TY 2019 Form 990 Schedule H

Instrumentl eFile RenderObject ID: 202231799349300208 - Rendered 2024-05-02 TIN: 90-0656139

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

MASS GENERAL BRIGHAM INCORPORATED &
AFFILIATES GROUP RETURN

Employer identification number

90-0656139

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	130,569,955	37,862,375	92,707,580	0.610 %
b	Medicaid (from Worksheet 3, column a) . . . . .	1,365,242,429	796,248,276	568,994,153	3.740 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	1,495,812,384	834,110,651	661,701,733	4.350 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	43,562,056	12,145,058	31,416,998	0.210 %
f	Health professions education (from Worksheet 5) . . .	252,178,948	70,488,271	181,690,677	1.190 %
g	Subsidized health services (from Worksheet 6) . . . .	141,587,214	83,407,320	58,179,894	0.380 %
h	Research (from Worksheet 7) .	1,866,740,075	1,604,676,696	262,063,379	1.720 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	15,903,934		15,903,934	0.100 %
j	Total. Other Benefits . .	2,319,972,227	1,770,717,345	549,254,882	3.600 %
k	Total. Add lines 7d and 7j .	3,815,784,611	2,604,827,996	1,210,956,615	7.950 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

82,104,091

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

2,335,632,270

Enter Medicare allowable costs of care relating to payments on line 5.....

3,256,966,518

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-921,334,248

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?15Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)									Other (describe)
1	THE GENERAL HOSPITAL CORPORATION 55 FRUIT STREET BOSTON,MA02114 WWW.MASSGENERAL.ORG 04-2697983	X	X	X	X		X	X
2	THE BRIGHAM AND WOMEN'S HOSPITAL INC 75 FRANCIS STREET BOSTON,MA02115 WWW.BRIGHAMANDWOMENS.ORG 04-2312909	X	X	X	X		X	X
3	NORTH SHORE MEDICAL CENTER INC 81 HIGHLAND AVENUE SALEM,MA01970 WWW.NSMC.PARTNERS.ORG 04-3399616	X	X	X	X		X	X
4	NEWTON-WELLESLEY HOSPITAL 2014 WASHINGTON STREET NEWTON,MA02462 WWW.NWH.ORG 04-2103611	X	X	X	X		X	X
5	BRIGHAM AND WOMEN'S FAULKNER HOSPITAL 1153 CENTRE STREET BOSTON,MA02130 WWW.BRIGHAMANDWOMENSFAULKNER.ORG 04-2768256	X	X		X		X	X
6	THE MCLEAN HOSPITAL CORPORATION 115 MILL STREET BELMONT,MA02478 WWW.MCLEANHOSPITAL.ORG 04-2697981	X			X		X
7	THE SPAULDING REHABILITATION HOSPITAL 300 FIRST AVENUE CHARLESTOWN,MA02129 WWW.SPAULDINGNETWORK.ORG 04-2551124	X							REHAB. FACILITY
8	REHABILITATION HOSPITAL OF THE CAPE 311 SERVICE ROAD EAST SANDWICH,MA02537 WWW.SPAULDINGNETWORK.ORG 04-3071419	X							REHAB. FACILITY
9	SPAULDING HOSPITAL - CAMBRIDGE INC 1575 CAMBRIDGE STREET CAMBRIDGE,MA02138 WWW.SPAULDINGNETWORK.ORG 27-0273715	X							REHAB. FACILITY
10	NANTUCKET COTTAGE HOSPITAL 57 PROSPECT STREET NANTUCKET,MA02554 WWW.NANTUCKETHOSPITAL.ORG 04-2103823	X						X
11	MARTHA'S VINEYARD HOSPITAL LINTON LANE PO BOX 1477 OAK BLUFFS,MA02557 WWW.MVHOSPITAL.COM 04-2104691	X				X		X
12	NORTH SHORE MEDICAL CENTER INC 500 LYNNFIELD STREET LYNN,MA01904 WWW.NSMC.PARTNERS.ORG 04-3399616	X	X	X	X		X	X
13	COOLEY DICKINSON HOSPITAL INC 30 LOCUST STREET NORTHHAMPTON,MA01060 WWW.COOLEY-DICKINSON.ORG 22-2617175	X	X					X
14	WENTWORTH-DOUGLASS HOSPITAL 789 CENTRAL AVENUE DOVER,NH03820 WWW.WDHOSPITAL.COM 02-0260334	X	X					X
15	MASSACHUSETTS EYE & EAR INFIRMARY 243 CHARLES STREET BOSTON,MA02114 WWW.MASSEYEANDEAR.ORG 04-2103591	X			X		X	X

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	THE GENERAL HOSPITAL CORPORATION
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	THE GENERAL HOSPITAL CORPORATION
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	THE GENERAL HOSPITAL CORPORATION
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	THE GENERAL HOSPITAL CORPORATION
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	THE BRIGHAM AND WOMEN'S HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	THE BRIGHAM AND WOMEN'S HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	THE BRIGHAM AND WOMEN'S HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	THE BRIGHAM AND WOMEN'S HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	NORTH SHORE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	NORTH SHORE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	NORTH SHORE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	NORTH SHORE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	NEWTON-WELLESLEY HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	NEWTON-WELLESLEY HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	NEWTON-WELLESLEY HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	NEWTON-WELLESLEY HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	BRIGHAM AND WOMEN'S FAULKNER HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	BRIGHAM AND WOMEN'S FAULKNER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	BRIGHAM AND WOMEN'S FAULKNER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	BRIGHAM AND WOMEN'S FAULKNER HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	THE MCLEAN HOSPITAL CORPORATION
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	THE MCLEAN HOSPITAL CORPORATION
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	THE MCLEAN HOSPITAL CORPORATION
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	THE MCLEAN HOSPITAL CORPORATION
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	THE SPAULDING REHABILITATION HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	THE SPAULDING REHABILITATION HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	THE SPAULDING REHABILITATION HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	THE SPAULDING REHABILITATION HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	REHABILITATION HOSPITAL OF THE CAPE
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	REHABILITATION HOSPITAL OF THE CAPE
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	REHABILITATION HOSPITAL OF THE CAPE
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	REHABILITATION HOSPITAL OF THE CAPE
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	SPAULDING HOSPITAL - CAMBRIDGE INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	SPAULDING HOSPITAL - CAMBRIDGE INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	SPAULDING HOSPITAL - CAMBRIDGE INC
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	SPAULDING HOSPITAL - CAMBRIDGE INC
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	NANTUCKET COTTAGE HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	NANTUCKET COTTAGE HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	NANTUCKET COTTAGE HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	NANTUCKET COTTAGE HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	MARTHA'S VINEYARD HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MARTHA'S VINEYARD HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	MARTHA'S VINEYARD HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	MARTHA'S VINEYARD HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	NORTH SHORE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	NORTH SHORE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	NORTH SHORE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	NORTH SHORE MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	COOLEY DICKINSON HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	COOLEY DICKINSON HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	COOLEY DICKINSON HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	COOLEY DICKINSON HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	WENTWORTH-DOUGLASS HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	WENTWORTH-DOUGLASS HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	WENTWORTH-DOUGLASS HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	WENTWORTH-DOUGLASS HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	MASSACHUSETTS EYE & EAR INFIRMARY
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFO

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MASSACHUSETTS EYE & EAR INFIRMARY
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H SUPPLEMENTAL INFO

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H SUPPLEMENTAL INFO

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	MASSACHUSETTS EYE & EAR INFIRMARY
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	MASSACHUSETTS EYE & EAR INFIRMARY
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
THE GENERAL HOSPITAL CORPORATION	PART V, SECTION B, LINE 5: IN EACH COLLABORATIVE, PARTICIPANTS ENGAGED COMMUNITY ORGANIZATIONS, LOCAL OFFICIALS, SCHOOLS, HEALTH CARE PROVIDERS, THE BUSINESS AND FAITH COMMUNITIES, RESIDENTS, AND OTHERS IN AN APPROXIMATELY YEAR-LONG PROCESS, TAILORED TO UNIQUE LOCAL CONDITIONS, TO BETTER UNDERSTAND THE HEALTH ISSUES THAT MOST AFFECT COMMUNITIES AND THE ASSETS AVAILABLE TO ADDRESS THEM. THE KEY METHODS OF THE CHNA INCLUDED: PRIMARY DATA COLLECTION VIA BROADLY DISTRIBUTED MULTILINGUAL (UP TO SEVEN LANGUAGES) COMMUNITY SURVEYS WITH 4,298 TOTAL RESPONDENTS; 39 FOCUS GROUPS WITH 350 COMMUNITY RESIDENTS IN ENGLISH, SPANISH, CHINESE, AND HAITIAN CREOLE; AND, 73 KEY INFORMANT INTERVIEWS WITH ORGANIZATIONAL, GOVERNMENT, AND COMMUNITY LEADERS. REVIEW OF SECONDARY DATA FROM MULTIPLE CITY, STATE, AND NATIONAL SOURCES INCLUDING THE U.S. CENSUS, THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, THE BOSTON PUBLIC HEALTH COMMISSION, AND THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS). RIGOROUS DATA ANALYSIS, INCLUDING REVIEWING DIFFERENCES AMONG CERTAIN POPULATIONS, SPECIFICALLY YOUTH AND ELDERLY, AS WELL AS BY RACE AND ETHNICITY. A HIGHLY PARTICIPATORY PROCESS. IN BOSTON THAT MEANT THE PUBLIC WAS INVITED TO THREE SEPARATE MEETINGS ATTENDED BY 75-150 PEOPLE EACH TO GUIDE THE PROCESS DESIGN, REVIEW DATA, SELECT PRIORITIES, AND DEVELOP STRATEGIES.
THE BRIGHAM AND WOMEN'S HOSPITAL, INC	PART V, SECTION B, LINE 5: BWH PARTICIPATED IN THE COLLABORATIVE, A COLLABORATION FORMED IN 2018 TO UNDERTAKE THE FIRST LARGE-SCALE COLLABORATIVE CITYWIDE CHNA-CHIP. THE COLLABORATIVE HIRED HEALTH RESOURCES IN ACTION (HRIA), A NONPROFIT PUBLIC HEALTH ORGANIZATION, AS A CONSULTANT PARTNER TO PROVIDE STRATEGIC GUIDANCE AND FACILITATION OF THE PROCESS, COLLECT AND ANALYZE DATA, AND PREPARE THE REPORT. THE COLLABORATIVE AIMED TO ENGAGE AGENCIES, ORGANIZATIONS, AND RESIDENTS IN BOSTON THROUGH ITS VARIOUS COMMITTEES AND GROUPS. SECONDARY DATA FROM A VARIETY OF SOURCES WERE ANALYZED DURING THIS PROCESS, INCLUDING, BUT NOT LIMITED TO, THE BOSTON BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BBRFSS), YOUTH RISK BEHAVIOR SURVEY (YRBS), U.S. CENSUS AMERICAN COMMUNITY SURVEY (ACS), VITAL RECORDS, AND THE ACUTE HOSPITAL CASE MIX DATABASE FROM THE CENTER FOR HEALTH INFORMATION AND ANALYSIS. PRIMARY DATA WERE COLLECTED THROUGH A COMMUNITY SURVEY, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. FORTY-FIVE KEY INFORMANT INTERVIEWS WERE COMPLETED, SIX OF WHICH WERE ADDITIONAL INTERVIEWS SUBMITTED BY WORK GROUP VOLUNTEERS. INTERVIEWS WERE 45-60 MINUTE SEMI-STRUCTURED DISCUSSIONS THAT ENGAGED INSTITUTIONAL, ORGANIZATIONAL, COMMUNITY LEADERS, AND FRONT-LINE STAFF ACROSS THE FOLLOWING SECTORS: PUBLIC HEALTH, HEALTH CARE, HOUSING AND HOMELESSNESS, TRANSPORTATION, COMMUNITY DEVELOPMENT, FAITH, EDUCATION, PUBLIC SAFETY, ENVIRONMENTAL JUSTICE, GOVERNMENT, WORKFORCE DEVELOPMENT, SOCIAL SERVICES, FOOD INSECURITY, AND BUSINESS ORGANIZATIONAL STAFF THAT WORK WITH SPECIFIC POPULATIONS SUCH AS YOUTH, SENIORS, DISABLED, LGBTQ, AND IMMIGRANTS.
NORTH SHORE MEDICAL CENTER, INC.	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT DEFINES HEALTH IN THE BROADEST SENSE AND RECOGNIZES THAT NUMEROUS FACTORS AND MULTIPLE LEVELSFROM LIFESTYLE BEHAVIORS (E.G., DIET AND EXERCISE) TO CLINICAL CARE (E.G., ACCESS TO MEDICAL SERVICES) TO SOCIAL AND ECONOMIC FACTORS (E.G., EMPLOYMENT OPPORTUNITIES) TO THE PHYSICAL ENVIRONMENT (E.G., AIR QUALITY) ALL HAVE AN IMPACT ON THE COMMUNITY'S HEALTH. APPROACH AND SOCIAL DETERMINANTS OF HEALTH FRAMEWORK IT IS IMPORTANT TO RECOGNIZE THAT MULTIPLE FACTORS HAVE AN IMPACT ON HEALTH, AND THERE IS A DYNAMIC RELATIONSHIP BETWEEN PEOPLE AND THEIR LIVED ENVIRONMENTS. WHERE WE ARE BORN, GROW, LIVE, WORK, AND AGEFROM THE ENVIRONMENT IN THE WOMB TO OUR COMMUNITY ENVIRONMENT LATER IN LIFEAND THE INTERCONNECTIONS AMONG THESE FACTORS ARE CRITICAL TO CONSIDER. THAT IS, NOT ONLY DO PEOPLE'S GENES AND LIFESTYLE BEHAVIORS AFFECT THEIR HEALTH, BUT HEALTH IS ALSO INFLUENCED BY MORE UPSTREAM FACTORS SUCH AS EMPLOYMENT STATUS AND QUALITY OF HOUSING STOCK. THE SOCIAL DETERMINANTS OF HEALTH FRAMEWORK ADDRESSES THE DISTRIBUTION OF WELLNESS AND ILLNESS AMONG A POPULATION. WHILE THE DATA TO WHICH WE HAVE ACCESS IS OFTEN A SNAPSHOT OF A POPULATION IN TIME, THE PEOPLE REPRESENTED BY THAT DATA HAVE LIVED THEIR LIVES IN WAYS THAT ARE CONSTRAINED AND ENABLED BY ECONOMIC CIRCUMSTANCES, SOCIAL CONTEXT, AND GOVERNMENT POLICIES. BUILDING ON THIS FRAMEWORK, THIS ASSESSMENT APPROACHES DATA IN A MANNER DESIGNED TO DISCUSS WHO IS HEALTHIEST AND LEAST HEALTHY IN THE COMMUNITY, AS WELL AS EXAMINES THE LARGER SOCIAL AND ECONOMIC FACTORS ASSOCIATED WITH GOOD AND ILL HEALTH.
NEWTON-WELLESLEY HOSPITAL	PART V, SECTION B, LINE 5: THE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH AND EXAMINED HEALTH IN ITS BROADEST CONTEXT. AS PART OF THIS ASSESSMENT, NWH SOUGHT INPUT FROM ITS COMMUNITY BENEFITS COMMITTEE TO INFORM THE METHODOLOGY, INCLUDING RECOMMENDATION OF SECONDARY DATA SOURCES, AND IDENTIFICATION OF KEY INFORMANTS AND FOCUS GROUP SEGMENTS. THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING DATA ON SOCIAL, ECONOMIC, AND HEALTH INDICATORS FROM VARIOUS SOURCES, AS WELL AS, CONDUCTING EIGHT INTERVIEWS AND SIX FOCUS GROUPS TO EXPLORE PERCEPTIONS OF THE COMMUNITY, HEALTH AND SOCIAL CHALLENGES FOR COMMUNITY MEMBERS, AND RECOMMENDATIONS FOR HOW TO ADDRESS THESE CONCERNS. IN TOTAL, OVER 50 INDIVIDUALS WERE ENGAGED IN THE 2018 ASSESSMENT PROCESS.
BRIGHAM AND WOMEN'S FAULKNER HOSPITAL	PART V, SECTION B, LINE 5: THE CHNA AIMED TO ENGAGE AGENCIES, ORGANIZATIONS AND RESIDENTS IN BOSTON THROUGH DIFFERENT AVENUES. THE COLLABORATIVE'S STRUCTURE PROVIDED AN ENGAGEMENT AND DECISION-MAKING FRAMEWORK FOR THIS WORK. IT IS COMPRISED OF THE FOLLOWING: STEERING COMMITTEE COMPRISED OF 19 MEMBERS REPRESENTING HOSPITALS, HEALTH CENTERS, BOSTON PUBLIC HEALTH COMMISSION, PUBLIC HEALTH ORGANIZATION FOCUSED ON COMMUNITY, COMMUNITY DEVELOPMENT CORPORATIONS AND 8 COMMUNITY REPRESENTATIVES. ITS ROLE IS TO PROVIDE STRATEGIC DIRECTION AND OVERSIGHT OF THE PROCESS. OPERATIONS COMMITTEE COMPRISED OF STEERING COMMITTEE CO-CHAIRS AND THE COLLABORATIVE'S COORDINATOR. THIS COMMITTEE RESOLVES OPERATIONAL ISSUES REQUIRING IMMEDIATE ACTIONS. WORK GROUPS COMPRISED OF GENERAL MEMBERSHIP AND OPEN TO ANYONE WHO IS INTERESTED IN BEING INVOLVED. THE WORK GROUPS PROVIDE INPUT AND ASSISTANCE ON IMPLEMENTING CHNA-CHIP ACTIVITIES. FOR THE BOSTON CHNA, TWO WORK GROUPS WERE FORMED: O SECONDARY DATA WORK GROUP COMPRISED OF 32 MEMBERS REPRESENTING A RANGE OF ORGANIZATIONS, INCLUDING HOSPITALS, HEALTH CENTERS, LOCAL PUBLIC HEALTH AND COMMUNITY-BASED ORGANIZATIONS, AMONG OTHERS. THE WORK GROUP'S CHARGE IS TO PROVIDE GUIDANCE ON SECONDARY DATA APPROACH AND INDICATORS AND FOSTER CONNECTIONS WITH KEY NETWORKS AND GROUPS TO PROVIDE RELEVANT DATA. COMMUNITY ENGAGEMENT WORK GROUP COMPRISED OF 54 MEMBERS REPRESENTING A RANGE OF ORGANIZATIONS, INCLUDING HOSPITALS, HEALTH CENTERS, LOCAL PUBLIC HEALTH, EDUCATION, COMMUNITY DEVELOPMENT, SOCIAL SERVICES AND COMMUNITY-BASED ORGANIZATIONS, AMONG OTHERS. THE WORK GROUP'S CHARGE IS TO PROVIDE GUIDANCE ON THE APPROACH TO COMMUNITY ENGAGEMENT, INPUT ON PRIMARY DATA COLLECTIONS METHODS AND SUPPORT WITH LOGISTICS FOR PRIMARY DATA COLLECTION. GENERAL MEMBERSHIP ATTENDS EVENTS, SHARES IN FORMATION AND PARTICIPATES IN WORK GROUPS. THE COLLABORATIVE HIRED HEALTH RESOURCES IN ACTION (HRIA), A NON-PROFIT PUBLIC HEALTH ORGANIZATION, AS A CONSULTANT PARTNER TO PROVIDE STRATEGIC GUIDANCE AND FACILITATION OF THE PROCESS, COLLECT AND ANALYZE DATA AND DEVELOP THE REPORT DELIVERABLES.
THE MCLEAN HOSPITAL CORPORATION	PART V, SECTION B, LINE 5: DUE TO MCLEAN'S HIGHLY SPECIALIZED MISSION AND SERVICES, WE RELY PRIMARILY ON COMMUNITY, REGIONAL AND STATE-WIDE PUBLIC HEALTH AND COMMUNITY NEEDS DATA AND ASSESSMENTS AS WELL AS FEEDBACK FROM CHNA 17 AND MIDDLEBOROUGH TOWN OFFICIALS. NEEDS ASSESSMENTS THAT WERE REVIEWED CAN BE FOUND BELOW: MOUNT AUBURN HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (2018)HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/APP/FILES/PUBLIC/1518/2018-COMMUNITY-HEALTHNEEDS-ASSESSMENT.PDF NEWTON-WELLESLEY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (AUGUST 2018)HTTPS://WWW.NWH.ORG/MEDIA/FILE/CHNA.PDF COMMUNITY HEALTH AND RACIAL EQUITY IN COMMUNITY HEALTH NETWORK AREA 17 (SEPTEMBER 2017)HTTPS://DRIVE.GOOGLE.COM/FILE/D/1I9M1GZMKJ3--KKICUICYKHVRSC44GALW/VIEWHTTPS://DRIVE.GOOGLE.COM/FILE/D/1M84WJM3QLD6ERBLF_PXLG55MK8GDXPDU/VIEW
THE SPAULDING REHABILITATION HOSPITAL	PART V, SECTION B, LINE 5: IN FY18, AN INTERNAL WORKING GROUP WITH SUPPORT OF AN OUTSIDE CONSULTANT CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF A CONTINUOUS QUALITY IMPROVEMENT APPROACH TO COMMUNITY BENEFIT PLANNING. THE ASSESSMENT INVOLVED A REVIEW OF PATIENT DATA FROM THE PAST YEAR (JUNE 1, 2017-MAY 31, 2018); DATA FROM THE CENSUS, AMERICAN COMMUNITY SURVEY DATA, AND MASSACHUSETTS BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (BRFSS); INFORMATION RELATED TO THE CENTER FOR DISEASE CONTROL AND PREVENTION'S (CDC) HEALTHY PEOPLE 2020 (HP2020); AND SEMI-STRUCTURED INTERVIEWS WITH PARTNERS INTERNAL (WITHIN SPAULDING BOSTON) AND EXTERNAL (IN THE COMMUNITY) PARTNERS. BASED ON THE ASSESSMENT FINDINGS, THE WORKING GROUP REFINED THE COMMUNITY BENEFIT AGENDA. THE PATIENT AND COMMUNITY DATA WERE USED IN FORMULATING THE COMMUNITY BENEFIT PRIORITIES, GOAL, OBJECTIVES, AND TARGET COMMUNITIES. THE PARTNER INTERVIEWS WERE USED TO DESCRIBE THE COMMUNITY BENEFIT WORK; DETERMINE THE EXTENT TO WHICH THE INITIATIVES ARE ALIGNED WITH THE REVISED PRIORITIES, GOALS AND OBJECTIVES; AND TO DESCRIBE THE PROGRESS MADE IN FY18. THE WORKING GROUP THEN ESTABLISHED A PLAN AND TARGETS FOR FY19. ON NOVEMBER 14, 2018, THE PLAN WAS REVIEWED AND APPROVED BY THE SPAULDING BOSTON BOARD OF TRUSTEES.
REHABILITATION HOSPITAL OF THE CAPE	PART V, SECTION B, LINE 5: IN FY19, AN INTERNAL WORKING GROUP AT SPAULDING CAPE COD CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF A CONTINUOUS QUALITY IMPROVEMENT APPROACH TO COMMUNITY BENEFIT PLANNING. IN 2016, IN COMPLIANCE WITH SECTION 501(R)(3) OF THE INTERNAL REVENUE CODE, SPAULDING CAPE COD CONDUCTED ITS FIRST COMMUNITY HEALTH ASSESSMENT USING A COLLABORATIVE AND DYNAMIC APPROACH TO REVIEW AVAILABLE DATA, EXISTING PROGRAMS, AND VIEWS FROM PEOPLE WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL. AS REQUIRED BY FEDERAL REGULATION, THESE ASSESSMENTS AND PLANS ARE REQUIRED EVERY THREE YEARS. THIS ASSESSMENT INCLUDED A REVIEW OF PATIENT DATA FROM THE PAST YEAR (OCTOBER 1, 2018-SEPTEMBER 30, 2019), A REVIEW OF PUBLICLY AVAILABLE HEALTH AND DEMOGRAPHIC DATA, AND INTERVIEWS WITH INTERNAL AND COMMUNITY PARTNERS. ADDITIONALLY, SPAULDING CAPE COD PARTICIPATES ACTIVELY IN THE HEALTHY AGING CAPE COD WORK GROUP, LED BY THE BARNSTABLE COUNTY DEPARTMENT OF HUMAN SERVICES. SPAULDING CAPE COD WILL CONTINUE TO WORK WITH OUR LOCAL HEALTH CARE PARTNERS, SPECIFICALLY CAPE COD HEALTHCARE, TO PARTNER FOR IMPLANTATION STRATEGIES THAT LEVERAGE OUR COLLECTIVE RESOURCES SERVING THE NEEDS OF OUR COMMUNITY. BASED ON THE ASSESSMENT FINDINGS, THE WORKING GROUP REFINED THE COMMUNITY BENEFIT AGENDA FROM 2016. GIVEN SPAULDING CAPE COD'S LOCATIONS AND THE SPECIALTY NATURE OF THE CARE PROVIDED, THE TARGET POPULATIONS FOR THE PURPOSES OF THE 2019 CHNA WERE DEFINED AS RESIDENTS OF BARNSTABLE COUNTY, PLYMOUTH COUNTY, AND THE ISLANDS, PARTICULARLY THE ELDERLY AND PERSONS LIVING WITH A DISABILITY. BOTH QUANTITATIVE AND QUALITATIVE DATA WERE COLLECTED AND REVIEWED FOR THIS CNHA IN ORDER TO HELP IDENTIFY MAJOR ASPECTS OF THE COMMUNITY THAT IMPACT THE HEALTH OF ITS PRIORITY POPULATIONS. THE DATA WERE EVALUATED THROUGH A SOCIAL DETERMINANTS OF HEALTH LENS, BY CONSIDERING THE ECONOMIC, ENVIRONMENTAL, AND SOCIAL FACTORS THAT INFLUENCE HEALTH. THE PROGRAMS AND INITIATIVES IDENTIFIED BY THE WORKING GROUP SUPPORT THE OVERALL NEEDS IDENTIFIED BY THE HEALTH ASSESSMENT AND DESCRIBED PROGRESS MADE IN FY19 AND PLANS FOR FY20-FY22. ON NOVEMBER 5, SPAULDING CAPE COD SENIOR MANAGEMENT REVIEWED THE FY20 GOALS AND PRIORITIES AND APPROVED OF THEIR PLAN. ON NOVEMBER 6, 2019, THE PLAN WAS REVIEWED AND APPROVED BY THE SPAULDING CAPE COD BOARD OF TRUSTEES. THIS REPORT DESCRIBES SPAULDING CAPE COD'S MISSION AND COMMUNITY BENEFIT REPORT FOR THE FINAL YEAR OF THE CYCLE (FY19 - OCTOBER 1, 2018-SEPTEMBER 30, 2019).
SPAULDING HOSPITAL - CAMBRIDGE, INC.	PART V, SECTION B, LINE 5: IN FY19, AN INTERNAL WORKING GROUP AT SPAULDING HOSPITAL CAMBRIDGE CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF A CONTINUOUS QUALITY IMPROVEMENT APPROACH TO COMMUNITY BENEFIT PLANNING. IN 2016, IN COMPLIANCE WITH SECTION 501(R)(3) OF THE INTERNAL REVENUE CODE, SPAULDING CAMBRIDGE CONDUCTED ITS FIRST COMMUNITY HEALTH ASSESSMENT USING A COLLABORATIVE AND DYNAMIC APPROACH TO REVIEW AVAILABLE DATA, EXISTING PROGRAMS, AND VIEWS FROM PEOPLE WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL. THIS YEAR'S ASSESSMENT INCLUDED A REVIEW OF PATIENT DATA FROM THE PAST YEAR (OCTOBER 1, 2018-SEPTEMBER 30, 2019), A REVIEW OF PUBLICLY AVAILABLE HEALTH AND DEMOGRAPHIC DATA, AND INTERVIEWS WITH INTERNAL AND COMMUNITY PARTNERS. BASED ON THE ASSESSMENT FINDINGS, THE WORKING GROUP REFINED THE COMMUNITY BENEFIT AGENDA FROM 2016. GIVEN THE SPECIALTY NATURE OF THE CARE PROVIDED AND THE BROAD GEOGRAPHIC REACH OF OUR PATIENTS, WE DEFINE OUR PRIMARY COMMUNITY SERVED BEYOND OUR IMMEDIATE GEOGRAPHIC LOCATION, BUT INSTEAD ON OUR SPECIFIC PATIENT POPULATION: THE ELDERLY, THOSE PERSONS WITH COMPLEX AND CHRONIC HEALTH CONDITIONS AND PERSONS LIVING WITH A DISABILITY. BOTH QUANTITATIVE AND QUALITATIVE DATA WERE COLLECTED FOR THIS CHA IN ORDER TO HELP IDENTIFY MAJOR ASPECTS OF THE COMMUNITY THAT IMPACT THE HEALTH OF ITS PRIORITY POPULATIONS. THE DATA WERE EVALUATED THROUGH A SOCIAL DETERMINANTS OF HEALTH LENS, BY CONSIDERING THE ECONOMIC, ENVIRONMENTAL, AND SOCIAL FACTORS THAT INFLUENCE HEALTH. THE PROGRAMS AND INITIATIVES IDENTIFIED BY THE WORKING GROUP SUPPORT THE OVERALL NEEDS IDENTIFIED BY THE HEALTH ASSESSMENT AND DESCRIBED PROGRESS MADE IN FY19 AND PLANS FOR FY20-FY22. ON NOVEMBER 6, 2019, THE PLAN WAS REVIEWED AND APPROVED BY THE SPAULDING CAMBRIDGE BOARD OF TRUSTEES.
NANTUCKET COTTAGE HOSPITAL	PART V, SECTION B, LINE 5: TO DESCRIBE THE SOCIO-ECONOMIC AND HEALTH STATUS OF THE NCH SERVICE AREA POPULATION, THIS REPORT DRAWS FROM AUTHORITATIVE SECONDARY DATA SOURCES AT THE COUNTY AND CITY LEVEL. SOURCES OF DATA INCLUDED, BUT WERE NOT LIMITED TO, COMMUNITY COMMONS, THE U.S. CENSUS, CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, HOUSING NANTUCKET, NATIONAL LOW INCOME HOUSING COALITION, AND THE F.B.I UNIFORM CRIME REPORTS. OTHER TYPES OF DATA INCLUDED SELF-REPORT OF HEALTH BEHAVIORS FROM LARGE, POPULATION-BASED SURVEYS SUCH AS THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VITAL STATISTICS BASED ON BIRTH AND DEATH RECORDS. WHEN POSSIBLE, SECONDARY DATA ARE COMPARED TO STATE AVERAGES. THE NANTUCKET QUALITY OF LIFE SURVEY PROVIDED AN IMPORTANT CONTRIBUTION TO THE 2015 CHNA AND, WHERE RELEVANT, INFORMATION CONFIRMED BY MORE RECENT COMMUNITY ENGAGEMENT PROCESSES ARE REPRESENTED IN THE 2018 CHNA. THE NCH COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) STEERING COMMITTEE MET AT A KICK-OFF MEETING ON SEPTEMBER 13, 2016 TO RECEIVE AN OVERVIEW OF THE PLANNING PROCESS, REVIEW DATA OUTCOMES FROM THE 2015 CHNA, AND REVIEW THE PROPOSED PROCESS AND TIMELINE FOR ENGAGING COMMUNITY MEMBERS FOR HEALTHY NANTUCKET 2020. THREE COMMUNITY FORUMS WERE HELD TO CONFIRM THE 2015 CHNA FINDINGS AND GATHER ADDITIONAL COMMUNITY INPUT. ON SEPTEMBER 20, 2016, A CONSULTANT, HEALTH RESOURCES IN ACTION, INC. (HRIA) FACILITATED TWO COMMUNITY FORUMS AT NANTUCKET HIGH SCHOOL. A THIRD COMMUNITY FORUM, FACILITATED BY NCH, WAS HELD ON OCTOBER 2, 2016 FOLLOWING THE SPANISH MASS AT ST. MARY'S CHURCH. DURING THE COMMUNITY FORUMS, THE 2015 CHNA FINDINGS WERE SHARED AS WELL AS AN OVERVIEW OF THE PRIORITIZATION PROCESS FOR IDENTIFYING CHIP PRIORITIES. PARTICIPANTS THEN TOOK PART IT A FACILITATED DISCUSSION DESIGNED TO GATHER INPUT ON THE CHNA FINDINGS AS WELL AS FEEDBACK ON HEALTH NEEDS THAT WERE NOT CAPTURED IN THE CHNA. A GROUP OF OVER 60 KEY STAKEHOLDERS GATHERED ON OCTOBER 6, 2016 TO IDENTIFY THE PRIORITIES FOR THE CHIP. AFTER REVIEWING THE CHNA FINDINGS, PARTICIPANTS PROVIDED FEEDBACK ON OTHER HEALTH PRIORITIES TO BE CONSIDERED AS PART OF THE PRIORITIZATION PROCESS. PARTICIPANTS THEN USED A RATING TOOL AND WITH DEFINED CRITERIA AND A VOTING PROCESS TO IDENTIFY THOSE HEALTH NEEDS THAT WERE BOTH IMPORTANT AND FEASIBLE FOR INCLUSION IN THE PLAN. FOUR KEY PRIORITIES WERE SELECTED FOR PLANNING: BEHAVIORAL HEALTH, ACCESS TO HEALTHCARE, WOMEN'S AND CHILDREN'S HEALTH, AND ACCESS TO HOUSING. LANGUAGE WAS PROPOSED AND AGREED UPON AS A CROSS-CUTTING STRATEGY. LANGUAGE INCLUDES TRANSLATION SERVICES, AVAILABILITY OF SERVICES AND MATERIALS IN MULTIPLE LANGUAGES, AND THE AVAILABILITY OF ENGLISH CLASSES. FOLLOWING THE OCTOBER MEETING, A GROUP OF KEY STAKEHOLDERS MET FOR TWO, HALF-DAY PLANNING SESSIONS IN NOVEMBER 2016 TO DEVELOP THE CORE ELEMENTS OF THE CHIP. IN THE FIRST PLANNING SESSION, PARTICIPANTS DEVELOPED AND REVISED GOALS, AND DEVELOPED DRAFT OBJECTIVES AND INDICATORS. IN THE SECOND PLANNING SESSION, PARTICIPANTS FINALIZED THEIR DRAFT OBJECTIVES AND INDICATORS, AND DEVELOPED STRATEGIES TO MEET EACH OBJECTIVE. ON MARCH 27, 2018, NCH HOSTED A CHNA PUBLIC FORUM AT THE NANTUCKET ATHENEUM, THE ISLAND'S PUBLIC LIBRARY. NCH REPRESENTATIVES PRESENTED THE OUTCOMES FROM BOTH THE 2015 CHNA AS WELL AS HEALTHY NANTUCKET 2020. THE PRESENTATION WAS FOLLOWED BY AN OVERVIEW OF THE LATEST COMMUNITY HEALTH DATA AVAILABLE FROM LOCAL, STATE AND FEDERAL SOURCES, AND THEN AN OPEN DISCUSSION ABOUT COMMUNITY HEALTH ON NANTUCKET. ATTENDEES WERE ASKED WHETHER THEY AGREED WITH THE FINDINGS OF TOP HEALTH ISSUES FOR NANTUCKET AS OUTLINED IN HEALTHY NANTUCKET 2020, WHETHER THEY SAW ANY GAPS IN CARE ON THE ISLAND, AND WHAT THINGS THEY MIGHT DO TO IMPROVE COMMUNITY HEALTH. THE PRIORITY HEALTH NEEDS AREAS OF HEALTHY NANTUCKET 2020 WERE CONFIRMED BY THE AUDIENCE, IN ADDITION TO SEVERAL COMMENTS REGARDING ELDER CARE, AIR QUALITY, AND CANCER INCIDENCE RATES.
MARTHA'S VINEYARD HOSPITAL	PART V, SECTION B, LINE 5: MVH'S FY19 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) KICKED OFF ON APRIL 22, 2019 WITH A MEETING OF THE HOSPITAL'S NEW 15-MEMBER COMMUNITY BENEFIT ADVISORY COMMITTEE (CBAC) REPRESENTING A RANGE OF HEALTH AND HUMAN SERVICES ORGANIZATIONS AND OFFERING VARIED EXPERTISE ABOUT POPULATIONS AND/OR HEALTH ISSUES ON THE ISLAND. THE GROUP REVIEWED THE ATTORNEY GENERAL'S REVISED COMMUNITY BENEFIT GUIDELINES, DISCUSSED DATA COLLECTION STRATEGIES AND THE CHNA TIMELINE, AND IDENTIFIED POPULATIONS AND ISSUES FOR INCLUSION IN THE CHNA, WHICH CONSISTED OF: (1) A REVIEW OF SECONDARY DATA FROM MULTIPLE PUBLICLY AVAILABLE LOCAL, STATE, AND FEDERAL SOURCES (E.G., U.S. CENSUS BUREAU, MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, MARTHA'S VINEYARD COMMISSION) WHICH PROVIDED DEMOGRAPHIC, HEALTH, AND BEHAVIORAL HEALTH DATA, AS WELL AS DATA ON SOCIAL DETERMINANTS OF HEALTH. (2) THE MARTHA'S VINEYARD QUALITY OF LIFE SURVEY WAS ADMINISTERED PRIMARILY AS AN ONLINE SURVEY IN ENGLISH AND PORTUGUESE WITH SOME SURVEYS COMPLETED IN HARD COPY. THE SURVEY WAS ADMINISTERED BETWEEN MAY 21 AND JUNE 14, 2019 AND RECEIVED 346 RESPONSES (327 IN ENGLISH AND 19 IN PORTUGUESE). DATA ANALYSIS WAS CONDUCTED USING EXCEL AND SPSS. (3) THE MARTHA'S VINEYARD HOSPITAL ANNUAL PUBLIC FORUM, HELD ON JUNE 4, 2019 AND ATTENDED BY ROUGHLY 60 COMMUNITY MEMBERS, INCLUDED A QUESTION AND ANSWER PERIOD IN WHICH RESIDENTS DISCUSSED HEALTH-RELATED CONCERNS. THE MEETING VIDEO, AVAILABLE ON THE MVH WEBSITE, WAS ANALYZED TO IDENTIFY COMMON AND DIVERGENT THEMES AMONG THE CONCERNS EXPRESSED BY ATTENDEES. (4) KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH 16 REPRESENTATIVES FROM A RANGE OF ORGANIZATIONS ON THE ISLAND WHO COULD OFFER PERSPECTIVES ON THE ISLAND'S HEALTH NEEDS IN GENERAL, AS WELL AS EXPERTISE ON SPECIFIC POPULATIONS AND/OR HEALTH ISSUES. THE INTERVIEWS WERE UP TO 60 MINUTES LONG, CONDUCTED VIA TELEPHONE, AND USED A SEMI-STRUCTURED INTERVIEW TOOL. THE INTERVIEW DATA WERE REVIEWED FOR COMMON AND DIVERGENT THEMES AND TO IDENTIFY ILLUSTRATIVE QUOTES THAT DEMONSTRATED THE MAJOR ISSUES AFFECTING THE HEALTH OF ISLAND RESIDENTS.
NORTH SHORE MEDICAL CENTER, INC.	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT DEFINES HEALTH IN THE BROADEST SENSE AND RECOGNIZES THAT NUMEROUS FACTORS AND MULTIPLE LEVELSFROM LIFESTYLE BEHAVIORS (E.G., DIET AND EXERCISE) TO CLINICAL CARE (E.G., ACCESS TO MEDICAL SERVICES) TO SOCIAL AND ECONOMIC FACTORS (E.G., EMPLOYMENT OPPORTUNITIES) TO THE PHYSICAL ENVIRONMENT (E.G., AIR QUALITY) ALL HAVE AN IMPACT ON THE COMMUNITY'S HEALTH. APPROACH AND SOCIAL DETERMINANTS OF HEALTH FRAMEWORK IT IS IMPORTANT TO RECOGNIZE THAT MULTIPLE FACTORS HAVE AN IMPACT ON HEALTH, AND THERE IS A DYNAMIC RELATIONSHIP BETWEEN PEOPLE AND THEIR LIVED ENVIRONMENTS. WHERE WE ARE BORN, GROW, LIVE , WORK, AND AGEFROM THE ENVIRONMENT IN THE WOMB TO OUR COMMUNITY ENVIRONMENT LATER IN LIFEAND THE INTERCONNECTIONS AMONG THESE FACTORS ARE CRITICAL TO CONSIDER. THAT IS, NOT ONLY DO PEOPLE'S GENES AND LIFESTYLE BEHAVIORS AFFECT THEIR HEALTH, BUT HEALTH IS ALSO INFLUENCED BY MORE UPSTREAM FACTORS SUCH AS EMPLOYMENT STATUS AND QUALITY OF HOUSING STOCK. THE SOCIAL DETERMINANTS OF HEALTH FRAMEWORK ADDRESSES THE DISTRIBUTION OF WELLNESS AND ILLNESS AMONG A POPULATION. WHILE THE DATA TO WHICH WE HAVE ACCESS IS OFTEN A SNAPSHOT OF A POPULATION IN TIME, THE PEOPLE REPRESENTED BY THAT DATA HAVE LIVED THEIR LIVES IN WAYS THAT ARE CONSTRAINED AND ENABLED BY ECONOMIC CIRCUMSTANCES, SOCIAL CONTEXT, AND GOVERNMENT POLICIES. BUILDING ON THIS FRAMEWORK, THIS ASSESSMENT APPROACHES DATA IN A MANNER DESIGNED TO DISCUSS WHO IS HEALTHIEST AND LEAST HEALTHY IN THE COMMUNITY, AS WELL AS EXAMINES THE LARGER SOCIAL AND ECONOMIC FACTORS ASSOCIATED WITH GOOD AND ILL HEALTH.
COOLEY DICKINSON HOSPITAL, INC.	PART V, SECTION B, LINE 5: THE 2019 CHNA UPDATES THE PRIORITIZED COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2016 CHNA. THE PRIORITIZED HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA INCLUDE COMMUNITY LEVEL SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTH, BARRIERS TO ACCESSING CARE, AND HEALTH BEHAVIORS AND OUTCOMES. WE ALSO PROVIDE CONTEXT FOR THE ROLE THAT SOCIAL POLICIES AND THE PRACTICES OF SYSTEMS HAVE ON HEALTH OUTCOMES. ASSESSMENT METHODS INCLUDED: 1) ANALYSIS OF SOCIAL, ECONOMIC, AND HEALTH QUANTITATIVE DATA FROM THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, THE U.S. CENSUS BUREAU, THE COUNTY HEALTH RANKING REPORTS, THE MASSACHUSETTS HEALTHY AGING COLLABORATIVE, SOCIAL EXPLORER, AND A VARIETY OF OTHER DATA SOURCES; 2) ANALYSIS OF FINDINGS FROM 12 FOCUS GROUPS, 45 INTERVIEWS WITH KEY INFORMANTS (INCLUDING WITH LOCAL AND REGIONAL PUBLIC HEALTH OFFICIALS), 10 COMMUNITY CHATS CONDUCTED BY THE CONSULTANT TEAM AND THE REGIONAL ADVISORY COUNCIL (RAC) AS PART OF THIS CHNA, AND A MEETING OF THE CDHC COMMUNITY BENEFITS ADVISORY COUNCIL; 3) THE EXPERIENCES OF COMMUNITY MEMBERS WHO GAVE INPUT IN FOCUS GROUPS OR KEY INFORMANT INTERVIEWS IN OTHER REGIONS WERE OCCASIONALLY CONSIDERED RELEVANT TO THIS SERVICE AREA AND WERE INCLUDED; AND 4) REVIEW OF EXISTING ASSESSMENT REPORTS PUBLISHED SINCE 2016 THAT WERE COMPLETED BY COMMUNITY AND REGIONAL AGENCIES SERVING HAMPSHIRE COUNTY. THE ASSESSMENT FOCUSED ON COUNTY-LEVEL DATA AND SELECT COMMUNITY-LEVEL DATA AS AVAILABLE. GIVEN DATA CONSTRAINTS, THE FOLLOWING COMMUNITIES WERE IDENTIFIED FOR THE MAJORITY OF THE COMMUNITY LEVEL DATA ANALYSES: AMHERST, EASTHAMPTON, AND NORTHAMPTON. OTHER COMMUNITIES WERE INCLUDED AS DATA WAS AVAILABLE AND ANALYSIS INDICATED AN IDENTIFIED HEALTH NEED FOR THAT COMMUNITY. SOME OF THE DATA SOURCES SUPPLIED DATA IN RATES (E.G. RATES PER 100,000 OF THE POPULATION), INCLUDING THE MAIN SOURCE OF DATA FOR HEALTH OUTCOMES, THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH. CREATING RATES ALLOWS US TO COMPARE OUTCOMES FROM GEOGRAPHIES THAT MIGHT BE DRASTICALLY DIFFERENT IN SIZE OR POPULATION, FOR EXAMPLE, THE STATE OF MASSACHUSETTS AND THE TOWN OF HATFIELD. IF ALL WE COULD REPORT WAS THE NUMBER OF PEOPLE HOSPITALIZED, FOR EXAMPLE, IT WOULD NOT BE POSSIBLE TO COMPARE HOW HATFIELD IS DOING COMPARED TO THE STATE. FOR EXAMPLE, IF 38 PEOPLE IN A TOWN OF ABOUT 3,300 (HATFIELD) WERE HOSPITALIZED IN ONE YEAR FOR CARDIOVASCULAR DISEASE, THE RATE IS 748 PER 100,000. IF OVER 92,000 PEOPLE ACROSS THE APPROXIMATELY 6.9 MILLION PEOPLE IN THE STATE OF MASSACHUSETTS WERE HOSPITALIZED FOR THE SAME THING IN ONE YEAR, THE RATE IS 1,216 PER 100,000. THUS, WE CAN SEE THAT THE TOWN OF HATFIELD HAD A LOWER RATE OF HOSPITALIZATION. COMMUNITY HEALTH NEEDS ASSESSMENTS ARE REQUIRED TO IDENTIFY "VULNERABLE POPULATIONS". WE USE THE TERM "PRIORITY POPULATIONS". TO THE EXTENT POSSIBLE GIVEN DATA AND RESOURCE CONSTRAINTS, PRIORITY POPULATIONS WERE IDENTIFIED USING QUALITATIVE AND QUANTITATIVE INFORMATION. QUALITATIVE DATA INCLUDED FOCUS GROUP FINDINGS, INTERVIEWS, INPUT FROM OUR REGIONAL ADVISORY COMMITTEE AND COMMUNITY BENEFITS ADVISORY COMMITTEES, AND COMMUNITY OUTREACH. WE USED QUANTITATIVE DATA TO IDENTIFY PRIORITY POPULATIONS BY DISAGGREGATING BY RACE/ETHNICITY; AGE WITH A FOCUS ON CHILDREN/YOUTH AND OLDER ADULTS; AND LGBTQ (LESBIAN/GAY/BI-SEXUAL/TRANSGENDER/QUEER) POPULATIONS.
WENTWORTH-DOUGLASS HOSPITAL	PART V, SECTION B, LINE 5: COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY COLLECTING AND ANALYZING DATA FROM MULTIPLE SOURCES. CONSIDERING A VAST ARRAY OF INFORMATION IS IMPORTANT WHEN ASSESSING COMMUNITY HEALTH NEEDS, TO ENSURE THE ASSESSMENT CAPTURES A WIDE RANGE OF FACTS AND PERSPECTIVES AND TO INCREASE CONFIDENCE THAT SIGNIFICANT COMMUNITY HEALTH NEEDS HAVE BEEN IDENTIFIED ACCURATELY AND OBJECTIVELY. STATISTICS FOR NUMEROUS COMMUNITY HEALTH INDICATORS WERE ANALYZED, INCLUDING DATA PROVIDED BY LOCAL, STATE, AND FEDERAL GOVERNMENT AGENCIES, LOCAL COMMUNITY SERVICE ORGANIZATIONS, AND WENTWORTH-DOUGLASS. COMPARISONS TO BENCHMARKS WERE MADE WHEREVER POSSIBLE. THIS CHNA ALSO INCORPORATED FINDINGS FROM OTHER RECENTLY CONDUCTED, RELEVANT STATE AND COUNTY HEALTH ASSESSMENTS. INPUT FROM 51 INDIVIDUALS FROM 30 INTERNAL AND EXTERNAL ORGANIZATIONS, REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WAS TAKEN INTO ACCOUNT THROUGH KEY INFORMANT INTERVIEWS. INTERVIEWEES INCLUDED: INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; LOCAL PUBLIC HEALTH DEPARTMENTS; AGENCIES WITH CURRENT DATA OR INFORMATION ABOUT THE HEALTH AND SOCIAL NEEDS OF THE COMMUNITY; REPRESENTATIVES OF SOCIAL SERVICE ORGANIZATIONS; AND LEADERS, REPRESENTATIVES, AND MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS.
MASSACHUSETTS EYE & EAR INFIRMARY	PART V, SECTION B, LINE 5: MASS. EYE AND EAR UTILIZED A SMALL COMMUNITY BENEFIT (CB) WORKING GROUP UNDER THE LEADERSHIP OF JENNIFER STREET, SENIOR VICE PRESIDENT FOR COMMUNICATIONS AND PLANNING AND OUTSIDE CONSULTANTS HOPE KENEFICK, MSW, PHD AND DAWN BAXTER, MBA TO COORDINATE ITS CHNA AND PLANNING PROCESSES. THE TEAM ANALYZED PATIENT AND COMMUNITY-LEVEL DATA, GATHERED INSIGHTS FROM COMMUNITY PARTNERS AND OTHER KEY INFORMANTS, IDENTIFIED THE HOSPITAL'S PRIORITY COMMUNITIES, POPULATIONS, AND ISSUES, AND DEVELOPED PRELIMINARY GOALS, OBJECTIVES, AND STRATEGIES FOR THE IMPLEMENTATION PLAN. JENNIFER STREET AND THE CB WORKING GROUP CONVENED THE CB ADVISORY COMMITTEE1 , A NEW 15-MEMBER GROUP COMPRISED OF INTERNAL AND EXTERNAL STAKEHOLDERS, TO REVIEW AND DISCUSS THE CHNA FINDINGS, PRIORITIES, AND THE PROPOSED IMPLEMENTATION PLAN ELEMENTS. MEMBERSHIP OF THE CB ADVISORY COMMITTEE WILL BE EXPANDED IN FY19 TO INCLUDE ADDITIONAL EXTERNAL PARTNERS WITH EXPERTISE IN THE PLAN'S PRIORITY POPULATIONS AND ISSUES. JENNIFER STREET THEN MET WITH THE HOSPITAL'S SENIOR LEADERSHIP, INCLUDING THE PRESIDENT/CEO, AND THE OFFICERS AND VICE PRESIDENTS FROM THE HOSPITALS CLINICAL, RESEARCH, AND ADMINISTRATIVE AREAS TO REVIEW THE COMMUNITY BENEFIT MISSION STATEMENT, CHNA FINDINGS, AND THE PROPOSED IMPLEMENTATION PLAN. THE CB WORKING GROUP INCORPORATED THE FEEDBACK PROVIDED BY THESE GROUPS AND READIED THE DOCUMENT FOR PRESENTATION TO THE HOSPITAL'S BOARD OF DIRECTORS IN MARCH OF 2019. FOLLOWING THE BOARD MEETING, THE CB WORKING GROUP PREPARED THE FINAL 2019-2021 COMMUNITY BENEFIT DOCUMENT.
COOLEY DICKINSON HOSPITAL, INC.	PART V, SECTION B, LINE 6A: COOLEY DICKINSON HEALTH CARE (CDHC) IS A MEMBER OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS ("COALITION"). THE COALITION IS A PARTNERSHIP BETWEEN EIGHT NON-PROFIT HOSPITALS/HEALTH PLAN IN WESTERN MASSACHUSETTS: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HEALTH CARE, MERCY MEDICAL CENTER, SHRINERS HOSPITALS FOR CHILDREN SPRINGFIELD, AND HEALTH NEW ENGLAND, A LOCAL HEALTH INSURER WHOSE SERVICE AREAS COVERS THE FOUR COUNTIES OF WESTERN MASSACHUSETTS. THE COALITION FORMED IN 2012 TO BRING HOSPITALS WITHIN WESTERN MASSACHUSETTS TOGETHER TO SHARE RESOURCES AND WORK IN PARTNERSHIP TO CONDUCT THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) AND ADDRESS REGIONAL NEEDS.
THE GENERAL HOSPITAL CORPORATION	PART V, SECTION B, LINE 6B: MASS GENERAL PARTICIPATED FOR THE FIRST TIME EVER IN THREE COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESSES IN BOSTON, NORTH SUFFOLK (CHELSEA, REVERE, AND WINTHROP), AND EVERETT-MALDEN. PREVIOUSLY, MASS GENERALAND MOST PROVIDERSCONDUCTED ASSESSMENTS INDEPENDENTLY. THE GOAL OF COLLABORATION IS TO DEVELOP COORDINATED STRATEGIES AS WELL AS SOLUTIONS THAT CAN ACHIEVE RESULTS. 2. THE COMMUNITIES IDENTIFIED HOUSING QUALITY AND AFFORDABILITY AND ECONOMIC STABILITY AND MOBILITY, IMPORTANT SOCIAL DETERMINANTS OF HEALTH, AMONG THEIR TOP FOUR PRIORITIES FOR THE FIRST TIME EVER. SUBSTANCE USE DISORDER REMAINS A TOP PRIORITY, WITH THE NEW ADDITION OF MENTAL HEALTH. 3. MASS GENERAL HAS A HISTORICAL COMMITMENT TO THE COMMUNITIES OF CHELSEA, REVERE, AND CHARLESTOWN WHERE WE HAVE HEALTH CENTERS. BUT, BECAUSE WE ARE PART OF THE BOSTON CHNA COLLABORATIVE, WE WILL ALSO INCLUDE THE NEIGHBORHOODS IN BOSTON WITH THE GREATEST DISPARITIESROXBURY, DORCHESTER, MATTAPAN AND EAST BOSTON, AMONG OTHERSAS NEIGHBORHOODS OF FOCUS. 4. FOR THE FIRST TIME, MASS GENERAL IS INCLUDING ADDITIONAL INFORMATION ON COMMUNITIES WHERE WE HAVE LICENSED HEALTH CARE FACILITIES, INCLUDING WALTHAM, NEWTON, DANVERS, AND CONCORD.IN BOSTON, A FIRST-EVER CITYWIDE COLLABORATIVE FORMED THAT INCLUDES EVERY BOSTON TEACHING HOSPITAL, THE BOSTON PUBLIC HEALTH COMMISSION, COMMUNITY HEALTH CENTERS, AND COMMUNITY-BASED ORGANIZATIONS. THE PROCESS WAS FACILITATED AND GUIDED BY HEALTH RESOURCES IN ACTION (HRIA), A NON-PROFIT PUBLIC HEALTH CONSULTING GROUP IN BOSTON. THE CONFERENCE OF BOSTON TEACHING HOSPITALS ACTED AS THE "BACKBONE ORGANIZATION, PROVIDING INFRASTRUCTURE SUPPORT. AS A MEMBER OF THE BOSTON COLLABORATIVE STEERING COMMITTEE, MASS GENERAL HELPED GUIDE THE ENTIRE PROCESS, INCLUDING DATA GATHERING, ANALYSIS, PRIORITIZATION, AND STRATEGY DEVELOPMENT. IN NORTH SUFFOLK (CHELSEA, REVERE, AND WINTHROP), CITY AND TOWN LEADERS FORMED THE NORTH SUFFOLK PUBLIC HEALTH COLLABORATIVE (NSPHC) TO INCREASE THEIR COLLECTIVE IMPACT ON IMPROVING HEALTH. LIKE BOSTON, THE COLLABORATIVE WAS MADE UP OF AREA HOSPITAL SYSTEMS, HEALTH CENTERS, LOCAL HEALTH DEPARTMENTS, AND COMMUNITY-BASED ORGANIZATIONS. MASS GENERAL CO-LED THE NORTH SUFFOLK CHNA PROCESS, OVERSEEING DATA COLLECTION, ANALYSIS, AND REPORTING. MASS GENERAL ALSO PROVIDED TECHNICAL SUPPORT FOR THE DESIGN OF FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND SURVEY QUESTIONS. IN EVERETT-MALDEN WE JOINED WITH TWO HEALTHCARE PROVIDERS TO CONDUCT A RAPID CHNA. MASS GENERAL ACTED AS CO-COORDINATOR WITH CAMBRIDGE HEALTH ALLIANCE AND MELROSE-WAKEFIELD HEALTHCARE, DEVELOPING A SURVEY INSTRUMENT AND FOCUS GROUP GUIDE, ASSISTING WITH DATA COLLECTION AND ANALYSIS, AND PILOTING A NEW CHNA FRAMEWORK CALLED THRIVE, A TOOL FOR ENGAGING COMMUNITIES IN UNDERSTANDING IMPACTS ON HEALTH AND HOW TO RESPOND. IN FOUR TOWNS WEST OF BOSTON (CONCORD, DANVERS, NEWTON, AND WALTHAM) WHERE MGH HAS OUTPATIENT FACILITIES, WE REVIEWED DATA AND CONFIRMED THE HEALTH NEEDS REPORTED IN EACH HOSPITAL'S CHNA.
THE BRIGHAM AND WOMEN'S HOSPITAL, INC	PART V, SECTION B, LINE 6B: BWH PARTNERED WITH OTHER ORGANIZATIONS AS PART OF THE BOSTON CHNA-CHIP COLLABORATIVE A HIGHLY-ENGAGED GROUP COMPRISED OF COMMUNITY ORGANIZATIONS AND BOSTON RESIDENTS, HOSPITALS, COMMUNITY HEALTH CENTERS, AND THE BOSTON PUBLIC HEALTH COMMISSION.
BRIGHAM AND WOMEN'S FAULKNER HOSPITAL	PART V, SECTION B, LINE 6B: OVERVIEW OF BOSTON CHNA-CHIP COLLABORATIVE THE BOSTON CHNA-CHIP COLLABORATIVE IS AN INITIATIVE CREATED BY SEVERAL STAKEHOLDERSCOMMUNITY ORGANIZATIONS, HEALTH CENTERS, HOSPITALS AND THE BOSTON PUBLIC HEALTH COMMISSIONFORMED TO UNDERTAKE THE FIRST LARGE-SCALE COLLABORATIVE CITY-WIDE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WITH WIDE RANGING PARTNERSHIP. WHILE COMMUNITY HEALTH ASSESSMENT AND PLANNING WORK HAVE BEEN LONG-STANDING ENDEAVORS AMONG INDIVIDUAL ORGANIZATIONS, THE BOSTON CHNA-CHIP COLLABORATIVE ALIGNS AND COORDINATES RESOURCES BETWEEN MULTI-SECTOR STAKEHOLDERS ACROSS BOSTON (LEARN MORE ABOUT THE COLLABORATIVE AT WWW.BOSTONCHNA.ORG).
COOLEY DICKINSON HOSPITAL, INC.	PART V, SECTION B, LINE 6B: COOLEY DICKINSON HEALTH CARE (CDHC) IS A MEMBER OF THE COALITION OF WESTERN MASSACHUSETTS HOSPITALS ("COALITION"). THE COALITION IS A PARTNERSHIP BETWEEN EIGHT NON-PROFIT HOSPITALS/HEALTH PLAN IN WESTERN MASSACHUSETTS: BAYSTATE MEDICAL CENTER, BAYSTATE FRANKLIN MEDICAL CENTER, BAYSTATE NOBLE HOSPITAL, BAYSTATE WING HOSPITAL, COOLEY DICKINSON HEALTH CARE, MERCY MEDICAL CENTER, SHRINERS HOSPITALS FOR CHILDREN SPRINGFIELD, AND HEALTH NEW ENGLAND, A LOCAL HEALTH INSURER WHOSE SERVICE AREAS COVERS THE FOUR COUNTIES OF WESTERN MASSACHUSETTS. THE COALITION FORMED IN 2012 TO BRING HOSPITALS WITHIN WESTERN MASSACHUSETTS TOGETHER TO SHARE RESOURCES AND WORK IN PARTNERSHIP TO CONDUCT THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) AND ADDRESS REGIONAL NEEDS.
WENTWORTH-DOUGLASS HOSPITAL	PART V, SECTION B, LINE 6B: THE HOSPITAL'S MOST RECENT CHNA WAS CONDUCTED WITH WENTWORTH-DOUGLASS PHYSICIAN CORP (WDPC), A RELATED 501(C) (3) ENTITY.
THE GENERAL HOSPITAL CORPORATION	PART V, SECTION B, LINE 11: MGH CCHI SUPPORTS MULTISECTOR COALITIONS IN THE COMMUNITIES OF REVERE, CHELSEA, CHARLESTOWN AND EAST BOSTON. RECOVERY COACHES, WHO ARE SIMILAR TO COMMUNITY HEALTH WORKERS FOR ADDICTION, ARE ASSIGNED TO EACH OF OUR HEALTH CENTERS, BOSTON HEALTH CARE FOR THE HOMELESS, AND HIGH UTILIZERS IN THE ED. THEY ARE PAIRED WITH MGH PATIENTS WHO HAVE BEEN DIAGNOSED WITH A SUBSTANCE USE DISORDER. THE KRAFT CENTER LAUNCHED THE CARE ZONE VAN, A MOBILE HEALTH PROGRAM IN PARTNERSHIP WITH THE BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM, COMBINES HARM REDUCTION, CLINICAL SERVICES INCLUDING MEDICATION ASSISTED TREATMENT (MAT), DATA HOT SPOTTING, AND MOBILITY TO BRING ADDICTION SERVICES TO BOSTON'S MOST VULNERABLE RESIDENTS LIVING WITH SUBSTANCE USE DISORDER (SUD). MASS GENERAL AND HEALTHY CHELSEA ARE MEMBERS OF THE CHELSEA THRIVES COLLABORATIVE, WHICH WORKS TO DECREASE CRIME AND INCREASE FEELINGS OF SAFETY IN CHELSEA. CHELSEA THRIVES LAUNCHED THE CHELSEA HUB, A POLICE LED INITIATIVE MADE UP OF DESIGNATED STAFF FROM COMMUNITY AND GOVERNMENT AGENCIES THAT MEET WEEKLY TO ADDRESS SPECIFIC SITUATIONS REGARDING CLIENTS FACING ELEVATED LEVELS OF RISK, AND DEVELOP IMMEDIATE, COORDINATED, AND INTEGRATED RESPONSES THROUGH MOBILIZATION OF RESOURCES. THROUGH HOSPITAL AND COMMUNITY PROGRAMS LIKE HAVEN (HELPING ABUSE & VIOLENCE END NOW) AND VIAP (VIOLENCE INTERVENTION ADVOCACY PROGRAM), WE ADDRESS INTIMATE PARTNER AND COMMUNITY VIOLENCE AND ASSIST VICTIMS WITH PHYSICAL AND EMOTIONAL RECOVERY, EMPOWERING THEM TO MAKE POSITIVE CHANGES IN THEIR LIVES. IN JUNE 2019, MASS GENERAL LAUNCHED THE CENTER FOR GUN VIOLENCE PREVENTION DEDICATED TO ADVANCING THE HEALTH AND SAFETY OF CHILDREN AND ADULTS THROUGH INJURY AND GUN VIOLENCE PREVENTION RESEARCH, CLINICAL CARE, EDUCATION AND COMMUNITY ENGAGEMENT.
THE BRIGHAM AND WOMEN'S HOSPITAL, INC	PART V, SECTION B, LINE 11: SUPPORT INTERVENTIONS AND PARTNERSHIPS THAT REDUCE FINANCIAL INSTABILITY AND INCREASE ECONOMIC MOBILITY FOR LOW-INCOME RESIDENTS IN OUR PRIORITY COMMUNITIES.PROVIDE ECONOMIC MOBILITY AND WORKFORCE DEVELOPMENT COACHING TO PREGNANT AND PARENTING WOMEN THROUGH THE FAMILY PARTNERSHIP PROGRAM, AS WELL AS GROUP-BASED SKILL DEVELOPMENT AND INFORMATION SHARING VIA OUR COMMUNITY CALENDAR.PARTNER WITH COMMUNITY-BASED ORGANIZATIONS IN OUR PRIORITY NEIGHBORHOODS TO SUPPORT FINANCIAL LITERACY AND WORKFORCE DEVELOPMENT FOR YOUNG PARENTS.PROVIDE A CONTINUUM OF EDUCATION, CAREER EXPOSURE, AND EMPLOYMENT PROGRAMMING FOR YOUNG PEOPLE IN PARTNERSHIP WITH BOSTON PUBLIC SCHOOLS AND THE BOSTON PRIVATE INDUSTRY COUNCIL.SUPPORT JAMAICA PLAIN NEIGHBORHOOD DEVELOPMENT CORPORATION TO LEAD A YOUTH EMPLOYMENT PROGRAM FOCUSED ON OUT OF SCHOOL YOUTH.INCREASE AWARENESS AND PROMOTION OF LOCAL BUSINESSES AMONG THE BWH COMMUNITY TO SUPPORT ECONOMIC VITALITY IN OUR LOCAL NEIGHBORHOODS.PROVIDE RESIDENTS FROM MISSION HILL AND OTHER LOCAL NEIGHBORHOODS WITH EMPLOYMENT AND CAREER COUNSELING, SKILLS DEVELOPMENT TRAINING AND REFERRALS, AND FACILITATE JOB INTERVIEWS OF QUALIFIED COMMUNITY RESIDENTS.PARTNER WITH LOCALLY BASED ORGANIZATIONS AND INSTITUTIONS TO CREATE CAREER TRAINING PROGRAMS AND PATHWAYS AT BRIGHAM HEALTH FOR ADULTS WHO HAVE EXPERIENCED SIGNIFICANT BARRIERS TO EMPLOYMENT.
NORTH SHORE MEDICAL CENTER, INC.	PART V, SECTION B, LINE 11: DECREASE THE MORBIDITY AND MORTALITY FOR COMMUNITY MEMBERS WHO HAVE MENTAL HEALTH NEEDS CONTINUE TO PROVIDE BEHAVIORAL HEALTH RESOURCES FOR PATIENTS AND FAMILIES THROUGH THE NSMC FAMILY RESOURCE CENTER EXPAND STRESS REDUCTION AND MINDFULNESS TRAINING FOR PROVIDERS EXPLORE OPPORTUNITIES TO IMPLEMENT TRAUMA INFORMED CARE BEST PRACTICES CONTINUE SUPPORT OF DOMESTIC VIOLENCE PROGRAMMING THROUGH HEALING ABUSE WORKING FOR CHANGE (HAWC)DECREASE THE MORBIDITY AND MORTALITY FOR COMMUNITY MEMBERS WHO HAVE SUBSTANCE USE DISORDERS IMPLEMENT ED INITIATED SUBOXONE PROGRAM EXPAND SUBSTANCE USE DISORDER CONSULTATIONS ON MEDICAL FLOORS INCREASE AWARENESS OF NSMC'S SUBSTANCE USE DISORDER CLINICAL SERVICES AND SUPPORT PROGRAMS AMONG KEY COMMUNITY GROUPS REDUCE GAPS IN ACCESS TO AND QUALITY OF BEHAVIORAL HEALTH TREATMENTS CONTINUE ADDICTION SERVICES CONSORTIUM COLLABORATION TO INCREASE ACCESS AND TREATMENT CAPACITY EXPLORE OPPORTUNITIES TO PROVIDE SEXUAL ASSAULT NURSE EXAMINER (SANE) SERVICES LOCALLY IMPROVE COMMUNITY AWARENESS THAT MH IS PART OF PHYSICAL HEALTH AND WELLNESS COLLABORATE WITH NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) ON AN ANTI-STIGMA CAMPAIGN.
NEWTON-WELLESLEY HOSPITAL	PART V, SECTION B, LINE 11: INCREASE ACCESS AND USE OF MENTAL HEALTH SERVICES, ALLEVIATE THE FRAGMENTATION OF SERVICES, AND ADDRESS ISSUES OF STIGMA ASSOCIATED WITH MENTAL HEALTH CARE.YOUTH MENTAL HEALTH UNDER THE SCHOOL-BASED RESILIENCE PROJECT, CONDUCT SITE VISITS TO ALL AREA HIGH SCHOOLS THAT INCLUDE A PSYCHIATRIST AND SOCIAL WORKER CLINICAL TEAM. EXPAND THE RESILIENCE PROJECT TO PRIVATE SCHOOLS AND MIDDLE SCHOOLS. PROVIDE PROFESSIONAL DEVELOPMENT FOR SCHOOL FACULTY AND STAFF. CONDUCT EDUCATIONAL SESSIONS FOR STUDENT AND PARENTS IN VARIOUS COMMUNITY VENUES. EXPAND SUPPORT OUTLETS FOR PARENTS AND TEENS AS WELL AS COMMUNITY KNOWLEDGE OF MENTAL HEALTH THROUGH WORKSHOPS AND GROUP SESSIONS. ADDRESS THE PREVALENCE OF MENTAL HEALTH CONCERNS AMONG YOUNG ADULTS IN THE COLLEGE SETTING. CONVENE NWH HEALTH IN HIGHER EDUCATION FORUMS QUARTERLY TO BRING TOGETHER HOSPITAL AND COLLEGE LEADERSHIP TO COLLABORATE AND CREATE PROCESSES AND WORK PROACTIVELY TO ADDRESS CAMPUS AND HOSPITAL CONCERNS. COLLABORATE WITH WALTHAM PARTNERSHIP FOR YOUTH TO ADDRESS THE HIGH PERCENTAGE OF WALTHAM STUDENTS REPORTING SELF-HARM, SUICIDE IDEATION, AND SUICIDE ATTEMPTS. PROMOTE EMPLOYMENT, EDUCATION, AND COMMUNITY INVOLVEMENT WITH SUPPORT OF THE YOUTH INTERPRETERS PROGRAM.ELDER MENTAL HEALTH COLLABORATE WITH COMMUNITY PARTNERS, I.E., HEALTHY CONNECTIONS (WALTHAM), NEWTON SENIOR SERVICES, AND JEWISH COMMUNITY HOUSING FOR THE ELDERLY, TO CREATE AND CONDUCT PROGRAMS THAT ADDRESS ISSUES OF SOCIAL ISOLATION AND FRAILTY. PROGRAMS TO INCLUDE TAI CHI, MINDFULNESS, MATTER OF BALANCE, AND SENIOR SUPPERS. PROVIDE A RESOURCE FOR VULNERABLE PATIENTS TO RECEIVE CUSTODIAL CARE (HOUSEKEEPING, LAUNDRY, GROCERY SHOPPING, AND PRESCRIPTION PICK UP) UPON DISCHARGE FROM THE HOSPITAL FOR A SAFE TRANSITION TO HOME. REVIEW DATA FOR PROGRAM EFFECTIVENESS. CREATE AN ELDER CARE COUNCIL THAT FOCUSES ON THE NEEDS OF ELDERS IN THE NWH COMMUNITY. PARTICIPATION TO INCLUDE CLINICAL EXPERTS, COMMUNITY EXPERTS, AND INTERESTED PATIENTS AND FAMILY MEMBERS. FOCUS ON NEEDS OF THE CAREGIVER IN THE ARENA OF ELDER MENTAL HEALTH. CREATE SUPPORT PROGRAMS FOR CAREGIVERS. CONDUCT A CAREGIVER SELF-CARE PROGRAM IN COLLABORATION WITH COMMUNITY COUNCIL ON AGING. PILOT CAREGIVER MOBILE APP IN WALTHAM. OFFER SAVVY CAREGIVER TRAINING (THE HEALTHY LIVING CENTER OF EXCELLENCE) TO NWH COMMUNITY CAREGIVERS.MATERNAL MENTAL HEALTH IMPLEMENT A CLINICAL TOOL TO IDENTIFY CONCERNS RELATED TO MATERNAL MENTAL HEALTH. ESTABLISH SOCIAL WORK STAFFING AND LAUNCH COMMUNICATION RESOURCES TO SUPPORT MATERNAL MENTAL HEALTH. D. IMMIGRANT MENTAL HEALTH IMPLEMENT CULTURAL CONSIDERATIONS WHEN ADDRESSING MENTAL HEALTH AMONG IMMIGRANT POPULATIONS, IN WALTHAM, IN PARTICULAR.
BRIGHAM AND WOMEN'S FAULKNER HOSPITAL	PART V, SECTION B, LINE 11: EXPANDED FOOD INSECURITY WORK WITH PARTNERS TO PROVIDE STIPENDS TO MORE FAMILIES IN ADDITIONAL NEIGHBORHOOD OF ROSLINDALE. EXPANDED TARGETED DIABETES EDUCATION AND FOOD STIPENDS ON THE FRESH TRUCK TO INCLUDE MORE THAN 550 PATIENTS AT HYDE PARK COMMUNITY PHYSICIANS. PROVIDED NEW INITIATIVES OF EDUCATION AND AWARENESS TO THE DRUG EPIDEMIC TO PARENTS, COMMUNITY RESIDENTS AND CHILDREN WITH OUR COMMUNITY PARTNERS. CLOSE COLLABORATIVE WORK WITH COMMUNITY GROUPS ON A VARIETY OF HEALTH ISSUES, SUCH AS SENIOR SAFETY; TRANSPORTATION BARRIERS AND FOOD INSECURITY. ADDED TRAUMA INFORMED YOGA CLASSES FOR VIOLENCE SURVIVORS AS PART OF THE DV WORK.
THE MCLEAN HOSPITAL CORPORATION	PART V, SECTION B, LINE 11: MCLEAN'S IMPLEMENTATION STRATEGY THAT ADDRESSES PRIORITIZED NEEDS IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT WAS APPROVED BY THE MCLEAN HOSPITAL BOARD OF TRUSTEES ON SEPTEMBER 15, 2016. THE IMPLEMENTATION STRATEGY, APPROVED BY THE MCLEAN HOSPITAL BOARD OF TRUSTEES ON JANUARY 19, 2017, FOCUSES ON PEOPLE AND FAMILIES AFFECTED BY PSYCHIATRIC ILLNESS AND SUBSTANCE USE DISORDERS WITHIN CHNA 17 SERVICE AREAS AND MIDDLEBOROUGH. FOR THE PERIOD 2017-2019, MCLEAN'S IMPLEMENTATION STRATEGY INCLUDES: EXPANDING PSYCHIATRIC SERVICES TO MEET COMMUNITY NEEDS IMPROVING COMMUNITY MENTAL HEALTH THROUGH INNOVATIVE PROGRAMS CARING FOR UNINSURED AND UNDERINSURED STRENGTHENING MENTAL HEALTH THROUGH EDUCATION FOR PROFESSIONALS, CONSUMERS AND THEIR FAMILIES, AND THE PUBLIC PROVIDING COMMUNITY SUPPORT AND CONTRIBUTIONS.
THE SPAULDING REHABILITATION HOSPITAL	PART V, SECTION B, LINE 11: ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH: SPAULDING IS COMMITTED TO ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH OF CHRONIC UNEMPLOYMENT ABOUT PEOPLE WITH DISABILITIES AND THE UNDEREMPLOYMENT FOR STAFF AND COMMUNITY MEMBERS WITH SOCIOECONOMIC LIMITATIONS TO FURTHER EDUCATION. THE SPAULDING BOSTON COMMUNITY BENEFIT PROGRAM SUPPORTED THE FOLLOWING INITIATIVES IN FY18 TO INCREASE OPPORTUNITIES FOR EDUCATION AND PROFESSIONAL ADVANCEMENT FOR THIS DISADVANTAGED COMMUNITIES. IMPROVING ACCESS TO CARE TO REDUCE BARRIERS TO HEALTH CARE, THE SPAULDING BOSTON COMMUNITY BENEFIT PROGRAM PROVIDES FREE CARE TO PATIENTS WHOSE CARE WOULD NOT OTHERWISE BE FULLY SUPPORTED BY THEIR PAYERS. IN FY18, SRH PROVIDED THE FOLLOWING FREE CARE: OUT-PATIENT SERVICES: $777,428 IN-PATIENT SERVICES $200,993 TOTAL $978,421PROMOTING WELLNESS AND PREVENTING INJURY AND DISEASE TO INCREASE WELLNESS AND PREVENT INJURY AND DISEASE, ESPECIALLY FOR CHILDREN, SENIORS, AND THOSE WITH DISABILITIES, SPAULDING BOSTON COMMUNITY BENEFIT PROGRAM SUPPORTED MANY INITIATIVES - PLEASE SEE THE CHNA FOR MORE DETAIL.
REHABILITATION HOSPITAL OF THE CAPE	PART V, SECTION B, LINE 11: IN LIGHT OF THE NEEDS IDENTIFIED AND THE CONSIDERATIONS ABOVE, SCC HAS COMMITTED TO ADDRESSING THE FOLLOWING PRIORITIES: ACCESS TO SPECIALTY REHABILITATION CARE SUPPORT AND ADVOCACY TO IMPROVE SAFETY AND INDEPENDENCE FOR OLDER ADULTS SUPPORT AND ADVOCACY FOR PERSONS LIVING WITH A DISABILITY IN ADDITION TO THESE IDENTIFIED NEEDS, SCC'S HOSPITAL LEADERS HAVE DECIDED TO ADD A PRIORITY AREA RELATED TO ENVIRONMENT TO ITS CHIP. GIVEN ITS LOCATIONS IN THE UNIQUE HABITAT OF CAPE COD AND ITS STATUS AS THE LARGEST PRIVATE EMPLOYER IN THE TOWN OF SANDWICH, SPAULDING CAPE COD RECOGNIZES ITS ROLE AS A LEADER IN ADOPTING GREEN PRACTICES TO HELP PRESERVE THE ENVIRONMENT OF CAPE COD. IN FACT, SCC HAS ADOPTED POLICIES TO REDUCE AND RECYCLE WASTE, SAVE ENERGY, AND EMPLOY SUSTAINABLE PRACTICES FOR MANY YEARS, INITIATIVES THAT RESULTED IN EARNING THE HIGHEST LEVEL RECOGNITION FROM PRACTICE GREENHEALTH IN 2016 FOR ITS ONGOING PROGRAMS. FURTHERMORE, EMERGING SCIENCE IS MAKING CLEAR THE LINK BETWEEN ENVIRONMENTAL FACTORS, SUCH AS CLIMATE CHANGE, ON HEALTH. IDENTIFIED NEEDS NOT ADDRESSED GIVEN THE SPECIFIC CLINICAL EXPERTISE AND LIMITED RESOURCES OF SPAULDING CAPE COD, ADDRESSING ALL OF THE ISSUES IDENTIFIED BY THIS CHNA IS NOT FEASIBLE. THE HOSPITAL INTENDS TO FOCUS ITS EFFORTS WHERE IT CAN MAKE THE STRONGEST IMPACT. AS A RESULT, THE FOLLOWING NEEDS WILL NOT BE PRIORITIZED BY THE HOSPITAL: SUBSTANCE USE DISORDERS MENTAL HEALTH DISORDERS HOUSING ASSISTANCE.
SPAULDING HOSPITAL - CAMBRIDGE, INC.	PART V, SECTION B, LINE 11: SHC USED THE FOLLOWING CRITERIA TO PRIORITIZE NEEDS IDENTIFIED BY THIS ASSESSMENT: COMMUNITY NEED: REVIEW OF CURRENT DATA AND ASSESSMENTS FROM LOCAL, STATE AND NATIONAL ORGANIZATIONS COLLABORATIVE OPPORTUNITIES: OVERVIEW AND EVALUATION OF PARTNERSHIPS WITH LOCAL COMMUNITY ORGANIZATIONS COMMUNITY INTEREST AND READINESS: IN-DEPTH AND THOUGHTFUL DIALOGUE AND INPUT FROM INDIVIDUALS THOUGH STAKEHOLDER MEETINGS, FOCUS GROUPS AND SURVEY OPPORTUNITIES ESTIMATED EFFECTIVENESS AND IMPACT ADEQUATE RESOURCES FOR IMPLEMENTATION IN LIGHT OF THE NEEDS IDENTIFIED AND THE CONSIDERATIONS ABOVE, SHC HAS COMMITTED TO ADDRESSING THE FOLLOWING PRIORITIES: ACCESS TO CARE DISABILITY/ELDER ADVOCACY ENVIRONMENT WORKFORCE DEVELOPMENT IDENTIFIED NEEDS NOT ADDRESSED GIVEN THE SPECIFIC CLINICAL EXPERTISE AND LIMITED RESOURCES OF SPAULDING HOSPITAL CAMBRIDGE, ADDRESSING ALL OF THE ISSUES IDENTIFIED BY THIS CHA IS NOT FEASIBLE. THE HOSPITAL INTENDS TO FOCUS ITS EFFORTS WHERE IT CAN MAKE THE STRONGEST IMPACT. AS A RESULT, THE FOLLOWING NEEDS WILL NOT BE PRIORITIZED BY THE HOSPITAL: AFFORDABLE HOUSING HOMELESSNESS SUBSTANCE USE DISORDERS
NANTUCKET COTTAGE HOSPITAL	PART V, SECTION B, LINE 11: ENHANCE OVERALL WELLNESS FOR THE NANTUCKET COMMUNITY THROUGH THE IMPLEMENTATION OF AN EFFECTIVE AND COLLABORATIVE BEHAVIORAL HEALTH SYSTEM:STRATEGIES: EDUCATE ALL EMPLOYERS (E.G., SMALL AND LARGE EMPLOYERS, BUILDER'S ASSOCIATION, CHAMBER OF COMMERCE), ON NANTUCKET AND IMPLEMENT EMPLOYEE ASSISTANCE PROGRAMS TO RECOGNIZE AND REFER HIGH RISK EMPLOYEES. EXPAND EDUCATION ABOUT SUICIDE RISK BY ASSESSING AND ENHANCING SIGNS OF SUICIDE (SOS) PROGRAM IN NANTUCKET SCHOOLS. REDUCE THE STIGMA SURROUNDING SUICIDAL THOUGHTS BY IMPLEMENTING AN EVIDENCED-BASED PEER-TO-PEER PROGRAM FOR THE REDUCTION OF SUICIDE IN THE MIDDLE AND HIGH SCHOOL (E.G., INCORPORATE IN EXISTING HEALTH EDUCATION OR ESTABLISH A HIRED POSITION). ESTABLISH A FULL-SERVICE MOBILE CRISIS UNIT. INCREASE THE AVAILABILITY TO ACCESS NEEDED BEHAVIORAL HEALTH SERVICES.BY 2020, DECREASE THE NEED FOR EMERGENCY EVALUATION FOR MENTAL HEALTH AND SUBSTANCE USE DISORDERS BY 10% PER YEAR: STRATEGIES: EDUCATE ALL EMPLOYERS (E.G., SMALL AND LARGE EMPLOYERS, BUILDER'S ASSOCIATION, CHAMBER OF COMMERCE), ON NANTUCKET AND IMPLEMENT EMPLOYEE ASSISTANCE PROGRAMS TO RECOGNIZE AND REFER HIGH RISK EMPLOYEES. EXPAND EDUCATION ABOUT SUICIDE RISK BY ASSESSING AND ENHANCING SIGNS OF SUICIDE (SOS) PROGRAM IN NANTUCKET SCHOOLS. REDUCE THE STIGMA SURROUNDING SUICIDAL THOUGHTS BY IMPLEMENTING AN EVIDENCED-BASED PEER-TO-PEER PROGRAM FOR THE REDUCTION OF SUICIDE IN THE MIDDLE AND HIGH SCHOOL (E.G., INCORPORATE IN EXISTING HEALTH EDUCATION OR ESTABLISH A HIRED POSITION). ESTABLISH A FULL-SERVICE MOBILE CRISIS UNIT. INCREASE THE AVAILABILITY TO ACCESS NEEDED BEHAVIORAL HEALTH SERVICES.
MARTHA'S VINEYARD HOSPITAL	PART V, SECTION B, LINE 11: THE CHNA DATA SERVE TO WEAVE A COMPLICATED STORY ABOUT THE HEALTH AND BEHAVIORAL HEALTH OF MARTHA'S VINEYARD RESIDENTS AND THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH. THERE ARE NUMEROUS IMPORTANT ISSUES THAT IMPACT SUB-POPULATIONS ON THE ISLAND, EACH OF WHICH DESERVES ATTENTION TO ENSURE THE HEALTH AND WELL-BEING OF THOSE GROUPS. HOWEVER, FOUR MAJOR THEMES EMERGED FROM THE RESEARCH BASED ON THE PRIORITIES OF RESIDENTS, AS IDENTIFIED BY KEY INFORMANTS, AND SUPPORTED BY THE SECONDARY DATA. THESE THEMES ARE: (1) INSUFFICIENT INVENTORY OF AND ACCESS TO QUALITY AFFORDABLE YEAR-ROUND HOUSING HAS A SIGNIFICANT IMPACT ON THE HEALTH AND BEHAVIORAL HEALTH OF MANY ISLAND RESIDENTS AND THEIR ABILITY TO REMAIN ON THE ISLAND. IT ALSO COMPLICATES THE ABILITY OF ORGANIZATIONS ON THE ISLAND TO HIRE AND RETAIN MUCH-NEEDED CLINICIANS AND STAFF TO PROVIDE HEALTH AND BEHAVIORAL HEALTH SERVICES. (2) THERE ARE A NUMBER OF SERVICES ISLAND RESIDENTS CANNOT SECURE ON THE ISLAND BUT GAINING ACCESS TO CARE ON THE MAINLAND IS COSTLY AND CHALLENGING, PARTICULARLY IN THE SUMMER MONTHS OR WHEN AMBULANCE TRANSPORT IS NEEDED FROM THE HOSPITAL TO AN OFF-ISLAND FACILITY. IT IS ALSO ESSENTIAL TO ENSURE COORDINATION OF CARE AMONG PROVIDERS, PARTICULARLY THOSE ON- AND OFF-ISLAND. BECAUSE PROVIDERS AND RESIDENTS DO NOT HAVE A FULL UNDERSTANDING OF THE RANGE OF SERVICES AVAILABLE ON THE ISLAND, SOME MAY BE TRAVELING OFF-ISLAND TO ACCESS CARE UNNECESSARILY. (3) MENTAL HEALTH AND SUBSTANCE USE DISORDERS ARE GROWING CONCERNS AND THERE ARE TOO FEW BEHAVIORAL HEALTH CLINICIANS AND SERVICES AVAILABLE ON THE ISLAND, ESPECIALLY FOR PORTUGUESE-SPEAKING RESIDENTS AND WHO ARE TRAINED TO WORK WITH CHILDREN AND YOUTH. SEVERAL POPULATIONS APPEAR TO BE AT RISK FOR BEHAVIORAL HEALTH PROBLEMS, INCLUDING YOUNG ADULTS; THOSE WHO ARE HOMELESS; ISOLATED SENIORS AND PEOPLE WITH DISABILITIES; AND CHILDREN AND YOUTH WHO'VE EXPERIENCE FAMILY AND HOUSING INSTABILITY AND OTHER ADVERSE LIFE EVENTS. (4) THE DEMOGRAPHICS OF THE ISLAND ARE SHIFTING AS MANY YOUNGER ADULTS LEAVE TO PURSUE OPPORTUNITIES ON THE MAINLAND THAT ARE NOT AVAILABLE TO THEM ON THE VINEYARD AND AS MORE SENIORS RETIRE TO THE ISLAND. ALTHOUGH EFFORTS ARE UNDERWAY TO IMPROVE SERVICES FOR THIS POPULATION, THERE ARE LEVELS OF CARE NEEDED THAT ARE NOT AVAILABLE OR PLENTIFUL ENOUGH TO MEET THE NEEDS OF THE ISLAND'S GROWING ELDER POPULATION, INCLUDING HOME-BASED AND MENTAL HEALTH AND DEMENTIA CARE. THE CBAC REVIEWED THE CHNA REPORT AND, AT ITS JULY 16, 2019 MEETING, DISCUSSED THE ASSESSMENT FINDINGS. IN ADDITION TO ACCEPTING THE MAJOR THEMES AS PRIORITIES FOR STRATEGIC IMPLEMENTATION PLANNING PHASE, THE GROUP ALSO IDENTIFIED OTHER ISSUES IT CONSIDERS IMPORTANT AND WORTHY OF MORE DISCUSSION. THESE ISSUES ARE: ENSURING THE NEEDS OF THE BRAZILIAN COMMUNITY, TRIBAL COMMUNITY, AND SEASONAL RESIDENTS ARE EXPLORED AND BETTER UNDERSTOOD; UNDERSTANDING BETTER THE ROLE OF POVERTY AND FOOD INSECURITY IN THE LIVES OF ISLANDERS; PREVENTING AND ENSURING EARLY TREATMENT OF LYME DISEASE AND OTHER TICK-BORNE ILLNESSES; IMPROVING ACCESS TO DENTAL SERVICES; AND CULTIVATING COMMUNITY LEADERS FROM AMONG YOUNGER RESIDENTS/SUCCESSION PLANNING. THE REPORT WAS SHARED, AND A SUMMARY OF THE THEMES AND PRIORITIES PRESENTED TO THE MVH BOARD OF DIRECTORS ON JULY 26 TO ENSURE THE BOARD'S ONGOING ENGAGEMENT IN THE HOSPITAL'S COMMUNITY BENEFIT WORK.
NORTH SHORE MEDICAL CENTER, INC.	PART V, SECTION B, LINE 11: DECREASE THE MORBIDITY AND MORTALITY FOR COMMUNITY MEMBERS WHO HAVE MENTAL HEALTH NEEDS CONTINUE TO PROVIDE BEHAVIORAL HEALTH RESOURCES FOR PATIENTS AND FAMILIES THROUGH THE NSMC FAMILY RESOURCE CENTER EXPAND STRESS REDUCTION AND MINDFULNESS TRAINING FOR PROVIDERS EXPLORE OPPORTUNITIES TO IMPLEMENT TRAUMA INFORMED CARE BEST PRACTICES CONTINUE SUPPORT OF DOMESTIC VIOLENCE PROGRAMMING THROUGH HEALING ABUSE WORKING FOR CHANGE (HAWC)DECREASE THE MORBIDITY AND MORTALITY FOR COMMUNITY MEMBERS WHO HAVE SUBSTANCE USE DISORDERS IMPLEMENT ED INITIATED SUBOXONE PROGRAM EXPAND SUBSTANCE USE DISORDER CONSULTATIONS ON MEDICAL FLOORS INCREASE AWARENESS OF NSMC'S SUBSTANCE USE DISORDER CLINICAL SERVICES AND SUPPORT PROGRAMS AMONG KEY COMMUNITY GROUPS REDUCE GAPS IN ACCESS TO AND QUALITY OF BEHAVIORAL HEALTH TREATMENTS CONTINUE ADDICTION SERVICES CONSORTIUM COLLABORATION TO INCREASE ACCESS AND TREATMENT CAPACITY EXPLORE OPPORTUNITIES TO PROVIDE SEXUAL ASSAULT NURSE EXAMINER (SANE) SERVICES LOCALLY IMPROVE COMMUNITY AWARENESS THAT MH IS PART OF PHYSICAL HEALTH AND WELLNESS COLLABORATE WITH NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) ON AN ANTI-STIGMA CAMPAIGN.
COOLEY DICKINSON HOSPITAL, INC.	PART V, SECTION B, LINE 11: SOCIAL AND ECONOMIC DETERMINANTS THAT IMPACT HEALTHSOCIAL ENVIRONMENT ALZHEIMER'S DISEASE AND DEMENTIA FOCUS: SOCIAL ISOLATION AND LONELINESS POPULATION: OLDER ADULTS GOAL: INCREASE OPPORTUNITIES FOR SOCIAL CONNECTIONS THROUGH COLLABORATION WITH COMMUNITY-BASED ORGANIZATIONS ACCESS TO HEALTHY FOOD, TRANSPORTATION, AND PLACES TO BE ACTIVE FOCUS: ACCESS TO HEALTHY FOOD POPULATION: LOWER INCOME IN AMHERST, EASTHAMPTON, NORTHAMPTON, AND OTHER COMMUNITIES GOAL: INCREASE OPPORTUNITIES TO ACCESS AFFORDABLE, FRESH, HEALTHY FOOD THROUGH COLLABORATION WITH COMMUNITY-BASED ORGANIZATIONS AND PROJECTS BARRIERS TO ACCESSING QUALITY HEALTH CARE TRANSPORTATION FOCUS: TRANSPORTATION TO MEDICAL APPOINTMENTS, FOOD ACCESS, AND SOCIAL EVENTS POPULATION: RURAL OLDER ADULTS GOAL: HELP SUPPORT THE HILLTOWN EASY RIDE THROUGH THE PROVISION OF FUNDING TO A COMMUNITY-BASED ORGANIZATION LACK OF CARE COORDINATION FOCUS: AGE-FRIENDLY HEALTH CARE INITIATIVE POPULATION: OLDER ADULTS GOAL: TRAIN PROVIDERS IN THE SERIOUS ILLNESS CONVERSATION MODEL FOCUS: HEALTH CARE FOR VETERANS POPULATION: VETERANS AND MILITARY FAMILIES GOAL: OPTIMIZE USE OF ELECTRONIC MEDICAL RECORD FOR SCREENING AND REFERRALS GOAL: TRAINING FOR PROVIDERS TO BETTER UNDERSTAND UNIQUE NEEDS OF VETERANS NEED FOR INCREASED CULTURALLY SENSITIVE CARE HEALTH LITERACY AND LANGUAGE BARRIERS FOCUS: LANGUAGE ACCESS THROUGH MEDICAL INTERPRETER SERVICES POPULATION: PATIENTS WITH LIMITED ENGLISH PROFICIENCY RECEIVING SERVICES AT A FEDERALLY QUALIFIED HEALTH CENTER GOAL: HELP MITIGATE BARRIERS TO ACCESS TO HEALTH CARE SERVICES FOR HEALTH CENTER PATIENTS 2019-2022 COOLEY DICKINSON COMMUNITY HEALTH IMPLEMENTATION PLAN FOCUS: TRAINING AND COMMUNITY CAPACITY BUILDING SUCH THAT NON-PROFIT HEALTH AND SOCIAL SERVICE BOARDS AND LEADERS REFLECT THE POPULATION: PEOPLE OF THE GLOBAL MAJORITY AND NON-PROFIT HEALTH AND SOCIAL SERVICE ORGANIZATIONS GOAL: INCREASE THE NUMBER OF PEOPLE OF THE GLOBAL MAJORITY SERVING ON NON-PROFIT BOARDS AS WELL AS THE CULTURAL COMPETENCY OF NON-PROFIT BOARDS FOCUS: SYSTEM DEVELOPMENT TO ENSURE ACCESS TO CULTURALLY APPROPRIATE SERVICES FOR LGBTQ RESIDENTS POPULATION: LGBTQ ADULTS AND YOUTH GOAL: INCREASE ORGANIZATIONAL EFFECTIVENESS PROVIDING HEALTH CARE TO LGBTQ RESIDENTS FOCUS: INFORMATION & REFERRAL POPULATION: SPANISH SPEAKING RESIDENTS GOAL: ENSURE ACCESS TO SERVICES THROUGH COLLABORATION WITH A COMMUNITY-BASED ORGANIZATION TO PROVIDE HEALTH AND SOCIAL SERVICE INFORMATION AND REFERRAL THAT IS BILINGUAL SPANISH.
WENTWORTH-DOUGLASS HOSPITAL	PART V, SECTION B, LINE 11: THIS IMPLEMENTATION STRATEGY DESCRIBES HOW WENTWORTH-DOUGLASS HOSPITAL PLANS TO ADDRESS THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA. THE HOSPITAL REVIEWED THE CHNA FINDINGS AND APPLIED THE FOLLOWING CRITERIA TO DETERMINE THE MOST APPROPRIATE NEEDS FOR WENTWORTH-DOUGLASS HOSPITAL TO ADDRESS: THE EXTENT TO WHICH THE HOSPITAL HAS RESOURCES AND COMPETENCIES TO ADDRESS THE NEED; THE IMPACT THAT THE HOSPITAL COULD HAVE ON THE NEED; THE FREQUENCY WITH WHICH STAKEHOLDERS IDENTIFIED THE NEED AS A SIGNIFICANT PRIORITY; AND THE EXTENT OF COMMUNITY SUPPORT FOR THE HOSPITAL TO ADDRESS THE ISSUE AND POTENTIAL FOR PARTNERSHIPS TO ADDRESS THE ISSUE. BY APPLYING THESE CRITERIA, THE HOSPITAL DETERMINED THAT IT WILL ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED BY Y (FOR YES) IN THE TABLE THAT FOLLOWS. ISSUES IDENTIFIED BY N (FOR NO) REPRESENT ISSUES THAT THE HOSPITAL DOES NOT PLAN TO DIRECTLY ADDRESS DURING THE 2020-2022 TIME PERIOD. HOWEVER, INTERVENTIONS MAY INDIRECTLY IMPACT MULTIPLE SIGNIFICANT HEALTH NEEDS. ACCESS TO HEALTH SERVICES Y; HEART DISEASE AND STROKE Y; MENTAL HEALTH Y; NUTRITION, PHYSICAL ACTIVITY, AND OBESITY Y; OLDER ADULTS Y; ORAL HEALTH Y; SOCIAL DETERMINANTS (BASIC NEEDS & TRANSPORTATION) Y; SUBSTANCE ABUSE Y; TOBACCO USE Y
MASSACHUSETTS EYE & EAR INFIRMARY	PART V, SECTION B, LINE 11: THE FIVE GOALS OF THE COMMUNITY BENEFIT IMPLEMENTATION PLAN ARE AS FOLLOWS: 1. IMPROVE VISION AMONG MEMBERS OF MASS. EYE AND EAR'S PRIORITY COMMUNITIES AND POPULATIONS BY ENSURING ACCESS TO THE INFORMATION, SUPPORT, SCREENING AND CLINICAL SERVICES THEY NEED TO PREVENT AND ADDRESS VISION PROBLEMS. 2. IMPROVE HEARING AMONG MEMBERS OF MASS. EYE AND EAR'S PRIORITY COMMUNITIES AND POPULATIONS BY ENSURING ACCESS TO THE INFORMATION, SUPPORT, SCREENING AND CLINICAL SERVICES THEY NEED TO PREVENT AND ADDRESS HEARING PROBLEMS. 3. INCREASE EDUCATION, SCREENING, SUPPORT, AND SERVICES FOR OTHER CLINICAL CONDITIONS (BEYOND VISION AND HEARING) RELATED TO THE HEAD AND NECK. 4. IMPROVE ACCESS TO CARE FOR MEMBERS OF MASS. EYE AND EAR'S PRIORITY COMMUNITIES AND POPULATIONS WHO MAY NOT BE ABLE TO GET THE SERVICES THEY NEED FOR VISION, HEARING, OR HEAD/NECK CONDITIONS DUE TO LINGUISTIC, TRANSPORTATION, OR FINANCIAL BARRIERS OR LACK OF INFORMATION. 5. INCREASE JOB READINESS OF MEMBERS OF SOCIALLY/ECONOMICALLY VULNERABLE GROUPS IN THE TARGET COMMUNITIES.
PART V, SECTION B - LINES 7 AND 10:	THE GENERAL HOSPITAL CORPORATIONHTTPS://WWW.MASSGENERAL.ORG/ASSETS/MGH/PDF/COMMUNITY-HEALTH/2019-CHNA-CHIP.PDFTHE BRIGHAM AND WOMEN'S HOSPITAL, INC.HTTPS://WWW.BRIGHAMANDWOMENS.ORG/ASSETS/BWH/ABOUT-BWH/PDFS/CHNA-CHIP-2019_3.6.20.PDFNORTH SHORE MEDICAL CENTER, INC.HTTPS://NSMC.PARTNERS.ORG/COMMITMENT_TO_COMMUNITYNEWTON-WELLESLEY HOSPITALHTTPS://WWW.NWH.ORG/MEDIA/FILE/CHNA.PDFBRIGHAM AND WOMEN'S/FAULKNER HOSPITALHTTPS://WWW.BRIGHAMANDWOMENSFAULKNER.ORG/ASSETS/FAULKNER/ABOUT-BWFH/COMMUNITY-HEALTH/DOCUMENTS/BWFH-CHNA-REPORT-2019.PDFTHE MCLEAN HOSPITAL CORPORATIONHTTPS://WWW.MCLEANHOSPITAL.ORG/SITES/DEFAULT/FILES/SHARED/MCL-CHNA-AND-ANNUAL-IMPLEMENTATION-STRATEGY-UPDATE-2019-FINAL-9.19.2019.PDFSPAULDING REHABILITATION HOSPITAL CORPORATIONHTTP://SPAULDINGREHAB.ORG/ABOUT/COMMUNITY-INVOLVEMENTREHABILITATION HOSPITAL OF THE CAPE AND ISLANDS CORPORATIONHTTP://SPAULDINGREHAB.ORG/ABOUT/COMMUNITY-INVOLVEMENTSPAULDING HOSPITAL CAMBRIDGE, INC.HTTP://SPAULDINGREHAB.ORG/ABOUT/COMMUNITY-INVOLVEMENTNANTUCKET COTTAGE HOSPITALHTTPS://NANTUCKETHOSPITAL.ORG/WP-CONTENT/UPLOADS/2019/07/NCH-CHNA-FY18.PDFMARTHA'S VINEYARD HOSPITALHTTPS://WWW.MVHOSPITAL.COM/MEDIA/IMAGES/MVH-FY19-CHNA-FINAL-REPORT-7.17.19.DOCX.PDFCOOLEY DICKINSON HOSPITAL, INC.HTTPS://WWW.COOLEYDICKINSON.ORG/WP-CONTENT/UPLOADS/2019/09/2019-CDHC-CHNA-9.18.19-SEPT-COVER.PDFWENTWORTH-DOUGLASS HOSPITALHTTPS://WWW.WDHOSPITAL.ORG/FILES/7615/6890/5432/2019_WDH_CHNA_-_FINAL.PDFMASSACHUSETTS EYE & EAR INFIRMARYHTTPS://WWW.MASSEYEANDEAR.ORG/ASSETS/MEE/PDFS/ABOUT/FY19-MASSEYEANDEAR-COMMUNITY-BENEFIT-REPORT-AND-PLAN-FINAL-032919.PDF
PART V, LINE 16A-C:	URLS FOR FINANCIAL ASSISTANCE POLICIES:HTTPS://WWW.MASSGENERALBRIGHAM.ORG/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE

Schedule H (Form 990) 2019

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?107
Name and address		Type of Facility (describe)
1	1 - MGH HEALTH CENTER CHELSEA 100 EVERETT AVENUE 1ST FLOOR 16C CHELSEA,MA02150	OUTPATIENT CLINIC & HEALTHCARE CENTER
2	2 - MGH CHARLESTOWN HEALTHCARE CENTER 73 HIGH STREET CHARLESTOWN,MA02129	OUTPATIENT CLINIC & HEALTHCARE CENTER
3	3 - MGH CHELSEA HEALTHCARE CENTER 151 EVERETT AVENUE FLOORS 1-4 CHELSEA,MA02150	OUTPATIENT CLINIC & HEALTHCARE CENTER
4	4 - MGH EVERETT FAMILY CARE 19-23 NORWOOD STREET EVERETT,MA02149	OUTPATIENT CLINIC & HEALTHCARE CENTER
5	5 - STUDENT HEALTH CENTER AT CHELSEA HIGH S 299 EVERETT AVENUE CHELSEA,MA02150	OUTPATIENT CLINIC & HEALTHCARE CENTER
6	6 - EMERSON HOSPITAL MGH-RADIATION ONCOLOGY ROUTE 2 JOHN CUMMINGS BUILDING CONCORD,MA01742	OUTPATIENT CLINIC & HEALTHCARE CENTER
7	7 - MGH REVERE HEALTHCARE CENTER 300 OCEAN AVENUE 3RD FLOOR REVERE,MA02151	OUTPATIENT CLINIC & HEALTHCARE CENTER
8	8 - MGH BACK BAY HEALTHCARE CENTER 388 COMMONWEALTH AVENUE BOSTON,MA02115	OUTPATIENT CLINIC & HEALTHCARE CENTER
9	9 - MASS GENERAL WALTHAM 52 SECOND AVENUE 200 360 420 1110 21 WALTHAM,MA02154	OUTPATIENT CLINIC & HEALTHCARE CENTER
10	10 - MGH REVERE SCHOOL BASED HEALTH CENTER 101 SCHOOL STREET REVERE,MA02151	OUTPATIENT CLINIC & HEALTHCARE CENTER
11	11 - LABORATORY FOR MOLECULAR MEDICINE 65 LANSDOWNE STREET 3RD FLOOR CAMBRIDGE,MA02139	OUTPATIENT DIAGNOSTIC LABORATORY
12	12 - MGH AT BOWDOIN SQUARE ONE BOWDOIN SQUARE 7TH 11TH FLOOR BOSTON,MA02114	OUTPATIENT CLINIC
13	13 - MGH CARDIOVASCULAR DISEASE PREVENTION C 25 NEW CHARDON STREET SUITE 301 BOSTON,MA02114	OUTPATIENT CLINIC & HEALTHCARE CENTER
14	14 - YAWKEY CENTER FOR OUTPATIENT CARE 32 FRUIT STREET BOSTON,MA02114	OUTPATIENT CLINIC
15	15 - MGH CHARLES RIVER PLAZA 165 CAMBRIDGE STREET 3RD 5TH 7TH-9TH BOSTON,MA02114	OUTPATIENT CLINIC
16	16 - MGH SPORTS MEDICINE CENTER 175 CAMBRIDGE STREET 4TH FLOOR BOSTON,MA02114	OUTPATIENT CLINIC
17	17 - MGH SLEEP DISORDERS TESTING UNIT 5 BLOSSOM STREET 2ND FLOOR BOSTON,MA02114	OUTPATIENT CLINIC
18	18 - MGH OUTPATIENT CARE 275 CAMBRIDGE STREET 3RD FLOOR BOSTON,MA02114	OUTPATIENT CLINIC
19	19 - MGH CHARLESTOWN MONUMENT STREET COUNSEL 76 MONUMENT STREET 1ST FLOOR CHARLESTOWN,MA02129	OUTPATIENT CLINIC
20	20 - MASS GENERALNORTH SHORE CENTER FOR OUT 102 ENDICOTT STREET 1ST AND 2ND FLOORS DANVERS,MA02129	OUTPATIENT CLINIC & HEALTHCARE CENTER
21	21 - MGH BROADWAY PRIMARY CARE - REVERE 385 BROADWAY REVERE,MA02151	OUTPATIENT CLINIC & HEALTHCARE CENTER
22	22 - MGH RADIATION ONCOLOGY AT NWH 2014 WASHINGTON STREET SOUTH WING NEWTON,MA02462	OUTPATIENT CLINIC
23	23 - BROOKSIDE COMMUNITY HEALTH CENTER 3297 WASHINGTON STREET BOSTON,MA02130	OUTPATIENT CLINIC & HEALTHCARE CENTER
24	24 - SOUTHERN JAMAICA PLAIN HEALTH CENTER 640 CENTRE STREET JAMAICA PLAIN,MA02130	OUTPATIENT CLINIC & HEALTHCARE CENTER
25	25 - BRIGHAM AND WOMEN'S HEALTH CARE CTR 850 BOYLSTON STREET CHESTNUT HILL,MA02467	OUTPATIENT CLINIC & HEALTHCARE CENTER
26	26 - BWH ADVANCED MRI CENTER 221 LONGWOOD AVENUE GROUND LEVEL BOSTON,MA02115	OUTPATIENT CLINIC
27	27 - BRIGHAM DERMATOLOGY ASSOCIATES 221 LONGWOOD AVENUE 1ST FLOOR BOSTON,MA02115	OUTPATIENT CLINIC
28	28 - BWH ENDOCRINOLOGY AND METABOLIC SERVICES 221 LONGWOOD AVENUE 2ND FLOOR BOSTON,MA02115	OUTPATIENT CLINIC
29	29 - BWH BEHAVIORAL AND COGNITIVE NEUROLOGY 221 LONGWOOD AVENUE RFB MEZZANINE BOSTON,MA02115	OUTPATIENT CLINIC
30	30 - BWH OUTPATIENT PSYCHIATRY 221 LONGWOOD AVENUE 4TH FLOOR BOSTON,MA02115	OUTPATIENT CLINIC
31	31 - BWH IMMUNOLOGY LAB 221 LONGWOOD AVENUE BL-059 BOSTON,MA02115	CLINICAL LABORATORY
32	32 - BWH NEWBORN MEDICINE 221 LONGWOOD AVENUE BLI L 1 3 BOSTON,MA02115	OUTPATIENT CLINIC
33	33 - BRIGHAM AND WOMEN'S HOSPITAL CARE CENTER 1153 CENTRE STREET 1ST FLOOR BOSTON,MA02130	OUTPATIENT CLINIC & HEALTHCARE CENTER
34	34 - BRIGHAM AND WOMEN'S HOSPITAL MOHS AND D 1153 CENTRE STREET SUITE 4349 BOSTON,MA02130	OUTPATIENT CLINIC
35	35 - BRIGHAM AND WOMEN'S MRI - WEST BRIDGEWAT 711 WEST CENTER STREET WEST BRIDGEWATER,MA02379	OUTPATIENT CLINIC
36	36 - BRIGHAM AND WOMEN'SMASS GENERAL HEALTH 20 PATRIOTS PLACE FLOORS 123 4 FOXBORO,MA02035	OUTPATIENT CLINIC & HEALTHCARE CENTER
37	37 - BRIGHAM AND WOMEN'S HOSPITAL ADVANCED P 301 SOUTH HUNTINGTON AVENUE JAMAICA PLAIN,MA02115	OUTPATIENT CLINIC
38	38 - KRAFT FAMILY BLOOD DONOR CTR AT DFCI 35 BINNEY STREET 1ST FLOOR BOSTON,MA02115	BLOOD DONOR CENTER
39	39 - NSMC OUTPATIENT SERVICES 1 HUTCHINSON DRIVE 1ST FLOOR DANVERS,MA01923	OUTPATIENT CLINIC
40	40 - NSMC PROFESSIONAL SERVICES HIGHLAND HALL 55 HIGHLAND AVENUE SALEM,MA01970	OUTPATIENT CLINIC
41	41 - NORTH SHORE MEDICAL CENTER OUTP HARTMAN HALL 490 LYNNFIELD STREET LYNN,MA01904	OUTPATIENT CLINIC
42	42 - RADIOLOGY SERVICES AT LYNN COMMUNITY H 269 UNION STREET LYNN,MA01901	OUTPATIENT CLINIC
43	43 - NSMC MAGNETIC IMAGING 4 CENTENNIAL DRIVE SUITE 104 PEABODY,MA01960	OUTPATIENT CLINIC
44	44 - NORTH SHORE MEDICAL CENTER ULTRASOUND AT 383 PARADISE ROAD SWAMPSCOTT,MA01907	OUTPATIENT CLINIC
45	45 - NEWTON-WELLESLEY FAMILY MEDICINE 111 NORFOLK AVENUE 1ST FLOOR WALPOLE,MA02081	OUTPATIENT CLINIC
46	46 - NEWTON-WELLESLEY URGENT CARE - WALTHAM DEVINCENT BUILDING 9 HOPE AVENUE WALTHAM,MA02453	OUTPATIENT CLINIC
47	47 - NEWTON-WELLESLEY AMBULATORY CARE CENTER 307 WEST CENTRAL STREET 1ST FLOOR NATICK,MA01760	OUTPATIENT CLINIC
48	48 - NEWTON-WELLESLEY SLEEP CENTER AT NEWTON 2345 COMMONWEALTH AVENUE BUILDING C NEWTON,MA02446	OUTPATIENT CLINIC
49	49 - NEWTON-WELLESLEY OUTPATIENT SURGERY CTR 25 WASHINGTON STREET WELLESLEY,MA02481	OUTPATIENT CLINIC
50	50 - NEWTON-WELLESLEY AMBULATORY CARE CENTER 159 WELLS AVENUE NEWTON,MA02459	OUTPATIENT CLINIC
51	51 - MCLEAN SOUTHEAST 23 ISAAC STREET MIDDLEBOROUGH,MA02346	OUTPATIENT CLINIC
52	52 - MCLEAN AMBULATORY TREATMENT CENTER 211 NORTH MAIN ST GROUND FIRST FL PETERSHAM,MA01366	OUTPATIENT CLINIC
53	53 - MCLEAN HOSPITAL AND ADOLESCENT MENTAL HC 799 CONCORD AVENUE 1ST FLOOR CAMBRIDGE,MA02138	OUTPATIENT CLINIC
54	54 - SPAULDING OUTPATIENT CENTER - BRIGHTON 20 GUEST STREET SUITE 150 BOSTON,MA02135	OUTPATIENT CLINIC
55	55 - SPAULDING OUTPATIENT CENTER - FRAMINGHAM 570 WORCESTER ROAD FRAMINGHAM,MA01702	OUTPATIENT CLINIC
56	56 - SPAULDING OUTPATIENT CENTER - MEDFORD 101 MAIN STREET SUITE 101 MEDFORD,MA02155	OUTPATIENT CLINIC
57	57 - SPAULDING OUTPATIENT CENTER - WELLESLEY 65 WALNUT STREET WELLESLEY,MA02181	OUTPATIENT CLINIC
58	58 - SPAULDING OUTPATIENT CENTER - BRAINTREE 300 GRANITE STREET 1ST FLOOR BRAINTREE,MA02184	OUTPATIENT CLINIC
59	59 - SPAULDING OUTPATIENT CENTER - DOWNTOWN 294 WASHINGTON STREET SUITE 215 BOSTON,MA02114	OUTPATIENT CLINIC
60	60 - SPAULDING OUTPATIENT CENTER - CAMBRIDGE 1575 CAMBRIDGE STREET 1ST FLOOR CAMBRIDGE,MA02138	OUTPATIENT CLINIC
61	61 - SPAULDING OUTPATIENT CENTER FOR CHILDREN 1 MAGUIRE ROAD 1ST FLOOR LEXINGTON,MA02421	OUTPATIENT CLINIC
62	62 - SPAULDING OUTPATIENT CENTER - WESTBOR 112 TURNPIKE ROAD SUITE 301 WESTBOROUGH,MA01581	OUTPATIENT CLINIC
63	63 - SPAULDING OUTPATIENT CENTER - PEABODY 4 CENTENNIAL DRIVE PEABODY,MA01960	OUTPATIENT CLINIC
64	64 - SPAULDING OUTPATIENT CENTER - MARBLEHEAD 40 LEGGIS HILL ROAD MARBLEHEAD,MA01945	OUTPATIENT CLINIC
65	65 - SPAULDING OUTPATIENT CENTER - CAPE ANN 1 BLACKBURN DRIVE GLOUCESTER,MA01930	OUTPATIENT CLINIC
66	66 - SPAULDING OUTPATIENT CENTER - MARBLEHEAD 4 COMMUNITY ROAD MARBLEHEAD,MA01945	OUTPATIENT CLINIC
67	67 - SPAULDING OUTPATIENT CENTER - LYNN 583 CHESTNUT STREET 3RD FLOOR LYNN,MA01904	OUTPATIENT CLINIC
68	68 - SPAULDING OUTPATIENT CENTER - SALEM 35 CONGRESS STREET 2ND FLOOR SALEM,MA01970	OUTPATIENT CLINIC
69	69 - SPAULDING OUTPATIENT CENTER - QUINCY 79 CODDINGTON STREET 2ND FLOOR QUINCY,MA02169	OUTPATIENT CLINIC
70	70 - SPAULDING OUTPATIENT CENTER - EMILSON 75 MILL STREET HANOVER,MA02339	OUTPATIENT CLINIC
71	71 - SPAULDING MALDEN 350 MAIN STREET 1ST FLOOR MALDEN,MA02148	OUTPATIENT CLINIC
72	72 - SPAULDING OUTPATIENT CENTER - ORLEANS 65 OLD COLONY WAY SUITE 2 ORLEANS,MA02653	OUTPATIENT CLINIC
73	73 - SPAULDING OUTPATIENT CENTER - YARMOUTH 130 ANSEL HALLET ROAD WEST YARMOUTH,MA02675	OUTPATIENT CLINIC
74	74 - SPAULDING EILEEN M WARD OUTPATIENT CTR 280-D ROUTE 130 SUITE 7 FORESTDALE,MA02644	OUTPATIENT CLINIC
75	75 - SPAULDING AQUATICS PROGRAM - YARMOUTH 579 BUCK ISLAND ROAD WEST YARMOUTH,MA02673	OUTPATIENT CLINIC
76	76 - SPAULDING OUTPATIENT CENTER - PLYMOUTH 1 SCOBEE CIRCLE PLYMOUTH,MA02360	OUTPATIENT CLINIC
77	77 - SPORTS MEDICINE AND PT ASSOCIATES OF NCH 6 BAYBERRY COURT GROUND LEVEL NANTUCKET,MA02554	OUTPATIENT CLINIC
78	78 - COOLEY DICKINSON SOUTH DEERFIELD CENTER 21 B ELM STREET 1ST FLOOR SOUTH DEERFIELD,MA01373	OUTPATIENT CLINIC
79	79 - COOLEY DICKINSON HOSPITAL 170 UNIVERSITY DRIVE AMHERST,MA01002	OUTPATIENT CLINIC
80	80 - THE COOLEY DICKINSON HOSPITAL OUTPATIENT 10 COLLEGE HIGHWAY SOUTHAMPTON,MA01073	OUTPATIENT CLINIC
81	81 - COOLEY DICKINSON HOSPITAL REHAB SERV 58 OLD NORTH ROAD SUITE 1 WORTHINGTON,MA01098	OUTPATIENT REHAB CLINIC
82	82 - COOLEY DICKINSON HOSPITAL REHAB SERV 380 RUSSELL STREET 1ST FLOOR HADLEY,MA01035	OUTPATIENT REHAB CLINIC
83	83 - COOLEY DICKINSON HOSPITAL P& OCC T 4 WEST STREET 2ND FLOOR WEST HATFIELD,MA01088	OUTPATIENT CLINIC
84	84 - COOLEY DICKINSON HOSPITAL P OCC & S 8 ATWOOD DRIVE NORTHAMPTON,MA01060	OUTPATIENT CLINIC
85	85 - COOLEY DICKINSON HOSPITAL OUTPATIENT DIA 22 ATWOOD DRIVE NORTHAMPTON,MA01060	DIAGNOSTIC SERVICES
86	86 - SEACOAST CANCER CENTER 10 MEMBERS WAY SUITE 200 DOVER,NH03820	SPECIALTY CARE PRACTICE
87	87 - LEE OTPTIMAGING 65 CALEF HIGHWAY LEE,NH03861	OCCUPATIONAL/PHYSICAL THERAPY/IMAGING
88	88 - EXPRESS CARE DOVER 781 CENTRAL AVENUE DOVER,NH03820	EXPRESS CARE
89	89 - WDH PROFESSIONAL CENTER 10 MEMBERS WAY DOVER,NH03820	DIAGNOSTIC SERVICES
90	90 - EXPRESS CARE LEE 65 CALEF HIGHWAY LEE,NH03861	EXPRESS CARE
91	91 - DIAGNOSTIC CARDIOLOGY 19 OLD ROLLINSFORD ROAD DOVER,NH03820	CARDIOLOGY SERVICES
92	92 - DURHAM REHAB & SPORTS THERAPY CENTER 16 JENKINS COURT DURHAM,NH03824	SPECIALTY CARE PRACTICE
93	93 - WDH EARLY LEARNING CENTER 789 CENTRAL AVENUE DOVER,NH03820	CHILDCARE SERVICES
94	94 - PEASE BUILDING B 73 CORPORATE DRIVE PORTSMOUTH,NH03801	IMAGING SERVICES & CARDIOLOGY
95	95 - PEASE BUILDING C 121 CORPORATE DRIVE PORTSMOUTH,NH03801	ONCOLOGY SERVICES
96	96 - THE DOORWAY 798 CENTRAL AVENUE DOVER,NH03820	SUBSTANCE ABUSE TREATMENT
97	97 - RIVERWODDS AT DURHAM 14 STONE QUARRY DRIVE DURHAM,NH03824	REHAB SERVICES
98	98 - HOSPITAL REHAB SERVICES 23 WORKS WAY SOMERSWORTH,NH03878	REHAB SERVICES
99	99 - WOMEN'S LIFE IMAGING 200 NH-108 SOMERSWORTH,NH03878	WOMEN'S IMAGING SERVICES
100	100 - MARSH BROOK REHAB 7 MARSH BROOK DRIVE SOMERSWORTH,NH03878	REHAB SERVICES
101	101 - PEASE BUILDING A 67 CORPORATE DRIVE PORTSMOUTH,NH03801	REHAB & IMAGING SERVICES
102	102 - NORTH SUBURBAN CENTER ONE MONTVALE AVENYE 5TH FLOOR STONEHAM,MA02180	LICENSED OUTPATIENT LOCATION
103	103 - MASSACHUSETTS EYE & EAR QUINCY (ANNEX) 500 CONGRESS STREET SUITE 1C QUINCY,MA02169	LICENSED OUTPATIENT LOCATION
104	104 - MASSACHUSETTS EYE & EAR INFIRMARY 54 BAKER AVENUE EXT 3RD FLOOR CONCORD,MA01742	LICENSED OUTPATIENT LOCATION
105	105 - MASSACHUSETTS EYE & EAR AT LONGWOOD 800 HUNTINGTON AVENUE BOSTON,MA02115	LICENSED OUTPATIENT LOCATION
106	106 - MEEI VESTIBULAR CENTER AT BRAINTREE R 250 POND STREET 1ST FLOOR BRAINTREE,MA02184	LICENSED OUTPATIENT LOCATION
107	107 - MASSACHUSETTS EYE & EAR INFIRMARY SNE 30 MAN MAR DRIVE SUITE 2 PLAINVILLE,MA02762	LICENSED OUTPATIENT LOCATION

Schedule H (Form 990) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
SCHEDULE H - PART I - SUPPLEMENTAL INFORMATION	PART I, LINE 3C: AFFILIATED ENTITIES ARE TAX-EXEMPT ENTITIES, WHOSE UNDERLYING MISSION IS TO PROVIDE SERVICES TO ALL IN NEED OF MEDICAL CARE. PATIENTS REQUIRING URGENT OR EMERGENT SERVICES SHALL NOT BE DENIED THOSE SERVICES BASED ON THEIR INABILITY TO PAY. MASS GENERAL BRIGHAM POST-ACUTE CARE AND BEHAVIORAL HEALTH HOSPITALS WILL WORK WITH PATIENTS WHO HAVE A DEMONSTRATED FINANCIAL NEED TO PROVIDE FINANCIAL ASSISTANCE TO THOSE PATIENTS SEEKING CARE IN THOSE SETTINGS.
PART I, LINE 7:	PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES DO NOT INCLUDE COSTS ASSOCIATED WITH PHYSICIAN CLINICS.PART I, LINE 7, COLUMN (F): THERE WAS $ 2,759,371 OF BAD DEBT EXPENSE SUBTRACTED FROM TOTAL EXPENSES FOR PURPOSES OF CALCULATING THE PERCENTAGE COLUMN.PART I, LINE 7: THE AMOUNTS REPORTED ON THE CHARITY CARE AND OTHER COMMUNITY BENEFITS TABLE ARE CALCULATED USING THE BEST AVAILABLE DATA USING A COST ACCOUNTING SYSTEM OR A COST TO CHARGE RATIO. IN MOST CASES, A COST ACCOUNTING SYSTEM WAS USED AND THE SYSTEM ADDRESSES ALL PATIENT SEGMENTS AND DIRECTLY ASSIGNS COSTS TO INDIVIDUAL SERVICES.
PART II, COMMUNITY BUILDING ACTIVITIES:	MASS GENERAL BRIGHAM' HOSPITALS ARE WORKING TO DEVELOP A PROCESS TO QUANTIFY THE EXPENDITURES ASSOCIATED WITH THE VARIOUS COMMUNITY BUILDING ACTIVITIES TO BE REPORTED IN PART II. BELOW IS A DESCRIPTION OF SOME OF THESE ACTIVITIES THAT TOOK PLACE DURING THE REPORTING PERIOD. YOUTH PATHWAYS PROGRAMS EMPOWER BOSTON'S NEW GENERATIONSLEADERS OF YOUTH PATHWAYS PROGRAMS AT MASS GENERAL BRIGHAM DON'T NEED TO LOOK VERY FAR TO SEE THE SUCCESS OF THEIR EFFORTS. THEY CAN SIMPLY LOOK DOWN THEIR HOSPITAL CORRIDORS.THE HEALTH SYSTEM PROVIDES EDUCATION AND TRAINING SUPPORT FOR BOSTON PUBLIC SCHOOL STUDENTS FROM PRE-KINDERGARTEN THROUGH GRADE 12 AND THROUGHOUT THE COLLEGE YEARS. "THE TRUE TESTAMENT OF THE WORK THAT WE DO IS WHEN STUDENTS START WORKING HERE," SAID CHRISTY EGUN, SENIOR DIRECTOR OF BOSTON PARTNERSHIPS, EQUITY & INCLUSION AT MASSACHUSETTS GENERAL HOSPITAL. "WE HAVE A STUDENT WHO'S BEEN WORKING HERE TWO YEARS AND RECENTLY GOT PROMOTED. THAT IS THE ESSENCE OF WHAT WE'RE HOPING TO DO."MASS GENERAL'S YOUTH SCHOLARS PROGRAM, THE STUDENT SUCCESS JOBS PROGRAM AT BRIGHAM AND WOMEN'S HOSPITAL, AND A TRIO OF YOUTH SUCCESS PROGRAMS AT BRIGHAM AND WOMEN'S FAULKNER HOSPITAL ALL OFFER PROGRAM TO STUDENTS FROM THE GREATER BOSTON AREA, INCLUDING CHELSEA AND REVERE. THESE PROGRAMS ARE AIMED AT STIMULATING INTEREST IN SCIENCE, TECHNOLOGY, ENGINEERING, AND MATH, WHILE ALSO TEACHING GOOD HEALTH AND NUTRITION HABITS.25 OF 68 PROGRAM GRADUATES NOW IN THE WORKING WORLD ARE EMPLOYED AT MASS GENERAL BRIGHAM INSTITUTIONS IN JOBS RANGING FROM RESEARCH COORDINATOR TO REGISTERED NURSE."OUR ANCHOR STRATEGY IS BUILDING THE SKILLS AND PARTICIPATION OF YOUNG PEOPLE WHO REALLY ARE OUR FUTURE WORKFORCE." MICHELLE KEENAN SENIOR DIRECTOR OF THE HEALTH EQUITY AND SOCIAL INNOVATION CENTER FOR COMMUNITY HEALTH AND HEALTH EQUITY BRIGHAM AND WOMEN'S HOSPITAL."WE WORK TOGETHER, CHECKING IN ON EACH OTHER'S PROGRAMS AND FIGURING OUT WHAT WORKS AND WHAT COULD BE MORE EFFECTIVE. THERE MAY NOT ALWAYS BE THE JOB OPPORTUNITY AT THAT TIME FOR ALUMNI AT OUR HOME INSTITUTION, BUT THERE COULD BE WITHIN THE SYSTEM. IT JUST EXPANDS POSSIBLE FUTURE JOB OPPORTUNITIES."THE PROOF IS IN THE NUMBERS: 25 OF 68 PROGRAM GRADUATES NOW IN THE WORKING WORLD ARE EMPLOYED IN JOBS WITHIN OUR SYSTEM, RANGING FROM RESEARCH COORDINATOR TO REGISTERED NURSE, ACCORDING TO A 7-YEAR STUDY OF THE PROGRAMS AT THE FLAGSHIP ACADEMIC MEDICAL CENTERS CONDUCTED BY THE UNIVERSITY OF MASSACHUSETTS DONAHUE INSTITUTE.BUT OUTREACH BEGINS BEFORE MANY CHILDREN EVEN ENTER SCHOOL, NOTED TRACY SYLVEN, DIRECTOR OF COMMUNITY HEALTH AND WELLNESS AT BRIGHAM AND WOMEN'S FAULKNER HOSPITAL, WHICH WORKS WITH CHILDREN IN JAMAICA PLAIN, ROSLINDALE, WEST ROXBURY, AND HYDE PARK."WE DO THINGS LIKE HEALTH IN THE CLASSROOM, GETTING THE STUDENTS TO ENJOY SCIENCE AND HEALTH AND TO LET THEM RECOGNIZE THAT THERE'S MORE TO A HOSPITAL THAN JUST A NURSE OR A DOCTOR. AND THEN THE STUDENTS WALK UP TO THE HOSPITAL ON A DIFFERENT DAY AND VISIT THAT SAME STAFF IN THEIR DEPARTMENT FOR A MORE HANDS-ON LESSON."AS THE STUDENTS GET OLDER, BRIGHAM AND WOMEN'S FAULKNER HOSPITAL OFFERS SUMMER JOBS AND JOB SHADOWING OPPORTUNITIES IN BOTH CLINICAL AND NON-CLINICAL ROLES."THAT RANGES FROM THE NURSING DEPARTMENT TO FOOD SERVICE TO TRANSPORT TO RADIOLOGY," EXPLAINS KATIE PLANTE, BRIGHAM AND WOMEN'S FAULKNER HOSPITAL COMMUNITY HEALTH AND WELLNESS PROGRAM COORDINATOR.OLDER STUDENTS ALSO CAN TAKE PART IN THE MASS GENERAL HOSPITAL AND BRIGHAM AND WOMEN'S HOSPITAL PROGRAMS DESIGNED TO SUPPORT ACADEMIC AND CAREER SUCCESS WITH AN EMPHASIS ON HEALTH-RELATED CAREERS.PLANTE SAID, "OUR HOPE IS TO REALLY ENGAGE AND EXCITE YOUNG PEOPLE AND GET THEM TO UNDERSTAND THAT SCIENCE, TECHNOLOGY, ENGINEERING, AND MATH ARE RELEVANT TO THEIR EVERYDAY LIVES."RESULTS DOCUMENTED IN THE DONAHUE INSTITUTE REPORT SUGGEST THAT GOALS ARE BEING REACHED. ONE HUNDRED PERCENT OF THE 2019 PROGRAM GRADUATES COMPLETED HIGH SCHOOL. THE STUDY FOUND THAT 84 PERCENT OF STUDENTS WHO STARTED COLLEGE IN THE FALL OF 2012 GRADUATED WITHIN SIX YEARS."I BELIEVE THE MOST IMPORTANT PART OF THE PROGRAM WAS BEING PLACED IN A PROFESSIONAL SETTING AND BEING HELD TO THE SAME STANDARD AS EVERYONE ELSE WHO WORKED IN THE DEPARTMENT," A STUDENT AT A BRIGHAM AND WOMEN'S HOSPITAL PROGRAM TOLD EVALUATORS. "FEELING TREATED EQUALLY AND HAVING RESPONSIBILITIES PUSHED ME PERSONALLY TO IMPROVE MY WORK ETHICS.""THE INTERNSHIPS I HAD AT MGH WERE A ONCE-IN-A-LIFETIME EXPERIENCE," ADDED ANOTHER STUDENT. "I WATCHED SURGERIES, WORKED SIDE BY SIDE WITH NURSES, DOCTORS, AND OTHER HOSPITAL STAFF. THESE INTERNSHIPS WERE INCREDIBLY HELPFUL FOR CHOOSING CAREER PATHS AND FOR NETWORKING."BUT THE PROGRAMS OFFERED MORE THAN CLASSROOM AND JOB EXPERIENCE. MENTORSHIP AND HOME SUPPORT ALSO WERE CRUCIAL ELEMENTS IN PROGRAMS WHERE 87 PERCENT OF STUDENTS WERE PEOPLE OF COLOR, 69 PERCENT WOMEN, 66 PERCENT FROM LOW-INCOME FAMILIES, AND 62 PERCENT FROM HOMES WHERE ENGLISH IS NOT THE FIRST LANGUAGE SPOKEN.87 PERCENT OF STUDENTS WERE PEOPLE OF COLOR, 69 PERCENT WOMEN, 66 PERCENT FROM LOW-INCOME FAMILIES, AND 62 PERCENT FROM HOMES WHERE ENGLISH IS NOT THE FIRST LANGUAGE SPOKEN"I OFTEN CALL US THE ADDITIONAL FAMILY FOR YOUNG PEOPLE BECAUSE WE WORK WITH OUR STUDENTS, BUT WE ALSO WORK WITH THE FAMILIES," SAID EGUN. SHE ALSO CREDITS THE ROLE PLAYED BY RESIDENTS AND FELLOWS OF COLOR "WHO UNDERSTAND HOW IMPORTANT THESE PATHWAY PROGRAMS ARE BECAUSE MANY OF THEM ARE IN THE PLACES THEY ARE BECAUSE OF THESE TYPES OF PROGRAMS."MENTORSHIP IS A TWO-WAY STREET, KEENAN ADDED, TELLING ABOUT A FOCUS GROUP THAT WAS PART OF THE DONAHUE INSTITUTE STUDY, WHERE IT WAS CLEAR PARTICIPANTS FELT "TO BE ABLE TO MENTOR AND GUIDE A YOUNG PERSON POWERFULLY AFFECTED THEIR OWN POSITIVE EXPERIENCE OF THE WORKPLACE. I'VE ALWAYS FOUND THAT'S AN IMPORTANT COMPONENT OF WHAT WE DO."OFTEN UNSPOKEN TOO IS WHAT EGUN CALLED THE "ULTIMATE EQUALIZER. THE BETTER YOUR EDUCATION, THE BETTER YOUR HEALTH AND HOW LONG YOU MAY LIVE. WE ARE MOVING THE DIAL FROM POVERTY TO THE MIDDLE CLASS WITH THESE YOUNG PEOPLE. AND THAT MAKES A DIFFERENCE."MASS GENERAL BRIGHAM DELIVERS CARE KITS TO VULNERABLE POPULATIONSTHE COVID-19 PANDEMIC HAS DISPROPORTIONATELY IMPACTED VULNERABLE COMMUNITIES IN THE GREATER BOSTON AREA. TO HELP ADDRESS THIS MASS GENERAL BRIGHAM PUT IN PLACE A SYSTEM-WIDE COVID-19 COMMUNITY HEALTH EQUITY STRATEGY.ONE PIECE OF THIS STRATEGY WAS TO MITIGATE THE SPREAD OF COVID-19 WITH DISTRIBUTION OF MULTILINGUAL INFORMATION AND CARE KITS. SINCE EARLY APRIL, MASS GENERAL BRIGHAM EMPLOYEES HAVE BEEN PRODUCING AND DISTRIBUTING THESE CARE KITS WHICH INCLUDE MASKS, SOAP, HAND SANITIZER AND INFORMATION ON COVID-19 TO VULNERABLE COMMUNITIES THROUGHOUT THE REGION. TO DATE, THE SYSTEM HAS PRODUCED 330,000 CARE KITS, OVER 2.8 MILLION PROTECTIVE MASKS, 332,000 BARS OF SOAP, OVER 308,000 BOTTLES OF HAND SANITIZER, AS WELL AS INFORMATION TO STOP THE SPREAD OF COVID-19 TO OVER 30 CITIES, TOWNS AND COMMUNITY GROUPS.
PART III, LINE 2:	THE PATIENT LIABILITY IS REDUCED BY ALL PAYMENTS AND INSURANCE CONTRACTUAL ADJUSTMENTS. PREVIOUSLY APPLIED PATIENT DISCOUNTS ARE REVERSED PRIOR TO PLACEMENT IN BAD DEBT IF THE PATIENT DOES NOT PAY AFTER THE PRESCRIBED COLLECTION PROCESS OR IF THE PATIENT RENEGES ON A PREVIOUSLY AGREED PAYMENT SCHEDULE.
PART III, LINE 4:	TEXT OF BAD DEBT FOOTNOTE FROM AFS: (IN THOUSANDS OF DOLLARS)IN ADDITION TO CHARITY CARE AND INADEQUATE FUNDING FROM THE MEDICAID AND MEDICARE PROGRAMS, THERE ARE SIGNIFICANT LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENT FOR SERVICES RENDERED OR INSURED PATIENTS WHO FAIL TO REMIT CO-PAYMENTS AND DEDUCTIBLES AS REQUIRED UNDER THE APPLICABLE HEALTH INSURANCE ARRANGEMENT. THE ESTIMATED COST OF PROVIDING THESE SERVICES WAS APPROXIMATELY $65,171 AND $70,743 FOR 2020 AND 2019, RESPECTIVELY.
PART III, LINE 8:	ALL COSTS REPORTED ON THE MEDICARE COST REPORT HAVE BEEN DETERMINED IN ACCORDANCE WITH MEDICARE COST-FINDING PRINCIPLES. COSTS ALLOCABLE TO MEDICARE PATIENTS ARE LIMITED TO CERTAIN SERVICES AND DERIVED IN A NUMBER OF WAYS, INCLUDING AVERAGE COST PER DAY TIMES MEDICARE DAYS AND RATIO OF COST TO CHARGES APPLIED TO CHARGES FOR ANCILLARY SERVICES PROVIDED TO MEDICARE BENEFICIARIES. THE DETERMINATION OF ALLOWABLE COSTS VIA THE MEDICARE COST REPORT EXCLUDES THE COST AND REVENUE ASSOCIATED WITH CERTAIN SERVICES, LIMITS THE COSTS RECOGNIZED FOR OTHER SERVICES AND EXCLUDES CERTAIN COSTS OF DOING BUSINESS. IN ADDITION, THE MEDICARE COST REPORT METHODOLOGY DOES NOT ALLOCATE COSTS TO MEDICARE BENEFICIARIES AS PRECISELY AS COST ACCOUNTING SYSTEMS, WHICH, FOR EXAMPLE, ACCOUNT FOR THE MORE INTENSIVE NURSING CARE MEDICARE BENEFICIARIES OFTEN REQUIRE.LOSSES ON THE PROVISION OF CARE TO MEDICARE PATIENTS SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THEY REPRESENT A DIRECT SUBSIDY TO THE FEDERAL GOVERNMENT BY HOSPITALS TO COVER THE COST OF CARE IN EXCESS OF MEDICARE REIMBURSEMENT. PROVIDING CARE FOR THE ELDERLY AND DISABLED AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD BECAUSE ACCESS TO CARE IS ONE OF THE MOST IMPORTANT WAYS WE CAN SERVE OUR COMMUNITIES. THIS SUBSIDY HELPS TO MAKE THAT ACCESS POSSIBLE.
PART III, LINE 9B:	PATIENTS PROTECTED FROM COLLECTION ACTION. THE HOSPITAL WILL TAKE REASONABLE STEPS TO ENSURE THAT NO COLLECTION ACTIONS, INCLUDING TELEPHONE CALLS, STATEMENTS OR LETTERS, ARE INITIATED FOR THOSE PATIENT BALANCES THAT MAY BE EXEMPT FROM COLLECTION ACTION BY REGULATION, INCLUDING PATIENTS DETERMINED TO BE A LOW INCOME PATIENT BY THE OFFICE OF MEDICAID (EXCEPT FOR DENTAL-ONLY LOW INCOME PATIENTS), OR ENROLLED IN MASSHEALTH, CHILDREN'S MEDICAL SECURITY PLAN (CMSP) WITH A MAGI FAMILY INCOME EQUAL TO OR LESS THAN 300% OF THE FPG, EMERGENCY AID TO THE ELDERLY, DISABLED, AND CHILDREN (EAEDC), AND HEALTH SAFETY NET (FULL OR PARTIAL) EXCEPTING DEDUCTIBLES AND COPAYMENTS DETERMINED BY THOSE PROGRAMS TO BE A PATIENT RESPONSIBILITY, AND COPAYMENTS FROM ANY THIRD-PARTY PAYER EXCEPT MEDICARE.. IF IT IS DETERMINED THAT A PATIENT WAS ENROLLED IN ONE OF THOSE CATEGORIES, THEN ALL COLLECTION ACTIONS (EXCEPT APPLICABLE CO-PAYMENTS AND HSN DEDUCTIBLES) WITH THE PATIENT WILL BE CLOSED FOR SERVICES THAT OCCURRED DURING THE PATIENT'S PERIOD OF ELIGIBILITY. COLLECTION ACTIONS WILL ALSO CEASE FOR AS LONG AS THE PATIENT IS DETERMINED TO BE LOW INCOME IF THE BALANCE IS FROM A PERIOD WHEN THE PATIENT WAS NOT ENROLLED IN A QUALIFYING PROGRAM. THE HOSPITAL MAY CONTINUE TO SEND LETTERS REQUESTING INFORMATION OR ACTION BY THE PATIENT TO RESOLVE COVERAGE AND/OR ELIGIBILITY ISSUES WITH A PRIMARY PAYER, WORKERS COMPENSATION PROGRAM OR TO OBTAIN ANY THIRD PARTY LIABILITY OR MVA CARRIER INFORMATION.
PART VI, LINE 2:	MASS GENERAL BRIGHAM HAS A SYSTEM-WIDE STRATEGY TO IMPROVE PATIENT OUTCOMES AND EXPERIENCE, WHICH IS SUPPORTED BY OUR HISTORICAL AND ONGOING COMMITMENT TO DIGITAL HEALTH AND DATA ANALYTICS, POPULATION HEALTH, AND OUTPATIENT CARE. WE SEEK WAYS TO DELIVER CARE IN SUBURBAN SETTINGS THROUGH DEVELOPING COMMUNITY-BASED CARE CENTERS THAT OFFER PRIMARY AND BEHAVIORAL HEALTH CARE, AS WELL AS SPECIALTY AND SURGICAL SERVICES.TO FULLY UNDERSTAND THE RANGE OF NEEDS OF PATIENTS, MASS GENERAL BRIGHAM CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA). THESE STUDIES ARE AIMED AT IDENTIFYING THE MOST PRESSING SOCIAL, ECONOMIC, AND HEALTH ISSUES IN THE SERVICE AREA BY AIMING TO:SYSTEMATICALLY IDENTIFY THE HEALTH-RELATED NEEDS, STRENGTHS, AND RESOURCES OF THE SERVICE AREA TO INFORM FUTURE PLANNINGUNDERSTAND THE CURRENT HEALTH STATUS OF RESIDENTS WITHIN THE SERVICE AREA, AS WELL AS SUB-POPULATIONS WITHIN THEIR SOCIAL CONTEXTENGAGE THE COMMUNITY TO HELP DETERMINE COMMUNITY NEEDS AND SOCIAL DETERMINANT OF HEALTH NEEDS.IN ADDITION, ALL OF MASS GENERAL BRIGHAM'S MEMBER INSTITUTIONS CONDUCT CHNAS OF THEIR OWN, AT MINIMUM, EVERY 3 YEARS. SEE CHNAS FOR EACH HOSPITAL FACILITY AS REPORTED ON SCHEDULE H, PART V AS WELL AS THE COMMUNITY BENEFIT REPORTS FOUND AT THE MASSACHUSETTS ATTORNEY GENERAL: HTTPS://MASSAGO.ONBASEONLINE.COM/MASSAGO/1801CBS/ANNUALREPORT.ASPXWENTWORTH-DOUGLASS FILES ITS COMMUNITY BENEFIT REPORT WITH THE NH DEPARTMENT OF JUSTICE FOUND AT: HTTPS://WWW.DOJ.NH.GOV/CHARITABLE-TRUSTS/DOCUMENTS/2020-WENTWORTH-DOUGLASS.PDF
PART VI, LINE 3:	FINANCIAL COUNSELING SERVICESTHE HOSPITAL WILL SEEK TO IDENTIFY PATIENTS WHO MAY BE UNINSURED OR INADEQUATELY INSURED IN ORDER TO PROVIDE COUNSELING AND ASSISTANCE. THE HOSPITAL WILL PROVIDE FINANCIAL COUNSELING TO THESE PATIENTS AND THEIR FAMILIES, INCLUDING SCREENING FOR ELIGIBILITY FOR OTHER SOURCES OF COVERAGE, SUCH AS STATE PROGRAMS AND OTHER GOVERNMENT PROGRAMS (INCLUDING TO THE EXTENT POSSIBLE, MEDICAID PROGRAMS IN STATES OTHER THAN MASSACHUSETTS OR NEW HAMPSHIRE), AND PROVIDING INFORMATION REGARDING ALL ACCEPTABLE METHODS OF PAYMENT OF THE HOSPITAL BILL. THE HOSPITAL WILL ENCOURAGE PATIENTS WHO ARE POTENTIALLY ELIGIBLE FOR COVERAGE FROM STATE PROGRAMS OR OTHER GOVERNMENT PROGRAMS TO APPLY FOR COVERAGE AND SHALL ASSIST THE PATIENT IN APPLYING FOR BENEFITS. MA RESIDENTS MAY ALSO APPLY FOR AND BE APPROVED FOR COVERAGE BY THE HSN FOR CO-INSURANCE OR DEDUCTIBLES NOT COVERED BY THEIR PRIMARY INSURANCE PLAN. THE HOSPITAL WILL POST A NOTICE (SIGNS) OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS AND DESCRIBE WHERE TO GO TO FOR ASSISTANCE IN THE FOLLOWING LOCATIONS: 1. INPATIENT, CLINIC, EMERGENCY DEPARTMENT, AND COMMUNITY HEALTH CENTER ADMISSION AND/OR REGISTRATION AREAS; 2. FINANCIAL COUNSELING WAITING AREAS 3. CENTRAL ADMISSION/REGISTRATION AREAS THAT ARE OPEN TO PATIENTS 4. BUSINESS OFFICE WAITING AREAS THAT ARE OPEN TO PATIENTS. SIGNS WILL BE TRANSLATED INTO OTHER LANGUAGES TO THE EXTENT THAT THE LANGUAGE IS THE PRIMARY LANGUAGE OF MORE THAN 10% OF RESIDENTS IN THE HOSPITAL'S SERVICE. SIGNS WILL GENERALLY BE POSTED IN ENGLISH AND SPANISH. POSTED SIGNS WILL BE CLEARLY VISIBLE AND LEGIBLE TO PATIENTS VISITING THESE AREAS. SIGNAGE WILL ALSO INCLUDE INSTRUCTIONS ON ACCESS TO TRANSLATION SERVICES FOR PATIENTS WHO HAVE OTHER LANGUAGE NEEDS. STANDARD NOTICES WILL BE PROVIDED TO ALL PATIENTS AT THE TIME OF THEIR INITIAL REGISTRATION WITH MASS GENERAL BRIGHAM. THESE NOTICES WILL ALSO BE MADE WIDELY AVAILABLE THROUGHOUT ALL MASS GENERAL BRIGHAM HOSPITAL CREDIT & COLLECTION POLICY JANUARY 1, 2020 13 HOSPITALS AND HEALTH CENTERS AND ROUTINELY OFFERED TO EXISTING PATIENTS WHENEVER THEY ARE EXPECTED TO HAVE AN OUT-OF-POCKET LIABILITY. COMPLETE COPIES OF THIS POLICY AND THE MGB UNINSURED PATIENT DISCOUNT AND FINANCIAL ASSISTANCE POLICY WILL ALSO BE MADE AVAILABLE TO PATIENTS AS REQUIRED. BOTH POLICIES WILL ALSO BE POSTED ON THE INTERNET AT WWW.PARTNERS.ORG/PATIENTBILLING WITH LINKS TO THE HOMEPAGES OF ALL HOSPITAL ENTITIES IN READILY IDENTIFIABLE LOCATIONS.
PART VI, LINE 4:	MASS GENERAL BRIGHAM IS COMMITTED TO WORKING WITH COMMUNITY RESIDENTS AND ORGANIZATIONS TO MAKE MEASURABLE, SUSTAINABLE IMPROVEMENTS IN THE HEALTH STATUS OF UNDERSERVED POPULATIONS. AS A SYSTEM, MASS GENERAL BRIGHAM MAKES A SIGNIFICANT COMMITMENT TO COMMUNITY HEALTH. THROUGH INITIATIVES THAT INCLUDE ACCESS TO HEALTH CARE, PREVENTION, AND WORKFORCE DEVELOPMENT, MASS GENERAL BRIGHAM AND ITS HOSPITALS ARE MAKING A DIFFERENCE IN THE COMMUNITIES IN WHICH WE LIVE AND WORK. MASS GENERAL BRIGHAM HAS A DEEP COMMITMENT TO COMMUNITY HEALTH CENTERS. SINCE ITS FOUNDING IN 1994, MASS GENERAL BRIGHAM AND ITS HOSPITALS HAVE PROVIDED MORE THAN $83M TO ENSURE THAT HEALTH CENTERS HAVE THE SPACE AND TECHNOLOGY THEY NEED TO PROVIDE PATIENTS WITH EXCELLENT CARE.
PART VI, LINE 5:	THE HOSPITALS INCLUDED IN THE MASS GENERAL BRIGHAM SYSTEM HAVE GOVERNING BODIES THAT ARE COMPRISED OF COMMUNITY LEADERS WHO ARE GUIDED BY THE MISSION TO DELIVER EXCELLENCE IN PATIENT CARE, ADVANCE THAT CARE THROUGH INNOVATIVE RESEARCH AND EDUCATION AND IMPROVE THE HEALTH AND WELL-BEING OF THE DIVERSE COMMUNITIES SERVED.SURPLUS FUNDS ARE USED TO FURTHER THE ORGANIZATION'S TAX-EXEMPT MISSIONS OF PATIENT CARE, EDUCATION AND RESEARCH.
PART VI, LINE 6:	MASS GENERAL BRIGHAM IS ONE OF THE LARGEST CHARITABLE DIVERSIFIED HEALTH CARE SERVICES ORGANIZATIONS IN THE UNITED STATES, ESTABLISHED IN 1994 BY AN AFFILIATION BETWEEN THE BRIGHAM MEDICAL CENTER, INC., NOW KNOWN AS BRIGHAM HEALTH, INC., AND THE MASSACHUSETTS GENERAL HOSPITAL IN ORDER TO CREATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. MASS GENERAL BRIGHAM CURRENTLY OPERATES TWO TERTIARY AND SEVEN COMMUNITY ACUTE CARE HOSPITALS, HOSPITALS SPECIALIZING IN INPATIENT AND OUTPATIENT SERVICES IN BEHAVIORAL HEALTH, REHABILITATION MEDICINE AND OPHTHALMOLOGY AND OTOLARYNGOLOGY, A HOME HEALTH AGENCY, A NURSING HOME AND A PHYSICIAN NETWORK WITH APPROXIMATELY 7,200 EMPLOYED AND AFFILIATED PRIMARY CARE AND SPECIALTY CARE PHYSICIANS. MASS GENERAL BRIGHAM ALSO OPERATES A NON-PROFIT MANAGED CARE ORGANIZATION AND A FOR-PROFIT INSURANCE COMPANY THAT PROVIDE HEALTH INSURANCE PRODUCTS AND ADMINISTRATIVE SERVICES TO THE MASSACHUSETTS MEDICAID PROGRAM (MASSHEALTH), CONNECTORCARE (A STATE SUBSIDIZED PROGRAM FOR ADULTS WHO MEET INCOME AND IMMIGRATION GUIDELINES) AND COMMERCIAL POPULATIONS. MASS GENERAL BRIGHAM MAINTAINS THE LARGEST NON-UNIVERSITY-BASED, NON-PROFIT, PRIVATE MEDICAL RESEARCH ENTERPRISE IN THE UNITED STATES; ITS HOSPITALS ARE PRINCIPAL TEACHING AFFILIATES OF THE MEDICAL AND DENTAL SCHOOLS OF HARVARD UNIVERSITY; AND IT OPERATES A GRADUATE LEVEL PROGRAM FOR HEALTH SCIENCES.WITH APPROXIMATELY 53,300 FULL-TIME EQUIVALENT EMPLOYEES (FTES), MASS GENERAL BRIGHAM IS ONE OF THE LARGEST PRIVATE EMPLOYERS IN THE COMMONWEALTH OF MASSACHUSETTS (THE COMMONWEALTH). MASS GENERAL BRIGHAM INCORPORATED (F/K/A PARTNERS HEALTHCARE SYSTEM, INC.) AS THE PARENT CORPORATION OF THE MASS GENERAL BRIGHAM SYSTEM, PROVIDES A NUMBER OF SERVICES FOR ITS AFFILIATES, INCLUDING CLINICAL AFFAIRS, COMMUNITY BENEFITS, FINANCE, HUMAN RESOURCES, INFORMATION SYSTEMS, INTERNAL AUDIT, INVESTMENTS, LEGAL, MARKETING, MATERIALS MANAGEMENT, REAL ESTATE, RESEARCH ADMINISTRATION, STRATEGIC PLANNING AND TREASURY. THE FINANCE COMMITTEE OF THE INSTITUTION'S BOARD OF DIRECTORS OVERSEES CENTRALIZED OPERATING AND CAPITAL BUDGET, DEBT MANAGEMENT AND BUSINESS PLANNING PROCESSES FOR THE INSTITUTION AND ALL OF ITS AFFILIATES. CASH AND INVESTMENTS ARE MANAGED CENTRALLY UNDER POLICIES DEVELOPED BY THE INVESTMENT COMMITTEE OF THE INSTITUTION'S BOARD OF DIRECTORS AND REVIEWED BY THE FINANCE COMMITTEE. THE INSTITUTION ALSO COORDINATES THE RESEARCH AND MEDICAL EDUCATION PROGRAMS OF ITS AFFILIATES.
PART VI, LINE 7: STATE OF FILING COMMUNITY BENEFIT REPORT:	EACH OF THE HOSPITALS THAT COMPRISE THE MASS GENERAL BRIGHAM SYSTEM HAS A COMMUNITY BENEFIT PLANNING AND SERVICE DELIVERY STRUCTURE. EACH OF THESE ENTITIES (EXCEPT THE THREE REHABILITATION FACILITIES LISTED IN PART V, SECTION A) HAS FILED SEPARATE COMMUNITY BENEFIT REPORTS WITH ATTORNEY GENERAL OF THE COMMONWEALTH OF MASSACHUSETTS AND THE NEW HAMPSHIRE DEPARTMENT OF JUSTICE IN THE CASE OF WENTWORTH-DOUGLASS HOSPITAL.

Schedule H (Form 990) 2019

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