2016-08-12T18:40:23-05:00 2015-09-30 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2014-10-01 042103881 BETH ISRAEL DEACONESS MEDICAL CENTER BETH 6176678000 330 BROOKLINE AVE BOSTON MA 02215 STEVEN FISCHER SR VP & CFO 6176678000 2016-08-09 0 CHRISTINE KAWECKI P00743140 5169187000 2016-08-08 2014 2016-09-27 15:27:22Z DR KEVIN TABB 330 BROOKLINE AVE BOSTON MA 02215 1692449533 0 X WWW.BIDMC.HARVARD.EDU X 1915 MA TERTIARY CARE ACADEMIC MEDICAL CENTER 25 21 11073 550 14179096 0 25659510 33073856 1332513700 1413869113 37629394 28218706 66452877 73524435 1462255481 1548686110 42558157 39231187 0 0 682153776 734482908 152235 255587 8798322 660193605 708328219 1385057773 1482297901 77197708 66388209 1616172939 1613447672 708172838 763135898 908000101 850311774 X SEE SCHEDULE O 0 0 996549627 5677363 1180577254 SEE SCHEDULE O-PATIENT CARE 238481639 33553824 210999306 SEE SCHEDULE O-RESEARCH 95863881 34958330 SEE SCHEDULE O-TEACHING 1330895147 1 1 0 1 0 0 0 0 1 1 1 1 0 1 1 1 0 1 0 1 1 1 0 1 1 1 1 1 1 0 1 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 0 1 X 364 0 1 11073 1 1 1 0 0 0 0 1 1 0 0 0 0 0 X 25 21 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AK CO FL IL KY MA MD MI MN MS NC ND NH NJ NM NY OH OK OR SC TN UT WA WI X STEPHEN DEVEAU 6176671414 330 BROOKLINE AVENUE BOSTON MA 02215 BRADY MICHAEL J DIRECTOR, EX-OFFICIO 1.00 11.00 X 0 0 0 CHAIKOF MD PHD ELLIOT DIR(EX-OFF) & SURG CHIEF 30.00 35.00 X 485341 485341 110173 CHENG JILL DIRECTOR 1.00 0.00 X 0 0 0 CRONIN MICHAEL DIRECTOR 1.00 0.00 X 0 0 0 CUTLER JOEL DIRECTOR 1.00 0.00 X 0 0 0 DESIMONE THOMAS DIRECTOR (EX-OFFICIO) 1.00 0.00 X 0 0 0 DIPP MD PHD MICHELLE DIRECTOR 1.00 0.00 X 0 0 0 HINKLEY CLARK DIRECTOR (EX-OFFICIO) 1.00 11.00 X 0 0 0 JICK DANIEL J DIR & BOARD CHAIR 15.00 1.00 X 0 0 0 JOHNSTON WILLIAM DIRECTOR & TREASURER 2.00 0.00 X X 0 0 0 KAY STEPHEN B DIRECTOR (EX-OFFICIO) 1.00 0.00 X 0 0 0 LADD EDWARD DIRECTOR & VICE CHAIR 5.00 0.00 X 0 0 0 LAMERE DAVID DIRECTOR 1.00 0.00 X 0 0 0 LEPOFSKY ROBERT J DIRECTOR 1.00 0.00 X 0 0 0 LINDE DOUGLAS DIRECTOR 1.00 0.00 X 0 0 0 MACDOWELL VIRGINIA DIRECTOR & CLERK 2.00 1.00 X X 0 0 0 MANDELL MD JAMES DIRECTOR 1.00 0.00 X 0 0 0 MCKENNA MARGARET DIRECTOR 1.00 0.00 X 0 0 0 O'HANLEY RONALD DIRECTOR 1.00 0.00 X 0 0 0 PLINE JENNIFER DIRECTOR (EX-OFFICIO) 1.00 11.00 X 0 0 0 ROSENBERG MD STUART DIR & CEO-HMFP 1.00 64.00 X 0 902263 67444 ROTTENBERG ALAN DIRECTOR 1.00 0.00 X 0 0 0 SILVER JENNIFER DIRECTOR 1.00 0.00 X 0 0 0 TABB MD KEVIN PRESIDENT & CEO 60.00 5.00 X X 1453194 0 53346 ZEIDEL MD MARK L DIR(EX-OFF) & CHIEF, MED 30.00 35.00 X 365821 365820 63934 FISCHER STEVEN SR. VP - FINANCE & CFO 57.00 3.00 X 726292 0 61346 FORMELLA RN MSN NANCY CHIEF OPERATING OFFICER 58.00 2.00 X 884896 0 31260 ARMSTRONG WALTER SVP FACILITIES & ENG 60.00 0.00 X 469436 0 35544 BIEBER JUDITH SVP - HR 60.00 0.00 X 429132 0 61708 MAURER RN MSN MARSHA SVP-PAT CARE & CNO 60.00 0.00 X 573085 0 55512 SHEEHAN RN MSN JAYNE SVP AMBUL & EMERG SVCS 60.00 0.00 X 468420 0 41198 SUKHATME MD SCD VIKAS P SVP & CHIEF ACADEMIC OFFICER 54.00 6.00 X 590658 52861 54224 GEBHARDT MD MARK C CHIEF OF ORTHO SURGERY 30.00 35.00 X 382384 382383 82756 KRUSKAL MD PHD JONATHAN B CHIEF OF RADIOLOGY 30.00 35.00 X 343652 343652 61182 STEVENSON MD PHD MARY ANN CHIEF, RAD ONCOLOGY 30.00 35.00 X 322424 322425 79232 STERN MD ROBERT S CHIEF OF DERMATOLOGY 30.00 35.00 X 312143 312142 86061 LEWIS MD STANLEY SVP, NETWORK INTEGRATION 55.00 10.00 X 590530 65614 47294 ZANKMAN LISA FORMER VP, HR 0.00 0.00 X 160961 0 0 8558369 3232501 992214 1429 1 1 1 HARVARD MEDICAL FACULTY PHYS AT BIDMC 375 LONGWOOD AVE BOSTON MA 02215 PHYSICIAN SERVICES 125791476 SODEXO PO BOX 905374 CHARLOTTE NC 28204 FOOD SERVICE 7279510 MASCO SERVICES 375 LONGWOOD AVE BOSTON MA 02215 PARKING 7070355 BOND BROTHERS 145 SPRING STREET EVERETT MA 02049 CONSTRUCTION 5690269 SHAWMUT DESIGN 560 HARRISON AVE BOSTON MA 02118 CONSTRUCTION 5040051 78 130270 32943586 977785 33073856 NET PATIENT SERVICE RE 541700 637716559 637716559 MEDICARE/MEDICAID REV 900099 530194918 530194918 NIH FUNDED RESEARCH 541700 153243880 153243880 SPONSORED RESEARCH 541700 57755426 57755426 GRADUATE MED EDUCATION 611710 34958330 34958330 1413869113 4566063 297422 4268641 330832 330832 720752 24621 696131 696131 22209 673922 167105947 143453304 23652643 23652643 494477 23158166 58176 130270 272222 -214046 -214046 18594 13276 5318 5318 PARKING REVENUE 812930 23100565 22500 23078065 CRICO DISTRIBUTION 900099 7379143 7379143 WEB OMR 900099 5500000 165000 5335000 36726492 12665777 13177488 10883227 72706200 1548686110 1426534890 14179096 74898268 X 34365246 34365246 4865941 4865941 6923129 3467375 3455754 160961 80481 80480 604733439 547862891 52014447 4856101 24731136 22042367 2472619 216150 53325508 47527959 5331484 466065 44608735 39759165 4459796 389774 3713898 3713898 3862714 3862714 883783 883783 241115 241115 255587 255587 5478523 5478523 155562915 131021771 23605132 936012 2541461 554002 1981896 5563 214249685 212131940 1637182 480563 9236710 6193041 2917329 126340 77706658 71226508 6421941 58209 825411 566150 193020 66241 800707 687857 105130 7720 13737644 13737644 78108761 61982393 15995804 130564 8645881 8642289 3592 RESEARCH 62135360 62135360 0 0 CONTRACTED SERVICES 28294366 27510171 746936 37259 UNCOMPENSATED CARE 8819941 8819941 0 0 FOOD 3809686 2825062 404580 580044 29673000 22889593 6597277 186130 1482297901 1330895147 142604432 8798322 651823209 638880378 34346096 35258013 152818581 148370661 10238151 12967725 11525386 12048882 2181318642 1705660326 475780637 475658316 189499226 204747766 90141653 85515931 1616172939 1613447672 193894751 198170523 60043474 73997466 348697037 325952414 105537576 165015495 708172838 763135898 X 704580079 626160131 145424945 161021841 57995077 63129802 908000101 850311774 1616172939 1613447672 X 66388209 -18336100 -105740436 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1 1 1 0 1 0 1 241115 241115 0 PART II-B, LINE 1: THE MEDICAL CENTER ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER AFFILIATED NETWORK ENTITIES. ADDITIONALLY, THE MEDICAL CENTER 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 $241,115 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2015. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES. 1 816447 816447 0 0 203420022 23515697 10565055 13349131 224151643 192587429 10827103 12156351 12150860 203420023 172799187 9753810 20064195 10029763 192587429 158281306 10376111 16376503 12234733 172799187 172948409 -1735365 546551 13478289 158281306 0.31000 0.69000 0 0 24282879 24282879 303874994 247295145 56579849 599192809 386855335 212337474 1253967960 1071509846 182458114 475658316 OTHER INVESTMENT THROUGH CIP 204747766 F 204747766 DUE FROM AFFILIATES 37111574 A/R MISC 3341601 RESERVE FOR BAD DEBT -700000 DEPOSITS 1500000 CASH SURRENDER VALUE-EXEC LIFE 572520 HPHC WORKING CAPITAL 1436436 PROFESSIONAL LIABILITY REINSURANCE RECOVERIES 42253800 85515931 FUNDS HELD IN TRUST 1371383 FUNDS MANAGED BY OTHERS 6338810 MEDICAL MALPRACTICE 753000 POST RETIREMENT BENEFITS 98696314 CLINICAL TRIALS 15602188 PROFESSIONAL LIABILITY 42253800 165015495 X 2346394000 -18650708 852863766 834213058 1512180942 5091944 31413224 36505168 1548686110 2335375000 858531001 858531001 1476843999 5478523 -24621 5453902 1482297901 PART IV, LINE 1B: CUSTODIAN ARRANGEMENTS THE MEDICAL CENTER IS THE SOLE MEMBER OF BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BID-NEEDHAM) WHICH IS A COMMUNITY HOSPITAL EXEMPT FROM INCOME TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. DURING THE FISCAL YEAR COVERED BY THIS FILING, BID-NEEDHAM DID NOT MAINTAIN ITS OWN DEVELOPMENT STAFF. INSTEAD, AS PART OF THE RELATIONSHIP BETWEEN THE ENTITIES, THE MEDICAL CENTER'S DEVELOPMENT STAFF SOLICITED AND PROCESSED CONTRIBUTIONS FOR BID-NEEDHAM. UPON RECEIPT, THE CONTRIBUTIONS WERE DEPOSITED INTO A MEDICAL CENTER ACCOUNT. AT THE END OF EACH MONTH, THE TOTAL OF THE DEPOSITS ARE TRANSFERRED FROM THE MEDICAL CENTER TO BID-NEEDHAM. PART V, LINE 4: BETH ISRAEL DEACONESS MEDICAL CENTER ENDOWMENT FUND THE MEDICAL CENTER'S ENDOWMENT FUNDS ARE INTENDED TO ENSURE THAT THE MEDICAL CENTER ACCOMPLISHES ITS CHARITABLE MISSIONS OF PROVIDING EXCELLENT CLINICAL CARE, ENGAGING IN CUTTING EDGE RESEARCH AND EDUCATING THE HEALTH CARE PRACTITIONERS OF TOMORROW. THE SPECIFIC USES OF THE ENDOWMENT VARY DEPENDING ON THE NATURE OF RESTRICTIONS, IF ANY, IMPOSED BY DONORS. UNDER THE MEDICAL CENTER'S CURRENT LONG-TERM INVESTMENT SPENDING POLICY, WHICH IS WITHIN THE GUIDELINES SPECIFIED UNDER MASSACHUSETTS STATE LAW, 5-6% OF THE AVERAGE OF THE FAIR VALUE OF QUALIFYING LONG-TERM INVESTMENTS APPLIED TO A THREE-YEAR MOVING AVERAGE WITH A ONE-YEAR LAG IS APPROPRIATED AS STATED BY THE DONOR. DURING FY 2015 $3,246,804 WAS APPROPRIATED OF WHICH $364,735 WAS RELATED SPECIFICALLY TO FREE CARE AND IS INCLUDED IN THIS FORM 990 SCHEDULE H. IN ESTABLISHING THESE POLICIES, THE MEDICAL CENTER CONSIDERED THE EXPECTED RETURN ON ITS ENDOWMENT AND ITS PROGRAMMING NEEDS. ACCORDINGLY, THE MEDICAL CENTER EXPECTS THE CURRENT SPENDING POLICY TO ALLOW ITS ENDOWMENT TO MAINTAIN ITS PURCHASING POWER AND TO PROVIDE A PREDICTABLE AND STABLE SOURCE OF REVENUE FOR THE ANNUAL OPERATING BUDGET. ADDITIONAL REAL GROWTH WILL BE PROVIDED THROUGH NEW GIFTS OR EXCESS INVESTMENT RETURN. PART X, LINE 2: THE MEDICAL CENTER, MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP (APG), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM (BIDN), BETH ISRAEL DEACONESS HOSPITAL - MILTON (BIDM), BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH (BIDP) AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) HAVE ALL BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND, THEREFORE, ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE MEDICAL CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE MEDICAL CENTER DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS IN EITHER 2015 OR 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 13,349,131. CONSOLIDATED AFFILIATES REVENUE NET OF ELIMINATION 839,514,635. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDS MANAGED FOR OTHERS 130,575. RENT -24,621. TEMPORARILY AND PERMANENTLY RESTRICTED CONTRIBUTIONS 23,515,697. TEMPORARILY RESTRICTED REALIZED GAINS 8,077,071. DIRECT EXPENSES FROM FUNDRAISING EVENTS -272,222. DIRECT EXPENSES FROM GAMING EVENTS -13,276. PART XII, LINE 2D - OTHER ADJUSTMENTS: CONSOLIDATED AFFILIATES EXPENSE NET OF ELIMINATION 858,245,503. DIRECT EXPENSES FROM FUNDRAISING EVENTS 272,222. DIRECT EXPENSES FROM GAMING EVENTS 13,276. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENT -24,621. 1 CENTRAL AMERICA & THE CARIBBEAN 0 0 INVESTMENTS 73846748 EAST ASIA AND THE PACIFIC 0 0 INVESTMENTS 684697 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 4419258 NORTH AMERICA 0 0 INVESTMENTS 4292044 SOUTH AMERICA 0 0 INVESTMENTS 605857 CENTRAL AMERICA & THE CARIBBEAN 0 0 PROGRAM SERVICES JOINTLY OWNED FOREIGN INSURANCE 6763479 EAST ASIA & THE PACIFIC 0 0 PROGRAM SERVICES TEACHING/ RESEARCH / PATIENT CARE 142320 NORTH AMERICA 0 0 PROGRAM SERVICES TEACHING/ RESEARCH / PATIENT CARE 360169 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES TEACHING/ RESEARCH / PATIENT CARE 150147 EUROPE (INCLUDING ICELAND AND GREENLAND) 0 0 PROGRAM SERVICES TEACHING/ RESEARCH / PATIENT CARE 4281105 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES TEACHING/ RESEARCH / PATIENT CARE 27255 CENTRAL AMERICA & CARRIBBEAN 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/ PRESENTATIONS 7699 EAST ASIA & THE PACIFIC 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/ PRESENTATIONS 282934 EUROPE (INCLUDING ICELAND AND GREENLAND) 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/ PRESENTATIONS 244404 MIDDLE EAST AND NORTH AFRICA 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/ PRESENTATIONS 4997 NORTH AMERICA 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/ PRESENTATIONS 33367 SOUTH AMERICA 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/ PRESENTATIONS 7089 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES TRAVEL FOR EDUCATIONAL SEMINARS/ PRESENTATIONS 55602 CENTRAL AMERICA & CARRIBBEAN 0 0 PROGRAM SERVICES HUMANITARIAN MISSION 4571 SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES HUMANITARIAN MISSION 3605 SOUTH ASIA 0 0 PROGRAM SERVICES HUMANITARIAN MISSION 5672 EAST ASIA & THE PACIFIC 0 0 PROGRAM SERVICES HUMANITARIAN MISSION 5201 0 0 0 0 0 0 91114572 5113648 96228220 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 42500 WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 31681 WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 15650 WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 6040 WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 11722 WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 8635 WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 8474 WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 7227 WIRE TRANSFER 0 EAST ASIA AND THE PACIFIC RESEARCH SUB-AWARD 6916 WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 489295 WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 3547623 WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 54043 WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 16970 WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 80455 WIRE TRANSFER 0 EUROPE (INCLUDING ICELAND AND GREENLAND) RESEARCH SUB-AWARD 92719 WIRE TRANSFER 0 MIDDLE EAST AND NORTH AFRICA RESEARCH SUB-AWARD 27255 WIRE TRANSFER 0 NORTH AMERICA RESEARCH SUB-AWARD 23750 WIRE TRANSFER 0 NORTH AMERICA RESEARCH SUB-AWARD 49359 WIRE TRANSFER 0 NORTH AMERICA RESEARCH SUB-AWARD 7776 WIRE TRANSFER 0 NORTH AMERICA RESEARCH SUB-AWARD 8640 WIRE TRANSFER 0 NORTH AMERICA RESEARCH SUB-AWARD 9942 WIRE TRANSFER 0 NORTH AMERICA RESEARCH SUB-AWARD 253487 WIRE TRANSFER 0 SUB-SAHARAN AFRICA RESEARCH SUB-AWARD 32232 WIRE TRANSFER 0 SUB-SAHARAN AFRICA RESEARCH SUB-AWARD 32449 WIRE TRANSFER 0 24 1 0 0 1 0 1 PART I, LINE 2: AS NOTED IN BOTH SCHEDULES H, HOSPITALS AND SCHEDULE I, GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS, GOVERNMENTS, AND INDIVIDUALS IN THE UNITED STATES, AS PART OF THE MEDICAL CENTER'S COMMITMENT TO OUR COMMUNITY, THE MEDICAL CENTER PARTNERS WITH COMMUNITY LEADERS AND COMMUNITY-BASED ORGANIZATIONS WHO SERVE AS LINKS TO THE COMMUNITY AND TEACHERS OF HOW WE CAN BETTER SERVE THE POPULATIONS THEY REPRESENT. IN ADDITION, THE MEDICAL CENTER COLLABORATES WITH A WIDE VARIETY OF ORGANIZATIONS BOTH WITHIN AND OUTSIDE OF THE UNITED STATES BECAUSE HEALTHCARE SERVICES BY THEMSELVES ARE NOT ADEQUATE TO MAXIMIZE IMPROVEMENT OF HEALTH STATUS. AS SUCH, OUR INVOLVEMENT WITH OUR COMMUNITY IS ON-GOING AND PART OF THAT ON-GOING RELATIONSHIP INCLUDES REPORTING ON HOW GRANT FUNDS ARE EXPENDED. AS A RECIPIENT OF FEDERAL SPONSORED AWARDS, THE MEDICAL CENTER MUST COMPLY WITH THE GUIDELINES SPECIFIC TO THE FEDERAL AWARDING AGENCY FOR THE PARTICULAR PROGRAM. THE MEDICAL CENTER'S ADHERENCE TO THESE PROGRAMS' REQUIREMENTS IS AUDITED ANNUALLY AS REQUIRED BY OMB CIRCULAR A-133. THE MEDICAL CENTER IS REQUIRED BY FEDERAL REGULATION TO MONITOR EXPENSES OF FEDERAL FUNDS AWARDED TO THE MEDICAL CENTER THAT ARE SUB-CONTRACTED TO ANOTHER INSTITUTION, ORGANIZATION, OR INDIVIDUAL. FEDERAL SUBCONTRACTED RESEARCH GRANTS AS WELL AS OTHER SUBCONTRACTED RESEARCH GRANTS ARE MONITORED BY THE CLINICAL DEPARTMENT SPONSORING THE ACTIVITY. SIMILAR MONITORING PROGRAMS ARE IN PLACE THAT ASSURE ADHERENCE TO ALL NON-FEDERAL SPONSORS' GRANT REQUIREMENTS AS WELL THROUGH A GROUP OF DEDICATED RESEARCH ADMINISTRATIVE PROFESSIONALS THAT REPORT UP THROUGH THE OFFICE OF ACADEMIC AFFAIRS. THIS REPORTING STRUCTURE FURTHER ENHANCES INTERNAL CONTROLS. SCHEDULE F PART IV - FOREIGN FORMS ALTHOUGH BIDMC WAS AN INDIRECT SHAREHOLDER OF A PASSIVE FOREIGN INVESTMENT COMPANY OR QUALIFIED ELECTING FUND DURING THE PERIOD COVERED BY THIS FILING, BIDMC 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 V -- SUPPLEMENTAL INFORMATION GRANTS TO ENTITIES OUTSIDE THE UNITED STATES ARE RELATED TO AND FURTHER THE MEDICAL CENTER'S MISSION TO IMPROVE THE HEALTH OF ALL PATIENTS AND TO ENGAGE IN CUTTING EDGE RESEARCH. FUND RECIPIENTS PROVIDE THE MEDICAL CENTER WITH REPORTS DOCUMENTING THE USE OF SUCH FUNDS. X X X X X X 1 BENTZ WHALEY FLESSNER 7251 OHMS LANE MINNEAPOLIS MN 554392148 STRATEGY CONSULTING 0 0 167105 -167105 CCL BRANDING 300 S LIBERTY ST WINSTONSALEM NC 27101 STRATEGY CONSULTING 0 0 12258 -12258 DEVELOPMENT GUILDDDI 233 HARVARD ST BROOKLINE MA 02246 STRATEGY CONSULTING 0 0 8388 -8388 GRAHAM-PELTON 39 BEECHWOOD ROAD SUMMIT NJ 07901 STRATEGY CONSULTING 0 0 40636 -40636 ZURI GROUP 328 NW BOND ST BEND OR 97701 STRATEGY CONSULTING 0 0 27200 -27200 255587 -255587 AK CO FL IL KY MA MD MI MN MS NC ND NH NJ NM NY OH OK OR SC TN UT WA WI REASON TO RIDE 66658 43740 22918 1000 8450 EVENING OF MUSIC 63488 55990 7498 14016 10608 2 58300 30540 27760 52510 14000 171638 188446 130270 58176 1000 66526 14000 190696 272222 -214046 18594 12346 930 0 1.00000 18594 12346 930 13276 5318 MA 1 0 0 0 0.50000 0.50000 BETH ISRAEL DEACONESS LEGAL DEPARTMENT 330 BROOKLINE AVE BOSTON MA 02215 0 STEVEN FISCHER X 1 5318 1 1 1 X 1 X 1 1 0 1 1 23525436 7936422 15589014 0.01050 206162600 165180288 40982312 0.02760 229688036 173116710 56571326 0.03810 4803604 270373 4533231 0.00310 95482160 30868609 64613551 0.04360 66154827 34731789 31423038 0.02120 273227654 198265202 74962452 0.05060 15821871 760000 15061871 0.01020 455490116 264895973 190594143 0.12870 685178152 438012683 247165469 0.16680 508126 508126 0.00030 508126 508126 0.00030 1 19165721 360497427 363351530 -2854103 X 1 1 1 1 BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVE BOSTON MA 02215 WWW.BIDMC.ORG VL42 X X X X X X TERTIARY CARE ACADEMIC MEDICAL CENTER BETH ISRAEL DEACONESS MEDICAL CENTER 1 0 0 1 X X X X X X X 12 1 0 0 1 X SEE SUPPLEMENTAL INFORMATION X 1 12 1 SEE SUPPLEMENTAL INFORMATION 0 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X X X X 1 X 0 X X X X 1 X 0 0 BETH ISRAEL DEACONESS MEDICAL CENTER 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 MEDICAL CENTER 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. BETH ISRAEL DEACONESS MEDICAL CENTER PART V, SECTION B, LINE 22D: FOR DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION B PLEASE SEE SCHEDULE H PART VI SUPPLEMENTAL INFORMATION. 5 BETH ISRAEL DEACONESS HEALTHCARE LEXINGG 482 BEDFORD STREET LEXINGTON MA 02420 OUTPATIENT MEDICAL CARE BETH ISRAEL DEACONESS HEALTHCARE CHELS 1000 BROADWAY CHELSEA MA 02150 OUTPATIENT MEDICAL CARE BOWDOIN STREET HEALTH CENTER 230 BOWDOIN STREET DORCHESTER MA 02122 OUTPATIENT MEDICAL CARE CHESTNUT HILL AMBULATORY CARE 200 BOYLSTON STREET NEWTON MA 02467 OUTPATIENT MEDICAL CARE BETH ISRAEL DEACONESS CANCER CENTER 148 CHESTNUT STREET NEEDHAM MA 02492 OUTPATIENT CANCER CARE FORM 990 SCHEDULE H SUPPLEMENTAL INFORMATION DISCLOSURES FOR FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION WILL FOLLOW THOSE DISCLOSURES RELATED TO FORM 990 SCHEDULE H PART V, SECTION BFORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY BENEFITS MISSION STATEMENT THE MEDICAL CENTER IS COMMITTED TO ITS COMMUNITY. THE MEDICAL CENTER HAS A COVENANT TO CARE FOR THE UNDERSERVED AND TO WORK TO CHANGE DISPARITIES IN ACCESS TO CARE AND TO THAT END THE BOARD OF DIRECTORS HAS CHARGED ITS PERMANENT COMMUNITY BENEFITS COMMITTEE WITH AUTHORITY AND OVERSIGHT OF ACTIVITIES TO FULFILL THE MISSION OF COMMUNITY BENEFITS. THE MEDICAL CENTER KNOWS THAT TO BE SUCCESSFUL IT NEEDS TO LEARN FROM THOSE IT SERVES. THIS COMMUNITY BENEFIT MISSION IS FULFILLED BY:-IMPLEMENTING PROGRAMS AND SERVICES IN GREATER BOSTON AND OUTER CAPE COD TO IMPROVE THE CURRENT AND FUTURE HEALTH STATUS OF MEDICALLY UNDERSERVED COMMUNITIES WHICH ARE CHALLENGED BY BARRIERS IN ACCESSING AND INTERACTING EFFECTIVELY WITH THE HEALTHCARE SYSTEM AND IMPACTED BY OTHER SOCIAL DETERMINANTS OF HEALTH.-ENSURING THAT THE MEDICAL CENTER IS WELCOMING AND INCLUSIVE AND THAT ALL PATIENTS RECEIVE EQUITABLE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND-ENCOURAGING COLLABORATIVE RELATIONSHIPS WITH OTHER PROVIDERS AND GOVERNMENT ENTITIES TO SUPPORT AND ENHANCE RATIONAL AND EFFECTIVE HEALTH POLICIES AND PROGRAMS. DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $ 13,891,774 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY CARE ALLIANCE (CCA) AND COMMUNITY HEALTH CENTERS (CHC)BIDMC HAS PARTICULARLY STRONG RELATIONSHIPS WITH MANY OF THE PRIMARY CARE CLINICS THAT OPERATE IN ITS COMMUNITY BENEFITS SERVICE AREA, MANY OF WHOM ARE AFFILIATED WITH BIDMC'S COMMUNITY CARE ALLIANCE (CCA). SERVING OVER 100,000 PATIENTS ANNUALLY, THE CCA HEALTH CENTERS INCLUDE:-BOWDOIN STREET HEALTH CENTER-THE DIMOCK CENTER-FENWAY HEATH AND SIDNEY BORUM JR. HEALTH SERVICES-CHARLES RIVER COMMUNITY HEALTH (FORMERLY JOSEPH M. SMITH COMMUNITY HEALTH CENTER)-OUTER CAPE HEALTH SERVICES-SOUTH COVE COMMUNITY HEALTH CENTERTHE MEDICAL CENTER PROVIDED COMBINED DIRECT GRANT, FUNDING AND COMMUNITY BENEFIT PROGRAMMING SUPPORT OF THESE CHCS AND THE CCA OF $ 6,767,685. THESE AMOUNTS ARE INCLUDED IN SCHEDULE H PART I, LINES 7E, 7G AND 7I AND ARE REPORTED IN SCHEDULE I PART II. THE CCA HEALTH CENTERS ARE IDEAL COMMUNITY BENEFITS PARTNERS AS THEY ARE ROOTED IN THEIR COMMUNITIES AND, AS FEDERALLY QUALIFIED HEALTH CENTERS, MANDATED TO SERVE LOW INCOME, UNDERSERVED POPULATIONS. THESE CLINIC PARTNERS HAVE BEEN A VITAL PART OF BIDMC'S COMMUNITY HEALTH IMPROVEMENT STRATEGY SINCE 1968, WHEN BETH ISRAEL HOSPITAL FIRST JOINED FORCES WITH THE DIMOCK CENTER TO ADDRESS MATERNAL AND CHILD HEALTH ISSUES. HISTORICALLY, BIDMC HAS RELIED HEAVILY ON ITS CCA PARTNERS AS WELL AS A NUMBER OF OTHER KEY COMMUNITY HEALTH PARTNERS TO IMPLEMENT ITS COMMUNITY BENEFITS INITIATIVES. IN THIS REGARD, BIDMC HAS LEVERAGED CCA'S EXPERTISE AND THE VITAL CONNECTIONS THAT THESE ORGANIZATIONS HAVE WITH RESIDENTS AND ORGANIZATIONS IN THE COMMUNITIES THEY SERVE. COMMUNITY BENEFITS LEADERSHIP AND PROCESSTHE BOARD OF DIRECTORS HAS CHARGED ITS PERMANENT COMMUNITY BENEFITS COMMITTEE WITH AUTHORITY AND OVERSIGHT OF ACTIVITIES TO FULFILL THE MISSION OF COMMUNITY BENEFITS. SPECIFICALLY, THE RESPONSIBILITIES OF THE COMMITTEE ARE TO:-(I) RECOMMEND BROAD GUIDELINES BY WHICH THE CORPORATION'S PROGRAMS AND POLICIES SERVE ITS COMMUNITIES; (II) MAKE RECOMMENDATIONS OF POLICIES AND PRIORITIES WITH REGARD TO PROGRAMS THAT MEET THE HEALTH CARE NEEDS OF ITS COMMUNITIES; (III) STRENGTHEN THE INTEGRATION OF THE CORPORATION'S COMMUNITY SERVICE ACTIVITIES, PUBLIC HEALTH PROGRAMS AND ITS OVERALL STRATEGIC PLANNING EFFORTS; (IV) OVERSEE THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY BENEFIT PLAN TO ADDRESS IDENTIFIED NEEDS IN THE COMMUNITY; (V) IDENTIFY, SHARE AND REPLICATE INNOVATIVE AND EVIDENCE-BASED MODELS AND BEST PRACTICES TO ADDRESS THESE NEEDS; (VI) REVIEW, AT LEAST ANNUALLY, THE EXTENT AND NATURE OF THE COMMITMENT OF RESOURCES TO PROGRAMS TARGETED AT IMPROVING THE CURRENT AND FUTURE HEALTH STATUS OF SURROUNDING COMMUNITIES; (VII) ENCOURAGE COLLABORATIVE RELATIONSHIPS WITH OTHER PROVIDERS AND GOVERNMENT ENTITIES TO SUPPORT AND ENHANCE RATIONAL AND EFFECTIVE PUBLIC HEALTH POLICIES AND PROGRAMS; (VIII) DISCUSS PUBLIC POLICY ISSUES AND RELEVANT LEGAL AND REGULATORY MATTERS RELATED TO PUBLIC HEALTH AND COMMUNITY BENEFITS AND ADVISE THE BOARD OF DIRECTORS OF THE IMPLICATIONS FOR THE CORPORATION; (IV) EDUCATE DIRECTORS, TRUSTEES, OVERSEERS, STAFF AND THE COMMUNITY ABOUT HOW THE CORPORATION ADDRESSES ITS MISSION TO FOCUS ON THE HEALTH NEEDS OF ITS COMMUNITIES; AND (V) WORK TO RECOGNIZE AND CONFRONT HEALTH DISPARITIES AND ENSURE THAT THE CORPORATION IS WELCOMING AND INCLUSIVE FOR ALL INDIVIDUALS OF DIVERSE BACKGROUNDS."THE MEMBERSHIP OF THE MEDICAL CENTER'S COMMUNITY BENEFITS COMMITTEE ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND TARGET POPULATIONS OF OUR PROGRAMMATIC ENDEAVORS INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. SENIOR MANAGEMENT IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY BENEFITS PLAN, ENSURING THAT THE MEDICAL CENTER'S POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES.IT IS NOT ONLY THE BOARD AND SENIOR LEADERSHIP THAT ARE HELD ACCOUNTABLE IN FULFILLING THE MEDICAL CENTER'S COMMUNITY BENEFITS MISSION. CONSISTENT WITH THE MEDICAL CENTER'S CORE VALUES IS THE RECOGNITION THAT THE MOST SUCCESSFUL COMMUNITY BENEFITS PROGRAMS ARE THOSE THAT ARE IMPLEMENTED ORGANIZATION-WIDE AND INTEGRATED INTO THE VERY FABRIC OF THE MEDICAL CENTER'S CULTURE, POLICIES AND PROCEDURES. IT IS NOT A STAND-ALONE EFFORT THAT IS THE RESPONSIBILITY OF ONE STAFF OR DEPARTMENT BUT RATHER AN ORIENTATION AND VALUE MANIFESTED THROUGHOUT OUR STRUCTURE, REFLECTED IN HOW WE PROVIDE CARE HERE AT THE MEDICAL CENTER AND IN AFFILIATED PRACTICES IN URBAN NEIGHBORHOODS AND CERTAIN RURAL AREAS.PROVIDING DIRECTION FOR OUR COLLECTIVE COMMITMENT AND EFFORT ARE THE COMMUNITY BENEFIT GUIDING PRINCIPLES THAT FOLLOW. ADOPTED BY A BROAD-BASED CONSTITUENCY OF BOARD, SENIOR LEADERSHIP AND STAFF, THESE PRINCIPLES PROVIDE THE FRAMEWORK FOR THE EXECUTION OF THE PLAN, SPEARHEADED BY THE DIRECTOR OF COMMUNITY BENEFITS. THE DIRECTOR OF COMMUNITY BENEFITS IS ACCOUNTABLE TO THE SENIOR VICE PRESIDENT AND CHIEF STRATEGY OFFICER, WITH DIRECT ACCESS TO THE PRESIDENT/CEO. IT IS THE RESPONSIBILITY OF THESE THREE SENIOR MANAGERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF UNDERSERVED POPULATIONS ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THIS IS THE STRUCTURE AND METHODOLOGY EMPLOYED TO ENSURE THAT COMMUNITY BENEFITS IS NOT THE PURVIEW OF ONE OFFICE ALONE AND TO MAXIMIZE THE EXTENT TO WHICH EFFORTS ACROSS THE ORGANIZATION ARE FULFILLING THE GOALS OF COMMUNITY BENEFITS.THE MEDICAL CENTER ACCOMPLISHES THESE GOALS BY PARTNERING WITH OUR COMMUNITY AS FOLLOWS:-THE MEDICAL CENTER PARTNERS WITH COMMUNITY LEADERS AND COMMUNITY-BASED ORGANIZATIONS WHO SERVE AS LINKS TO THE COMMUNITY AND TEACHERS OF HOW WE CAN BETTER SERVE THE POPULATIONS THEY REPRESENT. IN ADDITION, THE MEDICAL CENTER COLLABORATES WITH A WIDE VARIETY OF ORGANIZATIONS BECAUSE HEALTHCARE SERVICES BY THEMSELVES ARE NOT ADEQUATE TO MAXIMIZE IMPROVEMENT OF HEALTH STATUS.-IMPROVING THE COMMUNITY'S HEALTH REQUIRES MORE THAN CLINICAL SERVICES. THE MEDICAL CENTER LOOKS TO PUBLIC HEALTH, PREVENTION, AND OTHER HEALTH-RELATED APPROACHES NOT TRADITIONALLY PROVIDED BY MANY ACUTE CARE HOSPITALS.-THE MEDICAL CENTER'S COMMITMENT TO THE COMMUNITY BENEFITS MISSION IS AS FUNDAMENTAL AS ITS COMMITMENT TO ITS PATIENT CARE AND ACADEMIC MISSIONS. THAT IS, RATHER THAN ABANDON ANY OF THESE FUNDAMENTAL MISSIONS WHEN BUDGET RESTRAINTS ARISE, THE MEDICAL CENTER WILL CONSTANTLY SEEK WAYS TO FULFILL ALL OF THEM IN AS EFFECTIVE AND EFFICIENT A MANNER AS POSSIBLE.-COMMUNITY BENEFITS PROGRAMS ARE MOST SUCCESSFUL WHEN IMPLEMENTED ORGANIZATION-WIDE, JUST AS QUALITY AND RESPECT. COMMUNITY BENEFITS CANNOT SUCCEED AS A STAND-ALONE ACTIVITY. THE IMPORTANCE OF THESE PRINCIPLES AND THE EFFORTS THAT RESULT MUST BE EMBRACED BY TRUSTEES, SENIOR MANAGEMENT AND PROVIDERS ALIKE, AS WELL AS BY THE COMMUNITIES SERVED. COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY HEALTH NEEDS ASSESSMENT - INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER MAINTAIN ITS TAX EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THE MEDICAL CENTER COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2013. THE NEEDS ASSESSMENT AND ACCOMPANYING IMPLEMENTATION PLAN WERE APPROVED BY THE BETH ISRAEL DEACONESS MEDICAL CENTER BOARD OF DIRECTORS ON SEPTEMBER 18, 2013. ADDITIONALLY, THE MEDICAL CENTER COMMENCED ITS NEXT CHNA PROCESS ON OCTOBER 1, 2015 AND WILL HAVE A NEW CHNA COMPLETED AND VOTED BY THE MEDICAL CENTER BOARD OR SUBCOMMITTEE OF THE BOARD, ON OR BEFORE SEPTEMBER 30, 2016. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ALONG WITH THE ASSOCIATED COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS THE CULMINATION OF NINE MONTHS (NOVEMBER 2012 - JULY 2013) OF WORK AND WAS BORNE LARGELY OUT OF BIDMC'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT BIDMC ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES, AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW THE MEDICAL CENTER, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT, WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE ASSESSMENT.COMMUNITY HEALTH NEEDS ASSESSMENT - COMMUNITY INFORMATIONBIDMC FOCUSES ITS COMMUNITY BENEFITS EFFORTS ON IMPROVING THE HEALTH STATUS OF THE LOW INCOME, UNDERSERVED POPULATIONS LIVING IN ALLSTON/BRIGHTON, CHINATOWN, DORCHESTER, FENWAY/KENMORE, ROXBURY, AND THE SOUTH END. BIDMC ALSO HAS HISTORICAL TIES TO UNDERSERVED COMMUNITIES IN QUINCY AND TO SOME OF THE MOST ISOLATED, VULNERABLE AREAS OF CAPE COD, SPECIFICALLY THE OUTER CAPE (HARWICH, WELLFLEET, TRURO, AND PROVINCETOWN). THESE COMMUNITIES MAKE UP BIDMC'S COMMUNITY BENEFITS SERVICE AREA AND INCLUDE THE COMMUNITY CARE ALLIANCE (CCA), THE NETWORK OF ONE LICENSED AND FIVE FEDERALLY QUALIFIED HEALTH CENTERS AFFILIATED WITH BIDMC. (SCHEDULE H PART VI QUESTION 4) COMMUNITY HEALTH NEEDS ASSESSMENT -- APPROACH AND METHODSTHE CHNA WAS CONDUCTED BY THE BIDMC COMMUNITY BENEFITS DEPARTMENT IN THREE PHASES, WHICH ALLOWED BIDMC TO: 1) COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA, 2) ENGAGE AND INVOLVE KEY STAKEHOLDERS, BIDMC SENIOR STAFF, AND THE COMMUNITY AT-LARGE THROUGHOUT THE PROCESS, 3) DEVELOP A REPORT AND DETAILED STRATEGIC PLAN, AND 4) COMPLY WITH ALL COMMONWEALTH ATTORNEY GENERAL AND FEDERAL IRS COMMUNITY BENEFIT REQUIREMENTS. BETH ISRAEL DEACONESS MEDICAL CENTER'S COMMUNITY BENEFITS PROGRAM IS PREDICATED ON THE NOTION OF PARTNERSHIP AND DIALOGUE WITH ITS MANY COMMUNITIES. THE MEDICAL CENTER'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM DISCUSSIONS WITH AND OBSERVATIONS BY, HEALTHCARE AND HEALTH-RELATED WORKERS IN THE NEIGHBORHOODS AS WELL AS MORE FORMAL ASSESSMENTS THROUGH AVAILABLE PUBLIC HEALTH DATA, FOCUS GROUPS, SURVEYS, ETC. THESE DATA ARE THEN AUGMENTED BY DEMOGRAPHIC AND HEALTH STATUS INFORMATION GLEANED FROM A VARIETY OF SOURCES INCLUDING THE MASSACHUSETTS' DEPARTMENT OF PUBLIC HEALTH, THE BOSTON PUBLIC HEALTH COMMISSION, FEDERAL RESOURCES SUCH AS THE INSTITUTE OF MEDICINE, AND CENTERS FOR DISEASE AND PREVENTION, AND REVIEW OF LITERATURE RELEVANT TO A PARTICULAR COMMUNITY'S NEEDS AS REPORTED IN SCHEDULE H, PART V, SECTION B, QUESTION 3. THE MEDICAL CENTER CONDUCTED THIS CHNA PROCESS INDEPENDENTLY AS REPORTED IN SCHEDULE H, PART V, SECTION B, QUESTION 6.THE ARTICULATION OF EACH SPECIFIC COMMUNITY'S NEEDS (DONE IN PARTNERSHIP BETWEEN BETH ISRAEL DEACONESS MEDICAL CENTER AND COMMUNITY PARTNERS) IS USED TO INFORM OUR DECISION-MAKING ABOUT PRIORITIES FOR COMMUNITY BENEFITS EFFORTS. FOLLOWING THE GUIDING PRINCIPLES DESCRIBED ABOVE, FOR EACH PRIORITY AREA, WE WORK IN CONCERT WITH COMMUNITY RESIDENTS AND LEADERS TO DESIGN SPECIFIC ACTIONS TO BE UNDERTAKEN EACH YEAR. EACH COMPONENT OF THE PLAN IS THUS DEVELOPED AND EVENTUALLY WOVEN INTO THE ANNUAL GOALS AND AGENDA FOR THE MEDICAL CENTER'S COMMUNITY BENEFITS PLAN THAT IS ADOPTED BY THE BOARD OF DIRECTOR'S COMMUNITY BENEFITS COMMITTEE. COMMUNITY HEALTH NEEDS ASSESSMENT - SUMMARY OF FINDINGS -LIMITED ACCESS AND BARRIERS TO COMMUNITY-BASED CARE FOR MANY RESIDENTS IN BOSTON. ACCORDING TO THE BOSTON PUBLIC HEALTH COMMISSION, NEARLY ONE IN FIVE (17% (2008)) BOSTON RESIDENTS DID NOT HAVE A PERSONAL HEALTH CARE PROVIDER; AND NEARLY ONE IN FOUR (23%) OF BOSTON RESIDENTS HAD NOT HAD A MEDICAL VISIT IN MORE THAN A YEAR (2010). DESPITE THE OVERALL SUCCESS OF THE COMMONWEALTH'S HEATH REFORM EFFORTS, SEGMENTS OF THE POPULATION, PARTICULARLY LOW INCOME AND RACIAL/ETHNIC MINORITY POPULATIONS, FACE SIGNIFICANT BARRIERS TO CARE AND STRUGGLE TO ACCESS SERVICES DUE TO LACK OF INSURANCE, COST, TRANSPORTATION, CULTURAL/LINGUISTIC BARRIERS, AND SHORTAGES OF COMMUNITY-BASED PRIMARY CARE PROVIDERS.-HIGH RATES OF OBESITY, LIMITED PHYSICAL EXERCISE, AND POOR NUTRITIONNEARLY TWO-THIRDS OF BOSTON ADULTS (18+) ARE EITHER OBESE OR OVERWEIGHT. ACCORDING TO THE CHNA SURVEY, RATES FOR SPECIFIC DEMOGRAPHIC, SOCIO-ECONOMIC AND GEOGRAPHIC POPULATION SEGMENTS LIVING IN NEIGHBORHOODS WITHIN BIDMC'S COMMUNITY BENEFITS SERVICE AREA ARE EVEN HIGHER. HIGH PROPORTIONS OF RESIDENTS IN BOSTON'S URBAN CORE DO NOT EXERCISE AND HAVE POOR NUTRITION, WHICH ARE THE LEADING FACTORS ASSOCIATED WITH OBESITY AND CHRONIC DISEASES, SUCH AS HEART DISEASE, HYPERTENSION, DIABETES, CANCER, AND DEPRESSION. -HIGH CHRONIC DISEASE AND CANCER RATES. RATES OF ILLNESS AND DEATH VARY BY CONDITION, BUT OVERALL RACIAL/ETHNIC MINORITY GROUPS ARE MORE LIKELY TO HAVE CHRONIC HEALTH CONDITIONS AND DIE FROM THEM THAN THEIR NON-HISPANIC, WHITE COUNTERPARTS. THIS PUTS A DISPROPORTIONATE BURDEN ON COMMUNITIES WITH HIGH PROPORTIONS OF RACIAL/ETHNIC MINORITIES, SUCH AS ROXBURY, NORTH AND SOUTH DORCHESTER, AND THE SOUTH END WHICH ARE NEIGHBORHOODS WITHIN BIDMC'S COMMUNITY BENEFITS SERVICE AREA. CARDIOVASCULAR DISEASE (HEART DISEASE), CANCER, AND CEREBROVASCULAR DISEASE (STROKE) ARE THE THREE LEADING CAUSES OF DEATH IN THE UNITED STATES, MASSACHUSETTS, AND BOSTON. IN ADDITION, DIABETES IS RANKED IN THE TOP 10 ACROSS ALL THREE OF THESE GEOGRAPHIC AREAS. ACCORDING TO THE COMMONWEALTH'S HOSPITAL DISCHARGE DATABASE RESIDENTS OF NORTH AND SOUTH DORCHESTER, ROXBURY, AND CHINATOWN/SOUTH END WERE MORE LIKELY TO RECEIVE INPATIENT SERVICES FOR HYPERTENSION, HEART FAILURE, ASTHMA, PNEUMONIA, AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE THAN RESIDENTS OF BOSTON AND MASSACHUSETTS OVERALL. SERVICE FOR THESE CONDITIONS ARE OFTEN CONSIDERED PREVENTABLE OR AVOIDABLE WITH REGULAR, PRIMARY CARE SERVICES AND THEREFORE ARE INDICATIVE OF POOR OR LIMITED ACCESS TO PRIMARY CARE. -HIGH RATES OF MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES ACCORDING TO MASSCHIP (2010) AND THE MASSACHUSETTS SUBSTANCE ABUSE BUREAU, BOSTON HAS STATISTICALLY HIGHER RATES OF SUBSTANCE ABUSE TREATMENT ADMISSIONS, INCLUDING COCAINE, HEROIN AND OTHER OPIOIDS, WHEN COMPARED TO THE COMMONWEALTH. RATES ARE PARTICULARLY HIGH IN SOUTH DORCHESTER AND ROXBURY. ACCORDING TO BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM DATA, 10% OF BOSTON RESIDENTS REPORTED BEING POOR MENTAL HEALTH STATUS FOR MORE THAN 15 DAYS IN A GIVEN MONTH. ACCORDING TO DATA FROM THE BIDMC CHNA SURVEY, APPROXIMATELY 30% OF RESPONDENTS WERE DEEMED AT RISK FOR DEPRESSION AND NEEDED ADDITIONAL MENTAL HEALTH ASSESSMENT BECAUSE THEY SCREENED POSITIVE FOR A SHORT SCREENING TOOL FOR DEPRESSION. -MATERNAL AND CHILD HEALTH NEEDS. ACCORDING TO THE MASSACHUSETTS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM AND BOSTON PUBLIC HEALTH COMMISSION THE INFANT DEATH RATE FOR HISPANICS/LATINOS IN BOSTON IS TWICE THE RATE OF NON-HISPANIC, WHITES, AND FOR AFRICAN AMERICANS/BLACKS THE RATE IS THREE TIMES THE RATE OF NON-HISPANIC, WHITES. ACCORDING TO THE MASSACHUSETTS VITAL RECORDS NATALITY INFANT DEATHS DATASET, RESIDENTS OF NORTH DORCHESTER AND ROXBURY HAVE HIGHER RATES OF INFANT MORTALITY COMPARED TO BOSTON OVERALL. HISPANIC/LATINO ADOLESCENTS IN BOSTON ARE THREE TIMES MORE LIKELY TO GIVE BIRTH TO A BABY AS NON-HISPANIC, WHITE ADOLESCENTS.-HIV/AIDS AND OTHER INFECTIOUS DISEASES STILL A MAJOR BURDEN ON SMALL BUT HIGH NEED SEGMENTS OF POPULATION. RATES OF HIV/AIDS ILLNESS, DEATH, AND TRANSMISSION HAVE DECLINED DRAMATICALLY OVER THE PAST DECADE. HOWEVER, HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS STILL HAS A MAJOR IMPACT ON THE LESBIAN, GAY, BISEXUAL AND TRANSGENDER (LGBT) COMMUNITY, DISCONNECTED, AT-RISK YOUTH, CERTAIN BOSTON NEIGHBORHOODS (FENWAY/KENMORE, ROXBURY, NORTH DORCHESTER), AND THE COMMUNITIES ON THE OUTER CAPE (WELLFLEET, TRURO, AND PROVINCETOWN). ADDITIONALLY, THE ASIAN COMMUNITY IS STILL AFFECTED BY HEPATITIS B INFECTIONS.COMMUNITY HEALTH NEEDS ASSESSMENT - ADDRESSING COMMUNITY HEALTH NEEDSLARGE PROPORTIONS OF INDIVIDUALS RESIDING WITHIN BOSTON AND BIDMC'S COMMUNITY BENEFITS SERVICE AREA LIVE IN POVERTY, HAVE LIMITED FORMAL EDUCATION, ARE UNEMPLOYED, AND STRUGGLE TO AFFORD FOOD AND OTHER ESSENTIAL HOUSEHOLD ITEMS. THESE POPULATIONS ARE DISPROPORTIONATELY FROM RACIAL/ETHNIC MINORITY GROUPS AND, PARTLY AS A RESULT OF THEIR POVERTY, FACE DISPARITIES IN HEALTH AND ACCESS TO CARE OUTCOMES. IT IS CRITICAL TO NOTE THAT THERE IS A MULTITUDE OF INDIVIDUAL, COMMUNITY AND SOCIETAL FACTORS THAT WORK TOGETHER TO CREATE THESE INEQUITIES. IT IS INSUFFICIENT TO TALK SOLELY ABOUT RACE/ETHNICITY, FOREIGN BORN STATUS, OR LANGUAGE; AS THE UNDERLYING AND CORRELATIVE ISSUES RELATED TO HEALTH AND WELL-BEING INVOLVE ECONOMIC OPPORTUNITY, EDUCATION, CRIME, AND COMMUNITY COHESION. BIDMC STRIVES TO ADDRESS THE PRIORITY AREAS AND IN ITS CHNA AND IMPLEMENTATION STRATEGY WHICH ARE AVAILABLE ON THE MEDICAL CENTER'S WEBSITE(HTTP://WWW.BIDMC.ORG/~/MEDIA/FILES/CENTERS%20AND%20DEPARTMENTS/ COMMUNITY%20INITIATIVES/FINALCHNAREPORT92313.PDF) AND UPON REQUEST. A SUMMARY OF THE MEDICAL CENTER'S COMMUNITY BENEFIT ACTIVITIES WHICH ADDRESS THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA AND PRIORITIZED IN THE MOST RECENT CHIP ARE PROVIDED HERE ALONG WITH THE ENTITIES WITH WHICH THE MEDICAL CENTER PARTNERS RELATED TO THESE EFFORTS. (PLEASE NOTE THAT THIS KEY RELATES TO THE DETAIL PROVIDED BELOW: KEY: BASELINE - 2013, YEAR 1 - 2014, YEAR 2 - 2015, YEAR 3 - 2016). PRIORITY AREA 1: HEALTHY LIVING - OBESITY, FITNESS, AND NUTRITION HEALTHY AND SAFE EATING IS IMPORTANT THROUGHOUT THE LIFESPAN. REGULAR PHYSICAL ACTIVITY COMBINED WITH HEALTHY EATING ARE IMPORTANT FOR PEOPLE OF ALL AGES. PHYSICAL ACTIVITY HELPS PREVENT MANY DISEASES (E.G. HEART DISEASE, DIABETES AND SOME CANCERS), STRENGTHENS BONES AND MUSCLES, REDUCES STRESS AND DEPRESSION, AND MAKES IT EASIER FOR PEOPLE TO MAINTAIN A HEALTHY BODY WEIGHT. EATING A HEALTHY DIET CAN HELP LOWER PEOPLE'S RISK FOR HEART DISEASE, HIGH BLOOD PRESSURE, DIABETES, AND CERTAIN CANCERS, AND ALSO HELPS PEOPLE MAINTAIN A HEALTHY BODY WEIGHT. ACCORDING TO DATA FROM THE MASSACHUSETTS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), NEARLY TWO-THIRDS OF BOSTON ADULTS (18+) (60%) ARE EITHER OBESE OR OVERWEIGHT. RATES FOR SPECIFIC DEMOGRAPHIC, SOCIO-ECONOMIC AND GEOGRAPHIC POPULATION SEGMENTS LIVING IN MANY OF BOSTON'S NEIGHBORHOODS ARE EVEN HIGHER. MASSACHUSETTS BRFSS DATA ALSO SHOWS THAT ONLY ONE IN FOUR ADULTS (18+) (26%) IN BOSTON ATE THE RECOMMENDED FIVE SERVINGS OF FRUITS AND VEGETABLES PER DAY, AND ROUGHLY THE SAME PERCENTAGE (25%) REPORTED GETTING NO PHYSICAL ACTIVITY IN THE PAST 30 DAYS. QUALITATIVE INFORMATION FROM THE ASSESSMENT'S INTERVIEWS AND FOCUS GROUPS CORROBORATED THESE FINDINGS AND NEARLY ALL DISCUSSION PARTICIPANTS CITED OBESITY, POOR NUTRITION, AND LACK OF PHYSICAL EXERCISE AS LEADING HEALTH ISSUES.KEY: BASELINE - 2013, YEAR 1 - 2014, YEAR 2 - 2015, YEAR 3 -- 2016GOAL: INCREASE PHYSICAL ACTIVITY AND HEALTHY EATINGTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 1.1 INCREASE THE NUMBER OF CHILDREN, YOUTH, AND ADULTS WHO ARE PHYSICALLY ACTIVECOMMUNITY ACTIVITIES/STRATEGIES:-SUPPORT COMMUNITY CARE ALLIANCE (CCA) CLINICS THROUGH MINI-GRANTS TO PROMOTE PHYSICAL ACTIVITY PROGRAMMING-SUPPORT AND PROMOTE THE DEVELOPMENT OF WALKING AND OTHER PHYSICAL ACTIVITY GROUPS IN SCHOOLS, COMMUNITY-BASED AND PRIMARY CARE-BASED SETTINGS (E.G., BOWDOIN STREET WELLNESS CENTER OPENED IN MAY 2015)-SUPPORT AND COLLABORATE WITH THE BOSTON PUBLIC HEALTH COMMISSION, THE BOSTON COLLABORATIVE FOR FOOD AND FITNESS, AND THE BOSTON ALLIANCE FOR COMMUNITY HEALTH, BOTH INDEPENDENTLY AND IN PARTNERSHIP WITH CCA CLINICS, ON EFFORTS RELATED TO ACTIVE LIVING (E.G., COMMUNITY POOLS, PARKS, ETC.)METRICS AND STATUS UPDATE:-EXPANDED WALKING CLUB PROGRAMMING O NUMBER OF SCHOOLS PARTICIPATING: 16 (BASELINE); 19 (YEAR 1); 19 (YEAR 2); O NUMBER OF CHILDREN ENROLLED: 3,755 (BASELINE); 4,176 (YEAR 1); 3,485 (YEAR 2); O NUMBER OF STAFF PARTICIPANTS: 292 (BASELINE); 585 (YEAR 1); 490 (YEAR 2) O NUMBER OF ADULT PARTICIPANTS: 1,648 (BASELINE); 1,999 (YEAR 1); 2,112 (YEAR 2) O NUMBER OF PEDOMETERS DISTRIBUTED: 7,082 (BASELINE); 8,937 (YEAR 1); 9,835 (YEAR 2)-OFFERED ZUMBA CLASSES AS PART OF BOSTON RACIAL AND ETHNIC APPROACHES TO COMMUNITY HEALTH: OBESITY AND HYPERTENSION DEMONSTRATION PROJECT (REACH), OBESITY PREVENTION INITIATIVE-ASSISTED BOWDOIN STREET HEALTH CENTER (BSHC) WITH OBTAINING AGENTS OF CHANGE FUNDING IN YEAR 1: 15 OLDER ADULTS PARTICIPATED IN TAI CHI CLASSES FOR 6 MONTHS. IN YEAR 2 20 OLDER ADULTS PARTICIPATED TWICE WEEKLY FOR 6 MONTHS. -BSHC TRAIN4CHANGE PROGRAM GRADUATED 5 COMMUNITY RESIDENTS WHO BECAME CERTIFIED GROUP FITNESS INSTRUCTORS IN THE WELLNESS CENTER1.2 DEVELOP BIDMC / BOWDOIN STREET WELLNESS CENTERCOMMUNITY ACTIVITIES/STRATEGIES:-SUPPORT FUNDRAISING EFFORTS-SUPPORT PLAN DEVELOPMENT PROCESSMETRICS AND STATUS UPDATE:-MOVED FORWARD WITH WELLNESS CENTER LAUNCH O MET $4M FUNDRAISING GOAL IN YEAR 1 O STARTED CONSTRUCTION ON SCHEDULE IN YEAR 1 (MAY 2014) O THE WELLNESS CENTER OPENED IN YEAR 2 (MAY 2015)1.3 INCREASE ACCESS TO HEALTHY AND AFFORDABLE FOODS IN COMMUNITIES1.4 IMPROVE NUTRITIONAL QUALITY OF THE FOOD SUPPLY1.5 DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITYCOMMUNITY ACTIVITIES/STRATEGIES: -SUPPORT CCA CLINICS THROUGH MINI-GRANTS TO PROMOTE HEALTHY EATING PROGRAMMING-SUPPORT AND PROMOTE COMMUNITY GARDENS IN CCA COMMUNITIES-SUPPORT AND PROMOTE PARTICIPATION IN BOSTON FARMERS MARKETS, COMMUNITY ASSISTED AGRICULTURE, AND BOUNTY BUCKS PROGRAMS-SUPPORT AND PROMOTE THE CORNER STORE INITIATIVE-SUPPORT AND COLLABORATE WITH THE BOSTON PUBLIC HEALTH COMMISSION, BOSTON COLLABORATIVE FOR FOOD AND FITNESS, AND THE BOSTON ALLIANCE FOR COMMUNITY HEALTHMETRICS AND STATUS UPDATE:-HELD BOWDOIN GENEVA FARMERS' MARKET WEEKLY FROM JULY TO OCTOBER OF YEAR 1 AND YEAR 2-PROVIDED 30 FAMILIES A SUBSIDIZED CSA INCLUDING CARTONS OF FRUITS AND VEGETABLES IN BASELINE YEAR AND YEAR 1; 38 FAMILIES IN YEAR 2-HOSTED HEALTHY CHAMPIONS - TALENTED AND UNDERPRIVILEGED YOUTH ENGAGED IN HEALTHY COOKING CLASSES AND NUTRITION EDUCATION WORKSHOPS: 10 HEALTHY CHAMPIONS (BASELINE), 8 (YEAR 1), 5 (YEAR 2)-PLANNED ROXBURY RISES AGAINST DIABETES (RRAD) AND SEAFOOD THROWDOWN IN YEAR 1, RRAD OCCURRED IN YEAR 2 WITH 200 ATTENDEES 1.6 INCREASE THE NUMBER OF CHILDREN AND YOUTH WHO ARE SCREENED FOR (BODY MASS INDEX) BMI AND PROVIDED COUNSELING/COACHING ON PHYSICAL EXERCISE, NUTRITION, AND OBESITY/OVERWEIGHTNESSCOMMUNITY ACTIVITIES/STRATEGIES:-SUPPORT PROGRAMS AT CCA CLINICS THAT SCREEN CHILD AND ADOLESCENT PATIENTS FOR BMI AND EDUCATE, COUNSEL/COACH PATIENTS ON NUTRITION, PHYSICAL ACTIVITY, AND OVERWEIGHTNESS/ OBESITYMETRICS AND STATUS UPDATE: -INCREASED PERCENT OF CHILDREN/YOUTH SEEN AT FEDERALLY QUALIFIED HEALTH CENTERS FQHCS WITH SCREENING FOR BMI AND COUNSELING FOR NUTRITION IN PHYSICAL ACTIVITY: 66% (BASELINE); 79% (YEAR 1); 79% (YEAR 2);-ENROLLED 12 NEW FAMILIES IN OPTIMAL WEIGHT FOR LIFE (OWL) IN YEAR 1. ENROLLED 14 NEW PARTICIPANTS IN YEAR 2 AND CONTINUED GROUP VISITS. -DOCUMENTED IMPROVEMENT OF BMI FOR OWL CHILDREN: 11% (YEAR 1); 8% (YEAR 2)-MAINTAINED ENROLLMENT OF CHILDREN IN FITNESS IN THE CITY FROM 100 (BASELINE); 101 (YEAR 1); 100 (YEAR 2)COMMUNITY PARTNERS: COMMUNITY CARE ALLIANCE, BOSTON PUBLIC HEALTH COMMISSION, BOSTON COLLABORATIVE FOR FOOD AND FITNESS, BOSTON ALLIANCE FOR COMMUNITY HEALTH, BOWDOIN STREET HEALTH CENTER, COMMUNITY GROCERS AND FOOD RETAILERS GOAL: ENVIRONMENTAL SUSTAINABILITY TARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 1.7 REDUCE ENERGY AND WATER CONSUMPTION1.8 INCREASE RECYCLINGCOMMUNITY ACTIVITIES/STRATEGIES: -IMPLEMENT ENVIRONMENTAL STRATEGIC PLAN-PROMOTE RECYCLING AND CONSERVATION OF WATER AND ENERGY THROUGHOUT BIDMCMETRICS AND STATUS UPDATE: -INCREASE RECYCLING RATE FROM 2008 BASELINE OF 20%; RECYCLING RATE: 33% (BASELINE); 23% (YEAR 1); 30% (YEAR 2)-REDUCED ENERGY USE BY 7% FROM 2008 BASELINE; REDUCTION FROM BASELINE: 7% (BASELINE), 5% (YEAR 1), 5% (YEAR 2) -REDUCED WATER USE BY 8% FROM 2008 BASELINE; REDUCTION FROM BASELINE: 14% (BASELINE), 7% (YEAR 1), 7% (YEAR 2) -MAINTAIN 30% REDUCTION IN FUEL CONSUMPTION FROM 2008 BASELINE; REDUCTION FROM BASELINE: 31% (BASELINE), 30% (YEAR 1), 30% (YEAR 2)COMMUNITY PARTNERS: MASCO, HEALTH CARE WITHOUT HARM, PRACTICE GREEN HEALTH, EPA, BEYOND BENIGN*****PRIORITY AREA 2: DISEASE MANAGEMENT AND PREVENTIONCARDIOVASCULAR DISEASE (HEART DISEASE), CANCER, AND CEREBROVASCULAR DISEASE (STROKE) ARE THE THREE LEADING CAUSES OF DEATH IN THE UNITED STATES, MASSACHUSETTS, AND BOSTON. IN ADDITION, DIABETES IS RANKED IN THE TOP 10 ACROSS ALL THREE OF THESE GEOGRAPHIC AREAS, AND ASTHMA AND OTHER RESPIRATORY DISEASES HAVE A HUGE IMPACT ON LARGE PORTIONS OF ADULTS AND CHILDREN. IN ADDITION TO BEING THE MOST COMMON CAUSES OF DEATH AND ILLNESS, THESE CONDITIONS ARE AMONG THE MOST COSTLY AND PREVENTABLE. ALL OF THESE CHRONIC CONDITIONS SHARE THE SEVERAL HEALTH RISK FACTORS (TOBACCO USE, LACK OF PHYSICAL EXERCISE, POOR NUTRITION AND OBESITY/OVERWEIGHTNESS).ACCORDING TO DATA FROM THE MASSACHUSETTS HOSPITAL INPATIENT DISCHARGE DATASET, RESIDENTS FROM BOSTON'S URBAN CORE OF DORCHESTER, ROXBURY, AND THE SOUTH END ARE MORE LIKELY TO BE HOSPITALIZED FOR CHRONIC DISEASES AND CANCER THAN RESIDENTS OF BOSTON AND MASSACHUSETTS OVERALL. IN SOME CASES, HOSPITALIZATION RATES WERE TWO TO THREE TIMES HIGHER. ACCORDING TO THE HEALTH OF BOSTON REPORT, 2012-13, BOSTON'S AFRICAN AMERICAN/BLACK AND HISPANIC/LATINO RESIDENTS HAD HIGHER RATES OF DIABETES, HEART DISEASE AND CEREBROVASCULAR DISEASE HOSPITALIZATIONS, AND CANCER DEATH RATES THAN NON-HISPANIC, WHITE RESIDENTS.KEY: BASELINE - 2013, YEAR 1 - 2014, YEAR 2 - 2015, YEAR 3 - 2016GOAL: INCREASE APPROPRIATE MONITORING, COUNSELING/ COACHING, AND REFERRALS FOR TREATMENT FOR ADULTS WITH DIABETES, HYPERTENSION, AND PERSISTENT ASTHMATARGET POPULATION: LOW INCOME ADULTSPROGRAMMATIC OBJECTIVES: 2.1 INCREASE THE NUMBER OF ADULTS WITH DIABETES, HYPERTENSION, AND PERSISTENT ASTHMA WHO RECEIVE EVIDENCE-BASED COUNSELING/COACHING AND TREATMENT2.2 INCREASE THE NUMBER OF ADULTS WITH DIABETES, HYPERTENSION, AND PERSISTENT ASTHMA WHOSE CONDITIONS ARE CONTROLLED2.3 IMPROVE DISEASE AND HEALTH LITERACYCOMMUNITY ACTIVITIES/STRATEGIES:-SUPPORT PROGRAMS IN CCA CLINICS THAT EDUCATE AND SCREEN PATIENTS FOR DIABETES, HYPERTENSION, AND PERSISTENT ASTHMA. PROVIDE EVIDENCED-BASED COUNSELING/COACHING AND TREATMENT, AS WELL AS APPROPRIATE REFERRALS FOR SPECIALTY CARE SERVICES FOR THOSE WHO SCREEN POSITIVEMETRICS AND STATUS UPDATE:-SOUGHT TO IMPROVE CARE MANAGEMENT FOR FQHC PATIENTS WITH CHRONIC DISEASE O INCREASED PERCENT OF PATIENTS WITH DIABETES WITH HBA1C < 9 FROM 78% (BASELINE), 83% (YEAR 1), 76% (YEAR 2) O PERCENT OF PATIENTS WITH DIABETES WITH HBA1C < 8: 73% (YEAR 1), 67% (YEAR 2) O PERCENT OF PATIENTS WITH HYPERTENSION WHO HAD A BLOOD PRESSURE < 140/90: 72% (BASELINE), 63% (YEAR 1), 64% (YEAR 2) O PERCENT OF PERSISTENT ASTHMATIC PATIENTS WITH PHARMACOLOGICAL THERAPY: 66% (BASELINE), 66% (YEAR 1), 92% (YEAR 2)-SOUGHT TO IMPROVE CARE MANAGEMENT FOR BSHC PATIENTS WITH CHRONIC DISEASE O BSHC PATIENTS THAT HAD AT LEAST ONE HBA1C TEST: 88% (BASELINE), 95% (YEAR 1), 92% (YEAR 2) O BSHC PATIENTS THAT HAD AT LEAST ONE LDL TEST: 82% (BASELINE), 77% (YEAR 1), 83% (YEAR 2) O BSHC PATIENTS THAT HAD AT LEAST ONE EYE EXAM: 62% (BASELINE), 68% (YEAR 1), 68% (YEAR 2)COMMUNITY PARTNERS: CCA CLINICS, BIDMC EMPLOYEES, COMMUNITYGOAL: INCREASE EDUCATION, SCREENING, AND COUNSELING/COACHING RELATED TO CANCER TARGET POPULATION: LOW INCOME AND RACIAL/ETHNIC MINORITY ADULTSPROGRAMMATIC OBJECTIVES: 2.4 INCREASE THE NUMBER OF LOW INCOME AND RACIAL/ETHNIC MINORITY ADULTS EDUCATED AND SCREENED FOR CANCER2.5 INCREASE THE NUMBER OF ADULTS WHO SCREEN POSITIVE FOR CANCER WHO ARE REFERRED FOR COUNSELING AND TREATMENT2.6 INCREASE THE NUMBER OF ADULTS WHO SCREEN POSITIVE FOR CANCER WHO ARE LINKED TO A CANCER NAVIGATORCOMMUNITY ACTIVITIES/STRATEGIES:-SUPPORT ACCESS TO CANCER SCREENING AND TREATMENT FOR LOW INCOME, UNINSURED ADULTS (BREAST, PROSTATE, AND COLON CANCERS) -SUPPORT AND PROMOTE THE CITY-WIDE CANCER NAVIGATORS PROGRAM-LINK PATIENTS SCREENED POSITIVE FOR CANCER TO CANCER PATIENT NAVIGATORSMETRICS AND STATUS UPDATE: -SOUGHT TO INCREASE ACCESS TO PATIENT NAVIGATORS O PATIENTS SERVED BY CHINESE PATIENT NAVIGATOR: 345 (BASELINE), 399 (YEAR 1), 401 (YEAR 2) O ENCOUNTERS PROVIDED BY CHINESE PATIENT NAVIGATOR: 2,115 (BASELINE), 2,052 (YEAR 1), 2,324 (YEAR 2) O PATIENT SERVED BY LATINA PATIENT NAVIGATOR: 364 (BASELINE), 354 (YEAR 1), 344 (YEAR 2) O ENCOUNTERS PROVIDED BY LATINA PATIENT NAVIGATOR: 568 (BASELINE), 435 (YEAR 1), 450 (YEAR 2) O PATIENT NAVIGATORS PARTICIPATE IN QUARTERLY NETWORK MEETINGS: 35 (BASELINE), 38 (YEAR 1), 25 (YEAR 2)-FACES OF FAITH PHOTOGRAPHY EXHIBIT PROFILED FAITH-BASED CANCER SURVIVORS: 13 (YEAR 1), 32 (YEAR 2)COMMUNITY PARTNERS: BIDMC PRACTICES, CANCER NAVIGATOR PROGRAM GOAL: SUPPORT THE IMPLEMENTATION OF THE PATIENT CENTERED MEDICAL HOME (PCMH) MODEL IN CCA CLINICSTARGET POPULATION: SAFETY NET CLINICS, LOW INCOME INDIVIDUALS AND FAMILIESPROGRAMMATIC OBJECTIVES: 2.7 INCREASE THE NUMBER OF CCA CLINIC SITES WHO MEET NCQA OR CMS PCMH CERTIFICATION REQUIREMENTS2.8 IMPROVE CARE COORDINATION AND CONTINUITY OF CARE2.9 COLLABORATE WITH CCA/HEALTH CENTERS ON RESEARCH AND BEST PRACTICESCOMMUNITY ACTIVITIES/STRATEGIES:-CCA HEALTH CENTERS HAVE "MAGIC BUTTONS" WITH FULL VIEWING OF BIDMC DATA-BIDMC SHARES MEANINGFUL USE DATA, INCLUDING IMMUNIZATIONS AND PUBLIC HEALTH SURVEILLANCE DATA WITH THE STATE VIS THE MASS HIWAY-IMPLEMENTING LAB INTEGRATION WITH FENWAY HEALTH-BIDMC IS ABLE TO SHARE PATIENT'S DAILY DISCHARGE INFORMATION WITH AN EXPANDED PRIMARY CARE NETWORK INCLUDING MEDICAL CARE OF BOSTON MANGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP (APG) AND ATRIUS HEALTH-COLLABORATING WITH APPLE TO CREATE NOVEL FUNCTIONALITY THAT WILL MAKE DISCHARGE INSTRUCTIONS AVAILABLE ON IPHONESMETRICS AND STATUS UPDATE: -ALL CCA HEALTH CENTERS ACHIEVED PATIENT CENTERED MEDICAL HOME (PCMH) RECOGNITION IN YEAR 1-BOWDOIN STREET HEALTH CENTER RENEWED LEVEL 3 PCMH IN YEAR 2-ONE HEALTH CENTER WAS IN PROCESS OF RENEWING LEVEL 3 PCMH IN YEAR 2COMMUNITY PARTNERS: CCA CLINICS*****PRIORITY AREA 3: ACCESS TO PRIMARY AND SPECIALTY CAREGREATER BOSTON HAS ONE OF THE STRONGEST AND MOST COMPREHENSIVE HEALTHCARE SYSTEMS IN THE WORLD. THIS SYSTEM IS EXPANSIVE AND SPANS THE FULL HEALTHCARE CONTINUUM, INCLUDING OUTREACH AND SCREENING SERVICES, PRIMARY CARE MEDICAL AND MEDICAL SPECIALTY CARE SERVICES. THERE ARE NO ABSOLUTE GAPS IN SERVICES ACROSS THE CONTINUUM, EVEN FOR LOW INCOME AND RACIAL/ETHNIC MINORITY POPULATIONS THAT OFTEN STRUGGLE WITH ACCESS TO HEALTH CARE SERVICES. THIS DOES NOT MEAN, HOWEVER, THAT EVERYONE IN GREATER BOSTON RECEIVES THE HIGHEST QUALITY SERVICES WHEN THEY WANT IT AND WHERE THEY WANT IT. IN FACT, DESPITE THE OVERALL SUCCESS OF THE COMMONWEALTH'S HEATH REFORM EFFORTS, DATA CAPTURED FOR THIS ASSESSMENT SHOWS THAT SEGMENTS OF THE POPULATION, PARTICULARLY LOW INCOME AND RACIAL/ETHNIC MINORITY POPULATIONS, FACE SIGNIFICANT BARRIERS TO CARE AND STRUGGLE TO ACCESS SERVICES DUE TO LACK OF INSURANCE, COST, TRANSPORTATION, CULTURAL/LINGUISTIC BARRIERS, AND SHORTAGES OF PROVIDERS WILLING TO SERVE MEDICAID INSURED OR LOW INCOME, UNINSURED PATIENTS. AMONG SOME OF BOSTON'S MOST PROMINENT SAFETY NET PRIMARY CARE CLINICS, THE UNINSURED RATES RANGE FROM 17% TO 48%. THESE CLINICS STRUGGLE TO ENSURE ACCESS TO CARE FOR THEIR PATIENTS, PARTICULARLY FOR MEDICAL SPECIALTY CARE SERVICES. MASSACHUSETTS BRFSS DATA ALSO INDICATES THAT APPROXIMATELY ONE IN FIVE (21%) RESIDENTS LIVING IN NORTH DORCHESTER AND ALLSTON/BRIGHTON DO NOT HAVE A PERSONAL HEALTH CARE PROVIDER OR PRIMARY CARE PROVIDER COMPARED TO ONE IN SIX (17%) FOR BOSTON RESIDENTS OVERALL.KEY: BASELINE - 2013, YEAR 1 - 2014, YEAR 2 - 2015, YEAR 3 -- 2016GOAL: INCREASE ACCESS TO QUALITY MEDICAL SERVICES, INCLUDING PRIMARY CARE, OB/GYN, AND SPECIALTY CARE IN BOSTON'S URBAN CORE, QUINCY, AND THE OUTER PORTION OF CAPE CODTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 3.1 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY MEDICAL CARE SERVICES, INCLUDING OB/GYN SERVICE AT CCA CLINICS3.2 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING SPECIALTY CARE MEDICAL SERVICES3.3 ENSURE ACCESS TO SERVICES FOR THOSE ON THE OUTER CAPE3.4 ENSURE ACCESS TO APPROPRIATE TRAUMA CARE AND EMERGENCY SERVICES3.5 MAINTAIN OR INCREASE SUPPORT FOR HSN TRUST FUND; AND ADVOCATE FOR LEGISLATION AND POLICIES SUPPORTING PUBLIC HEALTH, MENTAL HEALTH AND SUBSTANCE ABUSE AND ANTI-POVERTY PROGRAMS3.6 SCREEN AND ENROLL THOSE WHO QUALIFY FOR HEALTH INSURANCE THROUGH THE AFFORDABLE CARE ACT (ACA)COMMUNITY ACTIVITIES/STRATEGIES: -SUPPORT CLINICAL OPERATIONS AT CCA CLINICS-SUPPORT TRANSPORTATION FOR INDIGENT, LOW-INCOME PATIENTS -SUPPORT INSTITUTIONAL AND COMMUNITY EMERGENCY PREPAREDNESS -SUPPORT OUTER CAPE HEALTH SERVICES EFFORTS TO IMPLEMENT MAMMOGRAPHY AND DIGITAL RADIOLOGY SERVICES-SUPPORT MEDFLIGHT AND CENTRALIZED, COORDINATED EMERGENCY MEDICAL SERVICES FOR BOSTON-SUPPORT HSNMETRICS AND STATUS UPDATE: -PROVIDED LOW-INCOME PATIENTS SERVICES AT BIDMC-AFFILIATED FQHCS O SERVED 94,150 PATIENTS (BASELINE), 95,365 PATIENTS (YEAR 1), 98,988 PATIENTS (YEAR 2) O PROVIDED 486,220 VISITS (YEAR 1), 503,197 VISITS (YEAR 2), O PATIENTS BEST SERVED IN LANGUAGE OTHER THAN ENGLISH: 41% (BASELINE), 44% (YEAR 1), 43% (YEAR 2) O PATIENTS OF MINORITY RACE/ETHNICITY: 62% (BASELINE), 70% (YEAR 1), 68% (YEAR 2) O PATIENTS WITHOUT INSURANCE: 12% (BASELINE), 12% (YEAR 1), 12% (YEAR 2)-NUMBER OF BIDMC SPECIALISTS SERVING CCA CLINICS FROM 21 (BASELINE), 24 (YEAR 1), 24 (YEAR 2) -ASSIGNED RESIDENTS TO HEALTH CENTERS DURING ACADEMIC YEAR: 41 (BASELINE), 41 (YEAR 1), 37 (YEAR 2)-MADE REFERRALS THROUGH CARE CONNECTION CALL CENTER: 898 (BASELINE), 604 (YEAR 1), 812 (YEAR 2)-LAUNCHED TELEPHONIC PSYCHIATRIC CONSULTATION OF BIDMC PSYCHIATRIST TO HEALTH CENTER PCPS - 2 HOURS PER WEEK IN YEAR 1, CONTINUED IN YEAR 2-PROVIDED ONGOING SUPPORT TO MEDFLIGHT TO ENSURE ACCESS TO EMERGENCY SERVICES FOR THOSE IN ISOLATED AREAS-SCREENED INDIVIDUALS FOR INSURANCE ELIGIBILITY: 8,340 (BASELINE), 7,810 (YEAR 1), 8,480 (YEAR 2)-ENROLLED INDIVIDUALS IN ENTITLEMENT PROGRAMS: 7,255 (BASELINE), 7,625 (YEAR 1), 7,263 (YEAR 2)-SERVED HSN PATIENTS: 6,254 (BASELINE), 5,408 (YEAR 1), 5,534 (YEAR 2)COMMUNITY PARTNERS: CCA CLINICS GOAL: INCREASE ACCESS TO QUALITY PRIMARY CARE DENTAL SERVICES TARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:3.7 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY DENTAL CARE SERVICES AT CCA CLINIC3.8 PUBLIC POLICY ADVOCACYCOMMUNITY ACTIVITIES/STRATEGIES: -SUPPORT CLINICAL OPERATIONS AT CCA CLINICS-SUPPORT HSNMETRICS AND STATUS UPDATE:-DENTAL VISITS AT BIDMC-AFFILIATED HEALTH CENTERS: 70,009 (YEAR 1), 73,178 (YEAR 2)-UNIQUE PATIENTS WITH A DENTAL VISIT AT BIDMC-AFFILIATED HEALTH CENTERS: 24,471 (YEAR 1), 24,994 (YEAR 2)COMMUNITY PARTNERS: CCA CLINICSGOAL: INCREASE ACCESS TO QUALITY PRIMARY BEHAVIORAL HEALTH CARE SERVICESTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES: 3.9 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING PRIMARY BEHAVIORAL HEALTH CARE SERVICES AT CCA CLINICS3.10 PUBLIC POLICY ADVOCACYCOMMUNITY ACTIVITIES/STRATEGIES:-SUPPORT CLINICAL OPERATIONS AT CCA CLINICS-SUPPORT HSN-SUPPORT PRIMARY CARE - BEHAVIORAL HEALTH INTEGRATION AT CCA CLINICSMETRICS AND STATUS UPDATE:-MENTAL HEALTH AND SUBSTANCE ABUSE VISITS AT BIDMC-AFFILIATED HEALTH CENTERS: 60,223 (YEAR 1), 60,853 (YEAR 2)-UNIQUE PATIENTS WITH A MENTAL HEALTH/SUBSTANCE ABUSE VISIT AT BIDMC-AFFILIATED HEALTH CENTERS: 6,693 (YEAR 1), 6,554 (YEAR 2)COMMUNITY PARTNERS: CCA CLINICSGOAL: INCREASE QUALITY AND EFFICIENCY OF CLINICAL SERVICES AT CCA CLINICSTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:3.11 INCREASE PATIENT SATISFACTION3.12 INCREASE CLINIC EFFICIENCY AND PRODUCTIVITYCOMMUNITY ACTIVITIES/STRATEGIES:-IDENTIFY OPPORTUNITIES FOR ADMINISTRATIVE AND FISCAL SAVINGS-CONDUCT "MYSTERY SHOPPING" TO ADDRESS QUALITY IMPROVEMENT ISSUES RELATED TO ACCESS AND PATIENT EXPERIENCE-ADMINISTER ASK DEVELOPMENT EVALUATION PROGRAMMETRICS AND STATUS UPDATE:-COMPLETED MONTHLY MYSTERY SHOPPING SURVEYS AT 6 CCA HEALTH CENTERS: 92 (BASELINE), 72 (YEAR 1), 72 (YEAR 2)-CONNECTED BSHC AND FENWAY HEALTH TO BETH ISRAEL DEACONESS CARE ORGANIZATION'S (BIDCO) QUALITY DATA CENTER (QDC) IN YEAR 1; CONNECTED CHARLES RIVER COMMUNITY HEALTH, THE DIMOCK CENTER, OUTER CAPE HEALTH SERVICES AND SOUTH COVE COMMUNITY HEALTH CENTER TO QDC IN YEAR 2-IMPROVED MONTHLY REGULATORY OIG REVIEW FOR ALL CHC PERSONNEL AND VENDORS IN YEAR 1; CONTINUED IN YEAR 2COMMUNITY PARTNERS: CCA CLINICS*****PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE ABUSEMENTAL ILLNESS AND SUBSTANCE ABUSE HAVE A PROFOUND IMPACT ON THE HEALTH OF PEOPLE LIVING THROUGHOUT THE UNITED STATES, INCLUDING THOSE LIVING IN MASSACHUSETTS AND THE BOSTON AREA. MENTAL HEALTH AND SUBSTANCE ABUSE HOSPITALIZATION AND DEATH RATES ARE HIGHER FOR A NUMBER OF BOSTON'S NEIGHBORHOODS, PARTICULAR ROXBURY AND PARTS OF DORCHESTER. ACCORDING TO DATA FROM THE ASSESSMENT'S COMMUNITY SURVEY, HIGH PROPORTIONS OF BOSTON RESIDENTS STRUGGLE WITH PERSISTENT SADNESS AND/OR WERE AT RISK FOR DEPRESSION AND NEARLY ONE-THIRD (30%) OF RESPONDENTS QUALIFIED FOR ADDITIONAL MENTAL HEALTH SCREENING. NEARLY ONE IN SIX SURVEY RESIDENTS REPORTED POOR MENTAL HEALTH STATUS FOR MORE THAN 15 DAYS IN A GIVEN MONTH, COMPARED TO ONE IN TEN RESIDENTS IN BOSTON OVERALL. QUALITATIVE INFORMATION FROM THE ASSESSMENT'S INTERVIEWS AND FOCUS GROUPS CORROBORATED THESE FINDINGS AND A MAJORITY OF THE DISCUSSION PARTICIPANTS CITED MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES AS LEADING HEALTH ISSUES.KEY: BASELINE - 2013, YEAR 1 - 2014, YEAR 2 - 2015, YEAR 3 -- 2016 GOAL: INCREASE ACCESS TO QUALITY MENTAL HEALTH CARE AND SUBSTANCE ABUSE SERVICES IN THE PRIMARY CARE SETTINGTARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:4.1 MAINTAIN AND INCREASE THE NUMBER OF PATIENTS RECEIVING MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES IN THE PRIMARY CARE SETTING IN CCA CLINICSCOMMUNITY ACTIVITIES/STRATEGIES:-SUPPORT GENERAL CLINICAL OPERATIONS AT CCA CLINICS-SUPPORT PRIMARY CARE - BEHAVIORAL HEALTH INTEGRATION AT CCA CLINICS-PUBLIC POLICY ADVOCACYMETRICS AND STATUS UPDATE:-PROVIDED INDIVIDUAL AND GROUP PSYCHOTHERAPY VISITS O 1,250 VISITS (BASELINE), 1,848 (YEAR 1), 2,100 (YEAR 2) O 337 UNIQUE PATIENTS (YEAR 1), 319 UNIQUE PATIENTS (YEAR 2)-TRANSGENDER SUPPORT GROUP HOSTED ITS FIRST MEETING IN YEAR 2-IMPLEMENTED SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT), SCREENING IN ED IN YEAR 1; CONTINUED IN YEAR 2COMMUNITY PARTNERS: CCA CLINICSGOAL: PROMOTE INTEGRATED MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES IN PRIMARY CARE SETTINGSTARGET POPULATION: ADULTSPROGRAMMATIC OBJECTIVES: 4.2. INCREASE THE NUMBER OF ADULTS WITH MENTAL HEALTH AND SUBSTANCE ISSUES WHO ARE APPROPRIATELY MONITORED, ASSESSED, AND TREATED IN CCA CLINICSCOMMUNITY ACTIVITIES/STRATEGIES: -SUPPORT PROGRAMS IN CCA CLINICS TO INTEGRATE SERVICES PROVIDED BY BEHAVIORAL HEALTH SPECIALISTS AND MONITOR, ASSESS, AND TREAT THOSE WITH MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES (E.G., DEPRESSION, ANXIETY, ALCOHOL/PRESCRIPTION DRUG ABUSE)METRICS AND STATUS UPDATE:-SERVED PATIENTS IN DIMOCK CENTER OFFICE-BASED OPIOID TREATMENT PROGRAM: 63 PATIENTS SERVED (BASELINE), 60 (YEAR 1), 143 (YEAR 2)-REDUCED OBOT NO-SHOW RATE BY 25% (BASELINE), 8% (YEAR 1), RATE INCREASE TO 31% IN YEAR 2COMMUNITY PARTNERS: CCA CLINICS, OBOT PROVIDERS*****PRIORITY AREA 5: YOUTH VIOLENCE PREVENTIONCRIME AND VIOLENCE AFFECT ALL OF BOSTON'S RESIDENTS TO SOME EXTENT BUT HAVE A MAJOR IMPACT ON TWO OF BOSTON'S INNER CITY NEIGHBORHOODS, ROXBURY AND DORCHESTER. THESE IMPACTS INCLUDE DEATH AND INJURY, EMOTIONAL TRAUMA, ANXIETY, AND OTHER MENTAL HEALTH ISSUES, ISOLATION, AND LACK OF TRUST AND/OR COMMUNITY COHESION. SEVERAL OF THE ASSESSMENTS KEY INFORMANT INTERVIEWEES DISCUSSED THE IMPACTS OF CRIME AND VIOLENCE AND ITS ASSOCIATED TRAUMA, PARTICULARLY ON THE AREA'S YOUTH AND THEIR FAMILIES. RATES OF HOMICIDE AND NON-FATAL GUNSHOT WOUNDS SEEN IN BOSTON'S HOSPITAL EMERGENCY DEPARTMENTS ARE CONSIDERABLY HIGHER FOR ROXBURY AND DORCHESTER RESIDENTS THAN FOR RESIDENTS OF BOSTON OVERALL. ROXBURY AND DORCHESTER BOTH HAD A RATE OF 21 HOMICIDE DEATHS PER 100,000 IN 2008 COMPARED TO A RATE OF 9 FOR THE CITY OF BOSTON OVERALL AND A RATE OF 3 FOR THE COMMONWEALTH. ACCORDING TO DATA DRAWN FROM THE HEALTH OF BOSTON REPORT IN 2012-13, AFRICAN AMERICANS/BLACKS (2.2 PER 100,000) ARE MORE THAN TWICE AS LIKELY AS HISPANICS/LATINOS (.9 PER 100,000) TO HAVE AN EMERGENCY DEPARTMENT VISIT FOR A NON-FATAL GUNSHOT WOUND OR STABBING, AND MORE THAN 10 TIMES MORE LIKELY AS NON-HISPANIC, WHITES (0.2 PER 100,000).KEY: BASELINE - 2013, YEAR 1 - 2014, YEAR 2 - 2015, YEAR 3 -- 2016GOAL: PROVIDE SUPPORT AND THERAPEUTIC INTERVENTIONS TO VICTIMS OF DOMESTIC VIOLENCE, SEXUAL ASSAULT AND COMMUNITY VIOLENCETARGET POPULATION: CHILDREN, YOUTH, ADULTSPROGRAMMATIC OBJECTIVES:5.1 INCREASE ACCESS TO MENTAL HEALTH SERVICES AT BSHC FOR AFFECTED VICTIMS5.2 INCREASE PARTICIPATION IN ADVOCATE EDUCATION AND SUPPORT PROJECT5.3 PROVIDE COUNSELING AND OTHER MEDICAL SERVICES TO RAPE VICTIMS5.4 PROVIDE GRIEVING SUPPORT ACTIVITIES5.5 CONDUCT NEIGHBORHOOD CAMPAIGNS TO ENGAGE COMMUNITY AND CREATE GREATER COMMUNITY COHESIONCOMMUNITY ACTIVITIES/STRATEGIES:-SUPPORT PROGRAMS IN BSHC THAT INTEGRATE SERVICES PROVIDED BY BEHAVIORAL HEALTH SPECIALISTS AND MONITOR, ASSESS, AND TREAT THOSE EXPERIENCING TRAUMA FROM VIOLENCE -HOLD HEALING SERVICES WHEN APPROPRIATE FOR COMMUNITY RESIDENTS-PARTICIPATE IN COMMUNITY INTERVENTIONS THAT RAISE AWARENESS ABOUT VIOLENCE, ENGAGE THE COMMUNITY, ADDRESS FACTORS ASSOCIATED WITH VIOLENCE (E.G., "BROKEN WINDOW" THEORY, BLOCK CAPTAINS PROGRAM, ETC.), AND PROMOTE A SENSE OF COMMUNITY -SUPPORT AND PROMOTE THE IMPLEMENTATION OF TRAINING PROGRAMS, SUPPORT GROUPS FOR ADVOCATES AND AFFECTED COMMUNITY MEMBERS-PROVIDE OVERNIGHT STAYS FOR DOMESTIC VIOLENCE AND/OR SEXUAL ASSAULT VICTIMS WITHOUT SAFE SHELTER-PUBLIC POLICY ADVOCACY FOR SAFE SHELTERS AND LONG-TERM HOUSING SUPPORTMETRICS AND STATUS UPDATE:-PROVIDED SERVICES TO SEXUAL ASSAULT VICTIMS: 43 (BASELINE), 78 (YEAR 1), 62 (YEAR 2)-PROVIDED SAFE BED OVERNIGHT STAYS: 34 (BASELINE), 44 (YEAR 1), 59 (YEAR 2)-PROVIDED EDUCATIONAL PROGRAMMING TO ADVOCATES: 58 ADVOCATES (BASELINE), 58 (YEAR 1), 58 (YEAR 2)-PROVIDED HEALING CIRCLES WITH WOMEN, MEN, AND CHILDREN O 22 HEALING CIRCLES (BASELINE), 19 (YEAR 1), 45 (YEAR 2) O 345 PARTICIPANTS (BASELINE), 289 (YEAR 1), 473 (YEAR 2)-BIDMC SUPPORTED LOUIS D. BROWN PEACE INSTITUTE IN FY2015. SPONSORED THE LDBPI MOTHER'S DAY WALK FOR PEACE IN MAY, 2015 CO-CHAIRED BY BIDMC CEO KEVIN TABB, MD AND BOSTON MAYOR MARTY WALSH-PROVIDED THERAPEUTIC SERVICES THROUGH DEFENDING CHILDHOOD PROGRAM O 165 ENCOUNTERS (BASELINE), 659 (YEAR 1), 1,158 (YEAR 2)-PROVIDED RESOURCES TO BACH TO ESTABLISH COMMUNITY ACTION BOARD (CAB) IN YEAR 1; CONTINUED IN YEAR 2-PROVIDED SUPPORT TO BOWDOIN BIKE SCHOOL TO RECRUIT AND HIRE THREE DORCHESTER RESIDENTS, FACILITATE CLINICS ON BIKE REPAIR AND INCREASE PARTNERSHIPS WITHIN THE COMMUNITYCOMMUNITY PARTNERS: -BOWDOIN STREET HEALTH CENTER (BSHC)-BOSTON PUBLIC HEALTH COMMISSION-BOWDOIN BIKE SCHOOL-OTHER BOWDOIN/ GENEVA NEIGHBORHOOD ORGANIZATIONS*****AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, THE MEDICAL CENTER 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, THERE WERE SOME NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT INCLUDED IN THE CHIP: I.E. TRANSPORTATION, UNEMPLOYMENT AFFORDABLE HOUSING, AND SAFE PARKS/PLAYGROUNDS. THE MEDICAL CENTER IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES; HOWEVER, THE MEDICAL CENTER DID PARTICIPATE IN CERTAIN WORKFORCE DEVELOPMENT PROGRAMMING AS REPORTED IN THIS FORM 990 SCHEDULE H PART II AND AS DETAILED IN THE NARRATIVE TO THIS SCHEDULE H PART VI.AS NOTED IN DETAIL ABOVE, THE MEDICAL CENTER'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND CHIP (SCHEDULE H PART VI QUESTION 2). FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATION THE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW THE MEDICAL CENTER CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AS WELL AS COMMUNITY BUILDING ACTIVITIES. AS DEMONSTRATED IN THIS SCHEDULE H, DURING THE PERIOD COVERED BY THIS FILING, 16.68% OF THE MEDICAL CENTER'S TOTAL EXPENSES WERE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. IN ADDITION AS NOTED IN THE NARRATIVE BELOW, THERE ARE ADDITIONAL ACTIVITIES AND EXPENDITURES WHICH THE MEDICAL CENTER CONSIDERS FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. UNDER THE INSTRUCTIONS TO THIS SCHEDULE H QUESTION 7 THESE ITEMS ARE NOT QUANTIFIED IN SCHEDULE H QUESTION 7, BUT IT IS WORTH NOTING THAT IF THE MEDICAL CENTER HAD INCLUDED THESE IN SCHEDULE H QUESTION 7, THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WOULD BE 17.92% FOR THE PERIOD COVERED BY THIS FILING. COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORTIN ADDITION TO THE MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) WHICH WERE APPROVED BY THE COMMUNITY BENEFITS COMMITTEE AND BOARD OF DIRECTORS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE MEDICAL CENTER PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL. THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND AT THE MEDICAL CENTER UPON REQUEST. 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 THE MEDICAL CENTER FILED WITH THE ATTORNEY GENERAL'S OFFICE. IN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, THE MEDICAL CENTER IS A TERTIARY CARE LICENSED ACADEMIC MEDICAL CENTER, PROVIDING MEDICAL AND SURGICAL CARE, TEACHING AND RESEARCH AND AS NOTED ELSEWHERE IN THIS RETURN, PROVIDES 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS FINANCIAL ASSISTANCE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEAS REPORTED IN THE MEDICAL CENTER'S CONSOLIDATED FINANCIAL STATEMENT AND IN THIS FORM 990, SCHEDULE H, THE MEDICAL CENTER'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND PAYMENTS TO AND RECEIPTS FROM THE HEALTH SAFETY NET TRUST, WAS $15,589,015 IN FISCAL YEAR ENDED SEPTEMBER 30, 2015 AND HAS BEEN REPORTED AS PART OF THE FINANCIAL ASSISTANCE AND CHARITY CARE REPORTED IN THIS SCHEDULE H, PART I, LINE 7A. AS NOTED THROUGHOUT THIS FORM 990, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND IS THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER. THE OPERATIONS OF HMFP AND THE ENTITIES FOR WHICH HMFP SERVES AS MEMBER ARE INTEGRALLY RELATED TO THE MEDICAL CENTER'S ACCOMPLISHMENT OF ITS PURPOSES. AS PART OF THIS RELATIONSHIP, HMFP PATIENTS WHO MEET THE MEDICAL CENTER'S FREE CARE CRITERIA ARE PROVIDED FREE CARE AT HMFP AND ITS AFFILIATED ENTITIES. DURING THE FISCAL PERIOD COVERED BY THIS FILING, HMFP AND ITS AFFILIATED ENTITIES PROVIDED ADDITIONAL NET FREE CARE TO PATIENTS IN THE AMOUNT OF $2,916,899. SEE ADDITIONAL INFORMATION BELOW IN THIS SCHEDULE H NARRATIVE. OTHER UNCOMPENSATED CHARITY CARE - MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, THE MEDICAL CENTER ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW INCOME FAMILIES, INCLUDING 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 WHICH INSURE LOW INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 21.55%OR 238,329 OF THE MEDICAL CENTER'S PATIENT CASES WERE WITH MEDICAID PATIENTS. THIS TRANSLATES TO $165,180,288 IN MEDICAID REVENUE WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY THE MEDICAL CENTER FOR SUCH SERVICES BY $40,982,312, AS REPORTED ON THIS SCHEDULE H, PART I, LINE 7B. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 23.97% OR 265,084 OF THE MEDICAL CENTER'S PATIENT ENCOUNTERS WERE WITH MEDICARE PATIENTS. THIS TRANSLATED TO MEDICARE REVENUE OF $368,812,882. HOWEVER, BECAUSE PAYMENTS TO HOSPITALS THROUGH THIS GOVERNMENT SPONSORED PROGRAM HAVE NOT KEPT PACE WITH INFLATION, REVENUE COLLECTED WAS LESS THAN THE COST OF SERVICES BY $12,670,670. OF THIS AMOUNT, $9,816,567 IS INCLUDED IN FORM 990 SCHEDULE H PART I, LINE 7G AND RELATED TO THE PROVISION OF SUBSIDIZED HEALTH SERVICES FOR INPATIENT PSYCHIATRIC PATIENTS, THE MEDICAL CENTER'S BOWDOIN STREET COMMUNITY FACILITY, THE MEDICAL CENTER'S PROVISION OF OUTPATIENT AMBULATORY CARE AND CERTAIN PRIMARY CARE VISITS THROUGH BIDMC'S ONSITE PRIMARY CARE OFFICES AND $2,854,103 OF WHICH IS REPORTED IN THIS FORM 990 SCHEDULE H PART III LINE 7.IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH THE MEDICAL CENTER CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE ADDITIONAL MEDICARE SHORTFALL OF $2,854,103 IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, THE MEDICAL CENTER HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED.BAD DEBTSAS REPORTED IN THE BETH ISRAEL DEACONESS MEDICAL CENTER AND AFFILIATES AUDITED FINANCIAL STATEMENT FOR THE PERIOD COVERED BY THIS FILING, IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, THE MEDICAL CENTER 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 WERE $19,165,721 DURING THE FISCAL PERIOD COVERED BY THIS FILING AS REPORTED IN THE FINANCIAL STATEMENTS AND IN THIS FORM 990 SCHEDULE H, PART III AS REQUIRED.THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AT COST AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. AS REQUIRED BY THIS FORM 990, SCHEDULE H, PART III, LINE 4, BELOW ARE THE BAD DEBT AND ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTES FROM THE MEDICAL CENTER'S AUDITED FINANCIAL STATEMENTS. AS PREVIOUSLY NOTED IN THIS FORM 990, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE MEDICAL CENTER AND AFFILIATES FOR FISCAL YEAR ENDED SEPTEMBER 30, 2015 INCLUDE THE ACCOUNTS OF THE MEDICAL CENTER AND ITS SUBSIDIARIES, (MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A AFFILIATED PHYSICIANS GROUP (APG)), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER. THE MEDICAL CENTER'S FORM 990 IS PREPARED FOR THE MEDICAL CENTER ONLY AND AS SUCH, THE METRICS INCLUDED IN THESE FOOTNOTES WILL NOT TIE TO THE FACE OF THE MEDICAL CENTER'S FORM 990, SCHEDULE H.FINANCIAL STATEMENT FOOTNOTES:BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, THE MEDICAL CENTER 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 DEBTS ARE INCLUDED AS A COMPONENT OF NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS, AND INCLUDE THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. THE ESTIMATED COST OF PROVIDING SUCH SERVICES WAS $14,059,000 AND $14,495,000 IN 2015 AND 2014, RESPECTIVELY.PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSPATIENT ACCOUNTS RECEIVABLE ARE REFLECTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST COLLECTION HISTORY, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN GOVERNMENTAL AND EMPLOYEE HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS FOR EACH OF ITS MAJOR CATEGORIES OF REVENUE BY PAYOR TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR CATEGORIES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THROUGHOUT THE YEAR, THE MEDICAL CENTER, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, WILL WRITE OFF PATIENTS' UNMET OR UNCOLLECTED RESPONSIBILITY AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN ADDITION TO THE REVIEW OF THE CATEGORIES OF REVENUE, MANAGEMENT MONITORS THE WRITE OFFS AGAINST ESTABLISHED ALLOWANCES TO DETERMINE THE APPROPRIATENESS OF THE UNDERLYING ASSUMPTIONS USED IN ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE MEDICAL CENTER'S METHODOLOGY FOR VALUING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE REMAINED SUBSTANTIALLY CONSISTENT IN 2015 AND 2014. THE MEDICAL CENTER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS REPRESENTED APPROXIMATELY 12.6% OF PATIENT ACCOUNTS RECEIVABLE NET OF CONTRACTUAL ALLOWANCES IN 2015 AND 13.3% IN 2014.EMERGENCY CARE ACCESSAS NOTED IN THIS SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21, THE MEDICAL CENTER IS A FRONTLINE CAREGIVER PROVIDING MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO OUR FACILITY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR. CREDIT AND COLLECTION POLICY GUIDING PRINCIPLES THE MEDICAL CENTER ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, THE MEDICAL CENTER MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. THE MEDICAL CENTER'S CREDIT AND COLLECTION POLICY, WHICH APPLIES TO THE MEDICAL CENTER AND ANY OTHER ENTITY WHICH IS PART OF THE MEDICAL CENTER'S LICENSE OR TAX IDENTIFICATION NUMBER, IS DESIGNED TO COMPLY WITH BOTH THE MASSACHUSETTS HEALTH SAFETY NET REGULATIONS ON CREDIT AND COLLECTION POLICIES, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES MEDICARE BAD DEBT REQUIREMENTS, THE MEDICARE PROVIDER REIMBURSEMENT MANUAL AND THE FEDERAL HEALTHCARE REFORM LAW'S "FINANCIAL ASSISTANCE POLICY" FOR WHICH THE IRS HAD PROVIDED PRELIMINARY GUIDANCE AT THE TIME THE MEDICAL CENTER FINALIZED THIS POLICY. THE MEDICAL CENTER CONTINUES TO MONITOR GUIDANCE FROM THE IRS AS IT IS ISSUED. THE MEDICAL CENTER DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, CITIZENSHIP, ALIENAGE, RELIGION, CREED, SEX, SEXUAL ORIENTATION, DISABILITY, OR AGE IN ITS POLICIES OR IN ITS APPLICATION OF POLICIES CONCERNING THE ACQUISITION AND VERIFICATION OF FINANCIAL INFORMATION, PRE-ADMISSION OR PRE-TREATMENT DEPOSITS, PAYMENT PLANS, DEFERRED OR REJECTED ADMISSIONS, LOW INCOME PATIENT STATUS AS DETERMINED BY THE MASSACHUSETTS OFFICE OF MEDICAID, IN ITS DETERMINATION THAT A PATIENT IS LOW-INCOME, OR IN ITS BILLING AND COLLECTION PRACTICES. CREDIT AND COLLECTION POLICY - NOTICE OF AVAILABILITY OF FINANCIAL ASSISTANCE AND OTHER COVERAGE OPTIONS FINANCIAL ASSISTANCE IS INTENDED TO ASSIST LOW-INCOME PATIENTS WHO DO NOT OTHERWISE HAVE THE ABILITY TO PAY FOR THEIR HEALTH CARE SERVICES. SUCH ASSISTANCE TAKES INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR PATIENTS THAT ARE UNINSURED OR UNDERINSURED, THE MEDICAL CENTER WILL ASSIST THEM IN APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS.THE MEDICAL CENTER PROVIDES THIS ASSISTANCE FOR BOTH RESIDENTS AND NON-RESIDENTS OF MASSACHUSETTS; HOWEVER, THERE MAY NOT BE COVERAGE FOR A MASSACHUSETTS HOSPITAL'S SERVICES THROUGH AN OUT-OF STATE PROGRAM. IN ORDER FOR THE MEDICAL CENTER TO ASSIST UNINSURED AND UNDERINSURED PATIENTS FIND THE MOST APPROPRIATE COVERAGE OPTIONS, PATIENTS MUST ACTIVELY WORK WITH THE HOSPITAL'S FINANCIAL COUNSELORS TO VERIFY THEIR FINANCIAL AND OTHER INFORMATION THAT COULD BE USED IN DETERMINING ELIGIBILITY. THE MEDICAL CENTER ADVISES PATIENTS OF THEIR RIGHT TO (I) APPLY FOR MASSHEALTH AND LOW INCOME PATIENT DETERMINATION AND (II) A PAYMENT PLAN. THE MEDICAL CENTER'S FINANCIAL CLEARANCE UNIT (FCU) WILL ASSIST PATIENTS IN FULFILLING THEIR RIGHT TO APPLY FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM INCLUDING MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), CHILDREN'S MEDICAL SECURITY PLAN, MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET, HEALTH SAFETY NET AND/OR OTHER FINANCIAL PROGRAMS AS AVAILABLE AND APPROPRIATE. PLAIN LANGUAGE SUMMARIES OF THE FINANCIAL ASSISTANCE POLICY AND HOW TO APPLY FOR ASSISTANCE ARE INCLUDED IN BILLING STATEMENTS, POSTED IN THE EMERGENCY DEPARTMENT AND ADMISSIONS, AND FULL COPIES OF THE POLICY ARE AVAILABLE IN MULTIPLE LOCATIONS THROUGHOUT THE MEDICAL CENTER. ADDITIONAL HELP AND SUPPORT ARE PROVIDED BY ON-SITE FINANCIAL COUNSELORS. (SCHEDULE H PART VI QUESTION 3)THE MEDICAL CENTER ALSO WILL ASSIST UNINSURED OR UNDERINSURED PATIENTS, WHEN REQUESTED OR AS IDENTIFIED THROUGH INTERNAL SCREENING PROCEDURES, IN APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID MEDICAL CENTER BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE MEDICAL CENTER WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE INITIAL BILL THAT IS SENT TO PATIENTS WHO HAVE A FINANCIAL LIABILITY AS WELL AS IN GENERAL NOTICES THAT ARE POSTED THROUGHOUT THE MEDICAL CENTER.THE MEDICAL CENTER WILL TRY TO IDENTIFY AVAILABLE COVERAGE OPTIONS FOR PATIENTS WHO MAY BE UNINSURED OR UNDERINSURED WITH THEIR CURRENT INSURANCE PROGRAM WHEN THE PATIENT IS SCHEDULING SERVICES, WHILE THE PATIENT IS AT THE MEDICAL CENTER, UPON DISCHARGE, AND/OR FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THE HOSPITAL WILL DIRECT ALL PATIENTS SEEKING INFORMATION ON AVAILABLE COVERAGE OPTIONS OR THOSE THAT THE HOSPITAL DETERMINES MAY BE ELIGIBLE TO THE HOSPITAL'S FCU WHERE PATIENT FINANCIAL COUNSELORS CAN SCREEN PATIENTS FOR ELIGIBILITY IN AN APPROPRIATE COVERAGE OPTION. THE HOSPITAL WILL THEN ASSIST THE PATIENT IN APPLYING FOR APPROPRIATE COVERAGE OPTIONS THAT ARE AVAILABLE TO THEM.WHEN REQUESTED, THE HOSPITAL WILL ALSO PROVIDE INFORMATION ON HOW TO CONTACT THE APPROPRIATE STAFF WITHIN THE HOSPITAL'S FINANCE OFFICE TO VERIFY THE ACCURACY OF THE HOSPITAL BILL OR TO DISPUTE CERTAIN CHARGES. CONTACT INFORMATION IS PRINTED ON ALL PATIENT STATEMENTS.HOSPITALS HAVE NO ROLE IN SPECIFICALLY DETERMINING THE ELIGIBILITY FOR ENROLLMENT WITHIN A PUBLIC ASSISTANCE PROGRAM. IN MASSACHUSETTS, INDIVIDUALS WHO APPLY FOR COVERAGE IN MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), HEALTH SAFETY NET, THE CHILDREN'S MEDICAL SECURITY PROGRAM, OR MEDICAL HARDSHIP MUST DO SO THROUGH A SINGLE UNIFORM APPLICATION THAT IS SUBMITTED THROUGH THE STATE'S NEW ENROLLMENT SYSTEM CALLED THE HEALTH INSURANCE EXCHANGE (HIX). THROUGH THIS PROCESS, THE INDIVIDUAL SUBMITS AN APPLICATION USING AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), SUBMITS A PAPER APPLICATION, OR COMPLETES THE APPLICATION OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. THE MEDICAL CENTER ALSO HAS A CERTIFIED APPLICATION COUNSELOR WHO IS AVAILABLE TO HELP INDIVIDUALS WITH SUBMITTING THEIR APPLICATION EITHER ON THE WEBSITE OR ON PAPER. CREDIT AND COLLECTION POLICY - ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AS NOTED IN THIS, SCHEDULE H, PART III, SECTION C, QUESTION 9B, THE MEDICAL CENTER PROVIDES PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR OTHER AVAILABLE PROGRAMS FOR WHICH THE PATIENT MAY BE ELIGIBLE, WHICH MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILL. FOR PATIENTS THAT REQUEST SUCH ASSISTANCE, THE HOSPITAL ASSISTS THEM BY SCREENING FOR ELIGIBILITY IN AN AVAILABLE PUBLIC PROGRAM AND ASSISTING THEM IN APPLYING FOR THE PROGRAM. THESE PROGRAMS INCLUDE BUT ARE NOT LIMITED TO: MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OFFERED THROUGH THE HEALTH CONNECTOR (INCLUDING CONNECTORCARE), CHILDREN'S MEDICAL SECURITY PLAN, HEALTH SAFETY NET, AND OTHERS. WHEN APPLICABLE, THE HOSPITAL MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES AS A MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED FAMILY INCOME, CURRENT AND PRIOR INSURANCE COVERAGE AND ALLOWABLE MEDICAL EXPENSES.IT IS THE PATIENT'S OBLIGATION TO PROVIDE THE FINANCIAL COUNSELORS WITH ACCURATE AND TIMELY INFORMATION REGARDING THEIR FULL NAME, ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, INCLUDING OTHER INSURANCE OR COVERAGE OPTIONS (SUCH AS MOTOR VEHICLE POLICY OR WORKER'S COMPENSATION POLICY) THAT CAN COVER THE COST OF THE CARE RECEIVED AND ANY OTHER APPLICABLE FINANCIAL RESOURCES, AND CITIZENSHIP AND RESIDENCY INFORMATION. THIS INFORMATION IS USED TO DETERMINE IF THE PATIENT IS ELIGIBLE TO APPLY FOR CERTAIN HEALTH INSURANCE PROGRAMS. IF THERE IS NO SPECIFIC COVERAGE FOR THE SERVICES PROVIDED, THE HOSPITAL WILL USE THE INFORMATION TO DETERMINE IF THE SERVICES MAY BE COVERED BY AN APPLICABLE PROGRAM THAT WILL COVER CERTAIN SERVICES DEEMED BAD DEBT. IN ADDITION, THE HOSPITAL WILL USE THIS INFORMATION TO DISCUSS ELIGIBILITY FOR CERTAIN HEALTH INSURANCE PROGRAMS. THE SCREENING AND APPLICATION PROCESS FOR A PUBLIC HEALTH INSURANCE PROGRAM IS DONE THROUGH THE HEALTH INFORMATION EXCHANGE (HIX), WHICH IS AN INTERNET PORTAL DESIGNED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES IN ORDER TO PROVIDE THE GENERAL PUBLIC, MEDICAL PROVIDERS, AND COMMUNITY-BASED ORGANIZATIONS WITH AN ONLINE APPLICATION FOR THE PROGRAMS OFFERED BY THE STATE, OR THROUGH A STANDARD PAPER APPLICATION THAT IS COMPLETED BY THE PATIENT AND SUBMITTED DIRECTLY TO THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES FOR PROCESSING AS THIS OFFICE SOLELY MANAGES THE APPLICATION PROCESS LISTED ABOVE, WHICH IS AVAILABLE FOR CHILDREN, ADULTS, SENIORS, VETERANS, HOMELESS, AND DISABLED INDIVIDUALS. THE HOSPITAL SPECIFICALLY ASSISTS THE PATIENT IN COMPLETING THE APPLICATION AND SECURING THE NECESSARY DOCUMENTATION REQUIRED BY THE APPLICABLE FINANCIAL ASSISTANCE PROGRAM. NECESSARY DOCUMENTATION INCLUDES PROOF OF: (1) ANNUAL HOUSEHOLD INCOME (PAYROLL STUBS, RECORD OF SOCIAL SECURITY PAYMENTS, AND A LETTER FROM THE EMPLOYER, TAX RETURNS, OR BANK STATEMENTS), (2) CITIZENSHIP AND IDENTITY, AND (3) IMMIGRATION STATUS FOR NON-CITIZENS (IF APPLICABLE), AND (4) ASSETS OF THOSE INDIVIDUALS WHO ARE ALSO ENROLLED IN THE MEDICARE PROGRAM. THE HOSPITAL WILL THEN SUBMIT THIS DOCUMENTATION TO THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES AND ASSIST THE PATIENT IN SECURING ANY ADDITIONAL DOCUMENTATION IF SUCH IS REQUESTED BY THE COMMONWEALTH AFTER COMPLETING THE APPLICATION. THE COMMONWEALTH PLACES A THREE DAY TIME LIMITATION ON SUBMITTING ALL NECESSARY DOCUMENTATION FOLLOWING THE SUBMISSION OF THE APPLICATION FOR A PROGRAM. FOLLOWING THIS THREE DAY PERIOD, THE PATIENT MUST WORK WITH THE MASSHEALTH ENROLLMENT CENTERS TO SECURE THE ADDITIONAL DOCUMENTATION NEEDED FOR ENROLLMENT IN THE APPLICABLE FINANCIAL ASSISTANCE PROGRAM.IN SPECIAL CIRCUMSTANCES, THE HOSPITAL MAY APPLY FOR THE PATIENT FOR ELIGIBILITY IN THE HEALTH SAFETY NET PROGRAM USING A SPECIFIC FORM DESIGNED BY THE MASSACHUSETTS DIVISION OF HEALTH CARE FINANCE AND POLICY. SPECIAL CIRCUMSTANCES INCLUDE INDIVIDUALS SEEKING FINANCIAL ASSISTANCE COVERAGE DUE TO BEING INCARCERATED, VICTIMS OF SPOUSAL ABUSE, OR INDIVIDUALS APPLYING DUE TO A MEDICAL HARDSHIP.ALL APPLICATIONS FOR ASSISTANCE ARE REVIEWED AND PROCESSED BY THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES WHICH USES THE FEDERAL POVERTY GUIDELINES, ASSET INFORMATION AS WELL AS NECESSARY DOCUMENTATION LISTED ABOVE AS THE BASIS FOR DETERMINING ELIGIBILITY FOR STATE SPONSORED PUBLIC ASSISTANCE PROGRAMS. THE MEDICAL CENTER HAS NO ROLE IN THE DETERMINATION OF PROGRAM ELIGIBILITY MADE BY THE COMMONWEALTH, BUT MAY TAKE A DIRECT ROLE IN APPEALING OR SEEKING INFORMATION RELATED TO THE COVERAGE DECISIONS AT THE PATIENT'S REQUEST. IT IS STILL THE PATIENT'S RESPONSIBILITY TO INFORM THE HOSPITAL OF ALL COVERAGE DECISIONS MADE BY THE COMMONWEALTH TO ENSURE ACCURATE AND TIMELY ADJUDICATION OF ALL HOSPITAL BILLS AND THE AMOUNTS ULTIMATELY CHARGED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS IS DETERMINED BY THE SPECIFIC CONNECTOR PLAN FOR WHICH THEY QUALIFY. IN ADDITION, THE MEDICAL CENTER'S POLICY PROVIDES FOR INDIVIDUALS WHO ARE UNABLE TO AFFORD THEIR CARE BECAUSE OF MEDICAL HARDSHIP AND PROVIDES FOR FEES BASED ON A SLIDING SCALE RELATIVE TO PERCENTAGES OF THE FEDERAL POVERTY GUIDELINES (SCHEDULE H, PART V, SECTION B, QUESTION 22D). IN ADDITION, ALL MEDICAL CENTER PATIENTS WHO PRESENT WITHOUT PRIVATE INSURANCE ARE SCREENED FOR PRIOR HSN ELIGIBILITY AND/OR FINANCIAL ASSISTANCE BEFORE ANY BILLS ARE SENT TO THE PATIENT AND ONCE THE MEDICAL CENTER BECOMES AWARE OF A PATIENT'S HSN OR FINANCIAL ELIGIBILITY STATUS, ALL INVOICES ARE ADJUSTED ACCORDINGLY (SCHEDULE H, PART V, SECTION B, QUESTIONS 23 AND 24). CREDIT AND COLLECTION POLICY BIDMC STANDARD COLLECTION PRACTICES AS PREVIOUSLY NOTED IN THE NARRATIVE TO THIS FORM 990, SCHEDULE H, THE MEDICAL CENTER ASSISTS PATIENTS IN OBTAINING FINANCIAL ASSISTANCE FROM PUBLIC PROGRAMS AND OTHER SOURCES WHENEVER APPROPRIATE. ADDITIONALLY, TO REMAIN VIABLE AS IT FULFILLS ITS MISSION, THE MEDICAL CENTER MUST MEET ITS FIDUCIARY RESPONSIBILITY TO APPROPRIATELY BILL AND COLLECT FOR MEDICAL SERVICES PROVIDED TO PATIENTS. AS SUCH, THE MEDICAL CENTER HAS A FIDUCIARY DUTY TO SEEK REIMBURSEMENT FOR SERVICES IT HAS PROVIDED FROM INDIVIDUALS WHO ARE ABLE TO PAY, FROM THIRD PARTY INSURERS WHO COVER THE COST OF CARE, AND FROM OTHER PROGRAMS OF ASSISTANCE FOR WHICH THE PATIENT IS ELIGIBLE. TO DETERMINE WHETHER A PATIENT IS ABLE TO PAY FOR THE SERVICES PROVIDED AS WELL AS TO ASSIST THE PATIENT IN FINDING ALTERNATIVE COVERAGE OPTIONS IF THEY ARE UNINSURED OR UNDERINSURED, THE MEDICAL CENTER HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. THE MEDICAL CENTER MAKES THE SAME REASONABLE EFFORT AND FOLLOWS THE SAME REASONABLE PROCESS FOR COLLECTING ON BILLS OWED BY AN UNINSURED PATIENT AS IT DOES FOR ALL OTHER PATIENTS. THE MEDICAL CENTER WILL FIRST SHOW THAT IT HAS A CURRENT UNPAID BALANCE THAT IS RELATED TO SERVICES PROVIDED TO THE PATIENT AND NOT COVERED BY A PRIVATE INSURER OR A FINANCIAL ASSISTANCE PROGRAM. THE MEDICAL CENTER ALSO HAS ESTABLISHED CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. THE MEDICAL CENTER AND/OR ITS AGENTS DO NOT CHARGE INTEREST ON AN OVERDUE BALANCE FOR A LOW INCOME PATIENT OR ANY OTHER PATIENT. THE MEDICAL CENTER FOLLOWS THE MASSACHUSETTS MEDICAL HARDSHIP INCOME LEVELS AND PERCENTAGES IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY. THERE ARE NO INCOME LIMITS FOR MEDICAL HARDSHIP. MASSACHUSETTS RESIDENTS AT ALL INCOME LEVELS ARE ELIGIBLE IF A PATIENT'S FAMILY ALLOWED MEDICAL BILLS ARE HIGHER THAN A SPECIFIED SLIDING SCALE PERCENTAGE OF FAMILY INCOME.IN ADDITION TO PUBLICIZING THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION B, QUESTION 16A-F, THERE IS MULTI-LANGUAGE SIGNAGE IN THE FINANCIAL COUNSELING OFFICE STATING THAT A COPY OF THE POLICY IS AVAILABLE UPON REQUEST.CREDIT AND COLLECTION POLICY - OUTSIDE COLLECTION AGENCIESTHE MEDICAL CENTER CONTRACTS WITH OUTSIDE COLLECTION AGENCIES TO ASSIST IN THE COLLECTION OF CERTAIN ACCOUNTS, INCLUDING PATIENT RESPONSIBLE AMOUNTS NOT RESOLVED AFTER ISSUANCE OF HOSPITAL BILLS OR FINAL NOTICES. HOWEVER, AS DETERMINED THROUGH THE MEDICAL CENTER'S CREDIT AND COLLECTION POLICY, THE MEDICAL CENTER MAY ASSIGN SUCH DEBT AS BAD DEBT OR CHARITY CARE (OTHERWISE DEEMED AS UNCOLLECTIBLE) PRIOR TO 120 DAYS IF IT IS ABLE TO DETERMINE THAT THE PATIENT WAS UNABLE TO PAY FOLLOWING THE MEDICAL CENTER'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM.THE MEDICAL CENTER HAS A SPECIFIC AUTHORIZATION OR CONTRACT WITH ITS OUTSIDE COLLECTION AGENCIES AND REQUIRES SUCH AGENCIES TO ABIDE BY THE MEDICAL CENTER'S CREDIT AND COLLECTION POLICIES FOR DEBTS THAT THE AGENCY IS PURSUING, INCLUDING THE OBLIGATION TO REFRAIN FROM "EXTRAORDINARY COLLECTION ACTIVITIES" UNTIL SUCH TIME AS THE MEDICAL CENTER HAS MADE A REASONABLE EFFORT AND FOLLOWED A REASONABLE PROCESS FOR DETERMINING THAT A PATIENT IS ENTITLED TO ASSISTANCE OR EXEMPTION FROM ANY COLLECTION OR BILLING PROCEDURES UNDER THIS CREDIT AND COLLECTION POLICY. ALL OUTSIDE COLLECTION AGENCIES HIRED BY THE MEDICAL CENTER WILL PROVIDE THE PATIENT WITH AN OPPORTUNITY TO FILE A GRIEVANCE AND WILL FORWARD TO THE MEDICAL CENTER THE RESULTS OF SUCH PATIENT GRIEVANCES. THE MEDICAL CENTER REQUIRES THAT ANY OUTSIDE COLLECTION AGENCY THAT IT USES IS LICENSED BY THE COMMONWEALTH OF MASSACHUSETTS AND THAT THE OUTSIDE COLLECTION AGENCY ALSO IS IN COMPLIANCE WITH THE MASSACHUSETTS ATTORNEY GENERAL'S DEBT COLLECTION REGULATIONS. CREDIT AND COLLECTION POLICY - EXEMPTION FROM BIDMC COLLECTION PRACTICES THE MEDICAL CENTER EXEMPTS PATIENTS ENROLLED IN A PUBLIC HEALTH INSURANCE PROGRAM, INCLUDING BUT NOT LIMITED TO, MASSHEALTH, EMERGENCY AID TO THE ELDERLY, DISABLED AND CHILDREN, CHILDREN'S MEDICAL SECURITY PLAN AND "LOW INCOME PATIENTS" AS DETERMINED BY THE OFFICE OF MEDICAID, SUBJECT TO SOME EXCEPTIONS, FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS.CREDIT AND COLLECTION POLICY - HOSPITAL FINANCIAL ASSISTANCE PROGRAMSTHE MEDICAL CENTER, WHEN REQUESTED BY THE PATIENT AND BASED ON INTERNAL REVIEW OF EACH PATIENT'S FINANCIAL STATUS, MAY OFFER AN ADDITIONAL DISCOUNT ON AN UNPAID BILL. ANY SUCH REVIEW SHALL BE PART OF A SEPARATE HOSPITAL FINANCIAL ASSISTANCE PROGRAM THAT IS APPLIED ON A UNIFORM BASIS TO PATIENTS. ANY DISCOUNT THAT IS PROVIDED BY THE MEDICAL CENTER IS CONSISTENT WITH FEDERAL AND STATE REQUIREMENTS, AND DOES NOT INFLUENCE A PATIENT'S ABILITY TO RECEIVE SERVICES FROM THE MEDICAL CENTER. SUCH PROGRAMS INCLUDE: PROMPT PAY DISCOUNTS FOR UNINSURED PATIENTS, ONE TIME OR SPECIAL CIRCUMSTANCE SITUATIONS AND PAYMENT PLANS.CREDIT AND COLLECTION POLICY - DISCOUNT FOR UNINSURED PATIENTSIN ADDITION TO THE FINANCIAL ASSISTANCE INFORMATION PROVIDED ABOVE, THE MEDICAL CENTER GIVES A SELF-PAY DISCOUNT TO PATIENTS WHO ARE UNINSURED.BILLING AND COLLECTIONS BEFORE REASONABLE EFFORTSNEITHER THE MEDICAL CENTER NOR ANY AUTHORIZED THIRD PARTY TOOK ANY OF THE ACTIONS LISTED IN FORM 990, SCHEDULE H, PART V, SECTION B, QUESTION 18, 19 OR 20. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSCOMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLANDETAIL RELATED TO THE MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT, IMPLEMENTATION STRATEGY AND COMMUNITY BENEFITS ACTIVITIES HAS BEEN PROVIDED IN FORM 990, SCHEDULE H, PART V, SECTION C ABOVE.COMMUNITY BENEFITS - ANNUAL COMMUNITY BENEFITS REPORTIN ADDITION TO THE MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPLEMENTATION PLAN (CHIP) WHICH WERE APPROVED BY THE COMMUNITY BENEFITS COMMITTEE AND BOARD OF DIRECTORS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE MEDICAL CENTER PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL. THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND AT THE MEDICAL CENTER UPON REQUEST. 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 THE MEDICAL CENTER FILED WITH THE ATTORNEY GENERAL'S OFFICE. IN ADDITION, AS NOTED IN THIS FORM 990, PART V, SECTION A, THE MEDICAL CENTER IS A TERTIARY CARE LICENSED ACADEMIC MEDICAL CENTER, PROVIDING MEDICAL AND SURGICAL CARE, TEACHING AND RESEARCH AND AS NOTED ELSEWHERE IN THIS RETURN, PROVIDES 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - RESEARCH AS PREVIOUSLY NOTED IN THIS FORM 990, PART III, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS THAT IMPROVE THE QUALITY OF LIFE.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. MEDICAL CENTER INVESTIGATORS LEAD MORE THAN 1,285 ACTIVE FEDERAL AND INDUSTRY SPONSORED PROJECTS AND MORE THAN 6450 ACTIVE CLINICAL TRIALS DURING THE FISCAL PERIOD COVERED BY THIS FILING. THIS RESEARCH IS LED BY 568 PRINCIPAL INVESTIGATORS, 416 OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. WHO ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, AND CARDIOLOGY/CARDIAC SURGERY.AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE, TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO REACHES OUT AND COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS ALL ORIENTED TOWARD TRANSLATING NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE AND THE NEW ENGLAND JOURNAL OF MEDICINE WHICH HELPS TO BRING THE RESEARCH FINDINGS TO PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:-ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE -EMERGENCY MEDICINE -MEDICINE O ALLERGY AND INFLAMMATION O CARDIOVASCULAR MEDICINE O CENTER FOR VASCULAR BIOLOGY RESEARCH O CENTER FOR VIROLOGY AND VACCINE RESEARCH O CLINICAL INFORMATICS O CLINICAL NUTRITION O ENDOCRINOLOGY O EXPERIMENTAL MEDICINE O GASTROENTEROLOGY O GENERAL MEDICINE AND PRIMARY CARE O GENETICS O GERONTOLOGY O HEMATOLOGY AND ONCOLOGY O HEMOSTASIS AND THROMBOSIS O IMMUNOLOGY O INFECTIOUS DISEASE O INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY O MOLECULAR AND VASCULAR MEDICINE O NEPHROLOGY O PULMONOLOGY O RHEUMATOLOGY O SIGNAL TRANSDUCTION O TRANSLATIONAL RESEARCH O TRANSPLANT IMMUNOLOGY-NEONATOLOGY -NEUROLOGY -OBSTETRICS AND GYNECOLOGY -ORTHOPAEDIC SURGERY -PATHOLOGY -PSYCHIATRY -RADIOLOGY -SURGERY O CARDIAC SURGERY O CENTER FOR MINIMALLY INVASIVE SURGERY O NEUROSURGERY O PLASTIC AND RECONSTRUCTIVE SURGERY O VASCULAR SURGERY-TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER REPORTED $ 74,962,452 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE, WHICH REPRESENTED 5.06% OF THE MEDICAL CENTER'S TOTAL EXPENSES. ADDITIONALLY, THE MEDICAL CENTER REPORTED $198,265,202 OF RESEARCH EXPENSES FUNDED BY GOVERNMENTS AND OTHER TAX-EXEMPT ENTITIES INCLUDING OTHER HOSPITALS, UNIVERSITIES AND FOUNDATIONS WHICH, IF INCLUDED IN THE SCHEDULE H, PART I, LINE 7H CALCULATION, WOULD INCREASE THE NET COMMUNITY BENEFIT REPORTED FROM RESEARCH ACTIVITIES ON THIS SCHEDULE H, PART I, LINE 7H TO 18.19%. RESEARCH ENGAGED IN AT THE MEDICAL CENTER RESEARCH ENGAGED IN AT BIDMCVIKAS P. SUKHATME, M.D., SCD, THE MEDICAL CENTER'S CHIEF ACADEMIC OFFICER HAS SAID THAT THIS IS PERHAPS THE MOST VIGOROUS AND TRANSFORMING PERIOD IN THE HISTORY OF BIOMEDICAL RESEARCH, A TIME WHEN SOPHISTICATED TECHNOLOGIES ARE ENABLING THE PURSUIT OF HIGHLY ORIGINAL INVESTIGATIONS AND RAPIDLY EVOLVING GENOMIC DISCOVERIES ARE UNCOVERING IMPORTANT INSIGHTS INTO THE HEALTH OF THE INDIVIDUAL.THE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H, DEPENDING ON FUNDING SOURCE. GROUNDBREAKING GENETICS DISCOVERIES CHALLENGE SCIENTIFIC DOGMAIN THE HALF-CENTURY OLD CENTRAL DOGMA OF MOLECULAR BIOLOGY, IT WAS UNDERSTOOD AND ACCEPTED THAT DNA INSTRUCTS THE BODY ON HOW TO CONSTRUCT PROTEINS, THE BUILDING BLOCKS OF LIFE. PACKAGED IN GENES, THESE INSTRUCTIONS WERE TRANSPORTED TO CELLS' PROTEIN-MAKING MACHINERY BY WAY OF DNA'S CHEMICAL COUSIN RNA. IN BETWEEN THE GENES WERE LONG STRETCHES OF NONCODING RNA, WHICH WERE BELIEVED TO SERVE NO PURPOSE, AND WERE OFTEN REFERRED TO AS "JUNK DNA." BUT INVESTIGATORS AT BIDMC HAVE MADE KEY DISCOVERIES DEMONSTRATING THAT THIS "JUNK" MAY ACTUALLY BE HIDDEN TREASURE, REVEALING THAT NONCODING RNA PLAYS KEY ROLES IN HEALTH AND DISEASE, PARTICULARLY CANCER. RECOGNIZING THESE INSIGHTS INTO THE WORLD OF NON-CODING RNAS, BIDMC HAS SET UP THE INSTITUTE FOR RNA MEDICINE WITHIN THE BIDMC CANCER CENTER AND FRANK SLACK, PH.D., FORMERLY OF YALE UNIVERSITY, JOINED AS ITS DIRECTOR DURING THE PERIOD COVERED BY THIS FILING THIS FLAGSHIP PROGRAM WILL FURTHER ENHANCE BIDMC'S VISIBILITY IN THE WORLD OF SCIENCE AND IS ENTIRELY CONSISTENT WITH ITS BENCH TO BEDSIDE PHILOSOPHY."FIFTY PERCENT OF THE GENOME IS TRANSCRIBED, BUT ONLY TWO PERCENT MAKES PROTEIN, AND THERE WAS NO CODE, NO LANGUAGE FOR UNDERSTANDING THE REST," EXPLAINS CANCER CENTER DIRECTOR PIER PAOLO PANDOLFI, MD, PHD. "IN TERMS OF BIOMEDICAL RESEARCH, THE IMPACT IS IMMENSE, BECAUSE NOW [THERE ARE] ALL OF THESE NEW ENTITIES, PSEUDOGENES, LINCRNAS, CERNAS THAT HAVE BEEN GIVEN A FUNCTION. WE HAVE NOW ALMOST TRIPLED THE SIZE OF THE FUNCTIONAL GENOME AND THIS IS CRITICALLY IMPORTANT FOR CANCER GENETICS*****THE CO-CLINICAL TRIAL SPEEDS TESTING OF CANCER DRUGSCLINICAL TRIALS TO TEST NEW CANCER DRUGS ARE LENGTHY AND COMPLEX. AS A RESULT, THERE IS A BACKLOG OF MORE THAN 800 NEW TARGETED CANCER THERAPIES AWAITING CLINICAL TESTING. "THE CURRENT SYSTEM CAN'T KEEP PACE," SAYS PIER PAOLO PANDOLFI, MD, PHD. "THERE ISN'T ENOUGH TIME OR RESOURCES TO TEST EACH ONE OF THESE NEW DRUGS IN HUMAN SUBJECTS AS SINGLE AGENTS - LET ALONE IN COMBINATIONS." DR. PANDOLFI CONCEIVED AND DEVELOPED A REVOLUTIONARY NEW STREAMLINED TESTING METHOD KNOWN AS THE CO-CLINICAL TRIAL. IN THIS BIT OF SCIENTIFIC MULTITASKING, A HUMAN CLINICAL TRIAL IS SIMULTANEOUSLY PARTNERED WITH ANIMAL STUDIES OF MICE TO HELP DOCTORS LEARN MUCH MORE QUICKLY WHICH PATIENTS WITH WHICH MUTATIONS ARE BEING HELPED - OR NOT BEING HELPED - BY TARGETED CANCER DRUGS. PANDOLFI WAS AWARDED $4.2 MILLION IN AMERICAN REINVESTMENT AND RECOVERY ACT (ARRA) FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH (NIH) FOR THE CO-CLINICAL TRIAL INVESTIGATIONS. THE NEW MODEL TAKES ADVANTAGE OF THE TREMENDOUS TECHNOLOGICAL ADVANCES THAT ARE PROVIDING SCIENTISTS WITH VALUABLE NEW INFORMATION ABOUT CANCER'S GENETIC UNDERPINNINGS. IN MARCH 2012, THE FIRST FINDINGS USING THE CO-CLINICAL STRATEGY WERE PUBLISHED IN NATURE, REVEALING KEY INSIGHTS INTO NEW LUNG CANCER THERAPIES. NATURE DESCRIBED THIS PROCESS AS ONE OF "FOUR WAYS TO FIX THE CLINICAL TRIAL" STATING THAT "THE CO-CLINICAL MODEL...[BRINGS] FUNDAMENTAL CHANGES TO THE CLINICAL TRIAL SYSTEM TO MAKE IT FASTER, CHEAPER, MORE ADAPTABLE AND MORE IN TUNE WITH MODERN MOLECULAR MEDICINE." THE "...ULTIMATE GOAL IS TO FIND OUT EXACTLY WHY DIFFERENT PATIENTS RESPOND TO DIFFERENT TREATMENTS...SO THAT DRUGS ARE GIVEN ONLY TO THE PATIENTS WHO WILL RESPOND," SAYS DR. PANDOLFI. OVER THE LAST YEAR, CONTINUING ALONG THE SAME THEME, THE MEDICAL CENTER COMPLETED THE RECRUITMENT OF ANOTHER SEASONED INVESTIGATOR, DR. SENTHIL MUTHUSWAMY, WHO HAS PIONEERED WAYS OF PRESERVING TUMOR TISSUE IN VITRO IN SO-CALLED ORGANOIDS THAT MAINTAIN CHARACTERISTICS OF THE CANCER AND CAN BE RAPIDLY TESTED FOR SUSCEPTIBILITY TO DRUG TREATMENTS. THIS TECHNOLOGY COMPLEMENTS THE ANIMAL CO-CLINICAL STUDIES AND IS EXPECTED TO BE OF GREAT VALUE TO PATIENTS. PIONEERS IN THE QUEST FOR AN HIV VACCINE AIDS FIRST CAME TO LIGHT MORE THAN 30 YEARS AGO AND EVER SINCE HIV WAS IDENTIFIED AS THE VIRUS RESPONSIBLE FOR THIS FORMIDABLE DISEASE, MEDICAL CENTER SCIENTISTS HAVE DISTINGUISHED THEMSELVES AS INTERNATIONAL LEADERS IN THE QUEST TO DEVELOP AN HIV VACCINE. THERE ARE 2.7 MILLION NEW HIV INFECTIONS REPORTED EACH YEAR. DR. DAN BAROUCH, CHIEF OF THE DIVISION OF VIROLOGY AND VACCINE RESEARCH IN BIDMC'S DEPARTMENT OF MEDICINE, WAS THE RECENT RECIPIENT OF A $20 MILLION DOLLAR GRANT FROM THE BILL AND MELINDA GATES FOUNDATION. THIS IMPORTANT FUNDING WILL ENABLE DR. BAROUCH AND A TEAM OF 50 SCIENTISTS AT BIDMC TO TEST AN ANTIBODY THAT HAS PROVEN TO REDUCE THE HIV VIRUS IN MONKEYS. THE FOUR YEAR GRANT WILL FUND FURTHER TESTING ON MONKEY MODELS AS WELL AS OBSERVING IF THE ANTIBODY HAS A SIMILAR EFFECT ON HIV-INFECTED HUMANS. THE GOAL OF THIS WORK IS TO POTENTIALLY ATTACK THE VIRAL RESERVOIRS WITH THIS ANTIBODY IN THE HOPES OF REDUCING OR ELIMINATING THE VIRUS. THIS IS A MOST NOVEL APPROACH IN WHICH BIDMC IS A WORLD LEADER.*****SCIENTISTS UNCOVER THE EARLIEST STAGES OF ALZHEIMER'S DISEASEALZHEIMER'S DISEASE (AD) CURRENTLY AFFLICTS 5.4 MILLION AMERICANS AND 30 MILLION INDIVIDUALS WORLDWIDE. IT IS ESTIMATED THAT BY 2050, MEDICAL COSTS OF CARING FOR AD PATIENTS WILL SOAR TO OVER $1 TRILLION IN THE U.S. ALONE. MEDICAL CENTER INVESTIGATORS KUN PING LU, MD, PHD, AND XIAO ZHEN ZHOU, MD, PHD, HAVE IDENTIFIED THE FIRST, EARLY STEP IN WHICH THE TAU PROTEIN IS TRANSFORMED FROM ITS BENEFICIAL FUNCTION AS A MEANS OF NEURONAL SUPPORT AND TURNED INTO A TWISTED, MISSHAPEN VILLAIN RESPONSIBLE FOR DEBILITATING MEMORY LOSS. THE DISCOVERY OFFERS A PROMISING NEW DIRECTION FOR THE DEVELOPMENT OF THERAPEUTIC ANTIBODIES AND VACCINES, AND HINGES ON AN ENZYME CALLED PIN1 (PROLYL ISOMERASE), WHICH CAN UNTANGLE THE TWISTED TAU. PIN1 WAS CO-DISCOVERED BY LU IN 1995. A NEW ANTIBODY TECHNOLOGY DEVELOPED BY DR. LU AND DR. ZHOU HAS MADE IT POSSIBLE TO DISTINGUISH BETWEEN HEALTHY AND DISEASE-CAUSING TAU PROTEIN. THEIR WORK HAS DEMONSTRATED THAT THE PROTEIN'S PATHOGENIC FORM APPEARS IN THE BRAIN CELLS OF PATIENTS WITH EARLY DEMENTIA AND AS IT PROGRESSES TO ALZHEIMER'S RAPIDLY ACCUMULATES AT THE BRAIN LOCATION THAT IS CRITICAL FOR MEMORY.*****EUREKA! A POISONOUS GAS BECOMES A MEDICAL THERAPYALTHOUGH CARBON MONOXIDE'S BEST-KNOWN REPUTATION IS THAT OF A SINISTER, SILENT KILLER, IT TURNS OUT THE GAS IS VITAL TO OUR HEALTH AND WELL-BEING. EVERY CELL IN THE HUMAN BODY PRODUCES AND USES CO GAS MOLECULES TO RESPOND TO INTRACELLULAR STRESSES, AND TO HELP CONTROL BLOOD PRESSURE, MEMORY AND CIRCADIAN RHYTHMS. LEO OTTERBEIN, PHD, A SCIENTIST IN THE MEDICAL CENTER'S TRANSPLANT INSTITUTE, ACTIVELY INVESTIGATES THE UNDERLYING BIOLOGY BEHIND THE SEEMINGLY PARADOXICAL IDEA THAT VERY LOW LEVELS OF CARBON MONOXIDE CAN BE USED AS A THERAPY. HIS WORK, WHICH COULD LEAD TO NEW THERAPIES FOR A RANGE OF MEDICAL APPLICATIONS INCLUDING ADJUNCT CANCER TREATMENTS, IS CURRENTLY BEING TESTED AS A NOVEL WAY TO HELP KIDNEY TRANSPLANT PATIENTS AVOID ORGAN REJECTION. RECOVERING SPEECH THROUGH SONG FOR STROKE PATIENTS WHO HAVE LOST THE ABILITY TO SPEAK, MUSIC AND SINGING MAY PROVIDE A SURPRISING WAY TO RESTORE THEIR LANGUAGE. AS THE DIRECTOR OF THE MEDICAL CENTER'S MUSIC AND NEUROIMAGING LABORATORY, GOTTFRIED SCHLAUG, MD, PHD, IS CONDUCTING ONE OF THE FIRST RIGOROUS CLINICAL TRIALS TO TEST A TREATMENT CALLED MELODIC INTONATION THERAPY IN APHASIA PATIENTS. "MELODIC INTONATION THERAPY WAS FIRST DEVELOPED IN THE 1970S, AFTER CLINICIANS OBSERVED THAT SOME PATIENTS WHO SUFFERED STROKES WERE NO LONGER ABLE TO TALK, BUT COULD STILL SING," EXPLAINS DR. SCHLAUG, WHO ALSO LEADS THE MEDICAL CENTER'S STROKE SERVICE. THE THEORY BEHIND THE TREATMENT IS THAT THE LEFT AND RIGHT SIDES OF THE BRAIN HAVE NETWORKS THAT CAN SUPPORT VOCAL OUTPUT -ONE IS MORE ENGAGED IN SPEECH, THE OTHER WITH MUSIC AND SINGING. DR. SCHLAUG'S HOPE IS THAT " THIS THERAPY CAN HELP THE UNAFFECTED RIGHT SIDE OF THE BRAIN TO DEVELOP SKILLS TO HELP RESTORE SPEECH OUTPUT."DR. SCHLAUG'S WORK WAS FEATURED IN A PROFILE ON NATIONAL PUBLIC RADIO'S "MORNING EDITION AND HIS EXPERTISE WAS TAPPED BY ABC NEWS.COM AND OTHER MAJOR MEDIA OUTLETS, INSPIRED BY FORMER U.S. REP. GABRIELLE GIFFORDS' EXPERIENCE WITH MELODIC INTONATION THERAPY FOLLOWING HER BRAIN INJURY. BUILDING ON THE SUCCESS OF MELODIC INTONATION THERAPY, RESEARCHERS IN THE MEDICAL CENTER'S MUSIC AND NEUROIMAGING LABORATORY HAVE DEVELOPED A SIMILAR TREATMENT CALLED AUDITORY-MOTOR MAPPING TRAINING (AMMT) TO HELP NONVERBAL CHILDREN WITH AUTISM TO DEVELOP SPEECH. AMMT STEMS FROM THE OBSERVATIONS THAT CHILDREN WITH AUTISM - WHO TYPICALLY STRUGGLE WITH COMMUNICATION, AS WELL AS SOCIAL INTERACTIONS - OFTEN RESPOND POSITIVELY TO MUSIC, AND USES A COMBINATION OF SINGING AND MOTOR ACTIVITIES TO STRENGTHEN A NETWORK OF BRAIN REGIONS THAT IS THOUGHT TO BE ABNORMAL IN THESE CHILDREN. *****TEAMING UP TO TACKLE SEPSIS - FROM BENCH TO BEDSIDESEPSIS IS ONE OF THE MOST COMMON - AND MOST TERRIFYING - OF CONDITIONS TO BE FOUND IN HOSPITAL EMERGENCY DEPARTMENTS AND INTENSIVE CARE UNITS. SOMETIMES KNOWN AS BLOOD POISONING, SEPSIS OCCURS WHEN THE BODY OVERREACTS TO WHAT IS OFTEN A SIMPLE INFECTION, AND CAN RAPIDLY ESCALATE TO LIFE-THREATENING ORGAN SHUTDOWN. EACH YEAR, SEPSIS IS RESPONSIBLE FOR MORE THAN 200,000 DEATHS, MAKING IT A LEADING CAUSE OF HOSPITAL MORTALITY. AT THE MEDICAL CENTER, INTERDISCIPLINARY RESEARCH TEAMS HAVE MADE SEPSIS A PRIMARY FOCUS OF THEIR ATTENTION. BY LITERALLY BRINGING KEY SCIENTIFIC FINDINGS FROM THE LAB BENCH TO THE PATIENT BEDSIDE, EMERGENCY ROOM PHYSICIAN NATHAN SHAPIRO, MD, PHD, HAS BEEN INSTRUMENTAL IN LEADING INVESTIGATIONS INTO THE ORIGINS OF THIS EXTREMELY DANGEROUS CONDITION, ESTIMATED TO COST $17 BILLION PER YEAR, NATIONWIDE. AS A MEMBER OF THE CENTER FOR VASCULAR BIOLOGY RESEARCH (CVBR) DR. SHAPIRO HAS PARTNERED WITH BASIC SCIENTISTS SAMIR PARIKH, MD, AND WILLIAM AIRD, MD, TO EXPLORE THE ROLE THAT BLOOD VESSELS PLAY IN THE ONSET OF SEPSIS AND IN ITS ESCALATION TO A LIFE-THREATENING CONDITION. THEIR WORK INVESTIGATING THE ENDOTHELIUM LAYER, WHICH LINES THE BLOOD CELLS, IS UNCOVERING VITALLY IMPORTANT CLUES, INCLUDING THE ROLE THAT THE VEGF (VASCULAR ENDOTHELIAL GROWTH FACTOR) PROTEIN MAY PLAY IN THE ONSET OF THIS PROGRESSIVELY SEVERE ILLNESS. THE EMERGENCY-ROOM-AS-LABORATORY IS A UNIQUE AND VALUABLE APPROACH TO STUDYING SEPSIS, AND AS AN ATTENDING PHYSICIAN, DR. SHAPIRO HAS BEEN PRINCIPAL INVESTIGATOR OF NUMEROUS ER-BASED CLINICAL TRIALS TO HELP ASCERTAIN THE MOST EFFECTIVE AND PRUDENT MANAGEMENT OF THE CONDITION IN CASES IN WHICH SEPSIS HAS TAKEN HOLD.*****TRACING THE NEURAL CIRCUITRY OF APPETITE AND HUNGERIF YOU'VE EVER SKIPPED MEALS FOR A WHOLE DAY OR GONE ON A STRICT, LOW-CALORIE DIET, YOU KNOW JUST HOW POWERFUL AND UNCOMFORTABLE THE FEELING OF HUNGER CAN BE. HUNGER IS A COMPLEX MOTIVATION GOVERNED BY THE BRAIN AND BIDMC INVESTIGATOR BRADFORD LOWELL, MD, PHD, OF THE DIVISION OF ENDOCRINOLOGY, DIABETES AND METABOLISM IN BIDMC'S DEPARTMENT OF MEDICINE IS UNCOVERING THE INTRICATE NEUROCIRCUITRY THAT UNDERLIE THESE FEELINGS. IN A RECENT REPORT PUBLISHED IN NATURE NEUROSCIENCE, THE LOWELL LABORATORY MADE IMPORTANT PROGRESS IN UNDERSTANDING THE NEURAL BASIS OF APPETITE. USING A VARIETY OF INNOVATIVE TECHNOLOGIES TO CONTROL THE ACTIVITY IN THE BRAINS OF LIVING MICE, LOWELL AND HIS TEAM HAVE IDENTIFIED ONE PARTICULAR CIRCUIT THAT INVOLVES A GROUP OF MELANOCORTIN-4 RECEPTOR (MC4R) NEURONS THAT APPEARS TO SWITCH HUNGER OFF AND ON AND PROVIDED A HIGHLY PROMISING NEW STRATEGY FOR THE DEVELOPMENT OF WEIGHT LOSS DRUGS TO HELP COMBAT THE EPIDEMIC OF OBESITY.*****NEW CLASS OF FATTY MOLECULES BATTLES DIABETES IN MICELIPIDS, THE CHEMICAL FAMILY THAT INCLUDES FATS AND RELATED MOLECULES, GET BLAMED FOR CLOGGED ARTERIES AND HEART ATTACKS. BUT RESEARCHERS LED BY BIDMC'S BARBARA KAHN, MD, HAVE MADE A SURPRISING DISCOVERY OF A PREVIOUSLY UNIDENTIFIED CLASS OF LIPID MOLECULES THAT ACTUALLY ENHANCE INSULIN SENSITIVITY AND BLOOD SUGAR CONTROL. THESE NEW FINDINGS, RECENTLY PUBLISHED IN THE JOURNAL CELL, OFFER A PROMISING NEW AVENUE FOR THE PREVENTION AND TREATMENT OF TYPE 2 DIABETES. NAMED FATTY ACID HYDROXYL FATTY ACIDS, OR FAHFAS, THESE NEW MOLECULES ARE IN FAT CELLS AS WELL AS OTHER CELLS THROUGHOUT THE BODY, AND NOW JOIN A SMALL GROUP OF FATTY ACIDS KNOWN TO BENEFIT HEALTH, WHICH ALSO INCLUDES OMEGA-3 FATTY ACIDS FOUND IN FISH OIL. THE DISCOVERY OF FAHFAS PROVIDES IMPORTANT NEW INSIGHTS UNDERLYING METABOLIC AND INFLAMMATORY DISEASES, AND OFFERS VIABLE NEW TREATMENT AVENUES THAT KAHN AND HER TEAM HOPE TO BE ABLE TO TEST IN CLINICAL TRIALS. "THIS IS OF CRITICAL IMPORTANCE AS RATES OF OBESITY AND TYPE 2 DIABETES REMAIN AT EPIDEMIC PROPORTIONS WORLDWIDE," SAYS KAHN, AN INVESTIGATOR IN BIDMC'S DIVISION OF ENDOCRINOLOGY, DIABETES AND METABOLISM IN THE DEPARTMENT OF MEDICINE. ATTEMPTS ARE NOW IN PROGRESS TO TEST FAHFAS IN DIABETIC PATIENTS. FOR THIS AND OTHER PIONEERING WORK, DR. KAHN WAS AWARDED THE 2016 BANTING MEDAL FOR SCIENTIFIC ACHIEVEMENT FROM THE AMERICAN DIABETES ASSOCIATION. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS - GRADUATE MEDICAL EDUCATION THE MEDICAL CENTER'S DEVOTION TO TEACHING, RESPECT FOR STUDENTS/TRAINEES AND WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS, RESIDENTS AND FELLOWS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 48 ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH 611 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 42 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH 62 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW THROUGH SUPERVISION OF THEIR DAILY PATIENT CARE AND A RANGE OF INTERACTIVE LEARNING EXPERIENCES. CORE CLINICAL TRAINING PROGRAMS THE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS:-ANESTHESIOLOGY-EMERGENCY MEDICINE-INTERNAL MEDICINE-NEUROLOGY-OBSTETRICS AND GYNECOLOGY-PATHOLOGY-RADIOLOGY-SURGERYDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER HAD NET EXPENDITURES OF $64,613,551 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE MEDICAL CENTER'S TEACHING FUNCTION WHICH REPRESENTED 4.36% OF THE MEDICAL CENTER'S TOTAL EXPENSES.RESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE, AS WELL AS PSYCHIATRY. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. ALMOST HALF OF THESE PROGRAMS (48 OF 90) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS:-ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, CRITICAL CARE MEDICINE, NEUROANESTHESIA, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA-EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, TRAUMA, SIMULATION, ACADEMIC EMERGENCY MEDICINE AND FACULTY FELLOWSHIP-INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOSCOPY, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND ONCOLOGY, HEPATOLOGY, HOSPITAL AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY-NEUROLOGY: COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY-OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, MATERNAL FETAL MEDICINE, MINIMALLY INVASIVE GYNECOLOGIC SURGERY, REPRODUCTIVE ENDOCRINOLOGY-PATHOLOGY: CYTOPATHOLOGY, HEMATOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY - CPEP, SELECTIVE PATHOLOGY -RADIOLOGY-DIAGNOSTIC: ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, MRI, MUSCULOSKELETAL IMAGING - MSK, NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, VASCULAR AND INTERVENTIONAL RADIOLOGY, RADIATION ONCOLOGY-SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, COLORECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGICAL ONCOLOGY & STERIOTACTIC NEUROSURGERY, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, PLASTIC HAND SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, SURGICAL CRITICAL CARE, THORACIC SURGERY, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATED ADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS - EXAMPLES BELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HOSPITAL, TUFTS MEDICAL CENTER, ST. VINCENT HOSPITAL, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. INTERNAL MEDICINE EDUCATION AT BIDMC THE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.INTERNSHIPTHE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR "AMBULATORY BLOCKS" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL "TRACKS" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: -RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE.-DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: -DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: -DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC.-ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAM OUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH TO BE EFFECTIVE PRACTITIONERS IN UNDERSERVED, RESOURCE-LIMITED SETTINGS AND TO DESIGN, MANAGE, IMPROVE AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS THAT ADDRESS THE HEALTH PROBLEMS OF THE WORLD'S NEEDIEST POPULATIONS.PROGRAM OBJECTIVES -INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS -CONTRIBUTE TO THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS IN BOSTON AND AROUND THE WORLD -ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS WITH LIMITED RESOURCES -EXPAND RESEARCH OPPORTUNITIES -ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH SITE LOCATIONS -BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. -VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. PHYSICIAN AND NURSE TRAINING ON HIV/AIDS CARE IN VIETNAM TAKES PLACE THROUGH FUNDING FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. -ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH. NEUROLOGY EDUCATION AT BIDMC THE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS. *****PATHOLOGY EDUCATION AT BIDMCTHE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH "RESIDENT-AS-TEACHER" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING. RADIOLOGY EDUCATION AT BIDMC THE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE:-THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR.-FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR.-ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME. OUR UNIQUE EDUCATIONAL TRACKS CURRENTLY, SIX TRACKS ARE OFFERED:-CLINICAL-EDUCATION-RESEARCH-GLOBAL HEALTH-QUALITY IMPROVEMENT-HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION.*****SURGERY EDUCATION AT BIDMCTHE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, AND VASCULAR SURGERY. STUDENTS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. STUDENTS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE:-RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB -SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS -COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.CARL J. SHAPIRO SIMULATION AND SKILLS CENTERTHE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER (SASC) AT THE MEDICAL CENTER OFFERS THE LATEST ADVANCES IN MEDICAL SIMULATION TECHNOLOGY TO THE MEDICAL CENTER, NEIGHBORING INSTITUTIONS AND THE GLOBAL HEALTHCARE FIELD. THE SASC PROVIDES REALISTIC TRAINING OPPORTUNITIES FOR LEARNERS AT ALL LEVELS, FROM ALL DISCIPLINES, AND USES PROGRESSIVE TEACHING METHODS TO REPLICATE REAL-LIFE PATIENT CARE SITUATIONS, FROM ROUTINE PROCEDURES TO ACUTE MANAGEMENT CRISES. THE SASC RAISES THE BAR FOR MAJOR ACADEMIC MEDICAL CENTERS BY PROVIDING HEALTH CARE STUDENTS AND PROFESSIONALS WITH CURRICULA AND SKILLS TRAINING ON THE LATEST MEDICAL AND SURGICAL TECHNIQUES IN A STATE-OF-THE-ART, TECHNOLOGICALLY ADVANCED FACILITY. THE SASC INCLUDES A LARGE TELECONFERENCE ROOM FOR UP TO 65 LEARNERS AND CONTAINS LIVE MEDIA FEEDS TO FOUR DIFFERENT OPERATING ROOM ENDOSUITES, ALLOWING FOR TELEPROCTORING, INTER-INSTITUTIONAL COURSES, AND INTERCONTINENTAL BROADCASTING OF GRAND ROUNDS. THE HIGH FIDELITY MOCK OPERATING AND INTENSIVE CARE UNIT ROOMS USED FOR FULL-BODY SIMULATION FEATURE WORKING WATER AND GAS LINES, VIDEO CAMERAS AND OBSERVATION WINDOWS WITH STATE-OF-THE-ART TELECONFERENCING ABILITY. TWO SKILLS LAB AREAS ARE DEDICATED TO PROVIDING LEARNERS WITH HANDS-ON TRAINING FOR BASIC CLINICAL PROCEDURES, OPEN SURGICAL SKILLS, ENDOSCOPIC, ULTRA-SONOGRAPHY, AND LAPAROSCOPIC SKILLS WITH OVER 30 PARTIAL TASK TRAINERS AND HIGH-FIDELITY PROCEDURAL SIMULATORS.THE MEDICAL CENTER'S SASC HAS BEEN FORMALLY ACCREDITED SINCE 2006 AS A LEVEL 1 FACILITY BY THE AMERICAN COLLEGE OF SURGEONS (ACS), THE FIRST IN BOSTON AND NEW ENGLAND - AND ONE OF ONLY SEVEN INAUGURAL CERTIFIED CENTERS IN THE UNITED STATES - TO PROVIDE SIMULATION-BASED SKILLS TRAINING TO HEALTH CARE STUDENTS AND PROFESSIONALS FROM ALL MEDICAL AND SURGICAL DISCIPLINES. AS AN ACS ACCREDITED EDUCATION INSTITUTE, THE SASC IS PART OF THE ACS' DEVELOPING NETWORK OF REGIONAL EDUCATION FACILITIES DESIGNED TO "SPECIFICALLY ADDRESS THE TEACHING, LEARNING AND ASSESSMENT OF TECHNICAL SKILLS USING STATE-OF-THE-ART EDUCATIONAL METHODS AND CUTTING-EDGE TECHNOLOGY." SASC IS AMONG THE NATIONAL TEST SITES FOR FUNDAMENTALS OF LAPAROSCOPIC SURGERY (FLS) CANDIDATES. SASC FACULTY PROCTOR THE TWO-PART COGNITIVE AND MANUAL SKILLS EXAM FOR RESIDENTS, FELLOWS AND SURGEONS PERFORMING LAPAROSCOPIC SURGERY.THE SASC HAS ALSO BEEN ACCREDITED BY THE AMERICAN SOCIETY OF ANESTHESIOLOGY AND AMERICAN COLLEGE OF OBSTETRICS AND ONCOLOGY. SCHEDULE H PART VI QUESTIONS 5 AND 6 ADDITIONAL PROMOTION OF COMMUNITY HEALTH AND AFFILIATED HEALTH CARE SYSTEMAS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF THE MEDICAL CENTER'S BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. IN ADDITION, AS NOTED THROUGHOUT THIS FORM 990 AND SCHEDULES' NARRATIVE SUPPORT, THE MEDICAL CENTER IS PART OF THE CAREGROUP NETWORK OF AFFILIATES AND CAREGROUP SERVES AS THE MEDICAL CENTER'S SOLE MEMBER. IN ADDITION, THE MEDICAL CENTER SERVES AS THE SOLE MEMBER TO BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, BETH ISRAEL DEACONESS HOSPITAL - MILTON, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP AND JORDAN HEALTH SYSTEMS, INC. EACH OF THESE ENTITIES MAY, IN TURN, SERVE AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE MEDICAL CENTER AND EACH OF ITS AFFILIATES IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES THEY SERVE. 1 ALBERT EINSTEIN COLLEGE OF MEDICINE 1300 MORRIS PARK AVE BELFER BLDG STE 1108 BRONX NY 10461 472209056 580616 RESEARCH - SUBAWARD AMERICAN SOCIETY FOR CLINICAL PATHOLOGY 33 WEST MONROE ST SUITE 1600 CHICAGO IL 606035617 362406080 98667 RESEARCH - SUBAWARD APTIMA INC 12 GILL ST STE 1400 WOBURN MA 01801 043281859 1284031 RESEARCH - SUBAWARD ATRIUS HEALTH 275 GROVE STREET 300 AUBURNDALE MA 024662272 010803117 501(C) (3) 8488 RESEARCH - SUBAWARD BAYLOR COLLEGE OF MEDICINE DR PHILIP NG HOUSTON TX 77030 741613878 501(C) (3) 56870 RESEARCH - SUBAWARD BILLINGS CLINIC FOUNDATION PO BOX 31031 BILLINGS MT 59107 810407289 501(C) (3) 7153 RESEARCH - SUBAWARD BIOSURFACES 200 HOMER AVE UNIT 1P ASHLAND MA 01721 028600865 62963 RESEARCH - SUBAWARD BOSTON CHILDREN'S HOSPITAL RESEARCH FINANCE BOSTON MA 022414413 042774441 501(C) (3) 903669 RESEARCH - SUBAWARD BOSTON UNIVERSITY P O BOX 55057 BOSTON MA 02205 042103547 501(C) (3) 480874 RESEARCH - SUBAWARD BRIGHAM & WOMENS HOSP PO BOX 3149 ATTN PS 102450 BOSTON MA 022413149 042312909 501(C) (3) 4374901 RESEARCH - SUBAWARD BROAD INSTITUTE 415 MAIN ST CAMBRIDGE MA 02142 263428781 10974 RESEARCH - SUBAWARD CAMBRIDGE HEALTH ALLIANCE 1493 CAMBRIDGE ST CAMBRIDGE MA 02139 010676306 501(C) (3) 51719 RESEARCH - SUBAWARD CASE WESTERN RESERVE UNIVERSITY 1100 EUCLID AVE RM790 CLEVELAND OH 441066003 341018992 501(C) (3) 698663 RESEARCH - SUBAWARD CATALENT PHARMA SOLUTIONS 25109 NETWORK PLACE CHICAGO IL 606731251 133523163 1107251 RESEARCH - SUBAWARD CHARLES RIVER COMMUNITY HEALTH INC 1380 SOLDIERS FIELD RD 3RD FR BRIGHTON MA 02135 237221597 501(C) (3) 40633 RESEARCH - SUBAWARD CHICAGO ASSOC FOR RESEARCH & EDU IN SCIE PO BOX 250 HINES IL 60141 363334177 501(C) (3) 39265 RESEARCH - SUBAWARD CHILDREN'S HOSPITAL FINANCIAL REPORTING 300 LONGWOOD AVE BOSTON MA 02115 042774441 501(C) (3) 220162 RESEARCH - SUBAWARD CITY OF BOSTON - BIDMC ONE CITY HALL SQUARE BOSTON MA 02201 2546795 195256 SPACE & UTILITIES SUPPORT CITY OF BOSTON SERVICES & INFRASTRUCTURE CLEVELAND CLINIC PO BOX 931652 CLEVELAND OH 441935012 651133985 18422 RESEARCH - 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SUBAWARD FURMAN UNIVERSITY 3300 POINSETT HIGHWAY GREENVILLE SC 29613 570314395 36660 RESEARCH - SUBAWARD GEISINGER CLINIC GEISINGER HEALTH SYSTEM DANVILLE PA 178223069 236291113 54081 RESEARCH - SUBAWARD GEORGETOWN UNIVERSITY OFFICE OF TECH LIC HARRIS BLDG STE 1500 WASHINGTON DC 20007 530196603 19882 RESEARCH - SUBAWARD GROUP HEALTH COOPERATIVE CENTER FOR HEALTH STUDIES SEATTLE WA 981011448 910511770 80728 RESEARCH - SUBAWARD HARBOR -UCLA C/O LA BIOMED RESEARCH INSTITUTE LOS ANGELES CA 90060 952138184 11339 RESEARCH - SUBAWARD HARVARD CLINICAL RESEARCH INST P O BOX 846057 BOSTON MA 02284 043521077 501(C) (3) 197610 RESEARCH - SUBAWARD HARVARD SCHOOL OF DENTAL MEDICINE 188 LONGWOOD AVE BOSTON MA 02115 042103580 56173 RESEARCH - SUBAWARD HARVARD UNIVERSITY GENL ACCTS REC BOSTON MA 02212 042103580 264952 RESEARCH - SUBAWARD HARVARD VANGUARD MED ASSC 120 CENTRAL OB/GYN ADMIN BOSTON MA 02215 043397450 501(C) (3) 18944 RESEARCH - SUBAWARD HEALTH RESEARCH INC ELM AND CARLTON ST BUFFALO NY 14263 200356233 25000 RESEARCH - SUBAWARD HEBREW REHABILITATION CENTER ATTWENDY GUTTERSON PRACTICE ADMIN ROSLINDALE MA 02122 042104298 501(C) (3) 304134 RESEARCH - SUBAWARD IHC HEALTH SVS DBA INTERMOUNTAIN MED CTR PO BOX 57828 SALT LAKE CITY UT 84157 870269232 25440 RESEARCH - SUBAWARD JACKSON LABORATORY PO BOX 90260 CHICAGO IL 606960260 010211513 501(C) (3) 91791 RESEARCH - SUBAWARD JOHNS HOPKINS UNIVERSITY JHU REFERENCE LABORATORY BALTIMORE MD 212644478 520595110 16200 RESEARCH - SUBAWARD JOSLIN DIABETES CENTER TECH TRANS CONSULANT RM 503 BOSTON MA 02215 012203836 501(C) (3) 345693 RESEARCH - SUBAWARD MAINE MEDICAL CENTER DEPT OF EMERGENCY MEDICINE PORTLAND ME 04102 010238552 501(C) (3) 8825 RESEARCH - SUBAWARD MARY HITCHCOCK MEDICAL CENTER DARTMOUTH-HITCHCOCK LEBANON NH 03756 020222140 11058 RESEARCH - SUBAWARD MASS GENERAL HOSPITAL CORP SPONSORED RESEARCH LIC CHARLESTOWN MA 02129 041564655 501(C) (3) 1468493 RESEARCH - SUBAWARD MASSACHUSETTS INSTITUTE OF TECHNOLOGY C/O OFFICE OF SPONSERED PROG CAMBRIDGE MA 02139 042103594 212863 RESEARCH - SUBAWARD MEDICAL COLLEGE OF WISCONSIN 9200 WEST WISCONSIN AVE MILWAUKEE WI 53226 390806261 241117 RESEARCH - SUBAWARD MEDICAL UNIVERSITY OF SOUTH CAROLINA 173 ASHLEY THOMAS MSC 509 CHARLESTON SC 29425 576000722 288701 RESEARCH - SUBAWARD MIT CASHIERS CASHIERS OFFICE NE49-3077 CAMBRIDGE MA 02139 042103594 158911 RESEARCH - SUBAWARD NEW MEXICO CONSORTIUM INC 4200 WEST JEMEZ ROAD STE 301 LOS ALAMOS NM 87544 260370262 222340 RESEARCH - SUBAWARD NORTHWESTERN UNIVERSITY FEINBERG SCHOOL OF MEDICINE CHICAGO IL 606113008 362167817 71911 RESEARCH - SUBAWARD OHIO STATE UNIVERSITY COMPREHENSIVE CANCER CTR MASR COLUMBUS OH 43210 316025986 55936 RESEARCH - SUBAWARD OPENBIOME 196 BOSTON AVE STE 1000 MEDFORD MA 02155 461681862 65500 RESEARCH - SUBAWARD OREGON HEALTH & SCIENCES UNIVERSITY DEPT OF BIOMEDICAL ENGINEERING PORTLAND OR 97239 237083114 1380707 RESEARCH - SUBAWARD OUTER CAPE HEALTH SERVICES PO BOX 1413 WELLFLEET MA 02667 042509828 44958 RESEARCH - SUBAWARD PARTNERS HEALTHCARE C/O RESEARCH CORE FACILITY CHARLESTOWN MA 021291131 043230035 36425 RESEARCH - 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SUBAWARD THE DIMOCK CENTER 55 DIMOCK STREET ROXBURY MA 02119 043487835 501(C) (3) 81258 RESEARCH - SUBAWARD THE MIRIAM HOSPITAL ONE HOPPIN ST BOX 42 STE 1300 PROVIDENCE RI 029034141 050258905 501(C) (3) 544166 RESEARCH - SUBAWARD THE SCRIPPS RESEARCH INSTITUTE 10550 NORTH TORREY PINES RD LA JOLLA CA 92037 330435954 434936 RESEARCH - SUBAWARD THE UNIVERSITY OF CHICAGO SPONSORED AWARD ACCOUNTING CHICAGO IL 60637 362177139 10494 RESEARCH - SUBAWARD TRUSTEES OF BOSTON UNIVERSITY BOSTON UNIVERSITY BOSTON MA 02205 042103547 501(C) (3) 265723 RESEARCH - SUBAWARD TRUSTEES OF THE UNIV OF PENNSYLVANIA 3400 SPRUCE ST 569 DULLES BUILDING PHILADELPHIA PA 191044283 231352685 247178 RESEARCH - SUBAWARD TRUSTEES OF TUFTS COLLEGE DEPT OF PHARM EXPERIMENTAL BOSTON MA 02111 042103634 66568 RESEARCH - SUBAWARD TUFTS MEDICAL CENTER 800 WASHINGTON STREET BOX 115 BOSTON MA 02111 043400617 501(C) (3) 99824 RESEARCH - SUBAWARD U C REGENTS- UNIV OF CALIFORNIA S FRANC REMITTANCE CENTER LOS ANGELES CA 900246503 946036494 7839 RESEARCH - SUBAWARD UMASS MEDICAL SCHOOL 55 LAKE AVE NORTH WORCESTER MA 01655 043167352 161057 RESEARCH - SUBAWARD UNIVERSITY OF ARIZONA SPONSORED PROJECTS SERVICES TUCSON AZ 857190521 742652689 6267 RESEARCH - SUBAWARD UNIVERSITY OF CALIFORNIA SAN DIEGO CENTRAL CASHIER LA JOLLA CA 920930009 952872494 12233 RESEARCH - SUBAWARD UNIVERSITY OF CONNECTICUT 438 WHITNEY RD EXTN UNIT 1133 STORRS CT 062691133 060772160 251652 RESEARCH - SUBAWARD UNIVERSITY OF FLORIDA DEPT OF MEDICINE ADMIN GAINESVILLE FL 326103594 596002052 142882 RESEARCH - SUBAWARD UNIVERSITY OF HAWAII 2440 CAMPUS RD BOX 368 HONOLULU HI 96822 996000354 151190 RESEARCH - SUBAWARD UNIVERSITY OF IOWA DEPT OF OTOLARYNGOLOGY HNS 21154 PFP IOWA CITY IA 52242 426004813 34011 RESEARCH - SUBAWARD UNIVERSITY OF KANSAS CENTER FOR RESEARCH 2385 IRVING HILL ROAD LAWRENCE KS 66045 480680117 14689 RESEARCH - SUBAWARD UNIVERSITY OF MARYLAND 3501 UNIVERSITY BLVD EAST ADELPHI MD 20783 526002033 12294 RESEARCH - SUBAWARD UNIVERSITY OF MASSACHUSETTS CENTER FOR SURVEY RESEARCH BOSTON MA 021253393 043167352 133652 RESEARCH - SUBAWARD UNIVERSITY OF MIAMI DR ECHARD PODACK MIAMI FL 33136 590624458 586036 RESEARCH - SUBAWARD UNIVERSITY OF NORTH CAROLINA 120 MASON FARM RD CHAPEL HILL NC 27599 566001393 164067 RESEARCH - SUBAWARD UNIVERSITY OF PENNSYLVANIA P221 FRANKLIN BLDG PHILADELPHIA PA 19104 231352685 392538 RESEARCH - SUBAWARD UNIVERSITY OF PITTSBURGH UPMC HEALTH SYSTEM PITTSBURGH MA 152508007 250965591 214929 RESEARCH - SUBAWARD UNIVERSITY OF ROCHESTER ATTNAPRIL TIRABASSI ROCHESTER NY 14642 160743209 421861 RESEARCH - SUBAWARD UNIVERSITY OF TEXAS HEALTH SCIENCE CTR FINANCIAL ADMINSTRATIVE SUPPORT HOUSTON TX 772163382 741761309 20064 RESEARCH - SUBAWARD UNIVERSITY OF UTAH 50 N MEDICAL DRIVE SALT LAKE CITY UT 841321601 876000525 14286 RESEARCH - SUBAWARD UNIVERSITY OF WASHINGTON GRANT CONTRACT ACCOUNTING CHICAGO IL 60693 916001537 789838 RESEARCH - SUBAWARD UNIVERSITY OF WISCONSIN DEPT OF PATHOLOGY LABORATORY MEDICINE MADISON WI 537061532 396006492 44188 RESEARCH - SUBAWARD VGTI FLORIDA CORP 11350 SW VILLAGE PARKWAY3RD FLOOR PORT ST LUCIE FL 34987 364631835 206716 RESEARCH - SUBAWARD WAKE FOREST UNIVERSITY HEALTH SCIENCES OFFICE OF RESEARCH IRB OFFICE WINSTONSALEM NC 27157 223849199 14635 RESEARCH - SUBAWARD WASHINGTON UNIVERSITY ACCT PAYABLE DEPT BOX 1056 ST LOUIS MO 631121408 430653611 9437 RESEARCH - SUBAWARD WOMEN & INFANTS HOSPITAL OF RHODE ISLAND 101 DUDLEY ST PROVIDENCE RI 02905 050258937 13500 RESEARCH - SUBAWARD WEILL CORNELL MEDICAL COLLEGE DEPT OF PATHOLOGY LAB MEDICINE NEW YORK NY 10021 131623978 501(C) (3) 104995 RESEARCH - SUBAWARD WINTHROP UNIVERSITY HOSPITAL 259 FIRST STREET MINEOLA NY 11501 111633486 45095 RESEARCH - SUBAWARD YALE UNIVERSITY OFFICE OF CORPORATE RESEARCH NEW HAVEN CT 06511 060646973 501(C) (3) 44013 RESEARCH - SUBAWARD YALE UNIVERSITY SCHOOL OF MEDICINE TREASUREY OPERATIONS PO BOX 208087 NEW HAVEN CT 065208087 060646973 15969 RESEARCH - SUBAWARD ON DIAGNOSTICS LLC 2150 SHATTUCK AVE STE 610 BERKELEY CA 94704 159249 RESEARCH - SUBAWARD COVANCE INC 150 4TH AVE N STE 600 NASHVILLE TN 37219 223265977 18607 RESEARCH - SUBAWARD FORSYTH INSTITUTE C/O THOMAS J MCQUAID CAMBRIDGE MA 02142 042104230 501(C) (3) 16981 RESEARCH - SUBAWARD GEORGIA STATE UNIV RESEARCH FOUNDATION OFF OF LEGAL AFFAIRS- GWEN SPRATT ASSISTANT LEGAL ADVIS ATLANTA GA 30302 581845423 17730 RESEARCH - SUBAWARD HARTFORD HOSPITAL CLINICAL RESEARCH CENTER HARTFORD CT 061025037 060646668 501(C) (3) 12024 RESEARCH - SUBAWARD INDIANA UNIVERSITY PO BOX 66271 INDIANAPOLIS IN 462666271 356018940 11544 RESEARCH - SUBAWARD LAWRENCE GENERAL HOSPITAL 1 GENERAL ST PO BOX 189 LAWRENCE MA 01841 042103586 501(C) (3) 212720 RESEARCH - SUBAWARD LEIDOS BIOMEDICAL RESEARCH INC 1050 BOYLES STREET FREDERICK MD 21702 371611326 247094 RESEARCH - SUBAWARD PHASE V TECHNOLOGIES INC 20 WALNUT STREET WELLESLEY HILLS MA 024814407 042976455 8177 RESEARCH - SUBAWARD EASTERN VIRGINIA MEDICAL SCHOOL OFFICE OF GRANTS ACCOUNTING NORFOLK VA 23507 546055378 12433 RESEARCH - SUBAWARD COMMUNITY CARE ALLIANCE 330 BROOKLINE AVE BOSTON MA 02215 501(C) (3) 67000 PRIMARY CARE/HEALTHCARE ACCESS DIMOCK COMMUNITY HEALTH CENTER 55 DIMOCK STREET ROXBURY MA 02119 501(C) (3) 523125 PRIMARY CARE/HEALTHCARE ACCESS FENWAYSIDNEY BORUM COMMUNITY HEALTH CENTER 55 DIMOCK STREET ROXBURY MA 02119 501(C) (3) 704000 10000 TECHNOLOGY SUPPORT PRIMARY CARE/HEALTHCARE ACCESS HARVARD MEDICAL SCHOOL 25 SHATTUCK ST BOSTON MA 02215 501(C) (3) MEDICAL EDUCATION AND RESEARCH SUPPORT LOUIS DBROWN INST 15 CHRISTOPHER ST DORCHESTER MA 02122 501(C) (3) 5000 SUPPORT OF VIOLENCE PREVENTION SHAPIRO INSTITUTE FOR EDUCATION RESEARCH AT HARVARD MEDICAL SCHOOL - BIDMC 330 BROOKLINE AVENUE ES-200 BOSTON MA 02215 501(C) (3) 170744 SPACE & STAFF SUPPORT SUPPORT EDUCATION ACTIVITIES OF THE INST. THE FOOD PROJECT 10 LEWIS ST LINCOLN MA 01773 501(C) (3) 10000 SUPPORT HEALTHY FOOD FOR BOSTON RESIDENTS JOSEPH SMITH PRIMARY CARE 287 WESTERN AVE ALLSTON MA 02134 501(C) (3) 402980 PRIMARY CARE/HEALTHCARE ACCESS KIT CLARK COMMUNITY HEALTH CENTER 66 CANAL STREET BOSTON MA 02214 501(C) (3) 45000 SENIOR SERVICES COORDINATION SUPPORT OUTER CAPE PRIMARY CARE 3073 STATE HIGHWAY RTE 6 WELLFLEET MA 02653 501(C) (3) 122000 PRIMARY CARE/HEALTHCARE ACCESS COMMONWEALTH OF MASSACHUSETTS PO BOX 416936 BOSTON MA 02241 STATEWIDE HOSPITAL SUPPORT AIDS ACTION COMMITTEE OF MA 75 AMORY ST BOSTON MA 02119 501(C) (3) 7500 SUPPORT LOCAL ACTIVITIES OF AAC ALBERT SCHWERTER FELLOWSHIP 109 BROOKLINE AVE BOSTON MA 02215 501(C) (3) 10000 92640 SPACE SUPPORT ASF AMERICAN FOUNDATION FOR SUICIDE PREVENTION 120 WALL STREET 29TH FLOOR NEW YORK NY 10005 5000 324 STAFF SUPPORT SUICIDE PREVENTION DAILY TABLE 450 WASHINGTON ST DORCHESTER MA 02124 501(C) (3) 10000 PROVIDE FOOD FOR THOSE IN NEED 42 89 PART I, LINE 2: AS PREVIOUSLY DENOTED IN GREATER DETAIL IN THIS FORM 990, SCHEDULE H, HOSPITALS, WHICH DESCRIBES THE MEDICAL CENTER'S COMMITMENT TO ITS COMMUNITY, THE MEDICAL CENTER PARTNERS WITH COMMUNITY LEADERS AND COMMUNITY-BASED ORGANIZATIONS. THESE ORGANIZATIONS SERVE AS LINKS TO THE COMMUNITY AND TEACHERS OF HOW WE CAN BETTER SERVE THE POPULATIONS THEY REPRESENT. IN ADDITION, THE MEDICAL CENTER COLLABORATES WITH A WIDE VARIETY OF ORGANIZATIONS BECAUSE HEALTHCARE SERVICES BY THEMSELVES ARE NOT ADEQUATE TO MAXIMIZE IMPROVEMENT OF HEALTH STATUS. AS SUCH, THE MEDICAL CENTER'S INVOLVEMENT WITH OUR COMMUNITY IS ON-GOING AND PART OF THAT ON-GOING RELATIONSHIP INCLUDES REPORTING ON HOW GRANT FUNDS ARE EXPENDED. AS A RECIPIENT OF FEDERAL SPONSORED AWARDS, THE MEDICAL CENTER MUST COMPLY WITH THE GUIDELINES SPECIFIC TO THE FEDERAL AWARDING AGENCY FOR THE PARTICULAR PROGRAM. THE MEDICAL CENTER'S ADHERENCE TO THESE PROGRAMS REQUIREMENTS ARE AUDITED ANNUALLY AS REQUIRED BY OMB CIRCULAR A-133. THE MEDICAL CENTER IS REQUIRED BY FEDERAL REGULATION TO MONITOR EXPENSES OF FEDERAL FUNDS AWARDED TO THE MEDICAL CENTER THAT ARE SUB-CONTRACTED TO ANOTHER INSTITUTION, ORGANIZATION, OR INDIVIDUAL. FEDERAL SUBCONTRACTED RESEARCH GRANTS AS WELL AS OTHER SUBCONTRACTED RESEARCH GRANTS ARE MONITORED BY THE CLINICAL DEPARTMENT SPONSORING THE ACTIVITY. SIMILAR MONITORING PROGRAMS ARE IN PLACE THAT ASSURE ADHERENCE TO ALL NON-FEDERAL SPONSOR'S GRANT REQUIREMENTS AS WELL THROUGH A GROUP OF DEDICATED RESEARCH ADMINISTRATIVE PROFESSIONAL THAT REPORTS UP THROUGH THE OFFICE OF ACADEMIC AFFAIRS. THIS REPORTING STRUCTURE FURTHER ENHANCES INTERNAL CONTROLS. THE SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH IS AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED AND A SUPPORT ORGANIZATION OF THE MEDICAL CENTER. THE MEDICAL CENTER'S DEPARTMENTS OF FISCAL SERVICES AND MEDICAL EDUCATION MANAGEMENT MONITOR PERIODIC SPENDING REPORTS SENT BY THE SHAPIRO INSTITUTE FOR REVIEW AND APPROVAL. X 1 1 X X X X 1 1 0 0 0 0 0 1 1 1 CHAIKOF MD PHD ELLIOT DIR(EX-OFF) & SURG CHIEF 477557 477557 0 0 7784 7784 37764 37763 17323 17323 540428 540427 0 0 ROSENBERG MD STUART DIR & CEO-HMFP 0 669059 0 213612 0 19592 0 48750 0 18694 0 969707 0 0 TABB MD KEVIN PRESIDENT & CEO 967341 0 417000 0 68853 0 13000 0 40346 0 1506540 0 0 0 ZEIDEL MD MARK L DIR(EX-OFF) & CHIEF, MED 359745 359745 0 0 6076 6075 22473 22472 9494 9495 397788 397787 0 0 FISCHER STEVEN SR. VP - FINANCE & CFO 512851 0 160938 0 52503 0 13000 0 48346 0 787638 0 0 0 FORMELLA RN MSN NANCY CHIEF OPERATING OFFICER 591393 0 222813 0 70690 0 13000 0 18260 0 916156 0 0 0 ARMSTRONG WALTER SVP FACILITIES & ENG 324216 0 101563 0 43657 0 13000 0 22544 0 504980 0 0 0 BIEBER JUDITH SVP - HR 323324 0 67188 0 38620 0 22460 0 39248 0 490840 0 0 0 MAURER RN MSN MARSHA SVP-PAT CARE & CNO 397494 0 125000 0 50591 0 15330 0 40182 0 628597 0 0 0 SHEEHAN RN MSN JAYNE SVP AMBUL & EMERG SVCS 326563 0 100000 0 41857 0 18250 0 22948 0 509618 0 0 0 SUKHATME MD SCD VIKAS P SVP & CHIEF ACADEMIC OFFICER 459752 41478 117970 10258 12936 1125 34537 3003 15349 1335 640544 57199 0 0 GEBHARDT MD MARK C CHIEF OF ORTHO SURGERY 372956 372956 0 0 9428 9427 30995 30995 10383 10383 423762 423761 0 0 KRUSKAL MD PHD JONATHAN B CHIEF OF RADIOLOGY 338000 338000 0 0 5652 5652 15600 15600 14991 14991 374243 374243 0 0 STEVENSON MD PHD MARY ANN CHIEF, RAD ONCOLOGY 316734 316734 0 0 5690 5691 24375 24375 15241 15241 362040 362041 0 0 STERN MD ROBERT S CHIEF OF DERMATOLOGY 299820 299820 0 0 12323 12322 31398 31397 11633 11633 355174 355172 0 0 LEWIS MD STANLEY SVP, NETWORK INTEGRATION 441045 49005 137827 15314 11658 1295 25740 2860 16825 1869 633095 70343 0 0 ZANKMAN LISA FORMER VP, HR 0 0 0 0 160961 0 0 0 0 0 160961 0 0 0 PART I, LINE 1A SCHEDULE J - PART I QUESTION 1 GROSS-UP PAYMENTS AS NOTED BELOW IN THE EXPLANATORY NOTES TO THIS FORM 990, SCHEDULE J - PART I QUESTION 4B, THE MEDICAL CENTER IS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER, INC. ANNUITY RETIREMENT PLAN. INDIVIDUALS WHO QUALIFY AS PARTICIPANTS IN THIS PLAN, RECEIVE CURRENTLY TAXABLE INCOME, A PORTION OF WHICH IS DEFINED AS A GROSS-UP PAYMENT PURSUANT TO THE PLAN DOCUMENT. PART I, LINES 4A-B SCHEDULE J - PART I QUESTION 4A SEVERANCE AND CHANGE OF CONTROL PAYMENTS AS NOTED IN THIS FILING, LISA ZANKMAN RETIRED FROM HER POSITION AS SENIOR VICE PRESIDENT OF HUMAN RESOURCES ON JUNE 30, 2013 AND MS. ZANKMAN BECAME ELIGIBLE FOR CERTAIN SALARY CONTINUATION PAYMENTS ON LEAVING BIDMC AS NOTED IN MORE DETAIL IN THE DISCLOSURES BELOW. SCHEDULE J - PART I QUESTION 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REQUIRED BY THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, THE COMPENSATION DETAIL INCLUDED IN THE MEDICAL CENTER'S FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2015 IS CALENDAR YEAR 2014 DETAIL. DURING THE 2014 CALENDAR YEAR, THE MEDICAL CENTER WAS A PARTICIPATING EMPLOYER IN THE BETH ISRAEL DEACONESS MEDICAL CENTER, INC. ANNUITY RETIREMENT PLAN WHICH, UNDER THE DEFINITIONS TO THIS FORM 990, IS CONSIDERED A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. PARTICIPANTS RECEIVED BOTH CURRENTLY TAXABLE AND DEFERRED BENEFITS FROM THIS PLAN. AS PREVIOUSLY NOTED, THE CURRENTLY TAXABLE PORTION OF BENEFITS INCLUDES A GROSS-UP PURSUANT TO THE PLAN DESIGN. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. THE MEDICAL CENTER ALSO MAINTAINS AN IRC SEC. 457 PLAN PURSUANT TO WHICH ELIGIBLE EMPLOYEES CAN DEFER PART OF THEIR COMPENSATION. THIS PLAN IS STRICTLY EMPLOYEE FUNDED WITH NO EMPLOYER DEFERRALS. UNDER THE DEFINITIONS TO THIS FORM 990, THIS PLAN IS CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. AMOUNTS DEFERRED BY PARTICIPANTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION, IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. PART I, LINE 7 SCHEDULE J PART I QUESTION 7 NON-FIXED PAYMENTS THE MEDICAL CENTER'S EXECUTIVE COMPENSATION PACKAGES INCLUDE OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF MEETING OR EXCEEDING THE MEDICAL CENTER'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, THE MEDICAL CENTER'S BUDGETED CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. THE INCENTIVE COMPENSATION FOR EACH EXECUTIVE IS REVIEWED AND APPROVED BY THE MEDICAL CENTER'S COMPENSATION COMMITTEE, WHICH AS PREVIOUSLY NOTED, IS FULLY STAFFED BY INDEPENDENT MEMBERS. PART I, LINE 8 SCHEDULE J -PART I QUESTION 8 INITIAL CONTRACT EXCEPTION AS NOTED IN THIS FILING, DR. KEVIN TABB COMMENCED HIS POSITION AS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE MEDICAL CENTER DURING THE 2011 CALENDAR YEAR. ALL AMOUNTS PAID TO DR. TABB DURING THE CALENDAR YEAR 2014 AND REPORTED IN THIS FORM 990 WERE PAID PURSUANT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN TREASURY REGULATIONS SECTION 53.4958-4(A)(3) AND BIDMC FOLLOWED THE REBUTTABLE PRESUMPTION PROCEDURES DESCRIBED IN TREASURY REGULATIONS SECTION 53.4958-6(C) IN SETTING DR. TABB'S COMPENSATION. SCHEDULE J ADDITIONAL EXPLANATORY FOOTNOTES: 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. REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: AMOUNTS DEFERRED BY THE EMPLOYEE (PLUS EARNINGS) UNDER FULLY VESTED 457(B) PLAN; INCREASE/DECREASE IN VALUE OF NONQUALIFIED FULLY VESTED 457(B) PLAN; TAXABLE EMPLOYER-SUBSIDIZED PARKING; TAXABLE MOVING EXPENSES; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE; AND 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 NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE AMOUNTS FROM ONE OR MORE OF THE 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, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES BETH ISRAEL DEACONESS MEDICAL CENTER AND 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 BIDMC AND HMFP RESPECTIVELY. IN ADDITION, THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL MAY BE REFERRED TO AS PFHC, HMS OR PFHC/HMS. BRADY, MICHAEL J. DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR AND BOARD CHAIR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR AND BOARD CHAIR - MILTON HOSPITAL FOUNDATION DIRECTOR - COMMUNITY PHYSICIANS ASSOCIATES MR. BRADY DEVOTES, ON AVERAGE, A COMBINED 12 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. CHAIKOF, M.D., PHD, ELLIOT DIRECTOR (EX-OFFICIO) AND CHIEF (SURGERY) - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (SURGERY) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND PRESIDENT - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION TRUSTEE - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. JOHNSON & JOHNSON PROFESSOR OF SURGERY - HARVARD MEDICAL SCHOOL DR. CHAIKOF DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. CHAIKOF PERFORMS SERVICES FOR BOTH HMFP AND BIDMC. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. CHAIKOF IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. CHAIKOF'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 477,557 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,784 DEFERRED COMPENSATION: 37,763 NON-TAXABLE BENEFITS: 17,323 PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 477,557 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 7,784 DEFERRED COMPENSATION: 37,764 NON-TAXABLE BENEFITS: 17,323 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2014 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. CHAIKOF'S POSITION AS CHIEF OF SURGERY AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF SURGERY AND JOHNSON & JOHNSON PROFESSOR OF SURGERY, HARVARD MEDICAL SCHOOL: $214,774 BASE AND OTHER REPORTABLE COMPENSATION, $26,777 DEFERRED COMPENSATION AND $4,186 NON-TAXABLE BENEFITS. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) CHENG, JILL DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MS. CHENG'S TERM ON THE BIDMC BOARD BEGAN OCTOBER 1, 2014. MS. CHENG DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. CRONIN, MICHAEL DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. CRONIN DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. CUTLER, JOEL DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. CUTLER DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. DESIMONE, THOMAS DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. DESIMONE'S TERM ON THE BIDMC BOARD BEGAN OCTOBER 1, 2014. MR. DESIMONE DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. DIPP, MD, PHD, MICHELLE DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER DR. DIPP'S TERM ON THE BIDMC BOARD BEGAN OCTOBER 1, 2014. DR. DIPP DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. HINKLEY, CLARK DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR, CHAIR - BETH ISRAEL DEACONESS HOSPITAL -- PLYMOUTH DIRECTOR, CHAIR - JORDAN PHYSICIAN ASSOCIATES DIRECTOR, CHAIR - JORDAN HEALTH SYSTEM, INC MR. HINKLEY'S TERM ON THE BIDMC BOARD BEGAN OCTOBER 1, 2014. MR. HINKLEY DEVOTES, ON AVERAGE, A COMBINED 12 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. JICK, DANIEL J. DIRECTOR AND BOARD CHAIR - BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR (EX-OFFICIO) - CAREGROUP MR. JICK DEVOTES, ON AVERAGE, A COMBINED 16 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. JOHNSTON, WILLIAM DIRECTOR AND TREASURER - BETH ISRAEL DEACONESS MEDICAL CENTER MR. JOHNSTON DEVOTES, ON AVERAGE, 2 HOURS PER WEEK TO THE REPORTING ORGANIZATION. KAY, STEPHEN B. DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER MR. KAY'S POSITION ON THE BOARD ENDED ON SEPTEMBER 30, 2015. DURING THE PERIOD COVERED BY THIS FILING HE DEVOTED, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. LADD, EDWARD DIRECTOR AND VICE CHAIR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. LADD DEVOTES, ON AVERAGE, 5 HOURS PER WEEK TO THE REPORTING ORGANIZATION. LAMERE, DAVID DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. LAMERE DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. LEPOFSKY, ROBERT J. DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. LEPOFSKY DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. LINDE, DOUGLAS T. DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. LINDE DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. MACDOWELL, VIRGINIA DIRECTOR AND CLERK - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR - MEDICAL CARE OF BOSTON MANAGEMENT CORP. D/B/A AFFILIATED PHYSICIANS GROUP MS. MACDOWELL SERVED IN HER ROLES AS BIDMC DIRECTOR AND CLERK THROUGH SEPTEMBER 30, 2015 AND DEVOTED, ON AVERAGE, A COMBINED 3 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) MANDELL, M.D., JAMES DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER DR. MANDELL DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. MCKENNA, MARGARET DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MS. MCKENNA DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. O'HANLEY, RONALD DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. O'HANLEY DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. PLINE, JENNIFER DIRECTOR (EX-OFFICIO), BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE AND BOARD CHAIR - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM MS. PLINE'S TERM ON BIDMC'S BOARD BEGAN OCTOBER 1, 2014. MS. PLINE DEVOTES, ON AVERAGE, A COMBINED 12 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. ROSENBERG, M.D., STUART A DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT, CHIEF EXECUTIVE OFFICER AND DIRECTOR (EX-OFFICIO) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - LONGWOOD MEDICAL INTERNATIONAL FOUNDATION, INC. DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION DIRECTOR (EX-OFFICIO) - CONTINUING EDUCATION PROGRAM, INC. D/B/A BETH ISRAEL DEACONESS DEPARTMENT OF PSYCHIATRY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORP., D/B/A AFFILIATED PHYSICIANS GROUP DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON TRUSTEE - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. SENIOR LECTURER ON MEDICINE - HARVARD MEDICAL SCHOOL DR. ROSENBERG DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 668,059 INCENTIVE COMPENSATION: 213,612 OTHER REPORTABLE COMPENSATION: 19,592 DEFERRED COMPENSATION: 48,750 NON-TAXABLE BENEFITS: 18,694 INCENTIVE COMPENSATION REPORTED FOR THE 2014 CALENDAR YEAR INCLUDES A PAYMENT IN THE AMOUNT OF $80,000 PURSUANT TO A RETENTION INCENTIVE PLAN ESTABLISHED BY HMFP'S BOARD OF DIRECTORS IN 2012. AS REQUIRED BY THIS FORM 990, THIS INCENTIVE PAYMENT WAS REPORTED AS DEFERRED COMPENSATION IN THE 2012 FORM 990. PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 1,000 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 ROTTENBERG, ALAN DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MR. ROTTENBERG DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. SILVER, JENNIFER DIRECTOR - BETH ISRAEL DEACONESS MEDICAL CENTER MS. SILVER'S TERM ON THE BIDMC BOARD BEGAN OCTOBER 1, 2014. MS. SILVER DEVOTES, ON AVERAGE, 1 HOUR PER WEEK TO THE REPORTING ORGANIZATION. TABB, M.D., KEVIN DIRECTOR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON 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 DR. TABB DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 967,341 INCENTIVE COMPENSATION: 417,000 OTHER REPORTABLE COMPENSATION: 68,853 DEFERRED COMPENSATION: 13,000 NON-TAXABLE BENEFITS: 40,346 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $61,750. ZEIDEL, M.D. MARK L. DIRECTOR (EX-OFFICIO) AND CHIEF (MEDICINE) - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (MEDICINE) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP DIRECTOR - LONGWOOD MEDICAL INTERNATIONAL FOUNDATION PRESIDENT AND DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPT. OF MEDICINE FOUNDATION (BIDDM) TRUSTEE - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. ZEIDEL DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. ZEIDEL PERFORMS SERVICES FOR BOTH HMFP AND BIDMC. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. ZEIDEL IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. ZEIDEL'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 359,745 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,076 DEFERRED COMPENSATION: 22,473 NON-TAXABLE BENEFITS: 9,494 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 359,745 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 6,075 DEFERRED COMPENSATION: 22,472 NON-TAXABLE BENEFITS: 9,495 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY HMFP AND BIDMC FOR THE 2014 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. ZEIDEL'S POSITION AS CHIEF OF MEDICINE AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF MEDICINE AND HERMAN LUDWIG BLUMGART PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: $147,463 BASE AND OTHER REPORTABLE COMPENSATION, $16,345 DEFERRED COMPENSATION AND $1,836 NON-TAXABLE BENEFITS. FISCHER, STEVEN SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MR. FISCHER DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 512,851 INCENTIVE COMPENSATION: 160,938 OTHER REPORTABLE COMPENSATION: 52,503 DEFERRED COMPENSATION: 13,000 NON-TAXABLE BENEFITS: 48,346 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. FISCHER INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $61,750. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) FORMELLA, R.N., M.S.N,, NANCY CHIEF OPERATING OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. MS. FORMELLA DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 591,393 INCENTIVE COMPENSATION: 222,813 OTHER REPORTABLE COMPENSATION: 70,690 DEFERRED COMPENSATION: 13,000 NON-TAXABLE BENEFITS: 18,260 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. FORMELLA INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $61,750. ARMSTRONG, WALTER SENIOR VICE PRESIDENT, CAPITAL FACILITIES AND ENGINEERING - BETH ISRAEL DEACONESS MEDICAL CENTER MR. ARMSTRONG DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 324,216 INCENTIVE COMPENSATION: 101,563 OTHER REPORTABLE COMPENSATION: 43,657 DEFERRED COMPENSATION: 13,000 NON-TAXABLE BENEFITS: 22,544 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MR. ARMSTRONG INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $54,438. BIEBER, JUDITH SENIOR VICE PRESIDENT OF HUMAN RESOURCES - BETH ISRAEL DEACONESS MEDICAL CENTER MS. BIEBER DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 323,324 INCENTIVE COMPENSATION: 67,188 OTHER REPORTABLE COMPENSATION: 38,620 DEFERRED COMPENSATION: 22,460 NON-TAXABLE BENEFITS: 39,248 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. BIEBER INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $49,438. MAURER, R.N., M.S.N., MARSHA CHIEF NURSING OFFICER, SENIOR VICE PRESIDENT OF PATIENT CARE SERVICES - BETH ISRAEL DEACONESS MEDICAL CENTER MS. MAURER DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 397,494 INCENTIVE COMPENSATION: 125,000 OTHER REPORTABLE COMPENSATION: 50,591 DEFERRED COMPENSATION: 15,330 NON-TAXABLE BENEFITS: 40,182 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. MAURER INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $61,750. SHEEHAN, R.N., M.S.N, JAYNE SENIOR VICE PRESIDENT, AMBULATORY AND EMERGENCY SERVICES AND SYSTEMS CLINICAL INTEGRATION - BETH ISRAEL DEACONESS MEDICAL CENTER MS. SHEEHAN DEVOTES, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 326,563 INCENTIVE COMPENSATION: 100,000 OTHER REPORTABLE COMPENSATION: 41,857 DEFERRED COMPENSATION: 18,250 NON-TAXABLE BENEFITS: 22,948 OTHER REPORTABLE AND DEFERRED COMPENSATION FOR MS. SHEEHAN INCLUDES COMBINED PAYMENTS FROM A NONQUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $53,437. SUKHATME, M.D., SC.D., VIKAS P. SENIOR VICE PRESIDENT AND CHIEF ACADEMIC OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER NEPHROLOGIST - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. VICTOR J. ARESTY PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. SUKHATME DEVOTES, ON AVERAGE, A COMBINED 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. SUKHATME PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. SUKHATME IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. SUKHATME'S COMPENSATION ATTRIBUTABLE TO HIS SERVICES PERFORMED AT BIDMC HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 459,752 INCENTIVE COMPENSATION: 117,970 OTHER REPORTABLE COMPENSATION: 12,936 DEFERRED COMPENSATION: 34,537 NON-TAXABLE BENEFITS: 15,349 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 39,978 INCENTIVE COMPENSATION: 10,258 OTHER REPORTABLE COMPENSATION: 1,125 DEFERRED COMPENSATION: 3,003 NON-TAXABLE BENEFITS: 1,335 PAYMENTS REPORTED BY SHAPIRO INSTITUTE: BASE COMPENSATION: 1,500 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 0 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 AS REQUIRED BY THIS FORM 990, COMPENSATION REPORTED BY BIDMC AND HMFP FOR THE 2014 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. SUKHATME'S POSITION AS VICTOR J. ARESTY PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: $89,402 BASE AND OTHER REPORTABLE COMPENSATION, $8,940 DEFERRED COMPENSATION AND $140 NON-TAXABLE BENEFITS. GEBHARDT, M.D., MARK C. CHIEF OF ORTHOPAEDIC SURGERY - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO), BOARD CHAIR AND CHAIR, DEPARTMENT OF ORTHOPAEDIC SURGERY - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) - CAREGROUP, INC. DIRECTOR - LONGWOOD MEDICAL INTERNATIONAL FOUNDATION, INC. DIRECTOR (EX-OFFICIO) AND PRESIDENT - BETH ISRAEL DEACONESS ORTHOPAEDIC SURGERY FOUNDATION FREDERIC W. & JANE M. ILFELD PROFESSOR OF ORTHOPAEDIC SURGERY - HARVARD MEDICAL SCHOOL DR. GEBHARDT DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. GEBHARDT PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. GEBHARDT IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. GEBHARDT'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 372,956 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 9,428 DEFERRED COMPENSATION: 30,995 NON-TAXABLE BENEFITS: 10,383 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 372,956 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 9,427 DEFERRED COMPENSATION: 30,995 NON-TAXABLE BENEFITS: 10,383 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY BIDMC AND HMFP FOR THE 2014 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. GEBHARDT'S POSITION AS CHIEF OF ORTHOPAEDIC SURGERY AT BIDMC, CHAIR OF THE HMFP DEPARTMENT OF ORTHOPAEDIC SURGERY AND FREDERIC W. & JAMES M. ILFELD PROFESSOR OF ORTHOPAEDIC SURGERY, HARVARD MEDICAL SCHOOL: $92,866 BASE AND OTHER REPORTABLE COMPENSATION, $9,990 DEFERRED COMPENSATION AND $20,526 NON-TAXABLE BENEFITS. SCHEDULE J EXPLANATORY FOOTNOTES (CONTINUED) KRUSKAL, M.D., PHD, JONATHAN B. CHIEF OF RADIOLOGY - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR (RADIOLOGY) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - BIH RADIOLOGIC FOUNDATION PROFESSOR OF RADIOLOGY - HARVARD MEDICAL SCHOOL DR. KRUSKAL DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. KRUSKAL PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. KRUSKAL IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. KRUSKAL'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 338,000 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,652 DEFERRED COMPENSATION: 15,600 NON-TAXABLE BENEFITS: 14,991 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 338,000 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,652 DEFERRED COMPENSATION: 15,600 NON-TAXABLE BENEFITS: 14,991 STEVENSON, M.D., PHD, MARY ANN CHIEF, RADIATION ONCOLOGY -BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR, SECRETARY/CLERK AND CHAIR, RADIATION ONCOLOGY - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER TRUSTEE - CARL J. SHAPIRO INSTITUTE FOR EDUCATION & RESEARCH AT HARVARD MEDICAL SCHOOL & BETH ISRAEL DEACONESS MEDICAL CENTER, INC. ASSOCIATE PROFESSOR OF RADIATION ONCOLOGY - HARVARD MEDICAL SCHOOL DR. STEVENSON PERFORMS SERVICES FOR BOTH HMFP AND BIDMC AND DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. STEVENSON IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. STEVENSON'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS ALLOCATED TO BIDMC: BASE COMPENSATION: 316,734 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,690 DEFERRED COMPENSATION: 24,375 NON-TAXABLE BENEFITS: 15,241 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 316,734 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 5,691 DEFERRED COMPENSATION: 24,375 NON-TAXABLE BENEFITS: 15,241 STERN, M.D., ROBERT S, CHIEF OF DERMATOLOGY - BETH ISRAEL DEACONESS MEDICAL CENTER DIRECTOR (EX-OFFICIO) AND CHAIR OF DERMATOLOGY - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER PRESIDENT AND DIRECTOR (EX-OFFICIO) - BETH ISRAEL DERMATOLOGY FOUNDATION CARL J. HERZOG PROFESSOR OF DERMATOLOGY - HARVARD MEDICAL SCHOOL DR. STERN DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. STERN PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY THIS FORM 990, ALTHOUGH DR. SIMON IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. SIMON'S COMPENSATION ATTRIBUTABLE TO EACH POSITION HAS BEEN SEPARATELY REPORTED ON THIS FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 299,820 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 12,323 DEFERRED COMPENSATION: 31,398 NON-TAXABLE BENEFITS: 11,633 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 299,820 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 12,322 DEFERRED COMPENSATION: 31,397 NON-TAXABLE BENEFITS: 11,633 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED BY BIDMC AND HMFP FOR THE 2014 CALENDAR YEAR INCLUDES THE FOLLOWING PAYMENTS FROM THE PRESIDENT AND FELLOWS OF HARVARD COLLEGE/HARVARD MEDICAL SCHOOL RELATED TO DR. STERN'S POSITION AS CHIEF OF DERMATOLOGY AT BIDMC, CHAIR OF DERMATOLOGY AT HMFP AND THE CARL J. HERZOG PROFESSOR OF DERMATOLOGY, HARVARD MEDICAL SCHOOL: $100,922 BASE AND OTHER REPORTABLE COMPENSATION, $10,795 DEFERRED COMPENSATION, AND $20,526 NON-TAXABLE BENEFITS. LEWIS, M.D., STANLEY SENIOR VICE PRESIDENT, NETWORK INTEGRATION - BETH ISRAEL DEACONESS MEDICAL CENTER CARDIOLOGIST - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. DIRECTOR (EX-OFFICIO) - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A AFFILIATED PHYSICIANS GROUP TRUSTEE - BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - MILTON DIRECTOR - BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH DIRECTOR - JORDAN HEALTH SYSTEMS, INC. ASSOCIATE PROFESSOR OF MEDICINE - HARVARD MEDICAL SCHOOL DR. LEWIS DEVOTES, ON AVERAGE, A COMBINED 65 HOURS PER WEEK TO THE REPORTING ORGANIZATION AND ALL RELATED ENTITIES FOR THE POSITIONS LISTED HERE. DR. LEWIS PERFORMS SERVICES FOR BOTH BIDMC AND HMFP. AS REQUIRED BY FORM 990, ALTHOUGH DR. LEWIS IS PAID DIRECTLY BY HMFP, THE PORTION OF DR. LEWIS' COMPENSATION ATTRIBUTABLE TO HIS SERVICES PERFORMED AT BIDMC HAS BEEN SEPARATELY REPORTED ON FORM 990, AS FURTHER OUTLINED BELOW. PAYMENTS REPORTED BY BIDMC: BASE COMPENSATION: 441,045 INCENTIVE COMPENSATION: 137,827 OTHER REPORTABLE COMPENSATION: 11,658 DEFERRED COMPENSATION: 25,740 NON-TAXABLE BENEFITS: 16,825 PAYMENTS REPORTED BY HMFP: BASE COMPENSATION: 49,005 INCENTIVE COMPENSATION: 15,314 OTHER REPORTABLE COMPENSATION: 1,295 DEFERRED COMPENSATION: 2,860 NON-TAXABLE BENEFITS: 1,869 ZANKMAN, LISA FORMER SENIOR VICE PRESIDENT, HUMAN RESOURCES - BETH ISRAEL DEACONESS MEDICAL CENTER MS. ZANKMAN RETIRED FROM HER ROLE AS SENIOR VICE PRESIDENT, HUMAN RESOURCES ON JUNE 30, 2013. PRIOR TO RETIREMENT, MS. ZANKMAN DEVOTED, ON AVERAGE, 60 HOURS PER WEEK TO THE REPORTING ORGANIZATION. PAYMENTS MADE BY BIDMC: BASE COMPENSATION: 0 INCENTIVE COMPENSATION: 0 OTHER REPORTABLE COMPENSATION: 160,961 DEFERRED COMPENSATION: 0 NON-TAXABLE BENEFITS: 0 OTHER REPORTABLE COMPENSATION FOR MS. ZANKMAN INCLUDES SALARY CONTINUATION PAYMENTS PAID IN THE AMOUNT OF $160,961 DURING THE CALENDAR YEAR 2014. A MASS DEVELOPMENT FINANCE AGENCY 043431814 57584XDH1 2015-09-02 203702204 SEE PART VI 0 0 0 B MASS DEVELOPMENT FINANCE AGENCY 043431814 2012-07-11 49910000 REFUND ISSUES DATED 2/11/1998 0 0 0 C MASS DEVELOPMENT FINANCE AGENCY 043431814 2011-09-15 120280000 REFUND ISSUES DATED 2/11/1998 0 0 0 D MASS HEALTH AND ED FACILITIES AUTHORITY 042456011 57586C3S2 2008-06-09 377527010 SEE PART VI 0 0 0 A 203702204 201353725 2348479 1 1 0 1 B 49910000 368094 49541906 1 0 1 1 C 40485000 120280000 290672 119989328 1 0 1 1 D 89715000 100675000 378911689 27356617 3929290 134556855 213068927 2011 1 0 1 1 A 0 1 1 1 0 0.00100 0.00200 0.00300 0 0 1 D 0 1 1 1 0 0.00100 0.00600 0.00700 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K - EXPLANATORY STATEMENT CAREGROUP, INC., (CAREGROUP) IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED THAT SERVES AS A SUPPORT ORGANIZATION OF BETH ISRAEL DEACONESS MEDICAL CENTER, BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, BETH ISRAEL DEACONESS HOSPITAL - MILTON, BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, MOUNT AUBURN HOSPITAL, NEW ENGLAND BAPTIST HOSPITAL AND THESE ENTITIES' PHYSICIAN GROUPS AND OTHER AFFILIATED ENTITIES. CAREGROUP'S PURPOSE IS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MAKE UP THE CAREGROUP SYSTEM. CAREGROUP AND SOME OF ITS AFFILIATES JOINTLY BORROW DEBT AS AN OBLIGATED GROUP. THE OBLIGATED GROUP MEMBERS ARE: CAREGROUP, BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS - NEEDHAM (BID-NEEDHAM), MOUNT AUBURN PROFESSIONAL SERVICES (MAPS), MEDICAL CARE OF BOSTON MANAGEMENT CORP D/B/A AFFILIATED PHYSICIANS GROUP (APG), BETH ISRAEL DEACONESS HOSPITAL - MILTON AND BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH. THE INFORMATION REPORTED ON SCHEDULE K FOR BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER) REFLECTS THE COMBINED CAREGROUP OBLIGATED GROUP DEBT ISSUED AFTER DECEMBER 31, 2002 WITH AN OUTSTANDING PRINCIPAL BALANCE IN EXCESS OF $100,000. SCHEDULE K, PART 1, COLUMN F - DESCRIPTION OF TAX-EXEMPT DEBT PURPOSE PURPOSES OF CAREGROUP SERIES H BONDS: -REFUNDING THE REMAINING PORTION OF THE OUTSTANDING PRINCIPAL BALANCE OF THE MILTON SERIES D BONDS, THE PLYMOUTH SERIES D BONDS, THE PLYMOUTH SERIES E BONDS, AND A PORTION OF THE CAREGROUP SERIES E BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED SEPTEMBER 2,2015 PURPOSES OF CAREGROUP SERIES G BONDS: -REFUNDING THE REMAINING PORTION OF THE OUTSTANDING PRINCIPAL BALANCE OF THE CAREGROUP SERIES A BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED JULY 1,2012 PURPOSES OF CAREGROUP SERIES F BONDS: -REFUNDING OF A PORTION OF THE OUTSTANDING PRINCIPAL BALANCE OF THE CAREGROUP SERIES A BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED SEPTEMBER 1, 2011 PURPOSES OF CAREGROUP SERIES E BONDS: -TO FINANCE OR REFINANCE VARIOUS RENOVATION AND CONSTRUCTION PROJECTS AND CAPITAL EQUIPMENT ACQUISITIONS FOR THE MEDICAL CENTER -TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR MAH'S NEW AND EXPANDED FACILITIES WITH APPROXIMATELY 250,000 SQUARE FEET OF NEW AND RENOVATED SPACE TO INCLUDE: A NEW SIX-STORY ACUTE CARE FACILITY TO SUPPORT ADDITIONAL CRITICAL CARE AND MEDICAL /SURGICAL BEDS, EXPANDED OPERATING ROOMS AND INTERVENTIONAL RADIOLOGY ROOMS AND A NEW PARKING GARAGE -TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR NEBH'S MASTER FACILITY PLAN, INCLUDING A NEW ATRIUM OF APPROXIMATELY 2,740 SQUARE FEET, A PRE-OPERATIVE AND POST ANESTHESIA UNIT OF APPROXIMATELY 14, 310 SQUARE FEET, CONSTRUCTION OF A CENTRAL STERILE SUPPLY AREA OF APPROXIMATELY 8,290 SQUARE FEET AND CONSTRUCTION OF NEW OPERATING ROOMS OF APPROXIMATELY 18,615 SQUARE FEET; -TO FINANCE OR REFINANCE CONSTRUCTION, RENOVATION, FURNISHING AND VARIOUS OTHER CAPITAL ACQUISITIONS FOR BID-NEEDHAM'S NEW AND EXPANDED FACILITIES INCLUDING AN APPROXIMATELY 59,000 SQUARE FOOT PROJECT ON TWO FLOORS TO RENOVATE AND EXPAND SERVICES IN THE EMERGENCY DEPARTMENT, INPATIENT UNITS, RADIOLOGY DEPARTMENT AND ASSOCIATED SUPPORT SERVICES; -TO REFINANCE $201,975,000 OF DEBT PREVIOUSLY ISSUED BY MEMBERS OF THE OBLIGATED GROUP, INCLUDING $138,075,000 OF THE CAREGROUP SERIES C BONDS DESCRIBED BELOW. PURPOSES OF CAREGROUP SERIES D BONDS: -REFUNDING OF THE OUTSTANDING PRINCIPAL BALANCE OF THE MAH SERIES B BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED JULY 13, 2004 PURPOSES OF CAREGROUP SERIES C BONDS: -REFUNDING OF THE OUTSTANDING PRINCIPAL BALANCE OF THE BETH ISRAEL HOSPITAL ASSOCIATION SERIES G BONDS BY CREATING AN IRREVOCABLE REFUNDING TRUST DATED JULY 13, 2004 SCHEDULE K PART II, COLUMN D, LINE 2 THE AMOUNT OF BONDS LEGALLY DEFEASED: THE 2015 ISSUE ADVANCE REFUNDED $100,675,000 OF THE 2008 ISSUE. THESE BONDS WILL BE CALLED BY JULY 1, 2018. SCHEDULE K PART II, COLUMN D, LINE 3 THE TOTAL PROCEEDS OF THE ISSUE EXCEED THE ISSUE PRICE DUE TO THE INVESTMENT EARNINGS ON THE PROJECT FUND. SCHEDULE K PART II, LINE 11 COLUMNS B, C AND D THE OTHER SPENT PROCEEDS ARE THE PROCEEDS USED TO REFUND PRIOR ISSUE(S). THE AMOUNTS ARE NOT LISTED ON LINE 6 BECAUSE THEY ARE NO LONGER IN ESCROW. COLUMN A THE OTHER SPENT PROCEEDS ARE THE PROCEEDS USED TO REFUND PRIOR ISSUE(S). THE AMOUNTS ARE NOT LISTED ON LINE 6 BECAUSE THEY ARE NO LONGER IN ESCROW. SCHEDULE K PART II, COLUMN C, LINE 11 OF THE PROCEEDS LISTED, $8,993,760 WERE USED FOR TERMINATION OF THE HEDGE AGREEMENT, WITH THE REMAINDER USED FOR REFUNDING PURPOSES OF THE ISSUE. SCHEDULE K PART III COLUMNS B AND C BOTH THE 2012 AND 2011 ISSUES ARE EXEMPT FROM COMPLETING PART III AS BOTH ISSUES WERE REFUNDINGS OF BONDS ISSUED PRIOR TO DECEMBER 31, 2002. COLUMNS A THE 2004 ISSUE IS EXEMPT FROM COMPLETING PART III BECAUSE IT REFUNDED BONDS ISSUED PRIOR TO DECEMBER 31, 2002. SCHEDULE K PART III QUESTIONS 2 AND 3: FACILITIES FINANCED WITH TAX-EXEMPT BONDS ARE PRIMARILY OCCUPIED BY CAREGROUP AND ITS AFFILIATED TAX-EXEMPT ENTITIES, INCLUDING BUT NOT LIMITED TO THE MEDICAL CENTER, BID-NEEDHAM, BID-PLYMOUTH, BID-MILTON, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, NEBH, NEW ENGLAND BAPTIST MEDICAL ASSOCIATES, MAH, MAPS AND APG. SOME FINANCED SPACE MAY CONTAIN LEASE ARRANGEMENTS, AND THE AFFILIATES WHICH OWN THE DEBT FINANCED SPACE MAY OPT TO ENGAGE A MANAGEMENT SERVICES COMPANY (I.E. CLEANING, PATIENT TRANSPORT, AND FOOD SERVICES) OR ENGAGE IN RESEARCH PURSUANT TO RESEARCH AGREEMENTS WITHIN TAX EXEMPT DEBT FINANCED SPACE. ANY SUCH AGREEMENTS IN PLACE AS OF SEPTEMBER 30, 2015 WERE REVIEWED TO ENSURE PROPER ACCOUNTING OF ANY PRIVATE USE GENERATED FROM SUCH ACTIVITIES. IN ADDITION, SUCH AGREEMENTS ARE GENERALLY REVIEWED BY INSIDE COUNSEL PRIOR TO FINALIZING. SCHEDULE K PART IV, LINE 2C COLUMN D, LINE 2C : AN ARBITRAGE REBATE CALCULATION WAS COMPLETED AS OF SEPTEMBER 30, 2015. SCHEDULE K PART IV, COLUMN D, LINE 4C AT THE TIME OF ISSUE, THE CAREGROUP OBLIGATED GROUP ENTERED INTO THREE FLOATING-TO-FIXED INTEREST RATE SWAPS, TWO OF WHICH HAD 21 YEAR MATURITY DATES AND THE THIRD HAD A 20 YEAR MATURITY. THESE HEDGES WERE TERMINATED IN 2008. A MASS HEALTH AND ED FACILITIES AUTHORITY 042456011 57586CDK8 2004-08-12 187125000 REFUND ISSUES DATED 9/23/92 & 11/9/94 0 0 0 A 157025000 187125000 1796643 7991727 177336630 1 0 1 1 A 0 0 1 0 1 1 CITI BANK 21.000000000000 0 1 0 0 1 A 1 E ROSENBERG FAMILY OF S. ROSENBERG 23923 SALARY - SEE SUPPLEMENTAL INFORMATION 0 K RAND FAMILY OF S. ROSENBERG 46026 SALARY - SEE SUPPLEMENTAL INFORMATION 0 DONOR #9 SUBSTANTIAL CONTRIBUTOR 115156 SURGICAL SUPPLIES 0 DONOR #58 SUBSTANTIAL CONTRIBUTOR 2959309 CONSTRUCTION 0 DONOR #299 SUBSTANTIAL CONTRIBUTOR 2068824 CONSULTING SERVICES 0 SCHEDULE L PART IV COL D, DESC. OF TRANSACTIONS INVOLVING INTERESTED PERSONS STUART A. ROSENBERG, M.D., IS A DIRECTOR (EX-OFFICIO) OF BIDMC AND PRESIDENT AND CEO OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP). DR. ROSENBERG'S DAUGHTER, ELIZABETH ROSENBERG, IS AN ULTRASOUND TECHNOLOGIST AT BIDMC. HER SALARY AND OTHER INCOME FOR THE CALENDAR YEAR 2014 INCLUDE:BASE COMPENSATION: 22,823INCENTIVE COMPENSATION: 0OTHER REPORTABLE COMPENSATION: 0DEFERRED COMPENSATION: 0NON-TAXABLE BENEFITS: 1,100 IN ADDITION, DR. ROSENBERG'S DAUGHTER KATHERINE RAND IS A NURSE AND IS ALSO EMPLOYED BY BIDMC. HER SALARY AND OTHER INCOME FOR THE CALENDAR YEAR 2014 INCLUDE:BASE COMPENSATION: 38,774INCENTIVE COMPENSATION: 0OTHER REPORTABLE COMPENSATION: 0DEFERRED COMPENSATION: 2,062NON-TAXABLE BENEFITS: 5,190 VARIOUS CURRENT AND FORMER OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES OF BIDMC MAY ALSO HOLD POSITIONS WITH OTHER ENTITIES WHICH MAKE CHARITABLE CONTRIBUTIONS TO BIDMC. SUCH CONTRIBUTIONS HAVE NOT BEEN INCLUDED IN THE DISCLOSURES ABOVE. BIDMC MAINTAINS AN ACCOUNTABLE BUSINESS EXPENSE REIMBURSEMENT PLAN. FROM TIME TO TIME, BIDMC 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 AT ARMS-LENGTH AND IN ACCORDANCE WITH THE BIDMC CONFLICT OF INTEREST POLICY. X 1 500 REPLACEMENT COST X 57 972815 STOCK MARKET QUOTE X FASHION ACCESS8 5 1990 COST/SELLING PRICE X ELECTRONIC 1 1880 REPLACEMENT COST X PIANO 1 600 REPLACEMENT COST 0 1 0 PART I, COLUMN (B): BIDMC REPORTS THE NUMBER OF EACH SEPARATE GIFT AS AN ITEM FOR PURPOSES OF REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART III, LINE 1 TO PROVIDE EXTRAORDINARY CARE, WHERE THE PATIENT COMES FIRST, SUPPORTED BY WORLD-CLASS EDUCATION AND RESEARCH. THE MISSION OF THE BETH ISRAEL DEACONESS MEDICAL CENTER (MEDICAL CENTER) IS TO SERVE OUR PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM AND THEIR FAMILIES. THE MEDICAL CENTER'S MISSION IS SUPPORTED BY ITS COMMITMENT TO PERSONALIZED, EXCELLENT CARE FOR ITS PATIENTS; A WORKFORCE COMMITTED TO INDIVIDUAL ACCOUNTABILITY, MUTUAL RESPECT AND COLLABORATION; AND A COMMITMENT TO MAINTAINING OUR FINANCIAL HEALTH. FORM 990, PART III, LINE 4A PATIENT CARE THE MEDICAL CENTER IS PASSIONATE ABOUT LEADING-EDGE PATIENT CARE. THE MEDICAL CENTER'S PATIENTS RECEIVE TREATMENTS THAT ARE TODAY'S GOLD STANDARD OF CARE OR INNOVATIVE THERAPIES THAT WILL BECOME THE GOLD STANDARD OF TOMORROW. THE MEDICAL CENTER HAS DEVELOPED FIVE MAJOR COMPREHENSIVE CARE CENTERS THAT ALLOW PHYSICIANS AND CLINICAL STAFF FROM MULTIPLE DISCIPLINES - SUCH AS MEDICINE, SURGERY, PATHOLOGY, RADIOLOGY, ONCOLOGY, AND SOCIAL WORK - TO WORK TOGETHER SO THAT OUR PATIENTS ARE RECEIVING THE MOST COORDINATED, COMPREHENSIVE CARE POSSIBLE. THESE CENTERS INCLUDE A CANCER CENTER, A CARDIOVASCULAR INSTITUTE, A DIGESTIVE DISEASE CENTER, A SPINE CENTER, AND A TRANSPLANT INSTITUTE. OTHER NOTABLE AREAS WHERE THE MEDICAL CENTER LEADS THE WAY IN PATIENT CARE SPAN A WIDE ARRAY OF SERVICES INCLUDING AREAS SUCH AS VASCULAR SERVICES FOR PATIENTS WITH DIABETES COMPLICATIONS, AND OBSTETRIC CARE FOR ROUTINE PREGNANCIES AS WELL AS THE MOST COMPLEX PATIENT CIRCUMSTANCES. THE MEDICAL CENTER ALSO OFFERS A CENTER FOR MINIMALLY INVASIVE SURGERY, A STATE-OF-THE-ART EMERGENCY ROOM, A LEVEL ONE TRAUMA CENTER, AHEAD OF THE CURVE IMAGING SYSTEMS. THE MEDICAL CENTER WAS THE FIRST IN NEW ENGLAND TO OFFER A DYNAMIC NEW NONINVASIVE RADIATION THERAPY. SOME OF THE MEDICAL CENTER'S KEY STATISTICS FOR FY 2015 REGARDING PATIENT VOLUME ARE IDENTIFIED IN THE FOLLOWING TABLE: INPATIENT DISCHARGES 39,183 OUTPATIENT STATISTICS CLINIC ENCOUNTERS 605,599 EMERGENCY DEPARTMENT VISITS 56,197 RADIOLOGY EXAMS 221,005 AMBULATORY SURGERY CASES 15,354 RADIATION THERAPY TREATMENTS 23,835 ENDOSCOPY TREATMENTS 25,605 CHARITY CARE THE MEDICAL CENTER PROVIDES CARE WITHOUT CHARGE OR AT DISCOUNTED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE SERVICES ARE NOT REPORTED AS REVENUE EXCEPT TO THE EXTENT REIMBURSED BY THE MASSACHUSETTS HEALTH SAFETY NET TRUST (HEALTH SAFETY NET TRUST). THE MEDICAL CENTER ALSO MAKES PAYMENTS TO THE HEALTH SAFETY NET TRUST TO SUPPORT THE DELIVERY OF CHARITY CARE TO PATIENTS THROUGHOUT MASSACHUSETTS. THESE PAYMENTS ARE REPORTED AS A COMPONENT OF UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. THE MEDICAL CENTER'S NET COST OF CHARITY CARE REPORTED ON SCHEDULE H, PART I, LINE 7A, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO FREE AND DISCOUNTED CARE ELIGIBLE PATIENTS AND INCLUDING PAYMENTS TO AND RECEIPTS FROM THE HEALTH SAFETY NET TRUST, WAS $15,589,015 IN 2015: CHARITY CARE, AT COST 14,857,980 PAYMENTS TO HEALTH SAFETY NET TRUST 8,323,996 PAYMENTS FROM HEALTH SAFETY NET TRUST (7,592,961) NET CHARITY CARE 15,589,015 OTHER UNCOMPENSATED CARE THE MEDICAL CENTER 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, WHICH INSURE LOW INCOME POPULATIONS, DO NOT COVER THE COST OF SERVICES PROVIDED. IN AGGREGATE, THE COST OF CARE PROVIDED BY THE MEDICAL CENTER FOR SUCH SERVICES EXCEEDED REIMBURSEMENT BY $40,982,312 IN 2015 AS REPORTED ON PART I, LINE 7B OF SCHEDULE H, HOSPITALS. THE MEDICAL CENTER ALSO TREATS PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM, THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS. BECAUSE PAYMENTS TO HOSPITALS HAVE NOT KEPT PACE WITH INFLATION IN RECENT YEARS, PAYMENTS TO THE MEDICAL CENTER FOR THOSE SERVICES ALSO DO NOT COVER THE COSTS OF SERVICES PROVIDED. IN AGGREGATE, THE COST OF CARE PROVIDED BY THE MEDICAL CENTER FOR SUCH SERVICES EXCEEDED REIMBURSEMENT BY $12,670,670 IN 2015, $9,816,567 OF WHICH IS INCLUDED IN FORM 990 SCHEDULE H PART I, LINE 7G AND RELATED TO THE PROVISION OF SUBSIDIZED HEALTH SERVICES FOR INPATIENT PSYCHIATRIC PATIENTS, THE MEDICAL CENTER'S BOWDOIN STREET COMMUNITY FACILITY, THE MEDICAL CENTER'S PROVISION OF OUTPATIENT AMBULATORY CARE AND CERTAIN PRIMARY CARE VISITS THROUGH BIDMC'S ONSITE PRIMARY CARE OFFICES AND $2,854,103 OF WHICH IS REPORTED IN THIS FORM 990 SCHEDULE H PART III LINE 7. BAD DEBTS IN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, THE MEDICAL CENTER 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. THE NET PROVISION FOR BAD DEBT EXPENSE IS INCLUDED IN NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE NET PROVISION FOR BAD DEBT EXPENSE REPORTED IN THE AUDITED FINANCIAL STATEMENTS AND THIS FORM 990 SCHEDULE H, PART III, LINE 2 IS $ 19,165,721. FORM 990, PART III, LINE 4B RESEARCH THE MISSION OF THE MEDICAL CENTER IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF THE LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS THAT IMPROVE THE QUALITY OF LIFE. THE MEDICAL CENTER COMMITS TO MAINTAIN A COLLABORATIVE CULTURE AND MODERN, HIGH-QUALITY FACILITIES AND TO TAKE FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS AS WELL AS REACHING OUT AND COLLABORATING WITH NATIONALLY RECOGNIZED AND WORLD RENOWNED EXPERTS IN VARIOUS FIELDS. THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP FOUR IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING AMONG INDEPENDENT HOSPITALS. THE MEDICAL CENTER'S SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACTS THE LIVES OF PATIENTS AND IMPROVES THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,285 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 645 ACTIVE CLINICAL TRIALS WERE LED BY APPROXIMATELY 568 MEDICAL CENTER PRINCIPAL INVESTIGATORS, 416 OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, AND CARDIOLOGY/CARDIAC SURGERY. THE MEDICAL CENTER'S EXTRAORDINARY FACULTY HAS ESTABLISHED A CULTURE THAT IS COLLABORATIVE AND ORIENTED TOWARD TRANSLATING NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. ADDITIONAL DETAIL IS INCLUDED IN FORM 990, SCHEDULE H. FORM 990, PART III, LINE 4C TEACHING THE MEDICAL CENTER'S DEVOTION TO TEACHING, TO RESPECTING STUDENTS, AND TO EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION MAKE THE MEDICAL CENTER A TOP CHOICE AMONG MEDICAL STUDENTS AND HEALTH CARE PROFESSIONALS. THE MEDICAL CENTER TRAINS HUNDREDS OF MEDICAL STUDENTS, INTERNS AND RESIDENTS, AS WELL AS PROFESSIONALS IN NURSING, SOCIAL WORK AND THE ALLIED HEALTH SCIENCES. THE MEDICAL CENTER HAS 48 APPROVED CLINICAL RESIDENCY AND FELLOWSHIP PROGRAMS WITH MORE THAN 600 RESIDENTS AND CLINICAL FELLOWS. IN ADDITION, THE MEDICAL CENTER HAS 42 NONSTANDARD CLINICAL FELLOWSHIP PROGRAMS WITH OVER 60 TRAINEES PER YEAR. STAFF PHYSICIANS AT THE MEDICAL CENTER WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW BY SUPERVISING OF THEIR DAILY PATIENT CARE AND BY CONDUCTING A RANGE OF INTERACTIVE LEARNING EXPERIENCES THE CARL J. SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL AND BIDMC, A SUPPORT ORGANIZATION OF THE MEDICAL CENTER AND AN INTEGRAL COMPONENT OF THE CENTER FOR EDUCATION AT THE MEDICAL CENTER, IS BOTH A "THINK TANK" FOR ADVANCING MEDICAL EDUCATION AND A UNIQUE TRAINING RESOURCE. WITHIN THE CENTER, THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER PROVIDES HIGH-TECH LEARNING EXPERIENCES ON TOPICS RANGING FROM MINIMALLY INVASIVE SURGERY TO INTENSIVE CARE AND OFFERS UNIQUE OPPORTUNITIES FOR FACULTY MEMBERS TO SHARE YEARS OF COLLECTIVE EXPERIENCE IN MASTERING THE ART OF SCIENCE AND MEDICINE WITH THEIR STUDENTS. IT ALSO OFFERS AN EXCEPTIONAL OPPORTUNITY AND EXTENSION OF MORE TRADITIONAL METHODS FOR MEDICAL STUDENTS AND RESIDENTS TO PRACTICE AND HONE THEIR MEDICAL AND SURGICAL SKILLS. ADDITIONAL DETAIL IS INCLUDED IN THE NARRATIVE SUPPORT TO THIS FORM 990, SCHEDULE H. FORM 990, PART IV, LINE 12 AND 12A AUDITED FINANCIAL STATEMENTS THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE MEDICAL CENTER AND AFFILIATES FOR FISCAL YEAR ENDED SEPTEMBER 30, 2015. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE MEDICAL CENTER AND ITS SUBSIDIARIES, (MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A AFFILIATED PHYSICIANS GROUP (APG), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), AND HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES, AS WELL AS ALL ENTITIES FOR WHICH THESE ENTITIES SERVE AS MEMBER). FORM 990, PART IV, LINE 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 IV, LINE 24A AS DESCRIBED IN THIS FORM 990, CAREGROUP, INC., IS AN ENTITY EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, IS A SUPPORT ORGANIZATION OF AND SOLE MEMBER OF THE MEDICAL CENTER. THE MEDICAL CENTER IS A MEMBER OF THE CAREGROUP OBLIGATED GROUP AND ITS TAX EXEMPT BOND FINANCING IS ISSUED THROUGH CAREGROUP. THE SCHEDULE K AS INCLUDED IN THIS FORM 990 INCLUDES ALL OF THE CAREGROUP OBLIGATED GROUP OUTSTANDING DEBT FOR BONDS ISSUED AFTER DECEMBER 31, 2002 ONLY A PORTION OF WHICH IS ALLOCABLE TO AND REPORTED ON THE MEDICAL CENTER'S BALANCE SHEET. FORM 990, PART V, LINE 2A STATEMENT RE PAYROLL THE MEDICAL CENTER SERVES AS THE COMMON PAY AGENT FOR THE FOLLOWING ENTITIES FOR WHICH IT ALSO SERVES AS MEMBER OR WHICH SERVE AS THE MEDICAL CENTER MEMBER: CAREGROUP, INC. (CAREGROUP), APG, AND BID-NEEDHAM. IN ACCORDANCE WITH INSTRUCTIONS TO THE 2014 FORM 990, THE MEDICAL CENTER IS REPORTING ONLY THOSE FORMS W-2 ISSUED TO ITS OWN EMPLOYEES. FORMS W-2 ISSUED BY THE MEDICAL CENTER AS AGENT FOR CAREGROUP, APG AND BID-NEEDHAM ARE REPORTED BY THOSE ENTITIES AS IF ISSUED DIRECTLY BY THEM. FORM 990, PART V, LINE 7G CONTRIBUTIONS OF INTELLECTUAL PROPERTY THE MEDICAL CENTER DID NOT RECEIVE ANY CONTRIBUTIONS OF INTELLECTUAL PROPERTY AND AS SUCH, WAS NOT REQUIRED TO FILE FORM 8899. FORM 990, PART V, LINE 7H CONTRIBUTIONS OF CARS, BOATS, AIRPLANES AND OTHER VEHICLES THE MEDICAL CENTER 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, PART VI, SECTION A, LINE 2 BUSINESS AND FAMILY RELATIONSHIPS THE FOLLOWING MEDICAL CENTER OFFICERS, DIRECTOR/TRUSTEES, AND KEY EMPLOYEES HAVE BUSINESS OR FAMILY RELATIONSHIPS: KEVIN TABB, M.D. AND JAMES MANDELL, M.D. - BUSINESS RELATIONSHIP DANIEL JICK, WILLIAM JOHNSTON, STEPHEN KAY AND DOUGLAS LINDE - BUSINESS RELATIONSHIP AS NOTED IN VARIOUS NARRATIVE DISCLOSURES WHICH SUPPORT THIS FORM 990 AND RELATED SCHEDULES, CAREGROUP IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CAREGROUP'S PURPOSE IS TO OVERSEE THE FINANCIAL WELL-BEING OF THE AFFILIATED ENTITIES WHICH MAKE UP THE CAREGROUP SYSTEM. CAREGROUP SERVES AS THE SOLE MEMBER OF THE MEDICAL CENTER. THE MEDICAL CENTER IS THE SOLE MEMBER OF BID-NEEDHAM, APG, BID-MILTON, BID-PLYMOUTH AND JORDAN HEALTH SYSTEMS, INC. (JHSI). IN ADDITION, HMFP IS THE DEDICATED PHYSICIAN PRACTICE OF THE MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING THE MEDICAL CENTER ACCOMPLISH ITS CHARITABLE PURPOSES. CAREGROUP ALSO SERVES AS THE SOLE MEMBER OF NEW ENGLAND BAPTIST HOSPITAL (NEBH) AND MOUNT AUBURN HOSPITAL (MAH). IN TURN, NEBH SERVES AS THE SOLE MEMBER OF NEW ENGLAND BAPTIST MEDICAL ASSOCIATES (NEBMA) AND MAH SERVES AS THE SOLE MEMBER OF MOUNT AUBURN PROFESSIONAL SERVICES (MAPS) AND CAREGROUP PARMENTER HOME CARE & HOSPICE, INC.. EACH OF THE ENTITIES LISTED IN THIS PARAGRAPH MAY, IN TURN, SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE CAREGROUP NETWORK OF 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 BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN EMPLOYMENT RELATIONSHIP ONE OR MORE ENTITIES WITHIN THE CAREGROUP 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 6 CAREGROUP, INC. (CAREGROUP) SERVES AS THE SOLE MEMBER OF THE MEDICAL CENTER. ACCORDING TO THE MEDICAL CENTER'S BYLAWS CAREGROUP APPROVES BUT DOES NOT ELECT MEMBERS OF THE GOVERNING BODY. ACCORDING TO THE MEDICAL CENTER'S BYLAWS, AS SOLE MEMBER, CAREGROUP HAS THE FOLLOWING RIGHTS: -TO APPROVE ANNUAL OPERATING AND CAPITAL BUDGETS; -TO APPROVE UNBUDGETED CAPITAL EXPENDITURES IN EXCESS OF FIVE PERCENT (5%) OF THE MOST RECENT APPROVED ANNUAL CAPITAL BUDGET; -TO APPROVE ANY UNBUDGETED CAPITAL COMMITMENT IN EXCESS OF $20 MILLION; -TO SELECT THE INDEPENDENT AUDITOR TO EXAMINE THE FINANCIAL ACCOUNTS; -TO APPROVE THE BORROWING OR INCURRENCE OF DEBT IN ANY AMOUNT, OTHER THAN (I) FOR THE PURPOSE OF SECURING WORKING CAPITAL FROM A LENDER APPROVED BY THE MEMBER AND PURSUANT TO THE EXISTING LOAN DOCUMENTATION CONTAINING THE TERMS AND PROVISIONS RELATING TO SUCH BORROWING APPROVED BY THE MEMBER AND, (II) DEBT INCURRED IN THE ORDINARY COURSE OF BUSINESS WHICH IS IN THE MEMBER APPROVED ANNUAL BUDGET; -TO APPROVE ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE MEDICAL CENTER, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE MEDICAL CENTER'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION, OR THE ENTERING INTO ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE MEDICAL CENTER; -THE POWER AND AUTHORITY TO INITIATE AND TAKE ANY OF THE FOLLOWING ACTIONS: ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE MEDICAL CENTER, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE MEDICAL CENTER'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION, OR THE ENTERING INTO ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE MEDICAL CENTER; -THE EXCLUSIVE POWER AND AUTHORITY TO INITIATE ANY BANKRUPTCY OR INSOLVENCY ACTION ON BEHALF OF THE MEDICAL CENTER OR ANY OF ITS SUBSIDIARIES INCLUDING ANY DIRECT AFFILIATES; AND, -OTHER POWERS AND RIGHTS AS VESTED BY LAW. IN ADDITION, THE MEMBER HAS ADDITIONAL APPROVAL RIGHTS AS NOTED BELOW. -THE ANNUAL SLATE OF THE BOARD OF DIRECTORS SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. IN ADDITION, A VACANCY ON THE BOARD MAY BE FILED BY THE BOARD OF DIRECTORS, SUBJECT TO APPROVAL OF THE MEMBER; -THE PRESIDENT OF THE CORPORATION, IN COLLABORATION WITH THE CORPORATION'S BOARD OF DIRECTORS, SHALL DEVELOP OVERALL STRATEGIC AND FINANCIAL PLANS FOR THE CORPORATION, WHICH SHALL BE CONSISTENT WITH THE STRATEGIC AND FINANCIAL PLANS AND PROGRAMS OF THE MEMBER AND SHALL BE SUBJECT TO APPROVAL BY THE MEMBER; -THE BOARD OF MANAGERS OF THE MEMBER IS AUTHORIZED TO ACT ON BEHALF OF THE BOARD OF DIRECTORS TO SELL OR OTHERWISE TRANSFER INVESTMENTS AND ASSETS OF THE CORPORATION THAT ARE NOT USED OR INVOLVED IN THE OPERATION OF THE CORPORATION, INCLUDING SECURITIES AND REAL PROPERTY BUT EXCLUDING INVESTMENTS, IF ANY, SEPARATELY HELD TO SATISFY OBLIGATIONS OF THE CORPORATION WITH RESPECT TO ANY PENSION OR BENEFIT PLAN. THE BOARD OF MANAGERS OF THE MEMBER MAY EMPLOY AND COMPENSATE FROM FUNDS OF THE CORPORATION SUCH INVESTMENT ADVISER OR ADVISERS AS THE BOARD OF MANAGERS OF THE MEMBER MAY CONSIDER NECESSARY OR DESIRABLE, AND IT SHALL HAVE DISCRETION TO ACCEPT OR REJECT ANY OR ALL ADVICE GIVEN BY ANY SUCH ADVISER OR ADVISERS, ALL IN ACCORDANCE WITH THE PROVISIONS RELATING TO THE BOARD OF MANAGERS SET FORTH IN THE BY-LAWS OF THE MEMBER; -THE PRESIDENT SHALL BE APPOINTED BY, AND MAY BE REMOVED BY, THE BOARD OF DIRECTORS, SUBJECT TO THE APPROVAL OF THE MEMBER. THE PRESIDENT MAY ALSO BE REMOVED BY THE MEMBER IN ACCORDANCE WITH THE BY-LAWS OF THE MEMBER AS SUCH BY-LAWS MAY, AT THE TIME OF SUCH REMOVAL, PROVIDE; AND, -THE CORPORATION'S BY-LAWS MAY BE ALTERED, AMENDED OR REPEALED AT ANY MEETING OF THE MEMBER IN ACCORDANCE WITH THE BY-LAWS OF THE MEMBER AS SUCH BY-LAWS MAY, AT THE TIME OF SUCH MEETING, PROVIDE. WITHOUT LIMITING THE FOREGOING, THE BOARD OF DIRECTORS MAY RECOMMEND AMENDMENTS TO THESE BY-LAWS, WHICH AMENDMENTS SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A CAREGROUP, INC. (CAREGROUP) SERVES AS THE SOLE MEMBER OF THE MEDICAL CENTER. ACCORDING TO THE MEDICAL CENTER'S BYLAWS CAREGROUP APPROVES BUT DOES NOT ELECT MEMBERS OF THE GOVERNING BODY. ACCORDING TO THE MEDICAL CENTER'S BYLAWS, AS SOLE MEMBER, CAREGROUP HAS THE FOLLOWING RIGHTS: -TO APPROVE ANNUAL OPERATING AND CAPITAL BUDGETS; -TO APPROVE UNBUDGETED CAPITAL EXPENDITURES IN EXCESS OF FIVE PERCENT (5%) OF THE MOST RECENT APPROVED ANNUAL CAPITAL BUDGET; -TO APPROVE ANY UNBUDGETED CAPITAL COMMITMENT IN EXCESS OF $20 MILLION; -TO SELECT THE INDEPENDENT AUDITOR TO EXAMINE THE FINANCIAL ACCOUNTS; -TO APPROVE THE BORROWING OR INCURRENCE OF DEBT IN ANY AMOUNT, OTHER THAN (I) FOR THE PURPOSE OF SECURING WORKING CAPITAL FROM A LENDER APPROVED BY THE MEMBER AND PURSUANT TO THE EXISTING LOAN DOCUMENTATION CONTAINING THE TERMS AND PROVISIONS RELATING TO SUCH BORROWING APPROVED BY THE MEMBER AND, (II) DEBT INCURRED IN THE ORDINARY COURSE OF BUSINESS WHICH IS IN THE MEMBER APPROVED ANNUAL BUDGET; -TO APPROVE ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE MEDICAL CENTER, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE MEDICAL CENTER'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION, OR THE ENTERING INTO ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE MEDICAL CENTER; -THE POWER AND AUTHORITY TO INITIATE AND TAKE ANY OF THE FOLLOWING ACTIONS: ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE MEDICAL CENTER, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE MEDICAL CENTER'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION, OR THE ENTERING INTO ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE MEDICAL CENTER; -THE EXCLUSIVE POWER AND AUTHORITY TO INITIATE ANY BANKRUPTCY OR INSOLVENCY ACTION ON BEHALF OF THE MEDICAL CENTER OR ANY OF ITS SUBSIDIARIES INCLUDING ANY DIRECT AFFILIATES; AND, -OTHER POWERS AND RIGHTS AS VESTED BY LAW. IN ADDITION, THE MEMBER HAS ADDITIONAL APPROVAL RIGHTS AS NOTED BELOW. -THE ANNUAL SLATE OF THE BOARD OF DIRECTORS SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. IN ADDITION, A VACANCY ON THE BOARD MAY BE FILED BY THE BOARD OF DIRECTORS, SUBJECT TO APPROVAL OF THE MEMBER; -THE PRESIDENT OF THE CORPORATION, IN COLLABORATION WITH THE CORPORATION'S BOARD OF DIRECTORS, SHALL DEVELOP OVERALL STRATEGIC AND FINANCIAL PLANS FOR THE CORPORATION, WHICH SHALL BE CONSISTENT WITH THE STRATEGIC AND FINANCIAL PLANS AND PROGRAMS OF THE MEMBER AND SHALL BE SUBJECT TO APPROVAL BY THE MEMBER; -THE BOARD OF MANAGERS OF THE MEMBER IS AUTHORIZED TO ACT ON BEHALF OF THE BOARD OF DIRECTORS TO SELL OR OTHERWISE TRANSFER INVESTMENTS AND ASSETS OF THE CORPORATION THAT ARE NOT USED OR INVOLVED IN THE OPERATION OF THE CORPORATION, INCLUDING SECURITIES AND REAL PROPERTY BUT EXCLUDING INVESTMENTS, IF ANY, SEPARATELY HELD TO SATISFY OBLIGATIONS OF THE CORPORATION WITH RESPECT TO ANY PENSION OR BENEFIT PLAN. THE BOARD OF MANAGERS OF THE MEMBER MAY EMPLOY AND COMPENSATE FROM FUNDS OF THE CORPORATION SUCH INVESTMENT ADVISER OR ADVISERS AS THE BOARD OF MANAGERS OF THE MEMBER MAY CONSIDER NECESSARY OR DESIRABLE, AND IT SHALL HAVE DISCRETION TO ACCEPT OR REJECT ANY OR ALL ADVICE GIVEN BY ANY SUCH ADVISER OR ADVISERS, ALL IN ACCORDANCE WITH THE PROVISIONS RELATING TO THE BOARD OF MANAGERS SET FORTH IN THE BY-LAWS OF THE MEMBER; -THE PRESIDENT SHALL BE APPOINTED BY, AND MAY BE REMOVED BY, THE BOARD OF DIRECTORS, SUBJECT TO THE APPROVAL OF THE MEMBER. THE PRESIDENT MAY ALSO BE REMOVED BY THE MEMBER IN ACCORDANCE WITH THE BY-LAWS OF THE MEMBER AS SUCH BY-LAWS MAY, AT THE TIME OF SUCH REMOVAL, PROVIDE; AND, -THE CORPORATION'S BY-LAWS MAY BE ALTERED, AMENDED OR REPEALED AT ANY MEETING OF THE MEMBER IN ACCORDANCE WITH THE BY-LAWS OF THE MEMBER AS SUCH BY-LAWS MAY, AT THE TIME OF SUCH MEETING, PROVIDE. WITHOUT LIMITING THE FOREGOING, THE BOARD OF DIRECTORS MAY RECOMMEND AMENDMENTS TO THESE BY-LAWS, WHICH AMENDMENTS SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CAREGROUP, INC. (CAREGROUP) SERVES AS THE SOLE MEMBER OF THE MEDICAL CENTER. ACCORDING TO THE MEDICAL CENTER'S BYLAWS CAREGROUP APPROVES BUT DOES NOT ELECT MEMBERS OF THE GOVERNING BODY. ACCORDING TO THE MEDICAL CENTER'S BYLAWS, AS SOLE MEMBER, CAREGROUP HAS THE FOLLOWING RIGHTS: -TO APPROVE ANNUAL OPERATING AND CAPITAL BUDGETS; -TO APPROVE UNBUDGETED CAPITAL EXPENDITURES IN EXCESS OF FIVE PERCENT (5%) OF THE MOST RECENT APPROVED ANNUAL CAPITAL BUDGET; -TO APPROVE ANY UNBUDGETED CAPITAL COMMITMENT IN EXCESS OF $20 MILLION; -TO SELECT THE INDEPENDENT AUDITOR TO EXAMINE THE FINANCIAL ACCOUNTS; -TO APPROVE THE BORROWING OR INCURRENCE OF DEBT IN ANY AMOUNT, OTHER THAN (I) FOR THE PURPOSE OF SECURING WORKING CAPITAL FROM A LENDER APPROVED BY THE MEMBER AND PURSUANT TO THE EXISTING LOAN DOCUMENTATION CONTAINING THE TERMS AND PROVISIONS RELATING TO SUCH BORROWING APPROVED BY THE MEMBER AND, (II) DEBT INCURRED IN THE ORDINARY COURSE OF BUSINESS WHICH IS IN THE MEMBER APPROVED ANNUAL BUDGET; -TO APPROVE ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE MEDICAL CENTER, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE MEDICAL CENTER'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION, OR THE ENTERING INTO ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE MEDICAL CENTER; -THE POWER AND AUTHORITY TO INITIATE AND TAKE ANY OF THE FOLLOWING ACTIONS: ANY VOLUNTARY DISSOLUTION, MERGER OR CONSOLIDATION OF THE MEDICAL CENTER, THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE MEDICAL CENTER'S ASSETS, THE CREATION, ACQUISITION OR DISPOSAL OF ANY SUBSIDIARY OR AFFILIATED CORPORATION, OR THE ENTERING INTO ANY JOINT VENTURE OR OTHER PARTNERSHIP ARRANGEMENTS BY THE MEDICAL CENTER; -THE EXCLUSIVE POWER AND AUTHORITY TO INITIATE ANY BANKRUPTCY OR INSOLVENCY ACTION ON BEHALF OF THE MEDICAL CENTER OR ANY OF ITS SUBSIDIARIES INCLUDING ANY DIRECT AFFILIATES; AND, -OTHER POWERS AND RIGHTS AS VESTED BY LAW. IN ADDITION, THE MEMBER HAS ADDITIONAL APPROVAL RIGHTS AS NOTED BELOW. -THE ANNUAL SLATE OF THE BOARD OF DIRECTORS SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. IN ADDITION, A VACANCY ON THE BOARD MAY BE FILED BY THE BOARD OF DIRECTORS, SUBJECT TO APPROVAL OF THE MEMBER; -THE PRESIDENT OF THE CORPORATION, IN COLLABORATION WITH THE CORPORATION'S BOARD OF DIRECTORS, SHALL DEVELOP OVERALL STRATEGIC AND FINANCIAL PLANS FOR THE CORPORATION, WHICH SHALL BE CONSISTENT WITH THE STRATEGIC AND FINANCIAL PLANS AND PROGRAMS OF THE MEMBER AND SHALL BE SUBJECT TO APPROVAL BY THE MEMBER; -THE BOARD OF MANAGERS OF THE MEMBER IS AUTHORIZED TO ACT ON BEHALF OF THE BOARD OF DIRECTORS TO SELL OR OTHERWISE TRANSFER INVESTMENTS AND ASSETS OF THE CORPORATION THAT ARE NOT USED OR INVOLVED IN THE OPERATION OF THE CORPORATION, INCLUDING SECURITIES AND REAL PROPERTY BUT EXCLUDING INVESTMENTS, IF ANY, SEPARATELY HELD TO SATISFY OBLIGATIONS OF THE CORPORATION WITH RESPECT TO ANY PENSION OR BENEFIT PLAN. THE BOARD OF MANAGERS OF THE MEMBER MAY EMPLOY AND COMPENSATE FROM FUNDS OF THE CORPORATION SUCH INVESTMENT ADVISER OR ADVISERS AS THE BOARD OF MANAGERS OF THE MEMBER MAY CONSIDER NECESSARY OR DESIRABLE, AND IT SHALL HAVE DISCRETION TO ACCEPT OR REJECT ANY OR ALL ADVICE GIVEN BY ANY SUCH ADVISER OR ADVISERS, ALL IN ACCORDANCE WITH THE PROVISIONS RELATING TO THE BOARD OF MANAGERS SET FORTH IN THE BY-LAWS OF THE MEMBER; -THE PRESIDENT SHALL BE APPOINTED BY, AND MAY BE REMOVED BY, THE BOARD OF DIRECTORS, SUBJECT TO THE APPROVAL OF THE MEMBER. THE PRESIDENT MAY ALSO BE REMOVED BY THE MEMBER IN ACCORDANCE WITH THE BY-LAWS OF THE MEMBER AS SUCH BY-LAWS MAY, AT THE TIME OF SUCH REMOVAL, PROVIDE; AND, -THE CORPORATION'S BY-LAWS MAY BE ALTERED, AMENDED OR REPEALED AT ANY MEETING OF THE MEMBER IN ACCORDANCE WITH THE BY-LAWS OF THE MEMBER AS SUCH BY-LAWS MAY, AT THE TIME OF SUCH MEETING, PROVIDE. WITHOUT LIMITING THE FOREGOING, THE BOARD OF DIRECTORS MAY RECOMMEND AMENDMENTS TO THESE BY-LAWS, WHICH AMENDMENTS SHALL BE SUBJECT TO APPROVAL BY THE MEMBER. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE CHIEF FINANCIAL OFFICER OF THE MEDICAL CENTER, THE TAX DIRECTOR OF CAREGROUP, WHICH IS THE MEMBER OF THE MEDICAL CENTER, AND DELOITTE TAX, LLP. THE COMPLETE FORM 990 IS PRESENTED TO THE MEDICAL CENTER'S COMPLIANCE, AUDIT AND RISK COMMITTEE FOR REVIEW AND DISCUSSION. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF THE MEDICAL CENTER BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE MEDICAL CENTER HAS A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL MEMBERS OF ITS WORKFORCE, INCLUDING EMPLOYEES, PROFESSIONAL STAFF, TRAINEES, CONSULTANTS, CONTRACTORS, AGENTS, AND VENDORS, AND TO THE MEMBERS OF THE BOARD OF DIRECTORS. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER (HMFP) IS AN INTEGRALLY RELATED ENTITY TO THE MEDICAL CENTER AND EMPLOYS THE MAJORITY OF PHYSICIANS PROVIDING PATIENT CARE AT THE MEDICAL CENTER. HMFP ALSO HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY. PURSUANT TO THESE POLICIES, ALL MEMBERS OF THE MEDICAL CENTER'S WORKFORCE MUST DISCLOSE CONFLICTS OF INTEREST AT THE TIME OF INSTITUTIONAL TRANSACTIONS AND MUST REFRAIN FROM TAKING ANY ADMINISTRATIVE ACTION WITHIN THE INSTITUTION THAT IS BENEFICIAL TO AN OUTSIDE BUSINESS IN WHICH S/HE OR A FAMILY MEMBER HAS A POSITION OR A FINANCIAL INTEREST UNLESS S/HE INFORMS HIS/HER SUPERVISOR AND OBTAINS ADVANCE APPROVAL. THE MEDICAL CENTER MONITORS COMPLIANCE WITH THIS POLICY BY REQUIRING ALL MEMBERS OF THE WORKFORCE PARTICIPATING IN THE PROCESS TO COMPLETE A WRITTEN DISCLOSURE FORM AT THE TIME OF DISCUSSIONS AND NEGOTIATIONS WITH A SUPPLIER AND BY REQUIRING THE SUPPLIER TO IDENTIFY IN WRITING THOSE PARTICIPANTS WHO HAVE AN OUTSIDE RELATIONSHIP WITH THE SUPPLIER. A SUPPLIER'S FAILURE TO MAKE A REQUIRED DISCLOSURE MAY RESULT IN DISQUALIFICATION FROM BEING A SUPPLIER AND CAN BE GROUNDS FOR TERMINATION OF THE CONTRACT. SIMILARLY, ANY MEMBER OF THE BOARD OF DIRECTORS OF THE MEDICAL CENTER WHO IS IN A POSITION TO VOTE ON OR INFLUENCE A PARTICULAR TRANSACTION OR DECISION OF THE MEDICAL CENTER MUST NOTIFY THE BOARD OR THE COMMITTEE IF S/HE OR A FAMILY MEMBER MIGHT MATERIALLY BENEFIT AND RECUSE HIMSELF/HERSELF FROM PARTICIPATION AND VOTING ON THE DECISION. IN ADDITION, ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES OF BOTH THE MEDICAL CENTER AND HMFP ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT DISCLOSURE WHICH IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS RELATIONSHIPS MAINTAINED BY OFFICERS, DIRECTORS OR KEY EMPLOYEES AND THEIR IMMEDIATE FAMILY MEMBERS WHICH MAY RESULT IN A CONFLICT OF INTEREST. PURSUANT TO THE MEDICAL CENTER'S CONFLICT OF INTEREST POLICY, MANY INDIVIDUALS IN ADDITION TO THOSE REPORTED ON THE TAX RETURNS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT DISCLOSURE. THESE ADDITIONAL CATEGORIES INCLUDE OFFICERS, SENIOR MANAGEMENT, CHIEFS OF SERVICE, DIVISION CHIEFS, AND OTHER WORKFORCE AND PROFESSIONAL STAFF CATEGORIES AS IDENTIFIED FROM TIME TO TIME BY THE CHIEF EXECUTIVE OFFICER, THE SENIOR VICE PRESIDENT FOR COMPLIANCE, AUDIT, AND RISK OR THE CONFLICTS OF INTEREST COMMITTEE. FOR THESE EMPLOYEES, PROVIDING A DISCLOSURE IS A CONDITION OF EMPLOYMENT AND/OR MEDICAL STAFF APPOINTMENT. THE OFFICE OF COMPLIANCE AND BUSINESS CONDUCT COLLECTS, REVIEWS, AND DETERMINES APPROPRIATE ACTION FOR THE ANNUAL CONFLICT OF INTEREST DISCLOSURES ON BEHALF OF THE MEDICAL CENTER. THE DISCLOSURE MAY BE REFERRED TO MANAGEMENT AND TO THE CONFLICT OF INTEREST COMMITTEE, A SUBCOMMITTEE OF THE COMPLIANCE, AUDIT, AND RISK COMMITTEE, FOR REVIEW. THE HMFP COMPLIANCE OVERSIGHT COMMITTEE REVIEWS ANNUAL CONFLICT OF INTEREST DISCLOSURES ON BEHALF OF HMFP. BECAUSE OF THE INTEGRAL RELATIONSHIP BETWEEN THE MEDICAL CENTER AND HMFP, MANY INDIVIDUALS ARE COVERED BY BOTH ENTITIES' CONFLICT OF INTEREST POLICIES AND ANNUAL DISCLOSURE REQUIREMENTS. IN CASES OF DUAL RESPONSIBILITIES, THE RESPONSES ARE REVIEWED BY BOTH THE MEDICAL CENTER AND HMFP FOR DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. PURSUANT TO EACH INSTITUTION'S 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. CAREGROUP IS THE SOLE MEMBER OF THE MEDICAL CENTER. IN ADDITION TO THE CONFLICT OF INTEREST PROCESS OUTLINED ABOVE, THE MEDICAL CENTER OFFICE OF COMPLIANCE AND BUSINESS CONDUCT AND THE CAREGROUP TAX DEPARTMENT JOINTLY ISSUE A TAX QUESTIONNAIRE TO ALL CURRENT AND FORMER MEMBERS OF THE MEDICAL CENTER BOARD OF DIRECTORS AS WELL AS CURRENT AND FORMER MEDICAL CENTER OFFICERS AND KEY EMPLOYEES. THE TAX QUESTIONNAIRE IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR THE MEDICAL CENTER 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 THE MEDICAL CENTER HAS A COMPENSATION COMMITTEE THAT IS COMPOSED OF MEMBERS OF THE BOARD OF DIRECTORS. ALL MEMBERS ARE INDEPENDENT. THE COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE OF THE CEO, COO, CFO, CLINICAL CHIEFS OF SERVICE, CHIEF ACADEMIC OFFICER, CHIEF INFORMATION OFFICER, GENERAL COUNSEL, SR. VICE PRESIDENTS AND VICE PRESIDENTS. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND THAT IT COMPLIES WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIED UPON WRITTEN COMPENSATION SURVEYS AND 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 PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. TO ENSURE INDEPENDENCE, THE SENIOR VICE PRESIDENT OF HUMAN RESOURCES AND CHIEF OPERATING OFFICER EACH RECUSED THEMSELVES FROM DISCUSSIONS AND VOTING RELATED TO THEIR OWN COMPENSATION PACKAGES AND FROM DISCUSSIONS RELATED TO THE PRESIDENT AND CEO'S COMPENSATION PACKAGE. THE COMPENSATION COMMITTEE THEN VOTED TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE CEO. THE COMPENSATION PACKAGE FOR THE CEO VOTED BY THE COMPENSATION COMMITTEE WAS SUBMITTED TO THE FULL BOARD OF DIRECTORS FOR APPROVAL. ALL DELIBERATIONS WERE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. SUBSEQUENT TO THE VOTE OF THE COMMITTEE, THE OUTSIDE CONSULTING FIRM PROVIDED A "REASONABLENESS LETTER" ATTESTING TO THE INDEPENDENCE OF THE COMMITTEE AND REASONABLENESS OF THE EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE MEDICAL CENTER'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL DEACONESS MEDICAL CENTER OFFICES 330 BROOKLINE AVENUE BOSTON, MA 02215 FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 2,003,280. MANAGEMENT AND GENERAL EXPENSES 3,315,264. FUNDRAISING EXPENSES 582,985. TOTAL EXPENSES 5,901,529. MD FEES: PROGRAM SERVICE EXPENSES 57,609,698. MANAGEMENT AND GENERAL EXPENSES 13,261,650. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 70,871,348. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 71,408,793. MANAGEMENT AND GENERAL EXPENSES 7,028,218. FUNDRAISING EXPENSES 353,027. TOTAL EXPENSES 78,790,038. FORM 990, PART XI, LINE 9: UNREALIZED CHG IN EQUITY INTEREST IN LIMITED PARTNERSHIP -18,650,708. CHANGE IN FUNDED STATUS OF EMPLOYEE BENEFIT PLANS -69,962,282. TRANSFER (TO) FROM AFFILIATE -22,979,074. TRANSFER TO RESTRICTED NET ASSETS 5,982,203. FUNDS MANAGED BY OTHERS -130,575. FORM 990, PART XII, LINE 2B AND 2C FINANCIAL STATEMENTS AND COMMITTEE OVERSIGHT AS PREVIOUSLY REPORTED IN THIS FILING, THE MEDICAL CENTER IS A PUBLIC CHARITY AND A TERTIARY CARE ACADEMIC MEDICAL CENTER EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THE FINANCIAL RECORDS OF THE MEDICAL CENTER ARE AUDITED EACH YEAR AS PART OF THE MEDICAL CENTER'S CONSOLIDATED AUDITED FINANCIAL STATEMENT PROCESS. FOR THE PERIOD COVERED BY THIS FILING, THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THESE FINANCIAL STATEMENTS. THIS PROCESS IS MONITORED AND REVIEWED INTERNALLY BY THE MEDICAL CENTER'S COMPLIANCE, AUDIT AND RISK COMMITTEE. 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