TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) ROWAN MICHAEL...................................................................... TTEE(EXO)(CEO DESIG)EVP HOS&AMB BILH	1.00 ................. 64.00	X		0	2,302,117	2,401,778
(2) SHORETT PETER...................................................................... TTEE(CEO DESIG) (SR EVP & COO, BILH)	1.00 ................. 64.00	X		0	1,559,476	48,246
(3) CAMPBELL RN MBA FACHE AL...................................................................... PRESIDENT & TRUSTEE (EX-OFFICIO)	55.00 ................. 2.00	X	X	574,948	0	2,802
(4) BRECKWOLDT MD WILLIAM...................................................................... TRUSTEE; GENERAL SURGEON	1.00 ................. 56.00	X		0	499,014	13,777
(5) MCALMON MD KAREN...................................................................... TRUSTEE; NEONATOLOGIST	1.00 ................. 56.00	X		0	381,368	111,297
(6) LUBIN MD ANDREW...................................................................... TTEE (EX-OFF) (PRES, MEDICAL STAFF)	1.00 ................. 56.00	X		0	343,820	48,268
(7) TAYLOR MD JOSEPH...................................................................... TTEE; PHYSICIAN, INTERNAL MEDICINE	1.00 ................. 56.00	X		0	204,619	39,075
(8) SMITH KEVIN F...................................................................... TRUSTEE & CHAIR	1.00 ................. 1.00	X	X	0	0	0
(9) TARBY III ESQ JOSEPH...................................................................... TRUSTEE & VICE CHAIR	1.00 ................. 1.00	X	X	0	0	0
(10) CARUCCI DEAN...................................................................... TTEE (EXO) (BILH DIV PRES COMMUNITY)	1.00 ................. 12.00	X		0	0	0
(11) DEERING DIANA...................................................................... TTEE (EX-OFF) (PRES, WINSTON CLUB)	1.00 ................. 1.00	X		0	0	0
(12) DEROSA CINDY...................................................................... TTEE (PRES, FRIENDS WINCHESTER HOSP)	1.00 ................. 1.00	X		0	0	0
(13) DUBROW MD JOHN...................................................................... TTEE (EX-OFF) (PRES, MEDICAL STAFF)	1.00 ................. 1.00	X		0	0	0
(14) FORTUNATO MD ROBERT...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(15) FULLER MD ARLAN...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(16) MANGANARO PAUL...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(17) MARTIGNETTI JOHN...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) MCCANCE WILLIAM........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(19) STOTT GABRIELLE........................................................................ TTEE (EX-OFF) (PRES, WINSTON CLUB)	1.00 .......................1.00	X					0	0	0
(20) THURLOW JULIEANN........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(21) YADAV SUJATA........................................................................ TRUSTEE	1.00 .......................1.00	X					0	0	0
(22) TABB MD KEVIN........................................................................ CEO (EX-OFF) (CEO, BILH)	1.00 .......................64.00		X				0	4,313,387	1,097,028
(23) RIOS CINDY........................................................................ TREAS (EX-OFF) (EXEC VP & CFO, BILH)	1.00 .......................64.00		X				0	1,471,427	217,736
(24) KATZ ESQ JAMIE........................................................................ CLERK (EX-OFF); GENERAL COUNSEL BILH	1.00 .......................64.00		X				0	1,270,175	32,002
(25) WOODS MATTHEW........................................................................ ASSTTREAS/CFO (INT DIV CFO,COMM BILH	1.00 .......................57.00		X				0	524,076	55,268
(26) GLASS ESQ HANNAH........................................................................ ASST CLERK (ASST GEN COUNSEL, BILH)	1.00 .......................57.00		X				0	107,113	6,138
(27) ZITKOVSKY MD DANA........................................................................ SENIOR VP AND CHIEF MEDICAL OFFICER	55.00 .......................0.00			X			517,389	0	49,282
(28) KEANEY MPAH RN ACHCE KAREN........................................................................ CNO AND VP OF PATIENT CARE SERVICES	55.00 .......................0.00			X			383,375	0	50,014
(29) ROBERTSON MPH CATHARINE........................................................................ VICE PRESIDENT, AMBULATORY SERVICES	55.00 .......................1.00			X			327,683	0	40,084
(30) TAYLOR ELIZABETH BETH........................................................................ EXEC DIR, HR BUSINESS PARTNER	55.00 .......................0.00			X			201,059	0	33,052
(31) SACHETTI NANCY........................................................................ DIRECTOR, HIGHLAND HEALTH	55.00 .......................0.00				X		260,816	0	38,378
(32) PARKER MD MARIANNA........................................................................ NEONATOLOGIST	55.00 .......................0.00				X		229,359	0	61,549
(33) GREGA JOANNE........................................................................ EXECUTIVE DIR, ANCILLARY SERVICES	55.00 .......................0.00				X		238,931	0	44,375
(34) LEVENSON HEATHER........................................................................ REGISTERED NURSE OBSTETRICS/DELIVERY	55.00 .......................0.00				X		206,077	0	44,823
(35) SORRENTINO RACHEL........................................................................ CLINICAL NURSE SUPERVISOR	55.00 .......................0.00				X		201,814	0	31,960
(36) WEINER MD RICHARD........................................................................ FRMR TTEE & PRES (EX-OFF)	0.00 .......................0.00					X	116,315	0	16,781
(37) SOMANI TUSHAR........................................................................ FRMR COO, WINCHESTER HOSPITAL	0.00 .......................0.00					X	407,609	0	388,055

(A) Name and business address	(B) Description of services	(C) Compensation
BETH ISRAEL LAHEY HEALTH INC 529 MAIN STREET CHARLESTOWN,MA02129	PROFESSIONAL & OTHER SERVICES	299,313,176
AMERISOURCEBERGEN DRUG CORP PO BOX 29808 NEW YORK,NY10087	PHARMACEUTICAL & HEALTHCARE SVCS	23,481,820
HEALTHCARE WORKFORCE LOGISTICS LLC 2655 NORTHWINDS PARKWAY ALPHARETTA,GA30009	STAFFING SERVICES	9,026,233
VARIAN MEDICAL SYSTEMS INC 700 HARRIS STREET CHARLOTTESVILLE,VA22903	MEDICAL EQUIP & SOFTWARE	4,111,943
US BANK TRUST CO NATIONAL ASSN 111 SW FIFTH AVENUE PORTLAND,OR97204	INVESTMENT MGMT SERVICES	3,815,875
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 119

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization WINCHESTER HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization WINCHESTER HOSPITAL		Employer identification number 04-2104434

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization WINCHESTER HOSPITAL			Employer identification number 04-2104434
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Yes

Media advertisements? ...................................................................................................

Yes

Mailings to members, legislators, or the public? .............................................................................

Yes

Publications, or published or broadcast statements? ...........................................................

Yes

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

73,943

Total. Add lines 1c through 1i ....................................................................................................

73,943

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	WINCHESTER HOSPITAL ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER NETWORK AFFILIATES AND/OR PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $73,943 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES.

Return Reference

Explanation

PART II-B, LINE 1:

WINCHESTER HOSPITAL ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER NETWORK AFFILIATES AND/OR PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $73,943 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	27,139,662	25,962,568	29,404,147	26,551,785	24,968,323
b	Contributions ...
c	Net investment earnings, gains, and losses	3,278,078	1,177,094	-3,441,579	2,852,362	1,583,462
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	30,417,740	27,139,662	25,962,568	29,404,147	26,551,785

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

68.000 %

Permanent endowment right arrow

32.000 %

Term endowment right arrow

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	16,524,129		16,524,129
b	Buildings ....	108,243,437	54,961,737	53,281,700
c	Leasehold improvements	10,257,314	7,953,107	2,304,207
d	Equipment ....	140,147,550	100,445,309	39,702,241
e	Other .....	9,106,284	3,801,727	5,304,557
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				117,116,834

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) INVESTMENTS - OTHER SECURITIES	64,093,382	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	64,093,382

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)OTHER RECEIVABLES				3,592,635
(2)OTHER CURRENT ASSETS				2,216,345
(3)DUE FROM AFFILIATES				74,302,113
(4)PROF LIABILITY INSURANCE RECOVERY				205,349
(5)ASSETS HELD IN PERPETUAL TRUSTS				5,277,690
(6)ASSET REVALUATION DUE TO AFFILIATE MERGER				11,331,200
(7)OPERATING LEASED ASSETS				9,584,841
(8)DEFERRED COMPENSATION				6,554,370
(9)DEPOSIT RECEIVABLE				5,419,942
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				118,484,485

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
OPERATING LEASED LIABILITIES	9,689,880
ASSET RETIREMENT OBLIGATIONS	709,813
ESTIMATED THIRD PARTY SETTLEMENTS	5,770,524
OTHER LIABILITIES	745,763
PROFESSIONAL LIABILITY RESERVES	4,384,374
WORKERS COMPENSATION	1,063,683
DEFERRED COMPENSATION	5,609


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	22,369,646
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART V, LINE 4:

WINCHESTER HOSPITAL ENDOWMENTS ARE FOR GENERAL HOSPITAL OPERATIONS.

PART X, LINE 2:

BETH ISRAEL LAHEY HEALTH, INC., WHICH SERVES AS THE PARENT OF THE SYSTEM, HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE AN ORGANIZATION DESCRIBED UNDER INTERNAL REVENUE CODE (THE "CODE") SECTION 501(C)(3) AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ALSO DETERMINED THAT THE OTHER ENTITIES IN THE SYSTEM, EXCLUDING ITS FOR-PROFIT SUBSIDIARIES, QUALIFY AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, MEET THE CODE'S REQUIREMENTS UNDER SECTION 509(A), AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION HAS BEEN RECORDED FOR INCOME TAXES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS FOR THE YEARS ENDED SEPTEMBER 30, 2024 AND 2023, RESPECTIVELY.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right arrow

Attach to Form 990. Right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in the region
	CENTRAL AMERICA AND THE CARIBBEAN			INVESTMENTS	9,777,383
	EUROPE (INCLUDING ICELAND & GREENLAND)			INVESTMENTS	13,483,345















3a	Sub-total ....	0	0		23,260,728
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		23,260,728

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2023

Schedule F (Form 990) 2023

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2023

Schedule F (Form 990) 2023Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2023

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2023

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation

Schedule F (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 40000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	4,270,365	921,380	3,348,985	0.920 %
b	Medicaid (from Worksheet 3, column a) . . . . .	6,191,882	4,782,073	1,409,809	0.390 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	10,462,247	5,703,453	4,758,794	1.310 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,104,325	357,541	746,784	0.200 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	70,619,288	55,634,862	14,984,426	4.100 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	254,621	0	254,621	0.070 %
j	Total. Other Benefits . .	71,978,234	55,992,403	15,985,831	4.370 %
k	Total. Add lines 7d and 7j .	82,440,481	61,695,856	20,744,625	5.680 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development			26,524		26,524	0.010 %
9	Other
10	Total			26,524		26,524	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,764,577

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

87,188,755

Enter Medicare allowable costs of care relating to payments on line 5.....

95,561,781

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-8,373,026

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	WINCHESTER HOSPITAL 41 HIGHLAND AVENUE WINCHESTER,MA01890 WWW.WINCHESTERHOSPITAL.ORG	X

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	WINCHESTER HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART VI

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART VI

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	WINCHESTER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 400.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART VI

The FAP application form was widely available on a website (list url):

SEE PART VI

A plain language summary of the FAP was widely available on a website (list url):
SEE PART VI

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	WINCHESTER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	WINCHESTER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
WINCHESTER HOSPITAL	PART V, SECTION B, LINE 5: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
WINCHESTER HOSPITAL	PART V, SECTION B, LINE 11: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?15
Name and address		Type of Facility (describe)
1	1 - WINCHESTER HOSPITAL 1021 MAIN STREET WINCHESTER,MA02180	ADMIN OFFICES, BILLING, DOCTOR OFFICES
2	2 - WINCHESTER HOSPITAL 200 UNICORN DRIVE WOBURN,MA01801	COMMUNITY HEALTH, MRI, BREAST CANCER CENTER
3	3 - WINCHESTER HOSPITAL 620 WASHINGTON STREET WINCHESTER,MA01801	RADIOLOGY/ONCOLOGY SERVICES FACILITY
4	4 - WINCHESTER HOSPITAL - BALDWIN PARK I 12 ALFRED STREET WOBURN,MA01801	COMMUNITY HEALTH INST., SLEEP CARE & ADMIN OFFICES
5	5 - WINCHESTER HOSPITAL - BALDWIN PARK II 7 ALFRED STREET WOBURN,MA01801	BREAST CARE, IMAGING HEMOTOLOGY/ONCOLOGY LAB, PHARMACY, CHIRO
6	6 - FAMILY MEDICAL SERVICES 500 SALEM STREET WILMINGTON,MA01887	AUDIOLOGY, OB/GYN, CARDIO-PUL, LAB, PT, URGENT CARE, PEDI
7	7 - WINCHESTER HOSPITAL RUSSELL HILL BUILDINGS 955 MAIN STREET WINCHESTER,MA01890	LAB, RADIOLOGY & PHYSICAL THERAPY
8	8 - READING HEALTH CENTER 20 POND MEADOW DRIVE READING,MA01867	LAB
9	9 - WINCHESTER HOSPITAL 75 RIVERSIDE AVENUE MEDFORD,MA02155	LAB, WEIGHT MGMT, WOUND CARE CENTER
10	10 - WINCHESTER HOSPITAL 10P COMMERCE WAY WOBURN,MA01801	ENDOSCOPY CENTER
11	11 - CHOATE MEDICAL CENTER 23 WARREN AVENUE WOBURN,MA01801	PHYSICAL THERAPY
12	12 - WINCHESTER HOSPITAL ORTHOPEDICS 20 POND MEADOW DRIVE READING,MA01867	LAB
13	13 - WINCHESTER HOSPITAL 75 RIVERSIDE AVENUE MEDFORD,MA02155	LAB, WEIGHT MGMT, WOUND CARE CENTER
14	14 - PAIN MANAGEMENT CENTER 444 WASHINGTON STREET WOBURN,MA01801	PAIN CLINIC CENTER
15	15 - WINCHESTER HOSPITAL RUSSELL HILL BUILDINGS 955 MAIN STREET WINCHESTER,MA01890	LAB, RADIOLOGY & PHYSICAL THERAPY

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE	H PART V, SECTION BWINCHESTER HOSPITAL AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF WINCHESTER 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.WINCHESTER HOSPITAL COMMUNITY BENEFITS MISSION STATEMENT WINCHESTER HOSPITAL'S MISSION IS "TO CARE. TO HEAL. TO EXCEL. IN SERVICE TO OUR COMMUNITY." THIS MISSION IS SUPPORTED BY THE HOSPITAL'S COMMITMENT TO PERSONALIZED, EXCELLENT CARE FOR PATIENTS; A WORKFORCE COMMITTED TO INDIVIDUAL ACCOUNTABILITY, MUTUAL RESPECT, AND COLLABORATION; AND A COMMITMENT TO MAINTAINING FINANCIAL HEALTH. WINCHESTER HOSPITAL IS ALSO COMMITTED TO BEING ACTIVE IN THE COMMUNITY. SERVICE TO COMMUNITY IS AT THE CORE OF WINCHESTER HOSPITAL'S MISSION. THE WINCHESTER HOSPITAL FOUNDERS MADE A COVENANT TO CARE FOR THE UNDERSERVED IN THE HOSPITAL'S SERVICE AREA, ATTEND TO UNMET NEEDS, AND ADDRESS DISPARITIES IN ACCESS TO CARE AND HEALTH OUTCOMES. WINCHESTER HOSPITAL'S COMMITMENT TO THIS COVENANT AND THE PEOPLE IT SERVES REMAINS STEADFAST TODAY. WINCHESTER HOSPITAL'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING WINCHESTER HOSPITAL'S 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 NEEDS AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, AND ECONOMIC FACTORS; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN WINCHESTER 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 A 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, WINCHESTER HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $1,001,405 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE WINCHESTER 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. WINCHESTER HOSPITAL'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF WINCHESTER HOSPITAL'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF THE WINCHESTER HOSPITAL'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. WINCHESTER HOSPITAL COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE DIRECTOR OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS. THE REGIONAL MANAGER OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE WINCHESTER 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 WINCHESTER HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH WINCHESTER HOSPITAL'S LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT WINCHESTER HOSPITAL'S COMMUNITY BENEFITS MISSION: TO BENEFIT ALL OF THE COMMUNITIES WE SERVE BY COLLABORATING WITH COMMUNITY PARTNERS TO IDENTIFY HEALTH NEEDS, IMPROVE THE HEALTH STATUS OF COMMUNITY RESIDENTS, ADDRESS HEALTH DISPARITIES, AND EDUCATE COMMUNITY MEMBERS ABOUT PREVENTION AND SELF-CARE. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF WINCHESTER HOSPITAL'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF WINCHESTER HOSPITAL'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF WINCHESTER HOSPITAL'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY WINCHESTER HOSPITAL'S PROGRAMMATIC ENDEAVORS.WINCHESTER HOSPITAL'S CBAC MEMBERS INCLUDE: AL CAMPBELL, PRESIDENT, WINCHESTER HOSPITAL KAREN MCALMON, WINCHESTER HOSPITAL NEONATOLOGIST AND BOARD OF TRUSTEES MEMBER SUSAN BIBBINS, MEDFORD DISABILITIES COMMISSION JESSIE BENCOSME, EXECUTIVE DIRECTOR, COUNCIL OF SOCIAL CONCERN ANGELINE BRADY, COMMUNITY HEALTH PROGRAMS SUPERVISOR, WINCHESTER HOSPITAL CENTER FOR HEALTHY LIVING DOT BUTLER, WINCHESTER SAFER COALITION CHRISTINE HEALEY, DIRECTOR OF COMMUNITY BENEFITS/COMMUNITY RELATIONS, BETH ISRAEL LAHEY HEALTH KAREN KEANEY, CHIEF NURSING OFFICER TERRI MARCIELLO, DIRECTOR OF ELDERLY SERVICES, WILMINGTON JENNIFER MURPHY, DIRECTOR OF HEALTH, WINCHESTER HEALTH DEPARTMENT JAIMIE BOWERS, INFORMATION AND REFERRALS BENEFITS SPECIALIST, MYSTIC VALLEY ELDER SERVICES SHARON RON, PUBLIC HEALTH PLANNER, METROPOLITAN AREA PLANNING COMMISSION ADAM ROGERS, EXECUTIVE DIRECTOR, BOYS & GIRLS CLUB OF STONEHAM & WAKEFIELD MAUREEN RYAN, ASSISTANT SUPERINTENDENT, WOBURN PUBLIC SCHOOLS JOSHUA SHEEHAN, WINCHESTER HOSPITAL PRIMARY CARE LEIGHANNE TAYLOR, REGIONAL MANAGER, COMMUNITY BENEFITS AND COMMUNITY RELATIONS WINCHESTER HOSPITAL CASEY TAYLOR, ADVOCATES MATTHEW WOODS, CHIEF FINANCIAL OFFICER, WINCHESTER HOSPITAL
COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY	MOST 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. WINCHESTER HOSPITAL COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE WINCHESTER HOSPITAL BOARD OF TRUSTEES ON SEPTEMBER 13, 2022.THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 13, 2022, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE CHNA AND THE ASSOCIATED IS REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF WINCHESTER 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 WINCHESTER HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW WINCHESTER HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.COMMUNITY HEALTH NEEDS ASSESSMENTPRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, WINCHESTER HOSPITAL COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF WINCHESTER HOSPITAL'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES NINE CITIES AND TOWNS: MEDFORD, NORTH READING, READING, STONEHAM, WAKEFIELD, WILMINGTON, WINCHESTER, WOBURN, AND TEWKSBURY.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR WINCHESTER 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).WINCHESTER 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 MEDFORD, NORTH READING, READING, STONEHAM, WAKEFIELD, WILMINGTON, WINCHESTER, WOBURN, AND TEWKSBURY AS FOLLOWS: YOUTH LOW-RESOURCED POPULATIONS OLDER ADULTS RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS; AND LGBTQIA+ COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSWINCHESTER 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 WINCHESTER HOSPITAL'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. WINCHESTER 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, WINCHESTER HOSPITAL CONDUCTED 21 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 800 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. IN TOTAL, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 1,000 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY PARTNERS.COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSWINCHESTER HOSPITAL RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. WINCHESTER 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 WINCHESTER HOSPITAL LEVERAGED INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020) U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020) U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021) BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2019) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) FBI UNIFORM CRIME REPORTS (2019) MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020) MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018) ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, WINCHESTER HOSPITAL WORKED WITH COLLABORATORS TO CONDUCT 21 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT WINCHESTER 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 WINCHESTER 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 WINCHESTER 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)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, WINCHESTER HOSPITAL FACILITATED THREE FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES; STONEHAM WAKEFIELD BOYS & GIRLS CLUB, MEDFORD COUNCIL ON AGING, AND A WOBURN PUBLIC SCHOOLS PARENTS' GROUP. IN ADDITION, WINCHESTER HOSPITAL ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 800 RESIDENTS AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. IN TOTAL, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 1,000 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY PARTNERS. WINCHESTER HOSPITAL HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF WINCHESTER HOSPITAL'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, COMMUNITY EVENTS AND LARGE APARTMENT BUILDINGS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE WINCHESTER 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 WINCHESTER HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS. IDENTIFY WINCHESTER HOSPITAL'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE WINCHESTER HOSPITAL'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY WINCHESTER 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 ENDING SEPTEMBER 30, 2022, WERE: YOUTH LOW-RESOURCED POPULATIONS LGBTQIA+ OLDER ADULTS RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONSWINCHESTER 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, 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 WINCHESTER HOSPITAL'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025.
COMMUNITY HEALTH NEEDS ASSESSMENT	MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEWINCHESTER HOSPITAL STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, WINCHESTER 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 WINCHESTER HOSPITAL WEBSITE AT:HTTPS://WINCHESTERHOSPITAL.ORG/-/MEDIA/FILES/WINCHESTER/WH-2022-COMMUNITY-HEALTH-NEEDS.PDF IN ADDITION TO THE CHNA, WINCHESTER 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 WINCHESTER HOSPITAL WEBSITE AT:HTTPS://WINCHESTERHOSPITAL.ORG/-/MEDIA/FILES/WINCHESTER/WH-2022-CHNA-IMPLEMENTATION-093022.PDFWINCHESTER HOSPITAL COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE WINCHESTER HOSPITAL WEBSITE AT: HTTPS://WINCHESTERHOSPITAL.ORG/-/MEDIA/FILES/WINCHESTER/WH-2019-CHNA-091319.PDFFINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING WINCHESTER HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE WINCHESTER HOSPITAL WEBSITE AT:HTTPS://WINCHESTERHOSPITAL.ORG/-/MEDIA/FILES/WINCHESTER/WH-IMPLEMENTATION-STRATEGY-2020-2022.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).
COMMUNITY HEALTH NEEDS ASSESSMENT	ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, WINCHESTER 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 WINCHESTER 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, WINCHESTER HOSPITAL HAS BEEN STRATEGIC IN IDENTIFYING ITS PRIORITY AREAS IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: MENTAL HEALTH AND SUBSTANCE USE DISORDER GOAL: ADDRESS THE PREVALENCE AND IMPACT, STIGMA, RISK/PROTECTIVE FACTORS, AND ACCESS ISSUES ASSOCIATED WITH MENTAL HEALTH AND SUBSTANCE USE DISORDER. PRIORITY AREA 2: CHRONIC COMPLEX CONDITIONS AND RISK FACTORS GOAL: PREVENT, DETECT, AND MANAGE CHRONIC DISEASE AND COMPLEX CONDITIONS AND ENHANCE ACCESS TO TREATMENT AND SUPPORT ACTIVITIES. PRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE GOAL: ADDRESS SOCIAL DETERMINANTS OF HEALTH AND BARRIERS TO CARE. COMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)WINCHESTER HOSPITAL HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES WINCHESTER HOSPITAL OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES AMONG THEIR FOCUS COHORTS THROUGHOUT THEIR PRIORITY CITIES AND TOWNS.WINCHESTER HOSPITAL SUPPORTS A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE METRO HOUSING BOSTON'S CO-LOCATION PROGRAM TO ADDRESS HOUSING STABILITY THROUGH RENTAL ASSISTANCE AND EVICTION PREVENTION SUPPORT FOR WINCHESTER HOSPITAL PATIENTS. IN FY23, FREE COUNSELING WAS PROVIDED TO 18 LOW- TO MODERATE-INCOME INDIVIDUALS AND FAMILIES TO PREVENT EVICTION, INCREASE HOUSING STABILITY AND ECONOMIC SELF-SUFFICIENCY, AND IMPROVE THEIR OVERALL QUALITY OF LIFE. COUNSELORS ALSO HELPED WITH HOUSING SEARCHES, EMERGENCY ASSISTANCE, RAPID REHOUSING, AND BENEFITS MAXIMIZATION, AND CONNECTED PARTICIPANTS TO COMMUNITY RESOURCES. TO FURTHER ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, WINCHESTER HOSPITAL IS COMMITTED TO ENSURING ACCESS TO AFFORDABLE, HEALTHY FOOD FOR PEOPLE OF ALL INCOME LEVELS. THIS WORK IS ACCOMPLISHED THROUGH SUPPORT OF A 20-WEEK ANNUAL FARMER'S MARKET AT WINCHESTER HOUSING AUTHORITY, WHICH SUPPLIED 3,200 POUNDS OF FRESH PRODUCE, INCLUDING MORE THAN SIX VARIETIES OF FRUITS AND VEGETABLES TO PARTICIPATING LOW-INCOME RESIDENTS. IN FY24, FREE COUNSELING WAS PROVIDED TO 18 LOW- TO MODERATE-INCOME INDIVIDUALS AND FAMILIES TO PREVENT EVICTION, INCREASE HOUSING STABILITY AND ECONOMIC SELF-SUFFICIENCY, AND IMPROVE THEIR OVERALL QUALITY OF LIFE. COUNSELORS ALSO HELPED WITH HOUSING SEARCHES, EMERGENCY ASSISTANCE, RAPID REHOUSING, AND BENEFITS MAXIMIZATION, AND CONNECTED PARTICIPANTS TO COMMUNITY RESOURCES. TO FURTHER ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, WINCHESTER HOSPITAL IS COMMITTED TO ENSURING ACCESS TO AFFORDABLE, HEALTHY FOOD FOR PEOPLE OF ALL INCOME LEVELS. THIS WORK IS ACCOMPLISHED THROUGH SUPPORT OF A 20-WEEK ANNUAL FARMER'S MARKET AT MEDFORD COUNCIL OF AGING, WHICH SUPPLIED 3,200 POUNDS OF FRESH PRODUCE, INCLUDING MORE THAN SIX VARIETIES OF FRUITS AND VEGETABLES TO PARTICIPATING LOW-INCOME RESIDENTS.WINCHESTER HOSPITAL IS A PARTNER IN PROVIDING HEALTHCARE TO POPULATIONS WHO HAVE HISTORICALLY NOT HAD ADEQUATE ACCESS TO CARE. IN FY23, WINCHESTER HOSPITAL PHLEBOTOMY STAFF PROVIDED HOME BLOOD DRAWS FOR 6,488 PATIENTS WHO WERE HOMEBOUND DUE TO ILLNESS, INJURY, OR TRANSPORTATION ISSUES. TO FURTHER SUPPORT ACCESS TO AFFORDABLE CARE, THE HOSPITAL ALSO PARTNERED WITH MINUTEMAN SENIOR SERVICES TO PROVIDE MEDICARE BENEFITS COUNSELING TO 171 INDIVIDUALS IN THE CBSA. IN FY24, WINCHESTER HOSPITAL LAB SERVICES PROVIDED 1,341 FREE IN-HOME BLOOD DRAWS. IN ADDITION TO APPRECIATING THE CONVENIENCE OF THE HOME BLOOD DRAW, PATIENTS REPORTED REDUCED FEELINGS OF ISOLATION, AS THE VISIT WITH THE PHLEBOTOMIST PROVIDED THEM WITH A SOCIAL OPPORTUNITY. WINCHESTER HOSPITAL HAS FOCUSED ITS EFFORTS ON CREATING TARGETED PROGRAMS THAT ADDRESS CHRONIC DISEASES SUCH AS CANCER, DIABETES, AND ASTHMA. THESE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO WINCHESTER HOSPITAL'S ONCOLOGY NURSE NAVIGATORS, BREAST CANCER RISK ASSESSMENT PROGRAM, CENTER FOR HEALTHY LIVING CHAMP ASTHMA PROGRAM, AND VARIOUS SUPPORT GROUPS FOR PEOPLE DIAGNOSED WITH CANCER. DETAILS OF OTHER WINCHESTER PROGRAMS ADDRESSING CHRONIC DISEASE MANAGEMENT ARE INCLUDED IN THE IMPLEMENTATION STRATEGY UPDATE BELOW.AMONG THE MANY WAYS WINCHESTER HOSPITAL AND ITS PARTNERS ADDRESS BEHAVIORAL HEALTH NEEDS IS BY EXPANDING BEHAVIORAL HEALTH INTEGRATION AT WINCHESTER HOSPITAL AFFILIATED PRIMARY CARE SITES THROUGH THE COLLABORATIVE CARE MODEL. RESULTS OF BEHAVIORAL HEALTH INTEGRATION SHOW THAT MORE HIGH-RISK PATIENTS ARE ACCESSING MENTAL HEALTH SERVICES, AN INCREASE IN APPOINTMENTS KEPT BY PATIENTS WHO RECEIVE A "WARM-HAND OFF" BY THEIR PROVIDER TO THERAPISTS, AND REDUCED WAIT TIME FOR MENTAL HEALTH APPOINTMENTS. WINCHESTER HOSPITAL ALSO SUPPORTS IN-COMMUNITY MENTAL HEALTH PROGRAMMING THROUGH A PARTNERSHIP WITH THE BOYS AND GIRLS CLUB OF STONEHAM AND WAKEFIELD, WHO LEAD PROGRAMS TO ADDRESS YOUTH MENTAL HEALTH, AND THROUGH SUPPORT OF MYSTIC VALLEY ELDER SERVICES' MOBILE MENTAL HEALTH PROGRAM TO ADDRESS OLDER ADULT HEALTH NEEDS. NEW MENTAL HEALTH PROMOTION PARTNERSHIPS WERE ESTABLISHED IN FY23 THROUGH GRANT FUNDING TO THE BURBANK YMCA AND TOWN OF TEWKSBURY.A FULL UPDATE ON WINCHESTER HOSPITAL'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.
FY24 SCHEDULE HIMPLEMENTATION STRATEGY UPDATE	PRIORITY AREA 1: EQUITABLE ACCESS TO CAREIN THE 2022 CHNA, INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS ARE AT THE SYSTEM LEVEL AND STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM-LEVEL ISSUES INCLUDE PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTH CARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE ARE 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 EMERGENT CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL LINGUISTIC AND ECONOMIC BARRIERSSTRATEGIES: PROMOTE ACCESS TO HEALTH CARE, HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICAL SERVICES FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED. PROMOTE EQUITABLE CARE, HEALTH EQUITY, HEALTH LITERACY, AND FOR PATIENTS, ESPECIALLY THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS. REDUCE BARRIERS TO CARE BY PROVIDING/ SUPPORTING FREE OR REDUCED COST TRANSPORTATION FOR HOMEBOUND RESIDENTS NEEDING CARE. PROVIDE AND PROMOTE CAREER SUPPORT SERVICES AND CAREER MOBILITY PROGRAMS TO HOSPITAL EMPLOYEES.INITIATIVES: PATIENT FINANCIAL COUNSELORS HOME BLOOD DRAW PROGRAM SERVING THE HEALTH INSURANCE NEEDS OF EVERYONE (SHINE) PRIMARY CARE SUPPORT INTERPRETER SERVICES MEDICAL TRANSPORTATION VOUCHER PROGRAM JENKS CENTER TRANSPORTATION PROGRAM CAREER AND ACADEMIC ADVISING HOSPITAL-SPONSORED COLLEGE COURSES HOSPITAL-SPONSORED ENGLISH SPEAKERS OF OTHER LANGUAGE CLASSES (ESOL) DIVERSE TALENT PROMOTION AND ACQUISITIONMETRICS/STATUS UPDATE: FINANCIAL COUNSELORS: # OF PATIENTS SCREENEDBASELINE: SCREENED 13,802 PATIENTS OF WHICH 592 WERE APPROVED FOR ENTITLEMENT PROGRAMS. YEAR 1: SCREENED 5,319 PATIENTS FOR ASSISTANCE PROGRAMS OF WHICH 295 PATIENTS QUALIFIED FOR MASSHEALTH HOME BLOOD DRAW PROGRAM: # OF DRAWSBASELINE: PROVIDED 6,488 HOME BLOOD DRAWS FOR PATIENTS; YEAR 1: PROVIDED 1,341 HOME BLOOD DRAWS FOR PATIENTS SHINE: # OF CLIENTS SERVEDBASELINE: SERVED 639 CONSUMERS. YEAR 1: SERVED PROVIDED 579 INDIVIDUALS PRIMARY CARE SUPPORT BASELINE: N/A; YEAR 1: N/A INTERPRETER SERVICES: # OF ENCOUNTERS AND TOP LANGUAGE REQUESTBASELINE: PROVIDED 3,275 INTERPRETER SERVICES ENCOUNTERS. THE TOP THREE LANGUAGE REQUESTS WERE SPANISH, PORTUGUESE, AND CHINESE MANDARIN. YEAR 1: PROVIDED 1,498 INTERPRETER ENCOUNTERS. THE TOP THREE LANGUAGE REQUESTS WERE: SPANISH, PORTUGUESE, AND HAITIAN CREOLE. TRANSPORTATION VOUCHERS: NUMBER OF RIDES PROVIDED AND NUMBER OF VOUCHERS FROM THE CANCER CENTERBASELINE: PROVIDED 130 RIDES TO PATIENTS WITH TRANSPORTATION NEEDSYEAR 1: PROVIDED OVER 700 RIDES TO PATIENTS WITH TRANSPORTATION NEEDSBASELINE: CANCER CARE PROVIDED VOUCHERS FOR 240 RIDES FOR PATIENTS. YEAR 1: CANCER CARE PROVIDED VOUCHERS FOR 120 RIDES FOR PATIENTS. JENKS CENTER TRANSPORTATION PROGRAMBASELINE: N/A; YEAR 1: N/A CAREER AND ACADEMIC ADVISINGBASELINE: 225 JOB SEEKERS WERE REFERRED TO BILH AND 70 WERE HIRED ACROSS BILH YEAR 1: 412 JOB SEEKERS WERE REFERRED TO BILH AND 111 WERE HIRED ACROSS BILH BASELINE: 67 EVENTS AND PRESENTATIONS WERE CONDUCTED WITH COMMUNITY PARTNERS ACROSS THE BILH SERVICE AREA. BASELINE: 54 COMMUNITY MEMBERS PLACED IN INTERNSHIPS ACROSS BILH HOSPITALS TO LEARN VALUABLE SKILLS; YEAR 1: 107 COMMUNITY MEMBERS PLACED IN INTERNSHIPS ACROSS BILH HOSPITALS. BASELINE: 22 INTERNS WERE HIRED PERMANENTLY IN BILH HOSPITALS. YEAR 1: 37 INTERNS WERE HIRED PERMANENTLY IN BILH HOSPITALS.BASELINE: 20 BILH EMPLOYEES ATTENDED CITIZENSHIP CLASSES; YEAR 1:14 BILH EMPLOYEES ATTENDED CITIZENSHIP CLASSESBASELINE: 135 BILH EMPLOYEES ATTENDED CAREER DEVELOPMENT WORKSHOPS; YEAR 1: 15 BILH EMPLOYEES ATTENDED CAREER DEVELOPMENT WORKSHOPS BASELINE: 189 BILH EMPLOYEES ATTENDED FINANCIAL LITERACY CLASSES; YEAR 1: 207 BILH EMPLOYEES ATTENDED FINANCIAL LITERACY CLASSES.BASELINE: 45 EMPLOYEES ACROSS BILH WERE ENROLLED IN ESOL CLASSES; YEAR 1: 82 EMPLOYEES ACROSS BILH WERE ENROLLED IN ESOL CLASSES
PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH	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 THE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE WINCHESTER HOSPITAL CBSA. INFORMATION GATHERED DURING THE 2022 CHNA REINFORCED THAT SOCIAL DETERMINANTS OF HEALTH HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE WINCHESTER HOSPITAL CBSA - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, ANDECONOMIC 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.STRATEGIES: SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE HEALTHY EATING AND ACCESS TO AFFORDABLE, HEALTHY FOODS. SUPPORT IMPACTFUL PROGRAMS THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSING SUPPORT IMPACTFUL PROGRAMS THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTH. PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO CONVENE STAKEHOLDERS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH.INITIATIVES: COUNCIL OF SOCIAL CONCERN FOOD PANTRY PROGRAM WOBURN PUBLIC SCHOOLS BACKPACK FOOD PROGRAM WINCHESTER HOUSING AUTHORITY FREE FARMER'S MARKET FARMER'S MARKET SNAP GAP MATCHING FUNDS AND PROGRAMS WINCHESTER HOSPITAL MEALS ON WHEELS PROGRAM METRO HOUSING BOSTON HOUSING SECURITY AND STABILITY PROGRAM PROVIDE COMMUNITY GRANTS TO ADDRESS EMERGING NEEDS RELATED TO SOCIAL DETERMINANTS OF HEALTH PARTICIPATE IN COMMUNITY COALITIONS NETWORK FOR SOCIAL JUSTICE HOUSING COALITION MEDFORD FOOD POLICY COUNCIL MIDDLESEX REGIONAL FOOD SECURITY COALITIONMETRICS/STATUS UPDATE: COUNCIL OF SOCIAL CONCERN FOOD PANTRY PROGRAM- SEE WOBURN PUBLIC SCHOOLS BACKPACK PROGRAM WOBURN PUBLIC SCHOOLS BACKPACK FOOD PROGRAM: # OF STUDENTS SERVEBASELINE: PROVIDED BACKPACKS WITH HEALTHY FOOD AND SNACKS TO 5 STUDENTS FROM THE WOBURN PUBLIC SCHOOLS WEEKLY. YEAR 1: PROVIDED BACKPACKS WITH HEALTHY FOOD AND SNACKS TO 35-50 STUDENTS FROM THE WOBURN PUBLIC SCHOOLS WEEKLY. WINCHESTER HOUSING AUTHORITY FREE FARMER'S MARKET: POUNDS OF PRODUCEBASELINE: PROVIDED MORE THAN 3,200 POUNDS OF FRESH PRODUCE TO PARTICIPATING RESIDENTS. YEAR 1: PROVIDED MORE THAN 3,200 POUNDS OF FRESH PRODUCE TO PARTICIPATING RESIDENTS FARMER'S MARKET SNAP GAP MATCHING FUNDS AND PROGRAMS; # SERVED AND SNAP DOLLARS MATCHEDBASELINE:15 FAMILIES WERE SERVED DURING THE 17-WEEK MARKET SEASON AND A TOTAL OF NEARLY $2,500 DOLLARS IN SNAP MATCH DOLLARS WERE DISTRIBUTED; YEAR 1: 116 FAMILIES SERVED; SNAP MATCH: N/A WINCHESTER HOSPITAL MEALS ON WHEELS PROGRAM: # OF MEALS PACKED AND DELIVERED TO HOMEBOUND RESIDENTSBASELINE: PACKED AND DELIVERED 4,780 MEALS TO HOMEBOUND RESIDENTS; YEAR 1: PACKED AND DELIVERED 5,143 MEALS TO HOMEBOUND RESIDENTS METRO HOUSING BOSTON: # PROVIDED COUNSELING SUPPORTBASELINE: COUNSELING TO 18 LOW- TO MODERATE-INCOME INDIVIDUALS AND FAMILIES TO PREVENT EVICTION, INCREASE HOUSING STABILITY AND ECONOMIC SELF-SUFFICIENCY; YEAR 1: COUNSELING TO 18 PARTICIPANTS WHO PRESENTED WITH A HOUSING CONCERN OR CRISIS. # OF COMMUNITY GRANTS PROVIDEDBASELINE: 9 GRANTS; YEAR 1: 9 GRANTS PARTICIPATE IN COMMUNITY COALITIONSBASELINE: PARTICIPATED AS A COALITION MEMBER IN THE MYSTIC VALLEY PUBLIC HEALTH COMMITTEE; YEAR 1: PARTICIPATED AS A COALITION MEMBER IN THE MYSTIC VALLEY PUBLIC HEALTH COMMITTEE NETWORK FOR SOCIAL JUSTICE HOUSING COALITION BASELINE: PARTICIPATED AS A COALITION MEMBER IN THE NETWORK FOR SOCIAL JUSTICE HOUSING COALITION; YEAR 1: PARTICIPATED AS A COALITION MEMBER IN THE NETWORK FOR SOCIAL JUSTICE HOUSING COALITION. MEDFORD FOOD POLICY COUNCILBASELINE: N/A; YEAR 1: N/A MIDDLESEX REGIONAL FOOD SECURITY COALITIONBASELINE: N/A; YEAR 1: N/ABASELINE: N/A; YEAR 1: BILH GOVERNMENT AFFAIRS ADVOCATED, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, FOR 9 BILLS THAT SUPPORTED ACCESS TO SERVICES TO ADDRESS THE ROOT CAUSES OF POOR HEALTH OUTCOMES FOR ALL MASSACHUSETTS RESIDENTS
PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE	ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS IDENTIFIED BY THE COMMUNITY IN THE 2022 CHNA. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES ON YOUTH AND YOUNG ADULTS, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. INTERVIEWEES, FOCUS GROUP, AND COMMUNITY LISTENING SESSION PARTICIPANTS ALSO DISCUSSED THE STIGMA, SHAME, AND ISOLATION THAT THOSE WITH MENTAL HEALTH CHALLENGES FACE THAT LIMIT THEIR ABILITY TO ACCESS CARE AND COPE WITH THEIR ILLNESS. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INTERVIEWEES, FOCUS GROUPS, AND COMMUNITY LISTENING SESSION PARTICIPANTS 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). THOSE PARTICIPATING IN INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND OTHER MEETINGS ALSO REFLECTED ON THE NEED FOR TRANSITIONAL HOUSING AND OTHER RECOVERY SUPPORT SERVICES.GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE.STRATEGIES: SUPPORT IMPACTFUL PROGRAMS THAT PROMOTE HEALTHY DEVELOPMENT, SUPPORT CHILDREN, YOUTH, AND THEIR FAMILIES, AND INCREASE THEIR RESILIENCY, COPING, AND PREVENTION SKILLS. BUILD THE CAPACITY OF THE COMMUNITY TO UNDERSTAND THE IMPORTANCE OF MENTAL HEALTH AND AVAILABILITY OF SERVICES, AND REDUCE NEGATIVE STEREOTYPES, BIAS, AND STIGMA AROUND MENTAL ILLNESS AND SUBSTANCE USE. PROVIDE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION, AND TREATMENTS SUPPORT A MODEL THAT SPANS THE CONTINUUM OF CARE FROM INPATIENT TO OUTPATIENT AND COMMUNITY INITIATIVES THAT IDENTIFY AND ADDRESS MENTAL HEALTH NEEDS AND SUBSTANCE USE DISORDERS PARTICIPATE IN MULTI-SECTION COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT REDUCE AND PREVENT SUBSTANCE USE AND PROMOTE MENTAL HEALTH. INITIATIVES: SCHOOL-BASED MENTAL HEALTH AND SUBSTANCE USE PREVENTION PROGRAMS AND AFTER SCHOOL YOUTH PROGRAMS SCREENING, BRIEF INTERVENTION, REFERRAL TO TREATMENT (SBIRT) & QUESTION, PERSUADE, REFER (QPR) PROGRAMS AT BOYS AND GIRLS CLUB OF STONEHAM & WAKEFIELD CENTRALIZED BED MANAGEMENT DETOXIFICATION SERVICES BEHAVIORAL HEALTH EMERGENCY DEPARTMENT TECHNICIANS BILH COLLABORATIVE CARE MODEL MOBILE MENTAL HEALTH CLINIC MYSTIC VALLEY ELDER SERVICES (MVES) HEALING AND RECOVERING TOGETHER (HART) HOUSE TEWKSBURY TRANSITIONAL SUPPORT SERVICES - TEWKSBURY TOWN OF WINCHESTER SOCIAL WORKER COUNCIL ON AGING PROGRAMS FOR OLDER ADULTS MENTAL HEALTH PROMOTION AND SUBSTANCE USE PREVENTION INTERFACE REFERRAL SERVICE WINCHESTER AND STONEHAM PROVIDE COMMUNITY HEALTH GRANTS TO ADDRESS THIS NEED MYSTIC VALLEY PUBLIC HEALTH COMMITTEE MYSTIC VALLEY BEHAVIORAL HEALTH COALITION MIDDLESEX DISTRICT ATTORNEY (DA) OPIOID TASK FORCE LOCAL SUBSTANCE USE PREVENTION COALITIONSMETRICS/STATUS UPDATE: SCHOOL-BASED MENTAL HEALTH AND SUBSTANCE USE PREVENTION PROGRAMS AND AFTER SCHOOL YOUTH PROGRAMS; BURBANK YMCA GRANT: NUMBER OF TRAININGS; NUMBER OF STAFF TRAINED AND # OF PARTICIPANTSBASELINE: THREE MENTAL HEALTH FIRST AID TRAININGS WERE HELD AND 15 STAFF WERE TRAINED; YEAR 1: IMPLEMENTED OUR YOUTH HEATHY HABITS PROGRAM AND OUR MENTAL HEALTH FIRST AID TRAININGS FOR TEENS.BASELINE: TRAINED 15 STAFF; YEAR 1: N/ABASELINE: NUMBER OF PARTICIPANTS N/A; YEAR 1: 51 PARTICIPANTS THAT WENT THROUGH THE TRAININGS. SBIRT; NUMBER SCREENED; # OF TEENS PAIRED WITH MENTORS AND NUMBER OF WORKSHOPS/EVENTS CONDUCTEDBASELINE: OVER 300 STONEHAM YOUTH WERE SCREENED. YEAR 1: N/ABASELINE: 48 AT-RISK YOUTH WERE PAIRED WITH MENTORS; YEAR 1: 105 AT-RISK YOUTH WERE PAIRED WITH MENTORS BASELINE: FOUR CAMPAIGN EVENTS AND WORKSHOPS CONDUCTED; YEAR 1: 2 CAMPAIGN EVENTS AND WORKSHOPS INCLUDED: HOSTED A TRAINING FOR ALL STAFF CALLED SUPPORTING LGBTQ+ YOUTH IN SCHOOL AND COMMUNITY SETTINGS. CENTRALIZED BED MANAGEMENT BASELINE: N/A; YEAR 1: N/A DETOXIFICATION SERVICES BASELINE: N/A; YEAR 1: N/A BEHAVIORAL HEALTH EMERGENCY DEPARTMENT TECHNICIANS: NUMBER OF TECHNICIANS AND NUMBER OF PATIENT CARE HOURSBASELINE: TWO BEHAVIORAL HEALTH TECHNICIANS PROVIDED A TOTAL OF 1,005 HOURS OF BEHAVIORAL HEALTH PATIENT CARE. YEAR 1: TWO BEHAVIORAL HEALTH TECHNICIANS PROVIDED A TOTAL OF 2,047 HOURS OF BEHAVIORAL HEALTH PATIENT CARE BILH COLLABORATIVE CARE MODEL: # OF PATIENTS SERVED; # OF PRIMARY CARE PRACTICESBASELINE: 1,308 PATIENTS WERE SEEN THROUGH THE COLLABORATIVE CARE MODEL IN 12 PRIMARY CARE PRACTICES. YEAR 1: SERVED 1,607 PATIENTS IN 11 PRIMARY CARE PRACTICES. MOBILE MENTAL HEALTH CLINIC- SEE MYSTIC VALLEY ELDER SERVICES (MVES) MYSTIC VALLEY ELDER SERVICES (MVES); CLIENTS ENROLLED AND % REPORTED COPING WITH THEIR DAILY PROBLEMSBASELINE:135 NEW CONSUMERS ENROLLED. YEAR 1: 120 NEW CONSUMERS ENROLLED.BASELINE: 73% OF MVES MOBILE MENTAL HEALTH PROGRAM CONSUMERS INDICATED THAT THEY WERE COPING BETTER WITH THEIR DAILY PROBLEMS; YEAR 1: 71% OF MVES MOBILE MENTAL HEALTH PROGRAM CONSUMERS INDICATED THAT THEY WERE COPING BETTER WITH THEIR DAILY PROBLEMS. HEALING AND RECOVERING TOGETHER (HART) HOUSE TEWKSBURY; # OF BED DAYS OF CARE, # OF WOMEN AND CHILDREN SERVED.BASELINE: PROVIDED 5,155 BED DAYS OF CARE TO PROGRAM PREGNANT AND PARENTING WOMEN RECOVERING FROM SUBSTANCE USE DISORDER AND/OR ALCOHOL USE DISORDER TO 67 WOMEN AND 108 CHILDREN. YEAR 1: DATA UNAVAILABLE AS SITE MOVED FROM CBSA TRANSITIONAL SUPPORT SERVICES TEWKSBURY: SEE HART HOUSE TOWN OF WINCHESTER SOCIAL WORKER: # OF CASES AND # OF REFERRALS MADE TO COMMUNITY SERVICE PROGRAMSBASELINE: 46 CASES AND 20 REFERRALS MADE TO COMMUNITY SERVICES AND PROGRAMS. YEAR 1: 44 CASES AND 14 REFERRALS MADE TO COMMUNITY SERVICES AND PROGRAMS. COUNCIL ON AGING PROGRAMS FOR OLDER ADULTS MENTAL HEALTH PROMOTION AND SUBSTANCE USE PREVENTION SEE MYSTIC VALLEY ELDER SERVICES PROGRAM INTERFACE REFERRAL SERVICE NUMBER OF RESIDENTS SERVED AND % SEEKING INDIVIDUAL THERAPYBASELINE: 47 STONEHAM RESIDENTS WERE SERVED BY INTERFACE; YEAR 1: 37 STONEHAM RESIDENTS WERE SERVED BY INTERFACE.BASELINE: 86%, WERE SEEKING INDIVIDUAL THERAPY. YEAR 1: 87%, WERE SEEKING INDIVIDUAL THERAPY. PROVIDE COMMUNITY HEALTH GRANTS TO ADDRESS THIS NEED - SOCIAL CAPITAL INC. AND NETWORK FOR SOCIAL JUSTICE; NUMBER OF PARTICIPANTS ENGAGED AS INTERNS; NUMBER OF EVENTS HELD; NUMBER OF WEBSITE VISITORSBASELINE: 10 YOUTH ENGAGED AS INTERNS. YEAR 1: 13 YOUTH ENGAGED AS INTERNSBASELINE: 5 COMMUNITY EVENTS HELD. YEAR 1: 6 COMMUNITY EVENTS HELD.BASELINE: ATTENDANCE AT THESE EVENTS TOTALED 131. YEAR 2: ATTENDANCE AT THESE EVENTS TOTALED 303BASELINE: THE WEBSITE RECEIVED 592 VISITORS AND 216 VISITS TO THE MENTAL HEALTH EVENT LISTINGS ON THE SITE. YEAR 1: THE WEBSITE RECEIVED 622 VISITORS AND 1099 VISITS TO THE MENTAL HEALTH EVENT LISTINGS ON THE SITEBASELINE: 6 BLOG POSTS ADDED AND OVER 100 CALENDAR EVENTS. YEAR 1: N/A RESILIENCY SKILLS BUILDING OPPORTUNITIES TO THE LGBTQIA+ COMMUNITY IN TEWKSBURY; NUMBER OF WORKSHOPS AND NUMBER OF PEOPLE SERVED BASELINE: TWO LISTENING SESSIONS WERE CONDUCTED; YEAR 1: HELD TWO WORKSHOPS, TWO EVENTS AND MEDITATION CLASSESBASELINE: N/A; YEAR 1: OVERDOSE VIGIL WITH 200 PARTICIPANTS, A PRIDE EVENT PICNIC WITH 35 PARTICIPANTS AND A WEEKLY MEDITATION CLASS AT THE LIBRARY WITH AN AVERAGE OF 20 TO 45 PEOPLE PER WEEK. MYSTIC VALLEY PUBLIC HEALTH COMMITTEEBASELINE: PARTICIPATED AS A COALITION MEMBER; YEAR 1: PARTICIPATED AS A COALITION MEMBER MYSTIC VALLEY BEHAVIORAL HEALTH COALITIONBASELINE: N/A; YEAR 1: N/A MIDDLESEX DISTRICT ATTORNEY (DA) OPIOID TASK FORCEBASELINE: PARTICIPATED AS A COALITION MEMBER; YEAR 1: PARTICIPATED AS A COALITION MEMBER LOCAL SUBSTANCE USE PREVENTION COALITIONS; SEE MYSTIC VALLEY HEALTH COMMISSION
PRIORITY AREA 4: CHRONIC AND COMPLEX CONDITIONS	CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN MASSACHUSETTS AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.GOALS: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS A-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 RESOURCESSTRATEGIES: PROVIDE PREVENTIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENTS AND SELF-MANAGEMENT PROGRAMS. SUPPORT COMMUNITY-BASED PROGRAMS THAT INCREASE ACCESS TO FREE OR LOW-COST HEALTH-PROMOTING SUPPORTS TO PREVENT CHRONIC DISEASEINITIATIVES BREAST CANCER RISK ASSESSMENT ONCOLOGY NURSE NAVIGATOR CENTER FOR HEALTHY LIVING HEALTH EDUCATION PROGRAMS CHAMP PEDIATRIC ASTHMA PROGRAM FIGHTING FATIGUE PROGRAM A CARING PLACEWIG DONATION PROGRAM MOUNT VERNON HOUSE RESIDENT HEALTH PROGRAM PATIENT SUPPORT GROUPS INTEGRATIVE THERAPIES FOR CANCER PATIENTS OUTPATIENT LACTATION PROGRAM DIABETES MANAGEMENT PROGRAM MONTHLY CLINICMETRICS/STATUE UPDATE BREAST CANCER RISK ASSESSMENT: # OF SCREENINGSBASELINE: 4,216 FREE BREAST CANCER RISK SCREENINGS; YEAR 1: 2,989 FREE BREAST CANCER RISK SCREENINGS. ONCOLOGY NURSE NAVIGATOR: DEDICATED HOURS AND # OF PATIENTS SERVEDBASELINE: 1744 HOURS, SERVING 2324 NEW PATIENTS; YEAR 1: 1680 HOURS PROVIDING SERVING 1890 PATIENTS CENTER FOR HEALTHY LIVING HEALTH EDUCATION PROGRAMS: # OF CLASS REGISTRATIONSBASELINE: 3,702 CLASS REGISTRATIONS; YEAR 1: 1,078 CLASS REGISTRATIONS CHAMP PEDIATRIC ASTHMA PROGRAM: # SERVED; # OF HOME VISITS;# OF TRAININGS; # OF VISITS; # OF ASTHMA ACTION PLANSBASELINE: 117 CHILDREN PARTICIPATED IN CHAMP; YEAR 1: 109 CHILDREN PARTICIPATED IN CHAMP.BASELINE: 146 HOME VISITS; YEAR 1: 108 HOME VISITSBASELINE: ONE SCHOOL TRAINING SESSION WAS HELD VIA ZOOM; YEAR 1: N/ABASELINE: 218 ASTHMA ACTION PLANS COMPLETED; YEAR 1: 139 ASTHMA ACTION PLANS COMPLETED FIGHTING FATIGUE PROGRAMBASELINE: N/A; YEAR 1: N/A A CARING PLACEWIG DONATION PROGRAM; # OF PATIENTS SERVED WITH HEAD COVERINGS; # OF PATIENTS SERVED WITH KNITTING CLASSBASELINE: SERVED 795 PATIENTS IN WITH COMPRESSION PRODUCTS, COLD CAPS, AND WIGS OR HEAD COVERINGS. YEAR 1: 359 PATIENTS WERE WITH COMPRESSION PRODUCTS, COLD CAPS, AND WIGS OR HEAD COVERINGS. MOUNT VERNON HOUSE RESIDENT HEALTH PROGRAM BASELINE: N/A ; YEAR 1: N/A PATIENT SUPPORT GROUPS: SEE CENTER FOR HEALTHY LIVING EDUCATION PROGRAMS INTEGRATIVE THERAPIES FOR CANCER PATIENTSBASELINE: N/A; YEAR 1: N/A OUTPATIENT LACTATION PROGRAM: # OF PARTICIPANTS; # REPORTED MEETING BREAST FEEDING GOAL; % REPORTED BREAST FEEDING AT SIX MONTHSBASELINE: 848 MOTHERS PARTICIPATED IN THE PROGRAM. YEAR 1: 615 MOTHERS PARTICIPATED IN THE PROGRAM.BASELINE: 89% OF THE NEW MOTHERS SURVEYED AFTER THE PROGRAM REPORTED MEETING THE BREASTFEEDING GOAL; YEAR 1: 80% OF THE NEW MOTHERS SURVEYED AFTER THE PROGRAM REPORTED MEETING THE BREASTFEEDING GOAL.BASELINE: 88% REPORTED SUCCESSFULLY BREASTFEEDING FOR SIX MONTHS OR MORE; YEAR 1:73% REPORTED SUCCESSFULLY BREASTFEEDING FOR SIX MONTHS OR MORE. DIABETES MANAGEMENT PROGRAM MONTHLY CLINICBASELINE: N/A; YEAR 1: N/A
COMMUNITY PARTNERS	WINCHESTER 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: BOYS & GIRLS CLUB OF STONEHAM & WAKEFIELD BURBANK YMCA CHNA15 CITY OF MEDFORD CITY OF WOBURN COUNCIL OF SOCIAL CONCERN METRO HOUSING BOSTON MINUTEMAN SENIOR SERVICES MYSTIC VALLEY ELDER SERVICES MYSTIC VALLEY PUBLIC HEALTH COALITION NETWORK FOR SOCIAL JUSTICE SOCIAL CAPITAL INC. STONEHAM COALITION FOR A HEALTHY COMMUNITY TOWN OF READING TOWN OF STONEHAM TOWN OF TEWKSBURY TOWN OF WAKEFIELD TOWN OF WILMINGTON TOWN OF WINCHESTER WINCHESTER HOUSING AUTHORITY WINCHESTER SAFER COALITIONAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, WINCHESTER HOSPITAL IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY. THOSE NEEDS ARE: SUPPORTING EDUCATION ACROSS THE LIFESPAN AND STRENGTHENING THE BUILT ENVIRONMENT (I.E., IMPROVING ROADS/SIDEWALKS AND ENHANCING ACCESS TO SAFE RECREATIONAL SPACES/ACTIVITIES). WINCHESTER HOSPITAL WILL BE UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES AND WHILE THESE ISSUES ARE IMPORTANT, WH'S CBAC AND SENIOR LEADERSHIP TEAM DECIDED THAT THESE ISSUES WERE OUTSIDE OF THE ORGANIZATION'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHERS AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. AS A RESULT, WH RECOGNIZED THAT OTHER PUBLIC AND PRIVATE ORGANIZATIONS IN ITS CBSA AND THE COMMONWEALTH WERE BETTER POSITIONED TO FOCUS ON THESE ISSUES. WH REMAINS OPEN AND WILLING TO WORK WITH COMMUNITY RESIDENTS, OTHER HOSPITALS, AND OTHER PUBLIC AND PRIVATE PARTNERS TO ADDRESS THESE ISSUES, PARTICULARLY AS PART OF A BROAD, STRONG COLLABORATIVE.AS NOTED IN DETAIL ABOVE, WINCHESTER 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).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW WINCHESTER HOSPITAL CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 5.67% OF WINCHESTER 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, WINCHESTER 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://WINCHESTERHOSPITAL.ORG/ABOUT/COMMUNITY-BENEFITS-NEEDSTHERE 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 WINCHESTER HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, WINCHESTER 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 ASSISTANCEWINCHESTER 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 $3,348,985 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, WINCHESTER HOSPITAL IS ONE OF ELEVEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $52 MILLION FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, FOR THE PERIOD COVERED BY THIS FILING, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW. OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, WINCHESTER 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, WINCHESTER HOSPITAL GENERATED $4,782,073 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY WINCHESTER HOSPITAL FOR SUCH SERVICES BY $1,409,809 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 9.3% OR 47,011 OF WINCHESTER HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 33.3% OR 169,003 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 WINCHESTER HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, WINCHESTER HOSPITAL GENERATED $95,561,781 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $8,373,026. OF THESE AMOUNTS, REVENUE OF $$20,361,357 IS RELATED TO THE PROVISION OF RHEUMATOLOGY, ENDOCRINE, CANCER, AND SPINE 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 $14,984,426. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH WINCHESTER 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, WINCHESTER 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 7.17%.
BAD DEBTS	IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, WINCHESTER HOSPITAL ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $2,764,577 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 RECOGNITION EMERGENCY CARE ACCESSTHE WINCHESTER 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 WINCHESTER 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 WINCHESTER HOSPITAL AS WELL AS PROVIDERS WHO FOLLOW WINCHESTER HOSPITAL'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN WINCHESTER HOSPITAL AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW WINCHESTER HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. WINCHESTER 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.FINANCIAL ASSISTANCE POLICYTRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ARABIC, ARMENIAN, CAPE VERDEAN, FRENCH, GREEK, GUJARATI, HAITIAN CREOLE, HINDI, ITALIAN, JAPANESE, KOREAN, KHMER/CAMBODIAN, PUNJABI, PORTUGUESE, RUSSIAN, SIMPLIFIED CHINESE, SPANISH, TRADITIONAL CHINESE, AND 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://WINCHESTERHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/FINANCIAL-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 WINCHESTER HOSPITAL FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. CREDIT AND COLLECTION POLICY APPLICATION FOR FINANCIAL ASSISTANCE MEDICAL HARDSHIP APPLICATION FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, ARABIC, ARMENIAN, CAPE VERDEAN, FRENCH, GREEK, GUJARATI, HAITIAN CREOLE, HINDI, ITALIAN, JAPANESE, KOREAN, KHMER/CAMBODIAN, PUNJABI, PORTUGUESE, RUSSIAN, SIMPLIFIED CHINESE, SPANISH, TRADITIONAL CHINESE, AND VIETNAMESE, CAN BE FOUND ON THE WINCHESTER HOSPITAL WEBSITE AT: HTTPS://WINCHESTERHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE.
LIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)	LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY 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, WINCHESTER HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH WINCHESTER 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 WINCHESTER HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY WINCHESTER HOSPITAL, BILH AND BEYOND. INFORMATION ON THE RESEARCH ENGAGED IN AT BIDMC AND JOSLIN, SISTER ENTITIES TO WINCHESTER HOSPITAL, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION. TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES: ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE EMERGENCY MEDICINE MEDICINE 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.RESEARCH ENGAGED IN AT THE MEDICAL CENTERTHE 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 BIDMC	BELOW 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."4. BIDMC'S COMPLEX HYPERTENSION CENTER IS THE REGION'S ONLY AMERICAN HEART ASSOCIATION-CERTIFIED COMPREHENSIVE CARE CENTER 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.
RESEARCH AT JOSLIN DIABETES CENTER	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."
5. JOSLIN EXPERTS' PILOT STUDY SHOWS HYBRID CARE LEADS TO BETTER OUTCOMES	OUTCOMES FOR SOME WITH T1DFOR 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
FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS	GRADUATE MEDICAL EDUCATION AS NOTED THROUGHOUT THIS FORM 990, WINCHESTER HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH BID-MILTON 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 WINCHESTER HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7F, AS ALREADY NOTED THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY WINCHESTER HOSPITAL AND BEYOND. IN ADDITION, INFORMATION ON THE TEACHING ACTIVITIES AT BIDMC, A SISTER ENTITY TO WINCHESTER 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:
HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMC	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. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR 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.
RADIOLOGY EDUCATION AT BIDMC	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.
IRC 501(R) REPORTING UNDER REVENUE PROCEDURE 2015-21:	DURING A REVIEW OF WINCHESTER 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. WINCHESTER 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)OPEN MEDICAL STAFFTHE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. AFFILIATED HEALTH CARE SYSTEM AND ACCOMPLISHMENTS AS NOTED THROUGHOUT THIS FORM 990, WINCHESTER HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.THE BILH CORE VALUES AND PRINCIPALS ARE LISTED HERE AS WELL AS NETWORK-WIDE ACCOMPLISHMENTS DURING THE FISCAL PERIOD COVERED BY THIS FILING. THE BILH NETWORK IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. THE BILH PURPOSE STATEMENT ARTICULATES THE IMPACT THAT EACH BILH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. THESE SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS.EQUITY. EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.BILH IS ACCOMPLISHING THIS MISSION BY PROVIDING SUPPORT TO ITS AFFILIATES WHICH INCLUDE:1. A PHYSICIAN ENTERPRISE THAT ENCOMPASSES THE SYSTEM'S NETWORK OF EMPLOYED PRIMARY CARE AND SPECIALTY PHYSICIANS LOCATED THROUGHOUT OUR REGION;2. A HOSPITAL AND AMBULATORY SERVICES GROUP THAT INCLUDES WORLD-CLASS ACADEMIC MEDICAL CENTERS AND TEACHING HOSPITALS WITH AFFILIATIONS WITH HARVARD MEDICAL SCHOOL, UM AND TUFTS UNIVERSITY SCHOOL OF MEDICINE; LEADING COMMUNITY HOSPITALS; A RENOWNED ORTHOPEDICS HOSPITAL; AND COMPREHENSIVE AMBULATORY CENTERS;3. A POPULATION HEALTH ENTERPRISE THAT EMBRACES A MODEL OF CARE TO IMPROVE THE HEALTH OF ALL THOSE SERVED BY BILH; THE POPULATION HEALTH DOMAIN INCLUDES THE SYSTEM'S CLINICALLY INTEGRATED NETWORK OF AFFILIATED PROVIDERS AND VITAL SERVICES, INCLUDING BEHAVIORAL HEALTH AND HOME CARE SERVICES; 4. A ROBUST NETWORK OF ADMINISTRATIVE AND OPERATIONAL SERVICES TO ADVANCE STRATEGIC GOALS, BOTH LOCALLY AND AT THE SYSTEM LEVEL, THAT OFFERS EXPERTISE AND STANDARDIZED RESOURCES BASED ON BEST PRACTICES.DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), THE JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC (EHRI) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND LHSS IN TURN SERVED AS THE SOLE MEMBER OF BETH ISRAEL LAHEY HEALTH PRIMARY CARE. THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. SEE FORM 990 SCHEDULE R FOR ADDITIONAL AFFILIATED ENTITIES. BILH PROVIDES CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS. BILH SUPPORT INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING SERVICES: DEVELOPMENT AND FUNDRAISING, STRATEGIC PLANNING, COMPLIANCE, GOVERNANCE AND LEGAL SUPPORT, HUMAN RESOURCES, PATIENT CARE PAYOR CONTRACTING, OPERATIONAL SUPPORT SUCH AS PROCESSING PAYROLL AND ACCOUNTS PAYABLE, NETWORK-WIDE BENEFIT PLAN STRUCTURING AND NETWORK-WIDE CASH MANAGEMENT. BILH OVERSEES THE FINANCIAL WELL-BEING OF ITS AFFILIATES, INCLUDING PROVIDING MANAGEMENT, LEADERSHIP, DEBT STRUCTURING SUPPORT, FINANCING OF CAPITAL PROJECTS THROUGH ITS OBLIGATED GROUP DEBT AND FINANCIAL SUPPORT SERVICES, INCLUDING INTERNAL AND EXTERNAL AUDIT, TREASURY, INSURANCE AND TAX SERVICES. FOR THE FISCAL PERIOD COVERED BY THIS FILING BILH, INC. PROVIDED SERVICES AND SUPPORT TO ITS AFFILIATES, IN THE AMOUNT OF $15,835,226,845.ADDITIONAL DETAIL ABOUT ACCOMPLISHMENTS ACROSS BILH ARE BELOW. BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES FISCAL YEAR ENDED SEPTEMBER 30, 2024BILH'S SUPPORT OF ITS AFFILIATES ENABLES THE NETWORK AS A WHOLE TO ACCOMPLISH ITS PRIMARY MISSION OF IMPROVING THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. AS NOTED PREVIOUSLY IN THIS FILING, BILH STRIVES TO ACCOMPLISH THIS MISSION BY DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO USE SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE AND BILH IS ACCOMPLISHING THIS GOAL BY PROVIDING SUPPORT TO EACH OF ITS AFFILIATES, PROVIDING AN ORGANIZATIONAL STRUCTURE AND OPERATING MODEL WHICH IS DRIVEN BY FOUR DEEPLY INTERCONNECTED DOMAINS DESIGNED TO ADVANCE MEANINGFUL PARTNERSHIPS ACROSS ORGANIZATIONS, CARE SETTINGS, SPECIALTIES, AND GEOGRAPHIES TO ENSURE BILH PATIENTS RECEIVE THE CARE THEY NEED IN THE COMMUNITIES WHERE THEY LIVE AND WORK.
PATIENT CARE DELIVERY ACROSS THE BILH NETWORK --	FISCAL YEAR ENDED SEPTEMBER 30, 2024HOSPITAL CARE:DURING THE PERIOD COVERED BY THIS FILING, THE BILH HOSPITALS PROVIDED CARE TO PATIENTS IN A FULL SPECTRUM OF SPECIALTIES AND UTILIZING A WIDE RANGE OF MODALITIES. BELOW ARE A SAMPLE OF THE HOSPITAL CARE PROVIDED TO BILH PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING, BILH HOSPITALS HAD APPROXIMATELY 4.9 MILLION OUTPATIENT ENCOUNTERS. APPROXIMATELY 80,000 OUTPATIENT/AMBULATORY SURGERIES AND OVER 100,000 ENDOSCOPIES WERE PERFORMED, IN ADDITION, ACROSS BILH HOSPITALS PATIENTS HAD MORE THAN 141,000 ONCOLOGY VISITS AND ALMOST 111,000 ONCOLOGY INFUSIONS, 268,000 EKGS, OVER 59,000 ORTHOPEDIC PROCEDURES, MORE THAN 758,000 RADIOLOGY EXAMS, OVER 312,000 CT EXAMS, MORE THAN 177,000 ULTRASOUND PROCEDURES, OVER 142,000 MRIS, OVER 221,000 OUTPATIENT BREAST IMAGING EXAMS, APPROXIMATELY 312,000 OUTPATIENT REHABILITATION AND PHYSICAL THERAPY VISITS AND MORE THAN 11.7 MILLION OUTPATIENT LAB TESTS WERE PERFORMED. THE BILH HOSPITALS ALSO HAD APPROXIMATELY 432,000 EMERGENCY DEPARTMENT VISITS, MORE THAN 35,000 OBSERVATION CASES AND MORE THAN 137,000 INPATIENT DISCHARGES WITH APPROXIMATELY 729,000 INPATIENT DAYS, INCLUDING MORE THAN 44,000 INPATIENT PSYCH DAYS. DURING THIS PERIOD MORE THAN 31,000 INPATIENT SURGERIES WERE PERFORMED AND APPROXIMATELY 14,000 NEWBORNS WERE DELIVERED AND THERE WERE APPROXIMATELY 52,000 PAIN CLINIC VISITS. BILH HOSPITALS ALSO HAD MORE THAN 75,000 URGENT CARE VISITS DURING THIS PERIOD. 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: ENHANCING THE BILHPN OPERATING MODELBILH PERFORMANCE NETWORK ("BILHPN") IS BILH'S CLINICALLY INTEGRATED NETWORK OF PHYSICIANS, CLINICIANS, AND HOSPITALS THAT WORK TOGETHER TO PROVIDE HIGH-QUALITY, COST-EFFECTIVE CARE FOR PATIENTS. BILHPN ACHIEVED ITS GOAL OF BECOMING A FULLY INTEGRATED CLINICALLY INTEGRATED NETWORK ("CIN") IN FY 2024. THIS MOVE POSITIONED ITS PROVIDERS TO IMPROVE CARE QUALITY AND SUCCEED IN A VALUE-BASED DELIVERY SYSTEM. ALONGSIDE THIS TRANSFORMATION, BILHPN HAS REDEFINED ITS OPERATING MODEL TO PRIORITIZE HIGH-QUALITY CARE, IMPROVE THE HEALTH OF THE POPULATIONS BILH SERVES, ENHANCE PERFORMANCE, AND PROMOTE WELL-BEING ACROSS ITS NETWORK. THROUGHOUT FY 2024, BILHPN CONCENTRATED ON QUALITY IMPROVEMENT INITIATIVES, SUCH AS REDUCING DISPARITY GAPS, LOWERING READMISSION RATES, IMPROVING DIABETES AND HYPERTENSION MANAGEMENT, AND ENHANCING SKILLED NURSING CARE VISITS. IMPROVING PHARMACY ACCESSTHROUGHOUT FY 2024, BILH PHARMACY EXPERIENCED SIGNIFICANT EXPANSION THAT REFLECTS ITS ONGOING COMMITMENT TO IMPROVING ACCESS TO CARE AND REDUCING THE COST OF CARE. ITS ACHIEVEMENTS INCLUDE: EXPANDED ACCESS TO 8,000 ADDITIONAL PATIENTS, INCLUDING 5,700 MEDICAID PATIENTS; IMPROVED PATIENT FINANCIAL ASSISTANCE SERVICES; LAUNCHED CLINICS FOCUSED ON WEIGHT LOSS AND IRRITABLE BOWEL SYNDROME AND EXPANDED ACCESS TO ANTICOAGULATION MANAGEMENT THROUGH THE CENTRALIZED ANTICOAGULATION MANAGEMENT PROGRAM; LAUNCHED INSCRIPT TO PROVIDE PHARMACY BENEFIT MANAGEMENT ("PBM") SERVICES TO FULLY INSURED AND SELF-FUNDED HEALTH PLANS, RESULTING IN HEALTH PLAN MEMBERS SAVING OVER 20% IN OUT-OF-POCKET COSTS AND GREATER ACCESS TO MEDICATION; AND, EXPANDED PHARMACY PRESENCE IN CLINICS TO IMPROVE ACCESS TO MEDICATIONS FOR TREATING DIABETES AND CARDIOVASCULAR DISEASES.
INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICES	IN 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.

Schedule H (Form 990) 2023

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
WINCHESTER HOSPITAL

Employer identification number
04-2104434

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) BOYS & GIRLS CLUB OF STONEHAM AND WAKEFIELD 15 DALE COURT STONEHAM,MA02180	23-7025777	501(C)(3)	20,000	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(2) COUNCIL OF SOCIAL CONCERN INC 2 MERRIMACK STREET WOBURN,MA01801	04-2494773	501(C)(3)	10,000	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(3) METRO HOUSING BOSTON 1411 TREMONT STREET BOSTON,MA02120	04-2775991	501(C)(3)	11,550	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(4) MINUTEMAN SENIOR SERVICES 26 CROSBY DRIVE BEDFORD,MA01730	04-2587212	501(C)(3)	9,871	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(5) MYSTIC VALLEY ELDER SERVICES 300 COMMERCIAL STREET MALDEN,MA02148	04-2562646	501(C)(3)	10,000	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(6) SOCIAL CAPITAL INC 165 NEW BOSTON STREET WOBURN,MA01801	76-0703107	501(C)(3)	19,350	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(7) TOWN OF TEWKSBURY 11 TOWN HALL AVENUE TEWKSBURY,MA01876	04-6001322	GOVERNMENT ENTITY	18,750	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(8) TOWN OF WINCHESTER 71 MOUNT VERNON STREET WINCHESTER,MA01890	04-6001371	GOVERNMENT ENTITY	120,000	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(9) WILMINGTON FARMER'S MARKET 4 JACQUITH ROAD WILMINGTON,MA01887	27-2854904	501(C)(3)	5,750	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(10) WOBURN CHAMBER OF COMMERCE 10 TOWER OFFICE PARK STE 416 WOBURN,MA01801	04-2845604	501(C)(6)	7,500	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(11) YMCA OF GREATER BOSTON INC 316 HUNTINGTON AVE STE 1 BOSTON,MA02115	04-2103551	501(C)(3)	20,500	0			CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
(12) BETH ISRAEL LAHEY HEALTH SPECIALTY CARE (FKA NORTHEAST MED PRACTICE) 529 MAIN ST 4TH FL CHARLESTOWN,MA02129	04-3201853	501(C)(3)	5,176,895	0			ACCESS TO PRIMARY AND/OR SPECIALTY CARE
(13) WINCHESTER HOUSING AUTHORITY 13 WESTLEY STREET WINCHESTER,MA01890	04-3036215	GOVERNMENT ENTITY	0	10,100	FMV	PRODUCE	FOOD AND FARM SUSTAINABILITY

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

AS PREVIOUSLY NOTED, WINCHESTER HOSPITAL MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND WINCHESTER HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. WINCHESTER HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.

PART IV, SUPPLEMENTAL INFORMATION - ACCESS TO PRIMARY AND/OR SPECIALTY CARE

AS PREVIOUSLY NOTED THROUGHOUT THIS FILING, WINCHESTER HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. 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. TO THAT END, WINCHESTER HOSPITAL PROVIDED GRANTS AND OTHER ASSISTANCE IN THE FORM OF CASH ALLOCATIONS FOR PRIMARY AND/OR SPECIALTY CARE OPERATIONS IN THE COMMUNITIES SERVED BY WINCHESTER HOSPITAL. THESE AMOUNTS ARE REPORTED IN THIS FORM 990 SCHEDULE I AND MAY NOT BE REFLECTED IN FORM 990 PART IX DEPENDING ON HOW THESE AMOUNTS WERE REPORTED IN THE AUDITED FINANCIAL STATEMENTS.

Schedule I (Form 990) 2023

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1TABB MD KEVIN CEO (EX-OFF) (CEO, BILH)	(i) (ii)	0 ------------- 2,183,284	0 ------------- 1,588,566	0 ------------- 541,537	0 ------------- 1,052,595	0 ------------- 44,433	0 ------------- 5,410,415	0 ------------- 0
2ROWAN MICHAEL TTEE(EXO)(CEO DESIG)EVP HOS&AMB BILH	(i) (ii)	0 ------------- 1,190,402	0 ------------- 617,208	0 ------------- 494,507	0 ------------- 2,372,445	0 ------------- 29,333	0 ------------- 4,703,895	0 ------------- 0
3RIOS CINDY TREAS (EX-OFF) (EXEC VP & CFO, BILH)	(i) (ii)	0 ------------- 926,412	0 ------------- 523,188	0 ------------- 21,827	0 ------------- 182,509	0 ------------- 35,227	0 ------------- 1,689,163	0 ------------- 0
4SHORETT PETER TTEE(CEO DESIG) (SR EVP & COO, BILH)	(i) (ii)	0 ------------- 902,677	0 ------------- 453,262	0 ------------- 203,537	0 ------------- 14,020	0 ------------- 34,226	0 ------------- 1,607,722	0 ------------- 0
5KATZ ESQ JAMIE CLERK (EX-OFF); GENERAL COUNSEL BILH	(i) (ii)	0 ------------- 820,540	0 ------------- 322,850	0 ------------- 126,785	0 ------------- 23,170	0 ------------- 8,832	0 ------------- 1,302,177	0 ------------- 0
6SOMANI TUSHAR FRMR COO, WINCHESTER HOSPITAL	(i) (ii)	313,841 ------------- 0	0 ------------- 0	93,768 ------------- 0	357,240 ------------- 0	30,815 ------------- 0	795,664 ------------- 0	0 ------------- 0
7WOODS MATTHEW ASSTTREAS/CFO (INT DIV CFO,COMM BILH	(i) (ii)	0 ------------- 390,356	0 ------------- 125,462	0 ------------- 8,258	0 ------------- 21,645	0 ------------- 33,623	0 ------------- 579,344	0 ------------- 0
8CAMPBELL RN MBA FACHE AL PRESIDENT & TRUSTEE (EX-OFFICIO)	(i) (ii)	394,231 ------------- 0	110,908 ------------- 0	69,809 ------------- 0	0 ------------- 0	2,802 ------------- 0	577,750 ------------- 0	0 ------------- 0
9ZITKOVSKY MD DANA SENIOR VP AND CHIEF MEDICAL OFFICER	(i) (ii)	391,147 ------------- 0	107,670 ------------- 0	18,572 ------------- 0	12,700 ------------- 0	36,582 ------------- 0	566,671 ------------- 0	0 ------------- 0
10BRECKWOLDT MD WILLIAM TRUSTEE; GENERAL SURGEON	(i) (ii)	0 ------------- 477,925	0 ------------- 0	0 ------------- 21,089	0 ------------- 12,919	0 ------------- 858	0 ------------- 512,791	0 ------------- 0
11MCALMON MD KAREN TRUSTEE; NEONATOLOGIST	(i) (ii)	0 ------------- 355,266	0 ------------- 9,900	0 ------------- 16,202	0 ------------- 66,000	0 ------------- 45,297	0 ------------- 492,665	0 ------------- 0
12KEANEY MPAH RN ACHCE KAREN CNO AND VP OF PATIENT CARE SERVICES	(i) (ii)	291,834 ------------- 0	80,753 ------------- 0	10,788 ------------- 0	12,684 ------------- 0	37,330 ------------- 0	433,389 ------------- 0	0 ------------- 0
13LUBIN MD ANDREW TTEE (EX-OFF) (PRES, MEDICAL STAFF)	(i) (ii)	0 ------------- 308,640	0 ------------- 27,500	0 ------------- 7,680	0 ------------- 13,198	0 ------------- 35,070	0 ------------- 392,088	0 ------------- 0
14ROBERTSON MPH CATHARINE VICE PRESIDENT, AMBULATORY SERVICES	(i) (ii)	261,767 ------------- 0	57,424 ------------- 0	8,492 ------------- 0	11,918 ------------- 0	28,166 ------------- 0	367,767 ------------- 0	0 ------------- 0
15SACHETTI NANCY DIRECTOR, HIGHLAND HEALTH	(i) (ii)	257,616 ------------- 0	0 ------------- 0	3,200 ------------- 0	7,433 ------------- 0	30,945 ------------- 0	299,194 ------------- 0	0 ------------- 0
16PARKER MD MARIANNA NEONATOLOGIST	(i) (ii)	199,994 ------------- 0	3,500 ------------- 0	25,865 ------------- 0	22,699 ------------- 0	38,850 ------------- 0	290,908 ------------- 0	0 ------------- 0
17GREGA JOANNE EXECUTIVE DIR, ANCILLARY SERVICES	(i) (ii)	236,159 ------------- 0	0 ------------- 0	2,772 ------------- 0	9,552 ------------- 0	34,823 ------------- 0	283,306 ------------- 0	0 ------------- 0
18LEVENSON HEATHER REGISTERED NURSE OBSTETRICS/DELIVERY	(i) (ii)	197,745 ------------- 0	7,750 ------------- 0	582 ------------- 0	8,553 ------------- 0	36,270 ------------- 0	250,900 ------------- 0	0 ------------- 0
19TAYLOR MD JOSEPH TTEE; PHYSICIAN, INTERNAL MEDICINE	(i) (ii)	0 ------------- 132,805	0 ------------- 71,080	0 ------------- 734	0 ------------- 9,745	0 ------------- 29,330	0 ------------- 243,694	0 ------------- 0
20TAYLOR ELIZABETH BETH EXEC DIR, HR BUSINESS PARTNER	(i) (ii)	192,738 ------------- 0	0 ------------- 0	8,321 ------------- 0	20,620 ------------- 0	12,432 ------------- 0	234,111 ------------- 0	0 ------------- 0
21SORRENTINO RACHEL CLINICAL NURSE SUPERVISOR	(i) (ii)	200,081 ------------- 0	1,300 ------------- 0	433 ------------- 0	8,750 ------------- 0	23,210 ------------- 0	233,774 ------------- 0	0 ------------- 0
22WEINER MD RICHARD FRMR TTEE & PRES (EX-OFF)	(i) (ii)	18,938 ------------- 0	0 ------------- 0	97,377 ------------- 0	15,712 ------------- 0	1,069 ------------- 0	133,096 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 1A	FROM TIME TO TIME AND UNDER CERTAIN CIRCUMSTANCES, WINCHESTER HOSPITAL OR ONE OF IT'S AFFILIATES MAY CHOOSE TO GROSS-UP A PAYMENT TO MAKE THE EMPLOYEE WHOLE FROM A TAX PERSPECTIVE. AS EXPLAINED FURTHER BELOW, ACROSS BILH THESE SITUATIONS ARE REVIEWED ON A CASE-BY-CASE BASIS AND THE COST OF ANY GROSS-UP IS CONSIDERED WHEN REVIEWING AN EMPLOYEE'S OVERALL COMPENSATION PACKAGE FOR REASONABLENESS. EXAMPLES OF THE TYPES OF EXPENSES WHICH MAY FALL INTO THIS CATEGORY ARE REIMBURSEMENT FOR RELOCATION AND TEMPORARY HOUSING. A HOUSING ALLOWANCE WAS PROVIDED TO ONE OFFICER DURING THE YEAR. THIS BENEFIT WAS TREATED AS PART OF THEIR TAXABLE COMPENSATION.
PART I, LINE 3	WINCHESTER HOSPITAL'S CHIEF EXECUTIVE OFFICER AND PRESIDENT ARE EMPLOYED THROUGH BETH ISRAEL LAHEY HEALTH (BILH), WHICH AS NOTED THROUGHOUT THIS FILING, IS THE DIRECT OR INDIRECT SOLE MEMBER OF WINCHESTER HOSPITAL. IN THIS CAPACITY, THE BILH COMPENSATION COMMITTEE SETS COMPENSATION FOR THE CEO AND PRESIDENT OF WINCHESTER HOSPITAL. AS NOTED IN RESPONSE TO THIS FORM 990 PART VI QUESTIONS 15A AND 15B, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER SENIOR EXECUTIVES IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO AS VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BILH BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS FOR BOTH THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES ARE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION.
PART I, LINES 4A-B	ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, RECEIVED SEVERANCE PAYMENTS. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. BILH AND ITS AFFILIATES MAINTAIN CERTAIN SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING PLANS, WHICH UNDER THE DEFINITION TO THIS FORM 990 ARE SUPPLEMENTAL NONQUALIFIED PLANS: BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM, BETH ISRAEL LAHEY HEALTH, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, LAHEY CLINIC FOUNDATION, INC. 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN PHYSICIANS, SENIOR MANAGEMENT AND DEFINED MEDICAL STAFF, THE JORDAN HEALTH SYSTEMS, INC. 457(F) DEFERRED COMPENSATION PLAN. IN ADDITION, DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THESE ADDITIONAL IRC 457(B) PLANS AND BENEFITS FROM PARTICIPATING IN ONE OF THESE PLANS IS ALSO REPORTED IN THIS FORM 990: ANNA JAQUES HOSPITAL SELECT GROUP 457(B) DEFERRED COMPENSATION PLAN, BETH ISRAEL DEACONESS HOSPITAL MILTON 457(B) PLAN, BETH ISRAEL DEACONESS MEDICAL CENTER 457(B) PLAN, BETH ISRAEL LAHEY HEALTH, INC. 457(B) DEFERRED COMPENSATION PLAN, LAHEY CLINIC FOUNDATION, INC. 457(B) NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN PHYSICIANS, SENIOR MANAGEMENT AND DEFINED MEDICAL STAFF, MOUNT AUBURN HOSPITAL 457(B) DEFERRED COMPENSATION PLAN, NEW ENGLAND BAPTIST HOSPITAL 457(B) PLAN, THE JORDAN HEALTH SYSTEMS, INC. ELIGIBLE DEFERRED COMPENSATION PLAN, WINCHESTER HOSPITAL SELECT GROUP 457(B) DEFERRED COMPENSATION PLAN, EXETER HEALTH RESOURCES, INC. 457(B) RETIREMENT SAVINGS PLAN, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. 457(B) DEFERRED COMPENSATION PLAN. THESE PLANS ARE NON-QUALIFIED DEFERRED COMPENSATION PLANS AND PURSUANT TO THE PLANS, ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS AND/OR CAN MAKE THEIR OWN EMPLOYEE DEFERRALS. AMOUNTS RECEIVED BY PARTICIPANTS AND DEFERRED BY PARTICIPANTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW.
PART I, LINE 7	AS NOTED ABOVE, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES. DURING THE 2023 CALENDAR YEAR, BILH MAINTAINED EXECUTIVE COMPENSATION PACKAGES WHICH INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF VARIOUS FACTORS, INCLUDING BUT NOT LIMITED TO, MEETING OR EXCEEDING THE EMPLOYING ENTITY'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, BUDGETED CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. IN EACH CASE, INCENTIVE COMPENSATION WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, AND FOR THE BILH CEO AS NOTED ABOVE, THE FULL BILH BOARD OF TRUSTEES. ADDITIONAL INFORMATION IS INCLUDED IN THE EXPLANATORY NOTES TO THIS SCHEDULE J.
SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES:	DIRECTORS AND TRUSTEES SERVE WITHOUT COMPENSATION: ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES IN THE NOTES BELOW. REPORTING PERIOD: AS REQUIRED BY FORM 990, COMPENSATION REPORTED IN THE FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024 IS CALENDAR YEAR 2023 COMPENSATION. COMPENSATION SOURCES: COMPENSATION REPORTED FOR INDIVIDUALS MAY INCLUDE COMPENSATION PAID BY THE REPORTING ENTITY, AN AFFILIATE OF THE REPORTING ENTITY AND IN SOME CASES UNRELATED ENTITIES AS REQUIRED BY FORM 990. REPORTABLE COMPENSATION: REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION: OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: ORDINARY WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER SUBSIDIZED PARKING; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE. DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401(K) RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403(B) RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT. NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE, AMONG OTHER THINGS, AMOUNTS FROM ONE OR MORE OF THE FOLLOWING NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ADDITIONAL INDIVIDUAL SPECIFIC INFORMATION IS INCLUDED BELOW.
SCHEDULE J FOOTNOTES (CONTINUED):	BRECKWOLDT, M.D., WILLIAM - TRUSTEE; GENERAL SURGEON WINCHESTER HOSPITAL - TRUSTEE; GENERAL SURGEON WINCHESTER HEALTHCARE MANAGEMENT, INC. CAMPBELL, RN, MBA, FACHE, AL UNLESS OTHERWISE NOTED BELOW, MR. CAMPBELL HELD THE POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2024: PRESIDENT & TRUSTEE (EX-OFFICIO) - WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. PRESIDENT & TRUSTEE (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. AS NOTED, MR. CAMPBELL SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. AS REPORTED IN THE PRIOR FORM 990, MR. CAMPBELL COMMENCED HIS POSITIONS ABOVE ON MARCH 6, 2023. OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR TEMPORARY HOUSING IN THE AMOUNT OF $68,494. CARUCCI, DEAN MR. CARUCCI BEGAN SERVING IN THE FOLLOWING ROLES ON AUGUST 5, 2024, UNLESS OTHERWISE NOTED BELOW: DIVISIONAL PRESIDENT, COMMUNITY - BETH ISRAEL LAHEY HEALTH, INC. TERM BEGAN ON JULY 29, 2024 TRUSTEE - WINCHESTER HEALTHCARE MANAGEMENT, INC. TERM BEGAN ON AUGUST 4, 2024 TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC TRUSTEE - BID - MILTON PHYSICIAN ASSOCIATES, INC. TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - EXETER HEALTH RESOURCES, INC. TRUSTEE - EXETER HOSPITAL, INC. TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - NORTHEAST HOSPITAL CORPORATION TRUSTEE - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - WINCHESTER HOSPITAL AS NOTED, MR. CARUCCI SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. ACCORDINGLY, SINCE MR. CARUCCI DID NOT BEGIN SERVING IN HIS POSITIONS UNTIL CALENDAR YEAR 2024, THERE IS NO COMPENSATION TO REPORT IN THIS FILING. GLASS, ESQ. HANNAH - ASSISTANT GENERAL COUNSEL BETH ISRAEL LAHEY HEALTH ASSISTANT CLERK (EX-OFFICIO)- WINCHESTER HOSPITAL - ASSISTANT CLERK (ASSISTANT GENERAL COUNSEL - BETH ISRAEL LAHEY HEALTH )- WINCHESTER HEALTHCARE MANAGEMENT, INC. ASSISTANT CLERK (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TERM BEGAN JANUARY 1, 2024 GREGA, JOANNE - EXECUTIVE DIRECTOR, ANCILLARY SERVICES- WINCHESTER HOSPITAL KATZ, J.D., JAMIE UNLESS OTHERWISE NOTED BELOW, MR. KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2024: GENERAL COUNSEL AND CLERK (EX-OFFICIO), - BETH ISRAEL LAHEY HEALTH, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. CLERK (EX-OFFICIO) - MOUNT AUBURN HOSPITAL CLERK (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. CLERK - COMMUNITY PHYSICIANS ASSOCIATES, INC. CLERK - BID - MILTON PHYSICIAN ASSOCIATES, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. CLERK - JORDAN PHYSICIAN ASSOCIATES, INC. CLERK - THE JORDAN HEALTH SYSTEMS, INC. CLERK (EX-OFFICIO) - ANNA JAQUES HOSPITAL CLERK - SEACOAST AFFILIATED GROUP PRACTICE, INC. TRUSTEE AND CLERK (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. TRUSTEE AND CLERK (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE AND CLERK (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND CLERK (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. TRUSTEE AND CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CLERK - WINCHESTER HEALTHCARE MANAGEMENT, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. CLERK - LAHEY CLINIC, INC. CLERK - LAHEY CLINIC HOSPITAL, INC.D/B/A LAHEY HOSPITAL & MEDICAL CENTER CLERK (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TRUSTEE AND CLERK (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) TRUSTEE AND CLERK - CAB HEALTH AND RECOVERY SERVICES, INC. TRUSTEE AND CLERK - HEALTH AND EDUCATION HOUSING SERVICES, INC. CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL CLERK - JOSLIN CLINIC, INC. CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. CLERK (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. CLERK - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. CLERK (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. CLERK - EXETER HOSPITAL, INC. CLERK (EX-OFFICIO) - CORE PHYSICIANS, LLC AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $76,930. IN ADDITION, MR. KATZ OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR GROUP TERM LIFE INSURANCE IN THE AMOUNTS OF $29,355. KEANEY, MPAH, RN, ACHCE, KAREN - CHIEF NURSING OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES- WINCHESTER HOSPITAL
SCHEDULE J FOOTNOTES (CONTINUED):	LEVENSON, HEATHER - REGISTERED NURSE, OBSTETRICS AND DELIVERY- WINCHESTER HOSPITAL LUBIN, M.D., ANDREW DR. LUBIN SERVED IN THE FOLLOWING ROLES UNTIL DECEMBER 31, 2023: TRUSTEE (EX-OFFICIO) (PRESIDENT, MEDICAL STAFF) WINCHESTER HOSPITAL TRUSTEE (PRESIDENT, MEDICAL STAFF) - WINCHESTER HEALTHCARE MANAGEMENT, INC. MCALMON, M.D., KAREN TRUSTEE; NEONATOLOGIST WINCHESTER HOSPITAL CORPORATION TRUSTEE; NEONATOLOGIST - WINCHESTER HEALTHCARE MANAGEMENT, INC. RIOS, CINDY MS. RIOS SERVED IN THE FOLLOWING POSITIONS FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2024: EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER & TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP TREASURER - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. TRUSTEE & TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TREASURER - BID - MILTON PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. TREASURER - JOSLIN CLINIC, INC. TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. TREASURER - THE JORDAN HEALTH SYSTEMS, INC. TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. TREASURER - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER TREASURER - LAHEY CLINIC, INC. TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TREASURER - SEACOAST AFFILIATED GROUP PRACTICE, INC. TRUSTEE & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. TREASURER - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE & TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TRUSTEE & TREASURER - HEALTH AND EDUCATION HOUSING SERVICES, INC. TRUSTEE & TREASURER - LAHEY HEALTH SHARED SERVICES, INC. TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE, INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE & TREASURER (EX-OFFICIO) - SEACOAST NURSING & REHABILITATION CENTER, INC. TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL TREASURER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. TREASURER - EXETER HOSPITAL, INC. TREASURER - EXETER MED REAL, INC. TRUSTEE & TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOC AND HOSPICE TREASURER (EX-OFFICIO) - CORE PHYSICIANS, LLC AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. DEFERRED COMPENSATION IN THE AMOUNT OF $125,000 RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2023, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. IN ADDITION, DEFERRED COMPENSATION INCLUDES AN UNVESTED CONTRIBUTION TO A NONQUALIFIED PLAN IN THE AMOUNT OF $52,757. PARKER, M.D., MARIANNA NEONATOLOGIST - WINCHESTER HOSPITAL ROBERTSON, MPH, CATHARINE VICE PRESIDENT, OPERATIONS - SEACOAST AFFILIATED GROUP PRACTICE, INC. TERM BEGAN ON OCTOBER 1, 2023 VICE PRESIDENT, AMBULATORY SERVICES - WINCHESTER HOSPITAL MS. ROBERTSON SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024, UNLESS OTHERWISE STATED. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J.
SCHEDULE J FOOTNOTES (CONTINUED):	ROWAN, MICHAEL MR. ROWAN SERVED IN THE FOLLOWING POSITIONS THROUGH HIS RETIREMENT ON DECEMBER 31, 2023: EXECUTIVE VICE PRESIDENT, HOSPITAL AND AMBULATORY SERVICES - BETH ISRAEL LAHEY HEALTH, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. TRUSTEE (CEO DESIGNATE) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - NORTHEAST HOSPITAL CORPORATION TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. TRUSTEE - THE JORDAN HEALTH SYSTEMS, INC. TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE - BID - MILTON PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JOSLIN CLINIC, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JOSLIN DIABETES CENTER, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - ANNA JAQUES HOSPITAL, INC. TRUSTEE (CEO DESIGNEE) - SEACOAST AFFILIATED GROUP PRACTICE, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (CEO DESIGNATE) - EXETER HOSPITAL, INC TRUSTEE (CEO DESIGNATE) - EXETER HEALTH RESOURCES, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. ROWAN INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $429,049. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. IN ADDITION, MR. ROWAN'S OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR GROUP TERM LIFE INSURANCE IN THE AMOUNTS OF $44,958. DEFERRED COMPENSATION FOR MR. ROWAN INCLUDES DEFERRED SEVERANCE PAYMENTS IN THE AMOUNT OF $2,353,850 TO BE PAID AFTER DECEMBER 31, 2023. SHORETT, PETER SENIOR EXECUTIVE VICE PRESIDENT AND CHIEF OPERATING OFFICER - BETH ISRAEL LAHEY HEALTH, INC. TERM BEGAN DECEMBER 10, 2023 EXECUTIVE VICE PRESIDENT AND CHIEF STRATEGY OFFICER - BETH ISRAEL LAHEY HEALTH, INC. TERM ENDED DECEMBER 9, 2023 TRUSTEE (EX-OFFICIO, CEO DESIGNATE) - MOUNT AUBURN HOSPITAL TERM ENDED ON JANUARY 31, 2024. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - ANNA JAQUES HOSPITAL, INC. TERM BEGAN ON JANUARY 1, 2024 TRUSTEE - SEACOAST AFFILIATED GROUP PRACTICE, INC. TERM BEGAN ON JANUARY 1, 2024 TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TERM BEGAN ON FEBRUARY 1, 2024 TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - LAHEY CLINIC FOUNDATION, INC. TERM BEGAN ON FEBRUARY 1, 2024 TRUSTEE - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER TERM BEGAN ON FEBRUARY 1, 2024 TRUSTEE - LAHEY CLINIC, INC. TERM BEGAN ON FEBRUARY 1, 2024 TRUSTEE (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TERM ENDED ON MARCH 29, 2024. TRUSTEE - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP TERM ENDED ON MARCH 29, 2024. IN ADDITION, MR. SHORETT SERVED IN THE FOLLOWING ROLES TERM DURING THE PERIOD JANUARY 1, 2024 AND ENDED AUGUST 4, 2024: TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. TRUSTEE - BID - MILTON PHYSICIAN ASSOCIATES, INC. TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - EXETER HEALTH RESOURCES, INC. TRUSTEE - EXETER HOSPITAL, INC. TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - NORTHEAST HOSPITAL CORPORATION TRUSTEE - THE JORDAN HEALTH SYSTEMS, INC. TRUSTEE - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - WINCHESTER HOSPITAL MR. SHORETT SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. SHORETT INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $179,843. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. SOMANI, TUSHAR MR. SOMANI'S TERM ENDED IN THE ABOVE POSITIONS ON SEPTEMBER 30, 2023 DURING A PRIOR FISCAL PERIOD FORMER CHIEF OPERATING OFFICER- WINCHESTER HOSPITAL AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. SOMANI INCLUDES SEVERANCE PAYMENTS RECEIVED IN 2023 IN THE AMOUNT OF $76,924. IN ADDITION, OTHER REPORTABLE COMPENSATION INCLUDES A PAYMENT RECEIVED WITH RESPECT TO A RETIREMENT BENEFIT IN THE AMOUNT OF $16,334.DEFERRED COMPENSATION FOR MR. SOMANI INCLUDES DEFERRED SEVERANCE PAYMENTS IN THE AMOUNT OF $353,855 TO BE PAID AFTER DECEMBER 31, 2023. SACHETTI, NANCY L -DIRECTOR, HIGHLAND HEALTH - WINCHESTER HOSPITAL SORRENTINO, RACHEL CLINICAL NURSE SUPERVISOR - WINCHESTER HOSPITAL
SCHEDULE J FOOTNOTES (CONTINUED):	TABB, M.D., KEVIN UNLESS OTHERWISE NOTED BELOW, DR. TABB HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2024: PRESIDENT AND CHIEF EXECUTIVE OFFICER; TRUSTEE (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. CHIEF EXECUTIVE OFFICER AND TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TRUSTEE (EX-OFFICIO) ROLE ENDED ON JANUARY 31, 2024 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER TRUSTEE (EX-OFFICIO) ROLE ENDED ON JANUARY 31, 2024 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC, INC. TRUSTEE (EX-OFFICIO) ROLE ENDED ON JANUARY 31, 2024 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. TRUSTEE (EX-OFFICIO) ROLE ENDED ON JANUARY 31, 2024 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. PRESIDENT (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE, BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HOSPITAL TRUSTEE AND PRESIDENT (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CHIEF EXECUTIVE OFFICER - WINCHESTER HEALTHCARE MANAGEMENT, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION CHIEF EXECUTIVE OFFICER (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE (EX-OFFICIO) ROLE ENDED ON OCTOBER 31, 2023 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE CHIEF EXECUTIVE OFFICER AND TRUSTEE - CAB HEALTH AND RECOVERY SERVICES, INC. TRUSTEE ROLE ENDED ON OCTOBER 31, 2023 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE CHIEF EXECUTIVE OFFICER AND TRUSTEE - HEALTH AND EDUCATION HOUSING SERVICES, INC. TRUSTEE ROLE ENDED ON OCTOBER 31, 2023 AT WHICH TIME HE APPOINTED A DESIGNEE TO THIS ROLE CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. CHIEF EXECUTIVE OFFICER - BID - MILTON PHYSICIAN ASSOCIATES, INC. CHIEF EXECUTIVE OFFICER - COMMUNITY PHYSICIANS ASSOCIATES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL CHIEF EXECUTIVE OFFICER - THE JORDAN HEALTH SYSTEMS, INC. CHIEF EXECUTIVE OFFICER - JORDAN PHYSICIAN ASSOCIATES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. CHIEF EXECUTIVE OFFICER - SEACOAST AFFILIATED GROUP PRACTICE, INC. CHIEF EXECUTIVE OFFICER - JOSLIN CLINIC, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. CHIEF EXECUTIVE OFFICER - EXETER HOSPITAL, INC. IN ADDITION TO THE POSITIONS NOTED ABOVE, DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNEE WHO THEN BECAME THE VOTING TRUSTEE IN HIS PLACE: TRUSTEE (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, BID-MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATES TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, THE JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL AND WINCHESTER HEALTHCARE MANAGEMENT TRUSTEE (EX-OFFICIO) ANNA JAQUES HOSPITAL, INC. AND SEACOAST AFFILIATED GROUP PRACTICE TRUSTEE (EX-OFFICIO) JOSLIN DIABETES CENTER TRUSTEE (EX-OFFICIO) JOSLIN CLINIC TRUSTEE (EX-OFFICIO) EXETER HEALTH RESOURCES, INC. TRUSTEE (EX-OFFICIO) EXETER HOSPITAL, INC. TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TRUSTEE (EX-OFFICIO) LAHEY CLINIC FOUNDATION, INC. TRUSTEE (EX-OFFICIO) LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER TRUSTEE (EX-OFFICIO) LAHEY CLINIC, INC. TRUSTEE (EX-OFFICIO) CAB HEALTH AND RECOVERY SERVICES, INC. TRUSTEE (EX-OFFICIO) HEALTH AND EDUCATION HOUSING SERVICES, INC. TRUSTEE (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2024. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $497,673. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. IN ADDITION, DR. TABB'S OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR GROUP TERM LIFE INSURANCE IN THE AMOUNTS OF $23,364. DEFERRED COMPENSATION IN THE AMOUNT OF $1,034,000 IS INCLUDED IN THIS FILING FOR DR. TABB. THIS AMOUNT RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2023, WAS NOT FUNDED, WAS NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. TAYLOR, JOSEPH TRUSTEE; PHYSICIAN, INTERNAL MEDICINE WINCHESTER HOSPITAL TRUSTEE; PHYSICIAN, INTERNAL MEDICINE WINCHESTER HEALTHCARE MANAGEMENT, INC. TAYLOR, ELIZABETH EXEC DIRECTOR, HUMAN RESOURCES BUSINESS PARTNER - WINCHESTER HOSPITAL WEINER, M.D., RICHARD FORMER PRESIDENT & TRUSTEE (EX-OFFICIO) - WINCHESTER HOSPITAL FORMER PRESIDENT (EX-OFFICIO) & TRUSTEE WINCHESTER HEALTHCARE MANAGEMENT, INC. FORMER TRUSTEE (EX-OFFICIO) & PRESIDENT - WINCHESTER HOSPITAL FOUNDATION, INC. DR. WEINER RETIRED FROM THE POSITIONS ABOVE ON DECEMBER 31, 2022 WHICH WAS DURING THE PRIOR FISCAL PERIOD. AS REQUIRED IN FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR DR. WEINER INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $96,820 AND RELATED TO SERVICES TO THE ENTITIES ABOVE PRIOR TO HIS RETIREMENT WOODS, MATTHEW UNLESS OTHERWISE NOTED BELOW, MR. WOODS HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2024: SENIOR VICE PRESIDENT, CORPORATE FINANCE - BETH ISRAEL LAHEY HEALTH, INC. TERM BEGAN ON SEPTEMBER 8, 2024 INTERIM DIVISIONAL CHIEF FINANCIAL OFFICER, COMMUNITY DIVISION - BETH ISRAEL LAHEY HEALTH, INC. TERM BEGAN ON APRIL 7, 2024 AND TERM ENDED ON SEPTEMBER 7,2024 CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2023 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. ZITKOVSKY, M.D., DANA - SENIOR VICE PRESIDENT AND CHIEF MEDICAL OFFICER - WINCHESTER HOSPITAL OTHER REPORTABLE COMPENSATION INCLUDES CASH PAYMENTS RELATED TO RETIREMENT IN THE AMOUNT OF $15,800.

Schedule J (Form 990) 2023

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
WINCHESTER HOSPITAL

Employer identification number
04-2104434

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584Y7K9	12-12-2023	442,970,000	MDFA - SERIES 2023M - SEE PART VI		X		X		X
B	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584YTK5	07-31-2019	211,922,775	MDFA - SERIES 2019K - SEE PART VI		X		X		X
C	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584YJW0	06-26-2018	479,594,374	MDFA - SERIES 2018J-1,J-2 - SEE PART VI		X		X		X
D	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584XMT5	05-12-2016	257,611,877	MDFA - SERIES 2016I - SEE PART VI		X		X		X
	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584XFW6	10-21-2015	262,828,878	MDFA - LAHEY SERIES F - SEE PART VI		X		X		X
	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584XDH1	09-02-2015	203,702,204	MDFA - SERIES 2015 H-1 - SEE PART VI		X		X		X
	NH HEALTH AND EDUCATION FACILITIES AUTHORITY	02-0279866	000000000	03-02-2015	24,020,000	EXETER SERIES 2015 - SEE PART VI		X		X		X
	NH HEALTH AND EDUCATION FACILITIES AUTHORITY	02-0279866	000000000	03-09-2012	32,565,000	EXETER SERIES 2012 - SEE PART VI		X		X		X
	MASS HEALTH & EDUCATIONAL FACILITIES AUTHORITY	04-2456011	57586CDD4	07-08-2004	30,340,000	MHEFA - WINCHESTER F - ADV REFUND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	35,800,000		33,635,000		17,085,000		61,215,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	452,893,704		211,922,775		504,358,641		257,618,370
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	4,857,465
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	3,559,000		2,931,137		4,594,374		2,515,889
8 Credit enhancement from proceeds .............	47,003
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	305,961,081		19,714,020		499,764,267		19,006,493
11 Other spent proceeds .............	160,202,232		189,277,618		23,857,846		236,095,988
12 Other unspent proceeds .............	143,373,623
13 Year of substantial completion .............	2021		2019		2021		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X		X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X	X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X	X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?			X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X	X			X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?					X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X			X		X		X
b Exception to rebate? ........		X	X			X		X
c No rebate due? .........		X	X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	MORGAN STANLEY
c Term of hedge .........	2000.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
BOND A, ENTITY 1:	PART I, ROW A, COLUMN F: THE ISSUE'S PROCEEDS WILL BE USED TO FINANCE PROJECTS AND PAY ISSUANCE COSTS.
BOND B, ENTITY 1:	PART I, ROW B, COLUMN F: FOR TAX PURPOSES (PURSUANT TO PROPOSED TREASURY REGULATIONS SECTION 1.150-1(D)(2)(II)(C)), THE ISSUE'S PROCEEDS OTHER THAN THOSE ALLOCATED TO COSTS OF ISSUANCE WERE ALLOCATED TO CAPITAL EXPENDITURES ON THE DATE OF CLOSING. THE PRESENTATION SHOWN HERE DEPARTS FROM THE TAX TREATMENT, REFLECTING THE CHARACTERIZATION OF THE TRANSACTION FOR OTHER PURPOSES, AND IS MORE IN ACCORDANCE TO THE FINANCIAL ACCOUNTING PRESENTATION. PART IV, COLUMN B, LINE 2C: ARBITRAGE REBATE CALCULATION PERFORMED ON 11/12/2024
BOND C, ENTITY 1:	PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $24,764,267 OF INVESTMENT EARNINGS. PART IV, COLUMN C, LINE 2C: FINAL REBATE CALCULATION SHOWING NO REBATE DUE COMPLETED ON 09/30/2023.
BOND D, ENTITY 1:	PART I, ROW D, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998. PART II, COLUMN D, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. PART IV, COLUMN D, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND A, ENTITY 2:	PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 08/17/2007 AND 07/14/2005. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $125,030 OF INVESTMENT EARNINGS. PART IV, COLUMN A, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND B, ENTITY 2:	PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES (DATED 06/09/2008; 11/30/2005; 07/16/2003; AND 06/04/1998), FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART II, COLUMN B, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW PART IV, COLUMN B, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019.
BOND C, ENTITY 2:	PART I, ROW C, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW C, COLUMN F: REFINANCING AND REFUNDING PRIOR BONDS ISSUED ON 11/20/2003 AND 12/19/2001. PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW.
BOND D, ENTITY 2:	PART I, ROW D, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW D, COLUMN F: REFINANCING AND REFUNDING PRIOR BOND ISSUANCE 12/19/2001. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW.
BOND A, ENTITY 3:	PART I, ROW A, COLUMN A: MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PART I, ROW A, COLUMN F: DESCRIPTION OF PURPOSE - REFUND ISSUE DATED 06/28/2000. PART II, COLUMN A, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. PART IV, ROW 2C, COLUMN A: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 10, 2009.
PART III, LINE 9 AND PART IV, LINE 7:	THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS ORIGINALLY FORMED IN JUNE 2020 AND EXPANDED WITH THE ADDITION OF EXETER HOSPITAL (EIN: 22-2674014) IN JULY 2024. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC) SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH NOT EVERY MEMBER OF THE BILH OBLIGATED GROUP HAS FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, THOSE THAT HAVE NOT NEVERTHELESS FOLLOW THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS. THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP. THE OBLIGATED GROUP INCLUDES THE FOLLOWING ENTITIES: BETH ISRAEL DEACONESS MEDICAL CENTER, INC., MOUNT AUBURN HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., NEW ENGLAND BAPTIST HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL MILTON, INC., BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC., MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, MOUNT AUBURN PROFESSIONAL SERVICES, INC., LAHEY CLINIC FOUNDATION, INC., LAHEY CLINIC, INC., LAHEY CLINIC HOSPITAL, INC., NORTHEAST HOSPITAL CORPORATION, WINCHESTER HOSPITAL, ANNA JAQUES HOSPITAL AND EXETER HOSPITAL. THE OBLIGATED GROUP IS AWARE OF THE INSTRUCTIONS TO SCHEDULE K THAT STATE THAT "IF THE ORGANIZATION HAS ONE OR MORE RELATED ORGANIZATIONS (FOR EXAMPLE, PARENT AND SUBSIDIARY RELATIONSHIP), IT MUST COMPLETE SCHEDULE K (FORM 990) CONSISTENT WITH THE FILINGS(S) OF ITS RELATED ORGANIZATION(S). THE SAME LIABILITY SHOULDN'T BE REPORTED BY MORE THAN ONE OF THE RELATED ORGANIZATIONS." THE OBLIGATED GROUP IS CURRENTLY WORKING TOWARD A DETERMINATION REGARDING THE REPORTING OF TAX-EXEMPT DEBT AMONG ITS MEMBERS WITH RESPECT TO SCHEDULE K. IN THE ABSENCE OF SUCH A DETERMINATION, FOR THE REPORTING PERIOD ENDING ON 09/30/2024, THE OBLIGATED GROUP HAS INCLUDED ALL TAX-EXEMPT BOND ISSUES ON EACH OF ITS MEMBER'S FORM 990 SCHEDULES K, WHICH IS CONSISTENT WITH THE APPROACH THAT HAS BEEN TAKEN SINCE THE OBLIGATED GROUP'S FORMATION.

Schedule K (Form 990) 2023

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
WINCHESTER HOSPITAL

Employer identification number
04-2104434

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584Y7K9	12-12-2023	442,970,000	MDFA - SERIES 2023M - SEE PART VI		X		X		X
B	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584YTK5	07-31-2019	211,922,775	MDFA - SERIES 2019K - SEE PART VI		X		X		X
C	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584YJW0	06-26-2018	479,594,374	MDFA - SERIES 2018J-1,J-2 - SEE PART VI		X		X		X
D	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584XMT5	05-12-2016	257,611,877	MDFA - SERIES 2016I - SEE PART VI		X		X		X
	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584XFW6	10-21-2015	262,828,878	MDFA - LAHEY SERIES F - SEE PART VI		X		X		X
	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584XDH1	09-02-2015	203,702,204	MDFA - SERIES 2015 H-1 - SEE PART VI		X		X		X
	NH HEALTH AND EDUCATION FACILITIES AUTHORITY	02-0279866	000000000	03-02-2015	24,020,000	EXETER SERIES 2015 - SEE PART VI		X		X		X
	NH HEALTH AND EDUCATION FACILITIES AUTHORITY	02-0279866	000000000	03-09-2012	32,565,000	EXETER SERIES 2012 - SEE PART VI		X		X		X
	MASS HEALTH & EDUCATIONAL FACILITIES AUTHORITY	04-2456011	57586CDD4	07-08-2004	30,340,000	MHEFA - WINCHESTER F - ADV REFUND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	35,800,000		33,635,000		17,085,000		61,215,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	452,893,704		211,922,775		504,358,641		257,618,370
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	4,857,465
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	3,559,000		2,931,137		4,594,374		2,515,889
8 Credit enhancement from proceeds .............	47,003
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	305,961,081		19,714,020		499,764,267		19,006,493
11 Other spent proceeds .............	160,202,232		189,277,618		23,857,846		236,095,988
12 Other unspent proceeds .............	143,373,623
13 Year of substantial completion .............	2021		2019		2021		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X		X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X	X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X	X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?			X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X	X			X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?					X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X			X		X		X
b Exception to rebate? ........		X	X			X		X
c No rebate due? .........		X	X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	MORGAN STANLEY
c Term of hedge .........	2000.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
BOND A, ENTITY 1:	PART I, ROW A, COLUMN F: THE ISSUE'S PROCEEDS WILL BE USED TO FINANCE PROJECTS AND PAY ISSUANCE COSTS.
BOND B, ENTITY 1:	PART I, ROW B, COLUMN F: FOR TAX PURPOSES (PURSUANT TO PROPOSED TREASURY REGULATIONS SECTION 1.150-1(D)(2)(II)(C)), THE ISSUE'S PROCEEDS OTHER THAN THOSE ALLOCATED TO COSTS OF ISSUANCE WERE ALLOCATED TO CAPITAL EXPENDITURES ON THE DATE OF CLOSING. THE PRESENTATION SHOWN HERE DEPARTS FROM THE TAX TREATMENT, REFLECTING THE CHARACTERIZATION OF THE TRANSACTION FOR OTHER PURPOSES, AND IS MORE IN ACCORDANCE TO THE FINANCIAL ACCOUNTING PRESENTATION. PART IV, COLUMN B, LINE 2C: ARBITRAGE REBATE CALCULATION PERFORMED ON 11/12/2024
BOND C, ENTITY 1:	PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $24,764,267 OF INVESTMENT EARNINGS. PART IV, COLUMN C, LINE 2C: FINAL REBATE CALCULATION SHOWING NO REBATE DUE COMPLETED ON 09/30/2023.
BOND D, ENTITY 1:	PART I, ROW D, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998. PART II, COLUMN D, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. PART IV, COLUMN D, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND A, ENTITY 2:	PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 08/17/2007 AND 07/14/2005. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $125,030 OF INVESTMENT EARNINGS. PART IV, COLUMN A, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND B, ENTITY 2:	PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES (DATED 06/09/2008; 11/30/2005; 07/16/2003; AND 06/04/1998), FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART II, COLUMN B, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW PART IV, COLUMN B, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019.
BOND C, ENTITY 2:	PART I, ROW C, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW C, COLUMN F: REFINANCING AND REFUNDING PRIOR BONDS ISSUED ON 11/20/2003 AND 12/19/2001. PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW.
BOND D, ENTITY 2:	PART I, ROW D, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW D, COLUMN F: REFINANCING AND REFUNDING PRIOR BOND ISSUANCE 12/19/2001. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW.
BOND A, ENTITY 3:	PART I, ROW A, COLUMN A: MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PART I, ROW A, COLUMN F: DESCRIPTION OF PURPOSE - REFUND ISSUE DATED 06/28/2000. PART II, COLUMN A, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. PART IV, ROW 2C, COLUMN A: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 10, 2009.
PART III, LINE 9 AND PART IV, LINE 7:	THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS ORIGINALLY FORMED IN JUNE 2020 AND EXPANDED WITH THE ADDITION OF EXETER HOSPITAL (EIN: 22-2674014) IN JULY 2024. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC) SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH NOT EVERY MEMBER OF THE BILH OBLIGATED GROUP HAS FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, THOSE THAT HAVE NOT NEVERTHELESS FOLLOW THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS. THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP. THE OBLIGATED GROUP INCLUDES THE FOLLOWING ENTITIES: BETH ISRAEL DEACONESS MEDICAL CENTER, INC., MOUNT AUBURN HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., NEW ENGLAND BAPTIST HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL MILTON, INC., BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC., MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, MOUNT AUBURN PROFESSIONAL SERVICES, INC., LAHEY CLINIC FOUNDATION, INC., LAHEY CLINIC, INC., LAHEY CLINIC HOSPITAL, INC., NORTHEAST HOSPITAL CORPORATION, WINCHESTER HOSPITAL, ANNA JAQUES HOSPITAL AND EXETER HOSPITAL. THE OBLIGATED GROUP IS AWARE OF THE INSTRUCTIONS TO SCHEDULE K THAT STATE THAT "IF THE ORGANIZATION HAS ONE OR MORE RELATED ORGANIZATIONS (FOR EXAMPLE, PARENT AND SUBSIDIARY RELATIONSHIP), IT MUST COMPLETE SCHEDULE K (FORM 990) CONSISTENT WITH THE FILINGS(S) OF ITS RELATED ORGANIZATION(S). THE SAME LIABILITY SHOULDN'T BE REPORTED BY MORE THAN ONE OF THE RELATED ORGANIZATIONS." THE OBLIGATED GROUP IS CURRENTLY WORKING TOWARD A DETERMINATION REGARDING THE REPORTING OF TAX-EXEMPT DEBT AMONG ITS MEMBERS WITH RESPECT TO SCHEDULE K. IN THE ABSENCE OF SUCH A DETERMINATION, FOR THE REPORTING PERIOD ENDING ON 09/30/2024, THE OBLIGATED GROUP HAS INCLUDED ALL TAX-EXEMPT BOND ISSUES ON EACH OF ITS MEMBER'S FORM 990 SCHEDULES K, WHICH IS CONSISTENT WITH THE APPROACH THAT HAS BEEN TAKEN SINCE THE OBLIGATED GROUP'S FORMATION.

Schedule K (Form 990) 2023

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
WINCHESTER HOSPITAL

Employer identification number
04-2104434

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584Y7K9	12-12-2023	442,970,000	MDFA - SERIES 2023M - SEE PART VI		X		X		X
B	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584YTK5	07-31-2019	211,922,775	MDFA - SERIES 2019K - SEE PART VI		X		X		X
C	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584YJW0	06-26-2018	479,594,374	MDFA - SERIES 2018J-1,J-2 - SEE PART VI		X		X		X
D	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584XMT5	05-12-2016	257,611,877	MDFA - SERIES 2016I - SEE PART VI		X		X		X
	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584XFW6	10-21-2015	262,828,878	MDFA - LAHEY SERIES F - SEE PART VI		X		X		X
	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	57584XDH1	09-02-2015	203,702,204	MDFA - SERIES 2015 H-1 - SEE PART VI		X		X		X
	NH HEALTH AND EDUCATION FACILITIES AUTHORITY	02-0279866	000000000	03-02-2015	24,020,000	EXETER SERIES 2015 - SEE PART VI		X		X		X
	NH HEALTH AND EDUCATION FACILITIES AUTHORITY	02-0279866	000000000	03-09-2012	32,565,000	EXETER SERIES 2012 - SEE PART VI		X		X		X
	MASS HEALTH & EDUCATIONAL FACILITIES AUTHORITY	04-2456011	57586CDD4	07-08-2004	30,340,000	MHEFA - WINCHESTER F - ADV REFUND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	35,800,000		33,635,000		17,085,000		61,215,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	452,893,704		211,922,775		504,358,641		257,618,370
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	4,857,465
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	3,559,000		2,931,137		4,594,374		2,515,889
8 Credit enhancement from proceeds .............	47,003
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	305,961,081		19,714,020		499,764,267		19,006,493
11 Other spent proceeds .............	160,202,232		189,277,618		23,857,846		236,095,988
12 Other unspent proceeds .............	143,373,623
13 Year of substantial completion .............	2021		2019		2021		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X		X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X	X
16 Has the final allocation of proceeds been made? ..........		X	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X	X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X	X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?			X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X	X			X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?					X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X			X		X		X
b Exception to rebate? ........		X	X			X		X
c No rebate due? .........		X	X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	MORGAN STANLEY
c Term of hedge .........	2000.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
BOND A, ENTITY 1:	PART I, ROW A, COLUMN F: THE ISSUE'S PROCEEDS WILL BE USED TO FINANCE PROJECTS AND PAY ISSUANCE COSTS.
BOND B, ENTITY 1:	PART I, ROW B, COLUMN F: FOR TAX PURPOSES (PURSUANT TO PROPOSED TREASURY REGULATIONS SECTION 1.150-1(D)(2)(II)(C)), THE ISSUE'S PROCEEDS OTHER THAN THOSE ALLOCATED TO COSTS OF ISSUANCE WERE ALLOCATED TO CAPITAL EXPENDITURES ON THE DATE OF CLOSING. THE PRESENTATION SHOWN HERE DEPARTS FROM THE TAX TREATMENT, REFLECTING THE CHARACTERIZATION OF THE TRANSACTION FOR OTHER PURPOSES, AND IS MORE IN ACCORDANCE TO THE FINANCIAL ACCOUNTING PRESENTATION. PART IV, COLUMN B, LINE 2C: ARBITRAGE REBATE CALCULATION PERFORMED ON 11/12/2024
BOND C, ENTITY 1:	PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $24,764,267 OF INVESTMENT EARNINGS. PART IV, COLUMN C, LINE 2C: FINAL REBATE CALCULATION SHOWING NO REBATE DUE COMPLETED ON 09/30/2023.
BOND D, ENTITY 1:	PART I, ROW D, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998. PART II, COLUMN D, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. PART IV, COLUMN D, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND A, ENTITY 2:	PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 08/17/2007 AND 07/14/2005. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $125,030 OF INVESTMENT EARNINGS. PART IV, COLUMN A, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND B, ENTITY 2:	PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES (DATED 06/09/2008; 11/30/2005; 07/16/2003; AND 06/04/1998), FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART II, COLUMN B, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW PART IV, COLUMN B, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019.
BOND C, ENTITY 2:	PART I, ROW C, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW C, COLUMN F: REFINANCING AND REFUNDING PRIOR BONDS ISSUED ON 11/20/2003 AND 12/19/2001. PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW.
BOND D, ENTITY 2:	PART I, ROW D, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW D, COLUMN F: REFINANCING AND REFUNDING PRIOR BOND ISSUANCE 12/19/2001. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW.
BOND A, ENTITY 3:	PART I, ROW A, COLUMN A: MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PART I, ROW A, COLUMN F: DESCRIPTION OF PURPOSE - REFUND ISSUE DATED 06/28/2000. PART II, COLUMN A, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. PART IV, ROW 2C, COLUMN A: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 10, 2009.
PART III, LINE 9 AND PART IV, LINE 7:	THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS ORIGINALLY FORMED IN JUNE 2020 AND EXPANDED WITH THE ADDITION OF EXETER HOSPITAL (EIN: 22-2674014) IN JULY 2024. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC) SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH NOT EVERY MEMBER OF THE BILH OBLIGATED GROUP HAS FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, THOSE THAT HAVE NOT NEVERTHELESS FOLLOW THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS. THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP. THE OBLIGATED GROUP INCLUDES THE FOLLOWING ENTITIES: BETH ISRAEL DEACONESS MEDICAL CENTER, INC., MOUNT AUBURN HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., NEW ENGLAND BAPTIST HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL MILTON, INC., BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC., MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, MOUNT AUBURN PROFESSIONAL SERVICES, INC., LAHEY CLINIC FOUNDATION, INC., LAHEY CLINIC, INC., LAHEY CLINIC HOSPITAL, INC., NORTHEAST HOSPITAL CORPORATION, WINCHESTER HOSPITAL, ANNA JAQUES HOSPITAL AND EXETER HOSPITAL. THE OBLIGATED GROUP IS AWARE OF THE INSTRUCTIONS TO SCHEDULE K THAT STATE THAT "IF THE ORGANIZATION HAS ONE OR MORE RELATED ORGANIZATIONS (FOR EXAMPLE, PARENT AND SUBSIDIARY RELATIONSHIP), IT MUST COMPLETE SCHEDULE K (FORM 990) CONSISTENT WITH THE FILINGS(S) OF ITS RELATED ORGANIZATION(S). THE SAME LIABILITY SHOULDN'T BE REPORTED BY MORE THAN ONE OF THE RELATED ORGANIZATIONS." THE OBLIGATED GROUP IS CURRENTLY WORKING TOWARD A DETERMINATION REGARDING THE REPORTING OF TAX-EXEMPT DEBT AMONG ITS MEMBERS WITH RESPECT TO SCHEDULE K. IN THE ABSENCE OF SUCH A DETERMINATION, FOR THE REPORTING PERIOD ENDING ON 09/30/2024, THE OBLIGATED GROUP HAS INCLUDED ALL TAX-EXEMPT BOND ISSUES ON EACH OF ITS MEMBER'S FORM 990 SCHEDULES K, WHICH IS CONSISTENT WITH THE APPROACH THAT HAS BEEN TAKEN SINCE THE OBLIGATED GROUP'S FORMATION.

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Return Reference	Explanation
FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:	THE MISSION OF WINCHESTER HOSPITAL IS "TO CARE. TO HEAL. TO EXCEL." THIS ETHOS PROVIDES EACH AND EVERY STAFF MEMBER WITH CLEAR EXPECTATIONS, PROMOTING TEAMWORK AND RESPECT WHILE ENSURING SAFETY, QUALITY AND EMPATHY FOR PATIENTS. WINCHESTER HOSPITAL'S SUCCESS IS BASED ON THIS SHARED COMMITMENT TO EXCELLENCE. THE HOSPITAL AND ITS STAFF TAKE PRIDE IN OFFERING AN EXCEPTIONAL PATIENT CARE EXPERIENCE, PROVIDING SAFE, HIGH-QUALITY, COMMUNITY-BASED HEALTH CARE AND ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH ITS AFFILIATES IN THE BETH ISRAEL LAHEY HEALTH NETWORK WITH THE ULTIMATE GOAL OF IMPROVING THE HEALTH OF THE HOSPITAL'S PATIENTS AND THE COMMUNITIES SERVED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL (AJH), 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), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), 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) AND EXETER HEALTH RESOURCES INC SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL. EACH OF THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES.
FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:	THE MISSION OF WINCHESTER HOSPITAL IS "TO CARE. TO HEAL. TO EXCEL." THIS ETHOS PROVIDES EACH AND EVERY STAFF MEMBER WITH CLEAR EXPECTATIONS, PROMOTING TEAMWORK AND RESPECT WHILE ENSURING SAFETY, QUALITY AND EMPATHY FOR PATIENTS. WINCHESTER HOSPITAL'S SUCCESS IS BASED ON THIS SHARED COMMITMENT TO EXCELLENCE. THE HOSPITAL AND ITS STAFF TAKE PRIDE IN OFFERING AN EXCEPTIONAL PATIENT CARE EXPERIENCE, PROVIDING SAFE, HIGH-QUALITY, COMMUNITY-BASED HEALTH CARE AND ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH ITS AFFILIATES IN THE BETH ISRAEL LAHEY HEALTH NETWORK WITH THE ULTIMATE GOAL OF IMPROVING THE HEALTH OF THE HOSPITAL'S PATIENTS AND THE COMMUNITIES SERVED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL (AJH), 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), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), 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) AND EXETER HEALTH RESOURCES INC SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL. EACH OF THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,700 PHYSICIANS AND 39,000 EMPLOYEES.
FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE:	OUTPATIENT CLINICS AND SERVICES WINCHESTER HOSPITAL'S TREMENDOUS PRESENCE AND COMMITMENT IN THE COMMUNITY IS EXEMPLIFIED BY THE VARIOUS OUTPATIENT FACILITIES THROUGHOUT THE NORTH-OF-BOSTON AREA, INCLUDING WOBURN, STONEHAM, WILMINGTON AND MEDFORD. THE AMBULATORY SURGERY CENTER IN WINCHESTER IS A STATE-OF-THE-ART OUTPATIENT SURGERY CENTER OFFERING ADVANCED DAY SURGERY. THE CENTER FEATURES REDUCED WAIT TIMES FOR SURGICAL CARE, EXPANDED CAPACITY AND SERVICES TO ADDRESS PATIENT NEEDS, AND A FACILITY THAT WILL ALLOW FOR FUTURE EXPANSION. THE FACILITY IS ALSO HOME TO THE HOSPITAL'S CENTER FOR CANCER CARE, WHICH WAS CREATED BASED ON THE VISION TO DEVELOP A STATE-OF-THE ART, COMMUNITY-BASED CENTER DEDICATED TO AN INTEGRATED MODEL OF CANCER CARE. WINCHESTER HOSPITAL IS PROUD TO OFFER PATIENTS DIAGNOSED WITH CANCER EASY ACCESS TO THE MOST ADVANCED CLINICAL CARE IN AN ENVIRONMENT UNIQUELY DEDICATED TO MEETING THEIR MEDICAL AND EMOTIONAL NEEDS. WINCHESTER HOSPITAL IN CONJUNCTION WITH THE MEDICAL STAFF PROVIDES OUTPATIENT PRIMARY CARE AS WELL AS ENDOSCOPIC, CHEMOTHERAPEUTIC AND CANCER MANAGEMENT, CARDIAC REHABILITATION AND DIABETES MANAGEMENT SERVICES, WOUND CARE AND HYPERBARIC PROGRAMS, AND SLEEP CLINIC SERVICES. WINCHESTER HOSPITAL ALSO OFFERS OCCUPATIONAL, PHYSICAL, AND SPEECH HEALTH SERVICES AND NUTRITIONAL COUNSELING. DIAGNOSTIC FACILITIES INCLUDE CT SCANNING, ULTRASOUND, MRI, MAMMOGRAPHY AND INTERVENTIONAL RADIOLOGY. ADDITIONALLY, THROUGH THE CENTER FOR HEALTHY LIVING, WINCHESTER HOSPITAL HELPS COMMUNITY MEMBERS TAKE RESPONSIBILITY FOR THEIR HEALTH AND WELLBEING BY OFFERING EDUCATION AND RESOURCES THAT FOCUS ON HEALTHY LIVING, YOGA, WELLNESS, AND CHILDBIRTH (INCLUDING LACTATION). DURING THE PERIOD COVERED BY THIS FILING, WINCHESTER HOSPITAL HAD 491,260 OUTPATIENT ENCOUNTERS. THIS INCLUDED 30,812 URGENT CARE VISITS, 2,297 OBSERVATION CASES, 3,558 PAIN CLINIC VISITS, 3,306 WOUND CENTER VISITS, 7,257 OUTPATIENT AMBULATORY SURGERIES, 10,409 OUTPATIENT ENDOSCOPY VISITS, 11,280 OUTPATIENT ONCOLOGY VISITS, 4,600 OUTPATIENT ONCOLOGY INFUSIONS, 21,454 OUTPATIENT EKG EXAMS, 2,557 OUTPATIENT ORTHOPEDIC PROCEDURES, 63,197 OUTPATIENT RADIOLOGY EXAMS, 29,187 OUTPATIENT CT SCANS, 19,929 OUTPATIENT ULTRASOUNDS, 19,748 OUTPATIENT MRIS, 1,438 OTHER NUCLEAR MEDICINE TESTS, 34,463 BREAST IMAGING EXAMS, 1,891,060 OUTPATIENT LAB TESTS, 48,219 OUTPATIENT REHABILITATION/PHYSICAL THERAPY VISITS, AND 52,221 OTHER TESTS AND PROCEDURES.
FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICE:	INPATIENT MEDICAL / SURGICAL AND INTENSIVE CARE WINCHESTER HOSPITAL PROVIDES A WIDE RANGE OF INPATIENT CARE INCLUDING PEDIATRICS, OBSTETRICS AND MATERNITY INCLUDING A SPECIAL CARE NURSERY, GENERAL SURGICAL SERVICES, INTENSIVE CARE AND COMPLETE DIAGNOSTIC FACILITIES. THE HOSPITAL'S INPATIENT FACILITIES INCLUDE MEDICAL/SURGICAL BEDS, OBSTETRIC BEDS AND AN INTENSIVE CARE UNIT. SURGICAL SERVICES ARE AVAILABLE 24 HOURS A DAY FOR CRITICALLY ILL OR INJURED PATIENTS REQUIRING IMMEDIATE SURGICAL INTERVENTION, OR FOR OTHER PATIENTS ON A NON-EMERGENT OR ELECTIVE BASIS. THE HOSPITAL'S HIGHLY QUALIFIED SURGEONS PERFORM ORTHOPEDIC PROCEDURES AND IMPLANTS, PLASTIC, GENERAL SURGICAL (INCLUDING BREAST), GYNECOLOGIC, AND UROLOGICAL PROCEDURES. OTHER SURGICAL SPECIALTIES INCLUDE COLON AND RECTAL, ENT, DERMATOLOGIC, ORAL, AND THORACIC AND WEIGHT LOSS SURGERY. PATIENTS ARE UNDER THE CARE OF THE MEDICAL STAFF, HOSPITALISTS AND/OR GENERAL SURGEONS ALONG WITH NURSES WHO ARE TRAINED IN CARING FOR PATIENTS WITH COMPLEX MEDICAL NEEDS. THE HOSPITAL WAS THE FIRST COMMUNITY HOSPITAL IN EASTERN MASSACHUSETTS TO PERFORM ROBOTIC SURGERY WITH THE DA VINCI SURGICAL SYSTEM, AND THE FIRST COMMUNITY HOSPITAL IN MASSACHUSETTS TO ACHIEVE MAGNET RECOGNITION. THE MAGNET PROGRAM WAS ESTABLISHED BY THE AMERICAN NURSES CREDENTIALING CENTER TO RECOGNIZE HEALTH CARE ORGANIZATIONS THAT PROVIDE THE VERY BEST IN NURSING CARE AND UPHOLD THE TRADITION OF PROFESSIONAL NURSING PRACTICE. IT IS THEIR HIGHEST HONOR FOR NURSING EXCELLENCE. THE NURSING CARE TEAM CONSISTS OF REGISTERED NURSES, SURGICAL TECHNICIANS AND QUALIFIED ANCILLARY PERSONNEL WORKING COLLABORATIVELY WITH SURGICAL AND ANESTHESIA PHYSICIANS. THE SCOPE OF NURSING PRACTICE IN THE PERIOPERATIVE AREA INCLUDES PREOPERATIVE ASSESSMENT AND PLANNING, INTRA-OPERATIVE INTERVENTION, POSTOPERATIVE ASSESSMENT AND INTERVENTION, DISCHARGE PLANNING AND DOCUMENTATION TO ENSURE HIGH QUALITY PATIENT CARE AND SAFETY. DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2024, WINCHESTER HOSPITAL HAD 13,568 INPATIENT DISCHARGES WITH 48,771 PATIENT DAYS, 3,543, PERFORMED 1,331 INPATIENT SURGERIES AND DELIVERED 2,5717 BABIES.
FORM 990, PART III, LINE 4C, DESCRIPTION OF PROGRAM SERVICE:	EMERGENCY DEPARTMENT WINCHESTER'S HOSPITAL'S EMERGENCY DEPARTMENT OFFERS ADVANCED EMERGENCY MEDICINE SERVICES TO LOCAL COMMUNITIES NORTH OF BOSTON. THE EMERGENCY DEPARTMENT IS OPEN 24 HOURS A DAY, SEVEN DAYS A WEEK AND PROVIDES EMERGENT CARE REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE HOSPITAL IS STAFFED BY BOARD-CERTIFIED, EMERGENCY MEDICINE PHYSICIANS AND NURSES WHO ARE EXTENSIVELY TRAINED IN EMERGENCY MEDICINE AND CERTIFIED IN ADVANCED CARDIAC LIFE SUPPORT (ACLS) AND PEDIATRIC ADVANCED LIFE SUPPORT (PALS). WINCHESTER HOSPITAL IS ALSO A PRIMARY STROKE SERVICE HOSPITAL, AS DESIGNATED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, PROVIDING LEADING-EDGE STROKE CARE. THE HOSPITAL ALSO OFFERS SPECIALIZED PEDIATRIC CARE PROVIDED BY AN ON-SITE PEDIATRICIAN FROM BOSTON CHILDREN'S HOSPITAL SPECIALIZING IN EMERGENCY MEDICINE. ON-SITE PEDIATRIC EMERGENCY PHYSICIANS ARE AVAILABLE EVERY DAY FROM NOON TO MIDNIGHT AND 24-HOUR PEDIATRICIAN CONSULTATION COVERAGE IS ALSO AVAILABLE. DURING THE FISCAL YEAR COVERED BY THIS FILING, WINCHESTER HOSPITAL HAD 52,134 ADULT AND PEDIATRIC EMERGENCY DEPARTMENT VISITS. IN ADDITION TO THE PROGRAM SERVICE ACCOMPLISHMENTS NOTED ABOVE, THE BILH NETWORK HAD SIGNIFICANT ACTIVITIES ACROSS ENTITIES RELATED TO BOTH BEHAVIORAL HEALTH AND OTHER HEALTHCARE INITIATIVES. SEE THE NARRATIVE SUPPORT FOR SCHEDULE H FOR ADDITIONAL DETAILS.
FORM 990, PART IV, LINE 24A:	AS DESCRIBED IN THIS FORM 990 AND FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND SERVED AS A SUPPORT ORGANIZATION OF AND DIRECT OR INDIRECT SOLE MEMBER OF WINCHESTER HOSPITAL. DURING THIS SAME PERIOD, WINCHESTER HOSPITAL WAS A MEMBER OF THE BILH OBLIGATED GROUP WHICH HAS ISSUED TAX-EXEMPT BOND FINANCING THROUGH EITHER THE BILH OBLIGATED GROUP OR THROUGH A PREVIOUS OBLIGATED GROUP WHICH IS NOW A PART OF THE BILH OBLIGATED GROUP. THE SCHEDULE K AS INCLUDED IN THIS FORM 990 INCLUDES ALL OF THE BILH OBLIGATED GROUP OUTSTANDING TAX-EXEMPT DEBT FOR BONDS ISSUED AFTER DECEMBER 31, 2002, ONLY A PORTION OF WHICH IS ALLOCABLE TO AND REPORTED ON WINCHESTER HOSPITAL'S BALANCE SHEET.
FORM 990, PART IV, LINE 24B:	AS REPORTED ON THE FORM 990 SCHEDULE K, THE LAHEY HEALTH SYSTEM INC. (LHSI) SERIES F BONDS WHICH WERE ISSUED IN 2015 ARE NOW PART OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP DEBT. THE BONDS WERE ISSUED IN 2015 AND AS OF SEPTEMBER 30, 2023 THERE WAS A BALANCE REMAINING IN THE CONSTRUCTION FUND. PROCEEDS IN THE CONSTRUCTION FUND WERE UNEXPECTEDLY HELD BEYOND THE THREE-YEAR TEMPORARY PERIOD, AND WERE YIELD RESTRICTED IN COMPLIANCE WITH FEDERAL TAX REQUIREMENTS. ALTHOUGH THESE BONDS ARE NOT ON THE WINCHESTER HOSPITAL'S BALANCE SHEET, WINCHESTER HOSPITAL IS INCLUDING THIS DISCLOSURE IN ITS FORM 990 BECAUSE WINCHESTER HOSPITAL IS A MEMBER OF THE BILH OBLIGATED GROUP.
FORM 990, PART IV, LINE 12:	THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2024. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (ANNA JAQUES HOSPITAL (AJH), 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), 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 OTHER AFFILIATES OF EHRI. EACH OF THESE BILH AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. IN ADDITION, THE BILH FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. THE ACCOUNTS OF THE ENTITIES FOR WHICH HMFP SERVES AS MEMBER ARE ALSO INCLUDED IN THE HMFP AND BILH AUDITED FINANCIAL STATEMENTS. THE AUDIT AND COMPLIANCE COMMITTEE OF BILH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE CONSOLIDATED AUDIT FOR THE NETWORK AS A WHOLE.
FORM 990, PART V, LINE 1A	AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS A SUPPORT ORGANIZATION AND THE DIRECT OR INDIRECT SOLE MEMBER OF WINCHESTER HOSPITAL. AS PART OF THAT RELATIONSHIP, BILH PROVIDED CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS, INCLUDING AMONG OTHER THINGS, OPERATIONAL SUPPORT SUCH AS PROCESSING PAYROLL AND ACCOUNTS PAYABLE. IN THIS CAPACITY BILH ISSUED ALL FORMS 1099 TO NOT ONLY ITS OWN VENDORS AND SERVICE PROVIDERS, BUT ALSO TO THOSE WHO PROVIDED SERVICES TO WINCHESTER HOSPITAL. FORMS 1099 WERE ALL ISSUED IN THE BILH NAME AND UNDER THE BILH EIN. HOWEVER, IN ACCORDANCE WITH INSTRUCTIONS TO THIS FORM 990, WINCHESTER HOSPITAL IS REPORTING THE NUMBER OF FORMS 1099 RELATED TO SERVICES PERFORMED FOR AND PAYMENTS RELATED TO, ITS SERVICE PROVIDERS AS IF THEY WERE PROCESSED DIRECTLY BY WINCHESTER HOSPITAL. EACH OTHER AFFILIATE IS SIMILARLY REPORTING THE NUMBER OF FORMS 1099 WHICH ARE ATTRIBUTABLE TO THEIR OWN SERVICE PROVIDERS.
PART V, LINE 7G:	WINCHESTER HOSPITAL DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899.
PART V, LINE 7H:	WINCHESTER HOSPITAL DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 1098-C.
FORM 990, PART VI, SECTION A, LINE 2	FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS DIRECT OR INDIRECT 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 CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC. (EHRI) AND EXETER HOSPITAL. EACH OF THESE AFFILIATES MAY HAVE, IN TURN, SERVED AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE BILH NETWORK OF AFFILIATES. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. FOR THIS SAME PERIOD HMFP SERVED AS THE SOLE MEMBER OF AFFILIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) AS WELL AS THE DIRECT OR INDIRECT MEMBER OF SEVERAL ADDITIONAL ENTITIES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE NETWORK OF THE AFFILIATED ORGANIZATIONS NOTED ABOVE. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J.
FORM 990, PART VI, SECTION A, LINE 6	FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS DIRECT OR INDIRECT 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 CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC. (EHRI), EXETER HOSPITAL AND TO AFFILIATES OF THESE ENTITIES.
FORM 990, PART VI, SECTION A, LINE 7A	THE MEMBER HAS THE EXCLUSIVE AUTHORITY TO (A) APPOINT AND REAPPOINT TRUSTEES, (B) FILL ANY VACANCIES IN THE OFFICES OF TRUSTEES, AND (C) ACTING BY VOTE OF NOT LESS THAN THREE QUARTERS (3/4) OF THE MEMBER'S TRUSTEES THEN IN OFFICE, REMOVE, WITH OR WITHOUT CAUSE, A TRUSTEE.
FORM 990, PART VI, SECTION A, LINE 7B	THE MEMBER HAS THE EXCLUSIVE AUTHORITY TO (A) APPOINT AND REAPPOINT TRUSTEES, (B) FILL ANY VACANCIES IN THE OFFICES OF TRUSTEES, AND (C) ACTING BY VOTE OF NOT LESS THAN THREE QUARTERS (3/4) OF THE MEMBER'S TRUSTEES THEN IN OFFICE, REMOVE, WITH OR WITHOUT CAUSE, A TRUSTEE.
FORM 990, PART VI, SECTION B, LINE 11B	AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE DIRECT OR INDIRECT SOLE MEMBER OF WINCHESTER HOSPITAL . THIS FORM 990 IS PREPARED BY THE BILH TAX DEPARTMENT IN CONJUNCTION WITH DELOITTE TAX, LLP (DELOITTE). AS PART OF THIS PROCESS, THE BILH TAX DEPARTMENT WORKS WITH OTHER DISCIPLINES AND FUNCTIONS WITHIN BILH AND WINCHESTER HOSPITAL TO ENSURE THAT ALL FINANCIAL AND NON-FINANCIAL DISCLOSURES ARE COMPLETE AND ACCURATE. EXAMPLES OF SUCH DEPARTMENTS INCLUDE BUT ARE NOT LIMITED TO: FINANCE AND ACCOUNTING, HUMAN RESOURCES AND PAYROLL, TREASURY, COMPLIANCE, LEGAL, COMMUNITY BENEFITS, FINANCIAL ASSISTANCE AND REIMBURSEMENT, GOVERNANCE, DEVELOPMENT, GRADUATE MEDICAL EDUCATION, GOVERNMENT RELATIONS, RESEARCH AND/OR RESEARCH FINANCE. WINCHESTER HOSPITAL 'S FORM 990 IS REVIEWED INTERNALLY BY THE BILH ASSISTANT VICE PRESIDENT, TAXATION AND EXTERNALLY BY DELOITTE. WINCHESTER HOSPITAL 'S FORM 990, ALONG WITH THE FORMS 990 OF ALL ENTITIES IN THE BILH NETWORK, ARE DISCUSSED WITH THE BILH AUDIT AND COMPLIANCE COMMITTEE. DELOITTE SIGNS THE FINAL RETURNS. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF WINCHESTER HOSPITAL 'S BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	AS NOTED THROUGHOUT THIS FILING, WINCHESTER HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) SYSTEM OF AFFILIATES. ALL ENTITIES IN THE BILH NETWORK ADHERE TO THE BILH CONFLICT OF INTEREST POLICY AND MAINTAIN A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY AT THE ENTITY LEVEL. PURSUANT TO THESE POLICIES, BILH ENTITIES' OFFICERS, TRUSTEES AND KEY EMPLOYEES AS WELL AS CERTAIN OTHER INDIVIDUALS ARE REQUIRED TO COMPLETE THE ANNUAL CONFLICT OF INTEREST AND TAX QUESTIONNAIRE (COI-TQ). THE COI-TQ IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS AND FAMILY RELATIONSHIPS AND AFFILIATIONS MAINTAINED BY OFFICERS, TRUSTEES, OR KEY EMPLOYEES AND THEIR FAMILY MEMBERS AND WHICH MAY RESULT IN A REAL OR PERCEIVED CONFLICT OF INTEREST. THE BILH OFFICE OF INTEGRITY AND COMPLIANCE, IN CONJUNCTION WITH THE BILH TAX DEPARTMENT, ADMINISTERS THE COI-TQ PROCESS ANNUALLY. BILH INTEGRITY AND COMPLIANCE COLLECTS AND REVIEWS ALL DISCLOSURES. DISCLOSURES FOR BILH EXECUTIVES AND KEY EMPLOYEES ARE ASSIGNED APPROPRIATE FOLLOW-UP ACTION IN ACCORDANCE WITH THE BILH POLICY. A SUMMARY OF POSITIVE RESPONSES FOR EACH BILH AFFILIATE IS PROVIDED TO THE COMPLIANCE OFFICER FOR THAT ENTITY FOR REVIEW FINAL DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. ANY ACTIVITY THAT REQUIRES ACTION UNDER THE CONFLICT OF INTEREST POLICIES IS SUBJECT TO ONGOING REVIEW BY WINCHESTER HOSPITAL AS WELL AS THE BILH INTEGRITY AND COMPLIANCE OFFICE. PURSUANT TO THE BILH CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A MANAGEMENT PLAN TO REQUIRE DISCLOSURE AND RECUSAL, INCLUDING APPROPRIATE DOCUMENTATION IN THE MINUTES. IN ADDITION, AS NOTED ABOVE, THE ANNUAL COI-TQ PROCESS OUTLINED ABOVE IS JOINTLY ISSUED BY THE BILH TAX DEPARTMENT, TO ENSURE THAT THE QUESTIONNAIRE IS DISTRIBUTED TO ALL CURRENT AND FORMER MEMBERS OF THE WINCHESTER HOSPITAL BOARD OF TRUSTEES AS WELL AS FORMER OFFICERS AND KEY EMPLOYEES. THE COI-TQ PROCESS IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR WINCHESTER HOSPITAL TO COMPLETELY AND ACCURATELY COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES.
FORM 990, PART VI, SECTION B, LINE 15	AS NOTED THROUGHOUT THIS FILING, WINCHESTER HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS WINCHESTER HOSPITAL 'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. IN THIS ROLE BILH MAINTAINS THE RESPONSIBILITY FOR SETTING COMPENSATION FOR EXECUTIVES AND SENIOR MANAGEMENT OF THE ENTITIES WHICH COMPRISED THE BETH ISRAEL LAHEY HEALTH NETWORK. THE BILH COMPENSATION COMMITTEE IS THEREFORE RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES, THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES AND EXCEPT AS OTHERWISE NOTED BELOW OR IN FORM 990 SCHEDULE J, THE COMPENSATION REPORTED IN THIS FORM 990 FOR WINCHESTER HOSPITAL 'S OFFICERS, TRUSTEES AND KEY EMPLOYEES WAS SET BY THE BILH COMPENSATION COMMITTEE. THE BILH COMPENSATION COMMITTEE PROCESS FOR SETTING COMPENSATION IS BELOW. THE BETH ISRAEL LAHEY HEALTH (BILH) COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER SENIOR EXECUTIVES IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO AS VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS FOR BOTH THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES ARE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION.
FORM 990, PART VI, SECTION C, LINE 19	AS NOTED THROUGHOUT THIS FILING, WINCHESTER HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS WINCHESTER HOSPITAL 'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. WINCHESTER HOSPITAL 'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL LAHEY HEALTH TAX DEPARTMENT SCHRAFFT'S CITY CENTER, 4TH FLOOR, 529 MAIN STREET CHARLESTOWN, MA 02129
FORM 990, PART VI, SECTION B, LINE 14:	AS NOTED THROUGHOUT THIS FILING, WINCHESTER HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) SYSTEM OF AFFILIATES AND BILH SERVES AS WINCHESTER HOSPITAL'S DIRECT OR INDIRECT SOLE MEMBER. ALTHOUGH WINCHESTER HOSPITAL'S BOARD HAS NOT FORMALLY ADOPTED A WRITTEN DOCUMENT RETENTION AND DESTRUTION POLICY, BECAUSE OF THE CLOSE CONNECTION AND AFFILIATION BETWEEN WINCHESTER HOSPITAL AND BILH, WINCHESTER HOSPITAL FOLLOWS THE FORMAL WRITTEN POLICY WHICH WAS ADOPTED BY THE BILH BOARD.
FORM 990, PART VI, SECTION B, LINE 16B, -- JOINT VENTURE POLICY	AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVES AS THE DIRECT OR INDIRECT SOLE MEMBER OF WINCHESTER HOSPITAL. ALTHOUGH WINCHESTER HOSPITAL'S BOARD HAS NOT FORMALLY ADOPTED A WRITTEN POLICY REGARDING INVESTMENT IN, CONTRIBUTION OF ASSETS TO AND/OR PARTICIPATION IN A JOINT VENTURE WITH A TAXABLE ENTITY, PROCEDURALLY IF/WHEN ANY SUCH TRANSACTION IS CONTEMPLATED BY ANY BILH AFFILIATE, BOTH THE BILH OFFICE OF GENERAL COUNSEL AND BILH TAX DEPARTMENT ARE INVOLVED TO EVALUATE PARTICIPATION. OUTSIDE COUNSEL IS ALSO CONSULTED WHERE NEEDED. THESE STEPS ARE TAKEN TO ENSURE THAT PARTICIPATION IN ANY JOINT VENTURE ARRANGEMENT HAS BEEN REVIEWED UNDER APPLICABLE FEDERAL TAX LAW AND TO ENSURE THAT WINCHESTER HOSPITAL'S EXEMPT STATUS IS SAFEGUARDED.
FORM 990, PART XI, LINE 9:	NET ASSETS RELEASED FOR CAPITAL 135,048. OTHER ADJUSTMENTS -112,665. RESTRICTED FUNDS ADJUSTMENT 0.
PART XII, LINE 2C:	AS NOTED THROUGHOUT THIS FORM 990, WINCHESTER HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL LAHEY HEALTH (BILH) SERVES AS THE DIRECT OR INDIRECT MEMBER OF WINCHESTER HOSPITAL AND WINCHESTER HOSPITAL IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF BETH ISRAEL LAHEY HEALTH. THE AUDIT AND COMPLIANCE COMMITTEE OF BILH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE CONSOLIDATED AUDIT FOR THE NETWORK AS A WHOLE.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

WINCHESTER HOSPITAL

Employer identification number

04-2104434

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) RADIATION THERAPY OF WINCHESTER LLC 41 HIGHLAND AVE WINCHESTER,MA01890 20-5330549	MA	0	0	WINCHESTER HOSPITAL

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ADDISON GILBERT SOCIETY INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 46-4371382	PROFESSIONAL SERVICES & FINANCIAL SUPPORT	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(2)ANNA JAQUES HOSPITAL 25 HIGHLAND AVE NEWBURYPORT,MA01950 04-2104338	HEALTHCARE	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(3)ASSOC PHYS HARVARD MED FAC PHY AT BIDMC 375 LONGWOOD AVE BOSTON,MA02215 32-0058309	TO PROVIDE EMERGENCY MEDICAL SERVICES	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(4)BAIM INSTITUTE FOR CLINICAL RESEARCH INC DBA BAIM INSTITUTE 930 COMMONWEALTH AVE BOSTON,MA02215 04-3521077	SCIENTIFIC & MEDICAL RESEARCH	MA	501(C)(3)	7	N/A		No
(5)BETH ISRAEL ANAESTHESIA FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2997215	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(6)BETH ISRAEL COMMUNITY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2776678	INACTIVE CORPORATION	MA	501(C)(3)	3	N/A		No
(7)BETH ISRAEL DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 36-4803234	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(8)BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-3079630	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(9)BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 20-8253452	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(10)BETH ISRAEL DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-3030397	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(11)BETH ISRAEL DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 20-4974585	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(12)BETH ISRAEL DEACONESS DEPARTMENT OF RADIATION ONCOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 87-3655583	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HMFP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(13)BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC 110 FRANCIS ST BOSTON,MA02215 02-0671240	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(14)BETH ISRAEL DEACONESS HOSPITAL MILTON INC 199 REEDSDALE RD MILTON,MA02186 04-2103604	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(15)BETH ISRAEL DEACONESS HOSPITAL NEEDHAM INC 148 CHESTNUT ST NEEDHAM,MA02492 04-3229679	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(16)BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH INC 275 SANDWICH ST PLYMOUTH,MA02360 22-2667354	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(17)BETH ISRAEL DEACONESS MEDICAL CENTER INC 330 BROOKLINE AVE BOSTON,MA02215 04-2103881	THE OPERATION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(18)BETH ISRAEL DERMATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-3117601	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(19)BETH ISRAEL LAHEY HEALTH PHARMACY INC 80 WILSON WAY WESTWOOD,MA02090 82-2526816	TO OPERATE A SPECIALTY PHARMACY AND 340B PROGRAM FOR BIDMC	MA	501(C)(3)	10	BETH ISRAEL DEACONESS MEDICAL CENTER INC	Yes
(20)BETH ISRAEL LAHEY HEALTH PRIMARY CARE 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 47-2248298	HEALTHCARE	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(21)BETH ISRAEL LAHEY HEALTH INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 83-2671600	MANAGEMENT PROFESSIONAL & IT SUPPORT SERVICES	MA	501(C)(3)	12C, III-FI	N/A		No
(22)BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP 300 LONGWOOD AVE BOSTON,MA02215 04-3200113	OUTPATIENT AMBULATORY CENTER - INACTIVE	MA	501(C)(3)	12A, I	N/A		No
(23)BIDMC OBSTETRICS AND GYNECOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2794855	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(24)BID-MILTON PHYSICIAN ASSOCIATES INC 199 REEDSDALE ROAD MILTON,MA02186 22-2566792	PROMOTE HEALTHCARE	MA	501(C)(3)	10	BETH ISRAEL DEACONESS HOSPITAL - MILTON	Yes
(25)BIH PATHOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 22-2548374	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(26)BIH RADIOLOGIC FOUNDATION INC 330 BROOKLINE AVE BOSTON,MA02215 04-2571853	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(27)CAB HEALTH AND RECOVERY SERVICES INC 199 ROSEWOOD DRIVE DANVERS,MA01923 04-2400270	SUBSTANCE ABUSE - INACTIVE	MA	501(C)(3)	10	NORTHEAST BEHAVIORAL HEALTH CORPORATION	Yes
(28)CENTER FOR MEDICAL SIMULATION 100 FIRST AVE BUILDING 39 4TH CHARLESTOWN,MA02129 04-3486127	TO IMPROVE PATIENT SAFETY AND HEALTH CARE QUALITY	MA	501(C)(3)	10	BETH ISRAEL ANAESTHESIA FOUNDATION INC	Yes
(29)COMMUNITY PHYSICIANS ASSOCIATES INC 199 REEDSDALE RD MILTON,MA02186 04-3243146	OUTPATIENT AND PRIMARY CARE SERVICES	MA	501(C)(3)	3	BETH ISRAEL DEACONESS HOSPITAL - MILTON	Yes
(30)CONTINUING EDU PROGRAM DBA BID DEPT OF PSYCH FDN 375 LONGWOOD AVE BOSTON,MA02215 04-3242952	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes
(31)CORE PHYSICIANS LLC 5 ALUMNI DRIVE EXETER,NH03833 87-0807914	PHYSICIAN PRACTICES	NH	501(C)(3)	10	EXETER HEALTH RESOURCES INC	Yes
(32)CPHCH INC DBA BILH AT HOME - WATERTOWN C/O NRPN 600 CUMMINGS CTR BEVERLY,MA01915 47-3111453	HOME CARE & HOSPICE - INACTIVE	MA	501(C)(3)	12A, I	NORTHEAST SENIOR HEALTH CORPORATION	Yes
(33)EXETER HEALTH RESOURCES SELF-INSURANCE TRUST 5 ALUMNI DRIVE EXETER,NH03833 20-0753662	SELF-INSURANCE TRUST	NH	501(C)(3)	12A, I	EXETER HEALTH RESOURCES INC	Yes
(34)EXETER HEALTH RESOURCES INC 5 ALUMNI DRIVE EXETER,NH03833 02-0222126	SUPPORT COMMUNITY HEALTH & NETWORK MGMT SVCS	NH	501(C)(3)	12A, I	BETH ISRAEL LAHEY HEALTH INC	Yes
(35)EXETER HOSPITAL INC 5 ALUMNI DRIVE EXETER,NH03833 22-2674014	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS.	NH	501(C)(3)	3	EXETER HEALTH RESOURCES INC	Yes
(36)EXETER MED REAL INC 5 ALUMNI DRIVE EXETER,NH03833 02-0418718	REAL ESTATE HOLDING COMPANY	NH	501(C)(25)		EXETER HEALTH RESOURCES INC	Yes
(37)HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC 375 LONGWOOD AVE BOSTON,MA02215 22-2768204	GENERAL AND SPECIALIZED MEDICAL SERVICES TO THE PATIENTS OF BIDMC AND OTHERS	MA	501(C)(3)	10	BETH ISRAEL DEACONESS MEDICAL CENTER INC	Yes
(38)HEALTH AND EDUCATION HOUSING SERVICES INC 199 ROSEWOOD DRIVE DANVERS,MA01923 22-3232914	HUD HOUSING - INACTIVE	MA	501(C)(3)	10	NORTHEAST BEHAVIORAL HEALTH CORPORATION	Yes
(39)JORDAN PHYSICIAN ASSOCIATES INC 275 SANDWICH ST PLYMOUTH,MA02360 04-3228556	OUTPATIENT AND PRIMARY CARE SERVICES	MA	501(C)(3)	10	BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC	Yes
(40)JOSLIN CLINIC INC ONE JOSLIN PLACE BOSTON,MA02215 22-2984590	PREVENTION, TREATMENT, AND CURE OF DIABETES	MA	501(C)(3)	12A, I	JOSLIN DIABETES CENTER INC	Yes
(41)JOSLIN DIABETES CENTER INC ONE JOSLIN PLACE BOSTON,MA02215 04-2203836	PREVENTION, TREATMENT, AND CURE OF DIABETES	MA	501(C)(3)	7	BETH ISRAEL LAHEY HEALTH INC	Yes
(42)LAHEY CLINIC CANADIAN FOUNDATION 130 KING ST WEST TORONTO,ONTARIO CA	FUNDRAISING ORG	CA			N/A		No
(43)LAHEY CLINIC FOUNDATION INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-2323457	FINANCIAL & OPERATIONAL SUPPORT TO LCI AND LCH	MA	501(C)(3)	7	BETH ISRAEL LAHEY HEALTH INC	Yes
(44)LAHEY CLINIC HOSPITAL INC DBA LAHEY HOSPITAL & MEDICAL CENTER AND LMC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-2704686	HEALTHCARE	MA	501(C)(3)	3	LAHEY CLINIC FOUNDATION INC	Yes
(45)LAHEY CLINIC INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-2704683	HEALTHCARE	MA	501(C)(3)	10	LAHEY CLINIC FOUNDATION INC	Yes
(46)LAHEY HEALTH SHARED SERVICES INC 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-3178972	ADMIN	MA	501(C)(3)	10	BETH ISRAEL LAHEY HEALTH INC	Yes
(47)MED CARE OF BOSTON MGMT CORP DBA BILH PRIMARY CARE 464 HILLSIDE AVE NEEDHAM,MA02494 04-2810972	OUTPATIENT, PRIMARY CARE AND SPECIALTY SERVICES	MA	501(C)(3)	10	BETH ISRAEL LAHEY HEALTH PRIMARY CARE	Yes
(48)MOUNT AUBURN HOSPITAL 330 MOUNT AUBURN ST CAMBRIDGE,MA02138 04-2103606	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(49)MOUNT AUBURN PROFESSIONAL SERVICES INC 330 MOUNT AUBURN ST CAMBRIDGE,MA02138 04-3026897	OFFERING MEDICAL CARE IN GENERAL AND SPECIALIZED PRACTICES	MA	501(C)(3)	12A, I	MOUNT AUBURN HOSPITAL	Yes
(50)NEW ENGLAND BAPTIST HOSPITAL 125 PARKER HILL AVE BOSTON,MA02120 04-2103612	ORTHOPEDIC SPECIALTY HOSPITAL	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(51)NEW ENGLAND BAPTIST MEDICAL ASSOCIATES INC 125 PARKER HILL AVE BOSTON,MA02120 04-3235796	OUTPATIENT MEDICAL SERVICES TO THE VARIOUS COMMUNITIES SERVICED BY NEBH	MA	501(C)(3)	3	NEW ENGLAND BAPTIST HOSPITAL	Yes
(52)NORTHEAST BEHAVIORAL HEALTH CORP DBA BILH BEHAVIORAL HEALTH SERVICES 199 ROSEWOOD DRIVE DANVERS,MA01923 04-2777145	HEALTHCARE	MA	501(C)(3)	10	BETH ISRAEL LAHEY HEALTH INC	Yes
(53)NORTHEAST HEALTH SYSTEMS INC 85 HERRICK ST BEVERLY,MA01915 04-3240453	FINANCIAL & OPERATIONAL SUPPORT	MA	501(C)(3)	12B, II	LAHEY HEALTH SHARED SERVICES INC	Yes
(54)NORTHEAST HOSPITAL CORPORATION 85 HERRICK ST BEVERLY,MA01915 04-2121317	HEALTHCARE	MA	501(C)(3)	3	BETH ISRAEL LAHEY HEALTH INC	Yes
(55)NORTHEAST MEDICAL PRACTICE INC 85 HERRICK ST BEVERLY,MA01915 04-3201853	HEALTHCARE	MA	501(C)(3)	10	NORTHEAST HOSPITAL CORPORATION	Yes
(56)NORTHEAST PROFESSIONAL REGISTRY OF NURSES INC DBA BILH AT HOME 800 CUMMINGS CENTER BEVERLY,MA01915 20-1287349	HEALTHCARE	MA	501(C)(3)	10	NORTHEAST SENIOR HEALTH CORPORATION	Yes
(57)NORTHEAST SENIOR HEALTH CORPORATION 85 HERRICK ST BEVERLY,MA01915 04-2731137	HEALTHCARE	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(58)ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE 5 ALUMNI DRIVE EXETER,NH03833 02-0274905	HOME CARE & HOSPICE	NH	501(C)(3)	10	EXETER HEALTH RESOURCES INC	Yes
(59)SEACOAST AFFILIATED GROUP PRACTICE INC 25 HIGHLAND AVE NEWBURYPORT,MA01915 04-3485648	PHYSICIAN GROUP	MA	501(C)(3)	10	ANNA JAQUES HOSPITAL INC	Yes
(60)SEACOAST NURSING AND REHABILITATION CENTER INC 300 WASHINGTON ST GLOUCESTER,MA01930 04-1305001	HEALTHCARE	MA	501(C)(3)	10	LAHEY HEALTH SHARED SERVICES INC	Yes
(61)THE JORDAN HEALTH SYSTEMS INC 275 SANDWICH ST PLYMOUTH,MA02360 04-2103805	PROMOTE HEALTHCARE	MA	501(C)(3)	7	BETH ISRAEL DEACONESS MEDICAL CENTER INC	Yes
(62)WINCHESTER COMMUNITY ACCOUNTABLE CARE ORGANIZATION INC 41 HIGHLAND AVE WINCHESTER,MA01890 22-3137856	ACO - INACTIVE	MA	501(C)(3)	12A, I	WINCHESTER HEALTHCARE MANAGEMENT INC	Yes
(63)WINCHESTER HEALTHCARE MANAGEMENT INC 41 HIGHLAND AVE WINCHESTER,MA01890 22-2701817	MANAGEMENT	MA	501(C)(3)	12A, I	LAHEY HEALTH SHARED SERVICES INC	Yes
(64)WINCHESTER HOSPITAL FOUNDATION INC 41 HIGHLAND AVE WINCHESTER,MA01890 04-3399570	PROFESSIONAL SERVICES & FINANCIAL SUPPORT	MA	501(C)(3)	12A, I	WINCHESTER HEALTHCARE MANAGEMENT INC	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) BETH ISRAEL LAHEY HEALTH SURGERY CENTER PLYMOUTH LLC 41 RESNIK ROAD PLYMOUTH,MA02360 88-3871838	SURGERY CENTER	MA	N/A					No			No
(2) BIDCO HOSPITAL LLC 247 STATION DRIVE NORTHWEST 1 WESTWOOD,MA02090 46-1643790	COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC	MA	N/A					No			No
(3) BIDCO PHYSICIAN LLC 600 UNICORN PARK DRIVE 4TH FL WOBURN,MA01801 46-1589743	COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BILH	MA	N/A					No			No
(4) BILH INVESTMENT PARTNERSHIP LLP 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 04-3278109	INVESTMENT PARTNERSHIP	MA	N/A					No			No
(5) NEBSC HOSPITAL HOLDINGS LLC 125 PARKER HILL AVE BOSTON,MA02120 87-4293833	INVESTMENT PARTNERSHIP	MA	N/A					No			No
(6) NEW ENGLAND BAPTIST SURGERY CENTER LLC 100 AVON MEADOW LANE AVON,MA06001 87-4311329	AMBULATORY SURGERY CENTER	MA	N/A					No			No
(7) PHYSICIANS PROFESSIONAL SERVICES LLP 200 RIVERS EDGE DRIVE MEDFORD,MA02155 04-3275078	TO PROVIDE MEDICAL BILLING SERVICES	MA	N/A					No			No
(8) SHIELDS IMAGING AT ANNA JAQUES HOSPITAL LLC 700 CONGRESS ST STE 204 QUINCY,MA02169 38-3989358	MRI SERVICES	MA	N/A					No			No
(9) WINCHESTER HOSPITALSHIELDS MRI LLC 700 CONGRESS ST STE 204 QUINCY,MA02169 46-2523117	MRI SERVICES	MA	WINCHESTER HOSPITAL	EXCLUDED	2,985,484	1,716,168		No			No	70.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) GREATER NEWBURYPORT MANAGEMENT SERVICES ORGANIZATION INC 25 HIGHLAND AVE NEWBURYPORT,MA01950 16-1744477	MANAGEMENT SERVICES	MA	N/A	C					No
(2) HUNTINGFIELD CORPORATION C/O LCF 529 MAIN ST 4TH FL CHARLESTOWN,MA02129 52-0717412	TO HOLD OWNERSHIP OF SUBTERRANEAN RIGHTS	DE	N/A	C					No
(3) LAHEY CLINIC INSURANCE CO LTD CRAIG APPIN HOUSE PO BOX HM 2450 HAMILTON BD	INSURANCE	BD	N/A	C					No
(4) LEDGEWOOD HEALTH CARE CORPORATION 87 HERRICK STREET BEVERLY,MA01915 04-2855189	NURSING HOME	MA	N/A	C					No
(5) NORTHEAST PROPRIETARY CORP 85 HERRICK STREET BEVERLY,MA01915 04-2855191	MEDICAL SERVICES	MA	N/A	C					No
(6) WINCHESTER HEALTHCARE ENTERPRISES INC 41 HIGHLAND AVE WINCHESTER,MA01890 04-2932059	MANAGEMENT SERVICES	MA	N/A	C					No
(7) WINCHESTER PHYSICIAN ASSOCIATES INC 41 HIGHLAND AVE WINCHESTER,MA01890 04-3262963	MANAGEMENT SERVICES	MA	N/A	C					No
(8) WINCHESTER PHYSICIAN HOSPITAL ORGANIZATION INC 41 HIGHLAND AVE WINCHESTER,MA01890 47-2646454	INACTIVE	MA	N/A	C					No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) SEE PART VII	M	1,657,500	FMV
(2) SEE PART VII	M	681,109	FMV
(3) SEE PART VII	M	300,065,275	FMV
(4) SEE PART VII	O	2,456,278	FMV
(5) SEE PART VII	R	355,076,563	FMV
(6) SEE PART VII	O	332,750	FMV
(7) SEE PART VII	P	56,002	FMV
(8) SEE PART VII	M	555,296	FMV
(9) SEE PART VII	M	246,241	FMV
(10) SEE PART VII	M	1,498,728	FMV
(11) SEE PART VII	M	183,367	FMV
(12) SEE PART VII	M	1,120,168	FMV
(13) SEE PART VII	P	343,113	FMV
(14) WINCHESTER HOSPITAL FOUNDATION INC	C	719,749	FMV
(15) SEE PART VII	J	547,794	FMV
(16) SEE PART VII	L	1,743,102	FMV
(17) SEE PART VII	M	1,806,640	FMV
(18) SEE PART VII	O	1,458,680	FMV
(19) SEE PART VII	P	204,115	FMV
(20) SEE PART VII	G	220,349	FMV
(21) SEE PART VII	D	2,071,311,000	FMV
(22) SEE PART VII	E	70,022,000	FMV
(23) SEE PART VII	R	5,176,895	FMV

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation
FORM 990, SCH R, PART V, LN 1C	GIFT, GRANT, OR CONTRIBUTION FROM RO WINCHESTER HOSPITAL'S ("WH") MISSION IS TO CARE, TO HEAL AND TO EXCEL. WINCHESTER HOSPITAL FOUNDATION ("WHF") WAS CREATED FOR THE SOLE PURPOSE OF CULTIVATING ONGOING DONOR SUPPORT FOR WH. FUNDS RAISED BY WHF SUPPORT WH'S GENERAL OPERATIONS, CAPITAL NEEDS AND CRITICAL PROGRAMS. DURING THE PERIOD COVERED BY THIS FILING, WH RECEIVED $719,749 FROM WHF IN FURTHERANCE OF BOTH WHF AND WH'S MISSIONS.
FORM 990, SCH R, PART V, LN 1R	OTHER TRANSFER OF CASH/PROP TO RO AS NOTED THROUGHOUT THIS FILING, WH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, WH TRANSFERRED CASH TO ONE OR MORE OF ITS AFFILIATED ENTITIES AS PART OF NETWORK-WIDE CASH MANAGEMENT AND IN FURTHERANCE OF THE EXEMPT PURPOSE OF WH AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, WH TRANSFERRED THE FOLLOWING CASH OR PROPERTY TO ITS AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH, INC. SEE NOTE ABOVE IN CODE M SUPPORTING DETAIL: $355,076,563 2. BETH ISRAEL LAHEY HEALTH SPECIALTY CARE F/K/A NORTHEAST MEDICAL PRACTICE, INC. TO FUND PRIMARY AND SPECIALTY CARE SERVICES IN THE COMMUNITY: $5,176,895
FORM 990, SCH R, PART V, LN 1D	LOANS/LOAN GUARANTEES TO/FOR RO WINCHESTER HOSPITAL ("WH") IS A MEMBER OF THE BILH OBLIGATED GROUP AND AS SUCH IS JOINTLY AND SEVERALLY LIABLE FOR ALL DEBT OF THE OBLIGATED GROUP. IN THIS CAPACITY, WH, HAS MADE LOAN GUARANTEES TO THE FOLLOWING OTHER MEMBERS OF THE OBLIGATED GROUP TOTALING $2,071,311,000: ANNA JACQUES HOSPITAL BETH ISRAEL DEACONESS MEDICAL CENTER LAHEY CLINIC FOUNDATION LAHEY CLINIC HOSPITAL LAHEY CLINIC, INC. MOUNT AUBURN HOSPITAL NORTHEAST HOSPITAL CORP BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH NEW ENGLAND BAPTIST HOSPITAL BETH ISRAEL DEACONESS HOSPITAL MILTON BETH ISRAEL DEACONESS HOSPITAL NEEDHAM EXETER HOSPITAL
FORM 990, SCH R, PART V, LN 1E	LOANS/LOAN GUARANTEES BY RO WH IS A MEMBER OF THE BILH OBLIGATED GROUP AND AS SUCH ALL OTHER MEMBERS OF THE BILH OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR THE OBLIGATED GROUP DEBT OUTSTANDING AT WH. IN THIS CAPACITY, THE ENTITIES LISTED BELOW HAVE LOAN GUARANTEES TO WH TOTALING $70,022,000: ANNA JACQUES HOSPITAL BETH ISRAEL DEACONESS MEDICAL CENTER LAHEY CLINIC FOUNDATION LAHEY CLINIC HOSPITAL LAHEY CLINIC, INC. MOUNT AUBURN HOSPITAL MOUNT AUBURN PROFESSIONAL SERVICES NORTHEAST HOSPITAL CORP. BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH NEW ENGLAND BAPTIST HOSPITAL BETH ISRAEL DEACONESS HOSPITAL - MILTON BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM EXETER HOSPITAL MEDICAL CARE OF BOSTON MANAGEMENT CORP. D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE
FORM 990, SCH R, PART V, LN 1J	LEASE OF FAC/EQUIP/OTHER ASSETS TO RO AS NOTED THROUGHOUT THIS FILING, WH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THE CLOSE CONNECTION BETWEEN WH AND WINCHESTER PHYSICIAN ASSOCIATES, INC. ("WPA," A RELATED ENTITY), WPA LEASES SPACE FROM WH TO PROVIDE PATIENT CARE SERVICES IN THE COMMUNITIES SERVED BY AND PATIENTS OF WH IN FURTHERANCE OF THE WH AND BILH TAX-EXEMPT PURPOSES. WPA PAID WH $547,794 FOR SPACE RENTAL.
FORM 990, SCH R, PART V, LN 1L	PERF OF SVCS/MEMBERSHIP/FUNDRAISING FOR RO AS NOTED THROUGHOUT THIS FILING, WH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, WH PROVIDES SERVICES TO OTHER NETWORK ENTITIES IN FURTHERANCE OF ITS EXEMPT PURPOSE AND IN FURTHERANCE OF THE EXEMPT PURPOSE OF ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, WH PROVIDED THE FOLLOWING SERVICES: 1. WINCHESTER PHYSICIAN ASSOCIATES, INC. - PHYSICIAN ANSWERING, CODING, BILLING SERVICES: $1,743,102
FORM 990, SCH R, PART V, LN 1M	PERF OF SVCS/MEMBERSHIP/FUNDRAISING BY RO AS NOTED THROUGHOUT THIS FILING, WH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, ONE OR MORE OF WH'S AFFILIATES PROVIDED SERVICES TO WH IN FURTHERANCE OF THE EXEMPT PURPOSE OF ITS WH AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, WH RECEIVED THE FOLLOWING SERVICES FROM ITS AFFILIATES: 1. AFFILIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PHYSICIAN SERVICES: $1,657,500 2. BETH ISRAEL DEACONESS MEDICAL CENTER RADIATION, ONCOLOGY AND OTHER SIMILAR SERVICES: $681,109 3. BETH ISRAEL LAHEY HEALTH, INC. AS A SUPPORT ORGANIZATION OF WH, BILH PROVIDES CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS. BILH SUPPORT INCLUDES THE FOLLOWING SERVICES: DEVELOPMENT AND FUNDRAISING, STRATEGIC PLANNING, COMPLIANCE, GOVERNANCE AND LEGAL SUPPORT, 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 MANAGEMENT, LEADERSHIP, DEBT STRUCTURING SUPPORT, FINANCING OF CAPITAL PROJECTS THROUGH ITS OBLIGATED GROUP DEBT AND FINANCIAL SUPPORT SERVICES, INCLUDING INTERNAL AND EXTERNAL AUDIT, INSURANCE AND TAX SERVICES: A. NETWORK ASSESSMENT FEE: $48,505,611 B. OPERATION OF PAYROLL AND PROVISION OF EMPLOYEE BENEFITS: $110,248,918 C. OPERATION OF ACCOUNTS PAYABLE AND PAYMENT FOR THIRD PARTY SERVICES: $141,310,746 D. SEE OTHER CODES FOR ADDITIONAL DETAIL. 4. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - PHYSICIAN SERVICES: $555,296 5. LAHEY CLINIC HOSPITAL - LAB AND MEDICAL SERVICES: $246,241 6. LAHEY CLINIC INC - PHYSICIAN SERVICES: $1,498,728 7. MOUNT AUBURN HOSPITAL - MICROBIOLOGY SERVICES: $183,367 8. NORTHEAST BEHAVIORAL HEALTH CORPORATION - PSYCH EVALUATION SERVICES: $1,120,168 9. WINCHESTER PHYSICIAN ASSOCIATES, INC. - ANTI-COAGULATION AND ONCOLOGY RELATED SERVICES: $1,806,640
FORM 990, SCH R, PART V, LN 1O	SHARING OF PAID EMPLOYEES WITH RO 1. BETH ISRAEL LAHEY HEALTH, INC. SEE NOTE ABOVE IN CODE M: $2,456,278 2. BETH ISRAEL LAHEY HEALTH PRIMARY CARE - $332,750 3. WINCHESTER PHYSICIAN ASSOCIATES, INC. - $1,458,680
FORM 990, SCH R, PART V, LN 1P	REIMB. PAID TO RO FOR EXPENSES AS NOTED THROUGHOUT THIS FILING, WH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, WH REIMBURSED ONE OR MORE OF ITS AFFILIATED ENTITIES FOR EXPENSES INCURRED ON BEHALF OF WH IN FURTHERANCE OF THE EXEMPT PURPOSE OF ITS WH AND AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, WH MADE THE FOLLOWING REIMBURSEMENTS FOR EXPENSES TO ITS AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH PRIMARY CARE RETIREMENT BENEFIT REIMBURSEMENTS: $56,002 2. NORTHEAST HOSPITAL CORPORATION MICROBIOLOGY REIMBURSEMENT: $343,113 3. WINCHESTER PHYSICIAN ASSOCIATES, INC. REIMBURSEMENTS FOR PHYSICIAN SERVICES: $204,115
FORM 990, SCH R, PART V, LN 1Q	REIMB. PAID BY RO FOR EXPENSES AS NOTED THROUGHOUT THIS FILING, WH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, WH WAS REIMBURSED BY ONE OR MORE OF ITS AFFILIATED ENTITIES FOR EXPENSES INCURRED IN FURTHERANCE OF THE EXEMPT PURPOSE OF ITS WH AND AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, WH RECEIVED THE FOLLOWING REIMBURSEMENTS FOR EXPENSES FROM ITS AFFILIATES: 1. WINCHESTER PHYSICIAN ASSOCIATES, INC. INSURANCE REIMBURSEMENTS: $220,349

Schedule R (Form 990) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	2,746
6	Total number of volunteers (estimate if necessary) .............	6	142
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	6,930,951
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	3,159,554

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	805,653	744,749
9	Program service revenue (Part VIII, line 2g) .........	339,750,400	374,942,181
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,519,731	21,407,384
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	12,105,982	15,065,573
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	356,181,766	412,159,887
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	229,891	265,871
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	160,019,502	162,923,640
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 1,149,889
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	183,090,204	202,669,412
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	343,339,597	365,858,923
19	Revenue less expenses. Subtract line 18 from line 12.......	12,842,169	46,300,964
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	484,574,894	554,782,429
21	Total liabilities (Part X, line 26).............	129,972,235	130,553,555
22	Net assets or fund balances. Subtract line 21 from line 20.....	354,602,659	424,228,874

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 325,027,078 including grants of $ 265,871 ) (Revenue $ 382,080,518 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	SEE SCHEDULE O

4c	(Code: ) (Expenses $ 0 including grants of $ ) (Revenue $ )
	SEE SCHEDULE O

	(Code: ) (Expenses $ 0 including grants of $ ) (Revenue $ )


4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses325,027,078

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	3,665,375	12,976,592	4,871,768

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	744,749
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		744,749

		Business Code
2a	OUTPATIENT CARE NPSR	621110	174,340,468	174,340,468
b	INPATIENT CARE NPSR	621110	162,698,753	162,698,753
c	EMERGENCY DEPT NPSR	621110	32,678,762	32,678,762
d	SALE OF SERVICES	621110	2,834,380	2,834,380
e	SERVICES TO AFFILIATES	621110	2,294,639	2,294,639
f	All other program service revenue.		95,179	95,179
g	Total. Add lines 2a–2f .....		374,942,181

3 Investment income (including dividends, interest, and othersimilar amounts) ......			21,169,897			21,169,897
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	719,884
b	Less: rental expenses	6b	1,116,605
c	Rental income or (loss)	6c	-396,721
d	Net rental income or (loss).......			-396,721			-423,639
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		370,521
b	Less: cost or other basis and sales expenses	7b		133,034
c	Gain or (loss)	7c		237,487
d	Net gain or (loss).........			237,487			237,487
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	NON-PATIENT LABS		621110	6,093,522		6,093,522
b	FEDERAL RECOVERY		923000	4,157,926	4,157,926
c	REBATES AND REFUNDS		621110	2,660,637	2,660,637
d	All other revenue ....			2,550,209	319,774	810,511	1,419,924
e	Total. Add lines 11a–11d ......			15,462,294
12	Total revenue. See instructions.....			412,159,887	382,080,518	6,930,951	22,403,669

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	265,871	265,871
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,005,209	1,975,953	29,256
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	523,924	516,280	7,644
7	Other salaries and wages........	126,214,302	124,372,835	1,841,467
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,910,473	3,853,419	57,054
9	Other employee benefits .......	19,978,586	19,687,098	291,488
10	Payroll taxes ...........	10,291,146	10,140,998	150,148
11	Fees for services (non-employees):
a	Management ......	47,320,542	10,680,247	35,490,406	1,149,889
b	Legal .........
c	Accounting ...........
d	Lobbying ...........	73,943		73,943
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	36,557,334	36,557,334
12	Advertising and promotion ....
13	Office expenses .......	1,182,031	1,172,028	10,003
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	17,695,818	16,128,728	1,567,090
17	Travel ............	106,477	106,477
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	2,310,319	2,310,319
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	17,937,327	17,937,327
23	Insurance ...
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	37,230,809	37,230,809
b	PHARMACEUTICALS	27,167,260	27,167,260
c	MEDICAID ASSESSMENT	7,034,544	7,034,544
d	MAINTENANCE CONTRACTS	2,787,897	2,787,897
e	All other expenses	5,265,111	5,101,654	163,457
25	Total functional expenses. Add lines 1 through 24e	365,858,923	325,027,078	39,681,956	1,149,889
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			991,236	1	1,133,222
2	Savings and temporary cash investments .........			7,921,652	2	8,208,698
3	Pledges and grants receivable, net ......			108,494	3	13,333
4	Accounts receivable, net .............			34,226,545	4	43,916,449
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			4,971,234	8	5,371,854
9	Prepaid expenses and deferred charges ......			510,982	9	618,186
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	284,278,714
b	Less: accumulated depreciation	10b	167,161,880	122,768,423	10c	117,116,834
11	Investments—publicly traded securities .			152,508,463	11	187,665,652
12	Investments—other securities. See Part IV, line 11 .....			55,505,377	12	64,093,382
13	Investments—program-related. See Part IV, line 11 ..			8,050,958	13	7,910,334
14	Intangible assets ...............			250,000	14	250,000
15	Other assets. See Part IV, line 11 ...........			96,761,530	15	118,484,485
16	Total assets. Add lines 1 through 15 (must equal line 33)...			484,574,894	16	554,782,429

17	Accounts payable and accrued expenses .....	34,183,226	17	37,974,132
18	Grants payable ...		18
19	Deferred revenue .........	102,936	19	187,734
20	Tax-exempt bond liabilities .........	73,977,146	20	70,022,043
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	21,708,927	25	22,369,646
26	Total liabilities. Add lines 17 through 25..	129,972,235	26	130,553,555

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	325,859,434	27	392,828,487
28	Net assets with donor restrictions ...........	28,743,225	28	31,400,387
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	354,602,659	32	424,228,874
33	Total liabilities and net assets/fund balances ........	484,574,894	33	554,782,429

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No