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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSANNA JAQUES HOSPITAL AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL. BILH IS A PURPOSE-DRIVEN, VALUES-BASED ORGANIZATION THAT UNITES 39,000 PEOPLE WHO PROVIDE EXCEPTIONAL HEALTH CARE TO EVERYONE WE SERVE. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND PARTS OF SOUTHERN NEW HAMPSHIRE 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 4,800 PHYSICIANS AND 39,000 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.BILH'S PURPOSE STATEMENT ARTICULATES THE IMPACT BILH AND EACH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. BILH'S SHARED VALUES GUIDE DAILY EFFORTS, KEEP BILH AND EACH AFFILIATE ALIGNED IN THE PURSUIT OF PURPOSE AND SHOW HOW BILH CARES FOR PATIENTS, EACH OTHER AND OUR COMMUNITIES.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.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 THREE-YEAR IMPLEMENTATION STRATEGY; ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT THE 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 AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, ECONOMIC AND SYSTEMIC FACTORS; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN ANNA JAQUES HOSPITAL'S 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; ANDFACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTHCARE 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.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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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 $327,355 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMANNA 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 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 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. ANNA JAQUES HOSPITAL'S CBAC MEMBERS INCLUDE: MICHELLE BRASIER, PRACTICE MANAGER, BETH ISRAEL LAHEY PRIMARY CARE HAVERHILL JANEL D'AGATA-LYNCH, MANAGER OF COMMUNITY BENEFITS COMMUNITY RELATIONS, ANNA JAQUES HOSPITAL, BETH ISRAEL LAHEY HEALTH 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 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 MARY WILLIAMSON, VICE PRESIDENT OF PHILANTHROPY, AJH 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 (IS OR CHIP) 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). THE CHNA AND THE ASSOCIATED 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 (CBSA) 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.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 (CHNA) 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 FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCED POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN AMESBURY, HAVERHILL, MERRIMAC, NEWBURYPORT, AND SALISBURY, AS FOLLOWS: YOUTH LOW-RESOURCED POPULATIONS OLDER ADULTS RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INDIVIDUALS WITH DISABILITIES
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSANNA JAQUES HOSPITAL'S 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. 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)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 WORKED WITH COLLABORATORS TO CONDUCT 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.COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)ANNA JAQUES HOSPITAL CONDUCTED THREE COMMUNITY FOCUS GROUPS AND HELD 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. 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).
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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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 HEALTHCARE 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. 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/COMMUNITY/OUTREACH-AND-INVOLVEMENT IN ADDITION TO THE CHNA, ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2023-2025-IMPLEMENTATION-STRATEGY-101122.PDFANNA 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://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.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://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).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 AND A SUMMARY OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THAT CHNA 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 PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: EQUITABLE ACCESS TO CARE GOAL: 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.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE.PRIORITY AREA 4: CHRONIC AND COMPLEX DISEASE GOAL 1: ADDRESS THE PREVALENCE AND IMPACT, RISK/PROTECTIVE FACTORS, AND ACCESS ISSUES ASSOCIATED WITH CANCER. GOAL 2: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.COMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)ANNA JAQUES HOSPITAL (AJH) HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES ANNA JAQUES HOSPITAL OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES AMONG THEIR FOCUS COHORTS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS.ANNA JAQUES HOSPITAL WORKED TO EXPAND ACCESS TO CARE BEING MINDFUL OF ITS PRIORITY COHORTS. KNOWING TRANSPORTATION WAS IDENTIFIED AS A BARRIER TO CARE FOR OLDER ADULTS IN THE 2022 CHNA, AJH SUPPORTED NORTHERN ESSEX ELDER TRANSPORT (NEET), WHICH PROVIDES TRANSPORTATION TO LOCAL AND OUT-OF-TOWN MEDICAL APPOINTMENTS FOR THOSE THAT ARE 60 OR OLDER WHO CANNOT ACCESS AND/OR AFFORD OTHER MEANS. IN ADDITION, AJH PAID PATIENTS' CARE RELATED TRANSPORTATION FROM EMERGENCY FUNDS. IN JANUARY 2023, ANNA JAQUES STARTED A NEW "WELCOME VISIT" PROGRAM THROUGH ITS BIRTH CENTER TO PREPARE NEW PARENTS FOR DELIVERY, WITH TARGETED OUTREACH TO THOSE WHO FALL INTO HIGH-RISK CATEGORIES AND THE MOST VULNERABLE PATIENTS. THE PROGRAM COORDINATES WITH SOCIAL WORK TO ENSURE THE MOST VULNERABLE PATIENTS ATTEND THE VISIT, AND TRANSPORTATION ASSISTANCE IS GIVEN, IF NEEDED. ANNA JAQUES HOSPITAL UNDERSTANDS THAT ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH IS VITAL TO MOVE TOWARD HEALTH EQUITY. HOUSING AND FOOD SECURITY WERE IDENTIFIED IN THE 2022 CHNA AND ARE THE FOCUS OF EFFORTS IN THE CURRENT IMPLEMENTATION STRATEGY. IN FY23, AJH SUPPORTED A WIDE VARIETY OF PROGRAMS AIMED AT INCREASING FOOD SECURITY WITHIN THE CBSA INCLUDING NOURISHING THE NORTHSHORE'S VEGOUT PROGRAM AND OUR NEIGHBORS' TABLE WEDNESDAY MEAL. AND, TO INCREASE HEALTH EQUITY IN GATEWAY MUNICIPALITIES, AND CONTINUE TO SERVE THE UNDERSERVED, 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. THE YMCA COLLABORATED WITH THE CITY OF HAVERHILL AND THE HAVERHILL PUBLIC SCHOOLS TO LOCATE THE FARM AT HAVERHILL'S GATEWAY ACADEMY, A PUBLIC MIDDLE AND HIGH SCHOOL. IN ADDITION TO FOOD, ANNA JAQUES HOSPITAL SUPPORTED EMMAUS, INC. MITCH'S PLACE, AN EMERGENCY OVERNIGHT SHELTER, WHICH EXPANDED ITS BED CAPACITY IN RESPONSE TO THE GROWING NUMBER OF UNSHELTERED MEN AND WOMEN IDENTIFIED DURING THE 2023 HOMELESS COUNT IN HAVERHILL. MENTAL HEALTH AND SUBSTANCE USE CONTINUE TO BE A PRIORITY FOR ANNA JAQUES HOSPITAL. THE PATIENT CARE NAVIGATOR AT AJH SUPPORTS WOMEN WITH SUBSTANCE USE DISORDER (SUD) AND/OR NEONATAL ABSTINENCE SYNDROME (NAS). 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 SUPPORTS 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 ADDITION, ANNA JAQUES HOSPITAL SUPPORTED THE PETTENGILL HOUSE'S BEHAVIORAL EVENT AND SUBSTANCE SUPPORT TEAM (BESST) PROGRAM, WHICH WAS ABLE TO RESPOND TO THE INCREASED MENTAL HEALTH AND SUBSTANCE RELATED NEEDS. THE 2022 AJH CHNA IDENTIFIED YOUTH MENTAL HEALTH AS A CRITICAL CONCERN IN AJH'S CBSA. AJH SUPPORTED THE RECENTLY CREATED CATCH (CHILDREN AND TEEN CENTER FOR HELP) PROGRAM AT LINK HOUSE TO INCREASE ACCESS TO MENTAL HEALTH AND SUBSTANCE-USE TREATMENT AND EDUCATION FOR SCHOOL-AGED CHILDREN AND TEENS. ANNA JAQUES HOSPITAL CONTINUES TO ADDRESS COMPLEX AND CHRONIC DISEASE WITH A FOCUS ON CANCER IN DIVERSE WAYS. ANNA 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. 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. A FULL UPDATE ON ANNA JAQUES HOSPITAL'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.FY23 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEKEY: BASELINE-2023PRIORITY AREA 1: EQUITABLE ACCESS TO CAREINDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, AND 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 HEALTH CARE 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 FORGO 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.GOAL: 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 BARRIERSCOMMUNITY STRATEGIES/ACTIVITIES PROMOTE ACCESS TO HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICATIONS FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED. PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS. SUPPORT PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION TO HEALTHCARE SERVICES.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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METRICS AND STATUS UPDATES 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 (FY23: $7,200) NUMBER OF PATIENTS ASSISTED (FY23: 240) TO ORIENT AND SUPPORT EXPECTANT PATIENTS, ESPECIALLY THOSE DEEMED "HIGH-RISK," BY PREPARING THEM FOR A HOSPITAL DELIVERY AND INITIAL NEWBORN CARE, AJH STARTED A "WELCOME VISIT" PROGRAM IN JANUARY 2023. THE VISIT IS FREE, AND OUTREACH IS DONE TO ENSURE THE MOST VULNERABLE PATIENTS ATTEND THE VISIT. WELCOME VISITS COMPLETED (FY23: 130) TO "TRANSFORM CARE DELIVERY BY DISMANTLING BARRIERS TO EQUITABLE HEALTH OUTCOMES AND BECOME THE PREMIER HEALTH SYSTEM TO ATTRACT, RETAIN AND DEVELOP DIVERSE TALENT," BILH'S DIVERSITY, EQUITY, AND INCLUSION (DEI) OFFICE DEVELOPS AND ADVOCATES FOR POLICIES, PROCESSES AND BUSINESS PRACTICES THAT BENEFIT THE COMMUNITIES AND OUR WORKFORCE. INCREASE IN BIPOC LEADERSHIP (DIRECTORS AND ABOVE) AND CLINICAL (PHYSICIANS AND NURSES) HIRES OVER FY22 (FY23: 25%) DOLLARS CONTRACTED TO WOMEN AND MINORITY-OWNED BUSINESS ENTERPRISES (WMBE) (FY23: $50 MILLION, A 22% INCREASE FROM FY22) SYSTEM-WIDE DEI TRAININGS CONDUCED FOR ALL BILH STAFF AND HOSPITALS (FY23: 8) ANNA JAQUES HOSPITAL IS FORMING A DIVERSITY, EQUITY AND INCLUSION COUNCIL TO GUIDE THE HOSPITAL'S EFFORTS TO NURTURE AND SUSTAIN A DIVERSE, EQUITABLE AND INCLUSIVE ORGANIZATIONAL CULTURE AND TO MAKE MEANINGFUL AND LASTING CHANGE FOR OUR PATIENTS, OUR EMPLOYEES AND OUR COMMUNITIES. TO SUPPORT OLDER ADULTS' ACCESS TO VITAL MEDICAL APPOINTMENTS, AJH SUPPORTED NORTHERN ESSEX ELDER TRANSPORT, INC. (NEET). NEET PROVIDES FREE TRANSPORTATION TO AND FROM HEALTHCARE APPOINTMENTS FOR THOSE OVER THE AGE OF 60. UNIQUE INDIVIDUALS RECEIVING TRANSPORTATION TO MEDICAL CARE (FY23: 436)PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTHTHE 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 HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION 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, LISTENING SESSIONS, AND THE ANNA JAQUES HOSPITAL COMMUNITY HEALTH SURVEY REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC INSTABILITY.GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.COMMUNITY STRATEGIES/ACTIVITIES PROVIDE COMMUNITY HEALTH GRANTS TO SUPPORT IMPACTFUL PROGRAMS THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTH. SUPPORT PROGRAMS AND INITIATIVES THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSING. SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE HEALTHY EATING AND ACCESS TO AFFORDABLE, HEALTHY FOODS. PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES THAT REDUCE AND PREVENT FOOD INSECURITY AND/OR HOUSING CHALLENGES.METRICS AND STATUS UPDATES 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. THE YMCA PARTNERED WITH THE HAVERHILL PUBLIC SCHOOLS TO HOUSE THE FARM AT GATEWAY ACADEMY, A PUBLIC MIDDLE AND HIGH SCHOOL. STUDENTS FROM THE SCHOOL AND THE YMCA AFTERSCHOOL PROGRAM HELP TO GROW, TEND, AND HARVEST PRODUCE. THE FREIGHT FARM GROWS A VARIETY OF VEGETABLES, INCLUDING LETTUCE, BOK CHOY, AND SPINACH, THAT ARE DISTRIBUTED TO GATEWAY STUDENTS, YMCA PARTICIPANTS AND SHARED WITH LOCAL FOOD PANTRIES/HOMELESS SHELTERS. UNIQUE PERSONS RECEIVING FOOD (FY23: 1,040) STUDENT PARTICIPANTS IN STEM AND NUTRITIONAL ACTIVITIES (FY23: 43) PEOPLE RECEIVED VIA COMMUNITY EVENTS (FY23: 154) 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 (FY23: 225) AJH ISSUED A COMMUNITY GRANT TO OUR NEIGHBORS' TABLE (ONT) TO SUPPORT THEIR WEDNESDAY MEAL PROGRAM, WHICH IS OPEN TO ANYONE. THE WEDNESDAY MEAL PROVIDES A HOT MEAL TO 300 500+ UNIQUE PEOPLE EACH MONTH. ONT ALSO PROVIDES HOME DELIVERIES OF THE WEDNESDAY MEAL TO THOSE WHO ARE HOMEBOUND AND DISTRIBUTES EXTRA PREPARED MEALS IN THE MARKET ON THURSDAY AS AN EXTRA CONVENIENCE FOR ONT GUESTS UNIQUE GUESTS SERVED THROUGH THE WEDNESDAY MEAL PROGRAM (FY23: 4,490) ANNA JAQUES HOSPITAL SUPPORTED THE FIRST PARISH NEWBURY FOOD PANTRY, WHICH PROVIDES FREE FOOD TO THOSE IN NEED, INCLUDING RESIDENTS OF NEWBURYPORT, SALISBURY, AMESBURY, AND OTHER SURROUNDING CITIES/TOWNS. THE ORGANIZATION SERVES APPROXIMATELY 600 GUESTS EACH WEEK, THE MAJORITY OF WHICH LIVE IN NEWBURYPORT (45%). MORE THAN HALF THE HOUSEHOLDS SERVED DON'T HAVE TRANSPORTATION AND DEPEND ON THE ORGANIZATION'S FOOD DELIVERY. THE ORGANIZATION HAS PANTRIES IN ALL THE SCHOOLS IN THE TRITON SCHOOL DISTRICT, WHICH INCLUDES SALISBURY ELEMENTARY SCHOOL AND TRITON HIGH SCHOOL, SERVING SALISBURY RESIDENTS. HOUSEHOLDS RECEIVING FOOD REGULARLY (FY23: 401) 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. UNIQUE HOUSEHOLDS RECEIVING FOOD (FY23: 1,000) ANNA JAQUES HOSPITAL SUPPORTED THE YWCA OF NEWBURYPORT'S AFFORDABLE HOUSING RESIDENTS WITH A GRANT TO PURCHASE HEALTHY, FRESH PRODUCE. ALL HOUSEHOLDS ARE BELOW 60% OF THE AREA MEDIAN INCOME. HOUSEHOLDS WITH INCOMES BELOW 80% AMI ARE CONSIDERED LOW INCOME. AT THE RESIDENCES AT SALISBURY SQUARE (RSS) SITE, 20 OF 42 UNITS ARE CURRENTLY HOUSING FAMILIES WHOSE INCOME IS AT OR BELOW 30% OF AREA MEDIAN (WHICH IS CONSIDERED EXTREMELY LOW INCOME. TENANTS ASSISTED WITH FOOD (FY23: 100)PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USEANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, 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. THOSE WHO PARTICIPATED IN THE ASSESSMENT ALSO REFLECTED ON STIGMA, SHAME, AND ISOLATION THAT THOSE WITH MENTAL HEALTH CHALLENGES FACE THAT LIMIT THEIR ABILITY TO ACCESS CARE AND COPE WITH THEIR ILLNESS. 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 AND ECONOMIC INSECURITY. INTERVIEWEES, FOCUS GROUP, AND LISTENING SESSION PARTICIPANTS ALSO REPORTED THAT ALCOHOL USE IS NORMALIZED, AND USE IS PREVALENT AMONG BOTH ADULTS AND YOUTH.GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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COMMUNITY STRATEGIES/ACTIVITIES: ENHANCE RELATIONSHIPS AND PARTNERSHIPS WITH SCHOOLS, YOUTH SERVING ORGANIZATIONS, AND OTHER COMMUNITY PARTNERS TO INCREASE RESILIENCY, COPING, AND PREVENTION SKILLS. PROVIDE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION AND TREATMENT. SUPPORT A MODEL THAT SPANS THE CONTINUUM OF CARE FROM INPATIENT TO OUTPATIENT AND COMMUNITY INITIATIVES THAT IDENTIFY AND ADDRESS MENTAL HEALTH NEEDS AND SUBSTANCE USE DISORDERS. PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO INCREASE RESILIENCY, PROMOTE MENTAL HEALTH, REDUCE SUBSTANCE USE, AND PREVENT OPIOID OVERDOSES AND DEATHS.METRICS AND STATUS UPDATES: AJH PROVIDES 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 SCREENS FOR BEHAVIORAL HEALTH (FY23: 974) COLLABORATIVE CARE MODEL (COCM) HAS BEEN ADOPTED IN BILH PRIMARY CARE PRACTICES TO PROVIDE BEHAVIORAL HEALTH SERVICES IN THE PRIMARY CARE SETTING. THE PRIMARY CARE PROVIDER AND THE BEHAVIORAL HEALTH CLINICIAN WILL DEVELOP A TREATMENT PLAN THAT IS SPECIFIC TO THE PATIENT'S PERSONAL GOALS. A CONSULTING PSYCHIATRIST MAY ADVISE THE PRIMARY CARE PROVIDER ON MEDICATIONS THAT MAY BE HELPFUL. NUMBER OF PATIENTS SERVED (FY23: 159) AJH SUPPORTED THE PETTENGILL HOUSE'S BEHAVIORAL EVENT AND SUBSTANCE SUPPORT TEAM (BESST), COLLECTIVE RESPONSE TO ADDRESS SYSTEM BARRIERS AND MEET GROWING COMMUNITY NEED BY CREATING A STREAMLINED PROCESS FOR COLLABORATION ACROSS EVERY LEVEL OF CARE TO ENHANCE QUALITY AND CONTINUITY OF CARE FOR THOSE STRUGGLING WITH SUBSTANCE MISUSE/BEHAVIORAL HEALTH. THROUGH A PERSON-CENTERED COORDINATED TEAM, BESST AIMS TO BRIDGE GAPS BY BREAKING DOWN BARRIERS, PROVIDING EDUCATION, REDUCING STIGMA, AND COORDINATING WRAPAROUND SUPPORTS TO IMPROVE STABILIZATION AND WELL-BEING FOR AT-RISK COMMUNITY MEMBERS STRUGGLING WITH SUBSTANCE MISUSE AND BEHAVIORAL HEALTH. NUMBER OF UNIQUE INDIVIDUALS RECEIVING DIRECT SERVICES (FY23: 481) NUMBER OF FAMILY MEMBERS RECEIVING SUPPORT (FY23: 94) AJH PROVIDED GRANT FUNDING TO THE GREATER NEWBURYPORT VILLAGE FOR THEIR MEMBERSHIP ASSISTANCE PROGRAM. THE VILLAGE'S GOOD NEIGHBOR VOLUNTEERS PROVIDE NEIGHBORLY HELP AT HOME AND RIDES TO APPOINTMENTS/EVENTS. IN ADDITION, THE VILLAGE FOLLOWS UP WITH NON-PARTICIPATING MEMBERS, WHO MAY BE SUFFERING FROM ISOLATION. PERCENT OF MEMBERS ENROLLED IN ASSISTANCE PROGRAM (FY23: 20%) 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. INDIVIDUALS SERVED THROUGH HELPLINES (FY23: 4,600) PARTICIPANTS IN TRAINING AND SUPPORTIVE PROGRAMS (FY23: 495) SUICIDE PREVENTION TRAINING SESSIONS (FY23: 330) 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. UNIQUE PERSONS ASSISTED (FY23: 104) AJH PROVIDED A COMMUNITY GRANT TO LINK HOUSE, INC.'S NEW CATCH (CHILDREN AND TEEN CENTER FOR HELP) PROGRAM TO ADDRESS THESE GROWING UNMET NEEDS AROUND MENTAL HEALTH AND SUBSTANCE-USE FOR SCHOOL-AGED CHILDREN AND TEENS IN THE COMMUNITY. THE FUNDS FROM THIS GRANT FOCUSED SPECIALLY ON CHILD AND TEENS AGE 5Y/O 18 Y/O, AND THEIR IMMEDIATE FAMILIES WHO ARE IN NEED OF RECEIVING TREATMENT AND/OR PSYCHOEDUCATION RELATED TO ACUTE OR CHRONIC MENTAL HEALTH CONCERNS, IN ADDITION TO TREATMENT, EDUCATION, AND/OR RELAPSE PREVENTION SKILLS. PATIENTS RECEIVING THERAPY (FY23 146) 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 (FY23: 300)PRIORITY 4: CHRONIC AND COMPLEX DISEASECHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN MASSACHUSETTS 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.GOALS: ADDRESS THE PREVALENCE AND IMPACT, RISK/PROTECTIVE FACTORS, AND ACCESS ISSUES ASSOCIATED WITH CANCER. IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.COMMUNITY STRATEGIES/ACTIVITIES: PROVIDE PREVENTIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMS. SUPPORT COMMUNITY-BASED PROGRAMS/ INITIATIVES THAT INCREASE ACCESS TO HEALTHY FOODS AND/OR PHYSICAL ACTIVITY TO SUPPORT CANCER SURVIVORSHIP. PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES THAT REDUCE AND PREVENT OR PROVIDE NEEDED SUPPORTS RELATED TO CANCER.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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METRICS AND STATUS UPDATES: AJH BREAST CARE NAVIGATOR OFFERS 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. THE NAVIGATOR PROVIDES CANCER PATIENTS WITH COORDINATED CARE THROUGH A HOLISTIC AND COLLABORATIVE APPROACH THAT INCLUDES COMMUNICATION AND COORDINATION WITH THE PATIENT'S FAMILY AND/OR CAREGIVERS, ALONG WITH A MULTIDISCIPLINARY TEAM CONSISTING OF PHYSICIANS, NURSE PRACTITIONERS, ONCOLOGY NURSES, AND SOCIAL WORKERS. THE NAVIGATOR WORKS IN COLLABORATION WITH THE CLINICAL TEAM TO DEVELOP CLINICAL PATHWAYS FOR APPROPRIATE CARE AND ACTS AS THE CONTACT CLINICAL PERSON FOR PATIENT-RELATED CONCERNS. INDIVIDUALS PROVIDED SUPPORT SERVICES AND CARE COORDINATION (FY23: 266 WOMEN SCHEDULED FOR IMAGE-GUIDED BREAST BIOPSIES AND 100 GBCC PATIENTS AND FAMILIES UNDERGOING BREAST SURGERY FOR BOTH BENIGN AND MALIGNANT CONDITIONS). AJH SUPPORTED THE NORTH OF BOSTON CANCER RESOURCES (NBCR), WHICH IS DESIGNED TO EDUCATE AND OFFER SUPPORT TO PEOPLE AFFECTED BY CANCER. THEY SERVE PEOPLE AFFECTED BY CANCER FROM DIAGNOSIS, THROUGH TREATMENT AND BEYOND. SERVICES INCLUDE ONCOLOGY MASSAGE, MANUAL LYMPH DRAINAGE, ACUPUNCTURE, REIKI, PERSONAL TRAINING, YOGA THERAPY, GUIDED IMAGERY, HEALTH COACHING AND NUTRITION COUNSELING. IN ADDITION, THEY HAVE AN EDUCATIONAL SPEAKER SERIES AND GIFT CERTIFICATE PROGRAM. INDIVIDUALS REACHED THROUGH SPEAKER SERIES (FY23: 271) COMPLEMENTARY CARE SESSIONS PROVIDED (FY23: 160) AJH HOSTS FREE WEEKLY "BABY AND ME" CLASSES IN NEWBURYPORT AND HAVERHILL FOR ANY PARENT IN THE COMMUNITY. THESE GROUPS ARE FACILITATED BY A BIRTH CENTER LACTATION CONSULTANT/REGISTERED NURSE TO SUPPORT EVERY PERSON'S PARENTING EXPERIENCE. A PERSON DOES NOT NEED TO BE BREASTFEEDING/CHEST FEEDING TO ENJOY THIS GROUP. ALL ASPECTS OF PARENTING ARE DISCUSSED. PARENTS PARTICIPATING WEEKLY IN CLASSES (FY23: 15) AJH SUPPORTED THE YWCA OF NEWBURYPORT'S ENCORE AND AFTER ENCORE PROGRAM, WHICH IS A UNIQUE SURVIVORSHIP PROGRAM FOR THOSE WHO HAVE EXPERIENCED CANCER AT ANY POINT IN THEIR LIVES. THE PROGRAM PROVIDES FREE ACCESS TO A TAILORED EXERCISE PROGRAM, INCORPORATING LAND AND WATER EXERCISES APPROPRIATE FOR ALL FITNESS LEVELS AT ANY POINT IN THEIR TREATMENT JOURNEY AND BEYOND. ENCORE/AFTER ENCORE PARTICIPANTS (FY23: 36) PARTICIPANTS WHO EXPERIENCED INCREASED HEALTH METRICS WITH REGULAR ATTENDANCE (FY23: 85%) AJH SUPPORTED THE CORNERSTONE PROGRAM AT THE GREATER HAVERHILL YMCA. CORNERSTONE IS A COLLABORATIVE HEALTH AND WELLNESS PROGRAM PROVIDING SUPPORT TO CANCER PATIENTS, CANCER SURVIVORS, AND THEIR IMMEDIATE FAMILIES. A FREE ONE-YEAR YMCA MEMBERSHIP IS PROVIDED TO THE FAMILY AND TWO WEEKS OF SUMMER CAMP PROGRAMMING AT NO COST. NUMBER OF SURVIVORSHIP SUPPORT PROGRAM MEMBERSHIPS (FY23: 41) NUMBER OF FAMILIES PROVIDED SUMMER CAMP (FY23: 8) ENHANCEFITNESS IS A PROVEN COMMUNITY-BASED SENIOR FITNESS AND ARTHRITIS MANAGEMENT PROGRAM. IT HELPS OLDER ADULTS BECOME MORE ACTIVE, ENERGIZED, AND EMPOWERED FOR INDEPENDENT LIVING. THE PROGRAM IS ESPECIALLY BENEFICIAL FOR OLDER ADULTS LIVING WITH ARTHRITIS. AJH SUPPORTED THIS PROGRAM AT THE YMCA OF GREATER HAVERHILL. PERCENT OF PARTICIPANTS THAT MAINTAINED/INCREASED THEIR FEELING OF OVERALL HEALTH DURING THE 16-WEEK PROGRAM (FY23: 90%) PERCENT OF PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ABILITIES OVER THE 16-WEEK PROGRAM (FY23: 75%) 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. SEVERAL VENDORS ACCEPT PAYMENT FROM THE SUPPLEMENTAL NUTRITION ASSISTANT PROGRAM (SNAP) AND WOMEN, INFANTS, AND CHILDREN (WIC) HELPING LOWER INCOME FAMILIES ACCESS LOCALLY GROWN FRESH PRODUCE. NUMBER OF WEEKLY MARKETS HOSTED (FY23:19)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: EMMAUS, INC. ESSEX COUNTY ASSET BUILDER NETWORK ESSEX COUNTY OUTREACH FAMILY SERVICES OF THE MERRIMACK VALLEY GREATER NEWBURYPORT VILLAGE HAVERHILL FARMERS MARKET/CREATIVE HAVERHILL LINK HOUSE, INC. NEW ENGLAND ELDER TRANSPORTATION NEWBURY FOOD PANTRY NEWBURYPORT DEI ALLIANCE NEWBURYPORT FARMERS' MARKET NEWBURYPORT RECREATION AND YOUTH SERVICES NORTH OF BOSTON CANCER RESOURCE NORTHERN ESSEX ELDER TRANSPORT NOURISHING THE NORTHSHORE OUR NEIGHBORS' TABLE THE PETTENGILL HOUSE REGIONAL SOCIAL SERVICES COLLABORATIVE ROTARY CLUB OF NEWBURYPORT SALISBURY PARKS & RECREATION DEPARTMENT YMCA OF NORTHSHORE/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 MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY. THOSE NEEDS 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. ANNA JAQUES HOSPITAL IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES, THE 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, ANNA JAQUES HOSPITAL'S PRIMARY TOOL FOR ASSESSING THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW ANNA JAQUES HOSPITAL CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 10.58% 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://AJH.ORG/ABOUT/COMMUNITY-BENEFITS-NEEDS.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.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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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 $1,004,100 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 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 ELEVEN 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 $ $73,152,852 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, FOR THE PERIOD COVERED BY THIS FILING, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, ANNA JAQUES HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ANNA JAQUES HOSPITAL GENERATED $2,862,888 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY ANNA JAQUES HOSPITAL FOR SUCH SERVICES BY $121,596 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 11.20% OR 24,814 OF ANNA JAQUES HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 52.60% OR 116.540 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE 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 $49,643,498 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $8,163,297. OF THESE AMOUNTS, REVENUE OF $47,565,621 IS RELATED TO THE PROVISION OF GENERAL MEDICINE, CANCER CENTER (INCLUDES HEMATOLOGY), BEHAVIORAL HEALTH, OBGYN, NEONATOLOGY/ NEWBORN SERVICES 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 $13,583,744.. 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. 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. COSTS FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF WERE $2,262,622 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 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), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER AND THEIR AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP). FINALLY, EFFECTIVE JULY 1, 2023, BILH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND THREE MONTHS OF EHRI'S ACTIVITY AS WELL AS THREE MONTHS OF EHRI'S AFFILIATES' ACTIVITY, INCLUDING EXETER HOSPITAL, ARE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF BILH AND AFFILIATES. THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSTHE SYSTEM'S PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING MANAGED CARE PAYERS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDE AN ESTIMATE OF VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE SYSTEM BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE SYSTEM'S FACILITY.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 POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE ANNA JAQUES HOSPITAL IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTHCARE 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.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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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 AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONS EFFECTIVE ON OR ABOUT AUGUST 15, 2020FINANCIAL ASSISTANCE POLICY APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ARABIC, FRENCH, GREEK, ITALIAN, JAPANESE, KHMER, PORTUGUESE, RUSSIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, SPANISH, VIETNAMESE. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://AJH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/ASSISTANCE#:~:TEXT=AT%20ANNA%20JAQUES%20HOSPITAL%2C%20WE%20PROVIDE%20FINANCIAL%20AID,THE%20NUMBER%20OF%20FAMILY%20MEMBERS%20IN%20THE%20HOUSEHOLD. 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 OR DISCHARGE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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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, ALL IN ENGLISH, SPANISH, ARABIC, FRENCH, GREEK, ITALIAN, JAPANESE, KHMER, PORTUGUESE, RUSSIAN, AND VIETNAMESE, CAN BE FOUND ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/ASSISTANCE#:~:TEXT=AT%20ANNA%20JAQUES%20HOSPITAL%2C%20WE%20PROVIDE%20FINANCIAL%20AID,THE%20NUMBER%20OF%20FAMILY%20MEMBERS%20IN%20THE%20HOUSEHOLD.LIMITATION ON CHARGES INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNT GENERALLY BILLED LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. 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 FORM 990, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH ANNA JAQUES HOSPITAL DOES NOT DIRECTLY ENGAGE IN RESEARCH, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC, NEW ENGLAND BAPTIST HOSPITAL AND JOSLIN DIABETES CENTER ALL ENGAGE IN RESEARCH ACTIVITIES DESIGNED TO CARE FOR PATIENTS NOT ONLY AT THESE HOSPITALS, BUT ACROSS THE COMMUNITIES SERVED BY BILH AND BEYOND. ALTHOUGH THE RESEARCH ACTIVITIES OF THESE BILH AFFILIATES ARE NOT QUANTIFIED HERE IN ANNA JAQUES HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL AND BEYOND AND INFORMATION ON THE RESEARCH ENGAGED IN AT BIDMC, A SISTER ENTITY TO ANNA JAQUES HOSPITAL, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION. TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.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 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 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 INCURRED OVER $320 MILLION IN RESEARCH EXPENSES, MORE THAN $82 MILLION OF WHICH WERE INTERNALLY FUNDED AND REPORTED ON THE BIDMC SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE.RESEARCH ENGAGED IN AT THE MEDICAL CENTER
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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THE 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. DETAIL ON RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. 1. A POTENTIAL NEW WEAPON IN THE WAR AGAINST SUPERBUGS"THE END OF MODERN MEDICINE AS WE KNOW IT." THAT'S HOW THE THEN-DIRECTOR GENERAL OF THE WORLD HEALTH ORGANIZATION CHARACTERIZED THE CREEPING PROBLEM OF ANTIMICROBIAL RESISTANCE IN 2012. WITHOUT ANTIBIOTICS TO MANAGE COMMON BACTERIAL INFECTIONS, SMALL INJURIES AND MINOR INFECTIONS BECOME POTENTIALLY FATAL ENCOUNTERS. IN 2019, MORE THAN 2.8 MILLION ANTIMICROBIAL-RESISTANT INFECTIONS OCCURRED IN THE UNITED STATES, AND MORE THAN 35,000 PEOPLE DIED AS A RESULT, ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). A REPORT FROM THE UNITED NATIONS ISSUED EARLIER THIS YEAR WARNED THAT NUMBER COULD RISE TO TEN MILLION GLOBAL DEATHS ANNUALLY IF NOTHING IS DONE TO COMBAT ANTIMICROBIAL RESISTANCE.FOR NEARLY 25 YEARS, JAMES KIRBY, MD, DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORY AT BIDMC, HAS WORKED TO ADVANCE THE FIGHT AGAINST INFECTIOUS DISEASES BY FINDING AND DEVELOPING NEW, POTENT ANTIMICROBIALS, AND BY BETTER UNDERSTANDING HOW DISEASE-CAUSING BACTERIA MAKE US SICK. IN A RECENT PAPER PUBLISHED IN PLOS BIOLOGY, KIRBY AND COLLEAGUES INVESTIGATED A NATURALLY OCCURRING ANTIMICROBIAL AGENT DISCOVERED MORE THAN 80 YEARS AGO. USING LEADING-EDGE TECHNOLOGY, KIRBY'S TEAM DEMONSTRATED THAT CHEMICAL VARIANTS OF THE ANTIBIOTIC, CALLED STREPTOTHRICINS, SHOWED POTENCY AGAINST SEVERAL CONTEMPORARY DRUG-RESISTANT STRAINS OF BACTERIA. WHAT'S MORE, THEY SHOWED THE ANTIBIOTIC HAD A THERAPEUTIC EFFECT IN AN ANIMAL MODEL AT NON-TOXIC CONCENTRATIONS."A SINGLE DOSE CLEARED THIS ORGANISM FROM AN INFECTED ANIMAL MODEL WHILE AVOIDING ANY TOXICITY," KIRBY SAID. "IT WAS REALLY REMARKABLE." THE RESEARCHERS ALSO REVEALED THE UNIQUE MECHANISM BY WHICH STREPTOTHRICIN FIGHTS OFF BACTERIAL INFECTIONS. "WE SHOWED THAT NOURSEOTHRICIN ACTS IN A COMPLETELY NEW WAY COMPARED TO ANY OTHER TYPE OF ANTIBIOTIC, BY INHIBITING THE ABILITY OF THE ORGANISM TO PRODUCE PROTEINS IN A VERY SNEAKY WAY," KIRBY EXPLAINED. "WHEN A CELL MAKES PROTEINS, IT MAKES THEM OFF A BLUEPRINT THAT TELLS THE CELL WHAT AMINO ACIDS TO LINK TOGETHER TO BUILD THE PROTEIN. OUR STUDY HELPS EXPLAIN HOW THIS ANTIBIOTIC CONFUSES THE MACHINERY SO THAT THE MESSAGE IS READ INCORRECTLY, AND IT STARTS TO PUT TOGETHER GIBBERISH. ESSENTIALLY THE BACTERIAL CELL GETS POISONED BECAUSE IT'S PRODUCING JUNK."STREPTOTHRICIN'S UNIQUE ACTION IS VERY POWERFUL BECAUSE IT MEANS BACTERIA ARE CURRENTLY HELPLESS AGAINST IT; THAT IS, THERE'S NO ENVIRONMENTAL RESERVOIR OF POTENTIAL RESISTANCE MECHANISMS, KIRBY SAID. THAT GIVES HUMANITY MORE TIME BEFORE PATHOGENS EVOLVE DEFENSE MECHANISMS AGAINST THIS BRAND-NEW CLASS OF ANTIBIOTIC."WE'RE STILL IN THE VERY EARLY STAGES OF DEVELOPMENT, BUT I THINK WE'VE VALIDATED THAT THIS IS A COMPOUND THAT'S WORTH INVESTING IN FURTHER STUDIES TO FIND EVEN BETTER VARIANTS THAT EVENTUALLY WILL MEET THE PROPERTIES OF A HUMAN THERAPEUTIC," KIRBY SAID. JANUARY 20, 20202. SEVERE COVID-19 LINKED WITH MOLECULAR SIGNATURES OF BRAIN AGING, RESEARCHERS FINDSCIENTISTS AT BIDMC FOUND THAT GENE USAGE IN THE BRAINS OF PATIENTS WITH COVID-19 IS SIMILAR TO THOSE OBSERVED IN AGING BRAINS. USING A MOLECULAR PROFILING TECHNIQUE CALLED RNA SEQUENCING TO MEASURE THE LEVELS OF EVERY GENE EXPRESSED IN A PARTICULAR TISSUE SAMPLE, THE SCIENTISTS ASSESSED CHANGES IN GENE EXPRESSION PROFILES IN THE BRAINS OF COVID-19 PATIENTS AND COMPARED THEM TO THOSE CHANGES OBSERVED IN THE BRAINS OF UNINFECTED INDIVIDUALS. THE TEAM'S ANALYSIS, PUBLISHED IN NATURE AGING, SUGGESTED THAT MANY BIOLOGICAL PATHWAYS THAT CHANGE WITH NATURAL AGING IN THE BRAIN ALSO CHANGED IN PATIENTS WITH SEVERE COVID-19.CO-FIRST AND CO-CORRESPONDING AUTHOR MARIA MAVRIKAKI, PHD, AN INSTRUCTOR OF PATHOLOGY AT BIDMC, AND COLLEAGUES ANALYZED A TOTAL OF 54 POSTMORTEM HUMAN FRONTAL CORTEX TISSUE SAMPLES FROM ADULTS 22 TO 85 YEARS OLD. "WE OBSERVED THAT GENE EXPRESSION IN THE BRAIN TISSUE OF PATIENTS WHO DIED OF COVID-19 CLOSELY RESEMBLED THAT OF UNINFECTED INDIVIDUALS 71 YEARS OLD OR OLDER," SAID CO-FIRST AUTHOR JONATHAN LEE, PHD, A POSTDOCTORAL RESEARCH FELLOW AT BIDMC."GIVEN THESE FINDINGS, WE ADVOCATE FOR NEUROLOGICAL FOLLOW-UP OF RECOVERED COVID-19 PATIENTS," SAID SENIOR AND CO-CORRESPONDING AUTHOR FRANK SLACK, PHD, DIRECTOR OF THE INSTITUTE FOR RNA MEDICINE AT BIDMC AND THE SHIELDS WARREN MALLINCKRODT PROFESSOR OF MEDICAL RESEARCH AT HARVARD MEDICAL SCHOOL. "WE ALSO EMPHASIZE THE POTENTIAL CLINICAL VALUE IN MODIFYING THE FACTORS ASSOCIATED WITH THE RISK OF DEMENTIA SUCH AS CONTROLLING WEIGHT AND REDUCING EXCESSIVE ALCOHOL CONSUMPTION TO REDUCE THE RISK OR DELAY THE DEVELOPMENT OF AGING-RELATED NEUROLOGICAL PATHOLOGIES AND COGNITIVE DECLINE."BETTER UNDERSTANDING OF THE MOLECULAR MECHANISMS UNDERLYING BRAIN AGING AND COGNITIVE DECLINE IN COVID-19 COULD LEAD TO THE DEVELOPMENT OF NOVEL THERAPEUTICS TO ADDRESS COGNITIVE DECLINE OBSERVED IN COVID-19 PATIENTS. THE TEAM IS NOW TRYING TO UNDERSTAND WHAT DRIVES THE AGING-LIKE EFFECTS IN THE BRAINS OF COVID-19 PATIENTS.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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RESEARCH SUGGESTS POLITICAL EVENTS IMPACT SLEEP: STUDY FINDS ASSOCIATION BETWEEN ELECTIONS AND SLEEP, ALCOHOL CONSUMPTION AND OVERALL PUBLIC MOODIN A PAPER PUBLISHED IN THE NATIONAL SLEEP FOUNDATION'S JOURNAL SLEEP HEALTH, RESEARCHERS AT BIDMC SHOWED THAT MAJOR SOCIOPOLITICAL EVENTS CAN HAVE GLOBAL IMPACTS ON SLEEP THAT ARE ASSOCIATED WITH SIGNIFICANT FLUCTUATIONS IN THE PUBLIC'S COLLECTIVE MOOD, WELL-BEING, AND ALCOHOL CONSUMPTION. AS PART OF A LARGER STUDY EXPLORING THE SLEEP AND PSYCHOLOGICAL REPERCUSSIONS OF THE COVID-19 PANDEMIC, THE TEAM SURVEYED 437 PARTICIPANTS IN THE UNITED STATES AND 106 INTERNATIONAL PARTICIPANTS DAILY BETWEEN OCTOBER 113, 2020 (BEFORE THE ELECTION) AND OCTOBER 30NOVEMBER 12, 2020 (DAYS SURROUNDING THE NOVEMBER 3 U.S. ELECTION). WITH REGARD TO SLEEP, BOTH U.S. AND NON-U.S. PARTICIPANTS REPORTED LOSING SLEEP IN THE RUN-UP TO THE ELECTION; HOWEVER, U.S. RESPONDENTS HAD SIGNIFICANTLY LESS TIME IN BED IN THE DAYS AROUND THE ELECTION. ON ELECTION NIGHT ITSELF, U.S. PARTICIPANTS REPORTED WAKING UP FREQUENTLY DURING THE NIGHT AND EXPERIENCING POORER SLEEP EFFICIENCY.U.S. PARTICIPANTS WHO EVER REPORTED DRINKING ALCOHOL SIGNIFICANTLY INCREASED CONSUMPTION ON THREE DAYS DURING THE ASSESSMENT PERIOD: HALLOWEEN, ELECTION DAY AND THE DAY THE ELECTION WAS CALLED BY MORE MEDIA OUTLETS, SATURDAY, NOVEMBER 7. AMONG NON-U.S. PARTICIPANTS, THERE WAS NO CHANGE IN ALCOHOL CONSUMPTION OVER THE NOVEMBER ASSESSMENT PERIOD.WHEN THE SCIENTISTS LOOKED AT HOW THESE CHANGES IN BEHAVIOR MAY HAVE AFFECTED MOOD AND WELL-BEING OF U.S PARTICIPANTS, THEY FOUND SIGNIFICANT LINKS BETWEEN SLEEP AND DRINKING, STRESS, NEGATIVE MOOD, AND DEPRESSION."THIS IS THE FIRST STUDY TO FIND THAT THERE IS A RELATIONSHIP BETWEEN THE PREVIOUSLY REPORTED CHANGES IN ELECTION DAY PUBLIC MOOD AND SLEEP THE NIGHT OF THE ELECTION," SAID CORRESPONDING AUTHOR TONY CUNNINGHAM, PHD, DIRECTOR OF THE CENTER FOR SLEEP AND COGNITION AT BIDMC. "MOREOVER, IT IS NOT JUST THAT ELECTIONS MAY INFLUENCE SLEEP, BUT EVIDENCE SUGGESTS THAT SLEEP MAY INFLUENCE CIVIC ENGAGEMENT AND PARTICIPATION IN ELECTIONS AS WELL. THUS, IF THE RELATIONSHIP BETWEEN SLEEP AND ELECTIONS IS ALSO BIDIRECTIONAL, IT WILL BE IMPORTANT FOR FUTURE RESEARCH TO DETERMINE HOW PUBLIC MOOD AND STRESS EFFECTS ON SLEEP LEADING UP TO AN ELECTION MAY EFFECT OR EVEN ALTER ITS OUTCOME."4. TARGETED CARE REVERSES RACIAL/ETHNIC HEALTH DISPARITIES IN COLON CANCER SCREENING, RESEARCHERS FINDIN A RETROSPECTIVE REVIEW OF PATIENTS WHO HAD A RECENT PRIMARY CARE VISIT IN A WELL-RESOURCED SAFETY-NET HEALTH SYSTEM SERVING A DIVERSE POPULATION, A TEAM LED BY RESEARCHERS AT BIDMC AIMED TO BETTER DEFINE THE LINKS BETWEEN PATIENTS' SOCIO-DEMOGRAPHIC CHARACTERISTICS AND COLORECTAL SCREENING. EVALUATING SELF-REPORTED FACTORS INCLUDING RACE, ETHNICITY, PREFERRED LANGUAGE, MENTAL HEALTH AND SUBSTANCE USE STATUS, THE TEAM'S MORE GRANULAR ASSESSMENT PROVIDED FINDINGS THAT CONTRADICT TRADITIONAL U.S. HEALTHCARE DISPARITIES, WITH HISPANIC AND SPANISH-SPEAKING PATIENTS SCREENING AT SIGNIFICANTLY HIGHER RATES THAN WHITE AND ENGLISH-SPEAKING PATIENTS. THE COUNTERINTUITIVE FINDINGS, PUBLISHED IN PREVENTIVE MEDICINE, DEMONSTRATE THAT A HEALTHCARE SYSTEM DESIGNED TO PROVIDE EQUAL ACCESS TO SCREENING FOR UNDERSERVED PATIENTS CAN ADDRESS THE DISPARITIES COMMONLY SEEN IN CANCER SCREENING."INVESTMENT INTO A MULTICULTURAL WORKFORCE AND OUTREACH EFFORTS TO UNDERSERVED PATIENTS MAY COUNTERACT SOME OF THE IMPLICIT OR EXPLICIT BIASES SEEN ON HEALTH SYSTEMS THAT HAVE LED TO TRADITIONAL RACIAL/ETHNIC DISPARITIES," SAID SENIOR AUTHOR HEIDI J. RAYALA, MD, PHD, UROLOGIST AT BIDMC. "OUR STUDY SHOWED DIFFERENCES IN ODDS OF SUCCESSFUL SCREENING BASED ON SUB-SECTIONS OF TRADITIONALLY DEFINED ETHNICITIES SUCH AS BREAKING DOWN "HISPANIC" INTO MORE SPECIFIC CULTURES AND BACKGROUNDS AND THAT SUGGESTS THAT FUTURE RESEARCH SHOULD FOCUS ON BETTER UNDERSTANDING INDIVIDUAL CULTURES AND COMMUNITIES, RATHER THAN LUMPING PATIENTS INTO OVERLY LARGE GROUPS."RAYALA AND COLLEAGUES LOOKED AT DE-IDENTIFIED RECORDS OF MORE THAN 22,000 PATIENTS BETWEEN 50- AND 75-YEARS OLD WHO SAW A PRIMARY CARE PHYSICIAN AT CAMBRIDGE HEALTH ALLIANCE (CHA) IN 2018 TO 2019. OF THE 22,000 PATIENTS INCLUDED IN THE STUDY, 16,065 UNDERWENT COLORECTAL SCREENING, AN OVERALL SCREENING RATE OF 73 PERCENT--ON PAR WITH MASSACHUSETTS' OVERALL COLORECTAL SCREENING RATES. HOWEVER, MASSACHUSETTS' NUMBERS REFLECT NATIONAL RACIAL AND ETHNIC DISPARITIES, IN WHICH PEOPLE OF COLOR DO NOT GET SCREENED AS OFTEN AS WHITE PEOPLE, SHOWING A SCREENING RATE OF 56 PERCENT OF HISPANIC INDIVIDUALS AND 68 PERCENT OF BLACK INDIVIDUALS COMPARED TO 76 PERCENT FOR WHITE INDIVIDUALS.IN CONTRAST, AT CHA, HISPANICS HAD THE HIGHEST SCREENING RATES OF 78 PERCENT. RAYALA AND COLLEAGUES FURTHER BROKE OUT PARTICIPANTS BY MORE GRANULAR DEMOGRAPHIC FACTORS, FINDING THE ETHNICITY OF PORTUGUESE/AZOREAN RECEIVED SCREENING AT 79 PERCENT. SPANISH SPEAKERS IN GENERAL HAD THE HIGHEST SCREENING RATE OF NEARLY 80 PERCENT.5. PATIENTS OVERWHELMINGLY PREFER IMMEDIATE ACCESS TO TEST RESULTS, EVEN WHEN THE NEWS MAY NOT BE GOODIN APRIL 2021, NEW FEDERAL RULES WENT INTO EFFECT MANDATING THAT HEALTHCARE PROVIDERS MAKE NEARLY ALL TEST RESULTS AND CLINICAL NOTES IMMEDIATELY AVAILABLE TO PATIENTS. EVIDENCE SUGGESTS THAT PATIENTS MAY GAIN IMPORTANT CLINICAL BENEFITS BY REVIEWING THEIR MEDICAL RECORDS, AND ACCESS THROUGH ELECTRONIC PATIENT PORTALS HAS BEEN ADVOCATED AS A STRATEGY FOR EMPOWERING PATIENTS TO MANAGE THEIR HEALTH CARE AND FOR STRENGTHENING PATIENT-CLINICIAN RELATIONSHIPS. HOWEVER, CONCERNS REMAIN ABOUT THE EFFECTS OF RELEASING TEST RESULTS TO PATIENTS BEFORE CLINICIANS OFFER COUNSEL OR INTERPRETATION.IN A FIRST-OF-ITS-KIND MULTISITE SURVEY OF MORE THAN 8,000 PATIENTS WHO ACCESSED THEIR TEST RESULTS VIA AN ONLINE PATIENT PORTAL ACCOUNT, RESEARCHERS AT BIDMC AND COLLEAGUES FOUND THAT USERS OVERWHELMINGLY SUPPORTED RECEIVING THE RESULTS IMMEDIATELY, EVEN IF THEIR PROVIDER HAD NOT YET REVIEWED THEM. THE FINDINGS, PUBLISHED IN JAMA NETWORK OPEN, SHOWED ONLY A SMALL SUBSET OF PATIENTS REPORTED EXPERIENCING ADDITIONAL WORRY AFTER RECEIVING ABNORMAL TEST RESULTS. IN ADDITION, PRE-COUNSELING BY THE HEALTH CARE TEAM BEFORE TESTS WERE ORDERED WAS LINKED TO REDUCED WORRY AMONG PATIENTS WITH ABNORMAL RESULTS."ONLINE PATIENT PORTALS HAVE EMERGED AS IMPORTANT TOOLS FOR INCREASING PATIENT ENGAGEMENT," SAID CO-SENIOR AUTHOR CATHERINE M. DESROCHES, DRPH, EXECUTIVE DIRECTOR OF OPENNOTES, THE INTERNATIONAL MOVEMENT BASED AT BIDMC FOCUSED ON INCREASING INFORMATION TRANSPARENCY IN HEALTHCARE. "THEY ENABLE PATIENTS TO ACCESS INFORMATION, PARTICIPATE IN MEDICAL DECISION-MAKING AND TO COMMUNICATE WITH CLINICIANS. PRIOR STUDIES PERFORMED BY OPENNOTES INVESTIGATORS ESTABLISHED IMMEDIATE RELEASE OF CLINICAL NOTES AS A RECOMMENDED BEST PRACTICE. HOWEVER, RELEASING TEST RESULTS TO PATIENTS IMMEDIATELY, OFTEN BEFORE A CLINICIAN CAN PROVIDE COUNSELLING AND CONTEXT, WAS YET TO BE STUDIED WIDELY."TO ASSESS PATIENT AND CAREGIVER ATTITUDES AND PREFERENCES RELATED TO RECEIVING TEST RESULTS THROUGH THE PATIENT PORTAL, DESROCHES AND COLLEAGUES DELIVERED SURVEYS TO MORE THAN 43,000 PATIENTS AND CARE PARTNERS WHO ACCESSED THEIR TEST RESULTS VIA AN ONLINE PATIENT PORTAL ACCOUNT BETWEEN APRIL 2021 AND APRIL 2022. WHEN ASKED ABOUT THEIR PREFERENCES FOR CONTACTS ABOUT FUTURE TEST RESULTS, 90 PERCENT OF RESPONDENTS WITH NORMAL RESULTS INDICATED THEY WOULD PREFER RECEIVING THEIR RESULT VIA THE PATIENT PORTAL. THE SURVEY RESULTS SUGGEST THAT PATIENTS RECEIVING NOT NORMAL RESULTS ARE INDEED AT INCREASED RISK FOR WORRY. NEVERTHELESS, MORE THAN 95 PERCENT OF PARTICIPANTS WHO RECEIVED ABNORMAL TEST RESULTS REPORTED PREFERRING TO CONTINUE TO RECEIVE IMMEDIATELY RELEASED RESULTS THROUGH THE PORTAL."RESPONDENTS OVERWHELMINGLY PREFERRED TO RECEIVE TEST RESULTS THROUGH THE PATIENT PORTAL, EVEN IF IT MEANT VIEWING RESULTS PRIOR TO DISCUSSING THEM WITH A HEALTHCARE PROFESSIONAL," SAID CO-AUTHOR LIZ SALMI, COMMUNICATIONS AND PATIENT INITIATIVES DIRECTOR OF OPENNOTES AT BIDMC. "AS HEALTHCARE SYSTEMS CONTINUE TO NAVIGATE THIS NEW ERA OF HEALTH INFORMATION TRANSPARENCY, BALANCING PATIENTS' EXPECTATION OF IMMEDIATE ACCESS TO THEIR INFORMATION WITH THE NEED TO MANAGE INCREASED WORRY IS IMPORTANT."
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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6. SHARP RISE IN CARDIOVASCULAR RISK FACTORS AMONG YOUNG ADULTS FORESHADOWS PUBLIC HEALTH CRISISIN A STUDY PUBLISHED IN JAMA AND PRESENTED AT THE AMERICAN COLLEGE OF CARDIOLOGY SCIENTIFIC SESSIONS, RESEARCHERS AT BIDMC ANALYZED MORE THAN A DECADE'S WORTH OF DATA TO EXAMINE RATES OF CARDIOVASCULAR RISK FACTORS SUCH AS HIGH BLOOD PRESSURE, DIABETES, OBESITY AND SMOKING AMONG US ADULTS FROM 2009 TO MARCH 2020. THE RESEARCHERS OBSERVED A RISE IN HYPERTENSION AND SIGNIFICANT INCREASES IN DIABETES AND OBESITY RATES AMONG YOUNG ADULTS, WITH NO SIGNIFICANT IMPROVEMENT IN CONTROL OF BLOOD PRESSURE OR BLOOD SUGAR. THE SCIENTISTS ALSO OBSERVED SUBSTANTIAL VARIATION IN THESE TRENDS BY RACE AND ETHNICITY."THE ONSET OF CARDIOVASCULAR RISK FACTORS EARLY IN LIFE IS ASSOCIATED WITH A HIGHER RISK OF HEART DISEASE AND ACUTE EVENTS, SUCH AS HEART ATTACK AND STROKE, RESULTING IN THE SUBSTANTIAL LOSS OF QUALITY OF LIFE AND YEARS OF LIFE," SAID CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, SECTION HEAD OF HEALTH POLICY AND EQUITY AT THE SMITH CENTER FOR OUTCOMES RESEARCH IN CARDIOLOGY AT BIDMC. "THEREFORE, THE SUBSTANTIAL RISE IN THE BURDEN OF CARDIOVASCULAR RISK FACTORS AMONG YOUNG ADULTS WILL HAVE MAJOR PUBLIC HEALTH IMPLICATIONS AS THE POPULATION AGES."WADHERA AND COLLEAGUES OBSERVED THAT THE PREVALENCE OF HYPERTENSION INCREASED AND SAW STATISTICALLY SIGNIFICANT INCREASES IN RATES OF DIABETES AND OBESITY DURING THE STUDY PERIOD. THE PERCENTAGE OF YOUNG ADULTS WITH A SMOKING HISTORY WAS HIGH AND DID NOT CHANGE. IN CONTRAST, RATES OF HIGH CHOLESTEROL DECLINED, A DECREASE THE SCIENTISTS SUGGEST REFLECTS GOVERNMENT REGULATION OF THE USE OF TRANS FATTY ACIDS AND OTHER PARTIALLY HYDROGENATED OILS IN PACKAGED CONVENIENCE FOODS AND FAST-FOOD RESTAURANTS.THE RESEARCHERS FOUND SUBSTANTIAL VARIATION IN PREVALENCE OF RISK FACTORS BY RACE AND ETHNICITY. OBESITY SIGNIFICANTLY INCREASED ACROSS ALL RACIAL AND ETHNIC GROUPS EXCEPT BLACK ADULTS. WHILE RATES OF HYPERTENSION INCREASED AMONG MEXICAN AMERICANS AND OTHER HISPANIC ADULTS, BLACK ADULTS EXPERIENCED THE HIGHEST RATES OF HYPERTENSION.THE RESEARCHERS ALSO EXAMINED CARDIOVASCULAR RISK FACTOR TREATMENT AND CONTROL RATES AMONG YOUNG ADULTS. ONLY ABOUT 55 PERCENT OF YOUNG ADULTS WITH HIGH BLOOD PRESSURE RECEIVE TREATMENT FOR THE CONDITION. RATES OF DIABETES TREATMENT WERE ALSO LOW, WITH ONE OUT OF TWO YOUNG ADULTS ON THERAPY FOR THEIR DIABETES. NEARLY HALF OF YOUNG ADULTS ON TREATMENT FOR DIABETES HAD POOR BLOOD SUGAR CONTROL."THE SUBOPTIMAL TREATMENT RATES FOR HIGH BLOOD PRESSURE AND DIABETES ARE CONCERNING AND MAY BE BECAUSE MANY YOUNG ADULTS AREN'T AWARE OF THEIR DIAGNOSIS," SAID WADHERA. "THE RISE IN CARDIOVASCULAR RISK FACTORS THAT WE OBSERVED SHOULD BE A CALL-TO-ACTION TO INTENSIFY PUBLIC HEALTH AND CLINICAL INTERVENTIONS FOCUSED ON THE PREVENTION AND TREATMENT OF CARDIOVASCULAR RISK FACTORS IN YOUNG ADULTS."7. COSTS OF NATURAL DISASTERS SET TO SPIRAL WITH CONTINUED RISE IN CO2 AND GLOBAL TEMPERATURE, STUDY SHOWSIN A PAPER PUBLISHED IN THE JOURNAL OF CLIMATE CHANGE AND HEALTH, MEMBERS OF THE BIDMC FELLOWSHIP IN DISASTER MEDICINE ESTIMATED THAT CLIMATE CHANGE-RELATED NATURAL DISASTERS HAVE INCREASED SINCE 1980 AND HAVE ALREADY COST THE UNITED STATES MORE THAN $2 TRILLION IN RECOVERY COSTS. THEIR ANALYSIS ALSO SUGGESTS THAT AS ATMOSPHERIC CARBON DIOXIDE LEVELS AND THE GLOBAL TEMPERATURE CONTINUE TO RISE, THE FREQUENCY AND SEVERITY OF DISASTERS WILL INCREASE, WITH RECOVERY COSTS POTENTIALLY RISING EXPONENTIALLY."THE UNITED STATES SPENDS A STAGGERING AMOUNT ON COSTS SECONDARY TO NATURAL DISASTERS," SAID SENIOR AUTHOR GREGORY CIOTTONE, MD, DIRECTOR OF THE DISASTER MEDICINE FELLOWSHIP AT BIDMC. "CARBON DIOXIDE LEVELS AND TEMPERATURES HAVE INCREASED OVER THE PAST FOUR DECADES AND ARE STRONGLY POSITIVELY CORRELATED WITH THE NUMBER AND COST OF BILLION-DOLLAR DISASTERS, SUGGESTING THE ANNUAL NUMBER OF EVENTS WILL CONTINUE TO INCREASE ALONG WITH THEIR ECONOMIC BURDEN. MEASURES ARE NEEDED TO MITIGATE THOSE COSTS."TO ASSESS THE RELATIONSHIP BETWEEN RISING CARBON DIOXIDE LEVELS, TEMPERATURES AND THE NUMBER OF DISASTERS COSTING A BILLION DOLLARS OR MORE IN THE UNITED STATES, CIOTTONE AND COLLEAGUES ANALYZED DATA BETWEEN 1980-2021 FROM THE NATIONAL CENTER FOR ENVIRONMENTAL INFORMATION (NCEI). THE TEAM FOUND THAT THE INCREASES IN ATMOSPHERIC CARBON DIOXIDE LEVELS AND TEMPERATURE TIGHTLY LINKED TO EACH OTHER WERE ASSOCIATED WITH INCREASING NUMBERS OF EVENTS PER YEAR, AS WELL AS FATALITIES. AFTER ADJUSTING DOLLAR VALUES FOR INFLATION, THEIR ANALYSIS SHOWED THAT MORE FREQUENT AND MORE SEVERE DISASTERS ARE INCURRING RISING COSTS.AMONG THEIR FINDINGS: FROM 1980-1989, THERE WERE 3 BILLION-DOLLAR EVENTS PER YEAR AND 297 DEATHS PER YEAR, COSTING A TOTAL OF $19.5 BILLION. BY 2010-2019, THE RISE IN CARBON DIOXIDE LEVELS AND TEMPERATURE WERE LINKED WITH 13 ANNUAL EVENTS, 523 ANNUAL DEATHS, AND $89.2 BILLION IN RECOVERY COSTS, A FOURFOLD INCREASE."FRAMING DISASTERS IN THIS ECONOMIC LIGHT CAN BRING MORE ATTENTION AND MOTIVATION FOR CHANGE TO ALTER POLICYMAKERS' DECISIONS," SAID CORRESPONDING AUTHOR VIJAI BHOLA, MD, A GRADUATE OF THE DISASTER MEDICINE FELLOWSHIP AT BIDMC, WHO NOTES THE CURRENT ANALYSIS CAPTURES JUST A FRACTION OF THE COSTS INCURRED BY CLIMATE CHANGE. "THESE COSTS REPRESENT A COMBINATION OF IMMEDIATE AND LONGER-TERM RESTORATION ESTIMATES. WHAT THEY DO NOT REFLECT, HOWEVER, ARE FACTORS SUCH AS DESTRUCTION OF NATURAL RESOURCES OR LOSS OF LIFE, AND THEREFORE THESE NUMBERS SIGNIFICANTLY UNDERESTIMATE THE TRUE COST OF CLIMATE-RELATED DISASTERS."8. RESEARCHERS TEST AI POWERED CHATBOTS MEDICAL DIAGNOSTIC ABILITYIN A RECENT EXPERIMENT PUBLISHED IN JAMA, PHYSICIAN-RESEARCHERS AT BIDMC TESTED ONE WELL-KNOWN PUBLICLY AVAILABLE CHATBOT'S ABILITY TO MAKE ACCURATE DIAGNOSES IN CHALLENGING MEDICAL CASES. THE TEAM FOUND THAT THE GENERATIVE AI, CHAT-GPT 4, SELECTED THE CORRECT DIAGNOSIS AS ITS TOP DIAGNOSIS NEARLY 40 PERCENT OF THE TIME AND PROVIDED THE CORRECT DIAGNOSIS IN ITS LIST OF POTENTIAL DIAGNOSES IN TWO-THIRDS OF CHALLENGING CASES.GENERATIVE AI CHATBOTS ARE POWERFUL TOOLS POISED TO REVOLUTIONIZE CREATIVE INDUSTRIES, EDUCATION, CUSTOMER SERVICE AND MORE. HOWEVER, LITTLE IS KNOWN ABOUT THEIR POTENTIAL PERFORMANCE IN THE CLINICAL SETTING, SUCH AS COMPLEX DIAGNOSTIC REASONING."RECENT ADVANCES IN ARTIFICIAL INTELLIGENCE HAVE LED TO GENERATIVE AI MODELS THAT ARE CAPABLE OF DETAILED TEXT-BASED RESPONSES THAT SCORE HIGHLY IN STANDARDIZED MEDICAL EXAMINATIONS," SAID ADAM RODMAN, MD, MPH, CO-DIRECTOR OF THE INNOVATIONS IN MEDIA AND EDUCATION DELIVERY (IMED) INITIATIVE AT BIDMC. "WE WANTED TO KNOW IF SUCH A GENERATIVE MODEL COULD 'THINK LIKE A DOCTOR, SO WE ASKED ONE TO SOLVE STANDARDIZED COMPLEX DIAGNOSTIC CASES USED FOR EDUCATIONAL PURPOSES. IT DID REALLY, REALLY WELL."TO ASSESS THE CHATBOT'S DIAGNOSTIC SKILLS, RODMAN AND COLLEAGUES USED CLINICOPATHOLOGICAL CASE CONFERENCES (CPCS), A SERIES OF COMPLEX AND CHALLENGING PATIENT CASES INCLUDING RELEVANT CLINICAL AND LABORATORY DATA, IMAGING STUDIES, AND HISTOPATHOLOGICAL FINDINGS PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE FOR EDUCATIONAL PURPOSES.EVALUATING 70 CPC CASES, THE ARTIFICIAL INTELLIGENCE EXACTLY MATCHED THE FINAL CPC DIAGNOSIS IN 27 (39 PERCENT) OF CASES. IN 64 PERCENT OF THE CASES, THE FINAL CPC DIAGNOSIS WAS INCLUDED IN THE AI'S DIFFERENTIAL A LIST OF POSSIBLE CONDITIONS THAT COULD ACCOUNT FOR A PATIENT'S SYMPTOMS, MEDICAL HISTORY, CLINICAL FINDINGS AND LABORATORY OR IMAGING RESULTS."WHILE CHATBOTS CANNOT REPLACE THE EXPERTISE AND KNOWLEDGE OF A TRAINED MEDICAL PROFESSIONAL, GENERATIVE AI IS A PROMISING POTENTIAL ADJUNCT TO HUMAN COGNITION IN DIAGNOSIS," SAID FIRST AUTHOR ZAHIR KANJEE, MD, MPH, A HOSPITALIST AT BIDMC. "IT HAS THE POTENTIAL TO HELP PHYSICIANS MAKE SENSE OF COMPLEX MEDICAL DATA AND BROADEN OR REFINE OUR DIAGNOSTIC THINKING. WE NEED MORE RESEARCH ON THE OPTIMAL USES, BENEFITS AND LIMITS OF THIS TECHNOLOGY, AND A LOT OF PRIVACY ISSUES NEED SORTING OUT, BUT THESE ARE EXCITING FINDINGS FOR THE FUTURE OF DIAGNOSIS AND PATIENT CARE.""OUR STUDY ADDS TO A GROWING BODY OF LITERATURE DEMONSTRATING THE PROMISING CAPABILITIES OF AI TECHNOLOGY," SAID CO-AUTHOR BYRON CROWE, MD, AN INTERNAL MEDICINE PHYSICIAN AT BIDMC. "FURTHER INVESTIGATION WILL HELP US BETTER UNDERSTAND HOW THESE NEW AI MODELS MIGHT TRANSFORM HEALTH CARE DELIVERY."
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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9. INTEGRATING TECHNOLOGY TO BETTER SUPPORT MENTAL HEALTH CAREOVER THE PAST DECADE, DEMAND FOR MENTAL HEALTH SERVICES HAS RISEN SIGNIFICANTLY, WITH THE NUMBER OF ADULTS RECEIVING PSYCHIATRIC CARE INCREASING BY MORE THAN 12 PERCENT SINCE 2011, ACCORDING TO THE NATIONAL ALLIANCE FOR MENTAL ILLNESS. HOWEVER, A SHORTAGE OF MENTAL HEALTH CLINICIANS MEANS MANY PEOPLE ARE STILL NOT ABLE TO ACCESS THE CARE THEY NEED. IN A CASE STUDY PUBLISHED IN NEJM CATALYST, CLINICIAN-INVESTIGATORS IN THE DIVISION OF DIGITAL PSYCHIATRY AT BIDMC HIGHLIGHT A MODEL THEY DEVELOPED FOR INTEGRATING DIGITAL TECHNOLOGIES AND BRIEF EVIDENCE-BASED TREATMENT INTO IN-PERSON PSYCHIATRY. KNOWN AS THE DIGITAL CLINIC, THE TEAM'S INNOVATIVE HYBRID CARE MODEL EXPANDS PATIENTS' ACCESS TO HIGHLY EFFECTIVE MENTAL HEALTH CARE WHILE SIGNIFICANTLY DECREASING PATIENT WAIT TIMES AND LENGTH OF TREATMENT. ADDITIONALLY, THE TEAM'S RECENT PILOT STUDY SUGGESTS THAT THIS MODEL MAY YIELD POST-TREATMENT IMPROVEMENTS IN PATIENTS' SYMPTOMS OF DEPRESSION AND ANXIETY THAT ARE COMPARABLE TO, IF NOT BETTER THAN, TRADITIONAL MODELS OF CARE."AS THE SEVERITY OF MENTAL HEALTH CRISES INCREASES, EVIDENCED BY RISING RATES OF DEPRESSION AND ANXIETY ESPECIALLY IN YOUNG PEOPLE, IT'S CRITICAL THAT INNOVATIVE SOLUTIONS ARE DEVELOPED TO INCREASE ACCESS TO HIGH-QUALITY PSYCHIATRIC CARE," SAID SENIOR AUTHOR JOHN TOROUS, MD, MBI, DIRECTOR OF THE DIVISION OF DIGITAL PSYCHIATRY AT BIDMC. "OUR ENCOURAGING FINDINGS SUGGEST THAT WHEN WE TARGET DEPRESSION AND ANXIETY WITH BRIEF, TECHNOLOGY-ENHANCED, EVIDENCE-BASED TREATMENT, OUR PATIENTS CAN OBTAIN MEANINGFUL GAINS."IN A RECENT PILOT STUDY OF 40 ADULT PATIENTS WHO RECEIVED EIGHT WEEKS OF TREATMENT FOR DEPRESSION AND/OR ANXIETY IN THE DIGITAL CLINIC BETWEEN OCTOBER 2022 AND JANUARY 2023, 67 PERCENT OF PATIENTS' MENTAL HEALTH OUTCOMES THAT WERE TARGETED IN TREATMENT REFLECTED CLINICALLY SIGNIFICANT IMPROVEMENT. NOTABLY, 64 PERCENT OF THOSE PATIENT OUTCOMES REFLECTED REMISSION, DEFINED AS HAVING "MILD, MINIMAL OR NO SYMPTOMS" BY THE END OF TREATMENT."THESE OUTCOMES MEET AND EXCEED OUTCOMES FROM LONGER-TERM TREATMENT," SAID TOROUS, WHO ADDED THAT RECENT META-ANALYSES OF MAINLY MAINSTREAM, EVIDENCE-BASED TREATMENTS FOUND REMISSION RATES OF JUST OVER HALF FOR ANXIETY DISORDERS AND ROUGHLY ONE THIRD FOR DEPRESSION. LIKEWISE, STUDIES HAVE SHOWN THAT DIGITAL APPROACHES TO MENTAL HEALTH CAN YIELD IMPRESSIVE RESULTS WHEN PATIENTS CONSISTENTLY ENGAGE WITH THEM, BUT DECADES OF USER-CENTERED DESIGN AND GAMIFICATION HAVE NOT SOLVED THE PROBLEM OF KEEPING PEOPLE REGULARLY INTERACTING WITH THE TECHNOLOGY LONG TERM."WE DESIGNED THE DIGITAL CLINIC TO HARNESS THE STRENGTHS OF BOTH TRADITIONAL AND DIGITAL MENTAL HEALTH CARE," SAID FIRST AUTHOR NATALIA MACRYNIKOLA, PHD, A POSTDOCTORAL RESEARCH FELLOW AT BIDMC. "THE BENEFITS OF HUMAN RAPPORT, THE THERAPEUTIC ALLIANCE, AND A THERAPIST'S ABILITY TO TAILOR EVIDENCED-BASED THERAPEUTIC INTERVENTIONS TO THE NEEDS OF EACH CLIENT ARE TANGIBLE ADVANTAGES OF TRADITIONAL CARE, WHEREAS THE SCALABILITY AND ACCESSIBILITY OF DIGITAL APPROACHES CONFER CLEAR ADVANTAGES THAT SHOULD NOT BE OVERLOOKED."10. NEW NATIONAL STANDARDS FOR NEONATAL INTENSIVE CARE AIM TO ACHIEVE HEALTH EQUITY FOR US NEWBORNS LED BY BIDMC NEONATOLOGIST ANN R. STARK, MD, IN HER CAPACITY AS MEDICAL DIRECTOR OF THE NICU VERIFICATION PROGRAM FOR THE AMERICAN ACADEMY OF PEDIATRICS (AAP), A TEAM OF NEONATAL LEADERS AND EXPERIENCED CLINICIANS HAVE ESTABLISHED NEW STANDARDS FOR LEVELS OF NEONATAL CARE THAT SPECIFY THE PERSONNEL, EQUIPMENT AND SERVICES HOSPITALS NEED TO PROVIDE FOR NEWBORNS AND FAMILIES. BASED ON AAP POLICY, EVIDENCE-BASED LITERATURE AND STANDARDS OF PROFESSIONAL PRACTICE, STANDARDS FOR LEVELS OF NEONATAL CARE: II, III, & IV, APPEARED IN THE AAP'S JOURNAL PEDIATRICS."WE HAVE CREATED THESE STANDARDS WITH A GOAL TO IMPROVE OUTCOMES, INCREASE ACCESS TO CARE, IMPROVE STANDARDIZATION ACROSS ALL LEVELS OF NEONATAL CARE AND ACHIEVE HEALTH EQUITY FOR BABIES ACROSS THE COUNTRY," SAID STARK, "WE WERE CONCERNED THAT FIRST, ALL BABIES SHOULD BE TREATED IN A PLACE WITH APPROPRIATE CARE AND SECOND, THAT THE FACILITY HAS THE PEOPLE AND THE EQUIPMENT THAT ARE APPROPRIATE FOR THEIR DEGREE OF ILLNESS OR IMMATURITY." THE UNITED STATES RANKS 35TH IN NEONATAL MORTALITY AMONG DEVELOPED NATIONS; MORE THAN THREE BABIES OUT OF EVERY 1,000 BABIES DIE WITHIN THEIR FIRST MONTH OF LIFE. MANY FACTORS CONTRIBUTE TO THESE SHOCKING NUMBERS, HOWEVER, EXPERTS AGREE ONE REASON IS THE LACK OF NATIONAL STANDARDS FOR NEONATAL INTENSIVE CARE UNITS (NICUS). WITH PUBLICATION OF THE NEW STANDARDS, AND WHEN PROCESSES ARE IN PLACE, THE AAP PROGRAM WILL BE ABLE TO VERIFY A NEONATAL FACILITY'S COMPLIANCE AND DESIGNATE THAT IT PROVIDES A SPECIFIC LEVEL OF NEONATAL CARE (II, III OR IV). HOSPITALS WILL SUBMIT DATA AND UNDERGO A SURVEY OF THEIR FACILITY. THOSE THAT MEET REQUIREMENTS WILL BE ABLE TO STATE THAT THEY ARE AAP-VERIFIED AT A PARTICULAR LEVEL OF NEONATAL CARE. THE DESIGNATION THEN WILL BE TRANSPARENT TO PHYSICIANS AND FAMILIES DECIDING WHERE TO DELIVER AND/OR SEEK CARE FOR THEIR BABY."PARENTS SHOULD UNDERSTAND THE LEVEL OF NEONATAL CARE AVAILABLE WHERE THEY ARE DELIVERING," SAID STARK. "WHETHER THEY ARE BORN IN URBAN ACADEMIC MEDICAL CENTERS OR RURAL COMMUNITY HOSPITALS, ALL BABIES DESERVE OPTIMAL CARE. ADOPTION OF THE AAP NEONATAL STANDARDS IS A VITAL STEP TOWARD HIGH-QUALITY AND EQUITABLE CARE."FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION AS NOTED THROUGHOUT THIS FORM 990, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH ANNA JAQUES HOSPITAL DOES NOT DIRECTLY ENGAGE IN HEALTH PROFESSIONS EDUCATION / GRADUATE MEDICAL EDUCATION, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND MOUNT AUBURN HOSPITAL ALL ENGAGE IN EDUCATIONAL ACTIVITIES DESIGNED TRAIN THE PHYSICIANS AND OTHER HEALTHCARE PRACTITIONERS OF TOMORROW. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $202 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $68 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $134 MILLION. ALTHOUGH THE EDUCATIONAL ACTIVITIES OF THESE BILH AFFILIATES ARE NOT QUANTIFIED HERE IN ANNA JAQUES HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7F, AS ALREADY NOTED THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL AND BEYOND. IN ADDITION, INFORMATION ON THE TEACHING ACTIVITIES AT BIDMC, A SISTER ENTITY TO ANNA JAQUES HOSPITAL, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. 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 63 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 731 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 44 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 53 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.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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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 UROLOGYRESIDENCY 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. MORE THAN HALF OF THESE PROGRAMS (47 OF 91) 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, ANESTHESIA MEDICAL EDUCATION 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, LGBTQIA+ HEALTH NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY, NEURO CRITICAL CARE 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: EARLY PSYCHOSIS 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, LYMPHATIC SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, OTOLARYNGOLOGY FELLOWSHIP, 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-INTEGRATED, JOINTS FELLOWSHIPADDITIONAL 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) 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 HEALTH ALLIANCE, TUFTS MEDICAL CENTER, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL, SOUTH SHORE 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. 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.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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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 HOUSESTAFF 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.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.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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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, VIDEO-RECORDING, 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 ECONOMICSEACH 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. RESIDENTS AND FELLOWS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. RESIDENTS AND FELLOWS 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.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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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 HOUSESTAFF 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 HOUSESTAFF 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 MEDICAL STAFFTHE 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 4,800 PHYSICIANS AND 39,000 EMPLOYEES.THE BILH PURPOSE STATEMENT ARTICULATES THE IMPACT THAT EACH BILH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. THESE SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS.EQUITY. EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.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. EFFECTIVE JULY 1, 2023, BILH ALSO BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND ITS AFFILIATES INCLUDING EXETER HOSPITAL. BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES FISCAL YEAR ENDED SEPTEMBER 30, 2023THE QUANTIFICATION IN THIS SCHEDULE H PART 1 QUESTION 7 IN THIS FILING REFLECTS ONLY THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST OF ANNA JAQUES HOSPITAL AND AS NOTED THROUGHOUT THIS FILING, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK. BELOW IS ADDITIONAL INFORMATION ON THE FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS ACTIVITIES ACROSS ALL OF THE BILH HOSPITALS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED MORE THAN $48 MILLION IN NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST.IN ADDITION TO THE CHARITY CARE REPORTED ABOVE, EACH OF THE BILH HOSPITALS ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICAID PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL EXCEEDING $61 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS. PAYMENTS FROM MEDICARE DO NOT COVER THE COST OF SERVICES PROVIDED. ALL BILH HOSPITALS PROVIDE CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICARE PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE, RESULTING IN A COMBINED SHORTFALL EXCEEDING $144 MILLION RELATED TO TREATING MEDICARE PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED COMBINED COMMUNITY BENEFITS, COMMUNITY HEALTH IMPROVEMENT SERVICES, CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS AS WELL AS COSTS INCURRED RELATED TO SUBSIDIES FOR PRIMARY CARE, BEHAVIORAL HEALTH CARE AND OTHER CARE PROVIDED AT A LOSS TOTALING OVER $88 MILLION. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $202 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $68 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $134 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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RESEARCH ACTIVITIES ACROSS BILH SERVE PATIENT CARE BOTH AT BILH AND BEYOND AS PART OF THE ADVANCEMENT OF SCIENCE. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION AND TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $320 MILLION IN RESEARCH EXPENSES, MORE THAN $82 MILLION OF WHICH WERE INTERNALLY FUNDED.FOR ADDITIONAL INFORMATION ON THESE ACTIVITIES AS WELL AS EACH HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY, PLEASE SEE FORM 990 SCHEDULE H FOR EACH OF THE BILH HOSPITALS. ADDITIONAL BILH NETWORK ACTIVITIES -- EXPANDING ACCESS AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES; CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST; BEHAVIORAL HEALTH; COMMUNITY INVESTMENTS FISCAL YEAR ENDED SEPTEMBER 30, 2023IN ADDITION, AS NOTED FURTHER BELOW, BETH ISRAEL LAHEY HEALTH ("BILH") AND ITS AFFILIATES FOCUSED ON EXPANDING ACCESS AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES. IN ADDITION, THERE WAS A STRONG FOCUS ON CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST, WHEN APPROPRIATE, AS DEMONSTRATED BY BILH'S EFFORTS TO LEVERAGE COMMUNITY SETTINGS, KEEP CARE WITHIN THE BILH PERFORMANCE NETWORK ("BILHPN"), AND ALLOW PATIENTS TO RECEIVE CARE IN THEIR HOMES. THE FOLLOWING HIGHLIGHTS SPECIFIC EFFORTS DURING THE PERIOD COVERED BY THIS FILING:ACCESS & EXPANSION TO PHARMACY SERVICES BILH PHARMACY HAS CONTINUED TO EXPAND ITS CONTRACTUAL RELATIONSHIPS, ALLOWING MORE PATIENTS TO UTILIZE ITS PHARMACY FOR THEIR PRESCRIPTIONS. IN FY 2023, BILH PHARMACY SUCCESSFULLY NEGOTIATED ACCESS TO THE POINT32HEALTH SPECIALTY PHARMACY NETWORK AS WELL AS THE WELLSENSE MEDICAID ACCOUNTABLE CARE ORGANIZATION ("ACO") PLAN. EXAMPLES OF BILH PHARMACY'S OTHER EFFORTS TO EXPAND PATIENT ACCESS TO MEDICATIONS INCLUDE: ENHANCED MEDICATION AUTHORIZATION AND ACCESS SERVICES TO HELP PATIENTS OBTAIN NECESSARY INSURANCE AUTHORIZATIONS AND FIND CO-PAY ASSISTANCE, EXPANDED THE MEDICATION REFILL CENTER TO ASSIST PATIENTS AND PROVIDERS IN EXPEDITING MEDICATION RENEWALS AND ENSURING PRESCRIBED MEDICATION AND DOSAGE ARE STILL APPROPRIATE, EXTENDED PATIENT CO-PAY ASSISTANCE PROGRAMS TO THE JOSLIN ADULT DIABETES CLINIC AND NORTHEAST HOSPITAL CORPORATION PATIENTS, AND EXPANDED CLINICAL PHARMACY SERVICES IN AMBULATORY CLINICS TO HELP MANAGE AND OPTIMIZE PATIENTS' COMPLEX MEDICATION THERAPIES. BILH PHARMACY ALSO EXPANDED ITS CLINICAL PHARMACY PRESENCE IN CLINICS TO REDUCE THE HEALTH EQUITY GAP IN THE USE OF HIGHLY IMPACTFUL MEDICATIONS TO TREAT PATIENTS WITH DIABETES AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASES BY IMPROVING THEIR BLOOD PRESSURE AND HEMOGLOBIN A1C. INTERVENTIONS CENTERED AROUND PRESCRIBING EVIDENCE-BASED MEDICATIONS, EDUCATING PATIENTS ABOUT THEIR CONDITIONS, AND ENSURING ACCESS TO MEDICATION. INITIAL RESULTS HAVE DEMONSTRATED AN INCREASE IN THE USE OF GLP-1 AGONISTS AND SGLT-2 INHIBITORS BY 32% IN BLACK AND HISPANIC POPULATIONS, AN AVERAGE REDUCTION IN HEMOGLOBIN A1C OF 0.8, AND A DECREASE OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURES OF 7MMHG AND 2MMHG RESPECTIVELY.IMPROVEMENT IN LAB SERVICES BILH OPTIMIZED THE TRANSPORTATION ROUTES OF COLLECTED LABORATORY SPECIMENS TO TESTING LABORATORIES, ENSURING HIGH STANDARDS FOR TURNAROUND TIMES AND MAXIMUM EFFICIENCY. THIS IS FOUNDATIONAL TO THE SYSTEM'S ABILITY TO CONSOLIDATE TESTING, EXPAND ACCESS TO IN-NETWORK LABORATORY SERVICES WHICH IN TURN GENERALLY REDUCES COST, AND SUPPORT THE PROVISION OF HIGH-QUALITY CARE AND THE CLINICIAN AND PATIENT EXPERIENCE. FOCUS REMAINED STRONG IN DEVELOPING PHYSICIAN PRACTICE DELIVERY MODELS AND RE-OPENING PATIENT SERVICE CENTERS. THESE EFFORTS ENHANCE COMMUNITY PROVIDERS' ABILITY TO USE BILH LABS AND INCREASE PATIENT ACCESS TO BILH LABS.LEVERAGING IN-NETWORK CARE BILH OPERATES A TRANSFER CENTER THAT FACILITATES PATIENT ACCESS TO THE APPROPRIATE PLACEMENT OF PATIENT TRANSFERS. WITH THE CREATION OF THE TRANSFER CENTER, BILH HAS BEEN ABLE TO RETAIN PATIENTS WHO MIGHT OTHERWISE HAVE GONE OUTSIDE OF THE SYSTEM. BY EXPANDING ITS FOCUS TO COMMUNITY HOSPITALS, BILH HAS ENHANCED ITS ABILITY TO PLACE PATIENTS, INCLUDING AT LOCATIONS POTENTIALLY CLOSER TO THE PATIENTS' HOMES. BILHPN OPERATES A CENTRALIZED REFERRAL MANAGEMENT PROGRAM THAT FOCUSES ON PATIENTS SEEKING OUT-OF-NETWORK SPECIALTY CARE AND REDIRECTING THEM TO IN-NETWORK SPECIALTY CARE, WHEN CLINICALLY APPROPRIATE. THROUGHOUT FY 2023, BILHPN REDIRECTED WELL OVER ONE THOUSAND PATIENT VISITS. IN MOST CASES, CARE RETAINED WITHIN BILH RESULTED IN ENHANCED CARE COORDINATION AT A LOWER COST OF CARE.ENABLING PATIENTS TO RECEIVE CARE AT HOME BILH LAUNCHED ITS HOSPITAL AT HOME PROGRAM IN FY 2023, STARTING WITH LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER. THIS HAS ALLOWED ELIGIBLE PATIENTS TO BE OFFERED CARE IN THE SETTING MOST COMFORTABLE FOR THEM THEIR HOMES WHILE ALSO CUSTOMIZING CARE PLANS AND IMPROVING PATIENTS' MOBILITY EVEN WHILE THEY ARE ACUTELY ILL. IN FY 2023, BILHPN PUT PROGRAMS IN PLACE TO MANAGE LENGTH OF STAY AT SKILLED NURSING FACILITIES ("SNFS"), REDUCE READMISSIONS, AND DISCHARGE MEDICALLY APPROPRIATE PATIENTS DIRECTLY TO THEIR HOMES WITH HOMECARE SERVICES INSTEAD OF TO A SNF, PROVIDED PATIENTS ARE MEDICALLY STABLE TO RETURN HOME AFTER AN ACUTE CARE STAY AND WILL LIKELY HAVE BETTER OUTCOMES AND LOWER COST OF CARE.BEHAVIORAL HEALTH IN FY 2023, BILH BEHAVIORAL SERVICES LAUNCHED ITS COMMUNITY BEHAVIORAL HEALTH CENTER ("CBHC") IN LAWRENCE, MASSACHUSETTS, CONSOLIDATING OUTPATIENT, MOBILE CRISIS INTERVENTION, AND ADULT COMMUNITY CRISIS STABILIZATION SERVICES. THE ESTABLISHMENT OF THE CBHC IS A PART OF THE COMMONWEALTH'S EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES ROADMAP FOR BEHAVIORAL HEALTH REFORM. IN ADDITION, AS PART OF THE ROADMAP FOR BEHAVIORAL HEALTH REFORM, BILH LAUNCHED AN EMERGENCY SERVICES REDESIGN THAT SHIFTS EMERGENCY EVALUATIONS OUT OF THE EMERGENCY DEPARTMENT ("ED"). BILH BEHAVIORAL SERVICES ALSO EXPANDED ITS ED INTEGRATION EFFORTS TO A TOTAL OF SIX EDS, INCLUDING ADDISON GILBERT HOSPITAL, ANNA JAQUES HOSPITAL, BEVERLY HOSPITAL, LAHEY MEDICAL CENTER-PEABODY, BETH ISRAEL DEACONESS HOSPITAL-MILTON, AND WINCHESTER HOSPITAL.HEALTH EQUITY BILH AND LAWYERS FOR CIVIL RIGHTS LAUNCHED A MEDICAL-LEGAL PARTNERSHIP TO PROVIDE FREE LEGAL SUPPORT TO LOW-INCOME PATIENTS, BEGINNING AT BETH ISRAEL DEACONESS MEDICAL CENTER. THE COLLABORATION WILL EXPAND BILH'S ABILITY TO ADDRESS HEALTH EQUITY AND EXPAND ACCESS TO HEALTH CARE FOR PATIENTS LIVING IN UNDER-RESOURCED COMMUNITIES. BILHPN FOCUSED ON REDUCING HEALTH EQUITY DISPARITIES IN DIABETES AND HYPERTENSION MANAGEMENT BY STRATIFYING HEALTH OUTCOMES BY RACE, ETHNICITY AND LANGUAGE; SHARING PERFORMANCE DATA WITH PRIMARY CARE GROUPS; AND IMPLEMENTING CLINICAL INITIATIVES SUCH AS OFF-HOUR CLINICS, HOME BLOOD PRESSURE MONITOR DISTRIBUTION, CONTINUOUS GLUCOSE MONITORING, AND OUTREACH TO PATIENTS WITH HIGHER NEEDS.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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ONGOING INITIATIVES: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. ALL BILH HOSPITALS AND PROVIDERS EMPLOYED BY BILH OR ON WHOSE BEHALF BILH JOINTLY CONTRACTS PARTICIPATE IN AND/OR 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 WENT INTO EFFECT IN APRIL 2023. AS PART OF THIS CONTRACT, BILHPN EXTENDED PARTICIPATION TO ALL ELIGIBLE PRIMARY CARE PROVIDERS ("PCPS") WHO WERE NOT OTHERWISE PARTICIPATING IN A MASSHEALTH ACO. PRIOR TO THAT TIME, WHILE ALL ELIGIBLE BILHPN PCPS WERE PARTICIPANTS IN A FORM OF MASSHEALTH, SOME PCPS WERE NOT PREVIOUSLY PARTICIPATING IN A MASSHEALTH ACO. BILH HAS DEVELOPED, REFINED AND IMPLEMENTED A MULTICULTURAL MARKETING, ADVERTISING, AND OUTREACH PLAN WITH THE PURPOSE OF EXPANDING ACCESS FOR UNDERSERVED POPULATIONS, INCLUDING MASSHEALTH PATIENTS, IN TARGETED BILH SERVICE AREAS. INVESTMENTS IN UNDERSERVED COMMUNITIES BILH HOSPITALS HAVE CREATED AND MAINTAIN 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 CONTINUES TO EXPLORE ADDITIONAL 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. 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. ADDICTION SERVICES NORTHEAST BEHAVIORAL HEALTH CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH BEHAVIORAL SERVICES (NBHC OR BILH BS) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS, PROVIDING HIGH-QUALITY MENTAL HEALTH AND ADDICTION TREATMENT. THIS INCLUDES A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TO COMMUNITY-BASED SERVICES. TREATMENT OFFERINGS INCLUDE MOBILE CRISIS TEAMS FOR BEHAVIORAL AND SUBSTANCE-RELATED EMERGENCIES; INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; RESIDENTIAL PROGRAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION CLINICS; AND MEDICATION-ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS. NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) HAS OVER 250 BEDS IN 9 FACILITIES FOR PATIENTS REQUIRING ACUTE PSYCHIATRIC, DETOXIFICATION AND POST-ACUTE DIVERSIONARY SERVICES. OTHER OFFERINGS INCLUDE MANY COMMUNITY-BASED SERVICES SUCH AS MOBILE EMERGENCY SERVICES TEAMS, SCHOOL AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES. BILHBS SERVES APPROXIMATELY 17,000 INDIVIDUALS ANNUALLY, PROVIDING OVER 380,000 UNITS OF SERVICE, IN A VAST ARRAY OF SETTINGS BASED ON THEIR NEEDS. BECAUSE OF THE COVID-19 EMERGENCY, NBHC WAS FORCED TO RECONFIGURE ITS DELIVERY MODEL FOR MANY SERVICES. WITH MULTIPLE "BRICK AND MORTAR" SITES TEMPORARILY CLOSED DURING THE HEIGHT OF THE PANDEMIC, NBHC OUTFITTED CLINICIANS WITH THE TOOLS NEEDED TO OFFER TELEHEALTH SERVICES. BY THE END OF THE FISCAL YEAR, OF THE TOTAL UNITS OF SERVICE LISTED ABOVE, ALMOST 61,000 WERE DELIVERED VIA TELEHEALTH. IN ADDITION, AS OUTLINED BELOW, NBHC SUPPORTED BILH'S SYSTEM-WIDE RESPONSE TO THE PANDEMIC BY QUICKLY STANDING UP A SHORT-TERM STAY COMMUNITY CRISIS STABILIZATION UNIT ON THE CAMPUS OF AN AFFILIATED ENTITY. BILH BS CONTINUES TO LEVERAGE TELEHEALTH SERVICES TO CONNECT TO COMMUNITIES SERVED ACROSS BILH. NBHC PROVIDED ADDICTION TREATMENT SERVICES WITH MORE THAN 200 INPATIENT AND RESIDENTIAL BEDS, OPERATING 24/7 FOR ADDICTION TREATMENT. ADDICTION TREATMENT INCLUDES BOTH OUTPATIENT AND INPATIENT TREATMENT AND PREVENTION. SUBSTANCE ABUSE COUNSELING AND GROUP THERAPY IS OFFERED FOR BOTH ADULTS AND TEENS, AS ARE A RANGE OF COURT-ORDERED PROGRAMS INCLUDING OPERATING UNDER THE INFLUENCE (OUI) EDUCATION AND EVALUATIONS. MEDICATION-ASSISTED TREATMENT FOR MEN AND WOMEN ADDICTED TO HEROIN OR PRESCRIPTION OPIOIDS IS PROVIDED AT LOCATIONS IN GLOUCESTER AND DANVERS. ACUTE TREATMENT PROGRAMS PROVIDING INPATIENT DETOXIFICATION SERVICES FROM DRUGS AND/OR ALCOHOL IN MEDICAL SETTINGS ARE AVAILABLE AT TREATMENT CENTERS IN DANVERS AND TEWKSBURY. IN FY23 THESE CENTERS SERVED APPROXIMATELY 2,600 PATIENTS. NBHC ALSO PROVIDED POST-DETOXIFICATION RESIDENTIAL SETTINGS AT MULTIPLE LOCATIONS SERVING BOTH MEN AND WOMEN, INCLUDING HART HOUSE IN TEWKSBURY WHICH EXCLUSIVELY SERVES MOTHERS WITH CHILDREN. IN FY23, NBHC'S OUTPATIENT ADDICTION PROGRAMS PROVIDED 196,350 UNITS OF SERVICE, INCLUDING 5,600 VIA TELEHEALTH, WHILE INPATIENT AND RESIDENTIAL PROGRAMS RECORDED 60,327 BED DAYS. AMBULATORY SERVICES BILH BS' AMBULATORY DIVISION SERVES NEARLY 4,300 PATIENTS EVERY YEAR, DELIVERING MORE THAN 108,000 UNITS OF SERVICES IN VARIOUS SETTINGS. MORE THAN 43,000 WERE DELIVERED BY TELEHEALTH AMBULATORY PROGRAMS AND SERVICES OFFERED UNDER THE CHILDREN'S BEHAVIORAL HEALTH INITIATIVE (CBHI) INCLUDING A BROAD RANGE OF COUNSELING AND THERAPY AS WELL AS MORE INTENSIVE TREATMENT MODALITIES. OUTPATIENT MENTAL HEALTH CLINICS IN SALEM, LAWRENCE, GLOUCESTER AND BEVERLY, AND AN OUTREACH CLINIC IN HAVERHILL, ASSIST INDIVIDUALS AND FAMILIES THROUGH PERIODS OF STRESS AND ADJUSTMENT, PROVIDING THERAPY FOR DEPRESSION, ANXIETY, TRAUMA, BIPOLAR DISEASE, AND CHRONIC MENTAL ILLNESS. OUTREACH COUNSELORS OFFER SHORT AND LONG-TERM THERAPY IN HOMES, SCHOOLS, AND OTHER APPROPRIATE COMMUNITY SETTINGS. ALL THERAPY PROGRAMS ARE SUPPORTED BY MEDICATION CLINICS IF THAT IS DETERMINED TO BE AN APPROPRIATE ADJUNCT TO TREATMENT. IN FY23, NBHC DELIVERED 99,419 UNITS OF AMBULATORY SERVICES, SUPPORTED BY 8,432 PSYCHOPHARMACOLOGY VISITS. EMERGENCY SERVICES THE EMERGENCY SERVICES DIVISION OFFERS EMERGENCY PSYCHIATRIC SERVICES AND INCLUDES THE EMERGENCY SERVICES PROGRAM (ESP) AND COMMUNITY CRISIS STABILIZATION (CCS) INPATIENT PROGRAM. ESP PROVIDES EMERGENCY PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES 24/7 IN A VARIETY OF SETTINGS, INCLUDING HOMES, SCHOOLS, OUTPATIENT CLINICS AND HOSPITALS. ESP SERVICES ARE PROVIDED WITHIN THE COMMUNITY AND WITHIN 10 HOSPITALS EMERGENCY DEPARTMENTS (ED) THROUGHOUT THE NORTH SHORE, CAPE ANN AND MERRIMACK VALLEY, INCLUDING 6 NON-BILH EMERGENCY DEPARTMENTS.
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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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BILH BS' EMERGENCY PSYCHIATRIC AND MOBILE RESPONSE TEAMS IN LAWRENCE, SALEM AND LOWELL ARE AVAILABLE AROUND THE CLOCK, PROVIDING PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES IN VARIOUS SETTINGS. NBHC PROVIDES THESE SERVICES IN CONJUNCTION WITH A LARGE NUMBER OF AREA HOSPITALS, INCLUDING FACILITIES OUTSIDE OF THE BILH UMBRELLA. MOBILE CRISIS CLINICIANS ALSO RESPOND TO SCHOOLS, HOMES AND OUTPATIENT CLINICS, AND NBHC ALSO PROVIDES WALK-IN SERVICES AT THE THREE TEAM LOCATIONS. IN ADDITION TO EMERGENCY EVALUATION, TEAM MEMBERS PROVIDE ONGOING CRISIS COUNSELING UNTIL THE PATIENT IS STABLE AND RELATIONSHIPS ARE ESTABLISHED WITH LONGER-TERM CARE PROVIDERS. THE LAWRENCE AND SALEM LOCATIONS ALSO HOUSE 8-BED COMMUNITY CRISIS STABILIZATION UNITS, WHICH OFFER SHORT-TERM (3-5 DAY) CRISIS BEDS IN LIEU OF HOSPITALIZATION FOR MASSHEALTH, MEDICARE, AND UNINSURED CLIENTS. IN JANUARY 2023, THE STATE OF MASSACHUSETTS IMPLEMENTED BEHAVIORAL HEALTH REDESIGN, WHICH SIGNIFICANTLY IMPACTED OUR EMERGENCY SERVICES TEAMS. BILH BS WAS AWARDED ONE COMMUNITY BEHAVIORAL HEALTH CENTER (CBHC), LOCATED IN LAWRENCE. THE SERVICE AREAS FOR SALEM AND LOWELL WERE TRANSITIONED TO A DIFFERENT VENDOR. HOWEVER, THIS ALLOWED OUR SALEM AND LOWELL TEAMS TO PIVOT INWARD TO SERVICE THE BILH SYSTEM NEEDS. DURING THE FISCAL PERIOD COVERED BY THIS FILING, EMERGENCY SERVICE PROGRAMS HAD 13,502 ENCOUNTERS, 1,895 OF WHICH WERE DONE REMOTELY, AND THE CCS PROGRAMS RECORDED 2,546 BED DAYS. NBHC IS ALSO ON THE FOREFRONT OF EXPANDING TREATMENT FOR OPIOID USE DISORDER (OUD). SEVERAL BILH ORGANIZATIONS HAVE TAKEN STEPS TO ENHANCE CARE FOR PATIENTS WITH OPIOID USE DISORDER (OUD) WHO PRESENT IN EMERGENCY DEPARTMENTS, PARTICULARLY AS THESE PATIENTS TRANSITION FROM THE HOSPITAL TO A LONG-TERM TREATMENT PROGRAM. THE NBHC BRIDGE CLINIC IN GLOUCESTER ACCEPTS PATIENTS REFERRED FROM THE NORTHEAST HOSPITAL CORP (NHC) EMERGENCY DEPARTMENTS AT BOTH BEVERLY HOSPITAL AND ADDISON GILBERT HOSPITAL AND OFFERS CONTINUATION OF MEDICATION ASSISTED TREATMENT AND SUPPORT FROM RECOVERY COACHES. BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH (BID-PLYMOUTH) TREATS PATIENTS WITH OUD THROUGH MEDICATION-ASSISTED TREATMENT IN THE EMERGENCY DEPARTMENT, AND THE HOSPITAL WORKS CLOSELY WITH COMMUNITY PARTNERS TO PROVIDE ONGOING SUPPORT TO PATIENTS. THESE PROGRAMS ARE SIMILAR TO SERVICES AT MOUNT AUBURN HOSPITAL WHICH ALSO OFFERS MEDICATION-ASSISTED TREATMENT IN ITS EMERGENCY DEPARTMENT. PATIENTS CAN THEN BE REFERRED TO THE BRIDGE CLINIC AT MOUNT AUBURN HOSPITAL OR BID-PLYMOUTH FOR CONTINUED OR ADDITIONAL TREATMENT. NORTHEAST HOSPITAL CORPORATION, BID-PLYMOUTH AND MOUNT AUBURN HOSPITALS ARE ALL PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK AND SISTER ENTITIES TO NBHC.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.