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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. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND PARTS OF SOUTHERN NEW HAMPSHIRE AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,700 PHYSICIANS AND 39,000 EMPLOYEES.AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES.BILH'S PURPOSE STATEMENT ARTICULATES THE IMPACT BILH AND EACH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. BILH'S SHARED VALUES GUIDE DAILY EFFORTS, KEEP BILH AND EACH AFFILIATE ALIGNED IN THE PURSUIT OF PURPOSE AND SHOW HOW BILH CARES FOR PATIENTS, EACH OTHER AND OUR COMMUNITIES.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.LAHEY CLINIC HOSPITAL COMMUNITY BENEFITS MISSION STATEMENT AT LAHEY CLINIC HOSPITAL OUR MISSION GUIDES US TOWARD SUCCESS. LAHEY CLINIC HOSPITAL IS COMMITTED TO PROVIDING SUPERIOR HEALTH CARE LEADING TO THE BEST POSSIBLE OUTCOMES FOR EVERY PATIENT, EXCEEDING OUR PATIENTS' HIGH EXPECTATIONS FOR SERVICE EACH DAY, ADVANCING MEDICINE THROUGH RESEARCH AND THE EDUCATION OF TOMORROW'S HEALTH CARE LEADERS, AND PROMOTING HEALTH AND WELLNESS IN PARTNERSHIP WITH THE DIVERSE COMMUNITIES IT SERVES. THE FOLLOWING ANNUAL REPORT PROVIDES SPECIFIC DETAILS ON HOW LAHEY CLINIC HOSPITAL IS HONORING ITS COMMITMENT AND INCLUDES INFORMATION ON ITS COMMUNITY BENEFITS SERVICE AREA (CBSA), COMMUNITY HEALTH PRIORITIES, TARGET POPULATIONS, COMMUNITY PARTNERS, AND DETAILED DESCRIPTIONS OF ITS COMMUNITY BENEFITS PROGRAMS AND THEIR IMPACT.LAHEY CLINIC HOSPITAL'S COMMUNITY BENEFITS MISSION IS FULFILLED BY:- 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, AND ECONOMIC 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 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 $3,482,287 AS 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. 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 AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. LAHEY CLINIC HOSPITAL'S CBAC MEMBERS INCLUDE:- BRIGITTE BOWEN-BENITICH, MBA, VICE PRESIDENTS OF SURGICAL SERVICES, 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- MELISSA HASTINGS-CRUZ, LAHEY HOSPITAL & MEDICAL CENTER BOARD OF TRUSTEES - CHRISTINE HEALEY, DIRECTOR, COMMUNITY BENEFITS, BETH ISRAEL LAHEY HEALTH - PETER KILCOMMONS, CORPORATE CONTROLLER, LAHEY HOSPITAL & MEDICAL CENTER- ALLISON KILCOYNE, VICE PRESIDENT INTEGRATION, NORTH SHORE COMMUNITY HEALTH - JENNIFER KNIGHT, DIRECTOR OF FAMILY AND COMMUNITY ENGAGEMENT, 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 - ANDY VILLANUEVA, MD, CHIEF QUALITY OFFICER, LAHEY HOSPITAL & MEDICAL CENTER, LAHEY HOSPITAL & MEDICAL CENTER BOARD OF TRUSTEESCOMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED.
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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 ASSESSMENTPRIORITY 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 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 ASSESSMENTMAKING 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://LAHEY.ORG/-/MEDIA/FILES/LHMC/LHMC-2022-CHNA.PDF 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/-/MEDIA/FILES/LHMC/LHMC-2023-2025-IMPLEMENTATION-STRATEGY-101022.PDF 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/-/MEDIA/FILES/LHMC/LHMC-2019-CHNA-FINAL.PDF 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/-/MEDIA/FILES/LHMC/LHMC-2020-2022-IMPLEMENTATION-STRATEGY.PDF EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, 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.
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COMMUNITY HEALTH NEEDS ASSESSMENT-APPROACH TO ADDRESSING HEALTH NEEDS
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(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 MA DPH'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.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.PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH- GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY OF LIFE.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 HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES LAHEY CLINIC HOSPITAL OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES AMONG THEIR FOCUS COHORTS THROUGHOUT THEIR PRIORITY CITIES AND TOWNS. LAHEY CLINIC HOSPITAL SUPPORTS A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH TO REACH ITS POPULATIONS OF FOCUS. PROGRAMS INCLUDE A LONG-STANDING, 20-WEEK ANNUAL FREE FARMER'S MARKET AT THE BURLINGTON, ARLINGTON AND BILLERICA COUNCILS ON AGING, WHICH SUPPLIED OVER 17,500 POUNDS OF FRESH PRODUCE, INCLUDING MORE THAN SIX VARIETIES OF FRUITS AND VEGETABLES TO OLDER ADULTS. LAHEY CLINIC HOSPITAL IS ALSO WORKING TO IMPROVE THE BUILT ENVIRONMENT OF THE CITY OF LOWELL BY PROVIDING FUNDING TO MILL CITY GROWS FOR THEIR COMMUNITY GARDENS PROGRAM AND SUPPORTING THEIR DEVELOPMENT OF A NEW COMMUNITY GARDEN IN A HISTORICALLY UNDERUTILIZED SPACE. IN FY 24, THE COMMUNITY GARDENS SERVED 591 INDIVIDUALS. LAHEY CLINIC HOSPITAL ALSO SUPPORTS VARIOUS PROGRAMS TO ASSIST INDIVIDUALS WITH STABILIZING THEIR HOUSING, INCLUDING COMMUNITY TEAMWORK, INC. (CTI) SECURE JOBS PROGRAM. SECURE JOBS HELPS TO PROVIDE INDIVIDUALS WITH THE NECESSARY SUPPORTS TO RETAIN EMPLOYMENT AND INCOME TO STABILIZE HOUSING. SECURE JOBS STAFF WORKS WITH THE CLIENT TO REMOVE BARRIERS TO SUCCESS BY LINKING PARTICIPANTS WITH CHILDCARE RESOURCES, TRANSPORTATION TO AND FROM TRAINING PROGRAMS, HELPING NAVIGATE OPTIONS FOR PEOPLE WHO HAVE CHALLENGES WITH CRIMINAL OFFENDER RECORD INFORMATION (CORI) AND PROVIDING SKILLS TRAINING, JOB READINESS TRAINING, AND JOB SEARCH SERVICES SPIRITUAL AND MENTAL WELLNESS. IN FY 24, 46 PARTICIPANTS WERE ENROLLED IN THE PROGRAM; 33 OUT OF THOSE 46 HAVE BEEN EMPLOYED. ONE OF THE MOST COMMON BARRIERS IS LANGUAGE; THERE ARE 6 PARTICIPANTS ENROLLED IN ENGLISH AS A SECOND LANGUAGE (ESOL) CLASSES AND 5 ARE ENROLLED IN TRAININGS.LAHEY CLINIC HOSPITAL ALSO MAINTAINS ITS EXTREMELY SUCCESSFUL PARTNERSHIP WITH MINUTEMAN SENIOR SERVICES TO CONTINUE TO PROVIDE INSURANCE COUNSELORS AT THE ARLINGTON AND BURLINGTON COUNCILS ON AGING. IN FY 24, MINUTEMAN PROVIDED 579 INDIVIDUALS RESIDING IN ARLINGTON, BURLINGTON AND WINCHESTER WITH MEDICARE BENEFITS COUNSELING, PUBLIC BENEFITS SCREENING, AND PLAN/COST COMPARISONS.AMONG THE MANY WAYS LAHEY CLINIC HOSPITAL AND ITS PARTNERS ADDRESS BEHAVIORAL HEALTH NEEDS IS BY EXPANDING BEHAVIORAL HEALTH INTEGRATION AT LAHEY CLINIC HOSPITAL-AFFILIATED PRIMARY CARE SITES THROUGH THE COLLABORATIVE CARE MODEL. RESULTS OF BEHAVIORAL HEALTH INTEGRATION SHOW THAT MORE HIGH-RISK PATIENTS ARE ACCESSING MENTAL HEALTH SERVICES, AN INCREASE IN APPOINTMENTS KEPT BY PATIENTS WHO RECEIVE A "WARM-HAND OFF" BY THEIR PROVIDER TO THERAPISTS, AND REDUCED WAIT TIME FOR MENTAL HEALTH APPOINTMENTS. LAHEY CLINIC HOSPITAL IS ALSO WORKING TO PROVIDE SUPPORT FOR COMMUNITY-BASED SYSTEMS OF CARE TO HELP TO CREATE RESILIENCY FOR INDIVIDUALS UNDERGOING SUBSTANCE USE RECOVERY BY WORKING WITH PLACE OF PROMISE TO PROVIDE SUPPORT FOR THEIR ADULT LONG-TERM RESIDENTIAL ADDICTION RECOVERY PROGRAM. IN FY 24 46 INDIVIDUALS WERE SERVED BY THE PROGRAM, OF WHICH 40 OBTAINED MEDICAL INSURANCE AND HAD A CARE PLAN ESTABLISHED WITH A PRIMARY CARE PHYSICIAN AND 43 OBTAINED NECESSARY PAPERWORK FOR EMPLOYMENT.LAHEY CLINIC HOSPITAL HAS FOCUSED ITS EFFORTS ON CREATING SPECIFIC PROGRAMS THAT ADDRESS CHRONIC DISEASE. THESE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO LAHEY CLINIC HOSPITAL'S ONCOLOGY NURSE NAVIGATORS AND BREAST CANCER RISK ASSESSMENT PROGRAM, AMONG OTHERS. LAHEY CLINIC HOSPITAL IS ALSO COMMITTED TO CREATING PROGRAMS THAT FOCUS ON CHRONIC DISEASE PREVENTION, INCLUDING MANY COMMUNITY-BASED EXERCISE CLASSES. LAHEY CLINIC HOSPITAL HAS PROVIDED FUNDING FOR MANY YEARS TO THE BURLINGTON COUNCIL ON AGING FOR A SENIOR STRETCH PROGRAM FOR A 52-WEEK EXERCISE PROGRAM; IN FY 24 THE CLASSES SERVED 327 INDIVIDUALS. LAHEY CLINIC HOSPITAL ALSO PROVIDES FREE SESSIONS OF TAI JI QUAN: MOVING FOR BETTER BALANCE SESSIONS FOR THE COMMUNITY, WHICH IS AN EVIDENCED-BASED FALL PREVENTION PROGRAM DESIGNED TO HELP AND IMPROVE BALANCE AS WELL AS CORE STRENGTH. IN FY 24, 9 PARTICIPANTS STARTED THE PROGRAM; WITH 8 COMPLETING IT (ATTENDED AT LEAST 75% OF THE SESSIONS). PARTICIPANTS AGES RANGED FROM 67 TO 81 YEARS OF AGE WITH 7 FEMALES AND 2 MALES. A FULL UPDATE ON LAHEY CLINIC HOSPITAL'S HEALTH PRIORITIES AND ASSOCIATED GOALS ARE INCLUDED BELOW.
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FY22 SCHEDULE H-IMPLEMENTATION STRATEGY UPDATE
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PRIORITY 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.FOCUS COHORTS: LOW-RESOURCED POPULATIONS, OLDER ADULTS, YOUTH, RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS AND LGTBQIA+STRATEGIES1. PROVIDE AND PROMOTE CAREER SUPPORT SERVICES AND CAREER MOBILITY PROGRAMS TO HOSPITAL EMPLOYEES AND ENCOURAGE LOCALLY-FOCUSED RECRUITMENT AND RETENTION.2. PROMOTE EQUITABLE CARE, AND HEALTH LITERACY 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 COMMUNITY COLLEGE COURSES- HOSPITAL-SPONSORED ENGLISH SPEAKERS OF OTHER LANGUAGE (ESOL) CLASSES- INTERPRETER SERVICES- LOWELL COMMUNITY HEALTH CENTER KEYS TO HEALTH EQUITY PROJECT: LANGUAGE SUPPORTS- 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 - # OF BILH EMPLOYEES ATTENDING/RECEIVING BILH-SPONSORED CLASSES/WORKSHOPS OR SERVICES - CITIZENSHIP CLASSES (BASELINE: 20; YEAR 1: 14)- CAREER DEVELOPMENT WORKSHOPS (BASELINE: 135; YEAR 1: 15) - FINANCIAL LITERACY CLASSES (BASELINE: 189: YEAR 1: 207)- CAREER DEVELOPMENT SERVICES (BASELINE: DATA NOT AVAILABLE; YEAR 1: 1044)- # OF BILH-SPONSORED COURSES SPONSORED (YEAR 1: 9 COLLEGE-LEVEL COURSES AND 2 PRE-COLLEGE COURSES)- # OF LHMC EMPLOYEES ENROLLED (YEAR 1: 39) - # OF BILH EMPLOYEES PARTICIPATING IN HOSPITAL-SPONSORED ESOL CLASSES (BASELINE: 45; YEAR 1: 82) - # OF COMMUNITY REFERRALS AND HIRES (BASELINE: 225 AND 70 HIRED; YEAR 1: 412 AND 111 HIRED) - # OF PRESENTATIONS AT COMMUNITY EVENTS ABOUT EMPLOYMENT OPPORTUNITIES (BASELINE: 67; YEAR 1: 33) - # OF COMMUNITY MEMBERS PARTICIPATING IN PAID TRAINING OR ASSOCIATE NURSING RESIDENCY PROGRAM (BASELINE: 89, INCLUDING PATIENT CARE TECHNICIAN OR NURSING ASSISTANT 30, PHARMACY TECH - 16; PERIOPERATIVE LPN 3, MEDICAL ASSISTANT 21, BEHAVIORAL HEALTH ROLE 4, ASSOCIATE DEGREE NURSING RESIDENCY PROGRAM 15; YEAR 1: 99, INCLUDING PATIENT CARE TECHNICIAN OR NURSING ASSISTANT 41, PHARMACY TECH 22, MEDICAL ASSISTANT 29, BEHAVIORAL HEALTH ROLE 3, ASSOCIATE DEGREE NURSING RESIDENCY PROGRAM 4; YEAR 1: BILH TRAINED TOTAL OF 99 COMMUNITY MEMBERS TO PATIENT CARE TECHNICIAN OR NURSING ASSISTANT (41), PHARMACY TECH (22), MEDICAL ASSISTANT (29), BEHAVIORAL HEALTH ROLES (3) OR INTO THE ASSOCIATE DEGREE NURSING RESIDENCY PROGRAM (4). LHMC PARTICIPATED IN OFFERING THESE TRAININGS)- # OF INTERNSHIPS AND # OF PERMANENT HIRES (BASELINE: DATA NOT AVAILABLE; YEAR 1: 107 ACROSS BILH WITH 37 HIRED PERMANENTLY)- # OF CLINICAL AFFILIATION AGREEMENTS WITH VOCATIONAL TECHNICAL HIGH SCHOOLS AND # OF PAID AND UNPAID CLINICAL PLACEMENTS (BASELINE: DATA NOT AVAILABLE; YEAR 1: 10 CLINICAL AFFILIATION AGREEMENTS, 47 HIGH SCHOOL STUDENTS IN PAID COOPERATIVE EDUCATION PLACEMENTS AND 11 INTO UNPAID CLINICAL PLACEMENTS)- # OF LAHEY CLINIC HOSPITAL INTERPRETER SERVICES ENCOUNTERS (BASELINE: 101,449; TOP 3 LANGUAGES SPANISH, PORTUGUESE-BRAZILIAN; CHINESE-MANDARIN; YEAR 1: 225,176; TOP 3 LANGUAGES SPANISH, PORTUGUESE-BRAZILIAN; CHINESE-MANDARIN) - # OF LOWELL COMMUNITY HEALTH CENTER INTERPRETER SERVICES ENCOUNTERS: (BASELINE: 176,347 SESSIONS OF INTERPRETATION (IN-HOUSE INTERPRETERS= 71,779; EXTERNAL LANGUAGES LINE=104,568): 17,000 PATIENTS SERVED; YEAR 1: 206,099 SESSIONS OF INTERPRETATION (IN-HOUSE INTERPRETERS = 84,728 IN 12 DIFFERENT LANGUAGES; EXTERNAL LANGUAGE LINE 121,371: OVER 20,000 PATIENTS SERVED; TOP LANGUAGES SPANISH, PORTUGUESE, KHMER, HAITIAN-CREOLE AND PASHTO) - # OF PATIENTS SCREENED FOR INSURANCE ELIGIBILITY (BASELINE: 17,871; YEAR 1: 7,051)- # APPROVED FOR ENTITLEMENT PROGRAMS (BASELINE: 2,103; YEAR 1: 794)- # PATIENTS SERVED WITH HEALTH SAFETY NET (BASELINE: 2,749; YEAR 1: 3,514)- # OF PRIMARY CARE PRACTICES PROVIDING COMMUNITY-BASED CARE (BASELINE: 6; YEAR 1: 6) - # OF STUDENTS PROVIDED SERVICES THROUGH THE PEABODY VETERANS MEMORIAL HIGH SCHOOL STUDENT-BASED HEALTH CENTER ((BASELINE: 377; YEAR 1: 360)- # OF MEDICAL VISITS TO PEABODY VETERAN'S MEMORIAL HIGH SCHOOL STUDENT-BASED HEALTH CENTER (BASELINE: MEDICAL: 748, ONSITE: 747, TELEHEALTH: 1 AND BEHAVIORAL HEALTH: 1286; YEAR 1 MEDICAL: 853 AND BEHAVIORAL HEALTH: 711)- # OF STUDENTS IN THE SUSPENSION DIVERSION PROGRAM (BASELINE: 21; YEAR 1: 44)- % OF STUDENTS WHO HAVE MASSHEALTH OR WHO ARE UNINSURED/UNDERINSURED: (BASELINE: 68%; YEAR 1: 71%)- # OF SCHOOL CLEARANCE AND IMMUNIZATION VISITS (BASELINE: DATA NOT AVAILABLE; YEAR 1: 63 AGES 4-14) - # OF COMMUNITY-BASED NAVIGATION PROGRAMS FUNDED THROUGH COMMUNITY GRANTS (BASELINE: 1; YEAR 1: 1)- # OF INDIVIDUALS SERVED BY SAHELI COMMUNITY HEALTH WORKER (BASELINE: 338; YEAR 1: 220)- # OF INDIVIDUALS WHO SECURED HOUSING THROUGH SAHELI COMMUNITY HEALTH WORKER (BASELINE: DATA NOT AVAILABLE; YEAR 1: 23) COMMUNITY PARTNERS: SAHELI, LOWELL COMMUNITY HEALTH CENTER, MINUTEMAN SENIOR SERVICES, NORTH 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 LIFEFOCUS COHORTS: LOW-RESOURCED POPULATIONS, OLDER ADULTS, YOUTH, RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS, AND LGTBQIA+STRATEGIES: 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- 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- # OF GRANTS TO COMMUNITY ORGANIZATIONS TO FUND PROGRAMS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH TO IMPROVE THE HEALTH OF THE COMMUNITY (BASELINE: 8; YEAR 1: 9) - # OF GRANTS PROVIDING SUPPORT TO COMMUNITY HOUSING EFFORTS (BASELINE: 2; YEAR 1: 3) - # OF RIDES PROVIDED THROUGH PEABODY COUNCIL ON AGING'S PROJECT MOBILITY (BASELINE: 32,064 RIDES OF WHICH 5,865 REQUIRED THE USE OF A WHEELCHAIR LIFT; YEAR 1: 33,346 RIDES OF WHICH 6,791 REQUIRED THE USE OF A WHEELCHAIR LIFT) - % OF INDIVIDUALS 65+ (BASELINE: 95%; YEAR 1: 95%) - # OF BILLS SUPPORTING EQUITABLE HEALTHCARE ACCESS ADVOCATED THROUGH STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS: (YEAR 1: 23)- # OF INTERNSHIPS PROVIDED FOR STUDENTS IN LAHEY CLINIC HOSPITAL RADIOLOGY DEPARTMENT (BASELINE: 2 INTERNSHIPS FOR STUDENTS IN DIAGNOSTIC ULTRASOUND, AND 2 INTERNSHIPS FOR STUDENTS IN VASCULAR ULTRASOUND; 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 DIAGNOSTIC RADIOLOGY HAD 5 GRADUATING SECOND YEARS. 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; YEAR 1: LAHEY CLINIC HOSPITAL PROVIDED 1 INTERNSHIP FOR STUDENTS IN DIAGNOSTIC ULTRASOUND. LAHEY CLINIC HOSPITAL NUCLEAR MEDICINE PROVIDED 2, 3-MONTH INTERNSHIPS FOR REGIS COLLEGE NUCLEAR MEDICINE STUDENTS. LAHEY CLINIC HOSPITAL DIAGNOSTIC RADIOLOGY HAD 8 GRADUATING SECOND YEARS. LAHEY CLINIC HOSPITAL DIAGNOSTIC RADIOLOGY HAD 6 FIRST YEARS)- # OF STUDENTS HIRED FOR EMPLOYMENT (BASELINE: 5; YEAR 1: 4)- # OF ACTIVE GARDENERS IN THE MILL CITY GROWS COMMUNITY GARDENS PROGRAM (BASELINE: DATA NOT AVAILABLE; YEAR 1: 591)- # OF COMMUNITY GARDENS (BASELINE: 21; YEAR 1: 21)- % OF GARDEN BEDS ENROLLED (BASELINE: DATA NOT AVAILABLE; YEAR 1: 90%)- # OF INDIVIDUALS ENROLLED IN SCHOOL-BASED COOKING CLASSES (BASELINE: DATA NOT AVAILABLE; YEAR 1: 25)- # DOMESTIC VIOLENCE INITIATIVE MEETINGS: (YEAR 1: PROGRAM STAFF LEFT) - # OF PARTNERSHIPS DEVELOPED TO SUPPORT COMMUNITY COLLABORATION (BASELINE: 1)- # OF MEETINGS ATTENDED WITH LOWELL COMMUNITY ROUNDTABLE (BASELINE: 8)- # OF ORGANIZATIONS PROVIDED WITH FINANCIAL SUPPORT TO INCREASE COMMUNITY-BASED COLLABORATION THROUGH REGIONAL COALITIONS (BASELINE: 1; YEAR 1: 1)- # OF EVENTS HOSTED BY MIDDLESEX 3 COALITION (BASELINE: DATA NOT AVAILABLE; YEAR 1: 19)- # OF ATTENDEES AT EVENTS (BASELINE: DATA NOT AVAILABLE; YEAR 1: 1,328)- # OF NEW PARTNERSHIPS DEVELOPED (BASELINE: DATA NOT AVAILABLE: YEAR 1: 35) - # OF SECTORS REPRESENTED IN MIDDLESEX 3 COALITION (BASELINE: 5; YEAR 1: 5) # OF COMMUNITY TRAININGS TO INCREASE THE CAPACITY OF THE EXTERNAL ORGANIZATIONS (BASELINE: 4; YEAR 1: 2)- # OF PARTICIPANTS (YEAR 1: 30 ORGANIZATIONS AND GRANTEES)- % OF RESPONDENTS WHO WERE SATISFIED OR VERY SATISFIED WITH THE WORKSHOPS (YEAR 1: 100%)- % OF SURVEY RESPONDENTS WHO STATED THAT THE WORKSHOPS WERE DIRECTLY RELEVANT TO THEIR ROLE AT THEIR ORGANIZATION (YEAR 1: 90%)- # OF ENCOUNTERS FOR THE BURLINGTON AFFORDABLE HOUSING COORDINATOR (BASELINE: 28; YEAR 1: 33)- # OF REFERRALS TO HOUSING SERVICES TO FAMILIES TO STABILIZE HOUSING (BASELINE: 10; YEAR 1: 16)- # OF GRANTS PROVIDED TO ORGANIZATIONS WORKING TO STABILIZE HOUSING (BASELINE: 1; YEAR 1: 3)- # OF FAMILIES SERVED BY 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 INDIVIDUALS WHO ARE LOW-RESOURCED DEVELOP AS LEADERS SO THAT THEY MAY ADVOCATE FOR THEMSELVES AND THEIR COMMUNITY (BASELINE: 119; YEAR 1: 78)- # OF FAMILIES WHO WERE PROVIDED FUNDING TO PREVENT HOMELESSNESS AND CREATE MORE STABLE TENANCIES (BASELINE: 56; YEAR 1: 42) - # OF HOUSEHOLDS PROVIDED REFERRALS TO SOCIAL SERVICES (BASELINE: 119; YEAR 1: 78)- # OF FAMILIES LIVING IN SHELTERS WHO WERE PROVIDED STABILIZED HOUSING THROUGH CITIZENS INN (BASELINE: DATA NOT AVAILABLE; YEAR 1: 13 FAMILIES)- # OF FAMILIES PROVIDED WITH RESOURCES TO INCREASE FOOD SECURITY (YEAR 1: 100 FAMILIES)- # OF INDIVIDUALS PROVIDED WITH RESOURCES TO OBTAIN A DRIVER'S LICENSE (YEAR 1: 151)- # OF INDIVIDUALS WHO OBTAINED A DRIVER'S LICENSE (YEAR 1: 55)- COMMUNITY TEAMWORK SECURE JOBS PROGRAM: - # PARTICIPANTS WHO ESTABLISH AND MAINTAIN SAVINGS ACCOUNTS (YEAR 1: DATA NOT AVAILABLE)- # PARTICIPANTS WHO MAINTAIN A BUDGET FOR AT LEAST 3 MONTHS (YEAR 1: DATA NOT AVAILABLE)- # OF SECURE JOBS GRADUATES WHO OBTAIN SAFE AND AFFORDABLE HOUSING THAT THEY ARE ABLE TO MAINTAIN WITH THEIR INCOME (YEAR 1: DATA NOT AVAILABLE) - # OF SECURE JOBS GRADUATES OBTAIN SUSTAINABLE EMPLOYMENT IN THE FIRST YEAR (YEAR 1: DATA NOT AVAILABLE) - SECURE JOBS GRADUATES MAINTAIN EMPLOYMENT FOR 90 DAYS (YEAR 1: DATA NOT AVAILABLE) - SECURE JOBS GRADUATES INCREASE THEIR INCOME IN THE FIRST YEAR OF EMPLOYMENT (YEAR 1: DATA NOT AVAILABLE) - # OF PARTICIPANTS WHO INCREASE THEIR EMPLOYABILITY THROUGH JOB READINESS AS DEMONSTRATED BY THE REDUCTION OR ELIMINATION OF BARRIERS, ACQUISITION OF SOFT AND HARD JOB SKILLS, AND/OR TRAINING (YEAR 1: DATA NOT AVAILABLE) - # OF MERRIMACK VALLEY FOOD BANK COMMUNITY MARKET SITES (BASELINE: 4; YEAR 1: 5)- # OF INDIVIDUALS SERVED (BASELINE: 553; YEAR 1: 635)- # OF COOKING UP GOOD HEALTH SESSIONS (BASELINE: 12; YEAR 1: 12)- # ATTENDEES (BASELINE: 71; YEAR 1: 80)- # OF INDIVIDUALS PROVIDED FREE, FRESH PRODUCE THROUGH THE NEW ENTRY SUSTAINABLE FARMING PROJECT COUNCIL ON AGING FARMERS MARKET PROGRAM (BASELINE: 50-80 SENIORS PER WEEK AT THE ARLINGTON, BURLINGTON AND BILLERICA COUNCILS ON AGING; YEAR 1: 50-80 SENIORS PER WEEK AT THE ARLINGTON, BURLINGTON AND BILLERICA COUNCILS ON AGING)- POUNDS OF PRODUCE DISTRIBUTED (BASELINE: 17,500; YEAR 1: 17,500)- # OF SHARES (BASELINE: 3,500; YEAR 1: 3,500)- % OF INDIVIDUALS WHO REPORTED INCREASING THEIR DAILY INTAKE OF FRUITS AND VEGETABLES (BASELINE: 69%; YEAR 1: 82%)
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- % INDIVIDUALS REPORTED EATING A GREATER VARIETY OF FRUITS AND/OR
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VEGTABLES (BASELINE: 72%; YEAR 1: 85%)- % OF INDIVIDUALS WHO REPORTED EATING HIGHER QUALITY PRODUCE (BASELINE: 8%; YEAR 1: 86%)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 AGING, COMMUNITY TEAMWORK, INC. PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USEANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES 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. FOCUS COHORTS: LOW-RESOURCED POPULATIONS, OLDER ADULTS, YOUTH, RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS, AND LGTBQIA+STRATEGIES: 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- OCAL SUBSTANCE USE PREVENTION COALITIONSMETRICS AND STATUS UPDATES- # OF GRANTS PROVIDED TO ORGANIZATIONS TO ADDRESS ISSUES RELATED TO MENTAL HEALTH AND SUBSTANCE USE (BASELINE: 6; YEAR 1: 7)- # OF INDIVIDUALS SERVED BY THE CENTER FOR HOPE AND HEALING PROGRAMS FOR SURVIVORS OF DOMESTIC VIOLENCE (BASELINE: 98; YEAR 1: 78)- # OF SUPPORT GROUPS HELD (BASELINE: 48; YEAR 1: 50)- # OF INDIVIDUALS SERVED BY THE PLACE OF PROMISE LONG-TERM RESIDENTIAL ADDICTION RECOVERY PROGRAM (BASELINE: 28; YEAR 1: 46)- # OF INDIVIDUALS WHO OBTAINED MEDICAL INSURANCE (BASELINE: 32; YEAR 1: 40)- # OF INDIVIDUALS WHO OBTAINED NECESSARY PAPERWORK FOR EMPLOYMENT (BASELINE: 32; YEAR 1: 43)- # OF STUDENTS WHO ATTEND BURLINGTON HIGH SCHOOL "WELLNESS DAYS" (BASELINE: 870; YEAR 1: 850)- # OF VENDORS WHO PARTICIPATED (BASELINE: 45; YEAR 1: 156) - # OF INDIVIDUALS SERVED BY THE BURLINGTON HIGH SCHOOL ADJUSTMENT COUNSELOR TO PROVIDE PREVENTATIVE AND SUPPORTIVE SERVICES FOR STUDENTS IDENTIFIED TO BE AT HIGH-RISK FOR MENTAL HEALTH DISORDER (BASELINE: 81; YEAR 1: 80)- TORIGIAN YMCA'S YOUTH MENTAL HEALTH SUPPORT AND SUBSTANCE USE PREVENTION PROGRAM- PROVIDE FINANCIAL ASSISTANCE TO ENSURE THE 40% OF FAMILIES SERVED CAN ACCESS Y PROGRAMS AND SERVICES, INCLUDING THE PROPOSED MENTAL HEALTH SUPPORTS (YEAR 1: DATA NOT AVAILABLE)- HIRE A BEHAVIORAL ANALYST TO PROVIDE MENTAL AND BEHAVIORAL HEALTH SUPPORT AND REFERRALS TO THE OVER 1,000 YOUTH ACROSS THE TORIGIAN FAMILY YMCA CHILDCARE PROGRAMS (YEAR 1: DATA NOT AVAILABLE) - # YMCA STAFF TRAINED IN YOUTH MENTAL HEALTH FIRST AID SO THAT THEY ARE ABLE TO IDENTIFY, UNDERSTAND, AND RESPOND TO SIGNS OF MENTAL HEALTH AND SUBSTANCE USE CHALLENGES AMONG CHILDREN AND ADOLESCENTS AGES 12-18 (YEAR 1: DATA NOT AVAILABLE) - KHMER OLDER ADULT ACTION GROUP (KOAAG) THROUGH THE GREATER LOWELL HEALTH ALLIANCE, WHICH ENGAGES OLDER CAMBODIAN ADULTS AS PAID COMMUNITY AMBASSADORS TO IDENTIFY COMMUNITY NEEDS AND IMPLEMENT INTERVENTIONS - # MEMBERS WHO ATTEND AT LEAST 1 MONTHLY MEETING (YEAR 1: DATA NOT AVAILABLE) - # OF COMMUNITY EVENTS, TRAININGS, OR EDUCATIONAL SESSIONS, OR PRODUCE AND DISTRIBUTE AT LEAST 3 KHMER-LANGUAGE RESOURCES (FLIER, BROCHURE, VIDEO, ETC.) FOR THE ELDER CAMBODIAN COMMUNITY THAT ADDRESS MENTAL HEALTH AND/OR THE FACTORS THAT DRIVE MENTAL HEALTH NEEDS IN THE CAMBODIAN COMMUNITY (YEAR 1: DATA NOT AVAILABLE)- # OF OLDER ADULT ASIAN PARTICIPANTS IN THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT WHO REPORT AN INCREASE IN REPORTING THAT THERE ARE OPPORTUNITIES FOR THEM TO ENGAGE IN THEIR COMMUNITY AND MAKE THEIR VOICES HEARD (Q. 26, 2022 BASELINE: 38.5%), THAT THEIR OVERALL MENTAL HEALTH IS BETTER THAN THE YEAR BEFORE (Q.27, 2022 BASELINE: 26.6%), AND A DECREASE IN THE PERCENT OF PARTICIPANTS REPORTING NOT BEING ABLE TO AFFORD MENTAL HEALTH CARE (Q.35,2022 BASELINE: 6.4%) (YEAR 1: DATA NOT AVAILABLE) - # OF SCHOOL DISTRICTS WHO PARTICIPATE IN THE SHARED YOUTH RISK BEHAVIOR SURVEY (BASELINE: 9; YEAR 1: DATA NOT AVAILABLE) - PEABODY DIVISION OF SOCIAL SERVICES COMMUNITY-BASED NAVIGATOR PROGRAM TO INCREASE ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SUPPORT SERVICES - # AND DEMOGRAPHICS OF INDIVIDUALS UTILIZING BEHAVIORAL HEALTH NAVIGATION SERVICES (YEAR 1: DATA NOT AVAILABLE)- # OF INDIVIDUALS SCREENED AND REFERRED TO SERVICES (YEAR 1: DATA NOT AVAILABLE)- SUCCESSFUL ACCESS AND UTILIZATION OF THE RECOMMENDED RESOURCES BY NAVIGATION PARTICIPANTS (YEAR 1: DATA NOT AVAILABLE) - INCREASED KNOWLEDGE ABOUT THE RESOURCES AVAILABLE TO PARTICIPANTS THROUGH EDUCATIONAL ACTIVITIES (YEAR 1: DATA NOT AVAILABLE) - NUMBER OF COMMUNITY PARTNERS ENGAGED THROUGH THE GRANT PERIOD (YEAR 1: DATA NOT AVAILABLE) - # OF MENTAL HEALTH FIRST AID EDUCATIONAL SESSIONS PROVIDED TO THE COMMUNITY (BASELINE: PROGRAM BEGAN IN YEAR 1; YEAR 1: 21)- # OF INDIVIDUALS TRAINED (BASELINE: PROGRAM BEGAN IN YEAR 1; YEAR 1: 350)- # OF INDIVIDUALS SERVED THROUGH THE COLLABORATIVE CARE MODEL TO INCREASE ACCESS TO BEHAVIORAL HEALTHCARE (BASELINE: 6 PRACTICES IN THE LAHEY CLINIC HOSPITAL SERVICE AREA SERVED 3179 INDIVIDUALS; YEAR 1: 7 PRACTICES IN THE LAHEY CLINIC HOSPITAL SERVICE AREA SERVED 2708 INDIVIDUALS)- # OF INITIAL AND FOLLOW-UP PSYCHOLOGICAL EVALUATIONS WERE CONDUCTED BY THE EMERGENCY SERVICES TEAM (BASELINE: DATA NOT AVAILABLE; YEAR 1: 5,704)- # OF INDIVIDUALS PROVIDED WITH MENTAL HEALTH RECOVERY BEDS AT HART HOUSE (BASELINE: DATA NOT AVAILABLE; YEAR 1: 78 WOMEN AND 141 CHILDREN)- # OF BED DAYS FOR INDIVIDUALS AT HART HOUSE (BASELINE: DATA NOT AVAILABLE; YEAR 1: 4,905)- # OF TELEPSYCHIATRY SERVICES PROVIDED THROUGH BILH BEHAVIORAL SERVICES WITHIN THE LAHEY CLINIC HOSPITAL COMMUNITY BENEFITS SERVICE AREA TO ENHANCE OUTPATIENT BEHAVIORAL HEALTHCARE (BASELINE: 95; YEAR 1:DATA NOT AVAILABLE) - # OF SCREENINGS FOR HOSPITAL-BASED ADDICTION SERVICES THROUGH THE EMERGENCY DEPARTMENT (BASELINE: 140 AT LAHEY PEABODY; YEAR 1: 171 AT LAHEY PEABODY AND 40 AT LAHEY BURLINGTON)- # OF SESSIONS OF THE TRAUMA SUPPORT GROUP (BASELINE: 11; YEAR 1: 11)- # OF PARTICIPANTS (BASELINE: 31; YEAR 1: 20)- # OF INFORMATIONAL PACKETS SENT MONTHLY TO SURVIVORS OF TRAUMA (BASELINE: 20; YEAR 1: 25) POUNDS OF MEDICATIONS DISPOSED OF THROUGH THE HOSPITAL-BASED MEDICATION DISPOSAL BOXES (BASELINE: DATA NOT AVAILABLE; YEAR 1: 850)
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- # OF ENCOUNTERS THROUGH THE BURLINGTON COUNCIL ON AGING'S SOCIAL WORKER
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OUTREACH PROGRAM (BASELINE: 3,283; YEAR 1: 4,116)- # OF REFERRALS PROVIDED (BASELINE: 614; YEAR 1: 679) - # OF INDIVIDUALS SERVED BY THE BURLINGTON POLICE DEPARTMENT SUBSTANCE USE COORDINATOR (BASELINE: 81; YEAR 1: 77)- # OF INDIVIDUALS WHO ACCEPTED RECOVERY SERVICES (BASELINE: 28; YEAR 1: 33)- # OF REFERRALS MADE BY THE COMMUNITY (BASELINE: DATA NOT AVAILABLE: YEAR 1: 58, WITH 19 WALK-INS)- # OF INDIVIDUALS SERVED BY BURLINGTON YOUTH & FAMILY SERVICES (BASELINE: 4,286; YEAR 1: 4,146)- # OF REFERRALS MADE TO OTHER ORGANIZATIONS (BASELINE: 285; YEAR 1: 270) - # OF TRAININGS (BASELINE: 6; YEAR 1: 4)- # OF SUPPORT GROUPS AND INDIVIDUALS SERVED BY SUPPORT GROUPS (BASELINE: 10 GROUPS AND 81 ATTENDED; YEAR 1: 10 GROUPS AND 103 ATTENDED)- # OF SPONSORSHIPS FOR A HEALTHY LYNNFIELD (BASELINE: 1; YEAR 1: 1) - # OF SUBSTANCE USE COALITION MEETINGS ATTENDED (BASELINE: 4; YEAR 1: 4) - # OF NEW PARTNERSHIPS DEVELOPED (BASELINE: 2 GRANTEES: YEAR 1: 2 GRANTEES)COMMUNITY PARTNERS: BURLINGTON HIGH SCHOOL, BURLINGTON COUNCIL ON AGING, BURLINGTON POLICE DEPARTMENT, CENTER FOR HOPE AND HEALING, PLACE OF PROMISE, A HEALTHY LYNNFIELD; GREATER LOWELL HEALTH ALLIANCE; METRO NORTH YMCAPRIORITY 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.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.FOCUS COHORTS: LOW-RESOURCED POPULATIONS, OLDER ADULTS, YOUTH, RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS, AND LGTBQIA+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- # OF BREAST CANCER RISK ASSESSMENTS CONDUCTED (BASELINE: 21,029; YEAR 1: 14,684)- # UNIQUE INDIVIDUALS SCREENED (BASELINE: 20,553; YEAR 1: 14,436)- % OF PATIENTS SCREENED WHO WERE IDENTIFIED AS HAVING A HIGH-RISK MUTATION (BASELINE: 27%; YEAR 1: 29%)- % OF PATIENTS SCREENED WHO WERE IDENTIFIED AS HAVING A HIGH LIFETIME RISK OF BREAST CANCER (BASELINE: 13%; YEAR 1: 13%)- # OF PATIENTS SERVED BY NURSE ONCOLOGY-NAVIGATORS (BASELINE: 10-15 PATIENTS PER DAY; YEAR 1: 10-15 PATIENTS PER DAY) - # OF INDIVIDUALS SERVED BY THE BURLINGTON DIABETES CARE PROGRAM (BASELINE: 32; YEAR 1: 33)- % REDUCTION IN A1C (BASELINE: 42%; YEAR 1: 50%)- % MAINTAINED A HEALTHY A1C OF 6.5 OR BELOW (BASELINE: 38%; YEAR 1: 34%)- # OF BONE HEALTH AND OSTEOPOROSIS PROGRAM CLASSES HELD (BASELINE: 6; YEAR 1: 6)- # OF PARTICIPANTS (BASELINE: 40; YEAR 1: 35) - # OF FREE SESSIONS OF TAI JI QUAN: MOVING FOR BETTER BALANCE SESSIONS FOR THE COMMUNITY (BASELINE: 48 CLASSES; YEAR 1: 48 CLASSES)- # OF INDIVIDUALS SERVED (BASELINE: 17 PARTICIPANTS STARTED THE PROGRAM IN OCTOBER 2022; 16 COMPLETED THE PROGRAM (ATTENDED AT LEAST 75% OF THE SESSIONS); YEAR 1: 9 PARTICIPANTS STARTED THE PROGRAM IN OCTOBER 2023; 8 COMPLETED THE PROGRAM (ATTENDED AT LEAST 75% OF THE SESSIONS) AND 1 DID NOT COMPLETE THE PROGRAM; AGES RANGED FROM 67 TO 81 YEARS OF AGE: 7 FEMALES AND 2 MALES)- # OF SESSIONS OF A MATTER OF BALANCE PROVIDED (BASELINE: 2; YEAR 1: 3)- % OF SURVEY RESPONDENTS WHO REPORT A DECREASED RISK OF FALLS (BASELINE: DATA NOT AVAILABLE; YEAR 1: 100%)- # OF INDIVIDUALS SERVED BY THE BURLINGTON COUNCIL ON AGING MEMORY CAF (BASELINE: 60; YEAR 1: 60) - # OF ENHANCE FITNESS PROGRAMS SUPPORTED (BASELINE: 2, YEAR 1: 2)- # OF INDIVIDUALS SERVED (BASELINE: 92 INDIVIDUALS ACROSS BOTH SITES AND GRADUATED 100% OF PARTICIPANTS AT THE GREATER BOSTON YMCA SITE; YEAR 1: 41 INDIVIDUALS ACROSS BOTH SITES AND AT LEAST 75% OF INDIVIDUALS AT BOTH SITES DEMONSTRATED IMPROVED FITNESS ASSESSMENTS)- % OF PARTICIPANTS REPORTING INCREASED STRENGTH AND MOBILITY (BASELINE: DATA NOT AVAILABLE; YEAR 1: 85%)- # OF INDIVIDUALS SERVED BY THE BURLINGTON COUNCIL ON AGING EXERCISE CLASSES (BASELINE: 359; YEAR 1: 327) 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. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE:- 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 - CITIZENS INN- COMMUNITY TEAMWORK, INC. - GREATER BOSTON YMCA- GREATER LOWELL HEALTH ALLIANCE- 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).
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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THE 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, 10.48% 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 $8,575,629 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024 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 ELEVEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $52 MILLION FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024.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 $17,783,620 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY LAHEY CLINIC HOSPITAL FOR SUCH SERVICES BY $6,019,991 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 10.1% OR 115,193 OF LAHEY CLINIC HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 48.7% OR 555,859 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. 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 $35.5 MILLION RELATED TO TREATING MEDICAID 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 $372,843,318 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS FELL SHORT OF REVENUE BY $2,692,275. OF THESE AMOUNTS, REVENUE OF $14,641,016 IS RELATED TO THE PROVISION OF ENDOCRINE, BEHAVIORAL HEALTH, ALLERGY AND IMMUNOLOGY, OB/GYN & GYNECOLOGY, AND GENETICS SERVICES AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $72,919,007. 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. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $6,085,393 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), EXETER HEALTH RESOURCES, INC. (EHRI), EXETER HOSPITAL (EH), 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). FINANCIAL STATEMENT FOOTNOTE: REVENUE RECOGNITIONTHE SYSTEM'S PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING MANAGED CARE PAYORS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDE AN ESTIMATE OF VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE SYSTEM BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE SYSTEM'S FACILITY.
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REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. PERFORMANCE
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OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE SYSTEM. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED (OR ACTUAL) CHARGES. THE SYSTEM BELIEVES THAT THIS METHOD PROVIDES A REASONABLE REPRESENTATION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO INPATIENT SERVICES. THE SYSTEM MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL, OR COMMENCEMENT OF A PATIENT SERVICE, TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TO THAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE OR COMPLETION OF THE OUTPATIENT SERVICES. PATIENT ENCOUNTERS AND RELATED EPISODES OF CARE AND PROCEDURES QUALIFY AS DISTINCT GOODS AND SERVICES, PROVIDED SIMULTANEOUSLY TOGETHER WITH OTHER READILY AVAILABLE RESOURCES, IN A SINGLE INSTANCE OF SERVICE, AND THEREBY CONSTITUTE A SINGLE PERFORMANCE OBLIGATION FOR EACH PATIENT ENCOUNTER AND, IN MOST INSTANCES, OCCUR AT READILY DETERMINABLE TRANSACTION PRICES. ALL SERVICES PROVIDED ARE EXPECTED TO RESULT IN CASH FLOWS AND ARE THEREFORE REFLECTED AS NET REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS.THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. THE ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS ARE BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES AND HISTORICAL CASH COLLECTION EXPERIENCE. DIFFERENCES BETWEEN STANDARD CHARGES AND ESTIMATED TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE AND ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. ADJUSTMENTS ARISING FROM A CHANGE IN THE TRANSACTION PRICE WERE NOT SIGNIFICANT DURING THE YEARS ENDED SEPTEMBER 30, FOR 2024 OR 2023. REVENUES 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. SETTLEMENTS WITH THIRD-PARTY PAYORS FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS OR INVESTIGATIONS ARE CONSIDERED VARIABLE CONSIDERATION AND ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE USING THE MOST LIKELY OUTCOME METHOD. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE PAYMENT AGREEMENT WITH THE PAYOR, CORRESPONDENCE FROM THE PAYOR AND HISTORICAL SETTLEMENT ACTIVITY, INCLUDING AN ASSESSMENT TO ENSURE THAT IT IS PROBABLE THAT A SIGNIFICANT REVERSAL IN THE AMOUNT OF CUMULATIVE REVENUE RECOGNIZED WILL NOT OCCUR WHEN THE UNCERTAINTY ASSOCIATED WITH THE RETROACTIVE ADJUSTMENT IS SUBSEQUENTLY RESOLVED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN, OR AS YEARS ARE SETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS.THE SYSTEM IS NOT AWARE OF ANY MATERIAL CLAIMS, DISPUTES, OR UNSETTLED MATTERS WITH ANY PAYORS THAT WOULD AFFECT REVENUES THAT HAVE NOT BEEN ADEQUATELY PROVIDED FOR AND DISCLOSED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. BECAUSE THE LAWS, REGULATIONS, INSTRUCTIONS AND RULE INTERPRETATIONS GOVERNING MEDICARE AND MEDICAID REIMBURSEMENT ARE COMPLEX, SUBJECT TO INTERPRETATION AND CAN CHANGE FREQUENTLY, THE ESTIMATES RECORDED COULD CHANGE BY MATERIAL AMOUNTS.CONSISTENT WITH THE SYSTEM'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (E.G., COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. PATIENTS WHO MEET THE SYSTEM'S CRITERIA FOR CHARITY CARE ARE PROVIDED CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE SYSTEM HAS DETERMINED THAT IT HAS PROVIDED SUFFICIENT IMPLICIT PRICE CONCESSIONS FOR THESE ACCOUNTS. PRICE CONCESSIONS, INCLUDING CHARITY CARE, ARE NOT REPORTED AS REVENUE.PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED CO-PAYS, CO-INSURANCE AND DEDUCTIBLES, WHICH VARY IN AMOUNT. THE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH CO-PAYS, CO-INSURANCE AND DEDUCTIBLES AND FOR THOSE WHO ARE UNINSURED BASED ON HISTORICAL COLLECTION EXPERIENCE AND CURRENT MARKET CONDITIONS. THE DISCOUNT OFFERED TO CERTAIN UNINSURED PATIENTS IS RECOGNIZED AS A CONTRACTUAL ALLOWANCE, WHICH REDUCES NET OPERATING REVENUES AT THE TIME THE SELF-PAY ACCOUNTS ARE RECORDED. THE UNINSURED PATIENT ACCOUNTS, NET OF CONTRACTUAL ALLOWANCES RECORDED, ARE FURTHER REDUCED TO THEIR NET REALIZABLE VALUE AT THE TIME THEY ARE RECORDED THROUGH IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION TRENDS FOR SELF-PAY ACCOUNTS AND OTHER FACTORS THAT AFFECT THE ESTIMATION PROCESS. ALTHOUGH OUTCOMES VARY, THE SYSTEM'S POLICY IS TO ATTEMPT TO COLLECT AMOUNTS DUE FROM PATIENTS, INCLUDING CO-PAYS, CO-INSURANCE AND DEDUCTIBLES DUE FROM PATIENTS WITH INSURANCE, AT THE TIME OF SERVICE WHILE COMPLYING WITH ALL FEDERAL AND STATE STATUTES AND REGULATIONS.OTHER REVENUE INCLUDES CONTRIBUTIONS AND NET ASSETS RELEASED FROM RESTRICTIONS AS WELL AS CAFETERIA AND PARKING INCOME. ADDITIONALLY, PHARMACY SALES AND OTHER CONTRACTS RELATED TO HEALTH CARE SERVICES ARE INCLUDED IN OTHER REVENUE AND CONSIST OF CONTRACTS WHICH VARY IN DURATION AND IN PERFORMANCE. REVENUE IS RECOGNIZED WHEN THE PERFORMANCE OBLIGATIONS IDENTIFIED WITHIN THE INDIVIDUAL CONTRACTS ARE SATISFIED AND COLLECTIONS ARE PROBABLE. OTHER REVENUE FOR THE YEARS ENDED SEPTEMBER 30, 2024 AND 2023 ALSO INCLUDED FUNDING RECEIVED FROM FEDERAL AND STATE SOURCES RELATED TO THE COVID-19 PANDEMIC AMOUNTING TO $17,500 AND $6,100, RESPECTIVELY.EMERGENCY CARE ACCESSLAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER(LCH OR LHMC)IS A WORLD-RENOWNED TERTIARY ACADEMIC MEDICAL CENTER KNOWN FOR ITS INNOVATIVE TECHNOLOGY, PIONEERING MEDICAL TREATMENTS AND LEADING-EDGE RESEARCH. AS A PHYSICIAN-LED HOSPITAL, LHMC OFFERS A LEGACY OF CARE AND EDUCATION COMMITTED TO PUTTING THE PATIENT AT THE CENTER THROUGH A MULTIDISCIPLINARY, COLLABORATIVE AND TEAM-BASED APPROACH. AS NOTED ELSEWHERE IN THIS RETURN, LHMC PROVIDES 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO 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).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 WHEN DETERMINING ELIGIBILITY.
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FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE
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AS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONS EFFECTIVE ON OR ABOUT APRIL 24, 2024.FINANCIAL ASSISTANCE POLICY-APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY-ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE-PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY-TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ARABIC, ARMENIAN, CAPE VERDEAN, FRENCH, GREEK, GUJARATI, HAITIAN CREOLE, HINDI, ITALIAN, KHMER, KOREAN, PORTUGUESE PUNJABI, RUSSIAN, SIMPLIFIED CHINESE, SPANISH, TRADITIONAL CHINESE, AND VIETNAMESE (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY-WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT: HTTPS://WWW.LAHEY.ORG/LHMC/YOUR-VISIT/INSURANCE-BILLING-RECORDS/FINANCIAL-COUNSELING-ASSISTANCE/IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G).
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FINANCIAL ASSISTANCE POLICY-PLAIN LANGUAGE SUMMARY
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AS 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, ARABIC, ARMENIAN, CAPE VERDEAN, FRENCH, GREEK, GUJARATI, HAITIAN CREOLE, HINDI, ITALIAN, KHMER, KOREAN, PORTUGUESE PUNJABI, RUSSIAN, SIMPLIFIED CHINESE, SPANISH, TRADITIONAL CHINESE, AND VIETNAMESE 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 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. THE HOSPITAL MAY DEFER OR REQUIRE PAYMENT BEFORE PROVIDING MEDICALLY NECESSARY SERVICES (OTHER THAN EMERGENCY MEDICAL SERVICES) TO PATIENTS WITH UNPAID BALANCES WHO HAVE FAILED TO PROVIDE REQUESTED INFORMATION FOR PROCESSING A FINANCIAL ASSISTANCE APPLICATION OR WITH RESPECT TO A PAYMENT PLAN. THE HOSPITAL DOES NOT PROVIDE A 30-DAY WRITTEN NOTICE IN ADVANCE OF TAKING SUCH ACTION, AS SUCH NOTICE IS NOT REQUIRED BY THE SECTION 501(R) REGULATIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS-RESEARCHAS NOTED 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 265 ACTIVE FEDERAL, CORPORATE, NON-PROFIT, AND INTERNALLY SPONSORED PROJECTS, AND MORE THAN 460 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL STUDIES. DURING THE SAME TIME, LHMC HAD OVER 207 PRINCIPAL INVESTIGATORS, MANY WHO ARE TUFTS UNIVERSITY SCHOOL OF MEDICINE FACULTY OR UNIVERSITY OF MASSACHUSETTS CHAN MEDICAL 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 1,000 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 OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED BOSTON TEACHING HOSPITALS. LHMC ALSO PARTICIPATES IN 2 CLINICAL AND TRANSLATIONAL SCIENCE AWARD (CTSA) PROGRAMS: THE UMASS CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE AND THE TUFTS CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE (TUFTS CTSI), WHICH PROMOTE COLLABORATIVE, CROSS-DISCIPLINARY, FULL-SPECTRUM TRANSLATIONAL RESEARCH AMONG 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 230 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- EXECUTIVE HEALTH- 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.
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EXAMPLES OF RESEARCH ENGAGEMENT AT LHMC
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HIGHLIGHTED 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.1. HYPERTROPHIC CARDIOMYOPATHYLHMC'S HYPERTROPHIC CARDIOMYOPATHY (HCM) CENTER, LED BY DRS. MARTIN S. MARON, BARRY J. MARON, AND ETHAN J. ROWIN, ARE INTERNATIONALLY RECOGNIZED AUTHORITIES AND INNOVATORS IN HCM, OFFERING HIGHLY PERSONALIZED CARE AND LEADING-EDGE TREATMENTS TO ACHIEVE A GOOD QUALITY OF LIFE AND LONGEVITY FOR PATIENTS WITH HCM. IN FY 2024, LHMC HCM RESEARCHERS CONTINUED TO ADVANCE THE MANAGEMENT OF HCM.HCM IS A RELATIVELY COMMON OFTEN INHERITED HEART DISEASE ENCUMBERED THROUGHOUT MUCH OF ITS ALMOST 60-YEAR HISTORY BY THE EXPECTATION OF AN UNFAVORABLE OUTCOME WITH SHORTENED LONGEVITY. HOWEVER, IT IS NOTABLE THAT IN 2023, MOST PATIENTS AFFECTED WITH HCM CAN NOW ACHIEVE NORMAL OR EXTENDED LIFE EXPECTANCY WITHOUT MAJOR DISABILITY BECAUSE OF A COMPREHENSIVE CONSTELLATION OF MANAGEMENT STRATEGIES THAT HAVE EVOLVED LARGELY OVER THE LAST 20 YEARS. DISTINCT ADVERSE DISEASE PATHWAYS DICTATE HIGH-BENEFIT LOW-RISK PERSONALIZED TREATMENTS, WITHOUT RELIANCE ON GENOMICS AND SARCOMERE MUTATIONS, INCLUDING: PRIMARY PREVENTION IMPLANTABLE DEFIBRILLATORS FOR SUDDEN CARDIAC DEATH PREVENTION, SURGICAL MYECTOMY AND PERCUTANEOUS ALCOHOL SEPTAL ABLATION TO REVERSE HEART FAILURE SYMPTOMS, ANTICOAGULATION TO PREVENT EMBOLIC STROKE ASSOCIATED WITH CONCOMITANT ATRIAL FIBRILLATION, EXTERNAL DEFIBRILLATION AND HYPOTHERMIA FOR OUT-OF-HOSPITAL CARDIAC ARREST, AND HEART TRANSPLANT IN A SMALL PATIENT SUBGROUP WITH END-STAGE DISEASE. LHMC HCM RESEARCHERS SHOWED THAT LARGE COHORT STUDIES USING THESE CONTEMPORARY MANAGEMENT STRATEGIES ACHIEVED REMARKABLY LOW HCM-RELATED MORTALITY (0.5%/YEAR) ACROSS ALL AGE GROUPS, WHICH IS LOWER THAN IN THE OTHER CARDIAC OR NON-CARDIAC RISKS OF LIVING, AND LARGELY CONFINED TO NON-OBSTRUCTIVE PATIENTS WITH PROGRESSIVE HEART FAILURE, INCLUDING THOSE AWAITING HEART TRANSPLANT.IN A NATIONAL CLINICAL TRIAL LED BY DR. MARTIN MARON, RESEARCHERS EVALUATED THE SAFETY AND EFFICACY OF METABOLIC MODULATION WITH NINERAFAXSTAT IN PATIENTS WITH NON-OBSTRUCTIVE HCM. THERE ARE NO APPROVED MEDICAL THERAPIES FOR NON-OBSTRUCTIVE HCM (NHCM), BUT EVIDENCE SUGGESTS THAT IMPAIRED MYOCARDIAL ENERGETICS IS A POTENTIAL CAUSE OF SYMPTOMS AND EXERCISE LIMITATION IN THESE PATIENTS. NINERAFAXSTAT, A NOVEL CARDIAC MITOTROPE, ENHANCES CARDIAC ENERGETICS, AND WAS THEREFORE EVALUATED AS A NOVEL THERAPEUTIC FOR NHCM. IN THIS STUDY, A TOTAL OF 67 PATIENTS WITH NHCM WERE ENROLLED AT 12 CENTERS (57 11.8 YEARS OF AGE; 55% WOMEN). SERIOUS ADVERSE EVENTS OCCURRED IN 11.8% (N = 4 OF 34) IN THE NINERAFAXSTAT GROUP AND 6.1% (N = 2 OF 33) OF PATIENTS IN THE PLACEBO GROUP. FROM BASELINE TO 12 WEEKS, NINERAFAXSTAT WAS ASSOCIATED WITH SIGNIFICANTLY BETTER VE/VCO2 (VENTILATORY EFFICIENCY) SLOPE COMPARED WITH PLACEBO WITH A LEAST-SQUARES (LS) MEAN DIFFERENCE BETWEEN THE GROUPS OF -2.1 (95% CI: -3.6 TO -0.6; P = 0.006), WITH NO SIGNIFICANT DIFFERENCE IN PEAK VO2 (P = 0.90). THE KANSAS CITY CARDIOMYOPATHY QUESTIONNAIRE CLINICAL SUMMARY SCORE WAS DIRECTIONALLY, THOUGH NOT SIGNIFICANTLY, IMPROVED WITH NINERAFAXSTAT VS PLACEBO (LS MEAN 3.2; 95% CI: -2.9 TO 9.2; P = 0.30); HOWEVER, IT WAS STATISTICALLY SIGNIFICANT WHEN ANALYZED POST HOC IN THE 35 PATIENTS WITH BASELINE KANSAS CITY CARDIOMYOPATHY QUESTIONNAIRE CLINICAL SUMMARY SCORE 80 (LS MEAN 9.4; 95% CI: 0.3-18.5; P = 0.04). DR. MARON, ET AL. CONCLUDED THAT, IN SYMPTOMATIC NHCM, THIS NOVEL DRUG THERAPY TARGETING MYOCARDIAL ENERGETICS WAS SAFE AND WELL TOLERATED AND ASSOCIATED WITH BETTER EXERCISE PERFORMANCE AND HEALTH STATUS AMONG THOSE MOST SYMPTOMATICALLY LIMITED. THE FINDINGS SUPPORTED ASSESSING NINERAFAXSTAT IN A PHASE 3 STUDY, WHICH IS NOW ALSO BEING LED BY DR. MARON AND LHMC HCM RESEARCHERS.IN ANOTHER NATION-WIDE CLINICAL TRIAL OF A NOVEL DRUG THERAPY FOR HCM, DR. MARTIN MARON AND OTHER SEQUOIA-HCM INVESTIGATORS EVALUATED AFICAMTEN FOR SYMPTOMATIC OBSTRUCTIVE HCM. KNOWING THAT ONE OF THE MAJOR DETERMINANTS OF EXERCISE INTOLERANCE AND LIMITING SYMPTOMS AMONG PATIENTS WITH OBSTRUCTIVE HCM IS ELEVATED INTRACARDIAC PRESSURE RESULTING FROM LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION. AFICAMTEN, AN ORAL SELECTIVE CARDIAC MYOSIN INHIBITOR THAT REDUCES LEFT VENTRICULAR OUTFLOW TRACT GRADIENTS BY MITIGATING CARDIAC HYPERCONTRACTILITY, WAS EVALUATED IN A PHASE 3 TRIAL OF 282 PATIENTS WITH OBSTRUCTIVE HCM. THE MEAN AGE WAS 59.1 YEARS, 59.2% WERE MEN, THE BASELINE MEAN RESTING LEFT VENTRICULAR OUTFLOW TRACT GRADIENT WAS 55.1 MM HG, AND THE BASELINE MEAN LEFT VENTRICULAR EJECTION FRACTION WAS 74.8%. AT 24 WEEKS, THE MEAN CHANGE IN THE PEAK OXYGEN UPTAKE WAS 1.8 ML PER KILOGRAM PER MINUTE (95% CONFIDENCE INTERVAL [CI], 1.2 TO 2.3) IN THE AFICAMTEN GROUP AND 0.0 ML PER KILOGRAM PER MINUTE (95% CI, -0.5 TO 0.5) IN THE PLACEBO GROUP (LEAST-SQUARES MEAN BETWEEN-GROUP DIFFERENCE, 1.7 ML PER KILOGRAM PER MINUTE; 95% CI, 1.0 TO 2.4; P<0.001). THE RESULTS FOR ALL 10 SECONDARY END POINTS WERE SIGNIFICANTLY IMPROVED WITH AFICAMTEN AS COMPARED WITH PLACEBO. THE INCIDENCE OF ADVERSE EVENTS APPEARED TO BE SIMILAR IN THE TWO GROUPS. PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE, DR. MARON AND THE SEQUOIA-HCM INVESTIGATORS CONCLUDED THAT AMONG PATIENTS WITH SYMPTOMATIC OBSTRUCTIVE HCM, TREATMENT WITH AFICAMTEN RESULTED IN A SIGNIFICANTLY GREATER IMPROVEMENT IN PEAK OXYGEN UPTAKE THAN PLACEBO A PROMISING NEW DRUG THERAPY FOR THE MANAGEMENT OF HCM.BEYOND THEIR RESEARCH EVALUATING INVESTIGATION NEW DRUGS FOR HCM, THE LHMC HCM RESEARCH TEAM IS IDENTIFYING HIGH-RISK FEATURES OF HCM IN ELECTROCARDIOGRAPHY IMAGING USING A DEEP-LEARNING APPROACH. PATIENTS WITH HCM ARE AT RISK OF SUDDEN DEATH, AND INDIVIDUALS WITH 1 MAJOR RISK MARKERS ARE CONSIDERED FOR PRIMARY PREVENTION IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS. GUIDELINES RECOMMEND CARDIAC MAGNETIC RESONANCE (CMR) IMAGING TO IDENTIFY HIGH-RISK IMAGING FEATURES. HOWEVER, CMR IMAGING IS RESOURCE INTENSIVE AND IS NOT WIDELY ACCESSIBLE WORLDWIDE. FOR THIS REASON, THE LHMC HCM RESEARCH TEAM CONDUCTED A STUDY TO DEVELOP ELECTROCARDIOGRAM (ECG) DEEP-LEARNING (DL) MODELS FOR THE IDENTIFICATION OF PATIENTS WITH HCM AND HIGH-RISK IMAGING FEATURES. THE RESULTS OF THE STUDY DEMONSTRATED THAT ECG-DL MODELS RELIABLY IDENTIFIED HIGH-RISK FEATURES (SYSTOLIC DYSFUNCTION, MASSIVE HYPERTROPHY, APICAL ANEURYSM, AND EXTENSIVE LATE GADOLINIUM ENHANCEMENT) DURING HOLDOUT TESTING (C-STATISTIC 0.72, 0.83, 0.93, AND 0.76) AND EXTERNAL VALIDATION (C-STATISTIC 0.71, 0.76, 0.91, AND 0.68). A HYPOTHETICAL SCREENING STRATEGY USING ECHOCARDIOGRAPHY COMBINED WITH ECG-DLGUIDED SELECTIVE CMR USE SHOWED A SENSITIVITY OF 97% FOR IDENTIFYING PATIENTS WITH HIGH-RISK FEATURES WHILE REDUCING THE NUMBER OF RECOMMENDED CMRS BY 61%. THE NEGATIVE PREDICTIVE VALUE WITH THIS SCREENING STRATEGY FOR THE ABSENCE OF HIGH-RISK FEATURES IN PATIENTS WITHOUT ECG-DL RECOMMENDATION FOR CMR WAS 99.5%. THEY CONCLUDED THAT, IN HCM, NOVEL ECG-DL MODELS RELIABLY IDENTIFIED PATIENTS WITH HIGH-RISK IMAGING FEATURES WHILE OFFERING THE POTENTIAL TO REDUCE CMR TESTING REQUIREMENTS IN UNDER-RESOURCED GEOGRAPHIC AREAS.
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2. PRIMARY IMMUNODEFICIENCY DISEASE (PID)
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PRIMARY IMMUNODEFICIENCY DISEASES ARE ACKNOWLEDGED AS IMPORTANT MEDICAL ISSUES. PRIMARY IMMUNODEFICIENCY DISEASES ENCOMPASS MORE THAN 200 DIFFERENT RARE DISEASES THAT SHARE AT LEAST TWO CHARACTERISTICS, INHERITANCE AND INCREASED SUSCEPTIBILITY TO INFECTIONS. THE MECHANISMS IMPLY DIFFERENT COMPONENTS SUCH AS B-CELLS, T-CELLS, PHAGOCYTES OR COMPLEMENT, AND MORE THAN 350 GENES ARE KNOWN TO BE INVOLVED IN PID. THE ESTIMATED OVERALL PREVALENCE OF THESE DISORDERS IN THE UNITED STATES IS APPROXIMATELY 1 IN 1200 LIVE BIRTHS (MCCUSKER ET AL, 2018). COMMON VARIABLE IMMUNODEFICIENCY (CVID) IS THE MOST PREVALENT PID WORLD-WIDE, AND IS COMPRISED OF A CONSORTIUM OF DISORDERS WITH SIMILAR ANTIBODY DEFICIENCY BUT A VARIETY OF DIFFERENT ETIOLOGIES THAT HAVE YET TO BE DEFINED AND STUDIED. WITH AN ESTIMATED INCIDENCE RATE OF ~1 IN 25,000 INDIVIDUALS, CVID ACCOUNTS FOR MORE THAN 50% OF DEFICIENCIES WITHIN THE PID GROUP (CUNNINGHAM RUNDLES ET AL, 2012; COOPER ET AL, 1973).PATIENTS WITH CVID WHO DEVELOP AUTOINFLAMMATORY COMPLICATIONS HAVE AN 11-FOLD HIGHER RISK OF DEATH, YET WE LACK PRECISION DIAGNOSTIC TOOLS TO PREDICT AND INFORM TREATMENT OF THESE AUTOINFLAMMATORY COMPLICATIONS. CURRENTLY, THERE ARE NO FDA-APPROVED THERAPIES AND NO STANDARD-OF-CARE PRACTICE GUIDELINES TO DIRECT THE MANAGEMENT OF AUTO-INFLAMMATORY DISEASE SEQUELAE OCCURRING IN CVID PATIENTS. AS A FOUNDING MEMBER OF THE NEW ENGLAND IMMUNE DEFICIENCY CONSORTIUM (NEIDC), JOSELYN FARMER, MD, PHD IS COLLABORATING WITH MASSACHUSETTS GENERAL HOSPITAL AND BOSTON UNIVERSITY TO STUDY ONE OF THE LARGEST CVID COHORTS IN THE COUNTRY. LEVERAGING THE ELECTRONIC HEALTH RECORD, DR. FARMER PAIRED A ROBUST DATABASE OF CLINICAL DATA ON CVID PATIENTS WITH A BIOBANK OF PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMCS), PLASMA, AND DNA FROM BLOOD. THE GOAL OF THIS WORK IS TO ELUCIDATE UNDERLYING IMMUNE PATHOMECHANISMS, TOWARDS DIRECT TRANSLATION TO PRECISION CARE OF CVID PATIENTS. WITH GRANTS FROM FOUNDATIONS AND INDUSTRY SPONSORS, DR. FARMER IS EXPLORING WHETHER OR NOT FUNCTIONAL IMMUNOPHENOTYPING, SPECIFICALLY BY OLINK 3K PROTEOME IN PERIPHERAL BLOOD, CAN IMPROVE DRUG-TARGETABLE PATHWAY DISCOVERY IN CVID. THE GOAL OF THIS WORK IS TO PAIR FUNCTIONAL PROTEOMICS WITH EXISTING WHOLE EXOME SEQUENCING DATA FROM CVID PROBANDS TO DEFINE CONVERGENT, AND POTENTIALLY DRUG-TARGETABLE, PATHWAYS OF IMMUNE DYSREGULATION IN CVID. THIS WORK WILL ADDRESS A CRITICAL GAP IN PATIENT CARE, WITH A SPECIFIC OVERARCHING GOAL TO USE FUNCTIONAL IMMUNOPHENOTYPING TO INFORM DRUG-TARGETABLE PATHWAY DISCOVERY IN CVID.THE VARIABILITY OF CVID REFERS TO THE DEVELOPMENT OF NONINFECTIOUS COMPLICATIONS IN ADDITION TO INCREASED VULNERABILITY TO INFECTION IN UP TO TWO-THIRDS OF PATIENTS. THE CLINICAL SPECTRUM OF CVID IS EXTENSIVE BUT IS COMPOSED OF TWO MAIN PHENOTYPES: ONE COHORT WITH RECURRENT INFECTIONS AND A SECOND COHORT WITH AUTOIMMUNE/INFLAMMATORY SYMPTOMS. NONINFECTIOUS COMPLICATIONS HAVE EMERGED AS A MAJOR CLINICAL CHALLENGE OF CVID, AND THE PATHOGENESIS IS POORLY UNDERSTOOD (HO ET AL, 2020). CVID PATIENTS WHO DEVELOP AUTO-INFLAMMATORY COMORBIDITIES (E.G., AUTO-INFLAMMATORY BOWEL, LUNG, LIVER, SKIN, JOINT DISEASE AND/OR AUTOIMMUNE CYTOPENIAS) HAVE AN 11-FOLD HIGHER RISK OF DEATH (RESNICK ET AL, 2012). THESE DATA HIGHLIGHT AN IMMENSE CLINICAL NEED TO BETTER MANAGE AUTOINFLAMMATORY DISEASE CO-MORBIDITIES OCCURRING IN CVID PATIENTS.IMMUNOGLOBULIN REPLACEMENT THERAPY IS THE CURRENT TREATMENT OPTION FOR CVID, WHICH USUALLY RELIEVES INFECTIOUS SYMPTOMS. MEDICATIONS PRESCRIBED FOR RECURRENT INFECTIONS MAY ALSO INCLUDE ANTIBIOTICS THAT MAY BE USED FOR A LONGER DURATION COMPARED TO A HEALTHY INDIVIDUAL AS A STANDARD OF CARE (ALBIN ET AL, 2014). HOWEVER, THERE ARE CURRENTLY NO FDA-APPROVED THERAPIES TO MANAGE TO THE AUTOINFLAMMATORY DISEASE CO-MORBIDITIES OCCURRING IN CVID PATIENTS.WITH THE ONSET OF CLINICAL WHOLE EXOME SEQUENCING, A PROBABLE DISEASE-CAUSING MUTATION HAS BEEN IDENTIFIED IN UP TO ONE-THIRD OF PATIENTS WITH CVID (MAFFUCCI ET AL 2016). THE CLINICAL CARE OF A CVID PATIENT WHO RECEIVES A CONFIRMED OR SUSPECTED GENETIC DIAGNOSIS IS VASTLY DIFFERENT. AS MENTIONED ABOVE, ALL CVID PATIENTS ARE TYPICALLY STARTED ON IMMUNOGLOBULIN REPLACEMENT THERAPY, YET THERE ARE NO CURRENT FDA-APPROVED THERAPIES FOR THE AUTOINFLAMMATORY DISEASE CO-MORBIDITIES THAT OCCUR IN CVID PATIENTS. THEREFORE, OBTAINING A GENETIC IDENTITY FOR THE CAUSE OF THE CVID OPENS UP THE OPPORTUNITY FOR USE OF MECHANISM-BASED THERAPEUTICS DIRECTED TO THE SPECIFIC GENE DEFECT (E.G., USE OF A PI3K INHIBITOR IN A PATIENT IDENTIFIED TO HAVE ACTIVATING PI3K-DELTA SYNDROME OR USE OF REPLACEMENT CTLA4-IG TO MANAGE CTLA4 DEFICIENCY). CURRENTLY, HOWEVER, THERE IS A CRITICAL BOTTLENECK IN CVID PATIENT CARE LIMITING ACCESS TO IMMUNOMODULATORS. THIS IMPORTANTLY INCLUDES THE LACK OF A PROBABLE DISEASE-CAUSING MUTATION IN THE MAJORITY OF CVID PATIENTS (MAFFUCCI ET AL 2016).DR. FARMER HYPOTHESIZES THAT FUNCTIONAL IMMUNOPHENOTYPING, USING THE OLINK 3K PROTEOMICS PLATFORM IN PERIPHERAL BLOOD, AMONG CVID PATIENTS WITH A KNOWN GENETIC ETIOLOGY CAN POTENTIALLY INFORM TREATMENT DECISION MAKING IN CVID PATIENTS WITHOUT A KNOWN GENETIC ETIOLOGY. THE OVERARCHING GOAL IS TO PRODUCE NOVEL GENOTYPE-IMMUNOPHENOTYPE-CLINICAL PRESENTATION ASSOCIATION MAPS THAT CAN ULTIMATELY PREDICT EFFICACY OF TARGETED IMMUNOMODULATORS MORE GLOBALLY IN CVID PATIENT CARE.3. URETHRAL STRICTURE DISEASE (USD)ONE OF THE MAIN COMPLICATIONS IN MEN WITH LICHEN SCLEROSUS (LS) IS URETHRAL STRICTURE DISEASE (USD). USD CAN LEAD TO URINARY SYMPTOMS, SEXUAL DYSFUNCTION, AND RENAL FAILURE IF OBSTRUCTION IS PROLONGED. LICHEN SCLEROSUS IS RESPONSIBLE FOR AROUND 15% OF ALL CASES OF USD AND IS ASSOCIATED WITH LONGER STRICTURES, HIGHER LEVELS OF INFLAMMATION, AND HIGHER RECURRENCE RATES AFTER URETHROPLASTY COMPARED TO NON-LS STRICTURES. LS URETHRAL STRICTURES ARE DISTINCT FROM NON-LS STRICTURES, IN THAT THEY PRESENT WITH SIGNIFICANT PHENOTYPIC VARIANCE AND SEVERITY. LICHEN SCLEROSUS STRICTURES PRESENT ALONG A SPECTRUM OF SEVERITY, RANGING FROM SIMPLE MEATAL STENOSIS, TO INVOLVEMENT OF THE ENTIRE ANTERIOR URETHRA (>20 CM). ADDITIONALLY, LS CAN AFFECT THE GENITAL SKIN WITH A RANGE OF DISEASE SEVERITY. THIS CAN MANIFEST AS ATROPHIC, HYPOPIGMENTED WHITE PATCHES OF PENILE AND GLANS SKIN, BUT MAY ALSO DEVELOP INTO SKIN EROSION, ULCERATIONS, GLANS ADHESIONS AND ULTIMATELY BURIED PENIS. MEN WITH GENITAL LS OFTEN HAVE LS ASSOCIATED URETHRAL STRICTURES. RECENT STUDIES HAVE SHOWN SIMILAR LEVELS OF INFLAMMATION IN SOME IDIOPATHIC STRICTURES COMPARED WITH LS-RELATED STRICTURES INDICATING THAT THE RATE OF LS-RELATED STRICTURES MAY BE HIGHER THAN PREVIOUSLY BELIEVED. ADDITIONALLY, THERE ARE CHARACTERISTIC HISTOLOGICAL CHANGES SEEN AND THE DISEASE PROCESS IS BELIEVED TO BE RELATED TO ALTERATIONS IN THE DERMAL-EPIDERMAL JUNCTION. UNFORTUNATELY, THESE FINDINGS ARE ONLY DISCOVERED AFTER SURGERY AND SELDOM LEAD TO CHANGES IN THERAPY. INTERESTINGLY, LEVY ET AL. FOUND THAT RECURRENT LS-INDUCED URETHRAL STRICTURES EXPRESSED LOWER LEVELS OF INFLAMMATORY MARKERS WITH DECREASED CELL TURNOVER HIGHLIGHTING A STARK CONTRAST TO WHAT IS BELIEVED TO CAUSE INDEX USD AND THE GAP THAT EXISTS IN OUR UNDERSTANDING OF LS STRICTURES. IN A RECENT STUDY LED BY DR. ALEX VANNI, PROFESSOR OF SURGERY AT UMASS CHAN-LAHEY, LHMC RESEARCHERS PROFILED URETHRAL TISSUE VIA BULK RNA SEQUENCING FROM LS PATIENTS (N=33) AND CONTROLS WITH IDIOPATHIC (N=28) OR INJURY INDUCED (N=15) STRICTURES, REVEALING SIGNIFICANT (FDR<0.05) DOWN-REGULATION OF THE ESTROGEN RECEPTOR PATHWAY AND STEROID HORMONE RECEPTORS INCLUDING ESTROGEN RECEPTOR 1 (ESR1), PROGESTERONE RECEPTOR (PGR), AND THE ANDROGEN RECEPTOR (AR) IN SAMPLES FROM LS PATIENTS. THEY OBSERVED UP-REGULATION OF THE INFLAMMATORY RESPONSE, INTERFERON ALPHA AND GAMMA RESPONSES, AND THE IL6-JAK-STAT SIGNALING PATHWAYS IN LS PATIENTS. AMONG THE SIGNIFICANTLY DIFFERENTIALLY EXPRESSED GENES ASSOCIATED WITH LS WERE EPITHELIAL, IMMUNE AND STROMAL CANONICAL CELL TYPE MARKERS INDICATING THAT MANY OF THE GENE EXPRESSION ALTERATIONS ARE LIKELY THE RESULT OF CELL TYPE COMPOSITIONAL CHANGES IN LS. AS A RESULT, IT IS DIFFICULT TO DISCRIMINATE BETWEEN PATHWAY ALTERATIONS AND CELL COMPOSITION CHANGES. THESE ANALYSES MAY HELP WITH THE DISCOVERY OF INFLAMMATORY AND FIBROTIC PATHWAYS UNIQUE TO LS INDUCED STRICTURES, GUIDE FURTHER INVESTIGATION, AND ULTIMATELY LEAD TO IMPROVED THERAPIES TO REVERSE DISEASE PROGRESSION OR PREVENT RECURRENCE.
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4. HAIR LOSS (ALOPECIA)
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BRUCE WILLIS AND MICHAEL JORDAN ARE JUST 2 OF MANY FAMOUS, BALD MEN RECOGNIZED INTERNATIONALLY. MOST INDIVIDUALS WOULD HAVE DIFFICULTY IDENTIFYING THE SAME NUMBER OF FAMOUS, BALD WOMEN. THIS OF COURSE IS NOT SURPRISING. CONSIDERING THE IMAGERY AND EXPECTATIONS IN OUR CULTURE OF WHAT A HEALTHY WOMAN SHOULD LOOK LIKE, IT IS NO WONDER THAT OF OVER 2,500 NEW ALOPECIA PATIENTS SEEN IN OUR HAIR LOSS CENTER SINCE 2016, 83% ARE FEMALE, AND FEMALES CONSISTENTLY REPORT THAT ALOPECIA HAS A LARGER NEGATIVE AFFECT ON QUALITY OF LIFE WHEN COMPARED TO MEN.CONSIDERING THIS, IN ADDITION TO THE FACT THAT LESS STUDIED FORMS OF INFLAMMATORY, SCARRING HAIR LOSS DISORDERS SUCH AS LICHEN PLANOPILARIS (LPP) PREFERENTIALLY AFFECT FEMALES (UP TO 90% OF ALL DIAGNOSES), IT IS PERPLEXING WHY MORE FOCUS IS NOT PUT INTO BETTER UNDERSTANDING THESE CONDITIONS. DR. MARYANNE MAKREDES SENNA, FOUNDING DIRECTOR OF THE LAHEY HAIR LOSS CENTER OF EXCELLENCE AND PRINCIPAL INVESTIGATOR, SEEKS TO ADDRESS THESE UNDER-RESEARCHED CONDITIONS WITH AN AIM TO INFORM FUTURE POTENTIAL THERAPEUTIC TARGETS.IN LPP, LYMPHOCYTIC INFLAMMATION DESTROYS THE HAIR FOLLICLE STEM CELLS (HFSCS), LEADING TO THE HAIR FOLLICLE'S (HF) INABILITY TO REGENERATE, FIBROSIS OF THE HF UNIT, AND DISFIGURING AND PAINFUL ALOPECIA. THE EXACT CAUSE FOR THIS IS UNKNOWN AND AS A RESULT, TREATMENTS ARE EXTREMELY LIMITED. IN HUMAN SCALP HAIR FOLLICLES, THE STEMS CELLS ARE LOCATED AT AN AREA CALLED THE BULGE, WHICH IS AN AREA OF THE BODY THAT NORMALLY HAS IMMUNE PRIVILEGE. IMMUNE PRIVILEGE IS SPECIFIC TO ONLY CERTAIN BODY SITES INCLUDING THE HAIR FOLLICLE, EYE, BRAIN, TESTES, AND PLACENTA, AND PROVIDES PROTECTION FROM IMMUNOLOGIC ATTACK BY A VARIETY OF MECHANISMS TO PROTECT THESE VULNERABLE TISSUES. THE COLLAPSE OF THE HAIR FOLLICLE'S IMMUNE PRIVILEGE IS THE FIRST STEP IN THE PATHOGENESIS OF LPP AND IT IS POSTULATED THAT THIS BREAKDOWN IS POTENTIATED BY THE PRO-INFLAMMATORY CYTOKINE, INTERFERON- (IFN), LEADING TO THE EVENTUAL SCARRING AND FIBROSIS OF THE HAIR FOLLICLE UNIT AND DISFIGURING ALOPECIA.IN AN RNA SEQUENCING (RNASEQ) STUDY CONDUCTED BY DR. SENNA'S LAB, OF 8 PAIRED SCALP TISSUE SPECIMENS FROM TREATMENT NAIVE PATIENTS, DIFFERENTIALLY EXPRESSED GENES (DEGS) THAT WERE STATISTICALLY SIGNIFICANTLY UPREGULATED MORE THAN 8-FOLD IN THE AFFECTED SCALP OF THESE PATIENTS COMPARED TO THE UNAFFECTED SCALP SKIN SHOWED A STRONG B CELL SIGNATURE. ADDITIONALLY, THERE WAS SIGNIFICANT UPREGULATION OF CXCL9 AND MATRIX METALLOPROTEINASES, WHICH ARE IMPLICATED IN OTHER FIBROSING INFLAMMATORY DISORDERS. RECENTLY PUBLISHED WORK BY ANOTHER GROUP THAT PERFORMED RNASEQ ON SCARRING ALOPECIA PATIENT SAMPLES REPORTED A SIGNIFICANT MAST CELL SIGNATURE IN AFFECTED VERSUS UNAFFECTED TISSUE. NOTABLY, THESE SAMPLES WERE OBTAINED FROM PATIENTS ON SYSTEMIC AND INTRALESIONAL TREATMENTS, WHICH LIKELY AFFECTED RESULTS. WHILE WE DID SEE STATISTICALLY SIGNIFICANT UPREGULATION OF SOME MAST CELL ACTIVATORS SUCH AS CCL8, THIS WAS NOT THE MOST PRONOUNCED SIGNAL IN LHMC'S DATASET. DR. SENNA BELIEVES THE DATA GENERATED BY HER LAB IS MORE RELIABLE, GIVEN THAT ALL SAMPLES WERE TAKEN FROM TREATMENT NAVE PATIENTS, AND SHE HYPOTHESIZES THAT IT IS AN INITIAL INNATE IMMUNE RESPONSE TO AN EXOGENOUS ANTIGEN THAT LEADS TO T CELL ACTIVATION, INFLAMMATION, AND EVENTUAL UPREGULATION OF A PRO-APOPTOTIC AND PRO-FIBROTIC PATHWAY THAT IS CENTRAL TO THE SUBSEQUENT SCARRING, LEADING TO PERMANENT ALOPECIA. SHE EXPECTS THE RESULTS OF THIS WORK WILL TRANSLATE TO IDENTIFICATION OF NOVEL THERAPEUTIC TARGETS AND FOSTER TRANSLATIONAL WORK IN DEVELOPING TREATMENTS FOR THESE DEVASTATING AND SYMPTOMATIC CONDITIONS.5. 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. IN FY 2024, THE CERI TEAM TESTED A CLOUD-BASED MODEL FOR ACTIVE SURVEILLANCE OF MEDICAL DEVICES USING THEIR PROPRIETARY DATA EXTRACTION AND LONGITUDINAL TREND ANALYSIS (DELTA) SYSTEM. SEEKING TO DEMONSTRATE USING THE DELTA SYSTEM IN THE NATIONAL EVALUATION SYSTEM FOR HEALTH TECHNOLOGY'S (NEST) MEDICAL DEVICE SURVEILLANCE CLOUD ENVIRONMENT, THEY ANALYZED CORONARY STENT SAFETY USING REAL WORLD CLINICAL DATA, AND COMPARED RESULTS TO CLINICAL TRIAL FINDINGS. ELECTRONIC HEALTH RECORD (EHR) DATA FROM TWO HEALTH SYSTEMS, THE SOCIAL SECURITY DEATH MASTER FILE, AND DEVICE DATABASES WERE INGESTED INTO THE NEST CLOUD, AND SAFETY ANALYSES OF TWO STENTS WERE PERFORMED USING DELTA. THE CERI TEAM EVALUATED CLINICAL OUTCOMES DATA FROM A COHORT OF PATIENTS RECEIVING ZOTAROLIMUS DRUG-ELUTING CORONARY STENTS (ZES) OR EVEROLIMUS ELUTING CORONARY STENTS (EES) BETWEEN JULY 1, 2015 AND DECEMBER 31, 2017. AFTER EXCLUSIONS, 3334 PATIENTS RECEIVING EES AND 1002 RECEIVING ZES WERE AVAILABLE FOR STUDY. ANALYSIS USING INVERSE PROBABILITY WEIGHTING SHOWED NO SIGNIFICANT DIFFERENCE IN ONE-YEAR MORTALITY OR MAJOR ADVERSE CARDIAC EVENTS (MACE) FOR EES COMPARED TO ZES [MORTALITY ODDS RATIO 0.94 (95% CI 0.81-1.175); P = 0.780] [MACE ODDS RATIO 1.04 (95% CI 0.92-1.16; P = 0.551]). ANALYSIS USING PROPENSITY MATCHING SHOWED NO SIGNIFICANT DIFFERENCE IN EES ONE-YEAR MORTALITY (547 OF 992 ALIVE AND AVAILABLE AFTER CENSORING) COMPARED TO ZES (546 OF 992) [LOG-RANK STATISTIC 0.3348 (P = 0.563)]. THEY CONCLUDED THAT AUTOMATED CLOUD-BASED MEDICAL DEVICE SAFETY SURVEILLANCE USING EHR DATA IS FEASIBLE AND WAS EFFICIENTLY PERFORMED USING DELTA. NO STATISTICALLY SIGNIFICANT DIFFERENCES IN 1-YEAR SAFETY OUTCOMES BETWEEN ZES AND EES WERE IDENTIFIED USING TWO STATISTICAL APPROACHES, CONSISTENT WITH RANDOMIZED TRIAL FINDINGS.
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6. IMPORTANT NIH-SPONSORED CLINICAL TRIALS
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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 THEA 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 (TUFTS) AND TEACHING PHYSICIANS AS WELL AS UMASS CHAN MEDICAL SCHOOL (UMASS). THESE PHYSICIANS HOLD FACULTY APPOINTMENTS AT TUFTS AND UMASS 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 MASTER AFFILIATION WITH UNIVERSITY OF MASSACHUSETTS (UMASS) CHAN MEDICAL SCHOOL. UMASS CHAN LAHEY, LOCATED AT LAHEY CLINIC HOSPITAL IN BURLINGTON, MA, IS A NEW REGIONAL CAMPUS OF UMASS CHAN MEDICAL SCHOOL. THE REGIONAL CAMPUS HOSTS 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 ARE APPOINTED TO THE UMASS CHAN MEDICAL SCHOOL. THE INAUGURAL COHORT OF 32 LEAD@LAHEY MEDICAL STUDENTS WILL FINISH THEIR FIRST YEAR OF MEDICAL SCHOOL AND TRAINING IN THE SPRING OF 2025, AS THE SCHOOL PREPARES TO WELCOME ITS SECOND CLASS AT THE END OF SUMMER 2025. STUDENTS IN THE T.H. CHAN SCHOOL OF MEDICINE ARE GROUPED INTO LEARNING COMMUNITIES, OR HOUSES, TO FOSTER INTERCLASS INTERACTION AND LINK STUDENTS WITH FACULTY MENTORS. EACH HOUSE HAS A REGIONALLY SIGNIFICANT NAME. THE LEARNING COMMUNITY FOR LEAD@LAHEY STUDENTS IS WALDEN HOUSE, INSPIRED BY THE TRANSFORMATIVE NATURE OF NEARBY WALDEN POND.THE MEDICAL EDUCATION DEPARTMENT OVERSEES THE ADMINISTRATIVE FUNCTIONS FOR GRADUATE, UNDERGRADUATE AND ADVANCED PRACTITIONER TRAINING PROGRAMS. THE CONTINUING MEDICAL EDUCATION (CME) PROGRAM HOLDS ACCREDITATION WITH COMMENDATION FROM THE ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION AND THE STATE OF THE ART SIMULATION CENTER IS A COMPREHENSIVE LEVEL 1 AMERICAN COLLEGE OF SURGEONS ACCREDITED EDUCATION INSTITUTE. 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 $28,680,792 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE HOSPITAL'S TEACHING FUNCTION WHICH REPRESENTED 2.51% OF THE HOSPITAL'S TOTAL EXPENSES. ACGME ACCREDITED GME PROGRAMS -- RESIDENCYLAHEY CLINIC HOSPITAL, INC. SPONSORS TEN RESIDENCY AND FOURTEEN FELLOWSHIP PROGRAMS THAT TRAIN 188 RESIDENTS AND FELLOWS. THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED THESE PROGRAMS LISTED BELOW. - ACGME ACCREDITED RESIDENCY PROGRAMS - ANESTHESIOLOGY- COLON RECTAL SURGERY- GENERAL SURGERY- INTERNAL MEDICINE- NEUROLOGY (TUFTS PROGRAM)- PLASTIC & RECONSTRUCTIVE SURGERY (INTEGRATED)- PLASTIC & RECONSTRUCTIVE SURGERY (INDEPENDENT)- DIAGNOSTIC RADIOLOGY- UROLOGY- PSYCHIATRY- 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 MEDICINE- HEMATOLOGY & MEDICAL ONCOLOGY- HOSPICE & PALLIATIVE MEDICINE - INTERVENTIONAL PULMONOLOGY LHMC 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 -- FELLOWSHIPSADDITIONAL TRAINING OPPORTUNITIES FOR UP TO 20 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- 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, 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, MASS GENERAL BRIGHAM, 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.
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GENERAL SURGERY
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LHMC'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 DISEASESUCH AS PENETRATING TRAUMA AND PEDIATRIC SURGERYLHMC'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 RADIOLOGYLHMC 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.PSYCHIATRYTHE PSYCHIATRY RESIDENCY RECEIVED ACGME ACCREDITATION IN FEBRUARY 2024 AND APPROVAL FOR FOUR RESIDENTS PER YEAR OVER A FOUR YEAR TRAINING PROGRAM, TOTALING SIXTEEN RESIDENTS ONCE THE PROGRAM IS COMPLETELY FILLED. THE INAUGURAL CLASS BEGINS JULY 2025. THE PROGRAM'S MISSION IS TO MENTOR AND EDUCATE FUTURE LEADERS OF PSYCHIATRY WHO ARE EXPERT AND COMPASSIONATE ACADEMIC CLINICIANS, EQUIPPED WITH THE COMPETENCIES, SKILLS, AND INTENT TO PROVIDE SUPERB PSYCHIATRIC CARE TO OUR COMMUNITIES AND ADVANCE A MORE EFFECTIVE HEALTHCARE SYSTEM. PROGRAM PARTICIPANTS ARE EXPOSED TO A RICH DIVERSITY OF SITES, INCLUDING A HIGH-COMPLEXITY HOSPITAL, A VA HOSPITAL, COMMUNITY HOSPITALS AND COMMUNITY BEHAVIORAL CENTERS. UPON COMPLETION OF THE PROGRAM, GRADUATES WILL BE READY TO PRACTICE IN A WIDE VARIETY OF SETTINGS. THE LAHEY PSYCHIATRY RESIDENCY PROGRAM TAKES ADVANTAGE OF THE RICH CLINICAL OPPORTUNITIES IN EASTERN MASSACHUSETTS AND EXPERIENCED FACULTY TO PROVIDE A COMPREHENSIVE AND STIMULATING TRAINING EXPERIENCE.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. ADVANCED PRACTITIONER PROGRAMPHYSICIAN ASSISTANT AND NURSE PRACTITIONER STUDENTS FROM SEVERAL LOCAL COLLEGES AND UNIVERSITIES ROTATE TO MULTIPLE DEPARTMENTS THROUGHOUT THE LHMC AS PART OF THEIR EDUCATIONAL EXPERIENCE. ON AVERAGE, LAHEY HAS TWO HUNDRED AP STUDENTS THAT ROTATE ANNUALLY. 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.FORM 990 SCHEDULE H PART VI - IRC 501(R) REPORTING UNDER REVENUE PROCEDURE 2015-21:DURING A REVIEW OF LAHEY CLINIC HOSPITAL'S SECTION 501(R) COMPLIANCE IN FY24, IT WAS DETERMINED THAT HOSPITAL WAS NOT CONSISTENTLY OFFERING A COPY OF ITS FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY (PLS) AS PART OF PATIENT INTAKE OR DISCHARGE. THE HOSPITAL HAS WORKED AND IS CONTINUING TO WORK ON TRAINING ITS INTAKE AND DISCHARGE TEAMS TO ENSURE THAT A COPY OF THE PLS IS OFFERED. THE HOSPITAL IS NOT AWARE OF ANY PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE THAT WERE ADVERSELY AFFECTED BY NOT BEING OFFERED A COPY OF THE PLS AT EITHER INTAKE OR DISCHARGE. LAHEY CLINIC HOSPITAL HAS ADOPTED PROCEDURES THAT REQUIRE IT TO REVIEW, ON A REGULAR BASIS, ITS POLICIES AND PROCEDURE TO ENSURE COMPLIANCE WITH THE REQUIREMENTS OF SECTION 501(R) AND THE REGULATIONS ISSUED THEREUNDER. THOSE PROCEDURES INCLUDE REVIEWING A SECTION 501(R) COMPLIANCE CHECKLIST.ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)
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COMMUNITY BOARD
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AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. AFFILIATED HEALTH CARE SYSTEM AND ACCOMPLISHMENTSAS NOTED THROUGHOUT THIS FORM 990, 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.THE BILH CORE VALUES AND PRINCIPALS ARE LISTED HERE AS WELL AS NETWORK-WIDE ACCOMPLISHMENTS DURING THE FISCAL PERIOD COVERED BY THIS FILING. THE BILH NETWORK IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. 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.BILH IS ACCOMPLISHING THIS MISSION BY PROVIDING SUPPORT TO ITS AFFILIATES WHICH INCLUDE:1. A PHYSICIAN ENTERPRISE THAT ENCOMPASSES THE SYSTEM'S NETWORK OF EMPLOYED PRIMARY CARE AND SPECIALTY PHYSICIANS LOCATED THROUGHOUT OUR REGION;2. A HOSPITAL AND AMBULATORY SERVICES GROUP THAT INCLUDES WORLD-CLASS ACADEMIC MEDICAL CENTERS AND TEACHING HOSPITALS WITH AFFILIATIONS WITH HARVARD MEDICAL SCHOOL, UM AND TUFTS UNIVERSITY SCHOOL OF MEDICINE; LEADING COMMUNITY HOSPITALS; A RENOWNED ORTHOPEDICS HOSPITAL; AND COMPREHENSIVE AMBULATORY CENTERS;3. A POPULATION HEALTH ENTERPRISE THAT EMBRACES A MODEL OF CARE TO IMPROVE THE HEALTH OF ALL THOSE SERVED BY BILH; THE POPULATION HEALTH DOMAIN INCLUDES THE SYSTEM'S CLINICALLY INTEGRATED NETWORK OF AFFILIATED PROVIDERS AND VITAL SERVICES, INCLUDING BEHAVIORAL HEALTH AND HOME CARE SERVICES; 4. A ROBUST NETWORK OF ADMINISTRATIVE AND OPERATIONAL SERVICES TO ADVANCE STRATEGIC GOALS, BOTH LOCALLY AND AT THE SYSTEM LEVEL, THAT OFFERS EXPERTISE AND STANDARDIZED RESOURCES BASED ON BEST PRACTICES.DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (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), THE JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC (EHRI) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND LHSS IN TURN SERVED AS THE SOLE MEMBER OF BETH ISRAEL LAHEY HEALTH PRIMARY CARE. THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. SEE FORM 990 SCHEDULE R FOR ADDITIONAL AFFILIATED ENTITIES. BILH PROVIDES CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS. BILH SUPPORT INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING SERVICES: DEVELOPMENT AND FUNDRAISING, STRATEGIC PLANNING, COMPLIANCE, GOVERNANCE AND LEGAL SUPPORT, HUMAN RESOURCES, PATIENT CARE PAYOR CONTRACTING, OPERATIONAL SUPPORT SUCH AS PROCESSING PAYROLL AND ACCOUNTS PAYABLE, NETWORK-WIDE BENEFIT PLAN STRUCTURING AND NETWORK-WIDE CASH MANAGEMENT. BILH OVERSEES THE FINANCIAL WELL-BEING OF ITS AFFILIATES, INCLUDING PROVIDING MANAGEMENT, LEADERSHIP, DEBT STRUCTURING SUPPORT, FINANCING OF CAPITAL PROJECTS THROUGH ITS OBLIGATED GROUP DEBT AND FINANCIAL SUPPORT SERVICES, INCLUDING INTERNAL AND EXTERNAL AUDIT, TREASURY, INSURANCE AND TAX SERVICES. FOR THE FISCAL PERIOD COVERED BY THIS FILING BILH, INC. PROVIDED SERVICES AND SUPPORT TO ITS AFFILIATES, IN THE AMOUNT OF $15,835,226,845.ADDITIONAL DETAIL ABOUT ACCOMPLISHMENTS ACROSS BILH ARE BELOW. BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES - FISCAL YEAR ENDED SEPTEMBER 30, 2024BILH'S SUPPORT OF ITS AFFILIATES ENABLES THE NETWORK AS A WHOLE TO ACCOMPLISH ITS PRIMARY MISSION OF IMPROVING THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. AS NOTED PREVIOUSLY IN THIS FILING, BILH STRIVES TO ACCOMPLISH THIS MISSION BY DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO USE SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE AND BILH IS ACCOMPLISHING THIS GOAL BY PROVIDING SUPPORT TO EACH OF ITS AFFILIATES, PROVIDING AN ORGANIZATIONAL STRUCTURE AND OPERATING MODEL WHICH IS DRIVEN BY FOUR DEEPLY INTERCONNECTED DOMAINS DESIGNED TO ADVANCE MEANINGFUL PARTNERSHIPS ACROSS ORGANIZATIONS, CARE SETTINGS, SPECIALTIES, AND GEOGRAPHIES TO ENSURE BILH PATIENTS RECEIVE THE CARE THEY NEED IN THE COMMUNITIES WHERE THEY LIVE AND WORK.PATIENT CARE DELIVERY ACROSS THE BILH NETWORK -- FISCAL YEAR ENDED SEPTEMBER 30, 2024HOSPITAL CARE:DURING THE PERIOD COVERED BY THIS FILING, THE BILH HOSPITALS PROVIDED CARE TO PATIENTS IN A FULL SPECTRUM OF SPECIALTIES AND UTILIZING A WIDE RANGE OF MODALITIES. BELOW ARE A SAMPLE OF THE HOSPITAL CARE PROVIDED TO BILH PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING, BILH HOSPITALS HAD APPROXIMATELY 4.9 MILLION OUTPATIENT ENCOUNTERS. APPROXIMATELY 80,000 OUTPATIENT/AMBULATORY SURGERIES AND OVER 100,000 ENDOSCOPIES WERE PERFORMED, IN ADDITION, ACROSS BILH HOSPITALS PATIENTS HAD MORE THAN 141,000 ONCOLOGY VISITS AND ALMOST 111,000 ONCOLOGY INFUSIONS, 268,000 EKGS, OVER 59,000 ORTHOPEDIC PROCEDURES, MORE THAN 758,000 RADIOLOGY EXAMS, OVER 312,000 CT EXAMS, MORE THAN 177,000 ULTRASOUND PROCEDURES, OVER 142,000 MRIS, OVER 221,000 OUTPATIENT BREAST IMAGING EXAMS, APPROXIMATELY 312,000 OUTPATIENT REHABILITATION AND PHYSICAL THERAPY VISITS AND MORE THAN 11.7 MILLION OUTPATIENT LAB TESTS WERE PERFORMED. THE BILH HOSPITALS ALSO HAD APPROXIMATELY 432,000 EMERGENCY DEPARTMENT VISITS, MORE THAN 35,000 OBSERVATION CASES AND MORE THAN 137,000 INPATIENT DISCHARGES WITH APPROXIMATELY 729,000 INPATIENT DAYS, INCLUDING MORE THAN 44,000 INPATIENT PSYCH DAYS. DURING THIS PERIOD MORE THAN 31,000 INPATIENT SURGERIES WERE PERFORMED AND APPROXIMATELY 14,000 NEWBORNS WERE DELIVERED AND THERE WERE APPROXIMATELY 52,000 PAIN CLINIC VISITS. BILH HOSPITALS ALSO HAD MORE THAN 75,000 URGENT CARE VISITS DURING THIS PERIOD.
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NON-HOSPITAL PHYSICIAN CARE:
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DURING THE PERIOD COVERED BY THIS FILING, THE BILH PHYSICIANS PROVIDED CARE TO PATIENTS OUTSIDE OF THE HOSPITALS AND IN PHYSICIAN OFFICE OR OTHER CLINICAL SETTINGS. BELOW ARE A SAMPLE OF THE NON-HOSPITAL PHYSICIAN SERVICES PROVIDED TO BILH PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING, MORE THAN 470 PRIMARY CARE AND FAMILY PRACTICE PROVIDERS HAD APPROXIMATELY 843,000 PATIENT VISITS AND PROVIDERS ACROSS THE FULL SPECTRUM OF SPECIALTIES HAD MORE THAN 624,000 PATIENT VISITS. IN ADDITION, JOSLIN DIABETES CENTER HAD MORE THAN 27,000 PATIENT VISITS RELATED TO DIABETES CARE AND THERE WERE MORE THAN 53,000 URGENT CARE VISITS TO NON-HOSPITAL URGENT CARE LOCATIONS. COMMUNITY BENEFITS, UNCOMPENSATED CARE, COSTS TO PROVIDE CARE TO MEDICAID AND MEDICARE PATIENTS - FISCAL YEAR ENDED SEPTEMBER 30, 2024DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED MORE THAN $52 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 ENSURE 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 $35.5 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 $161 MILLION RELATED TO TREATING MEDICARE PATIENTS. IN ADDITION TO THE COSTS NOTED ABOVE, 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 HEALTH CENTERS AND OTHER GROUPS AS WELL AS COSTS INCURRED RELATED TO SUBSIDIES FOR PRIMARY AND SPECIALTY CARE ACCESS, BEHAVIORAL HEALTH CARE AND OTHER CARE PROVIDED AT A LOSS TOTALING OVER $150 MILLION. 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. EDUCATION AND RESEARCH - FISCAL YEAR ENDED SEPTEMBER 30, 2024RESEARCH 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 $370 MILLION IN RESEARCH EXPENSES, MORE THAN $91 MILLION OF WHICH WERE INTERNALLY FUNDED.ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $210 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $67 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $143 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW.ADDITIONAL BILH NETWORK ACTIVITIES -- EXPANDING ACCESS AND SERVICES; CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST; BEHAVIORAL HEALTH; COMMUNITY INVESTMENTS - FISCAL YEAR ENDED SEPTEMBER 30, 2024THROUGHOUT THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH ("BILH") REMAINED COMMITTED TO DELIVERING HIGH-QUALITY CARE AT A LOWER COST BY LEVERAGING COMMUNITY SETTINGS AND MAINTAINING CARE WITHIN THE BILH PERFORMANCE NETWORK ("BILHPN"), WHEN APPROPRIATE. THE FOLLOWING HIGHLIGHTS SOME OF THESE ONGOING EFFORTS. IN ADDITIONAL TO THE ACCOMPLISHMENTS NOTED ABOVE, BILH CONTINUED THIS COMMITMENT WITH THE FOLLOWING ACTIVITIES: ENHANCING THE BILHPN OPERATING MODELBILH PERFORMANCE NETWORK ("BILHPN") IS BILH'S CLINICALLY INTEGRATED NETWORK OF PHYSICIANS, CLINICIANS, AND HOSPITALS THAT WORK TOGETHER TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE CARE FOR PATIENTS. BILHPN ACHIEVED ITS GOAL OF BECOMING A FULLY INTEGRATED CLINICALLY INTEGRATED NETWORK ("CIN") IN FY 2024. THIS MOVE POSITIONED ITS PROVIDERS TO IMPROVE CARE QUALITY AND SUCCEED IN A VALUE-BASED DELIVERY SYSTEM. ALONGSIDE THIS TRANSFORMATION, BILHPN HAS REDEFINED ITS OPERATING MODEL TO PRIORITIZE HIGH-QUALITY CARE, IMPROVE THE HEALTH OF THE POPULATIONS BILH SERVES, ENHANCE PERFORMANCE, AND PROMOTE WELL-BEING ACROSS ITS NETWORK. THROUGHOUT FY 2024, BILHPN CONCENTRATED ON QUALITY IMPROVEMENT INITIATIVES, SUCH AS REDUCING DISPARITY GAPS, LOWERING READMISSION RATES, IMPROVING DIABETES AND HYPERTENSION MANAGEMENT, AND ENHANCING SKILLED NURSING CARE VISITS. IMPROVING PHARMACY ACCESSTHROUGHOUT FY 2024, BILH PHARMACY EXPERIENCED SIGNIFICANT EXPANSION THAT REFLECTS ITS ONGOING COMMITMENT TO IMPROVING ACCESS TO CARE AND REDUCING THE COST OF CARE. ITS ACHIEVEMENTS INCLUDE:- EXPANDED ACCESS TO 8,000 ADDITIONAL PATIENTS, INCLUDING 5,700 MEDICAID PATIENTS;- IMPROVED PATIENT FINANCIAL ASSISTANCE SERVICES;- LAUNCHED CLINICS FOCUSED ON WEIGHT LOSS AND IRRITABLE BOWEL SYNDROME AND EXPANDED ACCESS TO ANTICOAGULATION MANAGEMENT THROUGH THE CENTRALIZED ANTICOAGULATION MANAGEMENT PROGRAM;- LAUNCHED INSCRIPT TO PROVIDE PHARMACY BENEFIT MANAGEMENT ("PBM") SERVICES TO FULLY INSURED AND SELF-FUNDED HEALTH PLANS, RESULTING IN HEALTH PLAN MEMBERS SAVING OVER 20% IN OUT-OF-POCKET COSTS AND GREATER ACCESS TO MEDICATION; AND, - EXPANDED PHARMACY PRESENCE IN CLINICS TO IMPROVE ACCESS TO MEDICATIONS FOR TREATING DIABETES AND CARDIOVASCULAR DISEASES.INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICESIN FY 2024, BILH AWARDED $1.2 MILLION TO FOUR COMMUNITY-BASED ORGANIZATIONS TO IMPLEMENT BEHAVIORAL HEALTH NAVIGATOR PROGRAMS THAT WILL FUND THE HIRING, TRAINING, AND SUPPORT OF COMMUNITY-BASED BEHAVIORAL HEALTH NAVIGATORS WHO WILL WORK TO IDENTIFY, UNDERSTAND, AND EFFECTIVELY CONNECT RESIDENTS EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE ISSUES TO APPROPRIATE SUPPORT AND ASSISTANCE. THE FOUR NONPROFIT ORGANIZATIONS IN THE GATEWAY MUNICIPALITIES OF HAVERHILL, LYNN, PEABODY, AND QUINCY HAVE BEEN GIVEN $300,000 EACH FROM FY 2024 TO 2027 TO LAUNCH THESE PROGRAMS IN THEIR COMMUNITIES. LABORATORY SERVICES EXPANSION AND OPTIMIZATIONBILH TRANSITIONED TO CENTRALIZED OVERSIGHT OF ALL LABORATORY DRAW SITES IN FY 2024 AND CREATED 11 NEW COMMUNITY-BASED LAB DRAW STATIONS, WHICH INCREASES PATIENT ACCESS TO LAB SERVICES AND IMPROVES BOTH PATIENT AND PROVIDER SATISFACTION. THE CENTRALIZED OVERSIGHT MODEL BETTER ENABLES BILH TO FOCUS ON QUALITY, SERVICE, AND PHLEBOTOMIST RECRUITMENT. IN ADDITION, BILH CONTINUES TO REFINE TRANSPORTATION ROUTES FOR LAB SPECIMENS, MAINTAINING HIGH STANDARDS FOR TURNAROUND TIMES AND EFFICIENCY, WHICH FURTHER IMPROVES THE OVERALL QUALITY OF LABORATORY SERVICES.ENHANCEMENT OF CARE DELIVERY ACROSS PRIMARY CARE PRACTICESBILH PRIMARY CARE ("BILHPC") CONTINUED TO ENHANCE CARE DELIVERY AND ELEVATE THE QUALITY OF CARE THROUGHOUT ITS PRACTICES, AS DEMONSTRATED BY THE FOLLOWING INITIATIVES:- PARTNERED WITH A BILHPN PHARMACIST AND LOCAL DIABETES NURSE EDUCATORS TO LAUNCH A DIABETES HUB AND SPOKE MODEL IN THE MILTON AND NEEDHAM PRIMARY CARE REGIONS, WHERE A DIABETES-SPECIALIZED ADVANCED PRACTICE PRACTITIONER IS EMBEDDED IN THE PRACTICE; - COLLABORATED WITH BILH PHARMACY TO PLAN THE EXPANSION OF REMOTE BLOOD PRESSURE MONITORING FOR IMPROVED HYPERTENSION MANAGEMENT;- EXPANDED THE VIRTUALIST PROGRAM, ENHANCING ACCESS TO ACUTE AND OVERFLOW CARE; AND - INTRODUCED A SELF-SCHEDULING TOOL FOR NEW PATIENTS SEEKING TO ESTABLISH CARE WITH A PRIMARY CARE PROVIDER.
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EDUCATION AND AWARENESS EFFORTS TO PROMOTE ACCESS TO CARE
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IN FY 2024, BILH WORKED TO IMPROVE ACCESS FOR MASSHEALTH PATIENTS IN EASTERN MASSACHUSETTS THROUGH VARIOUS COMMUNICATIONS INITIATIVES. A KEY EFFORT WAS LAUNCHING A MONTHLY NEWSLETTER, AVAILABLE IN SEVEN LANGUAGES, TO ENGAGE PATIENTS AND SHARE HEALTH INFORMATION. NEW ENGLAND BAPTIST HOSPITAL ("NEBH") HOSTED INFORMATION SESSIONS TO EDUCATE UNDERSERVED POPULATIONS ABOUT ITS SERVICES. NEBH ALSO PERFORMED OUTREACH TO COMMUNITY HOUSING FACILITIES, PARTICIPATED IN BOSTON MAYOR WU'S HISPANIC HERITAGE MONTH LUNCHEON, AND PARTNERED WITH NEIGHBORHOOD ASSOCIATIONS AND MAIN STREET BOARDS.
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Attach to Form 990 or Form 990-EZ.