2019-08-15T15:22:53-05:00 2018-09-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2017-10-01 222667354 BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC BETH 5087462000 275 SANDWICH STREET PLYMOUTH MA 023602183 JASON RADZEVICH CFO 5087462000 2019-08-14 1 CHRISTINE KAWECKI P00743140 5169187000 2019-08-12 167.219.88.220 2019-08-15 15:20:55 ED P 4869E5F49B9973F149F13A18DEB0F85868CD0247 5D794220C68C161820A811785299AFD302F4C684 2017 2019-02-21 02:37:17Z JASON RADZEVICH 275 SANDWICH STREET PLYMOUTH MA 023602183 278888981 0 X WWW.BIDPLYMOUTH.ORG X X 1985 MA SEE SCHEDULE O 17 10 2046 340 277239 0 5589236 5096008 254838846 269627909 707572 758178 1929336 1939566 263064990 277421661 51250 33200 0 0 128646903 139013829 19200 19200 533560 119643546 124135265 248360899 263201494 14704091 14220167 195620140 207373993 107468282 106362894 88151858 101011099 X SEE SCHEDULE O 0 0 120226294 33200 125320789 SEE SCHEDULE O 100723574 122868579 SEE SCHEDULE O 15621224 22099147 SEE SCHEDULE O 236571092 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 1 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 224 0 1 2046 1 1 1 0 0 0 0 1 1 0 0 0 0 X 17 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 MA X MARY DWYER 5087462000 275 SANDWICH STREET PLYMOUTH MA 02360 BABINI MR MICHAEL DIRECTOR 1.00 1.00 X 0 0 0 BAZZINOTTI MS LYLE LAWRENCE CHAIR, DIRECTOR 5.00 8.00 X X 0 0 0 CARNUCCIO JOHN DIRECTOR 1.00 1.00 X 0 0 0 COUGHLIN KEVIN PRESIDENT & CEO; DIR (EX-OFF) 60.00 5.00 X X 620350 155087 67726 DAHLEN SHAWN D DIRECTOR 1.00 1.00 X 0 0 0 FISCHER STEVEN DIRECTOR; ASST TREAS, BIDMC 1.00 64.00 X 0 720675 75965 FOSDICK KENNETH VICE CHAIR, DIRECTOR 1.00 2.00 X 0 0 0 GAGNON WILLIAM P DIRECTOR 1.00 1.00 X 0 0 0 HEWITT CHARLES DIRECTOR 1.00 1.00 X 0 0 0 HINKLEY CLARK DIRECTOR, CHAIR 5.00 8.00 X X 0 0 0 LAWRENCE MS MARY ELLEN DIRECTOR 1.00 1.00 X 0 0 0 LEWIS MD STANLEY M DIR; CHF SYS DEV OFF BIDMC 1.00 59.00 X 0 723552 79816 LONIS-SCHEUB MD KIMBERLY DIRECTOR 59.00 1.00 X 281651 0 63981 MUNCEY ESQ MR PETER DIRECTOR, SECRETARY 2.00 2.00 X X 0 0 0 PRIMAVERA DENNIS DIRECTOR 1.00 1.00 X 0 0 0 SMALL KEELAS DIRECTOR 1.00 1.00 X 0 0 0 STIGLITZ CYNTHIA DIRECTOR 1.00 1.00 X 0 0 0 STUHLFAUT MD JOSHUA DIR (EX-OFF)/PRES MED STAFF 1.00 59.00 X 0 521945 43002 TABB MD KEVIN DIRECTOR; BIDMC CEO 1.00 64.00 X 0 1594288 204209 TREHU MD STEPHEN DIRECTOR 1.00 20.00 X 0 257846 10630 RADZEVICH JASON VP OF FINANCE, CFO & TREASURER 48.00 12.00 X 314958 78740 59785 BARBOSA LISA BERRY VP, HR 48.00 12.00 X 227215 25246 46886 BROWNING MD THOMAS CHIEF OF MEDICINE 30.00 30.00 X 133028 133028 52120 CONNOLLY MD JOHN VP MED MGMT/CHR ANES. DEPT 59.00 1.00 X 410202 0 47754 DOHERTY RN DONNA CNO, VP PATIENT CARE SERVICES 60.00 0.00 X 420136 0 37487 RUTHERFORD RON VP & CIO 48.00 12.00 X 218941 54735 51071 DOLAWAY DEBORAH HOSPICE ADMINISTRATOR 50.00 0.00 X 214186 0 10489 GORSUCH PHD W BRIAN CHIEF PHYSICIAN ASSISTANT 50.00 0.00 X 262784 0 38861 HEBERT NP RICHARD M NURSE PRACTITIONER 60.00 0.00 X 209373 0 31359 HOLLERAN ANDREA VP STRATEGIC PLAN/EXT AFFAIRS 60.00 0.00 X 365370 0 40463 PASKOWSKI DC IAN CHIROPRACTOR 59.00 1.00 X 209872 0 8012 HOLDEN PETER J FORMER PRESIDENT & CEO 0.00 0.00 X 0 590499 0 3888066 4855641 969616 148 1 1 0 CARDINAL HEALTH 110 LLC 3763 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 MEDICAL 29266559 RUBICON BUILDERS LLC 792 SOUTH MAIN ST MANSFIELD MA 02048 CONSTRUCTION 3213254 ALLIANCE ONCOLOGY LLC PO BOX 6600 NEWPORT BEACH CA 92658 MEDICAL 1806123 ALLIANCE HEALTHCARE SERVICES PO BOX 96485 CHICAGO IL 606936485 MEDICAL 1592199 ISTO TECHNOLOGIES II LLC PB BOX 145 HOPKINGTON MA 01748 MEDICAL 993150 33 124379 1542140 3429489 19617 5096008 OUTPATIENT 621400 124748128 124748128 INPATIENT 900099 122868579 122868579 EMERGENCY SERVICES 642200 21956082 21956082 NON PATIENT LAB 621500 55120 55120 269627909 193406 959 192447 85871 23244 62627 62627 9040 53587 1879483 63100 1320011 57800 559472 5300 564772 31305 533467 79050 124379 63944 15106 15106 8026 2321 5705 5705 CAFETERIA SALES 722210 959587 959587 PURCHASE REBATES 900099 368001 368001 PET SCAN INCOME 900099 180815 180815 347725 347725 1856128 277421661 270288515 277239 1759899 33200 33200 3065781 1057149 2008632 105120714 96068920 8731758 320036 5706075 5180156 512891 13028 17083335 15473842 1569623 39870 8037924 7297083 722489 18352 8909355 8909355 386300 368587 17713 133926 133926 143832 143832 19200 19200 15302208 14443596 841313 17299 75944212 69102867 6755221 86124 10794875 6563321 4220741 10813 313049 266004 43441 3604 64003 44870 18568 565 2678399 2678399 7589685 7589685 1356066 1356066 DUES 519355 137992 376694 4669 263201494 236571092 26096842 533560 3868629 7639840 28097879 27843022 3782343 4271068 7533062 7809253 161369823 39819387 116190204 121550436 24623867 25772865 11524156 12487509 195620140 207373993 37831284 32874558 172244 8032 60231104 62677939 9233650 10802365 107468282 106362894 X 76828150 88738255 762690 1368969 10561018 10903875 88151858 101011099 195620140 207373993 X 14220167 417882 -1778808 X X 0 1 X 1 0 X 0 1 0 0 0 0 0 0 1 143832 143832 0 PART II-B, LINE 1: DESCRIPTION OF LOBBYING ACTIVITIES BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BID-PLYMOUTH) ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER AFFILIATED NETWORK ENTITIES. ADDITIONALLY, BID-PLYMOUTH PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS, OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. IN ADDITION, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), BID-PLYMOUTH'S SOLE MEMBER, ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER AFFILIATED NETWORK ENTITIES. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $143,832 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2018. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES. 11323708 1566548 164766 782175 12272847 10543116 586128 308650 114186 11323708 10350198 261896 68978 10543116 11250430 74005 -955949 18288 10350198 10758728 1393030 221017 1122345 11250430 0.00000 0.98000 0.02000 0 0 385907 385907 92215888 12515530 79700358 15859303 3118160 12741143 41100043 24185697 16914346 11808682 11808682 121550436 INVESTMENT IN SE MASS PETCT IMAGING LLC 129228 RESTRICTED USE ASSETS 12272848 DEPOSITS RECEIVABLE 68363 OTHER RECEIVABLES 17070 12487509 PROFESSIONAL LIABILITIES 7851744 THIRD PARTY SETTLEMENT LIABILITIES 842481 DUE TO AFFILIATES 1515246 ASSET RETIREMENT OBLIGATION 592894 10802365 X 2913815000 386177 2637495942 2637882119 275932881 1488780 1488780 277421661 2795835000 2532633506 2532633506 263201494 0 263201494 PART V, LINE 4: ENDOWMENT FUND BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH'S (BID-PLYMOUTH) ENDOWMENT FUNDS ARE INTENDED TO ENSURE THAT BID-PLYMOUTH ACCOMPLISHES ITS CHARITABLE MISSION OF IMPROVING THE HEALTH AND WELL-BEING OF ITS PATIENTS AND COMMUNITY BY PROVIDING A FULL CONTINUUM OF HEALTHCARE SERVICES. BID-PLYMOUTH DELIVERS THESE SERVICES WITH EXCELLENCE AND COMPASSION AND PROVIDES ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH ITS SOLE MEMBER, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. THE SPECIFIC USES OF THE ENDOWMENT VARY DEPENDING ON THE NATURE OF RESTRICTIONS, IF ANY, IMPOSED BY DONORS. THE BID-PLYMOUTH ENDOWMENT CONSISTS OF APPROXIMATELY FORTY FUNDS. INVESTMENT INCOME EARNED IS USED FOR HOSPITAL CAPITAL NEEDS, FREE CARE, AND FOR OTHER OPERATING EXPENSES AT THE DIRECTION OF THE DONORS. UNDER BID-PLYMOUTH'S CURRENT INVESTMENT SPENDING POLICY, WHICH IS WITHIN THE GUIDELINES SPECIFIED UNDER MASSACHUSETTS STATE LAW, 4% OF THE AVERAGE OF THE FAIR VALUE OF QUALIFYING LONG-TERM INVESTMENTS APPLIED TO A THREE-YEAR MOVING AVERAGE WITH A ONE YEAR LAG IS APPROPRIATED AS STATED BY THE DONOR. IN ESTABLISHING THIS POLICY, BID- PLYMOUTH CONSIDERED THE EXPECTED RETURN ON ITS ENDOWMENT AND ITS PROGRAMMING NEEDS. ACCORDINGLY, BID-PLYMOUTH EXPECTS THE CURRENT SPENDING POLICY TO ALLOW ITS ENDOWMENT TO MAINTAIN ITS PURCHASING POWER AND TO PROVIDE A PREDICTABLE AND STABLE SOURCE OF REVENUE FOR THE ANNUAL OPERATING BUDGET. ADDITIONAL REAL GROWTH WILL BE PROVIDED THROUGH NEW GIFTS OR EXCESS INVESTMENT RETURN. PART X, LINE 2: FINANCIAL STATEMENT FOOTNOTE REGARDING LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740) AS NOTED THROUGHOUT THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BIDP) AND BIDP WAS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF BIDMC AND AFFILIATES. THE TEXT OF THE FOOTNOTE BELOW IS FROM THE BIDMC CONSOLIDATED FINANCIAL STATEMENTS. THE MEDICAL CENTER, MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP (APG), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BIDN), BETH ISRAEL DEACONESS HOSPITAL - MILTON (BIDM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH (BIDP), JORDAN HEALTH SYSTEMS, INC. AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) HAVE ALL BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND, THEREFORE, ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE MEDICAL CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE MEDICAL CENTER DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS IN EITHER 2018 OR 2017. ON DECEMBER 22, 2017, THE PRESIDENT OF THE UNITED STATES SIGNED INTO LAW H.R. 1, ORIGINALLY KNOWN AS THE TAX CUTS AND JOBS ACTS. THE NEW LAW (PUBLIC LAW NO. 115-97) INCLUDES SUBSTANTIAL CHANGES TO THE TAXATION OF INDIVIDUALS, BUSINESSES, MULTINATIONAL ENTERPRISES AND OTHERS. IN ADDITION TO THE MANY GENERALLY APPLICABLE PROVISIONS, THE LAW CONTAINS SEVERAL SPECIFIC PROVISIONS THAT RESULT IN CHANGES TO THE TAX TREATMENT OF TAX-EXEMPT ORGANIZATIONS AND THEIR DONORS. THE MEDICAL CENTER HAS REVIEWED ITS PROVISIONS AND THE POTENTIAL IMPACT OF THE LAW AND CONCLUDED THAT THE ENACTMENT OF H.R. 1 WILL NOT HAVE A MATERIAL EFFECT ON THE OPERATIONS OF THE ORGANIZATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: CONSOLIDATED AFFILIATES NET ELIMINATION 2,637,495,942. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENT EXPENSE OFFSET -23,243. FUNDRAISING EVENTS EXPENSE OFFSET -66,210. GAMING ACTIVITIES EXPENSE OFFSET -2,320. RESTRICTED CONTRIBUTIONS 1,566,548. RESTRICTED REVENUE 14,005. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE RECLASS TO OFFSET REVENUE 23,243. FUNDRAISING EVENTS EXPENSE RECLASSED TO REVENUE 66,210. GAMING ACTIVITIES EXPENSE RECLASSED TO REVENUE 2,320. CONSOLIDATED AFFILIATES NET ELIMINATION 2,532,541,733. CENTRAL AMERICA & THE CARIBBEAN 0 0 INVESTMENTS 4338082 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 665422 NORTH AMERICA 0 0 INVESTMENTS 144717 0 0 0 0 0 0 5148221 0 5148221 1 0 1 1 1 0 SCHEDULE F PART IV - FOREIGN FORMS FORM 990, SCHEDULE F, PART IV, LINE 1 ALTHOUGH BIDP WAS AN INDIRECT U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION DURING THE TAX YEAR, SUCH TRANSFERS DID NOT RESULT IN AN OBLIGATION TO FILE FORM 926, RETURN BY A U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION. FORM 990, SCHEDULE F, PART IV, LINE 3 ALTHOUGH BIDP HAD AN INDIRECT OWNERSHIP INTEREST IN A FOREIGN CORPORATION DURING THE TAX YEAR, IT DID NOT MEET ANY OF THE FIVE CATEGORIES OF REQUIRED FILER AND AS SUCH WAS NOT REQUIRED TO FILE FORM 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS. FORM 990, SCHEDULE F, PART IV, LINE 4 ALTHOUGH BIDP WAS AN INDIRECT SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR A QUALIFIED ELECTING FUND DURING THE PERIOD COVERED BY THIS FILING, SUCH OWNERSHIP DID NOT RESULT IN AN OBLIGATION TO FILE FORM 8621, INFORMATION RETURN BY A SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR QUALIFIED ELECTING FUND. FORM 990, SCHEDULE F, PART IV, LINE 5 ALTHOUGH BIDP HELD AN INDIRECT OWNERSHIP INTEREST IN A FOREIGN PARTNERSHIP DURING THE TAX YEAR, THE INTEREST DID NOT RESULT IN AN OBLIGATION TO FILE FORM 8865, RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS X X X X X X 0 GUTHRIE AND ASSOCIATES LLC 189 EARLE DRIVE NORTH KINGSTOWN RI 02852 STRATEGY & PLANNING 0 0 19200 0 19200 CA CT FL GA MD ME MA MN NH NC OH RI VT BIDP GOLF TOURNAMENT 146305 102415 43890 1000 712 21560 3899 0 13926 CH GOLF TOURNAMENT 32215 16962 15253 350 4736 4337 0 603 1 24909 5002 19907 0 0 450 8914 0 3457 203429 124379 79050 1350 712 26746 17150 17986 63944 15106 1 1 1 X 1 X 1 1 0 1 1 2716148 634536 2081612 0.00790 35777662 29876948 5900714 0.02240 38493810 30511484 7982326 0.03030 3596797 1836674 1760123 0.00670 72629355 53161543 19467812 0.07400 33200 33200 0.00010 76259352 54998217 21261135 0.08080 114753162 85509701 29243461 0.11110 1 6469858 123416851 125133773 -1716922 X 1 1 1 1 BETH ISRAEL DEACONESS HOSPITAL- PLYMOUTH 275 SANDWICH STREET PLYMOUTH MA 023602183 WWW.BIDPLYMOUTH.ORG 2082 X X X COMMUNITY HOSPITAL BETH ISRAEL DEACONESS HOSPITAL- PLYMOUTH 1 0 0 1 X X X X X X X 15 1 1 0 1 X SEE PART VI X 1 15 1 SEE PART VI 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X SEE PART VI X SEE PART VI X SEE PART VI X X X X X X 1 X 0 X X X 1 X 0 0 3 1 - BID-PLYMOUTH REHABILITATION CENTER 10 CORDAGE PARK CIRCLE SUITE 225 PLYMOUTH MA 02360 OTHER LOCATIONS 2 - BID-PLYMOUTH REHABILITATION CENTER 3 VILLAGE GREEN NORTH SUITE 331 PLYMOUTH MA 02360 OTHER LOCATIONS 3 - BETH ISRAEL DEACONESS IMAGING THE PARK 45 RESNIK ROADSUITE 104-B106201 PLYMOUTH MA 02360 OTHER LOCATIONS FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENT BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH (BID-PLYMOUTH) SEEKS TO IMPROVE THE HEALTH AND WELLBEING OF ITS PATIENTS AND COMMUNITY BY PROVIDING A FULL CONTINUUM OF HEALTHCARE SERVICES WITH EXCELLENCE AND COMPASSION. SERVING THE GREATER PLYMOUTH REGION, THE HOSPITAL COLLABORATES WITH COMMUNITY LEADERS, PUBLIC AND PRIVATE AGENCIES, AND BUSINESSES, TOGETHER PROVIDING HEALTH PROMOTION, HEALTH PROTECTION AND PREVENTIVE SERVICES TO MEET THE BROAD RANGE OF THE COMMUNITY'S HEALTH AND WELLNESS NEEDS. THESE NEEDS ARE, IDENTIFIED THROUGH COMMUNITY FEEDBACK AND FORMAL COMMUNITY NEEDS ASSESSMENTS. AS PART OF ITS MISSION TO SUPPORT COMMUNITY HEALTH, BID-PLYMOUTH IS COMMITTED TO ASSESSING ROOT CAUSES OF HEALTH DISPARITIES AND TO ASSISTING IN IMPROVING HEALTH CARE FOR THE DISADVANTAGED AND UNDERSERVED.BID-PLYMOUTH COLLABORATES WITH COMMUNITY LEADERS, PUBLIC AND PRIVATE AGENCIES AND BUSINESSES ACROSS ALL SECTORS TO IMPLEMENT A BROAD RANGE OF COMMUNITY HEALTH IMPROVEMENT INITIATIVES, WHICH ARE GEARED TOWARD MEETING THE COMMUNITY'S DIVERSE HEALTH AND WELLNESS NEEDS, INCLUDING THE UNDERLYING SOCIAL DETERMINANTS. THESE INITIATIVES MAKE UP BID-PLYMOUTH'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND SERVE ALL IN NEED ACROSS THE DEMOGRAPHIC AND SOCIO-ECONOMIC SPECTRUM, WITH SPECIAL EMPHASIS ON THOSE WHO ARE UNDERSERVED, VULNERABLE AND MOST AT-RISK. THESE INITIATIVES ARE VARIED AND INCLUDE INITIATIVES AIMED AT: 1) COMMUNITY OUTREACH; SCREENING, AND PREVENTION; 2) HEALTH PROMOTION AND EDUCATION; 3) ENHANCING ACCESS TO SERVICES, 4) INTEGRATING SERVICES AND COORDINATING PATIENT CARE ACROSS THE CONTINUUM, AND 5) MANAGING CHRONIC DISEASE. BID-PLYMOUTH'S IMPLEMENTATION STRATEGY WAS INFORMED BY A ROBUST COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY ENGAGEMENT PROCESS THAT GATHERED ALL AVAILABLE QUANTITATIVE HEALTH-RELATED DATA FROM FEDERAL, COMMONWEALTH, AND LOCAL SOURCES AS WELL AS VITAL QUALITATIVE INFORMATION THROUGH COMMUNITY INTERVIEWS, FOCUS GROUPS, SURVEYS AND COMMUNITY FORUMS. BID-PLYMOUTH IS COMMITTED TO A DATA-DRIVEN APPROACH AS WELL AS ONE THAT IS INFORMED BY A ROBUST, INCLUSIVE COMMUNITY PROCESS THAT ENGAGES ALL STAKEHOLDERS, INCLUDING COMMUNITY RESIDENTS. BOTH OF THESE EFFORTS ARE CRUCIAL TO IDENTIFYING COMMUNITY HEALTH PRIORITIES, UNDERSTANDING THE ROOT CAUSES OF POOR HEALTH STATUS, AND FULLY APPRECIATING THE UNDERLYING SOCIAL DETERMINANTS THAT ARE AT THE HEART OF THE DISPARITIES IN ACCESS AND HEALTH OUTCOMES THAT EXIST IN ITS SERVICE AREA. BID-PLYMOUTH'S COMMUNITY BENEFITS MISSION IS FULFILLED BY:- INVOLVING BID-PLYMOUTH'S STAFF, INCLUDING ITS LEADERSHIP, AND DOZENS OF COMMUNITY PARTNERS IN THE COMMUNITY HEALTH ASSESSMENT PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION, AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY;- ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION, AND EVALUATION. IN THIS REGARD, SPECIAL ATTENTION IS GIVEN TO ENGAGING DIVERSE PERSPECTIVES FROM THOSE WHO ARE OFTEN LEFT OUT OF THESE ASSESSMENTS, PLANNING, AND PROGRAM IMPLEMENTATION PROCESSES, AS WELL AS FROM PATIENTS AND NON-PATIENTS ALIKE;- ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES;- IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN BID-PLYMOUTH'S SERVICE AREA GEARED TOWARD IMPROVING CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES, AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM, AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES;- PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM, AND BIGOTRY, AS WELL AS ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND- FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT, AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS, AND SERVICES.AS NOTED THROUGHOUT THIS NARRATIVE, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER, IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND FOR THE PERIOD COVERED BY THIS FILING SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH. THE MEDICAL CENTER IS COMMITTED TO ITS COMMUNITY. THE MEDICAL CENTER'S MISSION IS TO SERVE PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM AND THEIR FAMILIES. THAT MISSION IS SUPPORTED BY THE MEDICAL CENTER'S COMMITMENT TO PERSONALIZED, EXCELLENT CARE FOR OUR PATIENTS; A WORKFORCE COMMITTED TO INDIVIDUAL ACCOUNTABILITY, MUTUAL RESPECT AND COLLABORATION; AND A COMMITMENT TO MAINTAINING OUR FINANCIAL HEALTH. THE MEDICAL CENTER IS COMMITTED TO BEING ACTIVE IN THE COMMUNITY AS WELL. SERVICE TO COMMUNITY IS AT THE CORE AND AN IMPORTANT PART OF THE MEDICAL CENTER'S MISSION. BIDMC HAS A COVENANT TO CARE FOR THE UNDERSERVED AND TO WORK TO CHANGE DISPARITIES IN ACCESS TO CARE. THE MEDICAL CENTER KNOWS THAT TO BE SUCCESSFUL WE NEED TO LEARN FROM THOSE WE SERVE. THE MEDICAL CENTER'S COMMUNITY BENEFIT MISSION IS FULFILLED BY:- IMPLEMENTING PROGRAMS AND SERVICES IN GREATER BOSTON AND OUTER CAPE COD TO IMPROVE THE CURRENT AND FUTURE HEALTH STATUS OF MEDICALLY UNDERSERVED COMMUNITIES WHICH ARE CHALLENGED BY BARRIERS IN ACCESSING AND INTERACTING EFFECTIVELY WITH THE HEALTHCARE SYSTEM AND IMPACTED BY OTHER SOCIAL DETERMINANTS OF HEALTH.- ENSURING THAT ALL PATIENTS RECEIVE EQUITABLE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE AND THAT THE MEDICAL CENTER IS WELCOMING AND INCLUSIVE.; AND- ENCOURAGING COLLABORATIVE RELATIONSHIPS WITH OTHER PROVIDERS AND GOVERNMENT ENTITIES TO SUPPORT AND ENHANCE RATIONAL AND EFFECTIVE HEALTH POLICIES AND PROGRAMS. DURING THE FISCAL YEAR COVERED BY THIS FILING, BID-PLYMOUTH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS, CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $ 3,629,997 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I, COLUMN D. AS NOTED IN THE NARRATIVE DETAIL TO SCHEDULE H BELOW, BID-PLYMOUTH HAS COLLABORATED WITH THE COMMONWEALTH OF MASSACHUSETTS ON MANY OF THESE EFFORTS BECAUSE THE HOSPITAL IS UNIQUELY QUALIFIED IN ITS COMMUNITIES TO PROVIDE CERTAIN SERVICES. AS A RESULT, THE HOSPITAL HAS RECEIVED GRANT FUNDING TOTALING $1,836,674, WHICH HAS SIMILARLY BEEN REPORTED IN THIS SCHEDULE H, PART I, LINES 7E AND 7I, COLUMN D. IN ADDITION, DURING THE FISCAL YEAR COVERED BY THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER, WHICH SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH PROVIDED NET COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFITS OPERATIONS, CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $16,132,415 AS REPORTED ON THE MEDICAL CENTER'S SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIPBID-PLYMOUTH IS A PUBLIC CHARITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BID-PLYMOUTH UNDERSTANDS THE IMPORTANCE OF HAVING THE HIGHEST LEVEL OF THE HOSPITAL'S LEADERSHIP INVOLVED AND ENGAGED IN ALL ASPECTS OF THE DEVELOPMENT, IMPLEMENTATION, EVALUATION, AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY/CHIP. WITH THIS IN MIND, THE SENIOR LEADERSHIP TEAM NOTED BELOW (SLT), AND BID-PLYMOUTH'S BOARD OF DIRECTORS OVERSEE ALL ASPECTS OF THE HOSPITAL'S CHIP. THE SLT MEETS PERIODICALLY TO DISCUSS PROGRESS AND OVERSEE THE IMPLEMENTATION OF THE CHIP. IN ADDITION, THE BOARD OF DIRECTORS OVERSEES AND PROVIDES IMPORTANT INPUT. IN ADDITION TO OVERSEEING THE CHIP, THE SLT AND THE BOARD OF DIRECTORS OVERSEE AND ARE PERIODICALLY INVOLVED IN COMMUNITY ENGAGEMENT ACTIVITIES, THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, AND THE CREATION OF THE THREE-YEAR IMPLEMENTATION STRATEGY, ALONG WITH ITS ANNUAL UPDATES. BID-PLYMOUTH SENIOR LEADERSHIP TEAM FOR THE PERIOD COVERED BY THIS FILING, THE FOLLOWING INDIVIDUALS SERVED ON THE BID-PLYMOUTH SLT:- KEVIN COUGHLIN, PRESIDENT AND CHIEF EXECUTIVE OFFICER- LISA BERRY BARBOSA, VICE PRESIDENT OF HUMAN RESOURCES- MARY CHAPIN, VICE PRESIDENT AMBULATORY SERVICES & PROCESS IMPROVEMENT- DONNA DOHERTY, VICE PRESIDENT OF NURSING & CNO- ANDREA HOLLERAN, VICE PRESIDENT OF STRATEGIC PLANNING & EXTERNAL AFFAIRS- CYNTHIA OUTHOUSE, VICE PRESIDENT OF PHILANTHROPY- JASON RADZEVICH, VICE PRESIDENT OF FINANCE & CFO- RONALD RUTHERFORD, VICE PRESIDENT & CIOBID-PLYMOUTH BOARD OF DIRECTORSPLEASE SEE FORM 990 PART VII FOR A LIST OF INDIVIDUALS WHO SERVED ON THE BOARD OF DIRECTORS DURING THE PERIOD COVERED BY THIS FILING.SENIOR LEADERSHIP TEAM AND PATIENT FAMILY ADVISORY COUNCIL SENIOR LEADERSHIP TEAM. THE HOSPITAL'S SENIOR LEADERSHIP TEAM (SLT) MEETS WEEKLY TO ADDRESS HOSPITAL BUSINESS. THE AGENDA FOR THIS MEETING REGULARLY INCLUDES TOPICS RELEVANT TO THE HOSPITAL'S IMPLEMENTATION STRATEGY, INCLUDING ISSUES RELATED TO ASSESSMENT OF NEED, COMMUNITY OUTREACH/ENGAGEMENT, PARTNER DEVELOPMENT/COLLABORATION, COMMUNITY BENEFITS PROGRAM OPERATIONS, AND EVALUATION OF OUTCOMES/IMPACT. THE SLT IS DEDICATED TO PRIORITIZING, PLANNING AND TRACKING THE HOSPITAL'S IMPLEMENTATION STRATEGY TO ADDRESS THE FINDINGS OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT.PATIENT FAMILY ADVISORY COUNCIL. IN ADDITION TO THE SLT, THE VICE PRESIDENT FOR EXTERNAL AFFAIRS AND HER HOSPITAL COLLEAGUES WORK TO ENGAGE AND INVOLVE THE HOSPITAL'S PATIENT FAMILY ADVISORY COUNCIL (PFAC) IN DEVELOPING, IMPLEMENTING, AND EVALUATING THE IMPLEMENTATION STRATEGY. PERIODICALLY, THE HOSPITAL'S COMMUNITY BENEFITS STAFF PRESENT TO THE PFAC TO SEEK THEIR INPUT AND ENGAGE THEM IN IMPORTANT AND TARGETED WAYS THAT HELP TO ENSURE THE SUCCESS OF THE IMPLEMENTATION STRATEGY. DURING THE PERIOD COVERED BY THIS FILING, THE PFAC WORKED ON COMMUNITY EDUCATION EVENTS RELATED TO END OF LIFE CARE; MET WITH THE SUPERINTENDENT OF PLYMOUTH SCHOOLS TO DISCUSS LEADING HEALTH CONCERNS FOR YOUTH; AND MET WITH THE PLYMOUTH DIRECTOR OF PUBLIC HEALTH TO BETTER UNDERSTAND THE HEALTH NEEDS IN THE COMMUNITY, JUST TO NAME A FEW. THE PFAC MADE IMPORTANT CONTRIBUTIONS TO REFINING THESE INITIATIVES.COMMUNITY HEALTH NEEDS ASSESSMENTCOMMUNITY HEALTH NEEDS ASSESSMENT - INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE (IRC) SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BID-PLYMOUTH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2016. THE NEEDS ASSESSMENT AND ACCOMPANYING CHIP WERE APPROVED BY THE BID-PLYMOUTH BOARD OF DIRECTORS ON OR BEFORE SEPTEMBER 30, 2016. THE BID-PLYMOUTH COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP OR IMPLEMENTATION STRATEGY) WERE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OUT OF BID-PLYMOUTH'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLED THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BID-PLYMOUTH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW THE BID-PLYMOUTH, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT.COMMUNITY HEALTH NEEDS ASSESSMENT - TARGETED GEOGRAPHY AND POPULATIONTHE 2016 COMMUNITY HEALTH ASSESSMENT (CHNA) FOCUSED ON PLYMOUTH AND BARNSTABLE COUNTIES, INCLUDING THE COMMUNITIES OF BOURNE, CARVER, DUXBURY, HALIFAX, KINGSTON, PEMBROKE, PLYMPTON, PLYMOUTH, MARSHFIELD, MIDDLEBORO, SANDWICH AND WAREHAM. FOCUSING BID-PLYMOUTH'S CHNA ON THIS GEOGRAPHIC AREA FACILITATED THE ALIGNMENT OF THE HOSPITAL'S EFFORTS WITH COMMUNITY AND GOVERNMENTAL PARTNERS, AND MANY COMMUNITY-BASED ORGANIZATIONS. BID-PLYMOUTH'S COMMUNITY BENEFITS PRIMARY SERVICE AREA (CBSA) INCLUDES CARVER, DUXBURY, KINGSTON, AND PLYMOUTH. THIS PRIMARY SERVICE AREA ENCOMPASSES A POPULATION OF 101,093 WITH PLYMOUTH ACCOUNTING FOR OVER HALF OF THE POPULATION (59,885). THE CHNA ANALYSIS FOCUSED ON THIS PRIMARY SERVICE AREA BUT ALSO INCLUDED SECONDARY SERVICE AREA COMPARISONS. BID-PLYMOUTH'S SECONDARY SERVICE AREA INCLUDES BOURNE, HALIFAX, MARSHFIELD, MIDDLEBOROUGH, PEMBROKE, PLYMPTON, SANDWICH, AND WAREHAM. FINDINGS FROM BID-PLYMOUTH'S FY 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, ON WHICH THIS REPORT IS BASED, SHOWED THAT THERE WERE POCKETS OF VULNERABLE AND UNDERSERVED SEGMENTS THROUGHOUT THE SERVICE AREA. THE HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH STATUS AND WELL-BEING OF THOSE LIVING THROUGHOUT THIS AREA. THE ASSESSMENT ALSO CLEARLY SHOWED THAT THE LOW INCOME AND RACIALLY/ETHNICALLY DIVERSE POPULATIONS LIVING IN THE PLYMOUTH AREA WERE THE MOST AT-RISK SEGMENTS IN THE SERVICE AREA AND, AS A RESULT, THE TOWN OF PLYMOUTH IS THE FOCAL POINT OF MOST OF THE HOSPITAL'S CHIP/IMPLEMENTATION STRATEGY.BID-PLYMOUTH'S CHIP INCLUDES NUMEROUS INITIATIVES THAT SUPPORT RESIDENTS THROUGHOUT THE SERVICE AREA TO LIVE HEALTHY, ACTIVE, INDEPENDENT, AND FULFILLING LIVES. BASED ON THE QUANTITATIVE AND QUALITATIVE FINDINGS FROM THE FY 2016 CHNA, INCLUDING AN EXTENSIVE RANGE OF COMMUNITY ENGAGEMENT ACTIVITIES, THERE WAS BROAD AGREEMENT THAT BID-PLYMOUTH'S IMPLEMENTATION STRATEGY SHOULD PRIORITIZE YOUTH, ADULTS WITH OR AT RISK OF CHRONIC PHYSICAL OR BEHAVIORAL HEALTH CONDITIONS, LOW-INCOME INDIVIDUALS AND FAMILIES, AND OLDER ADULTS. THESE DEMOGRAPHIC AND SOCIO-ECONOMIC SEGMENTS ARE MORE LIKELY TO HAVE COMPLEX NEEDS AND FACE BARRIERS TO CARE, SERVICE GAPS, AND OTHER ADVERSE SOCIAL DETERMINANTS OF HEALTH. THESE FACTORS PUT THEM AT GREATER RISK AND LIMIT THEIR ACCESS TO NEEDED SERVICES, WHICH IN TURN LEADS TO DISPARITIES IN HEALTH OUTCOMES. COMMUNITY HEALTH NEEDS ASSESSMENT -- APPROACH AND METHODS CHNA COMPLETED DURING FISCAL YEAR ENDED SEPTEMBER 30, 2016 BID-PLYMOUTH, ALONG WITH ITS AFFILIATE HOSPITALS: BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM AND BETH ISRAEL DEACONESS HOSPITAL - MILTON CONTRACTED WITH JOHN SNOW, INC (JSI) TO CONDUCT ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FURTHER UNDERSTAND THE COMMUNITIES' UNMET HEALTH NEEDS. (SCHEDULE H PART V SECTION B QUESTION 6A). THE RESULTS OF THIS PROCESS HELPED GUIDE BID-PLYMOUTH'S EFFORTS TO IMPROVE THE HEALTH OF THE REGIONAL POPULATION SERVED. THE CHNA WAS CONDUCTED IN THREE PHASES, WHICH ALLOWED BID-PLYMOUTH TO:1. COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA2. ENGAGE AND INVOLVE KEY STAKEHOLDERS, BID-PLYMOUTH CLINICAL AND ADMINISTRATIVE STAFF, AND THE COMMUNITY AT-LARGE3. DEVELOP A REPORT AND DETAILED STRATEGIC PLAN4. COMPLY WITH ALL COMMONWEALTH ATTORNEY GENERAL AND FEDERAL IRS COMMUNITY BENEFITS REQUIREMENTSTHE 2016 CHNA WAS CONDUCTED IN A THREE-PHASED PROCESS. - PHASE I INVOLVED A RIGOROUS AND COMPREHENSIVE REVIEW OF EXISTING QUANTITATIVE DATA ALONG WITH QUALITATIVE DATA COLLECTION PRIMARILY THROUGH A SURVEY OF 190 PARTNERS TO CHARACTERIZE COMMUNITY NEEDS. OTHER DATA SOURCES INCLUDED: - VITAL STATISTICS, CANCER REGISTRY, COMMUNICABLE DISEASE REGISTRY, MA DPH/MASSCHIP - BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (MA DPH) - AMERICAN COMMUNITY SURVEY (US CENSUS)- PHASE II INVOLVED A MORE TARGETED ASSESSMENT OF NEED AND BROADER COMMUNITY ENGAGEMENT ACTIVITIES THAT INCLUDED LISTENING SESSIONS WITH HEALTH, SOCIAL SERVICE, AND PUBLIC HEALTH SERVICE PROVIDERS AS WELL AS FORUMS THAT INCLUDED THE COMMUNITY AT-LARGE. OTHER DATA SOURCES INCLUDED CLAIMS DATA FOR HOSPITAL INPATIENT AND EMERGENCY DEPARTMENT DISCHARGES (CHIA) AND RESOURCE INVENTORY. ANALYSES INCLUDED COMPARATIVE BENCHMARKING AND MAPPING OF HEALTH INDICATOR DATA. - PHASE III INVOLVED A SERIES OF STRATEGIC PLANNING AND REPORTING ACTIVITIES THAT INVOLVED A BROAD RANGE OF INTERNAL AND EXTERNAL STAKEHOLDERS. THIS PHASE ALSO INCLUDED A RANGE OF COMMUNITY FORUMS, WHEREBY BID-PLYMOUTH COMMUNICATED THE RESULTS OF THE CHNA AND OUTLINED THE CORE ELEMENTS OF ITS CURRENT AND REVISED CHIP. (SCHEDULE H PART V SECTION B QUESTION 5).IN COLLECTING THIS DATA, BID-PLYMOUTH SOUGHT TO DETERMINE WHERE COMMUNITY PROGRAMS ARE ALREADY MEETING HEALTH AND WELLNESS NEEDS AND DETERMINE WHICH COMMUNITY HEALTH NEEDS REMAIN UNMET. DATA SOURCES INCLUDED A BROAD ARRAY OF PUBLICLY AVAILABLE SECONDARY DATA, INTERVIEWS WITH KEY STAKEHOLDERS, A PARTNER SURVEY OF 190 PARTNERS IN THE BID-PLYMOUTH SERVICE AREA, AND FOUR FORUMS/FOCUS GROUPS. SINCE THE BEGINNING OF THE ASSESSMENT IN EARLY OCTOBER 2015, DOZENS OF INDIVIDUALS PARTICIPATED IN INTERVIEWS AND FORUMS/FOCUS GROUPS, AND ALMOST 200 INDIVIDUALS COMPLETED A PARTNER SURVEY FOR BID-PLYMOUTH'S SERVICE AREA. THESE PARTICIPANTS INCLUDED REPRESENTATIVES FROM HEALTH AND SOCIAL SERVICE PROVIDER ORGANIZATIONS, PUBLIC HEALTH DEPARTMENTS, COMMUNITY ADVOCACY GROUPS, COMMUNITY BUSINESSES, AND MANY OTHER TYPES OF COMMUNITY ORGANIZATIONS, AS WELL AS FROM THE COMMUNITY AT-LARGE. THE INFORMATION GATHERED AS PART OF THESE EFFORTS ALLOWED JSI AND BID-PLYMOUTH TO ENGAGE THE COMMUNITY AND GAIN A BETTER UNDERSTANDING OF COMMUNITY CAPACITY, STRENGTHS, AND CHALLENGES AS WELL AS COMMUNITY HEALTH STATUS, BARRIERS TO CARE, SERVICE GAPS, UNDERLYING DETERMINANTS OF HEALTH, AND OVERALL COMMUNITY NEED. THE CHNA UTILIZED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. AS NOTED ABOVE, THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS IN THE REGION AS WELL AS INFORMATION FROM COMMUNITY DIALOGUES CONDUCTED WITH COMMUNITY RESIDENTS, AND INTERVIEWS WITH COMMUNITY STAKEHOLDERS. (SCHEDULE H, PART V, SECTION B, QUESTION 5). BID-PLYMOUTH CONDUCTED THIS CHNA PROCESS IN CONJUNCTION WITH ITS SOLE MEMBER, BETH ISRAEL DEACONESS MEDICAL CENTER, AS WELL AS THE OTHER HOSPITALS FOR WHICH BIDMC SERVES AS SOLE MEMBER, BID-MILTON AND BID-NEEDHAM. ALTHOUGH THESE HOSPITALS WORKED TOGETHER ON THE CHNA PROCESS, EACH HOSPITAL ULTIMATELY COMPILED ITS OWN INDEPENDENT CHNA AND IMPLEMENTATION STRATEGY. (SCHEDULE H, PART V, SECTION B, QUESTION 6A AND 6B).IN ADDITION TO THE METHODOLOGIES LISTED ABOVE, BID-PLYMOUTH GATHERS DATA ON AN ON-GOING BASIS THROUGH ITS SPEAKER'S BUREAU PROGRAM, HOUSECALLS, WHERE STAFF GATHER SURVEY DATA BY ASKING THOSE WHO ATTEND THE HEALTH EDUCATION PROGRAMS TO PROVIDE FEEDBACK AND IDENTIFY HEALTH-RELATED TOPICS THEY WOULD LIKE TO HEAR PRESENTED BY BID-PLYMOUTH CLINICIANS. DURING THE PERIOD COVERED BY THIS FILING, MORE THAN 190 AREA RESIDENTS PARTICIPATED IN BID-PLYMOUTH'S HOUSECALLS EDUCATIONAL PROGRAMS. TOPICS INCLUDED MAKO TECHNOLOGY FOR PARTIAL KNEE REPLACEMENT, HERNIAS, WHEN SURGERY IS NECESSARY, MIGRAINE TREATMENT OPTIONS, BACK PAIN TREATMENT AND SLEEP APNEA.THE HOSPITAL ALSO WORKS WITH A PATIENT FAMILY ADVISORY COUNCIL (PFAC). THIS COMMITTEE MEETS AT LEAST QUARTERLY AND PROVIDES FEEDBACK TO HELP MAKE IMPROVEMENTS THROUGHOUT THE HOSPITAL. EXAMPLES OF IMPROVEMENT INITIATIVES INCLUDE END OF LIFE CARE EVENT, A DISCUSSION WITH THE SUPERINTENDENT OF PLYMOUTH SCHOOLS ON THE LEADING HEALTH CONCERNS FOR YOUTH, AND MET WITH THE PLYMOUTH DIRECTOR OF PUBLIC HEALTH TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITY.COMMUNITY HEALTH NEEDS ASSESSMENT - KEY FINDINGS - CHNA COMPLETED DURING FISCAL YEAR ENDED SEPTEMBER 30, 2016BID-PLYMOUTH'S CHNA IDENTIFIED THE FOLLOWING KEY HEALTH-RELATED OPPORTUNITIES:1. DECREASING ALCOHOL AND SUBSTANCE USE, INCLUDING OPIOID USE2. INCREASING ACCESS TO HEALTHY FOOD AND PHYSICAL ACTIVITY3. BETTER MANAGING MENTAL ILLNESS4. ADDRESSING THE COMMUNITY'S HIGH PREVALENCE OF CHRONIC DISEASE AND CANCER5. INCREASING SUPPORT FOR OLDER ADULTS6. ADDRESSING CONCERNS AROUND LYME DISEASE AND PNEUMONIA THE CHNA'S APPROACH AND PROCESS PROVIDED AMPLE OPPORTUNITY TO VET THE QUANTITATIVE AND QUALITATIVE DATA COMPILED DURING THE ASSESSMENT. BID-PLYMOUTH HAS FRAMED THE COMMUNITY HEALTH NEEDS UNDER THREE AREAS, WHICH TOGETHER ENCOMPASS THE BROAD RANGE OF HEALTH ISSUES FACING THE COMMUNITY. THESE THREE AREAS ARE: 1. HEALTH RISK FACTORS2. PHYSICAL DISEASE MANAGEMENT AND PREVENTION3. BEHAVIORAL HEALTH INCLUDING MENTAL HEALTH AND SUBSTANCE USE DISORDER.BID-PLYMOUTH ALREADY LEADS AND SUPPORTS A NUMBER OF INITIATIVES UNDER THESE AREAS, AND FOR THE PERIODS FOR WHICH THIS CHNA AND ASSOCIATED CHIP WILL INFORM BID-PLYMOUTH'S COMMUNITY BENEFITS OPERATIONS (FISCAL YEARS ENDING SEPTEMBER 30, 2017, SEPTEMBER 30, 2018 AND SEPTEMBER 30, 2019), BID-PLYMOUTH WILL SEEK TO EXPAND ON THESE INITIATIVES TO FURTHER PROMOTE COMMUNITY HEALTH. COMMUNITY HEALTH NEEDS ASSESSMENT - ADDRESSING COMMUNITY HEALTH NEEDS BID-PLYMOUTH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY, WHICH ARE AVAILABLE ON THE BID-PLYMOUTH WEBSITE. AS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, BID-PLYMOUTH'S MOST RECENTLY COMPLETED CHNA WAS COMPLETED DURING THE FISCAL YEAR ENDING 2016 AND THE FIRST YEAR OF ACCOMPLISHMENTS UNDER THAT CHNA AND IMPLEMENTATION STRATEGY (CHIP) ARE DETAILED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H FOR THIS FISCAL YEAR ENDING SEPTEMBER 30, 2018. THAT CHNA AND CHIP ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT (SCHEDULE H PART V SECTION B LINE 10A):HTTP://WWW.BIDPLYMOUTH.ORG/COMMUNITY-BENEFITSIN ADDITION, THE CHNA AND CHIP WHICH WERE PREVIOUSLY COMPLETED DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2013 AND UNDER WHICH COMMUNITY BENEFITS ACTIVITIES WERE GUIDED FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2014, SEPTEMBER 30, 2015 AND SEPTEMBER 30, 2016 IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE AT: HTTP://WWW.BIDPLYMOUTH.ORG/COMMUNITY-BENEFITSBOTH DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST. (SCHEDULE H, PART V, SECTION B, LINE 7A.) A SUMMARY OF BID-PLYMOUTH'S COMMUNITY BENEFITS ACTIVITIES, WHICH ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDING SEPTEMBER 30, 2016 AND PRIORITIZED IN THE RELATED CHIP, ARE PROVIDED HERE ALONG WITH THE ENTITIES WITH WHICH THE BID-PLYMOUTH PARTNERS RELATED TO THESE EFFORTS. ALSO INCLUDED ARE THE PRIORITY AREAS THAT THESE ACTIVITIES ADDRESS, ACTIVITY GOAL STATEMENTS, AND A SUMMARY OF KEY ACCOMPLISHMENTS RELATED TO THESE ACTIVITIES IN FY 2018.HEALTHY PLYMOUTH INITIATIVEPROGRAM DESCRIPTIONBID-PLYMOUTH, WITH THE TOWN OF PLYMOUTH AND PLYMOUTH PUBLIC SCHOOLS, HAS BROUGHT TOGETHER MORE THAN 60 COMMUNITY PARTNERS-FROM CITY OFFICIALS TO LOCAL FARMERS-TO ENVISION AND BUILD A MORE HEALTH-SUSTAINING COMMUNITY, WHERE THE HEALTHY CHOICE IS THE EASY CHOICE. BECAUSE OF THE COLLABORATIVE WORK INITIATED BY BID-PLYMOUTH, THE TOWN OF PLYMOUTH, PLYMOUTH PUBLIC SCHOOLS AND OTHER COMMUNITY PARTNERS ARE FINDING NEW WAYS TO FOSTER BETTER HEALTH IN OUR COMMUNITY, LONG-TERM, AND AT A LOWER COST, THROUGH THE HEALTHY PLYMOUTH INITIATIVE. SUPPORTED BY BID-PLYMOUTH'S VICE PRESIDENT OF EXTERNAL AFFAIRS, THE HOSPITAL HAS MADE A COMMUNITY-WIDE COMMITMENT TO THE SHARED GOAL OF DEVELOPING POLICY LEVEL CHANGES THAT WILL EXPAND THE BREADTH AND IMPACT OF HEALTH INITIATIVES IN THE REGION. THIS PROGRAM BEGAN AS A POPULATION HEALTH INITIATIVE FOCUSED ON EDUCATION AND COMMUNITY WIDE FACILITATION OF HEALTHY EATING AND ACTIVE LIVING. IN FY2015, THE STATEWIDE PRIORITY AND LOCAL CRISIS OF SUBSTANCE ABUSE AND INADEQUATE BEHAVIORAL HEALTH ACCESS BECAME THE MOST PRESSING CONCERN. TODAY, SEVERAL OF THE INITIATIVES ACTIVITIES ARE FOCUSED ON THESE KEY ISSUES.IN FY 18, THE HEALTHY PLYMOUTH INITIATIVE CONDUCTED A BROAD RANGE OF ACTIVITIES IN SCHOOL AND IN COMMUNITY-BASED SETTINGS GEARED TOWARDS YOUTH. THESE INCLUDED:- MIDDLE SCHOOL AND HIGH SCHOOL ENRICHMENT ACTIVITIES- FOOD ACCESS, HEALTHY EATING, AND ACTIVE LIVING ACTIVITIES- HEALTH EDUCATION AND HEALTH PROMOTION ACTIVITIES- EMPLOYMENT AND JOB READINESS ACTIVITIESHOSPITAL PRIORITY- PHYSICAL DISEASE MANAGEMENT AND PREVENTION- HEALTH RISK FACTORS- BEHAVIORAL HEALTHSTATEWIDE PRIORITY- CHRONIC DISEASE MANAGEMENT IN DISADVANTAGED POPULATIONS- PROMOTING WELLNESS OF VULNERABLE POPULATIONS- REDUCING HEALTH DISPARITYPROGRAM TYPE- COMMUNITY EDUCATION- COMMUNITY PARTICIPATION/CAPACITY BUILDING INITIATIVE- HEALTHY COMMUNITIES PARTNERSHIP- OUTREACH TO UNDERSERVED, PREVENTION- SCHOOL/HEALTH CENTER PARTNERSHIPTARGET POPULATIONREGIONS SERVED: COUNTY - PLYMOUTH, TOWNS - PLYMOUTHTARGET POPULATIONS: MEDICALLY UNDERSERVED, THE POOR, YOUTH AT RISKHEALTH INDICATOR: OBESITY, HEART DISEASE, LUNG DISEASE, CANCER, DIABETES, NUTRITIONSEX: ALL AGE GROUP: YOUTH AT RISKETHNIC GROUP: ALL LANGUAGE: ENGLISHPARTNERS- TERRA CURA, INC.- PLYMOUTH PUBLIC SCHOOLS- ZION LUTHERAN CHURCH- LORING LIBRARY- NEW ENGLAND VILLAGES- ALGONQUIN HEIGHTS HOUSING COMPLEX- COLCHESTER FARM- PLYMOUTH AREA DEPARTMENT OF DEVELOPMENTAL SERVICESGOAL 1: PPS/VPA COFFEE HOUSE: TO CREATE A WELCOMING ENVIRONMENT AND PUBLIC FORUM FOR PLYMOUTH MIDDLE AND HIGH SCHOOL STUDENTS TO PERFORM FOR PEERS AND THE PUBLIC IN 6 SCHEDULED EVENTS THROUGHOUT THE SCHOOL YEAR. THE PRIMARY AIMS OF THESE ACTIVITIES ARE TO PROMOTE TALENT AND DEVELOP CONFIDENCE AND SELF-AWARENESS.GOAL STATUS: ORGANIZED AND PRESENTED SIX COFFEE HOUSE EVENTS; FOUR HELD AT THE HIGH SCHOOLS AND TWO AT THE MIDDLE SCHOOLSGOAL 2: ALGONQUIN HEIGHTS/COLCHESTER FARM MARKET PROGRAM: TO DEVELOP A COLLABORATIVE, MULTI-AGENCY PROGRAM THAT PROMOTES SUMMER EDUCATION AND EMPLOYMENT OPPORTUNITIES FOR INCOME ELIGIBLE TEENS AT A LOCAL INCLUSIVE FARM WHILE AT THE SAME TIME CREATING A SUBSIDIZED FARMER'S MARKET FOR LOW INCOME RESIDENTS IN PLYMOUTH'S PUBLIC HOUSING COMPLEX. THE PROJECT WAS CONDUCTED IN PARTNERSHIP WITH TERRA CURA, INC., ALGONQUIN HEIGHTS HOUSING COMPLEX, NEW ENGLAND VILLAGES/COLCHESTER FARM, AND THE PLYMOUTH AREA DEPARTMENT OF DEVELOPMENTAL SERVICES.GOAL STATUS: ENGAGED FIVE INCOME-ELIGIBLE TEENS TO PARTICIPATE IN SUMMER EDUCATIONAL AND EMPLOYMENT OPPORTUNITIES AT COLCHESTER FARM AND PROVIDED 40 LOW INCOME HOUSEHOLDS FROM ALGONQUIN HEIGHTS HOUSING COMPLEX WITH $20 WORTH OF FRESH PRODUCEGOAL 3: AMAZING RACE: TO LAUNCH AN ANNUAL FUNDRAISER THAT PROMOTES HEALTHY ACTIVITIES, TEAMWORK, EDUCATION AND LOCAL CULTURE, WHILE RAISING FUNDS TO SUPPORT SCHOOL GARDEN INITIATIVE AND THE PEER HELPER MENTORSHIP PROGRAM.GOAL STATUS: THIRTY-FOUR (34) TEAMS OF FOUR PARTICIPATED IN THE AMAZING RACE FUNDRAISER, ENGAGING PHYSICAL, EDUCATIONAL AND MENTAL CHALLENGES IN LOCATIONS THROUGHOUT PLYMOUTH. THEY RAISED OVER $27,000 THROUGH FEES, DONORS, SPONSORS AND AN ONLINE AUCTION. NET FUNDS WILL SUPPORT THE HIRE OF PART TIME MULTI-SCHOOL GARDEN COORDINATORS TO ENHANCE GARDEN PROGRAMS ACROSS ALL SUBJECTS AND THE LAUNCH OF AN AFTER SCHOOL PEER HELPER PILOT FOR GRADES 6 AND 7 AT PLYMOUTH SOUTH MIDDLE SCHOOLGOAL 4: APRIL VACATION WEEK ENRICHMENT ACTIVITIES: TO CREATE POSITIVE ENRICHMENT ACTIVITIES FOR 6TH, 7TH, AND 8TH GRADERS IN PLYMOUTH BY IMPLEMENTING A FULL ROSTER OF PHYSICAL, CREATIVE, EDUCATIONAL AND SELF-AWARENESS ACTIVITIES. THE PROGRAM TOOK PLACE AT ZION LUTHERAN CHURCH AND LORING LIBRARY, MONDAY-FRIDAY FROM 10AM TO 4PM, DURING APRIL VACATION WEEK. 25 VOLUNTEERS HELPED TO ORGANIZE AND MANAGE ACTIVITIES THROUGHOUT THE WEEK, INCLUDING MUSIC, ART, CRAFTS, FITNESS, MINDFULNESS AND COOKING ACTIVITIES. YOUTH ALSO EXPLORED CAREER CHOICES AND RECEIVED EDUCATION RELATED TO RISKY BEHAVIORS AND POSITIVE COPING SKILLS. WORKING PARENTS/GUARDIANS BENEFIT FROM ACTIVE FREE PROGRAMMING RATHER THAN HAVING CHILDREN ALONE AT HOME OR WITH PAID PROVIDERS.GOAL STATUS: 190 6TH, 7TH, AND 8TH GRADERS PARTICIPATED IN THE PROGRAM, UP FROM 145 IN FY 2017GOAL 5: PERMACULTURE SCHOOL GARDEN CLUBS: TO PROMOTE AFTER SCHOOL ENRICHMENT ACTIVITIES AND PROMOTE ENGAGEMENT IN THE SCHOOL COMMUNITY BY PROVIDING OPPORTUNITIES FOR STUDENTS TO EXPERIENCE NATURE AND LEARN ABOUT GROWING, HARVESTING AND CONSUMING FOOD. ACTIVITIES ALSO PREVENTED STUDENTS FROM ENGAGING IN RISKY BEHAVIORS AFTER SCHOOL. GARDENS ARE LOCATED IN EVERY PLYMOUTH PUBLIC SCHOOL AND THE PLYMOUTH EARLY CHILDHOOD CENTER. GOAL STATUS: 150 STUDENTS ATTENDED THE PERMACULTURE SCHOOL GARDEN CLUB AFTER SCHOOL PROGRAM IN EIGHT ELEMENTARY SCHOOLSGOAL 6: PEER HELPER PROGRAM: TO DEVELOP A MENTORSHIP PROGRAM THAT PROMOTES POSITIVE INTER-GENERATIONAL INTERACTIONS, RESPECT AND TOLERANCE BETWEEN MIDDLE SCHOOL AND ELEMENTARY SCHOOL CHILDREN. MIDDLE SCHOOL CHILDREN WERE LINKED TO KINDERGARTENERS THROUGH SECOND GRADERS AND ASSISTED THEM WITH READING AND MATH SKILLS VIA AN AFTER-SCHOOL PROGRAM. OLDER STUDENTS DEVELOPED LEADERSHIP SKILLS AND BECAME ROLE MODELS FOR YOUNGER STUDENTS. YOUNGER STUDENTS BENEFITED FROM TUTORING. GOAL STATUS: 121 MIDDLE SCHOOL STUDENTS PARTICIPATED IN MENTORING ACTIVITIES WITH ELEMENTARY SCHOOL CHILDRENGOAL 7: HEALTHY MARKETS. TO CONTINUE TO SUPPORT FOUR HEALTHY MARKETS IN PLYMOUTH BY ROUTINELY CHECKING THEIR INVENTORY AND LABELING FOR HEALTHY OPTIONSGOAL STATUS: FOUR (4) HEALTHY MARKETS WERE MAINTAINED IN PLYMOUTH. HEALTHY OPTIONS WERE UPDATED MONTHLY. NEW HEALTHY RECIPE CARDS WERE PRINTED AND PLACED ON THE COUNTERS FOR THE PUBLIC TO TAKE WHEN DECIDING WHICH PRODUCTS TO PURCHASE. ACCESS TO CARE - UNINSURED AND UNDERINSURED PROGRAM DESCRIPTIONBID-PLYMOUTH WORKED WITH THE STATE TO COMMUNICATE NEW HEALTH COVERAGE PLANS FOR THE UNINSURED AND ENROLL THOSE WHO QUALIFY. FINANCIAL COUNSELORS SCREENED AND ENROLLED PATIENTS FOR MASSHEALTH, HEALTH SAFETY NET, MEDICAL HARDSHIP AND COMMONWEALTH CARE. HOSPITAL PRIORITY- PHYSICAL DISEASE MANAGEMENT AND PREVENTION- HEALTH RISK FACTORS- BEHAVIORAL HEALTHSTATEWIDE PRIORITY- CHRONIC DISEASE MANAGEMENT- MENTAL HEALTH- SUBSTANCE USEPROGRAM TYPE- DIRECT SERVICETARGET POPULATIONREGIONS SERVED: COUNTIES - PLYMOUTH, BRISTOL, BARNSTABLE, DUKESCITIES/TOWNS - 48 UNSPECIFIED TOWNSTARGET POPULATIONS: MEDICALLY UNDERSERVEDHEALTH INDICATOR: CHILD CARE, BEREAVEMENT, HOSPICESEX: ALLAGE GROUP: PRENATAL TO 19 YEARS OLDETHNIC GROUP: ALLLANGUAGE: ENGLISHPARTNERS- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH- MASSHEALTH- EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICESGOAL 1: PROVIDE FREE FINANCIAL ASSISTANCE COUNSELING TO UNINSURED AND UNDERINSURED RESIDENTS AND ENROLL THEM IN ENTITLEMENT PROGRAMS.GOAL STATUS: STAFF ENROLLED 9,152 PATIENTS INTO ENTITLEMENT PROGRAMSBID-PLYMOUTH BELIEVES THAT THIS IS A VERY IMPORTANT COMMUNITY BENEFIT ACTIVITY AND AS SUCH, THE DETAILS ARE INCLUDED HERE TO THE FORM 990 SCHEDULE H NARRATIVE. IN ACCORDANCE WITH THE INSTRUCTIONS TO THE FORM 990, THE COSTS ASSOCIATED WITH FINANCIAL COUNSELORS HAVE NOT BEEN INCLUDED IN THE QUANTIFICATION ON FORM 990 SCHEDULE H LINE 7E.THE HOSPITAL ALSO PROVIDES FINANCIAL SUPPORT TO HELP ENSURE THAT THE COMMUNITY CAN ACCESS PRIMARY CARE AND CERTAIN SPECIALTY CARE. DURING THE PERIOD COVERED BY THIS FILING, BID-PLYMOUTH PROVIDED $ 4,058,702 FOR SUCH ACTIVITIES AND THIS AMOUNT IS INCLUDED IN THIS FORM 990 SCHEDULE H PART I LINE 7G. IN ADDITION, AS NOTED THROUGHOUT THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH AND MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP (APG). APG ALSO WORKS WITH BID-PLYMOUTH TO PROVIDE ACCESS TO PRIMARY AND SPECIALTY CARE IN THE COMMUNITIES SERVED BY BID-PLYMOUTH AND DURING THE PERIOD COVERED BY THIS FILING, THE MEDICAL CENTER PROVIDED AN ADDITIONAL $158,022 OF SUPPORT RELATED TO THESE ACTIVITIES, BUT AS REQUIRED BY THIS FORM 990 SCHEDULE H, THIS AMOUNT HAS NOT BEEN REPORTED ON BID-PLYMOUTH'S SCHEDULE H PART I LINE 7G. ACCESS PROGRAMPROGRAM DESCRIPTIONTHE AIDS COMPREHENSIVE, CARE, EDUCATION, AND SUPPORT SERVICES PROGRAM (ACCESS PROGRAM) PROVIDES FREE AND ANONYMOUS HIV TESTING, MEDICAL CARE, PREVENTION EDUCATION, AND SUPPORT SERVICES TO PEOPLE LIVING WITH HIV/AIDS IN PLYMOUTH AND SURROUNDING TOWNS. PATIENTS MAY RECEIVE PRIMARY CARE SERVICES, INCLUDING PHYSICAL EXAMINATIONS; TREATMENT SERVICES AND PLANNING; LABORATORY TESTING; IMMUNIZATIONS AND SCREENING; ANTIVIRAL MEDICATIONS; REFERRALS TO SPECIALTY CARE AND CLINICAL TRIALS; AND MEDICAL CASE MANAGEMENT.THE FEDERAL RYAN WHITE CARE ACT (TITLE III) GRANT FOR EARLY INTERVENTION SERVICES PROVIDES FUNDING FOR THESE SERVICES. THE CARE ACT IS FUNDED THROUGH THE AIDS BUREAU OF THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA).HOSPITAL PRIORITY- PHYSICAL DISEASE MANAGEMENT AND PREVENTION- HEALTH RISK FACTORSSTATEWIDE PRIORITY- CHRONIC DISEASE MANAGEMENT IN DISADVANTAGED POPULATIONS- PROMOTING WELLNESS OF VULNERABLE POPULATIONSPROGRAM TYPE- DIRECT SERVICETARGET POPULATIONREGIONS SERVED: COUNTIES - PLYMOUTH, BARNSTABLE CITIES/TOWNS - ABINGTON, BOURNE, BRAINTREE, BRIDGEWATER, BUZZARDS BAY, CARVER, DARTMOUTH, DUXBURY, HALIFAX, HOLLISTON, HYANNIS, KINGSTON, LAKEVILLE, MARION, MARSHFIELD, MASHPEE, MIDDLEBORO, NEW BEDFORD, PEMBROKE, PLYMOUTH, PLYMPTON, ROCKLAND, SANDWICH, SALEM, SCITUATE, TRUROTARGET POPULATIONS: THE POOR, ELDERLY, LGBT, MEN WHO HAVE SEX WITH MEN (MSM), INTRAVENOUS DRUG USERS, HETEROSEXUALS, YOUTH, HIV+ NOT IN CARE, LOW-INCOME, NEWLY INFECTED WITH HIVHEALTH INDICATOR: OTHER (HIV/AIDS)SEX: ALL AGE GROUP: ADULTETHNIC GROUP: ALL LANGUAGE: ENGLISHPARTNERS- PLYMOUTH RESOURCE CENTER- BID-PLYMOUTH BEHAVIORAL HEALTH TEAM- BPHC DENTAL HEALTH PROGRAM- CLEAN STATE- HARBOR HEALTH- HIGH POINT OUTPATIENT TREATMENT SERVICES- PLYMOUTH FAMILY PLANNING- FATHER BILL'S AND MAINSPRING- THE BRIDGE- HABILITATION ASSISTANCEGOAL 1: TO ENROLL AT LEAST FIVE CLIENTS INTO CARE DURING THE GRANT YEAR.GOAL STATUS: ENROLLED 12 NEW CLIENTS PROVIDING THEM WITH FREE AND ANONYMOUS HIV TESTING, MEDICAL CARE, PREVENTION EDUCATION, AND SUPPORT SERVICES TO PEOPLE LIVING WITH HIV/AIDS IN PLYMOUTH AND SURROUNDING TOWNSGOAL 2: INCREASE NUMBER OF PEOPLE TESTED FOR HIVGOAL STATUS: TESTED 30 PEOPLE IN 2018 AND OF THE 30, NOT ONE HAD HIVGOAL 3: MAINTAIN VIRAL SUPPRESSION IN 95% OF OUR CLIENTSGOAL STATUS: ABLE TO MAINTAIN VIRAL SUPPRESSION IN 95% OF OUR CLIENTSDURING THE PERIOD COVERED BY THIS FILING, BID-PLYMOUTH PROVIDED OVER $350,000 IN CARE AND SERVICES RELATED TO ACCESS AND THE COSTS ASSOCIATED WITH THIS ACTIVITY HAVE BEEN REPORTED IN THIS FORM 990 SCHEDULE H PART I LINE 7E, COLUMN C. GRANT FUNDS RECEIVED WHICH ENABLE BID-PLYMOUTH TO PROVIDE THESE SERVICES TO THE COMMUNITY HAVE SIMILARLY BEEN REPORTED IN THIS FORM 990 SCHEDULE H PART I LINE 7E, COLUMN D AS REVENUE RECEIVED. AS SUCH, THE NET COMMUNITY BENEFIT CALCULATED IN THIS FORM 990 SCHEDULE H PART I LINE 7E, DOES NOT INCLUDE THE COST OF THESE ACTIVITIES. CANCER PATIENT SUPPORT PROGRAMPROGRAM DESCRIPTIONA CANCER DIAGNOSIS OFTEN CREATES FINANCIAL AND EMOTIONAL STRESS FOR PATIENTS AND FAMILIES. THE CANCER PATIENT SUPPORT PROGRAM IDENTIFIES CANCER PATIENTS WITH EXTREME EMOTIONAL AND FINANCIAL HARDSHIP AND MATCHES THEM WITH COUNSELING AND FINANCIAL SUPPORT WHEN POSSIBLE. THIS PROGRAM IS FREE TO CANCER PATIENTS WHENEVER SOURCES OF SUPPORT ARE AVAILABLE.BID-PLYMOUTH PROVIDES SUPPORT FOR PATIENTS AND FAMILIES THROUGH A SOCIAL WORKER, RESOURCE NURSE, AND NURSE NAVIGATOR. THIS TEAM PROVIDES COUNSELING, SUPPORT, AND WORKS TO FIND RESOURCES TO HELP ALLEVIATE OUT-OF-POCKET EXPENSES TYPICALLY NOT COVERED BY INSURANCE. THE TEAM MAY ALSO HELP TO FIND FUNDING SOURCES TO COVER THE COST OF HOUSEHOLD EXPENSES (E.G., GROCERIES, CAR PAYMENTS, HEATING, AND ELECTRIC).FINALLY, THIS PROGRAM FINDS RESOURCES TO PROMOTE CANCER SCREENINGS AND EDUCATION ABOUT WELLNESS AND PREVENTION TO HELP KEEP THE COMMUNITY HEALTHIER AND DECREASE RISK FACTORS THAT ARE ASSOCIATED WITH A CANCER DIAGNOSIS.HOSPITAL PRIORITY- PHYSICAL DISEASE MANAGEMENT AND PREVENTION- HEALTH RISK FACTORSSTATEWIDE PRIORITY- CHRONIC DISEASE MANAGEMENT IN DISADVANTAGED POPULATIONS PROGRAM TYPE- DIRECT SERVICETARGET POPULATIONREGIONS SERVED: COUNTIES - PLYMOUTH, BARNSTABLE, NORFOLK, DUKES, BRISTOLCITIES/TOWNS - 50 UNSPECIFIED TOWNSTARGET POPULATIONS: OTHER (PEOPLE WITH OR AT RISK FOR CANCER)HEALTH INDICATOR: OTHER (CANCER)SEX: ALLAGE GROUP: ALLETHNIC GROUP: ALLLANGUAGE: ENGLISHPARTNERS- JOE ANDRUZZI FOUNDATION- ELLI FUND- CABBIES- KEVILLE FOUNDATION- SCORE FOR A CURE- RALLY FOR A CAUSE- DUXBURY GRIDIRON CLUBGOAL 1: CONTINUE TO USE A SCREENING TOOL TO EVALUATE NEED FOR PSYCHOSOCIAL AND FINANCIAL SUPPORT, AND HELP FAMILIES FILL OUT FORMS FOR GRANTS FROM OUR FINANCIAL SUPPORT PARTNERSGOAL STATUS: SCREENED 450 PATIENTS/FAMILIES; 250 OF THOSE SCREENED WERE PROVIDED FUNDS THROUGH OUR PARTNERSGOAL 2: PROVIDE ANNUAL FREE SKIN CANCER SCREENINGS AND SUN EXPOSURE AWARENESS TO 100 PEOPLEGOAL STATUS: SCREENED 100 PEOPLE. 23 OUT OF THE 100 WERE REFERRED TO THEIR PRIMARY CARE PHYSICIAN AND OF THE 23, 15 WERE REFERRED FOR A BIOPSYGOAL 3: TO EVALUATE THE FACTORS OF DISTRESS IN OUR PATIENT POPULATION AND REVIEW SERVICES AVAILABLE TO MEET THE NEEDS OF THIS GROUP.GOAL STATUS: EVALUATED 450 PATIENTS AND PROVIDED THEM A LIST OF SERVICES TO HELP MEET THEIR NEEDS. THESE INCLUDE: PARTNERING WITH ACS, AS WELL AS MENTORING, EDUCATIONAL TOOLS, ROAD TO RECOVERY AND PARTICIPATION IN RELAY FOR LIFE. THE CANCER CENTER SPONSORS KEEP IT MOVING BOOT CAMP, A WEEKLY YOGA CLASS, AND WRITING GROUPSGOAL 4: OFFER 30 FREE SCREENINGS TO WOMEN EVERY OTHER MONTH, INCLUDING PAP SMEARS AND MAMMOGRAMSGOAL STATUS: SCREENED 48 WOMENGOAL 5: CONTINUE TO PROVIDE WEEKLY SUPPORT GROUPS TO PATIENTS, WITH 10 ATTENDEES EACH WEEKGOAL STATUS: PROVIDED SUPPORT GROUPS FOR OVER 20 ATTENDEES EACH WEEK THROUGH VARIOUS SUPPORT GROUPSGOAL 6: HOST 4TH BIANNUAL WOMEN'S HEALTH SYMPOSIUM FOR WOMEN TO EDUCATE AND INFORM THEM ON THE LATEST IN BREAST HEALTH; EVENT WAS FREE AND OPEN TO THE PUBLIC. DINNER WAS INCLUDED.GOAL STATUS: HOSTED THE BIANNUAL WOMEN'S HEALTH SYMPOSIUM WITH 400 WOMEN IN ATTENDANCE. PEDIATRIC PALLIATIVE CARE PROGRAM DESCRIPTIONTHE FRAGILE FOOTPRINTS PEDIATRIC PALLIATIVE CARE PROGRAM IS PART OF THE MASSACHUSETTS PEDIATRIC CARE NETWORK, ADMINISTERED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, DIVISION FOR PERINATAL, EARLY CHILDHOOD, AND SPECIAL HEALTH NEEDS. THROUGH THIS PROGRAM, BID-PLYMOUTH PROVIDES MEDICAL CASE MANAGEMENT AND SUPPORT SERVICES FOR CHILDREN WITH POTENTIALLY LIFE-LIMITING ILLNESSES AND THEIR FAMILIES. AN INTERDISCIPLINARY TEAM OF NURSES, SOCIAL WORKERS, CHILD LIFE SPECIALISTS, SPIRITUAL CARE, COMPLEMENTARY THERAPY, EXPRESSIVE ARTS PRACTITIONERS, AND TRAINED VOLUNTEERS COLLABORATE TO DESIGN CARE PLANS THAT COORDINATE AND AUGMENT EXISTING SERVICES BEING RECEIVED. THROUGH THIS COLLABORATIVE APPROACH, FRAGILE FOOTPRINTS WORKS TO ADDRESS THE ISSUES COMMONLY EXPERIENCED BY FAMILIES OF MEDICALLY FRAGILE CHILDREN, INCLUDING STRESS, ANXIETY, ISOLATION, FINANCIAL HARDSHIP, RELATIONSHIP ISSUES, AND INTERRUPTION OF DAILY ROUTINES. HOSPITAL PRIORITY- PHYSICAL DISEASE MANAGEMENT AND PREVENTION- HEALTH RISK FACTORS STATEWIDE PRIORITY- CHRONIC DISEASE MANAGEMENT IN DISADVANTAGED POPULATIONS PROGRAM TYPE- DIRECT SERVICE TARGET POPULATIONREGIONS SERVED: COUNTIES - PLYMOUTH, BRISTOL, BARNSTABLE, DUKESCITIES/TOWNS - 48 UNSPECIFIED TOWNSTARGET POPULATIONS: MEDICALLY UNDERSERVEDHEALTH INDICATOR: CHILD CARE, BEREAVEMENT, HOSPICESEX: ALLAGE GROUP: PRENATAL TO 19 YEARS OLDETHNIC GROUP: ALLLANGUAGE: ENGLISHPARTNERS- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH- PEDIATRIC PALLIATIVE CARE NETWORK GOAL 1: INCREASE OUTREACH TO 75 FAMILIES AND REDUCE WAITING LIST FROM 30 TO 20 IN FY18GOAL STATUS: INCREASED OUTREACH TO SERVE 77 FAMILIES AND REDUCED WAITING LIST FROM 30 TO 14 FAMILIESGOAL 2: EXPAND SCOPE OF SERVICES TO INCLUDE MUSIC THERAPY AND AROMA TOUCH FOR VERY YOUNG AND SIGNIFICANTLY IMPAIRED POPULATIONS AND THEIR CAREGIVERSGOAL STATUS: EXPANDED SCOPE OF SERVICES TO INCLUDE AN EXPRESSIVE THERAPIST WHO PROVIDES MUSIC AND ART THERAPY AND A CERTIFIED AROMA THERAPIST (RN) TO PROVIDE COMFORT AND RELAXATION SERVICES (IN ADDITION TO CONTRACTS WITH SOUTH SHORE CONSERVATORY AND SOUND JOURNEY)GOAL 3: EXPAND COMMUNITY COLLABORATIONS TO MAKE FAMILY AND GROUP PROGRAMS (E.G., RED SOX OUTINGS, BOWLING, SUMMER PROGRAM, MOTHER'S DAY EVENT, HOLIDAY PARTY, TRIPS TO ZOO AND FARM) MORE ACCESSIBLE THROUGHOUT THE SERVICE AREAGOAL STATUS: SECURED PRIVATE DONATIONS TO MAKE FAMILY AND GROUP PROGRAMS MORE ACCESSIBLE. DONATIONS WERE A RESULT OF COLLABORATIONS WITH THE ST. MARY'S CHURCH OF SCITUATE, DUXBURY SENIOR CENTER, THE VILLAGE OF DUXBURY, HOPE FLOATS HEALING AND WELLNESS CENTER, AND THE YAWKEY FOUNDATIONSMOKING CESSATIONPROGRAM DESCRIPTIONFROM OFFERING EDUCATION ON THE DANGERS OF TOBACCO USE, TO ITS SMOKE FREE CAMPUS, BID-PLYMOUTH HAS LONG BEEN A LEADER IN TOBACCO PREVENTION. SINCE 2013, THE HOSPITAL HAS TAKEN PREVENTION TO A NEW LEVEL BY DEVELOPING A FORMALIZED SYSTEM-WIDE APPROACH TO CONNECTING WITH TOBACCO USERS WHO WANT TO QUIT, AND MAKING IT EASIER FOR THEM TO REACH THEIR GOALS. THIS SYSTEM ESTABLISHES CONSISTENT METHODS TO SCREEN FOR SMOKING STATUS OR CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), A LEADING CAUSE OF HOSPITALIZATIONS IN THE REGION. THROUGHOUT FY18, BID-PLYMOUTH AND COMMUNITY PARTNERS WORKED WITH PATIENTS IN THE COMMUNITY TO REDUCE SMOKING. PROVIDERS HAVE ENCOURAGED THE USE OF PHARMACOLOGIC AND NON-PHARMACOLOGIC OPTIONS TO ASSIST WITH SMOKING CESSATION. ANECDOTAL REPORTS SUGGEST THE TREND OF PRESCRIBING CESSATION AIDS APPEARS TO HAVE INCREASED. THE CLINICAL PATHWAYS COMMITTEE IS WORKING WITH INDUSTRY PARTNERS TO COLLECT YEAR-OVER-YEAR DATA TO SUPPORT THIS PROCESS. BID-PLYMOUTH EXPANDED ITS EFFORTS TO INFORM PHYSICIANS ABOUT THE QUITTER'S TOBACCO TREATMENT PROGRAM, MAKING THE ENROLLMENT PROCESS EASIER FOR PATIENTS. THE SUCCESSFUL QUITTERS PROGRAM IS FACILITATED BY A CERTIFIED TOBACCO TREATMENT SPECIALIST (TTS). THE 6-WEEK COURSE INTRODUCES INTERACTIVE TECHNIQUES, RELAXATION, VISUALIZATION, AND EDUCATION TO HELP PARTICIPANTS LEARN WHY THEY SMOKE, WHAT HAPPENS WHEN THEY QUIT, HOW TO HANDLE CRAVINGS AND WITHDRAWAL, AND HOW TO AVOID RELAPSE. SESSIONS ARE AVAILABLE IN ONE-TO-ONE OR GROUP SETTINGS. RESEARCH SHOWS THIS MULTIFACETED APPROACH TO BE HIGHLY EFFECTIVE IN HELPING USERS KICK THE HABIT. THE PROGRAM REPRESENTS THE HOSPITAL'S COMMITMENT TO BETTER HEALTHCARE FOR EVERYONE - STANDARDIZING AN APPROACH TO ADDRESS KEY HEALTH CONCERNS AND ENSURING PATIENTS ACROSS PLYMOUTH COUNTY RECEIVE RELIABLE, EFFECTIVE TREATMENT. THIS PROGRAM PROVIDES ONE EXAMPLE OF BID-PLYMOUTH'S COMMITMENT TO FINDING NEW WAYS TO MANAGE RESOURCES AND IMPROVE CARE COMMUNITYWIDE, WHILE CONTROLLING HEALTHCARE COSTS.HOSPITAL PRIORITY- PHYSICAL DISEASE MANAGEMENT AND PREVENTION- HEALTH RISK FACTORS STATEWIDE PRIORITY- CHRONIC DISEASE MANAGEMENT PROGRAM TYPE- COMMUNITY EDUCATION- DIRECT SERVICE TARGET POPULATIONREGIONS SERVED: COUNTIES - PLYMOUTH, BARNSTABLECITIES/TOWNS - BOURNE, CARVER, DUXBURY, HALIFAX, KINGSTON, LAKEVILLE, PEMBROKE, PLYMOUTH, PLYMPTON, MARSHFIELD, MIDDLEBORO, SANDWICH, WAREHAMTARGET POPULATIONS: ADULTS, LOW INCOME, OTHER (PEOPLE WHO SMOKE)HEALTH INDICATOR: (OTHER) CANCERSEX: ALLAGE GROUP: ADULTSETHNIC GROUP: ALLLANGUAGE: ENGLISHPARTNERS- AFFILIATED PHYSICIAN GROUP (2018 AND 2019)- PLYMOUTH BAY MEDICAL ASSOCIATES (2018 AND 2019)- PMG ASSOCIATES, ATRIUS HEALTH GROUP (2019)GOAL 1 (FY18): ENCOURAGE AND INCREASE THE NUMBER OF PATIENTS TO ENROLL IN QUITTER'S SMOKING CESSATION PROGRAM BY 2%GOAL STATUS: THREE PERCENT (9 OUT OF 352) OF PATIENTS WERE REFERRED TO THE TOBACCO TREATMENT SPECIALIST AND ENROLLED IN QUIT SESSIONS. THIS NUMBER IS A DECREASE FROM 2017, WHERE 5% (16 OF 328) PATIENTS ENROLLEDGOAL 2 (FY18): RESPIRATORY THERAPISTS WILL ASSESS 95% OF SMOKERS WITH INTENT TO QUIT TO INCREASE THE NUMBER OF PATIENTS WHO WOULD LIKE TO BE CONTACTED BY THE TTS TO JOIN THE QUITTER'S PROGRAMGOAL STATUS: 92% OF INPATIENT SMOKERS WERE ASSESSED BY A RESPIRATORY THERAPIST; 20% OF PATIENTS ASSESSED BY THE RESPIRATORY THERAPIST REQUESTED CONTACT FROM A TTSGOAL 3 (FY18): PROVIDE QUITTER'S PROGRAM BROCHURES TO PRIMARY CARE OFFICES AFFILIATED WITH BID-PLYMOUTH AND INPATIENTS ASSESSED BY RESPIRATORY THERAPISTS. PROVIDERS SHOULD EXPLAIN THE BENEFIT OF THE QUITTER'S PROGRAM AND ENCOURAGE CESSATIONGOAL STATUS: 1500 BROCHURES WERE PROVIDED TO PRIMARY CARE AFFILIATES AND 1800 BROCHURES WERE DISTRIBUTED TO INPATIENTSBID-PLYMOUTH HOUSE CALLSPROGRAM DESCRIPTIONBID-PLYMOUTH LAUNCHED HOUSECALLS IN 2005 AS AN EDUCATIONAL SPEAKER SERIES THAT BRINGS IMPORTANT HEALTH AND PREVENTION INFORMATION TO THE COMMUNITY. BID-PLYMOUTH PHYSICIANS AND OTHER HEALTH CARE PROVIDERS PROVIDE REGULAR HEALTH INFORMATION SEMINARS AT VARIOUS LOCATIONS THROUGHOUT THE 12-TOWN BID-PLYMOUTH SERVICE AREA. ALL HOUSECALLS EVENTS ARE ONE HOUR AND ALLOW ATTENDEES TO ASK QUESTIONS. THE COMMUNITY BENEFITS STAFF COLLECTS DATA THROUGH AN EVALUATION THAT ATTENDEES COMPLETE AT THE END OF EACH LECTURE. THE EVALUATION INCLUDES QUESTIONS PROBING ON WHAT THEY THOUGHT ABOUT THE LECTURE, WHAT OTHER TOPICS THEY ARE INTERESTED IN, AND HOW THEY HEARD ABOUT THE LECTURE.ALL HOUSECALLS EVENTS ARE FREE AND OPEN TO THE PUBLIC. HOSPITAL PRIORITY- PHYSICAL DISEASE MANAGEMENT AND PREVENTION STATEWIDE PRIORITY- ADDRESS UNMET NEEDS OF THE UNDERSERVED, PROMOTING WELLNESS OF VULNERABLE POPULATIONSPROGRAM TYPE- COMMUNITY EDUCATIONTARGET POPULATIONREGIONS SERVED: COUNTY-PLYMOUTHTOWNS SERVED: ALL TOWNS IN BETWEEN PEMBROKE TO THE CAPETARGET POPULATIONS: ELDERLY, CHRONICALLY ILLHEALTH INDICATOR: OTHER: ARTHRITIS, OTHER: BACK PAIN, OTHER: MIGRAINE TREATMENT; OTHER: NUTRITION, OTHER: SLEEP APNEA, OTHER: KNEE PAIN, OTHER: HERNIA AND SPORTS INJURY PREVENTION SEX: ALL AGE GROUP: ADULT ETHNIC GROUP: ALL LANGUAGE: ENGLISHGOAL 1: TO EDUCATE COMMUNITY RESIDENTS ON HEALTH TOPICS RELEVANT TO THEM IN A LOCATION CLOSE TO THEIR HOME AT NO COST. THESE EVENTS HELP TO ENSURE THAT COMMUNITY RESIDENTS HAVE THE MOST UP-TO-DATE HEALTH INFORMATION AVAILABLE ON ISSUES CRITICAL TO THEIR HEALTH AND WELL-BEING, INCLUDING INFORMATION ON HEALTH PROMOTION AND WELLNESS, CHRONIC DISEASE MANAGEMENT, MENTAL HEALTH AND SUBSTANCE USE.GOAL STATUS: MORE THAN 190 AREA RESIDENTS PARTICIPATED IN BID-PLYMOUTH'S HOUSECALLS FY 2018 LECTURES INCLUDED SESSIONS ON TOTAL KNEE REPLACEMENT, BACK PAIN MANAGEMENT, CAUSES AND SOLUTIONS FOR BACK PAIN, HERNIAS AND WHEN SURGERY IS NECESSARY, MIGRAINE TREATMENT OPTIONS, AND SLEEP APNEATHREE PERCENT (9 OUT OF 352) OF PATIENTS WERE REFERRED TO THE TOBACCO TREATMENT SPECIALIST AND ENROLLED IN QUIT SESSIONS. THIS NUMBER IS A DECREASE FROM 2017, WHERE 5% (16 OF 328) PATIENTS ENROLLED. BEHAVIORAL HEALTH INTEGRATION PROGRAM DESCRIPTIONIN 2013, THE HOSPITAL CONDUCTED A BEHAVIORAL HEALTH ASSESSMENT TO IDENTIFY BEHAVIORAL HEALTH NEEDS IN THE COMMUNITY-ASSESSING CURRENT SERVICES, IDENTIFYING SERVICE GAPS, AND IDENTIFYING POTENTIAL SERVICE OPPORTUNITIES FOR THE HOSPITAL. IN 2016, AS PART OF THE FY 2016 CHNA, FURTHER QUANTITATIVE AND QUALITATIVE INFORMATION WAS COMPILED CONFIRMING COMMUNITY NEED, PROVIDER SHORTAGES, AND OTHER CHALLENGES. WITH THIS INFORMATION, HOSPITAL ADMINISTRATORS IN PARTNERSHIP WITH LOCAL MENTAL HEALTH AND SUBSTANCE USE PROVIDERS DEVELOPED THE FAMILY BEHAVIORAL HEALTH INTEGRATED CARE INITIATIVE. THE FAMILY BEHAVIORAL HEALTH INTEGRATED CARE INITIATIVETHIS INITIATIVE IS A CO-LOCATED BEHAVIORAL HEALTH MODEL THAT EMBEDS LICENSED CLINICAL SOCIAL WORKERS IN PRIMARY CARE AND SPECIALTY CARE SETTINGS WHO WORK WITH THE PRACTICES PRIMARY CARE PROVIDERS, AS AN ADVANCED PRACTICE NURSE PRACTITIONER WITH MENTAL HEALTH TRAINING, AND A PSYCHIATRIST TO INTEGRATE BEHAVIORAL HEALTH SCREENING, ASSESSMENT, AND TREATMENT SERVICES INTO THE PRACTICES' OPERATIONS. THIS TEAM HAS ALSO WORKED WITH OTHER COMMUNITY-BASED ORGANIZATIONS TO ADDRESS BARRIERS TO ACCESS AND EXPAND THE AVAILABILITY OF BEHAVIORAL HEALTH SERVICES.BID-PLYMOUTH CURRENTLY HAS THREE SOCIAL WORKERS AND ONE NURSE PRACTITIONER, ALL OF WHOM WORK UNDER A PSYCHIATRIST. BID-PLYMOUTH CONTINUED THIS WORK IN FY 2018 AND EMBEDDED BEHAVIORAL HEALTH CLINICIANS IN A GROWING NUMBER OF PRIMARY CARE AND SPECIALTY CARE PRACTICES. IN RESPONSE TO THE OPIOID CRISIS, BID-PLYMOUTH HAS ADDED SUBSTANCE ABUSE CLINICIANS AND A FULL-TIME NURSE PRACTITIONER TO ITS OVERALL INITIATIVE AND COLLABORATED WITH GOSNOLD FOR RECOVERY SPECIALISTS TO PROVIDE INTEGRATED SERVICES IN THE EMERGENCY DEPARTMENT. THESE CLINICIANS COLLABORATE WITH COMMUNITY TREATMENT PROVIDERS TO ADDRESS THE HIGH NUMBER OF SUBSTANCE ABUSE RELATED CASES AND PROVIDE THE RIGHT LEVEL OF CARE IN THE EMERGENCY SETTING. WITH BEHAVIORAL HEALTH SERVICES AVAILABLE IN THE EMERGENCY DEPARTMENT, PATIENTS MAY BEGIN TREATMENT IN THIS SETTING, RATHER THAN DELAYING TREATMENT UNTIL PSYCHIATRIC BEDS ARE AVAILABLE. THIS IMMEDIATE CARE OFTEN DECREASES THE LEVEL OF INTERVENTION REQUIRED. WITH THE HOSPITAL'S FULLY INTEGRATED SYSTEM, PATIENTS CAN ADDRESS MEDICAL AND BEHAVIORAL HEALTH NEEDS IN ONE LOCATION. MEDICAL STAFF IN PRIMARY CARE, SPECIALTY CARE, AND EMERGENCY DEPARTMENT SETTINGS HAVE ON-SITE ACCESS TO BEHAVIORAL HEALTH SUPPORT SO THAT THEY CAN PROVIDE COMPREHENSIVE HEALTHCARE IN A CONVENIENT, EFFICIENT AND COST-EFFECTIVE MANNER. IN ADDITION, THE HOSPITALS BEHAVIORAL HEALTH CLINICIANS COLLABORATE WITH LOCAL HIGH SCHOOLS, LAW ENFORCEMENT, AND OTHER COMMUNITY-BASED ORGANIZATIONS TO COORDINATE CARE AND ENSURE THAT THE COMMUNITY IS ABLE TO ACCESS THE NEEDED BREADTH OF EDUCATIONAL, OUTREACH, AND TREATMENT SERVICES TO ADDRESS THE EVER-INCREASING SUBSTANCE USE ISSUE IN BID-PLYMOUTH'S CBSA.PREVENTURE ADDICTION PREVENTION PROGRAMIN AN EFFORT TO ADDRESS THE ADDICTION CRISIS, BID-PLYMOUTH PARTNERED WITH PLYMOUTH MIDDLE SCHOOLS TO FUND THE PREVENTURE PROGRAM. PREVENTURE IS A RESEARCH-BASED ADDICTION PREVENTION PROGRAM TARGETING PERSONALITY TRAITS THAT CORRELATE WITH INCREASED RISK OF DEVELOPING SUBSTANCE USE ISSUES. BRIEF COPING SKILL INTERVENTIONS THAT TARGET PERSONALITY RISK FACTORS HAVE BEEN TESTED IN RANDOMIZED CONTROLLED TRIALS AND HAVE DEMONSTRATED BENEFITS THAT LAST UP TO THREE YEARS. STUDENTS THAT SCREENED FOR HIGH-RISK PERSONALITY PROFILES WERE IDENTIFIED TO PARTICIPATE IN TWO 90-MINUTE GROUP WORKSHOPS. WORKSHOPS FOCUSED ON DEVELOPING SPECIALIZED COPING SKILLS RELEVANT TO: SENSATION SEEKING; IMPULSIVITY; ANXIETY SENSITIVITY; NEGATIVE THINKING. THE INTERVENTION INCLUDED PSYCHO-EDUCATIONAL APPROACHES, MOTIVATIONAL INTERVIEWING, AND COGNITIVE BEHAVIORAL COMPONENTS. STUDENTS LEARN HOW THEIR PERSONALITY STYLE LEADS TO CERTAIN EMOTIONAL AND BEHAVIORAL REACTIONS. STUDENTS RECEIVED MANUALS THAT ILLUSTRATE SCENARIOS DESIGNED BY SIMILAR TEENS TO PROMOTE RELEVANCE. THE PROGRAM HAS PROVEN BOTH FEASIBLE AND EFFECTIVE WHEN DELIVERED BY TRAINED SCHOOL STAFF. PLYMOUTH COUNTY OUTREACH (PCO)PCO IS A COUNTY-WIDE INITIATIVE REACHING 27 COMMUNITIES. PCO IS A COLLABORATION OF PUBLIC SAFETY AGENCIES, HEALTHCARE PROVIDERS, AND TREATMENT ORGANIZATIONS TO PROVIDE COMMUNITY FOLLOW UP AFTER AN OPIOID OVERDOSE. PROVIDERS CREATED THIS PROGRAM TO RESPOND TO THE EVER-GROWING NUMBER OF OPIATE OVERDOSES BY CONDUCTING FOLLOW-UP VISITS WITHIN 12-24 HOURS AFTER AN OVERDOSE WITH AN OUTREACH TEAM (A PLAIN CLOTHED POLICE OFFICER AND A BEHAVIORAL HEALTH PROFESSIONAL) TO DISCUSS TREATMENT OPTIONS WITH THE INDIVIDUAL AND HELP THEM GET INTO TREATMENT AS SOON AS POSSIBLE. NOTE: THIS PROGRAM IS NOT LIMITED TO THOSE ADDICTED TO OPIATES, BUT RATHER EVERYONE IMPACTED BY ADDICTION. BID-PLYMOUTH'S DIRECTOR OF SOCIAL WORK PROVIDES TRIAGE FOR THIS PROGRAM, ROUTING THE APPROPRIATE CARE RESPONDER TO EACH CALL. PCO HOLDS DROP-IN CENTERS TWICE A MONTH FOR ANYONE NEEDING HELP AND/OR INFORMATION ABOUT DRUG AND ALCOHOL ADDICTION. REPRESENTATIVES FROM LOCAL TREATMENT CENTERS AS WELL AS COUNSELORS, INCLUDING BID-PLYMOUTH'S DIRECTOR OF SOCIAL WORK, ARE ON SITE AT THE DROP-IN CENTERS.HOSPITAL PRIORITY- BEHAVIORAL HEALTHSTATEWIDE PRIORITY- MENTAL HEALTH- SUBSTANCE USEPROGRAM TYPE- DIRECT SERVICETARGET POPULATIONREGIONS SERVED: PLYMOUTH, BARNSTABLETOWNS SERVED: PLYMOUTH, KINGSTON, CARVER, PEMBROKE, DUXBURY, MARSHFIELD, HALIFAX, HANSON, SANDWICH, WAREHAM, BOURNETARGET POPULATIONS: MEDICALLY UNDERSERVED, VICTIMS OF DOMESTIC VIOLENCE, UNINSURED, ELDERLY, THE POOR, PEOPLE OF COLOR, LGBT, PEOPLE WITH SUBSTANCE ABUSE ISSUES, PEOPLE WHO NEED BEHAVIORAL HEALTH SERVICESHEALTH INDICATOR: PROVIDER SHORTAGES, SCREENING RATES, REFERRAL RATES, DISEASE PREVALENCE, LEVEL OF SERVICE INTEGRATIONSEX: ALL AGE GROUP: ALLETHNIC GROUP: ALL LANGUAGE: ENGLISHGOAL 1: PROVIDE ACCESS AND TREATMENT OF DEPRESSION IN OUTPATIENT PCP AND SPECIALTY PRACTICES.GOAL STATUS: THROUGH A PATIENT HEALTH QUESTIONNAIRE (PHQ-9) THE SCORES DECREASED BY 42% FROM INTAKE TO DISCHARGEGOAL 2: CONTINUE TO PROVIDE FOLLOW UP THROUGH PLYMOUTH COUNTY OUTREACH INITIATIVE TO INDIVIDUALS WHO EXPERIENCED AN OVERDOSE AND ENCOURAGE THEM TO GET HELP.GOAL STATUS: PCO EXPANDED COUNTY-WIDE TO 27 TOWNS AND CITIES. FIVE HOSPITALS IN THE AREA JOINED THE INITIATIVE. OUT OF THE 736 ATTEMPTED FOLLOW-UP VISITS, 14% (105) ENDED WITH THE INDIVIDUAL ACCEPTING TREATMENT FROM THE OUTREACH TEAM. ANOTHER 16% (115) DECLINED TREATMENT OPTIONS, 8% (59) WERE ALREADY SEEKING TREATMENT, 8% (61) OUTCOMES WERE RECORDED AS "OTHER", 47% (342) OF THE VISITS DID NOT RESULT IN CONTACT WITH ANYONE, AND 7% (54) OF THE RECORDS DID NOT PROVIDE AN OUTCOME. EMERGENCY MEDICAL SERVICES (EMS) MEDICAL CONTROL AND DEFIBRILLATION PROGRAM DESCRIPTIONSINCE 2003, BID-PLYMOUTH HAS SUPPORTED POLICE DEPARTMENTS AND OTHER LOCAL TOWN OFFICES THROUGHOUT BID-PLYMOUTH'S SERVICE AREA WITH MEDICAL DIRECTION/EDUCATION FOR THEIR SEMI-AUTOMATIC OR AUTOMATIC EXTERNALS DEFIBRILLATORS (AEDS). THE AEDS ARE PURCHASED AND MAINTAINED BY THE TOWNS THEMSELVES. A TOWN-LEVEL MEDICAL DIRECTOR WHO IS DESIGNATED BY BID-PLYMOUTH OVERSEES OPERATION OF THE AEDS. THESE MEDICAL DIRECTORS OVERSEE TOWN-LEVEL ACTIVITIES RELATED TO THE AEDS AND ENSURE THE CLINICAL COMPETENCY OF THE PERSONNEL EMPLOYED BY THE TOWN WHO USE THE AEDS. THE EDUCATION ACTIVITIES INCLUDE TRAINING AND AUTHORIZATION TO USE THE DEVICE, REMEDIAL EDUCATION TO THOSE EMS PERSONNEL FOUND TO BE DEFICIENT IN CLINICAL PRACTICE, AND NOTIFICATION TO DEPARTMENT WITHIN 48 HOURS OF ANY INSTANCE IN WHICH AUTHORIZATION IS SUSPENDED, REVOKED OR RESTRICTED IN ANY MANNER.THE HOSPITAL ALSO REVIEWS AND REPORTS ON THE AEDS AS WELL AS THE USE OF EPINEPHRINE AUTO-INJECTORS AND USE OF THE INTRANASAL NALOXONE FOR QUALITY ASSURANCE AND CONTINUOUS IMPROVEMENT PURPOSES. THE HOSPITAL ALSO APPROVES TRAINING PROGRAMS FOR THE USE OF EPINEPHRINE AUTO-INJECTORS AND INTRANASAL NALOXONE, MAINTAINS A SYSTEM-WIDE DATABASE OF CARDIAC ARREST TRIP RECORDS FILED BY FIRST RESPONDERS, AND SUBMITS SUMMARY REPORTS TO MASSACHUSETTS DPH UPON REQUEST.THIS INITIATIVE ALSO PROVIDES A BROAD ARRAY OF OTHER SERVICES AND SUPPORTS TO ENHANCE THE CAPACITY AND PERFORMANCE OF THE REGIONS EMERGENCY MEDICAL SERVICE (EMS) PROVIDERS.- FIRST, A FOLLOW-UP PROGRAM HAS BEEN DEVELOPED THAT PROVIDES EMS STAFF WITH ALMOST REAL TIME FEEDBACK FROM THE HOSPITAL REGARDING THEIR PATIENT'S DIAGNOSIS, CLINICAL COURSE, AND OUTCOME FOLLOWING ADMISSION. THESE CASES ARE ALSO REVIEWED IN A PEER REVIEW FORMAT EACH MONTH.- SECOND, THE HOSPITAL IN PARTNERSHIP WITH EMS PROVIDERS HAVE INSTITUTED A TRAINING REQUEST PROGRAM THAT ALLOWS EMS PROVIDERS TO REQUEST CONTINUING EDUCATION TRAINING WITH SPECIALTY SERVICES FROM THE HOSPITAL (E.G., ANESTHESIA, PEDIATRICS, OB, NEURO AND CARDIOLOGY).- THIRD, BID-PLYMOUTH PROVIDES REAL TIME FOLLOW UP ON ST-ELEVATION MYOCARDIAL INFARCTION (STEMI) CASES AND ALL CARDIAC RELATED CASES THAT ORIGINATE IN THE PRE-HOSPITAL SETTING.- FOURTH, THE HOSPITAL HAS DEVELOPED A PROGRAM WHEREBY THE HOSPITAL WILL HOST PARAMEDIC STUDENTS IN THE EMERGENCY DEPARTMENT FOR THEIR CLINICAL ROTATIONS.- FIFTH, THE HOSPITAL HOSTS EDUCATIONAL OPPORTUNITIES WITH OUTSIDE AGENCIES (E.G., BOSTON MEDFLIGHT) TO EXPLORE CRITICAL CARE TRANSPORT AND PRE-HOSPITAL PATIENT CARE.IN FY 2018, THE PROGRAM SERVED EMS PROVIDERS THROUGHOUT THE REGION AND THE FOLLOWING TOWN OFFICES: CARVER POLICE, CARVER FIRE, CARVER SCHOOL SYSTEM, HALIFAX POLICE, KINGSTON POLICE, MARSHFIELD FIRE, PLYMPTON POLICE, PLYMPTON PUBLIC SCHOOLS, PLYMOUTH FIRE, PLYMOUTH PUBLIC SCHOOLS, TOWN OF PEMBROKE, TOWN OF PLYMOUTH - ADMINISTRATION OFFICES, TOWN OF PLYMOUTH - HARBORMASTER, & RISING TIDE CHARTER SCHOOL.HOSPITAL PRIORITY- PHYSICAL DISEASE MANAGEMENT AND PREVENTION- HEALTH RISK FACTORS- BEHAVIORAL HEALTHSTATEWIDE PRIORITY- CHRONIC DISEASE- SUBSTANCE USEPROGRAM TYPE- COMMUNITY EDUCATIONTARGET POPULATIONREGIONS SERVED: PLYMOUTH, BARNSTABLETOWNS SERVED: CARVER, DUXBURY, HALIFAX, KINGSTON, LAKEVILLE, MARSHFIELD, MIDDLEBORO, PLYMOUTH, PEMBROKE, PLYMPTON, SANDWICHTARGET POPULATIONS: MEDICALLY UNDERSERVED, VICTIMS OF DOMESTIC VIOLENCE, UNINSURED, ELDERLY, VICTIMS TO PRE-HOSPITAL ENVIRONMENTAL TRAUMA, INDUSTRIAL AND ACCIDENTAL. PATIENTS WITH SUBSTANCE ABUSE, OBSTETRIC, RESPIRATORY, CARDIOVASCULAR, GASTROINTESTINAL, AND PSYCHIATRIC CONDITIONS/DISEASES. ACUTELY ILL CEREBRAL VASCULAR ACCIDENT AND CORONARY ARTERY DISEASE, (STEMI) PATIENTS.HEALTH INDICATOR: LEVEL OF KNOWLEDGE AND AWARENESSSEX: ALL AGE GROUP: ALLETHNIC GROUP: ALL LANGUAGE: ENGLISHPARTNERS- BID-PLYMOUTH EMERGENCY DEPARTMENT- ALL AFFILIATED PUBLIC SAFETY AGENCIES- PLYMOUTH OPERATING ROOM/ANESTHESIA- BOSTON MEDFLIGHT, BIDMC EMERGENCY DEPARTMENT- BID-PLYMOUTH MARKETING/SENIOR LEADERSHIP, LABOR AND DELIVERY/THE BIRTHPLACEGOAL 1: CONTINUE TO PROVIDE MEDICAL CONTROL AND OVERSIGHT TO AFFILIATED EMS AGENCIESGOAL STATUS: CONTINUED THE ONGOING QUALITY ASSURANCE AND QUALITY INITIATIVE PROGRAM AND CONTINUING EDUCATION WITH NINE TOWNS. COMMUNITY PARTNERSBID-PLYMOUTH COLLABORATES WITH A WIDE RANGE OF COMMUNITY LEADERS AND LOCAL GROUPS TO IMPROVE THE HEALTH STATUS OF THE PEOPLE LIVING IN ITS SERVICE AREA AND TO PROVIDE THE CARE THEY NEED AT THE RIGHT PLACE AND RIGHT TIME. BID-PLYMOUTH'S LEADERS, CLINICAL AND ADMINISTRATIVE STAFF, AND VOLUNTEERS MEET REGULARLY WITH LEADERS FROM THE COMMUNITY INCLUDING ELECTED OFFICIALS, BUSINESS OWNERS, COMMUNITY SERVICE PROVIDERS, EMERGENCY PERSONNEL, SCHOOL ADMINISTRATORS, MEDIA REPRESENTATIVES AND OTHERS WITH INSIGHT INTO THE COMMUNITY'S HEALTH NEEDS. BEYOND ITS WALLS, BID-PLYMOUTH PLAYS AN ACTIVE ROLE IN COALITION BUILDING, WORKING TO EMPOWER A RANGE OF COMMUNITY LEADERS TO FOSTER SUSTAINABLE, HEALTHY LIFESTYLES THAT LEAD TO BETTER HEALTH FOR ALL MEMBERS OF THE COMMUNITY.BID-PLYMOUTH'S COMMUNITY BENEFITS STAFF REGULARLY ENGAGES ITS COMMUNITY PARTNERS IN THE DEVELOPMENT, IMPLEMENTATION, AND EVALUATION OF THE HOSPITAL'S CHIP/IMPLEMENTATION STRATEGY. THESE ENGAGEMENT EFFORTS ARE CONDUCTED BY SOLICITING FEEDBACK AT COMMUNITY EVENTS, WORKSHOPS, AND COMMUNITY COALITION MEETINGS. IN ADDITION, COMMUNITY BENEFITS STAFF AND OTHER HOSPITAL STAFF MEMBERS MEET WITH KEY PARTNERS ON A ONE-ON-ONE BASIS TO DISCUSS NEEDS AND POTENTIAL PARTNERSHIPS, SUCH AS WITH THE PLYMOUTH PUBLIC HEALTH DEPARTMENT, THE HEALTHY PLYMOUTH COLLABORATIVE, SUPERINTENDENT OF PLYMOUTH SCHOOLS, PLYMOUTH YOUTH DEVELOPMENT COUNCIL AND THE TRANSPORTATION PILOT PROGRAM STAFF. HOSPITAL STAFF SERVE ON NUMEROUS HEALTH-RELATED COMMITTEES, COALITIONS, AND BOARDS. IN ADDITION, REPRESENTATIVES FROM BID-PLYMOUTH'S PARTNER ORGANIZATIONS AND COMMUNITY RESIDENTS SERVE ON HOSPITAL COMMITTEES (E.G., BOARD OF DIRECTORS, PATIENT FAMILY ADVISORY COUNCIL, AND THE PATIENT CARE ASSESSMENT COMMITTEE), PROVIDING IMPORTANT FEEDBACK AND WORKING WITH STAFF TO IMPROVE SERVICE OPERATIONS AND COMMUNITY HEALTH CARE INITIATIVES. OUTSIDE OF BID-PLYMOUTH'S CHIP, HOSPITAL CLINICIANS AND STAFF REGULARLY COLLABORATE WITH DOZENS AND DOZENS OF COMMUNITY PARTNERS THROUGHOUT THE REGION AS PART OF EFFORTS TO PERFECT REGULAR HOSPITAL OPERATIONS AND OTHER COMMUNITY-FOCUSED ACTIVITIES. THESE ACTIVITIES ARE INSTRUMENTAL AND HELP TO INFORM THE DEVELOPMENT AND EXECUTION OF THE HOSPITAL'S CHIP.IN SUPPORT OF THE IDENTIFIED HEALTH PRIORITIES AND THE INITIATIVES THAT ARE PART OF THE IMPLEMENTATION STRATEGY, BID-PLYMOUTH COLLABORATES WITH NEARLY 50 COMMUNITY ORGANIZATIONS. BID-PLYMOUTH'S COMMUNITY PARTNERS (SEE LIST BELOW) WORK SIDE-BY-SIDE WITH THE HOSPITAL AND ARE ACTIVELY ENGAGED IN HEALTH INITIATIVES THROUGHOUT THE YEAR THAT FOSTER COMMUNITY HEALTH AND WELLNESS. THE HOSPITAL HAS COLLABORATED WITH THE COMMUNITY BUSINESS PARTNERS TO BRING ISSUES OF HEALTH AND WELLNESS TO THE FOREFRONT OF THIS GROUP. FINALLY, BID-PLYMOUTH WORKS WITH ITS EDUCATIONAL PARTNERS, WHICH ENHANCE ITS WORKFORCE, PROVIDE OPPORTUNITIES FOR LEARNING, AND BROADEN THE HOSPITAL'S PREVENTIVE REACH THROUGHOUT THE COMMUNITY BENEFITS SERVICE AREA AND BEYOND. COMMUNITY PARTNERS: - AD MAKEPEACE - AMERICAN HEART ASSOCIATION- ANCHOR HOUSE, INC.- BAYSIDE RUNNERS- BAY STATE COMMUNITY SERVICES, INC. - BETH ISRAEL DEACONESS MEDICAL CENTER- BID-PLYMOUTH COMMUNITY BUSINESS PARTNERS (APPROXIMATELY 69 BUSINESSES)- BOSTON PUBLIC HEALTH COMMISSION-RYAN WHITE PART A- CAPE COD CANAL REGION CHAMBER OF COMMERCE - CLEANSLATE CENTERS - COMMUNITY HEALTH EDUCATION NETWORK AREA 23 (CHNA 23) - DUXBURY COUNCIL ON AGING - FATHER BILL'S AND MAINSPRING- GOSNOLD- GREATER ATTLEBORO-TAUNTON REGIONAL TRANSIT AUTHORITY (GATRA)- GREATER PLYMOUTH AIDS CONSORTIUM - GREATER PLYMOUTH FOOD WAREHOUSE - HABILITATION ASSISTANCE- HARBOR COMMUNITY HEALTH CENTER- HEALTH IMPERATIVES, INC.- HEALTH RESOURCE & SERVICE ADMINISTRATION (HRSA)-RYAN WHITE PART C - HEALTHY PLYMOUTH - HIGH POINT TREATMENT CENTER- LORING LIBRARY- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH PEDIATRIC PALLIATIVE CARE NETWORK - MCLEAN HOSPITAL- NATIONAL ALLIANCE ON MENTAL ILLNESS OF MASSACHUSETTS (NAMI MASS)- OLD COLONY ELDER SERVICES- OLD COLONY PLANNING COUNCIL - OLD COLONY YMCA - PINEHILLS LLC - PLIMOTH PLANTATION - PLYMOUTH AREA CHAMBER OF COMMERCE- PLYMOUTH AREA COMMUNITY TELEVISION (PACTV)- PLYMOUTH BOARD OF SELECTMEN- PLYMOUTH CONSERVATION COMMISSION - PLYMOUTH COUNCIL ON AGING - PLYMOUTH COUNTY DISTRICT ATTORNEY'S OFFICE- PLYMOUTH COUNTY OUTREACH- PLYMOUTH COUNTY OUTREACH HOPE- PLYMOUTH DEPARTMENT OF PUBLIC WORKS (DPW) - PLYMOUTH FAMILY NETWORK - PLYMOUTH LIONS CLUB- PLYMOUTH PUBLIC LIBRARY - PLYMOUTH PUBLIC SCHOOLS - PLYMOUTH RESOURCE CENTER- PLYMOUTH YOUTH DEVELOPMENT COLLABORATIVE (PYDC) - RED CROSS BLOOD DRIVE- REGION V MASSACHUSETTS DPH BIO-TERRORISM COMMITTEE - ROTARY CLUB OF PLYMOUTH - SCHWARTZ CENTER ROUNDS - SODEXO- SOUTH SHORE COMMUNITY ACTION COUNCIL- TERRA CURA, INC.- THE BRIDGE- THE HERREN PROJECT - THE PARENT CONNECTION OF DUXBURY - THORBAHN - TOWN OF PLYMOUTH - TOWN OF PLYMOUTH OPEN SPACE COMM. - UNITED WAY OF GREATER PLYMOUTH COUNTY- VILLAGE AT DUXBURY - WILDLANDS TRUST - ZION LUTHERAN CHURCH ASSOCIATES- BOYS & GIRLS CLUB OF PLYMOUTH- BOYS & GIRLS CLUB OF BROCKTON- COLCHESTER NEIGHBORHOOD FARMS- KIWANIS CLUB OF PLYMOUTH- LEAGUE OF WOMEN VOTERS- OFFICE OF ADOLESCENT HEALTH AND YOUTH DEVELOPMENT - SIGNATURE HEALTHCARE / BROCKTON HOSPITAL - SOUTH SHORE CHAMBER OF COMMERCE- SOULE HOMESTEAD EDUCATION CENTER- SOUTHEASTERN MASSACHUSETTS AGRICULTURAL PARTNERSHIP, INC. (SEMAP)- SOUTHEASTERN REGIONAL OFFICE OF DEVELOPMENTAL DISABILITIESEDUCATIONAL PARTNERS- BAY STATE COLLEGE- BETHEL UNIVERSITY- BOSTON COLLEGE- BOSTON UNIVERSITY SCHOOL OF MEDICINE- BRIDGEWATER STATE UNIVERSITY - BRISTOL COMMUNITY COLLEGE- BUNKER HILL COMMUNITY COLLEGE- CAPE COD COMMUNITY COLLEGE- CHAMBERLAIN COLLEGE OF NURSING - COASTAL CAROLINA UNIVERSITY- CURRY COLLEGE- DREXEL UNIVERSITY- EASTERN NAZARENE COLLEGE- EDWARD VIA COLLEGE OF OSTEOPATHIC MEDICINE- EMS ACADEMY- FIRST RESPONSE EMERGENCY MEDICAL EDUCATION PROGRAM- FISHER COLLEGE- FRAMINGHAM STATE UNIVERSITY- FRONTIER NURSING UNIVERSITY- GEORGE WASHINGTON UNIVERSITY- GEORGETOWN UNIVERSITY- HARVARD MEDICAL SCHOOL- JOHNSON AND WALES UNIVERSITY- LABOURE COLLEGE- LESLEY UNIVERSITY- MASSACHUSETTS BAY COMMUNITY COLLEGE- MASSACHUSETTS COLLEGE OF PHARMACY & ALLIED HEALTH SCIENCES- MASSASOIT COMMUNITY COLLEGE- MEDICAL PROFESSIONAL INSTITUTE- MEDICAL UNIVERSITY OF SOUTH CAROLINA- MGH INSTITUTE OF HEALTH PROFESSIONS, INC.- NEW ENGLAND INSTITUTE OF TECHNOLOGY- NORTHERN ESSEX COMMUNITY COLLEGE- NORTHEASTERN UNIVERSITY- NOVA SOUTHEASTERN UNIVERSITY- OREGON HEALTH & SCIENCE UNIVERSITY- PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE- PHILADELPHIA UNIVERSITY- PRIORITY NUTRITION CARE, LLC- PROVIDENCE COLLEGE- QUINCY COLLEGE- REGIS COLLEGE- SALEM STATE UNIVERSITY- SIGNATURE HEALTHCARE- SIMMONS COLLEGE- SPRINGFIELD COLLEGE- ST. ANSELM COLLEGE- STONEHILL COLLEGE- TUFTS UNIVERSITY SCHOOL OF MEDICINE- UNIVERSITY OF BUFFALO- UNIVERSITY OF CONNECTICUT SCHOOL OF PHARMACY- UNIVERSITY OF MASSACHUSETTS- UNIVERSITY OF MASSACHUSETTS DARTMOUTH- UNIVERSITY OF NEW ENGLAND- UNIVERSITY OF NEW HAMPSHIRE- UNIVERSITY OF NORTH ALABAMA- UNIVERSITY OF RHODE ISLAND- UNIVERSITY OF SOUTH ALABAMA- UNIVERSITY OF ST. JOSEPH- UPPER CAPE COD REGIONAL TECHNICAL SCHOOL- UTAH STATE UNIVERSITY- WESTFIELD STATE UNIVERSITY- WINGATE UNIVERSITY- YALE SCHOOL OF NURSINGAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, BID-PLYMOUTH IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. HOWEVER, AS NOTED IN SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE 2016 CHNA THAT ARE NOT INCLUDED IN THE 2016 CHIP. EFFORTS TO IMPROVE TRANSPORTATION SYSTEMS ARE NOT PART OF THE HOSPITAL'S MISSION AND UNLIKE THE MANY PROGRAMS DESCRIBED HEREIN WHERE BID-PLYMOUTH IS UNIQUELY SITUATED TO IMPLEMENT SUCH PROGRAMS, IMPROVING TRANSPORTATION SYSTEMS IS OUTSIDE THE SCOPE OF THE HOSPITAL'S EXPERTISE, AND AS SUCH THESE NEEDS ARE NOT PART OF THE HOSPITAL'S 2016 CHIP. HOWEVER, AS NOTED WITHIN THIS NARRATIVE, THE HOSPITAL CAN AND DOES PROACTIVELY SUPPORT THE EVALUATION OF CURRENT TRANSPORTATION OPTIONS AND ADVOCATE FOR REVISIONS THAT WILL HELP AREA RESIDENTS EASILY ACCESS HEALTHY FOOD, EXERCISE AREAS, HEALTHCARE SERVICES, ETC. IN ADDITION, WHERE THE HOSPITAL IS UNABLE TO ADDRESS NEEDS BECAUSE OF LIMITED FINANCIAL RESOURCES, THE HOSPITAL EXPLORES PUBLIC FINANCING OPTIONS, PRIVATE FOUNDATION AND DONOR SUPPORT AND A RANGE OF OTHER FUNDING OPPORTUNITIES TO HELP MEET COMMUNITY NEEDS. AS RESOURCES ARE IDENTIFIED AND BUSINESS PLANS ARE JUSTIFIED, THE HOSPITAL IMPLEMENTS THOSE HIGH PRIORITY PROJECTS WITH THE HIGHEST POTENTIAL IMPACT FOR A HEALTHIER COMMUNITY. AS NOTED IN DETAIL ABOVE, THE BID-PLYMOUTH'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND CHIP/IMPLEMENTATION STRATEGY (SCHEDULE H PART VI QUESTION 2). FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BID-PLYMOUTH OR HOSPITAL) CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS REPORTED IN THIS SCHEDULE H, 12.38% OF BID-PLYMOUTH'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. IN ADDITION, IT IS IMPORTANT TO NOTE IN THIS CONTEXT THAT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER, ENTITY EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND FOR THE PERIOD COVERED BY THIS FILING SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH. THE FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS PROVIDED BY BIDMC ARE PROVIDED BY THE SAME HEALTH CARE SYSTEM, AND ALTHOUGH THOSE ACTIVITIES ARE NOT QUANTIFIED ON THE BID-PLYMOUTH SCHEDULE H PER THE INSTRUCTIONS TO THE FORM 990, THOSE ACTIVITIES ARE RELEVANT IN EVALUATING THE TOTAL COMMUNITY BENEFIT PROVIDED. BIDMC REPORTED OVER $253,000,000 IN NET EXPENDITURES AT COST WHICH REPRESENTED APPROXIMATELY 15% OF TOTAL EXPENSES INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST FOR THE FISCAL PERIOD COVERED BY THIS FILING. COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) WERE APPROVED BY THE COMMUNITY BENEFITS COMMITTEE AND BOARD OF DIRECTORS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016 AND RELATE TO THE COMMUNITY BENEFIT ACTIVITIES REPORTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H. IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE, ON THE HOSPITAL'S WEBSITE AND UPON REQUEST AT THE HOSPITAL. THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT THE MEDICAL CENTER FILED WITH THE ATTORNEY GENERAL'S OFFICE. COMMUNITY BENEFITS - EMERGENCY ROOM OPERATIONIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BID-NEEDHAM IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBID-PLYMOUTH'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $2,081,612 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A. THE MEDICAL CENTER, WHICH AS PREVIOUSLY NOTED IS THE SOLE MEMBER OF BID-PLYMOUTH, PROVIDED AN ADDITIONAL $17,420,672 OF FINANCIAL ASSISTANCE AND CHARITY CARE AT COST WHICH IS REPORTED ON THE MEDICAL CENTER FORM 990, SCHEDULE H, PART I, LINE 7A FOR THE SAME FISCAL PERIOD. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. HMFP IS THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER. THE OPERATIONS OF HMFP AND THE ENTITIES FOR WHICH HMFP SERVES AS MEMBER ARE INTEGRALLY RELATED TO THE MEDICAL CENTER'S ACCOMPLISHMENTS OF ITS PURPOSES. HMFP AND ITS AFFILIATES ARE INTEGRALLY RELATED TO BID-PLYMOUTH AND TO SERVING THE COMMUNITIES SERVED BY BID-PLYMOUTH. AS PART OF THIS RELATIONSHIP, HMFP PATIENTS WHO MEET THE FREE CARE CRITERIA OF THE MEDICAL CENTER ARE PROVIDED FREE CARE AT HMFP AND ITS AFFILIATED ENTITIES. DURING THE FISCAL PERIOD COVERED BY THIS FILING, HMFP AND ITS AFFILIATED ENTITIES PROVIDED ADDITIONAL NET FREE CARE TO PATIENTS IN THE AMOUNT OF $1,566,619. SEE ADDITIONAL INFORMATION BELOW IN THIS SCHEDULE H NARRATIVE. SEE ADDITIONAL INFORMATION BELOW IN THIS SCHEDULE H NARRATIVE.OTHER UNCOMPENSATED CHARITY CARE - MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BID-PLYMOUTH ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS WHICH INSURE LOW INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 15.3% OR 40,549 OF BID-PLYMOUTH'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. THIS TRANSLATED TO $29,876,948 IN MEDICAID REVENUE WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY BID-PLYMOUTH FOR SUCH SERVICES BY $5,900,714 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. IN ADDITION 21.4% OR 254,330 OF THE MEDICAL CENTER'S PATIENT CASES WERE WITH MEDICAID PATIENTS. THIS TRANSLATED TO AN ADDITIONAL $35,778,658 IN UNCOVERED COST BORNE BY BIDMC IN PROVIDING CARE TO MEDICAID PATIENTS. AS PREVIOUSLY NOTED, THIS ADDITIONAL BIDMC COST IS NOT QUANTIFIED IN THE BID- PLYMOUTH SCHEDULE H. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND THE BID-PLYMOUTH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 45.4% OR 120,625 OF BID-PLYMOUTH'S PATIENT ENCOUNTERS WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO $ $123,416,851 IN REVENUE. HOWEVER, BECAUSE PAYMENTS TO HOSPITALS THROUGH THIS GOVERNMENT SPONSORED PROGRAM HAVE NOT KEPT PACE WITH INFLATION, REVENUE COLLECTED WAS LESS THAN THE COST OF SERVICES BY $1,716,922. MANY OF THE SERVICES PROVIDED TO MEDICARE PATIENTS ARE RELATED TO THE PROVISION OF SUBSIDIZED HEALTH SERVICES AND MEDICARE LOSSES OF $6,318,224 RELATED TO THE PROVISION OF CARE FOR GERIATRIC PSYCHIATRIC PATIENTS, ONCOLOGY AND INFUSION PATIENTS, LAB AND CARDIAC CATH SERVICES ARE INCLUDED IN FORM 990 SCHEDULE H PART I, LINE 7G. REVENUES AND COSTS FOR OTHER MEDICARE SERVICES ARE REPORTED IN THIS FORM 990 SCHEDULE H PART III LINE 7 AS REQUIRED. BIDMC SIMILARLY PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 29.3% OR 348,544 OF THE MEDICAL CENTER'S PATIENT ENCOUNTERS WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO MEDICARE REVENUE OF $401,739,417. HOWEVER, BECAUSE PAYMENTS TO HOSPITALS THROUGH THIS GOVERNMENT SPONSORED PROGRAM HAVE NOT KEPT PACE WITH INFLATION, REVENUE COLLECTED WAS LESS THAN THE COST OF SERVICES BY $33,492,068. THIS ADDITIONAL BIDMC COST IS NOT QUANTIFIED IN THE BID-PLYMOUTH SCHEDULE H. BAD DEBTS IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BID-PLYMOUTH ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS, AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $ $6,469,858 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. BIDMC SIMILARLY INCURS BAD DEBT LOSSES AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE IN ITS FINANCIAL STATEMENTS. BIDMC CHARGES FOR THOSE SERVICES WERE $20,510,577 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND AS REPORTED ON THE BIDMC FORM 990, SCHEDULE H, PART III, LINE 2. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. AS REQUIRED BY THIS FORM 990, SCHEDULE H, PART III, LINE 4, BELOW ARE THE BAD DEBT AND ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTES FROM THE BETH ISRAEL DEACONESS MEDICAL CENTER'S (BIDMC OR MEDICAL CENTER) AUDITED FINANCIAL STATEMENTS. AS PREVIOUSLY NOTED IN THIS FORM 990, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE MEDICAL CENTER AND AFFILIATES FOR FISCAL YEAR ENDED SEPTEMBER 30, 2018 INCLUDE THE ACCOUNTS OF THE MEDICAL CENTER AND ITS SUBSIDIARIES, (BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BID-PLYMOUTH), JORDAN HEALTH SYSTEMS, INC., BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BIDN), MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP (APG)), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON)) AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER. THE BIDP FORM 990 IS PREPARED FOR BIDP ONLY AND AS SUCH, THE METRICS INCLUDED IN THESE FOOTNOTES WILL NOT TIE TO THE FACE OF THE BIDP FORM 990, SCHEDULE H.FINANCIAL STATEMENT FOOTNOTES:BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, THE MEDICAL CENTER ALSO INCURS LOSSES RELATED TO SELF PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBTS ARE INCLUDED AS A COMPONENT OF NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS, AND INCLUDE THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. THE ESTIMATED COST OF PROVIDING SUCH SERVICES WAS $20,111,000 AND $16,928,000 IN 2018 AND 2017, RESPECTIVELY. PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSPATIENT ACCOUNTS RECEIVABLE ARE REFLECTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST COLLECTION HISTORY, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN GOVERNMENTAL AND EMPLOYEE HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS FOR EACH OF ITS MAJOR CATEGORIES OF REVENUE BY PAYOR TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR CATEGORIES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THROUGHOUT THE YEAR, THE MEDICAL CENTER, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, WILL WRITE OFF PATIENTS' UNMET OR UNCOLLECTED RESPONSIBILITY AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN ADDITION TO THE REVIEW OF THE CATEGORIES OF REVENUE, MANAGEMENT MONITORS THE WRITE OFFS AGAINST ESTABLISHED ALLOWANCES TO DETERMINE THE APPROPRIATENESS OF THE UNDERLYING ASSUMPTIONS USED IN ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE MEDICAL CENTER'S METHODOLOGY FOR VALUING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE REMAINED SUBSTANTIALLY CONSISTENT IN 2017 AND 2016. THE MEDICAL CENTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS REPRESENTED APPROXIMATELY 8.8% AND 9.3% OF PATIENT ACCOUNTS RECEIVABLE, NET OF CONTRACTUAL ALLOWANCES IN 2018 AND 2017, RESPECTIVELY.EMERGENCY CARE ACCESSAS PREVIOUSLY NOTED IN THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, BIDMC SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH. THE MEDICAL CENTER IS A NATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER AND TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) IS AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BIDMC AND IS ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BID-PLYMOUTH EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. THE BID-PLYMOUTH DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR.FINANCIAL ASSISTANCE POLICY - INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE BID-PLYMOUTH'S MISSION IS TO DISTINGUISH ITSELF FROM OTHER PROVIDERS THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION, RESEARCH AND THROUGH IMPROVED HEALTH IN THE COMMUNITIES SERVED.BID-PLYMOUTH IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE RECEIVED FROM QUALIFYING PROVIDERS.BID-PLYMOUTH DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY. FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) WHICH APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY THE HOSPITAL'S BOARD PRIOR TO SEPTEMBER 30, 2017 AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF OCTOBER 1, 2017, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R). FINANCIAL ASSISTANCE POLICY - APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15).FINANCIAL ASSISTANCE POLICY - ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE - PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY - TRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH.THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: SPANISH, PORTUGUESE AND VIETNAMESE. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY - WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL OR BY MAIL FREE OF CHARGE AND ON THE HOSPITAL'S WEBSITE AT (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H):HTTP://WWW.BIDPLYMOUTH.ORG/BODY.CFM?ID=90IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY - PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, THE LOCATION (INCLUDING THE BUILDING AND ROOM NUMBER) AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LIMITATION ON CHARGES - INTERNAL REVENUE CODE SECTION 501(R)(5) LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED - LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS -- 501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. IRC 501(R) REPORTING UNDER REVENUE PROCEDURE 2015-21DURING A REVIEW OF THE HOSPITAL'S SECTION 501(R) COMPLIANCE IN FY18, IT WAS DETERMINED THAT CERTAIN INFORMATION IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP), PLAIN LANGUAGE SUMMARY (PLS) AND CREDIT AND COLLECTIONS POLICY (CCP) REQUIRED CLARIFICATION OR CORRECTION. IN ACCORDANCE WITH THE PROCEDURES SET FORTH IN REVENUE PROCEDURE 2015-21, EACH OF THOSE ITEMS IS LISTED ALONG WITH THE METHOD OF CORRECTION. CORRECTION OCCURRED BY ADOPTION OF A REVISED FAP, PLS AND CCP BY THE HOSPITAL'S AUTHORIZED BODY PRIOR TO FILING THIS RETURN. (1) WHILE THE FAP SPECIFIED THE PERCENTAGE OF DISCOUNTS AVAILABLE, IT DID NOT SPECIFICALLY REFER TO WHAT CHARGES THOSE DISCOUNTS WOULD BE APPLIED. THE FAP HAS BEEN REVISED TO CLARIFY THAT THE DISCOUNTS ARE APPLIED TO PATIENT GROSS CHARGES. (2) THE FAP DID NOT SPECIFY THE AMOUNTS GENERALLY BILLED (AGB) BY THE HOSPITAL OR SPECIFY THE METHODOLOGY FOR CALCULATING THE AGB. THE FAP HAS BEEN REVISED TO INCLUDE THIS INFORMATION. (3) THE LIST OF PROVIDERS OF EMERGENCY AND MEDICALLY NECESSARY CARE AT THE HOSPITAL DID NOT INCLUDE ALL PROVIDERS. THE LIST HAS BEEN UPDATED AND NOW REFLECTS ALL PROVIDERS. (4) THE PLS DID NOT INCLUDE THE DIRECT WEBSITE ADDRESS WHERE THE FAP AND FAP APPLICATION COULD BE OBTAINED. THE PLS HAS BEEN UPDATED ACCORDINGLY. (5) THE HOSPITAL HAD NOT YET MADE EFFORTS TO INFORM MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL ABOUT THE FAP IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. THE HOSPITAL HAS SINCE MADE SUCH EFFORTS, INCLUDING BY DISTRIBUTING COPIES OF ITS FAP AND FAP APPLICATION TO REFERRING STAFF PHYSICIANS AND TO COMMUNITY HEALTH CENTERS SERVING THE HOSPITAL'S COMMUNITY. (6) WHILE THE HOSPITAL HAD TRANSLATED ITS FAP, FAP APPLICATION AND PLS INTO SEVERAL LANGUAGES, IT HAD NOT YET TRANSLATED THOSE DOCUMENTS INTO ALL LANGUAGES SPOKEN BY LIMITED ENGLISH PROFICIENCY POPULATIONS IN THE HOSPITAL'S COMMUNITY. SUCH TRANSLATIONS HAVE NOW BEEN MADE. (7) THE HOSPITAL WAS NOT OFFERING COPIES OF THE PLS TO PATIENTS AS PART OF THE INTAKE OR DISCHARGE PROCESS. IT IS NOW DOING SO. (8) THE FAP SPECIFIED THAT FAP-ELIGIBLE PATIENTS WOULD RECEIVE REFUNDS FOR ANY AMOUNTS PAID IN EXCESS OF THE AGB. THIS LANGUAGE HAS BEEN REVISED TO CLARIFY THAT SUCH PATIENTS WILL RECEIVE REFUNDS FOR ANY AMOUNTS PAID IN EXCESS OF THEIR FAP DISCOUNTS. (9) THE CCP DID NOT INCLUDE A DESCRIPTION OF THE OFFICE, DEPARTMENT OR COMMITTEE WITH FINAL AUTHORITY FOR DETERMINING THAT THE MEDICAL CENTER HAS MADE REASONABLE EFFORTS TO DETERMINE FAP-ELIGIBILITY PRIOR TO ENGAGING IN ANY EXTRAORDINARY COLLECTION ACTIONS. THE CCP HAS BEEN REVISED TO INCLUDE SUCH A DESCRIPTION. (10) WHILE THE HOSPITAL HAS HAD A LONGSTANDING EMERGENCY MEDICAL CARE POLICY IN PLACE THE POLICY HAD NOT BEEN ADOPTED BY AN AUTHORIZED BODY. THE HOSPITAL HAS NOW INCLUDED LANGUAGE IN ITS FAP, ADOPTED BY AN AUTHORIZED BODY, REQUIRING THE HOSPITAL TO PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF WHETHER THEY ARE FAP-ELIGIBLE. (11) THE HOSPITAL HAD NOT BEEN INCLUDING WITH BILLS TO PATIENTS OFFERED DISCOUNTED BUT NOT FREE CARE AN EXPLANATION OF HOW THE PATIENT'S DISCOUNT HAD BEEN DETERMINED. THAT INFORMATION IS NOW INCLUDED WITH PATIENT BILLS. FINALLY, THE HOSPITAL HAS ADOPTED PROCEDURES THAT REQUIRE THE HOSPITAL TO REVIEW, ON A REGULAR BASIS, THE HOSPITAL'S POLICIES AND PROCEDURE TO ENSURE COMPLIANCE WITH THE REQUIREMENTS OF SECTION 501(R) AND THE REGULATIONS ISSUED THEREUNDER. THOSE PROCEDURES INCLUDE REVIEWING A SECTION 501(R) COMPLIANCE CHECKLIST.FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLANDETAIL TO BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH'S (BID-PLYMOUTH OR HOSPITAL) COMMUNITY HEALTH NEEDS ASSESSMENT, IMPLEMENTATION STRATEGY AND COMMUNITY BENEFITS ACTIVITIES HAVE BEEN PROVIDED IN FORM 990, SCHEDULE H, PART V SECTION C ABOVE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - GRADUATE MEDICAL EDUCATION AS PREVIOUSLY NOTED IN THROUGHOUT THIS FORM 990, FOR THE PERIOD COVERED BY THIS FILING BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS THE SOLE MEMBER OF BID-PLYMOUTH. ALTHOUGH BID-PLYMOUTH DOES NOT ENGAGE DIRECTLY IN GRADUATE MEDICAL EDUCATION, PROVIDING SUCH EDUCATION IS PART OF BIDMC'S CORE MISSION. THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 55 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 653 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 45 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 65 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMS THE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS:- ANESTHESIOLOGY- EMERGENCY MEDICINE- INTERNAL MEDICINE- NEUROLOGY- NEUROSURGERY- OBSTETRICS AND GYNECOLOGY- PATHOLOGY- PSYCHIATRY- RADIOLOGY- SURGERY- TRANSITIONAL YEARDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER HAD NET EXPENDITURES OF $74,862,985 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE MEDICAL CENTER'S TEACHING FUNCTION WHICH REPRESENTED 4.26% OF THE MEDICAL CENTER'S TOTAL EXPENSES.RESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. OVER HALF OF THESE PROGRAMS (55 OF 90) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS:- ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, CRITICAL CARE MEDICINE, NEUROANESTHESIA, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA- EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, ACADEMIC EMERGENCY MEDICINE- INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOSCOPY, CARDIAC MAGNETIC RESONANCE IMAGING CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY- NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY- OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, MATERNAL FETAL MEDICINE, MINIMALLY INVASIVE GYNECOLOGIC SURGERY, REPRODUCTIVE ENDOCRINOLOGY- PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY - CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY - RADIOLOGY-DIAGNOSTIC: ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED MRI, MUSCULOSKELETAL IMAGING - MSK, NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, VASCULAR AND INTERVENTIONAL RADIOLOGY, RADIATION ONCOLOGYSURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, COLORECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, INTERDISCIPLINARY BREAST SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, NEUROSURGICAL ONCOLOGY & STERIOTACTIC NEUROSURGERY, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, PLASTIC HAND SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATEDADDITIONAL INFORMATION ON THE MEDICAL CENTER'S CLINICAL RESIDENCY AND FELLOWSHIPS IS AVAILABLE IN THE SUPPORTING DETAIL TO THE MEDICAL CENTER'S FORM 990, SCHEDULE H. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - RESEARCHAS PREVIOUSLY NOTED IN THROUGHOUT THIS FORM 990, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS THE SOLE MEMBER OF BID-PLYMOUTH. ALTHOUGH BID-PLYMOUTH DOES NOT ENGAGE DIRECTLY IN ANY FUNDAMENTAL BENCH RESEARCH, CONDUCTING RESEARCH IS PART OF BIDMC'S MISSION. THE MEDICAL CENTER IS A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF LOCAL AND EXTENDED COMMUNITIES. THE BIDMC RESEARCH PROGRAM STRIVES TO BE, AND IS, RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS THAT IMPROVE THE QUALITY OF LIFE.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:- ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE - EMERGENCY MEDICINE - MEDICINE - ALLERGY AND INFLAMMATION - CARDIOVASCULAR MEDICINE - CENTER FOR VASCULAR BIOLOGY RESEARCH - CENTER FOR VIROLOGY AND VACCINE RESEARCH - CLINICAL INFORMATICS - CLINICAL NUTRITION - ENDOCRINOLOGY - EXPERIMENTAL MEDICINE - GASTROENTEROLOGY - GENERAL MEDICINE AND PRIMARY CARE - GENETICS - GERONTOLOGY - HEMATOLOGY AND ONCOLOGY - HEMOSTASIS AND THROMBOSIS - IMMUNOLOGY - INFECTIOUS DISEASE - INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY - MOLECULAR AND VASCULAR MEDICINE - NEPHROLOGY - PULMONOLOGY - RHEUMATOLOGY - SIGNAL TRANSDUCTION - TRANSLATIONAL RESEARCH - TRANSPLANT IMMUNOLOGY- NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY - CARDIAC SURGERY - CENTER FOR MINIMALLY INVASIVE SURGERY - NEUROSURGERY - PLASTIC AND RECONSTRUCTIVE SURGERY - VASCULAR SURGERY- TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $77,578,478 OF NET INTERNALLY FUNDED RESEARCH ON ITS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 4.42% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $219,244,237 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS ON SCHEDULE H, PART I LINE 7H COLUMN D, WHICH, IF INCLUDED IN SCHEDULE H, PART I, LINE 7H COLUMN E CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THIS SCHEDULE H, PART I, LINE 7H TO 16.77%. SCHEDULE H PART VI QUESTIONS 5 AND 6 ADDITIONAL PROMOTION OF COMMUNITY HEALTH AND AFFILIATED HEALTH CARE SYSTEMBID-PLYMOUTH MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. IN ADDITION, AS NOTED THROUGHOUT THIS NARRATIVE SUPPORT TO THE BID-PLYMOUTH FORM 990 AND SCHEDULES, THE MEDICAL CENTER IS PART OF THE CAREGROUP NETWORK OF AFFILIATES AND CAREGROUP SERVES AS THE MEDICAL CENTER'S SOLE MEMBER. THE MEDICAL CENTER SERVES AS THE SOLE MEMBER TO BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, BETH ISRAEL DEACONESS HOSPITAL - MILTON, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP AND JORDAN HEALTH SYSTEMS, INC. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC. EACH OF THESE ENTITIES MAY, IN TURN, SERVE AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. BID-PLYMOUTH, THE MEDICAL CENTER AND EACH OF ITS AFFILIATES IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES THEY SERVE. 0 JORDAN HOSPITAL CLUB 275 SANDWICH STREET PLYMOUTH MA 02360 237181730 501(C)(3) 20000 GENERAL PURPOSE 1 0 X 0 1 X X X X 1 1 0 0 0 0 0 1 0 COUGHLIN KEVIN PRESIDENT & CEO; DIR (EX-OFF) 523649 130911 93327 23332 3374 844 29671 7418 24510 6127 674531 168632 0 0 FISCHER STEVEN DIRECTOR; ASST TREAS, BIDMC 0 565792 0 99895 0 54988 0 25030 0 50935 0 796640 0 0 LEWIS MD STANLEY M DIR; CHF SYS DEV OFF BIDMC 0 555411 0 112992 0 55149 0 30330 0 49486 0 803368 0 0 LONIS-SCHEUB MD KIMBERLY DIRECTOR 275412 0 0 0 6239 0 32400 0 31581 0 345632 0 0 0 STUHLFAUT MD JOSHUA DIR (EX-OFF)/PRES MED STAFF 0 463165 0 49076 0 9704 0 21000 0 22002 0 564947 0 0 TABB MD KEVIN DIRECTOR; BIDMC CEO 0 1088019 0 485375 0 20894 0 158280 0 45929 0 1798497 0 0 TREHU MD STEPHEN DIRECTOR 0 226766 0 27242 0 3838 0 10500 0 130 0 268476 0 0 RADZEVICH JASON VP OF FINANCE, CFO & TREASURER 245844 61461 58256 14564 10858 2715 24146 6037 23682 5920 362786 90697 0 0 BARBOSA LISA BERRY VP, HR 183017 20335 42827 4759 1371 152 17627 1959 24570 2730 269412 29935 0 0 BROWNING MD THOMAS CHIEF OF MEDICINE 129929 129929 0 0 3099 3099 13500 13500 12560 12560 159088 159088 0 0 CONNOLLY MD JOHN VP MED MGMT/CHR ANES. DEPT 362394 0 0 0 47808 0 27000 0 20754 0 457956 0 0 0 DOHERTY RN DONNA CNO, VP PATIENT CARE SERVICES 254319 0 58905 0 106912 0 10187 0 27300 0 457623 0 0 0 RUTHERFORD RON VP & CIO 172083 43021 41821 10455 5037 1259 17657 4414 23200 5800 259798 64949 0 0 DOLAWAY DEBORAH HOSPICE ADMINISTRATOR 181533 0 5000 0 27653 0 7234 0 3255 0 224675 0 0 0 GORSUCH PHD W BRIAN CHIEF PHYSICIAN ASSISTANT 241533 0 5000 0 16251 0 9493 0 29368 0 301645 0 0 0 HEBERT NP RICHARD M NURSE PRACTITIONER 203333 0 0 0 6040 0 3973 0 27386 0 240732 0 0 0 HOLLERAN ANDREA VP STRATEGIC PLAN/EXT AFFAIRS 182649 0 48884 0 133837 0 10363 0 30100 0 405833 0 0 0 PASKOWSKI DC IAN CHIROPRACTOR 187223 0 21873 0 776 0 7448 0 564 0 217884 0 0 0 HOLDEN PETER J FORMER PRESIDENT & CEO 0 0 0 0 0 590499 0 0 0 0 0 590499 0 0 PART I, LINE 1A PART I QUESTION 1 GROSS-UP PAYMENTS BID-PLYMOUTH PROVIDES MEMBERS OF SENIOR MANAGEMENT WITH DISABILITY INSURANCE, THE COST OF WHICH IS TAXABLE TO THE PARTICIPANTS AND AS PART OF THAT BENEFIT, THE HOSPITAL INCLUDES A GROSS-UP TO COVER TAXES. EACH PARTICIPANT'S COST OF THE INSURANCE AND GROSS-UP ARE INCLUDED IN THE AMOUNTS REPORTED AS OTHER REPORTABLE COMPENSATION IN THIS FORM 990 SCHEDULE J. PART I, LINES 4A-B PART I QUESTION 4A SEVERANCE AND CHANGE OF CONTROL PAYMENTS AS NOTED IN THIS FILING, MR. PETER HOLDEN SERVED IN HIS ROLE AS CHIEF EXECUTIVE OFFICER THROUGH NOVEMBER 4, 2016 AND BECAME ELIGIBLE FOR CERTAIN SALARY CONTINUATION PAYMENTS ON LEAVING BID-PLYMOUTH AS NOTED IN MORE DETAIL IN THE DISCLOSURES BELOW. PART I QUESTION 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2018 IS CALENDAR YEAR 2017 DETAIL. IN ADDITION, AS NOTED THROUGHOUT THIS FILING, JORDAN HEALTH SYSTEMS INC. IS AN AFFILIATE OF BID-PLYMOUTH AND ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. DURING THE 2017 CALENDAR YEAR, JORDAN HEALTH SYSTEMS, INC. (JHSI) MAINTAINED AN IRC SECTION 457(B) PLAN PURSUANT TO WHICH ELIGIBLE EMPLOYEES COULD DEFER PART OF THEIR COMPENSATION. THIS PLAN WAS STRICTLY EMPLOYEE FUNDED WITH NO EMPLOYER DEFERRALS. UNDER THE DEFINITIONS TO THIS FORM 990, THIS PLAN IS CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. AMOUNTS DEFERRED ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. DURING THAT SAME PERIOD, BID-PLYMOUTH AND JORDAN HEALTH SYSTEMS, INC. (JHSI) MAINTAINED TWO IRC SECTION 457(F) PLANS. THESE PLANS WERE STRICTLY EMPLOYER FUNDED WITH NO EMPLOYEE DEFERRALS. UNDER THE DEFINITIONS TO THIS FORM 990, THESE PLANS ARE CONSIDERED SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. EMPLOYER CONTRIBUTIONS TO EMPLOYEES WHICH ARE NOT VESTED ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION. DISTRIBUTIONS FROM THESE PLANS AND/OR VESTED CONTRIBUTIONS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II COLUMN B(III), OTHER REPORTABLE COMPENSATION, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. IN ADDITION, AS NOTED THROUGHOUT THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH AND JHSI. DURING THE 2017 CALENDAR YEAR, THE MEDICAL CENTER WAS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM AND THE BETH ISRAEL DEACONESS MEDICAL CENTER 457(B) PLAN. PURSUANT TO THESE PLANS, ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS AND/OR CAN DEFER PART OF THEIR COMPENSATION. UNDER THE DEFINITIONS TO THIS FORM 990, THESE PLANS ARE CONSIDERED SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. AMOUNTS DEFERRED BY PARTICIPANTS OR RECEIVED BY PARTICIPANTS AND RELATED TO THESE PLANS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. PART I, LINE 7 NON-FIXED PAYMENTS BID-PLYMOUTH'S AND JHSI'S EXECUTIVE COMPENSATION PACKAGES INCLUDE OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING BID-PLYMOUTH'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, BID-PLYMOUTH'S CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. THE INCENTIVE COMPENSATION FOR EACH EXECUTIVE IS REVIEWED AND APPROVED BY THE BID-PLYMOUTH EXECUTIVE COMPENSATION COMMITTEE, WHICH AS PREVIOUSLY NOTED, IS FULLY STAFFED BY INDEPENDENT MEMBERS. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: REGULAR WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS QUANTIFIED IN OTHER REPORTABLE COMPENSATION WHICH MAY NOT BE SEPARATELY NOTED IN THIS FILING INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; DISTRIBUTIONS FROM A 457(B) PLAN; AMOUNTS INCLUDIBLE IN INCOME UNDER A 457(F) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED RETIREMENT BENEFITS; OTHER TAXABLE RETIREMENT BENEFITS DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401K RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403B RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT, UNFUNDED AND UNVESTED AMOUNTS DEFERRED UNDER 457(F) PLAN. NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THE NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES. BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH, BETH ISRAEL DEACONESS HOSPITAL-MILTON, BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM, BETH ISRAEL DEACONESS MEDICAL CENTER, JORDAN PHYSICIAN ASSOCIATES, JORDAN HEALTH SYSTEMS INC. AND ASSOCIATED PHYSICIANS OF HARVARD MEDICAL PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS BID-PLYMOUTH, BID-MILTON, BID-NEEDHAM, BIDMC, JPA, JHSI AND APHMFP RESPECTIVELY. IN ADDITION, BIDMC IS THE SOLE MEMBER OF MEDICAL CARE OF BOSTON MANAGEMENT CORP. D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP WHICH MAY BE REFERRED TO IN THESE EXPLANATORY NOTES AS BID - HEALTHCARE. FINALLY, THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL MAY BE REFERRED TO AS PFHC, HMS OR PFHC/HMS. BABINI, MICHAEL DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MR. BABINI DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. BAZZINOTTI, LYLE LAWRENCE CHAIR, DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH CHAIR, DIRECTOR - JORDAN HEALTH SYSTEMS, INC. CHAIR, TRUSTEE - JORDAN PHYSICIAN AFFILIATES DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER MS. BAZZINOTTI ASSUMED THE POSITION OF BOARD CHAIR ON JANUARY 31, 2018. MS. BAZZINOTTI DEVOTES, ON AVERAGE, A COMBINED 13 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. CARNUCCIO, JOHN DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MR. CARNUCCIO DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. COUGHLIN, KEVIN DIRECTOR (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER, PRESIDENT- BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER, PRESIDENT- JORDAN HEALTH SYSTEM, INC. CHIEF EXECUTIVE OFFICER, PRESIDENT, TRUSTEE - JORDAN PHYSICIAN AFFILIATES MR. COUGHLIN DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2017 CALENDAR YEAR, MR. COUGHLIN PERFORMED SERVICES FOR BID-PLYMOUTH AND JPA AND WAS COMPENSATED BY JHSI AND BETH ISRAEL DEACONESS MEDICAL CENTER. AS REQUIRED BY FORM 990, ALTHOUGH MR. COUGHLIN IS PAID DIRECTLY BY THESE ENTITIES, THE COMPENSATION ATTRIBUTABLE TO HIS SERVICES PERFORMED AT BID-PLYMOUTH AND JPA HAS BEEN REPORTED ON FORM 990 AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 523,648 INCENTIVE COMPENSATION: 93,327 OTHER REPORTABLE COMPENSATION: 3,374 DEFERRED COMPENSATION: 29,671 NON-TAXABLE BENEFITS: 24,510 PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 130,912 INCENTIVE COMPENSATION: 23,332 OTHER REPORTABLE COMPENSATION: 844 DEFERRED COMPENSATION: 7,418 NON-TAXABLE BENEFITS: 6,127 OTHER REPORTABLE AND DEFERRED COMPENSATION REPORTED FOR MR. COUGHLIN INCLUDES PAYMENTS TO NONQUALIFIED RETIREMENT PLANS AND A CHANGE IN THE VALUE OF THOSE PLANS TOTALING $27,541. OF THIS AMOUNT, $24,000 IS UNVESTED. DAHLEN, SHAWN D. DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MR. DAHLEN'S TERM ON THE BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH BOARD ENDED OCTOBER 28, 2017. MR. DAHLEN DEVOTED, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. FISCHER, STEVEN DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. ASSISTANT TREASURER - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR AND TREASURER - BIDMC PHARMACY TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM MR. FISCHER DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2017 CALENDAR YEAR, MR. FISCHER PERFORMED SERVICES FOR BIDMC. AS REQUIRED BY THIS FORM 990, MR. FISCHER'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 565,792 INCENTIVE COMPENSATION: 99,895 OTHER REPORTABLE COMPENSATION: 54,988 DEFERRED COMPENSATION: 25,030 NON-TAXABLE BENEFITS: 50,935 OTHER REPORTABLE COMPENSATION FOR MR. FISCHER INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $50,974. FOSDICK, KENNETH DIRECTOR AND VICE CHAIR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR AND VICE CHAIR - JORDAN HEALTH SYSTEMS, INC. DIRECTOR - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP MR. FOSDICK ASSUMED THE ROLE OF VICE CHAIR FOR BID-PLYMOUTH AND JHSI EFFECTIVE JANUARY 31, 2018. MR. FOSDICK DEVOTES, ON AVERAGE, A COMBINED 5 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) GAGNON, WILLIAM P. DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MR. GAGNON DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. HEWITT, CHARLES DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MR. HEWITT'S TERM ON THE BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH BOARD BEGAN JANUARY 31, 2018. MR. HEWITT DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. HINKLEY, CLARK CHAIR, DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH CHAIR, DIRECTOR - JORDAN HEALTH SYSTEMS, INC. CHAIR, TRUSTEE - JORDAN PHYSICIAN ASSOCIATES DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER MR. HINKLEY'S TERM AS BOARD CHAIR ENDED ON JANUARY 31, 2018. MR HINKLEY CONTINUES TO SERVE ON THE BOARD. FOR THE PERIOD COVERED BY THIS FILING, MR. HINKLEY DEVOTED, ON AVERAGE, A COMBINED 13 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. LAWRENCE, MARY ELLEN DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MS. LAWRENCE DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. LEWIS, M.D., STANLEY DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. SENIOR VICE PRESIDENT AND CHIEF SYSTEM DEVELOPMENT & STRATEGY OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES ASSOCIATE PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. LEWIS DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 555,411 INCENTIVE COMPENSATION: 112,992 OTHER REPORTABLE COMPENSATION: 55,149 DEFERRED COMPENSATION: 30,330 NON-TAXABLE BENEFITS: 49,486 OTHER REPORTABLE COMPENSATION FOR DR. LEWIS INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $48,770. LONIS-SCHEUB, M.D., KIMBERLY DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. EMERGENCY MEDICINE PHYSICIAN - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DR. LONIS-SCHEUB DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH FOR THE 2017 CALENDAR YEAR REPRESENTS PAYMENTS MADE TO DR. LONIS-SCHEUB BY APHMFP RELATED TO HER POSITION AS AN EMERGENCY MEDICINE PHYSICIAN AT BID-PLYMOUTH. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 275,412 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,239 DEFERRED COMPENSATION: 32,400 NON-TAXABLE BENEFITS: 31,581 MUNCEY, ESQ., PETER SECRETARY, DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH SECRETARY, DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MR. MUNCEY'S TERM ON THE BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH BOARD ENDED MAY 3, 2018. MR. MUNCEY DEVOTED, ON AVERAGE, A COMBINED 4 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PRIMAVERA, DENNIS DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MR. PRIMAVERA'S TERM ON THE BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH BOARD BEGAN JANUARY 31, 2018. MR. PRIMAVERA DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. SMALL, KEELAS DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MS. SMALL DEVOTES, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. STIGLITZ, CYNTHIA DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MS. STIGLITZ'S TERM ON THE BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH BOARD ENDED AUGUST 27, 2018. MS. STIGLITZ DEVOTED, ON AVERAGE, A COMBINED 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. STUHLFAUT, M.D., JOSHUA DIRECTOR (EX-OFFICIO), PRESIDENT OF THE MEDICAL STAFF - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR (EX-OFFICIO), PRESIDENT OF THE MEDICAL STAFF - JORDAN HEALTH SYSTEMS, INC. RADIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DR. STUHLFAUT DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH FOR THE 2017 CALENDAR YEAR INCLUDES PAYMENTS OF $297,687 PAID TO DR. STUHLFAUT BY RADIOLOGY ASSOCIATES OF PLYMOUTH FOR ADMINISTRATIVE AND MEDICAL SERVICES RELATED TO DR. STUHLFAUT'S SERVICES AT BID-PLYMOUTH. COMPENSATION FROM APHMFP RELATED TO DR. STUHLFAUT'S SERVICES TO BID-PLYMOUTH IS ALSO REPORTED HERE. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 463,165 INCENTIVE COMPENSATION: 49,076 OTHER REPORTABLE COMPENSATION: 9,704 DEFERRED COMPENSATION: 21,000 NON-TAXABLE BENEFITS: 22,002 TABB, M.D., KEVIN DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. DIRECTOR (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES PRESIDENT AND DIRECTOR - BIDMC PHARMACY PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. TABB DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 1,088,019 INCENTIVE COMPENSATION: 485,375 OTHER REPORTABLE COMPENSATION: 20,894 DEFERRED COMPENSATION: 158,280 NON-TAXABLE BENEFITS: 45,929 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $156,550. OF THIS AMOUNT, $138,550 IS BOTH UNFUNDED AND UNVESTED. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) TREHU, M.D., STEPHEN DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH CHIEF OF RADIOLOGY - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. DR. TREHU DEVOTES, ON AVERAGE, A COMBINED 21 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH FOR THE 2017 CALENDAR YEAR INCLUDES $139,266 PAID TO DR. TREHU BY RADIOLOGY ASSOCIATES OF PLYMOUTH FOR ADMINISTRATIVE AND MEDICAL SERVICES RELATED TO DR. TREHU'S POSITION AS CHIEF OF THE DEPARTMENT OF RADIOLOGY. COMPENSATION FROM APHMFP RELATED TO DR. TREHU'S SERVICES TO BID-PLYMOUTH IS ALSO REPORTED HERE. PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 226,766 INCENTIVE COMPENSATION: 27,242 OTHER REPORTABLE COMPENSATION: 3,838 DEFERRED COMPENSATION: 10,500 NON-TAXABLE BENEFITS: 130 RADZEVICH, JASON VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER, INTERIM VICE PRESIDENT OF HUMAN RESOURCES - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER, INTERIM VICE PRESIDENT OF HUMAN RESOURCES - JORDAN HEALTH SYSTEMS, INC. VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER AND TREASURER, INTERIM VICE PRESIDENT OF HUMAN RESOURCES - JORDAN PHYSICIAN ASSOCIATES MR. RADZEVICH DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2017 CALENDAR YEAR, MR. RADZEVICH PERFORMED SERVICES FOR BID-PLYMOUTH AND JPA AND WAS COMPENSATED BY JHSI. AS REQUIRED BY FORM 990, ALTHOUGH MR. RADZEVICH IS PAID DIRECTLY BY JHSI, HIS COMPENSATION IS ATTRIBUTABLE TO HIS SERVICES PERFORMED AT BID-PLYMOUTH AND JPA AND HAS BEEN REPORTED ON FORM 990 AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 245,844 INCENTIVE COMPENSATION: 58,256 OTHER REPORTABLE COMPENSATION: 10,858 DEFERRED COMPENSATION: 24,146 NON-TAXABLE BENEFITS: 23,682 PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 61,461 INCENTIVE COMPENSATION: 14,564 OTHER REPORTABLE COMPENSATION: 2,715 DEFERRED COMPENSATION: 6,037 NON-TAXABLE BENEFITS: 5,920 OTHER REPORTABLE AND DEFERRED COMPENSATION REPORTED FOR MR. RADZEVICH INCLUDES PAYMENTS PURSUANT TO A NONQUALIFIED RETIREMENT PLAN AND A CHANGE IN THE ACCOUNT'S VALUE OF $27,107. OF THIS AMOUNT $19,138 IS NOT VESTED. BERRY-BARBOSA, LISA VICE PRESIDENT, HUMAN RESOURCES - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH VICE PRESIDENT, HUMAN RESOURCES - JORDAN HEALTH SYSTEMS, INC. VICE PRESIDENT, HUMAN RESOURCES - JORDAN PHYSICIAN ASSOCIATES MS. BERRY-BARBOSA'S ROLE AS VICE PRESIDENT, HUMAN RESOURCES AT BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH ENDED SEPTEMBER 10, 2018. MS. BERRY-BARBOSA DEVOTED, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2017 CALENDAR YEAR, MS. BERRY-BARBOSA PERFORMED SERVICES FOR BID-PLYMOUTH AND JPA AND WAS COMPENSATED BY JHSI. AS REQUIRED BY FORM 990, ALTHOUGH MS. BERRY-BARBOSA WAS PAID DIRECTLY BY JHSI, HER COMPENSATION WAS ATTRIBUTABLE TO HER SERVICES PERFORMED AT BID-PLYMOUTH AND JPA AND HAS BEEN REPORTED ON FORM 990 AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 183,017 INCENTIVE COMPENSATION: 42,827 OTHER REPORTABLE COMPENSATION: 1,371 DEFERRED COMPENSATION: 17,627 NON-TAXABLE BENEFITS: 24,570 PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 20,335 INCENTIVE COMPENSATION: 4,759 OTHER REPORTABLE COMPENSATION: 152 DEFERRED COMPENSATION: 1,959 NON-TAXABLE BENEFITS: 2,730 DEFERRED COMPENSATION REPORTED FOR MS. BERRY BARBOSA INCLUDED A 457(F) PLAN CONTRIBUTION IN THE AMOUNT OF $12,360 WHICH WAS NOT VESTED AT DECEMBER 31, 2017. BROWNING, M.D., THOMAS CHIEF OF MEDICINE - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH CHIEF OF MEDICINE - JORDAN PHYSICIAN ASSOCIATES DR. BROWNING DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2017 CALENDAR YEAR, DR. BROWNING PERFORMED SERVICES FOR BID-PLYMOUTH AND JPA AND WAS COMPENSATED BY APHMFP. AS REQUIRED BY THIS FORM 990, DR. BROWNING'S COMPENSATION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 129,929 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 3,099 DEFERRED COMPENSATION: 13,500 NON-TAXABLE BENEFITS: 12,560 PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 129,929 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 3,099 DEFERRED COMPENSATION: 13,500 NON-TAXABLE BENEFITS: 12,560 CONNOLLY, M.D., JOHN VICE PRESIDENT, MEDICAL MANAGEMENT, CHIEF OF ANESTHESIA - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH VICE PRESIDENT, MEDICAL MANAGEMENT, CHIEF OF ANESTHESIA - JORDAN HEALTH SYSTEM, INC. DR. CONNOLLY'S TERM AS VICE PRESIDENT, MEDICAL MANAGEMENT ENDED JULY 1, 2018. DR. CONNOLLY DEVOTED, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH FOR THE 2017 CALENDAR YEAR INCLUDED THE FOLLOWING ESTIMATED PAYMENTS MADE TO DR. CONNOLLY BY GUARDIAN ANESTHESIA RELATED TO HIS POSITION AS CHIEF OF THE DEPARTMENT OF ANESTHESIA AT BID-PLYMOUTH: $347,105 BASE AND OTHER REPORTABLE COMPENSATION AND $23,877 NON-TAXABLE BENEFITS. COMPENSATION FROM APHMFP RELATED TO DR. CONNOLLY'S SERVICES TO BID-PLYMOUTH IS ALSO REPORTED HERE PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 362,394 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 47,808 DEFERRED COMPENSATION: 27,000 NON-TAXABLE BENEFITS: 20,754 DOHERTY, R.N., DONNA CHIEF NURSING OFFICER AND VICE PRESIDENT, PATIENT CARE SERVICES - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH MS. DOHERTY DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2017 CALENDAR YEAR, MS. DOHERTY PERFORMED SERVICES FOR BID-PLYMOUTH AND WAS COMPENSATED BY JHSI. AS REQUIRED BY FORM 990, ALTHOUGH MS. DOHERTY IS PAID DIRECTLY BY JHSI, THE COMPENSATION IS ATTRIBUTABLE TO HER SERVICES PERFORMED AT BID-PLYMOUTH AND HAS BEEN REPORTED ON FORM 990 AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 254,319 INCENTIVE COMPENSATION: 58,905 OTHER REPORTABLE COMPENSATION: 106,912 DEFERRED COMPENSATION: 10,187 NON-TAXABLE BENEFITS: 27,300 OTHER REPORTABLE COMPENSATION INCLUDES A DISTRIBUTION FROM A NON-QUALIFIED 457(F) PLAN IN THE AMOUNT OF $104,063. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) RUTHERFORD, RON VICE PRESIDENT AND CHIEF INFORMATION OFFICER - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH CHIEF INFORMATION OFFICER - JORDAN HEALTH SYSTEMS, INC. CHIEF INFORMATION OFFICER - JORDAN PHYSICIAN ASSOCIATES MR. RUTHERFORD DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2017 CALENDAR YEAR, MR. RUTHERFORD PERFORMED SERVICES FOR BID-PLYMOUTH AND JPA AND WAS COMPENSATED BY JHSI. AS REQUIRED BY THIS FORM 990, THE PORTION OF MR. RUTHERFORD'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 172,083 INCENTIVE COMPENSATION: 41,821 OTHER REPORTABLE COMPENSATION: 5,037 DEFERRED COMPENSATION: 17,657 NON-TAXABLE BENEFITS: 23,200 PAYMENTS REPORTED BY JPA: BASE COMPENSATION: 43,021 INCENTIVE COMPENSATION: 10,455 OTHER REPORTABLE COMPENSATION: 1,259 DEFERRED COMPENSATION: 4,414 NON-TAXABLE BENEFITS: 5,800 OTHER REPORTABLE AND DEFERRED COMPENSATION REPORTED FOR MR. RUTHERFORD INCLUDES PAYMENTS PURSUANT TO A NONQUALIFIED RETIREMENT PLAN AND A CHANGE IN THE ACCOUNT'S VALUE OF $17,076. OF THIS AMOUNT $13,075 IS NOT VESTED. GORSUCH, PHD., W. BRIAN CHIEF PHYSICIAN ASSISTANT - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH DR. GORSUCH DEVOTES, ON AVERAGE, 50 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 241,534 INCENTIVE COMPENSATION: 5,000 OTHER REPORTABLE COMPENSATION: 16,251 DEFERRED COMPENSATION: 9,493 NON-TAXABLE BENEFITS: 29,368 DOLAWAY, DEBORAH HOSPICE ADMINISTRATOR - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH MS. DOLAWAY DEVOTES, ON AVERAGE, 50 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 181,533 INCENTIVE COMPENSATION: 5,000 OTHER REPORTABLE COMPENSATION: 27,653 DEFERRED COMPENSATION: 7,234 NON-TAXABLE BENEFITS: 3,255 PASKOWSKI, D.C., IAN CHIROPRACTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH TRUSTEE - JORDAN PHYSICIAN ASSOCIATES DR. PASKOWSKI, DEVOTES ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 187,224 INCENTIVE COMPENSATION: 21,873 OTHER REPORTABLE COMPENSATION: 776 DEFERRED COMPENSATION: 7,448 NON-TAXABLE BENEFITS: 564 HEBERT, N.P., RICHARD M. NURSE PRACTITIONER - BETH ISRAEL DEACONESS - PLYMOUTH MR. HEBERT DEVOTES, ON AVERAGE, DEVOTES 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 203,334 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,040 DEFERRED COMPENSATION: 3,973 NON-TAXABLE BENEFITS: 27,386 HOLLERAN, ANDREA VICE PRESIDENT STRATEGIC PLANNING, EXTERNAL AFFAIRS - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH MS. HOLLERAN DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2017 CALENDAR YEAR, MS. HOLLERAN PERFORMED SERVICES FOR BID-PLYMOUTH AND WAS COMPENSATED BY JHSI, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-PLYMOUTH: BASE COMPENSATION: 182,649 INCENTIVE COMPENSATION: 48,884 OTHER REPORTABLE COMPENSATION: 133,837 DEFERRED COMPENSATION: 10,363 NON-TAXABLE BENEFITS: 30,100 OTHER REPORTABLE COMPENSATION INCLUDES A CONTRIBUTION TO AND DISTRIBUTION FROM A NON-QUALIFIED PLANS TOTALING $108,760. HOLDEN, PETER J. FORMER PRESIDENT, CHIEF EXECUTIVE OFFICER, DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH FORMER PRESIDENT, CHIEF EXECUTIVE OFFICER, DIRECTOR (EX-OFFICIO) - JORDAN HEALTH SYSTEMS, INC. FORMER PRESIDENT, CHIEF EXECUTIVE OFFICER, TRUSTEE (EX-OFFICIO) - JORDAN PHYSICIAN ASSOCIATES MR. HOLDEN SERVED IN THE ROLES NOTED ABOVE THROUGH NOVEMBER 4, 2016. AS NOTED IN THIS FORM 990, CALENDAR YEAR 2017 COMPENSATION IS REPORTED IN THIS FISCAL YEAR 2018 FILING. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2017 CALENDAR YEAR, MR. HOLDEN SEVERANCE PAYMENTS FROM JHSI WHICH RELATED TO HIS POSITIONS LISTED ABOVE. PAYMENTS MADE BY JHSI: BASE COMPENSATION: 0 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 590,499 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 AS NOTED ABOVE, MR. HOLDEN SEPARATED FROM JHSI, BID-PLYMOUTH AND JPA SERVICE ON NOVEMBER 4, 2016 AND BECAME ELIGIBLE FOR SEVERANCE AT THAT TIME. PAYMENTS INCLUDED IN OTHER REPORTABLE COMPENSATION REFLECT SEVERANCE AND TAXABLE BENEFITS PAID TO MR. HOLDEN. THESE AMOUNTS WERE REPORTED IN THE PRIOR YEAR FORM 990 AS DEFERRED COMPENSATION. A MASS DEVELOPMENT FINANCE AGENCY 043431814 57584YJW0 2018-06-13 479594374 SEE PART VI 0 0 0 B MASS DEVELOPMENT FINANCE AGENCY 043431814 57584XMT5 2016-05-12 257611877 SEE PART VI 0 0 0 C MASS DEVELOPMENT FINANCE AGENCY 043431814 57584XDH1 2015-09-02 203702204 SEE PART VI 0 0 0 D MASS DEVELOPMENT FINANCE AGENCY 043431814 000000000 2012-07-11 49910000 REFUND ISSUE DATED 02/11/1998 0 0 0 A 482429721 4594374 26884283 450951064 0 0 0 1 B 8805000 257618370 2515889 19006493 236095988 2016 0 1 1 1 C 22970000 203702204 2348479 201353725 1 1 1 1 D 49910000 368094 49541906 1 0 1 1 A 0 0 1 1 0 0 0 1 B 1 1 1 1 0 0 0 1 C 1 1 1 1 0 0.00500 0.00500 0.01000 0 0 1 D 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 EXPLANATORY STATEMENT FOR THE PERIOD COVERED BY THIS FILING, CAREGROUP, INC., (CAREGROUP) WAS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND SERVED AS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, BETH ISRAEL DEACONESS HOSPITAL - MILTON, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND THESE ENTITIES' PHYSICIAN GROUPS AND OTHER AFFILIATED ENTITIES. CAREGROUP'S PURPOSE WAS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MAKE UP THE CAREGROUP SYSTEM. CAREGROUP AND SOME OF ITS AFFILIATES JOINTLY BORROWED DEBT AS AN OBLIGATED GROUP. THE FOLLOWING IS A LIST OF THE ENTITIES WHICH PARTICIPATED AS MEMBERS OF THE CAREGROUP OBLIGATED GROUP: CAREGROUP, BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS - NEEDHAM (BID-NEEDHAM), MOUNT AUBURN PROFESSIONAL SERVICES (MAPS), MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP (APG), BETH ISRAEL DEACONESS HOSPITAL - MILTON AND BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH. THE INFORMATION REPORTED ON SCHEDULE K FOR BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH REFLECTS THE COMBINED CAREGROUP OBLIGATED GROUP DEBT ISSUED AFTER DECEMBER 31, 2002 WITH AN OUTSTANDING PRINCIPAL BALANCE IN EXCESS OF $100,000. SCHEDULE K (1 OF 2), PART 1, LINE A, COLUMN F DESCRIPTION OF TAX-EXEMPT DEBT PURPOSE PURPOSES OF CAREGROUP SERIES J BONDS: - TO CONSTRUCT A NEW INPATIENT BUILDING AT BETH ISRAEL DEACONESS MEDICAL CENTER INCLUDING ACUTE AND INTENSIVE CARE, OPERATING/ PROCEDURE ROOMS, ANCILLARY CLINICAL AND CLINICAL SUPPORT SPACES. - TO CONSTRUCT AN OUTPATIENT AMBULATORY CARE BUILDING AT BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM - FACILITY AND COMPUTER SYSTEM UPGRADES AT BETH ISRAEL DEACONESS HOSPITAL - MILTON, BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM AND BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH. SCHEDULE K (1 OF 2), PART 1, LINE B, COLUMN F - DESCRIPTION OF TAX-EXEMPT DEBT PURPOSE PURPOSES OF CAREGROUP SERIES I BONDS: - REFUNDING THE REMAINING PORTION OF THE OUTSTANDING PRINCIPAL BALANCE OF THE CAREGROUP SERIES B BONDS, A PORTION OF THE CAREGROUP SERIES D BONDS AND ALL OF THE CAREGROUP SERIES E-1 BONDS CREATING AN IRREVOCABLE REFUNDING TRUST DATED MAY 12, 2016. - TO FINANCE AND REFINANCE THE ACQUISITION AND IMPLEMENTATION OF AN INTEGRATED INFORMATION TECHNOLOGY PLATFORM FOR MOUNT AUBURN HOSPITAL - TO FINANCE AND REFINANCE THE ACQUISITION AND INSTALLATION OF CAPITAL EQUIPMENT AND THE CONSTRUCTION OF IMPROVEMENTS AND RENOVATIONS TO MISCELLANEOUS OBLIGATED GROUP FACILITIES SCHEDULE K (1 OF 2), PART 1, LINE C, COLUMN F - DESCRIPTION OF TAX-EXEMPT DEBT PURPOSE PURPOSES OF CAREGROUP SERIES H BONDS: - REFUNDING THE REMAINING PORTION OF THE OUTSTANDING PRINCIPAL BALANCE OF THE MILTON SERIES D BONDS, THE PLYMOUTH SERIES D BONDS, THE PLYMOUTH SERIES E BONDS, AND A PORTION OF THE CAREGROUP SERIES E BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED SEPTEMBER 2, 2015 SCHEDULE K (1 OF 2), PART 1, LINE D, COLUMN F - DESCRIPTION OF TAX-EXEMPT DEBT PURPOSE PURPOSES OF CAREGROUP SERIES G BONDS: - REFUNDING THE REMAINING PORTION OF THE OUTSTANDING PRINCIPAL BALANCE OF THE CAREGROUP SERIES A BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED JULY 1,2012 SCHEDULE K (2 OF 2), PART 1, LINE A, COLUMN F - DESCRIPTION OF TAX-EXEMPT DEBT PURPOSE PURPOSES OF CAREGROUP SERIES F BONDS: - REFUNDING OF A PORTION OF THE OUTSTANDING PRINCIPAL BALANCE OF THE CAREGROUP SERIES A BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED SEPTEMBER 1, 2011 SCHEDULE K (1 OF 2) PART II, COLUMN A, LINE 3 THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $26,884,283 OF INVESTMENT EARNINGS. SCHEDULE K (1 OF 2) PART II, COLUMN B, LINE 3 THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. SCHEDULE K (1 OF 2) PART II, COLUMNS B, C & D, LINE 11 THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW SCHEDULE K (2 OF 2) PART II, COLUMN A, LINE 11 $8,993,760 OF THE PROCEEDS LISTED WERE USED FOR TERMINATION OF THE HEDGE AGREEMENT, WITH THE REMAINDER BEING REFUNDING PROCEEDS THAT ARE NO LONGER IN ESCROW SCHEDULE K (1 OF 2) PART III, COLUMN B, LINE 6 TOTAL FINANCED PROPERTY USED IN A PRIVATE BUSINESS USE BY ENTITIES OTHER THAN A SECTION 501(C)(3) ORGANIZATION OR A STATE OR LOCAL GOVERNMENT AND FINANCED PROPERTY USED IN A PRIVATE BUSINESS USE AS A RESULT OF UNRELATED TRADE OR BUSINESS ACTIVITY CARRIED ON BY THE MEMBERS OF THE CAREGROUP OBLIGATED GROUP OR ANOTHER SECTION 501(C)(3) ORGANIZATION, OR A STATE OR LOCAL GOVERNMENT IS LESS THAN .1%. AS SUCH AND IN ACCORDANCE WITH THE INSTRUCTIONS FOR THE FORM 990, SCHEDULE K, THIS AMOUNT HAS BEEN REPORTED AS 0%. SCHEDULE K (1 OF 2) PART III, COLUMN D AND SCHEDULE K (2 OF 2) PART III, COLUMN A BOTH THE 2012 AND 2011 ISSUES ARE EXEMPT FROM COMPLETING PART III AS BOTH ISSUES WERE REFUNDINGS OF BONDS ISSUED PRIOR TO DECEMBER 31, 2002. SCHEDULE K PART III QUESTIONS 2 AND 3: FOR THE PERIOD COVERED BY THIS FILING, FACILITIES FINANCED WITH TAX-EXEMPT BONDS WERE PRIMARILY OCCUPIED BY CAREGROUP AND ITS AFFILIATED TAX-EXEMPT ENTITIES, INCLUDING BUT NOT LIMITED TO THE MEDICAL CENTER, BID-NEEDHAM, BID-PLYMOUTH, BID-MILTON, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, NEBH, NEW ENGLAND BAPTIST MEDICAL ASSOCIATES, MAH, MAPS AND APG. SOME FINANCED SPACE MAY CONTAIN LEASE ARRANGEMENTS, AND THE AFFILIATES WHICH OWN THE DEBT FINANCED SPACE MAY OPT TO ENGAGE A MANAGEMENT SERVICES COMPANY (I.E. CLEANING, PATIENT TRANSPORT, AND FOOD SERVICES) OR ENGAGE IN RESEARCH PURSUANT TO RESEARCH AGREEMENTS WITHIN TAX EXEMPT DEBT FINANCED SPACE. ANY SUCH AGREEMENTS IN PLACE AS OF SEPTEMBER 30, 2018 WERE REVIEWED TO ENSURE PROPER ACCOUNTING OF ANY PRIVATE USE GENERATED FROM SUCH ACTIVITIES. IN ADDITION, SUCH AGREEMENTS ARE GENERALLY REVIEWED BY INSIDE COUNSEL PRIOR TO FINALIZING. A MASS DEVELOPMENT FINANCE AGENCY 043431814 000000000 2011-09-15 120280000 REFUND ISSUE DATED 02/11/1998 0 0 0 A 75775000 120280000 290672 119989328 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 FORM 990, PART I AND PART III, LINE 1 DESCRIPTION OF ORGANIZATION'S MISSION THE MISSION OF THE BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH, INC. (BID-PLYMOUTH OR HOSPITAL) IS TO IMPROVE THE HEALTH AND WELL-BEING OF ITS PATIENTS AND COMMUNITY BY PROVIDING A FULL CONTINUUM OF HEALTHCARE SERVICES WITH EXCELLENCE AND COMPASSION AS WELL AS ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. BIDMC SERVED AS BID-PLYMOUTH'S SOLE MEMBER FOR THE PERIOD COVERED BY THIS FILING. SERVING THE GREATER PLYMOUTH REGION, BID-PLYMOUTH AND ITS AFFILIATES COLLABORATE WITH COMMUNITY LEADERS, PUBLIC AND PRIVATE AGENCIES AND BUSINESSES, TO PROVIDE HEALTH PROMOTION, HEALTH PROTECTION, AND PREVENTIVE SERVICES TO MEET THE BROAD RANGE OF THE COMMUNITY'S HEALTH AND WELLNESS NEEDS AS IDENTIFIED THROUGH COMMUNITY FEEDBACK AND FORMAL COMMUNITY NEEDS ASSESSMENTS. AS PART OF ITS MISSION TO SUPPORT COMMUNITY HEALTH, THE HOSPITAL IS COMMITTED TO ASSESSING ROOT CAUSES OF HEALTH DISPARITIES AND TO ASSISTING IN IMPROVING HEALTH CARE FOR THE DISADVANTAGED AND UNDERSERVED. BID-PLYMOUTH IS A 164-BED ACUTE CARE HOSPITAL SERVING MORE THAN 250,000 RESIDENTS IN PLYMOUTH AND BARNSTABLE COUNTIES, INCLUDING THE COMMUNITIES OF BOURNE, CARVER, DUXBURY, HALIFAX, KINGSTON, LAKEVILLE, PEMBROKE, PLYMPTON, PLYMOUTH, MARSHFIELD, MIDDLEBORO, SANDWICH AND WAREHAM. THE HOSPITAL IS THE REGION'S LEADING PROVIDER OF HIGH-QUALITY HEALTHCARE, PROVIDING COMPREHENSIVE HEALTHCARE RANGING FROM PRIMARY AND PREVENTIVE CARE TO SPECIALTY SERVICES. THROUGHOUT BID-PLYMOUTH, QUALITY IMPROVEMENT IS PARAMOUNT AND ENCOMPASSES BOTH CLINICAL OUTCOMES AND THE SERVICE COMPONENTS OF ALL INTERACTIONS WITH PATIENTS AND THEIR FAMILIES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER, IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL WAS THE SOLE MEMBER OF BID-PLYMOUTH FOR THE PERIOD COVERED BY THIS FILING. BIDMC IS EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS RECOGNIZED NATIONALLY FOR THE CLINICAL EXCELLENCE OF ITS FACULTY AND THE PATIENT CARE PROVIDED, AS WELL AS FOR THE MAGNITUDE AND BREADTH OF ITS RESEARCH AND FOR ITS COMMITMENT TO MEDICAL EDUCATION. MANY BID-PLYMOUTH PHYSICIANS ALSO HOLD APPOINTMENTS AT HARVARD OR OTHER MAJOR MEDICAL SCHOOLS AND ARE TIED CLOSELY WITH THEIR COLLEAGUES AT OTHER ACADEMIC MEDICAL CENTERS. FORM 990, PART III LINE 4A INPATIENT BID-PLYMOUTH PROVIDES A WIDE RANGE OF INPATIENT CARE INCLUDING SURGICAL SERVICES, INTENSIVE AND CARDIAC CARE, OBSTETRICS, SENIOR BEHAVIORAL HEALTH, AND COMPLETE DIAGNOSTIC FACILITIES. THE HOSPITAL'S INPATIENT UNITS INCLUDE 120 GENERAL MEDICAL/SURGICAL BEDS, 13 CRITICAL CARE BEDS, 12 OBSTETRICS BEDS, 13 NURSERY BASSINETS IN THE BIRTHPLACE, AND 19 BEDS IN A SECURE SENIOR BEHAVIORAL HEALTH UNIT. SURGICAL SERVICES ARE AVAILABLE 24 HOURS A DAY FOR CRITICALLY ILL OR INJURED PATIENTS REQUIRING IMMEDIATE SURGICAL INTERVENTION, OR FOR OTHER PATIENTS ON A NON-EMERGENT OR ELECTIVE BASIS. BID-PLYMOUTH'S HIGHLY QUALIFIED SURGEONS PERFORM ORTHOPEDIC PROCEDURES AND IMPLANTS, NEUROSURGERY, PLASTIC RECONSTRUCTION, GASTROINTESTINAL, GENERAL SURGICAL (INCLUDING BREAST), GYNECOLOGICAL, OPHTHALMOLOGIC, OTOLARYNOGOLOGIC, PODIATRIC, AND UROLOGICAL PROCEDURES. LIMITED VASCULAR AND THORACIC SURGERY IS ALSO PERFORMED. PATIENTS ARE UNDER THE CARE OF THE HOSPITAL'S MEDICAL STAFF, HOSPITALISTS, MID-LEVEL PROVIDERS AND SURGEONS IN GENERAL AND SPECIALTY PRACTICE. THE NURSING CARE TEAM CONSISTS OF REGISTERED NURSES AND QUALIFIED ANCILLARY CLINICIANS WORKING COLLABORATIVELY WITH SURGICAL AND ANESTHESIA PHYSICIANS. THE SCOPE OF NURSING PRACTICE IN THE PERIOPERATIVE AREA INCLUDES PREOPERATIVE ASSESSMENT AND PLANNING, INTRA-OPERATIVE INTERVENTION, POSTOPERATIVE ASSESSMENT AND INTERVENTION, DISCHARGE PLANNING AND DOCUMENTATION TO ENSURE HIGH QUALITY PATIENT CARE AND SAFETY. THE INPATIENT POPULATION THAT IS SERVED INCLUDES CHILDREN UNDER 15 YEARS OF AGE REQUIRING MINOR OUTPATIENT SURGERY AND ANY INDIVIDUALS WHO ARE 15 YEARS AND OLDER WHO REQUIRE MINOR OR MAJOR SURGICAL INTERVENTION. DURING THE PERIOD OCTOBER 1, 2017 TO SEPTEMBER 30, 2018 THE HOSPITAL HAD 10,793 ADMISSIONS, 825 NEWBORN DELIVERIES, 46,592 INPATIENT DAYS, AND PERFORMED 2,125 INPATIENT SURGICAL PROCEDURES. FORM 990, PART III LINE 4B EMERGENCY DEPARTMENT AS PREVIOUSLY NOTED IN THIS FILING, BIDMC IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER AND TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH FOR THE PERIOD COVERED BY THIS FILING. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) IS AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BIDMC AND ITS AFFILIATES AND IS ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BID-PLYMOUTH EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. DURING THE FISCAL YEAR COVERED BY THIS FILING, BID-PLYMOUTH HAD 46,952 EMERGENCY DEPARTMENT VISITS. FORM 990, PART III LINE 4C OUTPATIENT CLINICS AND SERVICES BID-PLYMOUTH PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES ENCOMPASSING GENERAL INTERNAL MEDICINE AND ALL THE SUBSPECIALTIES OF INTERNAL MEDICINE, COVERING THE GAMUT OF SERVICES FROM PRIMARY TO TERTIARY CARE AS WELL AS PROVIDING SURGICAL SERVICES ON AN OUTPATIENT BASIS. THE HOSPITAL'S MEDICAL STAFF BLENDS EXPERIENCED PRIMARY CARE PHYSICIANS AND SPECIALISTS IN A WIDE VARIETY OF DISCIPLINES. THE BID-PLYMOUTH SERVICES AND CENTERS OF EXCELLENCE INCLUDE: - AIDS/HIV CARE, EDUCATION, AND SUPPORT - ANTICOAGULATION CLINIC - BREAST CENTER - CANCER CARE SERVICES: RADIATION AND MEDICAL ONCOLOGY, ONCOLOGY SOCIAL WORK, GENETIC COUNSELING AND TESTING, AND SURGERY - CARDIOVASCULAR SERVICES: DIAGNOSTIC AND INTERVENTIONAL - CARDIAC & PULMONARY REHABILITATION - DIABETES/ENDOCRINOLOGY - ENDOSCOPY - HOSPICE AND PALLIATIVE CARE - IMAGING/RADIOLOGY SERVICES: DIGITAL MAMMOGRAPHY, MRI, BREAST MRI, CT, PET/CT, ULTRASOUND, NUCLEAR MEDICINE, GENERAL X-RAY - LUNG CANCER PROGRAM - NEUROLOGY - OCCUPATIONAL HEALTH - OBSTETRICS, GYNECOLOGY, AND MIDWIFERY - ORTHOPEDICS - PATHOLOGY - PAIN MANAGEMENT - PODIATRY - PRIMARY & FAMILY CARE - PHYSICAL THERAPY /REHAB - SLEEP CENTER - SPINE CARE - STROKE SERVICES - SUBSTANCE ABUSE & BEHAVIORAL HEALTH - SURGERY: GENERAL, LAPAROSCOPIC, NEUROSURGERY, OTOLARYNGOLOGY, THORACIC, VASCULAR - UROLOGY - VEIN CENTER - WOUND HEALING & HYPERBARIC CENTER IN ADDITION, DIAGNOSTIC FACILITIES INCLUDE A COMPLETE 24-HOUR HISTOPATHOLOGY LABORATORY AND BLOOD BANKING SERVICES AS WELL AS DIAGNOSTIC IMAGING INCLUDING CT SCANNING, ULTRASOUND, ULTRASONIC CARDIOGRAPHY, BONE DENSITOMETRY, NUCLEAR MEDICINE, PLAIN FILM RADIOLOGY AND FLUOROSCOPY. IN ADDITION, THE HOSPITAL'S PICTURE ARCHIVAL AND COMMUNICATION SYSTEM (PACS) CAN INSTANTANEOUSLY TRANSMIT RADIOLOGIC IMAGES BETWEEN BID-PLYMOUTH AND BIDMC, MEANING THAT PATIENTS IN PLYMOUTH HAVE ACCESS TO THE SAME WORLD-CLASS SPECIALISTS AS PATIENTS AT BIDMC. THE SYSTEM FACILITATES, WHEN NECESSARY, MULTI-DISCIPLINARY EVALUATION OF IMAGES, RESULTING IN IMPROVED TECHNICAL PERFORMANCE AND FEEDBACK AND DIAGNOSES WITH GREATER DIAGNOSTIC ACCURACY. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THERE WERE 285,000 OUTPATIENT ENCOUNTERS AT BID-PLYMOUTH, INCLUDING 4,143 AMBULATORY SURGICAL PROCEDURES, 18,853 ONCOLOGY VISITS, 28,689 PHYSICAL THERAPY VISITS, 5,826 ENDOSCOPIES, 4,183 PAIN CLINIC VISITS, 5,078 WOUND CENTER VISITS, 36,580 RADIOLOGIC EXAMS, 16,659 MAMMOGRAMS, 31,769 CT SCANS, 13,412 ULTRASOUND SCANS, 2,519 NUCLEAR MEDICINE EXAMS, AND 8,037 MRIS. SEE SCHEDULE H FOR ADDITIONAL INFORMATION ON CHARITY CARE AND COMMUNITY BENEFITS. FORM 990, PART IV, QUESTION 12 AND 12A STATEMENT RE AUDITED FINANCIAL STATEMENTS THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) AND AFFILIATES FOR FISCAL YEAR ENDED SEPTEMBER 30, 2018. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE MEDICAL CENTER AND THE ENTITIES WHICH WERE ITS SUBSIDIARIES DURING THE FISCAL PERIOD COVERED BY THIS FILING, (MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP (APG), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), JORDAN HEALTH SYSTEMS, INC. AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER). FORM 990,PART IV, QUESTION 24A STATEMENT REGARDING TAX EXEMPT BOND ISSUE AS DESCRIBED IN THIS FORM 990, FOR THE PERIOD COVERED BY THIS FILING, CAREGROUP, INC., WAS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND SERVED AS A SUPPORT ORGANIZATION OF AND SOLE MEMBER OF THE MEDICAL CENTER. DURING THAT SAME PERIOD THE MEDICAL CENTER SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH, BID-PLYMOUTH WAS A MEMBER OF THE CAREGROUP OBLIGATED GROUP AND ITS TAX EXEMPT BOND FINANCING IS ISSUED THROUGH CAREGROUP. THE SCHEDULE K AS INCLUDED IN THIS FORM 990 INCLUDES ALL OF THE CAREGROUP OBLIGATED GROUP OUTSTANDING DEBT FOR BONDS ISSUED AFTER DECEMBER 31, 2002 ONLY A PORTION OF WHICH IS ALLOCABLE TO AND REPORTED ON THE BID-PLYMOUTH BALANCE SHEET. FORM 990,PART IV, QUESTION 24B INVESTMENT OF TAX-EXEMPT BOND PROCEEDS BEYOND THE TEMPORARY PERIOD EXCEPTION PROCEEDS IN THE PROJECT FUND WERE UNEXPECTEDLY HELD BEYOND THE THREE-YEAR TEMPORARY PERIOD, BUT WERE YIELD RESTRICTED IN COMPLIANCE WITH FEDERAL TAX REQUIREMENTS. FORM 990,PART V,QUESTION 7G CONTRIBUTIONS OF INTELLECTUAL PROPERTY BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899. FORM 990, PART V,QUESTION 7H CONTRIBUTIONS OF CARS, BOATS, AIRPLANES AND OTHER VEHICLES BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 1098-C. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS AND FAMILY RELATIONSHIPS THE FOLLOWING BIDP OFFICERS, DIRECTOR/TRUSTEES, AND KEY EMPLOYEES HAVE BUSINESS OR FAMILY RELATIONSHIPS: - CLARK HINKLEY AND SHAWN DAHLEN -- BUSINESS RELATIONSHIP - SHAWN DAHLEN AND JOHN CARNUCCIO - BUSINESS RELATIONSHIP - JOSHUA STUHLFAUT, MD AND STEPHEN TREHU, MD - BUSINESS RELATIONSHIP IN ADDITION TO THE RELATIONSHIPS NOTED ABOVE AND AS NOTED IN VARIOUS NARRATIVE DISCLOSURES WHICH SUPPORT THIS FORM 990 AND RELATED SCHEDULES, CAREGROUP WAS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, WHICH MERGED INTO BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER OR BIDMC) EFFECTIVE MARCH 1, 2019. CAREGROUP'S PURPOSE WAS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MADE UP THE CAREGROUP SYSTEM. FOR THE PERIOD COVERED BY THIS FILING CAREGROUP SERVED AS THE SOLE MEMBER OF BIDMC FOR THE PERIOD COVERED BY THIS FILING, THE MEDICAL CENTER SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH, BID-NEEDHAM, APG, BID-MILTON AND JORDAN HEALTH SYSTEMS, INC. (JHSI). IN ADDITION, HMFP IS THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES. CAREGROUP ALSO SERVED AS THE SOLE MEMBER OF NEW ENGLAND BAPTIST HOSPITAL (NEBH) AND MOUNT AUBURN HOSPITAL (MAH). IN TURN, NEBH SERVES AS THE SOLE MEMBER OF NEW ENGLAND BAPTIST MEDICAL ASSOCIATES (NEBMA) AND MAH SERVES AS THE SOLE MEMBER OF MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) AND CAREGROUP PARMENTER HOME CARE & HOSPICE, INC. EACH OF THE ENTITIES LISTED IN THIS PARAGRAPH MAY, IN TURN, SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE NETWORK OF AFFILIATED ORGANIZATIONS. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. FORM 990, PART VI, SECTION A, LINE 6 STATEMENT RE MEMBERS OR STOCKHOLDERS BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER. BIDMC, A FLAGSHIP TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL, IS KNOWN FOR ITS EXEMPLARY PATIENT CARE, CONDUCTING "LEADING EDGE" CLINICAL AND BASIC SCIENCE RESEARCH AND SUPPORTING OUTSTANDING EDUCATIONAL PROGRAMS. BIDMC IS A HOSPITAL EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986 AS AMENDED, AND ACTING THROUGH ITS BOARD OF DIRECTORS, FOR THE PERIOD COVERED BY THIS FILING, WAS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH OR HOSPITAL). PURSUANT TO THE BYLAWS OF BID-PLYMOUTH, THE MEDICAL CENTER AS SOLE CORPORATE MEMBER OF THE HOSPITAL (THE MEMBER) HAD THE RIGHT TO APPOINT THREE OF THE HOSPITAL'S MAXIMUM OF SEVENTEEN ELECTED VOTING DIRECTORS. THE REMAINING DIRECTORS WERE NOMINATED BY THE BOARD OF DIRECTORS AND SUBMITTED TO THE MEMBER FOR APPROVAL. FOR THE PERIOD COVERED BY THIS FILING, A DIRECTOR COULD BE REMOVED FROM OFFICE BY THE MEMBER, EITHER WITH OR WITHOUT CAUSE. IN ADDITION, THE MEMBER COULD FILL ANY BOARD VACANCIES WITH PERSONS NOMINATED BY THE BOARD, UNLESS THE VACANCY WAS CREATED BY THE DEPARTURE OF A MEMBER-APPOINTED DIRECTOR, IN WHICH CASE THE MEMBER COULD ELECT A PERSON NOT NOMINATED BY THE BOARD. ADDITIONALLY, THE MEDICAL CENTER AS SOLE MEMBER HAD THE FOLLOWING RIGHTS AS NOTED IN THE BYLAWS: 1.THE MEMBER SHALL HAVE THE FOLLOWING RESERVED POWERS WHICH IT MAY EXERCISE ON ITS OWN INITIATIVE UPON A TWO-THIRDS (2/3) VOTE OF ITS DIRECTORS ELIGIBLE TO VOTE ON ITS BOARD OF DIRECTORS, WITH OR WITHOUT THE APPROVAL OF THE BOARD OF DIRECTORS OF THE HOSPITAL, OR UPON A MAJORITY VOTE OF ITS DIRECTORS ELIGIBLE TO VOTE IN THE EVENT THE BOARD OF DIRECTORS OF THE HOSPITAL HAS RECOMMENDED ANY OF THE LISTED ACTIONS: A.REMOVE A MEMBER OF THE HOSPITAL'S BOARD OF DIRECTORS; B.UPON PRIOR DISCUSSION WITH THE BOARD, ESTABLISH OR MODIFY THE COMPENSATION OF, AND/OR APPOINT OR REMOVE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE HOSPITAL UPON PRIOR CONSULTATION WITH THE HOSPITAL'S BOARD OF DIRECTORS; C.AMEND THE HOSPITAL'S BYLAWS OR ARTICLES OF ORGANIZATION; D.CAUSE THE HOSPITAL TO ENTER INTO: (I)MANAGED CARE CONTRACTS, OTHER PAYER AGREEMENTS, EXCLUSIVE CONTRACTS, AGREEMENTS-NOT-TO-COMPETE, OR SIMILAR ARRANGEMENTS (II)CONTRACTS FOR MANAGEMENT SERVICES WITH POTENTIALLY SIGNIFICANT MULTI-YEAR BUDGETARY IMPACT; OR (III)OTHER MULTI-YEAR SERVICE CONTRACTS WITH POTENTIALLY SIGNIFICANT MULTI-YEAR BUDGETARY IMPACT; E.MERGE OR OTHERWISE CONSOLIDATE THE HOSPITAL WITH ANOTHER ENTITY; F.DISPOSE OF ALL OR SUBSTANTIALLY ALL OF THE HOSPITAL'S PROPERTY AND ASSETS OR DISPOSE OF ANY HOSPITAL SUBSIDIARY OR AFFILIATED CORPORATIONS; G.CREATE OR ACQUIRE A HOSPITAL SUBSIDIARY OR AFFILIATED CORPORATION; H.DISCONTINUE OR INSTITUTE A CLINICAL DEPARTMENT OR DEPARTMENTS OR PROGRAMS, WHICH COULD REASONABLY BE ANTICIPATED TO MATERIALLY AND ADVERSELY AFFECT THE HOSPITAL'S FINANCIAL STATUS OR ITS ABILITY TO CONTINUE TO CONDUCT ITS BUSINESS; I.TO THE EXTENT LEGALLY PERMISSIBLE, TAKE SUCH ACTIONS TO CAUSE ASSETS OF THE HOSPITAL TO BE TRANSFERRED, OTHER THAN IN THE ORDINARY COURSE OF CONDUCT OF HOSPITAL BUSINESS, TO THE MEMBER TO ADVANCE THE CHARITABLE PURPOSES OF THE MEMBER OR THE HOSPITAL; AND J.TO DISSOLVE THE HOSPITAL TO THE EXTENT PERMITTED BY LAW. 2.IN ADDITION, THE FOLLOWING ACTIONS OF THE HOSPITAL'S BOARD OF DIRECTORS REQUIRED THE PRIOR APPROVAL OF THE MEMBER: A.REMOVAL OF A MEMBER OF THE HOSPITAL BOARD; B.ANY ACTION LISTED AS A MEMBER RESERVED POWER IN THE BYLAWS; C.APPROVAL OF THE HOSPITAL'S STRATEGIC, FINANCIAL AND OPERATIONAL PLANS; D.APPROVAL OF THE HOSPITAL'S ANNUAL OPERATING AND CAPITAL BUDGETS; E.THE APPOINTMENT OF THE INDEPENDENT AUDITOR AND APPROVAL OF THE INDEPENDENT FINANCIAL AUDITS; F.ENTRY INTO MANAGED CARE CONTRACTS, EXCLUSIVE CONTRACTS AND OTHER MULTI-YEAR MATERIAL CONTRACTS; G.ENTRY INTO ANY PARTNERSHIP/AFFILIATION ARRANGEMENTS OR JOINT VENTURE PROPOSALS; AND H.AMENDMENTS TO THE BYLAWS OR ARTICLES OF ORGANIZATION OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A SEE STATEMENT ABOVE FORM 990, PART VI, SECTION A, LINE 7B STATEMENT RE DECISION OF GOVERNING BODY SUBJECT TO APPROVAL - SEE LINE 6 STATEMENT ABOVE. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, FOR THE PERIOD COVERED BY THIS FILING OCTOBER 1, 2017 TO SEPTEMBER 30, 2018 (FISCAL YEAR ENDED SEPTEMBER 30, 2018) BETH ISRAEL DEACONESS MEDICAL CENTER SERVED AS THE SOLE MEMBER OF BID-PLYMOUTH AND CAREGROUP SERVED AS THE SOLE MEMBER OF THE MEDICAL CENTER. EFFECTIVE MARCH 1, 2019, PURSUANT TO A PLAN OF STATUTORY MERGER, CAREGROUP MERGED INTO THE MEDICAL CENTER AND BETH ISRAEL LAHEY HEALTH, INC. (BILH) BECAME THE SOLE MEMBER OF THE MEDICAL CENTER. THIS FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER OF BID-PLYMOUTH, THE TAX DIRECTOR OF BILH AND DELOITTE TAX, LLP. A COPY OF THE COMPLETE RETURN IS MADE AVAILABLE TO EACH MEMBER OF THE BID-PLYMOUTH BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BIDP) HAS A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY. PURSUANT TO THAT POLICY, ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES OF BIDP ARE ASKED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST FORM WHICH IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS RELATIONSHIPS MAINTAINED BY OFFICERS, DIRECTORS OR KEY EMPLOYEES AND THEIR FAMILY MEMBERS AND WHICH MAY RESULT IN A CONFLICT OF INTEREST. FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A TERTIARY CARE ACADEMIC MEDICAL CENTER EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, SERVED AS THE SOLE MEMBER OF BIDP. THE BIDMC OFFICE OF COMPLIANCE AND BUSINESS CONDUCT ADMINISTERED A CONFLICT OF INTEREST QUESTIONNAIRE PROCESS ANNUALLY IN CONJUNCTION WITH THE BIDP OFFICE OF COMPLIANCE AND BUSINESS CONDUCT AND PROVIDED A SUMMARY OF POSITIVE RESPONSES TO BIDP'S CHIEF COMPLIANCE & PRIVACY OFFICER WHO MET WITH THE BID-PLYMOUTH CONFLICT OF INTEREST SUB-COMMITTEE FOR REVIEW AND DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. ANY ACTIVITY THAT REQUIRED ACTION UNDER THE CONFLICT OF INTEREST POLICY WAS SUBJECT TO ONGOING REVIEW BY BIDP. PURSUANT TO THE CONFLICT OF INTEREST POLICY (CMPL0001), CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A PLAN TO REQUIRE DISCLOSURE AND RECUSAL, INCLUDING APPROPRIATE DOCUMENTATION IN THE MINUTES. AS PREVIOUSLY NOTED IN THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, CAREGROUP SERVED AS THE SOLE MEMBER OF THE MEDICAL CENTER. IN ADDITION TO THE CONFLICT OF INTEREST PROCESS OUTLINED ABOVE, THE MEDICAL CENTER OFFICE OF COMPLIANCE AND BUSINESS CONDUCT AND THE CAREGROUP TAX DEPARTMENT JOINTLY ISSUED A TAX QUESTIONNAIRE TO ALL CURRENT AND FORMER MEMBERS OF THE BID-PLYMOUTH BOARD OF DIRECTORS AS WELL AS CURRENT AND FORMER OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE PROCESS WAS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR BID-PLYMOUTH TO COMPLETELY AND ACCURATELY PROCESS AND COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 DESCRIPTION OF PROCESS TO DETERMINE COMPENSATION OF THE ORGANIZATIONS CEO AND OTHER OFFICERS AND KEY EMPLOYEES BID-PLYMOUTH HAS AN EXECUTIVE COMPENSATION COMMITTEE WHICH IS COMPOSED OF MEMBERS OF THE BOARD OF DIRECTORS, THE CHIEF FINANCIAL OFFICER AND THE VICE PRESIDENT OF HUMAN RESOURCES. THE BID-PLYMOUTH EXECUTIVE COMPENSATION COMMITTEE ESTABLISHES THE COMPENSATION STRUCTURE OF THE CHIEF EXECUTIVE OFFICER, CHIEF NURSING OFFICER, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER, CHIEF INFORMATION OFFICER SR. VICE PRESIDENTS AND VICE PRESIDENTS. THE BID-PLYMOUTH EXECUTIVE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT IT COMPLIES WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE EXECUTIVE COMPENSATION COMMITTEE APPROVES RECOMMENDATIONS FOR INCENTIVE COMPENSATION TO THESE INDIVIDUALS ON AN ANNUAL BASIS AND AS SUCH, REVIEWS TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS ANNUALLY. IN SETTING COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEY STUDIES PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF SIMILAR ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWED THE COMPENSATION SURVEY DATA PREPARED BY AN INDEPENDENT CONSULTING FIRM. TO ENSURE INDEPENDENCE, ONCE THE DATA WAS PRESENTED, NO BID-PLYMOUTH STAFF WAS PRESENT FOR THESE DISCUSSIONS. THE EXECUTIVE COMPENSATION COMMITTEE VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS LISTED ABOVE EXCEPT FOR THE CEO WHICH WAS APPROVED BY THE FULL BID-PLYMOUTH BOARD. IN ADDITION, AS NOTED THROUGHOUT THIS NARRATIVE SUPPORT TO THE FORM 990, BIDMC IS THE SOLE MEMBER OF BID-PLYMOUTH AND THE BIDMC COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF THE BID-PLYMOUTH CEO AND THE INFORMATION IS REPORTED TO THE FULL BIDMC BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH, INC. 275 SANDWICH STREET PLYMOUTH, MA 02360 FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATES -6,796,272. ASSETS RELEASED FROM RESTRICTION 438,624. PENSION ADJUSTMENT 4,578,695. OTHER 145. FORM 990, PART XII,QUESTION 2B, 2C AND 2D FINANCIAL STATEMENTS AND COMMITTEE OVERSIGHT AS PREVIOUSLY REPORTED IN THIS FILING, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BIDP) IS A PUBLIC CHARITY AND A COMMUNITY HOSPITAL, EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. ALSO AS PREVIOUSLY NOTED, FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER, A TERTIARY CARE ACADEMIC MEDICAL CENTER, FLAGSHIP TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL, AN ENTITY EXEMPT FROM INCOME TAXES UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, WAS THE SOLE MEMBER OF BIDP. THE FINANCIAL RECORDS OF BIDP WERE AUDITED AS PART OF THE BIDMC CONSOLIDATED AUDITED FINANCIAL STATEMENT PROCESS, AND FOR THE PERIOD COVERED BY THIS FILING THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THESE FINANCIAL STATEMENTS. THIS PROCESS WAS MONITORED AND REVIEWED INTERNALLY BY BOTH THE BIDMC AND BIDP COMPLIANCE, AUDIT AND RISK COMMITTEES. FORM 990 SCHEDULE L PART IV DISCLOSURES DESCRIPTION OF TRANSACTIONS INVOLVING INTERESTED PERSONS VARIOUS CURRENT AND FORMER OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES OF BID- PLYMOUTH MAY ALSO HOLD POSITIONS WITH OTHER ENTITIES WHICH MAKE CHARITABLE CONTRIBUTIONS TO BID-PLYMOUTH. SUCH CONTRIBUTIONS HAVE NOT BEEN INCLUDED IN THE DISCLOSURES ABOVE. BID-PLYMOUTH MAINTAINS AN ACCOUNTABLE BUSINESS EXPENSE REIMBURSEMENT PLAN. FROM TIME TO TIME, BID-PLYMOUTH MAY REIMBURSE ITS OFFICERS, DIRECTORS/TRUSTEES AND/OR KEY EMPLOYEES FOR EXPENSES THEY INCURRED AND WHICH ARE PROPERLY ORDINARY AND NECESSARY BUSINESS EXPENSES OF THE REPORTING ENTITY. THE POLICIES AND PROCEDURES REQUIRED BY THE ACCOUNTABLE BUSINESS PLAN MUST BE FOLLOWED IN ORDER TO RECEIVE REIMBURSEMENT FOR SUCH EXPENSES AND IT IS POSSIBLE THAT ONE OR MORE INDIVIDUALS RECEIVED NON-TAXABLE REIMBURSEMENTS WHICH TOTALED $10,000 OR MORE DURING THE FISCAL PERIOD COVERED BY THIS FILING. ALL OF THE ABOVE TRANSACTIONS WERE NEGOTIATED AT ARMS-LENGTH AND IN ACCORDANCE WITH THE BID-PLYMOUTH CONFLICT OF INTEREST POLICY. ASSOC PHYS HARVARD MED FAC PHY AT BIDMC 375 LONGWOOD AVE BOSTON MA 02215 320058309 TO PROVIDE EMERGENCY MEDICAL SERVICES MA 501(C)(3) LINE 12A, I HMFP AT BIDMC 0 BI ANAESTHESIA FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042997215 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 12A, I HMFP AT BIDMC 0 BI COMMUNITY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042776678 INACTIVE CORPORATION MA 501(C)(3) LINE 7 N/A 0 BI DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043079630 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 12A, I HMFP AT BIDMC 0 BI DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 208253452 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 12A, I HMFP AT BIDMC 0 BI DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043030397 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 12A, I HMFP AT BIDMC 0 BI DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 204974585 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 12A, I HMFP AT BIDMC 0 BI DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC 110 FRANCIS STREET BOSTON MA 02215 020671240 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) LINE 12A, I HMFP AT BIDMC 0 BI DEACONESS HOSPITAL - NEEDHAM INC 148 CHESTNUT ST NEEDHAM MA 02492 043229679 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. 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