ANNA JAQUES HOSPITAL: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: ANNA JAQUES HOSPITAL (EIN 04-2104338)
Tax period: 2022-10-01 to 2023-09-30
Filed: 2024-08-14
IRS object ID: 202412279349303066
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-08-14T15:51:44-05:00	ReturnTs
Tax Period End	2023-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	861065772	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	DELOITTE TAX LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE SUITE 4200	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46204	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	042104338	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ANNA JAQUES HOSPITAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ANNA	BusinessNameControlTxt
Phone	9784631000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	25 HIGHLAND AVE	AddressLine1Txt
City	NEWBURYPORT	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	01950	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CINDY RIOS	PersonNm
Person Title	TREASURER, BILH	PersonTitleTxt
Phone	9784631000	PhoneNum
Signature	2024-08-12	SignatureDt
Discuss With Paid Preparer	0	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ANGELA M MOORE	PreparerPersonNm
PTIN	P00244342	PTIN
Phone	3174648600	PhoneNum
Preparation	2024-08-07	PreparationDt

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2024-08-08 14:25:15Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	CINDY RIOS	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	25 HIGHLAND AVE	AddressLine1Txt
City	NEWBURYPORT	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	01950	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$149,528,719	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.AJH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1884	FormationYr
Legal Domicile State	MA	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O.	ActivityOrMissionDesc
Voting Members Governing Body	23	VotingMembersGoverningBodyCnt
Voting Members Independent	18	VotingMembersIndependentCnt
Total Employee	1349	TotalEmployeeCnt
Total Volunteers	126	TotalVolunteersCnt
Total Gross UBI	$40,675	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$3,467,332	PYContributionsGrantsAmt
CY Contributions Grants	$1,827,852	CYContributionsGrantsAmt
PY Program Service Revenue	$131,312,900	PYProgramServiceRevenueAmt
CY Program Service Revenue	$145,019,571	CYProgramServiceRevenueAmt
PY Investment Income	$371,402	PYInvestmentIncomeAmt
CY Investment Income	$409,852	CYInvestmentIncomeAmt
PY Other Revenue	$3,141,910	PYOtherRevenueAmt
CY Other Revenue	$2,220,148	CYOtherRevenueAmt
PY Total Revenue	$138,293,544	PYTotalRevenueAmt
CY Total Revenue	$149,477,423	CYTotalRevenueAmt
PY Grants And Similar Paid	$65,933	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$38,300	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$74,535,193	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$72,309,031	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$19,021	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$7,560	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$575,104	CYTotalFundraisingExpenseAmt
PY Other Expenses	$75,565,846	PYOtherExpensesAmt
CY Other Expenses	$90,875,655	CYOtherExpensesAmt
PY Total Expenses	$150,185,993	PYTotalExpensesAmt
CY Total Expenses	$163,230,546	CYTotalExpensesAmt
PY Revenues Less Expenses	-$11,892,449	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$13,753,123	CYRevenuesLessExpensesAmt
Total Assets BOY	$114,520,671	TotalAssetsBOYAmt
Total Assets EOY	$112,415,504	TotalAssetsEOYAmt
Total Liabilities BOY	$75,058,102	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$81,199,499	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$39,462,569	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$31,216,005	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$143,297,044	ExpenseAmt
Grant	$38,300	GrantAmt
Revenue	$146,307,967	RevenueAmt
Desc	OUTPATIENT CLINICS AND SERVICESSEE SCHEDULE O	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Desc	INPATIENTSEE SCHEDULE O	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Desc	EMERGENCY DEPARTMENT SEE SCHEDULE O	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$143,297,044	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	Yes (1)	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	Yes (1)	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	142	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	1349	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	23	GoverningBodyVotingMembersCnt
Independent Voting Member	18	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	FL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MO	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	ND	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NM	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NV	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OH	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	PA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	RI	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	SC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	WA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KAREN WOLFSON AVP TAXATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7817448924	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	BILH SCHRAFFTS CITY CENTER 4TH	AddressLine1Txt
City	CHARLESTOWN	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02129	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (46 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ROWAN MICHAEL
TRUSTEE (EX-OFFICIO) (CEO DESIGNEE)	1.00	64.00	Yes (X)	$0	$1,298,835	$37,039
NASEER-GHIASUDDIN MD SAIRA
TTEE; PHYSICIAN, INTERNAL MEDICINE	1.00	55.00	Yes (X)	$0	$959,390	$54,905
NESTO MD RICHARD
TRUSTEE (EX-OFFICIO) (CEO DESIGNEE)	1.00	58.00	Yes (X)	$0	$857,714	$34,418
PURSLEY MD DEWAYNE M
TRUSTEE	1.00	62.00	Yes (X)	$0	$741,058	$88,846
GOLDSTEIN MARK
PRESIDENT & TRUSTEE (EX-OFFICIO)	1.00	56.00	Yes (X)	$567,972	$0	$31,773	Yes (X)
FUNG MD CLAIRE
TRUSTEE	1.00	56.00	Yes (X)	$0	$319,980	$32,065
FOCHT MD GLENN
CMO; PRES & TTEE (EX-OFF) EFF 9/1/23	55.00	1.00	Yes (X)	$341,644	$0	$2,572	Yes (X)
BRICKMAN JEFFREY L
INTERIM PRES & TTEE (EX-OFF)	1.00	1.00	Yes (X)	$0	$0	$0	Yes (X)
CONNOLLY ESQ GRACE GONZALEZ
TRUSTEE & CHAIR	1.00	1.00	Yes (X)	$0	$0	$0	Yes (X)
KIRPAS JEFF
TRUSTEE, VICE CHAIR	1.00	1.00	Yes (X)	$0	$0	$0	Yes (X)
BOUTON PHD CHRISTOPHER
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
CANNON PATRICIA
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
CAPOLUPO WAYNE
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
COSTELLO MICHAEL
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
COUSINS JR FRANK G
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
CUSTODIA-LORA NOEMI
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
FELTER TIMOTHY
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
GHIASUDDIN MD SALMAN
TRUSTEE; CARDIOLOGIST	1.00	1.00	Yes (X)	$0	$0	$0
KHATIB MATT
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
MATTHEWS BYRON
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
PIENIAZEK MATT
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
PURINTON ELIZABETH
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
SEYMOUR MD PETER
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
SHENK III WILBUR
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
TARKAN MD JOSHUA
TTEE (EX-OFF) & PRES, MEDICAL STAFF	1.00	1.00	Yes (X)	$0	$0	$0
TRIM JEAN
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
WILEY MARGARET
TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
TABB MD KEVIN
CHIEF EXECUTIVE OFFICER (EX-OFFICIO)	1.00	64.00		$0	$2,507,235	$299,917	Yes (X)
KERNDL JOHN
TREAS (EX-OFF) (EVP & CFO, BILH)	1.00	64.00		$0	$1,301,463	$34,409	Yes (X)
RIOS CINDY
TREAS (EX-OFF) (INTERIM CFO, BILH)	1.00	64.00		$0	$802,046	$220,936	Yes (X)
KATZ ESQ JAMIE
CLERK (EX-OFFICIO)	1.00	64.00		$0	$898,193	$15,864	Yes (X)
SOLDANO JOSEPH
CO-INTERIM CFO/ DIR, FIN PLANNING	55.00	1.00		$169,428	$0	$49,662	Yes (X)
CIAMPA STEVEN
CO-INTERIM CFO, DIRECTOR OF FINANCE	55.00	1.00		$155,678	$0	$19,494	Yes (X)
KIM ESQ GRACE
ASST CLERK (EX-OFF) (ASST GC, BILH)	1.00	56.00		$0	$156,325	$10,038	Yes (X)
MATLOCK JOHN
CFO & ASST TREAS (EX-OFF)	1.00	56.00		$0	$94,143	$1,713	Yes (X)
CROWLEY SMITH JOANNE
INTERIM VP, HR BUSINESS PARTNER	1.00	57.00		$0	$272,064	$69,420		Yes (X)
MAKI DN RN RICHARD
CHIEF NURSING OFFICER	55.00	0.00		$250,497	$0	$35,987		Yes (X)
LEE GARY
VP, CLINICAL OPERATIONS	55.00	0.00		$190,674	$0	$53,558		Yes (X)
AHERN SEAN
CHIEF OPERATING OFFICER	1.00	55.00		$0	$182,698	$15,819		Yes (X)
HIGGINS LISA M
STAFF REGISTERED NURSE	55.00	0.00		$237,592	$0	$25,661			Yes (X)
BUCHANAN JR ROBERT R
EXEC DIR, EHR EPIC & CLIN SVCS	55.00	0.00		$195,870	$0	$49,738			Yes (X)
SZUKSTA WALTER F
DIRECTOR, PERI-OPERATIVE SERVICES	55.00	0.00		$164,949	$0	$46,893			Yes (X)
STEELE PATRICIA A
STAFF REGISTERED NURSE	55.00	0.00		$172,565	$0	$31,228			Yes (X)
BENNETT MATT
VP, HUMAN RESOURCES BUSINESS PARTNER	55.00	0.00		$169,334	$0	$22,442			Yes (X)
KILDAY KEVIN
FORMER CFO	0.00	55.00		$183,263	$0	$21,444				Yes (X)
SALVO STEPHEN
FORMER VP HR	0.00	55.00		$37,921	$138,375	$1,255				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,837,387	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$10,529,519	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,307,096	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	12	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
BETH ISRAEL LAHEY HEALTH INC
20 UNIVERSITY ROAD	CAMBRIDGE	MA	02138	MANAGEMENT & OPERATIONAL SERVICES	$14,611,925
AMERISOURCE
PO BOX 29808	NEW YORK	NY	100879808	PHARMACEUTICAL SOURCING AND DISTRIBUTION	$13,407,717
HEALTHCARE WORKFORCE LOGISTICS LLC
PO BOX 860573	MINNEAPOLIS	MN	554860573	WORKFORCE MANAGEMENT SOFTWARE SERVICES	$3,839,409
COLUMBIA CONSTRUCTION COMPANY
100 RIVERPARK DR	NORTH READING	MA	01864	CONSTRUCTION SERVICES	$2,365,954
STRYKER ORTHOPAEDICS
PO BOX 93213	CHICAGO	IL	606733213	MEDICAL EQUIPMENT SUPPLYING SERVICES	$2,326,191

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	94	CntrctRcvdGreaterThan100KCnt
Fundraising	$118,237	FundraisingAmt
All Other Contributions	$1,709,615	AllOtherContributionsAmt
Noncash Contributions	$35,866	NoncashContributionsAmt
Total Contributions	$1,827,852	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
INPATIENT CARE NPSR	621400	$63,674,743	$63,674,743
OUTPATIENT CARE NPSR	621400	$63,155,927	$63,155,927
EMERGENCY DEPT NPSR	624200	$11,898,644	$11,898,644
LAB SERVICES	541380	$6,228,509	$6,187,834	$40,675
SERVICES TO AFFILIATES	541511	$60,400	$60,400

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,348	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,348	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$145,019,571	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$409,852	TotalRevenueColumnAmt
Exclusion	$409,852	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$323,797	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$323,797	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$323,797	TotalRevenueColumnAmt
Exclusion	$323,797	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$39,532	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$118,237	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$51,296	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$11,764	TotalRevenueColumnAmt
Exclusion	-$11,764	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
REBATES & REFUNDS	900099	$888,033	$888,033
CAFETERIA REVENUE	900099	$579,044		$579,044
MEDICAL CREDENTIALING	621400	$240,225	$240,225

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$200,813	TotalRevenueColumnAmt
Related Or Exempt Func Income	$200,813	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,908,115	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$149,477,423	TotalRevenueColumnAmt
Related Or Exempt Func Income	$146,307,967	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$40,675	UnrelatedBusinessRevenueAmt
Exclusion	$1,300,929	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$38,300	TotalAmt
Program Services	$38,300	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,269,194	TotalAmt
Program Services	$1,179,124	ProgramServicesAmt
Management And General	$90,070	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$37,921	TotalAmt
Program Services	$35,230	ProgramServicesAmt
Management And General	$2,691	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$57,479,190	TotalAmt
Program Services	$53,400,101	ProgramServicesAmt
Management And General	$4,079,089	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,238,470	TotalAmt
Program Services	$2,079,614	ProgramServicesAmt
Management And General	$158,856	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,710,977	TotalAmt
Program Services	$6,234,724	ProgramServicesAmt
Management And General	$476,253	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,573,279	TotalAmt
Program Services	$4,248,730	ProgramServicesAmt
Management And General	$324,549	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$14,604,366	TotalAmt
Program Services	$3,083,548	ProgramServicesAmt
Management And General	$10,953,274	ManagementAndGeneralAmt
Fundraising	$567,544	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$14,122	TotalAmt
Management And General	$14,122	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$15,025	TotalAmt
Management And General	$15,025	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$66,068	TotalAmt
Management And General	$66,068	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$7,560	TotalAmt
Fundraising	$7,560	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$24,986,193	TotalAmt
Program Services	$24,403,203	ProgramServicesAmt
Management And General	$582,990	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$895,464	TotalAmt
Program Services	$874,231	ProgramServicesAmt
Management And General	$21,233	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,733,806	TotalAmt
Program Services	$3,236,836	ProgramServicesAmt
Management And General	$496,970	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$505,583	TotalAmt
Program Services	$505,583	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$5,644,112	TotalAmt
Program Services	$4,901,899	ProgramServicesAmt
Management And General	$742,213	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$599,169	TotalAmt
Program Services	$507,265	ProgramServicesAmt
Management And General	$91,904	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$15,334,418	$15,334,418
PHARMACEUTICALS	$14,928,921	$14,928,921
MAINTENANCE CONTRACTS	$2,740,022	$2,638,279	$101,743
OTHER EXPENSES	$2,129,171	$992,191	$1,136,980

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,679,215	TotalAmt
Program Services	$4,674,847	ProgramServicesAmt
Management And General	$4,368	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$163,230,546	TotalAmt
Program Services	$143,297,044	ProgramServicesAmt
Management And General	$19,358,398	ManagementAndGeneralAmt
Fundraising	$575,104	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$18,658,753	BOYAmt
EOY	$6,862,601	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,063,312	BOYAmt
EOY	$741,319	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$14,583,648	BOYAmt
EOY	$20,236,656	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$5,902,709	BOYAmt
EOY	$6,159,039	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,062,539	BOYAmt
EOY	$859,204	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$68,454,991	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$28,524,011	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$41,493,544	BOYAmt
EOY	$39,930,980	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$11,443,814	BOYAmt
EOY	$18,620,746	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
EOY	$8,268,203	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$20,312,352	BOYAmt
EOY	$10,736,756	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$114,520,671	BOYAmt
EOY	$112,415,504	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$13,952,700	BOYAmt
EOY	$17,616,989	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$288,461	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$17,958,565	BOYAmt
EOY	$16,367,397	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$43,146,837	BOYAmt
EOY	$46,926,652	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$75,058,102	BOYAmt
EOY	$81,199,499	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$26,955,443	BOYAmt
EOY	$18,026,533	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$12,507,126	BOYAmt
EOY	$13,189,472	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$39,462,569	BOYAmt
EOY	$31,216,005	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$114,520,671	BOYAmt
EOY	$112,415,504	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$13,753,123	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$1,576,505	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$3,930,054	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$66,068	OtherActivitiesAmt
Total Lobbying Expenditures	$66,068	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1, LOBBYING ACTIVITIES:	FormAndLineReferenceDesc
Explanation	ANNA JAQUES HOSPITAL, INC. 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 $66,068 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$8,389,666	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	-$435,780	InvestmentEarningsOrLossesAmt
Other Expenditures	$342,516	OtherExpendituresAmt
End Year Balance	$7,611,370	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$10,162,352	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	-$1,437,973	InvestmentEarningsOrLossesAmt
Other Expenditures	$334,713	OtherExpendituresAmt
End Year Balance	$8,389,666	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$14,408,734	BeginningYearBalanceAmt
Contributions	$11,470,408	ContributionsAmt
Investment Earnings Or Losses	$440,638	InvestmentEarningsOrLossesAmt
Other Expenditures	$16,157,428	OtherExpendituresAmt
End Year Balance	$10,162,352	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,080,614	BeginningYearBalanceAmt
Investment Earnings Or Losses	$444,089	InvestmentEarningsOrLossesAmt
Other Expenditures	$6,115,969	OtherExpendituresAmt
End Year Balance	$14,408,734	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$20,018,666	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$157,707	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$95,759	OtherExpendituresAmt
End Year Balance	$20,080,614	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.22000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.78000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,459,100	OtherCostOrOtherBasisAmt
Book Value	$2,459,100	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$32,918,974	OtherCostOrOtherBasisAmt
Depreciation	$9,834,999	DepreciationAmt
Book Value	$23,083,975	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,388,173	OtherCostOrOtherBasisAmt
Depreciation	$1,260,813	DepreciationAmt
Book Value	$2,127,360	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$23,617,935	OtherCostOrOtherBasisAmt
Depreciation	$13,271,018	DepreciationAmt
Book Value	$10,346,917	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,070,809	OtherCostOrOtherBasisAmt
Depreciation	$4,157,181	DepreciationAmt
Book Value	$1,913,628	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$39,930,980	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	OTHER SECURITIES	Desc
Book Value	$8,268,203	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$8,268,203	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
PROF LIABILITY INSURANCE RECOVERY	$1,057,690
OPERATING LEASED ASSETS	$7,151,061
DEFERRED COMPENSATION 457B	$2,528,005

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$10,736,756	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
OPERATING LEASED LIABILITIES	$7,270,240
DEFERRED COMPENSATION	$1,871,092
ESTIMATED THIRD PARTY SETTLEMENTS	$1,161,366
SECURITY DEPOSITS	$4,500
DEFINED BENEFIT PENSION LIABILITY	$10,126,509
DUE TO AFFILIATES	$25,363,255
PROFESSIONAL LIABILITY RESERVES	$1,129,690

Field	Value	IRS element (for citing)
Total Liability	$46,926,652	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

THE BOARD DESIGNATED FUNDS ON ANNA JAQUES HOSPITAL, INC.'S BOOKS ARE UNRESTRICTED, BUT REQUIRE A BOARD VOTE TO AUTHORIZE THEIR EXPENDITURE. THE TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE RESTRICTED BY THE DONORS FOR THE PURCHASE OF PROPERTY, PLANT AND EQUIPMENT. THE FUND WILL BE RELEASED ONCE THE RESTRICTION HAS BEEN MET AND THE EQUIPMENT HAS BEEN PURCHASED.

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 IN 2023 AND 2022, RESPECTIVELY.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM	RegionTxt
Offices	0	OfficesCnt
Employee	0	EmployeeCnt
Type Of Activities Conducted	INVESTMENTS	TypeOfActivitiesConductedTxt
Region Total Expenditures	$1,160,237	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$1,160,237	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$1,160,237	TotalSpentAmt
Transfer To Foreign Corp	Yes (1)	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	0	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART III ACCOUNTING METHOD:
PART IV, LINE 1	ANNA JACQUES HOSPITAL HAS REVIEWED ALL DOCUMENTATION TO DETERMINE THAT IT WAS A U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION DURING THE TAX YEAR AND HAS FILED FORMS.

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Mail Solicitations	Yes (X)	MailSolicitationsInd
Email Solicitations	Yes (X)	EmailSolicitationsInd
Phone Solicitations	Yes (X)	PhoneSolicitationsInd
In Person Solicitations	Yes (X)	InPersonSolicitationsInd
Solicitation Of Non Govt Grants	Yes (X)	SolicitationOfNonGovtGrantsInd
Special Fundraising Events	Yes (X)	SpecialFundraisingEventsInd
Agrmt Prof Fundraising Acty	Yes (1)	AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

Organization Business Name OrganizationBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ZURI GROUP LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	331 PARK AVE S 12TH FLOOR	AddressLine1Txt
City	NEW YORK	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	10010	ZIPCd

Field	Value	IRS element (for citing)
Activity	STRATEGY CONSULTING	ActivityTxt
Fundraiser Control Of Funds	0	FundraiserControlOfFundsInd
Gross Receipts	$0	GrossReceiptsAmt
Retained By Contractor	$7,560	RetainedByContractorAmt
Net To Organization	$0	NetToOrganizationAmt

Field	Value	IRS element (for citing)
Total Retained By Contractors	$7,560	TotalRetainedByContractorsAmt
Licensed States	FL	LicensedStatesCd
Licensed States	MA	LicensedStatesCd
Licensed States	MI	LicensedStatesCd
Licensed States	NV	LicensedStatesCd
Licensed States	NM	LicensedStatesCd
Licensed States	NC	LicensedStatesCd
Licensed States	ND	LicensedStatesCd
Licensed States	OH	LicensedStatesCd
Licensed States	PA	LicensedStatesCd
Licensed States	RI	LicensedStatesCd
Licensed States	SC	LicensedStatesCd
Licensed States	WA	LicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GOLF TOURNAMENT	Event1Nm
Gross Receipts Event1	$128,815	GrossReceiptsEvent1Amt
Charitable Contri Event1	$92,263	CharitableContriEvent1Amt
Gross Revenue Event1	$36,552	GrossRevenueEvent1Amt
Non Cash Prizes Event1	$1,890	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$14,629	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$16,190	FoodAndBeverageEvent1Amt
Other Direct Expenses Event1	$18,587	OtherDirectExpensesEvent1Amt
Event2	BOSTON MARATHON	Event2Nm
Gross Receipts Event2	$18,720	GrossReceiptsEvent2Amt
Charitable Contri Event2	$18,720	CharitableContriEvent2Amt
Other Events Total	1	OtherEventsTotalCnt
Gross Receipts Other Events	$10,234	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$7,254	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$2,980	GrossRevenueOtherEventsAmt
Gross Receipts Total	$157,769	GrossReceiptsTotalAmt
Charitable Contributions Tot	$118,237	CharitableContributionsTotAmt
Gross Revenue Total Events	$39,532	GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events	$1,890	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$14,629	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$16,190	FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events	$18,587	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$51,296	DirectExpenseSummaryEventsAmt
Net Income Summary	-$11,764	NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE G, PART II	FormAndLineReferenceDesc
Explanation	THE BOSTON MARATHON EVENT REPORTED IN THIS FORM 990 SCHEDULE G IS COORDINATED BY THE BETH ISRAEL LAHEY HEALTH ("BILH") DEVELOPMENT TEAM AS AN EVENT FOR THE BILH HEALTHCARE SYSTEM. RUNNERS PARTICIPATE IN THE MARATHON AND RAISE FUNDS FOR A SPECIFIC ENTITY WITHIN THE BILH SYSTEM. BILH REPORTS ALL EXPENSES FOR THE MARATHON ON ITS FORM 990, WHILE CONTRIBUTIONS RAISED BY RUNNERS ARE REPORTED AS REVENUE ON THE FORM 990 FOR EACH HOSPITAL OR OTHER HEALTHCARE ORGANIZATION DESIGNATED BY PARTICIPATING RUNNERS.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	400.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,490,489	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$486,389	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,004,100	NetCommunityBenefitExpnsAmt
Total Expense	0.00620	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,984,484	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,862,888	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$121,596	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,474,973	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,349,277	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,125,696	NetCommunityBenefitExpnsAmt
Total Expense	0.00690	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$272,505	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$272,505	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$63,374,456	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$47,565,621	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,808,835	NetCommunityBenefitExpnsAmt
Total Expense	0.09680	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$54,850	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$54,850	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$63,701,811	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$47,565,621	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,136,190	NetCommunityBenefitExpnsAmt
Total Expense	0.09880	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$68,176,784	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$50,914,898	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,261,886	NetCommunityBenefitExpnsAmt
Total Expense	0.10570	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$2,262,622	BadDebtExpenseAmt
Reimbursed By Medicare	$49,643,498	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$57,806,795	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$8,163,297	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ANNA JAQUES HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	25 HIGHLAND AVE	AddressLine1Txt
City	NEWBURYPORT	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	01950	ZIPCd

Field	Value	IRS element (for citing)
State License	2006	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ANNA JAQUES HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	21	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART VI	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	21	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART VI	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	400.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART VI	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART VI	FAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
ANNA JAQUES HOSPITAL	PART V, SECTION B, LINE 5: 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.
ANNA JAQUES HOSPITAL	PART V, SECTION B, LINE 11: 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.

Field	Value	IRS element (for citing)
Facility	7	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - ANNA JAQUES HOSPITAL
1 WALLACE BASHAW WAY	NEWBURYPORT	MA	01950	OP ONCOLOGY
2 - ANNA JAQUES HOSPITAL
21 HIGHLAND AVE	NEWBURYPORT	MA	01950	OP SERVICES
3 - ANNA JAQUES HOSPITAL
ONE PARK WAY	HAVERHILL	MA	01830	OP DIAGNOSTIC IMAGING
4 - ANNA JAQUES HOSPITAL
25 STOREY AVENUE	NEWBURYPORT	MA	01950	OP PYHSICAL THERAPY
5 - ANNA JAQUES HOSPITAL
255 LOW STREET	NEWBURYPORT	MA	01950	OTHER
6 - ANNA JAQUES HOSPITAL
600 PRIMROSE STREET	HAVERHILL	MA	01830	OTHER
7 - ANNA JAQUES HOSPITAL
13 MARKET STREET	NEWBURYPORT	MA	01950	OTHER

Supplemental Information Detail SupplementalInformationDetail (22 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSANNA JAQUES HOSPITAL AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF ANNA JAQUES HOSPITAL. BILH IS A PURPOSE-DRIVEN, VALUES-BASED ORGANIZATION THAT UNITES 39,000 PEOPLE WHO PROVIDE EXCEPTIONAL HEALTH CARE TO EVERYONE WE SERVE. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND PARTS OF SOUTHERN NEW HAMPSHIRE AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,800 PHYSICIANS AND 39,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES.BILH'S PURPOSE STATEMENT ARTICULATES THE IMPACT BILH AND EACH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. BILH'S SHARED VALUES GUIDE DAILY EFFORTS, KEEP BILH AND EACH AFFILIATE ALIGNED IN THE PURSUIT OF PURPOSE AND SHOW HOW BILH CARES FOR PATIENTS, EACH OTHER AND OUR COMMUNITIES.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.ANNA JAQUES HOSPITAL COMMUNITY BENEFITS MISSION STATEMENT THE MISSION OF ANNA JAQUES HOSPITAL IS TO PROVIDE HIGH-QUALITY, COMPASSIONATE MEDICAL CARE IN PARTNERSHIP WITH ITS MEDICAL STAFF TO IMPROVE THE HEALTH OF ITS COMMUNITIES. ESTABLISHED IN 1884 THROUGH THE VISION AND CHARITY OF MISS ANNA JAQUES, THE HOSPITAL STANDS AS A TESTAMENT TO ONE WOMAN AND HER PHYSICIAN'S COMMITMENT TO THE COMMUNITY AND ITS NEEDS. AJH PROUDLY CONTINUES THAT TRADITION TODAY BY ACTIVELY SERVING ITS COMMUNITY: BY ADDRESSING THE MOST PRESSING HEALTH NEEDS, SUPPORTING THE UNDERSERVED IN THE HOSPITAL'S SERVICE AREA, AND ADDRESSING DISPARITIES IN ACCESS TO CARE AND HEALTH OUTCOMES.ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING ANNA JAQUES HOSPITAL STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE THREE-YEAR IMPLEMENTATION STRATEGY; ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT THE HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, ECONOMIC AND SYSTEMIC FACTORS; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN ANNA JAQUES HOSPITAL'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED; PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; ANDFACILITATING 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.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, ANNA JAQUES HOSPITAL PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $327,355 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMANNA JAQUES HOSPITAL'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS CBSA AND BEYOND. ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF ANNA JAQUES HOSPITAL'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF ANNA JAQUES HOSPITAL'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. ANNA JAQUES HOSPITAL COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY A COMMUNITY BENEFITS MANAGER. THE COMMUNITY BENEFITS MANAGER HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE ANNA JAQUES HOSPITAL PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, THE LATTER OF WHOM REPORTS DIRECTLY TO THE BILH CHIEF DIVERSITY, EQUITY AND INCLUSION OFFICER. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE ANNA JAQUES HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH ANNA JAQUES HOSPITAL'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS MISSION PROVIDE HIGH-QUALITY, COMPASSIONATE MEDICAL CARE IN PARTNERSHIP WITH ITS MEDICAL STAFF TO IMPROVE THE HEALTH OF ITS COMMUNITIES. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF ANNA JAQUES HOSPITAL'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY ANNA JAQUES HOSPITAL'S PROGRAMMATIC ENDEAVORS, INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. ANNA JAQUES HOSPITAL'S CBAC MEMBERS INCLUDE: MICHELLE BRASIER, PRACTICE MANAGER, BETH ISRAEL LAHEY PRIMARY CARE HAVERHILL JANEL D'AGATA-LYNCH, MANAGER OF COMMUNITY BENEFITS COMMUNITY RELATIONS, ANNA JAQUES HOSPITAL, BETH ISRAEL LAHEY HEALTH ANDI EGMONT, DIRECTOR OF YOUTH SERVICES AND THE BEACON COALITION, CITY OF NEWBURYPORT TRACY FULLER, REGIONAL EXECUTIVE DIRECTOR, HAVERHILL YMCA ILENE HARNCH-GRADY, ENCORE PROGRAM LEADER, YWCA OF NEWBURYPORT CHRISTINE HEALEY, DIRECTOR OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, NORTH REGION, BETH ISRAEL LAHEY HEALTH TINA LOS, PROJECT COORDINATOR, ESSEX COUNTY ASSET BUILDER NETWORK TIFFANY NIGRO, EXECUTIVE DIRECTOR, THE PETTENGILL HOUSE OFFICER DANI SINCLAIR, NEWBURYPORT POLICE; ESSEX COUNTY OUTREACH JEAN TRIM, MANAGING DIRECTOR & PORTFOLIO MANAGER, VIGILANT CAPITAL MANAGEMENT, LLC; MEMBER, AJH BOARD OF TRUSTEES SHARI WILKINSON, MARKET COORDINATOR, NEWBURYPORT FARMERS MARKET MARY WILLIAMSON, VICE PRESIDENT OF PHILANTHROPY, AJH COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY (IS OR CHIP) PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE ANNA JAQUES HOSPITAL BOARD OF TRUSTEES ON SEPTEMBER 1, 2022. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 1, 2022 WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE CHNA AND THE ASSOCIATED IS REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF ANNA JAQUES HOSPITAL'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA (CBSA) WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT ANNA JAQUES HOSPITAL ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW ANNA JAQUES HOSPITAL, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.COMMUNITY HEALTH NEEDS ASSESSMENTPRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF ANNA JAQUES HOSPITAL'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES AMESBURY, HAVERHILL, MERRIMAC, NEWBURYPORT, AND SALISBURY.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCED POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN AMESBURY, HAVERHILL, MERRIMAC, NEWBURYPORT, AND SALISBURY, AS FOLLOWS: YOUTH LOW-RESOURCED POPULATIONS OLDER ADULTS RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INDIVIDUALS WITH DISABILITIES
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSANNA JAQUES HOSPITAL'S CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING ANNA JAQUES HOSPITAL'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. ANNA JAQUES HOSPITAL'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, ANNA JAQUES HOSPITAL CONDUCTED 18 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED THREE FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 750 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 800 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY PARTNERS. COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSANNA JAQUES HOSPITAL RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. ANNA JAQUES HOSPITAL] COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT ANNA JAQUES HOSPITAL LEVERAGED INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020) U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020) U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021) BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2019) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) FBI UNIFORM CRIME REPORTS (2019) MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020) MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018) ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)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, ANNA JAQUES HOSPITAL WORKED WITH COLLABORATORS TO CONDUCT 18 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT ANNA JAQUES HOSPITAL'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON ANNA JAQUES HOSPITAL'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN ANNA JAQUES HOSPITAL'S CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS.COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)ANNA JAQUES HOSPITAL CONDUCTED THREE COMMUNITY FOCUS GROUPS AND HELD COMMUNITY LISTENING SESSIONS THAT ENGAGED 800 RESIDENTS IN ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE SESSIONS WERE ORGANIZED IN COLLABORATION WITH THE LINK HOUSE IN AMESBURY, AMESBURY HIGH SCHOOL -LGBTQ YOUTH AND THE PETTENGILL HOUSE.ANNA JAQUES HOSPITAL HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF ANNA JAQUES HOSPITAL'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN MULTIPLE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, FOOD PANTIES AND COMMUNITY EVENTS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE ANNA JAQUES HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES. COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS WITH THE ANNA JAQUES HOSPITAL COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS. IDENTIFY ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE ANNA JAQUES HOSPITAL'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY ANNA JAQUES HOSPITAL DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021).
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2022, WERE: YOUTH LOW-RESOURCED POPULATIONS OLDER ADULTS RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS INDIVIDUALS WITH DISABILITIESANNA JAQUES HOSPITAL'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTHCARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY. HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023, SEPTEMBER 30, 2024, AND SEPTEMBER 30, 2025. COMMUNITY HEALTH NEEDS ASSESSMENTMAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEANNA JAQUES HOSPITAL STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://WWW.AJH.ORG/COMMUNITY/OUTREACH-AND-INVOLVEMENT IN ADDITION TO THE CHNA, ANNA JAQUES HOSPITAL COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2023-2025-IMPLEMENTATION-STRATEGY-101122.PDFANNA JAQUES HOSPITAL COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDFFINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING ANNA JAQUES HOSPITAL'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/-/MEDIA/FILES/AJH/AJH-2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, ANNA JAQUES HOSPITAL'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND A SUMMARY OF ANNA JAQUES HOSPITAL'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THAT CHNA AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, ANNA JAQUES HOSPITAL HAS BEEN STRATEGIC IN IDENTIFYING ITS COMMUNITY HEALTH PRIORITIES IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: EQUITABLE ACCESS TO CARE GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC, AND ECONOMIC BARRIERS.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE.PRIORITY AREA 4: CHRONIC AND COMPLEX DISEASE GOAL 1: ADDRESS THE PREVALENCE AND IMPACT, RISK/PROTECTIVE FACTORS, AND ACCESS ISSUES ASSOCIATED WITH CANCER. GOAL 2: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.COMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)ANNA JAQUES HOSPITAL (AJH) HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES ANNA JAQUES HOSPITAL OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES AMONG THEIR FOCUS COHORTS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS.ANNA JAQUES HOSPITAL WORKED TO EXPAND ACCESS TO CARE BEING MINDFUL OF ITS PRIORITY COHORTS. KNOWING TRANSPORTATION WAS IDENTIFIED AS A BARRIER TO CARE FOR OLDER ADULTS IN THE 2022 CHNA, AJH SUPPORTED NORTHERN ESSEX ELDER TRANSPORT (NEET), WHICH PROVIDES TRANSPORTATION TO LOCAL AND OUT-OF-TOWN MEDICAL APPOINTMENTS FOR THOSE THAT ARE 60 OR OLDER WHO CANNOT ACCESS AND/OR AFFORD OTHER MEANS. IN ADDITION, AJH PAID PATIENTS' CARE RELATED TRANSPORTATION FROM EMERGENCY FUNDS. IN JANUARY 2023, ANNA JAQUES STARTED A NEW "WELCOME VISIT" PROGRAM THROUGH ITS BIRTH CENTER TO PREPARE NEW PARENTS FOR DELIVERY, WITH TARGETED OUTREACH TO THOSE WHO FALL INTO HIGH-RISK CATEGORIES AND THE MOST VULNERABLE PATIENTS. THE PROGRAM COORDINATES WITH SOCIAL WORK TO ENSURE THE MOST VULNERABLE PATIENTS ATTEND THE VISIT, AND TRANSPORTATION ASSISTANCE IS GIVEN, IF NEEDED. ANNA JAQUES HOSPITAL UNDERSTANDS THAT ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH IS VITAL TO MOVE TOWARD HEALTH EQUITY. HOUSING AND FOOD SECURITY WERE IDENTIFIED IN THE 2022 CHNA AND ARE THE FOCUS OF EFFORTS IN THE CURRENT IMPLEMENTATION STRATEGY. IN FY23, AJH SUPPORTED A WIDE VARIETY OF PROGRAMS AIMED AT INCREASING FOOD SECURITY WITHIN THE CBSA INCLUDING NOURISHING THE NORTHSHORE'S VEGOUT PROGRAM AND OUR NEIGHBORS' TABLE WEDNESDAY MEAL. AND, TO INCREASE HEALTH EQUITY IN GATEWAY MUNICIPALITIES, AND CONTINUE TO SERVE THE UNDERSERVED, BETH ISRAEL LAHEY HEALTH (BILH) AWARDED THE YMCA OF THE NORTH SHORE/HAVERHILL YMCA A GRANT TO ADDRESS SOCIAL DETERMINANTS OF HEALTH NEEDS AND INCREASE FOOD ACCESS THROUGH THE INTRODUCTION OF A FREIGHT CONTAINER TO OPERATE A HYDROPONIC FARM. THE YMCA COLLABORATED WITH THE CITY OF HAVERHILL AND THE HAVERHILL PUBLIC SCHOOLS TO LOCATE THE FARM AT HAVERHILL'S GATEWAY ACADEMY, A PUBLIC MIDDLE AND HIGH SCHOOL. IN ADDITION TO FOOD, ANNA JAQUES HOSPITAL SUPPORTED EMMAUS, INC. MITCH'S PLACE, AN EMERGENCY OVERNIGHT SHELTER, WHICH EXPANDED ITS BED CAPACITY IN RESPONSE TO THE GROWING NUMBER OF UNSHELTERED MEN AND WOMEN IDENTIFIED DURING THE 2023 HOMELESS COUNT IN HAVERHILL. MENTAL HEALTH AND SUBSTANCE USE CONTINUE TO BE A PRIORITY FOR ANNA JAQUES HOSPITAL. THE PATIENT CARE NAVIGATOR AT AJH SUPPORTS WOMEN WITH SUBSTANCE USE DISORDER (SUD) AND/OR NEONATAL ABSTINENCE SYNDROME (NAS). THE PATIENT CARE NAVIGATOR SERVES WOMEN IN RECOVERY AND SEEKING ADDITIONAL SUPPORT, WHO HAVE SUFFERED FROM TRAUMA OR ABUSE, OR WHO HAVE BEEN DIAGNOSED WITH MENTAL HEALTH DISORDERS. THE PATIENT CARE NAVIGATOR SUPPORTS WOMEN THROUGHOUT THEIR PREGNANCY AND INTO THE FIRST YEAR OF MOTHERHOOD, WORKING IN COLLABORATION WITH WOMEN'S HEALTH CARE AND THE ANNA JAQUES BIRTH CENTER & NEONATAL CARE CENTER. IN ADDITION, ANNA JAQUES HOSPITAL SUPPORTED THE PETTENGILL HOUSE'S BEHAVIORAL EVENT AND SUBSTANCE SUPPORT TEAM (BESST) PROGRAM, WHICH WAS ABLE TO RESPOND TO THE INCREASED MENTAL HEALTH AND SUBSTANCE RELATED NEEDS. THE 2022 AJH CHNA IDENTIFIED YOUTH MENTAL HEALTH AS A CRITICAL CONCERN IN AJH'S CBSA. AJH SUPPORTED THE RECENTLY CREATED CATCH (CHILDREN AND TEEN CENTER FOR HELP) PROGRAM AT LINK HOUSE TO INCREASE ACCESS TO MENTAL HEALTH AND SUBSTANCE-USE TREATMENT AND EDUCATION FOR SCHOOL-AGED CHILDREN AND TEENS. ANNA JAQUES HOSPITAL CONTINUES TO ADDRESS COMPLEX AND CHRONIC DISEASE WITH A FOCUS ON CANCER IN DIVERSE WAYS. ANNA JAQUES HOSPITAL PARTNERS WITH COMMUNITY ORGANIZATIONS AIMED AT SUPPORTING A PERSON BEYOND THEIR CANCER DIAGNOSIS TO PROMOTE SURVIVORSHIP. FOR EXAMPLE, YMCA'S CORNERSTONE PROGRAM IS A COLLABORATIVE PROGRAM PROVIDING ESSENTIAL DAILY LIVING SUPPORT TO CANCER PATIENTS, CANCER SURVIVORS, AND THEIR FAMILIES. THE PROGRAM PROVIDES A MEMBERSHIP TO THE Y FOR PEOPLE DIAGNOSED WITHIN THE PAST FIVE YEARS, ACCESS TO SPECIALIZED PROGRAMS TO HELP THOSE WITH CANCER AND RECOVERING FROM CANCER, SPECIAL DROP-IN BABYSITTING FOR PARENTS WHO ARE CURRENTLY IN TREATMENT, WEEKS OF SUMMER CAMP IS OFFERED FOR FAMILIES WHO HAVE BEEN AFFECTED BY CANCER AND THE PROGRAM PROVIDES AN OVERALL SENSE OF COMMUNITY TO SUPPORT SURVIVORSHIP. ADDITIONALLY, AJH SUPPORTS THE YWCA OF NEWBURYPORT'S ENCORE PROGRAM A FREE 12-WEEK PROGRAM OFFERED TO ANY "THRIVER" WHO HAS EXPERIENCED CANCER AT ANY TIME IN THEIR LIVES, WHICH HAS SERVED HUNDREDS OF WOMEN IN OUR COMMUNITY. THE YWCA ENCORE PROGRAM IS DESIGNED TO EMPOWER WOMEN TO RECLAIM THEIR PHYSICAL AND EMOTIONAL HEALTH AND WELL-BEING AFTER A CANCER DIAGNOSIS AND TREATMENT. A FULL UPDATE ON ANNA JAQUES HOSPITAL'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.FY23 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEKEY: BASELINE-2023PRIORITY AREA 1: EQUITABLE ACCESS TO CAREINDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, AND STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM-LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTH CARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE.THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FORGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC, AND ECONOMIC BARRIERSCOMMUNITY STRATEGIES/ACTIVITIES PROMOTE ACCESS TO HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICATIONS FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED. PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS. SUPPORT PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION TO HEALTHCARE SERVICES.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	METRICS AND STATUS UPDATES TO SUPPORT VULNERABLE COMMUNITIES AND LIMIT BARRIERS SO PATIENTS RECEIVE THE CARE THEY NEED, AJH CASE MANAGEMENT HAS AN EMERGENCY FUND TO PROVIDE TRANSPORTATION REIMBURSEMENT TO PATIENTS WHO HAVE LIMITED RESOURCES AND SOCIAL SUPPORTS. THIS PROGRAM IS OFFERED TO ANY PATIENT WHO MEETS THE CRITERIA OF NEED DECIDED BY A SOCIAL WORKER. AMOUNT DISTRIBUTED TO PATIENTS (FY23: $7,200) NUMBER OF PATIENTS ASSISTED (FY23: 240) TO ORIENT AND SUPPORT EXPECTANT PATIENTS, ESPECIALLY THOSE DEEMED "HIGH-RISK," BY PREPARING THEM FOR A HOSPITAL DELIVERY AND INITIAL NEWBORN CARE, AJH STARTED A "WELCOME VISIT" PROGRAM IN JANUARY 2023. THE VISIT IS FREE, AND OUTREACH IS DONE TO ENSURE THE MOST VULNERABLE PATIENTS ATTEND THE VISIT. WELCOME VISITS COMPLETED (FY23: 130) TO "TRANSFORM CARE DELIVERY BY DISMANTLING BARRIERS TO EQUITABLE HEALTH OUTCOMES AND BECOME THE PREMIER HEALTH SYSTEM TO ATTRACT, RETAIN AND DEVELOP DIVERSE TALENT," BILH'S DIVERSITY, EQUITY, AND INCLUSION (DEI) OFFICE DEVELOPS AND ADVOCATES FOR POLICIES, PROCESSES AND BUSINESS PRACTICES THAT BENEFIT THE COMMUNITIES AND OUR WORKFORCE. INCREASE IN BIPOC LEADERSHIP (DIRECTORS AND ABOVE) AND CLINICAL (PHYSICIANS AND NURSES) HIRES OVER FY22 (FY23: 25%) DOLLARS CONTRACTED TO WOMEN AND MINORITY-OWNED BUSINESS ENTERPRISES (WMBE) (FY23: $50 MILLION, A 22% INCREASE FROM FY22) SYSTEM-WIDE DEI TRAININGS CONDUCED FOR ALL BILH STAFF AND HOSPITALS (FY23: 8) ANNA JAQUES HOSPITAL IS FORMING A DIVERSITY, EQUITY AND INCLUSION COUNCIL TO GUIDE THE HOSPITAL'S EFFORTS TO NURTURE AND SUSTAIN A DIVERSE, EQUITABLE AND INCLUSIVE ORGANIZATIONAL CULTURE AND TO MAKE MEANINGFUL AND LASTING CHANGE FOR OUR PATIENTS, OUR EMPLOYEES AND OUR COMMUNITIES. TO SUPPORT OLDER ADULTS' ACCESS TO VITAL MEDICAL APPOINTMENTS, AJH SUPPORTED NORTHERN ESSEX ELDER TRANSPORT, INC. (NEET). NEET PROVIDES FREE TRANSPORTATION TO AND FROM HEALTHCARE APPOINTMENTS FOR THOSE OVER THE AGE OF 60. UNIQUE INDIVIDUALS RECEIVING TRANSPORTATION TO MEDICAL CARE (FY23: 436)PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTHTHE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND THE ANNA JAQUES HOSPITAL COMMUNITY HEALTH SURVEY REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC INSTABILITY.GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.COMMUNITY STRATEGIES/ACTIVITIES PROVIDE COMMUNITY HEALTH GRANTS TO SUPPORT IMPACTFUL PROGRAMS THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTH. SUPPORT PROGRAMS AND INITIATIVES THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSING. SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE HEALTHY EATING AND ACCESS TO AFFORDABLE, HEALTHY FOODS. PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES THAT REDUCE AND PREVENT FOOD INSECURITY AND/OR HOUSING CHALLENGES.METRICS AND STATUS UPDATES BETH ISRAEL LAHEY HEALTH (BILH) AWARDED THE YMCA OF THE NORTH SHORE/HAVERHILL YMCA A GRANT TO ADDRESS SOCIAL DETERMINANTS OF HEALTH NEEDS AND INCREASE FOOD ACCESS THROUGH THE INTRODUCTION OF A FREIGHT CONTAINER TO OPERATE A HYDROPONIC FARM. THE YMCA PARTNERED WITH THE HAVERHILL PUBLIC SCHOOLS TO HOUSE THE FARM AT GATEWAY ACADEMY, A PUBLIC MIDDLE AND HIGH SCHOOL. STUDENTS FROM THE SCHOOL AND THE YMCA AFTERSCHOOL PROGRAM HELP TO GROW, TEND, AND HARVEST PRODUCE. THE FREIGHT FARM GROWS A VARIETY OF VEGETABLES, INCLUDING LETTUCE, BOK CHOY, AND SPINACH, THAT ARE DISTRIBUTED TO GATEWAY STUDENTS, YMCA PARTICIPANTS AND SHARED WITH LOCAL FOOD PANTRIES/HOMELESS SHELTERS. UNIQUE PERSONS RECEIVING FOOD (FY23: 1,040) STUDENT PARTICIPANTS IN STEM AND NUTRITIONAL ACTIVITIES (FY23: 43) PEOPLE RECEIVED VIA COMMUNITY EVENTS (FY23: 154) AJH SUPPORTED EMMAUS, INC. "MITCH'S PLACE" EMERGENCY SHELTER THAT PROVIDES OVERNIGHT SHELTER, NUTRITIOUS MEALS, AND NEEDED SUPPORT SERVICES YEAR-ROUND, INCLUDING DURING EXTREME CONDITIONS, TO HOMELESS MEN AND WOMEN THAT MAY OTHERWISE SPEND THE NIGHT ENGAGING IN HIGH-RISK, SELF-DESTRUCTIVE, AND/OR ILLEGAL ACTIVITIES. THE PROGRAM ALSO OFFERS CASE MANAGEMENT TO SUPPORT ACCESSING NEEDED SERVICES AND JOB OPPORTUNITIES. NUMBER OF INDIVIDUALS SERVED (FY23: 225) AJH ISSUED A COMMUNITY GRANT TO OUR NEIGHBORS' TABLE (ONT) TO SUPPORT THEIR WEDNESDAY MEAL PROGRAM, WHICH IS OPEN TO ANYONE. THE WEDNESDAY MEAL PROVIDES A HOT MEAL TO 300 500+ UNIQUE PEOPLE EACH MONTH. ONT ALSO PROVIDES HOME DELIVERIES OF THE WEDNESDAY MEAL TO THOSE WHO ARE HOMEBOUND AND DISTRIBUTES EXTRA PREPARED MEALS IN THE MARKET ON THURSDAY AS AN EXTRA CONVENIENCE FOR ONT GUESTS UNIQUE GUESTS SERVED THROUGH THE WEDNESDAY MEAL PROGRAM (FY23: 4,490) ANNA JAQUES HOSPITAL SUPPORTED THE FIRST PARISH NEWBURY FOOD PANTRY, WHICH PROVIDES FREE FOOD TO THOSE IN NEED, INCLUDING RESIDENTS OF NEWBURYPORT, SALISBURY, AMESBURY, AND OTHER SURROUNDING CITIES/TOWNS. THE ORGANIZATION SERVES APPROXIMATELY 600 GUESTS EACH WEEK, THE MAJORITY OF WHICH LIVE IN NEWBURYPORT (45%). MORE THAN HALF THE HOUSEHOLDS SERVED DON'T HAVE TRANSPORTATION AND DEPEND ON THE ORGANIZATION'S FOOD DELIVERY. THE ORGANIZATION HAS PANTRIES IN ALL THE SCHOOLS IN THE TRITON SCHOOL DISTRICT, WHICH INCLUDES SALISBURY ELEMENTARY SCHOOL AND TRITON HIGH SCHOOL, SERVING SALISBURY RESIDENTS. HOUSEHOLDS RECEIVING FOOD REGULARLY (FY23: 401) NOURISHING THE NORTHSHORE'S VEGOUT PROGRAM BRINGS HEALTHY, LOCAL PRODUCE TO MEMBERS IN THE COMMUNITY THAT OFTEN DO NOT HAVE ACCESS TO THESE FOOD CHOICES. NOURISHING THE NORTH SHORE COMBINES EXCESS PRODUCE FROM LOCAL FARMS WITH FOOD THAT IS GROWN AT THEIR GARDEN AND DISTRIBUTE PRODUCE DIRECTLY THROUGH THE COMMUNITY'S FOOD ACCESS AGENCIES AS WELL AS NNS-RUN FARMERS' MARKET STYLE PRODUCE STANDS. ALL PRODUCE IS FREE TO THOSE WHO ARE VISITING THE FOOD ACCESS SITES. UNIQUE HOUSEHOLDS RECEIVING FOOD (FY23: 1,000) ANNA JAQUES HOSPITAL SUPPORTED THE YWCA OF NEWBURYPORT'S AFFORDABLE HOUSING RESIDENTS WITH A GRANT TO PURCHASE HEALTHY, FRESH PRODUCE. ALL HOUSEHOLDS ARE BELOW 60% OF THE AREA MEDIAN INCOME. HOUSEHOLDS WITH INCOMES BELOW 80% AMI ARE CONSIDERED LOW INCOME. AT THE RESIDENCES AT SALISBURY SQUARE (RSS) SITE, 20 OF 42 UNITS ARE CURRENTLY HOUSING FAMILIES WHOSE INCOME IS AT OR BELOW 30% OF AREA MEDIAN (WHICH IS CONSIDERED EXTREMELY LOW INCOME. TENANTS ASSISTED WITH FOOD (FY23: 100)PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USEANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. THOSE WHO PARTICIPATED IN THE ASSESSMENT ALSO REFLECTED ON STIGMA, SHAME, AND ISOLATION THAT THOSE WITH MENTAL HEALTH CHALLENGES FACE THAT LIMIT THEIR ABILITY TO ACCESS CARE AND COPE WITH THEIR ILLNESS. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH AND ECONOMIC INSECURITY. INTERVIEWEES, FOCUS GROUP, AND LISTENING SESSION PARTICIPANTS ALSO REPORTED THAT ALCOHOL USE IS NORMALIZED, AND USE IS PREVALENT AMONG BOTH ADULTS AND YOUTH.GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	COMMUNITY STRATEGIES/ACTIVITIES: ENHANCE RELATIONSHIPS AND PARTNERSHIPS WITH SCHOOLS, YOUTH SERVING ORGANIZATIONS, AND OTHER COMMUNITY PARTNERS TO INCREASE RESILIENCY, COPING, AND PREVENTION SKILLS. PROVIDE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION AND TREATMENT. 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 MULTISECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO INCREASE RESILIENCY, PROMOTE MENTAL HEALTH, REDUCE SUBSTANCE USE, AND PREVENT OPIOID OVERDOSES AND DEATHS.METRICS AND STATUS UPDATES: AJH PROVIDES 24/7/365 BEHAVIORAL HEALTH CRISIS EVALUATION IN THE EMERGENCY DEPARTMENT (ED) AND THROUGHOUT OTHER HOSPITAL UNITS FOR INDIVIDUALS EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE RELATED CRISIS. SERVICES ARE PAYER AGNOSTIC AND PROVIDED VIA IN-PERSON OR TELEHEALTH BY A MULTIDISCIPLINARY TEAM OF QUALIFIED PROFESSIONALS, INCLUDING PSYCHIATRISTS, INDEPENDENTLY LICENSED AND MASTER'S LEVEL CLINICIANS, NURSE PRACTITIONERS, REGISTERED NURSES, CERTIFIED PEER SPECIALISTS, AND FAMILY PARTNERS. THE SERVICES INCLUDE INITIAL ASSESSMENTS FOR RISKS, CLINICAL STABILIZATION, TREATMENT INITIATION, CARE COORDINATION, AND ONGOING EVALUATION TO ENSURE APPROPRIATE LEVEL OF CARE PLACEMENT. NUMBER OF SCREENS FOR BEHAVIORAL HEALTH (FY23: 974) COLLABORATIVE CARE MODEL (COCM) HAS BEEN ADOPTED IN BILH PRIMARY CARE PRACTICES TO PROVIDE BEHAVIORAL HEALTH SERVICES IN THE PRIMARY CARE SETTING. THE PRIMARY CARE PROVIDER AND THE BEHAVIORAL HEALTH CLINICIAN WILL DEVELOP A TREATMENT PLAN THAT IS SPECIFIC TO THE PATIENT'S PERSONAL GOALS. A CONSULTING PSYCHIATRIST MAY ADVISE THE PRIMARY CARE PROVIDER ON MEDICATIONS THAT MAY BE HELPFUL. NUMBER OF PATIENTS SERVED (FY23: 159) AJH SUPPORTED THE PETTENGILL HOUSE'S BEHAVIORAL EVENT AND SUBSTANCE SUPPORT TEAM (BESST), COLLECTIVE RESPONSE TO ADDRESS SYSTEM BARRIERS AND MEET GROWING COMMUNITY NEED BY CREATING A STREAMLINED PROCESS FOR COLLABORATION ACROSS EVERY LEVEL OF CARE TO ENHANCE QUALITY AND CONTINUITY OF CARE FOR THOSE STRUGGLING WITH SUBSTANCE MISUSE/BEHAVIORAL HEALTH. THROUGH A PERSON-CENTERED COORDINATED TEAM, BESST AIMS TO BRIDGE GAPS BY BREAKING DOWN BARRIERS, PROVIDING EDUCATION, REDUCING STIGMA, AND COORDINATING WRAPAROUND SUPPORTS TO IMPROVE STABILIZATION AND WELL-BEING FOR AT-RISK COMMUNITY MEMBERS STRUGGLING WITH SUBSTANCE MISUSE AND BEHAVIORAL HEALTH. NUMBER OF UNIQUE INDIVIDUALS RECEIVING DIRECT SERVICES (FY23: 481) NUMBER OF FAMILY MEMBERS RECEIVING SUPPORT (FY23: 94) AJH PROVIDED GRANT FUNDING TO THE GREATER NEWBURYPORT VILLAGE FOR THEIR MEMBERSHIP ASSISTANCE PROGRAM. THE VILLAGE'S GOOD NEIGHBOR VOLUNTEERS PROVIDE NEIGHBORLY HELP AT HOME AND RIDES TO APPOINTMENTS/EVENTS. IN ADDITION, THE VILLAGE FOLLOWS UP WITH NON-PARTICIPATING MEMBERS, WHO MAY BE SUFFERING FROM ISOLATION. PERCENT OF MEMBERS ENROLLED IN ASSISTANCE PROGRAM (FY23: 20%) AJH SUPPORTED THE SAMARITANS OF THE MERRIMACK VALLEY THAT AIMS TO REDUCE THE INCIDENTS OF SUICIDE IN NORTHEASTERN MASSACHUSETTS BY PROVIDING A HOST OF PREVENTION AND POST-VENTION SERVICES INCLUDING COMMUNITY OUTREACH, TRAININGS, SURVIVOR SUPPORT AND A 24-HOUR CRISIS HOTLINE. INDIVIDUALS SERVED THROUGH HELPLINES (FY23: 4,600) PARTICIPANTS IN TRAINING AND SUPPORTIVE PROGRAMS (FY23: 495) SUICIDE PREVENTION TRAINING SESSIONS (FY23: 330) AJH CONTINUED PARTNERING WITH ESSEX COUNTY OUTREACH, A COLLABORATIVE EFFORT INVOLVING ALL 34 POLICE DEPARTMENTS WITHIN ESSEX COUNTY, AS WELL AS THE SHERIFF'S DEPARTMENT, PARTNERING WITH SOCIAL SERVICE AGENCIES, PEER SPECIALISTS, AND OTHER COMMUNITY SUPPORTS TO INCREASE RESOURCES FOR SUBSTANCE USE AND MENTAL HEALTH. UNIQUE PERSONS ASSISTED (FY23: 104) AJH PROVIDED A COMMUNITY GRANT TO LINK HOUSE, INC.'S NEW CATCH (CHILDREN AND TEEN CENTER FOR HELP) PROGRAM TO ADDRESS THESE GROWING UNMET NEEDS AROUND MENTAL HEALTH AND SUBSTANCE-USE FOR SCHOOL-AGED CHILDREN AND TEENS IN THE COMMUNITY. THE FUNDS FROM THIS GRANT FOCUSED SPECIALLY ON CHILD AND TEENS AGE 5Y/O 18 Y/O, AND THEIR IMMEDIATE FAMILIES WHO ARE IN NEED OF RECEIVING TREATMENT AND/OR PSYCHOEDUCATION RELATED TO ACUTE OR CHRONIC MENTAL HEALTH CONCERNS, IN ADDITION TO TREATMENT, EDUCATION, AND/OR RELAPSE PREVENTION SKILLS. PATIENTS RECEIVING THERAPY (FY23 146) AJH CONTINUED OFFERING THE PATIENT CARE NAVIGATOR THAT SUPPORTS WOMEN WITH SUBSTANCE USE DISORDER AND/OR NEONATAL ABSTINENCE SYNDROME, A CONDITION THAT IMPACTS ABOUT 14.5 CASES PER 1,000 BIRTHS IN MASSACHUSETTS. THE PATIENT CARE NAVIGATOR SERVES WOMEN IN RECOVERY AND SEEKING ADDITIONAL SUPPORT, WHO HAVE SUFFERED FROM TRAUMA OR ABUSE, OR WHO HAVE BEEN DIAGNOSED WITH MENTAL HEALTH DISORDERS. THE PATIENT CARE NAVIGATOR CHAMPIONS WOMEN THROUGHOUT THEIR PREGNANCY AND INTO THE FIRST YEAR OF MOTHERHOOD, WORKING IN COLLABORATION WITH WOMEN'S HEALTH CARE AND THE ANNA JAQUES BIRTH CENTER & NEONATAL CARE CENTER. NUMBER OF WOMEN SERVED IN RECOVERY OR SEEKING ADDITIONAL SUPPORT (FY23: 300)PRIORITY 4: CHRONIC AND COMPLEX DISEASECHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN MASSACHUSETTS AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.GOALS: ADDRESS THE PREVALENCE AND IMPACT, RISK/PROTECTIVE FACTORS, AND ACCESS ISSUES ASSOCIATED WITH CANCER. IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.COMMUNITY STRATEGIES/ACTIVITIES: PROVIDE PREVENTIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMS. SUPPORT COMMUNITY-BASED PROGRAMS/ INITIATIVES THAT INCREASE ACCESS TO HEALTHY FOODS AND/OR PHYSICAL ACTIVITY TO SUPPORT CANCER SURVIVORSHIP. PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES THAT REDUCE AND PREVENT OR PROVIDE NEEDED SUPPORTS RELATED TO CANCER.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	METRICS AND STATUS UPDATES: AJH BREAST CARE NAVIGATOR OFFERS INDIVIDUALIZED SUPPORT AND ASSISTANCE TO PATIENTS AND THEIR CAREGIVERS TO HELP THEM MAKE INFORMED DECISIONS ABOUT THEIR CARE AND TO OVERCOME BARRIERS TO OPTIMAL CARE. THE NAVIGATOR PROVIDES CANCER PATIENTS WITH COORDINATED CARE THROUGH A HOLISTIC AND COLLABORATIVE APPROACH THAT INCLUDES COMMUNICATION AND COORDINATION WITH THE PATIENT'S FAMILY AND/OR CAREGIVERS, ALONG WITH A MULTIDISCIPLINARY TEAM CONSISTING OF PHYSICIANS, NURSE PRACTITIONERS, ONCOLOGY NURSES, AND SOCIAL WORKERS. THE NAVIGATOR WORKS IN COLLABORATION WITH THE CLINICAL TEAM TO DEVELOP CLINICAL PATHWAYS FOR APPROPRIATE CARE AND ACTS AS THE CONTACT CLINICAL PERSON FOR PATIENT-RELATED CONCERNS. INDIVIDUALS PROVIDED SUPPORT SERVICES AND CARE COORDINATION (FY23: 266 WOMEN SCHEDULED FOR IMAGE-GUIDED BREAST BIOPSIES AND 100 GBCC PATIENTS AND FAMILIES UNDERGOING BREAST SURGERY FOR BOTH BENIGN AND MALIGNANT CONDITIONS). AJH SUPPORTED THE NORTH OF BOSTON CANCER RESOURCES (NBCR), WHICH IS DESIGNED TO EDUCATE AND OFFER SUPPORT TO PEOPLE AFFECTED BY CANCER. THEY SERVE PEOPLE AFFECTED BY CANCER FROM DIAGNOSIS, THROUGH TREATMENT AND BEYOND. SERVICES INCLUDE ONCOLOGY MASSAGE, MANUAL LYMPH DRAINAGE, ACUPUNCTURE, REIKI, PERSONAL TRAINING, YOGA THERAPY, GUIDED IMAGERY, HEALTH COACHING AND NUTRITION COUNSELING. IN ADDITION, THEY HAVE AN EDUCATIONAL SPEAKER SERIES AND GIFT CERTIFICATE PROGRAM. INDIVIDUALS REACHED THROUGH SPEAKER SERIES (FY23: 271) COMPLEMENTARY CARE SESSIONS PROVIDED (FY23: 160) AJH HOSTS FREE WEEKLY "BABY AND ME" CLASSES IN NEWBURYPORT AND HAVERHILL FOR ANY PARENT IN THE COMMUNITY. THESE GROUPS ARE FACILITATED BY A BIRTH CENTER LACTATION CONSULTANT/REGISTERED NURSE TO SUPPORT EVERY PERSON'S PARENTING EXPERIENCE. A PERSON DOES NOT NEED TO BE BREASTFEEDING/CHEST FEEDING TO ENJOY THIS GROUP. ALL ASPECTS OF PARENTING ARE DISCUSSED. PARENTS PARTICIPATING WEEKLY IN CLASSES (FY23: 15) AJH SUPPORTED THE YWCA OF NEWBURYPORT'S ENCORE AND AFTER ENCORE PROGRAM, WHICH IS A UNIQUE SURVIVORSHIP PROGRAM FOR THOSE WHO HAVE EXPERIENCED CANCER AT ANY POINT IN THEIR LIVES. THE PROGRAM PROVIDES FREE ACCESS TO A TAILORED EXERCISE PROGRAM, INCORPORATING LAND AND WATER EXERCISES APPROPRIATE FOR ALL FITNESS LEVELS AT ANY POINT IN THEIR TREATMENT JOURNEY AND BEYOND. ENCORE/AFTER ENCORE PARTICIPANTS (FY23: 36) PARTICIPANTS WHO EXPERIENCED INCREASED HEALTH METRICS WITH REGULAR ATTENDANCE (FY23: 85%) AJH SUPPORTED THE CORNERSTONE PROGRAM AT THE GREATER HAVERHILL YMCA. CORNERSTONE IS A COLLABORATIVE HEALTH AND WELLNESS PROGRAM PROVIDING SUPPORT TO CANCER PATIENTS, CANCER SURVIVORS, AND THEIR IMMEDIATE FAMILIES. A FREE ONE-YEAR YMCA MEMBERSHIP IS PROVIDED TO THE FAMILY AND TWO WEEKS OF SUMMER CAMP PROGRAMMING AT NO COST. NUMBER OF SURVIVORSHIP SUPPORT PROGRAM MEMBERSHIPS (FY23: 41) NUMBER OF FAMILIES PROVIDED SUMMER CAMP (FY23: 8) ENHANCEFITNESS IS A PROVEN COMMUNITY-BASED SENIOR FITNESS AND ARTHRITIS MANAGEMENT PROGRAM. IT HELPS OLDER ADULTS BECOME MORE ACTIVE, ENERGIZED, AND EMPOWERED FOR INDEPENDENT LIVING. THE PROGRAM IS ESPECIALLY BENEFICIAL FOR OLDER ADULTS LIVING WITH ARTHRITIS. AJH SUPPORTED THIS PROGRAM AT THE YMCA OF GREATER HAVERHILL. PERCENT OF PARTICIPANTS THAT MAINTAINED/INCREASED THEIR FEELING OF OVERALL HEALTH DURING THE 16-WEEK PROGRAM (FY23: 90%) PERCENT OF PARTICIPANTS WHO IMPROVED THEIR PHYSICAL ABILITIES OVER THE 16-WEEK PROGRAM (FY23: 75%) SPONSORSHIP OF THE HAVERHILL FARMERS' MARKET DEDICATED TO PROMOTING HEALTHY EATING, AND SUPPORTING LOCAL BUSINESS, SUSTAINABILITY, AND COMMUNITY SPIRIT BY PROVIDING FRESH, LOCAL PRODUCE, BAKED AND PREPARED FOODS AS WELL AS HAND-CRAFTED GOODS. SEVERAL VENDORS ACCEPT PAYMENT FROM THE SUPPLEMENTAL NUTRITION ASSISTANT PROGRAM (SNAP) AND WOMEN, INFANTS, AND CHILDREN (WIC) HELPING LOWER INCOME FAMILIES ACCESS LOCALLY GROWN FRESH PRODUCE. NUMBER OF WEEKLY MARKETS HOSTED (FY23:19)COMMUNITY PARTNERSANNA JAQUES HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE: EMMAUS, INC. ESSEX COUNTY ASSET BUILDER NETWORK ESSEX COUNTY OUTREACH FAMILY SERVICES OF THE MERRIMACK VALLEY GREATER NEWBURYPORT VILLAGE HAVERHILL FARMERS MARKET/CREATIVE HAVERHILL LINK HOUSE, INC. NEW ENGLAND ELDER TRANSPORTATION NEWBURY FOOD PANTRY NEWBURYPORT DEI ALLIANCE NEWBURYPORT FARMERS' MARKET NEWBURYPORT RECREATION AND YOUTH SERVICES NORTH OF BOSTON CANCER RESOURCE NORTHERN ESSEX ELDER TRANSPORT NOURISHING THE NORTHSHORE OUR NEIGHBORS' TABLE THE PETTENGILL HOUSE REGIONAL SOCIAL SERVICES COLLABORATIVE ROTARY CLUB OF NEWBURYPORT SALISBURY PARKS & RECREATION DEPARTMENT YMCA OF NORTHSHORE/HAVERHILL YWCA OF NEWBURYPORTAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, ANNA JAQUES HOSPITAL IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY. THOSE NEEDS ARE: SUPPORTING EDUCATION ACROSS THE LIFESPAN, STRENGTHENING THE BUILT ENVIRONMENT (I.E., IMPROVING ROADS/SIDEWALKS AND ENHANCING ACCESS TO SAFE RECREATIONAL SPACES/ACTIVITIES), AND DIGITAL DIVIDE/ACCESS TO TECH RESOURCES. ANNA JAQUES HOSPITAL IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES, THE FEASIBILITY OF AJH HAVING AN IMPACT, AND/OR BECAUSE IT WAS FELT THAT THE ISSUE WAS BEING ADDRESSED BY OTHER COMMUNITY PARTNERS. AS NOTED IN DETAIL ABOVE, ANNA JAQUES HOSPITAL'S PRIMARY TOOL FOR ASSESSING THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW ANNA JAQUES HOSPITAL CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 10.58% OF ANNA JAQUES HOSPITAL'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITSANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, ANNA JAQUES HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT : HTTPS://AJH.ORG/ABOUT/COMMUNITY-BENEFITS-NEEDS.THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT ANNA JAQUES HOSPITAL FILED WITH THE ATTORNEY GENERAL'S OFFICE.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, ANNA JAQUES HOSPITAL IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEANNA JAQUES HOSPITAL'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $1,004,100 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, ANNA JAQUES HOSPITAL IS ONE OF ELEVEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $ $73,152,852 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, FOR THE PERIOD COVERED BY THIS FILING, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, ANNA JAQUES HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ANNA JAQUES HOSPITAL GENERATED $2,862,888 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY ANNA JAQUES HOSPITAL FOR SUCH SERVICES BY $121,596 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 11.20% OR 24,814 OF ANNA JAQUES HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 52.60% OR 116.540 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND ANNA JAQUES HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ANNA JAQUES HOSPITAL GENERATED $49,643,498 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $8,163,297. OF THESE AMOUNTS, REVENUE OF $47,565,621 IS RELATED TO THE PROVISION OF GENERAL MEDICINE, CANCER CENTER (INCLUDES HEMATOLOGY), BEHAVIORAL HEALTH, OBGYN, NEONATOLOGY/ NEWBORN 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 $13,583,744.. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH ANNA JAQUES HOSPITAL CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, ANNA JAQUES HOSPITAL HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, ANNA JAQUES HOSPITAL ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. COSTS FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF WERE $2,262,622 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, 2023 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER AND THEIR AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP). FINALLY, EFFECTIVE JULY 1, 2023, BILH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND THREE MONTHS OF EHRI'S ACTIVITY AS WELL AS THREE MONTHS OF EHRI'S AFFILIATES' ACTIVITY, INCLUDING EXETER HOSPITAL, ARE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF BILH AND AFFILIATES. THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSTHE SYSTEM'S PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING MANAGED CARE PAYERS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDE AN ESTIMATE OF VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE SYSTEM BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE SYSTEM'S FACILITY.EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, ANNA JAQUES HOSPITAL IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE ANNA JAQUES HOSPITAL IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE FROM ANNA JAQUES HOSPITAL AS WELL AS PROVIDERS WHO FOLLOW ANNA JAQUES HOSPITAL'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN ANNA JAQUES HOSPITAL AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW ANNA JAQUES HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. ANNA JAQUES HOSPITAL DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONS EFFECTIVE ON OR ABOUT AUGUST 15, 2020FINANCIAL ASSISTANCE POLICY APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: ARABIC, FRENCH, GREEK, ITALIAN, JAPANESE, KHMER, PORTUGUESE, RUSSIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, SPANISH, VIETNAMESE. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://AJH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/ASSISTANCE#:~:TEXT=AT%20ANNA%20JAQUES%20HOSPITAL%2C%20WE%20PROVIDE%20FINANCIAL%20AID,THE%20NUMBER%20OF%20FAMILY%20MEMBERS%20IN%20THE%20HOUSEHOLD. IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE ANNA JAQUES HOSPITAL FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. CREDIT AND COLLECTION POLICY APPLICATION FOR FINANCIAL ASSISTANCE MEDICAL HARDSHIP APPLICATION FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN ENGLISH, SPANISH, ARABIC, FRENCH, GREEK, ITALIAN, JAPANESE, KHMER, PORTUGUESE, RUSSIAN, AND VIETNAMESE, CAN BE FOUND ON THE ANNA JAQUES HOSPITAL WEBSITE AT: HTTPS://AJH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/ASSISTANCE#:~:TEXT=AT%20ANNA%20JAQUES%20HOSPITAL%2C%20WE%20PROVIDE%20FINANCIAL%20AID,THE%20NUMBER%20OF%20FAMILY%20MEMBERS%20IN%20THE%20HOUSEHOLD.LIMITATION ON CHARGES INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNT GENERALLY BILLED LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS NOTED THROUGHOUT THIS FORM 990, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH ANNA JAQUES HOSPITAL DOES NOT DIRECTLY ENGAGE IN RESEARCH, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC, NEW ENGLAND BAPTIST HOSPITAL AND JOSLIN DIABETES CENTER ALL ENGAGE IN RESEARCH ACTIVITIES DESIGNED TO CARE FOR PATIENTS NOT ONLY AT THESE HOSPITALS, BUT ACROSS THE COMMUNITIES SERVED BY BILH AND BEYOND. ALTHOUGH THE RESEARCH ACTIVITIES OF THESE BILH AFFILIATES ARE NOT QUANTIFIED HERE IN ANNA JAQUES HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL AND BEYOND AND INFORMATION ON THE RESEARCH ENGAGED IN AT BIDMC, A SISTER ENTITY TO ANNA JAQUES HOSPITAL, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION. TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.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 O ALLERGY AND INFLAMMATIONO CARDIOVASCULAR MEDICINEO CENTER FOR VASCULAR BIOLOGY RESEARCHO CENTER FOR VIROLOGY AND VACCINE RESEARCHO CLINICAL INFORMATICSO CLINICAL NUTRITIONO ENDOCRINOLOGYO EXPERIMENTAL MEDICINEO GASTROENTEROLOGYO GENERAL MEDICINE AND PRIMARY CAREO GENETICSO GERONTOLOGYO HEMATOLOGY AND ONCOLOGYO HEMOSTASIS AND THROMBOSISO IMMUNOLOGYO INFECTIOUS DISEASEO INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGYO MOLECULAR AND VASCULAR MEDICINEO NEPHROLOGYO PULMONOLOGYO RHEUMATOLOGYO SIGNAL TRANSDUCTIONO TRANSLATIONAL RESEARCHO TRANSPLANT IMMUNOLOGY NEONATOLOGY NEUROLOGY OBSTETRICS AND GYNECOLOGY ORTHOPAEDIC SURGERY PATHOLOGY PSYCHIATRY RADIOLOGY SURGERY O CARDIAC SURGERYO CENTER FOR MINIMALLY INVASIVE SURGERYO NEUROSURGERYO PLASTIC AND RECONSTRUCTIVE SURGERYO VASCULAR SURGERY TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $320 MILLION IN RESEARCH EXPENSES, MORE THAN $82 MILLION OF WHICH WERE INTERNALLY FUNDED 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 CENTER
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. DETAIL ON RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. 1. A POTENTIAL NEW WEAPON IN THE WAR AGAINST SUPERBUGS"THE END OF MODERN MEDICINE AS WE KNOW IT." THAT'S HOW THE THEN-DIRECTOR GENERAL OF THE WORLD HEALTH ORGANIZATION CHARACTERIZED THE CREEPING PROBLEM OF ANTIMICROBIAL RESISTANCE IN 2012. WITHOUT ANTIBIOTICS TO MANAGE COMMON BACTERIAL INFECTIONS, SMALL INJURIES AND MINOR INFECTIONS BECOME POTENTIALLY FATAL ENCOUNTERS. IN 2019, MORE THAN 2.8 MILLION ANTIMICROBIAL-RESISTANT INFECTIONS OCCURRED IN THE UNITED STATES, AND MORE THAN 35,000 PEOPLE DIED AS A RESULT, ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). A REPORT FROM THE UNITED NATIONS ISSUED EARLIER THIS YEAR WARNED THAT NUMBER COULD RISE TO TEN MILLION GLOBAL DEATHS ANNUALLY IF NOTHING IS DONE TO COMBAT ANTIMICROBIAL RESISTANCE.FOR NEARLY 25 YEARS, JAMES KIRBY, MD, DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORY AT BIDMC, HAS WORKED TO ADVANCE THE FIGHT AGAINST INFECTIOUS DISEASES BY FINDING AND DEVELOPING NEW, POTENT ANTIMICROBIALS, AND BY BETTER UNDERSTANDING HOW DISEASE-CAUSING BACTERIA MAKE US SICK. IN A RECENT PAPER PUBLISHED IN PLOS BIOLOGY, KIRBY AND COLLEAGUES INVESTIGATED A NATURALLY OCCURRING ANTIMICROBIAL AGENT DISCOVERED MORE THAN 80 YEARS AGO. USING LEADING-EDGE TECHNOLOGY, KIRBY'S TEAM DEMONSTRATED THAT CHEMICAL VARIANTS OF THE ANTIBIOTIC, CALLED STREPTOTHRICINS, SHOWED POTENCY AGAINST SEVERAL CONTEMPORARY DRUG-RESISTANT STRAINS OF BACTERIA. WHAT'S MORE, THEY SHOWED THE ANTIBIOTIC HAD A THERAPEUTIC EFFECT IN AN ANIMAL MODEL AT NON-TOXIC CONCENTRATIONS."A SINGLE DOSE CLEARED THIS ORGANISM FROM AN INFECTED ANIMAL MODEL WHILE AVOIDING ANY TOXICITY," KIRBY SAID. "IT WAS REALLY REMARKABLE." THE RESEARCHERS ALSO REVEALED THE UNIQUE MECHANISM BY WHICH STREPTOTHRICIN FIGHTS OFF BACTERIAL INFECTIONS. "WE SHOWED THAT NOURSEOTHRICIN ACTS IN A COMPLETELY NEW WAY COMPARED TO ANY OTHER TYPE OF ANTIBIOTIC, BY INHIBITING THE ABILITY OF THE ORGANISM TO PRODUCE PROTEINS IN A VERY SNEAKY WAY," KIRBY EXPLAINED. "WHEN A CELL MAKES PROTEINS, IT MAKES THEM OFF A BLUEPRINT THAT TELLS THE CELL WHAT AMINO ACIDS TO LINK TOGETHER TO BUILD THE PROTEIN. OUR STUDY HELPS EXPLAIN HOW THIS ANTIBIOTIC CONFUSES THE MACHINERY SO THAT THE MESSAGE IS READ INCORRECTLY, AND IT STARTS TO PUT TOGETHER GIBBERISH. ESSENTIALLY THE BACTERIAL CELL GETS POISONED BECAUSE IT'S PRODUCING JUNK."STREPTOTHRICIN'S UNIQUE ACTION IS VERY POWERFUL BECAUSE IT MEANS BACTERIA ARE CURRENTLY HELPLESS AGAINST IT; THAT IS, THERE'S NO ENVIRONMENTAL RESERVOIR OF POTENTIAL RESISTANCE MECHANISMS, KIRBY SAID. THAT GIVES HUMANITY MORE TIME BEFORE PATHOGENS EVOLVE DEFENSE MECHANISMS AGAINST THIS BRAND-NEW CLASS OF ANTIBIOTIC."WE'RE STILL IN THE VERY EARLY STAGES OF DEVELOPMENT, BUT I THINK WE'VE VALIDATED THAT THIS IS A COMPOUND THAT'S WORTH INVESTING IN FURTHER STUDIES TO FIND EVEN BETTER VARIANTS THAT EVENTUALLY WILL MEET THE PROPERTIES OF A HUMAN THERAPEUTIC," KIRBY SAID. JANUARY 20, 20202. SEVERE COVID-19 LINKED WITH MOLECULAR SIGNATURES OF BRAIN AGING, RESEARCHERS FINDSCIENTISTS AT BIDMC FOUND THAT GENE USAGE IN THE BRAINS OF PATIENTS WITH COVID-19 IS SIMILAR TO THOSE OBSERVED IN AGING BRAINS. USING A MOLECULAR PROFILING TECHNIQUE CALLED RNA SEQUENCING TO MEASURE THE LEVELS OF EVERY GENE EXPRESSED IN A PARTICULAR TISSUE SAMPLE, THE SCIENTISTS ASSESSED CHANGES IN GENE EXPRESSION PROFILES IN THE BRAINS OF COVID-19 PATIENTS AND COMPARED THEM TO THOSE CHANGES OBSERVED IN THE BRAINS OF UNINFECTED INDIVIDUALS. THE TEAM'S ANALYSIS, PUBLISHED IN NATURE AGING, SUGGESTED THAT MANY BIOLOGICAL PATHWAYS THAT CHANGE WITH NATURAL AGING IN THE BRAIN ALSO CHANGED IN PATIENTS WITH SEVERE COVID-19.CO-FIRST AND CO-CORRESPONDING AUTHOR MARIA MAVRIKAKI, PHD, AN INSTRUCTOR OF PATHOLOGY AT BIDMC, AND COLLEAGUES ANALYZED A TOTAL OF 54 POSTMORTEM HUMAN FRONTAL CORTEX TISSUE SAMPLES FROM ADULTS 22 TO 85 YEARS OLD. "WE OBSERVED THAT GENE EXPRESSION IN THE BRAIN TISSUE OF PATIENTS WHO DIED OF COVID-19 CLOSELY RESEMBLED THAT OF UNINFECTED INDIVIDUALS 71 YEARS OLD OR OLDER," SAID CO-FIRST AUTHOR JONATHAN LEE, PHD, A POSTDOCTORAL RESEARCH FELLOW AT BIDMC."GIVEN THESE FINDINGS, WE ADVOCATE FOR NEUROLOGICAL FOLLOW-UP OF RECOVERED COVID-19 PATIENTS," SAID SENIOR AND CO-CORRESPONDING AUTHOR FRANK SLACK, PHD, DIRECTOR OF THE INSTITUTE FOR RNA MEDICINE AT BIDMC AND THE SHIELDS WARREN MALLINCKRODT PROFESSOR OF MEDICAL RESEARCH AT HARVARD MEDICAL SCHOOL. "WE ALSO EMPHASIZE THE POTENTIAL CLINICAL VALUE IN MODIFYING THE FACTORS ASSOCIATED WITH THE RISK OF DEMENTIA SUCH AS CONTROLLING WEIGHT AND REDUCING EXCESSIVE ALCOHOL CONSUMPTION TO REDUCE THE RISK OR DELAY THE DEVELOPMENT OF AGING-RELATED NEUROLOGICAL PATHOLOGIES AND COGNITIVE DECLINE."BETTER UNDERSTANDING OF THE MOLECULAR MECHANISMS UNDERLYING BRAIN AGING AND COGNITIVE DECLINE IN COVID-19 COULD LEAD TO THE DEVELOPMENT OF NOVEL THERAPEUTICS TO ADDRESS COGNITIVE DECLINE OBSERVED IN COVID-19 PATIENTS. THE TEAM IS NOW TRYING TO UNDERSTAND WHAT DRIVES THE AGING-LIKE EFFECTS IN THE BRAINS OF COVID-19 PATIENTS.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	RESEARCH SUGGESTS POLITICAL EVENTS IMPACT SLEEP: STUDY FINDS ASSOCIATION BETWEEN ELECTIONS AND SLEEP, ALCOHOL CONSUMPTION AND OVERALL PUBLIC MOODIN A PAPER PUBLISHED IN THE NATIONAL SLEEP FOUNDATION'S JOURNAL SLEEP HEALTH, RESEARCHERS AT BIDMC SHOWED THAT MAJOR SOCIOPOLITICAL EVENTS CAN HAVE GLOBAL IMPACTS ON SLEEP THAT ARE ASSOCIATED WITH SIGNIFICANT FLUCTUATIONS IN THE PUBLIC'S COLLECTIVE MOOD, WELL-BEING, AND ALCOHOL CONSUMPTION. AS PART OF A LARGER STUDY EXPLORING THE SLEEP AND PSYCHOLOGICAL REPERCUSSIONS OF THE COVID-19 PANDEMIC, THE TEAM SURVEYED 437 PARTICIPANTS IN THE UNITED STATES AND 106 INTERNATIONAL PARTICIPANTS DAILY BETWEEN OCTOBER 113, 2020 (BEFORE THE ELECTION) AND OCTOBER 30NOVEMBER 12, 2020 (DAYS SURROUNDING THE NOVEMBER 3 U.S. ELECTION). WITH REGARD TO SLEEP, BOTH U.S. AND NON-U.S. PARTICIPANTS REPORTED LOSING SLEEP IN THE RUN-UP TO THE ELECTION; HOWEVER, U.S. RESPONDENTS HAD SIGNIFICANTLY LESS TIME IN BED IN THE DAYS AROUND THE ELECTION. ON ELECTION NIGHT ITSELF, U.S. PARTICIPANTS REPORTED WAKING UP FREQUENTLY DURING THE NIGHT AND EXPERIENCING POORER SLEEP EFFICIENCY.U.S. PARTICIPANTS WHO EVER REPORTED DRINKING ALCOHOL SIGNIFICANTLY INCREASED CONSUMPTION ON THREE DAYS DURING THE ASSESSMENT PERIOD: HALLOWEEN, ELECTION DAY AND THE DAY THE ELECTION WAS CALLED BY MORE MEDIA OUTLETS, SATURDAY, NOVEMBER 7. AMONG NON-U.S. PARTICIPANTS, THERE WAS NO CHANGE IN ALCOHOL CONSUMPTION OVER THE NOVEMBER ASSESSMENT PERIOD.WHEN THE SCIENTISTS LOOKED AT HOW THESE CHANGES IN BEHAVIOR MAY HAVE AFFECTED MOOD AND WELL-BEING OF U.S PARTICIPANTS, THEY FOUND SIGNIFICANT LINKS BETWEEN SLEEP AND DRINKING, STRESS, NEGATIVE MOOD, AND DEPRESSION."THIS IS THE FIRST STUDY TO FIND THAT THERE IS A RELATIONSHIP BETWEEN THE PREVIOUSLY REPORTED CHANGES IN ELECTION DAY PUBLIC MOOD AND SLEEP THE NIGHT OF THE ELECTION," SAID CORRESPONDING AUTHOR TONY CUNNINGHAM, PHD, DIRECTOR OF THE CENTER FOR SLEEP AND COGNITION AT BIDMC. "MOREOVER, IT IS NOT JUST THAT ELECTIONS MAY INFLUENCE SLEEP, BUT EVIDENCE SUGGESTS THAT SLEEP MAY INFLUENCE CIVIC ENGAGEMENT AND PARTICIPATION IN ELECTIONS AS WELL. THUS, IF THE RELATIONSHIP BETWEEN SLEEP AND ELECTIONS IS ALSO BIDIRECTIONAL, IT WILL BE IMPORTANT FOR FUTURE RESEARCH TO DETERMINE HOW PUBLIC MOOD AND STRESS EFFECTS ON SLEEP LEADING UP TO AN ELECTION MAY EFFECT OR EVEN ALTER ITS OUTCOME."4. TARGETED CARE REVERSES RACIAL/ETHNIC HEALTH DISPARITIES IN COLON CANCER SCREENING, RESEARCHERS FINDIN A RETROSPECTIVE REVIEW OF PATIENTS WHO HAD A RECENT PRIMARY CARE VISIT IN A WELL-RESOURCED SAFETY-NET HEALTH SYSTEM SERVING A DIVERSE POPULATION, A TEAM LED BY RESEARCHERS AT BIDMC AIMED TO BETTER DEFINE THE LINKS BETWEEN PATIENTS' SOCIO-DEMOGRAPHIC CHARACTERISTICS AND COLORECTAL SCREENING. EVALUATING SELF-REPORTED FACTORS INCLUDING RACE, ETHNICITY, PREFERRED LANGUAGE, MENTAL HEALTH AND SUBSTANCE USE STATUS, THE TEAM'S MORE GRANULAR ASSESSMENT PROVIDED FINDINGS THAT CONTRADICT TRADITIONAL U.S. HEALTHCARE DISPARITIES, WITH HISPANIC AND SPANISH-SPEAKING PATIENTS SCREENING AT SIGNIFICANTLY HIGHER RATES THAN WHITE AND ENGLISH-SPEAKING PATIENTS. THE COUNTERINTUITIVE FINDINGS, PUBLISHED IN PREVENTIVE MEDICINE, DEMONSTRATE THAT A HEALTHCARE SYSTEM DESIGNED TO PROVIDE EQUAL ACCESS TO SCREENING FOR UNDERSERVED PATIENTS CAN ADDRESS THE DISPARITIES COMMONLY SEEN IN CANCER SCREENING."INVESTMENT INTO A MULTICULTURAL WORKFORCE AND OUTREACH EFFORTS TO UNDERSERVED PATIENTS MAY COUNTERACT SOME OF THE IMPLICIT OR EXPLICIT BIASES SEEN ON HEALTH SYSTEMS THAT HAVE LED TO TRADITIONAL RACIAL/ETHNIC DISPARITIES," SAID SENIOR AUTHOR HEIDI J. RAYALA, MD, PHD, UROLOGIST AT BIDMC. "OUR STUDY SHOWED DIFFERENCES IN ODDS OF SUCCESSFUL SCREENING BASED ON SUB-SECTIONS OF TRADITIONALLY DEFINED ETHNICITIES SUCH AS BREAKING DOWN "HISPANIC" INTO MORE SPECIFIC CULTURES AND BACKGROUNDS AND THAT SUGGESTS THAT FUTURE RESEARCH SHOULD FOCUS ON BETTER UNDERSTANDING INDIVIDUAL CULTURES AND COMMUNITIES, RATHER THAN LUMPING PATIENTS INTO OVERLY LARGE GROUPS."RAYALA AND COLLEAGUES LOOKED AT DE-IDENTIFIED RECORDS OF MORE THAN 22,000 PATIENTS BETWEEN 50- AND 75-YEARS OLD WHO SAW A PRIMARY CARE PHYSICIAN AT CAMBRIDGE HEALTH ALLIANCE (CHA) IN 2018 TO 2019. OF THE 22,000 PATIENTS INCLUDED IN THE STUDY, 16,065 UNDERWENT COLORECTAL SCREENING, AN OVERALL SCREENING RATE OF 73 PERCENT--ON PAR WITH MASSACHUSETTS' OVERALL COLORECTAL SCREENING RATES. HOWEVER, MASSACHUSETTS' NUMBERS REFLECT NATIONAL RACIAL AND ETHNIC DISPARITIES, IN WHICH PEOPLE OF COLOR DO NOT GET SCREENED AS OFTEN AS WHITE PEOPLE, SHOWING A SCREENING RATE OF 56 PERCENT OF HISPANIC INDIVIDUALS AND 68 PERCENT OF BLACK INDIVIDUALS COMPARED TO 76 PERCENT FOR WHITE INDIVIDUALS.IN CONTRAST, AT CHA, HISPANICS HAD THE HIGHEST SCREENING RATES OF 78 PERCENT. RAYALA AND COLLEAGUES FURTHER BROKE OUT PARTICIPANTS BY MORE GRANULAR DEMOGRAPHIC FACTORS, FINDING THE ETHNICITY OF PORTUGUESE/AZOREAN RECEIVED SCREENING AT 79 PERCENT. SPANISH SPEAKERS IN GENERAL HAD THE HIGHEST SCREENING RATE OF NEARLY 80 PERCENT.5. PATIENTS OVERWHELMINGLY PREFER IMMEDIATE ACCESS TO TEST RESULTS, EVEN WHEN THE NEWS MAY NOT BE GOODIN APRIL 2021, NEW FEDERAL RULES WENT INTO EFFECT MANDATING THAT HEALTHCARE PROVIDERS MAKE NEARLY ALL TEST RESULTS AND CLINICAL NOTES IMMEDIATELY AVAILABLE TO PATIENTS. EVIDENCE SUGGESTS THAT PATIENTS MAY GAIN IMPORTANT CLINICAL BENEFITS BY REVIEWING THEIR MEDICAL RECORDS, AND ACCESS THROUGH ELECTRONIC PATIENT PORTALS HAS BEEN ADVOCATED AS A STRATEGY FOR EMPOWERING PATIENTS TO MANAGE THEIR HEALTH CARE AND FOR STRENGTHENING PATIENT-CLINICIAN RELATIONSHIPS. HOWEVER, CONCERNS REMAIN ABOUT THE EFFECTS OF RELEASING TEST RESULTS TO PATIENTS BEFORE CLINICIANS OFFER COUNSEL OR INTERPRETATION.IN A FIRST-OF-ITS-KIND MULTISITE SURVEY OF MORE THAN 8,000 PATIENTS WHO ACCESSED THEIR TEST RESULTS VIA AN ONLINE PATIENT PORTAL ACCOUNT, RESEARCHERS AT BIDMC AND COLLEAGUES FOUND THAT USERS OVERWHELMINGLY SUPPORTED RECEIVING THE RESULTS IMMEDIATELY, EVEN IF THEIR PROVIDER HAD NOT YET REVIEWED THEM. THE FINDINGS, PUBLISHED IN JAMA NETWORK OPEN, SHOWED ONLY A SMALL SUBSET OF PATIENTS REPORTED EXPERIENCING ADDITIONAL WORRY AFTER RECEIVING ABNORMAL TEST RESULTS. IN ADDITION, PRE-COUNSELING BY THE HEALTH CARE TEAM BEFORE TESTS WERE ORDERED WAS LINKED TO REDUCED WORRY AMONG PATIENTS WITH ABNORMAL RESULTS."ONLINE PATIENT PORTALS HAVE EMERGED AS IMPORTANT TOOLS FOR INCREASING PATIENT ENGAGEMENT," SAID CO-SENIOR AUTHOR CATHERINE M. DESROCHES, DRPH, EXECUTIVE DIRECTOR OF OPENNOTES, THE INTERNATIONAL MOVEMENT BASED AT BIDMC FOCUSED ON INCREASING INFORMATION TRANSPARENCY IN HEALTHCARE. "THEY ENABLE PATIENTS TO ACCESS INFORMATION, PARTICIPATE IN MEDICAL DECISION-MAKING AND TO COMMUNICATE WITH CLINICIANS. PRIOR STUDIES PERFORMED BY OPENNOTES INVESTIGATORS ESTABLISHED IMMEDIATE RELEASE OF CLINICAL NOTES AS A RECOMMENDED BEST PRACTICE. HOWEVER, RELEASING TEST RESULTS TO PATIENTS IMMEDIATELY, OFTEN BEFORE A CLINICIAN CAN PROVIDE COUNSELLING AND CONTEXT, WAS YET TO BE STUDIED WIDELY."TO ASSESS PATIENT AND CAREGIVER ATTITUDES AND PREFERENCES RELATED TO RECEIVING TEST RESULTS THROUGH THE PATIENT PORTAL, DESROCHES AND COLLEAGUES DELIVERED SURVEYS TO MORE THAN 43,000 PATIENTS AND CARE PARTNERS WHO ACCESSED THEIR TEST RESULTS VIA AN ONLINE PATIENT PORTAL ACCOUNT BETWEEN APRIL 2021 AND APRIL 2022. WHEN ASKED ABOUT THEIR PREFERENCES FOR CONTACTS ABOUT FUTURE TEST RESULTS, 90 PERCENT OF RESPONDENTS WITH NORMAL RESULTS INDICATED THEY WOULD PREFER RECEIVING THEIR RESULT VIA THE PATIENT PORTAL. THE SURVEY RESULTS SUGGEST THAT PATIENTS RECEIVING NOT NORMAL RESULTS ARE INDEED AT INCREASED RISK FOR WORRY. NEVERTHELESS, MORE THAN 95 PERCENT OF PARTICIPANTS WHO RECEIVED ABNORMAL TEST RESULTS REPORTED PREFERRING TO CONTINUE TO RECEIVE IMMEDIATELY RELEASED RESULTS THROUGH THE PORTAL."RESPONDENTS OVERWHELMINGLY PREFERRED TO RECEIVE TEST RESULTS THROUGH THE PATIENT PORTAL, EVEN IF IT MEANT VIEWING RESULTS PRIOR TO DISCUSSING THEM WITH A HEALTHCARE PROFESSIONAL," SAID CO-AUTHOR LIZ SALMI, COMMUNICATIONS AND PATIENT INITIATIVES DIRECTOR OF OPENNOTES AT BIDMC. "AS HEALTHCARE SYSTEMS CONTINUE TO NAVIGATE THIS NEW ERA OF HEALTH INFORMATION TRANSPARENCY, BALANCING PATIENTS' EXPECTATION OF IMMEDIATE ACCESS TO THEIR INFORMATION WITH THE NEED TO MANAGE INCREASED WORRY IS IMPORTANT."
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	6. SHARP RISE IN CARDIOVASCULAR RISK FACTORS AMONG YOUNG ADULTS FORESHADOWS PUBLIC HEALTH CRISISIN A STUDY PUBLISHED IN JAMA AND PRESENTED AT THE AMERICAN COLLEGE OF CARDIOLOGY SCIENTIFIC SESSIONS, RESEARCHERS AT BIDMC ANALYZED MORE THAN A DECADE'S WORTH OF DATA TO EXAMINE RATES OF CARDIOVASCULAR RISK FACTORS SUCH AS HIGH BLOOD PRESSURE, DIABETES, OBESITY AND SMOKING AMONG US ADULTS FROM 2009 TO MARCH 2020. THE RESEARCHERS OBSERVED A RISE IN HYPERTENSION AND SIGNIFICANT INCREASES IN DIABETES AND OBESITY RATES AMONG YOUNG ADULTS, WITH NO SIGNIFICANT IMPROVEMENT IN CONTROL OF BLOOD PRESSURE OR BLOOD SUGAR. THE SCIENTISTS ALSO OBSERVED SUBSTANTIAL VARIATION IN THESE TRENDS BY RACE AND ETHNICITY."THE ONSET OF CARDIOVASCULAR RISK FACTORS EARLY IN LIFE IS ASSOCIATED WITH A HIGHER RISK OF HEART DISEASE AND ACUTE EVENTS, SUCH AS HEART ATTACK AND STROKE, RESULTING IN THE SUBSTANTIAL LOSS OF QUALITY OF LIFE AND YEARS OF LIFE," SAID CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, SECTION HEAD OF HEALTH POLICY AND EQUITY AT THE SMITH CENTER FOR OUTCOMES RESEARCH IN CARDIOLOGY AT BIDMC. "THEREFORE, THE SUBSTANTIAL RISE IN THE BURDEN OF CARDIOVASCULAR RISK FACTORS AMONG YOUNG ADULTS WILL HAVE MAJOR PUBLIC HEALTH IMPLICATIONS AS THE POPULATION AGES."WADHERA AND COLLEAGUES OBSERVED THAT THE PREVALENCE OF HYPERTENSION INCREASED AND SAW STATISTICALLY SIGNIFICANT INCREASES IN RATES OF DIABETES AND OBESITY DURING THE STUDY PERIOD. THE PERCENTAGE OF YOUNG ADULTS WITH A SMOKING HISTORY WAS HIGH AND DID NOT CHANGE. IN CONTRAST, RATES OF HIGH CHOLESTEROL DECLINED, A DECREASE THE SCIENTISTS SUGGEST REFLECTS GOVERNMENT REGULATION OF THE USE OF TRANS FATTY ACIDS AND OTHER PARTIALLY HYDROGENATED OILS IN PACKAGED CONVENIENCE FOODS AND FAST-FOOD RESTAURANTS.THE RESEARCHERS FOUND SUBSTANTIAL VARIATION IN PREVALENCE OF RISK FACTORS BY RACE AND ETHNICITY. OBESITY SIGNIFICANTLY INCREASED ACROSS ALL RACIAL AND ETHNIC GROUPS EXCEPT BLACK ADULTS. WHILE RATES OF HYPERTENSION INCREASED AMONG MEXICAN AMERICANS AND OTHER HISPANIC ADULTS, BLACK ADULTS EXPERIENCED THE HIGHEST RATES OF HYPERTENSION.THE RESEARCHERS ALSO EXAMINED CARDIOVASCULAR RISK FACTOR TREATMENT AND CONTROL RATES AMONG YOUNG ADULTS. ONLY ABOUT 55 PERCENT OF YOUNG ADULTS WITH HIGH BLOOD PRESSURE RECEIVE TREATMENT FOR THE CONDITION. RATES OF DIABETES TREATMENT WERE ALSO LOW, WITH ONE OUT OF TWO YOUNG ADULTS ON THERAPY FOR THEIR DIABETES. NEARLY HALF OF YOUNG ADULTS ON TREATMENT FOR DIABETES HAD POOR BLOOD SUGAR CONTROL."THE SUBOPTIMAL TREATMENT RATES FOR HIGH BLOOD PRESSURE AND DIABETES ARE CONCERNING AND MAY BE BECAUSE MANY YOUNG ADULTS AREN'T AWARE OF THEIR DIAGNOSIS," SAID WADHERA. "THE RISE IN CARDIOVASCULAR RISK FACTORS THAT WE OBSERVED SHOULD BE A CALL-TO-ACTION TO INTENSIFY PUBLIC HEALTH AND CLINICAL INTERVENTIONS FOCUSED ON THE PREVENTION AND TREATMENT OF CARDIOVASCULAR RISK FACTORS IN YOUNG ADULTS."7. COSTS OF NATURAL DISASTERS SET TO SPIRAL WITH CONTINUED RISE IN CO2 AND GLOBAL TEMPERATURE, STUDY SHOWSIN A PAPER PUBLISHED IN THE JOURNAL OF CLIMATE CHANGE AND HEALTH, MEMBERS OF THE BIDMC FELLOWSHIP IN DISASTER MEDICINE ESTIMATED THAT CLIMATE CHANGE-RELATED NATURAL DISASTERS HAVE INCREASED SINCE 1980 AND HAVE ALREADY COST THE UNITED STATES MORE THAN $2 TRILLION IN RECOVERY COSTS. THEIR ANALYSIS ALSO SUGGESTS THAT AS ATMOSPHERIC CARBON DIOXIDE LEVELS AND THE GLOBAL TEMPERATURE CONTINUE TO RISE, THE FREQUENCY AND SEVERITY OF DISASTERS WILL INCREASE, WITH RECOVERY COSTS POTENTIALLY RISING EXPONENTIALLY."THE UNITED STATES SPENDS A STAGGERING AMOUNT ON COSTS SECONDARY TO NATURAL DISASTERS," SAID SENIOR AUTHOR GREGORY CIOTTONE, MD, DIRECTOR OF THE DISASTER MEDICINE FELLOWSHIP AT BIDMC. "CARBON DIOXIDE LEVELS AND TEMPERATURES HAVE INCREASED OVER THE PAST FOUR DECADES AND ARE STRONGLY POSITIVELY CORRELATED WITH THE NUMBER AND COST OF BILLION-DOLLAR DISASTERS, SUGGESTING THE ANNUAL NUMBER OF EVENTS WILL CONTINUE TO INCREASE ALONG WITH THEIR ECONOMIC BURDEN. MEASURES ARE NEEDED TO MITIGATE THOSE COSTS."TO ASSESS THE RELATIONSHIP BETWEEN RISING CARBON DIOXIDE LEVELS, TEMPERATURES AND THE NUMBER OF DISASTERS COSTING A BILLION DOLLARS OR MORE IN THE UNITED STATES, CIOTTONE AND COLLEAGUES ANALYZED DATA BETWEEN 1980-2021 FROM THE NATIONAL CENTER FOR ENVIRONMENTAL INFORMATION (NCEI). THE TEAM FOUND THAT THE INCREASES IN ATMOSPHERIC CARBON DIOXIDE LEVELS AND TEMPERATURE TIGHTLY LINKED TO EACH OTHER WERE ASSOCIATED WITH INCREASING NUMBERS OF EVENTS PER YEAR, AS WELL AS FATALITIES. AFTER ADJUSTING DOLLAR VALUES FOR INFLATION, THEIR ANALYSIS SHOWED THAT MORE FREQUENT AND MORE SEVERE DISASTERS ARE INCURRING RISING COSTS.AMONG THEIR FINDINGS: FROM 1980-1989, THERE WERE 3 BILLION-DOLLAR EVENTS PER YEAR AND 297 DEATHS PER YEAR, COSTING A TOTAL OF $19.5 BILLION. BY 2010-2019, THE RISE IN CARBON DIOXIDE LEVELS AND TEMPERATURE WERE LINKED WITH 13 ANNUAL EVENTS, 523 ANNUAL DEATHS, AND $89.2 BILLION IN RECOVERY COSTS, A FOURFOLD INCREASE."FRAMING DISASTERS IN THIS ECONOMIC LIGHT CAN BRING MORE ATTENTION AND MOTIVATION FOR CHANGE TO ALTER POLICYMAKERS' DECISIONS," SAID CORRESPONDING AUTHOR VIJAI BHOLA, MD, A GRADUATE OF THE DISASTER MEDICINE FELLOWSHIP AT BIDMC, WHO NOTES THE CURRENT ANALYSIS CAPTURES JUST A FRACTION OF THE COSTS INCURRED BY CLIMATE CHANGE. "THESE COSTS REPRESENT A COMBINATION OF IMMEDIATE AND LONGER-TERM RESTORATION ESTIMATES. WHAT THEY DO NOT REFLECT, HOWEVER, ARE FACTORS SUCH AS DESTRUCTION OF NATURAL RESOURCES OR LOSS OF LIFE, AND THEREFORE THESE NUMBERS SIGNIFICANTLY UNDERESTIMATE THE TRUE COST OF CLIMATE-RELATED DISASTERS."8. RESEARCHERS TEST AI POWERED CHATBOTS MEDICAL DIAGNOSTIC ABILITYIN A RECENT EXPERIMENT PUBLISHED IN JAMA, PHYSICIAN-RESEARCHERS AT BIDMC TESTED ONE WELL-KNOWN PUBLICLY AVAILABLE CHATBOT'S ABILITY TO MAKE ACCURATE DIAGNOSES IN CHALLENGING MEDICAL CASES. THE TEAM FOUND THAT THE GENERATIVE AI, CHAT-GPT 4, SELECTED THE CORRECT DIAGNOSIS AS ITS TOP DIAGNOSIS NEARLY 40 PERCENT OF THE TIME AND PROVIDED THE CORRECT DIAGNOSIS IN ITS LIST OF POTENTIAL DIAGNOSES IN TWO-THIRDS OF CHALLENGING CASES.GENERATIVE AI CHATBOTS ARE POWERFUL TOOLS POISED TO REVOLUTIONIZE CREATIVE INDUSTRIES, EDUCATION, CUSTOMER SERVICE AND MORE. HOWEVER, LITTLE IS KNOWN ABOUT THEIR POTENTIAL PERFORMANCE IN THE CLINICAL SETTING, SUCH AS COMPLEX DIAGNOSTIC REASONING."RECENT ADVANCES IN ARTIFICIAL INTELLIGENCE HAVE LED TO GENERATIVE AI MODELS THAT ARE CAPABLE OF DETAILED TEXT-BASED RESPONSES THAT SCORE HIGHLY IN STANDARDIZED MEDICAL EXAMINATIONS," SAID ADAM RODMAN, MD, MPH, CO-DIRECTOR OF THE INNOVATIONS IN MEDIA AND EDUCATION DELIVERY (IMED) INITIATIVE AT BIDMC. "WE WANTED TO KNOW IF SUCH A GENERATIVE MODEL COULD 'THINK LIKE A DOCTOR, SO WE ASKED ONE TO SOLVE STANDARDIZED COMPLEX DIAGNOSTIC CASES USED FOR EDUCATIONAL PURPOSES. IT DID REALLY, REALLY WELL."TO ASSESS THE CHATBOT'S DIAGNOSTIC SKILLS, RODMAN AND COLLEAGUES USED CLINICOPATHOLOGICAL CASE CONFERENCES (CPCS), A SERIES OF COMPLEX AND CHALLENGING PATIENT CASES INCLUDING RELEVANT CLINICAL AND LABORATORY DATA, IMAGING STUDIES, AND HISTOPATHOLOGICAL FINDINGS PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE FOR EDUCATIONAL PURPOSES.EVALUATING 70 CPC CASES, THE ARTIFICIAL INTELLIGENCE EXACTLY MATCHED THE FINAL CPC DIAGNOSIS IN 27 (39 PERCENT) OF CASES. IN 64 PERCENT OF THE CASES, THE FINAL CPC DIAGNOSIS WAS INCLUDED IN THE AI'S DIFFERENTIAL A LIST OF POSSIBLE CONDITIONS THAT COULD ACCOUNT FOR A PATIENT'S SYMPTOMS, MEDICAL HISTORY, CLINICAL FINDINGS AND LABORATORY OR IMAGING RESULTS."WHILE CHATBOTS CANNOT REPLACE THE EXPERTISE AND KNOWLEDGE OF A TRAINED MEDICAL PROFESSIONAL, GENERATIVE AI IS A PROMISING POTENTIAL ADJUNCT TO HUMAN COGNITION IN DIAGNOSIS," SAID FIRST AUTHOR ZAHIR KANJEE, MD, MPH, A HOSPITALIST AT BIDMC. "IT HAS THE POTENTIAL TO HELP PHYSICIANS MAKE SENSE OF COMPLEX MEDICAL DATA AND BROADEN OR REFINE OUR DIAGNOSTIC THINKING. WE NEED MORE RESEARCH ON THE OPTIMAL USES, BENEFITS AND LIMITS OF THIS TECHNOLOGY, AND A LOT OF PRIVACY ISSUES NEED SORTING OUT, BUT THESE ARE EXCITING FINDINGS FOR THE FUTURE OF DIAGNOSIS AND PATIENT CARE.""OUR STUDY ADDS TO A GROWING BODY OF LITERATURE DEMONSTRATING THE PROMISING CAPABILITIES OF AI TECHNOLOGY," SAID CO-AUTHOR BYRON CROWE, MD, AN INTERNAL MEDICINE PHYSICIAN AT BIDMC. "FURTHER INVESTIGATION WILL HELP US BETTER UNDERSTAND HOW THESE NEW AI MODELS MIGHT TRANSFORM HEALTH CARE DELIVERY."
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	9. INTEGRATING TECHNOLOGY TO BETTER SUPPORT MENTAL HEALTH CAREOVER THE PAST DECADE, DEMAND FOR MENTAL HEALTH SERVICES HAS RISEN SIGNIFICANTLY, WITH THE NUMBER OF ADULTS RECEIVING PSYCHIATRIC CARE INCREASING BY MORE THAN 12 PERCENT SINCE 2011, ACCORDING TO THE NATIONAL ALLIANCE FOR MENTAL ILLNESS. HOWEVER, A SHORTAGE OF MENTAL HEALTH CLINICIANS MEANS MANY PEOPLE ARE STILL NOT ABLE TO ACCESS THE CARE THEY NEED. IN A CASE STUDY PUBLISHED IN NEJM CATALYST, CLINICIAN-INVESTIGATORS IN THE DIVISION OF DIGITAL PSYCHIATRY AT BIDMC HIGHLIGHT A MODEL THEY DEVELOPED FOR INTEGRATING DIGITAL TECHNOLOGIES AND BRIEF EVIDENCE-BASED TREATMENT INTO IN-PERSON PSYCHIATRY. KNOWN AS THE DIGITAL CLINIC, THE TEAM'S INNOVATIVE HYBRID CARE MODEL EXPANDS PATIENTS' ACCESS TO HIGHLY EFFECTIVE MENTAL HEALTH CARE WHILE SIGNIFICANTLY DECREASING PATIENT WAIT TIMES AND LENGTH OF TREATMENT. ADDITIONALLY, THE TEAM'S RECENT PILOT STUDY SUGGESTS THAT THIS MODEL MAY YIELD POST-TREATMENT IMPROVEMENTS IN PATIENTS' SYMPTOMS OF DEPRESSION AND ANXIETY THAT ARE COMPARABLE TO, IF NOT BETTER THAN, TRADITIONAL MODELS OF CARE."AS THE SEVERITY OF MENTAL HEALTH CRISES INCREASES, EVIDENCED BY RISING RATES OF DEPRESSION AND ANXIETY ESPECIALLY IN YOUNG PEOPLE, IT'S CRITICAL THAT INNOVATIVE SOLUTIONS ARE DEVELOPED TO INCREASE ACCESS TO HIGH-QUALITY PSYCHIATRIC CARE," SAID SENIOR AUTHOR JOHN TOROUS, MD, MBI, DIRECTOR OF THE DIVISION OF DIGITAL PSYCHIATRY AT BIDMC. "OUR ENCOURAGING FINDINGS SUGGEST THAT WHEN WE TARGET DEPRESSION AND ANXIETY WITH BRIEF, TECHNOLOGY-ENHANCED, EVIDENCE-BASED TREATMENT, OUR PATIENTS CAN OBTAIN MEANINGFUL GAINS."IN A RECENT PILOT STUDY OF 40 ADULT PATIENTS WHO RECEIVED EIGHT WEEKS OF TREATMENT FOR DEPRESSION AND/OR ANXIETY IN THE DIGITAL CLINIC BETWEEN OCTOBER 2022 AND JANUARY 2023, 67 PERCENT OF PATIENTS' MENTAL HEALTH OUTCOMES THAT WERE TARGETED IN TREATMENT REFLECTED CLINICALLY SIGNIFICANT IMPROVEMENT. NOTABLY, 64 PERCENT OF THOSE PATIENT OUTCOMES REFLECTED REMISSION, DEFINED AS HAVING "MILD, MINIMAL OR NO SYMPTOMS" BY THE END OF TREATMENT."THESE OUTCOMES MEET AND EXCEED OUTCOMES FROM LONGER-TERM TREATMENT," SAID TOROUS, WHO ADDED THAT RECENT META-ANALYSES OF MAINLY MAINSTREAM, EVIDENCE-BASED TREATMENTS FOUND REMISSION RATES OF JUST OVER HALF FOR ANXIETY DISORDERS AND ROUGHLY ONE THIRD FOR DEPRESSION. LIKEWISE, STUDIES HAVE SHOWN THAT DIGITAL APPROACHES TO MENTAL HEALTH CAN YIELD IMPRESSIVE RESULTS WHEN PATIENTS CONSISTENTLY ENGAGE WITH THEM, BUT DECADES OF USER-CENTERED DESIGN AND GAMIFICATION HAVE NOT SOLVED THE PROBLEM OF KEEPING PEOPLE REGULARLY INTERACTING WITH THE TECHNOLOGY LONG TERM."WE DESIGNED THE DIGITAL CLINIC TO HARNESS THE STRENGTHS OF BOTH TRADITIONAL AND DIGITAL MENTAL HEALTH CARE," SAID FIRST AUTHOR NATALIA MACRYNIKOLA, PHD, A POSTDOCTORAL RESEARCH FELLOW AT BIDMC. "THE BENEFITS OF HUMAN RAPPORT, THE THERAPEUTIC ALLIANCE, AND A THERAPIST'S ABILITY TO TAILOR EVIDENCED-BASED THERAPEUTIC INTERVENTIONS TO THE NEEDS OF EACH CLIENT ARE TANGIBLE ADVANTAGES OF TRADITIONAL CARE, WHEREAS THE SCALABILITY AND ACCESSIBILITY OF DIGITAL APPROACHES CONFER CLEAR ADVANTAGES THAT SHOULD NOT BE OVERLOOKED."10. NEW NATIONAL STANDARDS FOR NEONATAL INTENSIVE CARE AIM TO ACHIEVE HEALTH EQUITY FOR US NEWBORNS LED BY BIDMC NEONATOLOGIST ANN R. STARK, MD, IN HER CAPACITY AS MEDICAL DIRECTOR OF THE NICU VERIFICATION PROGRAM FOR THE AMERICAN ACADEMY OF PEDIATRICS (AAP), A TEAM OF NEONATAL LEADERS AND EXPERIENCED CLINICIANS HAVE ESTABLISHED NEW STANDARDS FOR LEVELS OF NEONATAL CARE THAT SPECIFY THE PERSONNEL, EQUIPMENT AND SERVICES HOSPITALS NEED TO PROVIDE FOR NEWBORNS AND FAMILIES. BASED ON AAP POLICY, EVIDENCE-BASED LITERATURE AND STANDARDS OF PROFESSIONAL PRACTICE, STANDARDS FOR LEVELS OF NEONATAL CARE: II, III, & IV, APPEARED IN THE AAP'S JOURNAL PEDIATRICS."WE HAVE CREATED THESE STANDARDS WITH A GOAL TO IMPROVE OUTCOMES, INCREASE ACCESS TO CARE, IMPROVE STANDARDIZATION ACROSS ALL LEVELS OF NEONATAL CARE AND ACHIEVE HEALTH EQUITY FOR BABIES ACROSS THE COUNTRY," SAID STARK, "WE WERE CONCERNED THAT FIRST, ALL BABIES SHOULD BE TREATED IN A PLACE WITH APPROPRIATE CARE AND SECOND, THAT THE FACILITY HAS THE PEOPLE AND THE EQUIPMENT THAT ARE APPROPRIATE FOR THEIR DEGREE OF ILLNESS OR IMMATURITY." THE UNITED STATES RANKS 35TH IN NEONATAL MORTALITY AMONG DEVELOPED NATIONS; MORE THAN THREE BABIES OUT OF EVERY 1,000 BABIES DIE WITHIN THEIR FIRST MONTH OF LIFE. MANY FACTORS CONTRIBUTE TO THESE SHOCKING NUMBERS, HOWEVER, EXPERTS AGREE ONE REASON IS THE LACK OF NATIONAL STANDARDS FOR NEONATAL INTENSIVE CARE UNITS (NICUS). WITH PUBLICATION OF THE NEW STANDARDS, AND WHEN PROCESSES ARE IN PLACE, THE AAP PROGRAM WILL BE ABLE TO VERIFY A NEONATAL FACILITY'S COMPLIANCE AND DESIGNATE THAT IT PROVIDES A SPECIFIC LEVEL OF NEONATAL CARE (II, III OR IV). HOSPITALS WILL SUBMIT DATA AND UNDERGO A SURVEY OF THEIR FACILITY. THOSE THAT MEET REQUIREMENTS WILL BE ABLE TO STATE THAT THEY ARE AAP-VERIFIED AT A PARTICULAR LEVEL OF NEONATAL CARE. THE DESIGNATION THEN WILL BE TRANSPARENT TO PHYSICIANS AND FAMILIES DECIDING WHERE TO DELIVER AND/OR SEEK CARE FOR THEIR BABY."PARENTS SHOULD UNDERSTAND THE LEVEL OF NEONATAL CARE AVAILABLE WHERE THEY ARE DELIVERING," SAID STARK. "WHETHER THEY ARE BORN IN URBAN ACADEMIC MEDICAL CENTERS OR RURAL COMMUNITY HOSPITALS, ALL BABIES DESERVE OPTIMAL CARE. ADOPTION OF THE AAP NEONATAL STANDARDS IS A VITAL STEP TOWARD HIGH-QUALITY AND EQUITABLE CARE."FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION AS NOTED THROUGHOUT THIS FORM 990, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH ANNA JAQUES HOSPITAL DOES NOT DIRECTLY ENGAGE IN HEALTH PROFESSIONS EDUCATION / GRADUATE MEDICAL EDUCATION, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND MOUNT AUBURN HOSPITAL ALL ENGAGE IN EDUCATIONAL ACTIVITIES DESIGNED TRAIN THE PHYSICIANS AND OTHER HEALTHCARE PRACTITIONERS OF TOMORROW. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $202 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $68 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $134 MILLION. ALTHOUGH THE EDUCATIONAL ACTIVITIES OF THESE BILH AFFILIATES ARE NOT QUANTIFIED HERE IN ANNA JAQUES HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7F, AS ALREADY NOTED THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY ANNA JAQUES HOSPITAL AND BEYOND. IN ADDITION, INFORMATION ON THE TEACHING ACTIVITIES AT BIDMC, A SISTER ENTITY TO ANNA JAQUES HOSPITAL, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 63 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 731 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 44 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 53 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS: ANESTHESIOLOGY EMERGENCY MEDICINE EAR, NOSE AND THROAT (OTOLARYNGOLOGY) INTERNAL MEDICINE NEUROLOGY NEUROSURGERY OBSTETRICS AND GYNECOLOGY PATHOLOGY PLASTIC SURGERY PSYCHIATRY RADIOLOGY SURGERY TRANSITIONAL YEAR UROLOGYRESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. MORE THAN HALF OF THESE PROGRAMS (47 OF 91) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS: ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA, ANESTHESIA MEDICAL EDUCATION DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS) EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, ACADEMIC EMERGENCY MEDICINE INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY, LGBTQIA+ HEALTH NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY, NEURO CRITICAL CARE OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY PSYCHIATRY: EARLY PSYCHOSIS RADIOLOGY: DIAGNOSTIC, ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING (MSK), NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, LYMPHATIC SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, OTOLARYNGOLOGY FELLOWSHIP, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATED, JOINTS FELLOWSHIPADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS -- EXAMPLESBELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HEALTH ALLIANCE, TUFTS MEDICAL CENTER, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL, SOUTH SHORE HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	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 TO BE EFFECTIVE PRACTITIONERS IN UNDERSERVED, RESOURCE-LIMITED SETTINGS AND TO DESIGN, MANAGE, IMPROVE AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS THAT ADDRESS THE HEALTH PROBLEMS OF THE WORLD'S NEEDIEST POPULATIONS.PROGRAM OBJECTIVES INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS CONTRIBUTE TO THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS IN BOSTON AND AROUND THE WORLD ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS WITH LIMITED RESOURCES EXPAND RESEARCH OPPORTUNITIES ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH SITE LOCATIONS BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. PHYSICIAN AND NURSE TRAINING ON HIV/AIDS CARE IN VIETNAM TAKES PLACE THROUGH FUNDING FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH. NEUROLOGY EDUCATION AT BIDMCTHE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	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 BIDMCTHE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE: THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR. FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR. ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.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.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE: RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)OPEN MEDICAL STAFFTHE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.BETH ISRAEL LAHEY HEALTH (BILH) IS THE PARENT AND A SUPPORT ORGANIZATION OF THE BILH NETWORK OF AFFILIATES. THE NETWORK COMPRISES AN INTEGRATED HEALTH CARE DELIVERY SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM INCLUDES ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,800 PHYSICIANS AND 39,000 EMPLOYEES.THE BILH PURPOSE STATEMENT ARTICULATES THE IMPACT THAT EACH BILH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. THESE SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES ONE PERSON AT A TIME THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS.EQUITY. EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.DURING THE FISCAL PERIOD COVERED BY THIS FILING, BILH SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER (LHMC). THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. EFFECTIVE JULY 1, 2023, BILH ALSO BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND ITS AFFILIATES INCLUDING EXETER HOSPITAL. BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES FISCAL YEAR ENDED SEPTEMBER 30, 2023THE QUANTIFICATION IN THIS SCHEDULE H PART 1 QUESTION 7 IN THIS FILING REFLECTS ONLY THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST OF ANNA JAQUES HOSPITAL AND AS NOTED THROUGHOUT THIS FILING, ANNA JAQUES HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK. BELOW IS ADDITIONAL INFORMATION ON THE FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS ACTIVITIES ACROSS ALL OF THE BILH HOSPITALS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED MORE THAN $48 MILLION IN NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST.IN ADDITION TO THE CHARITY CARE REPORTED ABOVE, EACH OF THE BILH HOSPITALS ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICAID PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL EXCEEDING $61 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS. PAYMENTS FROM MEDICARE DO NOT COVER THE COST OF SERVICES PROVIDED. ALL BILH HOSPITALS PROVIDE CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICARE PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE, RESULTING IN A COMBINED SHORTFALL EXCEEDING $144 MILLION RELATED TO TREATING MEDICARE PATIENTS. DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED COMBINED COMMUNITY BENEFITS, COMMUNITY HEALTH IMPROVEMENT SERVICES, CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS AS WELL AS COSTS INCURRED RELATED TO SUBSIDIES FOR PRIMARY CARE, BEHAVIORAL HEALTH CARE AND OTHER CARE PROVIDED AT A LOSS TOTALING OVER $88 MILLION. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $202 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $68 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $134 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	RESEARCH ACTIVITIES ACROSS BILH SERVE PATIENT CARE BOTH AT BILH AND BEYOND AS PART OF THE ADVANCEMENT OF SCIENCE. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION AND TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $320 MILLION IN RESEARCH EXPENSES, MORE THAN $82 MILLION OF WHICH WERE INTERNALLY FUNDED.FOR ADDITIONAL INFORMATION ON THESE ACTIVITIES AS WELL AS EACH HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY, PLEASE SEE FORM 990 SCHEDULE H FOR EACH OF THE BILH HOSPITALS. ADDITIONAL BILH NETWORK ACTIVITIES -- EXPANDING ACCESS AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES; CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST; BEHAVIORAL HEALTH; COMMUNITY INVESTMENTS FISCAL YEAR ENDED SEPTEMBER 30, 2023IN ADDITION, AS NOTED FURTHER BELOW, BETH ISRAEL LAHEY HEALTH ("BILH") AND ITS AFFILIATES FOCUSED ON EXPANDING ACCESS AND SERVICES, INCLUDING TO UNDERSERVED PATIENT POPULATIONS IN ORDER TO REDUCE HEALTH INEQUITIES. IN ADDITION, THERE WAS A STRONG FOCUS ON CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST, WHEN APPROPRIATE, AS DEMONSTRATED BY BILH'S EFFORTS TO LEVERAGE COMMUNITY SETTINGS, KEEP CARE WITHIN THE BILH PERFORMANCE NETWORK ("BILHPN"), AND ALLOW PATIENTS TO RECEIVE CARE IN THEIR HOMES. THE FOLLOWING HIGHLIGHTS SPECIFIC EFFORTS DURING THE PERIOD COVERED BY THIS FILING:ACCESS & EXPANSION TO PHARMACY SERVICES BILH PHARMACY HAS CONTINUED TO EXPAND ITS CONTRACTUAL RELATIONSHIPS, ALLOWING MORE PATIENTS TO UTILIZE ITS PHARMACY FOR THEIR PRESCRIPTIONS. IN FY 2023, BILH PHARMACY SUCCESSFULLY NEGOTIATED ACCESS TO THE POINT32HEALTH SPECIALTY PHARMACY NETWORK AS WELL AS THE WELLSENSE MEDICAID ACCOUNTABLE CARE ORGANIZATION ("ACO") PLAN. EXAMPLES OF BILH PHARMACY'S OTHER EFFORTS TO EXPAND PATIENT ACCESS TO MEDICATIONS INCLUDE: ENHANCED MEDICATION AUTHORIZATION AND ACCESS SERVICES TO HELP PATIENTS OBTAIN NECESSARY INSURANCE AUTHORIZATIONS AND FIND CO-PAY ASSISTANCE, EXPANDED THE MEDICATION REFILL CENTER TO ASSIST PATIENTS AND PROVIDERS IN EXPEDITING MEDICATION RENEWALS AND ENSURING PRESCRIBED MEDICATION AND DOSAGE ARE STILL APPROPRIATE, EXTENDED PATIENT CO-PAY ASSISTANCE PROGRAMS TO THE JOSLIN ADULT DIABETES CLINIC AND NORTHEAST HOSPITAL CORPORATION PATIENTS, AND EXPANDED CLINICAL PHARMACY SERVICES IN AMBULATORY CLINICS TO HELP MANAGE AND OPTIMIZE PATIENTS' COMPLEX MEDICATION THERAPIES. BILH PHARMACY ALSO EXPANDED ITS CLINICAL PHARMACY PRESENCE IN CLINICS TO REDUCE THE HEALTH EQUITY GAP IN THE USE OF HIGHLY IMPACTFUL MEDICATIONS TO TREAT PATIENTS WITH DIABETES AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASES BY IMPROVING THEIR BLOOD PRESSURE AND HEMOGLOBIN A1C. INTERVENTIONS CENTERED AROUND PRESCRIBING EVIDENCE-BASED MEDICATIONS, EDUCATING PATIENTS ABOUT THEIR CONDITIONS, AND ENSURING ACCESS TO MEDICATION. INITIAL RESULTS HAVE DEMONSTRATED AN INCREASE IN THE USE OF GLP-1 AGONISTS AND SGLT-2 INHIBITORS BY 32% IN BLACK AND HISPANIC POPULATIONS, AN AVERAGE REDUCTION IN HEMOGLOBIN A1C OF 0.8, AND A DECREASE OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURES OF 7MMHG AND 2MMHG RESPECTIVELY.IMPROVEMENT IN LAB SERVICES BILH OPTIMIZED THE TRANSPORTATION ROUTES OF COLLECTED LABORATORY SPECIMENS TO TESTING LABORATORIES, ENSURING HIGH STANDARDS FOR TURNAROUND TIMES AND MAXIMUM EFFICIENCY. THIS IS FOUNDATIONAL TO THE SYSTEM'S ABILITY TO CONSOLIDATE TESTING, EXPAND ACCESS TO IN-NETWORK LABORATORY SERVICES WHICH IN TURN GENERALLY REDUCES COST, AND SUPPORT THE PROVISION OF HIGH-QUALITY CARE AND THE CLINICIAN AND PATIENT EXPERIENCE. FOCUS REMAINED STRONG IN DEVELOPING PHYSICIAN PRACTICE DELIVERY MODELS AND RE-OPENING PATIENT SERVICE CENTERS. THESE EFFORTS ENHANCE COMMUNITY PROVIDERS' ABILITY TO USE BILH LABS AND INCREASE PATIENT ACCESS TO BILH LABS.LEVERAGING IN-NETWORK CARE BILH OPERATES A TRANSFER CENTER THAT FACILITATES PATIENT ACCESS TO THE APPROPRIATE PLACEMENT OF PATIENT TRANSFERS. WITH THE CREATION OF THE TRANSFER CENTER, BILH HAS BEEN ABLE TO RETAIN PATIENTS WHO MIGHT OTHERWISE HAVE GONE OUTSIDE OF THE SYSTEM. BY EXPANDING ITS FOCUS TO COMMUNITY HOSPITALS, BILH HAS ENHANCED ITS ABILITY TO PLACE PATIENTS, INCLUDING AT LOCATIONS POTENTIALLY CLOSER TO THE PATIENTS' HOMES. BILHPN OPERATES A CENTRALIZED REFERRAL MANAGEMENT PROGRAM THAT FOCUSES ON PATIENTS SEEKING OUT-OF-NETWORK SPECIALTY CARE AND REDIRECTING THEM TO IN-NETWORK SPECIALTY CARE, WHEN CLINICALLY APPROPRIATE. THROUGHOUT FY 2023, BILHPN REDIRECTED WELL OVER ONE THOUSAND PATIENT VISITS. IN MOST CASES, CARE RETAINED WITHIN BILH RESULTED IN ENHANCED CARE COORDINATION AT A LOWER COST OF CARE.ENABLING PATIENTS TO RECEIVE CARE AT HOME BILH LAUNCHED ITS HOSPITAL AT HOME PROGRAM IN FY 2023, STARTING WITH LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER. THIS HAS ALLOWED ELIGIBLE PATIENTS TO BE OFFERED CARE IN THE SETTING MOST COMFORTABLE FOR THEM THEIR HOMES WHILE ALSO CUSTOMIZING CARE PLANS AND IMPROVING PATIENTS' MOBILITY EVEN WHILE THEY ARE ACUTELY ILL. IN FY 2023, BILHPN PUT PROGRAMS IN PLACE TO MANAGE LENGTH OF STAY AT SKILLED NURSING FACILITIES ("SNFS"), REDUCE READMISSIONS, AND DISCHARGE MEDICALLY APPROPRIATE PATIENTS DIRECTLY TO THEIR HOMES WITH HOMECARE SERVICES INSTEAD OF TO A SNF, PROVIDED PATIENTS ARE MEDICALLY STABLE TO RETURN HOME AFTER AN ACUTE CARE STAY AND WILL LIKELY HAVE BETTER OUTCOMES AND LOWER COST OF CARE.BEHAVIORAL HEALTH IN FY 2023, BILH BEHAVIORAL SERVICES LAUNCHED ITS COMMUNITY BEHAVIORAL HEALTH CENTER ("CBHC") IN LAWRENCE, MASSACHUSETTS, CONSOLIDATING OUTPATIENT, MOBILE CRISIS INTERVENTION, AND ADULT COMMUNITY CRISIS STABILIZATION SERVICES. THE ESTABLISHMENT OF THE CBHC IS A PART OF THE COMMONWEALTH'S EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES ROADMAP FOR BEHAVIORAL HEALTH REFORM. IN ADDITION, AS PART OF THE ROADMAP FOR BEHAVIORAL HEALTH REFORM, BILH LAUNCHED AN EMERGENCY SERVICES REDESIGN THAT SHIFTS EMERGENCY EVALUATIONS OUT OF THE EMERGENCY DEPARTMENT ("ED"). BILH BEHAVIORAL SERVICES ALSO EXPANDED ITS ED INTEGRATION EFFORTS TO A TOTAL OF SIX EDS, INCLUDING ADDISON GILBERT HOSPITAL, ANNA JAQUES HOSPITAL, BEVERLY HOSPITAL, LAHEY MEDICAL CENTER-PEABODY, BETH ISRAEL DEACONESS HOSPITAL-MILTON, AND WINCHESTER HOSPITAL.HEALTH EQUITY BILH AND LAWYERS FOR CIVIL RIGHTS LAUNCHED A MEDICAL-LEGAL PARTNERSHIP TO PROVIDE FREE LEGAL SUPPORT TO LOW-INCOME PATIENTS, BEGINNING AT BETH ISRAEL DEACONESS MEDICAL CENTER. THE COLLABORATION WILL EXPAND BILH'S ABILITY TO ADDRESS HEALTH EQUITY AND EXPAND ACCESS TO HEALTH CARE FOR PATIENTS LIVING IN UNDER-RESOURCED COMMUNITIES. BILHPN FOCUSED ON REDUCING HEALTH EQUITY DISPARITIES IN DIABETES AND HYPERTENSION MANAGEMENT BY STRATIFYING HEALTH OUTCOMES BY RACE, ETHNICITY AND LANGUAGE; SHARING PERFORMANCE DATA WITH PRIMARY CARE GROUPS; AND IMPLEMENTING CLINICAL INITIATIVES SUCH AS OFF-HOUR CLINICS, HOME BLOOD PRESSURE MONITOR DISTRIBUTION, CONTINUOUS GLUCOSE MONITORING, AND OUTREACH TO PATIENTS WITH HIGHER NEEDS.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	ONGOING INITIATIVES:ENHANCED ACCESS FOR MASSHEALTH PATIENTS TO MITIGATE BARRIERS IN ACCESS TO CARE AND INCREASE THE NUMBER OF MASSHEALTH PATIENTS THAT BILH SERVES, THE SYSTEM COMMITTED TO UNIVERSAL NETWORK-WIDE PROVIDER PARTICIPATION IN MASSHEALTH. ALL BILH HOSPITALS AND PROVIDERS EMPLOYED BY BILH OR ON WHOSE BEHALF BILH JOINTLY CONTRACTS PARTICIPATE IN AND/OR HAVE APPLIED TO PARTICIPATE IN SOME FORM OF MASSHEALTH. IN FY 2022, BILH SIGNED A NEW MASSHEALTH ACO CONTRACT WITH BMC HEALTHNET PLAN / WELLSENSE HEALTH PLAN THAT WENT INTO EFFECT IN APRIL 2023. AS PART OF THIS CONTRACT, BILHPN EXTENDED PARTICIPATION TO ALL ELIGIBLE PRIMARY CARE PROVIDERS ("PCPS") WHO WERE NOT OTHERWISE PARTICIPATING IN A MASSHEALTH ACO. PRIOR TO THAT TIME, WHILE ALL ELIGIBLE BILHPN PCPS WERE PARTICIPANTS IN A FORM OF MASSHEALTH, SOME PCPS WERE NOT PREVIOUSLY PARTICIPATING IN A MASSHEALTH ACO. BILH HAS DEVELOPED, REFINED AND IMPLEMENTED A MULTICULTURAL MARKETING, ADVERTISING, AND OUTREACH PLAN WITH THE PURPOSE OF EXPANDING ACCESS FOR UNDERSERVED POPULATIONS, INCLUDING MASSHEALTH PATIENTS, IN TARGETED BILH SERVICE AREAS. INVESTMENTS IN UNDERSERVED COMMUNITIES BILH HOSPITALS HAVE CREATED AND MAINTAIN STRONG CONNECTIONS TO A NETWORK OF AFFILIATED HOSPITALS AND HEALTH CENTERS THAT PROVIDE COMMUNITY-BASED CARE TO HISTORICALLY UNDERSERVED POPULATIONS. IN THE REGIONS THAT THEY SERVE, THE SAFETY NET AFFILIATES ("SNAS") AND COMMUNITY CARE ALLIANCE ("CCA") COMMUNITY HEALTH CENTERS ("CHCS") ARE THE CORNERSTONE OF BILH'S DELIVERY SYSTEM REGARDING COMMUNITY-BASED CARE FOR MASSHEALTH AND HISTORICALLY UNDERSERVED PATIENTS.O CCA CHCS INCLUDE BOWDOIN STREET HEALTH CENTER, CHARLES RIVER COMMUNITY HEALTH, THE DIMOCK CENTER, FENWAY HEALTH, AND SOUTH COVE COMMUNITY HEALTH CENTER. O SNAS INCLUDE CAMBRIDGE HEALTH ALLIANCE AND SIGNATURE HEALTHCARE BROCKTON HOSPITAL. BILH CONTINUES TO INVEST IN THE CCA CHCS AND SNAS, ENABLING THEM TO EXPAND THEIR CAPABILITIES AND CARE FOR MORE HISTORICALLY UNDERSERVED PATIENTS. IN FY 2022, BILH INVESTED OVER $8 MILLION IN ITS CHCS AND SNAS, IN ADDITION TO ENGAGING IN REGIONAL PLANNING AND COLLABORATIVE PROGRAM DEVELOPMENT. THESE INVESTMENTS REPRESENT ONLY A PORTION OF A MUCH LARGER COMMUNITY BENEFITS INVESTMENT PORTFOLIO THAT IS DESCRIBED IN GREATER DETAIL IN THIS AND OTHER BILH NETWORK TAX FILINGS. BILH CONTINUES TO EXPLORE ADDITIONAL OPPORTUNITIES WITH CHCS IN ESSEX AND MIDDLESEX COUNTIES. FOR EXAMPLE, BILH HAS ESTABLISHED A TELEHEALTH PILOT PROGRAM BETWEEN PHYSICIANS AT ADDISON GILBERT AND BEVERLY HOSPITALS AND PATIENTS AT NORTH SHORE COMMUNITY HEALTH CENTER. BILH BEHAVIORAL HEALTH SERVICESTHE BETH ISRAEL LAHEY HEALTH NETWORK (BILH) IS COMMITTED TO THE BEHAVIORAL HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES SERVICED. BELOW ARE SOME OF ACTIVITIES THAT BILH BEHAVIORAL SERVICES (BILHBS) HAS PROVIDED TO THE PATIENTS AND COMMUNITIES SERVED BY BILH AND ITS AFFILIATED ENTITIES. ADDICTION SERVICES NORTHEAST BEHAVIORAL HEALTH CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH BEHAVIORAL SERVICES (NBHC OR BILH BS) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS, PROVIDING HIGH-QUALITY MENTAL HEALTH AND ADDICTION TREATMENT. THIS INCLUDES A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TO COMMUNITY-BASED SERVICES. TREATMENT OFFERINGS INCLUDE MOBILE CRISIS TEAMS FOR BEHAVIORAL AND SUBSTANCE-RELATED EMERGENCIES; INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; RESIDENTIAL PROGRAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION CLINICS; AND MEDICATION-ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS. NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) HAS OVER 250 BEDS IN 9 FACILITIES FOR PATIENTS REQUIRING ACUTE PSYCHIATRIC, DETOXIFICATION AND POST-ACUTE DIVERSIONARY SERVICES. OTHER OFFERINGS INCLUDE MANY COMMUNITY-BASED SERVICES SUCH AS MOBILE EMERGENCY SERVICES TEAMS, SCHOOL AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES. BILHBS SERVES APPROXIMATELY 17,000 INDIVIDUALS ANNUALLY, PROVIDING OVER 380,000 UNITS OF SERVICE, IN A VAST ARRAY OF SETTINGS BASED ON THEIR NEEDS. BECAUSE OF THE COVID-19 EMERGENCY, NBHC WAS FORCED TO RECONFIGURE ITS DELIVERY MODEL FOR MANY SERVICES. WITH MULTIPLE "BRICK AND MORTAR" SITES TEMPORARILY CLOSED DURING THE HEIGHT OF THE PANDEMIC, NBHC OUTFITTED CLINICIANS WITH THE TOOLS NEEDED TO OFFER TELEHEALTH SERVICES. BY THE END OF THE FISCAL YEAR, OF THE TOTAL UNITS OF SERVICE LISTED ABOVE, ALMOST 61,000 WERE DELIVERED VIA TELEHEALTH. IN ADDITION, AS OUTLINED BELOW, NBHC SUPPORTED BILH'S SYSTEM-WIDE RESPONSE TO THE PANDEMIC BY QUICKLY STANDING UP A SHORT-TERM STAY COMMUNITY CRISIS STABILIZATION UNIT ON THE CAMPUS OF AN AFFILIATED ENTITY. BILH BS CONTINUES TO LEVERAGE TELEHEALTH SERVICES TO CONNECT TO COMMUNITIES SERVED ACROSS BILH. NBHC PROVIDED ADDICTION TREATMENT SERVICES WITH MORE THAN 200 INPATIENT AND RESIDENTIAL BEDS, OPERATING 24/7 FOR ADDICTION TREATMENT. ADDICTION TREATMENT INCLUDES BOTH OUTPATIENT AND INPATIENT TREATMENT AND PREVENTION. SUBSTANCE ABUSE COUNSELING AND GROUP THERAPY IS OFFERED FOR BOTH ADULTS AND TEENS, AS ARE A RANGE OF COURT-ORDERED PROGRAMS INCLUDING OPERATING UNDER THE INFLUENCE (OUI) EDUCATION AND EVALUATIONS. MEDICATION-ASSISTED TREATMENT FOR MEN AND WOMEN ADDICTED TO HEROIN OR PRESCRIPTION OPIOIDS IS PROVIDED AT LOCATIONS IN GLOUCESTER AND DANVERS. ACUTE TREATMENT PROGRAMS PROVIDING INPATIENT DETOXIFICATION SERVICES FROM DRUGS AND/OR ALCOHOL IN MEDICAL SETTINGS ARE AVAILABLE AT TREATMENT CENTERS IN DANVERS AND TEWKSBURY. IN FY23 THESE CENTERS SERVED APPROXIMATELY 2,600 PATIENTS. NBHC ALSO PROVIDED POST-DETOXIFICATION RESIDENTIAL SETTINGS AT MULTIPLE LOCATIONS SERVING BOTH MEN AND WOMEN, INCLUDING HART HOUSE IN TEWKSBURY WHICH EXCLUSIVELY SERVES MOTHERS WITH CHILDREN. IN FY23, NBHC'S OUTPATIENT ADDICTION PROGRAMS PROVIDED 196,350 UNITS OF SERVICE, INCLUDING 5,600 VIA TELEHEALTH, WHILE INPATIENT AND RESIDENTIAL PROGRAMS RECORDED 60,327 BED DAYS. AMBULATORY SERVICES BILH BS' AMBULATORY DIVISION SERVES NEARLY 4,300 PATIENTS EVERY YEAR, DELIVERING MORE THAN 108,000 UNITS OF SERVICES IN VARIOUS SETTINGS. MORE THAN 43,000 WERE DELIVERED BY TELEHEALTH AMBULATORY PROGRAMS AND SERVICES OFFERED UNDER THE CHILDREN'S BEHAVIORAL HEALTH INITIATIVE (CBHI) INCLUDING A BROAD RANGE OF COUNSELING AND THERAPY AS WELL AS MORE INTENSIVE TREATMENT MODALITIES. OUTPATIENT MENTAL HEALTH CLINICS IN SALEM, LAWRENCE, GLOUCESTER AND BEVERLY, AND AN OUTREACH CLINIC IN HAVERHILL, ASSIST INDIVIDUALS AND FAMILIES THROUGH PERIODS OF STRESS AND ADJUSTMENT, PROVIDING THERAPY FOR DEPRESSION, ANXIETY, TRAUMA, BIPOLAR DISEASE, AND CHRONIC MENTAL ILLNESS. OUTREACH COUNSELORS OFFER SHORT AND LONG-TERM THERAPY IN HOMES, SCHOOLS, AND OTHER APPROPRIATE COMMUNITY SETTINGS. ALL THERAPY PROGRAMS ARE SUPPORTED BY MEDICATION CLINICS IF THAT IS DETERMINED TO BE AN APPROPRIATE ADJUNCT TO TREATMENT. IN FY23, NBHC DELIVERED 99,419 UNITS OF AMBULATORY SERVICES, SUPPORTED BY 8,432 PSYCHOPHARMACOLOGY VISITS. EMERGENCY SERVICES THE EMERGENCY SERVICES DIVISION OFFERS EMERGENCY PSYCHIATRIC SERVICES AND INCLUDES THE EMERGENCY SERVICES PROGRAM (ESP) AND COMMUNITY CRISIS STABILIZATION (CCS) INPATIENT PROGRAM. ESP PROVIDES EMERGENCY PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES 24/7 IN A VARIETY OF SETTINGS, INCLUDING HOMES, SCHOOLS, OUTPATIENT CLINICS AND HOSPITALS. ESP SERVICES ARE PROVIDED WITHIN THE COMMUNITY AND WITHIN 10 HOSPITALS EMERGENCY DEPARTMENTS (ED) THROUGHOUT THE NORTH SHORE, CAPE ANN AND MERRIMACK VALLEY, INCLUDING 6 NON-BILH EMERGENCY DEPARTMENTS.
FORM 990, SCHEDULE H, SUPPLEMENTAL INFORMATION	BILH BS' EMERGENCY PSYCHIATRIC AND MOBILE RESPONSE TEAMS IN LAWRENCE, SALEM AND LOWELL ARE AVAILABLE AROUND THE CLOCK, PROVIDING PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES IN VARIOUS SETTINGS. NBHC PROVIDES THESE SERVICES IN CONJUNCTION WITH A LARGE NUMBER OF AREA HOSPITALS, INCLUDING FACILITIES OUTSIDE OF THE BILH UMBRELLA. MOBILE CRISIS CLINICIANS ALSO RESPOND TO SCHOOLS, HOMES AND OUTPATIENT CLINICS, AND NBHC ALSO PROVIDES WALK-IN SERVICES AT THE THREE TEAM LOCATIONS. IN ADDITION TO EMERGENCY EVALUATION, TEAM MEMBERS PROVIDE ONGOING CRISIS COUNSELING UNTIL THE PATIENT IS STABLE AND RELATIONSHIPS ARE ESTABLISHED WITH LONGER-TERM CARE PROVIDERS. THE LAWRENCE AND SALEM LOCATIONS ALSO HOUSE 8-BED COMMUNITY CRISIS STABILIZATION UNITS, WHICH OFFER SHORT-TERM (3-5 DAY) CRISIS BEDS IN LIEU OF HOSPITALIZATION FOR MASSHEALTH, MEDICARE, AND UNINSURED CLIENTS. IN JANUARY 2023, THE STATE OF MASSACHUSETTS IMPLEMENTED BEHAVIORAL HEALTH REDESIGN, WHICH SIGNIFICANTLY IMPACTED OUR EMERGENCY SERVICES TEAMS. BILH BS WAS AWARDED ONE COMMUNITY BEHAVIORAL HEALTH CENTER (CBHC), LOCATED IN LAWRENCE. THE SERVICE AREAS FOR SALEM AND LOWELL WERE TRANSITIONED TO A DIFFERENT VENDOR. HOWEVER, THIS ALLOWED OUR SALEM AND LOWELL TEAMS TO PIVOT INWARD TO SERVICE THE BILH SYSTEM NEEDS. DURING THE FISCAL PERIOD COVERED BY THIS FILING, EMERGENCY SERVICE PROGRAMS HAD 13,502 ENCOUNTERS, 1,895 OF WHICH WERE DONE REMOTELY, AND THE CCS PROGRAMS RECORDED 2,546 BED DAYS. NBHC IS ALSO ON THE FOREFRONT OF EXPANDING TREATMENT FOR OPIOID USE DISORDER (OUD). SEVERAL BILH ORGANIZATIONS HAVE TAKEN STEPS TO ENHANCE CARE FOR PATIENTS WITH OPIOID USE DISORDER (OUD) WHO PRESENT IN EMERGENCY DEPARTMENTS, PARTICULARLY AS THESE PATIENTS TRANSITION FROM THE HOSPITAL TO A LONG-TERM TREATMENT PROGRAM. THE NBHC BRIDGE CLINIC IN GLOUCESTER ACCEPTS PATIENTS REFERRED FROM THE NORTHEAST HOSPITAL CORP (NHC) EMERGENCY DEPARTMENTS AT BOTH BEVERLY HOSPITAL AND ADDISON GILBERT HOSPITAL AND OFFERS CONTINUATION OF MEDICATION ASSISTED TREATMENT AND SUPPORT FROM RECOVERY COACHES. BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH (BID-PLYMOUTH) TREATS PATIENTS WITH OUD THROUGH MEDICATION-ASSISTED TREATMENT IN THE EMERGENCY DEPARTMENT, AND THE HOSPITAL WORKS CLOSELY WITH COMMUNITY PARTNERS TO PROVIDE ONGOING SUPPORT TO PATIENTS. THESE PROGRAMS ARE SIMILAR TO SERVICES AT MOUNT AUBURN HOSPITAL WHICH ALSO OFFERS MEDICATION-ASSISTED TREATMENT IN ITS EMERGENCY DEPARTMENT. PATIENTS CAN THEN BE REFERRED TO THE BRIDGE CLINIC AT MOUNT AUBURN HOSPITAL OR BID-PLYMOUTH FOR CONTINUED OR ADDITIONAL TREATMENT. NORTHEAST HOSPITAL CORPORATION, BID-PLYMOUTH AND MOUNT AUBURN HOSPITALS ARE ALL PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK AND SISTER ENTITIES TO NBHC.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt
OUR NEIGHBORS' TABLE
PO BOX 592	AMESBURY	MA	01913	043153941	501(C)(3)	$5,750	$0	CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
YMCA OF THE NORTH SHORE
ESSEX ST	BEVERLY	MA	01915	042104913	501(C)(3)	$10,000	$0	CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS
YWCA OF NEWBURYPORT
MARKET ST	NEWBURYPORT	MA	01950	042123678	501(C)(3)	$8,000	$0	CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	AS PREVIOUSLY NOTED IN THE FILING ANNA JAQUES HOSPITAL, INC., MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND ANNA JAQUES HOSPITAL, INC. WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. ANNA JAQUES HOSPITAL, INC. ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (25 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TABB MD KEVIN
CHIEF EXECUTIVE OFFICER (EX-OFFICIO)	$0	$2,103,982	$0	$0	$0	$403,253	$0	$257,320	$0	$42,597	$0	$2,807,152	$0	$0
ROWAN MICHAEL
TRUSTEE (EX-OFFICIO) (CEO DESIGNEE)	$0	$1,190,783	$0	$0	$0	$108,052	$0	$9,371	$0	$27,668	$0	$1,335,874	$0	$0
KERNDL JOHN
TREAS (EX-OFF) (EVP & CFO, BILH)	$0	$1,068,846	$0	$100,000	$0	$132,617	$0	$4,985	$0	$29,424	$0	$1,335,872	$0	$0
RIOS CINDY
TREAS (EX-OFF) (INTERIM CFO, BILH)	$0	$574,544	$0	$174,475	$0	$53,027	$0	$188,510	$0	$32,426	$0	$1,022,982	$0	$0
NASEER-GHIASUDDIN MD SAIRA
TTEE; PHYSICIAN, INTERNAL MEDICINE	$0	$516,607	$0	$449,414	$0	-$6,631	$0	$9,669	$0	$45,236	$0	$1,014,295	$0	$0
KATZ ESQ JAMIE
CLERK (EX-OFFICIO)	$0	$794,826	$0	$0	$0	$103,367	$0	$7,320	$0	$8,544	$0	$914,057	$0	$0
NESTO MD RICHARD
TRUSTEE (EX-OFFICIO) (CEO DESIGNEE)	$0	$792,617	$0	$0	$0	$65,097	$0	$7,320	$0	$27,098	$0	$892,132	$0	$0
PURSLEY MD DEWAYNE M
TRUSTEE	$0	$712,598	$0	$0	$0	$28,460	$0	$61,000	$0	$27,846	$0	$829,904	$0	$0
GOLDSTEIN MARK
PRESIDENT & TRUSTEE (EX-OFFICIO)	$592,923	$0	$0	$0	-$24,951	$0	$7,320	$0	$24,453	$0	$599,745	$0	$0	$0
FUNG MD CLAIRE
TRUSTEE	$0	$274,103	$0	$39,000	$0	$6,877	$0	$26,300	$0	$5,765	$0	$352,045	$0	$0
FOCHT MD GLENN
CMO; PRES & TTEE (EX-OFF) EFF 9/1/23	$341,189	$0	$0	$0	$455	$0	$0	$0	$2,572	$0	$344,216	$0	$0	$0
CROWLEY SMITH JOANNE
INTERIM VP, HR BUSINESS PARTNER	$0	$270,290	$0	$0	$0	$1,774	$0	$32,122	$0	$37,298	$0	$341,484	$0	$0
MAKI DN RN RICHARD
CHIEF NURSING OFFICER	$245,067	$0	$0	$0	$5,430	$0	$4,902	$0	$31,085	$0	$286,484	$0	$0	$0
HIGGINS LISA M
STAFF REGISTERED NURSE	$222,521	$0	$12,556	$0	$2,515	$0	$2,488	$0	$23,173	$0	$263,253	$0	$0	$0
BUCHANAN JR ROBERT R
EXEC DIR, EHR EPIC & CLIN SVCS	$187,761	$0	$0	$0	$8,109	$0	$6,688	$0	$43,050	$0	$245,608	$0	$0	$0
LEE GARY
VP, CLINICAL OPERATIONS	$197,049	$0	$0	$0	-$6,375	$0	$11,140	$0	$42,418	$0	$244,232	$0	$0	$0
SOLDANO JOSEPH
CO-INTERIM CFO/ DIR, FIN PLANNING	$159,839	$0	$6,000	$0	$3,589	$0	$8,722	$0	$40,940	$0	$219,090	$0	$0	$0
SZUKSTA WALTER F
DIRECTOR, PERI-OPERATIVE SERVICES	$158,042	$0	$0	$0	$6,907	$0	$6,908	$0	$39,985	$0	$211,842	$0	$0	$0
KILDAY KEVIN
FORMER CFO	$127,556	$0	$0	$0	$55,707	$0	$11,483	$0	$9,961	$0	$204,707	$0	$0	$0
STEELE PATRICIA A
STAFF REGISTERED NURSE	$165,827	$0	$6,588	$0	$150	$0	$6,159	$0	$25,069	$0	$203,793	$0	$0	$0
AHERN SEAN
CHIEF OPERATING OFFICER	$0	$165,387	$0	$0	$0	$17,311	$0	$3,155	$0	$12,664	$0	$198,517	$0	$0
BENNETT MATT
VP, HUMAN RESOURCES BUSINESS PARTNER	$169,198	$0	$0	$0	$136	$0	$10,016	$0	$12,426	$0	$191,776	$0	$0	$0
SALVO STEPHEN
FORMER VP HR	$0	$138,375	$0	$0	$37,921	$0	$0	$1,255	$0	$0	$37,921	$139,630	$0	$0
CIAMPA STEVEN
CO-INTERIM CFO, DIRECTOR OF FINANCE	$134,200	$0	$11,250	$0	$10,228	$0	$0	$0	$19,494	$0	$175,172	$0	$0	$0
KIM ESQ GRACE
ASST CLERK (EX-OFF) (ASST GC, BILH)	$0	$156,220	$0	$0	$0	$105	$0	$752	$0	$9,286	$0	$166,363	$0	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
CHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES:	SCHEDULE J PART I QUESTION 4A SEVERANCE AND CHANGE OF CONTROL PAYMENTS AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, AND AS NOTED ABOVE, THE COMPENSATION DETAIL INCLUDED IN ANNA JAQUES HOSPITAL (AJH) FORM 990 FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 IS CALENDAR YEAR 2022 DETAIL. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. SCHEDULE J PART I QUESTION 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN ANNA JAQUES HOSPITAL'S FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023 IS CALENDAR YEAR 2022 DETAIL. AMOUNTS RECEIVED BY PARTICIPANTS AND RELATED TO THIS PLAN 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. AMOUNTS DEFERRED BY PARTICIPANTS OR CONTRIBUTIONS RECEIVED BY PARTICIPANTS AND RELATED TO THESE PLANS 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. SCHEDULE J PART I QUESTION 7 NON-FIXED PAYMENTS ACROSS THE BILH NETWORK OF AFFILIATES, INCLUDING AJH, EXECUTIVE COMPENSATION PACKAGES AND CERTAIN EMPLOYEE COMPENSATION PACKAGES INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING PRE-DETERMINED GOALS. FOR THE PERIOD COVERED BY THIS FILING, THE INCENTIVE COMPENSATION FOR EACH EXECUTIVE REPORTED IN THIS FORM 990 WAS REVIEWED AND APPROVED BY THE BILH COMPENSATION COMMITTEE, WHICH AS PREVIOUSLY NOTED, WAS FULLY STAFFED BY INDEPENDENT MEMBERS. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES: 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 AND WAS PAID FOR POSITIONS HELD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED BY FORM 990, COMPENSATION REPORTED FOR THIS FISCAL YEAR IS CALENDAR YEAR 2022 COMPENSATION. COMPENSATION REPORTED FOR INDIVIDUALS MAY REFLECT AN ALLOCATION OF COMPENSATION PAID BY ENTITIES RELATED TO THE FILING ORGANIZATION AND WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK OR OTHER ENTITIES, AS REQUIRED. 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 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: REGULAR WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS QUANTIFIED IN OTHER REPORTABLE COMPENSATION WHICH MAY NOT BE SEPARATELY NOTED IN THIS FILING INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; DISTRIBUTIONS FROM A 457(B) PLAN; AMOUNTS INCLUDIBLE IN INCOME UNDER A 457(F) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED RETIREMENT BENEFITS; OTHER TAXABLE RETIREMENT BENEFITS 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 401K RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403B RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT, UNFUNDED AND UNVESTED AMOUNTS DEFERRED UNDER 457(F) PLAN NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THESE 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 COMPLETE TITLES AND ADDITIONAL EXPLANATORY INFORMATION FOR OFFICERS, DIRECTOR/TRUSTEES, KEY EMPLOYEES AND THE ENTITIES FIVE HIGHEST PAID EMPLOYEES OTHER THAN ODTKH ARE LISTED BELOW ALPHABETICALLY: BENNETT, MATT VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER - SEACOAST AFFILIATED GROUP PRACTICE, INC. VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER ANNA JAQUES HOSPITAL
SCHEDULE J FOOTNOTES (CONTINUED):	BOUTON, PH.D., CHRISTOPHER TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. CANNON, PATRICIA TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. CAPOLUPO, WAYNE TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. COSTELLO, MICHAEL TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. COUSINS, JR., FRANK G. TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. FAYRE, M.D., GAIL FORMER CHIEF MEDICAL OFFICER ANNA JAQUES HOSPITAL FORMER CHIEF OPERATING OFFICER SEACOAST AFFILIATED GROUP PRACTICE, INC. FUNG, M.D., CLAIRE TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. GHIASUDDIN, MD, SALMAN TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. GOLDSTEIN, MARK PRESIDENT & TRUSTEE (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. PRESIDENT AND TRUSTEE - SEACOAST AFFILIATED GROUP PRACTICE, INC. MR. GOLDSTEIN SERVED IN THE POSITIONS ABOVE FOR THE THROUGH MARCH 26, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 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 AND DEFERRED COMPENSATION FOR MR. GOLDSTEIN INCLUDES COMBINED PAYMENTS FROM, CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $(34,035). IN ADDITION TO CONTRIBUTIONS TO A NONQUALIFIED PLAN AS ALLOWED UP TO A STATUTORY LIMIT, THIS AMOUNT INCLUDES A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $36,719 AND UNREALIZED LOSSES OF $90,254. KATZ, J.D., JAMIE UNLESS OTHERWISE NOTED BELOW, MR. KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2023: 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 (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. CLERK (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. CLERK (EX-OFFICIO) - 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 (EX-OFFICIO) AND CLERK (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE (EX-OFFICIO)RAND 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. DIRECTOR AND CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CLERK (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC, INC. CLERK (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC.D/B/A LAHEY HOSPITAL & MEDICAL CENTER CLERK (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. TRUSTEE AND CLERK - CAB HEALTH AND RECOVERY SERVICES, INC. TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL CLERK (EX-OFFICIO) - 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 TERM BEGAN ON MARCH 31, 2023 CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TERM BEGAN ON MARCH 31, 2023 EFFECTIVE JULY 1, 2023, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES INC. WHICH IN TURN SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL AND ADDITIONAL AFFILIATES. AS OF THAT DATE MR. KATZ ASSUMED THE FOLLOWING ADDITIONAL POSITIONS: CLERK (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. CLERK (EX-OFFICIO) - EXETER HOSPITAL, INC. CLERK (EX-OFFICIO) - CORE PHYSICIANS, LLC SECRETARY (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 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 CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $68,094. INCLUDED IN THIS AMOUNT IS A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $72,875 AND AN UNREALIZED LOSS IN THE AMOUNT OF $24,281.
SCHEDULE J FOOTNOTES (CONTINUED):	KERNDL, JOHN UNLESS OTHERWISE NOTED BELOW, MR. KERNDL HELD THE FOLLOWING POSITIONS THROUGH DECEMBER 31, 2022: EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. TRUSTEE AND TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. TREASURER - CAREGROUP PARMENTER HOME CARE & HOSPICE, INC. TRUSTEE, TREASURER (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. TREASURER (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. TREASURER (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER TRUSTEE AND TREASURER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL TREASURER (EX-OFFICIO) MOUNT AUBURN PROFESSIONAL SERVICES ASSISTANT TREASURER (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP TREASURER (EX-OFFICIO) - BID - MILTON PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO), TREASURER(EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. TRUSTEE (EX-OFFICIO), TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TREASURER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. TRUSTEE AND TREASURER (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. TREASURER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL DIRECTOR (EX-OFFICIO) AND TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. TRUSTEE (EX-OFFICIO), TREASURER (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. MANAGING DIRECTOR - BETH ISRAEL DEACONESS PHYSICIAN ORGANIZATION, LLC MANAGING DIRECTOR, TREASURER - BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK, LLC TREASURER (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE ACCOUNTABLE CARE ORGANIZATION, LLC TREASURER (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE NETWORK, LLC ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TREASURER (EX-OFFICIO) - JOSLIN CLINIC, INC. TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 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. KERNDL INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $109,434. OF THIS AMOUNT, $89,934 WAS UNVESTED AT SEPTEMBER 30, 2023. OTHER REPORTABLE COMPENSATION FOR MR. KERNDL ALSO INCLUDES $ 7,961 RELATED TO TEMPORARY HOUSING. KHATIB, MATT TRUSTEE - ANNA JAQUES HOSPITAL TRUSTEE , BOARD CHAIR AND FOUNDATION - SEACOAST AFFILIATED GROUP PRACTICE, INC. KILDAY, KEVIN FORMER CHIEF FINANCIAL OFFICER - ANNA JAQUES HOSPITAL, INC. FORMER CHIEF FINANCIAL OFFICER AND CHIEF OPERATING OFFICER - SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. KILDAY INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $55,061. THIS AMOUNT INCLUDES A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $68,006 AND AN UNREALIZED LOSS IN THE AMOUNT OF $12,945 IMPACTING THE NONQUALIFIED UNVESTED BALANCE. LEE, GARY VICE PRESIDENT, CLINICAL OPERATIONS - ANNA JAQUES HOSPITAL, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. LEE INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $(7,103). THIS AMOUNT IS AN UNREALIZED LOSS IMPACTING THE NONQUALIFIED UNVESTED AMOUNT. MAKI, DN, RN, RICHARD CHIEF NURSING OFFICER - ANNA JAQUES HOSPITAL, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. MAKI INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $4,940. OF THIS AMOUNT, $4,940 IS UNVESTED. MATHEWS, BRYON TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. NASEER-GHIASUDDIN, SAIRA TRUSTEE; PHYSICIAN, INTERNAL MEDICINE - ANNA JAQUES HOSPITAL, INC. TRUSTEE; PHYSICIAN, INTERNAL MEDICINE - SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. NASEER INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $(7,234). INCLUDED IN THIS AMOUNT IS AN UNREALIZED LOSS IN THE AMOUNT OF $15,984 IMPACTING THE NONQUALIFIED UNVESTED BALANCE. TABB, M.D., KEVIN UNLESS OTHERWISE NOTED BELOW, DR. TABB HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2023: 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) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. 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 DIRECTOR AND PRESIDENT (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - 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 CHIEF EXECUTIVE OFFICER AND TRUSTEE - CAB HEALTH AND RECOVERY SERVICES, INC. CHIEF EXECUTIVE OFFICER AND TRUSTEE - HEALTH AND EDUCATION HOUSING SERVICES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - 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 (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN CLINIC, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. EFFECTIVE JULY 1, 2023, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES INC. WHICH IN TURN SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL AND ADDITIONAL AFFILIATES. AS OF THAT DATE DR. TABB ASSUMED THE FOLLOWING ADDITIONAL POSITIONS: CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HOSPITAL, INC.
SCHEDULE J FOOTNOTES (CONTINUED):	ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $388,031. THIS AMOUNT INCLUDES A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $453,944 AND UNREALIZED LOSSES IMPACTING HIS NONQUALIFIED BENEFIT IN THE AMOUNT OF $85,413. DEFERRED COMPENSATION IN THE AMOUNT OF $250,000 INCLUDED IN THIS FILING FOR DR. TABB RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2022, 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. TARKAN, M.D., JOSHUA TRUSTEE (EX-OFFICIO) AND PRESIDENT, MEDICAL STAFF ANNA JAQUES HOSPITAL, INC. TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. TRIM, JEAN TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. WILEY, MARGARET TRUSTEE ANNA JAQUES HOSPITAL TRUSTEE SEACOAST AFFILIATED GROUP PRACTICE, INC. ROWAN, MICHAEL UNLESS OTHERWISE NOTED BELOW, MR. ROWAN HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 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 (EX-OFFICIO) (CEO DESIGNATE) - COMMUNITY PHYSICIANS ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - THE JORDAN HEALTH SYSTEMS, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - 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. O TERM BEGAN ON APRIL 1, 2023. TRUSTEE (CEO DESIGNEE) - SEACOAST AFFILIATED GROUP PRACTICE, INC. O TERM BEGAN ON APRIL 1, 2023. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HOSPITAL TERM BEGAN ON MARCH 10, 2023. TRUSTEE (EX-OFFICIO) (CEO DESIGNATE) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TERM BEGAN ON MARCH 10, 2023. MR. ROWAN SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 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 AND DEFERRED COMPENSATION FOR MR. ROWAN INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $84,688. OF THIS AMOUNT, $65,188 IS UNVESTED AS OF SEPTEMBER 30, 2023. RIOS, CINDY TREASURER (EX-OFFICIO) AND INTERIM CHIEF FINANCIAL OFFICER BETH ISRAEL LAHEY HEALTH, INC. TERM BEGAN JANUARY 1, 2023. SENIOR VICE PRESIDENT AND OPERATIONS CHIEF FINANCIAL OFFICER BETH ISRAEL LAHEY HEALTH, INC. TERM ENDED DECEMBER 31, 2022 UNLESS OTHERWISE NOTED, EFFECTIVE JANUARY 1, 2023, MS. RIOS ALSO ASSUMED THE FOLLOWING POSITIONS: TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP TERM BEGAN MARCH 31, 2023 TREASURER (EX-OFFICIO) - CAREGROUP PARMENTER HOME CARE & HOSPICE, INC. TREASURER (EX-OFFICIO) - 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 (EX-OFFICIO) - 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. TERM BEGAN MARCH 31, 2023 TREASURER (EX-OFFICIO) - COMMUNITY PHYSICIANS ASSOCIATES, INC. TREASURER (EX-OFFICIO) - JOSLIN CLINIC, INC. TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. TREASURER (EX-OFFICIO) - THE JORDAN HEALTH SYSTEMS, INC. TREASURER (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) - LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER TREASURER (EX-OFFICIO) - 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 (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. DIRECTOR & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. TREASURER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE & TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TRUSTEE & TREASURER (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. TRUSTEE & TREASURER (EX-OFFICIO) - 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. TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE & TREASURER (EX-OFFICIO) - SEACOAST NURSING & REHABILITATION CENTER, INC. TRUSTEE & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL EFFECTIVE JULY 1, 2023, BETH ISRAEL LAHEY HEALTH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES INC. WHICH IN TURN SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL AND ADDITIONAL AFFILIATES. AS OF THAT DATE MS. RIOS ASSUMED THE FOLLOWING ADDITIONAL POSITIONS: TREASURER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. TREASURER (EX-OFFICIO) - EXETER HOSPITAL, INC. TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOC & HOSPICE MS. RIOS SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 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 INCLUDES PAYMENTS FOR TEMPORARY HOUSING AND MOVING EXPENSES IN THE AMOUNT OF $41,927 AND 9,904, RESPECTIVELY. DEFERRED COMPENSATION IN THE AMOUNT OF $187,500 INCLUDED IN THIS FILING FOR MS. RIOS RELATES TO A MILESTONE PAYMENT WHICH, AS OF DECEMBER 31, 2022, 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. NESTO, M.D., RICHARD DR. NESTO HELD THE FOLLOWING POSITIONS THROUGH MARCH 31, 2023 UNLESS OTHERWISE NOTED: CHIEF MEDICAL OFFICER - BETH ISRAEL LAHEY HEALTH, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNATE) ANNA JAQUES HOSPITAL, INC. TRUSTEE SEACOAST AFFILIATES GROUP PRACTICE, INC. TRUSTEE (EX-OFFICIO, CEO DESIGNATE) WINCHESTER HOSPITAL TERM ENDED ON MARCH 9, 2023. TRUSTEE (EX-OFFICIO, CEO DESIGNATE) WINCHESTER HEALTHCARE MANAGEMENT, INC. TERM ENDED ON MARCH 9, 2023. AS NOTED ABOVE, DR. NESTO SERVED IN THESE POSITIONS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2023. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 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 AND DEFERRED COMPENSATION FOR DR. NESTO INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $36,669. INCLUDED IN THIS AMOUNT IS A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $78,896 AND AN UNREALIZED LOSS IN THE AMOUNT OF $61,727 IMPACTING HIS NONQUALIFIED BENEFIT.
SCHEDULE J FOOTNOTES (CONTINUED):	FOCHT, M.D., GLENN DR. FOCHT SERVED IN THE FOLLOWING ROLES FROM OCTOBER 1, 2022, THROUGH SEPTEMBER 3, 2023: CHIEF MEDICAL OFFICER - ANNA JAQUES HOSPITAL, INC. CHIEF OPERATING OFFICER - - SEACOAST AFFILIATED GROUP PRACTICE, INC. EFFECTIVE SEPTEMBER 4, 2003, DR. FOCHT BEGAN SERVING IN THE FOLLOWING ROLES: PRESIDENT & TRUSTEE (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. PRESIDENT & TRUSTEE (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 COMPENSATION AND REFLECTS DR. FOCHT'S SERVICES AS CHIEF MEDICAL OFFICER FOR ANNA JAQUES HOSPITAL AND CHIEF OPERATING OFFICER FOR SEACOAST AFFILIATED GROUP PRACTICE. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. CIAMPA, STEVEN CO-INTERIM CFO, DIRECTOR OF FINANCE - ANNA JAQUES HOSPITAL, INC. CO-INTERIM CFO, DIRECTOR OF FINANCE - SEACOAST AFFILIATED GROUP PRACTICE, INC. MR. CIAMPA SERVED AS DIRECTOR OF FINANCE FOR BOTH ANNA JAQUES HOSPITAL AND SEACOAST AFFILIATED GROUP PRACTICE UNTIL MAY 11, 2022 WHEN HE BECAME THE CO-INTERIM CFO FOR BOTH ENTITIES. HE SERVED IN THESE LATTER POSITIONS UNTIL OCTOBER 14, 2022. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 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 INCLUDES PAYMENT FOR A PTO CASH-OUT IN THE AMOUNT OF $10,126. SALVO, STEPHEN FORMER VICE PRESIDENT HUMAN RESOURCES - ANNA JAQUES HOSPITAL, INC. FORMER VICE PRESIDENT HUMAN RESOURCES - SEACOAST AFFILIATED GROUP PRACTICE, INC. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. SALVO INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $37,921. INCLUDED IN THIS AMOUNT IS A DISTRIBUTION FROM A NONQUALIFIED PLAN IN THE AMOUNT OF $59,248 AND AN UNREALIZED LOSS IN THE AMOUNT OF $21,327 IMPACTING THE NONQUALIFIED UNVESTED BALANCE. SOLDANO, JOSEPH MR. SOLDANO SERVED IN THE FOLLOWING POSITIONS THROUGH OCTOBER 14, 2022: CO-INTERIM CHIEF FINANCIAL OFFICER, DIRECTOR OF FINANCIAL PLANNING - ANNA JAQUES HOSPITAL, INC. CO-INTERIM CHIEF FINANCIAL OFFICER, DIRECTOR OF FINANCIAL PLANNING - SEACOAST AFFILIATED GROUP PRACTICE, INC. MR. SOLDANO SERVED AS DIRECTOR OF FINANCIAL PLANNING FOR BOTH ANNA JAQUES HOSPITAL AND SEACOAST AFFILIATED GROUP PRACTICE UNTIL MAY 11, 2022 WHEN HE BECAME THE CO-INTERIM CFO FOR BOTH ENTITIES. HE SERVED IN THESE LATTER POSITIONS UNTIL OCTOBER 14, 2022. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2022 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 INCLUDES PAYMENT FOR PTO CASHED-OUT IN THE AMOUNT OF $3,399. PURSLEY, M.D., DEWAYNE M. TRUSTEE - SEACOAST AFFILIATED GROUP PRACTICE, INC. TRUSTEE - ANNA JAQUES HOSPITAL, INC. DIRECTOR EX OFFICIO, VICE CHAIR, NEO CHAIR; BIDMC NEO CHIEF - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR EX OFFICIO /PRESIDENT; BIDMC NEO CHIEF/HMFP CHAIR - BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION, INC. CROWLEY SMITH, JOANNE INTERIM VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER - ANNA JAQUES HOSPITAL, INC. VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER - SEACOAST AFFILIATED GROUP PRACTICE, INC. VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER - WINCHESTER HOSPITAL

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY
A	043431814	57584YTK5	2019-07-31	$211,922,775	MDFA - SERIES 2019K - SEE PART VI	0	0	0
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY
B	043431814	57584YJW0	2018-06-26	$479,594,374	MDFA - SERIES 2018J-1, J-2 - SEE PART VI	0	0	0
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY
C	043431814	57584XMT5	2016-05-12	$257,611,877	MDFA - SERIES 2016I - SEE PART VI	0	0	0
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY
D	043431814	57584XFW6	2015-10-21	$262,828,878	MDFA - LAHEY SERIES F - SEE PART VI	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Capitalized InterestCapitalizedInterestAmt
A	$27,790,000	$211,922,775	$2,931,137	$19,714,020	$189,277,638	2019	0	0	Yes (1)	Yes (1)
B	$13,875,000	$504,358,641	$4,594,374	$499,764,267		2021	0	0	Yes (1)	Yes (1)
C	$53,195,000	$257,618,370	$2,515,889	$19,006,493	$236,095,988	2016	0	Yes (1)	Yes (1)	Yes (1)
D	$28,000,000	$262,953,908	$3,129,474	$94,764,737	$160,202,232	2021	Yes (1)	Yes (1)	Yes (1)	Yes (1)	$4,857,465

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd
A	Yes (1)	Yes (1)	Yes (1)	0	Yes (1)
B	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)	Yes (1)	0	Yes (1)
D	0	0		0	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Rebate Not Due YetRebateNotDueYetInd	No Rebate DueNoRebateDueInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	Yes (1)	0	0	Yes (1)
B	0	Yes (1)	Yes (1)	Yes (1)
C	0	Yes (1)	0	Yes (1)
D	0	Yes (1)	Yes (1)	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
BOND A, ENTITY 1:	PART I, ROW A, 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.
BOND B, ENTITY 1:	PART I, ROW B, 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 B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $24,764,267 OF INVESTMENT EARNINGS. PART IV, COLUMN B, LINE 2C: FINAL REBATE CALCULATION SHOWING NO REBATE DUE COMPLETED ON 09/30/2023.
BOND C, ENTITY 1:	PART I, ROW C, 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 C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. PART IV, COLUMN C, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021.
BOND D, ENTITY 1:	PART I, ROW D, 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 D, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $125,030 OF INVESTMENT EARNINGS. 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 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 A, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019.
BOND A, ENTITY 2:	PART I, ROW B, COLUMN A: MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PART I, ROW B, COLUMN F: DESCRIPTION OF PURPOSE - REFUND ISSUE DATED 06/28/2000. PART II, COLUMN B, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. PART IV, ROW 2C, COLUMN B: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 10, 2009. THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS FORMED IN JUNE 2020. 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 WHICH WAS FORMED IN JUNE 2020. 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, AND ANNA JAQUES 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 09/30/2023, THE OBLIGATED GROUP HAS INCLUDED ALL TAX-EXEMPT BOND ISSUES ON EACH OF ITS MEMBER'S FORM 990 SCHEDULE KS, WHICH IS CONSISTENT WITH THE APPROACH THAT HAS BEEN TAKEN SINCE THE OBLIGATED GROUP'S FORMATION. THE OBLIGATED GROUP INTENDS TO MODIFY ITS FILING POSITION TO BE IN LINE WITH THE INSTRUCTIONS TO SCHEDULE K ON ALL SUBSEQUENT FORM 990S.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
MASSACHUSETTS DEVELOPMENT FINANCE AGENCY
A	043431814	57584XDH1	2015-09-02	$203,702,204	MDFA - SERIES 2015 H-1 - SEE PART VI	0	0	0
MASS HEALTH & EDUCATIONAL FACILITIES AUTHORITY
B	042456011	57586CDD4	2004-07-08	$30,340,000	MHEFA - WINCHESTER SERIES F - ADV REFUND	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Other Spent ProceedsOtherSpentProceedsAmt	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Credit EnhancementCreditEnhancementAmt
A	$94,030,000	$203,702,204	$2,348,479	$201,353,725	Yes (1)	Yes (1)	Yes (1)	Yes (1)
B	$8,860,000	$30,340,000	$365,445	$29,927,552	0	Yes (1)	Yes (1)	Yes (1)	$47,003

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	Yes (1)	Yes (1)	Yes (1)	0	0.00100	0.00000	0.00100	0	0	Yes (1)
B	0	0	0		0	0.00000	0.00000	0.00000	0	0	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
(no name)
A	0	0	0	Yes (1)	0	0	0	0	Yes (1)
MORGAN STANLEY
B	0	0	0	Yes (1)	Yes (1)	Yes (1)	0	0	Yes (1)	20.000000000000	0	0

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	3	ContributionCnt
Noncash Contributions Rpt F990	$16,285	NoncashContributionsRptF990Amt
Method Of Determining Revenues	COST OR SELLING PRICE	MethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)

Non Cash CheckboxNonCashCheckboxInd	DescDesc	ContributionContributionCnt	Noncash Contributions Rpt F990NoncashContributionsRptF990Amt	Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)	EVENT SUPPLIES	24	$7,125	COST OR SELLING PRIC
Yes (X)	SEE PART II	6	$7,110	COST OR SELLING PRIC
Yes (X)	AUCTION ITEMS	35	$5,346	COST OR SELLING PRIC

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (1)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, COLUMN (B):	THE NUMBERS REPORTED IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED.
SCHEDULE M, PART I:	LINE 26 : DESCRIPTION - ITEMS FOR PATIENTS / MEMBERS

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (21 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 1:	THE MISSION OF ANNA JAQUES HOSPITAL (AJH OR HOSPITAL) IS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE AND IMPROVE THE HEALTH OF THE COMMUNITY IN ALLIANCE WITH THE MEDICAL STAFF. AJH IS RECOGNIZED FOR DELIVERING HIGH QUALITY COMMUNITY HEALTH CARE AT A LOWER COST, WITH AN EMPHASIS ON PATIENT SATISFACTION. AJH PROVIDES THIS CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. AJH ASPIRES TO BE AMONG THE BEST COMMUNITY HOSPITALS IN EASTERN MASSACHUSETTS.
FORM 990, PART III, LINE 1:	THE MISSION OF ANNA JAQUES HOSPITAL (AJH OR HOSPITAL) IS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE AND IMPROVE THE HEALTH OF THE COMMUNITIES SERVED BY AJH IN ALLIANCE WITH THE AJH MEDICAL STAFF AND AJH AFFILIATES INCLUDING SEACOAST AFFILIATED GROUP PRACTICE AND OTHERS AS NOTED IN THIS FILING. AJH IS RECOGNIZED FOR DELIVERING HIGH QUALITY COMMUNITY HEALTH CARE AT A LOWER COST, WITH AN EMPHASIS ON PATIENT SATISFACTION. AJH PROVIDES THIS CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. AJH ASPIRES TO BE AMONG THE BEST COMMUNITY HOSPITALS IN EASTERN MASSACHUSETTS. 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), THE JOSLIN DIABETES CENTER AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). IN ADDITION, AS OF JULY 1, 2023, BILH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC WHICH IN TURNS SERVES AS THE SOLE MEMBER OF EXETER HOSPITAL. 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 4,800 PHYSICIANS AND 38,000 EMPLOYEES. IN ADDITION TO BEING A MEMBER OF BETH ISRAEL LAHEY HEALTH, ANNA JAQUES HOSPITAL IS ALSO A CLINICAL AFFILIATE AND SISTER ENTITY OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), WHICH IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER AND A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. BIDMC IS EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS RECOGNIZED NATIONALLY FOR THE CLINICAL EXCELLENCE OF ITS FACULTY AND THE PATIENT CARE PROVIDED, AS WELL AS FOR THE MAGNITUDE AND BREADTH OF ITS RESEARCH AND FOR ITS COMMITMENT TO MEDICAL EDUCATION.
FORM 990, PART III, LINE 4A:	OUTPATIENT CLINICS AND SERVICES ANNA JAQUES HOSPITAL PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES ENCOMPASSING GENERAL INTERNAL MEDICINE AND ALL THE SUBSPECIALTIES OF INTERNAL MEDICINE, COVERING THE GAMUT OF SERVICES FROM PRIMARY TO TERTIARY CARE AS WELL AS PROVIDING SURGICAL SERVICES ON AN OUTPATIENT BASIS. THE HOSPITAL'S MEDICAL STAFF BLENDS EXPERIENCED PRIMARY CARE PHYSICIANS AND SPECIALISTS IN A WIDE VARIETY OF DISCIPLINES. THE PRIMARY CARE AND SPECIALISTS AT AJH PROVIDE OUTPATIENT PRIMARY CARE AS WELL AS GASTROINTESTINAL, OPHTHALMOLOGIC, ORTHOPEDIC, CARDIAC, DERMATOLOGIC, UROLOGICAL AND PODIATRIC PROCEDURES, PAIN MANAGEMENT, CARDIAC REHABILITATION, PULMONARY REHABILITATION, DIABETES MANAGEMENT SERVICES, AND NUTRITIONAL COUNSELING. DIAGNOSTIC FACILITIES AT AJH INCLUDE A COMPLETE 24-HOUR LABORATORY AND BLOOD BANKING SERVICES AS WELL AS DIAGNOSTIC IMAGING INCLUDING CT SCANNING, ULTRASOUND, MRI, 3D MAMMOGRAPHY, ULTRASONIC CARDIOGRAPHY, BONE DENSITOMETRY, NUCLEAR MEDICINE, PLAIN FILM RADIOLOGY AND FLUOROSCOPY. THE ANNA JAQUES CANCER CENTER CANCER, AFFILIATED WITH BETH ISRAEL DEACONESS MEDICAL CENTER, PROVIDES A FULL ARRAY OF COMMUNITY-BASED CANCER SERVICES IN NEWBURYPORT AND WHEN NEEDED, ADVANCED TREATMENT OPTIONS AND SPECIALISTS AT BIDMC IN BOSTON. DURING THE FISCAL PERIOD OCTOBER 1, 2022 TO SEPTEMBER 30, 2023, ANNA JAQUES HOSPITAL HAD 215,385 OUTPATIENT ENCOUNTERS. HOSPITAL CLINICS HAD 21,146 VISITS, AND PERFORMED 3,719 ENDOSCOPY PROCEDURES. ONCOLOGY HAD 5,291 VISITS AND 4,429 INFUSIONS. IN ADDITION, AJH OUTPATIENT CARDIOLOGY PHYSICIANS AND PROFESSIONALS PERFORMED 9,705 EKG EXAMS AND ORTHOPEDISTS PERFORMED 933 OUTPATIENT PROCEDURES. AJH GENERAL RADIOLOGY PERFORMED 24,941 OUTPATIENT EXAMS, 15,122 CAT SCAN OUTPATIENT EXAMS, 15,731 OUTPATIENT ULTRASOUND PROCEDURES, 6,919 MRI EXAMS AND 1,026 NUCLEAR MEDICINE TESTS. FINALLY, DURING THE PERIOD COVERED BY THIS FILING AJH PERFORMED 481,013 OUTPATIENT LAB TESTS, AND 19,809 REHABILITATION VISITS. SEE SCHEDULE H FOR ADDITIONAL INFORMATION ON CHARITY CARE AND COMMUNITY BENEFITS.
FORM 990, PART III, LINE 4B:	INPATIENT ANNA JAQUES HOSPITAL (AJH OR HOSPITAL) IS A 119-BED ACUTE CARE HOSPITAL THAT SERVES PATIENTS OF ALL AGES AND SERVES COMMUNITIES IN NORTHERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE. THE HOSPITAL PROVIDES A WIDE RANGE OF INPATIENT CARE INCLUDING MEDICAL SURGICAL SERVICES, OBSTETRICS, INTENSIVE AND CARDIAC CARE AND COMPLETE DIAGNOSTIC FACILITIES. AJH INPATIENT FACILITIES INCLUDE 63 MEDICAL/SURGICAL BEDS AND AN 8 BED INTENSIVE UNIT. THE 12-BED BIRTH CENTER SEES 596 DELIVERIES ANNUALLY AND ALSO SUPPORTS MOTHERS WITH HIGH-RISK PREGNANCIES WITH THE LEVEL IIB NEONATAL CARE CENTER. THE HOSPITAL HAS A SURGICAL SUITE WITH SIX FULLY EQUIPPED OPERATING ROOMS INCLUDING A CARDIAC CATHERIZATION LABORATORY, FOUR AMBULATORY PROCEDURE ROOMS AND A POST-OPERATIVE 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. AJH IS THE ONLY COMMUNITY HOSPITAL IN THE REGION TO PROVIDE INPATIENT PSYCHIATRIC SERVICES TO ADULTS, ADOLESCENTS AND CHILDREN. INPATIENT PSYCHIATRIC CARE AT ANNA JAQUES HOSPITAL PROVIDES SHORT-TERM, ACUTE INPATIENT CARE TO ADULTS AND ADOLESCENTS AGES 16 AND OLDER WITH A BROAD SPECTRUM OF PSYCHIATRIC PROBLEMS. THE INPATIENT PROGRAM IS A 20-BED ACUTE CARE CO-ED UNIT. THE ANNA JAQUES CHILD AND ADOLESCENT PSYCHIATRY PROGRAM PROVIDES STRUCTURED AND SECURE INPATIENT PSYCHIATRIC SERVICES TO CHILDREN AND ADOLESCENTS AGES 4-17. THE 16-BED PROGRAM OFFERS SHORT-TERM INPATIENT TREATMENT AND STABILIZATION. AJH'S SURGEONS PERFORM ORTHOPEDIC PROCEDURES AND IMPLANTS, PLASTIC RECONSTRUCTION, GASTROINTESTINAL, GENERAL SURGICAL (INCLUDING BREAST) GYNECOLOGICAL, OPHTHALMOLOGIC, PODIATRIC, AND UROLOGICAL PROCEDURES. PATIENTS ARE UNDER THE CARE OF THE HOSPITAL'S MEDICAL STAFF, HOSPITALISTS AND/OR GENERAL SURGEONS ALONG WITH NURSES AND PHYSICIAN ASSISTANTS WHO ARE TRAINED IN CARING FOR PATIENTS WITH COMPLEX MEDICAL NEEDS, INCLUDING INTENSIVISTS IN THE ICU. THE NURSING CARE TEAM CONSISTS OF REGISTERED NURSES, SURGICAL TECHNICIANS AND QUALIFIED ANCILLARY PERSONNEL WORKING COLLABORATIVELY WITH SURGICAL AND ANESTHESIA PHYSICIANS. DURING THE PERIOD OCTOBER 1, 2022, TO SEPTEMBER 30, 2023, ANNA JAQUES HOSPITAL HAD 6,173 INPATIENT DISCHARGES WITH 28,650 PATIENT DAYS, AND 700 TOTAL INPATIENT SURGERIES. ADULT PSYCH DAYS WERE 4,883 AND PEDI PSYCH DAYS WERE 3,386
FORM 990, PART III, LINE 4C:	EMERGENCY DEPARTMENT ANNA JAQUES HOSPITAL'S EMERGENCY DEPARTMENT (ED) IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK AND PROVIDES EMERGENCY CARE TO ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE AJH EMERGENCY DEPARTMENT. A HIGHLY TRAINED NURSING STAFF ALSO PROVIDES CARE TO PATIENTS IN THE ED. AJH OPERATES AS A LEVEL III TRAUMA CENTER AND CERTIFIED STROKE CENTER. THE HOSPITAL OPERATES A TELE-STROKE PROGRAM WITH BETH ISRAEL DEACONESS MEDICAL CENTER WHERE NEUROLOGICAL IMAGES CAN BE TRANSMITTED BETWEEN AJH AND BIDMC, MEANING THAT PATIENTS IN THE GREATER NEWBURYPORT AREA HAVE ACCESS TO THE SAME WORLD-CLASS SPECIALISTS AS PATIENTS AT BIDMC IN BOSTON. THE SYSTEM FACILITATES, WHEN NECESSARY, MULTI-DISCIPLINARY EVALUATION OF IMAGES, RESULTING IN IMPROVED TECHNICAL PERFORMANCE AND FEEDBACK AND DIAGNOSES WITH GREATER DIAGNOSTIC ACCURACY. DURING THE FISCAL PERIOD OCTOBER 1, 2022 TO SEPTEMBER 30, 2023, ANNA JAQUES HOSPITAL HAD 24,573 EMERGENCY DEPARTMENT VISITS. IN ADDITION, THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES ENGAGED IN SIGNIFICANT ACTIVITIES SUPPORTING BEHAVIORAL HEALTH IN THE PRIMARY CARE AND OTHER HEALTHCARE SETTINGS AS WELL AS OTHER HEALTHCARE INITIATIVES FOR THE COMMUNITIES SERVED. PLEASE SEE FORM 990 SCHEDULE H FOR ADDITIONAL INFORMATION.
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, 2023. 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 DIRECT OR INDIRECT SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER AND THEIR AFFILIATES. EFFECTIVE JULY 1, 2023, BILH BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND THREE MONTHS OF EHRI'S ACTIVITY AS WELL AS THREE MONTHS OF EHRI'S AFFILIATES' ACTIVITY, INCLUDING EXETER HOSPITAL, ARE INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF BILH AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE THE ACCOUNTS OF, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND HMFP'S AFFILIATES. HMFP AND ITS AFFILIATES ARE INTEGRALLY RELATED TO HELPING BILH, BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES.
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 ANNA JAQUES HOSPITAL, INC. DURING THIS SAME PERIOD, WAS A MEMBER OF THE BILH OBLIGATED GROUP AND ITS TAX-EXEMPT BOND FINANCING WAS ISSUED 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 ANNA JAQUES HOSPITAL INC.'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, 2022 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 ANNA JAQUES HOSPITAL INC BALANCE SHEET, ANNA JAQUES HOSPITAL, INC. IS INCLUDING THIS DISCLOSURE IN ITS FORM 990 BECAUSE ANNA JAQUES HOSPITAL, INC. IS A MEMBER OF THE BILH OBLIGATED GROUP.
FORM 990, PART V, LINE 7G:	ANNA JAQUES HOSPITAL, INC. DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899.
FORM 990, PART V, LINE 7H:	ANNA JAQUES HOSPITAL, INC. 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 TO: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC.(NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF), LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER AND TO AFFILIATES OF THESE ENTITIES. EFFECTIVE JULY 1, 2023, BILH ALSO BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND ITS AFFILIATES', INCLUDING 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 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 AND TO AFFILIATES OF THESE ENTITIES. EFFECTIVE JULY 1, 2023, BILH ALSO BECAME THE SOLE MEMBER OF EXETER HEALTH RESOURCES, INC. (EHRI) AND ITS AFFILIATES', INCLUDING EXETER HOSPITAL. EACH OF THESE AFFILIATES MAY HAVE, IN TURN, SERVED AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE BILH NETWORK OF AFFILIATES.
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 OF ANNA JAQUES HOSPITAL, INC. HAS THE FOLLOWING RIGHTS, AS DESIGNATED IN ANNA JAQUES HOSPITAL, INC.'S BY-LAWS: SUBJECT TO THE PROVISIONS OF THE ARTICLES OF ORGANIZATION AND THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, BOTH POSITIVE AND NEGATIVE, CONFERRED BY MASSACHUSETTS GENERAL LAWS ("M.G.L.") CHAPTER 180, AS AMENDED, ON MEMBERS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. IN ADDITION, EXCEPT AS ARE EXPRESSLY GRANTED TO THE BOARD OF TRUSTEES OF THE CORPORATION ("BOARD") IN THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, POSITIVE AND NEGATIVE, CONFERRED BY M.G.L. CHAPTER 180 ON BOARDS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. NOTWITHSTANDING THE FOREGOING, THE MEMBER MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE BOARD: (A) APPROVE OR REQUIRE ANY CHANGE IN, OR CONSOLIDATION OF PHILANTHROPIC GIFTS, ASSETS, AND PROGRAMS OF THE CORPORATION, WHICH SHALL REMAIN UNDER THE CORPORATION'S CONTROL AND BE USED FOR THE BENEFIT OF THE CORPORATION AND NOT FOR OTHER COMPONENTS OF THE MEMBER'S SYSTEM, EXCEPT TO THE EXTENT THAT SUCH CHANGES INVOLVE BACK-OFFICE CONSOLIDATION WITH OTHER DIRECT OR INDIRECT SUBSIDIARIES OF THE MEMBER; (B) APPROVE OR REQUIRE ANY CHANGE IN THE NAME, BRAND, OR TRADEMARK OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES, EXCEPT SUCH COMPLEMENTARY CHANGES AS THE MEMBER MAY DETERMINE ARE REASONABLY APPROPRIATE IN ESTABLISHING A SYSTEM-WIDE IDENTITY FOR THE AFFILIATED ENTITIES; OR (C) AMEND OR RESTATE THESE BYLAWS TO CHANGE OR ELIMINATE EITHER OF THE FOREGOING LIMITATIONS ON ITS POWERS. FOR THE PERIOD ENDING ON THE THIRD ANNIVERSARY OF THE DATE THE MEMBER BECOMES THE SOLE CORPORATE MEMBER OF THE CORPORATION, THE MEMBER'S AUTHORITY TO CHANGE THE MEDICAL SCHOOL AFFILIATION OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES IS SUBJECT TO THE REQUIREMENT THAT IT OBTAIN THE UNANIMOUS CONSENT OF THE CORPORATION'S DESIGNATED TRUSTEES (AS DEFINED IN THE BYLAWS OF THE MEMBER) AND THE APPROVAL OF THE MEMBER'S BOARD OF TRUSTEES (THE "MEMBER'S BOARD"). THE MEMBER MAY NOT CAUSE THE CORPORATION TO CEASE OPERATING A SEPARATELY LICENSED HOSPITAL FACILITY, OR CLOSE ANY ESSENTIAL SERVICE OF SUCH HOSPITAL FACILITY, WITHOUT CONSULTING WITH THE BOARD PRIOR TO TAKING SUCH ACTION. THE POWERS AND RESPONSIBILITIES OF THE BOARD INCLUDE THE FOLLOWING: (A) PROVIDING RECOMMENDATIONS TO THE MEMBER REGARDING (I) APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES, (II) THE ESTABLISHMENT OF THE CORPORATION'S POLICIES, (III) THE MAINTENANCE OF PATIENT CARE QUALITY, AND (IV) THE PROVISION OF CLINICAL SERVICES AND COMMUNITY SERVICE PLANNING IN A MANNER RESPONSIVE TO LOCAL COMMUNITY NEEDS; (B) ENSURING COMPLIANCE WITH ALL LICENSURE AND ACCREDITATION REQUIREMENTS, INCLUDING CREDENTIALING AND OTHER MEDICAL STAFF MATTERS; (C) PROVIDING OVERSIGHT FOR INSTITUTIONAL PLANNING, MAKING RECOMMENDATIONS FOR NEW CLINICAL SERVICES, AND PARTICIPATING IN AN ANNUAL REVIEW OF THE CORPORATION'S STRATEGIC AND FINANCIAL PLAN AND GOALS; (D) REVIEWING AND RECOMMENDING APPROVAL OF OPERATING AND CAPITAL BUDGETS AS WELL AS MAKING RECOMMENDATIONS WITH RESPECT TO CAPITAL EXPENDITURES; (E) MAKING RECOMMENDATIONS WITH RESPECT TO QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS; (F) PROVIDING OVERSIGHT OF RISK MANAGEMENT PROGRAMS RELATING TO PATIENT CARE AND SAFETY; (G) REVIEWING DISASTER PLANS THAT DEAL WITH BOTH INTERNAL (E.G., FIRE) AND EXTERNAL DISASTERS; AND (H) EVALUATING RECRUITMENT NEEDS TO ENSURE ADEQUATE MEDICAL STAFF CAPACITY TO CONTINUE TO MEET COMMUNITY NEEDS. EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, THE BOARD SHALL ACT IN AN ADVISORY CAPACITY AND CONSISTENT THEREWITH SHALL HAVE ONLY THE FOLLOWING POWERS: (A) POWERS EXPRESSLY GRANTED BY THE MEMBER FROM TIME TO TIME; (B) POWER TO EXERCISE ITS AUTHORITY AS A MEMBER OF OTHER CORPORATIONS; (C) POWER TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THE BYLAWS OF THE MEMBER (AS DEFINED UNDER THE BYLAWS OF THE MEMBER) OR UNDER THESE BYLAWS WITH RESPECT TO THE MEMBER; AND (D) POWERS TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THAT AGREEMENT DATED JUNE 30, 2017 BY AND AMONG LAHEY HEALTH SYSTEM, INC., BETH ISRAEL DEACONESS MEDICAL CENTER, INC., NEW ENGLAND BAPTIST HOSPITAL, INC., MOUNT AUBURN HOSPITAL, CAREGROUP, INC., AND SEACOAST REGIONAL HEALTH SYSTEMS, INC. THE POWERS OF THE BOARD IN CLAUSES (A) AND (B) OF THE PRECEDING SENTENCE SHALL BE SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. THE POWERS OF THE BOARD IN CLAUSE (C) AND (D) OF THE FIRST SENTENCE OF THIS PARAGRAPH SHALL BE INDEPENDENT OF THE MEMBER AND NOT SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. NOTWITHSTANDING CLAUSE (B) ABOVE, THE POWER OF THE CORPORATION TO EXERCISE ITS AUTHORITY AS A MEMBER OF ANOTHER CORPORATION SHALL BE SUBJECT TO THE FOLLOWING LIMITATIONS: (X) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED BY THE CORPORATION ONLY AT THE EXPRESS AND EXPLICIT DIRECTION OF, AND WITH THE APPROVAL OF, THE MEMBER; (Y) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED DIRECTLY BY THE MEMBER AFTER CONSULTATION WITH THE CHAIR BUT OTHERWISE WITHOUT THE APPROVAL OR PARTICIPATION OF THE CORPORATION; AND (Z) OTHER THAN STATUTORY POWERS, THE CORPORATION SHALL HAVE ONLY THOSE POWERS AND AUTHORITIES OVER AND WITH RESPECT TO THE CORPORATIONS OF WHICH IT IS A MEMBER AS ARE EXPRESSLY AND EXPLICITLY DELEGATED OR DIRECTED TO THE CORPORATION BY ACTION OF THE MEMBER'S BOARD.
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 ANNA JAQUES HOSPITAL, INC. 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 ANNA JAQUES HOSPITAL, INC. 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. ANNA JAQUES HOSPITAL, INC.'S FORM 990 IS REVIEWED INTERNALLY BY THE BILH ASSISTANT VICE PRESIDENT, TAXATION AND EXTERNALLY BY DELOITTE. ANNA JAQUES HOSPITAL, INC.'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 ANNA JAQUES HOSPITAL, INC.'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, ANNA JAQUES HOSPITAL, INC. 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 ANNA JAQUES HOSPITAL, INC. 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 ANNA JAQUES HOSPITAL, INC. BOARD OF TRUSTEES AS WELL AS FORMER OFFICERS AND KEY EMPLOYEES. THE COI-TQ PROCESS IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR ANNA JAQUES HOSPITAL, INC. 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, ANNA JAQUES HOSPITAL, INC. IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS ANNA JAQUES HOSPITAL, INC.'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 ANNA JAQUES HOSPITAL, INC.'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, ANNA JAQUES HOSPITAL, INC. IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS ANNA JAQUES HOSPITAL, INC.'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. ANNA JAQUES HOSPITAL, INC.'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 IX, LINE 11G	PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 9,150,602. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,150,602. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 5,396,762. MANAGEMENT AND GENERAL EXPENSES 419,259. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,816,021. PSYCH & LITHROTRIPSY SERVICES: PROGRAM SERVICE EXPENSES 3,812,867. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,812,867. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,683,682. MANAGEMENT AND GENERAL EXPENSES 130,801. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,814,483. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 1,446,739. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,446,739. MISC SVCS PROVIDED BY AFFILIATES: PROGRAM SERVICE EXPENSES 955,566. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 955,566. LAUNDRY AND LINEN: PROGRAM SERVICE EXPENSES 572,369. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 572,369. MAINTENANCE EXPENSE: PROGRAM SERVICE EXPENSES 385,494. MANAGEMENT AND GENERAL EXPENSES 29,948. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 415,442. OTHER IMAGING SERVICES: PROGRAM SERVICE EXPENSES 295,742. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 295,742. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 212,879. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 212,879. OTHER MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 211,555. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 211,555. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 180,681. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 180,681. RECRUITMENT: PROGRAM SERVICE EXPENSES 38,389. MANAGEMENT AND GENERAL EXPENSES 2,982. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,371. TRANSPORTATION SERVICES CLIENT: PROGRAM SERVICE EXPENSES 37,866. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,866. INTERPRETER SERVICES: PROGRAM SERVICE EXPENSES 14,156. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,156. SECURITY: PROGRAM SERVICE EXPENSES 4,998. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,998. CONTRACT SERVICES SHARED: PROGRAM SERVICE EXPENSES 2,856. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,856.
FORM 990, PART XI, LINE 9:	NET ASSET RELEASE FROM RESTRICTIONS 564,659. NET ASSETS RELEASED FOR CAPITAL 101,332. TRUSTS TRUE-UP & OTHER ADJUSTMENTS 131,085. PENSION EXPENSE -1,138,831. CHANGE IN FUNDED STATUS OF BENEFITS PLANS 4,260,047. OTHER 11,762.
FORM 990, PART XII, LINE 2C:	AS NOTED THROUGHOUT THIS FORM 990, ANNA JAQUES HOSPITAL, INC. 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 ANNA JAQUES HOSPITAL, INC. AND ANNA JAQUES HOSPITAL, INC. 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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (66 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
ADDISON GILBERT SOCIETY INC
529 MAIN ST 4TH FL	CHARLESTOWN	MA	02129	464371382	PROFESSIONAL SERVICES & FINANCIAL SUPPORT	MA	501(C)(3)	LINE 10	LAHEY HEALTH SHARED SERVICES INC	Yes (1)
ANNA JAQUES HOSPITAL
25 HIGHLAND AVE	NEWBURYPORT	MA	01950	042104338	HEALTHCARE	MA	501(C)(3)	LINE 3	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
ASSOC PHYS HARVARD MED FAC PHY AT BIDMC
375 LONGWOOD AVE	BOSTON	MA	02215	320058309	TO PROVIDE EMERGENCY MEDICAL SERVICES	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BAIM INSTITUTE FOR CLINICAL RESEARCH INC DBA BAIM INSTITUTE
930 COMMONWEALTH AVE	BOSTON	MA	02215	043521077	SCIENTIFIC & MEDICAL RESEARCH	MA	501(C)(3)	LINE 7		0	N/A
BETH ISRAEL ANAESTHESIA FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	042997215	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BETH ISRAEL COMMUNITY FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	042776678	INACTIVE CORPORATION	MA	501(C)(3)	LINE 7		0	N/A
BETH ISRAEL DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	364803234	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	043079630	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	208253452	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BETH ISRAEL DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	043030397	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BETH ISRAEL DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	204974585	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BETH ISRAEL DEACONESS DEPARTMENT OF RADIATION ONCOLOGY FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	873655583	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HMFP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC
110 FRANCIS ST	BOSTON	MA	02215	020671240	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BETH ISRAEL DEACONESS HOSPITAL MILTON INC
199 REEDSDALE RD	MILTON	MA	02186	042103604	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	LINE 3	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
BETH ISRAEL DEACONESS HOSPITAL NEEDHAM INC
148 CHESTNUT ST	NEEDHAM	MA	02492	043229679	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	LINE 3	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH INC
275 SANDWICH ST	PLYMOUTH	MA	02360	222667354	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	LINE 3	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
BETH ISRAEL DEACONESS MEDICAL CENTER INC
330 BROOKLINE AVE	BOSTON	MA	02215	042103881	THE OPERATION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA	MA	501(C)(3)	LINE 3	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
BETH ISRAEL DERMATOLOGY FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	043117601	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BETH ISRAEL LAHEY HEALTH PHARMACY INC
80 WILSON WAY	WESTWOOD	MA	02090	822526816	TO OPERATE A SPECIALTY PHARMACY AND 340B PROGRAM FOR BIDMC	MA	501(C)(3)	LINE 10	BETH ISRAEL DEACONESS MEDICAL CENTER INC	Yes (1)
BETH ISRAEL LAHEY HEALTH PRIMARY CARE
529 MAIN ST 4TH FL	CHARLESTOWN	MA	02129	472248298	HEALTHCARE	MA	501(C)(3)	LINE 10	LAHEY HEALTH SHARED SERVICES INC	Yes (1)
BETH ISRAEL LAHEY HEALTH INC
529 MAIN ST 4TH FL	CHARLESTOWN	MA	02129	832671600	MANAGEMENT PROFESSIONAL & IT SUPPORT SERVICES	MA	501(C)(3)	LINE 12C, III-FI		0	N/A
BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP
300 LONGWOOD AVE	BOSTON	MA	02215	043200113	OUTPATIENT AMBULATORY CENTER - INACTIVE	MA	501(C)(3)	LINE 12A, I		0	N/A
BIDMC OBSTETRICS AND GYNECOLOGY FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	042794855	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BID-MILTON PHYSICIAN ASSOCIATES INC
199 REEDSDALE ROAD	MILTON	MA	02186	222566792	PROMOTE HEALTHCARE	MA	501(C)(3)	LINE 10	BETH ISRAEL DEACONESS HOSPITAL - MILTON	Yes (1)
BIH PATHOLOGY FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	222548374	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
BIH RADIOLOGIC FOUNDATION INC
330 BROOKLINE AVE	BOSTON	MA	02215	042571853	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
CAB HEALTH AND RECOVERY SERVICES INC
199 ROSEWOOD DRIVE	DANVERS	MA	01923	042400270	SUBSTANCE ABUSE - INACTIVE	MA	501(C)(3)	LINE 10	NORTHEAST BEHAVIORAL HEALTH CORPORATION	Yes (1)
COMMUNITY PHYSICIANS ASSOCIATES INC
199 REEDSDALE RD	MILTON	MA	02186	043243146	OUTPATIENT AND PRIMARY CARE SERVICES	MA	501(C)(3)	LINE 3	BETH ISRAEL DEACONESS HOSPITAL - MILTON	Yes (1)
CONTINUING EDU PROGRAM DBA BID DEPT OF PSYCH FDN
375 LONGWOOD AVE	BOSTON	MA	02215	043242952	SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
CORE PHYSICIANS LLC
5 ALUMNI DRIVE	EXETER	MA	03833	870807914	PHYSICIAN PRACTICES	MA	501(C)(3)	LINE 10	EXETER HEALTH RESOURCES INC	Yes (1)
CPHCH INC DBA BILH AT HOME - WATERTOWN
C/O NRPN 600 CUMMINGS CTR	BEVERLY	MA	01915	473111453	HOME CARE & HOSPICE - INACTIVE	MA	501(C)(3)	LINE 12A, I	NORTHEAST SENIOR HEALTH CORPORATION	Yes (1)
EXETER HEALTH RESOURCES SELF-INSURANCE TRUST
5 ALUMNI DRIVE	EXETER	MA	03833	200753662	SELF-INSURANCE TRUST	MA	501(C)(3)	LINE 12A, I	EXETER HEALTH RESOURCES INC	Yes (1)
EXETER HEALTH RESOURCES INC
5 ALUMNI DRIVE	EXETER	MA	03833	020222126	SUPPORT COMMUNITY HEALTH & NETWORK MGMT SVCS	MA	501(C)(3)	LINE 12A, I	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
EXETER HOSPITAL
5 ALUMNI DRIVE	EXETER	MA	03833	222674014	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS.	MA	501(C)(3)	LINE 3	EXETER HEALTH RESOURCES INC	Yes (1)
EXETER MED REAL INC
5 ALUMNI DRIVE	EXETER	MA	03833	020418718	REAL ESTATE HOLDING COMPANY	MA	501(C)(25)		EXETER HEALTH RESOURCES INC	Yes (1)
HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC
375 LONGWOOD AVE	BOSTON	MA	02215	222768204	GENERAL AND SPECIALIZED MEDICAL SERVICES TO THE PATIENTS OF BIDMC AND OTHERS	MA	501(C)(3)	LINE 10	BETH ISRAEL DEACONESS MEDICAL CENTER INC	Yes (1)
HEALTH AND EDUCATION HOUSING SERVICES INC
199 ROSEWOOD DRIVE	DANVERS	MA	01923	223232914	HUD HOUSING - INACTIVE	MA	501(C)(3)	LINE 10	NORTHEAST BEHAVIORAL HEALTH CORPORATION	Yes (1)
JORDAN PHYSICIAN ASSOCIATES INC
275 SANDWICH ST	PLYMOUTH	MA	02360	043228556	OUTPATIENT AND PRIMARY CARE SERVICES	MA	501(C)(3)	LINE 10	BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC	Yes (1)
JOSLIN CLINIC INC
ONE JOSLIN PLACE	BOSTON	MA	02215	222984590	PREVENTION, TREATMENT, AND CURE OF DIABETES	MA	501(C)(3)	LINE 12A, I	JOSLIN DIABETES CENTER INC	Yes (1)
JOSLIN DIABETES CENTER INC
ONE JOSLIN PLACE	BOSTON	MA	02215	042203836	PREVENTION, TREATMENT, AND CURE OF DIABETES	MA	501(C)(3)	LINE 7	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
LAHEY CLINIC CANADIAN FOUNDATION
					FUNDRAISING ORG					0	N/A	130 KING ST WEST	TORONTO	ONTARIO	CA	CA
LAHEY CLINIC FOUNDATION INC
529 MAIN ST 4TH FL	CHARLESTOWN	MA	02129	042323457	FINANCIAL & OPERATIONAL SUPPORT TO LCI AND LCH	MA	501(C)(3)	LINE 7	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
LAHEY CLINIC HOSPITAL INC DBA LAHEY HOSPITAL & MEDICAL CENTER AND LMC
529 MAIN ST 4TH FL	CHARLESTOWN	MA	02129	042704686	HEALTHCARE	MA	501(C)(3)	LINE 3	LAHEY CLINIC FOUNDATION INC	Yes (1)
LAHEY CLINIC INC
529 MAIN ST 4TH FL	CHARLESTOWN	MA	02129	042704683	HEALTHCARE	MA	501(C)(3)	LINE 10	LAHEY CLINIC FOUNDATION INC	Yes (1)
LAHEY HEALTH SHARED SERVICES INC
529 MAIN ST 4TH FL	CHARLESTOWN	MA	02129	043178972	ADMIN	MA	501(C)(3)	LINE 10	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
LONGWOOD MEDICAL ENERGY COLLABORATIVE INC
375 LONGWOOD AVE	BOSTON	MA	02215	043476764	COORDINATE AND PROVIDE STRATEGIC PLANNING OPP FOR HMS	MA	501(C)(3)	LINE 12A, I		0	N/A
LONGWOOD MEDICAL INTERNATIONAL FOUNDATION INC
375 LONGWOOD AVE	BOSTON	MA	02215	043208878	INACTIVE CORPORATION	MA	501(C)(3)	LINE 12A, I	HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER	Yes (1)
MED CARE OF BOSTON MGMT CORP DBA BILH PRIMARY CARE
464 HILLSIDE AVE	NEEDHAM	MA	02494	042810972	OUTPATIENT, PRIMARY CARE AND SPECIALTY SERVICES	MA	501(C)(3)	LINE 10	BETH ISRAEL LAHEY HEALTH PRIMARY CARE	Yes (1)
MOUNT AUBURN HOSPITAL
330 MOUNT AUBURN ST	CAMBRIDGE	MA	02138	042103606	HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS	MA	501(C)(3)	LINE 3	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
MOUNT AUBURN PROFESSIONAL SERVICES INC
330 MOUNT AUBURN ST	CAMBRIDGE	MA	02138	043026897	OFFERING MEDICAL CARE IN GENERAL AND SPECIALIZED PRACTICES	MA	501(C)(3)	LINE 12A, I	MOUNT AUBURN HOSPITAL	Yes (1)
NEW ENGLAND BAPTIST HOSPITAL
125 PARKER HILL AVE	BOSTON	MA	02120	042103612	ORTHOPEDIC SPECIALTY HOSPITAL	MA	501(C)(3)	LINE 3	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
NEW ENGLAND BAPTIST MEDICAL ASSOCIATES INC
125 PARKER HILL AVE	BOSTON	MA	02120	043235796	OUTPATIENT MEDICAL SERVICES TO THE VARIOUS COMMUNITIES SERVICED BY NEBH	MA	501(C)(3)	LINE 3	NEW ENGLAND BAPTIST HOSPITAL	Yes (1)
NORTHEAST BEHAVIORAL HEALTH CORP DBA BILH BEHAVIORAL HEALTH SERVICES
199 ROSEWOOD DRIVE	DANVERS	MA	01923	042777145	HEALTHCARE	MA	501(C)(3)	LINE 10	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
NORTHEAST HEALTH SYSTEMS INC
85 HERRICK ST	BEVERLY	MA	01915	043240453	FINANCIAL & OPERATIONAL SUPPORT	MA	501(C)(3)	LINE 12B, II	LAHEY HEALTH SHARED SERVICES INC	Yes (1)
NORTHEAST HOSPITAL CORPORATION
85 HERRICK ST	BEVERLY	MA	01915	042121317	HEALTHCARE	MA	501(C)(3)	LINE 3	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
NORTHEAST MEDICAL PRACTICE INC
85 HERRICK ST	BEVERLY	MA	01915	043201853	HEALTHCARE	MA	501(C)(3)	LINE 10	NORTHEAST HOSPITAL CORPORATION	Yes (1)
NORTHEAST PROFESSIONAL REGISTRY OF NURSES INC DBA BILH AT HOME
800 CUMMINGS CENTER	BEVERLY	MA	01915	201287349	HEALTHCARE	MA	501(C)(3)	LINE 10	NORTHEAST SENIOR HEALTH CORPORATION	Yes (1)
NORTHEAST SENIOR HEALTH CORPORATION
85 HERRICK ST	BEVERLY	MA	01915	042731137	HEALTHCARE	MA	501(C)(3)	LINE 10	LAHEY HEALTH SHARED SERVICES INC	Yes (1)
ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE
5 ALUMNI DRIVE	EXETER	MA	03833	020274905	HOME CARE & HOSPICE	MA	501(C)(3)	LINE 10	EXETER HEALTH RESOURCES INC	Yes (1)
SEACOAST AFFILIATED GROUP PRACTICE INC
25 HIGHLAND AVE	NEWBURYPORT	MA	01915	043485648	PHYSICIAN GROUP	MA	501(C)(3)	LINE 10	ANNA JAQUES HOSPITAL INC	Yes (1)
SEACOAST NURSING AND REHABILITATION CENTER INC
300 WASHINGTON ST	GLOUCESTER	MA	01930	041305001	HEALTHCARE	MA	501(C)(3)	LINE 10	LAHEY HEALTH SHARED SERVICES INC	Yes (1)
THE JORDAN HEALTH SYSTEMS INC
275 SANDWICH ST	PLYMOUTH	MA	02360	042103805	PROMOTE HEALTHCARE	MA	501(C)(3)	LINE 7	BETH ISRAEL DEACONESS MEDICAL CENTER INC	Yes (1)
WINCHESTER COMMUNITY ACCOUNTABLE CARE ORGANIZATION INC
41 HIGHLAND AVE	WINCHESTER	MA	01890	223137856	ACO - INACTIVE	MA	501(C)(3)	LINE 12A, I	WINCHESTER HEALTHCARE MANAGEMENT INC	Yes (1)
WINCHESTER HEALTHCARE MANAGEMENT INC
41 HIGHLAND AVE	WINCHESTER	MA	01890	222701817	MANAGEMENT	MA	501(C)(3)	LINE 12A, I	LAHEY HEALTH SHARED SERVICES INC	Yes (1)
WINCHESTER HOSPITAL
41 HIGHLAND AVE	WINCHESTER	MA	01890	042104434	HEALTHCARE	MA	501(C)(3)	LINE 3	BETH ISRAEL LAHEY HEALTH INC	Yes (1)
WINCHESTER HOSPITAL FOUNDATION INC
41 HIGHLAND AVE	WINCHESTER	MA	01890	043399570	PROFESSIONAL SERVICES & FINANCIAL SUPPORT	MA	501(C)(3)	LINE 12A, I	WINCHESTER HEALTHCARE MANAGEMENT INC	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	OwnershipOwnershipPct	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt
BETH ISRAEL LAHEY HEALTH SURGERY CENTER PLYMOUTH LLC
41 RESNIK ROAD	PLYMOUTH	MA	02360	883871838	SURGERY CENTER	MA	N/A	0	0
BIDCO HOSPITAL LLC
247 STATION DRIVE NORTHWEST 1	WESTWOOD	MA	02090	461643790	COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC	MA		0	0	BETH ISRAEL DEACONESS MEDICAL CENTER INC	EXCLUDED	0.09300
BIDCO PHYSICIAN LLC
600 UNICORN PARK DRIVE 4TH FL	WOBURN	MA	01801	461589743	COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BILH	MA	N/A	0	0
BILH INVESTMENT PARTNERSHIP LLP
529 MAIN ST 4TH FL	CHARLESTOWN	MA	02129	043278109	INVESTMENT PARTNERSHIP	MA	N/A	0	0
NEBSC HOSPITAL HOLDINGS LLC
125 PARKER HILL AVE	BOSTON	MA	02120	874293833	INVESTMENT PARTNERSHIP	MA	N/A	0	0
NEW ENGLAND BAPTIST SURGERY CENTER LLC
100 AVON MEADOW LANE	AVON	CT	06001	874311329	AMBULATORY SURGERY CENTER	MA	N/A	0	0
PHYSICIANS PROFESSIONAL SERVICES LLP
200 RIVERS EDGE DRIVE	MEDFORD	MA	02155	043275078	TO PROVIDE MEDICAL BILLING SERVICES	MA	N/A	0	0
SHIELDS IMAGING AT ANNA JAQUES HOSPITAL LLC
700 CONGRESS ST STE 204	QUINCY	MA	02169	383989358	MRI SERVICES	MA		0	0	ANNA JAQUES HOSPITAL INC	EXCLUDED	0.65810	$756,230	$1,673,135
WINCHESTER HOSPITALSHIELDS MRI LLC
700 CONGRESS ST STE 204	QUINCY	MA	02169	462523117	MRI SERVICES	MA	N/A	0	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
GREATER NEWBURYPORT MANAGEMENT SERVICES ORGANIZATION INC
25 HIGHLAND AVE	NEWBURYPORT	MA	01950	161744477	MANAGEMENT SERVICES	MA	ANNA JAQUES HOSPITAL INC	C	$666,351	1.00000	Yes (1)
HUNTINGFIELD CORPORATION
C/O LCF 529 MAIN ST 4TH FL	CHARLESTOWN	MA	02129	454047430	TO HOLD OWNERSHIP OF SUBTERRANEAN RIGHTS	DE		C			0	N/A
LAHEY CLINIC INSURANCE CO LTD
					INSURANCE			C			0	N/A	CRAIG APPIN HOUSE PO BOX HM 2450	HAMILTON	BD	BD
LEDGEWOOD HEALTH CARE CORPORATION
87 HERRICK STREET	BEVERLY	MA	01915	042855189	NURSING HOME	MA		C			0	N/A
NORTHEAST PROPRIETARY CORP
85 HERRICK STREET	BEVERLY	MA	01915	042855191	MEDICAL SERVICES	MA		C			0	N/A
WINCHESTER HEALTHCARE ENTERPRISES INC
41 HIGHLAND AVE	WINCHESTER	MA	01890	042932059	MANAGEMENT SERVICES	MA		C			0	N/A
WINCHESTER PHYSICIAN ASSOCIATES INC
41 HIGHLAND AVE	WINCHESTER	MA	01890	043262963	MANAGEMENT SERVICES	MA		C			0	N/A
WINCHESTER PHYSICIAN HOSPITAL ORGANIZATION INC
41 HIGHLAND AVE	WINCHESTER	MA	01890	472646454	INACTIVE	MA		C			0	N/A

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
BETH ISRAEL LAHEY HEALTH
M	$14,611,925	FMV
BETH ISRAEL LAHEY HEALTH
O	$5,587,574	FMV
BETH ISRAEL LAHEY HEALTH
R	$122,923,915	FMV
BETH ISRAEL LAHEY HEALTH
S	$71,958,703	FMV
BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK LLC
O	$498,939	FMV
HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER
M	$7,427,389	FMV
NORTHEAST BEHAVIORAL HEALTH CORPORATION
M	$626,169	FMV
NORTHEAST BEHAVIORAL HEALTH CORPORATION
P	$577,787	FMV