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FORM 990 SCHEDULE H PART V, SUPPLEMENTAL INFORMATION
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FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSANNA JAQUES HOSPITAL AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES.ANNA JAQUES HOSPITAL COMMUNITY BENEFITS MISSION STATEMENT ANNA JAQUES HOSPITAL IS A 123-BED COMMUNITY HOSPITAL SERVING CITIES AND TOWNS IN THE MERRIMACK VALLEY, NORTH SHORE AND SOUTHERN NEW HAMPSHIRE BORDER TOWNS. OUR MISSION IS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE, WELLNESS AND HEALTH EDUCATION TO OUR COMMUNITY, IN ALLIANCE WITH OUR MEDICAL STAFF. ANNA JAQUES HOSPITAL IS RECOGNIZED FOR DELIVERING HIGH QUALITY, LOW-COST COMMUNITY HEALTH CARE WITH AN EMPHASIS ON PATIENT SATISFACTION. WITH OUR MISSION AT THE HEART OF EVERYTHING WE DO, ANNA JAQUES GIVES BACK TO THE COMMUNITY IN MANY WAYS: - INVOLVING ANNA JAQUES HOSPITAL'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY.- ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. SPECIAL ATTENTION IS FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES.- ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES.- IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES ANNA JAQUES HOSPITAL'S SERVICE AREA GEARED TOWARD IMPROVING CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES;- PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND- FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, ANNA JAQUES HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $217,284 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE MEMBERSHIP OF ANNA JAQUES HOSPITAL'S CBAC REPRESENTS THE CONSTITUENCIES AND PRIORITY POPULATIONS OF OUR COMMUNITY BENEFITS EFFORTS, INCLUDING PEOPLE OF DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGES, SEXUAL ORIENTATIONS AND GENDER IDENTITIES AND THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. SENIOR MANAGEMENT IS ENGAGED IN THE DEVELOPMENT AND EXECUTION OF THE COMMUNITY BENEFITS IMPLEMENTATION STRATEGY, ENSURING HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. COMPRISED OF LOCAL LEADERS, REPRESENTATIVES FROM LOCAL HEALTH AND RELATED COMMUNITY SERVICE ORGANIZATIONS AND NON-PROFITS, AND INDIVIDUALS WHO ARE DEEPLY EMBEDDED AND DEDICATED TO OUR COMMUNITY, THE COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) FACILITATED BY THE COMMUNITY BENEFITS MANAGER - GUIDES THE HOSPITAL'S INVOLVEMENT AND SUPPORT OF EVENTS AND PROGRAMS THAT WORK TO ADDRESS THE MOST PRESSING HEALTH NEEDS IN OUR REGION. COMMUNITY BENEFITS ADVISORY COMMITTEE ANDREA (ANDI) EGMONT, CITY OF NEWBURYPORT, NEWBURYPORT YOUTH SERVICES/THE BEACON COALITION, DIRECTORILENE HARNCH-GRADY, YWCA OF NEWBURYPORT, ENCORE PROGRAM LEADERTINA LOS, ESSEX COUNTY ASSET BUILDER NETWORK, PROJECT COORDINATORTIFFANY NIGRO, EXECUTIVE DIRECTOR, THE PETTENGILL HOUSEPAM PALOMBO, RN, CITY OF NEWBURYPORT, NEWBURYPORT PUBLIC HEALTH NURSE AND NOURISHING THE NORTHSHORE (HIATUS DURING PANDEMIC)OFFICER DANI SINCLAIR, NEWBURYPORT POLICE, INSPECTORSHARI WILKINSON, THE NEWBURYPORT FARMERS MARKET, MARKET COORDINATORHOSPITAL REPRESENTATION KELLEY SULLIVAN, MANAGER OF COMMUNITY BENEFITS & COMMUNITY RELATIONSDANIELLE PERRY, VICE PRESIDENT OF BUSINESS DEVELOPMENT & MARKETING, AJH SENIOR LEADERSHIP REPRESENTATIVECHRISTINE HEALEY, DIRECTOR OF COMMUNITY BENEFITS, NORTH REGION, BETH ISRAEL LAHEY HEALTH REPRESENTATIVESENIOR MANAGEMENT PROVIDES ONGOING FEEDBACK AND EXPERTISE IN SUPPORT OF COMMUNITY BENEFITS PROGRAMMING WITH OVERSIGHT AND LEADERSHIP FROM: MARK GOLDSTEIN, PRESIDENT KEVIN KILDAY, VICE PRESIDENT, CHIEF FINANCIAL OFFICER GAIL B. FAYRE, MD, VICE PRESIDENT, CHIEF MEDICAL OFFICER RICHARD MAKI, VICE PRESIDENT, CHIEF NURSING OFFICER GARY LEE, VICE PRESIDENT OF CLINICAL SERVICES DANIELLE PERRY, VICE PRESIDENT, MARKETING AND BUSINESS DEVELOPMENTMARY WILLIAMSON, EXECUTIVE DIRECTOR, ANNA JAQUES COMMUNITY HEALTH FOUNDATIONCOMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE (IRC) SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN AUGUST 2019. THAT CHNA WAS APPROVED BY THE BOARD OF TRUSTEES ON SEPTEMBER 26, 2019. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 26, 2019, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED FY20-22 COMMUNITY HEALTH IMPLEMENTATION STRATEGY ARE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OF ANNA JAQUES HOSPITAL'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS COMMONWEALTH ATTORNEY GENERAL'S OFFICE (AGO) AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT ANNA JAQUES HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW ANNA JAQUES HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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2019 COMMUNITY HEALTH NEEDS ASSESSMENT TARGETED GEOGRAPHY AND POPULATIONAS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS LAST ASSESSMENT IN AUGUST 2019. THE GEOGRAPHICAL FOCUS OF THE 2019 CHNA ENCOMPASSES ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA), COMPRISED OF TEN CITIES AND TOWNS INCLUDING HAVERHILL, NEWBURYPORT, AMESBURY, SALISBURY, GEORGETOWN, NEWBURY, MERRIMAC, GROVELAND, WEST NEWBURY AND ROWLEY.TARGET POPULATIONS FOR ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R). WHILE ANNA JAQUES HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH STATUS AND WELL-BEING OF THOSE LIVING THROUGHOUT ITS ENTIRE SERVICE AREA, PER THE COMMONWEALTH'S UPDATED COMMUNITY BENEFITS GUIDELINES, ANNA JAQUES HOSPITAL'S IMPLEMENTATION STRATEGY WILL FOCUS ON POPULATIONS THAT ARE MOST AT-RISK. THE CHNA, SHOWED THAT ALTHOUGH ALL GEOGRAPHIC, DEMOGRAPHIC, AND SOCIO-ECONOMIC SEGMENTS OF THE POPULATION FACE CHALLENGES THAT CAN HINDER THE ABILITY TO ACCESS CARE OR MAINTAIN GOOD HEALTH, THE POPULATIONS LISTED BELOW WERE IDENTIFIED AS FACING THE GREATEST HEALTH DISPARITIES AND BEING THE MOST AT-RISK.- YOUTH AND ADOLESCENTS- OLDER ADULTS- INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS 2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE ASSESSMENT BEGAN IN DECEMBER 2018 AND WAS CONDUCTED IN THREE PHASES, ALLOWING FOR THE COLLECTION OF AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA:PHASE 1 PRELIMINARY ASSESSMENT AND ENGAGEMENTPHASE 2 TARGETED ENGAGEMENTPHASE 3 STRATEGIC PLANNING AND REPORTINGINDIVIDUALS FROM ACROSS ANNA JAQUES HOSPITAL'S SERVICE AREA WERE ENGAGED IN THE ASSESSMENT AND PLANNING PROCESS, INCLUDING HEALTH AND SOCIAL SERVICES PROVIDERS, PUBLIC HEALTH OFFICIALS, PUBLIC SCHOOL NURSES AND ADMINISTRATORS, FIRST RESPONDERS, LEADERS OF FAITH BASED ORGANIZATIONS, BILH SENIOR LEADERSHIP, STAFF, BOARD MEMBERS, AND COMMUNITY RESIDENTS. MEMBERS OF THE COMMUNITY BENEFITS ADVISORY COMMITTEE PROVIDED LEADERSHIP, DIRECTION, AND INPUT, AS WELL AS CONNECTED AJH TO AVAILABLE COMMUNITY DATA AND RESOURCES THAT REPRESENTS THE BROAD INTERESTS OF THE COMMUNITY TO DRIVE THE CONTENT OF THE CHNA. QUANTITATIVE DATA SOURCES: THE QUANTITATIVE ASSESSMENT INCLUDED AN EXTENSIVE ANALYSIS OF DEMOGRAPHIC AND SOCIOECONOMIC DATA, HEALTH STATUS, UTILIZATION RATES, AND BEHAVIORAL RISK SURVEY DATA. DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN ANNA JAQUES HOSPITAL'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF HEALTH-RELATED ISSUES.- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017)- MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES- FBI UNIFORM CRIME REPORTS (2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, OPIOID RELATED EMS INCIDENTS (2018)QUALITATIVE DATA SOURCES: TO OBTAIN TARGETED DATA AND UNDERSTAND THE CURRENT ISSUES FACING THE COMMUNITY: - INTERNAL STAKEHOLDER INTERVIEWS (BOARD MEMBERS, SENIOR LEADERS AND SERVICE LINE LEADERS) - EXTERNAL STAKEHOLDER INTERVIEWS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)WHILE IT WAS NOT POSSIBLE FOR THIS ASSESSMENT TO INVOLVE ALL COMMUNITY STAKEHOLDERS, WE MADE AN EFFORT TO BE INCLUSIVE AND TO PROVIDE A BROAD RANGE OF OPPORTUNITIES FOR PARTICIPATION OVER THE COURSE OF SEVERAL MONTHS. ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS BUILT ON PARTNERSHIP AND DIALOGUE WITH OUR MANY COMMUNITIES. OUR UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM DISCUSSIONS WITH AND OBSERVATIONS BY HEALTHCARE AND HEALTH-RELATED WORKERS IN THE NEIGHBORHOODS. THIS DATA WAS THEN AUGMENTED BY DEMOGRAPHIC AND HEALTH STATUS INFORMATION FROM A VARIETY OF SOURCES INCLUDING THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, FEDERAL RESOURCES SUCH AS THE INSTITUTE OF MEDICINE, AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. AN ARTICULATION OF EACH SPECIFIC COMMUNITY'S NEEDS (CRAFTED JOINTLY BY ANNA JAQUES AND COMMUNITY PARTNERS) INFORMS ANNA JAQUES HOSPITAL'S DECISION-MAKING ABOUT PRIORITIES FOR COMMUNITY BENEFITS EFFORTS. WE WORK IN CONCERT WITH COMMUNITY RESIDENTS AND LEADERS TO DESIGN SPECIFIC ACTIONS TO BE UNDERTAKEN EACH YEAR. EACH COMPONENT OF THE PLAN IS EVENTUALLY WOVEN INTO THE ANNUAL GOALS AND THE AGENDA FOR THE ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS IMPLEMENTATION STRATEGY, ADOPTED BY THE BOARD OF TRUSTEES.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTS2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSAFTER A COMPREHENSIVE REVIEW OF ALL THE QUANTITATIVE AND QUALITATIVE INFORMATION COLLECTED IN THE ANNA JAQUES HOSPITAL CHNA, THE KEY HEALTH-RELATED FINDINGS IDENTIFIED WERE: - IN JANUARY 2019, THE CBAC DETERMINED THAT AFTER THREE YEARS OF FOCUSING ON OBESITY, CANCER AND SUBSTANCE USE AS ITS SIGNIFICANT HEALTH PRIORITIES, THAT THE DATA AND AVAILABLE RESOURCES CONSULTED REFLECTED POSITIVE CHANGES FOR OBESITY BUT THAT CANCER AND SUBSTANCE USE SHOULD REMAIN THE PROGRAM'S CORE FOCUS. - THE CBAC VOTED THAT, IN ORDER TO ADDRESS THE MOST PRESSING HEALTH NEEDS IN OUR COMMUNITY AND INCORPORATE STATE-WIDE GOALS/SOCIAL DETERMINANTS OF HEALTH IN THE MOST IMPACTFUL AND REALISTIC WAY, TO PRIORITIZE CANCER AND SUBSTANCE USE (NOTING CONNECTION WITH MENTAL HEALTH) AS THE MOST SIGNIFICANT HEALTH NEEDS FACING ITS COMMUNITY FOR FY19-FY21. - WHILE OBESITY IS NOT A PRIMARY FOCUS, THE WORLD CANCER RESEARCH FUND ESTIMATES THAT ABOUT 20% OF ALL CANCERS DIAGNOSED IN THE US ARE RELATED TO BODY FATNESS, PHYSICAL INACTIVITY, EXCESS ALCOHOL CONSUMPTION, AND/OR POOR NUTRITION. THUS, ACCESS TO HEALTHY FOODS AS WELL AS OPPORTUNITIES FOR EXERCISE WILL HELP US ADDRESS FACTORS IMPACTING BOTH CANCER AND SUBSTANCE USE. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022. INTERIM CHANGES AND UPDATES TO IMPLEMENTATION STRATEGY BASED ON NEWLY IDENTIFIED COMMUNITY NEEDS COVID PANDEMICAS PREVIOUSLY NOTED IN THIS FILING, IRC SECTION 501(R)(3) AND THE PROMULGATED REGULATIONS REQUIRE THAT A TAX-EXEMPT HOSPITAL CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPT AN IMPLEMENTATION STRATEGY ADDRESSING COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA AT LEAST ONCE EVERY THREE YEARS. THE PREAMBLE TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R)(3) NOTES THAT THE TREASURY AND THE IRS INTENDED FOR THE CHNA AND IMPLEMENTATION STRATEGY REQUIREMENT TO ESTABLISH CONTINUAL FEEDBACK ON CHNA REPORTS AND A HOSPITAL IS REQUIRED TO CONSIDER COMMENTS RECEIVED RELATED TO THE EXISTING CHNA AND IMPLEMENTATION STRATEGY WHEN ENGAGING IN THE NEXT CHNA PROCESS NOT MORE THAN THREE YEARS AFTER ADOPTION. IN ADDITION, FINAL REGULATIONS DO NOT PROHIBIT IMPLEMENTATION STRATEGIES FROM DISCUSSING HEALTH NEEDS IDENTIFIED THROUGH MEANS OTHER THAN A CHNA, PROVIDED THAT THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA ARE ALSO DISCUSSED. FINALLY, THERE IS NOTHING IN THE REGULATIONS THAT PROHIBITS A HOSPITAL FROM UPDATING ITS IMPLEMENTATION STRATEGY BASED ON AN OFF CYCLE CHANGE TO THE COMMUNITY HEALTH NEEDS THAT ARISE. DURING THE PERIOD COVERED BY THIS FILING, OCTOBER 1, 2019 TO SEPTEMBER 30, 2020, THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL'S, WERE IMPACTED BY AN UNEXPECTED GLOBAL PANDEMIC. ON JANUARY 9, 2020, THE WORLD HEALTH ORGANIZATION (WHO) ANNOUNCED THE IDENTIFICATION OF A NEW AND NOVEL CORONAVIRUS-RELATED PNEUMONIA IN WUHAN, CHINA. ON JANUARY 21, 2020 THE UNITED STATES CENTER FOR DISEASE CONTROL CONFIRMED THE FIRST CASE OF THIS NEW CORONA VIRUS IN THE UNITED STATES. ON JANUARY 31, 2020, THE WHO ISSUED A GLOBAL HEALTH EMERGENCY AND ON FEBRUARY 3 THE UNITED STATES DECLARED A PUBLIC HEALTH EMERGENCY BECAUSE OF THE COVID-19 VIRUS. ON MARCH 11, 2020, THE WHO DECLARED COVID-19 A PANDEMIC AND TWO DAYS LATER, THE PRESIDENT OF THE UNITED STATES DECLARED COVID-19 A NATIONAL EMERGENCY.THE HEALTH OF THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL WERE IMPACTED BY THIS UNFORESEEN HEALTH CRISIS AND IN THE ABSENCE OF REGULATORY GUIDANCE TO THE CONTRARY, ANNA JAQUES HOSPITAL'S NEEDED TO QUICKLY REASSESS AND PIVOT TO MEET THE NEW AND PREVIOUSLY UNEXPECTED COMMUNITY NEEDS. AS SUCH, IN RESPONSE TO THE COVID-19 CRISIS ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS STAFF ALONG WITH THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND IN RESPONSE TO COVID, EXPANDED GOALS RELATED TO ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH TARGETED PRIMARILY AT LOW INCOME AND MINORITY POPULATIONS WHO HAVE BEEN DISPROPORTIONATELY IMPACTED BY COVID-19.COMMUNITY HEALTH NEEDS ASSESSMENT - MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLE ANNA JAQUES HOSPITAL STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT:HTTPS://WWW.AJH.ORG/COMMUNITY/OUTREACH-AND-INVOLVEMENT. IN ADDITION TO THE CHNA, ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://WWW.AJH.ORG/COMMUNITY/OUTREACH-AND-INVOLVEMENT. IN ADDITION, AS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015). THAT CHNA IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://WWW.AJH.ORG/COMMUNITY/OUTREACH-AND-INVOLVEMENT. FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING ANNA JAQUES HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015) IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://WWW.AJH.ORG/COMMUNITY/OUTREACH-AND-INVOLVEMENT. EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENT ADDRESSING COMMUNITY HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, ANNA JAQUES HOSPITAL'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THAT CHNA AND IMPLEMENTATION STRATEGY INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF ANNA JAQUES HOSPITAL FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020 AND WILL CONTINUE TO INFORM THE HOSPITAL'S COMMUNITY BENEFITS MISSION AND ACTIVITIES FOR THE FISCAL YEARS ENDING SEPTEMBER 30, 2021 AND SEPTEMBER 30, 2022. A SUMMARY OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, ANNA JAQUES HOSPITAL HAS BEEN STRATEGIC IN IDENTIFYING ITS HEALTH PRIORITIES IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH HEALTH PRIORITY ARE LISTED BELOW.PRIORITY AREA 1: CHRONIC DISEASE (CANCER)- INCREASE CANCER SCREENING AND PREVENTION- PROVIDE PATIENT SUPPORT SERVICES AND SURVIVORSHIP RESOURCES- INCREASE ACCESS TO PHYSICAL ACTIVITY, WELLNESS, AND HEALTHY EATING- PRIORITY AREA 2: BEHAVIORAL HEALTH (SUBSTANCE USE & MENTAL HEALTH)- INCREASE SCREENING, ACCESS TO CARE AND SERVICES- PROMOTE POSITIVE YOUTH RESOURCES- PRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTH- SUPPORT FOOD SECURITY EFFORTS- INCREASE AVAILABILITY OF EMERGENCY HOUSING- SUPPORT LOCAL ADVOCACY AND PREVENTION RESOURCESPRIORITY AREA 2: BEHAVIORAL HEALTH (SUBSTANCE USE & MENTAL HEALTH)- INCREASE SCREENING, ACCESS TO CARE AND SERVICES- PROMOTE POSITIVE YOUTH RESOURCESPRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTH- SUPPORT FOOD SECURITY EFFORTS- INCREASE AVAILABILITY OF EMERGENCY HOUSING- SUPPORT LOCAL ADVOCACY AND PREVENTION RESOURCESPRIORITY AREA 4: ACCESS TO CARE- DECREASE BARRIERS TO HEALTHCARE
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SCHEDULE H, PART V, SECTION B, LINE 11
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COMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS A SUMMARY OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESSES THE NEEDS IDENTIFIED IN THE 2019 CHNA COMPLETED DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2019 AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY IS PROVIDED BELOW, ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. THESE AREAS ARE (1) BEHAVIORAL HEALTH (SUBSTANCE USE AND MENTAL HEALTH) (2) CHRONIC DISEASE (CANCER) (3) ACCESS TO CARE AND (4) SOCIAL DETERMINANTS OF HEALTHBEHAVIORAL HEALTH (SUBSTANCE USE & MENTAL HEALTH)THE PERSIST PROGRAMTHE PERSIST PROGRAM AT ANNA JAQUES HOSPITAL (AJH) SUPPORTS WOMEN WITH SUBSTANCE USE DISORDER AND INFANTS WITH NEONATAL ABSTINENCE SYNDROME (NAS), WHICH IMPACTS ABOUT 14.5 CASES PER 1,000 BIRTHS IN MASSACHUSETTS. IN FY18, THE PERSIST PROGRAM SERVED 192 WOMEN WHO WERE IN RECOVERY AND SOUGHT ADDITIONAL SUPPORT, SUFFERED FROM TRAUMA OR ABUSE OR WERE DIAGNOSED WITH MENTAL HEALTH DISORDERS. A PATIENT CARE NAVIGATOR WORKS IN COLLABORATION WITH WOMEN'S HEALTH CARE AND THE ANNA JAQUES BIRTH CENTER & NEONATAL CARE CENTER TO CHAMPION WOMEN THROUGHOUT THEIR PREGNANCY AND FIRST YEAR OF MOTHERHOOD. PATIENTS SET TREATMENT GOALS SUCH AS MAINTAINING SOBRIETY, SECURING MENTAL HEALTH COUNSELING, OBTAINING STABLE HOUSING AND DISCONTINUING MARIJUANA USE. WOMEN ARE CONNECTED WITH RECOVERY SUPPORT SERVICES AND MENTAL HEALTH PROVIDERS TO HELP THEM ACHIEVE THEIR GOALS. THE PERSIST SUPPORT GROUP, A FREE GROUP THAT MEETS WEEKLY IN HAVERHILL, HOSTS SPEAKERS WHO SHOWCASE LOCAL RESOURCES AND USEFUL INFORMATION; TOPICS HAVE INCLUDED EMERGENCY SERVICES, HOUSING AND HEALTHY RELATIONSHIPS. IN FY18, 78% OF PATIENTS MET THEIR TREATMENT GOALS. IN FY19 THIS INCREASED TO 83% OF PATIENTS. OVERALL, THE NUMBER OF SUBSTANCE-EXPOSED BABIES STEADILY DECLINED FROM 91 IN 2017, TO 56 IN 2018 AND TO 24 IN 2019.COMMUNITY EDUCATION AND SUPPORTANNA JAQUES HOSPITAL COLLABORATED WITH NEWBURYPORT HIGH SCHOOL ON AN ANTI-VAPING CAMPAIGN TO CREATE A THREE STAGE CURRICULUM: A PRE-TEST TO COLLECT DATA FOR THE STUDENTS' PREVIOUS KNOWLEDGE, AN EDUCATIONAL VIDEO TO PROVIDE A VISUAL FOR THE HARMFUL EFFECT OF VAPING, AND A GROUP DISCUSSION ON THE NEGATIVE IMPACTS OF VAPING. THE CAMPAIGN HAS BEEN WELL RECEIVED BY STUDENTS AND SCHOOL STAFF.ANY RESULTS?THE HOSPITAL ALSO WORKS CLOSELY WITH THE PETTENGILL HOUSE'S TO PROVIDE SUPPORT FOR FAMILIES STRUGGLING WITH LIFE CHALLENGES. THEY START BY HELPING TO ENSURE BASIC NEEDS SUCH AS SAFETY, SHELTER, FOOD AND CLOTHING AND THEY WORK WITH INDIVIDUALS AND FAMILIES TO PROVIDE A LONG TERM PATH TO A BRIGHTER FUTURE. ESSEX COUNTY ASSET BUILDERANNA JAQUES HOSPITAL WORKS WITH THE ESSEX COUNTY ASSET BUILDER (ECAB) NETWORK TO CREATE REGIONAL CONNECTIONS AND SUPPORTS FOR INDIVIDUALS, FAMILIES AND ORGANIZATIONS FROM AMESBURY, GEORGETOWN, NEWBURY, ROWLEY, SALISBURY AND NEWBURYPORT, IN USING A POSITIVE YOUTH DEVELOPMENT APPROACH TO HELP YOUTH THRIVE. BEING A PART OF THE ECAB NETWORK BRINGS LOCAL AND REGIONAL OPPORTUNITIES. LOCALLY, COMMUNITIES HAVE ACCESS TO TRAININGS, DATA, AND BEST PRACTICES, AND RECEIVE GUIDANCE ON IMPLEMENTATION AND OUTREACH STRATEGIES THAT BUILD POSITIVE YOUTH DEVELOPMENT POSSIBILITIES. COMMUNITIES ALSO GET THE BENEFIT OF REGIONALIZING EFFORTS, WHERE NETWORKING, COMBINING RESOURCES, CURRENT POLICIES, AND A SHARED VISION STRENGTHEN THE TOWNS AND CITIES AS WELL AS THE REGION.AS A COLLABORATOR OF THIS NETWORK, ANNA JAQUES HOSPITAL SUPPORTED THE ACQUISITION OF A DATABASE THAT WOULD TRACK OVERDOSES BETWEEN COMMUNITIES AND ALLOW FOR A MORE COHESIVE, MULTI-AGENCY, APPROACH TO CONNECTING INDIVIDUALS WITH THE ASSISTANCE THAT THEY NEED AND THE SERVICES AVAILABLE IN THE AREA. THIS PROGRAM FOCUSED ON PARENTS (SPECIFICALLY PARENTS OF MIDDLE SCHOOLERS), CAREGIVERS OR ADULTS WHO WANTED TO LEARN HOW TO BETTER SUPPORT YOUNG PEOPLE. THIRTY-TWO PEOPLE SIGNED UP FOR ONE OR MORE OF THE SESSIONS. WITH ATTENDANCE VARYING FROM 14,10, 9 AND 10 PARTICIPANTS RESPECTIVELY ACROSS THE WORKSHOPS.AS A RESULT OF THE WORKSHOPS, PARTICIPANTS REPORTED HAVING A BETTER UNDERSTANDING OF THEIR PARENTING STYLES AND WERE MORE CONFIDENT IN THEIR ABILITY TO COMMUNICATE WITH THEIR TEEN AND SET AND ENFORCE FAMILY RULES AND BOUNDARIES. PARENTS REPORTED THEY WOULD RECOMMEND THESE WORKSHOPS TO FRIENDS, AND THEY THOUGHT THEY COULD BE DELIVERED AS STANDALONE WORKSHOPS OR AS A SERIES. WE NOW HAVE TWO LICENSED CLINICAL SOCIAL WORKERS WHO HAVE PRESENTED THESE WORKSHOPS AND NOW CAN WORK TOGETHER OR SEPARATELY TO DISSEMINATE THIS CONTENT TO MORE PARENTS IN OUR REGION. CHRONIC DISEASE (CANCER)CANCER SUPPORT SERVICESFOR MORE THAN 20 YEARS, ANNA JAQUES HOSPITAL (AJH) HAS HOSTED TWO MONTHLY SUPPORT GROUPS FOR COMMUNITY RESIDENTS COPING WITH A DIAGNOSIS OF CANCER OR BREAST CANCER. BOTH GROUPS ARE FACILITATED BY CLINICAL PROFESSIONALS WHO HAVE BEEN IMPACTED BY CANCER. ANNA JAQUES HOSPITAL COLLABORATES WITH COMMUNITY PROGRAMS TO PROMOTE AWARENESS OF THE IMPORTANCE OF BREAST CANCER SCREENING AND TO INCREASE AWARENESS OF RESOURCES FOR PEOPLE IMPACTED BY CANCER. IN FY19 ANNA JAQUES SUPPORTED THE LAUNCH OF THE NORTH OF BOSTON CANCER RESOURCE. THE COMPREHENSIVE ONLINE GUIDE SIMPLIFIES ACCESS TO RESOURCES, EDUCATION AND SERVICES TO HELP PEOPLE WITH CANCER SURVIVE AND THRIVE THROUGH DIAGNOSIS, TREATMENT AND BEYOND. THIS RESOURCE, DEVELOPED IN COLLABORATION WITH THREE OTHER ORGANIZATIONS, BUILDS UPON THE HOSPITAL'S RELATIONSHIPS WITH COMMUNITY PARTNERS WHO PROVIDE COMPLEMENTARY SERVICES IN THE ANNA JAQUES CANCER CENTER. THE ONLINE NORTH OF BOSTON CANCER RESOURCE RECORDED 10,900-PAGE VIEWS.THE HOSPITAL FEATURED MAMMOGRAM REMINDER CARDS THROUGHOUT THE COMMUNITY DURING BREAST CANCER AWARENESS MONTH, ADVOCATING THAT THE, BEST PREVENTION IS EARLY DETECTION. THE CARDS WERE FEATURED ALL THROUGHOUT THE COMMUNITY IN LOCAL BUSINESSES AND IN DOCTOR'S OFFICES THROUGHOUT THE YEAR.IN FY19, THE HOSPITAL DISTRIBUTED 25,000 COFFEE SLEEVES TO LOCAL SHOPS AND BAKERIES IN NEWBURYPORT, SALISBURY, AMESBURY, WEST NEWBURY, GROVELAND, HAVERHILL AND MERRIMAC WITH A REMINDER TO SCHEDULE AN ANNUAL MAMMOGRAM.LOCAL FARMERS' MARKETSSOME 6,000 PEOPLE IN NORTHEASTERN ESSEX COUNTY ARE FOOD INSECURE. ANNA JAQUES HOSPITAL (AJH) PARTNERS WITH BOTH THE NEWBURYPORT AND HAVERHILL FARMERS' MARKETS TO ENSURE THAT COMMUNITIES HAVE ACCESS TO HEALTHY AFFORDABLE FOODS, ESPECIALLY FRUITS AND VEGETABLES. BOTH MARKETS INCLUDE FARMERS AND VENDORS WHO ACCEPT EBT/SNAP TO MAKE HEALTHY EATING MORE ACCESSIBLE TO EVERYONE.THE NEWBURYPORT MARKET HOSTS SOME 30-35 VENDORS THAT OFFER FRESH PRODUCE, MEATS, CHEESES AND OTHER LOCALLY MADE GOODS. THE HOSPITAL HOSTS TABLES TO OFFER HEALTHY LIVING INFORMATION; FOR EXAMPLE, THE CARDIAC REHABILITATION MANAGER ATTENDS DURING AMERICAN HEART MONTH IN FEBRUARY TO PROVIDE HEART HEALTH INFORMATION AND FREE BLOOD PRESSURE CHECKS. NEWBURYPORT MARKET, WHICH HOSTED 40 MARKETS FOR 800 TO 1,200 PARTICIPANTS WEEKLYTHE HAVERHILL FARMERS' MARKET PROMOTES HEALTHY EATING AND IS EASILY ACCESSIBLE BY PUBLIC TRANSPORTATION. DURING BREAST CANCER AWARENESS MONTH IN OCTOBER, A SURVIVOR AND AN AJH REPRESENTATIVE DISTRIBUTED MAMMOGRAM REMINDER CARDS AND AN AJH PATIENT NAVIGATOR DISTRIBUTED INFORMATION ABOUT THE HOSPITAL'S PERSIST PROGRAM. HAVERHILL MARKET, WHICH HOSTED 19 MARKETS FOR AN ESTIMATED 700 PARTICIPANTS WEEKLY.FITNESS OPPORTUNITIESANNA JAQUES HOSPITAL CONTINUED FREE WORKOUTS FOR ALL AGES/ABILITIES IN AMESBURY & NEWBURYPORT. THE HOSPITAL PARTNERED WITH THE YANKEE HOMECOMING WATERFRONT WORKOUT SERIES WHERE OVER 300 PARTICIPANTS HAD ACCESS TO SEVEN DAYS OF FREE WORKOUTS, SIXTEEN CLASSES/HOURS AT TWELVE LOCAL STUDIOS. WORKOUT HAVE ALSO EXPANDED TO AMESBURY WHERE PARTICIPANTS HAVE ACCESS TO "FITNESS BY THE FALLS" EVERY SUNDAY THROUGH THE SUMMER. - HAVERHILL: THERE WERE 8 FREE CLASSES THAT AVERAGED 15-25 PEOPLE PER CLASS, AUDIENCE INCLUDED WOMEN 34-44 YEARS OLD, THE PROGRAM REACHED 6.5K ON FACEBOOK. - NEWBURYPORT: 300+ PARTICIPANTS; 7 DAYS OF FREE WORKOUTS; 16 CLASSES/HOURS; 12 LOCAL STUDIOS- AMESBURY: IN ITS SECOND YEAR, THE PROGRAM CONTINUES TO GROW; FREE WORKOUTS IN AMESBURY EVERY SUNDAY THROUGH THE SUMMER; GIVEAWAYS INCLUDED SUNSCREEN AND AJH WORKOUT TOWELSACCESS TO CAREBARRIERS TO OBTAINING HEALTH CARE INCLUDE TRANSPORTATION, ACCESS TO AVAILABLE RESOURCES, AFFORDABILITY, INSURANCE COVERAGES, INADEQUATE SERVICES, LACK OF HEALTH CARE PROVIDERS, AND LANGUAGE BARRIERS. TRANSPORTATION WAS THE LARGEST CONCERN THROUGHOUT ALL COMMUNITIES IN THE GREATER HAVERHILL AREA. AJH PROVIDES SERVICES TO ADDRESS THESE GAPS INCLUDING PATIENT FINANCIAL COUNSELORS, TRANSPORTATION SUPPORT AND INTERPRETER SERVICES.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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SOCIAL DETERMINANTS OF HEALTH FOOD SECURITYANNA JAQUES CONTINUES TO IDENTIFY WAYS TO SUPPORT THE WORK OF OUR NEIGHBORS' TABLE (ONT) WHICH SERVES 12 COMMUNITIES AMESBURY, SALISBURY, NEWBURYPORT, MERRIMAC, SOUTH HAMPTON, WEST NEWBURY, BYFIELD, NEWBURY, GROVELAND, GEORGETOWN, BOXFORD AND ROWLEY WITH THE MISSION OF SUPPLYING COMMUNITY-BASED ACCESS TO FOOD FOR THOSE IN NEED, INCLUDING FAMILIES, INDIVIDUALS, CHILDREN, PEOPLE WITH DISABILITIES AND THE ELDERLY. DR. GAIL FAYRE, CHIEF MEDICAL OFFICER AT ANNA JAQUES HOSPITAL, COLLABORATED WITH ONT AND PEDIATRIC PRACTICE, CHILDREN'S HEALTHCARE, TO IMPLEMENT SCREENING TOOLS TO BETTER IDENTIFY PATIENTS AND FAMILIES STRUGGLING WITH FOOD SECURITY. ANNA JAQUES ALSO SPONSORED ONE OF ONT'S "WEDNESDAY MEALS" A WEEKLY OFFERING THAT SERVES OVER 100 INDIVIDUALS PER MEAL. A FULL UPDATE ON ANNA JAQUES HOSPITAL'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.FY20 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: CHRONIC DISEASE (CANCER) CANCER IS THE LEADING CAUSE OF DEATH IN MASSACHSUETTS AND THE CAUSE OF ONE IN EVERY FOUR DEATHS IN THE UNITED STATES (CDC). IN MASSACHUSETTS, DEATHS DUE TO ALL CANCERS ARE SLIGHTLY HIGHER THAN THE STATE AVERAGE. LUNG CANCER DEATHS ARE HIGHER THAN THE STATE AVERAGE OVERALL, AND SIGNIFICANTLY HIGHER IN MERRIMAC, SALISBURY, HAVERHILL AND AMESBURY. AJH STRIVES TO PROMOTE PREVENTION AND AWARENESS THROUGH THE ADVOCACY OF ANNUAL CANCER SCREENINGS AND EDUCATION, WHILE ALSO ADDRESSING CERTAIN HEALTH RISK FACTORS THAT MAY LEAD TO CANCER, INCLUDING OBESITY, LACK OF EXERCISE AND POOR NUTRITION. GOAL: INCREASE CANCER SCREENING & PREVENTION COMMUNITY ACTIVITIES/STRATEGIES:- PROVIDE PREVENTION EDUCATION IN PARTNERSHIP WITH ANNA JAQUES CANCER PROGRAMS- INCREASE ANNUAL MAMMOGRAM SCREENINGS THROUGH AWARENESS CAMPAIGNS- SUPPORT LOCAL ORGANIZATIONS FOCUSED ON CANCER PREVENTIONMETRICS AND STATUS UPDATE: - NUMBER OF PATIENTS SCREENED FOR BREAST CANCER/MAMMOGRAPHY (FY20: 9,894)- AJH COLLABORATED WITH LOCAL BUSINESSES AND COMMUNITIES DURING BREAST CANCER AWARENESS MONTH TO INCREASE AWARENESS AND PREVENTION. (FY20: WORKPLACE WELLNESS AND ENGAGEMENT AROUND THE THEME "THE BEST PREVENTION IS EARLY DETECTION" IS SHARED THROUGHOUT SEVEN COMMUNITIES). - AJH PROMOTES PREVENTION OF OVARIAN CANCER IN COLLABORATION WITH GREATER NEWBURYPORT OVARIAN CANCER AWARENESS (GNOCA), DURING OVARIAN CANCER AWARENESS MONTH. (FY20: GNOCA PARTNERED WITH 17 EXTENDED-CARE FACILITIES IN THE COMMUNITY AND REACHED OUT TO 700 WOMEN WITH EDUCATION ON OVARIAN CANCER, INCLUDING INFORMATION ON SIGNS AND SYMPTOMS). COMMUNITY PARTNERS: GREATER NEWBURYPORT OVARIAN CANCER AWARENESS, ANNA JAQUES HOSPITAL/GERRISH BREAST CARE CENTERGOAL: PATIENT SUPPORT SERVICES & SURVIVORSHIP RESOURCESCOMMUNITY ACTIVITIES/STRATEGIES: - AJH BREAST CARE NAVIGATOR PROVIDES INDIVIDUALIZED SUPPORT AND ASSISTANCE TO PATIENTS AND THEIR CAREGIVERS TO HELP THEM MAKE INFORMED DECISIONS ABOUT THEIR CARE AND TO OVERCOME BARRIERS TO OPTIMAL CARE- ON-GOING SUPPORT GROUPS FOR CANCER SURVIVORS, IN-PERSON AND VIRTUAL- ONLINE RESOURCES AND DIRECTORIES TO CONNECT PEOPLE WITH VITAL RESOURCES AND LOCAL OFFERINGS RELATED TO CANCERMETRICS AND STATUS UPDATE: - AJH BREAST CARE NAVIGATOR GUIDES PATIENTS THROUGH THE COMPLEXITIES OF THE DISEASE, DIRECT THEM TO HEALTH CARE SERVICES FOR TIMELY TREATMENT AND INTO SURVIVORSHIP AND TO ACTIVELY IDENTIFY AND HELP TO ADDRESS BARRIERS TO CARE THAT MIGHT PREVENT THEM FROM RECEIVING TIMELY AND APPROPRIATE TREATMENT. (FY20: BREAST CARE NAVIGATOR PROVIDED SUPPORT TO 68 INDIVIDUAL PATIENTS AND THEIR FAMILIES OR CAREGIVERS. 61 PATIENTS WERE ALSO PROVIDED SURVIVORSHIP CARE PLANS).- AJH PARTNERS WITH THE NORTH OF BOSTON CANCER RESOURCE TO PROVIDE AN ONLINE SPEAKER SERIES TO EDUCATION AND OFFER SUPPORT TO PEOPLE AFFECTED BY CANCER. THIS RESOURCE BECAME EVEN MORE VITAL IN THE PANDEMIC ENVIRONMENT, EXTENDING MUCH-NEEDED CONNECTION AND INFORMATION IN A VIRTUAL AND SAFE WAY. (FY20: 8 SPEAKER SERIES SESSIONS WERE OFFERED WITH 84 PARTICIPANTS. - AJH HAS HOSTED TWO DIFFERENT FREE MONTHLY SUPPORTS GROUPS OPEN TO ANYONE IN THE COMMUNITY COPING WITH A CANCER DIAGNOSIS AND FOR THOSE WITH A BREAST CANCER DIAGNOSIS. (FY20: GROUPS WERE HOSTED MONTHLY FROM OCTOBER 2019 THROUGH MARCH 2020 AND SUSPENDED DUE TO COVID-19. STAFF WORKED TO PROVIDED REMOTE AND ONLINE RESOURCES FOR PATIENTS). COMMUNITY PARTNERS: NORTH OF BOSTON CANCER RESOURCE, YWCA ENCORE, ANNA JAQUES HOSPITAL CANCER PROGRAMSGOAL: INCREASE ACCESS TO PHYSICAL ACTIVITY, WELLNESS & HEALTY EATINGCOMMUNITY ACTIVITIES/STRATEGIES: - PROVIDE ACCESS TO FREE PHYSICAL ACTIVITY OPPORTUNITIES- SUPPORT EDUCATION ON IMPORTANCE OF PHYSICAL ACTIVITY METRICS AND STATUS UPDATE: - AJH SUPPORTS THE YWCA OF NEWBURYPORT'S ENCORE PROGRAM - A 12-WEEK PROGRAM DESIGNED TO EMPOWER WOMEN TO RECLAIM THEIR PHYSICAL AND EMOTIONAL HEALTH AND WELL-BEING AFTER A CANCER DIAGNOSIS AND TREATMENT. (FY20: PRE-PANDEMIC: ENCORE SERVED 80 WOMEN; MARCH THROUGH OCTOBER, SERVED 42 WOMEN VIRTUALLY AND/OR OUTDOORS). - ANNA JAQUES SPONSORS AN ANNUAL "ADOPT-A-TRAIL" TRAIL AS PART OF THE COASTAL TRAILS COALITION THAT PROVIDES FUNDS TO MANAGE THE TRAIL, ENSURE SAFETY AND OVERALL SUPPORTS THE POSITIVE ASSET AND OPPORTUNITY FOR HEALTHY ACTIVITY IT PROVIDES TO OUR COMMUNITIES. (FY20: AJH SPONSORED A PART OF THE TRAIL THAT SUPPORTS THE OFFERING OF A 30-MILE BIKE PATH THAT PROMOTES A HEALTHIER COMMUNITY, WHICH OFFERED A SAFE, OUTDOOR ACTIVITY DURING THE PANDEMIC). - AJH SPONSORED THE FRIENDS OF AMESBURY COUNCIL ON AGING'S "HEALTH & WELLNESS FEST" WHICH HOSTED FREE FITNESS AND HEALTH OPPORTUNITIES EVERY WEDNESDAY IN SEPTEMBER AS AN OPPORTUNITY FOR SENIORS TO RECONNECT AND RECEIVE DIRECT SERVICES SUCH AS FLU SHOTS, FITNESS DEMONSTRATIONS AND HEALTHY MEALS. OFFERINGS WERE HELD IN PERSON WITH MANY SAFETY MEASURES IN PLACE AND IN FULL COMPLIANCE OF STATE SAFETY GUIDELINES (FY20: HOSTED 4 HEALTH AND WELLNESS DAYS OVER MONTH OF SEPTEMBER WELCOMED 40 ELDERS EACH DAY; ADMINISTERED 125 FLU SHOTS; PROVIDED 200 GRAB & GO LUNCHES). - AJH SPONSORS THE HAVERHILL FARMERS' MARKET WHICH IS DEDICATED TO PROMOTING HEALTHY EATING, AND SUPPORTING LOCAL BUSINESS, SUSTAINABILITY, AND COMMUNITY SPIRIT BY PROVIDING FRESH, LOCAL PRODUCE, BAKED AND PREPARED FOODS AS WELL AS HAND-CRAFTED GOODS. HOSTED IN DOWNTOWN HAVERHILL AND EASILY ACCESSIBLE BY PUBLIC TRANSPORTATION, THE MARKET ACCEPTS EBT/SNAP. (FY20: WEEKLY MARKETS WERE HOSTED IN HAVERHILL JUNE THROUGH OCTOBER 2020 FOLLOWING STATE GUIDELINES RELATED TO COVID-19). COMMUNITY PARTNERS: YWCA ENCORE, NEWBURYPORT YANKEE HOMECOMING, AMESBURY CHAMBER OF COMMERCE, COASTAL TRAILS COALITION, HAVERHILL FARMERS' MARKET
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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PRIORITY AREA 2: BEHAVIORAL HEALTH (SUBSTANCE USE & MENTAL HEALTH)THE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) REPORTS THAT ONE-IN-FOUR INDIVIDUALS EXPERIENCES A MENTAL ILLNESS EACH YEAR, UNDERSCORING A CRITICAL NEED FOR MENTAL HEALTHCARE ACCESS ACROSS ALL PATIENT POPULATIONS. IN THE 2019 AJH CHNA, MENTAL HEALTH INCLUDING DEPRESSION, ANXIETY, STRESS, SERIOUS MENTAL ILLNESS, AND OTHER CONDITIONS WAS OVERWHELMINGLY IDENTIFIED AS ONE OF THE LEADING HEALTH ISSUES FOR RESIDENTS OF THE SERVICE AREA. STUDENT'S GRADES 6-12 IN THE AMESBURY, GEORGETOWN, NEWBURYPORT AND TRITON SCHOOL DISTRICTS ENGAGED IN AN ATTITUDES & BEHAVIOR SURVEY WHICH SHARED: WHILE FAMILY SUPPORT IS HIGH (84%), PARENT INVOLVED IN SCHOOL IS LACKING (37%) AND THAT POSITIVE FAMILY COMMUNICATIONS IS LOWER (39%); THE SURVEY ALSO REFLECTED THE STUDENTS PERCEIVE THAT ADULTS IN THE COMMUNITY VALUE YOUTH IS LOW (30%), AS WELL THAT YOUNG PEOPLE ARE GIVEN USEFUL ROLES IN THE COMMUNITY (39%). AJH PARTNERS WITH LOCAL SOCIAL SERVICES AGENCIES TO SUPPORT ACCESS TO CASE MANAGEMENT AND INTERVENTIONS, AS WELL AS COLLABORATES LOCALLY TO PROVIDE POSITIVE RESOURCES AND SUPPORTS FOR YOUTH. GOAL: INCREASE SCREENING, ACCESS TO CARE & SERVICES FOR SUBSTANCE ADDICTION/MENTAL HEALTHCOMMUNITY ACTIVITIES/STRATEGIES:- IMPROVE COORDINATION OF CARE FROM INPATIENT TO OUTPATIENT BEHAVIORAL HEALTH SERVICES- SUPPORT LOCAL CASE MANAGEMENT OFFERINGS AND INITIATIVES FOCUSED ON MENTAL HEALTH AND SUBSTANCE USEMETRICS AND STATUS UPDATE:- AJH CONTINUED OFFERING THE PERSIST PROGRAM THAT SUPPORTS WOMEN WITH SUBSTANCE USE DISORDER AND/OR NEONATAL ABSTINENCE SYNDROME, A CONDITION THAT IMPACTS ABOUT 14.5 CASES PER 1,000 BIRTHS IN MASSACHUSETTS. THE PROGRAM HAS SERVED 182 WOMEN EITHER IN RECOVERY AND SEEKING ADDITIONAL SUPPORT, WHO HAVE SUFFERED FROM TRAUMA OR ABUSE, OR WHO HAVE BEEN DIAGNOSED WITH MENTAL HEALTH DISORDERS. (FY20: THERE HAS BEEN A DECLINE IN THE NUMBER OF SUBSTANCE-EXPOSED BABIES FROM A HIGH OF 91 IN 2017, TO 56 IN 2018, DOWN TO 24 IN 2019, AND 56 IN 2020). - AJH PARTNERED WITH SOCIAL SERVICE AGENCY, THE PETTENGILL HOUSE, ON ITS SUBSTANCE ADDICTION/MENTAL HEALTH INITIATIVE WHICH PROVIDES PROFESSIONAL ASSESSMENTS, SUPPORT SERVICES AND INTERVENTIONS TO GREATER NEWBURYPORT RESIDENTS IN NEED. REALIZING THE COMPLEXITY OF SUBSTANCE ADDICTION AND MENTAL HEALTH, AND KNOWING THE NEED FOR INDIVIDUALIZED TREATMENT, PETTENGILL HOUSE IMPLEMENTS ITS THERAPEUTIC SYSTEM OF CARE MODEL WHICH PROVIDES COMPREHENSIVE CASE MANAGEMENT, ADVOCACY, AND INTENSIVE FOLLOW-UP ON BEHALF OF THE IDENTIFIED INDIVIDUALS IN NEED. (FY20: 83 INDIVIDUALS WERE SCREENED AND CONNECTED TO SERVICES; CONNECTED 67 WITH SUBSTANCE AND MENTAL HEALTH TREATMENT ACROSS THE SPECTRUM OF CARE). - IN COLLABORATION WITH THE LINK HOUSE CENTER FOR BEHAVIORAL HEALTH AND ADDICTION TREATMENT SERVICES, AJH PSYCHIATRIC SERVICES WORKED WITH THE BRIDGE CONSULTATION PROGRAM TO FIND A PATHWAY TO INCREASE THE LIKELIHOOD OF INPATIENTS SEEKING OUTPATIENT PSYCHIATRIC SERVICES UPON DISCHARGE. (FY20: THIS IS A NEW PARTNERSHIP WITH THE GOAL OF REDUCING ER VISITS AND CRISIS CALLS FROM THE PATIENT AND IMPROVE THE WELLBEING FOR THE PATIENT WHO IS TRANSITIONING FROM INPATIENT TO OUTPATIENT CARE). - AJH SUPPORTED THE SAMARITANS OF THE MERRIMACK VALLEY THAT AIMS TO REDUCE THE INCIDENTS OF SUICIDE IN NORTHEASTERN MASSACHUSETTS BY PROVIDING A HOST OF PREVENTION AND POST-VENATION SERVICES INCLUDING COMMUNITY OUTREACH, TRAININGS, SURVIVOR SUPPORT AND A 24-HOUR CRISIS HOTLINE. (FY20: HOSTED THREE 8-WEEK SERIES OF THE SUICIDE ATTEMPT SURVIVOR SUPPORT GROUP; COMPLETED 16 HOURS OF SUICIDE PREVENTION TRAININGS; HOSTED 10 "SAFE PLACE" SUPPORT GROUPS). COMMUNITY PARTNERS: LINK HOUSE, THE PETTENGILL HOUSE, FAMILY SERVICES OF THE MERRIMACK VALLEYGOAL: PROMOTE POSITIVE YOUTH RESOURCES FOR HEALTH & WELL-BEINGCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT COMMUNITY PROGRAMS AND OFFERINGS THAT PROVIDE YOUTH WITH HEALTHY ENGAGEMENT AND LEARNING OPPORTUNITIESMETRICS AND STATUS UPDATE: - AJH SUPPORTED THE ESSEX COUNTY ASSET BUILDER NETWORK'S LAUNCH OF A DEDICATED COVID-19 FAMILY RESOURCE WEBSITE COMPILED OF ARTICLES, VIDEOS AND TIPS FOR FAMILIES AND CHILDREN OF ALL AGES TO FIND INFORMATION ON SELF-CARE, MENTAL HEALTH AND ACCESS TO LOCAL RESOURCES SUCH AS LOCAL FOOD PANTRY, CLOTHING OR HELP WITH GRANT APPLICATIONS FOR ASSISTANCE FUNDING. (FY20: THE WEBSITE RECEIVED OVER 2,000 HITS; HOSTED 7 PARENT SPEAKER OR WEBINAR OPPORTUNITIES INCLUDING: "TEENS, TWEENS & QUARANTINES" (335 SIGN-UPS); "PARENTS THROUGH A PANDEMIC" (322 SIGN-UPS) "GOOD NEWS ABOUT BAD BEHAVIOR" (216 SIGN-UPS); MAILED SUPPORT MATERIALS TO 3,200 HOUSEHOLDS). - GIRLS INC. OF THE SEACOAST AREA IS AN EDUCATION AND ADVOCACY ORGANIZATION THAT INSPIRES GIRLS TO BE STRONG, SMART, AND BOLD. THE PROGRAM OFFERS RESEARCHED-BASED CURRICULUMS INCLUDING STEAM (SCIENCE, TECHNOLOGY, ENGINEERING, ART, AND MATH), MEDIA LITERACY, ECONOMIC LITERACY, GROWING UP STRONG, SMART AND BOLD AND HEALTHY LIVING/SELF-CARE. (FY20: SERVED 193 GIRLS DURING THE 2019-2020 SCHOOL YEAR WITH PROGRAMS IN 6 SCHOOLS). COMMUNITY PARTNERS: ESSEX COUNTY ASSET BUILDER NETWORK, GIRLS, INC., YWCA NORTH SHORE/HAVERHILL
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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PRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTHIN THE LAST DECADE, EVIDENCE HAS MADE IT INCREASINGLY CLEAR THAT THE UTILIZATION OF MEDICAL SERVICES IS NOT THE PRIMARY DETERMINANT OF COMMUNITY HEALTH. RATHER, THE SOCIAL CONDITIONS IN WHICH PEOPLE ARE BORN, GROW, LIVE, WORK, AND AGE PLAY A KEY ROLE IN DETERMINING HEALTH OUTCOMES AND HEALTH DISPARITIES. DESPITE THE IMPRESSION OF AFFLUENCE IN THE HOSPITAL'S SERVICE AREA, MANY RESIDENTS ARE STRUGGLING WITH POVERTY, FOOD INSECURITY AND HOMELESSNESS. AJH WORKED TO ADDRESS THESE HEALTH NEEDS BY PARTNERING WITH LOCAL ORGANIZATIONS TO INCREASE ACCESS AND SUPPORT SERVICES.COMMUNITY ACTIVITIES/STRATEGIES: - PARTNER WITH EXISTING PROGRAMS TO SUPPORT THEIR EFFORTS TO ADDRESS FOOD SECURITY- COLLABORATE WITH PEDIATRICIANS AND PRIMARY CARE TO REACH FAMILIES IN NEED WITH RESOURCESMETRICS AND STATUS UPDATE: - A COMMUNITY GRANT ISSUED IN FY20 TO OUR NEIGHBORS' TABLE (ONT) ENABLED THE PROGRAM TO PIVOT IN RESPONSE TO THE COVID-19 PANDEMIC TO PROVIDE TO-GO MEALS FOR INDIVIDUALS AND FAMILIES. IN RESPONSE TO PUBLIC HEALTH GUIDELINES RELATED TO COVID-19, ONT CLOSED ITS DINING ROOM IN MARCH AND PIVOTED SWIFTLY TO OFFER DINNERS AS INDIVIDUAL OR FAMILY-SIZED MEALS TO-GO. ONT SAW AN 89% INCREASE IN PEOPLE COMING TO RECEIVE A TAKE-HOME MEAL EACH WEEK, THE GREATEST AMONG THEM: FAMILIES WITH CHILDREN AND MEN AND WOMEN IN RECOVERY. (FY20: ONT HOSTED 5,267 DINNER GUESTS AND PROVIDED 787 HOME DELIVERIES. BETWEEN JANUARY AUGUST 2020 ALONE, ONT SERVED 5,650 DINNER GUESTS AND DID 606 HOME DELIVERIES). - AJH SUPPORTED A COMMUNITY FARMERS' MARKET THAT ACCEPTS EBT/SNAP THAT WAS OFFERED WEEKLY FROM JUNE THROUGH OCTOBER 2020, WITH MANY INFECTION CONTROL AND SAFETY MEASURES IN PLACE. COMMUNITY PARTNERS: OUR NEIGHBORS' TABLE, HAVERHILL FARMERS' MARKETCOMMUNITY ACTIVITIES/STRATEGIES: - SUPPORT LOCAL SOCIAL SERVICE AGENCIES EFFORTS TO INCREASE ACCESS TO EMERGENCY SHELTERMETRICS AND STATUS UPDATE: - AJH SUPPORTED EMMAUS, INC. "MITCH'S PLACE" EMERGENCY SHELTER THAT PROVIDES OVERNIGHT SHELTER, NUTRITIOUS MEALS, AND NEEDED SUPPORT SERVICES YEAR-ROUND, INCLUDING DURING EXTREME CONDITIONS, TO HOMELESS MEN AND WOMEN THAT MAY OTHERWISE SPEND THE NIGHT ENGAGING IN HIGH-RISK, SELF-DESTRUCTIVE, AND/OR ILLEGAL ACTIVITIES. THE PROGRAM ALSO OFFERS CASE MANAGEMENT TO SUPPORT ACCESSING NEEDED SERVICES AND JOB OPPORTUNITIES. (FY20: EMMAUS SERVED 267 INDIVIDUALS DESPITE MANY SAFETY RESTRICTIONS AND PRECAUTIONS RELATED TO COVID-19). COMMUNITY PARTNERS: EMMAUS, INC. GOAL: SUPPORT LOCAL RESOURCES AIMED AT ADVOCACY & PREVENTIONCOMMUNITY ACTIVITIES/STRATEGIES:- COLLABORATE WITH COMMUNITY PARTNERS TO PROVIDE LOCAL RESOURCES AIMED AT DOMESTIC VIOLENCE ADVOCACY AND PREVENTION METRICS AND STATUS UPDATE:- AJH SUPPORTS JEANNE GEIGER CRISIS CENTER'S COMMUNITY-BASED SERVICES THAT PROVIDE AN INTEGRATED WEB OF SUPPORT AS SURVIVORS 'NEEDS SHIFT FROM CRISIS TO INDEPENDENCE. THE CENTER COORDINATES WITH SOCIAL SERVICE AGENCIES, SCHOOLS, HOSPITALS, LAW ENFORCEMENT, AND OTHER COMMUNITY PARTNERS TO PROVIDE SUPPORT FOR THE SURVIVORS AND THEIR FAMILIES AS THEIR NEED'S CHANGES OVER TIME. (FY20: 779 ADULT SURVIVORS OF DOMESTIC VIOLENCE RECEIVED ADVOCACY SERVICES; 353 ADULT AND CHILD SURVIVORS OF DOMESTIC VIOLENCE RECEIVED THERAPEUTIC SERVICES; 117 ADULT SURVIVORS OF DOMESTIC VIOLENCE RECEIVED LEGAL SERVICES)COMMUNITY PARTNERS: JEANNE GEIGER CRISIS CENTERPRIORITY AREA 4: ACCESS TO CARE AN EXTENSIVE BODY OF RESEARCH ILLUSTRATES THE HEALTH DISPARITIES AND DIFFERENCES IN HEALTH CARE ACCESS AND UTILIZATION THAT EXIST FOR DIVERSE INDIVIDUALS/COHORTS AND FOREIGN-BORN POPULATIONS. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION, NON-HISPANIC BLACKS HAVE HIGHER RATES OF PREMATURE DEATH, INFANT MORTALITY, AND PREVENTABLE HOSPITALIZATION THAN DO NON-HISPANIC WHITES. HISPANICS HAVE THE HIGHEST UNINSURED RATES OF ANY RACIAL OR ETHNIC GROUP IN THE UNITED STATES. ASIANS ARE AT A HIGHER RISK FOR DEVELOPING DIABETES THAN ARE THOSE OF EUROPEAN ANCESTRY, DESPITE A LOWER AVERAGE BODY MASS INDEX. THESE DISPARITIES SHOW THE DISPROPORTIONATE AND OFTEN AVOIDABLE INEQUITIES THAT EXIST WITHIN COMMUNITIES AND REINFORCE THE IMPORTANCE OF UNDERSTANDING THE DEMOGRAPHIC MAKEUP OF A COMMUNITY TO IDENTIFY POPULATIONS MORE LIKELY TO EXPERIENCE ADVERSE HEALTH OUTCOMESKEY BARRIERS TO OBTAINING HEALTHCARE IN GREATER HAVERHILL INCLUDE TRANSPORTATION, ACCESS TO AVAILABLE RESOURCES, AFFORDABILITY, INSURANCE COVERAGES, INADEQUATE SERVICES, LACK OF HEALTHCARE PROVIDERS, AND LANGUAGE BARRIERS. GOAL: DECREASE BARRIERS TO HEALTHCARE SERVICES AT ANNA JAQUES HOSPITALCOMMUNITY ACTIVITIES/STRATEGIES:- PROVIDE INTERPRETER SERVICES AT NO COST TO ALL ANNA JAQUES HOSPITAL PATIENTS- PROVIDE PATIENT FINANCIAL ASSISTANCE TO ALL PATIENTS- UTILIZE AN EMERGENCY FUND TO SUPPORT TRANSPORTATION NEEDS OF ANNA JAQUES HOSPITAL PATIENTSMETRICS AND STATUS UPDATE:- AJH PROVIDES A FREE INTERPRETER/TRANSLATION SERVICE TO ALL ANNA JAQUES PATIENTS AT NO COST. WHILE SPANISH, CONTINENTAL PORTUGUESE, AND ASL ARE THE MOST COMMONLY UTILIZED SERVICES, AJH SERVICE OFFERED HUNDREDS OF LANGUAGE TRANSLATIONS AS NEEDED. (FY20: AJH PROVIDED 900 ENCOUNTERS OF PATIENT INTERPRETER SERVICE NEEDS). - TO ADDRESS FINANCIAL BARRIERS, AJH EMPLOYS TWO FULL-TIME FINANCIAL COUNSELORS WHO ARE CAC-CERTIFIED AND WHO CAN SCREEN PATIENTS AND ASSIST THEM IN APPLYING FOR STATE AID. THEY ALSO PROVIDE ESTIMATES FOR PATIENT'S FINANCIAL RESPONSIBILITY (COPAY, DEDUCTIBLE, COINSURANCE, SELF-PAY). (FY20: FINANCIAL COUNSELING DID A TOTAL OF 503 APPLICATIONS).- TO SUPPORT VULNERABLE COMMUNITIES AND LIMIT BARRIERS SO PATIENTS RECEIVE THE CARE THEY NEED, AJH CASE MANAGEMENT HAS AN EMERGENCY FUND TO PROVIDE TRANSPORTATION REIMBURSEMENT TO PATIENTS WHO HAVE LIMITED RESOURCES AND SOCIAL SUPPORTS. THIS PROGRAM IS OFFERED TO ANY PATIENT WHO MEETS THE CRITERIA OF NEED DECIDED BY A SOCIAL WORKER. (FY20: AJH DISTRIBUTED $5,217 OF EMERGENCY FUNDS TO PATIENTS). COMMUNITY PARTNERS: ANNA JAQUES HOSPITAL CASE MANAGEMENT AND PATIENT FINANCIAL COUNSELING
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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COMMUNITY PARTNERSANNA JAQUES HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE:- AMESBURY CHAMBER OF COMMERCE - AMESBURY COUNCIL ON AGING- THE ARC OF GREATER HAVERHILL-NEWBURYPORT - THE BEACON COALITION- COASTAL TRAILS COALITION - ELDER SERVICES OF THE MERRIMACK VALLEY/HOME HEALTH VNA - EMMAUS, INC. - ESSEX COUNTY ASSET BUILDER NETWORK- FAMILY SERVICES OF THE MERRIMACK VALLEY- GIRLS, INC. - GREATER HAVERHILL CHAMBER OF COMMERCE - GREATER HAVERHILL FARMERS MARKET/CREATIVE HAVERHILL- GREATER NEWBURYPORT CHAMBER OF COMMERCE - GREATER NEWBURYPORT OVARIAN CANCER AWARENESS OVATIONS FOR THE CURE - HEALTH PARTNERSHIP OF THE LOWER MERRIMACK VALLEY AND SEACOAST REGION - INSTITUTION FOR SAVINGS - JEANNE GEIGER CRISIS CENTER - LINK HOUSE, INC. - MERRIMAC SENIOR CENTER & COUNCIL ON AGING - MERRIMACK VALLEY HOSPICE HOME HEALTH FOUNDATION - MISS PINK ORGANIZATION- NEWBURYPORT COUNCIL ON AGING - NEWBURYPORT FARMERS' MARKET - NEWBURYPORT LIONS CLUB - NEWBURYPORT PUBLIC SCHOOLS - NEWBURYPORT YANKEE HOMECOMING - NEWBURYPORT YOUTH SERVICES - NEWBURYPORT ROTARY CLUB - NEWBURYPORT SOCIETY FOR THE RELIEF OF AGED WOMEN - NORTH OF BOSTON CANCER RESOURCE- NOURISHING THE NORTHSHORE - OPPORTUNITY WORKS - OUR NEIGHBORS' TABLE- THE PETTENGILL HOUSE - SALISBURY PARKS & RECREATION DEPARTMENT - SALISBURY SENIOR CENTER & COUNCIL ON AGING - TOUGH WARRIOR PRINCESSES - TRITON EDUCATION FOUNDATION - YMCA OF NORTHSHORE/HAVERHILL- YWCA OF GREATER HAVERHILL- YWCA OF NEWBURYPORT
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW ANNA JAQUES HOSPITAL CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 3.94 % OF ANNA JAQUES HOSPITAL'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, ANNA JAQUES HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://WWW.AJH.ORG/COMMUNITY/OUTREACH-AND-INVOLVEMENT. THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT ANNA JAQUES HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, ANNA JAQUES HOSPITAL IS A GENERAL MEDICINE AND SURGICAL HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEANNA JAQUES HOSPITAL'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $2,193,212 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, ANNA JAQUES HOSPITAL IS ONE OF TEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $44.7M FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020. DURING THE FISCAL YEAR COVERED BY THIS FILING, ANNA JAQUES HOSPITAL ADOPTED AN AMENDED WRITTEN FINANCIAL ASSISTANCE POLICY. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, UNDER THAT POLICY, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, ANNA JAQUES HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ANNA JAQUES HOSPITAL GENERATED $626,347 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY ANNA JAQUES HOSPITAL FOR SUCH SERVICES BY $448,223 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND ANNA JAQUES HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ANNA JAQUES HOSPITAL GENERATED $40,494,936 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $9,819,816. OF THESE AMOUNTS, REVENUE OF $11,346,153 IS RELATED TO THE PROVISION OF NCC, PEDIATRICS, AND ONCOLOGY PROGRAM, AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $2,277,291. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH ANNA JAQUES HOSPITAL CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, ANNA JAQUES HOSPITAL HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 8.99%.BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, ANNA JAQUES HOSPITAL ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $4,046,185 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2020 INCLUDE THE ACCOUNTS OF: BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES.THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.EMERGENCY CARE ACCESSBETH ISRAEL DEACONESS MEDICAL CENTER IS A TERTIARY CARE LICENSED ACADEMIC MEDICAL CENTER, PROVIDING MEDICAL AND SURGICAL CARE, TEACHING AND RESEARCH AND AS NOTED ELSEWHERE IN THIS RETURN, PROVIDES 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. THE ED'S MISSION, ALIGNED WITH BIDMC'S MISSION, IS TO DISTINGUISH ITSELF FROM OTHER PROVIDERS THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION, RESEARCH AND THROUGH IMPROVED HEALTH IN THE COMMUNITIES SERVED. BIDMC'S DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21)
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE ANNA JAQUES HOSPITAL IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THE ANNA JAQUES HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE FREE AND/OR DISCOUNTED CARE FROM ANNA JAQUES HOSPITAL AS WELL AS PROVIDERS WHO FOLLOW ANNA JAQUES HOSPITAL'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN ANNA JAQUES HOSPITAL AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW ANNA JAQUES HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. ANNA JAQUES HOSPITAL DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY AND THE AMOUNTS GENERALLY BILLED (AGB) CALCULATION IS UPDATED NOT LESS THAN ANNUALLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY, REVISED AUGUST 2020, WERE ADOPTED BY THE HOSPITAL'S BOARD PRIOR TO SEPTEMBER 30, 2017 AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF OCTOBER 1, 2017, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R).FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. THIS INFORMATION IS ALSO INCLUDED IN THE PLAIN LANGUAGE SUMMARY (PLS). IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY, APPLICATION FOR FINANCIAL ASSISTANCE AND HARDSHIP APPLICATION (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ENGLISH, ARABIC, FRENCH, GREEK, ITALIAN, JAPANESE, KHMER, PORTUGUESE, RUSSIAN, SIMPLIFIED CHINSE, SPANISH, TRADITIONAL CHINESE, VIETNAMESE. (SCHEDULE H PART V SECTION B QUESTION 16I)
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://WWW.AJH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE. IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDES CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE AND/OR DISCHARGE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICYPLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE FOLLOWING FINANCIAL ASSISTANCE POLICY (FAP) DOCUMENTS: CREDIT AND COLLECTION POLICY APPLICATION FOR FINANCIAL ASSISTANCE MEDICAL HARDSHIP APPLICATION FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY AS WELL AS ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, ARABIC, FRENCH, GREEK, ITALIAN, JAPANESE, KHMER, PORTUGUESE, RUSSIAN, SIMPLIFIED CHINSE, SPANISH, TRADITIONAL CHINESE, VIETNAMESE CAN BE FOUND ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://WWW.AJH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE. LIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLEDLOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB UPDATED NOT LESS FREQUENTLY THAN ANNUALLY AS REQUIRED PURSUANT TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R) AND THE AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. ANNA JAQUES HOSPITALADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)COMMUNITY BOARDAS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. ON MARCH 1, 2019, THE BETH ISRAEL LAHEY HEALTH SYSTEM WAS FORMED THROUGH THE COMBINATION OF THE HOSPITALS AND OTHER AFFILIATES OF THREE LEGACY HEALTH CARE SYSTEMS BASED PRIMARILY IN EASTERN MASSACHUSETTS, INCLUDING THE FORMER CAREGROUP HEALTH SYSTEM, THE FORMER LAHEY HEALTH SYSTEM, AND THE SEACOAST HEALTH SYSTEM. BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS NOW THE SOLE MEMBER OF THE HOSPITAL AND NINE ADDITIONAL AFFILIATED HOSPITALS. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE BILH HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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AFFILIATED HEALTH CARE SYSTEMAS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. BILH SERVES AS SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). LAHEY CLINIC FOUNDATION SERVES AS THE SOLE MEMBER OF LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES.FOR THE FISCAL YEAR 2020 THE BILH HOSPITALS NOTED ABOVE PROVIDED CARE TO MEDICAID PATIENTS AT COSTS WHICH EXCEEDED REVENUES BY OVER $86 MILLION AND PROVIDED CARE TO MEDICARE PATIENTS AT COSTS WHICH EXCEEDED REVENUES BY $117 MILLION. IN ADDITION, THE BILH HOSPITALS PROVIDED TOTAL COMMUNITY BENEFITS IN THE NATURE OF DIRECT SERVICES TO THE COMMUNITIES SERVED BY THE BILH NETWORK AS WELL AS FUNDS PROVIDED TO COMMUNITY PARTNERS IN THE AMOUNT OF $32 MILLION BILH HOSPITALS ALSO INCURRED NET COSTS FOR SUBSIDIZED HEALTH SERVICES TO ENSURE THAT CARE WAS AVAILABLE WITHIN THE COMMUNITIES SERVED ACROSS BILH IN THE AMOUNT OF $93 MILLION. FINALLY, BILH HOSPITALS ARE COMMITTED TO PROVIDING RESEARCH TO FURTHER ADVANCE CARE TO BILH PATIENTS AND TO THE GENERAL ADVANCEMENT TO HEALTHCARE TREATMENT BEYOND THE COMMUNITIES IMMEDIATELY SERVED BY BILH AND TO PROVIDING CUTTING EDGE TRAINING TO FUTURE HEALTHCARE PROVIDERS. BILH HOSPITALS INVESTED NET COSTS OF $183 MILLION. TOWARD THESE MISSIONS DURING THE FISCAL YEAR COVERED BY THIS FILING. IRC 501(R) REPORTING UNDER REVENUE PROCEDURE 2015-21:DURING A REVIEW OF LAHEY CLINIC HOSPITAL, INC.'S SECTION 501(R) COMPLIANCE IN THE HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2019, IT WAS DETERMINED THAT CERTAIN INFORMATION IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP), PLAIN LANGUAGE SUMMARY (PLS) AND CREDIT AND COLLECTIONS POLICY (CCP) AS THEN IN EFFECT REQUIRED CLARIFICATION OR CORRECTION. ALL CORRECTIONS AND CLARIFICATIONS WERE MADE AS REQUIRED PRIOR TO THE HOSPITAL'S FILING OF THE FORM 990 FOR THAT SAME FISCAL PERIOD. BECAUSE THE CORRECTIONS AND CLARIFICATIONS WERE MADE DURING THE FISCAL YEAR COVERED BY THE CURRENT FILING, THIS DISCLOSURE IS INCLUDED AGAIN IN THE FORM 990. IN ACCORDANCE WITH THE PROCEDURES SET FORTH IN REVENUE PROCEDURE 2015-21, EACH OF THE IDENTIFIED ITEMS IS LISTED ALONG WITH THE METHOD OF CORRECTION. CORRECTION OCCURRED BY ADOPTION OF A REVISED FAP, PLS AND CCP BY THE HOSPITAL'S AUTHORIZED BODY PRIOR TO FILING THE RETURN FOR FISCAL YEAR 2019, WHICH WAS FILED DURING THE HOSPITAL'S FISCAL YEAR 2020. (1) WHILE THE FAP SPECIFIED THE PERCENTAGE OF DISCOUNTS AVAILABLE, IT DID NOT SPECIFICALLY REFER TO WHAT CHARGES THOSE DISCOUNTS WOULD BE APPLIED. THE FAP HAS BEEN REVISED TO CLARIFY THAT THE DISCOUNTS ARE APPLIED TO PATIENT GROSS CHARGES. (2) THE FAP DID NOT SPECIFY THE AMOUNTS GENERALLY BILLED (AGB) BY THE HOSPITAL OR SPECIFY THE METHODOLOGY FOR CALCULATING THE AGB. THIS INFORMATION WAS POSTED ON THE HOSPITAL'S WEBSITE BUT WAS NOT SPECIFICALLY INCLUDED IN THE FAP. THE FAP HAS BEEN REVISED TO INCLUDE THIS INFORMATION. (3) THE FAP DID NOT CLEARLY DESCRIBE INFORMATION OBTAINED FROM SOURCES OTHER THAN THE INDIVIDUAL SEEKING FINANCIAL ASSISTANCE TO PRESUMPTIVELY DETERMINE THAT THE INDIVIDUAL IS FAP-ELIGIBLE. THE FAP HAS BEEN REVISED TO CLARIFY SUCH INFORMATION. (4) THE LIST OF PROVIDERS OF EMERGENCY AND MEDICALLY NECESSARY CARE AT THE HOSPITAL DID NOT INCLUDE ALL PROVIDERS. THE LIST HAS BEEN UPDATED AND NOW REFLECTS ALL PROVIDERS. (5) THE PLS DID NOT INCLUDE INSTRUCTIONS ON HOW AN INDIVIDUAL CAN OBTAIN A FREE COPY OF THE FAP AND FAP INSTRUCTIONS BY MAIL AND DID NOT INCLUDE THE CONTACT INFORMATION, INCLUDING TELEPHONE NUMBER AND PHYSICAL LOCATION OF THE HOSPITAL'S OFFICE OR DEPARTMENT THAT CAN PROVIDE ASSISTANCE WITH THE FAP APPLICATION PROCESS. THE PLS HAS BEEN REVISED TO INCLUDE THIS INFORMATION. (6) THE HOSPITAL HAD NOT YET MADE EFFORTS TO INFORM MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL ABOUT THE FAP IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. THE HOSPITAL HAS SINCE MADE SUCH EFFORTS, INCLUDING BY DISTRIBUTING COPIES OF ITS FAP AND FAP APPLICATION TO REFERRING STAFF PHYSICIANS AND TO COMMUNITY HEALTH CENTERS SERVING THE HOSPITAL'S COMMUNITY. (7) THE HOSPITAL HAD NOT BEEN OFFERING A PAPER COPY OF ITS PLS TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS. THE HOSPITAL HAS NOW ENSURED THAT IT IS DOING SO. (8) WHILE THE HOSPITAL HAD NOT BEEN ENGAGING IN ANY EXTRAORDINARY COLLECTION ACTIONS (ECAS), ITS CCP DID NOT INCLUDE A DESCRIPTION OF THE OFFICE, DEPARTMENT OR COMMITTEE WITH FINAL AUTHORITY FOR DETERMINING THAT REASONABLE EFFORTS HAD BEEN MADE TO DETERMINE FAP ELIGIBILITY BEFORE ENGAGING IN ANY ECAS. THE CCP HAS BEEN REVISED TO [EXPLICITLY PROHIBIT THE HOSPITAL FROM ENGAGING IN ECAS / INCLUDE SUCH A DESCRIPTION].FINALLY, THE HOSPITAL HAS ADOPTED PROCEDURES THAT REQUIRE THE HOSPITAL TO REVIEW, ON A REGULAR BASIS, THE HOSPITAL'S POLICIES AND PROCEDURE TO ENSURE COMPLIANCE WITH THE REQUIREMENTS OF SECTION 501(R) AND THE REGULATIONS ISSUED THEREUNDER. THOSE PROCEDURES INCLUDE REVIEWING A SECTION 501(R) COMPLIANCE CHECKLIST.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.