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SCHEDULE H NARRATIVES
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FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSNEW ENGLAND BAPTIST HOSPITAL (NEBH) AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF NEBH. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES. NEBH COMMUNITY BENEFITS MISSION STATEMENT NEW ENGLAND BAPTIST HOSPITAL (NEBH) IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED IN MUSCULOSKELETAL DISEASE AND COLLABORATE ON PROGRAMS TO ADDRESS THESE NEEDS, WITH SPECIAL FOCUS ON UNDERSERVED POPULATIONS THROUGH OUTREACH, EDUCATION AND PROVISION OF SERVICES TO ADDRESS MUSCULOSKELETAL HEALTH.NEBH'S COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING NEBH'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY; ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. SPECIAL ATTENTION IS FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES NEBH'S SERVICE AREA GEARED TOWARD IMPROVING CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES; PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $492,528 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMNEBH'S COMMUNITY BENEFITS LEADERSHIP TEAM INCLUDES REPRESENTATION FROM THE HOSPITAL'S SENIOR ADMINISTRATION, PATIENT FAMILY AND ADVISORY COUNCIL, AND REPRESENTATIVES FROM COMMUNITY AGENCIES, ALL OF WHOM ARE MEMBERS OF THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE. THE HOSPITAL'S COMMUNITY AND GOVERNMENT AFFAIRS DEPARTMENT MANAGES THE DAY-TO-DAY OPERATIONS OF THE COMMUNITY BENEFITS PROGRAM WITH GUIDANCE FROM HOSPITAL LEADERSHIP, THE FINANCE DEPARTMENT AND THE COMMUNITY BENEFITS ADVISORY COMMITTEE. COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED. NEBH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2019. THAT CHNA WAS APPROVED BY THE NEBH BOARD OF TRUSTEES ON SEPTEMBER 18, 2019. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 18, 2019 WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (IS) REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF NEBH'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT NEBH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW NEBH, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2019 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONAS NOTED ABOVE, NEBH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2019. THE GEOGRAPHICAL FOCUS OF NEBH'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES THE MISSION HILL AND ROXBURY NEIGHBORHOODS OF BOSTON, AS WELL AS THE CITIES OF DEDHAM, CHESTNUT HILL (NEWTON) AND BROOKLINE. THESE COMMUNITIES DEFINE NEBH'S COMMUNITY BENEFITS SERVICE AREA (CBSA). IN RECOGNITION OF THE CONSIDERABLE HEALTH DISPARITIES THAT EXIST IN SOME COMMUNITIES, NEBH FOCUSES THE BULK OF ITS COMMUNITY BENEFITS RESOURCES ON IMPROVING THE HEALTH STATUS OF LOW-INCOME AND UNDERSERVED POPULATIONS LIVING IN THE BOSTON NEIGHBORHOODS OF ROXBURY AND MISSION HILL. WHILE THERE ARE CERTAINLY SEGMENTS OF THE POPULATIONS IN BROOKLINE, CHESTNUT HILL, AND DEDHAM THAT ARE VULNERABLE AND UNDERSERVED, THE GREATEST DISPARITIES EXIST IN BOSTON. IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS RESOURCES, NEBH'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) VOTED TO PRIORITIZE AND FOCUS NEBH'S ATTENTION ON THE MORE URBAN, HIGH-NEED COMMUNITIES IN NEBH'S CBSA.TARGET POPULATIONS FOR NEBH'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).NEBH'S TARGET POPULATIONS FOCUS ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS AS FOLLOWS: LOW- AND MODERATE-INCOME POPULATIONS OLDER ADULTS RACIALLY AND ETHNICALLY DIVERSE POPULATIONS/NON-ENGLISH SPEAKERSCHILDREN AND FAMILIES
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2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODS
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THE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM 4,219 SURVEYS, 74 KEY INFORMANT INTERVIEWS, 35 FOCUS GROUPS AND 5 COMMUNITY MEETINGS. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE BOSTON AND NEIGHBORING CITIES THAT COMPRISE THE GREATER BOSTON REGION AND WITH A RANGE OF PEOPLE REPRESENTING DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., OLDER ADULTS) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 1,085 PEOPLE.NEBH HIRED JOHN SNOW, INC. (JSI), TO CONDUCT AND MANAGE THE CHNA PROCESS UNDERTAKEN DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND JSI WORKED CLOSELY WITH NEBH'S COMMUNITY BENEFITS STAFF THROUGHOUT THE PROCESS. THE MOST RECENT CHNA WAS DESIGNED AS A THREE-PHASE PROCESS: PHASE ONE INVOLVED PRELIMINARY ASSESSMENT AND ENGAGEMENT ACTIVITIES, INCLUDING: COLLECTION AND ANALYSIS OF QUANTITATIVE DATA TO CHARACTERIZE COMMUNITY CHARACTERISTICS AND DISEASE BURDEN KEY INFORMANT INTERVIEWS WITH HOSPITAL LEADERSHIP, THE PATIENT FAMILY ADVISORY COMMITTEE, AND COMMUNITY STAKEHOLDERS AN EVALUATION OF NEBH'S CURRENT PORTFOLIO OF COMMUNITY BENEFITS ACTIVITIESPHASE TWO INVOLVED TARGETED ENGAGEMENT ACTIVITIES, INCLUDING: FOCUS GROUPS WITH HOSPITAL LEADERSHIP, CLINICAL PROVIDERS AND COMMUNITY STAKEHOLDERS DISSEMINATION AND ANALYSIS OF A COMMUNITY HEALTH SURVEY TO CAPTURE RESIDENTS' PERCEPTIONS OF BARRIERS TO GOOD HEALTH, LEADING HEALTH ISSUES, VULNERABLE POPULATIONS, ACCESSIBILITY OF HEALTH SERVICES, AND OPPORTUNITIES FOR THE HOSPITAL TO IMPROVE THE SERVICES THEY OFFER TO THE COMMUNITYPHASE THREE INVOLVED A SERIES OF STRATEGIC PLANNING AND REPORTING ACTIVITIES, INCLUDING: MEETINGS WITH THE CBAC AND SENIOR LEADERSHIP TEAM (INCLUDING MEMBERS OF THE BOARD OF TRUSTEES) TO PRESENT CHNA FINDINGS, PRIORITIZE COMMUNITY HEALTH ISSUES, IDENTIFY VULNERABLE POPULATIONS, AND DISCUSS POTENTIAL RESPONSES CREATION OF A RESOURCE INVENTORY TO CATALOG LOCAL ORGANIZATIONS, SERVICE PROVIDERS, AND COMMUNITY ASSETS THAT HAVE THE POTENTIAL TO ADDRESS IDENTIFIED NEEDS LITERATURE REVIEW OF EVIDENCE-BASED STRATEGIES TO RESPOND TO IDENTIFIED HEALTH PRIORITIES DEVELOPMENT AND DISSEMINATION OF A FINAL CHNA REPORT AND IS
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2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHOD
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THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM THE DISSEMINATION AND ANALYSIS OF A COMMUNITY HEALTH SURVEY TO CAPTURE RESIDENTS' PERCEPTIONS OF BARRIERS TO GOOD HEALTH, LEADING HEALTH ISSUES, VULNERABLE POPULATIONS, ACCESSIBILITY OF HEALTH SERVICES AND OPPORTUNITIES FOR THE HOSPITAL TO IMPROVE THE SERVICES THEY OFFER TO THE COMMUNITY. QUANTITATIVE DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN NEBH'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF THE HEALTH-RELATED ISSUES. SOURCES INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017 AND 2018-2019) FBI UNIFORM CRIME REPORTS (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY 2013-2017) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018) THE CHNA ALSO INCLUDED SOME MORE REFINED ANALYSIS OF HOSPITAL DISCHARGE DATA COMPILED BY THE MASSACHUSETTS CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA). THIS ANALYSIS FOCUSED ON ANALYZING AMBULATORY CARE SENSITIVE CONDITIONS, WHICH ALLOW FOR THE ASSESSMENT OF THE STRENGTH OF A COMMUNITY'S PRIMARY CARE SYSTEM AND ITS ABILITY TO PREVENT OR AVOID HOSPITALIZATIONS.
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2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS
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KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS:NEBH, WITH THE HELP OF JSI, CONDUCTED 12 KEY INFORMANT INTERVIEWS WITH COMMUNITY STAKEHOLDERS, INCLUDING REPRESENTATIVES FROM HOSPITAL AND MUNICIPAL LEADERSHIP, THE BUSINESS COMMUNITY, PUBLIC HEALTH DEPARTMENTS, SOCIAL SERVICE PROVIDERS, SCHOOLS, FAITH-BASED COMMUNITIES, AND COMMUNITY HEALTH COALITIONS. JSI ALSO FACILITATED TWO FOCUS GROUPS. ADDITIONALLY, AS PART OF THE BOSTON COLLABORATIVE, NEBH'S CHNA WAS INFORMED BY 74 KEY INFORMANT INTERVIEWS THAT ENGAGED INSTITUTIONAL, ORGANIZATIONAL AND COMMUNITY LEADERS AND FRONT-LINE STAFF ACROSS SECTORS. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. INTERVIEWS WERE CONDUCTED IN PERSON AND ON THE PHONE USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING MAJOR HEALTH ISSUES, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS, AND TARGET POPULATIONS. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)TWO FOCUS GROUPS WITH IDENTIFIED UNDERSERVED POPULATIONS WERE ALSO HELD. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS. PARTICIPANTS REPRESENTED DIFFERENT AUDIENCES, INCLUDING COMMUNITY MEMBERS AND LONG-TERM PATIENTS FROM MILLION HILL WHO COME TOGETHER TO ORGANIZE SOCIAL EVENTS AND COMMUNITY -ORIENTED PROJECTS (SCHEDULE H, PART VJ, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 185 PEOPLE. APPENDIX A IN THE BEBH CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS AND THE QUESTIONS ASKED.
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2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS
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REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTS AS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS. IDENTIFY NEBH'S COMMUNITY BENEFITS PRIORITY POPULATIONS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. ANALYZE NEBH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2016 CHNA AND SUBSEQUENT IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY NEBH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015). DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018).THE NEBH COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS DEVELOPED BY A TEAM COMPRISED OF HOSPITAL LEADERSHIP, PATIENT ADVOCACY, MEDICAL STAFF, PUBLIC RELATIONS AND COMMUNITY REPRESENTATION. THE GROUP REVIEWED PROGRESS TOWARD GOALS AND OBJECTIVES OF THE PRIOR THREE-YEAR PERIOD, AS WELL AS THE CURRENT DATA COLLECTED THROUGH THE CHNA, TO HELP ENVISION AND DEFINE PRIORITY AREAS FOR THE FUTURE. THE IMPLEMENTATION STRATEGY IDENTIFIED PRIORITY AREAS AND DEFINED GOALS, ALONG WITH OBJECTIVES FOR EACH GOAL AND DRAFTED STRATEGIES TO OPERATIONALIZE THESE OBJECTIVES.
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2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGS
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THE NEBH 2019 CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: SOCIAL DETERMINANTS OF HEALTH CONTINUE TO HAVE A TREMENDOUS IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE CBSA'S LOW-INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY COHESION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. DISPARITIES IN HEALTH OUTCOMES EXIST IN NEBH'S CBSA BY RACE/ETHNICITY, FOREIGN BORN STATUS, INCOME AND LANGUAGE. THERE ARE MAJOR HEALTH DISPARITIES FOR RESIDENTS LIVING IN NEBH'S CBSA. THIS IS PARTICULARLY TRUE FOR RACIALLY/ETHNICALLY DIVERSE, FOREIGN BORN, LOW-INCOME, AND NON-ENGLISH SPEAKING RESIDENTS LIVING IN THE BOSTON NEIGHBORHOODS OF MISSION HILL AND ROXBURY. THE IMPACT OF RACISM, BARRIERS TO CARE, AND DISPARITIES IN HEALTH OUTCOMES THAT THESE POPULATIONS FACE ARE WIDELY DOCUMENTED IN THE LITERATURE AND CONFIRMED BY THE DATA CAPTURED BY THIS ASSESSMENT. HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS. THE ASSESSMENT'S QUANTITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN NEBH'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN MANY COMMUNITIES, THESE RATES ARE STATISTICALLY HIGHER THAN COMMONWEALTH RATES, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. HOWEVER, EVEN FOR THOSE COMMUNITIES WHERE THE RATES ARE NOT STATISTICALLY HIGHER, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH. HIGH RATES OF THE LEADING HEALTH RISK FACTORS. ONE OF THE LEADING FINDINGS FROM THE ASSESSMENT IS THAT MANY COMMUNITIES AND/OR POPULATION SEGMENTS IN NEBH'S CBSA HAVE HIGH RATES OF CHRONIC PHYSICAL AND BEHAVIORAL HEALTH CONDITIONS. IN SOME PEOPLE, THESE CONDITIONS HAVE UNDERLYING GENETIC ROOTS THAT ARE HARD TO COUNTER. HOWEVER, FOR MOST PEOPLE THESE CONDITIONS ARE WIDELY CONSIDERED PREVENTABLE OR MANAGEABLE. ADDRESSING THE LEADING RISK FACTORS IS AT THE ROOT OF A SOUND CHRONIC DISEASE PREVENTION AND MANAGEMENT STRATEGY. HIGH RATES OF SUBSTANCE USE AND MENTAL HEALTH ISSUES. THE IMPACT OF SOCIAL DETERMINANTS WAS THE LEAD FINDING, BUT A CLOSE SECOND WAS THE PROFOUND IMPACT OF BEHAVIORAL HEALTH ISSUES (I.E., SUBSTANCE USE AND MENTAL HEALTH) ON INDIVIDUALS, FAMILIES AND COMMUNITIES IN EVERY GEOGRAPHIC REGION AND EVERY POPULATION SEGMENT IN NEBH'S CBSA. DEPRESSION/ANXIETY, SUICIDE, ALCOHOL USE, OPIOID AND PRESCRIPTION DRUG USE, AND MARIJUANA USE ARE MAJOR HEALTH ISSUES AND ARE HAVING A SIGNIFICANT IMPACT ON THE POPULATION AS WELL AS A BURDEN ON THE SERVICE SYSTEM. THE FACT THAT PHYSICAL AND BEHAVIORAL HEALTH ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID USE AND THE IMPACTS OF TRAUMA. LIMITED ACCESS TO BEHAVIORAL HEALTH SERVICES, PARTICULARLY FOR LOW-INCOME, MEDICAID COVERED, UNINSURED, FOREIGN BORN, NON-ENGLISH SPEAKERS, AND THOSE WITH COMPLEX/MULTI-FACETED ISSUES. DESPITE THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON ALL SEGMENTS OF THE POPULATION, THERE IS AN EXTREMELY LIMITED SERVICE SYSTEM AVAILABLE TO MEET THE NEEDS THAT EXIST FOR THOSE WITH MILD TO MODERATE EPISODIC ISSUES OR THOSE WITH MORE SERIOUS AND COMPLEX, CHRONIC CONDITIONS. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE (INCLUDING STIGMA), AND IMPROVE THE QUALITY OF PRIMARY CARE AND SPECIALIZED BEHAVIORAL HEALTH SERVICES. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM NEBH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022.
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INTERIM CHANGES AND UPDATES TO IMPLEMENTATION STRATEGY
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BASED ON NEWLY IDENTIFIED COMMUNITY NEEDS COVID PANDEMICAS PREVIOUSLY NOTED IN THIS FILING, IRC SECTION 501(R)(3) AND THE PROMULGATED REGULATIONS REQUIRE THAT A TAX-EXEMPT HOSPITAL CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPT AN IMPLEMENTATION STRATEGY ADDRESSING COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA AT LEAST ONCE EVERY THREE YEARS. THE PREAMBLE TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R)(3) NOTES THAT THE TREASURY AND THE IRS INTENDED FOR THE CHNA AND IMPLEMENTATION STRATEGY REQUIREMENT TO ESTABLISH CONTINUAL FEEDBACK ON CHNA REPORTS AND A HOSPITAL IS REQUIRED TO CONSIDER COMMENTS RECEIVED RELATED TO THE EXISTING CHNA AND IMPLEMENTATION STRATEGY WHEN ENGAGING IN THE NEXT CHNA PROCESS NOT MORE THAN THREE YEARS AFTER ADOPTION. IN ADDITION, FINAL REGULATIONS DO NOT PROHIBIT IMPLEMENTATION STRATEGIES FROM DISCUSSING HEALTH NEEDS IDENTIFIED THROUGH MEANS OTHER THAN A CHNA, PROVIDED THAT THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA ARE ALSO DISCUSSED. FINALLY, THERE IS NOTHING IN THE REGULATIONS THAT PROHIBITS A HOSPITAL FROM UPDATING ITS IMPLEMENTATION STRATEGY BASED ON AN OFF-CYCLE CHANGE TO THE COMMUNITY HEALTH NEEDS THAT ARISE. DURING THE PERIOD COVERED BY THIS FILING, OCTOBER 1, 2019 TO SEPTEMBER 30, 2020, THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY NEBH, WERE IMPACTED BY AN UNEXPECTED GLOBAL PANDEMIC. ON JANUARY 9, 2020, THE WORLD HEALTH ORGANIZATION (WHO) ANNOUNCED THE IDENTIFICATION OF A NEW AND NOVEL CORONAVIRUS-RELATED PNEUMONIA IN WUHAN, CHINA. ON JANUARY 21, 2020 THE UNITED STATES CENTER FOR DISEASE CONTROL CONFIRMED THE FIRST CASE OF THIS NEW CORONA VIRUS IN THE UNITED STATES. ON JANUARY 31, 2020, THE WHO ISSUED A GLOBAL HEALTH EMERGENCY AND ON FEBRUARY 3 THE UNITED STATES DECLARED A PUBLIC HEALTH EMERGENCY BECAUSE OF THE COVID-19 VIRUS. ON MARCH 11, 2020, THE WHO DECLARED COVID-19 A PANDEMIC AND TWO DAYS LATER, THE PRESIDENT OF THE UNITED STATES DECLARED COVID-19 A NATIONAL EMERGENCY.THE HEALTH OF THE COMMUNITIES SERVED BY NEBH WERE IMPACTED BY THIS UNFORESEEN HEALTH CRISIS AND IN THE ABSENCE OF REGULATORY GUIDANCE TO THE CONTRARY, NEBH NEEDED TO QUICKLY REASSESS AND PIVOT TO MEET THE NEW AND PREVIOUSLY UNEXPECTED COMMUNITY NEEDS. AS SUCH, IN RESPONSE TO THE COVID-19 CRISIS NEBH'S COMMUNITY BENEFITS STAFF ALONG WITH THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND IN RESPONSE TO COVID, EXPANDED GOALS RELATED TO ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH TARGETED PRIMARILY AT LOW INCOME AND MINORITY POPULATIONS WHO HAVE BEEN DISPROPORTIONATELY IMPACTED BY COVID-19.THE ACTIONS TAKEN TOWARD ADDRESSING THESE NEEDS ARE INCLUDED FURTHER IN THIS NARRATIVE SUPPORT ALONG WITH NEBH'S DETAILED DESCRIPTION OF ACTIVITIES UNDERTAKEN TO MEET THE COMMUNITY NEEDS.BETH ISRAEL LAHEY HEALTH ("BILH") QUICKLY AND EFFECTIVELY MARSHALLED ITS RESOURCES TO MOUNT A COMPREHENSIVE RESPONSE TO THE COVID-19 PANDEMIC. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS IN PART III FOR FURTHER DETAILS REGARDING BILH'S COVID-19 RESPONSE IN FY20.
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COMMUNITY HEALTH NEEDS ASSESSMENT
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MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLENEBH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, NEBH COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE NEBH WEBSITE AT:HTTPS://WWW.NEBH.ORG/WP-CONTENT/UPLOADS/2019/09/NEBH-2019-CHNA.PDFIN ADDITION TO THE CHNA, NEBH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE NEBH WEBSITE AT:HTTPS://WWW.NEBH.ORG/WP-CONTENT/UPLOADS/2019/09/NEBH-2019-CHNA.PDFIN ADDITION, AS NOTED ABOVE, NEBH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015). THAT CHNA IS AVAILABLE ON THE NEBH WEBSITE AT:HTTPS://WWW.NEBH.ORG/WP-CONTENT/UPLOADS/2018/09/COMMUNITYBENEFITRPT2016-2.PDFFINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING NEBH'S FISCAL YEAR ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015) IS AVAILABLE ON THE NEBH WEBSITE AT:HTTPS://WWW.NEBH.ORG/WP-CONTENT/UPLOADS/2018/09/COMMUNITYBENEFITRPT2016-2.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).
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COMMUNITY HEALTH NEEDS ASSESSMENT
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ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, NEBH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THAT CHNA AND IMPLEMENTATION STRATEGY INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF NEBH FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020 AND WILL CONTINUE TO INFORM THE HOSPITAL'S COMMUNITY BENEFITS MISSION AND ACTIVITIES FOR THE FISCAL YEARS ENDING SEPTEMBER 30, 2021 AND SEPTEMBER 30, 2022. A SUMMARY OF NEBH'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, NEBH HAS BEEN STRATEGIC IN IDENTIFYING ITS PRIORITY AREAS IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH ARE LISTED BELOW.PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE GOAL 1: ENHANCE ACCESS TO CARE AND REDUCE THE IMPACT OF SOCIAL DETERMINANTS GOAL 2: REDUCE ELDER FALLS AND PROMOTE AGING IN PLACE GOAL 3: INCREASE ACCESS TO HEALTHY FOODS AND OTHER BASIC HOUSEHOLD NEEDS GOAL 4: PROMOTE VIOLENCE PREVENTION AND ADDRESS TRAUMA (SAFE NEIGHBORHOODS/COMMUNITY COHESION) GOAL 5: INCREASE JOB OPPORTUNITIES FOR YOUTH AND ADULTS GOAL 6: DECREASE TRANSPORTATION BARRIERSPRIORITY AREA 2: CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, REFERRAL, AND CHRONIC DISEASE MANAGEMENT SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS GOAL 2: REDUCE THE PREVALENCE OF TOBACCO USE GOAL 3: INCREASE PHYSICAL ACTIVITY AND HEALTHY EATING
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COMMUNITY HEALTH NEEDS ASSESSMENT
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APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)NEBH HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES NEBH OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES OF THEIR TARGET POPULATIONS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS.NEBH HAS BEEN A LEADER IN CREATING AND SUPPORTING A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE THE NEBH SENIOR CELTICS PROGRAM, HIGH SCHOOL PARTNERSHIPS THAT LEAD TO CAREERS, PARTNERSHIPS WITH LOCAL AFFORDABLE HOUSING ORGANIZATIONS, PROGRAMS ADDRESSING FOOD INSECURITY AND PROGRAMS RELATING TO TRANSPORTATION.AS NOTED ABOVE, NEBH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THAT CHNA AND IMPLEMENTATION STRATEGY INFORM THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF NEBH FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022. THIS FORM 990 COVERS NEBH'S FISCAL YEAR ENDED SEPTEMBER 30, 2020. NEBH'S IMPLEMENTATION STRATEGY FOR ITS COMMUNITY BENEFITS ACTIVITIES IS PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. A FULL UPDATE ON NEBH'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.
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FY20 IMPLEMENTATION STRATEGY UPDATE
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PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE DURING NEBH'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), DATA SHOWED CLEAR GEOGRAPHIC AND DEMOGRAPHIC DISPARITIES RELATED TO THE LEADING SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, HOUSING TRANSPORTATION, VIOLENCE, FOOD ACCESS, EDUCATION, AND COMMUNITY COHESION). THESE ISSUES INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN NEBH'S SERVICE AREA. TO IMPROVE NEBH'S COMMUNITY BENEFITS SERVICE AREA'S POPULATION HEALTH, EFFORTS MADE FOCUSED ON REDUCING THE IMPACT OF SOCIAL DETERMINANTS BY COMMITTING DIRECT COMMUNITY HEALTH PROGRAM INVESTMENTS, AND IN-KIND RESOURCES OF STAFF TIME AND MATERIALS. GOAL 1: ENHANCE ACCESS TO CARE AND REDUCE THE IMPACT OF SOCIAL DETERMINANTS TARGET POPULATION: YOUTH, OLDER ADULTS, LOW TO MODERATE INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE PARTNERSHIPS AND COLLABORATION WITH SOCIAL SERVICE AND OTHER COMMUNITY-BASED ORGANIZATIONS1.2 INCREASE EDUCATIONAL OPPORTUNITIES RELATED TO THE IMPORTANCE AND IMPACT OF SOCIAL DETERMINANTS1.3 DECREASE THE NUMBER OF PEOPLE WHO STRUGGLE WITH FINANCIAL INSECURITY1.4 INCREASE ACCESS TO LOW COST HEALTHY FOODS WITH AN EMPHASIS ON PRIORITY POPULATIONS SEGMENTS1.5 INCREASE ACCESS TO AFFORDABLE, SAFE TRANSPORTATION OPTIONS WITH AN EMPHASIS ON PRIORITY POPULATION SEGMENTS1.6 INCREASE TRAINING AND EMPLOYMENT OPPORTUNITIES FOR LOW TO MODERATE INCOME RESIDENTS WITH AN EMPHASIS ON PRIORITY POPULATION SEGMENTS1.7 INCREASE ACCESS TO SOCIAL EXPERIENCES FOR THOSE WHO ARE ISOLATED AND LACK FAMILY/CAREGIVER AND OTHER SUPPORTS1.8 EDUCATE INDIVIDUALS AND FAMILIES ABOUT HEALTHY EATING, MEAL PLANNING, HOUSEHOLD BUDGETING, ETC.1.9 DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITY AND/OR LACK BASIC HOUSEHOLD ITEMSCOMMUNITY ACTIVITIES/STRATEGIES: COMMUNITY BENEFIT AND OTHER HOSPITAL STAFF (E.G., NURSING) PARTICIPATE IN COALITIONS AND OTHER COMMUNITY MEETINGS TO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE COMMUNITY HEALTH IMPROVEMENT ACTIVITIES MAINTAIN MCLAUGHLIN FIELD TO ENGAGE YOUTH AND PROMOTE PHYSICAL ACTIVITY MAKE COMMUNITY IMPROVEMENTS TO WALKWAYS AND OTHER PUBLIC AREAS TO ADDRESS TRANSPORTATION ISSUES AND PROMOTE PHYSICAL ACTIVITY PROVIDE TRASH TRUCK AND CLEAN PUBLIC AREAS AFTER MOVE-IN DAY TO PROMOTE COMMUNITY ENGAGEMENT AND PHYSICAL ACTIVITY SUPPORT FOOD ACCESS AND NUTRITION PROGRAMMING TO LOW AND MODERATE INCOME POPULATIONS LIVING IN PUBLIC HOUSING, COUNCILS ON AGING, AND OTHER COMMUNITY VENUES PROVIDE ESSENTIAL HOUSEHOLD ITEMS TO SUPPORT THOSE LIVING IN POVERTY OR LOW INCOME HOUSEHOLDS PROVIDE TRANSPORTATION SUPPORT TO COMMUNITY RESIDENTS TO ENHANCE ACCESS TO AFFORDABLE, SAFE, ACCESSIBLE TRANSPORTATION OPTIONS ORGANIZE AND SUPPORT WORKFORCE MENTORSHIP AND TRAINING PROGRAMS FOR YOUTH AND ADULTS TO JOB TRAINING, SKILLS DEVELOPMENT, AND CAREER ADVANCEMENT WITH AN EMPHASIS ON PRIORITY POPULATIONS CONTINUE TO SUPPORT THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP PROGRAM TO SUPPORT SKILLS DEVELOPMENT AND CAREER ADVANCEMENT PROVIDE LINGUISTICALLY AND CULTURALLY APPROPRIATE HEALTH EDUCATION AND CARE MANAGEMENT SUPPORT THOUGH TARGETED COMMUNITY EVENTS FOR THOSE WITH OR IDENTIFIED AS AT-RISK OF CHRONIC/ COMPLEX CONDITIONS WITH AN EMPHASIS ON PRIORITY POPULATIONS SUPPORT ACTIVITIES SPONSORED BY MISSION HILL SENIOR LEGACY PROJECT SUPPORT COMMUNITY FOOD PANTRIESMETRICS AND STATUS UPDATE: MCLAUGHLIN FIELD WAS MAINTAINED DURING SPRING, SUMMER AND FALL. (OVER 30 WEEKS) AND MAINTAINED DURING THE WINTER AS NEEDED. NEBH HIRED A TRASH TRUCK DURING STUDENT MOVE IN WEEK (SEPTEMBER 1). NEBH STAFF CLEANED THE SURROUNDING STREETS DURING THE SPRING, SUMMER AND FALL AND HELP WITH SNOW REMOVAL DURING THE WINTER. OVER 6,748 RESIDENTS USED THE MISSION LINK BUS FOR TRANSPORTATION. DUE TO COVID, THE NUMBER OF RIDERS THAT USED THE BUS DECREASED. NEBH DISTRIBUTED $132,054 IN CASH TO ORGANIZATIONS IN MISSION HILL. OVER 300 RESIDENTS AND FAMILIES RECEIVED FOOD, ESSENTIAL HOUSEHOLD ITEMS AND GIFT CARDS TO GROCERY STORES. NEBH PROVIDED FINANCIAL SUPPORT TO THE ABCD-PARKER HILL FENWAY COMMUNITY SERVICE CENTER'S FOOD PANTRY. THE FOOD PANTRY PROVIDES EMERGENCY FOOD FOR LOW INCOME FAMILIES IN THE COMMUNITY. THE PANTRY SUPPLIES FOOD TO OVER 3,000 FAMILIES EACH YEAR. NEBH SUPPORTS TWO WORKFORCE DEVELOPMENT PROGRAMS, PROJECT SEARCH AND THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP. THE MEREDITH CAMERON INTERNSHIP WAS SUSPENDED DUE TO COVID-19. FOUR CITY OF BOSTON STUDENTS PARTICIPATED IN THE PROJECT SEARCH PROGRAM. TWO HEALTH LITERACY EVENTS WERE SCHEDULED BUT WERE CANCELLED DUE TO COVID-19. FOUR MISSION HILL SR. LEGACY EVENTS WERE HELD FOR OLDER ADULTS LIVING IN MISSION HILL. OVER 150 PEOPLE ATTENDED THE EVENTS, SR. CELTICS PROGRAM AND BIRTHDAY CELEBRATION EVENT. COMMUNITY PARTNERS: BOSTON CHNA-CHIP COLLABORATIVE, BOSTON PUBLIC HEALTH COMMISSION, BOSTON PUBLIC SCHOOLS, ELDER SERVICES PROVIDERS, ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD), SOCIEDAD LATINA, MADISON PARK HIGH SCHOOL, MORGAN MEMORIAL GOODWILL, ROXBURY TENANTS OF HARVARD (RTH), TOBIN COMMUNITY CENTER, ALICE TAYLOR HOUSING DEVELOPMENT, MISSION HILL SENIOR LEGACY PROJECT, MARIA SANCHEZ HOUSE, ONE GURNEY STREET APARTMENTS, FAIR FOODS, PRIVATE INDUSTRY COUNCIL (PIC), FRIENDS OF MCLAUGHLIN PARK, PROBLEM PROPERTIES TASK FORCE
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GOAL 2: REDUCE ELDER FALLS AND PROMOTE AGING IN PLACE
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TARGET POPULATION: OLDER ADULTSPROGRAMMATIC OBJECTIVES: 1.1 REDUCE FEAR OF FALLING1.2 REDUCE FALLS1.3 INCREASE ACTIVITY LEVELS1.4 INCREASE THE NUMBER OF OLDER ADULTS LIVING INDEPENDENTLY IN THEIR HOMESCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT OR ORGANIZE MATTER OF BALANCE WORKSHOPS FOR PRIORITY POPULATIONSMETRICS AND STATUS UPDATE: TWO FALL PREVENTION EVENTS WERE ORGANIZED IN FY20. OVER 150 PEOPLE PARTICIPATED IN THE FALL PREVENTION EVENTS.COMMUNITY PARTNERS: ELDER SERVICES AGENCIES, MISSION HILL SENIOR LEGACY PROJECT, ROXBURY TENANTS OF HARVARD, MARIA SANCHEZ HOUSE
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PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONS AND THEIR RISK FACTORS
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HEART DISEASE, STROKE AND CANCER ARE BY FAR THE LEADING CAUSES OF DEATH IN THE NATION, THE COMMONWEALTH, AND IN NEBH'S SERVICE AREA. ROUGHLY 7 IN 10 DEATHS CAN BE ATTRIBUTED TO THESE THREE CONDITIONS. IF YOU INCLUDE RESPIRATORY DISEASE (E.G., ASTHMA, CONGESTIVE HEART FAILURE, AND COPD) AND DIABETES, WHICH ARE IN THE TOP 10 LEADING CAUSES ACROSS NEARLY ALL GEOGRAPHIES THAN ONE CAN ACCOUNT FOR ALL BUT A SMALL FRACTION OF CAUSES OF DEATH. ALL OF THESE CONDITIONS ARE GENERALLY CONSIDERED TO BE CHRONIC AND COMPLEX AND CAN STRIKE EARLY IN ONE'S LIFE, QUITE OFTEN ENDING IN PREMATURE DEATH. IN THIS CATEGORY, HEART DISEASE, DIABETES, AND HYPERTENSION WERE THOUGHT TO BE OF THE HIGHEST PRIORITY, ALTHOUGH CANCER WAS ALSO DISCUSSED FREQUENTLY IN THE FOCUS GROUPS AND FORUMS. HIV/AIDS, OTHER SEXUALLY TRANSMITTED DISEASES AND HEPATITIS C WERE ALSO MENTIONED IN THE ASSESSMENT'S INTERVIEWS AND FOCUS GROUPS AND SHOULD CERTAINLY BE INCLUDED IN THE CHRONIC/COMPLEX CONDITION DOMAIN. IT IS ALSO IMPORTANT TO NOTE THAT THE RISK AND PROTECTIVE FACTORS FOR NEARLY ALL CHRONIC/COMPLEX CONDITIONS ARE THE SAME, INCLUDING TOBACCO USE, LACK OF PHYSICAL ACTIVITY, POOR NUTRITION, OBESITY, AND ALCOHOL USE.GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, REFERRAL, AND CHRONIC DISEASE MANAGEMENT SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS TARGET POPULATION: YOUTH, OLDER ADULTS, LOW AND MODERATE INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC / COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE THE NUMBER OF PEOPLE WHO ARE EDUCATED ABOUT CHRONIC DISEASE RISK FACTORS AND PROTECTIVE BEHAVIORS1.2 INCREASE THE NUMBER OF ADULTS WHO ARE ENGAGED IN EVIDENCE-BASED SCREENING, COUNSELING, SELF-MANAGEMENT SUPPORT, CHRONIC DISEASE MANAGEMENT, REFERRAL SERVICES, AND/OR SPECIALTY CARE SERVICES FOR DIABETES, HYPERTENSION, ASTHMA, CANCER, AND OTHER CHRONIC/COMPLEX CONDITIONS1.3 INCREASE THE NUMBER OF PEOPLE WITH CHRONIC/COMPLEX CONDITIONS WHOSE CONDITIONS ARE UNDER CONTROLCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT AND OFFER OPPORTUNITIES FOR CHRONIC DISEASE SELF-MANAGEMENT COURSES COMMUNITY BENEFITS AND OTHER HOSPITAL STAFF (E.G., NURSING) PARTICIPATE IN COALITIONS AND OTHER COMMUNITY MEETINGS TO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE COMMUNITY HEALTH IMPROVEMENT ACTIVITIES SUPPORT LITTLE LEAGUE AND SUMMER CAMP PROGRAMS TO ENGAGE YOUTH AND PROMOTE PHYSICAL ACTIVITY SUPPORT SR. CELTICS PROGRAM TO PROMOTE COMMUNITY ENGAGEMENT PROVIDE EVIDENCE-BASED HEALTH EDUCATION ON RISK/PROTECTIVE FACTORS, AND SELF MANAGEMENT SUPPORT PROGRAMS THROUGH PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS WITH AN EMPHASIS ON PRIORITY POPULATION SEGMENTS FITNESS CLASSES SUPPORT SCREENING, EDUCATION, AND REFERRAL PROGRAMS IN CLINICAL AND NONCLINICAL SETTINGS THAT SCREEN, EDUCATE, AND REFER PATIENTS IN NEED OF FURTHER ASSESSMENT AND CHRONIC DISEASE MANAGEMENT SUPPORTS (E.G., BLOOD PRESSURE, DIABETES, STROKE, CANCER) ORGANIZE NEBH "HOUSE CALL" EVENTS HOSTED BY HOSPITAL CLINICAL STAFF RELATED TO AWARENESS, EDUCATION, AND THE MANAGEMENT OF CHRONIC AND COMPLEX CONDITIONS IN TARGETED COMMUNITY-BASED SETTINGS SUPPORT YOGA FOR OLDER ADULTS SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS, WEIGHT LOSS CLASSES, AND EDUCATIONAL SESSIONS.METRICS AND STATUS UPDATE: NEBH CLINICAL STAFF MEMBERS ATTENDED FOUR HEALTH EDUCATION EVENTS THAT FOCUSED ON HEALTH EATING, STAYING ACTIVE, AND THE IMPORTANCE OF EXERCISE FOR OLDER ADULTS LIVING IN MISSION HILL. OVER PEOPLE 150 ATTENDED THE EVENTS.COMMUNITY PARTNERS: BOSTON CHNA-CHIP COLLABORATIVE, BOSTON PUBLIC HEALTH COMMISSION, LOCAL POLICE, FIRE AND EMS, BOSTON PUBLIC SCHOOLS, ELDER SERVICES PROVIDERS, ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD), SOCIEDAD LATINA, ROXBURY TENANTS OF HARVARD, TOBIN COMMUNITY CENTER, ALICE TAYLOR HOUSING DEVELOPMENT, MISSION HILL SENIOR LEGACY PROJECT, MARIA SANCHEZ HOUSE, FAIR FOODSGOAL 2: REDUCE THE PREVALENCE OF TOBACCO USETARGET POPULATION: YOUTH, OLDER ADULTS, LOW TO MODERATE INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONSPROGRAMMATIC OBJECTIVES: 2.1 INCREASE THE NUMBER OF PEOPLE WHO ARE ABLE TO STOP SMOKING CIGARETTES VAPING, OR USING E-CIGARETTES2.2 INCREASE ACCESS TO TOBACCO, VAPING/E-CIGARETTE CESSATION PROGRAMSCOMMUNITY ACTIVITIES/STRATEGIES: ORGANIZE, FACILITATE, OR SUPPORT SMOKING CESSATION PROGRAMS GEARED TO REDUCING TOBACCO, VAPING AND E-CIGARETTE USEMETRICS AND STATUS UPDATE: PROGRAM WAS NOT HELD DUE TO COVID-19.COMMUNITY PARTNERS: AMERICAN CANCER SOCIETY, ROXBURY TENANTS OF HARVARD, TOBIN COMMUNITY CENTERCOMMUNITY PARTNERSNEBH IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. ABCD PARKER HILL/FENWAY NEIGHBORHOOD SERVICE CENTER ALICE HEYWARD TAYLOR HOUSING DEVELOPMENT ARTHRITIS & LUPUS SUPPORT GROUP ARTHRITIS FOUNDATION, GREATER BOSTON CHAPTER BOSTON BUILDING MATERIALS RESOURCE CENTER BOSTON CELTICS BOSTON CENTER FOR YOUTH AND FAMILY SERVICES BOSTON HEART WALK BOSTON POLICE BOSTON PUBLIC HEALTH COMMISSION BOSTON PUBLIC LIBRARY, MISSION HILL BRANCH CITY OF BOSTON AGE STRONG COMMISSION CITY OF BOSTON MAYOR'S OFFICE CITY OF BOSTON, PARKS AND RECREATION DEPARTMENT DOE HOUSE PINE STREET INN FAIR FOODS FIRESIDE CHAT AA GROUP FRIENDS OF MCLAUGHLIN PARK MADISON PARK HIGH SCHOOL MAURICE J. TOBIN COMMUNITY CENTER MARIA SANCHEZ HOUSE MISSION CHURCH MISSION CHURCH HISPANIC COMMITTEE MISSION HILL CRIME COMMITTEE MISSION HILL ELEMENTARY SCHOOL MISSION HILL LINK MISSION HILL LITTLE LEAGUE MISSION HILL MAIN STREETS MISSION HILL NEIGHBORHOOD HOUSING SERVICES MISSION HILL ROAD RACE MISSION HILL SENIOR LEGACY PROJECT MISSION MAIN TASK FORCE MORGAN MEMORIAL GOODWILL INDUSTRIES ONE GURNEY STREET APARTMENTS PRIVATE INDUSTRY COUNCIL PROJECT SEARCH ROXBURY TENANTS OF HARVARD SOCIEDAD LATINA SOCIETY OF ST. VINCENT DEPAUL
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FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION
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COMMUNITY BENEFITSANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, NEBH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE COMMUNITY BENEFITS ADVISORY COMMITTEE AND BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT: HTTPS://WWW.NEBH.ORG/WP-CONTENT/UPLOADS/2020/10/NEBH-AG-REPORT-2019.PDFTHERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT NEBH FILED WITH THE ATTORNEY GENERAL'S OFFICE.
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EMERGENCY CARE ACCESS:
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AS REPORTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, NEBH IS A GENERAL MEDICAL AND SURGICAL HOSPITAL AND TEACHING HOSPITAL. AS ALSO PREVIOUSLY NOTED IN THIS FORM 990, NEBH IS NOT LICENSED TO OPERATE AN EMERGENCY DEPARTMENT, HOWEVER, NEBH STILL PROVIDES CARE TO ALL WHO NEED URGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. ALL PATIENTS WHO PRESENT AT NEBH ARE TRIAGED TO THE APPROPRIATE VENUE FOR THEIR CARE DEPENDING UPON THEIR CLINICAL PRESENTATION. A CLINICAL RESOURCE NURSE AND HOSPITALIST COLLABORATE TO IDENTIFY VENUE PRIOR TO THE ARRIVAL OF THE PATIENT IF POSSIBLE. THE HOSPITALIST WILL MAKE A DETERMINATION AS TO THE BEST PATIENT DISPOSITION. CLINICAL SITUATIONS RECEIVED BY PHONE OR WALK-IN REQUIRING EMERGENCY MANAGEMENT ARE DIRECTED TO THE NEAREST EMERGENCY DEPARTMENT, SUCH AS BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) WHICH IS LOCATED APPROXIMATELY ONE MILE FROM NEBH. BIDMC AND NEBH ARE BOTH MEMBER HOSPITALS OF BETH ISRAEL LAHEY HEALTH AND BIDMC IS A TERTIARY CARE ACADEMIC MEDICAL CENTER WHICH OPERATES A LEVEL 1 TRAUMA EMERGENCY DEPARTMENT 24 HOURS A DAY, 7 DAYS A WEEK.
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FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
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CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCENEBH'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $3,199,060 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2020 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH ADOPTED AN AMENDED WRITTEN FINANCIAL ASSISTANCE POLICY. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, UNDER THAT POLICY, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, NEBH ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, NEBH GENERATED $5,052,457 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY NEBH FOR SUCH SERVICES BY $2,474,928 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND NEBH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, NEBH GENERATED $77,529,811 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $27,684,323. OF THESE AMOUNTS, REVENUE OF $2,292,437 IS RELATED TO THE PROVISION OF ORTHOPEDIC BRACES TO PATIENTS, COMMUNITY HEALTH SERVICES IN MISSION HILL BY DR. TSIKITAS, NEBH HOSPITALISTS, NEBH SURGICAL HOUSE OFFICER, NEBH ORTHO SPECIALTY PRACTICE, PSYCHIATRIC CARE & COUNSELING AND MRSA TEST MEDICARE PATIENTS, AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $3,400,374. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH NEBH CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, NEBH HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 18.01%.
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BAD DEBTS:
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IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, NEBH ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $(923,482) AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2020 INCLUDE THE ACCOUNTS OF: BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES.THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.EMERGENCY CARE ACCESSAS PREVIOUSLY NOTED IN THIS FORM 990, NEBH IS NOT LICENSED TO OPERATE AN EMERGENCY DEPARTMENT, HOWEVER, NEBH STILL PROVIDES CARE TO ALL WHO NEED URGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. ALL PATIENTS WHO PRESENT AT NEBH ARE TRIAGED TO THE APPROPRIATE VENUE FOR THEIR CARE DEPENDING UPON THEIR CLINICAL PRESENTATION. A CLINICAL RESOURCE NURSE AND HOSPITALIST COLLABORATE TO IDENTIFY VENUE PRIOR TO THE ARRIVAL OF PATIENT IF POSSIBLE. THE HOSPITALIST WILL MAKE A DETERMINATION AS TO THE BEST PATIENT DISPOSITION. CLINICAL SITUATIONS RECEIVED BY PHONE OR WALK-IN REQUIRING EMERGENCY MANAGEMENT ARE DIRECTED TO THE NEAREST EMERGENCY DEPARTMENT, SUCH AS BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A RELATED AFFILIATE AND TERTIARY CARE ACADEMIC MEDICAL CENTER WHICH OPERATES A LEVEL 1 TRAUMA EMERGENCY DEPARTMENT 24 HOURS A DAY, 7 DAYS A WEEK AND IS LOCATED APPROXIMATELY 1 MILE FROM NEBH.
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FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)
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FINANCIAL ASSISTANCE POLICY PURPOSE NEBH IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THE NEBH FINANCIAL ASSISTANCE POLICY (FAP) IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE FREE AND/OR DISCOUNTED CARE FROM NEBH AS WELL AS PROVIDERS WHO FOLLOW NEBH'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN NEBH AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW NEBH'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. NEBH DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY AND THE AMOUNTS GENERALLY BILLED (AGB) CALCULATION IS UPDATED NOT LESS THAN ANNUALLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY, REVISED AUGUST 2020, WERE ADOPTED BY THE HOSPITAL'S BOARD PRIOR TO SEPTEMBER 30, 2017 AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF OCTOBER 1, 2017, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R). FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. THIS INFORMATION IS ALSO INCLUDED IN THE PLAIN LANGUAGE SUMMARY (PLS). IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).
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SCHEDULE H PART I QUESTION 3C
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FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMSIN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICYTRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY APPLICATION FOR FINANCIAL ASSISTANCE AND HARDSHIP APPLICATION (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: TRADITIONAL CHINESE, SIMPLIFIED CHINESE, KOREAN, AND SPANISH (SCHEDULE H PART V SECTION B QUESTION 16I).
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FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITY
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COPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT:HTTPS://WWW.NEBH.ORG/PATIENTS-CARE-PARTNERS/FINANCIAL-RESOURCES/FINANCIAL-SERVICES-GUIDE/ IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDES CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE AND/OR DISCHARGE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G).
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FINANCIAL ASSISTANCE POLICYPLAIN LANGUAGE SUMMARY
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AS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE NEBH FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. CREDIT AND COLLECTION POLICY APPLICATION FOR FINANCIAL ASSISTANCE MEDICAL HARDSHIP APPLICATION FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ARE AVAILABLE IN THE FOLLOWING LANGUAGES: TRADITIONAL CHINESE, SIMPLIFIED CHINESE, KOREAN, AND SPANISH, CAN BE FOUND ON THE NEBH WEBSITE AT: HTTPS://WWW.NEBH.ORG/PATIENTS-CARE-PARTNERS/FINANCIAL-RESOURCES/FINANCIAL-SERVICES-GUIDE.
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LIMITATION ON CHARGESINTERNAL REVENUE CODE SECTION 501(R)(5)
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LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLEDLOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB UPDATED NOT LESS FREQUENTLY THAN ANNUALLY AS REQUIRED PURSUANT TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R) AND THE AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00.
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BILLING AND COLLECTIONS501(R)(6)
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EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHNEW ENGLAND BAPTIST HOSPITAL (NEBH) IS AN ORTHOPEDIC CENTER OF EXCELLENCE WITH A SIGNIFICANT COMMITMENT TO RESEARCH. AS AN ORTHOPEDIC SPECIALTY HOSPITAL TREATING A HIGH VOLUME OF MUSCULOSKELETAL PATIENTS, NEBH IS IN A UNIQUE POSITION TO STUDY MUSCULOSKELETAL CONDITIONS, TREATMENTS, AND THERAPIES. THIS COMMITMENT TO RESEARCH, COMBINED WITH THE DEDICATION OF THE NEBH CLINICAL PROVIDERS, ALLOWS NEBH TO BRING THE LATEST ADVANCES AND NOVEL PROTOCOLS IN ORTHOPEDIC CARE TO NEBH PATIENTS AND TO SET NEW STANDARDS OF CARE NATIONALLY AND INTERNATIONALLY. THE PHYSICIANS AT NEBH TAKE PART IN RESEARCH INDEPENDENTLY AS WELL AS IN ASSOCIATION WITH RESEARCHERS OUTSIDE OF NEBH FOR CLINICAL, TRANSLATIONAL, AND PATIENT-CENTERED RESEARCH. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION AS AN ORTHOPEDIC SPECIALTY HOSPITAL TREATING A HIGH VOLUME OF MUSCULOSKELETAL PATIENTS, NEW ENGLAND BAPTIST HOSPITAL (NEBH) IS IN A UNIQUE POSITION TO TRAIN THE ORTHOPEDIC SPECIALISTS OF TOMORROW. NEBH IS A TEACHING AFFILIATE OF TUFTS UNIVERSITY SCHOOL OF MEDICINE AND CONDUCTS TEACHING PROGRAMS IN COLLABORATION WITH THE HARVARD SCHOOL OF PUBLIC HEALTH AND HARVARD MEDICAL SCHOOL. NEBH IS ONE OF FIVE HOSPITALS THAT PARTICIPATES IN THE TUFTS-AFFILIATED HOSPITALS ORTHOPAEDIC RESIDENCY PROGRAM. THIS EXCEPTIONALLY COMPETITIVE FIVE-YEAR ACGME ACCREDITED PROGRAM PROVIDES EXCEPTIONAL TRAINING IN THE OPERATIVE AND NON-OPERATIVE MANAGEMENT OF MUSCULOSKELETAL INJURY AND DISEASES AND ACCEPTS ONLY FOUR CANDIDATES INTO THE PROGRAM EACH YEAR. RESIDENTS TRAIN IN THE FULL RANGE OF ORTHOPEDIC MEDICINE AND ORTHOPEDIC SUBSPECIALTIES INCLUDING, AMONG OTHERS, SPORTS MEDICINE, JOINT RECONSTRUCTION, HAND AND UPPER EXTREMITY SURGERY AND FOOT AND ANKLE CARE. THESE CLINICAL ROTATIONS ENABLE THESE RESIDENTS TO GAIN THE SPECIALIZED KNOWLEDGE AND SKILLS TO BECOME WELL-ROUNDED ORTHOPEDISTS WITH SUPERIOR OPERATING SKILLS AND DECISION-MAKING ABILITIES.NEBH ALSO OFFERS FOURTEEN FELLOWSHIPS EACH YEAR IN JOINT IMPLANT SURGERY, HAND SURGERY, SPORTS MEDICINE, FOOT AND ANKLE SURGERY, PHYSICAL MEDICINE AND REHABILITATION, NEUROLOSURGICAL SPINE, AND SPINE SURGERY. THESE FELLOWSHIP PROGRAMS ARE AMONG THE MOST SOUGHT-AFTER IN THE NATION.IN ADDITION, NEBH ALSO OFFERS AN ORTHOPEDIC SURGERY PHYSICIAN ASSISTANT FELLOWSHIP.
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SCHEDULE H, PART VI, QUESTIONS 5 AND 6
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NEBHADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. ON MARCH 1, 2019, THE BETH ISRAEL LAHEY HEALTH SYSTEM WAS FORMED THROUGH THE COMBINATION OF THE HOSPITALS AND OTHER AFFILIATES OF THREE LEGACY HEALTH CARE SYSTEMS BASED PRIMARILY IN EASTERN MASSACHUSETTS, INCLUDING THE FORMER CAREGROUP HEALTH SYSTEM, THE FORMER LAHEY HEALTH SYSTEM, AND THE SEACOAST HEALTH SYSTEM. BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS NOW THE SOLE MEMBER OF THE HOSPITAL AND NINE ADDITIONAL AFFILIATED HOSPITALS. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE BILH HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. AFFILIATED HEALTH CARE SYSTEMAS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, NEBH IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BILH OPERATES AS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. BILH SERVES AS SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). LAHEY CLINIC FOUNDATION SERVES AS THE SOLE MEMBER OF LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. EACH OF THESE AFFILIATES IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES SERVED BY BILH. EACH OF THESE AFFILIATES MAY ALSO, IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES.FOR THE FISCAL YEAR 2020 THE BILH HOSPITALS NOTED ABOVE PROVIDED CARE TO MEDICAID PATIENTS AT COSTS WHICH EXCEEDED REVENUES BY OVER $86 MILLION AND PROVIDED CARE TO MEDICARE PATIENTS AT COSTS WHICH EXCEEDED REVENUES BY $117 MILLION. IN ADDITION, THE BILH HOSPITALS PROVIDED TOTAL COMMUNITY BENEFITS IN THE NATURE OF DIRECT SERVICES TO THE COMMUNITIES SERVED BY THE BILH NETWORK AS WELL AS FUNDS PROVIDED TO COMMUNITY PARTNERS IN THE AMOUNT OF $93 MILLION BILH HOSPITALS ALSO INCURRED NET COSTS FOR SUBSIDIZED HEALTH SERVICES TO ENSURE THAT CARE WAS AVAILABLE WITHIN THE COMMUNITIES SERVED ACROSS BILH IN THE AMOUNT OF $32 MILLION. FINALLY, BILH HOSPITALS ARE COMMITTED TO PROVIDING RESEARCH TO FURTHER ADVANCE CARE TO BILH PATIENTS AND TO THE GENERAL ADVANCEMENT TO HEALTHCARE TREATMENT BEYOND THE COMMUNITIES IMMEDIATELY SERVED BY BILH AND TO PROVIDING CUTTING EDGE TRAINING TO FUTURE HEALTHCARE PROVIDERS. BILH HOSPITALS INVESTED NET COSTS OF $183 MILLION TOWARD THESE MISSIONS DURING THE FISCAL YEAR COVERED BY THIS FILING.
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