CAPE COD HEALTHCARE INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: CAPE COD HEALTHCARE INC (EIN 90-0054984)
Tax period: 2017-10-01 to 2018-09-30
Filed: 2019-08-15
IRS object ID: 201902279349301435
Schema version: 2017v2.3
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-08-15T08:56:54-05:00	ReturnTs
Tax Period End	2018-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	101 SEAPORT BLVD SUITE 500	AddressLine1Txt
City	BOSTON	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02210	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	900054984	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CAPE COD HEALTHCARE INC & AFFILIATES	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% MICHAEL L CONNORS	InCareOfNm
Business Name Control	CAPE	BusinessNameControlTxt
Phone	5087711800	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	297 NORTH ST Suite BLDG 3	AddressLine1Txt
City	HYANNIS	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02601	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	MICHAEL L CONNORS	PersonNm
Person Title	SR VP FINANCE/ CFO	PersonTitleTxt
Signature	2019-08-14	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	GWEN SPENCER	PreparerPersonNm
PTIN	P00641463	PTIN
Phone	6175305000	PhoneNum
Preparation	2019-08-07	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.125.77	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	04363820192275000031	FederalOriginalSubmissionId
Federal Original Submission Id	2019-08-15	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	502E9D7DF2DC237FB1436A97DBD0F14D19F2DD5A	AtSubmissionCreationDeviceId
At Submission Filing Device Id	1563161100844465C8187993E1FFC143BF1C91FB	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	MICHAEL K LAUF	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	88 LEWIS BAY ROAD	AddressLine1Txt
City	HYANNIS	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02601	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$915,852,896	GrossReceiptsAmt
Group Return For Affiliates	Yes (true)	GroupReturnForAffiliatesInd
All Affiliates Included	Yes (true)	AllAffiliatesIncludedInd
Group Exemption	3901	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CAPECODHEALTH.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Activity Or Mission	SEE SCHEDULE O	ActivityOrMissionDesc
Voting Members Governing Body	17	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	5684	TotalEmployeeCnt
Total Volunteers	696	TotalVolunteersCnt
Total Gross UBI	$1,555,937	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$544,982	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$15,341,766	PYContributionsGrantsAmt
CY Contributions Grants	$15,447,109	CYContributionsGrantsAmt
PY Program Service Revenue	$844,858,980	PYProgramServiceRevenueAmt
CY Program Service Revenue	$884,728,875	CYProgramServiceRevenueAmt
PY Investment Income	$8,432,277	PYInvestmentIncomeAmt
CY Investment Income	$13,029,571	CYInvestmentIncomeAmt
PY Other Revenue	$2,195,757	PYOtherRevenueAmt
CY Other Revenue	$2,414,588	CYOtherRevenueAmt
PY Total Revenue	$870,828,780	PYTotalRevenueAmt
CY Total Revenue	$915,620,143	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,094,878	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$445,642,426	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$476,686,163	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$86,247	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$68,237	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$3,581,359	CYTotalFundraisingExpenseAmt
PY Other Expenses	$377,540,307	PYOtherExpensesAmt
CY Other Expenses	$391,316,079	CYOtherExpensesAmt
PY Total Expenses	$823,268,980	PYTotalExpensesAmt
CY Total Expenses	$869,165,357	CYTotalExpensesAmt
PY Revenues Less Expenses	$47,559,800	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$46,454,786	CYRevenuesLessExpensesAmt
Total Assets BOY	$963,305,006	TotalAssetsBOYAmt
Total Assets EOY	$1,023,990,733	TotalAssetsEOYAmt
Total Liabilities BOY	$258,793,996	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$269,099,333	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$704,511,010	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$754,891,400	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$789,043,793	ExpenseAmt
Grant	$1,094,878	GrantAmt
Revenue	$884,728,875	RevenueAmt
Desc	PATIENT SERVICES - SEE SCHEDULES H AND O	Desc
Total Program Service Expenses	$789,043,793	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	Yes (true)	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	Yes (true)	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	116	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	5684	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	17	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	false	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	MICHAEL L CONNORS	PersonNm
Phone	7744705537	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	297 NORTH STREET BLDG 3	AddressLine1Txt
City	HYANNIS	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02601	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (42 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
PHILIP MCLOUGHLIN
TRUSTEE (UNTIL 5/18)	2.0	2.0	Yes (X)	$0	$0	$0
MICHAEL K LAUF
PRESIDENT/CEO/TRUSTEE	55.0	5.0	Yes (X)	$0	$2,672,978	$289,344	Yes (X)
NATE RUDMAN MD
TRUSTEE	2.0	2.0	Yes (X)	$0	$0	$0
JOEL CROWELL
SEE SCH O FOR TITLE	2.0	2.0	Yes (X)	$0	$0	$0	Yes (X)
SUZANNE FAY GLYNN ESQ
TRUSTEE	2.0	2.0	Yes (X)	$0	$0	$0
DEWITT DAVENPORT
CHAIRMAN	2.0	2.0	Yes (X)	$0	$0	$0	Yes (X)
DIANE COLETTI
TRUSTEE	2.0	2.0	Yes (X)	$0	$0	$0
WILLIAM ZAMMER
TRUSTEE	2.0	2.0	Yes (X)	$0	$0	$0
SUMNER B TILTON JR
TRUSTEE	2.0	2.0	Yes (X)	$0	$0	$0
E JAMES MULCAHY JR
TRUSTEE	2.0	2.0	Yes (X)	$0	$0	$0
ROBERT TALERMAN
TRUSTEE	2.0	2.0	Yes (X)	$0	$0	$0
GARY VACON
VICE CHAIR/TRUSTEE	2.0	2.0	Yes (X)	$0	$0	$0	Yes (X)
ROBERT WILSTERMAN MD
TRUSTEE	40.0	2.0	Yes (X)	$791,933	$0	$60,781
WILLIAM AGEL MD
TRUSTEE	40.0	2.0	Yes (X)	$523,405	$0	$44,677
RAMANI AYER
TRUSTEE (FROM 5/18)	2.0	2.0	Yes (X)	$0	$0	$0
THEODORE CALIANOS MD
TRUSTEE	40.0	2.0	Yes (X)	$378,974	$0	$43,167
PAUL HOULE MD
TRUSTEE	40.0	2.0	Yes (X)	$1,099,091	$0	$62,207
BRUCE JOHNSTON
TRUSTEE/TREASURER (FROM 5/18)	2.0	2.0	Yes (X)	$0	$0	$0	Yes (X)
MICHAEL L CONNORS
SENIOR VP FINANCE/CFO	55.0	5.0		$0	$539,912	$92,817	Yes (X)
MICHAEL G JONES ESQ
SEE SCH O FOR TITLE	55.0	5.0		$0	$412,450	$78,339	Yes (X)
MICHAEL BUNDY
COO	45.0	5.0		$0	$452,973	$57,273		Yes (X)
DONALD A GUADAGNOLI MD
CMO CAPE COD HOSPITAL	45.0	5.0		$0	$529,045	$85,338		Yes (X)
ALEXANDER HEARD MD
CHIEF MEDICAL OFFICER - FH	45.0	5.0		$84,330	$611,313	$67,672		Yes (X)
PATRICK J KANE
SVP OF MRKTG,COMMUN AND DEVLP	45.0	5.0		$0	$395,113	$31,505		Yes (X)
CHRISTIAN BROWN
SR VP MANAGED CARE	45.0	5.0		$0	$393,040	$79,946		Yes (X)
EMILY SCHORER
SVP HUMAN RESOURCES	45.0	5.0		$0	$331,273	$58,910		Yes (X)
KEVIN RALPH
SVP DEVELOPMENT	45.0	5.0		$0	$297,026	$60,128		Yes (X)
THERESA M AHERN
SVP, STRAT, COMMUNITY/GOV REL.	45.0	5.0		$0	$334,682	$63,062		Yes (X)
KEVIN J MULROY
SVP CHIEF QUALITY & SAFETY OFF	45.0	5.0		$0	$474,478	$75,112		Yes (X)
JEANNE FALLON
SR VP & CIO (UNTIL 4/11/17)	45.0	5.0		$0	$316,781	$22,488		Yes (X)
JEFFREY S DYKENS
VP FINANCE & OPERATIONS	45.0	5.0		$0	$310,981	$64,327		Yes (X)
NOELENE CERVIN
VP BUDGETING & OPER. SUPPORT	45.0	5.0		$0	$262,379	$58,866		Yes (X)
LORI JEWETT
CEO - FH	45.0	5.0		$0	$287,208	$42,343		Yes (X)
DIANNE C KOLB
PRESIDENT VNA (UNTIL 8/8/17)	45.0	5.0		$0	$168,574	$38,377		Yes (X)
CARTER HUNT
ADMIN SPEC&HOSP BASED CARE	45.0	5.0		$0	$216,135	$64,415		Yes (X)
VICTOR OLIVEIRA
VP PATIENT SVCS(UNTIL 3/17)	45.0	5.0		$0	$241,943	$36,133		Yes (X)
JUDITH C QUINN
VP OF PATIENT CARE	45.0	5.0		$0	$279,725	$49,841		Yes (X)
RICHARD B ZELMAN MD
PHYSICIAN	40.0	0.0		$1,549,782	$0	$48,011			Yes (X)
ACHILLES PAPAVASILIOU MD
PHYSICIAN	40.0	0.0		$1,122,283	$0	$63,501			Yes (X)
NICHOLAS COPPA MD
PHYSICIAN	40.0	0.0		$1,082,702	$0	$65,372			Yes (X)
GORDON NAKATA MD
PHYSICIAN	40.0	0.0		$1,073,238	$0	$62,639			Yes (X)
PHILLIP J DOMBROWSKI MD
PHYSICIAN	40.0	0.0		$772,950	$0	$12,325			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$8,478,688	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$9,528,009	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,878,916	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	785	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CAPE COD HEALTHCARE INC
297 NORTH STREET BLDG 3	HYANNIS	MA	02601	PURCHASED SERVICES	$52,832,634
QUALITY IN REAL TIME
15 VERBENA AVENUE SUITE 210	FLORAL PARK	NY	11001	CODING REVIEW	$490,660
CORE MEDICAL GROUP
3000 GOFFS FALLS RD SUITE 101	MANCHESTER	NH	03103	CONTRACT RN, PT, OT	$396,003
DELTA HEALTH
400 LAKEMONT PARK BLVD	ALTOONA	PA	16602	MIS-SUPPORT	$275,159
MEDTRONIC CARE MANAGEMENT
7980 CENTURY BLVD	CHANHASSEN	MN	55317	PATIENT SUPPORT SVCS	$140,178

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	10	CntrctRcvdGreaterThan100KCnt
Fundraising	$9,350	FundraisingAmt
Government Grants	$1,154,606	GovernmentGrantsAmt
All Other Contributions	$14,283,153	AllOtherContributionsAmt
Noncash Contributions	$1,163,954	NoncashContributionsAmt
Total Contributions	$15,447,109	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	900099	$857,487,495	$857,487,495
LABORATORY SERVICES	621500	$8,011,151	$6,455,214	$1,555,937
PROGRAM RELATED RENTAL INCOME	900099	$3,501,400	$3,501,400
JOINT VENTURE REVENUE	900099	$2,953,856	$2,953,856
QUALITY EARNED PAYMENTS	900099	$8,747,405	$8,747,405

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,027,568	TotalRevenueColumnAmt
Related Or Exempt Func Income	$4,027,568	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$884,728,875	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,272,965	TotalRevenueColumnAmt
Exclusion	$7,272,965	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$5,756,606	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$5,756,606	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,756,606	TotalRevenueColumnAmt
Exclusion	$5,756,606	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$588,687	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$9,350	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$232,753	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$355,934	TotalRevenueColumnAmt
Exclusion	$355,934	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA INCOME	900099	$1,954,744	$1,954,744
MEDICAL RECORDS	900099	$103,910	$103,910

Field	Value	IRS element (for citing)
Other Revenue Total	$2,058,654	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$915,620,143	TotalRevenueColumnAmt
Related Or Exempt Func Income	$883,172,938	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,555,937	UnrelatedBusinessRevenueAmt
Exclusion	$15,444,159	ExclusionAmt

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

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,094,878	TotalAmt
Program Services	$1,094,878	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$2,974,982	TotalAmt
Program Services	$2,974,982	ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$116,158	TotalAmt
Program Services	$116,158	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$377,078,029	TotalAmt
Program Services	$339,720,279	ProgramServicesAmt
Management And General	$35,892,202	ManagementAndGeneralAmt
Fundraising	$1,465,548	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$11,080,193	TotalAmt
Program Services	$9,585,883	ProgramServicesAmt
Management And General	$1,435,688	ManagementAndGeneralAmt
Fundraising	$58,622	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$60,870,167	TotalAmt
Program Services	$54,776,086	ProgramServicesAmt
Management And General	$5,873,681	ManagementAndGeneralAmt
Fundraising	$220,400	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$24,566,634	TotalAmt
Program Services	$21,708,767	ProgramServicesAmt
Management And General	$2,745,753	ManagementAndGeneralAmt
Fundraising	$112,114	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$6,676,786	TotalAmt
Program Services	$3,297,281	ProgramServicesAmt
Management And General	$3,379,505	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$177,215	TotalAmt
Program Services	$7,316	ProgramServicesAmt
Management And General	$169,899	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$995,236	TotalAmt
Program Services	$200,853	ProgramServicesAmt
Management And General	$794,383	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$68,237	TotalAmt
Fundraising	$68,237	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$677,706	TotalAmt
Program Services	$67,562	ProgramServicesAmt
Management And General	$610,144	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$35,254,478	TotalAmt
Program Services	$34,068,162	ProgramServicesAmt
Management And General	$1,186,316	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$980,284	TotalAmt
Program Services	$908,046	ProgramServicesAmt
Management And General	$72,238	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,253,527	TotalAmt
Program Services	$4,847,418	ProgramServicesAmt
Management And General	$359,340	ManagementAndGeneralAmt
Fundraising	$46,769	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$11,824,044	TotalAmt
Program Services	$10,739,327	ProgramServicesAmt
Management And General	$999,064	ManagementAndGeneralAmt
Fundraising	$85,653	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$14,165,997	TotalAmt
Program Services	$13,159,581	ProgramServicesAmt
Management And General	$859,072	ManagementAndGeneralAmt
Fundraising	$147,344	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$6,580,980	TotalAmt
Program Services	$6,076,619	ProgramServicesAmt
Management And General	$455,813	ManagementAndGeneralAmt
Fundraising	$48,548	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$8,228	TotalAmt
Fundraising	$8,228	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,419,305	TotalAmt
Program Services	$5,797,389	ProgramServicesAmt
Management And General	$621,916	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$28,412,585	TotalAmt
Program Services	$25,720,184	ProgramServicesAmt
Management And General	$2,682,117	ManagementAndGeneralAmt
Fundraising	$10,284	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$3,003,255	TotalAmt
Program Services	$2,788,863	ProgramServicesAmt
Management And General	$214,392	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$130,295,787	$130,295,787
PURCHASED SERVICES	$44,454,194	$41,295,528	$3,109,599	$49,067
ADMIN OFFICE OVERHEAD	$53,528,156	$40,379,657	$12,602,411	$546,088
BAD DEBT	$14,392,093	$14,392,093

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$28,216,223	TotalAmt
Program Services	$25,025,094	ProgramServicesAmt
Management And General	$2,476,672	ManagementAndGeneralAmt
Fundraising	$714,457	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$869,165,357	TotalAmt
Program Services	$789,043,793	ProgramServicesAmt
Management And General	$76,540,205	ManagementAndGeneralAmt
Fundraising	$3,581,359	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$23,129,902	BOYAmt
EOY	$28,046,133	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,413,064	BOYAmt
EOY	$1,418,491	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$12,662,460	BOYAmt
EOY	$11,232,170	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$86,022,740	BOYAmt
EOY	$92,397,934	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$3,997,612	BOYAmt
EOY	$5,999,843	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$10,914,440	BOYAmt
EOY	$11,471,320	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,406,916	BOYAmt
EOY	$4,889,655	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$662,447,460	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$364,005,606	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$289,207,589	BOYAmt
EOY	$298,441,854	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$474,804,154	BOYAmt
EOY	$505,577,304	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$5,124,965	BOYAmt
EOY	-$562,504	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$9,346,552	BOYAmt
EOY	$10,089,047	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$44,274,612	BOYAmt
EOY	$54,989,486	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$963,305,006	BOYAmt
EOY	$1,023,990,733	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$54,459,109	BOYAmt
EOY	$67,602,305	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$429,407	BOYAmt
EOY	$387,349	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$150,522,013	BOYAmt
EOY	$132,147,783	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$13,407,900	BOYAmt
EOY	$20,887,363	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$39,975,567	BOYAmt
EOY	$48,074,533	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$258,793,996	BOYAmt
EOY	$269,099,333	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$630,388,180	BOYAmt
EOY	$681,649,081	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$41,022,954	BOYAmt
EOY	$39,258,698	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$33,099,876	BOYAmt
EOY	$33,983,621	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$704,511,010	BOYAmt
EOY	$754,891,400	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$963,305,006	BOYAmt
EOY	$1,023,990,733	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$46,454,786	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$3,981,759	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$56,155	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$9,458,675	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$15,572,146	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$13,584,232	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$15,341,766	CurrentTaxYearMinus1YearAmt
Current Tax Year	$15,447,109	CurrentTaxYearAmt
Total	$69,403,928	TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$9,458,675	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$15,572,146	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$13,584,232	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$15,341,766	CurrentTaxYearMinus1YearAmt
Current Tax Year	$15,447,109	CurrentTaxYearAmt
Total	$69,403,928	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$2,821,753	SubstantialContributorsTotAmt
Public Support Total170	$66,582,175	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$3,486,933	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$4,951,534	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,368,273	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,985,405	CurrentTaxYearMinus1YearAmt
Current Tax Year	$7,272,965	CurrentTaxYearAmt
Total	$27,065,110	TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,059,076	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,000,152	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$798,057	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$408	CurrentTaxYearMinus1YearAmt
Current Tax Year	-$544,982	CurrentTaxYearAmt
Total	$2,312,711	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,189,718	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,271,023	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,353,977	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,422,397	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,647,341	CurrentTaxYearAmt
Total	$11,884,456	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$110,666,205	TotalSupportAmt
Gross Receipts Rltd Activities	$4,036,039,797	GrossReceiptsRltdActivitiesAmt
Public Support CY170	0.60165	PublicSupportCY170Pct
Public Support PY170	0.65282	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

Field	Value	IRS element (for citing)
Power Appoint Majority Dir Trst	false	PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org	false	OperateBenefitNonSuprtOrgInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

Field	Value	IRS element (for citing)
Timely Provided Documents	false	TimelyProvidedDocumentsInd
Officers Close Relationship	false	OfficersCloseRelationshipInd
Supported Org Voice Investment	false	SupportedOrgVoiceInvestmentInd

Adjusted Net Income AdjustedNetIncomeGrp

Net ST Capital Gain Adj Net Incm NetSTCapitalGainAdjNetIncmGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Recoveries PY Distributions RecoveriesPYDistributionsGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Other Gross Income OtherGrossIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Adjusted Gross Income AdjustedGrossIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Production Income ProductionIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Other Expenses OtherExpensesGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Total Adjusted Net Income TotalAdjustedNetIncomeGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Minimum Asset Amount MinimumAssetAmountGrp

Average Monthly FMV Of Sec AverageMonthlyFMVOfSecGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Average Monthly Cash Balances AverageMonthlyCashBalancesGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

FMV Other Non Exempt Use Asset FMVOtherNonExemptUseAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Total FMV Of Non Exempt Use Asset TotalFMVOfNonExemptUseAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Field	Value	IRS element (for citing)
Discount Claimed	$0	DiscountClaimedAmt

Acquisition Indebtedness AcquisitionIndebtednessGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Adjusted FMV Less Indebtedness AdjustedFMVLessIndebtednessGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Cash Deemed Charitable CashDeemedCharitableGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Net Vl Non Exempt Use Assets NetVlNonExemptUseAssetsGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Pct Of Net Vl Non Exempt Use Ast PctOfNetVlNonExemptUseAstGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Recoveries PY Distri Min Asset RecoveriesPYDistriMinAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Total Minimum Asset TotalMinimumAssetGrp

Field	Value	IRS element (for citing)
Prior Year	$0	PriorYearAmt

Distributable Amount DistributableAmountGrp

Field	Value	IRS element (for citing)
CY Adj Net Income Distributable	$0	CYAdjNetIncomeDistributableAmt
CY Pct85 Adjusted Net Income	$0	CYPct85AdjustedNetIncomeAmt
CY Total Min Ast Distributable	$0	CYTotalMinAstDistributableAmt
CY Greater Adjusted Minimum	$0	CYGreaterAdjustedMinimumAmt
CY Income Tax Imposed PY	$0	CYIncomeTaxImposedPYAmt
CY Distributable As Adjusted	$0	CYDistributableAsAdjustedAmt

Distributions DistributionsGrp

Field	Value	IRS element (for citing)
CY Paid Accomplish Exempt Prps	$0	CYPaidAccomplishExemptPrpsAmt
CY Pd In Excess Income Activity	$0	CYPdInExcessIncomeActivityAmt
CY Administrative Expense Paid	$0	CYAdministrativeExpensePaidAmt
Exempt Use Assets Acquis Paid	$0	ExemptUseAssetsAcquisPaidAmt
Qualified Set Aside	$0	QualifiedSetAsideAmt
CY Other Distributions	$0	CYOtherDistributionsAmt
CY Total Annual Distributions	$0	CYTotalAnnualDistributionsAmt
CY Distri Attentive Suprt Org	$0	CYDistriAttentiveSuprtOrgAmt
CY Distributable As Adjusted	$0	CYDistributableAsAdjustedAmt
CY Distribution Yr	0	CYDistributionYrRt

Distribution Allocations DistributionAllocationsGrp

Field	Value	IRS element (for citing)
CY Distributable As Adjusted	$0	CYDistributableAsAdjustedAmt
Underdistributions	$0	UnderdistributionsAmt
Excess Distribution Cyov Yr4	$0	ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3	$0	ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2	$0	ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1	$0	ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov	$0	TotalExcessDistributionCyovAmt
Cyov Applied Underdistri PY	$0	CyovAppliedUnderdistriPYAmt
Cyov Applied Underdistr CPY	$0	CyovAppliedUnderdistrCPYAmt
Excess Distribution Cyov	$0	ExcessDistributionCyovAmt
CY Total Annual Distributions	$0	CYTotalAnnualDistributionsAmt
CY Distrib App Underdistri PY	$0	CYDistribAppUnderdistriPYAmt
Excess Distribution	$0	ExcessDistributionAmt
Remaining Underdistri PY	$0	RemainingUnderdistriPYAmt
Remaining Underdistri CY	$0	RemainingUnderdistriCYAmt
Excess Distri Cyov To Next Yr	$0	ExcessDistriCyovToNextYrAmt
Excess From Year5	$0	ExcessFromYear5Amt
Excess From Year4	$0	ExcessFromYear4Amt
Excess From Year3	$0	ExcessFromYear3Amt
Excess From Year2	$0	ExcessFromYear2Amt
Excess From Year1	$0	ExcessFromYear1Amt

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$963,629	OtherActivitiesAmt
Total Lobbying Expenditures	$963,629	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	Cape Cod Hospital and Falmouth Hospital Association, Inc. pay membership dues to the Massachusetts Hospital Association which engages in lobbying purposes as defined by Medicare. Per the MHA advisory, 90.14% of dues paid should be allocated to lobbying activity. MHA determined that of the 90.14%, 9.51% was related to federal lobbying and 80.63% was related to state-based lobbying. Please note that the increase in the percentage, as compared to previous years, was due primarily to MHA's activities surrounding the 2018 Massachusetts ballot question. The increase only impacted the FY 2018 dues that were paid to MHA in the fall of 2017. For FY18 for Cape Cod Hospital and Falmouth Hospital Association, Inc. combined, the lobbying portion equals $963,629.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$41,606,730	BeginningYearBalanceAmt
Contributions	$504,886	ContributionsAmt
Investment Earnings Or Losses	$1,353,728	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,014,678	OtherExpendituresAmt
End Year Balance	$42,450,666	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$38,809,089	BeginningYearBalanceAmt
Contributions	$30,699	ContributionsAmt
Investment Earnings Or Losses	$3,061,173	InvestmentEarningsOrLossesAmt
Other Expenditures	$759,148	OtherExpendituresAmt
Administrative Expenses	-$464,917	AdministrativeExpensesAmt
End Year Balance	$41,606,730	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$37,495,620	BeginningYearBalanceAmt
Contributions	$57,261	ContributionsAmt
Investment Earnings Or Losses	$2,000,285	InvestmentEarningsOrLossesAmt
Other Expenditures	$744,077	OtherExpendituresAmt
End Year Balance	$38,809,089	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$38,872,003	BeginningYearBalanceAmt
Contributions	$1,523,222	ContributionsAmt
Investment Earnings Or Losses	-$2,217,064	InvestmentEarningsOrLossesAmt
Other Expenditures	$682,541	OtherExpendituresAmt
End Year Balance	$37,495,620	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$36,060,986	BeginningYearBalanceAmt
Contributions	$1,925,651	ContributionsAmt
Investment Earnings Or Losses	$1,613,999	InvestmentEarningsOrLossesAmt
Other Expenditures	$728,633	OtherExpendituresAmt
End Year Balance	$38,872,003	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.80760	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.19240	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$23,627,542	OtherCostOrOtherBasisAmt
Book Value	$23,627,542	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$404,720,923	OtherCostOrOtherBasisAmt
Depreciation	$183,625,388	DepreciationAmt
Book Value	$221,095,535	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,024,463	OtherCostOrOtherBasisAmt
Depreciation	$1,748,550	DepreciationAmt
Book Value	$2,275,913	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$226,940,276	OtherCostOrOtherBasisAmt
Depreciation	$177,709,553	DepreciationAmt
Book Value	$49,230,723	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,134,256	OtherCostOrOtherBasisAmt
Depreciation	$922,115	DepreciationAmt
Book Value	$2,212,141	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$298,441,854	TotalBookValueLandBuildingsAmt
Financial Derivatives		FinancialDerivativesGrp
Closely Held Equity Interests		CloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (5 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
LONG-TERM INVESTMENTS	$417,657,717	F
FUNDS HELD UNDER BOND	$3,410,362	F
TEMP RESTRICTED INVESTMENTS	$24,888,547	F
PERM RESTRICTED INVESTMENTS	$33,785,042	F
SHORT TERM INVESTMENTS - FDN	$25,835,636	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$505,577,304	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp

Field	Value	IRS element (for citing)
Desc	DUE FROM AFFILIATES	Desc
Book Value	$54,989,486	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$54,989,486	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
DUE TO AFFILIATES	$26,643,493
EST. SETTLEMENTS W 3RD PARTIES	$19,778,364
OTHER CURRENT LIABILITIES	$808,193
ABANDONED PROPERTY	$185,604
INTEREST RATE SWAPS	$658,879

Field	Value	IRS element (for citing)
Total Liability	$48,074,533	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO FURTHER THE HEALTHCARE MISSION OF CAPE COD HEALTHCARE AND ITS AFFILIATES.
SCHEDULE D, PART X, LINE 2	THE ORGANIZATION DOES NOT HAVE A FIN 48 FOOTNOTE AS ANY UNCERTAIN TAX POSITIONS WERE DEEMED IMMATERIAL.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Offices	1	OfficesCnt
Type Of Activities Conducted	Program Services	TypeOfActivitiesConductedTxt
Specific Services Provided	CAPTIVE INSURANCE	SpecificServicesProvidedTxt
Region Total Expenditures	$2,957,963	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	1	SubtotalOfficesCnt
Total Office	1	TotalOfficeCnt
Subtotal Spent	$2,957,963	SubtotalSpentAmt
Total Spent	$2,957,963	TotalSpentAmt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	false	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE F, PART I, COLUMN F	FormAndLineReferenceDesc
Explanation	EXPENSES ARE CODED IN THE GENERAL LEDGER TO THE CAPTIVE INSURANCE COMPANY.	ExplanationTxt

Schedule G IRS990ScheduleG

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

Fundraiser Activity Info FundraiserActivityInfoGrp

Field	Value	IRS element (for citing)
Person	Borns GroupVDM	PersonNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	503 BROWN COUNTY 19N	AddressLine1Txt
City	ABERDEEN	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57401	ZIPCd

Field	Value	IRS element (for citing)
Activity	DIRECT MAIL	ActivityTxt
Fundraiser Control Of Funds	false	FundraiserControlOfFundsInd
Gross Receipts	$220,016	GrossReceiptsAmt
Retained By Contractor	$68,237	RetainedByContractorAmt
Net To Organization	$151,779	NetToOrganizationAmt

Field	Value	IRS element (for citing)
Total Gross Receipts	$220,016	TotalGrossReceiptsAmt
Total Retained By Contractors	$68,237	TotalRetainedByContractorsAmt
Total Net To Organization	$151,779	TotalNetToOrganizationAmt
Licensed States	CA	LicensedStatesCd
Licensed States	CT	LicensedStatesCd
Licensed States	FL	LicensedStatesCd
Licensed States	IL	LicensedStatesCd
Licensed States	KS	LicensedStatesCd
Licensed States	MA	LicensedStatesCd
Licensed States	MI	LicensedStatesCd
Licensed States	MO	LicensedStatesCd
Licensed States	NH	LicensedStatesCd
Licensed States	NJ	LicensedStatesCd
Licensed States	NY	LicensedStatesCd
Licensed States	NC	LicensedStatesCd
Licensed States	PA	LicensedStatesCd
Licensed States	RI	LicensedStatesCd
Licensed States	SC	LicensedStatesCd
Licensed States	WI	LicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GALA EVENT	Event1Nm
Gross Receipts Event1	$598,037	GrossReceiptsEvent1Amt
Charitable Contri Event1	$9,350	CharitableContriEvent1Amt
Gross Revenue Event1	$588,687	GrossRevenueEvent1Amt
Cash Prizes Event1	$0	CashPrizesEvent1Amt
Non Cash Prizes Event1	$43,000	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$6,800	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$74,539	FoodAndBeverageEvent1Amt
Entertainment Event1	$16,351	EntertainmentEvent1Amt
Other Direct Expenses Event1	$92,063	OtherDirectExpensesEvent1Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$598,037	GrossReceiptsTotalAmt
Charitable Contributions Tot	$9,350	CharitableContributionsTotAmt
Gross Revenue Total Events	$588,687	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$0	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$43,000	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$6,800	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$74,539	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$16,351	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$92,063	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$232,753	DirectExpenseSummaryEventsAmt
Net Income Summary	$355,934	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,681,622	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,121,069	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,560,553	NetCommunityBenefitExpnsAmt
Total Expense	0.00530	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$105,176,811	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$87,175,941	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$18,000,870	NetCommunityBenefitExpnsAmt
Total Expense	0.02110	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,286,642	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,366,669	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,919,973	NetCommunityBenefitExpnsAmt
Total Expense	0.00220	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$122,145,075	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$97,663,679	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$24,481,396	NetCommunityBenefitExpnsAmt
Total Expense	0.02860	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,642,379	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,642,379	NetCommunityBenefitExpnsAmt
Total Expense	0.00310	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,786,163	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$211,678	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,574,485	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$333,989,928	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$300,109,808	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$33,880,120	NetCommunityBenefitExpnsAmt
Total Expense	0.03960	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,078,867	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,078,867	NetCommunityBenefitExpnsAmt
Total Expense	0.00130	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$339,497,337	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$300,321,486	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$39,175,851	NetCommunityBenefitExpnsAmt
Total Expense	0.04580	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$461,642,412	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$397,985,165	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$63,657,247	NetCommunityBenefitExpnsAmt
Total Expense	0.07440	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$36,166	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$36,166	NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$705,572	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$705,572	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$741,738	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$741,738	NetCommunityBenefitExpnsAmt

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$14,392,093	BadDebtExpenseAmt
Bad Debt Expense Attributable	$9,003,313	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$278,629,043	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$260,616,527	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$18,012,516	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd
CAPE COD HOSPITAL
1	27 PARK STREET	HYANNIS	MA	02601	SEE PART V, SECTION C	2135	Yes (X)	Yes (X)	Yes (X)	A
FALMOUTH HOSPITAL ASSOCIATION INC
2	100 TER HEUN DRIVE	FALMOUTH	MA	02540	SEE PART V, SECTION C	2289	Yes (X)	Yes (X)	Yes (X)	A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
None Made	Yes (X)	NoneMadeInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION A	WEBSITES PART V, SECTION A, LINE 1 - CAPE COD HOSPITAL WWW.CAPECODHEALTH.ORG/LOCATIONS/CAPE-COD-HOSPITAL
PART V, SECTION A, LINE 2 - FALMOUTH HOSPITAL	WWW.CAPECODHEALTH.ORG/LOCATIONS/FALMOUTH-HOSPITAL
PART V, SECTION B, LINE 5	OVER 20 DATA SOURCES WERE UTILIZED TO COLLECT BARNSTABLE COUNTY AND TOWN-LEVEL HEALTH STATISTICS ON DISEASE INCIDENCE AND PREVALENCE, HOSPITAL UTILIZATION, MORBIDITY AND MORTALITY, BARRIERS TO ACCESSING CARE, AND BEHAVIORAL RISK FACTORS. REGIONAL STATISTICS WERE ANALYZED AND COMPARED TO STATE AND NATIONAL STATISTICS TO IDENTIFY WHERE DEMOGRAPHIC AND HEALTH DISPARITIES EXIST. ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL SELECTED JOHN SNOW, INC. (JSI) A PUBLIC HEALTH RESEARCH FIRM, TO CONDUCT PRIMARY RESEARCH INCLUDING HEALTH DATA RESEARCH, KEY INFORMANT INTERVIEWS AND FACILITATION OF COMMUNITY AND PROVIDER FORUMS. JSI INTERVIEWED OVER 25 REGIONAL LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY AND WHO OFFER INFORMATION OR EXPERTISE RELATIVE TO THE SIGNIFICANT HEALTH NEEDS OF VULNERABLE POPULATIONS. THEY INCLUDED SUCH ENTITIES AS MUNICIPAL PUBLIC HEALTH DEPARTMENTS,HUMAN SERVICE AGENCIES, SCHOOLS AND LAW ENFORCEMENT AGENCIES, FEDERALLY QUALIFIED HEALTH CENTERS,COMMUNITY ORGANIZATIONS SERVING LOW-INCOME, VULNERABLE AND MEDICALLY UNDERSERVED POPULATIONS, ELECTED OFFICIALS, AND HOSPITAL CLINICIANS AND ADMINISTRATORS. FIVE COMMUNITY INPUT FORUMS WERE HELD ACROSS BARNSTABLE COUNTY. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS ATTENDED. THESE FORUMS PROVIDED AN OPPORTUNITY TO PRESENT STATISTICAL HEALTH FINDINGS TO PARTICIPANTS AND IDENTIFY GAPS IN SERVICES. ADDITIONALLY, THE FORUMS FACILITATED DIALOGUE ON ISSUES NOT IDENTIFIED AND TARGET POPULATIONS MOST IMPACTED BY HEALTH ISSUES. A POST-FORUM SURVEY WAS PROVIDED TO PARTICIPANTS TO IDENTIFY AND RANK HEALTH PRIORITIES IN THE REGION. FEEDBACK AND INPUT FROM THE KEY INFORMANT INTERVIEWS AND FROM ATTENDEES OF THE COMMUNITY AND PROVIDER FORUMS WAS USED TO INFORM THE SELECTION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE COMMUNITY INPUT ACTIVITIES THROUGHOUT THE PHASES OF THE PROJECT: PUBLIC HEALTH EXPERTS, HEALTH CARE PROVIDERS AND HEALTH SERVICE ORGANIZATIONS AIDS SUPPORT GROUP OF CAPE COD ALZHEIMER'S FAMILY SUPPORT CENTER OF CAPE COD ARBOR COUNSELING SERVICES BARNSTABLE COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENT BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES BARNSTABLE COUNTY PUBLIC NURSING DIVISION CCHC EMERGENCY SERVICES CCHC CENTERS FOR BEHAVIORAL HEALTH CAPE & ISLANDS EMERGENCY MEDICAL SERVICES SYSTEM CARON TREATMENT CENTER COMMUNITY HEALTH CENTER OF CAPE COD DUFFY HEALTH CENTER EMERALD PHYSICIANS FALMOUTH HUMAN SERVICES GOSNOLD ON CAPE COD HARBOR COMMUNITY HEALTH CENTER-HYANNIS HOPE HEALTH HOPE DEMENTIA & ALZHEIMER'S SERVICES OF CAPE COD MASHPEE WAMPANOAG HEALTH SERVICE UNIT OUTER CAPE HEALTH SERVICES SPAULDING REHABILITATION HOSPITAL CAPE COD SPECIALTY NETWORK FOR THE UNINSURED TOWN OF BREWSTER HEALTH DEPARTMENT TOWN OF FALMOUTH HEALTH DEPARTMENT TOWN OF MASHPEE HUMAN SERVICES VINFEN VISITING NURSE ASSOCIATION OF CAPE COD ORGANIZATIONS SERVING LOW-INCOME, MEDICALLY UNDERSERVED OR VULNERABLE POPULATIONS: BARNSTABLE PUBLIC SCHOOL SYSTEM BOYS & GIRLS CLUB OF CAPE COD CAPE COD CENTER FOR WOMEN CAPE COD CHILD DEVELOPMENT CAPE COD COUNCIL OF CHURCHES CAPE COD WIC CAPE COD NEIGHBORHOOD SUPPORT COALITION CHILD AND FAMILY SERVICES COALITION FOR CHILDREN COMMUNITY ACTION COMMITTEE OF CAPE COD & THE ISLANDS CHILDREN'S COVE COMMUNITY DEVELOPMENT PARTNERSHIP ELDER SERVICES OF CAPE COD & THE ISLANDS FALMOUTH PUBLIC SCHOOL SYSTEM FALMOUTH SERVICE CENTER FALMOUTH TOGETHER WE CAN FALMOUTH VOLUNTEERS IN PUBLIC SCHOOLS THE FAMILY PANTRY OF CAPE COD GLENNA KOHL FUND FOR HOPE HEALTH IMPERATIVES HEALTHY LIVING CAPE COD HELPING OUR WOMEN HOMELESS PREVENTION COUNCIL HOUSING ASSISTANCE CORPORATION INDEPENDENCE HOUSE JUSTICE RESOURCE INSTITUTE LYME AWARENESS OF CAPE COD OUTER CAPE WOMEN INFANTS AND CHILDREN (WIC) MOTHER AND INFANT RECOVERY NETWORK NATIONAL ALLIANCE ON MENTAL ILLNESS CAPE COD SAMARITANS ON CAPE COD AND THE ISLANDS SANDPIPER NURSERY SCHOOL SANDWICH PUBLIC SCHOOL SYSTEM SHINE (SERVING HEALTH INFORMATION NEEDS OF EVERYONE) SIGHT LOSS SERVICES TOWN OF FALMOUTH COUNCIL ON AGING TOWN OF MASHPEE COUNCIL ON AGING TOWN OF PROVINCETOWN COUNCIL ON AGING TOWN OF SANDWICH COUNCIL ON AGING TOWN OF TRURO COUNCIL ON AGING WE CAN YMCA OF CAPE COD COUNTY, TOWN, OR MUNICIPAL ENTITIES AND REGIONAL TASK FORCES: CAPE & ISLANDS UNITED WA CAPE COD COMMUNITY COLLEGE CAPE COD DISTRICT ATTORNEY'S OFFICE CAPE COD FOUNDATION CAPE & ISLANDS SUICIDE PREVENTION COALITION YARMOUTH POLICE DEPARTMENT MA DEPARTMENT OF MENTAL HEALTH MA DEPARTMENT OF PUBLIC HEALTH MASHPEE WAMPANOAG TRIBE HEALTH SERVICES COMMUNITY HEALTH NETWORK AREA 27 BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS BARNSTABLE COUNTY REGIONAL SUBSTANCE ABUSE COUNCIL BARNSTABLE TOWN COUNCIL SUBSTANCE USE IN PREGNANCY TASK FORCE
PART V, SECTION B, LINE 6 (A)	CAPE COD HOSPITAL AND FALMOUTH HOSPITAL JOINTLY CONDUCTED THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORT.
PART V, SECTION B, LINE 7(A)	https://www.capecodhealth.org/about/caring-for-our-community/community-hea lth-needs-assessment-implementation-plans/
PART V, SECTION B, LINE 10(A)	https://www.capecodhealth.org/about/caring-for-our-community/community-hea lth-needs-assessment-implementation-plans/
PART V, SECTION B, LINE 11	THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDE CHRONIC AND INFECTIOUS DISEASE, BEHAVIORAL HEALTH, ACCESS TO CARE AND DISEASE PREVENTION AND WELLNESS. CAPE COD HOSPITAL (CCH) AND FALMOUTH HOSPITAL (FH) WILL ADDRESS THESE SPECIFIC ISSUES THROUGH A COMPREHENSIVE SET OF IMPLEMENTATION STRATEGIES THAT INCLUDE HOSPITAL-BASED PROGRAMS, COLLABORATIVE EFFORTS WITH NUMEROUS REGIONAL HEALTH PARTNERS AND PROVIDING GRANTS TO COMMUNITY BASED ORGANIZATIONS WITH INITIATIVES THAT ALIGN WITH COMMUNITY HEALTH IMPROVEMENT STRATEGIES. THREE SPECIFIC ISSUES IDENTIFIED THROUGH THE ASSESSMENT FALL OUTSIDE OF THE CORE COMPETENCIES OF THE HOSPITALS AND WERE NOT INCLUDED IN THE CCH AND FH IMPLEMENTATION STRATEGIES. THE ISSUES ARE TRANSPORTATION, HOUSING AND HOMELESSNESS, AND EMPLOYMENT. THESE ISSUES ARE LONG-STANDING REGIONAL CHALLENGES AND WERE IDENTIFIED IN THE PREVIOUS CHNA AS ISSUES OUTSIDE THE SCOPE OF SIGNIFICANT HEALTH NEEDS THAT THE HOSPITALS CAN REASONABLY ADDRESS. RESIDENTS IMPACTED BY THESE ISSUES WILL BE SERVED BY THE HOSPITALS SINCE IT IS THEIR MISSION TO SERVE ALL WITHOUT REGARD TO SEX, RACE, CREED, RESIDENCE, NATIONAL ORIGIN, SEXUAL ORIENTATION, OR ABILITY TO PAY. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL RECOGNIZE THAT THERE ARE REGIONAL ENTITIES WITH THE CORE COMPETENCIES, KNOWLEDGE, STAFF AND FUNDING SOURCES TO SPECIFICALLY ADDRESS THE ISSUES OF TRANSPORTATION, HOUSING AND HOMELESSNESS, AND EMPLOYMENT. THE HOSPITALS WILL COLLABORATE ON ACTIVITIES THAT ARE LED BY THE APPROPRIATE AGENCIES.
PART V, SECTION B, LINE 13(B)	IN SOME CASES, THE MASSACHUSETTS HEALTHCONNECTOR CALCULATOR OR MODIFIED ADJUSTED GROSS INCOME IS USED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY.
PART V, SECTION B, LINE 13(H)	STATE REGULATIONS
PART V, SECTION B, LINE 16(A), 16(B), 16(C)	HTTPS://WWW.CAPECODHEALTH.ORG/PATIENTS-VISITORS/PAYING-FOR-CARE/FINANCIAL- ASSISTANCE/

Field	Value	IRS element (for citing)
Facility	83	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (83 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Visiting Nurse Association of Cape Cod
255 Independence Drive	Hyannis	MA	02601	home health
CAPE COD HEALTHCARE INC
297 NORTH STREET BLDG 3	HYANNIS	MA	02601	ADMINISTRATIVE
Fontaine Medical Center
525 Long Pond Drive	HARWICH	MA	02645	medical group practice
CAPE COD HEALTHCARE NEUROSURGER
46 NORTH ST STE 4	HYANNIS	MA	02601	medical group practice
Bramblebush Medical Group
21 Bramblebush Park	FALMOUTH	MA	02540	medical group practice
Seaside Pediatrics
150 Ansel Hallet Road	West Yarmouth	MA	02673	medical group practice
Manning Jr William J MD
700 Attucks Lane Suite 1A	HYANNIS	MA	02601	medical group practice
Fontaine OUTPATIENT CENTER
525 Long Pond Drive	Harwich	MA	02645	medical group practice
Guo X Y David MD PhD-GASTROENTEROLOGY
90 TER HEUN DRIVE STE 302	Falmouth	MA	02540	medical group practice
BAYSIDE INTERNAL MEDICINE
2 Jan Sebastian Way Suite 100	Sandwich	MA	02563	medical group practice
SHAPIRO GARY& YAMIN JUSTIN MD-GASTRO
700 ATTUCKS LANE STE 1C	Hyannis	MA	02601	medical group practice
Theodore A Calianos II MD-PL&RECON
160 Falmouth Road Suite B	MASHPEE	MA	02649	medical group practice
CAPE COD OBSTETRICS & GYNECOLOGY
90 Ter Heun Drive SUITE 100	Falmouth	MA	02540	medical group practice
Chatham Medical Group
1629 Main Street	Chatham	MA	02633	medical group practice
Endocrine Center of Cape Cod
1030 FALMOUTH RD STE 201	Hyannis	MA	02601	medical group practice
Fal Specialty Care Practice
90 Ter Heun Drive Suite 302	Falmouth	MA	02540	medical group practice
NEUROLOGISTS OF CAPE COD
46 North Street SUITE 7	Hyannis	MA	02601	medical group practice
Nauset Family Practice
81 Old Colony Way STE D	ORLEANS	MA	02653	medical group practice
Devin McManus Medical Practice
10 BrambleBush Drive	FALMOUTH	MA	02540	medical group practice
Cape Health Insurance Company - FOREIGN
297 NORTH ST 3	HYANNIS	MA	02601	administrative
Healthcare Foundation
32 MAIN STREET	Hyannis	MA	02601	administrative
Healthcare Foundation
348 GIFFORD ST STE 4	FALMOUTH	MA	02540	ADMINISTRATIVE
JML Care Center
184 Ter Heun Drive	falmouth	MA	02540	skilled nur & rehab
Cape & Islands Health Services II
14 Yellow Brick Road	HYANNIS	MA	02601	COLLECTION CENTER
Cape & Islands Health Services II
5 Industrial Drive Suite 102	MASHPEE	MA	02649	COLLECTION CENTER
Cape & Islands Health Services II
200 Jones Road	FALMOUTH	MA	02540	COLLECTION CENTER
Cape & Islands Health Services II
525 Long Pond Drive	HARWICH	MA	02645	COLLECTION CENTER
Cape & Islands Health Services II
81 Old Colony Way	ORLEANS	MA	02653	COLLECTION CENTER
Cape & Islands Health Services II
2 Jan Sebastian Way Route 130	SANDWICH	MA	02563	COLLECTION CENTER
Cape & Islands Health Services II
860 Route 134 Unit 2	South Dennis	MA	02660	COLLECTION CENTER
Cape & Islands Health Services II
1 Trowbridge Road	Bourne	MA	02532	COLLECTION CENTER
Cape & Islands Health Services II
68B Route 6A	SANDWICH	MA	02563	COLLECTION CENTER
Cape & Islands Health Services II
1629 MAIN STREET	CHATHAM	MA	02633	COLLECTION CENTER
Cape & Islands Health Services II
27 PARK STREET	HYANNIS	MA	02601	COLLECTION CENTER
Heritage at Falmouth
140 Ter Heun Drive	FALMOUTH	MA	02540	ASSISTED LIVING
Cape Cod Human Services
460 West Main Street	HYANNIS	MA	02601	outpatient clinic
Cape Cod Human Services
525 Long Pond Drive	HARWICH	MA	02645	outpatient clinic
Cape Cod Medical Office Building Inc
20 Gleason Street	HYANNIS	MA	02601	administrative
Orleans Medical CENTER
204 Main Street	Orleans	MA	02653	Medical Group Practice
CAPE COD Dermatology
150 Ansel Hallett Road	W Yarmouth	MA	02673	Medical Group Practice
Cape Cod Rheumatology Center
1030 FALMOUTH RD STE 201	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
CCHC Cardiovascular Center
25 Main Street	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
Ziad Farah MD-Fontaine Medical Center
525 Long Pond Drive	HARWICH	MA	02645	MEDICAL GROUP PRACTICE
Fontaine Urgent Care Center
525 Long Pond Drive	HARWICH	MA	02645	MEDICAL GROUP PRACTICE
Park Street Primary Care
62 Park Street	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
Sandwich Medical Group
STONEMAN OUTPATIENT2 Jan Sebastian	SANDWICH	MA	02563	MEDICAL GROUP PRACTICE
Sandwich Primary Care
2 JAN SEBASTIAN WAY SUITE 202	SANDWICH	MA	02563	MEDICAL GROUP PRACTICE
Upper Cape Orthopedics
26 Edgerton Drive Suite C	NORTH FALMOUTH	MA	02556	MEDICAL GROUP PRACTICE
Michael Barnett MD Practice
348 Gifford Street	FALMOUTH	MA	02540	MEDICAL GROUP PRACTICE
Vascular And Vein Center Of Cape Cod
90 Ter Heun Drive 3RD Fl MOB STE	Falmouth	MA	02540	Medical Group Practice
CCHC General & Specialty Surgery
105 Park Street	Hyannis	MA	02601	Medical Group Practice
Cape Cod Sports Medicine
360 Gifford Street Unit 2B	Falmouth	MA	02540	Medical Group Practice
CARDIOVASCULAR CENTER - FALMOUTH
90 TER HEUN DRIVE SUITE 300	FALMOUTH	MA	02540	Medical Group Practice
GASTROENTEROLOGY HYANNIS - PARK STREET
105 PARK STREET	HYANNIS	MA	02601	Medical Group Practice
STONEMAN OUTPATIENT CENTER - URGENT CARE
2 JAN SEBASTIAN DRIVE SUITE 101	SANDWICH	MA	02563	Medical Group Practice
MASHPEE SURGICAL CENTER
160 FALMOUTH ROAD	MASHPEE	MA	02649	MEDICAL GROUP PRACTICE
SOUTHEASTERN SURGICAL ASSOCIATES
100 CAMP STREET	HYANNIS	MA	02601	MEIDCAL GROUP PRACTICE
FALMOUTH URGENT CARE
273 TEATICKET HIGHWAY	FALMOUTH	MA	02536	MEDICAL GROUP PRACTICE
HYANNIS URGENT CARE
1220 IYANNOUGH ROAD	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
UPPER CAPE EAR NOSE THROAT
200 A JONES ROAD	FALMOUTH	MA	02540	MEDICAL GROUP PRACTICE
ORTHOPEDIC SPECIALISTS
5 BRAMBLEBUSH DRIVE	FALMOUTH	MA	02540	MEDICAL GROUP PRACTICE
CCHC DEMENTIA&ALZHEIMER'S CAREGIVER SUPP
4 BAYVIEW ST	WEST YARMOUTH	MA	02673	ADMINISTRATIVE
CCHC PODIATRIC MEDICINE & FOOT SURGERY
1030 FALMOUTH RD 202	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
IDCS-INFECTIOUS DISEASE CLINICAL SERV
34 PARK ST	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
CCH OBGYN SATELLITE
60A PARK ST	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
MACCMSSP REFERRAL DEPT
25 COMMUNICATION WAY	HYANNIS	MA	02601	ADMINISTRATIVE
DIABETIC EDUCATION
22 LEWIS BAY RD STE 102	HYANNIS	MA	02601	EDUCATIONAL
DIABETIC EDUCATION
1629 MAIN ST	CHATHAM	MA	02633	EDUCATIONAL
TRADEWINDS ADULT DAY HEALTH OF VNA OF CC
290 ROUTE 130	SANDWICH	MA	02563	ADULT DAY HEALTH
COMPASS ADULT DAY HEALTH
1 AUSTON RD F	HARWICH	MA	02645	ADULT DAY HEALTH
VNA OF CAPE COD - EASTHAM
3960 STATE HWY RD 6 2	EASTHAM	MA	02642	HOME HEALTH
VNA OF CAPE COD - FALMOUTH
67 TER HEUN DR	FALMOUTH	MA	02540	HOME HEALTH
VNA OF CAPE COD - MARTHA'S VINEYARD
49 STATE RD	VINEYARD HAVEN	MA	02568	HOME HEALTH
VNA OF CAPE COD - NANTUCKET
2 SANFORD RD 2	NANTUCKET	MA	02554	HOME HEALTH
VNA OF CAPE COD -PLYMOUTH
57 OBERY ST U3	PLYMOUTH	MA	02360	HOME HEALTH
VNA OF CAPE COD - PROVINCETOWN
26 ALDEN ST	PROVINCETOWN	MA	02657	HOME HEALTH
VNA OF CAPE COD - SOUTH DENNIS
434 ROUTE 134 BLDG D 3	SOUTH DENNIS	MA	02660	HOME HEALTH
VNA OF CAPE COD - WAREHAM
185 MAIN ST	WAREHAM	MA	02571	HOME HEALTH
VNA THRIFTIQUE
1074 RTE 28	SOUTH YARMOUTH	MA	02664	THRIFT STORE
CCH THRIFT STORE
690 MAIN ST	HYANNIS	MA	02601	THRIFT STORE
CAPE & ISLANDS HEALTH SERVICES II
35 WILKENS LANE	HYANNIS	MA	02601	COLLECTION CENTER
ORLEANS MEDICAL CENTER
204 MAIN ST	ORLEANS	MA	02653	OUTPATIENT CLINIC
CAPE COD RESEARCH INSTITUTE
27 PARK ST	HYANNIS	MA	02601	RESEARCH

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C	N/A
PART I, LINE 6A	N/A
PART I, LINE 7, COLUMN F	THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F WAS $ 14,392,093. THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AND BY FOLLOWING THE FORM 990, SCHEDULE H INSTRUCTIONS. THE TOTAL PERCENTAGE OF CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST IN THE TABLE WAS CALCULATED ON A GROUP RETURN BASIS AS REQUIRED BY THE FORM 990 INSTRUCTIONS, AND NOT ON A HOSPITAL-ONLY BASIS.
PART II LINE 6 AND LINE 8	COALITION BUILDING Cape Cod Healthcare clinical, Community Benefits and support staff participated in a variety of coalition building activities within the service area to address and improve care related to women's health, behavioral health, chronic and infectious disease prevention and management and substance use and misuse in the region. Regional coalitions serve as alliances for combined and coordinated action to improve key health issues. Coalition activities ranged from implementation of new programs to offering community trainings and educational on important health topics to the development of multi-sector partnerships. WORKFORCE DEVELOPMENT CAPE COD HEALTHCARE'S PHYSICIAN RECRUITMENT PROGRAM STRIVES TO IDENTIFY AREAS OF UNMET NEED AND IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE FOR VULNERABLE POPULATIONS, ESPECIALLY THOSE OVER 65 WITH PUBLIC HEALTH INSURANCE COVERAGE. THROUGH RIGOROUS EFFORTS HIGHLY QUALIFIED PHYSICIANS AND PHYSICIAN EXTENDERS ARE RECRUITED AND RETAINED TO MEET THE HEALTH CARE NEEDS OF RESIDENTS OF CAPE COD.
PART III, LINES 2-3	THE ORGANIZATION IS REPORTING $9,003,313 OF BAD DEBT EXPENSE THAT MEETS ITS FINANCIAL ASSISTANCE POLICY. THIS AMOUNT IS RELATED TO BAD DEBT FROM BOTH HOSPITALS DURING FY18 OF UNINSURED PATIENTS WHO WERE SEEN IN THE ER AND RECEIVED MEDICALLY NECESSARY SERVICES. CAPE COD HEALTHCARE RECEIVES PAYMENTS FOR SERVICES RENDERED FROM FEDERAL AND STATE AGENCIES (UNDER THE MEDICARE AND MEDICAID PROGRAMS), MANAGED CARE PAYORS, COMMERCIAL INSURANCE COMPANIES, AND PATIENTS. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF CONTRACTUAL ALLOWANCES AND RESERVES FOR DENIALS, UNCOMPENSATED CARE, AND DOUBTFUL ACCOUNTS. THE LEVEL OF RESERVES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL AND PRIVATE EMPLOYER HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. IF A PATIENT IS INELIGIBLE FOR CHARITY CARE BECAUSE HIS OR HER INCOME EXCEEDS THE ELIGIBILITY GUIDELINES, ANY UNCOLLECTIBLE ACCOUNTS RECEIVABLE BALANCE IS WRITTEN OFF TO BAD DEBT AS REPORTED IN PART III, LINE 2.
PART III, LINE 4	REFER TO PAGES 14-15 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR FOOTNOTES RELATED TO ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BAD DEBT.
PART III LINE 9(B)	HOSPITAL FINANCIAL ASSISTANCE PROGRAMS PATIENTS WHO ARE ELIGIBLE FOR ENROLLMENT IN A STATE PUBLIC ASSISTANCE PROGRAM, LIKE THE MASSACHUSETTS MASSHEALTH OR HEALTH SAFETY NET PROGRAMS, ARE DEEMED ENROLLED IN A FINANCIAL ASSISTANCE PROGRAM. FOR ALL PATIENTS THAT ARE ENROLLED IN THESE STATE PUBLIC ASSISTANCE PROGRAMS, THE HOSPITAL MAY ONLY BILL THOSE PATIENTS FOR THE SPECIFIC CO-PAYMENT, CO-INSURANCE, OR DEDUCTIBLE THAT IS OUTLINED IN THE APPLICABLE STATE REGULATIONS AND WHICH MAY FURTHER BE INDICATED ON THE STATE MEDICAID MANAGEMENT INFORMATION SYSTEM. THE HOSPITAL WILL SEEK A SPECIFIED PAYMENT FOR THOSE PATIENTS THAT DO NOT QUALIFY FOR ENROLLMENT IN A MASSACHUSETTS STATE PUBLIC ASSISTANCE SUCH AS OUT-OF-STATE RESIDENTS, BUT WHO MAY OTHERWISE MEET THE GENERAL FINANCIAL ELIGIBILITY CATEGORIES OF A STATE PUBLIC ASSISTANCE PROGRAM. FOR THESE PATIENTS, THE PAYMENT AMOUNT WILL BE SET AT THE HOSPITAL, WHEN REQUESTED BY THE PATIENT AND BASED ON AN INTERNAL REVIEW OF EACH PATIENT'S FINANCIAL STATUS, MAY OFFER A PATIENT AN ADDITIONAL DISCOUNT ON AN UNPAID BILL. ANY SUCH REVIEW SHALL BE PART OF A SEPARATE HOSPITAL FINANCIAL ASSISTANCE PROGRAM THAT IS APPLIED ON A UNIFORM BASIS TO PATIENTS, AND WHICH TAKES INTO CONSIDERATION THE PATIENT'S DOCUMENTED FINANCIAL SITUATION AND THE PATIENT'S INABILITY TO MAKE A PAYMENT AFTER REASONABLE COLLECTION ACTIONS. ANY DISCOUNT THAT IS PROVIDED BY THE HOSPITAL IS CONSISTENT WITH FEDERAL AND STATE REQUIREMENTS, AND DOES NOT INFLUENCE A PATIENT TO RECEIVE SERVICES FROM THE HOSPITAL. POPULATIONS EXEMPT FROM COLLECTION ACTIVITIES: THERE ARE SEVERAL SITUATIONS WHERE A PATIENT CAN BE EXEMPTED FROM FURTHER BILLING AND COLLECTION PROCEDURES ONCE THE DETERMINATION IS MADE THAT THE PATIENT IS EXEMPT PURSUANT TO STATE REGULATIONS: A) PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, OR DESIGNATED A "LOW INCOME PATIENT" BY THE OFFICE OF MEDICAID, SUBJECT TO THE FOLLOWING EXCEPTIONS: (I) THE HOSPITAL MAY SEEK TO BILL AND COLLECT THE CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM. (II) THE HOSPITAL MAY ALSO INITIATE BILLING AND COLLECTION EFFORTS FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, (INCLUDING RECEIPT OR VERIFICATION OF THE SIGNED APPLICATION) THE HOSPITAL SHALL CEASE ITS BILLING AND COLLECTION ACTIVITIES. (III) THE HOSPITAL WILL NOT CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED BY THE HOSPITAL DURING THE PERIOD FOR WHICH HE OR SHE HAS BEEN DETERMINED TO BE A LOW INCOME PATIENT BY THE OFFICE OF MEDICAID. HOWEVER, THE HOSPITAL MAY CONTINUE COLLECTION ACTION ON A LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED, EXPIRED, OR NOT OTHERWISE IDENTIFIED ON THE STATE'S VIRTUAL GATEWAY OR RECIPIENT ELIGIBILITY VERIFICATION SYSTEM. ONCE A LOW INCOME PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN COMMONWEALTH CARE PROGRAMS, THE HOSPITAL WILL CEASE ITS BILLING AND COLLECTION EFFORTS FOR SERVICES PROVIDED PRIOR TO THE BEGINNING OF THEIR ELIGIBILITY. (IV) THE HOSPITALS 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.
PART VI, LINE 2	NEEDS ASSESSMENT: THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT (CHNA REPORT) AND IMPLEMENTATION PLAN WAS RELEASED AND MADE WIDELY AVAILABLE TO THE PUBLIC ON SEPTEMBER 30, 2016. THE GOALS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROJECT ARE TO MONITOR REGIONAL HEALTH DATA, ENGAGE HOSPITAL STAKEHOLDERS, PROMOTE PARTNERSHIPS BETWEEN THE HOSPITALS AND COMMUNITY ORGANIZATIONS AND DEVELOP MULTI-YEAR IMPLEMENTATION STRATEGIES TO GUIDE HOSPITAL INITIATIVES TO IMPROVE THE HEALTH OF BARNSTABLE COUNTY RESIDENTS. THE METHODOLOGY FOR CONDUCTING THE ASSESSMENT INCLUDED THE COLLECTION AND ANALYSIS OF PRIMARY AND SECONDARY HEALTH DATA, GATHERING SIGNIFICANT INPUT FROM THE COMMUNITY, AND THE IDENTIFICATION AND PRIORITIZATION OF KEY HEALTH NEEDS FOR THE REGION. OVER 20 DATA SOURCES WERE UTILIZED TO COLLECT BARNSTABLE COUNTY AND TOWN-LEVEL HEALTH STATISTICS ON DISEASE INCIDENCE AND PREVALENCE, HOSPITAL UTILIZATION, MORBIDITY AND MORTALITY, BARRIERS TO ACCESSING CARE, AND BEHAVIORAL RISK FACTORS. REGIONAL STATISTICS WERE ANALYZED AND COMPARED TO STATE AND NATIONAL STATISTICS TO IDENTIFY WHERE DEMOGRAPHIC AND HEALTH DISPARITIES EXIST. ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS REPRESENTING LOW-INCOME, MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS PROVIDED CRITICAL INSIGHT AND FEEDBACK ON THE REGIONAL HEALTH NEEDS THROUGH KEY INFORMATION INTERVIEWS AND COMMUNITY INPUT FORUMS. THROUGH THIS COLLECTION OF DATA AND COMMUNITY INPUT THE SIGNIFICANT HEALTH NEEDS OF BARNSTABLE COUNTY RESIDENTS WERE DISTINGUISHED AND PRIORITIZED BASED ON THE FREQUENCY, URGENCY, SCOPE, SEVERITY AND MAGNITUDE OF THE IDENTIFIED ISSUES. THE SIGNIFICANT HEALTH NEEDS AND ASSOCIATED TARGET POPULATIONS IDENTIFIED THROUGH THE CHNA REPORT WILL SERVE AS THE FOUNDATION FOR COMMUNITY BENEFITS AND HOSPITAL PLANNING SPANNING FISCAL YEARS 2017-2019. THE FOLLOWING SOURCES WERE UTILIZED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTS: - CAPE COD HOSPITAL AND FALMOUTH HOSPITAL UTILIZATION DATA - BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES: ANALYSIS OF SUBSTANCE ABUSE ON CAPE COD, A BASELINE ASSESSMENT, BARNSTABLE COUNTY BEHAVIORAL HEALTH WEB PORTAL, BARNSTABLE COUNTY PUBLIC HEALTH AND WELLNESS WEB PORTAL - CAPE COD FOUNDATION CONNECT CAPE COD - UNIVERSITY OF MASSACHUSETTS (UMASS) DONAHUE INSTITUTE LONG-TERM PROJECTIONS FOR MASSACHUSETTS REGIONAL AND MUNICIPALITIES - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH: MASSACHUSETTS COMMUNITY HEALTH INFORMATION PROFILE (MASS CHIP), MASSACHUSETTS BEHAVIORAL HEALTH RISK FACTOR SURVEILLANCE SYSTEM - US CENSUS BUREAU: US CENSUS 2010, AMERICAN COMMUNITY SURVEY ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL SELECTED JOHN SNOW, INC. (JSI) A PUBLIC HEALTH RESEARCH FIRM, TO CONDUCT PRIMARY RESEARCH INCLUDING HEALTH DATA RESEARCH, KEY INFORMANT INTERVIEWS AND FACILITATION OF COMMUNITY AND PROVIDER FORUMS. JSI INTERVIEWED OVER 25 REGIONAL LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY AND WHO OFFER INFORMATION OR EXPERTISE RELATIVE TO THE SIGNIFICANT HEALTH NEEDS OF VULNERABLE POPULATIONS. THEY INCLUDED SUCH ENTITIES AS MUNICIPAL PUBLIC HEALTH DEPARTMENTS, HUMAN SERVICE AGENCIES,SCHOOLS AND LAW ENFORCEMENT AGENCIES, FEDERALLY QUALIFIED HEALTH CENTERS, COMMUNITY ORGANIZATIONS SERVING LOW-INCOME, VULNERABLE AND MEDICALLY UNDERSERVED POPULATIONS, ELECTED OFFICIALS, AND HOSPITAL CLINICIANS AND ADMINISTRATORS. FIVE COMMUNITY INPUT FORUMS WERE HELD ACROSS BARNSTABLE COUNTY. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS ATTENDED. THESE FORUMS PROVIDED AN OPPORTUNITY TO PRESENT STATISTICAL HEALTH FINDINGS TO PARTICIPANTS AND IDENTIFY GAPS IN SERVICES. ADDITIONALLY, THE FORUMS FACILITATED DIALOGUE ON ISSUES NOT IDENTIFIED AND TARGET POPULATIONS MOST IMPACTED BY HEALTH ISSUES. A POST-FORUM SURVEY WAS PROVIDED TO PARTICIPANTS TO IDENTIFY AND RANK HEALTH PRIORITIES IN THE REGION. FEEDBACK AND INPUT FROM THE KEY INFORMANT INTERVIEWS AND FROM ATTENDEES OF THE COMMUNITY AND PROVIDER FORUMS WAS USED TO INFORM THE SELECTION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS.
PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FOR THOSE PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER THEIR UNPAID HOSPITAL BILLS. IN ORDER TO ASSIST UNINSURED AND UNDERINSURED PATIENTS IN FINDING AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES POSTED THROUGHOUT THE HOSPITAL. THE GOAL OF THESE NOTICES IS TO INFORM PATIENTS THAT THEY MAY BE ELIGIBLE TO APPLY FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM, SUCH AS, BUT NOT LIMITED TO, MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET. THE HOSPITAL WILL PROVIDE, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE DESIGNATED A LOW INCOME PATIENT UNDER EITHER THE STATE HEALTH SAFETY NET PROGRAM OR THROUGH THE HOSPITAL'S OWN INTERNAL CHARITY CARE PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT PAYMENT PLANS THAT MAY BE AVAILABLE TO HIM OR HER BASED ON THE SIZE OF HIS OR HER FAMILY AND FAMILY INCOME.
PART VI, LINE 4	DEMOGRAPHICS OF THE SERVICE AREA CAPE COD HEALTHCARE IS THE COMMUNITY SAFETY-NET PROVIDER OF HEALTH CARE SERVICES FOR THE YEAR-ROUND RESIDENTS AND MILLIONS OF ANNUAL VISITORS TO BARNSTABLE COUNTY, ALSO KNOWN AS "CAPE COD." CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, THE ONLY TWO ACUTE-CARE, NON-PROFIT HOSPITALS IN THE REGION, TOGETHER SHARE THE 15 TOWNS OF BARNSTABLE COUNTY AS THEIR PRIMARY SERVICE AREA. THE UPPER CAPE REGION INCLUDES THE MASHPEE WAMPANOAG TRIBAL REGION. CAPE COD HOSPITAL, LOCATED IN HYANNIS, MA, IS A 259-BED ACUTE-CARE, NON-PROFIT HOSPITAL. FALMOUTH HOSPITAL, LOCATED IN FALMOUTH, MA, IS A 95-BED ACUTE-CARE, NON-PROFIT HOSPITAL. BARNSTABLE COUNTY IS A GEOGRAPHICALLY ISOLATED REGION LOCATED ON THE EASTERN SEABOARD OF MASSACHUSETTS. THE NARROW PENINSULA SPANS OVER 70 MILES IN LENGTH AND HOSTS A YEAR-ROUND POPULATION OF 215,449 RESIDENTS. BARNSTABLE COUNTY CONSISTS OF 15 TOWNS THAT VARY IN YEAR-ROUND POPULATION SIZE FROM ABOUT 45,000 RESIDENTS (BARNSTABLE) TO SLIGHTLY MORE THAN 1,700 RESIDENTS (TRURO). IN ADDITION TO SERVING YEAR-ROUND RESIDENTS,THE REGIONAL COMMUNITY INFRASTRUCTURE, INCLUDING CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, MUST MEET THE DEMANDS OF A SIGNIFICANT INFLUX OF SEASONAL RESIDENTS AND VISITORS EACH YEAR. THE CAPE COD COMMISSION PRODUCED ESTIMATES, USING SURVEY DATA FROM SECOND HOMEOWNERS TO INDICATE THAT THE POPULATION OF SUMMER RESIDENTS ON CAPE COD, WHEN AVERAGED OVER A FULL YEAR, IS EQUIVALENT TO AN ADDITIONAL 68,856 FULL-TIME RESIDENTS. THIS COUPLED WITH DAY VISITORS AND SHORT TERM TRAVELER VOLUME RESULTS IN AN ESTIMATED 7 MILLION VISITORS AND RESIDENTS ON CAPE COD IN A GIVEN SUMMER SEASON. THIS SEASONAL POPULATION EXPANSION AND CONTRACTION CREATES UNIQUE CHALLENGES FOR THE CAPE'S HEALTH CARE SYSTEM, TRANSPORTATION NETWORK, WORKFORCE, BUSINESS COMMUNITY, AND HOUSING MARKET. POPULATION TRENDS AND AGE DEMOGRAPHIC ANALYSIS REVEALS TWO STRIKING TRENDS THAT WILL IMPACT BARNSTABLE COUNTY IN THE NEAR FUTURE. CURRENT DATA AND FUTURE DEMOGRAPHIC PREDICTIONS FOR THE REGION DEMONSTRATE THAT BARNSTABLE COUNTY'S OVERALL POPULATION IS DECLINING AND INCREASING IN AGE. ACCORDING TO THE LONG-TERM POPULATION PROJECTIONS FOR MASSACHUSETTS REGIONS AND MUNICIPALITIES, A PUBLICATION BY THE UMASS DONAHUE INSTITUTE, ALL REGIONS IN MA WILL EXPERIENCE POSITIVE POPULATION GROWTH FROM 2010-2035 EXCEPT FOR BARNSTABLE COUNTY AND THE ISLANDS OF NANTUCKET AND MARTHA'S VINEYARD. A PROJECTED NET LOSS OF 13% OF THE OVERALL POPULATION OF BARNSTABLE COUNTY IS PREDICTED BETWEEN 2010 AND 2035. BY 2035, THE TOTAL YEAR-ROUND POPULATION IS EXPECTED TO DECREASE TO APPROXIMATELY 188,000 RESIDENTS, A POPULATION SIMILAR TO HISTORIC 1990 NUMBERS. THIS DECLINE IS ATTRIBUTED TO TWO FACTORS, AN OUTFLOW OF YOUNG PEOPLE FROM THE REGION, AND DEATHS CONTINUING TO OUTNUMBER BIRTHS. IN ADDITION TO THE DECLINING POPULATION, THE YEAR-ROUND POPULATION OF BARNSTABLE COUNTY WILL CONTINUE TO HAVE A SIGNIFICANTLY LARGER PROPORTION OF SENIORS OVER THE AGE OF 65 THAN THE STATE OF MASSACHUSETTS (MA) AND THE UNITED STATES (U.S.). ACCORDING TO 2009-2013 AMERICAN COMMUNITY SURVEY ESTIMATES, NEARLY 26% OF THE YEAR-ROUND POPULATION OF BARNSTABLE COUNTY IS OVER THE AGE OF 65 COMPARED TO 14% IN MA AND 13% IN THE U.S. IT IS PREDICTED THAT BY THE YEAR 2035, NEARLY 35% OF THE POPULATION OF BARNSTABLE COUNTY WILL BE OVER THE AGE OF 65.4. IN MA, 58% OF THE OVERALL POPULATION IS COMPRISED OF RESIDENTS BETWEEN THE AGES OF 0-44 YEARS COMPARED TO ONLY 42% IN BARNSTABLE COUNTY. 'BABY BOOMERS', WHO ARE CURRENTLY INCLUDED IN THE AGE BRACKET OF 45 TO 64 YEAR-OLD RESIDENTS, REPRESENT AN ADDITIONAL 32% OF THE CAPE'S POPULATION. THESE COMBINED POPULATION STATISTICS SKEW BARNSTABLE COUNTY'S MEDIAN AGE TO OVER 50 YEARS OLD, THE HIGHEST FOR ALL COUNTIES IN MASSACHUSETTS. THIS IS MORE THAN A DECADE OLDER THAN THE MA MEDIAN AGE OF 39 YEARS AND THE U.S. MEDIAN AGE OF 37 YEARS. A COMMON THEME DISCUSSED IN STAKEHOLDER INTERVIEWS AND COMMUNITY/PROVIDER FORUMS WAS THAT PERSONS OVER THE AGE OF 65 AND YOUTH (15-24 YEARS OLD)REPRESENTED TWO OF THE MOST VULNERABLE POPULATIONS IN THE SERVICE AREA.YOUTH WERE IDENTIFIED AS A TARGET POPULATION DUE TO CONCERNS RELATED TO EARLY ONSET OF MENTAL HEALTH CONDITIONS, SUBSTANCE USE AND RISKY HEALTH BEHAVIORS. BARNSTABLE COUNTY'S GENDER DEMOGRAPHICS MIRROR THOSE OF MA; 52% OF RESIDENTS ARE FEMALE AND 48% ARE MALE. NEARLY 12% OF BARNSTABLE COUNTY RESIDENTS OVER THE AGE OF 18 ARE VETERANS WHICH IS HIGHER THAN THE PERCENTAGE IN BOTH MA (7%) AND THE U.S. (9%). IN BARNSTABLE COUNTY, 13% OF RESIDENTS REPORT THAT THEY ARE LIVING WITH A DISABILITY COMPARED TO 11% IN MA. BARNSTABLE COUNTY MUST MEET THE UNIQUE HEALTH NEEDS OF VETERANS AND PERSONS LIVING WITH DISABILITIES WHO MAY BE AT A GREATER RISK OF DEVELOPING COMORBID CONDITIONS AND OFTEN ENCOUNTER LIMITED ACCESS OR BARRIERS TO CARE. INCOME AND POVERTY ALTHOUGH BARNSTABLE COUNTY HAS A LOWER PROPORTION OF LOW-INCOME RESIDENTS THAN DOES MA (9% VS. 11%), REPRESENTATIVES OF ORGANIZATIONS THAT SERVE VULNERABLE, LOW-INCOME AND MEDICALLY UNDERSERVED POPULATIONS REPORT A GROWING NUMBER OF RESIDENTS WHO STRUGGLE TO SECURE AND MAINTAIN STABLE EMPLOYMENT. THEY ALSO RELY ON PUBLIC ASSISTANCE PROGRAMS TO AFFORD HEALTH INSURANCE, FOOD AND HOUSING. ACCORDING TO FIVE-YEAR CENSUS ESTIMATES (2009-2013), THE MEDIAN HOUSEHOLD INCOME OF BARNSTABLE COUNTY RESIDENTS WAS $60,526 COMPARED TO $66,866 FOR ALL MASSACHUSETTS RESIDENTS. IN 2014, A HIGHER PERCENT OF PER CAPITA INCOME WAS DERIVED FROM TRANSFER PAYMENTS (SOCIAL SECURITY, DISABILITY PENSIONS, HOUSING AND FOOD SUBSIDY PROGRAMS, AND UNEMPLOYMENT BENEFITS) IN BARNSTABLE COUNTY (19%) COMPARED TO MA (15%) AND THE U.S. (17%). VULNERABLE POPULATIONS ARE FURTHER CHALLENGED BY EMPLOYMENT OPPORTUNITIES ON CAPE COD WHICH DECREASE DURING WINTER MONTHS DUE TO CHARACTERISTICS INHERENT IN A SEASONAL ECONOMY DEPENDENT ON TOURISM AND OTHER FACTORS. IN 2015, THE UNEMPLOYMENT RATE IN BARNSTABLE COUNTY RANGED FROM 9% IN JANUARY TO 5% IN JULY COMPARED TO A STEADY ANNUAL RATE OF 6% UNEMPLOYMENT FOR MA OVERALL. ACCORDING TO FIVE-YEAR ESTIMATES (2009-2013) OF THE AMERICAN COMMUNITY SURVEY: - MORE THAN 48% OF BARNSTABLE COUNTY RESIDENTS WHO RENT AND 38% WHO OWN A HOUSING UNIT ARE COST-BURDENED, SPENDING 35% OR MORE OF THEIR TOTAL INCOME ON HOUSING. ACCORDING TO THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, FAMILIES WHO PAY MORE THAN 30% OF THEIR INCOME FOR HOUSING ARE CONSIDERED COST-BURDENED AND MAY HAVE DIFFICULTY AFFORDING NECESSITIES SUCH AS FOOD, CLOTHING, TRANSPORTATION AND MEDICAL CARE. - 42% OF BARNSTABLE COUNTY RESIDENTS RECEIVE PUBLICLY-FUNDED HEALTH INSURANCE COVERAGE COMPARED TO 32% OF RESIDENTS IN MA OVERALL, AND 42% OF RESIDENTS RECEIVE SOCIAL SECURITY PAYMENTS COMPARED TO 28% IN MA OVERALL. COMBINED TOGETHER, THESE INDICATORS PAINT A PICTURE OF MANY RESIDENTS IN NEED. THE COMMUNITY INPUT COLLECTION PHASE OF THE PROJECT IDENTIFIED NUMEROUS TARGET POPULATIONS IN NEED OF HEALTH INTERVENTIONS. THESE INCLUDED FINANCIALLY DISADVANTAGED POPULATIONS, INCLUDING INDIVIDUALS WITH TRANSITIONAL EMPLOYMENT, CHILDREN UNDER THE AGE OF 18, INDIVIDUALS/FAMILIES WITH HOUSING INSECURITIES, AND THOSE LIVING ON FIXED INCOMES. RACE, ETHNICITY AND LANGUAGE IN ADDITION TO AGE AND INCOME, RACE, ETHNICITY, AND LANGUAGE PLAY A ROLE IN DETERMINING HEALTH OUTCOMES FOR RESIDENTS. COMPARED TO MA, BARNSTABLE COUNTY HAS A RELATIVELY HOMOGENEOUS POPULATION WITH 92% IDENTIFYING AS CAUCASIAN IN 2009-2013 CENSUS ESTIMATES. MASSACHUSETTS IS MORE RACIALLY DIVERSE WITH ONLY 76% OF RESIDENTS IDENTIFYING AS CAUCASIAN. ACCORDING TO FIVE-YEAR ESTIMATES OF THE AMERICAN COMMUNITY SURVEY (2009-2013) THE LARGEST RACIAL/ETHNIC MINORITY GROUPS ON CAPE COD ARE HISPANICS/LATINOS AND AFRICAN-AMERICAN RESIDENTS WITH EACH GROUP REPRESENTING ABOUT 2% OF THE POPULATION. IN THAT SAME TIME PERIOD, 7% OF THE POPULATION LIVING IN BARNSTABLE COUNTY WAS FOREIGN-BORN, COMPARED TO 15% FOR THE COMMONWEALTH OF MASSACHUSETTS. SLIGHTLY MORE THAN 8% OF THE POPULATION FIVE YEARS OR OLDER IN BARNSTABLE COUNTY SPEAKS A LANGUAGE OTHER THAN ENGLISH AT HOME COMPARED TO 22% IN THE COMMONWEALTH. WHILE DIVERSITY MAY BE LOW COMPARATIVELY, PUBLIC HEALTH EXPERTS AND INDIVIDUALS REPRESENTING LOW-INCOME, VULNERABLE, AND MEDICALLY UNDERSERVED POPULATIONS ON CAPE COD CITE THAT FOREIGN-BORN RESIDENTS AND RACIAL/ETHNIC MINORITIES ON CAPE COD (E.G., HISPANICS, AFRICAN AMERICANS, AND PORTUGUESE-SPEAKING BRAZILIANS) WERE MOST LIKELY TO EXPERIENCE BARRIERS TO ACCESSING CARE AND ARE DISPROPORTIONALLY IDENTIFIED WITHIN HIGH NEEDS POPULATIONS AS COMPARED TO OTHERS.
INSURANCE STATUS	MASSACHUSETTS LEADS THE NATION AS THE STATE WITH THE LOWEST RATE OF UNINSURED RESIDENTS. IN 2014, ONLY 4% OF RESIDENTS IN THE COMMONWEALTH LACKED MEDICAL HEALTH INSURANCE, COMPARED TO 10% NATIONALLY, DUE TO THE STATE'S EARLY HEALTH REFORM EFFORTS WHICH BEGAN IN 2006. HOWEVER, THERE IS VARIATION IN INSURED POPULATIONS ACROSS THE STATE OF MA ACCORDING TO THE GEOGRAPHY OF UNINSURANCE IN MASSACHUSETTS 2009-2013, A PUBLICATION BY THE BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION AND THE URBAN INSTITUTE. ACCORDING TO THE STUDY, BARNSTABLE COUNTY, AT 3.4%, HAS THE HIGHEST PERCENTAGE OF UNINSURED CHILDREN (0-17 YEARS) IN THE STATE COMPARED TO ALL OTHER COUNTIES. BARNSTABLE COUNTY, WITH AN OVERALL 5% UNINSURED RATE (ADULTS AND CHILDREN), IS ALSO THE 4TH HIGHEST RANKING COUNTY IN MA FOR THE NUMBER OF UNINSURED PERSONS OF ALL AGES. INPUT FROM PUBLIC HEALTH EXPERTS AND INDIVIDUALS REPRESENTING LOW-INCOME, VULNERABLE, AND MEDICALLY-UNDERSERVED POPULATIONS ON CAPE COD NOTE THAT BEYOND INDIVIDUALS AND CHILDREN WHO ARE UNINSURED, THERE ARE MANY RESIDENTS WHO ARE 'UNDER-INSURED'. THIS POPULATION STRUGGLES WITH THE COST OF PUBLICLY AVAILABLE HEALTH PLANS, COVERAGE OF DEDUCTIBLES AND PRESCRIPTIONS, AND WITH MAINTAINING INSURANCE COVERAGE UNDER CONTINUOUS ENROLLMENT CHANGES. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL DERIVE APPROXIMATELY 67% OF PATIENT SERVICE REVENUES FROM PUBLIC PAYERS. FROM FY2013 TO FY2015 THE HOSPITALS' PERCENTAGE OF MEDICAID AND MEDICARE STEADILY INCREASED WHILE THE PERCENTAGE FROM NON-GOVERNMENT SOURCES STEADILY DECREASED. AS BOTH STATE AND FEDERAL PAYERS FACE BUDGETING CONCERNS, PUBLIC PAYER REIMBURSEMENT IS FORECASTED TO REMAIN FLAT OR DECLINE. MANY OF THE KEY SERVICES USED BY VULNERABLE POPULATIONS SUCH AS BEHAVIORAL HEALTH ARE POORLY REIMBURSED. THESE TRENDS DEMONSTRATE CONTINUED RELIANCE ON SOURCES OF PUBLIC HEALTH COVERAGE AS THE AREA DEMOGRAPHICS BECOME MORE CHALLENGING. CONCLUSION UNDERSTANDING THE COMMUNITY NEED AND HEALTH STATUS OF BARNSTABLE COUNTY RESIDENTS BEGINS WITH IDENTIFYING THE DEMOGRAPHIC PROFILE AND UNDERLYING SOCIO-ECONOMIC DRIVERS THAT IMPACT HEALTH AND HEALTH EQUITY. ASSESSING SOCIAL DETERMINANTS OF HEALTH SUCH AS AGE, INCOME, RACE/ETHNICITY,LANGUAGE, INCOME, POVERTY, UNEMPLOYMENT, INSURANCE COVERAGE, AND HOUSING STATUS PROVIDES CRITICAL INFORMATION FOR IDENTIFYING TARGET POPULATIONS AND COMMUNITY SETTINGS FOR HEALTH IMPROVEMENT INTERVENTIONS AND ACTIVITIES.
PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: Cape Cod Healthcare, Inc., (CCHC) through its Community Benefits initiatives, is committed to enhancing the quality of and access to comprehensive health care services for all residents of Cape Cod. Through continuous assessment of community needs, coordinated planning and the allocation of resources, this commitment includes a special focus on the unmet needs of the financially disadvantaged and underserved populations. We will take a leadership role in collaborative efforts joining our resources, talent, and commitment with that of other providers, organizations and community members. The Community Benefits Mission Statement was affirmed by the CCHC Community Health Committee and the Board of Trustees in 2000 and remains in effect. THE FOLLOWING IS A LIST OF FY 18 TARGET POPULATIONS: - Individuals managing or at risk of developing chronic and infectious diseases such as cancer, cardiovascular disease, Alzheimer's disease and dementia, Hepatitis C, and tick-borne diseases. - Residents facing barriers to care due to language, cost, or age, including those who are uninsured or under-insured. - Individuals with mental health disorders, substance use disorders, and co-occurring disorders. - Senior population, ages 65 and older. - Youth and young adults, ages 15 to 24 years old. Key Accomplishments of Reporting Year The 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report and Implementation Plan served as the foundation for CCHC's FY18 Community Benefits program. CCHC's Community Benefits activities focused on the four health priorities identified in the report: chronic and infectious disease, behavioral health, access to care, and disease prevention and wellness. New and expanded hospital programs were developed in alignment with implementation goals, objectives and strategies for each priority. CCHC supported partnerships with over 50 local non-profit health and human service organizations, and a network of federally qualified health centers, through project support and grant investments to improve the health of Barnstable County residents. Hospital staff dedicated time and expertise to strategic partnerships, coalitions, and task force efforts locally, regionally, and across Massachusetts. Chronic and Infectious Disease Prevention, screening, detection, and management of chronic and infectious diseases were supported through a variety of CCHC Community Benefits activities. Hospital cancer support services including counseling, support groups, and survivorship activities for patients and caregivers were complemented with a new Oncology Nutrition program, which started in February 2018. The successful Living Fit for You! Cancer Wellness Program at Falmouth Hospital was expanded in August 2018 to include Cape Cod Hospital's campus. The program provides free of charge rehabilitation, wellness consultations, exercise, and education services to help adults undergoing cancer treatment manage fatigue, de-conditioning and loss of physical function. CCHC Community Benefits also provided grants to the Cape Wellness Collaborative and YMCA Cape Cod LIVESTRONG program to ensure that patients undergoing and recovering from cancer treatment had access to community-based wellness programs and complementary services such as massage, acupuncture, yoga and nutritional counseling. The CCHC Integrated Cancer Committee, comprised of physicians, nurses and support staff, conducted educational campaigns and community outreach events. These events informed youth about the risks of tobacco use and the general public about skin cancer prevention, including high-risk screening opportunities. CCHC clinical teams provided disease education, rehabilitation and pathways to chronic disease self- management for individuals living with congestive heart failure, chronic pulmonary diseases, and diabetes. A Community Benefits grant to the Cape Cod Times Needy Fund provided assistance for basic needs such as housing and utility payments, transportation, adaptive medical equipment, and child care specifically for individuals managing a chronic disease. A CCHC Community Benefits grant supported the Alzheimer's Family Caregiver Support Centers expanding free counseling for families and caregivers in outposts across the Outer, Lower, Mid, and Upper regions of Cape Cod. In addition, the organization now hosts concurrent weekly support group meetings for individuals with Alzheimer's disease and their caregivers at Cape Cod Hospital. CCHC provided funding for two innovative community-based programs to support tick-borne disease education in FY18. Through a partnership with the UMASS Laboratory of Medical Zoology, CCHC was the only hospital system in MA to subsidize tick testing for residents within a hospital service area. CCHC also partnered with the Cape Cod Cooperative Extension to produce a 10-part online video series titled "Tickology" to provide easily accessible community education on tick disease prevention. CCHC Infectious Disease Clinical Services is the recipient of federal and state Ryan White grant funding to support comprehensive primary medical care and medical case management for individuals with HIV/AIDS living in Barnstable County. CCHC, through partnerships with other local organizations, aligned local efforts to meet National HIV/AIDS Strategy and the Massachusetts Integrated HIV Prevention and Care Plan to reduce the number of new HIV infections, increase access to care, improve health outcomes for individuals living with HIV/AIDS, and reduce HIV-related health inequities and disparities. Behavioral Health CCHC Community Benefits expanded hospital-based services and collaborations with local federally qualified health centers and behavioral health providers to strengthen regional services and community resources for individuals with mental health and substance use disorders. CCHC's Centers for Behavioral Health joined the MA Department of Public Health and MA Department of Mental Health on the Zero Suicide Initiative to increase suicide prevention and reduce suicide deaths on Cape Cod. CCHC also provides a Community Crisis Line, staffed by clinicians, offering free and confidential emotional support and referral assistance for individuals in crisis and their families. CCHC Community Benefits funded a community wide Mental Health First Aid Training project in partnership with the National Alliance on Mental Illness (NAMI) Cape Cod, which resulted in 13 certified instructors to train exponentially more people in the evidence-based program in our community. CCHC Community Benefits provided grants to three federally qualified health centers on Cape Cod. Duffy Health Center, Harbor Community Health Center- Hyannis, and Outer Cape Health Services received grants supporting integrated behavioral health services, establishing an Office Based Addiction Treatment program and continuation of a community navigator program that assists individuals most at risk in our region. Through a partnership with, and grant to Gosnold, Inc., CCHC Community Benefits expanded the Recovery Specialist program in the emergency departments at Cape Cod Hospital and Falmouth Hospital. The program provides peer-led recovery engagement services for patients with Substance Use Disorders. Recovery Specialists work as part of the emergency departments' care teams to motivate patients to accept treatment upon discharge from the emergency departments. Additional funding to Gosnold, Inc. provided Recovery Coaching scholarships for 30 individuals who completed treatment for their Substance Use Disorder. Recovery Coaches assist individuals with building recovery support systems and improving outcomes related to employment, housing, legal and life skills. Cape Cod Hospital received grant funding from Massachusetts Department of Public Health to provide assistance to pregnant women with Opioid Use Disorders through the Moms Do Care program. The program provides peer-led services to obtain prenatal care, substance use treatment, and address social determinant of health issues. At the conclusion of the grant, CCHC supported transitioning the program to the Duffy Health Center with a Community Benefits grant, and CCHC remains a strategic collaborator on the project. CCHC staff from the maternity and pediatric departments at Cape Cod Hospital and Falmouth Hospital actively participated in statewide initiatives by the Neonatal Quality Improvement Collaborative of MA. Initiatives included staff development and piloting new models of care for newborns and families impacted by perinatal opioid use and neonatal abstinence syndrome.
Access to Care	In FY18, CCHC continued to invest significantly in expanding access to care for vulnerable and medically underserved populations in Barnstable County. CCHC Community Benefits continued its grant support of the Specialty Network for the Uninsured (SNU) program in Barnstable County. The SNU program coordinates appointments and follow-up care with local medical specialists for uninsured and under-insured patients in our region, reducing barriers to local access and addressing gaps in specialty services not offered by local community health centers. Through the Community Based Interpreters program, CCHC Community Benefits funding provided free medical interpreter services for limited-English speaking patients in community-based primary and specialty care offices across the region. In partnership with the Cape and Islands Emergency Medical Services System, CCHC expanded the impact of medical interpreter services in pre-hospital settings. CCHC provides training and funding for phone-based interpreter services that connect paramedics and first responders to interpreters via cell phones in ambulances to improve communication with limited-English speaking patients during transport to a hospital. Hospital social workers and case managers assisted low-income and vulnerable patients in need through direct referrals to community services, prescription assistance, and transportation vouchers upon discharge. Financial counselors at Cape Cod Hospital and Falmouth Hospital were available to all Barnstable County residents to assist with health insurance questions and needs including Mass Health and Medicare coverage applications and renewal assistance. CCHC has been at the forefront of establishing strategic relationships ensuring a strong and skilled future allied health workforce in our region. Cape Cod Community College and Cape Cod Healthcare Nursing Education Collaborative is a program that expands opportunities for education, clinical training, and employment, as well as RN student debt relief and career exploration pathways for high school students. In several clinical departments including behavioral health, radiology, and laboratory services across both hospitals, clinicians provide supervision, training, and job shadowing for students from UMASS Medical School, regional community colleges, and local vocational and technical schools. Disease Prevention and Wellness In FY18, Cape Cod Healthcare efforts focused on building partnerships and support for community based prevention and wellness initiatives impacting residents across the lifespan from infants to seniors. CCHC Community Benefits expanded efforts supporting new families. Expanded efforts included prenatal and parenting classes in English and Portuguese, support groups for new mothers, fatherhood initiatives, and a breastfeeding warmline that provided families with phone support for questions related to breastfeeding. CCHC also partnered with a local Early Intervention program to provide pre-discharge meetings with Early Intervention staff. Early Intervention staff educated parents about services and supports available to infants, young children and their families through the program. Through a partnership with the Cape & Islands United Way, CCHC Community Benefits supported the Strong from the Start Initiative aimed at improving the social, emotional and developmental outcomes for children ages 0-3 years in Barnstable County. The objectives of Strong from the Start is to strengthen families, reduce achievement and word gaps and provide children with the social, emotional and language skills to thrive in school and in life. CCHC Community Benefits built a coalition of more than 50 community organizations to support the Quality of Life Initiative. The initiative provided guest speakers, materials and helpful tools to educate the community about the importance of advance care planning. In addition, CCHC Community Benefits joined a coalition of more than 30 organizations called Healthy Aging Cape Cod. Led by Barnstable County Department of Human Services, the purpose of the coalition is to undertake regional planning that supports our aging demographic and aligns local efforts with statewide efforts to build an Age and Dementia-friendly Massachusetts. Healthy Parks, Healthy People, a program supported through a collaboration between Cape Cod Healthcare, the US National Park Service, and the Cape Cod National Seashore, continued with its focus on promoting open space for physical activity and wellness. Activities included educational events by CCHC physicians and physical therapists, a walking program, and a 5K walk/run for residents and visitors of Cape Cod. CCHC Community Benefits grants supported elder suicide prevention trainings through the Samaritans of Cape Cod, HPV vaccination and cervical cancer education for providers, parents and youth by Team Maureen and chronic disease and mindfulness programs at local family homeless shelters by Housing Assistance Corporation on Cape Cod. In addition to these FY18 hospital initiatives, community collaborations, and grant investments, CCHC Community Benefits continued to play leadership roles in health and human service organizations and coalitions across our region. These included, but were not limited to, the Barnstable County Economic Development Council, Barnstable County Human Services Advisory Council, Barnstable County Regional Substance Use Council, Behavioral Health Provider Coalition of Cape Cod & the Islands, Cape Cod Chamber of Commerce, and the Cape & Islands Community Health Area Network (CHNA 27) Steering Committee. PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEMS ROLES: THE HOSPITALS ARE PART OF AN AFFILIATED HEALTHCARE SYSTEM AND THEIR RESPECTIVE ROLES ARE: CAPE COD HOSPITAL - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN HYANNIS,MASSACHUSETTS FALMOUTH HOSPITAL ASSOCIATION, INC. - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN FALMOUTH, MASSACHUSETTS CAPE COD HEALTHCARE, INC. - A NOT-FOR-PROFIT CORPORATION THAT SERVES AS THE PARENT COMPANY OF VARIOUS ENTITIES PROVIDING HEALTH CARE SERVICES TO THE POPULATION OF CAPE COD, MASSACHUSETTS CAPE COD HEALTHCARE FOUNDATION,INC. - A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE DEVELOPMENT AND FUNDRAISING SUPPORT TO CAPE COD HEALTHCARE CAPE AND ISLANDS HEALTH SERVICES II, INC. - A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE VARIOUS NON-HOSPITAL HEALTH CARE SERVICES MEDICAL AFFILIATES OF CAPE COD, INC. - A NOT-FOR-PROFIT MEDICAL GROUP PRACTICE VISITING NURSE ASSOCIATION OF CAPE COD - A NOT-FOR-PROFIT PROVIDER OF HOME HEALTH SERVICES CAPE COD HUMAN SERVICES, INC. - A NOT-FOR-PROFIT PROVIDER OF OUTPATIENT MENTAL HEALTH SERVICES FALMOUTH ASSISTED LIVING, INC., D/B/A HERITAGE AT FALMOUTH - A NOT-FOR-PROFIT CORPORATION THAT OWNS AN ASSISTED LIVING FACILITY JML CARE CENTER, INC. - A NOT-FOR-PROFIT SKILLED NURSING AND REHABILITATION FACILITY CAPE COD RESEARCH INSTITUTE - A NOT-FOR-PROFIT THAT CONDUCTS CLINICAL RESEARCH AND RELATED EDUCATIONAL ACTIVITIES CAPE HEALTH INSURANCE COMPANY - A CAPTIVE INSURANCE COMPANY THAT PROVIDES MEDICAL PROFESSIONAL AND GENERAL LIABILITY INSURANCE TO CAPE COD HEALTHCARE CAPE COD HOSPITAL MEDICAL OFFICE BUILDING - A PROVIDER OF LEASED AND SUBLEASED SPACE TO CAPE COD HOSPITAL AND RELATED AFFILIATIONS PART VI, LINE 7 ALL STATES WHERE ORGANIZATION FILES A COMMUNITY BENEFITS REPORT: MA

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (25 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt
Cape Cod Council of Churches
81 Willow Ave	Hyannis	MA	02601	042382479	501(c)(3)	$5,400	FMV	N/A	Behavioral Health
AIDS Support Group of Cape Cod
PO BOX 1522	Provincetown	MA	02657	042908722	501(c)(3)	$28,013	FMV	N/A	Chronic and Infectious Disease
Alzheimer's Family Caregiver Support Center Inc
309 Waverly Oaks Rd	Waltham	MA	02452	133039601	501(c)(3)	$30,000	FMV	N/A	Chronic and Infectious Disease
TOWN OF BARNSTABLE
367 MAIN ST	Hyannis	MA	02601	046001079	GOV'T	$22,000	FMV	N/A	Access to Healthcare
BC Sheriff Dept Community Mental Health Initiative
6000 SHERIFFS PL	Bourne	MA	02532	466002284	GOV'T	$60,000	FMV	N/A	Behavioral Health
Cape Cod Coop ExtBCHS RSAC
PO BOX 427	Barnstable	MA	02630	046001419	GOV'T	$42,000	FMV	N/A	Behavioral Health & Chronic Disease
C&I United Way Strong from Start Initiative
PO BOX 367	CENTERVILLE	MA	02632	042271714	501(c)(3)	$17,500	FMV	N/A	Prevention and Wellness
Cape Cod Healthcare Inc
297 North St	Hyannis	MA	02601	222600704	501(c)(3)	$24,945	FMV	N/A	General Support
Cape Cod Times Needy Fund
PO BOX 804	Hyannis	MA	02601	222480332	501(c)(3)	$15,000	FMV	N/A	Chronic and Infectious Disease
Cape Wellness Collaborative
11 Potter Ave	Hyannis	MA	02601	472360979	501(c)(3)	$30,000	FMV	N/A	Chronic and Infectious Disease
CC Child Development - Hospital to Home Program
83 Pearl St	Hyannis	MA	02601	237324732	501(c)(3)	$12,300	FMV	N/A	Behavioral Health
CYRACOM LLC
5780 N SWAN RD	Tucson	AZ	85718	271261982		$28,537	FMV	N/A	Access to Healthcare
Duffy Health Center
94 MAIN ST	Hyannis	MA	02601	043373741	501(c)(3)	$91,000	FMV	N/A	Behavioral Health Prevention and Wellness
Gosnold on Cape Cod
200 TER HEUN DRIVE	Falmouth	MA	02540	042502970	501(c)(3)	$125,000	FMV	N/A	Behavioral Health
Harbor Health Services Inc
1135 MORTON ST	MATTAPAN	MA	02126	237100550	501(c)(3)	$134,000	FMV	N/A	Behavioral Health
Helping our Women
34 CONWELL ST	Provincetown	MA	02657	043179955	501(c)(3)	$6,000	FMV	N/A	Chronic Disease
Housing Assistance Corp
460 W MAIN ST	Hyannis	MA	02601	237431255	501(c)(3)	$17,743	FMV	N/A	Prevention and Wellness
NAMI Cape Cod
5 MARK LANE	Hyannis	MA	02601	042785229	501(c)(3)	$30,000	FMV	N/A	Prevention and Wellness
Outer Cape Health Services
PO BOX 1413	WELLFLEET	MA	02667	042509828	501(c)(3)	$61,500	FMV	N/A	Access to Healthcare
Samaritans on Cape Cod & the Islands
PO BOX 65	Falmouth	MA	02541	042738811	501(c)(3)	$12,168	FMV	N/A	Prevention and Wellness
Team Maureen
PO Box 422	N Falmouth	MA	02556	452473500	501(c)(3)	$27,650	FMV	N/A	Chronic and Infectious Disease
Town of Yarmouth Health Dept
1146 ROUTE 28	S Yarmouth	MA	02664	046001377	GOV'T	$5,660	FMV	N/A	Prevention and Wellness
Umass Lab of Medical Zoology
333 South St Ste 450	Shrewsbury	MA	01545	043167352	501(c)(1)	$29,580	FMV	N/A	Chronic Disease
Wellstrong
385 Welliott Rd	Centerville	MA	02632	811935657	501(c)(3)	$10,000	FMV	N/A	Behavioral Health
YMCA Cape Cod - Livestrong
12245 IYANNOUGH RD	W Barnstable	MA	02668	042394925	501(c)(3)	$29,500	FMV	N/A	Chronic and Infectious Disease

Field	Value	IRS element (for citing)
Total501c3 Org	23	Total501c3OrgCnt
Total Other Org	2	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE U.S. CONSISTS OF FOLLOWING THE HUD GUIDELINES SET BY THEM.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (29 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MICHAEL K LAUF
PRESIDENT/CEO/TRUSTEE	$0	$991,489	$0	$1,488,900	$0	$192,589	$0	$249,053	$0	$40,291	$0	$2,962,322	$0	$102,000
ROBERT WILSTERMAN MD
TRUSTEE	$770,101	$0	$19,060	$0	$2,772	$0	$25,080	$0	$35,701	$0	$852,714	$0	$0	$0
WILLIAM AGEL MD
TRUSTEE	$448,809	$0	$58,422	$0	$16,174	$0	$10,800	$0	$33,877	$0	$568,082	$0	$0	$0
THEODORE CALIANOS MD
TRUSTEE	$370,781	$0	$6,387	$0	$1,806	$0	$10,800	$0	$32,367	$0	$422,141	$0	$0	$0
PAUL HOULE MD
TRUSTEE	$932,685	$0	$165,440	$0	$966	$0	$27,506	$0	$34,701	$0	$1,161,298	$0	$0	$0
MICHAEL L CONNORS
SENIOR VP FINANCE/CFO	$0	$431,607	$0	$77,850	$0	$30,455	$0	$55,606	$0	$37,211	$0	$632,729	$0	$19,481
MICHAEL G JONES ESQ
SEE SCH O FOR TITLE	$0	$316,680	$0	$76,632	$0	$19,138	$0	$43,278	$0	$35,061	$0	$490,789	$0	$15,965
MICHAEL BUNDY
COO	$0	$368,843	$0	$83,500	$0	$630	$0	$24,508	$0	$32,765	$0	$510,246	$0	$0
DONALD A GUADAGNOLI MD
CMO CAPE COD HOSPITAL	$0	$412,488	$0	$83,475	$0	$33,082	$0	$54,775	$0	$30,563	$0	$614,383	$0	$21,001
ALEXANDER HEARD MD
CHIEF MEDICAL OFFICER - FH	$84,330	$442,806	$0	$167,877	$0	$630	$3,066	$28,695	$0	$35,911	$87,396	$675,919	$0	$0
PATRICK J KANE
SVP OF MRKTG,COMMUN AND DEVLP	$0	$304,840	$0	$70,684	$0	$19,589	$0	$28,480	$0	$3,025	$0	$426,618	$0	$15,450
CHRISTIAN BROWN
SR VP MANAGED CARE	$0	$300,781	$0	$69,769	$0	$22,490	$0	$46,069	$0	$33,877	$0	$472,986	$0	$13,000
EMILY SCHORER
SVP HUMAN RESOURCES	$0	$257,318	$0	$62,220	$0	$11,735	$0	$24,581	$0	$34,329	$0	$390,183	$0	$10,345
KEVIN RALPH
SVP DEVELOPMENT	$0	$242,777	$0	$49,688	$0	$4,561	$0	$24,086	$0	$36,042	$0	$357,154	$0	$3,646
THERESA M AHERN
SVP, STRAT, COMMUNITY/GOV REL.	$0	$250,297	$0	$68,625	$0	$15,760	$0	$40,619	$0	$22,443	$0	$397,744	$0	$11,500
KEVIN J MULROY
SVP CHIEF QUALITY & SAFETY OFF	$0	$368,757	$0	$80,782	$0	$24,939	$0	$40,051	$0	$35,061	$0	$549,590	$0	$15,875
JEANNE FALLON
SR VP & CIO (UNTIL 4/11/17)	$0	$77,946	$0	$0	$0	$238,835	$0	$13,364	$0	$9,124	$0	$339,269	$0	$12,650
JEFFREY S DYKENS
VP FINANCE & OPERATIONS	$0	$246,358	$0	$41,876	$0	$22,747	$0	$28,158	$0	$36,169	$0	$375,308	$0	$12,000
NOELENE CERVIN
VP BUDGETING & OPER. SUPPORT	$0	$216,358	$0	$39,050	$0	$6,971	$0	$25,269	$0	$33,597	$0	$321,245	$0	$0
LORI JEWETT
CEO - FH	$0	$239,990	$0	$37,800	$0	$9,418	$0	$40,818	$0	$1,525	$0	$329,551	$0	$4,000
DIANNE C KOLB
PRESIDENT VNA (UNTIL 8/8/17)	$0	$131,411	$0	$0	$0	$37,163	$0	$22,480	$0	$15,897	$0	$206,951	$0	$10,403
CARTER HUNT
ADMIN SPEC&HOSP BASED CARE	$0	$194,445	$0	$18,713	$0	$2,977	$0	$27,409	$0	$37,006	$0	$280,550	$0	$0
VICTOR OLIVEIRA
VP PATIENT SVCS(UNTIL 3/17)	$0	$61,085	$0	$0	$0	$180,858	$0	$22,988	$0	$13,145	$0	$278,076	$0	$11,575
RICHARD B ZELMAN MD
PHYSICIAN	$1,393,164	$0	$100,000	$0	$56,618	$0	$10,800	$0	$37,211	$0	$1,597,793	$0	$0	$0
ACHILLES PAPAVASILIOU MD
PHYSICIAN	$932,608	$0	$189,045	$0	$630	$0	$28,800	$0	$34,701	$0	$1,185,784	$0	$0	$0
NICHOLAS COPPA MD
PHYSICIAN	$930,737	$0	$151,545	$0	$420	$0	$28,800	$0	$36,572	$0	$1,148,074	$0	$0	$0
GORDON NAKATA MD
PHYSICIAN	$932,608	$0	$140,000	$0	$630	$0	$27,938	$0	$34,701	$0	$1,135,877	$0	$0	$0
PHILLIP J DOMBROWSKI MD
PHYSICIAN	$697,101	$0	$50,000	$0	$25,849	$0	$10,800	$0	$1,525	$0	$785,275	$0	$0	$0
JUDITH C QUINN
VP OF PATIENT CARE	$0	$217,129	$0	$39,228	$0	$23,368	$0	$24,308	$0	$25,533	$0	$329,566	$0	$10,700

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PART I, LINE 4A

Jeanne Fallon, Sr. VP and CIO until 4/11/17, received severance payments of $173,208 during calendar year 2017. The arrangement provides for continued payment of the individual's salary and benefits for a period of 15 months, including medical and dental insurance coverage. Victor Oliveira, VP of Patient Services until 3/17, received severance payments of $124,000 during calendar year 2017. The arrangement provides for continued payment of the individual's salary and benefits for a period of 12 months, including medical and dental insurance coverage. SCHEDULE J, PART I, LINE 4B - 457(F) CAPE COD HEALTHCARE, INC. AND AFFILIATES SPONSORS A 457(F) VOLUNTARY PERSONAL DEFERRAL PLAN ("THE PLAN") FOR KEY EXECUTIVES. VESTING IS DEFERRED FOR AT LEAST TWO YEARS FROM THE DATE OF THE AWARD. THE PLAN OFFERS PARTICIPATING EMPLOYEES AN ANNUAL DEFERRAL OF CASH COMPENSATION. AMOUNTS DEFERRED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND AMOUNTS PAID UNDER THE PLAN DURING CALENDAR YEAR 2017 WERE AS FOLLOWS: - MICHAEL K. LAUF - $72,613 - MICHAEL G. JONES - $17,333 - MICHAEL L. CONNORS - $19,258 - DIANNE C. KOLB - $31,969 - JEANNE FALLON - $36,138 - JEFFREY S. DYKENS - $12,704 - PATRICK KANE - $16,817 - THERESA AHERN - $12,988 - VICTOR OLIVEIRA - $36,745 - DONALD GUADAGNOLI MD - $22,232 - EMILY SCHORER - $11,105 - KEVIN MULROY - $16,762 - CHRISTIAN BROWN - $13,853 - LORI JEWETT - $4,173 - JUDITH C. QUINN - $11,327 - KEVIN RALPH - $3,931 CAPE COD HEALTHCARE, INC. AND AFFILIATES ALSO SPONSOR A NONQUALIFIED PENSION RESTORATION ACCOUNT PLAN FOR KEY EXECUTIVES. THE ORGANIZATION MAKES CONTRIBUTIONS OF TWO PERCENT OF THE INDIVIDUAL'S ANNUAL SALARY (INCLUDING BONUS) THROUGHOUT THE PLAN YEAR. AMOUNTS DEFERRED ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND UNDER THE PLAN, PARTICIPANTS ARE ENTITLED TO CERTAIN BENEFITS UPON RETIREMENT, TERMINATION, OR DEATH. During calendar year 2017, Michael Lauf also participated in a Section 457(f) plan. Twelve percent of his base salary was contributed and each contribution is subject to a three year vesting schedule. The amount deferred in calendar year 2017 was $120,000 and is included in Schedule J, Part II, Column (C). IN ADDITION, $100,146 WAS PAID OUT FROM HIS CEO SUPPLEMENTAL PLAN, AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN B(III).

SCHEDULE J, PART I, LINE 7

Discretionary bonuses are awarded annually based upon both the performance of the organization and the individual. Bonuses are reflected in Schedule J, Part II, Column B(ii). THE INDIVIDUALS REPORTED IN SCHEDULE J, PART II REPORTED AS BEING PAID FROM A RELATED ORGANIZATION WERE EMPLOYEES OF, AND COMPENSATED BY CAPE COD HEALTHCARE, INC., THE PARENT CORPORATION.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
MHEFA REVENUE BONDS SERIES E
A	042456011	000000000	2012-01-12	$29,440,000	REISSUE SER E (6/18/08 & 2/12/09)	false	false	false
MHEFA REVENUE BONDS SERIES 2012A
B	043431814	000000000	2012-02-24	$25,800,000	REFUND SER B(8/15/98)& C(11/15/01)	false	false	false
MDFA REVENUE BONDS SERIES 2013
C	043431814	57584VAH8	2013-07-11	$50,831,729	REFUND SER C(10/9/01) & CAP.IMPR.	false	false	false
MDFA REVENUE BONDS SERIES 2014
D	043431814	000000000	2014-09-29	$24,000,000	RENOVATION & REAL ESTATE PURCHASE	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$19,626,666	$0	$29,440,000	$0	$0	$0	$0	$0	$0	$0	$29,440,000	$0	2012	Yes (true)	false	Yes (true)	Yes (true)
B	$15,480,000	$0	$25,800,000	$0	$0	$0	$336,100	$0	$0	$0	$25,463,900	$0	2012	Yes (true)	false	Yes (true)	Yes (true)
C	$0	$0	$50,843,109	$0	$1,295,804	$0	$803,269	$0	$0	$27,999,812	$20,735,223	$0	2014	Yes (true)	false	Yes (true)	Yes (true)
D	$1,400,000	$0	$24,001,267	$0	$0	$0	$0	$241,456	$0	$0	$23,759,811	$0	2015	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd
A	Yes (true)
B	Yes (true)
C	Yes (true)	false	false	false	false	false	false
D	Yes (true)	false	false	false	false	false	false

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	false	Yes (true)	Yes (true)	Yes (true)	false	false	0	false	Yes (true)
0
B	false	false	Yes (true)	Yes (true)	false	false	false	0	false	Yes (true)
0
C	false	false	Yes (true)	Yes (true)	false	false	false	0	false	Yes (true)
0
D	false	false	false	Yes (true)	false	false	false	0	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

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

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART IV, LINE 2(C)	FormAndLineReferenceDesc
Explanation	THE DATE THE REBATE COMPUTATIONS WERE LAST PERFORMED FOR EACH BOND ARE BELOW: MDFA, REVENUE BONDS, SERIES E - 07/12/2012 MDFA, REVENUE BONDS, SERIES 2012A - 06/30/2016 MDFA, REVENUE BONDS, SERIES 2013 - 06/30/2018 MDFA, REVENUE BONDS, SERIES 2014 - 08/31/2015 SINCE THE BOND PROCEEDS HAVE BEEN SPENT FOR EACH BOND AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	MDFA REVENUE BONDS SERIES 2017	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	043431814	BondIssuerEIN
CUSIP	000000000	CUSIPNum
Bond Issued	2017-02-01	BondIssuedDt
Issue Price	$52,315,359	IssuePriceAmt
Purpose	REFUND SERIES D(2/16/2010)	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$2,888,555	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$53,492,970	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$48,449,645	RefundingEscrowAmt
Issuance Costs From Proceeds	$302,138	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$106,973	CapitalExpendituresAmt
Other Spent Proceeds	$4,634,214	OtherSpentProceedsAmt
Unspent	$0	UnspentAmt
Substantial Completion	2017	SubstantialCompletionYr
Current Refunding	false	CurrentRefundingInd
Advance Refunding	Yes (true)	AdvanceRefundingInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	false	AnyResearchAgreementsInd
Private Bus Use By Others	0	PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Remedial Action Taken	false	RemedialActionTakenInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	Yes (true)	RebateNotDueYetInd
Exception To Rebate	false	ExceptionToRebateInd
No Rebate Due	false	NoRebateDueInd
Variable Rate Issue	Yes (true)	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
DR KATIE RUDMAN
SPOUSE OF TRUSTEE	$116,158	MACC EMPLOYEE	false
Sarah K Guadagnoli RN
DAUGHTER OF KEY EMPLOYEE	$65,484	CCH EMPLOYEE	false

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArtGrp
Art Historical Treasures		ArtHistoricalTreasuresGrp
Art Fractional Interest		ArtFractionalInterestGrp
Books And Publications		BooksAndPublicationsGrp
Clothing And Household Goods		ClothingAndHouseholdGoodsGrp
Cars And Other Vehicles		CarsAndOtherVehiclesGrp
Boats And Planes		BoatsAndPlanesGrp
Intellectual Property		IntellectualPropertyGrp

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	79	ContributionCnt
Noncash Contributions Rpt F990	$1,163,954	NoncashContributionsRptF990Amt
Method Of Determining Revenues	VALUE OF STOCK REC'D	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Securities Closely Held Stock		SecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust Intrsts		SecurPrtnrshpTrustIntrstsGrp
Securities Miscellaneous		SecuritiesMiscellaneousGrp
Qualified Contrib Hist Struct		QualifiedContribHistStructGrp
Qualified Contrib Other		QualifiedContribOtherGrp
Real Estate Residential		RealEstateResidentialGrp
Real Estate Commercial		RealEstateCommercialGrp
Real Estate Other		RealEstateOtherGrp
Collectibles		CollectiblesGrp
Food Inventory		FoodInventoryGrp
Drugs And Medical Supplies		DrugsAndMedicalSuppliesGrp
Taxidermy		TaxidermyGrp
Historical Artifacts		HistoricalArtifactsGrp
Scientific Specimens		ScientificSpecimensGrp
Archaeological Artifacts		ArchaeologicalArtifactsGrp
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (true)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	Yes (true)	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE M, PART I, COLUMN (B)	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED. SCHEDULE M, PART I, LINE 32(A) ON OCCASION THE ORGANIZATION UTILIZES A BROKER TO DISPOSE OF NONCASH CONTRIBUTIONS (OTHER THAN PUBLICLY TRADED SECURITIES).	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 1 AND PART III, LINE 1	WE WILL BE THE HEALTH SERVICE PROVIDER OF CHOICE FOR CAPE COD RESIDENTS BY ACHIEVING AND MAINTAINING THE HIGHEST STANDARDS IN HEALTH CARE DELIVERY AND SERVICE QUALITY. TO DO SO, WE WILL PARTNER WITH OTHER HEALTH AND HUMAN SERVICE PROVIDERS AS WELL AS INVEST IN NEEDED MEDICAL TECHNOLOGIES, HUMAN RESOURCES AND CLINICAL SERVICES. ABOVE ALL, WE WILL HELP IDENTIFY AND RESPOND TO THE NEEDS OF OUR COMMUNITY. Community Benefits Mission Statement Cape Cod Healthcare, Inc., (CCHC) through its Community Benefits initiatives, is committed to enhancing the quality of and access to comprehensive health care services for all residents of Cape Cod. Through continuous assessment of community needs, coordinated planning and the allocation of resources, this commitment includes a special focus on the unmet needs of the financially disadvantaged and underserved populations. We will take a leadership role in collaborative efforts joining our resources, talent, and commitment with that of other providers, organizations and community members. The Community Benefits Mission Statement was affirmed by the CCHC Community Health Committee and the Board of Trustees in 2000 and remains in effect.
Target Populations	Name of target population: Individuals managing or at risk of developing chronic and infectious diseases such as cancer, cardiovascular disease, Alzheimer's disease and dementia, Hepatitis C, diabetes and tick-borne diseases. Basis for Selection: Aligned with state and national health priorities, Barnstable County residents managing chronic diseases are at the greatest risk of declined health and death. Cancer, cardiovascular disease, Alzheimer's disease/dementia, Hepatitis C, diabetes and tick-borne diseases were identified in the 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report as diseases of particular concern for the region. Name of target population: Residents facing barriers to care due to language, cost, or age, including those who are uninsured or under-insured. Basis for Selection: The 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report identified specific target populations that encounter barriers to care or gaps in coverage despite high rates of insured residents in Barnstable County. The report specifically identified children ages 0-17 years, individuals lacking year-round employment, seniors living on a fixed income, seasonal workers, and foreign-born residents who do not meet eligibility criteria for Mass Health enrollment. Name of target population: Individuals with mental health disorders, substance use disorders and co-occurring disorders. Basis for Selection: Access to, and availability of, community-based behavioral health care in Barnstable County is an area of concern. This is evidenced by high rates of patients presenting with mental health and substance use disorders in hospital emergency departments. Specific challenges reported by the community and included in the 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report include a shortage of psychiatric providers, wait times for outpatient appointments, limited inpatient treatment options for substance use, and insurance barriers to care. Name of target population: Senior population, ages 65 and older. Basis for Selection: According to the U.S. Census Bureau, American Community Survey five year population estimates (2012-2016), nearly 28% of the year round population in Barnstable County is over the age of 65. Increasing consumption of and need for health care services, concerns of social isolation, availability of appropriate housing and transportation, and access to healthy and adequate food were specific challenges identified in the 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report for residents over the age of 65. Name of target population: Youth and young adults, ages 15 to 24 years old. Basis for Selection: Youth and young adults, ages 15-24 years old, were identified in the 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report as a specific at-risk population due to increasing rates of substance use treatment admissions and concerning health risk behaviors. Publication of Target Populations Annual Report Hospital/HMO Web Page Publicizing Target Pop. https://www.capecodhealth.org/about/caring-for-our-community/community-hea lth-needs-assessment-implementation-plans/ Key Accomplishments of Reporting Year The 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report and Implementation Plan served as the foundation for CCHC's FY18 Community Benefits program. CCHC's Community Benefits activities focused on the four health priorities identified in the report: chronic and infectious disease, behavioral health, access to care, and disease prevention and wellness. New and expanded hospital programs were developed in alignment with implementation goals, objectives and strategies for each priority. CCHC supported partnerships with over 50 local non-profit health and human service organizations, and a network of federally qualified health centers, through project support and grant investments to improve the health of Barnstable County residents. Hospital staff dedicated time and expertise to strategic partnerships, coalitions, and task force efforts locally, regionally, and across Massachusetts. Chronic and Infectious Disease Prevention, screening, detection, and management of chronic and infectious diseases were supported through a variety of CCHC Community Benefits activities. Hospital cancer support services including counseling, support groups, and survivorship activities for patients and caregivers were complemented with a new Oncology Nutrition program, which started in February 2018. The successful Living Fit for You! Cancer Wellness Program at Falmouth Hospital was expanded in August 2018 to include Cape Cod Hospital's campus. The program provides free of charge rehabilitation, wellness consultations, exercise, and education services to help adults undergoing cancer treatment manage fatigue, de-conditioning and loss of physical function. CCHC Community Benefits also provided grants to the Cape Wellness Collaborative and YMCA Cape Cod LIVESTRONG program to ensure that patients undergoing and recovering from cancer treatment had access to community-based wellness programs and complementary services such as massage, acupuncture, yoga and nutritional counseling. The CCHC Integrated Cancer Committee, comprised of physicians, nurses and support staff, conducted educational campaigns and community outreach events. These events informed youth about the risks of tobacco use and the general public about skin cancer prevention, including high-risk screening opportunities. CCHC clinical teams provided disease education, rehabilitation and pathways to chronic disease self- management for individuals living with congestive heart failure, chronic pulmonary diseases, and diabetes. A Community Benefits grant to the Cape Cod Times Needy Fund provided assistance for basic needs such as housing and utility payments, transportation, adaptive medical equipment, and child care specifically for individuals managing a chronic disease. A CCHC Community Benefits grant supported the Alzheimer's Family Caregiver Support Centers expanding free counseling for families and caregivers in outposts across the Outer, Lower, Mid, and Upper regions of Cape Cod. In addition, the organization now hosts concurrent weekly support group meetings for individuals with Alzheimer's disease and their caregivers at Cape Cod Hospital. CCHC provided funding for two innovative community-based programs to support tick-borne disease education in FY18. Through a partnership with the UMASS Laboratory of Medical Zoology, CCHC was the only hospital system in MA to subsidize tick testing for residents within a hospital service area. CCHC also partnered with the Cape Cod Cooperative Extension to produce a 10-part online video series titled "Tickology" to provide easily accessible community education on tick disease prevention. CCHC Infectious Disease Clinical Services is the recipient of federal and state Ryan White grant funding to support comprehensive primary medical care and medical case management for individuals with HIV/AIDS living in Barnstable County. CCHC, through partnerships with other local organizations, aligned local efforts to meet National HIV/AIDS Strategy and the Massachusetts Integrated HIV Prevention and Care Plan to reduce the number of new HIV infections, increase access to care, improve health outcomes for individuals living with HIV/AIDS, and reduce HIV-related health inequities and disparities. Behavioral Health CCHC Community Benefits expanded hospital-based services and collaborations with local federally qualified health centers and behavioral health providers to strengthen regional services and community resources for individuals with mental health and substance use disorders. CCHC's Centers for Behavioral Health joined the MA Department of Public Health and MA Department of Mental Health on the Zero Suicide Initiative to increase suicide prevention and reduce suicide deaths on Cape Cod. CCHC also provides a Community Crisis Line, staffed by clinicians, offering free and confidential emotional support and referral assistance for individuals in crisis and their families.
CCHC Community Benefits funded a community wide Mental Health	First Aid Training project in partnership with the National Alliance on Mental Illness (NAMI) Cape Cod, which resulted in 13 certified instructors to train exponentially more people in the evidence-based program in our community. CCHC Community Benefits provided grants to three federally qualified health centers on Cape Cod. Duffy Health Center, Harbor Community Health Center- Hyannis, and Outer Cape Health Services received grants supporting integrated behavioral health services, establishing an Office Based Addiction Treatment program and continuation of a community navigator program that assists individuals most at risk in our region. Through a partnership with, and grant to Gosnold, Inc., CCHC Community Benefits expanded the Recovery Specialist program in the emergency departments at Cape Cod Hospital and Falmouth Hospital. The program provides peer-led recovery engagement services for patients with Substance Use Disorders. Recovery Specialists work as part of the emergency departments' care teams to motivate patients to accept treatment upon discharge from the emergency departments. Additional funding to Gosnold, Inc. provided Recovery Coaching scholarships for 30 individuals who completed treatment for their Substance Use Disorder. Recovery Coaches assist individuals with building recovery support systems and improving outcomes related to employment, housing, legal and life skills. Cape Cod Hospital received grant funding from Massachusetts Department of Public Health to provide assistance to pregnant women with Opioid Use Disorders through the Moms Do Care program. The program provides peer-led services to obtain prenatal care, substance use treatment, and address social determinant of health issues. At the conclusion of the grant, CCHC supported transitioning the program to the Duffy Health Center with a Community Benefits grant, and CCHC remains a strategic collaborator on the project. CCHC staff from the maternity and pediatric departments at Cape Cod Hospital and Falmouth Hospital actively participated in statewide initiatives by the Neonatal Quality Improvement Collaborative of MA. Initiatives included staff development and piloting new models of care for newborns and families impacted by perinatal opioid use and neonatal abstinence syndrome. Access to Care In FY18, CCHC continued to invest significantly in expanding access to care for vulnerable and medically underserved populations in Barnstable County. CCHC Community Benefits continued its grant support of the Specialty Network for the Uninsured (SNU) program in Barnstable County. The SNU program coordinates appointments and follow-up care with local medical specialists for uninsured and under-insured patients in our region, reducing barriers to local access and addressing gaps in specialty services not offered by local community health centers. Through the Community Based Interpreters program, CCHC Community Benefits funding provided free medical interpreter services for limited-English speaking patients in community-based primary and specialty care offices across the region. In partnership with the Cape and Islands Emergency Medical Services System, CCHC expanded the impact of medical interpreter services in pre-hospital settings. CCHC provides training and funding for phone-based interpreter services that connect paramedics and first responders to interpreters via cell phones in ambulances to improve communication with limited-English speaking patients during transport to a hospital. Hospital social workers and case managers assisted low-income and vulnerable patients in need through direct referrals to community services, prescription assistance, and transportation vouchers upon discharge. Financial counselors at Cape Cod Hospital and Falmouth Hospital were available to all Barnstable County residents to assist with health insurance questions and needs including Mass Health and Medicare coverage applications and renewal assistance. CCHC has been at the forefront of establishing strategic relationships ensuring a strong and skilled future allied health workforce in our region. Cape Cod Community College and Cape Cod Healthcare Nursing Education Collaborative is a program that expands opportunities for education, clinical training, and employment, as well as RN student debt relief and career exploration pathways for high school students. In several clinical departments including behavioral health, radiology, and laboratory services across both hospitals, clinicians provide supervision, training, and job shadowing for students from UMASS Medical School, regional community colleges, and local vocational and technical schools. Disease Prevention and Wellness In FY18, Cape Cod Healthcare efforts focused on building partnerships and support for community based prevention and wellness initiatives impacting residents across the lifespan from infants to seniors. CCHC Community Benefits expanded efforts supporting new families. Expanded efforts included prenatal and parenting classes in English and Portuguese, support groups for new mothers, fatherhood initiatives, and a breastfeeding warm-line that provided families with phone support for questions related to breastfeeding. CCHC also partnered with a local Early Intervention program to provide pre-discharge meetings with Early Intervention staff. Early Intervention staff educated parents about services and supports available to infants, young children and their families through the program. Through a partnership with the Cape & Islands United Way, CCHC Community Benefits supported the Strong from the Start Initiative aimed at improving the social, emotional and developmental outcomes for children ages 0-3 years in Barnstable County. The objectives of Strong from the Start is to strengthen families, reduce achievement and word gaps and provide children with the social, emotional and language skills to thrive in school and in life. CCHC Community Benefits built a coalition of more than 50 community organizations to support the Quality of Life Initiative. The initiative provided guest speakers, materials and helpful tools to educate the community about the importance of advance care planning. In addition, CCHC Community Benefits joined a coalition of more than 30 organizations called Healthy Aging Cape Cod. Led by Barnstable County Department of Human Services, the purpose of the coalition is to undertake regional planning that supports our aging demographic and aligns local efforts with statewide efforts to build an Age and Dementia-friendly Massachusetts. Healthy Parks, Healthy People, a program supported through a collaboration between Cape Cod Healthcare, the US National Park Service, and the Cape Cod National Seashore, continued with its focus on promoting open space for physical activity and wellness. Activities included educational events by CCHC physicians and physical therapists, a walking program, and a 5K walk/run for residents and visitors of Cape Cod. CCHC Community Benefits grants supported elder suicide prevention trainings through the Samaritans of Cape Cod, HPV vaccination and cervical cancer education for providers, parents and youth by Team Maureen and chronic disease and mindfulness programs at local family homeless shelters by Housing Assistance Corporation on Cape Cod. In addition to these FY18 hospital initiatives, community collaborations, and grant investments, CCHC Community Benefits continued to play leadership roles in health and human service organizations and coalitions across our region. These included, but were not limited to, the Barnstable County Economic Development Council, Barnstable County Human Services Advisory Council, Barnstable County Regional Substance Use Council, Behavioral Health Provider Coalition of Cape Cod & the Islands, Cape Cod Chamber of Commerce, and the Cape & Islands Community Health Area Network (CHNA 27) Steering Committee. Plans for Next Reporting Year Annual Community Benefits plans for Cape Cod Hospital, Falmouth Hospital and Cape Cod Healthcare reflect the priorities, goals and objectives embedded in the three-year implementation strategies included in the 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report and Implementation Plan. CCHC Community Benefits FY17-FY19 Goals: 1.Improve chronic and infectious disease prevention and management to meet the growing needs of an aging and at-risk population. 2.Strengthen regional health services and community resources for individuals with mental health conditions, substance use, co-occurring disorders, and comorbidities. 3.Reduce barriers to care and strengthen the regional health safety net for vulnerable populations. 4.Improve the health and disease prevention of all residents of Barnstable County and sustain the wellness of seniors and caregivers.
5.Support regional health efforts through direct grant funding and	a competitive RFP grants program with funding guidelines that are aligned WITH COMMUNITY BENEFITS PRIORITIES AND TARGET POPULATIONS. 6.Strengthen regional collaboration and maintain leadership roles with the following community-based coalitions: Barnstable County Human Services Advisory Council, Barnstable County Regional Substance Use Council, Behavioral Health Provider Coalition of Cape Cod & the Islands, Community Health Area Network (CHNA 27) and Healthy Aging Cape Cod. Community Benefits Process Community Benefits Leadership/Team Cape Cod Healthcare, Cape Cod Hospital and Falmouth Hospital, along with our affiliates, strive to be the health service provider of choice for Barnstable County residents and visitors by achieving and maintaining the highest standards in healthcare delivery and service quality. To do so, we partner with other health and human service providers from across the region and invest in needed medical technologies, developing the current and future workforce and clinical services. The development of Cape Cod Healthcare's strategic initiatives and community collaborations, including the Community Benefits program, is led by Michael K. Lauf, Chief Executive Officer and Theresa M. Ahern, Senior Vice President, Strategy, Community and Governmental Affairs. Michael L. Connors, Cape Cod Healthcare's Chief Financial Officer, provides fiscal oversight of the Community Benefits reporting process. The Community Health Committee, a designated subcommittee of Cape Cod Healthcare's Board of Trustees, serves as the Community Benefits Advisory Council and provides strategic oversight to the program. The Committee is comprised of leaders of health and human services organizations, community health centers, county government, and community-based organizations representing residents across a spectrum of ages, socioeconomic status, and racial, cultural and ethnic diversity, as well as current members of the CCHC Board of Trustees. The Committee develops and recommends policies to the Cape Cod Healthcare Board of Trustees regarding Community Benefits programs, sets priorities, awards priority grant funding to community organizations, and advises on community health issues and initiatives including community health needs assessments and ongoing community engagement. FY18 Community Health Committee Members: Suzanne Fay Glynn, Esq. (Chair) CCHC Board Member Glynn Law Offices 49 Locust Street, Falmouth, MA 02540 508.548.8282 dar@glynnlawoffices.com Representing: CCHC Board of Trustees Elizabeth Albert Director Barnstable County Human Services P.O. Box 427, Barnstable, MA 02630 508.375.6626 balbert@barnstablecounty.org Representing: Regional health and human services community, regional network on homelessness, countywide substance use coalition and regional planning for aging demographics. Leo Blandford Director of Community-Based Coordinated Care Outer Cape Health Services 710 MA Route 28 Harwich Port, MA 02646 lblandford@outercape.org 508-905-2814 Representing: Federally Qualified Health Centers, Lower and Outer Cape region, behavioral health and substance use disorder services. Eleanor Claus Kinlin Grover Real Estate 927 Route 6A, Yarmouthport, MA 02675 508-362-3000 x203 eclaus@kinlingrover.com Representing: Community members at large. Alisa Galazzi Chief Executive Officer Housing Assistance Corporation on Cape Cod 460 West Main Street Hyannis, MA 02601 508-771-5400 agalazzi@haconcapecod.org Representing: Regional programs addressing homelessness, housing security, and development of attainable housing. Mary Devlin Public Health and Wellness Division Manager Visiting Nurse Association of Cape Cod 255 Independence Drive, Hyannis, MA 02601 508-957-7619 mdevlin@vnacapecod.org Representing: Regional public health programs with emphasis on chronic disease prevention and healthy aging of the senior population. Michael McGuire Director Cape Cod Cooperative Extension P.O. Box 367, Barnstable, MA 02630 508-375-6701 mmaguire@barnstablecounty.org Representing: Barnstable County initiatives related to nutrition, food safety, tick borne diseases, water quality protection and youth and family programs. Patricia Mitrokostas Director of Prevention Programs, Public Relations & Organizational Advancement Gosnold, Inc. 350 Gifford Street, Suite W-10, Falmouth, MA 02540 508-540-2317 pmitrokostas@gosnold.org Representing: Regional substance use prevention, intervention, and treatment programs for individuals and families. Stacie Peugh Chief Executive Officer YMCA Cape Cod 2245 Iyannough Rd, West Barnstable, MA 02668 508-362-6500 speugh@ymcacapecod.org Representing: Youth development, chronic disease management programs, wellness and prevention. Susan Travers Director Truro Council on Aging 7 Standish Way, North Truro 02652 508-487-2462 Stravers@truro-ma.gov Representing: Councils on Aging Serving Together (COAST), senior populations, and the Lower and Outer region of Barnstable County. Cape Cod Healthcare member: Theresa M. Ahern Senior Vice President, Strategy, Community and Governmental Affairs Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA 02601 774-470-5506 tahern@capecodhealth.org Community Benefits Team Meetings The FY18 Community Health Committee meetings were held on the following dates and times: November 7, 2017 9:00-11:00 am February 27, 2018 4:00-5:30 pm June 13, 2018 4:00-5:30 pm July 17, 2018 4:00-5:00 pm Community Partners AIDS Support Group of Cape Cod Alzheimer's Family Caregiver Support Center Arts Foundation of Cape Cod Barnstable County Cape Cod Cooperative Extension Services Barnstable County Department of Human Services Barnstable County Regional Substance Use Council Barnstable County Sheriff's Office Barnstable Public School District Behavioral Health Innovators Behavioral Health Provider Coalition of Cape Cod & the Islands Big Brothers Big Sisters of Cape Cod & the Islands Boys & Girls Club of Cape Cod Cape & Islands EMS Systems, Inc. Cape & Islands United Way Cape Cod Child Development Cape Cod Community College Cape Cod Foundation Cape Cod Hunger Network Cape Cod Medical Reserve Corps Cape Cod Times Needy Fund Cape Wellness Collaborative Caron Treatment Centers Children's Cove Community Health Network Area 27 Cape Cod & Islands (CHNA 27) Dance in the Rain Peer to Peer Mental Health Center Dream Day Cape Cod Duffy Health Center Falmouth Housing Corporation Family Pantry of Cape Cod Flower Angels USA Glenna Kohl Fund for Hope Good Grief Project Greater Hyannis Civic Association Hyannis Open Streets Project Gosnold, Inc. Harbor Community Health Centers Hyannis Healthy Aging Cape Cod Helping Our Women Housing Assistance Corporation Cape Cod Independence House Massachusetts Department of Public Health Massachusetts Department of Mental Health National Alliance on Mental Illness Cape Cod Outer Cape Health Services Parkinson Support Network of Cape Cod Pause A While Samaritans on Cape Cod and the Islands Shea's Youth Basketball Association Specialty Network for the Uninsured Sustainable CAPE Team Maureen Town of Barnstable Youth Commission Town of Yarmouth Park and Recreations Department United States National Park Service and Cape Cod National Seashore University of Massachusetts Laboratory of Medical Zoology University of Massachusetts Medical School WE CAN WellStrong YMCA Cape Cod Community Health Needs Assessment Date Last Assessment Completed and Current Status The 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report (CHNA Report) and Implementation Plan was released and made widely available to the public on September 30, 2016. Consultants/Other Organizations The following organizations participated in the 2017-2019 Cape Cod Hospital and Falmouth Hospital community health needs assessment project: AIDS Support Group of Cape Cod, Alzheimer's Family Support Center of Cape Cod, Arbor Counseling Services, Barnstable County Department of Health and Environment, Barnstable County Department of Human Services,
Barnstable County Public Nursing Division, Barnstable County Regional	Substance Use Council, Barnstable Public School System, Barnstable Town Council, Behavioral Health Provider Coalition of Cape Cod & the Islands, Boys & Girls Club of Cape Cod, Cape & Islands Emergency Medical Services System, Cape & Islands Suicide Prevention Coalition, Cape & Islands United Way, Cape Cod Center for Women, Cape Cod Child Development, Cape Cod Community College, Cape Cod Council of Churches, Cape Cod District Attorney's Office, Cape Cod Foundation, Cape Cod Neighborhood Support Coalition, Cape Cod WIC, Caron Treatment Center, CCHC Centers for Behavioral Health, CCHC Emergency Services, Child and Family Services, Children's Cove, Coalition for Children, Community Action Committee of Cape Cod & the Islands, Community Development Partnership, Community Health Center of Cape Cod, Community Health Network Area 27, Duffy Health Center, Elder Services of Cape Cod & the Islands, Emerald Physicians, Falmouth Human Services, Falmouth Public School System, Falmouth Service Center, Falmouth Together We Can Falmouth Volunteers in Public Schools, Glenna Kohl Fund for Hope, Gosnold, Inc., Harbor Community Health Center-Hyannis, Health Imperatives Cape Cod, Healthy Living Cape Cod, Helping Our Women, Homeless Prevention Council, HOPE Dementia & Alzheimer's Services of Cape Cod, Hope Health, Housing Assistance Corporation, Independence House, John Snow, Inc., Justice Resource Institute, Lyme Awareness of Cape Cod, MA Department of Mental Health, MA Department of Public Health, Mashpee Wampanoag Tribe Health Service Unit, Mother and Infant Recovery Network, National Alliance on Mental Illness Cape Cod, Outer Cape Health Services, Outer Cape Women Infants and Children (WIC), Samaritans on Cape Cod and the Islands, Sandpiper Nursery School, Sandwich Public School System, SHINE (Serving Health Information Needs of Everyone), Sight Loss Services, Spaulding Rehabilitation Hospital Cape Cod, Specialty Network for the Uninsured, Substance Use in Pregnancy Task Force, The Family Pantry of Cape Cod, Town of Brewster Health Department, Town of Falmouth Council on Aging, Town of Falmouth Health Department, Town of Mashpee Council on Aging, Town of Mashpee Human Services, Town of Provincetown Council on Aging, Town of Sandwich Council on Aging, Town of Truro Council on Aging, Vinfen, Visiting Nurse Association of Cape Cod, WE CAN, Yarmouth Police Department, and the YMCA Cape Cod. Data Sources CHNA, Community Focus Groups, Consumer Group, Hospital, Interviews, MassCHIP, Other, Public Health Personnel, Surveys, US Census: American Community Survey, Center for Disease Control and Prevention, Behavioral Health Risk Factor Surveillance System, and local and regional reports and studies on demographics, health conditions and community needs. CHNA Document - PDF format CCHC CHNA REPORT_2017-2019.PDF Implementation Strategy (optional) File Upload (optional) Not Specified Community Benefits Programs Annual Strategic Grants Program: Chronic and Infectious Disease and Prevention Program Type: Community Education, Community Participation/Capacity Building Initiative, Grant/Donation/Foundation/Scholarship, health Screening, Outreach to Underserved, Prevention, Support Group. Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantaged Populations, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity. EOHHS Focus Issue(s) (optional): Chronic Disease with focus on Cancer, Heart Disease, and Diabetes, Housing Stability/Homelessness, Mental Illness and Mental Health. DoN Health Priorities (optional): Built Environment, Housing. Target Population: Regions Served: County-Barnstable - Health Indicator: Immunization, Mental Health, Other: Cancer, Other: Elder Care, Other: First Aid/ACLS/CPR, Other: Hepatitis, Other: Homelessness, Other: Lyme Disease, Other: Nutrition, Other: Sexually Transmitted Diseases, Other: Stress Management, Physical Activity, Responsible Sexual Behavior - Sex: All - Age Group: All - Ethnic Group: All - Language: All. Goal Description Award up to $250,000 to local non-profit organizations operating quality programs with anticipated outcomes aligned with Cape Cod Hospital and Falmouth Hospital implementation strategies related to chronic and infectious diseases and prevention and wellness. Goal Status Eleven organizations received $250,474 in grants ranging from $5,400 to $30,000. The recipients of grant awards included AIDS Support Group of Cape Cod, A Baby Center, Alzheimer's Family Caregiver Support Center, Cape Cod Cooperative Extension, Cape Cod Times Needy Fund, Cape Wellness Collaborative, Housing Assistance Corporation on Cape Cod, National Alliance on Mental Illness Cape Cod, Samaritans on Cape Cod & the Islands, Team Maureen, and the YMCA Cape Cod. Partners - Partner Name, Description and Web Address AIDS Support Group of Cape Cod - www.asgcc.org Alzheimers Family Caregiver Support Center - www.alzheimerscapecod.org A Baby Center - www.ababycenter.org Cape Cod Cooperative Extension - www.capecodextension.org Cape Cod Times Needy Fund - www.needyfund.org Housing Assistance Corporation on Cape Cod - www.haconcapecod.org Cape Wellness Collaborative - www.capewellness.org Team Maureen - www.teammaureen National Alliance on Mental Illness Cape Cod - www.namicapecod Samaritians on Cape Cod & The Islands - www.capesamaritans.org YMCA Cape Cod - www.ymcacapecod.org Contact Information Mary Pumphery 297 North Street Building 3, 3rd Floor Hyannis, MA 02601 Phone: 774-470-5506 Detailed Description The FY18 Annual Strategic Grants Program was a competitive grant initiative with the objective to support community-based chronic and infectious disease and prevention and wellness projects aligned with two of the four health priorities identified in the FY17 - FY19 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report and Implementation Plan. Grants were awarded to organizations with projects that reached vulnerable populations, maximized partnership collaboration and featured evidence-based programs or promising practices with the objective to improve the health of Barnstable County residents. Recovery Specialist Program in the Emergency Departments at Cape Cod Hospital and Falmouth Hospital Program Type: Direct Services, Grant/Donation/Foundation/Scholarship, Outreach to Underserved. Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, reducing Health Disparity. EOHHS Focus Issue(s) (optional): Mental Illness and Mental Health, Substance Use Disorders. DoN Health Priorities (optional): Social Environment. Target Population: Regions Served: County-Barnstable - Health Indicator: Access to Health Care, Mental Health, Other: Alcohol and Substance Abuse, Other: Hepatitis, Other: Uninsured/Underinsured, substance Abuse - Sex: All - Age Group: Adult, Adult-Elder, Adult-Young, All Adults - Ethnic Group: All - Language: All. Goal Description Engage and consult with at least 250 patients with Substance Use Disorders treated in the Emergency Departments at Cape Cod Hospital and Falmouth Hospital. Goal Status The Recovery Specialists provided consultations to 548 patients in Cape Cod Hospital and Falmouth Hospital Emergency Departments in FY18. Goal Description Motivate and assist 40% of patients who receive a consultation from the Recovery Specialist to accept a transfer to treatment or direct referral to treatment prior to discharge from the Emergency Department. Goal Status Seventy-six percent (76%) of the 548 patients who received Recovery Specialist consultation and engagement accepted direct transfer or direct referrals to inpatient/outpatient treatment upon discharge from the Emergency Departments. Treatment modalities included inpatient detoxification, hospital transfers, intensive outpatient programs, and Medication Assisted Treatment and Office-Based Addiction Programs. Goal Description Offer post-discharge follow-up and assistance to patients with Substance Use Disorders who refused services while in the Emergency Departments. Goal Status Post-discharge follow-up was offered to patients beginning in February of 2018. Two hundred and eighty-four (284) patients received post-discharge follow-up by phone including Specialists extending their assistance by coordinating referrals and treatment program placement. Twenty-six percent (26%) of those receiving post-discharge follow-up support accepted direct referrals to treatment. accepted direct referrals to treatment.
Partner Name, Description and Web Address	Gosnold, Inc. - www.gosnold.org Barnstable County Regional Substance Use Council - www.bchumanservices.net/initiatives/regional-substance-use-council/ Outer Cape Health Services - www.outercape.org Duffy Health Center - www.duffyhealthcenter.org Community Health Center of Cape Cod - www.chcofcapecod.org Harbor Community Health Center- Hyannis - www.hhsi.us/locations/harbor-community-health-center-hyannis/ Contact Information: Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description - Cape Cod Hospital and Falmouth Hospital partnered with Gosnold, Inc. to provide peer-led Recovery Specialist services in the Emergency Departments at both hospitals. Recovery Specialists have the lived experience of addiction and recovery and engage patients with Substance Use Disorders prior to discharge from the Emergency Departments. Recovery Specialists work as part of the hospital care team with the objective to motivate patients to accept treatment for Substance Use Disorders through a transfer to an inpatient treatment program or direct referrals to outpatient treatment programs. CCHC Cancer Support Services and Survivorship Activities Program Type: Community Education, Direct Services, Grant/Donation/Foundation/Scholarship, Support Group. Statewide Priority: Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity. EOHHS Focus Issue(s) (optional): Chronic Disease with focus on Cancer, Heart Disease, and Diabetes. DoN Health Priorities (optional): Built Environment. Target Population: Regions Served: County-Barnstable - Health Indicator: Other: Cancer, Other: Cancer - Breast, Other: Cancer - Cervical, Other: Cancer - Colo-rectal, Other: Cancer - Lung, Other: Cancer - Multiple Myeloma, Other: Cancer - Other, Other: Cancer - Ovarian, Other: Cancer - Prostate, Other: Cancer - Skin, Other: Cardiac Disease, Other: Cultural Competency, Other: Nutrition, Physical Activity - Sex: All - Age Group: All - Ethnic Group: All - Language: All. Goal Description Oncology Social Workers will provide psycho-social support to over 3,000 patients. Goal Status Oncology Social Workers provided services to more than 3,500 oncology patients. Services included direct counseling, family counseling, referrals to support services, referrals to support groups and financial counseling. Patients were provided direct referrals to the following community-based programs: transportation provided by the American Cancer Society's Road to Recovery Program and Lyft rides to appointments through Boston Cancer Support program, access to free complementary services such as massage, acupuncture and nutritional counseling through the Cape Wellness Collaborative, and physical reconditioning programs through CCHC's Living Fit for You! Cancer Wellness Program and the YMCA's LIVESTRONG program. Goal Description Support groups will be provided to patients and families. Goal Status More than 550 patients and family members attended CCHC support groups in FY18. Support groups included Leukemia and Lymphoma Society Family Support Groups, Support for People with Oral, Health, and Neck Cancers, Breast Cancer Support Groups and Ostomy Clinics. Support groups were facilitated by CCHC staff and hosted at CCHC facilities. Goal Description Host a Cancer Survivorship Day event to celebrate survivors, inspire those recently diagnosed and support families and caregivers. Goal Status The FY18 Survivorship Day event hosted more than 150 attendees and 25 volunteers from the CCHC Cancer Program. Support organizations, including The American Cancer Society, Team Maureen, and the Cape Wellness Collaborative provided information on prevention, support programs and self-care. CCHC employees donated 103 gift bags that were distributed to survivors. Goal Description Host a Cancer Survivorship Day event to celebrate survivors, inspire those recently diagnosed and support families and caregivers. Goal Status The FY18 Survivorship Day event hosted more than 150 attendees and 25 volunteers from the CCHC Cancer Program. Support organizations, including The American Cancer Society, Team Maureen, and the Cape Wellness Collaborative provided information on prevention, support programs and self-care. CCHC employees donated 103 gift bags that were distributed to survivors. Goal Description Through a grant from the American Cancer Society, CCHC will offer an Oncology Nutrition program to improve patients' quality of life and outcomes. Goal Status CCHC launched an Oncology Nutrition program and provided 1:1 counseling for 216 patients and their families with a Registered Dietitian through 300 visits. Services offered by the Oncology Nutrition program include meal planning for various diets and nutritional needs, assistance with initiating a tube feed for patients who are no longer able to consume foods orally, working closely with patient's care team to ensure adequate nutrition at patient's home, and providing local grocery store and local organic market gift cards for patients in need of additional monetary/dietary support. Partner Name, Description and Web Address American Cancer Society www.cancer.org/about-us/local/massachusetts.html YMCA Cape Cod LIVESTRONG www.ymcacapecod.org/programs/health-well-being/livestrong/ Cape Wellness Collaborative Visiting Nurse Association of Cape Cod Team Maureen www.capewellness.org/ www.vnacapecod.org www.teammaureen.org Boston Cancer Support www.bostoncancersupport.org Contact Information: Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description CCHC Cancer Support Services provides oncology patients and their families' psychological and social support during their treatment journey. A team of Oncology Social Workers provide ongoing counseling and support groups and direct referrals to services such as transportation, home care, and community-based wellness services such as reiki, acupuncture and massage. A new Oncology Nutrition program was started in FY18 and cancer survivorship is celebrated, supported and recognized within hospital departments and in the community. Living Fit for you! Cancer Wellness Program at Cape Cod Hospital and Falmouth Hospital Program Type: Direct Services. Statewide Priority: Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations. EOHHS Focus Issue(s) (optional): Chronic Disease with focus on Cancer, Heart Disease, and Diabetes. DoN Health Priorities (optional): Not Specified. Target Population: Regions Served: County-Barnstable - Health Indicator: Mental Health, Other: Cancer, Other: Cancer - Breast, Other: Cancer - Cervical, Other: Cancer - Colo-rectal, Other: Cancer - Lung, Other: Cancer - Multiple Myeloma, Other: Cancer - Other, Other: Cancer - Ovarian, Other: Cancer - Prostate, Other: Cancer - Skin, Other: Chronic Pain, Other: Nutrition, Physical Activity, - Sex: All - Age Group: All - Ethnic Group: All - Language: All. Goal Description Provide free group exercise program, 1:1 wellness counseling, oncology rehabilitation screenings and access to cancer survivorship programs for adults undergoing or recovering from treatment for cancer. Goal Status In FY18, 82 patients were referred to the program with 262 individualized exercise classes and wellness consults provided to address fatigue, de-conditioning, stress reduction, distress management, nutritional services, diabetes education and sleep issues. Goal Description Referrals will be made to appropriate services to continue rehabilitation and improved health outcomes. Goal Status The program referred nearly 90% of patients to additional rehabilitative services including pulmonary, cardiac, nutrition, speech and occupational therapy. Partner Name, Description and Web Address Cape Cod Healthcare - www.capecodhealth.org/classes-events Cape Wellness Collaborative - www.capewellness.org Contact Information: Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description Living Fit for You! is a free, structured, and medically-supervised six-week exercise and education program for cancer survivors before, during or after treatment. Activities focus on improving fatigue, de-conditioning and a loss of physical function. The program was founded at Falmouth Hospital and expanded to include Cape Cod Hospital in August of 2018. Moms Do Care Cape Cod Program Type: Community Participation/Capacity Building Initiative, Direct Services, Grant/Donation/Foundation/Scholarship, Health Screening, Outreach to Underserved, School/Health Center Partnership, Support Group. Outreach to Underserved, School/Health Center Partnership, Support Group.
Program Type: Community Participation/Capacity Building Initiative,	Direct Services, Grant/Donation/Foundation/Scholarship, Health Screening, Outreach to Underserved, School/Health Center Partnership, Support Group. Outreach to Underserved, School/Health Center Partnership, Support Group Statewide Priority: Address Unmet Health Needs of the Uninsured, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity. EOHHS Focus Issue(s) (optional): Housing Stability/Homelessness, Mental Illness and Mental Health, Substance Use Disorders. DoN Health Priorities (optional): Built Environment, Employment, Housing, Social Environment. Target Population: Regions Served: County-Barnstable - Health Indicator: Access to Health Care, Mental Health, Other: Alcohol and Substance Abuse, Other: Family Planning, Other: Homelessness, Other: Language/Literacy, Other: Nutrition, Other: Parenting Skills, Other: Uninsured/Underinsured, Substance Abuse, - Sex: Female- Age Group: All Adults - Ethnic Group: All - Language: English. Goal Description Provide prenatal and postpartum care coordination, access to MAT programs, and addiction recovery services to 75 pregnant women in Barnstable County. Goal Status Moms Do Care enrolled 62 women in the program. Substance use treatment and access to prenatal care services were coordinated by a Certified Addiction Registered Nurse and a Recovery Coach provided peer support services and assistance addressing social determinants of health such as housing and transportation. Goal Description Increase positive health outcomes for the women enrolled in program. Outcomes measured using baseline data included, but was not limited to, overdose rates, use of alcohol and illegal use of drugs and increased utilization of outpatient mental health and Medication-Assisted Treatment. Goal Status Advocates for Human Potential, an organization selected by MA Department of Public Health, served as the evaluator for Moms Do Care Cape Cod and Moms Do Care Worcester projects. From baseline reporting at the time of enrollment through follow-up interviews 6 months after their child was delivered, aggregated data from both sites demonstrated that Moms Do Care participants experienced a reduction in the number of overdoses, a reduction in the use of alcohol or illegal drugs, and increased utilization and adherence to mental health and substance use treatment services. Goal Description Develop a sustainability plan to continue program activities in the community at the project funding conclusion in July 2018. Goal Status CCHC worked closely with collaborators transitioning the program to Duffy Health Center in August of 2018. Duffy Health Center was awarded a MA DPH grant to continue the program starting in October 2018. CCHC provided a bridge grant of $21,000 to support the program during the transition and ensure program activities continued between grant cycles. CCHC remains a committed collaborator on the project and refers to the program from different clinical departments including hospital emergency and maternity departments, behavioral health departments, and obstetrical practices. Partner Name, Description and Web Address The Duffy Health Center - www.duffyhealthcenter.org Gandara Center - www.gandaracenter.org Institute for Health and Recovery - www.healthrecovery.org/projects/moms-do-care/ Massachusetts Department of Public Health: Bureau of Substance Addiction Services - www.mass.gov/orgs/bureau-of-substance-addiction-services Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description Cape Cod Hospital received grant funds from the MA Department of Public Health to design and operate a program called Moms Do Care with the objectives of expanding access to substance use treatment, prenatal care and peer-based recovery support services for pregnant women with Opioid Use Disorders living in Barnstable County. Specialty Network for the Uninsured: Harbor Community Health Center Hyannis Program Type Grant/Donation/Foundation/Scholarship, Outreach to Underserved. Statewide Priority Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations. EOHHS Focus Issue(s) (optional) Chronic Disease with focus on Cancer, Heart Disease, and Diabetes. DoN Health Priorities (optional) Not Specified. Target Population: Regions Served: County-Barnstable - Health Indicator: Access to Health Care, Other: Arthritis, Other: Asthma/Allergies, Other: Cancer, Other: Cancer - Prostate, Other: Cardiac Disease, Other: Chronic Pain, Other: Colitis/Crohn Disease, Other: Cultural Competency, Other: Diabetes, Other: Family Planning, Other: Hearing, Other: Hepatitis, Other: Hypertension, Other: Language/Literacy, Other: Lyme Disease, Other: Osteoporosis/Menopause, Other: Parkinson's Disease, Other: Pregnancy, Other: Pulmonary Disease/Tuberculosis, Other: Stroke, Other: Uninsured/Underinsured, Other: Vision,- Sex: All - Age Group: All - Ethnic Group: All - Language: All, Portuguese, Spanish. Goal Description Increase access to specialty care for low-income, uninsured and under-insured individuals. Goal Status In FY18, SNU coordinated 518 appointments with local medical specialists for low-income, uninsured or under-insured individuals. The FY18 program experienced an increase of 5% over the number of visits provided in FY17. Goal Description Provide access to specialists for uninsured or under-insured residents who face language barriers to care. Goal Status The number of SNU participants requesting a medical interpreter during a specialty appointment nearly doubled from FY17 (10%) to FY18 (19%). In FY18, 81% of individuals requesting a medical interpreter requested Portuguese translation and 19% requested Spanish translation. Goal Description Analyze program utilization data to identify the specialty services most needed by SNU program participants. Goal Status In FY18, the five most frequently utilized specialty services included urology, ophthalmology, ear, nose and throat (ENT), cardiology and general surgery. Partner Name, Description and Web Address Cape Cod Healthcare - www.capecodhealth.org Community Health Center of Cape Cod - www.chcofcapecod.org Duffy Health Center - www.duffyhealthcenter.org Harbor Community Health Center Hyannis - www.hhsi.us Island Health Care - www.ihimv.org Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description Cape Cod Healthcare Community Benefits provides annual grant support to Harbor Community Health Center-Hyannis to coordinate the Specialty Network for the Uninsured (SNU). The SNU program increases access to specialty care for uninsured and under-insured residents of Barnstable County through managing a network of medical specialists who provide office visits, procedures and continued care of uninsured and under-insured individuals. Barnstable County Tick Disease Testing and Education Project Program Type: Grant/Donation/Foundation/Scholarship. Statewide Priority: Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations. EOHHS Focus Issue(s) (optional): Not Specified. DoN Health Priorities (optional): Not Specified. Target Population Regions Served: County-Barnstable - Health Indicator: Other: Lyme Disease - Sex: All - Age Group: All - Ethnic Group: All - Language: All. Goal Description Provide up to 1,500 subsidized tick tests for Barnstable County residents. Testing to include: identification of tick species and life stage, high resolution micrographs of tick, assessment of feeding status, and secure private delivery of pathogen testing results. Goal Status As of September 30, 2018, just over 1,110 tick tests were completed and the results provided data and information to aid in personal risk assessment. Goal Description Provide county-wide surveillance data for use by medical providers and public health officials. The detection of one or more pathogens in ticks will be reported. Goal Status Approximately, 32% of the 1,112 tested positive with one or more pathogens. Data and information is shared with the Cape Cod Cooperative Extension. It was also noted that Barnstable residents submitted a relatively low-rate of non-tick samples compared to other regions in MA, signaling that residents assisted by this grant appear more likely to properly detect and identify ticks as opposed to other arthropods or foreign substances. Goal Description The Cape Cod Extension will develop, produce and release an online series of tick disease education and prevention videos for the public featuring a local epidemiologist.
The online videos will be promoted across the county via public locations	including schools, libraries, councils on aging and other civic gathering locations. aging and other civic gathering locations. gathering locations. Goal Status A series of ten tick education videos titled "Tickology" were released to the public on September 25, 2018. Promotion of the videos has been targeted towards libraries, garden centers, businesses, museums, land use organizations, and public health officials. Videos can be accessed on the Cape Cod Extension's website, www.capecodextension.org/ticks/ and YouTube. Partner Name, Description and Web Address Cape Cod Cooperative Extension: www.capecodextension.org UMASS Laboratory of Medical Zoology: www.tickdiseases.org Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Phone: 774-470-5506 DETAILED DESCRIPTION CCHC Community Benefits provided grant funding to subsidize a tick-borne pathogen testing program and expanded tick borne disease prevention education for residents of Barnstable County. Tick-testing and reporting was conducted by the UMASS Laboratory of Medical Zoology. The Cape Cod Cooperative Extension developed, produced and released to the public a 10-part online video series titled "Tickology" providing easily-accessible community education on tick disease prevention by local epidemiologists. Community-Based Interpreter Services Program Type: Outreach to Underserved. Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, Reducing Health EOHHS Focus Issue(s) (optional): Chronic Disease with focus on Cancer, Heart Disease, and Diabetes,Stability/Homelessness, Substance Use Disorders. DoN Health Priorities (optional): Social Environment. Target Population Regions Served: Regions Served: County-Barnstable - Health Indicator: Access to Health Care, Other: Arthritis, Other: Asthma/Allergies, Other: Cancer, Other: Cardiac Disease, Other: Chronic Pain, Other: Colitis/Crohn Disease, Other: Cultural Competency, Other: Diabetes, Other: Family Planning, Other: Hepatitis, Other: HIV/AIDS, Other: Hypertension, Other: Lyme Disease, Other: Nutrition, Other: Osteoporosis/Menopause, Other: Parkinson's Disease, Other: Pregnancy, Other: Pulmonary Disease/Tuberculosis, Other: Sexually Transmitted Diseases, Other: Sickle Cell Disease, Other: Smoking/Tobacco, Other: Stroke, Other: Uninsured/Underinsured, Overweight and Obesity, Physical Activity, Substance Abuse, Tobacco Use - Sex: All - Age Group: All Adults - Ethnic Group: All, Portuguese, Spanish - Language: All, Portuguese, Spanish. Goal Description Assist more than 800 individuals with free medical interpreters in community-based primary care and specialty care settings. Goal Status The Community Based Interpreters program served 883 individuals with medical interpretation in community-based health care settings. Goal Description Analyze program utilization data to assess regional medical interpretation needs for program evaluation. Goal Status Over 80% of people served requested Portuguese translation and 19% requested Spanish translation. Overall the number of individuals served was similar to FY17; however the regions of Cape Cod where those served by the program reside shifted slightly. The Mid-Cape region experienced an increase of 5% of the total population served and the Upper Cape region experienced a decrease in people served. In FY17 and FY18, only 1% of individuals served by the program resided in the Outer and Lower regions of Cape Cod. Partner Name, Description and Web Address Community Based Medical Offices on Cape Cod - Various Harbor Community Health Center Hyannis - www.hhsi.us/cape-cod/harbor-community-health-center-hyannis Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description CCHC provides free medical language interpreters to community-based physician offices to assist limited and non-English speaking patients and their families. The availability of proficient and professional interpreter services ensures the delivery of safe, quality health care and positive clinical outcomes. EMS Interpreter's Services Program: A collaboration between Cape Cod Healthcare and the Cape and Islands Emergency Medical Services System Program Type: Direct Services, Grant/Donation/Foundation/Scholarship, Health Professional/Staff Training. Statewide Priority: Promoting Wellness of Vulnerable Populations, Reducing Health Disparity. EOHHS Focus Issue(s) (optional): N/A. DoN Health Priorities (optional): Social Environment. Brief Description or Objective: CCHC Community Benefits provides support to the regional SHINE program to expand information, counseling and assistance with Medicare and health insurance needs at various outposts across Barnstable County. Target Population Regions Served: County-Barnstable - Health Indicator: Other: Cultural Competency, Other: Language/Literacy - Sex: All - Age Group: All - Ethnic Group: All - Language: All. Goal Description Pilot the program with Hyannis Fire Department and Yarmouth Fire Department; two of the three largest fire and rescue departments in Barnstable County, to assess need, develop training resources and track service utilization. Goal Status According to survey data, over 90% of fire department staff from both towns identified that they had encountered language barriers making it difficult to accurately assess and document health information from a patient who speaks a language other than English prior to arrival at the hospital. In response, CCHC trained firefighters and emergency responders to use phone-based interpreter services and provided a toll free number to access interpreter services from their cell phones. In addition, a language identification poster and a medical visual translator document were provided to each ambulance in the town. In the pilot phase of the program, EMT's utilized the service for 32% of patients who required translation services upon arrival at the hospital. The average translation call was 3.8 minutes and cost less than $4 per call. Goal Description Expand the program beyond two pilot sites to other municipal fire and rescue departments in Barnstable County. Goal Status CCHC Community Benefits provided program funds for ongoing costs of interpreter services and materials for the program, expanding to 13 out of the 15 towns in Barnstable County. Staff from the interpreter services departments at Cape Cod Hospital and Falmouth Hospital provided training to the town departments on use of interpreter services and visual language identifiers. Data collection is ongoing. Partner Name, Description and Web Address Cape and Islands Emergency Medical Services System - www.capeandislandsems.org Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description Cape Cod Healthcare (CCHC) and the Cape and Islands Emergency Medical Services System partnered to create a unique program that provides phone-based medical interpreter services offered via the cell phones of paramedics and first responders on ambulances to improve communication with limited-English speaking patients during an emergency and to increase accuracy of information relayed by patients during transport to a hospital. Program Type: Community Participation/Capacity Building Initiative,Grant/Donation/Foundation/Scholarship, Health Screening, Prevention. Statewide Priority: Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations. EOHHS Focus Issue(s) (optional): Chronic Disease with focus on Cancer, Heart Disease, and Diabetes,DoN Health Priorities (optional) Built Environment, Social Environment. Target Population Regions Served: County-Barnstable - Health Indicator: Other: Hypertension, Other: Stroke, Overweight and Obesity, Physical Activity- Sex: All - Age Group: All Ethnic Group: All - Language: All. Goal Description Increase the number of residents participating in the Health Parks, Healthy People seasonal walking program and 5K Run/Walk aimed at improving health knowledge and awareness of free and open spaces for physical activity. Goal Status In FY18, over 285 individuals participated in the summer walking program and 5K Run/Walk at the Cape Cod National Seashore representing a 30% increase in the number of participants over FY17. Partner Name, Description and Web Address Cape Cod National Seashore - www.nps.gov/caco/index.htm National Park Service - www.nps.gov/.../healthy-parks-healthy-people Cape Cod Healthcare - www.capecodhealth.org/wellness-wise/healthy-parks-healthy-people/ www.capecodhealth.org/wellness-wise/healthy-parks-healthy-people/
National Alliance on Mental Illness (NAMI) Cape Cod www.namicapecod.org	Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description Cape Cod Healthcare collaborated with the Cape Cod National Seashore and the National Park Services to promote community open space for wellness, exercise and physical activity to improve the health of Cape Cod residents and visitors. Prescription Assistance Program for Vulnerable Populations:Cape Cod Hospital and Falmouth Hospital Program Type: Direct Services. Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Reducing Health Disparity. Disparity. Disparity. Disparity. Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Phone: 774-470-5506 DETAILED DESCRIPTION CCHC Community Benefits provided grant funding to subsidize a tick-borne pathogen testing program and expanded tick borne disease prevention education for residents of Barnstable County. Tick-testing and reporting was conducted by the UMASS Laboratory of Medical Zoology. The Cape Cod Cooperative Extension developed, produced and released to the public a 10-part online video series titled "Tickology" providing easily-accessible community education on tick disease prevention by local epidemiologists. Detailed Description Cape Cod Healthcare collaborated with the Cape Cod National Seashore and the National Park Services to promote community open space for wellness, exercise and physical activity to improve the health of Cape Cod residents and visitors. Prescription Assistance Program for Vulnerable Populations: Cape Cod Hospital and Falmouth Hospital Program Type: Direct Services. Statewide Priority: Address Unmet Health Needs of the Uninsured, Chronic Disease Management in Disadvantage Populations, Reducing Health Disparity. Disparity. Disparity. Disparity. EOHHS Focus Issue(s) (optional): Chronic Disease with focus on Cancer, Heart Disease, and Diabetes. DoN Health Priorities (optional): Not Specified. Target Population Regions Served: County-Barnstable - Health Indicator: Access to Health Care, Other: Uninsured/Underinsured- Sex: All Age Group: All Ethnic Group: All Language: All. Goal Description Assist residents who are unable to afford medications to ensure compliance with hospital discharge planning. Goal Status In FY18, Cape Cod Hospital and Falmouth Hospital emergency and behavioral health departments provided prescription vouchers and prescription assistance totaling more than $18,300 for uninsured, under-insured or financially disadvantaged populations. Total spending on the prescription assistance program dropped by approximately 22% from FY17. This reduction is attributed to the hospital pharmacies now providing subsidized prescriptions rather than the previous approach of providing vouchers for patients to purchase prescriptions from large, national retail pharmacies. Partner Name, Description and Web Address Cape Cod Hospital - www.capecodhealth.org Falmouth Hospital - www.capecodhealth.org Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description The Prescription Assistance Program is an initiative of Cape Cod Hospital and Falmouth Hospital emergency, behavioral health and pharmacy departments as a community benefit assisting uninsured, under-insured and financially disadvantaged patients with no other viable means to pay for medications upon discharge from hospital facilities. Transportation Assistance Program for Vulnerable Populations: Cape Cod Hospital and Falmouth Hospital Program Type Direct Services. Statewide Priority Reducing Health Disparity. EOHHS Focus Issue(s) (optional) Chronic Disease with focus on Cancer, Heart Disease, and Diabetes, Mental Illness and Mental Health, Substance Use Disorders. DoN Health Priorities (optional) Built Environment. Target Population Regions Served: County-Barnstable - Health Indicator: Access to Health Care, Other: Safety, Other: Uninsured/Underinsured - Sex: All - Age Group: All - Ethnic Group: All - Language: All. Goal Description Assist residents who are unable to afford or access transportation to ensure compliance with their discharge plan. Goal Status Cape Cod Hospital and Falmouth Hospital emergency and behavioral health departments provided transportation vouchers totaling more than $62,500 for financially disadvantaged patients upon discharge. FY18 hospital transportation assistance increased more than 50% over FY17. Partner Name, Description and Web Address Local Taxi Companies - N/A Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description In an effort to assist low-income and vulnerable populations, Cape Cod Hospital and Falmouth Hospital provided access to transportation upon discharge from emergency and behavioral health departments, to those patients without resources for transportation. Health Education and Support Services for Wellness at Cape Cod Hospital and Falmouth Hospital Program Type Community Education, Direct Services, Health Screening, Outreach to Underserved, Prevention, School/Health Center Partnership, Support Group. Statewide Priority Chronic Disease Management in Disadvantage Populations, Promoting Wellness of Vulnerable Populations, Reducing Health Disparity. EOHHS Focus Issue(s) (optional) Chronic Disease with focus on Cancer, Heart Disease, and Diabetes, Mental Illness and Mental Health, Substance Use Disorders. DoN Health Priorities (optional) Built Environment, Education. Target Population Regions Served: County-Barnstable - Health Indicator: Access to Health Care, Immunization, Mental Health, Other: Alcohol and Substance Abuse, Other: Alzheimer Disease, Other: Arthritis, Other: Asthma/Allergies, Other: Bereavement, Other: Cancer, Other: Cardiac Disease, Other: Cultural Competency, Other: Diabetes, Other: HIV/AIDS, Other: Hypertension, Other: Nutrition, Other: Parenting Skills, Other: Pregnancy, Other: Stroke, Overweight and Obesity, Physical Activity,- Sex: All - Age Group: All - Ethnic Group: All - Language: English, Portuguese, Spanish. Goal Description Provide health education and support activities for the community on a continuum of issues including, but not limited to, chronic disease prevention, screening and self-management for conditions such as cancer, heart disease, and diabetes, breastfeeding and parenting, behavioral health, and cultural competency in care. Goal Status In FY18, over 14,500 staff hours were dedicated to ensuring health education and support services. Classes and support groups were offered and facilitated for individuals, families and the community. Partner Name, Description and Web Address American Cancer Society - www.cancer.org Visiting Nurses Association of Cape Cod - www.vnacapecod.org YMCA Cape Cod - www.ymcacapecod.org Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 Detailed Description At Cape Cod Hospital and Falmouth Hospital, health education and outreach activities, classes, support groups and services to increase wellness are offered to the community across a number of different health areas. From maternity department tours and new parenting classes, to community-based diabetes and stroke education, fall prevention classes, bereavement support groups and advance care planning presentations, the hospitals dedicate clinical staff and resources to support the wellness of Barnstable County residents. Workforce and Career Development Initiatives: Cape Cod Healthcare Program Type Community Participation/Capacity Building Initiative, Health Professional/Staff Training, Mentorship/Career Training/Internship, Outreach to Underserved, School/Health Center Partnership. Statewide Priority Reducing Health Disparity, Supporting Healthcare Reform. EOHHS Focus Issue(s) (optional) Chronic Disease with focus on Cancer, Heart Disease, and Diabetes, Mental Illness and Mental Health. DoN Health Priorities (optional) Education, Employment. Target Population Regions Served: County-Barnstable - Health Indicator: Access to Health Care - Sex: All - Age Group: Adult, Adult-Young - Ethnic Group: All - Language: All. Goal Description CCHC staff in various departments will provide clinical oversight and supervision to students engaged in allied health programs and various job training initiatives in the region. CCHC staff in various departments will provide clinical oversight and supervision to students engaged in allied health programs and various job training initiatives in the region.
Goal Status	In FY18, over 26,000 staff hours were devoted to workforce and career development partnership efforts including supervision of student training, job shadowing and clinical oversight. Staff hours allocated to workforce development initiatives increased by more than 30% over FY17. This increase is reflective of growth in strategic partnerships aimed at increasing educational and employment opportunities in our region. increasing educational and employment opportunities in our region. Partner Name, Description and Web Address Barnstable High School - www.barnstable.k12.ma.us Cape Cod Community College - www.capecod.edu/ Cape Cod Regional Technical High School - www.capetech.us MA College of Pharmacy and Health Sciences - www.mcphs.edu The Riverview School - www.riverviewschool.org University of Massachusetts - www.massachusetts.edu/ Upper Cape Regional Technical School - www.uppercapetech.com/ Contact Information Mary Pumphery Cape Cod Healthcare 297 North Street, Building 3, 3rd Floor Hyannis, MA, 02601 Phone: 774-470-5506 DETAILED DESCRIPTION CCHC invests in partnerships with local high schools, vocational schools, community colleges, and allied health programs for job training and shadowing and internships with health care providers in various hospital departments including, but not limited to, phlebotomy, radiology, behavioral health, and materials management. Our efforts contributed to regional economic development efforts to increase opportunity for educational attainment and provide experience for individuals to obtain stable, quality, and well-compensated jobs in our region. CCHC invests in partnerships with local high schools, vocational schools, community colleges, and allied health programs for job training and shadowing and internships with health care providers in various hospital departments including, but not limited to, phlebotomy, radiology, behavioral health, and materials management. Our efforts contributed to regional economic development efforts to increase opportunity for educational attainment and provide experience for individuals to obtain stable, quality, and well-compensated jobs in our region. departments including, but not limited to, phlebotomy, radiology, behavioral health, and materials management. Our efforts contributed to regional economic development efforts to increase opportunity for educational attainment and provide experience for individuals to obtain stable, quality, and well-compensated jobs in our region. well-compensated jobs in our region.
FUNCTIONAL EXPENSE NOTE	FORM 990, PART I AND PART IX FUNDRAISING IS CONDUCTED ON BEHALF OF CAPE COD HEALTHCARE, INC. BY CAPE COD HEALTHCARE FOUNDATION, INC. CERTAIN OFFICERS ARE COMPENSATED BY CAPE COD HEATHCARE, INC. FUNDS RAISED ARE REPORTED AT CAPE COD HEALTHCARE, INC. AND AFFILIATES. FORM 990, PART I, LINE 6 CAPE COD HEALTHCARE, INC.'S VOLUNTEERS INCLUDE ITS TRUSTEES. FORM 990, PART VI, LINE 2 TRUSTEES AND OFFICERS SIT ON THE BOARDS OF THE FOLLOWING: EMERALD PHYSICIANS MEMBER TRUST: PHILIP MCLOUGHLIN JOEL CROWELL CAPE HEALTH INSURANCE COMPANY: MICHAEL K LAUF MICHAEL L CONNORS MICHAEL G JONES BRUCE JOHNSTON PHILIP MCLOUGHLIN THE MEMBERS OF CAPE COD HEALTHCARE, INC.'S BOARD ALSO SIT ON THE BOARD OF CAPE COD MEDICAL OFFICE BUILDING AND EMERALD PHYSICIAN SERVICES, LLC, FOR-PROFIT RELATED ORGANIZATIONS. FORM 990, PART VI, LINE 4 The organization's bylaws were amended to include the following items: deletion of the development and philanthropy committee as a standing board committee as the function has been absorbed by Cape Cod Healthcare Foundation; deletion of a minimum number of members; prior automatic removal as a member for failing to attend three consecutive annual meetings have been removed; trustees may serve a maximum of three consecutive 3-year terms instead of four; physician trustees may serve three consecutive 2-year terms instead of four, establishment of a requirement for the Compliance Officer to make an annual compliance report to the Board of Trustees, and proxy votes may be submitted by facsimile transmission. FORM 990, PART VI, LINES 6&7(A) THE ORGANIZATION HAS MEMBERS/INCORPORATORS WHO ELECT THE ORGANIZATION'S TRUSTEES. FORM 990, PART VI, LINE 7(B) THE DECISIONS OF THE GOVERNING BODY THAT NEED APPROVAL BY ITS MEMBERS/INCORPORATORS INCLUDE APPROVAL OF CHANGES MADE TO THE CORPORATION'S BYLAWS AND APPROVAL WHEN THERE IS A DIVESTING OF ONE OF THE MAJOR AFFILIATES OF THE ORGANIZATION. FORM 990, PART VI, LINE 11 THE ORGANIZATION'S FORM 990 IS REVIEWED AT SEVERAL LEVELS. THE ORGANIZATION ENGAGES A PUBLIC ACCOUNTING FIRM TO ASSIST IN THE PREPARATION AND REVIEW OF ITS FORM 990 AND WHO SIGNS AS PAID PREPARER. SENIOR MANAGEMENT OF THE ORGANIZATION IS RESPONSIBLE FOR THE TIMELY PREPARATION OF FORM 990. THE COMPLETED FORM 990, WITH THE EXCEPTION OF AN ANONYMOUS DONOR, IS PROVIDED TO THE FINANCE COMMITTEE AND THE ENTIRE BOARD IN ADVANCE OF THE FILING DEADLINE. FORM 990, PART VI, LINE 12 THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY AND REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THIS POLICY. ON AN ANNUAL BASIS, EACH TRUSTEE, OFFICER AND EMPLOYEE AT THE SENIOR MANAGEMENT LEVEL COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM. THE FORMS ARE REVIEWED BY CAPE COD HEALTHCARE, INC.'S ("CCHC") DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE WHO PREPARES A SUMMARY FOR CCHC'S COMPLIANCE OFFICER. ANY MATERIAL INTERESTS SO DISCLOSED ARE PRESENTED TO THE CORPORATION'S GOVERNANCE COMMITTEE FOR REVIEW AND RESOLUTION. ALL DISCLOSURE STATEMENTS SUBMITTED BY EMPLOYEES WILL BE REVIEWED BY HUMAN RESOURCES AND/OR CCHC'S DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE. FOR ANY DISCLOSURE THAT IS CONSIDERED SUBSTANTIVE THE EMPLOYEE'S AREA MANAGER WILL BE CONSULTED TO DETERMINE IF THE SITUATION IS GENERALLY ACCEPTABLE, REQUIRES FURTHER EXAMINATION AND POSSIBLE ACTION OR IS GENERALLY NOT ACCEPTABLE. ANY ACTION PLAN CREATED TO MANAGE A CONFLICT OF INTEREST WILL BE MONITORED BY THE EMPLOYEE'S AREA MANAGER OR SUPERVISOR. FORM 990, PART VI, LINE 15 THE ANNUAL PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, OFFICERS, EXECUTIVES AND KEY EMPLOYEES INCLUDE THE FOLLOWING: CEO - COMPENSATION WILL BE DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, AND WILL INCLUDE CONSIDERATION OF RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. OFFICERS, EXECUTIVES AND KEY EMPLOYEES - OFFICER, EXECUTIVE AND KEY EMPLOYEE COMPENSATION WILL BE DETERMINED BY THE CEO AND WILL INCLUDE CONSIDERATION OF RECENT RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. THE CEO'S DETERMINATION OF SUCH COMPENSATION WILL BE SUBJECT TO THE APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED IN THE MEETING MINUTES.
FORM 990, PART VI, LINE 19	THE ORGANIZATION MAKES ITS BYLAWS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THE ANNUALLY FILED FORM PC, A PUBLICLY DISCLOSED TAX-EXEMPT ORGANIZATION FILING FOR THE STATE OF MASSACHUSETTS.
FORM 990, PART VII, COLUMN (B)	THE INDIVIDUALS REPORTED AS RECEIVING COMPENSATION FROM A RELATED ORGANIZATION IN COLUMNS (E) AND (F) IN PART VII ARE EMPLOYEES AT CAPE COD HEALTHCARE, INC., A TAX-EXEMPT RELATED ORGANIZATION. FORM 990, PART VII, SECTION A TITLE FOR JOEL CROWELL: TRUSTEE, SERVED AS TREASURER/CLERK/TRUSTEE UNTIL 5/18 TITLE FOR MICHAEL G. JONES, ESQ: SR. VP & CHIEF LEGAL OFFICER / CLERK FROM 5/18 FORM 990, PART VII, SECTION B WITH THE EXCEPTION OF REPORTING FOR VISITING NURSE ASSOCIATION OF CAPE COD, INC, CAPE COD HEALTHCARE, INC. PAYS INDEPENDENT CONTRACTORS ON BEHALF OF ITS AFFILIATES WHO FILE AS PART OF A GROUP FORM 990 AS CAPE COD HEALTHCARE, INC. AND AFFILIATES.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS OR FUND BALANCES ($3,069,833) NET ASSETS RELEASED FROM RESTRICTION (563,057) TRANSFER TO/FROM AFFILIATES 575,802 CHANGE IN VALUE SPLIT INTEREST AGREEMENT 492,634 CHANGE IN VALUE BENEFICIAL INTEREST (174,493) TRANSFER OF NET ASSETS 2,736,781 CONTRIBUTIONS ELIMINATIONS (53,989) INCLUSION OF CCRI TO GROUP EXEMPTION ------------- ($56,155) OTHER CHANGES IN NET ASSETS OR FUND BALANCES

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CAPE COD HEALTHCARE INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	297 NORTH STREET BLDG 3	AddressLine1Txt
City	HYANNIS	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02601	ZIPCd

Field	Value	IRS element (for citing)
EIN	222600704	EIN
Primary Activities	PARENT CORP	PrimaryActivitiesTxt
Legal Domicile State	MA	LegalDomicileStateCd
Exempt Code Section	501(c) (3)	ExemptCodeSectionTxt
Public Charity Status	10	PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Controlled Organization	Yes (true)	ControlledOrganizationInd

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	CAPE AND ISLAND ENDOSCOPY CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	700 ATTUCKS LANE	AddressLine1Txt
City	HYANNIS	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02601	ZIPCd

Field	Value	IRS element (for citing)
Primary Activities	ENDOSCOPY CENTER	PrimaryActivitiesTxt
Legal Domicile State	MA	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Controlled OrganizationControlledOrganizationInd	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Legal Domicile StateLegalDomicileStateCd	OwnershipOwnershipPct
CAPE HEALTH INSURANCE COMPANY
PO BOX 1051GT	GRAND CAYMAN	CJ	981230418	INSURANCE	CJ	CAPE COD HLTHCR	C CORP	$0	$0	Yes (true)
CAPE COD MEDICAL OFFICE BUILDING INC
			042423073	RENTAL SRVCE		NA	C CORP	$0	$15,000	Yes (true)	27 PARK STREET	HYANNIS	MA	02601	MA	1.00000
POOLED INCOME FUNDS (2)
				SUPPORT		NA				Yes (true)					MA
EMERALD PHYSICIAN SERVICES LLC
			043369730	PRIMARY CARE		EMERALD TRUST	S CORP	$26,802,932	$13,385,182	Yes (true)	25 COMMUNICATION WAY	HYANNIS	MA	02601	MA	1.00000
EMERALD PHYSICIANS MEMBER TRUST
			467220648	EMRLD SHAREHO		MACC	TRUST	$0	$0	Yes (true)	297 NORTH STREET BLDG 3	HYANNIS	MA	02601	MA	1.00000
CHARITABLE REMAINDER TRUSTS (20)
				SUPPORT		NA				Yes (true)					MA

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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	CAPE HEALTH INSURANCE COMPANY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	R	TransactionTypeTxt
Involved	$2,957,963	InvolvedAmt
Method Of Amount Determination	FMV	MethodOfAmountDeterminationTxt

Affiliate Listing AffiliateListing

Affiliate Listing AffiliateListingGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Business Name ControlBusinessNameControlTxt
CAPE COD HOSPITAL
297 NORTH ST BLDG 3	HYANNIS	MA	02601	042103600	CAPE
VISITING NURSE ASSN OF CAPE COD INC
297 NORTH ST BLDG 3	HYANNIS	MA	02601	042104159	CAPE
FALMOUTH HOSPITAL ASSOCIATION INC
297 NORTH ST BLDG 3	HYANNIS	MA	02601	042220716	CAPE
CAPE COD HUMAN SERVICES INC
297 NORTH ST BLDG 3	HYANNIS	MA	02601	042323506	CAPE
MEDICAL AFFILIATES OF CAPE COD INC
297 NORTH ST BLDG 3	HYANNIS	MA	02601	043187299	CAPE
CAPE COD HEALTHCARE FOUNDATION INC
297 NORTH ST BLDG 3	HYANNIS	MA	02601	043475950	CAPE
CAPE & ISLANDS HEALTH SERVICES II
297 NORTH ST BLDG 3	HYANNIS	MA	02601	043572408	CAPE
FALMOUTH ASSISTED LIVING INC
297 NORTH ST BLDG 3	HYANNIS	MA	02601	223379395	CAPE
JML CARE CENTER INC
297 NORTH ST BLDG 3	HYANNIS	MA	02601	042995795	CAPE