2014-08-13T17:26:39-05:00 2013-09-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2012-10-01 222667354 JORDAN HOSPITAL INC JORD 5087462000 275 SANDWICH STREET PLYMOUTH MA 023602183 JASON RADZEVICH 5087462000 2014-08-06 1 CHRISTINE KAWECKI P00743140 5169187000 2014-08-05 2012 2015-11-30 17:44:51Z JASON RADZEVICH 275 SANDWICH STREET PLYMOUTH MA 023602183 196687305 0 X WWW.BIDPLYMOUTH.ORG X 1985 MA SEE SCHEDULE O. 13 13 1607 350 1775643 -997661 5112671 5165480 193077628 189766580 1113475 1655645 90127 86885 199393901 196674590 0 0 0 0 104809281 102214244 0 0 0 88368406 92047361 193177687 194261605 6216214 2412985 179578545 171748302 130525866 119878335 49052679 51869967 SEE COMMUNITY BENEFIT REPORT FOR 2012 - SCHEDULE O 0 0 172304167 187990937 SERVICES RENDERED INCLUDE INPATIENT, OUTPATIENT AND EMERGENCY CARE DELIVERED WITHIN THE INSTITUTION'S SERVICE AREA. 172304167 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 256 0 1 1607 1 1 1 0 0 0 0 0 0 0 0 0 0 X 13 13 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 1 0 MA X PATRICIA HALEY 5087462000 275 SANDWICH ST PLYMOUTH MA 02360 CLARK HINKLEY 1.00 2.00 X X 0 0 0 LYLE BAZZINOTTI 1.00 2.00 X X 0 0 0 PETER MUNCEY ESQ 1.00 2.00 X X 0 0 0 KENNETH FOSDICK 1.00 2.00 X 0 0 0 ROBERT KELLY 1.00 2.00 X 0 0 0 LYON CARTER 1.00 2.00 X 0 0 0 KIMBERLY SCHEUB MD 1.00 2.00 X 0 0 0 WILFRED SHEEHAN 1.00 2.00 X 0 0 0 KEELAS SMALL 1.00 2.00 X 0 0 0 FREDERIC CLIFFORD 1.00 2.00 X 0 0 0 JOHN CARNUCCIO 1.00 2.00 X 0 0 0 SHAWN DAHLEN 1.00 2.00 X 0 0 0 STEPHEN TREHU MD 1.00 2.00 X 0 0 0 MICHAEL BABINI 1.00 2.00 X 0 0 0 DENISE NORRIS 40.00 1.00 X 62941 0 18615 PETER HOLDEN 1.00 2.00 X 0 689851 30040 JOSEPH IANNONI 1.00 2.00 X 0 367303 30040 JOANNE FORD 60.00 X 198408 0 24187 GAIL ROBBINS 40.00 X 168397 0 23514 RON RUTHERFORD 40.00 X 156455 0 22857 MARK TARLTON 40.00 X 153278 0 22825 RUTH MCNAUGHTON 40.00 X 155070 0 22870 894549 1057154 194948 72 0 1 0 BAYSIDE EMERGENCY MEDICAL ASSOCIATES PC 1342 BELMONT STREET SUITE 205 BROCKTON MA 02301 EMERGENCY MEDICINE MGMNT 6922015 ALLIANCE ONCOLOGY LLC 100 BAYVIEW CIRCLE SUITE 400 NEWPORT BEACH CA 92660 RADIATION THERAPY MGMNT 2180606 ALLIANCE HEALTHCARE SERVICES 100 BAYVIEW CIRCLE SUITE 400 NEWPORT BEACH CA 92660 IMAGING SERVICE MGMNT 1342849 KAUFMAN HALL & ASSOCIATES INC 5202 OLD ORCHARD ROAD SUITE N700 SKOKIE IL 60077 FINANCIAL CONSULTANT 1022254 DONOGHUE BARRETT & SINGAL PC ONE BEACON STREET BOSTON MA 02108 LEGAL SERVICES 624400 8 2673307 2492173 24156 5165480 NET PATIENT REVENUE 900099 187990937 187990937 NON-PATIENT LAB 621500 1775643 1775643 189766580 676464 676464 86885 0 86885 86885 86885 991896 0 12715 991896 -12715 979181 979181 196674590 187990937 1775643 1742530 81556 81556 78499381 69603936 8895445 3886173 3442221 443952 13765972 12193362 1572610 5981162 5297881 683281 1959134 1959134 414807 414807 7698471 7698471 56906444 48162217 8744227 8843750 7959375 884375 258438 198997 59441 493734 315990 177744 4889202 4889202 9645942 9645942 937439 937439 194261605 172304167 21957438 0 12790425 6550912 10029 7125 21108678 19309676 2350753 2532891 5036275 6915934 186281378 103491767 87155144 82789611 26967759 29893090 24159482 23749063 179578545 171748302 24138705 24064263 77382596 75755611 29004565 20058461 130525866 119878335 X 37992092 41111239 1282064 514106 9778523 10244622 49052679 51869967 179578545 171748302 X 2412985 -178347 582650 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: JORDAN HOSPITAL PAID MEMBERSHIP DUES TO MEMBER ORGANIZATIONS WHICH MAY ENGAGE IN LOBBYING ACTIVITIES. THEREFORE, A PORTION OF THE DUE MAY BE ATTRIBUTABLE TO LOBBYING ACTIVITIES. 11060587 1326794 436271 2064924 10758728 9872294 896256 1256631 964594 11060587 11143750 1667255 -763788 2174923 9872294 11541125 1822428 162354 2382157 11143751 12515339 858367 -837782 994799 11541125 0.95220 0.04780 0 0 54225 54225 79940727 31204638 48736089 31569607 15761057 15808550 72959583 56526072 16433511 1757236 1757236 82789611 FUNDS HELD BY TRUSTEE 7061074 DUE FROM AFFILIATES 1966024 FUNDS HELD BY OUTSIDE TRUSTEES 9941868 CURRENT LIMITED USE ASSETS 4780097 23749063 ESTIMATED 3RD PARTY SETTLEMENT 1399299 OTHER CURRENT LIABILITIES 8588072 OTHER LIABILITIES 569776 CAPITAL LEASE 381365 ADDTL MINIMUM PENSION LIABILITY 9119949 20058461 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNCTIONS TO SUPPORT AND PROVIDE INCOME FOR THE FURTHERANCE OF THE HEALTHCARE MISSION OF JORDAN HOSPITAL, INC AND ITS AFFILIATES. 1 1 1 X 1 X 1 1 0 1 1 2280545 2280545 0.01170 20111962 15008302 5103660 0.02630 0.00000 22392507 15008302 7384205 0.03800 2043539 2043539 0.01050 0.00000 0.00000 0.00000 0.00000 2043539 2043539 0.01050 24436046 15008302 9427744 0.04850 0.00000 0.00000 82805 82805 0.00040 0.00000 0.00000 82805 82805 0.00040 0.00000 0.00000 0.00000 165610 165610 0.00080 1 5737093 0 81342083 87202541 -5860458 X 1 0 1 1 JORDAN HOSPITAL INC

275 SANDWICH STREET PLYMOUTH MA 023602183

X X X X JORDAN HOSPITAL INC 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X X X 1 0 1 1 400.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X X 1 X 0 1 X 0 0 PART III, LINE 4: THE SYSTEM PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY.THE SYSTEM GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY ARRANGEMENTS. ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PART III, LINE 8: MEDICARE INPATIENT, MEDICARE OUTPATIENT AND PSYCHIATRIC SERVICES TOTAL $5,815,832 OF THE LOSS REPORTED ON LINE 7. THESE LOSSES REPRESENT SUBSIDIZED HEALTH SERVICES PROVIDED TO THE MEDICARE POPULATION AND SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED IS COST TO CHARGE RATIOS TAKEN FROM THE MEDICARE COST REPORT. JORDAN HOSPITAL, INC PART V, SECTION B, LINE 3: NINE INTERVIEWS WERE CONDUCTED WITH COMMUNITY AND HOSPITAL GROUPS IDENTIFIED BY JORDAN HOSPITAL AS BEING KEY STAKEHOLDERS. BETWEEN ONE TO TWENTY INDIVIDUALS WERE PRESENT AT EACH INTERVIEW. INTERVIEWS WERE CONDUCTED BY INSTITUTE FOR COMMUNITY HEALTH (ICH) STAFF INDECEMBER 2012 AND JANUARY 2013 USING A SEMI-STRUCTURED INTERVIEW GUIDE DEVELOPED BY ICH.INTERVIEWS RECORDINGS AND NOTES WERE ANALYZED BY ICH STAFF TO IDENTIFY KEY THEMES IN RESPONSES.INTERVIEW QUESTIONS EXPLORED:- MAIN HEALTH CONCERNS IN THE JORDAN HOSPITAL SERVICE AREA- BIGGEST BARRIERS TO PREVENTING OR ADDRESSING HEALTH ISSUES- VULNERABLE POPULATIONS- EXISTING PROGRAMS AND SERVICES- IDEAS FOR NEW PROGRAMS, SERVICES, AND PARTNERSHIPINTERVIEWEES WERE ALSO SURVEYED TO ASSESS TOWN OF RESIDENCE, TOWN OF EMPLOYMENT, LENGTH OF TIME THE INTERVIEWEE HAS LIVED OR WORKED IN THE TOWN OF RESIDENCE OR EMPLOYMENT, AND THE TYPE OF ORGANIZATION THE INTERVIEWEE WORKS AT.63 INTERVIEWEES FILLED OUT THE SURVEY. WHILE MANY INTERVIEWEES LIVE OR WORK IN PLYMOUTH, OTHER TOWNS IN THE JORDAN HOSPITAL SERVICE AREA WERE NOT AS WELL REPRESENTED. IN PARTICULAR, NONE OF THE INTERVIEWEES LIVE OR WORK IN BOURNE OR SANDWICH.TOWN OF RESIDENCE:- PLYMOUTH: 28 INTERVIEWEES- MARSHFIELD: 3 INTERVIEWEES- KINGSTON: 3 INTERVIEWEES- DUXBURY: 3 INTERVIEWEES- HALIFAX: 2 INTERVIEWEES- PEMBROKE: 1 INTERVIEWEE- TOWNS OUTSIDE OF THE SERVICE AREA: 22 INTERVIEWEESTOWN OF EMPLOYMENT (SOME INTERVIEWEES WORK IN MULTIPLE TOWNS):- PLYMOUTH: 54 INTERVIEWEES- DUXBURY: 5 INTERVIEWEES- KINGSTON: 4 INTERVIEWEES- MIDDLEBORO: 4 INTERVIEWEES- WAREHAM: 4 INTERVIEWEES- CARVER: 3 INTERVIEWEES- HALIFAX: 3 INTERVIEWEES- MARSHFIELD: 3 INTERVIEWEES - PEMBROKE: 3 INTERVIEWEES- PLYMPTON: 3 INTERVIEWEES- TOWNS OUTSIDE OF THE SERVICE AREA: 8 INTERVIEWEES JORDAN HOSPITAL, INC PART V, SECTION B, LINE 18E: NEITHER THE JORDAN HOSPITAL NOR ANY AUTHORIZED THIRD PARTY TOOK ANY OF THE ACTIONS LISTED IN FORM 990, SCHEDULE H, PART V, SECTION B, QUESTION 17 OR 18. JORDAN HOSPITAL, INC PART V, SECTION B, LINE 20D: ACCOUNTING USES THE FPIG FEDERAL POVERTY INCOME GUIDELINES PUBLISHED ANNUALLY TO DETERMINE ELIGIBILITY FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE. THESE ARE ALSO THE STATE LOW INCOME PATIENT GUIDELINES. PART VI, LINE 2: NEEDS ASSESSMENT:JORDAN HOSPITAL SEEKS COMMUNITY INVOLVEMENT IN THE HOSPITAL'S DEVELOPMENT AND EVALUATION OF ITS HEALTH AND EDUCATION PROGRAMS. BY SOLICITING FEEDBACK AT COMMUNITY EVENTS AND WORKSHOPS, AND CONDUCTING LARGER COMMUNITY HEALTH ASSESSMENTS, JORDAN HOSPITAL IS ABLE TO FOCUS ITS RESOURCES ON CLINICAL SERVICES AND OTHER INITIATIVES THAT DIRECTLY SUPPORT OUR COMMUNITY'S HEALTH NEEDS. IN ADDITION, COMMUNITY MEMBERS SERVE ON COMMITTEES THROUGHOUT JORDAN HOSPITAL, PROVIDING FEEDBACK AND WORKING WITH STAFF TO IMPROVE COMMUNITY HEALTH CARE INITIATIVES. THE HOSPITAL'S PARTNERS THROUGHOUT THE REGION PARTICIPATE IN JORDAN HOSPITAL PROGRAMS, COMMITTEES AND OTHER COMMUNITY-FOCUSED ACTIVITIES AND HELP INFORM THE HOSPITAL'S COMMUNITY BENEFITS PLANNING BASED ON THEIR DATA COLLECTION REGARDING THE COMMUNITY'S HEALTH DISPARITIES. IN SUPPORT OF THE IDENTIFIED HEALTH PRIORITIES AND PROGRAM INITIATIVES WITHIN GREATER PLYMOUTH, JORDAN HOSPITAL COLLABORATES WITH MORE THAN 90 COMMUNITY ORGANIZATIONS. ACTIVE COLLABORATORS ARE MARKED WITH A +; THOSE MARKED WITH * PARTICIPATED IN HEALTHY PLYMOUTH (WWW.HEALTHYPLYMOUTH.ORG) ACTIVITIES: - AD MAKEPEACE + * - AMERICAN HEART ASSOCIATION - BAY STATE COLLEGE - BAYSIDE RUNNERS + * - BEAT CANCER BOOT CAMP - BOSTON COLLEGE - BOSTON PUBLIC HEALTH COMMISSION-RYAN WHITE PART A - BOSTON UNIVERSITY SCHOOL OF MEDICINE - BOYS & GIRLS CLUB OF BROCKTON* - BOYS & GIRLS CLUB OF PLYMOUTH* - BRIDGEWATER STATE COLLEGE* - BRISTOL COMMUNITY COLLEGE - CAPE COD CANAL REGION CHAMBER OF COMMERCE + * - CAPE COD COMMUNITY COLLEGE - COLCHESTER NEIGHBORHOOD FARMS* - COMMUNITIES MOBILIZING FOR CHANGE ON ALCOHOL (CMCA) + * - COMMUNITY HEALTH EDUCATION NETWORK AREA 23 (CHNA 23) + * - CURRY COLLEGE - DUXBURY COUNCIL ON AGING + * - EIGHT-TOWN TOBACCO CONTROL PROGRAM - ESSENTIAL COMMUNITY PROVIDER TRUST FUND - EXPLORE HISTORIC PLYMOUTH* - FITNESS MANAGEMENT SYSTEMS - GREATER ATTLEBORO-TAUNTON REGIONAL TRANSIT AUTHORITY (GATRA)* - GREATER PLYMOUTH AIDS CONSORTIUM + - GREATER PLYMOUTH FOOD WAREHOUSE + * - GREATER PLYMOUTH COUNCIL OF HUMAN SERVICES AGENCIES - HEALTH RESOURCE & SERVICE ADMINISTRATION (HRSA)-RYAN WHITE PART C + - HEALTHY PLYMOUTH + * - JORDAN HOSPITAL COMMUNITY BUSINESS PARTNERS (-69 BUSINESSES)* - KIWANIS CLUB OF PLYMOUTH - LABOURE COLLEGE - LEAGUE OF WOMEN VOTERS* - LESLEY COLLEGE - MARIBETT FARMS + * - MASS BAY COMMUNITY COLLEGE - MASSACHUSETTS COLLEGE OF PHARMACY & ALLIED HEALTH SCIENCES - MASSACHUSETTS DEPT OF PUBLIC HEALTH + * - MA DEPARTMENT OF PUBLIC HEALTH PEDIATRIC PALLIATIVE CARE NETWORK + * - MASSASOIT COMMUNITY COLLEGE - MASSACHUSETTS GENERAL HOSPITAL INSTITUTE OF HEALTH PROFESSIONS - METROPOLITAN AREA PLANNING COUNCIL (MAPC) + * - MGH INSTITUTE OF HEALTH PROFESSIONS - NEW ENGLAND INSTITUTE OF TECHNOLOGY - NEW ENGLAND VILLAGES* - NORTH RIVER FARMERS* - NORTHEASTERN UNIVERSITY - OFFICE OF YOUTH AND ADOLESCENT DEVELOPMENT* - OLD COLONY ELDER SERVICES + * - OLD COLONY PLANNING COUNCIL + * - PINEHILLS LLC + * - PLIMOTH PLANTATION + *- PLYMOUTH AREA COMMUNITY ACCESS TELEVISION (PACTV) + * - PLYMOUTH BOARD OF SELECTMEN + * - PLYMOUTH CHAMBER OF COMMERCE + * - PLYMOUTH CONSERVATION COMMISSION + * - PLYMOUTH COUNCIL ON AGING + * - PLYMOUTH COUNTY DISTRICT ATTORNEY'S OFC + - PLYMOUTH DEPARTMENT OF PUBLIC WORKS (DPW) + * - PLYMOUTH FAMILY NETWORK + * - PLYMOUTH GARDEN CLUB* - PLYMOUTH HOUSING AUTHORITY* - PLYMOUTH LIONS CLUB - PLYMOUTH PUBLIC LIBRARY + * - PLYMOUTH PUBLIC SCHOOLS + * - PLYMOUTH PUBLIC SCHOOLS HEALTH ADVISORY COMMITTEE + * - PLYMOUTH ROTARY + * - PLYMOUTH TOWN HALL + * - PLYMOUTH YOUTH DEVELOPMENT COALITION + * - QUINCY COLLEGE - QUINNIPIAC UNIVERSITY - RED CROSS BLOOD DRIVE + - REGION V MASSACHUSETTS DPH BIO-TERRORISM COMMITTEE + - REGIS COLLEGE - SCHWARTZ CENTER ROUNDS + - SALEM STATE UNIVERSITY - SOUTH SHORE CHAMBER OF COMMERCE* - SIGNATURE HEALTHCARE BROCKTON - SIMMONS COLLEGE - SODEXO + - SOULE HOMESTEAD EDUCATION CENTER* - SOUTH SHORE COMMUNITY ACTION COUNCIL + * - SOUTH SHORE WOMEN'S RESOURCE CENTER (SSWRC) + * - SOUTH SHORE BOARDS OF HEALTH TOBACCO COLLABORATIVE PROGRAM - SOUTHEASTERN MASSACHUSETTS AGRICULTURAL PARTNERSHIP, INC. (SEMAP)* - SOUTHEASTERN MA AREA HEALTH EDUCATION CENTER (SMAHEC) - SOUTHEASTERN REGIONAL OFFICE OF THE MA DEPT OF MENTAL RETARDATION - THE MAGNIFICENT LEAVEN + * - THE PARENT CONNECTION OF DUXBURY + * - THORBAHN + * - TOWN OF PLYMOUTH + * - TOWN OF PLYMOUTH OPEN SPACE COMM. + * - TUFTS UNIVERSITY SCHOOL OF MEDICINE - UNITED WAY + * - UNIVERSITY OF NEW ENGLAND COLLEGE OF HEALTH PROFESSIONS - UPPER CAPE COD REGIONAL TECHNICAL SCHOOL - VILLAGE AT DUXBURY + * - WILDLANDS TRUST + * PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:JORDAN HOSPITAL'S FINANCIAL COUNSELING SERVICES PROVIDE CONSULTATION AND ASSISTANCE TO ALL PATIENTS ABOUT INSURANCE, MEDICAL EXPENSES AND FINANCIAL OPTIONS. COUNSELING ALSO IS AVAILABLE ON METHODS OF PAYMENT, MANAGED CARE PLANS, AND ASSISTANCE IN PROCESSING APPLICATIONS OR APPLYING FOR FREE CARE AND OTHER AVAILABLE PROGRAMS THAT MAY COVER YOUR MEDICAL EXPENSES. PART VI, LINE 4: COMMUNITY INFORMATION:THIS WORK HAS ALREADY MADE PROGRESS IN LAUNCHING HEALTH-ENHANCING INITIATIVES: JORDAN HEALTH SYSTEM HOSTED A WELL-ATTENDED COMPLETE STREETS TRAINING PROGRAM FOR AREA MUNICIPALITIES TO EDUCATE DIVERSE COMMUNITY LEADERS ABOUT HOW STREETS DESIGNED FOR MULTIPLE MODES OF TRANSPORTATION SUPPORT HEALTH AND TO INTRODUCE IDEAS FOR IMPLEMENTATION THROUGHOUT THE REGION. THE HOSPITAL, ALONG WITH THE TOWN OF PLYMOUTH AND OLD COLONY PLANNING COUNCIL, HAS DEVELOPED A THREE-YEAR WORK PLAN THAT INCLUDES INPUT FROM RESIDENTS, INTERESTED GROUPS, AND MUNICIPAL LEADERSHIP. NEW POLICIES WILL ENSURE ROADWAY IMPROVEMENTS AND RENOVATIONS THAT ENABLE RESIDENTS TO WALK, BIKE AND DRIVE SAFELY TO THEIR DESTINATIONS, EXPANDING HEALTH-ENHANCING TRANSPORTATION OPTIONS FOR ALL RESIDENTS, INCLUDING THE UNDERSERVED AND ADDRESSING OBESITY AND RESULTING CHRONIC ILLNESS. THE HEALTHY COMMUNITY INITIATIVE'S TRAILS, PARKS, AND RECREATION GROUP IS SUPPORTING THE WORK OF THE PLYMOUTH OPEN SPACE COMMITTEE TO CONNECT TRAILS THROUGHOUT THE REGION, GIVING RESIDENTS ACCESS TO BUSINESSES AND BASIC SERVICES THAT THEY USE ALL THE TIME. THIS WORK FURTHER SIMPLIFIES THE PROCESS OF MAKING ACTIVE LIFESTYLE CHOICES THAT ARE COST EFFECTIVE AND GIVE GREATER ACCESS TO BASIC SERVICES TO THE UNDERSERVED. PLYMOUTH YOUTH DEVELOPMENT COUNCIL IS BROADENING ITS FOCUS BEYOND MANAGING SUBSTANCE ABUSE IN AT-RISK YOUTH TO ENCOURAGING HEALTHY YOUTH CHOICES BY INCLUDING ACTIVE LIVING AND HEALTHY EATING IN THE SPECTRUM OF ISSUES WHERE THEY PROVIDE SUPPORT AND EDUCATION. THIS WORK ADDRESSES OUR FINDINGS OF A HIGH INCIDENCE OF SMOKING, LUNG AND HEART DISEASE IN OUR COMMUNITY AND PROVIDES PROACTIVE PREVENTION MEASURES FOR AT-RISK YOUTH. THE HEALTHY COMMUNITY INITIATIVE'S COMMUNITY NUTRITION GROUP, WILL THE SUPPORT OF JORDAN HOSPITAL, HAS DEVELOPED A THREE-YEAR WORK PLAN, FOCUSING ON THE DEVELOPMENT OF HEALTHY NEIGHBORHOOD MARKETS AND ASSISTING THE PLYMOUTH PUBLIC SCHOOLS IN IMPROVING SCHOOL NUTRITION. FOR ALL HEALTHY COMMUNITY INITIATIVE EFFORTS, WORK PLANS WITH MEASURABLE GOALS TIED TO CDC AND STATE HEALTH PRIORITIES FOCUS ON REDUCING OBESITY BY ENCOURAGING NUTRITION, EXERCISE, AND SMOKING CESSATION. JORDAN HOSPITAL'S WORK TO MERGE THE MISSION OF HEALTHCARE, BUSINESS AND CONSERVATION GROUPS GENERATES SUSTAINABLE SOLUTIONS THAT HAVE THE POTENTIAL TO BRING BETTER HEALTH TO ALL MEMBERS OF THE COMMUNITY, FOR MANY GENERATIONS. JORDAN HOSPITAL SUCCESSFULLY APPLIED FOR $XXX IN GRANTS TO SUPPORT COMMUNITY HEALTH INITIATIVES ADDRESSING AIDS/HIV, CANCER, PARENTING, BIOTERRORISM AND PEDIATRIC PALLIATIVE CARE AMONG OTHERS. OTHER SUCCESSFUL GRANTS SUPPORTED HOSPITAL-BASED CLINICAL AND PATIENT CARE IMPROVEMENTS. JORDAN HOSPITAL CONTINUES TO ADDRESS THE HIGH PREVALENCE OF HEART AND LUNG DISEASE AND SMOKING DURING PREGNANCY IN PLYMOUTH COUNTY THROUGH OUR OUTREACH PROGRAM TO LOCAL SCHOOLS, EDUCATING PARENTS AND STUDENTS ABOUT TOBACCO AVOIDANCE, NUTRITION AND EXERCISE. THIS PROGRAMMING SUPPORTS STATE INITIATIVES TO REDUCE OBESITY AND SERVES TO ADDRESS THE LOCAL INCIDENCE OF CHRONIC DISEASES, SUCH AS DIABETES AND HEART DISEASE, WHICH OFTEN RESULT FROM OBESITY AND WERE SHOWN TO BE SIGNIFICANT COMMUNITY HEALTH ISSUES IN OUR REGION. JORDAN HOSPITAL WORKED WITH THE STATE TO COMMUNICATE NEW HEALTH COVERAGE PLANS FOR THE UNINSURED AND ENROLL THOSE WHO QUALIFY. FINANCIAL COUNSELORS SCREEN AND ENROLLED PATIENTS FOR MASSHEALTH, HEALTH SAFETY NET, MEDICAL HARDSHIP AND COMMONWEALTH CARE. THE HOSPITAL ASSISTED PEOPLE WITH ENROLLMENT IN STATE INSURANCE PARTNERSHIP PROGRAMS. PLANS FOR THE NEXT REPORTING YEAR: JORDAN HOSPITAL WILL REVIEW THE DATA COLLECTED THROUGH ITS 2010 COMMUNITY NEEDS ASSESSMENT AND ONGOING WORK IN LIGHT OF IDENTIFIED HEALTH AND HUMAN SERVICES (EOHHS) STATEWIDE PRIORITIES TO SUPPORT HEALTH CARE REFORM, MANAGE CHRONIC DISEASE IN DISADVANTAGED POPULATIONS, REDUCE HEALTH DISPARITIES, AND PROMOTE WELLNESS OF VULNERABLE POPULATIONS. THE HOSPITAL WILL ALSO CONTINUE TO GATHER DATA AND FEEDBACK THROUGH ITS WORK WITH THE WIDE- REACHING HEALTHY COMMUNITY INITIATIVE. JORDAN HOSPITAL WILL CONTINUE TO PLAY A LEADERSHIP ROLE IN BUILDING COMMUNITY-WIDE COALITIONS TO DEVELOP INFRASTRUCTURE AND PROGRAMS THAT FACILITATE HEALTHY LIFESTYLE CHOICES FOR ALL, INCLUDING DISADVANTAGED POPULATIONS. OUR OUTREACH WILL CONTINUE TO SUPPORT STUDENT EDUCATION AND AWARENESS OF HEALTH AND WELLNESS ISSUES. JORDAN HOSPITAL WILL CONTINUE TO OFFER ITS CURRENT ROSTER OF COMMUNITY EDUCATION PROGRAMS AT LITTLE OR NO CHARGE TO THE PUBLIC THROUGH THE USE OF GRANTS AND OTHER FUNDING SOURCES. THE HEALTHY COMMUNITY INITIATIVE PROGRAMS AS WELL AS THE HOSPITAL'S FAMILY EDUCATION, DIABETES EDUCATION, AND ACCESS PROGRAM (AIDS COMPREHENSIVE CARE, EDUCATION & SUPPORT SERVICES PROGRAM) ARE INITIATIVES THAT THE HOSPITAL PLANS TO FOSTER AND FURTHER DEVELOP. THE HOSPITAL WILL CONTINUE TO STRIVE, WITH OUR COMMUNITY PARTNERS, TO MEET THE COMMUNITY HEALTH NEEDS IN OUR REGION AND TO GO BEYOND BY EXTENDING OPTIONS FOR HEALTHY LIFESTYLES TO ALL COMMUNITY MEMBERS, MAKING BETTER HEALTH SUSTAINABLE AND COST EFFECTIVE. CONTACT: FOR FURTHER INFORMATION, PLEASE CONTACT ANDREA HOLLERAN, VICE PRESIDENT OF EXTERNAL AFFAIRS, JORDAN HOSPITAL, 275 SANDWICH STREET, PLYMOUTH, MA 02360. TEL: (508) 830- 2427. EMAIL: AHOLLERAN@JORDANHOSPITAL.ORGSELECT COMMUNITY BENEFITS PROGRAMS: ACCESS PROGRAM BRIEF DESCRIPTION OR OBJECTIVE ACCESS (AIDS COMPREHENSIVE CARE, EDUCATION & SUPPORT SERVICES PROGRAM) PROVIDES MEDICAL CARE, EDUCATION, SUPPORT AND MEDICAL CASE MANAGEMENT TO PEOPLE WITH HIV/AIDS AND THEIR FAMILIES. IN ADDITION TO PATIENT CARE, THE PROGRAM OFFERS HIV EDUCATION TO THE COMMUNITY. FREE AND ANONYMOUS HIV TESTING IS ALSO AVAILABLE. PROGRAM TYPE DIRECT SERVICES TARGET POPULATION REGIONS SERVED: COUNTY- PLYMOUTH HEALTH INDICATOR: OTHER: HIV/AIDS SEX: ALL AGE GROUP: ADULT ETHNIC GROUP: NOT SPECIFIED LANGUAGE: NOT SPECIFIED PARTNERS AIDS BUREAU OF THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) (HTTP://HAB.HRSA.GOV/) CONTACT INFORMATION: RUTH COOPER, RN, PROGRAM DIRECTOR, AT (508) 732- 8981 OR EMAIL AT RCOOPER@JORDANHOSPITAL.ORG. FOR FREE ANONYMOUS COUNSELING AND TESTING INFORMATION, PLEASE CONTACT ASHLEY FRAZIER, (508) 732- 8982 OR EMAIL AT AFRAZIER@JORDANHOSPITAL.ORG. DETAILED DESCRIPTION: JORDAN HOSPITAL PROVIDES PRIMARY MEDICAL CARE AND MEDICAL CASE MANAGEMENT SERVICES FOR PERSONS LIVING WITH HIV/AIDS IN THE GREATER PLYMOUTH AREA. FREE AND ANONYMOUS HIV COUNSELING AND TESTING IS ALSO PROVIDED. PARTS A AND C FUNDING IS RECEIVED FOR THESE SERVICES THROUGH THE RYAN WHITE CARE ACT. PART C FUNDING IS PROVIDED THROUGH THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) FOR EARLY INTERVENTION SERVICES. PART A FUNDING IS PROVIDED THROUGH THE BOSTON PUBLIC HEALTH COMMISSION (BPHC) FOR MEDICAL CASE MANAGEMENT. THE AIDS COMPREHENSIVE CARE EDUCATION AND SUPPORT SERVICES PROGRAM (ACCESS) PROVIDES PRIMARY MEDICAL CARE TO HIV/AIDS CLIENTS. CARE INCLUDES: PHYSICAL EXAMINATIONS; TREATMENT PLANNING; LABORATORY TESTING; IMMUNIZATIONS AND SCREENING; REFERRALS TO SPECIALTY CARE AND CLINICAL TRIALS AS WELL AS MEDICAL CASE MANAGEMENT. FOR INFORMATION ABOUT ELIGIBILITY AND SERVICES PROVIDED UNDER THE GRANT, PLEASE CONTACT RUTH COOPER, RN, ,PROGRAM DIRECTOR, AT (508) 732-8981. FOR FREE ANONYMOUS COUNSELING AND TESTING, PLEASE CONTACT ASHLEY FRAZIER AT (508) 732- 8982 OR AFRAZIER@JORDANHOSPITAL.ORGJORDAN HOSPITAL PHYSICIAN SPEAKING PROGRAM: BRIEF DESCRIPTION OR OBJECTIVE: JORDAN HOSPITAL HEALTHCARE PROFESSIONALS, FROM PHYSICIANS TO DIETICIANS, OFFER A RANGE OF PROGRAMS TO COMMUNITY RESIDENTS. THE RECENT COMMUNITY NEEDS ASSESSMENT INSTRUCTS PROGRAM CONTENT. JORDAN HOSPITAL OFFERED SEMINARS FOCUSED ON BREAST CANCER, SLEEP DISORDERS, DIABETES, OBESITY, DEMENTIA, HEART DISEASE, PREGNANCY, SPORT INJURIES, SINUSITIS, AND ARTHRITIS. PROGRAM TYPE COMMUNITY EDUCATION TARGET POPULATION REGIONS SERVED: COUNTY- PLYMOUTH HEALTH INDICATOR: OTHER: ARTHRITIS, OTHER: CANCER, OTHER: CARDIAC DISEASE, OTHER: DIABETES, OTHER: NUTRITION, OTHER: PROSTATE DISEASE, OTHER: OSTEOPOROSIS/MENOPAUSE, PHYSICAL ACTIVITY, DEMENTIA, EXERCISE AND SPORTS INJURY PREVENTION SEX: ALL AGE GROUP: ADULT ETHNIC GROUP: NOT SPECIFIED LANGUAGE: NOT SPECIFIED PARTNERS: NOT SPECIFIED CONTACT INFORMATION ALL HOUSE CALLS EVENTS ARE FREE AND OPEN TO THE PUBLIC. PRE-REGISTRATION IS REQUIRED. REGISTER AT 800-2JORDAN (800-256-7326).DETAILED DESCRIPTION: JORDAN HOSPITAL LAUNCHED HOUSE CALLS IN 2005 AS AN EDUCATIONAL SPEAKER SERIES THAT BRINGS IMPORTANT HEALTH AND PREVENTION INFORMATION TO THE COMMUNITY. JORDAN HOSPITAL PHYSICIANS AND OTHER HEALTH CARE PROVIDERS WILL PROVIDE REGULAR HEALTH INFORMATION SEMINARS AT VARIOUS LOCATIONS THROUGHOUT THE 12-TOWN JORDAN HOSPITAL SERVICE AREA. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:BRIEF DESCRIPTION OR OBJECTIVE: JORDAN HOSPITAL, WITH THE TOWN OF PLYMOUTH AND PLYMOUTH PUBLIC SCHOOLS, HAS BROUGHT TOGETHER MORE THAN 60 COMMUNITY PARTNERS- FROM CITY OFFICIALS TO LOCAL FARMERS- TO ENVISION AND BUILD A MORE HEALTH SUSTAINING COMMUNITY, WHERE THE HEALTHY CHOICE IS THE EASY CHOICE. PROGRAM TYPE: COMMUNITY EDUCATION, COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY PARTICIPATION/CAPACITY BUILDING INITIATIVE, HEALTHY COMMUNITIES PARTNERSHIP, OUTREACH TO UNDERSERVED, PREVENTION, SCHOOL/HEALTH CENTER PARTNERSHIP.TARGET POPULATION REGIONS SERVED: COUNTY- PLYMOUTHHEALTH INDICATOR: OBESITY, HEART DISEASE, LUNG DISEASE, CANCER, DIABETES, NUTRITION, SEX: ALLAGE GROUP: ALLETHNIC GROUP: NOT SPECIFIEDPARTNERS: TOWN OF PLYMOUTH, PLYMOUTH PUBLIC SCHOOLS, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTHCONTACT: ANDREA HOLLERAN, VP OF EXTERNAL AFFAIRS JORDAN HOSPITAL, 275 SANDWICH STREET, PLYMOUTH, MA 02360 (508) 830-2029 AHOLLERAN@JORDANHOSPITAL.ORGDETAILED DESCRIPTION: AS A RESULT OF THE COLLABORATIVE WORK INITIATED BY JORDAN HOSPITAL, THE TOWN OF PLYMOUTH, PLYMOUTH PUBLIC SCHOOLS AND OTHER COMMUNITY PARTNERS ARE NOW FINDING NEW WAYS TO WORK TOGETHER WITH JORDAN HOSPITAL TO FOSTER BETTER HEALTH IN OUR COMMUNITY, LONG-TERM, AND AT A LOWER COST, THROUGH THE HEALTHY COMMUNITY INITIATIVE (HCI). SUPPORTED BY JORDAN HOSPITAL'S VICE PRESIDENT OF EXTERNAL AFFAIRS, THE HOSPITAL HAS MADE A COMMUNITY-WIDE COMMITMENT TO THE SHARED GOAL OF EXPANDING THE BREADTH AND IMPACT OF HEALTH INITIATIVES IN THE REGION. AS PART OF THE MASS IN MOTION MUNICIPAL WELLNESS PROGRAM, THE HOSPITAL HAS BEEN ACTIVELY INVOLVED IN ALL STAGES, FROM VISION TO IMPLEMENTATION, AND HAS COMMITTED WITH THE TOWN OF PLYMOUTH AND PLYMOUTH PUBLIC SCHOOLS TO FOCUSING ON FOUR KEY AREAS TO REDUCE OBESITY, IMPROVE NUTRITION AND PROMOTE ACTIVE LIVING COMMUNITY-WIDE. THE PROGRAM'S THREE-YEAR PLAN HAS MEASURABLE OBJECTIVES BASED ON THE HIGHEST PRIORITIES IDENTIFIED THROUGH COMMUNITY INPUT. THE PLAN ADDRESSES:1. SAFE ROUTES TO SCHOOL: IMPROVING WALKABILITY AND BIKEABILITY TO AREA SCHOOLS. OBJECTIVE: BY SEPTEMBER 30, 2012, PLYMOUTH WILL PROMOTE THE MASSDOT SAFE ROUTES TO SCHOOL PROGRAM SO THAT THE TOWN HAS A MINIMUM OF 50% OF ELEMENTARY AND MIDDLE SCHOOL STUDENTS ENROLLED IN AN ACTIVE SAFE ROUTE TO SCHOOL PROGRAM;2. SCHOOL NUTRITION: IMPROVING NUTRITIONAL QUALITY OF FOODS AND BEVERAGES IN LOCAL SCHOOLS. OBJECTIVE: BY SEPTEMBER 30,2014, 100% OF THE PLYMOUTH SCHOOL SYSTEM WILL HAVE IMPLEMENTED THE BASIC NUTRITIONAL GUIDELINES IN THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH GUIDELINES. 3. COMPLETE STREETS INITIATIVE: MAKING STREETS SAFE FOR ALL USERS (PEDESTRIANS, BICYCLISTS AND USERS OF PUBLIC TRANSPORTATION) BY ESTABLISHING COMMUNITY DESIGN STANDARDS. OBJECTIVE: BY SEPTEMBER 30, 2014, A COMPLETE STREETS POLICY WILL BE PROMULGATED AND IMPLEMENTED IN PLYMOUTH;4. HEALTHY NEIGHBORHOOD MARKET: INCREASING ACCESSIBILITY, AVAILABILITY, AFFORDABILITY AND IDENTIFICATION OF HEALTHY FOODS IN COLLABORATION WITH LOCAL RETAILERS. OBJECTIVE: BY SEPTEMBER 30, 2014, A MINIMUM OF 25% OF CONVENIENCE/SMALL STORES WITHIN THE TOWN OF PLYMOUTH WILL OFFER AND PROMOTE HEALTHIER FOOD AND BEVERAGES (INCLUDING FRESH FRUITS AND VEGETABLES, WHOLE GRAIN PRODUCTS, LOWER SODIUM OPTIONS, AND LOW FAT DAIRY) THROUGH AN ESTABLISHED HEALTHY NEIGHBORHOOD MARKET PROGRAM.PEDIATRIC PALLATIVE CARE:BRIEF DESCRIPTION OR OBJECTIVE: THE FRAGILE FOOTPRINTS PEDIATRIC PALLATIVE CARE PROGRAM IS PART OF THE MASSACHUSETTS PEDIATRIC CARE NETWORK ADMINISTERED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, DIVISION FOR PERINATAL, EARLY CHILDHOOD AND SPECIAL HEALTH NEEDS. THE PROGRAM PROVIDES MEDICAL CASE MANAGEMENT ADN SUPPORT TO MEDICALLY FRAGILE CHILDREN AND THEIR FAMILIES. PROGRAM TYPE DIRECT SERVICE TARGET POPULATION REGIONS SERVED: 48 TOWNS IN PLYMOUTH, BRISTON, BARNSTABLE AND DUKES COUNTIES.HEALTH INDICATOR: CHILD CARE, BEREAVEMENT, HOSPICE. SEX: ALLAGE GROUP: PRENATAL TO 19 YEARSETHIC GROUP: NOT SPECIFIEDLANGUAGE: NOT SPECIFIEDPARTNERS MASSACHUSETTS DEPARTMENT OF PUBLIC HELATH, PEDIATRIC PALLIATIVE CARE NETWORK CONTACT INFORMATION: DEBORAL DOLAWAY, LICSW. ADMINISTRATOR, CRANBERRY HOSPICE & PALLIATIVE CARE, 36 CORDAGE PARK CIRCLE, PLYMOUTH. 508-746-0215. DDOLAWAY@JORDANHOSPITAL.ORGDETAILED DESCRIPTION: FRAGILE FOOTPRINTS PEDIATRIC PALLIATIVE CARE PROGRAM IS DESIGNED TO IMPROVE THE QUALITY OF LIFE FOR CHILDREN WITH POTENTIALLY LIFE-LIMITING ILLNESS AND THEIR FAMILIES. AN INTERDISCIPLINARY TEAM OF NURSES, SOCIAL WORKERS, CHILD LIFE SPECIALISTS, SPIRITUAL CARE, COMPLEMENTARY THERAPY ADN EXPRESSIVE ARTS PRACTITIONERS AND TRAINED VOLUNTEERS HELP TO DESIGN A PLAY OF CARE THAT WILL COORDINATE AND AUGMENT EXISTING SERVICES. BY PROVIDING A COLLATORATIVE APPROACH, FRAGILE FOOTPRINTS WORKS TO ADDRESS PROBLEMS COMMONLY EXPERIENECED BY FAMILIES OF MEDICALLY FRAGILE CHILDREN INCLUDING EMOTIONAL STRESS AND ANXIETY, SCHOOL AND ACTIVITY INTERRUPTIONS OF SIBLINGS, ISOLATION, FINANCIAL AND RELATIONSHIP ISSUES CREATED BY COMPLEX MEDICAL DEMANDS AND DISRUPTION OF "NORMAL" ROUTINES. THE FRAGILE FOOTPRINTS STAFF WORKS CLOSELY WITH AREA HEALTH PROVIDERS, TERTIARY HOSPITALS, AND COMMUNITY SUPPORT PROGRAMS TO SIMPLIFY AND CREATE A COMPREHENSIVE PLAN TO SUPPORT CHILDREN, PARENTS AND SIBLINGS. BIOTERRORISM PROGRAM (IN CONJUNCTION WITH MASS DPH ASPR GRANT):BRIEF DESCRIPTION OR OBJECTIVE THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (MDPH) HAS BEEN AWARDED, FOR THE TENTH YEAR, COOPERATIVE AGREEMENT FUNDING FROM THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES, OFFICE OF THE ASSISTANT SECRETARY FOR PREPAREDNESS PROGRAM (HPP). THE PURPOSE OF THIS FUNDING IS TO CONTINUE TO DEVELOP AND SUPPORT AN EFFECTIVE STATEWIDE HOSPITAL AND HEALTH CARE EMERGENCY PREPAREDNESS AND RESPONSE SYSTEM IN MASSACHUSETTS. JORDAN HOSPITAL HAS A REPRESENTATIVE THAT PARTICIPATES IN HOSPITAL PREPAREDNESS AND COLLABORATES WITH ALL THE OTHER ACUTE CARE HOSPITALS WITHIN REGION 5 IN HOSPITAL PREPAREDNESS AND IN DEVELOPING PRIORITIES FOR BOTH THE REGION AND THE HOSPITAL. THE JORDAN HOSPITAL EMERGENCY PREPAREDNESS REPRESENTATIVE ATTENDS MONTHLY MEETINGS, WORKS WITH COMMUNITY PARTNERS SUCH AS POLICE, FIRE, EMD AND THE JORDAN HOSPITAL STAFF TO ASSURE READINESS IN THE CASE OF A DISASTER. PROGRAM TYPE OUTREACH TO UNDERSERVED, PREVENTION TARGET POPULATIONREGIONS SERVED: COUNTY-PLYMOUTH, REGION 5HEALTH INDICATOR: ENVIRONMENTAL QUALITYSEX: ALLETHNIC GROUP: NOT SPECIFIEDLANGUAGE: NOT SPECIFIEDPARTNERS REGION 5 HOSPITALS CONTACT INFORMATION: JANE STILES RN, MM- EMERGENCY PREPAREDNESS COORDATION, AT 508-830-2812, JSTILES@JORDANHOSPITAL.ORGDETAILED DESCRIPTION: THE FUNDING HAS OVERARCHING REQUIREMENTS SUCH AS NATIONAL INCIDENT MANAGEMENT SYSTEMS (NIMS), NEEDS FOR AT-RISK POPULATIONS, EDUCATION, PREPAREDNESS TRAINING, EXERCISES, EVALUATIONS AND CORRECTIVE ACTIONS. ALSO LEVEL ONE SUB-CAPABILITIES SUCH AS INTEROPERABLE COMMUNICATION SYSTEM, HOSPITAL AVAILABLE BED TRACKING SYSTEM (HAVBED), PARTIALLY MANAGEMENT PLANS, HOSPITAL EVACUATION AND SELTER-IN-PLACE PLANS, DECONTAMINATION PROCEDURES AND THE MDU (MASS DECONTAIMINATION UNIT WITH PLYMOUTH FIRE DEPARTMENT), PHARMACEUTICAL CACHES, PERSONAL PROTECTIVE EQUIPMET, REGIONAL PROJECT DEVELOPMENT AND LABORATORY RESPONSE NETOWRK. ESSENTIAL COMMUNITY PROVIDER PROGRAM:BRIEF DESCRIPTION OR OBJECTIVE OF EHR (ELECTRONIC HEALTH RECORD) COMMITTEE WAS FORMED TO DESIGN, IMPLEMENT, AND ADOPT A FULLY FUNCTIONAL EHR TO INCLUDE COMPUTERIZED PHYSICIAL ORDER ENTRY (CPOE) AND ELECTRONIC PHYSICIAL DOCUMENTATION. PROGRAM TYPE DIRECT SERVICE TARGET POPULATION:REGIONS SERVED: COUNTY-PLYMOUTHHEALTH INDICATOR: ALLSEX: ALLAGE GROUP: ALLETHNIC GROUP: NOT SPECIFIEDLANGUAGE: NOT SPECIFIEDPARTNERS CONTACT INFORMATION: RON RUTHERFORD, DEPUTY CIO JORDAN HOSPITAL, INC. 275 SANDWICH ST, PLYMOUTH, MA 02360; (508) 830-2286 OR EMAIL: RRUTHERFORD@JORDANHOSPITAL.ORGDETAILED DESCRIPTION: THE ESSENTIAL COMMUNITY PROVIDED FUNDING ASSISTS IN THE TRANSITION TOWARDS PROVIDING MORE ACCESSIBLE AND COST-EFFECTIVE HEALTH CARE AND ALLOWS US TO FOCUS ON AREAS FOR INNOVATION AND IMPROVEMENT TO BENEFIT OUR RESIDENTS. MAJOR INITIATIVES INCLUDE: THE TARGETED AREAS OF FOCUS INCLUDE CONVERSION OF PAPER-BASED DOCUMENTATION, INFRASTRUCTURE DEVELOPMENT, AND PLANNING FOR A FUNCTIONAL HEALTH INFORMATION EXCHANGE (HIE). THESE INITIATIVES ARE CRITICAL TO THE DEVELOPMENT OF A COMPLETE AND FULLY FUCNTIONAL ELECTRONIC HEALTH RECORD THAT IS PLANNED FOR COMPLETED IMPLEMENTATION BY 2013. THE MAJOR COMPONENETS OF THE EHR HAVE BEEN SPORADICALLY IMPLEMENETED OVER THE PAST FEW YEARS AT JORDAN HOSPITAL. SIGNIFICANT INVESTMENTS IN CAPITAL AND LABOR HAVE BEEN MADE TO FULLY IMPLEMENT ALL COMPONENTS OF THE EMR IN AN EFFORT TO IMPROVE PATIENT SAFETY AND QUALIFY FOR FEDERAL FUNDS UNDER MEANINGFUL USE STAGE I. THIS INCLUDES COMPUTERIZED PHYSICIAN ORDER ENTRY, PHYSICIAN ELECTRONIC DOCUMENTATION, CLINICIAN DOCUMENTATION, ELECTRONICMEDICATION ADMINISTRATION RECORDS AND OTHER REQUIREMENTS FOR ACHIEVING MEANINGFUL PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:JORDAN HEALTH SYSTEMS, INC. (THE PARENT), AND AFFILIATES (COLLECTIVELY, THE SYSTEM) IS COMPOSED OF A NONPROFIT HOSPITAL CORPORATION, JORDAN HOSPITAL, INC. (THE HOSPITAL), A REAL ESTATE CORPORATION (JH REALTYCORPORATION), AN AMBULATORY CARE PROVIDER (JORDAN AMBULATORY HEALTH CARE, INC.), LOCAL PHYSICIAN PRACTICES (JORDAN PHYSICIAN ASSOCIATES, INC.), A FOUNDATION (JORDAN HEALTH FOUNDATION, INC.), A FOR PROFIT ACCOUNTABLE CARE ORGANIZATION (JORDAN COMMUNITY ACO, INC.) AND A FOR-PROFIT MANAGEMENT CORPORATION(ATLANTIC MEDICAL MANAGEMENT, INC.). THE SYSTEM WORKS COLLABORATIVELY TO PROMOTE THE HEALTH OF THE GREATER PLYMOUTH AREA. REPORTS FILED WITH STATES PART VI, LINE 7 MA LINE 5, PROMOTION OF COMMUNITY HEALTH CONT. HEALTHY COMMUNITY INITIATIVE (NOW HEALTHY PLYMOUTH) BRIEF DESCRIPTION OR OBJECTIVE JORDAN HOSPITAL, WITH THE TOWN OF PLYMOUTH AND PLYMOUTH PUBLIC SCHOOLS, HAS BROUGHT TOGETHER MORE THAN 60 COMMUNITY PARTNERS - FROM CITY OFFICIALS TO LOCAL FARMERS - TO ENVISION AND BUILD A MORE HEALTH-SUSTAINING COMMUNITY, WHERE THE HEALTHY CHOICE IS THE EASY CHOICE. PROGRAM TYPE COMMUNITY EDUCATION, COMMUNITY HEALTH NEEDS ASSESSMENT, COMMUNITY PARTICIPATION/CAPACITY BUILDING INITIATIVE, HEALTHY COMMUNITIES PARTNERSHIP, OUTREACH TO UNDERSERVED, PREVENTION, SCHOOL/HEALTH CENTER PARTNERSHIP TARGET POPULATION REGIONS SERVED: COUNTY-PLYMOUTH HEALTH INDICATOR: OBESITY, HEART DISEASE, LUNG DISEASE, CANCER, DIABETES, NUTRITION SEX: ALL AGE GROUP: ALL ETHNIC GROUP: ALL LANGUAGE: NOT SPECIFIED PARTNERS TOWN OF PLYMOUTH, PLYMOUTH PUBLIC SCHOOLS, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH CONTACT INFORMATION ANDREA HOLLERAN, VP OF EXTERNAL AFFAIRS JORDAN HOSPITAL, 275 SANDWICH ST, PLYMOUTH, MA 02360 (508) 830-2029 AHOLLERAN@BIDPLYMOUTH.ORG DETAILED DESCRIPTION AS A RESULT OF THE COLLABORATIVE WORK INITIATED BY JORDAN HOSPITAL, THE TOWN OF PLYMOUTH, PLYMOUTH PUBLIC SCHOOLS AND OTHER COMMUNITY PARTNERS ARE NOW FINDING NEW WAYS TO WORK TOGETHER WITH JORDAN HOSPITAL TO FOSTER BETTER HEALTH IN OUR COMMUNITY, LONG-TERM, AND AT A LOWER COST, THROUGH THE HEALTHY COMMUNITY INITIATIVE (HCI). SUPPORTED BY JORDAN HOSPITAL'S VICE PRESIDENT OF EXTERNAL AFFAIRS, THE HOSPITAL HAS MADE A COMMUNITY-WIDE COMMITMENT TO THE SHARED GOAL OF DEVELOPING POLICY LEVEL CHANGES THAT WILL EXPAND THE BREADTH AND IMPACT OF HEALTH INITIATIVES IN THE REGION. AS PART OF THE MASS IN MOTION MUNICIPAL WELLNESS PROGRAM, THE HOSPITAL HAS BEEN ACTIVELY INVOLVED IN ALL STAGES, FROM VISION TO IMPLEMENTATION, AND HAS COMMITTED WITH THE TOWN OF PLYMOUTH AND PLYMOUTH PUBLIC SCHOOLS TO FOCUS ON FOUR KEY AREAS TO REDUCE OBESITY, IMPROVE NUTRITION AND PROMOTE ACTIVE LIVING COMMUNITY-WIDE. THE PROGRAM'S THREE-YEAR PLAN HAS MEASURABLE OBJECTIVES BASED ON THE HIGHEST PRIORITIES IDENTIFIED THROUGH COMMUNITY INPUT. ACCOUNTABLE CARE ORGANIZATION PHYSICIAN SPEAKING PROGRAM BRIEF DESCRIPTION OR OBJECTIVE JORDAN HOSPITAL HEALTHCARE PROFESSIONALS, FROM PHYSICIANS TO DIETICIANS, OFFER A RANGE OF EDUCATIONAL TALKS FOR THE COMMUNITY. THE HOSPITAL'S RECENT COMMUNITY NEEDS ASSESSMENT AND FEEDBACK FROM ACO INITIATIVES INSTRUCTS PROGRAM EDUCATIONAL CONTENT. IN ADDITION TO THE TALKS, WHICH ARE BROADCAST LOCALLY FOR WIDER DISTRIBUTION, MONTHLY ARTICLES COVERING THE TOPICS APPEAR IN THE LOCAL NEWSPAPER. THE PROGRAM FOCUSES ON PREVENTION AND CONSIDERS TOPICS OF PARTICULAR INTEREST TO UNDERSERVED ACO BENEFICIARIES. PROGRAM TYPE COMMUNITY EDUCATION TARGET POPULATION - REGIONS SERVED: COUNTY-PLYMOUTH - HEALTH INDICATOR: OTHER: ARTHRITIS, OTHER: CANCER, OTHER: CARDIAC DISEASE, OTHER: DIABETES, OTHER: NUTRITION, OTHER: PROSTATE DISEASE, OTHER: OSTEOPOROSIS/MENOPAUSE, PHYSICAL ACTIVITY, DEMENTIA, EXERCISE AND SPORTS INJURY PREVENTION - SEX: ALL - AGE GROUP: ADULT - ETHNIC GROUP: ALL - LANGUAGE: NOT SPECIFIED PARTNERS NOT SPECIFIED CONTACT INFORMATION EVENTS ARE FREE AND OPEN TO THE PUBLIC. PRE-REGISTRATION IS REQUIRED. REGISTER AT 855-4-BIDPLY (855-424-3759). DETAILED DESCRIPTION JORDAN HOSPITAL HEALTHCARE PROFESSIONALS, FROM PHYSICIANS TO DIETICIANS, OFFER A RANGE OF PREVENTION-FOCUSED EDUCATIONAL TALKS FOR THE COMMUNITY, COVERING TOPICS OF INTEREST TO THE UNDERSERVED COMMUNITY OF ACO BENEFICIARIES. THE HOSPITAL'S RECENT COMMUNITY NEEDS ASSESSMENT AND INPUT FROM CURRENT ACO INITIATIVES INSTRUCTS PROGRAM EDUCATIONAL CONTENT. IN ADDITION TO THE TALKS, WHICH ARE BROADCAST LOCALLY FOR WIDER DISTRIBUTION, MONTHLY ARTICLES APPEAR IN THE LOCAL NEWSPAPER AND ARE PROMOTED ON THE HOSPITAL WEBSITE AND SOCIAL MEDIA. TOPICS IN 2013 INCLUDED: GLAUCOMA; MANAGING CHOLESTEROL; GETTING THE MOST OUT OF VISITS WITH YOUR DOCTOR; MEDICATION MANAGEMENT; CARE TRANSITIONS; PREVENTIVE EFFECT OF EXERCISE, NUTRITION, AND SOCIAL ENGAGEMENT; MEMORY LOSS; PHYSIOLOGY OF GRACEFUL AGING; HEART DISEASE; FALL PREVENTION; AND SEASONAL AFFECTIVE DISORDER. 2014 PROGRAMS ARE LIKELY TO ADDRESS: NON-SURGICAL METHODS OF MANAGING OSTEOARTHRITIS PAIN, EYE HEALTH, MEDICATION SAFETY, DEPRESSION, ADVANCE DIRECTIVES, KIDNEY FUNCTION, MANAGING DEHYDRATION, ACID REFLUX, HEALTH EFFECTS OF POOR SLEEP, STAYING HEALTHY WITH COPD. 1 0 0 0 0 0 0 0 0 PETER HOLDEN 0 454953 0 69525 0 165373 0 0 0 30040 0 719891 0 0 JOSEPH IANNONI 0 315753 0 38316 0 13234 0 0 0 30040 0 397343 0 0 JOANNE FORD 180955 0 200 0 17253 0 0 0 24187 0 222595 0 0 0 GAIL ROBBINS 166458 0 0 0 1939 0 0 0 23514 0 191911 0 0 0 RON RUTHERFORD 150436 0 0 0 6019 0 0 0 22857 0 179312 0 0 0 MARK TARLTON 146852 0 0 0 6426 0 0 0 22825 0 176103 0 0 0 RUTH MCNAUGHTON 148754 0 100 0 6216 0 0 0 22870 0 177940 0 0 0 PART I, LINE 4A UNDER A SEPARATION AGREEMENT,JOANNE FORD RECEIVED COMPENSATION, BENEFITS AND OUTPLACEMENT SERVICES. AMOUNTS PAID UNDER THE SEVERANCE AGREEMENT AS OF JUNE 30, 2013 WERE $66,851. A MHEFA SERIES E REVENUE BONDS 042456011 57585K5J3 2003-07-01 49935000 CONSTRUCTION & CAPITAL PROJECTS 0 0 0 A 49935000 49599080 7384190 779069 217346 37065899 2005 0 0 1 1 A 0 0 0 0 0.00690 0.00690 1 0 1 A 0 0 0 1 0 0 0 0 1 A 1 SCHEDULE K PART IV, ARBITRAGE, LINE 2C DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MHEFA SERIES E REVENUE BONDS DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2013 FORM 990, PART I LINE 1 AND PART III, LINE 1 JORDAN HOSPITAL SEEKS TO PROMOTE HEALTH AND WELLNESS SERVICES WITH EXCELLENCE. SERVING THE GREATER PLYMOUTH REGION, THE HOSPITAL COLLABORATES WITH COMMUNITY LEADERS, PUBLIC AND PRIVATE AGENCIES AND BUSINESSES, TO PROVIDE HEALTH PROMOTION, HEALTH PROTECTION AND PREVENTIVE SERVICES TO MEET THE BROAD RANGE OF OUR COMMUNITY'S HEALTH AND WELLNESS NEEDS AS IDENTIFIED THROUGH COMMUNITY FEEDBACK AND FORMAL COMMUNITY NEEDS ASSESSMENTS. AS PART OF ITS MISSION TO SUPPORT COMMUNITY HEALTH, JORDAN HOSPITAL IS COMMITTED TO ASSESSING ROOT CAUSES OF HEALTH DISPARITIES AND TO ASSISTING IN IMPROVING HEALTH CARE FOR THE DISADVANTAGED AND UNDERSERVED. FORM 990, PART VI, SECTION A, LINE 2 MANY OF THE PERSONS LISTED ON PART VII HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON BOARDS OF ENTITIES RELATED TO JORDAN HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11 JORDAN HOSPITAL, INC'S FORM 990 IS INITIALLY PREPARED BY AN OUTSIDE PAID PREPARER. THE 990 IS REVIEWED BY INTERNAL MANAGEMENT AND FOLLOWING THAT REVIEW, IT IS PRESENTED BY MANAGEMENT TO THE AUDIT COMMITTEE FOR REVIEW AND COMMENT. THE COMPLETED 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C JORDAN HEALTH SYSTEMS, INC. HAS A WRITTEN CONFLICT OF INTEREST POLICY, WHISTLES BLOWER POLICY, AND DOCUMENT RETENTION AND DESTRUCTION POLICY IN PLACE WHICH APPLIES TO THE SYSTEM AND ITS RELATED ORGANIZATIONS. ALL OFFICERS AND BOARD MEMBERS ARE SUBJECT TO THE POLICIES. OFFICERS AND DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE, IN WRITING, ANNUALLY, TO DISCLOSE ANY FINANCIAL OR BUSINESS RELATIONSHIPS THAT HE, SHE OR ANY FAMILY MEMBER MAY HAVE WITHIN THE JORDAN SYSTEM. THE QUESTIONNAIRE RESPONSES ARE REVIEWED BY THE ORGANIZATION. ALL CONFLICTS ARE RESOLVED AT THIS REVIEW IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: NET TRANSFERS TO AFFILIATES -3,047,230. PENSION ADJUSTMENT 3,629,880. JORDAN PHYSICIAN ASSOCIATES INC 275 SANDWICH STREET PLYMOUTH MA 02360 043228556 HEALTHCARE MA 501(C)(3) LINE 9: 509(A)(2) JHSI 0 JORDAN AMBULATORY HEALTH CARE INC 36 CORDAGE PARK CIRCLE PLYMOUTH MA 02360 222667348 HEALTHCARE MA 501(C)(3) LINE 3: 170(B)(1)(A) JHSI 0 JORDAN HEALTH FOUNDATION INC 275 SANDWICH STREET PLYMOUTH MA 02360 510432984 PHILANTHROPY MA 501(C)(3) LINE 11, TYPE I: 509 JHSI 0 JORDAN HEALTH SYSTEMS INC 275 SANDWICH STREET PLYMOUTH MA 02360 042103805 HEALTHCARE MA 501(C)(3) LINE 7: 170(B)(1)(A) N/A 0 JH REALTY CORPORATION 275 SANDWICH STREET PLYMOUTH MA 02360 222667673 REAL ESTATE MA 501(C)(3) LINE 11, TYPE I: 509 JHSI 0 ATLANTIC MEDICAL MANAGEMENT 275 SANDWICH STREET PLYMOUTH MA 02360 043161451 SUPPORT STAFFING MA JHSI C 0 JORDAN COMMUNITY ACO INC 275 SANDWICH STREET PLYMOUTH MA 02360 454047430 HEALTH CARE SERVICES MA JHSI C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1