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) MICHAEL K LAUF...................................................................... PRESIDENT/CEO/TRUSTEE	55.0 ................. 5.0	X	X	0	1,624,399	287,478
(2) NATE RUDMAN MD...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	12,800	0
(3) JOEL CROWELL...................................................................... TRUSTEE (UNTIL 5/19)	2.0 ................. 2.0	X		0	0	0
(4) SUZANNE FAY GLYNN ESQ...................................................................... TRUSTEE (UNTIL 5/19)	2.0 ................. 2.0	X		0	0	0
(5) WILLIAM ZAMMER...................................................................... TRUSTEE (UNTIL 5/19)	2.0 ................. 2.0	X		0	0	0
(6) LAWRENCE CAPODILUPO...................................................................... TRUSTEE (AS OF 5/19)	2.0 ................. 2.0	X		0	0	0
(7) SHARON KENNEDY...................................................................... TRUSTEE (AS OF 9/19)	2.0 ................. 2.0	X		0	0	0
(8) DEWITT DAVENPORT...................................................................... CHAIRMAN	2.0 ................. 2.0	X	X	0	0	0
(9) DIANE COLETTI...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(10) SUMNER B TILTON JR...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(11) E JAMES MULCAHY JR...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(12) ROBERT TALERMAN...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	0	0
(13) ROBERT BIRMINGHAM...................................................................... VICE CHAIRMAN (AS OF 9/19)	2.0 ................. 2.0	X	X	0	0	0
(14) GARY VACON...................................................................... VICE CHAIR/TRUSTEE (UNTIL 9/19	2.0 ................. 2.0	X	X	0	0	0
(15) ROBERT WILSTERMAN MD...................................................................... TRUSTEE	40.0 ................. 2.0	X		698,956	0	58,766
(16) WILLIAM AGEL MD...................................................................... TRUSTEE	40.0 ................. 2.0	X		503,554	0	42,937
(17) RAMANI AYER...................................................................... TRUSTEE	2.0 ................. 2.0	X		0	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) THEODORE CALIANOS MD........................................................................ TRUSTEE	40.0 .......................2.0	X					374,116	0	40,895
(19) PAUL HOULE MD........................................................................ TRUSTEE	40.0 .......................2.0	X					1,115,006	0	63,425
(20) BRUCE JOHNSTON........................................................................ TRUSTEE/TREASURER	2.0 .......................2.0	X	X				0	0	0
(21) MICHAEL L CONNORS........................................................................ SENIOR VP FINANCE/CFO	55.0 .......................5.0		X				0	564,220	98,642
(22) MICHAEL G JONES ESQ........................................................................ Sr VP & Chief Legal Off/Clerk	55.0 .......................5.0		X				0	427,390	77,085
(23) MICHAEL BUNDY........................................................................ COO (UNTIL 1/19)	45.0 .......................5.0			X			0	487,067	60,786
(24) DONALD A GUADAGNOLI MD........................................................................ CMO CAPE COD HOSPITAL	45.0 .......................5.0			X			0	538,512	89,760
(25) ALEXANDER HEARD MD........................................................................ CMO FALMOUTH HOSPITAL	45.0 .......................5.0			X			84,330	494,260	91,392
(26) PATRICK J KANE........................................................................ SVP OF MRKTG,COMMUN AND DEVLP	45.0 .......................5.0			X			0	413,493	43,334
(27) CHRISTIAN BROWN........................................................................ SR VP MANAGED CARE	45.0 .......................5.0			X			0	408,806	77,197
(28) EMILY SCHORER........................................................................ SVP HUMAN RESOURCES	45.0 .......................5.0			X			0	348,995	56,162
(29) KEVIN RALPH........................................................................ SVP DEVELOPMENT (UNTIL 4/18)	45.0 .......................5.0			X			0	194,282	19,287
(30) THERESA M AHERN........................................................................ SVP STRAT, COMMUNITY/GOV REL.	45.0 .......................5.0			X			0	381,591	56,236
(31) KEVIN J MULROY........................................................................ SVP CHIEF QUALITY & SAFETY OFF	45.0 .......................5.0			X			0	481,743	80,126
(32) JOHN PAUL SOLVERSON........................................................................ SR VP & CIO	45.0 .......................5.0			X			0	522,603	35,313
(33) JEFFREY S DYKENS........................................................................ VP FINANCE & OPERATIONS	45.0 .......................5.0			X			0	301,438	64,536
(34) NOELENE CERVIN........................................................................ VP BUDGETING AND OPER. SUPPORT	45.0 .......................5.0			X			0	263,292	58,685
(35) LORI JEWETT........................................................................ CEO - FH	45.0 .......................5.0			X			0	301,367	46,764
(36) ANNE MARIE PECKHAM........................................................................ PRESIDENT VNA	45.0 .......................5.0			X			0	243,689	42,036
(37) CARTER HUNT........................................................................ ADMIN SPEC&HOSP BASED CARE	45.0 .......................5.0			X			0	220,439	69,954
(38) REBECCA FRANCE........................................................................ SEE SCHEDULE O	45.0 .......................5.0			X			0	272,625	7,499
(39) JUDITH C QUINN........................................................................ VP OF PATIENT CARE	45.0 .......................5.0			X			0	278,758	62,434
(40) DEBRA ROBINSON........................................................................ ASSOCIATE VP OF NURSING	45.0 .......................5.0			X			238,217	0	0
(41) CYNTHIA MARLIN........................................................................ VP PERIOPERATIVE & SURGICAL SV	45.0 .......................5.0			X			0	231,373	40,917
(42) ELIZABETH DUNTON........................................................................ ADMIN PRIMARY CARE PRACTICE	45.0 .......................5.0			X			0	225,596	16,791
(43) RICHARD B ZELMAN MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,666,806	0	48,548
(44) NICHOLAS COPPA MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,095,670	0	60,606
(45) ACHILLES PAPAVASILIOU MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,093,070	0	63,416
(46) GORDON NAKATA MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		1,093,070	0	63,416
(47) PHILLIP J DOMBROWSKI MD........................................................................ PHYSICIAN	40.0 .......................0.0				X		929,471	0	55,728
(48) JEANNE FALLON........................................................................ Former SR VP/CIO	0.0 .......................0.0					X	0	143,042	0

(A) Name and business address	(B) Description of services	(C) Compensation
CAPE COD HEALTHCARE INC, 297 NORTH STREET BLDG 3 HYANNIS,MA02601	PURCHASED SERVICES	70,437,741
CMG CIT ACQUISITION LLC, 655 SOUTH WILLOW ST STE 128 MANCHESTER,NH03103	NURSING SVCS	788,014
BOURNE MANOR, 146 MACARTHUR BLVD BOURNE,MA02532	HOSPICE ROOM & BOARD	168,097


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 3

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(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

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

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.") ..	15,572,146	13,584,232	15,341,766	15,447,109	18,471,535	78,416,788
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....						0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
4	Total. Add lines 1 through 3	15,572,146	13,584,232	15,341,766	15,447,109	18,471,535	78,416,788
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)..						4,797,416
6	Public support. Subtract line 5 from line 4.						73,619,372

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..	15,572,146	13,584,232	15,341,766	15,447,109	18,471,535	78,416,788
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	4,951,534	5,368,273	5,985,405	7,272,965	14,133,036	37,711,213
9	Net income from unrelated business activities, whether or not the business is regularly carried on..	1,000,152	798,057	408	-544,982	-986,182	267,453
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	2,271,023	2,353,977	2,422,397	2,647,341	2,299,730	11,994,468
11	Total support. Add lines 7 through 10						128,389,922

Gross receipts from related activities, etc. (see instructions) ..................

4,256,192,478

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

57.341 %

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

60.165 %

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

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.)

Section B. Total Support

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.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1	0
2	Recoveries of prior-year distributions	2	0
3	Other gross income (see instructions)	3	0
4	Add lines 1 through 3	4	0
5	Depreciation and depletion	5	0
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	0
7	Other expenses (see instructions)	7	0
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8	0

	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	0
b	Average monthly cash balances	1b	0
c	Fair market value of other non-exempt-use assets	1c	0
d	Total (add lines 1a, 1b, and 1c)	1d	0
e	Discount claimed for blockage or other factors (explain in detail in Part VI): 0
2	Acquisition indebtedness applicable to non-exempt use assets	2	0
3	Subtract line 2 from line 1d	3	0
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4	0
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5	0
6	Multiply line 5 by .035	6	0
7	Recoveries of prior-year distributions	7	0
8	Minimum Asset Amount (add line 7 to line 6)	8	0

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1	0
2	Enter 85% of line 1	2	0
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3	0
4	Enter greater of line 2 or line 3	4	0
5	Income tax imposed in prior year	5	0
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6	0

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes		0
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity		0
3 Administrative expenses paid to accomplish exempt purposes of supported organizations		0
4 Amounts paid to acquire exempt-use assets		0
5 Qualified set-aside amounts (prior IRS approval required)		0
6 Other distributions (describe in Part VI). See instructions		0
7Total annual distributions. Add lines 1 through 6.		0
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions		0
9 Distributable amount for 2018 from Section C, line 6		0
10 Line 8 amount divided by Line 9 amount		0 %

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			0
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.		0
3 Excess distributions carryover, if any, to 2018:
a From 2013.......0
b From 2014.......0
c From 2015.......0
d From 2016.......0
e From 2017.......0
fTotal of lines 3a through e	0
g Applied to underdistributions of prior years		0
h Applied to 2018 distributable amount			0
i Carryover from 2013 not applied (see instructions)	0
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.	0
4Distributions for 2018 from Section D, line 7:
$ 0
a Applied to underdistributions of prior years		0
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.	0
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.		0
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.			0
7 Excess distributions carryover to 2019. Add lines 3j and 4c.	0
8 Breakdown of line 7:
a Excess from 2014......0
b Excess from 2015.....0
c Excess from 2016.....0
d Excess from 2017.....0
e Excess from 2018.....0

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

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

OMB No. 1545-0047

2018

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization CAPE COD HEALTHCARE INC & AFFILIATES

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization CAPE COD HEALTHCARE INC & AFFILIATES		Employer identification number 90-0054984

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization CAPE COD HEALTHCARE INC & AFFILIATES			Employer identification number 90-0054984
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

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

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

151,245

Total. Add lines 1c through 1i ....................................................................................................

151,245

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1I	CAPE COD HOSPITAL AND FALMOUTH HOSPITAL ASSOCIATION, INC. PAY MEMBERSHIP DUES TO THE MASSACHUSETTS HOSPITAL ASSOCIATION WHICH ENGAGES IN LOBBYING PURPOSES AS DEFINED BY MEDICARE. PER THE MHA ADVISORY, 44.47% OF DUES PAID SHOULD BE ALLOCATED TO LOBBYING ACTIVITY.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(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 ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	42,450,666	41,606,730	38,809,089	37,495,620	38,872,003
b	Contributions ...	1,510,214	504,886	30,699	57,261	1,523,222
c	Net investment earnings, gains, and losses	-670,422	1,353,728	3,061,173	2,000,285	-2,217,064
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,053,697	1,014,678	759,148	744,077	682,541
f	Administrative expenses ....			-464,917
g	End of year balance ......	42,236,761	42,450,666	41,606,730	38,809,089	37,495,620

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

83.060 %

Temporarily restricted endowment SchDMd Bullet

16.940 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	23,635,112		23,635,112
b	Buildings ....	438,807,830	195,911,960	242,895,870
c	Leasehold improvements	5,032,244	2,271,740	2,760,504
d	Equipment ....	229,299,083	176,610,566	52,688,517
e	Other .....	4,053,294	1,461,463	2,591,831
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				324,571,834

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(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) LONG-TERM INVESTMENTS	412,367,257	F
(B) TEMP RESTRICTED INVESTMENTS	17,417,237	F
(C) PERM RESTRICTED INVESTMENTS	34,939,545	F
(D) SHORT TERM INVESTMENTS - FDN	25,246,048	F
(E) INVESTMENT IN 457 PLANS	5,587,375	F
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	495,557,462

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(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.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
DUE TO AFFILIATES	40,615,845
EST. SETTLEMENTS W 3RD PARTIES	18,393,568
OTHER CURRENT LIABILITIES	1,109,683
ABANDONED PROPERTY	142,096
INTEREST RATE SWAPS	780,742
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	61,041,934
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

Schedule D (Form 990) 2018

Page 4

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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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
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
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
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
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PART V, LINE 4	THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO FURTHER THE HEALTHCARE MISSION OF CAPE COD HEALTHCARE AND ITS AFFILIATES.
SCHEDULE D, PART X, LINE 2	THE ORGANIZATION DOES NOT HAVE A FIN 48 FOOTNOTE AS ANY UNCERTAIN TAX POSITIONS WERE DEEMED IMMATERIAL.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

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
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	Central America and the Caribbean	1	0	Program Services	CAPTIVE INSURANCE	6,512,209
















3a	Sub-total .....	1	0			6,512,209
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	1	0			6,512,209

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018

Schedule F (Form 990) 2018

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2018

Schedule F (Form 990) 2018Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2018

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2018

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation
SCHEDULE F, PART I, COLUMN F	EXPENSES ARE CODED IN THE GENERAL LEDGER TO THE CAPTIVE INSURANCE COMPANY.

Schedule F (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

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
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)		(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
			Yes	No
	Borns GroupVDM 503 BROWN COUNTY 19N ABERDEEN, SD57401	DIRECT MAIL		No	221,719	56,538	165,181
	Five Maples 78 RIVER ROAD SOUTH PUTNEY, VT05346	Direct Mail		No	27,465	13,893	13,572








Total . . . . . . . . . . . . . . . . . . . .					249,184	70,431	178,753

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

CA, CT, FL, IL, KS, MA, MI, MO, NH, NJ, NY, NC, PA, RI, SC, WI

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2018

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Sunday Summer (event type)	(b) Event #2 Celebrate Summe (event type)	(c) Other events 1 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	253,950	158,000	215,410	627,360
2	Less: Contributions . . . .	122,030	61,500	70,975	254,505
3	Gross income (line 1 minus line 2) . . . . . .	131,920	96,500	144,435	372,855

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	4,000		2,500	6,500
7	Food and beverages . . .	29,011		34,798	63,809
8	Entertainment . . . .	2,300	1,900	1,600	5,800
9	Other direct expenses . . .	26,964	8,800	12,347	48,111
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				124,220
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				248,635

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2018

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- 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

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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? . . . . . .

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) . . .	6,603,418	2,004,805	4,598,613	0.500 %
b	Medicaid (from Worksheet 3, column a) . . . . .	109,049,023	89,915,768	19,133,255	2.090 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	10,735,728	8,633,068	2,102,660	0.230 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	126,388,169	100,553,641	25,834,528	2.820 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,832,150	0	1,832,150	0.200 %
f	Health professions education (from Worksheet 5) . . .	1,492,372	85,481	1,406,891	0.150 %
g	Subsidized health services (from Worksheet 6) . . . .	345,865,909	307,593,351	38,272,558	4.190 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1,689,336	0	1,689,336	0.180 %
j	Total. Other Benefits . .	350,879,767	307,678,832	43,200,935	4.720 %
k	Total. Add lines 7d and 7j .	477,267,936	408,232,473	69,035,463	7.540 %

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.

		(c) Total community building expense	(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	36,936	36,936
7	Community health improvement advocacy
8	Workforce development	1,042,582	1,042,582	0.110 %
9	Other
10	Total	1,079,518	1,079,518	0.110 %

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. ......

20,267,078

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. ......

11,071,739

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).....

301,242,986

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

265,664,249

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

35,578,737

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?2Name, 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)					Facility reporting group
1	CAPE COD HOSPITAL 27 PARK STREET HYANNIS,MA02601 SEE PART V, SECTION C 2135	X	X	X	A
2	FALMOUTH HOSPITAL ASSOCIATION INC 100 TER HEUN DRIVE FALMOUTH,MA02540 SEE PART V, SECTION C 2289	X	X	X	A

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)

	A
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 V, SECTION C

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 V, SECTION C

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)

	A
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 200.% and FPG family income limit for eligibility for discounted care of 400.%

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 V, SECTION C

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

SEE PART V, SECTION C

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

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

	A
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)

	A
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
PART V, SECTION A	WEBSITES PART V, SECTION A, LINE 1 - CAPE COD HOSPITAL WWW.CAPECODHEALTH.ORG/LOCATIONS/CAPE-COD-HOSPITAL
PART V, SECTION A, LINE 2 - FALMOUTH HOSPITAL	WWW.CAPECODHEALTH.ORG/LOCATIONS/FALMOUTH-HOSPITAL
PART V, SECTION B, LINE 5	Many sources and data collection methodologies were used to obtain a comprehensive view of the health and health care needs of the region and the people served by CCH and FH. Input on the design of data collection instruments was solicited from public health experts, health care consumers, and persons representing vulnerable and medically underserved populations and minorities. Conscientious efforts were made to reach a wide-ranging population of residents during data collection to ensure broad representation of community interests and perspectives. The data sources and methodologies included: 1. Secondary Data. A comprehensive review of existing data drawn from national, state, and local sources was conducted. Data sources included, but were not limited to, the U.S. Census Bureau, the Centers for Disease Control and Prevention, the Massachusetts Department of Public Health, among others. Types of data included demographics, vital statistics, public health surveillance, as well as self-report of select health behaviors from large, population-based surveys such as the Massachusetts Behavioral Risk Factor Surveillance Survey (BRFSS). The selection of secondary data points was generally based on the prior CHNAs to allow for examination of trends over time. However, additional secondary data sources were explored when major themes or issues arose from qualitative data collection. When available, data were stratified by age group or by income/poverty level to identify areas of disparity. 2. Community Stakeholder Dialogues. Two facilitated "stakeholder dialogues" were held with staff from a broad array of agencies and organizations actively working in the health and human services sectors of Barnstable County. Approximately 70 people attended these sessions. 3. Key Informant Interviews. Key informant interviews were conducted via phone with 25 community leaders from organizations across all of Barnstable County, representing health centers, public safety organizations, housing organizations, and other human service groups. Key informants were identified for participation based on their in-depth knowledge of the health needs and resources of the region. Discussions focused on health strengths and needs in the community and opportunities and challenges to addressing community needs. They were also asked to describe organizational partnerships within Barnstable County, perceptions of community services, and perceptions of CCHC. 4. Focus Groups. Two focus groups, one conducted in Spanish and one in Portuguese, were held with residents to gather information about the community, health challenges and needs, existing services, and suggestions for the future. One focus group of Portuguese-speaking residents was conducted at IPR Cape Cod Church and involved 14 participants. The other involved six Spanish speaking participants and was held at the Immigration Resource Center at Community Action Committee of Cape Cod. 5. Community Survey. A community survey asking about community and individual health and health care needs was developed and made available on-line and on paper to residents of Barnstable County. The survey was conducted in English, Spanish, and Portuguese and was completed by 2,011 total residents.
PART V, SECTION B, LINE 6 (A)	CAPE COD HOSPITAL AND FALMOUTH HOSPITAL JOINTLY CONDUCTED THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORT.
PART V, SECTION B, LINE 7(A)	https://www.capecodhealth.org/app/files/public/9327/community-health-needs -assessment-2020-2022.pdf
PART V, SECTION B, LINE 10(A)	https://www.capecodhealth.org/app/files/public/9327/community-health-needs -assessment-2020-2022.pdf
PART V, SECTION B, LINE 11	In early February 2019, HRiA led a facilitated process with leadership from Cape Cod Healthcare and community stakeholders including Barnstable County Human Services and behavioral health and infectious disease representatives from CCHC, to identify the priorities, goals and objectives for the Strategic Implementation Plan (SIP). HRiA presented the key health issues identified in the FY2020-FY2022 community health needs assessment (CHNA) project, including the magnitude and severity of these issues and their impact on priority populations. The following key health issues emerged most frequently from a review of the available data and community input and were considered in the selection of the Strategic Implementation Plan (SIP) health priorities: Housing, Transportation, Seasonal Economy and Employment Variation, Behavioral Health (including Substance Use and Mental Health), Aging Population, Physical Health Conditions, Healthcare Access. To address these needs, CCHC collaborates with community partners across the region to assess community needs, identifies promising programs, and implements strategies to improve people's health. Through an open and competitive Annual Strategic Grants program, CCHC funds projects addressing a variety of health needs. Additionally, CCHC has invested in new and expanded hospital programs in areas such as cancer support, chronic disease self-management, case management for individuals living with HIV/AIDS, suicide prevention, and support for new families, among others. CCHC community benefits' funding also supports medical interpreter services for limited English-speaking patients, hospital social workers and case managers, and financial counselors. Finally, CCHC plays a leadership role through participation in, among others, the Barnstable County Economic Development Council, the Barnstable County Human Services Advisory Council, the Barnstable County Regional Substance Use Council, the Cape Cod Chamber of Commerce, and the Cape and Islands Community Health Area Network (CHNA 27) Steering Committee. Regarding Seasonal Economy & Employment Variation: CCHC is best positioned to support and collaborate on initiatives that aim to develop the regional healthcare workforce as part of this SIP. In this way, CCHC is hoping to have a positive influence on the economy and employment opportunities in Barnstable County. Addressing the complex challenges created by a seasonal economy and employment variation in the region in industries outside of healthcare is beyond the core competencies of CCHC and our mission.
PART V, SECTION B, LINE 13(B)	IN SOME CASES, THE MASSACHUSETTS HEALTHCONNECTOR CALCULATOR OR MODIFIED ADJUSTED GROSS INCOME IS USED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY.
PART V, SECTION B, LINE 13(H)	STATE REGULATIONS
PART V, SECTION B, LINE 16(A), 16(B), 16(C)	HTTPS://WWW.CAPECODHEALTH.ORG/PATIENTS-VISITORS/PAYING-FOR-CARE/FINANCIAL- ASSISTANCE/

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?89
Name and address		Type of Facility (describe)
1	Visiting Nurse Association of Cape Cod 255 Independence Drive Hyannis,MA02601	home health
2	CAPE COD HEALTHCARE INC 297 NORTH STREET BLDG 3 HYANNIS,MA02601	ADMINISTRATIVE
3	Fontaine Medical Center 525 Long Pond Drive HARWICH,MA02645	medical group practice
4	CAPE COD HEALTHCARE NEUROSURGER 46 NORTH ST STE 4 HYANNIS,MA02601	medical group practice
5	Bramblebush Medical Group 21 Bramblebush Park FALMOUTH,MA02540	medical group practice
6	Seaside Pediatrics 150 Ansel Hallet Road West Yarmouth,MA02673	medical group practice
7	Manning Jr William J MD 700 Attucks Lane Suite 1A HYANNIS,MA02601	medical group practice
8	Fontaine OUTPATIENT CENTER 525 Long Pond Drive Harwich,MA02645	medical group practice
9	Guo X Y David MD PhD-GASTROENTEROLOGY 90 TER HEUN DRIVE STE 302 Falmouth,MA02540	medical group practice
10	BAYSIDE INTERNAL MEDICINE 2 Jan Sebastian Way Suite 100 Sandwich,MA02563	medical group practice
11	SHAPIRO GARY& YAMIN JUSTIN MD-GASTRO 700 ATTUCKS LANE STE 1C Hyannis,MA02601	medical group practice
12	Theodore A Calianos II MD-PL&RECON 160 Falmouth Road Suite B MASHPEE,MA02649	medical group practice
13	CAPE COD OBSTETRICS & GYNECOLOGY 90 Ter Heun Drive SUITE 100 Falmouth,MA02540	medical group practice
14	Chatham Medical Group 1629 Main Street Chatham,MA02633	medical group practice
15	Endocrine Center of Cape Cod 1030 FALMOUTH RD STE 201 Hyannis,MA02601	medical group practice
16	Fal Specialty Care Practice 90 Ter Heun Drive Suite 302 Falmouth,MA02540	medical group practice
17	NEUROLOGISTS OF CAPE COD 46 North Street SUITE 7 Hyannis,MA02601	medical group practice
18	Nauset Family Practice 81 Old Colony Way STE D ORLEANS,MA02653	medical group practice
19	Devin McManus Medical Practice 10 BrambleBush Drive FALMOUTH,MA02540	medical group practice
20	Cape Health Insurance Company - FOREIGN 297 NORTH ST 3 HYANNIS,MA02601	administrative
21	Healthcare Foundation 32 MAIN STREET Hyannis,MA02601	administrative
22	Healthcare Foundation 348 GIFFORD ST STE 4 FALMOUTH,MA02540	ADMINISTRATIVE
23	JML Care Center 184 Ter Heun Drive falmouth,MA02540	skilled nur & rehab
24	Cape & Islands Health Services II 14 Yellow Brick Road HYANNIS,MA02601	COLLECTION CENTER
25	Cape & Islands Health Services II 5 Industrial Drive Suite 102 MASHPEE,MA02649	COLLECTION CENTER
26	Cape & Islands Health Services II 200 Jones Road FALMOUTH,MA02540	COLLECTION CENTER
27	Cape & Islands Health Services II 525 Long Pond Drive HARWICH,MA02645	COLLECTION CENTER
28	Cape & Islands Health Services II 81 Old Colony Way ORLEANS,MA02653	COLLECTION CENTER
29	Cape & Islands Health Services II 2 Jan Sebastian Way Route 130 SANDWICH,MA02563	COLLECTION CENTER
30	Cape & Islands Health Services II 860 Route 134 Unit 2 South Dennis,MA02660	COLLECTION CENTER
31	Cape & Islands Health Services II 1 Trowbridge Road Bourne,MA02532	COLLECTION CENTER
32	Cape & Islands Health Services II 68B Route 6A SANDWICH,MA02563	COLLECTION CENTER
33	Cape & Islands Health Services II 1629 MAIN STREET CHATHAM,MA02633	COLLECTION CENTER
34	Cape & Islands Health Services II 27 PARK STREET HYANNIS,MA02601	COLLECTION CENTER
35	Heritage at Falmouth 140 Ter Heun Drive FALMOUTH,MA02540	ASSISTED LIVING
36	Cape Cod Human Services 460 West Main Street HYANNIS,MA02601	outpatient clinic
37	Cape Cod Human Services 525 Long Pond Drive HARWICH,MA02645	outpatient clinic
38	Cape Cod Medical Office Building Inc 20 Gleason Street HYANNIS,MA02601	administrative
39	Orleans Medical CENTER 204 Main Street Orleans,MA02653	Medical Group Practice
40	CAPE COD Dermatology 134 Ansel Hallet Road W Yarmouth,MA02673	Medical Group Practice
41	Cape Cod Rheumatology Center 1030 FALMOUTH RD STE 201 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
42	CCHC Cardiovascular Center 25 Main Street HYANNIS,MA02601	MEDICAL GROUP PRACTICE
43	Ziad Farah MD-Fontaine Medical Center 525 Long Pond Drive HARWICH,MA02645	MEDICAL GROUP PRACTICE
44	Fontaine Urgent Care Center 525 Long Pond Drive HARWICH,MA02645	MEDICAL GROUP PRACTICE
45	Park Street Primary Care 62 Park Street HYANNIS,MA02601	MEDICAL GROUP PRACTICE
46	Sandwich Medical Group STONEMAN OUTPATIENT2 Jan Sebastian SANDWICH,MA02563	MEDICAL GROUP PRACTICE
47	Sandwich Primary Care 2 JAN SEBASTIAN WAY SUITE 202 SANDWICH,MA02563	MEDICAL GROUP PRACTICE
48	Upper Cape Orthopedics 26 Edgerton Drive Suite C NORTH FALMOUTH,MA02556	MEDICAL GROUP PRACTICE
49	Michael Barnett MD Practice 348 Gifford Street FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
50	Vascular And Vein Center Of Cape Cod 90 Ter Heun Drive 3RD Fl MOB STE Falmouth,MA02540	Medical Group Practice
51	CCHC General & Specialty Surgery 105 Park Street Hyannis,MA02601	Medical Group Practice
52	Cape Cod Sports Medicine 360 Gifford Street Unit 2B Falmouth,MA02540	Medical Group Practice
53	CARDIOVASCULAR CENTER - FALMOUTH 90 TER HEUN DRIVE SUITE 300 FALMOUTH,MA02540	Medical Group Practice
54	GASTROENTEROLOGY HYANNIS - PARK STREET 105 PARK STREET HYANNIS,MA02601	Medical Group Practice
55	STONEMAN OUTPATIENT CENTER - URGENT CARE 2 JAN SEBASTIAN DRIVE SUITE 101 SANDWICH,MA02563	Medical Group Practice
56	MASHPEE SURGICAL CENTER 160 FALMOUTH ROAD MASHPEE,MA02649	MEDICAL GROUP PRACTICE
57	SOUTHEASTERN SURGICAL ASSOCIATES 100 CAMP STREET HYANNIS,MA02601	MEIDCAL GROUP PRACTICE
58	FALMOUTH URGENT CARE 273 TEATICKET HIGHWAY FALMOUTH,MA02536	MEDICAL GROUP PRACTICE
59	HYANNIS URGENT CARE 1220 IYANNOUGH ROAD HYANNIS,MA02601	MEDICAL GROUP PRACTICE
60	UPPER CAPE EAR NOSE THROAT 200 A JONES ROAD FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
61	ORTHOPEDIC SPECIALISTS 5 BRAMBLEBUSH DRIVE FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
62	CCHC DEMENTIA&ALZHEIMER'S CAREGIVER SUPP 4 BAYVIEW ST WEST YARMOUTH,MA02673	ADMINISTRATIVE
63	CCHC PODIATRIC MEDICINE & FOOT SURGERY 1030 FALMOUTH RD 202 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
64	IDCS-INFECTIOUS DISEASE CLINICAL SERV 34 PARK ST HYANNIS,MA02601	MEDICAL GROUP PRACTICE
65	CCH OBGYN SATELLITE 60A PARK ST HYANNIS,MA02601	MEDICAL GROUP PRACTICE
66	MACCMSSP REFERRAL DEPT 25 COMMUNICATION WAY HYANNIS,MA02601	ADMINISTRATIVE
67	DIABETIC EDUCATION 22 LEWIS BAY RD STE 102 HYANNIS,MA02601	EDUCATIONAL
68	DIABETIC EDUCATION 1629 MAIN ST CHATHAM,MA02633	EDUCATIONAL
69	TRADEWINDS ADULT DAY HEALTH OF VNA OF CC 290 ROUTE 130 SANDWICH,MA02563	ADULT DAY HEALTH
70	COMPASS ADULT DAY HEALTH 1 AUSTON RD F HARWICH,MA02645	ADULT DAY HEALTH
71	VNA OF CAPE COD - EASTHAM 3960 STATE HWY RD 6 2 EASTHAM,MA02642	HOME HEALTH
72	VNA OF CAPE COD - FALMOUTH 67 TER HEUN DR FALMOUTH,MA02540	HOME HEALTH
73	VNA OF CAPE COD - MARTHA'S VINEYARD 49 STATE RD VINEYARD HAVEN,MA02568	HOME HEALTH
74	VNA OF CAPE COD - NANTUCKET 2 SANFORD RD 2 NANTUCKET,MA02554	HOME HEALTH
75	VNA OF CAPE COD -PLYMOUTH 57 OBERY ST U3 PLYMOUTH,MA02360	HOME HEALTH
76	VNA OF CAPE COD - PROVINCETOWN 26 ALDEN ST PROVINCETOWN,MA02657	HOME HEALTH
77	VNA OF CAPE COD - SOUTH DENNIS 434 ROUTE 134 BLDG D 3 SOUTH DENNIS,MA02660	HOME HEALTH
78	VNA OF CAPE COD - WAREHAM 185 MAIN ST WAREHAM,MA02571	HOME HEALTH
79	VNA THRIFTIQUE 1074 RTE 28 SOUTH YARMOUTH,MA02664	THRIFT STORE
80	CCH THRIFT STORE 690 MAIN ST HYANNIS,MA02601	THRIFT STORE
81	CAPE & ISLANDS HEALTH SERVICES II 35 WILKENS LANE HYANNIS,MA02601	COLLECTION CENTER
82	ORLEANS MEDICAL CENTER 204 MAIN ST ORLEANS,MA02653	OUTPATIENT CLINIC
83	CAPE COD RESEARCH INSTITUTE 27 PARK ST HYANNIS,MA02601	RESEARCH
84	Cotuit Primary Care 3880 Falmouth Road Cotuit,MA02635	MEDICAL GROUP PRACTICE
85	Harwich Primary Care 1421 Orleans Road Harwich,MA02645	MEDICAL GROUP PRACTICE
86	North Falmouth Primary Care 33 Edgerton Drive Falmouth,MA02556	MEDICAL GROUP PRACTICE
87	North Street Primary Care 130 North Street Hyannis,MA02601	MEDICAL GROUP PRACTICE
88	Cape Cod Ear Nose and Throat Specialist 65 Cedar Street Hyannis,MA02601	MEDICAL GROUP PRACTICE
89	CCHC Pulmonary Medicine 51 Bayview Street Hyannis,MA02601	MEDICAL GROUP PRACTICE

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
PART I, LINE 3C	N/A
PART I, LINE 6A	N/A
PART I, LINE 7, COLUMN F	THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F WAS $ 20,267,078. THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AND BY FOLLOWING THE FORM 990, SCHEDULE H INSTRUCTIONS. THE TOTAL PERCENTAGE OF CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST IN THE TABLE WAS CALCULATED ON A GROUP RETURN BASIS AS REQUIRED BY THE FORM 990 INSTRUCTIONS, AND NOT ON A HOSPITAL-ONLY BASIS.
PART II LINE 6 AND LINE 8	COALITION BUILDING CAPE COD HEALTHCARE CLINICAL, COMMUNITY BENEFITS AND SUPPORT STAFF PARTICIPATED IN A VARIETY OF COALITION BUILDING ACTIVITIES WITHIN THE SERVICE AREA TO ADDRESS AND IMPROVE CARE RELATED TO WOMEN'S HEALTH, BEHAVIORAL HEALTH, CHRONIC AND INFECTIOUS DISEASE PREVENTION AND MANAGEMENT AND SUBSTANCE USE AND MISUSE IN THE REGION. REGIONAL COALITIONS SERVE AS ALLIANCES FOR COMBINED AND COORDINATED ACTION TO IMPROVE KEY HEALTH ISSUES. COALITION ACTIVITIES RANGED FROM IMPLEMENTATION OF NEW PROGRAMS TO OFFERING COMMUNITY TRAININGS AND EDUCATIONAL ON IMPORTANT HEALTH TOPICS TO THE DEVELOPMENT OF MULTI-SECTOR PARTNERSHIPS. WORKFORCE DEVELOPMENT CAPE COD HEALTHCARE'S PHYSICIAN RECRUITMENT PROGRAM STRIVES TO IDENTIFY AREAS OF UNMET NEED AND IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE FOR VULNERABLE POPULATIONS, ESPECIALLY THOSE OVER 65 WITH PUBLIC HEALTH INSURANCE COVERAGE. THROUGH RIGOROUS EFFORTS HIGHLY QUALIFIED PHYSICIANS AND PHYSICIAN EXTENDERS ARE RECRUITED AND RETAINED TO MEET THE HEALTH CARE NEEDS OF RESIDENTS OF CAPE COD.
PART III, LINES 2-3	THE ORGANIZATION IS REPORTING $11,071,739 OF BAD DEBT EXPENSE THAT MEETS ITS FINANCIAL ASSISTANCE POLICY. THIS AMOUNT IS RELATED TO BAD DEBT FROM BOTH HOSPITALS DURING FY19 OF UNINSURED PATIENTS WHO WERE SEEN IN THE ER AND RECEIVED MEDICALLY NECESSARY SERVICES. CAPE COD HEALTHCARE RECEIVES PAYMENTS FOR SERVICES RENDERED FROM FEDERAL AND STATE AGENCIES (UNDER THE MEDICARE AND MEDICAID PROGRAMS), MANAGED CARE PAYORS, COMMERCIAL INSURANCE COMPANIES, AND PATIENTS. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF CONTRACTUAL ALLOWANCES AND RESERVES FOR DENIALS, UNCOMPENSATED CARE, AND DOUBTFUL ACCOUNTS. THE LEVEL OF RESERVES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL AND PRIVATE EMPLOYER HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. IF A PATIENT IS INELIGIBLE FOR CHARITY CARE BECAUSE HIS OR HER INCOME EXCEEDS THE ELIGIBILITY GUIDELINES, ANY UNCOLLECTIBLE ACCOUNTS RECEIVABLE BALANCE IS WRITTEN OFF TO BAD DEBT AS REPORTED IN PART III, LINE 2.
PART III, LINE 4	THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE RELATED TO BAD DEBT OR ALLOWANCE FOR DOUBTFUL ACCOUNTS.
PART III LINE 9(B)	HOSPITAL FINANCIAL ASSISTANCE PROGRAMS PATIENTS WHO ARE ELIGIBLE FOR ENROLLMENT IN A STATE PUBLIC ASSISTANCE PROGRAM, LIKE THE MASSACHUSETTS MASSHEALTH OR HEALTH SAFETY NET PROGRAMS, ARE DEEMED ENROLLED IN A FINANCIAL ASSISTANCE PROGRAM. FOR ALL PATIENTS THAT ARE ENROLLED IN THESE STATE PUBLIC ASSISTANCE PROGRAMS, THE HOSPITAL MAY ONLY BILL THOSE PATIENTS FOR THE SPECIFIC CO-PAYMENT, CO-INSURANCE, OR DEDUCTIBLE THAT IS OUTLINED IN THE APPLICABLE STATE REGULATIONS AND WHICH MAY FURTHER BE INDICATED ON THE STATE MEDICAID MANAGEMENT INFORMATION SYSTEM.THE HOSPITAL WILL SEEK A SPECIFIED PAYMENT FOR THOSE PATIENTS THAT DO NOT QUALIFY FOR ENROLLMENT IN A MASSACHUSETTS STATE PUBLIC ASSISTANCE SUCH AS OUT-OF-STATE RESIDENTS, BUT WHO MAY OTHERWISE MEET THE GENERAL FINANCIAL ELIGIBILITY CATEGORIES OF A STATE PUBLIC ASSISTANCE PROGRAM. FOR THESE PATIENTS, THE PAYMENT AMOUNT WILL BE SET AT THE HOSPITAL, WHEN REQUESTED BY THE PATIENT AND BASED ON AN INTERNAL REVIEW OF EACH PATIENT'S FINANCIAL STATUS, MAY OFFER A PATIENT AN ADDITIONAL DISCOUNT ON AN UNPAID BILL. ANY SUCH REVIEW SHALL BE PART OF A SEPARATE HOSPITAL FINANCIAL ASSISTANCE PROGRAM THAT IS APPLIED ON A UNIFORM BASIS TO PATIENTS, AND WHICH TAKES INTO CONSIDERATION THE PATIENT'S DOCUMENTED FINANCIAL SITUATION AND THE PATIENT'S INABILITY TO MAKE A PAYMENT AFTER REASONABLE COLLECTION ACTIONS. ANY DISCOUNT THAT IS PROVIDED BY THE HOSPITAL IS CONSISTENT WITH FEDERAL AND STATE REQUIREMENTS, AND DOES NOT INFLUENCE A PATIENT TO RECEIVE SERVICES FROM THE HOSPITAL. POPULATIONS EXEMPT FROM COLLECTION ACTIVITIES: THERE ARE SEVERAL SITUATIONS WHERE A PATIENT CAN BE EXEMPTED FROM FURTHER BILLING AND COLLECTION PROCEDURES ONCE THE DETERMINATION IS MADE THAT THE PATIENT IS EXEMPT PURSUANT TO STATE REGULATIONS: A) PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, OR DESIGNATED A "LOW INCOME PATIENT" BY THE OFFICE OF MEDICAID, SUBJECT TO THE FOLLOWING EXCEPTIONS: (I) THE HOSPITAL MAY SEEK TO BILL AND COLLECT THE CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM. (II) THE HOSPITAL MAY ALSO INITIATE BILLING AND COLLECTION EFFORTS FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, (INCLUDING RECEIPT OR VERIFICATION OF THE SIGNED APPLICATION) THE HOSPITAL SHALL CEASE ITS BILLING AND COLLECTION ACTIVITIES. (III) THE HOSPITAL WILL NOT CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED BY THE HOSPITAL DURING THE PERIOD FOR WHICH HE OR SHE HAS BEEN DETERMINED TO BE A LOW INCOME PATIENT BY THE OFFICE OF MEDICAID. HOWEVER, THE HOSPITAL MAY CONTINUE COLLECTION ACTION ON A LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED, EXPIRED, OR NOT OTHERWISE IDENTIFIED ON THE STATE'S VIRTUAL GATEWAY OR RECIPIENT ELIGIBILITY VERIFICATION SYSTEM. ONCE A LOW INCOME PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN COMMONWEALTH CARE PROGRAMS, THE HOSPITAL WILL CEASE ITS BILLING AND COLLECTION EFFORTS FOR SERVICES PROVIDED PRIOR TO THE BEGINNING OF THEIR ELIGIBILITY. (IV) THE HOSPITALS MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE.
PART VI, LINE 2	NEEDS ASSESSMENT: THE 2020-2022 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT (CHNA REPORT) AND IMPLEMENTATION PLAN WAS RELEASED AND MADE WIDELY AVAILABLE TO THE PUBLIC IN SEPTEMBER, 2019. THE GOALS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROJECT ARE TO MONITOR REGIONAL HEALTH DATA, ENGAGE HOSPITAL STAKEHOLDERS, PROMOTE PARTNERSHIPS BETWEEN THE HOSPITALS AND COMMUNITY ORGANIZATIONS AND DEVELOP MULTI-YEAR IMPLEMENTATION STRATEGIES TO GUIDE HOSPITAL INITIATIVES TO IMPROVE THE HEALTH OF BARNSTABLE COUNTY RESIDENTS. Many sources and data collection methodologies were used to obtain a comprehensive view of the health and health care needs of the region and the people served by CCH and FH. Input on the design of data collection instruments was solicited from public health experts, health care consumers, and persons representing vulnerable and medically underserved populations and minorities. Conscientious efforts were made to reach a wide-ranging population of residents during data collection to ensure broad representation of community interests and perspectives. 1. Secondary Data. A comprehensive review of existing data drawn from national, state, and local sources was conducted. Data sources included, but were not limited to, the U.S. Census Bureau, the Centers for Disease Control and Prevention, the Massachusetts Department of Public Health, among others. Types of data included demographics, vital statistics, public health surveillance, as well as self-report of select health behaviors from large, population-based surveys such as the Massachusetts Behavioral Risk Factor Surveillance Survey (BRFSS). The selection of secondary data points was generally based on the prior CHNAs to allow for examination of trends over time. However, additional secondary data sources were explored when major themes or issues arose from qualitative data collection. When available, data were stratified by age group or by income/poverty level to identify areas of disparity. 2. Community Stakeholder Dialogues. Two facilitated "stakeholder dialogues" were held with staff from a broad array of agencies and organizations actively working in the health and human services sectors of Barnstable County. Approximately 70 people attended these sessions. 3. Key Informant Interviews. Key informant interviews were conducted via phone with 25 community leaders from organizations across all of Barnstable County, representing health centers, public safety organizations, housing organizations, and other human service groups. Key informants were identified for participation based on their in-depth knowledge of the health needs and resources of the region. Discussions focused on health strengths and needs in the community and opportunities and challenges to addressing community needs. They were also asked to describe organizational partnerships within Barnstable County, perceptions of community services, and perceptions of CCHC. 4. Focus Groups. Two focus groups, one conducted in Spanish and one in Portuguese, were held with residents to gather information about the community, health challenges and needs, existing services, and suggestions for the future. One focus group of Portuguese-speaking residents was conducted at IPR Cape Cod Church and involved 14 participants. The other involved six Spanishspeaking participants and was held at the Immigration Resource Center at Community Action Committee of Cape Cod. 5. Community Survey. A community survey asking about community and individual health and health care needs was developed and made available on-line and on paper to residents of Barnstable County. The survey was conducted in English, Spanish, and Portuguese and was completed by 2,011 total residents.
PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FOR THOSE PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER THEIR UNPAID HOSPITAL BILLS. IN ORDER TO ASSIST UNINSURED AND UNDERINSURED PATIENTS IN FINDING AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES POSTED THROUGHOUT THE HOSPITAL. THE GOAL OF THESE NOTICES IS TO INFORM PATIENTS THAT THEY MAY BE ELIGIBLE TO APPLY FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM, SUCH AS, BUT NOT LIMITED TO, MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET. THE HOSPITAL WILL PROVIDE, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE DESIGNATED A LOW INCOME PATIENT UNDER EITHER THE STATE HEALTH SAFETY NET PROGRAM OR THROUGH THE HOSPITAL'S OWN INTERNAL CHARITY CARE PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT PAYMENT PLANS THAT MAY BE AVAILABLE TO HIM OR HER BASED ON THE SIZE OF HIS OR HER FAMILY AND FAMILY INCOME.
PART VI, LINE 4	DEMOGRAPHICS OF THE SERVICE AREA CCHC's primary service area is Barnstable County. Barnstable County is a geographically isolated region located on the eastern seaboard of Massachusetts. The narrow peninsula spans over 70 miles in length and hosts a year-round population of 214,703 residents. Barnstable County consists of 15 towns that vary in population size from about 45,000 residents (Barnstable) to slightly more than 1,500 residents (Truro). In addition to serving year-round residents, the regional community infrastructure, including CCH and FH, must meet the demands of a significant influx of seasonal residents and visitors each year which, by one estimate, is equivalent to about seven million visitors and residents on Cape Cod in a given summer season. Population Demographic Trends Nearly half of the total population of Barnstable County reside in the three largest towns (Barnstable, Falmouth, and Yarmouth) and population size becomes increasingly smaller in towns of the lower (Harwich, Brewster, Chatham, and Orleans) and outer cape (Eastham, Wellfleet, Truro, and Provincetown), many of which are considered rural. Between 2011 and 2016, the overall population of Barnstable County remained stable with a slight decrease of -0.9%. In comparison, the state population grew by 3.5% during that time period. The overall population of Barnstable County and the islands of Nantucket and Martha's Vineyard is projected to decline in coming decades (an estimated -13.0% between 2010 and 2035), attributed to outmigration of younger residents and to the fact that deaths currently outnumber births. Consistent with the previous CHNA, the population of Barnstable County is older than for the state overall. The median age in Barnstable County is 51.8 years compared to 39. years for the state overall. Proportionally, residents age 65 years and older comprise 27.8% of the population in Barnstable County, compared to the state at 15.1%. In contrast, the proportion of residents under 18 years is lower in Barnstable County than in the state at 15.9% vs. 20.6%, respectively. Similarly, the proportion of residents between 18 and 24 years is lower in Barnstable County than in the state at 7.3% vs. 10.4%, respectively. Several towns on the lower and outer cape have a notably higher proportions of residents age 65 years and older, including Chatham (38.9%), Orleans (38.7%), and Wellfleet (38.0%), compared to the County average. More detailed data on the age of residents reveal that Barnstable County also has a higher proportion of residents who are within the 'oldest' age categories compared to Massachusetts overall, including those age 75 to 84 (8.8% vs. 4.4%, respectively) and those age 85 years and older (3.9% vs. 2.3%, respectively). Concern about meeting the needs of an aging population was a prominent theme in key informant interviews, stakeholder dialogues, and the community survey. 'Aging health concerns' was the most frequently identified health concern for the community by survey respondents (72.6%) with 'health care services focused on seniors'support to older adults to maintain independent living' ranking among the most frequently selected health and social service priorities by survey respondents. Key informant interviewees also noted that the population in the region is older and aging, which affects and will continue to affect the health and social service infrastructure. One phenomenon discussed by key informant interviewees and substantiated by existing data is the large and growing number of seniors who are caring for grandchildren. Between 2011 and 2016, the proportion of grandchildren residing with their grandparents, who are responsible for them, declined in Massachusetts from 29.8% to 28.0%, while it increased substantially in Barnstable County from 27.0% to 42.8%. This increase occurred in parallel timing with the inception of the opioid epidemic in 2012, which has disproportionally impacted Barnstable County. While grandparents' homes can provide stability and support when parents are unable to care for their children, caring for grandchildren can be physically and emotionally demanding for seniors, create financial challenges, and strain social and family relationships. These all contribute to poorer mental and physical health among grandparents. Related in part to the older age of the population, Barnstable County has a larger proportion of veterans and residents with disabilities than the state overall. Eleven percent (11.0%) of county residents identified as veterans compared to 6.4% for the state overall. The largest proportion of veterans residing in Barnstable County is of the Vietnam era (36.2%). Approximately 14% of residents in Barnstable have a disability, compared to 11.6% for the state. Between about 5% to 7% of Barnstable County residents have a hearing, cognitive, ambulatory, or independent living disability. In terms of race and ethnicity, the population of Barnstable County is less diverse than the state overall. Ninety percent (90.6%) of Barnstable County residents identify as White, non-Hispanic compared to 73.7% in the state overall. Though comprising a small proportion of the overall population, approximately 20,000 Barnstable County residents identify as a racial or ethnic minority. Similarly, smaller proportions (7.8%) of Barnstable County residents speak a language other than English compared to the state overall (22.7%). While language minorities comprise a small portion of the county's population, Spanish and Portuguese-speaking focus group participants shared those language barriers are a substantial barrier to economic advancement and the ability to access some health and social services. Focus group participants further reported that limited spaces in English as a Second Language (ESL) classes make it difficult for immigrants to learn English.
PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: CAPE COD HEALTHCARE, INC., (CCHC) THROUGH ITS COMMUNITY BENEFITS INITIATIVES, IS COMMITTED TO ENHANCING THE QUALITY OF AND ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES FOR ALL RESIDENTS OF CAPE COD. THROUGH CONTINUOUS ASSESSMENT OF COMMUNITY NEEDS, COORDINATED PLANNING AND THE ALLOCATION OF RESOURCES, THIS COMMITMENT INCLUDES A SPECIAL FOCUS ON THE UNMET NEEDS OF THE FINANCIALLY DISADVANTAGED AND UNDERSERVED POPULATIONS. WE WILL TAKE A LEADERSHIP ROLE IN COLLABORATIVE EFFORTS JOINING OUR RESOURCES, TALENT, AND COMMITMENT WITH THAT OF OTHER PROVIDERS, ORGANIZATIONS AND COMMUNITY MEMBERS. THE COMMUNITY BENEFITS MISSION STATEMENT WAS AFFIRMED BY THE CCHC COMMUNITY HEALTH COMMITTEE AND THE BOARD OF TRUSTEES IN 2000 AND REMAINS IN EFFECT. THE FOLLOWING IS A LIST OF FY 19 TARGET POPULATIONS: - INDIVIDUALS MANAGING OR AT RISK OF DEVELOPING CHRONIC AND INFECTIOUS DISEASES SUCH AS CANCER, CARDIOVASCULAR DISEASE, ALZHEIMER'S DISEASE AND DEMENTIA, HEPATITIS C, AND TICK-BORNE DISEASES. - RESIDENTS FACING BARRIERS TO CARE DUE TO LANGUAGE, COST, OR AGE, INCLUDING THOSE WHO ARE UNINSURED OR UNDER-INSURED. - INDIVIDUALS WITH MENTAL HEALTH DISORDERS, SUBSTANCE USE DISORDERS, AND CO-OCCURRING DISORDERS. - SENIOR POPULATION, AGES 65 AND OLDER. - YOUTH AND YOUNG ADULTS, AGES 15 TO 24 YEARS OLD. KEY ACCOMPLISHMENTS OF REPORTING YEAR CCHC Community Benefits provided financial and service support to Health and Human Services organizations and Hospital Based Programs and Services that were aligned with CHNA 17-19. We addressed our own institutional and community wide systems barriers by adding new forms of educators and supportive connectors in the continuum of care. Examples: Alzheimer's Support Groups, Recovery Coaches, Community Navigators, Chronic Disease Outreach, integrative therapies and transportation solutions. CCHC Community Benefits empowered the community through a collaborative engagement process to produce the FY20-22 Community Health Needs Assessment, a guiding document for all of Cape Cod. CCHC Community Benefits expanded cross-sector community partnerships and leadership within and throughout the Cape Cod non-profit health and human service system. The 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report and Implementation Plan served as the foundation for CCHC's FY19 Community Benefits program. CCHC's Community Benefits activities focused on the four health priorities identified in the report: chronic and infectious disease, behavioral health, access to care, and disease prevention and wellness. New and expanded hospital programs were developed in alignment with implementation goals, objectives and strategies for each priority. CCHC supported partnerships with over 50 local nonprofit health and human service organizations, and a network of federally qualified health centers through project support and grant investments to improve the health of Barnstable County residents. Hospital staff dedicated time and expertise to strategic partnerships, coalitions, and task force efforts locally, regionally, and across Massachusetts. Chronic and Infectious Disease Prevention, screening, detection, and management of chronic and infectious diseases were supported through a variety of CCHC Community Benefits activities. Hospital cancer support services including counseling, support groups, and survivorship activities for patients and caregivers were complimented with a new Oncology Nutrition program. The successful Living Fit for You! Cancer Wellness Program provides free of charge rehabilitation, wellness consultations, exercise, and education services to help adults undergoing cancer treatment manage fatigue, de-conditioning and loss of physical function. CCHC Community Benefits also provided grants to the Cape Wellness Collaborative and YMCA Cape Cod LIVESTRONG program to ensure that patients undergoing and recovering from cancer treatment had access to community-based wellness programs and complementary services such as massage, acupuncture, yoga and nutritional counseling. The CCHC Integrated Cancer Committee, comprised of physicians, nurses and support staff, conducted educational campaigns and community outreach events. These events informed youth about the risks of tobacco use and the public about skin cancer prevention, including high-risk screening opportunities. CCHC clinical teams provided disease education, rehabilitation and pathways to chronic disease self- management for individuals living with congestive heart failure, chronic pulmonary diseases, and diabetes. A Community Benefits grant to the Cape Cod Times Needy Fund helped with basic needs such as housing and utility payments, transportation, adaptive medical equipment, and child care specifically for individuals managing a chronic disease. A CCHC Community Benefits grant supported the Alzheimer's Family Caregiver Support Center's expanding free counseling for families and caregivers in outposts across the Outer, Lower, Mid, and Upper regions of Cape Cod. In addition, the organization now hosts concurrent weekly support group meetings for individuals with Alzheimer's disease and their caregivers at Cape Cod Hospital. Through a partnership with the UMASS Laboratory of Medical Zoology, CCHC was the only healthcare system in MA to subsidize tick testing for residents within a hospital service area. CCHC also partnered with the Cape Cod Cooperative Extension to produce a 10-part online video series titled "Tickology" to provide easily accessible community education on tick disease prevention. CCHC Infectious Disease Clinical Services is the recipient of federal and state Ryan White grant funding to support comprehensive primary medical care and medical case management for individuals with HIV/AIDS living in Barnstable County. CCHC, through partnerships with other local organizations, aligned local efforts to meet National HIV/AIDS Strategy and the Massachusetts Integrated HIV Prevention and Care Plan to reduce the number of new HIV infections, increase access to care, improve health outcomes for individuals living with HIV/AIDS, and reduce HIV-related health inequities and disparities. Behavioral Health CCHC Community Benefits expanded hospital-based services and collaborations with local federally qualified health centers and behavioral health providers to strengthen regional services and community resources for individuals with mental health and substance use disorders. CCHC's Centers for Behavioral Health joined the MA Department of Public Health and MA Department of Mental Health on the Zero Suicide Initiative to increase suicide prevention and reduce suicide deaths on Cape Cod. CCHC also provides a Community Crisis Line, staffed by clinicians, offering free and confidential emotional support and referral assistance for individuals in crisis and their families. CCHC Community Benefits funded a community wide Mental Health education program through National Alliance on Mental Illness (NAMI) Cape Cod, targeting the Portuguese population. CCHC Community Benefits provided grants to three federally qualified health centers on Cape Cod. Duffy Health Center, Harbor Community Health Center- Hyannis, and Outer Cape Health Services received grants supporting integrated behavioral health services, establishing an Office Based Addiction Treatment program and continuation of a community navigator program that assists individuals most at risk in our region. Through a partnership with, and grant to Gosnold, Inc., CCHC Community Benefits expanded the Recovery Specialist program in the emergency departments at Cape Cod Hospital and Falmouth Hospital. The program provides peer-led recovery engagement services for patients with Substance Use Disorders. Recovery Specialists work as part of the emergency departments' care teams to motivate patients to accept treatment upon discharge from the emergency departments. Additional funding to Gosnold, Inc. provided Recovery Coaching scholarships for 30 individuals who completed treatment for their Substance Use Disorder. Recovery Coaches assist individuals with building recovery support systems and improving outcomes related to employment, housing, legal and life skills.
ACCESS TO CARE	In FY19, CCHC continued to invest, significantly, in expanding access to care for vulnerable and medically underserved populations in Barnstable County. CCHC Community Benefits continued its grant support of the Specialty Network for the Uninsured (SNU) program in Barnstable County. The SNU program coordinates appointments and follow-up care with local medical specialists for uninsured and under-insured patients in our region, reducing barriers to local access and addressing gaps in specialty services not offered by local community health centers. Through the Community Based Interpreters program, CCHC Community Benefits funding provided free medical interpreter services for limited-English speaking patients in community based primary and specialty care offices across the region. In partnership with the Cape and Islands Emergency Medical Services System, CCHC expanded the impact of medical interpreter services to pre-hospital settings. CCHC provides training and funding for phone-based interpreter services that connect paramedics and first responders to interpreters via cell phones in ambulances to improve communication with limited-English speaking patients during transport to a hospital. Hospital social workers and case managers assisted low-income and vulnerable patients in need through direct referrals to community services, prescription pharmacy assistance, and transportation vouchers upon discharge. Financial counselors at Cape Cod Hospital and Falmouth Hospital were available to all Barnstable County residents to assist with health insurance questions and needs including Mass Health and Medicare coverage applications and renewal assistance. CCHC has been at the forefront of establishing strategic relationships ensuring a strong and skilled future allied health workforce in our region. Cape Cod Community College and Cape Cod Healthcare Nursing Education Collaborative is a program that expands opportunities for education, clinical training, and employment, as well as RN student debt relief and career exploration pathways for high school students. In several clinical departments including behavioral health, radiology, and laboratory services across both hospitals, clinicians provide supervision, training, and job shadowing for students from UMASS Medical School, regional community colleges, and local vocational and technical schools. Disease Prevention and Wellness In FY19, Cape Cod Healthcare efforts focused on building partnerships and support for community-based prevention and wellness initiatives impacting residents across the lifespan from infants to seniors. CCHC Community Benefits expanded efforts supporting new families. Expanded efforts included prenatal and parenting classes in English and Portuguese, support groups for new mothers, fatherhood initiatives, and a breastfeeding 'warm line' that provided families with phone support for questions related to breastfeeding. CCHC also partnered with a local Early Intervention program to provide pre-discharge meetings with Early Intervention staff. Early Intervention staff educated parents about services and supports available to infants, young children and their families through the program. Through a partnership with the Cape & Islands United Way, CCHC Community Benefits supported the Strong from the Start Initiative aimed at improving the social, emotional and developmental outcomes for children ages 0-3 years in Barnstable County. The objectives of Strong from the Start are to strengthen families, reduce achievement and word gaps and provide children with the social, emotional and language skills to thrive in school and in life. CCHC Community Benefits built a coalition of more than 50 community organizations to support the Quality of Life Initiative. The initiative provided guest speakers, materials and helpful tools to educate the community about the importance of advance care planning. In addition, CCHC Community Benefits joined a coalition of more than 30 organizations called Healthy Aging Cape Cod. Led by Barnstable County Department of Human Services, the purpose of the coalition is to undertake regional planning that supports our aging demographic and their families through conversations projects that align local efforts with statewide efforts to build an Age and Dementia-friendly Massachusetts. Healthy Parks, Healthy People, a program supported through a collaboration between Cape Cod Healthcare, the US National Park Service, and the Cape Cod National Seashore, continued with its focus on promoting open space for physical activity and wellness. Activities included educational events by CCHC physicians and physical therapists, a walking program, and a 5K walk/run for residents and visitors of Cape Cod. CCHC Community Benefits grants supported elder suicide prevention trainings through the Samaritans of Cape Cod, HPV vaccination and cervical cancer education for providers, parents and youth by Team Maureen and chronic disease and mindfulness programs at local family homeless shelters by Housing Assistance Corporation on Cape Cod.
PART VI, LINE 7	ALL STATES WHERE ORGANIZATION FILES A COMMUNITY BENEFITS REPORT: MA

Schedule H (Form 990) 2018

Additional Data

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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
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number
90-0054984

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	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) Cape Cod Foundation Inc 261 WHITES PATH YARMOUTH,MA02664	51-0140462	501(c)(3)	214,600	FMV	N/A	Prevention & Wellness
(2) Harbor Health Center 1135 MORTON ST MATTAPAN,MA02126	23-7100550	501(c)(3)	100,000	FMV	N/A	Access to Care
(3) Duffy Health Center Inc 94 MAIN ST HYANNIS,MA02452	04-3373741	501(c)(3)	89,000	FMV	N/A	Access to Care
(4) Outer Cape Health Services PO Box 1413 Wellfleet,MA02667	04-2509828	501(c)(3)	66,500	FMV	N/A	Access to Care
(5) Alzheimer's Family Caregiver Support Center Inc 309 Waverly Oaks Rd Waltham,MA02452	13-3039601	501(c)(3)	40,000	FMV	N/A	Prevention & Wellness
(6) Cape Cod Commercial Fisherman's Alliance 1566 Main St Chatham,MA02633	04-3138784	501(c)(3)	31,500	FMV	N/A	Prevention & Wellness
(7) Cape Wellness Collaborative 11 Potter Ave Hyannis,MA02601	47-2360979	501(c)(3)	30,000	FMV	N/A	Chronic & Infectious Disease
(8) The Family Pantry of Cape Cod 133 Queen Anne Rd Harwich,MA02645	22-3079904	501(c)(3)	30,000	FMV	N/A	Prevention & Wellness
(9) Wellstrong Inc 385 Welliott Rd Centerville,MA02632	81-1935657	501(c)(3)	30,000	FMV	N/A	Behavioral Health
(10) YMCA Cape Cod 12245 IYANNOUGH RD W BARNSTABLE,MA02668	04-2394925	501(c)(3)	30,000	FMV	N/A	Chronic & Infectious Disease
(11) AIDS Support Group of Cape Cod Inc PO BOX 1522 PROVINCETOWN,MA02657	04-2908722	501(c)(3)	29,724	FMV	N/A	Chronic & Infectious Disease
(12) Cape Cod Times Needy Fund Inc PO BOX 804 HYANNIS,MA02601	22-2480332	501(c)(3)	25,000	FMV	N/A	Access to Care
(13) UMASS Lab of Medical Zoology 333 South St Ste 450 Shrewsbury,MA01545	04-3167352	501(c)(3)	22,500	FMV	N/A	Chronic & Infectious Disease
(14) Barnstable Public Schools 367 MAIN ST HYANNIS,MA02601	04-6001079	GOV'T	22,000	FMV	N/A	SDOH
(15) HEALTH IMPERATIVES INC 942 W CHESTNUT ST BROCKTON,MA02301	04-2609177	501(c)(3)	22,000	FMV	N/A	Prevention & Wellness
(16) Housing Assistance Corporation 460 W MAIN ST HYANNIS,MA02601	23-7431255	501(c)(3)	21,000	FMV	N/A	SDOH
(17) Team Maureen PO Box 422 N Falmouth,MA02556	45-2473500	501(c)(3)	19,530	FMV	N/A	Chronic & Infectious Disease
(18) Cape Cod Child Development Inc 83 Pearl St Hyannis,MA02601	23-7324732	501(c)(3)	17,410	FMV	N/A	Prevention & Wellness
(19) Samaritans on Cape Cod & the Islands PO BOX 65 falmouth,MA02541	04-2738811	501(c)(3)	16,223	FMV	N/A	Behavioral Health
(20) Boston Cancer Support Org Inc 831 Beacon St Newton,MA02459	30-0863587	501(c)(3)	15,000	FMV	N/A	Chronic & Infectious Disease
(21) Cape Cod Literacy Council 319 Main Street Hyannis,MA02601	22-3098035	501(c)(3)	15,000	FMV	N/A	Prevention & Wellness
(22) Cape Abilities 895 Mary Dunn Rd Hyannis,MA02664	04-2453166	501(C)(3)	10,500	FMV	N/A	Chronic & Infectious Disease
(23) NAMI Cape Cod Inc 5 MARK LANE HYANNIS,MA02601	04-2785229	501(c)(3)	10,000	FMV	N/A	Behavioral Health
(24) Friends of Yarmouth Council on Aging 528 Forest Rd West Yarmouth,MA02673	04-3330127	501(C)(3)	5,310	FMV	N/A	SDOH - Transportation

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

SCHEDULE I, PART I, LINE 2

Cape Cod Healthcare monitors the use of grant funds it provides to other organizations through documentation and measurement requirements and metric reporting. The recipient organization agrees to submit an Annual Summary & Outcomes Report to Cape Cod Healthcare for inclusion in Cape Cod Healthcare's Community Benefits State Attorney General's reporting. An outline of specific reporting requirements is included as an attachment in each agreement and a reporting template is provided to each organization. The recipient organization agrees to send a completed template to Cape Cod Healthcare by October 31st of the year the grant is awarded (CCHC grant program schedules run from January 1 - September 30). Additionally, Cape Cod Healthcare may request an Annual Summary & Outcomes Report or documentation of outcomes related to services outlined in the agreement at any time during the duration of the grant.

Schedule I (Form 990) 2018

Additional Data

Software ID:
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- 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

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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)
1MICHAEL K LAUF PRESIDENT/CEO/TRUSTEE	(i) (ii)	0 ------------- 997,055	0 ------------- 400,000	0 ------------- 227,344	0 ------------- 250,847	0 ------------- 36,631	0 ------------- 1,911,877	0 ------------- 163,550
2ROBERT WILSTERMAN MD TRUSTEE	(i) (ii)	691,441 ------------- 0	4,743 ------------- 0	2,772 ------------- 0	26,154 ------------- 0	32,612 ------------- 0	757,722 ------------- 0	0 ------------- 0
3WILLIAM AGEL MD TRUSTEE	(i) (ii)	441,320 ------------- 0	46,028 ------------- 0	16,206 ------------- 0	11,367 ------------- 0	31,570 ------------- 0	546,491 ------------- 0	0 ------------- 0
4THEODORE CALIANOS MD TRUSTEE	(i) (ii)	370,702 ------------- 0	1,608 ------------- 0	1,806 ------------- 0	11,288 ------------- 0	29,607 ------------- 0	415,011 ------------- 0	0 ------------- 0
5PAUL HOULE MD TRUSTEE	(i) (ii)	932,440 ------------- 0	160,000 ------------- 0	22,566 ------------- 0	31,813 ------------- 0	31,612 ------------- 0	1,178,431 ------------- 0	0 ------------- 0
6MICHAEL L CONNORS SENIOR VP FINANCE/CFO	(i) (ii)	0 ------------- 431,439	0 ------------- 97,350	0 ------------- 35,431	0 ------------- 64,490	0 ------------- 34,152	0 ------------- 662,862	0 ------------- 18,275
7MICHAEL G JONES ESQ Sr VP & Chief Legal Off/Clerk	(i) (ii)	0 ------------- 328,038	0 ------------- 77,119	0 ------------- 22,233	0 ------------- 44,533	0 ------------- 32,552	0 ------------- 504,475	0 ------------- 15,219
8MICHAEL BUNDY COO (UNTIL 1/19)	(i) (ii)	0 ------------- 396,437	0 ------------- 90,000	0 ------------- 630	0 ------------- 35,478	0 ------------- 25,308	0 ------------- 547,853	0 ------------- 0
9DONALD A GUADAGNOLI MD CMO CAPE COD HOSPITAL	(i) (ii)	0 ------------- 412,496	0 ------------- 92,925	0 ------------- 33,091	0 ------------- 62,853	0 ------------- 26,907	0 ------------- 628,272	0 ------------- 19,957
10ALEXANDER HEARD MD CMO FALMOUTH HOSPITAL	(i) (ii)	84,330 ------------- 352,395	0 ------------- 134,312	0 ------------- 7,553	0 ------------- 58,669	0 ------------- 32,723	84,330 ------------- 585,652	0 ------------- 0
11PATRICK J KANE SVP OF MRKTG,COMMUN AND DEVLP	(i) (ii)	0 ------------- 312,048	0 ------------- 79,213	0 ------------- 22,232	0 ------------- 28,782	0 ------------- 14,552	0 ------------- 456,827	0 ------------- 15,514
12CHRISTIAN BROWN SR VP MANAGED CARE	(i) (ii)	0 ------------- 313,201	0 ------------- 75,913	0 ------------- 19,692	0 ------------- 46,980	0 ------------- 30,217	0 ------------- 486,003	0 ------------- 14,125
13EMILY SCHORER SVP HUMAN RESOURCES	(i) (ii)	0 ------------- 267,249	0 ------------- 65,280	0 ------------- 16,466	0 ------------- 25,820	0 ------------- 30,342	0 ------------- 405,157	0 ------------- 12,950
14KEVIN RALPH SVP DEVELOPMENT (UNTIL 4/18)	(i) (ii)	0 ------------- 78,028	0 ------------- 0	0 ------------- 116,254	0 ------------- 7,382	0 ------------- 11,905	0 ------------- 213,569	0 ------------- 9,896
15THERESA M AHERN SVP STRAT, COMMUNITY/GOV REL.	(i) (ii)	0 ------------- 295,913	0 ------------- 66,375	0 ------------- 19,303	0 ------------- 44,764	0 ------------- 11,472	0 ------------- 437,827	0 ------------- 12,000
16KEVIN J MULROY SVP CHIEF QUALITY & SAFETY OFF	(i) (ii)	0 ------------- 367,439	0 ------------- 86,269	0 ------------- 28,035	0 ------------- 46,974	0 ------------- 33,152	0 ------------- 561,869	0 ------------- 18,750
17JOHN PAUL SOLVERSON SR VP & CIO	(i) (ii)	0 ------------- 420,766	0 ------------- 100,031	0 ------------- 1,806	0 ------------- 20,789	0 ------------- 14,524	0 ------------- 557,916	0 ------------- 0
18JEFFREY S DYKENS VP FINANCE & OPERATIONS	(i) (ii)	0 ------------- 246,289	0 ------------- 0	0 ------------- 55,149	0 ------------- 31,526	0 ------------- 33,010	0 ------------- 365,974	0 ------------- 13,250
19NOELENE CERVIN VP BUDGETING AND OPER. SUPPORT	(i) (ii)	0 ------------- 216,289	0 ------------- 40,000	0 ------------- 7,003	0 ------------- 29,383	0 ------------- 29,302	0 ------------- 321,977	0 ------------- 0
20LORI JEWETT CEO - FH	(i) (ii)	0 ------------- 249,221	0 ------------- 42,000	0 ------------- 10,146	0 ------------- 45,210	0 ------------- 1,554	0 ------------- 348,131	0 ------------- 10,375
21ANNE MARIE PECKHAM PRESIDENT VNA	(i) (ii)	0 ------------- 197,826	0 ------------- 35,889	0 ------------- 9,974	0 ------------- 20,321	0 ------------- 21,715	0 ------------- 285,725	0 ------------- 0
22CARTER HUNT ADMIN SPEC&HOSP BASED CARE	(i) (ii)	0 ------------- 197,544	0 ------------- 20,688	0 ------------- 2,207	0 ------------- 36,908	0 ------------- 33,046	0 ------------- 290,393	0 ------------- 0
23REBECCA FRANCE SEE SCHEDULE O	(i) (ii)	0 ------------- 119,911	0 ------------- 15,000	0 ------------- 137,714	0 ------------- 2,083	0 ------------- 5,416	0 ------------- 280,124	0 ------------- 0
24JUDITH C QUINN VP OF PATIENT CARE	(i) (ii)	0 ------------- 217,082	0 ------------- 42,543	0 ------------- 19,133	0 ------------- 39,127	0 ------------- 23,307	0 ------------- 341,192	0 ------------- 10,875
25DEBRA ROBINSON ASSOCIATE VP OF NURSING	(i) (ii)	191,755 ------------- 0	36,913 ------------- 0	9,549 ------------- 0	0 ------------- 0	0 ------------- 0	238,217 ------------- 0	0 ------------- 0
26CYNTHIA MARLIN VP PERIOPERATIVE & SURGICAL SV	(i) (ii)	0 ------------- 190,373	0 ------------- 36,010	0 ------------- 4,990	0 ------------- 19,231	0 ------------- 21,686	0 ------------- 272,290	0 ------------- 0
27ELIZABETH DUNTON ADMIN PRIMARY CARE PRACTICE	(i) (ii)	0 ------------- 205,168	0 ------------- 20,050	0 ------------- 378	0 ------------- 15,237	0 ------------- 1,554	0 ------------- 242,387	0 ------------- 0
28RICHARD B ZELMAN MD PHYSICIAN	(i) (ii)	1,564,034 ------------- 0	100,000 ------------- 0	2,772 ------------- 0	12,077 ------------- 0	36,471 ------------- 0	1,715,354 ------------- 0	0 ------------- 0
29NICHOLAS COPPA MD PHYSICIAN	(i) (ii)	935,250 ------------- 0	160,000 ------------- 0	420 ------------- 0	31,804 ------------- 0	28,802 ------------- 0	1,156,276 ------------- 0	0 ------------- 0
30ACHILLES PAPAVASILIOU MD PHYSICIAN	(i) (ii)	932,440 ------------- 0	160,000 ------------- 0	630 ------------- 0	31,804 ------------- 0	31,612 ------------- 0	1,156,486 ------------- 0	0 ------------- 0
31GORDON NAKATA MD PHYSICIAN	(i) (ii)	932,440 ------------- 0	160,000 ------------- 0	630 ------------- 0	31,804 ------------- 0	31,612 ------------- 0	1,156,486 ------------- 0	0 ------------- 0
32PHILLIP J DOMBROWSKI MD PHYSICIAN	(i) (ii)	835,032 ------------- 0	66,667 ------------- 0	27,772 ------------- 0	34,273 ------------- 0	21,455 ------------- 0	985,199 ------------- 0	0 ------------- 0
33JEANNE FALLON Former SR VP/CIO	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 143,042	0 ------------- 0	0 ------------- 0	0 ------------- 143,042	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, LINE 4A	JEANNE FALLON, FORMER SR. VP AND CIO, RECEIVED SEVERANCE PAYMENTS OF $143,042 DURING CALENDAR YEAR 2018. THE ARRANGEMENT PROVIDES FOR CONTINUED PAYMENT OF THE INDIVIDUAL'S SALARY FOR A PERIOD OF FIFTEEN MONTHS. KEVIN RALPH, SVP OF DEVELOPMENT UNTIL 4/18, RECEIVED SEVERANCE PAYMENTS OF $86,539 DURING CALENDAR YEAR 2018. THE ARRANGEMENT PROVIDES FOR CONTINUED PAYMENT OF THE INDIVIDUAL'S SALARY AND BENEFITS FOR A PERIOD OF TWELVE MONTHS, INCLUDING MEDICAL AND DENTAL INSURANCE COVERAGE. REBECCA FRANCE, VP PATIENT FINANCIAL SERVICES & REVENUE CYCLE UNTIL 6/12/18, RECEIVED SEVERANCE PAYMENTS OF $125,500 DURING CALENDAR YEAR 2018. THE ARRANGEMENT PROVIDES FOR CONTINUED PAYMENT OF THE INDIVIDUAL'S SALARY AND BENEFITS FOR A PERIOD OF TWELVE MONTHS, INCLUDING MEDICAL AND DENTAL INSURANCE COVERAGE.
SCHEDULE J, PART I, LINE 4B - 457(F)	CAPE COD HEALTHCARE, INC. AND AFFILIATES SPONSORS A 457(F) VOLUNTARY PERSONAL DEFERRAL PLAN ("THE PLAN") FOR KEY EXECUTIVES. VESTING IS DEFERRED FOR AT LEAST TWO YEARS FROM THE DATE OF THE AWARD. THE PLAN OFFERS PARTICIPATING EMPLOYEES AN ANNUAL DEFERRAL OF CASH COMPENSATION. AMOUNTS DEFERRED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND AMOUNTS PAID UNDER THE PLAN DURING CALENDAR YEAR 2018 WERE AS FOLLOWS: - MICHAEL K. LAUF - $87,514 - MICHAEL G. JONES - $20,427 - MICHAEL L. CONNORS - $24,198 - JEFFREY S. DYKENS - $45,007 - PATRICK KANE - $19,460 - THERESA AHERN - $16,531 - DONALD GUADAGNOLI MD - $22,241 - EMILY SCHORER - $15,836 - KEVIN MULROY - $19,857 - CHRISTIAN BROWN - $16,920 - LORI JEWETT - $9,516 - JUDITH C. QUINN - $11,515 - KEVIN RALPH - $12,698 - REBECCA FRANCE - $2,094 CAPE COD HEALTHCARE, INC. AND AFFILIATES ALSO SPONSOR A NONQUALIFIED PENSION RESTORATION ACCOUNT PLAN FOR KEY EXECUTIVES. THE ORGANIZATION MAKES CONTRIBUTIONS OF TWO PERCENT OF THE INDIVIDUAL'S ANNUAL SALARY (INCLUDING BONUS) THROUGHOUT THE PLAN YEAR. AMOUNTS DEFERRED ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND UNDER THE PLAN, PARTICIPANTS ARE ENTITLED TO CERTAIN BENEFITS UPON RETIREMENT, TERMINATION, OR DEATH. DURING CALENDAR YEAR 2018, MICHAEL LAUF ALSO PARTICIPATED IN A SECTION 457(F) PLAN. TWELVE PERCENT OF HIS BASE SALARY WAS CONTRIBUTED AND EACH CONTRIBUTION IS SUBJECT TO A THREE YEAR VESTING SCHEDULE. THE AMOUNT DEFERRED IN CALENDAR YEAR 2018 WAS $120,000 AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN (C). IN ADDITION, $120,000 WAS PAID OUT FROM HIS CEO SUPPLEMENTAL PLAN, AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN B(III).
SCHEDULE J, PART I, LINE 7	DISCRETIONARY BONUSES ARE AWARDED ANNUALLY BASED UPON BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. BONUSES ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B(II).THE INDIVIDUALS REPORTED IN SCHEDULE J, PART II REPORTED AS BEING PAID FROM A RELATED ORGANIZATION WERE EMPLOYEES OF, AND COMPENSATED BY CAPE COD HEALTHCARE, INC., THE PARENT CORPORATION.

Schedule J (Form 990) 2018

Additional Data

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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
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number
90-0054984

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	MHEFA REVENUE BONDS SERIES E	04-2456011	000000000	01-12-2012	29,440,000	REISSUE SER E (6/18/08 & 2/12/09)		X		X		X
B	MHEFA REVENUE BONDS SERIES 2012A	04-3431814	000000000	02-24-2012	25,800,000	REFUND SER B(8/15/98)& C(11/15/01)		X		X		X
C	MDFA REVENUE BONDS SERIES 2013	04-3431814	57584VAH8	07-11-2013	50,831,729	REFUND SER C(10/9/01) & CAP.IMPR.		X		X		X
D	MDFA REVENUE BONDS SERIES 2014	04-3431814	000000000	09-29-2014	24,000,000	RENOVATION & REAL ESTATE PURCHASE		X		X		X
	MDFA REVENUE BONDS SERIES 2017	04-3431814	000000000	02-01-2017	52,315,359	REFUND SERIES D(2/16/2010)		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	22,570,666		18,060,000		0		2,300,000
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	29,440,000		25,800,000		50,834,109		24,001,267
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		1,295,804		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	0		336,100		803,269		0
8 Credit enhancement from proceeds .............	0		0		0		241,456
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		0		27,999,812		0
11 Other spent proceeds .............	29,440,000		25,463,900		20,735,224		23,759,811
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2012		2012		2014		2015
	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............

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
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?
c Are there any research agreements that may result in private business use of bond-financed property? .............		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?
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 .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		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
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? .............		X				X		X
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 ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

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 ..........	0		0		0		0
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

PART IV, LINE 2(C)

THE DATE THE REBATE COMPUTATIONS WERE LAST PERFORMED FOR EACH BOND ARE BELOW: MDFA, REVENUE BONDS, SERIES E - 07/12/2012 MDFA, REVENUE BONDS, SERIES 2012A - 06/30/2016 MDFA, REVENUE BONDS, SERIES 2013 - 06/30/2018 MDFA, REVENUE BONDS, SERIES 2014 - 08/31/2015 MDFA, REVENUE BONDS, SERIES 2017 - 06/30/2018 SINCE THE BOND PROCEEDS HAVE BEEN SPENT FOR EACH BOND AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY.

Schedule K (Form 990) 2018

Additional Data

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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
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number
90-0054984

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	MHEFA REVENUE BONDS SERIES E	04-2456011	000000000	01-12-2012	29,440,000	REISSUE SER E (6/18/08 & 2/12/09)		X		X		X
B	MHEFA REVENUE BONDS SERIES 2012A	04-3431814	000000000	02-24-2012	25,800,000	REFUND SER B(8/15/98)& C(11/15/01)		X		X		X
C	MDFA REVENUE BONDS SERIES 2013	04-3431814	57584VAH8	07-11-2013	50,831,729	REFUND SER C(10/9/01) & CAP.IMPR.		X		X		X
D	MDFA REVENUE BONDS SERIES 2014	04-3431814	000000000	09-29-2014	24,000,000	RENOVATION & REAL ESTATE PURCHASE		X		X		X
	MDFA REVENUE BONDS SERIES 2017	04-3431814	000000000	02-01-2017	52,315,359	REFUND SERIES D(2/16/2010)		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	22,570,666		18,060,000		0		2,300,000
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	29,440,000		25,800,000		50,834,109		24,001,267
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		1,295,804		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	0		336,100		803,269		0
8 Credit enhancement from proceeds .............	0		0		0		241,456
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		0		27,999,812		0
11 Other spent proceeds .............	29,440,000		25,463,900		20,735,224		23,759,811
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2012		2012		2014		2015
	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............

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
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?
c Are there any research agreements that may result in private business use of bond-financed property? .............		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?
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 .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		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
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? .............		X				X		X
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 ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

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 ..........	0		0		0		0
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

PART IV, LINE 2(C)

Schedule K (Form 990) 2018

Additional Data

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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

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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) DR KATIE RUDMAN	SPOUSE OF TRUSTEE	110,248	MACC EMPLOYEE		No
(2) Sarah K Guadagnoli RN	DAUGHTER OF KEY EMPLOYEE	76,524	CCH EMPLOYEE		No
(3) KIRA JONES	SPOUSE OF OFFICER	86,616	FH EMPLOYEE		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	13,526	3,176,038	VALUE OF STOCK REC'D
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which is not required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

Yes

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2018)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE M, PART I, COLUMN (B)	THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED. SCHEDULE M, PART I, LINE 32(A) ON OCCASION THE ORGANIZATION UTILIZES A BROKER TO DISPOSE OF NONCASH CONTRIBUTIONS (OTHER THAN PUBLICLY TRADED SECURITIES).

Schedule M (Form 990) (2018)

Additional Data

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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

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Return Reference	Explanation
FORM 990, PART I, LINE 1 AND PART III, LINE 1	WE WILL BE THE HEALTH SERVICE PROVIDER OF CHOICE FOR CAPE COD RESIDENTS BY ACHIEVING AND MAINTAINING THE HIGHEST STANDARDS IN HEALTH CARE DELIVERY AND SERVICE QUALITY. TO DO SO, WE WILL PARTNER WITH OTHER HEALTH AND HUMAN SERVICE PROVIDERS AS WELL AS INVEST IN NEEDED MEDICAL TECHNOLOGIES, HUMAN RESOURCES AND CLINICAL SERVICES. ABOVE ALL, WE WILL HELP IDENTIFY AND RESPOND TO THE NEEDS OF OUR COMMUNITY. COMMUNITY BENEFITS MISSION STATEMENT CAPE COD HEALTHCARE, INC., (CCHC) THROUGH ITS COMMUNITY BENEFITS INITIATIVES, IS COMMITTED TO ENHANCING THE QUALITY OF AND ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES FOR ALL RESIDENTS OF CAPE COD. THROUGH CONTINUOUS ASSESSMENT OF COMMUNITY NEEDS, COORDINATED PLANNING AND THE ALLOCATION OF RESOURCES, THIS COMMITMENT INCLUDES A SPECIAL FOCUS ON THE UNMET NEEDS OF THE FINANCIALLY DISADVANTAGED AND UNDERSERVED POPULATIONS. WE WILL TAKE A LEADERSHIP ROLE IN COLLABORATIVE EFFORTS JOINING OUR RESOURCES, TALENT, AND COMMITMENT WITH THAT OF OTHER PROVIDERS, ORGANIZATIONS AND COMMUNITY MEMBERS. THE COMMUNITY BENEFITS MISSION STATEMENT WAS AFFIRMED BY THE CCHC COMMUNITY HEALTH COMMITTEE AND THE BOARD OF TRUSTEES IN 2000 AND REMAINS IN EFFECT. TARGET POPULATIONS 1. NAME OF TARGET POPULATION: INDIVIDUALS MANAGING OR AT RISK OF DEVELOPING CHRONIC AND INFECTIOUS DISEASES SUCH AS CANCER, CARDIOVASCULAR DISEASE, ALZHEIMER'S DISEASE AND DEMENTIA, HEPATITIS C, DIABETES AND TICK-BORNE DISEASES. BASIS FOR SELECTION: ALIGNED WITH STATE AND NATIONAL HEALTH PRIORITIES, BARNSTABLE COUNTY RESIDENTS MANAGING CHRONIC DISEASES ARE AT THE GREATEST RISK OF DECLINED HEALTH AND DEATH. CANCER, CARDIOVASCULAR DISEASE, ALZHEIMER'S DISEASE/DEMENTIA, HEPATITIS C, DIABETES AND TICK-BORNE DISEASES WERE IDENTIFIED IN THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AS DISEASES OF CONCERN FOR THE REGION. 2. NAME OF TARGET POPULATION: RESIDENTS FACING BARRIERS TO CARE DUE TO LANGUAGE, COST, OR AGE, INCLUDING THOSE WHO ARE UNINSURED OR UNDER-INSURED. BASIS FOR SELECTION: THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IDENTIFIED SPECIFIC TARGET POPULATIONS THAT ENCOUNTER BARRIERS TO CARE OR GAPS IN COVERAGE DESPITE HIGH RATES OF INSURED RESIDENTS IN BARNSTABLE COUNTY. THE REPORT SPECIFICALLY IDENTIFIED CHILDREN AGES 0-17 YEARS, INDIVIDUALS LACKING YEAR-ROUND EMPLOYMENT, SENIORS LIVING ON A FIXED INCOME, SEASONAL WORKERS, AND FOREIGN-BORN RESIDENTS WHO DO NOT MEET ELIGIBILITY CRITERIA FOR MASS HEALTH ENROLLMENT. 3. NAME OF TARGET POPULATION: INDIVIDUALS WITH MENTAL HEALTH DISORDERS, SUBSTANCE USE DISORDERS AND CO-OCCURRING DISORDERS. BASIS FOR SELECTION: ACCESS TO, AND AVAILABILITY OF, COMMUNITY-BASED BEHAVIORAL HEALTH CARE IN BARNSTABLE COUNTY IS AN AREA OF CONCERN. THIS IS EVIDENCED BY HIGH RATES OF PATIENTS PRESENTING WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERS IN HOSPITAL EMERGENCY DEPARTMENTS. SPECIFIC CHALLENGES REPORTED BY THE COMMUNITY AND INCLUDED IN THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT INCLUDE A SHORTAGE OF PSYCHIATRIC PROVIDERS, WAIT TIMES FOR OUTPATIENT APPOINTMENTS, LIMITED INPATIENT TREATMENT OPTIONS FOR SUBSTANCE USE, AND INSURANCE BARRIERS TO CARE. 4. NAME OF TARGET POPULATION: SENIOR POPULATION, AGES 65 AND OLDER. BASIS FOR SELECTION: ACCORDING TO THE U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY FIVE-YEAR POPULATION ESTIMATES (2012-2016), NEARLY 28% OF THE YEARROUND POPULATION IN BARNSTABLE COUNTY IS OVER THE AGE OF 65. INCREASING CONSUMPTION OF AND NEED FOR HEALTH CARE SERVICES, CONCERNS OF SOCIAL ISOLATION, AVAILABILITY OF APPROPRIATE HOUSING AND TRANSPORTATION, AND ACCESS TO HEALTHY AND ADEQUATE FOOD WERE SPECIFIC CHALLENGES IDENTIFIED IN THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT FOR RESIDENTS OVER THE AGE OF 65. 5. NAME OF TARGET POPULATION: YOUTH AND YOUNG ADULTS, AGES 15 TO 24 YEARS OLD. BASIS FOR SELECTION: YOUTH AND YOUNG ADULTS, AGES 15-24 YEARS OLD, WERE IDENTIFIED IN THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AS A SPECIFIC AT-RISK POPULATION DUE TO INCREASING RATES OF SUBSTANCE USE TREATMENT ADMISSIONS AND CONCERNING HEALTH RISK BEHAVIORS. PUBLICATION OF TARGET POPULATIONS MARKETING COLLATERAL, WEBSITE COMMUNITY HEALTH NEEDS ASSESSMENT DATE LAST ASSESSMENT COMPLETED CHNA REPORT 20-22 PUBLISHED TO CCHC CARING COMMUNITIES WEBSITE DATA SOURCES COMMUNITY FOCUS GROUPS, HOSPITAL, INTERVIEWS, OTHER, SURVEYS, CHNA DOCUMENT CCHC CHNA REPORT_2017-2019.PDF IMPLEMENTATION STRATEGY IMPLEMENTATION STRATEGY DOCUMENT: NOT SPECIFIED KEY ACCOMPLISHMENTS OF REPORTING YEAR 1) CCHC COMMUNITY BENEFITS PROVIDED FINANCIAL AND SERVICE SUPPORT TO HEALTH AND HUMAN SERVICES ORGANIZATIONS AND HOSPITAL BASED PROGRAMS AND SERVICES THAT WERE ALIGNED WITH CHNA 17-19. WE ADDRESSED OUR OWN INSTITUTIONAL AND COMMUNITY WIDE SYSTEMS BARRIERS BY ADDING NEW FORMS OF EDUCATORS AND SUPPORTIVE CONNECTORS IN THE CONTINUUM OF CARE. EXAMPLES: ALZHEIMER'S SUPPORT GROUPS, RECOVERY COACHES, COMMUNITY NAVIGATORS, CHRONIC DISEASE OUTREACH, INTEGRATIVE THERAPIES AND TRANSPORTATION SOLUTIONS. 2) CCHC COMMUNITY BENEFITS EMPOWERED THE COMMUNITY THROUGH A COLLABORATIVE ENGAGEMENT PROCESS TO PRODUCE THE FY20-22 COMMUNITY HEALTH NEEDS ASSESSMENT, A GUIDING DOCUMENT FOR ALL OF CAPE COD. 3) CCHC COMMUNITY BENEFITS EXPANDED CROSS-SECTOR COMMUNITY PARTNERSHIPS AND LEADERSHIP WITHIN AND THROUGHOUT THE CAPE COD NON-PROFIT HEALTH AND HUMAN SERVICE SYSTEM. THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION PLAN SERVED AS THE FOUNDATION FOR CCHC'S FY19 COMMUNITY BENEFITS PROGRAM. CCHC'S COMMUNITY BENEFITS ACTIVITIES FOCUSED ON THE FOUR HEALTH PRIORITIES IDENTIFIED IN THE REPORT: CHRONIC AND INFECTIOUS DISEASE, BEHAVIORAL HEALTH, ACCESS TO CARE, AND DISEASE PREVENTION AND WELLNESS. NEW AND EXPANDED HOSPITAL PROGRAMS WERE DEVELOPED IN ALIGNMENT WITH IMPLEMENTATION GOALS, OBJECTIVES AND STRATEGIES FOR EACH PRIORITY. CCHC SUPPORTED PARTNERSHIPS WITH OVER 50 LOCAL NONPROFIT HEALTH AND HUMAN SERVICE ORGANIZATIONS, AND A NETWORK OF FEDERALLY QUALIFIED HEALTH CENTERS THROUGH PROJECT SUPPORT AND GRANT INVESTMENTS TO IMPROVE THE HEALTH OF BARNSTABLE COUNTY RESIDENTS. HOSPITAL STAFF DEDICATED TIME AND EXPERTISE TO STRATEGIC PARTNERSHIPS, COALITIONS, AND TASK FORCE EFFORTS LOCALLY, REGIONALLY, AND ACROSS MASSACHUSETTS.
CHRONIC AND INFECTIOUS DISEASE	PREVENTION, SCREENING, DETECTION, AND MANAGEMENT OF CHRONIC AND INFECTIOUS DISEASES WERE SUPPORTED THROUGH A VARIETY OF CCHC COMMUNITY BENEFITS ACTIVITIES. HOSPITAL CANCER SUPPORT SERVICES INCLUDING COUNSELING, SUPPORT GROUPS, AND SURVIVORSHIP ACTIVITIES FOR PATIENTS AND CAREGIVERS WERE COMPLIMENTED WITH A NEW ONCOLOGY NUTRITION PROGRAM. THE SUCCESSFUL LIVING FIT FOR YOU! CANCER WELLNESS PROGRAM PROVIDES FREE OF CHARGE REHABILITATION, WELLNESS CONSULTATIONS, EXERCISE, AND EDUCATION SERVICES TO HELP ADULTS UNDERGOING CANCER TREATMENT MANAGE FATIGUE, DE-CONDITIONING AND LOSS OF PHYSICAL FUNCTION. CCHC COMMUNITY BENEFITS ALSO PROVIDED GRANTS TO THE CAPE WELLNESS COLLABORATIVE AND YMCA CAPE COD LIVESTRONG PROGRAM TO ENSURE THAT PATIENTS UNDERGOING AND RECOVERING FROM CANCER TREATMENT HAD ACCESS TO COMMUNITY-BASED WELLNESS PROGRAMS AND COMPLEMENTARY SERVICES SUCH AS MASSAGE, ACUPUNCTURE, YOGA AND NUTRITIONAL COUNSELING. THE CCHC INTEGRATED CANCER COMMITTEE, COMPRISED OF PHYSICIANS, NURSES AND SUPPORT STAFF, CONDUCTED EDUCATIONAL CAMPAIGNS AND COMMUNITY OUTREACH EVENTS. THESE EVENTS INFORMED YOUTH ABOUT THE RISKS OF TOBACCO USE AND THE PUBLIC ABOUT SKIN CANCER PREVENTION, INCLUDING HIGH-RISK SCREENING OPPORTUNITIES. CCHC CLINICAL TEAMS PROVIDED DISEASE EDUCATION, REHABILITATION AND PATHWAYS TO CHRONIC DISEASE SELF- MANAGEMENT FOR INDIVIDUALS LIVING WITH CONGESTIVE HEART FAILURE, CHRONIC PULMONARY DISEASES, AND DIABETES. A COMMUNITY BENEFITS GRANT TO THE CAPE COD TIMES NEEDY FUND HELPED WITH BASIC NEEDS SUCH AS HOUSING AND UTILITY PAYMENTS, TRANSPORTATION, ADAPTIVE MEDICAL EQUIPMENT, AND CHILD CARE SPECIFICALLY FOR INDIVIDUALS MANAGING A CHRONIC DISEASE. A CCHC COMMUNITY BENEFITS GRANT SUPPORTED THE ALZHEIMER'S FAMILY CAREGIVER SUPPORT CENTER'S EXPANDING FREE COUNSELING FOR FAMILIES AND CAREGIVERS IN OUTPOSTS ACROSS THE OUTER, LOWER, MID, AND UPPER REGIONS OF CAPE COD. IN ADDITION, THE ORGANIZATION NOW HOSTS CONCURRENT WEEKLY SUPPORT GROUP MEETINGS FOR INDIVIDUALS WITH ALZHEIMER'S DISEASE AND THEIR CAREGIVERS AT CAPE COD HOSPITAL. THROUGH A PARTNERSHIP WITH THE UMASS LABORATORY OF MEDICAL ZOOLOGY, CCHC WAS THE ONLY HEALTHCARE SYSTEM IN MA TO SUBSIDIZE TICK TESTING FOR RESIDENTS WITHIN A HOSPITAL SERVICE AREA. CCHC ALSO PARTNERED WITH THE CAPE COD COOPERATIVE EXTENSION TO PRODUCE A 10-PART ONLINE VIDEO SERIES TITLED "TICKOLOGY" TO PROVIDE EASILY ACCESSIBLE COMMUNITY EDUCATION ON TICK DISEASE PREVENTION. CCHC INFECTIOUS DISEASE CLINICAL SERVICES IS THE RECIPIENT OF FEDERAL AND STATE RYAN WHITE GRANT FUNDING TO SUPPORT COMPREHENSIVE PRIMARY MEDICAL CARE AND MEDICAL CASE MANAGEMENT FOR INDIVIDUALS WITH HIV/AIDS LIVING IN BARNSTABLE COUNTY. CCHC, THROUGH PARTNERSHIPS WITH OTHER LOCAL ORGANIZATIONS, ALIGNED LOCAL EFFORTS TO MEET NATIONAL HIV/AIDS STRATEGY AND THE MASSACHUSETTS INTEGRATED HIV PREVENTION AND CARE PLAN TO REDUCE THE NUMBER OF NEW HIV INFECTIONS, INCREASE ACCESS TO CARE, IMPROVE HEALTH OUTCOMES FOR INDIVIDUALS LIVING WITH HIV/AIDS, AND REDUCE HIV-RELATED HEALTH INEQUITIES AND DISPARITIES. BEHAVIORAL HEALTH CCHC COMMUNITY BENEFITS EXPANDED HOSPITAL-BASED SERVICES AND COLLABORATIONS WITH LOCAL FEDERALLY QUALIFIED HEALTH CENTERS AND BEHAVIORAL HEALTH PROVIDERS TO STRENGTHEN REGIONAL SERVICES AND COMMUNITY RESOURCES FOR INDIVIDUALS WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERS. CCHC'S CENTERS FOR BEHAVIORAL HEALTH JOINED THE MA DEPARTMENT OF PUBLIC HEALTH AND MA DEPARTMENT OF MENTAL HEALTH ON THE ZERO SUICIDE INITIATIVE TO INCREASE SUICIDE PREVENTION AND REDUCE SUICIDE DEATHS ON CAPE COD. CCHC ALSO PROVIDES A COMMUNITY CRISIS LINE, STAFFED BY CLINICIANS, OFFERING FREE AND CONFIDENTIAL EMOTIONAL SUPPORT AND REFERRAL ASSISTANCE FOR INDIVIDUALS IN CRISIS AND THEIR FAMILIES. CCHC COMMUNITY BENEFITS FUNDED A COMMUNITY WIDE MENTAL HEALTH EDUCATION PROGRAM THROUGH NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) CAPE COD, TARGETING THE PORTUGUESE POPULATION. CCHC COMMUNITY BENEFITS PROVIDED GRANTS TO THREE FEDERALLY QUALIFIED HEALTH CENTERS ON CAPE COD. DUFFY HEALTH CENTER, HARBOR COMMUNITY HEALTH CENTER- HYANNIS, AND OUTER CAPE HEALTH SERVICES RECEIVED GRANTS SUPPORTING INTEGRATED BEHAVIORAL HEALTH SERVICES, ESTABLISHING AN OFFICE BASED ADDICTION TREATMENT PROGRAM AND CONTINUATION OF A COMMUNITY NAVIGATOR PROGRAM THAT ASSISTS INDIVIDUALS MOST AT RISK IN OUR REGION. THROUGH A PARTNERSHIP WITH, AND GRANT TO GOSNOLD, INC., CCHC COMMUNITY BENEFITS EXPANDED THE RECOVERY SPECIALIST PROGRAM IN THE EMERGENCY DEPARTMENTS AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL. THE PROGRAM PROVIDES PEER-LED RECOVERY ENGAGEMENT SERVICES FOR PATIENTS WITH SUBSTANCE USE DISORDERS. RECOVERY SPECIALISTS WORK AS PART OF THE EMERGENCY DEPARTMENTS' CARE TEAMS TO MOTIVATE PATIENTS TO ACCEPT TREATMENT UPON DISCHARGE FROM THE EMERGENCY DEPARTMENTS. ADDITIONAL FUNDING TO GOSNOLD, INC. PROVIDED RECOVERY COACHING SCHOLARSHIPS FOR 30 INDIVIDUALS WHO COMPLETED TREATMENT FOR THEIR SUBSTANCE USE DISORDER. RECOVERY COACHES ASSIST INDIVIDUALS WITH BUILDING RECOVERY SUPPORT SYSTEMS AND IMPROVING OUTCOMES RELATED TO EMPLOYMENT, HOUSING, LEGAL AND LIFE SKILLS. ACCESS TO CARE IN FY19, CCHC CONTINUED TO INVEST, SIGNIFICANTLY, IN EXPANDING ACCESS TO CARE FOR VULNERABLE AND MEDICALLY UNDERSERVED POPULATIONS IN BARNSTABLE COUNTY. CCHC COMMUNITY BENEFITS CONTINUED ITS GRANT SUPPORT OF THE SPECIALTY NETWORK FOR THE UNINSURED (SNU) PROGRAM IN BARNSTABLE COUNTY. THE SNU PROGRAM COORDINATES APPOINTMENTS AND FOLLOW-UP CARE WITH LOCAL MEDICAL SPECIALISTS FOR UNINSURED AND UNDER-INSURED PATIENTS IN OUR REGION, REDUCING BARRIERS TO LOCAL ACCESS AND ADDRESSING GAPS IN SPECIALTY SERVICES NOT OFFERED BY LOCAL COMMUNITY HEALTH CENTERS. THROUGH THE COMMUNITY BASED INTERPRETERS PROGRAM, CCHC COMMUNITY BENEFITS FUNDING PROVIDED FREE MEDICAL INTERPRETER SERVICES FOR LIMITED-ENGLISH SPEAKING PATIENTS IN COMMUNITY BASED PRIMARY AND SPECIALTY CARE OFFICES ACROSS THE REGION. IN PARTNERSHIP WITH THE CAPE AND ISLANDS EMERGENCY MEDICAL SERVICES SYSTEM, CCHC EXPANDED THE IMPACT OF MEDICAL INTERPRETER SERVICES TO PRE-HOSPITAL SETTINGS. CCHC PROVIDES TRAINING AND FUNDING FOR PHONE-BASED INTERPRETER SERVICES THAT CONNECT PARAMEDICS AND FIRST RESPONDERS TO INTERPRETERS VIA CELL PHONES IN AMBULANCES TO IMPROVE COMMUNICATION WITH LIMITED-ENGLISH SPEAKING PATIENTS DURING TRANSPORT TO A HOSPITAL. HOSPITAL SOCIAL WORKERS AND CASE MANAGERS ASSISTED LOW-INCOME AND VULNERABLE PATIENTS IN NEED THROUGH DIRECT REFERRALS TO COMMUNITY SERVICES, PRESCRIPTION PHARMACY ASSISTANCE, AND TRANSPORTATION VOUCHERS UPON DISCHARGE. FINANCIAL COUNSELORS AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL WERE AVAILABLE TO ALL BARNSTABLE COUNTY RESIDENTS TO ASSIST WITH HEALTH INSURANCE QUESTIONS AND NEEDS INCLUDING MASS HEALTH AND MEDICARE COVERAGE APPLICATIONS AND RENEWAL ASSISTANCE. CCHC HAS BEEN AT THE FOREFRONT OF ESTABLISHING STRATEGIC RELATIONSHIPS ENSURING A STRONG AND SKILLED FUTURE ALLIED HEALTH WORKFORCE IN OUR REGION. CAPE COD COMMUNITY COLLEGE AND CAPE COD HEALTHCARE NURSING EDUCATION COLLABORATIVE IS A PROGRAM THAT EXPANDS OPPORTUNITIES FOR EDUCATION, CLINICAL TRAINING, AND EMPLOYMENT, AS WELL AS RN STUDENT DEBT RELIEF AND CAREER EXPLORATION PATHWAYS FOR HIGH SCHOOL STUDENTS. IN SEVERAL CLINICAL DEPARTMENTS INCLUDING BEHAVIORAL HEALTH, RADIOLOGY, AND LABORATORY SERVICES ACROSS BOTH HOSPITALS, CLINICIANS PROVIDE SUPERVISION, TRAINING, AND JOB SHADOWING FOR STUDENTS FROM UMASS MEDICAL SCHOOL, REGIONAL COMMUNITY COLLEGES, AND LOCAL VOCATIONAL AND TECHNICAL SCHOOLS. DISEASE PREVENTION AND WELLNESS IN FY19, CAPE COD HEALTHCARE EFFORTS FOCUSED ON BUILDING PARTNERSHIPS AND SUPPORT FOR COMMUNITY-BASED PREVENTION AND WELLNESS INITIATIVES IMPACTING RESIDENTS ACROSS THE LIFESPAN FROM INFANTS TO SENIORS. CCHC COMMUNITY BENEFITS EXPANDED EFFORTS SUPPORTING NEW FAMILIES. EXPANDED EFFORTS INCLUDED PRENATAL AND PARENTING CLASSES IN ENGLISH AND PORTUGUESE, SUPPORT GROUPS FOR NEW MOTHERS, FATHERHOOD INITIATIVES, AND A BREASTFEEDING 'WARM LINE' THAT PROVIDED FAMILIES WITH PHONE SUPPORT FOR QUESTIONS RELATED TO BREASTFEEDING. CCHC ALSO PARTNERED WITH A LOCAL EARLY INTERVENTION PROGRAM TO PROVIDE PRE-DISCHARGE MEETINGS WITH EARLY INTERVENTION STAFF. EARLY INTERVENTION STAFF EDUCATED PARENTS ABOUT SERVICES AND SUPPORTS AVAILABLE TO INFANTS, YOUNG CHILDREN AND THEIR FAMILIES THROUGH THE PROGRAM. THROUGH A PARTNERSHIP WITH THE CAPE & ISLANDS UNITED WAY, CCHC COMMUNITY BENEFITS SUPPORTED THE STRONG FROM THE START INITIATIVE AIMED AT IMPROVING THE SOCIAL, EMOTIONAL AND DEVELOPMENTAL OUTCOMES FOR CHILDREN AGES 0-3 YEARS IN BARNSTABLE COUNTY. THE OBJECTIVES OF STRONG FROM THE START ARE TO STRENGTHEN FAMILIES, REDUCE ACHIEVEMENT AND WORD GAPS AND PROVIDE CHILDREN WITH THE SOCIAL, EMOTIONAL AND LANGUAGE SKILLS TO THRIVE IN SCHOOL AND IN LIFE.
CCHC COMMUNITY BENEFITS BUILT A COALITION OF MORE THAN 50	COMMUNITY ORGANIZATIONS TO SUPPORT THE QUALITY OF LIFE INITIATIVE. THE INITIATIVE PROVIDED GUEST SPEAKERS, MATERIALS AND HELPFUL TOOLS TO EDUCATE THE COMMUNITY ABOUT THE IMPORTANCE OF ADVANCE CARE PLANNING. IN ADDITION, CCHC COMMUNITY BENEFITS JOINED A COALITION OF MORE THAN 30 ORGANIZATIONS CALLED HEALTHY AGING CAPE COD. LED BY BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES, THE PURPOSE OF THE COALITION IS TO UNDERTAKE REGIONAL PLANNING THAT SUPPORTS OUR AGING DEMOGRAPHIC AND THEIR FAMILIES THROUGH CONVERSATIONS PROJECTS THAT ALIGN LOCAL EFFORTS WITH STATEWIDE EFFORTS TO BUILD AN AGE AND DEMENTIA-FRIENDLY MASSACHUSETTS. HEALTHY PARKS, HEALTHY PEOPLE, A PROGRAM SUPPORTED THROUGH A COLLABORATION BETWEEN CAPE COD HEALTHCARE, THE US NATIONAL PARK SERVICE, AND THE CAPE COD NATIONAL SEASHORE, CONTINUED WITH ITS FOCUS ON PROMOTING OPEN SPACE FOR PHYSICAL ACTIVITY AND WELLNESS. ACTIVITIES INCLUDED EDUCATIONAL EVENTS BY CCHC PHYSICIANS AND PHYSICAL THERAPISTS, A WALKING PROGRAM, AND A 5K WALK/RUN FOR RESIDENTS AND VISITORS OF CAPE COD. CCHC COMMUNITY BENEFITS GRANTS SUPPORTED ELDER SUICIDE PREVENTION TRAININGS THROUGH THE SAMARITANS OF CAPE COD, HPV VACCINATION AND CERVICAL CANCER EDUCATION FOR PROVIDERS, PARENTS AND YOUTH BY TEAM MAUREEN AND CHRONIC DISEASE AND MINDFULNESS PROGRAMS AT LOCAL FAMILY HOMELESS SHELTERS BY HOUSING ASSISTANCE CORPORATION ON CAPE COD. PLANS FOR NEXT REPORTING YEAR IN FY20, CCHC COMMUNITY BENEFITS WILL FOLLOW THE CHNA 20-22 GOALS AND STRATEGIC IMPLEMENTATION PLAN THE PRIORITY AREAS AND GOALS ARE STATED BELOW: 1. PHYSICAL HEALTH CONDITIONS - REDUCE AND PREVENT THE OCCURRENCE AND SEVERITY OF CHRONIC AND INFECTIOUS DISEASE IN BARNSTABLE COUNTY THROUGH COLLABORATIVE APPROACHES. 2. BEHAVIORAL HEALTH - BE A LEADING PARTNER IN PROVIDING COMPREHENSIVE REGIONAL HEALTH SERVICES AND COMMUNITY RESOURCES FOR INDIVIDUALS WITH MENTAL HEALTH CONDITIONS AND SUBSTANCE USE DISORDERS. 3. SOCIAL DETERMINANTS OF HEALTH: TRANSPORTATION - WORK WITH REGIONAL TRANSPORTATION SYSTEMS TO INCREASE ACCESS TO HEALTH CARE AND OTHER HEALTH RELATED SERVICES IN BARNSTABLE COUNTY. HOUSING - WORK WITH REGIONAL PARTNERS TO ENSURE THAT VULNERABLE POPULATIONS SHOW IMPROVED HEALTH INDICATORS THROUGH ACCESS TO STABLE AND QUALITY HOUSING. HEALTHCARE WORKFORCE DEVELOPMENT - WORK WITH REGIONAL PARTNERS TO INSURE OUR COMMUNITY IS SERVED BY A STRONG, ADEQUATE HEALTHCARE WORKFORCE. FOOD/NUTRITION - FOSTER REGIONAL PARTNERSHIPS TO DEVELOP A FOOD SECURITY ASSESSMENT PROCESS. WORKPLAN ELEMENTS INTENDED TO SUPPORT ACHIEVEMENT OF THESE GOALS ARE AS FOLLOWS: 1) THE COMMUNITY ENGAGEMENT FOCUS IS ON INVOLVEMENT, COLLABORATION AND EMPOWERMENT. INTENTIONAL MODELING AND USE OF COMMON LANGUAGE AND DEFINITIONS, HEALTH INDICATORS, SMART MEASURES, BEST PRACTICES AND LEARNING/KNOWLEDGE SHARING WORKSHOPS AND EVENTS WILL BE INCORPORATED IN THE COMMUNITY BENEFITS PROCESSES. 2) THE EXPANSION OF LEADERSHIP TEAM(S) AND INTERSECTIONS WILL FOSTER INTERSECTIONALITY OF TRADITIONAL AND NON-TRADITIONAL STAKEHOLDERS. THE EXISTING COMMUNITY HEALTH COMMITTEE (CBAC) TEAM WILL INCLUDE MUNICIPAL GOVERNMENT AND PUBLIC HEALTH AGENT FOR A TOWN ON CAPE COD. A NEW INTERNAL PROGRAM COMMITTEE WILL BE DEVELOPED TO CROSS-POLLINATE THOUGHT AND COLLECTIVE LEADERSHIP FROM CCHC MIDDLE MANAGEMENT AND THE COMMUNITY HEALTH INITIATIVE COUNSEL WILL BE ASSEMBLED TO FOCUS ON SOCIAL DETERMINANTS OF HEALTH AND INSURE ALIGNMENT AND INTERSECTION WITH COMMUNITY HEALTH INITIATIVE AS IT RELATES TO DETERMINATION OF NEED AND COMMUNITY ENGAGEMENT. COMMUNITY BENEFITS PROGRAMS ANNUAL STRATEGIC GRANTS PROGRAM: CHRONIC AND INFECTIOUS DISEASE AND PREVENTION PROGRAM TYPE: COMMUNITY-CLINICAL LINKAGES. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: COMMUNITY EDUCATION, HEALTH SCREENING, PREVENTION, SUPPORT GROUP EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES, HOUSING STABILITY/HOMELESSNESS, MENTAL ILLNESS AND MENTAL HEALTH, SUBSTANCE USE DISORDERS DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, HOUSING, SOCIAL ENVIRONMENT. HEALTH ISSUES: CANCER-BREAST, CANCER-CERVICAL, CANCER-COLORECTAL, CANCER-LUNG, CANCER-MULTIPLE MYELOMA, CANCER-OTHER, CANCER-OVARIAN, CANCER-PROSTATE, CANCER-SKIN, CHRONIC DISEASE-ALZHEIMER'S DISEASE, CHRONIC DISEASE-ARTHRITIS, CHRONIC DISEASE-CARDIAC DISEASE, CHRONIC DISEASE-DIABETES, CHRONIC DISEASE- HYPERTENSION, HEALTH BEHAVIORS/MENTAL HEALTH-MENTAL HEALTH, HEALTH BEHAVIORS/MENTAL HEALTH-RESPONSIBLE SEXUAL BEHAVIOR, INFECTIOUS DISEASE-HEPATITIS, INFECTIOUS DISEASE-LYME DISEASE, INJURY-AUTO/PASSENGER INJURIES, MATERNAL/CHILD HEALTH-CHILD CARE, MATERNAL/CHILD HEALTH-REPRODUCTIVE AND MATERNAL HEALTH, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTHY FOOD, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO TRANSPORTATION, SOCIAL DETERMINANTS OF HEALTH-AFFORDABLE HOUSING, SOCIAL DETERMINANTS OF HEALTH-EDUCATION/LEARNING, SOCIAL DETERMINANTS OF HEALTH- INCOME AND POVERTY, SOCIAL DETERMINANTS OF HEALTH-NUTRITION, SOCIAL DETERMINANTS OF HEALTH-PUBLIC SAFETY, SUBSTANCE ADDICTION-ALCOHOL USE, SUBSTANCE ADDICTION-OPIOID USE, SUBSTANCE ADDICTION-SUBSTANCE USE. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL, PORTUGUESE - ADDITIONAL TARGET POPULATION STATUS: DISABILITY STATUS, INCARCERATION HISTORY, LGBT STATUS. GOAL DESCRIPTION GRANT AWARDS TO LOCAL NON-PROFIT ORGANIZATIONS OPERATING QUALITY PROGRAMS WITH ANTICIPATED OUTCOMES ALIGNED WITH CAPE COD HOSPITAL AND FALMOUTH HOSPITAL IMPLEMENTATION STRATEGIES RELATED TO CHRONIC AND INFECTIOUS DISEASES AND PREVENTION AND WELLNESS. GOAL STATUS EXECUTION OF AWARDING GRANTS COMPLETED AS SCHEDULED. PARTNER NAME, DESCRIPTION AND WEB ADDRESS AIDS SUPPORT GROUP OF CAPE COD - PROVIDING HEPATITIS C EDUCATION AND TESTING OLDER CAPE COD RESIDENTS - WWW.ASGCC.ORG ALZHEIMER'S FAMILY CAREGIVER SUPPORT CENTER - FREE IN-HOME CARE CONSULTATIONS FOR FAMILIES LIVING WITH ALZHEIMER'S AND DEMENTIA DISEASE- WWW.ALZHEIMERSCAPECOD.ORG A BABY CENTER - BABY BOXES AND CAR SEATS FOR LOW INCOME FAMILIES- WWW.ABABYCENTER.ORG UMASS & CAPE COD EXTENSION - TICK TESTING- WWW.CAPECODEXTENSION.ORG CAPE COD TIMES NEEDY FUND - BASIC NEEDS SAFETY NET FOR INDIVIDUALS WITH CHRONIC AND INFECTIOUS DISEASES- WWW.NEEDYFUND.ORG HOUSING ASSISTANCE CORPORATION ON CAPE COD- WWW.HACONCAPECOD.ORG CAPE WELLNESS COLLABORATIVE - WELLNESS CARDS FOR INTEGRATIVE SERVICES- WWW.CAPEWELLNESS.ORG TEAM MAUREEN - HPV PREVENTION THROUGH CAPE - WIDE EDUCATION - YEAR 2- WWW.TEAMMAUREEN NATIONAL ALLIANCE ON MENTAL ILLNESS CAPE COD - MENTAL WELLNESS IN THE PORTUGUESE COMMUNITY- WWW.NAMICAPECOD SAMARITANS ON CAPE COD & THE ISLANDS - ELDER SUICIDE OUTREACH PREVENTION PROGRAM- WWW.CAPESAMARITANS.ORG YMCA CAPE COD - CHRONIC DISEASE PROGRAM COORDINATOR- WWW.YMCACAPECOD.ORG CAPE ABILITIES INC. - HEALTHY AGING INITIATIVE - WWW.CAPABILITIES.ORG CAPE COD CHILD DEVELOPMENT - FUN, FOOD AND FITNESS SCHOOL AGE PROGRAM - WWW.CCCDP.ORG BOSTON CANCER SUPPORT - TREATMENT TRANSPORT PROGRAM - WWW.BOSTONCANCERSUPPORT.ORG CAPE COD COMMERCIAL FISHERMAN'S ALLIANCE - FISH FOR FAMILIES - WWW.CAPECODFISHERMEN.ORG THE FAMILY PANTRY OF CAPE COD - HEALTHY MEALS IN MOTION - WWW.THEFAMILYPANTRY.COM BARNSTABLE COUNTY SHERIFF - EDUCATIONAL INTERVENTIONS FOR CORRECTIONS - WWW.BSHERIFF.NET HEALTH IMPERATIVES - IMPROVING ACCESS TO WIC NUTRITION SERVICES - WWW.HEALTHIMPERATIVES.ORG WELLSTRONG, INC - ARRIVING AND THRIVING AT WELLSTRONG IN RECOVERY - HTTP://WWW.WELLSTRONG.ORG/ CONTACT INFORMATION MARY PUMPHERY 297 NORTH STREET BUILDING 3, 3RD FLOOR HYANNIS, MA 02601 PHONE: 774-470-5506 DETAILED DESCRIPTION THE FY19 ANNUAL STRATEGIC GRANTS PROGRAM WAS A COMPETITIVE GRANT INITIATIVE WITH THE OBJECTIVE TO SUPPORT COMMUNITY-BASED CHRONIC AND INFECTIOUS DISEASE AND PREVENTION AND WELLNESS PROJECTS ALIGNED WITH TWO OF THE FOUR HEALTH PRIORITIES IDENTIFIED IN THE FY17 - FY19 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION PLAN. GRANTS WERE AWARDED TO ORGANIZATIONS WITH PROJECTS THAT REACHED VULNERABLE POPULATIONS, MAXIMIZED PARTNERSHIP COLLABORATION AND FEATURED EVIDENCE-BASED PROGRAMS OR PROMISING PRACTICES WITH THE OBJECTIVE TO IMPROVE THE HEALTH OF BARNSTABLE COUNTY RESIDENTS.
SUBSTANCE USE DISORDER PROGRAMS INCLUDING RECOVERY SPECIALIST	PROGRAM IN THE EMERGENCY DEPARTMENTS AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROGRAM TYPE: COMMUNITY-CLINICAL LINKAGES PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: COMMUNITY EDUCATION, COMMUNITY HEALTH CENTER PARTNERSHIP, HEALTH PROFESSIONAL/STAFF TRAINING, PREVENTION, SUPPORT GROUP EOHHS FOCUS ISSUE(S) (OPTIONAL): MENTAL ILLNESS AND MENTAL HEALTH, SUBSTANCE USE DISORDERS. DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION, SOCIAL ENVIRONMENT. HEALTH ISSUES: SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO TRANSPORTATION, SOCIAL DETERMINANTS OF HEALTH-EDUCATION/LEARNING, SUBSTANCE ADDICTION-ALCOHOL USE, SUBSTANCE ADDICTION-OPIOID USE, SUBSTANCE ADDICTION-SUBSTANCE USE. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL - GENDER: ALL - RACE/ETHNICITY: ALL - LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: DOMESTIC VIOLENCE HISTORY, INCARCERATION HISTORY, LGBT STATUS, REFUGEE/IMMIGRANT STATUS, VETERAN STATUS GOAL DESCRIPTION ENGAGE AND CONSULT WITH AT LEAST 250 PATIENTS WITH SUBSTANCE USE DISORDERS TREATED IN THE EMERGENCY DEPARTMENTS AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL. GOAL STATUS EXCEEDED GOAL GOAL DESCRIPTION MOTIVATE AND ASSIST 40% OF PATIENTS WHO RECEIVE A CONSULTATION FROM THE RECOVERY SPECIALIST TO ACCEPT A TRANSFER TO TREATMENT OR DIRECT REFERRAL TO TREATMENT PRIOR TO DISCHARGE FROM THE EMERGENCY DEPARTMENT. GOAL STATUS EXCEEDED GOAL GOAL DESCRIPTION OFFER POST-DISCHARGE FOLLOW-UP AND ASSISTANCE TO PATIENTS WITH SUBSTANCE USE DISORDERS WHO REFUSED SERVICES WHILE IN THE EMERGENCY DEPARTMENTS. GOAL STATUS UNDERWAY ALONG WITH EXTENDING SERVICE FOR INPATIENT GOAL DESCRIPTION RAISE AWARENESS: SUD IS PART OF MENTAL HEALTH AND MENTAL HEALTH ISSUES IN OUR BEHAVIORAL HEALTH PROGRAMS. GOAL STATUS ONGOING PARTNER NAME, DESCRIPTION AND WEB ADDRESS GOSNOLD, INC. - WWW.GOSNOLD.ORG BARNSTABLE COUNTY REGIONAL SUBSTANCE USE COUNCIL - WWW.BCHUMANSERVICES.NET/INITIATIVES/REGIONAL-SUBSTANCE-USE-COUNCIL/ OUTER CAPE HEALTH SERVICES - WWW.OUTERCAPE.ORG DUFFY HEALTH CENTER - WWW.DUFFYHEALTHCENTER.ORG COMMUNITY HEALTH CENTER OF CAPE COD - WWW.CHCOFCAPECOD.ORG HARBOR COMMUNITY HEALTH CENTER- HYANNIS - WWW.HHSI.US/LOCATIONS/HARBOR-COMMUNITY-HEALTH-CENTER-HYANNIS/ CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION - CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PARTNERED WITH GOSNOLD, INC. TO PROVIDE PEER-LED RECOVERY SPECIALIST SERVICES IN THE EMERGENCY DEPARTMENTS AT BOTH HOSPITALS. RECOVERY SPECIALISTS HAVE THE LIVED EXPERIENCE OF ADDICTION AND RECOVERY AND ENGAGE PATIENTS WITH SUBSTANCE USE DISORDERS PRIOR TO DISCHARGE FROM THE EMERGENCY DEPARTMENTS. RECOVERY SPECIALISTS WORK AS PART OF THE HOSPITAL CARE TEAM WITH THE OBJECTIVE TO MOTIVATE PATIENTS TO ACCEPT TREATMENT FOR SUBSTANCE USE DISORDERS THROUGH A TRANSFER TO AN INPATIENT TREATMENT PROGRAM OR DIRECT REFERRALS TO OUTPATIENT TREATMENT PROGRAMS. SPECIALTY NETWORK FOR THE UNINSURED AND SUPPORT TO FEDERALLY QUALIFIED HEALTH CENTERS PROGRAM TYPE: COMMUNITY-CLINICAL LINKAGES. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: COMMUNITY EDUCATION, COMMUNITY HEALTH CENTER PARTNERSHIP, PREVENTION. EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES, HOUSING STABILITY/HOMELESSNESS, MENTAL ILLNESS AND MENTAL HEALTH, SUBSTANCE USE DISORDERS. DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION, SOCIAL ENVIRONMENT. HEALTH ISSUES: OTHER-DENTAL HEALTH, OTHER-SENIOR HEALTH CHALLENGES/CARE COORDINATION, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE, SOCIAL DETERMINANTS OF HEALTH-HOMELESSNESS, SOCIAL DETERMINANTS OF HEALTH-UNINSURED/UNDERINSURED, SUBSTANCE ADDICTION-SUBSTANCE USE. TARGET POPULATION: REGIONS SERVED: NOT SPECIFIED - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: DISABILITY STATUS, DOMESTIC VIOLENCE HISTORY, INCARCERATION HISTORY, LGBT STATUS, REFUGEE/IMMIGRANT STATUS, VETERAN STATUS GOAL DESCRIPTION PROVIDE FUNDING SUPPORT TO THE FEDERALLY QUALIFIED HEALTH CENTERS PER PROPOSALS AND PRIORITIES SET BY EACH OF THE FOUR ENTITIES ON CAPE COD IN ALIGNMENT WITH CHNA 17-19. GOAL STATUS SUPPORT FOR COMMUNITY NAVIGATORS, BEHAVIORAL HEALTH AND DENTAL EXPANSION HAS BENEFITTED THE CONTINUUM OF CARE. PARTNER NAME, DESCRIPTION AND WEB ADDRESS HARBOR - JONES DENTAL - HTTPS://WWW.HHSI.US/LOCATIONS/HARBOR-COMMUNITY-HEALTHCENTER-HYANNIS/ DUFFY - NAVIGATORS AND BEHAVIORAL HEALTH - HTTPS://WWW.DUFFYHEALTHCENTER.ORG/ OUTERCAPE HEALTH SERVICES - COMMUNITY NAVIGATORS - HTTPS://OUTERCAPE.ORG/ CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION - CAPE COD HEALTHCARE COMMUNITY BENEFITS PROVIDES ANNUAL GRANT SUPPORT TO HARBOR COMMUNITY HEALTH CENTER - HYANNIS TO COORDINATE THE SPECIALTY NETWORK FOR THE UNINSURED (SNU). THE SNU PROGRAM INCREASES ACCESS TO SPECIALTY CARE FOR UNINSURED AND UNDER-INSURED RESIDENTS OF BARNSTABLE COUNTY THROUGH MANAGING A NETWORK OF MEDICAL SPECIALISTS WHO PROVIDE OFFICE VISITS, PROCEDURES AND CONTINUED CARE OF UNINSURED AND UNDER-INSURED INDIVIDUALS. CCHC CANCER SUPPORT SERVICES AND SURVIVORSHIP ACTIVITIES PROGRAM TYPE: COMMUNITY-CLINICAL LINKAGES. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: COMMUNITY EDUCATION, HEALTH SCREENING, PREVENTION, SUPPORT GROUP. EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES. DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION, SOCIAL ENVIRONMENT. HEALTH ISSUES: CANCER-BREAST, CANCER-CERVICAL, CANCER-COLORECTAL, CANCER-LUNG, CANCER-MULTIPLE MYELOMA, CANCER-OTHER, CANCER-OVARIAN, CANCER-PROSTATE, CANCER-SKIN, HEALTH BEHAVIORS/MENTAL HEALTH- DEPRESSION, OTHER-HOSPICE, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTHY FOOD, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO TRANSPORTATION, SOCIAL DETERMINANTS OF HEALTH-EDUCATION/LEARNING, SOCIAL DETERMINANTS OF HEALTH-NUTRITION, SOCIAL DETERMINANTS OF HEALTH-UNINSURED/UNDERINSURED. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED GOAL DESCRIPTION ONCOLOGY SOCIAL WORKERS WILL PROVIDE PSYCHOSOCIAL SUPPORT TO OVER 3,000 PATIENTS. TIMEFRAME: YEAR 1 OF 3 GOAL STATUS AN ESTIMATED 5000 PATIENTS WERE SERVICED. GOAL DESCRIPTION SUPPORT GROUPS WILL BE PROVIDED TO PATIENTS AND FAMILIES. TIMEFRAME: YEAR 3 OF 3 GOAL STATUS SUPPORT GROUPS WERE PROVIDED TO PATIENTS AND FAMILIES GOAL DESCRIPTION HOST A CANCER SURVIVORSHIP DAY EVENT TO CELEBRATE SURVIVORS, INSPIRE THOSE RECENTLY DIAGNOSED AND SUPPORT FAMILIES AND CAREGIVERS. TIMEFRAME: YEAR 3 OF 3 GOAL STATUS CANCER SURVIVORSHIP DAY WAS ATTENDED BY 160 SURVIVORS AND 95 GUESTS. GOAL DESCRIPTION THROUGH A GRANT FROM THE AMERICAN CANCER SOCIETY, CCHC WILL OFFER AN ONCOLOGY NUTRITION PROGRAM TO IMPROVE PATIENTS' QUALITY OF LIFE AND OUTCOMES. TIMEFRAME: YEAR 3 OF 3 GOAL STATUS DIETICIAN WAS PROVIDED THREE DAYS PER WEEK. PARTNER NAME, DESCRIPTION AND WEB ADDRESS AMERICAN CANCER SOCIETY - WWW.CANCER.ORG/ABOUT-US/LOCAL/MASSACHUSETTS.HTML YMCA CAPE COD LIVESTRONG - WWW.YMCACAPECOD.ORG/PROGRAMS/HEALTH-WELLBEING/LIVESTRONG/ CAPE WELLNESS COLLABORATIVE - WWW.CAPEWELLNESS.ORG/ VISITING NURSE ASSOCIATION OF CAPE COD - WWW.VNACAPECOD.ORG TEAM MAUREEN - WWW.TEAMMAUREEN.ORG BOSTON CANCER SUPPORT - WWW.BOSTONCANCERSUPPORT.ORG CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION - CCHC CANCER SUPPORT SERVICES PROVIDES ONCOLOGY PATIENTS AND THEIR FAMILIES' PSYCHOLOGICAL AND SOCIAL SUPPORT DURING THEIR TREATMENT JOURNEY. A TEAM OF ONCOLOGY SOCIAL WORKERS PROVIDE ONGOING COUNSELING AND SUPPORT GROUPS AND DIRECT REFERRALS TO SERVICES SUCH AS TRANSPORTATION, HOME CARE, AND COMMUNITY BASED WELLNESS SERVICES SUCH AS REIKI, ACUPUNCTURE AND MASSAGE. A NEW ONCOLOGY NUTRITION PROGRAM WAS STARTED IN FY18 AND CANCER SURVIVORSHIP IS CELEBRATED, SUPPORTED AND RECOGNIZED WITHIN HOSPITAL DEPARTMENTS AND IN THE COMMUNITY.
HEALTH EDUCATION AND SUPPORT SERVICES FOR WELLNESS AT CAPE COD	HOSPITAL AND FALMOUTH HOSPITAL PROGRAM TYPE: TOTAL POPULATION OR COMMUNITY-WIDE INTERVENTIONS. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: NO PROGRAM HASHTAGS: COMMUNITY EDUCATION, PREVENTION. EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES. DON HEALTH PRIORITIES (OPTIONAL): EDUCATION, SOCIAL ENVIRONMENT. HEALTH ISSUES: CHRONIC DISEASE-DIABETES, CHRONIC DISEASE-HYPERTENSION, CHRONIC DISEASE-OSTEOPOROSIS, CHRONIC DISEASE-OVERWEIGHT AND OBESITY, CHRONIC DISEASE-PULMONARY DISEASE, CHRONIC DISEASE-STROKE, HEALTH BEHAVIORS/MENTAL HEALTH-BEREAVEMENT, HEALTH BEHAVIORS/MENTAL HEALTH-STRESS MANAGEMENT, MATERNAL/CHILD HEALTH-CHILD CARE, MATERNAL/CHILD HEALTH-FAMILY PLANNING, MATERNAL/CHILD HEALTH-MENOPAUSE, MATERNAL/CHILD HEALTH-PARENTING SKILLS, MATERNAL/CHILD HEALTH-REPRODUCTIVE AND MATERNAL HEALTH, OTHER-SENIOR HEALTH CHALLENGES/CARE COORDINATION, SOCIAL DETERMINANTS OF HEALTH-EDUCATION/LEARNING. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED GOAL DESCRIPTION PROVIDE HEALTH EDUCATION AND SUPPORT ACTIVITIES FOR THE COMMUNITY ON A CONTINUUM OF ISSUES INCLUDING, BUT NOT LIMITED TO, CHRONIC DISEASE PREVENTION, SCREENING AND SELF-MANAGEMENT FOR CONDITIONS SUCH AS CANCER, HEART DISEASE, AND DIABETES, BREASTFEEDING AND PARENTING, BEHAVIORAL HEALTH, AND CULTURAL COMPETENCY IN CARE. TIMEFRAME: YEAR 3 OF 3 GOAL STATUS EDUCATION AND SUPPORT ACTIVITIES ARE ONGOING AND SUSTAINING AND UTILIZATION IS INCREASING. PARTNER NAME, DESCRIPTION AND WEB ADDRESS AMERICAN CANCER SOCIETY - WWW.CANCER.ORG VISITING NURSES ASSOCIATION OF CAPE COD - WWW.VNACAPECOD.ORG YMCA CAPE COD - WWW.YMCACAPECOD.ORG CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, HEALTH EDUCATION AND OUTREACH ACTIVITIES, CLASSES, SUPPORT GROUPS AND SERVICES TO INCREASE WELLNESS ARE OFFERED TO THE COMMUNITY ACROSS A FEW DIFFERENT HEALTH AREAS. FROM MATERNITY DEPARTMENT TOURS AND NEW PARENTING CLASSES, TO COMMUNITY-BASED DIABETES AND STROKE EDUCATION, FALL PREVENTION CLASSES, BEREAVEMENT SUPPORT GROUPS AND ADVANCE CARE PLANNING PRESENTATIONS, THE HOSPITALS DEDICATE CLINICAL STAFF AND RESOURCES TO SUPPORT THE WELLNESS OF BARNSTABLE COUNTY RESIDENTS. COMMUNITY-BASED INTERPRETER SERVICES PROGRAM TYPE: COMMUNITY-CLINICAL LINKAGES. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: PREVENTION. EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES, HOUSING STABILITY/HOMELESSNESS, MENTAL ILLNESS AND MENTAL HEALTH, SUBSTANCE USE DISORDERS,. DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, SOCIAL ENVIRONMENT. HEALTH ISSUES: CANCER-BREAST, CANCER-CERVICAL, CANCER-COLORECTAL, CANCER-LUNG, CANCER-MULTIPLE MYELOMA, CANCER-OTHER, CANCER-OVARIAN, CANCER-PROSTATE, CANCER-SKIN, CHRONIC DISEASE-ALZHEIMER'S DISEASE, CHRONIC DISEASE-ARTHRITIS, CHRONIC DISEASE-ASTHMA/ALLERGIES, CHRONIC DISEASE-CARDIAC DISEASE, CHRONIC DISEASE-CHRONIC PAIN, CHRONIC DISEASE-COLITIS/CROHN'S DISEASE, CHRONIC DISEASE-DIABETES, CHRONIC DISEASE-HYPERTENSION, CHRONIC DISEASE-OSTEOPOROSIS, CHRONIC DISEASE-OVERWEIGHT AND OBESITY, CHRONIC DISEASE-PULMONARY DISEASE, CHRONIC DISEASE-SICKLE CELL DISEASE, CHRONIC DISEASE-STROKE, HEALTH BEHAVIORS/MENTAL HEALTH-BEREAVEMENT, HEALTH BEHAVIORS/MENTAL HEALTH-DEPRESSION, HEALTH BEHAVIORS/MENTAL HEALTH-IMMUNIZATION, HEALTH BEHAVIORS/MENTAL HEALTH-MENTAL HEALTH, HEALTH BEHAVIORS/MENTAL HEALTH-PHYSICAL ACTIVITY, HEALTH BEHAVIORS/MENTAL HEALTH-RESPONSIBLE SEXUAL BEHAVIOR, HEALTH BEHAVIORS/MENTAL HEALTH-STRESS MANAGEMENT, INFECTIOUS DISEASE-HEPATITIS, INFECTIOUS DISEASE-HIV/AIDS, INFECTIOUS DISEASE-LYME DISEASE, INFECTIOUS DISEASE-SEXUALLY TRANSMITTED DISEASES, INFECTIOUS DISEASE-TUBERCULOSIS, INJURY-AUTO/PASSENGER INJURIES, INJURY-FIRST AID/ACLS/CPR, INJURY-HOME INJURIES, INJURY-OTHER, INJURY-SPORTS INJURIES, MATERNAL/CHILD HEALTH-CHILD CARE, MATERNAL/CHILD HEALTH-FAMILY PLANNING, MATERNAL/CHILD HEALTH-MENOPAUSE, MATERNAL/CHILD HEALTH-PARENTING SKILLS, MATERNAL/CHILD HEALTH-REPRODUCTIVE AND MATERNAL HEALTH, OTHER-CULTURAL COMPETENCY, OTHER-DENTAL HEALTH, OTHER-EMERGENCY PREPAREDNESS, OTHER-HEARING, OTHER-HOSPICE, OTHER-SENIOR HEALTH CHALLENGES/CARE COORDINATION, OTHER-VISION, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTHY FOOD, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO TRANSPORTATION, SOCIAL DETERMINANTS OF HEALTH-AFFORDABLE HOUSING, SOCIAL DETERMINANTS OF HEALTH-DOMESTIC VIOLENCE, SOCIAL DETERMINANTS OF HEALTH- EDUCATION/LEARNING, SOCIAL DETERMINANTS OF HEALTH-ENVIRONMENTAL QUALITY, SOCIAL DETERMINANTS OF HEALTH-HOMELESSNESS, SOCIAL DETERMINANTS OF HEALTH-INCOME AND POVERTY, SOCIAL DETERMINANTS OF HEALTH-LANGUAGE/LITERACY, SOCIAL DETERMINANTS OF HEALTH-NUTRITION, SOCIAL DETERMINANTS OF HEALTH-PUBLIC SAFETY, SOCIAL DETERMINANTS OF HEALTH-RACISM AND DISCRIMINATION, SOCIAL DETERMINANTS OF HEALTH-UNINSURED/UNDERINSURED, SOCIAL DETERMINANTS OF HEALTH-VIOLENCE AND TRAUMA, SUBSTANCE ADDICTION-ALCOHOL USE, SUBSTANCE ADDICTION-DRIVING UNDER THE INFLUENCE, SUBSTANCE ADDICTION-OPIOID USE, SUBSTANCE ADDICTION-SMOKING/TOBACCO USE, SUBSTANCE ADDICTION-SUBSTANCE USE. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: DISABILITY STATUS, DOMESTIC VIOLENCE HISTORY, INCARCERATION HISTORY, LGBT STATUS, REFUGEE/IMMIGRANT STATUS, VETERAN STATUS. GOAL DESCRIPTION ASSIST MORE THAN 800 INDIVIDUALS WITH FREE MEDICAL INTERPRETERS IN COMMUNITY-BASED PRIMARY CARE AND SPECIALTY CARE SETTINGS. GOAL STATUS 984 ASSISTED. GOAL DESCRIPTION ANALYZE PROGRAM UTILIZATION DATA TO ASSESS REGIONAL MEDICAL INTERPRETATION NEEDS FOR PROGRAM EVALUATION. GOAL STATUS COMPLETED. PARTNER NAME, DESCRIPTION AND WEB ADDRESS COMMUNITY BASED MEDICAL OFFICES ON CAPE COD VARIOUS HARBOR COMMUNITY HEALTH CENTER HYANNIS - WWW.HHSI.US/CAPE-COD/HARBOR-COMMUNITY-HEALTH-CENTERHYANNIS/ COMMUNITY BASED MEDICAL OFFICES ON CAPE COD VARIOUS HARBOR COMMUNITY HEALTH CENTER HYANNIS - WWW.HHSI.US/CAPE-COD/HARBOR-COMMUNITY-HEALTH-CENTERHYANNIS/ CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION CCHC PROVIDES FREE MEDICAL LANGUAGE INTERPRETERS TO COMMUNITY BASED PHYSICIAN OFFICES TO ASSIST LIMITED AND NON-ENGLISH SPEAKING PATIENTS AND THEIR FAMILIES. THE AVAILABILITY OF PROFICIENT AND PROFESSIONAL INTERPRETER SERVICES ENSURES THE DELIVERY OF SAFE, QUALITY HEALTH CARE AND POSITIVE CLINICAL OUTCOMES. HEALTHY PARKS, HEALTHY PEOPLE: A COLLABORATION BETWEEN CAPE COD HEALTHCARE AND THE CAPE COD NATIONAL SEASHORE PROGRAM TYPE: TOTAL POPULATION OR COMMUNITY-WIDE INTERVENTIONS. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: COMMUNITY EDUCATION, PREVENTION. EOHHS FOCUS ISSUE(S) (OPTIONAL): N/A. DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION, SOCIAL ENVIRONMENT. HEALTH ISSUES: CHRONIC DISEASE-CARDIAC DISEASE, CHRONIC DISEASE-DIABETES, CHRONIC DISEASE-HYPERTENSION, CHRONIC DISEASE-OSTEOPOROSIS, CHRONIC DISEASE-OVERWEIGHT AND OBESITY, HEALTH BEHAVIORS/MENTAL HEALTH-DEPRESSION, HEALTH BEHAVIORS/MENTAL HEALTH-PHYSICAL ACTIVITY, HEALTH BEHAVIORS/MENTAL HEALTH-STRESS MANAGEMENT, SOCIAL DETERMINANTS OF HEALTH-EDUCATION/LEARNING,. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED GOAL DESCRIPTION INCREASE THE NUMBER OF RESIDENTS PARTICIPATING IN THE HEALTH PARKS, HEALTHY PEOPLE SEASONAL WALKING PROGRAM AND 5K RUN/WALK AIMED AT IMPROVING HEALTH KNOWLEDGE AND AWARENESS OF FREE AND OPEN SPACES FOR PHYSICAL ACTIVITY. GOAL STATUS INCREASED PARTICIPATION BY 15 PEOPLE. PARTNER NAME, DESCRIPTION AND WEB ADDRESS NOT SPECIFIED NOT SPECIFIED CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION CAPE COD HEALTHCARE COLLABORATED WITH THE CAPE COD NATIONAL SEASHORE AND THE NATIONAL PARK SERVICES TO PROMOTE COMMUNITY OPEN SPACE FOR WELLNESS, EXERCISE AND PHYSICAL ACTIVITY TO IMPROVE THE HEALTH OF CAPE COD RESIDENTS AND VISITORS.
PRESCRIPTION ASSISTANCE PROGRAM FOR VULNERABLE POPULATIONS:	CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROGRAM TYPE: COMMUNITY-CLINICAL LINKAGES. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: NO PROGRAM HASHTAGS: NOT SPECIFIED. EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES. DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT. HEALTH ISSUES: SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: DISABILITY STATUS. GOAL DESCRIPTION ASSIST RESIDENTS WHO ARE UNABLE TO AFFORD MEDICATIONS TO ENSURE COMPLIANCE WITH HOSPITAL DISCHARGE PLANNING. GOAL STATUS ONGOING ASSISTANCE OCCURS THROUGH PHARMACIES AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL. PARTNER NAME, DESCRIPTION AND WEB ADDRESS CAPE COD HOSPITAL - WWW.CAPECODHEALTH.ORG FALMOUTH HOSPITAL - WWW.CAPECODHEALTH.ORG CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION - THE PRESCRIPTION ASSISTANCE PROGRAM IS AN INITIATIVE OF CAPE COD HOSPITAL AND FALMOUTH HOSPITAL EMERGENCY, BEHAVIORAL HEALTH AND PHARMACY DEPARTMENTS AS A COMMUNITY BENEFIT ASSISTING UNINSURED, UNDER-INSURED AND FINANCIALLY DISADVANTAGED PATIENTS WITH NO OTHER VIABLE MEANS TO PAY FOR MEDICATIONS UPON DISCHARGE FROM HOSPITAL FACILITIES. BARNSTABLE COUNTY TICK DISEASE TESTING AND EDUCATION PROJECT PROGRAM TYPE: TOTAL POPULATION OR COMMUNITY-WIDE INTERVENTIONS. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: COMMUNITY EDUCATION, HEALTH SCREENING, PREVENTION. EOHHS FOCUS ISSUE(S) (OPTIONAL): N/A. DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION. HEALTH ISSUES: INFECTIOUS DISEASE-LYME DISEASE. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED. GOAL DESCRIPTION PROVIDE UP TO 1,500 SUBSIDIZED TICK TESTS FOR BARNSTABLE COUNTY RESIDENTS. TESTING TO INCLUDE: IDENTIFICATION OF TICK SPECIES AND LIFE STAGE, HIGH RESOLUTION MICROGRAPHS OF TICK, ASSESSMENT OF FEEDING STATUS, AND SECURE PRIVATE DELIVERY OF PATHOGEN TESTING RESULTS. TIMEFRAME: YEAR 3 OF 3. GOAL STATUS ACTUAL TICK TESTS 1,112. GOAL DESCRIPTION PROVIDE COUNTY-WIDE SURVEILLANCE DATA FOR USE BY MEDICAL PROVIDERS AND PUBLIC HEALTH OFFICIALS. THE DETECTION OF ONE OR MORE PATHOGENS IN TICKS WILL BE REPORTED. TIMEFRAME: YEAR 3 OF 3. GOAL STATUS PROVIDED. GOAL DESCRIPTION THE CAPE COD EXTENSION WILL DEVELOP, PRODUCE AND RELEASE AN ONLINE SERIES OF TICK DISEASE EDUCATION AND PREVENTION VIDEOS FOR THE PUBLIC FEATURING A LOCAL EPIDEMIOLOGIST. THE ONLINE VIDEOS WILL BE PROMOTED ACROSS THE COUNTY VIA PUBLIC LOCATIONS INCLUDING SCHOOLS, LIBRARIES, COUNCILS ON AGING AND OTHER CIVIC GATHERING LOCATIONS. TIMEFRAME: YEAR 3 OF 3. GOAL STATUS OUTREACH EDUCATION COMPLETED AS DESCRIBED. PARTNER NAME, DESCRIPTION AND WEB ADDRESS CAPE COD COOPERATIVE EXTENSION - WWW.CAPECODEXTENSION.ORG UMASS LABORATORY OF MEDICAL ZOOLOGY - WWW.TICKDISEASES.ORG CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION - CCHC COMMUNITY BENEFITS PROVIDED GRANT FUNDING TO SUBSIDIZE A TICK-BORNE PATHOGEN TESTING PROGRAM AND EXPANDED TICK-BORNE DISEASE PREVENTION EDUCATION FOR RESIDENTS OF BARNSTABLE COUNTY. TICK-TESTING AND REPORTING WAS CONDUCTED BY THE UMASS LABORATORY OF MEDICAL ZOOLOGY. THE CAPE COD COOPERATIVE EXTENSION DEVELOPED, PRODUCED AND RELEASED TO THE PUBLIC A 10-PART ONLINE VIDEO SERIES TITLED "TICKOLOGY" PROVIDING EASILY ACCESSIBLE COMMUNITY EDUCATION ON TICK DISEASE PREVENTION BY LOCAL EPIDEMIOLOGISTS. TRANSPORTATION ASSISTANCE PROGRAM FOR VULNERABLE POPULATIONS: CAPE COD HOSPITAL AND FALMOUTH HOSPITAL (SDOH) PROGRAM TYPE: COMMUNITY-CLINICAL LINKAGES. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: COMMUNITY EDUCATION, HEALTH SCREENING, PREVENTION. EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES, HOUSING STABILITY/HOMELESSNESS, MENTAL ILLNESS AND MENTAL HEALTH, SUBSTANCE USE DISORDERS, DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION. HEALTH ISSUES: CANCER-BREAST, CANCER-CERVICAL, CANCER-COLORECTAL, CANCER-LUNG, CANCER-MULTIPLE MYELOMA, CANCER-OTHER, CANCER-OVARIAN, CANCER-PROSTATE, CANCER-SKIN, CHRONIC DISEASE-ALZHEIMER'S DISEASE, CHRONIC DISEASE-ARTHRITIS, CHRONIC DISEASE-ASTHMA/ALLERGIES, CHRONIC DISEASE-CARDIAC DISEASE, CHRONIC DISEASE-CHRONIC PAIN, CHRONIC DISEASE-COLITIS/CROHN'S DISEASE, CHRONIC DISEASE-DIABETES, CHRONIC DISEASE-HYPERTENSION, CHRONIC DISEASE-OSTEOPOROSIS, CHRONIC DISEASE-OVERWEIGHT AND OBESITY, CHRONIC DISEASE-PULMONARY DISEASE, CHRONIC DISEASE-STROKE, HEALTH BEHAVIORS/MENTAL HEALTH-DEPRESSION, HEALTH BEHAVIORS/MENTAL HEALTH-MENTAL HEALTH, OTHER-SENIOR HEALTH CHALLENGES/CARE COORDINATION, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO TRANSPORTATION, SUBSTANCE ADDICTION-ALCOHOL USE, SUBSTANCE ADDICTION-DRIVING UNDER THE INFLUENCE, SUBSTANCE ADDICTION-OPIOID USE, SUBSTANCE ADDICTION-SUBSTANCE USE TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: DISABILITY STATUS, DOMESTIC VIOLENCE HISTORY, INCARCERATION HISTORY, LGBT STATUS, REFUGEE/IMMIGRANT STATUS, VETERAN STATUS. GOAL DESCRIPTION ASSIST RESIDENTS WHO ARE UNABLE TO AFFORD OR ACCESS TRANSPORTATION TO ENSURE COMPLIANCE WITH THEIR DISCHARGE PLAN. TIMEFRAME: YEAR 1 OF 1. GOAL STATUS ACUITY/LYFT UTILIZED AT BOTH HOSPITALS IN ADDITION TO LOCAL TAXI VOUCHER SYSTEM. PARTNER NAME, DESCRIPTION AND WEB ADDRESS LOCAL TAXI COMPANIES - N/A ACUITY/LYFT - SCHEDULING & TRANSPORTATION - HTTPS://WWW.ACUITY-LINK.NET/PARTNERSHIP-LYFT-ACUITY-LINKNOW-OFFERS-FULL-SU ITE-MEDICAL-TRANSPORTATION-OPTIONSHEALTHCARE-PROVIDERS CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION - IN AN EFFORT TO ASSIST LOW-INCOME AND VULNERABLE POPULATIONS, CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROVIDED ACCESS TO TRANSPORTATION UPON DISCHARGE FROM EMERGENCY AND BEHAVIORAL HEALTH DEPARTMENTS, TO THOSE PATIENTS WITHOUT RESOURCES FOR TRANSPORTATION.
WORKFORCE AND CAREER DEVELOPMENT INITIATIVES:	CAPE COD HEALTHCARE (SDOH) PROGRAM TYPE: INFRASTRUCTURE TO SUPPORT CB COLLABORATION. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: COMMUNITY EDUCATION, HEALTH PROFESSIONAL/STAFF TRAINING, MENTORSHIP/CAREER TRAINING/INTERNSHIP EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES, HOUSING STABILITY/HOMELESSNESS, MENTAL ILLNESS AND MENTAL HEALTH, SUBSTANCE USE DISORDERS. DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION, EMPLOYMENT, SOCIAL ENVIRONMENT. HEALTH ISSUES: SOCIAL DETERMINANTS OF HEALTH-EDUCATION/LEARNING. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: DISABILITY STATUS, LGBT STATUS, REFUGEE/IMMIGRANT STATUS, VETERAN STATUS. GOAL DESCRIPTION CCHC STAFF IN VARIOUS DEPARTMENTS WILL PROVIDE CLINICAL OVERSIGHT AND SUPERVISION TO STUDENTS ENGAGED IN ALLIED HEALTH PROGRAMS AND VARIOUS JOB-TRAINING INITIATIVES IN THE REGION. TIMEFRAME: YEAR 2 OF 3. GOAL STATUS WORKFORCE SHORTAGE HAS LIMITED EXPANSION OF STUDENT SUPERVISION. PARTNER NAME, DESCRIPTION AND WEB ADDRESS BARNSTABLE HIGH SCHOOL - WWW.BARNSTABLE.K12.MA.US CAPE COD COMMUNITY COLLEGE - WWW.CAPECOD.EDU/ CAPE COD REGIONAL TECHNICAL HIGH SCHOOL - WWW.CAPETECH.US MA COLLEGE OF PHARMACY AND HEALTH SCIENCES - WWW.MCPHS.EDU THE RIVERVIEW SCHOOL - WWW.RIVERVIEWSCHOOL.ORG UNIVERSITY OF MASSACHUSETTS - WWW.MASSACHUSETTS.EDU/ UPPER CAPE REGIONAL TECHNICAL SCHOOL - WWW.UPPERCAPETECH.COM/ CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION - CCHC INVESTS IN PARTNERSHIPS WITH LOCAL HIGH SCHOOLS, VOCATIONAL SCHOOLS, COMMUNITY COLLEGES, AND ALLIED HEALTH PROGRAMS FOR JOB TRAINING AND SHADOWING AND INTERNSHIPS WITH HEALTH CARE PROVIDERS IN VARIOUS HOSPITAL DEPARTMENTS INCLUDING, BUT NOT LIMITED TO, PHLEBOTOMY, RADIOLOGY, BEHAVIORAL HEALTH, AND MATERIALS MANAGEMENT. OUR EFFORTS CONTRIBUTED TO REGIONAL ECONOMIC DEVELOPMENT EFFORTS TO INCREASE OPPORTUNITY FOR EDUCATIONAL ATTAINMENT AND PROVIDE EXPERIENCE FOR INDIVIDUALS TO OBTAIN STABLE, QUALITY, AND WELL-COMPENSATED JOBS IN OUR REGION. FOOD: FISH FOR FAMILIES (SDOH) PROGRAM TYPE: TOTAL POPULATION OR COMMUNITY-WIDE INTERVENTIONS. PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES PROGRAM HASHTAGS: COMMUNITY EDUCATION, HEALTH SCREENING, PREVENTION. EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES. DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION, SOCIAL ENVIRONMENT. HEALTH ISSUES: SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTHY FOOD, SOCIAL DETERMINANTS OF HEALTH-INCOME AND POVERTY, SOCIAL DETERMINANTS OF HEALTH-NUTRITION. TARGET POPULATION: REGIONS SERVED: BARNSTABLE, BOURNE, BREWSTER, CHATHAM, DENNIS, EASTHAM, FALMOUTH, HARWICH, MASHPEE, ORLEANS, PROVINCETOWN, SANDWICH, TRURO, WELLFLEET, YARMOUTH, ENVIRONMENTS SERVED: ALL GENDER: ALL - AGE GROUP: ALL, ELDERLY - RACE/ETHNICITY: ALL LANGUAGE: ALL, PORTUGUESE, SPANISH - ADDITIONAL TARGET POPULATION STATUS: DISABILITY STATUS, DOMESTIC VIOLENCE HISTORY, INCARCERATION HISTORY, LGBT STATUS, REFUGEE/IMMIGRANT STATUS, VETERAN STATUS. GOAL DESCRIPTION EXPAND THE FISH FOR FAMILIES OFFERINGS THROUGH FOUR DISTRIBUTIONS WITH THE CAPE COD HUNGER NETWORK AND THE FAMILY, PANTRY OF CAPE COD. TARGET IS FOUR DISTRIBUTION SITES. TIMEFRAME: YEAR 1 OF 1. GOAL STATUS ACHIEVED. GOAL DESCRIPTION PROVIDE AT LEAST 8000 POUNDS OF SEAFOOD AT NO COST TO ELDERLY AND ECONOMICALLY CHALLENGED CAPE COD RESIDENTS. TIMEFRAME: YEAR 1 OF 1. GOAL STATUS EXCEEDED. ACTUAL: 8720 POUNDS. GOAL DESCRIPTION CREATE CONNECTIONS BETWEEN FISHING COMMUNITY AND HUNGER NETWORK COMMUNITY; INCREASING SUPPORT FOR LOCAL SEAFOOD. TIMEFRAME: YEAR 1 OF 1. GOAL STATUS ACHIEVED. PARTNER NAME, DESCRIPTION AND WEB ADDRESS CAPE COD COMMERCIAL FISHERMAN'S ALLIANCE - HTTPS://CAPECODFISHERMEN.ORG/ THE FAMILY PANTRY OF CAPE COD - THE FAMILY PANTRY OF CAPE COD IS A NON-PROFIT, NONDENOMINATIONAL ACTIVITY DEDICATED TO SERVING THE NEEDS OF THE LESS FORTUNATE OF CAPE COD - HTTPS://WWW.THEFAMILYPANTRY.COM/ABOUT-US THE CAPE COD HUNGER NETWORK - HTTP://WWW.CAPECODHUNGERNETWORK.ORG/ CAPE COD COUNCILS ON AGING SERVING TOGETHER - COAST COUNCILS ON AGING DIRECTORS COUNCIL DEDICATED TO REGIONAL AND LOCAL SOLUTIONS - HTTPS://WWW.FACEBOOK.COM/CAPECODCOAST CONTACT INFORMATION: MARY PUMPHERY CAPE COD HEALTHCARE 297 NORTH STREET, BUILDING 3, 3RD FLOOR HYANNIS, MA, 02601 PHONE: 774-470-5506 PROGRAM DESCRIPTION - FISHERMEN PROVIDE FISH TO FLASH FREEZE FOR FOOD PANTRY DISTRIBUTION.
FUNCTIONAL EXPENSE NOTE	FORM 990, PART I AND PART IX FUNDRAISING IS CONDUCTED ON BEHALF OF CAPE COD HEALTHCARE, INC. BY CAPE COD HEALTHCARE FOUNDATION, INC. CERTAIN OFFICERS ARE COMPENSATED BY CAPE COD HEATHCARE, INC. FUNDS RAISED ARE REPORTED AT CAPE COD HEALTHCARE, INC. AND AFFILIATES.
FORM 990, PART I, LINE 6	CAPE COD HEALTHCARE, INC.'S VOLUNTEERS INCLUDE ITS TRUSTEES.
FORM 990, PART VI, LINE 2	TRUSTEES AND OFFICERS SIT ON THE BOARDS OF THE FOLLOWING: CAPE HEALTH INSURANCE COMPANY: MICHAEL K LAUF MICHAEL L CONNORS MICHAEL G JONES BRUCE JOHNSTON ROBERT M BIRMINGHAM ACHILLES PAPAVASILIOU, MD THE MEMBERS OF CAPE COD HEALTHCARE, INC.'S BOARD ALSO SIT ON THE BOARD OF CAPE COD MEDICAL OFFICE BUILDING AND EMERALD PHYSICIAN SERVICES, LLC (THROUGH MAY 1, 2019), FOR-PROFIT RELATED ORGANIZATIONS. FOR-PROFIT RELATED ORGANIZATIONS.
FORM 990, PART VI, LINES 6 & 7(A)	THE ORGANIZATION HAS MEMBERS/INCORPORATORS WHO ELECT THE ORGANIZATION'S TRUSTEES.
FORM 990, PART VI, LINE 7(B)	THE DECISIONS OF THE GOVERNING BODY THAT NEED APPROVAL BY ITS MEMBERS/INCORPORATORS INCLUDE APPROVAL OF CHANGES MADE TO THE CORPORATION'S BYLAWS AND APPROVAL WHEN THERE IS A DIVESTING OF ONE OF THE MAJOR AFFILIATES OF THE ORGANIZATION.
FORM 990, PART VI, LINE 11B	THE ORGANIZATION'S FORM 990 IS REVIEWED AT SEVERAL LEVELS. THE ORGANIZATION ENGAGES A PUBLIC ACCOUNTING FIRM TO ASSIST IN THE PREPARATION AND REVIEW OF ITS FORM 990 AND WHO SIGNS AS PAID PREPARER. SENIOR MANAGEMENT OF THE ORGANIZATION IS RESPONSIBLE FOR THE TIMELY PREPARATION OF FORM 990. THE COMPLETED FORM 990, WITH THE EXCEPTION OF AN ANONYMOUS DONOR, IS PROVIDED TO THE FINANCE COMMITTEE AND THE ENTIRE BOARD IN ADVANCE OF THE FILING DEADLINE.
FORM 990, PART VI, LINE 12	THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY AND REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THIS POLICY. ON AN ANNUAL BASIS, EACH TRUSTEE, OFFICER AND EMPLOYEE AT THE SENIOR MANAGEMENT LEVEL COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM. THE FORMS ARE REVIEWED BY CAPE COD HEALTHCARE, INC.'S ("CCHC") DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE WHO PREPARES A SUMMARY FOR CCHC'S COMPLIANCE OFFICER. ANY MATERIAL INTERESTS SO DISCLOSED ARE PRESENTED TO THE CORPORATION'S GOVERNANCE COMMITTEE FOR REVIEW AND RESOLUTION. ALL DISCLOSURE STATEMENTS SUBMITTED BY EMPLOYEES WILL BE REVIEWED BY HUMAN RESOURCES AND/OR CCHC'S DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE. FOR ANY DISCLOSURE THAT IS CONSIDERED SUBSTANTIVE THE EMPLOYEE'S AREA MANAGER WILL BE CONSULTED TO DETERMINE IF THE SITUATION IS GENERALLY ACCEPTABLE, REQUIRES FURTHER EXAMINATION AND POSSIBLE ACTION OR IS GENERALLY NOT ACCEPTABLE. ANY ACTION PLAN CREATED TO MANAGE A CONFLICT OF INTEREST WILL BE MONITORED BY THE EMPLOYEE'S AREA MANAGER OR SUPERVISOR.
FORM 990, PART VI, LINE 15	THE ANNUAL PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, OFFICERS, EXECUTIVES AND KEY EMPLOYEES INCLUDE THE FOLLOWING: CEO - COMPENSATION WILL BE DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, AND WILL INCLUDE CONSIDERATION OF RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. OFFICERS, EXECUTIVES AND KEY EMPLOYEES - OFFICER, EXECUTIVE AND KEY EMPLOYEE COMPENSATION WILL BE DETERMINED BY THE CEO AND WILL INCLUDE CONSIDERATION OF RECENT RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. THE CEO'S DETERMINATION OF SUCH COMPENSATION WILL BE SUBJECT TO THE APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED IN THE MEETING MINUTES.
FORM 990, PART VI, LINE 19	THE ORGANIZATION MAKES ITS BYLAWS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THE ANNUALLY FILED FORM PC, A PUBLICLY DISCLOSED TAX-EXEMPT ORGANIZATION FILING FOR THE STATE OF MASSACHUSETTS. FORM 990, PART VII, SECTION A TITLE FOR REBECCA FRANCE: VP PATIENT FINANCIAL SERVICES & REVENUE CYCLE (UNTIL 6/12/18)
FORM 990, PART VII, COLUMN (B)	THE INDIVIDUALS REPORTED AS RECEIVING COMPENSATION FROM A RELATED ORGANIZATION IN COLUMNS (E) AND (F) IN PART VII ARE EMPLOYEES AT CAPE COD HEALTHCARE, INC., A TAX-EXEMPT RELATED ORGANIZATION.
FORM 990, PART VII, SECTION B	WITH THE EXCEPTION OF REPORTING FOR VISITING NURSE ASSOCIATION OF CAPE COD, INC, CAPE COD HEALTHCARE, INC. PAYS INDEPENDENT CONTRACTORS ON BEHALF OF ITS AFFILIATES WHO FILE AS PART OF A GROUP FORM 990 AS CAPE COD HEALTHCARE, INC. AND AFFILIATES.
FORM 990, PART XI, LINE 9	Net assets released from restriction: (6,148,283) Transfer to/from affiliates: (6,294,714) Change in value of split interest agreement: (27,045) Change in value beneficial interest: (399,866) Other changes to net assets: (2,269,418) Contributions Elimination: 9,130,467

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:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	5,761
6	Total number of volunteers (estimate if necessary) .............	6	720
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	54,342
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-986,182

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	15,447,109	18,471,535
9	Program service revenue (Part VIII, line 2g) .........	884,728,875	946,855,987
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	13,029,571	19,832,534
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,414,588	2,175,510
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	915,620,143	987,335,566
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,094,878	1,006,781
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)	476,686,163	513,672,399
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	68,237	70,431
b	Total fundraising expenses (Part IX, column (D), line 25) 4,222,199
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	391,316,079	418,938,620
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	869,165,357	933,688,231
19	Revenue less expenses. Subtract line 18 from line 12.......	46,454,786	53,647,335
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,023,990,733	1,056,059,478
21	Total liabilities (Part X, line 26).............	269,099,333	275,779,649
22	Net assets or fund balances. Subtract line 21 from line 20.....	754,891,400	780,279,829

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 849,467,916 including grants of $ 1,006,781 ) (Revenue $ 946,855,987 )
	PATIENT SERVICES - SEE SCHEDULES H AND O

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses849,467,916

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,892,266	9,381,780	1,980,151

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	254,505
d	Related organizations		1d
e	Government grants (contributions)		1e	695,946

f	All other contributions, gifts, grants, and similar amounts not included above		1f	17,521,084

g	Noncash contributions included in lines 1a - 1f:$ 3,176,038
h Total. Add lines 1a-1f.......		18,471,535

		Business Code
2a	PATIENT SERVICE REVENUE	900099	919,592,059	919,592,059
b	LABORATORY SERVICES	621500	6,604,296	6,038,691	565,605
c	PROGRAM RELATED RENTAL INCOME	900099	3,401,153	3,401,153
d	JOINT VENTURE REVENUE	900099	2,650,071	2,650,071
e	QUALITY EARNED PAYMENTS	900099	10,077,242	10,077,242
f	All other program service revenue.		4,531,166	4,531,166
g	Total. Add lines 2a–2f ....		946,855,987

3 Investment income (including dividends, interest, and othersimilar amounts) ......			9,489,503		-4,643,533	14,133,036
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		10,343,031
b	Less: cost or other basis and sales expenses
c	Gain or (loss)		10,343,031
d	Net gain or (loss).....			10,343,031		4,132,270	6,210,761
8a	Gross income from fundraising events (not including $ 254,505of contributions reported on line 1c). See Part IV, line 18 ....
	a		372,855
b	Less: direct expenses ...b		124,220
c	Net income or (loss) from fundraising events..			248,635			248,635
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA INCOME		900099	1,819,366			1,819,366
b	MEDICAL RECORDS		900099	107,461			107,461
c	EMPLOYEE PHARMACY		900099	48			48
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,926,875
12	Total revenue. See Instructions......			987,335,566	946,290,382	54,342	22,519,307

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	1,006,781	1,006,781
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,737,248	1,737,248	0	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	196,864	196,864
7	Other salaries and wages	409,442,549	371,292,121	36,493,949	1,656,479
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	11,979,005	10,452,988	1,459,758	66,259
9	Other employee benefits .......	64,098,639	58,127,670	5,772,017	198,952
10	Payroll taxes ...........	26,218,094	23,299,586	2,791,787	126,721
11	Fees for services (non-employees):
a	Management ......	6,416,989	3,342,133	3,074,856
b	Legal .........	173,468	15,056	158,412
c	Accounting ...........	778,298	209,585	568,713
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	70,431			70,431
f	Investment management fees ......	541,196	22,016	519,180
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	35,728,781	34,402,896	1,325,885	0
12	Advertising and promotion ....	1,143,970	1,048,027	95,943
13	Office expenses .......	4,417,951	4,105,857	280,266	31,828
14	Information technology ......	4,017,409	3,866,086	151,323
15	Royalties ..	0
16	Occupancy ...........	14,146,150	13,221,084	785,935	139,131
17	Travel ............	6,815,791	6,324,400	491,391
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	6,218,897	5,615,006	603,891
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	31,293,424	28,368,246	2,917,252	7,926
23	Insurance ...	5,609,159	5,184,822	420,931	3,406
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	MEDICAL SUPPLIES	139,978,043	139,978,043	0	0
b	ADMIN OFFICE OVERHEAD	70,970,349	53,428,644	17,009,096	532,609
c	PURCHASED SERVICES	38,475,697	35,961,680	2,345,715	168,302
d	BAD DEBTS	20,267,078	20,267,078
e	All other expenses	31,945,970	27,993,999	2,731,816	1,220,155
25	Total functional expenses. Add lines 1 through 24e	933,688,231	849,467,916	79,998,116	4,222,199
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 ........			28,046,133	1	31,950,245
2	Savings and temporary cash investments .........			1,418,491	2	1,423,924
3	Pledges and grants receivable, net ......			11,232,170	3	8,121,530
4	Accounts receivable, net .............			92,397,934	4	98,822,894
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
				0	5	0
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 ..............
				0	6	0
7	Notes and loans receivable, net ....			5,999,843	7	9,298,125
8	Inventories for sale or use ........			11,471,320	8	12,942,908
9	Prepaid expenses and deferred charges ......			4,889,655	9	3,300,556
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	700,827,563
b	Less: accumulated depreciation	10b	376,255,729	298,441,854	10c	324,571,834
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			505,577,304	12	495,557,462
13	Investments—program-related. See Part IV, line 11 ..			-562,504	13	254,265
14	Intangible assets ...............			10,089,047	14	23,710,077
15	Other assets. See Part IV, line 11 ...........			54,989,486	15	46,105,658
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,023,990,733	16	1,056,059,478

17	Accounts payable and accrued expenses .....	67,602,305	17	72,326,715
18	Grants payable ...	0	18	0
19	Deferred revenue .........	387,349	19	351,577
20	Tax-exempt bond liabilities .........	132,147,783	20	122,580,260
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
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..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	20,887,363	23	19,479,163
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
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	48,074,533	25	61,041,934
26	Total liabilities. Add lines 17 through 25..	269,099,333	26	275,779,649

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	681,649,081	27	710,386,474
28	Temporarily restricted net assets ...........	39,258,698	28	34,805,231
29	Permanently restricted net assets	33,983,621	29	35,088,124
	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 ...........	754,891,400	33	780,279,829
34	Total liabilities and net assets/fund balances ........	1,023,990,733	34	1,056,059,478

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No

(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)CAPE COD HEALTHCARE INC 297 NORTH STREET BLDG 3 HYANNIS,MA02601 22-2600704	PARENT CORP	MA	501(c) (3)	10	NA	Yes

(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	(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 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) CAPE AND ISLAND ENDOSCOPY CENTER 700 ATTUCKS LANE HYANNIS,MA02601	ENDOSCOPY CEN	MA	NA

(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