2023-08-15T13:29:47-05:00 2022-09-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2021-10-01 043229679 BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM INC BETH 7814533000 148 CHESTNUT STREET NEEDHAM MA 02492 CINDY RIOS TREASURER, BETH ISRAEL LAHEY HEALTH 7817448924 2023-08-14 0 CINDY RIOS XXX-XX-XXXX KENDALL SCHNURPEL P01478462 3174648600 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z CINDY RIOS 148 CHESTNUT STREET NEEDHAM MA 02492 139376774 0 X WWW.BIDNEEDHAM.ORG X 1994 MA SEE SCHEDULE O 22 19 961 19 -15070 0 5888241 4200780 119541878 131850835 1073401 656855 373517 2229521 126877037 138937991 0 0 0 0 61639138 70021045 14348 0 0 58989241 63750351 120642727 133771396 6234310 5166595 170627277 166387328 106610825 95919154 64016452 70468174 X SEE SCHEDULE O 0 0 112379758 134202433 SEE SCHEDULE O SEE SCHEDULE O SEE SCHEDULE O 112379758 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 1 1 0 0 1 X 232 0 1 961 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 22 19 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 FL IL MA NH NY RI X KAREN WOLFSON AVP TAXATION 7817448924 BILH SCHRAFFTS CITY CTR 4TH FL 529 CHARLESTOWN MA 02129 LEVINE BRUCE TRUSTEE 1.00 0.00 X 0 0 0 MEDALIE LESLIE TRUSTEE 1.00 0.00 X 0 0 0 KIERSTEAD JANA TRUSTEE 1.00 0.00 X 0 0 0 BARABINO GILDA TRUSTEE 1.00 0.00 X 0 0 0 FINE GAIL H TRUSTEE 1.00 0.00 X 0 0 0 DEAMORE DENISE TRUSTEE 1.00 0.00 X 0 0 0 COFFMAN BARRY TRUSTEE 1.00 0.00 X 0 0 0 CHAMOUN NASSIB TRUSTEE 1.00 0.00 X 0 0 0 AUTH JOSEPH TRUSTEE 1.00 0.00 X 0 0 0 ANTIN FRANCIS TRUSTEE 1.00 0.00 X 0 0 0 BUCKLE MD DAVID TRUSTEE 1.00 55.00 X 0 294641 46761 FLEMING PAUL TRUSTEE 1.00 0.00 X 0 0 0 ROWAN MICHAEL TTEE (EX-OFF); BILH EVP, HOSP & AMB 1.00 64.00 X 0 2019307 36905 TROTMAN BURMAN SAMANTHA TRUSTEE (EX-OFF), CHAIR BRD OF ADV 1.00 0.00 X 0 0 0 RILEY MD ANNE TRUSTEE (EX-OFF), PRES MED STAFF 1.00 0.00 X 0 0 0 ULLMAN SONAL TRUSTEE (EX-OFF), PRES MED STAFF 1.00 0.00 X 0 0 0 KANNAM MD JOSEPH TRUSTEE AND CARDIOLOGIST 1.00 55.00 X 0 452422 71420 POPEO PAUL D TRUSTEE 1.00 0.00 X 0 0 0 COUGHLIN JAMES C TRUSTEE 1.00 0.00 X 0 0 0 MARINO ROGER TRUSTEE 1.00 0.00 X 0 0 0 CARNAHAN VIRGINIA TRUSTEE, CHAIR 1.00 0.00 X X 0 0 0 FOGARTY JOHN PRESIDENT, TRUSTEE (EX-OFFICIO) 1.00 0.00 X X 0 0 0 SONTAG ESQ DAVID ASSISTANT CLERK EX OFFICIO 1.00 3.00 X 0 0 0 KERNDL JOHN TREASURER (EX-OFFICIO) 1.00 64.00 X 0 1365000 26877 VAZ ESQ BRIAN ASST CLERK (EX-OFF), ASST GC, BILH 1.00 0.00 X 0 0 0 SMITH MBA BRIAN ASST. TREASURER (EX-OFFICIO), CFO 60.00 0.00 X 0 0 0 HOFFMANN NANCY ASST. TREASURER (EX-OFFICIO), CFO 55.00 0.00 X 377536 0 21313 TABB MD KEVIN CHIEF EXECUTIVE OFFICER (EX-OFFICIO) 1.00 64.00 X 0 5034628 296171 KATZ ESQ JAMIE CLERK (EX-OFFICIO) 1.00 64.00 X 0 1255848 22043 WELCH JULIE A VP, HUMAN RESOURCES BUSINESS PARTNER 55.00 0.00 X 219034 0 26394 MCSWEENEY MD GREGORY SVP, CMO 55.00 0.00 X 428336 0 12222 DAVIDSON RN KATHLEEN SVP, CNO, COO 55.00 0.00 X 358308 0 37895 PIATELLI LUANNE CLINICAL NURSE II 55.00 0.00 X 199007 0 36872 SWANSON SHIRLEY MRI TECHNICIAN 55.00 0.00 X 198319 0 15233 BURKE ROBERT PHYSICIAN ASSISTANT 55.00 0.00 X 283321 0 35327 BERNARD LOUISE REGISTERED NURSE 55.00 0.00 X 181262 0 36403 ALPERT HEIDI SR DIRECTOR, CLIN SERV 55.00 0.00 X 181395 0 30951 FISCHER STEVEN P FORMER TREASURER (EX-OFFICIO) 0.00 0.00 X 0 974820 47235 2426518 11396666 800022 9 1 1 0 BOND BUILDING CONSTRUCTION INC 10 CABOT RD SUITE 300 MEDFORD MA 02155 CONTRACTOR SERVICES 2365788 CARDINAL HEALTH 110 LLC CO BOA LOCKBOX 3763 COLLECTION CEN CHICAGO IL 60693 MEDICAL SERVICES 1892288 CARDINAL HEALTH MEDICAL PRODUCTS SERVICES PO BOX NEWARK NJ 071880862 MEDICAL SERVICES 1716247 NEUROCARE INC 135 SOUTH LASALLE ST DEPT 2879 CHICAGO IL 606742879 MEDICAL SERVICES 1475482 CARDINAL HEALTHCAREALLEGIANCE 20 WIGGINS AVE BEDFORD MA 01730 MEDICAL SERVICES 1469976 94 394615 621934 3184231 4200780 OUTPATIENT SERVICES 621400 90637659 90637659 INPATIENT SERVICES 621110 41213176 41213176 131850835 438109 -39884 477993 133886 122498 11388 11388 11388 229981 11235 218746 218746 13426 205320 171585 394615 305050 -133465 -133465 REBATES 900099 526464 526464 DEFERRED REVNUE 900099 505344 505344 CAFETERIA SALES 812930 249162 249162 1070628 1070628 2351598 138937991 134202433 -15070 549848 X 1481038 1350727 130311 57104948 52080489 5024459 1304184 1176562 127622 5963786 5380194 583592 4167089 3759314 407775 7320591 354895 6965696 -22937 -22937 51405 51405 16436037 15287389 1148648 23798112 20478435 3319677 5211500 1713276 3498224 18410 13551 4859 13483 11584 1899 2001262 2001262 8549516 8549516 183899 155923 27976 DUES 189073 66641 122432 133771396 112379758 21391638 0 12502937 6745000 7656344 2008920 2008920 12428936 14196845 2470983 2184252 648779 529471 193986380 85139536 109253107 108846844 13079663 10625881 7608071 24219652 170627277 166387328 11552624 12220610 16676499 16160743 56815801 54066869 21565901 13470932 106610825 95919154 X 53508837 58349588 10507615 12118586 64016452 70468174 170627277 166387328 X 5166595 -870956 2156083 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 51405 51405 0 PART II-B, LINE 1: BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 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 $51,405 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES. 10507618 3674816 -339595 1724249 12118590 6617242 5393917 733262 2236807 10507614 8114437 849856 57581 2404632 6617242 6910189 2208834 61472 1066058 8114437 5315979 2779098 103582 1288470 6910189 0.37400 0.62600 0 0 3641800 3641800 114011318 114011318 1763449 1763449 67071335 67071335 7498478 85139536 -77641058 108846844 MALPRACTICE INS REC 4312705 OTHER ACCOUNT RECEIVABLES 17756593 RIGHT-OF-USE OPERATING LEASE ASSETS 1861659 OTHER A/R 288695 24219652 THIRD PARTY PAYORS SETTLEMENTS 524115 DUE TO AFFILIATES 6772453 ACC UNPAID MALPRACTICE LOSSES 4312705 OPERATING LEASE OBLIGATIONS 1861659 13470932 X 6825322000 -756358 6690213586 6689457228 135864772 3073219 3073219 138937991 7267359000 7133587604 7133587604 133771396 0 133771396 PART V, LINE 4: TO BE USED FOR HOSPITAL CLINICAL PROGRAMS PART X, LINE 2: BETH ISRAEL LAHEY HEALTH, INC., WHICH SERVES AS THE PARENT OF THE SYSTEM, HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE AN ORGANIZATION DESCRIBED UNDER INTERNAL REVENUE CODE (THE "CODE") SECTION 501(C)(3) AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ALSO DETERMINED THAT THE OTHER ENTITIES IN THE SYSTEM, EXCLUDING ITS FOR-PROFIT SUBSIDIARIES, QUALIFY AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, MEET THE CODE'S REQUIREMENTS UNDER SECTION 509(A), AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION HAS BEEN RECORDED FOR INCOME TAXES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, RESPECTIVELY. PART XI, LINE 2D - OTHER ADJUSTMENTS: CONSOLIDATED AFFILIATES NET ELIMINATIONS 6,689,318,079. NET ASSETS RELEASED FROM RESTRICTIONS FOE OPERATIONS 895,507. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS 3,016,933. RESTRICTED REVENUE 219,363. RENTAL EXPENSE RECLASS -163,077. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE RECLASS 163,077. CONSOLIDATED AFFILIATES NET ELIMINATIONS 7,133,424,527. X X X X X X 1 AMY KIMBALL EVENTS 47 MORTON RD SWAMPSCOTT MA 01907 EVENT MANAGEMENT 0 0 69050 -69050 RAISE THE BAR LLC 36 RANGELEY RD NEWTON MA 02465 REPORTING CONSULTING 0 0 7300 -7300 ZURI GROUP LLC 328 NW BOND ST STE 204 BEND OR 97701 STRATEGY CONSULTING 0 0 7632 -7632 83982 -83982 FL IL MA NH NY RI GALA 566200 394615 171585 41542 55860 6025 201623 566200 394615 171585 41542 55860 6025 201623 305050 -133465 1 1 X 1 X 400.000000000000 1 X 1 0 1 1 922826 922826 0.00690 2327585 1501394 826191 0.00620 3250411 1501394 1749017 0.01310 1365394 90000 1275394 0.00950 542131 76961 465170 0.00350 43658770 37223434 6435336 0.04810 371717 5000 366717 0.00270 45938012 37395395 8542617 0.06380 49188423 38896789 10291634 0.07690 1 3341839 44433001 46107782 -1674781 X 1 1 1 1 BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM 148 CHESTNUT STREET NEEDHAM MA 02492 WWW.BIDNEEDHAM.ORG MA STATE LICENSE #2054 X X X COMMUNITY HOSPITAL BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM 1 0 0 1 X X X X X X X 21 1 1 0 1 X SEE PART VI X 1 21 1 SEE PART VI 0 1 X 400.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART VI X SEE PART VI X SEE PART VI X X X X X X 1 X 0 X X X X 1 X 0 0 BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM 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. BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM 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. 2 1 - BIDH-NEEDHAM PHYSICAL AND OCCUP THERA 73 CHESTNUT STREET 1ST FLOOR NEEDHAM MA 02492 OTHER LOCATIONS 2 - CENTER FOR WOUND HEALING & DIABETES CA 145 ROSEMARY STREET 1ST FLOOR SUITE NEEDHAM MA 02494 OTHER LOCATIONS FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSBETH ISRAEL DEACONESS HOSPITALNEEDHAM AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITALNEEDHAM (BID-NEEDHAM). THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE 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 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 4,000 PHYSICIANS AND 35,000 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.BETH ISRAEL DEACONESS HOSPITALNEEDHAM COMMUNITY BENEFITS MISSION STATEMENT BID-NEEDHAM IS STEADFAST IN ITS COMMITMENT TO IMPROVING THE HEALTH AND WELLBEING OF COMMUNITY MEMBERS, THROUGH COLLABORATION WITH COMMUNITY PARTNERS TO REDUCE BARRIERS TO HEALTH CARE AND TO CONTINUALLY STRIVE TO REDUCE HEALTH DISPARITIES AND HEALTH INEQUITIES FOR THOSE WHO ARE MOST VULNERABLE IN OUR COMMUNITY. WE SEEK TO IDENTIFY CURRENT AND EMERGING HEALTH NEEDS AND ADDRESS THESE NEEDS THROUGH EDUCATION, PREVENTION, TREATMENT AND THE PROMOTION OF HEALTHY BEHAVIORS.BID-NEEDHAM'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING BID-NEEDHAM'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE HOSPITAL'S THREE-YEAR IMPLEMENTATION STRATEGY; ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT BID-NEEDHAM'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED NEEDS AND IDENTIFY COMMUNITIES AND POPULATION SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, ECONOMIC AND SYSTEMIC FACTORS; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED; PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, BID-NEEDHAM PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $1,642,111 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE BID-NEEDHAM 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. PROVIDING SAFE, HIGH-QUALITY, COMMUNITY-BASED HEALTH CARE AND ACCESS TO TERTIARY CARE, WITH AN UNDERLYING COMMITMENT TO HEALTH EQUITY ARE THE PRIMARY TENETS OF ITS MISSION. BID-NEEDHAM'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF BID-NEEDHAM'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 BID-NEEDHAM'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. BID-NEEDHAM'S COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE DIRECTOR OF COMMUNITY AND STRATEGIC INITIATIVES. THE DIRECTOR OF COMMUNITY AND STRATEGIC INITIATIVES HAS DIRECT ACCESS AND IS ACCOUNTABLE TO BID-NEEDHAM'S 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. BID-NEEDHAM'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH BID-NEEDHAM'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT BID-NEEDHAM'S COMMUNITY BENEFITS MISSION TO SERVE ITS PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM, THEIR FAMILIES, AND BID-NEEDHAM'S COMMUNITY. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF BID-NEEDHAM'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF BID-NEEDHAM'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF BID-NEEDHAM'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY BID-NEEDHAM'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. BID-NEEDHAM'S CBAC MEMBERS INCLUDE: LINA ARENA DEROSA, DIRECTOR, WESTWOOD COUNCIL ON AGING JANET BARRETT, ADVISOR, BID-NEEDHAM BOARD OF ADVISORS DIANE BARRY PRESTON, BOARD MEMBER, LIVABLE DEDHAM AND DEDHAM COUNCIL ON AGING CAROL BURAK, TRUSTEE, DEDHAM FOOD PANTRY VIRGINIA CARNAHAN, TRUSTEE, BID-NEEDHAM BOARD OF TRUSTEES; BILH COMMUNITY BENEFITS COMMITTEE JANET CLAYPOOLE, DIRECTOR, DOVER COUNCIL ON AGING SUE CROSSLEY, EXECUTIVE DIRECTOR, FAMILY PROMISE METROWEST KATHY DAVIDSON, CHIEF NURSING OFFICER, BID-NEEDHAM LISE ELCOCK, MEMBERSHIP DIRECTOR, CHARLES RIVER REGIONAL CHAMBER FRANK FLEMING, ASSOCIATE DIRECTOR OF INTEGRATED BEHAVIORAL HEALTH SERVICE, FENWAY HEALTH JEANNE GOLDBERG, REGIONAL PRACTICE DIRECTOR, BETH ISRAEL DEACONESS HEALTHCARE ALYSSA KENCE, DIRECTOR OF COMMUNITY AND STRATEGIC INITITATIVES, BID-NEEDHAM WANITA KENNEDY, ADVISOR, BID-NEEDHAM BOARD OF ADVISORS MATTHEW KUKLENTZ, ASSISTANT PRINCIPAL, THURSTON MIDDLE SCHOOL VALERIE LIN, BOARD MEMBER, DOVER PARKS AND RECREATION CYNDI LOCKE, DIRECTOR OF CLINICAL OPERATIONS, FENWAY HEALTH TIM MCDONALD, DIRECTOR, NEEDHAM PUBLIC HEALTH LESLIE MEDALIE, TRUSTEE, BID-NEEDHAM BOARD OF TRUSTEES MANNY OPPONG, ASSISTANT VICE PRESIDENT OF BEHAVIORAL HEALTH SERVICES, RIVERSIDE COMMUNITY CARE SHEILA PRANSKY, DIRECTOR, DEDHAM COUNCIL ON AGING SANDRA ROBINSON, DIRECTOR, NEEDHAM COMMUNITY COUNCIL SUSAN SHAVER, DIRECTOR, NEEDHAM COMMUNITY FARM NICOLE STEWART, ADVISOR, BID-NEEDHAM BOARD OF ADVISORS COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY 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. BID-NEEDHAM COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE BID-NEEDHAM BOARD OF TRUSTEES ON SEPTEMBER 8, 2022. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 8, 2022, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS) REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF BID-NEEDHAM'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BID-NEEDHAM ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BID-NEEDHAM, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2022 COMMUNITY HEALTH NEEDS ASSESSMENTPRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, BID-NEEDHAM COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF BID-NEEDHAM'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES DEDHAM, NEEDHAM, NORWOOD AND WESTWOOD.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR BID-NEEDHAM'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).BID-NEEDHAM'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF DEDHAM, NEEDHAM, NORWOOD AND WESTWOOD IN ITS CBSA, AS FOLLOWS: YOUTH LOW-RESOURCED POPULATIONS OLDER ADULTS RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS2022 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSBID-NEEDHAM'S 2022 CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING BID-NEEDHAM'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. BID-NEEDHAM'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, BETH ISRAEL DEACONESS HOSPITALNEEDHAM CONDUCTED 18 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED FOUR FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 480 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 600 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY PARTNERS.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODS'BETH ISRAEL DEACONESS HOSPITALNEEDHAM RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. BID NEEDHAM COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT BID-NEEDHAM LEVERAGED INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020) U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020) U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021) BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, 2019 MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) FBI UNIFORM CRIME REPORTS (2019) MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020) MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018) ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021)2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, BID-NEEDHAM CONDUCTED 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 BID-NEEDHAM'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 BID-NEEDHAM'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 BID-NEEDHAM'S CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)BID-NEEDHAM CONDUCTED FOUR COMMUNITY FOCUS GROUPS, AND HELD TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED 100 RESIDENTS IN BID-NEEDHAM'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH OTHER BILH HOSPITALS.BID-NEEDHAM HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF BID-NEEDHAM'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE COMMUNITY NETWORKS, PUBLIC LIBRARIES, COUNCILS ON AGING, FOOD PANTRIES AND LOCAL HOUSING AUTHORITIES TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE BID-NEEDHAM 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. 2022 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 BID-NEEDHAM COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS. IDENTIFY BID-NEEDHAM'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE BID-NEEDHAM'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY BID-NEEDHAM DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021).2022 COMMUNITY HEALTH NEEDS ASSESSMENT 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 BID-NEEDHAM'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY. HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM BID-NEEDHAM'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2023; SEPTEMBER 30, 2024; AND SEPTEMBER 30, 2025. PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFITS ACTIVITIES REPORTED IN THIS FORM 990 SCHEDULE HAS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, BID-NEEDHAM MOST RECENTLY COMPLETED CHNA WAS COMPLETED DURING THE FISCAL YEAR ENDED 2022 AND THE FIRST YEAR OF ACCOMPLISHMENTS UNDER THAT CHNA AND IMPLEMENTATION STRATEGY (IS) WILL BE REPORTED IN THE FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2023. THE PRIOR CHNA AND CHIP PROCESS WHICH WAS COMPLETED BY BID-NEEDHAM IN 2019 INFORMED THE COMMUNITY BENEFITS OPERATIONS AND ACCOMPLISHMENTS REPORTED IN THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AS DESCRIBED IN DETAIL BELOW. 2019 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATION BID-NEEDHAM COMPLETED ITS 2019 ASSESSMENT IN SEPTEMBER 2019. THE GEOGRAPHICAL FOCUS OF BID-NEEDHAM'S 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES DEDHAM, DOVER, NEEDHAM AND WESTWOOD. TARGET POPULATIONS FOR BID-NEEDHAM'S COMMUNITY BENEFITS INITIATIVES WERE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).BID-NEEDHAM'S TARGET POPULATIONS FOCUSED ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN DEDHAM, DOVER, NEEDHAM AND WESTWOOD, AS FOLLOWS: LOW- TO MODERATE-INCOME INDIVIDUALS AND FAMILIES INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS YOUTH OLDER ADULTS BID-NEEDHAM FOCUSES ITS COMMUNITY BENEFITS EFFORTS ON IMPROVING THE HEALTH STATUS OF THE LOW-INCOME AND UNDERSERVED POPULATIONS LIVING IN DEDHAM, DOVER, NEEDHAM, AND WESTWOOD. 2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS AS WELL AS INFORMATION FROM KEY INFORMANT INTERVIEWS, FOCUS GROUPS WITH RESIDENTS AND SOCIAL SERVICE ORGANIZATIONS, A COMMUNITY FORUM FOR ALL RESIDENTS IN THE SERVICE AREA, AND ONLINE AND IN-PERSON SURVEYS. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE FOUR TOWNS THAT COMPRISE THE BID-NEEDHAM SERVICE AREA AND WITH A RANGE OF PEOPLE REPRESENTING DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., YOUTH AND AGING). THE HOSPITAL WORKED COLLABORATIVELY WITH THE NEEDHAM DIVISION OF PUBLIC HEALTH TO SHARE INFORMATION FROM THEIR RESPECTIVE NEEDS ASSESSMENT ACTIVITIES RELATIVE TO THEIR EFFORTS TO BECOME AN ACCREDITED HEALTH DEPARTMENT. ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED MORE THAN 500 PEOPLE. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSTHE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM THE DISSEMINATION AND ANALYSIS OF A COMMUNITY HEALTH SURVEY TO CAPTURE RESIDENTS' PERCEPTIONS OF BARRIERS TO GOOD HEALTH, LEADING HEALTH ISSUES, VULNERABLE POPULATIONS, ACCESSIBILITY OF HEALTH SERVICES AND OPPORTUNITIES FOR THE HOSPITAL TO IMPROVE THE SERVICES THEY OFFER TO THE COMMUNITY. QUANTITATIVE DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN BID-NEEDHAM'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF THE HEALTH-RELATED ISSUES. SOURCES INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017, AND 2018-2019) FBI UNIFORM CRIME REPORTS (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY 2013-2017) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018) TO AUGMENT THE QUANTITATIVE DATA FROM MDPH, JSI WORKED WITH THE MASSACHUSETTS HEALTH DATA CONSORTIUM (MHDC) AND THE MASSACHUSETTS CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA) TO OBTAIN 2018 INPATIENT HOSPITAL DISCHARGE DATA FOR ALL OF THE MUNICIPALITIES IN BID-NEEDHAM'S SERVICE AREA. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BID-NEEDHAM CONDUCTED 14 KEY INFORMANT INTERVIEWS THAT ENGAGED INSTITUTIONAL, ORGANIZATIONAL AND COMMUNITY LEADERS AND FRONT-LINE STAFF ACROSS SECTORS. 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 BID-NEEDHAM'S WEBSITE. INTERVIEWEES INCLUDED REPRESENTATIVES FROM PUBLIC HEALTH DEPARTMENTS, LEGISLATORS, CLINICAL PROVIDERS, ELDER SERVICE PROVIDERS, BEHAVIORAL HEALTH PROVIDERS, AND FIRST RESPONDERS. KEY INFORMANT INTERVIEWS WERE DONE TO CONFIRM AND REFINE FINDINGS FROM SECONDARY DATA, TO PROVIDE COMMUNITY CONTEXT, AND TO CLARIFY NEEDS AND PRIORITIES OF THE COMMUNITY. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)JSI FACILITATED FOCUS GROUPS WITH THE NEEDHAM OPERATIONS/EXECUTIVE LEADERSHIP TEAM, MADE OF UP HOSPITAL LEADERSHIP AND CLINICAL PROVIDERS, AND OLDER ADULT RESIDENTS AT THE NEEDHAM SENIOR CENTER. THE NEEDHAM HEALTH DEPARTMENT, WORKING IN COLLABORATION WITH BID-NEEDHAM, FACILITATED FOCUS GROUPS WITH THE INTERFAITH CLERGY ASSOCIATION AND THE YOUTH RESOURCE NETWORK (TWO ORGANIZATIONS THAT WORK DIRECTLY WITH UNDERSERVED POPULATIONS IN THE CBSA), AS WELL AS PROVIDERS WHO SERVE OLDER ADULTS. BID-NEEDHAM WORKED WITH THE NEEDHAM HEALTH DEPARTMENT TO ENSURE THAT QUESTIONS FOR THE NEEDS ASSESSMENT WERE INCORPORATED INTO THEIR FOCUS GROUP GUIDE. NOTES WERE SHARED BETWEEN THE TWO ORGANIZATIONS TO INFORM EACH OTHER'S PROCESSES. FOCUS GROUPS ALLOWED FOR THE COLLECTION OF INFORMATION TO AUGMENT FINDINGS FROM SECONDARY DATA AND KEY INFORMANT INTERVIEWS AND EXPLORATION OF STRATEGIC AND PROGRAMMATIC OPTIONS TO ADDRESS IDENTIFIED HEALTH ISSUES, SERVICE GAPS, AND/OR BARRIERS TO CARE. PARTICIPANTS WERE RECRUITED BY BID-NEEDHAM, THE NEEDHAM PUBLIC HEALTH DIVISION, AND REPRESENTATIVES FROM HOST ORGANIZATIONS. FOCUS GROUPS WERE APPROXIMATELY 60 MINUTES AND WERE CONDUCTED IN-PERSON USING STRUCTURED INTERVIEW GUIDES. NOTES WERE TAKEN AT EACH SESSION. APPENDIX A INCLUDES SESSION DATES AND A FOCUS GROUP GUIDE. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSTHE BID-NEEDHAM COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS DEVELOPED BY A TEAM COMPRISED OF HOSPITAL LEADERSHIP, PATIENT ADVOCACY, MEDICAL STAFF, PUBLIC RELATIONS AND COMMUNITY REPRESENTATION. THE GROUP REVIEWED PROGRESS TOWARD GOALS AND OBJECTIVES OF THE PRIOR THREE-YEAR PERIOD, AS WELL AS THE CURRENT DATA COLLECTED THROUGH THE CHNA, TO HELP ENVISION AND DEFINE PRIORITY AREAS FOR THE FUTURE. THE IMPLEMENTATION STRATEGY IDENTIFIED PRIORITY AREAS AND DEFINED GOALS, ALONG WITH OBJECTIVES FOR EACH GOAL AND DRAFTED STRATEGIES TO OPERATIONALIZE THESE OBJECTIVES. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSBID-NEEDHAM'S CHNA RESULTED IN KEY FINDINGS RELATED TO SOCIAL DETERMINANTS OF HEALTH, BEHAVIORAL HEALTH, CHRONIC DISEASES AND THEIR RISK FACTORS AND NAVIGATING THE SYSTEM/ACCESS TO CARE. THE FOLLOWING ARE BRIEF SUMMARIES OF SOME OF THE ASSESSMENT'S KEY FINDINGS. A FULL REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION THAT WAS COLLECTED FOR THIS ASSESSMENT AND THAT LED THE CBAC AND THE CBLT TO IDENTIFY THE ISSUES THAT WERE PRIORITIZED BY THE ASSESSMENT IS INCLUDED IN THE FULL BODY OF THE CHNA. SOCIAL DETERMINANTS OF HEALTH CONTINUE TO HAVE A SUBSTANTIAL IMPACT ON MANY SEGMENTS OF THE POPULATION. ONE OF THE DOMINANT THEMES FROM THE ASSESSMENT'S FINDINGS WAS THE IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THOSE LIVING IN THE CBSA. THE SEGMENTS OF THE POPULATION MOST CHALLENGED BY THESE ISSUES ARE OLDER ADULTS, LOW-INCOME INDIVIDUALS/FAMILIES, RACIAL/ETHNIC MINORITIES, NON-ENGLISH SPEAKERS, AND THOSE WITH DISABILITIES OR WITH CHRONIC / COMPLEX CONDITIONS. MORE SPECIFICALLY, THESE SEGMENTS STRUGGLE WITH FINANCIAL INSECURITY, SAFE/AFFORDABLE HOUSING, TRANSPORTATION, ACCESS TO HEALTHY/AFFORDABLE FOOD, LACK OF SOCIAL SUPPORT, SOCIAL ISOLATION, AND LANGUAGE ACCESS /CULTURAL HUMILITY. THESE ISSUES IMPACT MANY PEOPLE'S AND FAMILIES' ABILITY TO ACCESS OR PAY FOR THE SERVICES, HOUSING, FOOD, OR OTHER ESSENTIAL ITEMS THEY NEED AND/OR TO LIVE A HAPPY, FULFILLING, PRODUCTIVE LIFE. THE BURDEN OF SUBSTANCE USE AND MENTAL HEALTH ISSUES MENTAL HEALTH AND SUBSTANCE USE ISSUES CONTINUE TO BE ONE OF THE REGION'S MOST PREVALENT AND CHALLENGING ISSUES AND ARE HAVING A PROFOUND IMPACT ON INDIVIDUALS, FAMILIES, AND COMMUNITIES THROUGHOUT THE CBSA. THESE ISSUES ARE ALSO A MAJOR BURDEN ON THE HEALTH AND SOCIAL SERVICE SYSTEM. HEALTH AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH AGENCIES, FIRST-RESPONDERS, AND COMMUNITY-BASED ORGANIZATIONS ARE CONFRONTED ON A DAILY BASIS WITH PEOPLE STRUGGLING WITH ACUTE OR CHRONIC CONDITIONS AND STRUGGLE TO PROVIDE OR LINK THEM TO THE CARE THEY NEED. WITH RESPECT TO MENTAL HEALTH ISSUES, DEPRESSION/ANXIETY, STRESS, SOCIAL ISOLATION, AND THE IMPACTS OF TRAUMA ARE THE LEADING ISSUES. WITH RESPECT TO SUBSTANCE USE, THE OPIOID CRISIS CONTINUES TO HAVE A TREMENDOUS IMPACT ON THE REGION, ALONG WITH ALCOHOL USE, MARIJUANA USE, AND VAPING IN YOUTH. THE FACT THAT PHYSICAL, MENTAL HEALTH, AND SUBSTANCE USE ISSUES ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID USE AND THE IMPACTS OF TRAUMA. LIMITED ACCESS TO BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE) SERVICES. DESPITE THE PREVALENCE OF MENTAL HEALTH AND SUBSTANCE USE ISSUES AND THE IMPACT THAT THESE ISSUES ARE HAVING ON INDIVIDUALS, FAMILIES, AND COMMUNITIES, THE BEHAVIORAL HEALTH SERVICE SYSTEM IN THE REGION IS EXTREMELY LIMITED. THERE ARE MAJOR SHORTAGES OF SPECIALIZED PROVIDERS - SUCH AS PSYCHIATRISTS, THERAPISTS, ADDICTION SPECIALISTS, AND CASE MANAGERS, WHO ARE CAPABLE OF PROVIDING THE FULL BREADTH OF PREVENTIVE, SCREENING, ASSESSMENT, TREATMENT, AND RECOVERY SUPPORT SERVICES THAT THE COMMUNITY NEEDS. THIS IS PARTICULARLY TRUE FOR THOSE WHO HAVE LIMITED ENGLISH SKILLS OR DIFFERENT CULTURAL PERSPECTIVES THAT REQUIRE SPECIALIZED CARE, SUCH AS IMMIGRANTS, RACIAL/ETHNIC MINORITIES, AND LGBTQ INDIVIDUALS. UNINSURED INDIVIDUALS, THOSE COVERED BY MEDICAID, AND THOSE IN LOW TO MODERATE INCOME BRACKETS ALSO STRUGGLE TO ACCESS OR PAY FOR THE SERVICES THEY NEED OR TO FIND PROVIDERS WHO ARE ABLE TO TAKE THEIR COVERAGE OR INSURANCE. HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS. ANOTHER MAJOR FINDING FROM THE ASSESSMENT IS THE HIGH RATES OF CHRONIC AND COMPLEX CONDITIONS THAT EXIST FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA) IN THE CBSA. OVERALL, THE RATES OF ILLNESS AND DEATH ARE NOT STATISTICALLY HIGHER THAN THE RATES FOR THE COMMONWEALTH, HOWEVER, IT IS IMPORTANT TO NOTE THAT THESE CHRONIC PHYSICAL HEALTH CONDITIONS ARE STILL THE LEADING CAUSES OF DEATH AND MUST BE ADDRESSED TO IMPROVE THE REGION'S HEALTH STATUS. HIGH RATES OF THE LEADING HEALTH RISK FACTORS (E.G., LACK OF NUTRITIONAL FOOD AND PHYSICAL ACTIVITY, ALCOHOL/ILLICIT DRUG USE, AND TOBACCO USE). BASED ON INFORMATION GATHERED FROM FOCUS GROUPS, INTERVIEWS, COMMUNITY MEETINGS, THE COMMUNITY HEALTH SURVEY, AND QUANTITATIVE SOURCES, THE ASSESSMENT FOUND THAT THERE WERE SUBSTANTIAL CONCERNS RELATED TO THE LEADING HEALTH RISK FACTORS, SUCH AS HEALTHY EATING, PHYSICAL ACTIVITY, OBESITY, TOBACCO USE/VAPING, ALCOHOL USE, AND STRESS. MANY OF THOSE WHO WERE INVOLVED IN THE ASSESSMENT BELIEVED THAT THERE WAS A NEED FOR MORE HEALTH EDUCATION AND A GREATER EMPHASIS ON HEALTH PROMOTION AND PREVENTION. CHALLENGES NAVIGATING THE SYSTEM AND COORDINATING NEEDED SERVICES. ANOTHER MAJOR THEME FROM THE INTERVIEWS, FOCUS GROUPS, AND COMMUNITY MEETINGS CONDUCTED FOR THE ASSESSMENT WAS THE CHALLENGES THAT MANY PEOPLE IN THE CBSA FACE NAVIGATING THE HEALTH AND SOCIAL SERVICE SYSTEM. THERE WAS A GENERAL SENSE THAT THERE WAS A BROAD RANGE OF HEALTH AND SOCIAL SERVICES AVAILABLE IN THE REGION BUT THAT MANY DID NOT KNOW WHERE TO GO FOR SERVICES OR STRUGGLED TO ACCESS THE SERVICES EVEN WHEN THEY KNEW WHERE TO GO. ONCE AGAIN, THE POPULATION SEGMENT WHO STRUGGLE MOST TO NAVIGATE THE SYSTEM ARE OLDER ADULTS, LOW-INCOME INDIVIDUALS/FAMILIES, RACIAL/ETHNIC MINORITIES, NON-ENGLISH SPEAKERS, AND THOSE WITH DISABILITIES OR CHRONIC/COMPLEX CONDITIONS. MANY PEOPLE SAID THAT THERE WAS A NEED FOR A RESOURCE INVENTORY THAT WOULD HELP RESIDENTS ACCESS SERVICES, ALONG WITH COUNSELORS OR CASE MANAGERS WHO COULD FURTHER ASSIST PEOPLE TO OBTAIN AND ACCESS THE SERVICES THEY NEEDED. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM BETH ISRAEL DEACONESS HOSPITALNEEDHAM'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022. INTERIM CHANGES AND UPDATES TO 2019 IMPLEMENTATION STRATEGY BASED ON NEWLY IDENTIFIED COMMUNITY NEEDS COVID PANDEMICAS PREVIOUSLY NOTED IN THIS FILING, IRC SECTION 501(R)(3) AND THE PROMULGATED REGULATIONS REQUIRE THAT A TAX-EXEMPT HOSPITAL CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPT AN IMPLEMENTATION STRATEGY ADDRESSING COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA AT LEAST ONCE EVERY THREE YEARS. THE PREAMBLE TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R)(3) NOTES THAT THE TREASURY AND THE IRS INTENDED FOR THE CHNA AND IMPLEMENTATION STRATEGY REQUIREMENT TO ESTABLISH CONTINUAL FEEDBACK ON CHNA REPORTS AND A HOSPITAL IS REQUIRED TO CONSIDER COMMENTS RECEIVED RELATED TO THE EXISTING CHNA AND IMPLEMENTATION STRATEGY WHEN ENGAGING IN THE NEXT CHNA PROCESS NOT MORE THAN THREE YEARS AFTER ADOPTION. IN ADDITION, FINAL REGULATIONS DO NOT PROHIBIT IMPLEMENTATION STRATEGIES FROM DISCUSSING HEALTH NEEDS IDENTIFIED THROUGH MEANS OTHER THAN A CHNA, PROVIDED THAT THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA ARE ALSO DISCUSSED. FINALLY, THERE IS NOTHING IN THE REGULATIONS THAT PROHIBITS A HOSPITAL FROM UPDATING ITS IMPLEMENTATION STRATEGY BASED ON AN OFF-CYCLE CHANGE TO THE COMMUNITY HEALTH NEEDS THAT ARISE. DURING THE FISCAL PERIOD, OCTOBER 1, 2019 TO SEPTEMBER 30, 2020, THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY BID-NEEDHAM, WERE IMPACTED BY AN UNEXPECTED GLOBAL PANDEMIC. ON JANUARY 9, 2020, THE WORLD HEALTH ORGANIZATION (WHO) ANNOUNCED THE IDENTIFICATION OF A NEW AND NOVEL CORONAVIRUS-RELATED PNEUMONIA IN WUHAN, CHINA. ON JANUARY 21, 2020 THE UNITED STATES CENTER FOR DISEASE CONTROL CONFIRMED THE FIRST CASE OF THIS NEW CORONA VIRUS IN THE UNITED STATES. ON JANUARY 31, 2020, THE WHO ISSUED A GLOBAL HEALTH EMERGENCY AND ON FEBRUARY 3 THE UNITED STATES DECLARED A PUBLIC HEALTH EMERGENCY BECAUSE OF THE COVID-19 VIRUS. ON MARCH 11, 2020, THE WHO DECLARED COVID-19 A PANDEMIC AND TWO DAYS LATER, THE PRESIDENT OF THE UNITED STATES DECLARED COVID-19 A NATIONAL EMERGENCY.THE HEALTH OF THE COMMUNITIES SERVED BY BID-NEEDHAM WERE IMPACTED BY THIS UNFORESEEN HEALTH CRISIS AND IN THE ABSENCE OF REGULATORY GUIDANCE TO THE CONTRARY, BID-NEEDHAM NEEDED TO QUICKLY REASSESS AND PIVOT TO MEET THE NEW AND PREVIOUSLY UNEXPECTED COMMUNITY NEEDS. AS SUCH, IN RESPONSE TO THE COVID-19 CRISIS BID-NEEDHAM'S COMMUNITY BENEFITS STAFF ALONG WITH THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND IN RESPONSE TO COVID, EXPANDED GOALS RELATED TO ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH TARGETED PRIMARILY AT LOW INCOME AND MINORITY POPULATIONS WHO HAVE BEEN DISPROPORTIONATELY IMPACTED BY COVID-19.THE ADDITIONAL AND NEWLY URGENT HEALTH NEEDS IN RESPONSE TO COVID-19 WERE: ENSURE ACCESS TO PREVENTIVE MEASURES, TESTING, SCREENING AND TREATMENT FOR THOSE AT-RISK OR EXPOSED TO COVID-19 AND MITIGATE THE IMPACTS OF THE PANDEMIC ON THE SOCIAL DETERMINANTS OF HEALTH. THE ACTIONS TAKEN TOWARD ADDRESSING THESE NEEDS ARE INCLUDED FURTHER IN THIS NARRATIVE SUPPORT ALONG WITH BID-NEEDHAM'S DETAILED DESCRIPTION OF ACTIVITIES UNDERTAKEN TO MEET THE COMMUNITY NEEDS. COMMUNITY HEALTH NEEDS ASSESSMENT MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEBID-NEEDHAM STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, BID-NEEDHAM 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 BID-NEEDHAM WEBSITE AT: HTTPS://WWW.BIDNEEDHAM.ORG/ABOUT/COMMUNITY-INVOLVEMENT/COMMUNITY-BENEFITS. IN ADDITION TO THE CHNA, BID-NEEDHAM COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE BID-NEEDHAM WEBSITE AT: HTTPS://WWW.BIDNEEDHAM.ORG/WRITABLE/FILES/BID-NEEDHAM-2023-2025-IMPLEMENTATION-STRATEGY-101122.PDF. IN ADDITION, AS NOTED ABOVE, BID-NEEDHAM COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE BID-NEEDHAM WEBSITE AT: HTTPS://WWW.BIDNEEDHAM.ORG/WRITABLE/FILES/NEEDHAM-CHNA-REPORT.PDF. FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING BID-NEEDHAM'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE BID-NEEDHAM WEBSITE AT: HTTPS://WWW.BIDNEEDHAM.ORG/WRITABLE/FILES/BID-NEEDHAM-2020-2022-IMPLEMENTATION-STRATEGY-041423.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, BID-NEEDHAM'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 BUT IT IS THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY WHICH INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF BID-NEEDHAM FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 WHICH ARE REPORTED HERE. A SUMMARY OF BID-NEEDHAM'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 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, BID-NEEDHAM 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: MENTAL HEALTH AND SUBSTANCE USE GOAL 1: EDUCATE ABOUT AND REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH AND SUBSTANCE USE GOAL 2: ENHANCE ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SCREENING, ASSESSMENT, AND TREATMENT SERVICES GOAL 3: DECREASE THE NUMBER OF PRESCRIPTION DRUGS AND OTHER HARMFUL DRUGS FROM THE COMMUNITY PRIORITY AREA 2: CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, REFERRAL, AND CHRONIC DISEASE MANAGEMENT SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS GOAL 2: REDUCE THE PREVALENCE OF TOBACCO USE PRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE GOAL 1: ENHANCE ACCESS TO CARE AND REDUCE THE IMPACT OF SOCIAL DETERMINANTS GOAL 2: REDUCE ELDER FALLS AND PROMOTE AGING IN PLACE COMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)BID-NEEDHAM RECOGNIZES ITS ROLE AS A TERTIARY/ACADEMIC RESOURCE IN A LARGER HEALTH SYSTEM AND KNOWS THAT TO BE SUCCESSFUL IT NEEDS TO COLLABORATE WITH ITS COMMUNITY PARTNERS AND THOSE IT SERVES. BID-NEEDHAM'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY WERE COMPLETED IN CLOSE COLLABORATION WITH BID-NEEDHAM'S STAFF, ITS HEALTH AND SOCIAL SERVICE PARTNERS, AND THE COMMUNITY AT LARGE. BID-NEEDHAM'S COMMUNITY BENEFITS PROGRAM EXEMPLIFIES THE SPIRIT OF COLLABORATION THAT IS SUCH A VITAL PART OF BID-NEEDHAM'S MISSION. BID-NEEDHAM SERVES AND COLLABORATES WITH ALL SEGMENTS OF THE POPULATION. HOWEVER, IN RECOGNITION OF ITS LONG-STANDING TIES TO THE SURROUNDING COMMUNITIES AND THE HEALTH DISPARITIES THAT EXIST IN THESE COMMUNITIES, BID-NEEDHAM FOCUSES ITS COMMUNITY BENEFITS EFFORTS ON IMPROVING THE HEALTH STATUS OF THE LOW-INCOME AND UNDERSERVED POPULATIONS LIVING IN DEDHAM, DOVER, NEEDHAM, AND WESTWOOD. BID-NEEDHAM CURRENTLY SUPPORTS MANY EDUCATIONAL, OUTREACH, COMMUNITY HEALTH IMPROVEMENT, AND HEALTH SYSTEM STRENGTHENING INITIATIVES WITHIN THE COMMUNITY. IN SO DOING, THE HOSPITAL COLLABORATES WITH MANY LOCAL LEADING HEALTHCARE, PUBLIC HEALTH, AND SOCIAL SERVICE ORGANIZATIONS. BID-NEEDHAM WORKS CLOSELY WITH THE PUBLIC HEALTH DEPARTMENTS IN THE AREA, AS WELL AS LOCAL COUNCILS ON AGING, TO ADDRESS SUBSTANCE ABUSE PREVENTION, MENTAL HEALTH, CHRONIC DISEASE MANAGEMENT, FOOD ACCESS, AND TRANSPORTATION. THE HOSPITAL ALSO SUPPORTS LOCAL ORGANIZATIONS THAT PROVIDE OPPORTUNITIES TO PREVENT AND MANAGE CHRONIC DISEASE, SUCH AS THE BOSTON JCC AND THE CHARLES RIVER YMCA. THE HOSPITAL PROVIDES FUNDING TO AND PROGRAMMING WITH MENTAL HEALTH ORGANIZATIONS SUCH AS THE CHARLES RIVER CENTER, WALKER, AND RIVERSIDE COMMUNITY CARE. BID-NEEDHAM IS ALSO AN ACTIVE PARTICIPANT IN SEVERAL LOCAL COALITIONS AND COMMITTEES, INCLUDING THE NEEDHAM COMMUNITY CRISIS INTERVENTION TEAM (CCIT), YOUTH RESOURCE NETWORK, AND THE NEEDHAM LOCAL EMERGENCY PLANNING COMMITTEE. JOINING WITH SUCH GRASS-ROOTS COMMUNITY GROUPS, PUBLIC HEALTH AND FIRST RESPONDERS, BID-NEEDHAM STRIVES TO CREATE A VISION FOR HEALTH IMPROVEMENT AND PREPAREDNESS, AND TO ADDRESS ON-GOING CRISES FOR RESIDENTS IN THE COMMUNITY. ALSO IMPORTANT ARE PARTNERSHIPS TO ADDRESS SUBSTANCE USE AND MENTAL HEALTH, INCLUDING BID-NEEDHAM'S INVOLVEMENT WITH THE SUBSTANCE PREVENTION ALLIANCE OF NEEDHAM (SPAN), CHARLES RIVER OPIOID TASKFORCE, AND CHNA 18. BID-NEEDHAM'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS SERVICE AREA AND BEYOND. WORLD-CLASS CLINICAL EXPERTISE, EDUCATION, AND RESEARCH, ALONG WITH AN UNDERLYING COMMITMENT TO HEALTH EQUITY, ARE THE PRIMARY TENETS OF ITS MISSION. BID-NEEDHAM'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF BID-NEEDHAM'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. A FULL UPDATE ON BID-NEEDHAM'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW. FY22 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: MENTAL HEALTH AND SUBSTANCE USE AS IT IS THROUGHOUT THE COMMONWEALTH AND THE NATION, THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON INDIVIDUALS, FAMILIES, COMMUNITIES AND SERVICE PROVIDERS IN BID-NEEDHAM'S SERVICE AREA IS OVERWHELMING. NEARLY EVERY KEY INFORMANT INTERVIEW, FOCUS GROUP AND COMMUNITY MEETING INCLUDED DISCUSSIONS ON THESE TOPICS. FROM A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION, DEPRESSION, ANXIETY/STRESS, SOCIAL ISOLATION, OPIOIDS, ALCOHOL, AND E-CIGARETTE/VAPING WERE THE LEADING ISSUES IN THIS DOMAIN. DESPITE INCREASED COMMUNITY AWARENESS AND SENSITIVITY ABOUT THE UNDERLYING ISSUES AND ORIGINS OF MENTAL HEALTH AND SUBSTANCE USE ISSUES, THERE IS STILL A GREAT DEAL OF STIGMA RELATED TO THESE CONDITIONS. THERE IS A GENERAL LACK OF APPRECIATION FOR THE FACT THAT THESE ISSUES ARE OFTEN ROOTED IN GENETICS, PHYSIOLOGY AND ENVIRONMENT, RATHER THAN AN INHERENT, CONTROLLABLE CHARACTER FLAW. THERE IS, HOWEVER, A DEEP APPRECIATION AND A GROWING UNDERSTANDING FOR THE ROLE THAT TRAUMA PLAYS FOR MANY OF THOSE WITH MENTAL AND/OR SUBSTANCE USE ISSUES, WITH MANY PEOPLE USING ILLICIT OR CONTROLLED SUBSTANCES TO SELF-MEDICATE AND COPE WITH LOSS, STRESS, ABUSE, PAIN, AND OTHER UNRESOLVED TRAUMATIC EVENTS. GOAL: EDUCATE ABOUT AND REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH AND SUBSTANCE USE ISSUES TARGET POPULATION: YOUTH, OLDER ADULTS, LOW- TO MODERATE-INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/ COMPLEX CONDITIONS PROGRAMMATIC OBJECTIVES: 1. INCREASE COMMUNITY EDUCATION AND AWARENESS OF SUBSTANCE USE/MISUSE AND HEALTHY MENTAL, EMOTIONAL, AND SOCIAL HEALTH. 2. REDUCE THE STIGMA ASSOCIATED WITH MENTAL ILLNESS/ MENTAL HEALTH AND SUBSTANCE USE/MISUSE, AND ADDICTION. COMMUNITY ACTIVITIES/STRATEGIES SUPPORT MENTAL HEALTH FIRST AID TRAININGS IN TARGETED COMMUNITY-BASED SETTINGS TO RAISE AWARENESS, REDUCE STIGMA, AND EDUCATE RESIDENTS AND SERVICE PROVIDERS ABOUT MENTAL HEALTH AND SUBSTANCE USE. PROVIDE COMMUNITY HEALTH MINI GRANTS TO LOCAL DEPARTMENTS OF HEALTH OR OTHER COMMUNITY-BASED PARTNERS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT PROMOTE MENTAL HEALTH AND SUBSTANCE USE EDUCATION AND PREVENTION. SUPPORT MENTAL HEALTH AND SUBSTANCE USE SUPPORT GROUPS FOR THOSE WITH OR IN RECOVERY FROM MENTAL HEALTH OR SUBSTANCE USE AND THEIR FAMILY/FRIENDS/CAREGIVERS TO RAISE AWARENESS, REDUCE STIGMA, EDUCATE, AND PROMOTE COPING/RECOVERY. SUPPORT COMMUNITY-BASED HEALTH EDUCATION EVENTS AND PROGRAMMING WITH COMMUNITY PARTNERS TO RAISE AWARENESS, AND EDUCATE ON RISK/PROTECTIVE FACTORS, AND SERVICES AVAILABLE IN THE COMMUNITY. SUPPORT SUBSTANCE USE PREVENTION PROGRAMMING AND CURRICULUM IN LOCAL SCHOOLS. METRICS AND STATUS UPDATE: NUMBER OF MENTAL HEALTH TRAININGS CONDUCTED. (FY20: 1 QPR TRAINING; FY21: 1 YOUTH MENTAL HEALTH FIRST AID TRAINING; FY22: 1 MENTAL HEALTH FIRST AID TRAINING). NUMBER OF EVIDENCE-BASED PROGRAMS CONDUCTED AND NUMBER OF PARTICIPANTS. (FY20: "FAMILY DINNER PROJECT" WITH MORE THAN 50 FAMILY MEMBERS ATTENDING; FY21: "NAVIGATING SCREEN TIME, DIGITAL SOCIALIZING AND PARENTING DURING COVID-19" VIRTUAL PROGRAM FOR MIDDLE SCHOOL YOUTH WITH 177 ATTENDING AND 98% REPORTING THAT THE INFORMATION WAS USEFUL; FY22: NO PROGRAMS CONDUCTED BY PARTNERS). NUMBER OF EVENTS AND PROGRAMMING PROVIDED AND NUMBER OF PARTICIPANTS. (FY20: SUPPORT SCHOLARSHIP FUND FOR PARENTS OF YOUNG CHILDREN TO ATTEND PARENT SUPPORT GROUPS; FY21: SUPPORT SOCIALLY DISTANT AND SAFE GATHERING SPACE FOR YOUTH AND OLDER ADULTS, WITH 30 YOUTH AND 50 OLDER ADULTS USING SPACE; FY22: SUPPORT ADVOCACY AND COMMUNITY EDUCATION ON CYBER HARMS AND SUBSTANCE USE WITH 3 EVENTS HELD AND AN ART THERAPY AFTER SCHOOL PROGRAM THAT WAS ATTENDED BY 24 STUDENTS). IN FY22, HOURS WERE EXTENDED FOR REGULARLY-SCHEDULED SUPPORT GROUPS FOR OLDER ADULTS WHO ARE BEREAVED, STRUGGLING WITH CAREGIVING RESPONSIBILITIES, OR EXPERIENCING MENTAL HEALTH CHALLENGES BY SUPPORTING A SOCIAL WORKER TO CONDUCT GROUPS. NUMBER OF SUBSTANCE USE PREVENTION PROGRAMS/CURRICULUM PROVIDED AND NUMBER OF PARTICIPANTS. (FY20: "LIFE SKILLS CONFERENCE" PROVIDED TO GRADUATING HIGH SCHOOL SENIORS 393 PARTICIPATING; FY20 FY22: RESILIENCE AND REFUSAL TRAINING OFFERED WITH 100 HIGH SCHOOL AND 500 8TH GRADE STUDENTS COMPLETING TRAINING ANNUALLY). COMMUNITY PARTNERS: BECCA SCHMILL FOUNDATION, CHNA 18, DEDHAM COUNCIL ON AGING, DEDHAM PUBLIC LIBRARY, DOVER COUNCIL ON AGING, DOVER PARKS & RECREATION, NEEDHAM PUBLIC SCHOOLS, NEEDHAM PUBLIC HEALTH, NEEDHAM YOUTH & FAMILY SERVICES, PARENT TALK, SPAN, SALSA, THE FAMILY DINNER PROJECT, WALKER GOAL: ENHANCE ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SCREENING, ASSESSMENT, AND TREATMENT SERVICES TARGET POPULATION: YOUTH, OLDER ADULTS, LOW- TO MODERATE-INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS PROGRAMMATIC OBJECTIVES: 1. PROMOTE CROSS-SECTOR PARTNERSHIP, COLLABORATION, AND INFORMATION SHARING ACROSS THE BROAD HEALTH SYSTEM TO ADDRESS ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SERVICES. 2. INCREASE ACCESS TO CLINICAL AND NON-CLINICAL SUPPORT SERVICES FOR THOSE WITH MENTAL HEALTH AND SUBSTANCE USE ISSUES, WITH AN EMPHASIS ON PRIORITY POPULATIONS. 3. INCREASE ACCESS TO PEER SUPPORT FOR THOSE WITH MENTAL HEALTH AND SUBSTANCE USE AND THEIR FAMILY, FRIENDS, AND CAREGIVERS. 4. REDUCE INAPPROPRIATE USE OF ED AND OTHER ACUTE CARE SERVICES. 5. INCREASE ACCESS TO SCREENING, EDUCATION, REFERRAL, AND PATIENT ENGAGEMENT SERVICES FOR THOSE IDENTIFIED WITH OR AT-RISK OF MENTAL HEALTH AND SUBSTANCE USE ISSUES IN CLINICAL AND NON-CLINICAL SETTINGS, WITH AN EMPHASIS ON PRIORITY POPULATIONS. 6. INCREASE ACCESS TO INSURANCE, PATIENT NAVIGATION SUPPORT, AND OTHER ENABLING/ SUPPORTIVE SERVICES FOR THOSE WITH MENTAL HEALTH AND SUBSTANCE USE ISSUES, WITH AN EMPHASIS ON PRIORITY POPULATIONS. 7. INCREASE ACCESS TO PEER RECOVERY COACHES FOR THOSE WITH SUBSTANCE USE/MISUSE ISSUES. 8. REDUCE ELDER HEALTH ISOLATION AND DEPRESSION. 9. INCREASE THE NUMBER OF PRACTICE SETTINGS WITH INTEGRATED BEHAVIORAL HEALTH AND PRIMARY CARE/SPECIALTY CARE SERVICES.10. INCREASE PRIMARY CARE AND SPECIALTY CARE FOLLOW-UP AFTER DISCHARGE FROM HOSPITAL SETTINGS. COMMUNITY ACTIVITIES/STRATEGIES: PARTICIPATE IN LOCAL AND REGIONAL COALITIONS AND TASK FORCES TO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. PROVIDE HEALTH INSURANCE ENROLLMENT COUNSELING/ASSISTANCE AND PATIENT NAVIGATION SUPPORT SERVICES TO UNINSURED OR UNDERINSURED RESIDENTS AND PATIENTS WITH MENTAL HEALTH AND SUBSTANCE USE ISSUES. SUPPORT THE INTERFACE MENTAL HEALTH HOTLINE, WHICH PROVIDES EDUCATION AND REFERRAL SERVICES FOR THOSE SEEKING MENTAL HEALTH COUNSELING SERVICES. LOOK INTO DEVELOPING INTEGRATED BEHAVIORAL HEALTH SERVICES (MENTAL HEALTH AND SUBSTANCE USE) IN PRIMARY CARE AND OTHER SPECIALTY CARE SETTINGS (IMPACT MODEL) FOR THOSE WITH OR AT-RISK OF MENTAL HEALTH ISSUES, INCLUDING SCREENING, ASSESSMENT, AND TREATMENT. EXPLORE PARTNERSHIPS WITH ELDER SERVICE PROVIDERS THAT REACH OUT TO AND SERVE ISOLATED OLDER ADULTS NOT CURRENTLY ENGAGED IN COUNCIL ON AGING ACTIVITIES. EXPLORE PARTNERSHIPS WITH LOCAL HEALTH DEPARTMENTS, SUBSTANCE USE PROVIDERS, AND BIDNEEDHAM DEPARTMENTS TO IMPLEMENT PEER RECOVERY COACH PROGRAMS GEARED TO LINKING THOSE WITH SUBSTANCE USE/MISUSE ISSUES TO PEER RECOVERY. COACHES WHO PROVIDE RECOVERY, CASE MANAGEMENT, AND NAVIGATION SUPPORT RESEARCH IMPLEMENTATION OF A BIDNEEDHAM BRIDGE PROGRAM FOR THOSE SUFFERING FROM SUBSTANCE USE DISORDER THAT SCREENS, IDENTIFIES, ASSESSES, INITIATES TREATMENT, AND LINKS PARTICIPANTS TO LONG-TERM SUD SERVICES IN THE COMMUNITY. SUPPORT THE COMMUNITY CRISIS INTERVENTION TEAM (CCIT), A PARTNERSHIP BETWEEN HOSPITAL EMERGENCY DEPARTMENTS, PUBLIC SAFETY OFFICIALS, AND BEHAVIORAL HEALTH PROVIDERS GEARED TO REACHING OUT TO, REFERRING, AND ENGAGING SUBSTANCE USERS/MISUSERS IN TREATMENT. EXPLORE PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS THAT PROVIDE SOCIAL ENGAGEMENT ACTIVITIES FOR THOSE WHO ARE ISOLATED OR STRUGGLING WITH MENTAL HEALTH ISSUES. METRICS AND STATUS UPDATE: PARTICIPATION IN COALITIONS AND TASKFORCES. (FY20-FY22: ACTIVE ON THE SUBSTANCE PREVENTION ALLIANCE OF NEEDHAM (SPAN), NEEDHAM'S YOUTH RESOURCE NETWORK AND CHARLES RIVER OPIOID TASKFORCE). NUMBER OF PATIENTS PROVIDED WITH ASSISTANCE ENROLLING IN HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM OR ENROLLING IN HEALTH INSURANCE. (FY20: 125; FY21: 70; FY22: 127). PROVIDED SERVICES FOR PATIENTS EXPERIENCING MENTAL HEALTH ISSUES COMING TO BID-NEEDHAM'S EMERGENCY DEPARTMENT, INCLUDING EVALUATION AND SUPPORTING TRANSITIONS TO INPATIENT LEVELS OF CARE, AS NEEDED. NUMBER OF INDIVIDUALS SERVED BY INTERFACE MENTAL HEALTH HOTLINE. (FY20: 141 SERVED IN NEEDHAM, AND 86 IN MEDFIELD; FY21: 166 SERVED IN NEEDHAM, AND 77 IN MEDFIELD; FY22: 185 SERVED IN NEEDHAM, 178 IN MEDFIELD, AND 114 IN WESTWOOD). IMPLEMENTED COLLABORATIVE CARE MODEL IN PRIMARY CARE PHYSICIAN OFFICES TO SUPPORT THE MENTAL HEALTH NEEDS OF PATIENTS. INTEGRATION OF BEHAVIORAL HEALTHCARE INTO PATIENT CARE IN SPECIALTY CARE SETTINGS AND EMERGENCY DEPARTMENT AND ASSIST WITH PATIENT NAVIGATION AND SUPPORT SERVICES. (FY21: EMBEDDED A SOCIAL WORKER IN THE EMERGENCY DEPARTMENT, AND ADDED A DIRECTOR OF BEHAVIORAL HEALTH TO OVERSEE THE STRATEGIC DEVELOPMENT OF THE HOSPITAL'S BEHAVIORAL HEALTH PROGRAM; FY22: EXPANDED THE BEHAVIORAL HEALTH STAFF AT THE HOSPITAL, WHICH NOW INCLUDES A CHIEF OF PSYCHIATRY, A DIRECTOR OF MEDICAL PSYCHIATRY, AND PSYCHIATRY NURSE PRACTITIONERS TO PROVIDE WEEKEND COVERAGE VIA TELEHEALTH, AND HIRED A WILLIAM JAMES INTERN IN SEPTEMBER 2022 TO ASSIST WITH PILOTING BEHAVIORAL HEALTH PROGRAMS TO ASSIST PATIENTS AFTER DISCHARGE). EXPLORED PARTNERSHIPS WITH ELDER SERVICES PROVIDERS, INCLUDING WINGATE, NORTHBRIDGE AND HEBREW SENIOR LIFE. BID-NEEDHAM ALSO PROVIDED A SENIOR VOLUNTEER PROGRAM FOR OLDER ADULTS. THE PROGRAM HAD 65 VOLUNTEERS IN FY20, 25 IN FY21 (AFTER COVID) AND 15 IN FY22. EXPLORED PARTNERSHIPS WITH SUBSTANCE USE PROVIDERS, INCLUDING GOSNOLD AND RIVERSIDE. PROVIDED GRANT TO NEEDHAM PUBLIC HEALTH FOR A PILOT PROJECT TO TRAIN AND DISTRIBUTE NARCAN TO THE COMMUNITY (FY21) WITH PROGRAM IMPLEMENTED IN FY22. RESEARCHED THE IMPLEMENTATION OF A BRIDGE PROGRAM IN FY22, WITH PEER RECOVER COACH PROGRAM TO BE IMPLEMENTED AT BID-NEEDHAM IN FY23. THE HOSPITAL WAS INVOLVED WITH THE NEEDHAM CCIT IN FY20-FY22 AND NORWOOD CCIT IN FY22. METRICS AND STATUS UPDATE NUMBER OF ACTIVITIES/PROGRAMS AND PARTICIPANTS. (FY20: SUPPORTED WALKER SCHOOL'S RE-OPENING PLAN AFTER COVID-19 AND RIVERSIDE COMMUNITY CARE'S RIVERSIDE SCHOOL TO PROVIDE SUPPORT TO TWO STUDENTS AND STAFF; FY21: PROVIDED SCHOLARSHIPS FOR YOUTH TO PARTICIPATE IN PLUGGED IN BAND PROGRAM AND ST. JOE'S SUMMER THEATER PROGRAM, PROVIDED FUNDING TO DOVER PARKS & RECREATION FOR OUTDOOR YOUTH PROGRAMMING WITH AN AVERAGE OF 30 STUDENTS PARTICIPATING, TO WALKER FOR ITS THERAPEUTIC SUMMER PROGRAMS WITH 25 STUDENTS PARTICIPATING AND FUNDING TO RIVERSIDE SCHOOL TO SUPPORT TWO STUDENTS AND STAFF; FY22: SUPPORTED THE WALKER PROGRAM'S OUTPATIENT AND IN-HOME THERAPY PROGRAMS AND THERAPEUTIC MENTORING PROGRAMS WITH 119 UNDUPLICATED INDIVIDUALS SERVED, AND RIVERSIDE'S 2-DAY SOLUTION FOCUSED THERAPY TRAINING ATTENDED BY 22 CLINICIANS, WITH 10 MONTHS OF HOURLY CONSULTATION FOLLOWING THE TRAINING).COMMUNITY PARTNERS: BETH ISRAEL DEACONESS HEALTHCARE, DOVER PARKS AND RECREATION, GOSNOLD, MEDFIELD COALITION FOR SUICIDE PREVENTION, NEEDHAM POLICE, NEEDHAM FIRE, NEEDHAM YOUTH & FAMILY SERVICES, NEEDHAM PUBLIC HEALTH, NEWTON WELLESLEY HOSPITAL, PLUGGED IN BAND, RIVERSIDE COMMUNITY CARE, SPAN, ST. JOE'S SUMMER THEATER, WALKER, WESTWOOD YOUTH AND FAMILY SERVICES, WILLIAM JAMES COLLEGE GOAL: DECREASE THE NUMBER OF PRESCRIPTION DRUGS AND OTHER HARMFUL DRUGS FROM THE COMMUNITY TARGET POPULATION: YOUTH, OLDER ADULTS, LOW- TO MODERATE-INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/ COMPLEX CONDITIONS PROGRAMMATIC OBJECTIVES: 1. DECREASE THE AVAILABILITY OF UNUSED PRESCRIPTION DRUGS. 2. INCREASE THE # OF OPPORTUNITIES THAT RESIDENTS OF THE SERVICE AREA CAN GIVE BACK UNUSED PRESCRIPTIONS. COMMUNITY ACTIVITIES/STRATEGIES: SUPPORT "DRUG TAKE BACK DAYS" WITH COMMONWEALTH AND LOCAL LAW ENFORCEMENT AND OTHER COMMUNITY-BASED PARTNERS MAINTAIN PRESCRIPTION DRUG DISPOSAL KIOSK IN THE LOBBY OF THE HOSPITAL TO PROVIDE A SAFE PLACE FOR THE COMMUNITY TO DISPOSE OF UNWANTED/ UNNEEDED DRUGS CONTINUE BID-NEEDHAM OPIOID TASKFORCE TO DECREASE USE OF AND PRESCRIBING OF OPIOIDS IN THE HOSPITAL, AND TO EDUCATE PATIENTS ON OPIOID USE AND ALTERNATIVES FOR PAIN MANAGEMENT. METRICS AND STATUS UPDATE: THE HOSPITAL SUPPORTED THE NEEDHAM DRUG TAKE BACK DAY BY PROMOTING IN THE EMPLOYEE NEWSLETTER AND ON SOCIAL MEDIA. NUMBER OF PRESCRIPTION DRUGS AND SHARPS COLLECTED. (FY20: 89 POUNDS OF PRESCRIPTION DRUGS AND FIVE SHARPS CONTAINERS, FY21:376 POUNDS OF PRESCRIPTION DRUGS AND 74 GALLONS OF SHARPS. FY 22: 409 POUNDS OF MEDICATION AND 106 GALLONS OF SHARPS). BID-NEEDHAM'S INTERNAL "PAIN MANAGEMENT & OPIOID TASKFORCE" RAN FROM FY20-FY22 TO ADDRESS PAIN MANAGEMENT, PRESCRIBING PRACTICES, AND CLINICIAN EDUCATION FOR THE HOSPITAL TO REDUCE OPIOID MISUSE. COMMUNITY PARTNERS: NEEDHAM PUBLIC HEALTH PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONS AND THEIR RISK FACTORS WHILE MENTAL HEALTH AND SUBSTANCE USE WERE PERCEIVED TO BE THE LEADING ISSUES IN BIDNEEDHAM'S SERVICE AREA, ONE CANNOT LOSE SIGHT OF THE FACT THAT HEART DISEASE, STROKE AND CANCER ARE THE LEADING CAUSES OF DEATH IN THE NATION AND THE COMMONWEALTH. IF YOU INCLUDE RESPIRATORY DISEASE (E.G., ASTHMA, COPD) AND DIABETES, WHICH ARE IN THE TOP 10 LEADING CAUSES ACROSS ALL GEOGRAPHIES, THEN ONE CAN ACCOUNT FOR THE VAST MAJORITY OF CAUSES OF DEATH. WITHIN THIS PRIORITY AREA, ACCORDING TO THOSE WHO PARTICIPATED IN INTERVIEWS, FOCUS GROUPS, THE COMMUNITY MEETING, AND THE COMMUNITY HEALTH SURVEY, CARDIOVASCULAR DISEASE, CANCER, DIABETES, AND ALZHEIMER'S DISEASE AND OTHER DEMENTIAS WERE THOUGHT TO BE OF THE HIGHEST PRIORITY. IT IS ALSO IMPORTANT TO NOTE THAT THE RISK FACTORS FOR NEARLY ALL CHRONIC/COMPLEX CONDITIONS ARE MUCH THE SAME, INCLUDING LACK OF PHYSICAL ACTIVITY, POOR NUTRITION, OBESITY, TOBACCO USE, AND ALCOHOL USE. GOAL: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, REFERRAL, AND CHRONIC DISEASE MANAGEMENT SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS TARGET POPULATION: OLDER ADULTS, LOW- TO MODERATE-INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/ COMPLEX CONDITIONS PROGRAMMATIC OBJECTIVES: 1. INCREASE THE NUMBER OF PEOPLE WHO ARE EDUCATED ABOUT CHRONIC DISEASE RISK FACTORS AND PROTECTIVE BEHAVIORS. 2. INCREASE THE NUMBER OF ADULTS WHO ARE ENGAGED IN EVIDENCE-BASED SCREENING, COUNSELING, SELF-MANAGEMENT SUPPORT, CHRONIC DISEASE MANAGEMENT, REFERRAL SERVICES, AND/OR SPECIALTY CARE SERVICES. 3. INCREASE THE NUMBER OF PEOPLE WITH CHRONIC/COMPLEX CONDITIONS WHOSE CONDITIONS ARE UNDER CONTROL. COMMUNITY ACTIVITIES/STRATEGIES: PARTICIPATE IN COALITIONS AND TASK FORCES TO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. PARTNER WITH COMMUNITY GROUPS TO OFFER WELLNESS, FITNESS EDUCATION AND OTHER EVENTS AS PART OF COMPREHENSIVE CHRONIC DISEASE MANAGEMENT FOR UNDERSERVED COMMUNITY MEMBERS, AND OTHER PRIORITY POPULATION SEGMENTS. PROVIDE FIRST AID, CPR AND STROKE MANAGEMENT TRAININGS TO RESIDENTS, SERVICE PROVIDERS, AND FIRST RESPONDERS AS PART OF COMPREHENSIVE CHRONIC DISEASE PREVENTION AND MANAGEMENT EFFORTS. PROVIDE EVIDENCE-BASED HEALTH EDUCATION ON RISK/PROTECTIVE FACTORS, AND SELF-MANAGEMENT SUPPORT PROGRAMS THROUGH PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS. SUPPORT SCREENING, EDUCATION, AND REFERRAL PROGRAMS IN CLINICAL AND NON-CLINICAL SETTINGS. PROMOTE ENHANCED CARE TRANSITIONS, CARE COORDINATION AND FOLLOW-UP CARE PROGRAMS TARGETING THOSE WITH CHRONIC/COMPLEX CONDITIONS AFTER DISCHARGE FROM THE HOSPITAL. PROVIDE COMMUNITY HEALTH MINI GRANTS TO COMMUNITY PARTNERS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT PROMOTE HEALTH EDUCATION, SCREENING, REFERRAL, AND CHRONIC DISEASE MANAGEMENT FOR PRIORITY POPULATIONS. METRICS AND STATUS UPDATE: A BID-NEEDHAM REPRESENTATIVE SERVED ON THE PLANNING BOARD FOR CHNA18 IN FY20 AND FY21, AND HELPED WITH THE DISTRIBUTION OF GRANTS. NUMBER OF FREE, VIRTUAL HEALTH EDUCATION PROGRAMS CONDUCTED AND NUMBER OF PARTICIPANTS. (FY 20: SOME OF THE TALKS WERE CANCELLED DUE TO COVID-19, BUT "REDUCING ANXIETY WITH TAI CHI" WAS HELD WITH 17 ATTENDEES, FY 21 TALKS INCLUDED "STRATEGIES TO MAINTAIN AND PREVENT BRAIN HEALTH AND PREVENT MEMORY LOSS," "REDUCING ANXIETY WITH TAI CHI, AND "MYTHS AND TRUTHS ABOUT GETTING OLDER," WITH APPROXIMATELY 30 ATTENDEES EACH; FY 22 TALKS HELD INCLUDING "MYTHS & TRUTHS ABOUT THE COVID PANDEMIC," "THE ROAD BACK TO WELLNESS POST-COVID," "MEN'S HEALTH AND AGING, AND "ACHIEVING A BETTER NIGHT'S SLEEP," WITH APPROXIMATELY 20 ATTENDEES PER TALK). BID-NEEDHAM HAS AN ONGOING PARTNERSHIP PROGRAM WITH LOCAL PARAMEDICS TO IDENTIFY AND PREPARE FOR STROKE PATIENTS COMING INTO THE EMERGENCY DEPARTMENT, TO GET THEM CARE AS QUICKLY AS POSSIBLE. NUMBER OF PATIENTS WITH CANCER (PAST OR PRESENT) GRADUATING FROM LIVESTRONG PROGRAM. (FY20: 34 INDIVIDUALS GRADUATED; FY21: 24 INDIVIDUALS GRADUATED; FY22: 11 INDIVIDUALS GRADUATED). BID-NEEDHAM PROVIDES FINANCIAL SUPPORT TO BETH ISRAEL DEACONESS HEALTHCARE PRIMARY CARE OFFICES WITHIN THE SERVICE AREA, TO ENSURE ACCESS TO SCREENING AND EDUCATION FOR LOCAL RESIDENTS. NUMBER OF RIDES TO/FROM MEDICAL APPOINTMENTS THROUGH NEEDHAM COMMUNITY COUNCIL GRANT. (FY20: 375 RIDES; FY21: 577 RIDES; FY22: 1,377 RIDES). NUMBER OF TAXI AND UBER RIDES HOME FROM MEDICAL APPOINTMENTS/DISCHARGE AT THE HOSPITAL. (FY20: 28 TAXI RIDES AND 80 UBER RIDES, FY21: 500 UBER RIDES, FY22: 1,007 UBER RIDES). TWO CONGESTIVE HEART FAILURE (CHF) NURSES (34 HOURS A WEEK AND 28 HOURS A WEEK) FOLLOW PATIENTS WHO HAVE HIGH-RISK CHF BY MAKING FREQUENT CALLS TO ASSESS FOR SYMPTOMS, MEDICATION CHANGES, TESTS OR PROCEDURES, EDUCATION ON PREVENTION OF CHF EXACERBATION, DIETARY TEACHING, REFERRALS AND COORDINATION OF CARE. IMPACT OF COMMUNITY MINI-GRANTS AT CHARLES RIVER CENTER: (FY20: EAR LOBE PULSE OXIMETERS AND PORTABLE VITAL SIGN MACHINES FOR FIVE RESIDENTIAL PROGRAMS, SERVING 32 RESIDENTS. FY21: PURCHASE AND INSTALL THREE AED MACHINES, AND TRAIN STAFF TO USE THE EQUIPMENT). IMPACT FOR UNDERSERVED RESIDENTS FACING SUDDEN CRISIS, ASSISTED WITH MEAL PREPARATION, RIDES, AND BASIC HOUSEHOLD CHORES THROUGH NEIGHBOR BRIGADE (FY20: THREE MONTHS OF INCREASED COSTS COVERED TO FACILITATE SERVICE DURING COVID-19. FY21: RIDES TO COVID-19 TESTING AND VACCINATIONS, FY22: 417 CLIENTS SERVED). SUPPORT AND COMMUNICATE WITH LOCAL ORGANIZATIONS. (FY20: "COMMUNITY RESOURCE GROUP," MET IN-PERSON ONCE, FY21 AND FY22: TRANSITIONED TO AN EMAIL NEWSLETTER DISTRIBUTED TO 113 ORGANIZATIONS ON A SEMI-ANNUAL BASIS). COMMUNITY PARTNERS: BETH ISRAEL DEACONESS HEALTHCARE, BOSTON JCC, CHNA 18, CHARLES RIVER CHAMBER OF COMMERCE, CHARLES RIVER YMCA, CHARLES RIVER CENTER, FALLON AMBULANCE, FAMILY PROMISE METROWEST, NEEDHAM COMMUNITY COUNCIL, NEEDHAM FIRE DEPARTMENT, NEEDHAM PUBLIC SCHOOLS, NEIGHBOR BRIGADE, NORWOOD FIRE DEPARTMENT, WESTWOOD COUNCIL ON AGING, WESTWOOD FIRE DEPARTMENT, VNA CARE NETWORK GOAL: REDUCE THE PREVALENCE OF TOBACCO USE TARGET POPULATION: YOUTH, OLDER ADULTS, LOW- TO MODERATE-INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/ COMPLEX CONDITIONS PROGRAMMATIC OBJECTIVES: 1. INCREASE THE NUMBER OF PEOPLE WHO QUIT SMOKING CIGARETTES, VAPING, OR USING E-CIGARETTES2. INCREASE ACCESS TO TOBACCO, VAPING/E-CIGARETTE CESSATION PROGRAMS COMMUNITY ACTIVITIES/STRATEGIES: SUPPORT SMOKING CESSATION PROGRAMS GEARED TO REDUCING TOBACCO, VAPING AND E-CIGARETTE USE. PROVIDE COMMUNITY EDUCATION ON THE RISKS OF VAPING AND TOBACCO USE. METRICS AND STATUS UPDATE: BID-NEEDHAM HAD PLANNED TO PARTNER WITH NEEDHAM PUBLIC HEALTH TO OFFER A SMOKING CESSATION PROGRAM TO NEEDHAM PUBLIC HOUSING IN FY20, BUT THE PROGRAM WAS CANCELLED DUE TO THE COVID-19 PANDEMIC. FY20 BID-NEEDHAM, SPAN AND THE BOSTON JCC COLLABORATED TO BRING A TALK, "YOUTH VAPING: THE NEW LOOK OF NICOTINE ADDICTION" WITH 12 ATTENDEES; AND THE BID-NEEDHAM RESPIRATORY TEAM HOSTED AN INFORMATION TABLE AT NEEDHAM HIGH SCHOOL IN FY20 FOR STUDENTS AND TEACHERS TO DEMONSTRATE THE EFFECTS OF VAPING ON THE LUNGS WITH APPROXIMATELY 15 PEOPLE RECEIVING INFORMATION. THE HOSPITAL ALSO SUPPORTED SPAN'S CAMPAIGNS TO EDUCATE STUDENTS AND PARENTS ON THE RISKS OF VAPING AND NICOTINE USE. COMMUNITY PARTNERS: BOSTON JCC, NEEDHAM HIGH SCHOOL, SPAN PRIORITY AREA 3: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE A DOMINANT THEME FROM THE ASSESSMENT WAS THE TREMENDOUS IMPACT THAT UNDERLYING SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY ACCESS TO AFFORDABLE HOUSING, TRANSPORTATION, POVERTY/EMPLOYMENT, AND FOOD INSECURITY HAVE ON THE ENTIRE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE OFTEN THE DRIVERS OR UNDERLYING FACTORS THAT CREATE OR EXACERBATE MENTAL HEALTH ISSUES, SUBSTANCE MISUSE, AND CHRONIC/COMPLEX CONDITIONS. THESE SOCIAL DETERMINANTS OF HEALTH, PARTICULAR POVERTY, UNDERLIE THE ACCESS TO CARE ISSUES THAT WERE PRIORITIZED IN THE ASSESSMENT: NAVIGATING THE HEALTH SYSTEM (INCLUDING HEALTH INSURANCE), CHRONIC DISEASE MANAGEMENT, AND ACCESS TO CULTURALLY AND LINGUISTICALLY COMPETENT CARE. GOAL: ENHANCE ACCESS TO CARE AND REDUCE THE IMPACT OF SOCIAL DETERMINANTS TARGET POPULATION: YOUTH, OLDER ADULTS, LOW- TO MODERATE-INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/ COMPLEX CONDITIONS PROGRAMMATIC OBJECTIVES: 1. INCREASE PARTNERSHIPS AND COLLABORATION WITH SOCIAL SERVICE AND OTHER COMMUNITY-BASED ORGANIZATIONS.2. INCREASE EDUCATIONAL OPPORTUNITIES RELATED TO THE IMPORTANCE AND IMPACT OF SOCIAL DETERMINANTS.3. DECREASE THE NUMBER OF PEOPLE WHO STRUGGLE WITH FINANCIAL INSECURITY.4. INCREASE ACCESS TO LOW COST HEALTHY FOODS WITH AN EMPHASIS ON PRIORITY POPULATION SEGMENTS.5. INCREASE ACCESS TO AFFORDABLE, SAFE TRANSPORTATION OPTIONS WITH AN EMPHASIS ON PRIORITY POPULATION SEGMENTS.6. INCREASE TRAINING AND EMPLOYMENT OPPORTUNITIES FOR LOW TO MODERATE INCOME RESIDENTS WITH AN EMPHASIS ON PRIORITY POPULATION SEGMENTS.7. INCREASE THE NUMBER OF PEOPLE ASSISTED WITH INSURANCE AND OTHER PUBLIC PROGRAM ENROLLMENT, AND PATIENT NAVIGATION.8. INCREASE ACCESS TO SOCIAL EXPERIENCES FOR THOSE WHO ARE ISOLATED AND LACK FAMILY/CAREGIVER AND OTHER SOCIAL SUPPORTS. COMMUNITY ACTIVITIES/STRATEGIES: PARTICIPATE IN REGIONAL AND LOCAL TASK FORCES AND COALITIONS TO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. PROVIDE COMMUNITY HEALTH MINI GRANTS TO COMMUNITY PARTNERS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT ADDRESS SOCIAL DETERMINANTS AND ACCESS TO CARE. SUPPORT FARMERS MARKETS AND OTHER FOOD ACCESS INITIATIVES THAT PROVIDE FRESH, LOCALLY-GROWN PRODUCE TO LOW TO MODERATE INCOME, UNDERSERVED POPULATIONS. SUPPORT LOCAL FOOD ACCESS ORGANIZATIONS AND INITIATIVES TO PROVIDE NUTRITION EDUCATION AND FOOD ACCESS TO LOW AND MODERATE INCOME POPULATIONS LIVING IN PUBLIC HOUSING, SCHOOL-BASED AFTER-SCHOOL PROGRAMS, COUNCILS ON AGING, AND OTHER COMMUNITY VENUES. SUPPORT WELLNESS AND NUTRITION EDUCATION EVENTS IN PARTNERSHIP WITH COMMUNITY PARTNERS. PROVIDE ENROLLMENT COUNSELING/ ASSISTANCE AND PATIENT NAVIGATION SUPPORT SERVICES TO UNINSURED OR UNDERINSURED RESIDENTS TO ENHANCE ACCESS TO CARE. PROVIDE LINGUISTICALLY AND CULTURALLY APPROPRIATE HEALTH EDUCATION AND CARE MANAGEMENT SUPPORT. EXPLORE TRANSPORTATION ACCESS PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND OTHER COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE, SAFE, ACCESSIBLE TRANSPORTATION OPTIONS. ORGANIZE AND SUPPORT WORKFORCE MENTORSHIP AND TRAINING PROGRAMS TO ENHANCE JOB TRAINING, SKILLS DEVELOPMENT AND CAREER ADVANCEMENT. METRICS AND STATUS UPDATE: REPRESENTATIVES FROM BID-NEEDHAM SERVE ON THE COMMUNITY CRISIS INTERVENTION TEAMS (CCIT) IN NEEDHAM AND NORWOOD, WHICH ADDRESSED NOT ONLY MENTAL HEALTH AND SUBSTANCE USE, BUT ALSO SOCIAL DETERMINANTS OF HEALTH FOR RESIDENTS IN THE COMMUNITY. NUMBER OF INDIVIDUALS/FAMILIES SERVED TO SUPPORT HOMELESSNESS PREVENTION THROUGH FAMILY PROMISE METROWEST. (FY20: 50 FAMILIES WERE PROVIDED WITH RESOURCES TO ADDRESS HEALTH NEEDS; FY21: THE 22 FAMILIES ENROLLED WERE ABLE TO AVOID GOING INTO SHELTERS, FY22: 11 FAMILIES WHO GRADUATED FROM THE LIFE PROGRAM RETAINED SAFE, AFFORDABLE HOUSING, AND THE 22 FAMILIES CURRENTLY ENROLLED ALL REMAINED IN THEIR HOMES OR WERE MOVED TO OTHER SAFE AFFORDABLE HOUSING). NUMBER OF UNDERSERVED PATIENTS IN INPATIENT AND EMERGENCY DEPARTMENT PROVIDED NEW, FREE ESSENTIAL UPON DISCHARGE. (FY21: PROVIDED 294 ITEMS OF CLOTHING, 168 PERSONAL HYGIENE ITEMS, 43 PAIRS OF SNEAKERS AND 324 UNDERGARMENTS/SOCKS; FY22: 567 ITEMS OF CLOTHING, 24 BACKPACKS, 68 PAIRS OF SHOES, 24 RAIN PONCHOS, AND 380 UNDERGARMENTS/SOCKS). NUMBER OF "WELCOMEBACKPACKS" (BACKPACKS CONTAINING HYGIENE AND SAFETY SUPPLIES) PROVIDED TO INCARCERATED MEN AND WOMEN UPON RELEASE BY CONCORD PRISON OUTREACH: (FY21: 60 WELCOMEBACKPACKS PROVIDED). NUMBER OF MASS BAY COMMUNITY COLLEGE STUDENTS PROVIDED MEAL SCHOLARSHIP TO PURCHASE FOOD DURING THE SUMMER MONTHS. (FY21: 12 STUDENTS). NUMBER OF FAMILIES SERVED, POUNDS AND VALUE OF FRESH PRODUCE DISTRIBUTED FROM NEEDHAM COMMUNITY FARM FOR SEASONAL MOBILE MARKET AND GARDENING PROGRAMS AT NEEDHAM HOUSING AUTHORITY. (FY20 MORE THAN 125 FAMILIES, MORE THAN 1,900 POUNDS OF FRESH PRODUCE, VALUED AT OVER $14,000; FY21: MORE THAN 100 FAMILIES MORE THAN 1,700 POUNDS OF FRESH PRODUCE, VALUED AT OVER $14,000; FY22: MORE THAN 200 FAMILIES APPROXIMATELY 3,000 POUNDS OF FRESH PRODUCE, VALUED AT APPROXIMATELY $18,000). FOOD DISTRIBUTED BY DEDHAM FOOD PANTRY. (FY21: 15,000 POUNDS OF FOOD; FY22: 324,000 POUNDS OF FOOD DISTRIBUTED TO 1,702 SENIORS, 3,652 ADULTS AND 2,817 CHILDREN. THE PANTRY SPENDS APPROXIMATELY $14,000 PER MONTH ON FOOD, SO THE HOSPITAL'S GRANT COVERED ABOUT 2 WEEKS OF FOOD DISTRIBUTION). IN FY20 AND FY21, THE HOSPITAL SUPPORTED THREE SQUARES RIDE FOR FOOD, AN ORGANIZATION THAT RAISES FUNDS FOR LOCAL HUNGER RELIEF ORGANIZATIONS. THE ORGANIZATION WORKS WITH 24 LOCAL FOOD DISTRIBUTION PARTNERS TO DISTRIBUTE 4,000,000 POUNDS OF FOOD ANNUALLY. NUMBER OF SHOPPERS AT THE NEEDHAM FARMER'S MARKET. (FY20: MORE THAN 7,787; FY21: 12,225; FY22: 10,325). NUMBER OF PATIENTS SUCCESSFULLY IN MASSHEALTH IN FY20, BY FINANCIAL COUNSELORS. (FY20: 125 PATIENTS; FY21:70 PATIENTS; FY22: 127 PATIENTS). NUMBER OF INTERPRETATION SERVICES ACCESSED VIA VIDEO REMOTE, FACE-TO-FACE AND TELEPHONIC INTERPRETER SERVICES. (FY20: VIDEO REMOTE 1,060 TIMES, FACE-TO-FACE 33 TIMES AND TELEPHONIC 710 TIMES; FY21: VIDEO REMOTE 1,300 TIMES, FACE-TO-FACE DISCONTINUED DUE TO COVID-19 AND TELEPHONIC 710 TIMES; FY22: VIDEO REMOTE 2,476 TIMES, FACE-TO-FACE DISCONTINUED DUE TO COVID-19 AND TELEPHONIC 1,332 TIMES). MEETINGS BETWEEN BID-NEEDHAM PRESIDENT, NEEDHAM TOWN MANAGER AND STATE REPRESENTATIVE TO DISCUSS TRANSPORTATION AND OTHER ISSUES IN TOWN (FY20: 10, FY21: 10, FY22: 11). NUMBER OF MENTORS TRAINED IN BID-NEEDHAM PEER SUPPORT PROGRAM. (FY22: 22). NUMBER OF STAFF WHO PARTICIPATED IN PEER SUPPORT PROGRAM. (FY22: 44).COMMUNITY PARTNERS: AMN STRATUS, BETH ISRAEL DEACONESS HEALTHCARE, CIRCLE OF HOPE, CONCORD PRISON OUTREACH, DEDHAM FOOD PANTRY, FAMILY PROMISE METROWEST, MASS BAY COMMUNITY COLLEGE, NEEDHAM BANK, NEEDHAM COMMUNITY FARM, NEEDHAM FARMER'S MARKET, NEEDHAM STEPS UP, THREE SQUARES NEW ENGLAND GOAL: REDUCE ELDER FALLS AND PROMOTE AGING IN PLACE TARGET POPULATION: OLDER ADULTS PROGRAMMATIC OBJECTIVES: 1. REDUCE FEAR OF FALLING 2. REDUCE FALLS 3. INCREASE ACTIVITY LEVELS 4. REDUCE PREVENTABLE EMERGENCY DEPARTMENT AND INPATIENT VISITS 5. INCREASE THE NUMBER OF OLDER ADULTS LIVING INDEPENDENTLY IN THEIR HOMES COMMUNITY ACTIVITIES/STRATEGIES: SUPPORT SAFETY AT HOME PROGRAM FOR OLDER ADULTS TO PROMOTE AGING IN PLACE AND REDUCE FALLS. SUPPORT THE FALL PREVENTION COMMITTEE TO REDUCE FALLS. ORGANIZE MATTER OF BALANCE WORKSHOPS FOR PRIORITY POPULATIONS. SUPPORT OTHER ELDER SERVICE PROGRAMMING TO ENCOURAGE AGING IN PLACE. CONTINUE 5-YEAR COMMITMENT TO ADDRESS HEALTHY AGING, WITH NEEDHAM PUBLIC HEALTH AND NEEDHAM COUNCIL ON AGING. METRICS AND STATUS UPDATE: BID-NEEDHAM HAD PLANNED TO PARTNER WITH THE NEEDHAM PUBLIC HEALTH DEPARTMENT TO OFFER A "SAFETY AT HOME" PROGRAM, WHERE HOME REPAIRS AND SAFETY MEASURES COULD BE ADDED TO HELP OLDER ADULTS AGE IN PLACE. HOWEVER, THE PROGRAM WAS DISCONTINUED DUE TO COVID-19. BID-NEEDHAM CONTINUES THE WORK OF THE FALL PREVENTION COMMITTEE TO ENSURE THE SAFETY OF PATIENTS WHO MAY BE AT-RISK FOR FALLS, BOTH WHILE IN THE HOSPITAL AND UPON DISCHARGE. TRAVELING MEALS PROVIDED TO OLDER ADULTS WHO WERE HOMEBOUND IN NEEDHAM. (FY20 AND FY21: 9,500 PER YEAR; FY22: 10,200). NUMBER OF OLDER ADULTS PROVIDED WITH HEALTHY FOOD THROUGH WESTWOOD AND DOVER COUNCILS ON AGING (COA) TO ADDRESS FOOD INSECURITY AND NUTRITION. (FY20: 40 FARM SHARES; FY21: 23 SHELF STABLE FOOD BOXES TAILORED TO NUTRITIONAL NEEDS, AND 708 ADULTS ACCESSING "GRAB & GO MEALS AND OUTDOOR, DISTANCED SOCIALIZATION EVENTS; FY22: 32 BI-MONTHLY FARM SHARES PROVIDED). NUMBER OF STAFF TRAINED AND PATIENTS DISCHARGED FROM VNA CARE NETWORK'S "REMOVING BARRIERS TO HEALTH" PROGRAM. (FY20: ALL CLINICIANS AND SOCIAL WORKERS TRAINED IN COMMUNITY RESOURCES; FY21: 437 PATIENTS DISCHARGED WITH NEEDS/GOALS MET). NUMBER OF UNDERSERVED OLDER ADULTS WITH NEEDS MET BY DEDHAM COUNCIL ON AGING. (FY20 1,000 BAGS OF FOOD DELIVERED TO 250 OLDER ADULT HOUSEHOLDS; FY21: TWENTY IPADS AND WIFI ACCESS PROVIDED). NUMBER OF ADULTS PROVIDED WITH FITNESS, HEALTH, SOCIAL PROGRAMS, GROCERY DELIVERY AND TRANSPORTATION THROUGH "HEALTHY AGING" INITIATIVE WITH NEEDHAM PUBLIC HEALTH. (FY20: 30 OLDER ADULTS AND STUDENTS PARTICIPATED IN "BRIDGE THE GAP" SOCIAL PROGRAM PRIOR TO THE PANDEMIC, AND DURING THE PANDEMIC 36 OLDER ADULTS PER WEEK WERE PROVIDED WITH GROCERY DELIVERY; FY21: 36 OLDER ADULTS PER WEEK WERE PROVIDED WITH GROCERY DELIVERY, AND VIRTUAL FITNESS CLASSES OFFERED; FY22: PROVIDED EVIDENCE-BASED CLASSES INCLUDING FITNESS FOR ARTHRITIS WITH 365 PARTICIPANTS, TRAIN THE BRAIN WITH 25 PARTICIPANTS, CORE STRENGTH WITH 130 PARTICIPANTS AND STRETCHING WITH 295 PARTICIPANTS). COMMUNITY PARTNERS: DEDHAM COUNCIL ON AGING, DOVER COUNCIL ON AGING, NEEDHAM PUBLIC HEALTH, NEEDHAM COUNCIL ON AGING, WESTWOOD COUNCIL ON AGING, VNA CARE NETWORK COMMUNITY PARTNERSBID-NEEDHAM 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: AMERICAN CANCER SOCIETY AMN STRATUS BETH ISRAEL DEACONESS HEALTHCARE CHARLES RIVER CENTER CHARLES RIVER REGIONAL CHAMBER CHARLES RIVER YMCA CHNA 18 CIRCLE OF HOPE CONCORD PRISON OUTREACH DEDHAM COUNCIL ON AGING DEDHAM FOOD PANTRY DEDHAM YOUTH COMMISSION DOVER COUNCIL ON AGING DOVER PARKS & RECREATION FAMILY DINNER PROJECT FAMILY PROMISE METROWEST GREATER BOSTON JCC HESSCO LANGUAGE LINE LIVABLE DEDHAM LIVESTRONG AT THE YMCA MASS BAY COMMUNITY COLLEGE MEDFIELD COALITION FOR SUICIDE PREVENTION MEDFIELD PUBLIC SCHOOLS NEEDHAM BANK NEEDHAM CLERGY ASSOCIATION NEEDHAM COMMUNITY COUNCIL NEEDHAM COMMUNITY EDUCATION NEEDHAM COMMUNITY FARM NEEDHAM COUNCIL ON AGING NEEDHAM DOMESTIC VIOLENCE ACTION COMMITTEE NEEDHAM EMERGENCY MANAGEMENT NEEDHAM FARMER'S MARKET NEEDHAM FIRE DEPARTMENT NEEDHAM HISTORY CENTER AND MUSEUM NEEDHAM HOUSING AUTHORITY NEEDHAM POLICE DEPARTMENT NEEDHAM PUBLIC HEALTH NEEDHAM PUBLIC SCHOOLS NEEDHAM RESILIENCE NETWORK NEEDHAM SPORTS BOOSTERS NEEDHAM STEPS UP NEEDHAM TRAVELING MEALS PROGRAM NEEDHAM YOUTH & FAMILY SERVICES NEIGHBOR BRIGADE NEWTON WELLESLEY HOSPITAL NORWOOD FIRE DEPARTMENT NORWOOD POLICE DEPARTMENT PARENT TALK PLUGGED IN BAND RIPPLES OF HOPE RIVERSIDE COMMUNITY CARE SEAN D. BIGGS MEMORIAL FOUNDATION ST. JOE'S SUMMER THEATER STUDENTS ADVOCATING LIFE WITHOUT SUBSTANCE ABUSE (SALSA) SUBSTANCE PREVENTION ALLIANCE OF NEEDHAM (SPAN) THREE SQUARES NEW ENGLAND TOWN OF DEDHAM TOWN OF NEEDHAM VNA CARE NETWORK WALKER WESTWOOD COUNCIL ON AGING WESTWOOD YOUTH & FAMILY SERVICES WESTWOOD FIRE DEPARTMENT WILLIAM JAMES COLLEGE AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, BID-NEEDHAM IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE IS. IN THE FY 2023 - 2025 IS, WHICH WILL GUIDE BID-NEEDHAM'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2023, SEPTEMBER 30, 2024 AND SEPTEMBER 30, 2025, EXAMPLES OF IDENTIFIED NEEDS THAT WILL NOT BE MET IN THESE YEARS ARE SUPPORTING EDUCATION ACROSS THE LIFESPAN, AFFORDABILITY OF CHILDCARE, DIGITAL DIVIDE, TACKLING MISINFORMATION, CONNECTIONS BETWEEN POLICE AND COMMUNITY, AND STRENGTHENING THE BUILT ENVIRONMENT (I.E., IMPROVING ROADS/SIDEWALKS AND ENHANCING ACCESS TO SAFE RECREATIONAL SPACES/ACTIVITIES). IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE 2019 CHNA THAT ARE NOT INCLUDED IN THE 2019 IS AND WHICH HAVE GUIDED BID-NEEDHAM'S COMMUNITY BENEFITS ACTIVITIES THE PERIOD FOR THE FISCAL PERIOD COVERED BY THIS FILING. BID-NEEDHAM WILL BE UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES, AS BID-NEEDHAM'S CBAC AND SENIOR LEADERSHIP TEAM DECIDED THAT THESE ISSUES WERE OUTSIDE OF THE ORGANIZATION'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHERS AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. AS NOTED IN DETAIL ABOVE, THE BID-NEEDHAM'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BID-NEEDHAM CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 7.68% OF BID-NEEDHAM'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, BID-NEEDHAM'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://WWW.BIDNEEDHAM.ORG/ABOUT/COMMUNITY-INVOLVEMENT/COMMUNITY-BENEFITS. 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 BID-NEEDHAM FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESS IN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BID-NEEDHAM 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 ASSISTANCEBID-NEEDHAM'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 $922,826 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, BID-NEEDHAM IS ONE OF TEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $55,879,719 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, 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, BID-NEEDHAM 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, BID-NEEDHAM GENERATED $1,501,394 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY BID-NEEDHAM FOR SUCH SERVICES BY $826,191 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 7.5% OR 17,960 OF BID-NEEDHAM'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 49.3% OR 118,520 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND BID-NEEDHAM PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BID-NEEDHAM GENERATED $44,433,001 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $1,674,781. OF THESE AMOUNTS, REVENUE OF $37,223,434 IS RELATED TO THE PROVISION OF OBSERVATION SERVICES, EMERGENCY SERVICES, AND DISEASES AND DISORDERS OF THE RESPIRATORY SYSTEM 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 $6,435,336. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH BID-NEEDHAM 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, BID-NEEDHAM HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 8.93%.BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BID-NEEDHAM ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $3,341,839 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. AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM (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) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).FINANCIAL STATEMENT FOOTNOTESREVENUES UNDER THE TRADITIONAL FEE FOR SERVICE MEDICARE AND MEDICAID PROGRAMS ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS. RETROSPECTIVELY DETERMINED COST-BASED REVENUES UNDER THESE PROGRAMS, WHICH WERE MORE PREVALENT IN EARLIER PERIODS, AND CERTAIN OTHER PAYMENTS, SUCH AS DISPROPORTIONATE SHARE HOSPITAL AND BAD DEBT EXPENSE REIMBURSEMENT, WHICH ARE BASED ON OUR HOSPITALS' COST REPORTS, ARE ESTIMATED USING HISTORICAL TRENDS AND CURRENT FACTORS. COST REPORT SETTLEMENTS UNDER THESE PROGRAMS ARE SUBJECT TO AUDIT BY MEDICARE AND MEDICAID AUDITORS AND ADMINISTRATIVE AND JUDICIAL REVIEW, AND IT CAN TAKE SEVERAL YEARS UNTIL FINAL SETTLEMENT OF SUCH MATTERS IS DETERMINED AND COMPLETELY RESOLVED. THE SYSTEM RECORDS ACCRUALS TO REFLECT THE EXPECTED FINAL SETTLEMENTS ON COST REPORTS. FOR FILED COST REPORTS, THE ACCRUAL IS RECORDED BASED ON THOSE COST REPORTS AND SUBSEQUENT ACTIVITY. THE ACCRUAL FOR PERIODS FOR WHICH A COST REPORT IS YET TO BE FILED IS RECORDED BASED ON ESTIMATES OF WHAT THE SYSTEM EXPECTS TO REPORT ON THE FILED COST REPORTS. AFTER THE COST REPORT IS FILED, THE ACCRUAL MAY NEED TO BE ADJUSTED.EMERGENCY CARE ACCESSAS PREVIOUSLY NOTED IN THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM AND BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER OR BIDMC) IS A SISTER ENTITY TO BID-NEEDHAM. THE MEDICAL CENTER IS A NATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER AND TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) IS AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BIDMC AND IS ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BID-NEEDHAM EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. THE BID-NEEDHAM DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR. FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4) FINANCIAL ASSISTANCE POLICY PURPOSE BID-NEEDHAM IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE 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 BID-NEEDHAM AS WELL AS PROVIDERS WHO FOLLOW BID-NEEDHAM'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN BID-NEEDHAM AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW BID-NEEDHAM'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. BID-NEEDHAM DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY THE HOSPITAL'S BOARD EFFECTIVE ON OR ABOUT AUGUST 15, 2020.FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICYTRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, AND RUSSIAN. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://WWW.BIDNEEDHAM.ORG/YOUR-VISIT/INSURANCE-AND-FINANCIAL-INFORMATION. IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICYPLAIN LANGUAGE SUMMARY AS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE BID-NEEDHAM 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 SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, AND RUSSIAN, CAN BE FOUND ON THE BID-NEEDHAM WEBSITE AT: HTTPS://WWW.BIDNEEDHAM.ORG/YOUR-VISIT/INSURANCE-AND-FINANCIAL-INFORMATION. LIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLEDLOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT 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 FILING BIDN IS PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER IN BOSTON AND A SISTER ENTITY OF BIDN. AS PART OF THE SAME NETWORK, THE RESEARCH IN WHICH BIDMC ENGAGES SUPPORTS NOT ONLY THE MISSION AND CARE FOR BIDMC PATIENTS AND COMMUNITIES BUT ALSO HELPS TO IMPROVE PATIENT CARE FOR THE COMMUNITIES OF OTHER BILH AFFILIATES AND BEYOND. THE DETAIL BELOW PROVIDES BACKGROUND ON THE RESEARCH ACTIVITIES AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING.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 1,800 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,400 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 260 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE EMERGENCY MEDICINE MEDICINE ALLERGY AND INFLAMMATIONCARDIOVASCULAR MEDICINECENTER FOR VASCULAR BIOLOGY RESEARCHCENTER FOR VIROLOGY AND VACCINE RESEARCHCLINICAL INFORMATICSCLINICAL NUTRITIONENDOCRINOLOGYEXPERIMENTAL MEDICINEGASTROENTEROLOGYGENERAL MEDICINE AND PRIMARY CAREGENETICSGERONTOLOGYHEMATOLOGY AND ONCOLOGYHEMOSTASIS AND THROMBOSISIMMUNOLOGYINFECTIOUS DISEASEINTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGYMOLECULAR AND VASCULAR MEDICINENEPHROLOGYPULMONOLOGYRHEUMATOLOGYSIGNAL TRANSDUCTIONTRANSLATIONAL RESEARCHTRANSPLANT IMMUNOLOGYNEONATOLOGY NEUROLOGY OBSTETRICS AND GYNECOLOGY ORTHOPAEDIC SURGERY PATHOLOGY PSYCHIATRY RADIOLOGY SURGERY CARDIAC SURGERYCENTER FOR MINIMALLY INVASIVE SURGERYNEUROSURGERYPLASTIC AND RECONSTRUCTIVE SURGERYVASCULAR SURGERYTRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $241,917,383 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 2.99% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $307,298,416 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS ON SCHEDULE H, PART I LINE 7H COLUMN D, WHICH, IF INCLUDED IN SCHEDULE H, PART I, LINE 7H COLUMN E CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THIS SCHEDULE H, PART I, LINE 7H TO 2.21%. RESEARCH ENGAGED IN AT THE MEDICAL CENTER 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. COVID-19 VACCINE RESEARCHTHE PERIOD COVERED BY THIS FILING IS THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, DURING WHICH THE COVID-19 PANDEMIC CONTINUED TO DISRUPT LIFE IN THE UNITED STATES AND ACROSS THE GLOBE. RESEARCH CONDUCTED AT BIDMC DURING THIS FISCAL PERIOD HIGHLIGHTS BIDMC'S CONTINUING NATIONAL LEADERSHIP DURING THIS ONGOING PUBLIC HEALTH CRISIS.AS OF LATE JULY, 2021, ABOUT 48.5 PERCENT OF AMERICANS, OR ABOUT 159 MILLION PEOPLE, WERE FULLY VACCINATED AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19. BIDMC IMMUNOLOGIST DAN BAROUCH, MD, PHD, PLAYED AN INSTRUMENTAL ROLE IN DESIGNING AND DEVELOPING ONE OF THE FIRST THREE COVID-19 VACCINES TO COME TO MARKET IN THE UNITED STATES. AS DIRECTOR OF BIDMC'S CENTER FOR VIROLOGY AND VACCINE RESEARCH (CVVR), DR. BAROUCH AND HIS COLLEAGUES BEGAN WORKING ON A COVID-19 VACCINE ON JANUARY 10, 2020, THE SAME NIGHT THAT CHINESE SCIENTISTS RELEASED THE SARS-COV-2 VIRUS'S GENOME. DR. BAROUCH'S TEAM QUICKLY DESIGNED A SERIES OF VACCINE CANDIDATES, EVALUATED IN CLINICAL STUDIES LED BY PRIMARY INVESTIGATOR KATHRYN E. STEPHENSON, MD, MPH, DIRECTOR OF THE CLINICAL TRIALS UNIT AT CVVR.DR. BAROUCH'S INNOVATIVE VACCINE DESIGN NOW THE BASIS OF THE JOHNSON & JOHNSON SINGLE SHOT VACCINE USES A COMMON-COLD VIRUS, CALLED THE ADENOVIRUS, TO DELIVER A SMALL BIT OF THE COVID-19 DNA INTO HOST CELLS, WHERE IT STIMULATES THE BODY TO RAISE IMMUNE RESPONSES AGAINST THE VIRUS. SHOWN TO BE SAFE AND EFFECTIVE, THE COVID-19 VACCINE WAS GRANTED EMERGENCY USE APPROVAL BY THE U.S. FDA IN FEBRUARY, 2021.SINCE THEN, BAROUCH AND COLLEAGUES HAVE CONTINUED TO STUDY THE VIRUS' IMPACT ON THE IMMUNE SYSTEM AND HOW THE VACCINES AND THERAPIES DEVELOPED TO PROTECT AGAINST THE ORIGINAL STRAIN OF SARS-COV-2 ARE HOLDING UP AGAINST THE EMERGING VARIANTS. FOLLOWING IS A SUMMARY OUTLINING RESEARCH FROM FISCAL YEAR 2021.A STUDY LED BY BAROUCH AND COLLEAGUES SHED MORE LIGHT ON HOW MOLECULES OF THE IMMUNE AND VASCULAR SYSTEMS INTERACT TO PRODUCE THE EXTENSIVE DAMAGE TO THE LUNG AND VASCULAR TISSUES SEEN IN PATIENTS WITH SEVERE DISEASE. RESEARCHERS CONDUCTED COMPREHENSIVE ANALYSES OF TISSUE AND BLOOD SAMPLES FROM HUMANS AND FROM NON-HUMAN PRIMATES INFECTED WITH COVID-19. THE TEAM'S FINDINGS, PUBLISHED IN THE JOURNAL CELL, HELP DEFINE THE PATHWAYS BY WHICH COVID-19 INDUCES VASCULAR DISEASE AND ALSO POINT TO POTENTIAL THERAPEUTIC TARGETS. "OVERALL, OUR DATA REVEAL THE KEY BIOLOGICAL PROCESSES INVOLVED IN TRIGGERING THE CLOTTING AND VASCULAR DAMAGE OBSERVED WITH SARS-COV-19 INFECTION," SAID BAROUCH. "OUR RESULTS SUGGEST A MODEL IN WHICH CRITICAL INTERACTIONS BETWEEN INFLAMMATORY AND CLOTTING PATHWAYS LEAD TO SEVERE VASCULAR INJURY SEEN IN CRITICALLY ILL PATIENTS WITH COVID-19." IN A PAPER IN THE JOURNAL NATURE, BAROUCH, AND COLLEAGUES ELUCIDATED THE ROLE OF ANTIBODIES AND IMMUNE CELLS IN PROTECTION AGAINST SARS-COV-2, THE VIRUS THAT CAUSES COVID-19, IN RHESUS MACAQUES. "IN THIS STUDY, WE DEFINE THE ROLE OF ANTIBODIES VERSUS T CELLS IN PROTECTION AGAINST COVID-19 IN MONKEYS. WE REPORTTHAT A RELATIVELY LOW ANTIBODY TITER (THE CONCENTRATION OF ANTIBODIES IN THE BLOOD) IS NEEDED FOR PROTECTION," SAID BAROUCH. "SUCH KNOWLEDGE WILL BE IMPORTANT IN THE DEVELOPMENT OF NEXT GENERATION VACCINES, ANTIBODY-BASED THERAPEUTICS, AND PUBLIC HEALTH STRATEGIES FOR COVID-19." IN ANOTHER STUDY IN NATURE, BAROUCH AND COLLEAGUES ALSO TESTED JOHNSON & JOHNSON'S COVID-19 VACCINE IN RHESUS MACAQUES CHALLENGED WITH THE VIRAL VARIANT B.1.351 AND IN RHESUS MACAQUES CHALLENGED WITH THE ORIGINAL STRAIN IDENTIFIED, DESIGNATED WA1/2020. BAROUCH AND COLLEAGUES WHO HELPED DEVELOP JOHNSON & JOHNSON'S SINGLE-SHOT VIRAL VECTOR VACCINE, CALLED AD26.COV2.S REPORT THAT THE VACCINE PRODUCES ROBUST PROTECTION AGAINST BOTH. THE FINDINGS HAVE IMPORTANT IMPLICATIONS FOR THE VACCINE CONTROL OF SARS-COV-2 VARIANTS OF CONCERN. "THE EMERGENCE OF SARS-COV-2 VARIANTS THAT PARTIALLY EVADE NEUTRALIZING ANTIBODIES POSES A THREAT TO THE EFFICACY OF CURRENT COVID-19 VACCINES," SAID BAROUCH, SENIOR AUTHOR OF THE STUDY AND DIRECTOR OF VACCINE AND VIROLOGY RESEARCH AT BIDMC. "HERE WE SHOW THAT THE AD26.COV2.S VACCINE ELICITS HUMORAL AND CELLULAR IMMUNE RESPONSES THAT CROSS-REACT WITH THE B.1.351 VARIANT AND PROTECTS AGAINST THE B.1.351 CHALLENGE IN RHESUS MACAQUES." IN FINDINGS PUBLISHED IN THE NEW ENGLAND JOURNAL OF MEDICINE, BAROUCH'S TEAM REPORTED ON THE DURABILITY OF JOHNSON & JOHNSON'S AD26.COV2.S VACCINE IN HUMANS. THE SINGLE-SHOT VIRAL VECTOR VACCINE DEVELOPED IN PART BY BAROUCH AND COLLEAGUES AT BIDMC WAS ALSO EVALUATED FOR ITS COVERAGE AGAINST THE ALPHA, BETA, GAMMA, DELTA, EPSILON AND KAPPA SARS-COV-2 VARIANTS. "OUR DATA SHOW THAT THE AD26.COV2.S VACCINE ELICITED DURABLE IMMUNE RESPONSES WITH MINIMAL DECLINE FOR AT LEAST EIGHT MONTHS, THE TIMEFRAME EXAMINED, FOLLOWING IMMUNIZATION," SAID BAROUCH, CORRESPONDING AUTHOR OF THE PAPER AND ALSO PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. "WE ALSO SHOWED GOOD NEUTRALIZATION COVERAGE OF THE DELTA VARIANT AS WELL AS OTHER VARIANTS." LAST SUMMER, BAROUCH'S TEAM WAS AWARDED $4.9 MILLION IN ANNUAL FUNDING OVER THE NEXT FIVE YEARS TO FIND A CURE FOR HIV. BAROUCH WAS ONE OF TEN PRIMARY INVESTIGATORS TO RECEIVE A 2021 NATIONAL INSTITUTES OF HEALTH (NIH) MARTIN DELANEY COLLABORATORIES FOR HIV CURE RESEARCH AWARD, WHICH AIMS TO EXPEDITE HUMAN IMMUNODEFICIENCY VIRUS (HIV) CURE RESEARCH BY BRINGING TOGETHER RESEARCH PARTNERS IN ACADEMIA, GOVERNMENT, THE PRIVATE SECTOR AND THE COMMUNITY; COORDINATING COMPLEX RESEARCH STUDIES, AND MENTORING THE NEXT GENERATION OF HIV CURE RESEARCHERS. BAROUCH AND COLLEAGUES WILL FOCUS ON UNDERSTANDING THE VIRAL RESERVOIR DORMANT HIV-INFECTED IMMUNE CELLS THAT REMAIN IN THE BODY DESPITE ANTI-RETROVIRAL THERAPY (ART) AND CAN SPRING BACK INTO ACTION IF ART IS INTERRUPTED AND ON DEVELOPING NEW IMMUNOLOGIC STRATEGIES TARGETING THE RESERVOIR TO CONTROL OR ERADICATE HIV INFECTION. WITH MORE THAN 35 MILLION PEOPLE WORLDWIDE LIVING WITH THE VIRUS AND NEARLY 2 MILLION NEW CASES EACH YEAR, HIV REMAINS A MAJOR GLOBAL EPIDEMIC. "THE LATENT VIRAL RESERVOIR IS THE CRITICAL BARRIER FOR THE DEVELOPMENT OF A CURE FOR HIV-1 INFECTION," SAID BAROUCH. "OUR OVERALL HYPOTHESIS IS THAT MULTIPLE IMMUNOLOGIC STRATEGIES WILL NEED TO BE EXPLORED AND COMBINED TO ACHIEVE LONG-TERM, ART-FREE VIROLOGIC CONTROL OR COMPLETE VIRUS ERADICATION. WE'RE VERY GRATEFUL FOR THIS GRANT AND TREMENDOUSLY EXCITED TO SEE THE PROGRESS WE CAN MAKE WITH THIS LONG-TERM SOURCE OF SUPPORT." DETAIL ON ADDITIONAL COVID AND NON-COVID RESEARCH EFFORTS DETAIL ON ADDITIONAL COVID AND NON-COVID RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. STUDY FINDS ENTIRE HOUSEHOLD AT INCREASED RISK WHEN POST-SURGICAL PATIENTS REFILL PRESCRIPTION OPIOIDS NEARLY THREE-QUARTERS OF PEOPLE WHO MISUSE OPIOIDS REPORT GETTING THEM WITH OR WITHOUT PERMISSION FROM A FRIEND OR FAMILY MEMBER WHO HAS A PRESCRIPTION. IN A STUDY PUBLISHED IN JAMA SURGERY, PHYSICIAN-SCIENTISTS AT BIDMC SOUGHT TO BETTER UNDERSTAND HOW PRESCRIBING OPIATES TO PATIENTS AFTER SURGERY MAY CONTRIBUTE TO SUBSEQUENT OPIOID MISUSE NOT JUST FOR THE POST-OPERATIVE PATIENT, BUT FOR HOUSEHOLD MEMBERS AS WELL. TO QUANTIFY HOW PRESCRIPTION DURATION AND REFILLS FOR A SURGICAL PATIENT IMPACTED THE RISK FOR MISUSE AND CHRONIC USE IN THEIR FAMILY MEMBERS, CORRESPONDING AUTHOR GABRIEL BRAT, MD, A TRAUMA SURGEON AT BIDMC, AND COLLEAGUES RETROSPECTIVELY EXAMINED DE-IDENTIFIED COMMERCIAL INSURANCE CLAIMS FILED BETWEEN 2008 AND EARLY 2016. AMONG THE 843,531 PATIENT-FAMILY PAIRS IDENTIFIED, THE RESEARCHERS FOUND THE RATES OF OVERALL OPIOID MISUSE (MEASURED BY SUBSEQUENT DIAGNOSTIC CODES) AND CHRONIC USE (MEASURED BY FILLED PRESCRIPTIONS) WERE BOTH LESS THAN ONE PERCENT. HOWEVER, THE RISK OF MISUSE USE ROSE IN HOUSEHOLDS WHERE THE SURGICAL PATIENT OBTAINED REFILLS. THOSE IN HOUSEHOLDS WITH ANY REFILL HAD A 33 PERCENT INCREASED HAZARD OF MISUSE, AND EACH ADDITIONAL REFILL WAS LINKED WITH A 19 PERCENT INCREASE IN HAZARD OF MISUSE BY A FAMILY MEMBER. "OUR DATA SUGGEST THAT THERE ARE SECOND VICTIMS OF OPIOID OVER-PRESCRIBING, THAT THE ADVERSE EFFECTS OF OPIOID PRESCRIPTIONS EXTEND BEYOND THE SURGICAL PATIENT WHO RECEIVED A PRESCRIPTION AND HAVE BROADER IMPLICATIONS FOR THE FAMILY," SAID, BRAT. "IT IS IMPORTANT THAT PRESCRIBERS, PATIENTS, AND THE PUBLIC UNDERSTAND THIS MULTI-FACETED PROBLEM EXTENDS BEYOND THE SURGICAL PATIENT AND HAS BROADER IMPLICATIONS FOR THE FAMILY."NATIONWIDE SPIKE IN CARDIOVASCULAR DEATHS SHOWN TO BE AN INDIRECT COST OF COVID-19 PANDEMICTWO YEARS INTO THE COVID-19 PANDEMIC, MORE THAN ONE MILLION AMERICANS HAVE DIED FROM THE VIRUS. BUT REPORTS DESCRIBE AN INCREASE IN MORTALITY DURING THE PANDEMIC THAT CANNOT BE EXPLAINED BY COVID-19 ALONE. RESEARCHERS LED BY CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, A PHYSICIAN-RESEARCHER AT THE SMITH CENTER FOR OUTCOMES RESEARCH IN CARDIOLOGY AT BIDMC, EVALUATED THE RATE OF U.S. DEATHS DUE TO CARDIOVASCULAR CAUSES DURING THE FIRST 11 WEEKS OF THE COVID-19 PANDEMIC (MID-MARCH TO JUNE, 2020) RELATIVE TO THE IMMEDIATELY PRECEDING 11 WEEKS PRE-PANDEMIC. THE TEAM ALSO COMPARED THESE TWO PERIODS OF 2020 TO THE SAME WEEKS IN 2019. THE OBSERVATIONAL STUDY, PUBLISHED IN THE JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (JACC), SUGGESTS THAT PATIENTS MAY HAVE AVOIDED HOSPITALS OUT OF FEAR OF CONTRACTING THE NOVEL CORONAVIRUS AND THAT SOME DIED FROM CARDIOVASCULAR CONDITIONS WITHOUT SEEKING MEDICAL CARE. THE TEAM FOUND A MARKED NATIONWIDE RISE IN CARDIAC DEATHS AFTER THE ONSET OF THE PANDEMIC IN THE U.S. DEATHS DUE-TO ISCHEMIC HEART DISEASES (RELATED TO NARROWING OF THE ARTERIES) AND HYPERTENSIVE (RELATED TO HIGH BLOOD PRESSURE) DISEASES INCREASED BY 11 PERCENT AND 17 PERCENT, RESPECTIVELY, COMPARED TO THE PREVIOUS YEAR. IN CONTRAST, THE RESEARCHERS OBSERVED NO INCREASE IN DEATHS DUE TO OTHER CARDIOVASCULAR CONDITIONS, SUCH AS HEART FAILURE, POTENTIALLY BECAUSE THEY OFTEN DO NOT REQUIRE EMERGENT HOSPITALIZATION FOR POTENTIALLY LIFE-SAVING TREATMENT. DR. WADHERA AND COLLEAGUES SUGGEST THAT THE CANCELLATION OF SEMI-ELECTIVE PROCEDURES AND OUTPATIENT VISITS AS A RESULT OF THE PANDEMIC CONTRIBUTED TO THE INCREASE IN DEATHS BY DELAYING IMPORTANT DIAGNOSTIC TESTING AND LIMITING PATIENTS' ACCESS TO PRESCRIPTION MEDICATIONS. THE STRAIN IMPOSED BY COVID-19 ON SOME HOSPITALS MAY HAVE ALSO LED TO DELAYS IN CARE FOR HOSPITALIZED PATIENTS WITHOUT COVID-19, THE RESEARCHERS ADD. PANDEMIC-RELATED DELAYS IN EMERGENCY SERVICE RESPONSE TIMES AND A REDUCTION IN BYSTANDER CPR RATES ALSO LIKELY CONTRIBUTED TO REDUCED SURVIVAL AFTER CARDIAC ARREST. ADDITIONALLY, BEYOND HEALTHCARE SYSTEM FACTORS, GREATER PSYCHOSOCIAL, COMMUNITY, AND ENVIRONMENTAL STRESS AMID THE PANDEMIC MAY ALSO HAVE PLAYED AN IMPORTANT ROLE. "OVERALL, OUR DATA HIGHLIGHT THE URGENT NEED TO IMPROVE PUBLIC HEALTH MESSAGING TO ENSURE PATIENTS WITH EMERGENT CONDITIONS SEEK AND RECEIVE MEDICAL CARE PARTICULARLY IN REGIONS CURRENTLY EXPERIENCING A SURGE OR RESURGENCE OF COVID 19 CASES," WADHERA SAID. BIDMC RESEARCHERS REVEAL HOW GENETIC VARIATIONS ARE LINKED TO COVID-19 DISEASE SEVERITYMORE THAN 90 MILLION AMERICANS HAVE BECOME INFECTED WITH COVID-19; HOWEVER, PHYSICIANS STILL AREN'T SURE WHY SOME PEOPLE EXPERIENCE MILD TO NO SYMPTOMS WHILE OTHERS BECOME CRITICALLY ILL. RESEARCH LED BY ROBERT E. GERSZTEN, MD, CHIEF OF THE DIVISION OF CARDIOVASCULAR MEDICINE AT BIDMC SHEDS NEW LIGHT ON THE GENETIC RISK FACTORS THAT MAKE INDIVIDUALS MORE OR LESS SUSCEPTIBLE TO SEVERE COVID-19. THE FINDINGS, PUBLISHED IN A LETTER IN THE NEW ENGLAND JOURNAL OF MEDICINE (NEJM), ILLUMINATE THE MECHANISMS UNDERLYING COVID-19, AND POTENTIALLY OPEN THE DOOR TO NOVEL TREATMENTS FOR THE DISEASE. A GROWING BODY OF GENETIC EVIDENCE FROM PATIENTS IN CHINA, EUROPE AND THE UNITES STATES LINKS COVID-19 OUTCOMES TO VARIATIONS IN TWO REGIONS OF THE HUMAN GENOME, FINDINGS WHICH WERE PUBLISHED IN THE NEJM. BUT THE STATISTICAL ASSOCIATION DOESN'T EXPLAIN HOW THE DIFFERENCES MODULATE DISEASE. TO DO THAT, SCIENTISTS NEED TO UNDERSTAND WHICH PROTEINS THESE SECTIONS OF THE GENOME CODE FOR AND THE ROLE THESE PROTEINS PLAY IN THE BODY IN THE CONTEXT OF DISEASE. OVER THE LAST DECADE, GERSZTEN AND COLLEAGUES HAVE GENERATED JUST SUCH A DATABASE AN IMMENSE LIBRARY OF ALL THE PROTEINS AND METABOLITES ASSOCIATED WITH VARIOUS REGIONS OF THE HUMAN GENOME. WHEN THEY LOOKED UP ONE GENOMIC "HOT SPOT" FOUND TO BE ASSOCIATED WITH COVID-19 DISEASE SEVERITY, THEY QUICKLY REALIZED THAT THE VERY SAME REGION WAS LINKED TO A PROTEIN THAT HAS RECENTLY BEEN IMPLICATED IN THE PROCESS BY WHICH THE SARS-COV-2 VIRUS INFECTS HUMAN CELLS. "GROUPS ARE INCREASINGLY FINDING GENOMIC HOTSPOTS RELATED TO DISEASES, BUT IT'S OFTEN NOT CLEAR HOW THEY IMPACT THE MECHANISMS OF DISEASE," SAID GERSZTEN. "WE LEVERAGED OUR HUGE DATABASE IT'S MORE THAN 100 TERABYTES' WORTH OF DATA TO VERY QUICKLY DETERMINE THAT THE PROTEIN MOST HIGHLY EXPRESSED BY THAT REGION TURNED OUT TO BE A CO-RECEPTOR FOR THE VIRUS THAT CAUSES COVID-19, SUGGESTING THAT THIS MIGHT BE A TARGET FOR THERAPEUTIC INTERVENTIONS. THE SO-CALLED ANTIBODY COCKTAILS CURRENTLY AVAILABLE MOSTLY TARGET THE SPIKE PROTEINS ON THE VIRUS. IN TURN, OUR WORK IDENTIFIES WHICH PROTEINS IN THE HUMAN BODY THAT SARS-COV-2 AND OTHER CORONAVIRUSES LATCH ON TO." RESEARCHERS DEMONSTRATE HOW CHRONIC ALCOHOL CONSUMPTION CAUSES INFLAMMATION IN THE BRAINALCOHOL USE DISORDER IMPACTS MILLIONS OF PEOPLE AROUND THE WORLD, INCLUDING AT LEAST 17 MILLION AMERICANS. NEARLY 100,000 PATIENTS DIE EACH YEAR FROM THE CONSEQUENCES OF CHRONIC DRINKING, WHICH INDUCES ORGAN INJURY THROUGHOUT THE BODY, PARTICULARLY TO THE LIVER AND BRAIN. RESEARCH LED BY GYONGYI SZABO, MD, PHD, HON. SCD, CHIEF ACADEMIC OFFICER OF BIDMC AND BETH ISRAEL LAHEY HEALTH, SHED LIGHT ON THE MECHANISMS BY WHICH CHRONIC ALCOHOL CONSUMPTION CAUSES DAMAGE TO BRAIN CELLS AND CELLS OF THE CENTRAL NERVOUS SYSTEM, WHICH IN TURN POTENTIALLY TRIGGERS ADDICTIVE BEHAVIOR. THE FINDINGS, PUBLISHED IN THE JOURNAL OF NEUROINFLAMMATION, ALSO SUGGEST POSSIBLE TARGETS FOR A THERAPEUTIC APPROACH TO CHRONIC ALCOHOL USE DISORDER. "CHRONIC ALCOHOL EXPOSURE INDUCES A COMPLEX, MULTI-ORGAN RESPONSE WITH ACTIVATION OF A VARIETY OF IMMUNE RESPONSES AND INFLAMMATORY EXPRESSION," SAID SZABO. "OUR DATA IDENTIFIES THE SIGNALING PATHWAY BY WHICH CHRONIC ALCOHOL CONSUMPTION PROMOTES INFLAMMATION IN TISSUES OF THE CENTRAL NERVOUS SYSTEM AND OUR FURTHER ANALYSIS SUGGESTS A STRATEGY FOR BLOCKING THIS ALCOHOL-INDUCED NEUROINFLAMMATION." DETAIL ON ADDITIONAL COVID AND NON-COVID RESEARCH EFFORTS [CONTINUED] IN AN EXPERIMENT SZABO AND COLLEAGUES STUDIED THE IMPACT OF CHRONIC ALCOHOL-CONSUMPTION ON VARIOUS REGIONS OF THE BRAIN IN A MOUSE MODEL. THE SCIENTISTS OBSERVED THAT IMMUNE CELLS CALLED MACROPHAGES INVADED THE BRAIN PARENCHYMA (OR TISSUE), PARTICULARLY IN THE HIPPOCAMPUS A REGION OF THE BRAIN CRITICAL TO LEARNING AND MEMORY THAT IS WELL KNOWN TO LOSE VOLUME IN PATIENTS WITH CHRONIC ALCOHOL USE DISORDER. SZABO AND COLLEAGUES POINT OUT THAT, FOR DECADES, SCIENTIFIC DOGMA HELD THAT IMMUNE CELLS COULD NOT REACH THE TISSUES OF THE CENTRAL NERVOUS SYSTEM (CNS). RESEARCHERS SUBSEQUENTLY DEMONSTRATED THE PRESENCE OF IMMUNE CELLS IN CNS TISSUES IN THE SETTING OF DISEASE. GENE EXPRESSION ANALYSIS REVEALED THE SIGNALING PATHWAY BY WHICH ALCOHOL CONSUMPTION PROMOTES NEUROINFLAMMATION. MOREOVER, THE RESEARCHERS ALSO DEMONSTRATED THAT BLOCKING IMMUNE CELL INVASION WITH AN INVESTIGATIONAL DRUG RESTORED SOME LOST BRAIN CELL FUNCTION; HOWEVER, ADMINISTRATION OF THE INVESTIGATIONAL DRUG DID NOT CHANGE THE ALCOHOL CONSUMPTION OR PREFERENCES OF THE LABORATORY ANIMALS. HOSPITALIZED PATIENTS WITH COVID-19 SIX TIMES MORE LIKELY TO DIE THAN PATIENTS HOSPITALIZED WITH INFLUENZA, RESEARCH FINDSCOVID-19 AND INFLUENZA ARE BOTH CONTAGIOUS RESPIRATORY VIRAL DISEASES THAT CAN LEAD TO PNEUMONIA AND ACUTE RESPIRATORY FAILURE IN SEVERE CASES. HOWEVER, DETAILED COMPARISON OF THE EPIDEMIOLOGY AND CLINICAL CHARACTERISTICS OF COVID-19 AND THOSE OF INFLUENZA ARE LACKING. IN A PAPER PUBLISHED IN THE JOURNAL OF GENERAL INTERNAL MEDICINE, PHYSICIAN-RESEARCHERS AT BIDMC ASSESSED THE RELATIVE IMPACT OF COVID-19 ON PATIENTS HOSPITALIZED WITH THE VIRAL INFECTION IN MARCH AND APRIL 2020, VERSUS PATIENTS HOSPITALIZED WITH INFLUENZA DURING THE LAST FIVE FLU SEASONS AT THE MEDICAL CENTER. OVERALL, THE TEAM DEMONSTRATED THAT COVID-19 CASES RESULTED IN SIGNIFICANTLY MORE WEEKLY HOSPITALIZATIONS, MORE USE OF MECHANICAL VENTILATION AND HIGHER MORTALITY RATES THAN INFLUENZA. CORRESPONDING AUTHOR MICHAEL DONNINO, MD, A CRITICAL CARE AND EMERGENCY MEDICINE PHYSICIAN AT BIDMC, AND COLLEAGUES INCLUDED A TOTAL OF 1,634 HOSPITALIZED PATIENTS IN THEIR STUDY, 582 OF WHOM HAD LABORATORY-CONFIRMED COVID-19 AND 1,052 OF WHOM HAD CONFIRMED INFLUENZA. WHILE 174 PATIENTS WITH COVID-19 (OR 30 PERCENT) RECEIVED MECHANICAL VENTILATION DURING THE TWO-MONTH PERIOD, JUST 84 PATIENTS WITH INFLUENZA (OR 8 PERCENT) WERE PLACED ON VENTILATION OVER ALL FIVE SEASONS OF INFLUENZA. LIKEWISE, THE PROPORTION OF PATIENTS WHO DIED WAS MUCH HIGHER FOR COVID-19 THAN FOR INFLUENZA; 20 PERCENT OF ADMITTED PATIENTS WITH COVID-19 DIED IN THE TWO-MONTH PERIOD, COMPARED TO THREE PERCENT OF PATIENTS WITH INFLUENZA OVER FIVE SEASONS. FURTHER ANALYSIS REVEALED THAT HOSPITALIZED PATIENTS WITH COVID-19 TENDED TO BE YOUNGER THAN THOSE HOSPITALIZED WITH INFLUENZA. AMONG PATIENTS REQUIRING MECHANICAL VENTILATION, PATIENTS WITH COVID-19 WERE ON VENTILATION MUCH LONGER A MEDIAN DURATION OF TWO WEEKS COMPARED TO JUST OVER THREE DAYS FOR PATIENTS WITH INFLUENZA. MOREOVER, AMONG PATIENTS REQUIRING MECHANICAL VENTILATION, PATIENTS WITH COVID-19 WERE FAR LESS LIKELY TO HAVE HAD PRE-EXISTING MEDICAL CONDITIONS. "OUR DATA ILLUSTRATE THAT 98 PERCENT OF THE DEATHS OF PATIENTS HOSPITALIZED WITH COVID-19 ARE DIRECTLY OR INDIRECTLY RELATED TO THEIR COVID-19 ILLNESS, WHICH HELPS DEBUNK THE IDEA THAT THE HIGH NUMBER OF U.S. COVID-19 DEATHS ARE AN ARTIFACT OF THE WAY CAUSES OF DEATHS ARE BEING RECORDED," SAID DONNINO. "WE ALSO SHOWED THAT COVID-19 CAUSED A SUBSTANTIAL NUMBER OF PATIENTS WITHOUT MAJOR PRE-EXISTING CONDITIONS TO REQUIRE MECHANICAL VENTILATION, WHICH HAPPENS RARELY IN PATIENTS WITH INFLUENZA," SAID DONNINO. BIDMC RESEARCHERS DEVELOP MODEL TO ESTIMATE FALSE-NEGATIVE RATE FOR COVID-19 TESTS AS OF JUNE 2020, THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) HAD GRANTED EMERGENCY USE AUTHORIZATION FOR MORE THAN 85 DIFFERENT VIRAL DNA TEST KITS OR ASSAYS EACH WITH WIDELY VARYING DEGREES OF SENSITIVITY AND UNKNOWN RATES OF ACCURACY. HOWEVER, WITH NO EXISTING GOLD STANDARD TEST FOR COVID-19, THERE'S LITTLE DATA ON WHICH TO JUDGE THESE VARIOUS TESTS' USEFULNESS. RESEARCHERS AT BIDMC DEVELOPED A MATHEMATICAL MEANS OF ASSESSING TESTS' FALSE-NEGATIVE RATE. THE TEAM'S METHODOLOGY, WHICH ALLOWS AN APPLES-TO-APPLES COMPARISON OF THE VARIOUS ASSAYS' CLINICAL SENSITIVITY, IS PUBLISHED IN THE JOURNAL CLINICAL INFECTIOUS DISEASES. "WE FOUND THAT CLINICAL SENSITIVITIES VARY WIDELY, WHICH HAS CLEAR IMPLICATIONS FOR PATIENT CARE, EPIDEMIOLOGY AND THE SOCIAL AND ECONOMIC MANAGEMENT OF THE ONGOING PANDEMIC," SAID CO-CORRESPONDING AUTHOR JAMES E. KIRBY, MD, DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORIES AT BIDMC. USING DATA FROM MORE THAN 27,000 TESTS FOR COVID-19 PERFORMED AT BETH ISRAEL LAHEY HEALTH HOSPITAL SITES FROM MARCH 26 TO MAY 2, 2020, KIRBY, AND CO-CORRESPONDING AUTHOR RAMY ARNAOUT, MD, DPHIL, ASSOCIATE DIRECTOR OF THE CLINICAL MICROBIOLOGY LABORATORIES AT BIDMC, AND COLLEAGUES FIRST DEMONSTRATED THAT VIRAL LOADS CAN BE DEPENDABLY REPORTED. "THIS HELPS DISTINGUISH POTENTIAL SUPERSPREADERS, AT ONE EXTREME, FROM CONVALESCENT PEOPLE, WITH ALMOST NO VIRUS, AND THEREFORE LOW LIKELIHOOD OF SPREADING THE INFECTION," ARNAOUT SAID. NEXT, THE RESEARCHERS ESTIMATED THE CLINICAL SENSITIVITY AND THE FALSE-NEGATIVE RATE FIRST FOR THE IN-HOUSE TEST WHICH WAS AMONG THE FIRST TO BE IMPLEMENTED NATIONWIDE AND CONSIDERED AMONG THE BEST IN CLASS. ANALYZING REPEAT TEST RESULTS FOR THE NEARLY 5,000 PATIENTS WHO TESTED POSITIVE ALLOWED THE RESEARCHERS TO DETERMINE THAT THE IN-HOUSE TEST PROVIDED A FALSE NEGATIVE IN ABOUT 10 PERCENT OF CASES, GIVING THE ASSAY A CLINICAL SENSITIVITY OF ABOUT 90 PERCENT. TO ESTIMATE THE ACCURACY OF OTHER ASSAYS, THE TEAM BASED THEIR CALCULATIONS ON EACH TESTS LIMIT OF DETECTION, OR LOD, DEFINED AS THE SMALLEST AMOUNT OF VIRAL DNA DETECTABLE THAT A TEST WILL CATCH 95 PERCENT OR MORE OF THE TIME. ARNAOUT, KIRBY, AND COLLEAGUES DEMONSTRATED THAT THE LIMIT OF DETECTION CAN BE USED AS A PROXY TO ESTIMATE A GIVEN ASSAY'S CLINICAL SENSITIVITY. BY THE TEAM'S CALCULATIONS, AN ASSAY WITH A LIMIT OF DETECTION OF 1,000 COPIES VIRAL DNA PER ML IS EXPECTED TO DETECT JUST 75 PERCENT OF PATIENTS WITH COVID-19, PROVIDING ONE OUT OF EVERY FOUR PEOPLE WITH A FALSE-NEGATIVE. THE TEAM ALSO SHOWED THAT ONE TEST AVAILABLE TODAY MISSES AS MANY AS ONE IN THREE INFECTED INDIVIDUALS, WHILE ANOTHER MAY MISS UP TO 60 PERCENT OF POSITIVE CASES. FIRST-OF-ITS-KIND STUDY FOUND INFANTS OF SOCIALLY VULNERABLE MOTHERS WERE AT HIGHEST RISK OF COVID-19 INFECTIONIN A STUDY PUBLISHED IN JAMA NETWORK OPEN, PHYSICIAN-RESEARCHERS FROM BIDMC, BRIGHAM AND WOMEN'S HOSPITAL, BOSTON CHILDREN'S HOSPITAL AND MASSACHUSETTS GENERAL HOSPITAL REVEALED THAT, WHILE MOTHER-TO-NEWBORN TRANSMISSION OF THE VIRUS IS RARE, NEWBORNS OF EXPECTANT MOTHERS WITH COVID-19 CAN SUFFER INDIRECT ADVERSE HEALTH RISKS AS A RESULT OF WORSENING MATERNAL COVID-19 ILLNESS. EXAMINING NEONATAL OUTCOMES DURING THE FIRST MONTH OF LIFE FOR BABIES BORN AT 11 HOSPITALS THAT REPRESENT APPROXIMATELY 50 PERCENT OF ALL BIRTHS IN MASSACHUSETTS, THE TEAM IDENTIFIED 255 NEONATES DELIVERED BETWEEN MARCH 1 JULY 31, 2020, TO MOTHERS WITH A RECENT POSITIVE SARS-COV-2 TEST RESULT. THE RESEARCHERS USED THE AMERICAN ACADEMY OF PEDIATRICS' NATIONAL REGISTRY FOR SURVEILLANCE AND EPIDEMIOLOGY OF PERINATAL COVID-19 INFECTION COMPLEMENTED BY A MASSACHUSETTS-SPECIFIC REGISTRY. OUT OF THE 255 NEONATES STUDIED, 88.2 PERCENT WERE TESTED FOR SARS-COV-2, AND ONLY 2.2 PERCENT HAD POSITIVE RESULTS. HOWEVER, WHILE INFECTION RATES AMONG NEWBORNS WERE RELATIVELY LOW, WORSENING MATERNAL ILLNESS ACCOUNTED FOR 73.9 PERCENT OF PRETERM BIRTHS. PREMATURE BIRTH CAN OFTEN LEAD TO ACUTE AND CHRONIC COMPLICATIONS, INCLUDING RESPIRATORY DISTRESS, CHRONIC HEALTH PROBLEMS AND DEVELOPMENTAL DISABILITIES. NEWBORNS OF SOCIALLY VULNERABLE MOTHERS, AS DETERMINED USING A TOOL CREATED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION USING RESIDENTIAL ZIP-CODES, WERE AT AN INCREASED RISK FOR TESTING POSITIVE. THE SPECIFIC PATHWAYS BY WHICH SOCIAL VULNERABILITY MIGHT AFFECT MOTHER-TO-CHILD TRANSMISSION OF COVID-19 INCLUDE DIFFERENTIAL ACCESS TO CARE AND CLINICIAN BIAS. DISCRIMINATION MAY ALSO BE A FACTOR IN CHRONIC STRESS, WHICH CAN DIMINISH ANTIVIRAL IMMUNE RESPONSES. "THIS OBSERVATION THAT NEWBORNS OF SOCIALLY VULNERABLE MOTHERS WERE FIVE TIMES MORE LIKELY TO HAVE COVID-19 HIGHLIGHTS THAT HEALTH DISPARITIES ARE VERY COMPLEX AND EXTEND BEYOND RACE, ETHNICITY AND LANGUAGE STATUS," SAID CORRESPONDING AUTHOR ASIMENIA ANGELIDOU, MD, PHD, A NEONATOLOGIST AT BIDMC. "SOCIAL VULNERABILITY LIKELY AFFECTS HEALTH AND IMMUNITY AND OUR STUDY SUPPORTS FURTHER RESEARCH IN THIS AREA. REALLOCATION OF RESOURCES TO SOCIALLY VULNERABLE COMMUNITIES COULD GO A LONG WAY IN DECREASING HUMAN SUFFERING AND ECONOMIC LOSS DURING DISEASE OUTBREAKS." DETAIL ON ADDITIONAL COVID AND NON-COVID RESEARCH EFFORTS [CONTINUED] JANUARY 20, 2020SCIENTISTS CREATE FIRST-OF-ITS-KIND 3D ORGANOID MODEL OF THE HUMAN PANCREAS BECAUSE PANCREATIC CANCER IS HIDDEN DEEP WITHIN THE BODY AND OFTEN SYMPTOMLESS, IT'S FREQUENTLY DIAGNOSED AFTER THE DISEASE HAS PROGRESSED TOO FAR FOR SURGICAL INTERVENTION AND/OR HAS SPREAD THROUGHOUT THE BODY. RESEARCH INDICATES THAT EARLIER DETECTION OF PANCREATIC TUMORS COULD QUADRUPLE SURVIVAL RATES; HOWEVER, NO VALIDATED AND RELIABLE TESTS FOR EARLY DETECTION OF PANCREATIC CANCER CURRENTLY EXIST. RESEARCHERS AT THE CANCER RESEARCH INSTITUTE AT BIDMC HAVE SUCCESSFULLY CREATED THE FIRST THREE-DIMENSIONAL (3D) ORGANOID MODELS OF THE PANCREAS FROM HUMAN STEM CELLS. UNLIKE PREVIOUS PLATFORMS FOR THE STUDY OF PANCREATIC CANCER, THIS FIRST-OF-ITS-KIND ORGANOID MODEL INCLUDES BOTH THE ACINAR AND DUCTAL STRUCTURES THAT PLAY A CRITICAL ROLE IN THE MAJORITY OF PANCREATIC CANCERS. THE NEW RESEARCH PLATFORM WHICH IS NOT EXPECTED TO GUIDE PATIENT CARE AT THIS TIME WILL SHED NEW LIGHT ON THE ORIGINS AND DEVELOPMENT OF PANCREATIC CANCER, AS WELL AS REVEAL POTENTIAL MEANS FOR DISCOVERING MARKERS OF EARLY DIAGNOSIS AND MONITORING THE DISEASE. THE TEAM'S REPORT APPEARS IN CELL STEM CELL. "WE THOUGHT, IF WE HAD A WAY TO USE HUMAN PANCREATIC CELLS TO FORWARD ENGINEER CANCER, WE COULD BEGIN TO UNDERSTAND THE EARLIEST STEPS IN THE DEVELOPMENT OF THIS DISEASE," SAID CORRESPONDING AUTHOR SENTHIL MUTHUSWAMY, PHD, DIRECTOR OF CELL BIOLOGY AT THE CANCER RESEARCH INSTITUTE AT BIDMC. "THIS MODEL COULD ALSO SERVE AS A PLATFORM TO POTENTIALLY DISCOVER BIOMARKERS MEASURABLE CHANGES LINKED TO DISEASE THAT WE HOPE TO USE IN THE CLINIC TO MONITOR CANCER DEVELOPMENT." THE PANCREAS IS A HORMONE-SECRETING ORGAN CONSISTING OF DUCTS AND ACINAR STRUCTURES, OR SACLIKE STRUCTURES THAT STORE PANCREATIC SECRETIONS. UNTIL NOW, SCIENTISTS HAVE NOT BEEN ABLE TO SUCCESSFULLY GROW AND MAINTAIN HUMAN ACINAR STRUCTURES IN THE LAB CHALLENGING THEIR ABILITY TO TEST THE HYPOTHESIS IN A MODEL. RESEARCHERS SUSPECT THAT THE MOST COMMON KIND OF PANCREATIC CANCER ARISES IN THE CELLS LINING ACINAR AND DUCTAL STRUCTURES.THE CULMINATION OF FIVE-PLUS YEARS' OF WORK, THE STUDY REPRESENTS THE FIRST TIME RESEARCHERS SUCCESSFULLY GENERATED HUMAN ACINAR CELLS IN CULTURE AND MAINTAINED THEM LONG ENOUGH TO BE ABLE TO USE THEM IN EXPERIMENTS. FINANCIAL BURDENS ASSOCIATED WITH CANCER CARE DISPROPORTIONATELY AFFECTS YOUNG, NON-WHITE PATIENTS WITH GYNECOLOGIC CANCERSTHE COST OF CANCER CARE IN UNITED STATES WAS AN ESTIMATED $183 BILLION IN 2015 AND IS PROJECTED TO RISE BY 30 PERCENT BY 2030, ACCORDING TO THE AMERICAN CANCER SOCIETY. WHILE PRIVATE AND GOVERNMENT INSURANCE MAY COVER MUCH OF THE COST OF CARE, EVEN PATIENTS WITH INSURANCE CAN STRUGGLE TO PAY FOR OFFICE VISIT CO-PAYMENTS, PRESCRIPTION MEDICATIONS OR OTHER CANCER-RELATED EXPENSES. YET LIMITED DATA DESCRIBES HOW FINANCIAL HARDSHIP IMPACTS PATIENT BEHAVIOR AND HOW THAT IN TURN MAY IMPACT PATIENTS' HEALTH. IN A STUDY DESIGNED TO PROVIDE A MORE COMPREHENSIVE PICTURE OF HOW A DIVERSE COHORT OF GYNECOLOGIC CANCER PATIENTS ARE AFFECTED BY FINANCIAL DISTRESS ALSO CALLED "FINANCIAL TOXICITY" IN ACKNOWLEDGMENT OF THE HEALTH HAZARD IT CAN POSE RESEARCHER-PHYSICIANS AT BIDMC AND THE UNIVERSITY OF ALABAMA (UAB) ANALYZED PREVIOUSLY COLLECTED SURVEY DATA OF GYNECOLOGIC ONCOLOGY PATIENTS FROM THEIR RESPECTIVE INSTITUTIONS. THEIR FINDINGS ARE REPORTED IN THE INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER. USING THE COMPREHENSIVE SCORE FOR FINANCIAL TOXICITY (COST) TO MEASURE THE ECONOMIC BURDEN EXPERIENCED BY PATIENTS WITH CANCER, CORRESPONDING AUTHOR KATHARINE M. ESSELEN, MD, MBA, OF THE DIVISION OF GYNECOLOGIC ONCOLOGY IN THE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY, AND COLLEAGUES ANALYZED PREVIOUSLY COLLECTED SURVEY DATA FROM 308 PATIENTS WITH GYNECOLOGIC CANCER 240 PATIENTS SURVEYED AT BIDMC AND 121 SURVEYED AT UAB. THEY FOUND THAT NEARLY HALF OF PATIENTS WITH GYNECOLOGIC CANCER REPORTED EXPERIENCING MODERATE TO SEVERE FINANCIAL TOXICITY. FURTHER ANALYSIS OF SURVEY DATA REVEALED THAT YOUNGER PATIENTS WERE AT GREATER RISK OF EXPERIENCING FINANCIAL TOXICITY FOR A VARIETY OF REASONS. YOUNGER PATIENTS ARE NOT ELIGIBLE FOR MEDICARE, AND DIAGNOSIS AND TREATMENT MAY IMPACT THEIR ABILITY TO WORK. THEY HAVE ALSO HAD FEWER EARNING YEARS TO ACCUMULATE A FINANCIAL SAFETY NET. PATIENTS REPORTING SEVERE FINANCIAL TOXICITY ACCOUNTED FOR 15 PERCENT OF THOSE SURVEYED. ESSELEN AND COLLEAGUES FOUND THIS GROUP MORE LIKELY TO REPORT CHANGING SPENDING HABITS AND BORROWING MONEY DUE TO THE COSTS OF CANCER CARE. MOST ALARMINGLY, THOSE REPORTING SEVERE FINANCIAL HARDSHIP WERE NEARLY FIVE TIMES MORE LIKELY TO ATTEMPT TO COPE WITH THE HIGH COST OF CARE THROUGH MEDICATION NON-COMPLIANCE. IMMUNOTHERAPY MAY BE EFFECTIVE FOR SUBSET OF PROSTATE CANCER IN RECENT YEARS, CANCER IMMUNOTHERAPY HAS BEEN EFFECTIVE IN TREATING PATIENTS WITH IMMUNOGENIC, OR SO-CALLED "HOT" TUMORS WITH INCREASED LEVELS OF INFLAMMATION AND THE PRESENCE OF IMMUNE CELLS IN AND AROUND THE TUMORS. PROSTATE CANCER, HOWEVER, IS CONSIDERED A "COLD" TUMOR, WITH FEW IMMUNE CELLS RECOGNIZING AND INFILTRATING PROSTATE MALIGNANCIES. ACCORDINGLY, PROSTATE CANCER HAS BEEN FOUND TO RESPOND POORLY TO THE CLASS OF IMMUNOTHERAPIES KNOWN AS IMMUNE CHECKPOINT INHIBITORS. IN PREVIOUS WORK, A TEAM LED BY MEDICAL ONCOLOGISTS AT BIDMC IDENTIFIED A SUBSET OF PROSTATE CANCERS THAT EXHIBITED CHARACTERISTICS MORE TYPICAL OF HOT CANCERS. IN A PAPER APPEARING IN THE JOURNAL CLINICAL CANCER RESEARCH, RESEARCHERS REPORT THAT ABOUT A QUARTER OF LOCALIZED PROSTATE CANCERS MAY DEMONSTRATE THESE IMMUNOLOGIC TRAITS, SUGGESTING THAT A SUBSTANTIAL NUMBER OF PATIENTS WITH PROSTATE CANCER MAY, IN FACT, BENEFIT FROM IMMUNOTHERAPIES. "WE WERE SURPRISED TO FIND ALL THE FEATURES OF MORE TRADITIONALLY IMMUNOGENIC CANCERS IN THESE PROSTATE CANCERS, AND THAT THIS IS NOT A RARE SUBTYPE, OBSERVED IN ABOUT A QUARTER OF HIGH-RISK TUMORS," SAID CO-CORRESPONDING AUTHOR DAVID J. EINSTEIN, MD, A MEDICAL ONCOLOGIST AT BIDMC. "WE'RE INTERESTED IN WHETHER THERE IS A SUBSET OF PATIENTS WITH LOCALIZED PROSTATE CANCER, ESPECIALLY MORE AGGRESSIVE ONES, WHOSE CANCERS MIGHT BE MORE RECOGNIZED BY THE IMMUNE SYSTEM AND THEREFORE MORE TREATABLE WITH IMMUNOTHERAPIES. THESE WOULD ALSO BE SOME OF THE PATIENTS AT GREATEST RISK FOR RELAPSE AND METASTATIC SPREAD." EINSTEIN AND COLLEAGUES, INCLUDING CO-CORRESPONDING AUTHOR STEVEN BALK, MD, PHD, A PHYSICIAN AT BIDMC, FOCUSED ON TWO CHARACTERISTICS THAT MAKE TRADITIONALLY IMMUNOGENIC CANCERS SUSCEPTIBLE TO IMMUNOTHERAPY: PD-L1 EXPRESSION AND T CELL INFILTRATION. PD-L1 IS A PROTEIN INVOLVED IN TUMOR EVASION OF THE IMMUNE SYSTEM. T CELLS ARE THE SENTINELS OF THE IMMUNE SYSTEM, PATROLLING THE BODY FOR POTENTIAL PATHOGENS OR DISEASE. THE RESEARCHERS IDENTIFIED PROSTATE CANCERS THAT HAD BEEN REMOVED FROM PATIENTS, LOOKING FOR THOSE THAT HAD AREAS OF HIGH PD-L1 EXPRESSION AND THEN LOOKED FOR THE PRESENCE OF INFILTRATING T CELLS. NEXT, THE TEAM COMPARED THE T CELL LANDSCAPE IN THE MORE IMMUNOGENIC PROSTATE CANCERS TO THAT OF MORE TYPICAL PROSTATE CANCERS, AS WELL AS TO KIDNEY CANCER, ONE OF THE MOST IMMUNOGENIC TUMOR TYPES. FINALLY, THE TEAM USED DNA SEQUENCING TO COMPARE THE GENETIC PROFILES FROM THESE IMMUNOLOGICALLY HOT AREAS TO THAT OF THE SO-CALLED COLD AREAS IN THE SAME TUMORS, AS WELL AS TO THE GENOMIC LANDSCAPE OF IMMUNOGENIC CANCERS IN GENERAL. THE SCIENTISTS WERE SURPRISED TO LEARN HOW MANY MORE T CELLS INFILTRATED THE IMMUNOGENIC PROSTATE CANCERS COMPARED WITH MORE TYPICAL PROSTATE CANCERS, AND TO OBSERVE ALL THE FEATURES OF MORE TRADITIONALLY IMMUNOGENIC CANCERS LIKE KIDNEY CANCER IN THESE MORE IMMUNOGENIC PROSTATE CANCERS. THEY ALSO NOTED SIGNIFICANTLY MORE LOSS OF SOME KEY TUMOR SUPPRESSOR GENES IN THESE IMMUNOGENIC PROSTATE CANCERS COMPARED WITH TYPICAL PROSTATE CANCER, A DIFFERENCE THAT COULD POTENTIALLY SERVE AS MARKERS TO FIND CANCERS MORE TREATABLE WITH IMMUNOTHERAPIES. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS -GRADUATE MEDICAL EDUCATION 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 59 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 670 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 50 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 62 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS: ANESTHESIOLOGY EMERGENCY MEDICINE INTERNAL MEDICINE NEUROLOGY NEUROSURGERY OBSTETRICS AND GYNECOLOGY PATHOLOGY PSYCHIATRY RADIOLOGY SURGERY TRANSITIONAL YEARDURING THE FISCAL YEAR COVERED BY THIS FILING, BID-NEEDHAM HAD NET EXPENDITURES OF $542,131 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO BID-NEEDHAM'S TEACHING FUNCTION WHICH REPRESENTED 0.35% OF BID-NEEDHAM'S TOTAL EXPENSES.RESIDENCY 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. OVER HALF OF THESE PROGRAMS (59 OF 109) 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 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 NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY 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 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, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, 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-INTEGRATEDADDITIONAL 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) IS 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 HOSPITAL, TUFTS MEDICAL CENTER, ST. VINCENT HOSPITAL, ST. LUKE'S HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM 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 BIDMC THE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE. DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC. ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH 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 BIDMC THE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. PATHOLOGY EDUCATION AT BIDMCTHE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAININGRADIOLOGY 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 TRACKS CURRENTLY, 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.THE 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. STUDENTS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. STUDENTS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE: RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)THE 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, BID-NEEDHAM 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 4,000 PHYSICIANS AND 35,000 EMPLOYEES.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. AS A SUPPORT ORGANIZATION OF THESE ENTITIES, BILH PROVIDES CENTRALIZED SERVICES AND SUPPORT TO ITS AFFILIATES IN AREAS SUCH AS MANAGEMENT, STRATEGIC PLANNING, HUMAN RESOURCES AND BENEFITS, DEVELOPMENT AND FUNDRAISING, LEGAL SERVICES, FINANCE, TREASURY, INVESTMENT, INSURANCE, COMPLIANCE AND TAXATION AS WELL AS PATIENT CARE CONTRACTING AND OTHER SERVICES.BILH'S SUPPORT OF ITS AFFILIATES ENABLES THE NETWORK AS A WHOLE TO ACCOMPLISH ITS PRIMARY MISSION OF IMPROVING THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO USE SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE AND BILH IS ACCOMPLISHING THIS GOAL BY PROVIDING SUPPORT TO EACH OF ITS AFFILIATES, PROVIDING AN ORGANIZATIONAL STRUCTURE AND OPERATING MODEL WHICH IS DRIVEN BY FOUR DEEPLY INTERCONNECTED DOMAINS DESIGNED TO ADVANCE MEANINGFUL PARTNERSHIPS ACROSS ORGANIZATIONS, CARE SETTINGS, SPECIALTIES, AND GEOGRAPHIES TO ENSURE BILH PATIENTS RECEIVE THE CARE THEY NEED IN THE COMMUNITIES WHERE THEY LIVE AND WORK.BILH IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. BILH IS ACCOMPLISHING THIS MISSION BY PROVIDING SUPPORT TO ITS AFFILIATES WHICH INCLUDE:1. A PHYSICIAN ENTERPRISE THAT ENCOMPASSES THE SYSTEM'S NETWORK OF EMPLOYED PRIMARY CARE AND SPECIALTY PHYSICIANS LOCATED THROUGHOUT OUR REGION;2. A HOSPITAL AND AMBULATORY SERVICES GROUP THAT INCLUDES WORLD-CLASS ACADEMIC MEDICAL CENTERS AND TEACHING HOSPITALS WITH AFFILIATIONS WITH HARVARD MEDICAL SCHOOL AND TUFTS UNIVERSITY SCHOOL OF MEDICINE; LEADING COMMUNITY HOSPITALS; A RENOWNED ORTHOPEDICS HOSPITAL; AND COMPREHENSIVE AMBULATORY CENTERS;3. A POPULATION HEALTH ENTERPRISE THAT EMBRACES A NEW MODEL OF CARE TO IMPROVE THE HEALTH OF ALL THOSE SERVED BY BILH; THE POPULATION HEALTH DOMAIN INCLUDES THE SYSTEM'S CLINICALLY INTEGRATED NETWORK OF AFFILIATED PROVIDERS AND VITAL SERVICES, INCLUDING BEHAVIORAL HEALTH AND HOME CARE SERVICES;4. A ROBUST NETWORK OF ADMINISTRATIVE AND OPERATIONAL SERVICES TO ADVANCE STRATEGIC GOALS, BOTH LOCALLY AND AT THE SYSTEM LEVEL, THAT OFFERS EXPERTISE AND STANDARDIZED RESOURCES BASED ON BEST PRACTICES. BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES FISCAL YEAR ENDED SEPTEMBER 30, 2022SINCE COMING TOGETHER AS A HEALTH SYSTEM, BETH ISRAEL LAHEY HEALTH ("BILH") HAS CONTINUED TO MAKE SIGNIFICANT INVESTMENTS AND UNDERTAKE INITIATIVES TO IMPROVE ACCESS FOR PATIENTS AND SUPPORT ITS SURROUNDING COMMUNITIES. IN FY 2022 ALONE, BILH INVESTED OVER $8 MILLION IN ITS COMMUNITY HEALTH CENTER PARTNERS AND SAFETY NET AFFILIATES, DEVELOPED ACCESSIBLE PATIENT MESSAGING AND EDUCATION, AND INVESTED OVER $5 MILLION IN SEVERAL BEHAVIORAL HEALTH-FOCUSED INITIATIVES. BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK ("BILHPN") CONTINUES TO OPTIMIZE ITS POPULATION HEALTH-FOCUSED INITIATIVES, INCLUDING THOSE FOCUSED ON ADDRESSING HEALTH DISPARITIES. HIGHLIGHTS OF THE SYSTEM'S EFFORTS INCLUDE: 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. SPECIFICALLY, AS OF OCTOBER 2020, ALL BILH HOSPITALS AND PROVIDERS EMPLOYED BY BILH OR ON WHOSE BEHALF BILH JOINTLY CONTRACTS 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 WILL GO INTO EFFECT IN APRIL 2023. AS PART OF THIS CONTRACT, BILHPN WILL EXTEND PARTICIPATION TO ALL ELIGIBLE PRIMARY CARE PROVIDERS ("PCPS") WHO WERE NOT OTHERWISE PARTICIPATING IN A MASSHEALTH ACO. WHILE ALL ELIGIBLE BILHPN PCPS WERE PARTICIPANTS IN A FORM OF MASSHEALTH, SOME PCPS HAVE PREVIOUSLY NOT PARTICIPATED IN A MASSHEALTH ACO. DURING FY 2022, BILH DEVELOPED AND REFINED A MULTICULTURAL MARKETING, ADVERTISING, AND OUTREACH PLAN WITH THE PURPOSE OF EXPANDING ACCESS FOR UNDERSERVED POPULATIONS, INCLUDING MASSHEALTH PATIENTS, IN TARGETED BILH SERVICE AREAS. IMPLEMENTATION OF THAT PLAN WILL OCCUR IN FY 2023. INVESTMENTS IN UNDERSERVED COMMUNITIES BILH HOSPITALS HAVE CREATED 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 IS EXPLORING 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. COMMITMENT TO BEHAVIORAL HEALTH CARE BETH ISRAEL LAHEY HEALTH BEHAVIORAL SERVICES IS THE LARGEST MENTAL HEALTH AND SUBSTANCE USE DISORDER NETWORK IN EASTERN MASSACHUSETTS. WITH A FOCUS ON COMMUNITY HEALTH, BILH BEHAVIORAL SERVICES SUPPORTS THE NEEDS OF CHILDREN, TEENS, AND ADULTS THROUGH A RANGE OF OPTIONS, FROM INPATIENT CARE TO COMMUNITY-BASED PROGRAMS. IN FY 2022, BILH INVESTED OVER $5 MILLION IN THE FOLLOWING BEHAVIORAL HEALTH INITIATIVES: THE COLLABORATIVE CARE MODEL, CENTRALIZED BED MANAGEMENT PROGRAM, AND MEDICATION ASSISTED THERAPY ("MAT") AS OF SEPTEMBER 30, 2022, 60 OF 78 EMPLOYED PRIMARY CARE PRACTICES2 ARE PARTICIPATING IN THE IMPACT MODEL, WITH 12 NEW SITES ADDED FROM THE PREVIOUS YEAR. THE IMPACT MODEL (ALSO REFERRED TO AS THE "COLLABORATIVE CARE" MODEL) IS A BEHAVIORAL HEALTH INTEGRATION MODEL, WHICH INVOLVES INTRODUCING PRIMARY CARE PATIENTS WHO ARE IDENTIFIED THROUGH SCREENINGS AND DIRECT REFERRALS TO AN EMBEDDED BEHAVIORAL HEALTH CLINICIAN. BILH HAS CONTINUED TO EXPAND ITS BRIDGE CLINICS AT ADDISON GILBERT AND BEVERLY HOSPITALS, INCREASING SAME-DAY ADMISSION FOR MAT PATIENTS FROM 24 TO 40 HOURS PER WEEK, OBTAINING ADDITIONAL STAFF, AND EXPANDING ITS INDUCTION PROGRAM. BILH HAS EXPANDED ITS SYSTEM-WIDE SUBSTANCE USE DISORDER TASKFORCE, DEFINING NEW PATHWAYS FOR CONNECTING BILH PRIMARY CARE TEAMS WITH COMMUNITY ACUTE DETOX AND OTHER ADDICTION-BASED SERVICES, INCREASING THE CAPACITY OF BILH PCPS TO PRESCRIBE MEDICATIONS IN SUPPORT OF OFFICE-BASED ADDICTION TREATMENT, AND PROVIDING EDUCATIONAL TRAININGS TO PCPS TO SCREEN AND TREAT SUBSTANCE USE DISORDERS. THE PRACTICE OF MAT INDUCTION AND REFERRAL IN THE ED AT BID-PLYMOUTH CONTINUED IN FY 2022, WITH RECOVERY NAVIGATORS, AN ADDICTION LPN NURSE, AND A PSYCHIATRIC NP AS AVAILABLE RESOURCES TO PATIENTS. BID-PLYMOUTH ALSO CONTINUED ITS PARTNERSHIP WITH AREA COALITIONS TO HAND OUT SUPPLIES AND RESOURCES, INCLUDING NARCAN, TO THOSE PATIENTS WHO ARE RESIDENTS OF THE AREA AND WHO PRESENT TO THE BID-PLYMOUTH EMERGENCY ROOM WITH AN OPIOID OVERDOSE. ADDITIONAL INFORMATION ON BEHAVIORAL HEALTH IS BELOW.POPULATION HEALTH INITIATIVES BILHPN SUPPORTS AND IMPROVES ACCESS, QUALITY AND EFFICIENCY OF PATIENT-CENTERED CARE BY LEVERAGING BEST PRACTICES IN CLINICAL EXCELLENCE AND DATA ANALYTICS TO HELP PROVIDERS IMPROVE PATIENT HEALTH OUTCOMES. FOR EXAMPLE, BILHPN'S CARE MANAGEMENT TEAM WORKS WITH THE HIGHEST-RISK PATIENTS IN AN EFFORT TO EDUCATE THEM ON THEIR DISEASE, IMPROVE MEDICATION COMPLIANCE, AND HELP THEM NAVIGATE THE COMPLEXITIES OF THE HEALTHCARE SYSTEM. THE GOAL OF BILHPN'S CARE MANAGERS IS TO IMPROVE OUTCOMES FOR PATIENTS WHILE AVOIDING UNNECESSARY EMERGENCY ROOM VISITS OR HOSPITAL STAYS. DURING FY 2022, BILH UNDERTOOK SEVERAL INITIATIVES TO IMPROVE POPULATION HEALTH AND PATIENT CARE, INCLUDING: O BILHPN'S QUALITY TEAM DEVELOPED AND IMPLEMENTED EIGHT TEXT-BASED OUTREACH CAMPAIGNS FOR PATIENTS, ADDRESSING CANCER SCREENINGS, IMMUNIZATIONS, AND DIABETES CARE TO IMPROVE POPULATION HEALTH METRICS.O BILHPN CONTINUED TO OPTIMIZE ITS ENTERPRISE-WIDE POPULATION HEALTH DATA WAREHOUSE TO IDENTIFY PATIENTS WITH CARE GAPS. THROUGH COLLABORATION WITH BILH PHYSICIAN LEADERS, BILHPN MODIFIED PRACTICE WORKFLOWS AND CREATED OUTREACH PROGRAMS TO CLOSE IDENTIFIED GAPS. THESE EFFORTS RESULTED IN BILH REACHING MORE PATIENTS.O DURING FY 2022, BILHPN AND THE BILH OFFICE FOR DIVERSITY, EQUITY AND INCLUSION CO-LED EFFORTS TO INCREASE ACCESS AND IMPROVE OUTCOMES FOR UNDERSERVED POPULATIONS, WITH A FOCUS ON CLOSING DISPARITIES IN DIABETES CARE FOR BLACK AND HISPANIC PATIENTS. ONE AREA OF COLLABORATION CENTERED AROUND A $1.8 MILLION GRANT FROM THE INSTITUTE OF HEALTHCARE IMPROVEMENT / BLUE CROSS BLUE SHIELD OF MASSACHUSETTS THAT ALLOWED THE SYSTEM TO HIRE AND EMBED PATIENT NAVIGATORS WITHIN ITS MOST DIVERSE PRACTICES TO ASSIST PATIENTS ALONG THE CONTINUUM OF CARE. BILH BEHAVIORAL HEALTH SERVICES THE 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. BILHBS (WHICH INCLUDES THE ACTIVITIES OF BILH'S TAX-EXEMPT AFFILIATE NORTHEAST BEHAVIORAL HEALTH CORP) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS. BILHBS' NETWORK OF BEHAVIORAL HEALTH CARE INCLUDES SERVICES FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TREATMENT TO COMMUNITY-BASED PROGRAMS. SERVICES INCLUDE: INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; EMERGENCY PSYCHIATRIC AND MOBILE EMERGENCY SERVICES TEAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION TREATMENT; INDIVIDUAL/COUPLE/FAMILY THERAPY; MEDICATION ASSISTED TREATMENT PROGRAMS; AND SCHOOL-BASED AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES.AS NOTED PREVIOUSLY, SINCE ITS CREATION IN MARCH 2019, BILH HAS CONTINUED TO INVEST SIGNIFICANTLY IN IMPROVING ACCESS TO BEHAVIORAL HEALTH CARE THROUGH A SYSTEM-WIDE APPROACH TO CARE DELIVERY. AS ONE OF SEVERAL ONGOING INITIATIVES, BILH HAS MADE A MULTI-YEAR COMMITMENT TO PROVIDE BEHAVIORAL HEALTH SUPPORT TO ITS EMPLOYED PRIMARY CARE PRACTICES USING AN EVIDENCE-BASED APPROACH KNOWN AS THE IMPACT MODEL. BY THE END OF FY 2022, BILH HAD IMPLEMENTED THE IMPACT MODEL IN 74.36% OF ITS EMPLOYED PRIMARY CARE PRACTICES AS PART OF ITS COLLABORATIVE CARE PROGRAM IMPLEMENTATION. IN MARCH 2021, BILHBS LAUNCHED ITS CENTRALIZED BED FINDING TEAM. THIS TEAM IS PART OF A BILHBS CENTRAL CALL CENTER, WHICH CENTRALIZES CALLS TO BILHBS' THREE EMERGENCY SERVICE PROGRAM (ESP) CATCHMENT AREAS REDUCING REDUNDANCIES ACROSS THE AGENCY AND STREAMLINING ALL CALLS TO ONE CENTRAL SERVICE. THIS CENTRALIZED BED FINDING TEAM IS RESPONSIBLE FOR CONDUCTING BED SEARCHES FOR PATIENTS SEEN THROUGH THE ESP AND WHO ARE AWAITING AN INPATIENT PSYCHIATRIC PLACEMENT. THIS TEAM DIRECTLY INCREASES THE AVAILABILITY OF CLINICIANS TO CONTINUE TO SEE PATIENTS IN THE EMERGENCY DEPARTMENT (ED) AND THE COMMUNITY WHO ARE EXPERIENCING A BEHAVIORAL HEALTH AND/OR CO-OCCURRING SUBSTANCE USE DISORDER CRISIS WHILE OTHER TEAM MEMBERS SEARCH FOR AVAILABLE INPATIENT PLACEMENTS. THIS INITIATIVE SUPPORTS DECREASED RESPONSE TIME TO RESPONDING TO NEW PATIENTS IN CRISIS AND REDUCES ED BOARDING TIME FOR PATIENTS WHO CAN BE SAFELY MANAGED IN THE COMMUNITY.IN FY2022, THE STATE OF MASSACHUSETTS SET FORTH THE MASSACHUSETTS BEHAVIORAL HEALTH ROADMAP TO INCLUDE FOUR PRIMARY OUTCOMES IN EFFORTS TO ADVANCE HEALTH EQUITY: (1) THE DEVELOPMENT OF COMMUNITY BEHAVIORAL HEALTH CENTERS (CBHCS); (2) SHIFTING BEHAVIORAL HEALTH EMERGENCY SERVICES TO THE COMMUNITY FROM THE EMERGENCY DEPARTMENTS; (3) TREATMENT ON DEMAND (OUTPATIENT EVALUATION AND TREATMENT); AND (4) BEHAVIORAL HEALTH HELP LINE. IN RESPONSE TO THIS MOVEMENT, BILHBS RECEIVED AN AWARD TO OPERATE A CBHC IN THE LAWRENCE LOCATION AND BEGAN THE PLANNING TO PIVOT EMERGENCY SERVICES TEAMS TO SERVE THE BILH SYSTEM EMERGENCY DEPARTMENTS. BILHBS SERVES APPROXIMATELY 35,000 UNDUPLICATED INDIVIDUALS ANNUALLY, OFFERING A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS. SERVICES RANGE FROM INPATIENT TO HOME AND COMMUNITY-BASED SERVICES. BILHBS OPERATES OVER 250 BEDS IN 9 FACILITIES FOR CLIENTS REQUIRING ACUTE PSYCHIATRIC CARE, DETOXIFICATION AND RESIDENTIAL STEP-DOWN SERVICES. DURING THE PERIOD COVERED BY THIS FILING, COMMUNITY-BASED SERVICES INCLUDED MOBILE EMERGENCY SERVICES TEAMS IN THREE CATCHMENT AREAS AND HOME-BASED COUNSELING FOR ADULTS, YOUTH AND THEIR FAMILIES. BILHBS ALSO PROVIDED SERVICES IN 63 MIDDLE AND HIGH SCHOOLS, AS WELL AS 9 POLICE DEPARTMENTS. IN ADDITION, BILH'S COMMUNITY CRISIS STABILIZATION ("CCS") UNITS IN LAWRENCE AND SALEM, WHICH TYPICALLY CARE FOR PATIENTS WITH MENTAL HEALTH ISSUES, INCREASED THEIR ABILITY TO TREAT PERSONS WITH CO-OCCURRING SUBSTANCE USE DISORDERS. THE CCS UNITS CONTINUE TO BE ABLE TO INDUCT PATIENTS WITH OPIOID USE DISORDER (OUD) ON BUPRENORPHINE AND ARE ALSO ABLE TO MAINTAIN PATIENTS WHO ARE ALREADY ON ANY OF THE THREE FDA APPROVED MEDICATIONS FOR THE TREATMENT OF OUD. THESE UNITS ARE SEEING AN INCREASE IN THE NUMBER OF PATIENTS WITH METHAMPHETAMINE DISORDERS AND HAVE DEVELOPED A PROTOCOL TO MANAGE WITHDRAWAL SYMPTOMS IN THIS POPULATION. 1 FAMILY PROMISE METROWEST 6 MULLIGAN ST NATICK MA 01760 205963640 501(C)(3) 7500 0 COMMUNITY SUPPORT DEDHAM COUNCIL ON AGING 450 WASHINGTON ST DEDHAM MA 02026 042932984 501(C)(3) 6000 0 COMMUNITY SUPPORT WESTWOOD YOUTH & FAMILY SERVICES 273 WASHINGTON STREET WESTWOOD MA 02090 046001362 501(C)(3) 6000 0 COMMUNITY SUPPORT NEEDHAM COMMUNITY COUNCIL 570 HILLSIDE AVE NEEDHAM MA 02494 042121365 501(C)(3) 6000 0 COMMUNITY SUPPORT NEIGHBOR BRIGADE 0 PO BOX 735 MAYNARD MA 01754 271871610 501(C)(3) 6000 0 COMMUNITY SUPPORT CHARLES RIVER YMCA 863 GREAT PLAIN AVENUE NEEDHAM MA 12492 042103551 501(C)(3) 6000 0 COMMUNITY SUPPORT RIVERSIDE COMMUNITY CARE 270 BRIDGE STREET DEDHAM MA 12492 043097170 501(C)(3) 6000 0 SUPPORT FOR COMMUNITY MENTAL HEALTH DEDHAM FOOD PANTRY PO BOX 46 0 DEDHAM MA 12027 043098455 501(C)(3) 6000 0 COMMUNITY SUPPORT NEEDHAM COMMUNITY FARM 1155 CENTRAL AVE NEEDHAM MA 12492 113822708 501(C)(3) 11000 0 COMMUNITY SUPPORT CIRCLE OF HOPE 1329 HIGHLAND AVE NEEDHAM MA 12492 263478964 501(C)(3) 25000 0 COMMUNITY SUPPORT NEEDHAM RESILIENCE NETWORK 62 GREEN STREET NEEDHAM MA 12492 364818585 501(C)(3) 25000 0 COMMUNITY SUPPORT NEEDHAM PUBLIC HEALTH 178 ROSEMARY ST NEEDHAM MA 12492 501(C)(3) 8000 0 COMMUNITY SUPPORT NORWOOD FIRE DEPARTMENT 137 NAHANTON STREET NORWOOD MA 12062 501(C)(3) 0 6410 OTHER COST OF SUPPLIES COMMUNITY SUPPORT WESTWOOD FIRE DEPARTMENT 637 HIGH STREET WESTWOOD MA 12090 501(C)(3) 0 5540 OTHER COST OF SUPPLIES COMMUNITY SUPPORT TOWN OF NEEDHAM 1471 HIGHLAND AVENUE NEEDHAM MA 12492 046001238 501(C)(3) 39985 0 SUPPORT FOR TOWNWIDE EDUCATION, HEALTH SUPPLIES AND MENTAL HEALTH SUPPORT MEDFIELD COALITION FOR SUICIDE PREVENTION 459 MAIN ST MEDFIELD MA 12052 043559057 501(C)(3) 6000 0 COMMUNITY SUPPORT CHARLES RIVER CHAMBER 117 KENDRICK STREET NEEDHAM MA 12494 041670500 501(C)(6) 10800 0 COMMUNITY SUPPORT 17 1 PART I, LINE 2: AS PREVIOUSLY NOTED IN THE FILING BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS. X X X X 0 1 0 0 0 0 0 1 0 TABB MD KEVIN CHIEF EXECUTIVE OFFICER (EX-OFFICIO) 0 1866181 0 2590331 0 578116 0 256516 0 39655 0 5330799 0 0 ROWAN MICHAEL TTEE (EX-OFF); BILH EVP, HOSP & AMB 0 1089875 0 730070 0 199362 0 8550 0 28355 0 2056212 0 0 KERNDL JOHN TREASURER (EX-OFFICIO) 0 813559 0 491357 0 60084 0 0 0 26877 0 1391877 0 0 KATZ ESQ JAMIE CLERK (EX-OFFICIO) 0 744211 0 386130 0 125507 0 12825 0 9218 0 1277891 0 0 FISCHER STEVEN P FORMER TREASURER (EX-OFFICIO) 0 359497 0 337500 0 277823 0 34320 0 12915 0 1022055 0 0 KANNAM MD JOSEPH TRUSTEE AND CARDIOLOGIST 0 339835 0 109239 0 3348 0 31900 0 39520 0 523842 0 0 MCSWEENEY MD GREGORY SVP, CMO 298627 0 79889 0 49820 0 10851 0 1371 0 440558 0 0 0 HOFFMANN NANCY ASST. TREASURER (EX-OFFICIO), CFO 271544 0 73232 0 32760 0 10158 0 11155 0 398849 0 0 0 DAVIDSON RN KATHLEEN SVP, CNO, COO 243916 0 64711 0 49681 0 8955 0 28940 0 396203 0 0 0 BUCKLE MD DAVID TRUSTEE 0 274302 0 17612 0 2727 0 33277 0 13484 0 341402 0 0 BURKE ROBERT PHYSICIAN ASSISTANT 264976 0 659 0 17686 0 5257 0 30070 0 318648 0 0 0 WELCH JULIE A VP, HUMAN RESOURCES BUSINESS PARTNER 188321 0 500 0 30213 0 5667 0 20727 0 245428 0 0 0 PIATELLI LUANNE CLINICAL NURSE II 192110 0 500 0 6397 0 5102 0 31770 0 235879 0 0 0 BERNARD LOUISE REGISTERED NURSE 165006 0 500 0 15756 0 4099 0 32304 0 217665 0 0 0 SWANSON SHIRLEY MRI TECHNICIAN 192635 0 500 0 5184 0 7927 0 7306 0 213552 0 0 0 ALPERT HEIDI SR DIRECTOR, CLIN SERV 178840 0 500 0 2055 0 10408 0 20543 0 212346 0 0 0 PART I, LINE 4B NON-QUALIFIED PLANS DURING THE 2021 CALENDAR YEAR, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) WAS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM WHICH IS A NON-QUALIFIED DEFERRED COMPENSATION PLAN AND PURSUANT TO THE PLAN ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS. 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. PART I, LINE 7 NON-FIXED PAYMENTS DURING THE 2021 CALENDAR YEAR, THE FILING ORGANIZATION MAINTAINS EXECUTIVE COMPENSATION PACKAGES WHICH INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF VARIOUS FACTORS, INCLUDING BUT NOT LIMITED TO, MEETING OR EXCEEDING THE EMPLOYING ENTITY'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, BUDGETED CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. IN EACH CASE, INCENTIVE COMPENSATION WAS REVIEWED BY THE COMPENSATION COMMITTEE WHICH 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, 2022. AS REQUIRED BY FORM 990, COMPENSATION REPORTED FOR THIS FISCAL YEAR IS CALENDAR YEAR 2021 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 THE 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: ANTIN, FRANCIS TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM AUTH, JOSEPH TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM BARABINO, GILDA TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. BUCKLE, M.D., DAVID TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM CARNAHAN, VIRGINIA TRUSTEE AND CHAIR BETH ISRAEL DEACONESS HOSPITAL NEEDHAM CHAMOUN, NASSIB TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. COFFMAN, BARRY TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM COUGHLIN, JAMES C. TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM DAVIDSON, R.N., KATHLEEN SENIOR VICE PRESIDENT, CHIEF NURSING OFFICER AND CHIEF OPERATING OFFICER - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM OTHER REPORTABLE COMPENSATION INCLUDES PTO CASH BUYOUT IN THE AMOUNT OF $47,108. DEAMORE, DENISE TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM FINE, GAIL H. TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM FLEMING, PAUL TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM FOGARTY, JOHN PRESIDENT, TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. MANAGING DIRECTOR - BETH ISRAEL DEACONESS PHYSICIAN ORGANIZATION, LLC OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. FOGARTY INCLUDES COMBINED CONTRIBUTIONS TO, AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $96,636. OF THIS AMOUNT, $5,170 IS UNVESTED. HOFFMANN, NANCY CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM OTHER REPORTABLE COMPENSATION INCLUDES PTO CASH BUYOUT IN THE AMOUNT OF $30,978. KANNAM, M.D., JOSEPH P. TRUSTEE AND CARDIOLOGIST BETH ISRAEL DEACONESS HOSPITAL NEEDHAM KATZ, J.D., JAMIE UNLESS OTHERWISE NOTED BELOW, MR. KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2022: 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 - BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK, LLC 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) AND CLERK (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND CLERK (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. TRUSTEE (EX-OFFICIO) 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. CLERK (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE ACCOUNTABLE CARE ORGANIZATION, LLC CLERK (EX-OFFICIO) - LAHEY CLINICAL PERFORMANCE NETWORK, LLC 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 AND CLERK (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL CLERK - JOSLIN CLINIC, INC. COMMENCED POSITION AS CLERK ON NOVEMBER 1, 2021 CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. COMMENCED POSITION AS CLERK ON NOVEMBER 1, 2021 CLERK (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. COMMENCED POSITION AS CLERK (EX-OFFICIO) ON MARCH 18, 2022 MR. KATZ SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2021 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 $99,848. KERNDL, JOHN UNLESS OTHERWISE NOTED BELOW, MR. KERNDL HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2022: EXECUTIVE VICE PRESIDENT AND 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 ASSISTANT TREASURER (EX-OFFICIO) MOUNT AUBURN PROFESSIONAL SERVICES (TERM OCTOBER 20, 2021 MARCH 17, 2022) TREASURER (EX-OFFICIO) MOUNT AUBURN PROFESSIONAL SERVICES (TERM BEGAN MARCH 18, 2022) SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) 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 TRUSTEE (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 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. COMMENCED POSITION AS TREASURER (EX-OFFICIO) ON NOVEMBER 1, 2021 TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. COMMENCED POSITION AS TREASURER (EX-OFFICIO) ON NOVEMBER 1, 2021 ALTHOUGH MR. KERNDL SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2021 COMPENSATION. OTHER REPORTABLE COMPENSATION FOR MR. KERNDL INCLUDES $ 48,375 RELATED TO RELOCATION AND TEMPORARY HOUSING WHEN MR. KERNDL RELOCATED TO MASSACHUSETTS RELATED TO THE POSITIONS NOTED ABOVE. KIERSTEAD, JANA TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM LEVINE, BRUCE TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM MARINO, ROGER TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM MCSWEENEY, M.D., GREGORY SENIOR VICE PRESIDENT AND CHIEF MEDICAL OFFICER BETH ISRAEL DEACONESS HOSPITAL NEEDHAM MEDALIE, LESLIE TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM POPEO, PAUL D. TRUSTEE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM RILEY, M.D., ANNE TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM ROWAN, MICHAEL UNLESS OTHERWISE NOTED BELOW, MR. ROWAN HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2022: EXECUTIVE VICE PRESIDENT, HOSPITAL AND AMBULATORY SERVICES - BETH ISRAEL LAHEY HEALTH, INC. MANAGING DIRECTOR - BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK, LLC 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. COMMENCED POSITION AS TRUSTEE (EX-OFFICIO) CEO DESIGNATEON NOVEMBER 1, 2021 TRUSTEE (EX-OFFICIO) CEO DESIGNATE - JOSLIN DIABETES CENTER, INC. COMMENCED POSITION AS TRUSTEE (EX-OFFICIO) CEO DESIGNATE ON NOVEMBER 1, 2021 MR. ROWAN SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2021 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 $175,998. OF THIS AMOUNT, $154,177 IS UNVESTED AS OF SEPTEMBER 30, 2022. SMITH, MBA, BRIAN ASSISTANT TREASURER (EX-OFFICIO), CFO - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC.(TERM BEGAN MARCH 18, 2022) SONTAG, ESQ, DAVID ASSISTANT CLERK EX OFFICIO (SENIOR ASSOCIATE GENERAL COUNSEL AND DIRECTOR OF ETHICS - BILH; CO-CHAIR, ETHICS ADVISORY COMMITTEE - BIDMC) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. ASSISTANT CLERK EX OFFICIO (SENIOR ASSOCIATE GENERAL COUNSEL AND DIRECTOR OF ETHICS - BILH; CO-CHAIR, ETHICS ADVISORY COMMITTEE - BIDMC) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. ASSISTANT CLERK EX OFFICIO (SENIOR ASSOCIATE GENERAL COUNSEL AND DIRECTOR OF ETHICS - BILH; CO-CHAIR, ETHICS ADVISORY COMMITTEE - BIDMC) BID - MILTON PHYSICIAN ASSOCIATES, INC. ASSISTANT CLERK EX OFFICIO (SENIOR ASSOCIATE GENERAL COUNSEL AND DIRECTOR OF ETHICS - BILH; CO-CHAIR, ETHICS ADVISORY COMMITTEE - BIDMC) - COMMUNITY PHYSICIANS ASSOCIATES, INC. TABB, M.D., KEVIN UNLESS OTHERWISE NOTED BELOW, DR. TABB HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2022: 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, LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER AND LAHEY CLINIC FOUNDATION - LAHEY CLINIC HOSPITAL, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO), LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER AND LAHEY CLINIC FOUNDATION - LAHEY CLINIC, INC. TRUSTEE (EX-OFFICIO), 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), CHAIR(EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. TRUSTEE (EX-OFFICIO), CHAIR(EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE, CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX OFFICIO) AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO), LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL & MEDICAL CENTER AND LAHEY CLINIC FOUNDATION - LAHEY CLINIC FOUNDATION, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER (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 SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE, INC. CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. COMMENCED POSITION AS CLERK ON NOVEMBER 1, 2021 PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL IN ADDITION TO THE POSITIONS NOTED ABOVE, DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNATE WHO THEN BECAME THE VOTING TRUSTEE IN HIS PLACE: TRUSTEE (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, BID-MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATES TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, THE JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) ANNA JAQUES HOSPITAL, INC. TRUSTEE (EX-OFFICIO) JOSLIN DIABETES CENTER TRUSTEE (EX-OFFICIO) JOSLIN CLINIC ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2021 COMPENSATION. INCENTIVE COMPENSATION FOR DR. TABB INCLUDES $750,000 WHICH WAS PREVIOUSLY REPORTED AS DEFERRED 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 $610,860. DEFERRED COMPENSATION IN THE AMOUNT OF $200,000 INCLUDED IN THIS FILING FOR DR. TABB RELATES TO CERTAIN MILESTONE PAYMENTS WHICH, AS OF DECEMBER 31, 2021, 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. DEFERRED COMPENSATION IN THE AMOUNT OF $47,966 INCLUDED IN THIS FILING FOR DR. TABB RELATES TO CERTAIN MILESTONE PAYMENTS WHICH, AS OF DECEMBER 31, 2021, WERE NOT FUNDED, WERE NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THEY ARE INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. TROTMAN BURMAN, SAMANTHA TRUSTEE (EX-OFFICIO) AND CHAIR OF THE BOARD OF ADVISORS - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM ULLMAN, SONAL TRUSTEE (EX-OFFICIO), PRESIDENT OF MEDICAL STAFF - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. WELCH, JULIE A. VICE PRESIDENT OF HUMAN RESOURCES - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM VAZ, ESQ, BRIAN ASSISTANT CLERK (EX-OFFICIO), ASSISTANT GENERAL COUNSEL, BILH - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) FISCHER, STEVEN EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. MR. FISCHER RETIRED FROM HIS POSITION HELD AT BILH AS WELL AS THE POSITIONS DESCRIBED BELOW ON APRIL 2, 2021. UNLESS NOTED BELOW, MR. FISCHER HELD EACH POSITION THROUGH HIS DATE OF RETIREMENT. TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TREASURER (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITALMILTON TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITALNEEDHAM TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITALPLYMOUTH TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) BID-MILTON PHYSICIAN ASSOCIATES F/K/A MILTON HOSPITAL FOUNDATION TREASURER (EX-OFFICIO) MOUNT AUBURN HOSPITAL TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) COMMUNITY PHYSICIANS ASSOCIATES TRUSTEE AND TREASURER (EX-OFFICIO) JORDAN PHYSICIAN ASSOCIATES TRUSTEE AND TREASURER (EX-OFFICIO) THE JORDAN HEALTH SYSTEMS, INC. TREASURER (EX-OFFICIO) ANNA JAQUES HOSPITAL TREASURER (EX-OFFICIO) - SEACOAST AFFILIATED GROUP PRACTICE TRUSTEE AND TREASURER (EX-OFFICIO) LAHEY HEALTH SHARED SERVICES, INC. ASSISTANT TREASURER BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) NORTHEAST HEALTH SYSTEM, INC. TRUSTEE AND TREASURER (EX-OFFICIO) NORTHEAST PROFESSIONAL REGISTRY OF NURSES TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE AND TREASURER (EX-OFFICIO) SEACOAST NURSING & REHABILITATION CENTER, INC. TREASURER (EX-OFFICIO) WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) WINCHESTER HOSPITAL FOUNDATION, INC. TREASURER (EX-OFFICIO) WINCHESTER HEALTHCARE MANAGEMENT, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL & MEDICAL CENTER MANAGING DIRECTOR AND TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK LLC TREASURER (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) NORTHEAST MEDICAL PRACTICE, INC. TRUSTEE (EX-OFFICIO) AND TREASURER (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND TREASURER CAB HEALTH & RECOVERY SERVICES, INC. TREASURER CAREGROUP PARMENTER HOME CARE AND HOSPICE, INC. TRUSTEE AND TREASURER HEALTH & EDUCATION HOUSING SERVICES, INC. COMPENSATION REPORTED IN THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 IS CALENDAR YEAR 2021 COMPENSATION. ALTHOUGH MR. FISCHER RETIRED PRIOR TO THE BEGINNING OF THE FISCAL PERIOD COVERED BY THIS FILING, HE PROVIDED SERVICES IN THE CAPACITIES NOTED ABOVE DURING CALENDAR YEAR 2021 AND PRIOR TO HIS RETIREMENT. COMPENSATION REPORTED HERE RELATES TO THOSE SERVICES. 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. FISCHER INCLUDES COMBINED CONTRIBUTIONS TO, PAYMENTS FROM AND CHANGE IN VALUE OF, NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $ 122,431. A MDFA - SERIES 2019K 043431814 57584YTK5 2019-07-31 211922775 SEE PART VI 0 0 0 B MDFA - SERIES 2018J-1 J-2 043431814 57584YJW0 2018-06-13 479594374 SEE PART VI 0 0 0 C MDFA - SERIES 2016I 043431814 57584XMT5 2016-05-12 257611877 SEE PART VI 0 0 0 D MDFA - LAHEY SERIES F 042323457 NONEXXXXX 2015-10-21 262828878 SEE PART VI 0 0 0 A 20980000 211922775 2931137 208991638 2019 0 0 1 1 B 10816000 504358641 4594374 499764263 4 0 0 0 1 C 45550000 257618370 2515889 19006493 236095988 2016 0 1 1 1 D 28000000 262953908 4857465 3129474 94764737 160202232 2021 1 1 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 BOND A, ENTITY 1: PART I, ROW A, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. PART I, ROW A, COLUMN F: THE ISSUE REFUNDED ISSUES DATED 06/09/2008, 11/30/2005, 6/16/2003, AND 6/4/1998. BOND B, ENTITY 1: PART I, ROW B, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. 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. BOND C, ENTITY 1: PART I, ROW C, COLUMN A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. 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 A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY. 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 $123,904 OF INVESTMENT EARNINGS. 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 FACILITIES 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. 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 A: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 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 06/03/1998), FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $1,360,617 OF INVESTMENT EARNINGS. PART IV, COLUMN A, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019. BOND B, 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 IV, ROW 2C, COLUMN A: 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 FACILITIES 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. A MDFA - SERIES 2015 H-1 043431814 57584XDH1 2015-09-02 203702204 SEE PART VI 0 0 0 B MHEFA - WINCHESTER SERIES F 042456011 57586CDD4 2004-07-08 30340000 SERIAL BOND SERIES F - ADV REFUND 0 0 0 A 58285000 203702204 2348479 201353725 2015 1 1 1 1 B 7165000 30340000 412448 29927552 2004 0 1 1 1 A 0 1 1 1 0 0.00100 0.00000 0.00100 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 0 1 1 1 MORGAN STANLEY 20.000000000000 0 0 0 0 1 A 1 B 1 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 285456 CONSTRUCTION SERVICES 0 X 9 883705 OTHER X AUCTION ITEMS 3 35000 OTHER X TICKETS 8 6804 OTHER 0 1 0 FORM 990, PART I & PART III, LINE 1 THE MISSION OF THE BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BIDN OR HOSPITAL) IS TO PROVIDE SAFE, HIGH-QUALITY, COMMUNITY-BASED HEALTH CARE AND ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH ITS AFFILIATES IN THE BETH ISRAEL LAHEY HEALTH NETWORK. BIDN PROVIDES THIS CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. THE COMMUNITY BENEFITS MISSION STATES THAT BIDN IS COMMITTED TO WORKING IN PARTNERSHIP WITH RESIDENTS AND COMMUNITY LEADERS AS WELL AS CIVIC, SOCIAL AND MEDICAL ORGANIZATIONS FROM THE COMMUNITIES THAT WE SERVE. BIDN IS DEDICATED TO THE PLANNING, DEVELOPMENT, IMPLEMENTATION AND MONITORING OF PROGRAMS THAT ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITY AND OFFER CLINICAL, EDUCATIONAL AND FINANCIAL RESOURCES. THESE PROGRAMS ARE DESIGNED TO IMPROVE AWARENESS OF COMMUNITY HEALTH CARE ISSUES AND INCREASE PARTICIPATION IN WELLNESS AND PREVENTATIVE HEALTH ACTIVITIES. FOR ADDITIONAL DETAIL, SEE FORM 990 SCHEDULE H. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (NEEDHAM), 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 -- 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 PHARMACY, THE JOSLIN DIABETES CENTER AND THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN). 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). 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 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. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. PART III, LINE 4: OUTPATIENT CLINICS AND SERVICES BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BIDN OR HOSPITAL), IS A 58-BED ACUTE CARE COMMUNITY HOSPITAL THAT HAS SERVED THE RESIDENTS OF NEEDHAM AND SURROUNDING COMMUNITIES CONTINUOUSLY FOR MORE THAN 100 YEARS. THE 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 AND WORKS IN CLOSE COLLABORATION WITH ITS BILH AFFILIATES. BIDN'S MEDICAL STAFF BLENDS EXPERIENCED PRIMARY CARE PHYSICIANS AND SPECIALISTS IN A WIDE VARIETY OF DISCIPLINES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER, IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND A SISTER HOSPITAL OF BIDN. 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. MANY BIDMC PHYSICIANS ALSO HOLD APPOINTMENTS AT HARVARD OR OTHER MAJOR MEDICAL SCHOOLS AND ARE TIED CLOSELY WITH THEIR COLLEAGUES AT OTHER ACADEMIC MEDICAL CENTERS. THE PRIMARY CARE AND SPECIALISTS AT BIDN PROVIDE OUTPATIENT PRIMARY CARE AS WELL AS ENDOSCOPIC, DERMATOLOGIC AND PODIATRIC PROCEDURES, CHEMOTHERAPEUTIC AND CANCER MANAGEMENT, CARDIAC REHABILITATION AND DIABETES MANAGEMENT SERVICES, WOUND CARE AND HYPERBARIC PROGRAM AND SLEEP CLINIC. BIDN ALSO OFFERS OCCUPATIONAL HEALTH SERVICES AND NUTRITIONAL COUNSELING. DIAGNOSTIC FACILITIES INCLUDE COMPLETE 24-HOUR HISTOPATHOLOGY LABORATORY AND BLOOD BANKING SERVICES AS WELL AS DIAGNOSTIC IMAGING INCLUDING CT SCANNING, ULTRASOUND, MRI, 3D MAMMOGRAPHY, ULTRASONIC CARDIOGRAPH, BONE DENSITOMETRY, NUCLEAR MEDICINE, PLAIN FILM RADIOLOGY AND FLUOROSCOPY. IN ADDITION, THE BIDN PICTURE ARCHIVAL AND COMMUNICATION SYSTEM (PACS) CAN INSTANTANEOUSLY TRANSMIT RADIOLOGIC IMAGES BETWEEN BIDN AND BIDMC, MEANING THAT PATIENTS IN NEEDHAM HAVE ACCESS TO THE SAME WORLD-CLASS SPECIALISTS AS PATIENTS AT BIDMC. 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 PERIOD COVERED BY THIS FILING, BIDN HAD 230,560 PATIENT ENCOUNTERS. FORM 990, PART III, LINE 4B: INPATIENT MEDICAL / SURGICAL AND INTENSIVE CAR BIDN PROVIDES A WIDE RANGE OF INPATIENT CARE INCLUDING SURGICAL SERVICES, INTENSIVE AND CARDIAC CARE AND COMPLETE DIAGNOSTIC FACILITIES. BIDN'S INPATIENT FACILITIES INCLUDE MEDICAL/SURGICAL BEDS AND A SEVEN-BED INTENSIVE AND CARDIAC CARE UNIT. BIDN HAS A FULLY RENOVATED STATE OF-THE ART SURGICAL SUITE WITH SIX FULLY EQUIPPED OPERATING ROOMS AND A POST-OPERATIVE ANESTHESIA 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. BIDN'S HIGHLY QUALIFIED SURGEONS PERFORM ORTHOPEDIC PROCEDURES AND IMPLANTS, PLASTIC / RECONSTRUCTION, GASTROINTESTINAL, GENERAL SURGICAL (INCLUDING BREAST) GYNECOLOGICAL, OPHTHALMOLOGIC, PODIATRIC, AND UROLOGICAL PROCEDURES. LIMITED VASCULAR AND THORACIC SURGERY IS ALSO PERFORMED. PATIENTS ARE UNDER THE CARE OF OUR MEDICAL STAFF, HOSPITALISTS AND/OR GENERAL SURGEONS ALONG WITH NURSES WHO ARE TRAINED IN CARING FOR PATIENTS WITH COMPLEX MEDICAL NEEDS. THE NURSING CARE TEAM CONSISTS OF REGISTERED NURSES, SURGICAL TECHNICIANS AND QUALIFIED ANCILLARY PERSONNEL WORKING COLLABORATIVELY WITH SURGICAL AND ANESTHESIA PHYSICIANS. THE SCOPE OF NURSING PRACTICE IN THE PERIOPERATIVE AREA INCLUDES PREOPERATIVE ASSESSMENT AND PLANNING, INTRA-OPERATIVE INTERVENTION, POSTOPERATIVE ASSESSMENT AND INTERVENTION, DISCHARGE PLANNING AND DOCUMENTATION TO ENSURE HIGH QUALITY PATIENT CARE AND SAFETY. THE INPATIENT POPULATION THAT IS SERVED INCLUDES CHILDREN UNDER 15 YEARS OF AGE REQUIRING MINOR OUTPATIENT SURGERY AND ANY INDIVIDUALS WHO ARE 15 YEARS AND OLDER WHO REQUIRE MINOR OR MAJOR SURGICAL INTERVENTION. DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 BIDN HAD 3,980 INPATIENT DISCHARGES WITH 17,246 PATIENT DAYS, 1,232 OBSERVATION PATIENTS AND PERFORMED 3,883 OUTPATIENT SURGERIES AND 489 INPATIENT SURGERIES. FORM 990, PART III, LINE 4C: EMERGENCY DEPARTMENT AS PREVIOUSLY NOTED, BIDMC IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER AND TEACHING HOSPITAL OF THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) IS THE INTEGRALLY RELATED DEDICATED PHYSICIAN PRACTICE OF BIDMC AND IS ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. HMFP PHYSICIANS, HARVARD MEDICAL SCHOOL FACULTY AND ATTENDING PHYSICIANS FROM THE BIDMC DEPARTMENT OF EMERGENCY MEDICINE, PROVIDE ROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BIDN EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. DURING THE FISCAL YEAR COVERED BY THIS FILING, BIDN HAD 22,178 EMERGENCY DEPARTMENT VISITS. FORM 990, PART III, LINE 4D: OTHER PROGRAM SERVICE ACCOMPLISHMENTS BIDN PROVIDES ANCILLARY SERVICES AND COMMUNITY SERVICES IN ADDITION TO, AND AS PART OF, THE INPATIENT AND OUTPATIENT SERVICES DETAILED ABOVE. BIDN PROVIDES RADIOLOGIC PROCEDURES AS PART OF INPATIENT CARE AS WELL AS LABORATORY SERVICES FOR BOTH INPATIENTS AND OUTPATIENTS. BIDN HAD 77,678 OUTPATIENT LAB ENCOUNTERS. DIAGNOSTIC FACILITIES INCLUDE COMPLETE 24-HOUR HISTOPATHOLOGY LABORATORY AND BLOOD BANKING SERVICES AS WELL AS DIAGNOSTIC IMAGING INCLUDING CT SCANNING, ULTRASOUND, ULTRASONIC CARDIOGRAPHY, BONE DENSITOMETRY, NUCLEAR MEDICINE, PLAIN FILM RADIOLOGY AND FLUOROSCOPY. THE HOSPITAL HAD 23,175 OUTPATIENT GENERAL RADIOLOGY EXAMS, 6,780 OUTPATIENT MRI EXAMS, 15,649 OUTPATIENT CAT SCANS, 7,375 OUTPATIENT ULTRASOUND PROCEDURES, 10,243 OUTPATIENT BREAST IMAGING EXAMS, AND 571 OUTPATIENT NUCLEAR MEDICINE EXAMS. BIDN IS ACCREDITED BY THE MASSACHUSETTS MEDICAL SOCIETY TO PROVIDE MEDICAL EDUCATION FOR PHYSICIANS. IT'S CRUCIAL FOR PRIMARY CARE PRACTITIONERS TO CONTINUOUSLY UPDATE THEIR KNOWLEDGE AND SKILLS IN THE AREA OF EVIDENCE-BASED MEDICINE, SPECIFICALLY - CURRENT BEST PRACTICES, DIAGNOSTIC SKILLS, RISK FACTOR IDENTIFICATION AND CURRENT TREATMENT OPTIONS. 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 AND 12A: 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, 2022 THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (BETH ISRAEL DEACONESS MEDICAL CENTER (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, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. FORM 990, PART IV, LINE 24A AS DESCRIBED IN THIS FORM 990, 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 SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC DURING THIS SAME PERIOD, BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, IN WAS A MEMBER OF THE BILH OBLIGATED GROUP AND ITS TAX EXEMPT BOND FINANCING WAS ISSUED THROUGH BILH 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 BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, 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, 2020 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 BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC BALANCE SHEET, BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC IS INCLUDING THIS DISCLOSURE IN ITS FORM 990 BECAUSE BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC IS A MEMBER OF THE BILH OBLIGATED GROUP. FORM 990, PART V, QUESTION 7G: BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899. FORM 990, PART V, QUESTION 7H: BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, 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. 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, LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY HAVE, IN TURN, SERVED AS MEMBER OF ADDITIONAL ENTITIES 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 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 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 EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM. PRIOR TO THAT DATE, BIDMC SERVED AS SOLE MEMBER. 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 BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM HAS THE FOLLOWING RIGHTS, AS DESIGNATED IN BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM'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 BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 04-3229679 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 BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 04-3229679 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 BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 04-3229679 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 SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM. THIS FORM 990 IS PREPARED IN CONJUNCTION WITH THE BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM FINANCE STAFF. IN ADDITION, THE BILH TAX DEPARTMENT WORKS WITH OTHER DISCIPLINES AND DEPARTMENTS WITHIN BILH, BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM AND OTHER AFFILIATES TO ENSURE THAT OTHER FINANCIAL AND NON-FINANCIAL DISCLOSURES ARE COMPLETE AND ACCURATE. EXAMPLES OF SUCH DEPARTMENTS MAY INCLUDE: FINANCIAL ASSISTANCE AND REIMBURSEMENT, COMPLIANCE, GRADUATE MEDICAL EDUCATION, LEGAL, COMMUNITY BENEFITS, GOVERNANCE, DEVELOPMENT, HUMAN RESOURCES AND PAYROLL, GOVERNMENT RELATIONS, RESEARCH AND/OR RESEARCH FINANCE. THE TAX RETURNS REVIEWED BY THE BILH EXECUTIVE DIRECTOR, TAXATION, BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM'S CHIEF FINANCIAL OFFICER AND DELOITTE TAX, LLP. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM'S BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 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, ALL OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE THE ANNUAL CONFLICT OF INTEREST AND TAX QUESTIONNAIRE WHICH IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS 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 CONFLICT OF INTEREST AND TAX QUESTIONNAIRE 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 OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM IS PROVIDED TO THE BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 'S COMPLIANCE OFFICER 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 BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 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 CONFLICT OF INTEREST PROCESS OUTLINE ABOVE IS JOINTLY ISSUED BY THE BILH TAX DEPARTMENT, TO ENSURE THAT THE QUESTIONNAIRE IS DISTRIBUTED TO ALL CURRENT AND FORMER MEMBERS OF THE BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM BOARD OF TRUSTEES AS WELL AS FORMER OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE PROCESS IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 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, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, 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 EMPLOYEES AND SENIOR MANAGEMENT OF THE ENTITIES WHICH COMPRISED THE BETH ISRAEL LAHEY HEALTH NETWORK AND TO THAT END, BILH HAS A COMPENSATION COMMITTEE COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES AND EXCEPT AS OTHERWISE NOTED BELOW, COMPENSATION REPORTED IN THIS FORM 990 FOR BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, 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 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, 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 VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS WERE 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. IN ADDITION, AS REQUIRED BY THIS FORM 990 AND FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, COMPENSATION REPORTED HEREIN IS CALENDAR YEAR 2021 COMPENSATION. PRIOR TO THE MARCH 1, 2019 WHEN BILH BECAME THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC , OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BILH NETWORK, COMPENSATION FOR BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC WAS SET BY BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC'S COMPENSATION COMMITTEE AS DESCRIBED BELOW. BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC'S COMPENSATION COMMITTEE ESTABLISHED THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC'S SENIOR MANAGEMENT AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC'S CHIEF EXECUTIVE OFFICER. THE COMPENSATION COMMITTEE WAS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS WAS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND WAS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES, 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 MET 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. COMPENSATION FOR BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC'S CEO AND OTHER SENIOR EXECUTIVES IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC'S CEO. THE COMPENSATION PACKAGE FOR BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC'S CEO WAS VOTED BY THE COMPENSATION COMMITTEE AND SUBMITTED TO THE COMPENSATION COMMITTEE OF BETH ISRAEL DEACONESS MEDICAL CENTER, THE THEN SOLE MEMBER OF ENTITY FOR REVIEW AND APPROVAL. THE COMPENSATION PACKAGE OF BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC'S CEO THEN WENT TO BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, INC'S FULL BOARD OF DIRECTORS FOR APPROVAL. ALL DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. FORM 990, PART VI, SECTION C, LINE 19 BETH ISRAEL DEACONESS HOSPITAL NEEDHAM'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 FEES: PROGRAM SERVICE EXPENSES 8,847,457. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,847,457. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 6,439,932. MANAGEMENT AND GENERAL EXPENSES 1,148,648. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,588,580. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTION 0. CHANGE IN EQUITY INTEREST IN LIMITED PARTNERSHIP -615,220. NET ASSETS RELEASED FROM RESTRICTION FOR PPE ROUNDING GIFTS-IN KIND USED IN OPERATIONS TRANSFER FROM AFFILIATES 2,771,303. PART XII, LINE 2C: AS NOTED THROUGHOUT THIS FORM 990, BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, 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 BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. AND BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, 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 NETWORK AS A WHOLE. ADDISON GILBERT SOCIETY INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 464371382 PROFESSIONAL SERVICES & FINANCIAL SUPPORT MA 501(C)(3) 10 LAHEY HEALTH SHARED SERVICES INC 1 ANNA JAQUES HOSPITAL 25 HIGHLAND AVE NEWBURYPORT MA 01950 042104338 HEALTHCARE MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BAIM INSTITUTE FOR CLINICAL RESEARCH INC DBA BAIM INSTITUTE 930 COMMONWEALTH AVE BOSTON MA 02215 043521077 SCIENTIFIC & MEDICAL RESEARCH MA 501(C)(3) 7 N/A 0 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL COMMUNITY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042776678 INACTIVE CORPORATION MA 501(C)(3) 7 N/A 0 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 3 BETH ISRAEL LAHEY HEALTH INC 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) 3 BETH ISRAEL LAHEY HEALTH INC 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) 3 BETH ISRAEL LAHEY HEALTH INC 1 BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP 300 LONGWOOD AVE BOSTON MA 02215 043200113 OUTPATIENT AMBULATORY CENTER MA 501(C)(3) 12A, I N/A 0 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 3 BETH ISRAEL LAHEY HEALTH INC 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL LAHEY HEALTH INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 832671600 MANAGEMENT PROFESSIONAL & IT SUPPORT SERVICES MA 501(C)(3) 12C, III-FI N/A 0 BETH ISRAEL LAHEY HEALTH PRIMARY CARE 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 472248298 HEALTHCARE MA 501(C)(3) 10 LAHEY HEALTH SHARED SERVICES INC 1 BID-MILTON PHYSICIAN ASSOCIATES INC 199 REEDSDALE ROAD MILTON MA 02186 222566792 PROMOTE HEALTHCARE MA 501(C)(3) 7 BETH ISRAEL DEACONESS HOSPITAL - MILTON 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I 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