2020-08-17T22:17:25-05:00 2019-09-30 861065772 DELOITTE TAX LLP 2 JERICHO PLAZA JERICHO NY 11753 990 2018-10-01 042103604 BETH ISRAEL DEACONESS HOSPITAL - MILTON BETH 6173131000 199 REEDSDALE ROAD MILTON MA 02186 MICHAEL CONKLIN CFO 6173131000 2020-08-17 0 CHRISTINE KAWECKI P00743140 5169187000 2020-08-17 72.49.173.45 2020-08-17 21:42:50 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 0F15B0CDE5A4E1FB9EC7511A30B41E30291BB2E7 2018 2020-09-23 17:36:50Z RICHARD FERNANDEZ 199 REEDSDALE ROAD MILTON MA 02186 128379769 0 X WWW.BIDMILTON.ORG X 1952 MA SEE SCHEDULE O. 20 17 0 0 -42524 0 983966 1825616 114856696 123374443 1210843 1354784 1758727 1397637 118810232 127952480 39907 69656 0 0 55469815 58979371 57610 406875 1124118 55295067 61724960 110862399 121180862 7947833 6771618 161184171 159532516 70068182 67225796 91115989 92306720 X SEE SCHEDULE O 0 0 58779393 69656 68273473 SEE SCHEDULE O 9752830 15379449 SEE SCHEDULE O 40972737 39881498 SEE SCHEDULE O 109504960 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 0 0 1 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 20 17 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X MICHAEL CONKLIN 6176964600 199 REEDSDALE ROAD MILTON MA 02186 ALEXOPOULOS ALEXANDA DIRECTOR 1.00 2.00 X 0 0 0 BRADY MICHAEL J DIRECTOR, CHAIR 10.00 11.00 X X 0 0 0 CHI CHANG DANIEL SAO DIRECTOR (EX-OFFICIO) 1.00 2.00 X 0 0 0 CICHELLO ANTHONY DIRECTOR & VICE CHAIR 5.00 15.00 X X 0 0 0 CRONIN MD JON DIRECTOR 1.00 2.00 X 0 0 0 DOHERTY MAURA DIRECTOR 1.00 2.00 X 0 0 0 FERNANDEZ RICHARD DIR (EX-OFF)/PRESIDENT 60.00 4.00 X X 501086 15498 48361 FISCHER STEVEN P DIRECTOR; TREASURER 1.00 62.00 X X 0 770210 75762 GREENE DONALD DIRECTOR 1.00 2.00 X 0 0 0 HEAVEY CHRISTOPHER DIRECTOR & TREASURER 2.00 4.00 X X 0 0 0 HODGMAN JANE DIRECTOR 1.00 3.00 X 0 0 0 KERWIN MARK DIRECTOR 1.00 2.00 X 0 0 0 LAURENCE ANDREW DIRECTOR & ASST. CLERK 2.00 4.00 X X 0 0 0 LEWIS MD STANLEY M DIRECTOR 1.00 68.00 X 0 732103 72582 LONGMAID MD H ESTERBROOK DIR (EX-OFF)/PRES OF MED STAFF 8.00 2.00 X 115000 0 0 MARR JEFFREY DIRECTOR 1.00 2.00 X 0 0 0 NEEDHAM ELLEN DIRECTOR 1.00 2.00 X 0 0 0 O'CONNOR MD HEIDI DIRECTOR, INTENSIVIST 60.00 2.00 X 310557 16345 43881 PATHAK RAJU DIRECTOR 1.00 2.00 X 0 0 0 SHIH DIN DIRECTOR 1.00 2.00 X 0 0 0 TABB MD KEVIN DIRECTOR (EX-OFFICIO), CEO 1.00 65.00 X X 0 1756953 143704 CONKLIN MICHAEL ASST. TREAS.; VP FINANCE/CFO 55.00 9.00 X 336374 10403 43579 KATZ JAMIE CLERK 1.00 59.00 X 0 560463 44008 BARNETT MD SHEILA CHIEF MEDICAL OFFICER 1.00 59.00 X 0 479359 88125 CRONIN RN LYNN CNO 60.00 0.00 X 197525 0 51220 HARRINGTON KATHLEEN VP HUMAN RESOURCES 60.00 0.00 X 200593 0 32280 YEATS MD ASHLEY CHIEF MEDICAL OFFICER 60.00 0.00 X 357488 0 48332 COUGHLIN KAY KATHLEEN VICE CHAIR, ASS PROF HMS 60.00 0.00 X 168836 0 21639 LOUIS RN CONCESA C NURSE RN 60.00 0.00 X 239996 0 13254 TRUESDELL STEPHANIE L VP DEVELOPMENT 60.00 0.00 X 187794 0 28453 WILLIAMS ANDREA COMPLIANCE OFFICER 60.00 0.00 X 168962 0 42268 YANSON ROSIE S NURSE RN 60.00 0.00 X 182316 0 5359 2966527 4341334 802807 13 0 1 0 DELLBROOK CONSTRUCTION LLC ONE ADAMS PLACE 859 WILLARD STREET QUINCY MA 02169 CONSTRUCTION 4840729 HARVARD MEDICAL FACULTY PHYSCIANS 600 UNICORN PARK DRIVE 4TH FLOOR WOBURN MA 01801 MEDICAL SERVICES 3555414 BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVENUE BOSTON MA 02215 MEDICAL SERVICES 2512432 ASSOCIATED PHYS OF HMFP 330 BROOKLINE AVENUE BOSTON MA 02215 MEDICAL SERVICES 1044923 BETH ISRAEL DEACONESS PHYS ORG LLC 247 STATION DRIVE SUITE NORTHWEST WESTWOOD MA 02090 MEDICAL SERVICES 1011905 12 259581 771225 794810 1825616 NET PATIENT SERVICE RE 622110 122607004 122607004 OPD PROGRAM REVENUE 621400 428978 428978 APG&CPA RENT 532000 337620 337620 OTHER ANCILLARY 622110 841 841 123374443 277805 -59764 337569 897893 427289 470604 470604 470604 1076979 0 1076979 1076979 1076979 110521 259581 0 110521 110521 CAFETERIA/VENDING MACH 722310 639295 639295 REBATES & REFUNDS 900099 131341 131341 LAB WORK 900099 17240 17240 28636 28636 816512 127952480 123534420 -42524 2634968 X 69656 69656 4656132 4237080 419052 43656516 41470129 1830451 355936 2037573 1861731 167692 8150 5147911 4923322 205479 19110 3481239 3329362 138954 12923 171612 171612 87500 87500 175919 175919 155500 155500 406875 406875 253474 253474 14998836 11741214 3162963 94659 994947 994947 1305133 1111883 173304 19946 5068353 4630955 417125 20273 6364646 5149902 1211642 3102 7507 5454 2028 25 35732 22735 12997 1559939 1559939 7909406 7226824 650944 31638 656052 656052 MEDICAL SUPPLIES 17557614 17450093 107521 UNCOMPENSATED CARE 1838726 1838726 EQUIPMENT RENTALS 1032516 982806 49710 FOOD & OTHER SUPPLIES 788861 766696 18631 3534 762687 298789 315951 147947 121180862 109504960 10551784 1124118 8775831 2819251 10707635 11493751 1786607 2732616 1509360 1417480 699036 703419 143488272 42030375 99911661 101457897 34550458 35286538 3243583 3621564 161184171 159532516 13975560 12651490 33103805 32433291 537808 142447 22451009 21998568 70068182 67225796 X 83344844 84436044 4913811 4998342 2857334 2872334 91115989 92306720 161184171 159532516 X 6771618 116272 -5697159 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 155510 155510 0 PART II-B, LINE 1: BETH ISRAEL DEACONESS HOSPITAL - MILTON ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER NETWORK AFFILIATES AND/OR PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $155,510 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES. 13111055 74725 87818 1882 13271716 12401390 200068 405643 -103954 13111055 19534830 97114 787972 8018526 12401390 17855848 117019 1698620 136657 19534830 18396252 10000 -550404 17855848 0.36000 0.64000 0 0 9338758 9338758 87274332 24905447 62368885 662734 157492 505242 44687514 16967436 27720078 1524934 1524934 101457897 SHORT TERM INVESTMENTS 27415862 C DONOR RESTRICTED INVESTMENTS 7870676 C 35286538 PENSION LIABILITY 12770445 DUE TO THIRD PARTY 1867305 PROFESSIONAL LIABILITY 4124284 DUE TO AFFILIATES 3236534 21998568 X 3267670000 75987 3191988297 3192064284 75605716 52346764 52346764 127952480 70576992 20414 20414 70556578 50624283 50624283 121180861 PART V, LINE 4: BETH ISRAEL DEACONESS HOSPITAL - MILTON'S ENDOWMENT FUNDS ARE INTENDED TO ENSURE THAT THE BETH ISRAEL DEACONESS HOSPITAL - MILTON ACCOMPLISHES ITS CHARITABLE MISSION OF IMPROVING PATIENT HEALTH BY PROVIDING HIGH QUALITY, PERSONALIZED HEALTH CARE WITH COMPASSION, DIGNITY AND RESPECT IN A COST EFFECTIVE AND SAFE MANNER IN CLOSE COLLABORATION WITH ITS AFFILIATE, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. THE SPECIFIC USES OF THE ENDOWMENT VARY DEPENDING ON THE NATURE OF RESTRICTIONS, IF ANY, IMPOSED BY DONORS. THE BETH ISRAEL DEACONESS HOSPITAL - MILTON ENDOWMENT CONSISTS OF THREE POOLS: 1. BOARD DESIGNATED FUNDS ARE UNRESTRICTED AND ARE USED AS DEEMED BY THE GOVERNING BOARD 2. TEMPORARY SPECIFIC PURPOSE FUNDS ARE THOSE GIFTS THAT ARE TO BE USED AS STIPULATED IN THE DONORS' GIFTS TO THE HOSPITAL (I.E. FOR EQUIPMENT, SPECIFIC PROGRAMS, FREE CARE ETC.) 3. ENDOWMENT FUNDS ARE PERMANENTLY RESTRICTED FUNDS THE INCOME FROM WHICH IS USED AS THE DONOR SPECIFIES. PART X, LINE 2: EACH ENTITY WITHIN THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. THE SYSTEM DID NOT RECOGNIZED THE EFFECT OF ANY INCOME TAX POSITIONS IN 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION USED FOR OPERATION 1,882. CHANGES IN EQUITY INTERESTS IN LIMITED PARTNERSHIP -422,166. CONSOLIDATED AFFILIATES NET ELIMINIATIONS 3,192,408,581. PART XI, LINE 4B - OTHER ADJUSTMENTS: 5 MONTH REVENUE NOT IN AFS 52,306,050. RESTRICTED CONTRIBUTIONS 74,725. RESTRICTED REVENUE -13,596. RENTAL/ FUNDRAISING/ INVESTMENT EXPENSE RECLASS -20,414. ROUNDING -1. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL/ FUNDRAISING/ INVESTMENT EXPENSE RECLASS 20,414. PART XII, LINE 4B - OTHER ADJUSTMENTS: 5 MONTH EXPENSES NOT IN AFS 50,624,285. ROUNDING -2. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 6825333 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 974219 0 0 0 0 0 0 7799552 0 7799552 1 0 1 1 1 0 PART IV, QUESTION 3: ALTHOUGH BETH ISRAEL DEACONESS HOSPITAL - MILTON HAD AN INDIRECT OWNERSHIP INTEREST IN A FOREIGN CORPORATION, IT DID NOT MEET ANY OF THE FIVE CATEGORIES OF REQUIRED FILER AND AS SUCH WAS NOT REQUIRED TO FILE FORM 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS. PART IV, QUESTION 4: ALTHOUGH BETH ISRAEL DEACONESS HOSPITAL - MILTON WAS AN INDIRECT SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR QUALIFIED ELECTING FUND DURING THE PERIOD COVERED BY THIS FILING, BETH ISRAEL DEACONESS HOSPITAL - MILTON WAS NOT REQUIRED TO FILE FORM 8621, INFORMATION RETURNS BY A SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR QUALIFIED ELECTING FUND. SCHEDULE F PART IV QUESTION 5: ALTHOUGH BETH ISRAEL DEACONESS HOSPITAL - MILTON HELD AN INDIRECT OWNERSHIP INTEREST IN A FOREIGN PARTNERSHIP DURING THE TAX YEAR, THE INTEREST DID NOT RESULT IN AN OBLIGATION TO FILE FORM 8865, RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS. X X X X X X 1 BIDMC 330 BROOKLINE AVENUE BOSTON MA 02215 FUNDRAISING SERVICES 1 957654 406875 550779 957654 406875 550779 CT MA RI GALA 262313 163807 98506 GOLF TOURNAMENT 107789 95774 12015 370102 259581 110521 110521 PART I, LINE 2B, COLUMN (III): AS PREVIOUSLY NOTED, EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) BECAME THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON, AND BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) BECAME A SISTER ENTITY. PRIOR TO THIS DATE BIDMC SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON. AS PART OF THIS CLOSE RELATIONSHIP, BIDMC PROCESSED CONTRIBUTIONS FOR BETH ISRAEL DEACONESS HOSPITAL - MILTON. UPON RECEIPT, THE CONTRIBUTIONS WERE DEPOSITED INTO A BIDMC ACCOUNT. AT THE END OF EACH MONTH THE TOTAL OF THE DEPOSITS WERE TRANSFERRED FROM BIDMC TO BETH ISRAEL DEACONESS HOSPITAL - MILTON. PAYMENTS TO BIDMC REPORTED HERE REPRESENT A REIMBURSEMENT TO BIDMC FOR THESE SERVICES. 1 1 X 1 X 400.000000000000 1 X 1 0 1 1 1088903 1088903 0.00900 9079031 6991862 2087169 0.01720 10167934 6991862 3176072 0.02620 281957 4400 277557 0.00230 33010509 18387031 14623478 0.12070 86950 86950 0.00070 33379416 18391431 14987985 0.12370 43547350 25383293 18164057 0.14990 500 500 0.00000 500 500 0.00000 1 5982861 47057726 44768976 2288750 X 1 1 1 1 BETH ISRAEL DEACONESS HOSPITAL -- MILTON 199 REEDSDALE AVENUE MILTON MA 02186 WWW.BIDMILTON.ORG MA STATE LICENSE #2227 X X X COMMUNITY HOSPITALS BETH ISRAEL DEACONESS HOSPITAL -- MILTON 1 0 0 1 X X X X X X X 18 1 1 0 1 X SEE PART VI X 1 18 1 SEE PART VI 0 1 X 400.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART VI X SEE PART VI X SEE PART VI X X X X X X 1 X 0 X X X X 1 X 0 0 BETH ISRAEL DEACONESS HOSPITAL -- MILTON PART V, SECTION B, LINE 5: PART V, SECTION B, LINE 5: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION. BETH ISRAEL DEACONESS HOSPITAL -- MILTON PART V, SECTION B, LINE 11: PART V, SECTION B, LINE 11: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION. FORM 990 SCHEDULE H PART V, SECTION C: SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENTBETH ISRAEL DEACONESS HOSPITAL-MILTON'S (BID MILTON) COMMUNITY BENEFITS MISSION IS "TO PROVIDE FREE OR LOW-COST PROGRAMS THAT ADDRESS UNMET HEALTH AND WELLNESS NEEDS OF RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE COMMUNITIES IN MILTON, RANDOLPH AND QUINCY, IN A MANNER SHAPED BY COMMUNITY INPUT, ALIGNED WITH HOSPITAL RESOURCES, AND GUIDED BY OUR OBJECTIVE TO DELIVER HIGH-QUALITY CARE WITH COMPASSION, DIGNITY AND RESPECT."THIS COMMUNITY BENEFITS MISSION IS FULFILLED BY: INVOLVING BID MILTON'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE IMPLEMENTATION STRATEGY; ENGAGING RESIDENTS THROUGHOUT THE HOSPITAL'S SERVICE AREAS IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, INCLUDING ASSESSMENT, PLANNING, IMPLEMENTATION AND EVALUATION. SPECIAL ATTENTION IS FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO IDENTIFY UNMET HEALTH-RELATED NEEDS AND TO CHARACTERIZE THOSE IN THE COMMUNITY WHO ARE MOST VULNERABLE AND FACE DISPARITIES IN ACCESS AND OUTCOMES; IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES BID MILTON'S SERVICE AREA GEARED TOWARD IMPROVING CURRENT AND FUTURE HEALTH STATUS OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY REMOVING BARRIERS TO CARE, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, STRENGTHENING THE HEALTHCARE SYSTEM AND WORKING TO DECREASE THE BURDEN OF THE LEADING HEALTH ISSUES; PROMOTING HEALTH EQUITY BY ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS SUMMARYDURING THE FISCAL YEAR COVERED BY THIS FILING, BID MILTON PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $364,507 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMBID MILTON'S COMMUNITY BENEFITS LEADERSHIP TEAM INCLUDES REPRESENTATION FROM THE HOSPITAL'S SENIOR ADMINISTRATION, PATIENT FAMILY AND ADVISORY COUNCIL AND COMMUNITY SERVICE PROVIDERS, ALL OF WHOM ARE MEMBERS OF THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE. THE HOSPITAL'S PUBLIC RELATIONS DEPARTMENT MANAGES THE DAY-TO-DAY OPERATIONS OF THE COMMUNITY BENEFITS PROGRAM WITH GUIDANCE FROM HOSPITAL LEADERSHIP, THE FINANCE DEPARTMENT AND THE COMMUNITY BENEFITS ADVISORY COMMITTEE. COMMUNITY HEALTH NEEDS ASSESSMENTMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE (IRC) SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL DEACONESS HOSPITAL-MILTON COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2019. THAT CHNA WAS APPROVED BY THE BID MILTON BOARD OF TRUSTEES ON SEPTEMBER 23, 2019. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO APPROVED BY THE BOARD ON SEPTEMBER 23, 2019, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). BID MILTON'S MOST RECENT CHNA AND THE ASSOCIATED IMPLEMENTATION STRATEGY ARE THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OF BID MILTON'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST VULNERABLE OR DISADVANTAGED. THE PROJECT WAS ALSO DESIGNED TO FULFILL COMMONWEALTH ATTORNEY GENERAL'S OFFICE (AGO) AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BID MILTON ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BID MILTON, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY 2019 COMMUNITY HEALTH NEEDS ASSESSMENT TARGETED GEOGRAPHY AND POPULATIONSAS NOTED ABOVE, BETH ISRAEL DEACONESS HOSPITAL-MILTON COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2019. THE GEOGRAPHICAL FOCUS OF BID MILTON'S MOST RECENTLY COMPLETED CHNA ENCOMPASSES THE CITY OF QUINCY AND THE TOWNS OF MILTON AND RANDOLPH.TARGET POPULATIONS FOR BID MILTON'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).BETH ISRAEL DEACONESS HOSPITAL-MILTON'S TARGET POPULATIONS FOCUS ON MEDICALLY UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN THE TOWNS OF MILTON AND RANDOLPH AND THE CITY OF QUINCY, AS FOLLOWS: YOUTH OLDER ADULTS LOW- TO-MODERATE INCOME INDIVIDUALS AND FAMILIES INDIVIDUALS WITH CHRONIC AND COMPLEX CONDITIONS RACIAL/ETHNIC MINORITIES AND NON-ENGLISH SPEAKERSBID MILTON'S PROGRAMS MIRROR THE FIVE CORE PRINCIPLES OUTLINED BY THE PUBLIC HEALTH INSTITUTE IN TERMS OF THE "EMPHASIS ON COMMUNITIES WITH DISPROPORTIONATE UNMET HEALTH-RELATED NEEDS; EMPHASIS ON PRIMARY PREVENTION; BUILDING A SEAMLESS CONTINUUM OF CARE; BUILDING COMMUNITY CAPACITY; AND COLLABORATIVE GOVERNANCE." PROGRAMS DEVELOPED WILL AIM TO ADDRESS AND IMPROVE UPON THE FOLLOWING PRIORITY AREAS: MENTAL HEALTH AND SUBSTANCE USE CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE2019 COMMUNITY HEALTH NEEDS ASSESSMENT SUMMARY OF APPROACH AND METHODSBID MILTON CONDUCTED THIS CHNA PROCESS IN CONJUNCTION WITH BETH ISRAEL DEACONESS MEDICAL CENTER, WHICH SERVES AS THE SOLE MEMBER OF BID MILTON UNTIL MARCH 1, 2019, AS WELL AS WITH BID NEEDHAM AND BID PLYMOUTH, HOSPITALS FOR WHICH THE MEDICAL CENTER ALSO SERVES AS SOLE MEMBER. ALTHOUGH THE PROCESS WAS JOINTLY CONDUCTED, EACH HOSPITAL PRODUCED ITS OWN CHNA AND IMPLEMENTATION STRATEGY (SCHEDULE H, PART V, SECTION B, QUESTIONS 6A AND 6B).THE BID MILTON CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. BID MILTON HIRED JOHN SNOW, INC., TO CONDUCT AND MANAGE THE CHNA PROCESS UNDERTAKEN DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND JSI WORKED CLOSELY WITH BID MILTON COMMUNITY BENEFITS STAFF THROUGHOUT THE PROCESS. THE MOST RECENT CHNA WAS DESIGNED AS A THREE-PHASE PROCESS: PHASE ONE INVOLVED PRELIMINARY ASSESSMENT AND ENGAGEMENT ACTIVITIES, INCLUDING: COLLECTION AND ANALYSIS OF QUANTITATIVE DATA TO CHARACTERIZE COMMUNITY CHARACTERISTICS AND DISEASE BURDEN KEY INFORMANT INTERVIEWS WITH HOSPITAL LEADERSHIP, LOCAL SERVICE PROVIDERS, AND COMMUNITY STAKEHOLDERS AN EVALUATION OF BID MILTON'S CURRENT PORTFOLIO OF COMMUNITY BENEFITS ACTIVITIESPHASE TWO INVOLVED TARGETED ENGAGEMENT ACTIVITIES, INCLUDING: ADDITIONAL INTERVIEWS WITH HOSPITAL LEADERSHIP, CLINICAL PROVIDERS AND COMMUNITY STAKEHOLDERS DISSEMINATION AND ANALYSIS OF A COMMUNITY HEALTH SURVEY TO CAPTURE RESIDENTS' PERCEPTIONS OF BARRIERS TO GOOD HEALTH, LEADING HEALTH ISSUES, VULNERABLE POPULATIONS, ACCESSIBILITY OF HEALTH SERVICES AND OPPORTUNITIES FOR THE HOSPITAL TO IMPROVE THE SERVICES THEY OFFER TO THE COMMUNITY FOCUS GROUPS WITH IDENTIFIED UNDERSERVED POPULATIONSPHASE THREE INVOLVED A SERIES OF STRATEGIC PLANNING AND REPORTING ACTIVITIES, INCLUDING: MEETINGS WITH THE CBAC AND CBSLT (INCLUDING MEMBER OF THE BOARD OF TRUSTEES) TO PRESENT CHNA FINDINGS, PRIORITIZE COMMUNITY HEALTH ISSUES, IDENTIFY VULNERABLE POPULATIONS, AND DISCUSS POTENTIAL RESPONSES CREATION OF A RESOURCE INVENTORY TO CATALOG LOCAL ORGANIZATIONS, SERVICE PROVIDERS, AND COMMUNITY ASSETS THAT HAVE THE POTENTIAL TO ADDRESS IDENTIFIED NEEDS LITERATURE REVIEW OF EVIDENCE-BASED STRATEGIES TO RESPOND TO IDENTIFIED HEALTH PRIORITIES DEVELOPMENT OF A FINAL CHNA REPORT AND IMPLEMENTATION STRATEGY2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS DETAIL OF APPROACH AND METHODSTHE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM THE DISSEMINATION AND ANALYSIS OF A COMMUNITY HEALTH SURVEY TO CAPTURE RESIDENTS' PERCEPTIONS OF BARRIERS TO GOOD HEALTH, LEADING HEALTH ISSUES, VULNERABLE POPULATIONS, ACCESSIBILITY OF HEALTH SERVICES AND OPPORTUNITIES FOR THE HOSPITAL TO IMPROVE THE SERVICES THEY OFFER TO THE COMMUNITY. QUANTITATIVE DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN BID MILTON'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF THE HEALTH-RELATED ISSUES. SOURCES INCLUDED: U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017) MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017 AND 2018-2019) FBI UNIFORM CRIME REPORTS (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017) MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016) MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2017) MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY 2013-2017) MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018) TO AUGMENT THE QUANTITATIVE DATA FROM MDPH, JSI WORKED WITH THE MASSACHUSETTS HEALTH DATA CONSORTIUM (MHDC) AND THE MASSACHUSETTS CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA) TO OBTAIN 2018 INPATIENT HOSPITAL DISCHARGE DATA FOR ALL OF THE MUNICIPALITIES IN BID MILTON'S SERVICE AREA. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BID MILTON, WITH THE HELP OF JOHN SNOW, INC., CONDUCTED 17 KEY INFORMANT INTERVIEWS WITH COMMUNITY STAKEHOLDERS, INCLUDING REPRESENTATIVES FROM HOSPITAL AND MUNICIPAL LEADERSHIP, THE BUSINESS COMMUNITY, PUBLIC HEALTH DEPARTMENTS, SOCIAL SERVICE PROVIDERS, SCHOOLS, FAITH-BASED COMMUNITIES, AND COMMUNITY HEALTH COALITIONS. JSI ALSO FACILITATED FOUR FOCUS GROUPS. APPENDIX A IN THE BID MILTON CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.2019 COMMUNITY HEATH NEEDS ASSESSMENT PROCESS FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)FOUR FOCUS GROUPS WITH IDENTIFIED UNDERSERVED POPULATIONS WERE ALSO HELD. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE CITY AND TOWNS THAT COMPRISE THE MILTON REGION. PARTICIPANTS REPRESENTED DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., YOUTH, SENIORS, MINORITY GROUPS AND FOREIGN-LANGUAGE SPEAKERS) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED APPROXIMATELY 300 PEOPLE. APPENDIX A IN THE BID MILTON CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED.2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTS THE BID MILTON COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS DEVELOPED BY A TEAM COMPRISED OF HOSPITAL LEADERSHIP, PATIENT ADVOCACY, MEDICAL STAFF, PUBLIC RELATIONS AND COMMUNITY REPRESENTATION. THE GROUP REVIEWED PROGRESS TOWARD GOALS AND OBJECTIVES OF THE PRIOR THREE-YEAR PERIOD, AS WELL AS THE CURRENT DATA COLLECTED THROUGH THE CHNA, TO HELP ENVISION AND DEFINE PRIORITY AREAS FOR THE FUTURE. THE IMPLEMENTATION STRATEGY IDENTIFIED PRIORITY AREAS AND DEFINED GOALS, ALONG WITH OBJECTIVES FOR EACH GOAL AND DRAFTED STRATEGIES TO OPERATIONALIZE THESE OBJECTIVES. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY FINDINGS THE KEY PRIORITY POPULATIONS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2019, WERE: YOUTH OLDER ADULTS LOW- TO-MODERATE INCOME INDIVIDUALS AND FAMILIES INDIVIDUALS WITH CHRONIC AND COMPLEX CONDITIONS RACIAL/ETHNIC MINORITIES AND NON-ENGLISH SPEAKERSBETH ISRAEL DEACONESS HOSPITAL-MILTON'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: SOCIAL DETERMINANTS OF HEALTH CONTINUE TO HAVE A SUBSTANTIAL IMPACT ON MANY SEGMENTS OF THE POPULATION. ONE OF THE DOMINANT THEMES FROM THE ASSESSMENT'S FINDINGS WAS THE IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THOSE LIVING IN THE CBSA. THE SEGMENTS OF THE POPULATION MOST CHALLENGED BY THESE ISSUES ARE OLDER ADULTS, LOW-INCOME INDIVIDUALS/FAMILIES, RACIAL/ETHNIC MINORITIES, NON- ENGLISH SPEAKERS, AND THOSE WITH DISABILITIES OR WITH CHRONIC / COMPLEX CONDITIONS. MORE SPECIFICALLY, THESE SEGMENTS STRUGGLE WITH FINANCIAL INSECURITY, SAFE/AFFORDABLE HOUSING, TRANSPORTATION, ACCESS TO HEALTHY/AFFORDABLE FOOD, LACK OF SOCIAL SUPPORT, SOCIAL ISOLATION, AND LANGUAGE ACCESS ISSUES. THESE ISSUES IMPACT MANY PEOPLE'S AND FAMILIES' ABILITY TO ACCESS OR PAY FOR THE SERVICES, HOUSING, FOOD, OR OTHER ESSENTIAL ITEMS THEY NEED AND/OR TO LIVE A HAPPY, FULFILLING, PRODUCTIVE LIFE. THE BURDEN OF SUBSTANCE USE AND MENTAL HEALTH ISSUES. MENTAL HEALTH AND SUBSTANCE USE ISSUES CONTINUE TO BE ONE OF THE REGION'S MOST PREVALENT AND CHALLENGING ISSUES AND ARE HAVING A PROFOUND IMPACT ON INDIVIDUALS, FAMILIES, AND COMMUNITIES THROUGHOUT THE CBSA. THESE ISSUES ARE ALSO A MAJOR BURDEN ON THE HEALTH AND SOCIAL SERVICE SYSTEM. HEALTH AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH AGENCIES, FIRST-RESPONDERS, AND COMMUNITY-BASED ORGANIZATIONS ARE CONFRONTED ON A DAILY BASIS WITH PEOPLE STRUGGLING WITH ACUTE OR CHRONIC CONDITIONS AND STRUGGLE TO PROVIDE OR LINK THEM TO THE CARE THEY NEED. WITH RESPECT TO MENTAL HEALTH ISSUES, DEPRESSION/ANXIETY, STRESS, SOCIAL ISOLATION, AND THE IMPACTS OF TRAUMA ARE THE LEADING ISSUES. WITH RESPECT TO SUBSTANCE USE, THE OPIOID CRISIS CONTINUES TO HAVE A TREMENDOUS IMPACT ON THE REGION, ALONG WITH ALCOHOL USE, MARIJUANA USE, AND VAPING IN YOUTH. THE FACT THAT PHYSICAL, MENTAL HEALTH, AND SUBSTANCE ISSUES ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID USE AND THE IMPACTS OF TRAUMA. LIMITED ACCESS TO BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE) SERVICES. DESPITE THE PREVALENCE OF MENTAL HEALTH AND SUBSTANCE USE ISSUES AND THE IMPACT THAT THESE ISSUES ARE HAVING ON INDIVIDUALS, FAMILIES, AND COMMUNITIES, THE BEHAVIORAL HEALTH SERVICE SYSTEM IN THE REGION IS EXTREMELY LIMITED. THERE ARE MAJOR SHORTAGES OF SPECIALIZED PROVIDERS - SUCH AS PSYCHIATRISTS, THERAPISTS, ADDICTION SPECIALISTS, AND CASE MANAGERS - WHO ARE CAPABLE OF PROVIDING THE FULL BREADTH OF PREVENTIVE, SCREENING, ASSESSMENT, TREATMENT, AND RECOVERY SUPPORT SERVICES THAT THE COMMUNITY NEEDS. THIS IS PARTICULARLY TRUE FOR THOSE WHO HAVE LIMITED ENGLISH SKILLS OR DIFFERENT CULTURAL PERSPECTIVES WHO REQUIRE MORE SPECIALIZED CARE, SUCH AS RECENT IMMIGRANTS, RACIAL/ETHNIC MINORITIES, AND LGBTQ INDIVIDUALS. UNINSURED INDIVIDUALS, THOSE COVERED BY MEDICAID, AND THOSE IN LOW- TO MODERATE-INCOME BRACKETS ALSO STRUGGLE TO ACCESS OR PAY FOR THE SERVICES THEY NEED AND TO FIND PROVIDERS WHO ARE ABLE TO TAKE THEIR COVERAGE OR INSURANCE. HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS. ANOTHER MAJOR FINDING FROM THE ASSESSMENT IS THE HIGH RATES OF CHRONIC AND COMPLEX CONDITIONS THAT EXIST FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA) IN THE CBSA. IN MANY COMMUNITIES, THE RATES OF ILLNESS AND DEATH ARE STATISTICALLY HIGHER THAN THE RATES FOR THE COMMONWEALTH, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. EVEN IN THE COMMUNITIES WHERE THE RATES ARE LOWER THAN THE COMMONWEALTH AVERAGE, CHRONIC PHYSICAL HEALTH CONDITIONS, SUCH AS HEART DISEASE, CANCER, STROKE, DIABETES, AND RESPIRATORY DISEASE, ARE STILL BY FAR THE LEADING CAUSES OF DEATH. HIGH RATES OF THE LEADING HEALTH RISK FACTORS (E.G., LACK OF NUTRITIONAL FOOD AND PHYSICAL ACTIVITY, ALCOHOL/ILLICIT DRUG USE, AND TOBACCO USE). BASED ON INFORMATION GATHERED FROM FOCUS GROUPS, INTERVIEWS, COMMUNITY MEETINGS, THE COMMUNITY HEALTH SURVEY, AND QUANTITATIVE SOURCES, THE ASSESSMENT FOUND THAT THERE WERE SUBSTANTIAL CONCERNS RELATED TO THE LEADING HEALTH RISK FACTORS, SUCH AS HEALTHY EATING, PHYSICAL ACTIVITY, OBESITY, TOBACCO USE/VAPING, ALCOHOL USE, AND STRESS. MANY OF THOSE WHO WERE INVOLVED IN THE ASSESSMENT BELIEVED THAT THERE WAS A NEED FOR MORE HEALTH EDUCATION AND A GREATER EMPHASIS ON HEALTH PROMOTION AND ILLNESS PREVENTION. CHALLENGES NAVIGATING THE SYSTEM AND COORDINATING NEEDED SERVICES. ANOTHER MAJOR THEME FROM THE INTERVIEWS, FOCUS GROUPS, AND COMMUNITY MEETINGS CONDUCTED FOR THE ASSESSMENT WAS THE CHALLENGES THAT MANY PEOPLE IN THE CBSA FACE NAVIGATING THE HEALTH AND SOCIAL SERVICE SYSTEM. THERE WAS A GENERAL SENSE THAT THERE WAS A BROAD RANGE OF HEALTH AND SOCIAL SERVICES AVAILABLE IN THE REGION BUT THAT MANY DID NOT KNOW WHERE TO GO FOR SERVICES OR STRUGGLED TO ACCESS THE SERVICES EVEN IF THEY KNEW WHERE TO GO. ONCE AGAIN, THE POPULATION SEGMENT WHO STRUGGLE MOST TO NAVIGATE THE SYSTEM ARE OLDER ADULTS, LOW-INCOME INDIVIDUALS/FAMILIES, RACIAL/ETHNIC MINORITIES, NON-ENGLISH SPEAKERS, AND THOSE WITH CHRONIC / COMPLEX CONDITIONS. MANY PEOPLE SAID THAT IF THERE WAS A RESOURCE INVENTORY THAT WOULD HELP RESIDENTS ACCESS SERVICES, ALONG WITH COUNSELORS OR CASE MANAGERS WHO COULD FURTHER ASSIST PEOPLE TO OBTAIN AND ACCESS THE SERVICES THEY NEEDED.THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, WILL INFORM BID MILTON'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022.COMMUNITY HEALTH NEEDS ASSESSMENT AND ACTIVITIES REPORTED IN THIS FILINGTHE 2016 CHNA AND ACCOMPANYING IMPLEMENTATION STRATEGY WERE APPROVED BY THE MILTON BOARD OF TRUSTEES BEFORE SEPTEMBER 30, 2016, AND INFORMED BID MILTON'S COMMUNITY BENEFIT PROCESS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2016; SEPTEMBER 30, 2017; AND SEPTEMBER 30, 2018. AS SUCH, THE ACCOMPLISHMENTS AND ACTIVITIES INCLUDED IN THIS FILING AND REPORTED BELOW RELATE TO THE DOCUMENTS APPROVED AS OF SEPTEMBER 30, 2016. 2016 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY THE BETH ISRAEL DEACONESS HOSPITAL-MILTON CHNA AND ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2016, WAS THE CULMINATION OF SEVERAL MONTHS OF WORK AND WERE BORNE LARGELY OF BID MILTON'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST VULNERABLE OR DISADVANTAGED. THE PROJECT WAS ALSO DESIGNED TO FULFILL COMMONWEALTH ATTORNEY GENERAL'S OFFICE (AGO) AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BID MILTON ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW BID MILTON, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA.2016 COMMUNITY HEALTH NEEDS ASSESSMENT TARGETED GEOGRAPHY AND POPULATIONTHE GEOGRAPHICAL FOCUS OF BID MILTON'S 2016 CHNA ENCOMPASSES THE CITY OF QUINCY AND THE TOWNS OF MILTON AND RANDOLPH. TARGET POPULATIONS FOR BID MILTON'S COMMUNITY BID MILTON CONDUCTED THIS CHNA PROCESS IN CONJUNCTION WITH BETH ISRAEL DEACONESS MEDICAL CENTER, WHICH SERVED AS THE SOLE MEMBER OF BID MILTON UNTIL MARCH 1, 2019, AS WELL AS WITH BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM AND BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH HOSPITALS FOR WHICH THE MEDICAL CENTER ALSO SERVED AS SOLE MEMBER. ALTHOUGH THE PROCESS WAS JOINTLY CONDUCTED, EACH HOSPITAL PRODUCED ITS OWN CHNA AND IMPLEMENTATION STRATEGY (SCHEDULE H, PART V, SECTION B, QUESTIONS 6A AND 6B).BETH ISRAEL DEACONESS HOSPITAL-MILTON'S TARGET POPULATIONS FOCUS ON MEDICALLY UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN THE TOWNS OF MILTON AND RANDOLPH AND THE CITY OF QUINCY, AS FOLLOWS: YOUTH ADULTS WITH OR AT RISK OF BEHAVIORAL HEALTH AND CHRONIC HEALTH CONDITIONS LOW-INCOME INDIVIDUALS AND FAMILIES OLDER ADULTS 2016 COMMUNITY HEALTH NEEDS ASSESSMENT SUMMARY OF APPROACH AND METHODSTHE BID MILTON CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE 2016 CHNA WAS DESIGNED AS A THREE-PHASE PROCESS: PHASE ONE INVOLVED PRELIMINARY ASSESSMENT AND ENGAGEMENT ACTIVITIES, INCLUDING: COLLECTION AND ANALYSIS OF QUANTITATIVE DATA TO CHARACTERIZE COMMUNITY CHARACTERISTICS AND DISEASE BURDEN KEY INFORMANT INTERVIEWS WITH LOCAL SERVICE PROVIDERS AND COMMUNITY STAKEHOLDERSPHASE TWO FOCUSED ON ENGAGING KEY STAKEHOLDERS AND DATA ANALYSIS, INCLUDING: ADDITIONAL QUANTITATIVE DATA COLLECTION KEY INFORMANT INTERVIEWS WITH HOSPITAL LEADERSHIP ANALYSIS, BENCHMARKING, AND DATA MAPPINGPHASE THREE FOCUSED ON STRATEGIC PLANNING AND REPORTING ACTIVITIES, INCLUDING: STRATEGIC PLANNING RETREAT DEVELOPMENT OF A FINAL CHNA REPORT AND IMPLEMENTATION STRATEGY2016 COMMUNITY HEALTH NEEDS ASSESSMENT MAJOR HEALTH NEEDS AND HOW PRIORITIES WERE DETERMINEDTHE CHNA'S APPROACH AND PROCESS PROVIDED AMPLE OPPORTUNITY FOR KEY STAKEHOLDERS TO VET THE QUANTITATIVE AND QUALITATIVE DATA COMPILED DURING THE ASSESSMENT. IN ADDITION, INTERVIEW AND COMMUNITY/PROVIDER FORUM PARTICIPANTS WERE ASKED WHAT THEY PERCEIVED TO BE THE LEADING COMMUNITY HEALTH PRIORITIES. ULTIMATELY, THERE WAS LITTLE DEBATE THAT THE MOST SIGNIFICANT HEALTH-RELATED ISSUE FACING THE COMMUNITIES FELL INTO THE FOLLOWING FOUR PRIORITY AREAS: HEALTH RISK FACTORS BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE), PHYSICAL DISEASE MANAGEMENT AND PREVENTION, AND HEALTHY AGINGA FIFTH AREA WAS IDENTIFIED, COMMUNITY BENEFITS INFRASTRUCTURE, WITH THE GOAL OF THIS AREA TO SUPPORT IMPLEMENTATION OF EFFORTS IN THE OTHER THREE AREAS. THESE HEALTH PRIORITIES DIRECTED BID MILTON'S COMMUNITY HEALTH IMPROVEMENT PLANNING PROCESS AND HELPED IDENTIFY TARGET POPULATIONS MOST IN NEED OF PROGRAMS AND SERVICES. THE PRIORITIES WERE DESIGNED TO PROMOTE COMMUNITY-BASED WELLNESS AND DISEASE PREVENTION AND ENSURE ONGOING SELF-MANAGEMENT OF CHRONIC DISEASES AND BEHAVIORAL HEALTH DISORDERS. THE GOALS AND ACTIVITIES DRAWN FROM THESE PRIORITIES MADE EXTENSIVE USE OF EXISTING PARTNERSHIPS, RESOURCES AND PROGRAMS IN ORDER TO MAKE THE LARGEST POSSIBLE HEALTH IMPACT.2016 COMMUNITY HEALTH NEEDS ASSESSMENT KEY FINDINGS OPPORTUNITIES TO DECREASE ALCOHOL AND SUBSTANCE USE. DATA FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION SUGGESTS THAT APPROXIMATELY ONE IN FOUR (25%) ADULTS IN THE UNITED STATES HAS A MENTAL HEALTH DISORDER, AND AN ESTIMATED 22 MILLION AMERICANS STRUGGLE WITH DRUG OR ALCOHOL PROBLEMS. IN NORFOLK COUNTY,16% ENGAGED IN BINGE DRINKING AND 8% REPORTED HEAVY DRINKING. FURTHERMORE, ALMOST ONE IN FIVE ADULTS (18%) IN NORFOLK COUNTY HAS BEEN DIAGNOSED WITH DEPRESSION. ALTHOUGH UTILIZATION RELATED TO MENTAL DISORDERS AND SUBSTANCE USE WAS NOT HIGH ACROSS ALL TOWNS IN THE PRIMARY SERVICE AREA, QUINCY HAD SIGNIFICANTLY HIGHER HOSPITAL UTILIZATION RATES WHERE ALCOHOL OR HEROIN WAS THE PRIMARY SUBSTANCE. FOR HOSPITAL OR EMERGENCY DEPARTMENT (ED) UTILIZATION RELATED TO MENTAL HEALTH, QUINCY HAD HIGHER RATES OF MENTAL DISORDER RELATED HOSPITALIZATIONS AND MENTAL DISORDER ED DISCHARGES THAN THE COMMONWEALTH OVERALL. ACCESS TO BEHAVIORAL HEALTH SERVICES WAS CONSISTENTLY NOTED AS A SIGNIFICANT ISSUE DURING THE INTERVIEWS AND COMMUNITY FORUMS, ESPECIALLY FOR LOW INCOME INDIVIDUALS AS WELL AS THE LACK OF PROVIDERS THAT UNDERSTAND THE NEEDS OF OLDER ADULTS OR DIFFERENT CULTURES (INCLUDING PROVIDERS THAT SPEAK LANGUAGES OTHER THAN ENGLISH). RAPIDLY INCREASING OPIOID USE. OPIOID USE WAS THE NUMBER ONE HEALTH ISSUE IDENTIFIED BY THE MAJORITY OF THE INTERVIEWEES AND COMMUNITY FORUM PARTICIPANTS. THE NUMBER OF OPIOID RELATED DEATHS IN NORFOLK COUNTY INCREASED BY OVER 400% FROM 24 IN 2000 TO 124 IN 2014, A TREND SEEN THROUGHOUT THE STATE OF MASSACHUSETTS. 8 WITHIN THE PRIMARY SERVICE AREA, THE DATA INDICATE THAT THE EPIDEMIC HAS IMPACTED QUINCY SIGNIFICANTLY. THE CITY HAS HIGHER RATES ACROSS THE MAJORITY OF OPIOID METRICS WHEN COMPARED TO THE STATE AS A WHOLE, MAKING IT A "HOT SPOT". THIS INCLUDES SIGNIFICANTLY HIGHER RATES OF ADMISSIONS TO DEPARTMENT OF PUBLIC HEALTH-FUNDED PROGRAMS WHERE HEROIN WAS THE PRIMARY SUBSTANCE, OPIOID-RELATED DISCHARGES, OPIOID-RELATED ED DISCHARGES, AND OPIOID RELATED FATAL OVERDOSES COMPARED TO THE STATE OVERALL. HIGH PREVALENCE OF CHRONIC DISEASE. THROUGHOUT THE UNITED STATES, CHRONIC DISEASES SUCH AS HEART DISEASE, STROKE, CANCER, RESPIRATORY DISEASES, AND DIABETES ARE RESPONSIBLE FOR APPROXIMATELY 7 OF 10 DEATHS EACH YEAR AND TREATING PEOPLE WITH CHRONIC DISEASES ACCOUNTS FOR 86% OF OUR NATION'S HEALTH CARE COSTS. HALF OF ALL AMERICAN ADULTS HAVE AT LEAST ONE CHRONIC CONDITION, AND ONE IN FOUR AT LEAST TWO CHRONIC CONDITIONS. A CHRONIC CONDITION IS DEFINED AS A HEALTH CONDITION OR DISEASE THAT LASTS A YEAR OR MORE AND REQUIRES ONGOING MEDICAL ATTENTION OR THAT LIMITS ACTIVITIES OF DAILY LIVING. PREVALENCE OF CHRONIC DISEASE IN NORFOLK COUNTY AND THE COMMONWEALTH OVERALL ARE SIMILAR. IN NORFOLK COUNTY, JUST UNDER A THIRD (29%) OF ADULTS HAD HYPERTENSION,14% HAD EVER HAD ASTHMA, ONE IN 10 HAD DIABETES, 4% HAD HAD A HEART ATTACK, AND 3% HAD A STROKE. WHILE THERE ARE SOME DISEASE-SPECIFIC UTILIZATION RATES IN QUINCY AND MILTON THAT ARE SIGNIFICANTLY HIGHER THAN THE STATE, THE DATA SHOW THAT THERE IS GREATEST NEED IN RANDOLPH. THERE IS SIGNIFICANT CARE AND PREVENTION NEED FOR CHRONIC DISEASES IN RANDOLPH WHERE ALL THE AGE ADJUSTED HOSPITAL UTILIZATION AND ED UTILIZATION RATES FOR ALL CHRONIC DISEASES (EXCEPT HEART DISEASE) WERE HIGHER THAN THE STATE OVERALL. CANCER INCIDENCE. CANCER IS THE SECOND LEADING CAUSE OF DEATH IN THE UNITED STATES AND THE FIRST LEADING CAUSE OF DEATH IN THE COMMONWEALTH AND NORFOLK COUNTY. ACCORDING TO 2013-2014 BRFSS DATA, 15% OF NORFOLK COUNTY RESIDENTS REPORTED EVER RECEIVING A DIAGNOSIS OF CANCER, SIGNIFICANTLY HIGHER THAN MASSACHUSETTS OVERALL (12%).14 WITH RESPECT TO INCIDENCE, QUINCY HAD SIGNIFICANTLY HIGHER RATES OF LUNG CANCER AND A HIGHER RATE OF LUNG CANCER DEATHS THAN THE STATE OVERALL. EFFORTS NEED TO BE MADE TO SCREEN FOR AND IDENTIFY THOSE WITH CANCER WITH AN EMPHASIS ON THOSE FACING BARRIERS TO CARE. FURTHERMORE, EFFORTS SHOULD ENSURE THAT THOSE WHO HAVE CANCER HAVE ACCESS TO THE HIGHEST QUALITY CARE AND THE SUPPORTIVE SERVICES THEY NEED TO MANAGE AND COPE WITH THEIR ILLNESS. NEED FOR INCREASED SUPPORT FOR OLDER ADULTS. DURING THE QUALITATIVE INTERVIEWS AND THE COMMUNITY AND PROVIDER FORUMS, PARTICIPANTS IDENTIFIED OLDER ADULTS AS A HIGH-RISK POPULATION AND CITED THE FOLLOWING CONCERNS: THE NEED FOR MORE SUPPORT FOR AGING IN THE HOME; NOT ENOUGH AFFORDABLE HOUSING; NOT ENOUGH PROVIDERS WITH EXPERTISE IN GERIATRIC PRIMARY CARE OR MENTAL HEALTH; NEED BETTER COORDINATION OF CARE FOR ELDERS, LINKAGES BETWEEN HOSPITALS, HOUSING, BETTER POST-ACUTE SYSTEM; TRANSPORTATION NEEDS; AND FALLS PREVENTION. COMMUNITY HEALTH NEEDS ASSESSMENT MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEBETH ISRAEL DEACONESS HOSPITAL-MILTON STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED, BID MILTON COMPLETED ITS MOST RECENT CHNA DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THE 2019 CHNA AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST AND ON THE HOSPITAL'S WEBSITE AT:HTTPS://WWW.BIDMILTON.ORG/ASSETS/UPLOADS/COMMUNITY-BENEFITS/BID MILTON-2019-FINAL-CHNA-REPORT-WITH-APPENDICES.PDFIN ADDITION, THE 2016 CHNA AND IMPLEMENTATION STRATEGY THAT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2016 ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT: HTTPS://WWW.BIDMILTON.ORG/ASSETS/UPLOADS/COMMUNITY-BENEFITS/MILTON-CHNA-FINAL-SEPTEMBER-2016.PDFBOTH DOCUMENTS ARE ALSO AVAILABLE UPON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A). COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, BID MILTON'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THAT CHNA AND IMPLEMENTATION STRATEGY WILL INFORM THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF BID MILTON FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2019; SEPTEMBER 30, 2020; AND SEPTEMBER 30, 2021. THIS FORM 990 COVERS BID MILTON'S FISCAL YEAR ENDED SEPTEMBER 30, 2019. THE 2016 CHNA AND ACCOMPANYING IMPLEMENTATION STRATEGY WERE APPROVED BY THE BID MILTON BOARD OF TRUSTEES BEFORE SEPTEMBER 30, 2016 AND INFORMED THE HOSPITAL'S COMMUNITY BENEFITS PROCESS FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2016; SEPTEMBER 30, 2017; AND SEPTEMBER 30, 2018. AS SUCH, THE ACCOMPLISHMENTS AND ACTIVITIES INCLUDED IN THIS FILING AND REPORTED BELOW RELATE TO THE DOCUMENTS APPROVED AS OF SEPTEMBER 30, 2016. BID MILTON'S IMPLEMENTATION STRATEGY FOR ITS COMMUNITY BENEFITS ACTIVITIES IS PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS.FY19 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: HEALTH RISK FACTORS CERTAIN HEALTH RISK FACTORS, SUCH AS OBESITY, LACK OF PHYSICAL EXERCISE, POOR NUTRITION, TOBACCO USE, AND OTHERS HAVE AN IMPACT ON PHYSICAL HEALTH STATUS. IN ADDITION, MENTAL/EMOTIONAL HEALTH PROBLEMS ARE A GROWING CONCERN. TO IMPROVE BID MILTON'S COMMUNITY BENEFITS SERVICE AREA'S POPULATION HEALTH, EFFORTS MADE FOCUSED ON PREVENTION, INCLUDING INCREASING ACCESS TO HEALTHY FOODS AND OPPORTUNITIES FOR CONTINUED EDUCATION ON CHRONIC DISEASE AND MENTAL HEALTH. BID MILTON'S OVER-ARCHING GOAL FOR COMBATTING HEALTH RISK FACTORS IS TO BUILD COMMUNITY CAPACITY TO ADDRESS CHRONIC HEALTH NEEDS BY SUPPORTING COMMUNITY INITIATIVES THAT ARE DESIGNED TO PREVENT CHRONIC DISEASE.GOAL: RAISE AWARENESS AND EDUCATE PUBLIC ON MENTAL HEALTH ISSUES, CANCER AND CHRONIC DISEASE PREVENTIONTARGET POPULATION: YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 1.1 EDUCATE ON HEALTH RISK FACTORS AND HEALTHY BEHAVIORSCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE EDUCATION AND CONTINUED LEARNING ON CHRONIC DISEASE PREVENTION AND MAINTENANCE SUPPORT COMMUNITY PROGRAMS FOCUSED ON AWARENESS OF MENTAL HEALTH ISSUES AND SUBSTANCE MISUSE SUPPORT GROUPS FOR ADULTS AND CHILDREN WITH ADHDMETRICS AND STATUS UPDATE: NUMBER OF HEALTH LECTURES CONDUCTED BY BID MILTON MEDICAL STAFF (FY19: 8) NUMBER OF COMMUNITY MEMBERS (187) NUMBER OF HEALTH EDUCATION LECTURES TARGETED AT SENIORS (FY19: 10) NUMBER OF SENIORS (270) NUMBER OF COMMUNITY MEMBERS ATTENDING ANNUAL DIABETES FAIR (FY19: 160) GRANT ISSUED TO MILTON HIGH SCHOOL IN FY19 TO SUPPORT PRESENTATION OF DRUG STORY THEATRE TO HIGH SCHOOL STUDENTS. DRUG STORY THEATRE IS AN EVIDENCE-BASED SUBSTANCE MISUSE TREATMENT AND PREVENTION PRESENTATION WHOSE CAST MEMBERS ARE YOUNG ADULTS IN RECOVERY. THE INTERACTIVE PERFORMANCES ARE DESIGNED TO MAGNIFY INDIVIDUAL RECOVERY STORIESTRANSFORMING THE TREATMENT OF ONE PERSON INTO THE PREVENTION OF MANY PEOPLE. DRUG STORY THEATER RESOURCES ARE DEVOTED TO THE TREATMENT AND PREVENTION OF ADOLESCENT SUBSTANCE ABUSE. A TOTAL OF 326 STUDENTS PARTICIPATED. FUNDED SPEAKER STIPEND FOR MILTON SUBSTANCE ABUSE PREVENTION COALITION AND MILTON POLICE DEPARTMENT TO HOST DR. KEVIN SABET (FORMER WHITE HOUSE OFFICE OF NATIONAL DRUG CONTROL POLICY ADVISOR.) SUPPORTED MILTON SUBSTANCE ABUSE PREVENTION COALITION BY CONTINUING TO FUND "PROMOTING AWARENESS AND RESOURCES FOR THE EMOTIONAL NURTURING OF TEENS (PARENT) SPEAKER SERIES FOR MILTON PUBLIC SCHOOLS AS PART OF ITS SOCIAL-EMOTIONAL LEARNING CURRICULUM. THE OVERARCHING THEME OF THE PROGRAM IS TO PROVIDE PARENTS WITH THE SKILLS AND EDUCATION NEEDED TO BUILD EMOTIONAL RESILIENCE IN YOUTH. IN FY19, FOUR PROGRAMS WERE HELD, REACHING APPROXIMATELY 400 PARENTS. MONTHLY SUPPORT GROUPS HELD AT BID MILTON FOR INDIVIDUALS WITH ADHD OR PARENTS OF CHILDREN WITH ADHDCOMMUNITY PARTNERS: MILTON COUNCIL ON AGING, BID MILTON MEDICAL STAFF, MILTON PUBLIC SCHOOLS, MILTON SUBSTANCE ABUSE PREVENTION COALITIONGOAL: REDUCE TOBACCO USETARGET POPULATION: ADULTSPROGRAMMATIC OBJECTIVES: 2.1 REDUCE NUMBER OF CURRENT SMOKERSCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT GROUPS FOR CURRENT SMOKERS EDUCATE ON THE DANGERS OF SMOKINGMETRICS AND STATUS UPDATE: WEEKLY NICOTINE ANONYMOUS SUPPORT GROUPS HELD AT BID MILTON IN FY19, GRANT FUNDING WAS PROVIDED TO QUINCY PUBLIC SCHOOLS TO IMPLEMENT VAPING PREVENTION EDUCATION TO ALL 10TH GRADE STUDENTS. PROGRAM WILL LAUNCH IN FY20.COMMUNITY PARTNERS: NICOTINE ANONYMOUS, QUINCY PUBLIC SCHOOLSGOAL: INCREASE PHYSICAL ACTIVITYTARGET POPULATION: YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 3.1 INCREASE NUMBER OF CHILDREN AND ADULTS WITH ACCESS TO OPPORTUNITIES FOR PHYSICAL ACTIVITYCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE ACCESS TO LOW-COST/FREE PHYSICAL ACTIVITY OPPORTUNITIES SUPPORT EDUCATION ON IMPORTANCE OF PHYSICAL ACTIVITY METRICS AND STATUS UPDATE: NUMBER OF ADULTS ENROLLED IN BID MILTON TAI CHI CLASS (FY19: 60)GOAL: INCREASE ACCESS TO HEALTHY FOODTARGET POPULATION: YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 4.1 INCREASE NUMBER OF CHILDREN AND ADULTS WITH ACCESS TO OPPORTUNITIES TO EAT HEALTHYCOMMUNITY ACTIVITIES/STRATEGIES: PROVIDE EDUCATION ON PROPER NUTRITIONAL GUIDELINES PROMOTE HEALTHY EATING HABITSMETRICS AND STATUS UPDATE: WORKING WITH RANDOLPH PUBLIC SCHOOLS AND PARTNERING WITH NATIONAL ORGANIZATION BLESSINGS IN A BACKPACK, BID MILTON CONTRIBUTED $6,300 TO SUPPLY 50 ELEMENTARY AGED CHILDREN (WHO QUALIFY FOR THE FREE OR REDUCED LUNCH PLAN), WITH ACCESS TO HEALTHY FOOD OVER THE WEEKEND. FUNDING WAS PROVIDED IN THE BEGINNING OF THE 2019-2020 SCHOOL YEAR. BID MILTON REGISTERED DIETITIANS PROVIDED FREE GROCERY SHOPPING TOURS AT MILTON'S FRUIT CENTER MARKETPLACE. DIETITIANS LED PARTICIPANTS THROUGH THE GROCERY STORE AND DISCUSSED HEALTHY FOOD OPTIONS, HOW TO READ NUTRITION LABELS AND PROVIDED HEALTHY RECIPE OPTIONS. EACH PARTICIPANT ALSO RECEIVED $20 GIFT CARDS FOR USE IN PURCHASING GROCERIES AT THE FRUIT CENTER. SIX PARTICIPANTS SIGNED UP FOR THE FIRST TOUR HELD IN JUNE OF 2019.COMMUNITY PARTNERS: RANDOLPH PUBLIC SCHOOLS, BLESSINGS IN A BACKPACK, FRUIT CENTER MARKETPLACEGOAL: BUILD COMMUNITY CAPACITY TO ADDRESS CHRONIC HEALTH NEEDSTARGET POPULATION: COMMUNITYPROGRAMMATIC OBJECTIVES: 5.1 SUPPORT COMMUNITY INITIATIVES THAT ARE DESIGNED TO PREVENT CHRONIC DISEASE; STRENGTHEN COMMUNITY PARTNERSHIPSCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT LOCAL AGENCIES WHO ADDRESS CHRONIC DISEASE AND UNDERLYING CAUSES OF DISEASE SUCH AS SOCIAL DETERMINANTS OF HEALTHMETRICS AND STATUS UPDATE: BID MILTON JOINED ITS PARTNERS IN THE BLUE HILLS COMMUNITY HEALTH ALLIANCE (CHNA 20) TO BEST IDENTIFY SOLUTIONS TO THE LACK OF TRANSPORTATION OPTIONS IN THE QUINCY REGION. BID MILTON PROVIDED FUNDING IN THE AMOUNT OF $10,000. THE FUNDING ALLOWED THE CHNA 20 TO MOVE FORWARD AND ESTABLISH THE BLUE HILLS REGIONAL COORDINATING COUNCIL (BHRCC). ISSUED $15,000 GRANT TO QUINCY COMMUNITY ACTION PROGRAM. THE GRANT HELPS SUPPORT QCAP'S HOUSING PROGRAM WHICH WORKS TO SECURE AND STABILIZE HOUSING FOR RENTERS AND HOMEOWNERS, THEREBY REDUCING THE NUMBER OF HOMELESS INDIVIDUALS AND FAMILIES. FUNDING WILL APPROXIMATELY SAVE 12 HOUSEHOLDS FROM EVICTION EACH YEAR.COMMUNITY PARTNERS: CHNA 20, BLUE HILLS REGIONAL COORDINATING COUNCIL, QUINCY COMMUNITY ACTION PROGRAM PRIORITY AREA 2: PHYSICAL DISEASE MANAGEMENT AND PREVENTION HIGH PREVALENCE OF CHRONIC DISEASE. A CHRONIC CONDITION IS DEFINED AS A HEALTH CONDITION OR DISEASE THAT LASTS A YEAR OR MORE AND REQUIRES ONGOING MEDICAL ATTENTION OR THAT LIMITS ACTIVITIES OF DAILY LIVING. IN BID MILTON'S COMMUNITY BENEFITS SERVICE AREA, JUST UNDER A THIRD (29%) OF ADULTS HAD HYPERTENSION, 14% HAD EVER HAD ASTHMA, 10% HAD DIABETES, 4% HAD HAD A HEART ATTACK, AND 3% HAD A STROKE. WHILE THERE ARE SOME DISEASE-SPECIFIC UTILIZATION RATES IN QUINCY AND MILTON THAT ARE SIGNIFICANTLY HIGHER THAN THE STATE, THE DATA SHOW THAT THERE IS GREATEST NEED IN RANDOLPH. THERE IS SIGNIFICANT CARE AND PREVENTION NEED FOR CHRONIC DISEASES IN RANDOLPH WHERE ALL THE AGE ADJUSTED HOSPITAL UTILIZATION AND ED UTILIZATION RATES FOR ALL CHRONIC DISEASES (EXCEPT HEART DISEASE) WERE HIGHER THAN THE STATE OVERALL. GOAL: IMPROVE CHRONIC DISEASE MANAGEMENT TARGET POPULATION: ADULTS WITH CHRONIC DISEASEPROGRAMMATIC OBJECTIVES: 1.1 REDUCE IMPACT OF CHRONIC DISEASECOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT AND OFFER OPPORTUNITIES FOR CHRONIC DISEASE SELF-MANAGEMENT COURSESMETRICS AND STATUS UPDATE: RESULTS FROM GRANT ISSUED IN FY18 TO ENHANCE ASIAN SERVICES ON HEALTH (EACH) TO SUPPORT PRE-DIABETES/DIABETES WORKSHOPS TO CHINESE COMMUNITY MEMBERS. PROGRAM TOOK PLACE IN FY19. FUNDING ALLOWED FOR WORKSHOP MATERIALS TO BE TRANSLATED INTO CHINESE. A TOTAL OF 26 LESSONS WERE TRANSLATED AND EIGHT PARTICIPANTS TOOK PART IN THE COURSE. BID MILTON PARTNERED WITH SOUTH SHORE YMCA TO CONDUCT EVIDENCE-BASED DIABETES SELF-MANAGEMENT COURSES. FIRST 6-WEEK COURSE TOOK PLACE IN JUNE 2019. A TOTAL OF 11 COMMUNITY MEMBERS SUCCESSFULLY COMPLETED COURSE, WITH AN ADDITIONAL THREE PARTICIPANTS TAKING ADVANTAGE OF FREE YMCA MEMBERSHIP. MULTI-YEAR GRANT ISSUED TO EACH IN FY19. EACH WILL EMBARK A MULTI-YEAR HEALTH GRANT PROJECT TO IMPLEMENT THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS (CDSMP) IN CHINESE. PROGRAM TO TAKE PLACE IN FY20.COMMUNITY PARTNERS: SOUTH SHORE YMCA, ENHANCE ASIAN COMMUNITY ON HEALTH (EACH) GOAL: CONTINUE CHRONIC DISEASE SCREENINGSTARGET POPULATION: ADULTS PROGRAMMATIC OBJECTIVES: 2.1 INCREASE NUMBER OF ADULTS SCREENED FOR HIGH BLOOD PRESSURE, CHOLESTEROL AND BLOOD SUGARCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT LOW-COST MEANS OF DETERMINING HEALTH RISK FACTORS METRICS AND STATUS UPDATE: NUMBER OF ADULTS SCREENED FOR CHOLESTEROL/GLUCOSE (FY19: 78) COMMUNITY PARTNERS: MEDICAL STAFFGOAL: CONTINUE CANCER SCREENINGSTARGET POPULATION: ADULTS PROGRAMMATIC OBJECTIVES: 3.1 INCREASE THE NUMBER OF ADULTS SCREENED FOR CANCERCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT ACCESS TO CANCER SCREENINGS LOW-DOSE LUNG CANCER SCREENINGSMETRICS AND STATUS UPDATE: NUMBER OF PATIENTS SCREENED FOR SKIN CANCER (FY19: 59) NUMBER OF PATIENTS SCREENED FOR PROSTATE CANCER (FY19: 11) NUMBER OF PATIENTS SCREENED FOR ORAL, HEAD AND NECK CANCERS (FY19: 20) IN FY19, BETH ISRAEL DEACONESS HOSPITAL-MILTON BEGAN TO OFFER LOW-DOSE CT SCANS TO DIAGNOSE LUNG CANCER. SURPASSED GOAL OF 90 PATIENTS IN FIRST YEAR OF PROGRAM WITH 162 PATIENTS BEING SCREENED. COMMUNITY PARTNERS: MEDICAL STAFFGOAL: INCREASE PROVIDER CAPACITYTARGET POPULATION: PROVIDERS PROGRAMMATIC OBJECTIVES: 4.1 INCREASE NUMBER OF PROVIDERS ABLE TO SUPPORT CHRONIC DISEASE PREVENTIONCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT EDUCATION OF FUTURE PROVIDERS RECRUIT PHYSICIANS TO SUPPORT CHRONIC DISEASE PREVENTIONMETRICS AND STATUS UPDATE: THREE NEW PRIMARY CARE PHYSICIANS RECRUITED TO HOSPITAL STAFF. TWO PHYSICIANS IN MILTON AND ONE FAMILY PRACTITIONER IN RANDOLPH. MILTON PRIMARY CARE VISITS FOR THE TWO DOCTORS WERE 4, 052. PHYSICIAN VISITS IN RANDOLPH WERE 1,755, WITH 20% OF THOSE VISITS AS PEDIATRIC VISITS.COMMUNITY PARTNERS: MEDICAL STAFFPRIORITY AREA 3: BEHAVIORAL HEALTHTHE BURDEN OF MENTAL ILLNESS IS SUBSTANTIAL. THESE ISSUES IMPACT ALL SEGMENTS AND AGE GROUPS IN THE POPULATION. HOSPITALIZATION RATES FOR SUBSTANCE MISUSE AND MENTAL HEALTH ARE HIGHER IN MANY OF THE TOWNS THE HOSPITAL SERVICES, WHEN COMPARED TO THE COMMONWEALTH. LARGE PORTIONS OF THE POPULATION ALSO STRUGGLE WITH ALCOHOL ABUSE AND BINGE DRINKING. DESPITE INCREASED COMMUNITY AWARENESS AND SENSITIVITY ABOUT MENTAL ILLNESS AND ADDICTION, THERE IS STILL A GREAT DEAL OF STIGMA RELATED TO THESE CONDITIONS AND THERE IS A GENERAL LACK OF APPRECIATION FOR THE FACT THAT THESE ISSUES ARE OFTEN ROOTED IN GENETICS AND PHYSIOLOGY SIMILAR TO OTHER CHRONIC DISEASES. BID MILTON WORKED TO ADDRESS BEHAVIORAL HEALTH ISSUES THROUGH INCREASED AWARENESS AND EDUCATION AND SUPPORT SERVICES.GOAL: INCREASE AWARENESS ON BEHAVIORAL HEALTH ISSUESTARGET POPULATION: YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE AWARENESS OF COMMUNITY MEMBERS ABOUT MENTAL HEALTH ISSUES AND HOW TO HELP SOMEONE IN NEEDCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT SOCIAL-EMOTIONAL LEARNING IN SCHOOLS PROVIDE TRAINING AND EDUCATION ON BEHAVIORAL HEALTH ISSUESMETRICS AND STATUS UPDATE: RESULTS FROM GRANT ISSUED IN FY18 TO TUCKER ELEMENTARY SCHOOL IN MILTON TO HELP THE SCHOOL PROMOTE THE BEHAVIORAL HEALTH NEEDS OF STUDENTS THROUGH A PROGRAM CALLED "POSITIVE BEHAVIORAL INTERVENTIONS AND SUPPORTS." THE GRANT HELPED TO UNDERWRITE THE COST OF SENDING FOUR TEACHERS TO PROFESSIONAL DEVELOPMENT TRAINING AT THE MAY INSTITUTE. IN FY19, SCHOOL WAS ABLE TO IMPLEMENT PROGRAM AS A RESULT: EVIDENCE-BASED STRATEGIES AND SYSTEMS PUT INTO PLACE TO ASSIST SCHOOLS INCREASE ACADEMIC PERFORMANCE, INCREASE SAFETY AND DECREASE PROBLEM BEHAVIOR. SIX STAFF MEMBERS TRAINED, WITH 460 STUDENTS PARTICIPATING IN PROGRAMMING TO SUPPORT SOCIAL-EMOTIONAL LEARNING. BID MILTON PROVIDED FUNDING TO MILTON PUBLIC SCHOOLS TO IMPLEMENT BOTVIN LIFE SKILLS HEALTH CURRICULUM IN ALL FIFTH GRADE CLASSROOMS. THE PROGRAM HELPS KIDS THINK ABOUT AND DEVELOP A VARIETY OF GENERAL LIFE AND DRUG RESISTANCE SKILLS. PILOT PROGRAM IN FY19 SAW: 100% OF STUDENTS REPORTED LEARNING NEW SKILLS (SELF-ESTEEM, DECISION-MAKING MODEL AND ASSERTIVENESS) TO COMBAT PEER PRESSURE AND REFUSE SUBSTANCE USE; 87% OF STUDENTS SAID THEY LEARNED NEW INFORMATION REGARDING VAPING HEALTH CONCERNS AND MARKETING TECHNIQUES; 72% OF STUDENTS REPORTED LEARNING A NEW COPING SKILL TO HELP MANAGE STRESS.COMMUNITY PARTNERS: MILTON PUBLIC SCHOOLSGOAL: REDUCE BURDEN OF OPIOID USETARGET POPULATION: ADULTS AND YOUTH WITH BEHAVIORAL HEALTH CONDITION, PROVIDERSPROGRAMMATIC OBJECTIVES:2.1 INCREASE CAPACITY OF PROVIDERS TO ADDRESS OPIOID USECOMMUNITY ACTIVITIES/STRATEGIES: CONTINUE TO WORK WITH SOUTH SHORE MENTAL HEALTH (ASPIRE HEALTH ALLIANCE) PROVIDERS TO ADDRESS LENGTH OF STAY AND TREATMENT FOR BEHAVIORAL HEALTH PATIENTS IN HOSPITAL'S EMERGENCY DEPARTMENT. SERVICES INCLUDED: TIMELIER CRISIS EVALUATION, INSURANCE VERIFICATION AND CARE TRANSITION MANAGEMENT; AND THERAPEUTIC INTERVENTIONS (I.E. COGNITIVE BEHAVIORAL THERAPY), MEDICATION MANAGEMENT, MUSIC THERAPY, FAITH COUNSELING, PEER SERVICES AND FAMILIAL COUNSELING AND SUPPORT.METRICS AND STATUS UPDATE: CONTINUATION OF CHART II PROGRAM. DEDICATED BEHAVIORAL HEALTH CLINICIAN EMBEDDED INTO EMERGENCY DEPARTMENT LAID GROUNDWORK (ELECTRONIC MEDICAL RECORD ACCESS, EMPLOYEE CLEARANCE, LEGAL CONTRACTS) FOR PEER RECOVERY COACH PROGRAM WITH GOSNOLD TO BEGIN IN FY20. PARTNERED WITH MILTON POLICE DEPARTMENT MILTON POLICE DEPARTMENT'S (MPD) MENTAL HEALTH SPECIALIST. THIS SPECIALIST FOLLOWS UP WITH ALL BID MILTON PATIENTS DISCHARGED FROM THE HOSPITAL WITH MENTAL HEALTH AND/OR SUBSTANCE USE ISSUES. THE SPECIALIST PROVIDES SUPPORT AND REFERRAL TO APPROPRIATE TREATMENT, IF WANTED. COMMUNITY PARTNERS: BETH ISRAEL DEACONESS HEALTHCARE, SOUTH SHORE MENTAL HEALTH (ASPIRE HEALTH ALLIANCE), GOSNOLD RECOVERY SERVICES, MILTON POLICE DEPARTMENT GOAL: INCREASE CULTURAL COMPETENCY TARGET POPULATION: ADULTS AND YOUTH WITH BEHAVIORAL HEALTH CONDITIONPROGRAMMATIC OBJECTIVES:4.1 REDUCE ED/INPATIENT UTILIZATION FOR ALCOHOL AND SUBSTANCE USECOMMUNITY ACTIVITIES/STRATEGIES: EXPLORE AVAILABLE TOOLS AND RESOURCES TO FACILITATE CROSS-CULTURAL COMMUNICATIONMETRICS AND STATUS UPDATE: GOAL NOT ADDRESSED IN FY19GOAL: INCREASE CRISIS MANAGEMENT WITHIN COMMUNITY AND IMPROVE CONNECTIONS BETWEEN REGIONAL PROVIDERSTARGET POPULATION: ADULTS AND YOUTH WITH BEHAVIORAL HEALTH CONDITIONS, SERVICE PROVIDERSPROGRAMMATIC OBJECTIVES:5.1 INCREASE SAFETY OF COMMUNITY MEMBERS AND INCREASE ACCESS TO CARECOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT AND COLLABORATE WITH TOWN AGENCIES TO FACILITATE ACCESS TO BEHAVIORAL CARE SUPPORT GROUPS FOR ADULTS BATTLING ALCOHOL ADDICTIONMETRICS AND STATUS UPDATE: SUPPORT AND FUNDED INTERFACE, A BEHAVIORAL HEALTH TELEPHONE REFERRAL SERVICE FOR MILTON RESIDENTS SEEKING HELP FOR THEMSELVES OR OTHERS WHO MAY BE STRUGGLING WITH MENTAL HEALTH OR SUBSTANCE MISUSE ISSUES. THE REFERRAL SERVICE IS STAFFED BY TRAINED CLINICIANS WHO CONDUCT AN ASSESSMENT OVER THE PHONE, AND IF APPLICABLE, PROVIDE A REFERRAL TO A LOCAL PROVIDER. NUMBER OF CASES FROM DECEMBER 2018 TO MAY 2019: 42 PRIMARY PRESENTING CONCERNS WERE ANXIETY (18); DEPRESSION (14) ADDITIONALLY THERE WERE 7 REFERRALS EACH FOR: BEHAVIORAL ISSUES AND FAMILY RELATED ISSUES. OF NOTE, THERE WAS 4 REFERRAL REPORTING SELF-INJURIOUS BEHAVIORS CURRENTLY OR IN THE RECENT PAST. BID MILTON HELD WEEKLY ALCOHOLIC ANONYMOUS, ALANON AND ALATEEN MEETINGS IN FY19.COMMUNITY PARTNERS: MILTON SUBSTANCE ABUSE PREVENTION COALITION, MILTON BOARD OF HEALTHPRIORITY AREA 4: HEALTHY AGING OLDER ADULTS ARE MUCH MORE LIKELY TO DEVELOP CHRONIC ILLNESSES AND RELATED DISABILITIES SUCH AS HEART DISEASE, HYPERTENSION, AND DIABETES AS WELL AS CONGESTIVE HEART FAILURE, DEPRESSION, ANXIETY, ALZHEIMER'S, PARKINSON'S DISEASE, AND DEMENTIA. THE OLDER YOU GET THE MORE LIKELY IT IS THAT YOU HAVE ONE OR MORE CHRONIC CONDITIONS: 80% OF PEOPLE 65 AND OLDER LIVE WITH ONE OR MORE CHRONIC CONDITIONS .MANY EXPERIENCE HOSPITALIZATIONS, NURSING HOME ADMISSIONS, AND LOW-QUALITY CARE. THEY ALSO MAY LOSE THE ABILITY TO LIVE INDEPENDENTLY AT HOME. BID MILTON HAS IDENTIFIED OLDER ADULTS AS A TARGET POPULATION AND THEIR OBJECTIVES BELOW ARE AIMED AT INCREASING QUALITY OF LIFE FOR OLDER ADULTS.GOAL: EDUCATE ON FALLS PREVENTIONTARGET POPULATION: OLDER ADULTSPROGRAMMATIC OBJECTIVES:1.1 PREVENT FALLS IN THE COMMUNITYCOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT HEALTH AND WELLNESS PROGRAMMING INCREASE STRENGTH AND REDUCE THE RISK OF FALLSMETRICS AND STATUS UPDATE: ADULTS ENROLLED IN TAI CHI CLASS AT BID MILTON (FY19: 60)GOAL: SUPPORT OLDER ADULTS AND CAREGIVERS TO AGE IN PLACE AND REDUCE ISOLATION OF OLDER ADULTSTARGET POPULATION: OLDER ADULTS PROGRAMMATIC OBJECTIVES:2.1 DECREASE ISOLATION OF OLDER ADULTS2.2 PREVENT UNNECESSARY UTILIZATION DUE TO LACK OF ACCESS TO SERVICES 2.3 INCREASE OLDER ADULT CAPACITY TO CONTINUE AGING AT HOMECOMMUNITY ACTIVITIES/STRATEGIES: SUPPORT INITIATIVES TO INCREASE INDEPENDENCE OF OLDER ADULTS METRICS AND STATUS UPDATE: NUMBER OF PARTICIPANTS ENROLLED IN AARP DRIVER SAFETY COURSES AT BID MILTON (FY19:21)COMMUNITY PARTNERS: AARPBID MILTON COMMUNITY PARTNERSBETH ISRAEL DEACONESS HOSPITAL-MILTON IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. AARP ASIAN AMERICAN SERVICE ASSOCIATION ASPIRE HEALTH ALLIANCE (FORMERLY SOUTH SHORE MENTAL HEALTH) BAY STATE COMMUNITY SERVICES BID MILTON PATIENT FAMILY ADVISORY COUNCIL BLUE HILLS REGIONAL COORDINATING COUNCIL BLUE HILLS REGIONAL HEALTH NETWORK (CHNA 20) CURRY COLLEGE ENHANCE ASIAN COMMUNITIES ON HEALTH FIRST BAPTIST CHURCH, RANDOLPH FULLER VILLAGE GREATER BOSTON UROLOGY INTERFAITH SOCIAL SERVICES MANET COMMUNITY HEALTH CENTERS MILTON BOARD OF HEALTH MILTON COUNCIL ON AGING MILTON SUBSTANCE ABUSE PREVENTION COALITION MILTON POLICE DEPARTMENT MILTON PUBLIC SCHOOLS QUINCY BOARD OF HEALTH QUINCY COMMUNITY ACTION PROGRAMS QUINCY FAMILY RESOURCE CENTER QUINCY PUBLIC SCHOOLS RANDOLPH BOARD OF HEALTH RANDOLPH INTERGENERATIONAL CENTER RANDOLPH PUBLIC SCHOOLS SOUTH SHORE DERMATOLOGY SOUTH SHORE ELDER SERVICES SOUTH SHORE YMCACOMMUNITY HEALTH NEEDS OTHER INITIATIVESAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, BETH ISRAEL DEACONESS HOSPITAL-MILTON IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, AS NOTED IN SCHEDULE H, PART V, SECTION B, QUESTION 11, BETH ISRAEL DEACONESS HOSPITAL-MILTON IS UNABLE TO ADDRESS ALL NEEDS. DURING THE PERIOD COVERED BY THIS FILING, BETH ISRAEL DEACONESS HOSPITAL-MILTON WAS UNABLE TO ADDRESS THE NEED FOR WORKFORCE DEVELOPMENT OPPORTUNITIES OR EXTENSIVE PALLIATIVE CARE RESOURCES IDENTIFIED IN THE CHNA AND THE IMPLEMENTATION STRATEGY BECAUSE OF LIMITED FINANCIAL RESOURCES. AS NOTED IN DETAIL ABOVE, THE BETH ISRAEL DEACONESS HOSPITAL-MILTON'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IMPLEMENTATION STRATEGY (SCHEDULE H PART VI QUESTION 2).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW BETH ISRAEL DEACONESS HOSPITAL-MILTON CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 14.99% OF BID MILTON'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. IN ADDITION, THERE ARE ADDITIONAL ACTIVITIES AND EXPENDITURES WHICH BETH ISRAEL DEACONESS HOSPITAL-MILTON CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. ALTHOUGH THOSE ACTIVITIES ARE NOT QUANTIFIED ON THE BETH ISRAEL DEACONESS HOSPITAL-MILTON SCHEDULE H PER THE INSTRUCTIONS TO THE FORM 990, THOSE ACTIVITIES ARE RELEVANT IN EVALUATING THE TOTAL COMMUNITY BENEFITS PROVIDED. IF BETH ISRAEL DEACONESS HOSPITAL-MILTON HAD INCLUDED THESE IN SCHEDULE H, QUESTION 7, BETH ISRAEL DEACONESS HOSPITAL-MILTON WOULD HAVE REPORTED OVER $20,173,635 IN NET EXPENDITURES AT COST, WHICH REPRESENTED APPROXIMATELY 16.7% OF TOTAL EXPENSES INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST FOR THE FISCAL PERIOD COVERED BY THIS FILING. COMMUNITY BENEFITS ANNUAL COMMUNITY BENEFITS REPORT AS PREVIOUSLY NOTED IN THIS FILING, BETH ISRAEL DEACONESS HOSPITAL-MILTON'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE COMMUNITY BENEFITS ADVISORY COMMITTEE AND BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT:HTTPS://WWW.BIDMILTON.ORG/EVENTS-AND-EDUCATION/COMMUNITY-BENEFITS/THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT THAT BID MILTON FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A BETH ISRAEL DEACONESS HOSPITAL-MILTON IS A GENERAL MEDICAL AND SURGICAL HOSPITAL, PROVIDING 24-HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEBETH ISRAEL DEACONESS HOSPITAL-MILTON NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $1,088,903 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A. OTHER UNCOMPENSATED CHARITY CARE MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, BETH ISRAEL DEACONESS HOSPITAL-MILTON ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. MEDICAID IS A GOVERNMENT INSURANCE PROGRAM FOR INDIVIDUALS WITH LIMITED INCOME AND RESOURCES, AND BETH ISRAEL DEACONESS HOSPITAL-MILTON PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICAID PROGRAM. PAYMENTS TO HOSPITALS THROUGH THIS GOVERNMENT SPONSORED PROGRAM HAVE NOT KEPT PACE WITH INFLATION AND ALTHOUGH THE PROVISION OF HEALTH CARE TO THESE PATIENTS GENERATED $6,991,862 IN MEDICAID REVENUE THIS WAS LESS THAN THE COST OF CARE PROVIDED BY BETH ISRAEL DEACONESS HOSPITAL-MILTON FOR SUCH SERVICES BY $2,087,169 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 7.9% OR 11,171 OF BETH ISRAEL DEACONESS HOSPITAL-MILTON'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 40.3% OR 56,815 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, BETH ISRAEL DEACONESS HOSPITAL-MILTON ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $5,982,861 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. BETH ISRAEL DEACONESS HOSPITAL-MILTON SIMILARLY INCURS BAD DEBT LOSSES AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE IN ITS FINANCIAL STATEMENTS. BETH ISRAEL DEACONESS HOSPITAL-MILTON CHARGES FOR THOSE SERVICES WERE $5,982,861 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND AS REPORTED ON THE BIDMC FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER THE AMOUNT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED. THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F, WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR THE SEVEN MONTHS ENDED SEPTEMBER 30, 2019 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).THE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.EMERGENCY CARE ACCESSAS PREVIOUSLY NOTED IN THIS FILING, FOR THE PERIOD COVERED BY THIS FILING, BIDMC SERVED AS THE SOLE MEMBER OF BID MILTON UNTIL MARCH 1, 2019. THE MEDICAL CENTER IS A NATIONALLY RECOGNIZED ACADEMIC MEDICAL CENTER AND TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP) IS AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BIDMC AND IS ALSO EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BID MILTON EMERGENCY DEPARTMENT. THESE PHYSICIANS ARE ALL CERTIFIED OR BOARD-ELIGIBLE IN LEVEL 1 TRAUMA. THE BID MILTON DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR. FINANCIAL ASSISTANCE POLICY INTERNAL REVENUE CODE SECTION 501(R)(4) FINANCIAL ASSISTANCE POLICY PURPOSE BETH ISRAEL DEACONESS HOSPITAL-MILTON IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE RECEIVED FROM QUALIFYING BETH ISRAEL DEACONESS HOSPITAL-MILTON PROVIDERS.BETH ISRAEL DEACONESS HOSPITAL-MILTON DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) WHICH APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY THE HOSPITAL'S BOARD PRIOR TO SEPTEMBER 30, 2019 AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF OCTOBER 2, 2019, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R). FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE (SCHEDULE H PART V SECTION B QUESTION 15).FINANCIAL ASSISTANCE POLICYELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION MAY BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCEPUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HER OR HIS CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICYTRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS USING THE HEALTH AND HUMAN SECRETARY GUIDANCE SAFE HARBOR OF 5% OF THE POPULATION OR 1,000 PERSONS, WHICHEVER IS LESS. BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: SPANISH, HAITIAN CREOLE, VIETNAMESE, SIMPLIFIED CHINESE AND TRADITIONAL CHINESE (SCHEDULE H PART V SECTION B QUESTION 16I).FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL OR BY MAIL FREE OF CHARGE AND ON THE HOSPITAL'S WEBSITE AT (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) AT HTTPS://WWW.BIDMILTON.ORG/FOR-PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY AS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS' APPROVAL UNDER THE FAP WILL APPLY. LIMITATION ON CHARGES INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES.AMOUNTS GENERALLY BILLED LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAT EXCEED THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS 501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED AND FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. BID MILTON ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY AND AFFILIATED HEALTH CARE SYSTEM (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. ON MARCH 1, 2019, THE BETH ISRAEL LAHEY HEALTH SYSTEM WAS FORMED THROUGH THE COMBINATION OF THE HOSPITALS AND OTHER AFFILIATES OF THREE LEGACY HEALTH CARE SYSTEMS BASED PRIMARILY IN EASTERN MASSACHUSETTS, INCLUDING THE FORMER CAREGROUP HEALTH SYSTEM, THE FORMER LAHEY HEALTH SYSTEM, AND THE SEACOAST HEALTH SYSTEM. BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS NOW THE SOLE MEMBER OF THE HOSPITAL AND NINE ADDITIONAL AFFILIATED HOSPITALS. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE BILH HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. AFFILIATED HEALTH CARE SYSTEMAS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. BILH SERVES AS SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). LAHEY CLINIC FOUNDATION SERVES AS THE SOLE MEMBER OF LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES. 1 MILTON SUBSTANCE ABUSE PREVENTION COALITION 525 CANTON AVENUE MILTON MA 02186 18500 SUPPORT MENTAL HEALTH ACCESS TOWN OF MILTON 525 CANTON AVENUE MILTON MA 02186 14856 SUPPORT OF EDUCATION BLUE HILLS COMMUNITY HEALTH ALLIANCE 1120 HANCOCK STREET QUINCY MA 02169 10000 HEALTH CARE ACCESS CITY OF QUINCY 1305 HANCOCK STREET QUINCY MA 02169 5000 SUPPORT FOR SMOKING/VAPING CESSATION BLESSINGS IN A BACKPACK 4121 SHELBYVILLE RD LOIUSVILLE KY 40207 261964620 501(C)(3) 6300 COMMUNITY SUPPORT QUINCY COMMUNITY ACTION PROGRAMS 1509 HANCOCK ST QUINCY MA 02169 261964620 501(C)(3) 15000 HOUSING ASSISTANCE ENHANCE ASIAN COMMUNITY ON HEALTH (EACH) 1 FRANKLIN STREET UNIT 1207 BOSTON MA 02110 472130807 501(C)(3) 5000 SUPPORT OF HEALTH EDUCATION 5 7 PART I, LINE 2: AS PREVIOUSLY NOTED IN THE FILING BETH ISRAEL DEACONESS HOSPITAL - MILTON, MAINTAINS STRONG RELATIONSHIP WITH MANY PARTNERS AND BETH ISRAEL DEACONESS HOSPITAL - MILTON WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFIT MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS. BETH ISRAEL DEACONESS HOSPITAL - MILTON ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS. 0 1 0 0 0 0 0 1 0 FERNANDEZ RICHARD DIR (EX-OFF)/PRESIDENT 402116 12437 97966 3030 1004 31 6402 198 40508 1253 547996 16949 0 0 FISCHER STEVEN P DIRECTOR; TREASURER 0 565045 0 151691 0 53474 0 18750 0 57012 0 845972 0 0 LEWIS MD STANLEY M DIRECTOR 0 539594 0 145095 0 47414 0 20100 0 52482 0 804685 0 0 O'CONNOR MD HEIDI DIRECTOR, INTENSIVIST 232447 12234 74678 3930 3432 181 23750 1250 17937 944 352244 18539 0 0 TABB MD KEVIN DIRECTOR (EX-OFFICIO), CEO 0 1184747 0 552000 0 20206 0 93674 0 50030 0 1900657 0 0 CONKLIN MICHAEL ASST. TREAS.; VP FINANCE/CFO 284686 8804 47918 1482 3770 117 23765 735 18507 572 378646 11710 0 0 KATZ JAMIE CLERK 0 415671 0 111276 0 33516 0 17792 0 26216 0 604471 0 0 BARNETT MD SHEILA CHIEF MEDICAL OFFICER 0 432022 0 25800 0 21537 0 55000 0 33125 0 567484 0 0 CRONIN RN LYNN CNO 165144 0 24967 0 7414 0 22000 0 29220 0 248745 0 0 0 HARRINGTON KATHLEEN VP HUMAN RESOURCES 172277 0 27280 0 1036 0 22020 0 10260 0 232873 0 0 0 YEATS MD ASHLEY CHIEF MEDICAL OFFICER 232741 0 51960 0 72787 0 24254 0 24078 0 405820 0 0 0 COUGHLIN KAY KATHLEEN VICE CHAIR, ASS PROF HMS 167011 0 0 0 1825 0 3458 0 18181 0 190475 0 0 0 LOUIS RN CONCESA C NURSE RN 239504 0 0 0 492 0 4832 0 8422 0 253250 0 0 0 TRUESDELL STEPHANIE L VP DEVELOPMENT 163787 0 23783 0 224 0 21900 0 6553 0 216247 0 0 0 WILLIAMS ANDREA COMPLIANCE OFFICER 167775 0 0 0 1187 0 13230 0 29038 0 211230 0 0 0 YANSON ROSIE S NURSE RN 181829 0 0 0 487 0 3664 0 1695 0 187675 0 0 0 PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 90, 2019 IS CALENDAR YEAR 2018 DETAIL. DURING THE 2018 CALENDAR YEAR, BETH ISRAEL DEACONESS HOSPITAL MILTON MAINTAINED AN IRC SECTION 457(B) PLAN PURSUANT TO WHICH BID-MILTON MADE EMPLOYER CONTRIBUTIONS FOR ELIGIBLE EMPLOYEES. UNDER THE DEFINITIONS TO THIS FORM 990, THIS PLAN IS CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. CONTRIBUTIONS ARE INCLUDED IN THE FORM 990 SCHEDULE J, PART II, COLUMN C(III), OTHER REPORTABLE COMPENSATION, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. IN ADDITION, AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A SISTER ENTITY TO BID-MILTON AND FOR THE CALENDAR YEAR 2018 SERVED AS THE SOLE MEMBER OF BID-MILTON. DURING THE 2018 CALENDAR YEAR, THE MEDICAL CENTER WAS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM WHICH IS A NON-QUALIFIED DEFERRED COMPENSATION PLAN AND PURSUANT TO THE PLAN ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS. AMOUNTS RECEIVED BY PARTICIPANTS AND RELATED TO THIS PLAN ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. PART I, LINE 7 NON-FIXED PAYMENTS BID-MILTON'S EXECUTIVE COMPENSATION PACKAGES MAY INCLUDE OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING THE BID-MILTON'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, THE BUDGETED CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. THE INCENTIVE COMPENSATION FOR EACH EXECUTIVE REPORTED IN THIS RETURN WAS REVIEWED AND APPROVED BY THE BID-MILTON'S COMPENSATION COMMITTEE, WHICH AS PREVIOUSLY NOTED, WAS FULLY STAFFED BY INDEPENDENT MEMBERS. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES THE FILING ORGANIZATION HAS PROVIDED DETAILED NARRATIVE DISCLOSURE FOR EACH INDIVIDUAL LISTED IN PART VII. NOTE, HOWEVER, THAT THE ORDER OF THE NARRATIVE DISCLOSURE INCLUDED BELOW MAY NOT COINCIDE WITH THE ORDER OF THE INDIVIDUALS LISTED IN PART VII. REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: REGULAR WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS QUANTIFIED IN OTHER REPORTABLE COMPENSATION WHICH MAY NOT BE SEPARATELY NOTED IN THIS FILING INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; DISTRIBUTIONS FROM A 457(B) PLAN; AMOUNTS INCLUDIBLE IN INCOME UNDER A 457(F) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED RETIREMENT BENEFITS; OTHER TAXABLE RETIREMENT BENEFITS DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401K RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403B RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT, UNFUNDED AND UNVESTED AMOUNTS DEFERRED UNDER 457(F) PLAN NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THESE NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ALL DIRECTORS SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES BETH ISRAEL DEACONESS HOSPITAL MILTON, BETH ISRAEL DEACONESS MEDICAL CENTER AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER MAY BE REFERRED TO IN THESE EXPLANATORY NOTES TO FORM 990 PART VII AND FORM 990 SCHEDULE J AS BID-MILTON, BIDMC, HMFP, APHMFP AND MHF RESPECTIVELY. IN ADDITION, BIDMC IS THE SOLE MEMBER OF MEDICAL CARE OF BOSTON MANAGEMENT CORP. D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP AND THE MILTON HOSPITAL FOUNDATION IS THE SOLE MEMBER OF COMMUNITY PHYSICIANS ASSOCIATES WHICH MAY BE REFERRED TO IN THESE EXPLANATORY NOTES AS BID-HEALTHCARE AND CPA RESPECTIVELY. FINALLY, THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL MAY BE REFERRED TO AS PFHC, HMS OR PFHC/HMS. ALEXOPOULOS, ALEXANDRA TRUSTEE BETH ISRAEL DEACONESS HOSPITAL MILTON TRUSTEE MILTON HOSPITAL FOUNDATION TRUSTEE COMMUNITY PHYSICIANS ASSOCIATES BRADY, MICHAEL J. DIRECTOR AND BOARD CHAIR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR AND BOARD CHAIR MILTON HOSPITAL FOUNDATION DIRECTOR AND BOARD CHAIR COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER CICHELLO, ANTHONY DIRECTOR AND VICE CHAIR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR AND VICE CHAIR MILTON HOSPITAL FOUNDATION DIRECTOR AND VICE CHAIR COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR AND BOARD CHAIR MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, INC. D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP CRONIN, M.D., JON DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES CLINICAL INSTRUCTOR IN MEDICINE HARVARD MEDICAL SCHOOL DOHERTY, MAURA DIRECTOR BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR MILTON HOSPITAL FOUNDATION FERNANDEZ, RICHARD TRUSTEE (EX-OFFICIO) AND PRESIDENT BETH ISRAEL DEACONESS HOSPITAL MILTON TRUSTEE (EX-OFFICIO) AND PRESIDENT BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES F/K/A MILTON HOSPITAL FOUNDATION TRUSTEE (EX-OFFICIO) AND PRESIDENT COMMUNITY PHYSICIAN ASSOCIATES AS REQUIRED BY THE FORM 990, COMPENSATION REPORTED HERE IS FOR THE 2018 CALENDAR YEAR, DURING WHICH TIME MR. FERNANDEZ PERFORMED SERVICES FOR BOTH BID-MILTON AND CPA AND WAS COMPENSATED BY BIDMC. MR. FERNANDEZ'S COMPENSATION ATTRIBUTABLE TO HIS SERVICES PERFORMED AT BID-MILTON AND CPA HAS BEEN SEPARATELY REPORTED ON FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDM: BASE COMPENSATION: 402,116 INCENTIVE COMPENSATION: 97,966 OTHER REPORTABLE COMPENSATION: 1,004 DEFERRED COMPENSATION: 6,402 NON-TAXABLE BENEFITS: 40,508 PAYMENTS REPORTED BY CPA: BASE COMPENSATION: 12,437 INCENTIVE COMPENSATION: 3,030 OTHER REPORTABLE COMPENSATION: 31 DEFERRED COMPENSATION: 198 NON-TAXABLE BENEFITS: 1,253 FISCHER, STEVEN EFFECTIVE MARCH 1, 2019 MR. FISCHER HELD THE FOLLOWING POSITIONS: EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. TREASURER BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR AND TREASURER BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY, INC. TREASURER (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER BETH ISRAEL DEACONESS HOSPITAL MILTON TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM TRUSTEE (EX-OFFICIO, CEO DESIGNATE) AND TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH TRUSTEE (EX-OFFICIO) AND TREASURER BETH ISRAEL DEACONESS MILTON PHYSICIANS ASSOCIATES F/K/A MILTON HOSPITAL FOUNDATION TREASURER (EX-OFFICIO) MOUNT AUBURN HOSPITAL TREASURER (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE AND TREASURER COMMUNITY PHYSICIANS ASSOCIATES TRUSTEE AND TREASURER JORDAN PHYSICIAN ASSOCIATES DIRECTOR AND TREASURER JORDAN HEALTH SYSTEMS, INC. TREASURER (EX-OFFICIO) ANNA JACQUES HOSPITAL TREASURER (EX-OFFICIO) SEACOAST AFFILIATED GROUP PRACTICE TRUSTEE AND TREASURER LAHEY HEALTH SHARED SERVICES, INC. TREASURER (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. F/K/A LAHEY PHYSICIAN COMMUNITY ORGANIZATION I, INC. TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND TREASURER NORTHEAST HEALTH SYSTEM, INC. TREASURER NORTHEAST PROFESSIONAL REGISTRY OF NURSES TRUSTEE (EX-OFFICIO) AND TREASURER NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND TREASURER SEACOAST NURSING & REHABILITATION CENTER, INC. TRUSTEE (EX-OFFICIO) AND TREASURER WINCHESTER HOSPITAL FOUNDATION, INC. TREASURER WINCHESTER HEALTHCARE MANAGEMENT, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC FOUNDATION, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC, INC. TREASURER (EX-OFFICIO) LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL AND MEDICAL CENTER TREASURER (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND TREASURER NORTHEAST MEDICAL PRACTICE, INC. TRUSTEE (EX-OFFICIO) AND TREASURER NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND TREASURER CAB HEALTH & RECOVERY SERVICES, INC. TRUSTEE AND TREASURER HEALTH & EDUCATION HOUSING SERVICES, INC. TREASURER (EX-OFFICIO) WINCHESTER HOSPITAL ASSISTANT TREASURER MEDICAL CARE OF BOSTON MANAGEMENT CORP A/K/A AFFILIATED PHYSICIANS GROUP TREASURER LEDGEWOOD HEALTH CARE CORP. MR. FISCHER HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: ASSISTANT TREASURER BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR AND TREASURER BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY, INC. DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH DIRECTOR JORDAN PHYSICIAN ASSOCIATES DIRECTOR JORDAN HEALTH SYSTEMS, INC. AS NOTED IN THIS FILING, AND AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 COMPENSATION. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 565,046 INCENTIVE COMPENSATION: 151,691 OTHER REPORTABLE COMPENSATION: 53,474 DEFERRED COMPENSATION: 18,750 NON-TAXABLE BENEFITS: 57,012 OTHER REPORTABLE COMPENSATION FOR MR. FISCHER INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $47,015. ADDITIONAL EXPLANATORY FOOTNOTES(CONTINUED): KATZ, J.D., JAMIE EFFECTIVE MARCH 1, 2019, MR. KATZ HELD THE FOLLOWING POSITIONS: GENERAL COUNSEL AND CLERK (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR AND CLERK BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY, INC. CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM CLERK (EX-OFFICIO) MOUNT AUBURN HOSPITAL CLERK (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON CLERK COMMUNITY PHYSICIANS ASSOCIATION, INC. CLERK BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES F/K/A MILTON HOSPITAL FOUNDATION CLERK (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH CLERK (EX-OFFICIO) JORDAN PHYSICIANS ASSOCIATES, INC. CLERK JORDAN HEALTH SYSTEMS CLERK (EX-OFFICIO) ANNA JACQUES HOSPITAL CLERK (EX-OFFICIO) SEACOAST AFFILIATED GROUP PRACTICE TRUSTEE AND CLERK LAHEY HEALTH SHARED SERVICES, INC. TRUSTEE, CHAIR, PRESIDENT AND CLERK BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. CLERK (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. TRUSTEE (EX-OFFICIO) AND CLERK NORTHEAST HEALTH SYSTEM, INC. CLERK NORTHEAST PROFESSIONAL REGISTRY OF NURSES TRUSTEE (EX-OFFICIO) AND CLERK NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK SEACOAST NURSING & REHABILITATION CENTER, INC. CLERK (EX-OFFICIO) WINCHESTER HOSPITAL FOUNDATION, INC. CLERK WINCHESTER HEALTHCARE MANAGEMENT, INC. CLERK (EX-OFFICIO) LAHEY CLINIC FOUNDATION, INC. CLERK (EX-OFFICIO) LAHEY CLINIC, INC. CLERK (EX-OFFICIO) LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL AND MEDICAL CENTER CLERK (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CLERK NORTHEAST MEDICAL PRACTICE, INC. TRUSTEE (EX-OFFICIO) AND CLERK NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE AND CLERK CAB HEALTH & RECOVERY SERVICES, INC. TRUSTEE AND CLERK HEALTH & EDUCATION HOUSING SERVICES, INC. CLERK (EX-OFFICIO) WINCHESTER HOSPITAL MR. KATZ HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: SENIOR VICE PRESIDENT AND GENERAL COUNSEL BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR AND CLERK BETH ISRAEL DEACONESS MEDICAL CENTER PHARMACY, INC. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 415,671 INCENTIVE COMPENSATION: 111,276 OTHER REPORTABLE COMPENSATION: 33,516 DEFERRED COMPENSATION: 17,792 NON-TAXABLE BENEFITS: 26,216 OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $30,123. GREENE, DONALD DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES MR. GREENE'S TERM ON THE BETH ISRAEL DEACONESS HOSPITAL MILTON BOARD ENDED MAY 18, 2019 HEAVEY, CHRISTOPHER DIRECTOR AND TREASURER BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR AND TREASURER MILTON HOSPITAL FOUNDATION DIRECTOR AND TREASURER COMMUNITY PHYSICIANS ASSOCIATES MR. HEAVEY'S TERM AS TREASURER FOR THE BETH ISRAEL DEACONESS HOSPITAL MILTON ENDED FEBRUARY 28, 2019. HODGMAN, JANE DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES KERWIN, MARK DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES LAURENCE, ANDREW DIRECTOR AND CLERK BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR AND CLERK COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR AND CLERK MILTON HOSPITAL FOUNDATION MR. LAURANCE'S TERM AS CLERK ON THE BETH ISRAEL DEACONESS HOSPITAL MILTON BOARD ENDED FEBRUARY 28, 2019. LEWIS, M.D., STANLEY CHIEF OF STRATEGY BETH ISRAEL LAHEY HEALTH (EFFECTIVE MARCH 1, 2019) SENIOR VICE PRESIDENT AND CHIEF SYSTEM DEVELOPMENT & STRATEGY OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER (THROUGH MARCH 1, 2019) TRUSTEE (EX-OFFICIO, CEO DESIGNATE) NEW ENGLAND BAPTIST HOSPITAL (EFFECTIVE MARCH 1, 2019) TRUSTEE BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH (THROUGH MARCH 1,2019) TRUSTEE JORDAN HEALTH SYSTEMS, INC. (THROUGH MARCH 1, 2019) DIRECTOR (EX-OFFICIO) MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL DEACONESS HEALTHCARE A/K/A AFFILIATED PHYSICIANS GROUP TRUSTEE (EX-OFFICIO, CEO DESIGNATE) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM (EFFECTIVE MARCH 1, 2019) TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON (THROUGH MARCH 1, 2019) DIRECTOR (EX-OFFICIO) BETH ISRAEL DEACONESS MILTON PHYSICIANS ASSOCIATES F/K/A MILTON HOSPITAL FOUNDATION (THROUGH MARCH 1, 2019) DIRECTOR (EX-OFFICIO) COMMUNITY PHYSICIANS ASSOCIATES (THROUGH MARCH 1, 2019) TRUSTEE (EX-OFFICIO, CEO DESIGNATE) MOUNT AUBURN HOSPITAL (EFFECTIVE MARCH 1, 2019) ASSOCIATE PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 539,594 INCENTIVE COMPENSATION: 145,095 OTHER REPORTABLE COMPENSATION: 47,414 DEFERRED COMPENSATION: 20,100 NON-TAXABLE BENEFITS: 52,482 OTHER REPORTABLE COMPENSATION FOR DR. LEWIS INCLUDES COMBINED PAYMENTS RELATED TO NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $42,720. LONGMAID, M.D., H. ESTERBROOK DIRECTOR (EX-OFFICIO) AND PRESIDENT OF MEDICAL STAFF BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR (EX-OFFICIO) MILTON HOSPITAL FOUNDATION DIRECTOR (EX-OFFICIO) COMMUNITY PHYSICIANS ASSOCIATES DR. LONGMAID'S TERM AS PRESIDENT OF THE BID-MILTON MEDICAL STAFF AND ON THE BETH ISRAEL DEACONESS HOSPITAL MILTON BOARD ENDED JANUARY 24, 2019. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 115,000 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 MARR, JEFFREY DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR MILTON HOSPITAL FOUNDATION NEEDHAM, ELLEN DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES O'CONNOR, M.D., HEIDI DIRECTOR AND INTENSIVIST BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR MILTON HOSPITAL FOUNDATION DURING THE PERIOD COVERED BY THIS FILING, DR. O'CONNOR PERFORMED SERVICES FOR BOTH BID-MILTON WAS COMPENSATED BY APHMFP. AS REQUIRED BY FORM 990, DR. O'CONNOR'S COMPENSATION ATTRIBUTABLE TO THIS POSITION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 232,447 INCENTIVE COMPENSATION: 74,678 OTHER REPORTABLE COMPENSATION: 3,432 DEFERRED COMPENSATION: 23,750 NON-TAXABLE BENEFITS: 17,937 PAYMENTS REPORTED BY APHMFP: BASE COMPENSATION: 12,234 INCENTIVE COMPENSATION: 3,930 OTHER REPORTABLE COMPENSATION: 181 DEFERRED COMPENSATION: 1,250 NON-TAXABLE BENEFITS: 944 PATHAK, RAJU DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES SHIH, DIN DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES MR. SHIH'S TERM ON THE BETH ISRAEL DEACONESS HOSPITAL MILTON BOARD BEGAN JANUARY 1, 2019. TABB, M.D., KEVIN EFFECTIVE MARCH 1, 2019 DR. TABB HELD THE FOLLOWING POSITIONS: PRESIDENT, CHIEF EXECUTIVE OFFICER, AND TRUSTEE (EX-OFFICIO) BETH ISRAEL LAHEY HEALTH, INC. DIRECTOR AND CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER, INC. TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY HOSPITAL AND MEDICAL CENTER TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER LAHEY CLINIC, INC. TRUSTEE, PRESIDENT, AND CHIEF EXECUTIVE OFFICER LAHEY HEALTH SHARED SERVICES, INC. DIRECTOR AND PRESIDENT BIDMC PHARMACY, INC. TRUSTEE (EX-OFFICIO), CHAIRMAN, AND PRESIDENT NORTHEAST HEALTH SYSTEM, INC. TRUSTEE (EX-OFFICIO), PRESIDENT, CHAIRMAN AND CHIEF EXECUTIVE OFFICER NORTHEAST SENIOR HEALTH CORPORATION TRUSTEE (EX-OFFICIO), CHAIRMAN AND PRESIDENT SEACOAST NURSING & REHABILITATION CENTER, INC. TRUSTEE (EX-OFFICIO) AND PRESIDENT WINCHESTER HOSPITAL FOUNDATION, INC. CHIEF EXECUTIVE OFFICER AND CHIEF OPERATING OFFICER WINCHESTER HEALTHCARE MANAGEMENT, INC. TRUSTEE (EX-OFFICIO), CHIEF EXECUTIVE OFFICER AND CHIEF OPERATING OFFICER LAHEY CLINIC FOUNDATION, INC. CHIEF EXECUTIVE OFFICER NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER NORTHEAST BEHAVIORAL HEALTH CORPORATION TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER CAB HEALTH & RECOVERY SERVICES, INC. CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS HOSPITAL MILTON CHIEF EXECUTIVE OFFICER MILTON HOSPITAL FOUNDATION CHIEF EXECUTIVE OFFICER COMMUNITY PHYSICIANS ASSOCIATION CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS HOSPITAL NEEDHAM CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH CHIEF EXECUTIVE OFFICER MOUNT AUBURN HOSPITAL CHIEF EXECUTIVE OFFICER NEW ENGLAND BAPTIST HOSPITAL ADDITIONAL EXPLANATORY FOOTNOTES(CONTINUED): CHIEF EXECUTIVE OFFICER JORDAN HEALTH SYSTEMS, INC. CHIEF EXECUTIVE OFFICER JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) AND CHIEF EXECUTIVE OFFICER HEALTH & EDUCATION HOUSING SERVICES, INC. PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL IN ADDITION TO THE POSITIONS NOTED ABOVE, EFFECTIVE MARCH 1, 2019 DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNATE: TRUSTEE (EX-OFFICIO NORTHEAST HOSPITAL CORPORATION TRUSTEE (EX-OFFICIO BETH ISRAEL DEACONESS HOSPITAL MILTON, BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATION TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL TRUSTEE (EX-OFFICIO) ANNA JACQUES HOSPITAL, INC. TRUSTEE (EX-OFFICIO) SEACOAST AFFILIATED GROUP PRACTICES, INC. DR. TABB HELD THE FOLLOWING POSITIONS FROM OCTOBER 1, 2018 UNTIL MARCH 1, 2019: DIRECTOR AND CHIEF EXECUTIVE OFFICER BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR (EX-OFFICIO) HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR MILTON HOSPITAL FOUNDATION DIRECTOR COMMUNITY PHYSICIANS ASSOCIATES DIRECTOR JORDAN HEALTH SYSTEMS, INC. DIRECTOR JORDAN PHYSICIAN ASSOCIATES, INC. DIRECTOR BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH DIRECTOR AND PRESIDENT BIDMC PHARMACY, INC. TRUSTEE (EX-OFFICIO) AND CO-CHAIR CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. PROFESSOR OF MEDICINE HARVARD MEDICAL SCHOOL AS NOTED IN THIS FILING, AND AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 IS CALENDAR YEAR 2018 COMPENSATION. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 1,184,748 INCENTIVE COMPENSATION: 552,000 OTHER REPORTABLE COMPENSATION: 20,206 DEFERRED COMPENSATION: 93,674 NON-TAXABLE BENEFITS: 50,030 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES $94,326 COMBINED PAYMENTS TO NONQUALIFIED RETIREMENT PLANS PLUS THE INCREASE/DECREASE IN VALUE OF THOSE ACCOUNTS DURING THE 2018 CALENDAR YEAR. OF THIS AMOUNT, $80,324 WAS UNVESTED AT SEPTEMBER 30, 2019. CONKLIN, MICHAEL VICE PRESIDENT, FINANCE AND CHIEF FINANCIAL OFFICER BETH ISRAEL DEACONESS HOSPITAL MILTON VICE PRESIDENT, FINANCE AND CHIEF FINANCIAL OFFICER MILTON HOSPITAL FOUNDATION CHIEF FINANCIAL OFFICER COMMUNITY PHYSICIANS ASSOCIATES DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2018 CALENDAR YEAR, MR. CONKLIN PERFORMED SERVICES FOR BOTH BID-MILTON AND CPA AND WAS COMPENSATED DIRECTLY BY BID-MILTON. AS REQUIRED BY FORM 990, MR. CONKLIN'S COMPENSATION ATTRIBUTABLE TO HIS SERVICES PERFORMED AT BID-MILTON AND CPA HAS BEEN SEPARATELY REPORTED ON FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 284,686 INCENTIVE COMPENSATION: 47,918 OTHER REPORTABLE COMPENSATION: 3,770 DEFERRED COMPENSATION: 23,765 NON-TAXABLE BENEFITS: 18,507 PAYMENTS REPORTED BY CPA: BASE COMPENSATION: 8,541 INCENTIVE COMPENSATION: 1,438 OTHER REPORTABLE COMPENSATION: 113 DEFERRED COMPENSATION: 713 NON-TAXABLE BENEFITS: 555 DEFERRED COMPENSATION FOR MR. CONKLIN INCLUDES AN $18,500 CONTRIBUTION TO A 457(B) PLAN CRONIN, R.N., LYNN CHIEF NURSING OFFICER BETH ISRAEL DEACONESS HOSPITAL MILTON PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 165,144 INCENTIVE COMPENSATION: 24,967 OTHER REPORTABLE COMPENSATION: 7,414 DEFERRED COMPENSATION: 22,000 NON-TAXABLE BENEFITS: 29,220 CURRIE, JEANNETTE E. CHIEF INFORMATION OFFICER BETH ISRAEL DEACONESS HOSPITAL MILTON CHIEF INFORMATION OFFICER BETH ISRAEL DEACONESS HOSPITAL NEEDHAM ENTERPRISE CLINICAL INTEGRATION ARCHITECT BETH ISRAEL DEACONESS MEDICAL CENTER MS. CURRIE PERFORMS SERVICES FOR BOTH BID-NEEDHAM AND BID-MILTON AND WAS COMPENSATED BY BIDMC. AS REQUIRED BY THIS FORM 990, MS. CURRIE'S COMPENSATION ATTRIBUTABLE TO HER SERVICES PERFORMED AT BID-MILTON AND BID-NEEDHAM HAS BEEN SEPARATELY REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 135,959 INCENTIVE COMPENSATION: 2,500 OTHER REPORTABLE COMPENSATION: 131 DEFERRED COMPENSATION: 5,692 NON-TAXABLE BENEFITS: 3,169 PAYMENTS REPORTED BY BID-NEEHAM: BASE COMPENSATION: 135,959 INCENTIVE COMPENSATION: 2,500 OTHER REPORTABLE COMPENSATION: 131 DEFERRED COMPENSATION: 5,692 NON-TAXABLE BENEFITS: 3,169 HARRINGTON, KATHLEEN VICE PRESIDENT, HUMAN RESOURCES BETH ISRAEL DEACONESS HOSPITAL MILTON VICE PRESIDENT, HUMAN RESOURCES COMMUNITY PHYSICIANS ASSOCIATES VICE PRESIDENT, HUMAN RESOURCES MILTON HOSPITAL FOUNDATION PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 172,277 INCENTIVE COMPENSATION: 27,280 OTHER REPORTABLE COMPENSATION: 1,036 DEFERRED COMPENSATION: 22,020 NON-TAXABLE BENEFITS: 10,260 OTHER REPORTABLE COMPENSATION FOR MS. HARRINGTON INCLUDES AN $18,500 CONTRIBUTION TO A 457(B) PLAN MARTENS, M.D., PETER CHIEF OF MEDICINE BETH ISRAEL DEACONESS HOSPITAL MILTON CHIEF OF MEDICINE COMMUNITY PHYSICIANS ASSOCIATES CHIEF OF MEDICINE MILTON HOSPITAL FOUNDATION YEATS, M.D., ASHLEY CHIEF MEDICAL OFFICER BETH ISRAEL DEACONESS HOSPITAL MILTON DR. YEATS' TERM AS CHIEF MEDICAL OFFICER FOR BETH ISRAEL DEACONESS HOSPITAL MILTON ENDED MAY 2019. DURING THE PERIOD COVERED BY THIS FILING AND FOR THE 2018 CALENDAR YEAR, DR. YEATS PERFORMED SERVICES FOR BID-MILTON AND WAS COMPENSATED BY APHMFP. AS REQUIRED BY FORM 990, DR. YEATS' COMPENSATION ATTRIBUTABLE TO THIS POSITION HAS BEEN REPORTED AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 232,741 INCENTIVE COMPENSATION: 51,960 OTHER REPORTABLE COMPENSATION: 72,787 DEFERRED COMPENSATION: 24,254 NON-TAXABLE BENEFITS: 24,078 LOUIS, RN, CONCESA C. RN NURSE BETH ISRAEL DEACONESS HOSPITAL MILTON PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 239,504 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 492 DEFERRED COMPENSATION: 4,832 NON-TAXABLE BENEFITS: 8,422 WILLIAMS, ANDREA COMPLIANCE OFFICER BETH ISRAEL DEACONESS HOSPITAL MILTON PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 167,775 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 1,187 DEFERRED COMPENSATION: 13,230 NON-TAXABLE BENEFITS: 29,038 COUGHLIN KAY, KATHLEEN VICE CHAIR BETH ISRAEL DEACONESS HOSPITAL MILTON PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 172,277 INCENTIVE COMPENSATION: 27,280 OTHER REPORTABLE COMPENSATION: 1,036 DEFERRED COMPENSATION: 22,020 NON-TAXABLE BENEFITS: 10,260 DEFERRED COMPENSATION FOR MS. HARRINGTON INCLUDES AN $18,500 CONTRIBUTION TO A 457(B) PLAN TRUESDELL, STEPHANIE L VICE PRESIDENT OF DEVELOPMENT BETH ISRAEL DEACONESS HOSPITAL MILTON PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 163,787 INCENTIVE COMPENSATION: 23,783 OTHER REPORTABLE COMPENSATION: 224 DEFERRED COMPENSATION: 21,900 NON-TAXABLE BENEFITS: 6,553 YANSON, ROSIE S RN NURSE BETH ISRAEL DEACONESS HOSPITAL MILTON PAYMENTS REPORTED BY BID-MILTON: BASE COMPENSATION: 181,830 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 487 DEFERRED COMPENSATION: 3,664 NON-TAXABLE BENEFITS: 1,695 BARNETT, M.D., SHEILA CHIEF OF ANESTHESIOLOGY BETH ISRAEL DEACONESS HOSPITAL MILTON CHIEF MEDICAL OFFICER -- BETH ISRAEL DEACONESS HOSPITAL MILTON DIRECTOR HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DR. BARNETT COMMENCED HER ROLE AS CHIEF MEDICAL OFFICER FOR BETH ISRAEL DEACONESS HOSPITAL MILTON ON MAY 27, 2019. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 432,022 INCENTIVE COMPENSATION: 25,800 OTHER REPORTABLE COMPENSATION: 21,537 DEFERRED COMPENSATION: 55,000 NON-TAXABLE BENEFITS: 33,125 A MDFA - SERIES 2019K 043431814 57584YTK5 2019-07-31 211922775 SEE PART VI 0 0 0 B MDFA - SERIES 2018J-1 J-2 043431814 57584YJW0 2018-06-13 479594374 SEE PART VI 0 0 0 C MDFA - SERIES 2016I 043431814 57584XMT5 2016-05-12 257611877 SEE PART VI 0 0 0 D MDFA - LAHEY SERIES F 042323457 NONEXXXXX 2015-10-21 262828878 RETIRE BONDS & CAP ACQUISITION 0 0 0 A 211922775 2931137 208991638 0 0 0 1 B 493298411 4594374 114836435 362998912 0 0 1 1 C 8805000 257618370 2515889 19006493 236095988 0 1 1 1 D 28000000 261009548 4857465 160202232 1310144 64587388 31060330 1 1 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 0 A 1 B 1 C 1 D 0 BOND A, ENTITY 1: PART I, ROW A, COLUMN F, DESCRIPTION OF PURPOSE: THE ISSUE REFUNDED ISSUES DATED 06/09/2008, 11/30/2005, 6/16/2003, AND 6/4/1998. BOND B, ENTITY 1: PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998 PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $13,704,037 OF INVESTMENT EARNINGS BOND C, ENTITY 1: PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN C, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $26,884,283 OF INVESTMENT EARNINGS PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW BOND D, ENTITY 1: PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN D: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. BOND A, ENTITY 2: PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES, FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART IV, COLUMN A, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019. BOND B, ENTITY 2: PART I, ROW B, COLUMN F: DESCRIPTION OF PURPOSE: CONSTRUCTION & EQUIPPING OF A POWER PLANT AND ACQUISITION OF CAPITAL ASSETS. PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN B: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. BOND C, ENTITY 2: PART II, COLUMN C, LINE 11: 8,993,760 OF THE PROCEEDS LISTED WERE USED FOR TERMINATION OF THE HEDGE AGREEMENT, WITH THE REMAINDER BEING REFUNDING PROCEEDS THAT ARE NO LONGER IN ESCROW PART III, COLUMN C: THE 2012 ISSUE ARE EXEMPT FROM COMPLETING PART III AS THE ISSUE ARE REFUNDINGS OF BONDS ISSUED PRIOR TO 12/31/2002. BOND D, ENTITY 2: PART II, COLUMNS D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW PART III, COLUMN C: THE 2011 ISSUE ARE EXEMPT FROM COMPLETING PART III AS THE ISSUE ARE REFUNDINGS OF BONDS ISSUED PRIOR TO 12/31/2002. BOND A, ENTITY 3: PART III, COLUMN D, LINE 9: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE THAT ALL NONQUALIFIED BONDS OF THE THESE ISSUES ARE REMEDIATED IN ACCORDANCE WITH THE REQUIREMENTS UNDER REGULATIONS SECTIONS 1.141-12 AND 1.145-2. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. PART V, COLUMN B: AS OF FISCAL YEAR END 2019, BETH ISRAEL LAHEY HEALTH HAS PLANS TO INCLUDE BOTH LAHEY SERIES F AND LAHEY SERIES E UNDER ITS WRITTEN POLICIES AND PROCEDURES TO ENSURE VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED THROUGH VOLUNTARY CLOSING AGREEMENT PROGRAM AND SELF-REMEDIATION ISN'T AVAILABLE. THE DELAY IN ADOPTING UPDATED POLICIES AND PROCEDURES HAS RESULTED, IN LARGE PART, DUE TO COMPLICATIONS RESULTING FROM COVID-19. A MDFA - SERIES 2015 H-1 043431814 57584XDH1 2015-09-02 203702204 SEE PART VI 0 0 0 B MDFA - LAHEY SERIES E 043431814 NONEXXXXX 2013-03-07 130000000 POWER PLANT & CAPITAL ACQUISITION 0 0 0 C MDFA - SERIES 2012G 043431814 NONEXXXXX 2012-07-11 49910000 REFUND ISSUE DATED 02/11/1998 0 0 0 D MDFA - SERIES 2011F-1 F-2 F-3 043431814 NONEXXXXX 2011-09-15 120280000 REFUND ISSUE DATED 02/11/1998 0 0 0 A 42965000 203702204 2348479 201353725 1 1 1 1 B 77815000 130050301 500000 129550301 0 0 1 1 C 49910000 368094 49541906 1 0 1 1 D 88820000 120280000 290672 119989328 1 0 1 1 A 0 1 1 1 0 0.00500 0.00400 0.00900 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 0 0 0 0 0 D 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 A MHEFA - WINCHESTER SERIES F 042456011 57586CDD4 2004-07-08 30340000 SERIAL BOND SERIES F - ADV REFUND 0 0 0 A 2330000 30340000 412448 29927552 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 1 1 1 MORGAN STANLEY 20.000000000000 0 0 0 0 1 A 1 SUBSTANTIAL CONTRIBUTOR # 16 SUBSTANTIAL CONTRIBUTOR 187571 RENTAL PROPERTY (RANDOLPH CROSSINGS REALTY TRUST INC 0 SUBSTANTIAL CONTRIBUTOR # 29 SUBSTANTIAL CONTRIBUTOR 1187899 PROVIDES FOOD SERVICES FOR HOSPITAL/AND ALSO HOUSEKEEPING SERVICES 0 MARK HODGMAN MD FAMILY MEMBER OF JANE HODGMAN 119000 SERVICES 0 SCHEDULE L PART IV COLUMN (D) DESCRIPTION OF TRANSACTIONS INVOLVING INTERESTED PERSONS JANE HODGMAN, SERVES AS A DIRECTOR ON THE BOARDS OF BID-MILTON, BID-MILTON PHYSICIAN ASSOCIATES, AND COMMUNITY PHYSICIAN ASSOCIATES, INC. MS. HODGMAN'S HUSBAND, MARK HODGMAN, MD, IS THE FORMER CHIEF OF MEDICINE AT BID-MILTON AND A PHYSICIAN PARTNER AT SOUTH SHORE INTERNAL MEDICINE ASSOCIATES (SSIM). DURING THE PERIOD COVERED BY THIS FILING, BID-MILTON MADE PAYMENTS TO SSIM IN THE AMOUNT OF $119,000 RELATED TO DR. HODGMAN'S SERVICES TO BID-MILTON. EXPENSES PAID FOR THE PROVISION OF SERVICES REFLECT FAIR MARKET VALUE.VARIOUS CURRENT AND FORMER OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES OF BID- MILTON MAY ALSO HOLD POSITIONS WITH OTHER ENTITIES WHICH MAKE CHARITABLE CONTRIBUTIONS TO BID-MILTON. SUCH CONTRIBUTIONS HAVE NOT BEEN INCLUDED IN THE DISCLOSURES ABOVE. BID-MILTON MAINTAINS AN ACCOUNTABLE BUSINESS EXPENSE REIMBURSEMENT PLAN. FROM TIME TO TIME, BID-MILTON MAY REIMBURSE ITS OFFICERS, DIRECTORS/TRUSTEES AND/OR KEY EMPLOYEES FOR EXPENSES THEY INCURRED AND WHICH ARE PROPERLY ORDINARY AND NECESSARY BUSINESS EXPENSES OF THE REPORTING ENTITY. THE POLICIES AND PROCEDURES REQUIRED BY THE ACCOUNTABLE BUSINESS PLAN MUST BE FOLLOWED IN ORDER TO RECEIVE REIMBURSEMENT FOR SUCH EXPENSES AND IT IS POSSIBLE THAT ONE OR MORE INDIVIDUALS RECEIVED NON-TAXABLE REIMBURSEMENTS WHICH TOTALED $10,000 OR MORE DURING THE FISCAL PERIOD COVERED BY THIS FILING. ALL OF THE ABOVE TRANSACTIONS WERE NEGOTIATED AT ARMS-LENGTH AND IN ACCORDANCE WITH THE BID-MILTON CONFLICT OF INTEREST POLICY. X 3 10059 OTHER X 4 600 REPLACEMENTS COST X 10 1760 REPLACEMENTS COST X MEDICAL EQUIPMENT 2 12300 OPINIONS OF EXPERTS X ALT FURNISHINGS 11 2060 REPLACEMENTS COST X ELECTRONICS 2 900 REPLACEMENTS COST X CLOTHES & ACCESSORIES 8 710 REPLACEMENTS COST 0 0 0 FORM 990, PART I & PART III, LINE 1 THE MISSION OF THE BETH ISRAEL DEACONESS HOSPITAL-MILTON, INC. (BID-MILTON OR HOSPITAL) IS TO PROVIDE SAFE, HIGH-QUALITY, COMMUNITY-BASED HEALTH CARE AND ACCESS TO TERTIARY CARE IN CLOSE COLLABORATION WITH BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER). BID-MILTON PROVIDES THIS CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY, RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, NATIONAL ORIGIN, ANCESTRY, AGE, OR DISABILITY. BID-MILTON ASPIRES TO BE AMONG THE BEST COMMUNITY HOSPITALS IN EASTERN MASSACHUSETTS. BETH ISRAEL DEACONESS HOSPITAL - MILTON (BID-MILTON OR HOSPITAL), IS A 102-BED ACUTE CARE HOSPITAL THAT SERVES PATIENTS OF ALL AGES AND SERVES THE COMMUNITIES OF MILTON, QUINCY, BRAINTREE, RANDOLPH, CANTON, HYDE PARK DORCHESTER AND OTHER LOCAL COMMUNITIES. THE HOSPITAL PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES AND DELIVERS CARE IN ACCORDANCE WITH BID-MILTON'S CORE VALUES OF PATIENT COMFORT, CONFIDENTIALITY AND CONVENIENCE WITH THE ULTIMATE GOAL OF PLAYING AN INTEGRAL ROLE IN IMPROVING THE OVERALL HEALTH OF THE COMMUNITIES SERVED. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC OR MEDICAL CENTER), IS A NATIONALLY RECOGNIZED TERTIARY CARE ACADEMIC MEDICAL CENTER, IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND AFFILIATE OF BID-MILTON. BIDMC IS EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS RECOGNIZED NATIONALLY FOR THE CLINICAL EXCELLENCE OF ITS FACULTY AND THE PATIENT CARE PROVIDED, AS WELL AS FOR THE MAGNITUDE AND BREADTH OF ITS RESEARCH AND FOR ITS COMMITMENT TO MEDICAL EDUCATION. MANY BID-MILTON PHYSICIANS ALSO HOLD APPOINTMENTS AT HARVARD OR OTHER MAJOR MEDICAL SCHOOLS AND ARE TIED CLOSELY WITH THEIR COLLEAGUES AT OTHER ACADEMIC MEDICAL CENTERS. ON MARCH 1, 2019, LAHEY HEALTH SYSTEM INCLUDING THE LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER, WINCHESTER HOSPITAL, NORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL AND BAYRIDGE HOSPITAL, THE BETH ISRAEL DEACONESS SYSTEM INCLUDING BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS MILTON, BETH ISRAEL DEACONESS NEEDHAM AND BETH ISRAEL DEACONESS PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL, ANNA JAQUES HOSPITAL AS WELL AS ENTITIES FOR WHICH THESE LISTED ORGANIZATIONS SERVE AS SOLE MEMBER AND ADDITIONAL AFFILIATES CAME TOGETHER TO FORM BETH ISRAEL LAHEY HEALTH (BILH). BILH IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES FORM 990, PART III, LINE 4A INPATIENT BID-MILTON PROVIDES A WIDE RANGE OF INPATIENT CARE INCLUDING SURGICAL SERVICES, INTENSIVE AND CARDIAC CARE AND COMPLETE DIAGNOSTIC FACILITIES. BID-MILTON'S INPATIENT FACILITIES INCLUDE MEDICAL/SURGICAL BEDS AND AN EIGHT-BED INTENSIVE AND CARDIAC CARE UNIT. THE HOSPITAL HAS A FULLY RENOVATED STATE-OF-THE ART SURGICAL SUITE WITH SEVEN FULLY EQUIPPED OPERATING ROOMS, ONE MINOR SURGERY ROOM AND A POST-OPERATIVE ANESTHESIA CARE UNIT. SURGICAL SERVICES ARE AVAILABLE 24 HOURS A DAY FOR CRITICALLY ILL OR INJURED PATIENTS REQUIRING IMMEDIATE SURGICAL INTERVENTION, OR FOR OTHER PATIENTS ON A NON-EMERGENT OR ELECTIVE BASIS. BID-MILTON'S HIGHLY QUALIFIED SURGEONS PERFORM ORTHOPEDIC PROCEDURES AND IMPLANTS, PLASTIC RECONSTRUCTION, GASTROINTESTINAL, BARIATRIC, GENERAL SURGICAL (INCLUDING BREAST) GYNECOLOGICAL, OPHTHALMOLOGIC, PODIATRIC, AND UROLOGICAL PROCEDURES. LIMITED VASCULAR AND THORACIC SURGERY IS ALSO PERFORMED. PATIENTS ARE UNDER THE CARE OF THE HOSPITAL'S MEDICAL STAFF, HOSPITALISTS AND/OR GENERAL SURGEONS ALONG WITH NURSES AND PHYSICIAN ASSISTANTS WHO ARE TRAINED IN CARING FOR PATIENTS WITH COMPLEX MEDICAL NEEDS. THE NURSING CARE TEAM CONSISTS OF REGISTERED NURSES, SURGICAL TECHNICIANS AND QUALIFIED ANCILLARY PERSONNEL WORKING COLLABORATIVELY WITH SURGICAL AND ANESTHESIA PHYSICIANS. THE SCOPE OF NURSING PRACTICE IN THE PERIOPERATIVE AREA INCLUDES PREOPERATIVE ASSESSMENT AND PLANNING, INTRA-OPERATIVE INTERVENTION, POSTOPERATIVE ASSESSMENT AND INTERVENTION, DISCHARGE PLANNING AND DOCUMENTATION TO ENSURE HIGH QUALITY PATIENT CARE AND SAFETY. THE INPATIENT POPULATION THAT IS SERVED INCLUDES INDIVIDUALS WHO ARE 15 YEARS AND OLDER WHO REQUIRE MINOR OR MAJOR SURGICAL INTERVENTION. DURING THE PERIOD OCTOBER 1, 2018 TO SEPTEMBER 30, 2019, BID-MILTON HAD 7,948 INPATIENT DISCHARGES WITH 26,092 PATIENT DAYS, AND 2,035 TOTAL INPATIENT SURGERIES. FORM 990, PART III, LINE 4B OUTPATIENT CLINICS AND SERVICES BID-MILTON PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES ENCOMPASSING GENERAL INTERNAL MEDICINE AND ALL THE SUBSPECIALTIES OF INTERNAL MEDICINE, COVERING THE GAMUT OF SERVICES FROM PRIMARY TO TERTIARY CARE AS WELL AS PROVIDING SURGICAL SERVICES ON AN OUTPATIENT BASIS. THE HOSPITAL'S MEDICAL STAFF BLENDS EXPERIENCED PRIMARY CARE PHYSICIANS AND SPECIALISTS IN A WIDE VARIETY OF DISCIPLINES. THE PRIMARY CARE AND SPECIALISTS AT BID-MILTON PROVIDE OUTPATIENT PRIMARY CARE AS WELL AS ENDOSCOPIC, OPHTHALMOLOGIC, ORTHOPEDIC, DERMATOLOGIC AND PODIATRIC PROCEDURES, CARDIAC REHABILITATION, DIABETES MANAGEMENT SERVICES, NUTRITIONAL COUNSELING AND ELDER ASSESSMENT PROGRAMS. . DIAGNOSTIC FACILITIES AT BID-MILTON INCLUDE A COMPLETE 24-HOUR HISTOPATHOLOGY LABORATORY AND BLOOD BANKING SERVICES AS WELL AS DIAGNOSTIC IMAGING INCLUDING CT SCANNING, ULTRASOUND, MRI, 3D MAMMOGRAPHY, ULTRASONIC CARDIOGRAPHY, BONE DENSITOMETRY, NUCLEAR MEDICINE, PLAIN FILM RADIOLOGY AND FLUOROSCOPY. IN ADDITION, THE HOSPITAL'S PICTURE ARCHIVAL AND COMMUNICATION SYSTEM (PACS) CAN INSTANTANEOUSLY TRANSMIT RADIOLOGIC IMAGES BETWEEN BID-MILTON AND BIDMC, MEANING THAT PATIENTS IN MILTON HAVE ACCESS TO THE SAME WORLD-CLASS SPECIALISTS AS PATIENTS AT BIDMC IN BOSTON. THE SYSTEM FACILITATES, WHEN NECESSARY, MULTI-DISCIPLINARY EVALUATION OF IMAGES, RESULTING IN IMPROVED TECHNICAL PERFORMANCE AND FEEDBACK AND DIAGNOSES WITH GREATER DIAGNOSTIC ACCURACY. DURING THE FISCAL PERIOD OCTOBER 1, 2018 TO SEPTEMBER 30, 2019, BID-MILTON HAD 155,262 OUTPATIENT ENCOUNTERS. HOSPITAL CLINICS HAD 16,794 VISITS, AND PERFORMED 6,556 ENDOSCOPY PROCEDURES,. IN ADDITION, BID-MILTON OUTPATIENT CARDIOLOGY PHYSICIANS AND PROFESSIONALS PERFORMED 7,385 EKG EXAMS AND ORTHOPEDISTS PERFORMED 613 OUTPATIENT PROCEDURES. BID-MILTON GENERAL RADIOLOGY PERFORMED 39,020 OUTPATIENT EXAMS, 12,347 CAT SCAN OUTPATIENT EXAMS, 8,602 OUTPATIENT ULTRASOUND PROCEDURES, OVER 3,197 MRI EXAMS AND 993 NUCLEAR MEDICINE TESTS. FINALLY, DURING THE PERIOD COVERED BY THIS FILING BID-MILTON PERFORMED 333,971 OUTPATIENT LAB TESTS, HAD 29,148 REHABILITATION VISITS AND PERFORMED 11,614 OTHER PROCEDURES AND TESTS NOT INCLUDED IN THE DETAIL ABOVE. SEE SCHEDULE H FOR ADDITIONAL INFORMATION ON CHARITY CARE AND COMMUNITY BENEFITS. FORM 990, PART III, LINE 4C EMERGENCY DEPARTMENT BID-MILTON'S EMERGENCY DEPARTMENT (ED) IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK AND PROVIDES EMERGENCY CARE TO ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE ED IS STAFFED BY ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (APHMFP), AN INTEGRALLY RELATED PHYSICIAN PRACTICE OF BIDMC WHICH IS EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. APHMFP PHYSICIANS PROVIDE AROUND THE CLOCK PHYSICIAN PATIENT CARE COVERAGE AND MEDICAL DIRECTION OF THE BID-MILTON EMERGENCY DEPARTMENT. A HIGHLY TRAINED NURSING STAFF ALSO PROVIDES CARE TO PATIENTS IN THE ED. CRITICALLY INJURED PATIENTS NEEDING THE SERVICES OF A LEVEL ONE TRAUMA CENTER ARE STABILIZED AND TRANSFERRED TO BETH ISRAEL DEACONESS MEDICAL CENTER IN BOSTON. A RAPID CARDIAC TRANSFER PROGRAM WITH THE MEDICAL CENTER ALSO FACILITATES THE TRANSFER OF PATIENTS NEEDING EMERGENCY CARDIAC CATHETERIZATION. DURING THE FISCAL PERIOD OCTOBER 1, 2018 TO SEPTEMBER 30, 2019, BID-MILTON HAD MORE THAN 32,233 EMERGENCY DEPARTMENT VISITS. FORM 990, PART IV, QUESTION 24B INVESTMENT OF TAX-EXEMPT BOND PROCEEDS BEYOND THE TEMPORARY PERIOD EXCEPTION PROCEEDS IN THE PROJECT FUND WERE UNEXPECTEDLY HELD BEYOND THE THREE-YEAR TEMPORARY PERIOD, BUT WERE YIELD RESTRICTED IN COMPLIANCE WITH FEDERAL TAX REQUIREMENTS. FORM 990, PART V, QUESTION 7G CONTRIBUTIONS OF INTELLECTUAL PROPERTY BETH ISRAEL DEACONESS HOSPITAL - MILTON DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899. FORM 990, PART V, QUESTION 7H CONTRIBUTIONS OF CARS, BOATS, AIRPLANES AND OTHER VEHICLES BETH ISRAEL DEACONESS HOSPITAL - MILTON DID NOT RECEIVE ANY CONTRIBUTIONS OF CARS, BOATS, AIRPLANES OR OTHER VEHICLES AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 1098-C. FORM 990, PATY IV, QUESTION 12 AND 12A STATEMENT RE AUDITED FINANCIAL STATEMENTS THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2019. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. THE FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING BETH ISRAEL DEACONESS HOSPITAL-MILTON, INC. OFFICERS, DIRECTOR/TRUSTEES, AND KEY EMPLOYEES HAVE BUSINESS OR FAMILY RELATIONSHIPS: MICHAEL BRADY AND H. ESTERBROOK LONGMAID, MD HAVE A BUSINESS RELATIONSHIP. MICHAEL BRADY AND JON CRONIN, MD HAVE A BUSINESS RELATIONSHIP. IN ADDITION FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES, LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL CORPORATION (NBC), AND ANNA JAQUES HOSPITAL. THE LAHEY CLINIC FOUNDATION IN TURN SERVES AS SOLE MEMBER TO LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL DBA LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). ADDITIONAL ENTITIES LISTED HERE MAY ALSO IN TURN SERVE AS MEMBER TO OTHER NETWORK AFFILIATES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE NETWORK OF AFFILIATED ORGANIZATIONS. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. FORM 990, PART VI, SECTION A, LINE 4 BETH ISRAEL DEACONESS HOSPITAL - MILTON MADE CHANGES TO ITS BYLAWS DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 AS PART OF THE CREATION OF THE BETH ISRAEL LAHEY HEALTH (BILH), AN INTEGRATED HEALTH CARE SYSTEM PROVIDING PATIENT CARE INFORMED BY WORLD-CLASS RESEARCH AND EDUCATION. BETH ISRAEL LAHEY HEALTH, INC. BECAME THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON. CHANGES TO THE BYLAWS AFFECT: - FREQUENCY OF MEETINGS - MINIMUM & MAXIMUM NUMBER OF TRUSTEES - EX-OFFICIO TRUSTEES - APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES - COMMITTEES - OFFICERS - TERMS AND TERM LIMITS FORM 990, PART VI, SECTION A, LINE 6 EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON. PRIOR TO THAT DATE, BIDMC SERVED AS SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE EXCLUSIVE AUTHORITY TO (A) APPOINT AND REAPPOINT TRUSTEES, (B) FILL ANY VACANCIES IN THE OFFICES OF TRUSTEES, AND (C) ACTING BY VOTE OF NOT LESS THAN THREE QUARTERS (3/4) OF THE MEMBER'S TRUSTEES THEN IN OFFICE, REMOVE, WITH OR WITHOUT CAUSE, A TRUSTEE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON HAS THE FOLLOWING RIGHTS, AS DESIGNATED IN BETH ISRAEL DEACONESS HOSPITAL - MILTON'S BY-LAWS: SUBJECT TO THE PROVISIONS OF THE ARTICLES OF ORGANIZATION AND THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, BOTH POSITIVE AND NEGATIVE, CONFERRED BY MASSACHUSETTS GENERAL LAWS ("M.G.L.") CHAPTER 180, AS AMENDED, ON MEMBERS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. IN ADDITION, EXCEPT AS ARE EXPRESSLY GRANTED TO THE BOARD OF TRUSTEES OF THE CORPORATION ("BOARD") IN THESE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, POSITIVE AND NEGATIVE, CONFERRED BY M.G.L. CHAPTER 180 ON BOARDS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. NOTWITHSTANDING THE FOREGOING, THE MEMBER MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF THE BOARD: (A) APPROVE OR REQUIRE ANY CHANGE IN, OR CONSOLIDATION OF PHILANTHROPIC GIFTS, ASSETS, AND PROGRAMS OF THE CORPORATION, WHICH SHALL REMAIN UNDER THE CORPORATION'S CONTROL AND BE USED FOR THE BENEFIT OF THE CORPORATION AND NOT FOR OTHER COMPONENTS OF THE MEMBER'S SYSTEM, EXCEPT TO THE EXTENT THAT SUCH CHANGES INVOLVE BACK-OFFICE CONSOLIDATION WITH OTHER DIRECT OR INDIRECT SUBSIDIARIES OF THE MEMBER; (B) APPROVE OR REQUIRE ANY CHANGE IN THE NAME, BRAND, OR TRADEMARK OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES, EXCEPT SUCH COMPLEMENTARY CHANGES AS THE MEMBER MAY DETERMINE ARE REASONABLY APPROPRIATE IN ESTABLISHING A SYSTEM-WIDE IDENTITY FOR THE AFFILIATED ENTITIES; OR (C) AMEND OR RESTATE THESE BYLAWS TO CHANGE OR ELIMINATE EITHER OF THE FOREGOING LIMITATIONS ON ITS POWERS. FOR THE PERIOD ENDING ON THE THIRD ANNIVERSARY OF THE DATE THE MEMBER BECOMES THE SOLE CORPORATE MEMBER OF THE CORPORATION, THE MEMBER'S AUTHORITY TO CHANGE THE MEDICAL SCHOOL AFFILIATION OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES IS SUBJECT TO THE REQUIREMENT THAT IT OBTAIN THE UNANIMOUS CONSENT OF THE CORPORATION'S DESIGNATED TRUSTEES (AS DEFINED IN THE BYLAWS OF THE MEMBER) AND THE APPROVAL OF THE MEMBER'S BOARD OF TRUSTEES (THE "MEMBER'S BOARD"). THE MEMBER MAY NOT CAUSE THE CORPORATION TO CEASE OPERATING A SEPARATELY LICENSED HOSPITAL FACILITY, OR CLOSE ANY ESSENTIAL SERVICE OF SUCH HOSPITAL FACILITY, WITHOUT CONSULTING WITH THE BOARD PRIOR TO TAKING SUCH ACTION. THE POWERS AND RESPONSIBILITIES OF THE BOARD INCLUDE THE FOLLOWING: (A) PROVIDING RECOMMENDATIONS TO THE MEMBER REGARDING (I) APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES, (II) THE ESTABLISHMENT OF THE CORPORATION'S POLICIES, (III) THE MAINTENANCE OF PATIENT CARE QUALITY, AND (IV) THE PROVISION OF CLINICAL SERVICES AND COMMUNITY SERVICE PLANNING IN A MANNER RESPONSIVE TO LOCAL COMMUNITY NEEDS; (B) ENSURING COMPLIANCE WITH ALL LICENSURE AND ACCREDITATION REQUIREMENTS, INCLUDING CREDENTIALING AND OTHER MEDICAL STAFF MATTERS; (C) PROVIDING OVERSIGHT FOR INSTITUTIONAL PLANNING, MAKING RECOMMENDATIONS FOR NEW CLINICAL SERVICES, AND PARTICIPATING IN AN ANNUAL REVIEW OF THE CORPORATION'S STRATEGIC AND FINANCIAL PLAN AND GOALS; (D) REVIEWING AND RECOMMENDING APPROVAL OF OPERATING AND CAPITAL BUDGETS AS WELL AS MAKING RECOMMENDATIONS WITH RESPECT TO CAPITAL EXPENDITURES; (E) MAKING RECOMMENDATIONS WITH RESPECT TO QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS; (F) PROVIDING OVERSIGHT OF RISK MANAGEMENT PROGRAMS RELATING TO PATIENT CARE AND SAFETY; (G) REVIEWING DISASTER PLANS THAT DEAL WITH BOTH INTERNAL (E.G., FIRE) AND EXTERNAL DISASTERS; AND (H) EVALUATING RECRUITMENT NEEDS TO ENSURE ADEQUATE MEDICAL STAFF CAPACITY TO CONTINUE TO MEET COMMUNITY NEEDS. EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, THE BOARD SHALL ACT IN AN ADVISORY CAPACITY AND CONSISTENT THEREWITH SHALL HAVE ONLY THE FOLLOWING POWERS: (A) POWERS EXPRESSLY GRANTED BY THE MEMBER FROM TIME TO TIME; (B) POWER TO EXERCISE ITS AUTHORITY AS A MEMBER OF OTHER CORPORATIONS; (C) POWER TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THE BYLAWS OF THE MEMBER (AS DEFINED UNDER THE BYLAWS OF THE MEMBER) OR UNDER THESE BYLAWS WITH RESPECT TO THE MEMBER; AND (D) POWERS TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THAT AGREEMENT DATED JUNE 30, 2017 BY AND AMONG LAHEY HEALTH SYSTEM, INC., BETH ISRAEL DEACONESS MEDICAL CENTER, INC., NEW ENGLAND BAPTIST HOSPITAL, INC., MOUNT AUBURN HOSPITAL, CAREGROUP, INC., AND SEACOAST REGIONAL HEALTH SYSTEMS, INC. THE POWERS OF THE BOARD IN CLAUSES (A) AND (B) OF THE PRECEDING SENTENCE SHALL BE SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. THE POWERS OF THE BOARD IN CLAUSE (C) AND (D) OF THE FIRST SENTENCE OF THIS PARAGRAPH SHALL BE INDEPENDENT OF THE MEMBER AND NOT SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. NOTWITHSTANDING CLAUSE (B) ABOVE, THE POWER OF THE CORPORATION TO EXERCISE ITS AUTHORITY AS A MEMBER OF ANOTHER CORPORATION SHALL BE SUBJECT TO THE FOLLOWING LIMITATIONS: (X) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED BY THE CORPORATION ONLY AT THE EXPRESS AND EXPLICIT DIRECTION OF, AND WITH THE APPROVAL OF, THE MEMBER; (Y) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER CORPORATION UNDER MASSACHUSETTS LAW MAY BE EXERCISED DIRECTLY BY THE MEMBER AFTER CONSULTATION WITH THE CHAIR BUT OTHERWISE WITHOUT THE APPROVAL OR PARTICIPATION OF THE CORPORATION; AND (Z) OTHER THAN STATUTORY POWERS, THE CORPORATION SHALL HAVE ONLY THOSE POWERS AND AUTHORITIES OVER AND WITH RESPECT TO THE CORPORATIONS OF WHICH IT IS A MEMBER AS ARE EXPRESSLY AND EXPLICITLY DELEGATED OR DIRECTED TO THE CORPORATION BY ACTION OF THE MEMBER'S BOARD. FORM 990, PART VI, SECTION B, LINE 11B AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH, INC. (BILH) BECAME THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON. THIS FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER OF BETH ISRAEL DEACONESS HOSPITAL - MILTON, THE TAX DIRECTOR OF BILH AND DELOITTE TAX, LLP. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF THE BETH ISRAEL DEACONESS HOSPITAL - MILTON BOARD PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS BETH ISRAEL DEACONESS HOSPITAL MILTON (BIDM) HAS A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY. PURSUANT TO THAT POLICY, ALL OFFICERS, TRUSTEES AND KEY EMPLOYEES OF BIDM ARE ASKED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST FORM WHICH IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS RELATIONSHIPS MAINTAINED BY OFFICERS, TRUSTEES OR KEY EMPLOYEES AND THEIR FAMILY MEMBERS AND WHICH MAY RESULT IN A CONFLICT OF INTEREST. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND IS A SISTER ENTITY TO BIDM. THE BIDMC OFFICE OF COMPLIANCE AND BUSINESS CONDUCT ADMINISTERS A CONFLICT OF INTEREST QUESTIONNAIRE PROCESS ANNUALLY IN CONJUNCTION WITH THE BIDM OFFICE OF COMPLIANCE AND PROVIDES A SUMMARY OF POSITIVE RESPONSES TO BIDM'S COMPLIANCE OFFICER FOR REVIEW AND DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. ANY ACTIVITY THAT REQUIRES ACTION UNDER THE CONFLICT OF INTEREST POLICY IS SUBJECT TO ONGOING REVIEW BY BIDM. PURSUANT TO THE CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A PLAN TO REQUIRE DISCLOSURE AND RECUSAL, INCLUDING APPROPRIATE DOCUMENTATION IN THE MINUTES. AS PREVIOUSLY NOTED IN THIS FILING, EFFECTIVE MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH (BILH) BECAME THE SOLE MEMBER OF BID-MILTON. IN ADDITION TO THE CONFLICT OF INTEREST PROCESS OUTLINED ABOVE, THE BILH TAX DEPARTMENT ISSUED A TAX QUESTIONNAIRE TO ALL CURRENT AND FORMER MEMBERS OF THE BIDM BOARD OF TRUSTEES AS WELL AS CURRENT AND FORMER OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE PROCESS WAS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR BIDM TO COMPLETELY AND ACCURATELY PROCESS AND COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 DESCRIPTION OF PROCESS TO DETERMINE COMPENSATION OF THE ORGANIZATIONS CEO AND OTHER OFFICERS AND KEY EMPLOYEES AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL DEACONESS HOSPITAL MILTON (BID-MILTON) ALONG WITH ITS AFFILIATES BECAME MEMBERS OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES WITH BILH SERVING AS BID-MILTON'S SOLE MEMBER EFFECTIVE MARCH 1, 2019. PRIOR TO MARCH 1, 2019 BID-MILTON MAINTAINED A COMPENSATION COMMITTEE THAT WAS COMPOSED OF MEMBERS OF THE BOARD OF DIRECTORS. ALL MEMBERS WERE INDEPENDENT. AS REQUIRED BY THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, COMPENSATION REPORTED HEREIN IS CALENDAR YEAR 2018 COMPENSATION. AS SUCH, COMPENSATION REPORTED IN THIS FORM 990 FOR BID-MILTON OFFICERS, DIRECTORS AND KEY EMPLOYEES WAS SET BY THE BID-MILTON COMPENSATION COMMITTEE AND GUIDED BY THE COMMITTEE'S OBLIGATIONS AS OUTLINED BELOW. FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL DEACONESS HOSPITAL - MILTON (BID-MILTON) HAD A COMPENSATION COMMITTEE COMPOSED OF MEMBERS OF THE BID-MILTON BOARD OF DIRECTORS AND APPOINTED BY THE CHAIR OF THE BOARD. ALL MEMBERS WERE INDEPENDENT. THE BID-MILTON COMPENSATION COMMITTEE ESTABLISHED THE POLICIES AND THE COMPENSATION STRUCTURE OF THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND VICE PRESIDENTS. THE BID-MILTON COMPENSATION COMMITTEE WAS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS WAS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT IT COMPLIED WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEYS/STUDIES PRODUCED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT REGULARLY ASSESSES EXECUTIVE COMPENSATION AND BENEFITS OF SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MET TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWED THE COMPENSATION SURVEY DATA PREPARED BY AN INDEPENDENT COMPENSATION CONSULTING FIRM. TO ENSURE INDEPENDENCE, NO BID-MILTON STAFF THAT MIGHT PROVIDE ADMINISTRATIVE SUPPORT TO THIS COMMITTEE WAS PRESENT FOR THESE DISCUSSIONS. THE COMPENSATION COMMITTEE VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE CEO WHICH WAS APPROVED BY THE FULL BID-MILTON BOARD. IN ADDITION, AS NOTED THROUGHOUT THIS NARRATIVE SUPPORT TO THE FORM 990, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A CLOSE AFFILIATE OF BID-MILTON AND SERVED AS THE SOLE MEMBER OF BID-MILTON AT THE TIME THAT COMPENSATION REPORTED IN THIS FILING WAS SET.. THE BIDMC COMPENSATION COMMITTEE REVIEWED THE COMPENSATION OF THE BID-MILTON CEO AND THE INFORMATION WAS REPORTED TO THE FULL BIDMC BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 BETH ISRAEL DEACONESS HOSPITAL - MILTON'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL LAHEY HEALTH TAX DEPARTMENT 109 BROOKLINE AVENUE, SUITE 300 BOSTON, MA 02215 FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 7,202,915. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,202,915. CONSULTING & PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 4,538,299. MANAGEMENT AND GENERAL EXPENSES 3,162,963. FUNDRAISING EXPENSES 94,659. TOTAL EXPENSES 7,795,921. FORM 990, PART XI, LINE 9: CHANGES IN EQUITY INTERESTS IN LIMITED PARTNERSHIP -422,166. CHANGE IN FUNDED STATUS OF EMPLOYEE BENEFIT PLANS -2,949,002. NET ASSET TRANSFER FROM RELATED ENTITIES -2,325,990. ROUNDING -1. FORM 990, PART XII, LINE 2C: ON MARCH 1, 2019, LAHEY HEALTH SYSTEM INCLUDING THE LAHEY CLINIC AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER, WINCHESTER HOSPITAL, NORTHEAST HOSPITAL CORPORATION D/B/A BEVERLY HOSPITAL, ADDISON GILBERT HOSPITAL AND BAYRIDGE HOSPITAL, THE BETH ISRAEL DEACONESS SYSTEM INCLUDING BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS MILTON, BETH ISRAEL DEACONESS NEEDHAM AND BETH ISRAEL DEACONESS PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL, ANNA JAQUES HOSPITAL AS WELL AS ENTITIES FOR WHICH THESE LISTED ORGANIZATIONS SERVE AS SOLE MEMBER AND ADDITIONAL AFFILIATES CAME TOGETHER TO FORM BETH ISRAEL LAHEY HEALTH (BILH). AS A NEWLY CREATED HEALTHCARE SYSTEM, BILH ENGAGED KPMG TO PERFORM A FINANCIAL AUDIT OF THE SYSTEM. THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2019. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND ITS AFFILIATES. ADDISON GILBERT SOCIETY INC 41 MALL ROAD BURLINGTON MA 01805 464371382 SUPPORT MA 501(C)(3) 7 LAHEY HEALTH SHARED SERVICES INC 1 ANNA JAQUES COMMUNITY HEALTH FOUNDATION 25 HIGHLAND AVE NEWBURYPORT MA 01950 043318952 FUNDRSG ORG MA 501(C)(3) 12A, I ANNA JAQUES HOSPITAL INC 1 ANNA JAQUES HOSPITAL INC 25 HIGHLAND AVE NEWBURYPORT MA 01950 042104338 HEALTHCARE MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 ASSOC PHYS HARVARD MED FAC PHY AT BIDMC 375 LONGWOOD AVE BOSTON MA 02215 320058309 TO PROVIDE EMERGENCY MEDICAL SERVICES MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BAIM INSTITUTE OF CLINICAL RESEARCH INC FKA HCRI 930 COMMONWEALTH AVE BOSTON MA 02215 043521077 SCIENTIFIC & MEDICAL RESEARCH MA 501(C)(3) 7 N/A 1 BETH ISRAEL DEACONESS HOSPITAL - MILTON INC 199 REEDSDALE RD MILTON MA 02186 042103604 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM INC 148 CHESTNUT ST NEEDHAM MA 02492 043229679 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH INC 275 SANDWICH ST PLYMOUTH MA 02360 222667354 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVE BOSTON MA 02215 042103881 THE OPERATION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL LAHEY HEALTH PRIMARY CARE FKA LPCO 41 MALL ROAD BURLINGTON MA 01805 472248298 HEALTHCARE MA 501(C)(3) 10 LAHEY HEALTH SHARED SERVICES INC 1 BETH ISRAEL LAHEY HEALTH INC 20 UNIVERSITY ROAD CAMBRIDGE MA 02138 832671600 SUPPORT MA 501(C)(3) 12A, I N/A 1 BI ANAESTHESIA FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042997215 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BI COMMUNITY FOUNDATION INC 330 BROOKLINE AVE STE 300 BOSTON MA 02215 042776678 INACTIVE CORPORATION MA 501(C)(3) 7 N/A 1 BI DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION INC 330 BROOKLINE AVE W/CC-2 BOSTON MA 02215 364803234 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BI DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043079630 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BI DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 208253452 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BI DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043030397 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BI DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 204974585 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BI DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 020671240 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BI DERMATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043117601 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP 482 BEDFORD STREET LEXINGTON MA 02420 043200113 SUPPORT MA 501(C)(3) 12A, I N/A 0 BIDMC OBSTETRICS AND GYNECOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042794855 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BIDMC PHARMACY INC 330 BROOKLINE AVE BOSTON MA 02215 822526816 OPERATE A SPECIALTY PHARMACY MA 501(C)(3) 12A, I BETH ISRAEL DEACONESS MEDICAL CENTER 1 BID-MILTON PHYSICIAN ASSOCIATES INC FKA MHF 199 REEDSDALE RD MILTON MA 02186 222566792 PROMOTE HEALTHCARE MA 501(C)(3) 12A, I BETH ISRAEL DEACONESS HOSPITAL - MILTON 1 BIH PATHOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 222548374 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 BIH RADIOLOGIC FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042571853 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HMFP AT BIDMC 1 CAB HEALTH AND RECOVERY SERVICES INC 199 ROSEWOOD DRIVE SUITE 250 DANVERS MA 01923 042400270 SUBSTANCE ABUSE MA 501(C)(3) 10 NORTHEAST BEHAVIORAL HEALTH CORPORATION 1 CAREGROUP PARMENTER HOME CARE & HOSPICE INC 330 MOUNT AUBURN ST CAMBRIDGE MA 02138 473111453 HOME CARE & HOSPICE MA 501(C)(3) 12A, I MOUNT AUBURN HOSPITAL 1 CAREGROUP INC 109 BROOKLINE AVE STE 300 BOSTON MA 02215 222629185 OVERSEE FINANCIAL HEALTH OF AFFILIATES MA 501(C)(3) 12C, III-FI N/A 0 CARL J SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH 330 BROOKLINE AVE BOSTON MA 02215 043326928 DEVELOP INNOVATIVE PROG AND MODELS FOR TEACHING AND RESEARCH MA 501(C)(3) 12A, I N/A 0 COMMUNITY PHYSICIAN ASSOCIATES INC 199 REEDSDALE RD MILTON 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MED CARE OF BOSTON MGMT CORP DBA BID HEALTHCARE 400 HUNNEWELL ST NEEDHAM MA 02494 042810972 OUTPATIENT, PRIMARY CARE AND SPECIALTY SERVICES MA 501(C)(3) 10 BETH ISRAEL DEACONESS MEDICAL CENTER 1 MOUNT AUBURN HOSPITAL 330 MOUNT AUBURN ST CAMBRIDGE MA 02138 042103606 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 MOUNT AUBURN PROFESSIONAL SERVICES INC 330 MOUNT AUBURN ST CAMBRIDGE MA 02138 043026897 OFFERING MEDICAL CARE IN GENERAL AND SPECIALIZED PRACTICES MA 501(C)(3) 12A, I MOUNT AUBURN HOSPITAL 1 NEW ENGLAND BAPTIST HOSPITAL 125 PARKER HILL AVE BOSTON MA 02120 042103612 ORTHOPEDIC SPECIALTY HOSPITAL MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 NEW ENGLAND BAPTIST MEDICAL ASSOCIATES INC 125 PARKER HILL AVE BOSTON MA 02120 043235796 OUTPATIENT MEDICAL SERVICES TO THE VARIOUS COMMUNITIES SERVICED BY NEBH MA 501(C)(3) 3 NEW ENGLAND BAPTIST HOSPITAL 1 NORTHEAST BEHAVIORAL HEALTH CORPORATION 199 ROSEWOOD DRIVE 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ORGANIZATION INC 41 HIGHLAND AVE WINCHESTER MA 01890 472646454 PHYS HOSP ORG MA N/A C 1 NORTHEAST HEALTH SYSTEMS PHYSICIAN HOSPITAL ORGANIZATION INC 500 CUMMINGS CENTER STE 6500 BEVERLY MA 01915 043258053 MEDICAL SERVICES MA N/A C 1 NORTHEAST PHYSICIAN PRACTICE 85 HERRICK STREET BEVERLY MA 01915 043285837 PHYSICIAN OFFICE MA N/A C 1 NPP SUPPORT SERVICES 85 HERRICK STREET BEVERLY MA 01915 042721511 PHYSICIAN OFFICE MA N/A C 1 1 1 1 1 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 BETH ISRAEL LAHEY HEALTH INC R 726544 FMV BETH ISRAEL DEACONESS MEDICAL CENTER P 3837365 FMV BETH ISRAEL DEACONESS MEDICAL CENTER Q 171889 FMV JORDAN PHYSICIANS ASSOCIATES INC P 360960 FMV JORDAN PHYSICIANS ASSOCIATES INC S 211970 FMV BETH ISRAEL DEACONESS MEDICAL CENTER S 957654 FMV HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC P 3907375 FMV ASSOC PHYS HARVARD MED FAC PHY AT BIDMC P 1885911 FMV ASSOC PHYS HARVARD MED FAC PHY AT BIDMC Q 607629 FMV MED CARE OF BOSTON MGMT CORP DBA BID HEALTHCARE A 198804 FMV MED CARE OF BOSTON MGMT CORP DBA BID HEALTHCARE Q 195891 FMV MED CARE OF BOSTON MGMT CORP DBA BID HEALTHCARE P 50000 FMV MED CARE OF BOSTON MGMT CORP DBA BID HEALTHCARE P 688000 FMV HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC S 212024 FMV HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC A 69390 FMV HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC Q 113066 FMV HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC R 883679 FMV BIDCO HOSPITAL LLC P 950751 FMV PART I - V: AS NOTED THROUGHOUT THIS FILING, ON MARCH 1, 2019, BETH ISRAEL LAHEY HEALTH (BILH) BECAME SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES, LAHEY CLINIC FOUNDATION, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL CORPORATION (NBC), AND ANNA JAQUES HOSPITAL. THE LAHEY CLINIC FOUNDATION IN TURN SERVES AS SOLE MEMBER TO LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL DBA LAHEY HOSPITAL AND MEDICAL CENTER (LHMC). ADDITIONAL ENTITIES LISTED HERE MAY ALSO IN TURN SERVE AS MEMBER TO OTHER NETWORK AFFILIATES. BY-LAW CHANGES WERE MADE TO REFLECT THE CENTRALIZATION OF THE SYSTEM, AND AS SUCH, AFFILIATES WITHIN THE BILH SYSTEM ARE CONSIDERED CONTROLLED ENTITIES UNDER IRC SECTION 512(B)(13), AS EACH AFFILIATE IS UNDER COMMON GOVERNANCE CONTROL, AS DESCRIBED IN TREAS. REGS. 1.512(B)-1(L)(4). UNDER IRC SEC. 512, CONTROL MEANS THAT MORE THAN 50 PERCENT OF THE DIRECTORS OR TRUSTEES OF AN ORGANIZATION ARE EITHER REPRESENTATIVES OF, OR DIRECTLY OR INDIRECTLY CONTROLLED, BY AN EXEMPT ORGANIZATION. A TRUSTEE OR DIRECTOR IS A REPRESENTATIVE OF AN EXEMPT ORGANIZATION IF THEY ARE A TRUSTEE, DIRECTOR, AGENT, OR EMPLOYEE OF SUCH EXEMPT ORGANIZATION. UNDER THIS DEFINITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. AND AFFILIATES ARE INCLUDED IN BETH ISRAEL DEACONESS HOSPITAL - MILTON'S FORM 990, SCHEDULE R FOR THE CURRENT TAX YEAR.