TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) NESTO MD RICHARD...................................................................... TTEE (EX-OF)(CEO DESIGNEE); BILH CMO	1.00 ................. 54.00	X		0	1,341,157	41,369
(2) GOLDSTEIN MARK...................................................................... TTEE (EX-OFF); AJH & SAGP PRES	55.00 ................. 5.00	X	X	124,787	818,858	36,639
(3) PURSLEY MD DEWAYNE M...................................................................... TTEE; CHIEF OF NEONATOLOGY (BIDMC)	1.00 ................. 57.00	X		0	754,479	78,687
(4) CONNOLLY ESQ GRACE GONZALEZ...................................................................... TRUSTEE & CHAIR	10.00 ................. 1.00	X	X	0	0	0
(5) ERAMO GINNY...................................................................... TRUSTEE, ASSISTANT CLERK	1.00 ................. 1.00	X	X	0	0	0
(6) KIRPAS JEFF...................................................................... TRUSTEE, VICE CHAIR	1.00 ................. 1.00	X	X	0	0	0
(7) BOUTON PHD CHRISTOPHER...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(8) CANNON PATRICIA...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(9) CAPOLUPO WAYNE...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(10) COSTELLO MICHAEL...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(11) COUSINS JR FRANK G...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(12) FELTER TIMOTHY...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(13) FUNG MD CLAIRE...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(14) GHIASUDDIN MD SALMAN...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(15) KHATIB MATT...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(16) MATTHEWS BYRON...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(17) PIENIAZEK MATT...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) PURINTON ELIZABETH........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(19) SEYMOUR MD PETER........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(20) SHENK III WILBUR........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(21) TARKAN MD JOSHUA........................................................................ TRUSTEE (EX-OFF); PRES OF MED STAFF	1.00 .......................1.00	X					0	0	0
(22) TRIM JEAN........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(23) WILEY MARGARET........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(24) TABB MD KEVIN........................................................................ CHIEF EXECUTIVE OFFICER (EX-OFFICIO)	1.00 .......................64.00		X				0	5,034,628	296,171
(25) KERNDL JOHN........................................................................ TREASURER (EX-OFF); BILH EVP & CFO	1.00 .......................64.00		X				0	1,365,000	26,877
(26) KATZ ESQ JAMIE........................................................................ CLERK (EX-OFF); BILH GEN COUNSEL	1.00 .......................64.00		X				0	1,255,848	22,043
(27) KILDAY KEVIN........................................................................ CFO	55.00 .......................1.00		X				411,235	0	81,275
(28) SOLDANO JOSEPH........................................................................ CO-INTERIM CFO, DIRECTOR OF FINANCIAL PLANNING	55.00 .......................1.00		X				164,394	0	53,598
(29) CIAMPA STEVEN........................................................................ CO-INT CFP,DIR OF FIN (AS OF 1/1/22)	1.00 .......................1.00		X				0	0	0
(30) MAKI DN RN RICHARD........................................................................ CNO	55.00 .......................0.00			X			293,774	0	51,876
(31) LEE GARY........................................................................ VP, CLINICAL OPERATIONS	55.00 .......................0.00			X			225,298	0	57,110
(32) BUCHANAN JRROBERT R........................................................................ DIR OF INFO. SYSTEMS	55.00 .......................0.00				X		191,423	0	70,578
(33) PERRYDANIELLE C........................................................................ VP PUBLIC RELATIONS	55.00 .......................0.00				X		218,321	0	37,518
(34) NEWSOME-LEVINSANDRA L........................................................................ CHIEF QUALITY OFFICER, VP	55.00 .......................0.00				X		164,932	0	62,446
(35) HIGGINSLISA M........................................................................ REGISTERED NURSE	55.00 .......................0.00				X		184,078	0	40,419
(36) WILLIAMSONMARY E........................................................................ VP DVLPMT & ED OF THE ANNA JAQ COMM HLTH FOUND	55.00 .......................0.00				X		174,141	0	45,590
(37) FISCHER STEVEN P........................................................................ FRMR EX-OFF TREAS; FRMR BILH EVP&CFO	0.00 .......................0.00					X	0	974,820	47,235
(38) FAYRE MD GAIL........................................................................ FORMER CMO OF AJH & COO OF SAGP	0.00 .......................0.00					X	566,875	0	60,906

(A) Name and business address	(B) Description of services	(C) Compensation
CARDINAL HEALTH-PHARMACEUTICAL 5303 COLLECTIONS CENTER DRIVE CHICAGO,IL60693	MED SUPPLIES	9,541,674
COLUMBIA CONSTRUCTION COMPANY 100 RIVERPARK DR NORTH READING,MA01864	CONSTRUCTION SERVICES	6,200,422
CROTHALL CLINICAL EQUIPMENT SERVICE 13028 COLLECTIONS CENTER DRIVE CHICAGO,IL60693	EQUIPMENT	1,565,339
NE IP SPECIALISTS 47 HIGH ST STE 101 NORTH ANDOVER,MA01845	PHYSICIAN SERVICES	1,243,333
ASHLAND COMMERCIAL CONSTRUCTION CO 2 CENTENNIAL DR SUITE C PEABODY,MA01960	CONSTRUCTION SERVICES	1,088,470
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 51

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Part I

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

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

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

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2021

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990) 2021

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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

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

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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

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

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

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

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

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

Schedule A (Form 990) 2021

Page 6

Part V

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

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

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

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

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

Schedule A (Form 990) 2021

Page 7

Part V

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

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2021

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization ANNA JAQUES HOSPITAL INC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization ANNA JAQUES HOSPITAL INC		Employer identification number 04-2104338

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization ANNA JAQUES HOSPITAL INC			Employer identification number 04-2104338
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

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

OMB No. 1545-0047

2021

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

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

Yes

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

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

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

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

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

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

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

Yes

61,557

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

61,557

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	ANNA JAQUES HOSPITAL, INC. ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER NETWORK AFFILIATES AND/OR PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $61,557 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES.

Return Reference

Explanation

PART II-B, LINE 1:

ANNA JAQUES HOSPITAL, INC. ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER NETWORK AFFILIATES AND/OR PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $61,557 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	10,162,352	14,408,734	20,080,614	20,018,666	18,808,414
b	Contributions ...	0	11,470,408		0
c	Net investment earnings, gains, and losses	-1,437,973	440,638	444,089	157,707	1,210,252
d	Grants or scholarships ...				0
e	Other expenditures for facilities and programs ...	334,713	16,157,428	6,115,969	95,759
f	Administrative expenses ....
g	End of year balance ......	8,389,666	10,162,352	14,408,734	20,080,614	20,018,666

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

24.000 %

Term endowment SchDMd Bullet

76.000 %

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

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

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

1a	Land .....	2,459,100		2,459,100
b	Buildings ....	32,207,933	7,237,422	24,970,511
c	Leasehold improvements	3,377,737	941,498	2,436,239
d	Equipment ....	20,210,440	10,673,676	9,536,764
e	Other .....	2,459,527	368,597	2,090,930
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				41,493,544

Schedule D (Form 990) 2021

Page 3

Part VII

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

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

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

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1)ACCOUNTS RECEIVABLE OTHER				428,058
(2)INSURANCE RECOVERIES RECEIVABLE				540,024
(3)DUE FROM AJH AFFILIATES				8,801,995
(4)OPERATING LEASE ROU ASSETS				7,151,062
(5)INVESTMENT IN JOINT VENTURES				837,923
(6)DEFERRED COMPENSATION 457B				2,553,290
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				20,312,352

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	43,146,837
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	6,825,322,000
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	6,686,664,073
e	Add lines 2a through 2d .....................			2e	6,686,664,073
3	Subtract line 2e from line 1..................			3	138,657,927
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	138,657,927

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	7,267,359,000
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	7,117,173,007
e	Add lines 2a through 2d....................			2e	7,117,173,007
3	Subtract line 2e from line 1...................			3	150,185,993
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	150,185,993

Part XIII

Supplemental Information

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

Return Reference	Explanation
PART V, LINE 4:	THE BOARD DESIGNATED FUNDS ON ANNA JAQUES HOSPITAL, INC.'S BOOKS ARE UNRESTRICTED, BUT REQUIRE A BOARD VOTE TO AUTHORIZE THEIR EXPENDITURE. THE TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE RESTRICTED BY THE DONORS FOR THE PURCHASE OF PROPERTY, PLANT AND EQUIPMENT. THE FUND WILL BE RELEASED ONCE THE RESTRICTION HAS BEEN MET AND THE EQUIPMENT HAS BEEN PURCHASED.
PART X, LINE 2:	BETH ISRAEL LAHEY HEALTH, INC., WHICH SERVES AS THE PARENT OF THE SYSTEM, HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE AN ORGANIZATION DESCRIBED UNDER INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ALSO DETERMINED THAT THE OTHER ENTITIES IN THE SYSTEM, EXCLUDING ITS FOR-PROFIT SUBSIDIARIES, QUALIFY AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, MEET THE CODE'S REQUIREMENTS UNDER SECTION 509(A), AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS IN 2022 AND 2021, RESPECTIVELY.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	CONSOLIDATED AFFILIATES NET ELIMINATIONS 6,686,664,073.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	CONSOLIDATED AFFILIATES NET ELIMINATIONS 7,117,173,007.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

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

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

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Part I

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

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

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

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

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

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

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)		(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
			Yes	No
	ZURI GROUP LLC 328 NW BOND ST BEND, OR97701	STRATEGY CONSULTING		No	0	11,584	0
	RAISE THE BAR LLC 36 RANGELEY RD NEWTON, MA02465	REPORTING CONSULTING		No	0	7,437	0








Total . . . . . . . . . . . . . . . . . . . .						19,021

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

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

Cat. No. 50083H

Schedule G (Form 990) 2021

Page 2

Part II

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

		(a) Event #1 GOLF TOURNAMENT (event type)	(b) Event #2 GREAT CHEFS (event type)	(c) Other events 2 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	135,395	57,790	31,829	225,014
2	Less: Contributions . . . .	89,269	44,577	26,555	160,401
3	Gross income (line 1 minus line 2) . . . . . .	46,126	13,213	5,274	64,613

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	24,555	24,555
7	Food and beverages . . .	14,062	14,062
8	Entertainment . . . .
9	Other direct expenses . . .	10,301	10,301
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		48,918
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		15,695

Part III

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

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

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

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

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

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

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

YesNo

If "No," explain:

10a

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

YesNo

If "Yes," explain:

Schedule G (Form 990) 2021

Page 3

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

YesNo

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

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

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

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

13b

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

Name

Address

15a

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

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

YesNo

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

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

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

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

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

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

YesNo

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

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

Part IV

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

Return Reference	Explanation

Schedule G (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	1,232,893	536,458	696,435	0.470 %
b	Medicaid (from Worksheet 3, column a) . . . . .	4,462,883	1,468,476	2,994,407	2.020 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	5,695,776	2,004,934	3,690,842	2.490 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	950,844	419,955	530,889	0.360 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	23,389,662	11,118,369	12,271,293	8.280 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	127,758		127,758	0.090 %
j	Total. Other Benefits . .	24,468,264	11,538,324	12,929,940	8.730 %
k	Total. Add lines 7d and 7j .	30,164,040	13,543,258	16,620,782	11.220 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,064,119

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

46,122,868

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

51,839,241

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

-5,716,373

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	ANNA JAQUES HOSPITAL 25 HIGHLAND AVE NEWBURYPORT,MA01950 2006	X	X	X

Schedule H (Form 990) 2021

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ANNA JAQUES HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.AJH.ORG

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART VI

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ANNA JAQUES HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

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

SEE PART VI

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

SEE PART VI

A plain language summary of the FAP was widely available on a website (list url):

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	ANNA JAQUES HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	ANNA JAQUES HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
ANNA JAQUES HOSPITAL	PART V, SECTION B, LINE 5: PART V, SECTION B, LINE 5: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION.
ANNA JAQUES HOSPITAL	PART V, SECTION B, LINE 11: PART V, SECTION B, LINE 11: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION.

Schedule H (Form 990) 2021

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?7
Name and address		Type of Facility (describe)
1	1 - ANNA JAQUES HOSPITAL 1 WALLACE BASHAW WAY NEWBURYPORT,MA01950	OP ONCOLOGY
2	2 - ANNA JAQUES HOSPITAL 21 HIGHLAND AVE NEWBURYPORT,MA01950	OP SERVICES
3	3 - ANNA JAQUES HOSPITAL ONE PARK WAY HAVERHILL,MA01830	OP DIAGNOSTIC IMAGING
4	4 - ANNA JAQUES HOSPITAL 25 STOREY AVENUE NEWBURYPORT,MA01950	OP PYHSICAL THERAPY
5	5 - ANNA JAQUES HOSPITAL 255 LOW STREET NEWBURYPORT,MA01950	OTHER
6	6 - ANNA JAQUES HOSPITAL 600 PRIMROSE STREET HAVERHILL,MA01830	OTHER
7	7 - ANNA JAQUES HOSPITAL 13 MARKET STREET NEWBURYPORT,MA01950	OTHER
8
9
10

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSANNA JAQUES HOSPITAL AFFILIATIONANNA JAQUES HOSPITAL 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.ANNA JAQUES HOSPITAL COMMUNITY BENEFITS MISSION STATEMENT THE MISSION OF ANNA JAQUES HOSPITAL IS TO PROVIDE HIGH-QUALITY, COMPASSIONATE MEDICAL CARE IN PARTNERSHIP WITH ITS MEDICAL STAFF TO IMPROVE THE HEALTH OF ITS COMMUNITIES. ESTABLISHED IN 1884 THROUGH THE VISION AND CHARITY OF MISS ANNA JAQUES, THE HOSPITAL STANDS AS A TESTAMENT TO ONE WOMAN AND HER PHYSICIAN'S COMMITMENT TO THE COMMUNITY AND ITS NEEDS. AJH PROUDLY CONTINUES THAT TRADITION TODAY BY ACTIVELY SERVING ITS COMMUNITY: BY ADDRESSING THE MOST PRESSING HEALTH NEEDS, SUPPORTING THE UNDERSERVED IN THE HOSPITAL'S SERVICE AREA, AND ADDRESSING DISPARITIES IN ACCESS TO CARE AND HEALTH OUTCOMES.ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING ANNA JAQUES HOSPITAL STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE HOSPITAL'S THREE-YEAR IMPLEMENTATION STRATEGY. ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS, AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES. ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED NEEDS AND IDENTIFY COMMUNITIES AND POPULATION SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, ECONOMIC AND SYSTEMIC FACTORS. IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN ANNA JAQUES HOSPITAL CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED. PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, ANNA JAQUES HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $658,647 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE ANNA JAQUES HOSPITAL'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS CBSA AND BEYOND. ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF ANNA JAQUES HOSPITAL'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF THE ANNA JAQUES HOSPITAL'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. ANNA JAQUES HOSPITAL COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY A COMMUNITY BENEFITS MANAGER. THE COMMUNITY BENEFITS MANAGER HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE ANNA JAQUES 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 COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE ANNA JAQUES HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH ANNA JAQUES HOSPITAL'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS MISSION TO PROVIDE HIGH-QUALITY, COMPASSIONATE MEDICAL CARE IN PARTNERSHIP WITH ITS MEDICAL STAFF TO IMPROVE THE HEALTH OF ITS COMMUNITIES. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF ANNA JAQUES HOSPITAL'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY ANNA JAQUES 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. AJH'S HOSPITAL'S CBAC MEMBERS INCLUDE: MICHELLE BRASIER, PRACTICE MANAGER, BETH ISRAEL LAHEY PRIMARY CARE HAVERHILL ANDI EGMONT, DIRECTOR OF YOUTH SERVICES AND THE BEACON COALITION, CITY OF NEWBURYPORT TRACY FULLER, REGIONAL EXECUTIVE DIRECTOR, HAVERHILL YMCA ILENE HARNCH-GRADY, ENCORE PROGRAM LEADER, YWCA OF NEWBURYPORT CHRISTINE HEALEY, DIRECTOR OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, NORTH REGION, BETH ISRAEL LAHEY HEALTH TINA LOS, PROJECT COORDINATOR, ESSEX COUNTY ASSET BUILDER NETWORK TIFFANY NIGRO, EXECUTIVE DIRECTOR, THE PETTENGILL HOUSE PAM PALOMBO, PUBLIC HEALTH NURSE, CITY OF NEWBURYPORT OFFICER DANI SINCLAIR, NEWBURYPORT POLICE; ESSEX COUNTY OUTREACH JEAN TRIM, MANAGING DIRECTOR & PORTFOLIO MANAGER, VIGILANT CAPITAL MANAGEMENT, LLC; MEMBER, AJH BOARD OF TRUSTEES SHARI WILKINSON, MARKET COORDINATOR, NEWBURYPORT FARMERS MARKET 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 REVENUE CODE (IRC) OF 1986, AS AMENDED. ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE ANNA JAQUES HOSPITAL BOARD OF TRUSTEES ON SEPTEMBER 1, 2022. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 1, 2022, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R).
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	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 ANNA JAQUES HOSPITAL'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT ANNA JAQUES HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW ANNA JAQUES HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2022 COMMUNITY HEALTH NEEDS ASSESSMENTPRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF ANNA JAQUES HOSPITAL'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES AMESBURY, HAVERHILL, MERRIMAC, NEWBURYPORT, AND SALISBURY.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF AMESBURY, HAVERHILL, MERRIMAC, NEWBURYPORT, SALISBURY IN ITS CBSA, AS FOLLOWS: YOUTH LOW-RESOURCED POPULATIONS OLDER ADULTS RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INDIVIDUALS WITH DISABILITIES2022 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSANNA JAQUES HOSPITAL'S 2022 CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING ANNA JAQUES HOSPITAL'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. ANNA JAQUES HOSPITAL'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, ANNA JAQUES HOSPITAL CONDUCTED 18 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED THREE FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 750 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 800 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY PARTNERS.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSANNA JAQUES HOSPITAL RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. ANNA JAQUES HOSPITAL COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT ANNA JAQUES HOSPITAL LEVERAGED INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020) U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020) U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021) BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, 2019 MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) FBI UNIFORM CRIME REPORTS (2019) MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020) MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018) ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, ANNA JAQUES HOSPITAL CONDUCTED 18 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT ANNA JAQUES HOSPITAL'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON ANNA JAQUES HOSPITAL'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN ANNA JAQUES HOSPITAL'S CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)ANNA JAQUES HOSPITAL CONDUCTED 3 COMMUNITY FOCUS GROUPS AND HELD TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED 800 RESIDENTS IN ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE SESSIONS WERE ORGANIZED IN COLLABORATION WITH THE LINK HOUSE IN AMESBURY, AMESBURY HIGH SCHOOL -LGBTQ YOUTH AND THE PETTENGILL HOUSE. ANNA JAQUES HOSPITAL HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF ANNA JAQUES HOSPITAL'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN MULTIPLE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, FOOD PANTIES AND COMMUNITY EVENTS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE ANNA JAQUES HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS WITH THE ANNA JAQUES HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS. IDENTIFY ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE ANNA JAQUES HOSPITAL'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY ANNA JAQUES HOSPITAL DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021).2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2022, WERE: YOUTH LOW-RESOURCED POPULATIONS OLDER ADULTS RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INDIVIDUALS WITH DISABILITIESANNA JAQUES HOSPITAL'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY. HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY, AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023; SEPTEMBER 30, 2024; AND SEPTEMBER 30, 2025. PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFITS ACTIVITIES REPORTED IN THIS FORM 990 SCHEDULE HAS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, ANNA JAQUES HOSPITAL MOST RECENTLY COMPLETED CHNA WAS COMPLETED DURING THE FISCAL YEAR ENDED 2022 AND THE FIRST YEAR OF ACCOMPLISHMENTS UNDER THAT CHNA AND IMPLEMENTATION STRATEGY (IS) WILL BE REPORTED IN THE FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2023. THE PRIOR CHNA AND CHIP PROCESS WHICH WAS COMPLETED BY ANNA JAQUES HOSPITAL IN 2019 INFORMED THE COMMUNITY BENEFITS OPERATIONS AND ACCOMPLISHMENTS REPORTED IN THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS DESCRIBED IN DETAIL BELOW. 2019 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONANNA JAQUES HOSPITAL COMPLETED ITS 2019 ASSESSMENT IN SEPTEMBER 2019. THE GEOGRAPHICAL FOCUS OF ANNA JAQUES HOSPITAL'S 2019 CHNA ENCOMPASSES HAVERHILL, NEWBURYPORT, AMESBURY, SALISBURY, GEORGETOWN, NEWBURY, MERRIMAC, GROVELAND, WEST NEWBURY, AND ROWLEY.TARGET POPULATIONS FOR ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES WERE 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).ANNA JAQUES HOSPITAL'S TARGET POPULATIONS FOCUSED ON MEDICALLY UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN THE TOWNS ABOVE, AS FOLLOWS: YOUTH AND ADOLESCENTS OLDER ADULTS INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE ASSESSMENT BEGAN IN DECEMBER 2018 AND WAS CONDUCTED IN THREE PHASES, ALLOWING FOR THE COLLECTION OF AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA:PHASE 1 PRELIMINARY ASSESSMENT AND ENGAGEMENTPHASE 2 TARGETED ENGAGEMENTPHASE 3 STRATEGIC PLANNING AND REPORTINGINDIVIDUALS FROM ACROSS ANNA JAQUES HOSPITAL'S SERVICE AREA WERE ENGAGED IN THE ASSESSMENT AND PLANNING PROCESS, INCLUDING HEALTH AND SOCIAL SERVICES PROVIDERS, PUBLIC HEALTH OFFICIALS, PUBLIC SCHOOL NURSES AND ADMINISTRATORS, FIRST RESPONDERS, LEADERS OF FAITH-BASED ORGANIZATIONS, BILH SENIOR LEADERSHIP, STAFF, BOARD MEMBERS, AND COMMUNITY RESIDENTS. MEMBERS OF THE COMMUNITY BENEFITS ADVISORY COMMITTEE PROVIDED LEADERSHIP, DIRECTION, AND INPUT, AS WELL AS CONNECTED AJH TO AVAILABLE COMMUNITY DATA AND RESOURCES THAT REPRESENTS THE BROAD INTERESTS OF THE COMMUNITY TO DRIVE THE CONTENT OF THE CHNA.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSQUANTITATIVE DATA SOURCES: THE QUANTITATIVE ASSESSMENT INCLUDED AN EXTENSIVE ANALYSIS OF DEMOGRAPHIC AND SOCIOECONOMIC DATA, HEALTH STATUS, UTILIZATION RATES, AND BEHAVIORAL RISK SURVEY DATA. DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN ANNA JAQUES HOSPITAL'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF HEALTH-RELATED ISSUES. U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES FBI UNIFORM CRIME REPORTS (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, OPIOID RELATED EMS INCIDENTS (2018) QUALITATIVE DATA SOURCES: TO OBTAIN TARGETED DATA AND UNDERSTAND THE CURRENT ISSUES FACING THE COMMUNITY: INTERNAL STAKEHOLDER INTERVIEWS (BOARD MEMBERS, SENIOR LEADERS, AND SERVICE LINE LEADERS) EXTERNAL STAKEHOLDER INTERVIEWS2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)WHILE IT WAS NOT POSSIBLE FOR THIS ASSESSMENT TO INVOLVE ALL COMMUNITY STAKEHOLDERS, WE MADE AN EFFORT TO BE INCLUSIVE AND TO PROVIDE A BROAD RANGE OF OPPORTUNITIES FOR PARTICIPATION OVER THE COURSE OF SEVERAL MONTHS. ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS BUILT ON PARTNERSHIP AND DIALOGUE WITH OUR MANY COMMUNITIES. OUR UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM DISCUSSIONS WITH AND OBSERVATIONS BY HEALTHCARE AND HEALTH-RELATED WORKERS IN THE NEIGHBORHOODS. THIS DATA WAS THEN AUGMENTED BY DEMOGRAPHIC AND HEALTH STATUS INFORMATION FROM A VARIETY OF SOURCES INCLUDING THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, FEDERAL RESOURCES SUCH AS THE INSTITUTE OF MEDICINE, AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. AN ARTICULATION OF EACH SPECIFIC COMMUNITY'S NEEDS (CRAFTED JOINTLY BY ANNA JAQUES AND COMMUNITY PARTNERS) INFORMS ANNA JAQUES HOSPITAL'S DECISION-MAKING ABOUT PRIORITIES FOR COMMUNITY BENEFITS EFFORTS. WE WORK IN CONCERT WITH COMMUNITY RESIDENTS AND LEADERS TO DESIGN SPECIFIC ACTIONS TO BE UNDERTAKEN EACH YEAR. EACH COMPONENT OF THE PLAN IS EVENTUALLY WOVEN INTO THE ANNUAL GOALS AND THE AGENDA FOR THE ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS IMPLEMENTATION STRATEGY, ADOPTED BY THE BOARD OF TRUSTEES. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSPRIMARY DATA FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT IS DERIVED FROM SHARED RESOURCES AND AVAILABLE DATA FROM COMMUNITY PARTNERSHIPS AND ORGANIZATIONS. MEMBERS OF THE CBAC COLLABORATED WITH THE CB MANAGER, THROUGH MEETINGS AND CONVERSATIONS BETWEEN 2018 - 2019, TO CONNECT AJH WITH USEFUL RESOURCES AND REPORTS, BOTH FROM MEMBERS' OWN ORGANIZATIONS AS WELL AS PUBLICLY REPORTED DATA THAT REFLECTS THE SIGNIFICANT HEALTH NEEDS FACING COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL. THE MEMBERS OF THE CBAC REPRESENT THE INTERESTS OF AJH'S MOST VULNERABLE POPULATIONS, INCLUDING LOW-COME, MINORITY, HOMELESS, AND OTHER UNDERSERVED OR HIGH- RISK POPULATIONS. ADDITIONALLY, PAM PALOMBO, A MEMBER OF THE CBAC, SERVES AS NEWBURYPORT PUBLIC HEALTH NURSE, AND PROVIDED INSIGHT AND SUGGESTIONS TO THE CBAC REGARDING THE HEALTH NEEDS OF THAT COMMUNITY. DEMOGRAPHIC DATA WAS COLLECTED USING PUBLICLY AVAILABLE DATA FROM THE U.S. CENSUS BUREAU, HEALTH INDICATORS FROM THE MA DEPARTMENT OF HEALTH, AND THE CENTER FOR DISEASE CONTROL AND PREVENTION (CDC). HEALTH INDICATOR DATA SUCH AS MORTALITY, INCIDENCE, PREVALENCE, AND HOSPITALIZATION RATES WERE PROVIDED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, AND BY USING OTHER STATE, REGIONAL AND NATIONAL INFORMATION SOURCES ON CANCER INCIDENCE AND OPIOID USE TRENDS. SUMMARIES OF THE ORGANIZATIONS THAT PROVIDED PRIMARY DATA AND THE COMMUNITIES AND POPULATIONS THEY SERVE, INCLUDE: YWCA OF NEWBURYPORT IS DEDICATED TO ELIMINATING RACISM, EMPOWERING WOMEN, AND PROMOTING PEACE, JUSTICE, FREEDOM, AND DIGNITY FOR ALL. FOR OVER 135 YEARS OF SERVICE TO THE COMMUNITY, IT HAS PROVIDED FOR COMMUNITY MEMBERS REGARDLESS OF RACE, GENDER, OR ECONOMIC REALITY. SUPPORT IS OFFERED TO WOMEN AND THEIR FAMILIES THROUGH PROGRAMMING THAT ADDRESSES THEIR HEALTH AND WELLNESS, AIDS IN THE DEVELOPMENT OF JOB SKILLS AND PROVIDES ACCESS TO AFFORDABLE HOUSING AND CHILDCARE PROGRAMS. O COMMUNITIES SERVED: NEWBURYPORT, AMESBURY, SALISBURY O STATE-WIDE PRIORITIES & SOCIAL DETERMINANTS OF HEALTH YWCA SUPPORTS: HOMELESSNESS; HOUSING; BUILT ENVIRONMENT; EMPLOYMENT; VIOLENCE; CHRONIC DISEASE (YWCA OFFERS AFFORDABLE GYM); SOCIAL ENVIRONMENT PENNIES FOR POVERTY: MISSION IS TO EASE THE IMPACT OF POVERTY ON THE PEOPLE OF GREATER NEWBURYPORT BY ENDORSING MODELS OF ASSISTANCE THAT PROMOTE DIGNITY, SUPPORTING ALLIED ORGANIZATIONS BOTH FINANCIALLY AND COLLABORATIVELY, INCREASING COMMUNITY AWARENESS OF POVERTY THROUGH CITIZEN EDUCATION, AND INSPIRING AND ENCOURAGING VOLUNTEERISM. O COMMUNITIES SERVED: GREATER NEWBURYPORT O STATE-WIDE PRIORITIES & SOCIAL DETERMINANTS OF HEALTH YWCA SUPPORTS: EDUCATION; BUILT ENVIRONMENT; SOCIAL ENVIRONMENT; PREVENTION; MENTAL HEALTH OUR NEIGHBOR'S TABLE: ONT'S INNOVATIVE APPROACH TO FOOD ASSISTANCE IS AIMED AT PROVIDING FLEXIBLE, PERSONALIZED PROGRAMS TO INDIVIDUALS AND FAMILIES LIVING IN NORTHEASTERN ESSEX COUNTY. ONT PROVIDES 2019 COMMUNITY HEALTH NEEDS ASSESSMENT 12 GROCERIES, FRESH FOODS, AND TOILETRIES TO MORE THAN 500 HOUSEHOLDS FROM 12 CITIES AND TOWNS A WEEK ACROSS 4 MARKET LOCATIONS AND DELIVER GROCERIES AND HOT MEALS TO HOME-BOUND INDIVIDUALS IN 3 TOWNS. EACH HOLIDAY SEASON, WE DISTRIBUTE SPECIAL GROCERIES AND TURKEYS TO MORE THAN 700 FAMILIES. WITH 24/7 EMERGENCY HOTLINE FOR FOOD. O COMMUNITIES SERVED: AMESBURY, BOXFORD, BYFIELD, GEORGETOWN, GROVELAND, MERRIMAC, NEWBURY, NEWBURYPORT, ROWLEY, SALISBURY, SOUTH HAMPTON, AND WEST NEWBURY. O STATE-WIDE PRIORITIES & SOCIAL DETERMINANTS OF HEALTH YWCA SUPPORTS: SOCIAL ENVIRONMENT; HOMELESSNESS; CHRONIC DISEASE; PREVENTION ESSEX COUNTY ASSET BUILDER NETWORK (ECAB): CREATES REGIONAL CONNECTIONS AND SUPPORTS FOR INDIVIDUALS, FAMILIES AND ORGANIZATIONS USING A POSITIVE YOUTH DEVELOPMENT APPROACH TO HELP YOUTH THRIVE. LINK TO DATA IN CHNA REPORT.O COMMUNITIES SERVED: AMESBURY, GEORGETOWN, NEWBURY, ROWLEY, SALISBURY, NEWBURYPORT O STATE-WIDE PRIORITIES & SOCIAL DETERMINANTS OF HEALTH YWCA SUPPORTS: SUBSTANCE USE; EDUCATION; SOCIAL ENVIRONMENT; MENTAL HEALTH; PREVENTION 2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE ASSESSMENT BEGAN IN DECEMBER 2018 AND WAS CONDUCTED IN THREE PHASES, ALLOWING FOR THE COLLECTION OF AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA:PHASE 1 PRELIMINARY ASSESSMENT AND ENGAGEMENTPHASE 2 TARGETED ENGAGEMENTPHASE 3 STRATEGIC PLANNING AND REPORTINGINDIVIDUALS FROM ACROSS ANNA JAQUES HOSPITAL'S SERVICE AREA WERE ENGAGED IN THE ASSESSMENT AND PLANNING PROCESS, INCLUDING HEALTH AND SOCIAL SERVICES PROVIDERS, PUBLIC HEALTH OFFICIALS, PUBLIC SCHOOL NURSES AND ADMINISTRATORS, FIRST RESPONDERS, LEADERS OF FAITH-BASED ORGANIZATIONS, BILH SENIOR LEADERSHIP, STAFF, BOARD MEMBERS, AND COMMUNITY RESIDENTS. MEMBERS OF THE COMMUNITY BENEFITS ADVISORY COMMITTEE PROVIDED LEADERSHIP, DIRECTION, AND INPUT, AS WELL AS CONNECTED AJH TO AVAILABLE COMMUNITY DATA AND RESOURCES THAT REPRESENTS THE BROAD INTERESTS OF THE COMMUNITY TO DRIVE THE CONTENT OF THE CHNA. QUALITATIVE DATA SOURCES: TO OBTAIN TARGETED DATA AND UNDERSTAND THE CURRENT ISSUES FACING THE COMMUNITY: INTERNAL STAKEHOLDER INTERVIEWS (BOARD MEMBERS, SENIOR LEADERS, AND SERVICE LINE LEADERS) EXTERNAL STAKEHOLDER INTERVIEWS
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-KEY FINDINGSAFTER A COMPREHENSIVE REVIEW OF ALL THE QUANTITATIVE AND QUALITATIVE INFORMATION COLLECTED IN THE ANNA JAQUES HOSPITAL CHNA, THE KEY HEALTH-RELATED FINDINGS IDENTIFIED WERE: IN JANUARY 2019, THE CBAC DETERMINED THAT AFTER THREE YEARS OF FOCUSING ON OBESITY, CANCER AND SUBSTANCE USE AS ITS SIGNIFICANT HEALTH PRIORITIES, THAT THE DATA AND AVAILABLE RESOURCES CONSULTED REFLECTED POSITIVE CHANGES FOR OBESITY, BUT THAT CANCER AND SUBSTANCE USE SHOULD REMAIN THE PROGRAM'S CORE FOCUS. THE CBAC VOTED THAT, IN ORDER TO ADDRESS THE MOST PRESSING HEALTH NEEDS IN OUR COMMUNITY AND INCORPORATE STATE-WIDE GOALS/SOCIAL DETERMINANTS OF HEALTH IN THE MOST IMPACTFUL AND REALISTIC WAY, TO PRIORITIZE CANCER AND SUBSTANCE USE (NOTING CONNECTION WITH MENTAL HEALTH) AS THE MOST SIGNIFICANT HEALTH NEEDS FACING ITS COMMUNITY FOR FY19-FY21. WHILE OBESITY IS NOT A PRIMARY FOCUS, THE WORLD CANCER RESEARCH FUND ESTIMATES THAT ABOUT 20% OF ALL CANCERS DIAGNOSED IN THE US ARE RELATED TO BODY FATNESS, PHYSICAL INACTIVITY, EXCESS ALCOHOL CONSUMPTION, AND/OR POOR NUTRITION. THUS, ACCESS TO HEALTHY FOODS AS WELL AS OPPORTUNITIES FOR EXERCISE WILL HELP US ADDRESS FACTORS IMPACTING BOTH CANCER AND SUBSTANCE USE. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSAFTER A COMPREHENSIVE REVIEW OF ALL THE QUANTITATIVE AND QUALITATIVE INFORMATION COLLECTED IN THE ANNA JAQUES HOSPITAL CHNA, THE KEY HEALTH-RELATED FINDINGS IDENTIFIED WERE: IN JANUARY 2019, THE CBAC DETERMINED THAT AFTER THREE YEARS OF FOCUSING ON OBESITY, CANCER AND SUBSTANCE USE AS ITS SIGNIFICANT HEALTH PRIORITIES, THAT THE DATA AND AVAILABLE RESOURCES CONSULTED REFLECTED POSITIVE CHANGES FOR OBESITY, BUT THAT CANCER AND SUBSTANCE USE SHOULD REMAIN THE PROGRAM'S CORE FOCUS. THE CBAC VOTED THAT, IN ORDER TO ADDRESS THE MOST PRESSING HEALTH NEEDS IN OUR COMMUNITY AND INCORPORATE STATE-WIDE GOALS/SOCIAL DETERMINANTS OF HEALTH IN THE MOST IMPACTFUL AND REALISTIC WAY, TO PRIORITIZE CANCER AND SUBSTANCE USE (NOTING CONNECTION WITH MENTAL HEALTH) AS THE MOST SIGNIFICANT HEALTH NEEDS FACING ITS COMMUNITY FOR FY19-FY21. WHILE OBESITY IS NOT A PRIMARY FOCUS, THE WORLD CANCER RESEARCH FUND ESTIMATES THAT ABOUT 20% OF ALL CANCERS DIAGNOSED IN THE US ARE RELATED TO BODY FATNESS, PHYSICAL INACTIVITY, EXCESS ALCOHOL CONSUMPTION, AND/OR POOR NUTRITION. THUS, ACCESS TO HEALTHY FOODS AS WELL AS OPPORTUNITIES FOR EXERCISE WILL HELP US ADDRESS FACTORS IMPACTING BOTH CANCER AND SUBSTANCE USE. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022. INTERIM CHANGES AND UPDATES TO 2019 IMPLEMENTATION STRATEGY BASED ON NEWLY IDENTIFIED COMMUNITY NEEDS COVID PANDEMICAS PREVIOUSLY NOTED IN THIS FILING, IRC SECTION 501(R)(3) AND THE PROMULGATED REGULATIONS REQUIRE THAT A TAX-EXEMPT HOSPITAL CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPT AN IMPLEMENTATION STRATEGY ADDRESSING COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA AT LEAST ONCE EVERY THREE YEARS. THE PREAMBLE TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R)(3) NOTES THAT THE TREASURY AND THE IRS INTENDED FOR THE CHNA AND IMPLEMENTATION STRATEGY REQUIREMENT TO ESTABLISH CONTINUAL FEEDBACK ON CHNA REPORTS AND A HOSPITAL IS REQUIRED TO CONSIDER COMMENTS RECEIVED RELATED TO THE EXISTING CHNA AND IMPLEMENTATION STRATEGY WHEN ENGAGING IN THE NEXT CHNA PROCESS NOT MORE THAN THREE YEARS AFTER ADOPTION. IN ADDITION, FINAL REGULATIONS DO NOT PROHIBIT IMPLEMENTATION STRATEGIES FROM DISCUSSING HEALTH NEEDS IDENTIFIED THROUGH MEANS OTHER THAN A CHNA, PROVIDED THAT THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA ARE ALSO DISCUSSED. FINALLY, THERE IS NOTHING IN THE REGULATIONS THAT PROHIBITS A HOSPITAL FROM UPDATING ITS IMPLEMENTATION STRATEGY BASED ON AN OFF CYCLE CHANGE TO THE COMMUNITY HEALTH NEEDS THAT ARISE. DURING THE FISCAL PERIOD, OCTOBER 1, 2019, TO SEPTEMBER 30, 2020, THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL, WERE IMPACTED BY AN UNEXPECTED GLOBAL PANDEMIC. ON JANUARY 9, 2020, THE WORLD HEALTH ORGANIZATION (WHO) ANNOUNCED THE IDENTIFICATION OF A NEW AND NOVEL CORONAVIRUS-RELATED PNEUMONIA IN WUHAN, CHINA. ON JANUARY 21, 2020, THE UNITED STATES CENTER FOR DISEASE CONTROL CONFIRMED THE FIRST CASE OF THIS NEW CORONA VIRUS IN THE UNITED STATES. ON JANUARY 31, 2020, THE WHO ISSUED A GLOBAL HEALTH EMERGENCY AND ON FEBRUARY 3 THE UNITED STATES DECLARED A PUBLIC HEALTH EMERGENCY BECAUSE OF THE COVID-19 VIRUS. ON MARCH 11, 2020, THE WHO DECLARED COVID-19 A PANDEMIC AND TWO DAYS LATER, THE PRESIDENT OF THE UNITED STATES DECLARED COVID-19 A NATIONAL EMERGENCY.THE HEALTH OF THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL WERE IMPACTED BY THIS UNFORESEEN HEALTH CRISIS AND IN THE ABSENCE OF REGULATORY GUIDANCE TO THE CONTRARY, ANNA JAQUES HOSPITAL NEEDED TO QUICKLY REASSESS AND PIVOT TO MEET THE NEW AND PREVIOUSLY UNEXPECTED COMMUNITY NEEDS. AS SUCH, IN RESPONSE TO THE COVID-19 CRISIS ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS STAFF ALONG WITH THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND IN RESPONSE TO COVID, EXPANDED GOALS RELATED TO ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH TARGETED PRIMARILY AT LOW INCOME AND MINORITY POPULATIONS WHO HAVE BEEN DISPROPORTIONATELY IMPACTED BY COVID-19.COMMUNITY HEALTH NEEDS ASSESSMENTMAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEANNA JAQUES HOSPITAL STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT:HTTPS://WWW.AJH.ORG/WRITABLE/FILES/AJH-2022-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-093022.PDFIN ADDITION TO THE CHNA, ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://WWW.AJH.ORG/WRITABLE/FILES/AJH-2023-2025-IMPLEMENTATION-STRATEGY-101122.PDFIN ADDITION, AS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://WWW.AJH.ORG/WRITABLE/APPLICATIONS/CHNA-2019-FOR-WEBSITE-FINAL.PDFFINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING ANNA JAQUES HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://WWW.AJH.ORG/WRITABLE/APPLICATIONS/CHNA-2019-FOR-WEBSITE-FINAL.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, ANNA JAQUES HOSPITAL'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, BUT IT IS THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY WHICH INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF ANNA JAQUES HOSPITAL FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, WHICH ARE REPORTED HERE. A SUMMARY OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, ANNA JAQUES HOSPITAL HAS BEEN STRATEGIC IN IDENTIFYING ITS COMMUNITY HEALTH PRIORITIES IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH HEALTH PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: CHRONIC DISEASE GOAL 1: INCREASE CANCER SCREENING AND PREVENTION GOAL 2: PROVIDE PATIENT SUPPORT SERVICES AND SURVIVORSHIP RESOURCES GOALS 3: INCREASE ACCESS TO PHYSICAL ACTIVITY, WELLNESS, AND HEALTHY EATING PRIORITY AREA 2: BEHAVIORAL HEALTH (SUBSTANCE USE & MENTAL HEALTH) GOAL 1: INCREASE SCREENING, ACCESS TO CARE AND SERVICES GOAL 2: PROMOTE POSITIVE YOUTH RESOURCES PRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTH GOAL 1: SUPPORT FOOD SECURITY EFFORTS GOAL 2: INCREASE AVAILABILITY OF EMERGENCY HOUSING GOAL 3: SUPPORT LOCAL ADVOCACY AND PREVENTION RESOURCES PRIORITY AREA 4: ACCESS TO CARE GOAL: DECREASE BARRIERS TO HEALTHCARECOMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)A SUMMARY OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESSES THE NEEDS IDENTIFIED IN THE 2019 CHNA COMPLETED DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2019, AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY IS PROVIDED BELOW, ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. THESE AREAS ARE (1) BEHAVIORAL HEALTH (SUBSTANCE USE AND MENTAL HEALTH) (2) CHRONIC DISEASE (3) ACCESS TO CARE AND (4) SOCIAL DETERMINANTS OF HEALTH.BEHAVIORAL HEALTH (SUBSTANCE USE & MENTAL HEALTH)BEHAVIORAL HEALTH CRISIS CONSULTATIONTO PROVIDE 24/7/365 BEHAVIORAL HEALTH CRISIS EVALUATION IN THE EMERGENCY DEPARTMENT (ED) AND THROUGHOUT OTHER HOSPITAL UNITS FOR INDIVIDUALS EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE RELATED CRISIS. SERVICES ARE PAYER AGNOSTIC AND PROVIDED VIA IN-PERSON OR TELEHEALTH BY A MULTIDISCIPLINARY TEAM OF QUALIFIED PROFESSIONALS, INCLUDING PSYCHIATRISTS, INDEPENDENTLY LICENSED AND MASTER'S LEVEL CLINICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, CERTIFIED PEER SPECIALISTS, AND FAMILY PARTNERS. THE SERVICES INCLUDE INITIAL ASSESSMENTS FOR RISKS, CLINICAL STABILIZATION, TREATMENT INITIATION, CARE COORDINATION, AND ONGOING EVALUATION TO ENSURE APPROPRIATE LEVEL OF CARE PLACEMENT. A MULTIDISCIPLINARY TEAM, COMPRISED OF QUALIFIED BEHAVIORAL HEALTH PROVIDERS, PSYCHIATRY, FAMILY PARTNERS, AND PEER SPECIALISTS, IS EMPLOYED TO PROVIDE BEHAVIORAL HEALTH CRISIS CONSULTATIONS IN THE EMERGENCY DEPARTMENT OR MEDICAL FLOORS OF THE HOSPITAL. THE TEAM SERVED 432 PATIENTS IN FY22. COLLABORATIVE CARE MODELIN ORDER TO INCREASE ACCESS TO MENTAL HEALTH SERVICES, AJH HAS IMPLEMENTED THE COLLABORATIVE CARE MODEL, A NATIONALLY RECOGNIZED PRIMARY CARELED PROGRAM THAT SPECIALIZES IN PROVIDING BEHAVIORAL HEALTH SERVICES IN THE PRIMARY CARE SETTING. THE SERVICES, PROVIDED BY A BILH LICENSED BEHAVIORAL HEALTH CLINICIAN, INCLUDE COUNSELING SESSIONS, PHONE CONSULTATIONS WITH A PSYCHIATRIST, AND COORDINATION AND FOLLOW-UP CARE. THE BEHAVIORAL HEALTH CLINICIAN WORKS CLOSELY WITH THE PRIMARY CARE PROVIDER IN AN INTEGRATIVE TEAM APPROACH TO TREAT A VARIETY OF MEDICAL AND MENTAL HEALTH CONDITIONS. AJH OFFERED THIS COLLABORATIVE CARE MODEL IN TWO LOCATIONS IN FY22: AMESBURY (2) AND HAVERHILL (1) AND SERVED A TOTAL OF 529 PATIENTS. PATIENT NAVIGATOR AT ANNA JAQUES HOSPITALTHE PATIENT CARE NAVIGATOR AT AJH SUPPORTS WOMEN WITH SUBSTANCE USE DISORDER (SUD) AND/OR NEONATAL ABSTINENCE SYNDROME (NAS), A CONDITION THAT IMPACTS ABOUT 14.5 CASES PER 1,000 BIRTHS IN MASSACHUSETTS. THE PATIENT CARE NAVIGATOR SERVES WOMEN IN RECOVERY AND SEEKING ADDITIONAL SUPPORT, WHO HAVE SUFFERED FROM TRAUMA OR ABUSE, OR WHO HAVE BEEN DIAGNOSED WITH MENTAL HEALTH DISORDERS. THE PATIENT CARE NAVIGATOR CHAMPIONS WOMEN THROUGHOUT THEIR PREGNANCY AND INTO THE FIRST YEAR OF MOTHERHOOD, WORKING IN COLLABORATION WITH WOMEN'S HEALTH CARE AND THE ANNA JAQUES BIRTH CENTER & NEONATAL CARE CENTER.IN FY22, THE NAVIGATOR SERVED 251 WOMEN EITHER IN RECOVERY AND SEEKING ADDITIONAL SUPPORT, WHO HAVE SUFFERED FROM TRAUMA OR ABUSE, OR WHO HAVE BEEN DIAGNOSED WITH MENTAL HEALTH DISORDERS. COMMUNITY EDUCATION AND SUPPORTANNA JAQUES PARTNERS WITH AREA NON-PROFITS, SOCIAL SERVICE AGENCIES AND COMMUNITY GROUPS AIMED AT PROVIDING COMMUNITY EDUCATION, SUPPORT AND TRAINING. FOR EXAMPLE, THE ESSEX COUNTY OUTREACH IS A COLLABORATIVE EFFORT INVOLVING ALL 34 POLICE DEPARTMENTS WITHIN ESSEX COUNTY, AS WELL AS THE SHERIFF'S DEPARTMENT, PARTNERING WITH SOCIAL SERVICE AGENCIES, PEER SPECIALISTS, AND OTHER COMMUNITY SUPPORTS TO ASSIST WITH: SUBSTANCE USE DISORDER (SUD) MENTAL OR BEHAVIORAL HEALTH NEEDS HIGH RISK (OF OVERDOSING) REFERRALS HARM REDUCTION STRATEGIES ADDITIONAL SUPPORTS TO FAMILIES AND CHILDREN IMPACTED BY SUD SUPPORTS FOR THOSE THAT HAVE LOST A LOVED ONE TO SUD ECO ESTABLISHED AN OFFICE SPACE IN SALISBURY WHERE MEETINGS WILL BE HELD, LANDLINE ESTABLISHED, AND POTENTIAL FOR DROP IN VISITS AS A SPACE FOR INDIVIDUALS IN NEED TO COME TO FOR SUPPORT AND RESOURCES. ESSEX COUNTY WAS DIVIDED INTO 4 MANAGEABLE REGIONS WITH IDENTIFIED COORDINATORS FOR EACH REGION TO MEET QUARTERLY AND DISCUSS SUCCESSES, OBSTACLES, AREAS FOR IMPROVEMENT, ETC. WITHIN THE COUNTY. A SIM WORKSHOP WAS COMPLETED IN MAY 2022 WITH THE ASSISTANCE OF PRA AND COMMUNITY PARTNERS AND AREAS FOR COLLABORATION WERE IDENTIFIED. AN EMPLOYEE PORTAL VIA THE ECO WEBSITE HAS BEEN ESTABLISHED FOR COMMUNICATION AMONG PARTNERS, DOCUMENT, AND EVENT SHARING. ADDITIONALLY, THE SAMARITANS OF MERRIMACK VALLEY AIMS TO REDUCE THE INCIDENCE OF SUICIDE IN NORTHEASTERN MASSACHUSETTS BY PROVIDING A HOST OF PREVENTION AND AFTER-CARE SERVICES INCLUDING COMMUNITY OUTREACH, TRAININGS, SURVIVOR SUPPORT, AND A 24-HOUR CRISIS HOTLINE. THEY EXPANDED CRISIS HELPLINES AND PROVIDED SEVERAL TRAINING SESSIONS/SUPPORT GROUPS AS WELL AS CAREGIVER TRAINING. THE PETTENGILL HOUSE THE PETTENGILL HOUSE SUBSTANCE ADDICTION/MENTAL HEALTH INITIATIVE PROVIDES PROFESSIONAL ASSESSMENTS, SUPPORT SERVICES, AND INTERVENTIONS TO GREATER NEWBURYPORT RESIDENTS IN NEED. REALIZING THE COMPLEXITY OF SUBSTANCE ADDICTION AND MENTAL HEALTH, AND KNOWING THE NEED FOR INDIVIDUALIZED TREATMENT, THE PETTENGILL HOUSE IMPLEMENTS ITS THERAPEUTIC SYSTEM OF CARE MODEL, WHICH PROVIDES COMPREHENSIVE CASE MANAGEMENT, ADVOCACY, AND INTENSIVE FOLLOW-UP ON BEHALF OF THE IDENTIFIED INDIVIDUALS IN NEED.IN FY22, THE PROGRAM SCREENED 53 INDIVIDUALS FOR MENTAL HEALTH AND SUBSTANCE MISUSE NEEDS AND CONNECTED THEM WITH EITHER INPATIENT TREATMENT, OUTPATIENT TREATMENT, OR MEDICATION ASSISTED TREATMENT. 305 CASE MANAGEMENT INTERVENTIONS WERE CONDUCTED, 391 RECOVERY COACHING AND SUPPORT, 68 COMMUNITY OUTREACH OR WELLNESS VISITS; 185 CALLS, CASE CONSULTATIONS OR REFERRALS; AND 44 HARM REDUCTION SERVICES. THE PROGRAM ALSO WORKED WITH 91 FAMILIES OVER 189 CONSULTATION SESSIONS. CHRONIC DISEASESURVIVORSHIP PROGRAMMINGANNA JAQUES HOSPITAL PARTNERS WITH COMMUNITY ORGANIZATIONS AIMED AT SUPPORTING A PERSON BEYOND THEIR CANCER DIAGNOSIS TO PROMOTE SURVIVORSHIP. FOR EXAMPLE, YMCA'S CORNERSTONE PROGRAM IS A COLLABORATIVE PROGRAM PROVIDING ESSENTIAL DAILY LIVING SUPPORT TO CANCER PATIENTS, CANCER SURVIVORS, AND THEIR FAMILIES. THE PROGRAM PROVIDES A MEMBERSHIP TO THE Y FOR PEOPLE DIAGNOSED WITHIN THE PAST FIVE YEARS, ACCESS TO SPECIALIZED PROGRAMS TO HELP THOSE WITH CANCER AND RECOVERING FROM CANCER, SPECIAL DROP-IN BABYSITTING FOR PARENTS WHO ARE CURRENTLY IN TREATMENT, WEEKS OF SUMMER CAMP IS OFFERED FOR FAMILIES WHO HAVE BEEN AFFECTED BY CANCER AND THE PROGRAM PROVIDES AN OVERALL SENSE OF COMMUNITY TO SUPPORT SURVIVORSHIP. IN FY22, THE YMCA EXTENDED 49 CORNERSTONE MEMBERSHIPS TO SUPPORT HEALTHY LIVING TO FAMILIES IMPACTED BY CANCER.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	ADDITIONALLY, AJH SUPPORTS THE YWCA OF NEWBURYPORT'S ENCORE PROGRAM A FREE 12-WEEK PROGRAM OFFERED TO ANY "THRIVER" WHO HAS EXPERIENCED CANCER AT ANY TIME IN THEIR LIVES, WHICH HAS SERVED HUNDREDS OF WOMEN IN OUR COMMUNITY. THE YWCA ENCORE PROGRAM IS DESIGNED TO EMPOWER WOMEN TO RECLAIM THEIR PHYSICAL AND EMOTIONAL HEALTH AND WELL-BEING AFTER A CANCER DIAGNOSIS AND TREATMENT.VIRTUAL SUPPORT GROUP OFFERINGSANNA JAQUES HOSPITAL COLLABORATES WITH COMMUNITY PROGRAMS TO PROMOTE AWARENESS OF THE IMPORTANCE OF BREAST CANCER SCREENING AND TO INCREASE AWARENESS OF RESOURCES FOR PEOPLE IMPACTED BY CANCER. IN FY19 ANNA JAQUES SUPPORTED THE LAUNCH OF THE NORTH OF BOSTON CANCER RESOURCE. THE COMPREHENSIVE ONLINE GUIDE SIMPLIFIES ACCESS TO RESOURCES, EDUCATION AND SERVICES TO HELP PEOPLE WITH CANCER SURVIVE AND THRIVE THROUGH DIAGNOSIS, TREATMENT AND BEYOND. THIS RESOURCE, DEVELOPED IN COLLABORATION WITH THREE OTHER ORGANIZATIONS, BUILDS UPON THE HOSPITAL'S RELATIONSHIPS WITH COMMUNITY PARTNERS WHO PROVIDE COMPLEMENTARY SERVICES IN THE ANNA JAQUES CANCER CENTER. THE ONLINE NORTH OF BOSTON CANCER RESOURCE RECORDED 10,900 PAGE VIEWS. IN RESPONSE TO THE COVID-19 PANDEMIC, THE NORTH OF BOSTON CANCER RESOURCE SPEAKER SERIES SHIFTED VIRTUALLY TO EDUCATE AND OFFER SUPPORT TO PEOPLE AFFECTED BY CANCER. THE SESSIONS PROVIDE THE OPPORTUNITY FOR PARTICIPANTS TO LEARN ABOUT AND EXPERIENCE HEALING PRACTICES THAT CAN HELP THEM EASE THE DISTRESS OF A CANCER DIAGNOSIS AND TREATMENT AND ENHANCE THEIR WELL-BEING FROM DIAGNOSIS THROUGH TREATMENT AND BEYOND. NBCR HOSTED 10 SPEAKER SERIES EVENTS FOR A TOTAL OF 122 PARTICIPANTS. LOCAL FARMERS' MARKETSSOME 6,000 PEOPLE IN NORTHEASTERN ESSEX COUNTY ARE FOOD INSECURE. ANNA JAQUES HOSPITAL (AJH) PARTNERS WITH BOTH THE NEWBURYPORT AND HAVERHILL FARMERS' MARKETS TO ENSURE THAT COMMUNITIES HAVE ACCESS TO HEALTHY AFFORDABLE FOODS, ESPECIALLY FRUITS AND VEGETABLES. BOTH MARKETS INCLUDE FARMERS AND VENDORS WHO ACCEPT EBT/SNAP TO MAKE HEALTHY EATING MORE ACCESSIBLE TO EVERYONE.THE NEWBURYPORT MARKET 30 MARKETS HELD FROM MAY THROUGH NOVEMBER 2022. ROUGHLY 1,200 - 1,600 PEOPLE ATTENDED WEEKLY THE HAVERHILL FARMERS' MARKET PROMOTES HEALTHY EATING AND IS EASILY ACCESSIBLE BY PUBLIC TRANSPORTATION. HAVERHILL FARMERS' MARKET HOSTED MARKETS WEEKLY FROM JUNE THROUGH OCTOBER 2022 (TOTAL OF 19). THE MARKET SERVED ROUGHLY 700-800 RESIDENTS PER WEEK. FARMERS MARKETS ARE CRUCIAL IN PROVIDING FRESH LOCAL PRODUCE AND HEALTHY FOOD OPTIONS. ACCESS TO CAREBARRIER TO HEALTH CAREBARRIERS TO OBTAINING HEALTH CARE INCLUDE TRANSPORTATION, ACCESS TO AVAILABLE RESOURCES, AFFORDABILITY, INSURANCE COVERAGES, INADEQUATE SERVICES, LACK OF HEALTH CARE PROVIDERS, AND LANGUAGE BARRIERS. TRANSPORTATION WAS THE LARGEST CONCERN THROUGHOUT ALL COMMUNITIES IN THE GREATER HAVERHILL AREA. AJH PROVIDES SERVICES TO ADDRESS THESE GAPS INCLUDING PATIENT FINANCIAL COUNSELORS, TRANSPORTATION SUPPORT, AND INTERPRETER SERVICES. SOCIAL DETERMINANTS OF HEALTH FOOD SECURITYAJH SUPPORTS OUR NEIGHBORS' TABLE'S (ONT) YEAR-ROUND WEDNESDAY MEAL IS A FREE, OPEN, COMMUNITYWIDE DINING EXPERIENCE OFFERING A THREE-COURSE, NUTRITIOUS MEAL EACH WEEK. IN ADDITION TO THE MEAL ITSELF, THE PROGRAM OFFERS SOCIALIZATION AND CONNECTION TO OTHER RESOURCES AND SUPPORT FOR PEOPLE LIVING IN THE REGION, INCLUDING ONT'S GROCERY MARKETS AND SNAP.IN RESPONSE TO PUBLIC HEALTH GUIDELINES RELATED TO COVID-19, ONT CLOSED ITS DINING ROOM IN MARCH 2020 AND PIVOTED SWIFTLY TO OFFER DINNERS AS INDIVIDUAL OR FAMILY-SIZED MEALS TO-GO. ONT SAW AN 89% INCREASE IN PEOPLE COMING TO RECEIVE A TAKE-HOME MEAL EACH WEEK, WITH THE GREATEST AMONG THEM BEING FAMILIES WITH CHILDREN AND MEN AND WOMEN IN RECOVERY. SUPPORT PROVIDED BY AJH SPONSORED SIX WEEKS' WORTH OF MEALS FOR ONT GUESTS. IN 2022, ONT HAS PROVIDED 8,387 ADULTS AND 1,181 CHILDREN WITH A WEEKLY FREE MEAL AND INTRODUCED THEM TO ONT'S GROCERY PROGRAM WHERE THEY CAN ACCESS GROCERIES OF THEIR CHOICE ONCE A WEEK AT NO COST TO THEM. APPROXIMATELY 82% OF MEAL RECIPIENTS ARE RETURNING GUESTS EACH WEEK.FAMILIES WITH CHILDREN HAVE REPRESENTED THE GREATEST INCREASE IN ATTENDANCE AND HAVE HIGHLIGHTED SOME POSITIVE PROGRAMMATIC CHANGES RESULTING FROM THE PANDEMIC. ANONYMITY AND THE CONVENIENCE OF A GRAB-AND-GO, FAMILY-SIZED DINNER IS A DRAW FOR FAMILIES WHO DON'T HAVE ADEQUATE FOOD AT HOME NOR THE TIME OR ABILITY TO PREPARE DINNER WHILE JUGGLING PARENTING, HOMESCHOOLING, AND WORK. AJH'S SUPPORT WAS FOCUSED ON THE NEEDS RELATED TO OFFERING MEALS TO-GO ON A WEEKLY BASIS, YEAR-ROUND. HOUSINGAJH STRENGTHENED ITS PARTNERSHIP WITH EMMAUS THROUGH "MITCH'S PLACE EMERGENCY SHELTER" THAT SERVES ADULTS IMPACTED BY HOMELESSNESS IN THE GREATER HAVERHILL AREA AND EXPERIENCED A SIGNIFICANT INCREASE IN NEED DURING THE PANDEMIC. AJH SUPPORTED UNEXPECTED FINANCIAL BURDENS TO ENSURE THAT STATE SAFETY MEASURES RELATED TO COVID-19 WERE IN PLACE TO KEEP PATRONS SAFE DURING THE PANDEMIC.EMMAUS SERVED 222 INDIVIDUALS AT MITCH'S PLACE OVERNIGHT EMERGENCY SHELTER IN FY'22 JULY 2021 - JUNE 2022), UP FROM 119 IN FY'21 WHEN IT OPERATED AS A 24/7 PROGRAM DURING THE HEIGHT OF THE PANDEMIC. THE NUMBER OF INDIVIDUALS SERVED IN FY '22 APPROACHED PRE-PANDEMIC LEVELS WHEN 267 DIFFERENT INDIVIDUALS USED THE SHELTER. IN FY'22, EMMAUS CONTINUED TO PRIORITIZE GENERATING AND MAINTAINING PERMANENT HOUSING SOLUTIONS FOR THOSE IMPACTED BY HOMELESSNESS. THE AGENCY EXPANDED ITS RAPID REHOUSING PROGRAM, PLACING 56 INDIVIDUALS INTO PERMANENT HOUSING WITH ATTACHED SUPPORTIVE SERVICES IN THE 12-MONTH PERIOD. THE RAPID RE-HOUSING INITIATIVE KEPT THE LENGTH OF STAY IN SHELTER UNDER 30 DAYS FOR 71% OF THE MITCH'S PLACE SHELTER GUESTS. LESS THAN 5% OF SHELTER GUESTS REMAINED IN SHELTER FOR MORE THAN SIX MONTHS. EMMAUS CONTINUES TO MANAGE 99 UNITS OF PERMANENT AFFORDABLE HOUSING THAT IT OWNS AND OPERATES, INCLUDING 59 UNITS DESIGNATED FOR INDIVIDUAL ADULTS. RESIDENTS PAY 30% OF THEIR INCOME AND ARE RE-ASSESSED ANNUALLY. THE MAJORITY OF THESE RESIDENTS HAVE LIVED STABLY IN EMMAUS PROPERTIES FOR MANY YEARS. THERE IS VERY LITTLE TURNOVER IN THESE UNITS.FY22 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: CHRONIC DISEASE CANCER IS THE LEADING CAUSE OF DEATH IN MASSACHUSETTS AND THE CAUSE OF ONE IN EVERY FOUR DEATHS IN THE UNITED STATES (CDC). IN MASSACHUSETTS, DEATHS DUE TO ALL CANCERS ARE SLIGHTLY HIGHER THAN THE STATE AVERAGE. LUNG CANCER DEATHS ARE HIGHER THAN THE STATE AVERAGE OVERALL, AND SIGNIFICANTLY HIGHER IN MERRIMAC, SALISBURY, HAVERHILL, AND AMESBURY. AJH STRIVES TO PROMOTE PREVENTION AND AWARENESS THROUGH THE ADVOCACY OF ANNUAL CANCER SCREENINGS AND EDUCATION, WHILE ALSO ADDRESSING CERTAIN HEALTH RISK FACTORS THAT MAY LEAD TO CANCER, INCLUDING OBESITY, LACK OF EXERCISE AND POOR NUTRITION.GOAL 1: INCREASE CANCER SCREENING & PREVENTIONPROGRAMMATIC OBJECTIVES1.1 PROVIDE CANCER SCREENINGS AT A LOWER (OR NO) COST COMMUNITY OBJECTIVES / STRATEGIES PROVIDE PREVENTION EDUCATION IN PARTNERSHIP WITH ANNA JAQUES CANCER PROGRAMS INCREASE ANNUAL MAMMOGRAM SCREENINGS THROUGH AWARENESS CAMPAIGNS SUPPORT LOCAL ORGANIZATIONS FOCUSED ON CANCER PREVENTIONMETRICS AND STATUS UPDATES NUMBER OF PATIENTS SCREENED FOR BREAST CANCER/MAMMOGRAPHY (FY20: 9,894; FY21: 12,448 AJH COLLABORATED WITH LOCAL BUSINESSES AND COMMUNITIES DURING BREAST CANCER AWARENESS MONTH TO INCREASE AWARENESS AND PREVENTION. (FY20 AND FY21: WORKPLACE WELLNESS AND ENGAGEMENT AROUND THE THEME "THE BEST PREVENTION IS EARLY DETECTION" IS SHARED THROUGHOUT SEVEN COMMUNITIES). AJH PROMOTED PREVENTION OF OVARIAN CANCER IN COLLABORATION WITH GREATER NEWBURYPORT OVARIAN CANCER AWARENESS (GNOCA), DURING OVARIAN CANCER AWARENESS MONTH. NUMBER OF EXTENDED-CARE FACILITIES AND NUMBER OF WOMEN RECEIVING OUTREACH EDUCATION (FY20: 17 FACILITIES AND 700 WOMEN; FY21: 17 FACILITIES AND 700 WOMEN).COMMUNITY PARTNERS: GREATER NEWBURYPORT OVARIAN CANCER AWARENESS (GNOCA), ANNA JAQUES HOSPITAL/GERRISH BREAST CARE CENTERGOAL 2: PROVIDE PATIENT SUPPORT SERVICES AND SURVIVORSHIP RESOURCES PROGRAMMATIC OBJECTIVES1.1 CONTINUE TO SUPPORT LOCAL AND REGIONAL EFFORTS FOR PATIENT AND SURVIVOR SUPPORTCOMMUNITY ACTIVITIES / STRATEGIES AJH BREAST CARE NAVIGATOR PROVIDES INDIVIDUALIZED SUPPORT AND ASSISTANCE TO PATIENTS AND THEIR CAREGIVERS TO HELP THEM MAKE INFORMED DECISIONS ABOUT THEIR CARE AND TO OVERCOME BARRIERS TO OPTIMAL CARE ON-GOING SUPPORT GROUPS FOR CANCER SURVIVORS, IN-PERSON AND VIRTUAL ONLINE RESOURCES AND DIRECTORIES TO CONNECT PEOPLE WITH VITAL RESOURCES AND LOCAL OFFERINGS RELATED TO CANCER
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	METRICS AND STATUS UPDATES NUMBER OF PATIENTS AND FAMILIES PROVIDED WITH SUPPORT SERVICES BY AJH BREAST CARE NAVIGATOR (FY20: 68 INDIVIDUAL PATIENTS AND THEIR FAMILIES OR CAREGIVERS. 61 PATIENTS WERE ALSO PROVIDED SURVIVORSHIP CARE PLANS; FY21: 275+ WOMEN SCHEDULED FOR IMAGE-GUIDED BREAST BIOPSIES AND 133 GERRISH BREAST CARE CENTER (GBCC) PATIENTS AND FAMILIES; FY22: 300 WOMEN SCHEDULED FOR IMAGE-GUIDED BREAST BIOPSIES AND 100+ GBCC PATIENTS AND FAMILIES) NUMBER OF SPEAKER SERIES SESSIONS OFFERED BY NORTH OF BOSTON CANCER RESOURCE TO EDUCATE AND OFFER SUPPORT TO PEOPLE AFFECTED BY CANCER. (FY20: 8 EVENTS AND 84 PARTICIPANTS; FY21:10 EVENTS AND 138 PARTICIPANTS; FY22: 10 EVENTS AND 122 PARTICIPANTS) NUMBER OF SURVIVORSHIP SUPPORT PROGRAM MEMBERSHIPS OFFERED IN GREATER HAVERHILL BY YMCA CORNERSTONE (FY21: 45; FY22: 49) NUMBER OF MEMBERS IN YWCA NEWBURYPORT ENCORE CANCER SURVIVOR WELLNESS PROGRAM (FY20: 80, FY21: 20; FY22: 20)COMMUNITY PARTNERS: NORTH OF BOSTON CANCER RESOURCE, YMCA HAVERHILL CORNERSTONE, YWCA ENCORE, ANNA JAQUES HOSPITAL CANCER PROGRAMSGOAL 3: INCREASE ACCESS TO PHYSICAL ACTIVITY, WELLNESS, AND HEALTHY EATING PROGRAMMATIC OBJECTIVES1.1 PROVIDE SUPPORT FOR FITNESS AND ACCESS TO FRESH, HEALTHY FOODSCOMMUNITY ACTIVITIES / STRATEGIES PROVIDE ACCESS TO FREE PHYSICAL ACTIVITY OPPORTUNITIES SUPPORT EDUCATION ON IMPORTANCE OF PHYSICAL ACTIVITY SUPPORT LOCAL FARMERS' MARKETS THAT INCREASE ACCESSIBILITY TO FRESH, NUTRITIOUS FOODMETRICS AND STATUS UPDATES ANNUAL "ADOPT-A-TRAIL" SPONSORSHIP AS PART OF COASTAL TRAILS COALITION, PROVIDING FUNDS TO MANAGE TRAIL SAFETY AND OPPORTUNITY FOR HEALTHY ACTIVITY IN THE COMMUNITY FY20, FY21, FY22: AJH SPONSORED A PART OF THE TRAIL THAT SUPPORTS THE OFFERING OF A 30-MILE BIKE PATH. SPONSORSHIP OF THE HAVERHILL FARMERS' MARKET DEDICATED TO PROMOTING HEALTHY EATING, AND SUPPORTING LOCAL BUSINESS, SUSTAINABILITY, AND COMMUNITY SPIRIT BY PROVIDING FRESH, LOCAL PRODUCE, BAKED AND PREPARED FOODS AS WELL AS HAND-CRAFTED GOODS. HOSTED IN DOWNTOWN HAVERHILL AND EASILY ACCESSIBLE BY PUBLIC TRANSPORTATION, THE MARKET ACCEPTS EBT/SNAP. NUMBER OF WEEKLY MARKETS HOSTED AND NUMBER OF WEEKLY ATTENDEES (FY20: 17 MARKETS JUNE THROUGH OCT 2020; FY21: 19 MARKETS JUNE THRU OCT 2021 AND 700-800 ATTENDEES; FY22: 19 MARKETS JUNE THRU OCT 2022 AND 700-800 ATTENDEES, INCREASE IN SNAP/WIC BENEFITS). SPONSORSHIP OF NEWBURYPORT FAMERS MARKET TO PROMOTE AFFORDABLE, HEALTHY FOOD CHOICES AND REDUCE RISK OF CHRONIC DISEASE. EBT/SNAP ACCEPTED. NUMBER OF WEEKLY MARKETS HOSTED AND NUMBER OF WEEKLY ATTENDEES (FY21: 24 MARKETS JUNE THRU NOV 2021 AND 1200-1500 ATTENDEES; FY22: 30 MARKETS MAY THRU NOV 2022, 1200-1600 ATTENDEES) AJH SPONSORED THE FRIENDS OF AMESBURY COUNCIL ON AGING'S "HEALTH & WELLNESS FEST" WHICH HOSTED FREE FITNESS AND HEALTH OPPORTUNITIES EVERY WEDNESDAY IN SEPTEMBER AS AN OPPORTUNITY FOR SENIORS TO RECONNECT AND RECEIVE DIRECT SERVICES SUCH AS FLU SHOTS, FITNESS DEMONSTRATIONS AND HEALTHY MEALS. OFFERINGS WERE HELD IN PERSON WITH MANY SAFETY MEASURES IN PLACE AND IN FULL COMPLIANCE OF STATE SAFETY GUIDELINES FY20: HOSTED 4 HEALTH AND WELLNESS DAYS OVER MONTH OF SEPTEMBER WELCOMED 40 ELDERS EACH DAY; ADMINISTERED 125 FLU SHOTS; PROVIDED 200 GRAB & GO LUNCHES.COMMUNITY PARTNERS: AMESBURY COUNCIL ON AGING, NEWBURYPORT FARMERS MARKET, HAVERHILL FARMERS MARKET, COASTAL TRAILS COALITIONPRIORITY AREA 2: BEHAVIORAL HEALTH (SUBSTANCE USE & MENTAL HEALTH) THE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) REPORTS THAT ONE-IN-FOUR INDIVIDUALS EXPERIENCES A MENTAL ILLNESS EACH YEAR, UNDERSCORING A CRITICAL NEED FOR MENTAL HEALTHCARE ACCESS ACROSS ALL PATIENT POPULATIONS. IN THE 2019 AJH CHNA, MENTAL HEALTH INCLUDING DEPRESSION, ANXIETY, STRESS, SERIOUS MENTAL ILLNESS, AND OTHER CONDITIONS WAS OVERWHELMINGLY IDENTIFIED AS ONE OF THE LEADING HEALTH ISSUES FOR RESIDENTS OF THE SERVICE AREA. STUDENT'S GRADES 6-12 IN THE AMESBURY, GEORGETOWN, NEWBURYPORT AND TRITON SCHOOL DISTRICTS ENGAGED IN AN ATTITUDES & BEHAVIOR SURVEY WHICH SHARED: WHILE FAMILY SUPPORT IS HIGH (84%), PARENT INVOLVED IN SCHOOL IS LACKING (37%) AND THAT POSITIVE FAMILY COMMUNICATIONS IS LOWER (39%); THE SURVEY ALSO REFLECTED THE STUDENTS PERCEIVE THAT THE PERCENT OF ADULTS IN THE COMMUNITY WHO VALUE YOUTH IS LOW (30%), AS WELL THAT YOUNG PEOPLE ARE GIVEN USEFUL ROLES IN THE COMMUNITY (39%). AJH PARTNERS WITH LOCAL SOCIAL SERVICES AGENCIES TO SUPPORT ACCESS TO CASE MANAGEMENT AND INTERVENTIONS, AS WELL AS COLLABORATES LOCALLY TO PROVIDE POSITIVE RESOURCES AND SUPPORTS FOR YOUTH.GOAL 1: INCREASE SCREENING, ACCESS TO CARE AND SERVICESPROGRAMMATIC OBJECTIVES1. PROVIDE AND SUPPORT SUBSTANCE USE SERVICES AT THE HOSPITAL AND COMMUNITY.COMMUNITY OBJECTIVES / STRATEGIES IMPROVE COORDINATION OF CARE FROM INPATIENT TO OUTPATIENT BEHAVIORAL HEALTH SERVICES SUPPORT LOCAL CASE MANAGEMENT OFFERINGS AND INITIATIVES FOCUSED ON MENTAL HEALTH AND SUBSTANCE USEMETRICS AND STATUS UPDATES AJH BEGAN PROVIDING 24/7/365 BEHAVIORAL HEALTH CRISIS EVALUATION IN THE EMERGENCY DEPARTMENT (ED) AND THROUGHOUT OTHER HOSPITAL UNITS FOR INDIVIDUALS EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE RELATED CRISIS. SERVICES ARE PAYER AGNOSTIC AND PROVIDED VIA IN-PERSON OR TELEHEALTH BY A MULTIDISCIPLINARY TEAM OF QUALIFIED PROFESSIONALS, INCLUDING PSYCHIATRISTS, INDEPENDENTLY LICENSED AND MASTER'S LEVEL CLINICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, CERTIFIED PEER SPECIALISTS, AND FAMILY PARTNERS. THE SERVICES INCLUDE INITIAL ASSESSMENTS FOR RISKS, CLINICAL STABILIZATION, TREATMENT INITIATION, CARE COORDINATION, AND ONGOING EVALUATION TO ENSURE APPROPRIATE LEVEL OF CARE PLACEMENT. NUMBER OF PATIENTS WHO RECEIVED BEHAVIORAL HEALTH CRISIS CONSULTATION SERVICES (FY22: 432) AJH PARTNERED WITH SOCIAL SERVICE AGENCY, THE PETTENGILL HOUSE, ON ITS SUBSTANCE ADDICTION/MENTAL HEALTH INITIATIVE WHICH PROVIDES PROFESSIONAL ASSESSMENTS, SUPPORT SERVICES AND INTERVENTIONS TO GREATER NEWBURYPORT RESIDENTS IN NEED. REALIZING THE COMPLEXITY OF SUBSTANCE ADDICTION AND MENTAL HEALTH, AND KNOWING THE NEED FOR INDIVIDUALIZED TREATMENT, PETTENGILL HOUSE IMPLEMENTS ITS THERAPEUTIC SYSTEM OF CARE MODEL WHICH PROVIDES COMPREHENSIVE CASE MANAGEMENT, ADVOCACY, AND INTENSIVE FOLLOW-UP ON BEHALF OF THE IDENTIFIED INDIVIDUALS IN NEED. NUMBER OF INDIVIDUALS SCREENED AND CONNECTED TO SERVICES (FY20: 83, FY21: 53, FY22: 53) NUMBER OF INDIVIDUALS ACCESSING SUBSTANCE AND MENTAL HEALTH CARE (FY20: 67, FY21: 53, FY22: 87) AJH SUPPORTED THE SAMARITANS OF THE MERRIMACK VALLEY THAT AIMS TO REDUCE THE INCIDENTS OF SUICIDE IN NORTHEASTERN MASSACHUSETTS BY PROVIDING A HOST OF PREVENTION AND POST-VENTION SERVICES INCLUDING COMMUNITY OUTREACH, TRAININGS, SURVIVOR SUPPORT AND A 24-HOUR CRISIS HOTLINE. FY20: HOSTED THREE 8-WEEK SERIES OF THE SUICIDE ATTEMPT SURVIVOR SUPPORT GROUP; COMPLETED 16 HOURS OF SUICIDE PREVENTION TRAININGS; HOSTED 10 "SAFE PLACE" SUPPORT GROUPS FY21: RECRUITED AND TRAINED 14 NEW CRISIS-LINE VOLUNTEERS WHO ANSWERED 14,500+ CALLS; PROVIDED THREE 8-WEEK SERIES FOR A SUICIDE-ATTEMPT SUPPORT GROUP; ORGANIZED 40 SAFE PLACE SUPPORT GROUPS FOR SUICIDE LOSS SURVIVORS; COMPLETED 24-HOURS OF "GATEKEEPER" TRAINING WITH 240 GATEKEEPERS OF MIDDLE-AGED PERSONS FY22: ADDED 30 NEW STAFF AND 5 VOLUNTEERS TO PROVIDE COVERAGE FOR NEW 988 CRISIS CALL CENTERS TO ANSWER 1800 CALLS PER MONTH AND ANSWER RATE OF 92%. FOUR 8-WEEK SESSIONS OF THE SUICIDE ATTEMPT SURVIVOR SUPPORT GROUP; 28 HOURS OF "GATEKEEPER TRAINING" WITH 210 "GATEKEEPERS; 10 OUTREACH TRAINING SESSIONS TO COMMUNITY GROUPS AND SCHOOLS, 48 SAFE PLACE SUPPORT GROUPS FOR SUICIDE LOSS SURVIVORS AJH CONTINUED OFFERING THE PATIENT CARE NAVIGATOR THAT SUPPORTS WOMEN WITH SUBSTANCE USE DISORDER AND/OR NEONATAL ABSTINENCE SYNDROME, A CONDITION THAT IMPACTS ABOUT 14.5 CASES PER 1,000 BIRTHS IN MASSACHUSETTS. THE PATIENT CARE NAVIGATOR SERVES WOMEN IN RECOVERY AND SEEKING ADDITIONAL SUPPORT, WHO HAVE SUFFERED FROM TRAUMA OR ABUSE, OR WHO HAVE BEEN DIAGNOSED WITH MENTAL HEALTH DISORDERS. THE PATIENT CARE NAVIGATOR CHAMPIONS WOMEN THROUGHOUT THEIR PREGNANCY AND INTO THE FIRST YEAR OF MOTHERHOOD, WORKING IN COLLABORATION WITH WOMEN'S HEALTH CARE AND THE ANNA JAQUES BIRTH CENTER & NEONATAL CARE CENTER. NUMBER OF WOMEN SERVED IN RECOVERY OR SEEKING ADDITIONAL SUPPORT (FY20: 182; FY21: 155; FY22: 251). AJH CONTINUED PARTNERING WITH ESSEX COUNTY OUTREACH, A COLLABORATIVE EFFORT INVOLVING ALL 34 POLICE DEPARTMENTS WITHIN ESSEX COUNTY, AS WELL AS THE SHERIFF'S DEPARTMENT, PARTNERING WITH SOCIAL SERVICE AGENCIES, PEER SPECIALISTS, AND OTHER COMMUNITY SUPPORTS TO INCREASE RESOURCES FOR SUBSTANCE USE AND MENTAL HEALTH. FY21: 14 COMMUNITY EVENTS, FY22: SIM WORKSHOP, EMPLOYEE PORTAL, ADDITIONAL STAFF HIRED, AND POOL OF RECOVERY COACHES CREATED
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	GOAL 2: PROMOTE POSITIVE YOUTH RESOURCES FOR HEALTH & WELL-BEINGCOMMUNITY ACTIVITIES / STRATEGIES SUPPORT COMMUNITY PROGRAMS AND OFFERINGS THAT PROVIDE YOUTH WITH HEALTHY ENGAGEMENT AND LEARNING OPPORTUNITIES METRICS AND STATUS UPDATES AJH SUPPORTED THE ESSEX COUNTY ASSET BUILDER NETWORK'S LAUNCH OF A DEDICATED COVID-19 FAMILY RESOURCE WEBSITE COMPILED OF ARTICLES, VIDEOS AND TIPS FOR FAMILIES AND CHILDREN OF ALL AGES TO FIND INFORMATION ON SELF-CARE, MENTAL HEALTH AND ACCESS TO LOCAL RESOURCES SUCH AS LOCAL FOOD PANTRY, CLOTHING OR HELP WITH GRANT APPLICATIONS FOR ASSISTANCE FUNDING. FY20: THE WEBSITE RECEIVED OVER 2,000 HITS; HOSTED 7 PARENT SPEAKER OR WEBINAR OPPORTUNITIES INCLUDING: "TEENS, TWEENS & QUARANTINES" (335 SIGN-UPS); "PARENTS THROUGH A PANDEMIC" (322 SIGN-UPS) "GOOD NEWS ABOUT BAD BEHAVIOR" (216 SIGN-UPS); MAILED SUPPORT MATERIALS TO 3,200 HOUSEHOLDS GIRLS INC. OF THE SEACOAST AREA IS AN AFFILIATE OF GIRLS INCORPORATED, A NATIONAL RESEARCH, EDUCATION, AND DIRECT ADVOCACY ORGANIZATION THAT INSPIRES GIRLS TO BE STRONG, SMART, AND BOLD. THE PROGRAM OFFERS RESEARCH-BASED CURRICULUMS INCLUDING STEAM (SCIENCE, TECHNOLOGY, ENGINEERING, ART, AND MATH); MEDIA LITERACY; ECONOMIC LITERACY; GROWING UP STRONG, SMART, AND BOLD (FRIENDSHIPS AND CONFLICT RESOLUTION); AND HEALTHY LIVING/SELF-CARE. PROGRAMS ARE OFFERED DURING THE ACADEMIC SCHOOL YEAR, SCHOOL VACATIONS, AND THE SUMMER. NUMBER OF GIRLS SERVED (FY20: 193, FY21: 129, FY22: 164)COMMUNITY PARTNERS: THE PETTENGILL HOUSE, FAMILY SERVICES OF THE MERRIMACK VALLEY, JEANNE GEIGER CRISIS CENTER, GIRLS., INC., ESSEX COUNTY OUTREACH, ESSEX COUNTY ASSET BUILDER NETWORK PRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTHIN THE LAST DECADE, EVIDENCE HAS MADE IT INCREASINGLY CLEAR THAT THE UTILIZATION OF MEDICAL SERVICES IS NOT THE PRIMARY DETERMINANT OF COMMUNITY HEALTH. RATHER, THE SOCIAL CONDITIONS IN WHICH PEOPLE ARE BORN, GROW, LIVE, WORK, AND AGE PLAY A KEY ROLE IN DETERMINING HEALTH OUTCOMES AND HEALTH DISPARITIES. DESPITE THE IMPRESSION OF AFFLUENCE IN THE HOSPITAL'S SERVICE AREA, MANY RESIDENTS ARE STRUGGLING WITH POVERTY, FOOD INSECURITY AND HOMELESSNESS. AJH WORKED TO ADDRESS THESE HEALTH NEEDS BY PARTNERING WITH LOCAL ORGANIZATIONS TO INCREASE ACCESS AND SUPPORT SERVICES. GOAL 1: SUPPORT FOOD SECURITY EFFORTS PROGRAMMATIC OBJECTIVES1.1 SUPPORT PROGRAMS TO INCREASE HEALTHY EATING AND CONSISTENT ACCESS TO AFFORDABLE, HEALTHY FOODS.COMMUNITY ACTIVITIES / STRATEGIES PARTNER WITH EXISTING PROGRAMS TO SUPPORT THEIR EFFORTS TO ADDRESS FOOD SECURITY COLLABORATE WITH PEDIATRICIANS AND PRIMARY CARE TO REACH FAMILIES IN NEED WITH RESOURCES PROVIDE GRANTS TO INCREASE LOW-COST FOOD ACCESSMETRICS AND STATUS UPDATES A COMMUNITY GRANT ISSUED IN FY20 TO OUR NEIGHBORS' TABLE (ONT) ENABLED THE PROGRAM TO PIVOT IN RESPONSE TO THE COVID-19 PANDEMIC TO PROVIDE TO-GO MEALS FOR INDIVIDUALS AND FAMILIES. IN RESPONSE TO PUBLIC HEALTH GUIDELINES RELATED TO COVID-19, ONT CLOSED ITS DINING ROOM IN MARCH AND PIVOTED SWIFTLY TO OFFER DINNERS AS INDIVIDUAL OR FAMILY-SIZED MEALS TO-GO. ONT SAW AN 89% INCREASE IN PEOPLE COMING TO RECEIVE A TAKE-HOME MEAL EACH WEEK, THE GREATEST AMONG THEM: FAMILIES WITH CHILDREN AND MEN AND WOMEN IN RECOVERY. FY20: ONT HOSTED 5,267 DINNER GUESTS AND PROVIDED 787 HOME DELIVERIES. BETWEEN JANUARY AUGUST 2020 ALONE, ONT SERVED 5,650 DINNER GUESTS AND DID 606 HOME DELIVERIES FY21: SUPPORT PROVIDED BY AJH SPONSORED SIX WEEKS' WORTH OF MEALS FOR ONT GUESTS, SERVING A TOTAL OF 10,269 MEALS TO 6,903 ADULTS AND 775 CHILDREN. APPROXIMATELY 82% ARE RETURNING GUESTS EACH WEEK FY22: ONT HAS PROVIDED 8,387 ADULTS AND 1,181 CHILDREN WITH A WEEKLY FREE MEAL AND INTRODUCED THEM TO ONT'S GROCERY PROGRAM WHERE THEY CAN ACCESS GROCERIES OF THEIR CHOICE ONCE A WEEK AT NO COST TO THEM. APPROXIMATELY 82% OF MEAL RECIPIENTS ARE RETURNING GUESTS EACH WEEK. ONE OF EVERY 10 NEIGHBORS IN NEWBURY FOOD PANTRY'S SERVICE AREA DO NOT HAVE A RELIABLE SOURCE OF HEALTHY FOOD, ACCORDING TO THE GREATER BOSTON FOOD BANK. THE FIRST PARISH NEWBURY FOOD PANTRY SUPPORTS NEIGHBORS IN NEED, INCLUDING RESIDENTS OF NEWBURYPORT, SALISBURY, AND OTHER SURROUNDING TOWNS WITH FREE FOOD DONATIONS EVERY FRIDAY, TYPICALLY SERVING BETWEEN 250 AND 300 PEOPLE THROUGH DELIVERIES OR FOOD PICKUP. FY21: SERVED OVER 10,200 GUESTS IN 2020-2021 AND DELIVERED 60% OF ORDERS TO SENIORS AND OTHERS LACKING TRANSPORTATION FY22: GUESTS PLACED 8,900 ORDERS IN 2022, OBTAINING FOOD TO SERVE 19,400 PEOPLE DURING THE YEAR. GUEST ROSTER IN 2022 INCLUDED 1,090 GUESTS IN 498 HOUSEHOLDS. NEARLY 60% OF THE HOUSEHOLDS INCLUDED A GUEST OVER THE AGE OF 65. OVERALL, 44% OF GUESTS WERE ADULTS UNDER THE AGE OF 65, 23% WERE CHILDREN AND 33% WERE SENIORS. NOURISHING THE NORTHSHORE'S VEGOUT PROGRAM BRINGS HEALTHY, LOCAL PRODUCE TO MEMBERS IN THE COMMUNITY THAT OFTEN DO NOT HAVE ACCESS TO THESE FOOD CHOICES. NOURISHING THE NORTH SHORE COMBINES EXCESS PRODUCE FROM LOCAL FARMS WITH FOOD THAT IS GROWN AT THEIR GARDEN AND DISTRIBUTE PRODUCE DIRECTLY THROUGH THE COMMUNITY'S FOOD ACCESS AGENCIES AS WELL AS NNS-RUN FARMERS' MARKET STYLE PRODUCE STANDS. ALL PRODUCE IS FREE TO THOSE WHO ARE VISITING THE FOOD ACCESS SITES. FY21: DISTRIBUTED 34,000 POUNDS OF LOCAL PRODUCE TO FOOD INSECURE INDIVIDUALS; PARTNERED WITH 6 AREA FOOD ACCESS AGENCIES; PROVIDED 41 BAGS OF LOCAL PRODUCE FOR THANKSGIVING TO RESIDENTS OF KELLEHER PARK, A LOWER INCOME COMMUNITY HOUSING IN NEWBURYPORT FY22: DISTRIBUTED 38,000 POUNDS OF LOCAL PRODUCE TO FOOD INSECURE INDIVIDUALS THROUGH 2 MOBILE MARKETS AND 6 AREA FOOD ACCESS AGENCIES, PROVIDING 148,000 SERVINGS OF VEGETABLES; PROVIDED 120 THANKSGIVING PRODUCE BAGS; DELIVERED CURATED BAGS OF LOCAL PRODUCE TO 33 SENIOR HOUSEHOLDS AT HERITAGE HOUSE IN NEWBURYPORT FOR 8 CONSECUTIVE WEEKS; WORKED WITH 11 PARTNER FARMS AND 6 AREA FOOD ACCESS AGENCIES. BETH ISRAEL LAHEY HEALTH (BILH) AWARDED THE YMCA OF THE NORTH SHORE/HAVERHILL YMCA A GRANT TO ADDRESS SOCIAL DETERMINANTS OF HEALTH NEEDS AND INCREASE FOOD ACCESS THROUGH THE INTRODUCTION OF A FREIGHT CONTAINER TO OPERATE A HYDROPONIC FARM. METRICS (TENTATIVE): DEMOGRAPHIC PROFILES, AVERAGE NUMBER OF UNITS DISTRIBUTED WEEKLY, VARIETY OF QUARTERLY PRODUCEGOAL 2: INCREASE AVAILABILITY OF EMERGENCY HOUSINGPROGRAMMATIC OBJECTIVES1.1 SUPPORT PROGRAMS AND INITIATIVES THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSINGCOMMUNITY ACTIVITIES / STRATEGIES SUPPORT LOCAL SOCIAL SERVICE AGENCY EFFORTS TO INCREASE ACCESS TO EMERGENCY SHELTERMETRICS AND STATUS UPDATES AJH SUPPORTED EMMAUS, INC. "MITCH'S PLACE" EMERGENCY SHELTER THAT PROVIDES OVERNIGHT SHELTER, NUTRITIOUS MEALS, AND NEEDED SUPPORT SERVICES YEAR-ROUND, INCLUDING DURING EXTREME CONDITIONS, TO HOMELESS MEN AND WOMEN THAT MAY OTHERWISE SPEND THE NIGHT ENGAGING IN HIGH-RISK, SELF-DESTRUCTIVE, AND/OR ILLEGAL ACTIVITIES. THE PROGRAM ALSO OFFERS CASE MANAGEMENT TO SUPPORT ACCESSING NEEDED SERVICES AND JOB OPPORTUNITIES. NUMBER OF INDIVIDUALS SERVED (FY20: 267, FY21: 119, FY22: 222). NEWBURYPORT YWCA'S ROOF OVER HEAD COLLABORATIVE RENTAL HOUSING FOR LOW-INCOME WORKING FAMILIES WITH DEPENDENT CHILDREN FROM AMESBURY, NEWBURYPORT, AND SALISBURY. CASE MANAGERS ASSIST FAMILIES TO MOVE TOWARD PERMANENT HOUSING. ELIGIBLE FAMILIES MUST BE FROM AND HOMELESS OR AT-RISK OF BECOMING HOMELESS. NUMBER OF HOUSEHOLDS SUPPORTED (FY21:4, FY22: 4) LINK HOUSE'S WOMEN'S INDEPENDENT SOBER HOUSING (WISH) IS INDEPENDENT SOBER HOUSING, WHERE WOMEN SUSTAIN THEIR LONG-TERM RECOVERY IN A SUPPORTIVE, SAFE, AND SOBER. MEMBERS MUST BE FREE OF SUBSTANCE USE FOR A MINIMUM OF ONE YEAR, AND CONTRACT TO ABSTAIN FROM ALL SUBSTANCE USE AND OTHER ADDICTIVE BEHAVIORS, ATTEND APPROPRIATE AA/NA MEETINGS, PARTICIPATE IN HOUSE MEETINGS, CONSENT TO THE HOUSE RULES AND FULLY PARTICIPATE IN ALL ADDITIONAL ASPECTS OF RECOVERY. NUMBER OF WOMEN PROVIDED WITH SOBER HOUSING (FY21: 16) FY22: DONATION MADE TO SUPPORT HOUSING, ESSENTIAL PURCHASES, TRANSPORTATION ACCESSGOAL 3: SUPPORT LOCAL RESOURCES AIMED AT ADVOCACY AND PREVENTIONPROGRAMMATIC OBJECTIVES1.1 SUPPORT IMPACTFUL PROGRAMS THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTH.COMMUNITY ACTIVITIES / STRATEGIES COLLABORATE WITH COMMUNITY PARTNERS TO PROVIDE LOCAL RESOURCES AIMED AT DOMESTIC VIOLENCE ADVOCACY AND PREVENTION
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	METRICS AND STATUS UPDATES AJH SUPPORTS JEANNE GEIGER CRISIS CENTER'S COMMUNITY-BASED SERVICES THAT PROVIDE AN INTEGRATED WEB OF SUPPORT AS SURVIVORS 'NEEDS SHIFT FROM CRISIS TO INDEPENDENCE. THE CENTER COORDINATES WITH SOCIAL SERVICE AGENCIES, SCHOOLS, HOSPITALS, LAW ENFORCEMENT, AND OTHER COMMUNITY PARTNERS TO PROVIDE SUPPORT FOR THE SURVIVORS AND THEIR FAMILIES AS THEIR NEED'S CHANGES OVER TIME. NUMBER OF SURVIVORS WHO RECEIVED ADVOCACY SERVICES (FY20: 779; FY21: 767; FY22: 955) NUMBER OF ADULT AND CHILD SURVIVORS WHO RECEIVED THERAPEUTIC SERVICES (FY20: 353; FY21: 375, FY22: 327) NUMBER OF SURVIVORS WHO RECEIVED LEGAL SERVICES (FY20: 117; FY21: 265; FY22: 409)COMMUNITY PARTNERS: NEWBURY FOOD PANTRY, NOURISHING THE NORTHSHORE, OUR NEIGHBORS' TABLE, EMMAUS, INC., LINK HOUSE, YWCA NEWBURYPORT, JEANNE GEIGER CRISIS CENTERPRIORITY AREA 4: ACCESS TO CAREAN EXTENSIVE BODY OF RESEARCH ILLUSTRATES THE HEALTH DISPARITIES AND DIFFERENCES IN HEALTH CARE ACCESS AND UTILIZATION THAT EXIST FOR DIVERSE INDIVIDUALS/COHORTS AND FOREIGN-BORN POPULATIONS. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION, NON-HISPANIC BLACKS HAVE HIGHER RATES OF PREMATURE DEATH, INFANT MORTALITY, AND PREVENTABLE HOSPITALIZATION THAN DO NON-HISPANIC WHITES. HISPANICS HAVE THE HIGHEST UNINSURED RATES OF ANY RACIAL OR ETHNIC GROUP IN THE UNITED STATES. ASIANS ARE AT A HIGHER RISK FOR DEVELOPING DIABETES THAN ARE THOSE OF EUROPEAN ANCESTRY, DESPITE A LOWER AVERAGE BODY MASS INDEX. THESE DISPARITIES SHOW THE DISPROPORTIONATE AND OFTEN AVOIDABLE INEQUITIES THAT EXIST WITHIN COMMUNITIES AND REINFORCE THE IMPORTANCE OF UNDERSTANDING THE DEMOGRAPHIC MAKEUP OF A COMMUNITY TO IDENTIFY POPULATIONS MORE LIKELY TO EXPERIENCE ADVERSE HEALTH OUTCOMESKEY BARRIERS TO OBTAINING HEALTHCARE IN GREATER HAVERHILL INCLUDE TRANSPORTATION, ACCESS TO AVAILABLE RESOURCES, AFFORDABILITY, INSURANCE COVERAGES, INADEQUATE SERVICES, LACK OF HEALTHCARE PROVIDERS, AND LANGUAGE BARRIERS.GOAL 1: DECREASE BARRIERS TO HEALTHCARE SERVICES AT ANNA JAQUES HOSPITALPROGRAMMATIC OBJECTIVES1.1 PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC, AND ECONOMIC BARRIERS.COMMUNITY ACTIVITIES / STRATEGIES PROVIDE INTERPRETER SERVICES AT NO COST TO ALL ANNA JAQUES HOSPITAL PATIENTS PROVIDE PATIENT FINANCIAL ASSISTANCE TO ALL PATIENTS UTILIZE AN EMERGENCY FUND TO SUPPORT TRANSPORTATION NEEDS OF ANNA JAQUES HOSPITAL PATIENTSMETRICS AND STATUS UPDATES: AJH PROVIDES A FREE INTERPRETER/TRANSLATION SERVICE TO ALL ANNA JAQUES PATIENTS AT NO COST. WHILE SPANISH, CONTINENTAL PORTUGUESE, AND ASL ARE THE MOST COMMONLY UTILIZED SERVICES, AJH SERVICE OFFERED HUNDREDS OF LANGUAGE TRANSLATIONS AS NEEDED. NUMBER OF ENCOUNTERS PROVIDED (FY20: 900; FY21: 5,747; FY22: 5,747) TO ADDRESS FINANCIAL BARRIERS, AJH EMPLOYS TWO FULL-TIME FINANCIAL COUNSELORS WHO ARE CAC-CERTIFIED AND WHO CAN SCREEN PATIENTS AND ASSIST THEM IN APPLYING FOR STATE AID. THEY ALSO PROVIDE ESTIMATES FOR PATIENT'S FINANCIAL RESPONSIBILITY (COPAY, DEDUCTIBLE, COINSURANCE, SELF-PAY). NUMBER OF APPLICATIONS (FY20: 503, FY21: 287; FY22: 305). TO SUPPORT VULNERABLE COMMUNITIES AND LIMIT BARRIERS SO PATIENTS RECEIVE THE CARE THEY NEED, AJH CASE MANAGEMENT HAS AN EMERGENCY FUND TO PROVIDE TRANSPORTATION REIMBURSEMENT TO PATIENTS WHO HAVE LIMITED RESOURCES AND SOCIAL SUPPORTS. THIS PROGRAM IS OFFERED TO ANY PATIENT WHO MEETS THE CRITERIA OF NEED DECIDED BY A SOCIAL WORKER. AMOUNT DISTRIBUTED TO PATIENTS (FY20: $5,217; FY21: $7,233.25; FY22: $6,090.12) COMMUNITY PARTNERS: ANNA JAQUES HOSPITAL CASE MANAGEMENT AND PATIENT FINANCIAL COUNSELING COMMUNITY PARTNERSANNA JAQUES HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE:NOTE: PLEASE LIST THEM PARTNERS AS A BULLET LIST NOT AS A TABLE OR CUT/PASTE OF A CHART SINCE THE IRS SOFTWARE CANNOT ACCOMMODATE TABLES AND CHARTS. AMESBURY CHAMBER OF COMMERCE THE ARC OF GREATER HAVERHILL-NEWBURYPORT THE BEACON COALITION BOYS & GIRLS CLUB COASTAL TRAILS COALITION COMMUNITY ACTION, INC./WOMEN, INFANTS & CHILDREN (WIC) COUNCILS ON AGING (AMESBURY, NEWBURYPORT, MERRIMAC, SALISBURY, HAVERHILL) ELDER SERVICES OF THE MERRIMACK VALLEY/HOME HEALTH VNA EMMAUS, INC. ESSEX COUNTY ASSET BUILDER NETWORK ESSEX COUNTY OUTREACH FAMILY SERVICES OF THE MERRIMACK VALLEY GIRLS, INC. GREATER HAVERHILL CHAMBER OF COMMERCE GREATER LAWRENCE FAMILY HEALTH CENTER HAVERHILL OFFICE GREATER NEWBURYPORT CHAMBER OF COMMERCE GREATER NEWBURYPORT OVARIAN CANCER AWARENESS OVATIONS FOR THE CURE HAVERHILL FARMERS MARKET/CREATIVE HAVERHILL HOME HEALTH VNA/MERRIMACK VALLEY HOSPICE JEANNE GEIGER CRISIS CENTER LINK HOUSE, INC. MERRIMAC SENIOR CENTER & COUNCIL ON AGING MERRIMACK VALLEY BLACK & BROWN VOICES NEW ENGLAND ELDER TRANSPORTATION NEWBURY FOOD PANTRY NEWBURYPORT DEI ALLIANCE NEWBURYPORT FARMERS' MARKET NEWBURYPORT PUBLIC SCHOOLS NEWBURYPORT YANKEE HOMECOMING NEWBURYPORT YOUTH SERVICES NEWBURYPORT SOCIETY FOR THE RELIEF OF AGED WOMEN NORTH OF BOSTON CANCER RESOURCE NOURISHING THE NORTHSHORE OPPORTUNITY WORKS OUR NEIGHBORS' TABLE PARTNERSHIP OF AMESBURY COMMUNITY & TEENS (PACT) PENNIES FOR POVERTY THE PETTENGILL HOUSE REGIONAL SOCIAL SERVICES COLLABORATIVE ROTARY CLUBS (AMESBURY, HAVERHILL, NEWBURYPORT) SALISBURY PARKS & RECREATION DEPARTMENT YMCA OF NORTHSHORE/HAVERHILL YWCA OF GREATER HAVERHILL YWCA OF NEWBURYPORTAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, ANNA JAQUES HOSPITAL IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE IS. IN THE FY 2023 - 2025 IS, WHICH WILL GUIDE THE ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025, EXAMPLES OF IDENTIFIED NEEDS THAT WILL NOT BE MET IN THESE YEARS ARE SUPPORTING EDUCATION ACROSS THE LIFESPAN, STRENGTHENING THE BUILT ENVIRONMENT (I.E., IMPROVING ROADS/SIDEWALKS AND ENHANCING ACCESS TO SAFE RECREATIONAL SPACES/ACTIVITIES), AND DIGITAL DIVIDE/ACCESS TO TECH RESOURCES. IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE 2019 CHNA THAT ARE NOT INCLUDED IN THE 2019 IS AND WHICH HAVE GUIDED THE ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THE PERIOD FOR THE FISCAL PERIOD COVERED BY THIS FILING. ANNA JAQUES HOSPITAL WILL BE UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES, FEASIBILITY OF AJH HAVING AN IMPACT, AND/OR BECAUSE IT WAS FELT THAT THE ISSUE WAS BEING ADDRESSED BY OTHER COMMUNITY PARTNERS. AS NOTED IN DETAIL ABOVE, THE ANNA JAQUES HOSPITAL'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).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 ANNA JAQUES HOSPITAL CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, [INSERT %] OF ANNA JAQUES HOSPITAL'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITSANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, ANNA JAQUES HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://WWW.AJH.ORG/COMMUNITY/OUTREACH-AND-INVOLVEMENT.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT ANNA JAQUES HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, ANNA JAQUES HOSPITAL IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEANNA JAQUES HOSPITAL'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $696,435 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, ANNA JAQUES HOSPITAL IS ONE OF TEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $55,879,719 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, ANNA JAQUES HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT ENSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ANNA JAQUES HOSPITAL GENERATED $1,486,476 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY ANNA JAQUES HOSPITAL FOR SUCH SERVICES BY $2,976,407 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 10.9% OF 213,603 OF ANNA JAQUES HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION 51.3% OF 109,481 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND ANNA JAQUES HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ANNA JAQUES HOSPITAL GENERATED $46,122,868 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $5,716,373. OF THESE AMOUNTS, REVENUE OF $11,118,369 IS RELATED TO THE PROVISION OF NEONATOLOGY, WOUND CLINIC, AND CANCER CENTER, 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 $12,271,293. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH ANNA JAQUES HOSPITAL CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, ANNA JAQUES HOSPITAL HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 11.05%.BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, ANNA JAQUES HOSPITAL ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $2,064,119 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 WAS 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, 2022 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).FINANCIAL STATEMENT FOOTNOTESBAD DEBTSREVENUES UNDER THE TRADITIONAL FEE FOR SERVICE MEDICARE AND MEDICAID PROGRAMS ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS. RETROSPECTIVELY DETERMINED COST-BASED REVENUES UNDER THESE PROGRAMS, WHICH WERE MORE PREVALENT IN EARLIER PERIODS, AND CERTAIN OTHER PAYMENTS, SUCH AS DISPROPORTIONATE SHARE HOSPITAL AND BAD DEBT EXPENSE REIMBURSEMENT, WHICH ARE BASED ON OUR HOSPITALS' COST REPORTS, ARE ESTIMATED USING HISTORICAL TRENDS AND CURRENT FACTORS. COST REPORT SETTLEMENTS UNDER THESE PROGRAMS ARE SUBJECT TO AUDIT BY MEDICARE AND MEDICAID AUDITORS AND ADMINISTRATIVE AND JUDICIAL REVIEW, AND IT CAN TAKE SEVERAL YEARS UNTIL FINAL SETTLEMENT OF SUCH MATTERS IS DETERMINED AND COMPLETELY RESOLVED. THE SYSTEM RECORDS ACCRUALS TO REFLECT THE EXPECTED FINAL SETTLEMENTS ON COST REPORTS. FOR FILED COST REPORTS, THE ACCRUAL IS RECORDED BASED ON THOSE COST REPORTS AND SUBSEQUENT ACTIVITY. THE ACCRUAL FOR PERIODS FOR WHICH A COST REPORT IS YET TO BE FILED IS RECORDED BASED ON ESTIMATES OF WHAT THE SYSTEM EXPECTS TO REPORT ON THE FILED COST REPORTS. AFTER THE COST REPORT IS FILED, THE ACCRUAL MAY NEED TO BE ADJUSTED..EMERGENCY CARE ACCESSTHE ANNA JAQUES HOSPITAL DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR. FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE ANNA JAQUES HOSPITAL IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. 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 ANNA JAQUES HOSPITAL AS WELL AS PROVIDERS WHO FOLLOW ANNA JAQUES HOSPITAL'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN ANNA JAQUES HOSPITAL AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW ANNA JAQUES HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. ANNA JAQUES HOSPITAL DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. 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 EFFECTIVE ON OR ABOUT AUGUST 15, 2020. FINANCIAL ASSISTANCE POLICYAPPLYING 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 POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICYTRANSLATIONS 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: SPANISH, FRENCH, ITALIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, PORTUGUESE, VIETNAMESE, ARABIC, HAITIAN CREOLE, GREEK, MON-KHMER, CAMBODIAN, RUSSIAN. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://WWW.AJH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE. IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS 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 POLICYPLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE ANNA JAQUES HOSPITAL FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. CREDIT AND COLLECTION POLICY APPLICATION FOR FINANCIAL ASSISTANCE MEDICAL HARDSHIP APPLICATION FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, CAN BE FOUND ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://WWW.AJH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCELIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLEDLOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS NOTED THROUGHOUT THIS FILING AJH 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 AJH. 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 $88,164,361 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 4.70% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $203,874,650 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 15.56%.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	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 RESEARCHALTHOUGH THE PERIOD COVERED BY THIS FILING IS THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, BIDMC IS FILING THIS RETURN ON OR BEFORE THE EXTENDED DUE DATE WHICH IS AUGUST 17, 2020. IN THE INTERVENING MONTHS SINCE THE END OF THE FISCAL PERIOD COVERED BY THIS FILING, THE COVID-19 PANDEMIC HAS CHANGED LIFE IN THE UNITED STATES AND ACROSS THE GLOBE. WHILE THE COVID-19 PANDEMIC BEGAN AFTER THE END OF FY 2019, RESEARCH CONDUCTED AT BIDMC DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, SET THE STAGE FOR BIDMC'S NATIONAL LEADERSHIP DURING THIS ONGOING PUBLIC HEALTH CRISIS. IT IS FOR THIS REASON, THAT BIDMC IS INCLUDING DETAIL IN THIS FILING RELATED TO COVID-19 RESEARCH EVEN THOUGH THIS RESEARCH COMMENCED AFTER THE END OF THE FISCAL PERIOD COVERED BY THIS FILING. AS OF LATE JULY 2020, NEARLY FOUR MILLION COVID-19 INFECTIONS HAVE BEEN REPORTED IN THE UNITED STATES. PUBLIC HEALTH LEADERS HAVE SUGGESTED THAT EFFORTS TO ENFORCE PHYSICAL DISTANCING INCLUDING MASK MANDATES AND STAY-AT-HOME ADVISORIES MAY HAVE TO REMAIN IN PLACE, IF INTERMITTENTLY, UNTIL SCIENTISTS DEVELOP A VACCINE FOR COVID-19.BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IMMUNOLOGIST DAN BAROUCH, MD, PHD HAS BECOME A WORLD LEADER IN THE RACE TO DEVELOP A VACCINE AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19. AS DIRECTOR OF BIDMC'S CENTER FOR VIROLOGY AND VACCINE RESEARCH (CVVR), 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. BAROUCH'S TEAM QUICKLY DESIGNED A SERIES OF VACCINE CANDIDATES, WHICH ARE CURRENTLY BEING EVALUATED IN CLINICAL STUDIES AND LED BY PRIMARY INVESTIGATOR KATHRYN E. STEPHENSON, MD, MPH, DIRECTOR OF THE CLINICAL TRIALS UNIT AT CVVR.DR. BAROUCH'S INNOVATIVE VACCINE DESIGN 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. IF PROVEN SAFE AND EFFECTIVE, THE COVID-19 VACCINE COULD BE AVAILABLE FOR EMERGENCY USE BY EARLY 2021, WHICH MAY BE THE SHORTEST TIME FROM VIRAL EMERGENCE TO VACCINE IN MEDICAL HISTORY.OVER THE LAST 20 YEARS, DR. BAROUCH HAS APPLIED THE ADENOVIRUS STRATEGY FOR USE AGAINST PATHOGENS SUCH AS HIV AND ZIKA. ONE SUCH CANDIDATE HIV VACCINE DEVELOPED BY DR. BAROUCH AND COLLEAGUES IS CURRENTLY IN CLINICAL EFFICACY TRIALS AT SITES AROUND THE WORLD, THE ONLY REMAINING HIV VACCINE CURRENTLY IN LARGE-SCALE CLINICAL TRIALS. DETAIL ON ADDITIONAL NON-COVID RESEARCH EFFORTS WHICH WERE UNDERTAKEN DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. LARGE INTERNATIONAL STUDY CONFIRMS MEASURING BONE MICROARCHITECTURE WITH NEW IMAGING TECHNOLOGY ACCURATELY PREDICTS RISK OF FRACTURE IN OLDER WOMEN AND MENIN THE LARGEST PROSPECTIVE STUDY OF ITS KIND, RESEARCHERS FROM BETH ISRAEL DEACONESS MEDICAL CENTER AND THE INSTITUTE FOR AGING RESEARCH AT HEBREW SENIORLIFE USED HIGH-RESOLUTION TOMOGRAPHY IMAGING TO ASSESS WHETHER OTHER BONE CHARACTERISTICS BESIDES BONE MINERAL DENSITY CAN BE USED TO DETERMINE FRACTURE RISK. EVERY YEAR MORE THAN TWO MILLION OLDER AMERICANS EXPERIENCE A FRAGILITY FRACTURE TO THE HIP, SPINE, OR WRIST. LOSS OF BONE MINERAL DENSITY (BMD) THE CONDITION KNOWN AS OSTEOPOROSIS IS ONE-WAY BONES CAN BECOME FRAGILE, AND SCREENING PATIENTS FOR OSTEOPOROSIS IS THE CURRENT STANDARD FOR DETERMINING FRACTURE RISK IN OLDER ADULTS. HOWEVER, LOW BONE MINERAL DENSITY IS NOT THE ONLY CAUSE OF BONE FRAGILITY, AND THE MAJORITY OF OLDER ADULTS WHO SUSTAIN A FRAGILITY FRACTURE DO NOT MEET THE DIAGNOSTIC CRITERIA FOR OSTEOPOROSIS.THE TEAM FOUND THAT ASSESSING THE MICROSTRUCTURE OF THE TWO DIFFERENT TYPES OF BONE TISSUES COMPACT BONE AND SPONGY BONE MAY BE USEFUL TO PREDICT THE INCIDENCE OF FRAGILITY FRACTURES IN THOSE WHO WOULD NOT OTHERWISE BE IDENTIFIED AS AT RISK. STUDY CO-LEAD AUTHOR MARY L. BOUXSEIN, PHD, DIRECTOR OF THE CENTER FOR ADVANCED ORTHOPEDIC STUDIES AT BIDMC, AND COLLEAGUES PUBLISHED THEIR FINDINGS IN THE LANCET DIABETES AND ENDOCRINOLOGY.SURGE PROTECTOR: NOVEL APPROACH TO SUPPRESSING THERAPY-INDUCED TUMOR GROWTHIN A PREVIOUS STUDY, A TEAM OF RESEARCHERS LED BY DIPAK PANIGRAHY, MD, A PATHOLOGIST AT BETH ISRAEL DEACONESS MEDICAL CENTER, DEMONSTRATED THAT DEAD AND DYING CANCER CELLS KILLED BY CONVENTIONAL CANCER TREATMENTS PARADOXICALLY TRIGGER THE INFLAMMATION THAT PROMOTES TUMOR GROWTH AND METASTASIS. NOW, IN A FOLLOW-UP STUDY PUBLISHED IN PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCE, PANIGRAHY AND COLLEAGUES ILLUMINATE THE MECHANISM BY WHICH DEBRIS GENERATED BY OVARIAN TUMOR CELLS TARGETED BY FIRST-LINE CHEMOTHERAPY ACCELERATES TUMOR PROGRESSION. ADDITIONALLY, THE RESEARCHERS DESCRIBE A NOVEL APPROACH TO SUPPRESSING THE CHEMOTHERAPY-INDUCED TUMOR GROWTH. DR. PANIGRAHY AND COLLEAGUE'S ANALYSIS REVEALED THAT CHEMOTHERAPY-KILLED OVARIAN CANCER CELLS INDUCE SURROUNDING IMMUNE CELLS CALLED MACROPHAGES TO RELEASE A SURGE OF IMMUNE-RELATED CHEMICAL COMPOUNDS CYTOKINES AND LIPID MEDIATORS THAT CREATE OPTIMAL CONDITIONS IN WHICH TUMORS CAN SURVIVE AND GROW. NEXT, THE TEAM SHOWED THAT A COMMON ANTI-INFLAMMATORY DRUG CALLED A DUAL COX-2 INHIBITOR BLOCKED THE SURGE OF TUMOR-FRIENDLY CYTOKINES AND LIPIDS. "THE ROLE OF THESE CHEMOTHERAPY-INDUCED CYTOKINES AND LIPIDS IS UNDERAPPRECIATED AND POORLY CHARACTERIZED, AND OVARIAN CANCER PATIENTS MAY BENEFIT FROM SUPPRESSING THEIR RELEASE," SAID DR. PANIGRAHY. "FURTHER RESEARCH IS NEEDED BUT, DUAL INHIBITION OF THE COX-2 PATHWAYS IS A NOVEL THERAPEUTIC MODALITY THAT MAY COMPLIMENT CONVENTIONAL CANCER THERAPIES BY ACTING AS A SURGE PROTECTOR AGAINST CELL DEBRIS-STIMULATED TUMOR GROWTH." PREVENTING POSTOPERATIVE DELIRIUMAS MANY AS HALF OF ALL PATIENTS WHO UNDERGO CARDIAC SURGERY MAY EXPERIENCE DELIRIUM, A FORM OF ACUTE CONFUSION THAT CAN RESULT IN DISORIENTATION, IMPAIRED MEMORY, DELUSIONS, AND ABRUPT CHANGES IN MOOD AND BEHAVIOR, INCLUDING AGGRESSION. IN A STUDY PUBLISHED IN THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, PHYSICIAN-RESEARCHERS LED BY BALACHUNDHAR SUBRAMAINAM, MD, PHD, DIRECTOR OF THE CENTER FOR ANESTHESIA RESEARCH EXCELLENCE IN THE DEPARTMENT OF ANESTHESIA, CRITICAL CARE AND PAIN MEDICINE AT BETH ISRAEL DEACONESS MEDICAL CENTER FOUND THAT INTRAVENOUS ACETAMINOPHEN SIGNIFICANTLY REDUCED THE INCIDENCE OF POSTOPERATIVE DELIRIUM FOLLOWING CORONARY ARTERY BYPASS PROCEDURES IN PATIENTS OVER 60. THE FINDINGS OF THIS SINGLE-CENTER TRIAL MAY REPRESENT THE FIRST STEPS TOWARD A THERAPEUTIC INTERVENTION FOR THE PREVENTION OF POSTOPERATIVE DELIRIUM, A COMMON AND DEVASTATING COMPLICATION IN THE OFTEN HIGHLY VULNERABLE OLDER ADULTS WHO UNDERGO CARDIAC SURGERY."CURRENTLY, IV ACETAMINOPHEN ADMINISTRATION IS CONSIDERED AN EXPENSIVE INTERVENTION, AND THERE IS SIGNIFICANT VARIATION IN PAIN MANAGEMENT FOLLOWING CARDIAC SURGERY," SAID DR. 2SUBRAMAINAM. "IF OUR FINDINGS ARE REPLICATED IN A LARGER, MULTICENTER STUDY, POSTOPERATIVE INTRAVENOUS ADMINISTRATION OF ACETAMINOPHEN COULD BECOME A STANDARD OF CARE IN ALL CARDIAC SURGICAL PATIENTS AND COULD BE INCORPORATED IN CARDIAC SURGERY RECOVERY PROTOCOLS."
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	SURGEONS RETURNED TO MINIMALLY INVASIVE PROCEDURES FOR HYSTERECTOMY AFTER ABANDONING POTENTIALLY CANCER-SPREADING TECHNIQUEA STUDY BY SPECIALISTS AT BETH ISRAEL DEACONESS MEDICAL CENTER CHARACTERIZED NATIONAL TRENDS IN HYSTERECTOMY PRACTICE IN THE WAKE OF A 2014 FDA WARNING THAT A TOOL CALLED A POWER MORCELLATOR INTENDED TO ASSIST WITH MINIMALLY INVASIVE LAPAROSCOPIC HYSTERECTOMY COULD SPREAD CANCER IN SOME WOMEN. AFTER ENDING THE USE OF POWER MORCELLATION, SURGEONS INITIALLY RETURNED TO MORE INVASIVE ABDOMINAL HYSTERECTOMIES IN THE YEAR FOLLOWING THE FEDERAL WARNING, BIDMC'S RESEARCHERS REPORTED IN THE JOURNAL OBSTETRICS & GYNECOLOGY. HOWEVER, THE TEAM OBSERVED AN OVERALL INCREASE IN THE PROPORTION OF MINIMALLY INVASIVE HYSTERECTOMIES PERFORMED SINCE 2012. "PREVIOUS STUDIES REPORTED AN INCREASE IN ABDOMINAL HYSTERECTOMY IN RESPONSE TO THE FDA SAFETY COMMUNICATION, AND OUR RESULTS ARE CONSISTENT WITHIN THE INITIAL SIX-MONTH PERIOD AFTER THE FIRST CONCERNS ABOUT POWER MORCELLATION WERE REPORTED," SAID LEAD AUTHOR ELISA M. JORGENSEN, MD, A MINIMALLY INVASIVE GYNECOLOGY SURGERY FELLOW AT BIDMC. "HOWEVER, BY LOOKING AT DATA THROUGH 2016, WE FOUND A COMPLETE REVERSAL OF THE PREVIOUSLY REPORTED EFFECT. IN FACT, MINIMALLY INVASIVE HYSTERECTOMY WAS AT ITS PEAK INCIDENCE AT THE END OF OUR FIVE-YEAR STUDY PERIOD." QUASHING THE RESISTANCE: MICRORNA REGULATES DRUG TOLERANCE IN SUBSET OF LUNG CANCERSRELAPSE OF DISEASE FOLLOWING CONVENTIONAL TREATMENTS REMAINS ONE OF THE CENTRAL PROBLEMS IN CANCER MANAGEMENT, YET FEW THERAPEUTIC AGENTS TARGETING DRUG RESISTANCE AND TOLERANCE EXIST. NEW RESEARCH CONDUCTED AT THE CANCER CENTER AT BETH ISRAEL DEACONESS MEDICAL CENTER FOUND THAT A MICRORNA A SMALL FRAGMENT OF NON-CODING GENETIC MATERIAL THAT REGULATES GENE EXPRESSION MEDIATES DRUG TOLERANCE IN LUNG CANCERS WITH A SPECIFIC MUTATION. THE FINDINGS, PUBLISHED IN NATURE METABOLISM, SUGGEST THAT THE MICRORNA COULD SERVE AS A POTENTIAL TARGET FOR REVERSING AND PREVENTING DRUG TOLERANCE IN A SUBSET OF NON-SMALL-CELL LUNG CANCERS. "IN THIS STUDY, WE DISCOVERED THAT A MICRORNA KNOWN AS MIR-147B IS A CRITICAL MEDIATOR OF RESISTANCE AMONG A SUBPOPULATION OF TUMOR CELLS THAT ADOPT A TOLERANCE STRATEGY TO DEFEND AGAINST EGFR-BASED ANTICANCER TREATMENTS," SAID SENIOR AUTHOR FRANK J. SLACK, PHD, DIRECTOR OF THE HMS INITIATIVE FOR RNA MEDICINE AT THE CANCER CENTER AT BIDMC. "WE ARE CURRENTLY TESTING THE IDEA OF TARGETING THIS NEW PATHWAY AS A THERAPY IN CLINICALLY RELEVANT MOUSE MODELS OF EGFR-MUTANT LUNG CANCER."READING CLINICIAN VISIT NOTES CAN IMPROVE PATIENTS' ADHERENCE TO MEDICATIONSA STUDY OF PATIENTS READING THE VISIT NOTES THEIR CLINICIANS WRITE, REPORT POSITIVE EFFECTS ON THEIR USE OF PRESCRIPTION MEDICATIONS. PUBLISHED IN THE ANNALS OF INTERNAL MEDICINE, THE STUDY SHOWS THAT WHEN PATIENTS READ THEIR NOTES, THEY REPORT SIGNIFICANT BENEFITS, INCLUDING FEELING MORE COMFORTABLE WITH AND IN CONTROL OF THEIR MEDICATIONS, A GREATER UNDERSTANDING OF MEDICATION'S SIDE EFFECTS, AND BEING MORE LIKELY TO TAKE MEDICATIONS AS PRESCRIBED. THE STUDY OF APPROXIMATELY 20,000 ADULT PATIENTS AT BETH ISRAEL DEACONESS MEDICAL CENTER IN BOSTON AND TWO OTHER HEALTH SYSTEMS WAS CONDUCTED ONLINE BETWEEN JUNE AND OCTOBER OF 2017. THE THREE HEALTH SYSTEMS HAVE BEEN SHARING VISIT NOTES WRITTEN BY PRIMARY CARE DOCTORS, MEDICAL AND SURGICAL SPECIALISTS, AND OTHER CLINICIANS FOR SEVERAL YEARS. "SHARING CLINICAL NOTES WITH PATIENTS IS A RELATIVELY LOW-COST, LOW-TOUCH INTERVENTION," SAID STUDY LEAD CATHERINE DESROCHES, DRPH, EXECUTIVE DIRECTOR OF OPENNOTES, OF THE DIVISION OF GENERAL MEDICINE AT BIDMC AND AN ASSOCIATE PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. "WHILE NOTE SHARING REQUIRES A CULTURE SHIFT IN MEDICINE, IT IS NOT TECHNICALLY DIFFICULT WITH MOST ELECTRONIC HEALTH RECORD SYSTEMS (EHRS), AND COULD HAVE AN ENORMOUS PAYOFF, GIVEN THAT WE KNOW POOR ADHERENCE TO MEDICATIONS COSTS THE HEALTH CARE SYSTEM ABOUT $300 BILLION PER YEAR. ANYTHING THAT WE CAN DO TO IMPROVE ADHERENCE TO MEDICATIONS HAS SIGNIFICANT VALUE."STUDY: LEVELS OF LIVER FAT BIOMARKER ASSOCIATED WITH METABOLIC HEALTH BENEFITS OF REGULAR EXERCISEWHILE GENETICS AND OTHER FACTORS LIKE AGE AND GENDER CONTRIBUTE TO EACH INDIVIDUAL'S RESPONSE TO EXERCISE, LITTLE IS KNOWN ABOUT THE BIOLOGICAL MECHANISMS BY WHICH PHYSICAL ACTIVITY BRINGS ABOUT BENEFICIAL CHANGES TO THE BODY. IN A STUDY LED BY CARDIOLOGISTS AT BETH ISRAEL DEACONESS MEDICAL CENTER, SCIENTISTS FOUND THAT INCREASING EXERCISE CAN LOWER LEVELS OF DIMETHYLGUANIDINO VALERIC ACID (DMVG), A MOLECULE IN THE BLOOD LINKED TO POOR HEALTH OUTCOMES. HOWEVER, THE RESEARCHERS WERE SURPRISED TO FIND THAT PEOPLE WITH HIGHER BASELINE LEVELS OF DMVG THOSE WITH "MORE ROOM TO IMPROVE" ACTUALLY SAW LESS BENEFIT FROM EXERCISE THAN PEOPLE WITH LOWER BASELINE LEVELS OF DMVG THOSE IN BETTER HEALTH TO BEGIN WITH.LED BY CORRESPONDING AUTHOR ROBERT GERSZTEN, MD, CHIEF OF CARDIOVASCULAR MEDICINE AT BIDMC, THE SCIENTISTS WERE INTERESTED IN STUDYING DMGV BASED ON THEIR PREVIOUS RESEARCH FINDINGS SHOWING THAT THE MOLECULE WAS A MARKER OF LIVER FAT AND THAT CIRCULATING LEVELS WERE TIED THE DEVELOPMENT OF TYPE 2 DIABETES UP TO 12 YEARS PRIOR TO DISEASE ONSET. THE STUDY WAS PUBLISHED IN JAMA CARDIOLOGY.STRUCTURE OF ENZYME THAT PRODUCES FUEL FOR THE HEART OF MUSCLE CELLS REVEALED AFTER SIXTY YEARS OF INTENSIVE INVESTIGATION BY BIOCHEMISTS AND PHYSIOLOGISTS WORLDWIDE, A TEAM OF SCIENTISTS LED BY GABRIEL BIRRANE, PHD, A STRUCTURAL BIOLOGIST AT BETH ISRAEL DEACONESS MEDICAL CENTER, PROVIDED THE FIRST DETAILED PICTURE OF THE STRUCTURE OF THE LIPOPROTEIN LIPASE (LPL) PROTEIN. THE TEAM'S FINDINGS, PUBLISHED IN THE PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES, OFFER A BETTER UNDERSTANDING OF CARDIOVASCULAR METABOLISM AND COULD OPEN THE DOOR TO TARGETED TREATMENT FOR SEVERAL RARE CARDIOVASCULAR DISORDERS. "BECAUSE LPL ALONE IS NOT VERY STABLE, PREVIOUS EXPERIMENTERS HAD DIFFICULTY PRODUCING SUFFICIENT AMOUNTS LPL FOR STRUCTURAL ANALYSIS," EXPLAINED DR. BIRRANE. "MY COLLABORATORS PROVIDED THE BREAKTHROUGH DATA, INCLUDING METHODS TO PURIFY ACTIVE LPL AND A COMPANION PROTEIN THAT WAS CRUCIAL TO STABILIZE LPL. WITH THIS KNOWLEDGE, WE CONCENTRATED OUR EFFORTS ON CRYSTALLIZING A COMPLEX OF THE TWO PROTEINS. CRYSTALS OF THE COMPLEX PRODUCED X-RAY DATA OF MUCH HIGHER QUALITY THAN WE WERE ABLE TO OBTAIN WITH LPL ALONE AND THIS ALLOWED US TO ANALYZE THE STRUCTURE AT A MOLECULAR LEVEL." NOW THAT THE TEAM HAS REVEALED THE STRUCTURE OF THE PROTEIN COMPLEX, RESEARCHERS CAN UNDERSTAND HOW MUTATIONS IN LPL OR GPIHBP1 LEAD TO ELEVATED TRIGLYCERIDE LEVELS AND CORONARY ARTERY DISEASE. OTHER MOLECULES BIND TO AND REGULATE THE FUNCTION OF LPL. IN FOLLOW UP STUDIES, DR. BIRRANE AND HIS COLLABORATORS WOULD LIKE TO DETERMINE THESE MOLECULES' MECHANISM OF ACTION, INFORMATION THAT WILL ALLOW SCIENTISTS TO BETTER UNDERSTAND THE ROLE LPL PLAYS IN CARDIOVASCULAR DISEASE AND DIABETES. BOTSWANA STUDY OF HIV MEDICATION SAFETY IN PREGNANCY HAS LESSONS FOR THE USBABIES BORN TO WOMEN TAKING THE HIV THERAPY DOLUTEGRAVIR ARE AT A SLIGHTLY INCREASED RISK OF BIRTH DEFECTS CALLED NEURAL TUBE DEFECTS WHICH AFFECT THE BRAIN, SPINE, AND SPINAL CORD, ACCORDING TO A STUDY PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE. THE FINDINGS, PRESENTED BY INFECTIOUS DISEASE SPECIALIST REBECCA ZASH, MD, AN ASSISTANT PROFESSOR OF MEDICINE AT BETH ISRAEL DEACONESS MEDICAL CENTER AND A RESEARCH FELLOW AT THE HARVARD T.H. CHAN SCHOOL OF PUBLIC HEALTH, AT THE 10TH INTERNATIONAL AIDS SOCIETY CONFERENCE IN MEXICO CITY, COULD IMPACT TREATMENT GUIDELINES AROUND ANTIRETROVIRAL CHOICES FOR WOMEN OF REPRODUCTIVE AGE. "WHEN DOLUTEGRAVIR CAME OUT, IT WAS POISED TO BECOME THE MOST WIDELY RECOMMENDED ANTIRETROVIRAL MEDICATION BECAUSE IT IS VERY EFFECTIVE AGAINST HIV AND IS PARTICULARLY WELL TOLERATED," SAID DR. ZASH. "OUR STUDY SHOWS THAT DOLUTEGRAVIR IS NOT NECESSARILY A MAGIC BULLET AND CONTINUED EFFORTS ARE NEEDED TO DEVELOP NOVEL HIV TREATMENTS. WE PLAN TO CONTINUE OUR WORK IN BOTSWANA TO STUDY THE SAFETY OF CURRENT AND NEW ANTIRETROVIRAL MEDICATIONS IN PREGNANCY."RESEARCHERS FIND WIDESPREAD ASPIRIN USE DESPITE FEW BENEFITS, HIGH RISKSASPIRIN USE IS WIDESPREAD AMONG GROUPS AT RISK FOR HARM INCLUDING OLDER ADULTS AND ADULTS WITH PEPTIC ULCERS PAINFUL SORES IN THE LINING OF THE STOMACH THAT ARE PRONE TO BLEEDING THAT AFFECT ABOUT ONE IN TEN PEOPLE. IN A RESEARCH REPORT PUBLISHED IN ANNALS OF INTERNAL MEDICINE, RESEARCHERS FROM BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) REPORT ON THE EXTENT TO WHICH AMERICANS 40 YEARS OLD AND ABOVE USE ASPIRIN FOR PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION AS NOTED THROUGHOUT THIS FILING AJH 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 AJH. AS PART OF THE SAME NETWORK, THE ACADEMIC TEACHING AND TRAINING IN WHICH BIDMC ENGAGES SUPPORTS NOT ONLY THE BIDMC MISSION, CARE FOR BIDMC PATIENTS AND COMMUNITIES BUT BIDMC'S COMMITMENT TO TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW ALSO HELPS TO IMPROVE PATIENT CARE FOR THE COMMUNITIES OF OTHER BILH AFFILIATES AND BEYOND. THE DETAIL BELOW PROVIDES BACKGROUND ON THE TEACHING ACTIVITIES AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING.THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 60 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 785 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 52 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 60 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS: ANESTHESIOLOGY EMERGENCY MEDICINE EAR, NOSE AND THROAT (OTOLARYNGOLOGY) INTERNAL MEDICINE NEUROLOGY NEUROSURGERY OBSTETRICS AND GYNECOLOGY PATHOLOGY PLASTIC SURGERY PSYCHIATRY RADIOLOGY SURGERY TRANSITIONAL YEAR UROLOGYDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER HAD NET EXPENDITURES OF $68,456,175 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE MEDICAL CENTER'S TEACHING FUNCTION WHICH REPRESENTED 2.90% OF THE MEDICAL CENTER'S TOTAL EXPENSES.RESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. OVER HALF OF THESE PROGRAMS (59 OF 109) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS: ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS) EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, ACADEMIC EMERGENCY MEDICINE INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY PSYCHIATRY RADIOLOGY-DIAGNOSTIC: ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING MSK, NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATEDADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS -- EXAMPLESBELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HOSPITAL, TUFTS MEDICAL CENTER, ST. VINCENT HOSPITAL, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH-QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. *****
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD- AND FOURTH-YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSE STAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE. DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC. ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH TO BE EFFECTIVE PRACTITIONERS IN UNDERSERVED, RESOURCE-LIMITED SETTINGS AND TO DESIGN, MANAGE, IMPROVE AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS THAT ADDRESS THE HEALTH PROBLEMS OF THE WORLD'S NEEDIEST POPULATIONS.PROGRAM OBJECTIVES INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS CONTRIBUTE TO THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS IN BOSTON AND AROUND THE WORLD ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS WITH LIMITED RESOURCES EXPAND RESEARCH OPPORTUNITIES ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH SITE LOCATIONS BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. PHYSICIAN AND NURSE TRAINING ON HIV/AIDS CARE IN VIETNAM TAKES PLACE THROUGH FUNDING FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH. *****NEUROLOGY EDUCATION AT BIDMCTHE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2-BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY-BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. ***PATHOLOGY EDUCATION AT BIDMCTHE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST-YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING. ***RADIOLOGY EDUCATION AT BIDMCTHE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEORECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST-YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE: THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR. FOUR-WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR. ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.OUR UNIQUE EDUCATIONAL TRACKSCURRENTLY, SIX TRACKS ARE OFFERED: CLINICAL EDUCATION RESEARCH GLOBAL HEALTH QUALITY IMPROVEMENT HEALTH POLICY/HEALTH ECONOMICS
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	EACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.*****SURGERY EDUCATION AT BIDMCTHE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, NEUROSURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, UROLOGY, AND VASCULAR SURGERY. STUDENTS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. STUDENTS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSE STAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSE STAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE: RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)OPEN STAFF THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, ANNA JAQUES HOSPITAL 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), JOSLIN DIABETES CENTER 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.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.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES FISCAL YEAR ENDED SEPTEMBER 30, 2022SINCE COMING TOGETHER AS A HEALTH SYSTEM, BETH ISRAEL LAHEY HEALTH ("BILH") HAS CONTINUED TO MAKE SIGNIFICANT INVESTMENTS AND UNDERTAKE INITIATIVES TO IMPROVE ACCESS FOR PATIENTS AND SUPPORT ITS SURROUNDING COMMUNITIES. IN FY 2022 ALONE, BILH INVESTED OVER $8 MILLION IN ITS COMMUNITY HEALTH CENTER PARTNERS AND SAFETY NET AFFILIATES, DEVELOPED ACCESSIBLE PATIENT MESSAGING AND EDUCATION, AND INVESTED OVER $5 MILLION IN SEVERAL BEHAVIORAL HEALTH-FOCUSED INITIATIVES. BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK ("BILHPN") CONTINUES TO OPTIMIZE ITS POPULATION HEALTH-FOCUSED INITIATIVES, INCLUDING THOSE FOCUSED ON ADDRESSING HEALTH DISPARITIES. HIGHLIGHTS OF THE SYSTEM'S EFFORTS INCLUDE: ENHANCED ACCESS FOR MASSHEALTH PATIENTS TO MITIGATE BARRIERS IN ACCESS TO CARE AND INCREASE THE NUMBER OF MASSHEALTH PATIENTS THAT BILH SERVES, THE SYSTEM COMMITTED TO UNIVERSAL NETWORK-WIDE PROVIDER PARTICIPATION IN MASSHEALTH. SPECIFICALLY, AS OF OCTOBER 2020, ALL BILH HOSPITALS AND PROVIDERS EMPLOYED BY BILH OR ON WHOSE BEHALF BILH JOINTLY CONTRACTS HAVE APPLIED TO PARTICIPATE IN SOME FORM OF MASSHEALTH. IN FY 2022, BILH SIGNED A NEW MASSHEALTH ACO CONTRACT WITH BMC HEALTHNET PLAN / WELLSENSE HEALTH PLAN THAT WILL GO INTO EFFECT IN APRIL 2023. AS PART OF THIS CONTRACT, BILHPN WILL EXTEND PARTICIPATION TO ALL ELIGIBLE PRIMARY CARE PROVIDERS ("PCPS") WHO WERE NOT OTHERWISE PARTICIPATING IN A MASSHEALTH ACO. WHILE ALL ELIGIBLE BILHPN PCPS WERE PARTICIPANTS IN A FORM OF MASSHEALTH, SOME PCPS HAVE PREVIOUSLY NOT PARTICIPATED IN A MASSHEALTH ACO. DURING FY 2022, BILH DEVELOPED AND REFINED A MULTICULTURAL MARKETING, ADVERTISING, AND OUTREACH PLAN WITH THE PURPOSE OF EXPANDING ACCESS FOR UNDERSERVED POPULATIONS, INCLUDING MASSHEALTH PATIENTS, IN TARGETED BILH SERVICE AREAS. IMPLEMENTATION OF THAT PLAN WILL OCCUR IN FY 2023. INVESTMENTS IN UNDERSERVED COMMUNITIES BILH HOSPITALS HAVE CREATED STRONG CONNECTIONS TO A NETWORK OF AFFILIATED HOSPITALS AND HEALTH CENTERS THAT PROVIDE COMMUNITY-BASED CARE TO HISTORICALLY UNDERSERVED POPULATIONS. IN THE REGIONS THAT THEY SERVE, THE SAFETY NET AFFILIATES ("SNAS") AND COMMUNITY CARE ALLIANCE ("CCA") COMMUNITY HEALTH CENTERS ("CHCS") ARE THE CORNERSTONE OF BILH'S DELIVERY SYSTEM REGARDING COMMUNITY-BASED CARE FOR MASSHEALTH AND HISTORICALLY UNDERSERVED PATIENTS.O CCA CHCS INCLUDE BOWDOIN STREET HEALTH CENTER, CHARLES RIVER COMMUNITY HEALTH, THE DIMOCK CENTER, FENWAY HEALTH, AND SOUTH COVE COMMUNITY HEALTH CENTER. O SNAS INCLUDE CAMBRIDGE HEALTH ALLIANCE AND SIGNATURE HEALTHCARE BROCKTON HOSPITAL. BILH CONTINUES TO INVEST IN THE CCA CHCS AND SNAS, ENABLING THEM TO EXPAND THEIR CAPABILITIES AND CARE FOR MORE HISTORICALLY UNDERSERVED PATIENTS. IN FY 2022, BILH INVESTED OVER $8 MILLION IN ITS CHCS AND SNAS, IN ADDITION TO ENGAGING IN REGIONAL PLANNING AND COLLABORATIVE PROGRAM DEVELOPMENT. THESE INVESTMENTS REPRESENT ONLY A PORTION OF A MUCH LARGER COMMUNITY BENEFITS INVESTMENT PORTFOLIO THAT IS DESCRIBED IN GREATER DETAIL IN THIS AND OTHER BILH NETWORK TAX FILINGS. BILH IS EXPLORING OPPORTUNITIES WITH CHCS IN ESSEX AND MIDDLESEX COUNTIES. FOR EXAMPLE, BILH HAS ESTABLISHED A TELEHEALTH PILOT PROGRAM BETWEEN PHYSICIANS AT ADDISON GILBERT AND BEVERLY HOSPITALS AND PATIENTS AT NORTH SHORE COMMUNITY HEALTH CENTER. COMMITMENT TO BEHAVIORAL HEALTH CARE BETH ISRAEL LAHEY HEALTH BEHAVIORAL SERVICES IS THE LARGEST MENTAL HEALTH AND SUBSTANCE USE DISORDER NETWORK IN EASTERN MASSACHUSETTS. WITH A FOCUS ON COMMUNITY HEALTH, BILH BEHAVIORAL SERVICES SUPPORTS THE NEEDS OF CHILDREN, TEENS, AND ADULTS THROUGH A RANGE OF OPTIONS, FROM INPATIENT CARE TO COMMUNITY-BASED PROGRAMS. IN FY 2022, BILH INVESTED OVER $5 MILLION IN THE FOLLOWING BEHAVIORAL HEALTH INITIATIVES: THE COLLABORATIVE CARE MODEL, CENTRALIZED BED MANAGEMENT PROGRAM, AND MEDICATION ASSISTED THERAPY ("MAT") AS OF SEPTEMBER 30, 2022, 60 OF 78 EMPLOYED PRIMARY CARE PRACTICES2 ARE PARTICIPATING IN THE IMPACT MODEL, WITH 12 NEW SITES ADDED FROM THE PREVIOUS YEAR. THE IMPACT MODEL (ALSO REFERRED TO AS THE "COLLABORATIVE CARE" MODEL) IS A BEHAVIORAL HEALTH INTEGRATION MODEL, WHICH INVOLVES INTRODUCING PRIMARY CARE PATIENTS WHO ARE IDENTIFIED THROUGH SCREENINGS AND DIRECT REFERRALS TO AN EMBEDDED BEHAVIORAL HEALTH CLINICIAN. BILH HAS CONTINUED TO EXPAND ITS BRIDGE CLINICS AT ADDISON GILBERT AND BEVERLY HOSPITALS, INCREASING SAME-DAY ADMISSION FOR MAT PATIENTS FROM 24 TO 40 HOURS PER WEEK, OBTAINING ADDITIONAL STAFF, AND EXPANDING ITS INDUCTION PROGRAM. BILH HAS EXPANDED ITS SYSTEM-WIDE SUBSTANCE USE DISORDER TASKFORCE, DEFINING NEW PATHWAYS FOR CONNECTING BILH PRIMARY CARE TEAMS WITH COMMUNITY ACUTE DETOX AND OTHER ADDICTION-BASED SERVICES, INCREASING THE CAPACITY OF BILH PCPS TO PRESCRIBE MEDICATIONS IN SUPPORT OF OFFICE-BASED ADDICTION TREATMENT, AND PROVIDING EDUCATIONAL TRAININGS TO PCPS TO SCREEN AND TREAT SUBSTANCE USE DISORDERS. THE PRACTICE OF MAT INDUCTION AND REFERRAL IN THE ED AT BID-PLYMOUTH CONTINUED IN FY 2022, WITH RECOVERY NAVIGATORS, AN ADDICTION LPN NURSE, AND A PSYCHIATRIC NP AS AVAILABLE RESOURCES TO PATIENTS. BID-PLYMOUTH ALSO CONTINUED ITS PARTNERSHIP WITH AREA COALITIONS TO HAND OUT SUPPLIES AND RESOURCES, INCLUDING NARCAN, TO THOSE PATIENTS WHO ARE RESIDENTS OF THE AREA AND WHO PRESENT TO THE BID-PLYMOUTH EMERGENCY ROOM WITH AN OPIOID OVERDOSE. ADDITIONAL INFORMATION ON BEHAVIORAL HEALTH IS BELOW.POPULATION HEALTH INITIATIVES BILHPN SUPPORTS AND IMPROVES ACCESS, QUALITY AND EFFICIENCY OF PATIENT-CENTERED CARE BY LEVERAGING BEST PRACTICES IN CLINICAL EXCELLENCE AND DATA ANALYTICS TO HELP PROVIDERS IMPROVE PATIENT HEALTH OUTCOMES. FOR EXAMPLE, BILHPN'S CARE MANAGEMENT TEAM WORKS WITH THE HIGHEST-RISK PATIENTS IN AN EFFORT TO EDUCATE THEM ON THEIR DISEASE, IMPROVE MEDICATION COMPLIANCE, AND HELP THEM NAVIGATE THE COMPLEXITIES OF THE HEALTHCARE SYSTEM. THE GOAL OF BILHPN'S CARE MANAGERS IS TO IMPROVE OUTCOMES FOR PATIENTS WHILE AVOIDING UNNECESSARY EMERGENCY ROOM VISITS OR HOSPITAL STAYS. DURING FY 2022, BILH UNDERTOOK SEVERAL INITIATIVES TO IMPROVE POPULATION HEALTH AND PATIENT CARE, INCLUDING: O BILHPN'S QUALITY TEAM DEVELOPED AND IMPLEMENTED EIGHT TEXT-BASED OUTREACH CAMPAIGNS FOR PATIENTS, ADDRESSING CANCER SCREENINGS, IMMUNIZATIONS, AND DIABETES CARE TO IMPROVE POPULATION HEALTH METRICS.O BILHPN CONTINUED TO OPTIMIZE ITS ENTERPRISE-WIDE POPULATION HEALTH DATA WAREHOUSE TO IDENTIFY PATIENTS WITH CARE GAPS. THROUGH COLLABORATION WITH BILH PHYSICIAN LEADERS, BILHPN MODIFIED PRACTICE WORKFLOWS AND CREATED OUTREACH PROGRAMS TO CLOSE IDENTIFIED GAPS. THESE EFFORTS RESULTED IN BILH REACHING MORE PATIENTS.O DURING FY 2022, BILHPN AND THE BILH OFFICE FOR DIVERSITY, EQUITY AND INCLUSION CO-LED EFFORTS TO INCREASE ACCESS AND IMPROVE OUTCOMES FOR UNDERSERVED POPULATIONS, WITH A FOCUS ON CLOSING DISPARITIES IN DIABETES CARE FOR BLACK AND HISPANIC PATIENTS. ONE AREA OF COLLABORATION CENTERED AROUND A $1.8 MILLION GRANT FROM THE INSTITUTE OF HEALTHCARE IMPROVEMENT / BLUE CROSS BLUE SHIELD OF MASSACHUSETTS THAT ALLOWED THE SYSTEM TO HIRE AND EMBED PATIENT NAVIGATORS WITHIN ITS MOST DIVERSE PRACTICES TO ASSIST PATIENTS ALONG THE CONTINUUM OF CARE. 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; AND SCHOOL-BASED AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES.AS NOTED PREVIOUSLY, SINCE ITS CREATION IN MARCH 2019, BILH HAS CONTINUED TO INVEST SIGNIFICANTLY IN IMPROVING ACCESS TO BEHAVIORAL HEALTH CARE THROUGH A SYSTEM-WIDE APPROACH TO CARE DELIVERY. AS ONE OF SEVERAL ONGOING INITIATIVES, BILH 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 2022, BILH HAD IMPLEMENTED THE IMPACT MODEL IN 74.36% OF ITS EMPLOYED PRIMARY CARE PRACTICES AS PART OF ITS COLLABORATIVE CARE PROGRAM IMPLEMENTATION.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	IN MARCH 2021, BILHBS LAUNCHED ITS CENTRALIZED BED FINDING TEAM. THIS TEAM IS PART OF A BILHBS 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 EMERGENCY DEPARTMENT (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.IN FY2022, THE STATE OF MASSACHUSETTS SET FORTH THE MASSACHUSETTS BEHAVIORAL HEALTH ROADMAP TO INCLUDE FOUR PRIMARY OUTCOMES IN EFFORTS TO ADVANCE HEALTH EQUITY: (1) THE DEVELOPMENT OF COMMUNITY BEHAVIORAL HEALTH CENTERS (CBHCS); (2) SHIFTING BEHAVIORAL HEALTH EMERGENCY SERVICES TO THE COMMUNITY FROM THE EMERGENCY DEPARTMENTS; (3) TREATMENT ON DEMAND (OUTPATIENT EVALUATION AND TREATMENT); AND (4) BEHAVIORAL HEALTH HELP LINE. IN RESPONSE TO THIS MOVEMENT, BILHBS RECEIVED AN AWARD TO OPERATE A CBHC IN THE LAWRENCE LOCATION AND BEGAN THE PLANNING TO PIVOT EMERGENCY SERVICES TEAMS TO SERVE THE BILH SYSTEM EMERGENCY DEPARTMENTS. 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. IN ADDITION, 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.

Schedule H (Form 990) 2021

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
ANNA JAQUES HOSPITAL INC

Employer identification number
04-2104338

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) CHANGE HEALTHCARE 3055 LEBANON PIKE SUITE 1000 NASHVILLE,TN37214	82-2152098	501(C)(3)	16,683	0			COMMUNITY SUPPORT
(2) YWCA OF NEWBURYPORT 13 MARKET ST NEWBURYPORT,MA01950	04-2123678	501(C)(3)	10,000	0			COMMUNITY SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2021

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

AS PREVIOUSLY NOTED IN THE FILING ANNA JAQUES HOSPITAL, INC., MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND ANNA JAQUES HOSPITAL, INC. WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. ANNA JAQUES HOSPITAL, INC. ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.

Schedule I (Form 990) 2021

Additional Data

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Software Version:

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

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

Cat. No. 50053T

Schedule J (Form 990) 2021

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1TABB MD KEVIN CHIEF EXECUTIVE OFFICER (EX-OFFICIO)	(i) (ii)	0 ------------- 1,866,181	0 ------------- 2,590,331	0 ------------- 578,116	0 ------------- 256,516	0 ------------- 39,655	0 ------------- 5,330,799	0 ------------- 0
2KERNDL JOHN TREASURER (EX-OFF); BILH EVP & CFO	(i) (ii)	0 ------------- 813,559	0 ------------- 491,357	0 ------------- 60,084	0 ------------- 0	0 ------------- 26,877	0 ------------- 1,391,877	0 ------------- 0
3NESTO MD RICHARD TTEE (EX-OF)(CEO DESIGNEE); BILH CMO	(i) (ii)	0 ------------- 792,483	0 ------------- 392,337	0 ------------- 156,337	0 ------------- 14,250	0 ------------- 27,119	0 ------------- 1,382,526	0 ------------- 0
4KATZ ESQ JAMIE CLERK (EX-OFF); BILH GEN COUNSEL	(i) (ii)	0 ------------- 744,211	0 ------------- 386,130	0 ------------- 125,507	0 ------------- 12,825	0 ------------- 9,218	0 ------------- 1,277,891	0 ------------- 0
5FISCHER STEVEN P FRMR EX-OFF TREAS; FRMR BILH EVP&CFO	(i) (ii)	0 ------------- 359,497	0 ------------- 337,500	0 ------------- 277,823	0 ------------- 34,320	0 ------------- 12,915	0 ------------- 1,022,055	0 ------------- 0
6GOLDSTEIN MARK TTEE (EX-OFF); AJH & SAGP PRES	(i) (ii)	0 ------------- 592,840	0 ------------- 159,922	124,787 ------------- 66,096	0 ------------- 11,400	0 ------------- 25,239	124,787 ------------- 855,497	0 ------------- 0
7PURSLEY MD DEWAYNE M TTEE; CHIEF OF NEONATOLOGY (BIDMC)	(i) (ii)	0 ------------- 730,227	0 ------------- 17,010	0 ------------- 7,242	0 ------------- 58,000	0 ------------- 20,687	0 ------------- 833,166	0 ------------- 0
8FAYRE MD GAIL FORMER CMO OF AJH & COO OF SAGP	(i) (ii)	267,591 ------------- 0	87,274 ------------- 0	212,010 ------------- 0	36,926 ------------- 0	23,980 ------------- 0	627,781 ------------- 0	0 ------------- 0
9KILDAY KEVIN CFO	(i) (ii)	333,211 ------------- 0	68,691 ------------- 0	9,333 ------------- 0	38,825 ------------- 0	42,450 ------------- 0	492,510 ------------- 0	0 ------------- 0
10MAKI DN RN RICHARD CNO	(i) (ii)	250,148 ------------- 0	38,790 ------------- 0	4,836 ------------- 0	20,807 ------------- 0	31,069 ------------- 0	345,650 ------------- 0	0 ------------- 0
11LEE GARY VP, CLINICAL OPERATIONS	(i) (ii)	201,246 ------------- 0	21,103 ------------- 0	2,949 ------------- 0	18,377 ------------- 0	38,733 ------------- 0	282,408 ------------- 0	0 ------------- 0
12BUCHANAN JRROBERT R DIR OF INFO. SYSTEMS	(i) (ii)	190,923 ------------- 0	500 ------------- 0	0 ------------- 0	29,756 ------------- 0	40,822 ------------- 0	262,001 ------------- 0	0 ------------- 0
13PERRYDANIELLE C VP PUBLIC RELATIONS	(i) (ii)	184,070 ------------- 0	23,209 ------------- 0	11,042 ------------- 0	16,052 ------------- 0	21,466 ------------- 0	255,839 ------------- 0	0 ------------- 0
14NEWSOME-LEVINSANDRA L CHIEF QUALITY OFFICER, VP	(i) (ii)	164,382 ------------- 0	500 ------------- 0	50 ------------- 0	33,621 ------------- 0	28,825 ------------- 0	227,378 ------------- 0	0 ------------- 0
15HIGGINSLISA M REGISTERED NURSE	(i) (ii)	176,319 ------------- 0	7,759 ------------- 0	0 ------------- 0	10,596 ------------- 0	29,823 ------------- 0	224,497 ------------- 0	0 ------------- 0
16WILLIAMSONMARY E VP DVLPMT & ED OF THE ANNA JAQ COMM	(i) (ii)	154,866 ------------- 0	18,790 ------------- 0	485 ------------- 0	32,043 ------------- 0	13,547 ------------- 0	219,731 ------------- 0	0 ------------- 0
17SOLDANO JOSEPH CO-INTERIM CFO, DIRECTOR OF FINANCIA	(i) (ii)	163,842 ------------- 0	500 ------------- 0	52 ------------- 0	15,418 ------------- 0	38,180 ------------- 0	217,992 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINES 4A-B	SCHEDULE J PART I QUESTION 4A SEVERANCE AND CHANGE OF CONTROL PAYMENTS AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, AND AS NOTED ABOVE, THE COMPENSATION DETAIL INCLUDED IN ANNA JAQUES HOSPITAL (AJH) FORM 990 FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 IS CALENDAR YEAR 2021 DETAIL. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. SCHEDULE J PART I QUESTION 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN ANNA JAQUES HOSPITAL'S FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 IS CALENDAR YEAR 2021 DETAIL. AMOUNTS RECEIVED BY PARTICIPANTS AND RELATED TO THIS PLAN ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. AMOUNTS DEFERRED BY PARTICIPANTS OR CONTRIBUTIONS RECEIVED BY PARTICIPANTS AND RELATED TO THESE PLANS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW.
PART I, LINE 7	ACROSS THE BILH NETWORK OF AFFILIATES, INCLUDING AJH, EXECUTIVE COMPENSATION PACKAGES AND CERTAIN EMPLOYEE COMPENSATION PACKAGES INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING PRE-DETERMINED GOALS. FOR THE PERIOD COVERED BY THIS FILING, THE INCENTIVE COMPENSATION FOR EACH EXECUTIVE REPORTED IN THIS FORM 990 WAS REVIEWED AND APPROVED BY THE BILH COMPENSATION COMMITTEE, WHICH AS PREVIOUSLY NOTED, WAS FULLY STAFFED BY INDEPENDENT MEMBERS.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES:	ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES IN THE NOTES BELOW AND WAS PAID FOR POSITIONS HELD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. AS REQUIRED BY FORM 990, COMPENSATION REPORTED FOR THIS FISCAL YEAR IS CALENDAR YEAR 2021 COMPENSATION. COMPENSATION REPORTED FOR INDIVIDUALS MAY REFLECT AN ALLOCATION OF COMPENSATION PAID BY ENTITIES RELATED TO THE FILING ORGANIZATION AND WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK OR OTHER ENTITIES, AS REQUIRED. REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: REGULAR WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS QUANTIFIED IN OTHER REPORTABLE COMPENSATION WHICH MAY NOT BE SEPARATELY NOTED IN THIS FILING INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; DISTRIBUTIONS FROM A 457(B) PLAN; AMOUNTS INCLUDIBLE IN INCOME UNDER A 457(F) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED RETIREMENT BENEFITS; OTHER TAXABLE RETIREMENT BENEFITS DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401K RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403B RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT, UNFUNDED AND UNVESTED AMOUNTS DEFERRED UNDER 457(F) PLAN NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THESE NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE COMPLETE TITLES AND ADDITIONAL EXPLANATORY INFORMATION FOR OFFICERS, DIRECTOR/TRUSTEES, KEY EMPLOYEES AND THE ENTITIES FIVE HIGHEST PAID EMPLOYEES OTHER THAN ODTKH ARE LISTED BELOW ALPHABETICALLY: BENNETT, MATT VICE PRESIDENT, HUMAN RESOURCES ANNA JAQUES HOSPITAL VICE PRESIDENT, HUMAN RESOURCES ANNA JAQUES COMMUNITY HEALTH FOUNDATION VICE PRESIDENT, HUMAN RESOURCES SEACOAST AFFILIATED GROUP PRACTICE, INC. BOUTON, PH.D., CHRISTOPHER TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. CANNON, PATRICIA TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. CAPOLUPO, WAYNE TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. CONNOLLY, ESQ., GRACE GONZALEZ TRUSTEE, VICECHAIR OF THE BOARD ANNA JAQUES HOSPITAL TRUSTEE, VICE CHAIR OF THE BOARD SEACOAST AFFILIATED GROUP PRACTICE, INC. COSTELLO, MICHAEL TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. COUSINS, JR., FRANK G. TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. DESIMONE, SHELLEY FORMER VICE PRESIDENT OF HUMAN RESOURCES ANNA JAQUES HOSPITAL FORMER VICE PRESIDENT OF HUMAN RESOURCES ANNA JAQUES COMMUNITY HEALTH FOUNDATION FORMER VICE PRESIDENT OF HUMAN RESOURCES SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR SHELLEY DESIMONE INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $444.61. OF THIS AMOUNT, $444.61 IS UNVESTED. ERAMO, GINNY TRUSTEE, ASSISTANT CLERK ANNA JAQUES HOSPITAL TRUSTEE, ASSISTANT CLERK SEACOAST AFFILIATED GROUP PRACTICES, INC. FAYRE, M.D., GAIL CHIEF MEDICAL OFFICER ANNA JAQUES HOSPITAL CHIEF OPERATING OFFICER SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MRS. FAYRE INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $ 211,905. FUNG, M.D., CLAIRE TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. MRS. FUNG'S TERM AS TRUSTEE OF ANNA JAQUES HOSPITAL BEGAN ON OCTOBER 1, 2020. GHIASUDDIN, MD, SALMAN TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. MANAGING MEMBER - BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK, LLC GOLDSTEIN, MARK UNLESS OTHERWISE NOTED BELOW, MR. GOLDSTEIN HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2022. TRUSTEE (EX-OFFICIO), PRESIDENT ANNA JAQUES HOSPITAL PRESIDENT AND TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. ALTHOUGH MR. GOLDSTEIN SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2021 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. GOLDSTEIN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $115,230.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES:	KATZ, J.D., JAMIE UNLESS OTHERWISE NOTED BELOW, MR. KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2022: GENERAL COUNSEL AND CLERK (EX-OFFICIO), - BETH ISRAEL LAHEY HEALTH, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. CLERK - BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK, LLC CLERK (EX-OFFICIO) - MOUNT AUBURN HOSPITAL CLERK (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. CLERK - COMMUNITY PHYSICIANS ASSOCIATES, INC. CLERK (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. CLERK (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. CLERK (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. CLERK (EX-OFFICIO) - ANNA JAQUES HOSPITAL CLERK - SEACOAST AFFILIATED GROUP PRACTICE, INC. TRUSTEE AND CLERK (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND CLERK (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CLERK (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. CLERK (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE ACCOUNTABLE CARE ORGANIZATION, LLC CLERK (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE NETWORK, LLC CLERK (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. TRUSTEE AND CLERK - CAB HEALTH AND RECOVERY SERVICES, INC. TRUSTEE AND CLERK (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL CLERK - JOSLIN CLINIC, INC. O COMMENCED POSITION AS CLERK ON NOVEMBER 1, 2021 CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. O COMMENCED POSITION AS CLERK ON NOVEMBER 1, 2021 CLERK (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. O COMMENCED POSITION AS CLERK (EX-OFFICIO) ON MARCH 18, 2022 MR. KATZ SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2021 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $99,848. KERNDL, JOHN UNLESS OTHERWISE NOTED BELOW, MR. KERNDL HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2022: EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER AND TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. TRUSTEE AND TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. TREASURER - CAREGROUP PARMENTER HOME CARE & HOSPICE, INC. TRUSTEE, TREASURER (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. TREASURER (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. TREASURER (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER TRUSTEE AND TREASURER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC.TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL ASSISTANT TREASURER (EX-OFFICIO) MOUNT AUBURN PROFESSIONAL SERVICES (TERM OCTOBER 20, 2021 MARCH 17, 2022) TREASURER (EX-OFFICIO) MOUNT AUBURN PROFESSIONAL SERVICES (TERM BEGAN MARCH 18, 2022) ASSISTANT TREASURER (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP TREASURER (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO), TREASURER(EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. TRUSTEE (EX-OFFICIO), TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TREASURER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. TRUSTEE AND TREASURER (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. TREASURER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. TRUSTEE (EX-OFFICIO), TREASURER (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. MANAGING DIRECTOR - BETH ISRAEL DEACONESS PHYSICIAN ORGANIZATION, LLC MANAGING DIRECTOR, TREASURER - BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK, LLC TREASURER (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE ACCOUNTABLE CARE ORGANIZATION, LLC TREASURER (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE NETWORK, LLC ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TREASURER (EX-OFFICIO) - JOSLIN CLINIC, INC. O COMMENCED POSITION AS TREASURER (EX-OFFICIO) ON NOVEMBER 1, 2021 TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. O COMMENCED POSITION AS TREASURER (EX-OFFICIO) ON NOVEMBER 1, 2021 ALTHOUGH MR. KERNDL SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2021 COMPENSATION. OTHER REPORTABLE COMPENSATION FOR MR. KERNDL INCLUDES $ 48,375 RELATED TO RELOCATION AND TEMPORARY HOUSING WHEN MR. KERNDL RELOCATED TO MASSACHUSETTS RELATED TO THE POSITIONS NOTED ABOVE. KHATIB, MATT TRUSTEE, BOARD CHAIR ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE - ANNA JAQUES HOSPITAL TRUSTEE , BOARD CHAIR AND FOUNDATIONSEACOAST AFFILIATED GROUP PRACTICE, INC. KILDAY, KEVIN CHIEF FINANCIAL OFFICER ANNA JAQUES HOSPITAL TREASURER ANNA JAQUES COMMUNITY HEALTH FOUNDATION CHIEF FINANCIAL OFFICER AND CHIEF OPERATING OFFICER SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. KILDAY INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $9,206. OF THIS AMOUNT, $9,206 IS UNVESTED. KIRPAS, JEFF TRUSTEE, VICE CHAIR OF THE BOARD ANNA JAQUES HOSPITAL TRUSTEE, VICE CHAIR OF THE BOARD SEACOAST AFFILIATED GROUP PRACTICES, INC. LEE, GARY VICE PRESIDENT OF CLINICAL OPERATIONS ANNA JAQUES HOSPITAL OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. LEE INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $2,747. OF THIS AMOUNT, $2,47 IS UNVESTED. MAKI, DN, RN, RICHARD CHIEF NURSING OFFICER ANNA JAQUES HOSPITAL OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. MAKI INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $4,696. OF THIS AMOUNT, $4,696 IS UNVESTED. MATHEWS, BRYON TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. NASEER-GHIASUDDIN, SAIRA TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. NASEER-GHIASUDDIN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $36,033. OF THIS AMOUNT, $18,534 IS UNVESTED.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES:	TABB, M.D., KEVIN UNLESS OTHERWISE NOTED BELOW, DR. TABB HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2022: PRESIDENT AND CHIEF EXECUTIVE OFFICER; TRUSTEE (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. CHIEF EXECUTIVE OFFICER AND TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER, LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER AND LAHEY CLINIC FOUNDATION - LAHEY CLINIC HOSPITAL, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO), LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER AND LAHEY CLINIC FOUNDATION - LAHEY CLINIC, INC. TRUSTEE (EX-OFFICIO), CHAIR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. PRESIDENT (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO), CHAIR(EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE (EX-OFFICIO), CHAIR(EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE, CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO), LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER AND LAHEY CLINIC FOUNDATION - LAHEY CLINIC FOUNDATION, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION CHIEF EXECUTIVE OFFICER AND TRUSTEE - CAB HEALTH AND RECOVERY SERVICES, INC. CHIEF EXECUTIVE OFFICER AND TRUSTEE - HEALTH AND EDUCATION HOUSING SERVICES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. CHIEF EXECUTIVE OFFICER - COMMUNITY PHYSICIANS ASSOCIATES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL CHIEF EXECUTIVE OFFICER - THE JORDAN HEALTH SYSTEMS, INC. CHIEF EXECUTIVE OFFICER - JORDAN PHYSICIAN ASSOCIATES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - ANNA JAQUES HOSPITAL CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. O COMMENCED POSITION AS CLERK ON NOVEMBER 1, 2021 PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL IN ADDITION TO THE POSITIONS NOTED ABOVE, DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNATE WHO THEN BECAME THE VOTING TRUSTEE IN HIS PLACE: TRUSTEE (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, BID-MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATES TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, THE JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) ANNA JAQUES HOSPITAL, INC. TRUSTEE (EX-OFFICIO) JOSLIN DIABETES CENTER TRUSTEE (EX-OFFICIO) JOSLIN CLINIC ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2021 COMPENSATION. INCENTIVE COMPENSATION FOR DR. TABB INCLUDES $750,000 WHICH WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $610,860. DEFERRED COMPENSATION IN THE AMOUNT OF $200,000 INCLUDED IN THIS FILING FOR DR. TABB RELATES TO CERTAIN MILESTONE PAYMENTS WHICH, AS OF DECEMBER 31, 2021, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. TARKAN, M.D., JOSHUA TRUSTEE (EX-OFFICIO) AND PRESIDENT, MEDICAL STAFF ANNA JAQUES HOSPITAL TRUSTEE (EX-OFFICIO) ANNA JAQUES COMMUNITY HEALTH FOUNDATION TRUSTEE (EX-OFFICIO) AND PRESIDENT, MEDICAL STAFF SEACOAST AFFILIATED GROUP PRACTICE TRIM, JEAN TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE MR. TRIM'S TERM AS TRUSTEE OF ANNA JAQUES HOSPITAL BEGAN ON OCTOBER 1, 2020. WILEY, MARGARET TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. WILLIAMSON, MARY TRUSTEE (EX-OFFICIO), CEO (EX-OFFICIO) EXECUTIVE DIRECTOR SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS.WILLIAMSON INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $413. OF THIS AMOUNT, $413 IS UNVESTED.

Schedule J (Form 990) 2021

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
ANNA JAQUES HOSPITAL INC

Employer identification number
04-2104338

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MDFA - SERIES 2019K	04-3431814	57584YTK5	07-31-2019	211,922,775	SEE PART VI		X		X		X
B	MDFA - SERIES 2018J-1 J-2	04-3431814	57584YJW0	06-13-2018	479,594,374	SEE PART VI		X		X		X
C	MDFA - SERIES 2016I	04-3431814	57584XMT5	05-12-2016	257,611,877	SEE PART VI		X		X		X
D	MDFA - LAHEY SERIES F	04-2323457	NONEXXXXX	10-21-2015	262,828,878	SEE PART VI		X		X		X
	MDFA - SERIES 2015 H-1	04-3431814	57584XDH1	09-02-2015	203,702,204	SEE PART VI		X		X		X
	MHEFA - WINCHESTER SERIES F	04-2456011	57586CDD4	07-08-2004	30,340,000	SERIAL BOND SERIES F - ADV REFUND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	20,980,000		10,816,000		4,550,000		28,000,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	211,922,775		504,358,641		257,618,370		262,953,908
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............							4,857,465
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	2,931,137		4,594,372		2,515,889		3,129,474
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			499,764,263		19,006,493		94,764,737
11 Other spent proceeds .............	208,991,638		29,927,552		236,095,988		160,202,232
12 Other unspent proceeds .............			4
13 Year of substantial completion .............	2019		2004		2016		2021
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X	X		X
16 Has the final allocation of proceeds been made? ..........	X			X	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X			X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X			X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X	X			X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?			X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X			X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........		X		X	X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........			MORGAN STANLEY
c Term of hedge .........			2000.0000000000 %
d Was the hedge superintegrated? ......				X
e Was the hedge terminated? ........				X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
BOND A, ENTITY 1:	PART I, ROW A, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. PART I, ROW A, COLUMN F: THE ISSUE REFUNDED ISSUES DATED 06/09/2008, 11/30/2005, 6/16/2003, AND 6/4/1998.
BOND B, ENTITY 1:	PART I, ROW B, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $24,764,267 OF INVESTMENT EARNINGS.
BOND C, ENTITY 1:	PART I, ROW C, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. PART IV, COLUMN C, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND D, ENTITY 1:	PART I, ROW D, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. PART I, ROW D, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 08/17/2007 AND 07/14/2005. PART II, COLUMN D, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $123,904 OF INVESTMENT EARNINGS.
FORM 990 SCHEDULE K	THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS FORMED IN JUNE 2020. ANNA JAQUES HOSPITAL, INC. IS A MEMBER OF THE BILH OBLIGATED GROUP. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED FACILITIES AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC).SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH ANNA JAQUES HOSPITAL, INC. HAS NOT FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, ANNA JAQUES HOSPITAL, INC. FOLLOWS THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS.
PART IV, COLUMN D, LINE 2C:	PART IV, COLUMN D, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND A, ENTITY 2:	PART I, ROW A, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES (DATED 06/09/2008; 11/30/2005; 07/16/2003; AND 06/03/1998), FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $1,360,617 OF INVESTMENT EARNINGS. PART IV, COLUMN A, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019. PART I, ROW B, COLUMN A: MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PART I, ROW B, COLUMN F: DESCRIPTION OF PURPOSE - REFUND ISSUE DATED 06/28/2000. PART IV, ROW 2C, COLUMN A: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 10, 2009.
FORM 990 SCHEDULE K	THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS FORMED IN JUNE 2020. ANNA JAQUES HOSPITAL, INC. IS A MEMBER OF THE BILH OBLIGATED GROUP. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED FACILITIES AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC) SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH ANNA JAQUES HOSPITAL, INC. HAS NOT FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, ANNA JAQUES HOSPITAL, INC. FOLLOWS THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS

Schedule K (Form 990) 2021

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
ANNA JAQUES HOSPITAL INC

Employer identification number
04-2104338

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MDFA - SERIES 2019K	04-3431814	57584YTK5	07-31-2019	211,922,775	SEE PART VI		X		X		X
B	MDFA - SERIES 2018J-1 J-2	04-3431814	57584YJW0	06-13-2018	479,594,374	SEE PART VI		X		X		X
C	MDFA - SERIES 2016I	04-3431814	57584XMT5	05-12-2016	257,611,877	SEE PART VI		X		X		X
D	MDFA - LAHEY SERIES F	04-2323457	NONEXXXXX	10-21-2015	262,828,878	SEE PART VI		X		X		X
	MDFA - SERIES 2015 H-1	04-3431814	57584XDH1	09-02-2015	203,702,204	SEE PART VI		X		X		X
	MHEFA - WINCHESTER SERIES F	04-2456011	57586CDD4	07-08-2004	30,340,000	SERIAL BOND SERIES F - ADV REFUND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	20,980,000		10,816,000		4,550,000		28,000,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	211,922,775		504,358,641		257,618,370		262,953,908
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............							4,857,465
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	2,931,137		4,594,372		2,515,889		3,129,474
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			499,764,263		19,006,493		94,764,737
11 Other spent proceeds .............	208,991,638		29,927,552		236,095,988		160,202,232
12 Other unspent proceeds .............			4
13 Year of substantial completion .............	2019		2004		2016		2021
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X	X		X
16 Has the final allocation of proceeds been made? ..........	X			X	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X			X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X			X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X	X			X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?			X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X			X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........		X		X	X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........			MORGAN STANLEY
c Term of hedge .........			2000.0000000000 %
d Was the hedge superintegrated? ......				X
e Was the hedge terminated? ........				X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
BOND A, ENTITY 1:	PART I, ROW A, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. PART I, ROW A, COLUMN F: THE ISSUE REFUNDED ISSUES DATED 06/09/2008, 11/30/2005, 6/16/2003, AND 6/4/1998.
BOND B, ENTITY 1:	PART I, ROW B, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $24,764,267 OF INVESTMENT EARNINGS.
BOND C, ENTITY 1:	PART I, ROW C, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. PART IV, COLUMN C, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND D, ENTITY 1:	PART I, ROW D, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. PART I, ROW D, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 08/17/2007 AND 07/14/2005. PART II, COLUMN D, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $123,904 OF INVESTMENT EARNINGS.
FORM 990 SCHEDULE K	THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS FORMED IN JUNE 2020. ANNA JAQUES HOSPITAL, INC. IS A MEMBER OF THE BILH OBLIGATED GROUP. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED FACILITIES AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC).SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH ANNA JAQUES HOSPITAL, INC. HAS NOT FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, ANNA JAQUES HOSPITAL, INC. FOLLOWS THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS.
PART IV, COLUMN D, LINE 2C:	PART IV, COLUMN D, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND A, ENTITY 2:	PART I, ROW A, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES (DATED 06/09/2008; 11/30/2005; 07/16/2003; AND 06/03/1998), FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $1,360,617 OF INVESTMENT EARNINGS. PART IV, COLUMN A, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019. PART I, ROW B, COLUMN A: MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PART I, ROW B, COLUMN F: DESCRIPTION OF PURPOSE - REFUND ISSUE DATED 06/28/2000. PART IV, ROW 2C, COLUMN A: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 10, 2009.
FORM 990 SCHEDULE K	THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS FORMED IN JUNE 2020. ANNA JAQUES HOSPITAL, INC. IS A MEMBER OF THE BILH OBLIGATED GROUP. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED FACILITIES AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC) SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH ANNA JAQUES HOSPITAL, INC. HAS NOT FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, ANNA JAQUES HOSPITAL, INC. FOLLOWS THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS

Schedule K (Form 990) 2021

Additional Data

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Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	1	1,970	COST OR SELLING PRICE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( USE & OPERATIONS )	X	2	36,251	COST OR SELLING PRIC
26 Other ( EVENT ITEMS )	X	111	33,927	COST OR SELLING PRIC
27 Other ( PATIENT SUPPORT )	X	8	4,114	COST OR SELLING PRIC
28 Other ( )

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

Yes

30a

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

30a

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

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

Yes

32a

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

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

32a

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

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

Return Reference	Explanation
PART I, COLUMN (B):	THE NUMBERS REPORTED IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED.

Schedule M (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Return Reference	Explanation
FORM 990, PART I	THE MISSION OF ANNA JAQUES HOSPITAL (AJH OR HOSPITAL) IS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE AND IMPROVE THE HEALTH OF THE COMMUNITY IN ALLIANCE WITH THE MEDICAL STAFF. AJH IS RECOGNIZED FOR DELIVERING HIGH QUALITY COMMUNITY HEALTH CARE AT A LOWER COST, WITH AN EMPHASIS ON PATIENT SATISFACTION. AJH PROVIDES THIS CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. AJH ASPIRES TO BE AMONG THE BEST COMMUNITY HOSPITALS IN EASTERN MASSACHUSETTS.
FORM PART III, LINE 1	THE MISSION OF ANNA JAQUES HOSPITAL (AJH OR HOSPITAL) IS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE AND IMPROVE THE HEALTH OF THE COMMUNITIES SERVED BY AJH IN ALLIANCE WITH THE AJH MEDICAL STAFF AND AJH AFFILIATES INCLUDING SEACOAST AFFILIATED GROUP PRACTICE AND OTHERS AS NOTED IN THIS FILING. AJH IS RECOGNIZED FOR DELIVERING HIGH QUALITY COMMUNITY HEALTH CARE AT A LOWER COST, WITH AN EMPHASIS ON PATIENT SATISFACTION. AJH PROVIDES THIS CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. AJH ASPIRES TO BE AMONG THE BEST COMMUNITY HOSPITALS IN EASTERN MASSACHUSETTS. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL (AJH), 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), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), THE JOSLIN DIABETES CENTER 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 AND MEDICAL CENTER (LHMC). THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. IN ADDITION TO BEING A MEMBER OF BETH ISRAEL LAHEY HEALTH, ANNA JAQUES HOSPITAL IS ALSO A CLINICAL AFFILIATE AND SISTER ENTITY OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), WHICH IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER AND A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. BIDMC IS EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS RECOGNIZED NATIONALLY FOR THE CLINICAL EXCELLENCE OF ITS FACULTY AND THE PATIENT CARE PROVIDED, AS WELL AS FOR THE MAGNITUDE AND BREADTH OF ITS RESEARCH AND FOR ITS COMMITMENT TO MEDICAL EDUCATION.
FORM 990, PART III, LINE 4A	OUTPATIENT CLINICS AND SERVICES ANNA JAQUES HOSPITAL PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES ENCOMPASSING GENERAL INTERNAL MEDICINE AND ALL THE SUBSPECIALTIES OF INTERNAL MEDICINE, COVERING THE GAMUT OF SERVICES FROM PRIMARY TO TERTIARY CARE AS WELL AS PROVIDING SURGICAL SERVICES ON AN OUTPATIENT BASIS. THE HOSPITAL'S MEDICAL STAFF BLENDS EXPERIENCED PRIMARY CARE PHYSICIANS AND SPECIALISTS IN A WIDE VARIETY OF DISCIPLINES. THE PRIMARY CARE AND SPECIALISTS AT AJH PROVIDE OUTPATIENT PRIMARY CARE AS WELL AS GASTROINTESTINAL, OPHTHALMOLOGIC, ORTHOPEDIC, CARDIAC, DERMATOLOGIC, UROLOGICAL AND PODIATRIC PROCEDURES, PAIN MANAGEMENT, CARDIAC REHABILITATION, PULMONARY REHABILITATION, DIABETES MANAGEMENT SERVICES, AND NUTRITIONAL COUNSELING. DIAGNOSTIC FACILITIES AT AJH INCLUDE A COMPLETE 24-HOUR LABORATORY AND BLOOD BANKING SERVICES AS WELL AS DIAGNOSTIC IMAGING INCLUDING CT SCANNING, ULTRASOUND, MRI, 3D MAMMOGRAPHY, ULTRASONIC CARDIOGRAPHY, BONE DENSITOMETRY, NUCLEAR MEDICINE, PLAIN FILM RADIOLOGY AND FLUOROSCOPY. THE ANNA JAQUES CANCER CENTER CANCER, AFFILIATED WITH BETH ISRAEL DEACONESS MEDICAL CENTER, PROVIDES A FULL ARRAY OF COMMUNITY-BASED CANCER SERVICES IN NEWBURYPORT AND WHEN NEEDED, ADVANCED TREATMENT OPTIONS AND SPECIALISTS AT BIDMC IN BOSTON. DURING THE FISCAL PERIOD OCTOBER 1, 2021 TO SEPTEMBER 30, 2022, ANNA JAQUES HOSPITAL HAD 236,140 OUTPATIENT ENCOUNTERS. HOSPITAL CLINICS HAD 19,818 VISITS, AND PERFORMED 3,884 ENDOSCOPY PROCEDURES. ONCOLOGY HAD 4,890 VISITS AND 4,810 INFUSIONS. IN ADDITION, AJH OUTPATIENT CARDIOLOGY PHYSICIANS AND PROFESSIONALS PERFORMED 9,549 EKG EXAMS AND ORTHOPEDISTS PERFORMED 1,080 OUTPATIENT PROCEDURES. AJH GENERAL RADIOLOGY PERFORMED 24,669 OUTPATIENT EXAMS, 14,381 CAT SCAN OUTPATIENT EXAMS, 16,064 OUTPATIENT ULTRASOUND PROCEDURES, 6,603 MRI EXAMS AND 1,058 NUCLEAR MEDICINE TESTS. FINALLY, DURING THE PERIOD COVERED BY THIS FILING AJH PERFORMED 455,571 OUTPATIENT LAB TESTS, AND 20,829 REHABILITATION VISITS. SEE SCHEDULE H FOR ADDITIONAL INFORMATION ON CHARITY CARE AND COMMUNITY BENEFITS.
FORM 990, PART III, LINE 4B	INPATIENT ANNA JAQUES HOSPITAL (AJH OR HOSPITAL), IS A 119-BED ACUTE CARE HOSPITAL THAT SERVES PATIENTS OF ALL AGES AND SERVES COMMUNITIES IN NORTHERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE. THE HOSPITAL PROVIDES A WIDE RANGE OF INPATIENT CARE INCLUDING MEDICAL SURGICAL SERVICES, OBSTETRICS, INTENSIVE AND CARDIAC CARE AND COMPLETE DIAGNOSTIC FACILITIES. AJH INPATIENT FACILITIES INCLUDE 63 MEDICAL/SURGICAL BEDS AND AN EIGHT-BED INTENSIVE UNIT. THE 12-BED BIRTH CENTER SEES 650 DELIVERIES ANNUALLY AND ALSO SUPPORTS MOTHERS WITH HIGH-RISK PREGNANCIES WITH THE LEVEL IIB NEONATAL CARE CENTER. THE HOSPITAL HAS A SURGICAL SUITE WITH SIX FULLY EQUIPPED OPERATING ROOMS INCLUDING A CARDIAC CATHERIZATION LABORATORY, FOUR AMBULATORY PROCEDURE ROOMS AND A POST-OPERATIVE CARE UNIT. SURGICAL SERVICES ARE AVAILABLE 24 HOURS A DAY FOR CRITICALLY ILL OR INJURED PATIENTS REQUIRING IMMEDIATE SURGICAL INTERVENTION, OR FOR OTHER PATIENTS ON A NON-EMERGENT OR ELECTIVE BASIS. AJH IS THE ONLY COMMUNITY HOSPITAL IN THE REGION TO PROVIDE INPATIENT PSYCHIATRIC SERVICES TO ADULTS, ADOLESCENTS AND CHILDREN. INPATIENT PSYCHIATRIC CARE AT ANNA JAQUES HOSPITAL PROVIDES SHORT-TERM, ACUTE INPATIENT CARE TO ADULTS AND ADOLESCENTS AGES 16 AND OLDER WITH A BROAD SPECTRUM OF PSYCHIATRIC PROBLEMS. THE INPATIENT PROGRAM IS A 20-BED ACUTE CARE CO-ED UNIT. THE ANNA JAQUES CHILD AND ADOLESCENT PSYCHIATRY PROGRAM PROVIDES STRUCTURED AND SECURE INPATIENT PSYCHIATRIC SERVICES TO CHILDREN AND ADOLESCENTS AGES 4-17. THE 12-BED PROGRAM OFFERS SHORT-TERM INPATIENT TREATMENT AND STABILIZATION. AJH'S SURGEONS PERFORM ORTHOPEDIC PROCEDURES AND IMPLANTS, PLASTIC RECONSTRUCTION, GASTROINTESTINAL, GENERAL SURGICAL (INCLUDING BREAST) GYNECOLOGICAL, OPHTHALMOLOGIC, PODIATRIC, AND UROLOGICAL PROCEDURES. PATIENTS ARE UNDER THE CARE OF THE HOSPITAL'S MEDICAL STAFF, HOSPITALISTS AND/OR GENERAL SURGEONS ALONG WITH NURSES AND PHYSICIAN ASSISTANTS WHO ARE TRAINED IN CARING FOR PATIENTS WITH COMPLEX MEDICAL NEEDS, INCLUDING INTENSIVISTS IN THE ICU. THE NURSING CARE TEAM CONSISTS OF REGISTERED NURSES, SURGICAL TECHNICIANS AND QUALIFIED ANCILLARY PERSONNEL WORKING COLLABORATIVELY WITH SURGICAL AND ANESTHESIA PHYSICIANS. DURING THE PERIOD OCTOBER 1, 2021 TO SEPTEMBER 30, 2022, ANNA JAQUES HOSPITAL HAD 6,981 INPATIENT DISCHARGES WITH 30,360 PATIENT DAYS, AND 729 TOTAL INPATIENT SURGERIES. ADULT PSYCH DAYS WERE 5,413 AND PEDI PSYCH DAYS WERE 3,556.
FORM 990, PART III, LINE 4C	EMERGENCY DEPARTMENT ANNA JAQUES HOSPITAL'S EMERGENCY DEPARTMENT (ED) IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK AND PROVIDES EMERGENCY CARE TO ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE AJH EMERGENCY DEPARTMENT. A HIGHLY TRAINED NURSING STAFF ALSO PROVIDES CARE TO PATIENTS IN THE ED. AJH OPERATES AS A LEVEL III TRAUMA CENTER AND CERTIFIED STROKE CENTER. THE HOSPITAL OPERATES A TELE-STROKE PROGRAM WITH BETH ISRAEL DEACONESS MEDICAL CENTER WHERE NEUROLOGICAL IMAGES CAN BE TRANSMITTED BETWEEN AJH AND BIDMC, MEANING THAT PATIENTS IN THE GREATER NEWBURYPORT AREA HAVE ACCESS TO THE SAME WORLD-CLASS SPECIALISTS AS PATIENTS AT BIDMC IN BOSTON. THE SYSTEM FACILITATES, WHEN NECESSARY, MULTI-DISCIPLINARY EVALUATION OF IMAGES, RESULTING IN IMPROVED TECHNICAL PERFORMANCE AND FEEDBACK AND DIAGNOSES WITH GREATER DIAGNOSTIC ACCURACY. DURING THE FISCAL PERIOD OCTOBER 1, 2021 TO SEPTEMBER 30, 2022, ANNA JAQUES HOSPITAL HAD 24,252 EMERGENCY DEPARTMENT VISITS. IN ADDITION, THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES ENGAGED IN SIGNIFICANT ACTIVITIES SUPPORTING BEHAVIORAL HEALTH IN THE PRIMARY CARE AND OTHER HEALTHCARE SETTINGS AS WELL AS OTHER HEALTHCARE INITIATIVES FOR THE COMMUNITIES SERVED. PLEASE SEE FORM 990 SCHEDULE H FOR ADDITIONAL INFORMATION.
FORM 990, PART IV, LINE 12	THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2022. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER.
PART V, LINE 7G:	ANNA JAQUES HOSPITAL, INC. DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899.
PART V, LINE 7H:	ANNA JAQUES HOSPITAL, INC. DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 1098-C.
FORM 990, PART VI, SECTION A, LINE 2	FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES, LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL CORPORATION (NBC), AND ANNA JAQUES HOSPITAL. THE LAHEY CLINIC FOUNDATION IN TURN SERVES AS SOLE MEMBER TO LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL DBA LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). ADDITIONAL ENTITIES LISTED HERE MAY ALSO IN TURN SERVE AS MEMBER TO OTHER NETWORK AFFILIATES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE NETWORK OF AFFILIATED ORGANIZATIONS. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J.
FORM 990, PART VI, SECTION A, LINE 6	EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL, INC. SEACOAST REGIONAL HEALTH SYSTEMS, WHICH MERGED INTO ANNA JAQUES HOSPITAL, INC. EFFECTIVE MARCH 1, 2019, PREVIOUSLY SERVED AS SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7A	THE MEMBER HAS THE EXCLUSIVE AUTHORITY TO (A) APPOINT AND REAPPOINT TRUSTEES, (B) FILL ANY VACANCIES IN THE OFFICES OF TRUSTEES, AND (C) ACTING BY VOTE OF NOT LESS THAN THREE QUARTERS (3/4) OF THE MEMBER'S TRUSTEES THEN ANNA JAQUES HOSPITAL, INC. 04 2104338 IN OFFICE, REMOVE, WITH OR WITHOUT CAUSE, A TRUSTEE.
FORM 990, PART VI, SECTION A, LINE 7B	THE MEMBER OF ANNA JAQUES HOSPITAL, INC. HAS THE FOLLOWING RIGHTS, AS DESIGNATED IN ANNA JAQUES HOSPITAL, INC.'S BY-LAWS: SUBJECT TO THE PROVISIONS OF THE ARTICLES OF ORGANIZATION AND THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, BOTH POSITIVE AND NEGATIVE, CONFERRED BY MASSACHUSETTS GENERAL LAWS ("M.G.L.") CHAPTER 180, AS AMENDED, ON MEMBERS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. IN ADDITION, EXCEPT AS ARE EXPRESSLY GRANTED TO THE BOARD OF TRUSTEES OF THE CORPORATION ("BOARD") IN THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, POSITIVE AND NEGATIVE, CONFERRED BY M.G.L. CHAPTER 180 ON BOARDS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. NOTWITHSTANDING THE FOREGOING, THE MEMBER MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE BOARD: (A) APPROVE OR REQUIRE ANY CHANGE IN, OR CONSOLIDATION OF PHILANTHROPIC GIFTS, ASSETS, AND PROGRAMS OF THE CORPORATION, WHICH SHALL REMAIN UNDER THE CORPORATION'S CONTROL AND BE USED FOR THE BENEFIT OF THE CORPORATION AND NOT FOR OTHER COMPONENTS OF THE MEMBER'S SYSTEM, EXCEPT TO THE EXTENT THAT SUCH CHANGES INVOLVE BACK-OFFICE CONSOLIDATION WITH OTHER DIRECT OR INDIRECT SUBSIDIARIES OF THE MEMBER; (B) APPROVE OR REQUIRE ANY CHANGE IN THE NAME, BRAND, OR TRADEMARK OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES, EXCEPT SUCH COMPLEMENTARY CHANGES AS THE MEMBER MAY DETERMINE ARE REASONABLY APPROPRIATE IN ESTABLISHING A SYSTEM-WIDE IDENTITY FOR THE AFFILIATED ENTITIES; OR (C) AMEND OR RESTATE THESE BYLAWS TO CHANGE OR ELIMINATE EITHER OF THE FOREGOING LIMITATIONS ON ITS POWERS. FOR THE PERIOD ENDING ON THE THIRD ANNIVERSARY OF THE DATE THE MEMBER BECOMES THE SOLE CORPORATE MEMBER OF THE CORPORATION, THE MEMBER'S AUTHORITY TO CHANGE THE MEDICAL SCHOOL AFFILIATION OF THE CORPORATION OR ANNA JAQUES HOSPITAL, INC. 04-2104338 ANY OF ITS SUBSIDIARIES IS SUBJECT TO THE REQUIREMENT THAT IT OBTAIN THE UNANIMOUS CONSENT OF THE CORPORATION'S DESIGNATED TRUSTEES (AS DEFINED IN THE BYLAWS OF THE MEMBER) AND THE APPROVAL OF THE MEMBER'S BOARD OF TRUSTEES (THE "MEMBER'S BOARD"). THE MEMBER MAY NOT CAUSE THE CORPORATION TO CEASE OPERATING A SEPARATELY LICENSED HOSPITAL FACILITY, OR CLOSE ANY ESSENTIAL SERVICE OF SUCH HOSPITAL FACILITY, WITHOUT CONSULTING WITH THE BOARD PRIOR TO TAKING SUCH ACTION. THE POWERS AND RESPONSIBILITIES OF THE BOARD INCLUDE THE FOLLOWING: (A) PROVIDING RECOMMENDATIONS TO THE MEMBER REGARDING (I) APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES, (II) THE ESTABLISHMENT OF THE CORPORATION'S POLICIES, (III) THE MAINTENANCE OF PATIENT CARE QUALITY, AND (IV) THE PROVISION OF CLINICAL SERVICES AND COMMUNITY SERVICE PLANNING IN A MANNER RESPONSIVE TO LOCAL COMMUNITY NEEDS; (B) ENSURING COMPLIANCE WITH ALL LICENSURE AND ACCREDITATION REQUIREMENTS, INCLUDING CREDENTIALING AND OTHER MEDICAL STAFF MATTERS; (C) PROVIDING OVERSIGHT FOR INSTITUTIONAL PLANNING, MAKING RECOMMENDATIONS FOR NEW CLINICAL SERVICES, AND PARTICIPATING IN AN ANNUAL REVIEW OF THE CORPORATION'S STRATEGIC AND FINANCIAL PLAN AND GOALS; (D) REVIEWING AND RECOMMENDING APPROVAL OF OPERATING AND CAPITAL BUDGETS AS WELL AS MAKING RECOMMENDATIONS WITH RESPECT TO CAPITAL EXPENDITURES; (E) MAKING RECOMMENDATIONS WITH RESPECT TO QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS; (F) PROVIDING OVERSIGHT OF RISK MANAGEMENT PROGRAMS RELATING TO PATIENT CARE AND SAFETY; (G) REVIEWING DISASTER PLANS THAT DEAL WITH BOTH INTERNAL (E.G., FIRE) AND EXTERNAL DISASTERS; AND (H) EVALUATING RECRUITMENT NEEDS TO ENSURE ADEQUATE MEDICAL STAFF CAPACITY TO CONTINUE TO MEET COMMUNITY NEEDS. EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, THE BOARD SHALL ACT IN AN ADVISORY CAPACITY AND CONSISTENT THEREWITH SHALL HAVE ONLY THE FOLLOWING ANNA JAQUES HOSPITAL, INC. 04-2104338 POWERS: (A) POWERS EXPRESSLY GRANTED BY THE MEMBER FROM TIME TO TIME; (B) POWER TO EXERCISE ITS AUTHORITY AS A MEMBER OF OTHER CORPORATIONS; (C) POWER TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THE BYLAWS OF THE MEMBER (AS DEFINED UNDER THE BYLAWS OF THE MEMBER) OR UNDER THESE BYLAWS WITH RESPECT TO THE MEMBER; AND (D) POWERS TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THAT AGREEMENT DATED JUNE 30, 2017 BY AND AMONG LAHEY HEALTH SYSTEM, INC., BETH ISRAEL DEACONESS MEDICAL CENTER, INC., NEW ENGLAND BAPTIST HOSPITAL, INC., MOUNT AUBURN HOSPITAL, CAREGROUP, INC., AND SEACOAST REGIONAL HEALTH SYSTEMS, INC. THE POWERS OF THE BOARD IN CLAUSES (A) AND (B) OF THE PRECEDING SENTENCE SHALL BE SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. THE POWERS OF THE BOARD IN CLAUSE (C) AND (D) OF THE FIRST SENTENCE OF THIS PARAGRAPH SHALL BE INDEPENDENT OF THE MEMBER AND NOT SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. NOTWITHSTANDING CLAUSE (B) ABOVE, THE POWER OF THE CORPORATION TO EXERCISE ITS AUTHORITY AS A MEMBER OF ANOTHER CORPORATION SHALL BE SUBJECT TO THE FOLLOWING LIMITATIONS: (X) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED BY THE CORPORATION ONLY AT THE EXPRESS AND EXPLICIT DIRECTION OF, AND WITH THE APPROVAL OF, THE MEMBER; (Y) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED DIRECTLY BY THE MEMBER AFTER CONSULTATION WITH THE CHAIR BUT OTHERWISE WITHOUT THE APPROVAL OR PARTICIPATION OF THE CORPORATION; AND (Z) OTHER THAN STATUTORY POWERS, THE CORPORATION SHALL HAVE ONLY THOSE POWERS AND AUTHORITIES OVER AND WITH RESPECT TO THE CORPORATIONS OF WHICH IT IS A MEMBER AS ARE EXPRESSLY AND EXPLICITLY DELEGATED OR DIRECTED TO THE CORPORATION BY ACTION OF THE ANNA JAQUES HOSPITAL, INC. 04-2104338 MEMBER'S BOARD.
FORM 990, PART VI, SECTION B, LINE 11B	AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL, INC.. THIS FORM 990 IS PREPARED IN CONJUNCTION WITH THE ANNA JAQUES HOSPITAL, INC. FINANCE STAFF. IN ADDITION, THE BILH TAX DEPARTMENT WORKS WITH OTHER DISCIPLINES AND DEPARTMENTS WITHIN BILH, ANNA JAQUES HOSPITAL, INC. AND OTHER AFFILIATES TO ENSURE THAT OTHER FINANCIAL AND NON-FINANCIAL DISCLOSURES ARE COMPLETE AND ACCURATE. EXAMPLES OF SUCH DEPARTMENTS MAY INCLUDE: FINANCIAL ASSISTANCE AND REIMBURSEMENT, COMPLIANCE, GRADUATE MEDICAL EDUCATION, LEGAL, COMMUNITY BENEFITS, GOVERNANCE, DEVELOPMENT, HUMAN RESOURCES AND PAYROLL, GOVERNMENT RELATIONS, RESEARCH AND/OR RESEARCH FINANCE. THE TAX RETURNS REVIEWED BY THE BILH EXECUTIVE DIRECTOR, TAXATION, ANNA JAQUES HOSPITAL, INC.'S CHIEF FINANCIAL OFFICER AND DELOITTE TAX, LLP. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF ANNA JAQUES HOSPITAL, INC.'S BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	ANNA JAQUES HOSPITAL HAS A WRITTEN, CONFLICT OF INTEREST POLICY. TRUSTEES AND SENIOR EXECUTIVES REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY AND EACH IS ASKED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST FORM TO DISCLOSE POSSIBLE CONFLICTS. RESPONSES ARE REVIEWED BY THE BOARD CHAIR TO DETERMINE IF ANY CONFLICT EXISTS. ANY INDIVIDUAL WITH A CONFLICT IS ASKED TO ABSTAIN FROM VOTING ON A RELATED MATTER. THE BOARD CHAIR AND/OR SECRETARY MONITOR SURVEYS TO ENSURE COMPLIANCE.
FORM 990, PART VI, SECTION B, LINE 15	AS NOTED THROUGHOUT THIS FILING, ANNA JAQUES HOSPITAL AND SEACOAST AFFILIATED GROUP PRACTICE (AJH AND SAGP RESPECTIVELY) ALONG WITH THEIR OTHER RELATED ENTITIES BECAME MEMBERS OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES WITH BILH SERVING AS AJH'S SOLE MEMBER AND AJH, IN TURN SERVING AS SAGP'S SOLE MEMBER, EFFECTIVE MARCH 1, 2019. PRIOR TO THAT DATE, SEACOAST REGIONAL HEALTH SYSTEMS, INC.(SRHS) WHICH WAS ALSO AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, SERVED AS THE SOLE MEMBER OF BOTH AJH AND SAGP AND MAINTAINED A COMPENSATION COMMITTEE THAT WAS COMPOSED OF MEMBERS OF THE BOARD OF TRUSTEES. ALL MEMBERS WERE INDEPENDENT. AS REQUIRED BY THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, COMPENSATION REPORTED HEREIN IS CALENDAR YEAR 2021 COMPENSATION. AS SUCH, COMPENSATION REPORTED IN THIS FORM 990 FOR AJH AND SAGP OFFICERS, TRUSTEES AND KEY EMPLOYEES WAS SET BY THE SRHS COMPENSATION COMMITTEE AND GUIDED BY THE COMMITTEE'S PROCESS AS OUTLINED BELOW. THE COMPENSATION OF THE SENIOR EXECUTIVE TEAM WAS REVIEWED ANNUALLY BY AN INDEPENDENT COMMITTEE OF THE PARENT'S (SRHS) BOARD. THE COMMITTEE USED DATA RECEIVED FROM AN INDEPENDENT COMPENSATION CONSULTING FIRM TO DETERMINE THE FAIRNESS AND OVERALL COMPARABILITY OF EACH EXECUTIVE'S COMPENSATION PACKAGE INCLUDING POTENTIAL INCENTIVE COMPENSATION. THE COMMITTEE RELIED ON THE SALARY SURVEY DATA TO INFORM WHETHER ANY CHANGES TO AN EXECUTIVE'S COMPENSATION WAS APPROPRIATE. IN ADDITION, THE COMMITTEE AGREED ON AND SET BENCHMARKS FOR EXECUTIVE INCENTIVE PAYMENTS AT THE START OF EACH YEAR, AND REVIEWED PROGRESS RELATED TO THOSE BENCHMARKS AT THE CONCLUSION OF THE YEAR TO DETERMINE WHETHER INCENTIVES WOULD BE PAID AND IF SO, AT WHAT LEVEL.
FORM 990, PART VI, SECTION C, LINE 19	ANNA JAQUES HOSPITAL, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL LAHEY HEALTH TAX DEPARTMENT SCHRAFFT'S CITY CENTER, 4TH FLOOR, 529 MAIN STREET CHARLESTOWN, MA 02129
FORM 990, PART IX, LINE 11G	MD FEES: PROGRAM SERVICE EXPENSES 5,142,915. MANAGEMENT AND GENERAL EXPENSES 273,880. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,416,795. CONSULTING FEES: PROGRAM SERVICE EXPENSES 16,000. MANAGEMENT AND GENERAL EXPENSES 141,662. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 157,662. OTHER: PROGRAM SERVICE EXPENSES 9,116. MANAGEMENT AND GENERAL EXPENSES 233,331. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 242,447. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 11,815,615. MANAGEMENT AND GENERAL EXPENSES 716,028. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,531,643.
FORM 990, PART XI, LINE 9:	NET ASSET RELEASE FROM RESTRICTIONS 494,425. RESTRICTED CONTRIBUTIONS CHANGE IN MIN PENSION LIAB 9,047,073. TRANSFERS TO/FROM AFFILIATES WRITEDOWN OF DONATED INVENTORY CHANGE IN VALUE OF SWAP MK TO MKT CHANGE IN VALUE OF LIFE INS
PART XII, LINE 2C:	AS NOTED THROUGHOUT THIS FORM 990, AJH IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL LAHEY HEALTH (BILH) SERVES AS THE DIRECT OR INDIRECT MEMBER OF AJH AND AJH IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF BETH ISRAEL LAHEY HEALTH. THE AUDIT AND COMPLIANCE COMMITTEE OF BILH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE CONSOLIDATED AUDIT FOR NETWORK AS A WHOLE.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ANNA JAQUES HOSPITAL INC

Employer identification number

04-2104338

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ADDISON GILBERT SOCIETY INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 46-4371382	PROFESSIONAL SERVICES & FINANCIAL SUPPORT	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(2)ANNA JAQUES HOSPITAL 25 HIGHLAND AVE NEWBURYPORT,MA01950 04-2104338	HEALTHCARE	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(3)ASSOC PHYS HARVARD MED FAC PHY AT BIDMC 375 LONGWOOD AVE BOSTON,MA02215 32-0058309	TO PROVIDE EMERGENCY MEDICAL SERVICES	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(4)BAIM INSTITUTE FOR CLINICAL RESEARCH INC DBA BAIM INSTITUTE 930 COMMONWEALTH AVE BOSTON,MA02215 04-3521077	SCIENTIFIC & MEDICAL RESEARCH	MA	501(C)(3)	7	N/A		No
(5)BETH ISRAEL ANAESTHESIA FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2997215	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(6)BETH ISRAEL COMMUNITY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2776678	INACTIVE CORPORATION	MA	501(C)(3)	7	N/A		No
(7)BETH ISRAEL DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 36-4803234	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(8)BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-3079630	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(9)BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 20-8253452	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(10)BETH ISRAEL DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-3030397	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(11)BETH ISRAEL DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 20-4974585	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(12)BETH ISRAEL DEACONESS DEPARTMENT OF RADIATION ONCOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 87-3655583	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HMFP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(13)BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC 110 FRANCIS ST BOSTON,MA02215 02-0671240	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(14)BETH ISRAEL DEACONESS HOSPITAL MILTON INC 199 REEDSDALE RD MILTON,MA02186 04-2103604	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS.	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(15)BETH ISRAEL DEACONESS HOSPITAL NEEDHAM INC 148 CHESTNUT ST NEEDHAM,MA02492 04-3229679	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS.	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(16)BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH INC 275 SANDWICH ST PLYMOUTH,MA02360 22-2667354	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS.	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(17)BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP 300 LONGWOOD AVE BOSTON,MA02215 04-3200113	OUTPATIENT AMBULATORY CENTER	MA	501(C)(3)	12A, I	N/A		No
(18)BIDMC OBSTETRICS AND GYNECOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2794855	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(19)BETH ISRAEL DEACONESS MEDICAL CENTER INC 330 BROOKLINE AVE BOSTON,MA02215 04-2103881	THE OPERATION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(20)BETH ISRAEL DERMATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-3117601	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(21)BETH ISRAEL LAHEY HEALTH PHARMACY INC 80 WILSON WAY WESTWOOD,MA02090 82-2526816	TO OPERATE A SPECIALTY PHARMACY AND 340B PROGRAM FOR BIDMC	MA	501(C)(3)	12A, I		Yes
(22)BETH ISRAEL LAHEY HEALTH INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 83-2671600	MANAGEMENT PROFESSIONAL & IT SUPPORT SERVICES	MA	501(C)(3)	12C, III-FI	N/A		No
(23)BETH ISRAEL LAHEY HEALTH PRIMARY CARE 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 47-2248298	HEALTHCARE	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(24)BID-MILTON PHYSICIAN ASSOCIATES INC 199 REEDSDALE ROAD MILTON,MA02186 22-2566792	PROMOTE HEALTHCARE	MA	501(C)(3)	7	BETH ISRAEL DEACONESS HOSPITAL - MILTON	Yes
(25)BIH PATHOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 22-2548374	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(26)BIH RADIOLOGIC FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2571853	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(27)CAB HEALTH AND RECOVERY SERVICES INC 199 ROSEWOOD DRIVE DANVERS,MA01923 04-2400270	SUBSTANCE ABUSE	MA	501(C)(3)	10	NORTHEAST BEHAVIORAL HEALTH CORPORATION	Yes
(28)CPHCH INC DBA BILH AT HOME - WATERTOWN C/O NRPN 600 CUMMINGS CTR BEVERLY,MA01915 47-3111453	HOME CARE & HOSPICE	MA	501(C)(3)	12A, I	BETH ISRAEL DEACONESS HOSPITAL - MILTON	Yes
(29)COMMUNITY PHYSICIANS ASSOCIATES INC 199 REEDSDALE RD MILTON,MA02186 04-3243146	OUTPATIENT AND PRIMARY CARE SERVICES	MA	501(C)(3)	3	BETH ISRAEL DEACONESS HOSPITAL - MILTON	Yes
(30)CONTINUING EDU PROGRAM DBA BID DEPT OF PSYCH FDN 375 LONGWOOD AVE BOSTON,MA02215 04-3242952	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(31)HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC 375 LONGWOOD AVE BOSTON,MA02215 22-2768204	GENERAL AND SPECIALIZED MEDICAL SERVICES TO THE PATIENTS OF BIDMC AND OTHERS	MA	501(C)(3)	10		Yes
(32)HEALTH AND EDUCATION HOUSING SERVICES INC 199 ROSEWOOD DRIVE DANVERS,MA01923 22-3232914	HUD HOUSING	MA	501(C)(3)	10	NORTHEAST BEHAVIORAL HEALTH CORPORATION	Yes
(33)JORDAN PHYSICIAN ASSOCIATES INC 275 SANDWICH ST PLYMOUTH,MA02360 04-3228556	OUTPATIENT AND PRIMARY CARE SERVICES	MA	501(C)(3)	10	BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH INC	Yes
(34)LAHEY CLINIC CANADIAN FOUNDATION 130 KING ST WEST TORONTO,ONTARIO CA	FUNDRAISING ORG	CA			N/A		No
(35)LAHEY CLINIC FOUNDATION INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-2323457	FINANCIAL & OPERATIONAL SUPPORT TO LCI AND LCH	MA	501(C)(3)	7	BETH ISRAEL LAHEY HEALTH INC	Yes
(36)LAHEY CLINIC HOSPITAL INC DBA LAHEY HOSPITAL & MEDICAL CENTER AND LMC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-2704686	HEALTHCARE	MA	501(C)(3)	3	LAHEY CLINIC FOUNDATION INC	Yes
(37)LAHEY CLINIC INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-2704683	HEALTHCARE	MA	501(C)(3)	10	LAHEY CLINIC FOUNDATION INC	Yes
(38)LAHEY HEALTH SHARED SERVICES INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-3178972	ADMINISTRATION	MA	501(C)(3)	10	BETH ISRAEL LAHEY HEALTH INC	Yes
(39)LONGWOOD MEDICAL ENERGY COLLABORATIVE INC 375 LONGWOOD AVE BOSTON,MA02215 04-3476764	COORDINATE AND PROVIDE STRATEGIC PLANNING OPP FOR HMS	MA	501(C)(3)	12A, I	N/A		No
(40)LONGWOOD MEDICAL INTERNATIONAL FOUNDATION INC 375 LONGWOOD AVE BOSTON,MA02215 04-3208878	INACTIVE CORPORATION	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(41)MED CARE OF BOSTON MGMT CORP DBA BILH PRIMARY CARE 464 HILLSIDE AVE NEEDHAM,MA02494 04-2810972	OUTPATIENT, PRIMARY CARE AND SPECIALTY SERVICES	MA	501(C)(3)	10	BETH ISRAEL LAHEY HEALTH PRIMARY CARE	Yes
(42)MOUNT AUBURN HOSPITAL 330 MOUNT AUBURN ST CAMBRIDGE,MA02138 04-2103606	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(43)MOUNT AUBURN PROFESSIONAL SERVICES INC 330 MOUNT AUBURN ST CAMBRIDGE,MA02138 04-3026897	OFFERING MEDICAL CARE IN GENERAL AND SPECIALIZED PRACTICES	MA	501(C)(3)	12A, I	MOUNT AUBURN HOSPITAL	Yes
(44)NEW ENGLAND BAPTIST HOSPITAL 125 PARKER HILL AVE BOSTON,MA02120 04-2103612	ORTHOPEDIC SPECIALTY HOSPITAL	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(45)NEW ENGLAND BAPTIST MEDICAL ASSOCIATES INC 125 PARKER HILL AVE BOSTON,MA02120 04-3235796	OUTPATIENT MEDICAL SERVICES TO THE VARIOUS COMMUNITIES SERVICED BY NEBH	MA	501(C)(3)	3	NEW ENGLAND BAPTIST HOSPITAL	Yes
(46)NORTHEAST BEHAVIORAL HEALTH CORPORATION DBA BILH BEHAVIORAL HEALTHSERVICE 199 ROSEWOOD DRIVE DANVERS,MA01923 04-2777145	HEALTHCARE	MA	501(C)(3)	10	BETH ISRAEL LAHEY HEALTH INC	Yes
(47)NORTHEAST HEALTH SYSTEMS INC 85 HERRICK ST BEVERLY,MA01915 04-3240453	FINANCIAL & OPERATIONAL SUPPORT	MA	501(C)(3)	12B, II	LAHEY HEALTH SHARED SERVICES INC	Yes
(48)NORTHEAST HOSPITAL CORPORATION 85 HERRICK ST BEVERLY,MA01915 04-2121317	HEALTHCARE	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(49)NORTHEAST MEDICAL PRACTICE INC 85 HERRICK ST BEVERLY,MA01915 04-3201853	HEALTHCARE	MA	501(C)(3)	10	NORTHEAST HOSPITAL CORPORATION	Yes
(50)NORTHEAST PROFESSIONAL REGISTRY OF NURSES INC DBA BILH AT HOME 800 CUMMINGS CENTER BEVERLY,MA01915 20-1287349	HEALTHCARE	MA	501(C)(3)	10	NORTHEAST SENIOR HEALTH CORPORATION	Yes
(51)NORTHEAST SENIOR HEALTH CORPORATION 85 HERRICK ST BEVERLY,MA01915 04-2731137	HEALTHCARE	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(52)SEACOAST AFFILIATED GROUP PRACTICE INC 25 HIGHLAND AVE NEWBURYPORT,MA01915 04-3485648	PHYSICIAN GROUP	MA	501(C)(3)	10	ANNA JAQUES HOSPITAL INC	Yes
(53)SEACOAST NURSING AND REHABILITATION CENTER INC 300 WASHINGTON ST GLOUCESTER,MA01930 04-1305001	HEALTHCARE	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(54)THE JORDAN HEALTH SYSTEMS INC 275 SANDWICH ST PLYMOUTH,MA02360 04-2103805	PROMOTE HEALTHCARE	MA	501(C)(3)	7		Yes
(55)WINCHESTER COMMUNITY ACCOUNTABLE CARE ORGANIZATION INC 41 HIGHLAND AVE WINCHESTER,MA01890 22-3137856	ACO	MA	501(C)(3)	12A, I	WINCHESTER HEALTHCARE MANAGEMENT INC	Yes
(56)WINCHESTER HEALTHCARE MANAGEMENT INC 41 HIGHLAND AVE WINCHESTER,MA01890 22-2701817	MANAGEMENT	MA	501(C)(3)	12A, I	LAHEY HEALTH SHARED SERVICES INC	Yes
(57)WINCHESTER HOSPITAL 41 HIGHLAND AVE WINCHESTER,MA01890 04-2104434	HEALTHCARE	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(58)WINCHESTER HOSPITAL FOUNDATION INC 41 HIGHLAND AVE WINCHESTER,MA01890 04-3399570	PROFESSIONAL SERVICES & FINANCIAL SUPPORT	MA	501(C)(3)	12A, I	WINCHESTER HEALTHCARE MANAGEMENT INC	Yes
(59)JOSLIN DIABETES CENTER INC ONE JOSLIN PLACE BOSTON,MA02215 04-2203836	PREVENTION, TREATMENT, AND CURE OF DIABETES	MA	501(C)(3)	7	BETH ISRAEL LAHEY HEALTH INC	Yes
(60)JOSLIN CLINIC INC ONE JOSLIN PLACE BOSTON,MA02215 22-2984590	PREVENTION, TREATMENT, AND CURE OF DIABETES	MA	501(C)(3)	12A, I		Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) BIDCO HOSPITAL LLC 247 STATION DRIVE NORTHWEST 1 WESTWOOD,MA02090 46-1643790	COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC	MA	N/A	EXCLUDED				No			No
(2) SHIELDS IMAGING AT ANNA JAQUES HOSPITAL LLC 700 CONGRESS ST STE 204 QUINCY,MA02169 38-3989358	MRI SERVICES	MA	ANNA JAQUES HOSPITAL INC	EXCLUDED	914,319	1,773,061		No			No	69.380 %
(3) BIDCO PHYSICIAN LLC 600 UNICORN PARK DRIVE 4TH FLOOR WOBURN,MA01801 46-1589743	COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC	MA	N/A					No			No
(4) BILH INVESTMENT PARTNERSHIP LLP 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-3278109	INVESTMENT PARTNERSHIP	MA	N/A					No			No
(5) PHYSICIAN PROFESSIONAL SERVICES LLP 200 RIVERS EDGE DRIVE MEDFORD,MA02215 04-3275078	TO PROVIDE MEDICAL BILLING SERVICES	MA	N/A					No			No
(6) NEBSC HOSPITAL HOLDINGS LLC 125 PARKER HILL AVE BOSTON,MA02120 87-4293833	INVESTMENT PARTNERSHIP	MA	N/A					No			No
(7) NEW ENGLAND BAPTIST SURGERY CENTER LLC 40 ALLIED DRIVE DEDHAM,MA02026 87-4311329	AMBULATORY SURGERY CENTER	MA	N/A					No			No
(8) BETH ISRAEL LAHEY HEALTH SURGERY CENTER PLYMOUTH LLC 41 RESNIK ROAD PLYMOUTH,MA02360 88-3871838	SURGERY CENTER	MA	N/A					No			No
(9) WINCHESTER HOSPITALSHIELDS MRI LLC 700 CONGRESS ST STE 204 QUINCY,MA02169 46-2523117	MRI SERVICES	MA	N/A					No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) GREATER NEWBURYPORT MANAGEMENT SERVICES ORGANIZATION INC 25 HIGHLAND AVE NEWBURYPORT,MA01950 16-1744477	MANAGEMENT SERVICES	MA		C		884,115	100.000 %	Yes
(2) HUNTINGFIELD CORPORATION C/O LCF 529 MAIN ST 4TH FL CHARLESTOWN,MA02129	TO HOLD OWNERSHIP OF SUBTERRANEAN RIGHTS.	DE	N/A	C					No
(3) LAHEY CLINIC INSURANCE CO LTD CRAIG APPIN HOUSE PO BOX HM 2450 HAMILTON BD	INSURANCE	BD	N/A	C					No
(4) LEDGEWOOD HEALTH CARE CORPORATION 87 HERRICK STREET BEVERLY,MA01915 04-2855189	NURSING HOME	KY	N/A	C					No
(5) NORTHEAST PROPRIETARY CORP 85 HERRICK STREET BEVERLY,MA01915 04-2855191	MEDICAL SERVICES	MA	N/A	C					No
(6) WINCHESTER HEALTHCARE ENTERPRISES INC 41 HIGHLAND AVE WINCHESTER,MA01890 04-2932059	MANAGEMENT SERVICES	MA	N/A	C					No
(7) WINCHESTER PHYSICIAN ASSOCIATES INC 41 HIGHLAND AVE WINCHESTER,MA01890 04-3262963	MANAGEMENT SERVICES	MA	N/A	C					No

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) BETH ISRAEL LAHEY HEALTH INC	M	11,015,627	FMV
(2) BETH ISRAEL LAHEY HEALTH INC	O	3,958,401	FMV
(3) BETH ISRAEL LAHEY HEALTH INC	Q	769,593	FMV
(4) BETH ISRAEL LAHEY HEALTH INC	P	6,664,939	FMV
(5) MED CARE OF BOSTON MGMT CORP DBA BILH PRIMARY CARE	M	2,853,114	FMV
(6) NORTHEAST BEHAVIORAL HEALTH CORPORATION DBA BILH BEHAVIORAL HEALTHSERVICE	Q	62,500	FMV
(7) ASSOC PHYS HARVARD MED FAC PHY AT BIDMC	M	2,691,306	FMV
(8) ASSOC PHYS HARVARD MED FAC PHY AT BIDMC	O	2,894,090	FMV
(9) LAHEY HEALTH SHARED SERVICES INC	M	915,832	FMV
(10) HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC	M	361,000	FMV

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	23
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	20
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	1,264
6	Total number of volunteers (estimate if necessary) .............	6	118
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,808,060
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	6,012,863	3,467,332
9	Program service revenue (Part VIII, line 2g) .........	133,104,620	131,312,900
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,846,392	371,402
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,039,366	3,506,293
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	143,003,241	138,657,927
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	33,000	65,933
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	71,021,506	74,535,193
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	17,249	19,021
b	Total fundraising expenses (Part IX, column (D), line 25) 19,021
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	71,972,860	75,565,846
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	143,044,615	150,185,993
19	Revenue less expenses. Subtract line 18 from line 12.......	-41,374	-11,528,066
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	136,785,580	114,520,671
21	Total liabilities (Part X, line 26).............	88,900,945	75,058,102
22	Net assets or fund balances. Subtract line 21 from line 20.....	47,884,635	39,462,569

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 57,086,442 including grants of $ 65,933 ) (Revenue $ 58,256,172 )
	SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 60,011,747 including grants of $ ) (Revenue $ 61,241,418 )
	SEE SCHEDULE O.

4c	(Code: ) (Expenses $ 11,889,979 including grants of $ ) (Revenue $ 12,133,465 )
	SEE SCHEDULE O.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses128,988,168

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,719,258	11,544,790	1,110,337

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	160,401
d	Related organizations		1d
e	Government grants (contributions)		1e	1,135,154

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,171,777

g	Noncash contributions included in lines 1a - 1f:$		1g	76,262

h Total. Add lines 1a-1f.......		3,467,332

		Business Code
2a	PATIENT REVENUE	622110	128,504,840	128,504,840
b	REFERENCE LAB	621511	2,808,060		2,808,060
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		131,312,900

3 Investment income (including dividends, interest, and othersimilar amounts) ......			13,731			13,731
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		364,383	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		364,383	6c
d	Net rental income or (loss).......			364,383			364,383
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		717,671	7a
b	Less: cost or other basis and sales expenses		360,000	7b
c	Gain or (loss)		357,671	7c
d	Net gain or (loss).........			357,671			357,671
8a	Gross income from fundraising events (not including $ 160,401of contributions reported on line 1c). See Part IV, line 18 ....
			8a	64,613
b	Less: direct expenses ...		8b	48,918
c	Net income or (loss) from fundraising events..			15,695			15,695
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	REBATES & REFUNDS		900099	1,040,057	1,040,057
b	JV REVENUE		621400	861,063	861,063
c	CAFETERIA REVENUE		900099	504,517	504,517
d	All other revenue ....			720,578	720,578
e	Total. Add lines 11a–11d ......			3,126,215
12	Total revenue. See instructions.....			138,657,927	131,631,055	2,808,060	751,480

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	65,933	65,933
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	60,944,358	57,028,962	3,915,396
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,909,271	2,702,147	207,124
9	Other employee benefits .......	6,288,082	5,387,541	900,541
10	Payroll taxes ...........	4,393,482	3,994,310	399,172
11	Fees for services (non-employees):
a	Management ......	10,401,504		10,401,504
b	Legal .........
c	Accounting ...........	30,000		30,000
d	Lobbying ...........	61,557		61,557
e	Professional fundraising services. See Part IV, line 17	19,021			19,021
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	18,348,547	16,983,646	1,364,901
12	Advertising and promotion ....	66,850	49,575	17,275
13	Office expenses .......	35,181,155	33,011,152	2,170,003
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	3,427,222	2,541,720	885,502
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	40,138	24,574	15,564
20	Interest ...........	524,064	524,064
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	5,070,266	5,070,266
23	Insurance ...	626,725	626,725
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	REPAIRS	544,413	540,736	3,677
b	COLLECTIONS	395,106	0	395,106
c	RECRUITING	226,201	500	225,701
d	WASTE	213,333	213,333	0
e	All other expenses	408,765	222,984	185,781
25	Total functional expenses. Add lines 1 through 24e	150,185,993	128,988,168	21,178,804	19,021
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			39,067,751	2	18,658,753
3	Pledges and grants receivable, net ......			1,633,741	3	1,063,312
4	Accounts receivable, net .............			17,873,224	4	14,583,648
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			4,895,134	8	5,902,709
9	Prepaid expenses and deferred charges ......			1,932,119	9	1,062,539
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	60,714,737
b	Less: accumulated depreciation	10b	19,221,193	37,553,527	10c	41,493,544
11	Investments—publicly traded securities .			16,430,720	11	11,443,814
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			17,399,364	15	20,312,352
16	Total assets. Add lines 1 through 15 (must equal line 33)...			136,785,580	16	114,520,671

17	Accounts payable and accrued expenses .....	19,436,016	17	13,952,700
18	Grants payable ...		18
19	Deferred revenue .........	0	19
20	Tax-exempt bond liabilities .........	19,536,451	20	17,958,565
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	0	23
24	Unsecured notes and loans payable to unrelated third parties ..	8,809,514	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	41,118,964	25	43,146,837
26	Total liabilities. Add lines 17 through 25..	88,900,945	26	75,058,102

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	29,820,114	27	26,955,443
28	Net assets with donor restrictions ...........	18,064,521	28	12,507,126
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	47,884,635	32	39,462,569
33	Total liabilities and net assets/fund balances ........	136,785,580	33	114,520,671