENSATION FOR MR. FISCHER INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $47,015. FORTUNATO, M.D., ROBERT TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. FULLER, M.D., ARLAN TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. ONCOLOGIST, - WINCHESTER PHYSICIANS ASSOCIATES PAYMENTS REPORTED BY WINCHESTER PHYSICIANS ASSOCIATES: BASE COMPENSATION: 84,113 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0
GRANT, M.D., J.D., HOWARD R	DR. GRANT HELD THE FOLLOWING POSITIONS THROUGH HIS RETIREMENT ON SEPTEMBER 30, 2018: FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER WINCHESTER HOSPITAL FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER LAHEY HEALTH SYSTEM, INC. FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER LAHEY HEALTH SHARED SERVICES, INC. FORMER PRESIDENT, TRUSTEE AND CHIEF EXECUTIVE OFFICER LAHEY CLINIC FOUNDATION, INC. FORMER PRESIDENT, TRUSTEE AND CHIEF EXECUTIVE OFFICER LAHEY CLINIC , INC. FORMER PRESIDENT, TRUSTEE AND CHIEF EXECUTIVE OFFICER LAHEY CLINIC HOSPITAL , INC. FORMER TRUSTEE, OFFICER, PRESIDENT AND CHIEF EXECUTIVE OFFICER BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER ADDISON GILBERT SOCIETY FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER NORTHEAST HEALTH SYSTEM, INC. FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER NORTHEAST PROFESSIONAL REGISTRY OF NURSES FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER NORTHEAST SENIOR HEALTH CORPORATION FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER SEACOAST NURSING & REHABILITATION CENTER, INC. FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER WINCHESTER HOSPITAL FOUNDATION, INC. FORMER PRESIDENT AND TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER NORTHEAST HOSPITAL CORPORATION FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER NORTHEAST MEDICAL PRACTICE, INC. FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER NORTHEAST BEHAVIORAL HEALTH CORPORATION FORMER TRUSTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER CAB HEALTH & RECOVERY SERVICES, INC. FORMER PRESIDENT, TRUSTEE AND CHIEF EXECUTIVE OFFICER HEALTH & EDUCATION HOUSING SERVICES, INC. FORMER PRESIDENT AND DIRECTOR LEDGEWOOD HEALTHCARE CORPORATION FORMER PRESIDENT AND DIRECTOR NORTHEAST PROPRIETARY CORPORATION FORMER TRUSTEE -- CONCORD SPECIALISTS, LLC DR. GRANT'S POSITION AS LAHEY HEALTH SYSTEM, INC.'S PRESIDENT, TRUSTEE AND CHIEF EXECUTIVE OFFICER AS WELL AS HIS OTHER POSITIONS AT THE LAHEY AFFILIATES NOTED ABOVE, ENDED SEPTEMBER 30, 2018. AS REQUIRED BY THIS FORM 990, THE COMPENSATION AND BENEFITS REPORTED BELOW ARE FOR THE CALENDAR YEAR 2018. PAYMENTS REPORTED BY LHSI: BASE COMPENSATION: 842,785 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 3,600,085 DEFERRED COMPENSATION: 219,222 NON-TAXABLE BENEFITS: 29,044 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. GRANT INCLUDES TAXABLE SALARY CONTINUATION PAYMENTS IN THE AMOUNT OF $3,061,352 WHICH VESTED AT THE TIME OF DR. GRANT'S RETIREMENT AND $220,000 INCLUDABLE IN INCOME UNDER 457(F). IN ADDITION, DEFERRED COMPENSATION INCLUDES $189,341 OF DEFERRED RETIREMENT BENEFITS WHICH WERE PAID TO DR. GRANT AFTER MARCH 15, 2019. AS REQUIRED BY THE FORM 990, THESE AMOUNTS WILL BE REPORTED AGAIN AS OTHER REPORTABLE COMPENSATION IN THE LAHEY AFFILIATE TAX RETURNS COVERING THE FISCAL YEAR ENDING SEPTEMBER 30, 2020. HAYDEN, ERIC W. TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. HOUGHTON, JANICE TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. HUTCHESON, M.D., JOHN J. TRUSTEE (EX-OFFICIO), PRESIDENT OF MEDICAL STAFF WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO), PRESIDENT OF MEDICAL STAFF WINCHESTER HEALTHCARE MANAGEMENT, INC. ISEKE, RICHARD ISEKE, M.D., RICHARD CHIEF QUALITY OFFICER LAHEY HEALTH SYSTEM, INC. SENIOR VICE-PRESIDENT WINCHESTER PHYSICIAN ASSOCIATES, INC. FORMER CHIEF MEDICAL OFFICER WINCHESTER HOSPITAL PAYMENTS REPORTED BY WH: BASE COMPENSATION: 322,345 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 21,162 DEFERRED COMPENSATION: 9,160 NON-TAXABLE BENEFITS: 11,636 PAYMENTS REPORTED BY LHSI: BASE COMPENSATION: 62,262 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 3085 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 3,897 OTHER REPORTABLE COMPENSATION FOR DR. ISEKE INCLUDES COMBINED 457(B) PLAN DEFERRALS IN THE AMOUNT OF $18,500. KATZ, J.D., JAMIE EFFECTIVE MARCH 1, 2019, MR. KATZ HELD THE FOLLOWING POSITIONS: CLERK (EX-OFFICIO) WINCHESTER HOSPITAL GENERAL COUNSEL AND CLERK (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR AND CLERK BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY, INC. CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM CLERK (EX-OFFICIO) MOUNT AUBURN HOSPITAL CLERK (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON CLERK COMMUNITY PHYSICIANS ASSOCIATION, INC. CLERK BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES F/K/A MILTON HOSPITAL FOUNDATION CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH CLERK (EX-OFFICIO) JORDAN PHYSICIANS ASSOCIATES, INC. CLERK JORDAN HEALTH SYSTEMS CLERK (EX-OFFICIO) ANNA JACQUES HOSPITAL CLERK (EX-OFFICIO) SEACOAST AFFILIATED GROUP PRACTICE, INC TRUSTEE AND CLERK LAHEY HEALTH SHARED SERVICES, INC. TRUSTEE, CHAIR, PRESIDENT AND CLERK BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. CLERK (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND CLERK NORTHEAST HEALTH SYSTEM, INC. CLERK NORTHEAST PROFESSIONAL REGISTRY OF NURSES TRUSTEE (EX-OFFICIO) AND CLERK NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK SEACOAST NURSING & REHABILITATION CENTER, INC. CLERK (EX-OFFICIO) WINCHESTER HOSPITAL FOUNDATION, INC. CLERK WINCHESTER HEALTHCARE MANAGEMENT, INC. CLERK (EX-OFFICIO) LAHEY CLINIC FOUNDATION, INC. CLERK (EX-OFFICIO) LAHEY CLINIC, INC. CLERK (EX-OFFICIO) LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL AND MEDICAL CENTER CLERK (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK NORTHEAST MEDICAL PRACTICE, INC. TRUSTEE (EX-OFFICIO) AND CLERK NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND CLERK CAB HEALTH & RECOVERY SERVICES, INC. TRUSTEE AND CLERK HEALTH & EDUCATION HOUSING SERVICES, INC. MR. KATZ HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: SENIOR VICE PRESIDENT AND GENERAL COUNSEL BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR AND CLERK BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY, INC. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 415,671 INCENTIVE COMPENSATION: 111,276 OTHER REPORTABLE COMPENSATION: 33,516 DEFERRED COMPENSATION: 17,792 NON-TAXABLE BENEFITS: 26,216 OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $30,123. LITTLE, M.D., ARTHUR TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. MARTINI, JOHN C. TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. MCCANCE, WILLIAM TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. MR. MCCANCE COMMENCED HIS POSITION ON THE WINCHESTER HOSPITAL AND WINCHESTER HEALTHCARE MANAGEMENT BOARDS ON DECEMBER 18, 2018. MCDONOUGH, DEBORAH TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC.
NESTO, M.D., RICHARD	EFFECTIVE MARCH 1, 2019, DR. NESTO HELD THE FOLLOWING POSITIONS: CHIEF MEDICAL OFFICER, BETH ISRAEL LAHEY HEALTH TRUSTEE (EX-OFFICIO, BILH CEO DESIGNATE) ANNA JAQUES HOSPITAL TRUSTEE (EX-OFFICIO) SEACOAST AFFILIATED GROUP PRACTICE, INC TRUSTEE (EX-OFFICIO, BILH CEO DESIGNATE) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO, BILH CEO DESIGNATE) WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) WINCHESTER HEALTHCARE MANAGEMENT, INC. DIRECTOR, WINCHESTER PHYSICIAN ASSOCIATES DIRECTOR, CONCORD SPECIALISTS, LLC DR. NESTO HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: TRUSTEE (EX-OFFICIO) AND PRESIDENT LAHEY HEALTH SHARED SERVICES, INC. TRUSTEE AND PRESIDENT BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. F/K/A LAHEY PHYSICIAN COMMUNITY ORGANIZATION I, INC. TRUSTEE (EX-OFFICIO) AND PRESIDENT ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND PRESIDENT NORTHEAST HEALTH SYSTEM, INC. TRUSTEE AND PRESIDENT NORTHEAST PROFESSIONAL REGISTRY OF NURSES TRUSTEE (EX-OFFICIO) AND PRESIDENT NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND PRESIDENT SEACOAST NURSING & REHABILITATION CENTER, INC. TRUSTEE (EX-OFFICIO) AND PRESIDENT WINCHESTER HOSPITAL FOUNDATION, INC. TRUSTEE (EX-OFFICIO) AND PRESIDENT WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX-OFFICIO) AND PRESIDENT LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC, INC. TRUSTEE LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL AND MEDICAL CENTER TRUSTEE (EX-OFFICIO) & PRESIDENT NORTHEAST HOSPITAL CORPORATION TRUSTEE AND PRESIDENT NORTHEAST MEDICAL PRACTICE TRUSTEE (EX-OFFICIO) AND PRESIDENT NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND PRESIDENT CAB HEALTH & RECOVERY SERVICES, INC. TRUSTEE AND PRESIDENT HEALTH & EDUCATION HOUSING SERVICES, INC. TRUSTEE AND PRESIDENT WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO), PRESIDENT, AND CHIEF EXECUTIVE OFFICER LAHEY HEALTH SYSTEM, INC. PRESIDENT AND DIRECTOR LEDGEWOOD HEALTHCARE CORPORATION PRESIDENT AND DIRECTOR NORTHEAST PROPRIETARY CORPORATION DIRECTOR -- WINCHESTER PHYSICIAN ASSOCIATES AS NOTED IN THIS FILING, AND AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 COMPENSATION. PAYMENTS REPORTED BY LHSI: BASE COMPENSATION: 742,043 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 120,935 DEFERRED COMPENSATION: 36,500 NON-TAXABLE BENEFITS: 31,937 OTHER REPORTABLE COMPENSATION FOR DR. NESTO INCLUDES COMBINED PAYMENTS TO, AND CHANGE IN VALUE OF, A 457(F) PLAN IN THE AMOUNT OF $83,602. OCKERBLOOM, RICHARD TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. O'CONNOR, TIMOTHY MR. O'CONNOR HELD THE FOLLOWING POSITIONS COMMENCING ON MARCH 1, 2019: FINANCE INTEGRATION LEAD, BETH ISRAEL LAHEY HEALTH MR. O'CONNOR HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: TREASURER, EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER LAHEY HEALTH SYSTEM, INC. TRUSTEE, TREASURER AND CHIEF FINANCIAL OFFICER LAHEY HEALTH SHARED SERVICES TRUSTEE, EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TREASURER, EXECUTIVE VICE PRESIDENT, AND CHIEF FINANCIAL OFFICER ADDISON GILBERT SOCIETY, INC. TRUSTEE, EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER NORTHEAST HEALTH SYSTEM, INC. TRUSTEE, EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER NORTHEAST PROFESSIONAL REGISTRY OF NURSES EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE, EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER SEACOAST NURSING & REHABILITATION CENTER, INC. TRUSTEE, EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER WINCHESTER HOSPITAL FOUNDATION, INC. TREASURER, EXECUTIVE VICE PRESIDENT, AND CHIEF FINANCIAL OFFICER WINCHESTER HEALTHCARE MANAGEMENT, INC. TREASURER AND CHIEF FINANCIAL OFFICER LAHEY CLINIC FOUNDATION, INC. TREASURER AND CHIEF FINANCIAL OFFICER LAHEY CLINIC, INC. TREASURER AND CHIEF FINANCIAL OFFICER LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL AND MEDICAL CENTER TREASURER, EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER NORTHEAST HOSPITAL CORPORATION TRUSTEE, EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER NORTHEAST MEDICAL PRACTICE, INC. TREASURER, EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE, EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER CAB HEALTH & RECOVERY SERVICES, INC. TRUSTEE AND TREASURER HEALTH & EDUCATION HOUSING SERVICES, INC. TREASURER, EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER WINCHESTER HOSPITAL DIRECTOR AND TREASURER -- LAHEY CLINICAL PERFORMANCE NETWORK ACCOUNTABLE CARE ORGANIZATION TREASURER -- LAHEY CLINICAL PERFORMANCE NETWORK, LLC DIRECTOR AND TREASURER -- LEDGEWOOD HEALTHCARE CORPORATION DIRECTOR AND TREASURER -- NORTHEAST PROPRIETARY CORP. TRUSTEE CONCORD SPECIALISTS, LLC AS NOTED IN THIS FILING, AND AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 COMPENSATION. PAYMENTS REPORTED BY LHSI: BASE COMPENSATION: 671,617 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 437,105 DEFERRED COMPENSATION: 164,700 NON-TAXABLE BENEFITS: 32,847 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. O'CONNOR INCLUDES CONTRIBUTIONS TO A 457(F) PLAN AND AN INCREASE IN VALUE OF THAT PLAN TOTALING $506,458. OF THAT AMOUNT $128,200 WAS UNVESTED AT SEPTEMBER 30, 2019. ROTOLO, M.D., PETER J. TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. SAYRE, RICHARD TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. SCHULER, KATHY ANN CHIEF OPERATING OFFICER & CHIEF NURSING OFFICER - WINCHESTER HOSPITAL CHIEF OPERATING OFFICER & CHIEF NURSING OFFICER - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE - SEACOAST NURSING AND REHABILITATION SERVICES MS. SCHULER'S POSITIONS AS TRUSTEE OF NORTHEAST SENIOR HEALTH CORPORATION AND SEACOAST NURSING AND REHABILITATION SERVICES ENDED ON OCTOBER 18, 2019 PAYMENTS REPORTED BY WINCHESTER HOSPITAL: BASE COMPENSATION: 340,193 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 2,934 DEFERRED COMPENSATION: 11,531 NON-TAXABLE BENEFITS: 28,329 SMITH, KEVIN F. TRUSTEE AND VICE CHAIR WINCHESTER HOSPITAL TRUSTEE AND VICE-CHAIR WINCHESTER HEALTHCARE MANAGEMENT, INC. PAYMENTS REPORTED BY WINCHESTER HOSPITAL: BASE COMPENSATION: 0 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 31,198 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 MR. SMITH SERVED AS THE CHIEF EXECUTIVE OFFICER OF WINCHESTER HOSPITAL THROUGH JANUARY 1, 2016. THE PAYMENT ABOVE RELATES TO HIS PREVIOUS ROLE.
SPACKMAN, J.D., DAVID G.	MR. SPACKMAN RETIRED AS SENIOR VICE PRESIDENT GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK FOR THE LAHEY HEALTH SYSTEM AND ITS AFFILIATES ON MARCH 1, 2019. MR. SPACKMAN HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK LAHEY HEALTH SYSTEM, INC. TRUSTEE, SECRETARY AND GENERAL COUNSEL LAHEY HEALTH SHARED SERVICES, INC. TRUSTEE, SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND SECRETARY ADDISON GILBERT SOCIETY, INC. TRUSTEE, SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK NORTHEAST HEALTH SYSTEM, INC. TRUSTEE, SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK NORTHEAST PROFESSIONAL REGISTRY OF NURSES SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE, SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK SEACOAST NURSING & REHABILITATION CENTER, INC. TRUSTEE, SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK WINCHESTER HOSPITAL FOUNDATION, INC. SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK WINCHESTER HEALTHCARE MANAGEMENT, INC. CLERK AND GENERAL COUNSEL LAHEY CLINIC FOUNDATION, INC. CLERK AND GENERAL COUNSEL LAHEY CLINIC, INC. CLERK AND GENERAL COUNSEL LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL AND MEDICAL CENTER SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK NORTHEAST HOSPITAL CORPORATION TRUSTEE, SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK NORTHEAST MEDICAL PRACTICE, INC. SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND CLERK CAB HEALTH & RECOVERY SERVICES, INC. TRUSTEE AND CLERK HEALTH & EDUCATION HOUSING SERVICES, INC. SENIOR VICE PRESIDENT OF GOVERNMENT AFFAIRS, GENERAL COUNSEL AND CLERK WINCHESTER HOSPITAL PAYMENTS REPORTED BY LHSI: BASE COMPENSATION: 318,145 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,584 DEFERRED COMPENSATION: 29,881 NON-TAXABLE BENEFITS: 12,005 TABB, M.D., KEVIN EFFECTIVE MARCH 1, 2019 DR. TABB HELD THE FOLLOWING POSITIONS: PRESIDENT, CHIEF EXECUTIVE OFFICER, AND TRUSTEE (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. DIRECTOR AND CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL AND MEDICAL CENTER TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER LAHEY CLINIC, INC. TRUSTEE, PRESIDENT, AND CHIEF EXECUTIVE OFFICER LAHEY HEALTH SHARED SERVICES, INC. DIRECTOR AND PRESIDENT BIDMC PHARMACY, INC. TRUSTEE (EX-OFFICIO), CHAIRMAN, AND PRESIDENT NORTHEAST HEALTH SYSTEM, INC. TRUSTEE (EX-OFFICIO), PRESIDENT, CHAIRMAN AND CHIEF EXECUTIVE OFFICER NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO), CHAIRMAN AND PRESIDENT SEACOAST NURSING & REHABILITATION CENTER, INC. TRUSTEE (EX-OFFICIO) AND PRESIDENT WINCHESTER HOSPITAL FOUNDATION, INC. CHIEF EXECUTIVE OFFICER AND CHIEF OPERATING OFFICER WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX-OFFICIO), CHIEF EXECUTIVE OFFICER AND CHIEF OPERATING OFFICER LAHEY CLINIC FOUNDATION, INC. CHIEF EXECUTIVE OFFICER NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER CAB HEALTH & RECOVERY SERVICES, INC. CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS HOSPITAL MILTON CHIEF EXECUTIVE OFFICER MILTON HOSPITAL FOUNDATION CHIEF EXECUTIVE OFFICER COMMUNITY PHYSICIANS ASSOCIATION CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS HOSPITAL NEEDHAM CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH CHIEF EXECUTIVE OFFICER MOUNT AUBURN HOSPITAL CHIEF EXECUTIVE OFFICER NEW ENGLAND BAPTIST HOSPITAL CHIEF EXECUTIVE OFFICER JORDAN HEALTH SYSTEMS, INC. CHIEF EXECUTIVE OFFICER JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER HEALTH & EDUCATION HOUSING SERVICES, INC. PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL IN ADDITION TO THE POSITIONS NOTED ABOVE, EFFECTIVE MARCH 1, 2019 DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNATE: TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO BETH ISRAEL DEACONESS HOSPITAL MILTON, BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATION TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) ANNA JACQUES HOSPITAL, INC. TRUSTEE (EX-OFFICIO) SEACOAST AFFILIATED GROUP PRACTICE, INC DR. TABB HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: DIRECTOR AND CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR (EX-OFFICIO) HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR JORDAN HEALTH SYSTEMS, INC. DIRECTOR JORDAN PHYSICIAN ASSOCIATES, INC. DIRECTOR BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH DIRECTOR AND PRESIDENT BIDMC PHARMACY, INC. TRUSTEE (EX-OFFICIO) AND CO-CHAIR CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL AS NOTED IN THIS FILING, AND AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 COMPENSATION. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 1,184,748 INCENTIVE COMPENSATION: 552,000 OTHER REPORTABLE COMPENSATION: 20,206 DEFERRED COMPENSATION: 93,674 NON-TAXABLE BENEFITS: 50,030 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES $94,326 COMBINED PAYMENTS TO NONQUALIFIED RETIREMENT PLANS PLUS THE INCREASE/DECREASE IN VALUE OF THOSE ACCOUNTS DURING THE 2018 CALENDAR YEAR. OF THIS AMOUNT, $80,324 WAS UNVESTED AT SEPTEMBER 30, 2019. TARBY, J.D., JOSEPH III TRUSTEE AND ASSISTANT CLERK WINCHESTER HOSPITAL TRUSTEE ASSISTANT CLERK WINCHESTER HEALTHCARE MANAGEMENT, INC. TAYLOR, M.D., JOSEPH TRUSTEE WINCHESTER HOSPITAL TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. PHYSICIAN, INTERNAL MEDICINE, WINCHESTER PHYSICIANS ASSOCIATES PAYMENTS REPORTED BY WINCHESTER PHYSICIANS ASSOCIATES: BASE COMPENSATION: 43,300 INCENTIVE COMPENSATION: 25,000 OTHER REPORTABLE COMPENSATION: 745 DEFERRED COMPENSATION: 609 NON-TAXABLE BENEFITS: 5,409 WALSH, JANE TRUSTEE AND VICE CHAIR WINCHESTER HOSPITAL TRUSTEE AND VICE CHAIR WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE - BETH ISRAEL LAHEY HEALTH MS. WALSH'S TERM ON THE BETH ISRAEL LAHEY HEALTH'S BOARD BEGAN ON MARCH 1, 2019. WEINER, M.D., RICHARD EFFECTIVE MARCH 1, 2019 DR. WEINER HELD THE FOLLOWING POSITIONS: PRESIDENT AND TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL. PRESIDENT, AND TRUSTEE (EX-OFFICIO) WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. PRESIDENT AND DIRECTOR - WINCHESTER PHYSICIAN ASSOCIATES, INC. DR. WEINER HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: PRESIDENT, CHIEF EXECUTIVE OFFICER AND TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL CHIEF EXECUTIVE OFFICER AND TRUSTEE (EX-OFFICIO) WINCHESTER HEALTHCARE MANAGEMENT, CHIEF EXECUTIVE OFFICER AND TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL FOUNDATION PRESIDENT AND DIRECTOR -WINCHESTER PHYSICIAN ASSOCIATES, INC. PAYMENTS REPORTED BY WINCHESTER HOSPITAL: BASE COMPENSATION: 356,699 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 2,936 DEFERRED COMPENSATION: 11,984 NON-TAXABLE BENEFITS: 33,859 WOODS, MATTHEW J. ASSISTANT TREASURER AND VICE PRESIDENT, FINANCE WINCHESTER HOSPITAL. ASSISTANT TREASURER AND VICE PRESIDENT, FINANCE WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX-OFFICIO) AND ASSISTANT TREASURER WINCHESTER HOSPITAL FOUNDATION, INC. TREASURER AND DIRECTOR WINCHESTER PHYSICIAN ASSOCIATES, INC. DIRECTOR AND TREASURER WINCHESTER HEALTHCARE ENTERPRISES, INC. MR. WOODS' POSITION AS ASSISTANT TREASURER FOR THE WINCHESTER HOSPITAL FOUNDATION, INC. ENDED MARCH 1, 2019 PAYMENTS REPORTED BY LAHEY HEALTH SHARED SERVICES, INC.: BASE COMPENSATION: 366,293 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 8,721 DEFERRED COMPENSATION: 22,570 NON-TAXABLE BENEFITS: 34,307
ZITKOVSKY, M.D., DANA	CHIEF MEDICAL OFFICER WINCHESTER HOSPITAL CHIEF MEDICAL OFFICER WH WINCHESTER HEALTHCARE MANAGEMENT, INC. PAYMENTS REPORTED BY WINCHESTER HOSPITAL: BASE COMPENSATION: 175,147 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 875 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 ROBERTSON, CATHERINE A. VICE PRESIDENT, PHYSICIAN SERVICES WINCHESTER HOSPITAL PAYMENTS REPORTED BY WINCHESTER HOSPITAL: BASE COMPENSATION: 257,831 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 631 DEFERRED COMPENSATION: 8,746 NON-TAXABLE BENEFITS: 316 SACHETTI, NANCY L. DIRECTOR, HIGHLAND HEALTH IPA WINCHESTER HOSPITAL PAYMENTS REPORTED BY WINCHESTER HOSPITAL: BASE COMPENSATION: 229,799 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 2,957 DEFERRED COMPENSATION: 9,125 NON-TAXABLE BENEFITS: 32,573 GREGA, JOANNE M. ADMINISTRATIVE DIRECTOR RADIOLOGY WINCHESTER HOSPITAL PAYMENTS REPORTED BY WINCHESTER HOSPITAL: BASE COMPENSATION: 215,686 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 1,975 DEFERRED COMPENSATION: 8,350 NON-TAXABLE BENEFITS: 29,751 ACKER, DAVID QUALIFT AND SAFETY ADVISOR & PHYSICIAN WINCHESTER HOSPITAL PAYMENTS REPORTED BY WINCHESTER HOSPITAL: BASE COMPENSATION: 211,016 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 2,178 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 1,364 BEYERMAN, KATHLEEN ACNO NURSING STAFF DEVELOPMENT WINCHESTER HOSPITAL PAYMENTS REPORTED BY WINCHESTER HOSPITAL: BASE COMPENSATION: 193,835 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,355 DEFERRED COMPENSATION: 7,633 NON-TAXABLE BENEFITS: 26,926

Schedule J (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
WINCHESTER HOSPITAL

Employer identification number
04-2104434

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MDFA - SERIES 2019K	04-3431814	57584YTK5	07-31-2019	211,922,775	SEE PART VI		X		X		X
B	MDFA - SERIES 2018J-1 J-2	04-3431814	57584YJW0	06-13-2018	479,594,374	SEE PART VI		X		X		X
C	MDFA - SERIES 2016I	04-3431814	57584XMT5	05-12-2016	257,611,877	SEE PART VI		X		X		X
D	MDFA - LAHEY SERIES F	04-2323457	NONEXXXXX	10-21-2015	262,828,878	RETIRE BONDS & CAP ACQUISITION		X		X		X
	MDFA - SERIES 2015 H-1	04-3431814	57584XDH1	09-02-2015	203,702,204	SEE PART VI		X		X		X
	MDFA - LAHEY SERIES E	04-3431814	NONEXXXXX	03-07-2013	130,000,000	POWER PLANT & CAPITAL ACQUISITION		X		X		X
	MDFA - SERIES 2012G	04-3431814	NONEXXXXX	07-11-2012	49,910,000	REFUND ISSUE DATED 02/11/1998		X		X		X
	MDFA - SERIES 2011F-1 F-2 F-3	04-3431814	NONEXXXXX	09-15-2011	120,280,000	REFUND ISSUE DATED 02/11/1998		X		X		X
	MHEFA - WINCHESTER SERIES F	04-2456011	57586CDD4	07-08-2004	30,340,000	SERIAL BOND SERIES F - ADV REFUND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	42,965,000		77,815,000		8,805,000		28,000,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	211,922,775		493,298,411		257,618,370		261,009,548
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............							4,857,465
6 Proceeds in refunding escrows ...............							160,202,232
7 Issuance costs from proceeds ...............	2,931,137		4,594,374		2,515,889		1,310,144
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	208,991,638		114,836,435		19,006,493		64,587,388
11 Other spent proceeds .............	201,353,725				236,095,998		119,989,328
12 Other unspent proceeds .............			362,998,912				31,060,330
13 Year of substantial completion .............			2015		2016		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X	X		X
16 Has the final allocation of proceeds been made? ..........		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

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

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	MORGAN STANLEY
c Term of hedge .........	2000.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

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

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
BOND A, ENTITY 1:	PART I, ROW A, COLUMN F, DESCRIPTION OF PURPOSE: THE ISSUE REFUNDED ISSUES DATED 06/09/2008, 11/30/2005, 6/16/2003, AND 6/4/1998.
BOND B, ENTITY 1:	PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998 PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $13,704,037 OF INVESTMENT EARNINGS
BOND C, ENTITY 1:	PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $26,884,283 OF INVESTMENT EARNINGS PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW
BOND D, ENTITY 1:	PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN D: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19.
BOND A, ENTITY 2:	PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES, FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART IV, COLUMN A, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019.
BOND B, ENTITY 2:	PART I, ROW B, COLUMN F: DESCRIPTION OF PURPOSE: CONSTRUCTION & EQUIPPING OF A POWER PLANT AND ACQUISITION OF CAPITAL ASSETS. PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN B: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19.
BOND C, ENTITY 2:	PART II, COLUMN C, LINE 11: 8,993,760 OF THE PROCEEDS LISTED WERE USED FOR TERMINATION OF THE HEDGE AGREEMENT, WITH THE REMAINDER BEING REFUNDING PROCEEDS THAT ARE NO LONGER IN ESCROW PART III, COLUMN C: THE 2012 ISSUE ARE EXEMPT FROM COMPLETING PART III AS THE ISSUE ARE REFUNDINGS OF BONDS ISSUED PRIOR TO 12/31/2002.
BOND D, ENTITY 2:	PART II, COLUMNS D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW PART III, COLUMN C: THE 2011 ISSUE ARE EXEMPT FROM COMPLETING PART III AS THE ISSUE ARE REFUNDINGS OF BONDS ISSUED PRIOR TO 12/31/2002.
BOND A, ENTITY 3:	PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN B: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19.

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
WINCHESTER HOSPITAL

Employer identification number
04-2104434

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MDFA - SERIES 2019K	04-3431814	57584YTK5	07-31-2019	211,922,775	SEE PART VI		X		X		X
B	MDFA - SERIES 2018J-1 J-2	04-3431814	57584YJW0	06-13-2018	479,594,374	SEE PART VI		X		X		X
C	MDFA - SERIES 2016I	04-3431814	57584XMT5	05-12-2016	257,611,877	SEE PART VI		X		X		X
D	MDFA - LAHEY SERIES F	04-2323457	NONEXXXXX	10-21-2015	262,828,878	RETIRE BONDS & CAP ACQUISITION		X		X		X
	MDFA - SERIES 2015 H-1	04-3431814	57584XDH1	09-02-2015	203,702,204	SEE PART VI		X		X		X
	MDFA - LAHEY SERIES E	04-3431814	NONEXXXXX	03-07-2013	130,000,000	POWER PLANT & CAPITAL ACQUISITION		X		X		X
	MDFA - SERIES 2012G	04-3431814	NONEXXXXX	07-11-2012	49,910,000	REFUND ISSUE DATED 02/11/1998		X		X		X
	MDFA - SERIES 2011F-1 F-2 F-3	04-3431814	NONEXXXXX	09-15-2011	120,280,000	REFUND ISSUE DATED 02/11/1998		X		X		X
	MHEFA - WINCHESTER SERIES F	04-2456011	57586CDD4	07-08-2004	30,340,000	SERIAL BOND SERIES F - ADV REFUND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	42,965,000		77,815,000		8,805,000		28,000,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	211,922,775		493,298,411		257,618,370		261,009,548
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............							4,857,465
6 Proceeds in refunding escrows ...............							160,202,232
7 Issuance costs from proceeds ...............	2,931,137		4,594,374		2,515,889		1,310,144
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	208,991,638		114,836,435		19,006,493		64,587,388
11 Other spent proceeds .............	201,353,725				236,095,998		119,989,328
12 Other unspent proceeds .............			362,998,912				31,060,330
13 Year of substantial completion .............			2015		2016		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X	X		X
16 Has the final allocation of proceeds been made? ..........		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

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

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	MORGAN STANLEY
c Term of hedge .........	2000.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

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

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
BOND A, ENTITY 1:	PART I, ROW A, COLUMN F, DESCRIPTION OF PURPOSE: THE ISSUE REFUNDED ISSUES DATED 06/09/2008, 11/30/2005, 6/16/2003, AND 6/4/1998.
BOND B, ENTITY 1:	PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998 PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $13,704,037 OF INVESTMENT EARNINGS
BOND C, ENTITY 1:	PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $26,884,283 OF INVESTMENT EARNINGS PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW
BOND D, ENTITY 1:	PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN D: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19.
BOND A, ENTITY 2:	PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES, FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART IV, COLUMN A, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019.
BOND B, ENTITY 2:	PART I, ROW B, COLUMN F: DESCRIPTION OF PURPOSE: CONSTRUCTION & EQUIPPING OF A POWER PLANT AND ACQUISITION OF CAPITAL ASSETS. PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN B: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19.
BOND C, ENTITY 2:	PART II, COLUMN C, LINE 11: 8,993,760 OF THE PROCEEDS LISTED WERE USED FOR TERMINATION OF THE HEDGE AGREEMENT, WITH THE REMAINDER BEING REFUNDING PROCEEDS THAT ARE NO LONGER IN ESCROW PART III, COLUMN C: THE 2012 ISSUE ARE EXEMPT FROM COMPLETING PART III AS THE ISSUE ARE REFUNDINGS OF BONDS ISSUED PRIOR TO 12/31/2002.
BOND D, ENTITY 2:	PART II, COLUMNS D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW PART III, COLUMN C: THE 2011 ISSUE ARE EXEMPT FROM COMPLETING PART III AS THE ISSUE ARE REFUNDINGS OF BONDS ISSUED PRIOR TO 12/31/2002.
BOND A, ENTITY 3:	PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN B: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19.

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
WINCHESTER HOSPITAL

Employer identification number
04-2104434

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MDFA - SERIES 2019K	04-3431814	57584YTK5	07-31-2019	211,922,775	SEE PART VI		X		X		X
B	MDFA - SERIES 2018J-1 J-2	04-3431814	57584YJW0	06-13-2018	479,594,374	SEE PART VI		X		X		X
C	MDFA - SERIES 2016I	04-3431814	57584XMT5	05-12-2016	257,611,877	SEE PART VI		X		X		X
D	MDFA - LAHEY SERIES F	04-2323457	NONEXXXXX	10-21-2015	262,828,878	RETIRE BONDS & CAP ACQUISITION		X		X		X
	MDFA - SERIES 2015 H-1	04-3431814	57584XDH1	09-02-2015	203,702,204	SEE PART VI		X		X		X
	MDFA - LAHEY SERIES E	04-3431814	NONEXXXXX	03-07-2013	130,000,000	POWER PLANT & CAPITAL ACQUISITION		X		X		X
	MDFA - SERIES 2012G	04-3431814	NONEXXXXX	07-11-2012	49,910,000	REFUND ISSUE DATED 02/11/1998		X		X		X
	MDFA - SERIES 2011F-1 F-2 F-3	04-3431814	NONEXXXXX	09-15-2011	120,280,000	REFUND ISSUE DATED 02/11/1998		X		X		X
	MHEFA - WINCHESTER SERIES F	04-2456011	57586CDD4	07-08-2004	30,340,000	SERIAL BOND SERIES F - ADV REFUND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	42,965,000		77,815,000		8,805,000		28,000,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	211,922,775		493,298,411		257,618,370		261,009,548
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............							4,857,465
6 Proceeds in refunding escrows ...............							160,202,232
7 Issuance costs from proceeds ...............	2,931,137		4,594,374		2,515,889		1,310,144
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	208,991,638		114,836,435		19,006,493		64,587,388
11 Other spent proceeds .............	201,353,725				236,095,998		119,989,328
12 Other unspent proceeds .............			362,998,912				31,060,330
13 Year of substantial completion .............			2015		2016		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X	X		X
16 Has the final allocation of proceeds been made? ..........		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

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

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	MORGAN STANLEY
c Term of hedge .........	2000.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

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

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
BOND A, ENTITY 1:	PART I, ROW A, COLUMN F, DESCRIPTION OF PURPOSE: THE ISSUE REFUNDED ISSUES DATED 06/09/2008, 11/30/2005, 6/16/2003, AND 6/4/1998.
BOND B, ENTITY 1:	PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998 PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $13,704,037 OF INVESTMENT EARNINGS
BOND C, ENTITY 1:	PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $26,884,283 OF INVESTMENT EARNINGS PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW
BOND D, ENTITY 1:	PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN D: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19.
BOND A, ENTITY 2:	PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES, FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART IV, COLUMN A, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019.
BOND B, ENTITY 2:	PART I, ROW B, COLUMN F: DESCRIPTION OF PURPOSE: CONSTRUCTION & EQUIPPING OF A POWER PLANT AND ACQUISITION OF CAPITAL ASSETS. PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN B: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19.
BOND C, ENTITY 2:	PART II, COLUMN C, LINE 11: 8,993,760 OF THE PROCEEDS LISTED WERE USED FOR TERMINATION OF THE HEDGE AGREEMENT, WITH THE REMAINDER BEING REFUNDING PROCEEDS THAT ARE NO LONGER IN ESCROW PART III, COLUMN C: THE 2012 ISSUE ARE EXEMPT FROM COMPLETING PART III AS THE ISSUE ARE REFUNDINGS OF BONDS ISSUED PRIOR TO 12/31/2002.
BOND D, ENTITY 2:	PART II, COLUMNS D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW PART III, COLUMN C: THE 2011 ISSUE ARE EXEMPT FROM COMPLETING PART III AS THE ISSUE ARE REFUNDINGS OF BONDS ISSUED PRIOR TO 12/31/2002.
BOND A, ENTITY 3:	PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN B: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19.

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

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

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

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

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

Part II

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

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






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

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) R WOODS	FAMILY MEMBER OF J. LEAHY	79,278	SERVICES		No
(2) R SAYRE	FAMILY MEMBER OF E. SAYRE HAMILTON	145,667	SERVICES		No

Part V

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

Return Reference

Explanation

SCHEDULE L PART IV:

MATTHEW J. WOODS, THE VP OF FINANCE AT WINCHESTER HOSPITAL (WH), IS THE BROTHER OF JANET LEAHY WHO IS A REGISTERED NURSE AT WH. HER SALARY AND OTHER INCOME FOR THE CALENDAR YEAR 2018 INCLUDE:BASE COMPENSATION: $61,015 INCENTIVE COMPENSATION: $0OTHER REPORTABLE COMPENSATION: $214DEFERRED COMPENSATION: $0NON-TAXABLE BENEFITS: $18,049RICHARD SAYRE, AT TRUSTEE AT WH, IS THE FATHER OF ELLEN SAYRE HAMILTON WHO IS A REGISTERED NURSE AT WH. HER SALARY AND OTHER INCOME FOR THE CALENDAR YEAR 2018 INCLUDE:BASE COMPENSATION: $114,528 INCENTIVE COMPENSATION: $0OTHER REPORTABLE COMPENSATION: $70DEFERRED COMPENSATION: $0NON-TAXABLE BENEFITS: $31,069VARIOUS CURRENT AND FORMER OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES OF WH MAY ALSO HOLD POSITIONS WITH OTHER ENTITIES WHICH MAKE CHARITABLE CONTRIBUTIONS TO WH. SUCH CONTRIBUTIONS HAVE NOT BEEN INCLUDED IN THE DISCLOSURES ABOVE. WH MAINTAINS AN ACCOUNTABLE BUSINESS EXPENSE REIMBURSEMENT PLAN. FROM TIME TO TIME, WH MAY REIMBURSE ITS OFFICERS, DIRECTORS/TRUSTEES AND/OR KEY EMPLOYEES FOR EXPENSES THEY INCURRED AND WHICH ARE PROPERLY ORDINARY AND NECESSARY BUSINESS EXPENSES OF THE REPORTING ENTITY. THE POLICIES AND PROCEDURES REQUIRED BY THE ACCOUNTABLE BUSINESS PLAN MUST BE FOLLOWED IN ORDER TO RECEIVE REIMBURSEMENT FOR SUCH EXPENSES AND IT IS POSSIBLE THAT ONE OR MORE INDIVIDUALS RECEIVED NON-TAXABLE REIMBURSEMENTS WHICH TOTALED $10,000 OR MORE DURING THE FISCAL PERIOD COVERED BY THIS FILING. ALL OF THE ABOVE TRANSACTIONS WERE NEGOTIATED AT ARMS-LENGTH AND IN ACCORDANCE WITH THE WH CONFLICT OF INTEREST POLICIES.

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Return Reference	Explanation
PART III, LINE 1	WINCHESTER HOSPITAL'S MISSION IS TO CARE. TO HEAL. TO EXCEL. IN SERVICE TO OUR COMMUNITY. IT IS A SIMPLE BUT POWERFUL STATEMENT THAT GUIDES OUR STAFF EVERY DAY. THE CORNERSTONE OF THE HOSPITAL IS THE PROMISE VALUES, WHICH PROVIDE EACH AND EVERY STAFF MEMBER WITH CLEAR BEHAVIORAL AND ORGANIZATIONAL EXPECTATIONS AND FOCUS: PROMOTING TEAMWORK; RESPECT, OWNERSHIP, MAINTAINING A POSITIVE ATTITUDE, INITIATIVE, SAFETY AND QUALITY, AND EMPATHY. WINCHESTER HOSPITAL'S SUCCESS IS BASED ON THIS SHARED COMMITMENT TO EXCELLENCE. THE HOSPITAL AND ITS STAFF TAKE PRIDE IN OFFERING AN EXCEPTIONAL PATIENT CARE EXPERIENCE, A SAFE ENVIRONMENT FOR PATIENTS AND STAFF AND ENGAGING OUR EMPLOYEES AND WORKING WITH PHYSICIANS TO ACHIEVE COMMON GOALS, AND INCREASE HOSPITAL SERVICES IN ORDER TO REINVEST IN THE HOSPITAL'S PROGRAMS, TECHNOLOGY AND PEOPLE WHICH FURTHER THE CARE OF THE HOSPITAL'S PATIENTS AND HEALTH OF THE LARGER COMMUNITY. ON MARCH 1, 2019, LAHEY HEALTH SYSTEM INCLUDING THE LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER, WINCHESTER HOSPITAL, NORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL AND BAYRIDGE HOSPITAL, THE BETH ISRAEL DEACONESS SYSTEM INCLUDING BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS MILTON, BETH ISRAEL DEACONESS NEEDHAM AND BETH ISRAEL DEACONESS PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL, ANNA JAQUES HOSPITAL AS WELL AS ENTITIES FOR WHICH THESE LISTED ORGANIZATIONS SERVE AS SOLE MEMBER AND ADDITIONAL AFFILIATES CAME TOGETHER TO FORM BETH ISRAEL LAHEY HEALTH (BILH). 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 AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES.
FORM 990, PART III, LINE 1	WINCHESTER HOSPITAL'S MISSION IS TO CARE. TO HEAL. TO EXCEL. IN SERVICE TO OUR COMMUNITY. IT IS A SIMPLE BUT POWERFUL STATEMENT THAT GUIDES OUR STAFF EVERY DAY. THE CORNERSTONE OF THE HOSPITAL IS THE PROMISE VALUES, WHICH PROVIDE EACH AND EVERY STAFF MEMBER WITH CLEAR BEHAVIORAL AND ORGANIZATIONAL EXPECTATIONS AND FOCUS: PROMOTING TEAMWORK; RESPECT, OWNERSHIP, MAINTAINING A POSITIVE ATTITUDE, INITIATIVE, SAFETY AND QUALITY, AND EMPATHY. WINCHESTER HOSPITAL'S SUCCESS IS BASED ON THIS SHARED COMMITMENT TO EXCELLENCE. THE HOSPITAL AND ITS STAFF TAKE PRIDE IN OFFERING AN EXCEPTIONAL PATIENT CARE EXPERIENCE, A SAFE ENVIRONMENT FOR PATIENTS AND STAFF AND ENGAGING OUR EMPLOYEES AND WORKING WITH PHYSICIANS TO ACHIEVE COMMON GOALS, AND INCREASE HOSPITAL SERVICES IN ORDER TO REINVEST IN THE HOSPITAL'S PROGRAMS, TECHNOLOGY AND PEOPLE WHICH FURTHER THE CARE OF THE HOSPITAL'S PATIENTS AND HEALTH OF THE LARGER COMMUNITY. ON MARCH 1, 2019, LAHEY HEALTH SYSTEM INCLUDING THE LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER, WINCHESTER HOSPITAL, NORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL AND BAYRIDGE HOSPITAL, THE BETH ISRAEL DEACONESS SYSTEM INCLUDING BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS MILTON, BETH ISRAEL DEACONESS NEEDHAM AND BETH ISRAEL DEACONESS PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL, ANNA JAQUES HOSPITAL AS WELL AS ENTITIES FOR WHICH THESE LISTED ORGANIZATIONS SERVE AS SOLE MEMBER AND ADDITIONAL AFFILIATES CAME TOGETHER TO FORM BETH ISRAEL LAHEY HEALTH (BILH). 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 AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES.
PART IV, LINE 12:	THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2019. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (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). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER.
PART IV, QUESTION 2, 17, 18, 19 AND 29:	AS NOTED IN THIS FILING, WINCHESTER HOSPITAL IS A SISTER-ORGANIZATION TO WINCHESTER HOSPITAL FOUNDATION (WHF, EIN: 04-3399570) AND LAHEY HEALTH SHARED SERVICES, INC. (LHSS EIN: 04-3178972). ALL THREE ENTITIES ARE EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. WHF AND LHSS PERFORM FUNDRAISING ACTIVITIES ON BEHALF OF , AND IN THE NAME OF, WINCHESTER HOSPITAL, INCLUDING SPECIAL FUNDRAISING EVENTS AS WELL AS MAIL AND AS NOTED IN THIS FILING, WINCHESTER HOSPITAL IS A SISTER-ORGANIZATION TO WINCHESTER HOSPITAL FOUNDATION (WHF, EIN: 04-3399570) AND LAHEY HEALTH SHARED SERVICES, INC. (LHSS EIN: 04-3178972). ALL THREE ENTITIES ARE EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. WHF AND LHSS PERFORM FUNDRAISING ACTIVITIES ON BEHALF OF , AND IN THE NAME OF, WINCHESTER HOSPITAL, INCLUDING SPECIAL FUNDRAISING EVENTS AS WELL AS MAIL AND IN-PERSON SOLICITATIONS FROM INDIVIDUALS, CORPORATIONS AND FOUNDATIONS. DETAILED DISCLOSURES CAN BE FOUND IN THE FORM 990 AND SCHEDULE G, SUPPLEMENTAL INFORMATION REGARDING FUNDRAISING OR GAMING ACTIVITIES, FILED AS PART OF THE WHF AND LHSS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019.IN-PERSON SOLICITATIONS FROM INDIVIDUALS, CORPORATIONS AND FOUNDATIONS. DETAILED DISCLOSURES CAN BE FOUND IN THE FORM 990 AND SCHEDULE G, SUPPLEMENTAL INFORMATION REGARDING FUNDRAISING OR GAMING ACTIVITIES, FILED AS PART OF THE WHF AND LHSS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019.
PART V, LINE 7G:	WINCHESTER HOSPITAL DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899.
PART V, LINE 7H:	WINCHESTER HOSPITAL DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 1098-C.
FORM 990, PART VI, SECTION A, LINE 2	THE FOLLOWING WINCHESTER HOSPITAL OFFICERS, DIRECTOR/TRUSTEES, AND KEY EMPLOYEES HAVE BUSINESS OR FAMILY RELATIONSHIPS: DEBORAH MCDONOUGH AND BILL MCCANCE HAVE A BUSINESS RELATIONSHIP IN ADDITION FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. SERVED AS THE SOLE MEMBER 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 HEALTH SHARED SERVICES, LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL CORPORATION (NBC), AND ANNA JAQUES HOSPITAL. THE LAHEY CLINIC FOUNDATION IN TURN SERVES AS SOLE MEMBER TO LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL DBA LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). ADDITIONAL ENTITIES LISTED HERE MAY ALSO IN TURN SERVE AS MEMBER TO OTHER NETWORK AFFILIATES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE NETWORK OF AFFILIATED ORGANIZATIONS. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J.
FORM 990, PART VI, SECTION A, LINE 4	WINCHESTER HOSPITAL MADE CHANGES TO ITS BYLAWS DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 AS PART OF THE CREATION OF THE BETH ISRAEL LAHEY HEALTH (BILH), AN INTEGRATED HEALTH CARE SYSTEM PROVIDING PATIENT CARE INFORMED BY WORLD-CLASS RESEARCH AND EDUCATION. BETH ISRAEL LAHEY HEALTH, INC. BECAME THE SOLE MEMBER OF WINCHESTER HOSPITAL. CHANGES TO THE BYLAWS AFFECT: - FREQUENCY OF MEETINGS - MINIMUM & MAXIMUM NUMBER OF TRUSTEES - EX-OFFICIO TRUSTEES - APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES - COMMITTEES - OFFICERS - TERMS AND TERM LIMITS
FORM 990, PART VI, SECTION A, LINE 6	EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE SOLE MEMBER OF WINCHESTER HOSPITAL. LAHEY HEALTH SYSTEM, INC. WHICH MERGED INTO LAHEY CLINIC FOUNDATION EFFECTIVE MARCH 1, 2019, PREVIOUSLY SERVED AS SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	THE MEMBER HAS THE EXCLUSIVE AUTHORITY TO (A) APPOINT AND REAPPOINT TRUSTEES, (B) FILL ANY VACANCIES IN THE OFFICES OF TRUSTEES, AND (C) ACTING BY VOTE OF NOT LESS THAN THREE QUARTERS (3/4) OF THE MEMBER'S TRUSTEES THEN IN OFFICE, REMOVE, WITH OR WITHOUT CAUSE, A TRUSTEE.
FORM 990, PART VI, SECTION A, LINE 7B	THE MEMBER OF WINCHESTER HOSPITAL HAS THE FOLLOWING RIGHTS, AS DESIGNATED IN WINCHESTER HOSPITAL'S BY-LAWS: SUBJECT TO THE PROVISIONS OF THE ARTICLES OF ORGANIZATION AND THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, BOTH POSITIVE AND NEGATIVE, CONFERRED BY MASSACHUSETTS GENERAL LAWS ("M.G.L.") CHAPTER 180, AS AMENDED, ON MEMBERS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. IN ADDITION, EXCEPT AS ARE EXPRESSLY GRANTED TO THE BOARD OF TRUSTEES OF THE CORPORATION ("BOARD") IN THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, POSITIVE AND NEGATIVE, CONFERRED BY M.G.L. CHAPTER 180 ON BOARDS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. NOTWITHSTANDING THE FOREGOING, THE MEMBER MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE BOARD: (A) APPROVE OR REQUIRE ANY CHANGE IN, OR CONSOLIDATION OF PHILANTHROPIC GIFTS, ASSETS, AND PROGRAMS OF THE CORPORATION, WHICH SHALL REMAIN UNDER THE CORPORATION'S CONTROL AND BE USED FOR THE BENEFIT OF THE CORPORATION AND NOT FOR OTHER COMPONENTS OF THE MEMBER'S SYSTEM, EXCEPT TO THE EXTENT THAT SUCH CHANGES INVOLVE BACK-OFFICE CONSOLIDATION WITH OTHER DIRECT OR INDIRECT SUBSIDIARIES OF THE MEMBER; (B) APPROVE OR REQUIRE ANY CHANGE IN THE NAME, BRAND, OR TRADEMARK OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES, EXCEPT SUCH COMPLEMENTARY CHANGES AS THE MEMBER MAY DETERMINE ARE REASONABLY APPROPRIATE IN ESTABLISHING A SYSTEM-WIDE IDENTITY FOR THE AFFILIATED ENTITIES; OR (C) AMEND OR RESTATE THESE BYLAWS TO CHANGE OR ELIMINATE EITHER OF THE FOREGOING LIMITATIONS ON ITS POWERS. FOR THE PERIOD ENDING ON THE THIRD ANNIVERSARY OF THE DATE THE MEMBER BECOMES THE SOLE CORPORATE MEMBER OF THE CORPORATION, THE MEMBER'S AUTHORITY TO CHANGE THE MEDICAL SCHOOL AFFILIATION OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES IS SUBJECT TO THE REQUIREMENT THAT IT OBTAIN THE UNANIMOUS CONSENT OF THE CORPORATION'S DESIGNATED TRUSTEES (AS DEFINED IN THE BYLAWS OF THE MEMBER) AND THE APPROVAL OF THE MEMBER'S BOARD OF TRUSTEES (THE "MEMBER'S BOARD"). THE MEMBER MAY NOT CAUSE THE CORPORATION TO CEASE OPERATING A SEPARATELY LICENSED HOSPITAL FACILITY, OR CLOSE ANY ESSENTIAL SERVICE OF SUCH HOSPITAL FACILITY, WITHOUT CONSULTING WITH THE BOARD PRIOR TO TAKING SUCH ACTION. THE POWERS AND RESPONSIBILITIES OF THE BOARD INCLUDE THE FOLLOWING: (A) PROVIDING RECOMMENDATIONS TO THE MEMBER REGARDING (I) APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES, (II) THE ESTABLISHMENT OF THE CORPORATION'S POLICIES, (III) THE MAINTENANCE OF PATIENT CARE QUALITY, AND (IV) THE PROVISION OF CLINICAL SERVICES AND COMMUNITY SERVICE PLANNING IN A MANNER RESPONSIVE TO LOCAL COMMUNITY NEEDS; (B) ENSURING COMPLIANCE WITH ALL LICENSURE AND ACCREDITATION REQUIREMENTS, INCLUDING CREDENTIALING AND OTHER MEDICAL STAFF MATTERS; (C) PROVIDING OVERSIGHT FOR INSTITUTIONAL PLANNING, MAKING RECOMMENDATIONS FOR NEW CLINICAL SERVICES, AND PARTICIPATING IN AN ANNUAL REVIEW OF THE CORPORATION'S STRATEGIC AND FINANCIAL PLAN AND GOALS; (D) REVIEWING AND RECOMMENDING APPROVAL OF OPERATING AND CAPITAL BUDGETS AS WELL AS MAKING RECOMMENDATIONS WITH RESPECT TO CAPITAL EXPENDITURES; (E) MAKING RECOMMENDATIONS WITH RESPECT TO QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS; (F) PROVIDING OVERSIGHT OF RISK MANAGEMENT PROGRAMS RELATING TO PATIENT CARE AND SAFETY; (G) REVIEWING DISASTER PLANS THAT DEAL WITH BOTH INTERNAL (E.G., FIRE) AND EXTERNAL DISASTERS; AND (H) EVALUATING RECRUITMENT NEEDS TO ENSURE ADEQUATE MEDICAL STAFF CAPACITY TO CONTINUE TO MEET COMMUNITY NEEDS. EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, THE BOARD SHALL ACT IN AN ADVISORY CAPACITY AND CONSISTENT THEREWITH SHALL HAVE ONLY THE FOLLOWING POWERS: (A) POWERS EXPRESSLY GRANTED BY THE MEMBER FROM TIME TO TIME; (B) POWER TO EXERCISE ITS AUTHORITY AS A MEMBER OF OTHER CORPORATIONS; (C) POWER TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THE BYLAWS OF THE MEMBER (AS DEFINED UNDER THE BYLAWS OF THE MEMBER) OR UNDER THESE BYLAWS WITH RESPECT TO THE MEMBER; AND (D) POWERS TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THAT AGREEMENT DATED JUNE 30, 2017 BY AND AMONG LAHEY HEALTH SYSTEM, INC., BETH ISRAEL DEACONESS MEDICAL CENTER, INC., NEW ENGLAND BAPTIST HOSPITAL, INC., MOUNT AUBURN HOSPITAL, CAREGROUP, INC., AND SEACOAST REGIONAL HEALTH SYSTEMS, INC. THE POWERS OF THE BOARD IN CLAUSES (A) AND (B) OF THE PRECEDING SENTENCE SHALL BE SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. THE POWERS OF THE BOARD IN CLAUSE (C) AND (D) OF THE FIRST SENTENCE OF THIS PARAGRAPH SHALL BE INDEPENDENT OF THE MEMBER AND NOT SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. NOTWITHSTANDING CLAUSE (B) ABOVE, THE POWER OF THE CORPORATION TO EXERCISE ITS AUTHORITY AS A MEMBER OF ANOTHER CORPORATION SHALL BE SUBJECT TO THE FOLLOWING LIMITATIONS: (X) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED BY THE CORPORATION ONLY AT THE EXPRESS AND EXPLICIT DIRECTION OF, AND WITH THE APPROVAL OF, THE MEMBER; (Y) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED DIRECTLY BY THE MEMBER AFTER CONSULTATION WITH THE CHAIR BUT OTHERWISE WITHOUT THE APPROVAL OR PARTICIPATION OF THE CORPORATION; AND (Z) OTHER THAN STATUTORY POWERS, THE CORPORATION SHALL HAVE ONLY THOSE POWERS AND AUTHORITIES OVER AND WITH RESPECT TO THE CORPORATIONS OF WHICH IT IS A MEMBER AS ARE EXPRESSLY AND EXPLICITLY DELEGATED OR DIRECTED TO THE CORPORATION BY ACTION OF THE MEMBER'S BOARD.
FORM 990, PART VI, SECTION B, LINE 11B	AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) BECAME THE SOLE MEMBER OF LAHEY HEALTH SHARE SERVICES, WHICH IS THE SOLE MEMBER OF WINCHESTER HEALTHCARE MANAGEMENT, INC., WHICH IS THE SOLE MEMBER OF WINCHESTER HOSPITAL. THIS FORM 990 IS REVIEWED BY THE VP OF FINANCE OF WINCHESTER HOSPITAL, THE TAX DIRECTOR OF BILH AND DELOITTE TAX, LLP. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF THE WINCHESTER HOSPITAL BOARD PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS ADDISON GILBERT SOCIETY, INC. HAS A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY. PURSUANT TO THAT POLICY, ALL OFFICERS, TRUSTEES, MANAGERS AND KEY EMPLOYEES ARE ASKED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST FORM WHICH IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS RELATIONSHIPS MAINTAINED BY THESE INDIVIDUALS AND/OR THEIR FAMILY MEMBERS AND WHICH MAY RESULT IN A CONFLICT OF INTEREST. LAHEY HEALTH SHARED SERVICES (LHSS), AN AFFILIATE OF ADDISON GILBERT SOCIETY, INC., IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND PROVIDES ADMINISTRATIVE AND CENTRALIZED OPERATIONAL SUPPORT TO ITS AFFILIATES. THE LHSS COMPLIANCE DEPARTMENT ADMINISTERS THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSURE PROCESS ON BEHALF OF ITS AFFILIATES. ALL POSITIVE RESPONSES ARE REVIEWED AND EVALUATED BY A COMPLIANCE TEAM MEMBER FOR DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. ANY ACTIVITY THAT REQUIRES FURTHER REVIEW IS CAREFULLY EVALUATED. ADDITIONAL DOCUMENTATION MAY BE REQUESTED AND/OR A MANAGEMENT PLAN DEVELOPED DEPENDING ON THE NATURE AND TYPE OF POTENTIAL CONFLICT. AT TIMES, A PARTICULAR ARRANGEMENT MAY BE REVIEWED BY LEGAL AND/OR REVIEWED BY A COMMITTEE OR OTHER AUTHORIZED LEADERSHIP BODY. PURSUANT TO THE CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A MANAGEMENT PLAN THAT MAY REQUIRE DISCLOSURE AND RECUSAL, AS WELL AS APPROPRIATE DOCUMENTATION. ADDITIONALLY, AS PREVIOUSLY NOTED IN THIS FILING, EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH (BILH) BECAME THE SOLE MEMBER OF LHSS AND ADDISON GILBERT SOCIETY, INC.'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BILH SYSTEM. IN ADDITION TO THE CONFLICT OF INTEREST PROCESS OUTLINED ABOVE, THE BILH TAX DEPARTMENT ISSUED A TAX QUESTIONNAIRE TO ALL CURRENT AND FORMER MEMBERS OF THE ADDISON GILBERT SOCIETY, INC. BOARD OF TRUSTEES, OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE PROCESS WAS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR ADDISON GILBERT SOCIETY, INC. TO COMPLETELY AND ACCURATELY PROCESS AND COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES.
FORM 990, PART VI, SECTION B, LINE 15	AS NOTED THROUGHOUT THIS FILING, WINCHESTER HOSPITAL BECAME A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES WITH BILH SERVING AS WINCHESTER HOSPITAL'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK EFFECTIVE MARCH 1, 2019. PRIOR TO THAT DATE WINCHESTER HOSPITAL WAS A MEMBER OF THE LAHEY HEALTH SYSTEM, AND LAHEY HEALTH SYSTEM, INC. (LHSI) SERVED AS WINCHESTER HOSPITAL'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE LAHEY HEALTH SYSTEM. IN THIS ROLE LHSI MAINTAINED THE RESPONSIBILITY FOR SETTING COMPENSATION FOR EMPLOYEES AND SENIOR MANAGEMENT OF THE ENTITIES WHICH COMPRISED THE LAHEY HEALTH SYSTEM. TO THAT END, LHSI HAD A COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES. AS REQUIRED BY THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, COMPENSATION REPORTED HEREIN IS CALENDAR YEAR 2018 COMPENSATION. AS SUCH, COMPENSATION REPORTED IN THIS FORM 990 FOR WINCHESTER HOSPITAL'S OFFICERS, TRUSTEES AND KEY EMPLOYEES WAS SET BY THE LHSI COMPENSATION COMMITTEE PRIOR TO THE CREATION OF BILH. THE LHSI COMPENSATION COMMITTEE PROCESS FOR SETTING COMPENSATION IS BELOW. THE LHSI COMPENSATION COMMITTEE ESTABLISHED THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE LAHEY HEALTH SYSTEM NETWORK OF AFFILIATES INCLUDING THE LHSI CHIEF EXECUTIVE OFFICER, OTHER MEMBERS OF SENIOR MANAGEMENT AT LHSI AND ITS AFFILIATES THE COMPENSATION COMMITTEE WAS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS WAS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT IT COMPLIED WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEYS AND STUDIES PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. THE COMPENSATION COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE LHSI CEO. THE COMPENSATION PACKAGE FOR THE LHSI CEO VOTED BY THE COMPENSATION COMMITTEE WAS SUBMITTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	WINCHESTER HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL LAHEY HEALTH TAX DEPARTMENT 109 BROOKLINE AVENUE, SUITE 300 BOSTON, MA 02215
FORM 990, PART XI, LINE 9:	TRANSFERS TO/FROM AFFILIATES -8,789,404. NET ASSETS RELEASED FROM RESTRICTION FROM AFFILIATES 435,604. CHANGE IN VALUATION OF SWAPS (NET ASSETS) -1,698,588. OTHER CHANGES IN TRUST -133,384. CHANGE IN INTEREST OF FOUNDATION 1,444,979. NET ASSETS RELEASED FROM RESTRICTION - OPERATIONS 224,956.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ADDISON GILBERT SOCIETY INC 41 MALL ROAD BURLINGTON,MA01805 46-4371382	SUPPORT	MA	501(C)(3)	7	LAHEY HEALTH SHARED SERVICES INC	Yes
(2)ANNA JAQUES COMMUNITY HEALTH FOUNDATION 25 HIGHLAND AVE NEWBURYPORT,MA01950 04-3318952	FUNDRSG ORG	MA	501(C)(3)	12A, I	ANNA JAQUES HOSPITAL INC	Yes
(3)ANNA JAQUES HOSPITAL INC 25 HIGHLAND AVE NEWBURYPORT,MA01950 04-2104338	HEALTHCARE	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(4)ASSOC PHYS HARVARD MED FAC PHY AT BIDMC 375 LONGWOOD AVE BOSTON,MA02215 32-0058309	TO PROVIDE EMERGENCY MEDICAL SERVICES	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(5)BAIM INSTITUTE OF CLINICAL RESEARCH INC FKA HCRI 930 COMMONWEALTH AVE BOSTON,MA02215 04-3521077	SCIENTIFIC & MEDICAL RESEARCH	MA	501(C)(3)	7	N/A	Yes
(6)BETH ISRAEL DEACONESS HOSPITAL - MILTON INC 199 REEDSDALE RD MILTON,MA02186 04-2103604	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS.	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(7)BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM INC 148 CHESTNUT ST NEEDHAM,MA02492 04-3229679	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS.	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(8)BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH INC 275 SANDWICH ST PLYMOUTH,MA02360 22-2667354	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS.	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(9)BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVE BOSTON,MA02215 04-2103881	THE OPERATION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(10)BETH ISRAEL LAHEY HEALTH PRIMARY CARE FKA LPCO 41 MALL ROAD BURLINGTON,MA01805 47-2248298	HEALTHCARE	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(11)BETH ISRAEL LAHEY HEALTH INC 20 UNIVERSITY ROAD CAMBRIDGE,MA02138 83-2671600	SUPPORT	MA	501(C)(3)	12A, I	N/A	Yes
(12)BI ANAESTHESIA FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2997215	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(13)BI COMMUNITY FOUNDATION INC 330 BROOKLINE AVE STE 300 BOSTON,MA02215 04-2776678	INACTIVE CORPORATION	MA	501(C)(3)	7	N/A	Yes
(14)BI DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION INC 330 BROOKLINE AVE W/CC-2 BOSTON,MA02215 36-4803234	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(15)BI DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-3079630	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(16)BI DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 20-8253452	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(17)BI DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-3030397	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(18)BI DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 20-4974585	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(19)BI DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 02-0671240	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(20)BI DERMATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-3117601	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(21)BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP 482 BEDFORD STREET LEXINGTON,MA02420 04-3200113	SUPPORT	MA	501(C)(3)	12A, I	N/A		No
(22)BIDMC OBSTETRICS AND GYNECOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2794855	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(23)BIDMC PHARMACY INC 330 BROOKLINE AVE BOSTON,MA02215 82-2526816	OPERATE A SPECIALTY PHARMACY	MA	501(C)(3)	12A, I	BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(24)BID-MILTON PHYSICIAN ASSOCIATES INC FKA MHF 199 REEDSDALE RD MILTON,MA02186 22-2566792	PROMOTE HEALTHCARE	MA	501(C)(3)	12A, I	BETH ISRAEL DEACONESS HOSPITAL - MILTON	Yes
(25)BIH PATHOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 22-2548374	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(26)BIH RADIOLOGIC FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2571853	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(27)CAB HEALTH AND RECOVERY SERVICES INC 199 ROSEWOOD DRIVE SUITE 250 DANVERS,MA01923 04-2400270	SUBSTANCE ABUSE	MA	501(C)(3)	10	NORTHEAST BEHAVIORAL HEALTH CORPORATION	Yes
(28)CAREGROUP PARMENTER HOME CARE & HOSPICE INC 330 MOUNT AUBURN ST CAMBRIDGE,MA02138 47-3111453	HOME CARE & HOSPICE	MA	501(C)(3)	12A, I	MOUNT AUBURN HOSPITAL	Yes
(29)CAREGROUP INC 109 BROOKLINE AVE STE 300 BOSTON,MA02215 22-2629185	OVERSEE FINANCIAL HEALTH OF AFFILIATES	MA	501(C)(3)	12C, III-FI	N/A		No
(30)CARL J SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH 330 BROOKLINE AVE BOSTON,MA02215 04-3326928	DEVELOP INNOVATIVE PROG AND MODELS FOR TEACHING AND RESEARCH	MA	501(C)(3)	12A, I	N/A		No
(31)COMMUNITY PHYSICIAN ASSOCIATES INC 199 REEDSDALE RD MILTON,MA02186 04-3243146	OUTPATIENT AND PRIMARY CARE SERVICES	MA	501(C)(3)	3	MILTON HOSPITAL FOUNDATION	Yes
(32)CONTINUING EDU PROGRAM DBA BID DEPT OF PSYCH FDN 185 PILGRIM ROAD BOSTON,MA02215 04-3242952	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(33)HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC 375 LONGWOOD AVE BOSTON,MA02215 22-2768204	GENERAL AND SPECIALIZED MEDICAL SERVICES TO THE PATIENTS OF BIDMC AND OTHERS	MA	501(C)(3)	10	BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(34)HEALTH AND EDUCATION HOUSING SERVICES 199 ROSEWOOD DRIVE DANVERS,MA01923 22-3232914	HUD HOUSING	MA	501(C)(3)	10	NORTHEAST BEHAVIORAL HEALTH CORPORATION	Yes
(35)JORDAN HEALTH SYSTEMS INC 275 SANDWICH ST PLYMOUTH,MA02360 04-2103805	PROMOTE HEALTHCARE	MA	501(C)(3)	7	BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(36)JORDAN PHYSICIANS ASSOCIATES INC 275 SANDWICH ST PLYMOUTH,MA02360 04-3228556	OUTPATIENT AND PRIMARY CARE SERVICES	MA	501(C)(3)	10	JORDAN HEALTH SYSTEMS INC	Yes
(37)LAHEY CLINIC CANADIAN FOUNDATION 130 KING STREET WEST TORONTO CA	FUNDRSG ORG	CA	NON-US		N/A		No
(38)LAHEY CLINIC FOUNDATION INC 41 MALL ROAD BURLINGTON,MA01805 04-2323457	SUPPORT	MA	501(C)(3)	7	BETH ISRAEL LAHEY HEALTH INC	Yes
(39)LAHEY CLINIC HOSPITAL INC 41 MALL ROAD BURLINGTON,MA018050001 04-2704686	HEALTHCARE	MA	501(C)(3)	3	LAHEY CLINIC FOUNDATION INC	Yes
(40)LAHEY CLINIC INC 41 MALL ROAD BURLINGTON,MA018050001 04-2704683	HEALTHCARE	MA	501(C)(3)	10	LAHEY CLINIC FOUNDATION INC	Yes
(41)LAHEY HEALTH SHARED SERVICES INC 41 MALL ROAD BURLINGTON,MA01805 04-3178972	ADMINISTRATION	MA	501(C)(3)	10	BETH ISRAEL LAHEY HEALTH INC	Yes
(42)LAHEY HEALTH SYSTEMS INC 41 MALL ROAD BURLINGTON,MA01805 61-1665701	SUPPORT	MA	501(C)(3)	12C, III-FI	N/A		No
(43)LONGWOOD MEDICAL ENERGY COLLABORATIVE 160 LONGWOOD AVENUE BOSTON,MA02215 04-3476764	COORDINATE AND PROVIDE STATEGIC PLANNING OPP FOR HMS	MA	501(C)(3)	12A, I	N/A	Yes
(44)LONGWOOD MEDICAL INTL FOUNDATION 375 LONGWOOD AVENUE BOSTON,MA02215 04-3208878	INACTIVE CORPORATION	MA	501(C)(3)	12A, I		Yes
(45)MED CARE OF BOSTON MGMT CORP DBA BID HEALTHCARE 400 HUNNEWELL ST NEEDHAM,MA02494 04-2810972	OUTPATIENT, PRIMARY CARE AND SPECIALTY SERVICES	MA	501(C)(3)	10	BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(46)MOUNT AUBURN HOSPITAL 330 MOUNT AUBURN ST CAMBRIDGE,MA02138 04-2103606	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(47)MOUNT AUBURN PROFESSIONAL SERVICES INC 330 MOUNT AUBURN ST CAMBRIDGE,MA02138 04-3026897	OFFERING MEDICAL CARE IN GENERAL AND SPECIALIZED PRACTICES	MA	501(C)(3)	12A, I	MOUNT AUBURN HOSPITAL	Yes
(48)NEW ENGLAND BAPTIST HOSPITAL 125 PARKER HILL AVE BOSTON,MA02120 04-2103612	ORTHOPEDIC SPECIALTY HOSPITAL	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(49)NEW ENGLAND BAPTIST MEDICAL ASSOCIATES INC 125 PARKER HILL AVE BOSTON,MA02120 04-3235796	OUTPATIENT MEDICAL SERVICES TO THE VARIOUS COMMUNITIES SERVICED BY NEBH	MA	501(C)(3)	3	NEW ENGLAND BAPTIST HOSPITAL	Yes
(50)NORTHEAST BEHAVIORAL HEALTH CORPORATION 199 ROSEWOOD DRIVE DANVERS,MA01923 04-2777145	HEALTHCARE	MA	501(C)(3)	10	BETH ISRAEL LAHEY HEALTH INC	Yes
(51)NORTHEAST HEALTH SYSTEM INC 85 HERRICK ST BEVERLY,MA01915 04-3240453	SUPPORT	MA	501(C)(3)	12A, I	LAHEY HEALTH SHARED SERVICES INC	Yes
(52)NORTHEAST HOSPITAL CORPORATION 85 HERRICK STREET BEVERLY,MA01915 04-2121317	HEALTHCARE	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(53)NORTHEAST MEDICAL PRACTICE INC 85 HERRICK ST BEVERLY,MA01915 04-3201853	HEALTHCARE	MA	501(C)(3)	10	NORTHEAST HOSPITAL CORPORATION	Yes
(54)NORTHEAST PROFESSIONAL REGISTRY OF NURSES 800NCUMMINGS CENTER BEVERLY,MA01915 20-1287349	HEALTHCARE	MA	501(C)(3)	10	NORTHEAST SENIOR HEALTH CORPORATION	Yes
(55)NORTHEAST SENIOR HEALTH CORPORATION 85 HERRICK STREET BEVERLY,MA01915 04-2731137	HEALTHCARE	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(56)SEACOAST AFFILIATED GROUP PRACTICE INC 25 HIGHLAND AVE NEWBURYPORT,MA01915 04-3485648	PHYSICIAN GROUP	MA	501(C)(3)	10	ANNA JAQUES HOSPITAL INC	Yes
(57)SEACOAST NURSING AND REHABILITION CENTER 300 WASHINGTON ST GLOUCESTER,MA01930 04-1305001	HEALTHCARE	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(58)SEACOAST REGIONAL HEALTH SYSTEMS INC 25 HIGHLAND AVE NEWBURYPORT,MA01915 22-2814214	SUPPORT ORG	MA	501(C)(3)	12A, I	N/A		No
(59)SEACOAST REGIONAL MRI INC 25 HIGHLAND AVE NEWBURYPORT,MA01915 32-0443663	HEALTH SVCS	MA	501(C)(3)	10	N/A		No
(60)WINCHESTER COMMUNITY ACCOUNTABLE CARE ORGANIZATION INC 41 HIGHLAND AVENUE WINCHESTER,MA01890 22-3137856	ACO	MA	501(C)(3)	12A, I	WINCHESTER HEALTHCARE MANAGEMENT INC	Yes
(61)WINCHESTER HEALTHCARE MANAGEMENT INC 41 HIGHLAND AVENUE WINCHESTER,MA01890 22-2701817	MANAGEMENT	MA	501(C)(3)	12A, I	LAHEY HEALTH SHARED SERVICES INC	Yes
(62)WINCHESTER HOSPITAL FOUNDATION INC 41 HIGHLAND AVENUE WINCHESTER,MA01890 04-3399570	SUPPORT	MA	501(C)(3)	12A, I	WINCHESTER HEALTHCARE MANAGEMENT INC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) BIDCO PHYSICIAN LLC ONE UNIVERSITY AVE NORTH ENTRANCE WESTWOOD,MA02090 46-1589743	COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC	MA	N/A
(2) BIDCO HOSPITAL LLC 247 STATION DRIVE NORTHWEST 1 WESTWOOD,MA02090 46-1643790	COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC	MA	N/A
(3) CAREGROUP CLINICAL RESEARCH LLC 109 BROOKLINE AVENUE BOSTON,MA02215 30-0228711	TO PARTICIPATE IN A CLINICAL RESEARCH PARTNERSHIP	MA	N/A
(4) CAREGROUP INVESTMENT PARTNERSHIP LLP 109 BROOKLINE AVENUE BOSTON,MA02215 04-3278109	INVESTMENT PARTNERSHIP	MA	N/A
(5) PHYSICIAN PROFESSIONAL SERVICES LLP 10 CABOT ROAD MEDFORD,MA02215 04-3275078	TO PROVIDE MEDICAL BILLING SERVICES	MA	N/A
(6) NEW ENGLAND BAPTIST ORTHOPEDIC NETWORK LLC 125 PARKER HILL AVE BOSTON,MA02120 46-5120176	TO PROVIDE ORTHOPEDIC MEDICAL SERVICES	MA	N/A
(7) WINCHESTER HOSPITALSHIELDS MRI LLC 700 CONGRESS ST QUINCY,MA02169 46-2523117	MRI SERVICES	MA	WINCHESTER HOSPITAL	EXCLUDED	3,214,827	1,355,781		No			No	70.000 %
(8) SHIELDS IMAGING AT ANNA JAQUES HOSPITAL LLC 700 CONGRESS ST STE 204 QUINCY,MA02169 38-3989358	MRI SERVICES	MA	N/A
(9) HAVERHILL MOB LLC 50 CHESTNUT ST NEEDHAM,MA02492 81-2856118	MEDICAL OFFICE BUILDING	MA	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) JORDAN COMMUNITY ACO INC 275 SANDWICH ST PLYMOUTH,MA02360 45-4047430	COORDINATED, SAFE AND COST EFFECTIVE PATIENT CARE AT BID-PLYMOUTH	MA	N/A	C			Yes
(2) GREATER NEWBURYPORT MANAGEMENT SERVICES ORGANIZATION INC 25 HIGHLAND AVE NEWBURYPORT,MA01950 16-1744477	MANAGEMENT SERVICES	MA	N/A	C			Yes
(3) LAHEY CLINIC INSURANCE CO LTD CRAIG APPIN HOUSE PO BOX HM 2450 HAMILTON BD	INSURANCE	BD	N/A	C			Yes
(4) LEDGEWOOD HEALTHCARE CORPORATION 680 SOUTH FOURTH STREET LOUISVILLE,KY40202 04-2855189	NURSING HOME	KY	N/A	C			Yes
(5) NORTHEAST PROPRIETARY CORP 85 HERRICK STREET BEVERLY,MA01915 04-2855191	MEDICAL SERVICES	MA	N/A	C			Yes
(6) WINCHESTER PHYSICIAN ASSOCIATES INC 41 HIGHLAND AVE WINCHESTER,MA01890 04-3262963	MANAGEMENT SERVICES	MA	N/A	C			Yes
(7) WINCHESTER HEALTHCARE ENTERPRISES INC 41 HIGHLAND AVE WINCHESTER,MA01890 04-2932059	MANAGEMENT SERVICES	MA	N/A	C			Yes
(8) WINCHESTER PHYSICIAN HOSPITAL ORGANIZATION INC 41 HIGHLAND AVE WINCHESTER,MA01890 47-2646454	PHYS HOSP ORG	MA	N/A	C			Yes
(9) NORTHEAST HEALTH SYSTEMS PHYSICIAN HOSPITAL ORGANIZATION INC 500 CUMMINGS CENTER STE 6500 BEVERLY,MA01915 04-3258053	MEDICAL SERVICES	MA	N/A	C			Yes
(10) NORTHEAST PHYSICIAN PRACTICE 85 HERRICK STREET BEVERLY,MA01915 04-3285837	PHYSICIAN OFFICE	MA	N/A	C			Yes
(11) NPP SUPPORT SERVICES 85 HERRICK STREET BEVERLY,MA01915 04-2721511	PHYSICIAN OFFICE	MA	N/A	C			Yes

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) BETH ISRAEL LAHEY HEALTH INC	R	229,735	FMV
(2) BETH ISRAEL LAHEY HEALTH INC	M	1,267,735	FMV
(3) LAHEY CLINIC INC	R	1,896,157	FMV
(4) NORTHEAST HOSPITAL CORPORATION	L	1,017,750	FMV
(5) NORTHEAST BEHAVIORAL HEALTH CORPORATION	M	278,004	FMV
(6) NORTHEAST BEHAVIORAL HEALTH CORPORATION	R	2,298,652	FMV
(7) WINCHESTER PHYSICIAN ASSOCIATES INC	S	5,327,353	FMV
(8) WINCHESTER PHYSICIAN ASSOCIATES INC	A	410,796	FMV
(9) BETH ISRAEL LAHEY HEALTH INC	R	623,378	FMV
(10) WINCHESTER PHYSICIAN HOSPITAL ORGANIZATION INC	Q	753,613	FMV
(11) WINCHESTER PHYSICIAN ASSOCIATES INC	R	1,234,848	FMV

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference

Explanation

PART I - V:

AS NOTED THROUGHOUT THIS FILING, ON MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH (BILH) BECAME SOLE MEMBER 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 HEALTH SHARED SERVICES, LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL CORPORATION (NBC), AND ANNA JAQUES HOSPITAL. THE LAHEY CLINIC FOUNDATION IN TURN SERVES AS SOLE MEMBER TO LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL DBA LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). ADDITIONAL ENTITIES LISTED HERE MAY ALSO IN TURN SERVE AS MEMBER TO OTHER NETWORK AFFILIATES. BY-LAW CHANGES WERE MADE TO REFLECT THE CENTRALIZATION OF THE SYSTEM, AND AS SUCH, AFFILIATES WITHIN THE BILH SYSTEM ARE CONSIDERED CONTROLLED ENTITIES UNDER IRC SECTION 512(B)(13), AS EACH AFFILIATE IS UNDER COMMON GOVERNANCE CONTROL, AS DESCRIBED IN TREAS. REGS. 1.512(B)-1(L)(4). UNDER IRC SEC. 512, CONTROL MEANS THAT MORE THAN 50 PERCENT OF THE DIRECTORS OR TRUSTEES OF AN ORGANIZATION ARE EITHER REPRESENTATIVES OF, OR DIRECTLY OR INDIRECTLY CONTROLLED, BY AN EXEMPT ORGANIZATION. A TRUSTEE OR DIRECTOR IS A REPRESENTATIVE OF AN EXEMPT ORGANIZATION IF THEY ARE A TRUSTEE, DIRECTOR, AGENT, OR EMPLOYEE OF SUCH EXEMPT ORGANIZATION. UNDER THIS DEFINITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. AND AFFILIATES ARE INCLUDED IN WINCHESTER HOSPITAL'S FORM 990, SCHEDULE R FOR THE CURRENT TAX YEAR.

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: WINCHESTER HOSPITAL'S MISSION IS TO CARE. TO HEAL. TO EXCEL. IN SERVICE TO OUR COMMUNITY. IT IS A SIMPLE BUT POWERFUL STATEMENT THAT GUIDES OUR STAFF EVERY DAY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	24
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	17
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	2,676
6	Total number of volunteers (estimate if necessary) .............	6	720
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	6,481,910
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	503,942

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	481,193	0
9	Program service revenue (Part VIII, line 2g) .........	256,992,441	281,262,984
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,534,600	1,449,439
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	11,696,005	5,120,543
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	273,704,239	287,832,966
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	170,309
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	137,985,753	135,503,512
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	139,226,746	144,024,757
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	277,212,499	279,698,578
19	Revenue less expenses. Subtract line 18 from line 12.......	-3,508,260	8,134,388
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	449,734,895	449,193,408
21	Total liabilities (Part X, line 26).............	155,483,639	152,061,918
22	Net assets or fund balances. Subtract line 21 from line 20.....	294,251,256	297,131,490

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 103,675,686 including grants of $ 170,309 ) (Revenue $ 124,221,709 )
	LINE 4A OUTPATIENT SERVICESWINCHESTER HOSPITAL'S TREMENDOUS PRESENCE AND COMMITMENT IN THE COMMUNITY IS EXEMPLIFIED BY OUR VARIOUS OUTPATIENT FACILITIES THROUGHOUT THE NORTH-OF-BOSTON AREA, INCLUDING WOBURN, STONEHAM, WILMINGTON AND MEDFORD.THE AMBULATORY SURGERY CENTER IN WINCHESTER IS A STATE-OF-THE-ART OUTPATIENT SURGERY CENTER OFFERING ADVANCED DAY SURGERY. THE CENTER FEATURES REDUCED WAIT TIMES FOR SURGICAL CARE, EXPANDED CAPACITY AND SERVICES TO ADDRESS PATIENT NEEDS, AND A FACILITY THAT WILL ALLOW FOR FUTURE EXPANSION. THE FACILITY IS ALSO HOME TO THE HOSPITAL'S CENTER FOR CANCER CARE, WHICH WAS CREATED BASED ON THE VISION TO DEVELOP A STATE-OF-THE ART, COMMUNITY-BASED CENTER DEDICATED TO AN INTEGRATED MODEL OF CANCER CARE. WINCHESTER HOSPITAL IS PROUD TO OFFER PATIENTS DIAGNOSED WITH CANCER EASY ACCESS TO THE MOST ADVANCED CLINICAL CARE IN AN ENVIRONMENT UNIQUELY DEDICATED TO MEETING THEIR MEDICAL AND EMOTIONAL NEEDS.

4b	(Code: ) (Expenses $ 106,918,601 including grants of $ ) (Revenue $ 128,107,291 )
	LINE 4B INPATIENT SERVICESINPATIENT SERVICES AT WINCHESTER HOSPITAL OFFER PATIENTS HIGH-QUALITY ACUTE-CARE IN CLINICAL AREAS SUCH AS PEDIATRICS, OBSTETRICS AND MATERNITY INCLUDING A SPECIAL CARE NURSERY.WITH APPROXIMATELY 2,000 BABIES DELIVERED EVERY YEAR, WINCHESTER HOSPITAL IS RECOGNIZED AS A LEADER IN MATERNITY CARE. THE HOSPITAL WAS THE FIRST COMMUNITY HOSPITAL IN EASTERN MASSACHUSETTS TO PERFORM ROBOTIC SURGERY WITH THE DA VINCI SURGICAL SYSTEM, AND THE FIRST COMMUNITY HOSPITAL IN MASSACHUSETTS TO ACHIEVE MAGNET RECOGNITION. THE MAGNET PROGRAM WAS ESTABLISHED BY THE AMERICAN NURSES CREDENTIALING CENTER TO RECOGNIZE HEALTH CARE ORGANIZATIONS THAT PROVIDE THE VERY BEST IN NURSING CARE AND UPHOLD THE TRADITION OF PROFESSIONAL NURSING PRACTICE. IT IS THEIR HIGHEST HONOR FOR NURSING EXCELLENCE.

4c	(Code: ) (Expenses $ 20,214,328 including grants of $ ) (Revenue $ 24,220,321 )
	LINE 4C EMERGENCY ROOM SERVICESWINCHESTER'S HOSPITAL'S EMERGENCY DEPARTMENT OFFERS ADVANCED EMERGENCY MEDICINE SERVICES TO LOCAL COMMUNITIES NORTH OF BOSTON.THE HOSPITAL IS STAFFED BY BOARD-CERTIFIED, EMERGENCY MEDICINE PHYSICIANS AND NURSES WHO ARE EXTENSIVELY TRAINED IN EMERGENCY MEDICINE AND CERTIFIED IN ADVANCED CARDIAC LIFE SUPPORT (ACLS) AND PEDIATRIC ADVANCED LIFE SUPPORT (PALS). WINCHESTER HOSPITAL IS ALSO A PRIMARY STROKE SERVICE HOSPITAL, AS DESIGNATED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, PROVIDING LEADING-EDGE STROKE CARE. THE HOSPITAL ALSO OFFERS SPECIALIZED PEDIATRIC CARE PROVIDED BY AN ON-SITE PEDIATRICIAN FROM BOSTON CHILDREN'S HOSPITAL SPECIALIZING IN EMERGENCY MEDICINE. ON-SITE PEDIATRIC EMERGENCY PHYSICIANS ARE AVAILABLE EVERY DAY FROM NOON TO MIDNIGHT AND 24-HOUR PEDIATRICIAN CONSULTATION COVERAGE IS ALSO AVAILABLE. THE WINCHESTER HOSPITAL EMERGENCY DEPARTMENT SEES MORE THAN 45,000 PATIENTS EACH YEAR, PROVIDING SEPARATE TREATMENT AREAS FOR PEOPLE WHO ARE CRITICALLY ILL, THOSE WITH LESS SEVERE NEEDS, AND FOR CHILDREN.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses230,808,615

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,374,753	10,426,932	1,117,201

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

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

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......

		Business Code
2a	INPATIENT PROGRAM	900099	128,107,291	128,107,291
b	OUTPATIENT PROGRAM	621400	124,221,709	124,221,709
c	EMERGENCY PROGRAM	900099	24,220,321	24,220,321
d	LABORATORY	621500	4,678,663		4,678,663
e	RELATED ORG. RENT	531110	35,000			35,000
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		281,262,984

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,718,906		467,408	3,251,498
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		2,472,620
b	Less: rental expenses		1,150,774
c	Rental income or (loss)		1,321,846
d	Net rental income or (loss)......			1,321,846		157,541	1,164,305
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,000
b	Less: cost or other basis and sales expenses	375	2,270,092
c	Gain or (loss)	625	-2,270,092
d	Net gain or (loss).....			-2,269,467			-2,269,467
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	GAIN-BOND DEFEASEMENT		900099	1,495,685			1,495,685
b	LOAN STAFF		621110	976,101		976,101
c	CAFETERIA		722514	903,498			903,498
d	All other revenue ....			423,413		202,197	221,216
e	Total. Add lines 11a–11d ......			3,798,697
12	Total revenue. See Instructions......			287,832,966	276,549,321	6,481,910	4,801,735

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	170,309	170,309
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	2,375,753	2,224,153	151,600
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	103,685,185	97,110,691	6,574,494
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,825,495	1,435,204	390,291
9	Other employee benefits .......	19,867,333	15,619,697	4,247,636
10	Payroll taxes ...........	7,749,746	6,092,850	1,656,896
11	Fees for services (non-employees):
a	Management ......	656,445		656,445
b	Legal .........
c	Accounting ...........	-38,339		-38,339
d	Lobbying ...........	23,323		23,323
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	239,292		239,292
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	25,682,931	21,240,593	4,442,338
12	Advertising and promotion ....	361,213	283,986	77,227
13	Office expenses .......	52,431,065	50,805,740	1,625,325
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	4,965,919	3,904,206	1,061,713
17	Travel ............	122,716	96,479	26,237
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	3,967,084	3,118,921	848,163
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	17,292,551	6,483,299	10,809,252
23	Insurance ...	1,384,203	1,214,724	169,479
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	ADMIN. & GENERAL	21,403,027	16,827,060	4,575,967
b	HEALTH AND SAFETY NET A	5,542,565		5,542,565
c
d
e	All other expenses	9,990,762	4,180,703	5,810,059
25	Total functional expenses. Add lines 1 through 24e	279,698,578	230,808,615	48,889,963	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			33,475,761	1	39,679,301
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			30,088,315	4	29,302,296
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....			1,270,944	7	1,072,072
8	Inventories for sale or use ........			3,437,666	8	3,398,754
9	Prepaid expenses and deferred charges ......			1,160,824	9	1,136,447
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	224,111,799
b	Less: accumulated depreciation	10b	86,036,190	145,916,222	10c	138,075,609
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			185,552,445	12	190,255,552
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			48,832,718	15	46,273,377
16	Total assets. Add lines 1 through 15 (must equal line 34)...			449,734,895	16	449,193,408

17	Accounts payable and accrued expenses .....	40,637,381	17	39,725,493
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	91,769,565	20	86,583,369
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	23,076,693	25	25,753,056
26	Total liabilities. Add lines 17 through 25..	155,483,639	26	152,061,918

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	268,772,454	27	271,036,543
28	Temporarily restricted net assets ...........	17,621,447	28	17,530,876
29	Permanently restricted net assets	7,857,355	29	8,564,071
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	294,251,256	33	297,131,490
34	Total liabilities and net assets/fund balances ........	449,734,895	34	449,193,408

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


Total

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

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

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

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

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

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

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

1a	Beginning of year balance ....	24,701,561	24,924,879	21,823,910	22,475,805	23,661,535
b	Contributions ...
c	Net investment earnings, gains, and losses	266,762	-223,318	3,100,969	-651,895	-1,185,730
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	24,968,323	24,701,561	24,924,879	21,823,910	22,475,805

1a	Land .....	16,524,129		16,524,129
b	Buildings ....	90,022,514	27,088,193	62,934,321
c	Leasehold improvements	10,697,196	5,674,960	5,022,236
d	Equipment ....	98,511,552	50,944,335	47,567,217
e	Other .....	8,356,408	2,328,702	6,027,706
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				138,075,609

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) INVESTMENTS, OTHER 457B	914,354	F
(B) AWUL TEMP RESTR INVESTMENTS	14,607,903	F
(C) AWUL PERM RESTR INVESTMENTS	1,790,975	F
(D) TRUST - PERM RESTR IRREV TRUST	4,305,492	F
(E) LT INVESTMENTS - OTHER	168,636,828	F
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	190,255,552

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

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
CURRENT PORTION OF LONG TERM DEBT	3,258,275
ESTIMATED SETTLEMENT AMOUNT	8,510,426
OTHER LONG TERM LIABILITIES	4,978,249
PROFESSIONAL LIABILITY RESERVES	9,006,106
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	25,753,056
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	3,594,794,000
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	3,432,054,425
e	Add lines 2a through 2d....................			2e	3,432,054,425
3	Subtract line 2e from line 1...................			3	162,739,575
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	-467,005
b	Other (Describe in Part XIII.) ............	4b	117,426,008
c	Add lines 4a and 4b.....................			4c	116,959,003
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	279,698,578

Return Reference	Explanation
PART X, LINE 2:	EACH ENTITY WITHIN THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. THE SYSTEM DID NOT RECOGNIZED THE EFFECT OF ANY INCOME TAX POSITIONS IN 2019.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	NET ASSETS RELEASED FROM RESTRICTIONS FOR OPERATIONS 1,866,228. CONSOLIDATED AFFILIATES NET ELIMINATIONS 3,532,233,536. TRANSFERS TO/FROM AFFILIATES -8,789,404.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	FIVE MONTHS OF REVENUE NOT IN AFS 117,235,208. RESTRICTED REVENUE 292,694.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	CONSOLIDATED NET AFFILIATES ELIMINATIONS 3,432,054,425.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	FIVE MONTHS OF EXPENSES NOT IN AFS 117,426,008.