2019-08-14T14:15:08-05:00 2018-09-30 KPMG LLP 60 South Street Boston MA 02111 990 2017-10-01 043314093 Boston Medical Center % KAITLYN CLIFFORD BOST 6174141628 ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 JULIE JONCAS VP FOR FINANCE 6174141628 2019-08-14 true Shy Joseph P01085371 6179881000 2019-08-12 167.68.102.5 04502320192265000065 2019-08-14 P 1D210D884DC4702CA0C83F60B1FF5F96292C00F6 072F242B0F8FA55BC44C4BBFD6D81B3F0B7E1C92 2017 2020-04-17 16:48:07Z X KATHLEEN E WALSH ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 1522219102 false X WWW.BMC.ORG X 1996 MA Boston Medical Center's mission is to provide consistently excellent and accessible health services to all in need of care regardless of status and ability to pay. 30 25 8737 726 1915852 1280268 41186207 24563859 1286759275 1451452658 50277000 39167021 5581008 5979248 1383803490 1521162786 19345949 24328888 0 0 613712287 632054238 77000 96475 5070570 670162297 786511648 1303297533 1442991249 80505957 78171537 2249873000 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CLIFFORD 6174145907 ONE BOSTON MEDICAL CENTER PLACE BOSTON MA 02118 X David Ament Trustee 1.0 2.0 X 0 0 0 Karen Antman MD Trustee 1.0 2.0 X 0 0 0 Anita Bekenstein Trustee 1.0 0.0 X 0 0 0 James Blue Trustee (until 5/8/2018) 1.0 2.0 X 0 0 0 Barry Bock Trustee 1.0 0.0 X 0 0 0 David Coleman MD Trustee 1.0 55.0 X 0 730843 37789 Sandra Cotterell Trustee 1.0 2.0 X 0 0 0 Pierre Cremieux Trustee 1.0 1.0 X 0 0 0 Randi Cutler Trustte 1.0 0.0 X 0 0 0 Paul Egerman Trustee 1.0 0.0 X 0 0 0 Ruth Ellen Fitch Trustee 1.0 0.0 X 0 0 0 Melanie Foley Trustee 1.0 0.0 X 0 0 0 Eileen Grayken Trustee (as of 5/8/2018) 1.0 0.0 X 0 0 0 John T Hailer Trustee 1.0 0.0 X 0 0 0 William J Halpin Jr Trustee 1.0 1.0 X 0 0 0 Karen Kames Trustee 1.0 0.0 X 0 0 0 Azra Kanji Trustee 1.0 0.0 X 0 0 0 Manuel Lopes Trustee 1.0 2.0 X 0 0 0 Monica Valdes Lupi Trustee 1.0 0.0 X 0 0 0 Brendan Magauran MD Trustee 1.0 54.0 X 0 378096 66191 Richard Marks Trustee 1.0 0.0 X 0 0 0 Jerod Mayo Trustee 1.0 0.0 X 0 0 0 Tricia Patrick Trustee 1.0 0.0 X 0 0 0 Claire Perlman Trustee 1.0 0.0 X 0 0 0 James S Phalen Trustee 1.0 1.0 X 0 0 0 Martha Samuelson Trustee/Chair 1.0 1.0 X 0 0 0 Richard Slifka Trustee 1.0 1.0 X 0 0 0 Jennifer Tseng MD Trustee 1.0 50.0 X 0 457811 6495 Kathleen Walsh President and CEO 50.0 7.5 X X 1737330 0 195056 Rev Liz Walker Trustee (as of 5/8/2018) 1.0 0.0 X 0 0 0 Andrew Youniss Trustee 1.0 0.0 X 0 0 0 David Beck SVP/Chief Legal Counsel/Clerk 50.0 13.5 X 472512 0 83326 Charles Orlando SVP/CFO/TREAS (as of 11/14/17) 50.0 0.0 X 142059 0 0 Mary Beth Begley Treasurer (until 11/14/2017) 50.0 0.0 X 236554 0 29734 Alastair Bell SVP Ops & Strategy/COO 50.0 0.0 X 1096200 0 90000 Ravin Davidoff MD SVP MEDICAL AFFAIRS AND CMO 50.0 1.5 X 742860 0 35358 Nancy Gaden SVP CHIEF NURSING OFFICER 50.0 0.0 X 473744 0 87997 Stanley Hochberg MD SVP Qual,Sfty,&Tech (12/31/17) 50.0 1.0 X 518600 0 36952 Lisa A Kelly-Croswell SVP/CHRO 50.0 0.0 X 527699 0 67772 Bob Biggio SVP Facility & Supt Svcs 50.0 0.0 X 542998 0 86055 Joe Camillus SVP Ambulatory & Prf Svc 50.0 0.5 X 423750 0 84957 Norman Stein SVP Chief Development Officer 50.0 0.0 X 540459 0 33626 Arthur Harvey VP/CIO 50.0 0.0 X 419823 0 44111 Thea James VP Missions & Associate CMO 50.0 0.0 X 381956 0 30364 Richard Silveria Former SVP Fin/CFO/Treas 50.0 4.5 X 611958 0 36797 8868502 1566750 1052580 1242 true true false Boston University One Silber Way BOSTON MA 02215 SHARED RESEARCH SVCS 67238043 Suffolk Construction Company 69 Allerton Street BOSTON MA 02119 Construction 38310255 Accenture LLP 161 N Clark Street CHICAGO IL 60601 EHR Implementation 16824539 Supplemental Heath Care Services I 1640 W Redstone Center Dr Ste 200 PARK CITY UT 84098 Healthcare Staffing 10862648 Morrison Health Care Inc 400 Northridge Road Ste 600 ATLANTA GA 30350 Cafeteria/Food Svcs 7226717 333 4479068 20084791 2033745 24563859 PATIENT SERVICE REVENUE 900099 1092621402 1092621402 PHARMACY REVENUE 900099 263386044 261470192 1915852 GRANT & CONTRACT REVENUE 900099 90560607 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0.42687 0.51010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 60000 false true 106232 166232 false Schedule C, Part II-B, Line 1 Boston Medical Center pays dues to Massachusetts Hospital Association, Conference of Boston Teaching Hospitals, and State House News Service, and a portion of the dues are allocated to lobbying efforts. The portion of dues that was allocated to lobbying efforts was $106,232. BMC also paid Robert White Associates, $60,000 to represent the organization. These fees were paid to the lobbyists listed to advance Boston Medical Center's mission: "to consistently provide excellent and accessible health care services to all in need of care, regardless of status or ability to pay" as set out in Chapter 147 of the Acts and Resolves of 1996 of the Commonwealth of Massachusetts. 697009021 21885406 40783482 47477741 3125787 709074381 642296242 127298970 71375617 142059930 1901878 697009021 618328530 42882728 16736661 2178355 642296242 671956753 9615073 60452156 2791140 618328530 663410609 59523521 48287389 2689988 671956753 0.53090 0.05230 0.41680 false false 2949000 2949000 897487000 310789000 586698000 30336000 13449000 16887000 973112000 695327000 277785000 884319000 DONOR RESTRICTED INVESTMENTS 191706000 F 191706000 OTHER L-T ASSETS 209173000 FUNDS HELD BY TRUSTEES 61396000 BRD-DES. INVEST FOR FUNDED DEP 376419000 NONCURRENT NOTES RECEIVABLE 3941000 INSURANCE RECOVERY RECEIVABLES 37222000 688151000 0 EST SETTLEMENT W/3RD PARTY PAY 49132000 CAPITAL LEASE OBLIGATIONS 44928000 OTHER LONG-TERM LIABILITIES 41855000 PROFESSIONAL LIABILITY CLAIMS 37222000 TAXABLE BONDS PAYABLE 181047000 RELATED PARTY LIABILITIES 31962000 386146000 X Schedule D, Part V, Line 4 General Endowment The general endowment includes funds from a number of sources with various restrictions on use and treatment. The endowment funds have been contributed for specific purposes including construction, maintenance, research, clinical care, education, development, staffing, salaries, laboratory equipment and supplies, and convalescent care. Schedule D, Part X, Line 2 The Health System Corporation, the Medical Center, BMCHP, UDF, ECMF, BUAP, Faculty and the Plans, BACO, BMCICS, and BMCIC of Vermont are all nonprofit corporations that have been recognized as tax-exempt pursuant to Section 501(C)(3) of the Internal revenue Code. The shareholders of NAB are nonprofit, tax-exempt corporations. The Health System recognized tax positions when it is more-likely-than-not that the positions will be sustainable based on the merits of the position. Management has concluded that there are no material uncertain tax positions that need to be recorded as of September 30, 2018 and 2017. The Health System annually assesses whether it must recognize an unrelated business income tax expense (UBIT). The amounts recognized as UBIT expense were not material to the Health Systems consolidated operations or changes in net assets for the years ended September 30, 2018 and 2017. true North America Grantmaking 90320 South America Grantmaking 61000 Sub-Saharan Africa 2 8 Grantmaking 568792 East Asia and the Pacific Grantmaking 23345 Russia and the Newly Independent States Grantmaking 56644 Europe (Including Iceland and Greenland) Investments 26062959 North America Investments 53158439 Central America and the Caribbean Investments 9601954 Central America and the Caribbean Program Services PREMIUMS 11045782 2 8 2 8 100669235 100669235 North America Subaward 90321 Wire South America Subaward 61000 Wire Sub-Saharan Africa Subaward 131379 Wire East Asia and the Pacific Subaward 23345 Wire Russia and the Newly Independent States Subaward 56644 Wire Sub-Saharan Africa Subaward 385327 Wire Sub-Saharan Africa Subaward 52086 Wire 8 true false true true true false Schedule F, Part I, Line 2 The principal investigator and administrator approve all subcontract invoices, including those from a foreign country. The foreign subcontract recipient has a budget to which invoices are matched to ensure that all spending is appropriate. Additionally, the organizations principal investigators regularly contact the foreign subcontract recipients to monitor the progress of the recipients work. Schedule F, Part II, Line 1 Foreign expenditures are separately identified on the organization's General Ledger. X X X X X X X true Blue Sky Entertainment 150 Washington Street Norwell MA 02061 Sweet Feet, Golf false 615932 84475 531457 33 Munroe LLC 33 Munroe Street Unit 1 Lynn MA 01901 Catwalk false 291776 12000 279776 907708 96475 811233 MA Gala 2923197 2669898 253299 151218 35081 53004 123012 Food 4 Thought 795457 780557 14900 60089 20161 5 1255555 1028613 226942 45451 102332 5000 257106 4974209 4479068 495141 196669 197502 58004 400279 852454 -357313 MA true true X true X false true true false false 93799986 37381069 56418917 0.03910 775336486 633474370 141862116 0.09830 869136472 670855439 198281033 0.13740 18710967 0 18710967 0.01290 62175435 14852345 47323090 0.03280 759 90560606 76749313 13811293 0.00960 759 171447008 91601658 79845350 0.05530 759 1040583480 762457097 278126383 0.19270 25746 25746 0.00000 2 15830000 15830000 0.01100 16 10145563 9614977 530586 0.00040 1 856596 856596 0.00060 2 640259 640259 0.00040 21 27498164 9614977 17883187 0.01240 true 20823718 205810898 193745169 12065729 X true true 1 1 Boston Medical Center One Boston medical Center Place Boston MA 02118 http://www.bmc.org V112 X X X X X Boston Medical Center 1 false false true X X X X X X X X X 15 true false false true X See Part V, Page 8 X true 15 true See Part V, Page 8 false true X 200. 0. X X true true X X X X true X See Part V, Page 8 X See Part V, Page 8 X See Part V, Page 8 X X X X X true X false X true X false false Schedule H, Part V, Line 16a FAP Website: HTTP://WWW.BMC.ORG/SERVICES/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM Schedule H, Part V, Line 16b FAP Application Website: HTTP://WWW.BMC.ORG/SERVICES/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM Schedule H, Part V, Line 16c FAP Plain Language Summary Website: HTTP://WWW.BMC.ORG/SERVICES/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM Schedule H, Part V, Section B, Line 5 Over 62 individuals, persons with expertise in public health; leaders, representatives and members of medically underserved, low-income, minority populations; and populations with chronic disease needs from the community served by the hospital were engaged in focus groups and interviews to gauge their perceptions of the community, priority health concerns, and what programming, services, or initiatives are most needed to address these concerns. In total, four focus groups and nine key informant discussions were conducted October 2015 through February 2016. Focus groups were held with 54 community residents representing the following population segments: Spanish language speaking adults in East Boston; Cape Verdean Creole language speaking adults in Dorchester; and English language speaking adults in the South End and Roxbury. BMC partnered with community health centers that recruited community residents living in the CHCs immediate community and who were medically underserved and low-income, and who represented predominantly minority populations. Nine key informant discussions were conducted with individuals representing the local, regional, and statewide level. Key informants represented a number of sectors including non-profit/community service, Boston Public Health Commission, hospital or health care, education, housing, substance abuse, and emergency preparedness. Focus group and interview discussions explored participants perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. The Director of Community Benefits contact information is found on the website where the CHNA is posted. The hospital facility did not receive any written comments about the most recently conducted CHNA and most recently adopted implementation strategy. Schedule H, Part V, Section B, Line 7A https://www.bmc.org/sites/default/files/About_Us/Commitment_to_Our_Communi ty/field_Attachments/BMC-Community-HealthNeedsAssessment-HNA.pdf Schedule H, Part V, Section B, Line 10A https://www.bmc.org/sites/default/files/About_Us/Commitment_to_Our_Communi ty/field_Attachments/Implementation-Strategy.pdf Schedule H, Part V, Section B, Line 11 Unwavering in our commitment to address the health needs of our community, BMC provides a wide range of programs beyond the traditional medical model. Core to fulfilling our public health mission and consistent with the CHNA findings, the goals of our community benefits program are to improve access to health services and improve health outcomes for underserved populations in our community. Key findings that emerged from the CHNA included health care access, chronic diseases and risk factors, mental health and substance abuse, and violence. For detailed information about each of the programs and initiatives that addressed the needs last year, please see Line 5, promotion of community health below. Schedule H, Part V, Section B, Line 13a For patients who fall outside commonwealth assistance programs, patients are charged at the same levels as insurers are charged; however, they are offered a prompt-pay discount of 40% (regardless of income level, etc.) if the payments are made within the first 30 days from service. Schedule H, Part V, Section B, Line 13h By the definition of BMC's financial assistance policy (FAP), patients who qualify for the FAP have applied for one of the Commonwealth's financial assistance programs (connectorcare, medicaid, or health safety net) or have been rendered urgent/emergent services. In those instances, patients are viewed as unable to pay for these charges and the hospital submits the charge for reimbursement from the health safety net. 2 MARGARET M SHEA RN ADULT HEALTH PROGR RIVER STREET MATTAPAN MA 02126 ADULT DAYCARE SUPPORTING PARENTS & RESILIENT KIDS CT 225 RIVER STREET MATTAPAN MA 02126 THERAPEUTIC CENTER Schedule H, PART I, LINE 3C: For patients who fall outside Commonwealth assistance programs, patients are charged at the same levels as insurers are charged; however, they are offered a prompt-pay discount of 40% (regardless of income level,etc.) if the payments are made within the first 30 days from service. Introduction The statute that created Boston Medical Center (BMC) requires it to serve all populations. BMC is a private, not-for-profit, 514-bed, urban academic medical center which emphasizes community-based, accessible care and the mission to provide consistently accessible health services to all in need of care regardless of status and ability to pay. BMC is the largest safety-net hospital in New England and provides a full spectrum of pediatric and adult care services from primary to family medicine to advanced specialty care. Driven by the social determinants of health that impact health outcomes among our patients and community, the goal of our community health improvement activities, or community benefits, is to improve community health. Approximately 57% of our patients are from underserved populations, such as the low-income and elderly, who rely on government payers such as Medicaid, the Health Safety Net and Medicare for their coverage, and 32% do not speak English as a primary language. To address the health needs of its diverse patient population, BMC provides a wide range of services beyond the traditional medical model. These programs, including but not limited to patient navigation and a food pantry, help reduce barriers to accessing health services and eliminate disparities in health care among the various populations BMC serves. With more than 26,339 admissions and 1,001,304 patient visits per year, BMC provides a comprehensive range of inpatient, clinical and diagnostic services in more than 70 areas of medical specialties and subspecialties. The largest 24-hour Level I trauma center in New England, BMCs Emergency Department has more than 130,000 patient visits annually. BMC serves the urban community of Greater Boston. The majority of the communities that BMC serves are Boston census tracts that are federally-designated medically underserved areas/populations. Although Massachusetts universal care enables individuals to seek care at any hospital, BMC remains the largest safety net provider in Boston and New England. The implementation of universal care did not reduce the real number or percent of underserved communities served by BMC. An estimated 20.5% of Boston residents live below the federal poverty level. According to the 2018 Massachusetts Health Insurance Survey, an estimate of 4% of residents were uninsured. 96% of Massachusetts residents had coverage during the survey of which 62.7% reported employer-sponsored insurance (ESI) and 37.3% reported other non-ESI. Of BMCs patients in 2018, approximately 11.93% were uninsured and coverage rates for primary insurance were approximately: 11.35% Medicare; 47.2% Medicaid; and 29.53% private or ESI. Schedule H, PART I, LINE 5C The organization's charity care did not exceed budgeted amounts. The budgeted amounts are predicted charity care amounts. The organization did not have any excess funds. Schedule H, PART I, LINE 7 FOR THE CALCULATION OF COSTS OF CHARITY CARE (LINE 7A) & MEDICAID COST (LINE 7B), AN OVERALL COST TO CHARGE RATIO WAS USED. A COST TO CHARGE RATIO IS DETERMINED BY DIVIDING THE TOTAL CHARGES FOR ALL SERVICES INTO THE TOTAL COST OF PROVIDING THE SERVICES. THE RATIO IS MULTIPLIED BY THE CHARGES FOR CHARITY CARE & MEDICAID TO OBTAIN THEIR RESPECTIVE COSTS. FOR THE CALCULATION OF COMMUNITY HEALTH IMPROVEMENT SERVICES (LINE 7E) DISCRETE COSTING WAS USED. FOR THE CALCULATION OF HEALTH PROFESSIONS EDUCATION COST (LINE 7F) THE CENTERS FOR MEDICARE & MEDICAID (CMS) COST ALLOCATION METHODOLOGY PER CMS FORM 2552 WAS USED. CMS FORM 2552 IS A REQUIRED ANNUAL FILING TO THE FEDERAL GOVERNMENT. Schedule H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE WAS $0. DURING FISCAL YEAR 2018, THE MEDICAL CENTER RECEIVED NET FAVORABLE SETTLEMENTS FROM MEDICARE, MEDICAID, BMC HEALTH PLAN BLUE CROSS, AND OTHER PAYORS RELATED TO PRIOR YEARS WHICH RESULTED IN THE RECOGNITION OF AN APPROXIMATE $9,000,000 GAIN. Schedule H, PART II, COMMUNITY BUILDING ACTIVITIES: BMC CONTRIBUTES TO THE COMMUNITY THROUGH ITS PAYMENT OF LINKAGE FEES TO THE CITY OF BOSTON. THOSE LINKAGE FEE FUNDS SUPPORT PROGRAMS FOR AFFORDABLE HOUSING AND NEIGHBORHOOD HEALTH CARE. BMC ALSO PROVIDES SUBSIDIES TO BOSTON HEALTHNET, WHICH SUPPORTS COMMUNITY-BASED SERVICES. PHYSICIAL IMPROVEMENTS AND HOUSING: ACCORDING TO THE DEVELOPMENT IMPACT PROJECT AGREEMENT FOR BMC NEW AMBULATORY CARE BUILDING-SHAPIRO PROJECT BETWEEN BOSTON MEDICAL CENTER AND THE BOSTON REDEVELOPMENT AUTHORITY DATED MAY 5, 2014, BMC PAID LINKAGE FEES OF $366,223.70 IN OCTOBER 2016. THIS PAYMENT WAS THE FINAL INSTALLMENT OF BMC'S OBLIGATION TO THE NEIGHBORHOOD JOBS TRUST. PHYSICAL IMPROVEMENTS AND HOUSING: ACCORDING TO THE DEVELOPMENT IMPACT PROJECT AGREEMENT FOR THE MOAKLEY CENTER ADDITION AND INPATIENT BUILDING PHASE I TRANSPORT BRIDGE PROJECT BETWEEN BOSTON MEDICAL CENTER AND THE BOSTON REDEVELOPMENT AUTHORITY, DATED MAY 5, 2014, BMC AGREES TO PAY LINKAGE FEES OF $22,746.14, ENDING IN 2022 TO THE NEIGHBORHOOD JOBS TRUST. MATTAPAN COMMUNITY HEALTH CENTER, A COMMUNITY HEALTH CENTER AFFILIATED WITH BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $8,200,000 FROM BOSTON MEDICAL CENTER DURING 2009 AND 2010 IN THE FORM OF A LOAN THAT WAS ORIGINATED ON SEPTEMBER 30, 2010. EFFECTIVE JUNE 30, 2009, $1,000,000 OF THE 2009 PORTION OF THE MATTAPAN LOAN WAS FORGIVEN. COMMENCING NOVEMBER 1, 2011, BOSTON MEDICAL CENTER SHALL FORGIVE TEN PERCENT OF THE REMAINING PRINCIPAL AMOUNT ($7,200,000) OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING SHALL BE FORGIVEN IN TEN YEARS. AS OF MARCH 1, 2018, BACO ENTERED INTO A CONTRACT WITH THE STATE, CHANGING THE NATURE OF THE RELATIONSHIP WITH THE HEALTH CENTERS. AS A RESULT BOSTON MEDICAL CENTER FULLY RESERVED AGAINST THE NOTE RECEIVABLE AS NO PAYMENTS WERE ANTICIPAITED. BOSTON MEDICAL CENTER INCURRED EXPENSE OF $2,220,000 RELATED TO THIS TRANSACTION. EAST BOSTON NEIGHBORHOOD HEALTH CENTER, A COMMUNITY HEALTH CENTER AFFILIATED WITH BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $1,000,000 FROM BOSTON MEDICAL CENTER DURING 2013 IN THE FORM OF A LOAN THAT WAS ORIGINATED EFFECTIVE JANUARY 15, 2013. COMMENCING SEPTEMBER 30, 2013, BOSTON MEDICAL CENTER SHALL FORGIVE TEN PERCENT OF THE ORIGINAL PRINCIPAL AMOUNT OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING SHALL BE FORGIVEN IN TEN YEARS. AS OF MARCH 1, 2018, BACO ENTERED INTO A CONTRACT WITH THE STATE, CHANGING THE NATURE OF THE RELATIONSHIP WITH THE HEALTH CENTERS. AS A RESULT BOSTON MEDICAL CENTER FULLY RESERVED AGAINST THE NOTE RECEIVABLE AS NO PAYMENTS WERE ANTICIPAITED. BOSTON MEDICAL CENTER INCURRED EXPENSE OF $500,000 RELATED TO THIS TRANSACTION. SOUTH BOSTON COMMUNITY HEALTH CENTER, A COMMUNITY HEALTH CENTER AFFILIATED WITH BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $600,000 FROM BOSTON MEDICAL CENTER DURING 2016 IN THE FORM OF A LOAN THAT WAS ORIGINATED EFFECTIVE JANUARY 26, 2016. COMMENCING JANUARY 26, 2017, BOSTON MEDICAL CENTER SHALL FORGIVE TEN PERCENT OF THE ORIGINAL PRINCIPAL AMOUNT OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING SHALL BE FORGIVEN IN TEN YEARS. AS OF MARCH 1, 2018, BACO ENTERED INTO A CONTRACT WITH THE STATE, CHANGING THE NATURE OF THE RELATIONSHIP WITH THE HEALTH CENTERS. AS A RESULT BOSTON MEDICAL CENTER FULLY RESERVED AGAINST THE NOTE RECEIVABLE AS NO PAYMENTS WERE ANTICIPAITED. BOSTON MEDICAL CENTER INCURRED EXPENSE OF $540,000 RELATED TO THIS TRANSACTION. IN ADDITION, SOUTH BOSTON RECEVIED A CONTRIBUTION OF $860,000 FROM BOSTON MEDICAL CENTER TO FUND ITS EXPANSION. BOSTON MEDICAL CENTER INCURRED EXPENSE OF $860,000 RELATED TO THIS TRANSACTION. SOUTH END COMMUNITY HEALTH CENTER, A COMMUNITY HEALTH CENTER AFFILIATED WITH BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $200,000 FROM BOSTON MEDICAL CENTER DURING 2017 IN THE FORM OF A LOAN THAT WAS ORIGINATED EFFECTIVE JUNE 16, 2017. COMMENCING JUNE 16, 2017, BOSTON MEDICAL CENTER SHALL FORGIVE ONE-THIRD OF THE ORIGINAL PRINCIPAL AMOUNT AND ACCRUED INTEREST OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING SHALL BE FORGIVEN IN THREE YEARS. AS OF MARCH 1, 2018, BACO ENTERED INTO A CONTRACT WITH THE STATE, CHANGING THE NATURE OF THE RELATIONSHIP WITH THE HEALTH CENTERS. AS A RESULT BOSTON MEDICAL CENTER FULLY RESERVED AGAINST THE NOTE RECEIVABLE AS NO PAYMENTS WERE ANTICIPAITED. BOSTON MEDICAL CENTER INCURRED EXPENSE OF $200,000 RELATED TO THIS TRANSACTION. CAPITAL INVESTMENTS IN BOSTON HEALTHNET: WHILE THE NEED FOR COMMUNITY-BASED SERVICES CONTINUES TO GROW, IT HAS BECOME INCREASINGLY DIFFICULT FOR HEALTH CENTERS TO MEET THE DEMAND. REIMBURSEMENT OFTEN DOES NOT COVER THE FULL COST OF CARING FOR THE COMPLEX NEEDS OF HEALTH CENTERS' DIVERSE PATIENT POPULATION. COMPOUNDING THIS PROBLEM, IN THE MID-LATE 1990S, MANY HEALTH CENTERS FOUND THEMSELVES OPERATING IN FACILITIES THAT WERE IN DESPERATE NEED OF RESTORATION OR EXPANSION. COSTLY INFORMATION TECHNOLOGY UPGRADES WERE ALSO REQUIRED TO ENHANCE MANAGEMENT EFFICIENCIES AND PATIENT CARE. IN RESPONSE TO THE HEALTH CENTERS' NEEDS, BMC PROVIDED APPROXIMATELY $16 MILLION IN OPERATING SUPPORT TO THE BOSTON HEALTHNET HEALTH CENTERS EACH YEAR. OTHER NET SUBSIDIES INCLUDE MOSTLY ECONOMIC DEVELOPMENT, COMMUNITY HEALTH IMPROVEMENT AND WORKFORCE DEVELOPMENT. Schedule H, PART III, LINE 2: SCHEDULE H, PART III, LINE 3 REPORTS BAD DEBT EXPENSE AT COST. PATIENT PAYMENTS ON ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AND RECORDED AS A BAD DEBT RECOVERY, REDUCING THE GROSS BAD DEBT WRITE-OFF. Schedule H, PART III, LINE 3: THE ORGANIZATION ESTIMATED $0 OF THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST) AS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY DUE TO THE MANNER IN WHICH THE DETAIL OF THE BAD DEBT EXPENSE IS PROCESSED IN ITS SYSTEM. Schedule H, PART III, LINE 4: THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED IN FOOTNOTE 15 FOUND ON PAGE 39 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS Schedule H, PART III, LINE 8: MEDICARE ALLOWABLE COSTS OF $193,745,169 WERE CALCULATED USING THE CMS FORM 2552 METHODOLOGY OF DETERMINING MEDICARE COSTS. THIS UTILIZES THE STEP DOWN METHOD OF DETERMINING FULLY-ALLOCATED COSTS BY DISTINCT CLINICAL COST CENTERS AS DEFINED BY CMS. THESE FULLY-ALLOCATED COSTS ARE APPLIED AGAINST TOTAL CHARGES TO CALCULATE A RATIO OF COST TO CHARGES (RCC). THE RCC IS APPLIED TO MEDICARE CHARGES BY DISTINCT CLINICAL COST CENTERS TO DETERMINE THE MEDICARE COSTS. Schedule H, PART III, LINE 9B: POPULATIONS EXEMPT FROM COLLECTION ACTIVITIES THE HOSPITAL WILL NOT REQUIRE PRE-ADMISSION OR PRE-TREATMENT DEPOSITS FROM INDIVIDUALS REQUIRING EMERGENCY SERVICES OR DETERMINED TO BE LOW-INCOME. THE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS: A. PATIENTS WITH MASSHEALTH, Emergency Aid to the Elderly, Disabled and Children FOR THE DISABLED AND CHILDREN AND FULL Health Safety Net OR PATIENTS WITH County Medical Services Program OR PARTIAL hepatosplenomegaly BELOW THE PROGRAM DEFINED Federal Poverty Level OR Modified Adjusted Gross Income GUIDELINE OR OTHERS DETERMINED TO BE LOW-INCOME PATIENTS ARE EXEMPT FROM COLLECTION SUBJECT TO THE FOLLOWING: 1. THE HOSPITAL MAY SEEK COLLECTION ACTION AGAINST ANY LOW-INCOME PATIENT DESCRIBED ABOVE FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM. 2. THE HOSPITAL MAY SEEK COLLECTION TO ALLOW A PATIENT TO MEET THE COMMONWEALTH ONE-TIME DEDUCTIBLE. 3. THE HOSPITAL MAY ALSO INITIATE BILLING OR COLLECTION FOR A LOW-INCOME PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT WHO FAILS TO PROVIDE PROOF OF HIS OR HER PARTICIPATION AND WHOSE INSURANCE CANNOT BE VERIFIED IN THE HOSPITAL ELIGIBILITY SYSTEM. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, INCLUDING RECEIPT OR VERIFICATION FROM THE INSURANCE CARRIER, THE HOSPITAL SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES. 4. THE HOSPITAL MAY CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED OR EXPIRED. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL CEASE COLLECTION ACTIVITY FOR SERVICES PROVIDED PRIOR TO THE BEGINNING OF THE PATIENT'S ELIGIBILITY. 5. THE HOSPITAL MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE. Schedule H, PART V, SECTION A THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH HAS LICENSED BOSTON MEDICAL CENTER TO OPERATE A HOSPITAL AT ONE BOSTON MEDICAL CENTER PLACE, BOSTON, MA 02118. THIS LOCATION IS (1) A LICENSED HOSPITAL, (2) PROVIDES GENERAL MEDICAL & SURGICAL TREATMENT, (3) IS A TEACHING HOSPITAL, AND (4) OPERATES AN ER 24 HOURS. WHILE THE HOSPITAL LICENSE LISTS THREE CAMPUSES, ONLY TWO CAMPUSES OPERATE: 1. BOSTON MEDICAL CENTER CORPORATION, MENINO PAVILION, 830-840 HARRISON AVENUE, BOSTON MA 02118, AND 2. BOSTON MEDICAL CENTER CORPORATION, NEWTON PAVILION, 88 EAST NEWTON STREET, BOSTON, MA 02118 BOSTON MEDICAL CENTER ALSO OPERATES THE FOLLOWING OUTPATIENT CENTERS, WHICH ARE UNDER THE HOSPITAL'S LICENSE: CODMAN SQUARE HEALTH CENTER BRIGHTON HIGH SCHOOL STUDENT HEALTH CENTER BOSTON MEDICAL CENTER RADIOLOGY AT RYAN CENTER BOSTON UNIVERSITY EAST BOSTON NEIGHBORHOOD HEALTH CENTER (10 GOVE STREET) DOTHOUSE HEALTH MADISON PARK HIGH SCHOOL STUDENT HEALTH CENTER JEREMIAH E. BURKE STUDENT HEALTH CENTER GREATER ROSLINDALE MEDICAL & DENTAL LATIN ACADEMY STUDENT HEALTH CENTER TECHBOSTON ACADEMY SCHOOL HEALTH CENTER BOSTON MEDICAL CENTER RADIOLOGY AT WHITTIER STREET HEALTH CENTER BOSTON MEDICAL CENTER RADIOLOGY AT UPHAM'S CORNER HEALTH CENTER MURIEL SNOWDEN INTERNATIONAL HIGH SCHOOL HEALTH CENTER SOUTH BOSTON COMMUNITY HEALTH CENTER 386 WEST BROADWAY SOUTH BOSTON COMMUNITY HEALTH CENTER 409 WEST BROADWAY BOSTON MEDICAL CENTER BASED CENTER AT BOSTON COMMUNITY LEADERSHIP ACADEMY EAST BOSTON NEIGHBORHOOD HEALTH CENTER - 20 MAVERICK SQUARE BOSTON MEDICAL CENTER RADIOLOGY AT MATTAPAN COMMUNITY HEALTH CENTER EAST BOSTON NEIGHBORHOOD HEALTH CENTER (79 PARIS STREET) EBHS SCHOOL BASED HEALTH CENTER WINTHROP COMMUNITY HEALTH CENTER SOUTH BOSTON COMMUNITY HEALTH CENTER SEAPORT PRIMARY CARE Schedule H, PART VI, LINE 2 NEEDS ASSESSMENT In 2016, Boston Medical Center (BMC) conducted a comprehensive community health needs assessment (CHNA), which included reviewing existing social, economic, and health data among residents of Boston and those who are traditionally underserved; conducting focus groups with community members; and conducting key informant interviews with health care providers and community stakeholders. BMCs CHNA identified the health-related needs of and assets in the community served by BMC through a social determinants of health framework, which defines health broadly and recognizes numerous factors at multiple levels-from lifestyle behaviors (e.g., healthy eating and active living) to clinical care (e.g., access to medical services) to social and economic factors (e.g., poverty) to the physical environment (e.g., air quality)-which have an impact on the communitys health. Over 62 individuals, persons with expertise in public health; leaders, representatives, and members of medically underserved, low-income, minority populations; and populations with chronic disease needs from the community served by the hospital were engaged in focus groups and interviews to gauge their perceptions of the community, priority health concerns, and what programming, services, or initiatives are most needed to address these concerns. In total, four focus groups and nine key informant discussions were conducted October 2015 through February 2016. Focus groups were held with 54 community residents representing the following population segments: Spanish language speaking adults in East Boston; Cape Verdean Creole language speaking adults in Dorchester; and English language speaking adults in the South End and Roxbury. Nine key informant discussions were conducted with individuals representing the local, regional, and statewide level. Key informants represented a number of sectors including non-profit/community service, city government, hospital or health care, education, housing, substance abuse, and emergency preparedness. Focus group and interview discussions explored participants perceptions of their communities, priority health concerns, perceptions of public health, prevention, and health care services, and suggestions for future programming and services to address these issues. Existing social, economic, and health data were drawn from national, state, county, and local sources, such as the National Cancer Institute, the U.S. Census, U.S. Bureau of Labor Statistics, Massachusetts Department of Public Health, Boston Public Health Commission, and the Boston Police Department. Key findings that emerged from the CHNA included health care access, chronic diseases and risk factors, mental health and substance abuse, and violence. Unwavering in our commitment to address the health needs of our community, BMC provides a wide range of programs beyond the traditional medical model. Core to fulfilling our public health mission and consistent with the CHNA findings, the goals of our community benefits program are to improve access to health services and improve health outcomes for underserved populations in our community. Schedule H, PART VI, LINE 3: THE HOSPITAL POSTS A NOTICE (SIGNS) OF AVAILABILITY OF FINANCIAL ASSISTANCE IN THE FOLLOWING LOCATIONS: I.INPATIENT, CLINIC, AND EMERGENCY DEPARTMENT AND/OR WAITING AREAS; II. PATIENT FINANCIAL COUNSELOR AREAS; III. CENTRAL ADMISSION/REGISTRATION AREAS; AND/OR IV. BUSINESS OFFICE AREAS THAT ARE OPEN TO PATIENTS. POSTED SIGNS ARE CLEARLY VISIBLE AND LEGIBLE TO PATIENTS VISITING THESE AREAS. THE HOSPITAL ALSO INCLUDES A NOTICE ABOUT THE AVAILABILITY OF FINANCIAL ASSITANCE IN ALL INITIAL BILLS. WHEN THE PATIENT CONTACTS THE HOSPITAL, THE PATIENT FINANCIAL SERVICES STAFF NOTIFIES THE PATIENT IF THEY QUALIFY FOR A PAYMENT PLAN. A PATIENT WHO IS ENROLLED IN A PUBLIC FINANCIAL ASSISTANCE PROGRAM (E.G., MASSHEALTH, HEALTH SAFETY NET, OR FOR MEDICAL HARDSHIP) MAY QUALIFY FOR CERTAIN PLANS. PATIENTS MAY ALSO QUALIFY FOR ADDITIONAL ASSISTANCE BASED ON THE HOSPITAL'S OWN INTERNAL CRITERIA FOR FINANCIAL ASSISTANCE. FOR CASES WHERE THE HOSPITAL IS USING THE VIRTUAL GATEWAY APPLICATION, THE HOSPITAL ASSISTS THE PATIENT IN COMPLETING THE APPLICATION FOR MASSHEALTH CONNECTORCARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTH START, HEALTHSAFETY NET,OR OTHER FORMS OF FINANCIAL ASSISTANCE PROGRAMS AS THEY BECOME PART OF THE VIRTUAL GATEWAY PROGRAM. ALL SIGNS AND NOTICES ARE TRANSLATED INTO LANGUAGES OTHER THAN ENGLISH IF SUCH LANGUAGE IS SPOKEN BY 10% OR MORE OF THE POPULATION RESIDING IN THE HOSPITAL SERVICE AREA. CURRENTLY, THE HOSPITAL TRANSLATES THE NOTICES INTO ENGLISH, PORTUGUESE, SPANISH, AND HAITIAN CREOLE. Schedule H, PART VI, LINE 4: COMMUNITY INFORMATION PLEASE SEE INTRODUCTION Schedule H, PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH HEALTH CARE ACCESS BIRTH SISTERS AND CENTERING PREGNANCY: BMC HAS DEVELOPED TWO PROGRAMS, BIRTH SISTERS AND CENTERING PREGNANCY, TO IMPROVE HEALTH OUTCOMES OF CHILDBEARING WOMEN AT RISK FOR POOR MATERNAL AND INFANT OUTCOMES. BIRTH SISTERS ARE WOMEN WHO ARE TRAINED TO PROVIDE SOCIAL SUPPORT AND EDUCATION TO MOTHERS FROM THEIR OWN COMMUNITIES DURING PREGNANCY, LABOR, AND THE POSTPARTUM PERIOD. THE BIRTH SISTERS PROGRAM HAS BEEN LINKED TO SIGNIFICANTLY HIGHER BREASTFEEDING RATES AND FEWER CESAREAN DELIVERIES. CENTERING PREGNANCY IS AN INNOVATIVE AND PROVEN MODEL OF CARE THAT OFFERS PRENATAL CARE IN 10 TWO-HOUR GROUP SESSIONS USING A CURRICULUM MODIFIED TO MEET THE COMPLEX SOCIAL NEEDS OF BMC'S POPULATION. AT THESE SESSIONS, BEGINNING EARLY IN THE SECOND TRIMESTER, PATIENTS RECEIVE HEALTH VISITS, PRENATAL AND PARENTING EDUCATION, AND PEER GROUP SUPPORT ALL IN ONE VISIT. THE PROGRAMS SERVED OVER 300 PATIENTS IN FY18. BOSTON CENTER FOR REFUGEE HEALTH AND HUMAN RIGHTS: THE MISSION OF THE BOSTON CENTER FOR REFUGEE HEALTH AND HUMAN RIGHTS IS TO PROVIDE COMPREHENSIVE HEALTH CARE FOR REFUGEES AND SURVIVORS OF TORTURE AND RELATED TRAUMA, COORDINATED WITH LEGAL AID AND SOCIAL SERVICES; TO EDUCATE AND TRAIN AGENCIES AND PROFESSIONALS WHO SERVE THESE COMMUNITIES; TO ADVOCATE FOR THE PROMOTION OF HEALTH AND HUMAN RIGHTS IN THE UNITED STATES AND WORLDWIDE; AND TO CONDUCT CLINICAL, EPIDEMIOLOGICAL, AND LEGAL RESEARCH FOR THE BETTER UNDERSTANDING AND PROMOTION OF HEALTH AND QUALITY OF LIFE FOR SURVIVORS OF TORTURE AND RELATED TRAUMA. THE CENTER SERVES AN AVERAGE OF 375 PATIENTS ANNUALLY. CATALYST CLINIC: IN MAY 2016, BOSTON MEDICAL CENTER LAUNCHED THE CATALYST CLINIC (CENTER FOR ADDICTION TREATMENT FOR ADOLESCENT/YOUNG ADULTS WHO USE SUBSTANCES), A PROGRAM DESIGNED TO TREAT YOUNG PEOPLE AGED 25 AND UNDER WHO ARE STRUGGLING WITH SUBSTANCE USE, OR WHO HAVE EXPERIMENTED WITH DRUGS AND ALCOHOL AND MAY BE AT RISK FOR DEVELOPING AN ADDICTION. THE CATALYST CLINIC TEAM WORKS TO PROVIDE INTERDISCIPLINARY, TEAM-BASED CARE THAT INCLUDES PHYSICIANS, A NURSE, A SOCIAL WORKER, A COMMUNITY OUTREACH NAVIGATOR AND A PROGRAM MANAGER. THE CATALYST CLINIC TEAM WORKS TOGETHER TO OFFER ASSESSMENT, DIAGNOSIS, AND TREATMENT OF VARIOUS SUBSTANCE USE DISORDERS, AS WELL AS A TRANSITION FROM ADOLESCENT TO ADULT CARE WHEN APPROPRIATE. IN FISCAL YEAR 2018, THE CATALYST CLINIC RECEIVED APPROXIMATELY 191 REFERRALS TO THE CLINIC; 446 HAVE BEEN RECEIVED SINCE THE PROGRAM'S INCEPTION. CHILD LIFE PROGRAM: THE CHILD LIFE PROGRAM ASSISTS CHILDREN AND FAMILIES IN MANAGING THE STRESSES ASSOCIATED WITH HOSPITALIZATION AND ILLNESS. PROGRAM TEAM MEMBERS ARE ALL TRAINED DEVELOPMENTAL SPECIALISTS, AIMING TO SUPPORT CHILDREN AND FAMILIES THROUGH THE HOSPITAL EXPERIENCE. THE GOALS OF THE PROGRAM ARE TO: HELP CHILDREN EXPRESS THEIR FEELINGS THROUGH PLAY IN A SAFE AND SUPPORTIVE ENVIRONMENT; ADVOCATE FOR CHILDREN, OFFERING SUPPORT TO EFFECTIVELY WORK THROUGH PAIN MANAGEMENT; OFFER CHILDREN DEVELOPMENTALLY APPROPRIATE CHOICES THAT INCREASE FEELINGS OF INDEPENDENCE, SELF-ESTEEM, AND TRUST; AND ASSIST WITH IMPLEMENTATION OF COPING TECHNIQUES DURING STRESSFUL SITUATIONS. THE CHILD LIFE PROGRAM CURRENTLY COVERS THE AREAS OF INPATIENT PEDIATRICS AND THE PEDIATRIC INTENSIVE CARE UNIT, PEDIATRIC AMBULATORY CARE CLINIC, PEDIATRIC EMERGENCY DEPARTMENT, AND PEDIATRIC OTOLARYNGOLOGY/OR; WE WILL BE ADDING A POSITION IN 2019 FOR RADIOLOGY. THE TEAM REMAINS A CONSULT SERVICE TO CHILDREN OF ADULT FAMILIES AS NEEDED. CLOTHING BANK: BMC'S SOCIAL WORKERS ACCESS THE CLOTHING BANK IN REAL TIME WHEN A PROVIDER CONTACTS SOCIAL WORK ABOUT A BASIC CLOTHING NEED (SWEAT PANTS, SHIRTS, UNDERWEAR, SOCKS, SHOES, AND WINTER COATS) FOR A LOW-INCOME PATIENT. CENTER FOR THE URBAN CHILD AND HEALTHY FAMILY: THE CENTER FOR THE URBAN CHILD AND HEALTHY FAMILY WAS ESTABLISHED BY THE DEPARTMENT OF PEDIATRICS IN 2016 TO DEVELOP INNOVATIVE WAYS TO MEET THE COMPLEX HEALTH AND SOCIAL NEEDS OF CHILDREN AND THEIR FAMILIES. THE CENTER'S MISSION IS TO ACHIEVE DRAMATIC IMPROVEMENTS IN OUTCOMES FOR CHILDREN AND FAMILIES FACING ADVERSITY SUCH THAT ALL CHILDREN HAVE AN EQUAL OPPORTUNITY TO BE HEALTHY, READY TO LEARN, AND TO ACHIEVE THEIR FULL POTENTIAL. THIS WILL BE ACHIEVED THROUGH DEVELOPING, TESTING, AND SCALING NOVEL HEALTH DELIVERY APPROACHES THAT SERVE CHILDREN WITH THEIR CAREGIVERS AND THAT BRING COMMUNITIES, CHILD-SERVING SECTORS, AND HEALTH PROVIDERS TOGETHER ACROSS DISCIPLINES. THE CENTER AIMS TO BUILD THE PEDIATRIC PRACTICE OF THE FUTURE THROUGH FUNDAMENTAL SYSTEMS CHANGE-- CREATING & SCALING NOVEL HEALTH DELIVERY APPROACHES AND WORKING WITH FAMILIES, INTER-DISCIPLINARY COLLEAGUES, COMMUNITIES, AND OTHER FAMILY-SERVING SECTORS. ELDERS LIVING AT HOME PROGRAM: THE GOAL OF ELDERS LIVING AT HOME PROGRAM IS TO HELP OLDER ADULTS WHO ARE HOMELESS OR AT RISK FOR HOMELESSNESS SECURE AND MAINTAIN A PERMANENT RESIDENCE AND LIVE AS INDEPENDENTLY AS POSSIBLE. THE PROGRAM SERVED 211 CLIENTS DURING THE 2018 FISCAL YEAR. OF THIS NUMBER, 102 RECEIVED HOUSING SEARCH AND PLACEMENT SERVICES; 40 RECEIVED HOUSING STABILIZATION SERVICES; 70 RECEIVED HOMELESSNESS PREVENTION ASSISTANCE; AND 25 CLIENTS WERE SERVED THROUGH THE NEW LIVING WELL AT HOME PROJECT, A COMMUNITY-BASED COMPLEX CARE MANAGEMENT PILOT DESIGNED TO IMPROVE HEALTH OUTCOMES FOR FRAIL RESIDENTS OF AN ELDERLY/DISABLED HOUSING COMPLEX IN ROXBURY. SOME CLIENTS RECEIVED MORE THAN ONE TYPE OF SERVICE. THIRTY-SIX (36) CLIENTS RECEIVED NUTRITIONAL ASSISTANCE. ALL CLIENTS SUFFER FROM AT LEAST ONE CHRONIC ILLNESS, AND 177 SUFFER FROM TWO OR MORE DISABLING MEDICAL CONDITIONS. REMARKABLY, ALL OF THE PROGRAM CLIENTS WHO WERE PLACED IN HOUSING AND ALL WHO RECEIVED STABILIZATION SERVICES HAVE REMAINED SAFELY HOUSED DURING THIS PERIOD. OF THOSE CLIENTS WHO RECEIVED HOMELESSNESS PREVENTION SERVICES, 68 (100% WITH THE EXCLUSION OF TWO CLIENTS WHO DIED BEFORE THEIR CASES WERE RESOLVED) HAVE REMAINED IN STABLE HOUSING. OVER THE LAST TEN YEARS, THE SUCCESS RATE OF THE PROGRAM'S STABILIZATION SERVICES REMAINS AT AN EXTRAORDINARY 98%. GROW CLINIC: THE GROW CLINIC WAS FOUNDED IN 1984 BY DR. DEBORAH A. FRANK WITHIN BMC'S DEPARTMENT OF PEDIATRICS. THE PRIMARY GOAL OF THE GROW CLINIC IS TO PROVIDE COMPREHENSIVE MULTIDISCIPLINARY MEDICAL, NUTRITIONAL, AND SOCIAL SERVICES AS WELL AS DEVELOPMENTAL SUPPORT TO CHILDREN FROM THE GREATER BOSTON AREA DIAGNOSED WITH FAILURE TO THRIVE (FTT). CHILDREN WITH FTT HAVE SIGNIFICANT DIFFICULTY GROWING BECAUSE OF MALNUTRITION ASSOCIATED WITH ILLNESS, POVERTY, AND OTHER FAMILY STRESSORS. THE EFFECTS OF FTT INCLUDE SHORTENED ATTENTION SPANS, EMOTIONAL PROBLEMS, DELAYED COGNITIVE DEVELOPMENT, LASTING GROWTH FAILURE, AND FREQUENT SERIOUS ILLNESS, WHICH CAN RESULT IN HOSPITALIZATION. THE GROW CLINIC PROVIDES MEDICAL TREATMENT, NUTRITIONAL ASSESSMENT, HOME HEALTH EDUCATION, SOCIAL SERVICE ADVOCACY, DEVELOPMENTAL REFERRALS, ACCESS TO BMC'S THERAPEUTIC FOOD PANTRY, NUTRITIONAL SUPPLEMENTS, CHILDREN'S CLOTHES, DIAPERS, BOOKS, AND EDUCATIONAL TOYS, AMONG OTHER SERVICES. THERE ARE APPROXIMATELY 200 CHILDREN TREATED ANNUALLY BY THE GROW CLINIC. IN FY18 THERE WERE 79 NEW PATIENTS. THIRTY-TWO PERCENT (32%) OF CLINIC PATIENTS WERE 12 MONTHS OF AGE OR YOUNGER; THE AVERAGE AGE AT REFERRAL WAS 36 MONTHS; AND THE AVERAGE LENGTH OF TREATMENT WAS 29 MONTHS. THERE WERE 956 TOTAL CLINIC VISITS DURING THIS PERIOD. APPROXIMATELY 8.5% OF PATIENT FAMILIES WERE HOMELESS AND LIVING IN SHELTERS. CLINICIANS MADE 429 HOME VISITS IN FY18. ALL PATIENTS DEMONSTRATED IMPROVED GROWTH, AND 80% DEMONSTRATED SIGNIFICANT WEIGHT IMPROVEMENT. IMMIGRANT AND REFUGEE HEALTH PROGRAM: THE IMMIGRANT & REFUGEE HEALTH PROGRAM PROVIDES COMPREHENSIVE PRIMARY CARE SERVICES TO IMMIGRANT AND REFUGEE PATIENTS. THE TEAM OF CLINICIANS TAKES CARE OF GENERAL HEALTHCARE NEEDS THROUGH REGULAR CHECK-UPS, IMMUNIZATIONS, AND SCREENINGS, AS WELL AS THROUGH PROVIDING CARE FOR ILLNESSES AND INJURIES. IF NEEDED, THE TEAM WILL COORDINATE PATIENT CARE WITH A SPECIALIST FOR A MORE SERIOUS HEALTH ISSUE. FOREIGN AND SIGN LANGUAGE INTERPRETERS ARE AVAILABLE TO HELP PATIENTS COMMUNICATE WITH THE STAFF. THE PRACTICE PROVIDES ON-SITE INTERPRETERS AND OVER THE PHONE INTERPRETERS FOR MORE THAN 250 LANGUAGES. THE PROGRAM ALSO OFFERS ACCESS TO PSYCHIATRIC AND CASE MANAGEMENT SUPPORT TO PROVIDE CARE FOR THE WIDE RANGE OF PATIENT NEEDS. BOSTON MEDICAL CENTER'S IMMIGRANT AND REFUGEE HEALTH PROGRAM SEES OVER 400 NEW IMMIGRANT, REFUGEE, AND ASYLUM SEEKER PATIENTS PER YEAR AND HAS AN OVERALL LONG-TERM PRIMARY CARE PATIENT POPULATION OF ABOUT 1,900. INTEGRATIVE MEDICINE: STARTED IN 2004, THE PROGRAM FOR INTEGRATIVE MEDICINE AND HEALTH CARE DISPARITIES AT BOSTON MEDICAL CENTER COMBINES CONVENTIONAL MEDICAL TREATMENT, COMPLEMENTARY THERAPIES, AND LIFESTYLE CHANGES. THE CORE PURPOSE OF THIS PROGRAM IS TO PIONEER A WIDELY ACCESSIBLE, MULTICULTURAL, CROSS-DISCIPLINARY, NATIONAL MODEL OF INTEGRATIVE HEALTH FOR ALL THROUGH CLINICAL SERVICES, EDUCATION, RE Schedule H, PART VI, LINE 6 BMC HealthNet Plan BMC HealthNet Plan is a non-profit health plan that provides health insurance coverage to Massachusetts residents, including low income, underserved, disabled and elderly populations. BMC Healthnet Plan was established in 1997 by Boston Medical Center, the largest safety net hospital in New England and has more than 20 years of experience delivering accessible care to complex populations. BMC Healthnet Plan, under the name "Well Sense Health Plan," also provides health coverage to Medicaid members in New Hampshire. BMC HealthNet Plan serves over 330,000 members across Massachusetts. Boston HealthNet Established in 1995, Boston HealthNet is an integrated health care delivery system comprised of BMC, the Boston University School of Medicine, and 14 community health centers. Physicians who practice at HealthNet locations provide a wide range of comprehensive health care services to adult and pediatric patients, with a focus on disease prevention and health education. Patients receiving primary care at HealthNet sites have access to highly trained specialists and cutting-edge technology at BMC while maintaining individualized and culturally sensitive care in their neighborhoods. Now in its 24th year, Boston Healthnet and its Community Health Center partners have extended BMCs presence into Boston-area neighborhoods, significantly improving the health of their residents. The accomplishments of the network are evidenced by: the growth of Community Health Center admissions to BMC; the collaborative development of quality improvement initiatives, clinical protocols, and standards of practice; increased access to specialty services; a successful public health outreach campaign; and the significant development and coordination of Boston Healthnets information technology programs and services. Boston HealthNet has partnered with the Massachusetts League of Community Health Centers to participate in a federal Health Center Controlled Network grant, a $900,000 three year grant (2016-2019) that supported quality improvement, reporting, and clinical EMR training. Since 2015, Boston healthnet Community Health Centers, in collaboration with BMC, have implemented an electronic health record and practice management system. The system allows both Community health center and BMC providers to gain access to the health records of their mutual patients. A two-year $895,965 Partnership for Community Health grant awarded in 2015 supports Boston Healthnets Improving Community Health, an initiative that takes advantage of informatics through a patient portal to enhance patient engagement. Key goals of the project are to improve blood pressure management among patients with hypertension and ensure that patients do not miss routine cancer screenings. Research: A Boston Healthnet Research Subcommittee was set up in 2005 to review all research projects that are proposed at the health centers; 244 projects have been reviewed to date. Increasing Patient Access: Community Access to BMC is enhanced through a free shuttle bus service and an UBER program. One shuttle bus is provided to EBNHC that circulates twice and hour and the UBER program is to allow patients greater access to appointments for patients at 10 other health centers. Last year, the shuttle bus transported 211,999 patients and their families between BMC and the EBNHC. The Pilot Uber program, implemented to service 10 Boston HealthNet Health Centers, increased 83% in its first year transporting 2,237 patients. Advancing Medical Education: A number of HealthNet Community Health Centers also serve as the primary community-based training sites for Boston University School of Medicine pediatric, family medicine, psychiatry and general medicine residents. BUSM students and physician assistants also round at the CHCs to supplement their training with direct patient contact. Schedule H, PART VI, LINE 7 BMC DOES NOT FILE A COMMUNITY BENEFITS REPORT WITH THE COMMONWEALTH OF MASSACHUSETTS. true Albert Einstein College Of Med 500 West 185th Street New York NY 10033 131624225 501(c)(3) 296384 Subaward American Academy of Pediatrics 141 Northwest Point Blvd Elk Grove Village IL 60007 362275597 501(c)(3) 69896 Subaward Bay Cove Human Service 66 Canal Street Boston MA 02114 042518575 501(c)(3) 7275790 Subaward Baystate Medical Center 759 Chestmut Street Springfield MA 01199 042790311 501(c)(3) 463692 Subaward Berkeley County First steps 6215 Murray Drive Room 114 Hannah SC 29410 571097780 501(c)(3) 35000 Subaward Beth Israel Deaconess PO Box 3784 Boston MA 02241 042103881 501(c)(3) 356682 Subaward Boston Housing Authority 52 Chauncy Street Boston MA 02111 046001907 501(c)(3) 39452 Subaward Boston Public Health 1010 Massachusetts Ave Boston MA 02118 043316655 501(c)(3) 61463 Subaward Boston University 715 Albany Street Boston MA 02118 042103547 501(c)(3) 1969077 Subaward Brigham & Womens Hospital PO Box 3149 Boston MA 02241 042312909 501(c)(3) 265720 Subaward Brockton Area Multi-Services 10 Christys Drive Brockton MA 02301 042562377 501(c)(3) 157991 Subaward Brockton Neighborhood 63 Main Street Brockton MA 02301 043165044 501(c)(3) 21063 Subaward Cambridge Health Alliance 1493 Cambridge Street Cambridge MA 02139 043320571 501(c)(3) 226531 Subaward Cape Cod Hospital 27 Part Street Hyannis MA 02601 042103600 501(c)(3) 443144 Subaward Center for Community Health Education Research 360 Huntington Avenue 222 YMCA Boston MA 02115 043286409 501(c)(3) 34286 Subaward Child & Family Service 3057 Acushnet Avenue New Bedford MA 02745 042104754 501(c)(3) 144750 Subaward Children's Defense Fund 555 Park Street Saint Paul MN 55105 520895622 501(c)(3) 35000 Subaward Children's Hospital Corp 300 Longwood Avenue Boston MA 02115 042774441 501(c)(3) 28091 Subaward Codman Square Health 637 Washington Avenue Boston MA 02124 042678774 501(c)(3) 13939 Subaward Colorado Statewide Parent Coalition 7150 Hooker Street Suite B Denver CO 80030 742563848 501(c)(3) 35000 Subaward Community Outreach And Patient Empowerment Inc 208 West Coal Gallup NM 87301 465551998 501(c)(3) 35000 Subaward Cooper Health System 1 Cooper Plz Camden NJ 08103 210634462 501(c)(3) 45000 Subaward Dana Farber Cancer In 042263040 501(c)(3) 38078 Subaward Dimock Chc 55 Dimock Street Roxbury MA 02119 043487835 501(c)(3) 6268 Subaward Drexel University 3141 Chestnut Street Philadelphia PA 19104 231352630 501(C)(3) 6270 Subaward Emory University 1762 Clifton Rd Suite 1400 Atlanta GA 30322 580566256 501(C)(3) 296602 Subaward Every Mother Inc PO Box 615 Greenville MS 38702 205325053 501(c)(3) 22663 Subaward GE Global Research 1 Research Cir Niskayauna NY 12309 140689340 CORP 5979 Subaward General Electric Medical Sysytems Information Tech 5517 Collections Center Dr Chicago IL 60693 140689340 Corp 24966 Subaward Georgia State University 33 Gilmer Street Atlanta GA 30303 586002050 115 10732 Subaward Gosnold Inc 200 Ter Heun Dr Falmouth MA 02540 042502970 501(c)(3) 211002 Subaward Harvard Pilgrim Health 1600 Clown Colony Dr Quincy MA 02169 042452600 501(c)(3) 15506 Subaward Harvard University 677 Huntington Avenue Boston MA 02115 042103580 501(c)(3) 82961 Subaward Health Resources in Action Inc 2 Boylston Street 4th Floor Boston MA 02115 042229839 501(c)(3) 6385 Subaward Healthinsight 756 Winchester St Suite 200 Salt Lake City UT 84107 870303872 501(c)(3) 11954 Subaward Institute for Health 349 Broadway Cambridge MA 02139 043086647 501(c)(3) 44518 Subaward John Hopkins University 600 Wolfe Street Baltimore MD 21287 520595110 501(c)(3) 23038 Subaward Joslin Diabetes Center One Joslin Place Boston MA 02215 042203836 501(c)(3) 13177 Subaward Martha S Vineyard Community Services Inc 111 Edgartown Rd Vineyard Haven MA 02568 042301598 501(c)(3) 218636 Subaward Mass Institute of Technology 77 Massachusetts Avenue NE 49-4097 Cambridge MA 02139 042103594 501(c)(3) 111156 Subaward Massachusetts General Hospital 55 Fruit Street Boston MA 02114 042697983 501(c)(3) 235234 Subaward Medstar Health Research 6525 Belcrest Road Hyattsville MD 20782 526056274 501(c)(3) 11793 Subaward Mgh Neurogenetics Dna 185 Cambridge Street Boston MA 02110 042807148 501(c)(3) 252083 Subaward Minneapolis Red Research 600 Shapiro Building Minneapolis MN 55404 411677920 501(c)(3) 10212 Subaward North Suffolk Mental 301 Broadway Avenue Chelsea MA 02150 042317215 501(c)(3) 3869043 Subaward Northeastern University 360 Huntington Avenue Boston MA 02115 041679980 501(c)(3) 442104 Subaward Nuestra Comunidad Development Corp 56 Warren Street Suite 200 Roxbury MA 02119 042741543 501(c)(3) 8234 Subaward Partners in Health 888 Comm Ave 3rd Floor Boston MA 02215 043567502 501(c)(3) 14154 Subaward Program for Parents Inc 570 Broad Street Newark NJ 07102 222504469 501(c)(3) 35000 Subaward Project Hope 550 Dudley Street Roxbury MA 02119 042748880 501(c)(3) 42984 Subaward Reaching our Sisters 3614 Columbia Pkwy Decatur GA 30034 452803568 501(c)(3) 65276 Subaward Regents of the Univ of California 2760 Fifth Avenue San Diego CA 92103 956006144 501(c)(3) 33075 Subaward Research Triangle Ins 3040 E Cornwallis Road PO Box 1219 Research Triangle Park NC 27709 560686338 501(c)(3) 9998 Subaward Rhode Island Hospital 593 Eddy St Providence RI 02903 050258954 501(c)(3) 101351 Subaward Riverside Research Institute 156 William St 9th Fl New York NY 10038 132593244 501(c)(3) 69558 Subaward Rutgers the State University 65 Davidson Road Piscataway NJ 08854 462354111 501(c)(3) 1436915 Subaward Seattle Biomedical Research Institute 307 Westlake Ave N Ste 500 Seattle WA 98109 910961784 501(c)(3) 247753 Subaward The Board of Trustees of Univ of Alabama 651 Peter Bryce Blvd Tusscaloosa AL 35401 630803491 501(c)(3) 35000 Subaward The Miriam Hospital 164 Summit Avenue Providence RI 02906 050258905 501(c)(3) 48037 Subaward The New York Immigrant 131 West 33rd Street Suite 610 New York NY 10001 133573409 501(c)(3) 35000 Subaward The University of Rhode Island 75 Lower College Road Kingston RI 02881 223011455 115 7920 Subaward Third Sector New England 89 South Street 7th Floor Boston MA 02111 042261109 501(c)(3) 265563 Subaward Trustees of the University of Pennsylvania 3451 Walnut Street Suite 305 Philadelphia PA 19104 231352685 501(c)(3) 25600 Subaward Tufts University 715 Albany Street Boston MA 02118 042103634 501(c)(3) 212402 Subaward US Civilian Research and development 1776 Wilson Blvd Suite 3000 Arlington VA 22209 541773406 501(c)(3) 150198 Subaward United Way of Metropolitan Chicago 333 South Wabash Avenue Chicago IL 60604 300200478 501(c)(3) 35000 Subaward University of Massachusetts 55 Lake Avenue North Worcester MA 01655 043167352 115 44912 Subaward University of Michigan 3003 S State Street Ann Arbor MI 48109 386006309 501(c)(3) 84452 Subaward University of N Carolina CB 13501 Chapel Hill NC 27599 566001393 501(c)(3) 5734 Subaward University of Pittsburgh 116 Atwood Street Suite 201 Pittsburgh PA 15260 250965591 115 62192 Subaward University of Washington Box 359505 Gift Services Seattle WA 98195 916001537 115 110057 Subaward Vanderbilt University Gift Processing VU Station B 3577 2301 Vanderbilt Pl Nashville TN 37235 620476822 501(c)(3) 130675 Subaward Vinfen Corp PO Box 5059 Boston MA 02206 042632219 501(c)(3) 2107839 Subaward Whatcom County 311 Grand Ave Bellingham WA 98225 916001383 115 35000 Subaward Yale University PO Box 208239 New Haven CT 06520 060646973 501(C)(3) 34584 Subaward 74 2 Schedule I, Part I, Line 2 Grants Administration uses Lawson general ledger and LBI reporting to monitor all grant funding. In addition, each Principal Investigator and Department Administrator have desktop access so they are able to review their funding and expenditures on a daily basis. X X X X X X true true false false false false false true false David Beck SVP/Chief Legal Counsel/Clerk 375245 0 76864 0 20403 0 62700 0 20626 0 555838 0 14000 0 Richard Silveria Former SVP Fin/CFO/Treas 204932 0 0 0 407026 0 5625 0 31172 0 648755 0 45800 0 Alastair Bell SVP Ops & Strategy/COO 681700 0 369912 0 44588 0 86700 0 3300 0 1186200 0 28967 0 Bob Biggio SVP Facility & Supt Svcs 412787 0 115966 0 14245 0 47500 0 38555 0 629053 0 12800 0 Joe Camillus SVP Ambulatory & Prf Svc 342551 0 70795 0 10404 0 54000 0 30957 0 508707 0 2500 0 David Coleman MD Trustee 0 564437 0 0 166406 0 35960 0 1829 0 768632 0 0 Brendan Magauran MD Trustee 0 290256 0 0 0 87840 0 35960 0 30231 0 444287 0 Jennifer Tseng MD Trustee 0 417511 0 0 0 40300 0 0 0 6495 0 464306 0 0 Kathleen Walsh President and CEO 1194790 0 339818 0 202722 0 189750 0 5306 0 1932386 0 148442 0 Ravin Davidoff MD SVP MEDICAL AFFAIRS AND CMO 493916 0 101136 0 147808 0 13500 0 21858 0 778218 0 39720 0 Nancy Gaden SVP CHIEF NURSING OFFICER 390507 0 80909 0 2328 0 54900 0 33097 0 561741 0 0 0 Stanley Hochberg MD SVP Qual,Sfty,&Tech (12/31/17) 412419 0 53453 0 52728 0 13500 0 23452 0 555552 0 16100 0 Lisa A Kelly-Croswell SVP/CHRO 421066 0 85966 0 20667 0 58230 0 9542 0 595471 0 11300 0 Norman Stein SVP Chief Development Officer 366096 0 125165 0 49198 0 18900 0 14726 0 574085 0 24456 0 Arthur Harvey VP/CIO 346700 0 70795 0 2328 0 35300 0 8811 0 463934 0 0 0 Thea James VP Missions & Associate CMO 295402 0 60682 0 25872 0 8100 0 22264 0 412320 0 0 0 Mary Beth Begley Treasurer (until 11/14/2017) 236055 0 499 16081 13653 266288 Schedule J, Part I, Line 4a Richard Silveria received severance compensation in the amount of $297,500, which is included in Schedule J, Part II, Column B(iii). Richard Silveria received the standard severance package, which is twelve months of salary plus medical and dental benefits. Schedule J, Part I, Line 4b Boston Medical Center Provides A Supplemental Executive Retirement Plan To Certain Executives. Amounts Are Credited To Participants' Accounts Each Year. Plan Amounts Are Subject To Forfeiture And Payment Only If Certain Conditions Are Met, As Outlined In The Plan Agreement. Boston Medical Center Maintains An Executive Benefit Plan Which Offers Participating Executives The Option Of Annually Allocating Benefit Dollars To A Supplemental Retirement/Pre-Tax Savings Account. Amounts Vest On Specified Dates Based On Continued Employment But No Later Than The Executive's 62nd Birthday. Amounts Accrued In The Plan Are Reported In Schedule J, Part II, Column C. The Following Amounts Became Vested And Were Paid To The Following Executives In Calendar Year 2017: Walsh - $127,425 Beck - $18,075 Bell - $42,260 Biggio - $11,917 Davidoff - $145,480 Hochberg - $50,400 Kelly-Croswell - $18,339 Stein - $46,870 Silveria - $108,556 James - $24,000 Camillus - $8,076 BMC Provided A Supplemental Executive Retirement Plan To Kathleen Walsh, President And CEO As Of March 1, 2010. Pursuant To The Terms Of The Agreement, Certain Amounts Were Credited To The President And CEO's Account In Prior Years. These Amounts Are Subject To Forfeiture And Payment Will Be Made Only If Certain Conditions Are Met, As Outlined In The Agreement. For Calendar Year 2017, $47,250 was vested and is reflected in Schedule J, Part II, Column B (iii). Schedule J, Part I, Line 7 BMC Has An Annual Executive Performance Incentive Plan. Performance Targets And Payout Metrics Are Established And Approved By The Compensation Committee At The Beginning Of Each Performance Cycle. Fy17 Performance Bonus Payouts were Approved By The Committee after it reviewed the FY17 Performance Results Against Pre-Established Performance Targets, And Approved The Formula-Based Payouts Accordingly. A MDFA 2012 Series C 043431814 57583URP5 2012-06-14 117490498 Refunding of 1998 Bonds true false false B MDFA 2015 Series D 043431814 57583U6Q6 2015-04-08 167471151 FINANCE CAPITAL PROJECTS false false false C MDFA 2016 Series E 043431814 57584XWT4 2016-09-22 203977951 FINANCE NEW PROJECTS D MDFA 2017 Series F 043431814 57584X6Z9 2017-12-20 45272849 FINANCE CAPITAL PROJECTS A 34010000 38675000 117498730 5202013 0 0 1684889 0 0 0 115805649 0 true false true true B 0 0 168580681 15556101 429994 0 2013155 0 0 150236813 0 0 false false false true C 450000 0 203977951 0 0 0 1705945 0 0 29221589 172974053 76364 false true false true D 0 0 45710324 0 0 0 272257 0 0 22351224 0 23086843 false false false true A 0 B false true true true true true 0.00000 0.00000 0.00000 false false false true C false true true true true false 0 false false false true D false true true true false 0 false false false true A true false false 0 true AIG Matched Funding 27. true true true B false true false false false false 0 false 0 false true C false true false false false false 0 false 0 true true D false true false false false false 0 false 0 false true A true B true C true D true Column A Part I(F): The prior bonds were issues on July 8, 1998, by the Massachusetts Health and Educational Facilities Authority. Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS. Part II, Line 4: Debt service reserve fund was funded by proceeds of the prior bonds. Part II, Line 13: Since the proceeds of the 2012 bonds were used for refunding purposes, the year of substantial completion is not applicable. Part III: Because proceeds of the bonds were used to refund bonds issued before January 1, 2003, the issuer is not required to complete Part II. Part IV, Line 1: The most recent five year rebate report, dated July 25, 2017, was prepared by BLX Group, LLC. COLUMN B Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS. PART III, LINE 7 AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. Column C Part I(F): The prior bonds were issued on July 1, 2008, by the Massachusetts Health and Educational Facilities Authority. Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS. Part II, Line 12: Unspent bond proceeds deposited to the project and expense funds. PART III, LINE 7 AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. COLUMN D Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS. PART III, LINE 7 AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. A MHEFA 2009 Series O-1 042456011 57586ELD1 2009-08-14 101485000 Refunding of Series M3-B false false true A 5906734 0 13688734 77815 0 0 0 0 0 0 13688734 0 true false true true A false false true true false 0.00000 0.00000 0.00000 false false false true A false false true true true false 0 false 0 false true A true Column A THE BONDS ARE PART OF A POOLED FINANCING (TOTAL PAR $101,485,000) AND THUS, EXCEPT FOR PART I, ONLY THE BORROWER'S ALLOCABLE PORTION $13,688,734 IS REPRESENTED. PART I(F): THE BORROWER'S PORTION OF THE BONDS REFINANCED THE PORTION OF THE ISSUER'S SERIES M3-B (2005) BONDS (ISSUES ON OCTOBER 3, 2005) ALLOCABLE TO THE BORROWER. PART II, LINE 4: THE RESERVE HAS BEEN FUNDED BY THE PROCEEDS OF THE PRIOR BONDS. PART II, LINE 13: SINCE THE PROCEEDS OF THE BONDS WERE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART III, LINE 7 AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2(B): BOND PROCEEDS WERE EXPENDED TO FINANCE A CURRENT REFUNDING, WHICH HAS MET AN EXCEPTION TO THE REBATE REQUIREMENT. NO COMPUTATION HAS BEEN MADE THAT WOULD INDICATE WHETHER ANY REBATE WOULD BE DUE ON THE PROCEEDS TRANSFERRED FROM THE PRIOR BONDS. HANNAH LEAVER Daughter of Trustee 142224 EMPLOYMENT false SCHEDULE L, PART IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: HANNAH LEAVER, DAUGHTER OF TRUSTEE MARKS, IS EMPLOYED BY BMC. LEAVER HAS BEEN EMPLOYED BY BMC SINCE BEFORE TRUSTEE MARKS JOINED THE BMC BOARD IN 2016. X 0 DONOR ESTIMATE X 7861 DONOR ESTIMATE X 37 1808154 stock sale proceeds X 8 1735 DONOR ESTIMATE X 38 91692 DONOR ESTIMATE X Gift Certificate 93 46122 Donor Estimate X Tickets 62 32080 Donor Estimate X Jewelry 2 990 Donor Estimate X Toys 18 100 Donor Estimate X Travel 35 44934 DONOR ESTIMATE X Miscellaneous 7 77 DONOR ESTIMATE false true false Schedule M, Part I, Column b The organization is reporting the number of items contributed. Form 990, Part III, Line 4a The statute that created Boston Medical Center (BMC) requires it to serve all populations. BMC is a private, not-for-profit, 514-licensed bed, urban academic medical center which emphasizes community-based, accessible care and the mission to provide consistently accessible health services to all in need of care regardless of status and ability to pay. BMC is the largest safety net hospital in New England and provides a full spectrum of pediatric and adult care services from primary to family medicine to advanced specialty care. Approximately 72% of our patient visits come from underserved populations, such as the low-income and elderly, who rely on government payers such as medicaid, the health safety net and medicare for their coverage, and 32% do not speak english as a primary language. To address the health needs of diverse patient population, BMC provides a wide range of services beyond the traditional medical model. These programs, including but not limited to patient navigation and a food pantry to help reduce barriers to accessing health services and eliminate disparities in health care among the various populations BMC serves. Form 990, Part IV, Line 12 Boston Medical Center is included in the consolidated financial statements for BMC Health System, Inc. Form 990, Part VI, Section A, Line 2 Karen Antman, M.D. David Coleman, M.D. Brendan Magauran, M.D. Jennifer Tseng, M.D. Business relationship - Karen Antman, M.D., is a key employee at Boston University; Boston University also employs Drs Coleman, Magauran, and Tseng. Monica Valdes Lupi, JD, MPH Kathleen E. Walsh Business Relationship - Ms. Valdes Lupo is executive director of the Boston Public Health Commission and Ms. Walsh serves on the board of health that governs the Commission. Karen Antman, M.D. David Beck David Coleman, M.D. Brendan Magauran, M.D. Jennifer Tseng, M.D. Kathleen E. Walsh Business Relationship - Each serves as an officer or director of Faculty Practice Foundation, Inc. David Coleman, M.D. Melanie Foley (as of May 29, 2018) Charles Orlando (as of May 29, 2018) Jennifer Tseng, M.D. (as of May 29, 2018) Kathleen E. Walsh Business Relationship - Each serves as a director of Boston Medical Center Insurance Company, LTD. Martha Samuelson Pierre Cremieux BUSINESS RELATIONSHIP - Martha Samuelson is CEO/Chairman and Trustee , and Pierre Cremieux is President of Analysis Group. David Beck Alastair Bell Barry Bock Sandra Cotterell Ravin Davidoff, M.D. William J. Halpin, JR. Stanley Hochberg, M.D. Charles Orlando BUSINESS RELATIONSHIP - Each serves as an officer or director of Boston Accountable Care Organization. David Beck is an officer of each Faculty Practice foundation corporation that employs David Coleman, M.D., Brendan Magauran, M.D., Jennifer Tseng, M.D. David Beck Manuel Lopes Kathleen Walsh BUSINESS RELATIONSHIP - Each serves as an officer or trustee of Univer Development Foundation, Inc. David Beck Joe Camillus Ravin Davidoff, M.D. Kathleen Walsh BUSINESS RELATIONSHIP - Each serves as an officer or trustee of Boston University Affiliated Physicians. Form 990, Part VI, Section A, Line 6 The sole member of the organization is BMC Health System, Inc. (BMCHS). Form 990, Part VI, Section A, Line 7B BMC Health System has the right to take certain actions including, but not limited to, the approval of budgets, mergers, acquisitions, and indebtedness. Form 990, Part VI, Section B, Line 11B Boston Medical Center's (BMC) Form 990 is prepared by KPMG LLP and Reviewed by BMC's internal management. Following that review, BMC's internal management and KPMG present the Form 990 to the audit committee for review and comment. The completed Form 990 is provided to all members of the board of trustees prior to the Form being filed with the IRS. Form 990, Part VI, Section B, Line 12C Conflict of interest questionnaires for the fiscal year ending September 30, 2018 were distributed by BMC's corporate compliance department. The Chief Compliance Officer of BMC or the Chief Compliance Officer's designee queries trustees, officers, and directors on at least an annual basis regarding relationships that may create potential conflicts of interest. The Chief Compliance Officer or the Chief Compliance Officer's designee reviews all disclosures and determines whether there are actual or potential conflicts of interest. The Chief Compliance Officer or the Chief Compliance Officer's designee informs the Chief Legal Counsel of any actual or potential conflicts of interest. The Chief Legal Counsel advises the board of trustees and officers of the corporation accordingly. Form 990, Part VI, Section B, Line 15 An independent committee, formed of individuals whose compensation is not in issue, determines the compensation of officers, key employees, and the highest compensated employees. The committee members are not under the control or direction of any BMC executive seeking compensation. The compensation plan is supported by comparable data, which includes compensation paid for comparable positions by similarly situated organizations, both taxable and tax-exempt, compensation surveys compiled independently, and actual written offers from similar institutions competing for the services of the BMC executive. The independent committee's assessment of these considerations are contained in the minutes of the committee meeting. The review process includes - and minutes indicate - discussions and evaluations of each executive's prior performance, qualification, and experience. Executives are not present for the independent committee's discussions and vote on compensation. The minutes reflect the fact that no executive was present. Form 990, Part VI, Section C, Line 19 Boston Medical Center does not make its governing documents, conflict of interest policy, and financial statements publically available. However, the restated articles of the organization are posted on the Secretary of the Commonwealth's website. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Transfer from Affiliates $ 2,000,000 Pension related changes other than Periodic pension costs $ 8,120,000 Other Changes $ 206,000 Adjustment for Univer $ -1,808,000 Adjustment for BMCICS $ 88,000 Rounding $ 26 Total $ 8,606,026 BMC Health System Inc One Boston Medical Center Pl Boston MA 02118 463556853 Support Svcs. 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