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FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION
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FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSLAHEY CLINIC HOSPITAL, INC. AFFILIATIONTHE LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC) IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BILH IS A PURPOSE-DRIVEN, VALUES-BASED ORGANIZATION THAT UNITES 38,000 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 AND ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,800 PHYSICIANS AND 38,000 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.LAHEY CLINIC HOSPITAL COMMUNITY BENEFITS MISSION STATEMENT AT LAHEY CLINIC HOSPITAL OUR MISSION GUIDES THE HOSPITAL TOWARD SUCCESS. LAHEY CLINIC HOSPITAL IS COMMITTED TO PROVIDING SUPERIOR HEALTH CARE LEADING TO THE BEST POSSIBLE OUTCOMES FOR EVERY PATIENT, EXCEEDING OUR PATIENTS' HIGH EXPECTATIONS FOR SERVICE EACH DAY, ADVANCING MEDICINE THROUGH RESEARCH AND THE EDUCATION OF TOMORROW'S HEALTH CARE LEADERS, AND PROMOTING HEALTH AND WELLNESS IN PARTNERSHIP WITH THE DIVERSE COMMUNITIES IT SERVES. LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS MISSION IS FULFILLED BY:- INVOLVING LAHEY CLINIC HOSPITAL STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE HOSPITAL'S THREE-YEAR IMPLEMENTATION STRATEGY;- ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES;- ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED NEEDS AND IDENTIFY COMMUNITIES AND POPULATION SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, ECONOMIC AND SYSTEMIC FACTORS;- IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN LAHEY CLINIC HOSPITAL'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED;- PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND- FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, LAHEY CLINIC HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $2,642,687 REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE LAHEY CLINIC HOSPITAL'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS CBSA AND BEYOND. LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF LAHEY CLINIC HOSPITAL'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF THE LAHEY CLINIC HOSPITAL'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. LAHEY CLINIC HOSPITAL COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE REGIONAL MANAGER OF COMMUNITY BENEFITS. THE REGIONAL MANAGER OF COMMUNITY BENEFITS HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE LAHEY CLINIC HOSPITAL PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, THE LATTER OF WHOM REPORTS DIRECTLY TO THE BILH CHIEF DIVERSITY, EQUITY AND INCLUSION OFFICER. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE LAHEY CLINIC HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH LAHEY CLINIC HOSPITAL'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS MISSION. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF LAHEY CLINIC HOSPITAL'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY LAHEY CLINIC HOSPITAL'S PROGRAMMATIC ENDEAVORS, INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. LAHEY CLINIC HOSPITAL'S CBAC MEMBERS INCLUDE:- SUSAN MOFFATT-BRUCE, MD, PHD, PRESIDENT, LAHEY HOSPITAL & MEDICAL CENTER- TIM LIESCHING, MD, CHIEF MEDICAL OFFICER, LAHEY HOSPITAL & MEDICAL CENTER- JEAN BUSHNELL, DIRECTOR, BILLERICA COUNCIL ON AGING - SHARON CAMERON, DIRECTOR OF HEALTH AND HUMAN SERVICES, CITY OF PEABODY - STEPHANIE CRONIN, EXECUTIVE DIRECTOR, MIDDLESEX 3 COALITION - RANDI EPSTEIN, COORDINATOR, COMMUNITY HEALTH NETWORK AREA 15 - GREG SCHMERGEL, LAHEY HOSPITAL & MEDICAL CENTER BOARD OF TRUSTEES - CHRISTINE HEALEY, DIRECTOR, COMMUNITY RELATIONS, BETH ISRAEL LAHEY HEALTH - RYAN RIBERIO-RODRIGUEZ, VICE PRESIDENT OPERATIONS, NORTH SHORE COMMUNITY HEALTH - ROSEMARIE DESOUSA, BURLINGTON PUBLIC SCHOOLS - KELLY MAGEE WRIGHT, EXECUTIVE DIRECTOR, MINUTEMAN SENIOR SERVICES - ELVIRA OMEROVIC, DIRECTOR, SITE OPERATIONS, BETH ISRAEL LAHEY HEALTH PRIMARY CARE - RICK PARKER, EXECUTIVE DIRECTOR, BURLINGTON RESIDENT - MICHELLE SNYDER, REGIONAL MANAGER, COMMUNITY RELATIONS, LAHEY HOSPITAL & MEDICAL CENTER- ERICA SCHWARTZ, EXECUTIVE DIRECTOR, HOUSING CORPORATION OF ARLINGTONCOMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMEN TINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED.
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LAHEY CLINIC HOSPITAL COMPLETED ITS MOST RECENT NEEDS ASSESSMENT
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IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE LAHEY CLINIC HOSPITAL BOARD OF TRUSTEES ON SEPTEMBER 12, 2022. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 12, 2022, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS) REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF LAHEY CLINIC HOSPITAL'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT LAHEY CLINIC HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW LAHEY CLINIC HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, LAHEY CLINIC HOSPITAL COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF LAHEY CLINIC HOSPITAL'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES ARLINGTON, BEDFORD, BILLERICA, BURLINGTON, DANVERS, LEXINGTON, LOWELL, LYNNFIELD, AND PEABODY.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF ARLINGTON, BEDFORD, BILLERICA, BURLINGTON, DANVERS, LEXINGTON, LOWELL, LYNNFIELD, PEABODY IN ITS CBSA, AS FOLLOWS:- YOUTH- LOW-RESOURCED POPULATIONS- OLDER ADULTS- RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS- LESBIAN, GAY, BISEXUAL, TRANSGENDER, QUEER OR QUESTIONING, INTERSEX, ASEXUAL (LGBTQIA+) INDIVIDUALS2022 COMMUNITY HEALTH NEEDS ASSESSMENT SUMMARY OF APPROACH AND METHODSLAHEY CLINIC HOSPITAL'S 2022 CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING LAHEY CLINIC HOSPITAL'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. LAHEY CLINIC HOSPITAL'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, LAHEY CLINIC HOSPITAL CONDUCTED 20 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED FOUR FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES (INCLUDING ONE FOCUS GROUP IN COLLABORATION WITH NORTHEAST HOSPITAL CORPORATION), ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 900 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 1,000 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY PARTNERS.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS DETAIL OF APPROACH AND METHODSLAHEY CLINIC HOSPITAL RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. LAHEY CLINIC HOSPITAL COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT LAHEY CLINIC HOSPITAL LEVERAGED INCLUDED:- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020)- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020)- U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021)- BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, 2019- MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021)- FBI UNIFORM CRIME REPORTS (2019)- MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021)- MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019)- MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020)- MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018)- ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, LAHEY CLINIC HOSPITAL CONDUCTED 20 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT LAHEY CLINIC HOSPITAL'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON LAHEY CLINIC HOSPITAL'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN LAHEY CLINIC HOSPITAL'S CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)LAHEY CLINIC HOSPITAL CONDUCTED FOUR COMMUNITY FOCUS GROUPS, AND HELD FOUR COMMUNITY LISTENING SESSIONS THAT ENGAGED APPROXIMATELY 100 RESIDENTS IN LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH COMMUNITY ORGANIZATIONS INCLUDING THE RAINBOW COALITION IN ARLINGTON, DANVERS CARES, SAHELI AND IGREJA COMUNIDADE DE CRISTO.LAHEY CLINIC HOSPITAL HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF LAHEY CLINIC HOSPITAL'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, PRINT ADVERTISEMENTS, DIGITAL ADVERTISEMENTS, AUDIO ADVERTISEMENTS ACROSS MULTIPLE PLATFORMS, PUBLIC SCHOOLS, PLACES OF WORSHIP, AND RECREATIONAL CENTERS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA.
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THE LAHEY CLINIC HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC)
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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. 2022 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 LAHEY CLINIC HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS.- IDENTIFY LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES.- ANALYZE LAHEY CLINIC HOSPITAL'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY LAHEY CLINIC HOSPITAL DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018).- DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021).2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2022, WERE:- YOUTH- LOW-RESOURCED POPULATIONS- OLDER ADULTS- RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS- LESBIAN, GAY, BISEXUAL, TRANSGENDER, QUEER OR QUESTIONING, INTERSEX, ASEXUAL (LGBTQIA+) INDIVIDUALSLAHEY CLINIC HOSPITAL'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.- SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY.- HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS).- HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM LAHEY CLINIC HOSPITAL'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 AVAILABLELAHEY CLINIC HOSPITAL STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, LAHEY CLINIC HOSPITAL COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE LAHEY CLINIC HOSPITAL WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/LAHEY-PROMISE/IN-THE-COMMUNITY/HEALTH-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION-STRATEGIES/ IN ADDITION TO THE CHNA, LAHEY CLINIC HOSPITAL COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE LAHEY CLINIC HOSPITAL WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/LAHEY-PROMISE/IN-THE-COMMUNITY/HEALTH-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION-STRATEGIES/ LAHEY CLINIC HOSPITAL COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE LAHEY CLINIC HOSPITAL WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/LAHEY-PROMISE/IN-THE-COMMUNITY/HEALTH-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION-STRATEGIES/ FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING LAHEY CLINIC HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE LAHEY CLINIC HOSPITAL WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/LAHEY-PROMISE/IN-THE-COMMUNITY/HEALTH-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION-STRATEGIES/ EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENT ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, LAHEY CLINIC HOSPITAL'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND A SUMMARY OF LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THAT CHNA AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, LAHEY CLINIC HOSPITAL HAS BEEN STRATEGIC IN IDENTIFYING ITS PRIORITY AREAS IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: EQUITABLE ACCESS TO CARE - GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC, AND ECONOMIC BARRIERS.
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PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH
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- GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY OF LIFE.PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE- GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE. PRIORITY AREA 4: CHRONIC AND COMPLEX CONDITIONS- GOAL: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/ OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES. COMMUNITY HEALTH NEEDS ASSESSMENT APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)LAHEY CLINIC HOSPITAL RECOGNIZES THAT AUTHENTIC COMMUNITY ENGAGEMENT IS CRITICAL TO ASSESSING COMMUNITY NEEDS, IDENTIFYING HEALTH PRIORITIES AND POPULATIONS OF FOCUS, AND CREATING A ROBUST IMPLEMENTATION STRATEGY. THE HOSPITAL WAS COMMITTED TO ENGAGING THE COMMUNITY THROUGHOUT THIS PROCESS. USING THE COMMUNITY ENGAGEMENT CONTINUUM INCLUDED IN MDPH'S COMMUNITY ENGAGEMENT STANDARDS FOR COMMUNITY HEALTH PLANNING AS A GUIDE, LAHEY CLINIC HOSPITAL EMPLOYED A VARIETY OF APPROACHES TO ENSURE THAT COMMUNITY MEMBERS WERE INFORMED, CONSULTED, AND INVOLVED THROUGHOUT THE ASSESSMENT PROCESS, AND THAT THEY WERE COLLABORATORS IN ENSURING THAT THE IMPLEMENTATION STRATEGY ADDRESSED PRIORITY ISSUES AND VULNERABLE POPULATIONS.LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS PREDICATED ON THE NOTION OF PARTNERSHIP AND DIALOGUE WITH ITS MANY COMMUNITIES. LAHEY CLINIC HOSPITAL'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM DISCUSSIONS WITH AND OBSERVATIONS BY HEALTH CARE AND HEALTH-RELATED WORKERS IN THE NEIGHBORHOODS AS WELL AS MORE FORMAL ASSESSMENTS THROUGH AVAILABLE PUBLIC HEALTH DATA, FOCUS GROUPS, SURVEYS, ETC. THIS DATA WAS THEN AUGMENTED BY DEMOGRAPHIC AND HEALTH STATUS INFORMATION GLEANED FROM A VARIETY OF SOURCES, INCLUDING THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, THE BOSTON PUBLIC HEALTH COMMISSION, FEDERAL RESOURCES SUCH AS THE INSTITUTE OF MEDICINE AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND REVIEW OF LITERATURE RELEVANT TO A PARTICULAR COMMUNITY'S NEEDS.THE ARTICULATION OF EACH SPECIFIC COMMUNITY'S NEEDS (DONE IN PARTNERSHIP BETWEEN LAHEY CLINIC HOSPITAL AND COMMUNITY PARTNERS) IS USED TO INFORM LAHEY CLINIC HOSPITAL'S DECISION-MAKING ABOUT PRIORITIES FOR ITS COMMUNITY BENEFITS EFFORTS. LAHEY CLINIC HOSPITAL WORKS IN CONCERT WITH COMMUNITY RESIDENTS AND LEADERS TO DESIGN SPECIFIC ACTIONS TO BE UNDERTAKEN EACH YEAR.A FULL UPDATE ON LAHEY CLINIC HOSPITAL'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.FY22 SCHEDULE H IMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: EQUITABLE ACCESS TO CAREINDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL AND STEMMED FROM THE WAY IN WHICH THE SYSTEM DID OR DID NOT FUNCTION. SYSTEM-LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTH CARE SYSTEM THAT WAS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL-LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FORGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC, AND ECONOMIC BARRIERS.TARGET POPULATION: LOW-RESOURCE INDIVIDUALS AND FAMILIES, OLDER ADULTS, YOUTH/ADOLESCENTS, RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS, AND LGTBQIA+ POPULATIONSSTRATEGIES1. PROVIDE AND PROMOTE CAREER SUPPORT SERVICES AND CAREER MOBILITY PROGRAMS TO HOSPITAL EMPLOYEES AND ENCOURAGE LOCALLY-FOCUSED RECRUITMENT AND RETENTION.2. PROMOTE EQUITABLE CARE, HEALTH LITERACY, AND CULTURAL HUMILITY FOR PATIENTS, ESPECIALLY THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS.3. PROMOTE ACCESS TO HEALTH CARE, HEALTH INSURANCE, AND PATIENT FINANCIAL COUNSELORS FOR PATIENTS AND COMMUNITY MEMBERS WHO ARE UNINSURED OR UNDERINSURED.INITIATIVES TO ADDRESS THE PRIORITY- CAREER AND ACADEMIC ADVISING- HOSPITAL-SPONSORED ENGLISH SPEAKERS OF OTHER LANGUAGE (ESOL) CLASSES- DIVERSE TALENT PROMOTION AND ACQUISITION- INTERPRETER SERVICES- LOWELL COMMUNITY HEALTH CENTER KEYS TO HEALTH EQUITY PROJECT: LANGUAGE SUPPORTS- LAHEY CLINIC HOSPITAL DIVERSITY, EQUITY, AND INCLUSION COMMITTEE- PATIENT FINANCIAL COUNSELING- SERVING THE HEALTH INSURANCE NEEDS OF EVERYONE (SHINE) PROGRAM- PRIMARY CARE SUPPORT- PEABODY HIGH SCHOOL STUDENT-BASED HEALTH CENTER- PROVIDE COMMUNITY GRANTS TO SUPPORT NEED- EXPLORE WAYS TO ENHANCE CARE NAVIGATION WITHIN THE COMMUNITYMETRICS AND STATUS UPDATES- IN FY 23 LAHEY CLINIC HOSPITAL SCREENED 17,871 PATIENTS FOR INSURANCE ELIGIBILITY OF WHICH 2,103 WERE APPROVED FOR AN ENTITLEMENT PROGRAM. THE NUMBER OF PATIENTS WITH HEALTH SAFETY NET (HSN) SERVED AT LAHEY CLINIC HOSPITAL WERE 2,749- IN FY 23, LAHEY CLINIC HOSPITAL PROVIDED INTERPRETATION SERVICES TO 101,449 WITH THE FOLLOWING TOP 3 LANGUAGES: SPANISH, PORTUGUESE-BRAZILIAN, CHINESE-MANDARIN- IN FY 23, THE LOWELL COMMUNITY HEALTH CENTER PROVIDED 176,347 SESSIONS OF INTERPRETATIONS (IN-HOUSE INTERPRETERS = 71,779; EXTERNAL LANGUAGE LINE = 104,568) TO 17,000 PATIENTS. - ACROSS BILH THERE WAS A 25% INCREASE IN BLACK, INDIGENOUS PEOPLE OF COLOR (BIPOC) LEADERSHIP (DIRECTORS AND ABOVE) AND CLINICAL (PHYSICIANS AND NURSES) HIRES OVER FY22. - MORE THAN $50 MILLION WAS CONTRACTED TO WOMEN AND MINORITY-OWNED BUSINESS ENTERPRISES (WMBE) IN FY23. THIS IS A 22% INCREASE OVER FY22. - 8 SYSTEM-WIDE DEI TRAININGS WERE CONDUCTED FOR ALL BILH STAFF AND HOSPITALS. - LAHEY CLINIC HOSPITAL IS FORMING A DIVERSITY, EQUITY AND INCLUSION COUNCIL TO GUIDE THE HOSPITAL'S EFFORTS TO NURTURE AND SUSTAIN A DIVERSE, EQUITABLE AND INCLUSIVE ORGANIZATIONAL CULTURE AND TO MAKE MEANINGFUL AND LASTING CHANGE FOR OUR PATIENTS, OUR EMPLOYEES AND OUR COMMUNITIES. - 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, BILH TRAINED TOTAL OF 89 COMMUNITY MEMBERS TO PATIENT CARE TECHNICIAN OR NURSING ASSISTANT (30), PHARMACY TECH (16), PERIOPERATIVE LPN (3), MEDICAL ASSISTANT (21), BEHAVIORAL HEALTH ROLES (4) OR INTO THE ASSOCIATE DEGREE NURSING RESIDENCY PROGRAM (15). LAHEY CLINIC HOSPITAL PARTICIPATED IN OFFERING THESE TRAININGS. - IN FY23, 45 EMPLOYEES ACROSS BILH WERE ENROLLED IN ENGLISH AS A SECOND LANGUAGE (ESOL) CLASSES. LAHEY CLINIC HOSPITAL 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. LAHEY CLINIC HOSPITAL EMPLOYEES PARTICIPATED IN THESE OFFERINGS. - IN FY23 MINUTEMAN SENIOR SERVICES REGIONAL SHINE PROGRAM SERVED 639 CONSUMERS. MINUTEMAN SENIOR SERVICES REGIONAL SHINE PROGRAM HOSTED 9 COMMUNITY EDUCATION PRESENTATION TO PEOPLE NEW TO MEDICARE TURNING 65 OR RETIRING AT ARLINGTON ADULT EDUCATION, ARLINGTON HOUSING AUTHORITY, ARLINGTON COUNCIL ON AGING AND BURLINGTON COUNCIL ON AGING. - IN FY23, THE PEABODY STUDENT-BASED HEALTH CENTER HAD THE FOLLOWING IMPACTS: MEDICAL: 748 ONSITE: 747 TELEHEALTH: 1 BEHAVIORAL HEALTH: 1286 TOTAL NUMBER UNDUPLICATED PATIENTS 377 TOTAL NUMBER OF VISITS WHERE CLIENT HAD NO INSURANCE AT TIME OF VISIT AND VISIT WAS NOT PAID OUT OF ANOTHER REVENUE SOURCE: 112 THE TOP 3 DIAGNOSES WERE ANXIETY DISORDER, ADJUSTMENT DISORDER WITH MIXED ANXIETY AND DEPRESSED MOOD, ADJUSTMENT DISORDER. - IN FY 23 LAHEY CLINIC HOSPITAL CONTINUED ITS PARTNERSHIP WITH SAHELI TO PROVIDE SUPPORT FOR THEIR PROGRAMS TO GROW AND STRENGTHEN COMMUNITY-BASED OUTREACH, ENGAGEMENT AND EDUCATION TARGETED TO THE UNIQUE NEEDS OF THE SOUTH ASIAN AND ARAB IMMIGRANT COMMUNITIES THROUGH A COMMUNITY HEALTH WORKER. SAHELI ENGAGED WITH 338 UNDUPLICATED CLIENTS THROUGHOUT THE REGION; 42 OF THOSE CLIENTS WERE SEEKING EMERGENCY SUPPORTS AND FINANCIAL ASSISTANCE. COMMUNITY PARTNERS: SAHELI, LOWELL COMMUNITY HEALTH CENTER, MINUTEMAN SENIOR SERVICES, NORT SHORE COMMUNITY HEALTH, PEABODY HIGH SCHOOL
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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 LAHEY CLINIC HOSPITAL 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 LAHEY CLINIC HOSPITAL COMMUNITY HEALTH SURVEY REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC INSTABILITY.GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY OF LIFETARGET POPULATION: LOW-RESOURCE INDIVIDUALS AND FAMILIES, OLDER ADULTS, YOUTH/ADOLESCENTS, RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS, AND LGTBQIA+ POPULATIONSSTRATEGIES: 1. PROVIDE ADVOCACY OR GRANT FUNDING TO SUPPORT PROGRAMS, POLICIES AND INITIATIVES THAT WORK TO IMPROVE THE HEALTH OF THE COMMUNITY2. ADVOCATE FOR AND SUPPORT POLICIES AND SYSTEMS THAT IMPROVE THE HEALTH THE COMMUNITIES3. COLLABORATE WITH LOCAL COMMUNITY PARTNERS TO SUPPORT PROGRAMS THAT STRENGTHEN THE LOCAL WORKFORCE AND ADDRESS UNDEREMPLOYMENT4. PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE ACTIVITIES WITH INTERNAL COLLEAGUES AND EXTERNAL PARTNERS5. SUPPORT PROGRAMS THAT STABILIZE AND PROMOTE AFFORDABLE HOUSING6. SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE ACCESS TO AFFORDABLE, HEALTHY FOODSINITIATIVES TO ADDRESS THE PRIORITY: - PEABODY COUNCIL ON AGING TRANSPORTATION SUPPORT- PROVIDE GRANTS TO SUPPORT EMERGING COMMUNITY NEEDS- SUPPORT RELEVANT POLICIES WHEN PROPOSED- RADIOLOGY INTERNSHIP PROGRAM- WORK WITH BILH DEI TO EXPAND CONTRACTS WITH DIVERSE SUPPLIERS AND VENDORS- DOMESTIC VIOLENCE INITIATIVE- PROVIDE GRANT FUNDING TO SUPPORT COMMUNITY COLLABORATION- BURLINGTON AFFORDABLE HOUSING COORDINATOR- PROVIDE GRANT FUNDING TO SUPPORT COMMUNITY HOUSING SUPPORTS- MERRIMACK VALLEY FOOD BANK COMMUNITY MARKET PROGRAM- MILL CITY GROWS COMMUNITY GARDENS PROGRAM- COOKING UP GOOD HEALTH PROGRAM- COUNCIL ON AGING FARMERS MARKET PROGRAMMETRICS AND STATUS UPDATES- IN FY 23, LAHEY CLINIC HOSPITAL SUPPORTED THE PEABODY COUNCIL ON AGING'S TRANSPORTATION PROGRAM "PROJECT MOBILITY." PROJECT MOBILITY PROVIDED 32,064 RIDES OF WHICH 5,865 REQUIRED THE USE OF A WHEELCHAIR LIFT, MAKING SERVICES MORE ACCESSIBLE TO ALL. 6,470 RIDES WERE PROVIDED FOR MEDICAL APPOINTMENTS TO 957 UNDUPLICATED INDIVIDUALS. AT THE PRESENT TIME 95% OF CLIENTS ARE AGED 60 YEARS AND OLDER. - IN FY23, LAHEY CLINIC HOSPITAL PROVIDED 2 INTERNSHIPS FOR STUDENTS IN DIAGNOSTIC ULTRASOUND, AND 2 INTERNSHIPS FOR STUDENTS IN VASCULAR ULTRASOUND; 1 GRADUATING INTERN WAS NOT HIRED BY LAHEY CLINIC HOSPITAL. LAHEY CLINIC HOSPITAL NUCLEAR MEDICINE PROVIDED 3, 3-MONTH INTERNSHIPS FOR REGIS COLLEGE NUCLEAR MEDICINE STUDENTS. ONE STUDENT COMPLETED 2 INTERNSHIPS AND THE SECOND STUDENT COMPLETED 1 INTERNSHIP. LAHEY CLINIC HOSPITAL HIRED 1 STUDENT FOR A 20-HOUR POSITION AFTER GRADUATION IN SPRING 2023. LAHEY CLINIC HOSPITAL DIAGNOSTIC RADIOLOGY HAD 5 GRADUATING SECOND YEARS AND HIRED 4. LAHEY CLINIC HOSPITAL DIAGNOSTIC RADIOLOGY HAD 6 FIRST YEARS FROM JAN. 2023 TO MAY 2023, FROM MAY 2023 TO AUGUST 2023, 8 FIRST YEARS, AND FROM SEPT. 2023 TO DEC. 2023, 7 SECOND YEARS AND 6 FIRST YEARS. - LAHEY CLINIC HOSPITAL PARTNERS WITH MILL CITY GROWS (MCG) TO PROVIDE FUNDING FOR IMPROVEMENTS TO ITS COMMUNITY-BASED GARDEN PROGRAM. MCG, A LONGTIME PARTNER OF LAHEY CLINIC HOSPITAL, HAS DESIGNED AND BUILT AND NOW OVERSEES 21 COMMUNITY AND SCHOOL GARDENS IN LOWELL THAT ARE USED BY OVER 6,500 LOWELL RESIDENTS. IN FY23, MCG UNDERTOOK AN EFFORT TO OFFER ACCESSIBLE PLANTING BEDS AND NOW EACH GARDEN HAS AT LEAST 2 FUNCTIONAL WHEELCHAIR ACCESSIBLE BEDS. IF GARDENERS REQUEST TALLER BEDS, MILL CITY GROWS WILL BE ABLE TO MEET THAT REQUEST.- LAHEY CLINIC HOSPITAL PARTNERS WITH THE MERRIMACK VALLEY FOOD BANK (MVFB) TO PROVIDE FUNDING TO SUPPORT ITS COMMUNITY MARKET PROGRAM, WHICH SERVES RESIDENTS OF FOUR LOWELL HOUSING AUTHORITY (LHA) PROPERTIES, OFFERING THEM THE OPPORTUNITY TO SUPPLEMENT THEIR FOOD BY ENJOYING FRESH PRODUCE AT NO COST. IN FY 23, THE MARKETS SERVED 553 CLIENTS, 23% SELF-IDENTIFIED AS ASIAN, 22% AS BLACK, AND 57% AS WHITE- IN FY 23, LAHEY CLINIC HOSPITAL CONTINUED ITS PARTNERSHIP WITH NEW ENTRY SUSTAINABLE FARMING PROJECT TO RUN 20-WEEK FARMERS' MARKETS AT BURLINGTON, ARLINGTON, AND BILLERICA COUNCILS ON AGING. DEPENDING ON LOCATION, THE PROGRAM SERVED 50-80 SENIORS PER WEEK FROM JUNE THROUGH OCTOBER, AND ON AVERAGE, PARTICIPANTS TOOK HOME 6 VARIETIES OF FRESH, LOCAL PRODUCE EACH WEEK. IN FY 23 17,500 POUNDS OF PRODUCE WERE DISTRIBUTED. - LAHEY CLINIC HOSPITAL PARTNERS WITH THE HOUSING CORPORATION OF ARLINGTON TO PROVIDE AN INTEGRATED SET OF SOCIAL SERVICE PROGRAMS THAT PROVIDE AFFORDABLE HOUSING, PREVENT HOMELESSNESS, CONNECT FAMILIES TO VITAL RESOURCES, AND HELP LOW-INCOME PEOPLE DEVELOP AS LEADERS SO THAT THEY MAY ADVOCATE FOR THEMSELVES AND THEIR COMMUNITY. IN FY 23, THERE WERE 119 TOTAL FAMILIES ASSISTED WITH SOCIAL SERVICES - LAHEY CLINIC HOSPITAL COLLABORATES WITH THE TOWN OF BURLINGTON TO PROVIDE AN AFFORDABLE HOUSING COORDINATOR. IN FY 23, THE BURLINGTON AFFORDABLE HOUSING COORDINATOR REPORTED 28 TOTAL ENCOUNTERS AND WAS ABLE TO PROVIDE 10 REFERRALS FOR ADDITIONAL HOUSING SERVICES AND SUPPORTS. ALL ENCOUNTERS WERE RESIDENTS WHO QUALIFIED AS LOW INCOME. COMMUNITY PARTNERS: TOWN OF BURLINGTON, HOUSING CORPORATION OF ARLINGTON, NEW ENTRY SUSTAINABLE FARMING PROJECT, BURLINGTON COUNCIL ON AGING, ARLINGTON COUNCIL ON AGING, BILLERICA COUNCIL ON AGING, MERRIMACK VALLEY FOOD BANK, MILL CITY GROWS, REGIS COLLEGE, PEABODY COUNCIL ON AGINGPRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USEANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES 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 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. INTERVIEWEES AND PARTICIPANTS IN FOCUS GROUPS AND LISTENING SESSIONS 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). THOSE PARTICIPATING IN INTERVIEWS, FOCUS GROUPS, AND LISTENING SESSIONS ALSO REFLECTED ON THE TREMENDOUS NEED FOR MORE TREATMENT OPTIONS ACROSS THE SPECTRUM OF CARE, ESPECIALLY IN THE AREAS OF INPATIENT TREATMENT, TRANSITIONAL HOUSING, AND OTHER RECOVERY SUPPORT SERVICES. GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE.
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STRATEGIES:
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1. ENHANCE RELATIONSHIPS AND PARTNERSHIPS WITH SCHOOLS, YOUTH-SERVING ORGANIZATIONS, AND OTHER COMMUNITY PARTNERS TO BUILD CAPACITY AND INCREASE RESILIENCY, COPING AND PREVENTION SKILLS2. PROVIDE ACCESS TO HIGH QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND/OR SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION AND TREATMENT SERVICES3. IMPROVE SYSTEMS FOR MANAGEMENT AND CONTROL OF SUBSTANCE USE DISORDER THROUGH EDUCATION, REDUCING ACCESS TO SUBSTANCES, AND MULTIDISCIPLINARY EFFORTS4. PARTICIPATE IN MULTI-SECTOR COMMUNITY COALITIONS TO CONVENE COLLABORATORS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO INCREASE RESILIENCY, REDUCE SUBSTANCE USE, AND PREVENT OPIOID OVERDOSES AND DEATHSINITIATIVES TO ADDRESS THE PRIORITY- PROVIDE COMMUNITY GRANTS OR EDUCATION TO ADDRESS NEED- BILH COLLABORATIVE CARE MODEL- OUTPATIENT BEHAVIORAL HEALTH PROGRAMS- HOSPITAL-BASED ADDICTION SUPPORT- TRAUMA SURVIVORS SUPPORT GROUP- LAHEY CLINIC HOSPITAL MEDICATION DISPOSAL PROGRAM- BURLINGTON POLICE DEPARTMENT SUBSTANCE USE COORDINATOR- BURLINGTON COUNCIL ON AGING OUTREACH WORKERS- BURLINGTON YOUTH AND FAMILY SERVICES PROGRAMS- A HEALTHY LYNNFIELD- MIDDLESEX DA OPIOID TASKFORCE- LOCAL SUBSTANCE USE PREVENTION COALITIONSMETRICS AND STATUS UPDATES- IN FY 23, LAHEY CLINIC HOSPITAL SUPPORTED THE BURLINGTON COUNCIL ON AGING'S SOCIAL WORKER OUTREACH PROGRAM. IN FY 23, THEY REPORTED 3,283 ENCOUNTERS UP FROM 1,962 ENCOUNTERS SERVING 621 UP FROM 504 PEOPLE (INCLUDING FAMILY MEMBERS OR CAREGIVERS) AND PROVIDED 614 REFERRALS TO SUPPORTIVE AGENCIES. - LAHEY CLINIC HOSPITAL PARTNERS WITH THE BURLINGTON POLICE DEPARTMENT TO PROVIDE A SUBSTANCE USE COORDINATOR POSITION. IN FY 23, 81 INDIVIDUALS WERE CONTACTED AND 28 ACCEPTED RECOVERY SERVICES.- IN FY 23 LAHEY CLINIC HOSPITAL PARTNERED WITH BURLINGTON YOUTH & FAMILY SERVICES TO PROVIDE COMPREHENSIVE SUPPORTIVE MENTAL HEALTH SERVICES TO YOUTH AND FAMILIES IN BURLINGTON. 4,286 INDIVIDUALS WERE SERVED AND 285 REFERRALS MADE FOR SUPPORTIVE SERVICES.- LAHEY CLINIC HOSPITAL PARTNERS WITH BURLINGTON HIGH SCHOOL TO PROVIDE AN ONSITE ADJUSTMENT COUNSELOR TO PROVIDE PREVENTATIVE AND SUPPORTIVE SERVICES FOR STUDENTS IDENTIFIED TO BE AT HIGH-RISK FOR MENTAL HEALTH DISORDER. IN FY 23, 81 INDIVIDUALS WERE SERVED. - IN FY 23, LAHEY CLINIC HOSPITAL PARTNERED WITH THE CENTER FOR HOPE AND HEALING TO SERVE 98 DOMESTIC VIOLENCE SURVIVORS IN THE COMMUNITY THROUGH OVER 48 SESSIONS OF VARIOUS SUPPORT GROUPS.- LAHEY CLINIC HOSPITAL PARTNERS WITH A HEALTHY LYNNFIELD TO PARTICIPATE ON THEIR SUBSTANCE USE PREVENTION TASKFORCE- LAHEY CLINIC HOSPITAL PARTNERS WITH PLACE OF PROMISE TO PROVIDE SUPPORT FOR THEIR ADULT LONG-TERM RESIDENTIAL ADDICTION RECOVERY PROGRAM. IN FY 23, 38 INDIVIDUALS WERE SERVED. 32 OBTAINED MEDICAL INSURANCE AND 82% HAD A CARE PLAN ESTABLISHED WITH A PRIMARY CARE PHYSICIAN. 32 ALSO OBTAINED THE NECESSARY PAPERWORK FOR EMPLOYMENT.- IN FY 23, 6 PRACTICES IN THE LAHEY CLINIC HOSPITAL SERVICE AREA SERVED 3179 INDIVIDUALS THROUGH THE COLLABORATIVE CARE MODEL- A MULTIDISCIPLINARY TEAM, COMPRISED OF QUALIFIED BEHAVIORAL HEALTH PROVIDERS, PSYCHIATRY, FAMILY PARTNERS, AND PEER SPECIALISTS, IS EMPLOYED TO PROVIDE BEHAVIORAL HEALTH CRISIS CONSULTATIONS IN THE EMERGENCY DEPARTMENT OR MEDICAL FLOORS OF THE HOSPITAL. THE TEAM SERVED 140 PATIENTS AT LAHEY PEABODY IN FY23.- IN FY 23, 95 TELEPSYCHIATRY SERVICES WERE PROVIDED THROUGH BILH BEHAVIORAL SERVICES WITHIN THE LAHEY CLINIC HOSPITAL COMMUNITY BENEFITS SERVICE AREA TO ENHANCE OUTPATIENT BEHAVIORAL HEALTHCARE- IN FY 23 LAHEY CLINIC HOSPITAL PROVIDED 11 SESSIONS OF A SUPPORT GROUP FOR SURVIVORS OF TRAUMA. ON AVERAGE THERE WERE 3-4 PARTICIPANTS PER SESSION. THE TOTAL NUMBER OF PARTICIPANTS FOR THE YEAR WAS 31. LAHEY CLINIC HOSPITAL ALSO SENT OUT 20 INFORMATION PACKETS PER MONTH TO OUR TRAUMA SURVIVORS. - LAHEY CLINIC HOSPITAL PROVIDES SUPPORT TO BURLINGTON HIGH SCHOOL FOR THEIR "WELLNESS DAYS." IN FY 23, 870 STUDENTS FROM BURLINGTON HIGH SCHOOL PARTICIPATED WITH AN ADDITIONAL 80 STAFF OF BURLINGTON PUBLIC SCHOOLS WHO ALSO PARTICIPATED. 45 VENDORS PARTICIPATED AND OFFERED WORKSHOPS FOCUSING ON STRESS REDUCTION, MENTAL HEALTH, AND SHARING AVAILABLE COMMUNITY RESOURCES. COMMUNITY PARTNERS: BURLINGTON HIGH SCHOOL, BURLINGTON COUNCIL ON AGING, BURLINGTON POLICE DEPARTMENT, CENTER FOR HOPE AND HEALING, PLACE OF PROMISE, A HEALTHY LYNNFIELDPRIORITY AREA 4: CHRONIC AND COMPLEX CONDITIONSCHRONIC 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.STRATEGIES 1. ADDRESS BARRIERS TO TIMELY CANCER SCREENING AND FOLLOW-UP CANCER CARE THROUGH NAVIGATION2. PROVIDE PREVENTATIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT-RISK FOR COMPLEX AND/OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMSINITIATIVES TO ADDRESS THE PRIORITY- CANCER SCREENING AND PREVENTION PROGRAMS- ONCOLOGY NURSE NAVIGATOR AND SUPPORTIVE SERVICES FOR CANCER PATIENTS- BURLINGTON DIABETES CARE PROGRAM- BONE HEALTH PROGRAM- TAI JI QUAN: MOVING FOR BETTER BALANCE- A MATTER OF BALANCE- MEMORY CAF PROGRAM- ENHANCE FITNESS PROGRAM- PROVIDE SUPPORT FOR COMMUNITY-BASED EXERCISE CLASSESMETRICS AND STATUS UPDATES- LAHEY CLINIC HOSPITAL PARTNERS WITH THE TOWN OF BURLINGTON TO SUPPORT THE BURLINGTON DIABETES CARE PROGRAM. IN FY 23, THE PROGRAM SERVED 34 OUT OF 92 ELIGIBLE INDIVIDUALS. 42% OF PROGRAM PARTICIPANTS HAD A REDUCTION IN A1C AND 38% OF PROGRAM PARTICIPANTS MAINTAINED A HEALTHY A1C OF 6.5 OR BELOW - IN FY 23 LAHEY CLINIC HOSPITAL HOSTED 12 SESSIONS OF COOKING UP GOOD HEALTH WITH 71 TOTAL ATTENDEES. - LAHEY CLINIC HOSPITAL PARTNERS WITH THE BURLINGTON COUNCIL ON AGING TO PROVIDE A MONTHLY MEMORY CAF. IN FY 23, 60 INDIVIDUALS WERE SERVED BY THIS PROGRAM, WITH AN AGE RANGE OF 45-65+- IN FY23, LAHEY CLINIC HOSPITAL PROVIDED FUNDING TO THE BURLINGTON COUNCIL ON AGING FOR A SENIOR STRETCH PROGRAM FOR A 52 WEEK EXERCISE PROGRAM. OVERALL, THE CLASSES SERVED 359 OLDER ADULTS IN BURLINGTON- LAHEY CLINIC HOSPITAL PARTNERS WITH THE METRO NORTH YMCA AND GREATER BOSTON YMCA TO PROVIDE ENHANCE FITNESS CLASSES. ENHANCE FITNESS IS AN EVIDENCE-BASED HEALTH INTERVENTION OFFSETTING THE EFFECTS OF AGING AND CHRONIC ILLNESS AS WELL AS MINIMIZING FALL RISK. IN FY 23 THIS PROGRAM SERVED 92 INDIVIDUALS ACROSS BOTH SITES AND GRADUATED 100% OF PARTICIPANTS AT THE GREATER BOSTON YMCA SITE. - IN FY 23, LAHEY CLINIC HOSPITAL PROVIDED 48 CLASSES OF TAI JI QUAN: MOVING FOR BETTER BALANCE. IT IS AN EVIDENCED-BASED FALL PREVENTION PROGRAM DESIGNED TO HELP AND IMPROVE BALANCE AS WELL AS CORE STRENGTH. 17 PARTICIPANTS STARTED THE PROGRAM IN OCTOBER 2022; 16 COMPLETED THE PROGRAM (ATTENDED AT LEAST 75% OF THE SESSIONS)- LAHEY CLINIC HOSPITAL PROVIDED 6 CLASSES OF THE BONE HEALTH AND OSTEOPOROSIS PROGRAM WITH A TOTAL OF 40 PARTICIPANTS IN FY23.- LAHEY CLINIC HOSPITAL CONDUCTED 2 SESSIONS OF A MATTER OF BALANCE THAT SERVED INDIVIDUALSIN FY 23 ONCOLOGY NAVIGATORS ASSISTED 10-15 PATIENTS PER DAY AND PROVIDED REFERRAL AND SUPPORTIVE SERVICES. - IN FY 23, LAHEY CLINIC HOSPITAL COMPLETED 21,029 BREAST CANCER RISK ASSESSMENTS FOR 20,553 UNIQUE INDIVIDUALS. 13% OF PATIENTS SCREENED WERE IDENTIFIED AS HAVING A HIGH LIFETIME RISK OF BREAST CANCER AND 27% WERE IDENTIFIED AS HAVING A HIGH-RISK MUTATION. COMMUNITY PARTNERS: GREATER BOSTON YMCA, METRO NORTH YMCA, BURLINGTON COUNCIL ON AGING, TOWN OF BURLINGTONCOMMUNITY PARTNERSLAHEY CLINIC HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS.
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THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE:
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- A HEALTHY LYNNFIELD COALITION - ARLINGTON COUNCIL ON AGING- BILLERICA COUNCIL ON AGING - BURLINGTON COUNCIL ON AGING- BURLINGTON POLICE DEPARTMENT- BURLINGTON RECREATION DEPARTMENT - BURLINGTON SCHOOL DEPARTMENT - CENTER FOR HOPE AND HEALING- CITY OF PEABODY - GREATER BOSTON YMCA- HOUSING CORPORATION OF ARLINGTON - LOWELL COMMUNITY HEALTH CENTER- MERRIMACK VALLEY FOOD BANK - METRO NORTH YMCA - MILL CITY GROWS - MINUTEMAN SENIOR SERVICES - NEW ENTRY SUSTAINABLE FARMING PROJECT - NORTH SHORE COMMUNITY HEALTH - NORTH SUBURBAN YMCA - PEABODY COUNCIL ON AGING- PEABODY MEMORIAL VETERANS HIGH SCHOOL- PLACE OF PROMISE- SAHELI AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, LAHEY CLINIC HOSPITAL IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE IS. IN THE FY 2023 - 2025 IS, WHICH WILL GUIDE THE LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2023, SEPTEMBER 30, 2024 AND SEPTEMBER 30, 2025, EXAMPLES OF IDENTIFIED NEEDS THAT WILL NOT BE MET IN THESE YEARS ARE SUPPORTING EDUCATION ACROSS THE LIFESPAN AND STRENGTHENING THE BUILT ENVIRONMENT (I.E., IMPROVING ROADS/SIDEWALKS AND ENHANCING ACCESS TO SAFE RECREATIONAL SPACES/ACTIVITIES). IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE 2019 CHNA THAT ARE NOT INCLUDED IN THE 2019 IS AND WHICH HAVE GUIDED THE LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THE PERIOD FOR THE FISCAL PERIOD COVERED BY THIS FILING. LAHEY CLINIC HOSPITAL WILL BE UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES, LACK OF IMPACT BY LAHEY CLINIC HOSPITAL LONG-TERM, CLINICAL EXPERTISE OF THE ORGANIZATION, LIMITED BURDEN ON SERVICE AREA RESIDENTS, AND OTHER COMMUNITY PARTNERS EFFORTS THAT ARE ALREADY ADDRESSING THESE ISSUES. HOWEVER, LAHEY CLINIC HOSPITAL REMAINS OPEN AND WILLING TO WORK WITH BILH HOSPITALS AND OTHER PARTNERS TO ADDRESS THESE ISSUES.AS NOTED IN DETAIL ABOVE, THE LAHEY CLINIC HOSPITAL'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW LAHEY CLINIC HOSPITAL CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 14.15% OF LAHEY CLINIC HOSPITAL'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, LAHEY CLINIC HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 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.LAHEY.ORG/ABOUT/COMMUNITY-BENEFITS-NEEDS.THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT LAHEY CLINIC HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, LAHEY CLINIC HOSPITAL IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, RESEARCH HOSPITAL AND TEACHING HOSPITAL PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCELAHEY CLINIC HOSPITAL'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $ 7,177,898 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, LAHEY CLINIC HOSPITAL IS ONE OF TEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $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 CARE MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, LAHEY CLINIC HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, LAHEY CLINIC HOSPITAL GENERATED $ 22,349,043 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY LAHEY CLINIC HOSPITAL FOR SUCH SERVICES BY $5,426,731 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 10.40%OR 126,823 OF LAHEY CLINIC HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 52.90%OR 645,092 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND LAHEY CLINIC HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, LAHEY CLINIC HOSPITAL GENERATED $342,291,889 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $11,187,828. OF THESE AMOUNTS, REVENUE OF $73,204,291 IS RELATED TO THE PROVISION OF PATIENT CARE IN THE AREAS OF NEUROSCIENCES, INCLUDING DEMENTIA, PULMONARY MEDICINE, NEPHROLOGY, GENERAL MEDICINE, ENDOCRINE, OBSTETRICS AND GYNECOLOGY AND BEHAVIORAL 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 $17,804,802. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH LAHEY CLINIC HOSPITAL CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, LAHEY CLINIC HOSPITAL HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, LAHEY CLINIC HOSPITAL ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. COSTS FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $ 6,682,828 ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2.
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AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H,
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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 (LAHEY CLINIC HOSPITAL), 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 SOLEMEMBER 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. FINANCIAL STATEMENT FOOTNOTESPATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSREVENUES UNDER THE TRADITIONAL FEE FOR SERVICE MEDICARE AND MEDICAID PROGRAMS ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS. RETROSPECTIVELY DETERMINED COST-BASED REVENUES UNDER THESE PROGRAMS, WHICH WERE MORE PREVALENT IN EARLIER PERIODS, AND CERTAIN OTHER PAYMENTS, SUCH AS DISPROPORTIONATE SHARE HOSPITAL AND BAD DEBT EXPENSE REIMBURSEMENT, WHICH ARE BASED ON OUR HOSPITALS' COST REPORTS, ARE ESTIMATED USING HISTORICAL TRENDS AND CURRENT FACTORS. COST REPORT SETTLEMENTS UNDER THESE PROGRAMS ARE SUBJECT TO AUDIT BY MEDICARE AND MEDICAID AUDITORS AND ADMINISTRATIVE AND JUDICIAL REVIEW, AND IT CAN TAKE SEVERAL YEARS UNTIL FINAL SETTLEMENT OF SUCH MATTERS IS DETERMINED AND COMPLETELY RESOLVED. THE SYSTEM RECORDS ACCRUALS TO REFLECT THE EXPECTED FINAL SETTLEMENTS ON COST REPORTS. FOR FILED COST REPORTS, THE ACCRUAL IS RECORDED BASED ON THOSE COST REPORTS AND SUBSEQUENT ACTIVITY. THE ACCRUAL FOR PERIODS FOR WHICH A COST REPORT IS YET TO BE FILED IS RECORDED BASED ON ESTIMATES OF WHAT THE SYSTEM EXPECTS TO REPORT ON THE FILED COST REPORTS. AFTER THE COST REPORT IS FILED, THE ACCRUAL MAY NEED TO BE ADJUSTED.EMERGENCY CARE ACCESSLAHEY CLINIC HOSPITAL R IS A TERTIARY CARE LICENSED ACADEMIC MEDICAL CENTER, PROVIDING MEDICAL AND SURGICAL CARE, TEACHING AND RESEARCH AND AS NOTED ELSEWHERE IN THIS RETURN, PROVIDES 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. THE ED'S MISSION, ALIGNED WITH THE HOSPITAL'S MISSION, IS TO DISTINGUISH ITSELF FROM OTHER PROVIDERS THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION, RESEARCH AND THROUGH IMPROVED HEALTH IN THE COMMUNITIES SERVED. THE HOSPITAL'S DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21).THE LAHEY CLINIC HOSPITAL DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR.FINANCIAL ASSISTANCE POLICY INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE LAHEY CLINIC HOSPITAL IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE 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 LAHEY CLINIC HOSPITAL AS WELL AS PROVIDERS WHO FOLLOW LAHEY CLINIC HOSPITAL'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN LAHEY CLINIC HOSPITAL AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW LAHEY CLINIC HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. LAHEY CLINIC HOSPITAL DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONS EFFECTIVE ON OR ABOUT AUGUST 15, 2020FINANCIAL ASSISTANCE POLICY APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).
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FINANCIAL ASSISTANCE PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION
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IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ENGLISH, ARABIC, ARMENIAN, FRENCH, GREEK, GUJARATI, HAITIAN CREOLE, HINDI, ITALIAN, KHMER, KOREAN, PORTUGUESE, PUNJABI, RUSSIAN, SIMPLIFIED CHINESE, SPANISH, TRADITIONAL CHINESE, AND VIETNAMESE (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT: HTTPS://WWW.LAHEY.ORG/LHMC/YOUR-VISIT/INSURANCE-BILLING-RECORDS/FINANCIAL-COUNSELING-ASSISTANCE/ IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE 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 LAHEY CLINIC HOSPITAL FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. - CREDIT AND COLLECTION POLICY- APPLICATION FOR FINANCIAL ASSISTANCE- MEDICAL HARDSHIP APPLICATION- FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, ARMENIAN, CHINESE, FRENCH, GREEK, HAITIAN CREOLE, PORTUGUESE, RUSSIAN, AND SPANISH, CAN BE FOUND ON THE LAHEY CLINIC HOSPITAL WEBSITE AT: HTTPS://WWW.LAHEY.ORG/LHMC/YOUR-VISIT/INSURANCE-BILLING-RECORDS/FINANCIAL-COUNSELING-ASSISTANCE/ LIMITATION ON CHARGES INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS 501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE.
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCH
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AS NOTED IN THIS FILING, THE LAHEY CLINIC INC. (LCI) IS A SISTER ENTITY TO THE LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). EACH IS AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND EACH IS INTEGRALLY RELATED TO ACCOMPLISHING THEIR COMBINED MISSIONS OF PATIENT CARE, EDUCATION AND RESEARCH. ALTHOUGH THE EXPENSES ASSOCIATED WITH RESEARCH ARE NOT INCLUDED IN COSTS REPORTED IN THIS FORM 990 SCHEDULE H PART I LINE 7H BECAUSE THEY ARE ACCOUNTED FOR AS COSTS OF LAHEY CLINIC INC., THESE ACTIVITIES ARE IMPORTANT TO THE COMBINED MISSIONS OF BOTH ENTITIES AND TO THE COMMUNITIES SERVED BY THE HOSPITAL, AND AS SUCH, DETAIL SUPPORTING THESE ACCOMPLISHMENTS ARE INCLUDED IN THE NARRATIVE SUPPORT TO THIS FILING. SINCE LAHEY CLINIC'S INCEPTION, ITS CLINICIANS HAVE ENGAGED IN FURTHERING RESEARCH IN ORDER TO ADVANCE THE PRACTICE OF MEDICINE, NOT ONLY FOR LAHEY PATIENTS BUT FOR ALL PATIENTS. ADVANCING MEDICINE THROUGH RESEARCH AND THE EDUCATION OF TOMORROW'S HEALTH CARE LEADERS IS A LONGSTANDING, CORE COMPONENT OF THE LAHEY CLINIC MISSION. WHETHER WORKING IN THE LABORATORY SETTING OR PARTICIPATING IN CLINICAL TRIALS TO TREAT PATIENTS AND ADVANCE CLINICAL MEDICINE, THEY ARE HELPING TO SHAPE THE NEW TREATMENTS THAT IMPROVE QUALITY CARE FOR PATIENTS, BOTH SAFELY AND EFFECTIVELY.THE MAJORITY OF THE RESEARCH CONDUCTED AT LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC) CONSISTS OF CLINICAL TRIALS THAT HAVE A DIRECT IMPACT ON THE LIVES OF LAHEY CLINIC AND LHMC PATIENTS. DURING THE FISCAL PERIOD COVERED BY THIS FILING, LHMC WAS ENGAGED IN APPROXIMATELY 280 ACTIVE FEDERAL, CORPORATE, NON-PROFIT, AND INTERNALLY SPONSORED PROJECTS, AND MORE THAN 470 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL STUDIES. DURING THE SAME TIME, LHMC HAD OVER 140 PRINCIPAL INVESTIGATORS, MANY WHO ARE TUFTS UNIVERSITY SCHOOL OF MEDICINE FACULTY OR UNIVERSITY OF MASSACHUSETTS CHAN SCHOOL FACULTY, AND NEARLY THE SAME NUMBER OF CO-INVESTIGATORS DEMONSTRATING A ROBUST CULTURE OF RESEARCH ENGAGEMENT AMONG PHYSICIANS AND CLINICAL DISCIPLINES. THIS BROAD ENGAGEMENT RESULTED IN OVER 1,900 PATIENTS RECEIVING MEDICAL CARE AS PART OF CLINICAL TRIALS. THE KEY AREAS OF RESEARCH INCLUDE THERAPEUTIC INVESTIGATIONAL DRUG AND MEDICAL DEVICE CLINICAL TRIALS, COMPARATIVE EFFECTIVENESS RESEARCH, AND TRANSLATIONAL RESEARCH ALL OF WHICH SERVE THE GOAL OF TREATING PATIENTS AND PROVIDING THE CUTTING EDGE CARE OF TOMORROW. AS NOTED IN THIS FILING, LHMC IS A TEACHING HOSPITAL, AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE WITH TUFTS AS WELL AS OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED BOSTON TEACHING HOSPITALS. LHMC ALSO PARTICIPATES IN THE TUFTS CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE (TUFTS CTSI), WHICH PROMOTES COLLABORATIVE, CROSS-DISCIPLINARY, FULL-SPECTRUM TRANSLATIONAL RESEARCH AMONG ITS MULTIPLE HOSPITALS AND HEALTH PLANS, INDUSTRY LEADERS, COMMUNITY ORGANIZATIONS, AND OTHER PARTICIPANTS WHO PLACE A UNIQUE EMPHASIS ON ENGAGING THEIR LOCAL COMMUNITIES IN BIOMEDICAL RESEARCH. THE COLLABORATIVE NATURE OF THE RESEARCH CONDUCTED AT LHMC RESULTED IN THEIR PUBLISHING OVER 290 PEER-REVIEWED JOURNAL ARTICLES DURING THE PERIOD COVERED BY THIS FILING. LHMC ENGAGES IN RESEARCH IN NEARLY ALL DISCIPLINES:- ALLERGY AND IMMUNOLOGY- ANESTHESIOLOGY- CARDIOVASCULAR AND THORACIC SURGERY- CARDIOVASCULAR MEDICINE- CELL AND MOLECULAR BIOLOGY RESEARCH LABORATORY- COLON AND RECTAL SURGERY- DERMATOLOGY- DIAGNOSTIC RADIOLOGY- FOOD & NUTRITION SERVICES- GASTROENTEROLOGY- GENERAL INTERNAL MEDICINE- GENERAL SURGERY- GYNECOLOGY- HEMATOLOGY AND ONCOLOGY- HOSPITAL MEDICINE- INFECTIOUS DISEASES- LABORATORY MEDICINE- NEUROLOGY- NEUROSURGERY- NURSING- OPHTHALMOLOGY- ORTHOPAEDIC SURGERY- OTOLARYNGOLOGY/HEAD & NECK SURGERY- PATHOLOGY- PHYSICAL THERAPY- PLASTIC AND RECONSTRUCTIVE SURGERY- PROFESSIONAL DEVELOPMENT AND SIMULATION- PSYCHIATRY AND BEHAVIORAL HEALTH- PULMONARY AND CRITICAL CARE MEDICINE- RADIATION ONCOLOGY- SURGICAL CRITICAL CARE- TRANSPLANTATION- TRAUMA CENTER- TRAVEL AND TROPICAL MEDICINE- UROLOGYRESEARCH ENGAGEMENT AT LHMCADVANCING MEDICINE THROUGH DISCOVERY, RESEARCH AND INNOVATION IS THE MISSION OF THE RESEARCH PROGRAM AT LHMC. ITS FOCUS CENTERS ON BRINGING THE LATEST THERAPEUTICS TO THE CLINIC, EVALUATING AND IMPLEMENTING PREVENTATIVE INTERVENTIONS FOR THE PURPOSE OF IMPROVING HEALTH OUTCOMES, ASSESSING THE QUALITY AND EFFECTIVENESS OF MEDICAL CARE, AND TRANSFORMING THE PRACTICE OF MEDICINE THROUGH SCIENTIFIC DISCOVERY. EXAMPLES OF RESEARCH ENGAGEMENT AT LHMCHIGHLIGHTED BELOW ARE A FEW EXAMPLES OF THE TRANSFORMATIVE RESEARCH CONDUCTED AT LHMC. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS LHMC IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPLORING REAL WORLD DATA TO CHANGE MEDICAL PRACTICEUNDER THE LEADERSHIP OF DRS. FREDERIC RESNIC AND ZOHER GHOGAWALA, THE COMPARATIVE EFFECTIVENESS RESEARCH INSTITUTE (CERI) AT LHMC UTILIZES REAL-WORLD DATA TO EVALUATE THE IMPACT OF MEDICAL DEVICES USED TO TREAT CARDIOVASCULAR DISEASE, AND TO COMPARE THE EFFECTIVENESS OF NEUROSURGICAL DEVICES. THEIR RESEARCH IS FOCUSED ON MEDICAL DEVICE SAFETY AND IMPROVING PATIENT OUTCOMES. CERI HAS BEEN THE RECIPIENT OF NUMEROUS FEDERAL AWARDS TO STUDY THE PERFORMANCE AND LONG-TERM SAFETY SURVEILLANCE OF IMPLANTABLE MEDICAL DEVICES. IN COLLABORATION WITH RESEARCHERS AT VANDERBILT UNIVERSITY MEDICAL CENTER, AND WITH SUPPORT FROM THE NATIONAL INSTITUTES OF HEALTH, DR. RESNIC AND HIS TEAM DEVELOPED AN ANALYTIC STRATEGY TO MEASURE LEARNING EFFECTS ON DEVICE OUTCOMES. THIS RESEARCH SEEKS TO INTEGRATE INTO A LARGER FRAMEWORK THE IMPACT OF PROVIDER LEARNING AND INTRINSIC DEVICE SAFETY SIGNALING, THEREBY FURTHER SOLIDIFYING THE CURRENT MEDICAL DEVICE SAFETY SURVEILLANCE APPROACHES, AND REFINING OUTCOME MEASUREMENTS. IN PARTNERSHIP WITH AN INDEPENDENT MEDICAL DEVICE RESEARCH ORGANIZATION, AND WITH SUPPORT FROM THE FOOD AND DRUG ADMINISTRATION, CERI HAS BEEN SERVING AS A TECHNICAL ADVISOR AND DATA PARTNER IN THE DESIGN AND DEVELOPMENT OF AN ACTIVE SAFETY SURVEILLANCE NETWORK HUB. THE HUB AIMS TO ENABLE NATIONAL NETWORK PARTNERS TO COLLABORATE ON FUTURE MEDICAL DEVICE SURVEILLANCE PROJECTS. A GROUNDBREAKING STUDY PUBLISHED IN THE JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY: CLINICAL ELECTROPHYSIOLOGY (DOI: 10.1016/J.JACEP.2023.06.008) CONDUCTED BY A TEAM OF RESEARCHERS FROM THE LHMC DIVISION OF CARDIOVASCULAR MEDICINE UTILIZING THE TRINETX RESEARCH NETWORK HAS FOUND THAT SODIUM-GLUCOSE COTRANSPORTER 2 INHIBITORS (SGLT2-IS) SUBSTANTIALLY DECREASE THE RECURRENCE OF ATRIAL FIBRILLATION (AF) IN PATIENTS WITH TYPE 2 DIABETES MELLITUS (DM) WHO HAVE UNDERGONE CATHETER ABLATION. THE RESEARCH INVOLVED THE ANALYSIS OF DATA FROM TWO PROPENSITY-MATCHED COHORTS OF 2,225 PATIENTS EACH, TO EVALUATE THE IMPACT OF BASELINE SGLT2-I USE ON AF RECURRENCE. THE PRIMARY OUTCOME MEASURED INCLUDED THE NEED FOR CARDIOVERSION, NEW ANTIARRHYTHMIC DRUG (AAD) THERAPY, OR REPEAT AF ABLATION. SECONDARY OUTCOMES INCLUDED HEART FAILURE EXACERBATIONS, ISCHEMIC STROKE, ALL-CAUSE HOSPITALIZATION, AND DEATH OVER A 12-MONTH FOLLOW-UP PERIOD. THE FINDINGS REVEALED THAT SGLT2-I USE WAS ASSOCIATED WITH A 32% REDUCTION IN THE RISK OF THE PRIMARY OUTCOME (ADJUSTED OR: 0.68; 95% CI: 0.602-0.776; P < 0.0001) AND A HIGHER PROBABILITY OF EVENT-FREE SURVIVAL AT 12 MONTHS (HR: 0.85, 95% CI: 0.77-0.95; P = 0.003). WHILE SECONDARY OUTCOMES WERE GENERALLY LOWER IN THE SGLT2-I GROUP, THE INCIDENCE OF ISCHEMIC STROKE DID NOT SIGNIFICANTLY DIFFER BETWEEN THE TWO GROUPS. THIS STUDY HIGHLIGHTS THE POTENTIAL BENEFITS OF SGLT2 INHIBITORS IN MANAGING AF RECURRENCE IN DIABETIC PATIENTS' POST-ABLATION. FINDINGS SUGGEST THAT SGLT2-IS COULD PLAY A CRUCIAL ROLE IN IMPROVING OUTCOMES FOR THIS HIGH-RISK PATIENT POPULATION.
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THE PREVALENCE OF INTERSTITIAL LUNG ABNORMALITIES (ILA)
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AND THE ASSOCIATION WITH CLINICALLY SIGNIFICANT OUTCOMES INCLUDING MORTALITY, HOSPITALIZATIONS, CANCER, AND INTERSTITIAL LUNG DISEASE (ILD) DIAGNOSIS WAS EXAMINED IN LHMC'S LARGE CT LUNG CANCER SCREENING PROGRAM. 1699 SUBJECTS MET INCLUSION CRITERIA. 41 (2.4%) HAD ILA AND 101 (5.9%) HAD INDETERMINATE ILA ON BASELINE CTS. ILD WAS DIAGNOSED IN 10 (24.4%) OF 41 WITH ILA ON BASELINE CT WITH A MEAN TIME FROM BASELINE CT TO DIAGNOSIS OF 4.47 2.72 YEARS. ON MULTIVARIABLE MODELING, THE PRESENCE OF ILA REMAINED A SIGNIFICANT PREDICTOR OF DEATH, HR 3.87 (2.07, 7.21; P < 0.001) WHEN ADJUSTED FOR AGE, SEX, BMI, PACK YEARS AND ACTIVE SMOKING, BUT NOT OF LUNG CANCER AND ALL-CAUSE HOSPITAL ADMISSION. APPROXIMATELY 50% WITH BASELINE ILA HAD PROGRESSION ON THE LONGITUDINAL SCAN. THIS RESEARCH DEMONSTRATED THAT ILA IDENTIFIED ON BASELINE LUNG CANCER SCREENING EXAMS ARE ASSOCIATED WITH ALL-CAUSE MORTALITY AND A SIGNIFICANT PROPORTION OF PATIENTS WITH ILA ARE SUBSEQUENTLY DIAGNOSED WITH ILD AND HAVE CT PROGRESSION ON LONGITUDINAL SCANS.COVID RESEARCHAS THE COVID-19 PUBLIC HEALTH EMERGENCY CAME TO AN END, LHMC CONTINUED TO PRODUCE ORIGINAL, THOUGHT PROVOKING RESEARCH. A RECENT STUDY PUBLISHED IN CRITICAL CARE SHED LIGHT ON THE ESCALATING USE OF MECHANICAL CARDIOPULMONARY RESUSCITATION (MCPR) DURING IN-HOSPITAL CARDIAC ARREST (IHCA) AMID THE COVID-19 PANDEMIC. LED BY A TEAM IN THE DIVISION OF PULMONARY AND CRITICAL CARE MEDICINE, THIS INVESTIGATION UNDERSCORES THE EVOLVING LANDSCAPE OF RESUSCITATION STRATEGIES IN RESPONSE TO THE GLOBAL HEALTH CRISIS. ANALYZING DATA FROM THE AMERICAN HEART ASSOCIATION'S GET WITH THE GUIDELINES RESUSCITATION DATABASE, THE STUDY OBSERVED A SIGNIFICANT RISE IN MCPR UTILIZATION FROM 2.4% TO 6.0% BETWEEN JANUARY 2019 AND DECEMBER 2021. NOTABLY, MANY INSTITUTIONS EMBRACED MCPR FOR THE FIRST TIME DURING THIS PERIOD, MARKING A NOTABLE SHIFT IN RESUSCITATION PRACTICES. WITH THE PANDEMIC PROMPTING HEIGHTENED CONCERNS FOR HEALTHCARE WORKER SAFETY, THE AMERICAN HEART ASSOCIATION RECOMMENDED MCPR AS A MEANS TO MITIGATE EXPOSURE TO AEROSOLIZED VIRUS DURING CPR PROCEDURES. THIS GUIDANCE LIKELY FUELED THE RAPID ADOPTION OF MCPR ACROSS HEALTHCARE FACILITIES, WITH 6.5% OF HOSPITALS EXPERIENCING A SUBSTANTIAL INCREASE IN MCPR CASES. WHILE TRIALS HAVE YET TO DEFINITIVELY ESTABLISH THE SUPERIORITY OF MCPR OVER MANUAL CPR IN THE IN-HOSPITAL SETTING, THIS STUDY UNDERSCORES THE URGENT NEED FOR FURTHER RESEARCH TO INFORM RESUSCITATION PROTOCOLS EFFECTIVELY. DR. SARJU GANATRA, A CLINICAL INVESTIGATOR FROM THE LHMC DIVISION OF CARDIOVASCULAR MEDICINE, IN COLLABORATION WITH RESEARCHERS FROM BRIGHAM AND WOMEN'S HOSPITAL AND HARVARD MEDICAL SCHOOL, PUBLISHED A HIGH-IMPACT STUDY IN CLINICAL INFECTIOUS DISEASES (DOI: 10.1093/CID/CIAD400), WHICH REVEALED THAT THE USE OF ORAL NIRMATRELVIR AND RITONAVIR (PAXLOVID) SIGNIFICANTLY REDUCES THE RISK OF EMERGENCY DEPARTMENT VISITS, HOSPITALIZATION, AND MORTALITY IN VACCINATED ADULTS AGED 18-50 DIAGNOSED WITH COVID-19. THE COHORT STUDY, WHICH ANALYZED DATA FROM 86,119 PATIENTS WITHIN THE TRINETX DATABASE, COMPARED 2,547 PATIENTS WHO RECEIVED PAXLOVID TO A MATCHED CONTROL GROUP. RESULTS INDICATED A 30% RELATIVE RISK REDUCTION IN ADVERSE OUTCOMES FOR THOSE TREATED WITH PAXLOVID, WITH THE NUMBER NEEDED TO TREAT (NNT) BEING 47. PARTICULARLY NOTABLE BENEFITS WERE OBSERVED IN SUBGROUPS WITH SERIOUS COMORBIDITIES SUCH AS CANCER (NNT = 45), CARDIOVASCULAR DISEASE (NNT = 30), AND BOTH CONDITIONS (NNT = 16). CONVERSELY, NO SIGNIFICANT BENEFITS WERE FOUND FOR PATIENTS WITH ONLY CHRONIC LOWER RESPIRATORY DISORDERS LIKE ASTHMA OR COPD, OR THOSE WITHOUT SERIOUS COMORBIDITIES. THIS STUDY UNDERSCORES THE IMPORTANCE OF IDENTIFYING HIGH-RISK PATIENTS WHO COULD BENEFIT THE MOST FROM PAXLOVID. FINDINGS SUGGEST THAT WHILE PAXLOVID IS BENEFICIAL FOR MANY, ITS OVERPRESCRIPTION, ESPECIALLY IN LOWER-RISK GROUPS, SHOULD BE AVOIDED, SO THAT VITAL TREATMENTS REMAIN AVAILABLE FOR THOSE WHO REALLY NEED THEM AND ARE NOT WASTED ON THOSE WHO STAND TO GAIN NO BENEFIT.TRANSLATING DISCOVERY RESEARCH INTO CLINICAL SOLUTIONS THE IAN C. SUMMERHAYES CELL AND MOLECULAR BIOLOGY (ICSCMB) LAB AT LHMC PERFORMS TRANSLATIONAL RESEARCH AND DURING LHMC'S FISCAL YEAR ENDED SEPTEMBER 30, 2023 FOCUSED ON FIVE DISEASES: BLADDER CANCER, BREAST CANCER, KIDNEY CANCER, LUNG CANCER, AND URETHRAL STRICTURE DISEASE. THE BREAST, BLADDER, AND KIDNEY CANCER RESEARCH WAS FOCUSED ON THE MECHANISMS OF ACTION OF DYSREGULATED MICRORNAS AND PROTEINS IN AGGRESSIVE TUMORS. LHMC RESEARCHERS EXAMINED PROTEINS AND THE ROLES THEY MAY HAVE IN THE METASTATIC PROCESS, IN PARTICULAR, CELL PROLIFERATION MIGRATION, AND INVASION. THE KIDNEY CANCER RESEARCH PROJECT INVESTIGATED THE PERFORMANCE OF DROPLET DIGITAL PCR (DDPCR) COMPARED TO QRT- PCR IN IDENTIFYING MIRNA BIOMARKERS THAT DIFFERENTIATE MALIGNANT FROM BENIGN RENAL MASSES. POTENTIAL BIOMARKERS OF RCC WERE IDENTIFIED FROM A LITERATURE REVIEW. RNA WAS EXTRACTED FROM THE PLASMA OF 56 PATIENTS. ALL THE SAMPLES UNDERWENT ANALYSIS VIA DDPCR AS WELL AS QRT-PCR, AND EXPRESSION LEVELS WERE RECORDED FOR THE FOLLOWING MIRNAS: MIR-93, -144, -210, -221, AND -222. TUMORS WERE GROUPED INTO LOW-GRADE CCRCC, HIGH-GRADE CCRCC, PAPILLARY RCC, AND BENIGN MASSES (PRIMARILY ANGIOMYOLIPOMA). THE MIRNA MIR-210 (P = 0.034) AND THE COMBINATION OF MIRS-210 AND MIR-222 (P = 0.003) WERE EXPRESSED AT SIGNIFICANTLY HIGHER RATES AMONG THOSE WITH RCC THAN THOSE WITH BENIGN MASSES, AS MEASURED BY DDPCR. USING THE COMBINATION OF MIR-210 AND MIR-222, DDPCR IDENTIFIED SIGNIFICANT DIFFERENCES BETWEEN THE SUBGROUPS: PAPILLARY RCC VERSUS BENIGN (P = 0.03), LOW-GRADE CCRCC VERSUS BENIGN (P = 0.026), AND HIGH-GRADE CCRCC VERSUS BENIGN (P = 0.002). THE ONLY SIGNIFICANT DIFFERENCE BETWEEN THESE SUBGROUPS USING QRT-PCR WAS BETWEEN HIGH-GRADE CCRCC AND BENIGN (P = 0.045). ALL THE AUCS WERE SIGNIFICANT WHEN COMPARING EACH RCC SUBGROUP WITH BENIGN FOR BOTH PCR TECHNOLOGIES. THIS STUDY SHOWED THAT USING A COMBINATION OF MIR-210 AND MIR-222, DDPCR IDENTIFIED SIGNIFICANT DIFFERENCES BETWEEN BENIGN AND MALIGNANT RENAL MASSES THAT WERE NOT IDENTIFIED AS SIGNIFICANT BY CONVENTIONAL QRT-PCR.ADDITIONAL LHMC RESEARCHERS INVESTIGATED THE ROLE OF MIRNA AND GENE EXPRESSION IN LICHEN SCLEROSUS (LS), WHICH IS A CHRONIC INFLAMMATORY CONDITION THAT CAN LEAD TO MALE URETHRAL STRICTURE DISEASE (USD). LS USD IS CHARACTERIZED BY SCARRING OF THE URETHRA, AND ITS PATHOPHYSIOLOGY IS POORLY UNDERSTOOD. IDENTIFYING NON-INVASIVE BIOMARKERS THAT DISTINGUISH LS INDUCED FROM NON-LS INDUCED URETHRAL STRICTURES WOULD HAVE BROAD IMPLICATIONS FOR THE DIAGNOSIS, COUNSELING, AND TREATMENT OF URETHRAL STRICTURE DISEASE (USD). IN ADDITION, IDENTIFYING THE DYSREGULATED GENES INVOLVED IN THIS DISEASE IS CRUCIAL TO BETTER UNDERSTANDING ITS CAUSE. LHMC RESEARCHERS ALSO CONTINUE TO FOCUS THEIR EFFORTS ON SEVERAL PROJECTS IN LUNG CANCER WITH THE GOAL TO DEVELOP AN ACCURATE NASAL BIOMARKER INTEGRATING EXPRESSION PROFILING OF GENES AND MIRNA, CLINICAL VARIABLES, AND NODULE CHARACTERISTICS IN ORDER TO DISTINGUISH EARLY LUNG MALIGNANCIES FROM BENIGN PULMONARY NODULES. WE ARE ALSO WORKING ON A STUDIES TO DEVELOP AN UNDERSTANDING OF THE GENETIC CHANGES RESULTING IN AGGRESSIVE LIFE THREATENING LUNG CANCER.
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LHMC RESEARCHERS CONTRIBUTED TO A STUDY THAT SOUGHT
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TO VALIDATE A CLINICAL-GENOMIC CLASSIFIER DEVELOPED USING WHOLE-TRANSCRIPTOME SEQUENCING OF NASAL EPITHELIAL CELLS FROM PATIENTS WITH A PN 30 MM WHO SMOKE OR HAVE PREVIOUSLY SMOKED. THE RESEARCHERS WERE ASSESSING IF THE PROBABILITY OF LUNG CANCER (PCA) IN INDIVIDUALS WITH A PULMONARY NODULE (PN) AND A HISTORY OF SMOKING CAN BE PREDICTED BY A CLASSIFIER THAT USES CLINICAL FACTORS AND GENOMIC DATA FROM NASAL EPITHELIAL CELLS OBTAINED BY CYTOLOGIC BRUSHING. MACHINE LEARNING WAS USED TO TRAIN A CLASSIFIER USING GENOMIC AND CLINICAL FEATURES ON 1,120 PATIENTS WITH PNS LABELED AS BENIGN OR MALIGNANT ESTABLISHED BY A FINAL DIAGNOSIS OR A MINIMUM OF 12 MONTHS OF RADIOGRAPHIC SURVEILLANCE. THE CLASSIFIER WAS DESIGNED TO YIELD LOW-, INTERMEDIATE-, AND HIGH-RISK CATEGORIES. THE CLASSIFIER WAS VALIDATED IN AN INDEPENDENT SET OF 312 PATIENTS, INCLUDING 63 PATIENTS WITH A PRIOR HISTORY OF CANCER (OTHER THAN LUNG CANCER), COMPARING THE CLASSIFIER PREDICTION WITH THE KNOWN CLINICAL OUTCOME. IN THE PRIMARY VALIDATION SET, SENSITIVITY AND SPECIFICITY FOR LOW-RISK CLASSIFICATION WERE 96% AND 42%, WHEREAS SENSITIVITY AND SPECIFICITY FOR HIGH-RISK CLASSIFICATION WAS 58% AND 90%, RESPECTIVELY. SENSITIVITY WAS SIMILAR ACROSS STAGES OF NON-SMALL CELL LUNG CANCER, INDEPENDENT OF SUBTYPE. PERFORMANCE COMPARED FAVORABLY WITH CLINICAL-ONLY RISK MODELS. ANALYSIS OF 63 PATIENTS WITH PRIOR CANCER SHOWED SIMILAR PERFORMANCE AS DID SUBANALYSES OF PATIENTS WITH LIGHT VS HEAVY SMOKING BURDEN AND THOSE ELIGIBLE FOR LUNG CANCER SCREENING VS THOSE WHO WERE NOT. THE RESEARCH SHOWED THAT THE NASAL CLASSIFIER PROVIDES AN ACCURATE ASSESSMENT OF PCA IN INDIVIDUALS WITH A PN 30 MM WHO SMOKE OR HAVE PREVIOUSLY SMOKED. CLASSIFIER-GUIDED DECISION-MAKING COULD LEAD TO FEWER DIAGNOSTIC PROCEDURES IN PATIENTS WITHOUT CANCER AND MORE TIMELY TREATMENT IN PATIENTS WITH LUNG CANCER.TOGETHER WITH THEIR COLLABORATORS, LHMC INVESTIGATORS ALSO ASSESSED WHETHER PATHOLOGIC CLASSIFICATION IS REPRODUCIBLE AND WHETHER SUBSETS OF ADENOCARCINOMAS PREDICT WORSE OUTCOMES WHEN TREATED BY WEDGE RESECTION COMPARED TO LOBECTOMY. A RETROSPECTIVE COHORT OF 108 RECIPIENTS OF WEDGE RESECTION AND 187 RECIPIENTS OF LOBECTOMY FOR STAGE I/0 LUNG ADENOCARCINOMAS 2.0 CM WAS ASSEMBLED FROM 2 INSTITUTIONS. ALL TUMORS WERE CLASSIFIED BY A SINGLE PATHOLOGIST, AND INTEROBSERVER REPRODUCIBILITY WAS ASSESSED IN A SUBSET (N = 92) BY 5 PATHOLOGISTS. ANGIOINVASIVE ADENOCARCINOMA (21%-27% OF CASES) WAS ASSOCIATED WITH WORSE OUTCOMES WHEN TREATED WITH WEDGE RESECTION COMPARED TO LOBECTOMY (5-YEAR RECURRENCE-FREE SURVIVAL, 57% VS 85% [P = .007]; 5-YEAR DISEASE-FREE SURVIVAL [DSS], 70% VS 90% [P = .043]; 7-YEAR OVERALL SURVIVAL, 37% VS 58% [P = .143]). ADENOCARCINOMA IN SITU (AIS), MINIMALLY INVASIVE ADENOCARCINOMA (MIA), AND LMP EXHIBITED 100% 5-YEAR DSS REGARDLESS OF THE SURGICAL APPROACH. MULTIVARIABLE ANALYSIS SHOWED THAT ANGIOINVASION, TUMOR SIZE, MARGIN STATUS, AND EXTENT OF NODAL SAMPLING WERE SIGNIFICANTLY ASSOCIATED WITH RECURRENCE BUT NOT WITH SURGICAL PROCEDURE. THERE WAS SUBSTANTIAL INTEROBSERVER REPRODUCIBILITY AMONG THE PATHOLOGISTS FOR THE DIAGNOSIS OF ANGIOINVASIVE ADENOCARCINOMA ( = 0.71) AND THE COMBINED INDOLENT AIS/MIA/LMP GROUP ( = 0.74). THE MAJORITY (75%) OF LUNG ADENOCARCINOMAS 2 CM ARE ADEQUATELY MANAGED WITH WEDGE RESECTION; HOWEVER, ANGIOINVASIVE ADENOCARCINOMAS (25%) TREATED BY WEDGE RESECTION WITH SUBOPTIMAL NODAL SAMPLING EXHIBIT POOR OUTCOMES, WITH A 40% TO 45% RATE OF RECURRENCE WITHIN 5 YEARS AND 60% TO 65% OVERALL MORTALITY AT 7 YEARS.LHMC RESEARCHERS TOGETHER WITH COLLABORATORS FROM TUFTS MEDICAL CENTER AND TUFTS UNIVERSITY AIMED TO DEVELOP AND TEST A PROTOTYPE OF A DEEP LEARNING SURGICAL GUIDANCE SYSTEM (CASL) THAT CAN INTRA-OPERATIVE IDENTIFY PERITONEAL SURFACE METASTASES ON ROUTINE LAPAROSCOPY IMAGES. CASL WAS DEVELOPED AND TESTED USING STAGING LAPAROSCOPY IMAGES RECORDED FROM 132 PATIENTS WITH HISTOLOGICALLY-CONFIRMED ADENOCARCINOMA INVOLVING THE GASTROINTESTINAL TRACT. THE DATA INCLUDED IMAGES DEPICTING 4287 VISIBLE PERITONEAL SURFACE LESIONS AND 3650 IMAGE PATCHES OF 365 BIOPSIED PERITONEAL SURFACE LESIONS. THE PROTOTYPE'S DIAGNOSTIC PERFORMANCE WAS COMPARED TO RESULTS FROM A NATIONAL SURVEY EVALUATING 111 ONCOLOGIC SURGEONS IN A SIMULATED CLINICAL ENVIRONMENT. IN A SIMULATED ENVIRONMENT, SURGEONS' ACCURACY OF CORRECTLY RECOMMENDING A BIOPSY FOR METASTASES WHILE OMITTING A BIOPSY FOR BENIGN LESIONS WAS ONLY 52%. IN THIS ENVIRONMENT, THE PROTOTYPE OF A DEEP LEARNING SURGICAL GUIDANCE SYSTEM DEMONSTRATED IMPROVED PERFORMANCE IN IDENTIFYING PERITONEAL SURFACE METASTASES COMPARED TO ONCOLOGIC SURGEONS WITH AN AREA UNDER THE RECEIVER OPERATING CHARACTERISTIC CURVE OF 0.69 (ONCOLOGIC SURGEON) VERSUS 0.78 (CASL) VERSUS 0.79 (HUMAN-COMPUTER COMBINED). A PROPOSED MODEL WOULD HAVE IMPROVED THE IDENTIFICATION OF METASTASES BY 5% WHILE REDUCING THE NUMBER OF UNNECESSARY BIOPSIES BY 28% COMPARED TO CURRENT STANDARD PRACTICE. THE FINDINGS FROM THIS STUDY DEMONSTRATED A PATHWAY FOR AN ARTIFICIAL INTELLIGENCE SYSTEM FOR INTRA-OPERATIVE IDENTIFICATION OF PERITONEAL SURFACE METASTASES, BUT IT STILL REQUIRES ADDITIONAL DEVELOPMENT AND FUTURE VALIDATION IN A MULTI-INSTITUTIONAL CLINICAL SETTING.UNDER THE LEADERSHIP OF DR. AJAY WAKHLOO, INVESTIGATORS IN THE LHMC IMAGE GUIDED THERAPY LAB UTILIZED STEREOLITHOGRAPHIC 3D PRINTING TECHNOLOGY TO CREATE DISEASE MODELS FOR EVALUATING ENDOVASCULAR DEVICES TO TREAT CEREBRAL ANEURYSMS. IN COLLABORATION WITH INDUSTRY PARTNERS, THE IGT LAB TRANSFORMED DE-IDENTIFIED HUMAN IMAGING DATA INTO LIFELIKE, FUNCTIONAL CEREBROSPINAL FLUID MODELS NECESSARY FOR PRE-CLINICAL ASSESSMENT OF CATHETER-BASED SYSTEMS USED IN ENDOSCOPIC THIRD VENTRICULOSTOMY PROCEDURES. IGT LAB INVESTIGATOR-INITIATED RESEARCH SUPPORTED THROUGH THE ROBERT E. WISE INSTITUTE RESULTED IN THE SUCCESSFUL DEPLOYMENT OF A HEMORRHAGE STROKE MODEL TO EVALUATE THE EFFICACY OF FLOW DIVERTERS IN SLOWING BLEEDING AND MINIMIZING HEMATOMA GROWTH. SUBSEQUENT INDUSTRY PARTNERSHIPS INVOLVED THE FABRICATION OF PATIENT-SPECIFIC CEREBRAL ANEURYSM MODELS, LEADING TO THE IMPROVED USE OF ENDOVASCULAR DEVICES FOR HARD-TO-TREAT CASES. ONE PARTNERSHIP INVOLVED THE QUANTITATIVE CHARACTERIZATION OF THE HUMAN CAROTID SIPHON BY ANALYZING VESSEL ATTRIBUTES SUCH AS TORTUOSITY, CURVATURE, AND TWIST ANGLE IN 25 PATIENTS. THESE EFFORTS AIMED TO PREDICT GEOMETRIC INDICATORS CAUSING FLOW DIVERTER FLATTENING DURING ANEURYSM TREATMENT, THEREBY AIDING IN PREOPERATIVE DECISION-MAKING FOR SUCCESSFUL DEVICE DELIVERY.STUDIES PERFORMED IN THE PLASTIC AND RECONSTRUCTIVE SURGERY LAB INVESTIGATED THE IMPACT OF DIABETIC ADIPOSE-DERIVED STEM CELL (ASCS) IN THE TREATMENT OF DIABETIC WOUNDS. DIABETIC ASCS (DMA) AND NONDIABETIC ASCS WERE ISOLATED FROM DB/DB AND C57BL/6J MICE, AND CHARACTERIZED BY IMMUNOCYTOCHEMISTRY, PROLIFERATION, DIFFERENTIATION, AND GENE EXPRESSION ASSAYS. THE EFFECTS OF BOTH ASCS ON HEALING WERE INVESTIGATED USING 36 MALE 10- TO 12-WEEK-OLD DB/DB MICE. WOUND SIZE WAS MEASURED SEMIWEEKLY UNTIL DAY 28, AND HISTOLOGIC AND MOLECULAR ANALYSES WERE PERFORMED AT DAY 14. BOTH ASCS HAD FIBROBLAST-LIKE MORPHOLOGY AND WERE CD44 + /CD90 + /CD34 - /CD45 - AT PASSAGE 4. COMPARED WITH NONDIABETIC ASCS IN VITRO, DMA PROLIFERATIVE CAPABILITY WAS RESTORED BY PASSAGE 4 (P > 0.05). ALTHOUGH DMA OSTEOGENESIS WAS ATTENUATED (P < 0.01), BOTH ASCS HAD SIMILAR ADIPOGENESIS AND EXPRESSIONS OF PPAR/LPL/OCN/RUNX2 (P > 0.05). IN VIVO EXPERIMENTS SHOWED THAT, COMPARED WITH PHOSPHATE-BUFFERED SALINE CONTROL, BOTH ASCS ARE COMPARABLE IN IMPROVING WOUND HEALING ( P < 0.0001), ANGIOGENESIS ( P < 0.05), EPITHELIAL CELL PROLIFERATION ( P < 0.05), AND GRANULATION TISSUE FORMATION ( P < 0.0001). RESULTS FROM THIS STUDY SHOWED THAT IN BOTH IN VITRO AND IN VIVO MURINE MODELS, DMAS HAVE SHOWN A COMPARABLE THERAPEUTIC CAPACITY TO NORMAL ASCS IN PROMOTING DIABETIC WOUND HEALING BY IMPROVING ANGIOGENESIS, REEPITHELIALIZATION, AND GRANULATION TISSUE FORMATION. THESE RESULTS SUPPORT CLINICAL APPLICATIONS OF AUTOLOGOUS ASCS IN DIABETIC WOUND TREATMENTS. THIS WORK HAS PARTICULAR SURGICAL RELEVANCE AS IT HIGHLIGHTS A THEORETICAL AND CLINICAL PATHWAY TO USE DIABETIC PATIENTS' OWN ASCS TO TREAT THEIR WOUNDS, BYPASSING ANY CONCERNS OF CROSS-HOST SOURCING ISSUES IN REGENERATIVE MEDICINE.
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IMPORTANT NIH-SPONSORED CLINICAL TRIALS
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LHMC ONCOLOGISTS CO-LEAD A MULTICENTER NCI-SPONSORED CLINICAL TRIAL ENTITLED "IMMUNE CHECKPOINT INHIBITED TOXICITY (I-CHECKIT): A PROSPECTIVE OBSERVATIONAL STUDY." THE OBJECTIVES OF THE STUDY WERE TO DEVELOP AND INDEPENDENTLY VALIDATE A RISK PREDICTION MODEL FOR COMMON TERMINOLOGY CRITERIA FOR ADVERSE EVENTS (CTCAE) GRADE 3 OR HIGHER NON-HEMATOLOGICAL IMMUNE-RELATED ADVERSE EVENTS (IRAES) IN THE FIRST YEAR OF IMMUNE CHECKPOINT INHIBITOR (ICI)-BASED THERAPY FOR THE TREATMENT OF SOLID TUMORS. THIS STUDY EXAMINED HOW CERTAIN RISK FACTORS (SUCH AS AGE, GENDER, OTHER MEDICAL CONDITIONS, AND THE TYPE OF IMMUNOTHERAPY USED TO TREAT THE CANCER) AFFECT WHETHER A PATIENT WITH A MALIGNANT SOLID TUMOR WILL DEVELOP MILD OR SERIOUS SIDE EFFECTS FROM THE IMMUNOTHERAPY MEDICATIONS. IN ADDITION TO CO-LEADING THE STUDY, LHMC WAS ONE OF THE TOP ACCRUING SITES.LHMC HAS CONTINUED TO BE A KEY MEMBER OF THE NCI-SPONSORED COOPERATIVE CLINICAL TRIALS GROUP SWOG. ONE INITIATIVE LHMC INVESTIGATORS HAVE PLAYED A CRITICAL ROLE IN LEADING IS THE SWOG LUNG COMMITTEE, WHICH IS LEADING EFFORTS TO BETTER ENGAGE COMMUNITY-BASED ONCOLOGISTS. ONE OF THE BEST SUCCESS STORIES TO DATE HAS BEEN THE COMMITTEE'S INVOLVEMENT IN AN INNOVATIVE LUNG CANCER TRIAL KNOWN AS THE S2302 PRAGMATICA-LUNG TRIAL, WHICH WAS DESIGNED TO BE A PRAGMATIC CLINICAL TRIAL AIMED AT ELIMINATING TRADITIONAL BARRIERS TO ENROLL A MORE DIVERSE PATIENT POPULATION. TO DATE, THE RATE OF OVERALL AND MINORITY GROUP ENROLLMENT ON THIS TRIAL HAS FAR EXCEEDED EXPECTATIONS. LHMC ENROLLED THE FIRST THREE PATIENTS ONTO THIS NCI HIGH-PRIORITY TRIAL NATIONALLY AFTER IT OPENED, AND IT REMAINS ONE OF THE TOP ACCRUING SITES NATIONALLY.NIH HAS CREATED THE A NATIONAL NETWORK, NIH STROKENET, TO CONDUCT SMALL AND LARGE CLINICAL TRIALS AND RESEARCH STUDIES TO ADVANCE ACUTE STROKE TREATMENT, STROKE PREVENTION, AND RECOVERY AND REHABILITATION FOLLOWING A STROKE ACROSS THE LIFESPAN. THIS NETWORK OF 27 REGIONAL CENTERS ACROSS THE U.S., IS DESIGNED TO SERVE AS THE INFRASTRUCTURE AND PIPELINE FOR EXCITING NEW POTENTIAL TREATMENTS FOR PATIENTS WITH STROKE AND THOSE AT RISK FOR STROKE. NIH STROKENET ALSO PROVIDES AN EDUCATIONAL PLATFORM FOR STROKE PHYSICIANS, CLINICAL TRIAL COORDINATORS AND STROKE RESEARCHERS. LHMC IS DESIGNATED COMPREHENSIVE STROKE CENTER AND MAIN MEMBER OF THE NEW ENGLAND REGIONAL COORDINATION CENTER (NERCC), WHICH IS A COLLABORATION OF SITES ENCOMPASSING TWELVE OF THE TOP ACADEMIC MEDICAL CENTERS IN NEW ENGLAND. THE NERCC SERVES A LARGE AND DIVERSE PATIENT POPULATION FROM ACROSS NEW ENGLAND, CONSISTENTLY SCORING HIGHLY ON PERFORMANCE MEASURES DEVELOPED BY THE NIH STROKENET. LHMC HAS MADE SIGNIFICANT CONTRIBUTIONS TO NIH STROKENET CLINICAL TRIALS, AND AS A MEMBER OF THE NERCC, IT IS COMMITTED TO RECRUITMENT, RETENTION AND HIGH-QUALITY DATA CAPTURE AS A PARTICIPATING NIH STROKENET CENTER. IT'S CURRENTLY INVOLVED IN 4 NIH STROKENET CLINICAL TRIALS, INCLUDING SATURN, ASPIRE, FASTEST AND VERIFY.AS NOTED IN THIS FILING, THE LAHEY CLINIC INC. (LCI) IS A SISTER ENTITY TO THE LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). EACH IS AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND EACH IS INTEGRALLY RELATED TO ACCOMPLISHING THEIR COMBINED MISSIONS OF PATIENT CARE, EDUCATION AND RESEARCH. ALTHOUGH THE EXPENSES ASSOCIATED WITH RESEARCH ARE NOT INCLUDED IN COSTS REPORTED IN THIS FORM 990 SCHEDULE H PART I LINE 7H BECAUSE THEY ARE ACCOUNTED FOR AS COSTS OF LAHEY CLINIC INC., THESE ACTIVITIES ARE IMPORTANT TO THE COMBINED MISSIONS OF BOTH ENTITIES AND TO THE COMMUNITIES SERVED BY THE HOSPITAL, AND AS SUCH, DETAIL SUPPORTING THESE ACCOMPLISHMENTS ARE INCLUDED IN THE NARRATIVE SUPPORT TO THIS FILING. SINCE LAHEY CLINIC'S INCEPTION, ITS CLINICIANS HAVE ENGAGED IN FURTHERING RESEARCH IN ORDER TO ADVANCE THE PRACTICE OF MEDICINE, NOT ONLY FOR LAHEY PATIENTS BUT FOR ALL PATIENTS. ADVANCING MEDICINE THROUGH RESEARCH AND THE EDUCATION OF TOMORROW'S HEALTH CARE LEADERS IS A LONGSTANDING, CORE COMPONENT OF THE LAHEY CLINIC MISSION. WHETHER WORKING IN THE LABORATORY SETTING OR PARTICIPATING IN CLINICAL TRIALS TO TREAT PATIENTS AND ADVANCE CLINICAL MEDICINE, THEY ARE HELPING TO SHAPE THE NEW TREATMENTS THAT IMPROVE QUALITY CARE FOR PATIENTS, BOTH SAFELY AND EFFECTIVELY.THE MAJORITY OF THE RESEARCH CONDUCTED AT LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC) CONSISTS OF CLINICAL TRIALS THAT HAVE A DIRECT IMPACT ON THE LIVES OF LAHEY CLINIC AND LHMC PATIENTS. DURING THE FISCAL PERIOD COVERED BY THIS FILING, LHMC WAS ENGAGED IN APPROXIMATELY 280 ACTIVE FEDERAL, CORPORATE, NON-PROFIT, AND INTERNALLY SPONSORED PROJECTS, AND MORE THAN 470 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL STUDIES. DURING THE SAME TIME, LHMC HAD OVER 140 PRINCIPAL INVESTIGATORS, MANY WHO ARE TUFTS UNIVERSITY SCHOOL OF MEDICINE FACULTY OR UNIVERSITY OF MASSACHUSETTS CHAN SCHOOL FACULTY, AND NEARLY THE SAME NUMBER OF CO-INVESTIGATORS DEMONSTRATING A ROBUST CULTURE OF RESEARCH ENGAGEMENT AMONG PHYSICIANS AND CLINICAL DISCIPLINES. THIS BROAD ENGAGEMENT RESULTED IN OVER 1,900 PATIENTS RECEIVING MEDICAL CARE AS PART OF CLINICAL TRIALS. THE KEY AREAS OF RESEARCH INCLUDE THERAPEUTIC INVESTIGATIONAL DRUG AND MEDICAL DEVICE CLINICAL TRIALS, COMPARATIVE EFFECTIVENESS RESEARCH, AND TRANSLATIONAL RESEARCH ALL OF WHICH SERVE THE GOAL OF TREATING PATIENTS AND PROVIDING THE CUTTING EDGE CARE OF TOMORROW. AS NOTED IN THIS FILING, LHMC IS A TEACHING HOSPITAL, AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE WITH TUFTS AS WELL AS OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED BOSTON TEACHING HOSPITALS. LHMC ALSO PARTICIPATES IN THE TUFTS CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE (TUFTS CTSI), WHICH PROMOTES COLLABORATIVE, CROSS-DISCIPLINARY, FULL-SPECTRUM TRANSLATIONAL RESEARCH AMONG ITS MULTIPLE HOSPITALS AND HEALTH PLANS, INDUSTRY LEADERS, COMMUNITY ORGANIZATIONS, AND OTHER PARTICIPANTS WHO PLACE A UNIQUE EMPHASIS ON ENGAGING THEIR LOCAL COMMUNITIES IN BIOMEDICAL RESEARCH. THE COLLABORATIVE NATURE OF THE RESEARCH CONDUCTED AT LHMC RESULTED IN THEIR PUBLISHING OVER 290 PEER-REVIEWED JOURNAL ARTICLES DURING THE PERIOD COVERED BY THIS FILING. LHMC ENGAGES IN RESEARCH IN NEARLY ALL DISCIPLINES:- ALLERGY AND IMMUNOLOGY- ANESTHESIOLOGY- CARDIOVASCULAR AND THORACIC SURGERY- CARDIOVASCULAR MEDICINE- CELL AND MOLECULAR BIOLOGY RESEARCH LABORATORY- COLON AND RECTAL SURGERY- DERMATOLOGY- DIAGNOSTIC RADIOLOGY- FOOD & NUTRITION SERVICES- GASTROENTEROLOGY- GENERAL INTERNAL MEDICINE- GENERAL SURGERY- GYNECOLOGY- HEMATOLOGY AND ONCOLOGY- HOSPITAL MEDICINE- INFECTIOUS DISEASES- LABORATORY MEDICINE- NEUROLOGY- NEUROSURGERY- NURSING- OPHTHALMOLOGY- ORTHOPAEDIC SURGERY- OTOLARYNGOLOGY/HEAD & NECK SURGERY- PATHOLOGY- PHYSICAL THERAPY- PLASTIC AND RECONSTRUCTIVE SURGERY- PROFESSIONAL DEVELOPMENT AND SIMULATION- PSYCHIATRY AND BEHAVIORAL HEALTH- PULMONARY AND CRITICAL CARE MEDICINE- RADIATION ONCOLOGY- SURGICAL CRITICAL CARE- TRANSPLANTATION- TRAUMA CENTER- TRAVEL AND TROPICAL MEDICINE- UROLOGYRESEARCH ENGAGEMENT AT LHMCADVANCING MEDICINE THROUGH DISCOVERY, RESEARCH AND INNOVATION IS THE MISSION OF THE RESEARCH PROGRAM AT LHMC. ITS FOCUS CENTERS ON BRINGING THE LATEST THERAPEUTICS TO THE CLINIC, EVALUATING AND IMPLEMENTING PREVENTATIVE INTERVENTIONS FOR THE PURPOSE OF IMPROVING HEALTH OUTCOMES, ASSESSING THE QUALITY AND EFFECTIVENESS OF MEDICAL CARE, AND TRANSFORMING THE PRACTICE OF MEDICINE THROUGH SCIENTIFIC DISCOVERY. EXAMPLES OF RESEARCH ENGAGEMENT AT LHMCHIGHLIGHTED BELOW ARE A FEW EXAMPLES OF THE TRANSFORMATIVE RESEARCH CONDUCTED AT LHMC. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS LHMC IS MAKING TO PATIENT CARE TODAY AND TOMORROW.
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EXPLORING REAL WORLD DATA TO CHANGE MEDICAL PRACTICE
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UNDER THE LEADERSHIP OF DRS. FREDERIC RESNIC AND ZOHER GHOGAWALA, THE COMPARATIVE EFFECTIVENESS RESEARCH INSTITUTE (CERI) AT LHMC UTILIZES REAL-WORLD DATA TO EVALUATE THE IMPACT OF MEDICAL DEVICES USED TO TREAT CARDIOVASCULAR DISEASE, AND TO COMPARE THE EFFECTIVENESS OF NEUROSURGICAL DEVICES. THEIR RESEARCH IS FOCUSED ON MEDICAL DEVICE SAFETY AND IMPROVING PATIENT OUTCOMES. CERI HAS BEEN THE RECIPIENT OF NUMEROUS FEDERAL AWARDS TO STUDY THE PERFORMANCE AND LONG-TERM SAFETY SURVEILLANCE OF IMPLANTABLE MEDICAL DEVICES. IN COLLABORATION WITH RESEARCHERS AT VANDERBILT UNIVERSITY MEDICAL CENTER, AND WITH SUPPORT FROM THE NATIONAL INSTITUTES OF HEALTH, DR. RESNIC AND HIS TEAM DEVELOPED AN ANALYTIC STRATEGY TO MEASURE LEARNING EFFECTS ON DEVICE OUTCOMES. THIS RESEARCH SEEKS TO INTEGRATE INTO A LARGER FRAMEWORK THE IMPACT OF PROVIDER LEARNING AND INTRINSIC DEVICE SAFETY SIGNALING, THEREBY FURTHER SOLIDIFYING THE CURRENT MEDICAL DEVICE SAFETY SURVEILLANCE APPROACHES, AND REFINING OUTCOME MEASUREMENTS. IN PARTNERSHIP WITH AN INDEPENDENT MEDICAL DEVICE RESEARCH ORGANIZATION, AND WITH SUPPORT FROM THE FOOD AND DRUG ADMINISTRATION, CERI HAS BEEN SERVING AS A TECHNICAL ADVISOR AND DATA PARTNER IN THE DESIGN AND DEVELOPMENT OF AN ACTIVE SAFETY SURVEILLANCE NETWORK HUB. THE HUB AIMS TO ENABLE NATIONAL NETWORK PARTNERS TO COLLABORATE ON FUTURE MEDICAL DEVICE SURVEILLANCE PROJECTS. A GROUNDBREAKING STUDY PUBLISHED IN THE JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY: CLINICAL ELECTROPHYSIOLOGY (DOI: 10.1016/J.JACEP.2023.06.008) CONDUCTED BY A TEAM OF RESEARCHERS FROM THE LHMC DIVISION OF CARDIOVASCULAR MEDICINE UTILIZING THE TRINETX RESEARCH NETWORK HAS FOUND THAT SODIUM-GLUCOSE COTRANSPORTER 2 INHIBITORS (SGLT2-IS) SUBSTANTIALLY DECREASE THE RECURRENCE OF ATRIAL FIBRILLATION (AF) IN PATIENTS WITH TYPE 2 DIABETES MELLITUS (DM) WHO HAVE UNDERGONE CATHETER ABLATION. THE RESEARCH INVOLVED THE ANALYSIS OF DATA FROM TWO PROPENSITY-MATCHED COHORTS OF 2,225 PATIENTS EACH, TO EVALUATE THE IMPACT OF BASELINE SGLT2-I USE ON AF RECURRENCE. THE PRIMARY OUTCOME MEASURED INCLUDED THE NEED FOR CARDIOVERSION, NEW ANTIARRHYTHMIC DRUG (AAD) THERAPY, OR REPEAT AF ABLATION. SECONDARY OUTCOMES INCLUDED HEART FAILURE EXACERBATIONS, ISCHEMIC STROKE, ALL-CAUSE HOSPITALIZATION, AND DEATH OVER A 12-MONTH FOLLOW-UP PERIOD. THE FINDINGS REVEALED THAT SGLT2-I USE WAS ASSOCIATED WITH A 32% REDUCTION IN THE RISK OF THE PRIMARY OUTCOME (ADJUSTED OR: 0.68; 95% CI: 0.602-0.776; P < 0.0001) AND A HIGHER PROBABILITY OF EVENT-FREE SURVIVAL AT 12 MONTHS (HR: 0.85, 95% CI: 0.77-0.95; P = 0.003). WHILE SECONDARY OUTCOMES WERE GENERALLY LOWER IN THE SGLT2-I GROUP, THE INCIDENCE OF ISCHEMIC STROKE DID NOT SIGNIFICANTLY DIFFER BETWEEN THE TWO GROUPS. THIS STUDY HIGHLIGHTS THE POTENTIAL BENEFITS OF SGLT2 INHIBITORS IN MANAGING AF RECURRENCE IN DIABETIC PATIENTS POST-ABLATION. FINDINGS SUGGEST THAT SGLT2-IS COULD PLAY A CRUCIAL ROLE IN IMPROVING OUTCOMES FOR THIS HIGH-RISK PATIENT POPULATIONTHE PREVALENCE OF INTERSTITIAL LUNG ABNORMALITIES (ILA) AND THE ASSOCIATION WITH CLINICALLY SIGNIFICANT OUTCOMES INCLUDING MORTALITY, HOSPITALIZATIONS, CANCER AND INTERSTITIAL LUNG DISEASE (ILD) DIAGNOSIS WAS EXAMINED IN LHMC'S LARGE CT LUNG CANCER SCREENING PROGRAM. 1699 SUBJECTS MET INCLUSION CRITERIA. 41 (2.4%) HAD ILA AND 101 (5.9%) HAD INDETERMINATE ILA ON BASELINE CTS. ILD WAS DIAGNOSED IN 10 (24.4%) OF 41 WITH ILA ON BASELINE CT WITH A MEAN TIME FROM BASELINE CT TO DIAGNOSIS OF 4.47 2.72 YEARS. ON MULTIVARIABLE MODELING, THE PRESENCE OF ILA REMAINED A SIGNIFICANT PREDICTOR OF DEATH, HR 3.87 (2.07, 7.21; P < 0.001) WHEN ADJUSTED FOR AGE, SEX, BMI, PACK YEARS AND ACTIVE SMOKING, BUT NOT OF LUNG CANCER AND ALL-CAUSE HOSPITAL ADMISSION. APPROXIMATELY 50% WITH BASELINE ILA HAD PROGRESSION ON THE LONGITUDINAL SCAN. THIS RESEARCH DEMONSTRATED THAT ILA IDENTIFIED ON BASELINE LUNG CANCER SCREENING EXAMS ARE ASSOCIATED WITH ALL-CAUSE MORTALITY AND A SIGNIFICANT PROPORTION OF PATIENTS WITH ILA ARE SUBSEQUENTLY DIAGNOSED WITH ILD AND HAVE CT PROGRESSION ON LONGITUDINAL SCANS.COVID RESEARCHAS THE COVID-19 PUBLIC HEALTH EMERGENCY CAME TO AN END, LHMC CONTINUED TO PRODUCE ORIGINAL, THOUGHT PROVOKING RESEARCH. A RECENT STUDY PUBLISHED IN CRITICAL CARE SHED LIGHT ON THE ESCALATING USE OF MECHANICAL CARDIOPULMONARY RESUSCITATION (MCPR) DURING IN-HOSPITAL CARDIAC ARREST (IHCA) AMID THE COVID-19 PANDEMIC. LED BY A TEAM IN THE DIVISION OF PULMONARY AND CRITICAL CARE MEDICINE, THIS INVESTIGATION UNDERSCORES THE EVOLVING LANDSCAPE OF RESUSCITATION STRATEGIES IN RESPONSE TO THE GLOBAL HEALTH CRISIS. ANALYZING DATA FROM THE AMERICAN HEART ASSOCIATION'S GET WITH THE GUIDELINES RESUSCITATION DATABASE, THE STUDY OBSERVED A SIGNIFICANT RISE IN MCPR UTILIZATION FROM 2.4% TO 6.0% BETWEEN JANUARY 2019 AND DECEMBER 2021. NOTABLY, MANY INSTITUTIONS EMBRACED MCPR FOR THE FIRST TIME DURING THIS PERIOD, MARKING A NOTABLE SHIFT IN RESUSCITATION PRACTICES. WITH THE PANDEMIC PROMPTING HEIGHTENED CONCERNS FOR HEALTHCARE WORKER SAFETY, THE AMERICAN HEART ASSOCIATION RECOMMENDED MCPR AS A MEANS TO MITIGATE EXPOSURE TO AEROSOLIZED VIRUS DURING CPR PROCEDURES. THIS GUIDANCE LIKELY FUELED THE RAPID ADOPTION OF MCPR ACROSS HEALTHCARE FACILITIES, WITH 6.5% OF HOSPITALS EXPERIENCING A SUBSTANTIAL INCREASE IN MCPR CASES. WHILE TRIALS HAVE YET TO DEFINITIVELY ESTABLISH THE SUPERIORITY OF MCPR OVER MANUAL CPR IN THE IN-HOSPITAL SETTING, THIS STUDY UNDERSCORES THE URGENT NEED FOR FURTHER RESEARCH TO INFORM RESUSCITATION PROTOCOLS EFFECTIVELY. DR. SARJU GANATRA, A CLINICAL INVESTIGATOR FROM THE LHMC DIVISION OF CARDIOVASCULAR MEDICINE, IN COLLABORATION WITH RESEARCHERS FROM BRIGHAM AND WOMEN'S HOSPITAL AND HARVARD MEDICAL SCHOOL, PUBLISHED A HIGH-IMPACT STUDY IN CLINICAL INFECTIOUS DISEASES (DOI: 10.1093/CID/CIAD400), WHICH REVEALED THAT THE USE OF ORAL NIRMATRELVIR AND RITONAVIR (PAXLOVID) SIGNIFICANTLY REDUCES THE RISK OF EMERGENCY DEPARTMENT VISITS, HOSPITALIZATION, AND MORTALITY IN VACCINATED ADULTS AGED 18-50 DIAGNOSED WITH COVID-19. THE COHORT STUDY, WHICH ANALYZED DATA FROM 86,119 PATIENTS WITHIN THE TRINETX DATABASE, COMPARED 2,547 PATIENTS WHO RECEIVED PAXLOVID TO A MATCHED CONTROL GROUP. RESULTS INDICATED A 30% RELATIVE RISK REDUCTION IN ADVERSE OUTCOMES FOR THOSE TREATED WITH PAXLOVID, WITH THE NUMBER NEEDED TO TREAT (NNT) BEING 47. PARTICULARLY NOTABLE BENEFITS WERE OBSERVED IN SUBGROUPS WITH SERIOUS COMORBIDITIES SUCH AS CANCER (NNT = 45), CARDIOVASCULAR DISEASE (NNT = 30), AND BOTH CONDITIONS (NNT = 16). CONVERSELY, NO SIGNIFICANT BENEFITS WERE FOUND FOR PATIENTS WITH ONLY CHRONIC LOWER RESPIRATORY DISORDERS LIKE ASTHMA OR COPD, OR THOSE WITHOUT SERIOUS COMORBIDITIES. THIS STUDY UNDERSCORES THE IMPORTANCE OF IDENTIFYING HIGH-RISK PATIENTS WHO COULD BENEFIT THE MOST FROM PAXLOVID. FINDINGS SUGGEST THAT WHILE PAXLOVID IS BENEFICIAL FOR MANY, ITS OVERPRESCRIPTION, ESPECIALLY IN LOWER-RISK GROUPS, SHOULD BE AVOIDED, SO THAT VITAL TREATMENTS REMAIN AVAILABLE FOR THOSE WHO REALLY NEED THEM AND ARE NOT WASTED ON THOSE WHO STAND TO GAIN NO BENEFIT.TRANSLATING DISCOVERY RESEARCH INTO CLINICAL SOLUTIONS THE IAN C. SUMMERHAYES CELL AND MOLECULAR BIOLOGY (ICSCMB) LAB AT LHMC PERFORMS TRANSLATIONAL RESEARCH AND DURING LHMC'S FISCAL YEAR ENDED SEPTEMBER 30, 2023 FOCUSED ON FIVE DISEASES: BLADDER CANCER, BREAST CANCER, KIDNEY CANCER, LUNG CANCER, AND URETHRAL STRICTURE DISEASE. THE BREAST, BLADDER, AND KIDNEY CANCER RESEARCH WAS FOCUSED ON THE MECHANISMS OF ACTION OF DYSREGULATED MICRORNAS AND PROTEINS IN AGGRESSIVE TUMORS. LHMC RESEARCHERS EXAMINED PROTEINS AND THE ROLES THEY MAY HAVE IN THE METASTATIC PROCESS, IN PARTICULAR, CELL PROLIFERATION MIGRATION, AND INVASION.
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THE KIDNEY CANCER RESEARCH PROJECT INVESTIGATED THE PERFORMANCE
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OF DROPLET DIGITAL PCR (DDPCR) COMPARED TO QRT- PCR IN IDENTIFYING MIRNA BIOMARKERS THAT DIFFERENTIATE MALIGNANT FROM BENIGN RENAL MASSES. POTENTIAL BIOMARKERS OF RCC WERE IDENTIFIED FROM A LITERATURE REVIEW. RNA WAS EXTRACTED FROM THE PLASMA OF 56 PATIENTS. ALL THE SAMPLES UNDERWENT ANALYSIS VIA DDPCR AS WELL AS QRT-PCR, AND EXPRESSION LEVELS WERE RECORDED FOR THE FOLLOWING MIRNAS: MIR-93, -144, -210, -221, AND -222. TUMORS WERE GROUPED INTO LOW-GRADE CCRCC, HIGH-GRADE CCRCC, PAPILLARY RCC, AND BENIGN MASSES (PRIMARILY ANGIOMYOLIPOMA). THE MIRNA MIR-210 (P = 0.034) AND THE COMBINATION OF MIRS-210 AND MIR-222 (P = 0.003) WERE EXPRESSED AT SIGNIFICANTLY HIGHER RATES AMONG THOSE WITH RCC THAN THOSE WITH BENIGN MASSES, AS MEASURED BY DDPCR. USING THE COMBINATION OF MIR-210 AND MIR-222, DDPCR IDENTIFIED SIGNIFICANT DIFFERENCES BETWEEN THE SUBGROUPS: PAPILLARY RCC VERSUS BENIGN (P = 0.03), LOW-GRADE CCRCC VERSUS BENIGN (P = 0.026), AND HIGH-GRADE CCRCC VERSUS BENIGN (P = 0.002). THE ONLY SIGNIFICANT DIFFERENCE BETWEEN THESE SUBGROUPS USING QRT-PCR WAS BETWEEN HIGH-GRADE CCRCC AND BENIGN (P = 0.045). ALL THE AUCS WERE SIGNIFICANT WHEN COMPARING EACH RCC SUBGROUP WITH BENIGN FOR BOTH PCR TECHNOLOGIES. THIS STUDY SHOWED THAT USING A COMBINATION OF MIR-210 AND MIR-222, DDPCR IDENTIFIED SIGNIFICANT DIFFERENCES BETWEEN BENIGN AND MALIGNANT RENAL MASSES THAT WERE NOT IDENTIFIED AS SIGNIFICANT BY CONVENTIONAL QRT-PCR.ADDITIONAL LHMC RESEARCHERS INVESTIGATED THE ROLE OF MIRNA AND GENE EXPRESSION IN LICHEN SCLEROSUS (LS), WHICH IS A CHRONIC INFLAMMATORY CONDITION THAT CAN LEAD TO MALE URETHRAL STRICTURE DISEASE (USD). LS USD IS CHARACTERIZED BY SCARRING OF THE URETHRA, AND ITS PATHOPHYSIOLOGY IS POORLY UNDERSTOOD. IDENTIFYING NON-INVASIVE BIOMARKERS THAT DISTINGUISH LS INDUCED FROM NON-LS INDUCED URETHRAL STRICTURES WOULD HAVE BROAD IMPLICATIONS FOR THE DIAGNOSIS, COUNSELING, AND TREATMENT OF URETHRAL STRICTURE DISEASE (USD). IN ADDITION, IDENTIFYING THE DYSREGULATED GENES INVOLVED IN THIS DISEASE IS CRUCIAL TO BETTER UNDERSTANDING ITS CAUSE. LHMC RESEARCHERS ALSO CONTINUE TO FOCUS THEIR EFFORTS ON SEVERAL PROJECTS IN LUNG CANCER WITH THE GOAL TO DEVELOP AN ACCURATE NASAL BIOMARKER INTEGRATING EXPRESSION PROFILING OF GENES AND MIRNA, CLINICAL VARIABLES, AND NODULE CHARACTERISTICS IN ORDER TO DISTINGUISH EARLY LUNG MALIGNANCIES FROM BENIGN PULMONARY NODULES. WE ARE ALSO WORKING ON A STUDIES TO DEVELOP AN UNDERSTANDING OF THE GENETIC CHANGES RESULTING IN AGGRESSIVE LIFE THREATENING LUNG CANCER.LHMC RESEARCHERS CONTRIBUTED TO A STUDY THAT SOUGHT TO VALIDATE A CLINICAL-GENOMIC CLASSIFIER DEVELOPED USING WHOLE-TRANSCRIPTOME SEQUENCING OF NASAL EPITHELIAL CELLS FROM PATIENTS WITH A PN 30 MM WHO SMOKE OR HAVE PREVIOUSLY SMOKED. THE RESEARCHERS WERE ASSESSING IF THE PROBABILITY OF LUNG CANCER (PCA) IN INDIVIDUALS WITH A PULMONARY NODULE (PN) AND A HISTORY OF SMOKING CAN BE PREDICTED BY A CLASSIFIER THAT USES CLINICAL FACTORS AND GENOMIC DATA FROM NASAL EPITHELIAL CELLS OBTAINED BY CYTOLOGIC BRUSHING. MACHINE LEARNING WAS USED TO TRAIN A CLASSIFIER USING GENOMIC AND CLINICAL FEATURES ON 1,120 PATIENTS WITH PNS LABELED AS BENIGN OR MALIGNANT ESTABLISHED BY A FINAL DIAGNOSIS OR A MINIMUM OF 12 MONTHS OF RADIOGRAPHIC SURVEILLANCE. THE CLASSIFIER WAS DESIGNED TO YIELD LOW-, INTERMEDIATE-, AND HIGH-RISK CATEGORIES. THE CLASSIFIER WAS VALIDATED IN AN INDEPENDENT SET OF 312 PATIENTS, INCLUDING 63 PATIENTS WITH A PRIOR HISTORY OF CANCER (OTHER THAN LUNG CANCER), COMPARING THE CLASSIFIER PREDICTION WITH THE KNOWN CLINICAL OUTCOME. IN THE PRIMARY VALIDATION SET, SENSITIVITY AND SPECIFICITY FOR LOW-RISK CLASSIFICATION WERE 96% AND 42%, WHEREAS SENSITIVITY AND SPECIFICITY FOR HIGH-RISK CLASSIFICATION WAS 58% AND 90%, RESPECTIVELY. SENSITIVITY WAS SIMILAR ACROSS STAGES OF NON-SMALL CELL LUNG CANCER, INDEPENDENT OF SUBTYPE. PERFORMANCE COMPARED FAVORABLY WITH CLINICAL-ONLY RISK MODELS. ANALYSIS OF 63 PATIENTS WITH PRIOR CANCER SHOWED SIMILAR PERFORMANCE AS DID SUBANALYSES OF PATIENTS WITH LIGHT VS HEAVY SMOKING BURDEN AND THOSE ELIGIBLE FOR LUNG CANCER SCREENING VS THOSE WHO WERE NOT. THE RESEARCH SHOWED THAT THE NASAL CLASSIFIER PROVIDES AN ACCURATE ASSESSMENT OF PCA IN INDIVIDUALS WITH A PN 30 MM WHO SMOKE OR HAVE PREVIOUSLY SMOKED. CLASSIFIER-GUIDED DECISION-MAKING COULD LEAD TO FEWER DIAGNOSTIC PROCEDURES IN PATIENTS WITHOUT CANCER AND MORE TIMELY TREATMENT IN PATIENTS WITH LUNG CANCER.TOGETHER WITH THEIR COLLABORATORS, LHMC INVESTIGATORS ALSO ASSESSED WHETHER PATHOLOGIC CLASSIFICATION IS REPRODUCIBLE AND WHETHER SUBSETS OF ADENOCARCINOMAS PREDICT WORSE OUTCOMES WHEN TREATED BY WEDGE RESECTION COMPARED TO LOBECTOMY. A RETROSPECTIVE COHORT OF 108 RECIPIENTS OF WEDGE RESECTION AND 187 RECIPIENTS OF LOBECTOMY FOR STAGE I/0 LUNG ADENOCARCINOMAS 2.0 CM WAS ASSEMBLED FROM 2 INSTITUTIONS. ALL TUMORS WERE CLASSIFIED BY A SINGLE PATHOLOGIST, AND INTEROBSERVER REPRODUCIBILITY WAS ASSESSED IN A SUBSET (N = 92) BY 5 PATHOLOGISTS. ANGIOINVASIVE ADENOCARCINOMA (21%-27% OF CASES) WAS ASSOCIATED WITH WORSE OUTCOMES WHEN TREATED WITH WEDGE RESECTION COMPARED TO LOBECTOMY (5-YEAR RECURRENCE-FREE SURVIVAL, 57% VS 85% [P = .007]; 5-YEAR DISEASE-FREE SURVIVAL [DSS], 70% VS 90% [P = .043]; 7-YEAR OVERALL SURVIVAL, 37% VS 58% [P = .143]). ADENOCARCINOMA IN SITU (AIS), MINIMALLY INVASIVE ADENOCARCINOMA (MIA), AND LMP EXHIBITED 100% 5-YEAR DSS REGARDLESS OF THE SURGICAL APPROACH. MULTIVARIABLE ANALYSIS SHOWED THAT ANGIOINVASION, TUMOR SIZE, MARGIN STATUS, AND EXTENT OF NODAL SAMPLING WERE SIGNIFICANTLY ASSOCIATED WITH RECURRENCE BUT NOT WITH SURGICAL PROCEDURE. THERE WAS SUBSTANTIAL INTEROBSERVER REPRODUCIBILITY AMONG THE PATHOLOGISTS FOR THE DIAGNOSIS OF ANGIOINVASIVE ADENOCARCINOMA ( = 0.71) AND THE COMBINED INDOLENT AIS/MIA/LMP GROUP ( = 0.74). THE MAJORITY (75%) OF LUNG ADENOCARCINOMAS 2 CM ARE ADEQUATELY MANAGED WITH WEDGE RESECTION; HOWEVER, ANGIOINVASIVE ADENOCARCINOMAS (25%) TREATED BY WEDGE RESECTION WITH SUBOPTIMAL NODAL SAMPLING EXHIBIT POOR OUTCOMES, WITH A 40% TO 45% RATE OF RECURRENCE WITHIN 5 YEARS AND 60% TO 65% OVERALL MORTALITY AT 7 YEARS.LHMC RESEARCHERS TOGETHER WITH COLLABORATORS FROM TUFTS MEDICAL CENTER AND TUFTS UNIVERSITY AIMED TO DEVELOP AND TEST A PROTOTYPE OF A DEEP LEARNING SURGICAL GUIDANCE SYSTEM (CASL) THAT CAN INTRA-OPERATIVE IDENTIFY PERITONEAL SURFACE METASTASES ON ROUTINE LAPAROSCOPY IMAGES. CASL WAS DEVELOPED AND TESTED USING STAGING LAPAROSCOPY IMAGES RECORDED FROM 132 PATIENTS WITH HISTOLOGICALLY-CONFIRMED ADENOCARCINOMA INVOLVING THE GASTROINTESTINAL TRACT. THE DATA INCLUDED IMAGES DEPICTING 4287 VISIBLE PERITONEAL SURFACE LESIONS AND 3650 IMAGE PATCHES OF 365 BIOPSIED PERITONEAL SURFACE LESIONS. THE PROTOTYPE'S DIAGNOSTIC PERFORMANCE WAS COMPARED TO RESULTS FROM A NATIONAL SURVEY EVALUATING 111 ONCOLOGIC SURGEONS IN A SIMULATED CLINICAL ENVIRONMENT. IN A SIMULATED ENVIRONMENT, SURGEONS' ACCURACY OF CORRECTLY RECOMMENDING A BIOPSY FOR METASTASES WHILE OMITTING A BIOPSY FOR BENIGN LESIONS WAS ONLY 52%. IN THIS ENVIRONMENT, THE PROTOTYPE OF A DEEP LEARNING SURGICAL GUIDANCE SYSTEM DEMONSTRATED IMPROVED PERFORMANCE IN IDENTIFYING PERITONEAL SURFACE METASTASES COMPARED TO ONCOLOGIC SURGEONS WITH AN AREA UNDER THE RECEIVER OPERATING CHARACTERISTIC CURVE OF 0.69 (ONCOLOGIC SURGEON) VERSUS 0.78 (CASL) VERSUS 0.79 (HUMAN-COMPUTER COMBINED). A PROPOSED MODEL WOULD HAVE IMPROVED THE IDENTIFICATION OF METASTASES BY 5% WHILE REDUCING THE NUMBER OF UNNECESSARY BIOPSIES BY 28% COMPARED TO CURRENT STANDARD PRACTICE. THE FINDINGS FROM THIS STUDY DEMONSTRATED A PATHWAY FOR AN ARTIFICIAL INTELLIGENCE SYSTEM FOR INTRA-OPERATIVE IDENTIFICATION OF PERITONEAL SURFACE METASTASES, BUT IT STILL REQUIRES ADDITIONAL DEVELOPMENT AND FUTURE VALIDATION IN A MULTI-INSTITUTIONAL CLINICAL SETTING.
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UNDER THE LEADERSHIP OF DR. AJAY WAKHLOO, INVESTIGATORS
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IN THE LHMC IMAGE GUIDED THERAPY LAB UTILIZED STEREOLITHOGRAPHIC 3D PRINTING TECHNOLOGY TO CREATE DISEASE MODELS FOR EVALUATING ENDOVASCULAR DEVICES TO TREAT CEREBRAL ANEURYSMS. IN COLLABORATION WITH INDUSTRY PARTNERS, THE IGT LAB TRANSFORMED DE-IDENTIFIED HUMAN IMAGING DATA INTO LIFELIKE, FUNCTIONAL CEREBROSPINAL FLUID MODELS NECESSARY FOR PRE-CLINICAL ASSESSMENT OF CATHETER-BASED SYSTEMS USED IN ENDOSCOPIC THIRD VENTRICULOSTOMY PROCEDURES. IGT LAB INVESTIGATOR-INITIATED RESEARCH SUPPORTED THROUGH THE ROBERT E. WISE INSTITUTE RESULTED IN THE SUCCESSFUL DEPLOYMENT OF A HEMORRHAGE STROKE MODEL TO EVALUATE THE EFFICACY OF FLOW DIVERTERS IN SLOWING BLEEDING AND MINIMIZING HEMATOMA GROWTH. SUBSEQUENT INDUSTRY PARTNERSHIPS INVOLVED THE FABRICATION OF PATIENT-SPECIFIC CEREBRAL ANEURYSM MODELS, LEADING TO THE IMPROVED USE OF ENDOVASCULAR DEVICES FOR HARD-TO-TREAT CASES. ONE PARTNERSHIP INVOLVED THE QUANTITATIVE CHARACTERIZATION OF THE HUMAN CAROTID SIPHON BY ANALYZING VESSEL ATTRIBUTES SUCH AS TORTUOSITY, CURVATURE, AND TWIST ANGLE IN 25 PATIENTS. THESE EFFORTS AIMED TO PREDICT GEOMETRIC INDICATORS CAUSING FLOW DIVERTER FLATTENING DURING ANEURYSM TREATMENT, THEREBY AIDING IN PREOPERATIVE DECISION-MAKING FOR SUCCESSFUL DEVICE DELIVERY.STUDIES PERFORMED IN THE PLASTIC AND RECONSTRUCTIVE SURGERY LAB INVESTIGATED THE IMPACT OF DIABETIC ADIPOSE-DERIVED STEM CELL (ASCS) IN THE TREATMENT OF DIABETIC WOUNDS. DIABETIC ASCS (DMA) AND NONDIABETIC ASCS WERE ISOLATED FROM DB/DB AND C57BL/6J MICE, AND CHARACTERIZED BY IMMUNOCYTOCHEMISTRY, PROLIFERATION, DIFFERENTIATION, AND GENE EXPRESSION ASSAYS. THE EFFECTS OF BOTH ASCS ON HEALING WERE INVESTIGATED USING 36 MALE 10- TO 12-WEEK-OLD DB/DB MICE. WOUND SIZE WAS MEASURED SEMIWEEKLY UNTIL DAY 28, AND HISTOLOGIC AND MOLECULAR ANALYSES WERE PERFORMED AT DAY 14. BOTH ASCS HAD FIBROBLAST-LIKE MORPHOLOGY AND WERE CD44 + /CD90 + /CD34 - /CD45 - AT PASSAGE 4. COMPARED WITH NONDIABETIC ASCS IN VITRO, DMA PROLIFERATIVE CAPABILITY WAS RESTORED BY PASSAGE 4 (P > 0.05). ALTHOUGH DMA OSTEOGENESIS WAS ATTENUATED (P < 0.01), BOTH ASCS HAD SIMILAR ADIPOGENESIS AND EXPRESSIONS OF PPAR/LPL/OCN/RUNX2 (P > 0.05). IN VIVO EXPERIMENTS SHOWED THAT, COMPARED WITH PHOSPHATE-BUFFERED SALINE CONTROL, BOTH ASCS ARE COMPARABLE IN IMPROVING WOUND HEALING ( P < 0.0001), ANGIOGENESIS ( P < 0.05), EPITHELIAL CELL PROLIFERATION ( P < 0.05), AND GRANULATION TISSUE FORMATION ( P < 0.0001). RESULTS FROM THIS STUDY SHOWED THAT IN BOTH IN VITRO AND IN VIVO MURINE MODELS, DMAS HAVE SHOWN A COMPARABLE THERAPEUTIC CAPACITY TO NORMAL ASCS IN PROMOTING DIABETIC WOUND HEALING BY IMPROVING ANGIOGENESIS, REEPITHELIALIZATION, AND GRANULATION TISSUE FORMATION. THESE RESULTS SUPPORT CLINICAL APPLICATIONS OF AUTOLOGOUS ASCS IN DIABETIC WOUND TREATMENTS. THIS WORK HAS PARTICULAR SURGICAL RELEVANCE AS IT HIGHLIGHTS A THEORETICAL AND CLINICAL PATHWAY TO USE DIABETIC PATIENTS' OWN ASCS TO TREAT THEIR WOUNDS, BYPASSING ANY CONCERNS OF CROSS-HOST SOURCING ISSUES IN REGENERATIVE MEDICINE.IMPORTANT NIH-SPONSORED CLINICAL TRIALSLHMC ONCOLOGISTS CO-LEAD A MULTICENTER NCI-SPONSORED CLINICAL TRIAL ENTITLED "IMMUNE CHECKPOINT INHIBITED TOXICITY (I-CHECKIT): A PROSPECTIVE OBSERVATIONAL STUDY." THE OBJECTIVES OF THE STUDY WERE TO DEVELOP AND INDEPENDENTLY VALIDATE A RISK PREDICTION MODEL FOR COMMON TERMINOLOGY CRITERIA FOR ADVERSE EVENTS (CTCAE) GRADE 3 OR HIGHER NON-HEMATOLOGICAL IMMUNE-RELATED ADVERSE EVENTS (IRAES) IN THE FIRST YEAR OF IMMUNE CHECKPOINT INHIBITOR (ICI)-BASED THERAPY FOR THE TREATMENT OF SOLID TUMORS. THIS STUDY EXAMINED HOW CERTAIN RISK FACTORS (SUCH AS AGE, GENDER, OTHER MEDICAL CONDITIONS, AND THE TYPE OF IMMUNOTHERAPY USED TO TREAT THE CANCER) AFFECT WHETHER A PATIENT WITH A MALIGNANT SOLID TUMOR WILL DEVELOP MILD OR SERIOUS SIDE EFFECTS FROM THE IMMUNOTHERAPY MEDICATIONS. IN ADDITION TO CO-LEADING THE STUDY, LHMC WAS ONE OF THE TOP ACCRUING SITES.LHMC HAS CONTINUED TO BE A KEY MEMBER OF THE NCI-SPONSORED COOPERATIVE CLINICAL TRIALS GROUP SWOG. ONE INITIATIVE LHMC INVESTIGATORS HAVE PLAYED A CRITICAL ROLE IN LEADING IS THE SWOG LUNG COMMITTEE, WHICH IS LEADING EFFORTS TO BETTER ENGAGE COMMUNITY-BASED ONCOLOGISTS. ONE OF THE BEST SUCCESS STORIES TO DATE HAS BEEN THE COMMITTEE'S INVOLVEMENT IN AN INNOVATIVE LUNG CANCER TRIAL KNOWN AS THE S2302 PRAGMATICA-LUNG TRIAL, WHICH WAS DESIGNED TO BE A PRAGMATIC CLINICAL TRIAL AIMED AT ELIMINATING TRADITIONAL BARRIERS TO ENROLL A MORE DIVERSE PATIENT POPULATION. TO DATE, THE RATE OF OVERALL AND MINORITY GROUP ENROLLMENT ON THIS TRIAL HAS FAR EXCEEDED EXPECTATIONS. LHMC ENROLLED THE FIRST THREE PATIENTS ONTO THIS NCI HIGH-PRIORITY TRIAL NATIONALLY AFTER IT OPENED, AND IT REMAINS ONE OF THE TOP ACCRUING SITES NATIONALLY.NIH HAS CREATED THE A NATIONAL NETWORK, NIH STROKENET, TO CONDUCT SMALL AND LARGE CLINICAL TRIALS AND RESEARCH STUDIES TO ADVANCE ACUTE STROKE TREATMENT, STROKE PREVENTION, AND RECOVERY AND REHABILITATION FOLLOWING A STROKE ACROSS THE LIFESPAN. THIS NETWORK OF 27 REGIONAL CENTERS ACROSS THE U.S., IS DESIGNED TO SERVE AS THE INFRASTRUCTURE AND PIPELINE FOR EXCITING NEW POTENTIAL TREATMENTS FOR PATIENTS WITH STROKE AND THOSE AT RISK FOR STROKE. NIH STROKENET ALSO PROVIDES AN EDUCATIONAL PLATFORM FOR STROKE PHYSICIANS, CLINICAL TRIAL COORDINATORS AND STROKE RESEARCHERS. LHMC IS DESIGNATED COMPREHENSIVE STROKE CENTER AND MAIN MEMBER OF THE NEW ENGLAND REGIONAL COORDINATION CENTER (NERCC), WHICH IS A COLLABORATION OF SITES ENCOMPASSING TWELVE OF THE TOP ACADEMIC MEDICAL CENTERS IN NEW ENGLAND. THE NERCC SERVES A LARGE AND DIVERSE PATIENT POPULATION FROM ACROSS NEW ENGLAND, CONSISTENTLY SCORING HIGHLY ON PERFORMANCE MEASURES DEVELOPED BY THE NIH STROKENET. LHMC HAS MADE SIGNIFICANT CONTRIBUTIONS TO NIH STROKENET CLINICAL TRIALS, AND AS A MEMBER OF THE NERCC, IT IS COMMITTED TO RECRUITMENT, RETENTION AND HIGH-QUALITY DATA CAPTURE AS A PARTICIPATING NIH STROKENET CENTER. IT'S CURRENTLY INVOLVED IN 4 NIH STROKENET CLINICAL TRIALS, INCLUDING SATURN, ASPIRE, FASTEST AND VERIFY.FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC OR HOSPITAL) IS COMMITTED TO THE HIGHEST QUALITY MEDICAL CARE. THE ENTIRE LAHEY COMMUNITY RECOGNIZES THAT THIS GOAL CANNOT BE ACCOMPLISHED WITHOUT A COMMITMENT TO EDUCATION. EDUCATIONAL PROGRAMS HAVE BEEN AN INTEGRAL PART OF LAHEY'S MISSION ADVANCING QUALITY PATIENT CARE SINCE ITS FOUNDING IN 1923. LHMC IS AN AFFILIATE FOR TUFTS MEDICAL SCHOOL AND TEACHING PHYSICIANS. THESE PHYSICIANS HOLD FACULTY APPOINTMENTS AT TUFTS AND INSTRUCT THE DOCTORS OF TOMORROW. THE INSTITUTIONAL COMMITMENT TO EDUCATION SUPPORTS PROFESSIONAL GROWTH OPPORTUNITIES AND CONTRIBUTES TO THE GOAL OF PROVIDING OPTIMAL PATIENT CARE. IN ADDITION TO THE RELATIONSHIP WITH TUFTS, LAHEY HAS A NEW AFFILIATION WITH UNIVERSITY OF MASSACHUSETTS (UMASS) CHAN MEDICAL SCHOOL. UMASS CHAN LAHEY, LOCATED AT LAHEY HOSPITAL IN BURLINGTON, MA, IS A NEW REGIONAL CAMPUS OF UMASS CHAN MEDICAL SCHOOL. THE REGIONAL CAMPUS WILL HOST LEAD@LAHEY, AN EXCLUSIVE TRACK AND DEDICATED PATHWAY OF THE T.H. CHAN SCHOOL OF MEDICINE PROGRAM LEADING TO THE MD DEGREE. FACULTY AT THE REGIONAL CAMPUS WILL BE APPOINTED TO THE UMASS CHAN MEDICAL SCHOOL. THE INAUGURAL CLASS OF 2028 WILL MATRICULATE IN AUGUST 2024. LEAD@LAHEY WILL COMMENCE WITH THE ENROLLMENT OF 25 ADDITIONAL STUDENTS TO THE T.H. CHAN SCHOOL OF MEDICINE IN THE INCOMING CLASS OF 2024 AND AN ADDITIONAL 25 STUDENTS PER YEAR THEREAFTER, SUCH THAT AFTER FOUR YEARS THERE WILL BE 100 CHAN MEDICAL STUDENTS ENROLLED IN THE LEAD@LAHEY TRACK. THE MEDICAL EDUCATION DEPARTMENT OVERSEES THE ADMINISTRATIVE FUNCTIONS FOR GRADUATE, UNDERGRADUATE AND ADVANCED PRACTITIONER TRAINING PROGRAMS AND ITS CONTINUING MEDICAL EDUCATION (CME) PROGRAM HOLDS ACCREDITATION WITH COMMENDATION FROM THE ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION. INTELLECTUAL STIMULATION PRODUCED IN AN ENVIRONMENT OF TEACHING AND LEARNING ENHANCES THE HOSPITAL'S ABILITY TO ENSURE THAT THE REQUIREMENTS FOR CURRICULA, SCHOLARLY ACTIVITY AND THE GENERAL COMPETENCIES CAN BE MET. DURING THE FISCAL YEAR COVERED BY THIS FILING, LHMC HAD NET EXPENDITURES OF $26,964,530 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE HOSPITAL'S TEACHING FUNCTION WHICH REPRESENTED 2.5% OF THE HOSPITAL'S TOTAL EXPENSES. ACGME ACCREDITED GME PROGRAMS -- RESIDENCYLAHEY CLINIC HOSPITAL, INC. SPONSORS NINE RESIDENCY AND ELEVEN FELLOWSHIP PROGRAMS THAT TRAINS 170 RESIDENTS AND FELLOWS. THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED THESE PROGRAMS LISTED BELOW.
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- ACGME ACCREDITED RESIDENCY PROGRAMS
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- ANESTHESIOLOGY- COLON RECTAL SURGERY- GENERAL SURGERY- INTERNAL MEDICINE- NEUROLOGY (TUFTS PROGRAM)- PLASTIC & RECONSTRUCTIVE SURGERY (INTEGRATED)- PLASTIC & RECONSTRUCTIVE SURGERY (INDEPENDENT)- DIAGNOSTIC RADIOLOGY- UROLOGY- ACGME ACCREDITED FELLOWSHIP PROGRAMS: - CARDIOLOGY- CARDIOLOGY CLINICAL CARDIAC ELECTROPHYSIOLOGY- CARDIOLOGY INTERVENTIONAL - MICROGRAPHIC SURGERY & DERMATOLOGIC ONCOLOGY- INTERVENTIONAL RADIOLOGY- ENDOCRINOLOGY- GASTROENTEROLOGY- TRANSPLANT HEPATOLOGY- NEUROLOGY EMG (TUFTS)- HAND SURGERY (ORTHOPEDIC)- PULMONARY & CRITICAL CARE MEDICINELHMC ALSO SERVES AS THE TEACHING SITE FOR A CLINICAL NEUROPHYSIOLOGY PROGRAM UNDER THE SPONSORSHIP OF TUFTS MEDICAL CENTER.ADDITIONAL INFORMATION ON LHMC'S CORE RESIDENCY PROGRAMS IS BELOW.NON-ACCREDITED GME PROGRAMS -- FELLOWSHIPS- ADDITIONAL TRAINING OPPORTUNITIES FOR UP TO 15 TRAINEES ARE OFFERED IN MULTIPLE SPECIALTIES THAT INCLUDE FELLOWSHIPS IN - ADVANCED ENDOSCOPY (THERAPEUTIC ENDOCRINOLOGY)- ANESTHESIOLOGY TRANSPLANT- BARIATRIC SURGERY- BEHAVIORAL NEUROLOGY & NEUROPSYCHIATRY- BREAST IMAGING / WOMEN'S HEALTH- CARDIOLOGY ADVANCED STRUCTURAL HEART- CARDIOLOGY - VASCULAR MEDICINE - GYNECOLOGY MINIMALLY INVASIVE (PELVIC SURGERY)- INTERVENTIONAL NEURORADIOLOGY- INTERVENTIONAL PULMONOLOGY- NEUROSURGERY SPINE- OPHTHALMOLOGY CORNEA- OPHTHALMOLOGY GLAUCOMA- OPHTHALMOLOGY RETINAL SURGERY- RECONSTRUCTIVE UROLOGIC SURGERY- SLEEP MEDICINE- STROKE- TRANSPLANT AND HPB SURGERYTHE HOSPITAL ALSO HOSTS ROTATING RESIDENTS AND FELLOWS IN ANESTHESIOLOGY, DERMATOLOGY, EMERGENCY MEDICINE, GYNECOLOGY, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASE, INTERNAL MEDICINE, NEUROLOGY, NEUROSURGERY, OPHTHALMOLOGY, OTOLARYNGOLOGY, ORTHOPAEDIC SURGERY, CARDIOTHORACIC SURGERY AND SURGICAL TRANSPLANT AND SERVES AS A ROTATION SITE FOR RESIDENTS AND FELLOWS FROM MULTIPLE LOCAL HOSPITALS INCLUDING, TUFTS MEDICAL CENTER, MASSACHUSETTS GENERAL HOSPITAL, BOSTON MEDICAL CENTER, ST. ELIZABETH'S HOSPITAL AND LEMUEL SHATTUCK HOSPITAL. THESE ACCOUNT FOR OVER 200 ROTATIONS PER YEAR.CORE ACGME ACCREDITED RESIDENCY PROGRAMSINTERNAL MEDICINETHE INTERNAL MEDICINE PROGRAM IS THE LARGEST RESIDENCY PROGRAM WITH 43 RESIDENTS, INCLUDING 12 CATEGORICAL AND 6 PRELIMINARY INTERNS. AS HEALTHCARE IS RAPIDLY CHANGING AND INTERNISTS CARE FOR PATIENTS IN A VARIETY OF SETTINGS WITH A WIDE-RANGE OF MEDICAL CONDITIONS, THE HOSPITAL'S TRAINING PROGRAM'S MISSION IS TO PROVIDE RESIDENTS WITH THE SKILLS NECESSARY TO THRIVE IN THIS CHANGING MEDICAL ENVIRONMENT. RESIDENTS CARE FOR PATIENTS ACROSS A WIDE SPECTRUM OF DISEASE IN AN EFFICIENT SYSTEM INCLUSIVE OF ACTIVE FACULTY MEMBERS, SUPPORTIVE ADMINISTRATION, AND CONSCIENTIOUS ANCILLARY STAFF. THE PROGRAM ALSO OFFERS RESIDENTS THE OPPORTUNITY TO PARTICIPATE IN OTHER ASPECTS OF HOSPITAL AND AMBULATORY CLINIC ACTIVITIES, INCLUDING SERVING ON COMMITTEES, SERVING ON FOCUS GROUPS FOR THE RESIDENCY AND PARTICIPATING IN QUALITY IMPROVEMENT PROJECTS.GENERAL SURGERYLHMC'S DIVISION OF SURGERY HAS 80 FULL-TIME FACULTY WHO CONTRIBUTE TO THE TRAINING OF FIVE CATEGORICAL GENERAL SURGERY RESIDENTS PER YEAR. IN EACH SPECIALTY, INCLUDING GENERAL SURGERY, RESIDENTS ACQUIRE THE SKILLS AND KNOWLEDGE NECESSARY TO BECOME COMPETENT AND SKILLED INDEPENDENT GENERAL SURGEONS.SURGICAL SPECIALTIES ARE WELL ESTABLISHED, WITH FACULTY COMBINING BUSY CLINICAL PRACTICES WITH STRONG ACADEMIC CREDENTIALS. IN FIELDS WHERE REGIONAL CENTERS CONCENTRATE ON PARTICULAR TYPES OF DISEASE SUCH AS PENETRATING TRAUMA AND PEDIATRIC SURGERY LHMC'S RESIDENTS ROTATE TO THESE REGIONAL CENTERS TO BROADEN THEIR EXPOSURE. LHMC'S OUTPATIENT CLINICS, HOSPITAL AND OPERATING ROOMS ARE UNDER ONE ROOF, SO RESIDENTS CAN READILY PARTICIPATE IN OUTPATIENT EVALUATION, OPERATIVE PROCEDURES, POSTOPERATIVE CARE AND POST-HOSPITAL FOLLOW-UP.UNDER THE SUPERVISION OF ATTENDING STAFF, RESIDENTS ASSUME INCREASED RESPONSIBILITY AS THEY PROGRESS THROUGH THE PROGRAM, INCLUDING TEACHING JUNIOR RESIDENTS AND MEDICAL STUDENTS. THE COMBINATION OF AN ACTIVE EMERGENCY SERVICE WITH 2,400 ANNUAL VISITS, A COMMUNITY-BASED PRACTICE AND WIDE TERTIARY REFERRAL ENSURES EACH RESIDENT WILL SEE A BROAD RANGE OF CASES. ANESTHESIOLOGYTHIS FOUR-YEAR RESIDENCY HAS UP TO EIGHT RESIDENTS PER ANNUAL COHORT. TRAINING OCCURS IN A COLLABORATIVE ENVIRONMENT. OPERATIVE CASES RANGE FROM ROUTINE AMBULATORY PROCEDURES TO COMPLEX NEUROSURGICAL, VASCULAR, CARDIOTHORACIC AND TRANSPLANT SURGERIES. CASE ASSIGNMENTS ARE INDIVIDUALIZED TO EACH RESIDENT'S ABILITY AND LEVEL OF TRAINING. THE DEPARTMENT OF ANESTHESIOLOGY AT LHMC AND THE AMBULATORY SURGERY CENTER, LAHEY MEDICAL CENTER PEABODY, COMBINED ADMINISTER MORE THAN 25,000 ANESTHETICS ANNUALLY AND THE VARIETY AND COMPLEXITY OF CASES PROVIDE A RICH ENVIRONMENT FOR RESIDENCY TRAINING.DIAGNOSTIC RADIOLOGY LHMC IN BURLINGTON IS A LEVEL 1 TRAUMA CENTER. RESIDENTS BECOME ACCOMPLISHED IN THE TECHNIQUES OF BASIC RADIOGRAPHY, FLUOROSCOPY, IMAGE INTERPRETATION, AND RADIATION PROTECTION AS WELL AS ROUTINE CT, MRI, AND ULTRASOUND STUDIES INCLUDING BRAIN, SPINE, EXTREMITIES, CHEST AND ABDOMINAL CASES. LHMC PERFORMS STATE-OF-THE-ART CT AND MR ANGIOGRAPHY (NEUROVASCULAR, CARDIAC, AND PERIPHERAL VASCULAR IMAGING). A DEDICATED 3-D IMAGING LABORATORY ALLOWS FOR THE MANIPULATION OF IMAGES TO BETTER INTERPRET STUDIES, WHICH INCREASES THE RESIDENTS' LEVEL OF KNOWLEDGE AND EXPERIENCE. LHMC HAS INSTALLED SIMILAR SOFTWARE AT ALL RADIOLOGY PACS STATIONS WHICH PROVIDES RESIDENTS WITH TREMENDOUS HANDS-ON TRAINING IN THE USE OF 3-D POST-PROCESSING SOFTWARE. RESIDENTS ALSO HAVE THE OPPORTUNITY TO TRAIN IN ADVANCED SUBSPECIALTY IMAGING, OFTEN RESERVED FOR FELLOWS IN OTHER DEPARTMENTS (I.E., CT COLONOGRAPHY, BREAST MRI, LUNG SCREENING, ETC.).UROLOGYTHE UROLOGY PROGRAM CONSISTS OF FIVE CLINICAL YEARS VERTICALLY INTEGRATED WITH GRADED RESPONSIBILITY FOR PATIENT CARE. IN ADDITION TO ACGME ACCREDITATION, THIS TRAINING PROGRAM MEETS ALL THE REQUIREMENTS OF THE AMERICAN BOARD OF UROLOGY (ABU) RESIDENTS BECOME FAMILIAR WITH THE PHYSIOLOGY AND PATHOPHYSIOLOGY OF UROLOGIC DISEASES AND HAVE A DEDICATED ROTATION IN THE BASIC SCIENCE RESEARCH LAB AS WELL AS CLINICAL TRAINING FOCUSING INITIALLY ON BASIC UROLOGY INCLUDING ENDOSCOPY, INPATIENT CONSULTS AND EARLY EXPOSURE TO ROBOTICS AND PROGRESSES TO EXPERIENCE WITH MORE COMPLEX ENDOSCOPIC PROCEDURES AS WELL AS PERFORMING MAJOR AND MINOR OPERATIVE PROCEDURES. THE FIFTH YEAR OF THIS PROGRAM IS SPENT AS A CHIEF RESIDENT AT LHMC. THE CHIEF RESIDENT SPENDS THE YEAR BECOMING PROFICIENT IN MAJOR OPERATIVE PROCEDURES AND IS RESPONSIBLE FOR ORGANIZING EDUCATIONAL CONFERENCES. THE CHIEF RESIDENTS SUPERVISE AND COORDINATE THE JUNIOR RESIDENTS AS WELL AS MEDICAL STUDENTS. THIS INCREASING LEVEL OF INDEPENDENCE PREPARES THE CHIEF RESIDENTS FOR THE TRANSITION TO FELLOWSHIP OR INDEPENDENT PRACTICE.EXAMPLES OF THE HOSPITAL'S ACGME ACCREDITED FELLOWSHIP PROGRAMS GASTROENTEROLOGY FELLOWSHIPTHE GASTROENTEROLOGY FELLOWSHIP IS A THREE-YEAR WHERE FELLOWS GAIN PROFICIENCY IN ALL AREAS OF GASTROENTEROLOGY AND HEPATOLOGY. APPROXIMATELY EIGHTEEN MONTHS ARE SPENT ON THE GASTROENTEROLOGY SERVICE, WHICH COMPRISES THE INPATIENT SERVICE FOR PATIENTS ADMITTED WITH PRIMARY GASTROINTESTINAL DISORDERS, AS WELL AS THE CONSULTATION SERVICE. THE HOSPITAL IS A BUSY LIVER TRANSPLANT CENTER, AND TRAINEES SPEND A TOTAL OF SIX MONTHS ON THE INPATIENT LIVER SERVICE CARING FOR PATIENTS WITH COMPLICATED LIVER DISEASE. FELLOWS MAINTAIN THEIR OWN CONTINUITY CLINIC, WHICH MEETS WEEKLY FOR THREE YEARS. FELLOWS ALSO ROTATE INTO IBD AND HEPATOLOGY OUTPATIENT CLINICS DURING THEIR THIRD YEAR. ROTATIONS IN ENDOSCOPY, CLINICAL RESEARCH, MOTILITY AND NUTRITION ARE ALSO PART OF THE EDUCATIONAL EXPERIENCE. THERE IS A RICH CONFERENCE SCHEDULE INCLUDING DIDACTIC LECTURES, INSTRUCTION IN PATHOLOGY AND RADIOLOGY, AND CASE DISCUSSIONS AND FELLOWS HAVE MULTIPLE OPPORTUNITIES FOR TEACHING OF RESIDENTS AND MEDICAL STUDENTS. GRADUATING FELLOWS ARE WELL SUITED FOR A CAREER IN ACADEMIC CLINICAL GASTROENTEROLOGY.PULMONARY AND CRITICAL CARE MEDICINE FELLOWSHIPPULMONARY AND CRITICAL CARE MEDICINE FELLOWSHIP INCLUDES TRAINING IN INTERVENTIONAL PULMONOLOGY AND PREPARATION FOR CERTIFICATION IN BOTH PULMONARY MEDICINE AND CRITICAL CARE MEDICINE. ROTATIONS ARE SCHEDULED IN THE MEDICAL AND SURGICAL INTENSIVE CARE UNITS.FELLOWS WORK DIRECTLY WITH PULMONARY AND CRITICAL CARE MEDICINE PROFESSIONALS AND ALSO INTERACT WITH PHYSICIANS AND TRAINEES IN ANESTHESIOLOGY, CARDIOTHORACIC SURGERY, GENERAL SURGERY, INTERNAL MEDICINE AND ITS SUBSPECIALTIES, NEUROLOGY, NEUROSURGERY, ORTHOPAEDIC SURGERY AND UROLOGY. RESEARCH OPPORTUNITIES ARE AN ESSENTIAL PART OF THE TRAINING AND SIX MONTHS SPACED THROUGHOUT THE FELLOWSHIP ARE SET ASIDE SPECIFICALLY FOR RESEARCH.
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ADVANCED PRACTITIONER PROGRAM
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PHYSICIAN ASSISTANT AND NURSE PRACTITIONER STUDENTS FROM SEVERAL LOCAL COLLEGES AND UNIVERSITIES ROTATE TO MULTIPLE DEPARTMENTS THROUGHOUT THE LHMC AS PART OF THEIR EDUCATIONAL EXPERIENCE.ADVANCED PRACTICE EDUCATION IS INTRINSIC TO LHMC'S TRADITION OF PATIENT-CENTERED CARE. THE ADVANCED PRACTICE COUNCIL OVERSEES THE PROFESSIONAL PRACTICE AND DEVELOPMENT OF THE ADVANCE PRACTITIONERS WHILE LEARNING AND TRAINING AT LHMC AND ASSURES THAT THE MEDICAL STAFF, NURSING DEPARTMENT, HOSPITAL ADMINISTRATION, AND PHYSICIAN LEADERS ARE CONNECTED IN THEIR SUPPORT OF OUR ADVANCED PRACTICE PROVIDERS AND THEIR STUDENTS. OUR TEAM MODEL ENSURES A SEAMLESS, COORDINATED APPROACH TO PATIENT CARE.ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, LAHEY CLINIC HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.BETH ISRAEL LAHEY HEALTH (BILH) IS THE PARENT AND A SUPPORT ORGANIZATION OF THE BILH NETWORK OF AFFILIATES. THE NETWORK COMPRISES AN INTEGRATED HEALTH CARE DELIVERY SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM INCLUDES ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,800 PHYSICIANS AND 38,000 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 (LAHEY CLINIC HOSPITAL). THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. EFFECTIVE JULY 1, 2023, BILH ALSO BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND ITS AFFILIATES INCLUDING EXETER HOSPITAL. BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES FISCAL YEAR ENDED SEPTEMBER 30, 2023THE QUANTIFICATION IN THIS SCHEDULE H PART 1 QUESTION 7 IN THIS FILING REFLECTS ONLY THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST OF LAHEY CLINIC HOSPITAL AND AS NOTED THROUGHOUT THIS FILING, LAHEY CLINIC HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK. BELOW IS ADDITIONAL INFORMATION ON THE FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS ACTIVITIES ACROSS ALL OF THE BILH HOSPITALS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED MORE THAN $48 MILLION IN NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST.IN ADDITION TO THE CHARITY CARE REPORTED ABOVE, EACH OF THE BILH HOSPITALS ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICAID PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL EXCEEDING $61 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS. PAYMENTS FROM MEDICARE DO NOT COVER THE COST OF SERVICES PROVIDED. ALL BILH HOSPITALS PROVIDE CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICARE PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE, RESULTING IN A COMBINED SHORTFALL EXCEEDING $144 MILLION RELATED TO TREATING MEDICARE PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED COMBINED COMMUNITY BENEFITS, COMMUNITY HEALTH IMPROVEMENT SERVICES, CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS AS WELL AS COSTS INCURRED RELATED TO SUBSIDIES FOR PRIMARY CARE, BEHAVIORAL HEALTH CARE AND OTHER CARE PROVIDED AT A LOSS TOTALING OVER $88 MILLION. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $202 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $68 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $134 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW. 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.
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ADDITIONAL BILH NETWORK ACTIVITIES -- EXPANDING ACCESS
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AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES; CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST; BEHAVIORAL HEALTH; COMMUNITY INVESTMENTS FISCAL YEAR ENDED SEPTEMBER 30, 2023IN ADDITION, AS NOTED FURTHER BELOW, BETH ISRAEL LAHEY HEALTH ("BILH") AND ITS AFFILIATES FOCUSED ON EXPANDING ACCESS AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES. IN ADDITION, THERE WAS A STRONG FOCUS ON CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST, WHEN APPROPRIATE, AS DEMONSTRATED BY BILH'S EFFORTS TO LEVERAGE COMMUNITY SETTINGS, KEEP CARE WITHIN THE BILH PERFORMANCE NETWORK ("BILHPN"), AND ALLOW PATIENTS TO RECEIVE CARE IN THEIR HOMES. THE FOLLOWING HIGHLIGHTS SPECIFIC EFFORTS DURING THE PERIOD COVERED BY THIS FILING:ACCESS & EXPANSION TO PHARMACY SERVICES- BILH PHARMACY HAS CONTINUED TO EXPAND ITS CONTRACTUAL RELATIONSHIPS, ALLOWING MORE PATIENTS TO UTILIZE ITS PHARMACY FOR THEIR PRESCRIPTIONS. IN FY 2023, BILH PHARMACY SUCCESSFULLY NEGOTIATED ACCESS TO THE POINT32HEALTH SPECIALTY PHARMACY NETWORK AS WELL AS THE WELLSENSE MEDICAID ACCOUNTABLE CARE ORGANIZATION ("ACO") PLAN. EXAMPLES OF - - - BILH PHARMACY'S OTHER EFFORTS TO EXPAND PATIENT ACCESS TO MEDICATIONS INCLUDE: - - ENHANCED MEDICATION AUTHORIZATION AND ACCESS SERVICES TO HELP PATIENTS OBTAIN NECESSARY INSURANCE AUTHORIZATIONS AND FIND CO-PAY ASSISTANCE, - - EXPANDED THE MEDICATION REFILL CENTER TO ASSIST PATIENTS AND PROVIDERS IN EXPEDITING MEDICATION RENEWALS AND ENSURING PRESCRIBED MEDICATION AND DOSAGE ARE STILL APPROPRIATE, - - EXTENDED PATIENT CO-PAY ASSISTANCE PROGRAMS TO THE JOSLIN ADULT DIABETES CLINIC AND NORTHEAST HOSPITAL CORPORATION PATIENTS, AND - - EXPANDED CLINICAL PHARMACY SERVICES IN AMBULATORY CLINICS TO HELP MANAGE AND OPTIMIZE PATIENTS' COMPLEX MEDICATION THERAPIES. - BILH PHARMACY ALSO EXPANDED ITS CLINICAL PHARMACY PRESENCE IN CLINICS TO REDUCE THE HEALTH EQUITY GAP IN THE USE OF HIGHLY IMPACTFUL MEDICATIONS TO TREAT PATIENTS WITH DIABETES AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASES BY IMPROVING THEIR BLOOD PRESSURE AND HEMOGLOBIN A1C. INTERVENTIONS CENTERED AROUND PRESCRIBING EVIDENCE-BASED MEDICATIONS, EDUCATING PATIENTS ABOUT THEIR CONDITIONS, AND ENSURING ACCESS TO MEDICATION. INITIAL RESULTS HAVE DEMONSTRATED AN INCREASE IN THE USE OF GLP-1 AGONISTS AND SGLT-2 INHIBITORS BY 32% IN BLACK AND HISPANIC POPULATIONS, AN AVERAGE REDUCTION IN HEMOGLOBIN A1C OF 0.8, AND A DECREASE OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURES OF 7MMHG AND 2MMHG RESPECTIVELY.IMPROVEMENT IN LAB SERVICES- BILH OPTIMIZED THE TRANSPORTATION ROUTES OF COLLECTED LABORATORY SPECIMENS TO TESTING LABORATORIES, ENSURING HIGH STANDARDS FOR TURNAROUND TIMES AND MAXIMUM EFFICIENCY. THIS IS FOUNDATIONAL TO THE SYSTEM'S ABILITY TO CONSOLIDATE TESTING, EXPAND ACCESS TO IN-NETWORK LABORATORY SERVICES WHICH IN TURN GENERALLY REDUCES COST, AND SUPPORT THE PROVISION OF HIGH-QUALITY CARE AND THE CLINICIAN AND PATIENT EXPERIENCE.- FOCUS REMAINED STRONG IN DEVELOPING PHYSICIAN PRACTICE DELIVERY MODELS AND RE-OPENING PATIENT SERVICE CENTERS. THESE EFFORTS ENHANCE COMMUNITY PROVIDERS' ABILITY TO USE BILH LABS AND INCREASE PATIENT ACCESS TO BILH LABS.LEVERAGING IN-NETWORK CARE- BILH OPERATES A TRANSFER CENTER THAT FACILITATES PATIENT ACCESS TO THE APPROPRIATE PLACEMENT OF PATIENT TRANSFERS. WITH THE CREATION OF THE TRANSFER CENTER, BILH HAS BEEN ABLE TO RETAIN PATIENTS WHO MIGHT OTHERWISE HAVE GONE OUTSIDE OF THE SYSTEM. BY EXPANDING ITS FOCUS TO COMMUNITY HOSPITALS, BILH HAS ENHANCED ITS ABILITY TO PLACE PATIENTS, INCLUDING AT LOCATIONS POTENTIALLY CLOSER TO THE PATIENTS' HOMES. - BILHPN OPERATES A CENTRALIZED REFERRAL MANAGEMENT PROGRAM THAT FOCUSES ON PATIENTS SEEKING OUT-OF-NETWORK SPECIALTY CARE AND REDIRECTING THEM TO IN-NETWORK SPECIALTY CARE, WHEN CLINICALLY APPROPRIATE. THROUGHOUT FY 2023, BILHPN REDIRECTED WELL OVER ONE THOUSAND PATIENT VISITS. IN MOST CASES, CARE RETAINED WITHIN BILH RESULTED IN ENHANCED CARE COORDINATION AT A LOWER COST OF CARE.ENABLING PATIENTS TO RECEIVE CARE AT HOME- BILH LAUNCHED ITS HOSPITAL AT HOME PROGRAM IN FY 2023, STARTING WITH LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER. THIS HAS ALLOWED ELIGIBLE PATIENTS TO BE OFFERED CARE IN THE SETTING MOST COMFORTABLE FOR THEM THEIR HOMES WHILE ALSO CUSTOMIZING CARE PLANS AND IMPROVING PATIENTS' MOBILITY EVEN WHILE THEY ARE ACUTELY ILL. - IN FY 2023, BILHPN PUT PROGRAMS IN PLACE TO MANAGE LENGTH OF STAY AT SKILLED NURSING FACILITIES ("SNFS"), REDUCE READMISSIONS, AND DISCHARGE MEDICALLY APPROPRIATE PATIENTS DIRECTLY TO THEIR HOMES WITH HOMECARE SERVICES INSTEAD OF TO A SNF, PROVIDED PATIENTS ARE MEDICALLY STABLE TO RETURN HOME AFTER AN ACUTE CARE STAY AND WILL LIKELY HAVE BETTER OUTCOMES AND LOWER COST OF CARE.BEHAVIORAL HEALTH- IN FY 2023, BILH BEHAVIORAL SERVICES LAUNCHED ITS COMMUNITY BEHAVIORAL HEALTH CENTER ("CBHC") IN LAWRENCE, MASSACHUSETTS, CONSOLIDATING OUTPATIENT, MOBILE CRISIS INTERVENTION, AND ADULT COMMUNITY CRISIS STABILIZATION SERVICES. THE ESTABLISHMENT OF THE CBHC IS A PART OF THE COMMONWEALTH'S EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES ROADMAP FOR BEHAVIORAL HEALTH REFORM. - IN ADDITION, AS PART OF THE ROADMAP FOR BEHAVIORAL HEALTH REFORM, BILH LAUNCHED AN EMERGENCY SERVICES REDESIGN THAT SHIFTS EMERGENCY EVALUATIONS OUT OF THE EMERGENCY DEPARTMENT ("ED"). BILH BEHAVIORAL SERVICES ALSO EXPANDED ITS ED INTEGRATION EFFORTS TO A TOTAL OF SIX EDS, INCLUDING ADDISON GILBERT HOSPITAL, ANNA JAQUES HOSPITAL, BEVERLY HOSPITAL, LAHEY MEDICAL CENTER-PEABODY, BETH ISRAEL DEACONESS HOSPITAL-MILTON, AND WINCHESTER HOSPITAL.HEALTH EQUITY- BILH AND LAWYERS FOR CIVIL RIGHTS LAUNCHED A MEDICAL-LEGAL PARTNERSHIP TO PROVIDE FREE LEGAL SUPPORT TO LOW-INCOME PATIENTS, BEGINNING AT BETH ISRAEL DEACONESS MEDICAL CENTER. THE COLLABORATION WILL EXPAND BILH'S ABILITY TO ADDRESS HEALTH EQUITY AND EXPAND ACCESS TO HEALTH CARE FOR PATIENTS LIVING IN UNDER-RESOURCED COMMUNITIES.- BILHPN FOCUSED ON REDUCING HEALTH EQUITY DISPARITIES IN DIABETES AND HYPERTENSION MANAGEMENT BY STRATIFYING HEALTH OUTCOMES BY RACE, ETHNICITY AND LANGUAGE; SHARING PERFORMANCE DATA WITH PRIMARY CARE GROUPS; AND IMPLEMENTING CLINICAL INITIATIVES SUCH AS OFF-HOUR CLINICS, HOME BLOOD PRESSURE MONITOR DISTRIBUTION, CONTINUOUS GLUCOSE MONITORING, AND OUTREACH TO PATIENTS WITH HIGHER NEEDS.ONGOING INITIATIVES:ENHANCED ACCESS FOR MASSHEALTH PATIENTS- TO MITIGATE BARRIERS IN ACCESS TO CARE AND INCREASE THE NUMBER OF MASSHEALTH PATIENTS THAT BILH SERVES, THE SYSTEM COMMITTED TO UNIVERSAL NETWORK-WIDE PROVIDER PARTICIPATION IN MASSHEALTH. ALL BILH HOSPITALS AND PROVIDERS EMPLOYED BY BILH OR ON WHOSE BEHALF BILH JOINTLY CONTRACTS PARTICIPATE IN AND/OR HAVE APPLIED TO PARTICIPATE IN SOME FORM OF MASSHEALTH. IN FY 2022, BILH SIGNED A NEW MASSHEALTH ACO CONTRACT WITH BMC HEALTHNET PLAN / WELLSENSE HEALTH PLAN THAT WENT INTO EFFECT IN APRIL 2023. AS PART OF THIS CONTRACT, BILHPN EXTENDED PARTICIPATION TO ALL ELIGIBLE PRIMARY CARE PROVIDERS ("PCPS") WHO WERE NOT OTHERWISE PARTICIPATING IN A MASSHEALTH ACO. PRIOR TO THAT TIME, WHILE ALL ELIGIBLE BILHPN PCPS WERE PARTICIPANTS IN A FORM OF MASSHEALTH, SOME PCPS WERE NOT PREVIOUSLY PARTICIPATING IN A MASSHEALTH ACO. - BILH HAS DEVELOPED, REFINED AND IMPLEMENTED A MULTICULTURAL MARKETING, ADVERTISING, AND OUTREACH PLAN WITH THE PURPOSE OF EXPANDING ACCESS FOR UNDERSERVED POPULATIONS, INCLUDING MASSHEALTH PATIENTS, IN TARGETED BILH SERVICE AREAS.
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INVESTMENTS IN UNDERSERVED COMMUNITIES
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- BILH HOSPITALS HAVE CREATED AND MAINTAIN STRONG CONNECTIONS TO A NETWORK OF AFFILIATED HOSPITALS AND HEALTH CENTERS THAT PROVIDE COMMUNITY-BASED CARE TO HISTORICALLY UNDERSERVED POPULATIONS. IN THE REGIONS THAT THEY SERVE, THE SAFETY NET AFFILIATES ("SNAS") AND COMMUNITY CARE ALLIANCE ("CCA") COMMUNITY HEALTH CENTERS ("CHCS") ARE THE CORNERSTONE OF BILH'S DELIVERY SYSTEM REGARDING COMMUNITY-BASED CARE FOR MASSHEALTH AND HISTORICALLY UNDERSERVED PATIENTS.-- CCA CHCS INCLUDE BOWDOIN STREET HEALTH CENTER, CHARLES RIVER COMMUNITY HEALTH, THE DIMOCK CENTER, FENWAY HEALTH, AND SOUTH COVE COMMUNITY HEALTH CENTER. -- SNAS INCLUDE CAMBRIDGE HEALTH ALLIANCE AND SIGNATURE HEALTHCARE BROCKTON HOSPITAL.- BILH CONTINUES TO INVEST IN THE CCA CHCS AND SNAS, ENABLING THEM TO EXPAND THEIR CAPABILITIES AND CARE FOR MORE HISTORICALLY UNDERSERVED PATIENTS. IN FY 2022, BILH INVESTED OVER $8 MILLION IN ITS CHCS AND SNAS, IN ADDITION TO ENGAGING IN REGIONAL PLANNING AND COLLABORATIVE PROGRAM DEVELOPMENT. THESE INVESTMENTS REPRESENT ONLY A PORTION OF A MUCH LARGER COMMUNITY BENEFITS INVESTMENT PORTFOLIO THAT IS DESCRIBED IN GREATER DETAIL IN THIS AND OTHER BILH NETWORK TAX FILINGS. - BILH CONTINUES TO EXPLORE ADDITIONAL OPPORTUNITIES WITH CHCS IN ESSEX AND MIDDLESEX COUNTIES. FOR EXAMPLE, BILH HAS ESTABLISHED A TELEHEALTH PILOT PROGRAM BETWEEN PHYSICIANS AT ADDISON GILBERT AND BEVERLY HOSPITALS AND PATIENTS AT NORTH SHORE COMMUNITY HEALTH CENTER. BILH BEHAVIORAL HEALTH SERVICESTHE BETH ISRAEL LAHEY HEALTH NETWORK (BILH) IS COMMITTED TO THE BEHAVIORAL HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES SERVICED. BELOW ARE SOME OF ACTIVITIES THAT BILH BEHAVIORAL SERVICES (BILHBS) HAS PROVIDED TO THE PATIENTS AND COMMUNITIES SERVED BY BILH AND ITS AFFILIATED ENTITIES. ADDICTION SERVICES NORTHEAST BEHAVIORAL HEALTH CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH BEHAVIORAL SERVICES (NBHC OR BILH BS) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS, PROVIDING HIGH-QUALITY MENTAL HEALTH AND ADDICTION TREATMENT. THIS INCLUDES A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TO COMMUNITY-BASED SERVICES. TREATMENT OFFERINGS INCLUDE MOBILE CRISIS TEAMS FOR BEHAVIORAL AND SUBSTANCE-RELATED EMERGENCIES; INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; RESIDENTIAL PROGRAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION CLINICS; AND MEDICATION-ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS. NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) HAS OVER 250 BEDS IN 9 FACILITIES FOR PATIENTS REQUIRING ACUTE PSYCHIATRIC, DETOXIFICATION AND POST-ACUTE DIVERSIONARY SERVICES. OTHER OFFERINGS INCLUDE MANY COMMUNITY-BASED SERVICES SUCH AS MOBILE EMERGENCY SERVICES TEAMS, SCHOOL AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES. BILHBS SERVES APPROXIMATELY 17,000 INDIVIDUALS ANNUALLY, PROVIDING OVER 380,000 UNITS OF SERVICE, IN A VAST ARRAY OF SETTINGS BASED ON THEIR NEEDS. BECAUSE OF THE COVID-19 EMERGENCY, NBHC WAS FORCED TO RECONFIGURE ITS DELIVERY MODEL FOR MANY SERVICES. WITH MULTIPLE "BRICK AND MORTAR" SITES TEMPORARILY CLOSED DURING THE HEIGHT OF THE PANDEMIC, NBHC OUTFITTED CLINICIANS WITH THE TOOLS NEEDED TO OFFER TELEHEALTH SERVICES. BY THE END OF THE FISCAL YEAR, OF THE TOTAL UNITS OF SERVICE LISTED ABOVE, ALMOST 61,000 WERE DELIVERED VIA TELEHEALTH. IN ADDITION, AS OUTLINED BELOW, NBHC SUPPORTED BILH'S SYSTEM-WIDE RESPONSE TO THE PANDEMIC BY QUICKLY STANDING UP A SHORT-TERM STAY COMMUNITY CRISIS STABILIZATION UNIT ON THE CAMPUS OF AN AFFILIATED ENTITY. BILH BS CONTINUES TO LEVERAGE TELEHEALTH SERVICES TO CONNECT TO COMMUNITIES SERVED ACROSS BILH. NBHC PROVIDED ADDICTION TREATMENT SERVICES WITH MORE THAN 200 INPATIENT AND RESIDENTIAL BEDS, OPERATING 24/7 FOR ADDICTION TREATMENT. ADDICTION TREATMENT INCLUDES BOTH OUTPATIENT AND INPATIENT TREATMENT AND PREVENTION. SUBSTANCE ABUSE COUNSELING AND GROUP THERAPY IS OFFERED FOR BOTH ADULTS AND TEENS, AS ARE A RANGE OF COURT-ORDERED PROGRAMS INCLUDING OPERATING UNDER THE INFLUENCE (OUI) EDUCATION AND EVALUATIONS. MEDICATION-ASSISTED TREATMENT FOR MEN AND WOMEN ADDICTED TO HEROIN OR PRESCRIPTION OPIOIDS IS PROVIDED AT LOCATIONS IN GLOUCESTER AND DANVERS. ACUTE TREATMENT PROGRAMS PROVIDING INPATIENT DETOXIFICATION SERVICES FROM DRUGS AND/OR ALCOHOL IN MEDICAL SETTINGS ARE AVAILABLE AT TREATMENT CENTERS IN DANVERS AND TEWKSBURY. IN FY23 THESE CENTERS SERVED APPROXIMATELY 2,600 PATIENTS. NBHC ALSO PROVIDED POST-DETOXIFICATION RESIDENTIAL SETTINGS AT MULTIPLE LOCATIONS SERVING BOTH MEN AND WOMEN, INCLUDING HART HOUSE IN TEWKSBURY WHICH EXCLUSIVELY SERVES MOTHERS WITH CHILDREN. IN FY23, NBHC'S OUTPATIENT ADDICTION PROGRAMS PROVIDED 196,350 UNITS OF SERVICE, INCLUDING 5,600 VIA TELEHEALTH, WHILE INPATIENT AND RESIDENTIAL PROGRAMS RECORDED 60,327 BED DAYS. AMBULATORY SERVICES BILH BS' AMBULATORY DIVISION SERVES NEARLY 4,300 PATIENTS EVERY YEAR, DELIVERING MORE THAN 108,000 UNITS OF SERVICES IN VARIOUS SETTINGS. MORE THAN 43,000 WERE DELIVERED BY TELEHEALTH AMBULATORY PROGRAMS AND SERVICES OFFERED UNDER THE CHILDREN'S BEHAVIORAL HEALTH INITIATIVE (CBHI) INCLUDING A BROAD RANGE OF COUNSELING AND THERAPY AS WELL AS MORE INTENSIVE TREATMENT MODALITIES. OUTPATIENT MENTAL HEALTH CLINICS IN SALEM, LAWRENCE, GLOUCESTER AND BEVERLY, AND AN OUTREACH CLINIC IN HAVERHILL, ASSIST INDIVIDUALS AND FAMILIES THROUGH PERIODS OF STRESS AND ADJUSTMENT, PROVIDING THERAPY FOR DEPRESSION, ANXIETY, TRAUMA, BIPOLAR DISEASE, AND CHRONIC MENTAL ILLNESS. OUTREACH COUNSELORS OFFER SHORT AND LONG-TERM THERAPY IN HOMES, SCHOOLS, AND OTHER APPROPRIATE COMMUNITY SETTINGS. ALL THERAPY PROGRAMS ARE SUPPORTED BY MEDICATION CLINICS IF THAT IS DETERMINED TO BE AN APPROPRIATE ADJUNCT TO TREATMENT. IN FY23, NBHC DELIVERED 99,419 UNITS OF AMBULATORY SERVICES, SUPPORTED BY 8,432 PSYCHOPHARMACOLOGY VISITS. EMERGENCY SERVICES THE EMERGENCY SERVICES DIVISION OFFERS EMERGENCY PSYCHIATRIC SERVICES AND INCLUDES THE EMERGENCY SERVICES PROGRAM (ESP) AND COMMUNITY CRISIS STABILIZATION (CCS) INPATIENT PROGRAM. ESP PROVIDES EMERGENCY PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES 24/7 IN A VARIETY OF SETTINGS, INCLUDING HOMES, SCHOOLS, OUTPATIENT CLINICS AND HOSPITALS. ESP SERVICES ARE PROVIDED WITHIN THE COMMUNITY AND WITHIN 10 HOSPITALS EMERGENCY DEPARTMENTS (ED) THROUGHOUT THE NORTH SHORE, CAPE ANN AND MERRIMACK VALLEY, INCLUDING 6 NON-BILH EMERGENCY DEPARTMENTS. 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.
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NBHC IS ALSO ON THE FOREFRONT OF EXPANDING TREATMENT
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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.