CAPE COD HEALTHCARE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: CAPE COD HEALTHCARE INC (EIN 90-0054984)
Tax period: 2016-10-01 to 2017-09-30
Filed: 2018-08-15
IRS object ID: 201842279349301819
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-08-15T11:39:39-05:00	ReturnTs
Tax Period End	2017-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

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

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	900054984	EIN

Business Name BusinessName

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

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	MICHAEL L CONNORS	PersonNm
Person Title	SR VP FINANCE/ CFO	PersonTitleTxt
Signature	2018-08-14	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	GWEN SPENCER	PreparerPersonNm
PTIN	P00641463	PTIN
Phone	6175305000	PhoneNum
Preparation	2018-08-08	PreparationDt

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd
Principal Officer	MICHAEL K LAUF	PrincipalOfficerNm

US Address USAddress

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

Field	Value	IRS element (for citing)
Gross Receipts	$871,055,420	GrossReceiptsAmt
Group Return For Affiliates	Yes (true)	GroupReturnForAffiliatesInd
All Affiliates Included	false	AllAffiliatesIncludedInd
Group Exemption	3901	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CAPECODHEALTH.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Activity Or Mission	SEE SCHEDULE O	ActivityOrMissionDesc
Voting Members Governing Body	17	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	5664	TotalEmployeeCnt
Total Volunteers	739	TotalVolunteersCnt
Total Gross UBI	$2,285,942	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$408	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$13,584,232	PYContributionsGrantsAmt
CY Contributions Grants	$15,341,766	CYContributionsGrantsAmt
PY Program Service Revenue	$813,097,623	PYProgramServiceRevenueAmt
CY Program Service Revenue	$844,858,980	CYProgramServiceRevenueAmt
PY Investment Income	$10,134,688	PYInvestmentIncomeAmt
CY Investment Income	$8,432,277	CYInvestmentIncomeAmt
PY Other Revenue	$2,193,542	PYOtherRevenueAmt
CY Other Revenue	$2,195,757	CYOtherRevenueAmt
PY Total Revenue	$839,010,085	PYTotalRevenueAmt
CY Total Revenue	$870,828,780	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$421,295,177	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$445,642,426	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$120,968	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$86,247	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$3,386,990	CYTotalFundraisingExpenseAmt
PY Other Expenses	$362,645,424	PYOtherExpensesAmt
CY Other Expenses	$377,540,307	CYOtherExpensesAmt
PY Total Expenses	$784,061,569	PYTotalExpensesAmt
CY Total Expenses	$823,268,980	CYTotalExpensesAmt
PY Revenues Less Expenses	$54,948,516	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$47,559,800	CYRevenuesLessExpensesAmt
Total Assets BOY	$904,223,714	TotalAssetsBOYAmt
Total Assets EOY	$963,305,006	TotalAssetsEOYAmt
Total Liabilities BOY	$270,275,550	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$258,793,996	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$633,948,164	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$704,511,010	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$744,018,504	ExpenseAmt
Revenue	$844,858,980	RevenueAmt
Desc	PATIENT SERVICES - SEE SCHEDULES H AND O	Desc
Total Program Service Expenses	$744,018,504	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	Yes (true)	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	Yes (true)	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	127	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	5664	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	17	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	false	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	25 COMMUNICATION WAY	AddressLine1Txt
City	HYANNIS	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02601	ZIPCd

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

Form990 Part VII Section A Form990PartVIISectionAGrp (44 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
ELEANOR CLAUS
TRUSTEE (UNTIL 5/17)	2.0	2.5	Yes (X)	$0	$0	$0
HOWARD CROW JR
TRUSTEE (UNTIL 3/17)	2.0	2.5	Yes (X)	$0	$0	$0
PHILIP MCLOUGHLIN
TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0
MICHAEL K LAUF
PRESIDENT/CEO/TRUSTEE	55.0	5.5	Yes (X)	$0	$1,386,267	$244,399	Yes (X)
NATE RUDMAN MD
TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0
JOEL CROWELL
TREASURER/CLERK/TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0	Yes (X)
SUZANNE FAY GLYNN ESQ
TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0
PATRICK J FLYNN MD
TRUSTEE (UNTIL 5/17)	40.0	2.5	Yes (X)	$557,822	$0	$20,133
DEWITT DAVENPORT
SEE SCHEDULE O FOR TITLE	2.0	2.5	Yes (X)	$0	$0	$0	Yes (X)
DIANE COLETTI
TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0
WILLIAM ZAMMER
CHAIRMAN (UNTIL 5/17)/TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0	Yes (X)
SUMNER B TILTON JR
TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0
PAUL EVANS MD
TRUSTEE (UNTIL 1/17)	2.0	2.5	Yes (X)	$0	$0	$0
E JAMES MULCAHY JR
TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0
ROBERT TALERMAN
TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0
GARY VACON
VICE CHAIR(AS OF 5/17)/TRUSTEE	2.0	2.5	Yes (X)	$0	$0	$0	Yes (X)
ROBERT WILSTERMAN MD
TRUSTEE	40.0	2.5	Yes (X)	$786,161	$0	$52,391
WILLIAM AGEL MD
TRUSTEE (AS OF 5/17)	40.0	2.5	Yes (X)	$482,609	$0	$44,181
THEODORE CALIANOS MD
TRUSTEE (AS OF 5/17)	40.0	2.5	Yes (X)	$392,217	$0	$44,181
PAUL HOULE MD
TRUSTEE (AS OF 5/17)	40.0	2.5	Yes (X)	$921,100	$18,944	$61,789
BRUCE JOHNSTON
TRUSTEE (AS OF 5/17)	2.0	2.5	Yes (X)	$0	$0	$0
MICHAEL G JONES
Sr VP Chief Legal OffICER	55.0	5.5		$0	$406,665	$77,730	Yes (X)
MICHAEL L CONNORS
SENIOR VP FINANCE/CFO	55.0	5.5		$0	$562,528	$86,951	Yes (X)
DIANNE C KOLB
President VNA	45.0	5.0		$0	$258,229	$62,719		Yes (X)
JEANNE FALLON
SR VP & CIO	45.0	5.0		$0	$303,074	$64,025		Yes (X)
JEFFREY S DYKENS
SEE SCH O FOR TITLE	45.0	5.0		$0	$304,817	$65,522		Yes (X)
PATRICK KANE
SVP OF MRKTG,COMMUN AND DEVLP	45.0	5.0		$0	$392,787	$50,808		Yes (X)
THERESA M AHERN
SVP, STRAT, COMMUNITY/GOV REL.	45.0	5.0		$0	$306,644	$61,351		Yes (X)
VICTOR OLIVEIRA
VP OF PATIENT SERVICES	45.0	5.0		$0	$302,363	$72,285		Yes (X)
DONALD GUADAGNOLI MD
CMO CAPE COD HOSPITAL	45.0	5.0		$0	$543,148	$71,461		Yes (X)
EMILY SCHORER
SVP HUMAN RESOURCES	45.0	5.0		$0	$318,698	$56,154		Yes (X)
MICHAEL BUNDY
COO (AS OF 6/16)	45.0	5.0		$0	$196,525	$31,354		Yes (X)
LORI JEWETT RN MSN
COO - FH (AS OF 6/16)	45.0	5.0		$0	$267,870	$27,235		Yes (X)
KEVIN J MULROY
SEE SCH O FOR TITLE	45.0	5.0		$0	$476,987	$74,706		Yes (X)
ALEXANDER HEARD MD
CMO FALMOUTH HOSPITAL	45.0	5.0		$53,430	$483,297	$64,162		Yes (X)
CHRISTIAN BROWN
SR VP MANAGED CARE	45.0	5.0		$0	$385,690	$79,019		Yes (X)
KEVIN RALPH
SVP DEVELOPMENT	45.0	5.0		$0	$301,014	$59,729		Yes (X)
CARTER HUNT
SEE SCHEDULE O FOR TITLE	45.0	5.0		$0	$203,048	$59,663		Yes (X)
NOELENE CERVIN
SEE SCHEDULE O FOR TITLE	45.0	5.0		$0	$245,994	$43,219		Yes (X)
RICHARD B ZELMAN MD
PHYSICIAN	40.0	0.0		$1,554,027	$0	$47,558			Yes (X)
GORDON NAKATA MD
PHYSICIAN	40.0	0.0		$1,017,932	$0	$64,558			Yes (X)
ACHILLE PAPAVASILIOU MD
PHYSICIAN	40.0	0.0		$1,004,446	$0	$64,558			Yes (X)
NICHOLAS COPPA MD
PHYSICIAN	40.0	0.0		$874,605	$0	$38,881			Yes (X)
PHILIP J DOMBROWSKI MD
PHYSICIAN	40.0	0.0		$740,750	$0	$12,125			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$8,385,099	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$7,664,589	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,802,847	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	746	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CAPE COD HEALTHCARE INC
297 NORTH STREET BLDG 3	HYANNIS	MA	02601	PURCHASED SERVICES	$52,045,981
CORE MEDICAL GROUP
3000 GOFFS FALLS RD STE 101	MANCHESTER	NH	03103	CONTRACT RN, PT, OT	$515,173
QUALITY IN REAL TIME
15 VEBENA AVE STE 210	FLORAL PARK	NY	11001	CODING REVIEW SRVCS	$451,225
DELTA HEALTH
400 LAKEMONT PARK BLVD	ALTOONA	PA	16602	MIS SUPPORT	$229,660
MEDTRONIC CARE MANAGEMENT
7980 CENTURY BLVD	CHANHASSEN	MA	55317	PATIENT SUPPORT SRVC	$224,978

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	13	CntrctRcvdGreaterThan100KCnt
Fundraising	$18,125	FundraisingAmt
Government Grants	$1,500,657	GovernmentGrantsAmt
All Other Contributions	$13,822,984	AllOtherContributionsAmt
Noncash Contributions	$173,993	NoncashContributionsAmt
Total Contributions	$15,341,766	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE	900099	$816,840,229	$816,840,229
LABORATORY SERVICES	621500	$9,029,180	$6,743,238	$2,285,942
QUALITY EARNED PAYMENTS	900099	$8,732,275	$8,732,275
PROGRAM RELATED RENTAL INCOME	900099	$3,460,315	$3,460,315
JOINT VENTURE REVENUE	900099	$2,866,958	$2,866,958

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,930,023	TotalRevenueColumnAmt
Related Or Exempt Func Income	$3,930,023	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$844,858,980	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,985,405	TotalRevenueColumnAmt
Exclusion	$5,985,405	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Rental Income Or Loss RentalIncomeOrLossGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,446,872	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$2,446,872	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,446,872	TotalRevenueColumnAmt
Exclusion	$2,446,872	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$583,640	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$18,125	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$226,640	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$357,000	TotalRevenueColumnAmt
Exclusion	$357,000	ExclusionAmt

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

Net Income From Gaming NetIncomeFromGamingGrp

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

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA INCOME	900099	$1,687,091	$1,687,091
MEDICAL RECORDS	900099	$107,873	$107,873
EMPLOYEE PHARMACY	900099	$43,793	$43,793

Field	Value	IRS element (for citing)
Other Revenue Total	$1,838,757	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$870,828,780	TotalRevenueColumnAmt
Related Or Exempt Func Income	$842,573,038	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$2,285,942	UnrelatedBusinessRevenueAmt
Exclusion	$10,628,034	ExclusionAmt

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

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

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

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

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

Foreign Grants ForeignGrantsGrp

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

Benefits To Members BenefitsToMembersGrp

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

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,576,847	TotalAmt
Program Services	$3,576,847	ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$120,450	TotalAmt
Program Services	$120,450	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$348,325,415	TotalAmt
Program Services	$311,847,974	ProgramServicesAmt
Management And General	$35,119,811	ManagementAndGeneralAmt
Fundraising	$1,357,630	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$10,780,093	TotalAmt
Program Services	$9,320,996	ProgramServicesAmt
Management And General	$1,404,792	ManagementAndGeneralAmt
Fundraising	$54,305	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$59,523,129	TotalAmt
Program Services	$53,251,653	ProgramServicesAmt
Management And General	$6,086,711	ManagementAndGeneralAmt
Fundraising	$184,765	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$23,316,492	TotalAmt
Program Services	$20,525,967	ProgramServicesAmt
Management And General	$2,686,666	ManagementAndGeneralAmt
Fundraising	$103,859	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$7,451,324	TotalAmt
Program Services	$3,258,798	ProgramServicesAmt
Management And General	$4,192,526	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$208,561	TotalAmt
Program Services	$8,401	ProgramServicesAmt
Management And General	$200,160	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$888,326	TotalAmt
Program Services	$179,649	ProgramServicesAmt
Management And General	$708,677	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

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

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$86,247	TotalAmt
Fundraising	$86,247	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$553,181	TotalAmt
Program Services	$56,407	ProgramServicesAmt
Management And General	$496,774	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$33,621,505	TotalAmt
Program Services	$33,013,606	ProgramServicesAmt
Management And General	$607,899	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$955,364	TotalAmt
Program Services	$898,655	ProgramServicesAmt
Management And General	$56,709	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,512,488	TotalAmt
Program Services	$5,057,099	ProgramServicesAmt
Management And General	$388,573	ManagementAndGeneralAmt
Fundraising	$66,816	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$10,063,272	TotalAmt
Program Services	$9,165,050	ProgramServicesAmt
Management And General	$898,222	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$16,907,423	TotalAmt
Program Services	$15,606,989	ProgramServicesAmt
Management And General	$1,156,257	ManagementAndGeneralAmt
Fundraising	$144,177	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$5,078,671	TotalAmt
Program Services	$4,770,078	ProgramServicesAmt
Management And General	$308,593	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

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

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,502,270	TotalAmt
Program Services	$5,868,340	ProgramServicesAmt
Management And General	$633,930	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$27,183,915	TotalAmt
Program Services	$24,620,750	ProgramServicesAmt
Management And General	$2,555,913	ManagementAndGeneralAmt
Fundraising	$7,252	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,605,123	TotalAmt
Program Services	$2,496,793	ProgramServicesAmt
Management And General	$108,330	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$116,943,969	$116,943,969	$0	$0
PURCHASED SERVICES	$46,896,526	$43,479,503	$3,355,286	$61,737
ADMINISTRATION OFFICE OVERHEAD	$53,004,843	$39,996,172	$12,462,581	$546,090
BAD DEBTS	$14,533,756	$14,533,756	$0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$28,629,790	TotalAmt
Program Services	$25,420,602	ProgramServicesAmt
Management And General	$2,435,076	ManagementAndGeneralAmt
Fundraising	$774,112	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$823,268,980	TotalAmt
Program Services	$744,018,504	ProgramServicesAmt
Management And General	$75,863,486	ManagementAndGeneralAmt
Fundraising	$3,386,990	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$41,486,722	BOYAmt
EOY	$23,129,902	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,407,662	BOYAmt
EOY	$1,413,064	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$13,712,338	BOYAmt
EOY	$12,662,460	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$88,033,760	BOYAmt
EOY	$86,022,740	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$5,375,686	BOYAmt
EOY	$3,997,612	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$11,108,863	BOYAmt
EOY	$10,914,440	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$7,950,467	BOYAmt
EOY	$2,406,916	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$633,018,852	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$343,811,263	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$292,692,694	BOYAmt
EOY	$289,207,589	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$400,979,488	BOYAmt
EOY	$474,804,154	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$9,294,601	BOYAmt
EOY	$5,124,965	EOYAmt

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$22,834,881	BOYAmt
EOY	$44,274,612	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$904,223,714	BOYAmt
EOY	$963,305,006	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$57,125,221	BOYAmt
EOY	$54,459,109	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$781,816	BOYAmt
EOY	$429,407	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$156,420,826	BOYAmt
EOY	$150,522,013	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$15,137,718	BOYAmt
EOY	$13,407,900	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$40,809,969	BOYAmt
EOY	$39,975,567	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$270,275,550	BOYAmt
EOY	$258,793,996	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$564,517,008	BOYAmt
EOY	$630,388,180	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$37,490,718	BOYAmt
EOY	$41,022,954	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$31,940,438	BOYAmt
EOY	$33,099,876	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$633,948,164	BOYAmt
EOY	$704,511,010	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$904,223,714	BOYAmt
EOY	$963,305,006	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$47,559,800	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$27,845,699	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$4,842,653	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$17,223,613	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$9,458,675	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$15,572,146	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$13,584,232	CurrentTaxYearMinus1YearAmt
Current Tax Year	$15,341,766	CurrentTaxYearAmt
Total	$71,180,432	TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

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

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

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

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$17,223,613	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$9,458,675	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$15,572,146	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$13,584,232	CurrentTaxYearMinus1YearAmt
Current Tax Year	$15,341,766	CurrentTaxYearAmt
Total	$71,180,432	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$1,918,069	SubstantialContributorsTotAmt
Public Support Total170	$69,262,363	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$680,260	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$3,486,933	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$4,951,534	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$5,368,273	CurrentTaxYearMinus1YearAmt
Current Tax Year	$5,985,405	CurrentTaxYearAmt
Total	$20,472,405	TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$187,290	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,059,076	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,000,152	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$798,057	CurrentTaxYearMinus1YearAmt
Current Tax Year	$408	CurrentTaxYearAmt
Total	$3,044,983	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,163,050	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,189,718	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,271,023	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,353,977	CurrentTaxYearMinus1YearAmt
Current Tax Year	$2,422,397	CurrentTaxYearAmt
Total	$11,400,165	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$106,097,985	TotalSupportAmt
Gross Receipts Rltd Activities	$3,846,013,159	GrossReceiptsRltdActivitiesAmt
Public Support CY170	0.65282	PublicSupportCY170Pct
Public Support PY170	0.66980	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

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

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

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

Adjusted Net Income AdjustedNetIncomeGrp

Net ST Capital Gain Adj Net Incm NetSTCapitalGainAdjNetIncmGrp

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

Recoveries PY Distributions RecoveriesPYDistributionsGrp

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

Other Gross Income OtherGrossIncomeGrp

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

Adjusted Gross Income AdjustedGrossIncomeGrp

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

Depreciation Depletion DepreciationDepletionGrp

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

Production Income ProductionIncomeGrp

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

Other Expenses OtherExpensesGrp

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

Total Adjusted Net Income TotalAdjustedNetIncomeGrp

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

Minimum Asset Amount MinimumAssetAmountGrp

Average Monthly FMV Of Sec AverageMonthlyFMVOfSecGrp

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

Average Monthly Cash Balances AverageMonthlyCashBalancesGrp

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

FMV Other Non Exempt Use Asset FMVOtherNonExemptUseAssetGrp

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

Total FMV Of Non Exempt Use Asset TotalFMVOfNonExemptUseAssetGrp

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

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

Acquisition Indebtedness AcquisitionIndebtednessGrp

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

Adjusted FMV Less Indebtedness AdjustedFMVLessIndebtednessGrp

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

Cash Deemed Charitable CashDeemedCharitableGrp

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

Net Vl Non Exempt Use Assets NetVlNonExemptUseAssetsGrp

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

Pct Of Net Vl Non Exempt Use Ast PctOfNetVlNonExemptUseAstGrp

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

Recoveries PY Distri Min Asset RecoveriesPYDistriMinAssetGrp

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

Total Minimum Asset TotalMinimumAssetGrp

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

Distributable Amount DistributableAmountGrp

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

Distributions DistributionsGrp

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

Distribution Allocations DistributionAllocationsGrp

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$62,386	OtherActivitiesAmt
Total Lobbying Expenditures	$62,386	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	Cape Cod Hospital and Falmouth Hospital Association, Inc. pay membership dues to the Massachusetts Hospital Association which engages in lobbying purposes as defined by Medicare. Per the MHA advisory, 18.94% of dues paid should be allocated to lobbying activity. For FY17 for Cape Cod Hospital and Falmouth Hospital Association, Inc. combined, the lobbying portion equals $62,386.	ExplanationTxt

Schedule D IRS990ScheduleD

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

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$35,475,473	BeginningYearBalanceAmt
Contributions	$60,508	ContributionsAmt
Investment Earnings Or Losses	$1,238,094	InvestmentEarningsOrLossesAmt
Other Expenditures	$713,089	OtherExpendituresAmt
End Year Balance	$36,060,986	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.79560	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.20440	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$23,308,713	OtherCostOrOtherBasisAmt
Book Value	$23,308,713	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$392,421,994	OtherCostOrOtherBasisAmt
Depreciation	$177,401,887	DepreciationAmt
Book Value	$215,020,107	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,904,390	OtherCostOrOtherBasisAmt
Depreciation	$1,460,870	DepreciationAmt
Book Value	$2,443,520	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$209,135,425	OtherCostOrOtherBasisAmt
Depreciation	$163,275,658	DepreciationAmt
Book Value	$45,859,767	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,248,330	OtherCostOrOtherBasisAmt
Depreciation	$1,672,848	DepreciationAmt
Book Value	$2,575,482	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$289,207,589	TotalBookValueLandBuildingsAmt
Financial Derivatives		FinancialDerivativesGrp
Closely Held Equity Interests		CloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (5 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
LONG-TERM INVESTMENTS	$409,264,981	F
FUNDS HELD UNDER BOND	$3,115,029
TEMP RESTRICTED INVESTMENTS	$28,509,222	F
PERM RESTRICTED INVESTMENTS	$33,080,268	F
SHORT TERM INVESTMENTS - FDN	$834,654	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$474,804,154	TotalBookValueSecuritiesAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
DUE TO AFFILIATES	$16,284,660
EST. SETTLEMENTS W 3RD PARTIES	$21,578,855
OTHER CURRENT LIABILITIES	$725,618
ABANDONED PROPERTY	$16,896
INTEREST RATE SWAPS	$1,369,538

Field	Value	IRS element (for citing)
Total Liability	$39,975,567	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

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

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Offices	1	OfficesCnt
Employee	0	EmployeeCnt
Type Of Activities Conducted	Program Services	TypeOfActivitiesConductedTxt
Specific Services Provided	CAPTIVE INSURANCE	SpecificServicesProvidedTxt
Region Total Expenditures	$2,491,282	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	1	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Total Office	1	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$2,491,282	SubtotalSpentAmt
Total Spent	$2,491,282	TotalSpentAmt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	false	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	false	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

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

Schedule G IRS990ScheduleG

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

Fundraiser Activity Info FundraiserActivityInfoGrp

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

US Address USAddress

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

Field	Value	IRS element (for citing)
Activity	DIRECT MAIL	ActivityTxt
Fundraiser Control Of Funds	false	FundraiserControlOfFundsInd
Gross Receipts	$261,070	GrossReceiptsAmt
Retained By Contractor	$86,247	RetainedByContractorAmt
Net To Organization	$174,823	NetToOrganizationAmt

Field	Value	IRS element (for citing)
Total Gross Receipts	$261,070	TotalGrossReceiptsAmt
Total Retained By Contractors	$86,247	TotalRetainedByContractorsAmt
Total Net To Organization	$174,823	TotalNetToOrganizationAmt
Licensed States	CA	LicensedStatesCd
Licensed States	CT	LicensedStatesCd
Licensed States	FL	LicensedStatesCd
Licensed States	IL	LicensedStatesCd
Licensed States	MA	LicensedStatesCd
Licensed States	MI	LicensedStatesCd
Licensed States	NH	LicensedStatesCd
Licensed States	NJ	LicensedStatesCd
Licensed States	NY	LicensedStatesCd
Licensed States	NC	LicensedStatesCd
Licensed States	PA	LicensedStatesCd
Licensed States	SC	LicensedStatesCd
Licensed States	WI	LicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GALA EVENT	Event1Nm
Gross Receipts Event1	$601,765	GrossReceiptsEvent1Amt
Charitable Contri Event1	$18,125	CharitableContriEvent1Amt
Gross Revenue Event1	$583,640	GrossRevenueEvent1Amt
Non Cash Prizes Event1	$26,387	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$6,500	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$75,833	FoodAndBeverageEvent1Amt
Entertainment Event1	$20,776	EntertainmentEvent1Amt
Other Direct Expenses Event1	$97,144	OtherDirectExpensesEvent1Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$601,765	GrossReceiptsTotalAmt
Charitable Contributions Tot	$18,125	CharitableContributionsTotAmt
Gross Revenue Total Events	$583,640	GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events	$26,387	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$6,500	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$75,833	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$20,776	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$97,144	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$226,640	DirectExpenseSummaryEventsAmt
Net Income Summary	$357,000	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,698,123	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,794,478	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,903,645	NetCommunityBenefitExpnsAmt
Total Expense	0.00480	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$96,936,483	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$87,354,539	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,581,944	NetCommunityBenefitExpnsAmt
Total Expense	0.01180	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,421,947	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,854,220	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,567,727	NetCommunityBenefitExpnsAmt
Total Expense	0.00190	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$113,056,553	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$98,003,237	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,053,316	NetCommunityBenefitExpnsAmt
Total Expense	0.01850	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,832,150	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,832,150	NetCommunityBenefitExpnsAmt
Total Expense	0.00230	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,492,372	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$85,481	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,406,891	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$300,571,243	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$266,321,365	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$34,249,878	NetCommunityBenefitExpnsAmt
Total Expense	0.04230	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,689,336	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,689,336	NetCommunityBenefitExpnsAmt
Total Expense	0.00210	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$305,585,101	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$266,406,846	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$39,178,255	NetCommunityBenefitExpnsAmt
Total Expense	0.04840	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$418,641,654	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$364,410,083	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$54,231,571	NetCommunityBenefitExpnsAmt
Total Expense	0.06690	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$36,936	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$36,936	NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,042,582	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,042,582	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,079,518	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,079,518	NetCommunityBenefitExpnsAmt

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$14,533,756	BadDebtExpenseAmt
Bad Debt Expense Attributable	$10,004,187	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$255,213,259	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$240,615,064	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$14,598,195	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Hospital Facilities HospitalFacilitiesGrp (2 entries)

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

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

Supplemental Information SupplementalInformationGrp (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION A	WEBSITES PART V, SECTION A, LINE 1 - CAPE COD HOSPITAL WWW.CAPECODHEALTH.ORG/LOCATIONS/CAPE-COD-HOSPITAL
PART V, SECTION A, LINE 2 - FALMOUTH HOSPITAL	WWW.CAPECODHEALTH.ORG/LOCATIONS/FALMOUTH-HOSPITAL
PART V, SECTION B, LINE 5	OVER 20 DATA SOURCES WERE UTILIZED TO COLLECT BARNSTABLE COUNTY AND TOWN-LEVEL HEALTH STATISTICS ON DISEASE INCIDENCE AND PREVALENCE, HOSPITAL UTILIZATION, MORBIDITY AND MORTALITY, BARRIERS TO ACCESSING CARE, AND BEHAVIORAL RISK FACTORS. REGIONAL STATISTICS WERE ANALYZED AND COMPARED TO STATE AND NATIONAL STATISTICS TO IDENTIFY WHERE DEMOGRAPHIC AND HEALTH DISPARITIES EXIST. ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL SELECTED JOHN SNOW, INC. (JSI) A PUBLIC HEALTH RESEARCH FIRM, TO CONDUCT PRIMARY RESEARCH INCLUDING HEALTH DATA RESEARCH, KEY INFORMANT INTERVIEWS AND FACILITATION OF COMMUNITY AND PROVIDER FORUMS. JSI INTERVIEWED OVER 25 REGIONAL LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY AND WHO OFFER INFORMATION OR EXPERTISE RELATIVE TO THE SIGNIFICANT HEALTH NEEDS OF VULNERABLE POPULATIONS. THEY INCLUDED SUCH ENTITIES AS MUNICIPAL PUBLIC HEALTH DEPARTMENTS,HUMAN SERVICE AGENCIES, SCHOOLS AND LAW ENFORCEMENT AGENCIES, FEDERALLY QUALIFIED HEALTH CENTERS,COMMUNITY ORGANIZATIONS SERVING LOW-INCOME, VULNERABLE AND MEDICALLY UNDERSERVED POPULATIONS, ELECTED OFFICIALS, AND HOSPITAL CLINICIANS AND ADMINISTRATORS. FIVE COMMUNITY INPUT FORUMS WERE HELD ACROSS BARNSTABLE COUNTY. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS ATTENDED. THESE FORUMS PROVIDED AN OPPORTUNITY TO PRESENT STATISTICAL HEALTH FINDINGS TO PARTICIPANTS AND IDENTIFY GAPS IN SERVICES. ADDITIONALLY, THE FORUMS FACILITATED DIALOGUE ON ISSUES NOT IDENTIFIED AND TARGET POPULATIONS MOST IMPACTED BY HEALTH ISSUES. A POST-FORUM SURVEY WAS PROVIDED TO PARTICIPANTS TO IDENTIFY AND RANK HEALTH PRIORITIES IN THE REGION. FEEDBACK AND INPUT FROM THE KEY INFORMANT INTERVIEWS AND FROM ATTENDEES OF THE COMMUNITY AND PROVIDER FORUMS WAS USED TO INFORM THE SELECTION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS. THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE COMMUNITY INPUT ACTIVITIES THROUGHOUT THE PHASES OF THE PROJECT: PUBLIC HEALTH EXPERTS, HEALTH CARE PROVIDERS AND HEALTH SERVICE ORGANIZATIONS AIDS SUPPORT GROUP OF CAPE COD ALZHEIMER'S FAMILY SUPPORT CENTER OF CAPE COD ARBOR COUNSELING SERVICES BARNSTABLE COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENT BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES BARNSTABLE COUNTY PUBLIC NURSING DIVISION CCHC EMERGENCY SERVICES CCHC CENTERS FOR BEHAVIORAL HEALTH CAPE & ISLANDS EMERGENCY MEDICAL SERVICES SYSTEM CARON TREATMENT CENTER COMMUNITY HEALTH CENTER OF CAPE COD DUFFY HEALTH CENTER EMERALD PHYSICIANS FALMOUTH HUMAN SERVICES GOSNOLD ON CAPE COD HARBOR COMMUNITY HEALTH CENTER-HYANNIS HOPE HEALTH HOPE DEMENTIA & ALZHEIMER'S SERVICES OF CAPE COD MASHPEE WAMPANOAG HEALTH SERVICE UNIT OUTER CAPE HEALTH SERVICES SPAULDING REHABILITATION HOSPITAL CAPE COD SPECIALTY NETWORK FOR THE UNINSURED TOWN OF BREWSTER HEALTH DEPARTMENT TOWN OF FALMOUTH HEALTH DEPARTMENT TOWN OF MASHPEE HUMAN SERVICES VINFEN VISITING NURSE ASSOCIATION OF CAPE COD ORGANIZATIONS SERVING LOW-INCOME, MEDICALLY UNDERSERVED OR VULNERABLE POPULATIONS: BARNSTABLE PUBLIC SCHOOL SYSTEM BOYS & GIRLS CLUB OF CAPE COD CAPE COD CENTER FOR WOMEN CAPE COD CHILD DEVELOPMENT CAPE COD COUNCIL OF CHURCHES CAPE COD WIC CAPE COD NEIGHBORHOOD SUPPORT COALITION CHILD AND FAMILY SERVICES COALITION FOR CHILDREN COMMUNITY ACTION COMMITTEE OF CAPE COD & THE ISLANDS CHILDREN'S COVE COMMUNITY DEVELOPMENT PARTNERSHIP ELDER SERVICES OF CAPE COD & THE ISLANDS FALMOUTH PUBLIC SCHOOL SYSTEM FALMOUTH SERVICE CENTER FALMOUTH TOGETHER WE CAN FALMOUTH VOLUNTEERS IN PUBLIC SCHOOLS THE FAMILY PANTRY OF CAPE COD GLENNA KOHL FUND FOR HOPE HEALTH IMPERATIVES HEALTHY LIVING CAPE COD HELPING OUR WOMEN HOMELESS PREVENTION COUNCIL HOUSING ASSISTANCE CORPORATION INDEPENDENCE HOUSE JUSTICE RESOURCE INSTITUTE LYME AWARENESS OF CAPE COD OUTER CAPE WOMEN INFANTS AND CHILDREN (WIC) MOTHER AND INFANT RECOVERY NETWORK NATIONAL ALLIANCE ON MENTAL ILLNESS CAPE COD SAMARITANS ON CAPE COD AND THE ISLANDS SANDPIPER NURSERY SCHOOL SANDWICH PUBLIC SCHOOL SYSTEM SHINE (SERVING HEALTH INFORMATION NEEDS OF EVERYONE) SIGHT LOSS SERVICES TOWN OF FALMOUTH COUNCIL ON AGING TOWN OF MASHPEE COUNCIL ON AGING TOWN OF PROVINCETOWN COUNCIL ON AGING TOWN OF SANDWICH COUNCIL ON AGING TOWN OF TRURO COUNCIL ON AGING WE CAN YMCA OF CAPE COD COUNTY, TOWN, OR MUNICIPAL ENTITIES AND REGIONAL TASK FORCES: CAPE & ISLANDS UNITED WA CAPE COD COMMUNITY COLLEGE CAPE COD DISTRICT ATTORNEY'S OFFICE CAPE COD FOUNDATION CAPE & ISLANDS SUICIDE PREVENTION COALITION YARMOUTH POLICE DEPARTMENT MA DEPARTMENT OF MENTAL HEALTH MA DEPARTMENT OF PUBLIC HEALTH MASHPEE WAMPANOAG TRIBE HEALTH SERVICES COMMUNITY HEALTH NETWORK AREA 27 BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS BARNSTABLE COUNTY REGIONAL SUBSTANCE ABUSE COUNCIL BARNSTABLE TOWN COUNCIL SUBSTANCE USE IN PREGNANCY TASK FORCE
PART V, SECTION B, LINE 6 (A)	CAPE COD HOSPITAL AND FALMOUTH HOSPITAL JOINTLY CONDUCTED THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORT.
PART V, SECTION B, LINE 7(A)	https://www.capecodhealth.org/about/caring-for-our-community/community-hea lth-needs-assessments/
PART V, SECTION B, LINE 7(B)	https://www.capecodhealth.org/about/caring-for-our-community/community-hea lth-needs-assessments/
PART V, SECTION B, LINE 10(A)	https://www.capecodhealth.org/about/caring-for-our-community/community-hea lth-needs-assessments/
PART V, SECTION B, LINE 11	THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDE CHRONIC AND INFECTIOUS DISEASE, BEHAVIORAL HEALTH, ACCESS TO CARE AND DISEASE PREVENTION AND WELLNESS. CAPE COD HOSPITAL (CCH) AND FALMOUTH HOSPITAL (FH) WILL ADDRESS THESE SPECIFIC ISSUES THROUGH A COMPREHENSIVE SET OF IMPLEMENTATION STRATEGIES THAT INCLUDE HOSPITAL-BASED PROGRAMS, COLLABORATIVE EFFORTS WITH NUMEROUS REGIONAL HEALTH PARTNERS AND PROVIDING GRANTS TO COMMUNITY BASED ORGANIZATIONS WITH INITIATIVES THAT ALIGN WITH COMMUNITY HEALTH IMPROVEMENT STRATEGIES. THREE SPECIFIC ISSUES IDENTIFIED THROUGH THE ASSESSMENT FALL OUTSIDE OF THE CORE COMPETENCIES OF THE HOSPITALS AND WERE NOT INCLUDED IN THE CCH AND FH IMPLEMENTATION STRATEGIES. THE ISSUES ARE TRANSPORTATION, HOUSING AND HOMELESSNESS, AND EMPLOYMENT. THESE ISSUES ARE LONG-STANDING REGIONAL CHALLENGES AND WERE IDENTIFIED IN THE PREVIOUS CHNA AS ISSUES OUTSIDE THE SCOPE OF SIGNIFICANT HEALTH NEEDS THAT THE HOSPITALS CAN REASONABLY ADDRESS. RESIDENTS IMPACTED BY THESE ISSUES WILL BE SERVED BY THE HOSPITALS SINCE IT IS THEIR MISSION TO SERVE ALL WITHOUT REGARD TO SEX, RACE, CREED, RESIDENCE, NATIONAL ORIGIN, SEXUAL ORIENTATION, OR ABILITY TO PAY. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL RECOGNIZE THAT THERE ARE REGIONAL ENTITIES WITH THE CORE COMPETENCIES, KNOWLEDGE, STAFF AND FUNDING SOURCES TO SPECIFICALLY ADDRESS THE ISSUES OF TRANSPORTATION, HOUSING AND HOMELESSNESS, AND EMPLOYMENT. THE HOSPITALS WILL COLLABORATE ON ACTIVITIES THAT ARE LED BY THE APPROPRIATE AGENCIES.
PART V, SECTION B, LINE 13(B)	IN SOME CASES, THE MASSACHUSETTS HEALTHCONNECTOR CALCULATOR OR MODIFIED ADJUSTED GROSS INCOME IS USED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY.
PART V, SECTION B, LINE 13(H)	STATE REGULATIONS
PART V, SECTION B, LINE 16(A)	HTTPS://WWW.CAPECODHEALTH.ORG/APP/FILES/PUBLIC/3908/FAP-POLICY-CCHC-8-29-2 016.PDF
PART V, SECTION B,LINE 16(B)	HTTPS://WWW.CAPECODHEALTH.ORG/PATIENTS-VISITORS
PART V, SECTION B, LINE 16(C)	HTTPS://WWW.CAPECODHEALTH.ORG/APP/FILES/PUBLIC/3910/PLAIN-LANGUAGE-SUMMARY -9-15-2016.PDF

Field	Value	IRS element (for citing)
Facility	67	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (67 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Visiting Nurse Association of Cape Cod
255 Independence Drive	Hyannis	MA	02601	home health
CAPE COD HEALTHCARE CORP
88 LEWIS BAY RD	HYANNIS	MA	02601	ADMINISTRATIVE
Fontaine Medical Center
525 Long Pond Drive	HARWICH	MA	02645	medical group practice
NEUROSURGEONS OF CAPE COD
46 NORTH ST STE 4	HYANNIS	MA	02601	medical group practice
Bramblebush Medical Group
21 Bramblebush Park	FALMOUTH	MA	02540	medical group practice
Seaside Pediatrics
150 Ansel Hallet Road	West Yarmouth	MA	02673	medical group practice
Manning Jr William J MD
700 Attucks Lane Suite 1A	HYANNIS	MA	02601	medical group practice
Fontaine OUTPATIENT CENTER
525 Long Pond Drive	Harwich	MA	02645	medical group practice
Guo X Y David MD PhD
90 TER HEUN DRIVE STE 302	Falmouth	MA	02540	medical group practice
BAYSIDE INTERNAL MEDICINE
2 Jan Sebastian Way Suite 100	Sandwich	MA	02563	medical group practice
SHAPIRO GARY MD & YAMIN JUSTIN MD
700 ATTUCKS LANE STE 1C	Hyannis	MA	02601	medical group practice
Theodore A Calianos II MD
160 Falmouth Road Suite B	MASHPEE	MA	02649	medical group practice
CAPE COD OBSTETRICS & GYNECOLOGY
90 Ter Heun Drive SUITE 100	Falmouth	MA	02540	medical group practice
Yarmouth Internists
257 Station Avenue	SOUTH YARMOUTH	MA	02664	medical group practice
Chatham Medical Group
1629 Main Street	Chatham	MA	02633	medical group practice
Endocrine Center of Cape Cod
40 Quinlan Way 2nd Fl Suite 206	Hyannis	MA	02601	medical group practice
Fal Specialty Care Practice
90 Ter Heun Drive Suite 302	Falmouth	MA	02540	medical group practice
MACC NEUROLOGY - CCHC
46 North Street SUITE 7	Hyannis	MA	02601	medical group practice
Cape Cod Pediatrics
55 Route 130	Forestdale	MA	02644	medical group practice
Nauset Family Practice
81 Old Colony Way STE D	ORLEANS	MA	02653	medical group practice
Devin McManus Medical Practice
10 BrambleBush Drive	FALMOUTH	MA	02540	medical group practice
Cape Health Insurance Company - FOREIGN
297 NORTH ST 3	HYANNIS	MA	02601	administrative
Healthcare Foundation
One Financial Place 297 North Stre	Hyannis	MA	02601	administrative
Healthcare Foundation
Homeport 348C Gifford Street	FALMOUTH	MA	02540	ADMINISTRATIVE
JML Care Center
184 Ter Heun Drive	falmouth	MA	02540	skilled nur & rehab
Cape & Islands Health Services II
14 Yellow Brick Road	HYANNIS	MA	02601	COLLECTION CENTER
Cape & Islands Health Services II
5 Industrial Drive Suite 102	MASHPEE	MA	02649	COLLECTION CENTER
Cape & Islands Health Services II
200 Jones Road	FALMOUTH	MA	02540	COLLECTION CENTER
Cape & Islands Health Services II
525 Long Pond Drive	HARWICH	MA	02645	COLLECTION CENTER
Cape & Islands Health Services II
81 Old Colony Way	ORLEANS	MA	02653	COLLECTION CENTER
Cape & Islands Health Services II
2 Jan Sebastian Way Route 130	SANDWICH	MA	02563	COLLECTION CENTER
Cape & Islands Health Services II
860 Route 134 Unit 2	South Dennis	MA	02660	COLLECTION CENTER
Cape & Islands Health Services II
1 Trowbridge Road	Bourne	MA	02532	COLLECTION CENTER
Cape & Islands Health Services II
68B Route 6A	SANDWICH	MA	02563	COLLECTION CENTER
Cape & Islands Health Services II
1629 MAIN STREET	CHATHAM	MA	02633	COLLECTION CENTER
Cape & Islands Health Services II
27 PARK STREET	HYANNIS	MA	02601	COLLECTION CENTER
Cape & Islands Health Services II
30 Shankpainter Road	PROVINCETOWN	MA	02657	COLLECTION CENTER
Heritage at Falmouth
140 Ter Heun Drive	FALMOUTH	MA	02540	ASSISTED LIVING
Cape Cod Human Services
460 West Main Street	HYANNIS	MA	02601	outpatient clinic
Cape Cod Human Services
525 Long Pond Drive	HARWICH	MA	02645	outpatient clinic
Cape Cod Medical Office Building Inc
20 Gleason Street	HYANNIS	MA	02601	administrative
Orleans Medical CENTER
204 Main Street	Orleans	MA	02653	Medical Group Practice
CAPE COD Dermatology
134 Ansel Hallett Road	W Yarmouth	MA	02673	Medical Group Practice
Cape Cod Rheumatology Center
40 Quinlan Way 2nd Fl Suite 206	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
CCHC Cardiovascular Center
25 Main Street	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
Ziad Farah MD-Fontaine Medical Center
525 Long Pond Drive	HARWICH	MA	02645	MEDICAL GROUP PRACTICE
Fontaine Urgent Care Center
525 Long Pond Drive	HARWICH	MA	02645	MEDICAL GROUP PRACTICE
Park Street Primary Care
62 Park Street	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
Sandwich Medical Group
STONEMAN OUTPATIENT2 Jan Sebastian	SANDWICH	MA	02563	MEDICAL GROUP PRACTICE
Sandwich Primary Care
2 JAN SEBASTIAN WAY SUITE 202	SANDWICH	MA	02563	MEDICAL GROUP PRACTICE
Upper Cape Orthopedics
26 Edgerton Drive Suite C	NORTH FALMOUTH	MA	02556	MEDICAL GROUP PRACTICE
Michael Barnett MD Practice
348 Gifford Street	FALMOUTH	MA	02540	MEDICAL GROUP PRACTICE
All Cape Urology Practice
20 Gleason Street	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
Vascular And Vein Center Of Cape Cod
90 Ter Heun Drive 3RD Fl MOB STE	Falmouth	MA	02540	Medical Group Practice
CCHC General & Specialty Surgery
105 Park Street	Hyannis	MA	02601	Medical Group Practice
Cape Cod Sports Medicine
360 Gifford Street Unit 2B	Falmouth	MA	02540	Medical Group Practice
CARDIOVASCULAR CENTER - FALMOUTH
90 TER HEUN DRIVE SUITE 300	FALMOUTH	MA	02540	Medical Group Practice
GASTROENTEROLOGY HYANNIS - PARK STREET
105 PARK STREET	HYANNIS	MA	02601	Medical Group Practice
STONEMAN OUTPATIENT CENTER - URGENT CARE
2 JAN SEBASTIAN DRIVE SUITE 101	SANDWICH	MA	02563	Medical Group Practice
MASHPEE SURGICAL CENTER
160 FALMOUTH ROAD	MASHPEE	MA	02649	MEDICAL GROUP PRACTICE
CAPE COD HEALTHCARE WOUND CARE
905 ATTUCKS LANE	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
SOUTHEASTERN SURGICAL ASSOCIATES
100 CAMP STREET	HYANNIS	MA	02601	MEIDCAL GROUP PRACTICE
FALMOUTH URGENT CARE
273 TEATICKET HIGHWAY	FALMOUTH	MA	02536	MEDICAL GROUP PRACTICE
HYANNIS URGENT CARE
1220 IYANNOUGH ROAD	HYANNIS	MA	02601	MEDICAL GROUP PRACTICE
UPPER CAPE EAR NOSE THROAT
200 A JONES ROAD	FALMOUTH	MA	02540	MEDICAL GROUP PRACTICE
ORTHOPEDIC SPECIALISTS
5 BRAMBLEBUSH DRIVE	FALMOUTH	MA	02540	MEDICAL GROUP PRACTICE
PATIENT SERVICE CENTER
35 WILKENS LANE	BARNSTABLE	MA	02601	MEDICAL GROUP PRACTICE

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C	N/A
PART I, LINE 6A	N/A
PART I, LINE 7, COLUMN F	THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F WAS $14,533,756. THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE RATIO OF PATIENT CARE COST TO CHARGES AND BY FOLLOWING THE FORM 990, SCHEDULE H INSTRUCTIONS. THE TOTAL PERCENTAGE OF CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST IN THE TABLE WAS CALCULATED ON A GROUP RETURN BASIS AS REQUIRED BY THE FORM 990 INSTRUCTIONS, AND NOT ON A HOSPITAL-ONLY BASIS.
PART II LINE 6	CAPE COD HEALTHCARE CLINICAL, COMMUNITY BENEFITS AND SUPPORT STAFF PARTICIPATED IN A VARIETY OF COALITION BUILDING ACTIVITIES WITHIN THE SERVICE AREA TO ADDRESS AND IMPROVE CARE RELATED TO WOMEN'S HEALTH, BEHAVIORAL HEALTH, CHRONIC DISEASE SELF MANAGEMENT AND SUBSTANCE USE DISORDERS. COALITION ACTIVITIES RANGED FROM NEW PROGRAM DEVELOPMENT TO REACH MEDICALLY UNDERSERVED POPULATIONS TO THE EXPANSION OF EXISTING ACTIVITIES TO STRENGTHEN COLLABORATION BETWEEN REGIONAL HEALTH CARE PROVIDERS AND HUMAN SERVICE AGENCIES.
PART II LINE 8	COALITION BUILDING Cape Cod Healthcare clinical, Community Benefits and support staff participated in a variety of coalition building activities within the service area to address and improve care related to womens health, behavioral health, chronic and infectious disease prevention and management and substance use and misuse in the region. Regional coalitions serve as alliances for combined and coordinated action to improve key health issues. Coalition activities ranged from implementation of new programs to offering community trainings and educational on important health topics to the development of multi-sector partnerships. WORKFORCE DEVELOPMENT CAPE COD HEALTHCARE'S PHYSICIAN RECRUITMENT PROGRAM STRIVES TO IDENTIFY AREAS OF UNMET NEED AND IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE FOR VULNERABLE POPULATIONS, ESPECIALLY THOSE OVER 65 WITH PUBLIC HEALTH INSURANCE COVERAGE. THROUGH RIGOROUS EFFORTS HIGHLY QUALIFIED PHYSICIANS AND PHYSICIAN EXTENDERS ARE RECRUITED AND RETAINED TO MEET THE HEALTH CARE NEEDS OF RESIDENTS OF CAPE COD.
PART III, LINES 2-3	THE ORGANIZATION IS REPORTING $10,004,187 OF BAD DEBT EXPENSE THAT MEETS ITS FINANCIAL ASSISTANCE POLICY. THIS AMOUNT IS RELATED TO BAD DEBT FROM BOTH HOSPITALS DURING FY17 OF UNINSURED PATIENTS WHO WERE SEEN IN THE ER AND RECEIVED MEDICALLY NECESSARY SERVICES. CAPE COD HEALTHCARE RECEIVES PAYMENTS FOR SERVICES RENDERED FROM FEDERAL AND STATE AGENCIES (UNDER THE MEDICARE AND MEDICAID PROGRAMS), MANAGED CARE PAYORS, COMMERCIAL INSURANCE COMPANIES, AND PATIENTS. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF CONTRACTUAL ALLOWANCES AND RESERVES FOR DENIALS, UNCOMPENSATED CARE, AND DOUBTFUL ACCOUNTS. THE LEVEL OF RESERVES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL AND PRIVATE EMPLOYER HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. IF A PATIENT IS INELIGIBLE FOR CHARITY CARE BECAUSE HIS OR HER INCOME EXCEEDS THE ELIGIBILITY GUIDELINES, ANY UNCOLLECTIBLE ACCOUNTS RECEIVABLE BALANCE IS WRITTEN OFF TO BAD DEBT AS REPORTED IN PART III, LINE 2.
PART III, LINE 4	REFER TO PAGE 15 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR FOOTNOTES RELATED TO ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BAD DEBT.
PART III LINE 9(B)	HOSPITAL FINANCIAL ASSISTANCE PROGRAMS PATIENTS WHO ARE ELIGIBLE FOR ENROLLMENT IN A STATE PUBLIC ASSISTANCE PROGRAM, LIKE THE MASSACHUSETTS MASSHEALTH OR HEALTH SAFETY NET PROGRAMS, ARE DEEMED ENROLLED IN A FINANCIAL ASSISTANCE PROGRAM. FOR ALL PATIENTS THAT ARE ENROLLED IN THESE STATE PUBLIC ASSISTANCE PROGRAMS, THE HOSPITAL MAY ONLY BILL THOSE PATIENTS FOR THE SPECIFIC CO-PAYMENT, CO-INSURANCE, OR DEDUCTIBLE THAT IS OUTLINED IN THE APPLICABLE STATE REGULATIONS AND WHICH MAY FURTHER BE INDICATED ON THE STATE MEDICAID MANAGEMENT INFORMATION SYSTEM. THE HOSPITAL WILL SEEK A SPECIFIED PAYMENT FOR THOSE PATIENTS THAT DO NOT QUALIFY FOR ENROLLMENT IN A MASSACHUSETTS STATE PUBLIC ASSISTANCE SUCH AS OUT-OF-STATE RESIDENTS, BUT WHO MAY OTHERWISE MEET THE GENERAL FINANCIAL ELIGIBILITY CATEGORIES OF A STATE PUBLIC ASSISTANCE PROGRAM. FOR THESE PATIENTS, THE PAYMENT AMOUNT WILL BE SET AT THE HOSPITAL, WHEN REQUESTED BY THE PATIENT AND BASED ON AN INTERNAL REVIEW OF EACH PATIENT'S FINANCIAL STATUS, MAY OFFER A PATIENT AN ADDITIONAL DISCOUNT ON AN UNPAID BILL. ANY SUCH REVIEW SHALL BE PART OF A SEPARATE HOSPITAL FINANCIAL ASSISTANCE PROGRAM THAT IS APPLIED ON A UNIFORM BASIS TO PATIENTS, AND WHICH TAKES INTO CONSIDERATION THE PATIENT'S DOCUMENTED FINANCIAL SITUATION AND THE PATIENT'S INABILITY TO MAKE A PAYMENT AFTER REASONABLE COLLECTION ACTIONS. ANY DISCOUNT THAT IS PROVIDED BY THE HOSPITAL IS CONSISTENT WITH FEDERAL AND STATE REQUIREMENTS, AND DOES NOT INFLUENCE A PATIENT TO RECEIVE SERVICES FROM THE HOSPITAL. POPULATIONS EXEMPT FROM COLLECTION ACTIVITIES: THERE ARE SEVERAL SITUATIONS WHERE A PATIENT CAN BE EXEMPTED FROM FURTHER BILLING AND COLLECTION PROCEDURES ONCE THE DETERMINATION IS MADE THAT THE PATIENT IS EXEMPT PURSUANT TO STATE REGULATIONS: A) PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, HEALTHY START, CHILDREN'S MEDICAL SECURITY PLAN, OR DESIGNATED A "LOW INCOME PATIENT" BY THE OFFICE OF MEDICAID, SUBJECT TO THE FOLLOWING EXCEPTIONS: (I) THE HOSPITAL MAY SEEK TO BILL AND COLLECT THE CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM. (II) THE HOSPITAL MAY ALSO INITIATE BILLING AND COLLECTION EFFORTS FOR A PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT FAILS TO PROVIDE PROOF OF SUCH PARTICIPATION. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, (INCLUDING RECEIPT OR VERIFICATION OF THE SIGNED APPLICATION) THE HOSPITAL SHALL CEASE ITS BILLING AND COLLECTION ACTIVITIES. (III) THE HOSPITAL WILL NOT CONTINUE COLLECTION ACTION ON ANY LOW INCOME PATIENT FOR SERVICES RENDERED BY THE HOSPITAL DURING THE PERIOD FOR WHICH HE OR SHE HAS BEEN DETERMINED TO BE A LOW INCOME PATIENT BY THE OFFICE OF MEDICAID. HOWEVER, THE HOSPITAL MAY CONTINUE COLLECTION ACTION ON A LOW INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW INCOME PATIENT STATUS HAS BEEN TERMINATED, EXPIRED, OR NOT OTHERWISE IDENTIFIED ON THE STATE'S VIRTUAL GATEWAY OR RECIPIENT ELIGIBILITY VERIFICATION SYSTEM. ONCE A LOW INCOME PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN COMMONWEALTH CARE PROGRAMS, THE HOSPITAL WILL CEASE ITS BILLING AND COLLECTION EFFORTS FOR SERVICES PROVIDED PRIOR TO THE BEGINNING OF THEIR ELIGIBILITY. (IV) THE HOSPITALS MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE.
PART VI, LINE 2	NEEDS ASSESSMENT: THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT (CHNA REPORT) AND IMPLEMENTATION PLAN WAS RELEASED AND MADE WIDELY AVAILABLE TO THE PUBLIC ON SEPTEMBER 30, 2016. THE GOALS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROJECT ARE TO MONITOR REGIONAL HEALTH DATA, ENGAGE HOSPITAL STAKEHOLDERS, PROMOTE PARTNERSHIPS BETWEEN THE HOSPITALS AND COMMUNITY ORGANIZATIONS AND DEVELOP MULTI-YEAR IMPLEMENTATION STRATEGIES TO GUIDE HOSPITAL INITIATIVES TO IMPROVE THE HEALTH OF BARNSTABLE COUNTY RESIDENTS. THE METHODOLOGY FOR CONDUCTING THE ASSESSMENT INCLUDED THE COLLECTION AND ANALYSIS OF PRIMARY AND SECONDARY HEALTH DATA, GATHERING SIGNIFICANT INPUT FROM THE COMMUNITY, AND THE IDENTIFICATION AND PRIORITIZATION OF KEY HEALTH NEEDS FOR THE REGION. OVER 20 DATA SOURCES WERE UTILIZED TO COLLECT BARNSTABLE COUNTY AND TOWN-LEVEL HEALTH STATISTICS ON DISEASE INCIDENCE AND PREVALENCE, HOSPITAL UTILIZATION, MORBIDITY AND MORTALITY, BARRIERS TO ACCESSING CARE, AND BEHAVIORAL RISK FACTORS. REGIONAL STATISTICS WERE ANALYZED AND COMPARED TO STATE AND NATIONAL STATISTICS TO IDENTIFY WHERE DEMOGRAPHIC AND HEALTH DISPARITIES EXIST. ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS REPRESENTING LOW-INCOME, MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS PROVIDED CRITICAL INSIGHT AND FEEDBACK ON THE REGIONAL HEALTH NEEDS THROUGH KEY INFORMATION INTERVIEWS AND COMMUNITY INPUT FORUMS. THROUGH THIS COLLECTION OF DATA AND COMMUNITY INPUT THE SIGNIFICANT HEALTH NEEDS OF BARNSTABLE COUNTY RESIDENTS WERE DISTINGUISHED AND PRIORITIZED BASED ON THE FREQUENCY, URGENCY, SCOPE, SEVERITY AND MAGNITUDE OF THE IDENTIFIED ISSUES. THE SIGNIFICANT HEALTH NEEDS AND ASSOCIATED TARGET POPULATIONS IDENTIFIED THROUGH THE CHNA REPORT WILL SERVE AS THE FOUNDATION FOR COMMUNITY BENEFITS AND HOSPITAL PLANNING SPANNING FISCAL YEARS 2017-2019. THE FOLLOWING SOURCES WERE UTILIZED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTS: - CAPE COD HOSPITAL AND FALMOUTH HOSPITAL UTILIZATION DATA - BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES: ANALYSIS OF SUBSTANCE ABUSE ON CAPE COD, A BASELINE ASSESSMENT, BARNSTABLE COUNTY BEHAVIORAL HEALTH WEB PORTAL, BARNSTABLE COUNTY PUBLIC HEALTH AND WELLNESS WEB PORTAL - CAPE COD FOUNDATION CONNECT CAPE COD - UNIVERSITY OF MASSACHUSETTS (UMASS) DONAHUE INSTITUTE LONG-TERM PROJECTIONS FOR MASSACHUSETTS REGIONAL AND MUNICIPALITIES - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH: MASSACHUSETTS COMMUNITY HEALTH INFORMATION PROFILE (MASS CHIP), MASSACHUSETTS BEHAVIORAL HEALTH RISK FACTOR SURVEILLANCE SYSTEM - US CENSUS BUREAU: US CENSUS 2010, AMERICAN COMMUNITY SURVEY ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL SELECTED JOHN SNOW, INC. (JSI) A PUBLIC HEALTH RESEARCH FIRM, TO CONDUCT PRIMARY RESEARCH INCLUDING HEALTH DATA RESEARCH, KEY INFORMANT INTERVIEWS AND FACILITATION OF COMMUNITY AND PROVIDER FORUMS. JSI INTERVIEWED OVER 25 REGIONAL LEADERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY AND WHO OFFER INFORMATION OR EXPERTISE RELATIVE TO THESIGNIFICANT HEALTH NEEDS OF VULNERABLE POPULATIONS. THEY INCLUDED SUCH ENTITIES AS MUNICIPAL PUBLIC HEALTH DEPARTMENTS, HUMAN SERVICE AGENCIES,SCHOOLS AND LAW ENFORCEMENT AGENCIES, FEDERALLY QUALIFIED HEALTH CENTERS, COMMUNITY ORGANIZATIONS SERVING LOW-INCOME, VULNERABLE AND MEDICALLY UNDERSERVED POPULATIONS, ELECTED OFFICIALS, AND HOSPITAL CLINICIANS AND ADMINISTRATORS. FIVE COMMUNITY INPUT FORUMS WERE HELD ACROSS BARNSTABLE COUNTY. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS ATTENDED. THESE FORUMS PROVIDED AN OPPORTUNITY TO PRESENT STATISTICAL HEALTH FINDINGS TO PARTICIPANTS AND IDENTIFY GAPS IN SERVICES. ADDITIONALLY, THE FORUMS FACILITATED DIALOGUE ON ISSUES NOT IDENTIFIED AND TARGET POPULATIONS MOST IMPACTED BY HEALTH ISSUES. A POST-FORUM SURVEY WAS PROVIDED TO PARTICIPANTS TO IDENTIFY AND RANK HEALTH PRIORITIES IN THE REGION. FEEDBACK AND INPUT FROM THE KEY INFORMANT INTERVIEWS AND FROM ATTENDEES OF THE COMMUNITY AND PROVIDER FORUMS WAS USED TO INFORM THE SELECTION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS.
PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FOR THOSE PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER THEIR UNPAID HOSPITAL BILLS. IN ORDER TO ASSIST UNINSURED AND UNDERINSURED PATIENTS IN FINDING AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES POSTED THROUGHOUT THE HOSPITAL. THE GOAL OF THESE NOTICES IS TO INFORM PATIENTS THAT THEY MAY BE ELIGIBLE TO APPLY FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM, SUCH AS, BUT NOT LIMITED TO, MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET. THE HOSPITAL WILL PROVIDE, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE DESIGNATED A LOW INCOME PATIENT UNDER EITHER THE STATE HEALTH SAFETY NET PROGRAM OR THROUGH THE HOSPITAL'S OWN INTERNAL CHARITY CARE PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT PAYMENT PLANS THAT MAY BE AVAILABLE TO HIM OR HER BASED ON THE SIZE OF HIS OR HER FAMILY AND FAMILY INCOME.
PART VI, LINE 4	DEMOGRAPHICS OF THE SERVICE AREA CAPE COD HEALTHCARE IS THE COMMUNITY SAFETY-NET PROVIDER OF HEALTH CARE SERVICES FOR THE YEAR-ROUND RESIDENTS AND MILLIONS OF ANNUAL VISITORS TO BARNSTABLE COUNTY, ALSO KNOWN AS "CAPE COD." CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, THE ONLY TWO ACUTE-CARE, NON-PROFIT HOSPITALS IN THE REGION, TOGETHER SHARE THE 15 TOWNS OF BARNSTABLE COUNTY AS THEIR PRIMARY SERVICE AREA. THE UPPER CAPE REGION INCLUDES THE MASHPEE WAMPANOAG TRIBAL REGION. CAPE COD HOSPITAL, LOCATED IN HYANNIS, MA, IS A 259-BED ACUTE-CARE, NON-PROFIT HOSPITAL. FALMOUTH HOSPITAL, LOCATED IN FALMOUTH, MA, IS A 95-BED ACUTE-CARE, NON-PROFIT HOSPITAL. BARNSTABLE COUNTY IS A GEOGRAPHICALLY ISOLATED REGION LOCATED ON THE EASTERN SEABOARD OF MASSACHUSETTS. THE NARROW PENINSULA SPANS OVER 70 MILES IN LENGTH AND HOSTS A YEAR-ROUND POPULATION OF 215,449 RESIDENTS. BARNSTABLE COUNTY CONSISTS OF 15 TOWNS THAT VARY IN YEAR-ROUND POPULATION SIZE FROM ABOUT 45,000 RESIDENTS (BARNSTABLE) TO SLIGHTLY MORE THAN 1,700 RESIDENTS (TRURO). IN ADDITION TO SERVING YEAR-ROUND RESIDENTS,THE REGIONAL COMMUNITY INFRASTRUCTURE, INCLUDING CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, MUST MEET THE DEMANDS OF A SIGNIFICANT INFLUX OF SEASONAL RESIDENTS AND VISITORS EACH YEAR. THE CAPE COD COMMISSION PRODUCED ESTIMATES, USING SURVEY DATA FROM SECOND HOMEOWNERS TO INDICATE THAT THE POPULATION OF SUMMER RESIDENTS ON CAPE COD, WHEN AVERAGED OVER A FULL YEAR, IS EQUIVALENT TO AN ADDITIONAL 68,856 FULL-TIME RESIDENTS. THIS COUPLED WITH DAY VISITORS AND SHORT TERM TRAVELER VOLUME RESULTS IN AN ESTIMATED 7 MILLION VISITORS AND RESIDENTS ON CAPE COD IN A GIVEN SUMMER SEASON. THIS SEASONAL POPULATION EXPANSION AND CONTRACTION CREATES UNIQUE CHALLENGES FOR THE CAPE'S HEALTH CARE SYSTEM, TRANSPORTATION NETWORK, WORKFORCE, BUSINESS COMMUNITY, AND HOUSING MARKET. POPULATION TRENDS AND AGE DEMOGRAPHIC ANALYSIS REVEALS TWO STRIKING TRENDS THAT WILL IMPACT BARNSTABLE COUNTY IN THE NEAR FUTURE. CURRENT DATA AND FUTURE DEMOGRAPHIC PREDICTIONS FOR THE REGION DEMONSTRATE THAT BARNSTABLE COUNTY'S OVERALL POPULATION IS DECLINING AND INCREASING IN AGE. ACCORDING TO THE LONG-TERM POPULATION PROJECTIONS FOR MASSACHUSETTS REGIONS AND MUNICIPALITIES, A PUBLICATION BY THE UMASS DONAHUE INSTITUTE, ALL REGIONS IN MA WILL EXPERIENCE POSITIVE POPULATION GROWTH FROM 2010-2035 EXCEPT FOR BARNSTABLE COUNTY AND THE ISLANDS OF NANTUCKET AND MARTHA'S VINEYARD. A PROJECTED NET LOSS OF 13% OF THE OVERALL POPULATION OF BARNSTABLE COUNTY IS PREDICTED BETWEEN 2010 AND 2035. BY 2035, THE TOTAL YEAR-ROUND POPULATION IS EXPECTED TO DECREASE TO APPROXIMATELY 188,000 RESIDENTS, A POPULATION SIMILAR TO HISTORIC 1990 NUMBERS. THIS DECLINE IS ATTRIBUTED TO TWO FACTORS, AN OUTFLOW OF YOUNG PEOPLE FROM THE REGION, AND DEATHS CONTINUING TO OUTNUMBER BIRTHS. IN ADDITION TO THE DECLINING POPULATION, THE YEAR-ROUND POPULATION OF BARNSTABLE COUNTY WILL CONTINUE TO HAVE A SIGNIFICANTLY LARGER PROPORTION OF SENIORS OVER THE AGE OF 65 THAN THE STATE OF MASSACHUSETTS (MA) AND THE UNITED STATES (U.S.). ACCORDING TO 2009-2013 AMERICAN COMMUNITY SURVEY ESTIMATES, NEARLY 26% OF THE YEAR-ROUND POPULATION OF BARNSTABLE COUNTY IS OVER THE AGE OF 65 COMPARED TO 14% IN MA AND 13% IN THE U.S. IT IS PREDICTED THAT BY THE YEAR 2035, NEARLY 35% OF THE POPULATION OF BARNSTABLE COUNTY WILL BE OVER THE AGE OF 65.4. IN MA, 58% OF THE OVERALL POPULATION IS COMPRISED OF RESIDENTS BETWEEN THE AGES OF 0-44 YEARS MCOMPARED TO ONLY 42% IN BARNSTABLE COUNTY. 'BABY BOOMERS', WHO ARE CURRENTLY INCLUDED IN THE AGE BRACKET OF 45 TO 64 YEAR-OLD RESIDENTS, REPRESENT AN ADDITIONAL 32% OF THE CAPE'S POPULATION. THESE COMBINED POPULATION STATISTICS SKEW BARNSTABLE COUNTY'S MEDIAN AGE TO OVER 50 YEARS OLD, THE HIGHEST FOR ALL COUNTIES IN MASSACHUSETTS. THIS IS MORE THAN A DECADE OLDER THAN THE MA MEDIAN AGE OF 39 YEARS AND THE U.S. MEDIAN AGE OF 37 YEARS. A COMMON THEME DISCUSSED IN STAKEHOLDER INTERVIEWS AND COMMUNITY/PROVIDER FORUMS WAS THAT PERSONS OVER THE AGE OF 65 AND YOUTH (15-24 YEARS OLD)REPRESENTED TWO OF THE MOST VULNERABLE POPULATIONS IN THE SERVICE AREA.YOUTH WERE IDENTIFIED AS A TARGET POPULATION DUE TO CONCERNS RELATED TO EARLY ONSET OF MENTAL HEALTH CONDITIONS, SUBSTANCE USE AND RISKY HEALTH BEHAVIORS. BARNSTABLE COUNTY'S GENDER DEMOGRAPHICS MIRROR THOSE OF MA; 52% OF RESIDENTS ARE FEMALE AND 48% ARE MALE. NEARLY 12% OF BARNSTABLE COUNTY RESIDENTS OVER THE AGE OF 18 ARE VETERANS WHICH IS HIGHER THAN THE PERCENTAGE IN BOTH MA (7%) AND THE U.S. (9%). IN BARNSTABLE COUNTY, 13% OF RESIDENTS REPORT THAT THEY ARE LIVING WITH A DISABILITY COMPARED TO 11% IN MA. BARNSTABLE COUNTY MUST MEET THE UNIQUE HEALTH NEEDS OF VETERANS AND PERSONS LIVING WITH DISABILITIES WHO MAY BE AT A GREATER RISK OF DEVELOPING COMORBID CONDITIONS AND OFTEN ENCOUNTER LIMITED ACCESS OR BARRIERS TO CARE. INCOME AND POVERTY ALTHOUGH BARNSTABLE COUNTY HAS A LOWER PROPORTION OF LOW-INCOME RESIDENTS THAN DOES MA (9% VS. 11%), REPRESENTATIVES OF ORGANIZATIONS THAT SERVE VULNERABLE, LOW-INCOME AND MEDICALLY UNDERSERVED POPULATIONS REPORT A GROWING NUMBER OF RESIDENTS WHO STRUGGLE TO SECURE AND MAINTAIN STABLE EMPLOYMENT. THEY ALSO RELY ON PUBLIC ASSISTANCE PROGRAMS TO AFFORD HEALTH INSURANCE, FOOD AND HOUSING. ACCORDING TO FIVE-YEAR CENSUS ESTIMATES (2009-2013), THE MEDIAN HOUSEHOLD INCOME OF BARNSTABLE COUNTY RESIDENTS WAS $60,526 COMPARED TO $66,866 FOR ALL MASSACHUSETTS RESIDENTS. IN 2014, A HIGHER PERCENT OF PER CAPITA INCOME WAS DERIVED FROM TRANSFER PAYMENTS (SOCIAL SECURITY, DISABILITY PENSIONS, HOUSING AND FOOD SUBSIDY PROGRAMS, AND UNEMPLOYMENT BENEFITS) IN BARNSTABLE COUNTY (19%) COMPARED TO MA (15%) AND THE U.S. (17%). VULNERABLE POPULATIONS ARE FURTHER CHALLENGED BY EMPLOYMENT OPPORTUNITIES ON CAPE COD WHICH DECREASE DURING WINTER MONTHS DUE TO CHARACTERISTICS INHERENT IN A SEASONAL ECONOMY DEPENDENT ON TOURISM AND OTHER FACTORS. IN 2015, THE UNEMPLOYMENT RATE IN BARNSTABLE COUNTY RANGED FROM 9% IN JANUARY TO 5% IN JULY COMPARED TO A STEADY ANNUAL RATE OF 6% UNEMPLOYMENT FOR MA OVERALL. ACCORDING TO FIVE-YEAR ESTIMATES (2009-2013) OF THE AMERICAN COMMUNITY SURVEY: * MORE THAN 48% OF BARNSTABLE COUNTY RESIDENT WHO RENT AND 38% WHO OWN A HOUSING UNIT ARE COST-BURDENED, SPENDING 35% OR MORE OF THEIR TOTAL INCOME ON HOUSING. ACCORDING TO THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, FAMILIES WHO PAY MORE THAN 30% OF THEIR INCOME FOR HOUSING ARE CONSIDERED COST-BURDENED AND MAY HAVE DIFFICULTY AFFORDING NECESSITIES SUCH AS FOOD, CLOTHING, TRANSPORTATION AND MEDICAL CARE. * 42% OF BARNSTABLE COUNTY RESIDENTS RECEIVE PUBLICILY-FUNDED HEALTH INSURANCE COVERAGE COMPARED TO 32% OF RESIDENTS IN MA OVERALL, AND 42% OF RESIDENTS RECEIVE SOCIAL SECURITY PAYMENTS COMPARED TO 28% IN MA OVERALL. COMBINED TOGETHER, THESE INDICATORS PAINT A PICTURE OF MANY RESIDENTS IN NEED. THE COMMUNITY INPUT COLLECTION PHASE OF THE PROJECT IDENTIFIED NUMEROUS TARGET POPULATIONS IN NEED OF HEALTH INTERVENTIONS. THESE INCLUDED FINANCIALLY DISADVANTAGED POPULATIONS, INCLUDING INDIVIDUALS WITH TRANSITIONAL EMPLOYMENT, CHILDREN UNDER THE AGE OF 18, INDIVIDUALS/FAMILIES WITH HOUSING INSECURITIES, AND THOSE LIVING ON FIXED INCOMES. RACE, ETHNICITY AND LANGUAGE IN ADDITION TO AGE AND INCOME, RACE, ETHNICITY, AND LANGUAGE PLAY A ROLE IN DETERMINING HEALTH OUTCOMES FOR RESIDENTS. COMPARED TO MA, BARNSTABLE COUNTY HAS A RELATIVELY HOMOGENEOUS POPULATION WITH 92% IDENTIFYING AS CAUCASIAN IN 2009-2013 CENSUS ESTIMATES. MASSACHUSETTS IS MORE RACIALLY DIVERSE WITH ONLY 76% OF RESIDENTS IDENTIFYING AS CAUCASIAN. ACCORDING TO FIVE-YEAR ESTIMATES OF THE AMERICAN COMMUNITY SURVEY (2009-2013) THE LARGEST RACIAL/ETHNIC MINORITY GROUPS ON CAPE COD ARE HISPANICS/LATINOS AND AFRICAN-AMERICAN RESIDENTS WITH EACH GROUP REPRESENTING ABOUT 2% OF THE POPULATION. IN THAT SAME TIME PERIOD, 7% OF THE POPULATION LIVING IN BARNSTABLE COUNTY WAS FOREIGN-BORN, COMPARED TO 15% FOR THE COMMONWEALTH OF MASSACHUSETTS. SLIGHTLY MORE THAN 8% OF THE POPULATION FIVE YEARS OR OLDER IN BARNSTABLE COUNTY SPEAKS A LANGUAGE OTHER THAN ENGLISH AT HOME COMPARED TO 22% IN THE COMMONWEALTH. WHILE DIVERSITY MAY BE LOW COMPARATIVELY, PUBLIC HEALTH EXPERTS AND INDIVIDUALS REPRESENTING LOW-INCOME, VULNERABLE, AND MEDICALLY UNDERSERVED POPULATIONS ON CAPE COD CITE THAT FOREIGN-BORN RESIDENTS AND RACIAL/ETHNIC MINORITIES ON CAPE COD (E.G., HISPANICS, AFRICAN AMERICANS, AND PORTUGUESE-SPEAKING BRAZILIANS) WERE MOST LIKELY TO EXPERIENCE BARRIERS TO ACCESSING CARE AND ARE DISPROPORTIONALLY IDENTIFIED WITHIN HIGH NEEDS POPULATIONS AS COMPARED TO OTHERS.
INSURANCE STATUS MASSACHUSETTS LEADS THE NATION AS THE STATE WITH THE	LOWEST RATE OF UNINSURED RESIDENTS. IN 2014, ONLY 4% OF RESIDENTS IN THE COMMONWEALTH LACKED MEDICAL HEALTH INSURANCE, COMPARED TO 10% NATIONALLY, DUE TO THE STATE'S EARLY HEALTH REFORM EFFORTS WHICH BEGAN IN 2006. HOWEVER, THERE IS VARIATION IN INSURED POPULATIONS ACROSS THE STATE OF MA ACCORDING TO THE GEOGRAPHY OF UNINSURANCE IN MASSACHUSETTS 2009-2013, A PUBLICATION BY THE BLUE CROSS BLUE SHIELD OF MASSACHUSETTS FOUNDATION AND THE URBAN INSTITUTE. ACCORDING TO THE STUDY, BARNSTABLE COUNTY, AT 3.4%, HAS THE HIGHEST PERCENTAGE OF UNINSURED CHILDREN (0-17 YEARS) IN THE STATE COMPARED TO ALL OTHER COUNTIES. BARNSTABLE COUNTY, WITH AN OVERALL 5% UNINSURED RATE (ADULTS AND CHILDREN), IS ALSO THE 4TH HIGHEST RANKING COUNTY IN MA FOR THE NUMBER OF UNINSURED PERSONS OF ALL AGES. INPUT FROM PUBLIC HEALTH EXPERTS AND INDIVIDUALS REPRESENTING LOW-INCOME, VULNERABLE, AND MEDICALLY-UNDERSERVED POPULATIONS ON CAPE COD NOTE THAT BEYOND INDIVIDUALS AND CHILDREN WHO ARE UNINSURED, THERE ARE MANY RESIDENTS WHO ARE 'UNDER-INSURED'. THIS POPULATION STRUGGLES WITH THE COST OF PUBLICLY AVAILABLE HEALTH PLANS, COVERAGE OF DEDUCTIBLES AND PRESCRIPTIONS, AND WITH MAINTAINING INSURANCE COVERAGE UNDER CONTINUOUS ENROLLMENT CHANGES. CAPE COD HOSPITAL AND FALMOUTH HOSPITAL DERIVE APPROXIMATELY 67% OF PATIENT SERVICE REVENUES FROM PUBLIC PAYERS. FROM FY2013 TO FY2015 THE HOSPITALS' PERCENTAGE OF MEDICAID AND MEDICARE STEADILY INCREASED WHILE THE PERCENTAGE FROM NON-GOVERNMENT SOURCES STEADILY DECREASED. AS BOTH STATE AND FEDERAL PAYERS FACE BUDGETING CONCERNS, PUBLIC PAYER REIMBURSEMENT IS FORECASTED TO REMAIN FLAT OR DECLINE. MANY OF THE KEY SERVICES USED BY VULNERABLE POPULATIONS SUCH AS BEHAVIORAL HEALTH ARE POORLY REIMBURSED. THESE TRENDS DEMONSTRATE CONTINUED RELIANCE ON SOURCES OF PUBLIC HEALTH COVERAGE AS THE AREA DEMOGRAPHICS BECOME MORE CHALLENGING. CONCLUSION UNDERSTANDING THE COMMUNITY NEED AND HEALTH STATUS OF BARNSTABLE COUNTY RESIDENTS BEGINS WITH IDENTIFYING THE DEMOGRAPHIC PROFILE AND UNDERLYING SOCIO-ECONOMIC DRIVERS THAT IMPACT HEALTH AND HEALTH EQUITY. ASSESSING SOCIAL DETERMINANTS OF HEALTH SUCH AS AGE, INCOME, RACE/ETHNICITY,LANGUAGE, INCOME, POVERTY, UNEMPLOYMENT, INSURANCE COVERAGE, AND HOUSING STATUS PROVIDES CRITICAL INFORMATION FOR IDENTIFYING TARGET POPULATIONS AND COMMUNITY SETTINGS FOR HEALTH IMPROVEMENT INTERVENTIONS AND ACTIVITIES.
PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: Cape Cod Healthcare, Inc., (CCHC) through its Community Benefits initiative, is committed to enhancing the quality of and access to comprehensive health care services for all residents of Cape Cod. Through continuous assessment of community needs, coordinated planning and the allocation of resources, this commitment includes a special focus on the unmet needs of the financially disadvantaged and underserved populations. We will take a leadership role in collaborative efforts joining our resources, talent, and commitment with that of other providers, organizations and community members. The Community Benefits Mission Statement was affirmed by the CCHC Community Health Committee and the Board of Trustees in 2000 and remains in effect. THE FOLLOWING IS A LIST OF FY 17 TARGET POPULATIONS: - Individuals managing or at risk of developing chronic and infectious diseases such as cancer, cardiovascular disease, Alzheimers disease and dementia, Hepatitis C, and tick-borne diseases. - Residents facing barriers to care due to language, cost, or age, including those who are uninsured or under-insured. - Individuals with mental health disorders, substance use disorders, and co-occurring disorders. - Senior population, ages 65 and older. - Youth and young adults, ages 15 to 24 years old. Key Accomplishments of Reporting Year Cape Cod Hospital, Falmouth Hospital, and Cape Cod Healthcare (CCHC) continued to stand out in the areas of quality, innovation and patient appreciation in FY17. The system garnered several important awards and recognition. Americas 100 Great Community Hospitals Cape Cod Hospital was named to the list of Americas 100 Great Community Hospitals by Beckers Hospital Review for the sixth consecutive year. This recognition is based on quality of care and service to our community, and demonstrates that the hospital is successfully and consistently achieving top results in patient care and satisfaction. American Heart Association/American Stroke Association Get With the Guidelines - Falmouth Hospital earned the Get With the Guidelines-Stroke Gold-Plus Quality Achievement Award for the eighth consecutive year. This achievement recognizes the hospitals commitment and success in implementing specific quality improvement measures outlineD by the American Heart Association/American Stroke Association for the treatment of stroke patients. Cape Cod Hospital earned the Silver Plus Achievement Award. Leapfrog Hospital Safety Score - Cape Cod Hospital achieved straight As in the annual Hospital Safety Score for the sixth straight year. Falmouth Hospital was recognized with a B Hospital Safety Score. The Hospital Safety Score is the gold standard rating for patient safety and is compiled by The Leapfrog Group, a non-profit hospital safety watchdog. RN Residency Accreditation - The RN Residency Transition Program at CCHC EARNED "ACCREDITATION WITH DISTINCTION" FROM THE AMERICAN NURSES Credentialing Centers Commission on Accreditation. This is the highest recognition awarded by the program. The Commission noted the strength of the CCHC programs leadership, and highlighted the programs flexibility to grow into other areas within the healthcare system. Hepatitis B Birth Dose Honor Roll - The Division of Epidemiology and Immunization, Massachusetts Department of Public Health named Cape Cod Hospital to its honor roll for Hepatitis B Birth Dose for achieving 95% coverage in our maternity department. In FY17, the expansion and implementation of hospital-based and community-based health improvement activities mirrored the quality of and commitment to clinical achievements. The release of the 2017-2019 Cape Cod Hospital and Falmouth Hospital Community Health Needs Assessment Report and Implementation Plan served as the guide for implementation of health improvement strategies, partnership development and identification of community investment opportunities. CCHCs Community Benefits activities focused on the four key health priorities identified in the report: chronic and infectious disease, behavioral health, access to care, and disease prevention and wellness. These priorities were addressed through new and existing hospital programs, collaboration with a network of federally qualified health centers, grant investments in community-based health and human service organizations, and expanding participation in regional coalitions and task force efforts. Chronic and infectious disease management, prevention, screening, and detection efforts were supported through a variety of CCHC Community Benefits activities. Hospital efforts included cancer survivorship services, oncology support groups, and physician-led cancer prevention workshops and health fairs. A partnership with the Cape Wellness Collaborative provided patients undergoing cancer treatment with free community-based services such as massage, acupuncture and nutritional counseling to complement their treatment at Cape Cod Hospital and Falmouth Hospital. CCHC partnered with Team Maureen, a local nonprofit organization dedicated to ending cervical cancer, to produce an HPV prevention public service announcement targeted at youth and young adults. The video was accepted for screening by the Global Health Film Festival at the American Public Health Associations annual conference in Atlanta. In FY17, CCHC launched the CCHC Congestive Heart Failure Clinic designed to provide residents with chronic disease self-management and wellness resources. Nutrition counseling, disease education, and pharmacology are integrated and offered to patients to assist them in staying well and active at home and in the community. As a recipient of state and federal grants including the Ryan White HIV/AIDS Program grant for the region, CCHC Infectious Disease Clinical Services coordinates regional HIV/AIDS screening, testing, care management, and health related supports for residents with HIV and AIDS through partnerships with community-based health and human service organizations. CCHC Community Benefits provided grants to the Alzheimers Family Caregiver Support Center and HOPE Dementia and Alzheimers Services to fund new support groups, free counseling for families, and respite grants for caregivers. The YMCA Cape Cod in partnership with the National Alliance on Mental Illness received funding from CCHC to develop support groups and wellness programs to address the co-morbidities of diabetes and depression. CCHC partnered with the Cape Cod Cooperative Extension and the UMASS Laboratory of Medical Zoology to offer an innovative tick testing program for our region. CCHC funding subsidized a portion of each tick test submitted by Barnstable County residents. Tick disease results were provided to the resident, and aggregated disease surveillance data was shared with collaborating agencies. CCHCs Centers for Behavioral Health expanded staff capacity and outpatient services to increase access and strengthen regional health services for individuals with mental health, substance use, and co-occurring disorders. As a partner in new privatized services awarded by The MA Department of Mental Health, CCHC staff collaborated with community-based agencies, coalitions, advocacy groups, and law enforcement to implement a new model of crisis intervention services for our region. CCHC is also a collaborative partner with the MA Department of Public Health and MA Department of Mental Health on the Zero Suicide initiative to increase suicide prevention and reduce suicide deaths on Cape Cod and the islands of Marthas Vineyard and Nantucket. CCHC Community Benefits provided grant awards to two federally qualified health centers, Duffy Health Center and Outer Cape Health Services, to support regional efforts to reach and serve high risk target populations with behavioral health needs. Outer Cape Health Services launched the Community Resource Navigator program to provide short-term case management and assistance with social determinants of health for individuals with behavioral health disorders on the Lower and Outer Cape. Duffy Health Center maintained key behavioral health services for homeless individuals and those at risk of homelessness in Barnstable County. CCHC provided funding and coordination with four federally qualified health centers to increase regional Medication Assisted Treatment outpatient services across all regions of Cape Cod. In addition to expanding outpatient treatment options, CCHC implemented a Recovery Specialist program in the emergency departments at Cape Cod Hospital and Falmouth Hospital. In partnership with Gosnold on Cape Cod, the Recovery Specialist program provides peer-recovery professionals to engage patients and assist in referrals and transition to inpatient and outpatient substance use disorder treatment programs upon discharge from the emergency departments.
CCHC led an effort to improve care for pregnant women on Cape Cod with	substance use disorders. Our Moms Do Care program, a program funded through a three-year Massachusetts Department of Public Health grant, provides integrated prenatal care and substance use treatment for pregnant women with opioid use disorders. Physicians and clinical leaders at Cape Cod Hospital and Falmouth Hospital are active contributors to the Neonatal Quality Improvement Collaborative of MA to improve care of newborns and families impacted by perinatal opioid use and neonatal abstinent syndrome. CCHCs support reached beyond clinical settings through a partnership with Cape Cod Child Development to increase acceptance of Early Intervention services by families with newborns exposed to substances in utero. A grant to the Mothers and Infants Recovery Network helped to launch additional support groups in new locations on Cape Cod including the Barnstable County correctional facility for women. CCHCs commitment to improve access to care was demonstrated through support of existing programs and new initiatives designed to reduce barriers to care for vulnerable populations. In partnership with the Cape and Islands Emergency Medical Services System, CCHC introduced an innovative model to provide medical interpreter services for limited-English speaking patients in pre-hospital settings. The program provides phone based interpreter services to paramedics and first responders on ambulances to improve communication with patients during transport to the hospital. In FY17, partnerships increased from two to thirteen municipal fire and rescue departments. Also, CCHC Interpreter Services continued to provide free medical interpreter services for limited-English speaking patients in community-based primary and specialty care offices across the region. CCHC Community Benefits grant funding supported the coordination of the Specialty Network for the Uninsured (SNU). The SNU program provides free/sliding-scale fees for visits to specialists for uninsured and under-insured residents of Barnstable County. Coordination of visits with local specialists reduces the need for residents without coverage for these services to travel outside of the region, and addresses a gap in certain services not offered by federally qualified health centers. A CCHC grant to the Barnstable County Human Services Department supported the SHINE (Serving the Health Insurance Needs of Everyone) program to increase the number of seniors who received Medicare counseling, education, and enrollment assistance at Council on Aging offices across all 15 towns in Barnstable County. Strategic workforce development partnerships with Cape Cod Community College, local vocational programs, and several high schools in the region were strengthened in an effort to ensure a strong and skilled future workforce on Cape Cod. CCHC provided funding, job shadowing and training opportunities for diverse allied health programs, including nursing and CNA employment tracks. CCHC health improvement implementation strategies also addressed disease prevention for all residents of Barnstable County and sustaining the wellness of elders and caregivers. A specific area of focus in FY17 was to increase access to nutritious food for low-income populations. CCHC provided a strategic grant to the Family Pantry of Cape Cod to launch a mobile food pantry to deliver healthy foods to isolated seniors and caregivers in remote geographic locations. The FlavorRX project featured collaboration between Sustainable CAPE and EMERALD PHYSICIANS, AN AFFILIATE OF CCHC, TO 'PRESCRIBE' PLANT-BASED foods and offer incentives for Mass Health patients to purchase locally grown fruits and vegetables at local farmers markets. CCHC also partnered with the Cape Cod Fishermans Alliance to increase the number of food pantries as distribution points for the Fish for Families program. The program provides locally sourced fish and shellfish as a nutrient dense protein option for food pantry clients across Cape Cod. Healthy Parks, Healthy People, a walking and health promotion program for residents and visitors to Cape Cod, was continued through a partnership between the US National Park Service, the Cape Cod National Seashore, and Cape Cod Healthcare. CCHC staff including physicians and physical therapists provided classes, education and resources to residents participating in the program. The Parkinsons Support Network was awarded funding to offer additional wellness programs and support groups for individuals with Parkinsons disease and their caregivers. Calmer Choice was awarded a CCHC Community Benefits grant to offer community-based universal prevention programs that teach young people how to effectively and safely manage stress and resolve conflict with the goal to diminish the risk of violence, substance abuse, and other self-destructive behaviors. The Cape Cod Hoarding Task Force received funding to offer broad community education events on the topic of hoarding and specialized training for members of the task force who work directly with residents on issues of hoarding and health. In addition to these hospital-based programs and grant funded community-based projects, community benefits and hospital staff continued to play leadership roles in health and human service organizations and coalitions across Barnstable County. These include, but are not limited to, the Barnstable County Human Services Advisory Council, Barnstable County RegionaL Substance Use Council, Behavioral Health Provider Coalition of Cape Cod & the Islands, Cape & Islands Community Health Area Network (CHNA 27) Steering Committee, Healthy Aging Cape Cod, Quality of Life Initiative, and the Substance Use in Pregnancy Task Force. Substance Use Council, Behavioral Health Provider Coalition of Cape Cod & the Islands, Cape & Islands Community Health Area Network (CHNA 27) Steering Committee, Healthy Aging Cape Cod, Quality of Life Initiative, and the Substance Use in Pregnancy Task Force.
PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEMS ROLES: THE HOSPITALS ARE PART OF AN AFFILIATED HEALTHCARE SYSTEM AND THEIR RESPECTIVE ROLES ARE: CAPE COD HOSPITAL - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN HYANNIS,MASSACHUSETTS FALMOUTH HOSPITAL ASSOCIATION, INC. - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN FALMOUTH, MASSACHUSETTS CAPE COD HEALTHCARE, INC. - A NOT-FOR-PROFIT CORPORATION THAT SERVES AS THE PARENT COMPANY OF VARIOUS ENTITIES PROVIDING HEALTH CARE SERVICES TO THE POPULATION OF CAPE COD, MASSACHUSETTS CAPE COD HEALTHCARE FOUNDATION,INC. - A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE DEVELOPMENT AND FUNDRAISING SUPPORT TO CAPE COD HEALTHCARE CAPE AND ISLANDS HEALTH SERVICES II, INC. - A NOT-FOR-PROFIT CORPORATION ORGANIZED TO PROVIDE VARIOUS NON-HOSPITAL HEALTH CARE SERVICES MEDICAL AFFILIATES OF CAPE COD, INC. - A NOT-FOR-PROFIT MEDICAL GROUP PRACTICE VISITING NURSE ASSOCIATION OF CAPE COD - A NOT-FOR-PROFIT PROVIDER OF HOME HEALTH SERVICES CAPE COD HUMAN SERVICES, INC. - A NOT-FOR-PROFIT PROVIDER OF OUTPATIENT MENTAL HEALTH SERVICES FALMOUTH ASSISTED LIVING, INC., D/B/A HERITAGE AT FALMOUTH - A NOT-FOR-PROFIT CORPORATION THAT OWNS AN ASSISTED LIVING FACILITY JML CARE CENTER, INC. - A NOT-FOR-PROFIT SKILLED NURSING AND REHABILITATION FACILITY CAPE HEALTH INSURANCE COMPANY - A CAPTIVE INSURANCE COMPANY THAT PROVIDES MEDICAL PROFESSIONAL AND GENERAL LIABILITY INSURANCE TO CAPE COD HEALTHCARE CAPE COD HOSPITAL MEDICAL OFFICE BUILDING - A PROVIDER OF LEASED AND SUBLEASED SPACE TO CAPE COD HOSPITAL AND RELATED AFFILIATIONS PART VI, LINE 7 ALL STATES WHERE ORGANIZATION FILES A COMMUNITY BENEFITS REPORT: MA

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (29 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DIANNE C KOLB
President VNA	$0	$205,110	$0	$40,516	$0	$12,603	$0	$38,637	$0	$24,082	$0	$320,948	$0	$10,403
MICHAEL G JONES
Sr VP Chief Legal OffICER	$0	$311,790	$0	$75,817	$0	$19,058	$0	$41,622	$0	$36,108	$0	$484,395	$0	$15,965
MICHAEL K LAUF
PRESIDENT/CEO/TRUSTEE	$0	$870,690	$0	$308,438	$0	$207,139	$0	$204,404	$0	$39,995	$0	$1,630,666	$0	$146,200
MICHAEL L CONNORS
SENIOR VP FINANCE/CFO	$0	$431,640	$0	$101,200	$0	$29,688	$0	$49,993	$0	$36,958	$0	$649,479	$0	$18,911
PATRICK J FLYNN MD
TRUSTEE (UNTIL 5/17)	$555,902	$0	$1,290	$0	$630	$0	$18,872	$0	$1,261	$0	$577,955	$0	$0	$0
JEANNE FALLON
SR VP & CIO	$0	$247,021	$0	$40,360	$0	$15,693	$0	$39,535	$0	$24,490	$0	$367,099	$0	$12,075
JEFFREY S DYKENS
SEE SCH O FOR TITLE	$0	$241,390	$0	$43,813	$0	$19,614	$0	$29,606	$0	$35,916	$0	$370,339	$0	$11,000
RICHARD B ZELMAN MD
PHYSICIAN	$1,318,563	$0	$125,000	$0	$110,464	$0	$10,600	$0	$36,958	$0	$1,601,585	$0	$0	$0
GORDON NAKATA MD
PHYSICIAN	$723,420	$0	$293,882	$0	$630	$0	$28,600	$0	$35,958	$0	$1,082,490	$0	$0	$0
ACHILLE PAPAVASILIOU MD
PHYSICIAN	$723,420	$0	$280,396	$0	$630	$0	$28,600	$0	$35,958	$0	$1,069,004	$0	$0	$0
PATRICK KANE
SVP OF MRKTG,COMMUN AND DEVLP	$0	$303,315	$0	$71,080	$0	$18,392	$0	$28,493	$0	$22,315	$0	$443,595	$0	$15,450
THERESA M AHERN
SVP, STRAT, COMMUNITY/GOV REL.	$0	$235,864	$0	$57,600	$0	$13,180	$0	$36,075	$0	$25,276	$0	$367,995	$0	$10,094
VICTOR OLIVEIRA
VP OF PATIENT SERVICES	$0	$240,640	$0	$44,630	$0	$17,093	$0	$36,327	$0	$35,958	$0	$374,648	$0	$10,750
DONALD GUADAGNOLI MD
CMO CAPE COD HOSPITAL	$0	$411,654	$0	$98,400	$0	$33,094	$0	$34,503	$0	$36,958	$0	$614,609	$0	$21,001
ROBERT WILSTERMAN MD
TRUSTEE	$783,389	$0	$0	$0	$2,772	$0	$20,359	$0	$32,032	$0	$838,552	$0	$0	$0
EMILY SCHORER
SVP HUMAN RESOURCES	$0	$254,611	$0	$59,580	$0	$4,507	$0	$22,372	$0	$33,782	$0	$374,852	$0	$0
WILLIAM AGEL MD
TRUSTEE (AS OF 5/17)	$427,863	$0	$41,780	$0	$12,966	$0	$10,600	$0	$33,581	$0	$526,790	$0	$0	$0
THEODORE CALIANOS MD
TRUSTEE (AS OF 5/17)	$370,820	$0	$19,591	$0	$1,806	$0	$10,600	$0	$33,581	$0	$436,398	$0	$0	$0
PAUL HOULE MD
TRUSTEE (AS OF 5/17)	$723,420	$18,944	$196,714	$0	$966	$0	$25,831	$0	$35,958	$0	$982,889	$18,944	$0	$0
MICHAEL BUNDY
COO (AS OF 6/16)	$0	$178,384	$0	$17,850	$0	$291	$0	$14,914	$0	$16,440	$0	$227,879	$0	$0
LORI JEWETT RN MSN
COO - FH (AS OF 6/16)	$0	$219,994	$0	$43,500	$0	$4,376	$0	$25,787	$0	$1,448	$0	$295,105	$0	$0
KEVIN J MULROY
SEE SCH O FOR TITLE	$0	$368,790	$0	$86,250	$0	$21,947	$0	$39,898	$0	$34,808	$0	$551,693	$0	$13,000
ALEXANDER HEARD MD
CMO FALMOUTH HOSPITAL	$53,333	$389,345	$0	$93,419	$97	$533	$4,946	$19,347	$6,290	$33,579	$64,666	$536,223	$0	$0
CHRISTIAN BROWN
SR VP MANAGED CARE	$0	$299,089	$0	$70,150	$0	$16,451	$0	$45,438	$0	$33,581	$0	$464,709	$0	$13,000
KEVIN RALPH
SVP DEVELOPMENT	$0	$242,884	$0	$57,500	$0	$630	$0	$24,015	$0	$35,714	$0	$360,743	$0	$0
NICHOLAS COPPA MD
PHYSICIAN	$726,589	$0	$147,596	$0	$420	$0	$5,300	$0	$33,581	$0	$913,486	$0	$0	$0
PHILIP J DOMBROWSKI MD
PHYSICIAN	$664,901	$0	$50,000	$0	$25,849	$0	$10,600	$0	$1,525	$0	$752,875	$0	$0	$0
CARTER HUNT
SEE SCHEDULE O FOR TITLE	$0	$188,454	$0	$14,000	$0	$594	$0	$25,437	$0	$34,226	$0	$262,711	$0	$0
NOELENE CERVIN
SEE SCHEDULE O FOR TITLE	$0	$204,798	$0	$38,500	$0	$2,696	$0	$9,876	$0	$33,343	$0	$289,213	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PART I, LINE 4B - 457(F)

CAPE COD HEALTHCARE, INC. AND AFFILIATES SPONSORS A 457(F) VOLUNTARY PERSONAL DEFERRAL PLAN ("THE PLAN") FOR KEY EXECUTIVES. VESTING IS DEFERRED FOR AT LEAST TWO YEARS FROM THE DATE OF THE AWARD. THE PLAN OFFERS PARTICIPATING EMPLOYEES AN ANNUAL DEFERRAL OF CASH COMPENSATION. AMOUNTS DEFERRED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND AMOUNTS PAID UNDER THE PLAN DURING CALENDAR YEAR 2016 WERE AS FOLLOWS: - MICHAEL K. LAUF - $70,336 - MICHAEL G. JONES - $17,252 - MICHAEL L. CONNORS - $19,421 - DIANNE C. KOLB - $11,082 - JEANNE FALLON - $12,781 - JEFFREY S. DYKENS - $12,226 - PATRICK KANE - $15,620 - THERESA AHERN - $10,408 - VICTOR OLIVEIRA - $11,358 - DONALD GUADAGNOLI MD - $22,244 - EMILY SCHORER - $3,877 - KEVIN MULROY - $13,770 - CHRISTIAN BROWN - $13,679 CAPE COD HEALTHCARE, INC. AND AFFILIATES ALSO SPONSOR A NONQUALIFIED PENSION RESTORATION ACCOUNT PLAN FOR KEY EXECUTIVES. THE ORGANIZATION MAKES CONTRIBUTIONS OF TWO PERCENT OF THE INDIVIDUAL'S ANNUAL SALARY (INCLUDING BONUS) THROUGHOUT THE PLAN YEAR. AMOUNTS DEFERRED ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND UNDER THE PLAN, PARTICIPANTS ARE ENTITLED TO CERTAIN BENEFITS UPON RETIREMENT, TERMINATION, OR DEATH. During calendar year 2016, Michael Lauf also participated in a Section 457(f) plan. Twelve percent of his base salary was contributed and each contribution is subject to a three year vesting schedule. The amount deferred in calendar year 2016 was $102,000 and is included in Schedule J, Part II, Column (C). IN ADDITION, $100,146 WAS PAID OUT FROM HIS CEO SUPPLEMENTAL PLAN, AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN B(III).

SCHEDULE J, PART I, LINE 7

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

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

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

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$16,682,667	$0	$29,440,000	$0	$0	$0	$0	$0	$0	$0	$29,440,000	$0	2012	Yes (true)	false	Yes (true)	Yes (true)
B	$12,900,000	$0	$25,800,000	$0	$0	$0	$336,100	$0	$0	$0	$25,463,900	$0	2012	Yes (true)	false	Yes (true)	Yes (true)
C	$0	$0	$50,834,109	$519,529	$1,295,804	$0	$803,269	$0	$0	$27,999,812	$20,735,223	$0	2014	Yes (true)	false	Yes (true)	Yes (true)
D	$600,000	$0	$24,001,267	$0	$0	$0	$0	$241,456	$0	$0	$23,759,811	$0	2015	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct	Change In Use Bond Financed PropChangeInUseBondFinancedPropPct	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0.00000	0.00000	0.00000	0.00000
B	0
C	0.00000	0.00000	0.00000		false	false	false	false	false	false	Yes (true)
D	0.00000	0.00000	0.00000	0.00000	false	false	false	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

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

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART IV, LINE 2(C)	FormAndLineReferenceDesc
Explanation	THE DATE THE REBATE COMPUTATIONS WERE LAST PERFORMED FOR EACH BOND ARE BELOW: MHEFA, REVENUE BONDS, SERIES E - 7/12/12 MHEFA, REVENUE BONDS, SERIES 2012 A - 6/30/16 MHEFA, REVENUE BONDS, SERIES 2014 - 8/31/10 SINCE THE BOND PROCEEDS HAVE BEEN SPENT FOR EACH BOND AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

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

Issuer Name IssuerName

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

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

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$0	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$52,800,024	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$51,858,248	RefundingEscrowAmt
Issuance Costs From Proceeds	$302,138	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$106,973	CapitalExpendituresAmt
Other Spent Proceeds	$532,665	OtherSpentProceedsAmt
Unspent	$0	UnspentAmt
Substantial Completion	2017	SubstantialCompletionYr
Current Refunding	false	CurrentRefundingInd
Advance Refunding	Yes (true)	AdvanceRefundingInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	false	AnyResearchAgreementsInd
Private Bus Use By Others	0.00000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Change In Use Bond Financed Prop	0.00000	ChangeInUseBondFinancedPropPct
Remedial Action Taken	false	RemedialActionTakenInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

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

Hedge Provider Name HedgeProviderName

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

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

GIC Provider Name GICProviderName

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

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

Procedures Corrective Action ProceduresCorrectiveActionGrp

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

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	DR KATIE RUDMAN	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	SPOUSE OF TRUSTEE	RelationshipDescriptionTxt
Transaction	$120,450	TransactionAmt
Transaction	MACC EMPLOYEE	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule M IRS990ScheduleM

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

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	19	ContributionCnt
Noncash Contributions Rpt F990	$173,993	NoncashContributionsRptF990Amt
Method Of Determining Revenues	VALUE OF STOCK REC'D	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Securities Closely Held Stock		SecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust Intrsts		SecurPrtnrshpTrustIntrstsGrp
Securities Miscellaneous		SecuritiesMiscellaneousGrp
Qualified Contrib Hist Struct		QualifiedContribHistStructGrp
Qualified Contrib Other		QualifiedContribOtherGrp
Real Estate Residential		RealEstateResidentialGrp
Real Estate Commercial		RealEstateCommercialGrp
Real Estate Other		RealEstateOtherGrp
Collectibles		CollectiblesGrp
Food Inventory		FoodInventoryGrp
Drugs And Medical Supplies		DrugsAndMedicalSuppliesGrp
Taxidermy		TaxidermyGrp
Historical Artifacts		HistoricalArtifactsGrp
Scientific Specimens		ScientificSpecimensGrp
Archaeological Artifacts		ArchaeologicalArtifactsGrp
Form8283 Received	19	Form8283ReceivedCnt
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (true)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	Yes (true)	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 1 AND PART III, LINE 1	WE WILL BE THE HEALTH SERVICE PROVIDER OF CHOICE FOR CAPE COD RESIDENTS BY ACHIEVING AND MAINTAINING THE HIGHEST STANDARDS IN HEALTH CARE DELIVERY AND SERVICE QUALITY. TO DO SO, WE WILL PARTNER WITH OTHER HEALTH AND HUMAN SERVICE PROVIDERS AS WELL AS INVEST IN NEEDED MEDICAL TECHNOLOGIES, HUMAN RESOURCES AND CLINICAL SERVICES. ABOVE ALL, WE WILL HELP IDENTIFY AND RESPOND TO THE NEEDS OF OUR COMMUNITY.
COMMUNITY BENEFITS MISSION STATEMENT	CAPE COD HEALTHCARE, INC., (CCHC) THROUGH ITS COMMUNITY BENEFITS INITIATIVE, IS COMMITTED TO ENHANCING THE QUALITY OF AND ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES FOR ALL RESIDENTS OF CAPE COD. THROUGH CONTINUOUS ASSESSMENT OF COMMUNITY NEEDS, COORDINATED PLANNING AND THE ALLOCATION OF RESOURCES, THIS COMMITMENT INCLUDES A SPECIAL FOCUS ON THE UNMET NEEDS OF THE FINANCIALLY DISADVANTAGED AND UNDERSERVED POPULATIONS. WE WILL TAKE A LEADERSHIP ROLE IN COLLABORATIVE EFFORTS JOINING OUR RESOURCES, TALENT, AND COMMITMENT WITH THAT OF OTHER PROVIDERS, ORGANIZATIONS AND COMMUNITY MEMBERS. THE COMMUNITY BENEFITS MISSION STATEMENT WAS AFFIRMED BY THE CCHC COMMUNITY HEALTH COMMITTEE AND THE BOARD OF TRUSTEES IN 2000 AND REMAINS IN EFFECT. TARGET POPULATIONS NAME OF TARGET POPULATION: INDIVIDUALS MANAGING OR AT RISK OF DEVELOPING CHRONIC AND INFECTIOUS DISEASES SUCH AS CANCER, CARDIOVASCULAR DISEASE, ALZHEIMERS DISEASE AND DEMENTIA, HEPATITIS C, AND TICK-BORNE DISEASES. BASIS FOR SELECTION: ALIGNED WITH STATE AND NATIONAL HEALTH PRIORITIES, BARNSTABLE COUNTY RESIDENTS MANAGING CHRONIC DISEASES ARE AT THE GREATEST RISK OF DECLINED HEALTH AND DEATH. CANCER, CARDIOVASCULAR DISEASE, ALZHEIMERS DISEASE/DEMENTIA, HEPATITIS C, AND TICK-BORNE DISEASES WERE IDENTIFIED IN THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AS DISEASES OF PARTICULAR CONCERN FOR THE REGION. NAME OF TARGET POPULATION: RESIDENTS FACING BARRIERS TO CARE DUE TO LANGUAGE, COST, OR AGE, INCLUDING THOSE WHO ARE UNINSURED OR UNDER-INSURED. BASIS FOR SELECTION: THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IDENTIFIED SPECIFIC TARGET POPULATIONS THAT ENCOUNTER BARRIERS TO CARE OR GAPS IN COVERAGE DESPITE HIGH RATES OF INSURED RESIDENTS IN BARNSTABLE COUNTY. THE REPORT SPECIFICALLY IDENTIFIED CHILDREN AGES 0-17 YEARS, INDIVIDUALS LACKING YEAR-ROUND EMPLOYMENT, SENIORS LIVING ON A FIXED INCOME, SEASONAL WORKERS, AND FOREIGN-BORN RESIDENTS WHO DO NOT MEET ELIGIBILITY CRITERIA FOR MASS HEALTH ENROLLMENT. NAME OF TARGET POPULATION: INDIVIDUALS WITH MENTAL HEALTH DISORDERS, SUBSTANCE USE DISORDERS, AND CO-OCCURRING DISORDERS. BASIS FOR SELECTION: ACCESS TO, AND AVAILABILITY OF, COMMUNITY-BASED BEHAVIORAL HEALTH CARE IN BARNSTABLE COUNTY IS AN AREA OF CONCERN. THIS IS EVIDENCED BY HIGH RATES OF PATIENTS PRESENTING WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERS IN HOSPITAL EMERGENCY DEPARTMENTS. SPECIFIC CHALLENGES REPORTED BY THE COMMUNITY AND INCLUDED IN THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT INCLUDE A SHORTAGE OF PSYCHIATRIC PROVIDERS, LONG WAIT TIMES FOR OUTPATIENT APPOINTMENTS, LIMITED INPATIENT TREATMENT OPTIONS FOR SUBSTANCE USE, AND INSURANCE BARRIERS TO CARE NAME OF TARGET POPULATION: SENIOR POPULATION, AGES 65 AND OLDER BASIS FOR SELECTION: ACCORDING TO CENSUS DATA, 26% OF THE YEAR ROUND POPULATION IN BARNSTABLE COUNTY IS OVER THE AGE OF 65. OVER 40% OF BARNSTABLE COUNTY HOUSEHOLDS REPORT AT LEAST ONE RESIDENT OVER THE AGE OF 65 RESIDES IN THE HOME. INCREASING CONSUMPTION OF AND NEED FOR HEALTH CARE SERVICES, ISOLATION, LACK OF SOCIALIZATION, APPROPRIATE HOUSING AND TRANSPORTATION, AND FOOD ACCESS WERE SPECIFIC CHALLENGES IDENTIFIED IN THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT FOR RESIDENTS OVER THE AGE OF 65. NAME OF TARGET POPULATION: YOUTH AND YOUNG ADULTS, AGES 15 TO 24 YEARS OLD. BASIS FOR SELECTION: YOUTH AND YOUNG ADULTS, AGES 1524 YEARS OLD, WERE IDENTIFIED IN THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AS A SPECIFIC AT-RISK POPULATION DUE TO INCREASING RATES OF SUBSTANCE USE TREATMENT ADMISSIONS AND CONCERNING HEALTH RISK BEHAVIORS. PUBLICATION OF TARGET POPULATIONS NOT SPECIFIED, OTHER- COMMUNITY HEALTH NEEDS ASSESSMENT REPORT HOSPITAL/HMO WEB PAGE PUBLICIZING TARGET POP. HTTPS://WWW.CAPECODHEALTH.ORG/ABOUT/CARING-FOR-OUR-COMMUNITY/COMMUNITY-HEA LTH-NEEDS-ASSESSMENTS/ KEY ACCOMPLISHMENTS OF REPORTING YEAR CAPE COD HOSPITAL, FALMOUTH HOSPITAL, AND CAPE COD HEALTHCARE (CCHC) CONTINUED TO STAND OUT IN THE AREAS OF QUALITY, INNOVATION AND PATIENT APPRECIATION IN FY17. THE SYSTEM GARNERED SEVERAL IMPORTANT AWARDS AND RECOGNITION. - AMERICAS 100 GREAT COMMUNITY HOSPITALS CAPE COD HOSPITAL WAS NAMED TO THE LIST OF AMERICAS 100 GREAT COMMUNITY HOSPITALS BY BECKERS HOSPITAL REVIEW FOR THE SIXTH CONSECUTIVE YEAR. THIS RECOGNITION IS BASED ON QUALITY OF CARE AND SERVICE TO OUR COMMUNITY, AND DEMONSTRATES THAT THE HOSPITAL IS SUCCESSFULLY AND CONSISTENTLY ACHIEVING TOP RESULTS IN PATIENT CARE AND SATISFACTION. - AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION GET WITH THE GUIDELINES - FALMOUTH HOSPITAL EARNED THE GET WITH THE GUIDELINES-STROKE GOLD-PLUS QUALITY ACHIEVEMENT AWARD FOR THE EIGHTH CONSECUTIVE YEAR. THIS ACHIEVEMENT RECOGNIZES THE HOSPITALS COMMITMENT AND SUCCESS IN IMPLEMENTING SPECIFIC QUALITY IMPROVEMENT MEASURES OUTLINE BY THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION FOR THE TREATMENT OF STROKE PATIENTS. CAPE COD HOSPITAL EARNED THE SILVER PLUS ACHIEVEMENT AWARD. - LEAPFROG HOSPITAL SAFETY SCORE - CAPE COD HOSPITAL ACHIEVED STRAIGHT AS IN THE ANNUAL HOSPITAL SAFETY SCORE FOR THE SIXTH STRAIGHT YEAR. FALMOUTH HOSPITAL WAS RECOGNIZED WITH A B HOSPITAL SAFETY SCORE. THE HOSPITAL SAFETY SCORE IS THE GOLD STANDARD RATING FOR PATIENT SAFETY AND IS COMPILED BY THE LEAPFROG GROUP, A NON-PROFIT HOSPITAL SAFETY WATCHDOG. - RN RESIDENCY ACCREDITATION - THE RN RESIDENCY TRANSITION PROGRAM AT CCHC EARNED "ACCREDITATION WITH DISTINCTION" FROM THE AMERICAN NURSES CREDENTIALING CENTERS COMMISSION ON ACCREDITATION. THIS IS THE HIGHEST RECOGNITION AWARDED BY THE PROGRAM. THE COMMISSION NOTED THE STRENGTH OF THE CCHC PROGRAMS LEADERSHIP, AND HIGHLIGHTED THE PROGRAMS FLEXIBILITY TO GROW INTO OTHER AREAS WITHIN THE HEALTHCARE SYSTEM. - HEPATITIS B BIRTH DOSE HONOR ROLL - THE DIVISION OF EPIDEMIOLOGY AND IMMUNIZATION, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH NAMED CAPE COD HOSPITAL TO ITS HONOR ROLL FOR HEPATITIS B BIRTH DOSE FOR ACHIEVING 95% COVERAGE IN OUR MATERNITY DEPARTMENT. IN FY17, THE EXPANSION AND IMPLEMENTATION OF HOSPITAL-BASED AND COMMUNITY-BASED HEALTH IMPROVEMENT ACTIVITIES MIRRORED THE QUALITY OF AND COMMITMENT TO CLINICAL ACHIEVEMENTS. THE RELEASE OF THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION PLAN SERVED AS THE GUIDE FOR IMPLEMENTATION OF HEALTH IMPROVEMENT STRATEGIES, PARTNERSHIP DEVELOPMENT AND IDENTIFICATION OF COMMUNITY INVESTMENT OPPORTUNITIES. CCHCS COMMUNITY BENEFITS ACTIVITIES FOCUSED ON THE FOUR KEY HEALTH PRIORITIES IDENTIFIED IN THE REPORT: CHRONIC AND INFECTIOUS DISEASE, BEHAVIORAL HEALTH, ACCESS TO CARE, AND DISEASE PREVENTION AND WELLNESS. THESE PRIORITIES WERE ADDRESSED THROUGH NEW AND EXISTING HOSPITAL PROGRAMS, COLLABORATION WITH A NETWORK OF FEDERALLY QUALIFIED HEALTH CENTERS, GRANT INVESTMENTS IN COMMUNITY-BASED HEALTH AND HUMAN SERVICE ORGANIZATIONS, AND EXPANDING PARTICIPATION IN REGIONAL COALITIONS AND TASK FORCE EFFORTS. CHRONIC AND INFECTIOUS DISEASE MANAGEMENT, PREVENTION, SCREENING, AND DETECTION EFFORTS WERE SUPPORTED THROUGH A VARIETY OF CCHC COMMUNITY BENEFITS ACTIVITIES. HOSPITAL EFFORTS INCLUDED CANCER SURVIVORSHIP SERVICES, ONCOLOGY SUPPORT GROUPS, AND PHYSICIAN-LED CANCER PREVENTION WORKSHOPS AND HEALTH FAIRS. A PARTNERSHIP WITH THE CAPE WELLNESS COLLABORATIVE PROVIDED PATIENTS UNDERGOING CANCER TREATMENT WITH FREE COMMUNITY-BASED SERVICES SUCH AS MASSAGE, ACUPUNCTURE AND NUTRITIONAL COUNSELING TO COMPLEMENT THEIR TREATMENT AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL. CCHC PARTNERED WITH TEAM MAUREEN, A LOCAL NONPROFIT ORGANIZATION DEDICATED TO ENDING CERVICAL CANCER, TO PRODUCE AN HPV PREVENTION PUBLIC SERVICE ANNOUNCEMENT TARGETED AT YOUTH AND YOUNG ADULTS. THE VIDEO WAS ACCEPTED FOR SCREENING BY THE GLOBAL HEALTH FILM FESTIVAL AT THE AMERICAN PUBLIC HEALTH ASSOCIATIONS ANNUAL CONFERENCE IN ATLANTA. IN FY17, CCHC LAUNCHED THE CCHC CONGESTIVE HEART FAILURE CLINIC DESIGNED TO PROVIDE RESIDENTS WITH CHRONIC DISEASE SELF-MANAGEMENT AND WELLNESS RESOURCES. NUTRITION COUNSELING, DISEASE EDUCATION, AND PHARMACOLOGY ARE INTEGRATED AND OFFERED TO PATIENTS TO ASSIST THEM IN STAYING WELL AND ACTIVE AT HOME AND IN THE COMMUNITY. AS A RECIPIENT OF STATE AND FEDERAL GRANTS INCLUDING THE RYAN WHITE HIV/AIDS PROGRAM GRANT FOR THE REGION, CCHC INFECTIOUS DISEASE CLINICAL SERVICES COORDINATES REGIONAL HIV/AIDS SCREENING, TESTING, CARE MANAGEMENT, AND HEALTH RELATED SUPPORTS FOR RESIDENTS WITH HIV AND AIDS THROUGH PARTNERSHIPS WITH COMMUNITY-BASED HEALTH AND HUMAN SERVICE ORGANIZATIONS.
CCHC COMMUNITY BENEFITS PROVIDED GRANTS TO THE ALZHEIMER'S FAMILY	CAREGIVER SUPPORT CENTER AND HOPE DEMENTIA AND ALZHEIMERS SERVICES TO FUND NEW SUPPORT GROUPS, FREE COUNSELING FOR FAMILIES, AND RESPITE GRANTS FOR CAREGIVERS. THE YMCA CAPE COD IN PARTNERSHIP WITH THE NATIONAL ALLIANCE ON MENTAL ILLNESS RECEIVED FUNDING FROM CCHC TO DEVELOP SUPPORT GROUPS AND WELLNESS PROGRAMS TO ADDRESS THE CO-MORBIDITIES OF DIABETES AND DEPRESSION. CCHC PARTNERED WITH THE CAPE COD COOPERATIVE EXTENSION AND THE UMASS LABORATORY OF MEDICAL ZOOLOGY TO OFFER AN INNOVATIVE TICK TESTING PROGRAM FOR OUR REGION. CCHC FUNDING SUBSIDIZED A PORTION OF EACH TICK TEST SUBMITTED BY BARNSTABLE COUNTY RESIDENTS. TICK DISEASE RESULTS WERE PROVIDED TO THE RESIDENT, AND AGGREGATED DISEASE SURVEILLANCE DATA WAS SHARED WITH COLLABORATING AGENCIES. CCHCS CENTERS FOR BEHAVIORAL HEALTH EXPANDED STAFF CAPACITY AND OUTPATIENT SERVICES TO INCREASE ACCESS AND STRENGTHEN REGIONAL HEALTH SERVICES FOR INDIVIDUALS WITH MENTAL HEALTH, SUBSTANCE USE, AND CO-OCCURRING DISORDERS. AS A PARTNER IN NEW PRIVATIZED SERVICES AWARDED BY THE MA DEPARTMENT OF MENTAL HEALTH, CCHC STAFF COLLABORATED WITH COMMUNITY-BASED AGENCIES, COALITIONS, ADVOCACY GROUPS, AND LAW ENFORCEMENT TO IMPLEMENT A NEW MODEL OF CRISIS INTERVENTION SERVICES FOR OUR REGION. CCHC IS ALSO A COLLABORATIVE PARTNER WITH THE MA DEPARTMENT OF PUBLIC HEALTH AND MA DEPARTMENT OF MENTAL HEALTH ON THE ZERO SUICIDE INITIATIVE TO INCREASE SUICIDE PREVENTION AND REDUCE SUICIDE DEATHS ON CAPE COD AND THE ISLANDS OF MARTHAS VINEYARD AND NANTUCKET. CCHC COMMUNITY BENEFITS PROVIDED GRANT AWARDS TO TWO FEDERALLY QUALIFIED HEALTH CENTERS, DUFFY HEALTH CENTER AND OUTER CAPE HEALTH SERVICES, TO SUPPORT REGIONAL EFFORTS TO REACH AND SERVE HIGH RISK TARGET POPULATIONS WITH BEHAVIORAL HEALTH NEEDS. OUTER CAPE HEALTH SERVICES LAUNCHED THE COMMUNITY RESOURCE NAVIGATOR PROGRAM TO PROVIDE SHORT-TERM CASE MANAGEMENT AND ASSISTANCE WITH SOCIAL DETERMINANTS OF HEALTH FOR INDIVIDUALS WITH BEHAVIORAL HEALTH DISORDERS ON THE LOWER AND OUTER CAPE. DUFFY HEALTH CENTER MAINTAINED KEY BEHAVIORAL HEALTH SERVICES FOR HOMELESS INDIVIDUALS AND THOSE AT RISK OF HOMELESSNESS IN BARNSTABLE COUNTY. CCHC PROVIDED FUNDING AND COORDINATION WITH FOUR FEDERALLY QUALIFIED HEALTH CENTERS TO INCREASE REGIONAL MEDICATION ASSISTED TREATMENT OUTPATIENT SERVICES ACROSS ALL REGIONS OF CAPE COD. IN ADDITION TO EXPANDING OUTPATIENT TREATMENT OPTIONS, CCHC IMPLEMENTED A RECOVERY SPECIALIST PROGRAM IN THE EMERGENCY DEPARTMENTS AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL. IN PARTNERSHIP WITH GOSNOLD ON CAPE COD, THE RECOVERY SPECIALIST PROGRAM PROVIDES PEER-RECOVERY PROFESSIONALS TO ENGAGE PATIENTS AND ASSIST IN REFERRALS AND TRANSITION TO INPATIENT AND OUTPATIENT SUBSTANCE USE DISORDER TREATMENT PROGRAMS UPON DISCHARGE FROM THE EMERGENCY DEPARTMENTS. CCHC LED AN EFFORT TO IMPROVE CARE FOR PREGNANT WOMEN ON CAPE COD WITH SUBSTANCE USE DISORDERS. OUR MOMS DO CARE PROGRAM, A PROGRAM FUNDED THROUGH A THREE-YEAR MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH GRANT, PROVIDES INTEGRATED PRENATAL CARE AND SUBSTANCE USE TREATMENT FOR PREGNANT WOMEN WITH OPIOID USE DISORDERS. PHYSICIANS AND CLINICAL LEADERS AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL ARE ACTIVE CONTRIBUTORS TO THE NEONATAL QUALITY IMPROVEMENT COLLABORATIVE OF MA TO IMPROVE CARE OF NEWBORNS AND FAMILIES IMPACTED BY PERINATAL OPIOID USE AND NEONATAL ABSTINENT SYNDROME. CCHCS SUPPORT REACHED BEYOND CLINICAL SETTINGS THROUGH A PARTNERSHIP WITH CAPE COD CHILD DEVELOPMENT TO INCREASE ACCEPTANCE OF EARLY INTERVENTION SERVICES BY FAMILIES WITH NEWBORNS EXPOSED TO SUBSTANCES IN UTERO. A GRANT TO THE MOTHERS AND INFANTS RECOVERY NETWORK HELPED TO LAUNCH ADDITIONAL SUPPORT GROUPS IN NEW LOCATIONS ON CAPE COD INCLUDING THE BARNSTABLE COUNTY CORRECTIONAL FACILITY FOR WOMEN. CCHCS COMMITMENT TO IMPROVE ACCESS TO CARE WAS DEMONSTRATED THROUGH SUPPORT OF EXISTING PROGRAMS AND NEW INITIATIVES DESIGNED TO REDUCE BARRIERS TO CARE FOR VULNERABLE POPULATIONS. IN PARTNERSHIP WITH THE CAPE AND ISLANDS EMERGENCY MEDICAL SERVICES SYSTEM, CCHC INTRODUCED AN INNOVATIVE MODEL TO PROVIDE MEDICAL INTERPRETER SERVICES FOR LIMITED-ENGLISH SPEAKING PATIENTS IN PRE-HOSPITAL SETTINGS. THE PROGRAM PROVIDES PHONE BASED INTERPRETER SERVICES TO PARAMEDICS AND FIRST RESPONDERS ON AMBULANCES TO IMPROVE COMMUNICATION WITH PATIENTS DURING TRANSPORT TO THE HOSPITAL. IN FY17, PARTNERSHIPS INCREASED FROM TWO TO THIRTEEN MUNICIPAL FIRE AND RESCUE DEPARTMENTS. ALSO, CCHC INTERPRETER SERVICES CONTINUED TO PROVIDE FREE MEDICAL INTERPRETER SERVICES FOR LIMITED-ENGLISH SPEAKING PATIENTS IN COMMUNITY-BASED PRIMARY AND SPECIALTY CARE OFFICES ACROSS THE REGION. CCHC COMMUNITY BENEFITS GRANT FUNDING SUPPORTED THE COORDINATION OF THE SPECIALTY NETWORK FOR THE UNINSURED (SNU). THE SNU PROGRAM PROVIDES FREE/SLIDING-SCALE FEES FOR VISITS TO SPECIALISTS FOR UNINSURED AND UNDER-INSURED RESIDENTS OF BARNSTABLE COUNTY. COORDINATION OF VISITS WITH LOCAL SPECIALISTS REDUCES THE NEED FOR RESIDENTS WITHOUT COVERAGE FOR THESE SERVICES TO TRAVEL OUTSIDE OF THE REGION, AND ADDRESSES A GAP IN CERTAIN SERVICES NOT OFFERED BY FEDERALLY QUALIFIED HEALTH CENTERS. A CCHC GRANT TO THE BARNSTABLE COUNTY HUMAN SERVICES DEPARTMENT SUPPORTED THE SHINE (SERVING THE HEALTH INSURANCE NEEDS OF EVERYONE) PROGRAM TO INCREASE THE NUMBER OF SENIORS WHO RECEIVED MEDICARE COUNSELING, EDUCATION, AND ENROLLMENT ASSISTANCE AT COUNCIL ON AGING OFFICES ACROSS ALL 15 TOWNS IN BARNSTABLE COUNTY. STRATEGIC WORKFORCE DEVELOPMENT PARTNERSHIPS WITH CAPE COD COMMUNITY COLLEGE, LOCAL VOCATIONAL PROGRAMS, AND SEVERAL HIGH SCHOOLS IN THE REGION WERE STRENGTHENED IN AN EFFORT TO ENSURE A STRONG AND SKILLED FUTURE WORKFORCE ON CAPE COD. CCHC PROVIDED FUNDING, JOB SHADOWING AND TRAINING OPPORTUNITIES FOR DIVERSE ALLIED HEALTH PROGRAMS, INCLUDING NURSING AND CNA EMPLOYMENT TRACKS. CCHC HEALTH IMPROVEMENT IMPLEMENTATION STRATEGIES ALSO ADDRESSED DISEASE PREVENTION FOR ALL RESIDENTS OF BARNSTABLE COUNTY AND SUSTAINING THE WELLNESS OF ELDERS AND CAREGIVERS. A SPECIFIC AREA OF FOCUS IN FY17 WAS TO INCREASE ACCESS TO NUTRITIOUS FOOD FOR LOW-INCOME POPULATIONS. CCHC PROVIDED A STRATEGIC GRANT TO THE FAMILY PANTRY OF CAPE COD TO LAUNCH A MOBILE FOOD PANTRY TO DELIVER HEALTHY FOODS TO ISOLATED SENIORS AND CAREGIVERS IN REMOTE GEOGRAPHIC LOCATIONS. THE FLAVORRX PROJECT FEATURED COLLABORATION BETWEEN SUSTAINABLE CAPE AND EMERALD PHYSICIANS, AN AFFILIATE OF CCHC, TO "PRESCRIBE" PLANT-BASED FOODS AND OFFER INCENTIVES FOR MASS HEALTH PATIENTS TO PURCHASE LOCALLY GROWN FRUITS AND VEGETABLES AT LOCAL FARMERS MARKETS. CCHC ALSO PARTNERED WITH THE CAPE COD FISHERMANS ALLIANCE TO INCREASE THE NUMBER OF FOOD PANTRIES AS DISTRIBUTION POINTS FOR THE FISH FOR FAMILIES PROGRAM. THE PROGRAM PROVIDES LOCALLY SOURCED FISH AND SHELLFISH AS A NUTRIENT DENSE PROTEIN OPTION FOR FOOD PANTRY CLIENTS ACROSS CAPE COD. HEALTHY PARKS, HEALTHY PEOPLE, A WALKING AND HEALTH PROMOTION PROGRAM FOR RESIDENTS AND VISITORS TO CAPE COD, WAS CONTINUED THROUGH A PARTNERSHIP BETWEEN THE US NATIONAL PARK SERVICE, THE CAPE COD NATIONAL SEASHORE, AND CAPE COD HEALTHCARE. CCHC STAFF INCLUDING PHYSICIANS AND PHYSICAL THERAPISTS PROVIDED CLASSES, EDUCATION AND RESOURCES TO RESIDENTS PARTICIPATING IN THE PROGRAM. THE PARKINSONS SUPPORT NETWORK WAS AWARDED FUNDING TO OFFER ADDITIONAL WELLNESS PROGRAMS AND SUPPORT GROUPS FOR INDIVIDUALS WITH PARKINSONS DISEASE AND THEIR CAREGIVERS. CALMER CHOICE WAS AWARDED A CCHC COMMUNITY BENEFITS GRANT TO OFFER COMMUNITY-BASED UNIVERSAL PREVENTION PROGRAMS THAT TEACH YOUNG PEOPLE HOW TO EFFECTIVELY AND SAFELY MANAGE STRESS AND RESOLVE CONFLICT WITH THE GOAL TO DIMINISH THE RISK OF VIOLENCE, SUBSTANCE ABUSE, AND OTHER SELF-DESTRUCTIVE BEHAVIORS. THE CAPE COD HOARDING TASK FORCE RECEIVED FUNDING TO OFFER BROAD COMMUNITY EDUCATION EVENTS ON THE TOPIC OF HOARDING AND SPECIALIZED TRAINING FOR MEMBERS OF THE TASK FORCE WHO WORK DIRECTLY WITH RESIDENTS ON ISSUES OF HOARDING AND HEALTH. IN ADDITION TO THESE HOSPITAL-BASED PROGRAMS AND GRANT FUNDED COMMUNITY-BASED PROJECTS, COMMUNITY BENEFITS AND HOSPITAL STAFF CONTINUED TO PLAY LEADERSHIP ROLES IN HEALTH AND HUMAN SERVICE ORGANIZATIONS AND COALITIONS ACROSS BARNSTABLE COUNTY. THESE INCLUDE, BUT ARE NOT LIMITED TO, THE BARNSTABLE COUNTY HUMAN SERVICES ADVISORY COUNCIL, BARNSTABLE COUNTY REGIONAL SUBSTANCE USE COUNCIL, BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS, CAPE & ISLANDS COMMUNITY HEALTH AREA NETWORK (CHNA 27) STEERING COMMITTEE, HEALTHY AGING CAPE COD, QUALITY OF LIFE INITIATIVE, AND THE SUBSTANCE USE IN PREGNANCY TASK FORCE.
PLANS FOR NEXT YEAR REPORTING YEAR	ANNUAL COMMUNITY BENEFITS PLANS FOR CAPE COD HOSPITAL, FALMOUTH HOSPITAL AND CAPE COD HEALTHCARE REFLECT THE PRIORITIES, GOALS AND OBJECTIVES EMBEDDED IN THE THREE-YEAR IMPLEMENTATION STRATEGIES INCLUDED IN THE 20172019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION PLAN. CCHC COMMUNITY BENEFITS FY17FY19 GOALS: - IMPROVE CHRONIC AND INFECTIOUS DISEASE PREVENTION AND MANAGEMENT TO MEET THE GROWING NEEDS OF AN AGING AND AT-RISK POPULATION. - STRENGTHEN REGIONAL HEALTH SERVICES AND COMMUNITY RESOURCES FOR INDIVIDUALS WITH MENTAL HEALTH CONDITIONS, SUBSTANCE USE, CO-OCCURRING DISORDERS, AND COMORBIDITIES. - REDUCE BARRIERS TO CARE AND STRENGTHEN THE REGIONAL HEALTH SAFETY NET FOR VULNERABLE POPULATIONS. - IMPROVE THE HEALTH AND DISEASE PREVENTION OF ALL RESIDENTS OF BARNSTABLE COUNTY AND SUSTAIN THE WELLNESS OF SENIORS AND CAREGIVERS. - SUPPORT REGIONAL HEALTH EFFORTS THROUGH DIRECT GRANT FUNDING AND A COMPETITIVE RFP GRANTS PROGRAM WITH FUNDING GUIDELINES THAT ARE ALIGNED WITH COMMUNITY BENEFITS PRIORITIES AND TARGET POPULATIONS. - STRENGTHEN REGIONAL COLLABORATION AND MAINTAIN LEADERSHIP ROLES WITH THE FOLLOWING COMMUNITY-BASED COALITIONS: BARNSTABLE COUNTY HUMAN SERVICES ADVISORY COUNCIL, BARNSTABLE COUNTY REGIONAL SUBSTANCE USE COUNCIL, BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS, COMMUNITY HEALTH AREA NETWORK (CHNA 27) STEERING COMMITTEE, HEALTHY AGING CAPE COD, AND THE SUBSTANCE USE IN PREGNANCY TASK FORCE. COMMUNITY BENEFITS PROCESS COMMUNITY BENEFITS LEADERSHIP/TEAM CAPE COD HEALTHCARE, CAPE COD HOSPITAL AND FALMOUTH HOSPITAL, ALONG WITH OUR AFFILIATES, STRIVE TO BE THE HEALTH SERVICE PROVIDER OF CHOICE FOR BARNSTABLE COUNTY RESIDENTS AND VISITORS BY ACHIEVING AND MAINTAINING THE HIGHEST STANDARDS IN HEALTHCARE DELIVERY AND SERVICE QUALITY. TO DO SO, WE PARTNER WITH OTHER HEALTH AND HUMAN SERVICE PROVIDERS FROM ACROSS THE REGION AND INVEST IN NEEDED MEDICAL TECHNOLOGIES, DEVELOPING THE CURRENT AND FUTURE WORKFORCE AND CLINICAL SERVICES. CAPE COD HEALTHCARE IS THE SAFETY NET HEALTH CARE PROVIDER FOR RESIDENTS OF BARNSTABLE COUNTY. OUR VALUES DRIVE OUR COMMITMENT TO BE COMPASSIONATE, RESPECTFUL AND PROFESSIONAL IN THE WAY WE DELIVER CARE. WE ARE RELENTLESS IN PURSUING THE HIGHEST STANDARD OF QUALITY THROUGH CONTINUOUS IMPROVEMENT, EMPHASIZING THE POWER OF TEAMWORK. WE ARE HONEST, ETHICAL AND OPEN IN ALL OF OUR RELATIONSHIPS. WE ARE RESPONSIBLE STEWARDS OF THE COMMUNITY`S RESOURCES BY WORKING EFFICIENTLY AND COST EFFECTIVELY. WE SERVE ALL WITHOUT REGARD TO SEX, RACE, CREED, RESIDENCE, NATIONAL ORIGIN, SEXUAL ORIENTATION OR ABILITY TO PAY. THE DEVELOPMENT OF CAPE COD HEALTHCARES STRATEGIC INITIATIVES AND COMMUNITY COLLABORATIONS, INCLUDING THE COMMUNITY BENEFITS PROGRAM, IS LED BY MICHAEL K. LAUF, CHIEF EXECUTIVE OFFICER AND THERESA M. AHERN, SENIOR VICE PRESIDENT, STRATEGY, COMMUNITY AND GOVERNMENTAL AFFAIRS. MANAGEMENT OF THE PROGRAM IS THE RESPONSIBILITY OF LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS AND GRANTS ADMINISTRATION. THE COMMUNITY HEALTH COMMITTEE, A DESIGNATED SUBCOMMITTEE OF CAPE COD HEALTHCARES BOARD OF TRUSTEES, PROVIDES STRATEGIC OVERSIGHT TO THE COMMUNITY BENEFITS PROGRAM. THE COMMITTEE IS COMPRISED OF LEADERS OF HEALTH AND HUMAN SERVICES ORGANIZATIONS, COMMUNITY HEALTH CENTERS, COUNTY GOVERNMENT, AND COMMUNITY-BASED ORGANIZATIONS REPRESENTING RESIDENTS ACROSS A SPECTRUM OF AGES, SOCIOECONOMIC STATUS, AND RACIAL, CULTURAL AND ETHNIC DIVERSITY, AS WELL AS CURRENT MEMBERS OF THE CCHC BOARD OF TRUSTEES. THE COMMITTEE DEVELOPS AND RECOMMENDS POLICIES TO THE CAPE COD HEALTHCARE BOARD OF TRUSTEES REGARDING COMMUNITY BENEFITS PROGRAMS, SETS PRIORITIES, AWARDS PRIORITY GRANT FUNDING TO COMMUNITY ORGANIZATIONS, AND ADVISES ON COMMUNITY HEALTH ISSUES AND INITIATIVES INCLUDING COMMUNITY HEALTH NEEDS ASSESSMENTS. FY17 COMMUNITY HEALTH COMMITTEE MEMBERS: SUZANNE FAY GLYNN, ESQ. (CHAIR) CCHC BOARD MEMBER GLYNN LAW OFFICES 49 LOCUST STREET, FALMOUTH, MA 02540 508-548-8282 LJARVIS@GLYNNLAWOFFICES.COM REPRESENTING: CCHC BOARD OF TRUSTEES ELEANOR CLAUS CCHC BOARD MEMBER KINLIN GROVER REAL ESTATE 927 ROUTE 6A, YARMOUTHPORT, MA 02675 508-362-3000 X203 ECLAUS@KINLINGROVER.COM REPRESENTING: CCHC BOARD OF TRUSTEES ELIZABETH ALBERT DIRECTOR BARNSTABLE COUNTY HUMAN SERVICES P.O. BOX 427, BARNSTABLE, MA 02630 508-375-6626 BALBERT@BARNSTABLECOUNTY.ORG REPRESENTING: HEALTH AND HUMAN SERVICES COMMUNITY AT LARGE & COUNTY DEPARTMENTS KAREN CARDEIRA DIRECTOR FALMOUTH HUMAN SERVICES 65 TOWN HALL SQUARE, FALMOUTH, MA 02540 508-548-0533 KCARDEIRA@FALMOUTHHUMANSERVICES.ORG REPRESENTING: COMMUNITY AT LARGE & UPPER CAPE REGION MARY DEVLIN PUBLIC HEALTH AND WELLNESS DIVISION MANAGER VISITING NURSE ASSOCIATION OF CAPE COD 255 INDEPENDENCE DRIVE, HYANNIS, MA 02601 508-957-7619 MDEVLIN@VNACAPECOD.ORG REPRESENTING: PROVINCETOWN TO PLYMOUTH WITH EMPHASIS ON CHRONIC DISEASE AND HEALTHY AGING OF THE SENIOR POPULATION KAREN GARDNER CHIEF EXECUTIVE OFFICER COMMUNITY HEALTH CENTER OF CAPE COD 107 COMMERCIAL ST., MASHPEE, MA 02649 508-477-7090 KGARDNER@CHCOFCAPECOD.ORG REPRESENTING: FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER NETWORK & UPPER CAPE COD STACIE PEUGH CHIEF EXECUTIVE OFFICER YMCA CAPE COD 2245 IYANNOUGH RD, WEST BARNSTABLE, MA 02668 508-362-6500 SPEUGH@YMCACAPECOD.ORG REPRESENTING: YOUTH DEVELOPMENT, DISEASE MANAGEMENT, WELLNESS AND PREVENTION SUSAN TRAVERS DIRECTOR TRURO COUNCIL ON AGING 7 STANDISH WAY, NORTH TRURO 02652 508-487-2462 STRAVERS@TRURO-MA.GOV REPRESENTING: COUNCILS ON AGING SERVING TOGETHER (COAST), SENIOR POPULATIONS & OUTER CAPE COD CAPE COD HEALTHCARE MEMBER: THERESA M. AHERN SENIOR VICE PRESIDENT, STRATEGY, COMMUNITY AND GOVERNMENTAL AFFAIRS CAPE COD HEALTHCARE 88 LEWIS BAY ROAD HYANNIS, MA 02601 508-862-5077 TAHERN@CAPECODHEALTH.ORG ADDITIONAL MEMBERS NOMINATED IN FY17 AND APPROVED TO JOIN COMMITTEE IN FY18: MICHAEL MCGUIRE DIRECTOR CAPE COD COOPERATIVE EXTENSION P.O. BOX 367, BARNSTABLE, MA 02630 508-375-6701 MMAGUIRE@BARNSTABLECOUNTY.ORG REPRESENTING: BARNSTABLE COUNTY INITIATIVES RELATED TO NUTRITION, FOOD SAFETY, TICK BORNE DISEASES, WATER QUALITY PROTECTION AND YOUTH AND FAMILY PROGRAMS. PATRICIA MITROKOSTAS DIRECTOR OF PREVENTION PROGRAMS, PUBLIC RELATIONS & ORGANIZATIONAL ADVANCEMENT GOSNOLD ON CAPE COD 350 GIFFORD STREET, SUITE W-10, FALMOUTH, MA 02540 (508) 540-2317 PMITROKOSTAS@GOSNOLD.ORG REPRESENTING: REGIONAL-WIDE SUBSTANCE USE PREVENTION AND EARLY INTERVENTION EFFORTS FOCUSED ON YOUTH, YOUTH ADULTS AND FAMILIES. COMMUNITY BENEFITS TEAM MEETINGS THE FY2017 COMMUNITY HEALTH COMMITTEE MEETINGS WERE HELD ON THE FOLLOWING DATES: NOVEMBER 11, 2016 9:00 11:00 AM FEBRUARY 21, 2017 4:00-5:30 PM MAY 23, 2017 4:00-5:00 PM JULY 18, 2017 4:00-5:00 PM COMMUNITY PARTNERS ALZHEIMERS FAMILY CAREGIVER SUPPORT CENTER BARNSTABLE COUNTY CAPE COD COOPERATIVE EXTENSION SERVICES BARNSTABLE COUNTY HUMAN SERVICES BARNSTABLE COUNTY REGIONAL SUBSTANCE USE COUNCIL BARNSTABLE COUNTY SHERIFF BARNSTABLE HIGH SCHOOL HEALTH CARE ACADEMY BARNSTABLE LAND TRUST BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS BIG BROTHERS BIG SISTERS OF CAPE COD & THE ISLANDS BOYS & GIRLS CLUB OF CAPE COD CALMER CHOICE CAPE & ISLANDS EMS SYSTEMS, INC CAPE & ISLANDS UNITED WAY CAPE COD CHILD DEVELOPMENT CAPE COD CHILDRENS MUSEUM CAPE COD CHILDRENS PLACE CAPE COD COMMERCIAL FISHERMANS ALLIANCE CAPE COD COMMUNITY COLLEGE CAPE COD FOUNDATION CAPE COD HOARDING TASK FORCE CAPE COD HUNGER NETWORK CAPE COD SHELTER AND DOMESTIC VIOLENCE SERVICES CHILDRENS COVE COALITION FOR CHILDREN COMMUNITY DEVELOPMENT PARTNERSHIP COMMUNITY HEALTH CENTER OF CAPE COD COMMUNITY HEALTH NETWORK AREA 27 CAPE COD & ISLANDS (CHNA 27) DREAM DAY CAPE COD DUFFY HEALTH CENTER FALMOUTH HOUSING CORPORATION FALMOUTH TOGETHER WE CAN FAMILY PANTRY OF CAPE COD FLOWER ANGELS USA GANDARA MENTAL HEALTH GLENNA KOHL FUND FOR HOPE GOSNOLD ON CAPE COD HARBOR COMMUNITY HEALTH CENTER HYANNIS HEALTHY AGING CAPE COD HELPING OUR WOMEN HOPE DEMENTIA & ALZHEIMERS SERVICESINDEPENDENCE HOUSE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH MOTHERS AND INFANTS RECOVERY NETWORK NATIONAL ALLIANCE ON MENTAL ILLNESS CAPE COD OUTER CAPE HEALTH SERVICES PARKINSON SUPPORT NETWORK OF CAPE COD QUALITY OF LIFE INITIATIVE RIVERVIEW SCHOOL ROBERT F. KENNEDY CHILDREN ACTION CORPS SAMARITANS ON CAPE COD AND THE ISLANDS SHEAS YOUTH BASKETBALL ASSOCIATION SPECIALTY NETWORK FOR THE UNINSURED SUSTAINABLE CAPE TEAM MAUREEN TOWN OF BARNSTABLE YOUTH COMMISSION TOWN OF YARMOUTH PARK AND RECREATIONS DEPARTMENT UNITED STATES NATIONAL PARK SERVICE AND CAPE COD NATIONAL SEASHORE UNIVERSITY OF MASSACHUSETTS LABORATORY OF MEDICAL ZOOLOGY WE CAN YMCA CAPE COD
COMMUNITY HEALTH NEEDS ASSESSMENT	DATE LAST ASSESSMENT COMPLETED AND CURRENT STATUS THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT (CHNA REPORT) AND IMPLEMENTATION PLAN WAS RELEASED AND MADE WIDELY AVAILABLE TO THE PUBLIC ON SEPTEMBER 30, 2016. THE GOALS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS ARE TO MONITOR REGIONAL HEALTH DATA, ENGAGE HOSPITAL STAKEHOLDERS, PROMOTE PARTNERSHIPS BETWEEN THE HOSPITALS AND COMMUNITY ORGANIZATIONS AND DEVELOP MULTI-YEAR IMPLEMENTATION STRATEGIES TO GUIDE HOSPITAL INITIATIVES TO IMPROVE THE HEALTH OF BARNSTABLE COUNTY RESIDENTS. THE METHODOLOGY FOR CONDUCTING THE ASSESSMENT INCLUDED THE COLLECTION AND ANALYSIS OF PRIMARY AND SECONDARY HEALTH DATA, GATHERING OF SIGNIFICANT INPUT FROM THE COMMUNITY, AND THE IDENTIFICATION AND PRIORITIZATION OF REGIONAL HEALTH NEEDS. CCHC ENGAGED JOHN SNOW, INC. TO ASSIST IN DATA COLLECTION, FACILITATION OF COMMUNITY FORUMS AND LEADERSHIP INTERVIEWS AND IDENTIFICATION OF KEY IMPLEMENTATION STRATEGIES FOR THE PROJECT. OVER 20 DATA SOURCES WERE UTILIZED TO COLLECT BARNSTABLE COUNTY AND TOWN-LEVEL HEALTH STATISTICS ON DISEASE INCIDENCE AND PREVALENCE, HOSPITAL UTILIZATION, MORBIDITY AND MORTALITY, BARRIERS TO ACCESSING CARE, AND BEHAVIORAL RISK FACTORS. REGIONAL STATISTICS WERE ANALYZED AND COMPARED TO STATE AND NATIONAL STATISTICS TO IDENTIFY WHERE DEMOGRAPHIC AND HEALTH DISPARITIES EXIST. ONCE COLLECTED, STATISTICAL DATA WAS VETTED AND AUGMENTED WITH COMMUNITY INPUT. MORE THAN 140 INDIVIDUALS AND 90 COMMUNITY ORGANIZATIONS REPRESENTING LOW-INCOME, MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS PROVIDED CRITICAL INSIGHT AND FEEDBACK ON THE REGIONAL HEALTH NEEDS THROUGH KEY INFORMATION INTERVIEWS AND COMMUNITY INPUT FORUMS. THROUGH THIS COLLECTION OF DATA AND COMMUNITY INPUT THE SIGNIFICANT HEALTH NEEDS OF BARNSTABLE COUNTY RESIDENTS WERE DISTINGUISHED AND PRIORITIZED BASED ON THE FREQUENCY, URGENCY, SCOPE, SEVERITY AND MAGNITUDE OF THE IDENTIFIED ISSUES. THE SIGNIFICANT HEALTH NEEDS AND ASSOCIATED TARGET POPULATIONS IDENTIFIED THROUGH THE NEEDS ASSESSMENT REPORT SERVE AS THE FOUNDATION FOR COMMUNITY BENEFITS AND HOSPITAL PLANNING SPANNING FISCAL YEARS 2017-2019. CONSULTANTS/OTHER ORGANIZATIONS THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE 2017-2019 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT PROJECT: AIDS SUPPORT GROUP OF CAPE COD ALZHEIMERS FAMILY SUPPORT CENTER OF CAPE COD ARBOR COUNSELING SERVICES BARNSTABLE COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENT BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES BARNSTABLE COUNTY PUBLIC NURSING DIVISION BARNSTABLE COUNTY REGIONAL SUBSTANCE ABUSE COUNCIL BARNSTABLE PUBLIC SCHOOL SYSTEM BARNSTABLE TOWN COUNCIL BEHAVIORAL HEALTH PROVIDER COALITION OF CAPE COD & THE ISLANDS BOYS & GIRLS CLUB OF CAPE COD CAPE & ISLANDS EMERGENCY MEDICAL SERVICES SYSTEM CAPE & ISLANDS SUICIDE PREVENTION COALITION CAPE & ISLANDS UNITED WAY CAPE COD CENTER FOR WOMEN CAPE COD CHILD DEVELOPMENT CAPE COD COMMUNITY COLLEGE CAPE COD COUNCIL OF CHURCHES CAPE COD DISTRICT ATTORNEYS OFFICE CAPE COD FOUNDATION CAPE COD NEIGHBORHOOD SUPPORT COALITION CAPE COD WIC CARON TREATMENT CENTER CCHC CENTERS FOR BEHAVIORAL HEALTH CCHC EMERGENCY SERVICES CHILD AND FAMILY SERVICES CHILDRENS COVE COALITION FOR CHILDREN COMMUNITY ACTION COMMITTEE OF CAPE COD & THE ISLANDS COMMUNITY DEVELOPMENT PARTNERSHIP COMMUNITY HEALTH CENTER OF CAPE COD COMMUNITY HEALTH NETWORK AREA 27 DUFFY HEALTH CENTER ELDER SERVICES OF CAPE COD & THE ISLANDS EMERALD PHYSICIANS FALMOUTH HUMAN SERVICES FALMOUTH PUBLIC SCHOOL SYSTEM FALMOUTH SERVICE CENTER FALMOUTH TOGETHER WE CAN FALMOUTH VOLUNTEERS IN PUBLIC SCHOOLS GLENNA KOHL FUND FOR HOPE GOSNOLD ON CAPE COD HARBOR COMMUNITY HEALTH CENTER-HYANNIS HEALTH IMPERATIVES HEALTHY LIVING CAPE COD HELPING OUR WOMEN HOMELESS PREVENTION COUNCIL HOPE DEMENTIA & ALZHEIMERS SERVICES OF CAPE COD HOPE HEALTH HOUSING ASSISTANCE CORPORATION INDEPENDENCE HOUSE JOHN SNOW, INC. JUSTICE RESOURCE INSTITUTE LYME AWARENESS OF CAPE COD MA DEPARTMENT OF MENTAL HEALTH MA DEPARTMENT OF PUBLIC HEALTH MASHPEE WAMPANOAG TRIBE HEALTH SERVICE UNIT MOTHER AND INFANT RECOVERY NETWORK NATIONAL ALLIANCE ON MENTAL ILLNESS CAPE COD OUTER CAPE HEALTH SERVICES OUTER CAPE WOMEN INFANTS AND CHILDREN (WIC) SAMARITANS ON CAPE COD AND THE ISLANDS SANDPIPER NURSERY SCHOOL SANDWICH PUBLIC SCHOOL SYSTEM SHINE (SERVING HEALTH INFORMATION NEEDS OF EVERYONE) SIGHT LOSS SERVICES SPAULDING REHABILITATION HOSPITAL CAPE COD SPECIALTY NETWORK FOR THE UNINSURED SUBSTANCE USE IN PREGNANCY TASK FORCE THE FAMILY PANTRY OF CAPE COD TOWN OF BREWSTER HEALTH DEPARTMENT TOWN OF FALMOUTH COUNCIL ON AGING TOWN OF FALMOUTH HEALTH DEPARTMENT TOWN OF MASHPEE COUNCIL ON AGING TOWN OF MASHPEE HUMAN SERVICES TOWN OF PROVINCETOWN COUNCIL ON AGING TOWN OF SANDWICH COUNCIL ON AGING TOWN OF TRURO COUNCIL ON AGING VINFEN VISITING NURSE ASSOCIATION OF CAPE COD WE CAN YARMOUTH POLICE DEPARTMENT YMCA OF CAPE COD DATA SOURCES COMMUNITY FOCUS GROUPS, HOSPITAL, INTERVIEWS, MASSCHIP, PUBLIC HEALTH PERSONNEL, SURVEYS, CHNA CHNA DOCUMENT - PDF FORMAT DOWNLOAD/VIEW ATTACHMENT (8347 KB) FILE NAME: CCHC CHNA REPORT_2017-2019.PDF IMPLEMENTATION STRATEGY (OPTIONAL) FILE UPLOAD (OPTIONAL) NOT SPECIFIED COMMUNITY BENEFITS PROGRAMS COMMUNITY-BASED INTERPRETER SERVICES IN PHYSICIAN OFFICES - PROGRAM TYPE: OUTREACH TO UNDERSERVED - STATEWIDE PRIORITY: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS, REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORM - EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES - DON HEALTH PRIORITIES (OPTIONAL): SOCIAL ENVIRONMENT - BRIEF DESCRIPTION OR OBJECTIVE: CCHC PROVIDES FREE MEDICAL LANGUAGE INTERPRETERS TO COMMUNITY-BASED PHYSICIAN OFFICES TO ASSIST LIMITED AND NON-ENGLISH SPEAKING PATIENTS AND THEIR FAMILIES. THE AVAILABILITY OF PROFICIENT AND PROFESSIONAL INTERPRETER SERVICES ENSURES THE DELIVERY OF SAFE, QUALITY HEALTH CARE AND POSITIVE CLINICAL OUTCOMES. - TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: ARTHRITIS, OTHER: ASTHMA/ALLERGIES, OTHER: CANCER, OTHER: CARDIAC DISEASE, OTHER: CHRONIC PAIN, OTHER: COLITIS/CROHN DISEASE, OTHER: CULTURAL COMPETENCY, OTHER: DIABETES, OTHER: FAMILY PLANNING, OTHER: HEPATITIS, OTHER: HIV/AIDS, OTHER: HYPERTENSION, OTHER: LYME DISEASE, OTHER: NUTRITION, OTHER: OSTEOPOROSIS/MENOPAUSE, OTHER: PARKINSONS DISEASE, OTHER: PREGNANCY, OTHER: PULMONARY DISEASE/TUBERCULOSIS, OTHER: SAFETY - HOME, OTHER: SEXUALLY TRANSMITTED DISEASES, OTHER: SICKLE CELL DISEASE, OTHER: SMOKING/TOBACCO, OTHER: STROKE, OTHER: UNINSURED/UNDERINSURED, OVERWEIGHT AND OBESITY, PHYSICAL ACTIVITY, RESPONSIBLE SEXUAL BEHAVIOR, SUBSTANCE ABUSE, TOBACCO USE - SEX: ALL - AGE GROUP: ALL - ETHNIC GROUP: ALL - LANGUAGE: ALL PARTNERS PARTNER NAME, DESCRIPTION AND WEB ADDRESS COMMUNITY-BASED MEDICAL OFFICES ON CAPE COD VARIOUS HARBOR COMMUNITY HEALTH CENTER-HYANNIS - HTTP://WWW.HHSI.US/CAPE-COD/HARBOR-COMMUNITY-HEALTH-CENTER-HYANNIS/ CONTACT INFORMATION LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS CAPE COD HEALTHCARE 88 LEWIS BAY ROAD HYANNIS, MA 0260 PHONE: 508-862-7896 LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED
SPECIALTY NETWORK FOR THE UNINSURED	HARBOR COMMUNITY HEALTH CENTER HYANNIS - PROGRAM TYPE: GRANT/DONATION/FOUNDATION/SCHOLARSHIP, OUTREACH TO UNDERSERVED - STATEWIDE PRIORITY: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS - EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES - DON HEALTH PRIORITIES (OPTIONAL): NOT SPECIFIED - BRIEF DESCRIPTION OR OBJECTIVE: CAPE COD HEALTHCARE COMMUNITY BENEFITS PROVIDES ANNUAL GRANT SUPPORT TO HARBOR COMMUNITY HEALTH CENTER HYANNIS TO COORDINATE THE SPECIALTY NETWORK FOR THE UNINSURED (SNU). THE SNU PROGRAM INCREASES ACCESS TO SPECIALTY CARE FOR UNINSURED AND UNDER-INSURED RESIDENTS OF BARNSTABLE COUNTY THROUGH MANAGING A NETWORK OF MEDICAL SPECIALISTS WHO PROVIDE FREE OR SIGNIFICANTLY REDUCED SLIDING-SCALE FEES FOR OFFICE VISITS, PROCEDURES AND CONTINUED CARE OF UNINSURED AND UNDER-INSURED INDIVIDUALS. - TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: ARTHRITIS, OTHER: ASTHMA/ALLERGIES, OTHER: CANCER, OTHER: CARDIAC DISEASE, OTHER: CHRONIC PAIN , OTHER: DIABETES, OTHER: FAMILY PLANNING, OTHER: HEARING, OTHER: HEPATITIS, OTHER: HYPERTENSION, OTHER: LYME DISEASE, OTHER: OSTEOPOROSIS/MENOPAUSE, OTHER: PARKINSONS DISEASE, OTHER: PREGNANCY, OTHER: PULMONARY DISEASE/TUBERCULOSIS, OTHER: STROKE, OTHER: UNINSURED/UNDERINSURED, OTHER: VISION- SEX: ALL - AGE GROUP: ALL - ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION INCREASE ACCESS TO SPECIALTY CARE FOR LOW-INCOME, UNINSURED AND UNDER-INSURED INDIVIDUALS. GOAL STATUS THE SNU PROGRAM PROVIDED 495 PATIENT APPOINTMENTS WITH SPECIALISTS IN FY17. THE MOST UTILIZED SPECIALTIES INCLUDED OPHTHALMOLOGY, GASTROENTEROLOGY, UROLOGY, EARS, NOSE AND THROAT (ENT), CARDIOLOGY AND PODIATRY. GOAL DESCRIPTION PROVIDE ACCESS TO SPECIALISTS FOR UNINSURED OR UNDER-INSURED RESIDENTS WHO FACE LANGUAGE BARRIERS TO CARE. GOAL STATUS TEN PERCENT (10%) OF SNU PATIENTS REQUESTED A MEDICAL INTERPRETER. EIGHT-SIX PERCENT (86%) OF THOSE PATIENTS REQUIRED INTERPRETATION IN PORTUGUESE AND 14% REQUIRED INTERPRETATION IN SPANISH. GOAL DESCRIPTION MAINTAIN REFERRAL RELATIONSHIP BETWEEN SNU PROGRAM AND FEDERALLY QUALIFIED HEALTH CENTERS IN THE REGION. GOAL STATUS NEARLY ALL (99%) PROGRAM REFERRALS WERE MADE BY REGIONAL COMMUNITY HEALTH CENTERS INCLUDING HARBOR COMMUNITY HEALTH CENTER-HYANNIS, COMMUNITY HEALTH CENTER OF CAPE COD, DUFFY HEALTH CENTER AND ISLAND HEALTH CARE. PARTNER NAME, DESCRIPTION AND WEB ADDRESS HARBOR COMMUNITY HEALTH CENTER- HYANNIS WWW.HHSI.US DUFFY HEALTH CENTER WWW.DUFFYHEALTHCENTER.ORG ISLAND HEALTH CARE WWW.IHIMV.ORG CAPE COD HEALTHCARE WWW.CAPECODHEALTH.ORG COMMUNITY HEALTH CENTER OF CAPE COD WWW.CHCOFCAPECOD.ORG CONTACT INFORMATION: LISA GUYON CAPE COD HEALTHCARE 88 LEWIS BAY ROAD HYANNIS, MA, 02601 PHONE: 508-862-7896 LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED PRESCRIPTION ASSISTANCE PROGRAM FOR VULNERABLE POPULATIONS: CAPE COD HOSPITAL AND FALMOUTH HOSPITAL - PROGRAM TYPE: DIRECT SERVICES - STATEWIDE PRIORITY: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, REDUCING HEALTH DISPARITY - EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES - DON HEALTH PRIORITIES (OPTIONAL): NOT SPECIFIED - BRIEF DESCRIPTION OR OBJECTIVE: THE PRESCRIPTION ASSISTANCE PROGRAM IS AN INITIATIVE OF CAPE COD HOSPITAL AND FALMOUTH HOSPITAL EMERGENCY, BEHAVIORAL HEALTH AND PHARMACY DEPARTMENTS AS A COMMUNITY BENEFIT ASSISTING UNINSURED, UNDER-INSURED AND FINANCIALLY DISADVANTAGED PATIENTS WITH NO OTHER VIABLE MEANS TO PAY FOR MEDICATIONS UPON DISCHARGE FROM HOSPITAL FACILITIES. - TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: UNINSURED/UNDERINSURED - AGE GROUP: ALL - ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION ASSIST RESIDENTS WHO ARE UNABLE TO AFFORD MEDICATIONS TO ENSURE COMPLIANCE WITH HOSPITAL DISCHARGE PLANNING. GOAL STATUS CAPE COD HOSPITAL AND FALMOUTH HOSPITAL EMERGENCY AND BEHAVIORAL HEALTH DEPARTMENTS PROVIDED PHARMACY VOUCHERS AND PRESCRIPTION ASSISTANCE TOTALING MORE THAN $23,500 FOR UNINSURED, UNDER-INSURED, OR FINANCIALLY CHALLENGED PATIENTS. PARTNER NAME, DESCRIPTION AND WEB ADDRESS CAPE COD HOSPITAL - WWW.CAPECODHEALTH.ORG FALMOUTH HOSPITAL - WWW.CAPECODHEALTH.ORG CONTACT INFORMATION LISA GUYON DIRECTOR OF COMMUNITY BENEFITS CAPE COD HEALTHCARE 88 LEWIS BAY ROAD HYANNIS, MA 02601 PHONE: 508-862-7896ETAILED DESCRIPTION LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED TRANSPORTATION ASSISTANCE PROGRAM FOR VULNERABLE POPULATIONS: CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROGRAM TYPE: DIRECT SERVICES STATEWIDE PRIORITY: REDUCING HEALTH DISPARITY EOHHS FOCUS ISSUE(S) (OPTIONAL): CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES, MENTAL ILLNESS AND MENTAL HEALTH, SUBSTANCE USE DISORDERS DON HEALTH PRIORITIES (OPTIONAL): NOT SPECIFIED BRIEF DESCRIPTION OR OBJECTIVE: IN AN EFFORT TO ASSIST LOW-INCOME AND VULNERABLE POPULATIONS, CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROVIDE TRANSPORTATION UPON DISCHARGE FROM EMERGENCY AND BEHAVIORAL HEALTH DEPARTMENTS, TO THOSE PATIENTS WITHOUT RESOURCES FOR TRANSPORTATION. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: ACCESS TO HEALTH CARE, OTHER: SAFETY, OTHER: UNINSURED/UNDERINSURED - SEX: ALL - AGE GROUP: ALL - ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION ASSIST RESIDENTS WHO ARE UNABLE TO AFFORD OR ACCESS TRANSPORTATION TO ENSURE COMPLIANCE WITH THEIR DISCHARGE PLAN. GOAL STATUS CAPE COD HOSPITAL AND FALMOUTH HOSPITAL EMERGENCY AND BEHAVIORAL HEALTH DEPARTMENTS PROVIDED TRANSPORTATION VOUCHERS TOTALING MORE THAN $40,200 FOR FINANCIALLY DISADVANTAGED PATIENTS UPON DISCHARGE. PARTNER NAME, DESCRIPTION AND WEB ADDRESS LOCAL TAXI COMPANIES N/A CONTACT INFORMATION LISA GUYON DIRECTOR OF COMMUNITY BENEFITS CAPE COD HEALTHCARE 88 LEWIS BAY ROAD HYANNIS, MA, 02601 PHONE: 508-862-7896 LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED
DUFFY HEALTH CENTER:	SUPPORTING BEHAVIORAL HEALTH AND MEDICATION ASSISTED TREATMENT SERVICES FOR HOMELESS AND AT RISK ADULTS PROGRAM TYPE: SCHOOL/HEALTH CENTER PARTNERSHIP STATEWIDE PRIORITY: ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS EOHHS FOCUS ISSUE(S) (OPTIONAL): MENTAL ILLNESS AND MENTAL HEALTH, HOUSING STABILITY/HOMELESSNESS, SUBSTANCE USE DISORDERS DON HEALTH PRIORITIES (OPTIONAL): NOT SPECIFIED BRIEF DESCRIPTION OR OBJECTIVE: THE DUFFY HEALTH CENTER PROVIDES PRIMARY CARE AND BEHAVIORAL HEALTH CARE TO HOMELESS ADULTS AND THOSE AT-RISK FOR HOMELESSNESS IN BARNSTABLE COUNTY. IN FY17, COMMUNITY BENEFITS FUNDING FROM CAPE COD HEALTHCARE SUPPORTED THE DUFFY HEALTH CENTERS BEHAVIORAL HEALTH SERVICES INCLUDING THERAPY, PSYCHIATRY, MEDICATION AND CASE MANAGEMENT SUPPORT FOR HEALTH CENTER PATIENTS. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: ACCESS TO HEALTH CARE, MENTAL HEALTH, OTHER: ALCOHOL AND SUBSTANCE ABUSE, OTHER: HOMELESSNESS, OTHER: UNINSURED/UNDERINSURED, SUBSTANCE ABUSE - SEX: ALL - AGE GROUP: ADULT, ADULT-ELDER, ADULT-YOUNG - ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION STAFFING LEVELS TO PROVIDE HEALTH SERVICES TO 1,200 PATIENTS WILL BE SUSTAINED. GOAL STATUS BEHAVIORAL HEALTH SERVICES WERE PROVIDED TO MORE THAN 1,300 DUFFY HEALTH CENTER PATIENTS. GOAL DESCRIPTION PSYCHIATRIC SERVICES, INCLUDING MEDICATION MANAGEMENT, WILL BE PROVIDED TO 300 PATIENTS. GOAL STATUS PSYCHIATRIC SERVICES, INCLUDING MEDICATION MANAGEMENT, WERE PROVIDED TO 630 PATIENTS. GOAL DESCRIPTION CAPACITY TO SERVE ADDITIONAL PATIENTS THROUGH EXPANDED OFFICE-BASED ADDICTION TREATMENT PROGRAMS WILL BE INCREASED TO SERVE 225 PATIENTS. GOAL STATUS MEDICATION ASSISTED TREATMENT PROGRAMS AT DUFFY SERVED 380 PATIENTS. PATIENT ENGAGEMENT WAS INCREASED THROUGH IMPLEMENTATION OF A NEW RECOVERY SUPPORT NAVIGATOR POSITION TO ENGAGE WITH DUFFY PATIENTS AND INDIVIDUALS IN NEED THROUGH OUTREACH AT CAPE COD HOSPITAL AND STREET OUTREACH. PARTNER NAME, DESCRIPTION AND WEB ADDRESS THE DUFFY HEALTH CENTER - WWW.DUFFYHEALTHCENTER.ORG CONTACT INFORMATION LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED SUPPORT GROUPS AND HEALTH EDUCATION CLASSES AT CAPE COD HOSPITAL AND FALMOUTH HOSPITAL PROGRAM TYPE COMMUNITY EDUCATION, SUPPORT GROUP STATEWIDE PRIORITY CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS EOHHS FOCUS ISSUE(S) (OPTIONAL) CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES DON HEALTH PRIORITIES (OPTIONAL) NOT SPECIFIED BRIEF DESCRIPTION OR OBJECTIVE AT CAPE COD AND FALMOUTH HOSPITAL, SUPPORT GROUPS FOR BEREAVEMENT AND CANCER SURVIVORSHIP, CLASSES AND COUNSELING FOCUSED ON BREASTFEEDING AND FATHERHOOD, AND HOLISTIC SERVICES TO COMPLEMENT TRADITIONAL MEDICAL CARE ARE OFFERED TO RESIDENTS FREE OF CHARGE. CLASSES AND GROUPS ARE AVAILABLE TO INDIVIDUALS, FAMILIES AND CAREGIVERS AND INCLUDE IN-PERSON MEETINGS TO OFFER SUPPORT AND REASSURANCE THROUGH THEIR SPECIFIC DISEASE/HEALTH CARE SITUATION. TARGET POPULATION: REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: OTHER: ARTHRITIS, OTHER: BEREAVEMENT, OTHER: CANCER, OTHER: CHILD CARE, OTHER: CHRONIC PAIN, OTHER: DIABETES, OTHER: HOSPICE, OTHER: HYPERTENSION, OTHER: NUTRITION, OTHER: PARENTING SKILLS, OTHER: PREGNANCY, OTHER: STRESS MANAGEMENT - SEX: ALL - AGE GROUP: ADULT, ADULT-ELDER, ADULT-YOUNG - ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION PROVIDE SUPPORT GROUPS AND EDUCATIONAL ACTIVITIES FOR PATIENTS, FAMILIES, CAREGIVERS, AND THE COMMUNITY ON A CONTINUUM OF ISSUES INCLUDING CANCER SURVIVORSHIP, PRENATAL/PARENTING GROUPS, BEHAVIORAL HEALTH, BEREAVEMENT, AND CHRONIC DISEASE SELF-MANAGEMENT. GOAL STATUS IN FY17, OVER 6,760 STAFF HOURS WERE DEDICATED TO ENSURING SUPPORT GROUPS AND CLASSES WERE OFFERED AND FACILITATED FOR INDIVIDUALS, FAMILIES AND THE COMMUNITY. PARTNER NAME, DESCRIPTION AND WEB ADDRESS AMERICAN CANCER SOCIETY - WWW.CANCER.ORG CAPE COD HEALTHCARE - WWW.CAPECODHEALTH.ORG/CLASSES-EVENTS/ VISITING NURSES ASSOCIATION - WWW.VNACAPECOD.ORG YMCA CAPE COD- WWW.YMCACAPECOD.ORG CONTACT INFORMATION LISA GUYON DIRECTOR OF COMMUNITY BENEFITS 88 LEWIS BAY ROAD HYANNIS, MA 02601 PHONE: 508-862-7896 LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED
WORKFORCE AND CAREER DEVELOPMENT INITIATIVES: CAPE COD HEALTHCARE	PROGRAM TYPE: MENTORSHIP/CAREER TRAINING/INTERNSHIP STATEWIDE PRIORITY: REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORM EOHHS FOCUS ISSUE(S) (OPTIONAL): NOT SPECIFIED DON HEALTH PRIORITIES (OPTIONAL): EDUCATION, EMPLOYMENT BRIEF DESCRIPTION OR OBJECTIVE: CCHC INVESTS IN PARTNERSHIPS WITH LOCAL HIGH SCHOOLS, VOCATIONAL SCHOOLS, COMMUNITY COLLEGES, AND ALLIED HEALTH PROGRAM FOR JOB SHADOWING, INTERNSHIPS, AND TRAINING WITH HEALTH CARE PROVIDERS IN VARIOUS HOSPITAL DEPARTMENTS INCLUDING PHLEBOTOMY, RADIOLOGY, BEHAVIORAL HEALTH, MATERIALS MANAGEMENT, ETC. OUR EFFORTS CONTRIBUTE TO ECONOMIC DEVELOPMENT IN OUR REGION, INCREASE OPPORTUNITY FOR EDUCATIONAL ATTAINMENT, AND PROVIDE EXPERIENCE FOR INDIVIDUALS TO OBTAIN STABLE, QUALITY, AND WELL COMPENSATED JOBS IN OUR REGION. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: ACCESS TO HEALTH CARE - SEX: ALL - AGE GROUP: ADULT, ADULT-YOUNG - ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION INCREASE THE SUPPLY OF QUALIFIED HEALTH PROFESSIONALS THROUGH OFFERING WORKFORCE AND CAREER DEVELOPMENT PARTNERSHIPS. GOAL STATUS IN FY17, OVER 19,550 STAFF HOURS WERE DEVOTED TO WORKFORCE AND CAREER DEVELOPMENT PARTNERSHIP EFFORTS INCLUDING SUPERVISION OF STUDENT TRAININGS, JOB SHADOWING, AND CLINICAL OVERSIGHT. PARTNER NAME, DESCRIPTION AND WEB ADDRESS CAPE COD COMMUNITY COLLEGE: WWW.CAPECOD.EDU/ UPPER CAPE REGIONAL TECHNICAL SCHOOL: WWW.UPPERCAPETECH.COM/ MA COLLEGE OF PHARMACY AND HEALTH SCIENCES: WWW.MCPHS.EDU THE RIVERVIEW SCHOOL: WWW.RIVERVIEWSCHOOL.ORG UNIVERSITY OF MASSACHUSETTS: WWW.MASSACHUSETTS.EDU/ CAPE COD REGIONAL TECHNICAL HIGH SCHOOL: WWW.CAPETECH.US BARNSTABLE HIGH SCHOOL: WWW.BARNSTABLE.K12.MA.US CONTACT INFORMATION LISA GUYON DIRECTOR OF COMMUNITY BENEFITS CAPE COD HEALTHCARE 88 LEWIS BAY ROAD HYANNIS, MA 02601 PHONE: 508-862-7896 LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED COMMUNITY RESOURCE NAVIGATOR PROJECT AT OUTER CAPE HEALTH SERVICES PROGRAM TYPE GRANT/DONATION/FOUNDATION/SCHOLARSHIP STATEWIDE PRIORITY ADDRESS UNMET HEALTH NEEDS OF THE UNINSURED, CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS, REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORM EOHHS FOCUS ISSUE(S) (OPTIONAL) MENTAL ILLNESS AND MENTAL HEALTH, HOUSING STABILITY/HOMELESSNESS, SUBSTANCE USE DISORDERS DON HEALTH PRIORITIES (OPTIONAL) BUILT ENVIRONMENT, SOCIAL ENVIRONMENT, HOUSING, EMPLOYMENT BRIEF DESCRIPTION OR OBJECTIVE CCHC COMMUNITY BENEFITS PROVIDES GRANT SUPPORT TO OUTER CAPE HEALTH SERVICES TO PILOT THE COMMUNITY RESOURCE NAVIGATOR PROJECT. THE PROJECT PROVIDES INTERVENTIONS AND SHORT-TERM CASE MANAGEMENT FOR UNDERSERVED RESIDENTS WITH MENTAL HEALTH, SUBSTANCE USE, OR CO-OCCURRING DISORDER. COMMUNITY-BASED RESOURCE NAVIGATORS ASSIST INDIVIDUALS IN GAINING ACCESS TO PRIMARY AND BEHAVIORAL HEALTH CARE AND ADDRESS ISSUES RELATED TO SOCIAL DETERMINANTS OF HEALTH (HOUSING, FOOD ACCESS, TRANSPORTATION, ETC.). TARGET POPULATION REGIONS SERVED: REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: ACCESS TO HEALTH CARE, ENVIRONMENTAL QUALITY, MENTAL HEALTH, OTHER: ALCOHOL AND SUBSTANCE ABUSE, OTHER: DENTAL HEALTH, OTHER: HEPATITIS, OTHER: HIV/AIDS, OTHER: HOMEBOUND, OTHER: HOMELESSNESS, OTHER: NUTRITION, OTHER: PUBLIC SAFETY, OTHER: SAFETY, OTHER: SAFETY - HOME, OTHER: SMOKING/TOBACCO, OTHER: STRESS MANAGEMENT, OTHER: UNINSURED/UNDERINSURED, SUBSTANCE ABUSE, TOBACCO USE SEX: ALL - AGE GROUP: ALL - ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION DURING THE PILOT PHASE, A COMMUNITY RESOURCE NAVIGATOR WILL WORK WITH 50 CLIENTS ANNUALLY TO ADDRESS BEHAVIORAL HEALTH AND SOCIAL DETERMINANTS OF HEALTH NEEDS. GOAL STATUS IN FY17, 105 RESIDENTS WERE REFERRED TO THE PROGRAM AND 78 RESIDENTS WERE ENROLLED AND SERVED. GOAL DESCRIPTION ASSESS THE GREATEST NEEDS AND MEASURE IMPROVEMENTS IN SELF-SUFFICIENCY THROUGH PRE AND POST ENGAGEMENT SURVEYS. GOAL STATUS SURVEYS IDENTIFIED ACCESS TO MENTAL HEALTH SERVICES AND SOCIAL SERVICES (FOOD, TRANSPORTATION AND TRANSITIONAL ASSISTANCE AS THE GREATEST COMMON NEEDS OF INDIVIDUALS SERVED THROUGH THE PROGRAM. A LIMITED GROUP OF PARTICIPANTS (16) WERE MONITORED FOR SELF-SUFFICIENCY CHANGES. SURVEYS MEASURED THAT 69% OF THESE PARTICIPANTS INCREASED BASELINE STATUS FROM BARELY SELF-SUFFICIENT' TO 'ADEQUATELY SELF-SUFFICIENT' WITHIN THREE A THREE MONTH SERVICE TIMELINE AND WERE DISCHARGED FROM THE PROGRAM. PARTNER NAME, DESCRIPTION AND WEB ADDRESS OUTER CAPE HEALTH SERVICES WWW.OUTERCAPE.ORG CONTACT INFORMATION LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE: 508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED SUPPORTING THE HEALTH INSURANCE NEEDS OF EVERYONE (CHINE): BARNSTABLE DEPARTMENT OF HUMAN SERVICES PROGRAM TYPE GRANT/DONATION/FOUNDATION/SCHOLARSHIP STATEWIDE PRIORITY REDUCING HEALTH DISPARITY, SUPPORTING HEALTHCARE REFORM EOHHS FOCUS ISSUE(S) (OPTIONAL) NOT SPECIFIED DON HEALTH PRIORITIES (OPTIONAL) NOT SPECIFIED BRIEF DESCRIPTION OR OBJECTIVE CCHC COMMUNITY BENEFITS PROVIDES SUPPORT TO THE REGIONAL SHINE PROGRAM TO EXPAND INFORMATION, COUNSELING AND ASSISTANCE WITH MEDICARE AND HEALTH INSURANCE NEEDS AT VARIOUS OUTPOSTS ACROSS BARNSTABLE COUNTY. TARGET POPULATION REGIONS SERVED:COUNTY-BARNSTABLE - HEALTH INDICATOR:ACCESS TO HEALTH CARE, OTHER: ELDER CARE, OTHER: UNINSURED/UNDERINSURED - SEX:ALL - AGE GROUP:ALL - ETHNIC GROUP:ALL - LANGUAGE:ALL GOAL DESCRIPTION INCREASE THE NUMBER OF REGIONAL MEDICARE BENEFICIARIES ASSISTED BY THE SHINE PROGRAM. GOAL STATUS IN FY17, SHINE SERVED 7,730 INDIVIDUALS IN BARNSTABLE COUNTY, A 5% INCREASE COMPARED TO THE PREVIOUS YEAR. GOAL DESCRIPTION INCREASE THE NUMBER OF TRAINED SHINE VOLUNTEER COUNSELORS AVAILABLE IN COUNCIL ON AGING OFFICES AND OTHER ORGANIZATIONS IN BARNSTABLE COUNTY. GOAL STATUS SHINE TRAINED 10 NEW VOLUNTEER COUNSELORS IN 2017, INCREASING THE NUMBER OF TRAINED COUNSELORS TO 69 FOR THE REGION. GOAL DESCRIPTION MEASURE THE POTENTIAL SAVINGS IN HEALTH CARE COSTS FOR MEDICARE BENEFICIARIES ASSISTED BY THE REGIONAL SHINE PROGRAM. GOAL STATUS FY17 DATA, PROVIDED BY THE EXECUTIVE OFFICE OF ELDER AFFAIRS, IS NOT AVAILABLE AS OF MARCH 2018. THE FY17 ESTIMATED POTENTIAL COST SAVINGS FOR BARNSTABLE COUNTY RESIDENTS ASSISTED BY THE REGIONAL SHINE PROGRAM IS $9,365,950. PARTNER NAME, DESCRIPTION AND WEB ADDRESS BARNSTABLE COUNTY HUMAN SERVICES WWW.BCHUMANSERVICES.NET/INITIATIVES/SHINE/ CONTACT INFORMATION LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED
DIABETES AND DEPRESSION: YMCA DIABETES RESOURCE CENTER	PROGRAM TYPE GRANT/DONATION/FOUNDATION/SCHOLARSHIP STATEWIDE PRIORITY CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS EOHHS FOCUS ISSUE(S) (OPTIONAL) CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES, MENTAL ILLNESS AND MENTAL HEALTH DON HEALTH PRIORITIES (OPTIONAL) NOT SPECIFIED BRIEF DESCRIPTION OR OBJECTIVE CCHC COMMUNITY BENEFITS AWARDED A GRANT TO THE YMCA CAPE COD TO EXPAND COLLABORATION WITH THE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) CAPE COD TO OFFER FREE COMMUNITY-BASED SUPPORT GROUPS, LIFESTYLE CLASSES AND COUNSELING SESSIONS FOR RESIDENTS WITH THE COMORBIDITIES OF DIABETES AND DEPRESSION. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: MENTAL HEALTH, OTHER: DIABETES, OTHER: NUTRITION, PHYSICAL ACTIVITY - SEX: ALL - AGE GROUP: ALL ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION OFFER NAMI SUPPORT GROUPS FOR INDIVIDUALS WITH DIABETES AND DEPRESSION AT THE YMCA DIABETES EDUCATION CENTER OVER A 12 WEEK PERIOD WITH A GOAL OF ENGAGING 20 PARTICIPANTS. GOAL STATUS THIRTY-NINE (39) INDIVIDUALS ATTENDING NAMI SUPPORT GROUPS TARGETING INDIVIDUALS WITH THE COMORBIDITIES OF DIABETES AND DEPRESSION. GOAL DESCRIPTION ENROLL 100 INDIVIDUALS IN A 12 WEEK YMCA DIABETES PREVENTION PROGRAM, A LIFESTYLE IMPROVEMENT PROGRAM FOR PREDIABETIC ADULTS. GOAL STATUS IN FY17, 229 INDIVIDUALS ENROLLED IN THE YMCA DIABETES PREVENTION PROGRAM. MORE THAN 60% OF PROGRAM PARTICIPANTS REDUCED BLOOD GLUCOSE LEVELS AND IMPROVED DISEASE SELF-MANAGEMENT. PARTNER NAME, DESCRIPTION AND WEB ADDRESS YMCA CAPE COD WWW.YMCACAPECOD.ORG NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) CAPE COD WWW.NAMICAPECOD.ORG CONTACT INFORMATION LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED FLAVORX: FRUIT AND VEGETABLE PRESCRIPTION PROGRAM PROGRAM TYPE COMMUNITY PARTICIPATION/CAPACITY BUILDING INITIATIVE,GRANT/DONATION/FOUNDATION/SCHOLARSHIP,HEALTH SCREENING,OUTREACH TO UNDERSERVED,PREVENTION STATEWIDE PRIORITY CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS EOHHS FOCUS ISSUE(S) (OPTIONAL) CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES DON HEALTH PRIORITIES (OPTIONAL) BUILT ENVIRONMENT, SOCIAL ENVIRONMENT, EDUCATION BRIEF DESCRIPTION OR OBJECTIVE FLAVORX IS A COLLABORATION BETWEEN PRIMARY CARE PHYSICIANS, FARMERS MARKETS AND COMMUNITY AGENCIES TO INCREASE ACCESS TO FRUIT AND VEGETABLES FOR HIGH-RISK, VULNERABLE POPULATIONS. THIS COMPREHENSIVE NUTRITION PROGRAM PROVIDES INCENTIVES FOR THE PURCHASE OF FRUITS AND VEGETABLES AT LOCAL FARMER'S MARKETS, INTEGRATES NUTRITION EDUCATION AND COOKING CLASSES, AND MEASURES IMPROVEMENTS TO OVERALL HEALTH AND CHRONIC DISEASE RISK/MANAGEMENT. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: OTHER: DIABETES, OTHER: HYPERTENSION, OTHER: NUTRITION, OVERWEIGHT AND OBESITY - SEX: ALL AGE GROUP: ADULT ETHNIC GROUP: ALL LANGUAGE: ALL GOAL DESCRIPTION ENROLL A PILOT GROUP OF MASS HEALTH PATIENTS TO PARTICIPATE IN THE FLAVORX PROGRAM. GOAL STATUS THIRTY-EIGHT (38) INDIVIDUALS WERE ENROLLED IN THE PROGRAM AND 24 INDIVIDUALS COMPLETED THE PROGRAM.PARTICIPANTS WERE DIVIDED INTO TWO GROUPS WITH ONE GROUP RECEIVING PRESCRIPTION VOUCHERS FOR FRUITS AND VEGETABLES, NUTRITION EDUCATION AND HEALTH MONITORING. THE SECOND GROUP RECEIVED GAS CARDS, NUTRITION EDUCATION AND HEALTH MONITORING. THE EFFECTIVENESS OF THE INTERVENTION WAS MEASURED USING A RANDOMIZED CONTROLLED TRIAL DESIGN. GOAL DESCRIPTION ALL PARTICIPANTS WILL INCREASE THEIR NUTRITIONAL KNOWLEDGE ABOUT PROTEIN AND DIETARY FIBER AND 10% WILL INCREASE THEIR CONFIDENCE IN HEALTHY COOKING. GOAL STATUS ONE-HUNDRED PERCENT OF PARTICIPANTS INCREASED KNOWLEDGE OF PROTEIN AND DIETARY FIBER. NINETEEN (19%)PERCENT INCREASED THEIR CONFIDENCE IN HEALTHY COOKING. GOAL DESCRIPTION TWENTY-FIVE PERCENT (25%) OF PARTICIPANTS WILL IMPROVE BLOOD GLUCOSE LEVELS. GOAL STATUS FORTY-TWO PERCENT (42%) OF PARTICIPANTS IMPROVED BLOOD GLUCOSE LEVELS. GOAL DESCRIPTION TWENTY-FIVE PERCENT (25%) OF PARTICIPANTS WILL IMPROVE BODY MASS INDEX. GOAL STATUS FORTY-FIVE PERCENT (45%) OF PARTICIPANTS IMPROVED BODY MASS INDEX. GOAL DESCRIPTION TWENTY-FIVE PERCENT (25%) OF PARTICIPANTS WILL IMPROVE TOTAL CHOLESTEROL LEVELS. GOAL STATUS FIFTY-FOUR PERCENT (54%) OF PARTICIPANTS IMPROVED TOTAL CHOLESTEROL LEVELS. PARTNER NAME, DESCRIPTION AND WEB ADDRESS YMCA CAPE COD WWW.YMCACAPECOD.ORG NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) CAPE COD WWW.NAMICAPECOD.ORG CONTACT INFORMATION LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED
BARNSTABLE COUNTY TICK TESTING AND TICK DISEASE SURVEILLANCE	PROJECT PROGRAM TYPE GRANT/DONATION/FOUNDATION/SCHOLARSHIP STATEWIDE PRIORITY CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS EOHHS FOCUS ISSUE(S) (OPTIONAL) NOT SPECIFIED DON HEALTH PRIORITIES (OPTIONAL) NOT SPECIFIED BRIEF DESCRIPTION OR OBJECTIVE CCHC COMMUNITY BENEFITS SUBSIDIZED A TICK DISEASE TESTING AND TICK-BORNE ILLNESS SURVEILLANCE PROGRAM FOR BARNSTABLE COUNTY RESIDENTS. TICK-TESTING WAS PROVIDED BY THE UMASS LABORATORY OF MEDICAL ZOOLOGY AND EDUCATION AND SURVEILLANCE WAS PROVIDED BY THE CAPE COD COOPERATIVE EXTENSION. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: OTHER: LYME DISEASE - SEX: ALL - AGE GROUP: ALL - ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION TICKS SUBMITTED BY BARNSTABLE COUNTY RESIDENTS WILL BE TESTED BY THE UMASS LABORATORY OF MEDICAL ZOOLOGY FOR EPIDEMIOLOGICAL AND INFECTION STATUS. RESULTS ARE REPORTED BACK TO RESIDENTS. GOAL STATUS IN TOTAL, 863 TICKS WERE SUBMITTED BY RESIDENTS FOR TESTING. RESULTS BASED ON A SUBSET OF TESTED ADULT DEER TICKS (391) DEMONSTRATED A 39% POSITIVE TEST LYME DISEASE, 9% TESTED POSITIVE FOR BABESIOSIS, AND 6% TESTED POSITIVE FOR ANAPLASMOSIS. GOAL DESCRIPTION REGIONAL EDUCATION REGARDING TICK BITE PREVENTION, TICK DISEASE RISK AND TICK TESTING OPPORTUNITIES WILL BE PROVIDED THROUGH COMMUNITY PRESENTATIONS, WORKSHOPS, EVENTS AND MEDIA OPPORTUNITIES. GOAL STATUS OVER 15,000 TICK TESTING PROGRAM BROCHURES WERE DISTRIBUTED TO RESIDENTS THROUGH PHYSICIAN OFFICES, LIBRARIES AND OTHER COMMUNITY SETTINGS. EPIDEMIOLOGY STAFF FROM THE CAPE COD COOPERATIVE EXTENSION CONDUCTED MORE THAN 70 EDUCATIONAL WORKSHOPS AND CONTRIBUTED TO VARIOUS MEDIA OPPORTUNITIES TO EDUCATE THE PUBLIC ON TICK BITE PREVENTION AND TESTING. PARTNER NAME, DESCRIPTION AND WEB ADDRESS CAPE COD COOPERATIVE EXTENSION WWW.CAPECODEXTENSION.ORG UMASS LABORATORY OF MEDICAL ZOOLOGY WWW.TICKDISEASES.ORG CONTACT INFORMATION LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED HEALTHY PARKS, HEALTHY PEOPLE: A COLLABORATION BETWEEN CAPE COD HEALTHCARE AND THE CAPE COD NATIONAL SEASHORE PROGRAM TYPE COMMUNITY PARTICIPATION/CAPACITY BUILDING INITIATIVE,GRANT/DONATION/FOUNDATION/SCHOLARSHIP,HEALTH SCREENING,PREVENTION STATEWIDE PRIORITY CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS EOHHS FOCUS ISSUE(S) (OPTIONAL) CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES DON HEALTH PRIORITIES (OPTIONAL) BUILT ENVIRONMENT, SOCIAL ENVIRONMENT BRIEF DESCRIPTION OR OBJECTIVE CAPE COD HEALTHCARE COLLABORATED WITH THE CAPE COD NATIONAL SEASHORE TO PROMOTE WELLNESS, EXERCISE AND PHYSICAL ACTIVITY TO IMPROVE THE HEALTH OF CAPE COD RESIDENTS AND VISITORS. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: OTHER: HYPERTENSION, OTHER: STROKE, OVERWEIGHT AND OBESITY, PHYSICAL ACTIVITY - SEX: ALL - AGE GROUP: ALL - ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION ENGAGE RESIDENTS IN SEASONAL WALKING PROGRAM AND 5K RUN/WALK FOR HEART HEALTH AIMED AT IMPROVING HEALTH KNOWLEDGE AND AWARENESS OF FREE AND OPEN SPACES FOR PHYSICAL ACTIVITY IN REGION. GOAL STATUS OVER 220 RESIDENTS PARTICIPATED IN THE SUMMER WALKING PROGRAM AND 5K RUN/WALK FOR HEART HEALTH AT THE CAPE COD NATIONAL SEASHORE. PARTNER NAME, DESCRIPTION AND WEB ADDRESS NATIONAL PARK SERVICE WWW.NPS.GOV/.../HEALTHY-PARKS-HEALTHY-PEOPLE CAPE COD NATIONAL SEASHORE WWW.NPS.GOV/CACO/INDEX.HTM CONTACT INFORMATION LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED LIVING FIT FOR YOU! CANCER WELLNESS PROGRAM AT FALMOUTH HOSPITAL PROGRAM TYPE DIRECT SERVICES STATEWIDE PRIORITY CHRONIC DISEASE MANAGEMENT IN DISADVANTAGE POPULATIONS, PROMOTING WELLNESS OF VULNERABLE POPULATIONS EOHHS FOCUS ISSUE(S) (OPTIONAL) CHRONIC DISEASE WITH FOCUS ON CANCER, HEART DISEASE, AND DIABETES DON HEALTH PRIORITIES (OPTIONAL) NOT SPECIFIED BRIEF DESCRIPTION OR OBJECTIVE LIVING FIT FOR YOU IS A FREE, STRUCTURED, AND MEDICALLY-SUPERVISED SIX-WEEK EXERCISE AND EDUCATION PROGRAM FOR CANCER SURVIVORS, BEFORE, DURING OR AFTER TREATMENT. ACTIVITIES FOCUS ON IMPROVING FATIGUE, DE-CONDITIONING AND A LOSS OF PHYSICAL FUNCTION. TARGET POPULATION REGIONS SERVED: COUNTY-BARNSTABLE - HEALTH INDICATOR: MENTAL HEALTH, OTHER: CANCER, OTHER: CANCER - BREAST, OTHER: CANCER - CERVICAL, OTHER: CANCER - COLO-RECTAL, OTHER: CANCER - LUNG, OTHER: CANCER - MULTIPLE MYELOMA, OTHER: CANCER - OTHER, OTHER: CANCER - OVARIAN, OTHER: CANCER - PROSTATE, OTHER: CANCER - SKIN, OTHER: CHRONIC PAIN , OTHER: NUTRITION, PHYSICAL ACTIVITY - SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL - LANGUAGE: ALL GOAL DESCRIPTION PROVIDE FREE EXERCISE AND EDUCATION CLASSES FOR CANCER SURVIVORS OF ALL AGES. GOAL STATUS IN FY17, 219 EXERCISE AND EDUCATION CLASSES WERE OFFERED. OVER 646 PATIENT ENCOUNTERS TOOK PLACE INCLUDING EXERCISE VISITS, INDIVIDUAL CONSULTATIONS, AND EDUCATION FOLLOW-UP MEETINGS. GOAL DESCRIPTION REFERRALS WILL BE MADE TO APPROPRIATE SERVICES TO CONTINUE REHABILITATION AND IMPROVED HEALTH OUTCOMES. GOAL STATUS EIGHTY-FOUR REFERRALS WERE MADE TO NUTRITIONISTS AND DIABETES EDUCATORS, SOCIAL WORKERS, PHYSICAL OR OCCUPATIONAL THERAPIST, OR FREE-COMMUNITY-BASED COMPLIMENTARY SERVICES SUCH AS MASSAGE, ACUPUNCTURE, AND YOGA. PARTNER NAME, DESCRIPTION AND WEB ADDRESS CAPE COD HEALTHCARE WWW.CAPECODHEALTH.ORG/CLASSES-EVENTS CAPE WELLNESS COLLABORATIVE WWW.CAPEWELLNESS.ORG CONTACT INFORMATION LISA GUYON, DIRECTOR OF COMMUNITY BENEFITS, CAPE COD HEALTHCARE, 88 LEWIS BAY ROAD, HYANNIS, MA 02601, PHONE:508-862-7896, LGUYON@CAPECODHEALTH.ORG DETAILED DESCRIPTION NOT SPECIFIED
FUNCTIONAL EXPENSE NOTE	FORM 990, PART I AND PART IX FUNDRAISING IS CONDUCTED ON BEHALF OF CAPE COD HEALTHCARE, INC. BY CAPE COD HEALTHCARE FOUNDATION, INC. CERTAIN OFFICERS ARE COMPENSATED BY CAPE COD HEATHCARE, INC. FUNDS RAISED ARE REPORTED AT CAPE COD HEALTHCARE, INC. AND AFFILIATES. FORM 990, PART I, LINE 6 CAPE COD HEALTHCARE, INC.'S VOLUNTEERS INCLUDE ITS TRUSTEES. FORM 990, PART VI, LINE 2 TRUSTEES SIT ON THE BOARDS OF THE FOLLOWING: EMERALD PHYSICIANS MEMBER TRUST: PHILIP MCLOUGHLIN JOEL CROWELL CAPE HEALTH INSURANCE COMPANY: MICHAEL K LAUF MICHAEL L CONNORS MICHAEL G JONES SUMNER B TILTON, JR PHILIP MCLOUGHLIN PATRICK J FLYNN, MD THE MEMBERS OF CAPE COD HEALTHCARE, INC.'S BOARD ALSO SIT ON THE BOARD OF CAPE COD MEDICAL OFFICE BUILDING AND EMERALD PHYSICIAN SERVICES, LLC, FOR-PROFIT RELATED ORGANIZATIONS. FORM 990, PART VI, LINES 6&7(A) THE ORGANIZATION HAS MEMBERS/INCORPORATORS WHO ELECT THE ORGANIZATION'S TRUSTEES. FORM 990, PART VI, LINE 7(B) THE DECISIONS OF THE GOVERNING BODY THAT NEED APPROVAL BY ITS MEMBERS/INCORPORATORS INCLUDE APPROVAL OF CHANGES MADE TO THE CORPORATION'S BYLAWS AND APPROVAL WHEN THERE IS A DIVESTING OF ONE OF THE MAJOR AFFILIATES OF THE ORGANIZATION. FORM 990, PART VI, LINE 11 THE ORGANIZATION'S FORM 990 IS REVIEWED AT SEVERAL LEVELS. THE ORGANIZATION ENGAGES A PUBLIC ACCOUNTING FIRM TO ASSIST IN THE PREPARATION AND REVIEW OF ITS FORM 990 AND WHO SIGNS AS PAID PREPARER. SENIOR MANAGEMENT OF THE ORGANIZATION IS RESPONSIBLE FOR THE TIMELY PREPARATION OF FORM 990. THE COMPLETED FORM 990, WITH THE EXCEPTION OF AN ANONYMOUS DONOR, IS PROVIDED TO THE FINANCE COMMITTEE AND THE ENTIRE BOARD IN ADVANCE OF THE FILING DEADLINE. FORM 990, PART VI, LINE 12 THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY AND REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THIS POLICY. ON AN ANNUAL BASIS, EACH TRUSTEE, OFFICER AND EMPLOYEE AT THE SENIOR MANAGEMENT LEVEL COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM. THE FORMS ARE REVIEWED BY CAPE COD HEALTHCARE, INC.'S ("CCHC") DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE WHO PREPARES A SUMMARY FOR CCHC'S COMPLIANCE OFFICER. ANY MATERIAL INTERESTS SO DISCLOSED ARE PRESENTED TO THE CORPORATION'S GOVERNANCE COMMITTEE FOR REVIEW AND RESOLUTION. ALL DISCLOSURE STATEMENTS SUBMITTED BY EMPLOYEES WILL BE REVIEWED BY HUMAN RESOURCES AND/OR CCHC'S DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE. FOR ANY DISCLOSURE THAT IS CONSIDERED SUBSTANTIVE THE EMPLOYEE'S AREA MANAGER WILL BE CONSULTED TO DETERMINE IF THE SITUATION IS GENERALLY ACCEPTABLE, REQUIRES FURTHER EXAMINATION AND POSSIBLE ACTION OR IS GENERALLY NOT ACCEPTABLE. ANY ACTION PLAN CREATED TO MANAGE A CONFLICT OF INTEREST WILL BE MONITORED BY THE EMPLOYEE'S AREA MANAGER OR SUPERVISOR. FORM 990, PART VI, LINE 15 THE ANNUAL PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, OFFICERS, EXECUTIVES AND KEY EMPLOYEES INCLUDE THE FOLLOWING: CEO - COMPENSATION WILL BE DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, AND WILL INCLUDE CONSIDERATION OF RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. OFFICERS, EXECUTIVES AND KEY EMPLOYEES - OFFICER, EXECUTIVE AND KEY EMPLOYEE COMPENSATION WILL BE DETERMINED BY THE CEO AND WILL INCLUDE CONSIDERATION OF RECENT RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. THE CEO'S DETERMINATION OF SUCH COMPENSATION WILL BE SUBJECT TO THE APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED IN THE MEETING MINUTES.
FORM 990, PART VI, LINE 19	THE ORGANIZATION MAKES ITS BYLAWS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THE ANNUALLY FILED FORM PC, A PUBLICLY DISCLOSED TAX-EXEMPT ORGANIZATION FILING FOR THE STATE OF MASSACHUSETTS.
FORM 990, PART VII, COLUMN (B)	THE INDIVIDUALS REPORTED AS RECEIVING COMPENSATION FROM A RELATED ORGANIZATION IN COLUMNS (E) AND (F) IN PART VII ARE EMPLOYEES AT CAPE COD HEALTHCARE, INC., A TAX-EXEMPT RELATED ORGANIZATION. FORM 990, PART VII, SECTION A TITLE FOR KEVIN MULROY: CHIEF OPERATING OFFICER (UNTIL 6/16), SVP CHIEF QUALITY & SAFETY OFFICER (AS OF 6/16) TITLE FOR JEFFREY S DYKENS: COO FALMOUTH HOSPITAL (UNTIL 6/16), VP FINANCE & OPERATIONS (AS OF 6/16) TITLE FOR CARTER HUNT: EXECUTIVE DIRECTOR - HOSPITAL/MEDICAL/SURGICAL PRACTICES (UNTIL 5/17), ADMINISTRATOR OF PRIMARY CARE (AS OF 5/17) TITLE FOR DEWITT DAVENPORT: VICE CHAIRMAN (UNTIL 5/17), CHAIRMAN (AS OF 5/17), TRUSTEE TITLE FOR NOELENE CERVIN: VP BUDGETING AND OPERATIONAL SUPPORT (AS OF 7/16) FORM 990, PART VII, SECTION B WITH THE EXCEPTION OF REPORTING FOR VISITING NURSE ASSOCIATION OF CAPE COD, INC, CAPE COD HEALTHCARE, INC. PAYS INDEPENDENT CONTRACTORS ON BEHALF OF ITS AFFILIATES WHO FILE AS PART OF A GROUP FORM 990 AS CAPE COD HEALTHCARE, INC. AND AFFILIATES.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS OR FUND BALANCES NET ASSETS RELEASED FROM RESTRICTION (4,931,497) TRANSFERS TO/FROM AFFILIATES (6,808,788) CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT 1,985,924 CHANGE IN VALUE OF BENEFICIAL INTEREST 1,067,696 TRANSFER OF NET ASSETS (20,000) OTHER CHANGES TO NET ASSETS 68,179 CONTRIBUTIONS ELIMINATIONS 3,795,833 -------------- ($4,842,653)
AFFILIATES INCLUDED IN GROUP RETURN:	CAPE COD RESEARCH INSTITUTE, INC. 27-0004441 IS FILING A SEPARATE FORM 990 FOR THE PERIOD OF 1/1/17-9/30/17 AND WILL BE INCLUDED IN THE GROUP RETURN EFFECTIVE SEPTEMBER 30, 2018. CAPE COD RESEARCH INSTITUTE, INC. CAN BE REACHED AT: 297 NORTH STREET, BUILDING #3, HYANNIS, MA 02601

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CAPE COD HEALTHCARE INC
297 NORTH STREET BLDG 3	HYANNIS	MA	02601	222600704	PARENT CORP	MA	501(c) (3)	10	NA	Yes (true)
CAPE COD RESEARCH INSTITUTE INC
297 NORTH ST BLDG 3	HYANNIS	MA	02601	270004441	RESEARCH	MA	501(C)(3)	10	CCHC	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

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

US Address USAddress

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

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

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Controlled OrganizationControlledOrganizationInd	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Legal Domicile StateLegalDomicileStateCd	OwnershipOwnershipPct
CAPE HEALTH INSURANCE COMPANY
PO BOX 1051GT	GRAND CAYMAN	CJ	981230418	INSURANCE	CJ	CAPE COD HLTHCR	C CORP	$0	$0	Yes (true)
CAPE COD MEDICAL OFFICE BUILDING INC
			042423073	RENTAL SRVCE		NA	C CORP	$11,250	$15,000	Yes (true)	27 PARK STREET	HYANNIS	MA	02601	MA	1.00000
POOLED INCOME FUNDS (2)
				SUPPORT		NA				Yes (true)					MA
EMERALD PHYSICIAN SERVICES LLC
			043369730	PRIMARY CARE		EMERALD TRUST	S CORP	$29,518,252	$17,352,931	Yes (true)	433 WEST MAIN STREET	HYANNIS	MA	02601	MA	1.00000
EMERALD PHYSICIANS MEMBER TRUST
			467220648	EMRLD SHAREHO		MACC	TRUST	$0	$0	Yes (true)	27 PARK STREET	HYANNIS	MA	02601	MA	1.00000
CHARITABLE REMAINDER TRUSTS (20)
				SUPPORT		NA									MA

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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

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

Field	Value	IRS element (for citing)
Transaction Type	R	TransactionTypeTxt
Involved	$2,491,282	InvolvedAmt
Method Of Amount Determination	FMV	MethodOfAmountDeterminationTxt

Affiliate Listing AffiliateListing

Affiliate Listing AffiliateListingGrp (9 entries)

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