2018-08-14T14:36:42-05:00 2017-09-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2016-10-01 042103881 BETH ISRAEL DEACONESS MEDICAL CENTER BETH 6176678000 330 BROOKLINE AVENUE BOSTON MA 02215 MICHAEL CULLEN CHIEF FINANCIAL OFFICER 6176678000 2018-08-14 0 CHRISTINE KAWECKI P00743140 5169187000 2018-08-13 2016 2022-09-23 18:48:47Z PETER HEALY 330 BROOKLINE AVENUE BOSTON MA 02215 1822147313 0 X WWW.BIDMC.HARVARD.EDU X 1915 MA TERTIARY CARE ACADEMIC MEDICAL CENTER 26 21 12547 550 16627695 -243165 45490922 49661227 1506694835 1573670302 34145115 16540686 54527029 85530605 1640857901 1725402820 76059350 75014484 0 0 729522284 746314230 332134 139663 8612019 771647298 842181789 1577561066 1663650166 63296835 61752654 1630757944 1657670213 764608027 698135747 866149917 959534466 X SEE SCHEDULE O 0 0 1158069921 36573006 1324537431 SEE SCHEDULE O - PATIENT CARE 260000809 38441478 231584034 SEE SCHEDULE O - RESEARCH 98540888 30724057 SEE SCHEDULE O - TEACHING 1516611618 1 1 0 1 0 0 0 0 1 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 X 364 0 1 12547 1 1 1 0 0 0 0 1 1 0 0 0 0 X 26 21 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AK CO DC FL IL KY MD MA MI MN MS NH NJ NM NY NC OR SC TN UT WA NV OH WI OK X STEPHEN DEVEAU 6176671414 330 BROOKLINE AVENUE BOSTON MA 02215 ANDERSON CAROL F DIRECTOR, FIRST VICE CHAIR 5.00 0.00 X 0 0 0 BRADY MICHAEL J DIR (EX-OFF); CHAIR BIDM BOARD 1.00 10.00 X 0 0 0 CHAIKOF MD PHD ELLIOT L DIRECTOR (EX-OFF) & SURG CHIEF 30.00 35.00 X 518647 518647 115728 CHENG JILL DIRECTOR 1.00 0.00 X 0 0 0 CRONIN MICHAEL DIRECTOR 1.00 0.00 X 0 0 0 DESIMONE THOMAS DIR EX-OFF/TEE ADVIS BOARD CHR 5.00 0.00 X 0 0 0 DIPP MD PHD MICHELLE DIRECTOR 1.00 0.00 X 0 0 0 FULP CAROL DIRECTOR 1.00 0.00 X 0 0 0 GORMAN LISA DIRECTOR 1.00 0.00 X 0 0 0 HINKLEY CLARK DIR (EX-OFF); CHAIR BIDP BOARD 1.00 10.00 X 0 0 0 JICK DANIEL J DIRECTOR & BOARD CHAIR 10.00 2.00 X X 0 0 0 JOHNSTON WILLIAM DIRECTOR & TREASURER 2.00 0.00 X X 0 0 0 KIMBALL MD ALEXA DIR (EX-OFF); PRES & CEO, HMFP 1.00 64.00 X 0 334498 52785 LADD EDWARD DIRECTOR & VICE CHAIR 5.00 0.00 X 0 0 0 LAMERE DAVID DIRECTOR 1.00 0.00 X 0 0 0 LEPOFSKY ROBERT J DIRECTOR & SECRETARY 2.00 0.00 X X 0 0 0 LI CHIANG DIR; GI RESEARCHER 1.00 14.00 X 0 56000 0 MANDELL MD JAMES DIRECTOR 1.00 0.00 X 0 0 0 MCKENNA MARGARET DIRECTOR, VICE CHAIR 5.00 0.00 X 0 0 0 O'HANLEY RONALD DIRECTOR, VICE CHAIR 1.00 0.00 X 0 0 0 PLINE JENNIFER DIR (EX-OFF); CHAIR BIDN BOARD 1.00 10.00 X 0 0 0 REHNERT GEOFF DIRECTOR 1.00 0.00 X 0 0 0 ROTTENBERG ALAN DIRECTOR 1.00 0.00 X 0 0 0 SILVER JENNIFER DIRECTOR 1.00 0.00 X 0 0 0 TABB MD KEVIN CEO & DIRECTOR (EX-OFFICIO) 60.00 5.00 X X 1445730 0 170597 ZEIDEL MD MARK L DIRECTOR (EX-OFF) & MED CHIEF 30.00 35.00 X 383713 383713 64398 CULLEN MICHAEL R CHIEF FINANCIAL OFFICER 60.00 0.00 X 0 0 0 FISCHER STEVEN ASSISTANT TREASURER 58.00 7.00 X 595328 0 75402 FORMELLA RN MSN NANCY CHIEF OPERATING OFFICER 58.00 2.00 X 693771 0 57562 HEALY PETER PRESIDENT 30.00 35.00 X 0 493595 59331 ARMSTRONG WALTER SVP, CAP FACILITIES & ENGINEER 60.00 0.00 X 361410 0 47128 BIEBER JUDITH CHIEF HR OFFICER 60.00 0.00 X 347916 0 81759 HALAMKA MD JOHN CHIEF INFOR OFFICER BID SYSTEM 60.00 0.00 X 416150 0 64138 LEWIS MD STANLEY M CHIEF SYS DEVMT & STRATEGY OFF 55.00 5.00 X 582311 0 73531 MAURER RN MSN MARSHA CNO & SVP, PATIENT CARE SVCS 60.00 0.00 X 497497 0 47221 SHEEHAN RN MSN JAYNE SVP, SYS INTEG, CARE COORD 60.00 0.00 X 360630 0 66593 SKURA SAMUEL SVP, AMBUL & CLINICAL SVCS 30.00 30.00 X 0 291217 50015 SUKHATME MD SCD VIKAS P CHIEF ACADEMIC OFFICER 60.00 0.00 X 542376 0 71491 TANDON MANU VP, DEPUTY CIO, CTO 60.00 0.00 X 321689 0 45854 GEBHARDT MD MARK C CHIEF OF ORTHOPAEDIC SURGERY 30.00 35.00 X 405958 405958 85404 KRUSKAL MD PHD JONATHAN B CHIEF OF RADIOLOGY 30.00 35.00 X 366584 366584 63786 STERN MD ROBERT S CHIEF OF DERMATOLOGY 30.00 35.00 X 327793 327793 83586 STEVENSON MD PHD MARY ANN CHIEF OF RADIATION ONCOLOGY 30.00 35.00 X 349254 349254 84734 TALMOR MD MPH DANIEL CHIEF OF ANESTHESIA 30.00 35.00 X 330603 330603 82436 8847360 3857862 1543479 1616 0 1 1 HARVARD MEDICAL FACULTY PHYSICIANS AT BI 375 LONGWOOD AVENUE BOSTON MA 02215 PHYSICIAN SERVICES 130867193 MASCO SERVICES 375 LONGWOOD AVENUE BOSTON MA 02215 PARKING 8992949 SODEXO PO BOX 905374 CHARLOTTE NC 28204 FOOD SERVICE 7759732 SHAWMUT DESIGN 560 HARRISON AVENUE BOSTON MA 02118 CONSTRUCTION 5083123 BOND BROTHERS 145 SPRING STREET EVERETT MA 02049 MANAGEMENT SERVICES 4417480 108 127190 49534037 2741299 49661227 MEDICARE/MEDICAID REVE 900099 710063045 710063045 NET PATIENT SERVICE RE 541700 599561717 599561717 NIH FUNDED RESEARCH 541700 176085909 176085909 SPONSORED RESEARCH 541700 57235574 55498125 1737449 GRADUATE MED EDUCATION 611710 30724057 30724057 1573670302 9009430 -270823 9280253 269481 269481 599461 90634 508827 508827 22658 486169 103836042 96304786 7531256 7531256 161334 7369922 90958 127190 334979 -244021 -244021 50560 14094 36466 36466 PARKING REVENUE 812930 17558687 23400 17535287 REBATES 900099 6174752 6174752 CAFETERIA INCOME 722514 5566520 5566520 55659893 14912669 14953677 25793547 84959852 1725402820 1586845522 16627695 72268376 X 74146502 74146502 867982 867982 8134183 2936391 5197792 611276163 548029461 57881027 5365675 31654904 28157055 3223637 274212 45253670 40253165 4608493 392012 49995310 44470856 5091367 433087 2995463 2995463 4159577 4159577 3373025 3373025 249964 249964 139663 139663 5702369 5702369 179275528 169963367 8865831 446330 2176605 570405 1601324 4876 272061939 270273037 1442832 346070 10763461 7308261 3337931 117269 81333495 74593972 6682262 57261 722524 492771 134543 95210 654561 533706 105906 14949 5730761 5730761 81506458 64574242 16804338 127878 8761351 8747866 13485 RESEARCH 93987690 93987690 CONTRACTED SERVICES 30516035 29695560 783611 36864 UNCOMPENSATED CARE 21253078 21253078 PARKING FEES 9285328 6915015 2135625 234688 27672577 23110475 4036127 525975 1663650166 1516611618 138426529 8612019 0 595573255 539161025 45480548 61802080 157440563 173453168 14326787 16473833 15324871 16500795 2406425758 1867022442 506848194 539403316 210771346 223910079 84992380 86965917 1630757944 1657670213 195981008 200438809 73159359 55096678 302470850 277363323 192996810 165236937 764608027 698135747 X 628640969 697429941 173038266 193526629 64470682 68577896 866149917 959534466 1630757944 1657670213 X 61752654 16534627 15097268 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1 1 1 0 1 0 1 249964 249964 0 PART II-B, LINE 1: THE MEDICAL CENTER ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER AFFILIATED NETWORK ENTITIES. ADDITIONALLY, THE MEDICAL CENTER PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $249,964 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2017. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES. 1 1685737 1685737 0 0 237508948 29262761 16022089 20689273 262104525 224151643 29798856 7575210 24016761 237508948 203420022 23515697 10565055 13349131 224151643 192587429 10827102 12156351 12150860 203420022 172799187 9753810 20064195 10029763 192587429 0.31000 0.69000 0 0 24282879 24282879 319784054 249356338 70427716 630203460 439662142 190541318 1432155365 1178003962 254151403 539403316 OTHER INVESTMENTS THROUGH CIP 223910079 F 223910079 DUE FROM AFFILIATES 32035623 ACCOUNTS RECEIVABLES- MISCELLANEOUS 10615520 DEPOSITS 1500000 CASH SURRENDER VALUE- EXEC LIFE 570802 HPHC WORKING CAPITAL 1436436 PROFESSIONAL LIABILITY REINSURANCE RECOVERIES 41552536 RESERVE FOR BAD DEBT -745000 86965917 MEDICAL MALPRACTICE RESERVE 773000 POST RETIREMENT MEDICAL BENEFITS 96439629 FUNDS MANAGED BY OTHERS 5533253 CLINICAL TRIALS 18743054 FUNDS HELD IN TRUST 2195465 PROFESSIONAL LIABILITY 41552536 165236937 X 2725168000 32109944 1012868365 1044978309 1680189691 6253617 38959512 45213129 1725402820 2636962000 979014203 979014203 1657947797 5702369 5702369 1663650166 PART IV, LINE 1B: CUSTODIAN ARRANGEMENTS THE MEDICAL CENTER IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BID-NEEDHAM) WHICH IS A COMMUNITY HOSPITAL EXEMPT FROM INCOME TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. DURING THE FISCAL YEAR COVERED BY THIS FILING, DID NOT MAINTAIN ALL OF ITS OWN DEVELOPMENT OPERATIONS. INSTEAD, AS PART OF THE RELATIONSHIP BETWEEN THE ENTITIES, THE MEDICAL CENTER'S DEVELOPMENT STAFF PROVIDED OPERATIONAL SUPPORT RELATED TO SOLICITING AND PROCESSING CONTRIBUTIONS FOR BID-NEEDHAM. UPON RECEIPT, THE CONTRIBUTIONS WERE DEPOSITED INTO A MEDICAL CENTER ACCOUNT. AT THE END OF EACH MONTH, THE TOTAL OF THE DEPOSITS WERE TRANSFERRED FROM THE MEDICAL CENTER TO BID-NEEDHAM. PART V, LINE 4: BETH ISRAEL DEACONESS MEDICAL CENTER ENDOWMENT FUND THE MEDICAL CENTER'S ENDOWMENT FUNDS ARE INTENDED TO ENSURE THAT THE MEDICAL CENTER ACCOMPLISHES ITS CHARITABLE MISSIONS OF PROVIDING EXCELLENT CLINICAL CARE, ENGAGING IN CUTTING EDGE RESEARCH AND EDUCATING THE HEALTH CARE PRACTITIONERS OF TOMORROW. THE SPECIFIC USES OF THE ENDOWMENT VARY DEPENDING ON THE NATURE OF RESTRICTIONS, IF ANY, IMPOSED BY DONORS. UNDER THE MEDICAL CENTER'S CURRENT LONG-TERM INVESTMENT SPENDING POLICY, WHICH IS WITHIN THE GUIDELINES SPECIFIED UNDER MASSACHUSETTS STATE LAW, 5-6% 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. DURING FY 2017 $3,519,909 WAS APPROPRIATED OF WHICH $350,650 WAS RELATED SPECIFICALLY TO FREE CARE AND IS INCLUDED IN THIS FORM 990 SCHEDULE H. IN ESTABLISHING THESE POLICIES, THE MEDICAL CENTER CONSIDERED THE EXPECTED RETURN ON ITS ENDOWMENT AND ITS PROGRAMMING NEEDS. ACCORDINGLY, THE MEDICAL CENTER 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) 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 2017 OR 2016. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 20,689,273. CONSOLIDATED AFFILIATES REVENUE NET OF ELIMINATIONS 992,179,092. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENT -90,634. TEMPORARILY AND PERMANENTLY RESTRICTED CONTRIBUTIONS 29,262,761. FUNDS MANAGED FOR OTHERS 7,631,764. RESTRICTED REALIZED GAINS 2,504,694. GAMING EXPENSES -14,094. FUNDRAISING EXPENSES -334,979. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENT 90,634. GAMING EXPENSES 14,094. FUNDRAISING EXPENSES 334,979. CONSOLIDATED AFFILIATES EXPENSE NET OF ELIMINATIONS 978,574,496. 1 CENTRAL AMERICA & THE CARIBBEAN 0 0 INVESTMENTS 89620472 EAST ASIA AND THE PACIFIC 0 0 INVESTMENTS 7 EUROPE (INCLUDING ICELAND AND GREENLAND) 0 0 INVESTMENTS 11246106 NORTH AMERICA 0 0 INVESTMENTS 3865091 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES TEACHING/ RESEARCH/ PATIENT CARE 328763 NORTH AMERICA 0 0 PROGRAM SERVICES TEACHING/ RESEARCH/ PATIENT CARE 153909 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES TEACHING/ RESEARCH/ PATIENT CARE 237197 EUROPE (INCLUDING ICELAND AND GREENLAND) 0 0 PROGRAM SERVICES TEACHING/ RESEARCH/ PATIENT CARE 132792 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES TEACHING/ RESEARCH/ PATIENT CARE 8000 SOUTH AMERICA 0 0 PROGRAM SERVICES TEACHING/ RESEARCH/ PATIENT CARE 173588 CENTRAL AMERICA & THE CARIBBEAN 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/PRESENTATIONS 1543 EAST ASIA AND THE PACIFIC 0 21 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/PRESENTATIONS 314300 EUROPE (INCLUDING ICELAND AND GREENLAND) 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/PRESENTATIONS 369674 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/PRESENTATIONS 22477 NORTH AMERICA 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/PRESENTATIONS 73452 SOUTH ASIA 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/PRESENTATIONS 6508 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/PRESENTATIONS 59610 CENTRAL AMERICA & THE CARIBBEAN 0 0 PROGRAM SERVICES HUMANITARIAN MISSION 6644 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES HUMANITARIAN MISSION 10625 NORTH AMERICA 0 0 PROGRAM SERVICES HUMANITARIAN MISSION 2180 SOUTH AMERICA 0 0 PROGRAM SERVICES HUMANITARIAN MISSION 2858 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES HUMANITARIAN MISSION 10651 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES GLOBAL HEALTH PROGRAM 97378 NORTH AMERICA 0 0 PROGRAM SERVICES GLOBAL HEALTH PROGRAM 13034 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES GLOBAL HEALTH PROGRAM 6898 SOUTH AMERICA 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/PRESENTATIONS 30832 0 0 0 21 0 21 105584337 1210252 106794589 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 32081 ELECTRONIC FUND/WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 22207 ELECTRONIC FUND/WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 63445 ELECTRONIC FUND/WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 59926 ELECTRONIC FUND/WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 25000 ELECTRONIC FUND/WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 50847 ELECTRONIC FUND/WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 68360 ELECTRONIC FUND/WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 6000 ELECTRONIC FUND/WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 6272 ELECTRONIC FUND/WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 10466 ELECTRONIC FUND/WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 39802 ELECTRONIC FUND/WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 70252 ELECTRONIC FUND/WIRE TRANSFER 0 MIDDLE EAST AND NORTH AFRICA RESEARCH SUB-AWARD 8000 ELECTRONIC FUND/WIRE TRANSFER 0 NORTH AMERICA RESEARCH SUB-AWARD 115875 ELECTRONIC FUND/WIRE TRANSFER 0 NORTH AMERICA RESEARCH SUB-AWARD 25000 ELECTRONIC FUND/WIRE TRANSFER 0 SOUTH AMERICA RESEARCH SUB-AWARD 173588 ELECTRONIC FUND/WIRE TRANSFER 0 SUB-SAHARAN AFRICA RESEARCH SUB-AWARD 21600 ELECTRONIC FUND/WIRE TRANSFER 0 SUB-SAHARAN AFRICA RESEARCH SUB-AWARD 29000 ELECTRONIC FUND/WIRE TRANSFER 0 SUB-SAHARAN AFRICA RESEARCH SUB-AWARD 40261 ELECTRONIC FUND/WIRE TRANSFER 0 19 1 0 1 1 1 1 PART I, LINE 2: GRANT MONITORING AS NOTED IN BOTH SCHEDULES H, HOSPITALS AND SCHEDULE I, GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS, GOVERNMENTS, AND INDIVIDUALS IN THE UNITED STATES, AS PART OF THE MEDICAL CENTER'S COMMITMENT TO OUR COMMUNITY, THE MEDICAL CENTER PARTNERS WITH COMMUNITY LEADERS AND COMMUNITY-BASED ORGANIZATIONS WHO SERVE AS LINKS TO THE COMMUNITY AND TEACHERS OF HOW WE CAN BETTER SERVE THE POPULATIONS THEY REPRESENT. IN ADDITION, THE MEDICAL CENTER COLLABORATES WITH A WIDE VARIETY OF ORGANIZATIONS BOTH WITHIN AND OUTSIDE OF THE UNITED STATES BECAUSE HEALTHCARE SERVICES BY THEMSELVES ARE NOT ADEQUATE TO MAXIMIZE IMPROVEMENT OF HEALTH STATUS. AS SUCH, OUR INVOLVEMENT WITH OUR COMMUNITY IS ON-GOING AND PART OF THAT ON-GOING RELATIONSHIP INCLUDES REPORTING ON HOW GRANT FUNDS ARE EXPENDED. AS A RECIPIENT OF FEDERAL SPONSORED AWARDS, THE MEDICAL CENTER MUST COMPLY WITH THE GUIDELINES SPECIFIC TO THE FEDERAL AWARDING AGENCY FOR THE PARTICULAR PROGRAM. THE MEDICAL CENTER'S ADHERENCE TO THESE PROGRAMS' REQUIREMENTS IS AUDITED ANNUALLY AS REQUIRED BY 2 CFR PART 200, UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS . THE MEDICAL CENTER IS REQUIRED BY FEDERAL REGULATION TO MONITOR EXPENSES OF FEDERAL FUNDS AWARDED TO THE MEDICAL CENTER THAT ARE SUB-CONTRACTED TO ANOTHER INSTITUTION, ORGANIZATION, OR INDIVIDUAL. FEDERAL SUBCONTRACTED RESEARCH GRANTS AS WELL AS OTHER SUBCONTRACTED RESEARCH GRANTS ARE MONITORED BY THE CLINICAL DEPARTMENT SPONSORING THE ACTIVITY. SIMILAR MONITORING PROGRAMS ARE IN PLACE THAT ASSURE ADHERENCE TO ALL NON-FEDERAL SPONSORS' GRANT REQUIREMENTS AS WELL THROUGH A GROUP OF DEDICATED RESEARCH ADMINISTRATIVE PROFESSIONALS THAT REPORT UP THROUGH THE OFFICE OF ACADEMIC AFFAIRS. THIS REPORTING STRUCTURE FURTHER ENHANCES INTERNAL CONTROLS. SCHEDULE F, PART IV, QUESTION 3 - FOREIGN FORMS ALTHOUGH BIDMC 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. SCHEDULE F, PART IV, QUESTION 4 - FOREIGN FORMS ALTHOUGH BIDMC WAS AN INDIRECT SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR QUALIFIED ELECTING FUND DURING THE PERIOD COVERED BY THIS FILING, BIDMC WAS NOT REQUIRED TO FILE FORM 8621, INFORMATION RETURNS BY A SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR QUALIFIED ELECTING FUND. SCHEDULE F, PART IV, QUESTION 5 - FOREIGN FORMS ALTHOUGH BIDMC 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. SCHEDULE F, PART V - SUPPLEMENTAL INFORMATION GRANTS TO ENTITIES OUTSIDE THE UNITED STATES ARE RELATED TO AND FURTHER THE MEDICAL CENTER'S MISSION TO IMPROVE THE HEALTH OF ALL PATIENTS AND TO ENGAGE IN CUTTING EDGE RESEARCH. FUND RECIPIENTS PROVIDE THE MEDICAL CENTER WITH REPORTS DOCUMENTING THE USE OF SUCH FUNDS. X X X X X X 1 BENTZ WHALEY FLESSNER 7251 OHMS LANE MINNEAPOLIS MN 554392148 STRATEGY CONSULTING 0 0 9913 -9913 ZURI GROUP 328 NW BOND ST SUITE 200 BEND OR 97701 STRATEGY CONSULTING 0 0 129750 -129750 139663 -139663 MA AK CO FL IL KY MD MI MN MS NV NH NJ NM NY NC OH OK OR SC TN UT WA WI DC GALA 82840 56580 26260 29011 80196 7619 170233 REASON TO RIDE 74538 14640 59898 20607 3 60770 55970 4800 27313 218148 127190 90958 29011 80196 7619 218153 334979 -244021 1 1 50560 11546 2548 0 50560 11546 2548 14094 36466 MA 1 0 0 0 0.50000 0.50000 BETH ISRAEL DEACONESS LEGAL DEPT 330 BROOKLINE AVENUE BOSTON MA 02215 0 MICHAEL CULLEN 0 SEE SCHEDULE J X 1 36466 1 1 1 X 1 X 1 1 0 1 1 17986153 5133803 12852350 0.00770 254838808 200527465 54311343 0.03260 272824961 205661268 67163693 0.04030 5318745 51647 5267098 0.00320 102314888 31746274 70568614 0.04240 110651857 73193551 37458306 0.02250 296760203 215267238 81492965 0.04900 11025923 10000 11015923 0.00660 526071616 320268710 205802906 0.12370 798896577 525929978 272966599 0.16400 764788 764788 0.00050 75178 75178 0.00000 839966 839966 0.00050 1 22472200 385925414 400197935 -14272521 X 1 1 1 1 BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVENUE BOSTON MA 02215 WWW.BIDMC.ORG VL42 X X X X X X TERTIARY CARE ACADEMIC MEDICAL CENTER BETH ISRAEL DEACONESS MEDICAL CENTER 1 0 0 1 X X X X X X X 16 1 1 0 1 X SEE SUPPLEMENTAL INFORMATION 1 15 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFORMATION X SEE SUPPLEMENTAL INFORMATION X X X X X X 1 X 0 X X X 1 X 0 0 BETH ISRAEL DEACONESS MEDICAL CENTER PART V, SECTION B, LINE 5: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H, PART V, SECTION B PLEASE SEE SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION BETH ISRAEL DEACONESS MEDICAL CENTER PART V, SECTION B, LINE 11: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H, PART V, SECTION B PLEASE SEE SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION 5 1 - BETH ISRAEL DEACONESS HEALTHCARE LEXIN 482 BEDFORD STREET LEXINGTON MA 02420 OUTPATIENT MEDICAL CARE 2 - BETH ISRAEL DEACONESS HEALTHCARE CHELS 1000 BROADWAY CHELSEA MA 02150 OUTPATIENT MEDICAL CARE 3 - BOWDOIN STREET HEALTH CENTER 230 BOWDOIN STREET DORCHESTER MA 02122 OUTPATIENT MEDICAL CARE 4 - CHESTNUT HILL AMBULATORY CARE 200 BOYLSTON STREET NEWTON MA 02467 OUTPATIENT MEDICAL CARE 5 - BETH ISRAEL DEACONESS CANCER CENTER 148 CHESTNUT STREET NEEDHAM MA 02492 OUTPATIENT MEDICAL CARE PART VI, LINE 5: ADDITIONAL PROMOTION OF COMMUNITY HEALTH AND AFFILIATED HEALTH CARE SYSTEMAS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF THE MEDICAL CENTER'S BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. IN ADDITION, AS NOTED THROUGHOUT THIS FORM 990 AND SCHEDULES' NARRATIVE SUPPORT, THE MEDICAL CENTER IS PART OF THE CAREGROUP NETWORK OF AFFILIATES AND CAREGROUP SERVES AS THE MEDICAL CENTER'S SOLE MEMBER. IN ADDITION, 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. EACH OF THESE ENTITIES MAY, IN TURN, SERVE AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE MEDICAL CENTER AND EACH OF ITS AFFILIATES IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES THEY SERVE. PART VI, LINE 6: SEE NARRATIVE ABOVE: ADDITIONAL PROMOTION OF COMMUNITY HEALTH AND AFFILIATED HEALTH CARE SYSTEM FORM 990 SCHEDULE H SUPPLEMENTAL INFORMATION 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 STATEMENTTHE MISSION OF BETH ISRAEL DEACONESS MEDICAL CENTER IS TO SERVE PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM AND THEIR FAMILIES. THE MEDICAL CENTER'S MISSION IS SUPPORTED BY A COMMITMENT TO PERSONALIZED, EXCELLENT PATIENT CARE; A WORKFORCE COMMITTED TO INDIVIDUAL ACCOUNTABILITY, MUTUAL RESPECT AND COLLABORATION; AND A COMMITMENT TO MAINTAINING THE INSTITUTION'S 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 OUR MISSION. THE MEDICAL CENTER HAS A COVENANT TO CARE FOR THE UNDERSERVED AND TO WORK TO CHANGE DISPARITIES IN ACCESS TO CARE.THIS 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, THE MEDICAL CENTER PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $16,283,021 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I.COMMUNITY CARE ALLIANCE (CCA) AND COMMUNITY HEALTH CENTERS (CHC)BIDMC HAS PARTICULARLY STRONG RELATIONSHIPS WITH MANY OF THE PRIMARY CARE CLINICS THAT OPERATE IN ITS COMMUNITY BENEFITS SERVICE AREA, MANY OF WHOM ARE AFFILIATED WITH BIDMC'S COMMUNITY CARE ALLIANCE (CCA). SERVING OVER 100,000 PATIENTS ANNUALLY, THE CCA HEALTH CENTERS INCLUDE:- BOWDOIN STREET HEALTH CENTER- THE DIMOCK CENTER- FENWAY HEATH AND SIDNEY BORUM JR. HEALTH SERVICES- CHARLES RIVER COMMUNITY HEALTH (FORMERLY JOSEPH M. SMITH COMMUNITY HEALTH CENTER)- OUTER CAPE HEALTH SERVICES- SOUTH COVE COMMUNITY HEALTH CENTERTHE MEDICAL CENTER PROVIDED COMBINED DIRECT GRANT, FUNDING AND COMMUNITY BENEFIT PROGRAMMING SUPPORT OF THESE CHCS AND THE CCA OF $6,838,529. THESE AMOUNTS ARE INCLUDED IN SCHEDULE H PART I, LINES 7E, 7G AND 7I AND ARE REPORTED IN SCHEDULE I PART II.THE CCA HEALTH CENTERS ARE IDEAL COMMUNITY BENEFITS PARTNERS AS THEY ARE ROOTED IN THEIR COMMUNITIES AND, AS FEDERALLY QUALIFIED HEALTH CENTERS, MANDATED TO SERVE LOW INCOME, UNDERSERVED POPULATIONS. THESE CLINIC PARTNERS HAVE BEEN A VITAL PART OF BIDMC'S COMMUNITY HEALTH IMPROVEMENT STRATEGY SINCE 1968, WHEN BETH ISRAEL HOSPITAL FIRST JOINED FORCES WITH THE DIMOCK CENTER TO ADDRESS MATERNAL AND CHILD HEALTH ISSUES. HISTORICALLY, BIDMC HAS RELIED HEAVILY ON ITS CCA PARTNERS AS WELL AS A NUMBER OF OTHER KEY COMMUNITY HEALTH PARTNERS TO IMPLEMENT ITS COMMUNITY BENEFITS INITIATIVES. IN THIS REGARD, BIDMC HAS LEVERAGED CCA'S EXPERTISE AND THE VITAL CONNECTIONS THAT THESE ORGANIZATIONS HAVE WITH RESIDENTS AND ORGANIZATIONS IN THE COMMUNITIES THEY SERVE.COMMUNITY BENEFITS LEADERSHIP AND PROCESSTHE BOARD OF DIRECTORS HAS CHARGED ITS PERMANENT COMMUNITY BENEFITS COMMITTEE WITH AUTHORITY AND OVERSIGHT OF ACTIVITIES TO FULFILL THE MISSION OF COMMUNITY BENEFITS. SPECIFICALLY, THE RESPONSIBILITIES OF THE COMMITTEE ARE TO:" (I) RECOMMEND BROAD GUIDELINES BY WHICH THE CORPORATION'S PROGRAMS AND POLICIES SERVE ITS COMMUNITIES; (II) MAKE RECOMMENDATIONS OF POLICIES AND PRIORITIES WITH REGARD TO PROGRAMS THAT MEET THE HEALTH CARE NEEDS OF ITS COMMUNITIES; (III) STRENGTHEN THE INTEGRATION OF THE CORPORATION'S COMMUNITY SERVICE ACTIVITIES, PUBLIC HEALTH PROGRAMS AND ITS OVERALL STRATEGIC PLANNING EFFORTS; (IV) OVERSEE THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY BENEFIT PLAN TO ADDRESS IDENTIFIED NEEDS IN THE COMMUNITY; (V) IDENTIFY, SHARE AND REPLICATE INNOVATIVE AND EVIDENCE-BASED MODELS AND BEST PRACTICES TO ADDRESS THESE NEEDS; (VI) REVIEW, AT LEAST ANNUALLY, THE EXTENT AND NATURE OF THE COMMITMENT OF RESOURCES TO PROGRAMS TARGETED AT IMPROVING THE CURRENT AND FUTURE HEALTH STATUS OF SURROUNDING COMMUNITIES; (V) ENCOURAGE COLLABORATIVE RELATIONSHIPS WITH OTHER PROVIDERS AND GOVERNMENT ENTITIES TO SUPPORT AND ENHANCE RATIONAL AND EFFECTIVE PUBLIC HEALTH POLICIES AND PROGRAMS; (VI) DISCUSS PUBLIC POLICY ISSUES AND RELEVANT LEGAL AND REGULATORY MATTERS RELATED TO PUBLIC HEALTH AND COMMUNITY BENEFITS AND ADVISE THE BOARD OF DIRECTORS OF THE IMPLICATIONS FOR THE CORPORATION; (VII) EDUCATE DIRECTORS, TRUSTEES, OVERSEERS, STAFF AND THE COMMUNITY ABOUT HOW THE CORPORATION ADDRESSES ITS MISSION TO FOCUS ON THE HEALTH NEEDS OF ITS COMMUNITIES; AND (VIII) WORK TO RECOGNIZE AND CONFRONT HEALTH DISPARITIES AND ENSURE THAT THE CORPORATION IS WELCOMING AND INCLUSIVE FOR ALL INDIVIDUALS OF DIVERSE BACKGROUNDS.."THE MEMBERSHIP OF THE MEDICAL CENTER'S COMMUNITY BENEFITS COMMITTEE ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND TARGET POPULATIONS OF OUR PROGRAMMATIC ENDEAVORS INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. SENIOR MANAGEMENT IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY BENEFITS PLAN, ENSURING THAT THE MEDICAL CENTER'S POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES.IT IS NOT ONLY THE BOARD AND SENIOR LEADERSHIP THAT ARE HELD ACCOUNTABLE IN FULFILLING THE MEDICAL CENTER'S COMMUNITY BENEFITS MISSION. CONSISTENT WITH THE MEDICAL CENTER'S CORE VALUES IS THE RECOGNITION THAT THE MOST SUCCESSFUL COMMUNITY BENEFITS PROGRAMS ARE THOSE THAT ARE IMPLEMENTED ORGANIZATION-WIDE AND INTEGRATED INTO THE VERY FABRIC OF THE MEDICAL CENTER'S CULTURE, POLICIES AND PROCEDURES. IT IS NOT A STAND-ALONE EFFORT THAT IS THE RESPONSIBILITY OF ONE STAFF OR DEPARTMENT BUT RATHER AN ORIENTATION AND VALUE MANIFESTED THROUGHOUT OUR STRUCTURE, REFLECTED IN HOW WE PROVIDE CARE HERE AT THE MEDICAL CENTER AND IN AFFILIATED PRACTICES IN URBAN NEIGHBORHOODS AND CERTAIN RURAL AREAS.PROVIDING DIRECTION FOR OUR COLLECTIVE COMMITMENT AND EFFORT ARE THE COMMUNITY BENEFIT GUIDING PRINCIPLES THAT FOLLOW. ADOPTED BY A BROAD-BASED CONSTITUENCY OF BOARD, SENIOR LEADERSHIP AND STAFF, THESE PRINCIPLES PROVIDE THE FRAMEWORK FOR THE EXECUTION OF THE PLAN, SPEARHEADED BY THE DIRECTOR OF COMMUNITY BENEFITS. THE DIRECTOR OF COMMUNITY BENEFITS IS ACCOUNTABLE TO THE GENERAL COUNSEL WITH DIRECT ACCESS TO THE PRESIDENT AND CEO. IT IS THE RESPONSIBILITY OF THESE THREE SENIOR MANAGERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF UNDERSERVED POPULATIONS ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THIS IS THE STRUCTURE AND METHODOLOGY EMPLOYED TO ENSURE THAT COMMUNITY BENEFITS IS NOT THE PURVIEW OF ONE OFFICE ALONE AND TO MAXIMIZE THE EXTENT TO WHICH EFFORTS ACROSS THE ORGANIZATION ARE FULFILLING THE GOALS OF COMMUNITY BENEFITS.THE MEDICAL CENTER ACCOMPLISHES THESE GOALS BY PARTNERING WITH OUR COMMUNITY AS FOLLOWS:- THE MEDICAL CENTER PARTNERS WITH COMMUNITY LEADERS AND COMMUNITY-BASED ORGANIZATIONS WHO SERVE AS LINKS TO THE COMMUNITY AND TEACHERS OF HOW WE CAN BETTER SERVE THE POPULATIONS THEY REPRESENT. IN ADDITION, THE MEDICAL CENTER COLLABORATES WITH A WIDE VARIETY OF ORGANIZATIONS BECAUSE HEALTHCARE SERVICES BY THEMSELVES ARE NOT ADEQUATE TO MAXIMIZE IMPROVEMENT OF HEALTH STATUS.- IMPROVING THE COMMUNITY'S HEALTH REQUIRES MORE THAN CLINICAL SERVICES. THE MEDICAL CENTER LOOKS TO PUBLIC HEALTH, PREVENTION, AND OTHER HEALTH-RELATED APPROACHES NOT TRADITIONALLY PROVIDED BY MANY ACUTE CARE HOSPITALS.- THE MEDICAL CENTER'S COMMITMENT TO THE COMMUNITY BENEFITS MISSION IS AS FUNDAMENTAL AS ITS COMMITMENT TO ITS PATIENT CARE AND ACADEMIC MISSIONS. THAT IS, RATHER THAN ABANDON ANY OF THESE FUNDAMENTAL MISSIONS WHEN BUDGET RESTRAINTS ARISE, THE MEDICAL CENTER WILL CONSTANTLY SEEK WAYS TO FULFILL ALL OF THEM IN AS EFFECTIVE AND EFFICIENT A MANNER AS POSSIBLE.- COMMUNITY BENEFITS PROGRAMS ARE MOST SUCCESSFUL WHEN IMPLEMENTED ORGANIZATION-WIDE, JUST AS QUALITY AND RESPECT. COMMUNITY BENEFITS CANNOT SUCCEED AS A STAND-ALONE ACTIVITY. THE IMPORTANCE OF THESE PRINCIPLES AND THE EFFORTS THAT RESULT MUST BE EMBRACED BY TRUSTEES, SENIOR MANAGEMENT AND PROVIDERS ALIKE, AS WELL AS BY THE COMMUNITIES SERVED. COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY HEALTH NEEDS ASSESSMENT - INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. THE MEDICAL CENTER COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2016. THAT CHNA WAS APPROVED BY THE BIDMC BOARD OF DIRECTORS ON SEPTEMBER 20, 2016. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 20, 2016 WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER IRC SECTION 501(R).THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ALONG WITH THE ASSOCIATED COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) WERE THE CULMINATION OF A YEAR OF WORK AND WAS BORNE LARGELY OUT OF BIDMC'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 WAS DESIGNED TO FULFILL THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BIDMC ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW THE MEDICAL CENTER, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT. THE MEDICAL CENTER ACCOMPLISHED THE 2016 CHNA IN CONJUNCTION WITH BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - MILTON (BID-MILTON) AND BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH (BID-PLYMOUTH). THE MEDICAL CENTER SERVES AS SOLE MEMBER OF THESE COMMUNITY HOSPITALS. THE MEDICAL CENTER'S IMPLEMENTATION STRATEGY WHICH RESULTED FROM THIS PROCESS, IS DESIGNED TO GUIDE AND INFORM ITS COMMUNITY BENEFITS PROGRAMMING FOR THE FOR THE FISCAL YEARS ENDED/ENDING SEPTEMBER 30, 2017, SEPTEMBER 30, 2018 AND SEPTEMBER 30, 2019.COMMUNITY HEALTH NEEDS ASSESSMENT - COMMUNITY INFORMATIONBIDMC FOCUSES ITS COMMUNITY BENEFITS EFFORTS ON IMPROVING THE HEALTH STATUS OF THE LOW INCOME, UNDERSERVED POPULATIONS LIVING IN ALLSTON/BRIGHTON, CHINATOWN, DORCHESTER, FENWAY/KENMORE AND ROXBURY. BIDMC ALSO HAS HISTORICAL TIES TO UNDERSERVED COMMUNITIES IN QUINCY AND TO SOME OF THE MOST ISOLATED, VULNERABLE AREAS OF CAPE COD, SPECIFICALLY THE OUTER CAPE (HARWICH, WELLFLEET, TRURO, AND PROVINCETOWN). THESE COMMUNITIES MAKE UP BIDMC'S COMMUNITY BENEFITS SERVICE AREA AND INCLUDE THE COMMUNITY CARE ALLIANCE (CCA), THE NETWORK OF ONE LICENSED AND FIVE FEDERALLY QUALIFIED HEALTH CENTERS AFFILIATED WITH BIDMC. (SCHEDULE H PART VI QUESTION 4).COMMUNITY HEALTH NEEDS ASSESSMENT -- APPROACH AND METHODSTHE FY 2016 CHNA WAS CONDUCTED IN THREE PHASES, WHICH ALLOWED BIDMC TO: 1) COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA, 2) ENGAGE AND INVOLVE KEY STAKEHOLDERS, BIDMC CLINICAL AND ADMINISTRATIVE STAFF, AND THE COMMUNITY AT-LARGE, 3) DEVELOP A REPORT AND DETAILED STRATEGIC PLAN, AND 4) COMPLY WITH ALL COMMONWEALTH ATTORNEY GENERAL AND FEDERAL IRS COMMUNITY BENEFITS REQUIREMENTS. DATA SOURCES INCLUDED A BROAD ARRAY OF PUBLICLY AVAILABLE SECONDARY DATA, KEY INFORMANT INTERVIEWS, AND FOUR COMMUNITY FORUMS.BETH ISRAEL DEACONESS MEDICAL CENTER'S COMMUNITY BENEFITS PROGRAM IS PREDICATED ON THE NOTION OF PARTNERSHIP AND DIALOGUE WITH ITS MANY COMMUNITIES. BIDMC'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM DISCUSSIONS WITH AND OBSERVATIONS BY, HEALTHCARE AND HEALTH-RELATED WORKERS IN THE NEIGHBORHOODS AS WELL AS MORE FORMAL ASSESSMENTS THROUGH AVAILABLE PUBLIC HEALTH DATA, FOCUS GROUPS, SURVEYS, ETC. THESE DATA WERE THEN AUGMENTED BY DEMOGRAPHIC AND HEALTH STATUS INFORMATION GLEANED FROM A VARIETY OF SOURCES INCLUDING THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, THE BOSTON PUBLIC HEALTH COMMISSION, FEDERAL RESOURCES SUCH AS THE INSTITUTE OF MEDICINE, AND CENTERS FOR DISEASE CONTROL AND PREVENTION, AND REVIEW OF LITERATURE RELEVANT TO A PARTICULAR COMMUNITY'S NEEDS.THE ARTICULATION OF EACH SPECIFIC COMMUNITY'S NEEDS (DONE IN PARTNERSHIP BETWEEN BETH ISRAEL DEACONESS MEDICAL CENTER AND COMMUNITY PARTNERS) IS USED TO INFORM BIDMC'S DECISION-MAKING ABOUT PRIORITIES FOR COMMUNITY BENEFITS EFFORTS. FOLLOWING THE GUIDING PRINCIPLES DESCRIBED ABOVE, FOR EACH PRIORITY AREA, BIDMC WORKS IN CONCERT WITH COMMUNITY RESIDENTS AND LEADERS TO DESIGN SPECIFIC ACTIONS TO BE UNDERTAKEN EACH YEAR. EACH COMPONENT OF THE PLAN IS THUS DEVELOPED AND EVENTUALLY WOVEN INTO THE ANNUAL GOALS AND AGENDA FOR THE MEDICAL CENTER'S COMMUNITY BENEFITS PLAN THAT IS ADOPTED BY THE BOARD OF DIRECTOR'S COMMUNITY BENEFITS COMMITTEE.2016 COMMUNITY HEALTH NEEDS ASSESSMENT - SUMMARY OF FINDINGSSOCIAL DETERMINANTS AND HEALTH RISK FACTORS- SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A TREMENDOUS IMPACT ON MANY SEGMENTS OF THE POPULATION: THE DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE CBSA'S LOW INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY INTEGRATION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. LARGE PROPORTIONS OF INDIVIDUALS RESIDING WITHIN BOSTON AND BIDMC'S COMMUNITY BENEFITS SERVICE AREA LIVE IN POVERTY, HAVE LIMITED FORMAL EDUCATION, ARE UNEMPLOYED, AND STRUGGLE TO AFFORD FOOD AND OTHER ESSENTIAL HOUSEHOLD ITEMS. THESE POPULATIONS ARE DISPROPORTIONATELY FROM RACIALLY/ETHNICALLY DIVERSE GROUPS AND, PARTLY AS A RESULT OF THEIR POVERTY, FACE DISPARITIES IN HEALTH AND ACCESS TO CARE OUTCOMES. IT IS CRITICAL TO NOTE THAT THERE IS A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. IT IS INSUFFICIENT TO TALK SOLELY ABOUT RACE/ETHNICITY, IMMIGRATION STATUS, OR LANGUAGE; AS THE UNDERLYING AND CORRELATIVE ISSUES RELATED TO HEALTH AND WELL-BEING INVOLVE ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION.- DISPARITIES IN HEALTH OUTCOMES EXIST IN BIDMC CBSA BY RACE/ETHNICITY, FOREIGN BORN STATUS, AND LANGUAGE: AS WAS ESTABLISHED IN THE FY 2013 BIDMC COMMUNITY BENEFITS CHNA REPORT, THERE ARE MAJOR HEALTH DISPARITIES FOR RESIDENTS LIVING IN BIDMC'S CBSA. THIS CONTINUES TO BE PARTICULARLY TRUE FOR RACIALLY/ETHNICALLY DIVERSE, FOREIGN-BORN, AND NON-ENGLISH SPEAKING RESIDENTS LIVING IN THE NEIGHBORHOODS IN BOSTON THAT ARE PART OF BIDMC'S CBSA (I.E., ALLSTON/BRIGHTON, DORCHESTER, FENWAY, ROXBURY, AND SOUTH END/CHINATOWN). THE IMPACT OF RACISM, BARRIERS TO CARE, AND DISPARITIES IN HEALTH OUTCOMES THAT THESE POPULATIONS FACE ARE WIDELY DOCUMENTED IN THE LITERATURE AND ARE CONFIRMED BY NUMEROUS NATIONAL, COMMONWEALTH, AND LOCAL DATA SOURCES, INCLUDING DATA FROM THE BOSTON PUBLIC HEALTH COMMISSION 2014-15 HEALTH OF BOSTON REPORT.- IT IS CRUCIAL THAT THESE DISPARITIES BE ADDRESSED AND, TO THIS END, BIDMC'S FY 17-19 CHIP CONTINUES TO INCLUDE A MYRIAD OF PROGRAMS, STRATEGIC INTERVENTIONS, AND SERVICES THAT ARE CAREFULLY TARGETED TO ADDRESS THESE DISPARITIES. HOWEVER, IT IS CRITICAL TO NOTE THAT THERE IS A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. THE UNDERLYING ISSUE IS NOT ONLY RACE/ETHNICITY, FOREIGN BORN STATUS, OR LANGUAGE BUT RATHER A BROAD ARRAY OF INTER-RELATED ISSUES INCLUDING ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION. ARGUABLY, THESE ARE THE LEADING DETERMINANTS OF HEALTH FOR ALL URBAN COMMUNITIES IN THE UNITED STATES, AND THEY ARE DAUNTING CHALLENGES. MANY OF BOSTON'S MAJOR ACADEMIC AND HEALTHCARE INSTITUTIONS, INCLUDING BIDMC, HAVE BEEN AT THE HEART OF THIS NATIONAL DIALOGUE FOR DECADES. BIDMC IS COMMITTED TO DOING WHAT IT CAN TO ADDRESS THESE FACTORS AND EVERY PRIORITY AREA AND GOAL IN BIDMC'S FY 16-19 CHIP IS STRUCTURED TO ADDRESS HEALTH DISPARITIES AND INEQUITIES IN SOME WAY. 2016 COMMUNITY HEALTH NEEDS ASSESSMENT - SUMMARY OF FINDINGS (CONTINUED) - LIMITED ACCESS TO PRIMARY CARE MEDICAL AND SPECIALTY CARE, ORAL HEALTH, AND BEHAVIORAL HEALTH SERVICES FOR LOW INCOME, MEDICAID INSURED, UNINSURED, AND OTHER POPULATION SEGMENTS FACING BARRIERS TO CARE. DESPITE THE FACT THAT MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE AND THE COMMUNITIES THAT MAKE UP BIDMC'S CBSA HAVE STRONG, ROBUST SAFETY NET SYSTEMS, THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW INCOME, MEDICAID INSURED, UNINSURED, AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL AND BEHAVIORAL HEALTH SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE, AND IMPROVE THE QUALITY OF PRIMARY CARE AND SPECIALTY MEDICAL, ORAL HEALTH, AND BEHAVIORAL HEALTH SERVICES.- HIGH RATES OF THE LEADING HEALTH RISK FACTORS (E.G., LACK OF NUTRITIONAL FOOD AND PHYSICAL ACTIVITY, ALCOHOL/ILLICIT DRUG USE, AND TOBACCO USE). ONE OF THE LEADING FINDINGS FROM THE ASSESSMENT IS THAT MANY COMMUNITIES AND/OR POPULATION SEGMENTS IN BIDMC'S CBSA HAVE HIGH RATES OF CHRONIC PHYSICAL AND BEHAVIORAL HEALTH CONDITIONS. IN SOME PEOPLE THESE CONDITIONS HAVE UNDERLYING GENETIC ROOTS THAT ARE HARD TO COUNTER. HOWEVER, FOR MOST PEOPLE THESE CONDITIONS ARE WIDELY CONSIDERED TO BE PREVENTABLE OR MANAGEABLE. ADDRESSING THE LEADING RISK FACTORS IS AT THE ROOT OF A SOUND CHRONIC DISEASE PREVENTION AND MANAGEMENT STRATEGY.BEHAVIORAL HEALTH- HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY, AND STRESS). IF THE IMPACT OF SOCIAL DETERMINANTS WAS THE LEADING FINDING, A CLOSE SECOND WAS THE PROFOUND IMPACT THAT BEHAVIORAL HEALTH ISSUES (I.E., SUBSTANCE USE AND MENTAL HEALTH) ARE HAVING ON INDIVIDUALS, FAMILIES AND COMMUNITIES IN EVERY GEOGRAPHIC REGION AND EVERY POPULATION SEGMENT IN BIDMC'S CBSA. DEPRESSION/ANXIETY, SUICIDE, OPIOID AND PRESCRIPTION DRUG DEPENDENCY, AND ALCOHOL AND MARIJUANA USE, PARTICULARLY IN YOUTH, ARE MAJOR HEALTH ISSUES AND ARE HAVING A TREMENDOUS IMPACT ON THE POPULATION AS WELL AS A BURDEN ON THE SERVICE SYSTEM. THE FACT THAT PHYSICAL AND BEHAVIORAL HEALTH ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID ABUSE IN THE COMMONWEALTH.- LIMITED ACCESS TO BEHAVIORAL HEALTH SERVICES, PARTICULARLY FOR LOW INCOME, MEDICAID INSURED, UNINSURED, AND THOSE WITH COMPLEX, MULTI-FACETED ISSUES. DESPITE THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON ALL SEGMENTS OF THE POPULATION, THERE IS AN EXTREMELY LIMITED SERVICE SYSTEM AVAILABLE TO MEET THE NEEDS THAT EXIST FOR THOSE WITH ALL MILD TO MODERATE EPISODIC ISSUES OR THOSE WITH MORE SERIOUS AND COMPLEX, CHRONIC CONDITIONS. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE (INCLUDING STIGMA), AND IMPROVE THE QUALITY OF PRIMARY CARE AND SPECIALIZED BEHAVIORAL HEALTH SERVICES.CHRONIC DISEASE MANAGEMENT- HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). THE ASSESSMENT'S QUANTITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN BIDMC'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN MANY COMMUNITIES THESE RATES ARE STATISTICALLY HIGHER THAN COMMONWEALTH RATES, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. HOWEVER, EVEN FOR THOSE COMMUNITIES WHERE THE RATES ARE NOT STATISTICALLY HIGHER, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH.- LIMITED ACCESS TO CANCER SCREENING FOR RACIAL/ETHNIC DIVERSITY AND OTHER AT-RISK POPULATIONS. MANY OF THE COMMUNITIES THAT ARE PART OF BIDMC'S CBSA HAVE HIGH CANCER MORTALITY RATES. THIS IS PARTICULARLY TRUE FOR CERTAIN CANCERS IN SPECIFIC COMMUNITIES IN SPECIFIC BOSTON NEIGHBORHOODS, SUCH AS ROXBURY, DORCHESTER, AND SOUTH END/CHINATOWN THAT HAVE A HIGH PROPORTION OF RACIAL/ETHNIC DIVERSITY. AT THE ROOT OF ADDRESSING HIGH MORTALITY IS SCREENING, EARLY DETECTION AND ACCESS TO TIMELY TREATMENT.- HIGH RATES OF HIV/AIDS PARTICULARLY ON THE OUTER PORTION OF CAPE COD AND IN A NUMBER OF BOSTON NEIGHBORHOODS THAT ARE PART OF BIDMC'S CBSA. GREAT STRIDES HAVE BEEN MADE IN CONTROLLING AND MANAGING HIV/AIDS, AND FOR MANY IT IS MANAGED AS A CHRONIC CONDITION WITH MEDICATIONS. RATES OF ILLNESS, DEATH, AND HIV TRANSMISSION DECLINED OVERALL IN THE PAST DECADE. HOWEVER, HIV/AIDS STILL HAS A MAJOR IMPACT ON CERTAIN SEGMENTS OF THE POPULATION, INCLUDING MEN WHO HAVE SEX WITH MEN AND INJECTION DRUG USERS. IN BIDMC'S CBSA, RATES OF HIV/AIDS ARE PARTICULARLY HIGH IN THE OUTER PORTION OF CAPE COD AND A NUMBER OF BOSTON'S NEIGHBORHOODS.ACCESS TO CARE- LIMITED ACCESS TO PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH CARE SERVICES FOR LOW INCOME, MEDICAID INSURED, UNINSURED, AND OTHER VULNERABLE POPULATIONS FACING HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT 1) MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE AND 2) THE COMMUNITIES THAT MAKE UP BIDMC'S CBSA HAVE STRONG, ROBUST SAFETY NET SYSTEMS THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW INCOME, MEDICAID INSURED, UNINSURED, AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL AND ORAL HEALTH SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE, AND IMPROVE THE QUALITY OF PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH SERVICES.- BARRIERS TO ACCESS AND DISPARITIES IN HEALTH OUTCOMES CONTINUE TO CHALLENGE THREE SPECIAL POPULATIONS (INFANTS/MOTHERS/FATHERS, FRAIL OLDER ADULTS, AND LESBIAN, GAY, BI-SEXUAL, AND TRANSGENDER (LGBT) POPULATIONS. BASED ON INFORMATION GATHERED PRIMARILY FROM THE INTERVIEWS AND COMMUNITY FORUMS, THE ASSESSMENT IDENTIFIED A NUMBER OF SPECIAL POPULATIONS THAT FACE BARRIERS TO CARE AND DISPARITIES IN ACCESS. MORE SPECIFICALLY, INFANTS/MOTHERS/FATHERS, FRAIL OLDER ADULTS, AND THE LESBIAN, GAY, BI-SEXUAL, AND TRANSGENDER (LGBT) POPULATIONS FACE DISPARITIES IN ACCESS AND OUTCOME AND ARE PARTICULARLY AT-RISK. IF THESE DISPARITIES ARE GOING TO BE ADDRESSED THEN CARE NEEDS TO BE TAKEN TO TAILOR IDENTIFICATION/ SCREENING AND PREVENTIVE SERVICES AS WELL AS ACUTE AND CHRONIC DISEASE MANAGEMENT SERVICES FOR THESE SPECIAL POPULATIONS. COMMUNITY HEALTH NEEDS ASSESSMENT - ADDRESSING COMMUNITY HEALTH NEEDS LARGE PROPORTIONS OF INDIVIDUALS RESIDING WITHIN BOSTON AND BIDMC'S COMMUNITY BENEFITS SERVICE AREA LIVE IN POVERTY, HAVE LIMITED FORMAL EDUCATION, ARE UNEMPLOYED, AND STRUGGLE TO AFFORD FOOD AND OTHER ESSENTIAL HOUSEHOLD ITEMS. THESE POPULATIONS ARE DISPROPORTIONATELY FROM RACIAL/ETHNIC MINORITY GROUPS AND, PARTLY AS A RESULT OF THEIR POVERTY, FACE DISPARITIES IN HEALTH AND ACCESS TO CARE OUTCOMES. IT IS CRITICAL TO NOTE THAT THERE IS A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. IT IS INSUFFICIENT TO TALK SOLELY ABOUT RACE/ETHNICITY, FOREIGN BORN STATUS, OR LANGUAGE; AS THE UNDERLYING AND CORRELATIVE ISSUES RELATED TO HEALTH AND WELL-BEING INVOLVE ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION.BIDMC STRIVES TO ADDRESS THE PRIORITY AREAS IDENTIFIED IN ITS CHNA AND IMPLEMENTATION STRATEGY WHICH ARE AVAILABLE ON THE MEDICAL CENTER'S WEBSITE.BIDMC'S MOST RECENTLY COMPLETED CHNA AND IMPLEMENTATION STRATEGY (CHIP) ARE AVAILABLE ON THE BIDMC WEBSITE AT: HTTP://WWW.BIDMC.ORG/~/MEDIA/FILES/CENTERS%20AND%20DEPARTMENTS/COMMUNITY%20INITIATIVES/FY16%20COMMUNITY%20HEALTH%20NEEDS%20ASSESSMENT.PDFIN ADDITION, THE CHNA AND CHIP WHICH WERE COMPLETED PREVIOUSLY COMPLETED DURING THE FISCAL YEAR ENDED 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'S ARE AVAILABLE ON THE BIDMC WEBSITE AT:HTTP://WWW.BIDMC.ORG/~/MEDIA/FILES/CENTERS%20AND%20DEPARTMENTS/COMMUNITY%20INITIATIVES/FINALCHNAREPORT92313.PDFIN ADDITION, ALL OF THESE DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST. (SCHEDULE H, PART V, SECTION B, LINE 7A)A SUMMARY OF THE MEDICAL CENTER'S COMMUNITY BENEFIT ACTIVITIES WHICH ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2017 AND PRIORITIZED IN THE RELATED CHIP ARE PROVIDED HERE ALONG WITH THE ENTITIES WITH WHICH THE MEDICAL CENTER PARTNERS RELATED TO THESE EFFORTS.KEY: BASELINE - 2017, YEAR 1 - 2018, YEAR 2 - 2019, YEAR 3 - 2020PRIORITY AREA 1: SOCIAL DETERMINANTS AND HEALTH RISK FACTORSSOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A TREMENDOUS IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM BIDMC'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE COMMUNITY BENEFITS SERVICE AREA'S LOW INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY INTEGRATION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. LARGE PROPORTIONS OF INDIVIDUALS RESIDING WITHIN BOSTON AND BIDMC'S COMMUNITY BENEFITS SERVICE AREA LIVE IN POVERTY, HAVE LIMITED FORMAL EDUCATION, ARE UNEMPLOYED, AND STRUGGLE TO AFFORD FOOD AND OTHER ESSENTIAL HOUSEHOLD ITEMS. THESE POPULATIONS ARE DISPROPORTIONATELY FROM RACIALLY/ETHNICALLY DIVERSE GROUPS AND, PARTLY AS A RESULT OF THEIR POVERTY, FACE DISPARITIES IN HEALTH AND ACCESS TO CARE OUTCOMES. IT IS CRITICAL TO NOTE THAT THERE IS A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. IT IS INSUFFICIENT TO TALK SOLELY ABOUT RACE/ETHNICITY, IMMIGRATION STATUS, OR LANGUAGE; AS THE UNDERLYING AND CORRELATIVE ISSUES RELATED TO HEALTH AND WELL-BEING INVOLVE ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION.KEY: BASELINE - 2017, YEAR 1 - 2018, YEAR 2 - 2019, YEAR 3 - 2020________________________________________GOAL: INCREASE PHYSICAL ACTIVITY AND HEALTHY EATINGTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:1.1 INCREASE THE NUMBER OF CHILDREN, YOUTH, AND ADULTS WHO ARE PHYSICALLY ACTIVE1.2 IMPLEMENT PROGRAMS AT BOWDOIN STREET WELLNESS CENTER1.3 INCREASE ACCESS TO HEALTHY AND AFFORDABLE FOODS IN COMMUNITY1.4 IMPROVE NUTRITIONAL QUALITY OF THE FOOD SUPPLY1.5 DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITYCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT AND PROMOTE THE DEVELOPMENT OF WALKING AND OTHER PHYSICAL ACTIVITY GROUPS IN SCHOOLS, COMMUNITY-BASED AND PRIMARY CARE-BASED SETTINGS (E.G., BOWDOIN STREET WELLNESS CENTER)- SUPPORT AND COLLABORATE WITH BPHC AND COMMUNITY-BASED ORGANIZATIONS (E.G., DAILY TABLE, GBFB, BACH, ETC.) TO PROMOTE ACCESSIBLE/AFFORDABLE HEALTHY FOOD INCLUDING HEALTHY INCENTIVES PROGRAM, FARMERS MARKETS, AND COMMUNITY SUPPORTED AGRICULTURE (CSA) PROGRAM- INCREASE ACCESS TO HEALTHY FOOD CHOICES AVAILABLE AT BIDMC FOR PATIENTS AND STAFF- SUPPORT HEALTHY CHAMPIONS, A GROUP OF TEENAGERS IN HEALTHY COOKING AND EDUCATION WORKSHOPS AT BSHCMETRICS AND STATUS UPDATE:- NUMBER OF SCHOOLS, COMMUNITY GROUPS, AND PRIMARY CARE SETTINGS PARTICIPATING IN WALKING PROGRAMS AND OTHER PHYSICAL ACTIVITY GROUPS (FY17: 44 PUBLIC SCHOOLS WITH 7,175 CHILDREN AND 1,000 SCHOOL STAFF)- NUMBER OF FAMILIES PARTICIPATING IN CSA (FY17: 30 FAMILIES)- PERCENTAGE OF BIDMC TOTAL FOOD AND BEVERAGE SPEND ON LOCAL PRODUCTS BY 2019 (GOAL: 12% BY 2019)- PERCENTAGE OF BIDMC TOTAL BEVERAGE SPEND ON HEALTHY BEVERAGES BY 2019 (GOAL 50% BY 2019)- OUNCES OF MEAT AND POULTRY PER MEAL SERVED BY BIDMC BY 2019 (GOAL: 1.5OZ BY 2019)- NUMBER OF HOSTED HEALTHY CHAMPIONS (FY17: 15 HEALTHY CHAMPIONS)- COMMUNITY PARTNERS: COMMUNITY CARE ALLIANCE, BOSTON PUBLIC HEALTH COMMISSION, BOSTON ALLIANCE FOR COMMUNITY HEALTH, BOWDOIN STREET HEALTH CENTER, BOSTON PUBLIC SCHOOLS, DAILY TABLE, GREATER BOSTON FOOD BAN, CHARLES RIVER COMMUNITY HEALTH, MAYOR'S OFFICE OF FOOD INITIATIVES GOAL: PROMOTE VIOLENCE PREVENTION- SAFE NEIGHBORHOODS AND COMMUNITY COHESION TARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:2.1 INCREASE ACCESS TO MENTAL HEALTH SERVICES AT BSHC FOR AFFECTED VICTIMS2.2 MAINTAIN PARTICIPATION IN ADVOCATE EDUCATION AND SUPPORT PROJECT2.3 PROVIDE COUNSELING AND OTHER MEDICAL SERVICES TO SEXUAL ASSAULT VICTIMS2.4 PROVIDE GRIEVING SUPPORT ACTIVITIES2.5 CONDUCT NEIGHBORHOOD CAMPAIGNS TO ENGAGE COMMUNITY AND CREATE GREATER COMMUNITY COHESIONCOMMUNITY ACTIVITIES/STRATEGIES: - SUPPORT PROGRAMS IN BSHC THAT INTEGRATE SERVICES PROVIDED BY BEHAVIORAL HEALTH SPECIALISTS AND MONITOR, ASSESS, AND TREAT THOSE EXPERIENCING TRAUMA FROM VIOLENCE- HOLD HEALING SERVICES WHEN APPROPRIATE FOR COMMUNITY RESIDENTS- PARTICIPATE IN COMMUNITY INTERVENTIONS THAT RAISE AWARENESS ABOUT VIOLENCE, ENGAGE THE COMMUNITY, ADDRESS FACTORS ASSOCIATED WITH VIOLENCE (E.G., "BROKEN WINDOW" THEORY, BLOCK CAPTAINS PROGRAM, ETC.), AND PROMOTE A SENSE OF COMMUNITY- SUPPORT AND PROMOTE THE IMPLEMENTATION OF TRAINING PROGRAMS, SUPPORT GROUPS FOR ADVOCATES AND AFFECTED COMMUNITY MEMBERS- PROVIDE OVERNIGHT STAYS FOR DOMESTIC VIOLENCE AND/OR SEXUAL ASSAULT VICTIMS WITHOUT SAFE SHELTER- CONDUCT PUBLIC POLICY ADVOCACY FOR SAFE SHELTERS AND LONG-TERM HOUSING SUPPORT- EMPOWER YOUTH TO DEVELOP LEADERSHIP SKILLS, PREVENT VIOLENCE AND CREATE CHANGE IN THEIR COMMUNITY THROUGH THE YOUTH LEADERSHIP PROGRAM AT BOWDOIN STREET HEALTH CENTERMETRICS AND STATUS UPDATE:- NUMBER OF SEXUAL ASSAULT VICTIMS RECEIVING SERVICES (FY17: PROVIDE SERVICES, INCLUDING COUNSELING FOR 75 SEXUAL ASSAULT VICTIMS. PROVIDE POST-HIV EXPOSURE PROPHYLAXIS MEDICATIONS TO 49 SEXUAL ASSAULT VICTIMS.)- NUMBER OF SAFE BED OVERNIGHT STAYS (FY17: 59)- NUMBER HEALING CIRCLES HELD WITH WOMEN, MEN, AND CHILDREN (FY17: 57)- NUMBER OF BOWDOIN GENEVA YOUTH PARTICIPATING IN THE BSHC YOUTH LEADERSHIP PROGRAM (FY17: 25)- PERCENTAGE OF YOUTH IN BSHC YOUTH LEADERSHIP PROGRAM WHO HAD A POSITIVE INCREASE ON A KNOWLEDGE AND ATTITUDE TEST BEFORE AND AFTER THE PROGRAMCOMMUNITY PARTNERS: BOWDOIN STREET HEALTH CENTER (BSHC), BOSTON PUBLIC HEALTH COMMISSION, OTHER BOWDOIN/ GENEVA NEIGHBORHOOD ORGANIZATIONS________________________________________GOAL: SUPPORT WORKFORCE DEVELOPMENT AND CREATION OF EMPLOYMENT OPPORTUNITIESTARGET POPULATION: YOUTH, YOUNG ADULTS, ADULTS, BIDMC EMPLOYEESPROGRAMMATIC OBJECTIVES: 3.1 ORGANIZE AND SUPPORT PIPELINE PROGRAMS TO ENHANCE SKILLS AND CAREER ADVANCEMENT3.2 PROVIDE OPPORTUNITIES THROUGH EMPLOYEE CAREER INITIATIVE (ECI) FOR COLLEGE-LEVEL COURSES AS WELL AS COUNSELING3.3 OFFER ESOL CLASSES, GED CLASSES, A BASIC COMPUTER SKILLS COURSE, CITIZENSHIP CLASSES, AND A FINANCIAL LITERACY CLASS3.4 PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR COMMUNITY RESIDENTS3.5 PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR MIDDLE AND HIGH SCHOOL STUDENTS3.6 CONTINUE TRAIN4CHANGE AT BSHC3.7 IMPLEMENT AND EXPAND LEARN AND EARN PROGRAM THROUGH BUNKER HILL COMMUNITY COLLEGECOMMUNITY ACTIVITIES/STRATEGIES: - ORGANIZE AND SUPPORT PIPELINE PROGRAMS TO ENHANCE SKILLS AND CAREER ADVANCEMENT - PROVIDE OPPORTUNITIES THROUGH EMPLOYEE CAREER INITIATIVE (ECI) FOR COLLEGE-LEVEL COURSES AS WELL AS COUNSELING - OFFER ESOL CLASSES, GED CLASSES, A BASIC COMPUTER SKILLS COURSE, CITIZENSHIP CLASSES, AND A FINANCIAL LITERACY CLASS - PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR COMMUNITY RESIDENTS- PROVIDE JOB AND CAREER INTRODUCTORY OPPORTUNITIES FOR MIDDLE AND HIGH SCHOOL STUDENTS- CONTINUE TRAIN4CHANGE AT BSHC- IMPLEMENT AND EXPAND LEARN AND EARN PROGRAM THROUGH BUNKER HILL COMMUNITY COLLEGEMETRICS AND STATUS UPDATE: - NUMBER OF PIPELINE PROGRAMS OFFERED (FY17: 4)- NUMBER OF PARTICIPANTS IN PIPELINE PROGRAM (FY17: 31)- NUMBER OF PARTICIPANTS GRADUATED FROM PIPELINE PROGRAMS (FY17: 21)- NUMBER OF EMPLOYEES RECEIVING ECI SERVICES (FY17: 707)- NUMBER OF EMPLOYEES ENROLLED IN ESOL CLASSES (FY17: 19)- NUMBER OF EMPLOYEES PARTICIPATING IN COMPUTER SKILLS, CITIZENSHIP, AND FINANCIAL LITERACY CLASSES (FY17: 107 EMPLOYEES PARTICIPATED IN A 10-WEEK COMPUTER SKILLS CLASS; 11 ATTENDED CITIZENSHIP CLASSES; AND 123 ATTENDED A FINANCIAL LITERACY CLASS)- NUMBER OF ADULT INTERNS PLACED (FY17: 8)- NUMBER OF ADULT INTERNS HIRED AFTER INTERNSHIPS (FY17: 3)- NUMBER OF REFERRALS/RECOMMENDATIONS GIVEN ON BEHALF OF INTERNS SEEKING JOBS AT LOCAL COMMUNITY ORGANIZATIONS (FY17: 81)- NUMBER OF PARTICIPANTS IN BSHC'S TRAIN4CHANGE (FY17: 4)- NUMBER OF INTERNS HIRED FROM BUNKER HILL COMMUNITY COLLEGE'S LEARN AND EARN PROGRAM (FY17: 1)- NUMBER OF SUMMER JOB OPPORTUNITIES PROVIDED (FY17: 41)- NUMBER OF SCHOOL INTERNS HIRED (FY17: 3)- NUMBER OF BOSTON PUBLIC SCHOOL STUDENTS HOSTED FOR PIC'S ANNUAL JOB SHADOW DAY (FY17: 31)- NUMBER OF MEDICAL CHAMPIONS MENTORED (FY17: 10)- NUMBER OF HIGH SCHOOL STUDENTS HOSTED IN SUMMER HEALTH CORPS PROGRAM (FY17: 41)COMMUNITY PARTNERS: BIDMC ADMIN. AND CLINICAL STAFF, BOSTON PUBLIC SCHOOLS, BOSTON PRIVATE INDUSTRY COUNCIL (PIC), BOWDOIN STREET HEALTH CENTER, BUNKER HILL COMMUNITY COLLEGE, JEWISH VOCATIONAL SERVICES (JVS), ONE-STOP CAREER CENTER, ST. MARY'S CENTER FOR WOMEN AND CHILDREN GOAL: PROMOTE ENVIRONMENTAL SUSTAINABILITY TARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:4.1 REDUCE ENERGY AND WATER CONSUMPTIONCOMMUNITY ACTIVITIES/STRATEGIES:- IMPLEMENT ENVIRONMENTAL STRATEGIC PLAN- PROMOTE RECYCLING, COMPOSTING, AND CONSERVATION OF WATER AND ENERGY THROUGHOUT BIDMC- REDUCE GREENHOUSE GAS EMISSIONS AND INCREASE DIVERSION RATE AT BIDMCMETRICS AND STATUS UPDATE: - GREEN CHEMICAL CLEANING PRODUCT SPEND AT BIDMC- GREENHOUSE GAS (GOAL: REDUCE EMISSIONS BY 25PERCENTAGE BY 2020)- DIVERSION RATE (GOAL: REACH 35PERCENTAGE BY 2019)COMMUNITY PARTNERS: MASCO, HEALTH CARE WITHOUT HARM, PRACTICE GREEN HEALTH, EPA, BOSTON GREEN RIBBON COMMISSION, BIDMC ENVIRONMENTAL SUSTAINABILITY COMMITTEE________________________________________GOAL: PROMOTE TRANSPORTATION EQUITYTARGET POPULATION: YOUTH, ADULTS, BIDMC EMPLOYEESPROGRAMMATIC OBJECTIVES:5.1 PROMOTE TRANSPORTATION EQUITY FOR EMPLOYEES AND PATIENTS AT BIDMCCOMMUNITY ACTIVITIES/STRATEGIES: - GREEN COMMUTING AT BIDMC - REDUCE TRANSPORTATION BARRIER FOR PATIENTS ACCESSING CARE AT BIDMC METRICS AND STATUS UPDATE: - NUMBER OF EMPLOYEES COMMUTING TO WORK VIA PUBLIC TRANSPORT, CAR, BIKE, WALKING, OTHER- NUMBER OF TAXI OR CHAIR CAR VOUCHERS PROVIDED TO PATIENTS BY BIDMCPRIORITY AREA 2: CHRONIC DISEASE MANAGEMENTHIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). THE ASSESSMENT'S QUANTITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN BIDMC'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN MANY COMMUNITIES THESE RATES ARE STATISTICALLY HIGHER THAN COMMONWEALTH RATES, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. HOWEVER, EVEN FOR THOSE COMMUNITIES WHERE THE RATES ARE NOT STATISTICALLY HIGHER, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH.LIMITED ACCESS TO CANCER SCREENING FOR RACIAL/ETHNIC DIVERSITY AND OTHER AT-RISK POPULATIONS. MANY OF THE COMMUNITIES THAT ARE PART OF BIDMC'S CBSA HAVE HIGH CANCER MORTALITY RATES. THIS IS PARTICULARLY TRUE FOR CERTAIN CANCERS IN SPECIFIC COMMUNITIES IN SPECIFIC BOSTON NEIGHBORHOODS, SUCH AS ROXBURY, DORCHESTER, AND SOUTH END/CHINATOWN THAT HAVE A HIGH PROPORTION OF RACIAL/ETHNIC DIVERSITY. AT THE ROOT OF ADDRESSING HIGH MORTALITY IS SCREENING, EARLY DETECTION AND ACCESS TO TIMELY TREATMENT.HIGH RATES OF HIV/AIDS PARTICULARLY ON THE OUTER PORTION OF CAPE COD AND IN A NUMBER OF BOSTON NEIGHBORHOODS THAT ARE PART OF BIDMC'S CBSA. GREAT STRIDES HAVE BEEN MADE IN CONTROLLING AND MANAGING HIV/AIDS, AND FOR MANY IT IS MANAGED AS A CHRONIC CONDITION WITH MEDICATIONS. RATES OF ILLNESS, DEATH, AND HIV TRANSMISSION DECLINED OVERALL IN THE PAST DECADE. HOWEVER, HIV/AIDS STILL HAS A MAJOR IMPACT ON CERTAIN SEGMENTS OF THE POPULATION, INCLUDING MEN WHO HAVE SEX WITH MEN AND INJECTION DRUG USERS. IN BIDMC'S CBSA, RATES OF HIV/AIDS ARE PARTICULARLY HIGH IN THE OUTER PORTION OF CAPE COD AND A NUMBER OF BOSTON'S NEIGHBORHOODS.KEY: BASELINE - 2017, YEAR 1 - 2018, YEAR 2 - 2019, YEAR 3 - 2020________________________________________GOAL: IMPROVE CHRONIC DISEASE MANAGEMENT TARGET POPULATION: LOW INCOME ADULTSPROGRAMMATIC OBJECTIVES:1.1 INCREASE THE NUMBER OF ADULTS WHO RECEIVE EDUCATION AND COUNSELING REGARDING RISK FACTORS, HEALTHY BEHAVIORS TO INCREASE CHRONIC DISEASE HEALTH LITERACY1.2 INCREASE THE NUMBER OF ADULTS SCREENED FOR DIABETES, HYPERTENSION, HIV/AIDS, AND ASTHMA1.3 INCREASE THE NUMBER OF ADULTS WITH DIABETES, HYPERTENSION, HIV/AIDS, AND PERSISTENT ASTHMA WHO RECEIVE EVIDENCE-BASED COUNSELING/ COACHING AND TREATMENT1.4 INCREASE THE NUMBER OF ADULTS WITH DIABETES, HYPERTENSION, HIV/AIDS, AND PERSISTENT ASTHMA WHOSE CONDITIONS ARE MONITORED AND CONTROLLEDCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT PROGRAMS IN CCA CLINICS INCLUDING LIVE AND LEARN DIABETES AT CRCH THAT EDUCATE AND SCREEN PATIENTS FOR DIABETES, HYPERTENSION, AND PERSISTENT ASTHMA- PROVIDE EVIDENCED-BASED COUNSELING/COACHING AND TREATMENT, AS WELL AS APPROPRIATE REFERRALS FOR SPECIALTY CARE SERVICES FOR THOSE WHO SCREEN POSITIVE FOR DIABETES, HYPERTENSION, HIV/AIDS, AND ASTHMA- PROVIDE SCREENING, EDUCATION/COUNSELING, AND TREATMENT SERVICES HIV/AIDS AND HIV/HCV CO-INFECTION- SUPPORT GROUPS FOR MEN AND WOMEN LIVING WITH HIV/AIDS- SUPPORT PRIMARY CARE PROVIDER EDUCATION AT CRCH IN THE AREA OF DIABETES MANAGEMENTMETRICS AND STATUS UPDATE:- NUMBER OF HIV/AIDS PATIENTS EDUCATED/COUNSELED, AND TREATED FOR HIV (FY17: 2,577)- PERCENTAGE OF HIV POSITIVE PATIENTS SCREENED FOR HCV (FY17: 99%)- NUMBER OF BSHC PATIENTS PARTICIPATING IN DISEASE MANAGEMENT PROGRAMS (FY17: 900)- PERCENTAGE OF CCA FQHC PATIENTS WITH DIABETES WITH HBA1C < 9 (FY17: 79%)- PERCENTAGE OF CCA FQHC PATIENTS WITH HYPERTENSION WHO HAD A BLOOD PRESSURE < 140/90 (FY17: 62.4%)- PERCENTAGE OF CCA FQHC PERSISTENT ASTHMATIC PATIENTS WITH PHARMACOLOGICAL THERAPY (FY17: 86%)- NUMBER OF GROUPS CONVENED FOR HIV/AIDS SUPPORT GROUPS (FY17: CONTINUED EXPERIENCED AND POSITIVE GROUP FOR GAY MEN WHO HAVE ADVANCED AIDS - 22 SESSIONS; 2 HOURS PER SESSION; 9 PARTICIPANTS AND SUPPORT GROUP FOR HIV+ WOMEN - 22 SESSIONS; 2 HOURS PER SESSION; 8 PARTICIPANTS)- IMPROVE CARE MANAGEMENT FOR BSHC PATIENTS WITH CHRONIC DISEASE - BSHC PATIENTS THAT HAD AT LEAST ONE HBA1C TEST (FY17: 87.5%) - BSHC PATIENTS THAT HAD AT LEAST ONE LDL TEST (FY17: 56%) - BSHC PATIENTS THAT HAD AT LEAST ONE EYE EXAM (FY17: 38.9%)COMMUNITY PARTNERS: CCA CLINICS, JOSLIN DIABETES CENTER GOAL: IMPROVE CARE TRANSITIONS FOR THOSE WITH CHRONIC HEALTH CONDITIONS TARGET POPULATION: ELDER ADULTS, LOW INCOME ADULTSPROGRAMMATIC OBJECTIVES:2.1 IMPROVE CARE TRANSITIONS FROM THE INPATIENT HOSPITAL SETTING TO OTHER CARE SETTINGS, TO IMPROVE QUALITY OF CARE AND TO REDUCE READMISSIONS FOR HIGH-RISK PATIENTSCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT PREVENTABLE ADMISSIONS CARE TEAM (PACT) PROGRAM METRICS AND STATUS UPDATE: - NUMBER OF HEALTH CENTER PATIENTS ENROLLED IN PACT PROGRAM- NUMBER OF MEDICAID PATIENTS ENROLLED IN PACT PROGRAMCOMMUNITY PARTNERS: CCA CLINICS________________________________________GOAL: INCREASE CANCER SCREENING AND SUPPORT CANCER PATIENTS/CAREGIVERSTARGET POPULATION: LOW INCOME AND RACIAL/ETHNIC DIVERSE ADULTSPROGRAMMATIC OBJECTIVES:3.1 MAINTAIN AND INCREASE THE NUMBER OF LOW INCOME AND RACIAL/ETHNIC DIVERSE ADULTS EDUCATED AND SCREENED FOR CANCER3.2 MAINTAIN AND INCREASE THE NUMBER OF ADULTS WHO SCREEN POSITIVE FOR CANCER WHO ARE REFERRED FOR EDUCATION, COUNSELING AND TREATMENT3.3 MAINTAIN AND INCREASE THE NUMBER OF ADULTS WHO SCREEN POSITIVE FOR CANCER WHO ARE LINKED TO A CANCER NAVIGATORCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT ACCESS TO CANCER SCREENING AND TREATMENT FOR LOW INCOME, UNINSURED ADULTS (BREAST, PROSTATE, COLON, AND LUNG, CANCERS), INCLUDING MAMMOGRAMS, COLORECTAL SCREENING, AND LUNG CT SCANS.- SUPPORT AND PROMOTE THE CITY-WIDE CANCER NAVIGATORS PROGRAM- LINK PATIENTS SCREENED POSITIVE FOR CANCER TO CANCER PATIENT NAVIGATORS- SUPPORT SURVIVOR SELF-PORTRAIT AND TESTIMONIES ACTIVITIES TO REDUCE STIGMA IN COMMUNITIES- PROVIDE EMOTIONAL CANCER PEER SUPPORT PROGRAMS SUCH AS THE PATIENT-TO-PATIENT AND HEART-TO-HEART PROGRAM- COLLABORATE WITH THE HARVARD CATALYST TO TRANSLATE RESEARCH INTO PRACTICEMETRICS AND STATUS UPDATE: - INCREASE ACCESS TO PATIENT NAVIGATORS - NUMBER OF PATIENTS SERVED BY CHINESE PATIENT NAVIGATOR (FY17: 469) - NUMBER OF ENCOUNTERS PROVIDED BY CHINESE PATIENT NAVIGATOR (FY17: 2,279) - NUMBER OF PATIENT SERVED BY LATINA PATIENT NAVIGATOR (FY17: 231) - NUMBER OF ENCOUNTERS PROVIDED BY LATINA PATIENT NAVIGATOR (FY17: 395)- NUMBER OF PATIENT NAVIGATORS PARTICIPATING IN QUARTERLY NETWORK MEETINGS (FY17: 21)- NUMBER OF MAMMOGRAMS PROVIDED FOR LOW-INCOME WOMEN IN FENWAY, OUTER CAPE, AND SOUTH COVE (FY17: 6,368)- NUMBER OF COLON CANCER SCREENINGS PROVIDED FOR LOW-INCOME PATIENTS (FY17: 1,492)- NUMBER OF PATIENTS SCREENED FOR LUNG CANCER (FY17: 100)- NUMBER OF PATIENTS PARTICIPATING IN CANCER PEER SUPPORT PROGRAMS (FY17: 172)COMMUNITY PARTNERS: CCA CLINICS, CANCER NAVIGATOR PROGRAM, DANA FARBER HARVARD CANCER CENTER (DFHCC)________________________________________GOAL: SUPPORT OLDER ADULTS TO AGE IN PLACETARGET POPULATION: OLDER ADULTSPROGRAMMATIC OBJECTIVES:4.1 REDUCE INAPPROPRIATE READMISSIONS FOR OLDER ADULTS4.2 REDUCE ELDERLY FALLS4.3 REDUCE SOCIAL ISOLATIONCOMMUNITY ACTIVITIES/STRATEGIES:- INCREASE STRENGTH AND REDUCE THE RISK OF FALLS- OFFER HEALTH AND WELLNESS PROGRAMMING- OTHER PROGRAMS WITH HSL (PENDING)METRICS AND STATUS UPDATE: - NUMBER OF ADULTS ENROLLED IN TAI CHI CLASSES AT BSHC (FY17:29)COMMUNITY PARTNERS: BIDMC STAFF AND CLINICIANS, KIT CLARK SENIOR SERVICES, CCA CLINICS, OTHER COMMUNITY PROVIDER, HEBREW SENIOR LIFEPRIORITY AREA 3: ACCESS TO CARELIMITED ACCESS TO PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH CARE SERVICES FOR LOW INCOME, MEDICAID INSURED, UNINSURED, AND OTHER VULNERABLE POPULATIONS FACING HEALTH CARE DISPARITIES AND BARRIERS TO CARE. DESPITE THE FACT THAT 1) MASSACHUSETTS HAS ONE OF HIGHEST RATES OF HEALTH INSURANCE AND 2) THE COMMUNITIES THAT MAKE UP BIDMC'S CBSA HAVE STRONG, ROBUST SAFETY NET SYSTEMS THERE ARE STILL SUBSTANTIAL NUMBERS OF LOW INCOME, MEDICAID INSURED, UNINSURED, AND OTHERWISE VULNERABLE INDIVIDUALS WHO FACE HEALTH DISPARITIES AND ARE NOT ENGAGED IN ESSENTIAL MEDICAL AND ORAL HEALTH SERVICES. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE, AND IMPROVE THE QUALITY OF PRIMARY CARE MEDICAL, MEDICAL SPECIALTY, AND ORAL HEALTH SERVICES.BARRIERS TO ACCESS AND DISPARITIES IN HEALTH OUTCOMES CONTINUE TO CHALLENGE THREE SPECIAL POPULATIONS (INFANTS/MOTHERS/FATHERS, FRAIL OLDER ADULTS, AND LESBIAN, GAY, BI-SEXUAL, AND TRANSGENDER (LGBT) POPULATIONS. BASED ON INFORMATION GATHERED PRIMARILY FROM THE INTERVIEWS AND COMMUNITY FORUMS, THE ASSESSMENT IDENTIFIED A NUMBER OF SPECIAL POPULATIONS THAT FACE BARRIERS TO CARE AND DISPARITIES IN ACCESS. MORE SPECIFICALLY, INFANTS/MOTHERS/FATHERS, FRAIL OLDER ADULTS, AND THE LESBIAN, GAY, BI-SEXUAL, AND TRANSGENDER (LGBT) POPULATIONS FACE DISPARITIES IN ACCESS AND OUTCOME AND ARE PARTICULARLY AT-RISK. IF THESE DISPARITIES ARE GOING TO BE ADDRESSED THEN CARE NEEDS TO BE TAKEN TO TAILOR IDENTIFICATION/ SCREENING AND PREVENTIVE SERVICES AS WELL AS ACUTE AND CHRONIC DISEASE MANAGEMENT SERVICES FOR THESE SPECIAL POPULATIONS.KEY: BASELINE - 2017, YEAR 1 - 2018, YEAR 2 - 2019, YEAR 3 - 2020 GOAL: INCREASE ACCESS TO QUALITY MEDICAL SERVICES, INCLUDING PRIMARY CARE, OB/GYN, AND SPECIALTY CARE IN BOSTON'S NEIGHBORHOODS, QUINCY, AND THE OUTER PORTION OF CAPE CODTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:1.1 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY MEDICAL CARE SERVICES, INCLUDING OB/GYN SERVICE AT CCA CLINICS1.2 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING SPECIALTY CARE MEDICAL SERVICES1.3 ENSURE ACCESS TO SERVICES FOR THOSE ON THE OUTER CAPE1.4 ENSURE ACCESS TO APPROPRIATE TRAUMA CARE AND EMERGENCY SERVICES1.5 MAINTAIN OR INCREASE SUPPORT FOR HSN TRUST FUND; AND ADVOCATE FOR LEGISLATION AND POLICIES SUPPORTING PUBLIC HEALTH, MENTAL HEALTH AND SUBSTANCE USE AND ANTI-POVERTY PROGRAMS1.6 SCREEN AND ENROLL THOSE WHO QUALIFY FOR HEALTH INSURANCE THROUGH ACACOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT INSTITUTIONAL AND COMMUNITY EMERGENCY PREPAREDNESS - ENSURE CONNECTION TO SPECIALTY CARE THROUGH CARE CONNECTION'S INPATIENT DISCHARGE FOLLOW UP PROGRAM- CARE INTEGRATION THROUGH INFORMATION SHARING VIA PARTICIPATION IN MASS HIWAY AND A HEALTH INFORMATION EXCHANGE- SUPPORT MED-FLIGHT AND COORDINATED EMS IN BOSTON- SUPPORT HSN- CONDUCT "MYSTERY SHOPPING" TO ADDRESS QUALITY IMPROVEMENT- ADMINISTER ASK DEVELOPMENT EVALUATION PROGRAM- SUPPORT RESIDENT ROTATIONS INTO CCA CLINICS- EXPLORE SPREADING PACT PROGRAM TO MEDICAID COHORTMETRICS AND STATUS UPDATE: - NUMBER OF PATIENTS SERVED AT FQHC CCA CLINICS (FY17: 106,463) - NUMBER OF VISITS PROVIDED AT FQHC CCA CLINICS (FY17: 543,713) - NUMBER OF PATIENTS WITHOUT INSURANCE SERVICED AT FQHC CCA CLINICS (FY17: 11,704) - NUMBER OF REFERRALS MADE THROUGH CARE CONNECTION CALL CENTER (FY17:986) - NUMBER OF INDIVIDUALS SCREENED FOR INSURANCE ELIGIBILITY (FY17: 9,776) - NUMBER OF INDIVIDUALS ENROLLED IN ENTITLEMENT PROGRAMS (FY17: 8,716) - NUMBER OF PATIENTS SUPPORTED THROUGH HSN (2,603) - NUMBER OF MYSTERY SHOPPING SURVEYS COMPLETED (FY17:72) - NUMBER OF RESIDENTS PLACED AT CCA CLINICS (FY17: 34)COMMUNITY PARTNERS: CCA CLINICS, BIDCO________________________________________GOAL: INCREASE ACCESS TO QUALITY ORAL HEALTHTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:2.1 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY DENTAL CARE SERVICES AT CCA CLINICS2.2 CONDUCT PUBLIC POLICY ADVOCACYCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT CCA CLINICS- SUPPORT HSNMETRICS AND STATUS UPDATE:- NUMBER OF DENTAL PATIENTS AT FQHC CCA CLINICS (FY17: 25,709)- NUMBER OF UNIQUE DENTAL VISITS AT FQHC CCA CLINICS (FY17: (80,622)COMMUNITY PARTNERS: CCA CLINICS________________________________________GOAL: INCREASE QUALITY AND EFFICIENCY OF CLINICAL SERVICES AT CCA CLINICSTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:3.1 MAINTAIN AND INCREASE THE NUMBER OF PROVIDERS AT CCA CLINICSCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT MEDICAL RESIDENTS AT CCA CLINICSMETRICS AND STATUS UPDATE:- NUMBER OF MEDICAL RESIDENTS PLACED AT CCA CLINICSCOMMUNITY PARTNERS: CCA CLINICS________________________________________GOAL: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WITH LIMITED ENGLISH PROFICIENCYTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:4.1 CONTINUE INTERPRETER SERVICES PROGRAM4.2 EDUCATE STAFF/CLINICIANS IN HEALTH EQUITY PRINCIPLES4.3 PROMOTE HEALTH EQUITY, HEALTH LITERACY, CULTURAL COMPETENCE ACROSS CCA CLINICSCOMMUNITY ACTIVITIES/STRATEGIES:- UNDERSTAND CULTURAL IMPACTS ON HEALTH CARE DELIVERY, HEALTH STATUS AND HEALTH OUTCOMES- EXPLORE AVAILABLE TOOLS AND RESOURCES TO FACILITATE CROSS-CULTURAL COMMUNICATION- EXPLORE OPPORTUNITIES FOR CCA CLINICS IN THEIR EFFORTS TO BECOME HEALTH LITERATE ORGANIZATIONS- IMPROVE ACCESSIBILITY OF INTERPRETER SERVICES FOR LEP PATIENTSMETRICS AND STATUS UPDATE:- NUMBER OF LEP PATIENTS SERVED AT BIDMC - NUMBER OF PATIENTS BEST SERVED IN LANGUAGE OTHER THAN ENGLISH AT FQHC CCA CLINICS (FY17: 43,900)- NUMBER OF PATIENTS OF DIVERSE RACE/ETHNICITY SERVED AT CCA CLINICS (FY17: 68,682)- TBD - LEP ACCESS INDICATORSCOMMUNITY PARTNERS: CCA CLINICS________________________________________GOAL: PROMOTE GREATER HEALTH EQUITY AND REDUCE DISPARITIES IN ACCESS FOR LGBT POPULATIONSTARGET POPULATION: LGBT POPULATIONPROGRAMMATIC OBJECTIVES:5.1 REDUCE DISPARITIES5.2 PROMOTE HEALTH EQUITYCOMMUNITY ACTIVITIES/STRATEGIES:- EXPLORE HOW TO BEST IMPLEMENT SEXUAL ORIENTATION/GENDER IDENTITY APPROPRIATE POLICIES AND PROCEDURES- CONTINUE JOINT RESIDENCY PROGRAM WITH FENWAY HEALTH- SUPPORT PRIDE CELEBRATION- SUPPORT EFFORTS TO ACHIEVE HEALTHCARE EQUALITY INDEX (HEI) RECOGNITION (E.G., SIGNAGE AND PATIENT SELF-IDENTIFICATION OF SEXUAL ORIENTATION)METRICS AND STATUS UPDATE:- NUMBER OF RESIDENTS PARTICIPATING IN JOINT RESIDENCY PROGRAM (FY17: 8)- ESTABLISH SOGI TASKFORCE- NUMBER OF LGBT PATIENTS SEEN AT FQHC CCA CLINICS (FY17: PATIENTS THAT IDENTIFY AS OTHER THAN STRAIGHT: 17,973; PATIENTS THAT IDENTIFY AS TRANSGENDER: 1,549COMMUNITY PARTNERS: CCA CLINICS, GLAD - LEGAL ADVOCATES & DEFENDERS FOR THE LGBTQ COMMUNITY, HARVARD MEDICAL SCHOOL, HEALTHCARE EQUALITY INDEX, HUMAN RIGHTS CAMPAIGN PRIORITY AREA 4: BEHAVIORAL HEALTH HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY, AND STRESS). IF THE IMPACT OF SOCIAL DETERMINANTS WAS THE LEADING FINDING OF THE CHNA, A CLOSE SECOND WAS THE PROFOUND IMPACT THAT BEHAVIORAL HEALTH ISSUES (I.E., SUBSTANCE USE AND MENTAL HEALTH) ARE HAVING ON INDIVIDUALS, FAMILIES AND COMMUNITIES IN EVERY GEOGRAPHIC REGION AND EVERY POPULATION SEGMENT IN BIDMC'S CBSA. DEPRESSION/ANXIETY, SUICIDE, OPIOID AND PRESCRIPTION DRUG DEPENDENCY, AND ALCOHOL AND MARIJUANA USE, PARTICULARLY IN YOUTH, ARE MAJOR HEALTH ISSUES AND ARE HAVING A TREMENDOUS IMPACT ON THE POPULATION AS WELL AS A BURDEN ON THE SERVICE SYSTEM. THE FACT THAT PHYSICAL AND BEHAVIORAL HEALTH ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID ABUSE IN THE COMMONWEALTH.LIMITED ACCESS TO BEHAVIORAL HEALTH SERVICES, PARTICULARLY FOR LOW INCOME, MEDICAID INSURED, UNINSURED, AND THOSE WITH COMPLEX, MULTI-FACETED ISSUES. DESPITE THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON ALL SEGMENTS OF THE POPULATION, THERE IS AN EXTREMELY LIMITED SERVICE SYSTEM AVAILABLE TO MEET THE NEEDS THAT EXIST FOR THOSE WITH ALL MILD TO MODERATE EPISODIC ISSUES OR THOSE WITH MORE SERIOUS AND COMPLEX, CHRONIC CONDITIONS. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE (INCLUDING STIGMA), AND IMPROVE THE QUALITY OF PRIMARY CARE AND SPECIALIZED BEHAVIORAL HEALTH SERVICES.KEY: BASELINE - 2017, YEAR 1 - 2018, YEAR 2 - 2019, YEAR 3 - 2020 ________________________________________GOAL: PROMOTE BEHAVIORAL HEALTH (BH)/PRIMARY CARE INTEGRATIONTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:1.1 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES IN THE PRIMARY CARE SETTING IN CCA CLINICS1.2 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY BEHAVIORAL HEALTH CARE SERVICES AT CCA CLINICS1.3 CONDUCT PUBLIC POLICY ADVOCACYCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT PRIMARY CARE - BEHAVIORAL HEALTH INTEGRATION AT CCA CLINICS- SUPPORT TELEPHONIC AND ONSITE PSYCHIATRIC CONSULTATION FOR PRIMARY CARE PROVIDERS SERVING THOSE WITH BH CONDITIONS- PROVIDE OB/GYN SERVICES FOR WOMEN WITH CHRONIC SUBSTANCE ABUSE ISSUES- PROVIDE CULTURALLY APPROPRIATE MENTAL HEALTH SERVICES FOR THE LATINO COMMUNITY- SUPPORT EDUCATIONAL OPPORTUNITIES ON CULTURAL PSYCHIATRY FOR SPANISH SPEAKING MENTAL HEALTH PROVIDERS- CONTINUE SBIRT IN BIDMC'S EMERGENCY DEPARTMENTMETRICS AND STATUS UPDATE:- NUMBER OF PATIENTS ACCESSING BH SERVICES IN FQHC CCA CLINICS: (FY17: 8,658)- NUMBER OF PCPS PARTICIPATING IN BH CONSULTATION PROGRAM AT CHARLES RIVER COMMUNITY HEALTH (FY17: 11)- NUMBER OF SESSIONS OF SOBREMESA (FY17: 1)COMMUNITY PARTNERS: CCA CLINICS________________________________________GOAL: REDUCE BURDEN OF OPIOID USETARGET POPULATION: ADULTSPROGRAMMATIC OBJECTIVES:2.1 INCREASE THE NUMBER OF ADULTS WITH SUBSTANCE ISSUES WHO ARE APPROPRIATELY MONITORED, ASSESSED, AND TREATED IN CCA CLINICS2.2 INCREASE THE NUMBER OF PATIENTS RECEIVING DETOX SERVICESCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT THE DEVELOPMENT OF SUBOXONE CLINICS IN HCA AND A "BRIDGING" CLINIC FOR NON-HCA PATIENTS (2 SESSIONS EACH)- SUPPORT THE RECRUITMENT OF AN ADDICTION PSYCHIATRIST, PSYCHE-NP, LCSW, AND ADMINISTRATIVE SUPPORT PERSON TO DEVELOP A CORE ADDICTIONS COMPETENCY.- SUPPORT THE DEVELOPMENT OF A BIDMC ADDICTIONS ADVISORY GROUP - SUPPORT THE EXPANSION OF THE DIMOCK INPATIENT DETOX FACILITYMETRICS AND STATUS UPDATE:- OPEN/BUILD DIMOCK'S INPATIENT DETOX PROGRAM- NUMBER OF ADDICTION SPECIALISTS HIRED- FORM ADDICTIONS ADVISORY GROUP- ESTABLISH SUBOXONE CLINIC- ESTABLISH BRIDGING CLINIC- ESTABLISH DASHBOARD METRICSCOMMUNITY PARTNERS: CCA CLINICS________________________________________GOAL: INCREASE ACCESS TO QUALITY BEHAVIORAL HEALTH CARE SERVICESTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:3.1 INCREASE PARTICIPATION IN LGBT SUPPORT GROUPSCOMMUNITY ACTIVITIES/STRATEGIES:- SUPPORT TRANSGENDER SUPPORT GROUPS AT BIDMCMETRICS AND STATUS UPDATE:- NUMBER OF PARTICIPANTS IN TRANSGENDER SUPPORT GROUPS AT BIDMC (FY17: 13)COMMUNITY PARTNERS: CCA CLINICS GOAL: IDENTIFY THOSE AT RISK FOR BH CONDITION AND PROVIDE ENHANCED CARE MANAGEMENTTARGET POPULATION: ADULTS PROGRAMMATIC OBJECTIVES:4.1 SUPPORT ENHANCED CARE MANAGEMENT FOR THOSE AT RISK FOR BH CONDITIONSCOMMUNITY ACTIVITIES/STRATEGIES: - CONTINUE TO PROVIDE CASE MANAGEMENT SUPPORT SERVICES FOR BSHC PATIENTS WITH COMPLEX PHYSICAL AND BEHAVIORAL HEALTH ISSUESMETRICS AND STATUS UPDATE:- NUMBER OF BSHC PATIENTS PARTICIPATING IN BROOKLINE MENTAL HEALTH PARTNERSHIP PROGRAM (FY17:18)COMMUNITY PARTNERS: CCA CLINICS*****AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, THE MEDICAL CENTER IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, AS NOTED IN SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE CHIP. EXAMPLES OF IDENTIFIED NEEDS THAT WON'T BE ADDRESSED UNDER THIS CHIP ARE AFFORDABLE HOUSING AND SAFE PARKS/PLAYGROUNDS. THE MEDICAL CENTER WAS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES; HOWEVER, THE MEDICAL CENTER DID PARTICIPATE IN CERTAIN WORKFORCE DEVELOPMENT PROGRAMMING AS REPORTED IN THIS FORM 990 SCHEDULE H PART II AND AS DETAILED IN THE NARRATIVE TO THIS SCHEDULE H PART VI.AS NOTED IN DETAIL ABOVE, THE MEDICAL CENTER'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND CHIP (SCHEDULE H PART VI QUESTION 2).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW THE MEDICAL CENTER CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AS WELL AS COMMUNITY BUILDING ACTIVITIES. AS DEMONSTRATED IN THIS SCHEDULE H, DURING THE PERIOD COVERED BY THIS FILING, 16.40% OF THE MEDICAL CENTER'S TOTAL EXPENSES WERE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. IN ADDITION AS NOTED IN THE NARRATIVE BELOW, THERE ARE ADDITIONAL ACTIVITIES AND EXPENDITURES WHICH THE MEDICAL CENTER CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. UNDER THE INSTRUCTIONS TO THIS SCHEDULE H QUESTION 7 THESE ITEMS ARE NOT QUANTIFIED IN SCHEDULE H QUESTION 7, BUT IT IS WORTH NOTING THAT IF THE MEDICAL CENTER HAD INCLUDED THESE IN SCHEDULE H QUESTION 7, THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WOULD BE 18.29% FOR THE PERIOD COVERED BY THIS FILING.FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - FINANCIAL ASSISTANCE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEAS REPORTED IN THE MEDICAL CENTER'S CONSOLIDATED FINANCIAL STATEMENT AND IN THIS FORM 990, SCHEDULE H, THE MEDICAL CENTER'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND PAYMENTS TO AND RECEIPTS FROM THE HEALTH SAFETY NET TRUST, WAS $12,852,350 IN FISCAL YEAR ENDED SEPTEMBER 30, 2017 AND HAS BEEN REPORTED AS PART OF THE FINANCIAL ASSISTANCE AND CHARITY CARE REPORTED IN THIS SCHEDULE H, PART I, LINE 7A.AS NOTED THROUGHOUT THIS FORM 990, 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 AND 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 ACCOMPLISHMENT OF ITS PURPOSES. AS PART OF THIS RELATIONSHIP, HMFP PATIENTS WHO MEET THE MEDICAL CENTER'S FREE CARE CRITERIA 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 $1,851,463. SEE ADDITIONAL INFORMATION BELOW IN THIS SCHEDULE H NARRATIVE.OTHER UNCOMPENSATED CHARITY CARE - MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, THE MEDICAL CENTER ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW INCOME FAMILIES, INCLUDING 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, 21.9% OR 253,831 OF THE MEDICAL CENTER'S PATIENT CASES WERE WITH MEDICAID PATIENTS. THIS TRANSLATES TO $200,527,465 IN MEDICAID REVENUE WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY THE MEDICAL CENTER FOR SUCH SERVICES BY $54,311,343, AS REPORTED ON THIS SCHEDULE H, PART I, LINE 7B.MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 30.5% OR 352,952 OF THE MEDICAL CENTER'S PATIENT ENCOUNTERS WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO MEDICARE REVENUE OF $402,276,572. 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 $24,617,418. OF THIS AMOUNT, $10,344,897 IS INCLUDED IN FORM 990 SCHEDULE H PART I, LINE 7G AND RELATED TO THE PROVISION OF SUBSIDIZED HEALTH SERVICES FOR INPATIENT PSYCHIATRIC PATIENTS, THE MEDICAL CENTER'S BOWDOIN STREET COMMUNITY FACILITY, THE MEDICAL CENTER'S PROVISION OF OUTPATIENT AMBULATORY CARE AND CERTAIN PRIMARY CARE VISITS THROUGH BIDMC'S ONSITE PRIMARY CARE OFFICES AND $14,272,521 OF WHICH IS REPORTED IN THIS FORM 990 SCHEDULE H PART III LINE 7. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH THE MEDICAL CENTER CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE ADDITIONAL MEDICARE SHORTFALL OF $14,272,521 IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, THE MEDICAL CENTER HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED.BAD DEBTSAS REPORTED IN THE BETH ISRAEL DEACONESS MEDICAL CENTER AND AFFILIATES AUDITED FINANCIAL STATEMENT FOR THE PERIOD COVERED BY THIS FILING, IN 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 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 WERE $22,472,200 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND IN THIS FORM 990 SCHEDULE H, PART III, SECTION A, LINE 2 AS REQUIRED.THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AT COST 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 MEDICAL CENTER'S 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, 2017 INCLUDE THE ACCOUNTS OF THE MEDICAL CENTER AND ITS SUBSIDIARIES, (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), 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 MEDICAL CENTER'S FORM 990 IS PREPARED FOR THE MEDICAL CENTER ONLY AND AS SUCH, THE METRICS INCLUDED IN THESE FOOTNOTES WILL NOT TIE TO THE FACE OF THE MEDICAL CENTER'S 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 $16,928,000 AND $16,257,000 IN 2017 AND 2016, 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 COLLECTIBILITY OF ACCOUNTS RECEIVABLE REMAINED SUBSTANTIALLY CONSISTENT IN 2017 AND 2016. THE MEDICAL CENTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS REPRESENTED APPROXIMATELY 9.3% OF PATIENT ACCOUNTS RECEIVABLE NET OF CONTRACTUAL ALLOWANCES IN 2017 AND 11.3% IN 2016.EMERGENCY CARE ACCESSAS NOTED IN THIS SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21, THE MEDICAL CENTER IS A FRONTLINE CAREGIVER PROVIDING MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO OUR 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 PURPOSEBIDMC'S MISSION IS TO DISTINGUISH ITSELF FROM OTHER PROVIDERS THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION, RESEARCH AND THROUGH IMPROVED HEALTH IN THE COMMUNITIES SERVED.BIDMC 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 BIDMC PROVIDERS.BIDMC 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 ASSISTANCETHE 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 GUIDELINESTHE 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 BYTHE 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 - TRANSLATIONSTHE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, USING THE HEALTH AND HUMAN SECRETARY GUIDANCE SAFE HARBOR OF 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS. BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, RUSSIAN, 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):HTTPS://WWW.BIDMC.ORG/PATIENT-AND-VISITOR-INFORMATION/PATIENT-INFORMATION/YOUR-HOSPITAL-BILL/FINANCIAL-ASSISTANCEIN 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, INCLUDING THE WEBSITE ADDRESS, 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. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22).PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00.BILLING AND 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 PERIODPATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLANDETAIL RELATED TO THE MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT, IMPLEMENTATION STRATEGY AND COMMUNITY BENEFITS ACTIVITIES HAS BEEN PROVIDED IN FORM 990, SCHEDULE H, PART V, SECTION C ABOVE.COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, MEDICAL CENTER'S MOST RECENT CHNA AND CHIP WERE COMPLETED AND APPROVED BY THE COMMUNITY BENEFITS COMMITTEE AND BOARD OF DIRECTORS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016 AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE MEDICAL CENTER 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, UPON REQUEST AT THE MEDICAL CENTER AND ON THE MEDICAL CENTER'S WEBSITE AT:HTTPS://WWW.BIDMC.ORG/-/MEDIA/FILES/BETH-ISRAEL-ORG/ABOUT-BIDMC/HELPING-OUR-COMMUNITY/COMMUNITY-INITIATIVES/COMMUNITY-BENEFITS/COMMUNITY-BENEFITS-2017-ATTORNEY-GENERAL-REPORT.ASHX?LA=EN&HASH=4CDBEF3185760C54F2AADD4616366528ACD04372THERE 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, THE MEDICAL CENTER IS A TERTIARY CARE LICENSED ACADEMIC MEDICAL CENTER, PROVIDING MEDICAL AND SURGICAL CARE, TEACHING AND RESEARCH AND AS NOTED ELSEWHERE IN THIS RETURN, PROVIDES 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - RESEARCHAS PREVIOUSLY NOTED IN THIS FORM 990, PART III, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS 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 1,300 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH LED BY MORE THAN 250 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 $81,492,965 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 4.90% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $215,267,238 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS WHICH, IF INCLUDED IN THE SCHEDULE H, PART I, LINE 7H CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THIS SCHEDULE H, PART I, LINE 7H TO 17.84%. RESEARCH ENGAGED IN AT THE MEDICAL CENTER VIKAS P. SUKHATME, M.D., SCD, WHO SERVED AS THE MEDICAL CENTER'S CHIEF ACADEMIC OFFICER, DURING THE PERIOD COVERED BY THIS FILING HAS SAID THAT THIS IS PERHAPS THE MOST VIGOROUS AND TRANSFORMING PERIOD IN THE HISTORY OF BIOMEDICAL RESEARCH, A TIME WHEN SOPHISTICATED TECHNOLOGIES ARE ENABLING THE PURSUIT OF HIGHLY ORIGINAL INVESTIGATIONS AND RAPIDLY EVOLVING GENOMIC DISCOVERIES ARE UNCOVERING IMPORTANT INSIGHTS INTO HUMAN HEALTH.THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H, DEPENDING ON FUNDING SOURCE.GROUNDBREAKING GENETICS DISCOVERIES CHALLENGE SCIENTIFIC DOGMAIN THE HALF-CENTURY OLD CENTRAL DOGMA OF MOLECULAR BIOLOGY, IT WAS UNDERSTOOD AND ACCEPTED THAT DNA INSTRUCTS THE BODY ON HOW TO CONSTRUCT PROTEINS, THE BUILDING BLOCKS OF LIFE. PACKAGED IN GENES, THESE INSTRUCTIONS WERE TRANSPORTED TO CELLS' PROTEIN-MAKING MACHINERY BY WAY OF DNA'S CHEMICAL COUSIN RNA. IN BETWEEN THE GENES WERE LONG STRETCHES OF NONCODING RNA, WHICH WERE BELIEVED TO SERVE NO PURPOSE, AND WERE OFTEN REFERRED TO AS "JUNK DNA." BUT INVESTIGATORS AT BIDMC HAVE MADE KEY DISCOVERIES DEMONSTRATING THAT THIS "JUNK" MAY ACTUALLY BE HIDDEN TREASURE, REVEALING THAT NONCODING RNA PLAYS KEY ROLES IN HEALTH AND DISEASE, PARTICULARLY CANCER. RECOGNIZING THESE INSIGHTS INTO THE WORLD OF NON-CODING RNAS, BIDMC HAS SET UP THE INSTITUTE FOR RNA MEDICINE WITHIN THE BIDMC CANCER CENTER AND FRANK SLACK, PHD, FORMERLY OF YALE UNIVERSITY, JOINED AS ITS DIRECTOR DURING THE PERIOD COVERED BY THIS FILING THIS FLAGSHIP PROGRAM WILL FURTHER ENHANCE BIDMC'S VISIBILITY IN THE WORLD OF SCIENCE AND IS ENTIRELY CONSISTENT WITH ITS BENCH TO BEDSIDE PHILOSOPHY."FIFTY PERCENT OF THE GENOME IS TRANSCRIBED, BUT ONLY TWO PERCENT MAKES PROTEIN, AND THERE WAS NO CODE, NO LANGUAGE FOR UNDERSTANDING THE REST," EXPLAINS CANCER CENTER DIRECTOR PIER PAOLO PANDOLFI, MD, PHD. "IN TERMS OF BIOMEDICAL RESEARCH, THE IMPACT IS IMMENSE, BECAUSE NOW [THERE ARE] ALL OF THESE NEW ENTITIES, PSEUDOGENES, LINCRNAS, CERNAS THAT HAVE BEEN GIVEN A FUNCTION. WE HAVE NOW ALMOST TRIPLED THE SIZE OF THE FUNCTIONAL GENOME AND THIS IS CRITICALLY IMPORTANT FOR CANCER GENETICS." A BIDMC RESEARCH TEAM LED BY PANDOLFI RECENTLY DISCOVERED THAT CIRCULAR RNAS - A CLASS OF NON-CODING RNAS - ARE AFFECTED BY GENOMIC REARRANGEMENTS IN CANCER, JUST LIKE THEIR PROTEIN COUNTERPARTS. THEY ALSO FOUND THAT CIRCULAR RNAS PROMOTE TUMOR GROWTH AND PROGRESSION. THE GROUP'S WORK PAVES THE WAY FOR THE DISCOVERY OF MANY MORE OF THESE UNUSUAL RNAS AND HOW THEY CONTRIBUTE TO CANCER, WHICH COULD REVEAL NEW MECHANISMS AND DRUGGABLE PATHWAYS INVOLVED IN THE PROGRESSION OF CANCER.*****THE CO-CLINICAL TRIAL SPEEDS TESTING OF CANCER DRUGSCLINICAL TRIALS TO TEST NEW CANCER DRUGS ARE LENGTHY AND COMPLEX. AS A RESULT, THERE IS A BACKLOG OF MORE THAN 800 NEW TARGETED CANCER THERAPIES AWAITING CLINICAL TESTING. "THE CURRENT SYSTEM CAN'T KEEP PACE," SAYS PIER PAOLO PANDOLFI, MD, PHD. "THERE ISN'T ENOUGH TIME OR RESOURCES TO TEST EACH ONE OF THESE NEW DRUGS IN HUMAN SUBJECTS AS SINGLE AGENTS - LET ALONE IN COMBINATIONS."DR. PANDOLFI CONCEIVED AND DEVELOPED A REVOLUTIONARY NEW STREAMLINED TESTING METHOD KNOWN AS THE CO-CLINICAL TRIAL. IN THIS BIT OF SCIENTIFIC MULTITASKING, A HUMAN CLINICAL TRIAL IS SIMULTANEOUSLY PARTNERED WITH ANIMAL STUDIES OF MICE TO HELP DOCTORS LEARN MUCH MORE QUICKLY WHICH PATIENTS WITH WHICH MUTATIONS ARE BEING HELPED - OR NOT BEING HELPED - BY TARGETED CANCER DRUGS. PANDOLFI WAS AWARDED $4.2 MILLION IN AMERICAN REINVESTMENT AND RECOVERY ACT (ARRA) FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH (NIH) FOR THE CO-CLINICAL TRIAL INVESTIGATIONS. THE NEW MODEL TAKES ADVANTAGE OF THE TREMENDOUS TECHNOLOGICAL ADVANCES THAT ARE PROVIDING SCIENTISTS WITH VALUABLE NEW INFORMATION ABOUT CANCER'S GENETIC UNDERPINNINGS. IN MARCH 2012, THE FIRST FINDINGS USING THE CO-CLINICAL STRATEGY WERE PUBLISHED IN NATURE, REVEALING KEY INSIGHTS INTO NEW LUNG CANCER THERAPIES. NATURE DESCRIBED THIS PROCESS AS ONE OF "FOUR WAYS TO FIX THE CLINICAL TRIAL" STATING THAT "THE CO-CLINICAL MODEL .[BRINGS] FUNDAMENTAL CHANGES TO THE CLINICAL TRIAL SYSTEM TO MAKE IT FASTER, CHEAPER, MORE ADAPTABLE AND MORE IN TUNE WITH MODERN MOLECULAR MEDICINE." THE "ULTIMATE GOAL IS TO FIND OUT EXACTLY WHY DIFFERENT PATIENTS RESPOND TO DIFFERENT TREATMENTS SO THAT DRUGS ARE GIVEN ONLY TO THE PATIENTS WHO WILL RESPOND," SAYS DR. PANDOLFI.IN ADDITION, SENTHIL MUTHUSWAMY, PHD, DIRECTOR OF THE CELL BIOLOGY PROGRAM IN THE CANCER RESEARCH INSTITUTE AT THE MEDICAL CENTER, HAS PIONEERED WAYS OF PRESERVING TUMOR TISSUE IN VITRO IN SO-CALLED ORGANOIDS THAT MAINTAIN CHARACTERISTICS OF THE CANCER AND CAN BE RAPIDLY TESTED FOR SUSCEPTIBILITY TO DRUG TREATMENTS. THIS NEW ORGANOID APPROACH NOW PROVIDES A 'LIVE' BIOBANK OF TISSUE FOR DISCOVERY AND VALIDATION OF NEW DRUGS AND TARGETS AND MODELING RESISTANCE TO THERAPY. BY USING A COHORT OF PATIENT SAMPLES FROM WHICH THEY CAN SCREEN FOR DRUGS AND MUTATIONS, MUTHUSWAMY AND TEAM CAN BEGIN TO UNDERSTAND WHY SOME PATIENTS RESPOND TO A TREATMENT WHILE OTHERS DO NOT, AND CAN THEREBY AVOID GIVING PATIENTS UNNECESSARY OR INEFFECTIVE TREATMENTS. THIS APPROACH COULD ALSO HELP PATIENTS AND THEIR ONCOLOGISTS MAKE TREATMENT DECISIONS.*****PIONEERS IN THE QUEST FOR VACCINES FOR HIV AND ZIKABETH ISRAEL DEACONESS MEDICAL CENTER SCIENTISTS HAVE DISTINGUISHED THEMSELVES AS INTERNATIONAL LEADERS IN THE DEVELOPMENT OF VACCINES FOR HIV AND ZIKA.DR. DAN BAROUCH, CHIEF OF THE DIVISION OF VIROLOGY AND VACCINE RESEARCH IN BIDMC'S DEPARTMENT OF MEDICINE, AND A TEAM OF 50 SCIENTISTS AT BIDMC ARE TESTING AN ANTIBODY THAT HAS PROVEN TO REDUCE THE HIV VIRUS IN MONKEYS, WITH A $20 MILLION DOLLAR GRANT FROM THE BILL AND MELINDA GATES FOUNDATION. THE FOUR YEAR GRANT WILL FUND FURTHER TESTING ON MONKEY MODELS AS WELL AS OBSERVING IF THE ANTIBODY HAS A SIMILAR EFFECT ON HIV-INFECTED HUMANS. THE GOAL OF THIS WORK IS TO POTENTIALLY ATTACK THE VIRAL RESERVOIRS WITH THIS ANTIBODY IN THE HOPES OF REDUCING OR ELIMINATING THE VIRUS. THIS IS A MOST NOVEL APPROACH IN WHICH BIDMC IS A WORLD LEADER.BAROUCH AND HIS TEAM ARE ALSO RACING TO DEVELOP SAFE AND EFFECTIVE MEASURES TO PREVENT THE ZIKA VIRUS. IN FEBRUARY 2016, THE WORLD HEALTH ORGANIZATION HAD DECLARED THE ZIKA EPIDEMIC A GLOBAL PUBLIC HEALTH EMERGENCY, BASED LARGELY ON THE VIRUS' NEWLY-ESTABLISHED LINK TO MICROCEPHALY AND OTHER MAJOR BIRTH DEFECTS IN BABIES BORN TO INFECTED MOTHERS. THE VIRUS HAS ALSO BEEN ASSOCIATED WITH THE NEUROLOGIC DISORDER GUILLAIN-BARR SYNDROME IN ADULTS. BAROUCH AND COLLEAGUES HAVE DEMONSTRATED THAT THREE DIFFERENT VACCINE CANDIDATES PROVIDED ROBUST PROTECTION AGAINST ZIKA VIRUS IN BOTH MICE AND RHESUS MONKEYS. SEVERAL HUMAN CLINICAL TRIALS BEGAN LAST FALL AT TEST SITES INCLUDING BIDMC, WALTER REED ARMY INSTITUTE OF RESEARCH AND NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES AFFILIATED CLINICAL TRIAL SITES.***** SCIENTISTS UNCOVER THE EARLIEST STAGES OF ALZHEIMER'S DISEASE ALZHEIMER'S DISEASE (AD) CURRENTLY AFFLICTS 5.4 MILLION AMERICANS AND 30 MILLION INDIVIDUALS WORLDWIDE. IT IS ESTIMATED THAT BY 2050, MEDICAL COSTS OF CARING FOR AD PATIENTS WILL SOAR TO OVER $1 TRILLION IN THE U.S. ALONE. MEDICAL CENTER INVESTIGATORS KUN PING LU, MD, PHD, AND XIAO ZHEN ZHOU, MD, PHD, HAVE IDENTIFIED THE FIRST, EARLY STEP IN WHICH THE TAU PROTEIN IS TRANSFORMED FROM ITS BENEFICIAL FUNCTION AS A MEANS OF NEURONAL SUPPORT AND TURNED INTO A TWISTED, MISSHAPEN VILLAIN RESPONSIBLE FOR DEBILITATING MEMORY LOSS. THE DISCOVERY OFFERS A PROMISING NEW DIRECTION FOR THE DEVELOPMENT OF THERAPEUTIC ANTIBODIES AND VACCINES, AND HINGES ON AN ENZYME CALLED PIN1 (PROLYL ISOMERASE), WHICH CAN UNTANGLE THE TWISTED TAU. PIN1 WAS CO-DISCOVERED BY LU IN 1995. A NEW ANTIBODY TECHNOLOGY DEVELOPED BY DR. LU AND DR. ZHOU HAS MADE IT POSSIBLE TO DISTINGUISH BETWEEN HEALTHY AND DISEASE-CAUSING TAU PROTEIN. THEIR WORK HAS DEMONSTRATED THAT THE PROTEIN'S PATHOGENIC FORM APPEARS IN THE BRAIN CELLS OF PATIENTS WITH EARLY DEMENTIA AND AS IT PROGRESSES TO ALZHEIMER'S RAPIDLY ACCUMULATES AT THE BRAIN LOCATION THAT IS CRITICAL FOR MEMORY.*****TEAMING UP TO TACKLE SEPSIS - FROM BENCH TO BEDSIDESEPSIS IS ONE OF THE MOST COMMON - AND MOST TERRIFYING - OF CONDITIONS TO BE FOUND IN HOSPITAL EMERGENCY DEPARTMENTS AND INTENSIVE CARE UNITS. SOMETIMES KNOWN AS BLOOD POISONING, SEPSIS OCCURS WHEN THE BODY OVERREACTS TO WHAT IS OFTEN A SIMPLE INFECTION, AND CAN RAPIDLY ESCALATE TO LIFE-THREATENING ORGAN SHUTDOWN. EACH YEAR, SEPSIS IS RESPONSIBLE FOR MORE THAN 200,000 DEATHS, MAKING IT A LEADING CAUSE OF HOSPITAL MORTALITY. AT THE MEDICAL CENTER, INTERDISCIPLINARY RESEARCH TEAMS HAVE MADE SEPSIS A PRIMARY FOCUS OF THEIR ATTENTION. BY LITERALLY BRINGING KEY SCIENTIFIC FINDINGS FROM THE LAB BENCH TO THE PATIENT BEDSIDE, EMERGENCY ROOM PHYSICIAN NATHAN SHAPIRO, MD, PHD, HAS BEEN INSTRUMENTAL IN LEADING INVESTIGATIONS INTO THE ORIGINS OF THIS EXTREMELY DANGEROUS CONDITION, ESTIMATED TO COST $17 BILLION PER YEAR, NATIONWIDE. AS A MEMBER OF THE CENTER FOR VASCULAR BIOLOGY RESEARCH (CVBR) DR. SHAPIRO HAS PARTNERED WITH BASIC SCIENTISTS SAMIR PARIKH, MD, AND WILLIAM AIRD, MD, TO EXPLORE THE ROLE THAT BLOOD VESSELS PLAY IN THE ONSET OF SEPSIS AND IN ITS ESCALATION TO A LIFE-THREATENING CONDITION. THEIR WORK INVESTIGATING THE ENDOTHELIUM LAYER, WHICH LINES THE BLOOD CELLS, IS UNCOVERING VITALLY IMPORTANT CLUES, INCLUDING THE ROLE THAT THE VEGF (VASCULAR ENDOTHELIAL GROWTH FACTOR) PROTEIN MAY PLAY IN THE ONSET OF THIS PROGRESSIVELY SEVERE ILLNESS. THE EMERGENCY-ROOM-AS-LABORATORY IS A UNIQUE AND VALUABLE APPROACH TO STUDYING SEPSIS, AND AS AN ATTENDING PHYSICIAN, DR. SHAPIRO HAS BEEN PRINCIPAL INVESTIGATOR OF NUMEROUS ER-BASED CLINICAL TRIALS TO HELP ASCERTAIN THE MOST EFFECTIVE AND PRUDENT MANAGEMENT OF THE CONDITION IN CASES IN WHICH SEPSIS HAS TAKEN HOLD.*****TRACING THE NEURAL CIRCUITRY OF APPETITE AND HUNGERIF YOU'VE EVER SKIPPED MEALS FOR A WHOLE DAY OR GONE ON A STRICT, LOW-CALORIE DIET, YOU KNOW JUST HOW POWERFUL AND UNCOMFORTABLE THE FEELING OF HUNGER CAN BE. HUNGER IS A COMPLEX MOTIVATION GOVERNED BY THE BRAIN AND BIDMC INVESTIGATOR BRADFORD LOWELL, MD, PHD, OF THE DIVISION OF ENDOCRINOLOGY, DIABETES AND METABOLISM IN BIDMC'S DEPARTMENT OF MEDICINE IS UNCOVERING THE INTRICATE NEUROCIRCUITRY THAT UNDERLIE THESE FEELINGS. IN A RECENT REPORT PUBLISHED IN NATURE NEUROSCIENCE, THE LOWELL LABORATORY MADE IMPORTANT PROGRESS IN UNDERSTANDING THE NEURAL BASIS OF APPETITE. USING A VARIETY OF INNOVATIVE TECHNOLOGIES TO CONTROL THE ACTIVITY IN THE BRAINS OF LIVING MICE, LOWELL AND HIS TEAM HAVE IDENTIFIED ONE PARTICULAR CIRCUIT THAT INVOLVES A GROUP OF MELANOCORTIN-4 RECEPTOR (MC4R) NEURONS THAT APPEARS TO SWITCH HUNGER OFF AND ON AND PROVIDED A HIGHLY PROMISING NEW STRATEGY FOR THE DEVELOPMENT OF WEIGHT LOSS DRUGS TO HELP COMBAT THE EPIDEMIC OF OBESITY. SCIENTISTS IN LOWELL'S LAB ALSO RECENTLY CATALOGUED A "PARTS LIST" OF BRAIN CELL TYPES IN ONE REGION OF THE MOUSE HYPOTHALAMUS. THEY FOUND SOME 50 DISTINCT CELL TYPES, INCLUDING A PREVIOUSLY UNDESCRIBED NEURON TYPE THAT MAY UNDERLIE SOME OF THE GENETIC RISK OF HUMAN OBESITY. THIS CATALOG OF CELL TYPES MARKS THE FIRST TIME NEUROSCIENTISTS HAVE ESTABLISHED A COMPREHENSIVE "PARTS LIST" FOR THIS AREA OF THE BRAIN. THE NEW INFORMATION WILL ALLOW RESEARCHERS TO ESTABLISH WHICH CELLS PLAY WHAT ROLE IN THIS REGION OF THE BRAIN.*****NEW CLASS OF FATTY MOLECULES BATTLES DIABETES IN MICELIPIDS, THE CHEMICAL FAMILY THAT INCLUDES FATS AND RELATED MOLECULES, GET BLAMED FOR CLOGGED ARTERIES AND HEART ATTACKS. BUT RESEARCHERS LED BY BIDMC'S BARBARA KAHN, MD, HAVE MADE A SURPRISING DISCOVERY OF A PREVIOUSLY UNIDENTIFIED CLASS OF LIPID MOLECULES THAT ACTUALLY ENHANCE INSULIN SENSITIVITY AND BLOOD SUGAR CONTROL. THESE NEW FINDINGS, RECENTLY PUBLISHED IN THE JOURNAL CELL, OFFER A PROMISING NEW AVENUE FOR THE PREVENTION AND TREATMENT OF TYPE 2 DIABETES. NAMED FATTY ACID HYDROXYL FATTY ACIDS, OR FAHFAS, THESE NEW MOLECULES ARE IN FAT CELLS AS WELL AS OTHER CELLS THROUGHOUT THE BODY, AND NOW JOIN A SMALL GROUP OF FATTY ACIDS KNOWN TO BENEFIT HEALTH, WHICH ALSO INCLUDES OMEGA-3 FATTY ACIDS FOUND IN FISH OIL. THE DISCOVERY OF FAHFAS PROVIDES IMPORTANT NEW INSIGHTS UNDERLYING METABOLIC AND INFLAMMATORY DISEASES, AND OFFERS VIABLE NEW TREATMENT AVENUES THAT KAHN AND HER TEAM HOPE TO BE ABLE TO TEST IN CLINICAL TRIALS. "THIS IS OF CRITICAL IMPORTANCE AS RATES OF OBESITY AND TYPE 2 DIABETES REMAIN AT EPIDEMIC PROPORTIONS WORLDWIDE," SAYS KAHN, AN INVESTIGATOR IN BIDMC'S DIVISION OF ENDOCRINOLOGY, DIABETES AND METABOLISM IN THE DEPARTMENT OF MEDICINE. ATTEMPTS ARE NOW IN PROGRESS TO TEST FAHFAS IN DIABETIC PATIENTS. FOR THIS AND OTHER PIONEERING WORK, DR. KAHN WAS AWARDED THE 2016 BANTING MEDAL FOR SCIENTIFIC ACHIEVEMENT FROM THE AMERICAN DIABETES ASSOCIATION.*****UNCOVERING DRUGS THAT MAY COMBAT DEADLY ANTIBIOTIC-RESISTANT BACTERIAIN RECENT YEARS, HOSPITALS HAVE REPORTED DRAMATIC INCREASES IN THE NUMBER OF CASES OF THE HIGHLY CONTAGIOUS, DIFFICULT-TO-TREAT, AND OFTEN DEADLY ANTIBIOTIC-RESISTANT BACTERIA CARBAPENEM-RESISTANT ENTEROBACTERIACEAE (CRE). RESEARCHERS AT THE MEDICAL CENTER HAVE DEVELOPED A PROMISING NEW METHOD OF IDENTIFYING NEW ANTIMICROBIALS THAT TARGET THESE ORGANISMS. WHILE THERE IS A CRITICAL NEED FOR NEW ANTIMICROBIAL AGENTS AGAINST CRE AND OTHER EMERGING ANTIBIOTIC-RESISTANT BACTERIA, THE NUMBER OF NEW ANTIBIOTICS THAT HAVE BEEN DEVELOPED AND APPROVED HAS STEADILY DECREASED IN RECENT DECADES. TO IDENTIFY NEW OR EXISTING DRUGS THAT CAN DESTROY MULTIDRUG-RESISTANT CRE, BIDMC RESEARCHERS JAMES KIRBY AND KENNETH SMITH EXAMINED APPROXIMATELY 10,000 COMPOUNDS WITH KNOWN ACTIVITY-SO CALLED KNOWN BIOACTIVE MOLECULES-INCLUDING MOST PREVIOUSLY FDA-APPROVED DRUGS, VETERINARY DRUGS AND INHIBITORS OF VARIOUS CELLULAR PROCESSES NOT CURRENTLY USED AS THERAPEUTICS. THROUGH A PROCESS CALLED HIGH THROUGHPUT SCREENING, THE INVESTIGATORS LOOKED TO SEE WHETHER ANY OF THESE COMPOUNDS COULD EITHER DIRECTLY INHIBIT THE GROWTH OF CRE OR RESTORE THE EFFECTIVENESS OF CARBAPENEM AGAINST THESE ORGANISMS. THEY FOUND THAT 79 COMPOUNDS INHIBITED CRE. OF THESE, THREE HAD ALREADY BEEN APPROVED FOR HUMAN AND VETERINARY USE. THESE ANTIMICROBIALS CURRENTLY HAVE OTHER INTENDED USES AND ARE NOT CURRENTLY CONSIDERED AS TREATMENTS FOR CRE, HOWEVER KIRBY AND SMITH'S FINDINGS SUGGEST THEY COULD POTENTIALLY BE REPURPOSED FOR CRE TREATMENT.***** NEW INSIGHT INTO GENETICS AND BRAIN CIRCUITRY OF IMPAIRED SOCIABILITY IN AUTISMAMONG THE BROAD CATEGORY OF COGNITIVE DEVELOPMENTAL DISABILITIES LIKE DOWN SYNDROME, AUTISM IS MARKED BY ITS SOCIAL IMPAIRMENTS. PEOPLE WITH THE DISORDER OFTEN HAVE DIFFICULTY MAKING EYE CONTACT, RECOGNIZING SOCIAL CUES OR FOCUSING ON OTHER PEOPLE. RESEARCHERS AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) HAVE GAINED NEW INSIGHT INTO THE GENETIC AND NEURONAL CIRCUIT MECHANISMS THAT MAY CONTRIBUTE TO THIS IMPAIRED SOCIABILITY IN SOME FORMS OF AUTISM SPECTRUM DISORDER. LED BY MATTHEW P. ANDERSON, MD, PHD, DIRECTOR OF NEUROPATHOLOGY AT BIDMC, THE SCIENTISTS DETERMINED HOW A GENE LINKED TO ONE COMMON FORM OF AUTISM WORKS IN A SPECIFIC POPULATION OF BRAIN CELLS TO IMPAIR SOCIABILITY. THE RESEARCH, PUBLISHED IN THE JOURNAL NATURE, REVEALS THE NEUROBIOLOGICAL CONTROL OF SOCIABILITY AND COULD REPRESENT IMPORTANT FIRST STEPS TOWARD INTERVENTIONS FOR PATIENTS WITH AUTISM.ANDERSON AND COLLEAGUES FOCUSED ON THE GENE UBE3A, MULTIPLE COPIES OF WHICH CAUSES A FORM OF AUTISM IN HUMANS. CONVERSELY, THE LACK OF THIS SAME GENE IN HUMANS LEADS TO A DIFFERENT DEVELOPMENTAL DISORDER CALLED ANGELMAN'S SYNDROME, CHARACTERIZED BY INCREASED SOCIABILITY. IN PREVIOUS WORK, ANDERSON'S TEAM DEMONSTRATED THAT MICE ENGINEERED WITH EXTRA COPIES OF THE UBE3A GENE SHOW IMPAIRED SOCIABILITY, AS WELL AS HEIGHTENED REPETITIVE SELF-GROOMING AND REDUCED VOCALIZATIONS WITH OTHER MICE.ANDERSON AND COLLEAGUES DETERMINED WHERE IN THE BRAIN THIS SOCIAL BEHAVIOR DEFICIT ARISES AND WHERE AND HOW COPIES OF THE UBE3A GENE INTERACT WITH OTHER GENES TO REPRESS IT. USING THEIR OWN ENGINEERED MOUSE MODEL, THE RESEARCHERS CONFIRMED THE PRECISE LOCATION, THE VENTRAL TEGMENTAL AREA (VTA), PART OF THE MIDBRAIN THAT PLAYS A ROLE IN THE REWARD SYSTEM AND ADDICTION. NEXT, THE TEAM SWITCHED THESE NEURONS ON AND OFF AND FOUND THEY COULD MAGNIFY SOCIABILITY."WE WERE ABLE TO ABOLISH SOCIABILITY BY INHIBITING THESE NEURONS AND WE COULD MAGNIFY AND PROLONG SOCIABILITY BY TURNING THEM ON," SAID ANDERSON. "SO WE HAVE A TOGGLE SWITCH FOR SOCIABILITY. IT HAS A THERAPEUTIC FLAVOR; SOMEDAY, WE MIGHT BE ABLE TO TRANSLATE THIS INTO A TREATMENT THAT WILL HELP PATIENTS."*****NEURONS ANTICIPATE BRAIN'S REPONSES TO FOOD AND WATERA THIRD OF U.S. ADULTS ARE OVERWEIGHT AND OBESE, A PROBLEM THAT COSTS THE NATION AN ESTIMATED $150 MILLION ANNUALLY IN HEALTH CARE SPENDING. USING LEADING-EDGE TECHNOLOGY, BIDMC NEUROSCIENTISTS LED BY MARK ANDERMANN, PHD, ASSISTANT PROFESSOR OF MEDICINE AND BRADFORD B. LOWELL, MD, PHD, A PROFESSOR OF MEDICINE, BOTH IN THE DIVISION OF ENDOCRINOLOGY, DIABETES AND METABOLISM, GAINED NEW INSIGHT INTO THE BRAIN CIRCUITRY THAT REGULATES WATER AND FOOD INTAKE.IN A RECENT STUDY IN MICE, THE RESEARCHERS MONITORED THE ACTIVITY OF THE NEURONS THAT SECRETE A HORMONE IN RESPONSE TO INGESTING FOOD AND WATER. IN THEIR PAPER, PUBLISHED ONLINE IN NEURON, THE RESEARCHERS DEMONSTRATED THAT A SUBSET OF NEURONS STARTS TO PREPARE THE BODY FOR AN INFLUX OF WATER IN THE SECONDS BEFORE DRINKING BEGINS. THESE NEURONS HELP REGULATE INTAKE BY ANTICIPATING THE EFFECTS OF DRINKING FROM THE "TOP DOWN," RATHER THAN TAKING CUES FROM THE BODY.THE RESEARCHERS SUGGEST WE MAY ONE DAY LEARN THAT ENHANCING THIS TOP-DOWN CONTROL MIGHT BE A WAY OF REGULATING MEAL SIZE WITHOUT INTERFERING WITH BASELINE APPETITE OR WITH THE PLEASURE OF TAKING THE FIRST BITE OF SOMETHING DELICIOUS. ANDERMANN ADDS THEIR HIGH-TECH METHODOLOGY WILL ALLOW THEM TO FURTHER INVESTIGATE THE NEURONS DIRECTLY "UPSTREAM.""BECAUSE WE CAN NOW MONITOR AND MANIPULATE THE ACTIVITY OF SPECIFIC SETS OF NEURONS, WE'RE GETTING CLOSER TO BEING ABLE TO DIRECTLY TEST THESE HYPOTHESES AND WORKING TOWARD STRATEGIES TO IMPROVE HUMAN HEALTH," HE SAID. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - GRADUATE MEDICAL EDUCATIONTHE 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 52 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 627 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 42 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 62 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES.CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS:- ANESTHESIOLOGY- EMERGENCY MEDICINE- INTERNAL MEDICINE- NEUROLOGY- NEUROSURGERY- OBSTETRICS AND GYNECOLOGY- PATHOLOGY- PSYCHIATRY- RADIOLOGY- SURGERY- TRANSITIONAL YEARDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER HAD NET EXPENDITURES OF $72,842,238 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE MEDICAL CENTER'S TEACHING FUNCTION WHICH REPRESENTED 4.62% 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 PROGRAMS IN 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- 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, 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, 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: CYTOPATHOLOGY, HEMATOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY - CPEP, 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 ONCOLOGY- SURGERY: 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 MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATEDADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS -- EXAMPLESBELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HOSPITAL, TUFTS MEDICAL CENTER, ST. VINCENT HOSPITAL, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER.*****INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION.THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS.AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS. JUNIOR AND SENIOR RESIDENCY RESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM.RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS:- RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE.- DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS:- DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS.SMALL GROUP PRESENTATIONS:- DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC.- ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS.INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH TO BE EFFECTIVE PRACTITIONERS IN UNDERSERVED, RESOURCE-LIMITED SETTINGS AND TO DESIGN, MANAGE, IMPROVE AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS THAT ADDRESS THE HEALTH PROBLEMS OF THE WORLD'S NEEDIEST POPULATIONS.PROGRAM OBJECTIVES- INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS- CONTRIBUTE TO THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS IN BOSTON AND AROUND THE WORLD- ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS WITH LIMITED RESOURCES - EXPAND RESEARCH OPPORTUNITIES- ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCHSITE LOCATIONS - BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA.- VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. PHYSICIAN AND NURSE TRAINING ON HIV/AIDS CARE IN VIETNAM TAKES PLACE THROUGH FUNDING FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION.- ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS.GLOBAL HEALTH TRACKLEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY.HOSPITAL-WIDE GLOBAL HEALTH PROGRAMTHE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH. *****NEUROLOGY EDUCATION AT BIDMCTHE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. ***** PATHOLOGY EDUCATION AT BIDMC THE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES.KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES.GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS.RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE.GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING.*****RADIOLOGY EDUCATION AT BIDMCTHE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL.WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE:- THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR.- FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR.- ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.OUR UNIQUE EDUCATIONAL TRACKSCURRENTLY, SIX TRACKS ARE OFFERED:- CLINICAL- EDUCATION- RESEARCH- GLOBAL HEALTH- QUALITY IMPROVEMENT- HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.***** SURGERY EDUCATION AT BIDMC THE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, AND VASCULAR SURGERY. STUDENTS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. STUDENTS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION.DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS.REQUIRED WEEKLY CONFERENCES INCLUDE:- RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB- SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS- COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.CARL J. SHAPIRO SIMULATION AND SKILLS CENTERTHE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER (SASC) AT THE MEDICAL CENTER OFFERS THE LATEST ADVANCES IN MEDICAL SIMULATION TECHNOLOGY TO THE MEDICAL CENTER, NEIGHBORING INSTITUTIONS AND THE GLOBAL HEALTHCARE FIELD. THE SASC PROVIDES REALISTIC TRAINING OPPORTUNITIES FOR LEARNERS AT ALL LEVELS, FROM ALL DISCIPLINES, AND USES PROGRESSIVE TEACHING METHODS TO REPLICATE REAL-LIFE PATIENT CARE SITUATIONS, FROM ROUTINE PROCEDURES TO ACUTE MANAGEMENT CRISES.THE SASC RAISES THE BAR FOR MAJOR ACADEMIC MEDICAL CENTERS BY PROVIDING HEALTH CARE STUDENTS AND PROFESSIONALS WITH CURRICULA AND SKILLS TRAINING ON THE LATEST MEDICAL AND SURGICAL TECHNIQUES IN A STATE-OF-THE-ART, TECHNOLOGICALLY ADVANCED FACILITY. THE SASC INCLUDES A LARGE TELECONFERENCE ROOM FOR UP TO 65 LEARNERS AND CONTAINS LIVE MEDIA FEEDS TO FOUR DIFFERENT OPERATING ROOM ENDOSUITES, ALLOWING FOR TELEPROCTORING, INTER-INSTITUTIONAL COURSES, AND INTERCONTINENTAL BROADCASTING OF GRAND ROUNDS. THE HIGH FIDELITY MOCK OPERATING AND INTENSIVE CARE UNIT ROOMS USED FOR FULL-BODY SIMULATION FEATURE WORKING WATER AND GAS LINES, VIDEO CAMERAS AND OBSERVATION WINDOWS WITH STATE-OF-THE-ART TELECONFERENCING ABILITY. TWO SKILLS LAB AREAS ARE DEDICATED TO PROVIDING LEARNERS WITH HANDS-ON TRAINING FOR BASIC CLINICAL PROCEDURES, OPEN SURGICAL SKILLS, ENDOSCOPIC, ULTRA-SONOGRAPHY, AND LAPAROSCOPIC SKILLS WITH OVER 30 PARTIAL TASK TRAINERS AND HIGH-FIDELITY PROCEDURAL SIMULATORS.THE MEDICAL CENTER'S SASC HAS BEEN FORMALLY ACCREDITED SINCE 2006 AS A LEVEL 1 FACILITY BY THE AMERICAN COLLEGE OF SURGEONS (ACS), THE FIRST IN BOSTON AND NEW ENGLAND - AND ONE OF ONLY SEVEN INAUGURAL CERTIFIED CENTERS IN THE UNITED STATES - TO PROVIDE SIMULATION-BASED SKILLS TRAINING TO HEALTH CARE STUDENTS AND PROFESSIONALS FROM ALL MEDICAL AND SURGICAL DISCIPLINES.AS AN ACS ACCREDITED EDUCATION INSTITUTE, THE SASC IS PART OF THE ACS' DEVELOPING NETWORK OF REGIONAL EDUCATION FACILITIES DESIGNED TO "SPECIFICALLY ADDRESS THE TEACHING, LEARNING AND ASSESSMENT OF TECHNICAL SKILLS USING STATE-OF-THE-ART EDUCATIONAL METHODS AND CUTTING-EDGE TECHNOLOGY." SASC IS AMONG THE NATIONAL TEST SITES FOR FUNDAMENTALS OF LAPAROSCOPIC SURGERY (FLS) CANDIDATES. SASC FACULTY PROCTOR THE TWO-PART COGNITIVE AND MANUAL SKILLS EXAM FOR RESIDENTS, FELLOWS AND SURGEONS PERFORMING LAPAROSCOPIC SURGERY.THE SASC HAS ALSO BEEN ACCREDITED BY THE AMERICAN SOCIETY OF ANESTHESIOLOGY AND AMERICAN COLLEGE OF OBSTETRICS AND ONCOLOGY. 1 ALBANY MEDICAL COLLEGE 43 NEW SCOTLAND AVENUE ALBANY NY 12208 146023119 501(C)(3) 109202 0 RESEARCH- SUBAWARD ALBERT EINSTEIN COLLEGE OF MEDICINE 1300 MORRIS PARK AVE BELFER BLDG STE 1108 BRONX NY 10461 472209056 501(C)(3) 36325 0 RESEARCH- SUBAWARD ALBERT SCHWEITZER FELLOWSHIP 109 BROOKLINE AVENUE BOSTON MA 02215 131982786 501(C)(3) 0 97899 FMV SPACE SUPPORT ASF ALTHEA TECHNOLOGIES INC 11040 ROSELLE ST SAN DIEGO CA 92121 330788907 106437 0 RESEARCH- SUBAWARD AMERICAN SOCIETY FOR CLINICAL PATHOLOGY 33 WEST MONROE ST SUITE 1600 CHICAGO IL 606035617 362406080 501(C)(3) 95996 0 RESEARCH- SUBAWARD APTIMA INC 12 GILL ST STE 1400 WOBURN MA 01801 043281859 501(C)(3) 398541 0 RESEARCH- SUBAWARD ATRIUS HEALTH 275 GROVE STREET 300 AUBURNDALE MA 024662272 010803117 501(C)(3) 47955 0 RESEARCH- SUBAWARD BAYLOR COLLEGE OF MEDICINE DR PHILIP NG HOUSTON TX 77030 741613878 501(C)(3) 44435 0 RESEARCH- SUBAWARD BAYLOR RESEARCH INSTITUTE 2001 BRYAN ST STE 2200 DALLAS TX 752013024 751921898 501(C)(3) 10000 0 RESEARCH- SUBAWARD BETH ISRAEL DEACONESS HOSPITAL - MILTON 199 REEDSDALE RD MILTON MA 02186 042103604 501(C)(3) 17622 0 UNRESTRICTED HOSPITAL SUPPORT BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 148 CHESTNUT STREET NEEDHAM MA 02492 043229679 501(C)(3) 10000 0 UNRESTRICTED HOSPITAL SUPPORT BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH 275 SANDWICH STREET PLYMOUTH MA 02360 222667354 501(C)(3) 25346 0 UNRESTRICTED HOSPITAL SUPPORT BLOOD SYSTEMS RESEARCH INSTITUTE PO BOX 53022 PHOENIX AZ 850723022 860098929 9517 RESEARCH- SUBAWARD BOARD OF REGENTS UNIVERSITY OF NEBRASKA 3835 HOLREGE STREET LINCOLN NE 68583 470049123 501(C)(3) 28626 0 RESEARCH- SUBAWARD BOSTON CHILDREN'S HOSPITAL 300 LONGWOOD AVE BOSTON MA 02115 042774441 501(C)(3) 531664 0 RESEARCH- SUBAWARD BOSTON MEDICAL CENTER 650 ALBANY ST ROOM 607 BOSTON MA 02118 043314093 19973 RESEARCH- SUBAWARD BOSTON UNIVERSITY P O BOX 55057 BOSTON MA 02205 042103547 501(C)(3) 820749 0 RESEARCH- SUBAWARD BREAST CANCER RESEARCH FOUNDATION 60 EAST 56TH STREET NEW YORK NY 10220 133727250 501(C)(3) 10600 0 SUPPORT BREAST CANCER RESEARCH BRIGHAM & WOMENS HOSP PO BOX 3149 ATTN PS 102450 BOSTON MA 022413149 042312909 501(C)(3) 3668823 0 RESEARCH- SUBAWARD BROAD INSTITUTE 415 MAIN ST CAMBRIDGE MA 02142 263428781 501(C)(3) 182652 0 RESEARCH- SUBAWARD BUTLER HOSPITAL 345 BLACKSTONE BLVD PROVIDENCE RI 02906 251441961 501(C)(3) 21394 0 RESEARCH- SUBAWARD CASE WESTERN RESERVE UNIVERSITY 1100 EUCLID AVE RM790 CLEVELAND OH 441066003 341018992 501(C)(3) 633092 0 RESEARCH- SUBAWARD CATALENT PHARMA SOLUTIONS 25109 NETWORK PLACE CHICAGO IL 606731251 133523163 2741215 0 RESEARCH- SUBAWARD CHARLES RIVER COMMUNITY HEALTH 495 WESTERN AVENUE BRIGHTON MA 02135 237221597 501(C)(3) 422980 3710 OTHER TECHNOLOGY SUPPORT PRIMARY CARE / HEALTHCARE ACCESS CHARLES RIVER LABS GPO BOX 27812 NEW YORK NY 100877812 061397316 94371 0 RESEARCH- SUBAWARD CITY OF BOSTON 1 CITY HALL SQUARE BOSTON MA 02201 3174163 209524 FMV EMS SPACE SUPPORT FOR CITY SERVICES COMMUNITY CARE ALLIANCE 330 BROOKLINE AVE BOSTON MA 02215 043756900 501(C)(3) 15140 59000 OTHER TECHNOLOGY SUPPORT PRIMARY CARE/ HEALTHCARE ACCESS COVANCE LABS PO BOX 2464 BURLINGTON NC 272162464 540898188 38036 RESEARCH- SUBAWARD DANA FARBER 44 BINNEY ST - M/S BP410 BOSTON MA 02115 042263040 501(C)(3) 1393407 0 RESEARCH- SUBAWARD DIMOCK COMMUNITY HEALTH CENTER 55 DIMOCK STREET DORCHESTER MA 02119 043487835 501(C)(3) 660126 15300 OTHER TECHNOLOGY SUPPORT PRIMARY CARE/ HEALTHCARE ACCESS/ HIV SUPPORT/ SUBSTANCE ABUSE SUPPORT DUKE UNIVERSITY OFFICE OF SPONSORED PROGRAM DURHAM NC 277080491 560532129 501(C)(3) 219361 0 RESEARCH- SUBAWARD EMORY UNIVERSITY SCHOOL OF MEDICINE ATLANTA GA 303224250 580566256 831670 0 RESEARCH- SUBAWARD FENWAY COMMUNITY HEALTH CENTER 1340 BOYLSTON STREET BOSTON MA 022154302 042510564 501(C)(3) 2206990 0 RESEARCH- SUBAWARD FENWAY SIDNEY BORUM COMMUNITY HEALTH CENTER 55 DIMOCK STREET DORCHESTER MA 02119 042510564 501(C)(3) 703000 41200 OTHER TECHNOLOGY SUPPORT PRIMARY CARE/ HEALTHCARE ACCESS FLORIDA A&M UNIVERSITY CONTRACTS GRANTS ACCOUNTING TALLAHASSEE FL 323073200 623751831 49814 RESEARCH- SUBAWARD FOUR CORNERS ACTION COALITION 367 WASHINGTON ST DORCHESTER MA 02125 043363133 18866 RESEARCH- SUBAWARD FRED HUTCHINSON CANCER RESEARCH CENTER 1100 FARIVIEW AVE N SEATTLE WA 981091024 237156071 501(C)(3) 494161 0 RESEARCH- SUBAWARD GEISINGER CLINIC GEISINGER HEALTH SYSTEM DANVILLE PA 178223069 236291113 501(C)(3) 48873 0 RESEARCH- SUBAWARD GEORGETOWN UNIVERSITY OFFICE OF TECH LIC HARRIS BLDG STE 1500 WASHINGTON DC 20007 530196603 501(C)(3) 118307 0 RESEARCH- SUBAWARD GROUP HEALTH COOPERATIVE CENTER FOR HEALTH STUDIES SEATTLE WA 981011448 910511770 501(C)(3) 9214 0 RESEARCH- SUBAWARD HEALTHCARE FOR ALL ONE FEDERAL STREET BOSTON MA 02110 501(C)(3) 7500 0 HEALTHCARE ACCESS HEBREW REHABILITATION CENTER ATTWENDY GUTTERSON PRACTICE ADMIN ROSLINDALE MA 02122 042104298 501(C)(3) 195473 0 RESEARCH- SUBAWARD HENRY FORD HEALTH SYSTEM DEPT OF NEUROLOGY W-1103 DETROIT MI 48202 381357020 29800 RESEARCH- SUBAWARD HSL INSTITUTE FOR AGING RESEARCH 1200 CENTRE STREET ROSLINDALE MA 02131 042104298 60756 0 RESEARCH- SUBAWARD INDIANA UNIVERSITY PO BOX 66271 INDIANAPOLIS IN 462666271 356018940 501(C)(3) 26473 0 RESEARCH- SUBAWARD JOHNS HOPKINS UNIVERSITY JHU REFERENCE LABORATORY BALTIMORE MD 212644478 520595110 501(C)(3) 429948 0 RESEARCH- SUBAWARD JOSLIN DIABETES CENTER TECH TRANS CONSULANT RM 503 BOSTON MA 02215 012203836 501(C)(3) 40746 0 RESEARCH- SUBAWARD KAISER FOUNDATION HEALTH PLAN INC ATTN NORTHERN CALIFORNIA CLAIMS ADMIN SAN FRANCISCO CA 94160 941340523 19407 RESEARCH- SUBAWARD KIT CLARK COMMUNITY HEALTH CENTER 66 CANAL STREET BOSTON MA 02214 460516856 501(C)(3) 45000 0 SENIOR SERVICES COORDINATION SUPPORT LEIDOS BIOMEDICAL RESEARCH INC 8560 PROGRESS DRIVE FREDERICK MD 21701 330653185 1277463 0 RESEARCH- SUBAWARD LOS ALAMOS NATIONAL LABORATORY PO BOX 1663 MAIL STOP P245 LOS ALAMOS NM 87545 203104541 273868 RESEARCH- SUBAWARD LOUIS D BROWN INSTITUTE 15 CHRISTOPHER ST DORCHESTER MA 02122 263068254 501(C)(3) 10000 0 SUPPORT OF VIOLENCE PREVENTION LOYOLA UNIVERSITY 2160 SOUTH FIRST AVE CTRERM258 MAYWOOD IL 60153 361408475 13375 RESEARCH- SUBAWARD MASSACHUSETTS GENERAL HOSPITAL MGH RESEARCH FINANCE BOSTON MA 022414876 041564655 501(C)(3) 2713351 0 RESEARCH- SUBAWARD MASSACHUSETTS INSTITUTE OF TECHNOLOGY 77 MASSACHUSETTS AVENUE CAMBRIDGE MA 02139 042103594 851748 0 RESEARCH- SUBAWARD MAYO CLINIC ROCHESTER 200 FIRST ST ROCHESTER MA 55901 416011702 9595 0 RESEARCH- SUBAWARD MD ANDERSON CANCER CENTER ACCOUNTS PAYABLE BOX 1699 HOUSTON TX 772301401 746001118 67114 0 RESEARCH- SUBAWARD MEDICAL CARE OF BOSTON MANAGEMENT CORP DBA BETH ISRAEL DEACONESS HEALTHCA 464 HILLSIDE AVE STE 304 NEEDHAM MA 02494 042810972 501(C)(3) 25599063 0 PRIMARY CARE / HEALTHCARE ACCESS MEDICAL COLLEGE OF WISCONSIN 9200 WEST WISCONSIN AVE MILWAUKEE WI 53226 390806261 501(C)(3) 26709 0 RESEARCH- SUBAWARD MEDICAL UNIVERSITY OF SOUTH CAROLINA 173 ASHLEY THOMAS MSC 509 CHARLESTON SC 29425 576000722 501(C)(3) 437300 0 RESEARCH- SUBAWARD NEW MEXICO CONSORTIUM INC 4200 WEST JEMEZ ROAD STE 301 LOS ALAMOS NM 87544 260370262 55049 0 RESEARCH- SUBAWARD ON DIAGNOSTICS LLC 2150 SHATTUCK AVE STE 610 BERKELEY CA 94704 30435 RESEARCH- SUBAWARD OCHIN INC 1881 SW NAITO PARKWAY PORTLAND OR 97201 200195556 40662 RESEARCH- SUBAWARD OPERATION ABLE 174 PORTLAND STREET 5TH FLOOR BOSTON MA 02114 042761871 501(C)(3) 10000 0 SUPPORT FOR CHILDREN IN NEED OREGON HEALTH & SCIENCE UNIVERSITY DEPT OF BIOMEDICAL ENGINEERING PORTLAND OR 97239 237083114 2796897 RESEARCH- SUBAWARD OUTER CAPE PRIMARY CARE 3073 STATE HIGHWAY RTE 6 WELLFLEET MA 02653 042509828 501(C)(3) 122000 1590 OTHER TECHNOLOGY SUPPORT PRIMARY CARE/ HEALTHCARE ACCESS PENNSYLVANIA STATE UNIV COLLEGE OF MED 227 W BEAVER AVE STE 401 STATE COLLEGE PA 168014819 246000376 236049 RESEARCH- SUBAWARD PRESIDENT & FELLOWS OF HARVARD COLLEGE PO BOX 4999 BOSTON MA 02212 042103580 501(C)(3) 4004040 0 RESEARCH- SUBAWARD PRESIDENT & FELLOWS OF HARVARD COLLEGE 25 SHATTUCK ST BOSTON MA 02215 042103580 501(C)(3) 4356073 0 MEDICAL EDUCATION AND RESEARCH SUPPORT REGENTS OF THE UNIVERSITY OF CALIFORNIA ACCOUNTS PAYABLE SAN FRANCISCO CA 94143 946036493 501(C)(3) 174933 0 RESEARCH- SUBAWARD REGENTS OF THE UNIVERSITY OF MICHIGAN UMHS C/O ALI JONES ANN ARBOR MI 481095346 386006309 501(C)(3) 36707 0 RESEARCH- SUBAWARD REGENTS OF THE UNIVERSITY OF MINNESOTA NW 5957 MINNEAPOLIS MN 554855957 416007513 501(C)(3) 44110 0 RESEARCH- SUBAWARD RHODE ISLAND HOSPITAL 593 EDDY ST RESEARCH ADMIN PROVIDENCE RI 02903 050258954 501(C)(3) 13304 0 RESEARCH- SUBAWARD RUSH UNIVERSITY MEDICAL CENTER 1725 W HARRISION ST STE 375 CHICAGO IL 60612 362174823 23438 RESEARCH- SUBAWARD SAINT VINCENT HOSPITAL PO BOX 3385 BOSTON MA 02241 621861198 501(C)(3) 13037 0 RESEARCH- SUBAWARD SALK INSTITUTE OF BIOLOGICAL STUDIES PO BOX 85800 SAN DIEGO CA 921865800 952160097 275288 RESEARCH- SUBAWARD SCRIPPS RESEARCH INSTITUTE 10550 NORTH TORREY PINES RD LA JOLLA CA 92037 330435954 1194305 RESEARCH- SUBAWARD SHAPIRO INSTITUTE FOR EDUCATION RESEARCH AT HARVARD MEDICAL SCHOOL 330 BROOKLINE AVE BOSTON MA 02215 043326928 501(C)(3) 0 167272 FMV SPACE & STAFF SUPPORT SUPPORT EDUCATION ACTIVITIES OF THE INSTITUTE SIGNATURE HEALTHCARE 680 CENTRE STREET BROCKTON MA 02302 042103554 501(C)(3) 25000 0 PRIMARY CARE / HEALTHCARE ACCESS SIMMONS COLLEGE ATHLETIC DEPT BOSTON MA 02215 042103629 107458 RESEARCH- SUBAWARD SOUTH COVE COMMUNITY HEALTH CENTER 145 SOUTH STREET BOSTON MA 02111 042501818 501(C)(3) 892920 23250 OTHER TECHNOLOGY SUPPORT PRIMARY CARE / HEALTHCARE ACCESS ST JOSEPH'S HOSPITAL AND MEDICAL CENTER RESEARCH ADMINISTRATION PHOENIX AZ 85013 721561134 8050 0 RESEARCH- SUBAWARD ST JOSEPH'S HOSPITAL AND MEDICAL CENTER RESEARCH ADMINISTRATION PHOENIX AZ 85013 721561134 8050 RESEARCH- SUBAWARD STANFORD UNIVERSITY OFFICE OF TECHNOLOGY LICENSING SAN FRANCISCO CA 941444439 941156365 501(C)(3) 85823 0 RESEARCH- SUBAWARD THE CLEVELAND CLINIC FOUNDATION PO BOX 931652 CLEVELAND OH 441935012 340714585 89647 RESEARCH- SUBAWARD THE COLLEGE OF WOOSTER ATTN ACCOUNTING MANAGER WOOSTER WI 44691 340714654 43972 RESEARCH- SUBAWARD THE HENRY M JACKSON FOUNDATION FOR ADVANCEMENT OF MILITARY MEDICINE BETHESDA MD 20817 521317896 178018 RESEARCH- SUBAWARD THE MIRIAM HOSPITAL ONE HOPPIN ST BOX 42 STE 1300 PROVIDENCE RI 029034141 050258905 501(C)(3) 475057 0 RESEARCH- SUBAWARD THE UNIVERSITY OF CHICAGO SPONSORED AWARD ACCOUNTING CHICAGO IL 60637 362177139 501(C)(3) 32940 0 RESEARCH- SUBAWARD TRUSTEES OF BOSTON UNIVERSITY BOSTON UNIVERSITY BOSTON MA 02205 042103547 501(C)(3) 212767 0 RESEARCH- SUBAWARD TRUSTEES OF COLUMBIA UNIVERSITY 630 W 168TH BOX 31 NEW YORK NY 10032 135598093 55938 0 RESEARCH- SUBAWARD TRUSTEES OF DARTMOUTH COLLEGE OFFICE OF SPONSORED PROJECTS HANOVER NH 037551404 020222111 501(C)(3) 114374 0 RESEARCH- SUBAWARD TRUSTEES OF TUFTS COLLEGE DEPT OF PHARM EXPERIMENTAL BOSTON MA 02111 042103634 501(C)(3) 332214 0 RESEARCH- SUBAWARD U C REGENTS- UNIV OF CALIFORNIA S FRANC REMITTANCE CENTER LOS ANGELES CA 900246503 946036493 21915 RESEARCH- SUBAWARD UMASS MEDICAL SCHOOL 55 LAKE AVE NORTH WORCESTER MA 01655 043167352 501(C)(3) 202091 0 RESEARCH- SUBAWARD UNIVERSITY OF COLORADO AT DENVER OFFICE OF GRANTS CONTRACTS F428 DENVER CO 802910439 32932 0 RESEARCH- SUBAWARD UNIVERSITY OF FLORIDA DEPT OF MEDICINE ADMIN GAINESVILLE FL 326103594 596002052 501(C)(3) 20247 0 RESEARCH- SUBAWARD UNIVERSITY OF FLORIDA BOARD OF TRUSTEES FINANCE ACCOUNTING-CONTRACTS GAINSVILLE FL 32611 596002052 501(C)(3) 63821 0 RESEARCH- SUBAWARD UNIVERSITY OF GEORGIA A LIFE SCIENCES BUILDING ATHENS GA 30602 586001998 59600 0 RESEARCH- SUBAWARD UNIVERSITY OF HAWAII OFFICE OF RESEARCH 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SUBAWARD VIRGINIA COMMONWEALTH UNIVERSITY GRANTS CONTRACTS ACCOUNTING RICHMOND VA 23284 232843035 33456 0 RESEARCH- SUBAWARD WE CAN DO BETTER DBA ACHIMEDES MOVEMENT PO BOX 13314 PORTLAND OR 97213 80000 0 RESEARCH- SUBAWARD WEILL CORNELL MEDICAL COLLEGE DEPT OF PATHOLOGY LAB MEDICINE NEW YORK NY 10021 131623978 501(C)(3) 197820 0 RESEARCH- SUBAWARD WHITEHEAD INSTITUTE 9 CAMBRIDGE CENTER CAMBRIDGE MA 02142 061043412 74036 0 RESEARCH- SUBAWARD WISCONSIN COLLABORATIVE FOR HC QUAILITY PO BOX 628578 MIDDLETON WI 535628578 550848113 10598 0 RESEARCH- SUBAWARD WOMEN & INFANTS HOSPITAL OF RHODE ISLAND 101 DUDLEY ST PROVIDENCE RI 02905 050258937 8000 RESEARCH- SUBAWARD YALE UNIVERSITY OFFICE OF CORPORATE RESEARCH NEW HAVEN CT 06511 060646973 501(C)(3) 174380 0 RESEARCH- SUBAWARD 77 47 PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE US AS PREVIOUSLY DENOTED IN GREATER DETAIL IN THIS FORM 990, SCHEDULE H, HOSPITALS, WHICH DESCRIBES THE MEDICAL CENTER'S COMMITMENT TO ITS COMMUNITY, THE MEDICAL CENTER PARTNERS WITH COMMUNITY LEADERS AND COMMUNITY-BASED ORGANIZATIONS. THESE ORGANIZATIONS SERVE AS LINKS TO THE COMMUNITY AND TEACHERS OF HOW WE CAN BETTER SERVE THE POPULATIONS THEY REPRESENT. IN ADDITION, THE MEDICAL CENTER COLLABORATES WITH A WIDE VARIETY OF ORGANIZATIONS BECAUSE HEALTHCARE SERVICES BY THEMSELVES ARE NOT ADEQUATE TO MAXIMIZE IMPROVEMENT OF HEALTH STATUS. AS SUCH, THE MEDICAL CENTER'S INVOLVEMENT WITH OUR COMMUNITY IS ON-GOING AND PART OF THAT ON-GOING RELATIONSHIP INCLUDES REPORTING ON HOW GRANT FUNDS ARE EXPENDED. AS A RECIPIENT OF FEDERAL SPONSORED AWARDS, THE MEDICAL CENTER MUST COMPLY WITH THE GUIDELINES SPECIFIC TO THE FEDERAL AWARDING AGENCY FOR THE PARTICULAR PROGRAM. THE MEDICAL CENTER'S ADHERENCE TO THESE PROGRAMS REQUIREMENTS ARE AUDITED ANNUALLY AS REQUIRED BY 2 CFR PART 200, UNIFORM ADMINISTRATIVE REQUIREMENTS, COST PRINCIPLES, AND AUDIT REQUIREMENTS FOR FEDERAL AWARDS. THE MEDICAL CENTER IS REQUIRED BY FEDERAL REGULATION TO MONITOR EXPENSES OF FEDERAL FUNDS AWARDED TO THE MEDICAL CENTER THAT ARE SUB-CONTRACTED TO ANOTHER INSTITUTION, ORGANIZATION, OR INDIVIDUAL. FEDERAL SUBCONTRACTED RESEARCH GRANTS AS WELL AS OTHER SUBCONTRACTED RESEARCH GRANTS ARE MONITORED BY THE CLINICAL DEPARTMENT SPONSORING THE ACTIVITY. SIMILAR MONITORING PROGRAMS ARE IN PLACE THAT ASSURE ADHERENCE TO ALL NON-FEDERAL SPONSOR'S GRANT REQUIREMENTS AS WELL THROUGH A GROUP OF DEDICATED RESEARCH ADMINISTRATIVE PROFESSIONAL THAT REPORTS UP THROUGH THE OFFICE OF ACADEMIC AFFAIRS. THIS REPORTING STRUCTURE FURTHER ENHANCES INTERNAL CONTROLS. THE SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH IS AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND A SUPPORT ORGANIZATION OF THE MEDICAL CENTER. THE MEDICAL CENTER'S DEPARTMENTS OF FISCAL SERVICES AND MEDICAL EDUCATION MANAGEMENT MONITOR PERIODIC SPENDING REPORTS SENT BY THE SHAPIRO INSTITUTE FOR REVIEW AND APPROVAL. X X X X 0 1 0 0 0 0 0 1 0 CHAIKOF MD PHD ELLIOT L DIRECTOR (EX-OFF) & SURG CHIEF 510664 510664 0 0 7983 7983 39388 39388 18476 18476 576511 576511 0 0 KIMBALL MD ALEXA DIR (EX-OFF); PRES & CEO, HMFP 0 302564 0 26097 0 5837 0 37100 0 15685 0 387283 0 0 TABB MD KEVIN CEO & DIRECTOR (EX-OFFICIO) 1019207 0 405820 0 20703 0 127000 0 43597 0 1616327 0 0 0 ZEIDEL MD MARK L DIRECTOR (EX-OFF) & MED CHIEF 376386 376386 0 0 7327 7327 23224 23224 8975 8975 415912 415912 0 0 FISCHER STEVEN ASSISTANT TREASURER 533797 0 13648 0 47883 0 23850 0 51552 0 670730 0 0 0 FORMELLA RN MSN NANCY CHIEF OPERATING OFFICER 610377 0 18540 0 64854 0 19875 0 37687 0 751333 0 0 0 HEALY PETER PRESIDENT 0 411576 0 63000 0 19019 0 20750 0 38581 0 552926 0 0 ARMSTRONG WALTER SVP, CAP FACILITIES & ENGINEER 328994 0 8375 0 24041 0 23850 0 23278 0 408538 0 0 0 BIEBER JUDITH CHIEF HR OFFICER 319151 0 8250 0 20515 0 39382 0 42377 0 429675 0 0 0 HALAMKA MD JOHN CHIEF INFOR OFFICER BID SYSTEM 387299 0 9897 0 18954 0 23850 0 40288 0 480288 0 0 0 LEWIS MD STANLEY M CHIEF SYS DEVMT & STRATEGY OFF 531104 0 13475 0 37732 0 29150 0 44381 0 655842 0 0 0 MAURER RN MSN MARSHA CNO & SVP, PATIENT CARE SVCS 389225 0 87500 0 20772 0 2520 0 44701 0 544718 0 0 0 SHEEHAN RN MSN JAYNE SVP, SYS INTEG, CARE COORD 331853 0 8480 0 20297 0 34829 0 31764 0 427223 0 0 0 SKURA SAMUEL SVP, AMBUL & CLINICAL SVCS 0 236448 0 48750 0 6019 0 26813 0 23202 0 341232 0 0 SUKHATME MD SCD VIKAS P CHIEF ACADEMIC OFFICER 481400 0 10463 0 50513 0 33204 0 38287 0 613867 0 0 0 TANDON MANU VP, DEPUTY CIO, CTO 313571 0 4875 0 3243 0 6300 0 39554 0 367543 0 0 0 GEBHARDT MD MARK C CHIEF OF ORTHOPAEDIC SURGERY 396166 396166 0 0 9792 9792 31659 31659 11043 11043 448660 448660 0 0 KRUSKAL MD PHD JONATHAN B CHIEF OF RADIOLOGY 360391 360391 0 0 6193 6193 15900 15900 15993 15993 398477 398477 0 0 STERN MD ROBERT S CHIEF OF DERMATOLOGY 316605 316605 0 0 11188 11188 31898 31898 9895 9895 369586 369586 0 0 STEVENSON MD PHD MARY ANN CHIEF OF RADIATION ONCOLOGY 342980 342980 0 0 6274 6274 24844 24844 17523 17523 391621 391621 0 0 TALMOR MD MPH DANIEL CHIEF OF ANESTHESIA 326291 326291 0 0 4312 4312 26500 26500 14718 14718 371821 371821 0 0 PART I, LINE 4B AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN THE MEDICAL CENTER'S FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2017 IS CALENDAR YEAR 2016 DETAIL DURING THE 2016 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 THE MEDICAL CENTER'S EXECUTIVE COMPENSATION PACKAGES INCLUDE OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING THE MEDICAL CENTER'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, THE MEDICAL CENTER'S BUDGETED CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. THE INCENTIVE COMPENSATION FOR EACH EXECUTIVE IS REVIEWED AND APPROVED BY THE MEDICAL CENTER'S 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 REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED FULLY VESTED 457(B) PLAN; VESTED AMOUNTS UNDER 457(F) PLAN; TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AND 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, 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, 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 MEDICAL CENTER AND HARVARD MEDICAL FACULTY 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 BIDMC AND HMFP RESPECTIVELY. IN ADDITION, THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL MAY BE REFERRED TO AS PFHC, HMS OR PFHC/HMS. ANDERSON, CAROL F. DIRECTOR AND FIRST VICE CHAIR - BETH ISRAEL DEACONESS MEDICAL CENTER MS. ANDERSON DEVOTES, ON AVERAGE, 5 HOURS PER WEEK TO THE REPORTING ORGANIZATION. BRADY, MICHAEL J. DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR AND BOARD CHAIR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR AND BOARD CHAIR - MILTON HOSPITAL FOUNDATION DIRECTOR AND BOARD CHAIR - COMMUNITY PHYSICIANS ASSOCIATES MR. BRADY DEVOTES, ON AVERAGE, A COMBINED 11 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. CHAIKOF, M.D., PHD, ELLIOT DIRECTOR (EX-OFFICIO) AND CHIEF (SURGERY) - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (SURGERY) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND PRESIDENT - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION TRUSTEE - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. JOHNSON & JOHNSON PROFESSOR OF SURGERY - HARVARD MEDICAL SCHOOL DR. CHAIKOF DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. CHAIKOF PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. CHAIKOF IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. CHAIKOF'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 510,664 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,983 DEFERRED COMPENSATION: 39,388 NON-TAXABLE BENEFITS: 18,476 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 510,664 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,983 DEFERRED COMPENSATION: 39,388 NON-TAXABLE BENEFITS: 18,476 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2016 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. CHAIKOF'S POSITION AS CHIEF OF SURGERY AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF SURGERY AND JOHNSON & JOHNSON PROFESSOR OF SURGERY, HARVARD MEDICAL SCHOOL: $230,605 BASE AND OTHER REPORTABLE COMPENSATION, $29,088 DEFERRED COMPENSATION AND $4,308 NON-TAXABLE BENEFITS. CHENG, JILL DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MS. CHENG DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. CRONIN, MICHAEL DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. CRONIN DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. DESIMONE, THOMAS DIRECTOR (EX-OFFICIO) AND TRUSTEE ADVISORY BOARD CHAIR- BETH ISRAEL DEACONESS MEDICAL CENTER MR. DESIMONE DEVOTES, ON AVERAGE, 5 HOURS PER WEEK TO THE REPORTING ORGANIZATION. DIPP, MD, PHD, MICHELLE DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER DR. DIPP DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. FULP, CAROL DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MS. FULP DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. GORMAN, LISA DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MS. GORMAN'S TERM ON THE BETH ISRAEL DEACONESS MEDICAL CENTER BOARD BEGAN FEBRUARY 14, 2017. MS. GORMAN DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. HINKLEY, CLARK DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR, CHAIR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH TRUSTEE, CHAIR - JORDAN PHYSICIAN ASSOCIATES DIRECTOR, CHAIR - JORDAN HEALTH SYSTEM, INC. MR. HINKLEY DEVOTES, ON AVERAGE, A COMBINED 11 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. JICK, DANIEL J. DIRECTOR AND BOARD CHAIR - BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE (EX-OFFICIO) - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR (EX-OFFICIO) - CAREGROUP , INC. MR. JICK DEVOTES, ON AVERAGE, A COMBINED 12 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES (CONTINUED): JOHNSTON, WILLIAM DIRECTOR AND TREASURER - BETH ISRAEL DEACONESS MEDICAL CENTER MR. JOHNSTON DEVOTES, ON AVERAGE, 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION. KIMBALL, M.D., MPH, ALEXA B. DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT, CHIEF EXECUTIVE OFFICER AND DIRECTOR (EX-OFFICIO) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - LONGWOOD MEDICAL INTERNATIONAL FOUNDATION, INC. DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION DIRECTOR (EX-OFFICIO) - CONTINUING EDUCATION PROGRAM, INC. D/B/A BETH ISRAEL DEACONESS DEPARTMENT OF PSYCHIATRY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORP., D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP PROFESSOR OF DERMATOLOGY - HARVARD MEDICAL SCHOOL DR. KIMBALL 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 HMFP: BASE COMPENSATION: 302,564 INCENTIVE COMPENSATION: 26,097 OTHER REPORTABLE COMPENSATION: 5,837 DEFERRED COMPENSATION: 37,100 NON-TAXABLE BENEFITS: 15,685 LADD, EDWARD DIRECTOR AND VICE CHAIR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. LADD DEVOTES, ON AVERAGE, 5 HOURS PER WEEK TO THE REPORTING ORGANIZATION. LAMERE, DAVID DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. LAMERE DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. LEPOFSKY, ROBERT J. DIRECTOR AND SECRETARY- BETH ISRAEL DEACONESS MEDICAL CENTER MR. LEPOFSKY DEVOTES, ON AVERAGE, 2 HOUR PER WEEK TO THE REPORTING ORGANIZATION. LI, M.D., CHIANG DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER DR. LI'S TERM ON THE BETH ISRAEL DEACONESS MEDICAL CENTER BOARD BEGAN OCTOBER 1, 2016. MR. LI DEVOTES, ON AVERAGE, 31 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND RELATED ENTITIES. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 56,000 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 MANDELL, M.D., JAMES DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER DR. MANDELL DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. MCKENNA, MARGARET DIRECTOR AND VICE CHAIR - BETH ISRAEL DEACONESS MEDICAL CENTER MS. MCKENNA DEVOTES, ON AVERAGE, 5 HOURS PER WEEK TO THE REPORTING ORGANIZATION. O'HANLEY, RONALD DIRECTOR AND VICE CHAIR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. O'HANLEY DEVOTES, ON AVERAGE, 5 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PLINE, JENNIFER DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE AND BOARD CHAIR - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM MS. PLINE DEVOTES, ON AVERAGE, A COMBINED 11 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. REHNERT, GEOFF DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. REHNERT'S TERM ON THE BETH ISRAEL DEACONESS MEDICAL CENTER BOARD BEGAN OCTOBER 1, 2016. MR. REHNERT DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. ROTTENBERG, ALAN DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. ROTTENBERG DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. SILVER, JENNIFER DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MS. SILVER DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. TABB, M.D., KEVIN 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 DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR - JORDAN HEALTH SYSTEMS, INC. DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR AND PRESIDENT - BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY TRUSTEE (EX-OFFICIO) AND CO-CHAIR - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. 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: 1,019,207 INCENTIVE COMPENSATION: 405,820 OTHER REPORTABLE COMPENSATION: 20,703 DEFERRED COMPENSATION: 127,000 NON-TAXABLE BENEFITS: 43,597 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $127,775. OF THIS AMOUNT, $109,775 IS BOTH UNFUNDED AND UNVESTED. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES (CONTINUED): ZEIDEL, M.D. MARK L. DIRECTOR (EX-OFFICIO) AND CHIEF (MEDICINE) - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (MEDICINE) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP DIRECTOR - LONGWOOD MEDICAL INTERNATIONAL FOUNDATION PRESIDENT AND DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPT. OF MEDICINE FOUNDATION TRUSTEE - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. ZEIDEL DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. ZEIDEL PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ZEIDEL IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. ZEIDEL'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 376,386 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,327 DEFERRED COMPENSATION: 23,224 NON-TAXABLE BENEFITS: 8,975 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 376,386 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,327 DEFERRED COMPENSATION: 23,224 NON-TAXABLE BENEFITS: 8,975 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2016 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. ZEIDEL'S POSITION AS CHIEF OF MEDICINE AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF MEDICINE AND HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: $155,902 BASE AND OTHER REPORTABLE COMPENSATION, $17,298 DEFERRED COMPENSATION AND $1,917 NON-TAXABLE BENEFITS. FISCHER, STEVEN SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER ASSISTANT TREASURER - BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - MILTON HOSPITAL FOUNDATION DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. DIRECTOR AND TREASURER - BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY MR. FISCHER SERVED AS A SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER OF BIDMC THROUGH APRIL 30, 2017 AND COMMENCED HIS POSITION AS ASSISTANT TREASURER OF BIDMC ON MAY 1, 2017. MR. FISCHER DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 533,797 INCENTIVE COMPENSATION: 13,648 OTHER REPORTABLE COMPENSATION: 47,883 DEFERRED COMPENSATION: 23,850 NON-TAXABLE BENEFITS: 51,552 OTHER REPORTABLE COMPENSATION FOR MR. FISCHER INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $43,955. FORMELLA, R.N., M.S.N., NANCY CHIEF OPERATING OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MS. FORMELLA'S POSITION AS BETH ISRAEL DEACONESS MEDICAL CENTER'S CHIEF OPERATING OFFICER ENDED DECEMBER 31, 2016. MS. FORMELLA DEVOTED, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 610,377 INCENTIVE COMPENSATION: 18,540 OTHER REPORTABLE COMPENSATION: 64,854 DEFERRED COMPENSATION: 19,875 NON-TAXABLE BENEFITS: 37,687 OTHER REPORTABLE COMPENSATION FOR MS. FORMELLA INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $62,185. CULLEN, MICHAEL R. CHIEF FINANCIAL OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER MR. CULLEN COMMENCED HIS POSITION AS BETH ISRAEL DEACONESS MEDICAL CENTER'S CHIEF FINANCIAL OFFICER ON MAY 1, 2017. MR. CULLEN DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. HEALY, PETER PRESIDENT - BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT, CHIEF EXECUTIVE OFFICER AND DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - MILTON PRESIDENT, CHIEF EXECUTIVE OFFICER AND DIRECTOR (EX-OFFICIO) - MILTON HOSPITAL FOUNDATION PRESIDENT, CHIEF EXECUTIVE OFFICER AND DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES MR. HEALY'S POSITION AS THE PRESIDENT OF BETH ISRAEL DEACONESS MEDICAL CENTER COMMENCED JANUARY 2, 2017. PRIOR TO SERVING AS BIDMC'S PRESIDENT, MR. HEALY SERVED AS THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON, MILTON HOSPITAL FOUNDATION AND COMMUNITY PHYSICIANS ASSOCIATES. MR. HEALY DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS NOTED IN THIS RETURN, COMPENSATION REPORTED IN THIS RETURN FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2017 IS CALENDAR YEAR 2016 COMPENSATION. FOR THE CALENDAR YEAR 2016, MR. HEALY SERVED AS THE PRESIDENT AND CEO FOR BID-MILTON, COMMUNITY PHYSICIANS ASSOCIATES AND THE MILTON HOSPITAL FOUNDATION. AS SUCH, ALTHOUGH MR. HEALY WAS PAID BY BIDMC DURING THE CALENDAR YEAR 2016, THE PAYMENTS MADE TO HIM HAVE BEEN REPORTED AS NOTED BELOW: PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 399,229 INCENTIVE COMPENSATION: 61,110 OTHER REPORTABLE COMPENSATION: 18,448 DEFERRED COMPENSATION: 20,128 NON-TAXABLE BENEFITS: 37,424 PAYMENTS REPORTED BY CPA: BASE COMPENSATION: 12,347 INCENTIVE COMPENSATION: 1,890 OTHER REPORTABLE COMPENSATION: 571 DEFERRED COMPENSATION: 623 NON-TAXABLE BENEFITS: 1,157 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. HEALY INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $22,850. OF THIS AMOUNT, $4,850 IS BOTH UNFUNDED AND UNVESTED. OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. HEALY INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $22,850. OF THIS AMOUNT, $4,850 IS BOTH UNFUNDED AND UNVESTED. ARMSTRONG, WALTER SENIOR VICE PRESIDENT, CAPITAL FACILITIES AND ENGINEERING - BETH ISRAEL DEACONESS MEDICAL CENTER MR. ARMSTRONG DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 328,994 INCENTIVE COMPENSATION: 8,375 OTHER REPORTABLE COMPENSATION: 24,041 DEFERRED COMPENSATION: 23,850 NON-TAXABLE BENEFITS: 23,278 OTHER REPORTABLE COMPENSATION FOR MR. ARMSTRONG INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $19,700. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES (CONTINUED): BIEBER, JUDITH CHIEF HUMAN RESOURCES OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER MS. BIEBER DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 319,151 INCENTIVE COMPENSATION: 8,250 OTHER REPORTABLE COMPENSATION: 20,515 DEFERRED COMPENSATION: 39,382 NON-TAXABLE BENEFITS: 42,377 OTHER REPORTABLE COMPENSATION FOR MS. BIEBER INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $18,000. HALAMKA, M.D., JOHN CHIEF INFORMATION OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER AND AFFILIATES DR. HALAMKA DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ITS RELATED ENTITIES. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 387,299 INCENTIVE COMPENSATION: 9,897 OTHER REPORTABLE COMPENSATION: 18,954 DEFERRED COMPENSATION: 23,850 NON-TAXABLE BENEFITS: 40,288 OTHER REPORTABLE COMPENSATION FOR DR. HALAMKA INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $18,000. LEWIS, M.D., STANLEY 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 DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. 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: 531,104 INCENTIVE COMPENSATION: 13,475 OTHER REPORTABLE COMPENSATION: 37,732 DEFERRED COMPENSATION: 29,150 NON-TAXABLE BENEFITS: 44,381 OTHER REPORTABLE COMPENSATION FOR DR. LEWIS INCLUDES PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $33,859. MAURER, R.N., M.S.N., MARSHA CHIEF NURSING OFFICER, SENIOR VICE PRESIDENT OF PATIENT CARE SERVICES - BETH ISRAEL DEACONESS MEDICAL CENTER MS. MAURER DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 389,225 INCENTIVE COMPENSATION: 87,500 OTHER REPORTABLE COMPENSATION: 20,772 DEFERRED COMPENSATION: 2,520 NON-TAXABLE BENEFITS: 44,701 OTHER REPORTABLE COMPENSATION FOR MS. MAURER INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $18,000. SHEEHAN, R.N., M.S.N., JAYNE SENIOR VICE PRESIDENT, SYSTEM INTEGRATION, CARE COORDINATION - BETH ISRAEL DEACONESS MEDICAL CENTER MS. SHEEHAN DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 331,853 INCENTIVE COMPENSATION: 8,480 OTHER REPORTABLE COMPENSATION: 20,297 DEFERRED COMPENSATION: 34,829 NON-TAXABLE BENEFITS: 31,764 OTHER REPORTABLE COMPENSATION FOR MS. SHEEHAN INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $18,000. SKURA, SAMUEL SENIOR VICE PRESIDENT, AMBULATORY AND CLINICAL SERVICES - BETH ISRAEL DEACONESS MEDICAL CENTER MR. SKURA COMMENCED HIS POSITION AS SENIOR VICE PRESIDENT, AMBULATORY AND CLINICAL SERVICES FOR BETH ISRAEL DEACONESS MEDICAL CENTER ON OCTOBER 1, 2016. PRIOR TO THAT TIME HE SERVED AS THE CHIEF ADMINISTRATIVE OFFICER FOR THE DEPARTMENT OF MEDICINE FOR BIDMC AND HMFP. DURING THE PERIOD COVERED BY THIS FILING MR. SKURA DEVOTED, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND RELATED ENTITIES. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 236,448 INCENTIVE COMPENSATION: 48,750 OTHER REPORTABLE COMPENSATION: 6,019 DEFERRED COMPENSATION: 26,813 NON-TAXABLE BENEFITS: 23,202 SUKHATME, M.D., SC.D., VIKAS P. CHIEF ACADEMIC OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE (EX-OFFICIO) - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. VICTOR J. ARESTY PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. SUKHATME 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: 481,400 INCENTIVE COMPENSATION: 10,463 OTHER REPORTABLE COMPENSATION: 50,513 DEFERRED COMPENSATION: 33,204 NON-TAXABLE BENEFITS: 38,287 OTHER REPORTABLE COMPENSATION FOR DR. SUKHATME INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $42,575. AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY BIDMC FOR THE 2016 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. SUKHATME'S POSITION AS VICTOR J. ARESTY PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: $93,544 BASE AND OTHER REPORTABLE COMPENSATION, $9,354 DEFERRED COMPENSATION AND $141 NON-TAXABLE BENEFITS. TANDON, MANU VICE PRESIDENT, DEPUTY CHIEF INFORMATION OFFICER, CHIEF TECHNOLOGY OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER MR. TANDON DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 313,571 INCENTIVE COMPENSATION: 4,875 OTHER REPORTABLE COMPENSATION: 3,243 DEFERRED COMPENSATION: 6,300 NON-TAXABLE BENEFITS: 39,554 OTHER REPORTABLE COMPENSATION FOR MR. TANDON INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $2,750. GEBHARDT, M.D., MARK C. CHIEF OF ORTHOPAEDIC SURGERY - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR, DEPARTMENT OF ORTHOPAEDIC SURGERY - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND PRESIDENT - BETH ISRAEL DEACONESS ORTHOPAEDIC SURGERY FOUNDATION FREDERIC W. & JANE M. ILFELD PROFESSOR OF ORTHOPAEDIC SURGERY - HARVARD MEDICAL SCHOOL DR. GEBHARDT DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. GEBHARDT PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. GEBHARDT IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. GEBHARDT'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 396,166 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 9,792 DEFERRED COMPENSATION: 31,659 NON-TAXABLE BENEFITS: 11,043 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 396,166 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 9,792 DEFERRED COMPENSATION: 31,659 NON-TAXABLE BENEFITS: 11,043 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY BIDMC AND HMFP FOR THE 2016 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. GEBHARDT'S POSITION AS CHIEF OF ORTHOPAEDIC SURGERY AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF ORTHOPAEDIC SURGERY AND FREDERIC W. & JAMES M. ILFELD PROFESSOR OF ORTHOPAEDIC SURGERY, HARVARD MEDICAL SCHOOL: $95,453 BASE AND OTHER REPORTABLE COMPENSATION, $10,317 DEFERRED COMPENSATION AND $21,846 NON-TAXABLE BENEFITS. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES (CONTINUED): KRUSKAL, M.D., PHD, JONATHAN B. CHIEF OF RADIOLOGY - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (RADIOLOGY) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - BIH RADIOLOGIC FOUNDATION PROFESSOR OF RADIOLOGY - HARVARD MEDICAL SCHOOL DR. KRUSKAL DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. KRUSKAL PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. KRUSKAL IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. KRUSKAL'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 360,391 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,193 DEFERRED COMPENSATION: 15,900 NON-TAXABLE BENEFITS: 15,993 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 360,391 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,193 DEFERRED COMPENSATION: 15,900 NON-TAXABLE BENEFITS: 15,993 STEVENSON, M.D., PHD, MARY ANN CHIEF, RADIATION ONCOLOGY - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO), SECRETARY, BOARD CHAIR AND CHAIR, RADIATION ONCOLOGY - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - LONGWOOD MEDICAL INTERNATIONAL FOUNDATION, INC TRUSTEE - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. ASSOCIATE PROFESSOR OF RADIATION ONCOLOGY - HARVARD MEDICAL SCHOOL DR. STEVENSON DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. STEVENSON IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. STEVENSON'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990 AS FURTHER OUTLINED BELOW: PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 342,980 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,274 DEFERRED COMPENSATION: 24,844 NON-TAXABLE BENEFITS: 17,523 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 342,980 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,274 DEFERRED COMPENSATION: 24,844 NON-TAXABLE BENEFITS: 17,523 STERN, M.D., ROBERT S. CHIEF OF DERMATOLOGY - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR OF DERMATOLOGY - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - BETH ISRAEL DERMATOLOGY FOUNDATION CARL J. HERZOG PROFESSOR OF DERMATOLOGY - HARVARD MEDICAL SCHOOL DR. STERN RETIRED FROM HIS POSITIONS AS CHIEF OF DERMATOLOGY AT BIDMC, CHAIR OF DERMATOLOGY AT HMFP AND PRESIDENT OF THE DERMATOLOGY FOUNDATION ON FEBRUARY 14, 2017. DR. STERN DEVOTED, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. STERN WAS PAID DIRECTLY BY HMFP, THE PORTION OF DR. STERN'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 316,605 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 11,188 DEFERRED COMPENSATION: 31,898 NON-TAXABLE BENEFITS: 9,895 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 316,605 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 11,188 DEFERRED COMPENSATION: 31,898 NON-TAXABLE BENEFITS: 9,895 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY BIDMC AND HMFP FOR THE 2016 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. STERN'S POSITION AS CHIEF OF DERMATOLOGY AT BIDMC, CHAIR OF DERMATOLOGY AT HMFP AND THE CARL J. HERZOG PROFESSOR OF DERMATOLOGY, HARVARD MEDICAL SCHOOL: $107,343 BASE AND OTHER REPORTABLE COMPENSATION, $10,795 DEFERRED COMPENSATION, AND $ 1,758 NON-TAXABLE BENEFITS. TALMOR, M.D., M.P.H, DANIEL CHIEF OF ANESTHESIA - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (ANESTHESIA) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - BETH ISRAEL ANAESTHESIA FOUNDATION PROFESSOR OF ANAESTHESIA - HARVARD MEDICAL SCHOOL DR. TALMOR DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. TALMOR PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. TALMOR IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. TALMOR'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 326,291 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 4,312 DEFERRED COMPENSATION: 26,500 NON-TAXABLE BENEFITS: 14,718 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 326,291 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 4,312 DEFERRED COMPENSATION: 26,500 NON-TAXABLE BENEFITS: 14,718 A MASS DEVELOPMENT FINANCE AGENCY 043431814 57584XMT5 2016-05-12 257611877 SEE PART VI 0 0 0 B MASS DEVELOPMENT FINANCE AGENCY 043431814 57584XDH1 2015-09-02 203702204 SEE PART VI 0 0 0 C MASS DEVELOPMENT FINANCE AGENCY 043431814 000000000 2012-07-11 49910000 REFUND ISSUE DATED 2/11/1998 0 0 0 D MASS DEVELOPMENT FINANCE AGENCY 043431814 000000000 2011-09-15 120280000 REFUND ISSUE DATED 2/11/1998 0 0 0 A 2980000 257618370 222053917 2515889 19006493 14042071 2016 0 1 1 1 B 14295000 203702204 97328921 2348479 104024804 1 1 1 1 C 49910000 368094 49541906 1 0 1 1 D 63350000 120280000 290672 119989328 1 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 0 0.00500 0.00300 0.00800 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K - EXPLANATORY STATEMENT CAREGROUP, INC., (CAREGROUP) IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED THAT SERVES 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 IS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MAKE UP THE CAREGROUP SYSTEM. CAREGROUP AND SOME OF ITS AFFILIATES JOINTLY BORROW DEBT AS AN OBLIGATED GROUP. THE OBLIGATED GROUP MEMBERS ARE: 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 MEDICAL CENTER (MEDICAL CENTER) 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 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 B, 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 C, 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 (1 OF 2), PART 1, LINE D, 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 (2 OF 2), PART 1, LINE A, COLUMN F - DESCRIPTION OF TAX-EXEMPT DEBT PURPOSE PURPOSES OF CAREGROUP SERIES E BONDS: - TO FINANCE OR REFINANCE VARIOUS RENOVATION AND CONSTRUCTION PROJECTS AND CAPITAL EQUIPMENT ACQUISITIONS FOR THE MEDICAL CENTER - TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR MAH'S NEW AND EXPANDED FACILITIES WITH APPROXIMATELY 250,000 SQUARE FEET OF NEW AND RENOVATED SPACE TO INCLUDE: A NEW SIX-STORY ACUTE CARE FACILITY TO SUPPORT ADDITIONAL CRITICAL CARE AND MEDICAL/SURGICAL BEDS, EXPANDED OPERATING ROOMS AND INTERVENTIONAL RADIOLOGY ROOMS AND A NEW PARKING GARAGE - TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR NEBH'S MASTER FACILITY PLAN, INCLUDING A NEW ATRIUM OF APPROXIMATELY 2,740 SQUARE FEET, A PRE-OPERATIVE AND POST ANESTHESIA UNIT OF APPROXIMATELY 14, 310 SQUARE FEET, CONSTRUCTION OF A CENTRAL STERILE SUPPLY AREA OF APPROXIMATELY 8,290 SQUARE FEET AND CONSTRUCTION OF NEW OPERATING ROOMS OF APPROXIMATELY 18,615 SQUARE FEET; - TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR BID-NEEDHAM'S NEW AND EXPANDED FACILITIES INCLUDING AN APPROXIMATELY 59,000 SQUARE FOOT PROJECT ON TWO FLOORS TO RENOVATE AND EXPAND SERVICES IN THE EMERGENCY DEPARTMENT, INPATIENT UNITS, RADIOLOGY DEPARTMENT AND ASSOCIATED SUPPORT SERVICES; - TO REFINANCE $201,975,000 OF DEBT PREVIOUSLY ISSUED BY MEMBERS OF THE OBLIGATED GROUP, INCLUDING $138,075,000 OF THE CAREGROUP SERIES C BONDS DESCRIBED BELOW. PURPOSES OF CAREGROUP SERIES D BONDS: - REFUNDING OF THE OUTSTANDING PRINCIPAL BALANCE OF THE MAH SERIES B BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED JULY 13, 2004 PURPOSES OF CAREGROUP SERIES C BONDS: - REFUNDING OF THE OUTSTANDING PRINCIPAL BALANCE OF THE BETH ISRAEL HOSPITAL ASSOCIATION SERIES G BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED JULY 13, 2004 SCHEDULE K (1 OF 2) PART II, COLUMN A, 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 A, B & C, LINE 11 THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW SCHEDULE K (1 OF 2) PART II, COLUMNS D, 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 (2 OF 2) PART II, COLUMN A, LINE 2 THE AMOUNT OF BONDS LEGALLY DEFEASED: THE 2015 ISSUE ADVANCE REFUNDED $100,675,000 OF THE 1998 AND 2008 ISSUES. THESE BONDS WILL BE CALLED BY JULY 1, 2018; THE 2016 ISSUE ADVANCED REFUNDED $143,845,000 OF THE E-1 ISSUE. THOSE BONDS WILL BE CALLED BY JULY 1, 2018. SCHEDULE K (2 OF 2) PART II, COLUMN A, LINE 3 THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE DUE TO THE INVESTMENT EARNINGS ON THE PROJECT FUND. SCHEDULE K (2 OF 2) PART II, COLUMN A, LINE 11 THE OTHER SPENT PROCEEDS ARE THE PROCEEDS USED TO REFUND PRIOR ISSUE(S). THE AMOUNTS ARE NOT LISTED ON LINE 6 BECAUSE THEY ARE NO LONGER IN ESCROW. SCHEDULE K (1 OF 2) PART III, COLUMNS C AND D 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 (2 OF 2) PART IV, COLUMN A, LINE 2C AN ARBITRAGE REBATE CALCULATION WAS COMPLETED AS OF SEPTEMBER 30, 2012 SCHEDULE K PART III QUESTIONS 2 AND 3: FACILITIES FINANCED WITH TAX-EXEMPT BONDS ARE 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, 2017 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 HEALTH AND ED FACILITIES AUTH 042456011 57586C3S2 2008-06-09 377527010 SEE PART VI 1 0 0 A 117220000 244520000 378911689 3929290 134556855 213068927 2011 1 0 1 1 A 0 1 1 1 0 0.00200 0.00100 0.00300 0 0 0 A 0 0 0 1 0 0 0 0 1 A 1 DONOR #27 SUBSTANTIAL CONTRIBUTOR 2019304 PATIENT CARE SERVICES AND SUPPORT 0 DONOR #38 SUBSTANTIAL CONTRIBUTOR 3422546 FINANCIAL AND INVESTMENT SERVICES 0 DONOR #52 SUBSTANTIAL CONTRIBUTOR 5999464 CONSTRUCTION SERVICES 0 DONOR #99 SUBSTANTIAL CONTRIBUTOR 89578802 BENEFIT PLAN SERVICES 0 DONOR #137 SUBSTANTIAL CONTRIBUTOR 130867193 PATIENT CARE, TEACHING, RESEARCH SERVICES 0 DONOR #254 SUBSTANTIAL CONTRIBUTOR 234344 PHARMACEUTICALS 0 SCHEDULE L, PART IV, COLUMN D DESCRIPTION OF TRANSACTIONS INVOLVING INTERESTED PERSONSVARIOUS CURRENT AND FORMER OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES OF BIDMC MAY ALSO HOLD POSITIONS WITH OTHER ENTITIES WHICH MAKE CHARITABLE CONTRIBUTIONS TO BIDMC. SUCH CONTRIBUTIONS HAVE NOT BEEN INCLUDED IN THE DISCLOSURES ABOVE.BIDMC MAINTAINS AN ACCOUNTABLE BUSINESS EXPENSE REIMBURSEMENT PLAN. FROM TIME TO TIME, BIDMC 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 AT ARMS-LENGTH AND IN ACCORDANCE WITH THE BIDMC CONFLICT OF INTEREST POLICY. X 60 2448352 STOCK MARKET QUOTE X EQUIPMENT 2 338595 REPLACEMENT COST X FURNITURE 1 1200 REPLACEMENT COST X FASHION ACCESORIES 3 900 COST/SELLING PRICE 0 0 1 0 FORM 990, PART III, LINE 1 TO PROVIDE EXTRAORDINARY CARE, WHERE THE PATIENT COMES FIRST, SUPPORTED BY WORLD-CLASS EDUCATION AND RESEARCH. THE MISSION OF THE BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER) IS TO SERVE OUR PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM AND THEIR FAMILIES. THE MEDICAL CENTER'S MISSION IS SUPPORTED BY ITS COMMITMENT TO PERSONALIZED, EXCELLENT CARE FOR ITS PATIENTS; A WORKFORCE COMMITTED TO INDIVIDUAL ACCOUNTABILITY, MUTUAL RESPECT AND COLLABORATION; AND A COMMITMENT TO MAINTAINING OUR FINANCIAL HEALTH. FORM 990, PART III, LINE 4A PATIENT CARE THE MEDICAL CENTER IS PASSIONATE ABOUT LEADING-EDGE PATIENT CARE. THE MEDICAL CENTER'S PATIENTS RECEIVE TREATMENTS THAT ARE TODAY'S GOLD STANDARD OF CARE OR INNOVATIVE THERAPIES THAT WILL BECOME THE GOLD STANDARD OF TOMORROW. THE MEDICAL CENTER HAS DEVELOPED FIVE MAJOR COMPREHENSIVE CARE CENTERS THAT ALLOW PHYSICIANS AND CLINICAL STAFF FROM MULTIPLE DISCIPLINES - SUCH AS MEDICINE, SURGERY, PATHOLOGY, RADIOLOGY, ONCOLOGY, AND SOCIAL WORK - TO WORK TOGETHER SO THAT OUR PATIENTS ARE RECEIVING THE MOST COORDINATED, COMPREHENSIVE CARE POSSIBLE. THESE CENTERS INCLUDE A CANCER CENTER, A CARDIOVASCULAR INSTITUTE, A DIGESTIVE DISEASE CENTER, A SPINE CENTER, AND A TRANSPLANT INSTITUTE. OTHER NOTABLE AREAS WHERE THE MEDICAL CENTER LEADS THE WAY IN PATIENT CARE SPAN A WIDE ARRAY OF SERVICES INCLUDING AREAS SUCH AS VASCULAR SERVICES FOR PATIENTS WITH DIABETES COMPLICATIONS, AND OBSTETRIC CARE FOR ROUTINE PREGNANCIES AS WELL AS THE MOST COMPLEX PATIENT CIRCUMSTANCES. THE MEDICAL CENTER ALSO OFFERS A CENTER FOR MINIMALLY INVASIVE SURGERY, A STATE-OF-THE-ART EMERGENCY ROOM, A LEVEL ONE TRAUMA CENTER, AHEAD OF THE CURVE IMAGING SYSTEMS. THE MEDICAL CENTER WAS THE FIRST IN NEW ENGLAND TO OFFER A DYNAMIC NEW NONINVASIVE RADIATION THERAPY. SOME OF THE MEDICAL CENTER'S KEY STATISTICS FOR FY 2017 REGARDING PATIENT VOLUME ARE IDENTIFIED IN THE FOLLOWING TABLE: INPATIENT DISCHARGES 40,656 OUTPATIENT STATISTICS CLINIC ENCOUNTERS 624,696 EMERGENCY DEPARTMENT VISITS 57,224 RADIOLOGY EXAMS 226,046 AMBULATORY SURGERY CASES 14,798 RADIATION THERAPY TREATMENTS 22,317 ENDOSCOPY TREATMENTS 28,832 CHARITY CARE THE MEDICAL CENTER PROVIDES CARE WITHOUT CHARGE OR AT DISCOUNTED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE SERVICES ARE NOT REPORTED AS REVENUE EXCEPT TO THE EXTENT REIMBURSED BY THE MASSACHUSETTS HEALTH SAFETY NET TRUST (HEALTH SAFETY NET TRUST). THE MEDICAL CENTER ALSO MAKES PAYMENTS TO THE HEALTH SAFETY NET TRUST TO SUPPORT THE DELIVERY OF CHARITY CARE TO PATIENTS THROUGHOUT MASSACHUSETTS. THESE PAYMENTS ARE REPORTED AS A COMPONENT OF UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. THE MEDICAL CENTER'S NET COST OF CHARITY CARE REPORTED ON SCHEDULE H, PART I, LINE 7A, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO FREE AND DISCOUNTED CARE ELIGIBLE PATIENTS AND INCLUDING PAYMENTS TO AND RECEIPTS FROM THE HEALTH SAFETY NET TRUST, WAS $12,852,350 FOR THE PERIOD COVERED BY THIS FILING: CHARITY CARE, AT COST 10,041,250 PAYMENTS TO HEALTH SAFETY NET TRUST (HSNT) 7,916,911 PAYMENTS TO HSNT, NET OF SHORTFALL -5,105,811 NET CHARITY CARE 12,852,350 OTHER UNCOMPENSATED CARE THE MEDICAL CENTER 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. IN AGGREGATE, THE COST OF CARE PROVIDED BY THE MEDICAL CENTER FOR SUCH SERVICES EXCEEDED REIMBURSEMENT BY $54,311,343 IN 2017 AS REPORTED ON PART I, LINE 7B OF SCHEDULE H, HOSPITALS. THE MEDICAL CENTER ALSO TREATS PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM, THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS. BECAUSE PAYMENTS TO HOSPITALS HAVE NOT KEPT PACE WITH INFLATION IN RECENT YEARS, PAYMENTS TO THE MEDICAL CENTER FOR THOSE SERVICES ALSO DO NOT COVER THE COSTS OF SERVICES PROVIDED. IN AGGREGATE, THE COST OF CARE PROVIDED BY THE MEDICAL CENTER FOR SUCH SERVICES EXCEEDED REIMBURSEMENT BY $24,617,418 IN THE FISCAL PERIOD COVERED BY THIS FILING, $10,344,897 OF WHICH IS INCLUDED IN FORM 990 SCHEDULE H PART I, LINE 7G AND RELATED TO THE PROVISION OF SUBSIDIZED HEALTH SERVICES FOR INPATIENT PSYCHIATRIC PATIENTS, THE MEDICAL CENTER'S BOWDOIN STREET COMMUNITY FACILITY, THE MEDICAL CENTER'S PROVISION OF OUTPATIENT AMBULATORY CARE AND CERTAIN PRIMARY CARE VISITS THROUGH BIDMC'S ONSITE PRIMARY CARE OFFICES AND $14,272,521 OF WHICH IS REPORTED IN FORM 990 SCHEDULE H PART III LINE 7. BAD DEBTS IN 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. THE NET PROVISION FOR BAD DEBT EXPENSE IS INCLUDED IN NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE NET PROVISION FOR BAD DEBT EXPENSE REPORTED IN THE AUDITED FINANCIAL STATEMENTS AND THIS FORM 990 SCHEDULE H, PART III, LINE 2 IS $22,472,200. FORM 990, PART III, LINE 4B RESEARCH THE MISSION OF THE MEDICAL CENTER IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF THE LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS THAT IMPROVE THE QUALITY OF LIFE. THE MEDICAL CENTER COMMITS TO MAINTAIN A COLLABORATIVE CULTURE AND MODERN, HIGH-QUALITY FACILITIES AND TO TAKE FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS AS WELL AS REACHING OUT AND COLLABORATING WITH NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS. THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP FOUR IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING AMONG INDEPENDENT HOSPITALS. THE MEDICAL CENTER'S SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACTS THE LIVES OF PATIENTS AND IMPROVES THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,300 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH LED BY MORE THAN 250 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE MEDICAL CENTER'S EXTRAORDINARY FACULTY HAS ESTABLISHED A CULTURE THAT IS COLLABORATIVE AND ORIENTED TOWARD TRANSLATING NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. ADDITIONAL DETAIL IS INCLUDED IN FORM 990, SCHEDULE H. FORM 990, PART III, LINE 4C TEACHING THE MEDICAL CENTER'S DEVOTION TO TEACHING, TO RESPECTING STUDENTS, AND TO EMBRACING 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 AND RESIDENTS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 52 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 627 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 42 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 62 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW BY SUPERVISING OF THEIR DAILY PATIENT CARE AND BY CONDUCTING A RANGE OF INTERACTIVE LEARNING EXPERIENCES. THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BIDMC, A SUPPORT ORGANIZATION OF THE MEDICAL CENTER AND AN INTEGRAL COMPONENT OF THE CENTER FOR EDUCATION AT THE MEDICAL CENTER, IS BOTH A "THINK TANK" FOR ADVANCING MEDICAL EDUCATION AND A UNIQUE TRAINING RESOURCE. WITHIN THE CENTER, THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER PROVIDES HIGH-TECH LEARNING EXPERIENCES ON TOPICS RANGING FROM MINIMALLY INVASIVE SURGERY TO INTENSIVE CARE AND OFFERS UNIQUE OPPORTUNITIES FOR FACULTY MEMBERS TO SHARE YEARS OF COLLECTIVE EXPERIENCE IN MASTERING THE ART OF SCIENCE AND MEDICINE WITH THEIR STUDENTS. IT ALSO OFFERS AN EXCEPTIONAL OPPORTUNITY AND EXTENSION OF MORE TRADITIONAL METHODS FOR MEDICAL STUDENTS AND RESIDENTS TO PRACTICE AND HONE THEIR MEDICAL AND SURGICAL SKILLS. ADDITIONAL DETAIL IS INCLUDED IN THE NARRATIVE SUPPORT TO THIS FORM 990, SCHEDULE H. FORM 990, PART IV, LINE 12 AND 12A AUDITED FINANCIAL STATEMENTS THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE MEDICAL CENTER AND AFFILIATES FOR FISCAL YEAR ENDED SEPTEMBER 30, 2017. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE MEDICAL CENTER AND ITS SUBSIDIARIES, (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, LINE 24A STATEMENT REGARDING TAX EXEMPT BOND ISSUE AS DESCRIBED IN THIS FORM 990, CAREGROUP, INC., IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, IS A SUPPORT ORGANIZATION OF AND SOLE MEMBER OF THE MEDICAL CENTER. THE MEDICAL CENTER IS 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 MEDICAL CENTER'S BALANCE SHEET. FORM 990, PART IV, LINE 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, LINE 7G CONTRIBUTIONS OF INTELLECTUAL PROPERTY THE MEDICAL CENTER 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 THE MEDICAL CENTER 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 V, LINE 2A STATEMENT RE PAYROLL THE MEDICAL CENTER SERVES AS THE COMMON PAY AGENT FOR THE FOLLOWING ENTITIES FOR WHICH IT ALSO SERVES AS MEMBER OR WHICH SERVE AS THE MEDICAL CENTER MEMBER: CAREGROUP, INC. (CAREGROUP), MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP (APG), AND BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM). IN ACCORDANCE WITH INSTRUCTIONS TO THE 2016 FORM 990, THE MEDICAL CENTER IS REPORTING ONLY THOSE FORMS W-2 ISSUED TO ITS OWN EMPLOYEES. FORMS W-2 ISSUED BY THE MEDICAL CENTER AS AGENT FOR CAREGROUP, APG AND BID-NEEDHAM ARE REPORTED BY THOSE ENTITIES AS IF ISSUED DIRECTLY. FORM 990, PART VI, SECTION A, LINE 2 BUSINESS AND FAMILY RELATIONSHIPS THE FOLLOWING MEDICAL CENTER OFFICERS, DIRECTOR/TRUSTEES, AND KEY EMPLOYEES HAVE BUSINESS OR FAMILY RELATIONSHIPS: - KEVIN TABB, M.D. AND JAMES MANDELL, M.D. - BUSINESS RELATIONSHIP - DANIEL JICK, WILLIAM JOHNSTON- BUSINESS RELATIONSHIP - DANIEL JICK, DOUGLAS LINDE - BUSINESS RELATIONSHIP - DANIEL JICK, MICHAEL CRONIN - BUSINESS RELATIONSHIP - JENNIFER SILVER, THOMAS DESIMONE, MARK ZEIDEL - BUSINESS RELATIONSHIP - JENNIFER PLINE, JILL CHENG - BUSINESS RELATIONSHIP - GEOFFREY REHNERT, JENNIFER PLINE - 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 IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CAREGROUP'S PURPOSE IS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MAKE UP THE CAREGROUP SYSTEM. CAREGROUP SERVES AS THE SOLE MEMBER OF THE MEDICAL CENTER. THE MEDICAL CENTER IS THE SOLE MEMBER OF BID-NEEDHAM, APG, BID-MILTON, BID-PLYMOUTH 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 SERVES 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 CAREGROUP 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 CAREGROUP 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 4 CHANGES TO GOVERNING DOCUMENTS THE MEDICAL CENTER BY-LAWS WERE AMENDED DURING THE FISCAL PERIOD COVERED BY THIS FILING TO BIFURCATE THE ROLES OF MEDICAL CENTER PRESIDENT AND CHIEF EXECUTIVE OFFICER, TO ESTABLISH THAT THE CHIEF EXECUTIVE OFFICER OF BIDMC SERVES AS AN EX-OFFICIO MEMBER OF THE MEDICAL CENTER BOARD WITH VOTE AND TO MODIFY THE ROLE OF THE MEDICAL CENTER COMPENSATION COMMITTEE RELATED TO THE CHIEF EXECUTIVE OFFICERS OF THE ENTITIES FOR WHICH BIDMC SERVES AS SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 6 STATEMENT RE MEMBERS OR STOCKHOLDERS FORM 990, PART VI, SECTION A, LINE 7A STATEMENT RE ELECTION OF MEMBERS OF GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B STATEMENT RE DECISION OF GOVERNING BODY SUBJECT TO APPROVAL CAREGROUP, INC. (CAREGROUP) SERVES AS THE SOLE MEMBER OF THE MEDICAL CENTER. ACCORDING TO THE MEDICAL CENTER'S BYLAWS CAREGROUP APPROVES BUT DOES NOT ELECT MEMBERS OF THE GOVERNING BODY. ACCORDING TO THE MEDICAL CENTER'S BYLAWS, AS SOLE MEMBER, CAREGROUP HAS THE FOLLOWING RIGHTS: - TO APPROVE ANNUAL OPERATING AND CAPITAL BUDGETS; - TO APPROVE UNBUDGETED CAPITAL EXPENDITURES IN EXCESS OF FIVE PERCENT (5%) OF THE MOST RECENT APPROVED ANNUAL CAPITAL BUDGET; - TO APPROVE ANY UNBUDGETED CAPITAL COMMITMENT IN EXCESS OF $20 MILLION; - TO SELECT THE INDEPENDENT AUDITOR TO EXAMINE THE FINANCIAL ACCOUNTS; - TO APPROVE THE BORROWING OR INCURRENCE OF DEBT IN ANY AMOUNT, OTHER THAN (I) FOR THE PURPOSE OF SECURING WORKING CAPITAL FROM A LENDER APPROVED BY THE MEMBER AND PURSUANT TO THE EXISTING LOAN DOCUMENTATION CONTAINING THE TERMS AND PROVISIONS RELATING TO SUCH BORROWING APPROVED BY THE MEMBER AND, (II) DEBT INCURRED IN THE ORDINARY COURSE OF BUSINESS WHICH IS IN THE MEMBER APPROVED ANNUAL BUDGET; - TO APPROVE ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE MEDICAL CENTER, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE MEDICAL CENTER'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION, OR THE ENTERING INTO ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE MEDICAL CENTER; - THE POWER AND AUTHORITY TO INITIATE AND TAKE ANY OF THE FOLLOWING ACTIONS: ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE MEDICAL CENTER, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE MEDICAL CENTER'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION, OR THE ENTERING INTO ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE MEDICAL CENTER; - THE EXCLUSIVE POWER AND AUTHORITY TO INITIATE ANY BANKRUPTCY OR INSOLVENCY ACTION ON BEHALF OF THE MEDICAL CENTER OR ANY OF ITS SUBSIDIARIES INCLUDING ANY DIRECT AFFILIATES; AND, - OTHER POWERS AND RIGHTS AS VESTED BY LAW. IN ADDITION, THE MEMBER HAS ADDITIONAL APPROVAL RIGHTS AS NOTED BELOW. - THE ANNUAL SLATE OF THE BOARD OF DIRECTORS SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. IN ADDITION, A VACANCY ON THE BOARD MAY BE FILED BY THE BOARD OF DIRECTORS, SUBJECT TO APPROVAL OF THE MEMBER; - THE CHIEF EXECUTIVE OFFICER (CEO)OF THE CORPORATION, IN COLLABORATION WITH THE CORPORATION'S BOARD OF DIRECTORS, SHALL DEVELOP OVERALL STRATEGIC AND FINANCIAL PLANS FOR THE CORPORATION, WHICH SHALL BE CONSISTENT WITH THE STRATEGIC AND FINANCIAL PLANS AND PROGRAMS OF THE MEMBER AND SHALL BE SUBJECT TO APPROVAL BY THE MEMBER; - THE BOARD OF MANAGERS OF THE MEMBER IS AUTHORIZED TO ACT ON BEHALF OF THE BOARD OF DIRECTORS TO SELL OR OTHERWISE TRANSFER INVESTMENTS AND ASSETS OF THE CORPORATION THAT ARE NOT USED OR INVOLVED IN THE OPERATION OF THE CORPORATION, INCLUDING SECURITIES AND REAL PROPERTY BUT EXCLUDING INVESTMENTS, IF ANY, SEPARATELY HELD TO SATISFY OBLIGATIONS OF THE CORPORATION WITH RESPECT TO ANY PENSION OR BENEFIT PLAN. THE BOARD OF MANAGERS OF THE MEMBER MAY EMPLOY AND COMPENSATE FROM FUNDS OF THE CORPORATION SUCH INVESTMENT ADVISER OR ADVISERS AS THE BOARD OF MANAGERS OF THE MEMBER MAY CONSIDER NECESSARY OR DESIRABLE, AND IT SHALL HAVE DISCRETION TO ACCEPT OR REJECT ANY OR ALL ADVICE GIVEN BY ANY SUCH ADVISER OR ADVISERS, ALL IN ACCORDANCE WITH THE PROVISIONS RELATING TO THE BOARD OF MANAGERS SET FORTH IN THE BY-LAWS OF THE MEMBER; - THE CEO SHALL BE APPOINTED BY, AND MAY BE REMOVED BY, THE BOARD OF DIRECTORS, SUBJECT TO THE APPROVAL OF THE MEMBER. THE CEO MAY ALSO BE REMOVED BY THE MEMBER IN ACCORDANCE WITH THE BY-LAWS OF THE MEMBER AS SUCH BY-LAWS MAY, AT THE TIME OF SUCH REMOVAL, PROVIDE; AND, - THE CORPORATION'S BY-LAWS MAY BE ALTERED, AMENDED OR REPEALED AT ANY MEETING OF THE MEMBER IN ACCORDANCE WITH THE BY-LAWS OF THE MEMBER AS SUCH BY-LAWS MAY, AT THE TIME OF SUCH MEETING, PROVIDE. WITHOUT LIMITING THE FOREGOING, THE BOARD OF DIRECTORS MAY RECOMMEND AMENDMENTS TO THESE BY-LAWS, WHICH AMENDMENTS SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A SEE NARRATIVE ABOVE FORM 990, PART VI, SECTION A, LINE 7B SEE NARRATIVE ABOVE FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE MEDICAL CENTER, THE TAX DIRECTOR OF CAREGROUP, WHICH IS THE MEMBER OF THE MEDICAL CENTER, AND DELOITTE TAX, LLP. THE COMPLETE FORM 990 IS PRESENTED TO THE MEDICAL CENTER'S COMPLIANCE, AUDIT AND RISK COMMITTEE FOR REVIEW AND DISCUSSION. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF THE MEDICAL CENTER 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 THE MEDICAL CENTER HAS A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL MEMBERS OF ITS WORKFORCE, INCLUDING EMPLOYEES, PROFESSIONAL STAFF, TRAINEES, CONSULTANTS, CONTRACTORS, AGENTS, AND VENDORS, AND TO THE MEMBERS OF THE BOARD OF DIRECTORS. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS AN INTEGRALLY RELATED ENTITY TO THE MEDICAL CENTER AND EMPLOYS THE MAJORITY OF PHYSICIANS PROVIDING PATIENT CARE AT THE MEDICAL CENTER. HMFP ALSO HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY. PURSUANT TO THESE POLICIES, ALL MEMBERS OF THE MEDICAL CENTER'S WORKFORCE MUST DISCLOSE CONFLICTS OF INTEREST AT THE TIME OF INSTITUTIONAL TRANSACTIONS AND MUST RECUSE HIMSELF/HERSELF FROM THE DECISION-MAKING REGARDING THE TRANSACTION BETWEEN THE MEDICAL CENTER AND THE OUTSIDE BUSINESS IN WHICH S/HE OR A FAMILY MEMBER HAS A POSITION OR A FINANCIAL INTEREST. LIMITED PARTICIPATION IN THE DISCUSSION AND/OR RECOMMENDATIONS ABOUT A TRANSACTION MAY BE ALLOWED, PROVIDED THAT THE PERSON WITH AUTHORITY OF THE FINAL DECISION-MAKING DETERMINES THAT THE INVOLVEMENT IS APPROPRIATE, AND THE OTHERS INVOLVED IN THE DISCUSSION ARE AWARE OF THE FINANCIAL INTEREST OF THE CONFLICTED PARTY. THE MEDICAL CENTER MONITORS COMPLIANCE WITH THIS POLICY BY REQUIRING ALL MEMBERS OF THE WORKFORCE PARTICIPATING IN THE PROCESS TO COMPLETE A WRITTEN DISCLOSURE FORM AT THE TIME OF DISCUSSIONS AND NEGOTIATIONS WITH A SUPPLIER AND BY REQUIRING THE SUPPLIER TO IDENTIFY IN WRITING THOSE PARTICIPANTS WHO HAVE AN OUTSIDE RELATIONSHIP WITH THE SUPPLIER. A SUPPLIER'S FAILURE TO MAKE A REQUIRED DISCLOSURE MAY RESULT IN DISQUALIFICATION FROM BEING A SUPPLIER AND CAN BE GROUNDS FOR TERMINATION OF THE CONTRACT. SIMILARLY, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE MEDICAL CENTER WHO IS IN A POSITION TO VOTE ON OR INFLUENCE A PARTICULAR TRANSACTION OR DECISION OF THE MEDICAL CENTER MUST NOTIFY THE BOARD OR THE COMMITTEE IF S/HE OR A FAMILY MEMBER MIGHT MATERIALLY BENEFIT AND RECUSE HIMSELF/HERSELF FROM PARTICIPATION AND VOTING ON THE DECISION. IN ADDITION, ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES OF BOTH THE MEDICAL CENTER AND HMFP ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT DISCLOSURE WHICH IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS RELATIONSHIPS MAINTAINED BY OFFICERS, DIRECTORS OR KEY EMPLOYEES AND THEIR IMMEDIATE FAMILY MEMBERS WHICH MAY RESULT IN A CONFLICT OF INTEREST. PURSUANT TO THE MEDICAL CENTER'S CONFLICT OF INTEREST POLICY, MANY INDIVIDUALS IN ADDITION TO THOSE REPORTED ON THE TAX RETURNS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT DISCLOSURE. THESE ADDITIONAL CATEGORIES INCLUDE OFFICERS, SENIOR MANAGEMENT, CHIEFS OF SERVICE, DIVISION CHIEFS, AND OTHER WORKFORCE AND PROFESSIONAL STAFF CATEGORIES AS IDENTIFIED FROM TIME TO TIME BY THE CHIEF EXECUTIVE OFFICER, THE SENIOR VICE PRESIDENT FOR COMPLIANCE, AUDIT, AND RISK OR THE CONFLICTS OF INTEREST COMMITTEE. FOR THESE EMPLOYEES, PROVIDING A DISCLOSURE IS A CONDITION OF EMPLOYMENT AND/OR MEDICAL STAFF APPOINTMENT. THE OFFICE OF COMPLIANCE AND BUSINESS CONDUCT (OCBC) COLLECTS, REVIEWS, AND DETERMINES APPROPRIATE ACTION FOR THE ANNUAL CONFLICT OF INTEREST DISCLOSURES ON BEHALF OF THE MEDICAL CENTER. THE DISCLOSURE MAY BE REFERRED TO MANAGEMENT AND TO THE CONFLICT OF INTEREST COMMITTEE FOR REVIEW. THE HMFP COMPLIANCE OVERSIGHT COMMITTEE REVIEWS ANNUAL CONFLICT OF INTEREST DISCLOSURES ON BEHALF OF HMFP. BECAUSE OF THE INTEGRAL RELATIONSHIP BETWEEN THE MEDICAL CENTER AND HMFP, MANY INDIVIDUALS ARE COVERED BY BOTH ENTITIES' CONFLICT OF INTEREST POLICIES AND ANNUAL DISCLOSURE REQUIREMENTS. IN CASES OF DUAL RESPONSIBILITIES, THE RESPONSES ARE REVIEWED BY BOTH THE MEDICAL CENTER AND HMFP FOR DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. PURSUANT TO EACH INSTITUTION'S CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED, WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A PLAN TO REQUIRE DISCLOSURE AND RECUSAL INCLUDING APPROPRIATE DOCUMENTATION IN THE MINUTES. CAREGROUP IS 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 ISSUE A TAX QUESTIONNAIRE TO ALL CURRENT AND FORMER MEMBERS OF THE MEDICAL CENTER BOARD OF DIRECTORS AS WELL AS CURRENT AND FORMER MEDICAL CENTER OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR THE MEDICAL CENTER 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 ORGANIZATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES THE MEDICAL CENTER HAS A COMPENSATION COMMITTEE THAT IS COMPOSED OF MEMBERS OF THE BOARD OF DIRECTORS. ALL MEMBERS ARE INDEPENDENT. FOR THE PERIOD COVERED BY THIS FILING, THE COMPENSATION COMMITTEE ESTABLISHED THE POLICIES AND THE COMPENSATION STRUCTURE OF THE BIDMC CHIEF EXECUTIVE OFFICER, PRESIDENT, CHIEF FINANCIAL OFFICER, CLINICAL CHIEFS OF SERVICE, CHIEF ACADEMIC OFFICER, CHIEF INFORMATION OFFICER, GENERAL COUNSEL, SR. VICE PRESIDENTS, VICE PRESIDENTS. THE COMPENSATION COMMITTEE WAS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS WAS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT IT COMPLIED WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEYS AND STUDIES PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWED THE COMPENSATION SURVEY PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. TO ENSURE INDEPENDENCE, THE SENIOR VICE PRESIDENT OF HUMAN RESOURCES RECUSED HERSELF FROM DISCUSSIONS AND VOTING RELATED TO HER OWN COMPENSATION PACKAGES AND FROM DISCUSSIONS RELATED TO THE PRESIDENT AND CEO'S COMPENSATION PACKAGE. THE COMPENSATION COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE CEO. THE COMPENSATION PACKAGE FOR THE CEO VOTED BY THE COMPENSATION COMMITTEE WAS SUBMITTED TO THE FULL BOARD OF DIRECTORS FOR APPROVAL. ALL DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. SUBSEQUENT TO THE VOTE OF THE COMMITTEE, THE OUTSIDE CONSULTING FIRM PROVIDED A "REASONABLENESS LETTER" ATTESTING TO THE INDEPENDENCE OF THE COMMITTEE AND REASONABLENESS OF THE EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE THE MEDICAL CENTER'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL DEACONESS MEDICAL CENTER OFFICES 330 BROOKLINE AVENUE BOSTON, MA 02215 FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 3,417,626. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,417,626. MD FEES: PROGRAM SERVICE EXPENSES 81,187,167. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 81,187,167. PURCHASED SERVICE: PROGRAM SERVICE EXPENSES 85,358,574. MANAGEMENT AND GENERAL EXPENSES 8,865,831. FUNDRAISING EXPENSES 446,330. TOTAL EXPENSES 94,670,735. FORM 990, PART XI, LINE 9: UNREALIZED CHG IN EQUITY INTEREST IN LIMITED PARTNERSHIP 32,109,945. CHANGE IN FUNDED STATUS OF EMPLOYEES BENEFIT PLANS 18,210,141. TRANSFER (TO) FROM AFFILIATE -27,591,053. FUNDS MANAGED BY OTHERS -7,631,765. ASSOC PHYS HARVARD MED FAC PHY AT BIDMC 375 LONGWOOD AVE BOSTON MA 02215 320058309 TO PROVIDE EMERGENCY MEDICAL SERVICES MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 0 BI COMMUNITY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042776678 INACTIVE CORPORATION MA 501(C)(3) 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 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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