Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 10-01-2019 , and ending 09-30-2020
BCheck if applicable:
CName of organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
% LAURA RANZINGER
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
297 NORTH ST Suite BLDG 3
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
HYANNIS, MA02601
D Employer identification number

90-0054984
E Telephone number

G Gross receipts $ 942,736,501
F Name and address of principal officer:
MICHAEL K LAUF
88 LEWIS BAY ROAD
HYANNIS,MA02601
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CAPECODHEALTH.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet3901
K Form of organization:  
L Year of formation:  
M State of legal domicile:
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 10
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 6,131
6 Total number of volunteers (estimate if necessary) ............. 6 516
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 320,050
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b -91,180
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 18,471,535 69,840,468
9 Program service revenue (Part VIII, line 2g) ......... 946,855,987 856,644,181
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 19,832,534 14,606,621
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,175,510 1,567,803
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 987,335,566 942,659,073
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,006,781 1,008,026
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) 513,672,399 512,925,879
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 70,431 59,071
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet3,597,855    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 418,938,620 415,810,545
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 933,688,231 929,803,521
19 Revenue less expenses. Subtract line 18 from line 12....... 53,647,335 12,855,552
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,056,059,478 1,248,997,758
21 Total liabilities (Part X, line 26)............. 275,779,649 443,904,319
22 Net assets or fund balances. Subtract line 21 from line 20..... 780,279,829 805,093,439
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 846,101,010 including grants of $ 1,008,026 ) (Revenue $ 856,644,181 )
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 expensesMediumBullet846,101,010
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....Click to see attachment
17
Yes
 
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV..................... Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
67
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
6,131
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
MA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletLAURA RANZINGER297 NORTH STREET BLDG 3   HYANNIS,MA02601 (774) 470-5537
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MICHAEL K LAUF......................................................................
PRESIDENT/CEO/TRUSTEE
 55.0
.................
5.0 		X   X       0 1,667,455 264,792
(2) RICHARD B ZELMAN MD......................................................................
PHYSICIAN
 40.0
.................
0.0 		        X   1,682,890 0 43,868
(3) PAUL HOULE MD......................................................................
TRUSTEE (UNTIL 1/20)
 40.0
.................
2.0 		X           1,070,875 0 45,020
(4) GORDON NAKATA MD......................................................................
PHYSICIAN
 40.0
.................
0.0 		        X   1,049,325 0 45,020
(5) ACHILLES PAPAVASILIOU MD......................................................................
PHYSICIAN
 40.0
.................
0.0 		        X   1,049,125 0 45,170
(6) NICHOLAS COPPA MD......................................................................
PHYSICIAN
 40.0
.................
0.0 		        X   1,051,539 0 42,210
(7) KARL B COYNER MD......................................................................
PHYSICIAN
 40.0
.................
0.0 		        X   1,017,584 0 22,990
(8) ROBERT WILSTERMAN MD......................................................................
TRUSTEE (UNTIL 1/20)
 40.0
.................
2.0 		X           694,083 0 42,381
(9) MICHAEL L CONNORS......................................................................
SENIOR VP FINANCE/CFO
 55.0
.................
5.0 		    X       0 566,015 73,488
(10) DONALD A GUADAGNOLI MD......................................................................
Senior VP & CMO
 45.0
.................
5.0 		      X     0 541,968 64,452
(11) MOLLY SULLIVAN MD......................................................................
TRUSTEE (AS OF 1/20)
 40.0
.................
2.0 		X           538,195 0 42,392
(12) JOHN PAUL SOLVERSON......................................................................
SR VP & CIO
 45.0
.................
5.0 		      X     0 525,027 52,186
(13) KEVIN MULROY......................................................................
SVP CHIEF QUALITY & SAFETY OFF
 45.0
.................
5.0 		      X     0 487,621 67,566
(14) WILLIAM AGEL MD......................................................................
TRUSTEE (UNTIL 04/2020)
 40.0
.................
2.0 		X           504,701 0 42,392
(15) CHRISTIAN BROWN......................................................................
SR VP MANAGED CARE
 45.0
.................
5.0 		      X     0 439,640 61,410
(16) MICHAEL G JONES ESQ......................................................................
SEE SCHEDULE O
 55.0
.................
5.0 		    X       0 427,594 64,733
(17) ALEXANDER HEARD MD......................................................................
CMO FALMOUTH HOSPITAL
 45.0
.................
5.0 		      X     216,393 204,529 64,283
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) PATRICK J KANE........................................................................
SVP OF MRKTG,COMMUN AND DEVLP
 45.0
.......................5.0 		      X     0 424,663 45,107
(19) THEODORE CALIANOS MD........................................................................
TRUSTEE
 40.0
.......................5.0 		X           372,357 0 42,221
(20) EMILY SCHORER........................................................................
SVP HUMAN RESOURCES
 45.0
.......................5.0 		      X     0 354,522 58,064
(21) JEFFREY S DYKENS........................................................................
VP FINANCE
 45.0
.......................5.0 		      X     0 356,971 50,640
(22) SHERYL DECILIO........................................................................
SEE SCHEDULE O
 45.0
.......................5.0 		      X     0 345,307 9,076
(23) JUDITH C QUINN........................................................................
VP OF PATIENT CARE
 45.0
.......................5.0 		      X     0 313,110 33,499
(24) CHRISTOPHER M LAWSON........................................................................
SVP DEVELOPMENT
 45.0
.......................5.0 		      X     0 306,516 39,044
(25) LORI JEWETT........................................................................
CEO - FH
 45.0
.......................5.0 		      X     0 308,592 24,742
(26) JEAN BUTLER........................................................................
SVP EMPLYD PHY GRP(AS OF 4/19)
 45.0
.......................5.0 		      X     0 285,844 36,871
(27) NOELENE CERVIN........................................................................
VP BUDGETING AND OPER. SUPPORT
 45.0
.......................5.0 		      X     0 269,775 47,205
(28) ANNE MARIE PECKHAM........................................................................
PRESIDENT VNA
 45.0
.......................5.0 		      X     0 273,658 32,200
(29) DEBRA ROBINSON........................................................................
ASSOC VP OF NRSNG
 45.0
.......................5.0 		      X     249,709 0 33,289
(30) CARTER HUNT........................................................................
ADMIN SPEC&HOSP BASED CARE
 45.0
.......................5.0 		      X     0 225,084 53,335
(31) CYNTHIA MARLIN........................................................................
VP PERIOPERATIVE & SURGICAL SV
 45.0
.......................5.0 		      X     0 228,069 44,010
(32) ELIZABETH DUNTON........................................................................
COO EMPLOYED PHYSICIAN SVCS
 45.0
.......................5.0 		      X     0 232,927 21,041
(33) THERESA M AHERN........................................................................
SVP STRATEGY & GOVT AFFAIRS
 45.0
.......................5.0 		      X     0 234,105 15,369
(34) NATHAN RUDMAN MD........................................................................
TRUSTEE
 5.0
.......................5.0 		X           0 21,120 0
(35) LAWRENCE CAPODILUPO........................................................................
TRUSTEE
 2.0
.......................2.0 		X           0 0 0
(36) SHARON KENNEDY........................................................................
TRUSTEE
 2.0
.......................2.0 		X           0 0 0
(37) DEWITT DAVENPORT........................................................................
CHAIRMAN (UNTIL 5/20)
 2.0
.......................2.0 		X   X       0 0 0
(38) DIANE COLETTI........................................................................
TRUSTEE
 2.0
.......................2.0 		X           0 0 0
(39) SUMNER B TILTON JR........................................................................
TRUSTEE
 2.0
.......................2.0 		X           0 0 0
(40) E JAMES MULCAHY JR........................................................................
TRUSTEE
 2.0
.......................2.0 		X           0 0 0
(41) ROBERT TALERMAN........................................................................
SEE SCHEDULE O
 2.0
.......................2.0 		X   X       0 0 0
(42) ROBERT BIRMINGHAM........................................................................
VICE CHAIR/TRUST (UNTIL 11/19)
 2.0
.......................2.0 		X   X       0 0 0
(43) RAMANI AYER........................................................................
SEE SCHEDULE O
 5.0
.......................5.0 		X   X       0 0 0
(44) BRUCE JOHNSTON........................................................................
SEE SCHEDULE O
 5.0
.......................5.0 		X   X       0 0 0
(45) CYNTHIA A HINES MD........................................................................
TRUSTEE (AS OF 01/20)
 2.0
.......................2.0 		X           0 0 0
(46) KEVIN VILSAINT MD........................................................................
TRUSTEE (AS OF 9/20)
 2.0
.......................2.0 		X           0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 9,247,067 7,269,530 1,386,746
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet987
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CAPE COD HEALTHCARE INC,
297 NORTH STREET BLDG 3
HYANNIS,MA02601 		PURCHASED SERVICES 70,060,946
CMG CIT ACQUISITION LLC,
655 SOUTH WILLOW ST STE 128
MANCHESTER,NH03103 		EMPLYMENT/STAFF 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 $100,000 of compensation from the organization MediumBullet3
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 76,176
d Related organizations1d  
e Government grants (contributions)1e 52,776,530
f All other contributions, gifts, grants, and similar amounts not included above1f 16,987,762
g Noncash contributions included in lines 1a - 1f:$ 1g 1,816,257
h Total. Add lines 1a-1f.......MediumBullet 69,840,468
Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 900099 827,050,609 827,050,609    
b LABORATORY SERVICES 621500 6,374,932 6,054,882 320,050  
c PROGRAM RELATED RENTAL INCOME 900099 3,190,300 3,190,300    
d JOINT VENTURE REVENUE 900099 2,807,616 2,807,616    
e QUALITY EARNED PAYMENTS 900099 13,205,322 13,205,322    
f All other program service revenue. 4,015,402 4,015,402    
g Total. Add lines 2a–2f .....MediumBullet 856,644,181
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 8,025,505     8,025,505
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss) 0 0 6c
d Net rental income or (loss).......MediumBullet 0      
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   6,581,116 7a
b Less: cost or other basis and sales expenses     7b
c Gain or (loss)   6,581,116 7c
d Net gain or (loss).........MediumBullet 6,581,116     6,581,116
8a Gross income from fundraising events (not including $ 76,176of contributions reported on line 1c). See Part IV, line 18 ....
8a 123,459
b Less: direct expenses ... 8b 77,428
c Net income or (loss) from fundraising events..MediumBullet 46,031   46,031
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a CAFETERIA INCOME 900099 1,414,445     1,414,445
b MEDICAL RECORDS 900099 107,327     107,327
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,521,772
12 Total revenue. See instructions.....MediumBullet 942,659,073 856,324,131 320,050 16,174,424
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 1,008,026 1,008,026
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, lines 15 and 16. ............. 0  
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 3,469,864 3,469,864    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 481,565 481,565    
7 Other salaries and wages........ 402,397,123 364,702,549 35,996,447 1,698,127
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 12,570,605 11,062,822 1,439,858 67,925
9 Other employee benefits ....... 68,201,507 61,756,676 6,137,277 307,554
10 Payroll taxes ........... 25,805,215 22,933,020 2,753,728 118,467
11 Fees for services (non-employees):        
a Management ...... 6,767,398 3,087,069 3,680,329  
b Legal ......... 1,056,899 22,204 1,029,695 5,000
c Accounting ........... 990,859 216,303 774,556  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 59,071 59,071
f Investment management fees ...... 550,932 42,797 508,135  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 33,916,811 33,755,300 161,511  
12 Advertising and promotion .... 834,615 759,351 64,960 10,304
13 Office expenses ....... 4,266,087 3,968,203 264,568 33,316
14 Information technology ...... 4,578,023 4,335,040 165,664 77,319
15 Royalties .. 0      
16 Occupancy ........... 14,294,702 13,436,389 733,977 124,336
17 Travel ............ 5,486,935 5,031,676 406,350 48,909
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 5,874,408 5,289,107 564,155 21,146
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 45,800,020 41,641,462 4,151,876 6,682
23 Insurance ... 5,962,892 5,564,937 397,955  
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 136,520,814 136,520,814    
b ADMIN OFFICE OVERHEAD 69,626,420 52,734,972 16,358,839 532,609
c PURCHASED SERVICES 35,407,413 32,993,110 2,292,962 121,341
d BAD DEBTS 16,525,789 16,525,789    
e All other expenses 27,349,528 24,761,965 2,221,814 365,749
25 Total functional expenses. Add lines 1 through 24e 929,803,521 846,101,010 80,104,656 3,597,855
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 31,950,245 1 47,772,011
2 Savings and temporary cash investments ......... 1,423,924 2 1,428,120
3 Pledges and grants receivable, net ...... 8,121,530 3 12,528,497
4 Accounts receivable, net ............. 98,822,894 4 80,313,108
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 9,298,125 7 14,560,536
8 Inventories for sale or use ............ 12,942,908 8 13,978,076
9 Prepaid expenses and deferred charges ...... 3,300,556 9 2,858,696
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 711,231,599
b Less: accumulated depreciation 10b 406,410,663 324,571,834 10c 304,820,936
11 Investments—publicly traded securities . 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 495,557,462 12 664,591,293
13 Investments—program-related. See Part IV, line 11 .. 254,265 13 289,008
14 Intangible assets ............... 23,710,077 14 21,989,350
15 Other assets. See Part IV, line 11 ........... 46,105,658 15 83,868,127
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,056,059,478 16 1,248,997,758
Liabilities 17 Accounts payable and accrued expenses ..... 72,326,715 17 72,068,541
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 351,577 19 1,255,770
20 Tax-exempt bond liabilities ......... 122,580,260 20 112,816,029
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 19,479,163 23 17,937,868
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 61,041,934 25 239,826,111
26 Total liabilities. Add lines 17 through 25.. 275,779,649 26 443,904,319
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 710,386,474 27 729,454,739
28 Net assets with donor restrictions ........... 69,893,355 28 75,638,700
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 780,279,829 32 805,093,439
33 Total liabilities and net assets/fund balances ........ 1,056,059,478 33 1,248,997,758
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
942,659,073
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
929,803,521
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
12,855,552
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
780,279,829
5
Net unrealized gains (losses) on investments ...............
5
-1,647,831
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
13,279,200
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
326,689
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
805,093,439
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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 instructions and the latest information.
OMB No. 1545-0047
2019
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. 13,584,232 15,341,766 15,447,109 18,471,535 69,840,468 132,685,110
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 13,584,232 15,341,766 15,447,109 18,471,535 69,840,468 132,685,110
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).. 1,210,386
6 Public support. Subtract line 5 from line 4. 131,474,724
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
7 Amounts from line 4.. 13,584,232 15,341,766 15,447,109 18,471,535 69,840,468 132,685,110
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... 5,368,273 5,985,405 7,272,965 14,133,036 8,025,505 40,785,184
9 Net income from unrelated business activities, whether or not the business is regularly carried on.. 798,057 408 -544,982 -986,182 -91,180 -823,879
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. 2,353,977 2,422,397 2,647,341 2,299,730 1,645,231 11,368,676
11 Total support. Add lines 7 through 10 184,015,091
12
12
4,346,185,646
13
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
14
14
71.448 %
15
15
57.341 %
16a
b
17a
b
18
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
No
1
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.
1
 
No
2
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.
2
 
No
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
No
2
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).
2
 
No
3
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.
3
 
No
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019 		(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6 0
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.		 0
3 Excess distributions carryover, if any, to 2019:
a From 2014.......0
b From 2015.......0
c From 2016.......0
d From 2017.......0
e From 2018.......0
fTotal of lines 3a through e 0
g Applied to underdistributions of prior years 0
h Applied to 2019 distributable amount 0
i Carryover from 2014 not applied (see
instructions) 		0
j Remainder. Subtract lines 3g, 3h, and 3i from 3f. 0
4Distributions for 2019 from Section D, line 7:
$ 0
a Applied to underdistributions of prior years 0
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4. 0
5 Remaining underdistributions for years prior to
2019, 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 2019. 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 2020. Add lines
3j and 4c.		 0
8 Breakdown of line 7:
a Excess from 2015.....0
b Excess from 2016.....0
c Excess from 2017.....0
d Excess from 2018.....0
e Excess from 2019.....0
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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) 2019


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
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






Form 990-PF




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
Special Rules
......... 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
CAPE COD HEALTHCARE INC & AFFILIATES
  		Employer identification number
90-0054984
Part I
Contributors
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


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2019)

Additional Data


Software ID:  
Software Version:  
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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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) 2019

Schedule C (Form 990 or 990-EZ) 2019
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ...................................................................................................................

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) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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|No
(b)
Amount
1
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:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
37,408
j
Total. Add lines 1c through 1i ....................................................................................................
37,408
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
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, 11.08% OF DUES PAID SHOULD BE ALLOCATED TO LOBBYING ACTIVITY.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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 instructions and the latest information.
OMB No. 1545-0047
2019
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
If the organization elected, as permitted under FASB 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.
b
If the organization elected, as permitted under FASB 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 $  
2
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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 .... 42,236,761 42,450,666 41,606,730 38,809,089 37,495,620
b Contributions ... 846,322 1,510,214 504,886 30,699 57,261
c Net investment earnings, gains, and losses 1,612,515 -670,422 1,353,728 3,061,173 2,000,285
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		1,074,167 1,053,697 1,014,678 759,148 744,077
f Administrative expenses ....       -464,917  
g End of year balance ...... 43,621,431 42,236,761 42,450,666 41,606,730 38,809,089
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet83.360 %
c
Term endowment SchDMd Bullet16.640 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
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 .....   23,635,113 23,635,113
b Buildings ....   421,002,311 201,692,248 219,310,063
c Leasehold improvements   5,032,242 2,691,660 2,340,582
d Equipment ....   231,449,167 186,056,052 45,393,115
e Other .....   30,112,766 15,970,703 14,142,063
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 304,820,936
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other 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) INVESTMENTS SHORT TERM		 163,636,519 F

(B) RESTRICTED CASH - ST		 2,159,963 F

(C) SERIES 2013 CURRENT		 848,530 F

(D) SERIES 2012A CURRENT		 2,195,837 F

(E) INVESTMENTS LT		 299,439,453 F

(F) INTERESTS IN FDN - UNRESTRICTD		 144,525,728 F

(G) RESTRICTED CASH - LT		 225,684 F

(H) INTEREST IN FDN - TEMP		 17,180,887 F

(I) INTEREST IN FDN - PERM		 34,378,692 F
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 664,591,293
Part VIII
Investments—Program 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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)DUE FROM AFFILIATES 83,868,127
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 83,868,127
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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 239,826,111
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) 2019

Schedule D (Form 990) 2019
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) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image 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
2019
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" on Form 990, Part IV, line 14b.
1
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? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
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 the region (d) Activities conducted in region (by type) (such as, 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 the region		 (f) Total expenditures
for and investments
in the region
Central America and the Caribbean 1 0 Program Services CAPTIVE INSURANCE 6,520,553
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 1 0 6,520,553
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 1 0 6,520,553
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on 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 noncash
assistance 		(h) Description
of noncash
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 .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on 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
noncash
assistance 		(g) Description
of noncash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 4
Part IV
Foreign Forms
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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). . . . . . . . . . . . . . . . . . . . . . . .
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .
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) .
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
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) 2019
Additional Data


Software ID:  
Software Version:  



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 arrowAttach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
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?
b
If "Yes," list the 10 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
             
Five Maples
78 RIVER ROAD SOUTH
 
PUTNEY, VT05346 		Direct Mail   No 332,553 59,071 273,483
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow 332,553 59,071 273,483
3
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) 2019
Schedule G (Form 990 or 990-EZ) 2019
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.









VerticalRevenue
(a) Event #1

Soiree on the B
(event type) 		(b) Event #2

 
(event type) 		(c) Other events

0
(total number) 		(d) Total events
(add col. (a) through col. (c))

1
Gross receipts . . . . .
199,635
 
 
199,635

2
Less: Contributions . . . .
76,176
 
 
76,176
3 Gross income (line 1 minus
line 2) . . . . . .
123,459
 
 
123,459



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . .        
6 Rent/facility costs . . . . 2,500     2,500
7 Food and beverages . . . 36,042     36,042
8 Entertainment . . . . 1,600     1,600
9 Other direct expenses . . . 37,286     37,286
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 77,428
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow 46,031
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.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1
Gross revenue . . . . .
 
 
 
 
VerticalDirectExpenses

2
Cash prizes . . . . .
 
 
 
 

3
Noncash prizes . . . .
 
 
 
 

4
Rent/facility costs . . . .
 
 
 
 

5
Other direct expenses . . .
 
 
 
 


6

Volunteer labor . . . .
%
%
%


7
Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow
 

8
Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow
 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2019
Schedule G (Form 990 or 990-EZ) 2019
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
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? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
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 $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
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) 2019
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
2019
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
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
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? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (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) . . . 		    6,298,606 2,091,727 4,206,879 0.460 %
b Medicaid (from Worksheet 3, column a) . . . . .     108,380,550 93,794,021 14,586,529 1.600 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     14,163,698 12,223,688 1,940,010 0.210 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     128,842,854 108,109,436 20,733,418 2.270 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     2,545,987 0 2,545,987 0.280 %
f Health professions education (from Worksheet 5) . . .     723,321 232,379 490,942 0.050 %
g Subsidized health services (from Worksheet 6) . . . .     631,810,894 571,945,811 59,865,083 6.550 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     1,194,262   1,194,262 0.130 %
j Total. Other Benefits . .     636,274,464 572,178,190 64,096,274 7.010 %
k Total. Add lines 7d and 7j .     765,117,318 680,287,626 84,829,692 9.280 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     100,000   100,000  
2 Economic development            
3 Community support            
4 Environmental improvements     25,000   25,000  
5 Leadership development and
training for community members		            
6 Coalition building     11,750   11,750  
7 Community health improvement advocacy            
8 Workforce development     16,973   16,973  
9 Other            
10 Total     153,723   153,723  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
16,525,789
3
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. ......
3
9,390,456
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
100,299,613
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
48,846,764
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
51,452,849
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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) 2019
Schedule H (Form 990) 2019
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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) 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) 2019
Schedule H (Form 990) 2019
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 No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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 No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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, 20a, 20b, 20c, 20d, 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) 2019
Schedule H (Form 990) 2019
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?87
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 Primary Care
525 Long Pond Drive
HARWICH,MA02645 		medical group practice
4 CCHC Neurosurgery
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 Fontaine OUTPATIENT CENTER
525 Long Pond Drive
Harwich,MA02645 		medical group practice
8 Guo X Y David MD PhD-GASTROENTEROLOGY
90 TER HEUN DRIVE STE 302
Falmouth,MA02540 		medical group practice
9 CCHC Stoneman Primary Care
2 Jan Sebastian Way Suite 100
Sandwich,MA02563 		medical group practice
10 CCHC Gastroenterology - Hyannis
700 ATTUCKS LANE STE 1E
Hyannis,MA02601 		medical group practice
11 CCHC Plastic Surgery
160 Falmouth Road Suite B
MASHPEE,MA02649 		medical group practice
12 CAPE COD OBSTETRICS & GYNECOLOGY
90 Ter Heun Drive SUITE 100
Falmouth,MA02540 		medical group practice
13 Endocrine Center of Cape Cod - Hyannis
1030 FALMOUTH RD STE 201
Hyannis,MA02601 		medical group practice
14 Fal Specialty Care Practice
90 Ter Heun Drive Suite 302
Falmouth,MA02540 		medical group practice
15 NEUROLOGISTS OF CAPE COD
46 North Street SUITE 7
Hyannis,MA02601 		medical group practice
16 Nauset Family Practice
81 Old Colony Way STE D
ORLEANS,MA02653 		medical group practice
17 Cape Health Insurance Company - FOREIGN
297 NORTH ST 3
HYANNIS,MA02601 		administrative
18 Healthcare Foundation
32 MAIN STREET
Hyannis,MA02601 		administrative
19 Healthcare Foundation
348 GIFFORD ST STE 4
FALMOUTH,MA02540 		ADMINISTRATIVE
20 JML Care Center
184 Ter Heun Drive
falmouth,MA02540 		skilled nur & rehab
21 Cape & Islands Health Services II Inc
14 Yellow Brick Road
HYANNIS,MA02601 		COLLECTION CENTER
22 Cape & Islands Health Services II
5 Industrial Drive Suite 102
MASHPEE,MA02649 		COLLECTION CENTER
23 Cape & Islands Health Services II
525 Long Pond Drive
HARWICH,MA02645 		COLLECTION CENTER
24 Cape & Islands Health Services II
81 Old Colony Way
ORLEANS,MA02653 		COLLECTION CENTER
25 Cape & Islands Health Services II
2 Jan Sebastian Way Route 130
SANDWICH,MA02563 		COLLECTION CENTER
26 Cape & Islands Health Services II
860 Route 134 Unit 2
South Dennis,MA02660 		COLLECTION CENTER
27 Cape & Islands Health Services II
1 Trowbridge Road
Bourne,MA02532 		COLLECTION CENTER
28 Cape & Islands Health Services II
1629 MAIN STREET
CHATHAM,MA02633 		COLLECTION CENTER
29 Cape & Islands Health Services II
27 PARK STREET
HYANNIS,MA02601 		COLLECTION CENTER
30 Heritage at Falmouth
140 Ter Heun Drive
FALMOUTH,MA02540 		ASSISTED LIVING
31 Cape Cod Human Services
460 West Main Street
HYANNIS,MA02601 		outpatient clinic
32 Cape Cod Human Services
525 Long Pond Drive
HARWICH,MA02645 		outpatient clinic
33 Cape Cod Medical Office Building Inc
20 Gleason Street
HYANNIS,MA02601 		administrative
34 Orleans Medical CENTER
204 Main Street
Orleans,MA02653 		Medical Group Practice
35 CAPE COD Dermatology
134 Ansel Halet Road
W Yarmouth,MA02673 		Medical Group Practice
36 Cape Cod Rheumatology Center - Falmouth
1030 FALMOUTH RD STE 201
HYANNIS,MA02601 		MEDICAL GROUP PRACTICE
37 CCHC Cardiovascular Center - Hyannis
25 Main Street
HYANNIS,MA02601 		MEDICAL GROUP PRACTICE
38 Endocrine Center of Cape Cod - Harwich
525 Long Pond Drive
HARWICH,MA02645 		MEDICAL GROUP PRACTICE
39 Fontaine Urgent Care Center
525 Long Pond Drive
HARWICH,MA02645 		MEDICAL GROUP PRACTICE
40 Park Street Primary Care
62 Park Street
HYANNIS,MA02601 		MEDICAL GROUP PRACTICE
41 Stoneman Primary Care
2 JAN SEBASTIAN WAY SUITE 100
SANDWICH,MA02563 		MEDICAL GROUP PRACTICE
42 Vascular & Vein Center Of Cape Cod - FAL
90 Ter Heun Drive 3RD Fl MOB STE
Falmouth,MA02540 		Medical Group Practice
43 CCHC General & Specialty Surgery
105 Park Street
Hyannis,MA02601 		Medical Group Practice
44 Cape Cod Sports Medicine
360 Gifford Street Unit 2B
Falmouth,MA02540 		Medical Group Practice
45 CARDIOVASCULAR CENTER - FALMOUTH
90 TER HEUN DRIVE SUITE 300
FALMOUTH,MA02540 		Medical Group Practice
46 GASTROENTEROLOGY HYANNIS - PARK STREET
105 PARK STREET
HYANNIS,MA02601 		Medical Group Practice
47 STONEMAN OUTPATIENT CENTER - URGENT CARE
2 JAN SEBASTIAN DRIVE SUITE 101
SANDWICH,MA02563 		Medical Group Practice
48 MASHPEE SURGICAL CENTER
160 FALMOUTH ROAD SUITE A
MASHPEE,MA02649 		MEDICAL GROUP PRACTICE
49 SOUTHEASTERN SURGICAL ASSOCIATES
100 CAMP STREET
HYANNIS,MA02601 		MEIDCAL GROUP PRACTICE
50 FALMOUTH URGENT CARE
273 TEATICKET HIGHWAY
FALMOUTH,MA02536 		MEDICAL GROUP PRACTICE
51 URGI CENTER MEDICAL GROUP - HYANNIS
1220 IYANNOUGH ROAD
HYANNIS,MA02601 		MEDICAL GROUP PRACTICE
52 UPPER CAPE EAR NOSE THROAT
200 A JONES ROAD
FALMOUTH,MA02540 		MEDICAL GROUP PRACTICE
53 Orthopedic Specialists Falmouth
5 BRAMBLEBUSH PARK
FALMOUTH,MA02540 		Medical group practice
54 CCHC DEMENTIA&ALZHEIMER'S CAREGIVER SUPP
4 BAYVIEW ST
WEST YARMOUTH,MA02673 		ADMINISTRATIVE
55 CCHC PODIATRIC MEDICINE & FOOT SURGERY
1030 FALMOUTH RD RTE 28 SUITE 20
HYANNIS,MA02601 		MEDICAL GROUP PRACTICE
56 IDCS-INFECTIOUS DISEASE CLINICAL SERV
34 PARK ST
HYANNIS,MA02601 		MEDICAL GROUP PRACTICE
57 CCH OBGYN SATELLITE
60A PARK ST
HYANNIS,MA02601 		MEDICAL GROUP PRACTICE
58 MACCMSSP REFERRAL DEPT
25 COMMUNICATION WAY
HYANNIS,MA02601 		ADMINISTRATIVE
59 DIABETIC EDUCATION
1010 FALMOUTH ROAD
HYANNIS,MA02601 		EDUCATIONAL
60 DIABETIC EDUCATION
1629 MAIN ST
CHATHAM,MA02633 		EDUCATIONAL
61 VNA of Cape Cod - Harwich
1 AUSTON RD F
HARWICH,MA02645 		HOME HEALTH
62 VNA OF CAPE COD - EASTHAM
3960 STATE HWY RD 6 2
EASTHAM,MA02642 		HOME HEALTH
63 VNA OF CAPE COD - FALMOUTH
67 TER HEUN DR
FALMOUTH,MA02540 		HOME HEALTH
64 VNA OF CAPE COD - MARTHA'S VINEYARD
49 STATE RD
VINEYARD HAVEN,MA02568 		HOME HEALTH
65 VNA OF CAPE COD - NANTUCKET
40 Sherburne Commons Sherburne Hou
NANTUCKET,MA02554 		HOME HEALTH
66 VNA OF CAPE COD - PROVINCETOWN
26 ALDEN ST
PROVINCETOWN,MA02657 		HOME HEALTH
67 VNA OF CAPE COD - SOUTH DENNIS
434 ROUTE 134 BLDG D 3
SOUTH DENNIS,MA02660 		HOME HEALTH
68 CAPE & ISLANDS HEALTH SERVICES II
35 WILKENS LANE
HYANNIS,MA02601 		COLLECTION CENTER
69 ORLEANS MEDICAL CENTER
204 MAIN ST
ORLEANS,MA02653 		OUTPATIENT CLINIC
70 CAPE COD RESEARCH INSTITUTE
27 PARK ST
HYANNIS,MA02601 		RESEARCH
71 North Falmouth Primary Care
33 Edgerton Drive
Falmouth,MA02556 		MEDICAL GROUP PRACTICE
72 North Street Primary Care
130 North Street
Hyannis,MA02601 		MEDICAL GROUP PRACTICE
73 Cape Cod Ear Nose and Throat Specialist
65 Cedar Street
Hyannis,MA02601 		MEDICAL GROUP PRACTICE
74 CCH Pulmonary Medicine
51 Bayview Street
Hyannis,MA02601 		MEDICAL GROUP PRACTICE
75 VNA of Cape Cod - Sagamore Beach
110 State Road Unit 3
Sagamore Beach,MA02562 		Home Health
76 William J Manning Jr MD
700 Attucks Lane Suite 1A
Hyannis,MA02601 		Medical Group Practice
77 CAPE & ISLANDS HEALTH SERVICES II
200 JONES ROAD
FALMOUTH,MA02540 		COLLECTION CENTER
78 CAPE & ISLANDS HEALTH SERVICES II
68B ROUTE 6A
SANDWICH,MA02563 		COLLECTION CENTER
79 Orthopedic Specialists North Falmouth
26 Edgerton Drive Suite C
North Falmouth,MA02556 		Medical group practice
80 CAPE COD RHEUMATOLOGY CENTER - FALMOUTH
90 TER HEUN DRIVE SUITE 302 3RD
FALMOUTH,MA02540 		MEDICAL GROUP PRACTICE
81 FALMOUTH PRIMARY CARE
90 TER HEUN DRIVE SUITE 2300
FALMOUTH,MA02540 		MEDICAL GROUP PRACTICE
82 MASHPEE PRIMARY CARE
5 INDUSTRIAL DRIVE SUITE 205
MASHPEE,MA02649 		MEDICAL GROUP PRACTICE
83 OSTERVILLE PRIMARY CARE
770 MAIN STREET
OSTERVILLE,MA02655 		MEDICAL GROUP PRACTICE
84 STRAWBERRY HILL PRIMARY CARE
1030 FALMOUTH ROAD 1ST FLOOR STE
HYANNIS,MA02601 		MEDICAL GROUP PRACTICE
85 TOTAL ORTHOPEDIC CARE
360 GIFFORD STREET
FALMOUTH,MA02540 		MEDICAL GROUP PRACTICE
86 YARMOUTH PRIMARY CARE
495 STATION AVE
SOUTH YARMOUTH,MA02664 		MEDICAL GROUP PRACTICE
87 OPPENHEIMIN CHATHAM
1629 Main St
CHATHAM,MA02633 		REHABILITATION
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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 $ 16,525,789. 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 LINES 1, 4, 6 AND 8 COALITION BUILDING ACTIVITIES CCHC CLINICAL, COMMUNITY BENEFITS AND SUPPORT STAFF PARTICIPATED IN A VARIETY OF COALITION BUILDING ACTIVITIES TO ADDRESS AND IMPROVE CARE RELATED TO BEHAVIORAL HEALTH, CARE COORDINATION DISEASE PREVENTION, HOMELESSNESS AND SUBSTANCE USE. REGIONAL COALITIONS SERVE AS ALLIANCES FOR COMBINED AND COORDINATED ACTION TO IMPROVE KEY HEALTH ISSUES. COALITION ACTIVITIES RANGED FROM IMPLEMENTATION OF NEW PROGRAMS TO PROVIDER COORDINATION TO THE DEVELOPMENT OF MULTI-SECTOR PARTNERSHIPS. WORKFORCE DEVELOPMENT CCHC'S PHYSICAL 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. PHYSICAL IMPROVEMENTS & HOUSING CCHC PARTNERED WITH THE HOUSING ASSISTANCE CORPORATION (HAC) AND OUTER CAPE HEALTH SERVICES ON THE HOUSING FOR HEALTH PARTNERSHIP TO PROVIDE HOUSING FUNDING TO PATIENTS WHOSE HEALTH MAY BE IMPACTED BY HOUSING INSTABILITY AND MAY NOT MEET ELIGIBILITY CRITERIA FOR EXISTING SERVICES. SINCE THE START OF THE PANDEMIC, HAC HAS SEEN A 400% INCREASE IN REQUESTS FOR FINANCIAL ASSISTANCE FOR HOUSING. WITHOUT A STABLE PLACE TO LIVE, PATIENTS HAVE DIFFICULTY IN ADHERING TO MEDICAL TREATMENT AND DISCHARGE PLANS. LACK OF STABLE HOUSING HAS ALSO BEEN DEMONSTRATED TO DRAMATICALLY INCREASE THE RISKS OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS. PROVIDING PATIENTS WITH A SOURCE OF FUNDS TO STABILIZE THEIR HOUSING PROVIDES A STRONG FOUNDATION FOR PATIENTS TO MORE EFFECTIVELY PARTICIPATE IN THEIR HEALTH TREATMENT PLAN AND IMPROVE THEIR MEDICAL AND BEHAVIORAL HEALTH. ENVIRONMENTAL IMPROVEMENTS CCHC PARTNERED WITH THE ASSOCIATION TO PRESERVE CAPE COD ON THE POND HEALTH PROGRAM TO EXPAND MONITORING AND INCREASE PUBLIC AWARENESS OF THE HEALTH RISKS OF CYANOTOXIN EXPOSURE IN LOCAL PONDS THAT ARE POPULAR FOR RECREATION. CYANOTOXIN EXPOSURE IS LINKED TO ALZHEIMER'S DISEASE AND OTHER NEUROLOGICAL CONDITIONS.
PART III, LINES 2-3 THE ORGANIZATION IS REPORTING $9,390,456 OF BAD DEBT EXPENSE THAT MEETS ITS FINANCIAL ASSISTANCE POLICY. THIS AMOUNT IS RELATED TO BAD DEBT FROM BOTH HOSPITALS DURING FY20 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 20 TARGET POPULATIONS: - RESIDENTS ACROSS BARNSTABLE COUNTY WITH FOCUS ON SPECIFIC REGIONS OF THE CAPE MOST ACUTELY IMPACTED BY GEOGRAPHIC ISOLATION, ACCESS TO SERVICES, TRANSPORTATION BARRIERS, AND ECONOMIC OPPORTUNITY. - POPULATIONS MANAGING MENTAL HEALTH AND/OR BEHAVIORAL HEALTH DISORDERS. - RESIDENTS OVER THE AGE OF 65. - TRANSITIONAL-AGED YOUTH (18-24 YEARS OLD). - LOW-INCOME INDIVIDUALS AND FAMILIES. 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 THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) 2020-2022. WE ADDRESSED BARRIERS TO CARE BY ADDING SUPPORTIVE CONNECTORS IN THE CONTINUUM OF CARE. EXAMPLES: ALZHEIMER'S SUPPORT GROUPS, RECOVERY COACHES, COMMUNITY NAVIGATORS, OUTREACH, INTEGRATIVE THERAPIES AND TRANSPORTATION SOLUTIONS. CCHC COMMUNITY BENEFITS EXPANDED CROSS-SECTOR COMMUNITY PARTNERSHIPS AND LEADERSHIP WITHIN AND THROUGHOUT THE CAPE COD NON-PROFIT HEALTH AND HUMAN SERVICE SYSTEM. THE MAJOR ACCOMPLISHMENT THIS YEAR WAS THE PUBLICATION OF THE 2020-2022 CCH AND FH CHNA AND IMPLEMENTATION PLAN. THIS PLAN SERVED AS THE FOUNDATION FOR CCHC'S FY20 COMMUNITY BENEFITS PROGRAM, WHICH FOCUSED ON THESE 5 PRIORITIES: PHYSICAL HEALTH CONDITIONS, BEHAVIORAL HEALTH, TRANSPORTATION, HOUSING, AND WORKFORCE DEVELOPMENT. NEW AND EXPANDED HOSPITAL PROGRAMS WERE DELIVERED 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. A SECOND MAJOR ACCOMPLISHMENT OF THIS YEAR IS THE ORGANIZATION'S RESPONSE TO OUR COMMUNITY NEEDS STEMMING FROM COVID-19. OUR HOSPITALS CONTINUED TO PROVIDE MEDICAL CARE, WHILE PROVIDING NEW SERVICES TO FIGHT COVID IN OUR COMMUNITY. IN 2020, CCHC: - EXPANDED ICU CAPACITIES AT BOTH HOSPITALS TO HANDLE AN INCREASE IN COVID PATIENTS - BUILT TRIAGE TENTS AT BOTH HOSPITALS - ESTABLISHED 3 TESTING SITES ACROSS THE REGION - UTILIZED THE EXPERTISE OF THE VNA TO LEAD THE COMMUNITY'S CONTACT TRACING PROGRAM - HELPED TO HOUSE HOMELESS PEOPLE WHO NEEDED TO BE QUARANTINED - CREATED A COVID-19 HOTLINE FOR THE COMMUNITY - SET UP A FIELD HOSPITAL AT JOINT BASE CAPE COD - ADMINISTERED COVID-19 VACCINES TO THE COMMUNITY.
PART VI, LINE 7 ALL STATES WHERE ORGANIZATION FILES A COMMUNITY BENEFITS REPORT: MA
Schedule H (Form 990) 2019
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
2019
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
1
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? ........................
2
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 (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) Harbor Health Center
1135 MORTON ST
MATTAPAN,MA02126 		23-7100550 501(c)(3) 100,000   FMV N/A Access to Care
(2) Duffy Health Center Inc
94 MAIN ST
HYANNIS,MA02452 		04-3373741 501(c)(3) 70,000   FMV N/A Access to Care
(3) Outer Cape Health Services
PO Box 1413
Wellfleet,MA02667 		04-2509828 501(c)(3) 123,000   FMV N/A Access to Care
(4) Alzheimer's Family Caregiver Support Center Inc
309 Waverly Oaks Rd
Waltham,MA02452 		13-3039601 501(c)(3) 30,000   FMV N/A Prevention & Wellness
(5) Cape Cod Commercial Fisherman's Alliance
1566 Main St
Chatham,MA02633 		04-3138784 501(c)(3) 30,000   FMV N/A Prevention & Wellness
(6) Cape Wellness Collaborative
11 Potter Ave
Hyannis,MA02601 		47-2360979 501(c)(3) 30,000   FMV N/A Chronic & Infectious Disease
(7) The Family Pantry of Cape Cod
133 Queen Anne Rd
Harwich,MA02645 		22-3079904 501(c)(3) 30,000   FMV N/A Prevention & Wellness
(8) YMCA Cape Cod
12245 IYANNOUGH RD
W BARNSTABLE,MA02668 		04-2394925 501(c)(3) 30,000   FMV N/A Chronic & Infectious Disease
(9) Cape Cod Times Needy Fund Inc
PO BOX 804
HYANNIS,MA02601 		22-2480332 501(c)(3) 30,000   FMV N/A Access to Care
(10) Stratus Video LLC
33 N Garden Ave
STE 100
Clearwater,FL33755 		47-2949558   12,444   FMV N/A Access to Care
(11) Barnstable County Sheriff's Office
6000 Sheriffs PL
Bourne,MA02532 		04-6002284 GOV'T 30,000   FMV N/A Access to Care
(12) HEALTH IMPERATIVES INC
942 W CHESTNUT ST
BROCKTON,MA02301 		04-2609177 501(c)(3) 30,000   FMV N/A Prevention & Wellness
(13) Team Maureen
PO Box 422 N
Falmouth,MA02556 		45-2473500 501(c)(3) 27,776   FMV N/A Chronic & Infectious Disease
(14) Samaritans on Cape Cod & the Islands
PO BOX 65
falmouth,MA02541 		04-2738811 501(c)(3) 15,831   FMV N/A Behavioral Health
(15) Boston Cancer Support Org Inc
831 Beacon St
Newton,MA02459 		30-0863587 501(c)(3) 20,000   FMV N/A Chronic & Infectious Disease
(16) NAMI Cape Cod Inc
5 MARK LANE
HYANNIS,MA02601 		04-2785229 501(c)(3) 25,000   FMV N/A Behavioral Health
(17) LC CREATIVE INC
62 Old Stone Ch Rd
Little Compton,RI02837 		03-7507635   7,415   FMV N/A Access To Care
(18) Housing Assistance Corporation
460 W Main Street
Hyannis,MA02601 		23-7431255 501(C)(3) 100,000   FMV N/A SDOH
(19) Cape & Islands Plastic Surgery
26 Gleason Street
Hyannis,MA02601 		45-2182632 501(C)(3) 64,047   FMV N/A Access to Care
(20) Association To Preserve Cape Cod
482 Main Street Route 6A
Dennis,MA02638 		04-2462788 501(C)(3) 25,000   FMV N/A SDOH - Built Environment
(21) Town of Barnstable
367 Main Street
Hyannis,MA02601 		04-6001079 GOV'T 25,000   FMV N/A Access to Care
(22) Barnstable County
PO Box 427
Barnstable,MA02630 		04-6001419 GOV'T 25,000   FMV N/A Access to Care
(23) Helping Our Women
34 Conwell St
Provincetown,MA02657 		04-3179955 501 (C)(3) 23,200   FMV N/A Chronic & Infectious Disease
(24) Cape Cod Literacy Council
PO Box 550
Hyannis,MA02601 		22-3098035 501(C)(3) 14,399   FMV N/A Prevention & Wellness
(25) PASTORAL MINISTRY
786 DARTMOUTH ST
DARTMOUTH,MA02748 		04-3096332 501(C)(3) 30,000       BEHAVIORAL HEALTH
(26) FAMILY TO FAMILY
500 MAIN STREET
HYANNIS,MA02601 		27-4058389 501(C)(3) 5,500       PREVENTION AND WELLNESS
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
24
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
2
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
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) 2019



Additional Data


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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
2019
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes on 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 .........
1b
 
 
2
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 on Line 1a? ..
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1MICHAEL K LAUF
PRESIDENT/CEO/TRUSTEE 		(i)

(ii)		 0
-------------
977,346 		0
-------------
450,000 		0
-------------
240,109 		0
-------------
233,600 		0
-------------
31,192 		0
-------------
1,932,247 		0
-------------
182,000
2ROBERT WILSTERMAN MD
TRUSTEE (UNTIL 1/20) 		(i)

(ii)		 672,311
-------------
0 		0
-------------
0 		21,772
-------------
0 		7,561
-------------
0 		34,820
-------------
0 		736,464
-------------
0 		0
-------------
0
3WILLIAM AGEL MD
TRUSTEE (UNTIL 04/2020) 		(i)

(ii)		 441,169
-------------
0 		47,326
-------------
0 		16,206
-------------
0 		11,200
-------------
0 		31,192
-------------
0 		547,093
-------------
0 		0
-------------
0
4THEODORE CALIANOS MD
TRUSTEE 		(i)

(ii)		 370,551
-------------
0 		0
-------------
0 		1,806
-------------
0 		11,200
-------------
0 		31,021
-------------
0 		414,578
-------------
0 		0
-------------
0
5PAUL HOULE MD
TRUSTEE (UNTIL 1/20) 		(i)

(ii)		 914,309
-------------
0 		116,000
-------------
0 		40,566
-------------
0 		11,200
-------------
0 		33,820
-------------
0 		1,115,895
-------------
0 		0
-------------
0
6MICHAEL L CONNORS
SENIOR VP FINANCE/CFO 		(i)

(ii)		 0
-------------
412,159 		0
-------------
101,200 		0
-------------
52,656 		0
-------------
38,347 		0
-------------
35,141 		0
-------------
639,503 		0
-------------
19,250
7MICHAEL G JONES ESQ
SEE SCHEDULE O 		(i)

(ii)		 0
-------------
312,542 		0
-------------
80,400 		0
-------------
34,652 		0
-------------
30,592 		0
-------------
34,141 		0
-------------
492,327 		0
-------------
15,219
8DONALD A GUADAGNOLI MD
Senior VP & CMO 		(i)

(ii)		 0
-------------
393,304 		0
-------------
96,600 		0
-------------
52,064 		0
-------------
36,860 		0
-------------
27,592 		0
-------------
606,420 		0
-------------
19,957
9ALEXANDER HEARD MD
CMO FALMOUTH HOSPITAL 		(i)

(ii)		 179,971
-------------
160,048 		33,300
-------------
0 		3,122
-------------
44,481 		5,657
-------------
24,656 		17,174
-------------
16,796 		239,224
-------------
245,981 		0
-------------
0
10PATRICK J KANE
SVP OF MRKTG,COMMUN AND DEVLP 		(i)

(ii)		 0
-------------
325,733 		0
-------------
79,600 		0
-------------
19,330 		0
-------------
30,284 		0
-------------
14,823 		0
-------------
469,770 		0
-------------
15,514
11CHRISTIAN BROWN
SR VP MANAGED CARE 		(i)

(ii)		 0
-------------
316,357 		0
-------------
79,200 		0
-------------
44,083 		0
-------------
30,218 		0
-------------
31,192 		0
-------------
501,050 		0
-------------
15,250
12EMILY SCHORER
SVP HUMAN RESOURCES 		(i)

(ii)		 0
-------------
263,136 		0
-------------
66,960 		0
-------------
24,426 		0
-------------
25,923 		0
-------------
32,141 		0
-------------
412,586 		0
-------------
12,950
13THERESA M AHERN
SVP STRATEGY & GOVT AFFAIRS 		(i)

(ii)		 0
-------------
205,482 		0
-------------
0 		0
-------------
28,623 		0
-------------
9,927 		0
-------------
5,442 		0
-------------
249,474 		0
-------------
12,000
14KEVIN MULROY
SVP CHIEF QUALITY & SAFETY OFF 		(i)

(ii)		 0
-------------
361,610 		0
-------------
90,500 		0
-------------
35,511 		0
-------------
33,575 		0
-------------
33,991 		0
-------------
555,187 		0
-------------
18,750
15JOHN PAUL SOLVERSON
SR VP & CIO 		(i)

(ii)		 0
-------------
420,721 		0
-------------
102,500 		0
-------------
1,806 		0
-------------
37,351 		0
-------------
14,835 		0
-------------
577,213 		0
-------------
0
16JEFFREY S DYKENS
VP FINANCE 		(i)

(ii)		 0
-------------
242,242 		0
-------------
84,126 		0
-------------
30,603 		0
-------------
23,983 		0
-------------
26,657 		0
-------------
407,611 		0
-------------
13,500
17NOELENE CERVIN
VP BUDGETING AND OPER. SUPPORT 		(i)

(ii)		 0
-------------
216,812 		0
-------------
44,700 		0
-------------
8,263 		0
-------------
21,419 		0
-------------
25,786 		0
-------------
316,980 		0
-------------
5,500
18LORI JEWETT
CEO - FH 		(i)

(ii)		 0
-------------
220,990 		0
-------------
51,400 		0
-------------
36,202 		0
-------------
23,217 		0
-------------
1,525 		0
-------------
333,334 		0
-------------
12,375
19ANNE MARIE PECKHAM
PRESIDENT VNA 		(i)

(ii)		 0
-------------
201,227 		0
-------------
37,087 		0
-------------
35,344 		0
-------------
9,806 		0
-------------
22,394 		0
-------------
305,858 		0
-------------
10,963
20CARTER HUNT
ADMIN SPEC&HOSP BASED CARE 		(i)

(ii)		 0
-------------
178,158 		0
-------------
22,551 		0
-------------
24,375 		0
-------------
19,194 		0
-------------
34,141 		0
-------------
278,419 		0
-------------
828
21JUDITH C QUINN
VP OF PATIENT CARE 		(i)

(ii)		 0
-------------
197,990 		0
-------------
46,835 		0
-------------
68,285 		0
-------------
9,607 		0
-------------
23,892 		0
-------------
346,609 		0
-------------
27,625
22DEBRA ROBINSON
ASSOC VP OF NRSNG 		(i)

(ii)		 168,045
-------------
0 		39,310
-------------
0 		42,354
-------------
0 		8,759
-------------
0 		24,530
-------------
0 		282,998
-------------
0 		11,137
-------------
0
23CYNTHIA MARLIN
VP PERIOPERATIVE & SURGICAL SV 		(i)

(ii)		 0
-------------
190,323 		0
-------------
36,460 		0
-------------
1,286 		0
-------------
19,098 		0
-------------
24,912 		0
-------------
272,079 		0
-------------
358
24ELIZABETH DUNTON
COO EMPLOYED PHYSICIAN SVCS 		(i)

(ii)		 0
-------------
205,001 		0
-------------
26,651 		0
-------------
1,275 		0
-------------
19,516 		0
-------------
1,525 		0
-------------
253,968 		0
-------------
828
25JEAN BUTLER
SVP EMPLYD PHY GRP(AS OF 4/19) 		(i)

(ii)		 0
-------------
188,563 		0
-------------
77,100 		0
-------------
20,181 		0
-------------
22,749 		0
-------------
14,122 		0
-------------
322,715 		0
-------------
1,438
26CHRISTOPHER M LAWSON
SVP DEVELOPMENT 		(i)

(ii)		 0
-------------
245,550 		0
-------------
60,000 		0
-------------
966 		0
-------------
7,933 		0
-------------
31,111 		0
-------------
345,560 		0
-------------
0
27SHERYL DECILIO
SEE SCHEDULE O 		(i)

(ii)		 0
-------------
264,923 		0
-------------
79,530 		0
-------------
854 		0
-------------
7,727 		0
-------------
1,349 		0
-------------
354,383 		0
-------------
0
28RICHARD B ZELMAN MD
PHYSICIAN 		(i)

(ii)		 1,466,656
-------------
0 		100,000
-------------
0 		116,234
-------------
0 		11,200
-------------
0 		32,668
-------------
0 		1,726,758
-------------
0 		0
-------------
0
29NICHOLAS COPPA MD
PHYSICIAN 		(i)

(ii)		 916,119
-------------
0 		116,000
-------------
0 		19,420
-------------
0 		11,200
-------------
0 		31,010
-------------
0 		1,093,749
-------------
0 		0
-------------
0
30ACHILLES PAPAVASILIOU MD
PHYSICIAN 		(i)

(ii)		 913,159
-------------
0 		116,000
-------------
0 		19,966
-------------
0 		11,200
-------------
0 		33,970
-------------
0 		1,094,295
-------------
0 		0
-------------
0
31GORDON NAKATA MD
PHYSICIAN 		(i)

(ii)		 914,309
-------------
0 		116,050
-------------
0 		18,966
-------------
0 		11,200
-------------
0 		33,820
-------------
0 		1,094,345
-------------
0 		0
-------------
0
32KARL B COYNER MD
PHYSICIAN 		(i)

(ii)		 671,237
-------------
0 		324,575
-------------
0 		21,772
-------------
0 		11,200
-------------
0 		11,790
-------------
0 		1,040,574
-------------
0 		0
-------------
0
33MOLLY SULLIVAN MD
TRUSTEE (AS OF 1/20) 		(i)

(ii)		 496,550
-------------
0 		20,839
-------------
0 		20,806
-------------
0 		11,200
-------------
0 		31,192
-------------
0 		580,587
-------------
0 		0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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 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 2019 WERE AS FOLLOWS: - MICHAEL K. LAUF - $82,576 - MICHAEL G. JONES - $17,269 - MICHAEL L. CONNORS - $22,423 - JEFFREY S. DYKENS - $16,021 - PATRICK KANE - $16,558 - THERESA AHERN - $13,409 - DONALD GUADAGNOLI MD - $22,215 - EMILY SCHORER - $13,735 - KEVIN MULROY - $19,834 - CHRISTIAN BROWN - $15,965 - LORI JEWETT - $11,621 - JUDITH C. QUINN - $39,701 - NOELENE CERVIN - $5,490 - ANNE MARIE PECKHAM - $22,314 - ELIZABETH DUNTON - $855 - CARTER HUNT - $803 - CYNTHIA MARLIN - $339 - DEBRA ROBINSON - $11,969 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 2019, 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 2019 WAS $120,000 AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN (C). IN ADDITION, $118,703 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) 2019

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet 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.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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
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 .................. 25,514,666 20,640,000 0 3,400,000
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 27,999,813 0
11 Other spent proceeds ............. 29,440,000 25,463,900 20,735,223 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 of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........ 		X   X   X     X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, 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) 2019

Schedule K (Form 990) 2019
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 ....SchKMediumBullet 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 ......... SchKMediumBullet        
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) 2019

Schedule K (Form 990) 2019
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 - 11/15/2019 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) 2019

Additional Data


Software ID:  
Software Version:  


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
SchKMediumBullet 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.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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
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 .................. 25,514,666 20,640,000 0 3,400,000
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 27,999,813 0
11 Other spent proceeds ............. 29,440,000 25,463,900 20,735,223 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 of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........ 		X   X   X     X
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, 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) 2019

Schedule K (Form 990) 2019
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 ....SchKMediumBullet 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 ......... SchKMediumBullet        
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) 2019

Schedule K (Form 990) 2019
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 - 11/15/2019 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) 2019

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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 section 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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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) 2019
Schedule L (Form 990 or 990-EZ) 2019
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?
Yes No
(1) DR KATHRYN RUDMAN SPOUSE OF TRUSTEE 321,010 MACC EMPLOYEE   No
(2) Sarah K Guadagnoli RN DAUGHTER OF KEY EMPLOYEE 75,660 CCH EMPLOYEE   No
(3) KIRA JONES SPOUSE OF OFFICER 84,895 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) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete 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 imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
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 14 1,816,257 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 Right pointing arrow large image ( )
26 Other Right pointing arrow large image ( )
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
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
29
 
Yes
No
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 isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization didn't 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) (2019)
Schedule M (Form 990) (2019)
Page 2
Part IISupplemental 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) (2019)

Additional Data


Software ID:  
Software Version:  
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
2019
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: RESIDENTS ACROSS BARNSTABLE COUNTY WITH FOCUS ON SPECIFIC REGIONS OF THE CAPE MOST ACUTELY IMPACTED BY GEOGRAPHIC ISOLATION, ACCESS TO SERVICES, TRANSPORTATION BARRIERS, AND ECONOMIC OPPORTUNITY. BASIS FOR SELECTION: CCHC'S PRIMARY SERVICE AREA IS BARNSTABLE COUNTY, WHICH IS A GEOGRAPHICALLY ISOLATED REGION LOCATED ON THE EASTERN SEABOARD OF MASSACHUSETTS AND IS MADE UP OF 15 TOWNS. NEARLY HALF THE POPULATION OF BARNSTABLE COUNTY RESIDE IN THE THREE LARGEST TOWNS. POPULATION SIZE BECOMES INCREASINGLY SMALLER IN TOWNS OF THE LOWER AND OUTER CAPE, AND MANY OF THESE TOWNS ARE CONSIDERED RURAL. LACK OF ACCESS TO HEALTHCARE AND OTHER SUPPORTIVE SERVICES IS A MAJOR BARRIER TO HEALTH FOR RESIDENTS OF THESE TOWNS. 2. NAME OF TARGET POPULATION: POPULATIONS MANAGING MENTAL HEALTH AND/OR BEHAVIORAL HEALTH 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 2020-2022 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT INCLUDE ACCESS TO SERVICES, LACK OF MENTAL HEALTH SERVICES, SUBSTANCE USE, LACK OF PREVENTATIVE SERVICES AND STIGMA. 3. NAME OF TARGET POPULATION: RESIDENTS OVER THE AGE OF 65. BASIS FOR SELECTION: CONSISTENT WITH THE PREVIOUS CHNA, THE POPULATION OF BARNSTABLE COUNTY IS OLDER THAN FOR THE STATE OVERALL (27.8% VS. 15.1%). BARNSTABLE COUNTY ALSO HAS A HIGHER PROPORTION OF RESIDENTS WHO ARE WITHIN THE "OLDEST" AGE CATEGORIES COMPARED TO MASSACHUSETTS OVERALL, INCLUDING THOSE AGE 75-84 (8.8% VS. 4.4%) AND THOSE AGE 85 AND OLDER (3.9% VS. 2.3%). "AGING HEALTH CONCERNS" WAS THE MOST FREQUENTLY IDENTIFIED HEALTH CONCERN FOR THE COMMUNITY BY SURVEY RESPONDENTS, 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. 4. NAME OF TARGET POPULATION: TRANSITIONAL-AGED YOUTH (18-24 YEARS OLD). BASIS FOR SELECTION: THE PROPORTION OF RESIDENTS OF BARNSTABLE COUNTY BETWEEN 18 AND 24 IS LOWER THAN IN THE STATE (7.3% VS. 10.4%). TRANSITIONAL-AGED YOUTH WERE IDENTIFIED IN THE 2020-2022 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. THE CHNA ALSO IDENTIFIED THE FOLLOWING NEEDS THAT IMPACT THIS POPULATION: WORKFORCE DEVELOPMENT, EMPLOYMENT, EDUCATION AND ECONOMIC OPPORTUNITIES. 5. NAME OF TARGET POPULATION: LOW-INCOME INDIVIDUALS AND FAMILIES. BASIS FOR SELECTION: ONE THIRD OF COMMUNITY SURVEY RESPONDENTS IDENTIFIED POVERTY AS ONE OF THEIR TOP SOCIAL CONCERNS. THE OVERALL MEDIAN HOUSEHOLD INCOME FOR BARNSTABLE COUNTY IS SLIGHTLY BELOW THE STATE ($65,382 VS. $70,954), AND GENERALLY MUCH LOWER IN NON-FAMILY AND RENTER-OCCUPIED HOUSEHOLDS. THE INDIVIDUAL POVERTY RATE FOR BARNSTABLE COUNTY IS LOWER THAN FOR THE STATE (5.4% VS. 9%). HOWEVER, THERE IS VARIABILITY BETWEEN TOWNS, WITH PROVINCETOWN (13.2%) AND CHATHAM (12.7%) HAVING HIGHER RATES OF POVERTY THAN THE STATE. PUBLICATION OF TARGET POPULATIONS MARKETING COLLATERAL, WEBSITE COMMUNITY HEALTH NEEDS ASSESSMENT DATE LAST ASSESSMENT COMPLETED CHNA REPORT 2020-2022 PUBLISHED TO CCHC CARING COMMUNITIES WEBSITE SEPTEMBER 2020. DATA SOURCES COMMUNITY FOCUS GROUPS, HOSPITAL, INTERVIEWS, OTHER, SURVEYS, CHNA DOCUMENT COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2020-2022.PDF IMPLEMENTATION STRATEGY IMPLEMENTATION STRATEGY DOCUMENT: FY20_SIP.PDF 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 THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) 2020-2022. WE ADDRESSED BARRIERS TO CARE BY ADDING SUPPORTIVE CONNECTORS IN THE CONTINUUM OF CARE. EXAMPLES: ALZHEIMER'S SUPPORT GROUPS, RECOVERY COACHES, COMMUNITY NAVIGATORS, OUTREACH, INTEGRATIVE THERAPIES AND TRANSPORTATION SOLUTIONS. CCHC COMMUNITY BENEFITS EXPANDED CROSS-SECTOR COMMUNITY PARTNERSHIPS AND LEADERSHIP WITHIN AND THROUGHOUT THE CAPE COD NON-PROFIT HEALTH AND HUMAN SERVICE SYSTEM. THE MAJOR ACCOMPLISHMENT THIS YEAR WAS THE PUBLICATION OF THE 2020-2022 CCH AND FH CHNA AND IMPLEMENTATION PLAN. THIS PLAN SERVED AS THE FOUNDATION FOR CCHC'S FY20 COMMUNITY BENEFITS PROGRAM, WHICH FOCUSED ON THESE 5 PRIORITIES: PHYSICAL HEALTH CONDITIONS, BEHAVIORAL HEALTH, TRANSPORTATION, HOUSING, AND WORKFORCE DEVELOPMENT. NEW AND EXPANDED HOSPITAL PROGRAMS WERE DELIVERED 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. A SECOND MAJOR ACCOMPLISHMENT OF THIS YEAR IS THE ORGANIZATION'S RESPONSE TO OUR COMMUNITY NEEDS STEMMING FROM COVID-19. OUR HOSPITALS CONTINUED TO PROVIDE MEDICAL CARE, WHILE PROVIDING NEW SERVICES TO FIGHT COVID IN OUR COMMUNITY. IN 2020, CCHC: . EXPANDED ICU CAPACITIES AT BOTH HOSPITALS TO HANDLE AN INCREASE IN COVID PATIENTS . BUILT TRIAGE TENTS AT BOTH HOSPITALS . ESTABLISHED 3 TESTING SITES ACROSS THE REGION . UTILIZED THE EXPERTISE OF THE VNA TO LEAD THE COMMUNITY'S CONTACT TRACING PROGRAM . HELPED TO HOUSE HOMELESS PEOPLE WHO NEEDED TO BE QUARANTINED . CREATED A COVID-19 HOTLINE FOR THE COMMUNITY . SET UP A FIELD HOSPITAL AT JOINT BASE CAPE COD . ADMINISTERED COVID-19 VACCINES TO THE COMMUNITY.
PLANS FOR NEXT REPORTING YEAR IN FY21, CCHC COMMUNITY BENEFITS WILL FOLLOW THE CHNA 2020-2022 GOALS AND STRATEGIC IMPLEMENTATION PLAN. THIS PLAN WAS PUT TOGETHER WITH CCHC LEADERSHIP AND OTHER COMMUNITY STAKEHOLDERS INCLUDING BARNSTABLE COUNTY HUMAN SERVICES AND BEHAVIORAL HEALTH AND INFECTIOUS DISEASE EXPERTS. IT IDENTIFIES THE PRIORITIES, POTENTIAL PARTNERS, AND GOALS AND OBJECTIVES FOR THE IMPLEMENTATION PLAN, WHICH WILL BE FOLLOWED FOR OUR NEXT REPORTING YEAR. THE PRIORITY AREAS AND GOALS FOR THE IMPLEMENTATION PLAN ARE: 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 ENSURE OUR COMMUNITY IS SERVED BY A STRONG, ADEQUATE HEALTHCARE WORKFORCE. FOOD/NUTRITION - FOSTER REGIONAL PARTNERS TO DEVELOP OF FOOD SECURITY ASSESSMENT PROCESS. SELF-ASSESSMENT FORM: HOSPITAL SELF-ASSESSMENT UPDATE FORM - YEARS 2 AND 3 COMMUNITY BENEFITS PROGRAMS ANNUAL STRATEGIC GRANTS PROGRAM: CHRONIC AND INFECTIOUS DISEASE AND PREVENTION AND WELLNESS PROJECTS . PROGRAM TYPE: COMMUNITY-CLINICAL LINKAGES. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES . PROGRAM DESCRIPTIONS: THE FY20 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 THE HEALTH PRIORITIES IDENTIFIED IN THE 2020-2022 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. . 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, EDUCATION, 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-DEPRESSION, 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, OTHER-SENIOR HEALTH CHALLENGES/CARE COORDINATION, 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-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, 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 - ADDITIONAL TARGET POPULATION 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 AND EVALUATING PROGRAMS COMPLETED AS SCHEDULED. PARTNERS PARTNER NAME, DESCRIPTION AND WEB ADDRESS 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 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 - OUTER CAPE HEALTH SERVICES HOUSING FOR HEALTH PARTNERSHIP - WWW.HACONCAPECOD.ORG CAPE WELLNESS COLLABORATIVE - WELLNESS CARDS FOR INTEGRATIVE SERVICES- WWW.CAPEWELLNESS.ORG TEAM MAUREEN - HPV PREVENTION THROUGH CAPE - WIDE EDUCATION - WWW.TEAMMAUREEN.ORG NATIONAL ALLIANCE ON MENTAL ILLNESS CAPE COD - MENTAL WELLNESS IN THE PORTUGUESE COMMUNITY- WWW.NAMICAPECOD.ORG SAMARITANS ON CAPE COD & THE ISLANDS - ELDER SUICIDE OUTREACH PREVENTION PROGRAM- WWW.CAPESAMARITANS.ORG YMCA CAPE COD - CHRONIC DISEASE PROGRAM COORDINATOR- WWW.YMCACAPECOD.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 ASSOCIATION TO PRESERVE CAPE COD - POND HEALTH PROGRAM - WWW.APCC.ORG HELPING OUR WOMEN - ACCESS AND EQUITY FOR OUTER CAPE WOMEN - HTTP://WWW.HELPINGOURWOMEN.ORG BRAIN INJURY ASSOCIATION OF MA - ANNUAL CERE-BRATION - HTTP://WWW.BIAMA.ORG ST. PETER THE APOSTLE CHURCH - ALZHEIMER'S AND DEMENTIA TRAINING FOR FIRST RESPONDERS AND COMMUNITY MEMBERS. - HTTP://WWW.STPETERS-PTOWN.ORG ROAR - RIDE FOR OPIOID ADDICTION RECOVERY - HTTP://WWW.ROARCAPECOD.COM CAPE COD LITERACY COUNCIL - HEALTH LITERACY - HTTP://WWW.CAPECODLITERACYCOUNCIL.ORG BARNSTABLE COUNTY SCHOOL DISTRICT - MEALS PROGRAM - HTTP://WWW.BARNSTABLE.K12.MA.US CAPE COD NATIONAL SEASHORE - HEALTHY PARKS HEALTHY PEOPLE EVENT 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. - HTTPS://WWW.NPS.GOV/CACO/INDEX.HTM DETAILED DESCRIPTION THE FY20 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 THE HEALTH PRIORITIES IDENTIFIED IN THE 2020-2022 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 HEALTH CENTER PARTNERSHIP, MENTORSHIP/CAREER TRAINING/INTERNSHIP, PREVENTION . EOHHS FOCUS ISSUE(S) (OPTIONAL): MENTAL ILLNESS AND MENTAL HEALTH, SUBSTANCE USE DISORDERS. . DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION, SOCIAL ENVIRONMENT. . HEALTH ISSUES: HEALTH BEHAVIORS/MENTAL HEALTH-MENTAL HEALTH, 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: NOT SPECIFIED
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 ONGOING GOAL DESCRIPTION RAISE AWARENESS: SUD IS PART OF MENTAL HEALTH AND MENTAL HEALTH ISSUES IN OUR BEHAVIORAL HEALTH PROGRAMS. GOAL STATUS ONGOING GOAL DESCRIPTION PROVIDE SUPPORT FOR SAFE OPPORTUNITIES FOR YOUTH IN BARNSTABLE COUNTY TO ENGAGE IN MEANINGFUL ACTIVITIES INCLUDING PHYSICAL ACTIVITIES AND MENTORSHIP. GOAL STATUS ONGOING GOAL DESCRIPTION PROVIDE SUPPORT FOR RECOVERY SERVICES IN THE COMMUNITY FOR PATIENTS WITH SUBSTANCE USE DISORDERS. GOAL STATUS ONGOING PARTNER NAME, DESCRIPTION AND WEB ADDRESS GOSNOLD, INC. - RECOVERY SPECIALISTS - WWW.GOSNOLD.ORG BARNSTABLE COUNTY REGIONAL SUBSTANCE USE COUNCIL - WWW.BCHUMANSERVICES.NET/INITIATIVES/REGIONAL-SUBSTANCE-USE-COUNCIL/ OUTER CAPE HEALTH SERVICES - OFFICE BASED ADDICTION TREATMENT - WWW.OUTERCAPE.ORG DUFFY HEALTH CENTER - RECOVERY COACH / NAVIGATOR PROGRAM - WWW.DUFFYHEALTHCENTER.ORG BIG BROTHERS BIG SISTERS - MENTORING PROGRAM FOR CHILDREN AT RISK FOR SUBSTANCE USE DISORDER - HTTPS://EMASSBIGS.ORG/CAPE-COD/ PAUSE A WHILE - PROVIDING ACCESS TO LONG TERM TREATMENT FOR SUD AS A COMPONENT OF THE TREATMENT FOR AND ITS RELATED IMPACT ON PHYSICAL WELLNESS - HTTPS://PAUSEAWHILE.ORG/ PROGRAM DESCRIPTION - CAPE COD HEALTHCARE HAS IDENTIFIED A SIGNIFICANT NEED FOR SUBSTANCE USE DISORDER PREVENTION AND TREATMENT IN OUR COMMUNITY. THROUGH A VARIETY OF PROGRAMS AND PARTNERSHIPS, CCHC HAS MADE A COMMITMENT TO DIRECT RESOURCES TOWARDS THIS COMMUNITY HEALTH ISSUE. PROGRAMS INCLUDE: - 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. - INVESTMENTS IN PREVENTION PROGRAMS INCLUDING MENTORING FOR AT RISK YOUTH - INNOVATIVE TREATMENTS INCLUDING OFFICE BASED ADDICTION TREATMENT - SUPPORT SERVICES TO MEET COMMUNITY MEMBERS WHERE THEY ARE, INCLUDING MATERNITY DEPARTMENT TOURS FOR MOTHERS EXPERIENCING SUBSTANCE USE DISORDER. SUPPORT TO FEDERALLY QUALIFIED HEALTH CENTERS . PROGRAM TYPE: ACCESS/COVERAGE SUPPORTS. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES . PROGRAM HASHTAGS: COMMUNITY HEALTH CENTER PARTNERSHIP . EOHHS FOCUS ISSUE(S) (OPTIONAL): MENTAL ILLNESS AND MENTAL HEALTH. . DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, SOCIAL ENVIRONMENT. . HEALTH ISSUES: HEALTH BEHAVIORS/MENTAL HEALTH-MENTAL HEALTH, INFECTIOUS DISEASES, COVID-19, 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: BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED 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 2020-2022. GOAL STATUS COMPLETE. CCHC WILL CONTINUE TO SUPPORT FQHCS IN BARNSTABLE COUNTY TO EXPAND THE CONTINUUM OF CARE AND INCREASE ACCESS TO SERVICES. 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/ PROGRAM DESCRIPTION - CAPE COD HEALTHCARE COMMUNITY BENEFITS PROVIDES SUPPORT TO FEDERALLY QUALIFIED HEALTH CENTERS ON CAPE COD TO INCREASE HEALTHCARE ACCESS TO THOSE WHO ARE UN- OR UNDERINSURED. PROGRAMS ALIGN WITH THE PRIORITIES IDENTIFIED IN THE 2020-2022 CHNA. CCHC CANCER SUPPORT SERVICES AND SURVIVORSHIP ACTIVITIES . PROGRAM TYPE: DIRECT CLINICAL SERVICES. . 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): 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 PSYCHO-SOCIAL SUPPORT TO OVER 3,000 PATIENTS. TIMEFRAME: YEAR 1 OF 3 GOAL STATUS EXCEEDED GOAL. GOAL DESCRIPTION SUPPORT GROUPS WILL BE PROVIDED TO PATIENTS AND FAMILIES. TIMEFRAME: YEAR 1 OF 3 GOAL STATUS ALTHOUGH COVID IMPACTED NUMBERS, THIS GOAL WAS MET. GOAL DESCRIPTION CCHC WILL OFFER AN ONCOLOGY NUTRITION PROGRAM TO IMPROVE PATIENTS' QUALITY OF LIFE AND OUTCOMES. TIMEFRAME: YEAR 1 OF 3 GOAL STATUS GOAL ACHIEVED. 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 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. SERVICES INCLUDE AN ONCOLOGY NUTRITION PROGRAM AND THE LIVING FIT FOR YOU! CANCER WELLNESS PROGRAM. CANCER SURVIVORSHIP IS CELEBRATED, SUPPORTED AND RECOGNIZED WITHIN HOSPITAL DEPARTMENTS AND IN THE COMMUNITY. CCHC ALSO OFFERS SPECIAL FINANCIAL NAVIGATORS IN THE CANCER CENTERS SPECIALLY TRAINED IN CANCER TREATMENT EXPENSES.
HEALTH EDUCATION . 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, MENTAL ILLNESS AND MENTAL HEALTH. . DON HEALTH PRIORITIES (OPTIONAL): 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-CARDIAC DISEASE, CHRONIC DISEASE-DIABETES, CHRONIC DISEASE-HYPERTENSION, CHRONIC DISEASE-OVERWEIGHT AND OBESITY, CHRONIC DISEASE-PULMONARY 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-STRESS MANAGEMENT, INFECTIOUS DISEASES, COVID-19, INJURY-HOME INJURIES, MATERNAL/CHILD HEALTH-PARENTING SKILLS, MATERNAL/CHILD HEALTH-REPRODUCTIVE AND MATERNAL HEALTH, OTHER-SENIOR HEALTH CHALLENGES/CARE COORDINATION, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE, SOCIAL DETERMINANTS OF HEALTH-EDUCATION/LEARNING. . TARGET POPULATION: REGIONS SERVED: BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED GOAL DESCRIPTION AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, HEALTH EDUCATION AND OUTREACH ACTIVITIES ARE OFFERED TO THE COMMUNITY ACROSS A NUMBER OF DIFFERENT HEALTH AREAS. FROM MATERNITY DEPARTMENT TOURS AND NEW PARENTING CLASSES, TO COMMUNITY-BASED DIABETES AND STROKE EDUCATION, FALL PREVENTION CLASSES, AND ADVANCE CARE PLANNING PRESENTATIONS, THE HOSPITALS DEDICATE CLINICAL STAFF AND RESOURCES TO SUPPORT THE EDUCATION AND HEALTH LITERACY OF BARNSTABLE COUNTY RESIDENTS. TIMEFRAME: YEAR 1 OF 3 GOAL STATUS EDUCATIONAL OFFERINGS ARE ONGOING. DUE TO COVID-RELATED RESTRICTIONS, MANY OFFERINGS PIVOTED TO VIRTUAL EVENTS. STAFF IS READY TO CONTINUE WITH IN-PERSON OFFERINGS WHEN APPROPRIATE. PARTNER NAME, DESCRIPTION AND WEB ADDRESS AMERICAN CANCER SOCIETY - WWW.CANCER.ORG VISITING NURSES ASSOCIATION OF CAPE COD - WWW.VNACAPECOD.ORG PROGRAM DESCRIPTION - AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, HEALTH EDUCATION AND OUTREACH ACTIVITIES ARE OFFERED TO THE COMMUNITY ACROSS A NUMBER OF DIFFERENT HEALTH AREAS. FROM MATERNITY DEPARTMENT TOURS, BREASTFEEDING AND NEW PARENTING CLASSES, TO COMMUNITY-BASED DIABETES, AND STROKE EDUCATION, THE HOSPITALS DEDICATE CLINICAL STAFF AND RESOURCES TO SUPPORT THE EDUCATION AND HEALTH LITERACY OF BARNSTABLE COUNTY RESIDENTS. THIS YEAR WE ALSO ENGAGED IN AWARENESS CAMPAIGNS ON ISSUES RELATED TO WOMEN'S HEALTH, HEART HEALTH, AND COVID-19. POPULAR PROGRAMS THIS YEAR INCLUDED AN ADVANCED CARE PLANNING PRESENTATION, COMMUNITY EDUCATION ON GENETIC TESTING AND CANCER SCREENINGS AND VARIOUS BEHAVIORAL HEALTH COMMUNITY EDUCATION EVENTS. COMMUNITY-BASED INTERPRETER SERVICES . PROGRAM TYPE: ACCESS/COVERAGE SUPPORTS. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES . PROGRAM HASHTAGS: HEALTH PROFESSIONAL/STAFF TRAINING. . 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: NOT SPECIFIED.
GOAL DESCRIPTION ASSIST MORE THAN 800 INDIVIDUALS WITH FREE MEDICAL INTERPRETERS IN COMMUNITY-BASED PRIMARY CARE AND SPECIALTY CARE SETTINGS. GOAL STATUS WE CONTINUED TO ASSIST INDIVIDUALS WITH FREE INTERPRETER SERVICES, ALTHOUGH NUMBERS ARE DOWN THIS YEAR DUE TO COVID. GOAL DESCRIPTION ANALYZE PROGRAM UTILIZATION DATA TO ASSESS REGIONAL MEDICAL INTERPRETATION NEEDS FOR PROGRAM EVALUATION. GOAL STATUS COMPLETED. GOAL DESCRIPTION REACH MORE AREAS THROUGHOUT THE CAPE BY IMPLEMENTING A VIDEO INTERPRETER PROGRAM GOAL STATUS COMPLETED: IMPLEMENTED 10 VIDEO REMOTE UNITS TO ENSURE THAT LIMITED SPEAKING PATIENTS HAVE BETTER ACCESS FOR AN INTERPRETER 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 OFFICE OF MULTICULTURAL AFFAIRS - DPH - HTTPS://WWW.MASS.GOV/OREI PROGRAM DESCRIPTION - CCHC PROVIDES FREE MEDICAL LANGUAGE INTERPRETERS TO COMMUNITY-BASED PHYSICIAN OFFICES AND HOSPITALS 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. CHILDREN'S COVE PARTNERSHIP . PROGRAM TYPE: DIRECT CLINICAL SERVICES. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: NO . PROGRAM HASHTAGS: HEALTH PROFESSIONAL/STAFF TRAINING. . EOHHS FOCUS ISSUE(S) (OPTIONAL): VIOLENCE. . DON HEALTH PRIORITIES (OPTIONAL): HEALTH BEHAVIORS/MENTAL HEALTH-DEPRESSION, HEALTH BEHAVIORS/MENTAL HEALTH-MENTAL HEALTH, INJURY-HOME INJURIES, SOCIAL DETERMINANTS OF HEALTH-VIOLENCE AND TRAUMA,. . TARGET POPULATION: REGIONS SERVED: BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: CHILDREN, INFANTS, TEENAGERS RACE/ETHNICITY: ALL, HYANNIS LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: DOMESTIC VIOLENCE HISTORY GOAL DESCRIPTION THE NURSE PRACTITIONER WILL: PROVIDE AN ONSITE VISUAL MEDICAL EXAM IN A CHILD-FRIENDLY SETTING ENSURE THE HEALTH AND SAFETY OF CHILD THROUGH A NON-INVASIVE EXAM "USING A DO NO HARM APPROACH" IDENTIFY, EDUCATE AND PROVIDE REFERRALS FOR INSTANCES OF SEXUALLY TRANSMITTED INFECTIONS AND/OR PREGNANCY PHOTO-DOCUMENT AND COLLECT EVIDENCE IF INDICATED. SUPPORT THE CHILD IN THEIR WELLNESS. GOAL STATUS ALL MEDICAL EXAMS ARE COMPLETED PRIVATELY AT CHILDREN'S COVE AND WITH PARENTAL PERMISSION. CHILDREN ARE ALWAYS TREATED WITH DIGNITY AND RESPECT, AND THE FOCUS OF THE EXAM IS TO SUPPORT THE CHILD IN THEIR WELLNESS. DURING THE EXAM, THE NURSE PRACTITIONER DOES NOT: USE ANY INVASIVE TOOLS CAUSE ANY PAIN INTERVIEW THE CHILD SPECULATE IF ANYTHING DID OR DID NOT HAPPEN. PARTNER NAME, DESCRIPTION AND WEB ADDRESS CHILDREN'S COVE - HTTP://WWW.CHILDRENSCOVE.ORG PROGRAM DESCRIPTION - FUNDING FOR A SPECIALTY TRAINED NURSE PRACTITIONER TO PROVIDE A NON-INVASIVE PHYSICAL EXAM TO CHILD VICTIMS OF ABUSE AND SEXUAL ASSAULT. AFTER A CHILD HAS MADE THE BRAVE CHOICE TO DISCLOSE THEIR ABUSE THERE IS OFTEN THE QUESTION "IS MY BODY OK?" WE WANT TO ALLEVIATE SOME OF THE STRESS FROM A CHILD AND CAREGIVERS MIND. BECAUSE OF THAT WE HAVE PARTNERED WITH CHILDREN'S COVE AND THE MASSACHUSETTS PEDIATRIC SEXUAL ASSAULT NURSE EXAMINER PROGRAM (PEDISANE) TO HAVE A SPECIALLY TRAINED NURSE PRACTITIONER ON STAFF TO ENSURE THE BEST HEALTH AND WELFARE OF THE CHILD. ALSO INCLUDED IS THE COST OF LAB TESTING SERVICES FOR THESE PATIENTS. MENTAL HEALTH SERVICES IN THE COMMUNITY . PROGRAM TYPE: DIRECT CLINICAL SERVICES. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: NO . PROGRAM HASHTAGS: COMMUNITY EDUCATION, COMMUNITY HEALTH CENTER PARTNERSHIP, HEALTH PROFESSIONAL/STAFF TRAINING. . EOHHS FOCUS ISSUE(S) (OPTIONAL): MENTAL ILLNESS AND MENTAL HEALTH. . DON HEALTH PRIORITIES (OPTIONAL): SOCIAL ENVIRONMENT. . HEALTH ISSUES: HEALTH BEHAVIORS/MENTAL HEALTH-BEREAVEMENT, HEALTH BEHAVIORS/MENTAL HEALTH-DEPRESSION, HEALTH BEHAVIORS/MENTAL HEALTH-MENTAL HEALTH, HEALTH BEHAVIORS/MENTAL HEALTH-STRESS MANAGEMENT. . TARGET POPULATION: REGIONS SERVED: BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ADULTS, CHILDREN, ELDERLY, TEENAGERS, RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED. GOAL DESCRIPTION 90% OF PATIENTS SEEN BY THE DUFFY TEAM AT CAPE COD HOSPITAL CONNECT TO DUFFY SERVICES POST-DISCHARGE. GOAL STATUS ACHIEVED. PARTNER NAME, DESCRIPTION AND WEB ADDRESS DUFFY HEALTH CENTER - BRIDGE CLINIC PROGRAM - HTTPS://WWW.DUFFYHEALTHCENTER.ORG PROGRAM DESCRIPTION - CAPE COD HEALTHCARE BEHAVIORAL HEALTH PHYSICIANS AND CLINICIANS PROVIDE COMMUNITY-BASED MENTAL HEALTH SERVICES IN OUR REGION. THIS INCLUDES PSYCHIATRIC CONSULTS TO FIRST RESPONDERS, SERVING AS THE ON-CALL PSYCHIATRIST TO THE COMMUNITY, A BEHAVIORAL HEALTH COMMUNITY HELPLINE, AND THE BRIDGE CLINIC, WHICH CONNECTS PATIENTS IN INPATIENT TREATMENT WITH COMMUNITY SERVICES. SHINE PROGRAM . PROGRAM TYPE: ACCESS/COVERAGE SUPPORTS. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES . PROGRAM HASHTAGS: COMMUNITY EDUCATION, HEALTH PROFESSIONAL/STAFF TRAINING. . EOHHS FOCUS ISSUE(S) (OPTIONAL): N/A. . DON HEALTH PRIORITIES (OPTIONAL): N/A. . HEALTH ISSUES: SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE. . TARGET POPULATION: REGIONS SERVED: BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ELDERLY RACE/ETHNICITY: ALL, HYANNIS LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED. GOAL DESCRIPTION PROVIDE OVER 5,000 COUNSELING SESSIONS TO CAPE & ISLAND RESIDENTS. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS EXCEEDED GOAL: IN FY20 SHINE PROVIDED 6,197 COUNSELING SESSIONS RESULTING IN 4,513 COUNSELING HOURS. GOAL DESCRIPTION REACH 1500 RESIDENTS THROUGH COMMUNITY TRAININGS AND PRESENTATIONS. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS EXCEEDED GOAL. PARTNER NAME, DESCRIPTION AND WEB ADDRESS BARNSTABLE COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES - HTTPS://WWW.BARNSTABLECOUNTYHEALTH.ORG/ PROGRAM DESCRIPTION - SHINE (SERVING THE HEALTH INSURANCE NEEDS OF EVERYONE) PROVIDES FREE HEALTH INSURANCE INFORMATION, COUNSELING AND ASSISTANCE TO MEDICARE BENEFICIARIES. THESE COMMUNITY BENEFITS FUNDS ARE SPECIFICALLY TARGETED TO HIRING PART TIME PROGRAM STAFF TO ASSIST THE PROGRAM MANAGER IN HANDLING THE INCREASING NUMBER OF SENIORS SEEKING ASSISTANCE WITH MEDICARE ENROLLMENT, ESPECIALLY DURING THE SEVEN WEEKS OF OPEN ENROLLMENT (OCTOBER 15 -DECEMBER 7). SHINE ASSISTS HUNDREDS OF ADDITIONAL MEDICARE BENEFICIARIES IN BARNSTABLE COUNTY.
ASSISTANCE PROGRAM FOR VULNERABLE POPULATIONS . PROGRAM TYPE: ACCESS/COVERAGE SUPPORTS. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: YES . PROGRAM HASHTAGS: 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, . DON HEALTH PRIORITIES (OPTIONAL): SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO TRANSPORTATION, SOCIAL DETERMINANTS OF HEALTH-INCOME AND POVERTY. . TARGET POPULATION: REGIONS SERVED: BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ALL RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED. GOAL DESCRIPTION ASSIST PATIENTS WHO ARE UNABLE TO AFFORD OR ACCESS TRANSPORTATION TO ENSURE COMPLIANCE WITH THEIR DISCHARGE PLAN. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS ACUITY/LYFT AND VOUCHERS FOR LOCAL TAXI SERVICE USED AT BOTH HOSPITALS. GOAL DESCRIPTION ASSIST RESIDENTS WHO ARE UNABLE TO AFFORD MEDICATIONS TO ENSURE COMPLIANCE WITH HOSPITAL DISCHARGE PLANNING. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS ONGOING ASSISTANCE OCCURS THROUGH PHARMACIES AT BOTH HOSPITALS GOAL DESCRIPTION ASSIST PATIENTS IN NEED WITH THEIR FINANCIAL QUESTIONS AND NEEDS. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS FINANCIAL COUNSELORS ARE AVAILABLE AT BOTH HOSPITALS. COUNSELORS ARE TRAINED IN THE SPECIFIC NEEDS OF THEIR DEPARTMENTS (EX. CANCER TREATMENT EXPENSES) PARTNER NAME, DESCRIPTION AND WEB ADDRESS CAPE COD HEALTHCARE PHARMACIES AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL - HTTPS://WWW.CAPECODHEALTH.ORG/MEDICAL-SERVICES/PHARMACY/ ACUITY/LYFT - SCHEDULING & TRANSPORTATION - HTTPS://WWW.LYFT.COM/BLOG/POSTS/RESEARCH-IMPROVING-ACCESS-TO-CARE-MEDICAID AMERICAN CANCER SOCIETY - HTTP://WWW.CANCER.ORG PROGRAM DESCRIPTION - IN AN EFFORT TO ASSIST LOW-INCOME AND VULNERABLE POPULATIONS, CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROVIDED VARIOUS SERVICES TO INCREASE ACCESS TO HEALTHCARE. THIS INCLUDES: - ACCESS TO TRANSPORTATION UPON DISCHARGE TO THOSE PATIENTS WITHOUT RESOURCES FOR TRANSPORTATION. - THE PRESCRIPTION ASSISTANCE PROGRAM: 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. THE ASSISTANCE PROGRAM FOR VULNERABLE POPULATIONS IS HIGHLY UTILIZED IN THE BEHAVIORAL HEALTH CENTER, THE CANCER CENTERS, AND THE EMERGENCY DEPARTMENTS. - FINANCIAL COUNSELORS ASSIST PATIENTS WITH COMPLICATED MEDICAL BILLS AND CONNECT THOSE IN NEED TO COMMUNITY RESOURCES. WORKFORCE AND CAREER DEVELOPMENT INITIATIVES . PROGRAM TYPE: TOTAL POPULATION OR COMMUNITY-WIDE INTERVENTIONS. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: NO . PROGRAM HASHTAGS: HEALTH PROFESSIONAL/STAFF TRAINING, MENTORSHIP/CAREER TRAINING/INTERNSHIP, PHYSICIAN/PROVIDER DIVERSITY, . EOHHS FOCUS ISSUE(S) (OPTIONAL): N/A. . DON HEALTH PRIORITIES (OPTIONAL): EDUCATION, EMPLOYMENT, SOCIAL ENVIRONMENT. . HEALTH ISSUES: SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE, SOCIAL DETERMINANTS OF HEALTH-EDUCATION/LEARNING, SOCIAL DETERMINANTS OF HEALTH-INCOME AND POVERTY. . TARGET POPULATION: REGIONS SERVED: BARNSTABLE - ENVIRONMENTS SERVED: ALL GENDER: ALL AGE GROUP: ADULTS, TEENAGERS, RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: DISABILITY 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 1 OF 3. GOAL STATUS COVID-19 RESTRICTIONS LIMITED STUDENT SUPERVISION OPPORTUNITIES THIS YEAR. GOAL DESCRIPTION CCHC WILL OFFER HIGH QUALITY AND DIVERSE TRAINING OPPORTUNITIES TO CLINICAL STAFF SERVING RESIDENTS OF BARNSTABLE COUNTY TO ENSURE RESIDENTS RECEIVE THE HIGHEST QUALITY HEALTHCARE. GOAL STATUS ALTHOUGH COVID-19 RESTRICTIONS REDUCED THE NUMBER OF IN-PERSON TRAINING OPPORTUNITIES, TRAINING PROGRAMS PIVOTED TO VIRTUAL OFFERINGS WHEN APPROPRIATE. PARTNER NAME, DESCRIPTION AND WEB ADDRESS THE RIVERVIEW SCHOOL - WWW.RIVERVIEWSCHOOL.ORG UPPER CAPE REGIONAL TECHNICAL SCHOOL - WWW.UPPERCAPETECH.COM/ CAPE COD COMMUNITY COLLEGE - HTTPS://WWW.CAPECOD.EDU/ DUFFY HEALTH CENTER - HTTP://WWW.DUFFYHEALTHCENTER.ORG OUTER CAPE HEALTH - HTTP://WWW.OUTERCAPE.ORG HARBOR HEALTH CENTER - HTTPS://WWW.HHSI.US/LOCATION/CAPE-COD-SOUTH-SHORE-HEALTH-CENTERS/ COMMUNITY HEALTH CENTER OF CAPE COD - HTTPS://CHCOFCAPECOD.ORG/ 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. CCHC ALSO INVESTS IN TRAININGS FOR CLINICAL STAFF PRACTICING IN BARNSTABLE COUNTY. EXAMPLES INCLUDE CREDENTIALING FOR BARNSTABLE COUNTY'S FQHC MEDICAL STAFF, SPECIALTY TRAININGS SUCH AS "AGE SPECIFIC CONSIDERATIONS IN CARING FOR THE CANCER PATIENT,TECHNICAL TRAININGS SUCH AS "INTRA-AORTIC BALLOON COUNTERPULSATION THERAPY." ADDITIONALLY, CCHC ENGAGES IN RECRUITMENT OF PROVIDERS FOR BARNSTABLE COUNTY'S FQHCS, WHICH INCREASES ACCESS TO HEALTHCARE BY INCREASING THE NUMBER OF PROVIDERS AVAILABLE IN THE REGION. COMMUNITY LEADERSHIP IN HEALTHCARE . PROGRAM TYPE: COMMUNITY-CLINICAL LINKAGES. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: NO . PROGRAM HASHTAGS: COMMUNITY EDUCATION, HEALTH PROFESSIONAL/STAFF TRAINING. . 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): N/A. . 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, 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?"COVID-19, INJURY-HOME INJURIES, INJURY-OTHER, MATERNAL/CHILD HEALTH-CHILD CARE, MATERNAL/CHILD HEALTH-FAMILY PLANNING, MATERNAL/CHILD HEALTH-PARENTING SKILLS, MATERNAL/CHILD HEALTH-REPRODUCTIVE AND MATERNAL HEALTH, OTHER-SENIOR HEALTH CHALLENGES/CARE COORDINATION, SOCIAL DETERMINANTS OF HEALTH-ACCESS TO HEALTH CARE, SOCIAL DETERMINANTS OF HEALTH-AFFORDABLE HOUSING, SOCIAL DETERMINANTS OF HEALTH-HOMELESSNESS, SOCIAL DETERMINANTS OF HEALTH-UNINSURED/UNDERINSURED, SOCIAL DETERMINANTS OF HEALTH-VIOLENCE AND TRAUMA, SUBSTANCE ADDICTION-ALCOHOL USE, SUBSTANCE ADDICTION-OPIOID USE, SUBSTANCE ADDICTION-SUBSTANCE USE. . TARGET POPULATION: REGIONS SERVED: BARNSTABLE, ENVIRONMENTS SERVED: ALL GENDER: ALL - AGE GROUP: ALL - RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED.
GOAL DESCRIPTION CCHC STAFF WILL SERVE AS LEADERS FOR COMMUNITY COALITIONS AND INITIATIVES THAT ADDRESS NEEDS IDENTIFIED IN THE 2020-2022 CHNA. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS ALTHOUGH SOME COALITIONS PAUSED OPERATIONS DURING THE COVID-19 CRISIS, MANY CONTINUED TO WORK VIRTUALLY. CCHC STAFF CONTINUED IN THEIR ROLES ON VARIOUS BOARDS AND COALITIONS IN THE COMMUNITY. PARTNER NAME, DESCRIPTION AND WEB ADDRESS ZERO SUICIDE INITIATIVE - HTTPS://ZEROSUICIDE.EDC.ORG/ JML CARE CENTER - SKILLED NURSING FACILITY COORDINATION - HTTPS://WWW.CAPECODHEALTH.ORG/LOCATIONS/PROFILE/JML-CARE-CENTER/ PROGRAM DESCRIPTION - CCHC STAFF ARE LEADERS IN OUR REGION ON ISSUES RELATED TO COMMUNITY HEALTH AND WELLNESS. STAFF SERVE IN LEADERSHIP POSITIONS ON A VARIETY OF COALITIONS AND INITIATIVES INCLUDING: THE ZERO SUICIDE INITIATIVE; VARIOUS COALITIONS WORKING ON MENTAL HEALTH, WELLNESS AND SUBSTANCE USE; COUNTY-LEVEL BOARD AND COMMITTEE POSITIONS; REGIONAL NETWORK ON HOMELESSNESS; POSTPARTUM DEPRESSION TASK FORCE; AND COORDINATION BETWEEN SKILLED NURSING FACILITIES IN OUR AREA. CCHC STAFF ARE INSTRUMENTAL IN CREATING POLICY AND PROGRAMS TO SERVE THE HEALTH AND WELLNESS OF OUR COMMUNITY. SUPPORT GROUPS AND COMMUNITY RESOURCES FOR WELLNESS . PROGRAM TYPE: DIRECT CLINICAL SERVICES. . PROGRAM IS PART OF A GRANT OR FUNDING PROVIDED TO AN OUTSIDE ORGANIZATION: NO . PROGRAM HASHTAGS: COMMUNITY EDUCATION, SUPPORT GROUP. . EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES, MENTAL ILLNESS AND MENTAL HEALTH. . DON HEALTH PRIORITIES (OPTIONAL): BUILT ENVIRONMENT, EDUCATION, SOCIAL ENVIRONMENT. . HEALTH ISSUES: CANCER-BREAST, CHRONIC DISEASE-ALZHEIMER'S DISEASE, CHRONIC DISEASE-CARDIAC DISEASE, CHRONIC DISEASE-DIABETES, HEALTH BEHAVIORS/MENTAL HEALTH-BEREAVEMENT, HEALTH BEHAVIORS/MENTAL HEALTH-DEPRESSION, HEALTH BEHAVIORS/MENTAL HEALTH-MENTAL HEALTH, HEALTH BEHAVIORS/MENTAL HEALTH-STRESS MANAGEMENT, MATERNAL/CHILD HEALTH-CHILD CARE, MATERNAL/CHILD HEALTH-FAMILY PLANNING, MATERNAL/CHILD HEALTH-PARENTING SKILLS, MATERNAL/CHILD HEALTH-REPRODUCTIVE AND MATERNAL HEALTH, OTHER-SENIOR HEALTH CHALLENGES/CARE COORDINATION,. . TARGET POPULATION: REGIONS SERVED: BARNSTABLE, ENVIRONMENTS SERVED: ALL GENDER: ALL - AGE GROUP: ALL - RACE/ETHNICITY: ALL LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED. GOAL DESCRIPTION WORK WITH COMMUNITY STAKEHOLDERS AND PROVIDERS TO DETERMINE NEEDS FOR SUPPORT GROUPS AND MENTAL HEALTH WELLNESS SERVICES AND IMPLEMENT SERVICES IN A WAY THAT MAKES THEM ACCESSIBLE TO THE ENTIRE COMMUNITY. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS SUPPORT GROUPS WERE IMPLEMENTED BASED ON FINDINGS FROM THE CHNA. GROUPS WERE ABLE TO PIVOT TO CONTINUE TO OFFER SERVICES DESPITE THE COVID-19 CRISIS. PARTNER NAME, DESCRIPTION AND WEB ADDRESS VISITING NURSE ASSOCIATION OF CAPE COD - VNA -HTTPS://WWW.CAPECODHEALTH.ORG/ABOUT/VNA/ PROGRAM DESCRIPTION - CAPE COD HEALTHCARE OFFERS A VARIETY OF SUPPORT GROUPS AND OTHER RESOURCES FOR MENTAL HEALTH AND WELLNESS IN OUR COMMUNITY. THESE INCLUDE HELPLINES FOR BEHAVIORAL HEALTH AND BREASTFEEDING HELP, VARIOUS SUPPORT GROUPS FOR NEW PARENTS, SUPPORT GROUPS FOR VARIOUS DISEASES AND PHYSICAL CONDITIONS, AND BEREAVEMENT SUPPORT GROUPS. THESE SERVICES NOT ONLY PROVIDE A SOCIAL SUPPORT SYSTEM THAT ENCOURAGES SHARING SIMILAR EXPERIENCES WITH THE GROUP, BUT ALSO ACTS AS A PLACE TO MEET PATIENTS WHERE THEY ARE AND REFER THEM TO ANY COMMUNITY SERVICES THEY MAY NEED. CONGESTIVE HEART FAILURE CLINIC . PROGRAM TYPE: DIRECT CLINICAL SERVICES. . 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): BUILT ENVIRONMENT, EDUCATION. . HEALTH ISSUES: CHRONIC DISEASE-CARDIAC DISEASE,. . TARGET POPULATION: REGIONS SERVED: BARNSTABLE, ENVIRONMENTS SERVED: ALL GENDER: ALL - AGE GROUP: ADULTS, ELDERLY, - RACE/ETHNICITY: ALL, HYANNIS LANGUAGE: ALL - ADDITIONAL TARGET POPULATION STATUS: NOT SPECIFIED. GOAL DESCRIPTION PROVIDE THE NECESSARY MATERIALS FOR THIS DEPARTMENT TO BE COMPLIANT WITH THE PROPER PROCEDURES AND DISPOSAL OF SHARPS TO PATIENTS IN THE CONGESTIVE HEART FAILURE CLINIC. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS ONGOING. GOAL DESCRIPTION KEEP HEART FAILURE PATIENTS OUT OF THE HOSPITAL. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS ONGOING. GOAL DESCRIPTION MODIFY PATIENTS' RISK FACTORS FOR HEART FAILURE SYMPTOMS AND CHANGE THE COURSE OF THEIR DISEASE. TIMEFRAME: YEAR 1 OF 3. GOAL STATUS ONGOING. PARTNER NAME, DESCRIPTION AND WEB ADDRESS CAPE COD HEALTHCARE HEART FAILURE CLINIC - HTTPS://WWW.CAPECODHEALTH.ORG/MEDICAL-SERVICES/HEART-VASCULAR-CARE/CARDIOL OGY/HEART-FAILURE-CLINIC/ PROGRAM DESCRIPTION - CAPE COD HEALTHCARE HELPS THOSE DIAGNOSED WITH HEART FAILURE STAY ACTIVE AND AVOID HOSPITALIZATION THROUGH THE HEART FAILURE CLINIC. THE COMMUNITY-BASED HEART FAILURE CLINIC AT THE CARDIOVASCULAR CENTER IN HYANNIS, UNDER THE DIRECTION OF CARDIOLOGIST ELISSA THOMPSON, MD, IS A RESOURCE DESIGNED TO EDUCATE AND HELP PATIENTS MAINTAIN THE BEST POSSIBLE QUALITY OF LIFE AND MANAGE THEIR SYMPTOMS. THE HEART FAILURE CLINIC PROVIDES ACCESS TO A MULTIDISCIPLINARY TEAM THAT INCLUDES A CARDIOLOGIST, NURSE PRACTITIONER, NUTRITIONIST, VISITING NURSE AND PHARMACIST TO TREAT AND EDUCATE PATIENTS. ONCE REFERRED TO THE CLINIC BY THEIR PRIMARY CARE PHYSICIAN, CARDIOLOGIST OR OTHER SPECIALIST, PATIENTS ARE OFFERED SAME-DAY OR NEXT-DAY APPOINTMENTS, AS WELL AS SCHEDULED VISITS, TO MANAGE THE SYMPTOMS OF HEART FAILURE. THE CLINIC WORKS WITH PATIENTS AS WELL AS FAMILIES AND TEACHES THEM HOW TO LIVE WITH THEIR ILLNESS. PATIENTS HAVE ONE-STOP ACCESS TO THE MULTIDISCIPLINARY TEAM. COMMUNITY BENEFITS ALSO PROVIDED FUNDING FOR SHARPS COMPLIANCE TRAINING AND MATERIALS TO CAPE COD HEALTHCARE'S CONGESTIVE HEART FAILURE CLINIC. CONTACT INFORMATION JENNIFER CUMMINGS 32 MAIN ST. HYANNIS, MA 02601 PHONE: 508-862-7849
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 THE MEMBERS OF CAPE COD HEALTHCARE, INC.'S BOARD ALSO SIT ON THE BOARD OF CAPE COD MEDICAL OFFICE BUILDING, INC., A FOR-PROFIT RELATED ORGANIZATION.
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 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, 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 A THE FULL TITLE FOR BRUCE JOHNSTON IS TRUSTEE/TREASURER (UNTIL 5/20) AND TRUSTEE/CHAIR (AS OF 5/20) THE FULL TITLE FOR SHERYL DECILIO IS VICE PRESIDENT OF PATIENT FINANCIAL SERVICES & REVENUE CYCLE (AS OF 1/19) THE FULL TITLE FOR MICHAEL G. JONES, ESQ IS CLERK (UNTIL 5/20) AND SR VP & CHIEF LEGAL OFFICER THE FULL TITLE FOR ROBERT TALERMAN IS TRUSTEE (UNTIL 5/20), CLERK (AS OF 5/20) THE FULL TITLE FOR RAMANI AYER IS TRUSTEE (UNTIL 5/20), VICE CHAIR & TREASURER (AS OF 5/20)
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 CHANGE IN VALUE SPLIT INTEREST AGREEMENT $ 85,752 CHANGE IN PERPETUAL TRUSTS $ 428,194 TRANSFERS TO/FROM AFFILIATES $ (50,329) NET ASSETS RELEASED FROM RESTRICTIONS $ (122,347) OTHER $ (14,581) ------------- OTHER CHANGES IN NET ASSETS $ 326,689 =============
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES
 
Employer identification number

90-0054984
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
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
 












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) CAPE AND ISLAND ENDOSCOPY CENTER

700 ATTUCKS LANE
HYANNIS,MA02601
 ENDOSCOPY CENTER MA NA
  		                 












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CAPE HEALTH INSURANCE COMPANY

PO BOX 1051GT
GRAND CAYMAN    
CJ
98-1230418 		INSURANCE CJ CAPE COD HLTHCR
  		C CORP 0 0     No
(2) CAPE COD MEDICAL OFFICE BUILDING INC

27 PARK STREET
HYANNIS,MA02601
04-2423073 		RENTAL SRVCE MA NA
  		C CORP 0 15,000 100.000 %   No
(3) POOLED INCOME FUNDS (2)

 
 
SUPPORT MA NA
  		          No
(4) CHARITABLE REMAINDER TRUSTS (20)

 
 
SUPPORT MA NA
  		          No






Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) CAPE HEALTH INSURANCE COMPANY

 R 6,520,553 FMV





Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2019

Additional Data


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