Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (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 |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 3,532,218 | 10,214,594 | 5,200,849 | 11,264,603 | 46,044,341 | 76,256,605 |
| 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 | 279,311,359 | 293,672,582 | 314,330,634 | 279,053,617 | 300,744,744 | 1,467,112,936 |
| 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 | 282,843,577 | 303,887,176 | 319,531,483 | 290,318,220 | 346,789,085 | 1,543,369,541 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 5,135 | 225,000 | 230,135 | |||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 5,135 | 225,000 | 230,135 | |||
| 8 | Public support. (Subtract line 7c from line 6.) | 1,543,139,406 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 282,843,577 | 303,887,176 | 319,531,483 | 290,318,220 | 346,789,085 | 1,543,369,541 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 89,128 | 141,729 | 255,866 | 876,626 | 4,045,799 | 5,409,148 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 89,128 | 141,729 | 255,866 | 876,626 | 4,045,799 | 5,409,148 |
| 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.).. | 282,932,705 | 304,028,905 | 319,787,349 | 291,194,846 | 350,834,884 | 1,548,778,689 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES, LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY HAVE, IN TURN, SERVED AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE BILH NETWORK OF AFFILIATES. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. FOR THIS SAME PERIOD HMFP SERVED AS THE SOLE MEMBER OF AFFILIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) AS WELL AS SEVERAL ADDITIONAL ENTITIES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE NETWORK OF THE AFFILIATED ORGANIZATIONS NOTED ABOVE. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. |
| FORM 990, PART VI, SECTION A, LINE 4 | DURING THE PERIOD COVERED BY THIS FILING, LAHEY CLINIC INC., AMENDED ITS BY-LAWS. AS REQUIRED BY THIS FORM 990, LAHEY CLINIC INC., HAS SUMMARIZED THOSE CHANGES BELOW: THE GOAL OF THE BYLAW AMENDMENTS WAS TO PROVIDE CLARIFICATION AND TO ALIGN THE LANGUAGE WITH CURRENT/BEST GOVERNANCE PRACTICES. AS A REMINDER TO THE READER AND AS NOTED THROUGHOUT THIS FORM 990, BETH ISRAEL LAHEY HEALTH (BILH) SERVES AS THE SOLE MEMBER OF LAHEY CLINIC INC.. THE AMENDMENTS INCLUDE: 1. TECHNICAL CHANGES AMENDS PURPOSES OF THE CORPORATION TO INCORPORATE DEEPER ARTICULATION OF THE BILH SYSTEM'S CORE VALUES. CLARIFIES HOW THE BILH BOARD MAY FUNCTIONALLY TAKE ACTION IN ITS CAPACITY AS THE INDIRECT SOLE CORPORATE MEMBER OF LAHEY CLINIC INC.. RESTRUCTURES THE BYLAWS OF LAHEY CLINIC FOUNDATION, INC., LAHEY CLINIC HOSPITAL, INC., AND LAHEY CLINIC, INC. ("LCI") TO BETTER REFLECT THAT THE THREE ENTITIES HAVE MIRROR BOARDS, COMMITTEES, AND OFFICERS. 2. CLARIFICATIONS REGARDING BOARD OF TRUSTEES AND COMMITTEES CLARIFIES THAT ANY TRUSTEES OR COMMITTEE MEMBERS WITH A TERM FEWER THAN OR MORE THAN THREE YEARS WILL BE CONSIDERED A FULL, THREE-YEAR TERM IF: (A) IT WAS TO ACHIEVE STAGGERING OR (B) DUE TO A TERM COMMENCING AT ANY TIME OTHER THAN OCTOBER 1 OF A GIVEN YEAR. CLARIFIES THAT TRUSTEES AND COMMITTEE MEMBERS APPOINTED TO FILL VACANCIES WILL SERVE THE REMAINDER OF THE THREE-YEAR TERM VACATED AND WILL BE ELIGIBLE FOR UP TO TWO CONSECUTIVE THREE-YEAR TERMS FOLLOWING THE END OF SUCH VACATED TERM. ALIGNS LAHEY CLINIC INC.'S BOARD'S ANNUAL MEETING WITH THE BILH BOARD'S ANNUAL MEETING IN SEPTEMBER. GIVES LAHEY CLINIC INC.S BOARD FLEXIBILITY TO ESTABLISH THE OPTIONAL STANDING COMMITTEES LISTED IN THE BYLAWS WITHOUT BILH BOARD APPROVAL. CLARIFIES THAT AD HOC COMMITTEES MAY BE ESTABLISHED NOT ONLY BY A MAJORITY OF THE TRUSTEES, BUT ALSO BY THE BOARD CHAIR (OR A COMMITTEE CHAIR IN CONSULTATION WITH THE BOARD CHAIR), AND THAT THESE COMMITTEES ARE INTENDED TO BE ESTABLISHED FOR SPECIFIC TASKS ON A SHORT-TERM BASIS. CONFIRMS THAT LAHEY CLINIC INC.'S COMMUNITY BENEFITS COMMITTEE HAS BEEN DISBANDED AT LAHEY CLINIC INC.. THE COMMUNITY BENEFITS COMMITTEE WILL BE AT THE BILH BOARD LEVEL AND LAHEY CLINIC INC.WILL HAVE A COMMUNITY BENEFITS ADVISORY COMMITTEE AS STATUTORILY REQUIRED BY THE COMMONWEALTH OF MASSACHUSETTS WHICH IS NOT A BOARD COMMITTEE. ADDS THE BOARD CHAIR AND PRESIDENT (OR THEIR RESPECTIVE DESIGNEES) EX OFFICIO TO ALL MANDATORY OR OPTIONAL STANDING COMMITTEES. CLARIFIES THAT THE CHAIRS OF THE FINANCE, QUALITY, AND GOVERNANCE/NOMINATING COMMITTEES WILL ACT AS THE PRINCIPAL LIAISON TO THE CORRESPONDING BILH COMMITTEE. GRANTS FLEXIBILITY TO THE GOVERNANCE/NOMINATING COMMITTEE TO OPERATE THROUGH ONE OR MORE SUBCOMMITTEES AND/OR GOVERNANCE/NOMINATING COMMITTEES. MAKES THE PHILANTHROPY COMMITTEE A MANDATORY RATHER THAN AN OPTIONAL STANDING COMMITTEE OF THE BOARD. AMENDS THE LAHEY CLINIC INC.'S COMPOSITION OF BOARD OF GOVERNORS AND THE TIME OF ELECTION TO THE BOARD OF GOVERNORS. 3. CLARIFICATIONS REGARDING OFFICERS CREATES TWO EX OFFICIO OFFICER POSITIONS: (1) ASSISTANT TREASURER (LAHEY CLINIC INC.'S CFO) AND (2) ASSISTANT CLERK (ATTORNEY ASSIGNED TO LAHEY CLINIC INC. BY BILH'S OFFICE OF GENERAL COUNSEL). LIMITS OFFICERS TO THOSE ENUMERATED IN THE BYLAWS (CHAIR, VICE-CHAIR(S), PRESIDENT, TREASURER, CLERK, ASSISTANT TREASURER, ASSISTANT CLERK). REQUIRES CHAIR AND VICE CHAIR TO BE INDEPENDENT TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 6 | EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE SOLE MEMBER OF LAHEY CLINIC FOUNDATION, THE MEMBER OF LAHEY CLINIC, INC.. |
| FORM 990, PART VI, SECTION A, LINE 7A | LAHEY CLINIC, INC.'S GOVERNING BODY IS COMPRISED OF THE SAME INDIVIDUALS SERVING ON THE MEMBER'S GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBER OF LAHEY CLINIC, INC. HAS THE FOLLOWING RIGHTS, AS DESIGNATED IN LAHEY CLINIC, INC.'S BYLAWS: SUBJECT TO THE PROVISIONS OF THE ARTICLES OF ORGANIZATION AND THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, BOTH POSITIVE AND NEGATIVE, CONFERRED BY MASSACHUSETTS GENERAL LAWS ("M.G.L.") CHAPTER 180, AS AMENDED, ON MEMBERS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. IN ADDITION, EXCEPT AS ARE EXPRESSLY GRANTED TO THE BOARD OF TRUSTEES OF THE CORPORATION ("BOARD") IN THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, POSITIVE AND NEGATIVE, CONFERRED BY M.G.L. CHAPTER 180 ON BOARDS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. NOTWITHSTANDING THE FOREGOING, THE MEMBER MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE BOARD: (A) APPROVE OR REQUIRE ANY CHANGE IN, OR CONSOLIDATION OF PHILANTHROPIC GIFTS, ASSETS, AND PROGRAMS OF THE CORPORATION, WHICH SHALL REMAIN UNDER THE CORPORATION'S CONTROL AND BE USED FOR THE BENEFIT OF THE CORPORATION AND NOT FOR OTHER COMPONENTS OF THE MEMBER'S SYSTEM, EXCEPT TO THE EXTENT THAT SUCH CHANGES INVOLVE BACK-OFFICE CONSOLIDATION WITH OTHER DIRECT OR INDIRECT SUBSIDIARIES OF THE MEMBER; (B) APPROVE OR REQUIRE ANY CHANGE IN THE NAME, BRAND, OR TRADEMARK OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES, EXCEPT SUCH COMPLEMENTARY CHANGES AS THE MEMBER MAY DETERMINE ARE REASONABLY APPROPRIATE IN ESTABLISHING A SYSTEM-WIDE IDENTITY FOR THE AFFILIATED ENTITIES; OR (C) AMEND OR RESTATE THESE BYLAWS TO CHANGE OR ELIMINATE EITHER OF THE FOREGOING LIMITATIONS ON ITS POWERS. FOR THE PERIOD ENDING ON THE THIRD ANNIVERSARY OF THE DATE THE SYSTEM MEMBER BECOMES THE SOLE CORPORATE MEMBER OF THE MEMBER, THE SYSTEM MEMBER'S AUTHORITY TO CHANGE THE MEDICAL SCHOOL AFFILIATION OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES IS SUBJECT TO THE REQUIREMENT THAT IT OBTAIN THE UNANIMOUS CONSENT OF THE CORPORATION'S DESIGNATED TRUSTEES (AS DEFINED IN THE BYLAWS OF THE MEMBER) AND THE APPROVAL OF THE SYSTEM MEMBER'S BOARD OF TRUSTEES. NOTWITHSTANDING ANYTHING TO THE CONTRARY HEREIN, THE POWERS OF THE MEMBER SHALL BE SUBJECT TO PROVISIONS BELOW: "THE POWER OF THE MEMBER TO EXERCISE ITS AUTHORITY AS A MEMBER OF ANOTHER CORPORATION SHALL BE SUBJECT TO THE FOLLOWING LIMITATIONS: (X) ALL STATUTORY POWERS THAT RESIDE IN THE MEMBER AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED BY THE MEMBER ONLY AT THE EXPRESS AND EXPLICIT DIRECTION OF, AND WITH THE APPROVAL OF, THE SYSTEM MEMBER; (Y) ALL STATUTORY POWERS THAT RESIDE IN THE MEMBER AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED DIRECTLY BY THE SYSTEM MEMBER AFTER CONSULTATION WITH THE CHAIR BUT OTHERWISE WITHOUT THE APPROVAL OR PARTICIPATION OF THE MEMBER; AND (Z) OTHER THAN STATUTORY POWERS, THE [MEMBER] SHALL HAVE ONLY THOSE POWERS AND AUTHORITIES OVER AND WITH RESPECT TO THE CORPORATIONS OF WHICH IT IS A MEMBER AS ARE EXPRESSLY AND EXPLICITLY DELEGATED OR DIRECTED TO THE MEMBER BY ACTION OF THE SYSTEM MEMBER'S BOARD." ANY ACTION TO BE TAKEN BY THE MEMBER OR THE SYSTEM MEMBER SHALL BE DEEMED DULY AUTHORIZED WHEN TAKEN, WITH RESPECT TO THE MEMBER, BY THE BOARD OF TRUSTEES OF THE MEMBER OR ITS DULY AUTHORIZED REPRESENTATIVE, AND WITH RESPECT TO THE SYSTEM MEMBER, BY THE SYSTEM MEMBER'S BOARD OR ITS DULY AUTHORIZED REPRESENTATIVE. ANY SUCH ACTIONS MAY BE TAKEN WITHOUT A MEETING IF CONFIRMED THROUGH A DULY AUTHORIZED WRITTEN COMMUNICATION BY THE RESPECTIVE BOARD OR ITS REPRESENTATIVE FILED WITH THE CLERK OF THE CORPORATION. IN EXERCISING ITS POWERS WITH RESPECT TO THE CORPORATION, THE MEMBER MAY CONSIDER THE RECOMMENDATIONS OF THE BOARD OF GOVERNORS OF LAHEY CLINIC, INC. THE POWERS AND RESPONSIBILITIES OF THE BOARD INCLUDE THE FOLLOWING: (A) PROVIDING RECOMMENDATIONS TO THE MEMBER REGARDING (I) APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES, (II) THE ESTABLISHMENT OF THE CORPORATION'S POLICIES, (III) THE MAINTENANCE OF PATIENT CARE QUALITY, AND (IV) THE PROVISION OF CLINICAL SERVICES AND COMMUNITY SERVICE PLANNING IN A MANNER RESPONSIVE TO LOCAL COMMUNITY NEEDS; (B) ENSURING COMPLIANCE WITH ALL LICENSURE AND ACCREDITATION REQUIREMENTS, INCLUDING CREDENTIALING AND OTHER MEDICAL STAFF MATTERS; (C) PROVIDING OVERSIGHT FOR INSTITUTIONAL PLANNING, MAKING RECOMMENDATIONS FOR NEW CLINICAL SERVICES, AND PARTICIPATING IN AN ANNUAL REVIEW OF THE CORPORATION'S STRATEGIC AND FINANCIAL PLAN AND GOALS; (D) REVIEWING AND RECOMMENDING APPROVAL OF OPERATING AND CAPITAL BUDGETS AS WELL AS MAKING RECOMMENDATIONS WITH RESPECT TO CAPITAL EXPENDITURES; (E) MAKING RECOMMENDATIONS WITH RESPECT TO QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS; (F) PROVIDING OVERSIGHT OF RISK MANAGEMENT PROGRAMS RELATING TO PATIENT CARE AND SAFETY; (G) REVIEWING DISASTER PLANS THAT DEAL WITH BOTH INTERNAL (E.G., FIRE) AND EXTERNAL DISASTERS; AND (H) EVALUATING RECRUITMENT NEEDS TO ENSURE ADEQUATE MEDICAL STAFF CAPACITY TO CONTINUE TO MEET COMMUNITY NEEDS. EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, THE BOARD SHALL ACT IN AN ADVISORY CAPACITY AND CONSISTENT THEREWITH SHALL HAVE ONLY THE FOLLOWING POWERS: (A) POWERS EXPRESSLY GRANTED BY THE MEMBER FROM TIME TO TIME; (B) POWER TO EXERCISE ITS AUTHORITY AS A MEMBER OF OTHER CORPORATIONS; (C) POWER TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THE BYLAWS OF THE MEMBER (AS DEFINED UNDER THE BYLAWS OF THE MEMBER) OR UNDER THESE BYLAWS WITH RESPECT TO THE MEMBER; AND (D) POWERS TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THAT AGREEMENT DATED JUNE 30, 2017 BY AND AMONG LAHEY HEALTH SYSTEM, INC., BETH ISRAEL DEACONESS MEDICAL CENTER, INC., NEW ENGLAND BAPTIST HOSPITAL, INC., MOUNT AUBURN HOSPITAL, CAREGROUP, INC., AND SEACOAST REGIONAL HEALTH SYSTEMS, INC. THE POWERS OF THE BOARD IN CLAUSES (A) AND (B) OF THE PRECEDING SENTENCE SHALL BE SUBJECT TO THE RESERVED POWERS OF THE MEMBER SET FORTH IN SECTION 2.2. THE POWERS OF THE BOARD IN CLAUSE (C) AND (D) OF THE FIRST SENTENCE OF THIS PARAGRAPH SHALL BE INDEPENDENT OF THE MEMBER AND NOT SUBJECT TO THE RESERVED POWERS OF THE MEMBER SET FORTH ABOVE. NOTWITHSTANDING CLAUSE (B) ABOVE, THE POWER OF THE CORPORATION TO EXERCISE ITS AUTHORITY AS A MEMBER OF ANOTHER CORPORATION SHALL BE SUBJECT TO THE FOLLOWING LIMITATIONS: (X) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED BY THE CORPORATION ONLY AT THE EXPRESS AND EXPLICIT DIRECTION OF, AND WITH THE APPROVAL OF, THE MEMBER; (Y) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED DIRECTLY BY THE MEMBER AFTER CONSULTATION WITH THE CHAIR BUT OTHERWISE WITHOUT THE APPROVAL OR PARTICIPATION OF THE CORPORATION; AND (Z) OTHER THAN STATUTORY POWERS, THE CORPORATION SHALL HAVE ONLY THOSE POWERS AND AUTHORITIES OVER AND WITH RESPECT TO THE CORPORATIONS OF WHICH IT IS A MEMBER AS ARE EXPRESSLY AND EXPLICITLY DELEGATED OR DIRECTED TO THE CORPORATION BY ACTION OF THE MEMBER'S BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE SOLE MEMBER OF THE LAHEY CLINIC FOUNDATION (LCF), WHICH IS IN TURN, THE SOLE MEMBER OF LAHEY CLINIC, INC. LAHEY HEALTH SHARED SERVICES (LHSS) IS A SISTER ENTITY TO LCF. THIS FORM 990 IS PREPARED IN CONJUNCTION WITH THE LHSS FINANCE STAFF. IN ADDITION, THE BILH TAX DEPARTMENT WORKS WITH OTHER DISCIPLINES AND DEPARTMENTS WITHIN BILH, LCF, LHSS AND LCI AND OTHER AFFILIATES TO ENSURE THAT OTHER FINANCIAL AND NON-FINANCIAL DISCLOSURES ARE COMPLETE AND ACCURATE. EXAMPLES OF SUCH DEPARTMENTS MAY INCLUDE: FINANCIAL ASSISTANCE AND REIMBURSEMENT, COMPLIANCE, GRADUATE MEDICAL EDUCATION, LEGAL, COMMUNITY BENEFITS, GOVERNANCE, DEVELOPMENT, HUMAN RESOURCES AND PAYROLL, GOVERNMENT RELATIONS, RESEARCH AND/OR RESEARCH FINANCE. THE TAX RETURNS REVIEWED BY THE BILH EXECUTIVE DIRECTOR, TAXATION, LAHEY CLINIC, INC.'S CHIEF FINANCIAL OFFICER AND DELOITTE TAX, LLP. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF LAHEY CLINIC'S BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | LAHEY CLINIC, INC. IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) SYSTEM OF AFFILIATES. ALL ENTITIES IN THE BILH NETWORK ADHERE TO THE BILH CONFLICT OF INTEREST POLICY AND MAINTAIN A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY AT THE ENTITY LEVEL. PURSUANT TO THESE POLICIES, ALL OF LAHEY CLINIC, INC.'S OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE THE ANNUAL CONFLICT OF INTEREST AND TAX QUESTIONNAIRE WHICH IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS RELATIONSHIPS AND AFFILIATIONS MAINTAINED BY OFFICERS, TRUSTEES, OR KEY EMPLOYEES AND THEIR FAMILY MEMBERS AND WHICH MAY RESULT IN A REAL OR PERCEIVED CONFLICT OF INTEREST. THE BILH OFFICE OF INTEGRITY AND COMPLIANCE, IN CONJUNCTION WITH THE BILH TAX DEPARTMENT, ADMINISTERS THE CONFLICT OF INTEREST AND TAX QUESTIONNAIRE PROCESS ANNUALLY. BILH INTEGRITY AND COMPLIANCE COLLECTS AND REVIEWS ALL DISCLOSURES. DISCLOSURES FOR BILH EXECUTIVES AND KEY EMPLOYEES ARE ASSIGNED APPROPRIATE FOLLOW-UP ACTION IN ACCORDANCE WITH THE BILH POLICY. A SUMMARY OF POSITIVE RESPONSES OF LAHEY CLINIC, INC. IS PROVIDED TO THE LAHEY CLINIC, INC.'S COMPLIANCE OFFICER FOR REVIEW FINAL DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. ANY ACTIVITY THAT REQUIRES ACTION UNDER THE CONFLICT OF INTEREST POLICIES IS SUBJECT TO ONGOING REVIEW BY LAHEY CLINIC, INC. AS WELL AS THE BILH INTEGRITY AND COMPLIANCE OFFICE. PURSUANT TO THE BILH CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A MANAGEMENT PLAN TO REQUIRE DISCLOSURE AND RECUSAL, INCLUDING APPROPRIATE DOCUMENTATION IN THE MINUTES. IN ADDITION AS NOTED ABOVE, THE ANNUAL CONFLICT OF INTEREST PROCESS OUTLINE ABOVE IS JOINTLY ISSUED BY THE BILH TAX DEPARTMENT, TO ENSURE THAT THE QUESTIONNAIRE IS DISTRIBUTED TO ALL CURRENT AND FORMER MEMBERS OF THE LAHEY CLINIC, INC. BOARD OF TRUSTEES AS WELL AS FORMER OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE PROCESS IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR LAHEY CLINIC, INC. TO COMPLETELY AND ACCURATELY COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | LAHEY CLINIC, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL LAHEY HEALTH TAX DEPARTMENT 109 BROOKLINE AVENUE, SUITE 300 BOSTON, MA 02215 |
| FORM 990, PART XI, LINE 9: | NET ASSETS RELEASED FROM DONOR RESTRICTIONS FOR OPERATIONS -4,113,125. NET ASSETS RELEASED FROM DONOR RESTRICTIONS FOR PP&E -6,764,215. TRANSFER OF NET ASSETS 58,405,375. REALIZED GAINS (LOSSES) ON SALE OF SECURITIES 0. SUPPORT FROM LAHEY CLINIC FOUNDATION, INC. 0. INVESTMENT INCOME 0. ROUNDING CONTRIBUTIONS 0. |
| PART V, QUESTION 7G: | LAHEY CLINIC, INC. DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899. |
| PART V, QUESTION 7H: | LAHEY CLINIC, INC. DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 1098-C. |
| PART IV, LINE 12: | THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2020 THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. |
| PART IV, LINE 24A: STATEMENT REGARDING TAX EXEMPT BOND ISSUE | AS DESCRIBED IN THIS FORM 990 BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND SERVED AS A SUPPORT ORGANIZATION OF AND SOLE MEMBER OF THE LAHEY CLINIC FOUNDATION, WHICH IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC, INC. DURING THIS SAME PERIOD, LAHEY CLINIC, INC WAS A MEMBER OF THE BILH OBLIGATED GROUP AND ITS TAX EXEMPT BOND FINANCING WAS ISSUED THROUGH BILH OR THROUGH A PREVIOUS OBLIGATED GROUP WHICH IS NOW A PART OF THE BILH OBLIGATED GROUP. THE SCHEDULE K AS INCLUDED IN THIS FORM 990 INCLUDES ALL OF THE BILH OBLIGATED GROUP OUTSTANDING TAX EXEMPT DEBT FOR BONDS ISSUED AFTER DECEMBER 31, 2002, ONLY A PORTION OF WHICH IS ALLOCABLE TO AND REPORTED ON LAHEY CLINIC, INC'S BALANCE SHEET. |
| PART IV, LINE 24B: | AS REPORTED ON THE FORM 990 SCHEDULE K, THE LAHEY HEALTH SYSTEM INC. SERIES F BONDS WHICH WERE ISSUED IN 2015 ARE NOW PART OF THE BETH ISRAEL LAHEY HEALTH OBLIGATED GROUP DEBT. THE BONDS WERE ISSUED IN 2015 AND AS OF SEPTEMBER 30, 2020 THERE WAS A BALANCE REMAINING IN THE CONSTRUCTION FUND. PROCEEDS IN THE CONSTRUCTION FUND WERE UNEXPECTEDLY HELD BEYOND THE THREE-YEAR TEMPORARY PERIOD, AND WERE YIELD RESTRICTED IN COMPLIANCE WITH FEDERAL TAX REQUIREMENTS. |
| FORM 990, PART VI, SECTION A, LINE 6: | EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE SOLE MEMBER OF LAHEY CLINIC FOUNDATION, THE MEMBER OF LAHEY CLINIC, INC.. |
| PART VI, LINE 15 | AS NOTED THROUGHOUT THIS FILING, LAHEY CLINIC, INC IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS LAHEY CLINIC, INC'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. IN THIS ROLE BILH MAINTAINS THE RESPONSIBILITY FOR SETTING COMPENSATION FOR EMPLOYEES AND SENIOR MANAGEMENT OF THE ENTITIES WHICH COMPRISED THE BETH ISRAEL LAHEY HEALTH NETWORK AND TO THAT END, BILH HAS A COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES AND EXCEPT AS OTHERWISE NOTED BELOW, COMPENSATION REPORTED IN THIS FORM 990 FOR LAHEY CLINIC, INC'S OFFICERS, TRUSTEES AND KEY EMPLOYEES WAS SET BY THE BILH COMPENSATION COMMITTEE. THE BILH COMPENSATION COMMITTEE PROCESS FOR SETTING COMPENSATION IS BELOW. THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES, IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER SENIOR EXECUTIVES IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION. IN ADDITION, AS REQUIRED BY THIS FORM 990 AND FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, COMPENSATION REPORTED HEREIN IS CALENDAR YEAR 2020 COMPENSATION. PRIOR TO THE MARCH 1, 2019 LAHEY CLINIC, INC'S EMPLOYEES MAY HAVE RECEIVED COMPENSATION FROM ANOTHER ENTITY WITHIN THE LAHEY HEALTH SYSTEM NETWORK OF AFFILIATES. ON BEHALF OF ALL MEMBERS OF LAHEY HEALTH SYSTEM, INC. (LHS), LHS MAINTAINED A PROCESS WHICH CONTAINED THE SAME PROCEDURES AS NOTED ABOVE FOR BILH AND EACH OF THOSE INDEPENDENT COMPENSATION COMMITTEES MAINTAINED PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION, AND THE COMPENSATION OF THE CHIEF EXECUTIVE FOR EACH ENTITY WAS SENT TO THE APPLICABLE BOARD FOR APPROVAL AFTER DELIBERATIONS BY THE ENTITY'S COMPENSATION COMMITTEE. |
| FORM 990, PART VI, SECTION A, LINE 7A: | LAHEY CLINIC, INC.'S GOVERNING BODY IS COMPRISED OF THE SAME INDIVIDUALS SERVING ON THE MEMBER'S GOVERNING BODY. |
| FORM 990, PART IV, LINE 11F: | EACH ENTITY WITHIN THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) SYSTEMRECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN LAHEY CLINIC, INC. 04-2704683 MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. THE SYSTEM DID NOT RECOGNIZED THE EFFECT OF ANY INCOME TAX POSITION IN 2020. |
| FORM 990, PART VI, LINE 15: | AS NOTED THROUGHOUT THIS FILING, LAHEY CLINIC, INC IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS LAHEY CLINIC, INC'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. IN THIS ROLE BILH MAINTAINS THE RESPONSIBILITY FOR SETTING COMPENSATION FOR EMPLOYEES AND SENIOR MANAGEMENT OF THE ENTITIES WHICH COMPRISED THE BETH ISRAEL LAHEY HEALTH NETWORK AND TO THAT END, BILH HAS A COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES AND EXCEPT AS OTHERWISE NOTED BELOW, COMPENSATION REPORTED IN THIS FORM 990 FOR LAHEY CLINIC, INC'S OFFICERS, TRUSTEES AND KEY EMPLOYEES WAS SET BY THE BILH COMPENSATION COMMITTEE. THE BILH COMPENSATION COMMITTEE PROCESS FOR SETTING COMPENSATION IS BELOW. THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES, IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER SENIOR EXECUTIVES IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION. IN ADDITION, AS REQUIRED BY THIS FORM 990 AND FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020, COMPENSATION REPORTED HEREIN IS CALENDAR YEAR 2019 COMPENSATION. PRIOR TO THE MARCH 1, 2019 LAHEY CLINIC, INC'S EMPLOYEES MAY HAVE RECEIVED COMPENSATION FROM ANOTHER ENTITY WITHIN THE LAHEY HEALTH SYSTEM NETWORK OF AFFILIATES. ON BEHALF OF ALL MEMBERS OF LAHEY HEALTH SYSTEM, INC. (LHS), LHS MAINTAINED A PROCESS WHICH CONTAINED THE SAME PROCEDURES AS NOTED ABOVE FOR BILH AND EACH OF THOSE INDEPENDENT COMPENSATION COMMITTEES MAINTAINED PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION, AND THE COMPENSATION OF THE CHIEF EXECUTIVE FOR EACH ENTITY WAS SENT TO THE APPLICABLE BOARD FOR APPROVAL AFTER DELIBERATIONS BY THE ENTITY'S COMPENSATION COMMITTEE. |
| FORM 990, PART XII, LINE 2C: | ON MARCH 1, 2019, LAHEY HEALTH SYSTEM INCLUDING THE LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER, WINCHESTER HOSPITAL, NORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL AND BAYRIDGE HOSPITAL, THE BETH ISRAEL DEACONESS SYSTEM INCLUDING BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS MILTON, BETH ISRAEL DEACONESS NEEDHAM AND BETH ISRAEL DEACONESS PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL, ANNA JAQUES HOSPITAL AS WELL AS ENTITIES FOR WHICH THESE LISTED ORGANIZATIONS SERVE AS SOLE MEMBER AND ADDITIONAL AFFILIATES CAME TOGETHER TO FORM BETH ISRAEL LAHEY HEALTH (BILH). AS A NEWLY CREATED HEALTHCARE SYSTEM, BILH ENGAGED KPMG TO PERFORM A FINANCIAL AUDIT OF THE SYSTEM. THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2020. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND ITS AFFILIATES. |
| PART III, LINE 1: | LAHEY CLINIC (LC) PROVIDES THE HIGHEST QUALITY INTERDISCIPLINARY AND COORDINATED PATIENT CARE LEADING TO THE BEST POSSIBLE OUTCOMES AND EXPERIENCES FOR EVERY PATIENT, ADVANCING MEDICINE THROUGH RESEARCH AND EDUCATING TOMORROW'S HEALTH CARE LEADERS, AND PROMOTING HEALTH AND WELLNESS IN PARTNERSHIP WITH THE DIVERSE COMMUNITIES SERVED. LAHEY CLINIC ACCOMPLISHES THESE MISSIONS IN CONJUNCTION WITH THE LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER AND THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES AS DESCRIBED FURTHER IN THIS FORM 990. BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), ANNA JAQUES HOSPITAL (AJH) , THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL &MEDICAL CENTER (LHMC). THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. |
| PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: | OVERALL FOCUS AND EMERGENCY CARE THE LAHEY CLINIC (LC) IS A MULTI-SPECIALTY GROUP PRACTICE THAT OPERATES IN SEVERAL COMMUNITY SITES PROVIDING OUTPATIENT, DIAGNOSTIC, THERAPEUTIC, EMERGENCY AND INPATIENT HEALTH CARE SERVICES. LC EMPLOYS PHYSICIANS IN OVER 40 MEDICAL AND SURGICAL SPECIALTIES, INCLUDING PRIMARY CARE. THE PHYSICIANS OF LAHEY CLINIC, INC. PROVIDE TERTIARY CARE IN TWO LOCATIONS OF A LICENSED HOSPITAL THAT IS COMPRISED OF 345 LICENSED BEDS AS WELL AS OTHER MEDICAL OFFICES IN THE COMMUNITY. THE PHYSICIANS AND MEDICAL STAFF OF LC TREAT MORE THAN ONE MILLION PATIENTS AT THE PHYSICIAN OFFICES, OVER 61,000 IN THE EMERGENCY ROOM AND PROVIDE OVER 19,000 SURGICAL PROCEDURES AND HOSPITAL DISCHARGES OF APPROXIMATELY 21,000 PATIENTS ON AN ANNUAL BASIS. LC PHYSICIANS PROVIDE EMERGENCY CARE TO PATIENTS IN LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC)'S EMERGENCY DEPARTMENT IN BURLINGTON, MASSACHUSETTS 24 HOURS A DAY, 7 DAYS A WEEK. AS A LEVEL I TRAUMA CENTER LC SURGEONS ARE AVAILABLE TO TREAT THE MOST CRITICALLY INJURED AND ILL PATIENTS WITHIN 15 MINUTES OF THEIR ARRIVAL AT LHMC. THE EMERGENCY DEPARTMENT PHYSICIANS ALSO SERVE AS "MEDICAL CONTROL" FOR VARIOUS AREA AMBULANCE SERVICES, FOR WHICH THEY DIRECT PRE-HOSPITALIZATION CARE BY RADIO TO PARAMEDICS AND EMERGENCY MEDICAL TECHNICIANS IN THE FIELD. LC PHYSICIANS ALSO PROVIDE 24-HOUR EMERGENCY CARE TO PATIENTS AT THE LHMC PEABODY CAMPUS. IN ADDITION, LC PHYSICIANS TRAIN RESIDENTS FROM THE BOSTON UNIVERSITY EMERGENCY MEDICINE PROGRAM. THESE RESIDENT COMPLETE ROTATIONS AT LHMC UNDER THE SUPERVISION OF LC PHYSICIANS DURING THEIR SECOND AND FOURTH YEARS OF STUDY. ADDITIONAL INFORMATION RELATED TO THE RESIDENT TRAINING PROGRAM IS INCLUDED IN THE LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC) FORM 990 SCHEDULE H. |
| PART III, LINE 4B, PROGRAM SERVICE ACCOMPLISHMENTS: | ANCILLARY SERVICES: RADIOLOGY, DIAGNOSTIC CARE AND TREATMENT LAHEY CLINIC (LC) PHYSICIANS PROVIDE, REVIEW AND INTERPRET A WIDE RANGE OF DIAGNOSTIC AND INTERVENTIONAL SERVICES CURRENTLY AVAILABLE IN IMAGING. THE TEAM OF MORE THAN 40 BOARD CERTIFIED RADIOLOGISTS PROVIDES SUBSPECIALTY EXPERTISE IN BREAST IMAGING, CT SCAN, GASTROINTESTINAL IMAGING, GENITOURINARY IMAGING, INTERVENTIONAL RADIOLOGY, INTERVENTIONAL NEURORADIOLOGY, MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE (INCLUDING SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY SCANNING CAPABILITIES AND A RADIONUCLIDE THERAPY PROGRAM), PET/CT IMAGING, THORACIC IMAGING, ULTRASOUND, VASCULAR IMAGING AND WOMEN'S IMAGING. LHMC DIAGNOSTIC RADIOLOGY IS ENTIRELY DIGITAL AND LC PHYSICIANS ARE TRAINED TO INTERPRET SCANS AND IMAGES ON ONE OF THE MOST COMPREHENSIVE PACS (PICTURE ARCHIVAL COMMUNICATIONS SYSTEM) SYSTEMS IN THE COUNTRY. LC PATIENTS RECEIVE THE MOST ACCURATE DIAGNOSES FROM LC TRAINED PHYSICIANS USING DIAGNOSTIC MODALITIES SUCH AS DIGITAL MAMMOGRAPHY INCLUDING 3-D TOMOSYNTHESIS, CT SCANNERS WITH RADIATION DOSE REDUCTION SOFTWARE, A BARIATRIC CT SCANNER AND MRI UNITS INCLUDING AN OPEN MAGNET AND A 3-TESLA MAGNET. PHYSICIANS AT THE LHMC BURLINGTON CAMPUS ALSO OFFER A FULL RANGE OF CARDIAC DIAGNOSTIC AND THERAPEUTIC MODALITIES WORKING IN A MULTIDISCIPLINARY MANNER WITH THE CARDIOLOGISTS AND PROVIDING CARE INCLUDING A CARDIAC CARE IN THE CARDIAC CATHETERIZATION AND ELECTROPHYSIOLOGY LABORATORIES. LC PHYSICIANS REVIEW AND INTERPRET MORE THAN 319,000 IMAGING EXAMINATIONS ANNUALLY IN THREE LOCATIONS: LAHEY HOSPITAL & MEDICAL CENTER (LHMC), BURLINGTON, LAHEY MEDICAL CENTER, PEABODY AND LAHEY OUTPATIENT CENTER, LEXINGTON. AS NOTED FURTHER IN THE FORM 990 SCHEDULE H OF LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC), LHMC IS A TEACHING HOSPITAL FOR THE TUFTS UNIVERSITY SCHOOL OF MEDICINE. LAHEY CLINIC BOARD CERTIFIED RADIOLOGISTS, TRAIN THE RADIOLOGISTS OF TOMORROW AS PART OF LC'S COMMITMENT TO MEDICAL EDUCATION. RESIDENTS PARTICIPATE IN A FOUR-YEAR RADIOLOGY RESIDENCY PROGRAM AND POST-RESIDENCY FELLOWSHIP TRAINING IS ALSO OFFERED IN FIELDS SUCH AS ABDOMINAL IMAGING, MUSCULOSKELETAL IMAGING AND INTERVENTIONAL NEURORADIOLOGY. INTERVENTIONAL RADIOLOGY AND RADIATION ONCOLOGY IN ADDITION TO THE DIAGNOSTIC CARE NOTED ABOVE, LAHEY CLINIC (LC) RADIOLOGISTS TREAT PATIENTS DIRECTLY IN AREAS SUCH AS INTERVENTIONAL RADIOLOGY AND ONCOLOGY. AS PART OF LHMC'S INTERVENTIONAL RADIOLOGY, LC PHYSICIANS PROVIDE STATE-OF-THE-ART 3-D AND BIPLANE INTERVENTIONAL ANGIOGRAPHY, AS WELL AS INTERVENTIONAL RADIOLOGY PROCEDURES IN SUCH SUBSPECIALTIES AS INVASIVE CARDIOLOGY, PERIPHERAL VASCULAR AND UROLOGY PROCEDURES AS WELL AS A DEDICATED INTERVENTIONAL NEURORADIOLOGY SERVICE WHERE PHYSICIANS PROVIDE INNOVATIVE IMAGING-GUIDED PROCEDURES FOR PATIENTS DIAGNOSED WITH VASCULAR (BLOOD VESSEL) DISEASES OF THE CENTRAL NERVOUS SYSTEM, INCLUDING THE BRAIN AND SPINE. LC PHYSICIANS ARE EXPERT IN THE INTERVENTIONAL TREATMENT OF ACUTE STROKES, ANEURYSMS, AND ARTERIOVENOUS MALFORMATIONS (AVMS), A CONGENITAL CONDITION INVOLVING A TANGLE OF ABNORMALLY CONNECTED ARTERIES AND VEINS IN THE HEAD. IN ADDITION, LC'S MULTIDISCIPLINARY APPROACH MEANS THAT RADIOLOGISTS WORK CLOSELY WITH OTHER CLINICAL DEPARTMENTS AND LC PHYSICIAN SPECIALISTS PRACTICING IN AREAS SUCH AS ENDOCRINOLOGY, NEUROLOGY AND NEUROSURGERY, ORTHOPAEDICS AND CARDIOLOGY (INCLUDING A FULL RANGE OF CARDIAC DIAGNOSTIC AND THERAPEUTIC MODALITIES IN THE CARDIAC CATHETERIZATION AND ELECTROPHYSIOLOGY LABORATORIES). THIS MULTIDISCIPLINARY APPROACH ENSURES THE BEST OPTIONS AND BEST COURSE OF TREATMENT FOR PATIENTS. THESE PROCEDURES BENEFIT PATIENTS OFFERING A MINIMALLY INVASIVE OPTION WHEN POSSIBLE, THEREBY ELIMINATING THE NEED FOR OPEN SURGERY, TREATING CONDITIONS THAT ARE OTHERWISE DIFFICULT TO TREAT OR ARE UNTREATABLE BY OPEN SURGERY AND ALLOWING FOR SHORTER PATIENT RECOVERY TIMES. THE LAHEY TEAM HAS PERFORMED MORE THAN 6,000 PROCEDURES IN THE AREAS DESCRIBED ABOVE. PHYSICIANS WITHIN THE LAHEY CLINIC (LC) DEPARTMENT OF RADIATION ONCOLOGY PROVIDE COMPREHENSIVE TREATMENT FOR PATIENTS WITH CANCER THROUGH THE USE OF THREE LINEAR ACCELERATORS AND SOPHISTICATED COMPUTER EQUIPMENT FOR TREATMENT PLANNING, WHICH INCLUDES CAT SIMULATORS, AND THEY ALSO PROVIDE ONGOING FOLLOW-UP CARE FOR ONCOLOGY PATIENTS THROUGH OTHER DEPARTMENTAL SERVICES INCLUDING A FULLY ACCREDITED MAMMOGRAPHY SERVICE, MAGNETIC RESONANCE MAMMOGRAPHY AND ULTRASOUND SERVICES. THE PATIENT CARE TREATMENT PHILOSOPHY IS ROOTED IN TEAMWORK, EASE OF ACCESS AND PATIENT EMPOWERMENT. RECOGNIZING THAT EACH PATIENT'S ONCOLOGY NEEDS ARE UNIQUE, LAHEY OFFERS A FULL RANGE OF TREATMENT OPTIONS TO MEET THE SPECIFIC NEEDS OF EACH PATIENT. EMBRACING A TEAM APPROACH THAT INVOLVES THE PATIENT EVERY STEP OF THE WAY ALLOWS LC PHYSICIANS TO PAVE THE WAY FOR SUPERIOR OUTCOMES, INCREASED PATIENT SATISFACTION AND, MOST IMPORTANT OF ALL, A HIGHER RATE OF SURVIVORSHIP. IN CONJUNCTION WITH ONCOLOGY CARE, LC PHYSICIANS COORDINATE MULTIDISCIPLINARY CARE FOR PATIENTS WORKING WITH TEAMS IN OTHER DEPARTMENTS AS NECESSARY, SUCH AS HEMATOLOGY, CANCER SERVICES AND THE FAMILIAL CANCER RISK ASSESSMENT CENTER. THIS COLLABORATION ALLOWS PHYSICIANS TO PROVIDE PERSONALIZED, COMPASSIONATE CARE TO PATIENTS. THIS SAME MULTIDISCIPLINARY APPROACH ALSO EXTENDS TO POST-CANCER CARE. |
| PART III, LINE 4C, PROGRAM SERVICE ACCOMPLISHMENTS: | GENERAL MEDICINE PRIMARY CARE AND ENDOSCOPY: GENERAL INTERNAL MEDICINE PHYSICIANS OFFER A LARGE COMPREHENSIVE CARE TEAM FOR PRIMARY HEALTH CARE NEEDS IN A MODERN PATIENT CENTER IN BURLINGTON AS WELL AS IN COMMUNITY BASED SETTINGS IN LEXINGTON, PEABODY AND OTHER COMMUNITY LOCATIONS THROUGHOUT NORTHEASTERN MASSACHUSETTS. PRIMARY CARE PHYSICIANS (PCPS) ARE MEDICAL DOCTORS WHO GENERALLY PROVIDE THE FIRST CONTACT FOR A PATIENT WITH A NON-EMERGENT UNDIAGNOSED HEALTH CONCERN, AS WELL AS CONTINUING CARE FOR A VARIETY OF MEDICAL CONDITIONS. THE PATIENT CARE FACILITY IN BURLINGTON SUPPLEMENTS PRIMARY CARE WITH A RADIOLOGY SUITE FOR X-RAYS, A PHLEBOTOMY STATION FOR BLOOD DRAWS, AND A PHARMACY TO HELP PROVIDE SEAMLESS CARE FOR LC PATIENTS. AS EXPERTS IN ADULT MEDICINE, LAHEY CLINIC PRIMARY CARE PROVIDERS WORK TOGETHER IN TEAMS TO DELIVER COMPREHENSIVE AND COMPASSIONATE HEALTH CARE. IN A TYPICAL FISCAL YEAR, APPROXIMATELY 60 PRIMARY CARE AND ADVANCED PRACTITIONERS WILL SEE 94,000 PATIENTS ANNUALLY IN THE BURLINGTON LOCATION ALONE. ENDOSCOPY SPECIALISTS AT THE LAHEY CLINIC TREAT PATIENTS IN THE LHMC ENDOSCOPY CENTER, PROVIDING A FULL RANGE OF ENDOSCOPY CARE, WHETHER PATIENTS NEED A DIAGNOSIS OR TREATMENT FOR A GASTROINTESTINAL, COLON OR RECTAL CONDITION. THIS STATE-OF-THE-ART ENDOSCOPY CENTER RECENTLY EXPANDED TO MORE THAN 13,000 SQUARE FEET TO MEET INCREASING PATIENT DEMAND WHILE ENHANCING A PATIENT'S EXPERIENCE. THE NEW FACILITY INCLUDES BOTH REGULAR AND ADVANCED PROCEDURE ROOMS, PRE-PROCEDURE AND POST-PROCEDURE BAYS FOR BOTH OUTPATIENTS AND INPATIENTS, LIGHT-FILLED WAITING ROOMS AND ITS OWN ENTRANCE AND PARKING LOT. THE SPACE ALSO INCLUDES UPDATED IMAGING EQUIPMENT, ADVANCED REPROCESSING TECHNOLOGY AND SEPARATE PROCESSES SUPPORTING THE DIFFERENCES BETWEEN OUTPATIENTS AND INPATIENTS. ADDITIONALLY, THIS NEW UNIT HAS THE LARGEST AUTOMATED CLEANING SYSTEM IN THE REGION, WHICH REDUCES THE RISK OF HUMAN ERROR AND CROSS-CONTAMINATION, ENSURING SAFE, PATIENT-READY ENDOSCOPES FOR EVERY PROCEDURE. LC ENDOSCOPY SPECIALISTS PERFORM SCREENINGS AND PROCEDURES FOR CONDITIONS OF THE LIVER, BILIARY TREE, PANCREAS AND GASTROINTESTINAL TRACT, INCLUDING ESOPHAGUS, COLON AND RECTUM. PROCEDURES INCLUDE EVERYTHING FROM COLON CANCER SCREENINGS TO TREATMENTS FOR SWALLOWING DISORDERS, BILE DUCT DISORDERS, MOTILITY PROCEDURES, INCLUDING TESTS THAT MEASURE ACID REFLUX, CHECK PH LEVELS AND/OR MEASURE THE MUSCLE STRENGTH IN A PATIENT'S ESOPHAGUS AS WELL AS TUMOR DIAGNOSIS USING ENDOSCOPIC ULTRASOUND. PHYSICIANS ALSO OFFER MANY ADVANCED PROCEDURES SUCH AS ENTEROSCOPY, ERCP (ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY) AND EUC (ENDOSCOPIC ULTRASOUND) WHICH ALLOW THESE SPECIALISTS TO VIEW AND TREAT CONDITIONS IN HARD-TO-REACH AREAS OF THE BILE DUCTS, PANCREAS AND SMALL INTESTINES. AS TEACHING PHYSICIANS, THESE SPECIALISTS ARE AT THE FOREFRONT OF FINDING NEW WAYS TO USE ENDOSCOPIC TOOLS AND PROCEDURES TO IMPROVE CARE AND TREATMENTS. ADVANCED TECHNOLOGY AIDS LC PHYSICIANS IN MAKING A MORE PRECISE DIAGNOSIS WHICH IN TURN, ALLOWS FOR MORE TARGETED TREATMENTS FOR CONDITIONS THAT CAN BE DIFFICULT TO PINPOINT. PATIENTS RECEIVE A DIAGNOSIS AND CARE QUICKLY THROUGH LAHEY'S ENDOSCOPY ON DEMAND SERVICE. A PATIENT'S PRIMARY CARE DOCTOR CAN REFER THEM AND SCHEDULE DIAGNOSTIC AND URGENT THERAPEUTIC PROCEDURES FOR THE PATIENT RIGHT AWAY. A GASTROENTEROLOGIST WILL THEN DISCUSS THE RESULTS WITH THE PATIENT AND THEIR DOCTOR. |
| PART III, LINE 4D, PROGRAM SERVICE ACCOMPLISHMENTS: | BILH'S COVID-19 RESPONSE IN FY 2020: BETH ISRAEL LAHEY HEALTH ("BILH") QUICKLY AND EFFECTIVELY MARSHALLED ITS RESOURCES TO MOUNT A COMPREHENSIVE RESPONSE TO THE COVID-19 PANDEMIC. SINCE THE START OF THE PANDEMIC (THROUGH JUNE OF 2021), BILH HAS TREATED OVER 8,500 HOSPITALIZED PATIENTS WITH COVID-19 AND PERFORMED MORE THAN 700,000 COVID-19 DIAGNOSTIC TESTS. HIGHLIGHTS OF THE SYSTEM'S PANDEMIC RESPONSE IN FY 2020 INCLUDE: BILH QUICKLY ESTABLISHED AN EMERGENCY OPERATIONS CENTER ("EOC") TO ALIGN SYSTEM EFFORTS ACROSS ITS HOSPITALS AND OTHER BUSINESS UNITS AND WITH EXTERNAL ENTITIES, INCLUDING THE STATE GOVERNMENT. THE EOC HELD REGULAR MEETINGS WITH INCIDENT COMMANDERS, EMERGENCY MANAGERS, AND SENIOR LEADERS FROM BILH HOSPITALS, PRIMARY CARE, AND OTHER SYSTEM ENTITIES TO COORDINATE PLANS, POLICIES, AND COMMUNICATIONS. IT PARTICIPATED IN WEEKLY CONFERENCE OF BOSTON TEACHING HOSPITALS ("COBTH") CALLS AND MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH COMMAND CENTER CALLS. A KEY ROLE OF THE EOC INVOLVED MANAGING THE FLOW OF INTERNAL AND EXTERNAL INFORMATION TO ENSURE SITUATIONAL AWARENESS AND ALIGNMENT OF RESPONSES TO THE PANDEMIC. FINALLY, THE EOC WORKED WITH INTERNAL AND EXTERNAL PARTNERS TO CENTRALIZE COVID-19 RELATED DATA COLLECTION AND REPORTING FOR THE SYSTEM, COMMONWEALTH, AND FEDERAL GOVERNMENT. IN MARCH 2020, BETH ISRAEL DEACONESS MEDICAL CENTER ("BIDMC") BECAME ONE OF THE FIRST HOSPITAL LABORATORIES IN THE STATE TO BEGIN IN-HOUSE HIGH-THROUGHPUT POLYMERASE CHAIN REACTION ("PCR") COVID-19 TESTING FOR PATIENTS AND HEALTHCARE WORKERS. BIDMC'S LABORATORY PROVIDED THIS TEST TO BILH HOSPITALS AND OTHER COMMUNITY PARTNERS, SUCH AS HEALTH CENTERS AND CORRECTIONS FACILITIES, AT A TIME OF CRITICAL SUPPLY SHORTAGE. THROUGHOUT THE PANDEMIC, BILH WORKED TOWARD ADDITIONAL IN-HOUSE TESTING CAPABILITIES, INCLUDING HIGH-THROUGHPUT THERMO FISHER INSTRUMENTS AT LAHEY HOSPITAL & MEDICAL CENTER ("LHMC"). THE SYSTEM OPERATIONALIZED MULTIPLE DRIVE-THROUGH COVID-19 TESTING SITES TO ENABLE EASY ACCESS FOR PATIENTS AND STAFF. IN THE SUMMER OF 2020, TO EXPAND HOSPITAL AND CLINIC-BASED COVID-19 TESTING SITES, BILH OPENED AN ADDITIONAL HIGH-CAPACITY DRIVE-THROUGH TESTING SITE IN WOBURN. TO ENSURE CONTINUED ACCESS TO CARE FOR ITS PATIENTS, BILH PRIMARY CARE RAPIDLY DEPLOYED A TELEHEALTH STRATEGY, QUICKLY TRANSITIONED TO COHORT CLINICS TO CARE FOR SICK PATIENTS, AND SUCCESSFULLY MANAGED A PHASED REOPENING BY JULY 2020. BILH ESTABLISHED A TEMPORARY COMMUNITY CRISIS STABILIZATION UNIT AT NEW ENGLAND BAPTIST HOSPITAL TO MANAGE BEHAVIORAL HEALTH PATIENT VOLUME DURING THE PANDEMIC. BILH ESTABLISHED A DAILY HUDDLE CONSISTING OF BILH ED AND BEHAVIORAL HEALTH LEADERS TO DETERMINE APPROPRIATE PATIENT TRANSFERS TO THE UNIT. BILH'S VIRTUAL TRANSFER CENTER WAS FORMED IN SEPTEMBER 2019 TO OPTIMIZE SYSTEM-WIDE BED CAPACITY USING REAL-TIME INFORMATION EXCHANGE AMONG THE THREE EXISTING TRANSFER CENTERS AT BIDMC, LHMC AND MOUNT AUBURN HOSPITAL ("MAH"). THE TRANSFER TEAM PERSONNEL AT THESE CENTERS WORK TOGETHER AS A SINGLE "VIRTUAL" CENTER TO ACCOMMODATE INCOMING TRANSFER REQUESTS BY MAKING ALL BEDS AVAILABLE IN THE SYSTEM BASED ON FACILITY CAPACITY AND LEVEL OF CARE REQUIRED. THE TRANSFER CENTER ENHANCED PATIENT QUALITY, SAFETY, AND ACCESS BY LOAD BALANCING COVID PATIENTS ACROSS ALL OF ITS HOSPITALS SO THAT THESE PATIENTS RECEIVED TIMELY ACCESS TO THE TYPE OF BED AND LEVEL OF CARE NEEDED. BILH COLLABORATED WITH EXTERNAL ENTITIES TO STAND UP A 1,000-BED FIELD HOSPITAL, THE BOSTON HOPE HOSPITAL, AND OPEN AND STAFF A COVID HOTEL FOR UNDERSERVED COMMUNITIES. BILH LAUNCHED A WEBSITE TITLED THE CORONAVIRUS RESOURCE CENTER TO PROVIDE ITS PATIENT COMMUNITY WITH UP-TO-DATE INFORMATION REGARDING THE SYSTEM'S RESPONSE TO THE PANDEMIC, AVAILABLE RESOURCES SUCH AS TESTING SITES, AND INNOVATION EFFORTS UNDERWAY THROUGHOUT BILH (E.G., VAPORIZED HYDROGEN PEROXIDE STERILIZATION FOR N95 RESPIRATORS). BILH LAUNCHED AN INTERNAL WEBSITE WITH RESOURCES FOR ITS STAFF AS WELL. BILH CREATED SYSTEM-WIDE GUIDELINES FOR INFECTION PREVENTION ACROSS MANY DOMAINS, INCLUDING PATIENT AND VISITOR SCREENING AND THE RECONFIGURATION OF AMBULATORY CLINIC SPACES TO ALLOW FOR RECOMMENDED PHYSICAL DISTANCING. BILH'S HUMAN RESOURCES TEAM DEVELOPED AND PROVIDED SYSTEM-WIDE PROGRAMS, POLICIES, AND TOOLS TO ENSURE ITS HOSPITALS WERE ABLE TO SUPPORT THE PHYSICAL AND EMOTIONAL WELL-BEING OF ITS STAFF WHILE DELIVERING SAFE, EFFECTIVE CARE TO ITS PATIENTS. EXAMPLES OF THESE RESOURCES INCLUDE AN ENHANCED SUPPLEMENTAL LEAVE POLICY; AN EASY-TO-USE, AUTOMATED EMPLOYEE COVID-19 SYMPTOM ATTESTATION TOOL; AN ONLINE, COGNITIVE BEHAVIORAL TREATMENT PROGRAM FOR MANAGING ANXIETY; AND TELECOMMUTING GUIDELINES. IN LATE MARCH 2020 BILH CREATED HOUSING FOR QUARANTINE OF STAFF EXPOSED TO COVID-19. HOUSING WAS SET UP AT A LOCAL UNIVERSITY AND HOTELS COVERING THE NETWORK'S SERVICE AREA. APPROXIMATELY 300 STAFF MEMBERS TOOK ADVANTAGE OF THE HOUSING FROM MARCH TO JULY 2020. IN ADDITION TO HOUSING, FOOD AND SUPPLY DELIVERY SERVICES WERE CREATED TO MINIMIZE PUBLIC CONTACT. BILH COLLABORATED REGULARLY WITH COMMUNITY HEALTH CENTER ("CHC") AFFILIATES ON COVID-RELATED CARE, TESTING, PERSONAL PROTECTIVE EQUIPMENT ("PPE"), AND PATIENT OUTREACH. BILH SHARED REAL-TIME ACCESS TO BILH COVID-19-RELATED OPERATIONAL POLICIES, PROCESSES, AND GUIDELINES IN ADDITION TO TRANSLATED PATIENT HANDOUTS, FLYERS, AND SOCIAL MEDIA GRAPHICS AROUND THE "STOP THE SPREAD" CAMPAIGN. AS HEALTH CENTERS WORKED TO ESTABLISH STABLE SUPPLY CHAINS OF PPE, BILH DONATED GLOVES, N95S, ISOLATION GOWNS, DISINFECTANT WIPES, EYE PROTECTION, HAND SANITIZER, AND SURGICAL MASKS. BILH DEPLOYED STAFF AT COMMUNITY TESTING SITES SUCH AS AT THE DIMOCK CENTER. CHC STAFF WERE INCLUDED IN THE AFOREMENTIONED BILH-FUNDED TEMPORARY HOUSING PROGRAM FOR STAFF. BILH ALSO SUPPORTED SAFETY NET AFFILIATE HOSPITALS WITH REAL-TIME BILH COVID-19 PROTOCOLS AND POLICIES, MED/SURG AND ICU BED LOAD-BALANCING EFFORTS, ICU STAFFING, AND PPE NEEDS. IN FY 2021, BILH CONTINUED TO PLAY A SIGNIFICANT ROLE IN THE COMMONWEALTH'S RESPONSE TO THIS UNPRECEDENTED PUBLIC HEALTH CRISIS, MOST NOTABLY THROUGH ITS PATIENT VACCINATION EFFORTS. BILH WILL PROVIDE DETAIL ON THESE EFFORTS IN ITS FY 2021 TAX RETURN FILING. |
| PART III | IN ADDITION TO THE PROGRAM SERVICE ACCOMPLISHMENTS NOTED ABOVE, THE BILH NETWORK HAD SIGNIFICANT ACTIVITIES ACROSS ENTITIES RELATED TO BOTH BEHAVIORAL HEALTH AND ITS RESPONSE TO THE ONGOING COVID-19 PANDEMIC. DETAILS ON BOTH ARE BELOW. BILH BEHAVIORAL HEALTH SERVICES THE BETH ISRAEL LAHEY HEALTH NETWORK (BILH) IS COMMITTED TO THE BEHAVIORAL HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES SERVICED. BELOW ARE SOME OF ACTIVITIES THAT BILH BEHAVIORAL SERVICES (BILHBS) HAS PROVIDED TO THE PATIENTS AND COMMUNITIES SERVED BY BILH AND ITS AFFILIATED ENTITIES. BILHBS (WHICH INCLUDES THE ACTIVITIES OF BILH'S TAX-EXEMPT AFFILIATE NORTHEAST BEHAVIORAL HEALTH CORP) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS. BILHBS' NETWORK OF BEHAVIORAL HEALTH CARE INCLUDES SERVICES FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TREATMENT TO COMMUNITY-BASED PROGRAMS. SERVICES INCLUDE: INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; EMERGENCY PSYCHIATRIC AND MOBILE EMERGENCY SERVICES TEAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION TREATMENT; INDIVIDUAL/COUPLE/FAMILY THERAPY; MEDICATION ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS; AND SCHOOL-BASED AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES. SINCE THE CREATION OF BILH IN MARCH 2019, BILH HAS INVESTED SIGNIFICANTLY IN IMPROVING ACCESS TO BEHAVIORAL HEALTH CARE THROUGH A SYSTEM-WIDE APPROACH TO CARE DELIVERY. FIRST, IT HAS MADE A MULTI-YEAR COMMITMENT TO PROVIDE BEHAVIORAL HEALTH SUPPORT TO ITS EMPLOYED PRIMARY CARE PRACTICES USING AN EVIDENCE-BASED APPROACH KNOWN AS THE IMPACT MODEL. BY THE END OF FY 2021, BILH HAD IMPLEMENTED THE IMPACT MODEL IN 67% OF ITS EMPLOYED PRIMARY CARE PRACTICES AS PART OF ITS COLLABORATIVE CARE PROGRAM IMPLEMENTATION. IN 2021, BILHBS EXPANDED ITS PRIMARY CARE BEHAVIORAL HEALTH INTEGRATION (PCBHI) SERVICES BY INCORPORATING A DSRIP PILOT PROJECT AIMED AT INTERPROFESSIONAL PSYCHIATRIC CONSULTS. THE PCBHI INTERPROFESSIONAL CONSULTATION INCLUDES AN ASSESSMENT AND MANAGEMENT SERVICE IN WHICH A PATIENT'S PRIMARY CARE PROVIDER (PCP) REQUESTS THE OPINION AND/OR TREATMENT ADVICE OF A PSYCHIATRIC CONSULTANT TO ASSIST IN THE DIAGNOSIS AND/OR MANAGEMENT OF THE PATIENT'S BEHAVIORAL HEALTH CONDITION WITHOUT THE NEED FOR THE PATIENT'S FACE-TO-FACE CONTACT WITH THE CONSULTANT. INTERPROFESSIONAL CONSULTATION ENABLES A COMPREHENSIVE ASSESSMENT, ENHANCES PATIENT CARE, REDUCES MISDIAGNOSIS, AND SUPPORTS THE INTEGRATION OF DISCIPLINES IN THE DELIVERY OF CARE. THE PCBHI INTERPROFESSIONAL PSYCHIATRIC CONSULTANTS PROVIDE PCPS WITH ANOTHER AVENUE FOR INTEGRATED CARE. THE IMPLEMENTATION OF PCBHI INTERPROFESSIONAL SERVICES WILL BE OFFERED IN PRACTICES WHERE COLLABORATIVE CARE IS NOT CURRENTLY AVAILABLE. ADDITIONALLY, IN 2021, BILHBS CONTINUED TO OVERSEE THE BILH-WIDE CENTRALIZED BEHAVIORAL HEALTH (BH) BED MANAGEMENT, WHICH SUPPORTS INPATIENT BEHAVIORAL HEALTH BED CAPACITY AND IMPROVING ACCESS TO THESE BEDS, WITH THE PARALLEL GOAL OF REDUCING BOARDING BY BEHAVIORAL HEALTH PATIENTS IN THE EMERGENCY DEPARTMENTS ("EDS"). AS PART OF THE CENTRALIZED BH BED MANAGEMENT, BILH STAFF ENGAGE IN A DAILY HUDDLE WITH REPRESENTATIVES FROM BILH HOSPITALS' EDS AND BEHAVIORAL HEALTH UNITS TO DISCUSS PATIENTS APPROPRIATE FOR TRANSFER TO THE UNIT. THE DAILY HUDDLES HAVE BECOME A FORUM FOR WHICH PARTICIPANTS DISCUSS BEHAVIORAL HEALTH PATIENT VOLUME AND BED CAPACITY ACROSS THE SYSTEM, AS WELL AS DISCHARGE PLANNING AND PLACEMENT OPPORTUNITIES FOR DIFFICULT-TO-PLACE PATIENTS. SEPARATELY, IN MARCH 2021, BILHBS LAUNCHED ITS CENTRALIZED BED FINDING TEAM. THIS TEAM IS PART OF OUR CENTRAL CALL CENTER, WHICH CENTRALIZES CALLS TO BILHBS' THREE EMERGENCY SERVICE PROGRAM (ESP) CATCHMENT AREAS REDUCING REDUNDANCIES ACROSS THE AGENCY AND STREAMLINING ALL CALLS TO ONE CENTRAL SERVICE. THIS CENTRALIZED BED FINDING TEAM IS RESPONSIBLE FOR CONDUCTING BED SEARCHES FOR PATIENTS SEEN THROUGH THE ESP AND WHO ARE AWAITING AN INPATIENT PSYCHIATRIC PLACEMENT. THIS TEAM DIRECTLY INCREASES THE AVAILABILITY OF CLINICIANS TO CONTINUE TO SEE PATIENTS IN THE ED AND THE COMMUNITY WHO ARE EXPERIENCING A BEHAVIORAL HEALTH AND/OR CO-OCCURRING SUBSTANCE USE DISORDER CRISIS WHILE OTHER TEAM MEMBERS SEARCH FOR AVAILABLE INPATIENT PLACEMENTS. THIS INITIATIVE SUPPORTS DECREASED RESPONSE TIME TO RESPONDING TO NEW PATIENTS IN CRISIS AND REDUCES ED BOARDING TIME FOR PATIENTS WHO CAN BE SAFELY MANAGED IN THE COMMUNITY. BILHBS SERVES APPROXIMATELY 35,000 UNDUPLICATED INDIVIDUALS ANNUALLY, OFFERING A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS. SERVICES RANGE FROM INPATIENT TO HOME AND COMMUNITY-BASED SERVICES. BILHBS OPERATES OVER 250 BEDS IN 9 FACILITIES FOR CLIENTS REQUIRING ACUTE PSYCHIATRIC CARE, DETOXIFICATION AND RESIDENTIAL STEP-DOWN SERVICES. DURING THE PERIOD COVERED BY THIS FILING, COMMUNITY-BASED SERVICES INCLUDED MOBILE EMERGENCY SERVICES TEAMS IN THREE CATCHMENT AREAS AND HOME-BASED COUNSELING FOR ADULTS, YOUTH AND THEIR FAMILIES. BILHBS ALSO PROVIDED SERVICES IN 63 MIDDLE AND HIGH SCHOOLS, AS WELL AS 9 POLICE DEPARTMENTS. BILHBS ALSO CONTINUES TO IMPROVE ACCESS THROUGH THE URGENT PSYCHOPHARMACOLOGY SERVICES IN BILH'S LOWELL EMERGENCY SERVICES PROGRAM. THIS CLINIC PROVIDES URGENT ACCESS FOR PATIENTS REQUIRING A CHANGE TO THEIR MEDICATIONS. THIS SERVICE IS OFFERED 20 HOURS PER WEEK AND INCLUDES UNINSURED, MEDICAID, AND MEDICARE POPULATIONS, AS WELL AS ANY PERSON IN NEED OF THE SERVICE REGARDLESS OF THE PAYER SOURCE. BILH'S COMMUNITY CRISIS STABILIZATION ("CCS") UNITS IN LAWRENCE AND SALEM, WHICH TYPICALLY CARE FOR PATIENTS WITH MENTAL HEALTH ISSUES, INCREASED THEIR ABILITY TO TREAT PERSONS WITH CO-OCCURRING SUBSTANCE USE DISORDERS. THE CCS UNITS CONTINUE TO BE ABLE TO INDUCT PATIENTS WITH OPIOID USE DISORDER (OUD) ON BUPRENORPHINE AND ARE ALSO ABLE TO MAINTAIN PATIENTS WHO ARE ALREADY ON ANY OF THE THREE FDA APPROVED MEDICATIONS FOR THE TREATMENT OF OUD. THESE UNITS ARE SEEING AN INCREASE IN THE NUMBER OF PATIENTS WITH METHAMPHETAMINE DISORDERS AND HAVE DEVELOPED A PROTOCOL TO MANAGE WITHDRAWAL SYMPTOMS IN THIS POPULATION. BILHBS CONTINUES TO MAINTAIN AND ENHANCE ITS TELEHEALTH PLATFORM AND CLINICAL DELIVERY THROUGH THE USE OF DIGITAL APPLICATIONS ACROSS ALL OF ITS AMBULATORY PROGRAMS. SPECIAL EMPHASIS WAS PLACED ON SPANISH-LANGUAGE ACCESS TO LAWRENCE-BASED PROGRAMS TO ENSURE PATIENTS IN THIS REGION ACCESS LINGUISTICALLY-APPROPRIATE CARE. IN 2021, BILHBS IDENTIFIED IMPROVEMENT OF THE PATIENT EXPERIENCE AS A KEY STRATEGIC PRIORITY. TO THAT END, ALL PROGRAM DIRECTORS ARE EVALUATED AGAINST THIS GOAL AND ARE REQUIRED TO COMPLETE TWO PLAN-DO-STUDY-ACT (PDSA) CYCLES ANNUALLY. PDSA IS A WELL-ESTABLISHED PROCESS IMPROVEMENT FRAMEWORK USED IN HEALTHCARE. PROGRAM DIRECTORS REVIEW PATIENT FEEDBACK TO DEVELOP PILOT INTERVENTIONS, ANALYZE THE RESULTS, AND THEN MAKE ADJUSTMENTS TO THE INTERVENTION. EXAMPLES OF OUTCOMES ACHIEVED THROUGH THE PDSA APPROACH INCLUDE ENHANCING THE PATIENT ENGAGEMENT MODEL FOR THE BEHAVIORAL HEALTH COMMUNITY PARTNERS (BHCP) PROGRAM; IMPROVING PATIENT EXPERIENCES AND ENGAGEMENT IN THE USE OF TELEHEALTH PLATFORMS IN BILHBS' LAWRENCE OUTPATIENT SITE, IMPROVING THE ADMISSION PROCESS IN THE BILHBS GLOUCESTER OPIOID TREATMENT CENTER, REDUCING ADMINISTRATIVE DISCHARGES BY IMPLEMENTING A HARM REDUCTION MODEL, AND IMPROVING EXTERNAL REFERRAL EXPERIENCE AT THE BILHBS HAVERHILL OUTPATIENT AND CHILDREN'S BEHAVIORAL HEALTH INITIATIVES (CBHI) PROGRAMS. |
| PART III | BETH ISRAEL LAHEY HEALTH'S COVID-19 PANDEMIC RESPONSE AS IN THE PRIOR YEAR, BETH ISRAEL LAHEY HEALTH'S ("BILH") HOSPITALS AND OTHER PATIENT CARE ORGANIZATIONS EXPENDED SIGNIFICANT TIME AND RESOURCES ACROSS FY 2021 IN THEIR CONTINUED EFFORTS TO RESPOND TO THE COVID-19 PANDEMIC. IN ADDITION TO PROVIDING COVID-19 TESTING AND TREATMENT, THE HEALTH SYSTEM INITIATED PATIENT AND STAFF VACCINATION EFFORTS IN FY 2021, REACHING OUT TO 1.3 MILLION PATIENTS USING A MULTICHANNEL, MULTILINGUAL APPROACH AND ULTIMATELY DELIVERING OVER 400,000 VACCINE DOSES. THE SYSTEM SUCCESSFULLY UNDERTOOK THESE EFFORTS WHILE ALSO NAVIGATING UNPRECEDENTED FINANCIAL AND OPERATIONAL CHALLENGES STEMMING FROM THE PANDEMIC, INCLUDING ONGOING WORKFORCE DISRUPTION AND A DECLINE IN PATIENT VOLUME DUE TO THE CURTAILMENT OF ELECTIVE SERVICES AND STAFFING CHALLENGES. HIGHLIGHTS OF THE SYSTEM'S PANDEMIC RESPONSE IN FY 2021 INCLUDE: STAFF TESTING, VACCINATION, AND SUPPORT IN NOVEMBER 2020, BILH IMPLEMENTED A PROGRAM TO PROVIDE ITS 36,000 EMPLOYEES WITH ACCESS TO ONSITE, VOLUNTARY, AND FREE-OF-CHARGE COVID-19 PCR TESTING, EVEN IF THEY HAD NO KNOWN EXPOSURE OR SYMPTOMS. IN ADDITION TO SERVING AS AN IMPORTANT ELEMENT TO CONTAIN COMMUNITY SPREAD OF COVID-19, THIS EFFORT BOOSTED BILH STAFF MORALE AND CONFIDENCE DURING THIS CHALLENGING PERIOD. IN DECEMBER 2020, BILH STOOD UP STAFF VACCINATION SITES AT ITS LOCAL HOSPITALS, ULTIMATELY DELIVERING 70,000 VACCINE DOSES TO ITS WORKFORCE IN FY 2021. THE SYSTEM TOOK PROGRESSIVE MEASURES AROUND EMPLOYEE PAID TIME OFF TO SUPPORT VACCINATION EFFORTS AS WELL AS FAMILY CARE NEEDS AND TIME MISSED DUE TO COVID-19 ILLNESS OR TESTING. IN THE SUMMER OF 2021, BILH COMMUNICATED THAT COVID-19 AND FLU VACCINE WOULD BE REQUIRED AS A CONDITION OF EMPLOYMENT; THE COVID-19 VACCINATION DEADLINE WAS SUCCESSFULLY COMPLETED ON OCTOBER 31, 2021. BILH OPERATIONALIZED A CENTRALIZED CALL CENTER TO SUPPORT STAFF WITH SYMPTOM REPORTING, COVID-19 TESTING, AND RETURN-TO-WORK PROCESSES. THE CALL CENTER ENSURED CONVENIENT AND ACCESSIBLE INFORMATION FOR A WORKFORCE SPREAD THROUGHOUT EASTERN MASSACHUSETTS. AT ITS PEAK, THE CENTRALIZED CALL CENTER HANDLED OVER 1,000 PHONE CALLS PER DAY. PATIENT VACCINATION NEARLY IMMEDIATELY UPON RECEIVING VACCINE SUPPLY THAT COULD BE USED FOR PATIENTS, BILH OPENED AND OPERATED 10 VACCINE ADMINISTRATION SITES ACROSS EASTERN MASSACHUSETTS. THE LOCATIONS WERE SELECTED BASED ON SEVERAL CRITERIA, INCLUDING PROXIMITY TO HARD-HIT COMMUNITIES AND EASE OF ACCESS IN TERMS OF TRANSPORTATION. THIS WAS A SIGNIFICANT LOGISTICAL FEAT IN LIGHT OF THE SHIFTING FORECASTS IN VACCINE SUPPLY AND SPECIAL HANDLING REQUIRED FOR THE PFIZER VACCINE. BILH DEVELOPED ITS OWN VACCINATION SCHEDULING TOOL, COVAX, TO SUPPORT STAFF AND PATIENT VACCINATION EFFORTS. THIS TOOL ENABLED BILH TO IDENTIFY PATIENTS ELIGIBLE FOR VACCINATION BASED ON STATE GUIDELINES, SCHEDULE APPOINTMENTS, AND TRACK VACCINATION ACTIVITY. BILH LED A TARGETED CAMPAIGN TO SUPPORT HEALTH EQUITY BY PRIORITIZING FOR VACCINATION BILH PATIENTS WHO RESIDED IN A COMMUNITY OR TOWN IDENTIFIED AS HAVING AMONG THE HIGHEST CUMULATIVE INCIDENCE OF COVID-19 WITHIN THE STATE OF MASSACHUSETTS. BILH ALSO COORDINATED WITH MULTIPLE COMMUNITY HEALTH CENTERS TO PROVIDE THEIR PATIENTS WITH PRIORITY ACCESS TO VACCINATION APPOINTMENTS. DUE TO THESE EFFORTS, BETH ISRAEL DEACONESS CARE ORGANIZATION ("BIDCO"), AN ACCOUNTABLE CARE ORGANIZATION ("ACO") WITHIN BILH, HAD THE HIGHEST COVID-19 VACCINATION RATE FOR MEDICAID MEMBERS AMONG ALL MEDICAID ACOS IN THE STATE. BILH ESTABLISHED THE COVID-19 HEALTH EQUITY ADVISORY COUNCIL ("THE COUNCIL") WITH A GOAL TO ADDRESS HEALTH DISPARITIES BROUGHT ON BY THE PANDEMIC, LANGUAGE BARRIERS, AND OTHER SOCIAL DETERMINANTS OF HEALTH. ITS MEMBERSHIP INCLUDED KEY BILH STAKEHOLDERS AND COMMUNITY HEALTH CENTER CHIEF MEDICAL OFFICERS. AS PART OF ITS RESPONSIBILITY, THE COUNCIL REVIEWED THE SYSTEM'S VACCINE ROLLOUT STRATEGY, INCLUDING THE PATIENT PRIORITIZATION AND SCHEDULING STRATEGY, CALL CENTER MODEL, VACCINE SITE LOCATION AND OPERATING MODEL, AND STAFF RESOURCES TO HELP COMMUNICATE AND ENGAGE WITH PATIENTS ABOUT VACCINE INFORMATION, CONCERNS, AND HESITANCY. TESTING IN FY 2021, BILH PERFORMED OVER 600,000 COVID-19 TESTS ACROSS ITS 10 HOSPITAL LABORATORIES FOR PATIENTS, HEALTHCARE PERSONNEL, AND OTHER PARTNERS, SUCH AS COMMUNITY HEALTH CENTERS AND CORRECTIONAL FACILITIES. IN JANUARY 2021, LAHEY HOSPITAL & MEDICAL CENTER BEGAN TESTING ON HIGH-THROUGHPUT THERMO FISHER INSTRUMENTS, GREATLY INCREASING THE SYSTEM'S CAPACITY FOR SAME-DAY TEST RESULTS. THESE INSTRUMENTS ALSO PROVIDED BACK-UP CAPACITY FOR OTHER LABS IN THE COMMUNITY, WHICH WERE EXPERIENCING HIGH VOLUME. THE THERMO FISHER INSTRUMENTS ADDED THE ABILITY TO RAPIDLY DETECT POTENTIAL COVID-19 VARIANTS (S-GENE DROPOUTS), A PROCESS PREVIOUSLY ONLY AVAILABLE THROUGH THE MASSACHUSETTS STATE LABORATORY. EVENTUALLY, BILH IMPLEMENTED SPECIFIC VARIANT PCR (POLYMERASE CHAIN REACTION) TESTING OF PATIENT SPECIMENS TO IDENTIFY SPECIFIC VARIANTS AND BETTER GUIDE DEVELOPMENT OF INFECTION PREVENTION RECOMMENDATIONS AND APPROPRIATE MONOCLONAL ANTIBODY TREATMENT SELECTION. THE SYSTEM MAINTAINED EIGHT DRIVE-THROUGH COVID-19 TESTING SITES ACROSS EASTERN MASSACHUSETTS TO ENABLE EASY ACCESS FOR PATIENTS AND STAFF, INCLUDING A STATE-SPONSORED "STOP THE SPREAD" SITE IN CHELSEA, MA. BILH PRIMARY CARE MADE POINT-OF-CARE COVID-19 TESTING AVAILABLE TO ITS PATIENTS IN APPROXIMATELY 20 PRACTICE SITES (25% OF TOTAL SITES) SPREAD THROUGHOUT BILH'S SERVICE AREA. INFECTION PREVENTION AND PERSONAL PROTECTIVE EQUIPMENT EFFORTS THROUGHOUT FY 2021, BILH INFECTION PREVENTION AND SUPPLY CHAIN STAFF CONTINUED TO PARTNER ON PROCURING PERSONAL PROTECTIVE EQUIPMENT ("PPE") AND OTHER RELATED SUPPLIES AND REPLENISHING BILH'S PANDEMIC SUPPLY WAREHOUSE. THIS ENSURED THE SYSTEM HAD AT LEAST 90 DAYS OF INVENTORY ON HAND FOR THE HIGHEST-UTILIZED PRODUCTS, SUCH AS GLOVES, GOWNS, FACEMASKS, AND EYE AND FACE SHIELDS. IN FY 2021, BILH SUPPLY CHAIN AND INFECTION PREVENTION COORDINATED A RESPIRATOR (N95 OR EQUIVALENT) FIT TESTING PROGRAM WITH A VENDOR TO FIT TEST MORE THAN 20,000 BILH EMPLOYEES TO BOTH DISPOSABLE AND REUSABLE RESPIRATORS. THIS UNIQUE PROGRAM INCORPORATING REUSABLE RESPIRATORS ENSURED THAT BILH STAFF WOULD NOT BE SUBJECT TO FLUCTUATIONS IN SUPPLY CHAIN DURING FUTURE WAVES OF COVID-19 OR OTHER RESPIRATORY VIRAL ILLNESSES AND MITIGATED WASTE RELATED TO DISPOSABLE RESPIRATORY PROTECTION. THROUGHOUT FY 2021, BILH INFECTION PREVENTION DEVELOPED AND UPDATED CLINICAL AND OPERATIONAL GUIDANCE INCLUDING POLICIES, TOOLS, AND EDUCATIONAL MATERIALS TO SUPPORT THE PREVENTION OF TRANSMISSION OF COVID-19. FOR EXAMPLE, BILH INFECTION PREVENTION DEVELOPED STAFF EDUCATION ON COVID-19 PREVENTION TO MEET THE OSHA COVID-19 EMERGENCY TEMPORARY STANDARD FOR USE BY ALL HOSPITAL/BUSINESS UNITS; CREATED SCREENING TOOLS FOR USE AT ALL POINTS OF ENTRY FOR PATIENTS AND VISITORS AND UPDATED CRITERIA AS NEEDED BASED ON LOCAL AND NATIONAL GUIDANCE; AND, UPDATED POLICIES FOR PREOPERATIVE AND PRE-PROCEDURAL TESTING AND PPE. TREATMENT BILH HOSPITALS CONTINUED TO PROVIDE TREATMENT TO ADMITTED PATIENTS WITH COVID-19, USING TREATMENTS AUTHORIZED FOR USE AT THE TIME. LEADERS ACROSS BILH HOSPITALS CONTINUED TO MEET AND SHARE INFORMATION TO ALLOW FOR APPROPRIATE RESOURCE ALLOCATION AND LOAD BALANCING TO ENSURE BILH WAS ABLE TO MEET PATIENT DEMAND. IN FY 2021, BILH BEGAN TO MAKE AVAILABLE TO AMBULATORY PATIENTS COVID-19 THERAPEUTICS (INTRAVENOUS MONOCLONAL ANTIBODIES AND REMDESEVIR) AND PROPHYLAXIS (EVUSHELD), WITH THESE EFFORTS EXPANDING ACROSS 2022. SAFETY NET AFFILIATE SUPPORT IN ORDER TO ENHANCE SITUATIONAL AWARENESS AND THE HEALTH SYSTEM'S UNDERSTANDING OF THE PANDEMIC'S IMPACT ON ITS SAFETY NET AFFILIATES ("SNAS"), BILH INCLUDED ITS SNAS IN DAILY HUDDLES AND INCIDENT COMMAND MEETINGS. THESE COLLABORATIVE FORUMS ENABLED BILH TO PROVIDE TARGETED, CONSISTENT SUPPORT, INCLUDING DISCUSSIONS ON PATIENT TRANSFER AVAILABILITY AND BED CAPACITY ACROSS BILH. THROUGH ITS COMMITMENT TO SUPPORTING LOCAL COMMUNITIES DEVASTATED BY THE PANDEMIC, BILH DONATED $410,000 TO COMMUNITY GROUPS LOCATED IN BROCKTON AND $600,000 TO THE CITY OF CHELSEA TO AID IN ADDRESSING PROBLEMS CREATED OR EXACERBATED BY THE PANDEMIC, INCLUDING TEMPORARY HOUSING FOR EVICTED PATRONS AND FOOD INSECURITY DUE TO LOSS OF INCOME. |
| PART III | UNDERPINNING THESE MANY INITIATIVES WERE VARIOUS MULTI-ENTITY, INTERDISCIPLINARY COMMITTEES AND DATA COLLECTION EFFORTS TO ENSURE THAT BILH WAS PROACTIVELY MONITORING THE TRAJECTORY OF THE PANDEMIC AND NIMBLY PLANNING THE SYSTEM'S RESPONSE. THE HEALTH SYSTEM'S EFFORTS SPANNED THE CLINICAL CARE CONTINUUM, FROM PRIMARY CARE TO POST-ACUTE CARE, AS WELL AS BOTH CLINICAL AND ADMINISTRATIVE DEPARTMENTS, FROM INFECTIOUS DISEASE AND NURSING TO HUMAN RESOURCES AND INFORMATION SERVICES. BILH SUCCESSFULLY MARSHALLED ITS RESOURCES THROUGHOUT THE SYSTEM TO SERVE AS ONE OF THE PRIMARY HUBS FOR COVID-19 RELATED CARE IN MASSACHUSETTS. |
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