2016-08-12T10:25:36-05:00 2015-09-30 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2014-10-01 042104298 Hebrew Rehabilitation Center % JAMES D HART CFO HEBR 6173638000 1200 CENTRE STREET BOSTON MA 02131 JAMES D HART CFO 6173638000 2016-08-11 true benjamin pitchkites P00362066 3176817000 2014 2016-09-27 15:27:22Z Louis J WoolfPresident CEO 1200 Centre Street BOSTON MA 02131 132761912 false X www.hebrewseniorlife.org X 1903 MA TO OPERATE ITS HARVARD MEDICAL SCHOOL AFFILIATED CHRONIC CARE HOSPITAL THAT PROVIDES SENIORS WITH COMPASSIONATE LONG-TERM, POST-ACUTE CARE, (SEE SCHEDULE O) 4 2 1871 350 257879 9700133 10478173 114485415 119593142 600667 675181 51103 30879 124837318 130777375 0 0 0 0 93879945 91741866 0 0 0 39442980 45252146 133322925 136994012 -8485607 -6216637 45014394 44139035 111921581 126108800 -66907187 -81969765 X TO OPERATE ITS HARVARD MEDICAL SCHOOL AFFILIATED CHRONIC CARE HOSPITAL THAT PROVIDES SENIORS WITH COMPASSIONATE LONG-TERM CARE, POST-ACUTE CARE, OUTPATIENT SERVICES AND ADULT DAY HEALTH CARE. false false 113664682 0 116568620 HEBREW REHABILITATION CENTER (HRC) IN ROSLINDALE IS HEBREW SENIORLIFE'S FLAGSHIP HEALTH-CARE FACILITY AND IS KNOWN NATIONALLY AS A LEADING PROVIDER OF GERIATRIC HEALTH-CARE SERVICES. LICENSED AS A CHRONIC CARE HOSPITAL, HRC'S FULL-TIME STAFF OF PRIMARY CARE GERIATRICIANS AND NURSE PRACTITIONERS ARE SOME OF THE FINEST GERIATRICS SPECIALISTS IN THE GREATER BOSTON AREA. HRC IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND SOME STAFF PHYSICIANS ALSO HOLD FACULTY APPOINTMENTS THERE. 6966925 0 734736 THE INSTITUTE FOR AGING RESEARCH (IFAR), A DIVISION OF HEBREW REHABILITATION CENTER, SEEKS TO TRANSFORM THE HUMAN EXPERIENCE OF AGING BY ENSURING A LIFE OF HEALTH, DIGNITY AND PRODUCTIVITY INTO ADVANCED AGE. IFAR'S MISSION IS TO CONDUCT RESEARCH THAT DISCOVERS THE MECHANISMS OF AGE-RELATED DISEASE AND DISABILITY; LEADS TO THE PREVENTION, TREATMENT AND CURE OF DISEASE; ADVANCES THE STANDARD OF CARE FOR OLDER PEOPLE; INFORMS PUBLIC DECISION-MAKING; AND DEVELOPS THE NEXT GENERATION OF LEADERS IN AGING RESEARCH. 2232743 0 2289786 THE REMAINING PROGRAM SERVICE RELATED EXPENSES INCLUDE TEACHING, FELLOWSHIPS, A VARIETY OF ANCILLARY PROGRAMS AND OTHER MISCELLANEOUS SERVICES. 122864350 true true false true false false false false true false true true false false true false false true false false false false false false false false true true false false true true false false false false false false false false false false true false false false false true true true false false true 159 0 true 1871 true true true false false false false false false false false false X 4 2 false false false false true true true true true false false true true true true true true false true false MA X JAMES D HART CFO 6173638770 1200 CENTRE STREET BOSTON MA 02131 MARSHA COHEN TREASURER 1.0 3.5 X X 0 0 0 LOUIS J WOOLF President & CEO 10.0 40.0 X X 0 806702 133140 JAMES D HART CFO & Secretary 12.0 38.0 X X 0 348736 48927 TODD FINARD CHAIR 1.0 3.5 X X 0 0 0 GREGORY TOOT COO 50.0 0.0 X 198455 0 30909 FRANCIS X HINCKLEY CIO, THRU MAY 2015 15.0 35.0 X 0 219562 54195 PETER INGRAM CIO, FROM July 27, 2015 15.0 35.0 X 0 0 0 KATELYN QUYNN VP, DEVELOPMENT 3.0 47.0 X 0 378453 65073 MARY MOSCATO President, HSL Health Care Srv 40.0 10.0 X 313113 0 55957 ROBERT J SCHREIBER MEDICAL DIRECTOR 50.0 0.0 X 292375 0 55144 LEWIS LIPSITZ Director, IFAR 50.0 0.0 X 316588 0 48068 HASSAN ARIF HOSPITALIST 50.0 0.0 X 274387 0 53529 SHARON K INOUYE Director, Aging Brain 50.0 0.0 X 314234 0 31432 HELEN CHEN CHIEF MEDICAL OFFICER 50.0 0.0 X 329616 0 38631 2038768 1753453 615005 113 false true false THE BRIDGESPAN GROUP 2 COPLEY PLACE SUITE 3700B BOSTON MA 02116 STRATEGY CONSULTANT 293846 QUEST DIAGNOSTICS INC 5763 COLLECTION CENTER DRIVE CHICAGO IL 60693 LAB SERVICES 282774 HART ASSOCIATES CO ETRANSMEDIA 385 JORDAN ROAD TROY NY 12180 REVENUE BILLING 256782 STUDER GROUP LLC PO BOX 71676 CHICAGO IL 60694 HEALTHCARE CONSULTAN 209513 THE ADVISORY BOARD COMPANY PO BOX 74961 BALTIMORE MD 212790461 TECH. 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OF THE TOTAL DUES PAID, $5,725 WAS USED FOR LOBBYING FOR ELDER CARE. false true X 202364 202364 56865736 50342804 6522932 58380298 49526740 8853558 3256311 1790423 1465888 17044742 PARENT INVESTMENT POOL 2253697 F 2253697 0 Pension Obligation 28083663 DUE TO AFFILIATES 67267109 ASSET RETIREMENT OBLIGATION 476645 95827417 AMOUNTS HELD FOR RESIDENTS SCHEDULE D, PART IV, LINE 2 DEPOSITS CONSIST OF FUNDS HELD FOR RESIDENTS FOR THEIR PERSONAL USE. IT IS REFERRED TO AS THE RESIDENTS' BANK, AS ALLOWED BY MEDICAID. EACH MONTH, $75 OF A RESIDENT'S SOCIAL SECURITY PAYMENT WILL GO TO THE RESIDENTS' BANK FOR HIS/HER PERSONAL USE. THE REMAINDER GOES TO PAY FOR HIS/HER CARE. ASC 740 DISCLOSURE SCHEDULE D, PART X, LINE 2 THE FINANCIAL STATEMENTS IN WHICH HEBREW REHABILITATION CENTER ARE CONSOLIDATED DO NOT INCLUDE A FOOTNOTE RELATED TO FIN 48/ASC 740. true true X true X true X true false true true 8619 8619 0.00010 73736231 71469369 2266862 0.01650 0 0 0 0.00000 73744850 71469369 2275481 0.01660 1422228 281396 1140832 0.00830 282262 0 282262 0.00210 15694010 12922660 2771350 0.02020 11198226 9330303 1867923 0.01360 0 0 0 0.00000 28596726 22534359 6062367 0.04420 102341576 94003728 8337848 0.06080 349268 0 349268 0.00250 349268 0 349268 0.00250 true 893494 354957 8140270 8299632 -159362 X true true 1 1 HEBREW REHABILITATION CENTER 1200 CENTRE STREET ROSLINDALE MA 02131 WWW.HEBREWSENIORLIFE.ORG 2290 X X X X HEBREW REHABILITATION CENTER 1 false false true X X X X X X X X 13 true false false true X see part v, section c true 14 true SEE PART V, SECTION C false false true X 200. 400. X X X true true X X true X true false X X false X X false false FORM 990, SCHEDULE H, PART V, LINE 5 The primary vehicle for gathering community input was an an online survey of community leaders, academics, Ageing Services Access Point (ASAPs), adult day health and home health agencies. These individual or organizations serve or represent members of the medically underserved, low income or minority populations in the community. FORM 990, SCHEDULE H, PART V, LINE 7A http://www.hebrewseniorlife.org/community-health-needs-assessment FORM 990, SCHEDULE H, PART V, LINE 10A HTTP://WWW.HEBREWSENIORLIFE.ORG/WORKFILES/HEALTHCARAE/OUTPATIENT/COMMUNITY _HEALTH_NEEDS_ASSESSMENT.PDF FORM 990, SCHEDULE H, PART V, LINE 11 In 2013, HEBREW REHABILITATION CENTER, INC. (hrc) conducted a Community Health Needs Assessment (CHNA). In response to these findings, HRC developed an implementation plan documenting goals, our current services, and our action plan and timeline. As a chronic care hospital that primarily serves a community of seniors via long-term care, post-acute care, adult day health and outpatient services, we know first-hand the health challenges of older populations. Our primary community is comprised of seniors and low income seniors, 65+, in certain neighborhoods of Boston, and the towns of Brookline, Dedham, Needham, Newton and Westwood. The senior community is the fastest growing population segment in Massachusetts. Approximately one in four households has at least one person 65 years old or older. At HRC, it is always our priority to keep seniors healthy and safe in their homes for as long as possible. From flu clinics to caregiver training sessions, we put significant emphasis on educating seniors and their loved ones on the necessary steps and care needed to remain independent. From 2012 through 2013, we researched and evaluated the needs of our community and the services we offer as well as those offered by others within and around the communities we serve. Several of our local communities have chronic disease and co-morbidity rates higher than the Boston and state averages. Our goal, ultimately, was to understand how we can move forward deliberately to meet the guidelines that the U.S. Department of Health and Human Services outlined for seniors in its Healthy People 2020 Report and better address the health needs of seniors in our community. Our findings clearly indicate that HRC already aligns with Healthy People 2020 in the areas of prevention, long-term services and supports for our seniors. However, the CHNA findings show that seniors in our communities also need assistance with the following: - Transportation - Diabetes care, screening and education - Educational and informational services around chronic diseases - Falls prevention - Mental health and depression counseling, services - Access to various geriatric specialists. HRC's CHNA also examined existing medical facilities in our community. According to U.S. News and World Report, there are 75 hospitals in Metro Boston alone (including Boston, Brookline, Cambridge and Chelsea). Of these, 14 are among the top ranking/high performing facilities in the country. From teaching hospitals to community health centers, Boston is a world-renowned medical destination. A significant number of additional hospitals, major care practices and community health facilities add to the depth of medical services available in our local communities. With so many world-class health facilities in the Greater Boston area, patients from all over the world come to Boston for treatment, and physicians from around the world come to train and practice cutting-edge techniques. Seniors in our local communities need go no further than their Boston doorstep to leverage the world's greatest medical minds and facilities. In determining priorities in light of the local medical community, our CHNA considered the degree of community need for additional resources, our ability to meet that need through our experience, expertise and programming, and the capability of other organizations to meet that same need. We determined that our priority is to work closely with patients to provide access to that great care, whether at HRC or our sister health care organizations. Even in a medically resource-rich area such as Greater Boston, it is still true that seniors fall through the cracks or do not have the resources required to navigate through the wealth of services and supports available to them. Economic concerns, as well as feelings of helplessness, loneliness, fear of potential discrimination or not understanding the medical care plan can be too much for a family or caregiver, let alone the senior him/herself. So while HRC already teams with its fellow world-class medical facilities in the Greater Boston area, and offers many community oriented programs, ongoing work is being done to effectively reach seniors in the communities of Roslindale, Brighton, West Roxbury, Jamaica Plain, Hyde Park, Dorchester, Roxbury, Brookline, Dedham, Needham, Newton and Westwood. HRC, its clinical team and its staff are active in the communities in which our facilities operate. From extensive chronic disease prevention and management education, to participation in community health fairs, to free educational resources, we are committed to senior health. Our implementation plan includes the following goals and action plans: - Transportation Resource Education: Educate community seniors about transportation resources available to help them maintain a healthy lifestyle and remain independent and in the community - Telehealth Expansion: Expand the HSL Home Care telehealth program to encompass diabetes management - Assess Risk Factors for Falls: Through the long-standing National Institute on Aging-funded MOBILIZE Boston study, assess seniors living in the community for risk factors for falls - Self-Management Training: Provide educational programs to help community seniors improve self-management of their diabetes and chronic diseases, and to prevent falls - Depression Screening: Introduce a new offering of depression screening services to Brookline seniors - Specialist Access: Increase access to HSL's geriatric specialists to community seniors in Brookline and Dedham. form 990, schedule h, part v, line 13h Hebrew Rehabilitation Center, Inc. uses Medicaid eligibility to determine eligibility for financial assistance. FORM 990, SCHEDULE H, PART V, LINE 21D HRC is a chronic care hospital and does not have an emergency department; all admissions are elective and are not for emergency services. Inpatients requiring emergency care that HRC cannot provide are transported, regardless of financial assistance status, to local acute care hospitals for appropriate treatment. FORM 990, SCHEDULE H, PART V, LINE 22D HRC uses Medicaid and Medicare payment rates to determine amounts due from FAP-eligible individuals. SUPPLEMENTAL INFORMATION Hebrew Rehabilitation Center (HRC) operates a 725-bed licensed chronic care hospital consisting of a 505-bed facility in the Roslindale section of Boston, MA and a 220-bed satellite facility in Dedham, MA (also known as the NewBridge Health Care Center, on the campus of the continuing care retirement community operated by NewBridge on the Charles, Inc.). HRC leases space from NewBridge on the Charles, Inc., an affiliated entity, to operate the 220-bed satellite. HRC also operates outpatient clinic satellites on the NewBridge campus, and in Canton, MA and Brookline, MA. Hebrew SeniorLife, Inc. (HSL), a regional and emerging national thought leader in senior health care, senior living, research and teaching, is HRC's sole member and also provides management services to HRC. HRC is accredited by CARF (Commission on Accreditation of Rehabilitation Facilities), and is the only geriatric specialist affiliated with Harvard Medical School. HRC provides a continuum of care to the senior community, focusing on the most frail and needy of the local senior population. Services provided by HRC include long-term care, medical acute care, post-acute rehabilitative care, primary and specialty care, outpatient clinics, outpatient rehabilitative services, and adult day care. In 2013, HSL introduced HSL Hospice Care to provide community hospice care. See Form 990 Part III Line 4A program service description. FORM 990, SCHEDULE H, PART I, LINE 6A HRC's annual community benefits report is prepared using the name of HRC's sole member, Hebrew SeniorLife, Inc. FORM 990, SCHEDULE H, PART I, LINE 7G The reported subsidized health services include costs of HRC's outpatient clinics, which operate at small volume at the Roslindale facility and at larger volume at HRC's satellite facilities in Dedham, Canton, and Brookline. These are hospital-based clinics utilizing primarily HRC-employed physicians and nurse practitioners, with direct costs in FY15 of $1,510,939. Other subsidized health services were for HRC's Recuperative Services Unit, Adult Day Care and Outpatient Rehabilitation programs. FORM 990, SCHEDULE H, PART I, LINE 7 COLUMN (F) Hebrew Rehabilitation Center, Inc. follows a standard accounting practice to calculate the amount to reserve on the balance sheet for future bad debts. Increases to the reserve are expensed in the provision for bad debts. Hebrew Rehabilitation Center, Inc. has used the proportion of self-pay reserve to the total required reserve to determine the amount of bad debt expense that is attributable to those eligible for financial assistance. FORM 990, SCHEDULE H, PART I, LINE 7 The costing methodology used is based primarily on the standard cost accounting methods of the Massachusetts state DHCFP-403 Cost Report for FY15 which follows the standard Medicare cost accounting principles of the Medicare Cost Report. To cost some specific programs, a Cost to Charge ratio specific to each program was developed. FORM 990, SCHEDULE H, PART II The $349,268 of Workforce Development represents HRC's Career Development programs for Certified Nurse Assistants (CNAs) and other staff. Included in this amount are costs of onsite remedial classes in math, ESOL, and reading for our employees. An outside vendor provides classes for 10 months of every year with the students meeting two times per week for two hours each class. For each class, HSL pays for one hour as release time and the employee attends one hour on their own time. The students also receive progress reports. These classes help prepare employees to pass the College Placement Test (CPT) so they are able to move on to degree programs. In FY12 this program received a $300K three-year grant from The Boston Foundation for the program "Advanced Career Path for CNAs: Creating Frontline Leaders." This unique nursing specialty certification program will enhance the skill set of CNAs and improve the quality of care that seniors receive; it is an extension of HSL's existing career development programs and is a replicable model for professional development. HRC serves as a primary training facility across a number of health-care disciplines for academic institutions in the Greater Boston area, including Harvard Medical School. HRC participates in the University of Massachusetts nursing program in which RNs employed by HSL may apply to UMass for a scholarship for their Bachelor in Nursing Degree. Over 800 students annually train at HRC in a wide of health professions including medicine, nursing, recreational therapy, pharmacy, dentistry, physical, occupational, and speech therapy, clinical pastoral and social work. HRC's SummerWorks Program, in partnership with Action for Boston Community Development (ABCD), provides high school students with summertime work experience in the Active Living Program. This initiative provides these students with training and hands-on experience in geriatrics in a health care setting. As part of its coalition building activity, HRC is actively involved in the Multicultural Coalition on Aging (MCA), and hosts the coalition's monthly meetings. The MCA is comprised of approximately 200 organizations and individuals serving seniors who have cultural and linguistic barriers to health-care information. The MCA has sponsored 11 bi-annual health and wellness conferences in which the curriculum is delivered in 10 different languages: English, Creole, Haitian Creole, Spanish, Portuguese, Vietnamese, Chinese, Cambodian, Russian, and Sub-Saharan African. These conferences usually serve about 350 seniors and are sponsored through the MCA member organizations. In FY15 there were 10 monthly MCA meetings and 1 Consumer Conference reaching total of 576 professionals and consumers. Most of monthly meetings include a speaker on issues relevant to cultural diversity. Other economic development, physical improvements, and environmental benefits were identified but not specifically costed in Part II. FORM 990, SCHEDULE H, PART III, LINE 2 HRC records provision for doubtful accounts as the amount needed to adjust the reserve, which is based on estimated percentages of accounts receivable by payor and aging category. THE COSTING METHODOLOGY USED IS BASED PRIMARILY ON THE STANDARD cost ACCOUNTING METHODS OF THE MASSACHUSETTS STATE CHIA (formerly D-403) COST REPORT FOR FY14 WHICH FOLLOWS THE STANDARD MEDICARE COST ACCOUNTING PRINCIPLES OF THE MEDICARE COST REPORT. TO COST SOME SPECIFIC PROGRAMS, A COST TO CHARGE RATIO SPECIFIC TO EACH PROGRAM WAS DEVELOPED. FORM 990, SCHEDULE H, PART III, LINE 4 HRC's financial statement footnotes do not contain a footnote describing bad debt expense. FORM 990, SCHEDULE H, PART III, LINE 8 Line 7 shows a "Medicare deficit" of $159,362 for services other than those reported as part of Subsidized Health Services. The reconciliation to line 7 includes an adjustment needed because the Medicare Cost Report method for computing Medicare allowable costs understates HRC's true costs. the Medicare Cost Report pools routine costs for HRC's long-term care (LTC) and Medical Acute Care Unit (MACU) services, making allowable costs appear low for the MACU Medicare Part A service. The amount on line 6 is the allowable cost as shown on the Medicare Cost Report; therefore "Other" is checked on line 8. $159,362 was HRC's true Medicare deficit (excluding activity reported as part of Subsidized Health Services). HRC treats all patients even if Medicare reimbursement falls short of cost. This level of care is critical to the community. Therefore, the medicare shortfall should be treated as a community benefit. FORM 990, SCHEDULE H, PART III, LINE 9B Patients found to be eligible for assistance through Massachusetts Medicaid (known as MassHealth) or other programs are not pursued through collection efforts but rather are assisted free-of-charge with the MassHealth application and eligibility process through to completion, including any necessary appeals. Hebrew Rehabilitation Center, Inc. treats all patients regardless of Medicare reimbursement, which often falls short of cost. FOR EXAMPLE, Medicare has life time limits on Part A days. Hebrew Rehabilitation Center, Inc. will continue to treat patients whose Medicare benefits have exhausted, or when payment is below cost. The patients are generally too sick to be transferred, so their continued stay is at Hebrew Rehabilitation Center, Inc.'s expense with no additional revenue. The health of the patient and not cost is paramount. FORM 990, SCHEDULE H, PART VI - SECTION 2 In order to proactively address the health needs of the rapidly growing senior population, HSL has worked over the past decades to reach deep into the community to understand and find ways to prevent chronic disease, establish a home health-care service, establish community hospice, expand our senior housing with health-care supports, expand post-acute care, actively reduce LTC beds, and dedicate HRC to a new model of LTC. HRC and HSL continue to assess and to develop programs based on the needs of seniors in our community through regular research aimed at consumers in our service area, including seniors and adult children, and to cultivate professional relationships with influencers such as geriatric care managers, hospital-based case managers, estate and elder law professionals, and clergy, among others. HRC leadership cultivate partnerships with tertiary hospitals in the Greater Boston area to prevent admission and readmission, and to explore ways that older patients may be better served in hospital settings, including direct admission to our post-acute units, thereby bypassing emergency care in acute-care hospitals which are not always the best settings for treating elderly patients. HRC benefits from the wealth of information offered by research studies conducted by HRC's Harvard Medical School-affiliated and HSL- sponsored Institute for Aging Research. Institute findings help HRC providers gain exceptional insight into the special health-care needs of older adults. In 2013 HRC conducted a comprehensive Community Health Needs Assessment (CHNA). Founded with the promise to honor our elders, for 111 years we have served seniors' health care needs in several communities within the city of Boston, and more recently, in the towns of Brookline, Dedham, Needham, Newton and Westwood. As a chronic care hospital, HRC offers long-term care, post-acute care, adult day health and outpatient services. As a hospital that primarily serves a community of seniors, it is always our priority to keep seniors healthy and safe in their homes for as long as possible. From flu clinics to caregiver training sessions, we put a lot of emphasis on educating seniors and their loved ones on the necessary steps and care needed to remain independent. From 2012 through 2013, we researched and evaluated the needs of our community and the services we offer as well as those offered by others within and around the communities we serve. Our goal, ultimately, was to understand how we can move forward deliberately to meet the guidelines that the U.S. Department of Health and Human Services outlined for seniors in its Healthy People 2020 Report and better address the health needs of seniors in our community. Our findings clearly indicate that HRC already aligns with Healthy People 2020 in the areas of prevention, long-term services and supports for our seniors. However, the CHNA findings show that seniors in our communities also need assistance with the following: - Transportation - Diabetes care, screening and education - Educational and informational services around chronic diseases - Falls prevention - Mental health and depression counseling, services - Access to various geriatric specialists. In response to these CHNA findings, HRC developed an Implementation Plan; it was approved by the Board in January 2014. FORM 990, SCHEDULE H, PART VI - SECTION 3 All patients admitted to HRC are counseled by an admissions coordinator about services rendered, billing procedures, patient rights and responsibilities, insurance coverage, and eligibility for assistance as required by guidelines established by the federal Centers for Medicare and Medicaid Services and the Commonwealth of Massachusetts' Department of Public Health. In addition to the admissions coordinator, a fiscal agent for HRC also provides education on eligibility under federal, state and local programs. All admissions documentation is reviewed and signed by the patient or responsible party on behalf of the patient at the time of admission and retained on file. HRC has provided financial assistance to selected adult day care participants since August 1999, covering the costs of transportation (in prior years) and some daily programs. The financial assistance has been essential to those participants who cannot afford to pay privately, but who have periods of ineligibility for MassHealth or other financial subsidies (given that the services are not covered by Medicare or private health insurance plans). FORM 990, SCHEDULE H, PART VI - SECTION 4 Hebrew SeniorLife provides services to seniors. HRC, in Roslindale, at the satellite Health Care Center at the NewBridge on the Charles campus in Dedham, and at the outpatient clinics in Dedham, Canton and Brookline, provides long-term care; post-acute care, including rehabilitative and hospital-level care; specialized geriatric primary and specialty outpatient clinics; outpatient services; hospice services; home health care and private care (through an HSL affiliate); and adult day health care. 95% of the patients of Hebrew Rehabilitation Center and its satellite medical clinics are on Medicare and are older than 65. Our primary community is seniors and low income seniors, 65+, in certain neighborhoods of Boston, and the towns of Dedham, Canton, Brookline, Needham, Newton and Westwood. HRC provides health care services to all without regard to race, religion, color, national origin, gender, sexual orientation, marital status, political persuasion, or qualified handicap. FORM 990, SCHEDULE H, PART VI - SECTION 5 Hebrew Rehabilitation Center contributes to community health in many ways. Part of HRC's mission is to promote the independence of seniors, including by supporting them in their homes and avoiding institutional care. It does this through outpatient care at its satellite clinics supporting senior housing, adult day health programs that help at-risk seniors stay at home, outpatient rehabilitative care designed to prevent rehospitalizations, and by offering many supportive programs and services that improve the physical and mental health and lives of seniors. Seniors learn to take control of their own health and maximize their physical and social vitality in a number of HRC-sponsored wellness programs, including Healthy Eating for Successful Living in Older Adults, A Matter of Balance, Chronic Disease Self-Management, Diabetes Self-Management, Fit For Your Life Exercise, and The Arthritis Foundation Exercise Program. All programs are evidence-based. In FY15, approximaltey 120 free wellness programs (each from 6-8 weeks in duration) offered across Massachusetts communities helped 1500 seniors (more than 10,000 to date) take a more active role in promoting their own good health. In addition, another 19 health information sessions were offered throughout Massachusetts, reaching another 750 participants. HRC's Volunteer department harnesses the energy of over 200 volunteers who provided over 22,000 of worked hours, helping seniors stay connected to the larger community. HRC's Chaplaincy department provides spiritual support, with weekly prayer services (Jewish and ecumenical), pastoral volunteer training, and weekly bible study class. HRC's Palliative Care program helps seniors, families and staff navigate difficult decisions and issues, helping seniors have dignity and comfort at end-of-life. HRC's medical staff, comprised of over 40 employed physicians and nurse practitioners, participate in community activities such as health and wellness lectures to senior groups living in the community in addition to their patient care and teaching activities. Seniors and the professional community are served through sponsored events such as senior resource fairs and healthy aging programs, and professional sponsorships (50 programs reached approximately 2,000 consumers in FY15). HRC also promotes health by educating the professional community through accredited continuing education in-service presentations to physicians, nurses, social workers, geriatric service providers, elder law attorneys, and other professionals serving the geriatric community (6 accredited programs reached 275 professionals in FY15). HRC's IFAR (Institute for Aging Research), described in general in the 990 Schedule O Part III Line 4b, had several important findings that will directly improve the health of seniors, these include - Up to three years of whole body vibration failed to improve bone, muscle or balance in seniors - results from the "VIBES" trial; - Low density muscle in the spine is associated with worse standing balance; - The treatment of hypertension can improve blood flow to the brain and prevent falls; - Tai Chi exercises twice a week can improve physical function and walking speed in elderly people; - Better infection management in advanced dementia reduces patient burden and resistant bacteria; - Mental inhibition and inattention predict physical function six months later in a sample of older adults with diabetes; - Executive function predicts exercise adherence, via self-efficacy, in non-active older adults with diabetes; - A twelve-week, titrated social cognitive intervention increases short-term self-efficacy and physical activity in diabetic older adults (presented at Society of Behavioral Medicine, manuscript in review); - Optimism influences longitudinal trajectory of well-being in older women; - A social cognitive framework, with specific emphasis on fatigue as a barrier, predicts exercise adherence in older breast cancer survivors; - identified evidence-based criteria for clinically meaningful weakness and low muscle mass in older adults; - there is a link between delirium and long term cognitive decline in all older persons; - Preoperative pain and depression are important risk factors for delirium in older persons. HRC collaborates with area providers and policy leaders to promote the health of seniors. In 2012 and 2013, HRC finalized preferred provider agreements with Beth Israel Deaconess Medical Center and New England Baptist Hospital to provide the highest quality, cost-effective hospital and post-hospital care. Driven by a commitment to reduce avoidable hospitalizations and readmissions, the goals of these agreements are to improve transitions of care for patients, access, communications, and information sharing, and ensure the best possible patient outcomes. In 2013 HRC's IFAR announced, with Brandeis University's Heller School for Social Policy and Management, the establishment of a joint Center to inform health care policy and practices in aging to address the impact of the nation's unprecedented demographic shift as baby boomers enter retirement years, and to collaborate to translate clinical research into policy and practice recommendations for healthy aging. HSL is governed by a large and active community board comprised entirely of independent persons from the community. HRC, as a subsidiary of HSL, has a board comprised of TWO employees (President & CEO, CFO) and two independent directors who are also members of HSL's Board of Directors (including the Board Chair). Surplus funds, should they exist, are reinvested in HRC as capital investment, for upkeep of the facility and for growing patient medical equipment and technology needs. FORM 990, SCHEDULE H, PART VI - SECTION 6 HRC is part of a group of not-for-profit affiliated entities whose sole member is Hebrew SeniorLife, Inc. HSL's coordinated system of care is based on the premise that research, training of geriatric health-care professionals, senior living and health care must be integrated in such a way to promote independence for all adults as they age. HRC's affiliates include senior supportive housing communities, which help keep seniors independent in their homes with supportive services including wellness and fitness programs, social service supports, access to health and home care, dining programs, and recreational activities. Coordinated services throughout the HSL network support seniors in their independence as well as provide for successful transitions between care settings. Examples of innovative programs include a grant-supported Depression Support service coordinating care of primary care and mental health providers and actively reaching out to monitor compliance and response, and a collaboration with a local college on a multi-generational course called "Nursing care of the Older Adult" which partners the older and younger groups to do active learning, form multi-generational relationships, and dispel stereotypes about aging. HSL's Chaplaincy Institute has been named one of the nation's 50 most innovative Jewish non-profits in Slingshot for its work to train chaplains in issues related to aging and improving the quality of Jewish pastoral care nationally. It trains 16 graduate level students in pastoral care (Clinical Pastoral Education, accredited by the Association for Clinical Pastoral Education) over the course of a year. HSL also provides employee scholarships for Roslindale or NewBridge employees and/or a child/spouse of an employee who has been employed at HSL for at least 6 months. The student must have an overall GPA of 2.5 or higher and must be entering the 2nd, 3rd or 4th year in an accredited undergraduate degree program, enrolled in 1st or 2nd year of LPN certificate program or enrolled in Graduate School. HSL's Employee Lifeline Program (H.E.L.P.) was created to help employees who, due to unexpected circumstances, are facing dire personal hardships that have negative financial consequences. The program provides some financial assistance to employees who meet the program's guidelines. Eligible beneficiaries include all staff who have been employed at HSL for a minimum of one year, are in good standing, and work a minimum of 1,000 hours on an annualized basis. HELP was designed by a group of employees and is funded through employee and Development efforts. Through its web site and Blog, HSL provides a wealth of free information on healthy aging to the general public, including an ebooks entitled "You and Your Aging Parents: A Family Approach to Lifelong Health, Wellness & Care" and "ReAge Your Personal Health: A Wellness Guide for Older Adults" and an enewsletter called "@SeniorLife." HSL is working to chart the course for senior life. Through our unparalleled combination of experience, optimism, vision and determination, we are working to improve the quality of life for people as they age and dispelling the notion that growing old has to mean growing frail. FORM 990, SCHEDULE H, PART VI - SECTION 7 This is not applicable as in Massachusetts only acute hospitals file community benefit reports with the state. HRC provides its Schedule H filing to the state via the Massachusetts Hospital Association. false true false true true true true true false KATELYN QUYNN VP, DEVELOPMENT 0 348195 0 30000 0 258 0 22600 0 42473 0 443526 0 0 LOUIS J WOOLF President & CEO 0 647157 0 158951 0 594 0 55100 0 78040 0 939842 0 0 JAMES D HART CFO & Secretary 0 298618 0 49860 0 258 0 5100 0 43827 0 397663 0 0 MARY MOSCATO President, HSL Health Care Srv 285904 0 26951 0 258 0 5100 0 50857 0 369070 0 0 0 ROBERT J SCHREIBER MEDICAL DIRECTOR 292117 0 0 0 258 0 5100 0 50044 0 347519 0 0 0 LEWIS LIPSITZ Director, IFAR 316192 0 0 0 396 0 5100 0 42968 0 364656 0 0 0 HASSAN ARIF HOSPITALIST 274327 0 0 0 60 0 4175 0 49354 0 327916 0 0 0 GREGORY TOOT COO 180507 0 17810 0 138 0 1958 0 28951 0 229364 0 0 0 SHARON K INOUYE Director, Aging Brain 313976 0 0 0 258 0 5100 0 26332 0 345666 0 0 0 FRANCIS X HINCKLEY CIO, THRU MAY 2015 0 219304 0 0 0 258 0 1673 0 52522 0 273757 0 0 HELEN CHEN CHIEF MEDICAL OFFICER 303978 0 25500 0 138 0 5100 0 33531 0 368247 0 0 0 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 3 HEBREW REHABILITATION CENTER RELIES UPON HSL AS THE PARENT ORGANIZATION TO ESTABLISH THE COMPENSATION OF THE ORGANIZATIONS' PRESIDENT/CEO AND CFO. HSL UTILIZES THE FOLLOWING IN ESTABLISHING SUCH COMPENSATION: COMPENSATION COMMITTEE WRITTEN EMPLOYMENT CONTRACT INDEPENDENT COMPENSATION CONSULTANT COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE SCHEDULE J, PART I, LINE 4B LOUIS J. WOOLF, PRESIDENT OF HSL (AND CEO AS OF FEBRUARY 2013), PARTICIPATED IN A 457(F) SUPPLEMENTAL RETIREMENT PLAN, THAT INCLUDED $50,000 OF EMPLOYER CONTRIBUTIONS DURING THE YEAR. THIS AMOUNT IS INCLUDED IN THE DEFERRED COMPENSATION SECTION SHOWN IN PART VII. Schedule J, Part I, LineS 5, 6 & 7 Each year, HRC withholds a portion of its senior leadership's compensation to create an "at risk" bonus, which is then paid, on an incentive basis, to its senior leadership when target goals are reached. Before any bonus is paid out under this arrangement, HSL's compensation committee reviews the financial position of the organization and, if feasible, will approve bonuses to eligible senior leadership. Bonuses are budgeted each year as a percentage of the eligible employee's base wages. The percentage payable ranges from 5 to 15 percent. The following employees received bonuses paid out under HRC's bonus arrangement in 2014: hELEN CHEN $25,500 Mary Moscato $26,951 Greg Toot $17,810 This amount is included in bonus & incentive compensation reported on Schedule J, Part II, Column (B)(ii). A MASSACHUSETTS HEALTH & EDUCATIONAL FACILITIES AUTH 042456011 57586CM93 2013-04-01 9974000 SEE PART VI false false false A 0 0 9974000 0 0 0 0 0 0 0 9974000 0 2013 false true true true A false false false true false 0 0.00316 0.00316 false false false true A false true false false false true BANK OF AMERICA 3.1 false true false 0 false true A true PURPOSE OF BOND SCHEDULE K, PART I VARIABLE RATE DEMAND REVENUE BONDS HEBREW REHABILITATION CENTER ISSUE SERIES A (2013). THE PROCEEDS OF THE 2013 BONDS WERE USED TO REFUND SERIES D. false false false MISSION STATEMENT FORM 990, PART I, LINE 1 OUTPATIENT SERVICES AND ADULT DAY HEALTH CARE. DESCRIPTION OF NEGATIVE ASSETS FORM 990, PART I, LINE 22 THE DECREASE IN UNRESTRICTED NET ASSETS AND UNRESTRICTED NET DEFICIT AT HEBREW REHABILITATION CENTER, inc. ("HRC") FOR FISCAL YEAR 2015 REFLECTS THE INCLUSION OF EXPENSES THAT ARE SUPPORTED BY HRC'S PARENT, HEBREW SENIORLIFE, inc. ("HSL"). HSL BENEFITS FROM BOTH MANAGEMENT FEES AND PHILANTHROPIC INCOME THAT ARE AVAILABLE TO FUND HRC'S OPERATING, PENSION FUND AND OTHER EXPENSES. AS SUCH, HSL'S MANAGEMENT, BOARD OF DIRECTORS AND LENDERS VIEW THE ORGANIZATION'S FINANCIAL CONDITION AS HSL'S AND HRC'S COMBINED BALANCE SHEET, WITH $46.5 MILLION IN UNRESTRICTED NET ASSETS AT 9/30/15. FORM 990, PART III, LINE 1 THESE SERVICES ARE PROVIDED TO A POPULATION RECEIVING MEDICARE AND/OR MEDICAID. MEDICARE AND MEDICAID ACCOUNT FOR 58% AND 20% OF REVENUES RECEIVED BY THE ORGANIZATION, RESPECTIVELY. FORM 990, PART III, LINE 4A HRC IS ACCREDITED BY CARF (COMMISSION ACCREDITATION OF REHABILITATION FACILITIES), AN INDEPENDENT NONPROFIT ORGANIZATION PROVIDING ACCREDITATION SERVICES WORLDWIDE. HRC MEETS AND SURPASSES CARF GUIDELINES FOR SERVICE AND QUALITY. HRC CONFORMS TO NATIONALLY AND INTERNATIONALLY RECOGNIZED SERVICE STANDARDS AND IS FOCUSED ON DELIVERING FIRST CLASS HEALTH CARE AND CONTINUES TO STRIVE FOR EXCELLENCE. LONG TERM CARE: HRC PROVIDES 405 BEDS OF LONG-TERM CARE IN BOSTON AND 220 LONG-TERM CARE BEDS AT THE GLORIA ADELSON FIELD HEALTH CENTER AT NEWBRIDGE ON THE CHARLES IN DEDHAM FOR A TOTAL OF 625 LONG-TERM CARE BEDS. Payments from Medicaid comprised 73% of net revenue, Medicare payments were 4%, self pay and other was 23%. POST-ACUTE CARE: THE MEDICAL ACUTE CARE UNIT AT HEBREW REHABILITATION CENTER IN BOSTON OFFERS 42 BEDS FOR EXTENDED MEDICAL AND REHABILITATIVE CARE FOR SENIORS WITH COMPLEX MEDICAL CONDITIONS. THE RECUPERATIVE SERVICES UNIT IN BOSTON PROVIDES 50 BEDS FOR SHORT-TERM, POST-ACUTE CARE IN A SKILLED NURSING SETTING. Payments from Medicare comprised 78%, Medicaid 5%, Commercial and Other 17%. OUTPATIENT CLINICS: HEBREW REHABILITATION CENTER, inc.'S OUTPATIENT SERVICES IS A BOSTON HEALTH CLINIC THAT OFFERS A WIDE RANGE OF MEDICAL SERVICES FOR SENIORS INCLUDING TREATMENT FOR CONDITIONS SUCH AS HEARING LOSS, MEMORY DISORDERS, OSTEOPOROSIS, REHABILITATION AND WOUND CARE. PATIENTS ARE TREATED BY EXPERTS WHO UNDERSTAND THE UNIQUE HEALTH NEEDS OF OLDER ADULTS. ALL OF THE HEALTH CLINICS WITHIN OUTPATIENT SERVICES OFFER THE HIGH-QUALITY SPECIALIZED CARE FOR BOSTON SENIORS. OUTPATIENT CLINICS ARE OPERATED BY HRC AT THE ORCHARD COVE, DEDHAM AND BROOKLINE LOCATIONS. Payments from Medicare comprised 84%, Medicaid was 1% and other payers were 15%. ADULT DAY HEALTH: HRC HAS OVER 19 YEARS OF EXPERIENCE CARING FOR SENIORS IN AN ADULT DAYCARE CENTER SETTING. WE PROVIDE A GREAT DAY FOR SENIORS AT TWO SITES - HRC IN ROSLINDALE AND JEWISH COMMUNITY HOUSING FOR THE ELDERLY (JCHE) IN BRIGHTON. WE SERVE ELDERS OF ALL BACKGROUNDS AND FAITHS AND PROVIDE BILINGUAL SERVICES FOR RUSSIAN-SPEAKING INDIVIDUALS AT BOTH SITES. Adult day health payments were 66% Medicaid and 34% self pay. NURSING, SOCIAL WORK, AND THERAPEUTIC RECREATION PROFESSIONALS STAFF HRC'S ADULT DAY HEALTH PROGRAMS. PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS PROVIDE TREATMENT AS NEEDED WHEN PRESCRIBED BY A PHYSICIAN. PROGRAM ASSISTANTS PROVIDE PERSONAL CARE AND HELP WITH ALL ASPECTS OF THE DAILY ROUTINE. THERE IS A MINIMUM OF ONE STAFF MEMBER TO SIX PARTICIPANTS. THE STAFF WORK AS AN INTERDISCIPLINARY TEAM TO MAKE SURE THAT THE PARTICIPANTS RECEIVE ATTENTION TO ALL ASPECTS OF THEIR LIVES. DURING THE YEAR ENDED SEPTEMBER 30, 2015, HEBREW REHABILITATION CENTER, inc. SERVED AN AVERAGE OF 45 DAY PROGRAM PARTICIPANTS. FORM 990, PART III, LINE 4B WITH NEARLY 50 YEARS OF HISTORY, IFAR IS THE LARGEST GERONTOLOGICAL RESEARCH FACILITY IN THE U.S. IN A CLINICAL SETTING, AND IS A RESEARCH AFFILIATE OF HARVARD MEDICAL SCHOOL. IT IS HOME TO FOUR PROFESSORS OF MEDICINE AT HARVARD MEDICAL SCHOOL, AND 16 OF ITS FACULTY HAVE ACADEMIC APPOINTMENTS THERE. IFAR CURRENTLY HAS A $43 MILLION GRANT PORTFOLIO, WITH MORE THAN 60 RESEARCH GRANTS AND 19 INVESTIGATORS. ITS RESEARCH FOCUSES ON FALLS, OSTEOPOROSIS AND FRACTURES, NUTRITION AND MUSCULOSKELETAL HEALTH, FOOT DISORDERS AND FOOT PAIN, GENETIC EPIDEMIOLOGY, DEMENTIA, DELIRIUM, PALLIATIVE CARE, HEALTH CARE QUALITY IMPROVEMENT, AND DEPRESSION AND MENTAL HEALTH. IFAR RESEARCHERS HAVE ACCESS TO SOME OF THE WORLD'S LARGEST DATABASES, AND TO THE MORE THAN 5,000 SENIORS ANNUALLY AFFILIATED WITH HEBREW SENIORLIFE ENTITIES. IN TURN, ITS RESEARCH INFORMS HSL'S HEALTH CARE SERVICES AND PROGRAMS, SO PATIENTS AND RESIDENTS BENEFIT FROM BEST PRACTICES IN THE TREATMENT OF COMMON CONDITIONS OF AGING. IN ADDITION TO GRANT FUNDING IFAR RECEIVES SUPPORT FROM PRIVATE PHILANTHROPY TO ADVANCE ITS MISSION, BY PROVIDING SEED MONEY FOR YOUNG AND ESTABLISHED RESEARCHERS TO TEST NEW IDEAS, AND IN HELPING TO DISSEMINATE RESEARCH FINDINGS SO THEY CAN IMPACT SENIORS AROUND THE WORLD. SENIORS AROUND THE WORLD. FORM 990, PART III, LINE 4c OTHER PROGRAM SERVICE REVENUE IS MADE UP OF MISCELLANEOUS NON-PATIENT SERVICE REVENUE AND EXPENSES, INCLUDE DEPARTMENT OF MEDICINE TEACHING, FELLOWSHIPS & OTHER SUPPORT, FOOD SERVICE, VARIETY OF ANCILLARY PROGRAMS, AND SPACE LEASED BY HSL. DESCRIPTION OF CLASSES OR MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 HEBREW SENIORLIFE, INC. IS THE SOLE CORPORATE MEMBER OF HEBREW REHABILITATION CENTER, inc. AND PROVIDES MANAGEMENT support as needed AND FUNDRAISING SERVICES TO HRC AND TO ITS OTHER AFFILIATES. MEMBERS WHO MAY ELECT ONE OR MORE OF THE GOVERNING BODY FORM 990, PART VI, LINE 7A THE HEBREW SENIORLIFE, inc. BOARD CHAIR APPOINTS THE MEMBERS OF THE HEBREW REHABILITATION CENTER, inc. BOARD OF DIRECTORS WITH THE ADVICE AND CONSENT OF THE HEBREW SENIORLIFE, inc. BOARD MEMBERS. DESCRIPTION CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B DECISIONS INVOLVING MAJOR CHANGES IN ORGANIZATION, DEBT PLACEMENT, SALE OF ASSETS, ETC. ARE ALSO SUBJECT TO APPROVAL BY HEBREW SENIORLIFE, inc.'S BOARD. ULTIMATELY, GOVERNANCE OF THE CORPORATION RESTS WITH THE BOARD OF DIRECTORS OF THE COMPANY'S SOLE CORPORATE MEMBER, HEBREW SENIORLIFE, INC. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, QUESTION 11 PREPARATION OF THE FORM 990 BEGINS INTERNALLY WITH HEBREW SENIORLIFE STAFF AND ERNST & YOUNG PREPARING THE FORM WITH INPUT PROVIDED BY HEBREW SENIORLIFE, inc. ALL FORMS 990 AND 990T OF THE AFFILIATES OF HEBREW SENIORLIFE, INC. (HSL IS THE SOLE CORPORATE MEMBER OF EACH AFFILIATE) WILL BE REVIEWED PRIOR TO FILING BY THE AUDIT COMMITTEE OF HEBREW SENIORLIFE, INC. SUBSEQUENT TO SUCH REVIEW AND PRIOR TO FILING COPIES WILL BE PROVIDED TO THE APPROPRIATE GOVERNING BOARD OF DIRECTORS FOR EACH AFFILIATE. THE GOVERNING BOARDS WILL HAVE 5 DAYS TIME IN WHICH TO VIEW THE FULL RETURNS PRIOR TO THEIR FILING. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C THE BOARD OF HEBREW REHABILITATION CENTER, inc. VOTED TO ADOPT THE HEBREW SENIORLIFE, inc. CONFLICT OF INTEREST POLICY. MONITORING AND DEALING WITH POTENTIAL OR ACTUAL CONFLICTS INDIVIDUALS COVERED UNDER THE CONFLICT OF INTEREST POLICY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE THE EXISTENCE OR POSSIBILITY OF A CONFLICT OF INTEREST AND SHALL BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE HEBREW SENIORLIFE CONFLICTS COMMITTEE. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY PROVIDES THAT ANNUALLY, EACH COVERED PERSON SHALL SIGN A STATEMENT AFFIRMING THAT SUCH PERSON RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, READ AND UNDERSTANDS THE POLICY AND AGREES TO COMPLY WITH THE POLICY. THE SIGNED STATEMENT AFFIRMS THAT THE PERSON UNDERSTANDS HEBREW REHABILITATION CENTER, inc. IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, HEBREW REHABILITATION CENTER, inc. MUST ENGAGE IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. WHO IS COVERED THE CONFLICT OF INTEREST POLICY COVERS ALL DIRECTORS, OFFICERS, MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, PERSONS SERVING IN SENIOR STAFF POSITIONS OUTLINED IN AN EXHIBIT ATTACHED TO THE CONFLICT OF INTEREST POLICY, AND ANY OTHER PERSON WHO IS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF ANY OF THE ORGANIZATION OR ANY OF ITS AFFILIATES. LEVEL AT WHICH DETERMINATIONS OF CONFLICT ARE MADE AND WHICH ACTUAL CONFLICTS ARE REVIEWED THE HEBREW SENIORLIFE CONFLICTS COMMITTEE IS RESPONSIBLE FOR DETERMINING IF A CONFLICT OF INTEREST EXISTS AND EVALUATING WHETHER THE ORGANIZATION WHETHER THE ORGANIZATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A TRANSACTION THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. THE CONFLICTS COMMITTEE REPORTS ITS FINDINGS TO THE BOARD OF DIRECTORS WHO ARE RESPONSIBLE FOR M ORCHARD COVE INC ONE DEL POND DRIVE CANTON MA 02021 223080006 CONT. 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