2026-08-14T16:50:29-05:00 2025-09-30 861065772 DELOITTE TAX LLP 7900 TYSONS ONE PLACE SUITE 800 MCLEAN VA 221024219 990 2024-10-01 042103604 BETH ISRAEL DEACONESS HOSPITAL - MILTON BETH 7817448924 CO BILH TAX 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 SCOTT HERNDON TREASURER 7817448924 2026-08-13 0 0 RACHEL KAUFMAN P01485017 7032511000 2024 2025-03-06 01:10:19Z KEVIN TABB MD C/O BILH TAX 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 168453122 0 X WWW.BIDMILTON.ORG X 1952 MA SEE SCHEDULE O 22 17 1202 51 91849 7654 2361255 2358648 161393574 158571268 711858 2141824 2397004 5198941 166863691 168270681 126553 175316 0 0 73170312 79566501 9030 10903 585411 99015916 102549176 172321811 182301896 -5458120 -14031215 187388607 184776727 77991743 87985194 109396864 96791533 X SEE SCHEDULE O 0 0 161143561 175316 69725413 SEE SCHEDULE O 70734847 SEE SCHEDULE O 21498078 SEE SCHEDULE O 161143561 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 1 1 0 0 1 X 218 0 1 1202 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 22 17 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 AK AL AR CA CO CT FL HI IL KS KY MA MD ME MI MN MO NC ND NH NJ NM NV NY OH OK OR PA RI SC TN UT VA WA WI WV X KAREN WOLFSON AVP TAXATION 7817448924 BILH SCHRAFFTS CITY CTR 4TH FL 529 CHARLESTOWN MA 02129 BERRY MD MICHAEL TRUSTEE; ORTHOPEDIC SURGEON 1.00 56.00 X 0 996791 45540 ANDERSON MD JONATHAN TTEE (EX-OFF) (PRES, MEDICAL STAFF) 55.00 2.00 X 686073 0 87025 FERNANDEZ RICHARD PRESIDENT & TRUSTEE (EX-OFFICIO) 55.00 3.00 X X 499792 0 50317 CARUCCI DEAN TTEE (EXO) (BILH DIV PRES COMMUNITY) 1.00 64.00 X 0 534306 13985 BRESNICK MD MORGAN TRUSTEE; SURGEON 1.00 57.00 X 0 354185 70070 O'CONNOR MD HEIDI TTEE; PHYS INT MED/PULMONARY DISEASE 55.00 2.00 X 370094 0 53523 CICHELLO ANTHONY TRUSTEE & CHAIR 1.00 2.00 X X 0 0 0 ALEXOPOULOS ALEXANDRA TRUSTEE 1.00 2.00 X 0 0 0 BURKE JOHN TRUSTEE 1.00 2.00 X 0 0 0 COLLINS HARRIS E TRUSTEE 1.00 2.00 X 0 0 0 DENNY STEPHEN TRUSTEE 1.00 2.00 X 0 0 0 FARRELL SCOTT TRUSTEE 1.00 2.00 X 0 0 0 GAFFNEY THERESA TRUSTEE 1.00 2.00 X 0 0 0 GLYNN MAUREEN TRUSTEE 1.00 2.00 X 0 0 0 JAXTIMER JOANNE TRUSTEE 1.00 2.00 X 0 0 0 LIANG JIMMY TRUSTEE 1.00 2.00 X 0 0 0 MARR JEFFREY TRUSTEE 1.00 2.00 X 0 0 0 OKARA EBI TRUSTEE 1.00 2.00 X 0 0 0 O'NEIL ALISA TRUSTEE 1.00 2.00 X 0 0 0 PATHAK RAJU TRUSTEE 1.00 2.00 X 0 0 0 RICE BRIDGET TRUSTEE 1.00 2.00 X 0 0 0 SULLIVAN JOSEPH C TRUSTEE 1.00 2.00 X 0 0 0 WILSON MAGGIE TRUSTEE 1.00 2.00 X 0 0 0 TABB MD KEVIN CEO (EX-OFF) (CEO, BILH) 1.00 64.00 X 0 3665891 1068480 RIOS CINDY TREAS (EX-OFF) (EXEC VP & CFO, BILH) 1.00 64.00 X 0 1386253 2208450 KATZ ESQ JAMIE CLERK (EX-OFF); BILH GENERAL COUNSEL 1.00 63.00 X 0 1001061 33790 FRANCIOLI CARL TREAS EX-OF; BILH INTRM CFO/BSTN CFO 1.00 64.00 X 0 558652 54959 RANGAVIZ SHEILAH ASST TREAS EX-OFF & CFO; MARKET CFO 1.00 61.00 X 0 342912 49209 GEE ESQ CARROLL ASST CLERK (ASSOC GEN COUNSEL, BILH) 1.00 60.00 X 0 212834 46015 HERNDON MBA CPA FACHE SCOTT TREAS (EX-OFF) (EXEC VP & CFO, BILH) 1.00 40.00 X 0 0 0 SIAO MD DANIEL CHI CHANG CHIEF MEDICAL OFFICER 55.00 0.00 X 393172 0 80297 CRONIN RN LYNN SR. VP, CNO, MILTON 55.00 0.00 X 260635 0 47615 FENTON ANGELA VP, AMBULATORY & CLINICAL SERVICES 55.00 2.00 X 227142 0 37921 FREED-LOEW CHERYL VP, HUMAN RESOURCES BUSINESS PARTNER 55.00 2.00 X 181090 0 23653 FEINSTEIN MD ALEXANDER DIAGNOSTIC RADIOLOGIST 55.00 0.00 X 611176 0 84701 DEREVIANKO MD VICTORIA M ANESTHESIOLOGIST 55.00 0.00 X 573201 0 85389 KOROPEY MD ANDREW J ANESTHESIOLOGIST 55.00 0.00 X 574131 0 81315 FULLERTON MD RUSSELL RADIOLOGIST 55.00 0.00 X 585345 0 61147 LIPSKY MD MARK A DIAGNOSTIC RADIOLOGIST 55.00 0.00 X 578242 0 45467 5540093 9052885 4328868 247 0 1 0 BETH ISRAEL LAHEY HEALTH INC 529 MAIN STREET 4TH FL CHARLESTOWN MA 02129 MGMT/FIN/LEGAL/HR/OTHER 77922217 HARVARD MEDICAL FACULTY PHYSICIANS 375 LONGWOOD AVENUE BOSTON MA 02215 PHYSICIAN SERVICES 7803904 CROSS COUNTRY STAFFING INC 6551 PARK OF COMMERCE BLVD BOCA RATON FL 33487 STAFFING SERVICES 4391581 VAYA WORKFORCE SOLUTIONS LLC 5930 CORNERSTONE COURT WEST SAN DIEGO CA 92121 STAFFING SERVICES 4384814 G GREENE CONSTRUCTION CO INC 240 LINCOLN STREET ALLSTON MA 02134 CONTRACTING SERVICES 2156360 40 30908 2327740 78383 2358648 INPATIENT CARE NPSR 622110 70734847 70734847 OUTPATIENT CARE NPSR 622110 56873934 56873934 EMERGENCY CARE NPSR 622110 21498078 21498078 OUTPATIENT LABS NPSR 622110 8209054 8209054 RENTS TO AFFILIATES 622110 665521 665521 589834 589834 158571268 2056904 -18953 2075857 607804 182441 425363 425363 425363 84920 0 84920 84920 84920 0 30908 0 0 REBATES & REFUNDS 622110 1365583 1365583 3RD PARTY INS STTLMNT 622110 1300000 1300000 FEDERAL RECOVERY 900099 1065761 1065761 1042234 321247 25882 695105 4773578 168270681 161958338 91849 3861846 X 175316 175316 2998349 2880252 118097 60943159 58542766 2400393 2256716 2167830 88886 8195048 7872266 322782 5173229 4969469 203760 21287673 4747410 15965755 574508 50532 50532 10903 10903 30474117 30275883 198234 557868 552448 5420 6872204 6085393 786811 8441 8441 310982 310982 13624140 13199378 424762 MEDICAL SUPPLIES 21056304 21056304 MEDICAID ASSESSMENT 2856626 2856626 PHARMACEUTICALS 2634187 2634187 DIETARY EXPENSE 925767 925767 1890335 1882843 7492 182301896 161143561 20572924 585411 10849946 845510 1148373 1227744 21875293 20715564 2062932 1773716 15604 266112 182969364 84475690 92588585 98493674 50389350 55829097 8458524 5625310 187388607 184776727 15782427 12572748 14276418 35885485 47932898 39526961 77991743 87985194 X 97667513 83017145 11729351 13774388 109396864 96791533 187388607 184776727 X -14031215 5940284 -13564 -4500836 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1 0 0 0 1 0 1 50532 50532 0 PART II-B, LINE 1: BETH ISRAEL DEACONESS HOSPITAL - MILTON ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER NETWORK AFFILIATES AND/OR PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $50,532 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES. 11729351 1747164 314604 4006 13564 13773549 10065988 1336099 327264 11729351 9274672 566457 224859 10065988 8956648 665470 -347446 9274672 7951012 668000 337636 8956648 0.21000 0.79000 0 1 1 6710585 6710585 104618506 46442639 58175867 3492236 1963689 1528547 53224983 33430689 19794294 14923054 2638673 12284381 98493674 INVESTMENT IN BILHIP 55139227 C ASSETS IN PERPETUAL TRUSTS 689870 C 55829097 ESTIMATED THIRD PARTY SETTLEMENTS 12928191 LEASE OBLIGATIONS 1411057 ASSET RETIREMENT OBLIGATIONS 146020 DUE TO AFFILIATES 24230084 WORKERS COMPENSATION 575342 DEFERRED COMPENSATION 236267 39526961 X PART V, LINE 4: BETH ISRAEL DEACONESS HOSPITAL - MILTON'S ENDOWMENT FUNDS ARE INTENDED TO ENSURE THAT THE BETH ISRAEL DEACONESS HOSPITAL - MILTON ACCOMPLISHES ITS CHARITABLE MISSION OF IMPROVING PATIENT HEALTH BY PROVIDING HIGH QUALITY, PERSONALIZED HEALTH CARE WITH COMPASSION, DIGNITY AND RESPECT IN A COST EFFECTIVE AND SAFE MANNER IN CLOSE COLLABORATION WITH ITS AFFILIATE, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. THE SPECIFIC USES OF THE ENDOWMENT VARY DEPENDING ON THE NATURE OF RESTRICTIONS, IF ANY, IMPOSED BY DONORS. THE BETH ISRAEL DEACONESS HOSPITAL - MILTON ENDOWMENT CONSISTS OF THREE POOLS: 1. BOARD DESIGNATED FUNDS ARE UNRESTRICTED AND ARE USED AS DEEMED BY THE GOVERNING BOARD 2. TEMPORARY SPECIFIC PURPOSE FUNDS ARE THOSE GIFTS THAT ARE TO BE USED AS STIPULATED IN THE DONORS' GIFTS TO THE HOSPITAL (I.E. FOR EQUIPMENT, SPECIFIC PROGRAMS, FREE CARE ETC.) 3. ENDOWMENT FUNDS ARE PERMANENTLY RESTRICTED FUNDS THE INCOME FROM WHICH IS USED AS THE DONOR SPECIFIES. PART X, LINE 2: BETH ISRAEL LAHEY HEALTH, INC., WHICH SERVES AS THE PARENT OF THE SYSTEM, HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE AN ORGANIZATION DESCRIBED UNDER INTERNAL REVENUE CODE (THE "CODE") SECTION 501(C)(3) AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ALSO DETERMINED THAT THE OTHER ENTITIES IN THE SYSTEM, EXCLUDING ITS FOR-PROFIT SUBSIDIARIES, QUALIFY AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, MEET THE CODE'S REQUIREMENTS UNDER SECTION 509(A), AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION HAS BEEN RECORDED FOR INCOME TAXES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS FOR THE YEARS ENDED SEPTEMBER 30, 2025 AND 2024, RESPECTIVELY. BOSTON MARATHON 30908 30908 30908 30908 SCHEDULE G, PART II, FUNDRAISING EVENT THE BOSTON MARATHON EVENT REPORTED IN THIS FORM 990 SCHEDULE G IS COORDINATED BY THE BETH ISRAEL LAHEY HEALTH ("BILH") DEVELOPMENT TEAM AS AN EVENT FOR THE BILH HEALTHCARE SYSTEM. RUNNERS PARTICIPATE IN THE MARATHON AND RAISE FUNDS FOR A SPECIFIC ENTITY WITHIN THE BILH SYSTEM. BILH REPORTS ALL EXPENSES FOR THE MARATHON ON ITS FORM 990, WHILE CONTRIBUTIONS RAISED BY RUNNERS ARE REPORTED AS REVENUE ON THE FORM 990 FOR EACH HOSPITAL OR OTHER HEALTHCARE ORGANIZATION DESIGNATED BY PARTICIPATING RUNNERS. 1 1 1 X 400.000000000000 1 X 1 0 1 1 1337593 457320 880273 0.00480 4944309 3500300 1444009 0.00790 6281902 3957620 2324282 0.01270 145962 145962 0.00080 53613827 36433048 17180779 0.09420 208466 208466 0.00110 53968255 36433048 17535207 0.09610 60250157 40390668 19859489 0.10880 13927 13927 0.00010 13927 13927 0.00010 1 -260100 50073667 58187301 -8113634 X 1 1 1 1 BETH ISRAEL DEACONESS HOSPITAL - MILTON 199 REEDSDALE AVENUE MILTON MA 02186 WWW.BIDMILTON.ORG MA STATE LICENSE #2227 X X X COMMUNITY HOSPITALS BETH ISRAEL DEACONESS HOSPITAL - MILTON 1 0 0 1 X X X X X X X X X 24 1 1 0 1 X SEE PART VI 1 24 1 SEE PART VI 0 1 X 400.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART VI X SEE PART VI X SEE PART VI X X X X X X 1 X 0 X X X 1 X 0 0 1 1 - BID-MILTON RADIOLOGY AT QUINCY 100 WALTER J HANNON PARKWAY QUINCY MA 02169 OUTPATIENT FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSBETH ISRAEL DEACONESS HOSPITAL-MILTON (BID MILTON) AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF BID MILTON. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND PARTS OF SOUTHERN NEW HAMPSHIRE 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, AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,900 PHYSICIANS AND 39,000 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.BILH'S PURPOSE STATEMENT ARTICULATES THE IMPACT BILH AND EACH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. BILH'S SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER, AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES - ONE PERSON AT A TIME - THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS.EQUITY. EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.ADDITIONAL INFORMATION ABOUT THE BILH SYSTEM AND ITS ACCOMPLISHMENTS ARE FURTHER BELOW IN THIS FORM 990 SCHEDULE H NARRATIVE SUPPORT IN THE SECTION NOTED AS "AFFILIATED HEALTH CARE SYSTEM AND ACCOMPLISHMENTS."BID MILTON COMMUNITY BENEFITS MISSION STATEMENT THE MISSION OF BID MILTON IS TO PROVIDE FREE OR LOW-COST PROGRAMS THAT ADDRESS UNMET HEALTH AND WELLNESS NEEDS OF RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE COMMUNITIES IN MILTON, RANDOLPH, AND QUINCY, IN A MANNER SHAPED BY COMMUNITY INPUT, ALIGNED WITH HOSPITAL RESOURCES, AND GUIDED BY OUR OBJECTIVE TO DELIVER HIGH-QUALITY CARE WITH COMPASSION, DIGNITY, AND RESPECT. BID MILTON'S COMMUNITY BENEFITS MISSION IS FULFILLED BY:- INVOLVING BID MILTON STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE THREE-YEAR IMPLEMENTATION STRATEGY;- ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT THE HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION 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 UNDERSTAND UNMET HEALTH-RELATED AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, AND ECONOMIC FACTORS;- IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN BID MILTON'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED;- PROMOTING HEALTH EQUITY BY ADDRESSING INEQUITIES, 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, HEALTHCARE 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, BID MILTON PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $354,428 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I.COMMUNITY BENEFITS LEADERSHIP/TEAMBID MILTON'S BOARD OF TRUSTEES ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF IS COMMITTED TO IMPROVING THE HEALTH OF OUR COMMUNITY BY PROVIDING EXCEPTIONAL, PERSONALIZED HEALTH CARE WITH DIGNITY, COMPASSION, AND RESPECT. BID MILTON'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF BID MILTON'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF BID MILTON'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES.THE BID MILTON COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE MANAGER OF COMMUNITY BENEFITS & COMMUNITY RELATIONS. THE MANAGER HAS DIRECT ACCESS AND IS ACCOUNTABLE TO THE BID MILTON PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE BID MILTON COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH BID MILTON HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT BID MILTON'S COMMUNITY BENEFITS MISSION TO SERVE ITS PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM, THEIR FAMILIES, AND BID MILTON'S COMMUNITY. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF BID MILTON'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF BID MILTON'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF BID MILTON'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY BID MILTON'S PROGRAMMATIC ENDEAVORS, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. BID MILTON'S CBAC MEMBERS INCLUDE:- KIMBERLY COUGHLIN, DIRECTOR OF NURSING, MILTON PUBLIC SCHOOLS - CATHERINE DENNY, CEO, CHOICE COMMUNITY SUPPORTS - RICK DOANE, EXECUTIVE DIRECTOR, INTERFAITH SOCIAL SERVICES - DR. NANCY DREW, PRIMARY CARE PHYSICIAN, BETH ISRAEL LAHEY HEALTH - EARL FAY, EXECUTIVE DIRECTOR, MILTON HOUSING AUTHORITY - ANGELA FENTON, VICE PRESIDENT OF AMBULATORY & CLINICAL SERVICES, BID MILTON - CLAIRE HOFFMAN, SENIOR PUBLIC HEALTH PLANNER, METROPOLITAN AREA PLANNING COUNCIL - DAVID HYMAN, VICE PRESIDENT OF PHILANTHROPY, BID MILTON - CAROLINE KINSELLA, HEALTH DIRECTOR AND PUBLIC HEALTH NURSE, MILTON BOARD OF HEALTH - VICKI MCCARTHY, RESIDENT, TOWN OF MILTON - EBI OKARA, EDD, BID MILTON BOARD OF TRUSTEES - DAMION OUTAR, COMMUNITY LIAISON, CITY OF QUINCY - LISA SCANLON, DIRECTOR OF COMMUNICATIONS & DEVELOPMENT, BAYSTATE COMMUNITY SERVICES - KRISTEN SCHLAPP, CHIEF OPERATING OFFICER, QUINCY COMMUNITY ACTION PROGRAMS - DEBORAH SCHOPPERLE, MARKETING MANAGER, QUINCY CREDIT UNION - CYNTHIA SIERRA, CHIEF EXECUTIVE OFFICER, MANET COMMUNITY HEALTH CENTER - CHRISTINE STANTON, EXECUTIVE DIRECTOR, MILTON COUNCIL ON AGING - JANICE SULLIVAN, CHIEF OF STRATEGY & COMMUNICATIONS, ASPIRE HEALTH ALLIANCE - KATELYN SZAFIR, VICE PRESIDENT OF OPERATIONS, HALE FAMILY/SOUTH SHORE YMCA - SARA TAN, EXECUTIVE DIRECTOR, ENHANCE ASIAN COMMUNITY ON HEALTH - CHRISTINE TANGISHAKA, RESIDENT, TOWN OF RANDOLPH- MICHELLE TYLER, PLANNER, TOWN OF RANDOLPH COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT-INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY (IS ) 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. BID MILTON COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2025. THAT CHNA WAS APPROVED BY THE BID MILTON BOARD OF TRUSTEES ON SEPTEMBER 15, 2025. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 15, 2025, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). (SCHEDULE H, PART V, SECTION B, LINE 3)THE CHNA AND THE ASSOCIATED IS REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF BID MILTON'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA (CBSA) 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 BID MILTON ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BID MILTON, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA. 2025 COMMUNITY HEALTH NEEDS ASSESSMENT-PRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, BID MILTON COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2025. THE GEOGRAPHICAL FOCUS OF BID MILTON'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES THE CITY OF QUINCY AND THE TOWNS OF MILTON AND RANDOLPH. COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR BID MILTON'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R). BID MILTON'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF QUINCY, MILTON AND RANDOLPH IN ITS CBSA, AS FOLLOWS: - YOUTH - LOW-RESOURCED POPULATIONS - OLDER ADULTS - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS - INDIVIDUALS LIVING WITH DISABILITIES2025 COMMUNITY HEALTH NEEDS ASSESSMENT-SUMMARY OF APPROACH AND METHODSBID MILTON'S CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING BID MILTON'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. BID MILTON'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL AND STATE LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, ACCOUNTABILITY, COMMUNITY ENGAGEMENT, AND IMPACT.THIS 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT IS AN INTEGRAL PART OF BID MILTON'S POPULATION HEALTH AND COMMUNITY ENGAGEMENT EFFORTS. IT SUPPLIES VITAL INFORMATION THAT IS APPLIED TO MAKE SURE THAT THE SERVICES AND PROGRAMS THAT BID MILTON PROVIDES ARE APPROPRIATELY FOCUSED, DELIVERED IN WAYS THAT ARE RESPONSIVE TO THOSE IN ITS CBSA, AND ADDRESS UNMET COMMUNITY NEEDS. THIS ASSESSMENT, ALONG WITH THE ASSOCIATED PRIORITIZATION AND PLANNING PROCESSES, ALSO PROVIDES A CRITICAL OPPORTUNITY FOR BID MILTON TO ENGAGE THE COMMUNITY AND STRENGTHEN THE COMMUNITY PARTNERSHIPS THAT ARE ESSENTIAL TO BID MILTON'S SUCCESS NOW AND IN THE FUTURE. THE ASSESSMENT ENGAGED MORE THAN 700 PEOPLE FROM ACROSS THE CBSA, INCLUDING LOCAL PUBLIC HEALTH OFFICIALS, CLINICAL AND SOCIAL SERVICE PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, FAITH LEADERS, GOVERNMENT OFFICIALS, AND COMMUNITY RESIDENTS.BETWEEN JUNE 2024 AND SEPTEMBER 2025, BID MILTON CONDUCTED 15 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED 5 FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, AND 1 COMMUNITY LISTENING SESSION. IN TOTAL, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 700 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS, AND OTHER KEY COMMUNITY PARTNERS2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-DETAIL OF APPROACH AND METHODSBID MILTON RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. BID MILTON COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT BID MILTON LEVERAGED INCLUDED:- BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2021-2022)- CENTERS FOR DISEASE CONTROL GEOSPATIAL RESEARCH, ANALYSIS, AND SERVICES PROGRAM (2018-2022)- CENTERS FOR DISEASE CONTROL AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY (2022)- CENTERS FOR MEDICARE AND MEDICAID SERVICES GEOSPATIAL RESEARCH, ANALYSIS AND SERVICES PROGRAM (2018-2022)- MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021)- FBI UNIFORM CRIME REPORTS (2019)- MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2024)- MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2024)- MASSACHUSETTS DEATH REPORT, COMMUNITY PROFILES (2024)- ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2022, 2023, 2024)- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2019-2023)- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2019-2023)- U.S. DEPARTMENT OF AGRICULTURE: AGRICULTURE MARKETING SERVICE (2023)- U.S. DEPARTMENT OF AGRICULTURE: RETAILER LOCATOR (2024)2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-COMMUNITY INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN JUNE 2024 AND SEPTEMBER 2025, BID MILTON WORKED WITH COLLABORATORS TO CONDUCT 15 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS FROM THE COMMUNITY, INCLUDING REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS, AND OTHERS THROUGHOUT BID MILTON'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF COMMUNITY INTERVIEWEES IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON BID MILTON'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN BID MILTON'S CBSA. INTERVIEWS WERE CONDUCTED USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS. FOCUS GROUPS AND COMMUNITY FORUMS 2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)ACROSS ALL FOUR COMPONENTS OF THE CHNA, BID MILTON CONDUCTED 5 COMMUNITY FOCUS GROUPS AND HELD A COMMUNITY LISTENING SESSION THAT ENGAGED PEOPLE IN BID MILTON'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH OTHER BETH ISRAEL LAHEY HEALTH (BILH) HOSPITALS.BID MILTON WAS INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF BID MILTON'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN THIRTEEN LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, COMMUNITY EVENTS, AND PUBLIC AND/OR SENIOR HOUSING BUILDINGS TO HELP ENSURE APPROPRIATE REPRESENTATION IN THE CHNA. THE BID MILTON COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES. 2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSTHE BID MILTON'S CBAC WAS ENGAGED AT THE OUTSET OF THE STRATEGIC PLANNING AND REPORTING PHASE OF THE PROJECT. THE CBAC WAS UPDATED ON ASSESSMENT PROGRESS AND WAS PROVIDED THE OPPORTUNITY TO VET AND COMMENT ON PRELIMINARY FINDINGS. THE CBAC THEN PARTICIPATED IN A PRIORITIZATION PROCESS USING A SET OF ANONYMOUS POLLS, WHICH ALLOWED THEM TO IDENTIFY A SET OF COMMUNITY HEALTH PRIORITIES AND POPULATION COHORTS THAT THEY BELIEVED SHOULD BE CONSIDERED FOR PRIORITIZATION AS BID MILTON DEVELOPED ITS IMPLEMENTATION STRATEGY (IS). AFTER PRIORITIZATION WITH THE CBAC, A COMMUNITY LISTENING SESSION WAS ORGANIZED WITH THE PUBLIC-AT-LARGE, INCLUDING COMMUNITY RESIDENTS, REPRESENTATIVES FROM CLINICAL AND SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY-BASED ORGANIZATIONS THAT PROVIDE SERVICES THROUGHOUT THE CBSA. USING THE SAME SET OF ANONYMOUS POLLS, COMMUNITY LISTENING SESSION PARTICIPANTS WERE ASKED TO PRIORITIZE THE ISSUES THAT THEY BELIEVED WERE MOST IMPORTANT. THE SESSION ALSO ALLOWED PARTICIPANTS TO SHARE THEIR IDEAS ON EXISTING COMMUNITY STRENGTHS AND ASSETS, AS WELL AS THE SERVICES, PROGRAMS, AND STRATEGIES THAT SHOULD BE IMPLEMENTED TO ADDRESS THE ISSUES IDENTIFIED. THE CBAC ANALYZED LISTENING SESSION DATA AND INTEGRATED COMMUNITY INPUT INTO THE FINAL PRIORITIZATION. AFTER THE PRIORITIZATION PROCESS, A CHNA REPORT WAS DEVELOPED AND BID MILTON'S EXISTING IS WAS AUGMENTED, REVISED, AND TAILORED. WHEN DEVELOPING THE IS, BID MILTON'S COMMUNITY BENEFITS STAFF RETAINED COMMUNITY HEALTH INITIATIVES THAT WORKED WELL AND ALIGNED WITH THE PRIORITIES FROM THE 2025 CHNA. AFTER DRAFTS OF THE BID MILTON CHNA REPORT AND IS WERE DEVELOPED, THEY WERE SHARED WITH BID MILTON'S SENIOR LEADERSHIP TEAM FOR INPUT AND COMMENT. THE HOSPITAL'S COMMUNITY BENEFITS STAFF THEN REVIEWED THESE INPUTS AND INCORPORATED ELEMENTS, AS APPROPRIATE, BEFORE THE FINAL 2025 CHNA REPORT AND 2026-2028 IS WERE SUBMITTED TO BID MILTON'S BOARD OF TRUSTEES FOR APPROVAL. AFTER THE BOARD OF TRUSTEES FORMALLY APPROVED THE 2025 CHNA REPORT AND ADOPTED 2026-2028 IS, THESE DOCUMENTS WERE POSTED ON BID MILTON'S WEBSITE, ALONGSIDE THE 2022 CHNA REPORT AND 2023-2025 IS, FOR EASY VIEWING AND DOWNLOAD. AS WITH ALL BID MILTON CHNA PROCESSES, THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC WHENEVER REQUESTED, ANONYMOUSLY AND FREE OF CHARGE. IT SHOULD ALSO BE NOTED THAT THE HOSPITAL'S COMMUNITY BENEFITS STAFF HAVE MECHANISMS IN PLACE TO RECEIVE WRITTEN COMMENTS ON THE MOST RECENT CHNA AND IS, ALTHOUGH NO COMMENTS HAVE BEEN RECEIVED SINCE THE LAST CHNA AND IS WERE MADE AVAILABLE2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--KEY FINDINGSBID MILTON'S PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDING SEPTEMBER 30, 2025, WERE:- YOUTH- LOW-RESOURCED POPULATIONS- OLDER ADULTS- RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS- INDIVIDUALS LIVING WITH DISABILITIESBID MILTON'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - EQUITABLE ACCESS TO CARE: IN THE CONTEXT OF THE HEALTHCARE SYSTEM, SYSTEMIC FACTORS INCLUDE A BROAD RANGE OF DIFFERENT CONSIDERATIONS THAT INFLUENCE A PERSON'S ABILITY TO ACCESS TIMELY, EQUITABLE, ACCESSIBLE, AND HIGH-QUALITY SERVICES. THERE IS A GROWING APPRECIATION FOR THE IMPORTANCE OF THESE FACTORS AS THEY ARE SEEN AS CRITICAL TO ENSURING THAT PEOPLE CAN FIND, ACCESS, AND ENGAGE IN THE SERVICES THEY NEED, COMMUNICATE WITH CLINICAL AND SOCIAL SERVICE PROVIDERS, AND TRANSITION SEAMLESSLY FROM ONE SERVICE SETTING TO ANOTHER. THE ASSESSMENT GATHERED INFORMATION RELATED TO PERCEPTIONS OF SERVICE GAPS, BARRIERS TO ACCESS (E.G., COST OF CARE, HEALTH INSURANCE STATUS, LANGUAGE ACCESS, CULTURAL COMPETENCE), CARE COORDINATION, AND INFORMATION SHARING.- SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE "THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS." THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEYS, AND THE LISTENING SESSION REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC STABILITY.- MENTAL HEALTH AND SUBSTANCE USE: ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS; TRAUMA EXPERIENCED BY IMMIGRANTS, MIGRANTS, AND REFUGEES, AND SOCIAL ISOLATION AMONG OLDER ADULTS. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR ASSISTANCE NAVIGATING A COMPLEX BEHAVIORAL HEALTH SYSTEM, AS IT CAN BE OVERWHELMING FOR INDIVIDUALS EXPERIENCING MENTAL HEALTH CHALLENGES. PROVIDING NAVIGATION ASSISTANCE ENSURES PEOPLE CAN ACCESS THE RIGHT SERVICES AT THE RIGHT TIME, IMPROVING CONTINUITY OF CARE AND HEALTH OUTCOMES. YOUTH MENTAL HEALTH WAS A CONCERN IN THE CBSA, INCLUDING THE PREVALENCE OF CHRONIC STRESS, ANXIETY, AND BEHAVIORAL ISSUES. THESE CONDITIONS WERE EXACERBATED THROUGHOUT THE PANDEMIC, BECAUSE OF ISOLATION, UNCERTAINTY, REMOTE LEARNING, AND FAMILY DYNAMICS.- HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN THE COMMONWEALTH, CHRONIC CONDITIONS LIKE CANCER, HEART DISEASE, CHRONIC LOWER RESPIRATORY DISEASE, AND STROKE ACCOUNT FOR FOUR OF THE SIX LEADING CAUSES OF DEATH STATEWIDE, AND IT IS ESTIMATED THAT THERE ARE MORE THAN $41 BILLION IN ANNUAL COSTS ASSOCIATED WITH CHRONIC DISEASE. PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETYTHE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM BID MILTON'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2026, SEPTEMBER 30, 2027, AND SEPTEMBER 30, 2028. BID MILTON'S COMMUNITY BENEFITS ACTIVITIES AND ACCOMPLISHMENTS WHICH ARE REPORTED IN THIS FORM 990 SCHEDULE H WERE INFORMED BY THE HOSPITAL'S PREVIOUS CHNA AND IMPLEMENTATION STRATEGY AND ARE PROVIDED IN MORE DETAIL BELOW. PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFITS ACTIVITIES AS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, BID MILTON MOST RECENTLY COMPLETED ITS CHNA DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024) AND THE FIRST YEAR OF ACCOMPLISHMENTS UNDER THAT CHNA AND IMPLEMENTATION STRATEGY (IS) WILL BE REPORTED IN THE FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2026. THE PRIOR CHNA AND IS PROCESS WHICH WAS COMPLETED BY BID MILTON DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 AND INFORMED BID MILTON'S COMMUNITY BENEFITS OPERATIONS AND ACCOMPLISHMENTS REPORTED IN THIS FORM 990. 2022 COMMUNITY HEALTH NEEDS ASSESSMENT-PRIORITY GEOGRAPHY AND COHORTSBID MILTON COMPLETED ITS 2022 ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF BID MILTON'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES THE CITY OF QUINCY AND TOWNS OF MILTON AND RANDOLPH.COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR BID MILTON'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).BID MILTON'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF QUINCY, MILTON AND RANDOLPH IN ITS CBSA, AS FOLLOWS:- YOUTH- LOW-RESOURCED POPULATIONS- OLDER ADULTS- RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS- INDIVIDUALS WITH DISABILITIES2022 COMMUNITY HEALTH NEEDS ASSESSMENT--SUMMARY OF APPROACH AND METHODSSIMILAR TO BID MILTON'S APPROACH AND METHODS FOR THE CHNA ADOPTED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025, THE BID MILTON'S PRIOR CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING BID MILTON'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. BID MILTON'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, STATE AND NATIONAL LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY. BETWEEN OCTOBER 2021 AND FEBRUARY 2022, BID MILTON CONDUCTED 19 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED THREE FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 500 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 600 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY PARTNERS.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-DETAIL OF APPROACH AND METHODSBID MILTON RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. BID MILTON COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT BID MILTON LEVERAGED INCLUDED:- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020)- U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020)- U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021)- BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2019)- MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021)- FBI UNIFORM CRIME REPORTS (2019)- MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021)- MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021)- MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019)- MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019)- MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020)- MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018)- ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021) 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, BID MILTON WORKED WITH COLLABORATORS TO CONDUCT 19 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, ELECTED/APPOINTED OFFICIALS AND OTHER KEY COLLABORATORS THROUGHOUT BID MILTON' CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON BID MILTON'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN BID MILTON' CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS. 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)BID MILTON CONDUCTED THREE COMMUNITY FOCUS GROUPS AND HELD TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED 77 RESIDENTS IN BID MILTON'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH THE SIGNATURE HEALTHCARE BROCKTON HOSPITAL AND OTHER BILH HOSPITALS. BID MILTON HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF BID MILTON'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, FAITH-BASED COMMUNITIES, COMMUNITY EVENTS AND SENIOR HOUSING FACILITIES TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE BID MILTON COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-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 WITH THE BID MILTON COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS.- IDENTIFY BID MILTON'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES.- ANALYZE BID MILTON'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY BID MILTON DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018).- 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, 2022 (TAX YEAR 2021).2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--KEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDING SEPTEMBER 30, 2022, WERE:- YOUTH - LOW-RESOURCED POPULATIONS - OLDER ADULTS - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS - INDIVIDUALS WITH DISABILITIESBID MILTON'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTHCARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.- SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY.- HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS).- HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY. COMMUNITY HEALTH NEEDS ASSESSMENT-MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEBID MILTON STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, BID MILTON COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE BID MILTON WEBSITE AT:HTTPS://BIDMILTON.ORG/-/MEDIA/FILES/MILTON/COMMUNITY-BENEFITS/BID MILTON-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2025.PDF. IN ADDITION TO THE CHNA, BID MILTON COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE BID MILTON WEBSITE AT:HTTPS://BIDMILTON.ORG/-/MEDIA/FILES/MILTON/COMMUNITY-BENEFITS/BID MILTON-CHNA-IMPLEMENTATION-STRATEGY-2026-2028.PDFBID MILTON COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THAT CHNA IS AVAILABLE ON THE BID MILTON WEBSITE AT: HTTPS://BIDMILTON.ORG/-/MEDIA/FILES/MILTON/COMMUNITY-BENEFITS/BID-MILTON-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2022.PDF FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING BID MILTON'S FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021) IS AVAILABLE ON THE BID MILTON WEBSITE AT:HTTPS://BIDMILTON.ORG/-/MEDIA/FILES/MILTON/COMMUNITY-BENEFITS/BID-MILTON-CHNA-IMPLEMENTATION-STRATEGY-2023-2025.PDF EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENT--ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, BID MILTON'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 BUT IT IS THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY WHICH INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF BID MILTON FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024) AND WHICH ARE REPORTED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, BID MILTON HAS BEEN STRATEGIC IN IDENTIFYING ITS COMMUNITY HEALTH PRIORITIES 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 PRIORITY AREA ARE LISTED BELOW.PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH - ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENT WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONS- IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.PRIORITY AREA 3: ACCESS TO CARE- PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC AND ECONOMIC BARRIERS. PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE USE - PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE ISSUES AND CONDITIONS. COMMUNITY HEALTH NEEDS ASSESSMENT-APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)A FULL UPDATE ON BID MILTON'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.SCHEDULE H-COMMUNITY BENEFITS ACCOMPLISHMENTS - IMPLEMENTATION STRATEGY UPDATEKEY: BASELINE-2023, YEAR 1-2024, YEAR 2-2025PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE THE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND THE BID MILTON COMMUNITY HEALTH SURVEY REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC INSTABILITY. GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENTS WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES.STRATEGIES1. PROVIDE SUPPORT FOR IMPACTFUL PROGRAMS AND COMMUNITY INITIATIVES THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTH.2. SUPPORT PROGRAMS THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSING.3. SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE HEALTHY EATING AND ACCESS TO AFFORDABLE, HEALTHY FOODS.4. INCREASE MENTORSHIP, TRAINING, AND EMPLOYMENT OPPORTUNITIES TO INCREASE EMPLOYMENT AND EARNINGS AND INCREASE FINANCIAL SECURITY FOR YOUTH, YOUNG ADULTS, AND ADULTS RESIDING IN THE COMMUNITIES.5. SUPPORT PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION.6. PARTICIPATE IN MULTI-SECTOR COMMUNITY COALITIONS TO CONVENE STAKEHOLDERS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. INITIATIVES TO ADDRESS THE PRIORITY- EMERGENCY FLEX FUNDING FOR DOMESTIC VIOLENCE SURVIVORS - COMMUNITY GRANT FUNDING FOR INITIATIVES TO ADDRESS ISSUES WITH SOCIAL DETERMINANTS OF HEALTH- RENTAL ASSISTANCE/EVICTION PREVENTION COMMUNITY GRANTS- COMMUNITY SUPPORTED AGRICULTURE (CSA) SHARES TO FOOD PANTRIES- NUTRITIONAL SUPPORTS FOR SENIORS IN AFFORDABLE HOUSING- COMMUNITY TABLE EVENTS- INTERNSHIP PROGRAMS IN MULTIPLE DEPARTMENTS: NURSING, RADIOLOGY, PHARMACY, ETC.- HIGH SCHOOL INTERNSHIP PROGRAM- HEALTHCARE SCHOLARSHIPSMETRICS AND STATUS UPDATE:* BASED ON DATA COLLECTED BETWEEN OCTOBER 1, 2024 AND SEPT 30, 2025- AMOUNT OF COMMUNITY GRANT DOLLARS FOR EMERGENCY FLEX FUNDING AWARDED TO DOVE FOR DOMESTIC VIOLENCE SURVIVORS (BASELINE: $5,000; YEAR 1: $5,000. YEAR 2: $5,000) - NUMBER OF PEOPLE SERVED (BASELINE: 5; YEAR 1:5) AND NUMBER OF CLIENTS PROVIDED WITH ADDITIONAL WRAP AROUND SERVICES (BASELINE: 5; YEAR 1: 5, YEAR 2: 14) - AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO ADDRESS SOCIAL DETERMINANTS OF HEALTH: (BASELINE: $5,000 ONE-TIME GRANT TO INSTALL NATIONAL FITNESS COURT TO ADDRESS BUILT ENVIRONMENT PROGRAM WAS FUNDED AND IMPLEMENTED FOR ONLY FOR FY23) - AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO MILTON EARLY CHILDHOOD ALLIANCE TO ADDRESS SOCIAL DETERMINANTS OF HEALTH (BASELINE: $5,000, YEAR 1: $5,000)- BID MILTON'S COMMUNITY HEALTH INITIATIVE - FRIENDLY FOOD PANTRY AMOUNT AWARDED (BASELINE: $20,603; YEAR 1: PROGRAM STAFF LEFT, YEAR 2: $41,206) - NUMBER OF POUNDS OF FOOD DISTRIBUTED (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 4,617, YEAR 2: METRIC NOT SUBMITTED) - NUMBER OF HOUSEHOLDS SERVED (YEAR 1: 460, YEAR 2: 677)- AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO THE MAY INSTITUTE TO IMPLEMENT WORKFORCE DEVELOPMENT INITIATIVES FOR YOUTH AND YOUNG ADULTS WITH DISABILITIES (BASELINE: $10,0000; YEAR 1: $10,000, YEAR 2: $10,000) - NUMBER OF STUDENTS PARTICIPATING (BASELINE: 50; YEAR 1: 30, YEAR 2: 35) - PERCENTAGE OF STUDENTS WITH INCREASED IMPROVEMENT IN SOCIAL AND TECHNICAL SKILLS (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 100% WITH 2 STUDENTS EARNING EMPLOYMENT IN THE COMMUNITY, YEAR 2: 100% IN AT LEAST ONE SKILL AREA)- AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO SOUTH SHORE ELDER SERVICES TO ADDRESS NON-MEDICAL TRANSPORTATION NEEDS FOR OLDER ADULTS IN (BASELINE: $6,000, YEAR 1: $6,000, YEAR 2: $9,000) - NUMBER OF RIDES PROVIDED: (BASELINE: DATA NOT YET AVAILABLE, YEAR 1: 610 ROUND-TRIP RIDES FOR 181 INDIVIDUALS, YEAR 2: 954 ROUND-TRIP RIDES FOR 395 INDIVIDUALS)- AMOUNT OF COMMUNITY GRANT FUNDING AWARDED TO QUINCY COMMUNITY ACTION PROGRAMS FOR RENTAL ASSISTANCE AND EVICTION PREVENTION (BASELINE: $15,000; YEAR 1: $15,000; YEAR 2: $15,000) - NUMBER OF INDIVIDUALS PREVENTED FROM EXPERIENCING HOMELESSNESS BY PROVIDING RENTAL ASSISTANCE (BASELINE: 15 HOUSEHOLDS FOR A TOTAL OF 25 INDIVIDUALS RECEIVED AN AVERAGE OF $900; YEAR 1: 13 HOUSEHOLDS FOR A TOTAL OF 31 INDIVIDUALS RECEIVED AN AVERAGE OF $923; YEAR 2: 25 HOUSEHOLDS FOR A TOTAL OF 65 INDIVIDUALS RECEIVED AN AVERAGE OF $1,200 ) AND PERCENT OF FAMILIES RECEIVING REFERRALS WHO THEN ENGAGED WITH ONE OR MORE AREA RESOURCES SERVICES (BASELINE:86%; YEAR 1: 100%; YEAR 2: 92% )- AMOUNT OF PRODUCE SUPPLIED TO FOOD PANTRIES (BASELINE: 420LBS.; YEAR 1: 420LBS; YEAR 2: 490LBS)- NUMBER OF MEALS DISTRIBUTED TO OLDER ADULTS (BASELINE: 500; YEAR 1: 500, YEAR 2: 500) - NUMBER OF NUTRITION CONSULTATIONS PERFORMED (BASELINE: 25; YEAR 1:30; YEAR 2: 35) AND NUMBER OF COMMUNAL LEARNING EVENTS (BASELINE: 2 COOKING DEMONSTRATIONS; YEAR 1: 7, YEAR 2: 2).- AMOUNT OF TRANSPORTATION VOUCHERS PROVIDED (BASELINE: $6,414; YEAR 1: $10,242, YEAR 2: $6,186)- NUMBER OF COLLEGE STUDENTS COMPLETING INTERNSHIPS (BASELINE: 4; YEAR 1: 5; YEAR 2: 3); NUMBER OF HOURS COMPLETED (BASELINE: 560; YEAR 1: 2,100, YEAR 2: 2,100); NUMBER OF STUDENTS HIRED FOR POSITIONS (BASELINE: 2; YEAR 1: 1; YEAR 2: 1)- NUMBER OF STUDENTS PARTICIPATING IN HIGH SCHOOL INTERNSHIP PROGRAM (BASELINE: 4; YEAR 1: 4; YEAR 2: 2) AND NUMBER OF HOURS COMPLETED (BASELINE: 200; YEAR 1: 271; YEAR 2: 168) - NUMBER OF JOB SHADOWING AND VOLUNTEER HOURS PROVIDED AT THE HOSPITAL BY AREA TEENAGERS (BASELINE: 500 HOURS; YEAR 1: 453).- NUMBER AND AMOUNT OF HEALTH CARE SCHOLARSHIPS PROVIDED (BASELINE: $500 SCHOLARSHIP PROVIDED TO 1 STUDENT; YEAR 1: $500 SCHOLARSHIP PROVIDED TO 1 STUDENT; YEAR 2: $500 SCHOLARSHIP PROVIDED TO 1 STUDENT)- BILH GOVERNMENT AFFAIRS ADVOCATED, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, FOR BILLS THAT SUPPORTED ACCESS TO SERVICES TO ADDRESS THE ROOT CAUSES OF POOR HEALTH OUTCOMES FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 9; YEAR 2: 12). PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONS CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN MASSACHUSETTS AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY. GOAL: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.STRATEGIES1. ADDRESS BARRIERS TO TIMELY CANCER AND CHRONIC DISEASE SCREENINGS AND FOLLOW-UP CARE THROUGH CULTURALLY APPROPRIATE NAVIGATION AND INNOVATIVE PROGRAMS.2. PROVIDE PREVENTATIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/ OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMS.3. ENSURE OLDER ADULTS HAVE ACCESS TO COORDINATED HEALTHCARE, SUPPORTIVE SERVICES AND RESOURCES THAT SUPPORT OVERALL HEALTH AND THE ABILITY TO AGE IN PLACE.INITIATIVES TO ADDRESS THE PRIORITY- LUNG CANCER SCREENING PROGRAM- DIABETES SELF-MANAGEMENT CLASSES- MATTER OF BALANCE CLASSES- PALLIATIVE CARE PROGRAM- MEDITATION CLASSESMETRICS AND STATUS UPDATES: - NUMBER OF PATIENTS SCREENED FOR LUNG CANCER (BASELINE: 786; YEAR 1: 917; YEAR 2: 1,148)- NUMBER OF COMMUNITY MEMBERS ENROLLED IN DIABETES SELF-MANAGEMENT COURSES (BASELINE: 8; YEAR 1: 6; YEAR 2: 12); PERCENTAGE OF PARTICIPANTS REPORTING A CHANGE IN BEHAVIOR TO BETTER MANAGE THEIR DIABETES (BASELINE: 80%; YEAR 1: 80%; YEAR 2: 100%) AND NUMBER OF PARTICIPANTS PROVIDED WITH FREE 3-MONTH GYM MEMBERSHIPS TO CONTINUE HEALTHY LIFESTYLE (BASELINE: 2; YEAR 1: 0; YEAR 2: 5)- NUMBER OF COMMUNITY MEMBERS ENROLLED IN MATTER OF BALANCE CLASSES (BASELINE: 8; YEAR 1: DATA NOT YET AVAILABLE, YEAR 2: 26); PERCENTAGE OF PARTICIPANTS REPORTING A DECREASED FEAR OF FALLING AND INCREASED PHYSICAL ACTIVITY LEVELS (BASELINE: 70%; YEAR 1: DATA NOT AVAILABLE; YEAR 2: 60%) AND NUMBER OF PARTICIPANTS PROVIDED WITH FREE 3-MONTH GYM MEMBERSHIPS TO CONTINUE A HEALTHY LIFESTYLE (BASELINE: 6; YEAR 1: 0; YEAR 2: 3) - NUMBER OF PALLIATIVE CARE CONSULTS PERFORMED (BASELINE:108; YEAR 1: 189; YEAR 2: 208) - NUMBER OF PROGRAMS CONDUCTED TO ADDRESS SOCIAL ISOLATION IN OLDER ADULTS (BASELINE: 22 MEDITATION CLASSES AND 14 MUSIC THERAPY CLASSES; YEAR 1: 16 MUSIC THERAPY CLASSES AND 6 COMMUNITY LUNCHEONS; YEAR 2: 16 MUSIC THERAPY CLASSES AND 8 BREAKFASTS) AND NUMBER OF PARTICIPANTS (BASELINE: 15-20 PARTICIPANTS IN EACH CLASS; YEAR 1: 10-15 PARTICIPANTS IN EACH CLASS, 120 PEOPLE FOR LUNCHEONS; YEAR 2: 10-15 PARTICIPANTS IN EACH CLASS, 160 PEOPLE FOR LUNCHEONS)PRIORITY AREA 3: EQUITABLE ACCESS TO CARE INDIVIDUALS IDENTIFIED SEVERAL BARRIERS TO ACCESSING AND NAVIGATING THE HEALTHCARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THE ISSUES STEM FROM HOW THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AND URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC AND ECONOMIC BARRIERS.STRATEGIES1. PROMOTE EQUITABLE CARE, HEALTH EQUITY, AND HEALTH LITERACY FOR PATIENTS, ESPECIALLY THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS.2. PROMOTE ACCESS TO HEALTH CARE, HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICATIONS FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED.3. PROVIDE AND PROMOTE CAREER SUPPORT SERVICES AND CAREER MOBILITY PROGRAMS TO HOSPITAL EMPLOYEES.INITIATIVES TO ADDRESS THE PRIORITY- INTERPRETER SERVICES- FINANCIAL COUNSELORS- PRIMARY CARE SUPPORT- PIPELINE PROGRAMS- CAREER AND ACADEMIC ADVISING - HOSPITAL-SPONSORED COMMUNITY COLLEGE COURSES - HOSPITAL-SPONSORED ENGLISH SPEAKERS OF OTHER LANGUAGES (ESOL) CLASSESMETRICS AND STATUS UPDATES: - NUMBER OF FACE-TO-FACE AND PHONE ENCOUNTERS PERFORMED BY INTERPRETER SERVICES (BASELINE: 9,169 ENCOUNTERS IN 57 LANGUAGES; YEAR 1:12,064 ENCOUNTERS IN 57 LANGUAGES; YEAR 2: 17,386 ENCOUNTERS IN 59 LANGUAGES)- NUMBER OF PEOPLE ASSISTED BY FINANCIAL COUNSELORS AND ENROLLED IN HEALTH INSURANCE (BASELINE: 520, YEAR 1: 124, WITH 1,098 UTILIZING THE HEALTH SAFETY NET; YEAR 2: 149 ASSISTED WITH 1,307 UTILIZING HEALTH SAFETY NET)- NUMBER OF NEW PATIENTS IN MILTON, QUINCY AND RANDOLPH PRIMARY CARE OFFICES (BASELINE: 3,159, YEAR 1: 2,248; YEAR 2: 2,080) - NUMBER OF WORKFORCE DEVELOPMENT EVENTS AND PRESENTATIONS CONDUCTED WITH COMMUNITY PARTNERS (BASELINE: 67, YEAR 1: 33; YEAR 2: 42)- NUMBER OF PIPELINE PROGRAMS OFFERED AT BID MILTON (BASELINE: 2, YEAR 1: 2, YEAR 2: 0)- NUMBER OF EMPLOYEES THAT SUCCESSFULLY COMPLETED CENTRAL STERILE TECH PROCESSING PIPELINE PROGRAM (CPTECH) AND HIRED (BASELINE: 2, YEAR 1: 0, YEAR 2: 0)- NUMBER OF EMPLOYEES THAT ACCESSED CAREER AND ACADEMIC ADVISING SESSIONS (BASELINE: 46, YEAR 1: 1,044 ACROSS BILH, YEAR 2: 831 ACROSS BILH)- NUMBER OF EMPLOYEES ENROLLED IN HOSPITAL-SPONSORED COLLEGE COURSES (BASELINE: 4; YEAR 1: 14 BILH EMPLOYEES ATTENDED CITIZENSHIP CLASSES, 15 BILH EMPLOYEES ATTENDED CAREER DEVELOPMENT WORKSHOPS AND 207 BILH EMPLOYEES ATTENDED FINANCIAL LITERACY CLASSES; YEAR 2: 12 BILH EMPLOYEES ATTENDED CITIZENSHIP CLASSES, 102 BILH EMPLOYEES ATTENDED CAREER DEVELOPMENT WORKSHOPS AND 138 BILH EMPLOYEES ATTENDED FINANCIAL LITERACY CLASSES)- NUMBER OF EMPLOYEES ENROLLED IN ESOL CLASSES AT BID MILTON (BASELINE: 1; YEAR 1: 82 ACROSS BILH; YEAR 2: 126 ACROSS BILH) - NUMBER OF JOB SEEKERS REFERRED TO BILH (BASELINE: 225; YEAR 1: 412; YEAR 2: 306)- NUMBER OF JOB SEEKERS HIRED ACROSS BILH (BASELINE: 70; YEAR 1: 111; YEAR 2: 79)- NUMBER OF COMMUNITY COLLEGE STUDENTS WHO APPLIED AS CERTIFIED NURSING ASSISTANTS AND HIRED (BASELINE: 9, PROGRAM WAS FUNDED AND IMPLEMENTED FOR ONLY FOR FY23)- NUMBER OF PEOPLE TRAINED (BASELINE: 89 COMMUNITY MEMBERS TRAINED ACROSS BILH - PATIENT CARE TECHNICIAN OR NURSING ASSISTANT (30), PHARMACY TECH (16), PERIOPERATIVE LPN (3), MEDICAL ASSISTANT (21) AND BEHAVIORAL HEALTH ROLES (4) AND 15 WERE ENROLLED INTO THE ASSOCIATE DEGREE NURSING RESIDENCY PROGRAM BID MILTON PARTICIPATED IN THESE TRAININGS); YEAR 1: 107 COMMUNITY MEMBERS PLACED IN INTERNSHIPS ACROSS BILH HOSPITALS, 37 INTERNS WERE HIRED PERMANENTLY IN BILH HOSPITALS; YEAR 2: 36 INTERNS HIRED ACROSS BILH).- BILH GOVERNMENT AFFAIRS ADVOCATED, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, FOR BILLS SUPPORTING EQUITABLE HEALTH CARE ACCESS FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 23; YEAR 2: 24). PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE USE ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES ON YOUTH AND YOUNG ADULTS, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. THOSE WHO PARTICIPATED IN THE ASSESSMENT ALSO REFLECTED ON THE STIGMA, SHAME, AND ISOLATION THAT THOSE WITH MENTAL HEALTH CHALLENGES FACE THAT LIMIT THEIR ABILITY TO ACCESS CARE AND COPE WITH THEIR ILLNESS. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH AND ECONOMIC INSECURITY. INTERVIEWEES, FOCUS GROUP, AND LISTENING SESSION PARTICIPANTS ALSO REPORTED THAT ALCOHOL USE IS NORMALIZED, AND USE IS PREVALENT AMONG BOTH ADULTS AND YOUTH.GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE ISSUES AND CONDITIONS.STRATEGIES1. SUPPORT IMPACTFUL PROGRAMS THAT PROMOTE HEALTHY DEVELOPMENT, SUPPORT CHILDREN, YOUTH, AND THEIR FAMILIES, AND INCREASE THEIR RESILIENCE, COPING AND PREVENTION SKILLS.2. BUILD THE CAPACITY OF COMMUNITY MEMBERS TO UNDERSTAND THE IMPORTANCE OF MENTAL HEALTH AND SUBSTANCE USE, AND REDUCE NEGATIVE STEREOTYPES, BIAS, AND STIGMA AROUND MENTAL ILLNESS AND SUBSTANCE USE DISORDERS.3. PARTICIPATE IN MULTISECTOR COMMUNITY COALITIONS TO CONVENE STAKEHOLDERS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO INCREASE RESILIENCY, REDUCE YOUTH SUBSTANCE USE, AND PREVENT OPIOID OVERDOSES AND DEATHS.4. PROVIDE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION, AND TREATMENT.INITIATIVES TO ADDRESS THE PRIORITY- TRAUMA INFORMED SCHOOLS- GETTING THE TEENS OUT- COMMUNITY GRANT FUNDING TO INCREASE RESILIENCE, COPING AND PREVENTION SKILLS- MENTAL HEALTH FIRST AID - COGNITIVE BEHAVIORAL THERAPY (CBT) CLASSES- COALITION INVOLVEMENT- RECOVERY COACHES- COLLABORATIVE CARE MODEL- PRESCRIPTION TAKE-BACK KIOSKMETRICS AND STATUS UPDATES* FY23 INFORMATION IS BASED ON DATA COLLECTED BETWEEN JULY 1, 2021 AND SEPT 30, 2023. A NEW COHORT OF BEHAVIORAL HEALTH GRANTEES RECEIVED 3-YEAR GRANTS THAT BEGAN JANUARY 2024. DATA COLLECTION BEGAN APRIL 2024 AND IS ONGOING.- AMOUNT OF GRANT FUNDING AWARDED TO MILTON PUBLIC SCHOOLS TO IMPLEMENT RESILIENCE, PREVENTION SKILLS AND MENTAL HEALTH PROGRAMS (BASELINE: $12,500; YEAR 1: $12,500; YEAR 2: $5,000) - NUMBER OF STAFF TRAINED TO IMPLEMENT TRAUMA INFORMED SCHOOLS CLASSROOM CURRICULUM (BASELINE:12, YEAR 1:18, YEAR 2: 15) - NUMBER OF 5TH GRADE STUDENTS PARTICIPATING IN BOTVIN LIFE SKILLS TRAINING (BASELINE: 164; YEAR 1: 368) AND CHANGE IN KNOWLEDGE, BEHAVIOR OR SKILLS (BASELINE: 80% REPORTED INCREASED LEARNING AND STRESS COPING MECHANISMS; YEAR 1: 77% REPORTED INCREASED LEARNING AND STRESS COPING MECHANISMS; YEAR 2: PROGRAM ENDED)- IN FY24 GRANT FUNDING PROVIDED BY BILH TO QUINCY PUBLIC SCHOOLS FOR DEVELOPMENT AND IMPLEMENTATION OF COMMUNITY BEHAVIORAL HEALTH NAVIGATOR PROGRAM - NUMBER OF STUDENTS AND FAMILIES REFERRED TO PARTNER MENTAL HEALTH AGENCIES AND QUINCY PUBLIC SCHOOLS STAFF (YEAR 2: 135) - NUMBER OF EDUCATIONAL EVENTS HELD TO INCREASE AWARENESS OF MENTAL HEALTH RESOURCES AND SUPPORTS (YEAR 2: 4) - NUMBER OF PARTICIPANTS REACHED AT EDUCATIONAL EVENTS (YEAR 2: 170)- NUMBER "GETTING THE TEENS OUT" GROUPS CONDUCTED AND NUMBER OF PARTICIPANTS (BASELINE: 12 GROUPS HELD WITH 116 PARTICIPANTS; YEAR 1: 4 GROUPS WITH 90 PARTICIPANTS; YEAR 2: PROGRAM ENDED)- NUMBER OF COMMUNITY MEMBERS TRAINED IN MENTAL HEALTH FIRST AID (BASELINE: 49; YEAR 1: 380; YEAR 2: 146) - NUMBER OF CBT CLASSES (BASELINE: PROGRAM STAFF LEFT; YEAR 1: PROGRAM STAFF LEFT)- AMOUNT OF GRANT FUNDING AWARDED TO THE MILTON COALITION (FORMERLY MILTON SUBSTANCE ABUSE PREVENTION COALITION) (BASELINE: $15,000; YEAR 1: $15,000; YEAR 2: $15,000), NUMBER OF SECTORS REPRESENTED ON COALITION (BASELINE: 14, YEAR 1: 14, YEAR 2:14 AND NUMBER OF ADDITIONAL YOUTH MEMBERS RECRUITED (BASELINE: 5, YEAR 1: 4, YEAR 2: 20) - NUMBER OF BILLS BILH GOVERNMENT AFFAIRS ADVOCATED FOR, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, TO SUPPORT ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SERVICES FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DATA NOT YET AVAILABLE; YEAR 1: 8; YEAR 2: 10)- NUMBER OF PATIENTS SCREENED AND TRANSFERRED TO TREATMENT BY RECOVERY COACHES (BASELINE: 418 SCREENED, 200 TRANSFERRED TO TREATMENT; YEAR 1: 436 SCREENED, 172 TRANSFERRED TO TREATMENT; YEAR 2: 379 SCREENED, 133 TRANSFERRED TO TREATMENT) - NUMBER OF PATIENTS RECEIVING EMERGENCY PSYCHIATRIC EVALUATIONS FOR PLACEMENT IN AN INPATIENT PSYCHIATRIC UNIT AND/OR CRISIS STABILIZATION UNIT (BASELINE: 571; YEAR 1: 1,027; YEAR 2: 1,872)- NUMBER OF PATIENTS SERVED BY BEHAVIORAL HEALTH CLINICIANS EMBEDDED INTO PRIMARY CARE PRACTICES (BASELINE: 336; YEAR 1: 462; YEAR 2: 584)- AMOUNT OF DISCARDED PRESCRIPTION MEDICATIONS COLLECTED (BASELINE: 23 POUNDS; YEAR 1: 79 POUNDS; YEAR 2: 122 POUNDS)COMMUNITY PARTNERSBID MILTON 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. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE:- A NEW WAY RECOVERY CENTER- ASIAN AMERICAN SERVICE ASSOCIATION- ASPIRE HEALTH ALLIANCE - BAY STATE COMMUNITY SERVICES - BID MILTON PATIENT FAMILY ADVISORY COUNCIL- BROOKWOOD COMMUNITY FARM- CHOICE COMMUNITY SUPPORTS- CURRY COLLEGE - DOVE, INC- ENHANCE ASIAN COMMUNITIES ON HEALTH- FATHER BILLS & MAINSPRING HOUSE- FRIENDLY FOOD PANTRY- FULLER VILLAGE - GOSNOLD RECOVERY SERVICES- HARBORVIEW RESIDENTS ASSOCIATION- INTERFAITH SOCIAL SERVICES - MANET COMMUNITY HEALTH CENTERS - MAY INSTITUTE- METROPOLITAN AREA PLANNING COUNCIL- MILTON BOARD OF HEALTH - MILTON CHAMBER OF COMMERCE- MILTON COUNCIL ON AGING - MILTON COALITION FORMERLY KNOWN AS MILTON SUBSTANCE ABUSE PREVENTION COALITION - MILTON EARLY CHILDHOOD ALLIANCE- MILTON HOUSING AUTHORITY- MILTON POLICE DEPARTMENT- MILTON PUBLIC LIBRARY- MILTON PUBLIC SCHOOLS - MILTON YOUTH ADVOCATES FOR CHANGE- PARKWAY UNITED METHODIST CHURCH- PARTNERSHIP FOR A HEALTHY MILTON- QUINCY ASIAN RESOURCES- QUINCY BOARD OF HEALTH - QUINCY CHAMBER OF COMMERCE- QUINCY COMMUNITY ACTION PROGRAMS - QUINCY CREDIT UNION- QUINCY FAMILY RESOURCE CENTER- QUINCY PUBLIC SCHOOLS - QUINCY POLICE DEPARTMENT- QUINCY PRIDE- RANDOLPH BOARD OF HEALTH - RANDOLPH COMMUNITY WELLNESS PLAN STEERING COMMITTEE- RANDOLPH COMMUNITY PARTNERSHIP- RANDOLPH EDUCATIONAL COLLABORATIVE- RANDOLPH INTERGENERATIONAL COMMUNITY CENTER- RANDOLPH PUBLIC SCHOOLS- SIMON C. FIREMAN COMMUNITY- SOUTH COVE COMMUNITY HEALTH CENTER- SOUTH SHORE CHAMBER OF COMMERCE- SOUTH SHORE ELDER SERVICES - SOUTH SHORE FOOD BANK- SOUTH SHORE YMCA- WINTER VALLEY- UNQUITY HOUSEAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, BID MILTON IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY MOST RECENTLY ADOPTED BY BID MILTON DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024) AND WHICH WILL INFORM BID MILTON'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2026, SEPTEMBER 30, 2027 AND SEPTEMBER 30, 2028. NEEDS IDENTIFIED IN THAT CHNA WHICH WILL NOT BE ADDRESSED ARE: STRENGTHENING THE BUILT ENVIRONMENT (I.E. IMPROVING ROADS/SIDEWALKS). BID MILTON IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES AND BID MILTON'S CBAC AND SENIOR LEADERSHIP TEAM DECIDING THAT THE ISSUE WAS OUTSIDE OF THE ORGANIZATION'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHERS AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. HOWEVER, BID MILTON REMAINS OPEN AND WILLING TO WORK WITH THE OTHER BILH HOSPITALS AND/OR COMMUNITY PARTNERS TO ADDRESS THESE ISSUES. IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE PREVIOUS CHNA THAT WERE NOT INCLUDED IN THE PREVIOUS IMPLEMENTATION STRATEGY, BOTH OF WHICH GUIDED BID MILTON'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIOD COVERED BY THIS FILING. BID MILTON WAS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES BID MILTON'S CBAC AND SENIOR LEADERSHIP TEAM DECIDING THAT THE ISSUE WAS OUTSIDE OF THE ORGANIZATION'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHERS AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. BID MILTON WAS OPEN TO, WILLING TO AND MAY HAVE WORKED WITH THE OTHER BILH HOSPITALS AND/OR COMMUNITY PARTNERS TO ADDRESS THESE ISSUES AS DESCRIBED IN THIS NARRATIVE SUPPORT TO FORM 990 SCHEDULE H. AS NOTED IN DETAIL ABOVE, BID MILTON'S PRIMARY TOOL FOR ASSESSING THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BID MILTON CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H,10.89% OF BID MILTON'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS--ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, BID MILTON'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025, 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://BIDMILTON.ORG/ABOUT/COMMUNITY-BENEFITS-NEEDS.THERE 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 BID MILTON FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, BID-MILTON IS A GENERAL MEDICAL AND SURGICAL HOSPITAL PROVIDING EMERGENCY MEDICAL CARE TO ALL PATIENTS 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR WITHOUT REGARD TO ABILITY TO PAY (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21).FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS--CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBID-MILTON'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 $880,273 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, BID-MILTON IS ONE OF ELEVEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING FOR THE MASSACHUSETTS HOSPITALS, PAYMENTS TO THE MASSACHUSETTS HEALTH SAFETY NET TRUST, WAS MORE THAN $62 MILLION FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, FOR THE PERIOD COVERED BY THIS FILING, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE. ELIGIBILITY IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CARE--MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BID-MILTON 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, BID-MILTON GENERATED $3,500,300 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY BID-MILTON FOR SUCH SERVICES WHICH RESULTED IN A MEDICAID SHORTFALL OF $1,444,009 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 15.0% OR APPROXIMATELY 33,159 PATIENT ENCOUNTERS OF BID-MILTON'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 43.3% OR APPROXIMATELY 95,929 PATIENT CASES OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. IN ADDITION EACH OF THE OTHER BILH HOSPITALS ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM AND AS NOTED ABOVE, PAYMENTS FROM MEDICAID FOR LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ACROSS THE BILH HOSPITALS THE COST OF PROVIDING CARE TO MEDICAID PATIENTS EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL OF APPROXIMATELY $104 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND BID-MILTON PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BID-MILTON GENERATED $50,073,667 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE WHICH RESULTED IN A MEDICARE SHORTFALL OF $8,113,634. OF THESE AMOUNTS, REVENUE OF $36,433,048 IS RELATED TO THE PROVISION OF ORTHOPEDICS, OBGYN, UROLOGY, 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 $3,661,504. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH BID-MILTON 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, BID-MILTON 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 15.34%. BAD DEBTS IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BID-MILTON 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. COSTS FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $260,100 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. (BILH) AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 INCLUDE THE ACCOUNTS OF: BETH ISRAEL LAHEY HEALTH (BILH), BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI), EXETER HOSPITAL (EH), BETH ISRAEL LAHEY HEALTH PHARMACY, THE ENTITIES WHICH COMPRISE, AMONG OTHER OPERATIONS, BETH ISRAEL LAHEY HEALTH CONTINUING CARE AND BETH ISRAEL LAHEY HEALTH MEDICAL GROUP AS WELL AS OTHER ENTITIES FOR WHICH BILH SERVES AS DIRECT OR INDIRECT SOLE MEMBER. THE BILH CONSOLIDATED FINANCIAL STATEMENTS ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) AND THE ENTITIES FOR WHICH HMFP SERVES AS DIRECT OR INDIRECT SOLE MEMBER. SEE FORM 990 SCHEDULE R AND A COPY OF THE AUDITED FINANCIAL STATEMENTS ATTACHED TO THIS FORM 990 FOR ADDITIONAL INFORMATIONFINANCIAL STATEMENT FOOTNOTESBAD DEBTSTHE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSTHE SYSTEM'S PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING MANAGED CARE PAYORS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDE AN ESTIMATE OF VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE SYSTEM BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE SYSTEM'S FACILITY.REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE SYSTEM. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED (OR ACTUAL) CHARGES. THE SYSTEM BELIEVES THAT THIS METHOD PROVIDES A REASONABLE REPRESENTATION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO INPATIENT SERVICES. THE SYSTEM MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL, OR COMMENCEMENT OF A PATIENT SERVICE, TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TOTHAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE OR COMPLETION OF THE OUTPATIENT SERVICES. PATIENT ENCOUNTERS AND RELATED EPISODES OF CARE AND PROCEDURES QUALIFY AS DISTINCT GOODS AND SERVICES, PROVIDED SIMULTANEOUSLY TOGETHER WITH OTHER READILY AVAILABLE RESOURCES, IN A SINGLE INSTANCE OF SERVICE, AND THEREBY CONSTITUTE A SINGLE PERFORMANCE OBLIGATION FOR EACH PATIENT ENCOUNTER AND, IN MOST INSTANCES, OCCUR AT READILY DETERMINABLE TRANSACTION PRICES. ALL SERVICES PROVIDED ARE EXPECTED TO RESULT IN CASH FLOWS AND ARE THEREFORE REFLECTED AS NET REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. THE ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS ARE BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES AND HISTORICAL CASH COLLECTION EXPERIENCE. DIFFERENCES BETWEEN STANDARD CHARGES AND ESTIMATED TRANSACTION PRICE AREGENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE AND ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. ADJUSTMENTS ARISING FROM A CHANGE IN THE TRANSACTION PRICE WERE NOT SIGNIFICANT DURING THE YEARS ENDED SEPTEMBER 30, FOR 2025 OR 2024.REVENUES UNDER THE TRADITIONAL FEE FOR SERVICE MEDICARE AND MEDICAID PROGRAMS ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS. RETROSPECTIVELY DETERMINED COST-BASED REVENUES UNDER THESE PROGRAMS, WHICH WERE MORE PREVALENT IN EARLIER PERIODS, AND CERTAIN OTHER PAYMENTS, SUCH AS DISPROPORTIONATE SHARE HOSPITAL AND BAD DEBT EXPENSE REIMBURSEMENT, WHICH ARE BASED ON OUR HOSPITALS' COST REPORTS, ARE ESTIMATED USING HISTORICAL TRENDS AND CURRENT FACTORS. COST REPORT SETTLEMENTS UNDER THESE PROGRAMS ARE SUBJECT TO AUDIT BY MEDICARE AND MEDICAID AUDITORS AND ADMINISTRATIVE AND JUDICIAL REVIEW, AND IT CAN TAKE SEVERAL YEARS UNTIL FINAL SETTLEMENT OF SUCH MATTERS IS DETERMINED AND COMPLETELY RESOLVED. THE SYSTEM RECORDS ACCRUALS TO REFLECT THE EXPECTED FINAL SETTLEMENTS ON COST REPORTS. FOR FILED COST REPORTS, THE ACCRUAL IS RECORDED BASED ON THOSE COST REPORTS AND SUBSEQUENT ACTIVITY. THE ACCRUAL FOR PERIODS FOR WHICH A COST REPORT IS YET TO BE FILED IS RECORDED BASED ON ESTIMATES OF WHAT THE SYSTEM EXPECTS TO REPORT ON THE FILED COST REPORTS. AFTER THE COST REPORT IS FILED, THE ACCRUAL MAY NEED TO BE ADJUSTED.SETTLEMENTS WITH THIRD-PARTY PAYORS FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS OR INVESTIGATIONS ARE CONSIDERED VARIABLE CONSIDERATION AND ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE USING THE MOST LIKELY OUTCOME METHOD. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE PAYMENT AGREEMENT WITH THE PAYOR, CORRESPONDENCE FROM THE PAYOR AND HISTORICAL SETTLEMENT ACTIVITY, INCLUDING AN ASSESSMENT TO ENSURE THAT IT IS PROBABLE THAT A SIGNIFICANT REVERSAL IN THE AMOUNT OF CUMULATIVE REVENUE RECOGNIZED WILL NOT OCCUR WHEN THE UNCERTAINTY ASSOCIATED WITH THE RETROACTIVE ADJUSTMENT IS SUBSEQUENTLY RESOLVED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN, OR AS YEARS ARE SETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS.THE SYSTEM IS NOT AWARE OF ANY MATERIAL CLAIMS, DISPUTES, OR UNSETTLED MATTERS WITH ANY PAYORS THAT WOULD AFFECT REVENUES THAT HAVE NOT BEEN ADEQUATELY PROVIDED FOR AND DISCLOSED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. BECAUSE THE LAWS, REGULATIONS, INSTRUCTIONS AND RULE INTERPRETATIONS GOVERNING MEDICARE AND MEDICAID REIMBURSEMENT ARE COMPLEX, SUBJECT TO INTERPRETATION AND CAN CHANGE FREQUENTLY, THE ESTIMATES RECORDED COULD CHANGE BY MATERIAL AMOUNTS. CONSISTENT WITH THE SYSTEM'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (E.G., COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. PATIENTS WHO MEET THE SYSTEM'S CRITERIA FOR CHARITY CARE ARE PROVIDED CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE SYSTEM HAS DETERMINED THAT IT HAS PROVIDED SUFFICIENT IMPLICIT PRICE CONCESSIONS FOR THESE ACCOUNTS. PRICE CONCESSIONS, INCLUDING CHARITY CARE, ARE NOT REPORTED AS REVENUE.PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED CO-PAYS, CO-INSURANCE AND DEDUCTIBLES, WHICH VARY IN AMOUNT. THE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH CO-PAYS, CO-INSURANCE AND DEDUCTIBLES AND FOR THOSE WHO ARE UNINSURED BASED ON HISTORICAL COLLECTION EXPERIENCE AND CURRENT MARKET CONDITIONS. THE DISCOUNT OFFERED TO CERTAIN UNINSURED PATIENTS IS RECOGNIZED AS A CONTRACTUAL ALLOWANCE, WHICH REDUCES NET OPERATING REVENUES AT THE TIME THE SELF-PAY ACCOUNTS ARE RECORDED. THE UNINSURED PATIENT ACCOUNTS, NET OF CONTRACTUAL ALLOWANCES RECORDED, ARE FURTHER REDUCED TO THEIR NET REALIZABLE VALUE AT THE TIME THEY ARE RECORDED THROUGH IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION TRENDS FOR SELF-PAY ACCOUNTS AND OTHER FACTORS THAT AFFECT THE ESTIMATION PROCESS. ALTHOUGH OUTCOMES VARY, THE SYSTEM'S POLICY IS TO ATTEMPT TO COLLECT AMOUNTS DUE FROM PATIENTS, INCLUDING CO-PAYS, CO-INSURANCE AND DEDUCTIBLES DUE FROM PATIENTS WITH INSURANCE, AT THE TIME OF SERVICE WHILE COMPLYING WITH ALL FEDERAL AND STATE STATUTES AND REGULATIONS.OTHER REVENUE INCLUDES CONTRIBUTIONS AND NET ASSETS RELEASED FROM RESTRICTIONS AS WELL AS CAFETERIA AND PARKING INCOME.ADDITIONALLY, PHARMACY SALES AND OTHER CONTRACTS RELATED TO HEALTH CARE SERVICES ARE INCLUDED IN OTHER REVENUE AND CONSIST OF CONTRACTS WHICH VARY IN DURATION AND IN PERFORMANCE. REVENUE IS RECOGNIZED WHEN THE PERFORMANCE OBLIGATIONS IDENTIFIED WITHIN THE INDIVIDUAL CONTRACTS ARE SATISFIED AND COLLECTIONS ARE PROBABLE. OTHER REVENUE FOR THE YEARS ENDED SEPTEMBER 30, 2025 AND 2024 ALSO INCLUDED FUNDING RECEIVED FROM FEDERAL AND STATE SOURCES RELATED TO THE COVID-19 PANDEMIC AMOUNTING TO $21,248 AND $17,500, RESPECTIVELY.FINANCIAL ASSISTANCE POLICY-INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE BID-MILTON IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTHCARE 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 AND MAINTAINS A FINANCIAL ASSISTANCE POLICY (FAP) WHICH IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE FREE OR DISCOUNTED CARE FROM BID-MILTON AS WELL AS PROVIDERS WHO FOLLOW BID-MILTON'S FAP. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN BID-MILTON AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW BID-MILTON'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. BID-MILTON DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION OR DISABILITY 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. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONSFINANCIAL ASSISTANCE POLICY-APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY-ELIGIBILITY 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).FINANCIAL ASSISTANCE-PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP,FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED,THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS.IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS,THE HOSPITAL WILL OFFER ALL INDIVIDUALS 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 POLICY-TRANSLATIONS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 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: ENGLISH, HAITIAN CREOLE, SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, AND VIETNAMESE (SCHEDULE H PART V SECTION B QUESTION 16I).FINANCIAL ASSISTANCE POLICY-WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FINANCIAL ASSISTANCE POLICY (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://BIDMILTON.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE.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 INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY--PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION 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 BID-MILTON 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, ALL IN ENGLISH, HAITIAN CREOLE, SPANISH, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, AND VIETNAMESE CAN BE FOUND ON BID-MILTON WEBSITE AT: HTTPS://BIDMILTON.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE. LIMITATION ON CHARGES--INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED-LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS-501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL HAS NOT ENGAGED 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).THE HOSPITAL MAY DEFER OR REQUIRE PAYMENT BEFORE PROVIDING MEDICALLY NECESSARY SERVICES (OTHER THAN EMERGENCY MEDICAL SERVICES) TO PATIENTS WITH UNPAID BALANCES WHO HAVE FAILED TO PROVIDE REQUESTED INFORMATION FOR PROCESSING A FINANCIAL ASSISTANCE APPLICATION OR WITH RESPECT TO A PAYMENT PLAN. THE HOSPITAL DOES NOT PROVIDE A 30-DAY WRITTEN NOTICE IN ADVANCE OF TAKING SUCH ACTION, AS SUCH NOTICE IS NOT REQUIRED BY THE SECTION 501(R) REGULATIONS. (SCHEDULE H PART V SECTION B QUESTION 20). 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 BENEFITSRESEARCHAS NOTED THROUGHOUT THIS FORM 990, BIDM IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH BIDM DOES NOT DIRECTLY ENGAGE IN RESEARCH, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC),LAHEY CLINIC, NEW ENGLAND BAPTIST HOSPITAL AND JOSLIN DIABETES CENTER ALL ENGAGE IN RESEARCH ACTIVITIES DESIGNED TO CARE FOR PATIENTS NOT ONLY AT THESE HOSPITALS, BUT ACROSS THE COMMUNITIES SERVED BY BILH AND BEYOND. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $398 MILLION IN RESEARCH EXPENSES, APPROXIMATELY $94 MILLION OF WHICH WERE INTERNALLY FUNDED. ALTHOUGH THE RESEARCH ACTIVITIES OF BIDMC AND OTHER BILH AFFILIATES ARE NOT QUANTIFIED HERE IN BIDM'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY BIDM, BILH AND BEYOND. INFORMATION ON THE RESEARCH ENGAGED IN AT BIDMC AND JOSLIN,A SISTER ENTITIES TO BIDM, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION.TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES.THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING.THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE.DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY.THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN,HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS.THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION.THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE,THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:- ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE - EMERGENCY MEDICINE - MEDICINE - ALLERGY AND INFLAMMATION - CARDIOVASCULAR MEDICINE - CENTER FOR VASCULAR BIOLOGY RESEARCH - CLINICAL INFORMATICS - CLINICAL NUTRITION - ENDOCRINOLOGY - EXPERIMENTAL MEDICINE - GASTROENTEROLOGY - GENERAL MEDICINE AND PRIMARY CARE - GENETICS - GERONTOLOGY - HEMATOLOGY AND ONCOLOGY - HEMOSTASIS AND THROMBOSIS - IMMUNOLOGY - INFECTIOUS DISEASE - INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY - MOLECULAR AND VASCULAR MEDICINE - NEPHROLOGY - PULMONOLOGY - RHEUMATOLOGY - SIGNAL TRANSDUCTION - TRANSLATIONAL RESEARCH - TRANSPLANT IMMUNOLOGY- NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY - CARDIAC SURGERY - CENTER FOR MINIMALLY INVASIVE SURGERY - NEUROSURGERY - PLASTIC AND RECONSTRUCTIVE SURGERY - VASCULAR SURGERY- TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $398 MILLION IN RESEARCH EXPENSES, APPROXIMATELY $94 MILLION OF WHICH WERE INTERNALLY FUNDED AND REPORTED ON THE BIDMC SCHEDULE H,PART I,LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE.RESEARCH ENGAGED IN AT THE MEDICAL CENTER:THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION.BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN THE MEDICAL CENTER'S FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H,PART I,LINE 7H COLUMN E,DEPENDING ON FUNDING SOURCE. DETAIL ON RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. 1. MORE AMERICANS ARE UNAWARE THEY HAVE DIABETES, HIGH BLOOD PRESSURE, CHOLESTEROLIN A NEW REPORT PUBLISHED IN JAMA CARDIOLOGY, HEALTH POLICY EXPERTS AT BIDMC'S RICHARD A. AND SUSAN F. SMITH CENTER FOR OUTCOMES RESEARCH SHOWED THAT MANY U.S. ADULTS ARE UNAWARE THEY HAVE HIGH BLOOD PRESSURE, DIABETES OR HIGH CHOLESTEROL-THREE MAJOR RISK FACTORS FOR CARDIOVASCULAR DISEASE AND DEATH. THE PROPORTION OF AMERICANS UNAWARE THEY HAVE HYPERTENSION HAS RISEN OVER THE PAST DECADE, ESPECIALLY AMONG YOUNGER ADULTS AND WOMEN."YOUNG ADULTS WERE THE MOST LIKELY TO NOT REALIZE THAT THEY HAD HIGH BLOOD PRESSURE, DIABETES, OR HIGH CHOLESTEROL," SAID RISHI WADHERA, MD, MPP, MPHIL, ASSOCIATE DIRECTOR OF THE SMITH CENTER. "IT'S ESPECIALLY CONCERNING THAT ONE IN THREE YOUNG ADULTS WERE UNAWARE OF THEIR HIGH BLOOD PRESSURE, TWO IN FIVE DIDN'T KNOW THEY HAD DIABETES, AND ONE IN FOUR WERE UNAWARE OF HAVING HIGH CHOLESTEROL.THAT'S A MAJOR PUBLIC HEALTH ISSUE."THE ANALYSIS INCLUDED MORE THAN 15,000 ADULTS, MOSTLY MIDDLE-AGED, WHO HAD AT LEAST ONE RISK FACTOR IDENTIFIED THROUGH PHYSICAL EXAMS OR LAB TESTING.THE PROPORTION WITH HYPERTENSION- A CONDITION THAT'S OFTEN SYMPTOMLESS-WHO WERE UNAWARE OF IT ROSE SIGNIFICANTLY OVER THE DECADE-LONG STUDY PERIOD; AWARENESS OF DIABETES AND HIGH CHOLESTEROL DIDN'T CHANGE.BUT WHEN WADHERA AND COLLEAGUES BROKE DOWN THE DATA BY AGE, THE RISE IN HYPERTENSION UNAWARENESS APPEARED ONLY AMONG ADULTS AGES 20 TO 44,WITH NO CHANGE AMONG THOSE OLDER THAN 45.BY SEX, UNAWARENESS ROSE AMONG WOMEN BUT NOT MEN. GIVEN DECLINING HEART HEALTH IN YOUNG ADULTS, IT'S CRITICAL THAT WE INTENSIFY PUBLIC HEALTH MESSAGING TO THIS GROUP ON THE IMPORTANCE OF SCREENING FOR HIGH BLOOD PRESSURE, DIABETES, AND HIGH CHOLESTEROL," SAID DANIEL JOHNSON, LEAD AUTHOR OF THE STUDY AND RESEARCH FELLOW AT THE SMITH CENTER. "WE NEED TO ADDRESS GAPS IN AWARENESS EARLY IN LIFE TO TO PREVENT THE ONSET OF CARDIOVASCULAR DISEASE, OR WORSE, LATER IN LIFE."STUDY MIMICKING LIFE-THREATENING CONDITION COMMON IN ICU PATIENTS SHOWS POTENTIAL PROTECTIVE ROLE OF IMMUNE CELLSACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) DREW WIDE ATTENTION DURING THE COVID-19 PANDEMIC AS A LEADING CAUSE OF DEATH IN PATIENTS WITH SEVERE CASES. NOW, A PRECLINICAL STUDY FROM BIDMC REVEALS A NOVEL APPROACH TO MITIGATING LUNG DAMAGE CAUSED BY PROLONGED EXPOSURE TO HIGH OXYGEN LEVELS--A CONDITION THAT MIMICS KEY FEATURES OF ARDS, INCLUDING WIDESPREAD INFLAMMATION AND DAMAGE TO THE LUNGS.IN FINDINGS PUBLISHED IN ANESTHESIA AND ANALGESIA, THE INVESTIGATORS DEMONSTRATED THAT A SINGLE ADMINISTRATION OF B CELLS DECREASED THE SEVERITY OF LUNG INJURY, IMPROVED OXYGENATION AND PROMOTED A MORE BALANCED IMMUNE RESPONSE (IMPROVED IMMUNE FUNCTION WITHOUT THE RISK OF RUNAWAY INFLAMMATION) IN A SMALL ANIMAL MODEL OF ARDS. B CELLS ARE A TYPE OF WHITE BLOOD CELL THAT PLAY A CENTRAL ROLE IN THE IMMUNE SYSTEM BY PRODUCING ANTIBODIES, BUT THEY ALSO HELP REGULATE IMMUNE RESPONSES BY COORDINATING WITH OTHER CELLS OF THE IMMUNE SYSTEM AND CALMING EXCESSIVE INFLAMMATION."ARDS DEVELOPS IN AT LEAST ONE IN TEN MECHANICALLY VENTILATED PATIENTS IN THE INTENSIVE CARE UNIT, AND HAS A HIGH MORTALITY RATE," SAID LEAD AUTHOR DUSAN HANIDZIAR, MD, PHD, A POSTDOCTORAL RESEARCH FELLOW IN THE CENTER FOR INFLAMMATION RESEARCH AT BIDMC. "NEW, TARGETED TREATMENTS NEED TO BE DEVELOPED FOR CLINICAL USE, AND WE'RE EXCITED THAT OUR DATA SUGGEST HARNESSING THE FUNCTIONS OF THE B CELL MAY REPRESENT A NOVEL THERAPY FOR ARDS."IN THIS FIRST-OF-ITS-KIND STUDY, HANIDZIAR AND COLLEAGUES SHOWED THAT, IN MICE EXPOSED TO HIGH OXYGEN LEVELS, THE NUMBER OF B CELLS DROPPED SHARPLY IN BOTH THE LUNGS AND THE BLOODSTREAM. ADMINISTERING B CELLS INTRAVENOUSLY 24 HOURS AFTER THE ONSET OF HIGH OXYGEN EXPOSURE, IMPROVED IMMUNE REGULATION, REDUCED HARMFUL INFLAMMATION, AND PARTIALLY RESTORED THE DIVERSITY OF IMMUNE CELLS IN THE ANIMALS' LUNGS."WE'VE KNOWN THAT HIGH OXYGEN LEVELS CAN SEVERELY DISRUPT IMMUNE BALANCE IN THE LUNGS, BUT THIS STUDY SHOWS THAT INFUSING B CELLS CAN HELP CORRECT THAT IMBALANCE AND REDUCE LUNG INJURY," SAID SENIOR AUTHOR SIMON C ROBSON, MD, PHD, DIRECTOR OF THE CENTER FOR INFLAMMATION RESEARCH. "THIS WORK LAYS IMPORTANT GROUNDWORK FOR EXPLORING B-CELL THERAPY AS A POTENTIAL TREATMENT FOR ARDS AND RELATED CONDITIONS."3. MORE THAN HALF OF U.S. ADULTS COULD BENEFIT FROM GLP-1 MEDICATIONS, RESEARCHERS FINDIN AN ANALYSIS OF NATIONAL DATA, RESEARCHERS AT THE RICHARD A. AND SUSAN F. SMITH CENTER FOR OUTCOMES RESEARCH AT BIDMC ESTIMATED THAT 137 MILLION U.S. ADULTS, MORE THAN HALF OF ALL ADULTS, ARE ELIGIBLE FOR SEMAGLUDTIDE FOR WEIGHT LOSS, DIABETES MANAGEMENT, OR PREVENTION OF RECURRENT CARDIOVASCULAR EVENTS. THE FINDINGS, PUBLISHED IN JAMA CARDIOLOGY, UNDERSCORE THE NEED TO INCREASE EQUITABLE ACCESS TO THIS NEW CLASS OF PHARMACEUTICALS.SEMAGLUTIDE, WHICH BELONGS TO A CLASS OF DRUGS KNOWN AS GLP-1 RECEPTOR AGONISTS, IS CURRENTLY APPROVED FOR THE MANAGEMENT OF DIABETES, TREATMENT OF OVERWEIGHT OR OBESITY, AND PREVENTION OF RECURRENT CARDIOVASCULAR DISEASE (E.G., IN PATIENTS WHO HAVE ALREADY EXPERIENCED A HEART ATTACK OR STROKE OR ARE LIVING WITH PERIPHERAL ARTERY DISEASE). ABOUT 15 MILLION ADULTS CURRENTLY TAKE SEMAGLUTIDE. BUT DATA IS RAPIDLY EMERGING ABOUT ITS EFFECTIVENESS FOR OTHER HEALTH CONDITIONS.IVY SHI, MD, WHO IS A RESIDENT IN INTERNAL MEDICINE AT BIDMC, WORKED WITH DHRUV S. KAZI, MD, MS, ASSOCIATE DIRECTOR OF THE SMITH CENTER AND DIRECTOR OF THE CARDIAC CRITICAL CARE UNIT AT BIDMC TO PRODUCE THE ANALYSIS. THEY USED FIVE YEARS' WORTH OF RECENT DATA FROM A LONG-RUNNING SURVEY OF THE U.S. POPULATION RUN BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO IDENTIFY U.S. ADULTS AGED 18 YEARS OR OLDER WHO WOULD BE ELIGIBLE FOR SEMAGLUTIDE TREATMENT BASED ON CURRENTLY APPROVED INDICATIONS.THEY FOUND THAT OF THE 136.8 MILLION US ADULTS ELIGIBLE FOR SEMAGLUTIDE, 35.0 MILLION ADULTS WOULD BE ELIGIBLE FOR THE MEDICATION FOR DIABETES MANAGEMENT, 129.2 MILLION ADULTS FOR WEIGHT LOSS, AND 8.9 MILLION ADULTS FOR SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE. THE SEMAGLUTIDE-ELIGIBLE POPULATION INCLUDES 26.8 MILLION ADULTS COVERED BY MEDICARE, 13.8 MILLION COVERED BY MEDICAID, AND 61.1 MILLION COVERED BY COMMERCIAL INSURANCE."THESE STAGGERING NUMBERS MEAN THAT WE ARE LIKELY TO SEE LARGE INCREASES IN SPENDING ON SEMAGLUTIDE AND RELATED MEDICATIONS IN YEARS TO COME," SAID KAZI. "ENSURING EQUITABLE ACCESS TO THESE EFFECTIVE BUT HIGH-COST MEDICATIONS, AS WELL AS SUPPORTING INDIVIDUALS SO THAT THEY CAN STAY ON THE THERAPY LONG-TERM, SHOULD BE A PRIORITY FOR OUR CLINICIANS AND POLICYMAKERS."4. SKIP THE EXTRA SALT: STUDY SHOWS HEART HEALTHY DIET AND SODIUM REDUCTION LOWER RISK OF HEART DISEASEMOST AMERICANS CONSUME FAR MORE SODIUM THAN RECOMMENDED, WITH THE AVERAGE INTAKE TOPPING 3,400 MILLIGRAMS (MG) PER DAY--WELL ABOVE THE RECOMMENDED FEDERAL GUIDELINE OF 2,300 MG AND THE AMERICAN HEART ASSOCIATION'S GOAL OF 1,500 MG. THE BULK OF AMERICAN'S DAILY SODIUM DOESN'T COME FROM THE SALTSHAKER, BUT FROM PROCESSED AND RESTAURANT FOODS LIKE BREADS, DELI MEATS, AND CANNED SOUPS. HEALTH EXPERTS WARN THIS EXCESS IS FUELING A NATIONAL EPIDEMIC OF HIGH BLOOD PRESSURE, A MAJOR RISK FACTOR FOR HEART DISEASE AND STROKE.A NEW ANALYSIS LED BY INVESTIGATORS AT BIDMC HAS FOUND THAT REDUCING DIETARY SODIUM, OR FOLLOWING THE EVIDENCED-BASED HEART-HEALTHY DASH DIET EACH INDEPENDENTLY LOWERED THE 10-YEAR ESTIMATED RISK OF DEVELOPING ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD)--HARDENING OF THE ARTERIES THAT CAN LEAD TO CHEST PAIN, HEART ATTACK OR STROKE--AMONG ADULTS WITH ELEVATED BLOOD PRESSURE BUT NO PRIOR CARDIOVASCULAR DISEASE.MOREOVER, THE COMBINATION OF THE DASH DIET AND REDUCING SODIUM INTAKE HAD ADDITIVE EFFECTS, RESULTING IN THE GREATEST REDUCTION IN ASCVD RISK. THE FINDINGS APPEAR IN THE AMERICAN JOURNAL OF PREVENTIVE CARDIOLOGY."COMPARED TO THE TYPICAL AMERICAN, HIGH-SODIUM DIET, REDUCING SODIUM TO THE RECOMMENDED LEVELS OR EVEN LOWER MARKEDLY DECREASED CARDIOVASCULAR DISEASE RISK SCORES, WITH THE GREATEST EFFECTS AMONG WOMEN, BLACK ADULTS AND PARTICIPANTS WITH BASELINE STAGE II HYPERTENSION," SAID SENIOR AUTHOR STEPHEN P. JURASCHEK, MD. "THESE DATA UNDERSCORE THE NEED FOR STRONGER DIETARY GUIDELINES AND PUBLIC HEALTH INTERVENTIONS THAT CAN BE REALISTICALLY IMPLEMENTED AND SUSTAINED OVER TIME--ESPECIALLY AMONG GROUPS AT HIGHEST RISK."TO EVALUATE THE IMPACT OF SODIUM REDUCTION ON BLOOD PRESSURE--ALONE AND IN COMBINATION WITH THE DASH DIET--JURASCHEK AND COLLEAGUES RANDOMIZED 390 ADULTS WITH ELEVATED BLOOD PRESSURE TO THE DASH DIET AND A TYPICAL AMERICAN DIET.AFTER THE 12-WEEK PERIOD, ANALYSIS REVEALED THAT BOTH THE DASH DIET AND LOWER SODIUM INTAKE INDEPENDENTLY REDUCED PARTICIPANTS' ASCVD RISK SCORES. LOWERING SODIUM INTAKE LED TO MEANINGFUL RISK REDUCTIONS EVEN WHEN NOT MEETING THE MOST AGGRESSIVE TARGETS. BUT THE GREATEST BENEFIT OCCURRED WHEN THE TWO INTERVENTIONS WERE COMBINED. 5. PRIVATE EQUITY MAY HAVE NEGATIVE EFFECT ON PATIENT CARE, STUDY SHOWS IN A PAPER PUBLISHED IN JAMA, BIDMC HEALTH POLICY EXPERTS REPORT THAT PATIENT CARE EXPERIENCE AND STAFF RESPONSIVENESS WORSENED AFTER PRIVATE EQUITY (PE) ACQUISITION OF U.S. HOSPITALS. RISHI WADHERA, MD, MPP, ANJALI BHATLA, MD, AND COLLEAGUES FOUND THAT CARE CONTINUED TO DECLINE WITH EACH ADDITIONAL YEAR AFTER ACQUISITION, SUGGESTING THAT PROFIT-DRIVEN CHANGES MAY COMPOUND OVER TIME."PATIENTS PROVIDE THE MOST IMPORTANT PERSPECTIVE ON WHETHER A HOSPITAL IS PROVIDING GOOD OR BAD CARE, AS THEY HAVE A 360-DEGREE VIEW OF THE ENTIRE CARE EXPERIENCE," SAID WADHERA, ASSOCIATE DIRECTOR OF THE SMITH CENTER FOR OUTCOMES RESEARCH AT BIDMC. "AFTER PRIVATE EQUITY TAKES OVER A HOSPITAL, PATIENT CARE EXPERIENCE SIGNIFICANTLY WORSENS. THAT'S VERY CONCERNING, GIVEN THE SURGE IN PE ACQUISITIONS OF HEALTH CARE FACILITIES OVER THE PAST DECADE."WADHERA AND COLLEAGUES IDENTIFIED 73 U.S. HOSPITALS NEWLY ACQUIRED BY PRIVATE EQUITY AND 293 MATCHED, NON-ACQUIRED HOSPITALS FROM 2008 TO 2019, AND FOUND THAT PATIENTS' OVERALL RATINGS, WILLINGNESS TO RECOMMEND THE HOSPITAL, AND REPORTED STAFF RESPONSIVENESS, DOCTOR AND NURSE COMMUNICATION, AND HOSPITAL ENVIRONMENT ALL WORSENED IN THE THREE YEARS AFTER ACQUISITION."THE RELATIVE DECLINE IN OVERALL PATIENT CARE EXPERIENCE SCORES AFTER PE ACQUISITION WAS LARGE," SAID ANJALI BHATLA, MD, A RESEARCH FELLOW AT THE SMITH CENTER. "POOR PATIENT EXPERIENCES ARE ASSOCIATED WITH SLOWER RECOVERY FROM ILLNESS, MEDICATION NONADHERENCE, AND GREATER HEALTH CARE UTILIZATION.""THE EVIDENCE TO DATE SUGGESTS THAT WHEN PRIVATE EQUITY TAKES OVER A HOSPITAL, THINGS GENERALLY GET WORSE FOR PATIENTS," SAID WADHERA, WHO IS ALSO AN ASSOCIATE PROFESSOR AT HARVARD MEDICAL SCHOOL. "AS PRIVATE EQUITY'S PRESENCE IN HEALTH CONTINUES TO GROW, THERE'S A PRESSING NEED FOR GREATER TRANSPARENCY, MONITORING, AND REGULATORY OVERSIGHT, TO ENSURE THAT PATIENTS ARE PROTECTED."PE INVESTORS SPENT MORE THAN $200 BILLION ON HEALTH CARE ACQUISITIONS IN 2021 ALONE -- $1 TRILLION OVER THE PAST DECADE, PER THE COMMONWEALTH FUND -- YET LITTLE RESEARCH HAS EVALUATED PE'S IMPACT ON THE PATIENT CARE EXPERIENCE.IN AN EARLIER STUDY, WADHERA FOUND THAT PE FIRMS DISPROPORTIONATELY ACQUIRED OUTPATIENT CARDIOLOGY PRACTICES IN WEALTHY COMMUNITIES, OFTEN FLIPPING THEM WITHIN A FEW YEARS -- A PATTERN THAT CAN INCENTIVIZE CARE CHANGES THAT MAXIMIZE PROFIT OVER QUALITY.6. RACIAL DISPARITIES IN PAIN ASSESSMENT EXPOSE AI'S FLAWED BELIEFS ABOUT RACEA STUDY LED BY ADAM RODMAN, MD, MPH, DIRECTOR OF AI PROGRAMS AT BIDMC, REVEALS THAT, RATHER THAN HELPING TO REDUCE RACIAL AND ETHNIC BIASES, AI-DRIVEN CHATBOTS MAY INSTEAD PERPETUATE AND EXACERBATE DISPARITIES IN MEDICINE. THE STUDY APPEARED IN JAMA NETWORK OPEN.IT'S WELL-DOCUMENTED THAT PHYSICIANS UNDERTREAT BLACK PATIENTS' PAIN VERSUS WHITE PATIENTS', A DISPARITY OFTEN ATTRIBUTED TO UNDERASSESSMENT OF THEIR PAIN. AI WAS INITIALLY SEEN AS A WAY TO ELIMINATE SUCH BIASES, WITH DATA-DRIVEN ALGORITHMS EXPECTED TO OFFER OBJECTIVE ASSESSMENTS FREE FROM HUMAN PREJUDICE."THESE MODELS ARE VERY GOOD AT REFLECTING HUMAN BIASES -- AND NOT JUST RACIAL BIASES -- WHICH IS PROBLEMATIC IF YOU'RE GOING TO USE THEM TO MAKE ANY SORT OF MEDICAL DECISION," RODMAN SAID. "IF THE SYSTEM IS BIASED THE SAME WAY HUMANS ARE, IT'S GOING TO SERVE TO MAGNIFY OUR BIASES OR MAKE HUMANS MORE CONFIDENT IN THEIR BIASES."TO INVESTIGATE, RODMAN AND COLLEAGUES REPLICATED A 2016 STUDY IN WHICH 222 MEDICAL STUDENTS AND RESIDENTS RATED PAIN LEVELS FOR TWO MEDICAL VIGNETTES -- ONE DESCRIBING A WHITE PATIENT, ONE BLACK -- ON A 10-POINT SCALE, AND RATED THEIR AGREEMENT WITH FALSE BELIEFS ABOUT RACIAL BIOLOGY, SUCH AS THE INACCURATE BUT WIDESPREAD NOTION THAT BLACK PEOPLE HAVE THICKER SKIN.IN THEIR STUDY, RODMAN'S TEAM APPLIED THE SAME SETUP TO THE AI MODELS GEMINI PRO AND GPT-4 TO SEE HOW THEY WOULD ASSESS PAIN ACROSS RACE AND ETHNICITY AND GAUGE THEIR UNDERSTANDING OF RACIAL BIOLOGY.THE RACIAL DISPARITIES PERSISTED. ACROSS THE BOARD, BLACK PATIENTS WERE UNDERASSESSED FOR THEIR PAIN COMPARED WITH WHITE PATIENTS, REGARDLESS OF WHETHER THE RATER WAS HUMAN OR AI. AS FOR FALSE BELIEFS ABOUT RACIAL BIOLOGY: THE GEMINI PRO AI MODEL EXHIBITED THE HIGHEST PERCENTAGE OF FALSE BELIEFS (24 PERCENT), FOLLOWED BY THE HUMAN TRAINEES (12 PERCENT), AND GPT-4 WITH THE LOWEST (9 PERCENT).AS MORE HOSPITALS AND CLINICS ADOPT AI FOR CLINICAL DECISION SUPPORT, THE FINDINGS SUGGEST CHATBOTS COULD PERPETUATE RACIAL AND ETHNIC BIASES IN MEDICINE, DEEPENING HEALTH CARE INEQUALITIES -- PARTICULARLY IF CONFIRMATION BIAS LEADS PHYSICIANS TO TRUST AI OUTPUTS ONLY WHEN THEY MATCH PRE-EXISTING BELIEFS.7. BIDMC-LED STUDY FINDS MOST CANCER PHYSICIANS-IN-TRAINING FEEL UNDERPREPARED TO ADVISE PATIENTS ABOUT MEDICAL MARIJUANAEVIDENCE SUGGESTS AS MANY AS 40 PERCENT OF ADULTS WITH CANCER TURN TO MARIJUANA -- MORE PROPERLY KNOWN AS CANNABIS -- TO MANAGE SYMPTOMS LIKE PAIN, NAUSEA AND ANXIETY, AND MANY WANT GUIDANCE FROM THEIR PHYSICIANS. YET A NATIONAL STUDY LED BY BIDMC INVESTIGATORS FINDS THAT MOST ONCOLOGISTS-IN-TRAINING, OR FELLOWS, FEEL UNDERPREPARED TO MANAGE THIS INCREASINGLY COMMON ASPECT OF PATIENT CARE."PERSONALIZED, PATIENT-CENTERED CARE STARTS WITH UNDERSTANDING AND COMMUNICATING THE BEST AVAILABLE EVIDENCE," SAID CO-LEAD AUTHOR KIAN TEHRANCHI, MD, A CLINICAL FELLOW IN HEMATOLOGY ONCOLOGY AT BIDMC. "AS MEDICAL CANNABIS BECOMES MORE WIDELY USED AND ACCEPTED, IT'S CRITICAL THAT FELLOWSHIP TRAINING EQUIPS FUTURE ONCOLOGISTS WITH THE KNOWLEDGE THEY NEED TO HAVE INFORMED, THOUGHTFUL CONVERSATIONS AND SUPPORT SHARED DECISION-MAKING WITH THEIR PATIENTS."PUBLISHED IN THE JOURNAL OF CANNABIS RESEARCH, THE STUDY SURVEYED 189 ONCOLOGY FELLOWS ACROSS 40 TRAINING PROGRAMS IN 25 STATES. ABOUT ONE IN FIVE HAD RECOMMENDED MEDICAL CANNABIS TO MORE THAN FIVE PATIENTS IN THE PREVIOUS YEAR. ABOUT A QUARTER HAD RECEIVED PRIOR TRAINING IN MEDICAL CANNABIS, AND THOSE WITH TRAINING WERE TWICE AS LIKELY TO RECOMMEND IT -- AND SIGNIFICANTLY MORE LIKELY TO HOLD INFORMED OPINIONS ABOUT ITS RISKS, BENEFITS, PREFERRED USE, AND WHICH PATIENTS MIGHT BENEFIT MOST.THE FINDINGS UNDERSCORE HOW EVEN BASIC TRAINING BUILDS FELLOWS' CONFIDENCE IN HAVING EVIDENCE-BASED CONVERSATIONS ABOUT CANNABIS USE, DESPITE LIMITED SAFETY AND EFFICACY DATA IN CANCER CARE.THE RESEARCHERS NOTE THAT EVIDENCE IS STRONGEST FOR CANNABIS RELIEVING CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING, WITH LESS SUPPORT FOR OTHER SYMPTOMS LIKE CHRONIC PAIN OR APPETITE LOSS, AND VIRTUALLY NONE FOR ISSUES LIKE DIARRHEA. THEY STRESS THE IMPORTANCE OF TRAINING ON ITS SIDE EFFECTS, DRUG INTERACTIONS, AND RISKS FOR PATIENTS RECEIVING IMMUNOTHERAPY."THIS IS ABOUT PREPARING THE NEXT GENERATION OF CANCER PHYSICIANS TO MEET PATIENTS WHERE THEY ARE," SAID LEAD AUTHOR DEEPA RANGACHARI, MD, DIRECTOR OF GRADUATE MEDICAL EDUCATION & HEMATOLOGY ONCOLOGY FELLOWSHIP PROGRAM DIRECTOR AT BIDMC. "WELL-INFORMED, PATIENT-CENTERED CARE STARTS WITH GIVING OUR TRAINEES THE TOOLS THEY NEED TO ENGAGE IN NUANCED, EVIDENCE-BASED CONVERSATIONS." 8. COVID-19 EXACERBATED AN ALREADY WIDENING GAP BETWEEN RURAL AND URBAN HEART HEALTH OVER LAST DECADEEXISTING SOCIOECONOMIC DISPARITIES LEFT THE U.S. RURAL POPULATION MORE VULNERABLE TO THE DIRECT AND INDIRECT CARDIOVASCULAR EFFECTS OF COVID-19, ACCORDING TO INVESTIGATORS AT BIDMC'S RICHARD A. AND SUSAN F. SMITH CENTER FOR OUTCOMES RESEARCH. IN A STUDY PRESENTED AT THE AMERICAN HEART ASSOCIATION SCIENTIFIC SESSIONS AND PUBLISHED IN THE JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, THE SCIENTISTS SHOWED THAT THE GAP IN HEALTH OUTCOMES BETWEEN RURAL AND URBAN POPULATIONS WIDENED MORE QUICKLY AFTER THE PANDEMIC.RESEARCHERS EVALUATED CARDIOVASCULAR MORTALITY IN THE UNITED STATES FROM 2010 TO 2022, FOCUSING ON THE IMPACT OF THE PANDEMIC ON EXISTING RURAL-URBAN DISPARITIES IN CARDIOVASCULAR HEALTH. PRIOR TO THE PANDEMIC, AGE-ADJUSTED CARDIOVASCULAR DEATH RATES HAD BEEN DECREASING IN URBAN AREAS OF THE UNITED STATES. IN CONTRAST, CARDIOVASCULAR DEATH RATES WERE INCREASING IN RURAL AREAS, DRIVEN LARGELY BY AN ALARMING RISE AMONG YOUNGER ADULTS.THE INVESTIGATORS FOUND THAT FOLLOWING THE ONSET OF THE PANDEMIC, WHILE THERE WAS AN INCREASE IN THE CARDIOVASCULAR MORTALITY RATE IN URBAN AREAS, THERE WAS A STEEPER INCREASE IN RURAL AREAS, PARTICULARLY AMONG RURAL ADULTS AGED 25-64. BY 2022, CARDIOVASCULAR MORTALITY RATES WERE 1.5 TIMES HIGHER IN RURAL COMPARED WITH URBAN AREAS.OTHER STUDIES SUGGEST THAT FOR MANY PEOPLE, RISK FACTORS SUCH AS HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, DIABETES, AND OBESITY WORSENED DURING THE PANDEMIC, AND RURAL AREAS MAY HAVE BEEN MORE SEVERELY AFFECTED DUE TO GREATER INTERRUPTIONS IN ACCESS TO HEALTH CARE. THE PANDEMIC-RELATED SURGE IN SUBSTANCE USE, DEPRESSION, AND SUICIDALITY ALSO DISPROPORTIONATELY IMPACTED RURAL POPULATIONS; THESE "DISEASES OF DESPAIR" CONFER AN INCREASED RISK OF CARDIOVASCULAR EVENTS."DETERIORATING SOCIOECONOMIC CONDITIONS AND HEALTH SYSTEM CHALLENGES THAT WERE EXACERBATED BY THE PANDEMIC MAY HAVE MADE RURAL ADULTS MORE VULNERABLE TO POOR CARDIOVASCULAR OUTCOMES," SAID CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, ASSOCIATE DIRECTOR OF THE SMITH CENTER AT BIDMC. "THERE'S A CARDIOMETABOLIC HEALTH CRISIS HAPPENING IN RURAL AMERICA -- ESPECIALLY AMONG YOUNG ADULTS -- AND IT'S VITAL THAT WE START TACKLING THE UNDERLYING SOCIOECONOMIC CONDITIONS THAT ARE DRIVING THIS PERSISTENT RISE IN CARDIOVASCULAR MORTALITY."9. MPOX VACCINE ANTIBODY RESPONSES WANED WITHIN A YEAR, STUDY SHOWSTHE 2022 OUTBREAK OF MPOX, FORMERLY KNOWN AS MONKEYPOX, MARKED THE FIRST TIME THE VIRUS SPREAD WIDELY ACROSS MULTIPLE COUNTRIES BEYOND ITS HISTORICALLY ENDEMIC REGIONS IN AFRICA. BOSTON REPORTED THE FIRST U.S. CASE IN MAY; BY AUGUST, ALL 50 STATES HAD DOCUMENTED INFECTIONS. SPREAD PRIMARILY THROUGH CLOSE SKIN-TO-SKIN CONTACT, ESPECIALLY DURING SEXUAL ACTIVITY, THE INFECTION MANIFESTS AS FEVER, SWOLLEN LYMPH NODES, AND PAINFUL RASHES OR SORES.TO CONTAIN THE OUTBREAK, PUBLIC HEALTH OFFICIALS PRIORITIZED VACCINATION FOR POPULATIONS AT HIGHER RISK OF EXPOSURE, INCLUDING PEOPLE WHO HAVE NEW OR MULTIPLE SEXUAL PARTNERS; HEALTHCARE WORKERS AND LABORATORY PERSONNEL; AND PEOPLE WHO HAVE TRAVELED TO A COMMUNITY WHERE MPOX HAS BEEN IDENTIFIED.IN A STUDY PUBLISHED IN JAMA, BIDMC RESEARCHERS DEMONSTRATED THAT MPOX ANTIBODY LEVELS DECLINED RAPIDLY AND NEARLY RETURNED TO BASELINE SIX TO 12 MONTHS AFTER RECEIVING THE MPOX VACCINATION. THE FINDINGS SUGGEST THAT PROTECTIVE IMMUNITY MAY WANE IN PREVIOUSLY VACCINATED INDIVIDUALS AND THAT BOOSTING MAY BE REQUIRED TO MAINTAIN ROBUST PROTECTION."IT IS IMPORTANT TO ASSESS THE INFECTION RISK FOR INDIVIDUALS WHO WERE VACCINATED AGAINST THE DISEASE DURING THE 2022 OUTBREAK," SAID CORRESPONDING AUTHOR DAN H. BAROUCH, MD, PHD, DIRECTOR OF THE CENTER FOR VACCINE AND VIROLOGY RESEARCH AT BIDMC."OUR STUDY ALSO HIGHLIGHTS THE IMPORTANCE OF COMPLETING THE RECOMMENDED TWO-DOSE MPOX VACCINE, WHETHER SUBCUTANEOUS OR INTRADERMAL, TO BOOST IMMUNITY -- REGARDLESS OF THE TIME BETWEEN DOSES," SAID LEAD AUTHOR AI-RIS YONEKURA COLLIER, MD, CO-DIRECTOR OF THE CLINICAL TRIALS UNIT AT BIDMC. "IN THIS MPOX OUTBREAK, ENSURING BROAD ACCESS TO THE FULL VACCINE SERIES IS CRUCIAL."10. INVESTIGATIONAL MRNA VACCINE PROTECTED MICE BETTER THAN THE CENTURY-OLD VACCINE -- LIMITING INFECTION AND SLOWING DISEASE SPREADTUBERCULOSIS, AN AIRBORNE BACTERIAL INFECTION, IS ONE OF HUMANITY'S OLDEST FOES AND TODAY THE WORLD'S TOP INFECTIOUS-DISEASE KILLER, CLAIMING 1.2 MILLION LIVES A YEAR. THE ONE AVAILABLE VACCINE PROTECTS YOUNG CHILDREN FROM SEVERE TB BUT DOES LITTLE TO STOP ITS SPREAD AMONG ADOLESCENTS AND ADULTS.NOW, BIDMC SCIENTISTS HAVE CREATED A NEW TB VACCINE CANDIDATE USING NEWLY IDENTIFIED ANTIGENS DELIVERED BY MRNA TECHNOLOGY -- THE SAME APPROACH BEHIND THE RAPID DEVELOPMENT OF COVID-19 VACCINES. THE TEAM, REPORTING IN CELL, PLANS CLINICAL TESTING IN ADULTS, A POTENTIAL ADVANCE IN TB PREVENTION FOR ALL AGE GROUPS."WE SYSTEMATICALLY EVALUATED MULTIPLE POTENTIAL TB VACCINE ANTIGENS TO DEVELOP A NOVEL TB VACCINE CANDIDATE," SAID CORRESPONDING AUTHOR DAN H. BAROUCH, MD, PHD, DIRECTOR OF THE CENTER FOR VIROLOGY AND VACCINE RESEARCH AT BIDMC, WHO CONTRIBUTED TO THE DEVELOPMENT OF JOHNSON & JOHNSON'S COVID-19 VACCINE. "WE USED THE MRNA PLATFORM THAT IS FLEXIBLE, SCALABLE, AND CAN COMBINE MULTIPLE ANTIGENS INTO ONE SHOT."TB LACKS AN OBVIOUS VACCINE TARGET. USING IMMUNE-RESPONSE DATA FROM PEOPLE EXPOSED TO TB, BAROUCH AND COLLEAGUES BUILT A SCREENING PIPELINE TO RANK CANDIDATE ANTIGENS BY IMMUNE RESPONSE, THEN SELECTED TOP CONTENDERS TO DESIGN A TRIVALENT VACCINE -- COMBINING THREE TB ANTIGENS -- TESTED IN AN ANIMAL MODEL."CHOOSING WHICH ANTIGENS TO TARGET IS A SIGNIFICANT CHALLENGE IN TB VACCINE DEVELOPMENT," SAID LEAD AUTHOR SAMUEL J. VIDAL, MD, PHD, A STAFF SCIENTIST IN THE BAROUCH LABORATORY AT BIDMC. "THE THREE ANTIGENS WE CHOSE HAVE NOT PREVIOUSLY BEEN EVALUATED IN CLINICAL TRIALS. OUR TRIVALENT MRNA VACCINE CONCEPT IMPROVED UPON THE CENTURY-OLD BCG SHOT IN ANIMAL MODELS -- IT REDUCED INFECTION RATES, REDUCED BACTERIAL SPREAD, AND LOWERED BACTERIAL LEVELS IN THE LUNGS."THE TRIVALENT VACCINE ANTIGENS ALSO TRIGGERED IMMUNE RESPONSES IN HUMANS EXPOSED TO TB, SUGGESTING THE APPROACH COULD WORK IN PEOPLE."TAKEN TOGETHER, OUR FINDINGS OPEN THE DOOR TO A NEW VACCINE CANDIDATE FOR TB," SAID BAROUCH, WHO IS ALSO A PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. "WE'RE EXCITED TO BE MOVING THIS NOVEL TB VACCINE CANDIDATE TOWARD CLINICAL TRIALS."RESEARCH AT JOSLIN DIABETES CENTERTHE JOSLIN DIABETES CENTER (JDC), IN CONJUNCTION WITH ITS AFFILIATE THE JOSLIN CLINIC, PROVIDES WORLD CLASS LEADING EDGE PATIENT CARE IN THE SPECIALTY AREA OF DIABETES AND CARING FOR PATIENTS THROUGH A RELENTLESS TEAM OF CLINICIANS, SKILLED HEALTH EDUCATORS, AND ACCESS TO PIONEERING DIABETES RESEARCH. JOSLIN IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND OFFERS A RICH EDUCATIONAL ENVIRONMENT INVOLVING COURSES, LECTURES, FELLOWSHIP OPPORTUNITIES AND CME COURSES. JDC ALSO PROVIDES INFRASTRUCTURE, MANAGEMENT AND SUPPORT SERVICES TO ITS AFFILIATE, THE JOSLIN CLINIC. IN ADDITION, JOSLIN'S MISSION IS NOT ONLY TO PROVIDE OUTSTANDING PATIENT CARE, BUT ALSO TO BRING BEST PRACTICES TO THE LARGER MEDICAL COMMUNITY. JOSLIN ENGAGES IN RESEARCH RELATED TO BETTER UNDERSTANDING DIABETES, HOW TO TREAT IT AND HOW TO HELP PATIENTS MANAGE AND LIVE HEALTHIER LIVES WITH THE DISEASE. JOSLIN DIABETES RESEARCH CENTER IS ONE OF ONLY 16 NIH-DESIGNATED DIABETES RESEARCH CENTERS IN THE UNITED STATES. JOSLIN'S RESEARCH TEAM IS WORLD-RENOWNED AND PASSIONATE ABOUT IMPROVING THE LIVES OF PEOPLE WITH DIABETESMILLIONS OF PEOPLE WITH DIABETES THROUGHOUT THE WORLD BENEFIT DIRECTLY FROM BASIC AND CLINICAL RESEARCH CONDUCTED AT THE CENTER. APPROXIMATELY 300 RESEARCHERS EMPLOYED AT THE JOSLIN DIABETES CENTER ARE WORKING ON VARIOUS ASPECTS OF DIABETES, SEARCHING FOR WAYS TO PREVENT AND TREAT DIABETES IN ALL ITS FORMS AND ULTIMATELY FIND A CURE FOR THE DISEASE.THE RESEARCH ENGAGED IN AT JDC HELPS IMPROVES THE LIVES AT JDC, ACROSS BILH AND IN THE WIDER COMMUNITY BEYOND EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE COMMUNITIES. AS NOTED ABOVE RELATED TO BIDMC, ALTHOUGH JOSLIN'S RESEARCH ACTIVITIES ARE NOT QUANTIFIED HERE IN THIS HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY THIS HOSPITAL, ALL OF BILH AND BEYOND. SOME EXAMPLES OF RESEARCH ENGAGED IN BY JOSLIN DURING THE PERIOD COVERED BY THIS FILING ARE BELOW. BRAIN INSULIN SIGNALING IMPACT ON DIABETES AND NEUROLOGICAL DISORDERS A STUDY FROM JOSLIN DIABETES CENTER EXPLORES THE ROLE OF INSULIN SIGNALING IN THE BRAIN'S IMMUNE CELLS, AND HOW IT MAY MEDIATE THE RELATIONSHIP BETWEEN TYPE 2 DIABETES AND ALZHEIMER'S DISEASE (AD). THE FINDINGS, PUBLISHED IN PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES, COULD HELP IDENTIFY POTENTIAL TARGETS TO TREAT DIABETES PATIENTS WITH AD."TYPE 2 DIABETES, OBESITY, AND METABOLIC SYNDROME ARE MAJOR CAUSES OF ILLNESS AND DEATH WORLDWIDE, AND INSULIN RESISTANCE, ESPECIALLY BRAIN INSULIN RESISTANCE, FEATURES PROMINENTLY IN ALL THESE CONDITIONS," SAID LEAD AUTHOR WENQIANG CHEN, PHD, INSTRUCTOR OF MEDICINE AT JOSLIN DIABETES CENTER. "A GROWING BODY OF EVIDENCE LINKS INSULIN RESISTANCE WITH INCREASED RISKS OF BRAIN DISORDERS, INCLUDING AD AND DEPRESSION, BUT EXACTLY HOW BRAIN INSULIN RESISTANCE LINKS TO THESE DISEASES REMAINS INCOMPLETELY UNDERSTOOD."TO BETTER UNDERSTAND INSULIN'S ROLE IN THE BRAIN, CHEN AND COLLEAGUES IN THE LAB OF RONALD KAHN, MD, CREATED A MOUSE MODEL IN WHICH THEY COULD "TURN OFF" INSULIN RECEPTORS IN CERTAIN BRAIN CELLS. THESE "KNOCKOUT MICE" GAVE THE SCIENTISTS A PRECISE TOOL TO STUDY HOW SPECIFIC BRAIN CELLS BEHAVE WITHOUT INSULIN'S INFLUENCE.THE JOSLIN INVESTIGATORS LOOKED SPECIFICALLY AT MICROGLIA--THE BRAIN'S RESIDENT IMMUNE CELLS. MOST IMPORTANTLY IN THE CONTEXT OF ALZHEIMER'S, THEY HELP CLEAR AWAY AMYLOID-BETA (A), A STICKY PROTEIN THAT CAN BUILD UP TO FORM THE DAMAGING PLAQUES IN THE BRAIN.THEIR FINDINGS:- MICE WITHOUT INSULIN SIGNALING IN MICROGLIA SHOWED DEPRESSIVE-LIKE BEHAVIORS AND ALTERED SOCIAL INTERACTION- WHEN THESE MICE WERE CROSSED WITH A WIDELY USED ALZHEIMER'S DISEASE MODEL, THE RESULTANT MICE DEVELOPED MORE SEVERE DISEASE- IN THE TEAM'S CELLULAR MODEL OF MICROGLIA LACKING INSULIN RECEPTORS, THE CELLS SHIFTED TO A LESS EFFICIENT WAY OF PRODUCING ENERGY AND BECAME LESS EFFECTIVE AT CLEARING AMYLOID-BETA."OUR FINDINGS POINT TO THE IMPORTANCE OF UNDERSTANDING A CELL TYPE SPECIFIC REGULATION OF INSULIN ACTION AND INSULIN RESISTANCE IN BRAIN HOMEOSTASIS AND DISEASE PATHOGENESIS," SAID SENIOR AUTHOR KAHN, WHO IS ALSO JOSLIN'S CHIEF ACADEMIC OFFICER. "THESE INSIGHTS WILL HELP IDENTIFY THE CELLULAR AND MOLECULAR MECHANISMS UNDERLYING THE LINK BETWEEN TYPE 2 DIABETES AND BRAIN DISORDERS, THUS BRINGING THE POTENTIAL FOR BETTER THERAPEUTICS FOR PATIENTS WITH THESE COMORBID CONDITIONS."JOSLIN SCIENTISTS UNCOVER CLUES TO MYSTERIOUS POST-BARIATRIC COMPLICATIONJOSLIN DIABETES CENTER RESEARCHERS HAVE IDENTIFIED METABOLIC CHANGES THAT MAY EXPLAIN WHY NEARLY 30 PERCENT OF PATIENTS WHO UNDERGO WEIGHT LOSS SURGERY DEVELOP POST-BARIATRIC HYPOGLYCEMIA (PBH). THIS SERIOUS CONDITION OCCURS WHEN THE BODY OVERPRODUCES INSULIN AFTER MEALS, CAUSING DANGEROUS BLOOD SUGAR CRASHES THAT CAN LEAD TO CONFUSION, FAINTING, AND SEIZURES."WHILE SOME PATIENTS CAN MANAGE PBH WITH DIET AND MEDICATION, SEVERE CASES DON'T ALWAYS RESPOND TO TREATMENT--OR EVEN TO REVERSING THE SURGERY," SAID CO-CORRESPONDING AUTHOR MARY-ELIZABETH PATTI, MD, DIRECTOR OF JOSLIN'S HYPOGLYCEMIA CLINIC. "THAT'S WHY FINDING TREATMENT OPTIONS IS SO IMPORTANT."BARIATRIC SURGERIES, SUCH AS GASTRIC BYPASS AND SLEEVE GASTRECTOMY, ARE POWERFUL TOOLS FOR TREATING TYPE 2 DIABETES (T2D), A CONDITION THAT AFFECTS MORE THAN 500 MILLION PEOPLE WORLDWIDE AND INCREASES THE RISK OF HEART DISEASE, KIDNEY FAILURE, AND NERVE DAMAGE. IN SOME INDIVIDUALS, GLUCOSE LEVELS CAN DROP TO LEVELS BELOW NORMAL, OR HYPOGLYCEMIA.IN PREVIOUS STUDIES, PATTI AND COLLEAGUES FOUND THAT PATIENTS WITH PBH HAD SIGNIFICANTLY HIGHER LEVELS OF A HORMONE CALLED FGF19 COMPARED TO POST-SURGICAL INDIVIDUALS WITHOUT HYPOGLYCEMIA. PEOPLE WITH OBESITY TEND TO HAVE LOWER LEVELS OF THIS HORMONE, BUT AFTER BARIATRIC SURGERY, ITS LEVELS RISE--SOMETIMES TOO MUCH.TO UNDERSTAND WHAT TRIGGERS THIS SPIKE IN FGF19, PATTI'S TEAM, WORKING WITH THE LABORATORY OF CO-CORRESPONDING AUTHOR SLOAN DEVLIN, ANALYZED BILE ACIDS--DIGESTIVE COMPOUNDS THAT HELP BREAK DOWN FATS. COMPARING SAMPLES FROM PATIENTS WITH PBH AND INDIVIDUALS WITHOUT THE CONDITION, THEY FOUND DISTINCT DIFFERENCES IN BILE ACID COMPOSITION, SUGGESTING THESE DIFFERENCES MAY BE RESPONSIBLE FOR THE EXCESSIVE INSULIN RESPONSE AND HYPOGLYCEMIA AFTER MEALS.THROUGH A SERIES OF EXPERIMENTS, THE RESEARCHERS MAPPED OUT THE METABOLIC STEPS LIKELY DRIVING PBH. BY IDENTIFYING SPECIFIC PROTEINS INVOLVED IN THE PROCESS, THEY UNCOVERED A POTENTIAL TREATMENT STRATEGY: BLOCKING A TRANSPORTER IN THE GUT RESPONSIBLE FOR SHUTTLING BILE ACIDS FROM INTESTINES INTO BLOOD. BY INHIBITING THIS TRANSPORTER IN MICE, THE RESEARCHERS WERE ABLE TO REDUCE THE BLOOD SUGAR DROP THAT HAPPENS AFTER A MEAL. MORE BROADLY, THIS WORK MAY HAVE IMPLICATIONS FOR PATIENTS STRUGGLING WITH HYPOGLYCEMIA IN OTHER CONTEXTS. THE FINDINGS APPEARED IN NATURE METABOLISM.FIRST-OF-ITS KIND STUDY COMPREHENSIVELY CHARACTERIZED COGNITIVE FUNCTION AND BRAIN PATHOLOGY IN AGING PEOPLE WITH T1DINVESTIGATORS AT JOSLIN DIABETES CENTER HAVE CONDUCTED THE FIRST COMPREHENSIVE CLINICAL CHARACTERIZATION OF COGNITIVE DECLINE IN PEOPLE WITH LONG-DURATION TYPE 1 DIABETES (T1D). PUBLISHED IN JCI INSIGHT, THE STUDY HELPS ANSWER QUESTIONS ABOUT THIS UNDERSTUDIED POPULATION AND HINTS THAT PRESERVING EYESIGHT MAY HELP PREVENT COGNITIVE DECLINE IN PEOPLE WITH T1D."COGNITIVE DYSFUNCTION IS RECOGNIZED AS A POTENTIAL COMPLICATION ASSOCIATED WITH DIABETES, BUT STUDIES HAVE MOSTLY FOCUSED ON TYPE 2 DIABETES OR YOUNGER TYPE 1 POPULATIONS," SAID CORRESPONDING AUTHOR GEORGE KING, CHIEF SCIENTIFIC OFFICER, JOSLIN DIABETES CENTER."DETAILED CLINICAL CHARACTERIZATION OF COGNITIVE DYSFUNCTION IN A LARGE COHORT OF PEOPLE WITH A LONG HISTORY OF LIVING WITH T1D HAS BEEN LIMITED GIVEN THAT LIVING LONGER THAN 55 YEARS WITH THE DISEASE HAS ONLY RECENTLY BECOME POSSIBLE," SAID CO-CORRESPONDING AUTHOR HETAL SHAH, JOSLIN DIABETES CENTER.ENTER THE MEDALISTS: SINCE 1970, JOSLIN HAS AWARDED MEDALS TO MORE THAN 7,000 PEOPLE, KNOWN AS THE MEDALISTS, FOR LIVING WITH THE CONDITION FOR 50 YEARS.KING AND COLLEAGUES RECRUITED MORE THAN 1,000 MEDALISTS WITH TYPE 1 DIABETES. PARTICIPANTS HAD A MEAN AGE OF 66 YEARS AND HAD BEEN LIVING WITH T1D AN AVERAGE OF 53 YEARS.BUT WHEN SHAH, KING AND COLLEAGUES ASSESSED THEIR COGNITIVE FUNCTION AND CONDUCTED BRAIN AND RETINAL IMAGING, THEY FOUND THE MEDALISTS PERFORMED WORSE THAN PEOPLE WITHOUT DIABETES IN MANY CATEGORIES, INCLUDING RECALL AND PSYCHOMOTOR CONTROL. NEUROIMAGING REVEALED THE MEDALISTS HAD LOWER TOTAL BRAIN VOLUME, EQUIVALENT TO NINE YEARS ACCELERATED AGING, THE RESEARCHERS CALCULATED.RETINAL IMAGING REVEALED THAT WORSE COGNITIVE FUNCTION, LOWER BRAIN VOLUMES, AND DIABETIC RETINOPATHY WERE LINKED WITH THE THINNING OF RETINAL TISSUES. TOGETHER, THESE FINDINGS SUGGEST THAT MAINTAINING EYESIGHT COULD BE ONE WAY TO MODIFY THE COURSE OF COGNITIVE DECLINE IN THIS POPULATION."OUR FINDINGS ARE VERY DIFFERENT FROM THOSE REPORTED FOR PEOPLE WITH TYPE 2 DIABETES," SAID KING. "THIS LINK BETWEEN BETTER VISUAL ACUITY AND THE PRESERVATION OF COGNITIVE FUNCTION AND HIGHER BRAIN VOLUMES IS NOVEL AND SUGGESTS A POTENTIAL THERAPEUTIC APPROACH TO PREVENT COGNITIVE DECLINE IN T1D THAT MAY EVEN BE APPLICABLE BEYOND THIS POPULATION TO AGE-RELATED DEMENTIA," SAID SHAH. STUDY EXPLORES INSTAGRAM'S ROLE IN YOUNG ADULTS LIVING WITH TYPE 1 DIABETES FOR MANY 18- TO 25-YEAR-OLDS WITH TYPE 1 DIABETES (T1D), MANAGING THEIR CONDITION DURING A TIME OF LIFE ALREADY MARKED BY CHANGE AND STRESS POSES A SIGNIFICANT CHALLENGE. FOR THESE SAME YOUNG ADULTS, SOCIAL MEDIA IS A DAILY HABIT, AND A POTENTIAL SOURCE OF SUPPORT. A QUALITATIVE STUDY PUBLISHED IN JMIR DIABETES EXPLORES HOW INSTAGRAM POSTS FOCUSED ON DIABETES MAY AFFECT YOUNG PEOPLE'S SELF-CARE BEHAVIORS AND EMOTIONAL WELL-BEING."OUR RESULTS DEMONSTRATE THAT SOCIAL MEDIA HAS THE POTENTIAL TO PROVIDE SUPPORT TO YOUNG PEOPLE WITH T1D AS WELL AS IMPACT THEIR WELL-BEING BY FOSTERING A SENSE OF COMMUNITY AND INCREASING ACCESS TO INFORMATION ABOUT DIABETES," SAID LEAD AUTHOR TARA MAXWELL, MD, MSHP, FORMERLY AT JOSLIN DIABETES CENTER. "WE ALSO DESCRIBE THE POTENTIAL NEGATIVE EFFECTS OF SOCIAL MEDIA ON DIABETES, SELF-MANAGEMENT, AND EMOTIONAL STATE."IN ONE-ON-ONE VIDEO INTERVIEWS, PARTICIPANTS REACTED TO A CURATED SET OF 10 INSTAGRAM POSTS REFLECTING COMMON DIABETES THEMES. POSTS WERE VIEWED MORE POSITIVELY WHEN THEY WERE MEDICALLY ACCURATE, EMOTIONALLY RELATABLE, AND VISUALLY APPEALING. BUT CONTENT THAT DRAMATIZED THE CONDITION OR IDEALIZED LIFE WITH T1D SOMETIMES UNDERMINED SELF-CARE OR WORSENED EMOTIONAL WELL-BEING.TO BETTER UNDERSTAND HOW SOCIAL MEDIA INFLUENCES PEOPLE WITH T1D, MAXWELL AND COLLEAGUES, INCLUDING SENIOR AUTHOR LORI LAFFEL, MD, MPH, RECRUITED 26 YOUNG ADULTS WHO RECEIVED REGULAR CARE AT JOSLIN AND HAD LIVED WITH T1D FOR AT LEAST A YEAR. WHILE ALL REPORTED DAILY SOCIAL MEDIA USE, MOST SAID THEY ONLY OCCASIONALLY VIEWED DIABETES-RELATED CONTENT AND RARELY POSTED ABOUT THEIR CONDITION THEMSELVES.THE RESEARCHERS ASKED PARTICIPANTS TO DESCRIBE HOW EACH POST MADE THEM FEEL, WHAT IT EMPHASIZED, AND HOW IT MIGHT INFLUENCE THEIR SELF-CARE. SOCIAL MEDIA SERVED TO HIGHLIGHT THE EXISTENCE OF A COMMUNITY OF PEOPLE WITH T1D; PROVIDE DIABETES INFORMATION; POTENTIALLY REINFORCE GOOD HABITS; AND INFLUENCE EMOTIONAL STATE, FOR BETTER OR FOR WORSE."SOCIAL MEDIA MAY NOT NECESSARILY BE GOOD OR BAD FOR YOUNG PEOPLE WITH T1D," SAID LAFFEL. "IT HAS THE POTENTIAL TO FOSTER COMMUNITY, SPARK REFLECTION, SUPPORT SELF-CARE, AND POSITIVELY AFFECT EMOTIONAL WELL-BEING. WITH THOUGHTFUL DESIGN AND MEANINGFUL ENGAGEMENT, SOCIAL MEDIA COULD BE A POWERFUL TOOL FOR IMPROVING OUTCOMES IN THIS POPULATION."FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION AS NOTED THROUGHOUT THIS FORM 990, BIDM IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH BIDM DOES NOT DIRECTLY ENGAGE IN HEALTH PROFESSIONS EDUCATION / GRADUATE MEDICAL EDUCATION, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND MOUNT AUBURN HOSPITAL ALL ENGAGE IN EDUCATIONAL ACTIVITIES DESIGNED TRAIN FUTURE PHYSICIANS AND OTHER FUTURE HEALTHCARE PRACTITIONERS. ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $216 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $70 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $145 MILLION WHICH IS AN INVESTMENT IN THE HEALTH SYSTEM OF TOMORROW. ALTHOUGH THE EDUCATIONAL ACTIVITIES OF THESE BILH AFFILIATES ARE NOT QUANTIFIED HERE IN BIDM'S FORM 990 SCHEDULE H, PART I, 7F, AS ALREADY NOTED THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY BIDM AND BEYOND. IN ADDITION, INFORMATION ON THE TEACHING ACTIVITIES AT BIDMC, A SISTER ENTITY TO BIDM, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 63 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 760 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 48 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 57 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS:- ANESTHESIOLOGY- EMERGENCY MEDICINE- EAR, NOSE AND THROAT (OTOLARYNGOLOGY)- INTERNAL MEDICINE- NEUROLOGY- NEUROSURGERY- OBSTETRICS AND GYNECOLOGY- PATHOLOGY- PLASTIC SURGERY - PSYCHIATRY- RADIOLOGY- SURGERY- TRANSITIONAL YEAR- UROLOGYRESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. MORE THAN HALF OF THESE PROGRAMS (47 OF 91) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS:- ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA, ANESTHESIA MEDICAL EDUCATION, ADVANCED CRITICAL CARE AND ULTRASOUND- DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS)- EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, MEDICAL EDUCATION IN EMERGENCY MEDICINE- INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY- NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY, NEURO CRITICAL CARE- OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY, UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY.- PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY - PSYCHIATRY: EARLY PSYCHOSIS, CONSULT LIAISON PSYCHIATRY- RADIOLOGY: DIAGNOSTIC, ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING (MSK), NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, ADVANCED CROSS-SECTIONAL IMAGING. - RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC- SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, LYMPHATIC SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, OTOLARYNGOLOGY FELLOWSHIP, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATED, JOINTS FELLOWSHIP ADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS - EXAMPLES BELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HEALTH ALLIANCE, TUFTS MEDICAL CENTER, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL, SOUTH SHORE HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: - RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE.- DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: - DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: - DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC.- ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS.PROGRAM OBJECTIVES - INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS - CONTRIBUTE TO THE HEALTH AND WELL-BEING OF POPULATIONS AROUND THE WORLD - ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS - EXPAND RESEARCH OPPORTUNITIES - ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH SITE LOCATIONS - BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. - VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. - ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH. NEUROLOGY EDUCATION AT BIDMCTHE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. PATHOLOGY EDUCATION AT BIDMCTHE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING. RADIOLOGY EDUCATION AT BIDMC THE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE:- THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR.- FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR.- ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.OUR UNIQUE EDUCATIONAL TRACKSCURRENTLY, SIX TRACKS ARE OFFERED:- CLINICAL- EDUCATION- RESEARCH- GLOBAL HEALTH- QUALITY IMPROVEMENT- HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.SURGERY EDUCATION AT BIDMCTHE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, NEUROSURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, UROLOGY, AND VASCULAR SURGERY. RESIDENTS AND FELLOWS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. RESIDENTS AND FELLOWS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE:- RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB - SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS - COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES. 1 MAY INSTITUTE INC 41 PACELLA PARK DRIVE RANDOLPH MA 023681755 042197449 501(C)(3) 10000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS MILTON FOUNDATION FOR EDUCATION INC PO BOX 223 MILTON MA 021860001 043307338 501(C)(3) 10000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS QUINCY ASIAN RESOURCE 1509 HANCOCK ST STE 209 QUINCY MA 021695242 010556446 501(C)(3) 9600 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS QUINCY COMMUNITY ACTION PROGRAMS 1509 HANCOCK STREET QUINCY MA 021695241 042391348 501(C)(3) 15000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS SOUTH SHORE ELDER SERVICES INC 350 GRANITE STREET BRAINTREE MA 021843958 042596213 501(C)(3) 9000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS TOWN OF MILTON 25 GILE ROAD MILTON MA 02186 046001228 GOVERNMENT ENTITY 24700 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS SOUTH SHORE YMCA 79 CODDINGTON STREET QUINCY MA 02169 042105881 501(C)(3) 10756 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS SOUTH SHORE FOOD BANKRANDOLPH FOOD PANTRY PO BOX 890009 WEYMOUTH MA 02189 043099272 501(C)(3) 41206 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS MEDICAL CARE OF BOSTON MANAGEMENT CORP 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 042810972 501(C)(3) 5737267 0 ACCESS TO PATIENT CARE COMMUNITY PHYSICIANS ASSOCIATES INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 043243146 501(C)(3) 4511163 0 ACCESS TO PATIENT CARE 8 0 PART I, LINE 2: COMMUNITY BENEFITS GRANTS -- AS PREVIOUSLY NOTED IN THIS FILING BETH ISRAEL DEACONESS HOSPITAL - MILTON MAINTAINS STRONG RELATIONSHIPS WITH MANY COMMUNITY PARTNERS AND BETH ISRAEL DEACONESS HOSPITAL - MILTON WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFITS MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS FOR THE PURPOSES AS NOTED IN SCHEDULE I PART II. BETH ISRAEL DEACONESS HOSPITAL - MILTON ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS. ADDITIONAL INFORMATION ABOUT COMMUNITY BENEFITS IS INCLUDED IN FORM 990 SCHEDULE H. ACCESS TO CARE SUBSIDIES AS PREVIOUSLY NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS HOSPITAL - MILTON IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. BILH, BETH ISRAEL DEACONESS HOSPITAL - MILTON AND ALL ENTITIES WITHIN THE BILH NETWORK ARE DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. BETH ISRAEL DEACONESS HOSPITAL - MILTON ENSURES THESE SUBSIDIES ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THE RECIPIENT ENTITIES. 1 1 0 0 0 0 0 1 1 1 TABB MD KEVIN CEO (EX-OFF) (CEO, BILH) 0 2267647 0 1000000 0 398244 0 1021480 0 47000 0 4734371 0 0 RIOS CINDY TREAS (EX-OFF) (EXEC VP & CFO, BILH) 0 1031770 0 125000 0 229483 0 2171401 0 37049 0 3594703 0 0 BERRY MD MICHAEL TRUSTEE; ORTHOPEDIC SURGEON 0 949238 0 0 0 47553 0 10350 0 35190 0 1042331 0 0 KATZ ESQ JAMIE CLERK (EX-OFF); BILH GENERAL COUNSEL 0 870522 0 0 0 130539 0 24780 0 9010 0 1034851 0 0 ANDERSON MD JONATHAN TTEE (EX-OFF) (PRES, MEDICAL STAFF) 427853 0 234006 0 24214 0 41400 0 45625 0 773098 0 0 0 FEINSTEIN MD ALEXANDER DIAGNOSTIC RADIOLOGIST 469893 0 135000 0 6283 0 41400 0 43301 0 695877 0 0 0 DEREVIANKO MD VICTORIA M ANESTHESIOLOGIST 522887 0 22000 0 28314 0 34500 0 50889 0 658590 0 0 0 KOROPEY MD ANDREW J ANESTHESIOLOGIST 541076 0 22000 0 11055 0 34500 0 46815 0 655446 0 0 0 FULLERTON MD RUSSELL RADIOLOGIST 445475 0 135000 0 4870 0 41400 0 19747 0 646492 0 0 0 LIPSKY MD MARK A DIAGNOSTIC RADIOLOGIST 413412 0 135000 0 29830 0 41400 0 4067 0 623709 0 0 0 FRANCIOLI CARL TREAS EX-OF; BILH INTRM CFO/BSTN CFO 0 531632 0 1095 0 25925 0 13814 0 41145 0 613611 0 0 FERNANDEZ RICHARD PRESIDENT & TRUSTEE (EX-OFFICIO) 454243 0 0 0 45549 0 16530 0 33787 0 550109 0 0 0 CARUCCI DEAN TTEE (EXO) (BILH DIV PRES COMMUNITY) 0 332702 0 200000 0 1604 0 0 0 13985 0 548291 0 0 SIAO MD DANIEL CHI CHANG CHIEF MEDICAL OFFICER 385531 0 1565 0 6076 0 34500 0 45797 0 473469 0 0 0 BRESNICK MD MORGAN TRUSTEE; SURGEON 0 315564 0 34360 0 4261 0 30500 0 39570 0 424255 0 0 O'CONNOR MD HEIDI TTEE; PHYS INT MED/PULMONARY DISEASE 271091 0 70953 0 28050 0 30000 0 23523 0 423617 0 0 0 RANGAVIZ SHEILAH ASST TREAS EX-OFF & CFO; MARKET CFO 0 322155 0 0 0 20757 0 13186 0 36023 0 392121 0 0 CRONIN RN LYNN SR. VP, CNO, MILTON 213295 0 15500 0 31840 0 8183 0 39432 0 308250 0 0 0 FENTON ANGELA VP, AMBULATORY & CLINICAL SERVICES 220232 0 0 0 6910 0 6951 0 30970 0 265063 0 0 0 GEE ESQ CARROLL ASST CLERK (ASSOC GEN COUNSEL, BILH) 0 187331 0 25340 0 163 0 7538 0 38477 0 258849 0 0 FREED-LOEW CHERYL VP, HUMAN RESOURCES BUSINESS PARTNER 159375 0 0 0 21715 0 11188 0 12465 0 204743 0 0 0 PART I, LINE 3 BETH ISRAEL DEACONESS HOSPITAL - MILTON'S CHIEF EXECUTIVE OFFICER AND PRESIDENT ARE EMPLOYED THROUGH BETH ISRAEL LAHEY HEALTH (BILH), WHICH AS NOTED THROUGHOUT THIS FILING, IS THE DIRECT OR INDIRECT SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON. IN THIS CAPACITY, THE BILH COMPENSATION COMMITTEE SETS COMPENSATION FOR THE CEO AND PRESIDENT OF BETH ISRAEL DEACONESS HOSPITAL - MILTON. AS NOTED IN RESPONSE TO THIS FORM 990 PART VI QUESTIONS 15A AND 15B, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF EXECUTIVE AND SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER MEMBERS OF EXECUTIVE MANAGEMENT IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO AS VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BILH BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS FOR BOTH THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES ARE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION. PART I, LINES 4A-B ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, RECEIVED SEVERANCE PAYMENTS. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. BILH AND ITS AFFILIATES MAINTAIN CERTAIN SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING PLANS, WHICH UNDER THE DEFINITION TO THIS FORM 990 ARE SUPPLEMENTAL NONQUALIFIED PLANS: BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM AND, BETH ISRAEL LAHEY HEALTH, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. IN ADDITION, DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THESE ADDITIONAL IRC 457(B) PLANS AND BENEFITS FROM PARTICIPATING IN ONE OF THESE PLANS IS ALSO REPORTED IN THIS FORM 990: BETH ISRAEL LAHEY HEALTH, INC. 457(B) DEFERRED COMPENSATION PLAN, EXETER HEALTH RESOURCES, INC. 457(B) RETIREMENT SAVINGS PLAN, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. 457(B) DEFERRED COMPENSATION PLAN. THESE PLANS ARE NON-QUALIFIED DEFERRED COMPENSATION PLANS AND PURSUANT TO THE PLANS, ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS AND/OR CAN MAKE THEIR OWN EMPLOYEE DEFERRALS. AMOUNTS RECEIVED BY PARTICIPANTS AND DEFERRED BY PARTICIPANTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. PART I, LINE 7 AS NOTED ABOVE, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF EXECUTIVE AND SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES. DURING THE 2024 CALENDAR YEAR, BILH MAINTAINED EXECUTIVE COMPENSATION PACKAGES WHICH INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF VARIOUS FACTORS, INCLUDING BUT NOT LIMITED TO, MEETING OR EXCEEDING THE EMPLOYING ENTITY'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, BUDGETED CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. IN EACH CASE, INCENTIVE COMPENSATION WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, AND FOR THE BILH CEO AS NOTED ABOVE, THE FULL BILH BOARD OF TRUSTEES. ADDITIONAL INFORMATION IS INCLUDED IN THE EXPLANATORY NOTES TO THIS SCHEDULE J. ADDITIONAL EXPLANATORY NOTES: DIRECTORS AND TRUSTEES SERVE WITHOUT COMPENSATION: ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES IN THE NOTES BELOW. REPORTING PERIOD: AS REQUIRED BY FORM 990, COMPENSATION REPORTED IN THE FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 IS CALENDAR YEAR 2024 COMPENSATION. COMPENSATION SOURCES: COMPENSATION REPORTED FOR INDIVIDUALS MAY INCLUDE COMPENSATION PAID BY THE REPORTING ENTITY, AN AFFILIATE OF THE REPORTING ENTITY AND IN SOME CASES UNRELATED ENTITIES AS REQUIRED BY FORM 990. REPORTABLE COMPENSATION: REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION: OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: ORDINARY WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER SUBSIDIZED PARKING; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE. DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401(K) RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403(B) RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT. NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE, AMONG OTHER THINGS, AMOUNTS FROM ONE OR MORE OF THE FOLLOWING NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ADDITIONAL INDIVIDUAL SPECIFIC INFORMATION IS INCLUDED BELOW. SCHEDULE J FOOTNOTES (CONTINUED): ANDERSON, M.D., JONATHAN DR. ANDERSON SERVED IN THE FOLLOWING POSITIONS DURING THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - TRUSTEE (PRESIDENT, BIDM MEDICAL STAFF) - BID-MILTON PHYSICIAN ASSOCIATES, INC. - TRUSTEE (PRESIDENT, BIDM MEDICAL STAFF) - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO); PRESIDENT, MEDICAL STAFF - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. BERRY, M.D., MICHAEL DR. BERRY HELD THE FOLLOWING POSITIONS UNTIL JUNE 1, 2025: - TRUSTEE; ORTHOPEDIC SURGEON - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TRUSTEE - BID-MILTON PHYSICIAN ASSOCIATES, INC. - TRUSTEE; ORTHOPEDIC SURGEON - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR DR. BERRY INCLUDES PAYMENTS FOR PTO PAID OUT AND GROUP TERM LIFE INSURANCE IN THE AMOUNTS OF $36,923 AND $10,630, RESPECTIVELY. BRESNICK, M.D., MORGAN DR. BRESNICK SERVED IN THE FOLLOWING POSITIONS DURING THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - TRUSTEE - BID-MILTON PHYSICIAN ASSOCIATES, INC. - TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - GENERAL SURGEON - ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER D/B/A LONGWOOD SPECIALTY PHYSICIANS (LSP) AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. CARUCCI, DEAN UNLESS OTHERWISE NOTED, MR. CARUCCI SERVED IN THE FOLLOWING POSITIONS DURING THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - DIVISIONAL PRESIDENT, COMMUNITY - BETH ISRAEL LAHEY HEALTH, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - ANNA JAQUES HOSPITAL - ROLE BEGAN FEBRUARY 1, 2025 - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC - TRUSTEE - BID-MILTON PHYSICIAN ASSOCIATES, INC. - TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - EXETER HEALTH RESOURCES, INC. - TRUSTEE - EXETER HOSPITAL, INC. - TRUSTEE - THE JORDAN HEALTH SYSTEMS, INC - TRUSTEE - JORDAN PHYSICIAN ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE - WINCHESTER HEALTHCARE MANAGEMENT, INC. - TRUSTEE (EX-OFFICIO, CEO DESIGNEE) - WINCHESTER HOSPITAL AS NOTED, MR. CARUCCI SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. CRONIN, R.N., LYNN - SENIOR VICE PRESIDENT, CHIEF NURSING OFFICER - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. MS. CRONIN SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. DEREVIANKO, M.D., VICTORIA M. - ANESTHESIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. DR. DEREVIANKO SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. FEINSTEIN, M.D., ALEXANDER - DIAGNOSTIC RADIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. DR. FEINSTEIN SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. FENTON, ANGELA - VICE PRESIDENT, AMBULATORY AND CLINICAL SERVICES - BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. - VICE PRESIDENT, AMBULATORY AND CLINICAL SERVICES - BID-MILTON PHYSICIAN ASSOCIATES, INC. - VICE PRESIDENT, AMBULATORY AND CLINICAL SERVICES - COMMUNITY PHYSICIANS ASSOCIATES, INC. MS. FENTON SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. FERNANDEZ, RICHARD - PRESIDENT AND TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. - PRESIDENT AND TRUSTEE - COMMUNITY PHYSICIANS ASSOCIATES, INC. - PRESIDENT AND TRUSTEE - BID-MILTON PHYSICIAN ASSOCIATES, INC. - TRUSTEE - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. MR. FERNANDEZ SERVED IN THE POSITIONS ABOVE FOR THE FULL FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. FERNANDEZ INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $18,580. SCHEDULE J FOOTNOTES (CONTINUED): FRANCIOLI, CARL MR. FRANCIOLI HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - CHIEF FINANCIAL OFFICER OF METRO BOSTON DIVISION - BETH ISRAEL LAHEY HEALTH, INC. - TREASURER (EX-OFFICIO) & CHIEF FINANCIAL OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. MR. FRANCIOLI SERVED IN THE FOLLOWING ADDITIONAL ROLES FROM OCTOBER 20, 2024 THROUGH AUGUST 3, 2025: - TREASURER (EX-OFFICIO) AND INTERIM CHIEF FINANCIAL OFFICER - BETH ISRAEL LAHEY HEALTH, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. - TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TREASURER - BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. - TREASURER (EX-OFFICIO) - CORE PHYSICIANS, LLC - TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TREASURER - EXETER HOSPITAL, INC. - TREASURER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - TREASURER - EXETER MED REAL, INC. - TREASURER - HEALTH AND EDUCATION HOUSING SERVICES, INC. - TREASURER - JOSLIN CLINIC, INC. - TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - TREASURER - THE JORDAN HEALTH SYSTEMS, INC. - TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TREASURER - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - TREASURER - LAHEY CLINIC, INC. - TRUSTEE & TREASURER - LAHEY HEALTH SHARED SERVICES, INC. - TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE, INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - TREASURER - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE - TREASURER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL - TRUSTEE & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - TREASURER - WINCHESTER HEALTHCARE MANAGEMENT, INC. MR. FRANCIOLI BEGAN SERVING IN THE FOLLOWING ROLE ON SEPTEMBER 11, 2025: -TRUSTEE (EX-OFFICIO) - BAIM INSTITUTE FOR CLINICAL RESEARCH, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. DEFERRED COMPENSATION INCLUDES AN UNVESTED CONTRIBUTION TO A NONQUALIFIED PLAN IN THE AMOUNT OF $5,534. FREED-LOEW, CHERYL MS. FREED-LOEW SERVED IN THE FOLLOWING POSITIONS DURING THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER - BID - MILTON PHYSICIAN ASSOCIATES, INC. - VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - VICE PRESIDENT, HUMAN RESOURCES BUSINESS PARTNER - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. FULLERTON, M.D., RUSSELL - RADIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. DR. FULLERTON SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. GEE, ESQ., CARROLL MS. GEE SERVED IN THE FOLLOWING POSITIONS DURING THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - ASSOCIATE GENERAL COUNSEL - BETH ISRAEL LAHEY HEALTH, INC. - ASSISTANT CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - ASSISTANT CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - ASSISTANT CLERK - BID - MILTON PHYSICIAN ASSOCIATES, INC. - ASSISTANT CLERK - COMMUNITY PHYSICIANS ASSOCIATES, INC. - ASSISTANT CLERK - JORDAN PHYSICIAN ASSOCIATES, INC. - ASSISTANT CLERK - THE JORDAN HEALTH SYSTEMS, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. INCENTIVE COMPENSATION FOR MS. GEE INCLUDES A MILESTONE PAYMENT IN THE AMOUNT OF $25,340. HERNDON, MBA, CPA, FACHE, SCOTT MR. HERNDON BEGAN SERVING IN THE FOLLOWING ROLES ON AUGUST 4, 2025: - TREASURER (EX-OFFICIO), EXECUTIVE VICE PRESIDENT, AND CHIEF FINANCIAL OFFICER - BETH ISRAEL LAHEY HEALTH, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. - TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TREASURER - BID - MILTON PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. - TREASURER (EX-OFFICIO) - CORE PHYSICIANS, LLC - TREASURER - EXETER HOSPITAL, INC. - TREASURER - EXETER HEALTH RESOURCES, INC. - TREASURER - EXETER MED REAL, INC. - TREASURER - HEALTH AND EDUCATION HOUSING SERVICES, INC. - TREASURER - JOSLIN CLINIC, INC. - TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - TREASURER - THE JORDAN HEALTH SYSTEMS, INC. - TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TREASURER - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - TREASURER - LAHEY CLINIC, INC. - TRUSTEE AND TREASURER - LAHEY HEALTH SHARED SERVICES, INC. - TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE AND TREASURER - NORTHEAST HEALTH SYSTEM, INC. - TREASURER (EX-OFFICIO) NORTHEAST MEDICAL PRACTICE, INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - TREASURER - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. - TRUSTEE AND TREASURER - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE AND TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE - TREASURER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE AND TREASURER (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL - TRUSTEE AND TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - TREASURER - WINCHESTER HEALTHCARE MANAGEMENT, INC. AS NOTED, MR. HERNDON BEGAN SERVING IN THE POSITION(S) ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. ACCORDINGLY, SINCE MR. HERNDON DID NOT BEGIN SERVING IN HIS/HER POSITION(S) UNTIL CALENDAR YEAR 2025, THERE IS NO COMPENSATION TO REPORT IN THIS FILING. SCHEDULE J FOOTNOTES (CONTINUED): KATZ, ESQ., JAMIE UNLESS OTHERWISE NOTED BELOW, MR. KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - GENERAL COUNSEL AND CLERK (EX-OFFICIO), - BETH ISRAEL LAHEY HEALTH, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. - CLERK (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - CLERK (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. - CLERK - COMMUNITY PHYSICIANS ASSOCIATES, INC. - CLERK - BID - MILTON PHYSICIAN ASSOCIATES, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. - CLERK - JORDAN PHYSICIAN ASSOCIATES, INC. - CLERK - THE JORDAN HEALTH SYSTEMS, INC. - CLERK (EX-OFFICIO) - ANNA JAQUES HOSPITAL - CLERK - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. - TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - CLERK (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TRUSTEE AND CLERK (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - CLERK - WINCHESTER HEALTHCARE MANAGEMENT, INC. - CLERK (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - CLERK - LAHEY CLINIC, INC. - CLERK - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - CLERK (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE AND CLERK (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - CLERK - CAB HEALTH AND RECOVERY SERVICES, INC. - CLERK - HEALTH AND EDUCATION HOUSING SERVICES, INC. - CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL - CLERK - JOSLIN CLINIC, INC. - CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - CLERK (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - CLERK - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - CLERK (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - CLERK - EXETER HOSPITAL, INC. - CLERK (EX-OFFICIO) - CORE PHYSICIANS, LLC AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $76,830. OTHER REPORTABLE COMPENSATION FOR MR. KATZ ALSO INCLUDES COMBINED PAYMENTS FOR GROUP TERM LIFE INSURANCE IN THE AMOUNTS OF $31,209. KOROPEY, M.D., ANDREW J - ANESTHESIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. DR. KOROPEY SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION INCLUDES PAYMENT FOR OTHER TAXABLE INSURANCE BENEFITS IN THE AMOUNT OF $10,580. LIPSKY, M.D., MARK A - DIAGNOSTIC RADIOLOGIST - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. DR. LIPSKY SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION INCLUDES PAYMENT FOR OTHER TAXABLE INSURANCE BENEFITS IN THE AMOUNT OF $10,342. O'CONNOR, M.D., HEIDI DR. O'CONNOR SERVED IN THE FOLLOWING POSITIONS DURING THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - TRUSTEE; PHYSICIAN, INTERNAL MEDICINE AND PULMONARY DISEASE - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TRUSTEE; PHYSICIAN, INTERNAL MEDICINE AND PULMONARY DISEASE - BID - MILTON PHYSICIAN ASSOCIATES, INC. - TRUSTEE; PHYSICIAN, INTERNAL MEDICINE AND PULMONARY DISEASE - COMMUNITY PHYSICIANS ASSOCIATES, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. RANGAVIZ, SHEILAH MS. RANGAVIZ SERVED IN THE FOLLOWING POSITIONS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. - MARKET CHIEF FINANCIAL OFFICER - BETH ISRAEL LAHEY HEALTH, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER - BID-MILTON PHYSICIAN ASSOCIATES, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. - CHIEF FINANCIAL OFFICER AND ASSISTANT TREASURER - THE JORDAN HEALTH SYSTEMS, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. RIOS, CINDY UNLESS OTHERWISE NOTED BELOW, MS. RIOS SERVED IN THE FOLLOWING POSITIONS UNTIL OCTOBER 19, 2024: - EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER & TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. - TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - TREASURER - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. - TRUSTEE & TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. - TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. - TREASURER - BID - MILTON PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TREASURER - JOSLIN CLINIC, INC. - TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - TREASURER - THE JORDAN HEALTH SYSTEMS, INC. - TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TREASURER - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - TREASURER - LAHEY CLINIC, INC. - TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TREASURER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - TREASURER - WINCHESTER HEALTHCARE MANAGEMENT, INC. - TRUSTEE & TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. - TRUSTEE & TREASURER - HEALTH AND EDUCATION HOUSING SERVICES, INC. - TRUSTEE & TREASURER - LAHEY HEALTH SHARED SERVICES, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE, INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - SEACOAST NURSING & REHABILITATION CENTER, INC. - TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL - TREASURER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - TREASURER - EXETER HOSPITAL, INC. - TREASURER - EXETER MED REAL, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOC AND HOSPICE - TREASURER (EX-OFFICIO) - CORE PHYSICIANS, LLC SCHEDULE J FOOTNOTES (CONTINUED): AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MS. RIOS INCLUDES SEVERANCE PAYMENTS PAID IN CALENDAR YEAR 2024 IN THE AMOUNT OF $203,538. DEFERRED COMPENSATION FOR MS. RIOS INCLUDES DEFERRED SEVERANCE PAYMENTS IN THE AMOUNT OF $2,118,462 TO BE PAID AFTER DECEMBER 31, 2024. IN ADDITION, DEFERRED COMPENSATION INCLUDES AN UNVESTED CONTRIBUTION TO A NONQUALIFIED PLAN IN THE AMOUNT OF $42,199. SIAO, MD., DANIEL CHI CHANG - CHIEF MEDICAL OFFICER - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. TABB, MD., KEVIN UNLESS OTHERWISE NOTED BELOW, DR. TABB HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2025: - PRESIDENT AND CHIEF EXECUTIVE OFFICER; TRUSTEE (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - CHIEF EXECUTIVE OFFICER - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - CHIEF EXECUTIVE OFFICER - LAHEY CLINIC, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - PRESIDENT (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. - TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE, BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HOSPITAL - TRUSTEE AND PRESIDENT (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - CHIEF EXECUTIVE OFFICER - WINCHESTER HEALTHCARE MANAGEMENT, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - CHIEF EXECUTIVE OFFICER - CAB HEALTH AND RECOVERY SERVICES, INC. - CHIEF EXECUTIVE OFFICER - HEALTH AND EDUCATION HOUSING SERVICES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. - CHIEF EXECUTIVE OFFICER - BID - MILTON PHYSICIAN ASSOCIATES, INC. - CHIEF EXECUTIVE OFFICER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - CHIEF EXECUTIVE OFFICER - THE JORDAN HEALTH SYSTEMS, INC. - CHIEF EXECUTIVE OFFICER - JORDAN PHYSICIAN ASSOCIATES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - CHIEF EXECUTIVE OFFICER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - CHIEF EXECUTIVE OFFICER - JOSLIN CLINIC, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - CHIEF EXECUTIVE OFFICER - EXETER HOSPITAL, INC. IN ADDITION TO THE POSITIONS NOTED ABOVE, DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNEE WHO THEN BECAME THE VOTING TRUSTEE IN HIS PLACE: - TRUSTEE (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - MILTON, BID-MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATES - TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM - TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, THE JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - TRUSTEE (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - TRUSTEE (EX-OFFICIO) - WINCHESTER HOSPITAL AND WINCHESTER HEALTHCARE MANAGEMENT - TRUSTEE (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. AND SEACOAST AFFILIATED GROUP PRACTICE - TRUSTEE (EX-OFFICIO) - JOSLIN DIABETES CENTER - TRUSTEE (EX-OFFICIO) - JOSLIN CLINIC - TRUSTEE (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - TRUSTEE (EX-OFFICIO) - EXETER HOSPITAL, INC. - TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TRUSTEE (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TRUSTEE (EX-OFFICIO) - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - TRUSTEE (EX-OFFICIO) - LAHEY CLINIC, INC. - TRUSTEE (EX-OFFICIO) - CAB HEALTH AND RECOVERY SERVICES, INC. - TRUSTEE (EX-OFFICIO) - HEALTH AND EDUCATION HOUSING SERVICES, INC. - TRUSTEE (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $352,380. OTHER REPORTABLE COMPENSATION FOR DR. TABB ALSO INCLUDES PAYMENTS IN THE AMOUNT OF $23,364 FOR GROUP TERM LIFE INSURANCE. DEFERRED COMPENSATION IN THE AMOUNT OF $1,000,000 IS INCLUDED IN THIS FILING FOR DR. TABB. THIS AMOUNT RELATES TO MILESTONE PAYMENTS WHICH, AS OF DECEMBER 31, 2024, WERE NOT FUNDED, WERE NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57585BPD4 2025-08-14 923737714 MDFA - SERIES 2025N - SEE PART VI 0 0 0 B MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584Y7K9 2023-12-12 442970000 MDFA - SERIES 2023M - SEE PART VI 0 0 0 C MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584YTK5 2019-07-31 211922775 MDFA - SERIES 2019K - SEE PART VI 0 0 0 D MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584YJW0 2018-06-26 479594374 MDFA - SERIES 2018J-1,J-2 - SEE PART VI 0 0 0 A 925222558 5454992 3304135 28217460 169812693 718433278 1 0 0 1 B 457215735 3559000 430865374 22791361 0 0 0 1 C 44260000 211922775 2931137 19714020 189277618 2019 0 0 1 1 D 20455000 504358641 4594374 499764267 2021 0 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 0 1 1 0 0 0 0 1 D 0 0 0 1 0 0 0 1 1 A 1 B 1 C 1 D 1 BOND A, ENTITY 1: PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 10/21/2015 AND 09/02/2015. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO INVESTMENT EARNINGS. BOND B, ENTITY 1: PART I, ROW B, COLUMN F: THE ISSUE'S PROCEEDS WILL BE USED TO FINANCE PROJECTS AND PAY ISSUANCE COSTS. PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO INVESTMENT EARNINGS. BOND C, ENTITY 1: PART I, ROW C, COLUMN F: FOR TAX PURPOSES (PURSUANT TO PROPOSED TREASURY REGULATIONS SECTION 1.150-1(D)(2)(II)(C)), THE ISSUE'S PROCEEDS OTHER THAN THOSE ALLOCATED TO COSTS OF ISSUANCE WERE ALLOCATED TO CAPITAL EXPENDITURES ON THE DATE OF CLOSING. THE PRESENTATION SHOWN HERE DEPARTS FROM THE TAX TREATMENT, REFLECTING THE CHARACTERIZATION OF THE TRANSACTION FOR OTHER PURPOSES, AND IS MORE IN ACCORDANCE TO THE FINANCIAL ACCOUNTING PRESENTATION. PART IV, COLUMN C, LINE 2C: ARBITRAGE REBATE CALCULATION PERFORMED ON 11/12/2024. BOND D, ENTITY 1: PART I, ROW D, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN D, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $24,764,267 OF INVESTMENT EARNINGS. PART IV, COLUMN D, LINE 2C: FINAL REBATE CALCULATION SHOWING NO REBATE DUE COMPLETED ON 09/30/2023. BOND A, ENTITY 2: PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. PART II, COLUMN A, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. PART IV, COLUMN A, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021. BOND B, ENTITY 2: PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 08/17/2007 AND 07/14/2005. PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $125,030 OF INVESTMENT EARNINGS. PART IV, COLUMN B, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021. BOND C, ENTITY 2: PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES (DATED 06/09/2008; 11/30/2005; 07/16/2003; AND 06/04/1998), FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW PART IV, COLUMN C, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019. BOND D, ENTITY 2: PART I, ROW D, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW D, COLUMN F: REFINANCING AND REFUNDING PRIOR BONDS ISSUED ON 11/20/2003 AND 12/19/2001. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. BOND A, ENTITY 3: PART I, ROW A, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW A, COLUMN F: REFINANCING AND REFUNDING PRIOR BOND ISSUANCE 12/19/2001. PART II, COLUMN A, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. BOND B, ENTITY 3: PART I, ROW B, COLUMN A: MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PART I, ROW B, COLUMN F: DESCRIPTION OF PURPOSE - REFUND ISSUE DATED 06/28/2000. PART II, COLUMN B, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. PART IV, ROW 2C, COLUMN B: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 10, 2009. PART III, LINE 9 AND PART IV, LINE 7: THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS ORIGINALLY FORMED IN JUNE 2020 AND EXPANDED WITH THE ADDITION OF EXETER HOSPITAL (EIN: 22-2674014) IN JULY 2024. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC) SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH NOT EVERY MEMBER OF THE BILH OBLIGATED GROUP HAS FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, THOSE THAT HAVE NOT NEVERTHELESS FOLLOW THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS. THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP. THE OBLIGATED GROUP INCLUDES THE FOLLOWING ENTITIES: BETH ISRAEL DEACONESS MEDICAL CENTER, INC., MOUNT AUBURN HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., NEW ENGLAND BAPTIST HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL MILTON, INC., BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC., MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, MOUNT AUBURN PROFESSIONAL SERVICES, INC., LAHEY CLINIC FOUNDATION, INC., LAHEY CLINIC, INC., LAHEY CLINIC HOSPITAL, INC., NORTHEAST HOSPITAL CORPORATION, WINCHESTER HOSPITAL, ANNA JAQUES HOSPITAL AND EXETER HOSPITAL. THE OBLIGATED GROUP IS AWARE OF THE INSTRUCTIONS TO SCHEDULE K THAT STATE THAT "IF THE ORGANIZATION HAS ONE OR MORE RELATED ORGANIZATIONS (FOR EXAMPLE, PARENT AND SUBSIDIARY RELATIONSHIP), IT MUST COMPLETE SCHEDULE K (FORM 990) CONSISTENT WITH THE FILINGS(S) OF ITS RELATED ORGANIZATION(S). THE SAME LIABILITY SHOULDN'T BE REPORTED BY MORE THAN ONE OF THE RELATED ORGANIZATIONS." THE OBLIGATED GROUP IS CURRENTLY WORKING TOWARD A DETERMINATION REGARDING THE REPORTING OF TAX-EXEMPT DEBT AMONG ITS MEMBERS WITH RESPECT TO SCHEDULE K. IN THE ABSENCE OF SUCH A DETERMINATION, FOR THE REPORTING PERIOD ENDING ON 09/30/2025, THE OBLIGATED GROUP HAS INCLUDED ALL TAX-EXEMPT BOND ISSUES ON EACH OF ITS MEMBER'S FORM 990 SCHEDULES K, WHICH IS CONSISTENT WITH THE APPROACH THAT HAS BEEN TAKEN SINCE THE OBLIGATED GROUP'S FORMATION. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584XMT5 2016-05-12 257611877 MDFA - SERIES 2016I - SEE PART VI 0 0 0 B MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584XFW6 2015-10-21 262828878 MDFA - LAHEY SERIES F - SEE PART VI 0 0 0 C MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584XDH1 2015-09-02 203702204 MDFA - SERIES 2015 H-1 - SEE PART VI 0 0 0 D NH HEALTH AND EDUCATION FACILITIES AUTHORITY 020279866 000000000 2015-03-02 24020000 EXETER SERIES 2015 - SEE PART VI 0 0 0 A 68715000 257618370 2515889 19006493 236095988 2016 0 1 1 1 B 168545000 262953908 4857465 3129474 94764737 160202232 2021 1 1 1 1 C 173200000 203702204 2348479 201353725 1 1 1 1 D 15240000 24020000 162154 23857846 2015 1 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 1 1 C 0 0 0 1 0 0 0 0 1 D 1 1 0 0 0 1 A 1 B 1 C 1 D 1 A NH HEALTH AND EDUCATION FACILITIES AUTHORITY 020279866 000000000 2012-03-09 32565000 EXETER SERIES 2012 - SEE PART VI 0 0 0 B MASS HEALTH & EDUCATIONAL FACILITIES AUTHORITY 042456011 57586CDD4 2004-07-08 30340000 MHEFA - WINCHESTER F - ADV REFUND 0 0 0 A 16685000 32565000 215404 32349596 2012 1 0 1 1 B 13590000 30340000 365445 47003 29927552 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 1 1 0 0 0 1 B 0 0 0 1 1 1 MORGAN STANLEY 20.000000000000 0 0 0 0 1 A 1 B 1 SUBSTANTIAL CONTRIBUTOR INDEPENDENT CONTRACTOR 239973 FROM TIME TO TIME, BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC.'S SERVICE PROVIDERS AND/OR VENDORS MAY MAKE A CHARITABLE CONTRIBUTION TO BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. TO SUPPORT BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC.'S TAX EXEMPT MISSION. ALL OF BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC.'S AGREEMENTS WITH VENDORS AND SERVICE PROVIDERS ARE REVIEWED BY THE BETH ISRAEL LAHEY HEALTH (BILH) OFFICE OF GENERAL COUNSEL AND OTHER BILH FUNCTIONS PURSUANT TO BILH'S POLICIES AND PROCEDURES BEFORE THEY ARE SIGNED. NO AGREEMENTS INCLUDE QUID PRO QUO PROVISIONS REQUIRING SERVICE PROVIDERS AND/OR VENDORS TO MAKE CONTRIBUTIONS TO BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. NOR ARE ANY CONTRIBUTIONS TAKEN INTO ACCOUNT AS AN INDUCEMENT TO SIGN AN AGREEMENT. ALL SUCH CONTRIBUTIONS ARE GIFTS MADE OUT OF GENEROSITY OF THE SERVICE PROVIDER/VENDOR. TRANSACTIONS WITH THOSE DONORS ARE REPORTED IN THIS FORM 990 SCHEDULE L AS REQUIRED. 0 SUBSTANTIAL CONTRIBUTOR INDEPENDENT CONTRACTOR 727268 FROM TIME TO TIME, BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC.'S SERVICE PROVIDERS AND/OR VENDORS MAY MAKE A CHARITABLE CONTRIBUTION TO BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. TO SUPPORT BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC.'S TAX EXEMPT MISSION. ALL OF BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC.'S AGREEMENTS WITH VENDORS AND SERVICE PROVIDERS ARE REVIEWED BY THE BETH ISRAEL LAHEY HEALTH (BILH) OFFICE OF GENERAL COUNSEL AND OTHER BILH FUNCTIONS PURSUANT TO BILH'S POLICIES AND PROCEDURES BEFORE THEY ARE SIGNED. NO AGREEMENTS INCLUDE QUID PRO QUO PROVISIONS REQUIRING SERVICE PROVIDERS AND/OR VENDORS TO MAKE CONTRIBUTIONS TO BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. NOR ARE ANY CONTRIBUTIONS TAKEN INTO ACCOUNT AS AN INDUCEMENT TO SIGN AN AGREEMENT. ALL SUCH CONTRIBUTIONS ARE GIFTS MADE OUT OF GENEROSITY OF THE SERVICE PROVIDER/VENDOR. TRANSACTIONS WITH THOSE DONORS ARE REPORTED IN THIS FORM 990 SCHEDULE L AS REQUIRED. 0 X 4 78383 COST OR SELLING PRICE 0 1 0 PART I, COLUMN (B): THE NUMBERS REPORTED IN COLUMN B REPRESENT THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: THE MISSION OF THE BETH ISRAEL DEACONESS HOSPITAL-MILTON, INC. (BID-MILTON OR HOSPITAL) IS TO PROVIDE SAFE, HIGH-QUALITY, COMMUNITY-BASED HEALTH CARE AND ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH ITS SISTER HOSPITAL, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) AND OTHER BETH ISRAEL LAHEY HEALTH AFFILIATES. BID-MILTON PROVIDES THIS CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. BID-MILTON ASPIRES TO BE AMONG THE BEST COMMUNITY HOSPITALS IN EASTERN MASSACHUSETTS. BETH ISRAEL DEACONESS HOSPITAL - MILTON (BID-MILTON OR HOSPITAL), IS A 102-BED ACUTE CARE HOSPITAL THAT SERVES PATIENTS OF ALL AGES AND SERVES THE COMMUNITIES OF MILTON, QUINCY, BRAINTREE, RANDOLPH, CANTON, HYDE PARK DORCHESTER AND OTHER LOCAL COMMUNITIES. THE HOSPITAL PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES AND DELIVERS CARE IN ACCORDANCE WITH BID-MILTON'S CORE VALUES OF PATIENT COMFORT, CONFIDENTIALITY AND CONVENIENCE WITH THE ULTIMATE GOAL OF PLAYING AN INTEGRAL ROLE IN IMPROVING THE OVERALL HEALTH OF THE COMMUNITIES SERVED. WHEN NEEDED, BID-MILTON PATIENTS HAVE ACCESS TO THE HOSPITAL'S SISTER ENTITY, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), WHICH IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER AND IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. BIDMC IS EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS RECOGNIZED NATIONALLY FOR THE CLINICAL EXCELLENCE OF ITS FACULTY AND THE PATIENT CARE PROVIDED, AS WELL AS FOR THE MAGNITUDE AND BREADTH OF ITS RESEARCH AND FOR ITS COMMITMENT TO MEDICAL EDUCATION. IN ADDITION, BID-MILTON IS DEDICATED TO PROVIDING COMMUNITY BENEFITS WITHIN THE COMMUNITIES IT SERVES. THE HOSPITAL IS COMMITTED TO WORKING IN PARTNERSHIP WITH RESIDENTS AND COMMUNITY LEADERS AS WELL AS CIVIC, SOCIAL AND MEDICAL ORGANIZATIONS FROM THE COMMUNITIES IT SERVES. IT IS DEDICATED TO THE PLANNING, DEVELOPMENT, IMPLEMENTATION AND MONITORING OF PROGRAMS THAT ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITY AND OFFER CLINICAL, EDUCATIONAL AND FINANCIAL RESOURCES. THESE PROGRAMS ARE DESIGNED TO IMPROVE AWARENESS OF THE HEALTH CARE ISSUES IN THE COMMUNITIES SERVED AND INCREASE PARTICIPATION IN WELLNESS AND PREVENTATIVE HEALTH ACTIVITIES. FOR ADDITIONAL DETAIL, SEE FORM 990 SCHEDULE H. THE HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK AND WORKS IN CLOSE COLLABORATION WITH BILH AND ITS AFFILIATES TO ACCOMPLISH ITS MISSION. BETH ISRAEL LAHEY HEALTH (BILH) IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE 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 4,900 PHYSICIANS AND 39,000 EMPLOYEES. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI) AND BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS, EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND LHSS IN TURN SERVED AS THE SOLE MEMBER OF THE ENTITIES WHICH COMPRISE, AMONG OTHER OPERATIONS, BETH ISRAEL LAHEY HEALTH CONTINUING CARE AND BETH ISRAEL LAHEY HEALTH MEDICAL GROUP. SEE FORM 990 SCHEDULE R FOR ADDITIONAL INFORMATION. FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: THE MISSION OF THE BETH ISRAEL DEACONESS HOSPITAL-MILTON, INC. (BID-MILTON OR HOSPITAL) IS TO PROVIDE SAFE, HIGH-QUALITY, COMMUNITY-BASED HEALTH CARE AND ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH ITS SISTER HOSPITAL, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) AND OTHER BETH ISRAEL LAHEY HEALTH AFFILIATES. BID-MILTON PROVIDES THIS CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. BID-MILTON ASPIRES TO BE AMONG THE BEST COMMUNITY HOSPITALS IN EASTERN MASSACHUSETTS. BETH ISRAEL DEACONESS HOSPITAL - MILTON (BID-MILTON OR HOSPITAL), IS A 102-BED ACUTE CARE HOSPITAL THAT SERVES PATIENTS OF ALL AGES AND SERVES THE COMMUNITIES OF MILTON, QUINCY, BRAINTREE, RANDOLPH, CANTON, HYDE PARK DORCHESTER AND OTHER LOCAL COMMUNITIES. THE HOSPITAL PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES AND DELIVERS CARE IN ACCORDANCE WITH BID-MILTON'S CORE VALUES OF PATIENT COMFORT, CONFIDENTIALITY AND CONVENIENCE WITH THE ULTIMATE GOAL OF PLAYING AN INTEGRAL ROLE IN IMPROVING THE OVERALL HEALTH OF THE COMMUNITIES SERVED. WHEN NEEDED, BID-MILTON PATIENTS HAVE ACCESS TO THE HOSPITAL'S SISTER ENTITY, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), WHICH IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER AND IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. BIDMC IS EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS RECOGNIZED NATIONALLY FOR THE CLINICAL EXCELLENCE OF ITS FACULTY AND THE PATIENT CARE PROVIDED, AS WELL AS FOR THE MAGNITUDE AND BREADTH OF ITS RESEARCH AND FOR ITS COMMITMENT TO MEDICAL EDUCATION. IN ADDITION, BID-MILTON IS DEDICATED TO PROVIDING COMMUNITY BENEFITS WITHIN THE COMMUNITIES IT SERVES. THE HOSPITAL IS COMMITTED TO WORKING IN PARTNERSHIP WITH RESIDENTS AND COMMUNITY LEADERS AS WELL AS CIVIC, SOCIAL AND MEDICAL ORGANIZATIONS FROM THE COMMUNITIES IT SERVES. IT IS DEDICATED TO THE PLANNING, DEVELOPMENT, IMPLEMENTATION AND MONITORING OF PROGRAMS THAT ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITY AND OFFER CLINICAL, EDUCATIONAL AND FINANCIAL RESOURCES. THESE PROGRAMS ARE DESIGNED TO IMPROVE AWARENESS OF THE HEALTH CARE ISSUES IN THE COMMUNITIES SERVED AND INCREASE PARTICIPATION IN WELLNESS AND PREVENTATIVE HEALTH ACTIVITIES. FOR ADDITIONAL DETAIL, SEE FORM 990 SCHEDULE H. THE HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK AND WORKS IN CLOSE COLLABORATION WITH BILH AND ITS AFFILIATES TO ACCOMPLISH ITS MISSION. BETH ISRAEL LAHEY HEALTH (BILH) IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE 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 4,900 PHYSICIANS AND 39,000 EMPLOYEES. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI) AND BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS, EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND LHSS IN TURN SERVED AS THE SOLE MEMBER OF THE ENTITIES WHICH COMPRISE, AMONG OTHER OPERATIONS, BETH ISRAEL LAHEY HEALTH CONTINUING CARE AND BETH ISRAEL LAHEY HEALTH MEDICAL GROUP. SEE FORM 990 SCHEDULE R FOR ADDITIONAL INFORMATION. FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: OUTPATIENT CLINICS AND SERVICES BETH ISRAEL DEACONESS HOSPITAL - MILTON (BID-MILTON) PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES ENCOMPASSING GENERAL INTERNAL MEDICINE AND ALL THE SUBSPECIALTIES OF INTERNAL MEDICINE, COVERING THE GAMUT OF SERVICES FROM PRIMARY TO TERTIARY CARE AS WELL AS PROVIDING SURGICAL SERVICES ON AN OUTPATIENT BASIS. THE HOSPITAL'S MEDICAL STAFF BLENDS EXPERIENCED PRIMARY CARE PHYSICIANS AND SPECIALISTS IN A WIDE VARIETY OF DISCIPLINES. THE PRIMARY CARE AND SPECIALISTS AT BID-MILTON PROVIDE OUTPATIENT PRIMARY CARE AS WELL AS ENDOSCOPIC, OPHTHALMOLOGIC, ORTHOPEDIC, DERMATOLOGIC AND PODIATRIC PROCEDURES, CARDIAC REHABILITATION, DIABETES MANAGEMENT SERVICES, NUTRITIONAL COUNSELING AND ELDER ASSESSMENT PROGRAMS. DIAGNOSTIC FACILITIES AT BID-MILTON INCLUDE A COMPLETE 24-HOUR HISTOPATHOLOGY LABORATORY AND BLOOD BANKING SERVICES AS WELL AS DIAGNOSTIC IMAGING INCLUDING CT SCANNING, ULTRASOUND, MRI, 3D MAMMOGRAPHY, ULTRASONIC CARDIOLOGY, BONE DENSITOMETRY, NUCLEAR MEDICINE, PLAIN FILM RADIOLOGY AND FLUOROSCOPY. IN ADDITION, THE HOSPITAL'S PICTURE ARCHIVAL AND COMMUNICATION SYSTEM (PACS) CAN INSTANTANEOUSLY TRANSMIT RADIOLOGIC IMAGES BETWEEN BID-MILTON AND BIDMC, MEANING THAT PATIENTS IN MILTON HAVE ACCESS TO THE SAME WORLD-CLASS SPECIALISTS AS PATIENTS AT BIDMC IN BOSTON. THE SYSTEM FACILITATES, WHEN NECESSARY, MULTI-DISCIPLINARY EVALUATION OF IMAGES, RESULTING IN IMPROVED TECHNICAL PERFORMANCE AND FEEDBACK AND DIAGNOSES WITH GREATER DIAGNOSTIC ACCURACY. DURING THE PERIOD COVERED BY THIS FILING, BID-MILTON HAD 325,482 OUTPATIENT ENCOUNTERS. THIS INCLUDED 14,369 URGENT CARE VISITS, 214,921 HOSPITAL CLINIC ENCOUNTERS, 3,250 OBSERVATION CASES, 4,311 PAIN CLINIC VISITS, 4,024 OUTPATIENT AMBULATORY SURGERIES, 7,069 OUTPATIENT ENDOSCOPY VISITS, 4,108 OUTPATIENT EKG EXAMS, 1,172 OUTPATIENT ORTHOPEDIC PROCEDURES, 51,662 OUTPATIENT RADIOLOGY EXAMS, 22,182 OUTPATIENT CT SCANS, 13,842 OUTPATIENT ULTRASOUNDS, 4,367 OUTPATIENT MRIS, 1,179 OTHER NUCLEAR MEDICINE TESTS, 10,273 BREAST IMAGING EXAMS, 649,646 OUTPATIENT LAB TESTS, 6,682 OUTPATIENT REHABILITATION/PHYSICAL THERAPY VISITS, AND 95,043 OTHER TESTS AND PROCEDURES. FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICE: INPATIENT MEDICAL / SURGICAL AND INTENSIVE CARE BID-MILTON OR HOSPITAL IS A 102-BED ACUTE CARE HOSPITAL THAT SERVES THE COMMUNITIES OF MILTON, QUINCY, BRAINTREE, RANDOLPH, CANTON, HYDE PARK, DORCHESTER AND OTHER LOCAL COMMUNITIES. THE INPATIENT POPULATION THAT IS SERVED INCLUDES INDIVIDUALS WHO ARE 15 YEARS AND OLDER WHO REQUIRE MINOR OR MAJOR SURGICAL INTERVENTION. BID-MILTON PROVIDES A WIDE RANGE OF INPATIENT CARE INCLUDING SURGICAL SERVICES, INTENSIVE, ORTHOPEDIC AND CARDIAC CARE AND COMPLETE DIAGNOSTIC FACILITIES. BID-MILTON'S INPATIENT FACILITIES INCLUDE MEDICAL/SURGICAL BEDS AND AN EIGHT-BED INTENSIVE AND CARDIAC CARE UNIT. THE HOSPITAL HAS A FULLY RENOVATED STATE-OF-THE ART SURGICAL SUITE WITH SEVEN FULLY EQUIPPED OPERATING ROOMS, ONE MINOR SURGERY ROOM AND A POST-OPERATIVE ANESTHESIA CARE UNIT. SURGICAL SERVICES ARE AVAILABLE 24 HOURS A DAY FOR CRITICALLY ILL OR INJURED PATIENTS REQUIRING IMMEDIATE SURGICAL INTERVENTION, OR FOR OTHER PATIENTS ON A NON-EMERGENT OR ELECTIVE BASIS. BID-MILTON'S HIGHLY QUALIFIED SURGEONS PERFORM ORTHOPEDIC PROCEDURES AND IMPLANTS, PLASTIC RECONSTRUCTION, GASTROINTESTINAL, BARIATRIC, GENERAL SURGICAL (INCLUDING BREAST) GYNECOLOGICAL, OPHTHALMOLOGIC, PODIATRIC, AND UROLOGICAL PROCEDURES. LIMITED VASCULAR AND THORACIC SURGERY IS ALSO PERFORMED. PATIENTS ARE UNDER THE CARE OF THE HOSPITAL'S MEDICAL STAFF, HOSPITALISTS AND/OR GENERAL SURGEONS ALONG WITH NURSES AND PHYSICIAN ASSISTANTS WHO ARE TRAINED IN CARING FOR PATIENTS WITH COMPLEX MEDICAL NEEDS. THE NURSING CARE TEAM CONSISTS OF REGISTERED NURSES, SURGICAL TECHNICIANS AND QUALIFIED ANCILLARY PERSONNEL WORKING COLLABORATIVELY WITH SURGICAL AND ANESTHESIA PHYSICIANS. THE SCOPE OF NURSING PRACTICE IN THE PERIOPERATIVE AREA INCLUDES PREOPERATIVE ASSESSMENT AND PLANNING, INTRA-OPERATIVE INTERVENTION, POSTOPERATIVE ASSESSMENT AND INTERVENTION, DISCHARGE PLANNING AND DOCUMENTATION TO ENSURE HIGH QUALITY PATIENT CARE AND SAFETY. DURING THE PERIOD COVERED BY THIS FILING, BID-MILTON HAD 6,272 INPATIENT DISCHARGES WITH 26,253 PATIENT DAYS, AND 1,312 TOTAL INPATIENT SURGERIES. FORM 990, PART III, LINE 4C, DESCRIPTION OF PROGRAM SERVICE: EMERGENCY DEPARTMENT BID-MILTON'S EMERGENCY DEPARTMENT (ED) IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK AND PROVIDES EMERGENCY CARE TO ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE ED IS STAFFED BY ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP), AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BID-MILTON'S SISTER ENTITY BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) AND BIDMC AFFILIATED ENTITIES WHICH IS EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BID-MILTON EMERGENCY DEPARTMENT. A HIGHLY TRAINED NURSING STAFF ALSO PROVIDES CARE TO PATIENTS IN THE ED. CRITICALLY INJURED PATIENTS NEEDING THE SERVICES OF A LEVEL I TRAUMA CENTER ARE STABILIZED AND TRANSFERRED TO BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER) IN BOSTON. A RAPID CARDIAC TRANSFER PROGRAM WITH THE MEDICAL CENTER ALSO FACILITATES THE TRANSFER OF PATIENTS NEEDING EMERGENCY CARDIAC CATHETERIZATION. DURING THE PERIOD COVERED BY THIS FILING, BID-MILTON HAD 40,202 EMERGENCY DEPARTMENT VISITS AND 1,872 BEHAVIORAL HEALTH CONSULTS. IN ADDITION TO THE PROGRAM SERVICE ACCOMPLISHMENTS NOTED ABOVE, THE HOSPITAL ENGAGED IN SIGNIFICANT COMMUNITY BENEFITS ACTIVITIES. ALSO AS PREVIOUSLY NOTED, THE HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. THE BILH NETWORK HAD SIGNIFICANT ACTIVITIES ACROSS ITS ENTITIES RELATED TO BOTH BEHAVIORAL HEALTH AND OTHER HEALTHCARE INITIATIVES. SEE THE NARRATIVE SUPPORT FOR SCHEDULE H FOR ADDITIONAL DETAILS. FORM 990, PART IV, LINE 12A AND 12B: THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2025. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE 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, (ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (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 HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), THE JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC. (EHRI) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, AND LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS. EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND OTHER AFFILIATES OF EHRI. EACH OF THESE BILH 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. IN ADDITION, THE BILH 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 ACCOUNTS OF THE ENTITIES FOR WHICH HMFP SERVES AS MEMBER ARE ALSO INCLUDED IN THE HMFP AND BILH AUDITED FINANCIAL STATEMENTS. THE AUDIT AND COMPLIANCE COMMITTEE OF BILH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE CONSOLIDATED AUDIT FOR THE NETWORK AS A WHOLE. FORM 990, PART V, LINE 1A: AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS A SUPPORT ORGANIZATION AND THE DIRECT OR INDIRECT SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON. AS PART OF THAT RELATIONSHIP, BILH PROVIDED CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS, INCLUDING AMONG OTHER THINGS, OPERATIONAL SUPPORT SUCH AS PROCESSING PAYROLL AND ACCOUNTS PAYABLE. IN THIS CAPACITY BILH ISSUED ALL FORMS 1099 TO NOT ONLY ITS OWN VENDORS AND SERVICE PROVIDERS, BUT ALSO TO THOSE WHO PROVIDED SERVICES TO BETH ISRAEL DEACONESS HOSPITAL - MILTON. FORMS 1099 WERE ALL ISSUED IN THE BILH NAME AND UNDER THE BILH EIN. HOWEVER, IN ACCORDANCE WITH INSTRUCTIONS TO THIS FORM 990, BETH ISRAEL DEACONESS HOSPITAL - MILTON IS REPORTING THE NUMBER OF FORMS 1099 RELATED TO SERVICES PERFORMED FOR AND PAYMENTS RELATED TO, ITS SERVICE PROVIDERS AS IF THEY WERE PROCESSED DIRECTLY BY BETH ISRAEL DEACONESS HOSPITAL - MILTON. EACH OTHER AFFILIATE IS SIMILARLY REPORTING THE NUMBER OF FORMS 1099 WHICH ARE ATTRIBUTABLE TO THEIR OWN SERVICE PROVIDERS. FORM 990, PART VI, SECTION A, LINE 2 FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS DIRECT OR INDIRECT SOLE MEMBER OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (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 HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS (LCH), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS (NHC), NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC. (EHRI) AND EXETER HOSPITAL. EACH OF THESE AFFILIATES MAY HAVE, IN TURN, SERVED AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE BILH NETWORK OF AFFILIATES. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. FOR THIS SAME PERIOD HMFP SERVED AS THE SOLE MEMBER OF ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER D/B/A LONGWOOD SPECIALTY PHYSICIANS (LSP) AS WELL AS THE DIRECT OR INDIRECT MEMBER OF SEVERAL ADDITIONAL ENTITIES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE NETWORK OF THE AFFILIATED ORGANIZATIONS NOTED ABOVE. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. FORM 990, PART VI, SECTION A, LINE 6 DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS THE SOLE DIRECT MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -- MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL -- NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI) AND BETH ISRAEL LAHEY HEALTH PHARMACY. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE DIRECT OR INDIRECT MEMBER OF THE FILING ENTITY, WITH RESERVED POWERS TO BILH. SEE ADDITIONAL INFORMATION IN FORM 990 PART VI QUESTIONS 7A AND 7B. FORM 990, PART VI, SECTION A, LINE 7A SEE FORM 990, PART VI SECTION A LINE 7B BELOW FORM 990, PART VI, SECTION A, LINE 7B AS NOTED PREVIOUSLY IN THIS FORM 990, BETH ISRAEL LAHEY HEALTH, INC. IS BETH ISRAEL DEACONESS HOSPITAL - MILTON'S SOLE MEMBER. THE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON HAS THE RIGHTS AND POWERS DELINEATED BELOW, AS DESIGNATED IN BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BY-LAWS. BETH ISRAEL DEACONESS HOSPITAL - MILTON MAY BE REFERRED TO AS "THE CORPORATION" IN THE PARAGRAPHS BELOW. RESERVED POWERS SUBJECT TO THE PROVISIONS OF THE ARTICLES OF ORGANIZATION AND BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, BOTH POSITIVE AND NEGATIVE, CONFERRED BY MASSACHUSETTS GENERAL LAWS ("M.G.L.") CHAPTER 180, AS AMENDED, ON MEMBERS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. IN ADDITION, EXCEPT AS ARE EXPRESSLY GRANTED TO BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BOARD OF TRUSTEES ("BOARD") IN THE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, POSITIVE AND NEGATIVE, CONFERRED BY M.G.L. CHAPTER 180 ON BOARDS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. NOTWITHSTANDING THE FOREGOING, THE MEMBER MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BOARD: (A) APPROVE OR REQUIRE ANY CHANGE IN, OR CONSOLIDATION OF PHILANTHROPIC GIFTS, ASSETS, AND PROGRAMS OF THE CORPORATION, WHICH SHALL REMAIN UNDER THE CORPORATION'S CONTROL AND BE USED FOR THE BENEFIT OF THE CORPORATION AND NOT FOR OTHER COMPONENTS OF THE MEMBER'S SYSTEM, EXCEPT TO THE EXTENT THAT SUCH CHANGES INVOLVE BACK-OFFICE CONSOLIDATION WITH OTHER DIRECT OR INDIRECT SUBSIDIARIES OF THE MEMBER; (B) APPROVE OR REQUIRE ANY CHANGE IN THE NAME, BRAND, OR TRADEMARK OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES, EXCEPT SUCH COMPLEMENTARY CHANGES AS THE MEMBER MAY DETERMINE ARE REASONABLY APPROPRIATE IN ESTABLISHING A SYSTEM-WIDE IDENTITY FOR THE AFFILIATED ENTITIES; OR (C) AMEND OR RESTATE BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BYLAWS TO CHANGE OR ELIMINATE EITHER OF THE FOREGOING LIMITATIONS ON ITS POWERS. THE MEMBER MAY NOT CAUSE THE CORPORATION TO CEASE OPERATING A SEPARATELY LICENSED HOSPITAL FACILITY, OR CLOSE ANY ESSENTIAL SERVICE OF SUCH HOSPITAL FACILITY, WITHOUT CONSULTING WITH THE BOARD PRIOR TO TAKING SUCH ACTION. APPOINTMENT, REAPPOINTMENT AND REMOVAL OF BOARD MEMBERS AND CERTAIN EX-OFFICIO STATUS THE MEMBER SHALL HAVE THE EXCLUSIVE AUTHORITY, AFTER CONSULTATION WITH THE CHAIR OF BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BOARD AND THE BETH ISRAEL DEACONESS HOSPITAL - MILTON PRESIDENT AND REVIEW OF RECOMMENDATIONS, IF ANY, MADE BY THE BOARD, TO: (A) APPOINT AND REAPPOINT TRUSTEES (B) FILL ANY VACANCIES IN THE OFFICES OF TRUSTEES, AND (C) ACTING BY VOTE OF NOT LESS THAN THREE QUARTERS (3/4) OF THE MEMBER'S TRUSTEES THEN IN OFFICE, REMOVE, WITH OR WITHOUT CAUSE, A TRUSTEE. NOTWITHSTANDING THE FOREGOING, ANY REMOVAL SHALL BE FOLLOWING NOTICE TO THE CHAIR (OR THE VICE-CHAIR IF THE CHAIR IS THE SUBJECT OF REMOVAL) AND AN OPPORTUNITY FOR THE CHAIR TO BE HEARD BY THE MEMBER'S BOARD OR A STANDING OR AD HOC COMMITTEE THEREOF, EXCEPT IN CIRCUMSTANCES WHERE THE MEMBER DETERMINES THAT IMMEDIATE REMOVAL IS IN THE BEST INTEREST OF THE CORPORATION. IN ADDITION, THE FOLLOWING SERVE EX-OFFICIO ON BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BOARD: - PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE MEMBER OR HIS OR HER DESIGNEE - THE PRESIDENT OF THE CORPORATION, WHO REPORTS TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE MEMBER BOARD POWERS AND RESPONSIBILITIES THE POWERS AND RESPONSIBILITIES OF THE BOARD INCLUDE THE FOLLOWING: (A) PROVIDING RECOMMENDATIONS TO THE MEMBER REGARDING (I) APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES, (II) THE ESTABLISHMENT OF THE CORPORATION'S POLICIES, (III) THE MAINTENANCE OF PATIENT CARE QUALITY, AND (IV) THE PROVISION OF CLINICAL SERVICES AND COMMUNITY SERVICE PLANNING IN A MANNER RESPONSIVE TO LOCAL COMMUNITY NEEDS; (B) ENSURING COMPLIANCE WITH ALL LICENSURE AND ACCREDITATION REQUIREMENTS, INCLUDING CREDENTIALING AND OTHER MEDICAL STAFF MATTERS; (C) PROVIDING OVERSIGHT FOR INSTITUTIONAL PLANNING, MAKING RECOMMENDATIONS FOR NEW CLINICAL SERVICES, AND PARTICIPATING IN AN ANNUAL REVIEW OF THE CORPORATION'S STRATEGIC AND FINANCIAL PLAN AND GOALS; (D) REVIEWING AND RECOMMENDING APPROVAL OF OPERATING AND CAPITAL BUDGETS AS WELL AS MAKING RECOMMENDATIONS WITH RESPECT TO CAPITAL EXPENDITURES; (E) MAKING RECOMMENDATIONS WITH RESPECT TO QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS; (F) PROVIDING OVERSIGHT OF RISK MANAGEMENT PROGRAMS RELATING TO PATIENT CARE AND SAFETY; (G) REVIEWING DISASTER PLANS THAT DEAL WITH BOTH INTERNAL (E.G., FIRE) AND EXTERNAL DISASTERS; AND (H) EVALUATING RECRUITMENT NEEDS TO ENSURE ADEQUATE MEDICAL STAFF CAPACITY TO CONTINUE TO MEET COMMUNITY NEEDS. LIMITATIONS ON BOARD POWERS EXCEPT AS OTHERWISE PROVIDED IN BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BYLAWS, THE BOARD SHALL ACT IN AN ADVISORY CAPACITY AND CONSISTENT THEREWITH SHALL HAVE ONLY THE FOLLOWING POWERS: (A) POWERS EXPRESSLY GRANTED BY THE MEMBER FROM TIME TO TIME; (B) POWER TO EXERCISE ITS AUTHORITY AS A MEMBER OF OTHER LEGAL ENTITIES; (C) POWER TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THE BYLAWS OF THE MEMBER (AS DEFINED UNDER THE BYLAWS OF THE MEMBER) OR UNDER BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BYLAWS WITH RESPECT TO THE MEMBER; AND (D) POWERS TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THAT AGREEMENT DATED JUNE 30, 2017 BY AND AMONG LAHEY HEALTH SYSTEM, INC., BETH ISRAEL DEACONESS MEDICAL CENTER, INC., NEW ENGLAND BAPTIST HOSPITAL, INC., MOUNT AUBURN HOSPITAL, CAREGROUP, INC., AND SEACOAST REGIONAL HEALTH SYSTEMS, INC. THE POWERS OF THE BOARD IN CLAUSES (A) AND (B) IMMEDIATELY ABOVE SHALL BE SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. NOTWITHSTANDING CLAUSE (B) ABOVE, THE POWER OF THE CORPORATION TO EXERCISE ITS AUTHORITY AS A MEMBER OF ANOTHER LEGAL ENTITY SHALL BE SUBJECT TO THE FOLLOWING LIMITATIONS: (X) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER LEGAL ENTITY UNDER MASSACHUSETTS LAW MAY BE EXERCISED BY THE CORPORATION ONLY AT THE EXPRESS AND EXPLICIT DIRECTION OF, AND WITH THE APPROVAL OF, ENTITY-NAME}}'S MEMBER; (Y) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER LEGAL ENTITY UNDER MASSACHUSETTS LAW MAY BE EXERCISED DIRECTLY BY BETH ISRAEL DEACONESS HOSPITAL - MILTON'S MEMBER AFTER CONSULTATION WITH THE CHAIR BUT OTHERWISE WITHOUT THE APPROVAL OR PARTICIPATION OF THE CORPORATION; AND (Z) OTHER THAN STATUTORY POWERS, THE CORPORATION SHALL HAVE ONLY THOSE POWERS AND AUTHORITIES OVER AND WITH RESPECT TO THE LEGAL ENTITIES OF WHICH IT IS A MEMBER AS ARE EXPRESSLY AND EXPLICITLY DELEGATED OR DIRECTED TO THE CORPORATION BY ACTION OF BETH ISRAEL DEACONESS HOSPITAL - MILTON'S MEMBER'S BOARD. OFFICERS APPOINTED BY PERSONS OTHER THAN THE GOVERNING BODY: THE FOLLOWING OFFICERS EACH SERVE EX-OFFICIO, DO NOT HAVE TERMS AND RETAIN THEIR RESPECTIVE POSITIONS AS OFFICERS SO LONG AS THEY RETAIN THE POSITIONS WITH THE MEMBER UPON WHICH EX-OFFICIO STATUS IS CONFERRED: - THE CEO, WHO SHALL BE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE MEMBER; - THE TREASURER, WHO SHALL BE THE TREASURER OF THE MEMBER AND WHO IS ALSO THE CHIEF FINANCIAL OFFICER OF THE MEMBER; - ASSISTANT TREASURER, WHO SHALL BE THE CHIEF FINANCIAL OFFICER (OR COMPARABLE POSITION) OF THE CORPORATION - THE CLERK, WHO SHALL BE THE CLERK OF THE MEMBER AND WHO ALSO SERVES AS GENERAL COUNSEL OF THE MEMBER; - THE ASSISTANT CLERK, WHO SHALL BE THE ATTORNEY IN THE BETH ISRAEL LAHEY HEALTH OFFICE OF GENERAL COUNSEL SUPPORTING THE CORPORATION THE PRESIDENT OF THE CORPORATION SHALL BE APPOINTED, AND MAY BE REMOVED, BY THE CEO AFTER CONSULTATION WITH BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BOARD CHAIR. COMPENSATION: COMPENSATION FOR THE PRESIDENT SHALL BE SET BY THE MEMBER AFTER CONSULTATION WITH BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BOARD CHAIR. COMPENSATION FOR SENIOR EXECUTIVES OF THE CORPORATION SHALL BE SET IN ACCORDANCE WITH POLICIES AND PROCEDURES ESTABLISHED BY THE MEMBER. SEE FORM 990 PART VI SECTION B QUESTIONS 15A AND 15B AS WELL AS FORM 990 SCHEDULE J PART I FOR ADDITIONAL DETAILS. STANDING COMMITTEES OF THE BOARD: BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BOARD SHALL HAVE THE FOLLOWING MANDATORY STANDING COMMITTEES UNLESS OTHERWISE AUTHORIZED BY THE MEMBER: - FINANCE - QUALITY/PATIENT EXPERIENCE AND CARE ASSESSMENT - GOVERNANCE/NOMINATING - MEDICAL STAFF APPOINTMENT - PHILANTHROPY CONFLICT OF INTEREST AND CONFIDENTIALITY OFFICERS, TRUSTEES AND NON-TRUSTEE COMMITTEE MEMBERS SHALL COMPLY IN ALL RESPECTS WITH THE CONFLICT OF INTEREST POLICIES AND PROCEDURES AND THE STATEMENT OF CONFIDENTIALITY OBLIGATIONS ADOPTED BY THE MEMBER FOR APPLICABILITY TO ALL SUBSIDIARIES AND AFFILIATES OF THE MEMBER. SEE FORM 990 PART VI SECTION B QUESTIONS 12A, 12B AND 12C FOR ADDITIONAL DETAILS FORM 990, PART VI, SECTION B, LINE 11B AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE DIRECT OR INDIRECT SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON. THIS FORM 990 IS PREPARED BY THE BILH TAX DEPARTMENT IN CONJUNCTION WITH DELOITTE TAX, LLP (DELOITTE). AS PART OF THIS PROCESS, THE BILH TAX DEPARTMENT WORKS WITH OTHER DISCIPLINES AND FUNCTIONS WITHIN BILH AND BETH ISRAEL DEACONESS HOSPITAL - MILTON TO ENSURE THAT ALL FINANCIAL AND NON-FINANCIAL DISCLOSURES ARE COMPLETE AND ACCURATE. EXAMPLES OF SUCH DEPARTMENTS INCLUDE BUT ARE NOT LIMITED TO: FINANCE AND ACCOUNTING, HUMAN RESOURCES AND PAYROLL, TREASURY, COMPLIANCE, LEGAL, COMMUNITY BENEFITS, FINANCIAL ASSISTANCE AND REIMBURSEMENT, GOVERNANCE, DEVELOPMENT, GRADUATE MEDICAL EDUCATION, GOVERNMENT RELATIONS, RESEARCH AND/OR RESEARCH FINANCE. BETH ISRAEL DEACONESS HOSPITAL - MILTON'S FORM 990 IS REVIEWED INTERNALLY BY THE BILH ASSISTANT VICE PRESIDENT, TAXATION AND EXTERNALLY BY DELOITTE. BETH ISRAEL DEACONESS HOSPITAL - MILTON'S FORM 990, ALONG WITH THE FORMS 990 OF ALL ENTITIES IN THE BILH NETWORK, ARE DISCUSSED WITH THE BILH AUDIT AND COMPLIANCE COMMITTEE. DELOITTE SIGNS THE FINAL RETURNS. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS HOSPITAL - MILTON IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) SYSTEM OF AFFILIATES. ALL ENTITIES IN THE BILH NETWORK ADHERE TO THE BILH CONFLICT OF INTEREST POLICY AND MAINTAIN A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY WHICH HAS BEEN ADOPTED AT THE ENTITY LEVEL. PURSUANT TO THESE POLICIES, BILH ENTITIES' OFFICERS, TRUSTEES AND KEY EMPLOYEES AS WELL AS CERTAIN OTHER INDIVIDUALS ARE REQUIRED TO COMPLETE THE ANNUAL CONFLICT OF INTEREST AND TAX QUESTIONNAIRE (COI-TQ). THE COI-TQ IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS AND FAMILY RELATIONSHIPS AND AFFILIATIONS MAINTAINED BY OFFICERS, TRUSTEES, OR KEY EMPLOYEES AND THEIR FAMILY MEMBERS AND WHICH MAY RESULT IN A REAL OR PERCEIVED CONFLICT OF INTEREST. THE BILH OFFICE OF INTEGRITY AND COMPLIANCE, IN CONJUNCTION WITH THE BILH TAX DEPARTMENT, ADMINISTERS THE COI-TQ PROCESS ANNUALLY. BILH INTEGRITY AND COMPLIANCE COLLECTS AND REVIEWS ALL DISCLOSURES. A SUMMARY OF POSITIVE RESPONSES FOR EACH BILH AFFILIATE IS PROVIDED TO THE COMPLIANCE OFFICER FOR THAT ENTITY FOR REVIEW FINAL DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. ANY ACTIVITY THAT REQUIRES ACTION UNDER THE CONFLICT OF INTEREST POLICIES IS SUBJECT TO ONGOING REVIEW BY BETH ISRAEL DEACONESS HOSPITAL - MILTON AS WELL AS THE BILH INTEGRITY AND COMPLIANCE OFFICE. PURSUANT TO THE BILH CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A MANAGEMENT PLAN INCLUDING DISCLOSURE AND RECUSAL WHICH REQUIRES APPROPRIATE DOCUMENTATION IN THE MINUTES. IN ADDITION, AS NOTED ABOVE, THE ANNUAL COI-TQ PROCESS OUTLINED ABOVE IS JOINTLY ISSUED BY THE BILH TAX DEPARTMENT, TO ENSURE THAT THE QUESTIONNAIRE IS DISTRIBUTED TO ALL CURRENT AND FORMER MEMBERS OF THE BETH ISRAEL DEACONESS HOSPITAL - MILTON BOARD OF TRUSTEES AS WELL AS CURRENT AND FORMER OFFICERS AND KEY EMPLOYEES. THE COI-TQ PROCESS IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR BETH ISRAEL DEACONESS HOSPITAL - MILTON TO COMPLETELY AND ACCURATELY COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS HOSPITAL - MILTON IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS BETH ISRAEL DEACONESS HOSPITAL - MILTON'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. IN THIS ROLE BILH MAINTAINS THE RESPONSIBILITY FOR SETTING COMPENSATION FOR EXECUTIVES, SENIOR MANAGEMENT, OFFICERS AND KEY EMPLOYEES OF THE ENTITIES WHICH COMPRISED THE BETH ISRAEL LAHEY HEALTH NETWORK. THE BILH COMPENSATION COMMITTEE IS THEREFORE RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES, THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES AND EXCEPT AS OTHERWISE NOTED BELOW OR IN FORM 990 SCHEDULE J, THE COMPENSATION REPORTED IN THIS FORM 990 FOR BETH ISRAEL DEACONESS HOSPITAL - MILTON'S OFFICERS AND KEY EMPLOYEES WAS SET BY THE BILH COMPENSATION COMMITTEE. THE BILH COMPENSATION COMMITTEE PROCESS FOR SETTING COMPENSATION IS BELOW. THE BETH ISRAEL LAHEY HEALTH (BILH) COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER MEMBERS OF EXECUTIVE MANAGEMENT IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO AS VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS FOR BOTH THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES ARE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS HOSPITAL - MILTON IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS BETH ISRAEL DEACONESS HOSPITAL - MILTON'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. BETH ISRAEL DEACONESS HOSPITAL - MILTON'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL LAHEY HEALTH TAX DEPARTMENT SCHRAFFT'S CITY CENTER, 4TH FLOOR, 529 MAIN STREET CHARLESTOWN, MA 02129 FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 17,153,012. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,153,012. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,583,783. MANAGEMENT AND GENERAL EXPENSES 198,234. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,782,017. OUTSIDE LABOR: PROGRAM SERVICE EXPENSES 3,819,324. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,819,324. LAB SERVICES: PROGRAM SERVICE EXPENSES 487,609. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 487,609. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 232,155. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 232,155. FORM 990, PART XI, LINE 9: CHANGE IN FUNDED STATUS OF BENEFITS 1,124,692. TRANSFER OF NET ASSETS -5,157,007. PLEDGE ADJUSTEMENT -403,633. LOSS ON EARLY EXTINGUISHMENT OF DEBT -64,888. PART XII, LINE 2C: AS NOTED THROUGHOUT THIS FORM 990, BETH ISRAEL DEACONESS HOSPITAL - MILTON IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL LAHEY HEALTH (BILH) SERVES AS THE DIRECT OR INDIRECT MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON AND BETH ISRAEL DEACONESS HOSPITAL - MILTON IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF BETH ISRAEL LAHEY HEALTH. THE AUDIT AND COMPLIANCE COMMITTEE OF BILH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE CONSOLIDATED AUDIT FOR THE NETWORK AS A WHOLE. ADDISON GILBERT SOCIETY INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 464371382 PROFESSIONAL SERVICES & FINANCIAL SUPPORT MA 501(C)(3) 10 LAHEY HEALTH SHARED SERVICES INC 1 ANNA JAQUES HOSPITAL 25 HIGHLAND AVE NEWBURYPORT MA 01950 042104338 HEALTHCARE MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 ASSOC PHYS HARVARD MED FAC PHY AT BIDMC 375 LONGWOOD AVE BOSTON MA 02215 320058309 TO PROVIDE EMERGENCY MEDICAL SERVICES MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BAIM INSTITUTE FOR CLINICAL RESEARCH INC DBA BAIM INSTITUTE 930 COMMONWEALTH AVE BOSTON MA 02215 043521077 SCIENTIFIC & MEDICAL RESEARCH MA 501(C)(3) 10 N/A 0 BETH ISRAEL ANAESTHESIA FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042997215 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL COMMUNITY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042776678 INACTIVE CORPORATION MA 501(C)(3) 7 N/A 0 BETH ISRAEL DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 364803234 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043079630 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 208253452 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043030397 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 204974585 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF RADIATION ONCOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 873655583 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HMFP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC 110 FRANCIS ST BOSTON MA 02215 020671240 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS HOSPITAL NEEDHAM INC 148 CHESTNUT ST NEEDHAM MA 02492 043229679 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH INC 275 SANDWICH ST PLYMOUTH MA 02360 222667354 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DEACONESS MEDICAL CENTER INC 330 BROOKLINE AVE BOSTON MA 02215 042103881 THE OPERATION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DERMATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043117601 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL LAHEY HEALTH PHARMACY INC 80 WILSON WAY WESTWOOD MA 02090 822526816 TO OPERATE A SPECIALTY PHARMACY AND 340B PROGRAM FOR BIDMC MA 501(C)(3) 10 BETH ISRAEL DEACONESS MEDICAL CENTER INC 1 BETH ISRAEL LAHEY HEALTH PRIMARY CARE 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 472248298 HEALTHCARE MA 501(C)(3) 10 LAHEY HEALTH SHARED SERVICES INC 1 BETH ISRAEL LAHEY HEALTH INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 832671600 MANAGEMENT PROFESSIONAL & IT SUPPORT SERVICES MA 501(C)(3) 12C, III-FI N/A 0 BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP 300 LONGWOOD AVE BOSTON MA 02215 043200113 OUTPATIENT AMBULATORY CENTER - 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IN THIS CAPACITY, BIDM, HAS MADE LOAN GUARANTEES TO THE FOLLOWING OTHER MEMBERS OF THE OBLIGATED GROUP TOTALING $2,802,213,634: 1. ANNA JAQUES HOSPITAL 2. BETH ISRAEL DEACONESS MEDICAL CENTER 3. LAHEY CLINIC FOUNDATION 4. MOUNT AUBURN HOSPITAL 5. NORTHEAST HOSPITAL CORP D/B/A BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS 6. WINCHESTER HOSPITAL 7. BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH 8. NEW ENGLAND BAPTIST HOSPITAL 9. BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 10. EXETER HOSPITAL FORM 990, SCH R, PART V, LN 1S - OTHER TRANSFER OF CASH/PROP TO RO AS NOTED THROUGHOUT THIS FILING, BIDM IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, ONE OR MORE OF ITS AFFILIATED ENTITIES MADE CASH PAYMENTS TO BIDM AS PART OF NETWORK-WIDE CASH MANAGEMENT AND IN FURTHERANCE OF THE EXEMPT PURPOSE OF BIDM AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, THE FOLLOWING CASH OR PROPERTY WAS TRANSFERRED TO BIDM BY ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH, INC.: A. NET ASSET TRANSFERS TO SUPPORT PATIENT CARE IN THE COMMUNITIES SERVED: $334,564 B. TRANSFERS - EMPLOYEE PAYROLL TAXES: $20,252,447 C. TRANSFERS RELATED TO EPIC IMPLEMENTATION: $11,462,214 D. OTHER FUNDS TRANSFER - BILHPN: $216,677 2. BID-MILTON PHYSICIAN ASSOCIATES: CASH TRANSFERS: $723,615 3. COMMUNITY PHYSICIANS ASSOCIATES: A. CASH TRANSFERS: $1,369,131 B. OTHER TRANSFERS: $164,847 FORM 990, SCH R, PART V, LN 1E LOANS/LOAN GUARANTEES BY RO BIDM IS A MEMBER OF THE BILH OBLIGATED GROUP AND AS SUCH ALL OTHER MEMBERS OF THE BILH OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR THE OBLIGATED GROUP DEBT OUTSTANDING AT BIDM. IN THIS CAPACITY, THE ENTITIES LISTED BELOW HAVE LOAN GUARANTEES TO BIDM TOTALING $70,069,082 1. ANNA JAQUES HOSPITAL 2. BETH ISRAEL DEACONESS MEDICAL CENTER 3. LAHEY CLINIC FOUNDATION 4. LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS 5. LAHEY CLINIC, INC. 6. MOUNT AUBURN HOSPITAL 7. MOUNT AUBURN PROFESSIONAL SERVICES 8. NORTHEAST HOSPITAL CORP. D/B/A BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS 9. WINCHESTER HOSPITAL 10. BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH 11. NEW ENGLAND BAPTIST HOSPITAL 12. BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 13. EXETER HOSPITAL 14. MEDICAL CARE OF BOSTON MANAGEMENT CORP. D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE FORM 990, SCH R, PART V, LN 1J - LEASE OF FAC/EQUIP/OTHER ASSETS TO RO AS NOTED THROUGHOUT THIS FILING, BIDM IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THE CLOSE CONNECTION BETWEEN BIDM, MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A BILH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP (("APG") A RELATED ENTITY EXEMPT UNDER IRC 501(C)(3)), AND COMMUNITY PHYSICIANS ASSOCIATES (("CPA") A RELATED ENTITY EXEMPT UNDER IRC 501(C)(3)), APG AND CPA LEASE SPACE FROM BIDM TO USE IN FURTHERANCE OF THE BIDM, APG, CPA, AND BILH TAX-EXEMPT PURPOSES. APG AND CPA PAID BIDM $502,974 AND $167,133, RESPECTIVELY, FOR SPACE RENTAL. FORM 990, SCH R, PART V, LN 1K LEASE OF FAC/EQUIP/OTHER ASSETS FROM RO AS NOTED ELSEWHERE IN THIS FILING, BIDM IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THE CLOSE CONNECTION BETWEEN BIDM AND BID-MILTON PHYSICIAN ASSOCIATES, INC. (("BIDMPA") A RELATED ENTITY EXEMPT UNDER IRC 501(C)(3)), BIDM LEASES SPACE FROM BIDMPA TO USE IN FURTHERANCE OF THE BIDM, BIDMPA, AND BILH TAX-EXEMPT PURPOSES. BIDM PAID BIDMPA $193,470 FOR SPACE RENTAL. FORM 990, SCH R, PART V, LN 1M - PERF OF SVCS/MEMBERSHIP/FUNDRAISING BY RO AS NOTED THROUGHOUT THIS FILING, BIDM IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, ONE OR MORE OF BIDM'S AFFILIATES PROVIDED SERVICES TO BIDM IN FURTHERANCE OF THE EXEMPT PURPOSE OF BIDM AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, BIDM RECEIVED THE FOLLOWING SERVICES FROM ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH, INC. AS A SUPPORT ORGANIZATION OF BIDM, BILH PROVIDES CENTRALIZED SUPPORT TO, AND OVERSEES THE FINANCIAL WELL-BEING OF, ITS NETWORK OF SUPPORTED ORGANIZATIONS. THESE ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING AREAS: EXECUTIVE MANAGEMENT AND OPERATIONAL LEADERSHIP, STRATEGIC PLANNING, HUMAN RESOURCES AND BENEFIT PLAN STRUCTURING, DEVELOPMENT AND FUNDRAISING, COMPLIANCE, GOVERNANCE AND LEGAL, PAYOR CONTRACTING, REVENUE CYCLE, FINANCIAL PLANNING & ANALYSIS, CAPITAL PLANNING, FINANCE AND ACCOUNTING INCLUDING PROCESSING PAYROLL AND ACCOUNTS PAYABLE, INTERNAL AND EXTERNAL AUDIT, INSURANCE, DEBT STRUCTURING SUPPORT AND FINANCING OF CAPITAL PROJECTS THROUGH ITS OBLIGATED GROUP DEBT, TAX SERVICES, INVESTMENT MANAGEMENT SERVICES, SUPPLY CHAIN MANAGEMENT AND PURCHASING AND NETWORK-WIDE CASH MANAGEMENT. NETWORK ASSESSMENT FEE FOR SERVICES ABOVE: $22,842,366 A. OPERATION OF PAYROLL AND PROVISION OF EMPLOYEE BENEFITS: $55,079,850 B. OPERATION OF ACCOUNTS PAYABLE AND PAYMENT FOR THIRD PARTY SERVICES: $79,102,804 C. SEE OTHER CODES FOR ADDITIONAL DETAIL. 2. BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH - HISTOLOGY LAB SERVICES: $213,514 3. BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH - INTERFACILITY LAB SERVICES: $239,629 4. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISREAL DEACONESS MEDICAL CENTER D/B/A LONGWOOD SPECIALTY PHYSICIANS - PHYSICIAN SERVICES TO CARE FOR PATIENTS: $11,378,414 5. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - PHYSICIAN SERVICES TO CARE FOR PATIENTS: $4,674,531 6. JORDAN PHYSICIAN ASSOCIATES - PHYSICIAN SERVICES TO CARE FOR PATIENTS: $158,732 7. NORTHEAST BEHAVIORAL HEALTH CORPORATION - PATIENT PSYCHOLOGICAL EVALUATION SERVICES: $1,089,606 8. WINCHESTER HOSPITAL - INTERFACILITY LAB SERVICES: $374,607 FORM 990, SCH R, PART V, LN 1O - SHARING OF PAID EMPLOYEES WITH RO 1. BETH ISRAEL LAHEY HEALTH, INC. - SEE NOTE ABOVE IN CODE M FOR SUPPORTING DETAIL: $466,993 2. BETH ISRAEL DEACONESS MEDICAL CENTER - SHARING OF EMPLOYEES: $87,435 3. BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH - SHARING OF EMPLOYEES: $51,595 4. COMMUNITY PHYSICIANS ASSOCIATES - SHARING OF EMPLOYEES: $73,085 FORM 990, SCH R, PART V, LN 1P - REIMB. PAID TO RO FOR EXPENSES AS NOTED THROUGHOUT THIS FILING, BIDM IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, BIDM REIMBURSED ONE OR MORE OF ITS AFFILIATED ENTITIES FOR EXPENSES INCURRED ON BEHALF OF BIDM IN FURTHERANCE OF THE EXEMPT PURPOSE OF BIDM AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, BIDM MADE THE FOLLOWING REIMBURSEMENTS FOR EXPENSES TO ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH, INC. - REIMBURSEMENT FOR EMPLOYEE SALARY AND BENEFITS CHARGES: $9,917,587 2. BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH - REIMBURSEMENT FOR EMPLOYEE SALARY AND BENEFITS CHARGES: $65,763 3. MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE - REIMBURSEMENT FOR MALPRACTICE REIMBURSEMENT: $124,469 4. JORDAN PHYSICIAN ASSOCIATES - REIMBURSEMENT FOR PATIENT PSYCHOLOGICAL EVALUATION SERVICES: $54,488 FORM 990, SCH R, PART V, LN 1Q - REIMB. PAID BY RO FOR EXPENSES AS NOTED THROUGHOUT THIS FILING, BIDM IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, BIDM WAS REIMBURSED BY ONE OR MORE OF ITS AFFILIATED ENTITIES FOR EXPENSES INCURRED IN FURTHERANCE OF THE EXEMPT PURPOSE OF BIDM AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, BIDM RECEIVED THE FOLLOWING REIMBURSEMENTS FOR EXPENSES FROM ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH, INC. - REIMBURSEMENT FOR CREDIT CARD PROCESSING FEES AND OTHER ADMINISTRATIVE EXPENSES: $468,339 2. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISREAL DEACONESS MEDICAL CENTER D/B/A LONGWOOD SPECIALTY PHYSICIANS - EXPENSE REIMBURSEMENT FOR RENT, MALPRACTICE INSURANCE, STAFF DUES AND OTHER EXPENSES: $1,119,637 3. BID-MILTON PHYSICIAN ASSOCIATES - A. EXPENSE REIMBURSEMENT FOR SALARIES, BENEFITS, ADMINISTRATIVE AND OTHER COSTS: $ 2,829,397 B. MANAGEMENT FEES: $48,000 4. COMMUNITY PHYSICIANS ASSOCIATES - EXPENSE REIMBURSEMENT FOR BENEFITS, MALPRACTICE INSURANCE AND OTHER EXPENSES: $293,739 5. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - EXPENSE REIMBURSEMENT FOR RENT, MALPRACTICE INSURANCE, STAFF DUES AND OTHER EXPENSES: $580,929 FORM 990, SCH R, PART V, LN 1R - OTHER TRANSFER OF CASH/PROP TO RO AS NOTED THROUGHOUT THIS FILING, BIDM IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, BIDM TRANSFERRED CASH TO ONE OR MORE OF ITS AFFILIATED ENTITIES AS PART OF NETWORK-WIDE CASH MANAGEMENT AND IN FURTHERANCE OF THE EXEMPT PURPOSE OF BIDM AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, BIDM TRANSFERRED THE FOLLOWING CASH OR PROPERTY TO ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH, INC. (SEE ADDITIONAL INFORMATION ABOVE IN CODE M) A. CASH TRANSFERS: $171,430,383 B. OTHER TRANSFERS: $617,707 2. BETH ISRAEL DEACONESS MEDICAL CENTER - A. OTHER CASH TRANSFERS: $370,209 3. BID-MILTON PHYSICIAN ASSOCIATES - NET ASSET TRANSFERS TO SUPPORT PATIENT CARE IN THE COMMUNITIES SERVED: $980,407 4. MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE: A. INSURANCE PREMIUM REBATE: $173,375 B. STIPEND EXPENSES: $110,000 5. COMMUNITY PHYSICIANS ASSOCIATES: A. NET ASSET TRANSFERS TO SUPPORT PATIENT CARE IN THE COMMUNITIES SERVED: $4,511,164 B. INSURANCE PREMIUM REBATE: $117,250