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FORM 990 SCHEDULE H PART V, SECTION C:
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SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSLAHEY CLINIC HOSPITAL, INC. AFFILIATION:LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC) IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. 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.LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS MISSION STATEMENT: AT LAHEY CLINIC HOSPITAL OUR MISSION GUIDES US TOWARD SUCCESS. LAHEY CLINIC HOSPITAL IS COMMITTED TO PROVIDING SUPERIOR HEALTH CARE LEADING TO THE BEST POSSIBLE OUTCOMES FOR EVERY PATIENT, EXCEEDING OUR PATIENTS' HIGH EXPECTATIONS FOR SERVICE EACH DAY, ADVANCING MEDICINE THROUGH RESEARCH AND THE EDUCATION OF TOMORROW'S HEALTH CARE LEADERS, AND PROMOTING HEALTH AND WELLNESS IN PARTNERSHIP WITH THE DIVERSE COMMUNITIES IT SERVES. THE FOLLOWING ANNUAL REPORT PROVIDES SPECIFIC DETAILS ON HOW LAHEY CLINIC HOSPITAL IS HONORING ITS COMMITMENT AND INCLUDES INFORMATION ON ITS COMMUNITY BENEFITS SERVICE AREA (CBSA), COMMUNITY HEALTH PRIORITIES, TARGET POPULATIONS, COMMUNITY PARTNERS, AND DETAILED DESCRIPTIONS OF ITS COMMUNITY BENEFITS PROGRAMS AND THEIR IMPACT.LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS MISSION IS FULFILLED BY:O INVOLVING LAHEY CLINIC 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;O 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;O 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 FACE DISPARITIES IN ACCESS AND OUTCOMES;O IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES LAHEY CLINIC 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;O 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; ANDO 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, LAHEY CLINIC HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $80,241,831 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMLAHEY HOSPITAL & MEDICAL CENTER COMMUNITY BENEFITS ADVISORY COMMITTEE 2021:STATHIS ANTONIADES, CHIEF OPERATING OFFICER, LAHEY HOSPITAL & MEDICAL CENTERJEAN BUSHNELL, DIRECTOR, BILLERICA COUNCIL ON AGINGSHARON CAMERON, DIRECTOR OF HEALTH AND HUMAN SERVICES, CITY OF PEABODYSTEPHANIE CRONIN, EXECUTIVE DIRECTOR, MIDDLESEX 3 COALITIONERIC CONTI, SUPERINTENDENT, BURLINGTON PUBLIC SCHOOLS; PRESIDENT, MIDDLESEX LEAGUERANDI EPSTEIN, COORDINATOR, COMMUNITY HEALTH NETWORK AREA 15MELISSA HASTINGS CRUZ, LAHEY HOSPITAL & MEDICAL CENTER BOARD OF TRUSTEESCHRISTINE HEALEY, DIRECTOR, COMMUNITY RELATIONS, BETH ISRAEL LAHEY HEALTHPETER KILCOMMONS, CORPORATE CONTROLLER, LAHEY HOSPITAL & MEDICAL CENTERJENNIFER KNIGHT, DIRECTOR OF FAMILY AND COMMUNITY ENGAGEMENT, BURLINGTON PUBLIC SCHOOLSKELLY MAGEE WRIGHT, EXECUTIVE DIRECTOR, MINUTEMAN SENIOR SERVICESMICHELLE MCCOOL-HEATLEY, ACNO EMERGENCY SERVICES, LAHEY HOSPITAL & MEDICAL CENTER ELVIRA OMEROVIC, DIRECTOR, SITE OPERATIONS, BETH ISRAEL LAHEY HEALTH PRIMARY CARERICK PARKER, EXECUTIVE DIRECTOR, BURLINGTON RESIDENTMICHELLE SNYDER, REGIONAL MANAGER, COMMUNITY RELATIONS, LAHEY HOSPITAL & MEDICAL CENTERANDY VILLANUEVA, MD, CHIEF QUALITY OFFICER, LAHEY HOSPITAL & MEDICAL CENTER, LAHEY HOSPITAL & MEDICAL CENTER BOARD OF TRUSTEESTHE MEMBERSHIP OF LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY POPULATIONS SERVED BY LAHEY CLINIC HOSPITAL'S PROGRAMMATIC ENDEAVORS, INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION, AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. SENIOR MANAGEMENT IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY BENEFITS PLAN, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. IT IS NOT ONLY THE BOARD MEMBERS AND SENIOR LEADERSHIP WHO ARE HELD ACCOUNTABLE FOR FULFILLING LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS MISSION. AMONG LAHEY CLINIC HOSPITAL'S CORE VALUES IS THE RECOGNITION THAT THE MOST SUCCESSFUL COMMUNITY BENEFITS PROGRAMS ARE IMPLEMENTED ORGANIZATION-WIDE AND INTEGRATED INTO THE VERY FABRIC OF THE HOSPITAL'S CULTURE, POLICIES, AND PROCEDURES. A COMMITMENT TO COMMUNITY BENEFITS IS A FOCUS AND VALUE MANIFESTED THROUGHOUT LHMC'S STRUCTURE AND REFLECTED IN HOW IT PROVIDES CARE AT THE HOSPITAL AND IN AFFILIATED PRACTICES.LAHEY CLINIC HOSPITAL IS A MEMBER OF BILH. WHILE LAHEY CLINIC HOSPITAL OVERSEES LOCAL COMMUNITY BENEFITS PROGRAMMING AND COMMUNITY ENGAGEMENT EFFORTS, COMMUNITY BENEFITS IS UNDER THE PURVIEW OF THE BILH CHIEF DIVERSITY, EQUITY, AND INCLUSION OFFICER. THIS STRUCTURE ENSURES THAT COMMUNITY BENEFITS EFFORTS, PRIORITIZATION, PLANNING, AND STRATEGY ALIGN AND ARE INTEGRATED WITH LOCAL AND SYSTEM STRATEGIC AND REGULATORY PRIORITIES. THE LAHEY CLINIC HOSPITAL COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE REGIONAL MANAGER OF COMMUNITY BENEFITS. THE REGIONAL MANAGER OF COMMUNITY BENEFITS HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE LAHEY CLINIC HOSPITAL PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, THE LATTER OF WHOM REPORTS DIRECTLY TO THE BILH CHIEF DIVERSITY, EQUITY, AND INCLUSION OFFICER. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF UNDERSERVED POPULATIONS ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THIS IS THE STRUCTURE AND METHODOLOGY EMPLOYED TO ENSURE THAT COMMUNITY BENEFITS IS NOT THE PURVIEW OF ONE OFFICE ALONE AND TO MAXIMIZE EFFORTS ACROSS THE ORGANIZATION TO FULFILL THE MISSION AND GOALS OF COMMUNITY BENEFITS.COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE 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, IN ORDER TO MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL
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FORM 990 SCHEDULE H PART V, SECTION C:
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REVENUE CODE (IRC) OF 1986, AS AMENDED. LAHEY CLINIC HOSPITAL COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN 2019. THAT CHNA WAS APPROVED BY THE LAHEY CLINIC HOSPITAL BOARD OF TRUSTEES ON SEPTEMBER 16, 2019. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 16, 2019 WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS) REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF LAHEY CLINIC INC'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 THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT LAHEY CLINIC HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW LAHEY CLINIC HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2019 COMMUNITY HEALTH NEEDS ASSESSMENT - TARGETED GEOGRAPHY AND POPULATION:AS NOTED ABOVE, LAHEY CLINIC HOSPITAL COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2019. THE GEOGRAPHICAL FOCUS OF LAHEY CLINIC HOSPITAL'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES EIGHT COMMUNITIES: ARLINGTON, BEDFORD, BILLERICA, BURLINGTON, LEXINGTON, LOWELL, LYNNFIELD, AND PEABODY.TARGET POPULATIONS FOR LAHEY CLINIC 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).LAHEY CLINIC HOSPITAL'S TARGET POPULATIONS FOCUS ON MEDICALLY UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN THE CBSA, AS FOLLOWS:O LOW-RESOURCE INDIVIDUALS AND FAMILIESO OLDER ADULTSO YOUTH/ADOLESCENTSO INDIVIDUALS AND FAMILIES WITH CHRONIC/COMPLEX CONDITIONS2019 COMMUNITY HEALTH NEEDS ASSESSMENT - SUMMARY OF APPROACH AND METHODS:THE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT BEGAN WITH THE CREATION OF A STEERING COMMITTEE COMPOSED OF REPRESENTATIVES FROM THE FORMER LAHEY HEALTH SYSTEM, INCLUDING LAHEY CLINIC HOSPITAL, WINCHESTER HOSPITAL, AND BEVERLY HOSPITAL-ADDISON GILBERT HOSPITAL. THE HOSPITAL HIRED JSI, A PUBLIC HEALTH RESEARCH AND CONSULTING FIRM IN BOSTON, TO COMPLETE THE CHNA AND IMPLEMENTATION STRATEGY. THE STEERING COMMITTEE PROVIDED VITAL OVERSIGHT OF THE CHNA APPROACH, METHODS, AND REPORTING PROCESS. LAHEY CLINIC HOSPITAL ENGAGED ITS CBAC, MADE UP OF HOSPITAL LEADERSHIP AND CLINICAL STAFF, LOCAL SERVICE PROVIDERS, AND KEY COMMUNITY STAKEHOLDERS, EXTENSIVELY THROUGHOUT THIS PROCESS. THIS GROUP MET THREE TIMES OVER THE COURSE OF THE ASSESSMENT AND PROVIDED INPUT ON THE ASSESSMENT APPROACH, VETTED PRELIMINARY FINDINGS, AND HELPED PRIORITIZE COMMUNITY HEALTH ISSUES AND VULNERABLE POPULATIONS. THE CBAC ALSO REVIEWED AND PROVIDED FEEDBACK ON THE ASSOCIATED IMPLEMENTATION STRATEGY. FINALLY, THE PROJECT ADVISORY COMMITTEE (PAC) WAS CONVENED TO PROVIDE INPUT AND FEEDBACK FROM A SYSTEM WIDE PERSPECTIVE. THE PAC WAS COMPOSED OF REPRESENTATIVES FROM CLINICAL AND ADMINISTRATIVE LEADERSHIP AND LOCAL PUBLIC HEALTH OFFICIALS, ALONG WITH COMMUNITY RELATIONS STAFF. THE PAC MET THREE TIMES OVER THE COURSE OF THE PROJECT, PROVIDED BROAD-BASED FEEDBACK ON THE APPROACH, AND VETTED PRELIMINARY FINDINGS RELATIVE TO PRIORITY COMMUNITY HEALTH ISSUES AND VULNERABLE POPULATIONS. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - DETAIL OF APPROACH AND METHODS:QUANTITATIVE DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN LAHEY CLINIC HOSPITAL'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF THE HEALTH-RELATED ISSUES. SOURCES INCLUDED:O U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017)O MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017 AND 2018-2019)O FBI UNIFORM CRIME REPORTS (2017)O MDPH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015)O MDPH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017)O MDPH, ANNUAL REPORTS ON BIRTHS (2016)O MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017)O MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY2013-2017)O MASSACHUSETTS CHIA HOSPITAL DISCHARGES (2017)O MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018)O YOUTH RISK BEHAVIOR SURVEYS (2017 AND 2018)TO AUGMENT THE QUANTITATIVE DATA FROM MDPH, JSI WORKED WITH THE MASSACHUSETTS CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA) TO OBTAIN 2018 INPATIENT HOSPITAL DISCHARGE DATA FOR ALL OF THE MUNICIPALITIES IN THE SERVICE AREA.THE IMPACT OF ANY ACTIONS TAKEN TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE HOSPITAL FACILITY'S PRIOR CHNA(S) WAS NOT INCLUDED IN THIS MOST RECENTLY CONDUCTED CHNA. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)LAHEY CLINIC HOSPITAL WITH THE HELP OF JOHN SNOW, INC., CONDUCTED 28 INDIVIDUAL KEY INFORMANT INTERVIEWS AND 4 GROUP INTERVIEWS WITH COMMUNITY STAKEHOLDERS, INCLUDING REPRESENTATIVES FROM HOSPITAL AND MUNICIPAL LEADERSHIP, THE BUSINESS COMMUNITY, PUBLIC HEALTH DEPARTMENTS, SOCIAL SERVICE PROVIDERS, SCHOOLS, AND COMMUNITY HEALTH COALITIONS. JSI ALSO FACILITATED FIVE FOCUS GROUPS. APPENDIX A IN THE LAHEY CLINIC HOSPITAL CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5):FIVE FOCUS GROUPS WITH IDENTIFIED UNDERSERVED POPULATIONS WERE ALSO HELD. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE CITY AND TOWNS THAT COMPRISE THE HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA. PARTICIPANTS REPRESENTED DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS SERVING POPULATIONS OF FOCUS (E.G., YOUTH, SENIORS, MINORITY GROUPS AND PERSONS WHO DO NOT SPEAK ENGLISH) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 500 PEOPLE. APPENDIX A IN THE LHMC CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSTHE LAHEY CLINIC HOSPITAL COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS DEVELOPED BY A TEAM COMPRISED OF HOSPITAL LEADERSHIP, MEDICAL STAFF, COMMUNITY BENEFITS STAFF AND COMMUNITY REPRESENTATION. THE GROUP REVIEWED PROGRESS TOWARD GOALS AND OBJECTIVES OF THE PRIOR THREE-YEAR PERIOD, AS WELL AS THE CURRENT DATA COLLECTED THROUGH THE CHNA, TO HELP ENVISION AND DEFINE PRIORITY AREAS FOR THE FUTURE. THE IMPLEMENTATION STRATEGY IDENTIFIED PRIORITY AREAS AND DEFINED GOALS, ALONG WITH OBJECTIVES FOR EACH GOAL AND DRAFTED STRATEGIES TO OPERATIONALIZE THESE OBJECTIVES. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS - KEY FINDINGS:BELOW IS A HIGH-LEVEL SUMMARY OF HEALTH-RELATED FINDINGS THAT WERE IDENTIFIED AFTER A COMPREHENSIVE REVIEW OF ALL THE QUANTITATIVE AND QUALITATIVE INFORMATION THAT WAS COLLECTED AS PART OF THE CHNA. A DETAILED AND IN-DEPTH DISCUSSION OF KEY FINDINGS IS INCLUDED IN THE FULL CHNA REPORT.O SOCIAL DETERMINANTS OF HEALTH (E.G., TRANSPORTATION, ECONOMIC STABILITY, ACCESS TO CARE, HOUSING, FOOD INSECURITY) AFFECT MANY SEGMENTS OF THE POPULATION. A KEY THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND COMMUNITY HEALTH SURVEY WAS THE CONTINUED IMPACT THAT SOCIAL DETERMINANTS OF HEALTH HAVE ON RESIDENTS OF LAHEY CLINIC HOSPITAL'S SERVICE AREA, ESPECIALLY THOSE WHO ARE LOW TO MODERATE INCOME, ARE FRAIL OR HOMEBOUND, HAVE MENTAL HEALTH OR SUBSTANCE USE ISSUES, OR LACK A CLOSE SUPPORT SYSTEM. O CERTAIN POPULATIONS ARE AT AN INCREASED RISK FOR HEALTHCARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE ENROLLMENT AND THE COMMUNITIES THAT MAKE UP LAHEY CLINIC HOSPITAL'S SERVICE AREA HAVE STRONG, ROBUST SAFETY-NET SYSTEMS, THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW-INCOME, MEDICAID-COVERED, UNINSURED, AND OTHERWISE HISTORICALLY UNDERSERVED INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL AND BEHAVIORAL SERVICES.
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FORM 990 SCHEDULE H PART V, SECTION C:
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EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE, AND IMPROVE THE QUALITY OF PRIMARY MEDICAL CARE, MEDICAL SPECIALTY, AND BEHAVIORAL HEALTH SERVICES.O MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY/STRESS, ACCESS TO TREATMENT, STIGMA) UNDERLIE MANY HEALTH AND SOCIAL CONCERNS. NEARLY EVERY KEY INFORMANT INTERVIEW, FOCUS GROUP, AND LISTENING SESSION INCLUDED DISCUSSIONS ON THE IMPACT OF MENTAL HEALTH ISSUES. A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION INDICATED THAT DEPRESSION, ANXIETY/STRESS, AND SOCIAL ISOLATION WERE THE LEADING CONCERNS. THERE WERE PARTICULAR CONCERNS ABOUT THE IMPACT OF DEPRESSION, ANXIETY, AND E-CIGARETTES/VAPING ON YOUTH AND SOCIAL ISOLATION AMONG OLDER ADULTS. O SUBSTANCE DEPENDENCY CONTINUES TO AFFECT INDIVIDUALS, FAMILIES, AND COMMUNITIES. THE OPIOID EPIDEMIC CONTINUES TO BE AN AREA OF FOCUS. BEYOND OPIOIDS, KEY INFORMANTS WERE ALSO CONCERNED ABOUT ALCOHOL MISUSE, CHANGING COMMUNITY NORMS IN LIGHT OF THE LEGALIZATION OF RECREATIONAL MARIJUANA USE, AND E-CIGARETTES/VAPING AMONG ADOLESCENTS. O CHRONIC DISEASES (E.G., CARDIOVASCULAR DISEASE, CANCER, DIABETES, ASTHMA) REQUIRE MORE EDUCATION, SCREENING/EARLY INTERVENTION, AND MANAGEMENT AND A FOCUS ON RISK FACTORS. ALTHOUGH THERE WAS MAJOR EMPHASIS ON BEHAVIORAL HEALTH ISSUES, MANY KEY INFORMANTS, FOCUS GROUP PARTICIPANTS, AND LISTENING SESSION PARTICIPANTS IDENTIFIED A NEED TO ADDRESS THE MANY RISK FACTORS ASSOCIATED WITH CHRONIC AND COMPLEX HEALTH CONDITIONS. PHYSICAL INACTIVITY AND POOR NUTRITION/LIFESTYLE WERE DISCUSSED BY MANY, WITH SOME OF THESE ISSUES BEING ASSOCIATED WITH AGE (MOBILITY ISSUES AMONG OLDER ADULTS), EDUCATION/HEALTH LITERACY (LACK OF UNDERSTANDING ABOUT HEALTHY EATING), AND SOCIOECONOMIC STATUS (FRESH FOODS BEING EXPENSIVE AND GYMS AND HEALTH CENTERS BEING UNAFFORDABLE). ADDRESSING THE LEADING RISK FACTORS IS AT THE ROOT OF MANY CHRONIC DISEASE PREVENTION AND MANAGEMENT STRATEGIES. COMMUNITY HEALTH NEEDS ASSESSMENT AND ACTIVITIES REPORTED IN THIS FILINGTHE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, WILL INFORM LAHEY CLINIC INC.'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022.COMMUNITY HEALTH NEEDS ASSESSMENT - MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLELAHEY CLINIC HOSPITAL STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY. AS NOTED ABOVE, THE 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 HOSPITAL'S WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/WP-CONTENT/UPLOADS/SITES/2/2019/08/LHMC-MASTER-REPORT-AND-APPENDICES.PDFIN ADDITION TO THE CHNA, LAHEY CLINIC 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 HOSPITAL'S WEBSITE AT:HTTPS://WWW.LAHEY.ORG/LHMC/WP-CONTENT/UPLOADS/SITES/2/2020/09/LHMC-FINAL-IS-2020-2022.PDFIN ADDITION, AS NOTED ABOVE, LAHEY CLINIC HOSPITAL COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015). THAT CHNA IS AVAILABLE ON THE HOSPITAL'S WEBSITE AT:HTTPS://WWW.LAHEY.ORG/LHMC/WP-CONTENT/UPLOADS/SITES/2/2019/08/LHMC-MASTER-REPORT-AND-APPENDICES.PDFFINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING LAHEY CLINIC INC'S FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015) IS AVAILABLE ON THE HOSPITAL'S WEBSITE AT:HTTPS://WWW.LAHEY.ORG/LHMC/WP-CONTENT/UPLOADS/SITES/2/2019/08/LHMC-MASTER-REPORT-AND-APPENDICES.PDF 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, LAHEY CLINIC 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 LAHEY CLINIC HOSPITAL FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2021 AND WILL CONTINUE TO INFORM THE HOSPITAL'S COMMUNITY BENEFITS MISSION AND ACTIVITIES FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2022. A SUMMARY OF LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2021 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, LAHEY CLINIC HOSPITAL HAS BEEN STRATEGIC IN IDENTIFYING ITS PRIORITY AREAS 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 PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: MENTAL HEALTH AND SUBSTANCE USE DISORDERO GOAL: ADDRESS THE PREVALENCE AND IMPACT, RISK/PROTECTIVE FACTORS, AND ACCESS ISSUES ASSOCIATED WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERPRIORITY AREA 2: CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORSO GOAL: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, AND REFERRAL SERVICES IN CLINICAL AND NONCLINICAL SETTINGSO GOAL: SUPPORT INDIVIDUALS WITH OR RECOVERING FROM CHRONIC/COMPLEX CONDITIONS AND THEIR CAREGIVERSPRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CAREO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARECOMMUNITY HEALTH NEEDS ASSESSMENT - APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)LAHEY CLINIC HOSPITAL RECOGNIZES THAT AUTHENTIC COMMUNITY ENGAGEMENT IS CRITICAL TO ASSESSING COMMUNITY NEEDS, IDENTIFYING HEALTH PRIORITIES AND POPULATIONS OF FOCUS, AND CREATING A ROBUST IMPLEMENTATION STRATEGY. THE HOSPITAL WAS COMMITTED TO ENGAGING THE COMMUNITY THROUGHOUT THIS PROCESS. USING THE COMMUNITY ENGAGEMENT CONTINUUM INCLUDED IN MDPH'S COMMUNITY ENGAGEMENT STANDARDS FOR COMMUNITY HEALTH PLANNING AS A GUIDE, LAHEY CLINIC HOSPITAL EMPLOYED A VARIETY OF APPROACHES TO ENSURE THAT COMMUNITY MEMBERS WERE INFORMED, CONSULTED, AND INVOLVED THROUGHOUT THE ASSESSMENT PROCESS, AND THAT THEY WERE COLLABORATORS IN ENSURING THAT THE IMPLEMENTATION STRATEGY ADDRESSED PRIORITY ISSUES AND VULNERABLE POPULATIONS.LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS PREDICATED ON THE NOTION OF PARTNERSHIP AND DIALOGUE WITH ITS MANY COMMUNITIES. LAHEY CLINIC HOSPITAL'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM DISCUSSIONS WITH AND OBSERVATIONS BY HEALTH CARE AND HEALTH-RELATED WORKERS IN THE NEIGHBORHOODS AS WELL AS MORE FORMAL ASSESSMENTS THROUGH AVAILABLE PUBLIC HEALTH DATA, FOCUS GROUPS, SURVEYS, ETC. THIS DATA WAS THEN AUGMENTED BY DEMOGRAPHIC AND HEALTH STATUS INFORMATION GLEANED FROM A VARIETY OF SOURCES, INCLUDING THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, THE BOSTON PUBLIC HEALTH COMMISSION, FEDERAL RESOURCES SUCH AS THE INSTITUTE OF MEDICINE AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND REVIEW OF LITERATURE RELEVANT TO A PARTICULAR COMMUNITY'S NEEDS.THE ARTICULATION OF EACH SPECIFIC COMMUNITY'S NEEDS (DONE IN PARTNERSHIP BETWEEN LAHEY CLINIC HOSPITAL AND COMMUNITY PARTNERS) IS USED TO INFORM LAHEY CLINIC HOSPITAL'S DECISION-MAKING ABOUT PRIORITIES FOR ITS COMMUNITY BENEFITS EFFORTS. LAHEY CLINIC HOSPITAL WORKS IN CONCERT WITH COMMUNITY RESIDENTS AND LEADERS TO DESIGN SPECIFIC ACTIONS TO BE UNDERTAKEN EACH YEAR.
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SCHEDULE H, PART V, SECTION B, LINE 5:
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FY21 SCHEDULE H - IMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: MENTAL HEALTH AND SUBSTANCE USE DISORDERAS IT IS THROUGHOUT THE COMMONWEALTH AND THE NATION, THE BURDEN OF MENTAL HEALTH ISSUES AND SUBSTANCE USE DISORDER ON INDIVIDUALS, FAMILIES, COMMUNITIES, AND SERVICE PROVIDERS IN LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA IS OVERWHELMING. NEARLY EVERY KEY INFORMANT INTERVIEW, FOCUS GROUP, AND LISTENING SESSION INCLUDED DISCUSSIONS ON THESE TOPICS. FROM A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION, DEPRESSION, ANXIETY/STRESS, AND SOCIAL ISOLATION WERE THE LEADING ISSUES IN THIS DOMAIN. THERE WERE PARTICULAR CONCERNS REGARDING THE IMPACT OF DEPRESSION, ANXIETY, AND E-CIGARETTE/VAPING ON YOUTH AND SOCIAL ISOLATION AMONG OLDER ADULTS. LAHEY CLINIC HOSPITAL RECOGNIZES THE IMPORTANCE OF PRIMARY PREVENTION, SO THE HOSPITAL WILL CONTINUE TO WORK WITH COMMUNITY PARTNERS TO OFFER EDUCATIONAL PROGRAMS AROUND MENTAL HEALTH AND SUBSTANCE USE DISORDER. THE HOSPITAL WILL ALSO ENHANCE PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS TO IDENTIFY, SCREEN, AND REFER YOUTH WITH MENTAL HEALTH AND SUBSTANCE USE ISSUES TO TREATMENT. LAHEY CLINIC HOSPITAL WILL CONTINUE TO PARTNER AND COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS THAT WORK WITH OLDER ADULTS TO ENHANCE ACCESS TO SUPPORTIVE SERVICES AND TO SERVICES TO REDUCE SOCIAL ISOLATION.________________________________________GOAL 1: ADDRESS THE PREVALENCE AND IMPACT, RISK/PROTECTIVE FACTORS, AND ACCESS ISSUES ASSOCIATED WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERTARGET POPULATION: LOW-RESOURCE INDIVIDUALS AND FAMILIES, OLDER ADULTS, YOUTH/ADOLESCENTS, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES: 1.1 PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE ACTIVITIES WITH INTERNAL COLLEAGUES AND EXTERNAL PARTNERS1.2 EXPLORE OPPORTUNITIES FOR PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS TO IDENTIFY, SCREEN, ASSESS, AND REFER THOSE WITH MENTAL HEALTH AND SUBSTANCE USE DISORDER TO TREATMENT1.3 REDUCE ENVIRONMENTAL RISK FACTORS ASSOCIATED WITH MENTAL HEALTH OR SUBSTANCE USE ISSUES1.4 INCREASE ACCESS TO APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT AND SUPPORT SERVICES1.5 ENHANCE THE ABILITY OF LOCAL PROVIDERS AND COMMUNITY PARTNERS TO UNDERSTAND, ANTICIPATE, AND RESPOND TO HEALTH NEEDS AND SOCIAL DETERMINANTS OF HEALTHCOMMUNITY ACTIVITIES/STRATEGIES:O SUPPORT COMMUNITY-BASED HEALTH EDUCATION EVENTS TO RAISE AWARENESS OF AND PROVIDE EDUCATION ABOUT RISK/PROTECTIVE FACTORS AND SERVICES AVAILABLE WITHIN THE COMMUNITY (E.G., EDUCATION SERIES ON VAPING)O PROVIDE FINANCIAL RESOURCES TO COMMUNITY-BASED PARTNERS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT ADDRESS MENTAL HEALTH AND SUBSTANCE USE DISORDER (E.G., FUNDS TO CHNAS, MINI-GRANTS)O PARTICIPATE IN COLLABORATIVES OR TASK FORCES THAT ADDRESS MENTAL HEALTH AND/OR SUBSTANCE USE DISORDERO ENHANCE PARTNERSHIPS WITH ELDER SERVICE PROVIDERS TO IDENTIFY OLDER ADULTS AT RISK FOR MENTAL HEALTH AND SUBSTANCE USE ISSUES AND PROMOTE ACCESS TO TREATMENT (E.G., LICENSED INDEPENDENT SOCIAL WORKERS AT SENIOR CENTERS/COUNCILS ON AGING (COAS)O ORGANIZE DRUG TAKEBACK OPPORTUNITIES AT THE HOSPITAL AND WITH COMMUNITY-BASED PARTNERS (E.G., A MEDICAL DISPOSAL PROGRAM)O SUPPORT INITIATIVES THAT HELP REDUCE ENVIRONMENTAL RISK FACTORS ASSOCIATED WITH DEVELOPING MENTAL HEALTH ISSUES (E.G., HOARDING, SOCIAL ISOLATION)O ENHANCE ACCESS TO INTEGRATED BEHAVIORAL HEALTH SERVICESO PROVIDE SUPPORT/REFERRALS TO INDIVIDUALS WITH MENTAL HEALTH AND/OR SUBSTANCE USE ISSUESO PROVIDE EDUCATION AND SUPPORT TO PROVIDERS AND COMMUNITY PARTNERS TO ALLOW THEM TO BETTER UNDERSTAND AND RESPOND TO EMERGING HEALTH NEEDS AND SOCIAL DETERMINANTS OF HEALTHO SUPPORT EFFORTS TO ASSESS THE OVERALL HEALTH OF THE COMMUNITY (E.G., A YOUTH RISK BEHAVIOR SURVEY)METRICS AND STATUS UPDATE:O NUMBER OF POUNDS OF MEDICATIONS DISPOSED OF AT HOSPITAL-BASED DROP BOX (FY21: 521 POUNDS).O PROVIDED ACCESS TO BEHAVIORAL HEALTH SERVICES THROUGH PRIMARY CARE FOR 2,827 INDIVIDUALS IN FY21. O PARTNERS WITH THE BURLINGTON POLICE DEPARTMENT TO PROVIDE A SUBSTANCE USE COORDINATOR. THE COORDINATOR PROVIDES ESSENTIAL OUTREACH TO PERSONS IDENTIFIED BY POLICE AS HAVING SUBSTANCE USE ISSUES. THE POSITION PROVIDES SUPPORT AND REFERRALS FOR THOSE INDIVIDUALS AND COORDINATES BETWEEN MULTIPLE TOWN AND COMMUNITY AGENCIES TO ENSURE THEY RECEIVE ESSENTIAL SERVICES. 27 INDIVIDUALS WERE SERVED IN FY 21. O PARTNERS WITH BURLINGTON YOUTH & FAMILY SERVICES TO HELP TO PROVIDE FUNDING FOR SUPPORT GROUPS, TRAININGS FOR STAFF TO ENHANCE SERVICES, AND CLINICAL CONSULTATION SERVICES FROM BEHAVIORAL HEALTH PROVIDERS. THERE WERE OVER 3,000 VISITS TO BYFS IN FY 21. O PARTNERS WITH ELEVEN CITIES AND TOWNS THROUGH THE MIDDLESEX LEAGUE WITH A COLLABORATIVE YOUTH RISK BEHAVIOR SURVEY. FY21 SURVEY WAS ADMINISTERED TO 7,337 MIDDLE SCHOOL STUDENTS AND 8,852 HIGH SCHOOL STUDENTS ACROSS 11 CITIES AND TOWNS.O PARTNERS WITH BURLINGTON HIGH SCHOOL ON A MENTAL HEALTH AND STUDENT NEEDS ASSESSMENT AND PROGRAMMING FOR SOCIAL-EMOTIONAL HEALTH CURRICULUM. 677 RESPONSES WERE GARNERED TO THE ASSESSMENT.O LHMC PARTNERS WITH NORTHSHORE COMMUNITY HEALTH CENTER TO PROVIDE SUPPORT FOR THE PEABODY VETERAN'S MEMORIAL HIGH SCHOOL STUDENT-BASED HEALTH CENTER. IN FY 21, 195 UNIQUE INDIVIDUALS WERE SERVED IN 332 MEDICAL VISITS (319 ONSITE AND 13 TELEHEALTH) AND 958 BEHAVIORAL HEALTH VISITS (182 ONSITE AND 776 TELEHEALTH) BETWEEN OCTOBER 2020-JUNE 2021. THE TOP 3 DIAGNOSES WERE ANXIETY DISORDER, MAJOR DEPRESSIVE DISORDER, AND ADJUSTMENT DISORDER (NEW FOR FY21).O PROVIDED FUNDING FOR OVER EIGHTY COMMUNITY-BASED PROGRAMS TO ADDRESS SUBSTANCE USE AND MENTAL HEALTH IN FY 21. O PROVIDED MEDICATION ASSISTED TREATMENT (MAT) FOR 4 INDIVIDUALS THROUGH THE EMERGENCY DEPARTMENT. O FACILITATED 9 SUPPORT GROUPS AT LAHEY CLINIC HOSPITALCOMMUNITY PARTNERS: COMMUNITY HEALTH NETWORK AREAS (CHNA) 13/14 AND 15, PEABODY VETERANS MEMORIAL HIGH SCHOOL, NORTH SHORE COMMUNITY HEALTH CENTER, MIDDLESEX LEAGUE, TOWN OF BURLINGTONPRIORITY AREA 2: CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORSLAHEY CLINIC HOSPITAL HAS A LONG HISTORY OF WORKING WITH COMMUNITY PARTNERS TO CREATE AWARENESS OF AND PROVIDE EDUCATION ON THESE RISK FACTORS AND THEIR LINK TO CHRONIC AND COMPLEX HEALTH CONDITIONS. THE HOSPITAL WILL CONTINUE TO SUPPORT PROGRAMS THAT PROVIDE OPPORTUNITIES FOR PEOPLE TO ACCESS LOW-COST, HEALTHY FOOD AND OPPORTUNITIES FOR SAFE AND AFFORDABLE PHYSICAL ACTIVITY. BEYOND ADDRESSING THE RISK FACTORS, LAHEY CLINIC HOSPITAL IS ALSO COMMITTED TO PROVIDING SCREENING AND EDUCATIONAL OPPORTUNITIES, SUPPORTING INDIVIDUALS AND CAREGIVERS THROUGHOUT THE SERVICE AREA TO ENGAGE IN CHRONIC DISEASE MANAGEMENT PROGRAMS AND SUPPORTIVE SERVICES (E.G., INTEGRATIVE THERAPIES, SUPPORT GROUPS), AND PROVIDING LINKS TO CARE.________________________________________GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, AND REFERRAL SERVICES IN CLINICAL AND NONCLINICAL SETTINGSTARGET POPULATION: LOW-RESOURCE INDIVIDUALS AND FAMILIES, OLDER ADULTS, YOUTH/ADOLESCENTS, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE AWARENESS OF AND EDUCATION ABOUT THE RISKS AND PROTECTIVE FACTORS ASSOCIATED WITH CHRONIC AND COMPLEX CONDITIONS1.2 SUPPORT PROGRAMS/ACTIVITIES IN CLINICAL AND NONCLINICAL SETTINGS THAT SCREEN, EDUCATE, AND REFER PATIENTS FOR CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS1.3 ENHANCE ACCESS TO AND PROMOTE EQUITABLE CARE FOR VULNERABLE INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSCOMMUNITY ACTIVITIES/STRATEGIES: O ORGANIZE EVENTS AND INITIATIVES HOSTED AND INFORMED BY CLINICAL STAFF RELATED TO EDUCATION AND MANAGEMENT OF CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS (E.G., THE WOMEN'S LECTURE SERIES)O IMPLEMENT AND EXPAND EVIDENCE-BASED PROGRAMS AND SCREENINGS (E.G., BREAST CANCER RISK ASSESSMENTS, SKIN CANCER AWARENESS AND PREVENTION, FALLS PREVENTION, AN OSTEOPOROSIS PROGRAM, MATTER OF BALANCE)O EXPLORE PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS THAT WORK WITH HISTORICALLY UNDERSERVED POPULATIONS TO OVERCOME BARRIERS TO CARE AND ENGAGE IN APPROPRIATE TREATMENTMETRICS AND STATUS UPDATE: O LAHEY CLINIC HOSPITAL HOSTED THREE SESSIONS OF THE WOMEN'S HEALTH LECTURE SERIES (FY 21 366 ATTENDEES)O PROVIDED SIX SESSIONS OF THE BONE HEALTH LECTURE SERIES THAT SERVED 48 INDIVIDUALS AND PROVIDED FREE BONE SCANS TO 42 INDIVIDUALS IN FY 21.O PROVIDED SIX SESSIONS OF THE COOKING UP GOOD HEALTH NUTRITION DEMONSTRATION (FY 21 AVERAGE OF 6 ATTENDEES PER SESSION).
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SCHEDULE H, PART V, SECTION B, LINE 5:
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O COMPLETED 16,892 RISK ASSESSMENT SCREENINGS FOR 17,303 UNIQUE INDIVIDUALS. 13% OF PATIENTS SCREENED ACROSS THE SYSTEM WERE IDENTIFIED AS HAVING A HIGH LIFETIME RISK OF BREAST CANCER AND 25% WERE IDENTIFIED AS HAVING A HIGH-RISK MUTATION.O PARTNER WITH THE TOWN OF BURLINGTON TO SUPPORT THE BURLINGTON DIABETES CARE PROGRAM. THIS PROGRAM PROVIDES ASSISTANCE FOR TOWN OF BURLINGTON EMPLOYEES WHO HAVE A DIAGNOSIS OF PRE-DIABETES OR ARE DIABETIC. 82 INDIVIDUALS WERE SERVED BY THIS PROGRAM IN FY 21. ________________________________________GOAL 2: SUPPORT INDIVIDUALS WITH OR RECOVERING FROM CHRONIC/COMPLEX CONDITIONS AND THEIR CAREGIVERSTARGET POPULATION: LOW-RESOURCE INDIVIDUALS AND FAMILIES, OLDER ADULTS, YOUTH/ADOLESCENTS, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES: 2.1 PARTNER WITH COMMUNITY-BASED ORGANIZATIONS TO INCREASE OPPORTUNITIES FOR CANCER SURVIVORS TO ENGAGE IN SAFE PHYSICAL ACTIVITIES AND REDUCE SOCIAL ISOLATION2.2 PROVIDE SUPPORT AND CARE NAVIGATION TO INDIVIDUALS WHO ARE UNDERGOING TREATMENT FOR CHRONIC/COMPLEX CONDITIONS AND THEIR FAMILIESCOMMUNITY ACTIVITIES/STRATEGIES: O PARTNER WITH COMMUNITY-BASED ORGANIZATIONS TO INCREASE OPPORTUNITIES FOR CANCER SURVIVORS TO ENGAGE IN SAFE PHYSICAL ACTIVITIES AND REDUCE SOCIAL ISOLATIONO PROVIDE SUPPORT AND CARE NAVIGATION TO INDIVIDUALS WHO ARE UNDERGOING TREATMENT FOR CHRONIC/COMPLEX CONDITIONS AND THEIR FAMILIESMETRICS AND STATUS UPDATE: O FY 21 SERVED 10-15 INDIVIDUALS PER DAY THROUGH THE ONCOLOGY NURSE NAVIGATOR PROGRAM WHICH EMPLOYS FIVE STAFF. O PARTNERED WITH THE BURBANK YMCA TO PROVIDE THE PINK PROGRAM FOR BREAST CANCER SURVIVORS. THE PINK PROGRAM HAS RESTRUCTURED, AND IS NOW OFFERED AS A CONTINUOUSLY OPERATING, DROP-IN GROUP EXERCISE CLASS/PROGRAM WITH UNIQUE SOCIAL SUPPORT FOR BREAST CANCER SURVIVORS. THE YMCA RAN A VIRTUAL CLASS AND 18 TOTAL PEOPLE PARTICIPATED TO DATE. O PARTNERED WITH THE NORTH SUBURBAN YMCA TO PROVIDE TWO SESSIONS OF THE LIVESTRONG PROGRAM FOR CANCER SURVIVORS. IN FY 21, 24 INDIVIDUALS COMPLETED THE CLASS AND REPORTED IMPROVEMENTS IN FATIGUE AND PAIN INTERFERENCE IN DAILY ACTIVITIES. O PROVIDED FUNDING TO THE BURLINGTON COUNCIL ON AGING FOR A MEMORY CAF PROGRAM FOR ALZHEIMER'S PATIENTS AND THEIR CAREGIVERS (FY 21 32 UNDUPLICATED ATTENDEES) COMMUNITY PARTNERS: BURBANK YMCA, BURLINGTON COUNCIL ON AGING, NORTH SUBURBAN YMCA________________________________________PRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARETHE SOCIAL DETERMINANTS OF HEALTH ARE OFTEN THE DRIVERS OF OR THE UNDERLYING FACTORS THAT CREATE OR EXACERBATE MENTAL HEALTH ISSUES, SUBSTANCE MISUSE, AND CHRONIC/COMPLEX CONDITIONS. THESE SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY POVERTY, ALSO UNDERLIE MANY OF THE ACCESS-TO-CARE ISSUES THAT WERE PRIORITIZED IN THE ASSESSMENT: NAVIGATING THE HEALTH SYSTEM (INCLUDING HEALTH INSURANCE), CHRONIC DISEASE MANAGEMENT, AND AFFORDING CARE.LAHEY CLINIC HOSPITAL IS COMMITTED TO ADDRESSING SOCIAL DETERMINANTS AND BREAKING DOWN BARRIERS TO CARE. THE HOSPITAL WILL CONTINUE TO COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS TO ENGAGE INDIVIDUALS IN SERVICES, REDUCE FINANCIAL BURDENS, INCREASE ACCESS TO APPROPRIATE PRIMARY AND SPECIALTY CARE SERVICES, AND SUPPORT HEALTHY FAMILIES AND COMMUNITIES. LAHEY CLINIC HOSPITAL IS ALSO COMMITTED TO STRENGTHENING THE LOCAL WORKFORCE AND ADDRESSING UNEMPLOYMENT BY SUPPORTING JOB-TRAINING PROGRAMS.________________________________________GOAL 1: ADDRESS THE SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARETARGET POPULATION: LOW-RESOURCE INDIVIDUALS AND FAMILIES, OLDER ADULTS, YOUTH/ADOLESCENTS, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE PARTNERSHIPS AND COLLABORATION WITH COMMUNITY-BASED ORGANIZATIONS TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH1.2 INCREASE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION OPTIONS1.3 EDUCATE PROVIDERS AND COMMUNITY MEMBERS ABOUT HOSPITAL AND/OR PUBLIC ASSISTANCE PROGRAMS THAT CAN HELP IDENTIFY AND ENROLL INDIVIDUALS IN APPROPRIATE HEALTH INSURANCE PLANS AND/OR REDUCE THEIR FINANCIAL BURDEN1.4 WORK TO HELP STRENGTHEN THE LOCAL WORKFORCE1.5 INCREASE AWARENESS OF DOMESTIC VIOLENCE AND PROMOTE LINKS TO SERVICES1.6 PROMOTE RESILIENCE AND EMERGENCY PREPAREDNESS1.7 INCREASE ACCESS TO AFFORDABLE AND NUTRITIOUS FOODS1.8 INCREASE ACCESS TO AFFORDABLE AND FREE OPPORTUNITIES FOR PHYSICAL ACTIVITY1.9 PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS1.10 ENSURE ACCESS TO PREVENTIVE MEASURES, TESTING, SCREENING AND TREATMENT FOR THOSE AT-RISK OR EXPOSED TO COVID-19 AND MITIGATE THE IMPACTS OF THE PANDEMIC ON THE SOCIAL DETERMINANTS OF HEALTHCOMMUNITY ACTIVITIES/STRATEGIES: O PROVIDE COMMUNITY HEALTH GRANTS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTHO SUPPORT PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATIONO PROVIDE ENROLLMENT COUNSELING/ASSISTANCE AND PATIENT NAVIGATION SUPPORT SERVICES TO UNINSURED AND/OR UNDERINSURED RESIDENTS TO ENHANCE ACCESS TO CARE (E.G., PATIENT FINANCIAL COUNSELORS, THE SERVING HEALTH INFORMATION NEEDS OF EVERYONE PROGRAM)O PROVIDE COMMUNITY HEALTH GRANTS TO COMMUNITY PARTNERS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT ADDRESS ISSUES ASSOCIATED WITH ACCESS-TO-CARE ISSUESO COLLABORATE WITH LOCAL COMMUNITY PARTNERS TO SUPPORT JOB-TRAINING PROGRAMS THAT STRENGTHEN THE LOCAL WORKFORCE AND ADDRESS UNDEREMPLOYMENTO PROVIDE CRISIS INTERVENTION AND EDUCATION TO STAFF TO IDENTIFY AND RESPOND TO THE NEEDS OF VICTIMSO PROMOTE PARTNERSHIP WITH LOCAL FIRST RESPONDERS AND COMMUNITY ORGANIZATIONS THAT ARE ADDRESSING DOMESTIC VIOLENCEO PROVIDE FREE TRAINING TO FIRST RESPONDERS AND COMMUNITY PARTNERSO SUPPORT COMMUNITY-BASED PROGRAMS THAT ADDRESS FOOD INSECURITY AND PROMOTE ACCESS TO HEALTHY FOODSO SUPPORT COMMUNITY-BASED ORGANIZATIONS THAT PROVIDE COUNSELING AND COACHING ON OBESITY AND EXERCISEO SUPPORT COMMUNITY-BASED INITIATIVES TO OFFER FREE OR LOW-COST PHYSICAL ACTIVITYO PROVIDE LINGUISTICALLY AND CULTURALLY APPROPRIATE HEALTH EDUCATION AND CARE MANAGEMENT AND SUPPORT COMMUNITY-BASED INITIATIVES THAT ARE ADDRESSING THIS NEEDO SUPPORT COMMUNITY AND HOSPITAL-BASED ACTIVITIES THAT ADDRESS THE IMPACTS OF COVID 19 IN THE COMMUNITYMETRICS AND STATUS UPDATE: O PARTNERED WITH MILL CITY GROWS TO PROVIDE FUNDING FOR IMPROVEMENTS TO ITS COMMUNITY-BASED GARDEN PROGRAM. MCG, A LONGTIME PARTNER OF LHMC, HAS DESIGNED AND BUILT AND NOW OVERSEES 21 COMMUNITY AND SCHOOL GARDENS IN LOWELL THAT ARE USED BY OVER 6,500 LOWELL RESIDENTS.O PARTNERS WITH MILL CITY GROWS (MCG) AND THEIR PARTNER, THE LOWELL COMMUNITY HEALTH CENTER ON REACH LOWELL, A MULTI-YEAR PROGRAM PARTLY FUNDED BY THE CENTERS FOR DISEASE CONTROL, TO PROVIDE A HOLISTIC CARE PLAN FOR SOUTHEAST ASIAN AND LATINX RESIDENTS WHO NEED ASSISTANCE IN PREVENTING AND MANAGING DIABETES. REACH LOWELL WILL INCLUDE CULTURALLY COMPETENT MEDICAL CARE, ACCESS TO FRESH FOOD, FAMILY-CENTERED FOOD EDUCATION, AND RESOURCES TO ENGAGE IN GARDENING AS PHYSICAL ACTIVITY. MCG WILL PROVIDE FARM SHARES, COOKING CLASSES, AND FOOD EDUCATION THROUGH RECIPES AND TASTE TESTS. (FY 21 SERVED 150 HOUSEHOLDS AND DISTRIBUTED 39,999 POUNDS OF FOOD).O PARTNERED WITH THE BURLINGTON RECREATION DEPARTMENT TO PROVIDE A FREE OUTDOOR FITNESS COURT FOR THE COMMUNITY (FY 21 SERVED APPROXIMATELY 13,205 INDIVIDUALS) O PROVIDED 2 INTERNSHIPS FOR STUDENTS IN ULTRASONOLOGY; 1 GRADUATING INTERN WAS HIRED BY LHMC; 4 THREE-MONTH INTERNSHIPS IN NUCLEAR MEDICINE, 1 GRADUATING INTERN WAS HIRED BY LHMC; 18 TWO-YEAR RADIOLOGY INTERNSHIPS; 7 OF 9 OF THOSE 18 WHO WERE GRADUATING WERE HIRED BY LHMC POST-INTERNSHIP.O PARTNERED WITH THE NEW ENTRY SUSTAINABLE FARMING PROJECT TO PROVIDE WEEKLY FARMERS MARKETS AT THE ARLINGTON, BURLINGTON, AND BILLERICA COUNCILS ON AGING. THIS PROGRAM PROVIDES FREE, FRESH PRODUCE EVERY WEEK TO OVER 200 SENIORS AT THOSE LOCATIONS AND WAS MODIFIED TO OPERATE SAFELY DURING THE COVID-19 PANDEMIC. O LHMC PARTNERS WITH THE LOWELL COMMUNITY HEALTH CENTER TO PROVIDE INTERPRETATION SERVICES. IN FY 21 44.27% OF A TOTAL OF 253,769 PATIENT VISITS (ALL CAUSE) TO THE LOWELL COMMUNITY HEALTH CENTER REQUIRED LANGUAGE ACCESS TO INTERPRETATION IN MORE THAN 50 LANGUAGES AND DIALECTS, TRANSLATION OF COVID-19 AND OTHER HEALTH GUIDANCE AND INFORMATION.O IN PARTNERSHIP WITH THE MERRIMACK VALLEY FOOD BANK, PROVIDED A TOTAL OF 535 CLIENTS 12,200 POUNDS OF FOOD THROUGH THE COMMUNITY MARKET PROGRAM.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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O PROVIDED FUNDING TO THE BURLINGTON COUNCIL ON AGING FOR A SENIOR STRETCH PROGRAM THAT OPERATED BOTH VIRTUALLY AND IN-PERSON AND A TAI CHI CLASS. OVERALL, THE CLASSES SERVED ALMOST 150 OLDER ADULTS IN BURLINGTON WITH SENIOR STRETCH (IN-PERSON) REPORTING 49 UNDUPLICATED, 452 DUPLICATED; VIRTUAL SENIOR STRETCH 78 UNDUPLICATED 4552 DUPLICATED AND TAI CHI 20 UNDUPLICATED 101 DUPLICATED. THE CLASSES RUN ONCE A WEEK FOR 52 WEEKS PER YEAR AND OPERATED BOTH VIRTUALLY AND IN-PERSON IN FY21. O PARTNERED WITH MINUTEMAN SENIOR SERVICES TO OFFER SERVING HEALTH INFORMATION NEEDS FOR EVERYONE (SHINE) INSURANCE COUNSELING AND FOLLOW UP REFERRAL SERVICES. 309 INDIVIDUALS WERE COUNSELED IN FY 21.THE FOLLOWING OUTCOMES WERE REPORTED BY 176 OF PARTICIPANTS WHO COMPLETED A POST-PROGRAM EVALUATION: 118 HAD A MEDIGAP SUPPLEMENTAL PLAN. 26 WERE NEW TO MEDICARE AND BENEFITED FROM THE INFORMATION/ASSISTANCE RECEIVED ON THE VARIOUS PLANS; 35 POST-PROGRAM EVALUATION PARTICIPANTS DID NOT REPORT ON INSURANCE STATUS. O PROVIDED FUNDING TO SAHELI TO IMPLEMENT ITS HOUSING STABILIZATION PROGRAM (SHSP) WHICH PROVIDES HOUSING SUPPORT SERVICES FOR DOMESTIC VIOLENCE SURVIVORS, MANY OF WHOM ARE IMMIGRANTS. THIS PROGRAM HELPS TO MAKE HOUSING ACCESSIBLE AND AFFORDABLE FOR THOSE WHO ARE OFTEN DISPROPORTIONATELY AFFECTED BY HOMELESSNESS (63 INDIVIDUALS SERVED IN FY 21). O PARTNERS WITH THE ARLINGTON COUNCIL ON AGING TO HELP TO PROVIDE A CURB TO CURB TRANSPORTATION TO IN-PERSON MEDICAL APPOINTMENTS FOR UNDERSERVED POPULATIONS. (FY 21 40 UNDUPLICATED INDIVIDUALS WERE SERVED AND PROVIDED WITH 164 RIDES TO APPOINTMENTS). O PARTNERS WITH THE BURLINGTON COUNCIL ON AGING ON OUTREACH WORKERS WHO PROVIDE ESSENTIAL SERVICES TO SENIORS IN THE TOWN. 840 REFERRALS TO VARIOUS AGENCIES SUCH AS LEGAL SERVICES, ADULT DAY HEALTH, HOUSING AND MINUTEMAN SENIOR SERVICES FOR HOME CARE SERVICES, HEALTH INSURANCE BENEFITS (SHINE), AND PROTECTIVE SERVICES WERE MADE IN FY 21. O PARTNERED WITH THE GREATER BOSTON YMCA AND THE METRO NORTH YMCA TO PROVIDE ENHANCE FITNESS CLASSES. ENHANCE FITNESS IS AN EVIDENCE-BASED HEALTH INTERVENTION OFFSETTING THE EFFECTS OF AGING AND CHRONIC ILLNESS AS WELL AS MINIMIZING FALL RISK (FY 21 62 INDIVIDUALS SERVED). O SUPPORTS THE CITIZENS INN'S HOMELESSNESS PREVENTION PROGRAM WHICH PROVIDES LONGER-TERM SUPPORTIVE CASE MANAGEMENT SERVICES TO OUR CLIENTS WHO HAVE MOVED ON TO PERMANENT HOUSING OR ARE EXPERIENCING A HOUSING CRISIS (FY 21 3,490 INDIVIDUALS SERVED). O SUPPORTS THE HOUSING CORPORATION OF ARLINGTON'S HOMELESSNESS PREVENTION PROGRAM (HPP). THE PROGRAM OPERATES BY IDENTIFYING ARLINGTON'S RESIDENTS WHO ARE MOST IN NEED AND STABILIZING THEM WITH SERVICES COORDINATED BY THE ARLINGTON HUMAN SERVICES NETWORK (AHSN) (101 INDIVIDUALS SERVED IN FY 21). COMMUNITY PARTNERS: MILL CITY GROWS, SAHELI, MINUTEMAN SENIOR SERVICES, YMCA OF THE METRO NORTH, BURLINGTON COUNCIL ON AGING, PEABODY COUNCIL ON AGING, BURLINGTON POLICE DEPARTMENT, MERRIMACK VALLEY FOOD BANK, LOWELL COMMUNITY HEALTH CENTER, NEW ENTRY SUSTAINABLE FARMING PROJECT, BILLERICA COUNCIL ON AGING, ARLINGTON COUNCIL ON AGING, BURLINGTON RECREATION DEPARTMENT, FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW LAHEY CLINIC HOSPITAL CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 13.49% OF LAHEY CLINIC 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, LAHEY CLINIC 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.LAHEY.ORG/LHMC/LAHEY-PROMISE/IN-THE-COMMUNITY/HEALTH-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION-STRATEGIES/ 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 LAHEY CLINIC HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, LAHEY CLINIC HOSPITAL IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, RESEARCH HOSPITAL AND TEACHING HOSPITAL PROVIDING 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCELAHEY CLINIC 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 $18,937,856 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, LAHEY CLINIC 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 $71,673,934 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020. DURING THE FISCAL YEAR COVERED BY THIS FILING, LAHEY CLINIC 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 CARE - MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, LAHEY CLINIC 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 ENSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, LAHEY CLINIC HOSPITAL GENERATED $64,688,984 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY LAHEY CLINIC HOSPITAL FOR SUCH SERVICES BY $16,193,229 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 10.3% OR 134,513 OF LAHEY CLINIC HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 52.1% OR 677,116 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND LAHEY CLINIC HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, LAHEY CLINIC HOSPITAL GENERATED $487,352,677 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $22,914,254. OF THESE AMOUNTS, REVENUE OF $238,295,216 IS RELATED TO THE PROVISION OF TRANSPLANTATION, HEMATOLOGY & ONCOLOGY, GENERAL INTERNAL MEDICINE, PULMONARY AND CRITAL CARE, AND ALLERGY 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 $77,553,653. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH LAHEY CLINIC 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, LAHEY CLINIC 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 3.32%.BAD DEBTS:IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, LAHEY CLINIC HOSPITAL ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $6,073,251 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 FISCAL YEAR ENDED SEPTEMBER 30, 2020 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.FINANCIAL ASSISTANCE POLICY - INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE:LAHEY CLINIC HOSPITAL IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE FROM LAHEY CLINIC HOSPITAL AS WELL AS PROVIDERS WHO FOLLOW LAHEY CLINIC HOSPITAL'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN LAHEY CLINIC HOSPITAL AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW LAHEY CLINIC HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. LAHEY CLINIC 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 POLICY:AS 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. 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 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 POLICY- APPLYING FOR ASSISTANCE:THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY - ELIGIBILITY GUIDELINES:THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE - PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C):IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. 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.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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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 OF THE FAP (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, ARMENIAN, FRENCH, GREEK, GUJARATI, HAITIAN CREOLE, HINDI, ITALIAN, KHMER, KOREAN, PORTUGUESE, PUNJABI, RUSSIAN, SIMPLIFIED CHINESE, SPANISH, TRADITIONAL CHINESE, AND VIETNAMESE. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY - WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE 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.LAHEY.ORG/LHMC/YOUR-VISIT/INSURANCE-BILLING-RECORDS/FINANCIAL-COUNSELING-ASSISTANCE/ IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY - PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, 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 LINK TO THE LAHEY CLINIC HOSPITAL FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. O CREDIT AND COLLECTION POLICYO APPLICATION FOR FINANCIAL ASSISTANCEO MEDICAL HARDSHIP APPLICATIONO FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, ARMENIAN, CHINESE, FRENCH, GREEK, HAITIAN CREOLE, PORTUGUESE, RUSSIAN, AND SPANISH, CAN BE FOUND ON THE LAHEY CLINIC HOSPITAL WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/YOUR-VISIT/INSURANCE-BILLING-RECORDS/FINANCIAL-COUNSELING-ASSISTANCE/LIMITATION ON CHARGES - INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED - LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF 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.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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BILLING AND COLLECTIONS - 501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE - MEDICAL EDUCATION DURING THE FISCAL YEAR COVERED BY THIS FILING, LHMC HAD NET EXPENDITURES OF $35,084,864 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO LHMC'S TEACHING FUNCTION WHICH REPRESENTED LHMC 2.45% OF THE LHMC'S TOTAL EXPENSES.FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - RESEARCHAS NOTED THROUGHOUT THIS FILING LHMC IS PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER IN BOSTON AND A SISTER ENTITY OF LHMC. AS PART OF THE SAME NETWORK, THE RESEARCH IN WHICH BIDMC ENGAGES SUPPORTS NOT ONLY THE MISSION AND CARE FOR BIDMC PATIENTS AND COMMUNITIES BUT ALSO HELPS TO IMPROVE PATIENT CARE FOR THE COMMUNITIES OF OTHER BILH AFFILIATES AND BEYOND. THE DETAIL BELOW PROVIDES BACKGROUND ON THE RESEARCH ACTIVITIES AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,800 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,400 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 260 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:- ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE - EMERGENCY MEDICINE - MEDICINE O ALLERGY AND INFLAMMATIONO CARDIOVASCULAR MEDICINEO CENTER FOR VASCULAR BIOLOGY RESEARCHO CENTER FOR VIROLOGY AND VACCINE RESEARCHO CLINICAL INFORMATICSO CLINICAL NUTRITIONO ENDOCRINOLOGYO EXPERIMENTAL MEDICINEO GASTROENTEROLOGYO GENERAL MEDICINE AND PRIMARY CAREO GENETICSO GERONTOLOGYO HEMATOLOGY AND ONCOLOGYO HEMOSTASIS AND THROMBOSISO IMMUNOLOGYO INFECTIOUS DISEASEO INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGYO MOLECULAR AND VASCULAR MEDICINEO NEPHROLOGYO PULMONOLOGYO RHEUMATOLOGYO SIGNAL TRANSDUCTIONO TRANSLATIONAL RESEARCHO TRANSPLANT IMMUNOLOGY- NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY O CARDIAC SURGERYO CENTER FOR MINIMALLY INVASIVE SURGERYO NEUROSURGERYO PLASTIC AND RECONSTRUCTIVE SURGERYO VASCULAR SURGERY TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $241,917,383 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 2.99% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $307,298,416 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS ON SCHEDULE H, PART I LINE 7H COLUMN D, WHICH, IF INCLUDED IN SCHEDULE H, PART I, LINE 7H COLUMN E CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THIS SCHEDULE H, PART I, LINE 7H TO 2.21%.RESEARCH ENGAGED IN AT THE MEDICAL CENTERTHE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. COVID-19 VACCINE RESEARCHTHE PERIOD COVERED BY THIS FILING IS THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, DURING WHICH THE COVID-19 PANDEMIC CONTINUED TO DISRUPT LIFE IN THE UNITED STATES AND ACROSS THE GLOBE. RESEARCH CONDUCTED AT BIDMC DURING THIS FISCAL PERIOD HIGHLIGHTS BIDMC'S CONTINUING NATIONAL LEADERSHIP DURING THIS ONGOING PUBLIC HEALTH CRISIS.AS OF LATE JULY, 2021, ABOUT 48.5 PERCENT OF AMERICANS, OR ABOUT 159 MILLION PEOPLE, WERE FULLY VACCINATED AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19. BIDMC IMMUNOLOGIST DAN BAROUCH, MD, PHD, PLAYED AN INSTRUMENTAL ROLE IN DESIGNING AND DEVELOPING ONE OF THE FIRST THREE COVID-19 VACCINES TO COME TO MARKET IN THE UNITED STATES. AS DIRECTOR OF BIDMC'S CENTER FOR VIROLOGY AND VACCINE RESEARCH (CVVR), DR. BAROUCH AND HIS COLLEAGUES BEGAN WORKING ON A COVID-19 VACCINE ON JANUARY 10, 2020, THE SAME NIGHT THAT CHINESE SCIENTISTS RELEASED THE SARS-COV-2 VIRUS'S GENOME. DR. BAROUCH'S TEAM QUICKLY DESIGNED A SERIES OF VACCINE CANDIDATES, EVALUATED IN CLINICAL STUDIES LED BY PRIMARY INVESTIGATOR KATHRYN E. STEPHENSON, MD, MPH, DIRECTOR OF THE CLINICAL TRIALS UNIT AT CVVR.DR. BAROUCH'S INNOVATIVE VACCINE DESIGN - NOW THE BASIS OF THE JOHNSON & JOHNSON SINGLE SHOT VACCINE - USES A COMMON-COLD VIRUS, CALLED THE ADENOVIRUS, TO DELIVER A SMALL BIT OF THE COVID-19 DNA INTO HOST CELLS, WHERE IT STIMULATES THE BODY TO RAISE IMMUNE RESPONSES AGAINST THE VIRUS. SHOWN TO BE SAFE AND EFFECTIVE, THE COVID-19 VACCINE WAS GRANTED EMERGENCY USE APPROVAL BY THE U.S. FDA IN FEBRUARY, 2021.SINCE THEN, BAROUCH AND COLLEAGUES HAVE CONTINUED TO STUDY THE VIRUS' IMPACT ON THE IMMUNE SYSTEM AND HOW THE VACCINES AND THERAPIES DEVELOPED TO PROTECT AGAINST THE ORIGINAL STRAIN OF SARS-COV-2 ARE HOLDING UP AGAINST THE EMERGING VARIANTS. FOLLOWING IS A SUMMARY OUTLINING RESEARCH FROM FISCAL YEAR 2021.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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A STUDY LED BY BAROUCH AND COLLEAGUES SHED MORE LIGHT ON HOW MOLECULES OF THE IMMUNE AND VASCULAR SYSTEMS INTERACT TO PRODUCE THE EXTENSIVE DAMAGE TO THE LUNG AND VASCULAR TISSUES SEEN IN PATIENTS WITH SEVERE DISEASE. RESEARCHERS CONDUCTED COMPREHENSIVE ANALYSES OF TISSUE AND BLOOD SAMPLES FROM HUMANS AND FROM NON-HUMAN PRIMATES INFECTED WITH COVID-19. THE TEAM'S FINDINGS, PUBLISHED IN THE JOURNAL CELL, HELP DEFINE THE PATHWAYS BY WHICH COVID-19 INDUCES VASCULAR DISEASE AND ALSO POINT TO POTENTIAL THERAPEUTIC TARGETS. "OVERALL, OUR DATA REVEAL THE KEY BIOLOGICAL PROCESSES INVOLVED IN TRIGGERING THE CLOTTING AND VASCULAR DAMAGE OBSERVED WITH SARS-COV-19 INFECTION," SAID BAROUCH. "OUR RESULTS SUGGEST A MODEL IN WHICH CRITICAL INTERACTIONS BETWEEN INFLAMMATORY AND CLOTTING PATHWAYS LEAD TO SEVERE VASCULAR INJURY SEEN IN CRITICALLY ILL PATIENTS WITH COVID-19." IN A PAPER IN THE JOURNAL NATURE, BAROUCH, AND COLLEAGUES ELUCIDATED THE ROLE OF ANTIBODIES AND IMMUNE CELLS IN PROTECTION AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19, IN RHESUS MACAQUES. "IN THIS STUDY, WE DEFINE THE ROLE OF ANTIBODIES VERSUS T CELLS IN PROTECTION AGAINST COVID-19 IN MONKEYS. WE REPORTTHAT A RELATIVELY LOW ANTIBODY TITER (THE CONCENTRATION OF ANTIBODIES IN THE BLOOD) IS NEEDED FOR PROTECTION," SAID BAROUCH. "SUCH KNOWLEDGE WILL BE IMPORTANT IN THE DEVELOPMENT OF NEXT GENERATION VACCINES, ANTIBODY-BASED THERAPEUTICS, AND PUBLIC HEALTH STRATEGIES FOR COVID-19." IN ANOTHER STUDY IN NATURE, BAROUCH AND COLLEAGUES ALSO TESTED JOHNSON & JOHNSON'S COVID-19 VACCINE IN RHESUS MACAQUES CHALLENGED WITH THE VIRAL VARIANT B.1.351 AND IN RHESUS MACAQUES CHALLENGED WITH THE ORIGINAL STRAIN IDENTIFIED, DESIGNATED WA1/2020. BAROUCH AND COLLEAGUES - WHO HELPED DEVELOP JOHNSON & JOHNSON'S SINGLE-SHOT VIRAL VECTOR VACCINE, CALLED AD26.COV2.S - REPORT THAT THE VACCINE PRODUCES ROBUST PROTECTION AGAINST BOTH. THE FINDINGS HAVE IMPORTANT IMPLICATIONS FOR THE VACCINE CONTROL OF SARS-COV-2 VARIANTS OF CONCERN. "THE EMERGENCE OF SARS-COV-2 VARIANTS THAT PARTIALLY EVADE NEUTRALIZING ANTIBODIES POSES A THREAT TO THE EFFICACY OF CURRENT COVID-19 VACCINES," SAID BAROUCH, SENIOR AUTHOR OF THE STUDY AND DIRECTOR OF VACCINE AND VIROLOGY RESEARCH AT BIDMC. "HERE WE SHOW THAT THE AD26.COV2.S VACCINE ELICITS HUMORAL AND CELLULAR IMMUNE RESPONSES THAT CROSS-REACT WITH THE B.1.351 VARIANT AND PROTECTS AGAINST THE B.1.351 CHALLENGE IN RHESUS MACAQUES." IN FINDINGS PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE, BAROUCH'S TEAM REPORTED ON THE DURABILITY OF JOHNSON & JOHNSON'S AD26.COV2.S VACCINE IN HUMANS. THE SINGLE-SHOT VIRAL VECTOR VACCINE - DEVELOPED IN PART BY BAROUCH AND COLLEAGUES AT BIDMC - WAS ALSO EVALUATED FOR ITS COVERAGE AGAINST THE ALPHA, BETA, GAMMA, DELTA, EPSILON AND KAPPA SARS-COV-2 VARIANTS. "OUR DATA SHOW THAT THE AD26.COV2.S VACCINE ELICITED DURABLE IMMUNE RESPONSES WITH MINIMAL DECLINE FOR AT LEAST EIGHT MONTHS, THE TIMEFRAME EXAMINED, FOLLOWING IMMUNIZATION," SAID BAROUCH, CORRESPONDING AUTHOR OF THE PAPER AND ALSO PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. "WE ALSO SHOWED GOOD NEUTRALIZATION COVERAGE OF THE DELTA VARIANT AS WELL AS OTHER VARIANTS." LAST SUMMER, BAROUCH'S TEAM WAS AWARDED $4.9 MILLION IN ANNUAL FUNDING OVER THE NEXT FIVE YEARS TO FIND A CURE FOR HIV. BAROUCH WAS ONE OF TEN PRIMARY INVESTIGATORS TO RECEIVE A 2021 NATIONAL INSTITUTES OF HEALTH (NIH) MARTIN DELANEY COLLABORATORIES FOR HIV CURE RESEARCH AWARD, WHICH AIMS TO EXPEDITE HUMAN IMMUNODEFICIENCY VIRUS (HIV) CURE RESEARCH BY BRINGING TOGETHER RESEARCH PARTNERS IN ACADEMIA, GOVERNMENT, THE PRIVATE SECTOR AND THE COMMUNITY; COORDINATING COMPLEX RESEARCH STUDIES, AND MENTORING THE NEXT GENERATION OF HIV CURE RESEARCHERS. BAROUCH AND COLLEAGUES WILL FOCUS ON UNDERSTANDING THE VIRAL RESERVOIR DORMANT HIV-INFECTED IMMUNE CELLS THAT REMAIN IN THE BODY DESPITE ANTI-RETROVIRAL THERAPY (ART) AND CAN SPRING BACK INTO ACTION IF ART IS INTERRUPTED AND ON DEVELOPING NEW IMMUNOLOGIC STRATEGIES TARGETING THE RESERVOIR TO CONTROL OR ERADICATE HIV INFECTION. WITH MORE THAN 35 MILLION PEOPLE WORLDWIDE LIVING WITH THE VIRUS AND NEARLY 2 MILLION NEW CASES EACH YEAR, HIV REMAINS A MAJOR GLOBAL EPIDEMIC. "THE LATENT VIRAL RESERVOIR IS THE CRITICAL BARRIER FOR THE DEVELOPMENT OF A CURE FOR HIV-1 INFECTION," SAID BAROUCH. "OUR OVERALL HYPOTHESIS IS THAT MULTIPLE IMMUNOLOGIC STRATEGIES WILL NEED TO BE EXPLORED AND COMBINED TO ACHIEVE LONG-TERM, ART-FREE VIROLOGIC CONTROL OR COMPLETE VIRUS ERADICATION. WE'RE VERY GRATEFUL FOR THIS GRANT AND TREMENDOUSLY EXCITED TO SEE THE PROGRESS WE CAN MAKE WITH THIS LONG-TERM SOURCE OF SUPPORT." DETAIL ON ADDITIONAL COVID AND NON-COVID RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. STUDY FINDS ENTIRE HOUSEHOLD AT INCREASED RISK WHEN POST-SURGICAL PATIENTS REFILL PRESCRIPTION OPIOIDS NEARLY THREE-QUARTERS OF PEOPLE WHO MISUSE OPIOIDS REPORT GETTING THEM WITH OR WITHOUT PERMISSION FROM A FRIEND OR FAMILY MEMBER WHO HAS A PRESCRIPTION. IN A STUDY PUBLISHED IN JAMA SURGERY, PHYSICIAN-SCIENTISTS AT BIDMC SOUGHT TO BETTER UNDERSTAND HOW PRESCRIBING OPIATES TO PATIENTS AFTER SURGERY MAY CONTRIBUTE TO SUBSEQUENT OPIOID MISUSE - NOT JUST FOR THE POST-OPERATIVE PATIENT, BUT FOR HOUSEHOLD MEMBERS AS WELL. TO QUANTIFY HOW PRESCRIPTION DURATION AND REFILLS FOR A SURGICAL PATIENT IMPACTED THE RISK FOR MISUSE AND CHRONIC USE IN THEIR FAMILY MEMBERS, CORRESPONDING AUTHOR GABRIEL BRAT, MD, A TRAUMA SURGEON AT BIDMC, AND COLLEAGUES RETROSPECTIVELY EXAMINED DE-IDENTIFIED COMMERCIAL INSURANCE CLAIMS FILED BETWEEN 2008 AND EARLY 2016. AMONG THE 843,531 PATIENT-FAMILY PAIRS IDENTIFIED, THE RESEARCHERS FOUND THE RATES OF OVERALL OPIOID MISUSE (MEASURED BY SUBSEQUENT DIAGNOSTIC CODES) AND CHRONIC USE (MEASURED BY FILLED PRESCRIPTIONS) WERE BOTH LESS THAN ONE PERCENT. HOWEVER, THE RISK OF MISUSE USE ROSE IN HOUSEHOLDS WHERE THE SURGICAL PATIENT OBTAINED REFILLS. THOSE IN HOUSEHOLDS WITH ANY REFILL HAD A 33 PERCENT INCREASED HAZARD OF MISUSE, AND EACH ADDITIONAL REFILL WAS LINKED WITH A 19 PERCENT INCREASE IN HAZARD OF MISUSE BY A FAMILY MEMBER. "OUR DATA SUGGEST THAT THERE ARE SECOND VICTIMS OF OPIOID OVER-PRESCRIBING, THAT THE ADVERSE EFFECTS OF OPIOID PRESCRIPTIONS EXTEND BEYOND THE SURGICAL PATIENT WHO RECEIVED A PRESCRIPTION AND HAVE BROADER IMPLICATIONS FOR THE FAMILY," SAID, BRAT. "IT IS IMPORTANT THAT PRESCRIBERS, PATIENTS, AND THE PUBLIC UNDERSTAND THIS MULTI-FACETED PROBLEM EXTENDS BEYOND THE SURGICAL PATIENT AND HAS BROADER IMPLICATIONS FOR THE FAMILY."NATIONWIDE SPIKE IN CARDIOVASCULAR DEATHS SHOWN TO BE AN INDIRECT COST OF COVID-19 PANDEMIC
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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TWO YEARS INTO THE COVID-19 PANDEMIC, MORE THAN ONE MILLION AMERICANS HAVE DIED FROM THE VIRUS. BUT REPORTS DESCRIBE AN INCREASE IN MORTALITY DURING THE PANDEMIC THAT CANNOT BE EXPLAINED BY COVID-19 ALONE. RESEARCHERS LED BY CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, A PHYSICIAN-RESEARCHER AT THE SMITH CENTER FOR OUTCOMES RESEARCH IN CARDIOLOGY AT BIDMC, EVALUATED THE RATE OF U.S. DEATHS DUE TO CARDIOVASCULAR CAUSES DURING THE FIRST 11 WEEKS OF THE COVID-19 PANDEMIC (MID-MARCH TO JUNE, 2020) RELATIVE TO THE IMMEDIATELY PRECEDING 11 WEEKS PRE-PANDEMIC. THE TEAM ALSO COMPARED THESE TWO PERIODS OF 2020 TO THE SAME WEEKS IN 2019. THE OBSERVATIONAL STUDY, PUBLISHED IN THE JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (JACC), SUGGESTS THAT PATIENTS MAY HAVE AVOIDED HOSPITALS OUT OF FEAR OF CONTRACTING THE NOVEL CORONAVIRUS AND THAT SOME DIED FROM CARDIOVASCULAR CONDITIONS WITHOUT SEEKING MEDICAL CARE. THE TEAM FOUND A MARKED NATIONWIDE RISE IN CARDIAC DEATHS AFTER THE ONSET OF THE PANDEMIC IN THE U.S. DEATHS DUE-TO ISCHEMIC HEART DISEASES (RELATED TO NARROWING OF THE ARTERIES) AND HYPERTENSIVE (RELATED TO HIGH BLOOD PRESSURE) DISEASES INCREASED BY 11 PERCENT AND 17 PERCENT, RESPECTIVELY, COMPARED TO THE PREVIOUS YEAR. IN CONTRAST, THE RESEARCHERS OBSERVED NO INCREASE IN DEATHS DUE TO OTHER CARDIOVASCULAR CONDITIONS, SUCH AS HEART FAILURE, POTENTIALLY BECAUSE THEY OFTEN DO NOT REQUIRE EMERGENT HOSPITALIZATION FOR POTENTIALLY LIFE-SAVING TREATMENT. DR. WADHERA AND COLLEAGUES SUGGEST THAT THE CANCELLATION OF SEMI-ELECTIVE PROCEDURES AND OUTPATIENT VISITS AS A RESULT OF THE PANDEMIC CONTRIBUTED TO THE INCREASE IN DEATHS BY DELAYING IMPORTANT DIAGNOSTIC TESTING AND LIMITING PATIENTS' ACCESS TO PRESCRIPTION MEDICATIONS. THE STRAIN IMPOSED BY COVID-19 ON SOME HOSPITALS MAY HAVE ALSO LED TO DELAYS IN CARE FOR HOSPITALIZED PATIENTS WITHOUT COVID-19, THE RESEARCHERS ADD. PANDEMIC-RELATED DELAYS IN EMERGENCY SERVICE RESPONSE TIMES AND A REDUCTION IN BYSTANDER CPR RATES ALSO LIKELY CONTRIBUTED TO REDUCED SURVIVAL AFTER CARDIAC ARREST. ADDITIONALLY, BEYOND HEALTHCARE SYSTEM FACTORS, GREATER PSYCHOSOCIAL, COMMUNITY, AND ENVIRONMENTAL STRESS AMID THE PANDEMIC MAY ALSO HAVE PLAYED AN IMPORTANT ROLE. "OVERALL, OUR DATA HIGHLIGHT THE URGENT NEED TO IMPROVE PUBLIC HEALTH MESSAGING TO ENSURE PATIENTS WITH EMERGENT CONDITIONS SEEK AND RECEIVE MEDICAL CARE PARTICULARLY IN REGIONS CURRENTLY EXPERIENCING A SURGE OR RESURGENCE OF COVID 19 CASES," WADHERA SAID. BIDMC RESEARCHERS REVEAL HOW GENETIC VARIATIONS ARE LINKED TO COVID-19 DISEASE SEVERITYMORE THAN 90 MILLION AMERICANS HAVE BECOME INFECTED WITH COVID-19; HOWEVER, PHYSICIANS STILL AREN'T SURE WHY SOME PEOPLE EXPERIENCE MILD TO NO SYMPTOMS WHILE OTHERS BECOME CRITICALLY ILL. RESEARCH LED BY ROBERT E. GERSZTEN, MD, CHIEF OF THE DIVISION OF CARDIOVASCULAR MEDICINE AT BIDMC SHEDS NEW LIGHT ON THE GENETIC RISK FACTORS THAT MAKE INDIVIDUALS MORE OR LESS SUSCEPTIBLE TO SEVERE COVID-19. THE FINDINGS, PUBLISHED IN A LETTER IN THE NEW ENGLAND JOURNAL OF MEDICINE (NEJM), ILLUMINATE THE MECHANISMS UNDERLYING COVID-19, AND POTENTIALLY OPEN THE DOOR TO NOVEL TREATMENTS FOR THE DISEASE. A GROWING BODY OF GENETIC EVIDENCE FROM PATIENTS IN CHINA, EUROPE AND THE UNITES STATES LINKS COVID-19 OUTCOMES TO VARIATIONS IN TWO REGIONS OF THE HUMAN GENOME, FINDINGS WHICH WERE PUBLISHED IN THE NEJM. BUT THE STATISTICAL ASSOCIATION DOESN'T EXPLAIN HOW THE DIFFERENCES MODULATE DISEASE. TO DO THAT, SCIENTISTS NEED TO UNDERSTAND WHICH PROTEINS THESE SECTIONS OF THE GENOME CODE FOR AND THE ROLE THESE PROTEINS PLAY IN THE BODY IN THE CONTEXT OF DISEASE. OVER THE LAST DECADE, GERSZTEN AND COLLEAGUES HAVE GENERATED JUST SUCH A DATABASE AN IMMENSE LIBRARY OF ALL THE PROTEINS AND METABOLITES ASSOCIATED WITH VARIOUS REGIONS OF THE HUMAN GENOME. WHEN THEY LOOKED UP ONE GENOMIC "HOT SPOT" FOUND TO BE ASSOCIATED WITH COVID-19 DISEASE SEVERITY, THEY QUICKLY REALIZED THAT THE VERY SAME REGION WAS LINKED TO A PROTEIN THAT HAS RECENTLY BEEN IMPLICATED IN THE PROCESS BY WHICH THE SARS-COV-2 VIRUS INFECTS HUMAN CELLS. "GROUPS ARE INCREASINGLY FINDING GENOMIC HOTSPOTS RELATED TO DISEASES, BUT IT'S OFTEN NOT CLEAR HOW THEY IMPACT THE MECHANISMS OF DISEASE," SAID GERSZTEN. "WE LEVERAGED OUR HUGE DATABASE - IT'S MORE THAN 100 TERABYTES' WORTH OF DATA - TO VERY QUICKLY DETERMINE THAT THE PROTEIN MOST HIGHLY EXPRESSED BY THAT REGION TURNED OUT TO BE A CO-RECEPTOR FOR THE VIRUS THAT CAUSES COVID-19, SUGGESTING THAT THIS MIGHT BE A TARGET FOR THERAPEUTIC INTERVENTIONS. THE SO-CALLED ANTIBODY COCKTAILS CURRENTLY AVAILABLE MOSTLY TARGET THE SPIKE PROTEINS ON THE VIRUS. IN TURN, OUR WORK IDENTIFIES WHICH PROTEINS IN THE HUMAN BODY THAT SARS-COV-2 AND OTHER CORONAVIRUSES LATCH ON TO."
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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RESEARCHERS DEMONSTRATE HOW CHRONIC ALCOHOL CONSUMPTION CAUSES INFLAMMATION IN THE BRAIN:ALCOHOL USE DISORDER IMPACTS MILLIONS OF PEOPLE AROUND THE WORLD, INCLUDING AT LEAST 17 MILLION AMERICANS. NEARLY 100,000 PATIENTS DIE EACH YEAR FROM THE CONSEQUENCES OF CHRONIC DRINKING, WHICH INDUCES ORGAN INJURY THROUGHOUT THE BODY, PARTICULARLY TO THE LIVER AND BRAIN. RESEARCH LED BY GYONGYI SZABO, MD, PHD, HON. SCD, CHIEF ACADEMIC OFFICER OF BIDMC AND BETH ISRAEL LAHEY HEALTH, SHED LIGHT ON THE MECHANISMS BY WHICH CHRONIC ALCOHOL CONSUMPTION CAUSES DAMAGE TO BRAIN CELLS AND CELLS OF THE CENTRAL NERVOUS SYSTEM, WHICH IN TURN POTENTIALLY TRIGGERS ADDICTIVE BEHAVIOR. THE FINDINGS, PUBLISHED IN THE JOURNAL OF NEUROINFLAMMATION, ALSO SUGGEST POSSIBLE TARGETS FOR A THERAPEUTIC APPROACH TO CHRONIC ALCOHOL USE DISORDER. "CHRONIC ALCOHOL EXPOSURE INDUCES A COMPLEX, MULTI-ORGAN RESPONSE WITH ACTIVATION OF A VARIETY OF IMMUNE RESPONSES AND INFLAMMATORY EXPRESSION," SAID SZABO. "OUR DATA IDENTIFIES THE SIGNALING PATHWAY BY WHICH CHRONIC ALCOHOL CONSUMPTION PROMOTES INFLAMMATION IN TISSUES OF THE CENTRAL NERVOUS SYSTEM AND OUR FURTHER ANALYSIS SUGGESTS A STRATEGY FOR BLOCKING THIS ALCOHOL-INDUCED NEUROINFLAMMATION." IN AN EXPERIMENT SZABO AND COLLEAGUES STUDIED THE IMPACT OF CHRONIC ALCOHOL-CONSUMPTION ON VARIOUS REGIONS OF THE BRAIN IN A MOUSE MODEL. THE SCIENTISTS OBSERVED THAT IMMUNE CELLS CALLED MACROPHAGES INVADED THE BRAIN PARENCHYMA (OR TISSUE), PARTICULARLY IN THE HIPPOCAMPUS - A REGION OF THE BRAIN CRITICAL TO LEARNING AND MEMORY THAT IS WELL KNOWN TO LOSE VOLUME IN PATIENTS WITH CHRONIC ALCOHOL USE DISORDER. SZABO AND COLLEAGUES POINT OUT THAT, FOR DECADES, SCIENTIFIC DOGMA HELD THAT IMMUNE CELLS COULD NOT REACH THE TISSUES OF THE CENTRAL NERVOUS SYSTEM (CNS). RESEARCHERS SUBSEQUENTLY DEMONSTRATED THE PRESENCE OF IMMUNE CELLS IN CNS TISSUES IN THE SETTING OF DISEASE. GENE EXPRESSION ANALYSIS REVEALED THE SIGNALING PATHWAY BY WHICH ALCOHOL CONSUMPTION PROMOTES NEUROINFLAMMATION. MOREOVER, THE RESEARCHERS ALSO DEMONSTRATED THAT BLOCKING IMMUNE CELL INVASION WITH AN INVESTIGATIONAL DRUG RESTORED SOME LOST BRAIN CELL FUNCTION; HOWEVER, ADMINISTRATION OF THE INVESTIGATIONAL DRUG DID NOT CHANGE THE ALCOHOL CONSUMPTION OR PREFERENCES OF THE LABORATORY ANIMALS. HOSPITALIZED PATIENTS WITH COVID-19 SIX TIMES MORE LIKELY TO DIE THAN PATIENTS HOSPITALIZED WITH INFLUENZA, RESEARCH FINDSCOVID-19 AND INFLUENZA ARE BOTH CONTAGIOUS RESPIRATORY VIRAL DISEASES THAT CAN LEAD TO PNEUMONIA AND ACUTE RESPIRATORY FAILURE IN SEVERE CASES. HOWEVER, DETAILED COMPARISON OF THE EPIDEMIOLOGY AND CLINICAL CHARACTERISTICS OF COVID-19 AND THOSE OF INFLUENZA ARE LACKING. IN A PAPER PUBLISHED IN THE JOURNAL OF GENERAL INTERNAL MEDICINE, PHYSICIAN-RESEARCHERS AT BIDMC ASSESSED THE RELATIVE IMPACT OF COVID-19 ON PATIENTS HOSPITALIZED WITH THE VIRAL INFECTION IN MARCH AND APRIL 2020, VERSUS PATIENTS HOSPITALIZED WITH INFLUENZA DURING THE LAST FIVE FLU SEASONS AT THE MEDICAL CENTER. OVERALL, THE TEAM DEMONSTRATED THAT COVID-19 CASES RESULTED IN SIGNIFICANTLY MORE WEEKLY HOSPITALIZATIONS, MORE USE OF MECHANICAL VENTILATION AND HIGHER MORTALITY RATES THAN INFLUENZA. CORRESPONDING AUTHOR MICHAEL DONNINO, MD, A CRITICAL CARE AND EMERGENCY MEDICINE PHYSICIAN AT BIDMC, AND COLLEAGUES INCLUDED A TOTAL OF 1,634 HOSPITALIZED PATIENTS IN THEIR STUDY, 582 OF WHOM HAD LABORATORY-CONFIRMED COVID-19 AND 1,052 OF WHOM HAD CONFIRMED INFLUENZA. WHILE 174 PATIENTS WITH COVID-19 (OR 30 PERCENT) RECEIVED MECHANICAL VENTILATION DURING THE TWO-MONTH PERIOD, JUST 84 PATIENTS WITH INFLUENZA (OR 8 PERCENT) WERE PLACED ON VENTILATION OVER ALL FIVE SEASONS OF INFLUENZA. LIKEWISE, THE PROPORTION OF PATIENTS WHO DIED WAS MUCH HIGHER FOR COVID-19 THAN FOR INFLUENZA; 20 PERCENT OF ADMITTED PATIENTS WITH COVID-19 DIED IN THE TWO-MONTH PERIOD, COMPARED TO THREE PERCENT OF PATIENTS WITH INFLUENZA OVER FIVE SEASONS. FURTHER ANALYSIS REVEALED THAT HOSPITALIZED PATIENTS WITH COVID-19 TENDED TO BE YOUNGER THAN THOSE HOSPITALIZED WITH INFLUENZA. AMONG PATIENTS REQUIRING MECHANICAL VENTILATION, PATIENTS WITH COVID-19 WERE ON VENTILATION MUCH LONGER - A MEDIAN DURATION OF TWO WEEKS - COMPARED TO JUST OVER THREE DAYS FOR PATIENTS WITH INFLUENZA. MOREOVER, AMONG PATIENTS REQUIRING MECHANICAL VENTILATION, PATIENTS WITH COVID-19 WERE FAR LESS LIKELY TO HAVE HAD PRE-EXISTING MEDICAL CONDITIONS. "OUR DATA ILLUSTRATE THAT 98 PERCENT OF THE DEATHS OF PATIENTS HOSPITALIZED WITH COVID-19 ARE DIRECTLY OR INDIRECTLY RELATED TO THEIR COVID-19 ILLNESS, WHICH HELPS DEBUNK THE IDEA THAT THE HIGH NUMBER OF U.S. COVID-19 DEATHS ARE AN ARTIFACT OF THE WAY CAUSES OF DEATHS ARE BEING RECORDED," SAID DONNINO. "WE ALSO SHOWED THAT COVID-19 CAUSED A SUBSTANTIAL NUMBER OF PATIENTS WITHOUT MAJOR PRE-EXISTING CONDITIONS TO REQUIRE MECHANICAL VENTILATION, WHICH HAPPENS RARELY IN PATIENTS WITH INFLUENZA," SAID DONNINO.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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BIDMC RESEARCHERS DEVELOP MODEL TO ESTIMATE FALSE-NEGATIVE RATE FOR COVID-19 TESTS AS OF JUNE 2020, THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) HAD GRANTED EMERGENCY USE AUTHORIZATION FOR MORE THAN 85 DIFFERENT VIRAL DNA TEST KITS - OR ASSAYS - EACH WITH WIDELY VARYING DEGREES OF SENSITIVITY AND UNKNOWN RATES OF ACCURACY. HOWEVER, WITH NO EXISTING GOLD STANDARD TEST FOR COVID-19, THERE'S LITTLE DATA ON WHICH TO JUDGE THESE VARIOUS TESTS' USEFULNESS. RESEARCHERS AT BIDMC DEVELOPED A MATHEMATICAL MEANS OF ASSESSING TESTS' FALSE-NEGATIVE RATE. THE TEAM'S METHODOLOGY, WHICH ALLOWS AN APPLES-TO-APPLES COMPARISON OF THE VARIOUS ASSAYS' CLINICAL SENSITIVITY, IS PUBLISHED IN THE JOURNAL CLINICAL INFECTIOUS DISEASES. "WE FOUND THAT CLINICAL SENSITIVITIES VARY WIDELY, WHICH HAS CLEAR IMPLICATIONS FOR PATIENT CARE, EPIDEMIOLOGY AND THE SOCIAL AND ECONOMIC MANAGEMENT OF THE ONGOING PANDEMIC," SAID CO-CORRESPONDING AUTHOR JAMES E. KIRBY, MD, DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORIES AT BIDMC. USING DATA FROM MORE THAN 27,000 TESTS FOR COVID-19 PERFORMED AT BETH ISRAEL LAHEY HEALTH HOSPITAL SITES FROM MARCH 26 TO MAY 2, 2020, KIRBY, AND CO-CORRESPONDING AUTHOR RAMY ARNAOUT, MD, DPHIL, ASSOCIATE DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORIES AT BIDMC, AND COLLEAGUES FIRST DEMONSTRATED THAT VIRAL LOADS CAN BE DEPENDABLY REPORTED. "THIS HELPS DISTINGUISH POTENTIAL SUPERSPREADERS, AT ONE EXTREME, FROM CONVALESCENT PEOPLE, WITH ALMOST NO VIRUS, AND THEREFORE LOW LIKELIHOOD OF SPREADING THE INFECTION," ARNAOUT SAID. NEXT, THE RESEARCHERS ESTIMATED THE CLINICAL SENSITIVITY AND THE FALSE-NEGATIVE RATE FIRST FOR THE IN-HOUSE TEST WHICH WAS AMONG THE FIRST TO BE IMPLEMENTED NATIONWIDE AND CONSIDERED AMONG THE BEST IN CLASS. ANALYZING REPEAT TEST RESULTS FOR THE NEARLY 5,000 PATIENTS WHO TESTED POSITIVE ALLOWED THE RESEARCHERS TO DETERMINE THAT THE IN-HOUSE TEST PROVIDED A FALSE NEGATIVE IN ABOUT 10 PERCENT OF CASES, GIVING THE ASSAY A CLINICAL SENSITIVITY OF ABOUT 90 PERCENT. TO ESTIMATE THE ACCURACY OF OTHER ASSAYS, THE TEAM BASED THEIR CALCULATIONS ON EACH TESTS LIMIT OF DETECTION, OR LOD, DEFINED AS THE SMALLEST AMOUNT OF VIRAL DNA DETECTABLE THAT A TEST WILL CATCH 95 PERCENT OR MORE OF THE TIME. ARNAOUT, KIRBY, AND COLLEAGUES DEMONSTRATED THAT THE LIMIT OF DETECTION CAN BE USED AS A PROXY TO ESTIMATE A GIVEN ASSAY'S CLINICAL SENSITIVITY. BY THE TEAM'S CALCULATIONS, AN ASSAY WITH A LIMIT OF DETECTION OF 1,000 COPIES VIRAL DNA PER ML IS EXPECTED TO DETECT JUST 75 PERCENT OF PATIENTS WITH COVID-19, PROVIDING ONE OUT OF EVERY FOUR PEOPLE WITH A FALSE-NEGATIVE. THE TEAM ALSO SHOWED THAT ONE TEST AVAILABLE TODAY MISSES AS MANY AS ONE IN THREE INFECTED INDIVIDUALS, WHILE ANOTHER MAY MISS UP TO 60 PERCENT OF POSITIVE CASES. FIRST-OF-ITS-KIND STUDY FOUND INFANTS OF SOCIALLY VULNERABLE MOTHERS WERE AT HIGHEST RISK OF COVID-19 INFECTIONIN A STUDY PUBLISHED IN JAMA NETWORK OPEN, PHYSICIAN-RESEARCHERS FROM BIDMC, BRIGHAM AND WOMEN'S HOSPITAL, BOSTON CHILDREN'S HOSPITAL AND MASSACHUSETTS GENERAL HOSPITAL REVEALED THAT, WHILE MOTHER-TO-NEWBORN TRANSMISSION OF THE VIRUS IS RARE, NEWBORNS OF EXPECTANT MOTHERS WITH COVID-19 CAN SUFFER INDIRECT ADVERSE HEALTH RISKS AS A RESULT OF WORSENING MATERNAL COVID-19 ILLNESS. EXAMINING NEONATAL OUTCOMES DURING THE FIRST MONTH OF LIFE FOR BABIES BORN AT 11 HOSPITALS THAT REPRESENT APPROXIMATELY 50 PERCENT OF ALL BIRTHS IN MASSACHUSETTS, THE TEAM IDENTIFIED 255 NEONATES DELIVERED BETWEEN MARCH 1 JULY 31, 2020, TO MOTHERS WITH A RECENT POSITIVE SARS-COV-2 TEST RESULT. THE RESEARCHERS USED THE AMERICAN ACADEMY OF PEDIATRICS' NATIONAL REGISTRY FOR SURVEILLANCE AND EPIDEMIOLOGY OF PERINATAL COVID-19 INFECTION COMPLEMENTED BY A MASSACHUSETTS-SPECIFIC REGISTRY. OUT OF THE 255 NEONATES STUDIED, 88.2 PERCENT WERE TESTED FOR SARS-COV-2, AND ONLY 2.2 PERCENT HAD POSITIVE RESULTS. HOWEVER, WHILE INFECTION RATES AMONG NEWBORNS WERE RELATIVELY LOW, WORSENING MATERNAL ILLNESS ACCOUNTED FOR 73.9 PERCENT OF PRETERM BIRTHS. PREMATURE BIRTH CAN OFTEN LEAD TO ACUTE AND CHRONIC COMPLICATIONS, INCLUDING RESPIRATORY DISTRESS, CHRONIC HEALTH PROBLEMS AND DEVELOPMENTAL DISABILITIES. NEWBORNS OF SOCIALLY VULNERABLE MOTHERS, AS DETERMINED USING A TOOL CREATED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION USING RESIDENTIAL ZIP-CODES, WERE AT AN INCREASED RISK FOR TESTING POSITIVE. THE SPECIFIC PATHWAYS BY WHICH SOCIAL VULNERABILITY MIGHT AFFECT MOTHER-TO-CHILD TRANSMISSION OF COVID-19 INCLUDE DIFFERENTIAL ACCESS TO CARE AND CLINICIAN BIAS. DISCRIMINATION MAY ALSO BE A FACTOR IN CHRONIC STRESS, WHICH CAN DIMINISH ANTIVIRAL IMMUNE RESPONSES. "THIS OBSERVATION THAT NEWBORNS OF SOCIALLY VULNERABLE MOTHERS WERE FIVE TIMES MORE LIKELY TO HAVE COVID-19 HIGHLIGHTS THAT HEALTH DISPARITIES ARE VERY COMPLEX AND EXTEND BEYOND RACE, ETHNICITY AND LANGUAGE STATUS," SAID CORRESPONDING AUTHOR ASIMENIA ANGELIDOU, MD, PHD, A NEONATOLOGIST AT BIDMC. "SOCIAL VULNERABILITY LIKELY AFFECTS HEALTH AND IMMUNITY AND OUR STUDY SUPPORTS FURTHER RESEARCH IN THIS AREA. REALLOCATION OF RESOURCES TO SOCIALLY VULNERABLE COMMUNITIES COULD GO A LONG WAY IN DECREASING HUMAN SUFFERING AND ECONOMIC LOSS DURING DISEASE OUTBREAKS."
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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JANUARY 20, 2020SCIENTISTS CREATE FIRST-OF-ITS-KIND 3D ORGANOID MODEL OF THE HUMAN PANCREAS BECAUSE PANCREATIC CANCER IS HIDDEN DEEP WITHIN THE BODY AND OFTEN SYMPTOMLESS, IT'S FREQUENTLY DIAGNOSED AFTER THE DISEASE HAS PROGRESSED TOO FAR FOR SURGICAL INTERVENTION AND/OR HAS SPREAD THROUGHOUT THE BODY. RESEARCH INDICATES THAT EARLIER DETECTION OF PANCREATIC TUMORS COULD QUADRUPLE SURVIVAL RATES; HOWEVER, NO VALIDATED AND RELIABLE TESTS FOR EARLY DETECTION OF PANCREATIC CANCER CURRENTLY EXIST. RESEARCHERS AT THE CANCER RESEARCH INSTITUTE AT BIDMC HAVE SUCCESSFULLY CREATED THE FIRST THREE-DIMENSIONAL (3D) ORGANOID MODELS OF THE PANCREAS FROM HUMAN STEM CELLS. UNLIKE PREVIOUS PLATFORMS FOR THE STUDY OF PANCREATIC CANCER, THIS FIRST-OF-ITS-KIND ORGANOID MODEL INCLUDES BOTH THE ACINAR AND DUCTAL STRUCTURES THAT PLAY A CRITICAL ROLE IN THE MAJORITY OF PANCREATIC CANCERS. THE NEW RESEARCH PLATFORM - WHICH IS NOT EXPECTED TO GUIDE PATIENT CARE AT THIS TIME - WILL SHED NEW LIGHT ON THE ORIGINS AND DEVELOPMENT OF PANCREATIC CANCER, AS WELL AS REVEAL POTENTIAL MEANS FOR DISCOVERING MARKERS OF EARLY DIAGNOSIS AND MONITORING THE DISEASE. THE TEAM'S REPORT APPEARS IN CELL STEM CELL. "WE THOUGHT, IF WE HAD A WAY TO USE HUMAN PANCREATIC CELLS TO FORWARD ENGINEER CANCER, WE COULD BEGIN TO UNDERSTAND THE EARLIEST STEPS IN THE DEVELOPMENT OF THIS DISEASE," SAID CORRESPONDING AUTHOR SENTHIL MUTHUSWAMY, PHD, DIRECTOR OF CELL BIOLOGY AT THE CANCER RESEARCH INSTITUTE AT BIDMC. "THIS MODEL COULD ALSO SERVE AS A PLATFORM TO POTENTIALLY DISCOVER BIOMARKERS - MEASURABLE CHANGES LINKED TO DISEASE - THAT WE HOPE TO USE IN THE CLINIC TO MONITOR CANCER DEVELOPMENT." THE PANCREAS IS A HORMONE-SECRETING ORGAN CONSISTING OF DUCTS AND ACINAR STRUCTURES, OR SACLIKE STRUCTURES THAT STORE PANCREATIC SECRETIONS. UNTIL NOW, SCIENTISTS HAVE NOT BEEN ABLE TO SUCCESSFULLY GROW AND MAINTAIN HUMAN ACINAR STRUCTURES IN THE LAB CHALLENGING THEIR ABILITY TO TEST THE HYPOTHESIS IN A MODEL. RESEARCHERS SUSPECT THAT THE MOST COMMON KIND OF PANCREATIC CANCER ARISES IN THE CELLS LINING ACINAR AND DUCTAL STRUCTURES.THE CULMINATION OF FIVE-PLUS YEARS' OF WORK, THE STUDY REPRESENTS THE FIRST TIME RESEARCHERS SUCCESSFULLY GENERATED HUMAN ACINAR CELLS IN CULTURE AND MAINTAINED THEM LONG ENOUGH TO BE ABLE TO USE THEM IN EXPERIMENTS. FINANCIAL BURDENS ASSOCIATED WITH CANCER CARE DISPROPORTIONATELY AFFECTS YOUNG, NON-WHITE PATIENTS WITH GYNECOLOGIC CANCERSTHE COST OF CANCER CARE IN UNITED STATES WAS AN ESTIMATED $183 BILLION IN 2015 AND IS PROJECTED TO RISE BY 30 PERCENT BY 2030, ACCORDING TO THE AMERICAN CANCER SOCIETY. WHILE PRIVATE AND GOVERNMENT INSURANCE MAY COVER MUCH OF THE COST OF CARE, EVEN PATIENTS WITH INSURANCE CAN STRUGGLE TO PAY FOR OFFICE VISIT CO-PAYMENTS, PRESCRIPTION MEDICATIONS OR OTHER CANCER-RELATED EXPENSES. YET LIMITED DATA DESCRIBES HOW FINANCIAL HARDSHIP IMPACTS PATIENT BEHAVIOR AND HOW THAT IN TURN MAY IMPACT PATIENTS' HEALTH. IN A STUDY DESIGNED TO PROVIDE A MORE COMPREHENSIVE PICTURE OF HOW A DIVERSE COHORT OF GYNECOLOGIC CANCER PATIENTS ARE AFFECTED BY FINANCIAL DISTRESS - ALSO CALLED "FINANCIAL TOXICITY" IN ACKNOWLEDGMENT OF THE HEALTH HAZARD IT CAN POSE - RESEARCHER-PHYSICIANS AT BIDMC AND THE UNIVERSITY OF ALABAMA (UAB) ANALYZED PREVIOUSLY COLLECTED SURVEY DATA OF GYNECOLOGIC ONCOLOGY PATIENTS FROM THEIR RESPECTIVE INSTITUTIONS. THEIR FINDINGS ARE REPORTED IN THE INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER. USING THE COMPREHENSIVE SCORE FOR FINANCIAL TOXICITY (COST) TO MEASURE THE ECONOMIC BURDEN EXPERIENCED BY PATIENTS WITH CANCER, CORRESPONDING AUTHOR KATHARINE M. ESSELEN, MD, MBA, OF THE DIVISION OF GYNECOLOGIC ONCOLOGY IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, AND COLLEAGUES ANALYZED PREVIOUSLY COLLECTED SURVEY DATA FROM 308 PATIENTS WITH GYNECOLOGIC CANCER - 240 PATIENTS SURVEYED AT BIDMC AND 121 SURVEYED AT UAB. THEY FOUND THAT NEARLY HALF OF PATIENTS WITH GYNECOLOGIC CANCER REPORTED EXPERIENCING MODERATE TO SEVERE FINANCIAL TOXICITY. FURTHER ANALYSIS OF SURVEY DATA REVEALED THAT YOUNGER PATIENTS WERE AT GREATER RISK OF EXPERIENCING FINANCIAL TOXICITY FOR A VARIETY OF REASONS. YOUNGER PATIENTS ARE NOT ELIGIBLE FOR MEDICARE, AND DIAGNOSIS AND TREATMENT MAY IMPACT THEIR ABILITY TO WORK. THEY HAVE ALSO HAD FEWER EARNING YEARS TO ACCUMULATE A FINANCIAL SAFETY NET. PATIENTS REPORTING SEVERE FINANCIAL TOXICITY ACCOUNTED FOR 15 PERCENT OF THOSE SURVEYED. ESSELEN AND COLLEAGUES FOUND THIS GROUP MORE LIKELY TO REPORT CHANGING SPENDING HABITS AND BORROWING MONEY DUE TO THE COSTS OF CANCER CARE. MOST ALARMINGLY, THOSE REPORTING SEVERE FINANCIAL HARDSHIP WERE NEARLY FIVE TIMES MORE LIKELY TO ATTEMPT TO COPE WITH THE HIGH COST OF CARE THROUGH MEDICATION NON-COMPLIANCE. IMMUNOTHERAPY MAY BE EFFECTIVE FOR SUBSET OF PROSTATE CANCER IN RECENT YEARS, CANCER IMMUNOTHERAPY HAS BEEN EFFECTIVE IN TREATING PATIENTS WITH IMMUNOGENIC, OR SO-CALLED "HOT" TUMORS WITH INCREASED LEVELS OF INFLAMMATION AND THE PRESENCE OF IMMUNE CELLS IN AND AROUND THE TUMORS. PROSTATE CANCER, HOWEVER, IS CONSIDERED A "COLD" TUMOR, WITH FEW IMMUNE CELLS RECOGNIZING AND INFILTRATING PROSTATE MALIGNANCIES. ACCORDINGLY, PROSTATE CANCER HAS BEEN FOUND TO RESPOND POORLY TO THE CLASS OF IMMUNOTHERAPIES KNOWN AS IMMUNE CHECKPOINT INHIBITORS.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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IN PREVIOUS WORK, A TEAM LED BY MEDICAL ONCOLOGISTS AT BIDMC IDENTIFIED A SUBSET OF PROSTATE CANCERS THAT EXHIBITED CHARACTERISTICS MORE TYPICAL OF HOT CANCERS. IN A PAPER APPEARING IN THE JOURNAL CLINICAL CANCER RESEARCH, RESEARCHERS REPORT THAT ABOUT A QUARTER OF LOCALIZED PROSTATE CANCERS MAY DEMONSTRATE THESE IMMUNOLOGIC TRAITS, SUGGESTING THAT A SUBSTANTIAL NUMBER OF PATIENTS WITH PROSTATE CANCER MAY, IN FACT, BENEFIT FROM IMMUNOTHERAPIES. "WE WERE SURPRISED TO FIND ALL THE FEATURES OF MORE TRADITIONALLY IMMUNOGENIC CANCERS IN THESE PROSTATE CANCERS, AND THAT THIS IS NOT A RARE SUBTYPE, OBSERVED IN ABOUT A QUARTER OF HIGH-RISK TUMORS," SAID CO-CORRESPONDING AUTHOR DAVID J. EINSTEIN, MD, A MEDICAL ONCOLOGIST AT BIDMC. "WE'RE INTERESTED IN WHETHER THERE IS A SUBSET OF PATIENTS WITH LOCALIZED PROSTATE CANCER, ESPECIALLY MORE AGGRESSIVE ONES, WHOSE CANCERS MIGHT BE MORE RECOGNIZED BY THE IMMUNE SYSTEM AND THEREFORE MORE TREATABLE WITH IMMUNOTHERAPIES. THESE WOULD ALSO BE SOME OF THE PATIENTS AT GREATEST RISK FOR RELAPSE AND METASTATIC SPREAD." EINSTEIN AND COLLEAGUES, INCLUDING CO-CORRESPONDING AUTHOR STEVEN BALK, MD, PHD, A PHYSICIAN AT BIDMC, FOCUSED ON TWO CHARACTERISTICS THAT MAKE TRADITIONALLY IMMUNOGENIC CANCERS SUSCEPTIBLE TO IMMUNOTHERAPY: PD-L1 EXPRESSION AND T CELL INFILTRATION. PD-L1 IS A PROTEIN INVOLVED IN TUMOR EVASION OF THE IMMUNE SYSTEM. T CELLS ARE THE SENTINELS OF THE IMMUNE SYSTEM, PATROLLING THE BODY FOR POTENTIAL PATHOGENS OR DISEASE. THE RESEARCHERS IDENTIFIED PROSTATE CANCERS THAT HAD BEEN REMOVED FROM PATIENTS, LOOKING FOR THOSE THAT HAD AREAS OF HIGH PD-L1 EXPRESSION AND THEN LOOKED FOR THE PRESENCE OF INFILTRATING T CELLS. NEXT, THE TEAM COMPARED THE T CELL LANDSCAPE IN THE MORE IMMUNOGENIC PROSTATE CANCERS TO THAT OF MORE TYPICAL PROSTATE CANCERS, AS WELL AS TO KIDNEY CANCER, ONE OF THE MOST IMMUNOGENIC TUMOR TYPES. FINALLY, THE TEAM USED DNA SEQUENCING TO COMPARE THE GENETIC PROFILES FROM THESE IMMUNOLOGICALLY HOT AREAS TO THAT OF THE SO-CALLED COLD AREAS IN THE SAME TUMORS, AS WELL AS TO THE GENOMIC LANDSCAPE OF IMMUNOGENIC CANCERS IN GENERAL. THE SCIENTISTS WERE SURPRISED TO LEARN HOW MANY MORE T CELLS INFILTRATED THE IMMUNOGENIC PROSTATE CANCERS COMPARED WITH MORE TYPICAL PROSTATE CANCERS, AND TO OBSERVE ALL THE FEATURES OF MORE TRADITIONALLY IMMUNOGENIC CANCERS LIKE KIDNEY CANCER IN THESE MORE IMMUNOGENIC PROSTATE CANCERS. THEY ALSO NOTED SIGNIFICANTLY MORE LOSS OF SOME KEY TUMOR SUPPRESSOR GENES IN THESE IMMUNOGENIC PROSTATE CANCERS COMPARED WITH TYPICAL PROSTATE CANCER, A DIFFERENCE THAT COULD POTENTIALLY SERVE AS MARKERS TO FIND CANCERS MORE TREATABLE WITH IMMUNOTHERAPIES. LHMC-ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, LHMC IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS 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. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.BETH ISRAEL LAHEY HEALTH (BILH) IS THE PARENT AND A SUPPORT ORGANIZATION OF THE BILH NETWORK OF AFFILIATES. THE NETWORK COMPRISES AN INTEGRATED HEALTH CARE DELIVERY 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 INCLUDES 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, 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. AS A SUPPORT ORGANIZATION OF THESE ENTITIES, BILH PROVIDES CENTRALIZED SERVICES AND SUPPORT TO ITS AFFILIATES IN AREAS SUCH AS MANAGEMENT, STRATEGIC PLANNING, HUMAN RESOURCES AND BENEFITS, DEVELOPMENT AND FUNDRAISING, LEGAL SERVICES, FINANCE, TREASURY, INVESTMENT, INSURANCE, COMPLIANCE AND TAXATION AS WELL AS PATIENT CARE CONTRACTING AND OTHER SERVICES.BILH'S SUPPORT OF ITS AFFILIATES ENABLES THE NETWORK AS A WHOLE TO ACCOMPLISH ITS PRIMARY MISSION OF IMPROVING THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO USE SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE AND BILH IS ACCOMPLISHING THIS GOAL BY PROVIDING SUPPORT TO EACH OF ITS AFFILIATES, PROVIDING AN ORGANIZATIONAL STRUCTURE AND OPERATING MODEL WHICH IS DRIVEN BY FOUR DEEPLY INTERCONNECTED DOMAINS DESIGNED TO ADVANCE MEANINGFUL PARTNERSHIPS ACROSS ORGANIZATIONS, CARE SETTINGS, SPECIALTIES, AND GEOGRAPHIES TO ENSURE BILH PATIENTS RECEIVE THE CARE THEY NEED IN THE COMMUNITIES WHERE THEY LIVE AND WORK.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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BILH IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. BILH IS ACCOMPLISHING THIS MISSION BY PROVIDING SUPPORT TO ITS AFFILIATES WHICH INCLUDE:1. A PHYSICIAN ENTERPRISE THAT ENCOMPASSES THE SYSTEM'S NETWORK OF EMPLOYED PRIMARY CARE AND SPECIALTY PHYSICIANS LOCATED THROUGHOUT OUR REGION;2. A HOSPITAL AND AMBULATORY SERVICES GROUP THAT INCLUDES WORLD-CLASS ACADEMIC MEDICAL CENTERS AND TEACHING HOSPITALS WITH AFFILIATIONS WITH HARVARD MEDICAL SCHOOL AND TUFTS UNIVERSITY SCHOOL OF MEDICINE; LEADING COMMUNITY HOSPITALS; A RENOWNED ORTHOPEDICS HOSPITAL; AND COMPREHENSIVE AMBULATORY CENTERS;3. A POPULATION HEALTH ENTERPRISE THAT EMBRACES A NEW MODEL OF CARE TO IMPROVE THE HEALTH OF ALL THOSE SERVED BY BILH; THE POPULATION HEALTH DOMAIN INCLUDES THE SYSTEM'S CLINICALLY INTEGRATED NETWORK OF AFFILIATED PROVIDERS AND VITAL SERVICES, INCLUDING BEHAVIORAL HEALTH AND HOME CARE SERVICES;4. A ROBUST NETWORK OF ADMINISTRATIVE AND OPERATIONAL SERVICES TO ADVANCE STRATEGIC GOALS, BOTH LOCALLY AND AT THE SYSTEM LEVEL, THAT OFFERS EXPERTISE AND STANDARDIZED RESOURCES BASED ON BEST PRACTICES.BILH BEHAVIORAL HEALTH SERVICESTHE 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.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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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.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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BETH ISRAEL LAHEY HEALTH'S COVID-19 PANDEMIC RESPONSEAS 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 SUPPORTOIN 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. O 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.O 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 VACCINATIONO 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. O 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. O 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. O 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.TESTINGO 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. O 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.O 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.O 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 EFFORTSO 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. O 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.
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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TREATMENT:O 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.O 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 SUPPORTO 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.O 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.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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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.