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FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION
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FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BANNA JAQUES HOSPITAL AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL. 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.ANNA JAQUES HOSPITAL COMMUNITY BENEFITS MISSION STATEMENT THE MISSION OF ANNA JAQUES HOSPITAL IS TO PROVIDE HIGH-QUALITY, COMPASSIONATE MEDICAL CARE IN PARTNERSHIP WITH ITS MEDICAL STAFF TO IMPROVE THE HEALTH OF ITS COMMUNITIES. ESTABLISHED IN 1884 THROUGH THE VISION AND CHARITY OF MISS ANNA JAQUES, THE HOSPITAL STANDS AS A TESTAMENT TO ONE WOMAN AND HER PHYSICIAN'S COMMITMENT TO THE COMMUNITY AND ITS NEEDS. AJH PROUDLY CONTINUES THAT TRADITION TODAY BY ACTIVELY SERVING ITS COMMUNITY: BY ADDRESSING THE MOST PRESSING HEALTH NEEDS, SUPPORTING THE UNDERSERVED IN THE HOSPITAL'S SERVICE AREA, AND ADDRESSING DISPARITIES IN ACCESS TO CARE AND HEALTH OUTCOMES. ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING ANNA JAQUES HOSPITAL STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE THREE-YEAR IMPLEMENTATION STRATEGY; ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT THE HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL AND ECONOMIC FACTORS; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN ANNA JAQUES HOSPITAL'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED; PROMOTING HEALTH EQUITY BY ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTHCARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, ANNA JAQUES HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $259,949 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I.
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COMMUNITY BENEFITS LEADERSHIP/TEAM
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ANNA JAQUES HOSPITAL'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS CBSA AND BEYOND. ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF ANNA JAQUES HOSPITAL'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF ANNA JAQUES HOSPITAL'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. ANNA JAQUES HOSPITAL COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY A COMMUNITY BENEFITS MANAGER. THE COMMUNITY BENEFITS MANAGER HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE ANNA JAQUES HOSPITAL PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE ANNA JAQUES HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH ANNA JAQUES HOSPITAL'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS MISSION PROVIDE HIGH-QUALITY, COMPASSIONATE MEDICAL CARE IN PARTNERSHIP WITH ITS MEDICAL STAFF TO IMPROVE THE HEALTH OF ITS COMMUNITIES. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF ANNA JAQUES HOSPITAL'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY ANNA JAQUES HOSPITAL'S PROGRAMMATIC ENDEAVORS AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. ANNA JAQUES HOSPITAL'S CBAC MEMBERS INCLUDE: NOAH BERGER, ADMINISTRATOR, MERRIMACK VALLEY TRANSIT LYNN CATARIUS, DIRECTOR OF STUDENT SERVICES, AMESBURY PUBLIC SCHOOLS ROSA CONN, NEWBURYPORT RESIDENT DIANNE CONNOLLY, DIRECTOR OF TITLE I AND COMMUNITY OUTREACH, HAVERHILL PUBLIC SCHOOLS MARY CONNOLLY, RN, COA DIRECTOR/PUBLIC HEALTH DIRECTOR, CITY OF HAVERHILL JANEL D'AGATA-LYNCH, MANAGER COMMUNITY BENEFITS COMMUNITY RELATIONS, BETH ISRAEL LAHEY HEALTH CHRISTINE HEALEY, DIRECTOR OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, BETH ISRAEL LAHEY HEALTH SANDRA LEVIN, INTERIM VICE PRESIDENT, ANNA JAQUES HOSPITAL DR. GLENN FOCHT, PRESIDENT, ANNA JAQUES HOSPITAL TINA LOS, ASSOCIATE DIRECTOR, SERVICES AND SUPPORTS, NEWBURYPORT YOUTH AND RECREATIONAL SERVICES/ESSEX COUNTY ASSET BUILDERS LAURI MURPHY, BESST COORDINATOR, PETTENGILL HOUSE DR. TIMOTHY PIKE, ASSOCIATE CHIEF MEDICAL OFFICER, ANNA JAQUES HOSPITAL OFFICER DANI SINCLAIR, NEWBURYPORT POLICE; ESSEX COUNTY OUTREACH JEAN TRIM, MANAGING DIRECTOR & PORTFOLIO MANAGER, VIGILANT CAPITAL MANAGEMENT, LLC; MEMBER, AJH BOARD OF TRUSTEES LAURA VLASUK, DIRECTOR OF PUBLIC HEALTH, CITY OF NEWBURYPORT; SHARI WILKINSON, MARKET COORDINATOR, NEWBURYPORT FARMERS MARKETCOMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY (IS OR CHIP) PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE ANNA JAQUES HOSPITAL BOARD OF TRUSTEES ON SEPTEMBER 1, 2022. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 1, 2022, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE CHNA AND THE ASSOCIATED IS REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF ANNA JAQUES HOSPITAL'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA (CBSA) WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT ANNA JAQUES HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW ANNA JAQUES HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.
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COMMUNITY HEALTH NEEDS ASSESSMENTPRIORITY GEOGRAPHY AND COHORTS
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AS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF ANNA JAQUES HOSPITAL'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES AMESBURY, HAVERHILL, MERRIMAC, NEWBURYPORT, AND SALISBURY.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCED POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE AMESBURY, HAVERHILL, MERRIMAC, NEWBURYPORT, AND SALISBURY, AS FOLLOWS: YOUTH LOW-RESOURCED POPULATIONS OLDER ADULTS RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INDIVIDUALS WITH DISABILITIESCOMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSANNA JAQUES HOSPITAL'S CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING ANNA JAQUES HOSPITAL'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. ANNA JAQUES HOSPITAL'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, ANNA JAQUES HOSPITAL CONDUCTED 18 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED THREE FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 750 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 800 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY PARTNERS.COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSANNA JAQUES HOSPITAL RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. ANNA JAQUES HOSPITAL COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT ANNA JAQUES HOSPITAL LEVERAGED INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020) U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020) U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021) BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2019) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) FBI UNIFORM CRIME REPORTS (2019) MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020) MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018) ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)
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COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS
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KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, ANNA JAQUES HOSPITAL WORKED WITH COLLABORATORS TO CONDUCT 18 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT ANNA JAQUES HOSPITAL'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON ANNA JAQUES HOSPITAL'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN ANNA JAQUES HOSPITAL'S CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS.COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)ANNA JAQUES HOSPITAL CONDUCTED 3 COMMUNITY FOCUS GROUPS AND HELD COMMUNITY LISTENING SESSIONS THAT ENGAGED 800 RESIDENTS IN ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE SESSIONS WERE ORGANIZED IN COLLABORATION WITH THE LINK HOUSE IN AMESBURY, AMESBURY HIGH SCHOOL YOUTH AND THE PETTENGILL HOUSE.ANNA JAQUES HOSPITAL HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF ANNA JAQUES HOSPITAL'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN MULTIPLE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, FOOD PANTIES AND COMMUNITY EVENTS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE ANNA JAQUES HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES. COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS WITH THE ANNA JAQUES HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS. IDENTIFY ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE ANNA JAQUES HOSPITAL'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY ANNA JAQUES HOSPITAL DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021).COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2022, WERE: YOUTH LOW-RESOURCED POPULATIONS OLDER ADULTS RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INDIVIDUALS WITH DISABILITIESANNA JAQUES HOSPITAL'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTHCARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY. HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, T TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025.
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COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS
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MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEANNA JAQUES HOSPITAL STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT:HTTPS://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2022-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF. IN ADDITION TO THE CHNA, ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2023-2025-IMPLEMENTATION-STRATEGY-101122.PDF. ANNA JAQUES HOSPITAL COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING ANNA JAQUES HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, ANNA JAQUES HOSPITAL'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND A SUMMARY OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THAT CHNA AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, ANNA JAQUES HOSPITAL HAS BEEN STRATEGIC IN IDENTIFYING ITS COMMUNITY HEALTH PRIORITIES IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: EQUITABLE ACCESS TO CARE GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC, AND ECONOMIC BARRIERS.PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE.PRIORITY AREA 4: CHRONIC AND COMPLEX DISEASE GOAL 1: ADDRESS THE PREVALENCE AND IMPACT, RISK/PROTECTIVE FACTORS, AND ACCESS ISSUES ASSOCIATED WITH CANCER. GOAL 2: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.COMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)ANNA JAQUES HOSPITAL (AJH) HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES ANNA JAQUES HOSPITAL OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES AMONG THEIR FOCUS COHORTS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS.ANNA JAQUES HOSPITAL WORKED TO EXPAND ACCESS TO CARE BEING MINDFUL OF ITS PRIORITY COHORTS. KNOWING TRANSPORTATION WAS IDENTIFIED AS A BARRIER TO CARE FOR OLDER ADULTS IN THE 2022 CHNA, AJH SUPPORTED NORTHERN ESSEX ELDER TRANSPORT (NEET), WHICH PROVIDES TRANSPORTATION TO LOCAL AND OUT-OF-TOWN MEDICAL APPOINTMENTS FOR THOSE THAT ARE 60 OR OLDER WHO CANNOT ACCESS AND/OR AFFORD OTHER MEANS. IN ADDITION, AJH PAID PATIENTS' CARE RELATED TRANSPORTATION FROM EMERGENCY FUNDS. AJH BIRTH CENTER'S NEW "WELCOME VISIT" PROGRAM PREPARED NEW PARENTS FOR DELIVERY, WITH TARGETED OUTREACH TO THOSE WHO FALL INTO HIGH-RISK CATEGORIES AND THE MOST VULNERABLE PATIENTS. THE PROGRAM COORDINATES WITH SOCIAL WORK TO ENSURE THE MOST VULNERABLE PATIENTS ATTEND THE VISIT, AND THE VISIT IS FREE OF CHARGE.ANNA JAQUES HOSPITAL UNDERSTANDS THAT ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH IS VITAL TO MOVE TOWARD HEALTH EQUITY. HOUSING AND FOOD SECURITY WERE IDENTIFIED IN THE 2022 CHNA AND ARE THE FOCUS OF EFFORTS IN THE CURRENT IMPLEMENTATION STRATEGY. IN FY24, AJH SUPPORTED A WIDE VARIETY OF PROGRAMS AIMED AT INCREASING FOOD SECURITY WITHIN THE CBSA INCLUDING NOURISHING THE NORTHSHORE'S VEGOUT PROGRAM AND OUR NEIGHBORS' TABLE WEDNESDAY MEAL. AJH PROVIDED FUNDING TO TWO NEW PROGRAMS WORKING TO INCREASE ACCESS TO HEALTHY FOODS FOR PERSONS WHO ARE UNHOUSED, INCLUDING HAVERHILL PUBLIC SCHOOLS' MCKINNEY VENTO PROGRAM AND COMMON GROUND MINISTRIES. AND, TO INCREASE HEALTH EQUITY IN GATEWAY MUNICIPALITIES, AND CONTINUE TO SERVE THE UNDERSERVED, BETH ISRAEL LAHEY HEALTH (BILH) SUPPORTED THE YMCA OF THE NORTH SHORE/HAVERHILL YMCA TO ADDRESS SOCIAL DETERMINANTS OF HEALTH NEEDS AND INCREASE FOOD ACCESS THROUGH THE INTRODUCTION OF A FREIGHT CONTAINER TO OPERATE A HYDROPONIC FARM. THE YMCA COLLABORATED WITH THE CITY OF HAVERHILL AND THE HAVERHILL PUBLIC SCHOOLS TO LOCATE THE FARM AT HAVERHILL'S GATEWAY ACADEMY, A PUBLIC MIDDLE AND HIGH SCHOOL. IN ADDITION TO FOOD, ANNA JAQUES HOSPITAL SUPPORTED EMMAUS, INC. MITCH'S PLACE, AN EMERGENCY OVERNIGHT SHELTER, WHICH EXPANDED ITS BED CAPACITY IN RESPONSE TO THE GROWING NUMBER OF UNSHELTERED MEN AND WOMEN IDENTIFIED DURING THE 2023 HOMELESS COUNT IN HAVERHILL. MENTAL HEALTH AND SUBSTANCE USE CONTINUE TO BE A PRIORITY FOR ANNA JAQUES HOSPITAL. THE PATIENT CARE NAVIGATOR AT AJH SUPPORTS WOMEN WITH SUBSTANCE USE DISORDER (SUD) AND/OR NEONATAL ABSTINENCE SYNDROME (NAS). THE PATIENT CARE NAVIGATOR SERVES WOMEN IN RECOVERY AND SEEKING ADDITIONAL SUPPORT, WHO HAVE SUFFERED FROM TRAUMA OR ABUSE, OR WHO HAVE BEEN DIAGNOSED WITH MENTAL HEALTH DISORDERS. THE PATIENT CARE NAVIGATOR SUPPORTS WOMEN THROUGHOUT THEIR PREGNANCY AND INTO THE FIRST YEAR OF MOTHERHOOD, WORKING IN COLLABORATION WITH WOMEN'S HEALTH CARE AND THE ANNA JAQUES BIRTH CENTER & NEONATAL CARE CENTER. IN ADDITION, ANNA JAQUES HOSPITAL SUPPORTED THE PETTENGILL HOUSE'S BEHAVIORAL EVENT AND SUBSTANCE SUPPORT TEAM (BESST) PROGRAM, WHICH WAS ABLE TO RESPOND TO THE INCREASED MENTAL HEALTH AND SUBSTANCE-RELATED NEEDS. THE 2022 AJH CHNA IDENTIFIED YOUTH MENTAL HEALTH AS A CRITICAL CONCERN IN AJH'S CBSA. AJH SUPPORTED THE CATCH (CHILDREN AND TEEN CENTER FOR HELP) PROGRAM AT LINK HOUSE TO INCREASE ACCESS TO MENTAL HEALTH AND SUBSTANCE-USE TREATMENT AND EDUCATION FOR SCHOOL-AGED CHILDREN AND TEENS. IN ADDITION, AJH SUPPORTED JEANNE GEIGER'S CRISIS CENTER'S YOUTH EMPOWERMENT SERIES, WHICH USES RESEARCH-BASED AND NATIONALLY RECOGNIZED APPROACHES TO VIOLENCE PREVENTION TO TEACH ELEMENTARY, MIDDLE AND HIGH SCHOOL STUDENTS HOW TO LEAD CONVERSATIONS ABOUT HEALTHY RELATIONSHIPS, RECOGNIZE SIGNS OF AN ABUSIVE RELATIONSHIP, AND BECOME EMPOWERED TO MAKE POSITIVE AND HEALTHY DECISIONS.
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ANNA JAQUES HOSPITAL CONTINUES TO ADDRESS COMPLEX
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AND CHRONIC DISEASE WITH A FOCUS ON CANCER IN DIVERSE WAYS. ANNA JAQUES HOSPITAL PARTNERS WITH COMMUNITY ORGANIZATIONS AIMED AT SUPPORTING A PERSON BEYOND THEIR CANCER DIAGNOSIS TO PROMOTE SURVIVORSHIP. FOR EXAMPLE, AJH SUPPORTS THE YWCA OF NEWBURYPORT'S ENCORE PROGRAM, IS A UNIQUE SURVIVORSHIP PROGRAM FOR THOSE WHO HAVE EXPERIENCED CANCER AT ANY POINT IN THEIR LIVES. ENCORE PROVIDES FREE ACCESS TO A TAILORED EXERCISE PROGRAM, INCORPORATING LAND AND WATER EXERCISES APPROPRIATE FOR ALL FITNESS LEVELS AT ANY POINT IN THEIR TREATMENT JOURNEY AND BEYOND. LOOKING AT CHRONIC DISEASE MORE BROADLY AND AMONG AJH'S PRIORITY COHORTS OF OLDER ADULTS AND THOSE RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE, SARAH'S PLACE ADULT HEALTH CENTER RECEIVED SUPPORT FOR BILINGUAL OUTREACH TO PROVIDE EDUCATION ABOUT THE RESOURCES AND BENEFITS OF ADULT DAY HEALTH PROGRAMS. SARAH'S PLACE ADULT DAY HEALTH CENTER PROVIDES MEDICAL OVERSIGHT AND ASSISTANCE WITH ACTIVITIES OF DAILY LIVING WHILE PROMOTING A SENSE OF PURPOSE AND A COMMUNITY OF CARING FOR PARTICIPANTS. WITH INCREASED AWARENESS, ACCESS TO ADULT DAY HEALTH PROGRAM KEEPS AGING ADULTS HEALTHY AND INDEPENDENT IN THE COMMUNITY. A FULL UPDATE ON ANNA JAQUES HOSPITAL'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.FY24 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEKEY: BASELINE-2023; YEAR 1-2024PRIORITY AREA 1: EQUITABLE ACCESS TO CAREINDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, AND STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM-LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTH CARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE.THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FORGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC, AND ECONOMIC BARRIERSSTRATEGY: PROMOTE ACCESS TO HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICATIONS FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED. INITIATIVE(S): PATIENT FINANCIAL SERVICES TRANSPORTATION SERVICESMETRICS AND STATUS UPDATES: SIGNIFICANT SEGMENTS OF THE COMMUNITY POPULATION LIVING WITHIN THE HOSPITAL'S CBSA, PARTICULARLY LOW-RESOURCED, FACE SIGNIFICANT BARRIERS TO CARE. THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM OFFERS EMERGENCY AND OTHER MEDICALLY NECESSARY SERVICES AT LOW OR NO COST TO QUALIFIED PATIENTS (WHEN QUALIFYING FAMILY INCOME IS AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL). THE HOSPITAL'S FINANCIAL COUNSELING STAFF SCREEN PEOPLE AND ASSIST THEM IN APPLYING FOR ALL ELIGIBLE FINANCIAL ASSISTANCE PROGRAMS. # OF PATIENTS SCREENED FOR STATE ASSISTANCE (BASELINE: 156; YEAR 1: 622) TO SUPPORT VULNERABLE COMMUNITIES AND LIMIT BARRIERS SO PATIENTS RECEIVE THE CARE THEY NEED, AJH PROVIDES TRANSPORTATION ASSISTANCE TO PATIENTS WHO HAVE LIMITED RESOURCES AND SOCIAL SUPPORT. THIS PROGRAM IS OFFERED TO ANY PATIENT WHO MEETS THE CRITERIA OF NEED DECIDED BY A SOCIAL WORKER. AMOUNT DISTRIBUTED TO PATIENTS (BASELINE: $7,200; YEAR 1: $7,400) TRANSPORTATION ASSISTANCE FOR PATIENTS (BASELINE: 240 PATIENTS; YEAR 1: 189 RIDES) TO ORIENT AND SUPPORT EXPECTANT PATIENTS, ESPECIALLY THOSE DEEMED "HIGH-RISK," BY PREPARING THEM FOR HOSPITAL DELIVERY AND INITIAL NEWBORN CARE, AJH STARTED A "WELCOME VISIT" PROGRAM IN JANUARY 2023. THE VISIT IS FREE, AND OUTREACH IS DONE TO ENSURE THE MOST VULNERABLE PATIENTS ATTEND THE VISIT. WELCOME VISITS COMPLETED (BASELINE: 130; YEAR 1: 206) THROUGHOUT ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA, AJH SUBSIDIZES PRIMARY CARE SERVICES PROVIDED BY THE HOSPITAL'S AFFILIATED PHYSICIAN'S GROUP. # OF PRACTICES PROVIDING PRIMARY CARE: (BASELINE: 5; YEAR 1: 5)STRATEGY: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS.INITIATIVES: INTERPRETER SERVICESMETRICS AND STATUS UPDATES: ANNA JAQUES HOSPITAL OFFERS FREE INTERPRETER SERVICES FOR NON-ENGLISH SPEAKING, LIMITED-ENGLISH SPEAKING, DEAF AND HARD-OF-HEARING PATIENTS. PROFESSIONAL INTERPRETATION SERVICES IN HUNDREDS OF LANGUAGES ARE AVAILABLE 24/7. AJH INTERPRETER ENCOUNTERS (BASELINE: 1,487, TOP LANGUAGES BEING SPANISH AND PORTUGUESE; YEAR 1: 1,953, TOP LANGUAGES BEING SPANISH AND PORTUGUESE) BILH IS STRONGLY COMMITTED TO WORKFORCE DEVELOPMENT PROGRAMS THAT ENHANCE THE SKILLS OF ITS EMPLOYEES AND PROVIDE CAREER ADVANCEMENT OPPORTUNITIES. BILH OFFERS INCUMBENT EMPLOYEES "PIPELINE" PROGRAMS TO TRAIN FOR PROFESSIONS SUCH AS PATIENT CARE TECHNICIAN, CENTRAL PROCESSING TECHNICIAN AND ASSOCIATE'S DEGREE NURSE RESIDENT. BILH'S EMPLOYEE CAREER INITIATIVE PROVIDES CAREER AND ACADEMIC COUNSELING, ACADEMIC ASSESSMENT, AND PRE-COLLEGE AND COLLEGE-LEVEL SCIENCE COURSES TO EMPLOYEES AT NO CHARGE, ALONG WITH TUITION REIMBURSEMENT, COMPETITIVE SCHOLARSHIPS AND ENGLISH FOR SPEAKERS OF OTHER LANGUAGES (ESOL) CLASSES. BILH IS ALSO COMMITTED TO MAKING EMPLOYMENT OPPORTUNITIES AVAILABLE TO QUALIFIED COMMUNITY RESIDENTS THROUGH TRAINING INTERNSHIPS CONDUCTED IN PARTNERSHIP WITH COMMUNITY AGENCIES AND HIRING CANDIDATES REFERRED BY COMMUNITY PROGRAMS. COMMUNITY EVENTS AND PRESENTATIONS CONDUCTED (BASELINE: 67; YEAR 1: 33) INTERNS HIRED AFTER INTERNSHIPS (BASELINE: 22; YEAR 1: 37) EMPLOYEES ENGAGE IN ESOL CLASSES (BASELINE: 45; YEAR 1: 82) INTERNSHIPS OFFERED TO ADULT COMMUNITY MEMBERS (BASELINE: 54; YEAR 1: 107) COMMUNITY MEMBERS REFERRED TO BILH (BASELINE: 225; YEAR 1: 412) COMMUNITY MEMBERS HIRED BY BILH (BASELINE: 70; YEAR 1: 111) BILH EMPLOYEES ENGAGED IN CITIZENSHIP CLASSES (YEAR 1: 14)* BILH EMPLOYEES ENGAGED IN CAREER DEVELOPMENT CLASSES (YEAR 1: 15)* BILH EMPLOYEES ENGAGED IN FINANCIAL LITERACY CLASSES (YEAR 1: 207)* BILH EMPLOYEES ENGAGE IN CAREER DEVELOPMENT SERVICES (YEAR 1: 1,044)**INITIATIVES BEGAN IN YEAR 1
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STRATEGY:
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SUPPORT PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION TO HEALTHCARE SERVICES.INITIATIVES: PROVIDE AN OPPORTUNITY FOR GRANT FUNDINGMETRICS AND STATUS UPDATES: IN YEAR 1, AJH RELEASED A COMPETITIVE REQUEST FOR PROPOSAL FOR COMMUNITY GRANTS TO SUPPORT THE FY23-FY25 IMPLEMENTATION STRATEGY. NORTHERN ESSEX ELDER TRANSPORT (NEET) WAS AWARDED FUNDING FOR YEAR 1 AND YEAR 2 TO ASSIST WITH TRANSPORTATION TO MEDICAL APPOINTMENTS. TO SUPPORT OLDER ADULTS' ACCESS TO VITAL MEDICAL APPOINTMENTS, AJH SUPPORTED NORTHERN ESSEX ELDER TRANSPORT, INC. (NEET). NEET PROVIDES FREE TRANSPORTATION TO AND FROM HEALTHCARE APPOINTMENTS FOR THOSE OVER THE AGE OF 60. UNIQUE INDIVIDUALS RECEIVING TRANSPORTATION TO MEDICAL CARE (BASELINE: 436) NEW VOLUNTEERS RECRUITED (YEAR 1:12) IN YEAR 1, ANNA JAQUES HOSPITAL STRENGTHENED ITS PARTNERSHIP WITH THE MERRIMACK VALLEY TRANSIT (MEVA), THE OPERATOR OF THE BUS SYSTEM THROUGHOUT THE COMMUNITY BENEFITS SERVICE AREA. IN THE SPRING 2024, MEVA AND AJH WORKED TOGETHER TO MOVE THE PUBLIC BUS STOP TO THE MAIN ENTRANCE TO THE HOSPITAL FROM A NON-HANDICAP-ACCESSIBLE LOCATION. IN ADDITION, AJH SUPPORTED MEVA'S APPLICATION FOR FUNDING TO INCREASE FREE BUS SERVICE BETWEEN LAWRENCE, HAVERHILL, AND NEWBURYPORT. THIS FUNDING WAS APPROVED AND THE BUS SERVICE BEGAN IN SEPTEMBER 2024. PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTHTHE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND THE ANNA JAQUES HOSPITAL COMMUNITY HEALTH SURVEY REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC INSTABILITY.GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.STRATEGY: PROVIDE COMMUNITY HEALTH GRANTS TO SUPPORT IMPACTFUL PROGRAMS THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTH.INITIATIVES: COMMUNITY HEALTH GRANTSMETRICS AND STATUS UPDATES: ANNA JAQUES HOSPITAL COMMUNITY BENEFITS AND COMMUNITY RELATIONS STAFF IMPLEMENTED EFFECTIVE AND EFFICIENT PROGRAMS THROUGH COMMUNITY HEALTH GRANTS THAT SUPPORT THE COMMUNITY HEALTH NEEDS OF THE COMMUNITY BENEFITS SERVICE AREA (CBSA). # OF PROGRAMS SUPPORTED AND IMPLEMENTED (BASELINE: 18; YEAR 1: 15) ANNA JAQUES HOSPITAL, IN COLLABORATION WITH BETH ISRAEL LAHEY HEALTH, REGULARLY CONVENES COMMUNITY TRAININGS TO INCREASE THE CAPACITY OF THE EXTERNAL ORGANIZATIONS # OF COMMUNITY CAPACITY BUILDING TRAININGS OFFERED (BASELINE: 4; YEAR 1: 2 EVALUATION WORKSHOPS TO 30 ORGANIZATIONS AND GRANTEES)STRATEGY: SUPPORT PROGRAMS AND INITIATIVES THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSING.INITIATIVES: YWCA NEWBURYPORT: ROOF OVER HEAD PROGRAM EMMAUS, INC. MITCH'S PLACE EMERGENCY SHELTERMETRICS AND STATUS UPDATES ANNA JAQUES HOSPITAL SUPPORTED THE YWCA OF NEWBURYPORT'S AFFORDABLE HOUSING RESIDENTS WITH A GRANT TO PURCHASE HEALTHY, FRESH PRODUCE. ALL HOUSEHOLDS ARE BELOW 60% OF THE AREA MEDIAN INCOME. HOUSEHOLDS WITH INCOMES BELOW 80% AMI ARE CONSIDERED LOW INCOME. AT THE RESIDENCES AT SALISBURY SQUARE (RSS) SITE, 20 OF 42 UNITS ARE CURRENTLY HOUSING FAMILIES WHOSE INCOME IS AT OR BELOW 30% OF AREA MEDIAN (WHICH IS CONSIDERED EXTREMELY LOW INCOME. TENANTS ASSISTED WITH FOOD (BASELINE: 100)STATUS: PROGRAM WAS FUNDED FOR BASELINE YEAR ONLY. AJH SUPPORTED EMMAUS, INC. "MITCH'S PLACE" EMERGENCY SHELTER THAT PROVIDES OVERNIGHT SHELTER, NUTRITIOUS MEALS, AND NEEDED SUPPORT SERVICES YEAR-ROUND, INCLUDING DURING EXTREME CONDITIONS, TO HOMELESS MEN AND WOMEN THAT MAY OTHERWISE SPEND THE NIGHT ENGAGING IN HIGH-RISK, SELF-DESTRUCTIVE, AND/OR ILLEGAL ACTIVITIES. THE PROGRAM ALSO OFFERS CASE MANAGEMENT TO SUPPORT ACCESSING NEEDED SERVICES AND JOB OPPORTUNITIES. NUMBER OF INDIVIDUALS SERVED (BASELINE: 225) (YEAR 1: 274)NUMBER OF UNHOUSED INDIVIDUALS WHO ACCESSED PERMANENT HOUSING (YEAR 1: 48)STRATEGY: SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE HEALTHY EATING AND ACCESS TO AFFORDABLE, HEALTHY FOODS.INITIATIVES: OUR NEIGHBORS' TABLE: WEEKLY WEDNESDAY MEAL PROGRAM NOURISHING THE NORTH SHORE: VEGOUT MOBILE MARKET COMMUNITY GRANT OPPORTUNITIESMETRICS AND STATUS UPDATES AJH ISSUED A COMMUNITY GRANT TO OUR NEIGHBORS' TABLE (ONT) TO SUPPORT THEIR WEDNESDAY MEAL PROGRAM, WHICH IS OPEN TO ANYONE. THE WEDNESDAY MEAL PROVIDES A HOT MEAL TO 300 500+ UNIQUE PEOPLE EACH MONTH. ONT ALSO PROVIDES HOME DELIVERIES OF THE WEDNESDAY MEAL TO THOSE WHO ARE HOMEBOUND AND DISTRIBUTES EXTRA PREPARED MEALS IN THE MARKET ON THURSDAY AS AN EXTRA CONVENIENCE FOR ONT GUESTS GUESTS SERVED THROUGH THE WEDNESDAY MEAL PROGRAM (BASELINE: 4,490) (YEAR 1: AVERAGE OF 263 PER WEEK) NOURISHING THE NORTHSHORE'S VEGOUT PROGRAM BRINGS HEALTHY, LOCAL PRODUCE TO MEMBERS IN THE COMMUNITY THAT OFTEN DO NOT HAVE ACCESS TO THESE FOOD CHOICES. NOURISHING THE NORTH SHORE COMBINES EXCESS PRODUCE FROM LOCAL FARMS WITH FOOD THAT IS GROWN AT THEIR GARDEN AND DISTRIBUTE PRODUCE DIRECTLY THROUGH THE COMMUNITY'S FOOD ACCESS AGENCIES AS WELL AS NNS-RUN FARMERS' MARKET STYLE PRODUCE STANDS. ALL PRODUCE IS FREE TO THOSE WHO ARE VISITING THE FOOD ACCESS SITES. UNIQUE HOUSEHOLDS RECEIVING FOOD (BASELINE: 1,000) SERVINGS OF FOOD DISTRIBUTED (YEAR 1: 190,000) BETH ISRAEL LAHEY HEALTH (BILH) AWARDED THE YMCA OF THE NORTH SHORE/HAVERHILL YMCA A GRANT TO ADDRESS SOCIAL DETERMINANTS OF HEALTH NEEDS AND INCREASE FOOD ACCESS THROUGH THE INTRODUCTION OF A FREIGHT CONTAINER TO OPERATE A HYDROPONIC FARM. THE YMCA PARTNERED WITH THE HAVERHILL PUBLIC SCHOOLS TO HOUSE THE FARM AT GATEWAY ACADEMY, A PUBLIC MIDDLE AND HIGH SCHOOL. STUDENTS FROM THE SCHOOL AND THE YMCA AFTERSCHOOL PROGRAM HELP TO GROW, TEND, AND HARVEST PRODUCE. THE FREIGHT FARM GROWS A VARIETY OF VEGETABLES, INCLUDING LETTUCE, BOK CHOY, AND SPINACH, THAT ARE DISTRIBUTED TO GATEWAY STUDENTS, YMCA PARTICIPANTS AND SHARED WITH LOCAL FOOD PANTRIES/HOMELESS SHELTERS. UNIQUE PERSONS RECEIVING FOOD (BASELINE: 1,040; YEAR 1: 3,200) STUDENT PARTICIPANTS IN STEM AND NUTRITIONAL ACTIVITIES (BASELINE: 43; YEAR 1: 30) PEOPLE RECEIVED VIA COMMUNITY EVENTS (BASELINE: 154; YEAR 1: 350) IN YEAR 1, AJH RELEASED A COMPETITIVE REQUEST FOR PROPOSAL FOR COMMUNITY GRANTS TO SUPPORT THE FY23-FY25 IMPLEMENTATION STRATEGY. FOUR ORGANIZATIONS WERE AWARDED FUNDING FOR YEAR 1 AND YEAR 2 TO ADDRESS FOOD INSECURITY. THE HAVERHILL PUBLIC SCHOOLS' MCKINNEY VENTO PROGRAM PROVIDES SUPPORT FOR STUDENTS AND THEIR FAMILIES WHO ARE UNHOUSED. ANNA JAQUES HOSPITAL'S SUPPORT FOR THE PROGRAM ASSISTS WITH MAINTAINING ONGOING FOOD RESOURCES WITHIN HAVERHILL SCHOOLS, SUCH AS HAVERHILL HIGH SCHOOL'S BACKPACK 68 PROGRAM AND SCHOOL FOOD CLOSETS. IN ADDITION, THIS FUNDING WILL SUPPORT CREATING ADDITIONAL SCHOOL FOOD CLOSETS OVER TWO YEARS. PARTNERSHIPS WITH LOCAL ORGANIZATIONS (YEAR 1: 5) STATUS: PROGRAM FUNDED IN YEAR 1.
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ANNA JAQUES HOSPITAL SUPPORTED
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COMMON GROUND MINISTRIES CAF, WHICH IS OPEN 365 DAYS A YEAR TO PROVIDE FOR THE FOUNDATIONAL NEEDS FOR THE UNHOUSED AND/OR LOWER INCOME POPULATION IN THE HAVERHILL AREA. THE PROGRAM PROVIDES FOOD, CLOTHING, HYGIENE PRODUCTS, RESOURCES, AND CARE FOR THIS SPECIFIC POPULATION. COMMON GROUND COLLABORATES WITH LOCAL SERVICE PROVIDERS AND THE HAVERHILL POLICE REGULARLY TO UNDERSTAND AND ADDRESS THE NEEDS OF THE UNHOUSED POPULATION. PERSONS SERVED PER DAY (YEAR 1: 60-80+) STATUS: PROGRAM FUNDED IN YEAR 1. ANNA JAQUES HOSPITAL SUPPORTED THE FIRST PARISH NEWBURY FOOD PANTRY, WHICH PROVIDES FREE FOOD TO THOSE IN NEED, INCLUDING RESIDENTS OF NEWBURYPORT, SALISBURY, AMESBURY, AND OTHER SURROUNDING CITIES/TOWNS. THE ORGANIZATION SERVES APPROXIMATELY 600 GUESTS EACH WEEK, THE MAJORITY OF WHICH LIVE IN NEWBURYPORT (45%). MORE THAN HALF THE HOUSEHOLDS SERVED DON'T HAVE TRANSPORTATION AND DEPEND ON THE ORGANIZATION'S FOOD DELIVERY. THE ORGANIZATION HAS PANTRIES IN ALL THE SCHOOLS IN THE TRITON SCHOOL DISTRICT, WHICH INCLUDES SALISBURY ELEMENTARY SCHOOL AND TRITON HIGH SCHOOL, SERVING SALISBURY RESIDENTS. HOUSEHOLDS RECEIVING FOOD REGULARLY (BASELINE: 401) STATUS: PROGRAM WAS FUNDED FOR BASELINE YEAR ONLY.STRATEGY: PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES THAT REDUCE AND PREVENT FOOD INSECURITY AND/OR HOUSING CHALLENGES.INITIATIVES: OUR NEIGHBORS' TABLE: FOOD TASK FORCEMETRICS AND STATUS UPDATES: STATUS: ANNA JAQUES HOSPITAL STAFF PARTICIPATE IN SEVERAL COALITIONS AND COMMITTEES THAT ADDRESS SOCIAL DETERMINANTS OF HEALTH, INCLUDING THE OUR NEIGHBORS' TABLE FOOD TASK FORCE. THIS TASK FORCE ADDRESSES FOOD SECURITY ACROSS ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA.PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USEANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. THOSE WHO PARTICIPATED IN THE ASSESSMENT ALSO REFLECTED ON STIGMA, SHAME, AND ISOLATION THAT THOSE WITH MENTAL HEALTH CHALLENGES FACE THAT LIMIT THEIR ABILITY TO ACCESS CARE AND COPE WITH THEIR ILLNESS. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH AND ECONOMIC INSECURITY. INTERVIEWEES, FOCUS GROUP, AND LISTENING SESSION PARTICIPANTS ALSO REPORTED THAT ALCOHOL USE IS NORMALIZED, AND USE IS PREVALENT AMONG BOTH ADULTS AND YOUTH.GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE.STRATEGY: ENHANCE RELATIONSHIPS AND PARTNERSHIPS WITH SCHOOLS, YOUTH SERVING ORGANIZATIONS, AND OTHER COMMUNITY PARTNERS TO INCREASE RESILIENCY, COPING, AND PREVENTION SKILLS.INITIATIVES: GIRLS INC. HEALTHY LIVING PROGRAM ESSEX COUNTY ASSET BUILDER NETWORKMETRICS AND STATUS UPDATES: ANNA JAQUES HOSPITAL PROVIDED A COMMUNITY GRANT TO JEANNE GEIGER CRISIS CENTER'S YOUTH EMPOWERMENT SERVICES (YES), WHICH USES RESEARCH-BASED AND NATIONALLY RECOGNIZED APPROACHES TO EDUCATE YOUTH. YES CONSISTS OF GIRLS, INC., BYSTANDER EDUCATION, AND HEALTHY RELATIONSHIPS PROGRAMMING. THESE ARE VIOLENCE PREVENTION PROGRAMS THAT TEACH ELEMENTARY, MIDDLE AND HIGH SCHOOL STUDENTS HOW TO LEAD CONVERSATIONS ABOUT HEALTHY RELATIONSHIPS, RECOGNIZE SIGNS OF AN ABUSIVE RELATIONSHIP, AND BECOME EMPOWERED TO MAKE POSITIVE AND HEALTHY DECISIONS. PROGRAM PARTICIPANTS (YEAR 1: 27) STATUS: PROGRAM FUNDED IN YEAR 1. ANNA JAQUES HOSPITAL REMAINS ENGAGED WITH THE ESSEX COUNTY ASSET BUILDER NETWORK. EVENTS HOSTED BY PROGRAM WITH HOSPITAL STAFF PARTICIPATION (YEAR 1: 2) AJH PROVIDED A COMMUNITY GRANT TO LINK HOUSE, INC.'S CATCH (CHILDREN AND TEEN CENTER FOR HELP) PROGRAM TO ADDRESS THESE GROWING UNMET NEEDS AROUND MENTAL HEALTH AND SUBSTANCE-USE FOR SCHOOL-AGED CHILDREN AND TEENS IN THE COMMUNITY. THE FUNDS FROM THIS GRANT FOCUSED ESPECIALLY ON CHILD AND TEENS AGE 5 YEARS OLD- 18 YEARS OLD, AND THEIR IMMEDIATE FAMILIES WHO REQUIRE RECEIVING TREATMENT AND/OR PSYCHOEDUCATION RELATED TO ACUTE OR CHRONIC MENTAL HEALTH CONCERNS, IN ADDITION TO TREATMENT, EDUCATION, AND/OR RELAPSE PREVENTION SKILLS. PATIENTS RECEIVING THERAPY (BASELINE: 146; YEAR 1: 171)STRATEGY: PROVIDE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION AND TREATMENT.INITIATIVES: BILH COLLABORATIVE CARE MODEL OUTPATIENT CLINIC, OUTREACH SERVICES HAVERHILL ADULT DAY TREATMENT SERVICES HAVERHILL PATIENT CARE NAVIGATORMETRICS AND STATUS UPDATES: BILH PROVIDES A RANGE OF BEHAVIORAL HEALTH, SUBSTANCE USE, AND ADDICTION RECOVERY SERVICES AND COUNSELING FOR ADULTS, YOUTH AND FAMILIES INCLUDING INPATIENT AND OUTPATIENT PSYCHIATRY SERVICES, OUTREACH AND COMMUNITY SERVICES. COLLABORATIVE CARE MODEL (COCM) HAS BEEN ADOPTED IN BILH PRIMARY CARE PRACTICES TO PROVIDE BEHAVIORAL HEALTH SERVICES IN THE PRIMARY CARE SETTING. THE PRIMARY CARE PROVIDER AND THE BEHAVIORAL HEALTH CLINICIAN WILL DEVELOP A TREATMENT PLAN THAT IS SPECIFIC TO THE PATIENT'S PERSONAL GOALS. A CONSULTING PSYCHIATRIST MAY ADVISE THE PRIMARY CARE PROVIDER ON MEDICATIONS THAT MAY BE HELPFUL. NUMBER OF PATIENTS SERVED (BASELINE: 159; YEAR 1: 83) AJH PROVIDES 24/7/365 BEHAVIORAL HEALTH CRISIS EVALUATION IN THE EMERGENCY DEPARTMENT (ED) AND THROUGHOUT OTHER HOSPITAL UNITS FOR INDIVIDUALS EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE RELATED CRISIS. SERVICES ARE PAYER AGNOSTIC AND PROVIDED VIA IN-PERSON OR TELEHEALTH BY A MULTIDISCIPLINARY TEAM OF QUALIFIED PROFESSIONALS, INCLUDING PSYCHIATRISTS, INDEPENDENTLY LICENSED AND MASTER'S LEVEL CLINICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, CERTIFIED PEER SPECIALISTS, AND FAMILY PARTNERS. THE SERVICES INCLUDE INITIAL ASSESSMENTS FOR RISKS, CLINICAL STABILIZATION, TREATMENT INITIATION, CARE COORDINATION, AND ONGOING EVALUATION TO ENSURE APPROPRIATE LEVEL OF CARE PLACEMENT. NUMBER OF SCREENS FOR BEHAVIORAL HEALTH (BASELINE: 974; YEAR 1: 1,377) AJH CONTINUED OFFERING THE PATIENT CARE NAVIGATOR THAT SUPPORTS WOMEN WITH SUBSTANCE USE DISORDER AND/OR NEONATAL ABSTINENCE SYNDROME, A CONDITION THAT IMPACTS ABOUT 9.1 CASES PER 1,000 BIRTHS IN MASSACHUSETTS. THE PATIENT CARE NAVIGATOR SERVES WOMEN IN RECOVERY AND SEEKING ADDITIONAL SUPPORT, WHO HAVE SUFFERED FROM TRAUMA OR ABUSE, OR WHO HAVE BEEN DIAGNOSED WITH MENTAL HEALTH DISORDERS. THE PATIENT CARE NAVIGATOR SUPPORTS WOMEN THROUGHOUT THEIR PREGNANCY AND INTO THE FIRST YEAR OF MOTHERHOOD, WORKING IN COLLABORATION WITH WOMEN'S HEALTH CARE AND THE ANNA JAQUES BIRTH CENTER & NEONATAL CARE CENTER. NUMBER OF WOMEN SERVED IN RECOVERY OR SEEKING ADDITIONAL SUPPORT (BASELINE: 300; YEAR 1: 285)STRATEGY: SUPPORT A MODEL THAT SPANS THE CONTINUUM OF CARE FROM INPATIENT TO OUTPATIENT AND COMMUNITY INITIATIVES THAT IDENTIFY AND ADDRESS MENTAL HEALTH NEEDS AND SUBSTANCE USE DISORDERS.
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INITIATIVES:
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THE PETTENGILL HOUSE: SUBSTANCE ADDICTION/ MENTAL HEALTH INITIATIVE ESSEX COUNTY OUTREACH COMMUNITY EDUCATION OFFERINGS FAMILY SERVICES OF THE MERRIMACK VALLEY: SAMARITANS PROGRAM LINK HOUSE OUTPATIENT SERVICESMETRICS AND STATUS UPDATES: AJH SUPPORTED THE PETTENGILL HOUSE'S BEHAVIORAL EVENT AND SUBSTANCE SUPPORT TEAM (BESST), WHICH IS AN INITIATIVE TO UNITE A BROAD NETWORK OF LOCAL PROVIDERS DEDICATED TO BREAKING DOWN BARRIERS AND PROVIDING SUBSTANCE MISUSE/BEHAVIORAL HEALTH SUPPORT FOR INDIVIDUALS AND FAMILIES OF ALL AGES. THE BESST MODEL TAKES AN "UPSTREAM" APPROACH TO ADDRESSING URGENT MENTAL HEALTH AND SUBSTANCE MISUSE CHALLENGES ALONG WITH ADDITIONAL SOCIAL DETERMINANTS OF HEALTH, IDENTIFYING CORE NEEDS AND IMPLEMENTING SYSTEMIC SOLUTIONS ROOTED IN BEST PRACTICES AND PERSON-CENTERED CARE. NUMBER OF UNIQUE INDIVIDUALS RECEIVING DIRECT SERVICES (BASELINE: 481; YEAR 1: 192) NUMBER OF FAMILY MEMBERS RECEIVING SUPPORT (BASELINE: 94) NUMBER OF HOSPITAL PATIENT CARE MEETINGS (YEAR 1: 48) AJH CONTINUED PARTNERING WITH ESSEX COUNTY OUTREACH (ECO), A COLLABORATIVE EFFORT INVOLVING ALL 34 POLICE DEPARTMENTS WITHIN ESSEX COUNTY, AS WELL AS THE SHERIFF'S DEPARTMENT, PARTNERING WITH SOCIAL SERVICE AGENCIES, PEER SPECIALISTS, AND OTHER COMMUNITY SUPPORTS TO INCREASE RESOURCES FOR SUBSTANCE USE AND MENTAL HEALTH. UNIQUE PERSONS ASSISTED (BASELINE: 104) STATUS: PROGRAM WAS FUNDED IN BASELINE YEAR ONLY. IN YEAR 1, ANNA JAQUES HOSPITAL HAD SEVERAL MEETINGS WITH ECO TO DISCUSS COLLABORATION AROUND PATIENT DISCHARGE AND RECOVERY COACHING. AJH SUPPORTED FAMILY SERVICES' SAMARITANS OF THE MERRIMACK VALLEY THAT AIMS TO REDUCE THE INCIDENTS OF SUICIDE IN NORTHEASTERN MASSACHUSETTS BY PROVIDING A HOST OF PREVENTION AND POST-VENTION SERVICES INCLUDING COMMUNITY OUTREACH, TRAININGS, SURVIVOR SUPPORT AND A 24-HOUR CRISIS HOTLINE. INDIVIDUALS SERVED THROUGH HELPLINES (BASELINE: 4,600) PARTICIPANTS IN TRAINING AND SUPPORTIVE PROGRAMS (BASELINE: 495) SUICIDE PREVENTION TRAINING SESSIONS (BASELINE: 330) STATUS: PROGRAM WAS FUNDED IN BASELINE YEAR ONLY. AJH PROVIDED GRANT FUNDING TO THE GREATER NEWBURYPORT VILLAGE FOR THEIR MEMBERSHIP ASSISTANCE PROGRAM. THE VILLAGE'S GOOD NEIGHBOR VOLUNTEERS PROVIDE NEIGHBORLY HELP AT HOME AND RIDES TO APPOINTMENTS/EVENTS. IN ADDITION, THE VILLAGE FOLLOWS UP WITH NON-PARTICIPATING MEMBERS, WHO MAY BE SUFFERING FROM ISOLATION. PERCENT OF MEMBERS ENROLLED IN ASSISTANCE PROGRAM (BASELINE: 20%) STATUS: PROGRAM WAS FUNDED IN BASELINE YEAR ONLY. TO SUPPORT INCREASED ACCESS AND UNDERSTANDING OF MENTAL HEALTH RESOURCES THROUGHOUT AJH'S COMMUNITY BENEFITS SERVICE AREA, LINK HOUSE WAS AWARDED A THREE-YEAR GRANT FOR WELLNESS DELIVERED, A COMPREHENSIVE BEHAVIORAL HEALTH EDUCATION PROGRAM. THIS PROGRAM EXPANDS THE REACH OF LINK HOUSE, INC.'S (LHI) OUTPATIENT SERVICES BY TAKING COMPREHENSIVE BEHAVIORAL HEALTH EDUCATION PROGRAMMING "ON THE ROAD" TO MEET THE COMMUNITY WHERE IT LIVES. COMMUNITY EDUCATION SESSIONS DELIVERED (YEAR 1: 2) STATUS: PROGRAM WAS IMPLEMENTED IN YEAR 1. TO SUPPORT INCREASED ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SERVICES AND SUPPORTS, ANNA JAQUES HOSPITAL PARTICIPATED WITH OTHER BILH HOSPITALS TO PILOT BEHAVIORAL HEALTH NAVIGATOR GRANT PROGRAMS, OFFER MENTAL HEALTH FIRST AID (MHFA) TRAININGS, PROVIDE BEHAVIORAL HEALTH NAVIGATION AND DIGITAL LITERACY TRAININGS TO BILH PHYSICAL HEALTH NAVIGATORS AND AMPLIFY ANTI-STIGMA MESSAGING, RESOURCES AND SUPPORTS. INDIVIDUALS TRAINED IN MENTAL HEALTH FIRST AID (YEAR 1: 350) STATUS: PROGRAM WAS IMPLEMENTED IN YEAR 1.STRATEGY: PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO INCREASE RESILIENCY, PROMOTE MENTAL HEALTH, REDUCE SUBSTANCE USE, AND PREVENT OPIOID OVERDOSES AND DEATHS.INITIATIVES: AMESBURY PARTNERSHIP OF AMESBURY COMMUNITY & TEENS (PACT) PARTICIPATE/ COLLABORATE WITH BESST TASK FORCE (MENTAL HEALTH / SUBSTANCE USE DISORDER TASK FORCE)METRICS AND STATUS UPDATES: STATUS: IN YEAR 1, THE COMMUNITY BENEFITS AND COMMUNITY RELATIONS MANAGER AT ANNA JAQUES HOSPITAL PARTICIPATED IN THE NEWBURYPORT PUBLIC SCHOOLS WELLNESS ADVISORY COMMITTEE AND JOINED THE PARTNERSHIP OF AMESBURY COMMUNITY AND TEENS (PACT), A YOUTH-FOCUSED SUBSTANCE PREVENTION COALITION. STATUS: ANNA JAQUES HOSPITAL SOCIAL WORKERS ARE REGULAR PARTICIPANTS IN THE BESST TASK FORCE'S MONTHLY MEETINGS. THE BESST COORDINATOR ALSO VISITS THE HOSPITAL WEEKLY TO CONSULT ON PATIENTS PRIOR TO DISCHARGE.PRIORITY 4: CHRONIC AND COMPLEX DISEASECHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN MASSACHUSETTS AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.GOAL: ADDRESS THE PREVALENCE AND IMPACT, RISK/PROTECTIVE FACTORS, AND ACCESS ISSUES ASSOCIATED WITH CANCER. IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.
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STRATEGY:
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PROVIDE PREVENTIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMS.INITIATIVES: BREAST CARE NAVIGATOR AT THE GERRISH BREAST CARE CENTER SOCIAL WORKER, AJH CANCER CENTER COMMUNITY PREVENTION AND DISEASE MANAGEMENT PROGRAMSMETRICS AND STATUS UPDATES: AJH BREAST CARE NAVIGATOR OFFERS INDIVIDUALIZED SUPPORT AND ASSISTANCE TO PATIENTS AND THEIR CAREGIVERS TO HELP THEM MAKE INFORMED DECISIONS ABOUT THEIR CARE AND TO OVERCOME BARRIERS TO OPTIMAL CARE. THE NAVIGATOR PROVIDES CANCER PATIENTS WITH COORDINATED CARE THROUGH A HOLISTIC AND COLLABORATIVE APPROACH THAT INCLUDES COMMUNICATION AND COORDINATION WITH THE PATIENT'S FAMILY AND/OR CAREGIVERS, ALONG WITH A MULTIDISCIPLINARY TEAM CONSISTING OF PHYSICIANS, NURSE PRACTITIONERS, ONCOLOGY NURSES, AND SOCIAL WORKERS. THE NAVIGATOR WORKS IN COLLABORATION WITH THE CLINICAL TEAM TO DEVELOP CLINICAL PATHWAYS FOR APPROPRIATE CARE AND ACTS AS THE CONTACT CLINICAL PERSON FOR PATIENT-RELATED CONCERNS. INDIVIDUALS PROVIDED SUPPORT SERVICES AND CARE COORDINATION (BASELINE: 266 WOMEN SCHEDULED FOR IMAGE-GUIDED BREAST BIOPSIES AND 100 GBCC PATIENTS AND FAMILIES UNDERGOING BREAST SURGERY FOR BOTH BENIGN AND MALIGNANT CONDITIONS). STATUS: PROGRAM ENDED IN FY2023. STATUS: THE AJH CANCER CENTER DOES NOT HAVE A SOCIAL WORKER ON STAFF. ENHANCEFITNESS IS A PROVEN COMMUNITY-BASED SENIOR FITNESS AND ARTHRITIS MANAGEMENT PROGRAM. IT HELPS OLDER ADULTS BECOME MORE ACTIVE, ENERGIZED, AND EMPOWERED FOR INDEPENDENT LIVING. THE PROGRAM IS ESPECIALLY BENEFICIAL FOR OLDER ADULTS LIVING WITH ARTHRITIS. AJH SUPPORTED THIS PROGRAM AT THE YMCA OF GREATER HAVERHILL. PERCENT OF PARTICIPANTS THAT MAINTAINED/INCREASED THEIR FEELING OF OVERALL HEALTH DURING THE 16-WEEK PROGRAM (BASELINE: 90%) PERCENT OF PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ABILITIES OVER THE 16-WEEK PROGRAM (BASELINE: 75%) STATUS: PROGRAM WAS FUNDED IN BASELINE YEAR ONLY. AJH HOSTS FREE WEEKLY "BABY AND ME" CLASSES IN NEWBURYPORT AND HAVERHILL FOR ANY PARENT IN THE COMMUNITY. THESE GROUPS ARE FACILITATED BY A BIRTH CENTER LACTATION CONSULTANT/REGISTERED NURSE TO SUPPORT EVERY PERSON'S PARENTING EXPERIENCE. A PERSON DOES NOT NEED TO BE BREASTFEEDING/CHEST FEEDING TO ENJOY THIS GROUP. ALL ASPECTS OF PARENTING ARE DISCUSSED. PARENTS PARTICIPATING WEEKLY IN CLASSES (BASELINE: 15; YEAR 1: 15) ANNA JAQUES HOSPITAL PROVIDED A COMMUNITY GRANT TO SARAH'S PLACE, WHICH PROVIDES MEDICAL OVERSIGHT AND ASSISTANCE WITH ACTIVITIES OF DAILY LIVING WHILE PROMOTING A SENSE OF PURPOSE AND A COMMUNITY OF CARING FOR PARTICIPANTS. WITH INCREASED AWARENESS, ACCESS TO ADULT DAY HEALTH PROGRAM KEEPS AGING ADULTS HEALTHY AND INDEPENDENT IN THE COMMUNITY. ANNA JAQUES HOSPITAL'S GRANT FUNDING SUPPORTS BILINGUAL OUTREACH TO PROVIDE EDUCATION ABOUT THE RESOURCES AND BENEFITS OF ADULT DAY HEALTH PROGRAMS. NUMBER OF ELDER/SENIOR HOUSING SITES RECEIVING ONSITE EDUCATION (YEAR 1: 4) STATUS: PROGRAM IMPLEMENTED IN YEAR 1.STRATEGY: SUPPORT COMMUNITY-BASED PROGRAMS/ INITIATIVES THAT INCREASE ACCESS TO HEALTHY FOODS AND/OR PHYSICAL ACTIVITY TO SUPPORT CANCER SURVIVORSHIP.INITIATIVES: YMCA HAVERHILL: CORNER STONE PROGRAM YWCA NEWBURYPORT: ENCORE PROGRAM NORTH OF BOSTON CANCER RESOURCE: SPEAKER SERIESMETRICS AND STATUS UPDATES: AJH SUPPORTED THE CORNERSTONE PROGRAM AT THE GREATER HAVERHILL YMCA. CORNERSTONE IS A COLLABORATIVE HEALTH AND WELLNESS PROGRAM PROVIDING SUPPORT TO CANCER PATIENTS, CANCER SURVIVORS, AND THEIR IMMEDIATE FAMILIES. A FREE ONE-YEAR YMCA MEMBERSHIP IS PROVIDED TO THE FAMILY AND TWO WEEKS OF SUMMER CAMP PROGRAMMING AT NO COST. NUMBER OF SURVIVORSHIP SUPPORT PROGRAM MEMBERSHIPS (BASELINE: 41) NUMBER OF FAMILIES PROVIDED SUMMER CAMP (BASELINE: 8) STATUS: PROGRAM WAS FUNDED IN BASELINE YEAR ONLY. AJH SUPPORTED THE YWCA OF NEWBURYPORT'S ENCORE AND AFTER ENCORE PROGRAM, WHICH IS A UNIQUE SURVIVORSHIP PROGRAM FOR THOSE WHO HAVE EXPERIENCED CANCER AT ANY POINT IN THEIR LIVES. THE PROGRAM PROVIDES FREE ACCESS TO A TAILORED EXERCISE PROGRAM, INCORPORATING LAND AND WATER EXERCISES APPROPRIATE FOR ALL FITNESS LEVELS AT ANY POINT IN THEIR TREATMENT JOURNEY AND BEYOND. ENCORE/AFTER ENCORE PARTICIPANTS (BASELINE: 36; YEAR 1: 48) AJH SUPPORTED THE NORTH OF BOSTON CANCER RESOURCE (NBCR), WHICH OFFERS SUPPORT AND EDUCATION TO PEOPLE AFFECTED BY CANCER FROM DIAGNOSIS, THROUGH TREATMENT AND BEYOND. THROUGH THE GIFT CERTIFICATE/VOUCHER PROGRAM THEY FUND SUPPORTIVE SERVICES FROM THEIR RESOURCE GUIDE TO RECIPIENTS. SERVICES INCLUDE ONCOLOGY MASSAGE, MANUAL LYMPH DRAINAGE, ACUPUNCTURE, REIKI, PERSONAL TRAINING, YOGA THERAPY, GUIDED IMAGERY, HEALTH COACHING AND NUTRITION COUNSELING. THROUGH THEIR MONTHLY SPEAKER SERIES, NBCR PROVIDES INFORMATION AND THAT PROMOTES EMPOWERMENT THROUGH KNOWLEDGE AND SELF-CARE. INDIVIDUALS REACHED THROUGH SPEAKER SERIES (BASELINE: 271; YEAR 1: 240) COMPLEMENTARY CARE SESSIONS PROVIDED (BASELINE: 160; YEAR 1: 226) AJH SPONSORS THE HAVERHILL FARMERS' MARKET, WHICH IS DEDICATED TO PROMOTING HEALTHY EATING AND SUPPORTING LOCAL BUSINESS, SUSTAINABILITY, AND COMMUNITY SPIRIT BY PROVIDING FRESH LOCAL PRODUCE, BAKED AND PREPARED FOODS, AND HANDCRAFTED GOODS. SEVERAL VENDORS ACCEPT PAYMENT FROM THE SUPPLEMENTAL NUTRITION ASSISTANT PROGRAM (SNAP) AND WOMEN, INFANTS, AND CHILDREN (WIC) HELPING LOWER INCOME FAMILIES ACCESS LOCALLY GROWN FRESH PRODUCE. THE MARKET IS ACCESSIBLE BY FREE, PUBLIC TRANSPORTATION. NUMBER OF WEEKLY MARKETS HOSTED PER YEAR (BASELINE:19; YEAR 1: 19)STRATEGY: PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES THAT REDUCE AND PREVENT OR PROVIDE NEEDED SUPPORTS RELATED TO CANCER.INITIATIVES: NORTH OF BOSTON CANCER RESOURCE BOARD OF DIRECTORSMETRICS AND STATUS UPDATES: NORTH OF BOSTON CANCER RESOURCE BOARD OF DIRECTORS# OF AJH STAFF IN BOARD POSITIONS (BASELINE: 2; YEAR 1: 2)COMMUNITY PARTNERSANNA JAQUES HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE: COMMON GROUND MINISTRIES ELIOT COMMUNITY HUMAN SERVICES EMMAUS, INC. ESSEX COUNTY ASSET BUILDER NETWORK ESSEX COUNTY OUTREACH HAVERHILL FARMERS MARKET/CREATIVE HAVERHILL HAVERHILL PUBLIC SCHOOLS JEANNE GEIGER CRISIS CENTER LINK HOUSE, INC. MERRIMACK VALLEY TRANSIT NEW ENGLAND ELDER TRANSPORTATION NEWBURYPORT FARMERS' MARKET NEWBURYPORT RECREATION AND YOUTH SERVICES NORTH OF BOSTON CANCER RESOURCE NORTHERN ESSEX ELDER TRANSPORT NOURISHING THE NORTHSHORE OUR NEIGHBORS' TABLE THE PETTENGILL HOUSE REGIONAL SOCIAL SERVICES COLLABORATIVE ROTARY CLUB OF HAVERHILL ROTARY CLUB OF NEWBURYPORT SARAH'S PLACE ADULT HEALTH CENTER YMCA OF NORTHSHORE/HAVERHILL YWCA OF NEWBURYPORT AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, ANNA JAQUES HOSPITAL IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE CURRENT IMPLEMENTATION STRATEGY. THOSE NEEDS ARE: SUPPORTING EDUCATION ACROSS THE LIFESPAN, STRENGTHENING THE BUILT ENVIRONMENT (I.E., IMPROVING ROADS/SIDEWALKS AND ENHANCING ACCESS TO SAFE RECREATIONAL SPACES/ACTIVITIES), AND DIGITAL DIVIDE/ACCESS TO TECH RESOURCES. ANNA JAQUES HOSPITAL IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES, THE FEASIBILITY OF AJH HAVING AN IMPACT, AND/OR BECAUSE IT WAS FELT THAT THE ISSUE WAS BEING ADDRESSED BY OTHER COMMUNITY PARTNERS. HOWEVER, ANNA JAQUES HOSPITAL REMAINS OPEN AND WILLING TO WORK WITH THE OTHER BILH HOSPITALS AND/OR COMMUNITY PARTNERS TO ADDRESS THESE ISSUES.AS NOTED IN DETAIL ABOVE, ANNA JAQUES HOSPITAL'S PRIMARY TOOL FOR ASSESSING THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).
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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 ANNA JAQUES HOSPITAL CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 18.7% OF ANNA JAQUES HOSPITAL'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITSANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, ANNA JAQUES HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://AJH.ORG/ABOUT/COMMUNITY-BENEFITS-NEEDS .THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT ANNA JAQUES HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, ANNA JAQUES HOSPITAL IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEANNA JAQUES HOSPITAL'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $1,305,713 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, ANNA JAQUES HOSPITAL IS ONE OF ELEVEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE MASSACHUSETTS 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 CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, ANNA JAQUES HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ANNA JAQUES HOSPITAL GENERATED $2,277,889 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY ANNA JAQUES HOSPITAL FOR SUCH SERVICES BY $505,747 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 13.5% OR 29,609 OF ANNA JACQUES HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 43.2% OR 94,395 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 ANNA JAQUES HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING ANNA JAQUES HOSPITAL GENERATED $45,946,335 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $9,962,171. OF THESE AMOUNTS, REVENUE OF $16,151,165 IS RELATED TO THE PROVISION OF GENERAL MEDICINE, CANCER (INCLUDES HEMATOLOGY), BEHAVIORAL HEALTH, OBGYN, NEONATOLOGY/ NEWBORN, GASTROENTEROLOGY, PULMONOLOGY, UROLOGY, NEPHROLOGY, AND HEPATOLOGY 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 $30,564,066. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH ANNA JAQUES HOSPITAL CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, ANNA JAQUES HOSPITAL HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 24.41%.
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BAD DEBTS
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IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, ANNA JAQUES HOSPITAL ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. COSTS FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $1,683,521 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.REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. PERFORMANCE 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.
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PATIENTS WHO ARE COVERED BY THIRD-PARTY
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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 ACCESSTHE ANNA JAQUES HOSPITAL DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR.FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE ANNA JAQUES HOSPITAL IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE FROM ANNA JAQUES HOSPITAL AS WELL AS PROVIDERS WHO FOLLOW ANNA JAQUES HOSPITAL'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN ANNA JAQUES HOSPITAL AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW ANNA JAQUES HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. ANNA JAQUES HOSPITAL DOES NOT DISCRIMINATE WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONS EFFECTIVE ON OR ABOUT APRIL 24, 2024.FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.
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FINANCIAL ASSISTANCE POLICYTRANSLATIONS
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THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ARABIC, FRENCH, GREEK, ITALIAN, JAPANESE, KHMER, PORTUGUESE, RUSSIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, SPANISH, VIETNAMESE. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://AJH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/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). FINANCIAL ASSISTANCE POLICYPLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE ANNA JAQUES HOSPITAL FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. CREDIT AND COLLECTION POLICY APPLICATION FOR FINANCIAL ASSISTANCE MEDICAL HARDSHIP APPLICATION FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN: ENGLISH, ARABIC, FRENCH, GREEK, ITALIAN, JAPANESE, KHMER, PORTUGUESE, RUSSIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, SPANISH, AND VIETNAMESE, CAN BE FOUND ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/ASSISTANCELIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLEDLOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT 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 THROUGHOUT THIS FORM 990, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH ANNA JAQUES HOSPITAL DOES NOT DIRECTLY ENGAGE IN RESEARCH, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC, NEW ENGLAND BAPTIST HOSPITAL AND JOSLIN DIABETES CENTER ALL ENGAGE IN RESEARCH ACTIVITIES DESIGNED TO CARE FOR PATIENTS NOT ONLY AT THESE HOSPITALS, BUT ACROSS THE COMMUNITIES SERVED BY BILH AND BEYOND. 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. ALTHOUGH THE RESEARCH ACTIVITIES OF THESE BIDMC AND OTHER BILH AFFILIATES ARE NOT QUANTIFIED HERE IN ANNA JAQUES HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL, BILH AND BEYOND. INFORMATION ON THE RESEARCH ENGAGED IN AT BIDMC AND JOSLIN, SISTER ENTITIES TO ANNA JAQUES HOSPITAL, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION. TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.
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THE MEDICAL CENTER'S NOTABLE RESEARCH
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ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES: ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE EMERGENCY MEDICINE MEDICINE ALLERGY AND INFLAMMATIONCARDIOVASCULAR MEDICINECENTER FOR VASCULAR BIOLOGY RESEARCHCLINICAL INFORMATICSCLINICAL NUTRITIONENDOCRINOLOGYEXPERIMENTAL MEDICINEGASTROENTEROLOGYGENERAL MEDICINE AND PRIMARY CAREGENETICSGERONTOLOGYHEMATOLOGY AND ONCOLOGYHEMOSTASIS AND THROMBOSISIMMUNOLOGYINFECTIOUS DISEASEINTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGYMOLECULAR AND VASCULAR MEDICINENEPHROLOGYPULMONOLOGYRHEUMATOLOGYSIGNAL TRANSDUCTIONTRANSLATIONAL RESEARCHTRANSPLANT IMMUNOLOGY NEONATOLOGY NEUROLOGY OBSTETRICS AND GYNECOLOGY ORTHOPAEDIC SURGERY PATHOLOGY PSYCHIATRY RADIOLOGY SURGERY CARDIAC SURGERYCENTER FOR MINIMALLY INVASIVE SURGERYNEUROSURGERYPLASTIC AND RECONSTRUCTIVE SURGERYVASCULAR SURGERY TRANSPLANT INSTITUTEDURING 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 AND REPORTED ON THE BIDMC SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE.
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RESEARCH ENGAGED IN AT THE MEDICAL CENTER
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THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. DETAIL ON RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. 1. FIRST-OF-ITS-KIND STUDY FINDS HIDDEN CLUES TO RARE TYPE OF PANCREATIC CANCER, OPENS DOORS TO NEW THERAPIESPANCREATIC NEUROENDOCRINE TUMORS (PANNETS) ARE A RARE KIND OF CANCER THAT FORMS IN THE PANCREAS. PHYSICIANS STILL HAVE DIFFICULTY PREDICTING HOW THE DISEASE WILL AFFECT INDIVIDUAL PATIENTS AND HOW BEST TO TREAT IT.BIDMC SCIENTISTS USED PROTEOGENOMICS, THE INTEGRATED LARGE-SCALE STUDY OF GENES AND PROTEINS IN CANCER CELLS, TO LEARN MORE ABOUT THESE TUMORS. USING 37 TUMOR SAMPLES, THE TEAM DISCOVERED FOUR PREVIOUSLY UNDESCRIBED PANNETS. TWO OF THESE SUBTYPES SHOWED HIGH RECURRENCE RATES, SUGGESTING A PREVIOUSLY UNRECOGNIZED CLINICAL AGGRESSIVENESS. THESE TUMORS ALSO SHOWED SIGNS OF LOW OXYGEN LEVELS AND INFLAMMATIONBOTH LINKED TO MORE AGGRESSIVE CANCERS.THE SCIENTISTS ALSO FOUND CHANGES IN HOW THE CANCER CELLS USE ENERGY AND HOW THEY HIDE FROM THE IMMUNE SYSTEM, FINDINGS WHICH COULD HELP RESEARCHERS DEVELOP NEW TREATMENTS.IMPORTANTLY, THE RESEARCHERS ADD, THESE PROTEOMIC SUBTYPES WOULD NOT HAVE BEEN DISCOVERABLE USING PRIOR GENOMICS-BASED APPROACHES TO PANNETS OR CURRENT STATE-OF-THE-ART CLINICOPATHOLOGICAL PANNET SUBTYPING. LEAD AUTHOR MICHAEL ROEHRL, CHIEF OF THE DEPARTMENT OF PATHOLOGY AND PI AT BIDMC SAID: "PROTEOGENOMICS REPRESENTS A SIGNIFICANT STEP FORWARD IN UNDERSTANDING PANCREATIC NEUROENDOCRINE TUMORS, AND OUR PUBLICLY AVAILABLE PROTEOMIC PANNET DATASET SHOULD BE OF IMMEDIATE INTEREST TO SCIENTISTS AND PHYSICIANS AROUND THE WORLD." 2. RESEARCHERS HALT PROGRESSION IN PARKINSON'S DISEASE MOUSE MODEL, OPENING THE DOOR TO POTENTIAL DISEASE-MODIFYING TREATMENT FOR PATIENTS WITH PARKINSON'S DISEASEINVESTIGATORS AT BIDMC SHED NEW LIGHT ON KEY CELLULAR PROCESSES INVOLVED IN THE PROGRESSION OF PARKINSON'S DISEASE (PD). AFFECTING AROUND 10 MILLION PEOPLE WORLDWIDE, PARKINSON'S DISEASE IS A NEURODEGENERATIVE DISORDER CAUSED BY THE PROGRESSIVE LOSS OF THE GROUP OF BRAIN CELLS RESPONSIBLE FOR PRODUCING DOPAMINE, A NEUROTRANSMITTER THAT PLAYS A CRITICAL ROLE IN REGULATING MOVEMENT AND COORDINATION. AS THESE NEURONS DEGENERATE AND DOPAMINE LEVELS DECREASE, INDIVIDUALS WITH PARKINSON'S DISEASE EXPERIENCE A WIDE RANGE OF SYMPTOMS, INCLUDING TREMORS, STIFFNESS AND DIFFICULTIES WITH BALANCE AND COORDINATION.RESEARCHERS IN THE LAB OF SENIOR AUTHOR DAVID K. SIMON, MD, PHD, DIRECTOR OF THE PARKINSON'S DISEASE & MOVEMENT DISORDERS CENTER, IN COLLABORATION WITH COLLEAGUES AT THE UNIVERSITY OF CAMBRIDGE AND MISSION THERAPEUTICS, PERFORMED TWO SETS OF COMPLEMENTARY EXPERIMENTS SHOWING THAT INHIBITING A SPECIFIC ENZYME IN A MOUSE MODEL PROTECTS THE DOPAMINE-PRODUCING NEURONS THAT ARE NORMALLY LOST AS PD PROGRESSES, EFFECTIVELY HALTING THE PROGRESSION OF THE DISEASE. THE FINDINGS OPEN THE DOOR TO THE DEVELOPMENT OF NOVEL THERAPEUTICS TARGETING THE ENZYME THAT MAY SLOW OR PREVENT THE PROGRESSION OF PARKINSON'S DISEASE IN PEOPLEA MAJOR UNMET NEED. "OUR LAB IS FOCUSED ON WORKING OUT THE ORIGINS OF PARKINSON'S DISEASE AND IT IS OUR HOPE THATONE DAYWE WILL BE ABLE TO SLOW DOWN OR EVEN PREVENT DISEASE PROGRESSION IN PATIENTS," SAID FIRST AUTHOR TRACY-SHI ZHANG FANG, PHD, AN INSTRUCTOR IN SIMON'S LAB. "THE CURRENT STUDY'S FINDINGS PAVE THE WAY TOWARD THAT FUTURE."3. AI CHATBOT SHOWS POTENTIAL AS DIAGNOSTIC PARTNER, RESEARCHERS FINDPHYSICIAN-INVESTIGATORS AT BIDMC COMPARED A CHATBOT'S PROBABILISTIC REASONING TO THAT OF HUMAN CLINICIANS. THE FINDINGS, PUBLISHED IN JAMA NETWORK OPEN, SUGGEST THAT ARTIFICIAL INTELLIGENCE COULD SERVE AS USEFUL CLINICAL DECISION SUPPORT TOOLS FOR PHYSICIANS.BASING THEIR STUDY ON A PREVIOUSLY PUBLISHED NATIONAL SURVEY OF MORE THAN 550 PRACTITIONERS PERFORMING PROBABILISTIC REASONING ON FIVE MEDICAL CASES, ADAM RODMAN, MD, AN INTERNAL MEDICINE PHYSICIAN AND INVESTIGATOR IN THE DEPARTMENT OF MEDICINE, AND COLLEAGUES FED THE PUBLICLY AVAILABLE LARGE LANGUAGE MODEL (LLM), CHAT GPT-4, THE SAME SERIES OF CASES AND RAN AN IDENTICAL PROMPT 100 TIMES TO GENERATE A RANGE OF RESPONSES.THE CHATBOTJUST LIKE THE PRACTITIONERS BEFORE THEMWAS TASKED WITH ESTIMATING THE LIKELIHOOD OF A GIVEN DIAGNOSIS BASED ON PATIENTS' PRESENTATION. THEN, GIVEN TEST RESULTS SUCH AS CHEST RADIOGRAPHY FOR PNEUMONIA, MAMMOGRAPHY FOR BREAST CANCER, STRESS TEST FOR CORONARY ARTERY DISEASE AND A URINE CULTURE FOR URINARY TRACT INFECTION, THE CHATBOT PROGRAM UPDATED ITS ESTIMATES.WHEN TEST RESULTS WERE POSITIVE, IT WAS SOMETHING OF A DRAW; THE CHATBOT WAS MORE ACCURATE IN MAKING DIAGNOSES THAN THE HUMANS IN TWO CASES, SIMILARLY ACCURATE IN TWO CASES AND LESS ACCURATE IN ONE CASE. BUT WHEN TESTS CAME BACK NEGATIVE, THE CHATBOT SHONE, DEMONSTRATING MORE ACCURACY IN MAKING DIAGNOSES THAN HUMANS IN ALL FIVE CASES.BUT RODMAN IS LESS INTERESTED IN HOW CHATBOTS AND HUMANS PERFORM TOE-TO-TOE THAN IN HOW HIGHLY SKILLED PHYSICIANS' PERFORMANCE MIGHT CHANGE IN RESPONSE TO HAVING THESE NEW SUPPORTIVE TECHNOLOGIES AVAILABLE TO THEM IN THE CLINIC, ADDED RODMAN."HUMANS STRUGGLE WITH PROBABILISTIC REASONING, THE PRACTICE OF MAKING DECISIONS BASED ON CALCULATING ODDS," SAID RODMAN. "WE CHOSE TO EVALUATE PROBABILISTIC REASONING IN ISOLATION BECAUSE IT IS A WELL-KNOWN AREA WHERE HUMANS COULD USE SUPPORT. HUMANS SOMETIMES FEEL THE RISK IS HIGHER THAN IT IS AFTER A NEGATIVE TEST RESULT, WHICH CAN LEAD TO OVERTREATMENT, MORE TESTS AND TOO MANY MEDICATIONS."
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BIDMC'S COMPLEX HYPERTENSION CENTER IS THE REGION'S ONLY AMERICAN HEART ASSO
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PHYSICIAN-SCIENTISTS AT BIDMC, LED BY ERIC A. SECEMSKY, MD, ARE AT THE FOREFRONT OF A BREAKTHROUGH TREATMENT FOR PATIENTS WITH TREATMENT-RESISTANT HYPERTENSIONDANGEROUSLY HIGH BLOOD PRESSURE THAT PERSISTS DESPITE TAKING THREE OR MORE MEDICATIONS. FOR THESE HIGH-RISK PATIENTS, BIDMC IS AMONG THE FIRST IN THE NATION TO OFFER RENAL DENERVATION (RDN), A MINIMALLY INVASIVE PROCEDURE THAT TARGETS OVERACTIVE NERVES NEAR THE KIDNEYS TO HELP LOWER BLOOD PRESSURE.SECEMSKY, DIRECTOR OF VASCULAR INTERVENTION AT BIDMC, PIONEERED THE USE OF RDN AT THE MEDICAL CENTER AND SERVES AS SITE PRINCIPAL INVESTIGATOR ON MAJOR CLINICAL TRIALS THAT HELPED SECURE FDA APPROVAL FOR TWO CATHETER-BASED RDN DEVICES. THE PROCEDURE INVOLVES THREADING A DEVICE THROUGH THE GROIN TO REACH THE RENAL ARTERIES. ONE USES HEAT-FILLED BALLOONS; THE OTHER, RADIOFREQUENCY ABLATIONBOTH DESIGNED TO DISRUPT NERVE SIGNALS THAT RAISE BLOOD PRESSURE.SO FAR, SECEMSKY AND HIS TEAM HAVE PERFORMED RDN ON SIX PATIENTS THROUGH BIDMC'S COMPLEX HYPERTENSION CLINIC, WHICH BRINGS TOGETHER A MULTIDISCIPLINARY TEAM TO CARE FOR PATIENTS WITH THE MOST DIFFICULT-TO-CONTROL BLOOD PRESSURE. ON AVERAGE, PATIENTS CAN EXPECT A 710 MMHG DROP IN BLOOD PRESSUREENOUGH TO MEANINGFULLY REDUCE THE RISK OF HEART ATTACK AND STROKE OVER TIME."THIS DEVICE IS NOVEL AND STATE-OF-THE ART, BUT MORE IMPORTANTLY, HAVING SOMETHING TO OFFER PEOPLE WITH TREATMENT RESISTANT BLOOD PRESSURE REPRESENTS ONE PART OF OUR OPPORTUNITY TO BUILD ONE OF THE LARGEST HYPERTENSION CENTERS IN NEW ENGLAND.5. NEW AI MODEL FLAGS 3.5 TIMES AS MANY PATIENTS AT RISK FOR PANCREATIC CANCER AS CURRENT SCREENING GUIDELINES; COULD LEAD TO EARLIER DETECTION OF PANCREATIC CANCERHOVERING AT JUST 11 PERCENT, PANCREATIC CANCER HAS THE LOWEST FIVE-YEAR RELATIVE SURVIVAL RATE OF ANY CANCER DIAGNOSIS, LARGELY BECAUSE THE DISEASE IS TYPICALLY CAUGHT IN ITS ADVANCED STAGES. IF CAUGHT IN ITS EARLIEST STAGES, FIVE-YEAR SURVIVAL RATES CAN REACH AS HIGH AS 80 PERCENT; HOWEVER, CURRENT SCREENING GUIDELINES APPLY ONLY TO ABOUT 10 PERCENT OF THE 62,000 PANCREATIC CANCER CASES THAT ARE DIAGNOSED EACH YEAR IN THE UNITED STATES. INVESTIGATORS AT BIDMC BUILT AND VALIDATED A RISK PREDICTION MODEL TO HELP PHYSICIANS IDENTIFY PATIENTS WHO ARE AT HIGH RISK FOR DEVELOPING PANCREATIC CANCER. THE TEAM'S MODEL, A NEURAL NETWORK TRAINED ON DE-IDENTIFIED DATA FROM ELECTRONIC HEALTH RECORDS FROM 55 U.S. HEALTH CARE ORGANIZATIONS, FLAGGED PATIENTS AS AT RISK OF DEVELOPING PANCREATIC CANCER UP TO 18 MONTHS BEFORE DIAGNOSIS IN PATIENTS 40 YEARS OR OLDER AND CAUGHT 3.5 TIMES AS MANY CASES THAN CURRENT SCREENING GUIDELINES WOULD IF APPLIED TO THE SAME GROUP. THEIR FINDINGS APPEAR IN EBIOMEDICINE, PART OF LANCET DISCOVERY SCIENCE.NAMED PRISMNN, THE TEAM'S MACHINE LEARNING MODEL WAS TRAINED ON DATA FROM MORE THAN 1.5 MILLION EHR PROVIDED BY INDUSTRY PARTNER TRINETX. THE DATA SET INCLUDED AN AVERAGE OF 13 YEARS OF HISTORICAL DATA ABOUT DEMOGRAPHICS, DOCTOR'S VISITS, DIAGNOSES, LAB WORK, PROCEDURES AND MEDICATIONS FOR MORE THAN 35,000 PATIENTS WHO EVENTUALLY DEVELOPED PANCREATIC CANCER AND MORE THAN 1.5 MILLION CONTROLS. THE MODEL FLAGGED PATIENTS AT HIGH RISK FOR DEVELOPING CANCER BASED ON 87 FEATURES IT AUTOMATICALLY SELECTED BASED ON THE INPUT TRAINING DATA."THERE ARE SIGNALS IN THE DATA THAT'S BEING ROUTINELY COLLECTED ALREADY WHEN PEOPLE SEE THEIR PRIMARY CARE PHYSICIAN OR GO TO THE ED WITH A BROKEN ANKLESYMPTOMS THAT SHOW UP, SUCH AS CERTAIN MEDICATIONS OR CHANGES IN LAB VALUES," LIMOR APPELBAUM, AN INVESTIGATOR AT BIDMC, SAID. "TAKEN TOGETHER, THESE ARE ALL SIGNALS THAT CAN PREDICT PANCREATIC CANCER BEFORE THE CANCER IS ACTUALLY DETECTED, AND THAT GIVES US THE OPPORTUNITY TO CATCH THOSE CANCERS EARLY, BEFORE IT HAS SPREAD."6. PLASMA PROTEIN CLUES COULD HELP PREDICT WHO WILL DEVELOP HYPERTENSIONEXERCISE TESTING CAN SERVE AS A POWERFUL PHYSIOLOGIC PROBE TO UNMASK SUBCLINICAL CARDIOVASCULAR ABNORMALITIES WELL BEFORE DISEASE ONSET. FOR EXAMPLE, BLOOD PRESSURE CHANGES DURING EXERCISE (EBP) CAN REVEAL A LATENT TENDENCY TOWARD FUTURE DEVELOPMENT OF HYPERTENSION. AT PRESENT, THERE IS NO RELIABLE CIRCULATING BIOMARKERA PROTEIN OR OTHER MOLECULE PRESENT IN THE BLOOD STREAMINDICATIVE OF FUTURE RISK OF HYPERTENSION.INVESTIGATORS AT BIDMC IDENTIFIED UNIQUE CIRCULATING PROTEINS THAT REFLECT EBP AND THAT MAY, IN TURN, BE EARLY INDICATORS OF FUTURE RISK OF HYPERTENSION. LED BY ROBERT E. GERSZTEN, MD, DIRECTOR OF BIDMC'S NATIONALLY RECOGNIZED PROGRAM IN PERSONAL GENOMICS AND CARDIOMETABOLIC DISEASE, JEREMY ROBBINS, MD, AND MARK SARZYNSKI, PHD, THE SCIENTISTS PERFORMED LARGE-SCALE PROTEOMIC PROFILING AND EBP MEASUREMENTS AMONG 681 HEALTHY ADULTS WHO UNDERWENT CARDIOPULMONARY EXERCISE TESTING BEFORE AND AFTER 20 WEEKS OF ENDURANCE EXERCISE TRAINING.THE STUDY TEAM, INCLUDING LEAD AUTHOR PRASHANT RAO, MBBS, IDENTIFIED 37 PROTEINS ASSOCIATED WITH EBP, MANY OF WHICH WOULD NOT HAVE BEEN IDENTIFIED THROUGH PROFILING RESTING BP ALONE. SEVERAL OF THESE PROTEINS WERE RELEVANT TO VASCULAR BIOLOGY.THE INVESTIGATORS DEMONSTRATED THAT THE EBP-ASSOCIATED PLASMA PROTEIN KNOWN AS TGFBR3 IS A NOVEL CIRCULATING BIOMARKER ASSOCIATED WITH A LOWER RISK OF INCIDENT HYPERTENSION. GENETICALLY PREDICTED LEVELS OF THIS PLASMA PROTEIN WERE INVERSELY ASSOCIATED WITH FUTURE HYPERTENSION RISK IN A DIVERSE POPULATION AND MAY PROTECT AGAINST THE DEVELOPMENT OF CVD. THIS WORK MAY HELP IN DETERMINING WHICH PATIENTS MIGHT BENEFIT FROM EARLY CLINICAL INTERVENTIONS TO REDUCE THE IMPACT OF CARDIOVASCULAR DISEASE.7.. DYNAMIC DUO: COMBINING CHOLESTEROL-LOWERING STATINS WITH EXISTING CANCER DRUG SHOWS POTENT EFFECT AGAINST AGGRESSIVE SUBTYPE OF BREAST CANCER IN PRE-CLINICAL MODELSIN A NEW TRANSLATIONAL RESEARCH STUDY, INVESTIGATORS AT BIDMC EXPLORED THE POTENTIAL OF STATINS COMMONLY USED MEDICATIONS FOR MANAGING CHOLESTEROL LEVELS TO WORK IN CONJUNCTION WITH AKT INHIBITORS, A CLASS OF DRUGS THAT TARGET A KEY PATHWAY INVOLVED IN CANCER CELL SURVIVAL AND GROWTH. RESEARCHERS DISCOVERED THAT THIS DRUG COMBINATION POTENTLY KILLED TRIPLE NEGATIVE BREAST CANCER (TNBC) CELLS IN PRECLINICAL MODELS. THE FINDINGS SUGGEST THE DRUG COMBINATION MAY PROVIDE A NEW, EFFECTIVE TREATMENT FOR TNBC, A SUBTYPE OF BREAST CANCER KNOWN FOR ITS AGGRESSIVENESS AND LIMITED TREATMENT OPTIONS AND THAT AFFECTS UP TO 15 PERCENT OF BREAST CANCER PATIENTS.THE BIDMC INVESTIGATORS AND THEIR COLLEAGUES USED A CRISPR-BASED SCREENING APPROACH IN TNBC TO IDENTIFY GENES THAT COULD BE TARGETED IN COMBINATION WITH A RECENTLY FDA-APPROVED AKT-INHIBITOR CALLED CAPIVASERTIB. THE SCREEN IDENTIFIED GENES IN CHOLESTEROL METABOLISM AS CANDIDATES, REVEALING A TNBC-SPECIFIC VULNERABILITY TO THE COMBINATION OF STATINSCHOLESTEROL-LOWERING DRUGS THAT TARGET CELLS' CHOLESTEROL METABOLISMAND AKT INHIBITORS.AS THE SCIENTISTS EXPECTED, THE COMBINATION KILLED TNBC CELLS IN A PANEL OF CELL LINES, PATIENT-DERIVED ORGANOIDS AND MOUSE MODELS. THE FINDINGS PAVE THE WAY FOR CLINICAL TRIALS TO DETERMINE THE SAFETY AND EFFECTIVENESS OF THIS COMBINATION IN PATIENTS. IF SUCCESSFUL, THIS BASIC, DISCOVERY SCIENCE APPROACH COULD LEAD TO A NEW TREATMENT OPTION FOR PATIENTS WITH TNBC, PROVIDING A MUCH-NEEDED ADVANCEMENT IN THE FIGHT AGAINST THIS AGGRESSIVE CANCER.
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RESEARCH AT JOSLIN DIABETES CENTER
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THE JOSLIN DIABETES CENTER (JDC), IN CONJUNCTION WITH ITS AFFILIATE THE JOSLIN CLINIC, PROVIDES WORLD CLASS LEADING EDGE PATIENT CARE IN THE SPECIALTY AREA OF DIABETES AND CARING FOR PATIENTS THROUGH A RELENTLESS TEAM OF CLINICIANS, SKILLED HEALTH EDUCATORS, AND ACCESS TO PIONEERING DIABETES RESEARCH. JOSLIN IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND OFFERS A RICH EDUCATIONAL ENVIRONMENT INVOLVING COURSES, LECTURES, FELLOWSHIP OPPORTUNITIES AND CME COURSES. JDC ALSO PROVIDES INFRASTRUCTURE, MANAGEMENT AND SUPPORT SERVICES TO ITS AFFILIATE, THE JOSLIN CLINIC. IN ADDITION, JOSLIN'S MISSION IS NOT ONLY TO PROVIDE OUTSTANDING PATIENT CARE, BUT ALSO TO BRING BEST PRACTICES TO THE LARGER MEDICAL COMMUNITY. JOSLIN ENGAGES IN RESEARCH RELATED TO BETTER UNDERSTANDING DIABETES, HOW TO TREAT IT AND HOW TO HELP PATIENTS MANAGE AND LIVE HEALTHIER LIVES WITH THE DISEASE. JOSLIN DIABETES RESEARCH CENTER IS ONE OF ONLY 16 NIH-DESIGNATED DIABETES RESEARCH CENTERS IN THE UNITED STATES. JOSLIN'S RESEARCH TEAM IS WORLD-RENOWNED AND PASSIONATE ABOUT IMPROVING THE LIVES OF PEOPLE WITH DIABETESMILLIONS OF PEOPLE WITH DIABETES THROUGHOUT THE WORLD BENEFIT DIRECTLY FROM BASIC AND CLINICAL RESEARCH CONDUCTED AT THE CENTER. APPROXIMATELY 300 RESEARCHERS EMPLOYED AT THE JOSLIN DIABETES CENTER ARE WORKING ON VARIOUS ASPECTS OF DIABETES, SEARCHING FOR WAYS TO PREVENT AND TREAT DIABETES IN ALL ITS FORMS AND ULTIMATELY FIND A CURE FOR THE DISEASE.THE RESEARCH ENGAGED IN AT JDC HELPS IMPROVES THE LIVES AT JDC, ACROSS BILH AND IN THE WIDER COMMUNITY BEYOND EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE COMMUNITIES. AS NOTED ABOVE RELATED TO BIDMC, ALTHOUGH JOSLIN'S RESEARCH ACTIVITIES ARE NOT QUANTIFIED HERE IN THIS HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY THIS HOSPITAL, ALL OF BILH AND BEYOND. SOME EXAMPLES OF RESEARCH ENGAGED IN BY JOSLIN DURING THE PERIOD COVERED BY THIS FILING ARE BELOW. 1. MORE THAN HALF OF PATIENTS WITH VISION-THREATENING CONDITION UNAWARE THEY HAVE ITA LONG-RUNNING STUDY OF 27,000 PEOPLE WITH DIABETES SUGGESTS THERE'S A MAJOR COMMUNICATION GAP BETWEEN PATIENTS AND THEIR EYE CARE PROVIDERS. IN A TEN-YEAR OBSERVATIONAL STUDY, INVESTIGATORS AT JOSLIN DIABETES CENTER ASSESSED THE SELF-REPORTED AWARENESS OF THE PRESENCE OF DIABETIC RETINOPATHYA SERIOUS COMPLICATION OF BOTH TYPE 1 AND TYPE 2 DIABETESIN 26,876 PATIENTS WITH DIABETES WHO UNDERWENT RETINAL IMAGING DURING AN ENDOCRINOLOGY VISIT. THESE PARTICIPANTS WERE NOT RECEIVING EYE CARE AT JOSLIN.WITH PREVIOUS DIAGNOSTIC INFORMATION AVAILABLE FOR MORE THAN 94 PERCENT OF PARTICIPANTS, THE INVESTIGATORS FOUND SUBSTANTIAL DISCREPANCIESWHAT THEY CALL "LOW CONCORDANCE"BETWEEN PARTICIPANTS' CURRENT EYE HEALTH STATUS AND THEIR SELF-REPORTED EYE HEALTH. WHILE NEARLY ALL PATIENTS WITHOUT DIABETIC RETINOPATHY REPORTED NOT HAVING ANY EYE DISEASE, 89 PERCENT OF PATIENTS WITH MILD CASES AND 55 PERCENT OF PATIENTS WITH VISION-THREATENING DIABETIC RETINOPATHY ALSO REPORTED THAT THEY WERE UNAWARE OF ANY EYE DISEASE. A QUARTER OF THOSE WITH VISION-THREATENING DISEASE ALSO DID NOT REPORT PLANNED FOLLOWUP IN ACCORDANCE WITH NATIONAL GUIDELINES.INCREASING AWARENESS OF DIABETIC RETINOPATHY WAS LINKED TO INCREASING EYE CARE PROVIDER SPECIALIZATION. AMONG THOSE WITH VISION-THREATENING DIABETIC RETINOPATHY, PATIENTS WHO SAW A RETINA PHYSICIAN HAD HIGHEST AWARENESS OF THEIR DIABETIC RETINOPATHY AND THE HIGHEST CONCORDANCE WITH FOLLOW UP.2. PREVENTING BETA CELL DYSFUNCTIONDIABETES RESULTS FROM FAILURE OF BETA () CELLS IN PANCREATIC ISLETS TO RELEASE SUFFICIENT INSULIN TO REGULATE BLOOD SUGAR IN THE BODY. RESEARCHERS AT JOSLIN DIABETES CENTER REVEALED THAT THE CHRONICALLY HIGH SUGAR LEVELS THAT OCCUR EARLY DURING THE DEVELOPMENT OF DIABETES FURTHER UNDERMINE THE ABILITY OF BETA CELLS TO PRODUCE INSULIN BY REDUCING TRANSLATION OF SPECIFIC MRNAS THAT CONTAIN THE CELL'S GENETIC INSTRUCTIONS FOR MAKING AND SECRETING INSULIN. BLOCKING THIS RESPONSE TO HIGH SUGAR LEVELS COULD BE A NEW WAY TO PREVENT PROGRESSION OF EARLY DIABETES OR EVEN AN EFFECTIVE STRATEGY TO IMPROVE THE FUNCTION OF BETA CELLS IMPLANTED IN PATIENTS TO CURE DIABETES.THE TEAM LOOKED AT THE IMPACT OF SUSTAINED ELEVATED GLUCOSE LEVELS ON CELL MRNA TRANSLATION ACROSS THE ENTIRE GENOME USING HIGH-THROUGHPUT RIBOSOME PROFILING AND NASCENT PROTEOMICS IN MIN6 INSULINOMA CELLS AND THEN VERIFIED SPECIFIC CHANGES IN HUMAN ISLETS. THEY DEMONSTRATED THAT SUSTAINED HIGH GLUCOSE SELECTIVELY IMPAIRS TRANSLATION OF GENES THAT SERVE CRITICAL ROLES AT ALMOST EVERY STEP OF GLUCOSE METABOLISMCOUPLED INSULIN SECRETION IN PANCREATIC CELLS.THE RESEARCH UNCOVERED A TRANSLATIONAL REGULATORY CIRCUIT DURING CELL GLUCOSE TOXICITY THAT IMPAIRS EXPRESSION OF PROTEINS WITH CRITICAL ROLES IN CELL FUNCTION THAT MAY BE LEVERAGED TO DEVELOP NEW THERAPEUTIC STRATEGIES FOR THE TREATMENT OF DIABETES. 3. STUDY COMPARES THE EFFECTS OF BARIATRIC SURGERY VERSUS MEDICAL MANAGEMENT FOR PEOPLE WITH TYPE 2 DIABETES A LANDMARK STUDY CONDUCTED AT FOUR SITES, INCLUDING JOSLIN DIABETES CENTER, REPORTS THAT PEOPLE WITH TYPE 2 DIABETES WHO UNDERWENT BARIATRIC SURGERY ACHIEVED BETTER LONG-TERM BLOOD GLUCOSE CONTROL COMPARED TO PEOPLE WHO RECEIVED MEDICAL MANAGEMENT PLUS LIFESTYLE INTERVENTIONS. PARTICIPANTS WHO UNDERWENT BARIATRIC SURGERY, ALSO CALLED METABOLIC OR WEIGHT-LOSS SURGERY, WERE ALSO MORE LIKELY TO STOP NEEDING DIABETES MEDICATIONS AND HAD HIGHER RATES OF DIABETES REMISSION UP TO 12 YEARS POST-SURGERY. THE FINDINGS, PUBLISHED IN JAMA, SUGGEST THAT WEIGHT LOSS SURGERY MAY CARRY BENEFITS FOR PEOPLE WITH DIABETES, EVEN THOSE WHO ARE BELOW THE TRADITIONAL BMI THRESHOLD OF 35 FOR BARIATRIC SURGERY. AMONG THE FINDINGS, THE STUDY SHOWED THAT: THE SURGERY GROUP EXPERIENCED AN AVERAGE 20 PERCENT WEIGHT LOSS COMPARED TO 8 PERCENT IN THE MEDICAL/LIFESTYLE GROUP. THE PERCENT OF PARTICIPANTS USING MEDICATIONS TO TREAT DIABETES IN THE SURGERY GROUP DECREASED FROM 98 PERCENT TO 61 PERCENT YET REMAINED LARGELY UNCHANGED IN THE MEDICATION/LIFESTYLE GROUP. 18 PERCENT OF PARTICIPANTS IN THE SURGERY GROUP WERE IN REMISSIONMEANING THEY NO LONGER REQUIRED MEDICATIONS TO CONTROL THEIR BLOOD GLUCOSE LEVELSFROM DIABETES, COMPARED TO 6 PERCENT OF PARTICIPANTS IN THE MEDICATION/LIFESTYLE GROUP. THE RESULTS AND DIFFERENCES BETWEEN GROUPS REMAINED SIGNIFICANT AT 12 YEARS."WHEN WE TREAT DIABETES, WE'RE REALLY TRYING TO PREVENT COMPLICATIONS LIKE HEART DISEASE, KIDNEY DISEASE, STROKE, NERVE DAMAGE AND EYE DAMAGE," SAID SITE PI M. E. PATTI, ENDOCRINOLOGIST IN THE ADULT DIABETES SECTION, AND DIRECTOR OF THE HYPOGLYCEMIA CLINIC AT JOSLIN DIABETES CENTER. "WE AREN'T JUST LOOKING TO REDUCE BODY WEIGHT, WE ALSO WANT TO IMPROVE OVERALL HEALTH. THIS RANDOMIZED STUDY IS AN IMPORTANT MILESTONE SHOWING SURGERY PROVIDES SUSTAINED IMPROVEMENTS IN DIABETES CONTROL."4. SHIFTING FOCUS: INVESTIGATORS DESCRIBE CHANGES TO PANCREATIC CELL AT ONSET OF TYPE 1 DIABETESABOUT EIGHT MILLION PEOPLE LIVE WITH TYPE 1 DIABETES (T1D) WORLDWIDE, A CHRONIC AUTOIMMUNE CONDITION IN WHICH THE BODY ATTACKS AND DESTROYS ITS OWN INSULIN-PRODUCING -CELLS (PRONOUNCED "BETA") IN THE PANCREAS, LEADING TO A LACK OF INSULIN AND INABILITY TO REGULATE BLOOD SUGAR. IT'S NOT KNOWN WHY THE BODY SUDDENLY PERCEIVES ITS OWN -CELLS AS THE ENEMY; SOME LINES OF EVIDENCE SUGGEST ENVIRONMENTAL FACTORS SUCH AS VIRAL INFECTIONS MAY TRIGGER THE ONSET OF T1D, OTHERS SUGGEST GENETICS MAY ALSO PLAY SOME ROLE.GROUNDBREAKING RESEARCH BY INVESTIGATORS AT JOSLIN DIABETES CENTER SHEDS NEW LIGHT ON THE SPECIFIC CHANGES -CELLS GO THROUGH AT THE ONSET OF T1D. THEIR FINDINGSPUBLISHED IN NATURE CELL BIOLOGYOFFER NEW AVENUES FOR TARGETED INTERVENTIONS FOR THE CHRONIC AUTOIMMUNE CONDITION."IN THE FIELD OF TYPE 1 DIABETES, RESEARCH HAS LARGELY FOCUSED ON UNDERSTANDING THE IMMUNE COMPONENT, BUT OUR STUDY ARGUES THAT THE -CELL IS A SIGNIFICANT PLAYER," SAID ROHIT N. KULKARNI, MD, PHD, MARGARET A. CONGLETON CHAIR AND CO-HEAD OF THE SECTION ON ISLET & REGENERATIVE BIOLOGY AT JOSLIN DIABETES CENTER. "OUR FINDINGS SUGGEST THAT THE -CELL COULD BE INITIATING KEY EVENTS WHICH THEN PROMOTE THE AUTOIMMUNE MECHANISM TO GO AWRY. IT'S A PARADIGM SHIFTING APPROACH."
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5. JOSLIN EXPERTS' PILOT STUDY SHOWS HYBRID CARE LEADS TO BETTER OUTCOMES FO
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FOR MOST YOUNG PEOPLE, LEAVING HOME AND LIVING INDEPENDENTLY FOR THE FIRST TIME MEANS SUDDENLY HAVING TO MANAGE THEIR OWN HEALTH, FROM SCHEDULING REGULAR DOCTOR APPOINTMENTS TO PREPARING HEALTHY MEALS. FOR YOUNG ADULTS WITH TYPE 1 DIABETES (T1D) WHO MUST MANAGE THEIR BLOOD SUGAR LEVELS 24/7 ON THEIR OWN, THE STAKES ARE ESPECIALLY HIGH. EVIDENCE SUGGESTS YOUNG ADULTS WITH T1D WITH SUBOPTIMAL GLYCEMIC CONTROL ARE AT HIGH RISK OF HOSPITALIZATION AND LONG-TERM COMPLICATIONS.TO ADDRESS MANY OF THE CHALLENGES TO DIABETES MANAGEMENT FACED BY YOUNG ADULTS WITH T1D, RESEARCHERS AT JOSLIN DIABETES CENTER DEVELOPED A PROGRAM THAT LEVERAGES TELEHEALTH AND PROVIDES SUPPORT FROM DEDICATED CASE MANAGERS WHO SERVE AS LIAISONS BETWEEN PATIENTS AND THEIR CARE TEAMS. IN A PAPER PUBLISHED IN ENDOCRINE PRACTICE, THE RESEARCHERS REPORTED THAT THEIR PILOT PROGRAM, KNOWN AS LEVERAGING INTENSIVE FOLLOW-UP TREATMENT IN YOUNG ADULTS (LIFT-YA) WAS ASSOCIATED WITH IMPROVED GLYCEMIC CONTROL AND AN INCREASE IN ADOPTION OF CONTINUOUS GLUCOSE MONITORS (CGM)TWO KEYS TO IMPROVED OUTCOMES FOR YOUNG ADULTS WITH DIABETES.AT THE END OF THE PILOT STUDY, THE RESEARCHERS COMPARED OUTCOMES OF THOSE ABLE TO COMPLETE THE PROGRAM AND THOSE ABLE TO ATTEND FEWER THAN HALF THE MEETINGS, AS WELL AS 33 PEOPLE WHO DID NOT PARTICIPATE. AS EXPECTED, THE "COMPLETERS" HAD A SIGNIFICANTLY HIGHER NUMBER OF TOTAL VISITS THAN THE OTHER TWO GROUPS.SIMILARLY, THE NUMBER OF CGM USERS INCREASED DRAMATICALLY BY 70 PERCENT AMONG THE COMPLETERS BUT REMAINED UNCHANGED IN THE OTHER TWO GROUPS. LIKEWISE, THE COMPLETERS SAW SIGNIFICANT REDUCTION IN THEIR HBA1C LEVELS, A MEASURE OF BLOOD SUGAR, WITHIN THEIR GROUP. "WE BELIEVE THE EFFORTS OF THE CASE MANAGERS TO OVERCOME OPERATIONAL HURDLES AND OTHER CLINICAL CHALLENGES BY COORDINATING EFFECTIVE COMMUNICATION BETWEEN PARTICIPANTS AND THE MULTIDISCIPLINARY CARE TEAM WERE PART OF THE REASON WE SAW THESE POSITIVE OUTCOMES," TOSCHI SAID. "LEVERAGING FREQUENT TELEHEALTH-BASED VISITS AND THE ANCHORING ROLE OF THE CASE MANAGERS PROVIDED ACTIONABLE SOLUTIONS FOR AT LEAST SOME OF THE SELF-REPORTED BARRIERS TO DIABETES CARE IN YOUNG ADULTS WITH T1D.SELECTED JOSLIN PUBLICATIONS FYE 9/30/24HYBRID CARE MODEL: COMBINING TELEMEDICINE AND OFFICE VISITS FOR DIABETES MANAGEMENT IN OLDER ADULTS WITH TYPE 1 DIABETESMED RES ARCH / SEP 30 2024BILH AUTHORS ELENA TOSCHI, ATIF ADAM, REBECCA HURLBERT, CHRISTINE SLYNE, LORI LAFFEL, MEDHA MUNSHI ROLE OF DIVALENT CATIONS IN INFECTIONS IN HOST-PATHOGEN INTERACTIONINT J MOL SCI / SEP 10 2024BILH AUTHORS JOHN A D'ELIA, LARRY A WEINRAUCHCHARACTERIZING VASCULAR WALL AND LUMEN CALIBER IN EYES WITH DIABETIC RETINOPATHY BASED ON ADAPTIVE OPTICS SCANNING LASER OPHTHALMOSCOPYDIAGNOSTICS (BASEL) / SEP 12 2024BILH AUTHORS KONSTANTINA SAMPANI, JENNIFER K SUNCAN INTRANASAL NALOXONE PREVENT HYPOGLYCEMIA-ASSOCIATED AUTONOMIC FAILURE?J CLIN ENDOCRINOL METAB / SEP 27 2024BILH AUTHORS HAMAYLE SAEED, MARY-ELIZABETH PATTIM6A MRNA METHYLATION BY METTL14 REGULATES EARLY PANCREATIC CELL DIFFERENTIATIONEMBO J / SEP 25 2024BILH AUTHORS SEVIM KAHRAMAN, DARIO F DE JESUS, NATALIE K BROWN, JIANG HU, ROHIT N KULKARNIEXERCISE ACTIVATES AMPK IN MOUSE AND HUMAN PANCREATIC ISLETS TO DECREASE SENESCENCENAT METAB / SEP 24 2024BILH AUTHORS PRISCILA CARAPETO, KANAKO IWASAKI, FRANCESKO HELA, JIHO KAHNG, ANA B ALVES-WAGNER, ROELAND J W MIDDELBEEK, MICHAEL F HIRSHMAN, LAURIE J GOODYEAR, CRISTINA AGUAYO-MAZZUCATOPOSTPRANDIAL METABOLOMICS ANALYSIS REVEALS DISORDERED SEROTONIN METABOLISM IN POST-BARIATRIC HYPOGLYCEMIAJ CLIN INVEST / SEP 12 2024BILH AUTHORS RAFAEL FERRAZ-BANNITZ, BERKCAN OZTURK, CAMERON CUMMINGS, VISSARION EFTHYMIOU, PILAR CASANOVA QUEROL, LINDSAY POULOS, HANNA WANG, VALERIE NAVARRETE, HAMAYLE SAEED, CHRISTOPHER M MULLA, HUI PAN, JONATHAN M DREYFUSS, MARY-ELIZABETH PATTI CIRCULATING METABOLITE BIOMARKERS OF GLYCEMIC CONTROL IN YOUTH-ONSET TYPE 2 DIABETESJAMA OPHTHALMOL / SEP 1 2024BILH AUTHORS CHANG LU, JONATHAN M DREYFUSS, SHUNING ZHENG, DANIELLE WOLFS, ELVIRA ISGANAITISULTRA-WIDEFIELD AND EARLY TREATMENT DIABETIC RETINOPATHY STUDY 7-FIELD GRADING OF DIABETIC RETINOPATHYJAMA OPHTHALMOL / SEP 2 2024BILH AUTHORS LLOYD PAUL AIELLO, JENNIFER K SUNASSESSMENT OF BASELINE ULTRAWIDEFIELD FLUORESCEIN ANGIOGRAPHIC QUANTITATIVE LEAKAGE PARAMETERS WITH ULTRAWIDEFIELD FUNDUS FEATURES AND CLINICAL PARAMETERS IN DIABETIC RETINOPATHY IN PROTOCOL AAOPHTHALMOL RETINA / AUG 30 2024BILH AUTHORS JENNIFER K SUNNEURODEGENERATIVE BIOMARKERS IN DIFFERENT CHAMBERS OF THE EYE RELATIVE TO PLASMA: AN AGREEMENT VALIDATION STUDYALZHEIMERS RES THER / AUG 26 2024BILH AUTHORS KONSTANTINA SAMPANIWHAT REALLY MATTERS?: HOW INSULIN DOSE, TIMING, AND DISTRIBUTION RELATE TO MEAL COMPOSITION IN FREE-LIVING PEOPLE WITH TYPE 1 DIABETESDIABETES TECHNOL THER / AUG 22 2024BILH AUTHORS ELENA TOSCHI, ASTRID ATAKOV-CASTILLO ENDOTHELIN 3/EDNRB SIGNALING INDUCES THERMOGENIC DIFFERENTIATION OF WHITE ADIPOSE TISSUENAT COMMUN / AUG 22 2024BILH AUTHORS CHIH-HAO WANG, TADATAKA TSUJI, TIAN LIAN HUANG, MARI SATO, FARNAZ SHAMSI, YU-HUA TSENGSCREENDMT REVEALS DIHOMES ARE REPLICABLY INVERSELY ASSOCIATED WITH BMI AND STIMULATE ADIPOCYTE CALCIUM INFLUXCOMMUN BIOL / AUG 14 2024BILH AUTHORS JONATHAN M DREYFUSS, HUI PAN LIGHT-RESPONSIVE ADIPOSE-HYPOTHALAMUS AXIS CONTROLS METABOLIC REGULATIONNAT COMMUN / AUG 8 2024BILH AUTHORS TADATAKA TSUJI, YANG ZHANG, TIAN LIAN HUANG, HENRIQUE CAMARA, MEGHAN HALPIN, MATTHEW D LYNESMATRISOME PROTEOMICS REVEALS NOVEL MEDIATORS OF MUSCLE REMODELING WITH AEROBIC EXERCISE TRAININGMATRIX BIOL PLUS / AUG 7 2024BILH AUTHORS PATTARAWAN PATTAMAPRAPANONT, EILEEN M COONEY, TARA L MACDONALD, HUI PAN, JONATHAN M DREYFUSS, SARAH J LESSARDLIGNAN INTAKE AND TYPE 2 DIABETES INCIDENCE AMONG US MEN AND WOMENJAMA NETW OPEN / AUG 1 2024BILH AUTHORS QI SUNEVERYTHING YOU WANTED TO KNOW ABOUT PANCREATIC DUCTS BUT DIDN'T KNOW WHERE TO LOOKGASTROENTEROLOGY / JUL 31 2024BILH AUTHORS ROHIT KULKARNIFENOFIBRATE SHOWS PROMISE IN SLOWING DIABETIC RETINOPATHY PROGRESSIONNEJM EVID / JUL 23 2024BILH AUTHORS PAOLO S SILVA, LLOYD PAUL AIELLOTHE ARDUOUS PATH TOWARD EQUITABLE ACCESS TO ENDOCRINOLOGY CAREJ ENDOCR SOC / JUL 15 2024BILH AUTHORS GIULIO R ROMEO, TIZIANA CAPUTOEXPRESSION PROFILING BY HIGH-THROUGHPUT SEQUENCING REVEALS GADD45, SMAD7, EGR-1 AND HOXA3 ACTIVATION IN MYOSTATIN (MSTN) AND GDF11 TREATED MYOBLASTSGENET MOL BIOL / JUL 15 2024BILH AUTHORS AMY J WAGERSEXERCISE TRAINING AND COLD EXPOSURE TRIGGER DISTINCT MOLECULAR ADAPTATIONS TO INGUINAL WHITE ADIPOSE TISSUECELL REP / JUL 13 2024BILH AUTHORS MARIA VAMVINI, PASQUALE NIGRO, TIZIANA CAPUTO, KRISTIN I STANFORD, MICHAEL F HIRSHMAN, ROELAND J W MIDDELBEEK, LAURIE J GOODYEARMULTI-STEP REGULATION OF MICRORNA EXPRESSION AND SECRETION INTO SMALL EXTRACELLULAR VESICLES BY INSULINCELL REP / JUL 13 2024BILH AUTHORS MARSEL LINO, RUBEN GARCIA-MARTIN, VITOR ROSETTO MUOZ, GABRIEL PALERMO RUIZ, ALLAH NAWAZ, BRUNA BRASIL BRANDO, JONATHAN DREYFUS, HUI PAN, C RONALD KAHNIMPACT OF A TUBELESS, DISPOSABLE INSULIN PUMP ON EMERGENCY DEPARTMENT VISITS AND INPATIENT ADMISSIONS AMONG A MEDICARE POPULATIONJ MANAG CARE SPEC PHARM / JUN 17 2024BILH AUTHORS MEDHA N MUNSHIRATIONALE OF BASIC AND CELLULAR MECHANISMS CONSIDERED IN UPDATING THE STAGING SYSTEM FOR DIABETIC RETINAL DISEASEOPHTHALMOL SCI / MAR 27 2024BILH AUTHORS WARD FICKWEILER, GEORGE KING, LLOYD PAUL AIELLO
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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AS NOTED THROUGHOUT THIS FORM 990, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH ANNA JAQUES HOSPITAL DOES NOT DIRECTLY ENGAGE IN HEALTH PROFESSIONS EDUCATION / GRADUATE MEDICAL EDUCATION, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND MOUNT AUBURN HOSPITAL ALL ENGAGE IN EDUCATIONAL ACTIVITIES DESIGNED TRAIN FUTURE PHYSICIANS AND OTHER FUTURE HEALTHCARE PRACTITIONERS. 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. ALTHOUGH THE EDUCATIONAL ACTIVITIES OF THESE BILH AFFILIATES ARE NOT QUANTIFIED HERE IN ANNA JAQUES HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7F, AS ALREADY NOTED THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL AND BEYOND. IN ADDITION, INFORMATION ON THE TEACHING ACTIVITIES AT BIDMC, A SISTER ENTITY TO ANNA JAQUES HOSPITAL, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 63 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 736 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 43 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 47 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS: ANESTHESIOLOGY EMERGENCY MEDICINE EAR, NOSE AND THROAT (OTOLARYNGOLOGY) INTERNAL MEDICINE NEUROLOGY NEUROSURGERY OBSTETRICS AND GYNECOLOGY PATHOLOGY PLASTIC SURGERY PSYCHIATRY RADIOLOGY SURGERY TRANSITIONAL YEAR UROLOGYRESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. MORE THAN HALF OF THESE PROGRAMS (47 OF 91) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS: ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA, ANESTHESIA MEDICAL EDUCATION, ADVANCED CRITICAL CARE AND ULTRASOUND DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS) EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, MEDICAL EDUCATION IN EMERGENCY MEDICINE INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY, NEURO CRITICAL CARE OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY, UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY. PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY PSYCHIATRY: EARLY PSYCHOSIS, CONSULT LIAISON PSYCHIATRY RADIOLOGY: DIAGNOSTIC, ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING (MSK), NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, ADVANCED CROSS-SECTIONAL IMAGING. RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, LYMPHATIC SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, OTOLARYNGOLOGY FELLOWSHIP, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATED, JOINTS FELLOWSHIPADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS -- EXAMPLESBELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:
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HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMC
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THE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HEALTH ALLIANCE, TUFTS MEDICAL CENTER, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL, SOUTH SHORE HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE. DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC. ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS.
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INTERNAL MEDICINE GLOBAL HEALTH PROGRAM
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OUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS.PROGRAM OBJECTIVES INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS CONTRIBUTE TO THE HEALTH AND WELL-BEING OF POPULATIONS AROUND THE WORLD ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS EXPAND RESEARCH OPPORTUNITIES ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH SITE LOCATIONS BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH. NEUROLOGY EDUCATION AT BIDMCTHE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. PATHOLOGY EDUCATION AT BIDMCTHE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING.
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RADIOLOGY EDUCATION AT BIDMC
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THE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE: THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR. FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR. ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.OUR UNIQUE EDUCATIONAL TRACKSCURRENTLY, SIX TRACKS ARE OFFERED: CLINICAL EDUCATION RESEARCH GLOBAL HEALTH QUALITY IMPROVEMENT HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.SURGERY EDUCATION AT BIDMCTHE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, NEUROSURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, UROLOGY, AND VASCULAR SURGERY. RESIDENTS AND FELLOWS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. RESIDENTS AND FELLOWS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE: RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.
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IRC 501(R) REPORTING UNDER REVENUE PROCEDURE 2015-21:
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DURING A REVIEW OF ANNA JAQUES 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. ANNA JAQUES 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)AS NOTED THROUGHOUT THIS FORM 990, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.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.
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BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES
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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. NON-HOSPITAL PHYSICIAN CARE: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:
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ENHANCING THE BILHPN OPERATING MODEL
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BILH 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.EDUCATION AND AWARENESS EFFORTS TO PROMOTE ACCESS TO CAREIN 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.