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SCHEDULE H-NARRATIVES
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FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSNEW ENGLAND BAPTIST HOSPITAL AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF NEW ENGLAND BAPTIST HOSPITAL (NEBH). 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.NEW ENGLAND BAPTIST HOSPITAL COMMUNITY BENEFITS MISSION STATEMENT NEW ENGLAND BAPTIST HOSPITAL (NEBH) IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED IN MUSCULOSKELETAL DISEASE AND COLLABORATE ON PROGRAMS TO ADDRESS THESE NEEDS, WITH SPECIAL FOCUS ON UNDERSERVED POPULATIONS THROUGH OUTREACH, EDUCATION AND PROVISION OF SERVICES TO ADDRESS MUSCULOSKELETAL HEALTH. NEW ENGLAND BAPTIST'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING NEBH 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 NEBH'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; AND FACILITATING 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.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $1,010,980 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE NEBH 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. WORLD-CLASS ORTHOPEDIC CLINICAL EXPERTISE, EDUCATION AND RESEARCH ALONG WITH AN UNDERLYING COMMITMENT TO HEALTH EQUITY ARE THE PRIMARY TENETS OF ITS MISSION. NEBH'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF NEBH'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 NEBH'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. NEBH'S COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE DIRECTOR OF COMMUNITY AND GOVERNMENT AFFAIRS. THE DIRECTOR OF COMMUNITY AND GOVERNMENT AFFAIRS HAS DIRECT ACCESS AND IS ACCOUNTABLE TO NEBH'S 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 NEBH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH NEBH'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT NEBH'S COMMUNITY BENEFITS MISSION TO TRANSFORM THE LIVES OF THOSE WE SERVE BY PROMOTING WELLNESS, RESTORING FUNCTION, LESSENING DISABILITY, ALLEVIATING PAIN, AND ADVANCING KNOWLEDGE IN MUSCULOSKELETAL DISEASES AND RELATED DISORDERS. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF NEBH'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF NEBH'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF NEBH'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY NEBH'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.
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NEBH CBAC MEMBERS INCLUDE:
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ELAINE ADAMS, FITNESS INSTRUCTOR, ROXBURY TENANTS OF HARVARD, MISSION HILL RESIDENT LAURA ADAMS, DIRECTOR OF SENIOR SERVICES, ROXBURY TENANTS OF HARVARD AND MISSION HILL RESIDENT MELISSA CARLSON, DEPUTY COMMISSIONER OF PROGRAMS AND PARTNERSHIPS, BOSTON AGE STRONG COMMISSION SOPHIE DEUNG, SENIOR PROGRAMS LEADER, ROXBURY TENANTS OF HARVARD AND MISSION HILL RESIDENT SYDNEY DUONG, CLINICAL NUTRITION MANAGER, NEBH CHRISTINE DWYER, DIRECTOR, COMMUNITY AND GOVERNMENT AFFAIRS, NEBH KAREN GATELY, EXECUTIVE DIRECTOR, ROXBURY TENANTS OF HARVARD MICHAEL J. HOWE, DIRECTOR, HEALTH EQUITY & SPECIAL PROJECTS, NEBH JOHN JACKSON, ADMINISTRATIVE COORDINATOR, BOSTON CENTER FOR YOUTH AND FAMILIES TOBIN COMMUNITY CENTER; BOARD MEMBER, NEBH BOARD OF TRUSTEES TONI KOMST, BOARD MEMBER, MISSION HILL MAIN STREETS AND MISSION HILL RESIDENT PAIGE LEGASSIE MAIN, VICE PRESIDENT OF HUMAN RESOURCES, NEBH BRIAN MILLER, SPECIAL EDUCATION TEACHER, MADISON PARK SCHOOL, BOSTON PUBLIC SCHOOLS DAVID PASSAFARO, PRESIDENT, NEBH LYNN STEWART, MANAGER OF AMENITIES AND STUDENT SERVICES, NEBH COURTNEY WRIGHT, EXECUTIVE DIRECTOR, MISSION MAIN STREETS DAVID WELCH, BOARD MEMBER, MISSION HILL NEIGHBORHOOD HOUSING SERVICES AND MISSION HILL RESIDENTCOMMUNITY 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. NEBH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE NEBH BOARD OF TRUSTEES ON SEPTEMBER 13, 2022. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 13, 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 NEBH'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 NEBH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW NEBH, 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, NEBH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF NEBH'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES THE MISSION HILL/ROXBURY NEIGHBORHOODS OF BOSTON, AS WELL AS THE CITIES OF DEDHAM, CHESTNUT HILL (NEWTON) AND BROOKLINE. THESE COMMUNITIES DEFINE NEBH'S COMMUNITY BENEFITS SERVICE AREA (CBSA). IN RECOGNITION OF THE CONSIDERABLE HEALTH DISPARITIES THAT EXIST IN SOME COMMUNITIES, NEBH FOCUSES THE BULK OF ITS COMMUNITY BENEFITS RESOURCES ON IMPROVING THE HEALTH STATUS OF LOW-INCOME AND UNDERSERVED POPULATIONS LIVING IN THE BOSTON NEIGHBORHOODS OF MISSION HILL/ROXBURY. WHILE THERE ARE CERTAINLY SEGMENTS OF THE POPULATIONS IN DEDHAM, CHESTNUT HILL (NEWTON), AND BROOKLINE THAT ARE VULNERABLE AND UNDERSERVED, THE GREATEST DISPARITIES EXIST IN BOSTON. IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS RESOURCES, NEBH'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) VOTED TO PRIORITIZE AND FOCUS NEBH'S ATTENTION ON THE MORE URBAN, HIGH-NEED COMMUNITIES IN NEBH'S CBSA. COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR NEBH'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS THROUGH A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).NEBH'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF MISSION HILL/ROXBURY IN ITS CBSA, AS FOLLOWS: YOUTH OLDER ADULTS INDIVIDUALS WITH DISABILITIES RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS LOW-RESOURCED POPULATIONS
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COMMUNITY HEALTH NEEDS ASSESSMENT SUMMARY OF APPROACH AND METHODS
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NEBH'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 NEBH'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. NEBH'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.THE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. RATHER THAN CONDUCTING A SINGLE ASSESSMENT, NEBH'S COMMUNITY BENEFITS STAFF CONDUCTED THEIR OWN ASSESSMENT AND PARTICIPATED IN A SERIES OF ADDITIONAL, CONCURRENT AND COMPREHENSIVE ASSESSMENTS THAT WERE THEN AGGREGATED TO CREATE THE 2022 CHNA REPORT. THESE CONCURRENT ASSESSMENTS WERE CONDUCTED IN PARTNERSHIP WITH THE BOSTON COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY HEALTH IMPROVEMENT PLAN COLLABORATIVE (BOSTON CHNA-CHIP COLLABORATIVE). THE BOSTON CHNA-CHIP COLLABORATIVE, CONSISTING OF BOSTON'S HOSPITALS AND COMMUNITY HEALTH CENTERS, THE BOSTON PUBLIC HEALTH COMMISSION, COMMUNITY-BASED ORGANIZATIONS, AND COMMUNITY RESIDENTS, CONDUCTED A ROBUST AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE CITY OF BOSTON AS A WHOLE. FACILITATED THROUGH THE CONFERENCE OF BOSTON TEACHING HOSPITALS (COBTH) AND THE CITY OF BOSTON'S HUMAN SERVICES DEPARTMENT, THE BOSTON CHNA-CHIP COLLABORATIVE ASSESSMENT FOCUSED ON THE SOCIAL DETERMINANTS OF HEALTH THROUGH THE LENS OF HEALTH EQUITY; IT AIMED TO UNCOVER AND UNDERSTAND HOW AND WHY INDIVIDUALS IN CERTAIN BOSTON NEIGHBORHOODS OR POPULATION GROUPS EXPERIENCE INEQUITIES IN HEALTH OUTCOMES AND BARRIERS TO CARE BASED ON SOCIOECONOMIC STATUS, RACE AND ETHNICITY, LANGUAGE, HEALTH STATUS, SEXUAL ORIENTATION, GENDER IDENTITY, AND OTHER FACTORS. THE OVERALL APPROACH WAS PARTICIPATORY AND COLLABORATIVE, ENGAGING COMMUNITY RESIDENTS AND COLLABORATORS THROUGHOUT THE CHNA PROCESS. NANCY KASEN, BILH'S VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, SERVED AS THE FOUNDING CO-CHAIR OF THE BOSTON CHNA-CHIP COLLABORATIVE STEERING COMMITTEE, AND CONTINUES TO SERVE ON ITS STEERING COMMITTEE AND WORKGROUPS. ROBERT TORRES, BILH'S DIRECTOR OF COMMUNITY BENEFITS FOR THE BOSTON REGION, SERVED AS THE CO-CHAIR OF THE COMMUNITY ENGAGEMENT WORKGROUP. NEBH COMMUNITY BENEFITS STAFF PARTICIPATED IN NUMEROUS BOSTON CHNA-CHIP COLLABORATIVE MEETINGS. NEBH AND THE BOSTON CHNA-CHIP COLLABORATIVE SHARED INFORMATION WITH EACH OTHER TO SUPPORT EACH OTHER'S ASSESSMENT EFFORTS.FINALLY, NEBH PARTICIPATED IN THE BETH ISRAEL LAHEY HEALTH (BILH) CHNA AND COLLABORATED WITH BETH ISRAEL DEACONESS NEEDHAM HOSPITAL (BID NEEDHAM) AND BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC). WITH RESPECT TO BID NEEDHAM, NEBH AND BID NEEDHAM BOTH INCLUDE DEDHAM IN THEIR CBSA, AND BOTH GATHERED AND SHARED INFORMATION ON THIS MUNICIPALITY AS PART OF THEIR ASSESSMENT PROCESSES. WITH RESPECT TO BIDMC, NEBH AND BIDMC BOTH INCLUDE THE ROXBURY AND MISSION HILL NEIGHBORHOODS OF BOSTON AND THE VILLAGE OF CHESTNUT HILL IN THEIR CBSAS. SIMILARLY, BOTH NEBH AND BIDMC SHARED THE INFORMATION GATHERED IN THESE AREAS AS PART OF THEIR PROCESSES. BIDMC ALSO SHARED INFORMATION FROM THE EXTENSIVE COMMUNITY ENGAGEMENT AND PLANNING ACTIVITIES THAT THEY ARE CONDUCTING AS PART OF BIDMC'S MASSACHUSETTS DETERMINATION OF NEED NEW INPATIENT BUILDING COMMUNITY-BASED HEALTH INITIATIVE (NIB-CHI).COMBINED, THESE EFFORTS HELPED TO ENSURE THAT A SOUND, OBJECTIVE, AND INCLUSIVE CHNA PROCESS WAS CONDUCTED ACROSS NEBH'S ENTIRE CBSA.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, NEBH'S ASSESSMENT INCLUDED 85 (20 BY NEBH/BIDMC) ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, 24 FOCUS GROUPS (5 BY NEBH/BIDMC) WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, AND TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED OVER 40 PARTICIPANTS. IN ADDITION, BID NEEDHAM CONDUCTED A COMMUNITY HEALTH SURVEY, WHICH GATHERED INFORMATION FROM MORE THAN 450 COMMUNITY RESIDENTS FROM BID NEEDHAM'S CBSA, INCLUDING 86 RESIDENTS FROM DEDHAM. BID NEEDHAM SHARED THIS INFORMATION WITH NEBH. THE BOSTON PUBLIC HEALTH COMMISSION FIELDED A COVID-19 HEALTH EQUITY SURVEY IN DECEMBER 2020/JANUARY 2021; AS SUCH, NEBH AND BIDMC, BASED ON RECOMMENDATIONS FROM THE BOSTON CHNA-CHIP COLLABORATIVE STEERING COMMITTEE, OPTED NOT TO FIELD A SURVEY IN BOSTON. THIS SURVEY OF A RANDOM SAMPLE OF OVER 1,650 RESIDENTS EXAMINED ISSUES RELATED TO JOB LOSS, FOOD INSECURITY, ACCESS TO SERVICES, MENTAL HEALTH, VACCINATION, AND PERCEPTIONS OF RISK AROUND COVID-19.COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSNEBH RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. NEBH COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT NEBH 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)
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COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY INFORMANT
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INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, NEBH WORKED WITH COLLABORATORS TO CONDUCT 85 (20 BY NEBH/BIDMC) KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT NEBH'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 NEBH'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 NEBH'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 PROCESS FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)NEBH'S ASSESSMENT INCLUDED 24 FOCUS GROUPS (5 BY NEBH/BIDMC) WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, AND TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED OVER 40 PARTICIPANTS. IN ADDITION, BID NEEDHAM CONDUCTED A COMMUNITY HEALTH SURVEY, WHICH GATHERED INFORMATION FROM MORE THAN 450 COMMUNITY RESIDENTS FROM BID NEEDHAM'S CBSA, INCLUDING 86 RESIDENTS FROM DEDHAM. BID NEEDHAM SHARED THIS INFORMATION WITH NEBH. THE BOSTON PUBLIC HEALTH COMMISSION FIELDED A COVID-19 HEALTH EQUITY SURVEY IN DECEMBER 2020/JANUARY 2021; AS SUCH, NEBH AND BIDMC, BASED ON RECOMMENDATIONS FROM THE BOSTON CHNA-CHIP COLLABORATIVE STEERING COMMITTEE, OPTED NOT TO FIELD A SURVEY IN BOSTON. THIS SURVEY OF A RANDOM SAMPLE OF OVER 1,650 RESIDENTS EXAMINED ISSUES RELATED TO JOB LOSS, FOOD INSECURITY, ACCESS TO SERVICES, MENTAL HEALTH, VACCINATION, AND PERCEPTIONS OF RISK AROUND COVID-19.NEBH HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF NEBH'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 FOCUS GROUPS AND LISTENING SESSIONS WERE HELD VIA ZOOM AND AVAILABLE WITH SPANISH AND CHINESE TRANSLATION. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO COMMUNITY RESIDENTS, COMMUNITY EVENTS AND HOUSING DEVELOPMENTS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE NEBH 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 PROCESS REVIEWING 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 NEBH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS. IDENTIFY NEBH'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE NEBH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY NEBH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2019). 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).COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS- KEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDING SEPTEMBER 30, 2022, WERE: YOUTH OLDER ADULTS INDIVIDUALS WITH DISABILITIES RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS LOW-RESOURCED POPULATIONS
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NEBH'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS:
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EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY. HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM NEBH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025. COMMUNITY HEALTH NEEDS ASSESSMENT MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLENEBH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, NEBH 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 NEBH WEBSITE AT: HTTPS://WWW.NEBH.ORG/WHO-WE-ARE/GIVING-BACK/IN ADDITION TO THE CHNA, NEBH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE NEBH WEBSITE AT: HTTPS://WWW.NEBH.ORG/WHO-WE-ARE/GIVING-BACK/NEBH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE NEBH WEBSITE AT: HTTPS://WWW.NEBH.ORG/WHO-WE-ARE/GIVING-BACK/FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING NEBH'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE NEBH WEBSITE AT: HTTPS://WWW.NEBH.ORG/WHO-WE-ARE/GIVING-BACK/EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENT ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, NEBH'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 NEBH'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, NEBH 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.
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GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW.
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PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE GOAL 1: ENHANCE ACCESS TO CARE AND REDUCE THE IMPACT OF SOCIAL DETERMINANTS GOAL 2: REDUCE ELDER FALLS AND PROMOTE AGING IN PLACE GOAL 3: INCREASE ACCESS TO HEALTHY FOODS AND OTHER BASIC HOUSEHOLD NEEDS GOAL 4: PROMOTE VIOLENCE PREVENTION AND ADDRESS TRAUMA (SAFE NEIGHBORHOODS/COMMUNITY COHESION) GOAL 5: INCREASE JOB OPPORTUNITIES FOR YOUTH AND ADULTS GOAL 6: DECREASE TRANSPORTATION BARRIERS PRIORITY AREA 2: CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, REFERRAL, AND CHRONIC DISEASE MANAGEMENT SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS GOAL 2: REDUCE THE PREVALENCE OF TOBACCO USE GOAL 3: INCREASE PHYSICAL ACTIVITY AND HEALTHY EATING COMMUNITY HEALTH NEEDS ASSESSMENT APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)NEBH 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 NEBH OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES AMONG THEIR FOCUS COHORTS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS.COMMUNITY BENEFITS PROGRAMS AND INITIATIVES NEBH OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES OF THEIR TARGET POPULATIONS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS. NEBH HAS BEEN A LEADER IN CREATING AND SUPPORTING A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE THE NEBH SENIOR CELTICS PROGRAM, HIGH SCHOOL PARTNERSHIPS THAT LEAD TO CAREERS, PARTNERSHIPS WITH LOCAL AFFORDABLE HOUSING ORGANIZATIONS, PROGRAMS ADDRESSING FOOD INSECURITY AND BASIC HOUSEHOLD ITEMS AND PROGRAMS RELATING TO TRANSPORTATION ACCESS. AS NOTED ABOVE, NEBH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. THAT CHNA AND IMPLEMENTATION STRATEGY WILL INFORM THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF NEBH FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2023; SEPTEMBER 30, 2024; AND SEPTEMBER 30, 2025. THIS FORM 990 COVERS NEBH'S FISCAL YEAR ENDED SEPTEMBER 30, 2023. NEBH'S IMPLEMENTATION STRATEGY FOR ITS COMMUNITY BENEFITS ACTIVITIES IS PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. A FULL UPDATE ON NEBH'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW. FY23 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: EQUITABLE ACCESS TO CARE INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, 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.RESOURCES/FINANCIAL INVESTMENT: NEBH EXPENDS SUBSTANTIAL RESOURCES ON ITS COMMUNITY BENEFITS PROGRAM TO ACHIEVE THE GOALS AND OBJECTIVES IN ITS IS. THESE RESOURCES ARE EXPENDED, ACCORDING TO ITS CURRENT IS, THROUGH DIRECT AND IN-KIND INVESTMENTS IN PROGRAMS OR SERVICES OPERATED BY NEBH AND/OR ITS PARTNERS TO IMPROVE THE HEALTH OF THOSE LIVING IN ITS CBSA. ADDITIONALLY, NEBH WORKS ON ITS OWN OR WITH ITS PARTNERS TO LEVERAGE FUNDS THROUGH PUBLIC OR PRIVATE GRANTS AND OTHER FUNDING SOURCES. FINALLY, NEBH SUPPORTS RESIDENTS IN ITS CBSA BY PROVIDING "CHARITY" CARE TO INDIVIDUALS WHO ARE LOW-RESOURCED AND UNABLE TO PAY FOR CARE AND SERVICES. MOVING FORWARD, NEBH WILL CONTINUE TO COMMIT RESOURCES THROUGH THE SAME ARRAY OF DIRECT, IN-KIND, LEVERAGED, OR "CHARITY" CARE EXPENDITURES TO CARRY OUT ITS COMMUNITY BENEFITS MISSION.GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES FOR THOSE WHO FACE ECONOMIC BARRIERS. TARGET POPULATION: LOW-RESOURCED POPULATIONS, INDIVIDUALS WITH DISABILITIES, RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS PROGRAMMATIC OBJECTIVES: 1. SUPPORT PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION.2. ADVOCATE FOR AND SUPPORT POLICIES AND SYSTEMS THAT IMPROVE ACCESS TO CARE.COMMUNITY ACTIVITIES/STRATEGIES: PROVIDE TRANSPORTATION SUPPORT TO COMMUNITY RESIDENTS TO ENHANCE ACCESS TO AFFORDABLE, SAFE, ACCESSIBLE TRANSPORTATION OPTIONS. DEVELOP A LOCAL RESOURCE DIRECTORY. SUPPORT LINGUISTIC SERVICES FINANCIAL COUNSELORS NEBH DIVERSITY, EQUITY, AND INCLUSION (DEI) COUNCIL SUPPORT RELEVANT POLICIES WHEN PROPOSEDMETRICS AND STATUS UPDATE: NEBH IS THE MAJOR FINANCIAL SUPPORTER OF THE MISSION LINK BUS. IN FY23, OVER 7,000 RESIDENTS USED THE MISSION LINK BUS TO GET TO PLACES LIKE THE GROCERY STORE, PHARMACY OR DOCTOR'S APPOINTMENT. IT ALSO PROVIDED TRANSPORTATION TO AND FROM EVENTS FOR OLDER ADULTS GIVING THEM THE OPPORTUNITY TO BE MORE SOCIAL AND ACTIVE. IN FY23, NEBH PROVIDED 1,144 INTERRUPTERS FOR PATIENTS, INCLUDING SPANISH, KOREAN CHINESE, ETC. NEBH FORMED/CREATED/SUSTAINED 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.
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PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH
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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 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 BID NEEDHAM 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.RESOURCES/FINANCIAL INVESTMENT: NEBH EXPENDS SUBSTANTIAL RESOURCES ON ITS COMMUNITY BENEFITS PROGRAM TO ACHIEVE THE GOALS AND OBJECTIVES IN ITS IS. THESE RESOURCES ARE EXPENDED, ACCORDING TO ITS CURRENT IS, THROUGH DIRECT AND IN-KIND INVESTMENTS IN PROGRAMS OR SERVICES OPERATED BY NEBH AND/OR ITS PARTNERS TO IMPROVE THE HEALTH OF THOSE LIVING IN ITS CBSA. ADDITIONALLY, NEBH WORKS ON ITS OWNOR WITH ITS PARTNERS TO LEVERAGE FUNDS THROUGH PUBLIC OR PRIVATE GRANTS AND OTHER FUNDING SOURCES. FINALLY, NEBH SUPPORTS RESIDENTS IN ITS CBSA BY PROVIDING "CHARITY" CARE TO INDIVIDUALS WHO ARE LOW-RESOURCED AND UNABLE TO PAY FOR CARE AND SERVICES. MOVING FORWARD, NEBH WILL CONTINUE TO COMMIT RESOURCES THROUGH THE SAME ARRAY OF DIRECT, IN-KIND, LEVERAGED, OR "CHARITY" CARE EXPENDITURES TO CARRY OUT ITS COMMUNITY BENEFITS MISSION.GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY OF LIFE.TARGET POPULATION: LOW-RESOURCED POPULATIONS, OLDER ADULTS, YOUTH, INDIVIDUALS WITH DISABILITIES, RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONSPROGRAMMATIC OBJECTIVES: 1. PROMOTE HEALTHY EATING AND ACTIVE LIVING BY ADVOCATING FOR SYSTEM CHANGES, INCREASING OPPORTUNITIES FOR PHYSICAL ACTIVITY, AND PROVIDING HEALTHY, LOW-COST FOOD RESOURCES TO COMMUNITIES AND SCHOOL ENVIRONMENTS.2. ADVOCATE FOR AND SUPPORT IMPACTFUL PROGRAMS THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSING.3. INCREASE MENTORSHIP, TRAINING, AND EMPLOYMENT OPPORTUNITIES FOR YOUTH, YOUNG ADULTS, AND ADULTS RESIDING IN THE COMMUNITIES, AS WELL AS HOSPITAL EMPLOYEES.COMMUNITY ACTIVITIES/STRATEGIES: PROVIDE GIFT CARDS TO THE LOCAL GROCERY STORE TO THOSE WHO ARE FOOD INSECURE SUPPORT FOOD ACCESS AND NUTRITION PROGRAMMING TO LOW RESOURCED POPULATIONS LIVING IN PUBLIC HOUSING, COUNCILS ON AGING, AND OTHER COMMUNITY VENUES SUPPORT COMMUNITY FOOD PANTRIES MAINTAIN MCLAUGHLIN FIELD TO ENGAGE YOUTH AND PROMOTE PHYSICAL ACTIVITY MAKE COMMUNITY IMPROVEMENTS TO WALKWAYS AND OTHER PUBLIC AREAS TO ADDRESS TRANSPORTATION ISSUES AND PROMOTE PHYSICAL ACTIVITY PROVIDE ESSENTIAL HOUSEHOLD ITEMS TO SUPPORT THOSE LIVING IN POVERTY OR LOW-INCOME HOUSEHOLDS ORGANIZE AND SUPPORT WORKFORCE MENTORSHIP AND TRAINING PROGRAMS FOR YOUTH AND ADULTS TO JOB TRAINING, SKILLS DEVELOPMENT, AND CAREER ADVANCEMENT WITH AN EMPHASIS ON PRIORITY POPULATIONS, INCLUDING HOSPITAL EMPLOYEES CONTINUE TO SUPPORT THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP PROGRAM TO SUPPORT SKILLS DEVELOPMENT AND CAREER ADVANCEMENT SUPPORT ACTIVITIES AND EVENTS FOR OLDER ADULTS COLLABORATE AND SUPPORT MISSION HILL NEIGHBORHOOD HOUSING SERVICES WITH THE RESIDENT SERVICES COORDINATOR PROGRAM.FY23 METRICS AND STATUS UPDATES: NEBH PROVIDED FOOD, MEALS AND GIFT CARDS TO THE LOCAL GROCERY STORE TO OVER 600 INDIVIDUALS AND FAMILIES LIVING IN MISSION HILL. NEBH PROVIDED FINANCIAL SUPPORT FOR THE FOOD PANTRY AT ROXBURY TENANTS OF HARVARD (RTH). THE PANTRY PROVIDED EMERGENCY FOOD FOR FAMILIES AND INDIVIDUALS THAT LIVE AT RTH. PROVIDED FINANCIAL SUPPORT FOR BAGS OF FRESH FRUIT AND VEGETABLES TO ROXBURY TENANTS OF HARVARD. OVER 645 BAGS OF FRESH PRODUCE WERE GIVEN TO RESIDENTS. NEBH COLLABORATED WITH STOP & SHOP TO DONATE 500 TURKEYS AND BAGS OF FOOD TO MISSION HILL RESIDENTS DURING THE HOLIDAYS. CLOTHING, SHOES, HOUSEHOLD ESSENTIALS, ETC. WERE DISTRIBUTED TO OVER 350 FAMILIES/INDIVIDUALS THAT LIVE IN MISSION HILL. NEBH PROVIDED ELEMENTARY AND HIGH SCHOOL CHILDREN LIVING IN LOW-INCOME HOUSING IN MISSION HILL THE SUPPLIES THEY NEED TO LEARN, SO THAT THEY CAN RETURN TO THE CLASSROOM PREPARED AND ON TRACK FOR SUCCESS. NEBH PROVIDED TUITION ASSISTANCE TO TWO MISSION HILL STUDENTS SO THAT THEY WOULD BE ABLE TO FINISH HIGH SCHOOL AND GO ONTO COLLEGE ON FULL SCHOLARSHIP. TWO WORKFORCE DEVELOPMENT PROGRAMS, PROJECT SEARCH AND THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP WERE HELD. SIX STUDENTS FROM MADISON PARK TECHNICAL VOCATIONAL HIGH SCHOOL (BOSTON PUBLIC SCHOOL) PARTICIPATED IN THE PROJECT SEARCH PROGRAM. THE LIFE WORK EXPERIENCE COMBINED WITH TRAINING IN EMPLOYABILITY AND INDEPENDENT LIVING SKILLS ASSIST YOUTHS WITH SIGNIFICANT DISABILITIES MAKE SUCCESSFUL TRANSITIONS FROM SCHOOL TO PRODUCTIVE ADULT LIFE. STUDENTS RECEIVED A WEEKLY STIPEND. FIVE HIGH SCHOOL/COLLEGE STUDENTS PARTICIPATED IN THE MEREDITH CAMERON INTERNSHIP. MCLAUGHLIN FIELD WAS MAINTAINED DURING SPRING, SUMMER AND FALL (OVER 30 WEEKS), AND WAS MAINTAINED DURING THE WINTER AS NEEDED. NEBH STAFF COLLABORATED WITH RESIDENTS AND MISSION MAIN STREETS TO BEAUTIFY AND HELP MAKE THE COMMUNITY A SAFER, CLEANER PLACE TO LIVE. NEBH COLLABORATED WITH MISSION HILL NEIGHBORHOOD HOUSING SERVICES TO PROVIDE A RESIDENT SERVICES COORDINATOR INTERN. THE RESIDENT SERVICES COORDINATOR INTERACTED WITH OVER 150 RESIDENTS. THESE INTERACTIONS INCLUDED CHECKING IN ON THEIR FINANCIAL, SOCIAL, AND PHYSICAL WELLBEING, ASSISTING THEM WITH APPLICATIONS AND RESOURCES, ENCOURAGING OLDER ADULTS TO ATTEND EVENTS, CONNECTING YOUTH TO PROGRAMS IN THE COMMUNITY, ETC. IN FY23, 225 JOB SEEKERS WERE REFERRED TO BILH AND 70 WERE HIRED ACROSS BILH HOSPITALS. IN FY23, 67 EVENTS AND PRESENTATIONS WERE CONDUCTED WITH COMMUNITY PARTNERS ACROSS THE BILH SERVICE AREA. IN FY23, 54 COMMUNITY MEMBERS PLACED IN INTERNSHIPS ACROSS BILH HOSPITALS TO LEARN VALUABLE SKILLS. NEBH PARTICIPATED IN OFFERING THESE INTERNSHIPS. IN FY23, 22 INTERNS WERE HIRED PERMANENTLY IN BILH HOSPITALS. NEBH PARTICIPATED IN THESE HIRINGS. IN FY23, 45 EMPLOYEES ACROSS BILH WERE ENROLLED IN ESOL CLASSES. NEBH EMPLOYEES PARTICIPATED IN THESE CLASSES. IN FY23, 20 BILH EMPLOYEES ATTENDED CITIZENSHIP CLASSES, 135 BILH EMPLOYEES ATTENDED CAREER DEVELOPMENT WORKSHOPS AND 189 BILH EMPLOYEES ATTENDED FINANCIAL LITERACY CLASSES. NEBH EMPLOYEES PARTICIPATED IN THESE OFFERINGS.
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PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE
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ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES ON 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 THE 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 WAS 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 A NEED TO ADDRESS DRUG USE IN COMMUNITY SPACES, AND THE NEED TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE AS CO-OCCURRING ISSUES.RESOURCES/FINANCIAL INVESTMENT: NEBH EXPENDS SUBSTANTIAL RESOURCES ON ITS COMMUNITY BENEFITS PROGRAM TO ACHIEVE THE GOALS AND OBJECTIVES IN ITS IS. THESE RESOURCES ARE EXPENDED, ACCORDING TO ITS CURRENT IS, THROUGH DIRECT AND IN-KIND INVESTMENTS IN PROGRAMS OR SERVICES OPERATED BY NEBH AND/OR ITS PARTNERS TO IMPROVE THE HEALTH OF THOSE LIVING IN ITS CBSA. ADDITIONALLY, NEBH WORKS ON ITS OWN OR WITH ITS PARTNERS TO LEVERAGE FUNDS THROUGH PUBLIC OR PRIVATE GRANTS AND OTHER FUNDING SOURCES. FINALLY, NEBH SUPPORTS RESIDENTS IN ITS CBSA BY PROVIDING "CHARITY" CARE TO INDIVIDUALS WHO ARE LOW-RESOURCED INDIVIDUALS AND TO PAY FOR CARE AND SERVICES. MOVING FORWARD, NEBH WILL CONTINUE TO COMMIT RESOURCES THROUGH THE SAME ARRAY OF DIRECT, IN- KIND, LEVERAGED, OR "CHARITY" CARE EXPENDITURES TO CARRY OUT ITS COMMUNITY BENEFITS MISSION.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.TARGET POPULATION: OLDER ADULTS, YOUTH, LOW-RESOURCED POPULATIONS, INDIVIDUALS WITH DISABILITIES, RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONSPROGRAMMATIC OBJECTIVES: 1. ENHANCE RELATIONSHIPS AND PARTNERSHIPS WITH MENTAL HEALTH, YOUTH-SERVING ORGANIZATIONS, AND OTHER COMMUNITY PARTNERS TO INCREASE RESILIENCY, COPING, AND PREVENTION SKILLS, AND REDUCE ISOLATION.2. BUILD THE CAPACITY OF COMMUNITY MEMBERS TO UNDERSTAND THE IMPORTANCE OF MENTAL HEALTH, AND REDUCE NEGATIVE STEREOTYPES, BIAS, AND STIGMA AROUND MENTAL ILLNESS AND SUBSTANCE USE.COMMUNITY ACTIVITIES/STRATEGIES: SUPPORT PROGRAMS AT THE TOBIN COMMUNITY CENTER INCLUDING THE AFTER SCHOOL AND BASKETBALL PROGRAMS AS WELL AS THE SUMMER CAMP SUPPORT THE MISSION HILL LITTLE LEAGUE SUPPORT THE MISSION GRAMMAR SCHOOL BASKETBALL TEAM SUPPORT THE POLICE ATHLETIC LEAGUE (PAL) PROGRAM AT THE TOBIN COMMUNITY CENTER SUPPORT ACTIVITIES AND EVENTS FOR OLDER ADULTS MAINTAIN MCLAUGHLIN FIELD TO ENGAGE YOUTH AND PROMOTE PHYSICAL ACTIVITY EXPLORE AND SUPPORT OPPORTUNITIES FOR TRAINING OF KEY LEADERS AND RESIDENTSFY23 METRICS AND STATUS UPDATES: NEBH PROVIDED FINANCIAL SUPPORT FOR THE SUMMER CAMP AT THE TOBIN COMMUNITY CENTER, 15 YOUTH WERE ABLE TO PARTICIPATE. NEBH PROVIDED FINANCIAL SUPPORT FOR THE AFTER-SCHOOL PROGRAM AT THE TOBIN COMMUNITY CENTER. THIS ALLOWS YOUTH TO PARTICIPATE IN TUTORING, AND EXTRACURRICULAR ACTIVITIES INCLUDING SPORTS PROGRAMS. NEBH PROVIDES FINANCIAL ASSISTANCE TO THE MISSION HILL LITTLE LEAGUE AND THE MISSION GRAMMAR SCHOOL BASKETBALL TEAM. MCLAUGHLIN FIELD WAS MAINTAINED DURING SPRING, SUMMER AND FALL (OVER 30 WEEKS), AND WAS MAINTAINED DURING THE WINTER AS NEEDED. NEBH WORKED WITH NEIGHBORHOOD ORGANIZATIONS INCLUDING THE BOSTON POLICE DEPARTMENT AND PAL TO COLLABORATE AND PROVIDE VIOLENCE PREVENTION EDUCATION AND OTHER ACTIVITIES FOR YOUTH. WILL EXPLORE OPPORTUNITY IN FY24 TO EDUCATE KEY LEADERS THAT WORK WITH YOUTH AND OLDER ADULTS IN THE COMMUNITY ON MENTAL ILLNESS AND SUBSTANCE USE.PRIORITY AREA 4: CHRONIC AND COMPLEX CONDITIONS CHRONIC 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.RESOURCES/FINANCIAL INVESTMENT: NEBH EXPENDS SUBSTANTIAL RESOURCES ON ITS COMMUNITY BENEFITS PROGRAM TO ACHIEVE THE GOALS AND OBJECTIVES IN ITS IS. THESE RESOURCES ARE EXPENDED, ACCORDING TO ITS CURRENT IS, THROUGH DIRECT AND IN-KIND INVESTMENTS IN PROGRAMS OR SERVICES OPERATED BY NEBH AND/OR ITS PARTNERS TO IMPROVE THE HEALTH OF THOSE LIVING IN ITS CBSA. ADDITIONALLY, NEBH WORKS ON ITS OWN OR WITH ITS PARTNERS TO LEVERAGE FUNDS THROUGH PUBLIC OR PRIVATE GRANTS AND OTHER FUNDING SOURCES. FINALLY, NEBH SUPPORTS RESIDENTS IN ITS CBSA BY PROVIDING "CHARITY" CARE TO INDIVIDUALS WHO ARE LOW-RESOURCED AND UNABLE TO PAY FOR CARE AND SERVICES. MOVING FORWARD, NEBH WILL CONTINUE TO COMMIT RESOURCES THROUGH THE SAME ARRAY OF DIRECT, IN-KIND, LEVERAGED, OR "CHARITY" CARE EXPENDITURES TO CARRY OUT ITS COMMUNITY BENEFITS MISSION.GOAL: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/ OR COMPLEX CONDITIONS. TARGET POPULATION: OLDER ADULTS, LOW-RESOURCED POPULATIONS, INDIVIDUALS DISABILITIES PROGRAMMATIC OBJECTIVES: 1. INCREASE OPPORTUNITIES FOR COMMUNITY MEMBERS TO DECREASE THEIR RISK FOR DEVELOPING AND/OR IMPROVE THEIR MANAGEMENT OF COMPLEX & CHRONIC CONDITIONS. COMMUNITY ACTIVITIES/STRATEGIES: SUPPORT THE MINDFUL MATTERS YOGA PROGRAM FOR OLDER ADULTS. SUPPORT EXERCISE AND WALKING PROGRAMS. SUPPORT SR. CELTICS PROGRAM TO PROMOTE COMMUNITY ENGAGEMENT AND EXERCISE METRICS AND STATUS UPDATE: NEBH COLLABORATED WITH THE BOSTON CELTICS TO OFFER THE SR. CELTICS PROGRAM TO MISSION HILL SENIORS. THREE EVENTS WERE HELD WITH OVER 140 SENIORS ATTENDING EACH EVENT. THE PROGRAM FOCUSED ON EXERCISE AND KEEPING SENIORS MOVING, FALL PREVENTION, MENTAL HEALTH AND NUTRITION. NEBH PROVIDED FINANCIAL SUPPORT FOR MINDFUL MOVEMENT, A WEEKLY YOGA CLASS FOR OLDER ADULTS LIVING IN MISSION HILL. OVER 30 OLDER ADULTS PARTICIPATED IN THE YOGA CLASS. PARTICIPANTS HAVE STATED THEY FEEL BETTER, HAVE MORE FLEXIBILITY, FEEL LESS STRESS AND ISOLATED. NEBH CONTINUES TO MAINTAIN THE CITY OF BOSTON'S MCLAUGHLIN PARK, BALL FIELDS AND WALKING PATH IN MISSION HILL. THIS ALLOWS THE RESIDENTS OF BOSTON TO USE THE FIELD AND PARKS FOR OUTDOOR PHYSICAL AND SOCIAL ACTIVITIES.
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COMMUNITY PARTNERS
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NEBH 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: ABCD-PARKER HILL FENWAY SERVICE CENTER ALICE HEYWARD TAYLOR HOUSING DEVELOPMENT BOSTON CELTICS BOSTON CENTER FOR YOUTH AND FAMILY SERVICES, TOBIN COMMUNITY CENTER BOSTON POLICE BOSTON PUBLIC HEALTH COMMISSION BOSTON PUBLIC LIBRARY, MISSION HILL BRANCH BOSTON PUBLIC SCHOOLS, MADISON PARK HIGH SCHOOL CITY OF BOSTON AGE STRONG COMMISSION CITY OF BOSTON MAYOR'S OFFICE CITY OF BOSTON, PARKS AND RECREATION DEPARTMENT FRIENDS OF MCLAUGHLIN PARK MARIA SANCHEZ HOUSE MAURICE J. TOBIN SCHOOL MISSION CHURCH MISSION GRAMMAR SCHOOL MISSION HILL CRIME COMMITTEE MISSION HILL HEALTH MOVEMENT MISSION HILL LITTLE LEAGUE MISSION HILL MAIN STREETS MISSION HILL NEIGHBORHOOD HOUSING SERVICES MISSION HILL SENIOR LEGACY PROJECT MISSION LINK MISSION MAIN TASK FORCE ONE GURNEY STREET APARTMENTS PRIVATE INDUSTRY COUNCIL ROXBURY TENANTS OF HARVARD SOCIEDAD LATINA STOP & SHOPAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, NEBH IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE IS. IN THE FY 2023 - 2025 IS, WHICH WILL GUIDE THE NEBH'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2023, SEPTEMBER 30, 2024 AND SEPTEMBER 30, 2025, EXAMPLES OF IDENTIFIED NEEDS THAT WILL NOT BE MET IN THESE YEARS ARE: DIGITAL DIVIDE (I.E., PROMOTING EQUITABLE ACCESS TO THE INTERNET), SUPPORTING EDUCATION ACROSS THE LIFESPAN, ADDRESSING POOR AIR QUALITY, AND ADDRESSING GENTRIFICATION. WHILE THESE ISSUES ARE IMPORTANT, NEBH'S CBAC AND SENIOR LEADERSHIP TEAM DECIDED THAT THESE ISSUES WERE OUTSIDE OF THE ORGANIZATION'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHERS AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. AS A RESULT, NEBH RECOGNIZED THAT OTHER PUBLIC AND PRIVATE ORGANIZATIONS IN ITS CBSA AND THE COMMONWEALTH WERE BETTER POSITIONED TO FOCUS ON THESE ISSUES. NEBH REMAINS OPEN AND WILLING TO WORK WITH COMMUNITY RESIDENTS, OTHER HOSPITALS, AND OTHER PUBLIC AND PRIVATE PARTNERS TO ADDRESS THESE ISSUES, PARTICULARLY AS PART OF A BROAD, STRONG COLLABORATIVE.IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE 2019 CHNA THAT ARE NOT INCLUDED IN THE 2019 IS AND WHICH HAVE GUIDED THE NEBH'S COMMUNITY BENEFITS ACTIVITIES THE PERIOD FOR THE FISCAL PERIOD COVERED BY THIS FILING. NEBH WILL BE UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES. IT IS IMPORTANT TO NOTE THAT THERE ARE COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED BY NEBH'S ASSESSMENT THAT, DUE TO THE LIMITED BURDEN THAT THESE ISSUES PRESENT AND/OR THE FEASIBILITY OF HAVING AN IMPACT IN THE SHORT- OR LONG-TERM ON THESE ISSUES, WERE NOT PRIORITIZED FOR INVESTMENT. NAMELY, EDUCATION AND BEHAVIORAL HEALTH WERE IDENTIFIED AS COMMUNITY NEEDS BUT THESE ISSUES WERE DEEMED BY THE CBC AND THE COMMUNITY BENEFITS LEADERSHIP TEAM TO BE OUTSIDE OF NEBH'S PRIMARY SPHERE OF INFLUENCE AND HAVE OPTED TO ALLOW OTHERS IN ITS CBSA AND THE COMMONWEALTH TO FOCUS ON THESE ISSUES. THIS IS NOT TO SAY THAT NEBH WILL NOT SUPPORT EFFORTS IN THESE AREAS. NEBH REMAINS OPEN AND WILLING TO WORK WITH HOSPITALS ACROSS BETH ISRAEL LAHEY HEALTH'S NETWORK AND OTHER PUBLIC AND PRIVATE PARTNERS TO ADDRESS THESE ISSUES, PARTICULARLY AS PART OF A BROAD, STRONG COLLABORATIVE.AS NOTED IN DETAIL ABOVE, THE NEBH'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW NEBH CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 4.28% OF NEBH'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, NEBH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT: HTTPS://WWW.NEBH.ORG/WHO-WE-ARE/GIVING-BACK/ 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 NEBH FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSAS REPORTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, NEBH IS A GENERAL MEDICAL AND SURGICAL HOSPITAL AND TEACHING HOSPITAL. AS ALSO PREVIOUSLY NOTED IN THIS FORM 990, NEBH IS NOT LICENSED TO OPERATE AN EMERGENCY DEPARTMENT, HOWEVER, NEBH STILL PROVIDES CARE TO ALL WHO NEED URGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. ALL PATIENTS WHO PRESENT AT NEBH ARE TRIAGED TO THE APPROPRIATE VENUE FOR THEIR CARE DEPENDING UPON THEIR CLINICAL PRESENTATION. A CLINICAL RESOURCE NURSE AND HOSPITALIST COLLABORATE TO IDENTIFY VENUE PRIOR TO THE ARRIVAL OF THE PATIENT IF POSSIBLE. THE HOSPITALIST WILL MAKE A DETERMINATION AS TO THE BEST PATIENT DISPOSITION. CLINICAL SITUATIONS RECEIVED BY PHONE OR WALK-IN REQUIRING EMERGENCY MANAGEMENT ARE DIRECTED TO THE NEAREST EMERGENCY DEPARTMENT, SUCH AS BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) WHICH IS LOCATED APPROXIMATELY ONE MILE FROM NEBH. BIDMC AND NEBH ARE BOTH MEMBER HOSPITALS OF BETH ISRAEL LAHEY HEALTH AND BIDMC IS A TERTIARY CARE ACADEMIC MEDICAL CENTER WHICH OPERATES A LEVEL 1 TRAUMA EMERGENCY DEPARTMENT 24 HOURS A DAY, 7 DAYS A WEEK. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMS
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FINANCIAL ASSISTANCE
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NEBH'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 $1,270,163 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, NEBH 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, NEBH 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, NEBH GENERATED $1,359,117 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY NEBH FOR SUCH SERVICES BY $459,719 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 2.00% OR 2,163 OF NEBH'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 52.00 % OR 56,250 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND NEBH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, NEBH GENERATED $78,726,558 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $10,976,847. OF THESE AMOUNTS, REVENUE OF $3,246,694 IS RELATED TO, AMONG OTHER THINGS, THE PROVISION OF ORTHOPEDIC CARE AND ORTHOPEDIC BRACES TO PATIENTS AT NO COST AND PSYCHIATRIC CARE & COUNSELING, 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 $5,105,705. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH NEBH CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, AND DURING THE FISCAL PERIOD COVERED BY THIS FILING, 50.95% OR 60,329 OF THE HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICARE PATIENTS, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, NEBH HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 6.69%. BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, NEBH 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 $636,402ARE 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.
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FINANCIAL STATEMENT FOOTNOTES
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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 ACCESSAS REPORTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, NEBH IS A GENERAL MEDICAL AND SURGICAL HOSPITAL AND TEACHING HOSPITAL. AS ALSO PREVIOUSLY NOTED IN THIS FORM 990, NEBH IS NOT LICENSED TO OPERATE AN EMERGENCY DEPARTMENT, HOWEVER, NEBH STILL PROVIDES CARE TO ALL WHO NEED URGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. ALL PATIENTS WHO PRESENT AT NEBH ARE TRIAGED TO THE APPROPRIATE VENUE FOR THEIR CARE DEPENDING UPON THEIR CLINICAL PRESENTATION. A CLINICAL RESOURCE NURSE AND HOSPITALIST COLLABORATE TO IDENTIFY VENUE PRIOR TO THE ARRIVAL OF THE PATIENT IF POSSIBLE. THE HOSPITALIST WILL MAKE A DETERMINATION AS TO THE BEST PATIENT DISPOSITION. CLINICAL SITUATIONS RECEIVED BY PHONE OR WALK-IN REQUIRING EMERGENCY MANAGEMENT ARE DIRECTED TO THE NEAREST EMERGENCY DEPARTMENT, SUCH AS BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) WHICH IS LOCATED APPROXIMATELY ONE MILE FROM NEBH. BIDMC AND NEBH ARE BOTH MEMBER HOSPITALS OF BETH ISRAEL LAHEY HEALTH AND BIDMC IS A TERTIARY CARE ACADEMIC MEDICAL CENTER WHICH OPERATES A LEVEL 1 TRAUMA EMERGENCY DEPARTMENT 24 HOURS A DAY, 7 DAYS A WEEK. FINANCIAL ASSISTANCE POLICY INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE NEBH 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 NEBH AS WELL AS PROVIDERS WHO FOLLOW NEBH'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN NEBH AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW NEBH'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. NEBH DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. 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, 2020.FINANCIAL ASSISTANCE POLICY APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.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.
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FINANCIAL ASSISTANCE POLICY TRANSLATIONS
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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: TRADITIONAL CHINESE, SIMPLIFIED CHINESE, KOREAN, AND SPANISH (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://WWW.NEBH.ORG/PATIENTS-CARE-PARTNERS/FINANCIAL-RESOURCES/FINANCIAL-SERVICES-GUIDE/ 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. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE NEBH 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, CHINESE, KOREAN, AND SPANISH, CAN BE FOUND ON THE NEBH WEBSITE AT: HTTPS://WWW.NEBH.ORG/PATIENTS-CARE-PARTNERS/FINANCIAL-RESOURCES/FINANCIAL-SERVICES-GUIDE/ LIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY 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.
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCH
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THE NEBH DIVISION OF RESEARCH SUPPORTS EXISTING RESEARCH GROUPS WITHIN AND OUTSIDE OF THE HOSPITAL IN CLINICAL, TRANSACTIONAL, AND PATIENT-CENTERED RESEARCH, WITH A FOCUS ON THREE KEY AREAS: JOINT REPLACEMENT, OSTEOARTHRITIS, AND SPINE RESEARCH. DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH REPORTED $958,153 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE. DURING FY 2023, THE NEBH DEPARTMENT OF RESEARCH PROVIDED SUPPORT TO RESEARCHERS, INCLUDING ORTHOPAEDIC SURGEONS (ARTHROPLASTY, SPINE, AND SPORTS), PHYSICIANS (INFECTION DISEASE, RADIOLOGY, AND PHYSIATRY), NURSES, AND PHYSICAL THERAPISTS ARE 1) CONSULTATION ON IRB APPLICATION; 2) CONSULTATION ON STUDY DESIGN AND METHODOLOGY; 3) BUILDING DATABASES OR DATA COLLECTION TOOLS; 4) COLLECTION OF STUDY DATA; 5) DATA ANALYSIS; 6) WRITING SCIENTIFIC MANUSCRIPT; 7) JOURNAL AND CONFERENCE SUBMISSIONS; 8) ORGANIZING RESEARCH MEETINGS AND MONITOR PROJECT TIMELINE; 9) MANAGEMENT OF SPONSORED CLINICAL TRIALS; 10) ORGANIZING THE COLLABORATION WITH RESEARCHERS AT OTHER LOCAL RESEARCH AND TEACHING INSTITUTIONS).SPECIFIC RESEARCH PROJECTS AND AREAS OF RESEARCH WERE:A. MARKETSCAN DATABASE RESEARCH SERIES ALSO A COLLABORATION WITH MGH CODMAN FELLOWSHIP PROGRAM: I. HEALTH SERVICES UTILIZATION AND COST IN A VARIETY OF ORTHOPAEDIC SURGERY SETTINGSII. SURGICAL OUTCOMES OF TOTAL JOINT ARTHROPLASTY AND SPINE SURGERIES OF PATIENTS WITH A VARIETY OF PREOPERATIVE DRUG PRESCRIPTIONSIII. TRENDS OF NEW DRUG AND NEW TECHNOLOGY USE AMONG PATIENTS UNDERGOING TOTAL JOINT ARTHROPLASTY AND SPINE SURGERIESIV. COST OF CARE AMONG TOTAL SHOULDER ARTHROPLASTY PATIENTSB. FACTORS AFFECTING ACHIEVEMENT OF SATISFACTORY PATIENT-REPORTED OUTCOMES (PROS) AMONG TOTAL JOINT ARTHROPLASTY PATIENTSC. RARE POSTOPERATIVE COMPLICATIONS (INCL. SCIATIC NERVE PALSY, CORROSION, URINARY RETENTION, ETC.) AMONG TOTAL JOINT ARTHROPLASTY PATIENTSD. USE OF NEW TECHNOLOGY (DIGITAL ALIGNMENT INSTRUMENT, BIOSIMILAR MICROFIBER, PERSONALIZED CAGE, ETC.) IN TOTAL JOINT ARTHROPLASTY AND SPINE SURGERY E. ESTABLISHMENT OF EVIDENCE BASED PRACTICE EDUCATION PROGRAM FOR NURSES AND ITS EFFECTIVENESS. NEW ENGLAND BAPTIST HOSPITAL BIBLIOGRAPHY 2023MANY PHYSICIANS AT NEBH AUTHOR OR CO-AUTHOR ARTICLES AS THE RESEARCH IN WHICH THEY ENGAGE. A LIST OF ARTICLES PUBLISHED DURING THE PERIOD COVERED BY THIS FILING AND RELATED TO RESEARCH EFFORTS ARE LISTED BELOW.1: DISANTIS A, ANDRADE AJ, BAILLOU A, BONIN N, BYRD T, CAMPBELL A, DOMB B, DOYLEH, ENSEKI K, GETZ B, GOSLING L, GRANT L, M ILIZALITURRI V JR, KOHLRIESER D,LASKOVSKI J, LIFSHITZ L, P MCGOVERN R, MONNINGTON K, O'DONNELL J, TAKLA A, TYLERT, VOIGHT M, WUERZ T, MARTIN RL. THE 2022 INTERNATIONAL SOCIETY FOR HIPPRESERVATION (ISHA) PHYSIOTHERAPY AGREEMENT ON ASSESSMENT AND TREATMENT OFGREATER TROCHANTERIC PAIN SYNDROME (GTPS): AN INTERNATIONAL CONSENSUS STATEMENT.J HIP PRESERV SURG. 2023 JAN 2;10(1):48-56. DOI: 10.1093/JHPS/HNAC050. PMID:37275836; PMCID: PMC10234389.2: BONO OJ, JENKIN B, FORLIZZI J, MOUSAD A, LE BRETON S, MACASKILL M, MANDALIAK, MITHOEFER K, RAMAPPA A, ROSS G, SHAH SS. EVIDENCE FOR UTILIZATION OFINJECTABLE BIOLOGIC AUGMENTATION IN PRIMARY ROTATOR CUFF REPAIR: A SYSTEMATICREVIEW OF DATA FROM 2010 TO 2022. ORTHOP J SPORTS MED. 2023 FEB3;11(2):23259671221150037. DOI: 10.1177/23259671221150037. PMID: 36756167;PMCID: PMC9900676.3: PARK DY, UPFILL-BROWN A, CURTIN N, HAMAD CD, SHAH A, KWON B, KIM YH, HEO DH,PARK CW, SHEPPARD WL. CLINICAL OUTCOMES AND COMPLICATIONS AFTER BIPORTALENDOSCOPIC SPINE SURGERY: A COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS OF3673 CASES. EUR SPINE J. 2023 AUG;32(8):2637-2646. DOI:10.1007/S00586-023-07701-9. EPUB 2023 APR 20. PMID: 37079079.4: MANDALIA K, MOUSAD A, WELBORN B, BONO O, LE BRETON S, MACASKILL M, FORLIZZIJ, IVES K, ROSS G, SHAH S. SCAFFOLD- AND GRAFT-BASED BIOLOGICAL AUGMENTATION OFROTATOR CUFF REPAIR: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS OFPRECLINICAL AND CLINICAL STUDIES FOR 2010-2022. J SHOULDER ELBOW SURG. 2023SEP;32(9):1784-1800. DOI: 10.1016/J.JSE.2023.03.031. EPUB 2023 MAY 11. PMID:37178960.5: SUDAH SY, MENENDEZ ME, MOVERMAN MA, PUZZITIELLO RN, LITTLE D, NICHOLSON AD,GARRIGUES GE. THE ROLE OF THE ANTERIOR SHOULDER JOINT CAPSULE IN PRIMARYGLENOHUMERAL OSTEOARTHRITIS. JSES REV REP TECH. 2022 OCT 18;3(1):21-27. DOI:10.1016/J.XRRT.2022.09.005. PMID: 37588061; PMCID: PMC10426523.6: GRANT AR, ABDEEN A, PAGANI NR, SMITH EL. PRODUCT WARRANTIES BY ORTHOPAEDICSURGERY COMPANIES. QUALITY CONTROL OR A NEW FAD? J ORTHOP. 2023 NOV 28;49:62-67.DOI: 10.1016/J.JOR.2023.11.058. PMID: 38090599; PMCID: PMC10711379.7: SIMON SJ, PATELL R, ZWICKER JI, KAZI DS, HOLLENBECK BL. VENOUSTHROMBOEMBOLISM IN TOTAL HIP AND TOTAL KNEE ARTHROPLASTY. JAMA NETW OPEN. 2023DEC 1;6(12):E2345883. DOI: 10.1001/JAMANETWORKOPEN.2023.45883. PMID: 38039005;PMCID: PMC10692868.8: LE BRETON S, FORLIZZI J, BONO O, MACASKILL M, MOUSAD A, KUSH S, O'BRIEN M,CHRISTENSEN A, MITHOEFER K, RAMAPPA A, ROSS G, SHAH SS. LOCAL INTRAOPERATIVEMARROW-DERIVED AUGMENTATION FOR PRIMARY ROTATOR CUFF REPAIR: AN UPDATEDSYSTEMATIC REVIEW AND META-ANALYSIS OF STUDIES FROM 2010 TO 2022. ORTHOP JSPORTS MED. 2023 MAR 28;11(3):23259671221147896. DOI: 10.1177/23259671221147896.PMID: 37009491; PMCID: PMC10061649.9: POLISETTY TS, SWANSON DP, HART PJ, CANNON DJ, GLASS EA, JAWA A, LEVY JC,KIRSCH JM. ANATOMIC AND REVERSE SHOULDER ARTHROPLASTY FOR MANAGEMENT OF TYPE B2AND B3 GLENOIDS: A MATCHED-COHORT ANALYSIS. J SHOULDER ELBOW SURG. 2023AUG;32(8):1629-1637. DOI: 10.1016/J.JSE.2023.02.125. EPUB 2023 MAR 18. PMID:36935078.10: MERZ M, THOMAS A, TALMO C, NANDI S. NO INCREASED RISK OF ASEPTIC LOOSENINGWITH TOURNIQUETLESS CEMENTED TOTAL KNEE ARTHROPLASTY. J SURG ORTHOP ADV. 2023SUMMER;32(2):111-113. PMID: 37668648.11: GOSWAMI K, CLARKSON S, TIPTON C, PHILLIPS CD, DENNIS DA, KLATT BA, O'MALLEYM, SMITH EL, GILILLAND J, PELT CE, PETERS CL, MALKANI AL, PALUMBO BT, LYONS ST,BERNASEK TL, MINTER J, GOYAL N, PURTILL W, MCDONALD JF 3RD, CROSS MB, PRIETO HA,LEE GC, HANSEN EN, BINI SA, WARD DT, ZHAO N, SHOHAT N, HIGUERA CA, NAM D, DELLAVALLE CJ, PARVIZI J; ORTHOPEDIC GENOMICS WORKGROUP. THE MICROBIOME OFOSTEOARTHRITIC HIP AND KNEE JOINTS: A PROSPECTIVE MULTICENTER INVESTIGATION. JBONE JOINT SURG AM. 2023 MAY 16. DOI: 10.2106/JBJS.22.00594. EPUB AHEAD OFPRINT. PMID: 37192280.12: LEROY TE, RUIZ-CARDOZO MA, MOLINA CA. TRANSDURAL VENTRAL SLING TECHNIQUE FORCALCIFIED THORACIC DISK HERNIATIONS. WORLD NEUROSURG. 2023 DEC 15;183:123-127.DOI: 10.1016/J.WNEU.2023.12.074. EPUB AHEAD OF PRINT. PMID: 38104932.13: LEROY TE, SMITH IC, KIM DH, GOLENBOCK SW, BAKER KC, ARNOLD PM, SASSO RC,PARK DK, FISCHGRUND JS, ZAIDI QH, HWANG RW. CLINICAL SIGNIFICANCE OF LATERALPEDICLE SCREW MALPOSITION IN LUMBAR SPINE FUSION. CLIN SPINE SURG. 2023 JUL1;36(6):E258-E262. DOI: 10.1097/BSD.0000000000001440. EPUB 2023 FEB 22. PMID:36823702.14: SWANSON DR 3RD, PURCELL KF. WHAT'S IMPORTANT: HAVING FRIENDS WHO DON'T LOOKLIKE YOU. J BONE JOINT SURG AM. 2024 JAN 17;106(2):169-170. DOI:10.2106/JBJS.23.00452. EPUB 2023 JUL 27. PMID: 37498996.15: HOFFMAN M, LANZA J, SIMON SJ, SCHOELLER L, FANG C, CODEN G, HOLLENBECK B.RISK FACTORS FOR SURGICAL SITE COMPLICATIONS AFTER OUTPATIENT LUMBAR SPINESURGERY. SURG INFECT (LARCHMT). 2023 AUG;24(6):527-533. DOI:10.1089/SUR.2023.040. EPUB 2023 JUL 12. PMID: 37437125.16: SULLIVAN KJ, NEMEC SM, MAHENDRARAJ KA, SWANSON DP, SAINI SS, MILLER SL. DOOUTCOMES DIFFER AFTER PROXIMAL HAMSTRING REPAIR FOR PATIENTS RECEIVING WORKERS'COMPENSATION? ORTHOP J SPORTS MED. 2023 MAY 2;11(5):23259671231165528. DOI:10.1177/23259671231165528. PMID: 37152550; PMCID: PMC10159255.
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCH
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17: GUTMAN MJ, KOHAN EM, HENDY BA, JOYCE CD, KIRSCH JM, SINGH A, SHERMAN M,AUSTIN LS, NAMDARI S, WILLIAMS GR JR. FACTORS ASSOCIATED WITH FUNCTIONALIMPROVEMENT AFTER POSTERIORLY AUGMENTED TOTAL SHOULDER ARTHROPLASTY. J SHOULDERELBOW SURG. 2023 JUN;32(6):1231-1241. DOI: 10.1016/J.JSE.2022.12.004. EPUB 2023JAN 4. PMID: 36610476.18: BABABEKOV YJ, CHEN YW, UDELSMAN BV, CAMER SJ, RAND FF, CHANG DC. UNEXPECTEDSUCCESSES: CAN WE IDENTIFY POSITIVE DEVIANCE IN SURGERY? ANN SURG OPEN. 2023 JAN12;4(1):E233. DOI: 10.1097/AS9.0000000000000233. PMID: 37600894; PMCID:PMC10431339.19: CODEN G, GREENWELL P, NIU R, FANG C, TALMO C, SMITH EL. ENERGY EXPENDITUREOF FEMORAL BROACHING IN DIRECT ANTERIOR TOTAL HIP REPLACEMENTS-COMPARISONBETWEEN MANUAL AND AUTOMATED TECHNIQUES. INT J MED ROBOT. 2023 NOV 20:E2592.DOI: 10.1002/RCS.2592. EPUB AHEAD OF PRINT. PMID: 37985232.20: SUN DC, MURPHY WS, AMUNDSON AJ, LANE PM, KOWAL JH, MURPHY SB. VALIDATION OFA NOVEL METHOD OF MEASURING CUP ORIENTATION USING BIPLANAR SIMULTANEOUSRADIOGRAPHIC IMAGES. J ARTHROPLASTY. 2023 JUL;38(7S):S252-S256. DOI:10.1016/J.ARTH.2023.04.011. EPUB 2023 APR 17. PMID: 37075906.21: ASES COMPLICATIONS OF RSA RESEARCH GROUP; LOHRE R, SWANSON DP, MAHENDRARAJKA, ELMALLAH R, GLASS EA, DUNN WR, CANNON DJ, FRIEDMAN LGM, GAUDETTE JA, GREENJ, GROBATY L, GUTMAN M, KAKALECIK J, KLOBY MA, KONRADE EN, KNACK MC, LOVELAND A,MATHEW JI, MYHRE L, NYFELER J, PARSELL DE, PAZIK M, POLISETTY TS, PONNURU P,SMITH KM, SPRENGEL KA, THAKAR O, TURNBULL L, VAUGHAN A, WHEELWRIGHT JC, ABBOUDJ, ARMSTRONG A, AUSTIN L, BROLIN T, ENTEZARI V, GARRIGUES GE, GRAWE B, GULOTTALV, HOBGOOD R, HORNEFF JG, IANNOTTI J, KHAZZAM M, KING JJ, KIRSCH JM, LEVY JC,MURTHI A, NAMDARI S, NICHOLSON GP, OTTO RJ, RICCHETTI ET, TASHJIAN R,THROCKMORTON T, WRIGHT T, JAWA A. PREDICTORS OF DISLOCATIONS AFTER REVERSESHOULDER ARTHROPLASTY: A STUDY BY THE ASES COMPLICATIONS OF RSA MULTICENTERRESEARCH GROUP. J SHOULDER ELBOW SURG. 2024 JAN;33(1):73-81. DOI:10.1016/J.JSE.2023.05.028. EPUB 2023 JUN 26. PMID: 37379964.22: AVANT-GARDE HEALTH AND CODMAN SHOULDER SOCIETY VALUE-BASED CARE GROUP;;O'DONNELL EA, BEST MJ, SIMON JE, LIU H, ZHANG X, ARMSTRONG AD, WARNER JJP, KHANAZ, FEDORKA CJ, GOTTSCHALK MB, KIRSCH J, COSTOUROS JG, FARES MY, BECK DA SILVAETGES AP, SRIKUMARAN U, WAGNER ER, JONES P, HAAS DA, ABBOUD JA. TRENDS ANDOUTCOMES OF OUTPATIENT TOTAL SHOULDER ARTHROPLASTY AFTER ITS REMOVAL FROM CMS'SINPATIENT-ONLY LIST. J SHOULDER ELBOW SURG. 2023 AUG 23:S1058-2746(23)00602-X.DOI: 10.1016/J.JSE.2023.07.019. EPUB AHEAD OF PRINT. PMID: 37625696.23: SUDAH S, MENENDEZ M, JAWA A, LEVY J, DENARD P. WIDE GEOGRAPHIC VARIATION INRESOURCE UTILIZATION AFTER SHOULDER ARTHROPLASTY. ORTHOP REV (PAVIA). 2023 FEB21;15:38653. DOI: 10.52965/001C.38653. PMID: 36843859; PMCID: PMC9946799.24: GRANT AR, ZVI YS, MICHALOWSKI AK, MATTINGLY DA, SMITH EL. THE RELATIVEIMPORTANCE OF FACTORS THAT APPLICANTS WEIGH WHEN RANKING ADULT RECONSTRUCTIONFELLOWSHIPS AS WELL AS THEIR PERSPECTIVES ON ROBOTIC-ASSISTED ARTHROPLASTY. JARTHROPLASTY. 2023 DEC 14:S0883-5403(23)01208-1. DOI:10.1016/J.ARTH.2023.12.016. EPUB AHEAD OF PRINT. PMID: 38103804.25: NIN DZ, CHEN YW, TALMO CT, HOLLENBECK BL, NIU R, CHANG DC, SMITH EL,MATTINGLY D. ARTHROSCOPIC PROCEDURES ARE PERFORMED IN 5% OF PATIENTS WITH KNEEOSTEOARTHRITIS 1 YEAR PRECEDING TOTAL KNEE ARTHROPLASTY AND ARE ASSOCIATED WITHINCREASED STIFFNESS AND INCREASED COSTS. ARTHROSC SPORTS MED REHABIL. 2023 AUG19;5(6):100776. DOI: 10.1016/J.ASMR.2023.100776. PMID: 38155763; PMCID:PMC10753171.26: HWANG RW, BRIGGS CM, GREENWALD SD, MANBERG PJ, CHAMOUN NG, TROMANHAUSER SG.SURGICAL TREATMENT OF SINGLE-LEVEL LUMBAR STENOSIS IS ASSOCIATED WITH LOWER2-YEAR MORTALITY AND TOTAL COST COMPARED WITH NONSURGICAL TREATMENT: A RISK-ADJUSTED, PAIRED ANALYSIS. J BONE JOINT SURG AM. 2023 FEB 1;105(3):214-222. DOI:10.2106/JBJS.22.00181. EPUB 2023 JAN 12. PMID: 36723465.27: HAYES-LATTIN M, SYLVIA SM, BRAGG JT, PUZZITIELLO RN, RICHMOND JC, SALZLERMJ. SUBJECTIVE OUTCOMES AFTER ALLOGRAFT RECONSTRUCTION AND NONOPERATIVETREATMENT OF ANTERIOR CRUCIATE LIGAMENT RUPTURES ARE SIMILAR IN PATIENTS AGED 40YEARS AND OLDER: A 2:1 PROPENSITY SCORE-MATCHED ANALYSIS. ARTHROSC SPORTS MEDREHABIL. 2023 APR 19;5(3):E657-E662. DOI: 10.1016/J.ASMR.2023.03.005. PMID:37388898; PMCID: PMC10300546.28: MANDALIA K, EFREMOV K, CHARUBHUMI V, NIN D, NIU R, LE BRETON S, CHANG D,IVES K, SMITH E, ROSS G, SHAH S. INCIDENCE OF PRIMARY ANATOMIC AND REVERSE TOTALSHOULDER ARTHROPLASTY IN PATIENTS LESS THAN 50 YEARS OF AGE AND HIGH EARLYREVISION RISK. J SHOULDER ELBOW SURG. 2023 SEP;32(9):1901-1908. DOI:10.1016/J.JSE.2023.01.040. EPUB 2023 MAR 2. PMID: 36868301.29: PUZZITIELLO RN, SYLVIA SM, PERRONE GS, BRAGG JT, RICHMOND JC, SALZLER MJ.PREOPERATIVE FACTORS ASSOCIATED WITH FAILURE TO REACH THE PATIENT ACCEPTABLESYMPTOM STATE AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN PATIENTS AGED40 AND OLDER. KNEE SURG SPORTS TRAUMATOL ARTHROSC. 2023 AUG;31(8):3204-3211.DOI: 10.1007/S00167-023-07334-X. EPUB 2023 FEB 22. PMID: 36811656.30: SIMON SJ, SATER M, HERRIOTT I, HUNTLEY M, BRIARS E, HOLLENBECK BL.<I>STAPHYLOCOCCUS EPIDERMIDIS</I> JOINT ISOLATES: WHOLE-GENOME SEQUENCINGDEMONSTRATES EVIDENCE OF HOSPITAL TRANSMISSION AND COMMON ANTIMICROBIALRESISTANCE. INFECT CONTROL HOSP EPIDEMIOL. 2024 FEB;45(2):150-156. DOI:10.1017/ICE.2023.253. EPUB 2023 DEC 15. PMID: 38099465.31: TESTA EJ, GLASS E, AMES A, SWANSON DP, POLISETTY TS, CANNON DJ, LE K, BOWLERA, LEVY JC, JAWA A, KIRSCH JM. INDICATION MATTERS: EFFECT OF INDICATION ONCLINICAL OUTCOME FOLLOWING REVERSE TOTAL SHOULDER ARTHROPLASTY-A MULTICENTERSTUDY. J SHOULDER ELBOW SURG. 2023 NOV 7:S1058-2746(23)00778-4. DOI:10.1016/J.JSE.2023.09.033. EPUB AHEAD OF PRINT. PMID: 37944747.32: BEST MJ, FEDORKA CJ, HAAS DA, ZHANG X, KHAN AZ, ARMSTRONG AD, ABBOUD JA,JAWA A, O'DONNELL EA, BELNIAK RM, SIMON JE, WAGNER ER, MALIK M, GOTTSCHALK MB,UPDEGROVE GF, WARNER JJP, SRIKUMARAN U; AVANT-GARDE HEALTH AND CODMAN SHOULDERSOCIETY VALUE BASED CARE GROUP. HIGHER SURGEON VOLUME IS ASSOCIATED WITH A LOWERRATE OF SUBSEQUENT REVISION PROCEDURES AFTER TOTAL SHOULDER ARTHROPLASTY: ANATIONAL ANALYSIS. CLIN ORTHOP RELAT RES. 2023 AUG 1;481(8):1572-1580. DOI:10.1097/CORR.0000000000002605. EPUB 2023 FEB 28. PMID: 36853863; PMCID:PMC10344546.33: CODEN G, BARTASHEVSKYY M, BERLINER Z, NIU R, FRECCERO D, BONO J, ABDEEN A,SMITH EL. MODULAR KNEE ARTHRODESIS AS DEFINITIVE TREATMENT FOR PERIPROSTHETICINFECTION, BONE LOSS, AND FAILURE OF THE EXTENSOR MECHANISM AFTER TOTAL KNEEARTHROPLASTY. ARTHROPLAST TODAY. 2023 DEC 29;25:101261. DOI:10.1016/J.ARTD.2023.101261. PMID: 38269067; PMCID: PMC10805633.34: POWERS AY, NIN DZ, CHEN YW, NIU R, KIM DH, CHANG DC, HWANG RW. ANTERIORCERVICAL DISCECTOMY AND FUSION WITH STRUCTURAL ALLOGRAFT IS ASSOCIATED WITHLOWER POSTOPERATIVE HEALTH CARE UTILIZATION AND REOPERATIONS COMPARED WITH CAGEIMPLANTS. OPER NEUROSURG (HAGERSTOWN). 2024 JAN 1;26(1):16-21. DOI:10.1227/ONS.0000000000000900. EPUB 2023 SEP 14. PMID: 37707420.35: BUCKLAND AJ, BRALY BA, O'MALLEY NA, ASHAYERI K, PROTOPSALTIS TS, KWON B,CHENG I, THOMAS JA. LATERAL DECUBITUS SINGLE POSITION ANTERIOR POSTERIOR SURGERYIMPROVES OPERATIVE EFFICIENCY, IMPROVES PERIOPERATIVE OUTCOMES, AND MAINTAINSRADIOLOGICAL OUTCOMES COMPARABLE WITH TRADITIONAL ANTERIOR POSTERIOR FUSION ATMINIMUM 2-YEAR FOLLOW-UP. SPINE J. 2023 MAY;23(5):685-694. DOI:10.1016/J.SPINEE.2023.01.001. EPUB 2023 JAN 12. PMID: 36641035.36: ALLEN AE, SAKHEIM ME, MAHENDRARAJ KA, NEMEC SM, NHO SJ, MATHER RC 3RD, WUERZTH. TIME-DRIVEN ACTIVITY-BASED COSTING ANALYSIS IDENTIFIES USE OF CONSUMABLESAND OPERATING ROOM TIME AS FACTORS ASSOCIATED WITH INCREASED COST OF OUTPATIENTPRIMARY HIP ARTHROSCOPIC LABRAL REPAIR. ARTHROSCOPY. 2023 NOV17:S0749-8063(23)00934-9. DOI: 10.1016/J.ARTHRO.2023.10.050. EPUB AHEAD OFPRINT. PMID: 37977413.
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37: ASES COMPLICATIONS OF RSA RESEARCH GROUP;
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37: ASES COMPLICATIONS OF RSA RESEARCH GROUP; LOHRE R, SWANSON DP, MAHENDRARAJKA, ELMALLAH R, GLASS EA, DUNN WR, CANNON DJ, FRIEDMAN LG, GAUDETTE JA, GREEN J,GROBATY L, GUTMAN M, KAKALECIK J, KLOBY MA, KONRADE EN, KNACK MC, LOVELAND A,MATHEW JI, MYHRE L, NYFELER J, PARSELL DE, PAZIK M, POLISETTY TS, PONNURU P,SMITH KM, SPRENGEL KA, THAKAR O, TURNBULL L, VAUGHAN A, WHEELWRIGHT JC, ABBOUDJ, ARMSTRONG A, AUSTIN L, BROLIN T, ENTEZARI V, GARRIGUES GE, GRAWE B, GULOTTALV, HOBGOOD R, HORNEFF JG, IANNOTTI J, KHAZZAM M, KING JJ, KIRSCH JM, LEVY JC,MURTHI A, NAMDARI S, NICHOLSON GP, OTTO RJ, RICCHETTI ET, TASHJIAN R,THROCKMORTON T, WRIGHT T, JAWA A. RISK FACTORS OF ACROMIAL AND SCAPULAR SPINESTRESS FRACTURES DIFFER BY INDICATION: A STUDY BY THE ASES COMPLICATIONS OFREVERSE SHOULDER ARTHROPLASTY MULTICENTER RESEARCH GROUP. J SHOULDER ELBOW SURG.2023 DEC;32(12):2483-2492. DOI: 10.1016/J.JSE.2023.05.015. EPUB 2023 JUN 15.PMID: 37330167.38: BROEKMAN MM, BRINKMAN N, SWANSON D, RING D, VAN DEN BEKEROM M, JAWA A.VARIATIONS IN 1-YEAR TRAJECTORIES OF LEVELS OF PAIN AND CAPABILITY AFTERSHOULDER ARTHROPLASTY ARE ASSOCIATED WITH BASELINE MENTAL HEALTH. CLIN ORTHOPRELAT RES. 2024 MAR 1;482(3):514-522. DOI: 10.1097/CORR.0000000000002821. EPUB2023 SEP 7. PMID: 37678387; PMCID: PMC10871746.FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION NEW ENGLAND BAPTIST HOSPITAL'S (NEBH) CENTRAL LONGSTANDING ACADEMIC FOCUS IN ORTHOPEDIC MEDICAL EDUCATION, AND A COMMITMENT TO TEACHING STUDENTS AND TRAINEES IN A RESPECTFUL AND COLLABORATIVE ACADEMIC ENVIRONMENT. THIS COMMITMENT, COUPLED WITH THE INSTITUTION'S WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION, MAKES NEBH A TOP CHOICE AMONG STUDENTS AND TRAINEES IN THE HEALTHCARE PROFESSIONS. THE HOSPITAL TRAINS MEDICAL RESIDENTS AND FELLOWS.NEBH IS A TEACHING HOSPITAL, WITH APPROXIMATELY 19 ORTHOPEDIC AND RADIOLOGY INTERNS WHO ROTATE THROUGHOUT THE YEAR FROM MULTIPLE INSTITUTIONS, AND 3 SPORTS FELLOWS DURING THE ACADEMIC YEAR JULY 1, 2022 JUNE 30, 2023, WHICH OVERLAPS WITH A PORTION OF NEBH'S FISCAL YEAR ACTIVITIES REPORTED IN THIS FILING. DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH HAD NET EXPENDITURES OF $875,866 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO NEBH'S TRAINING RESIDENTS AND FELLOWS. IN ADDITION, AS NOTED THROUGHOUT THIS FORM 990, NEBH IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. IN ADDITION TO NEBH ENGAGING HEALTH PROFESSIONS EDUCATION / GRADUATE MEDICAL EDUCATION, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC HOSPITAL AND MOUNT AUBURN HOSPITAL, WHICH ARE ALL SISTER ENTITIES TO NEBH, 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 ONLY THE EDUCATIONAL ACTIVITIES OF NEBH ARE QUANTIFIED IN NEBH'S FORM 990 SCHEDULE H, PART I, 7F, THESE OTHER EDUCATIONAL ARE ALSO IMPORTANT TO THE COMMUNITIES SERVED BY NEBH AND BEYOND. ADDITIONAL INFORMATION ON THE TEACHING ACTIVITIES AT BIDMC 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. 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
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FELLOWSHIP PROGRAMS
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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. 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.
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JUNIOR AND SENIOR RESIDENCY
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RESIDENCY 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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PATHOLOGY EDUCATION AT BIDMC
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THE 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.
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OUR UNIQUE EDUCATIONAL TRACKS
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CURRENTLY, 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.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, NEBH 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.
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BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES FISCAL YEAR ENDED SEPTEMBER 30
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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 NEBH AND AS NOTED THROUGHOUT THIS FILING, NEBH 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. 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.
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ADDICTION SERVICES
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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. 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.