2012-08-15T12:12:13-05:00 2011-09-30 PricewaterhouseCoopers LLP 125 High Street Boston MA 02110 990 2010-10-01 043314093 BOSTON MEDICAL CENTER BOST 6174141625 88 EAST NEWTON STREET BOSTON MA 02118 RICHARD SILVERIA 2012-08-14 true PRICEWATERHOUSECOOPERS LLP 6175305000 2010 2016-02-24 21:20:13Z KATHLEEN E WALSH 88 EAST NEWTON STREET BOSTON MA 02118 977733010 false X www.bmc.org X 1996 MA BOSTON MEDICAL CENTER'S MISSION IS TO PROVIDE CONSISTENTLY EXCELLENT AND ACCESSIBLE HEALTH SERVICES TO ALL IN NEED OF CARE REGARDLESS OF STATUS AND ABILITY TO PAY. 27 20 6854 600 257588 234137 10258928 11421383 974473842 944950551 19910000 16200000 6059575 4674796 1010702345 977246730 14988228 19306772 0 0 456758263 443215078 0 0 2507347 568108854 542567880 1039855345 1005089730 -29153000 -27843000 1745738000 1638938000 723047000 720441000 1022691000 918497000 X BOSTON MEDICAL CENTER'S MISSION IS TO PROVIDE CONSISTENTLY EXCELLENT AND ACCESSIBLE HEALTH SERVICES TO ALL IN NEED OF CARE REGARDLESS OF STATUS AND ABILITY TO PAY. false false 894408018 944950551 SEE SCHEDULE O. 18933913 18933913 BOSTON MEDICAL CENTER PROVIDES RESEARCH SUPPORT TO ORGANIZATION WITHIN THE US. 372859 372859 BOSTON MEDICAL CENTER PROVIDES RESEARCH SUPPORT TO FOREIGN ORGANIZATIONS. 913714790 true true false true false false false false true true true false true true false true true false true true true false true true false true true true false true true true false false false false false false false false true true true false false true true true true false false true 540 0 true 6854 true true true true LT false false false true true false false false false X 27 20 true false false false true true true true true false false true true true true true true true true false MA X JOHN C LINDSTEDT 6174141625 88 EAST NEWTON STREET BOSTON MA 02118 X JOEL M ABRAMS 1.0 X 0 0 0 REV DR JOHN M BORDERS III 1.0 X 0 0 0 KAREN ANTMAN MD 1.0 X 0 0 0 JAMES M BECKER MD 1.0 X 0 990684 50271 DAVID A PASSAFARO 1.0 X 0 0 0 CHRISTINE M DUNN 1.0 X 0 0 0 WILLIAM J HALPIN JR 1.0 X 0 0 0 edmond J english 1.0 X 0 0 0 Randi Cutler 1.0 X 0 0 0 ALYCE J LEE 1.0 X 0 0 0 JAMES MARTEN PHD 1.0 X 0 0 0 MARTHA S SAMUELSON 1.0 X 0 0 0 JAMES O TAYLOR MD 1.0 X 0 0 0 Thomas ALPERIN 1.0 X 0 0 0 STEVEN d levy 1.0 X 0 0 0 LISA GUSCOTT 1.0 X 0 0 0 RICHARD SLIFKA 1.0 X 0 0 0 AZZIE YOUNG MPA PHD 1.0 X 0 0 0 barbara ferrer phd 1.0 X 0 0 0 david coleman md 1.0 X 0 620350 35132 SUSAN DONAHUE 1.0 X 0 0 0 JOHN T HAILER 1.0 X 0 0 0 KATHLEEN E WALSH 50.0 X X 909332 0 431992 FERDINAND ALVARO JR 1.0 X 0 0 0 PAUL EGERMAN 1.0 X 0 0 0 PEGGY KOENIG 1.0 X 0 0 0 JAMES MONGAN MD 1.0 X 0 0 0 JAMES S PHALEN 1.0 X 0 0 0 RONALD L WALKER II 1.0 X 0 0 0 MARK NUNNELLY 1.0 X 0 0 0 THEA JAMES MD 1.0 X 0 265143 45489 RONALD BARTLETT 50.0 X 570603 0 114946 STEPHANIE LOVELL 40.0 X 507361 0 118576 RICHARD SILVERIA 50.0 X 78333 0 5060 LISA O'CONNOR 50.0 X 303602 0 86361 MEG ARANOW 50.0 X 388053 0 128548 RAVIN DAVIDOFF 45.0 X 527696 0 129055 PETER HEALY 40.0 X 275815 0 71519 NORMAN STEIN 50.0 X 474764 0 131042 THOMAS TRAYLOR 25.0 X 642124 0 180189 WILLIAM BARRON 50.0 X 525437 0 103094 ELAINE ULLIAN X 2011053 0 193935 EDWARD CHRISTIANSEN JR 50.0 X 284186 0 31015 PAUL DREW X 459369 0 16628 7957728 1876177 1872852 1220 true true false BOSTON UNIVERSITY 715 ALBANY STREET SUITE 580 BOSTON MA 021182528 SHARED RESEARCH SVCS 57590224 SUFFOLK CONSTRUCTION COMPANY 99 CONIFER HILL DRIVE DANVERS MA 01923 CONSTRUCTION 23791939 FTI CONSULTING INC 200 STATE STREET 2ND FLOOR BOSTON MA 02109 CONSULTING 7147900 MORRISON HEALTH CARE INC 5801 PEACHTREE DUNWOODY ROAD ATLANTA GA 30342 FOOD SVCS/CAFETERIA 5925877 BOSTON PHARMACY MANAGEMENT 24 STEVENS LANE COHASSET MA 02025 PHARMACY SERVICES 4995963 131 3363977 2868333 5189073 406152 11421383 PATIENT SVC REVENUE 900099 847270000 847270000 OTHER PROGRAM REVENUE 900099 9711551 9711551 GRANT/CONTRACT REVENUE 900099 87969000 87969000 944950551 13370000 257588 13112412 0 0 133688 89250 44438 44438 44438 2830000 2830000 2830000 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76772000 82234000 77442000 208210000 120610000 82701000 88970000 3508000 2807000 6251000 6826000 1162972000 708388000 501662000 454584000 45360000 68829000 171570000 165860000 614471000 576238000 1745738000 1638938000 133464000 122399000 19726000 19749000 362752000 358177000 13170000 26586000 193935000 193530000 723047000 720441000 X 619594000 600175000 386744000 301969000 16353000 16353000 1022691000 918497000 1745738000 1638938000 X -27843000 -76351000 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 150238 false true 81177 231415 false SCHEDULE C, PART II-B, LINE 1 BOSTON MEDICAL CENTER PAYS DUES TO NAPH, MHA, AND AHA, AND A PORTION OF THE DUES ARE ALLOCATED TO LOBBYING EFFORTS. THE PORTION OF THE DUES THAT was ALLOCATED TO LOBBYING EFFORTS WAS $81,177. BMC ALSO PAID GEORGE TRAYLOR $90,238, A LOBBYIST, TO REPRESENT THE ORGANIZATION. ADDITIONALLY, BOSTON MEDICAL CENTER PAID ROBERT WHITE ASSOCIATES $60,000 TO REPRESENT THE ORGANIZATION. THESE FEES WERE PAID TO THE LOBBYISTS LISTED TO ADVANCE BOSTON MEDICAL CENTER'S MISSION: "TO CONSISTENTLY PROVIDE EXCELLENT AND ACCESSIBLE HEALTH CARE SERVICES TO ALL IN NEED OF CARE, REGARDLESS OF STATUS OR ABILITY TO PAY" AS SET OUT IN CHAPTER 147 OF THE ACTS AND RESOLVES OF 1996 OF THE COMMONWEALTH OF MASSACHUSETTS. 405862208 127397784 -7312698 53911542 1694554 470341198 427693269 54430640 46804363 121360660 1705404 405862208 431600644 31375895 33917009 1366261 427693269 0.50100 0.03480 0.46420 false false 11291978 11291978 486653572 145404568 341249004 20516600 3420393 17096207 58532602 12529671 46002931 585977248 547033368 38943880 454584000 DONOR RESTRICTED INVESTMENTS 165860000 F 165860000 OTHER LT ASSETS 187015250 FUNDS HELD BY TRUSTEES 32250000 FOR FUNDED DEPRECIATION 237586000 BOND INDENTURE 69156000 NONCURRENT NOTES RECEIVABLE 26591000 INVESTMENT IN OTHER VENTURES 23639750 576238000 0 EST SETTLEMENT W/3RD PARTY PAY 27227000 LT DEBT AND OBL-CAPITAL LEASE 92293000 OTHER LONG-TERM LIABILITIES 28874709 LT ADDITIONAL PENSION LIABILITY 45135291 193530000 977246730 1005089730 -27843000 -24592000 -51759000 -76351000 -104194000 953141000 -24592000 -24592000 977733000 -486270 -486270 977246730 1005576000 1005576000 -486270 -486270 1005089730 SCHEDULE D, PART V, LINE 4 - GENERAL ENDOWMENT THE GENERAL ENDOWMENT INCLUDES FUNDS FROM A NUMBER OF SOURCES WITH VARIOUS RESTRICTIONS ON USE AND TREATMENT. THE ENDOWMENT FUNDS HAVE BEEN CONTRIBUTED FOR SPECIFIC PURPOSES INCLUDING CONSTRUCTION, MAINTENANCE, RESEARCH, CLINICAL CARE, EDUCATION, DEVELOPMENT, STAFFING, SALARIES, LABORATORY EQUIPMENT AND SUPPLIES, AND CONVALESCENT CARE. SCHEDULE D, PART X, LINE 2 THE ORGANIZATION'S FINANCIAL STATEMENTS DID NOT REPORT A LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. SCHEDULE D, PART XI, LINE 8 TERMINATION OF NEIDL AGREEMENT ($ 68,015,000) TRANSFER FROM BMCHP $ 23,000,000 OTHER ADJUSTMENTS $ 1,836,000 PENSION RELATED CHANGES OTHER THAN PERIODIC PENSION COSTS ($ 8,580,000) ------------- TOTAL ($ 51,759,000) SCHEDULE D, PART XII, LINE 4B RENTAL EXPENSE ($ 89,250) SPECIAL EVENTS EXPENSE ($ 397,020) ------------- TOTAL ($ 486,270) SCHEDULE D, PART XIII, LINE 2d RENTAL EXPENSE $ 89,250 SPECIAL EVENTS EXPENSE $ 397,020 ------------- TOTAL $ 486,270 true East Asia and the Pacific 0 3 Grantmaking 129248 Sub-Saharan Africa 2 8 Program Services HEALTH SVCS TRAINING 176861 Russia and the Newly Independent States Grantmaking 14510 Europe (Including Iceland and Greenland) Grantmaking 32668 North America Grantmaking 19572 Central America and the Caribbean Program Services SELF INSURANCE 9939 Central America and the Caribbean Investments 4756449 North America Investments 23300035 Europe (Including Iceland and Greenland) Investments 10905900 2 11 2 11 39345182 39345182 East Asia/Pacific 39166 WIRE TRANSFR East Asia/Pacific 14000 WIRE TRANSFR East Asia/Pacific 28082 WIRE TRANSFR Sub-Saharan Africa 159481 WIRE TRANSFR Sub-Saharan Africa 17380 WIRE TRANSFR East Asia/Pacific 48000 WIRE TRANSFR Russia 14510 WIRE TRANSFR Europe/Iceland/Greenland 32668 WIRE TRANSFR North America 19572 WIRE TRANSFR 0 9 true false true false true false SCHEDULE F, PART I, LINE 2 THE PRINCIPAL INVESTIGATOR AND ADMINISTRATOR APPROVE ALL SUBCONTRACT INVOICES, INCLUDING THOSE FROM A FOREIGN COUNTRY. THE FOREIGN SUBCONTRACT RECIPIENT HAS A BUDGET TO WHICH INVOICES ARE MATCHED TO ENSURE THAT ALL SPENDING IS APPROPRIATE. ADDITIONALLY, THE ORGANIZATION'S PRINCIPAL INVESTIGATORS REGULARLY CONTACT THE FOREIGN SUBCONTRACT RECIPIENTS TO MONITOR THE PROGRESS OF THE RECIPIENTS' WORK. SCHEDULE F, PART II, LINE 1 FOREIGN EXPENDITURES ARE SEPARATELY IDENTIFIED ON THE ORGANIZATION'S GENERAL LEDGER. X X X X X X X false WEDU EVENT PLANNING false ME MA GALA 2574840 2323973 250867 21163 140286 42070 76036 FOOD FOR THOUGH 955154 929054 26100 53053 14730 2 142600 110950 31650 1200 30000 15373 3119 3672594 3363977 308617 1200 51163 208712 42070 93885 397030 -88413 88 EAST NEWTON STREET BOSTON MA 02118 true true X true X 0 true X 0 true true true false false 75938 93801091 93801091 0 0.00000 282668 321986638 319405362 2581276 0.00270 358606 415787729 413206453 2581276 0.00270 23187905 4613141 17419446 0.01790 58970010 13077323 45892687 0.04720 687 95368479 95368479 0 0.00000 687 177526394 113058943 63312133 0.06510 687 358606 593314123 526265396 65893409 0.06780 98888 0 98888 0.00010 15930000 0 15930000 0.01640 742992 0 742992 0.00080 7935787 5808641 2127146 0.00220 481096 0 481096 0.00050 708384 0 708384 0.00070 25897147 5808641 20088506 0.02070 true 18349993 185293793 163401660 21892133 X true false 1 1 BOSTON MEDICAL CENTER

88 EAST NEWTON STREET BOSTON MA 02118

X X X X X REHABILITATION UNIT BOSTON MEDICAL CENTER 1 2 MARGARET M SHEA RN ADULT HEALTH PROGRAM

229 RIVER STREET MATTAPAN MA 02126

ADULT DAYCARE SUPPORTING PARENTS & RESILIENT KIDS CTR

255 RIVER STREET MATTAPAN MA 02126

THERAPEUTIC CENTER Introduction THE STATUTE THAT CREATED BOSTON MEDICAL CENTER (BMC) REQUIRES IT TO SERVE ALL POPULATIONS. BMC IS A PRIVATE, NOT-FOR-PROFIT, 508-LICENSED BED, URBAN ACADEMIC MEDICAL CENTER WHICH EMPHASIZES COMMUNITY-BASED, ACCESSIBLE CARE AND THE MISSION TO PROVIDE CONSISTENTLY ACCESSIBLE HEALTH SERVICES TO ALL IN NEED OF CARE REGARDLESS OF STATUS AND ABILITY TO PAY. BMC IS THE LARGEST SAFETY NET HOSPITAL IN NEW ENGLAND AND PROVIDES A FULL SPECTRUM OF PEDIATRIC AND ADULT CARE SERVICES FROM PRIMARY TO FAMILY MEDICINE TO ADVANCED SPECIALTY CARE. APPROXIMATELY 70 PERCENT OF BMC'S PATIENTS COME FROM UNDERSERVED POPULATIONS, INCLUDING LOW-INCOME FAMILIES, ELDERS, PEOPLE WITH DISABILITIES, AND IMMIGRANTS. SEVENTY PERCENT OF ALL PATIENTS ARE FROM RACIAL AND ETHNIC MINORITY POPULATIONS, AND 30 PERCENT DO NOT SPEAK ENGLISH AS A PRIMARY LANGUAGE. TO ADDRESS THE HEALTH NEEDS OF ITS DIVERSE PATIENT POPULATION, BMC PROVIDES A WIDE RANGE OF SERVICES BEYOND THE TRADITIONAL MEDICAL MODEL. THESE PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, PATIENT NAVIGATION, INTERPRETER SERVICES, AND A FOOD PANTRY, THAT HELP REDUCE BARRIERS TO ACCESSING HEALTH SERVICES AND ELIMINATE DISPARITIES IN HEALTH CARE AMONG THE VARIOUS POPULATIONS BMC SERVES. WITH MORE THAN 29,070 ADMISSIONS AND 853,343 PATIENT VISITS IN FY11, BMC PROVIDES A COMPREHENSIVE RANGE OF INPATIENT, CLINICAL AND DIAGNOSTIC SERVICES IN MORE THAN 70 AREAS OF MEDICAL SPECIALTIES AND SUBSPECIALTIES. THE LARGEST 24-HOUR LEVEL I TRAUMA CENTER IN NEW ENGLAND, BMC'S EMERGENCY DEPARTMENT HAD 128,231 VISITS IN FY11. BMC SERVES THE URBAN COMMUNITY OF GREATER BOSTON. THE MAJORITY OF THE COMMUNITIES THAT BMC SERVES ARE BOSTON CENSUS TRACTS THAT ARE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS/POPULATIONS. BMC'S SERVICE COMMUNITIES REPRESENT MORE THAN 50% OF THE 107 SUCH DESIGNATED TRACTS IN SUFFOLK COUNTY (COMPRISING BOSTON AND THREE TOWNS). ALTHOUGH MASSACHUSETTS' UNIVERSAL CARE ENABLES INDIVIDUALS TO SEEK CARE AT ANY HOSPITAL, BMC REMAINS THE LARGEST SAFETY NET PROVIDER IN BOSTON AND NEW ENGLAND. THE IMPLEMENTATION OF UNIVERSAL CARE DID NOT REDUCE THE REAL NUMBER OR PERCENT OF UNDERSERVED COMMUNITIES SERVED BY BMC. IN 2009, 17% OF BOSTON RESIDENTS HAD INCOMES BELOW THE FEDERAL POVERTY LEVEL, WHILE NEARLY HALF OF BMC'S PATIENTS HAVE INCOMES BELOW THE FEDERAL POVERTY LEVEL. ACCORDING TO THE 2010 MASSACHUSETTS HEALTH INSURANCE SURVEY (WHICH INCLUDES DATA FROM 2008-2010), 1.9% OF RESIDENTS WERE UNINSURED AND 98.1% OF MASSACHUSETTS RESIDENTS HAD COVERAGE DURING THE SURVEY. THE COMPOSITION OF THE LATTER IS: 16.4% MEDICAID; 65.1% EMPLOYER SPONSORED INSURANCE; AND 16.6% PUBLIC OR OTHER INSURANCE. OF BMC'S PATIENTS, NEARLY 4.6% ARE UNINSURED, AND COVERAGE RATES FOR PRIMARY INSURANCE WERE APPROXIMATELY: 18.8% MEDICAID; 52.9% PRIVATE OR OTHER INSURANCE (EMPLOYER SPONSORED AND OTHER); AND 23.7% PUBLIC. LINE 1: REQUIRED DESCRIPTIONS PART I, LINE 3C ORGANIZATION OFFERS A DISCOUNT FROM CHARGES REGARDLESS OF INCOME OR ASSETS. THE DISCOUNT IS EQUAL TO THE UNCOMPENSATED CARE COST TO CHARGE RATIO. PART I, LINE 7 FOR THE CALCULATION OF COSTS OF CHARITY CARE (LINE 7A) & MEDICAID COST (LINE 7B) AN OVERALL COST TO CHARGE RATIO WAS USED. A COST TO CHARGE RATIO IS DETERMINED BY DIVIDING THE TOTAL CHARGES FOR ALL SERVICES INTO THE TOTAL COST OF PROVIDING THE SERVICES. THE RESULTING RATIO IS KNOWN AS A COST TO CHARGE RATIO. THE RATIO IS MULTIPLIED BY THE CHARGES FOR CHARITY CARE & MEDICAID TO OBTAIN THEIR RESPECTIVE COSTS. FOR THE CALCULATION OF COMMUNITY HEALTH IMPROVEMENT SERVICES(LINE 7E) DISCRETE COSTING WAS USED. FOR THE CALCULATION OF HEALTH PROFESSIONS EDUCATION COST (LINE 7F) THE CENTERS FOR MEDICARE & MEDICAID (CMS) COST ALLOCATION METHODOLOGY PER CMS FORM 2552 WAS USED. CMS FORM 2552 IS A REQUIRED ANNUAL FILING TO THE FEDERAL GOVERNMENT. PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE WAS $33,585,564. PART II BMC CONTRIBUTES TO THE COMMUNITY THROUGH ITS PAYMENT OF LINKAGE FEES TO THE CITY OF BOSTON, WHICH FUND PROGRAMS FOR AFFORDABLE HOUSING AND NEIGHBORHOOD HEALTH CARE. BMC ALSO PROVIDES SUBSIDIES TO BOSTON HEALTHNET, WHICH SUPPORTS COMMUNITY-BASED SERVICES. PHYSICIAN IMPROVEMENTS AND HOUSING: ACCORDING TO THE DEVELOPMENT IMPACT PROJECT AGREEMENT FOR MOAKLEY MEDICAL SERVICES BUILDING PROJECT BETWEEN BOSTON MEDICAL CENTER AND THE BOSTON REDEVELOPMENT AUTHORITY IN 2005, BMC AGREES TO PAY SEVEN EQUAL ANNUAL LINKAGE FEES OF $74,012 TO THE NEIGHBORHOOD HOUSING TRUST TOTALING $518,000. BOSTON MEDICAL CENTER HAS AGREEMENTS WITH BOSTON ALLIANCE FOR COMMUNITY HEALTH. ACCORDING TO THE VARIOUS AGREEMENTS BMC HAS AGREED TO PAY LINKAGE FEES OF $46,892 FOR FIVE YEARS ENDING IN FISCAL YEAR 2013 TOTALING TO $234,460, $19,400 FOR FIVE YEARS ENDING IN FISCAL YEAR 2011 TOTALING TO $97,000, AND $16,700 FOR FIVE YEARS ENDING IN 2014 TOTALING TO $83,500. BOSTON MEDICAL CENTER ALSO HAS AN AGREEMENT WITH THE BRA TO PAY LINKAGE FEES FOR HOUSING OF $24,875 PER YEAR FOR 12 YEARS ENDING 2012 TOTALING TO $298,500. MATTAPAN COMMUNITY HEALTH CENTER, AN AFFILIATE OF BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $8,200,000 FROM BOSTON MEDICAL CENTER DURING 2009 AND 2010 IN THE FORM OF A LOAN THAT WAS ORIGINATED EFFECTIVE SEPTEMBER 30, 2010. COMMENCING NOVEMBER 1, 2011, BOSTON MEDICAL CENTER SHALL FORGIVE TEN PERCENT OF THE ORIGINAL PRINCIPAL AMOUNT OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING SHALL BE FORGIVEN IN TEN YEARS. THE FISCAL YEAR 2011 EXPENSE RELATED TO THE FORGIVENESS OF THIS LOAN WAS $660,000. CAPITAL INVESTMENTS IN BOSTON HEALTHNET: WHILE THE NEED FOR COMMUNITY-BASED SERVICES CONTINUES TO GROW, IT HAS BECOME INCREASINGLY DIFFICULT FOR HEALTH CENTERS TO MEET THE DEMAND. REIMBURSEMENT OFTEN DOES NOT COVER THE FULL COST OF CARING FOR THE COMPLEX NEEDS OF HEALTH CENTERS' DIVERSE PATIENT POPULATION. COMPOUNDING THIS PROBLEM, IN THE MID-LATE 1990S MANY HEALTH CENTERS FOUND THEMSELVES OPERATING IN FACILITIES THAT WERE IN DESPERATE NEED OF RESTORATION OR EXPANSION. COSTLY INFORMATION TECHNOLOGY UPGRADES WERE ALSO REQUIRED TO ENHANCE MANAGEMENT EFFICIENCIES AND PATIENT CARE. IN RESPONSE TO THE HEALTH CENTERS' NEEDS, BMC PROVIDES APPROXIMATELY $16 MILLION IN OPERATING SUPPORT TO THE BOSTON HEALTHNET HEALTH CENTERS EACH YEAR. OTHER NET SUBSIDIES INCLUDE MOSTLY ECONOMIC DEVELOPMENT, COMMUNITY HEALTH IMPROVEMENT AND WORKFORCE DEVELOPMENT SUCH AS PROVIDING FREE SHUTTLE SERVICES FOR PATIENTS, PAYMENT FOR PHYSICIAN SERVICES UNDER CONTRACT AND JOINT HIRES OF PHYSICIANS. PART III, LINE 3 THE ORGANIZATION ESTIMATED $0 OF THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST) AS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY DUE TO THE MANNER IN WHICH THE DETAIL OF THE BAD DEBT EXPENSE IS PROCESSED IN ITS SYSTEM. PART III, LINE 4 THERE IS NO FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE IS EQUAL TO THE CHANGE IN THE ACCOUNT RECEIVABLE RESERVE FOR UNCOLLECTIBLE ACCOUNTS. THE AMOUNT OF THE ACCOUNT RECEIVABLE RESERVE CONSIDERS THE ACCOUNT'S AGE AND PAYOR SOURCE WHEN DETERMINING THE LIKELIHOOD OF PAYMENT. THE RATE OF COST TO CHARGES (RCC) METHODOLOGY WAS USED FOR DETERMINING BAD DEBT EXPENSE DUE TO THE LACK OF A COST ACCOUNTING SYSTEM. THE HOSPITAL'S OPERATING LOSS HAS BEEN INCLUDED AS A COMMUNITY BENEFIT. THIS IS DUE TO THE HOSPITAL'S UNIQUE PROGRAMS AND DIVERSE AND UNDERSERVED PATIENT POPULATION. PART III, LINE 8 MEDICARE ALLOWABLE COSTS OF $163,401,660 WERE CALCULATED USING THE CMS FORM 2552 METHODOLOGY OF DETERMINING MEDICARE COSTS. THIS UTILIZES THE STEP DOWN METHOD OF DETERMINING FULLY ALLOCATED COSTS BY DISTINCT CLINICAL COST CENTERS AS DEFINED BY CMS. THESE FULLY ALLOCATED COSTS ARE APPLIED AGAINST TOTAL CHARGES TO CALCULATE A RATIO OF COST TO CHARGES (RCC). THE RCC IS APPLIED TO MEDICARE CHARGES BY DISTINCT CLINICAL COST CENTERS TO DETERMINE THE MEDICARE COSTS. PART V, SECTION A BOSTON MEDICAL CENTER ALSO OPERATES THE FOLLOWING OUTPATIENT CENTERS, WHICH ARE UNDER THE HOSPITAL'S LICENSE: CODMAN SQUARE HEALTH CENTER CHARLESTOWN HS STUDENT HEALTH CENTER BRIGHTON HIGH SCHOOL STUDENT HEALTH CENTER BMC RADIOLOGY AT RYAN CENTER BOSTON UNIVERSITY EAST BOSTON NEIGHBORHOOD HEALTH CENTER (10 GROVE ST.) EAST BOSTON NEIGHBORHOOD HEALTH CENTER (20 MAVERICK SQ.) DORCHESTER HOUSE MULTI-SERVICE CENTER MADISON PARK HS STUDENT HEALTH CENTER JEREMIAH E. BURKE STUDENT HEALTH CENTER GREATER ROSLINDALE MEDICAL & DENTAL LATIN ACADEMY STUDENT HEALTH CENTER TECHBOSTON ACADEMY SCHOOL HEALTH CENTER HARBOR SCHOOL BOSTON MEDICAL CENTER DEPT. OF RADIOLOGY AT WHITTIER HEALTH CENTER BOSTON MEDICAL CENTER DEPT. OF RADIOLOGY AT UPHAM'S CORNER HEALTH CENTER JOHN D. O'BRYANT STUDENT HEALTH CENTER MURIEL SNOWDEN INTERNATIONAL HS HEALTH CENTER BMC SCHOOL BASED CENTER AT BOSTON COMMUNITY LEADERSHIP ACADEMY ELDER SERVICE PLAN DISPENSING PHARMACY SOUTH BOSTON COMMUNITY HEALTH CENTER (386 WEST BROADWAY) SOUTH BOSTON COMMUNITY HEALTH CENTER (409 WEST BROADWAY) LINE 2: NEEDS ASSESSMENT BMC'S ASSESSMENT OF THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES IS BASED ON DEMONSTRATED NEED. THE MEDICAL LEGAL PARTNERSHIP I BOSTON (MLP) IS ONE OF MANY EXAMPLES OF HOW DEMONSTRATED NEED INFORMS BMC (BMC) COMMUNITY HEALTH IMPROVEMENT ACTIVITIES AND SERVICES. IN 1993, CLINICIANS WITHIN THE DEPARTMENT OF PEDIATRICS UNDERSTOOD THAT NUTRITION AND HOME ENERGY WERE ROOT CAUSES OF POOR HEALTH AND DEVELOPMENT AMONG THEIR PREDOMINANTLY LOW-INCOME PEDIATRIC PATIENTS. IN RESPONSE, MLP INITIATED THE "ENERGY CLINIC" IN 2006 TO PROVIDE TARGETED ADVOCACY AROUND ISSUES OF NUTRITION AND HOME ENERGY. TODAY, MLP IS A NATIONAL LEADER IN MEDICAL-LEGAL COLLABORATION TO ADDRESS THE ROOT CAUSES OF PEDIATRIC POOR HEALTH AND DEVELOPMENT. MLP SEEKS TO IMPROVE THE HEALTH AND WELLBEING OF PEOPLE IN POVERTY BY ADDRESSING THE NON-MEDICAL BARRIERS TO HEALTH FACED BY LOW-INCOME INDIVIDUALS. MLP ALLIES LAWYERS AND HEALTH PROFESSIONALS AND CREATES ACCESS TO LEGAL SERVICES IN THE CLINICAL SETTING TO ENSURE THAT LOW-INCOME PATIENTS' BASIC NEEDS-FOR FOOD, HOUSING, EDUCATION, HEALTH CARE, AND SAFETY/STABILITY-ARE MET. THE NATIONAL MLP NETWORK NOW EXTENDS TO MORE THAN 80 SITES ACROSS THE COUNTRY, SPANNING BOTH URBAN AND RURAL COMMUNITIES. LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FOR THOSE PATIENTS WHO ARE UNINSURED OR UNDERINSURED, BMC WILL ASSIST THEM IN APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL PROVIDE ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE BILLS THAT ARE SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES THAT ARE POSTED THROUGHOUT THE HOSPITAL. THE GOAL OF THESE NOTICES IS TO ASSIST PATIENTS IN APPLYING FOR COVERAGE WITHIN A FINANCIAL ASSISTANCE PROGRAM, SUCH AS MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR MEDICAL HARDSHIP THROUGH THE HEALTH SAFETY NET. THE HOSPITAL WILL PROVIDE, UPON REQUEST, SPECIFIC INFORMATION ABOUT THE ELIGIBILITY PROCESS TO BE A LOW INCOME PATIENT UNDER EITHER THE MASSACHUSETTS HEALTH SAFETY NET PROGRAM OR ADDITIONAL ASSISTANCE FOR PATIENTS WHO ARE LOW INCOME THROUGH THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL WILL ALSO NOTIFY THE PATIENT ABOUT AVAILABLE PAYMENT PLANS THAT MAY BE AVAILABLE TO THEM BASED ON THEIR FAMILY'S SIZE AND INCOME. THE HOSPITAL 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 THEIR SERVICES, WHILE THE PATIENT IS IN THE HOSPITAL, UPON DISCHARGE, AND FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THE HOSPITAL REGISTRATION AND ADMISSIONS STAFF WILL DIRECT ALL PATIENTS SEEKING AVAILABLE COVERAGE OPTIONS OR FINANCIAL ASSISTANCE, TO THE HOSPITAL'S PATIENT FINANCIAL COUNSELING OFFICE TO DETERMINE IF THEY ARE ELIGIBLE AND THEN TO SCREEN FOR ELIGIBILITY IN AN APPROPRIATE COVERAGE OPTION. THE HOSPITAL WILL THEN ASSIST THE PATIENT IN APPLYING FOR THE APPROPRIATE COVERAGE OPTIONS THAT ARE AVAILABLE OR NOTIFY THEM OF THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL WILL ALSO PROVIDE INFORMATION ON HOW TO CONTACT THE APPROPRIATE STAFF WITHIN THE HOSPITAL'S PATIENT FINANCIAL SERVICES DEPARTMENT (PFS) TO VERIFY THE ACCURACY OF THE HOSPITAL BILL OR TO DISPUTE CERTAIN CHARGES. THE HOSPITAL WILL POST A NOTICE (SIGNS) OF AVAILABILITY OF FINANCIAL ASSISTANCE AS OUTLINED IN THIS CREDIT AND COLLECTION POLICY IN THE FOLLOWING LOCATIONS: I. INPATIENT, CLINIC, AND EMERGENCY DEPARTMENT AND/OR WAITING AREAS; II. PATIENT FINANCIAL COUNSELOR AREAS; III. CENTRAL ADMISSION/REGISTRATION AREAS; AND/OR IV. BUSINESS OFFICE AREAS THAT IS OPEN TO PATIENTS. POSTED SIGNS WILL BE CLEARLY VISIBLE AND LEGIBLE TO PATIENTS VISITING THESE AREAS. THE HOSPITAL WILL ALSO INCLUDE A NOTICE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ALL INITIAL BILLS. WHEN THE PATIENT CONTACTS THE HOSPITAL, THE HOSPITAL PFS STAFF WILL NOTIFY THE PATIENT IF THEY MAY QUALIFY FOR A PAYMENT PLAN. A PATIENT WHO IS ENROLLED IN A PUBLIC FINANCIAL ASSISTANCE PROGRAM (E.G., MASSHEALTH, HEALTH SAFETY NET, OR FOR MEDICAL HARDSHIP) MAY QUALIFY FOR CERTAIN PLANS. PATIENTS MAY ALSO QUALIFY FOR ADDITIONAL ASSISTANCE BASED ON THE HOSPITAL'S OWN INTERNAL CRITERIA FOR FINANCIAL ASSISTANCE. FOR CASES WHERE THE HOSPITAL IS USING THE VIRTUAL GATEWAY (STATE'S PORTAL) APPLICATION, THE HOSPITAL WILL ASSIST THE PATIENT IN COMPLETING THE APPLICATION FOR MASSHEALTH, COMMONWEALTH CARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTHY START, HEALTH SAFETY NET, OR OTHER FORMS OF FINANCIAL ASSISTANCE PROGRAMS AS THEY BECOME PART OF THE VIRTUAL GATEWAY PROGRAM. ALL SIGNS AND NOTICES SHALL BE TRANSLATED INTO LANGUAGES OTHER THAN ENGLISH IF SUCH LANGUAGE IS SPOKEN BY 10% OR MORE OF THE POPULATION RESIDING IN THE HOSPITAL SERVICE AREA. CURRENTLY, THE HOSPITAL TRANSLATES THE NOTICES INTO THE FOLLOWING LANGUAGES: ENGLISH PORTUGUESE SPANISH HAITIAN CREOLE LINE 4: COMMUNITY INFORMATION SEE INTRODUCTION. LINE 5: PROMOTION OF COMMUNITY HEALTH SPECIAL SUPPORT FOR CHILDREN AND FAMILIES: CHILD LIFE PROGRAM (CLP): THE CLP HELPS CHILDREN AND FAMILIES MANAGE THE STRESSES ASSOCIATED WITH HOSPITALIZATION AND ILLNESS. THE CHILD LIFE TEAM IS TRAINED TO HELP CHILDREN AND FAMILIES UNDERSTAND THE HOSPITAL EXPERIENCE AND RELATED FEELINGS. THE GOALS OF THE CLP ARE TO: HELP CHILDREN EXPRESS THEIR FEELINGS IN A SAFE AND SUPPORTIVE ENVIRONMENT; HELP CHILDREN MANAGE PAIN EFFECTIVELY; OFFER CHILDREN CHOICES THAT INCREASE FEELINGS OF INDEPENDENCE, SELF ESTEEM AND TRUST; AND ASSIST WITH IMPLEMENTATION OF COPING TECHNIQUES DURING STRESSFUL SITUATIONS. CHILDREN'S HEALTH WATCH (CHW): CHW IS A NON-PARTISAN PEDIATRIC RESEARCH CENTER THAT MONITORS THE IMPACT OF ECONOMIC CONDITIONS AND PUBLIC POLICIES ON THE HEALTH AND WELL-BEING OF VERY YOUNG CHILDREN. CHW INTERVIEWS FAMILIES WITH YOUNG CHILDREN IN FIVE HOSPITALS ACROSS THE NATION, INCLUDING BMC (5,500 PATIENT INTERVIEWS IN FY11), THAT SERVE THE POOREST FAMILIES. THE DATABASE OF MORE THAN 44,000 CHILDREN, 80 PERCENT OF WHOM ARE MINORITIES, IS THE LARGEST CLINICAL DATABASE IN THE NATION ON VERY YOUNG CHILDREN LIVING IN POVERTY. DATA ARE COLLECTED ON A WIDE VARIETY OF ISSUES, INCLUDING DEMOGRAPHICS, FOOD SECURITY, PUBLIC BENEFITS, HOUSING, HOME ENERGY, AND CHILDREN'S HEALTH STATUS AND DEVELOPMENTAL RISK. WE SEEK TO PROVIDE POLICY MAKERS AND ADVOCACY GROUPS WITH THE EVIDENCE THEY NEED TO SHAPE POLICIES THAT PREVENT CHILD HUNGER AND PROMOTE CHILDREN'S HEALTH. PEDIATRIC ASSESSMENT OF COMMUNICATION CLINIC (THE AUTISM CLINIC): SINCE 2003, THE AUTISM CLINIC HAS PROVIDED EVALUATIONS AND ONGOING CARE FOR CHILDREN OF ALL AGES WHEN THERE IS A PEDIATRICIAN CONCERN ABOUT AUTISM SPECTRUM DISORDER (ASD) AND RELATED CONDITIONS, OR WHEN THEY HAVE A PREVIOUS DIAGNOSIS OF ASD. THE PRIMARY SERVICE PROVIDED BY THE AUTISM CLINIC STAFF IS EDUCATIONAL ADVOCACY. THE AUTISM CLINIC'S EDUCATIONAL SPECIALIST PROVIDES DIRECT SUPPORT SERVICES TO PRIMARILY LOW-INCOME AND/OR IMMIGRANT FAMILIES WHO HAVE LIMITED ENGLISH PROFICIENCY AND ARE MOST CHALLENGED BY THE COMPLEX REGULATIONS GOVERNING THE SPECIAL EDUCATION SYSTEM. AS NEEDED, SHE TRAVELS TO CLASSROOMS TO OBSERVE YOUNG PATIENTS WITH ASD AND TO HELP FAMILIES ACCESS THE PROPER SPECIAL EDUCATION PLACEMENT FOR THEIR CHILDREN, MUCH FASTER THAN THESE FAMILIES COULD MANAGE ON THEIR OWN. IN FY11, THE AUTISM CLINIC EVALUATED MORE THAN 300 NEW PATIENTS AND PROVIDED REGULAR FOLLOW-UP TO AN ADDITIONAL 400 FAMILIES. BIRTH SISTERS AND PERINATAL CARE: BMC HAS DEVELOPED TWO PROGRAMS, BIRTH SISTERS AND CENTERING PREGNANCY, TO IMPROVE HEALTH OUTCOMES OF CHILDBEARING WOMEN AT RISK FOR POOR MATERNAL AND INFANT OUTCOMES. BIRTH SISTERS ARE WOMEN WHO ARE TRAINED TO PROVIDE SOCIAL SUPPORT AND EDUCATION TO MOTHERS FROM THEIR OWN COMMUNITIES DURING PREGNANCY, LABOR, AND THE POSTPARTUM PERIOD. THE BIRTH SISTERS PROGRAM HAS BEEN LINKED TO SIGNIFICANTLY HIGHER BREASTFEEDING RATES AND FEWER CESAREAN DELIVERIES. CENTERING PREGNANCY IS AN INNOVATIVE AND PROVEN MODEL OF CARE THAT OFFERS PRENATAL CARE IN 10 TWO-HOUR GROUP SESSIONS USING A BMC-DEVELOPED CURRICULUM. AT THESE SESSIONS BEGINNING EARLY IN THE SECOND TRIMESTER, PATIENTS RECEIVE HEALTH VISITS, PRENATAL AND PARENTING EDUCATION AND PEER GROUP SUPPORT ALL IN ONE VISIT. THE PROGRAMS SERVICED A COMBINED 442 PATIENTS IN FY11. SUPPORTING PARENTS AND RESILIENT KIDS CENTER (SPARK): SPARK IS A THERAPEUTIC DAY PROGRAM FOR BOSTON'S MOST VULNERABLE CHILDREN, INCLUDING THOSE LIVING WITH HIV/AIDS; THOSE BORN VERY PREMATURELY; THOSE WHO HAVE SUFFERED PSYCHOLOGICAL TRAUMA DUE TO ABUSE/NEGLECT; AND THOSE WITH COMPLEX MEDICAL AND EMOTIONAL NEEDS. SPARK STAFF PROVIDE MEDICAL, EDUCATIONAL, NUTRITIONAL, AND MENTAL HEALTH SERVICES TO VULNERABLE CHILDREN FROM BIRTH TO AGE 22. SPARK OPERATES AN EARLY CHILDHOOD DAY PROGRAM, A SCHOOL-AGE AFTER-SCHOOL PROGRAM, A YOUNG ADULT JOB TRAINING PROGRAM AND A SUMMER CAMP PROGRAM, SERVING APPROXIMATELY 100 CHILDREN ANNUALLY WHO LIVE THROUGHOUT EASTERN MASSACHUSETTS. SPARK HELPS CHILDREN TO BUILD POSITIVE SOCIAL NETWORKS, POSITIVE SELF-REGARD AND COMMUNITY BELONGING. ADDITIONALLY, THE PROGRAM PROVIDES PARENTING EDUCATION AND SUPPORT. MEDICAL LEGAL PARTNERSHIP BOSTON (MLP-BOSTON): MLP-BOSTON SEEKS TO IMPROVE THE HEALTH AND WELLBEING OF PEOPLE LIVING IN POVERTY BY ADDRESSING THE NON-MEDICAL BARRIERS TO HEALTH THAT LOW-INCOME INDIVIDUALS SO OFTEN FACE. MLP-BOSTON ALLIES LAWYERS AND HEALTH PROFESSIONALS AND CREATES ACCESS TO LEGAL SERVICES IN THE CLINICAL SETTING TO ENSURE THAT LOW-INCOME PATIENTS' BASIC NEEDS-FOR FOOD, HOUSING, EDUCATION, HEALTH CARE, AND SAFETY/STABILITY-ARE MET. IN FY11, MLP-BOSTON SERVED 1,000 INDIVIDUALS. MARGARET M. SHEA RN ADULT DAY HEALTH PROGRAM: THIS PROGRAM OFFERS FAMILIES PEACE OF MIND AND A SUPPORT SYSTEM TO HELP THEM WITH DECISIONS INVOLVING THE CARE OF THEIR LOVED ONES. IT IS A HOLISTIC MEDICAL INTERVENTION PROGRAM THAT PROVIDES SERVICES IN AN AMBULATORY, HOME-LIKE SETTING FOR ADULTS WHO DO NOT REQUIRE 24-HOUR INSTITUTIONAL CARE, BUT BECAUSE OF PHYSICAL AND/OR MENTAL IMPAIRMENT, ARE NOT COMPLETELY ABLE TO LIVE INDEPENDENTLY. ALL PARTICIPANTS ARE REFERRED TO THE PROGRAM AND ARE SCREENED BEFORE ENTERING THE PROGRAM. SERVICES OFFERED BY THE PROGRAM INCLUDE NURSING, SOCIAL SERVICES, ACTIVITIES AND TRANSPORTATION. RESPONDING TO THE NEEDS OF PATIENTS AFFECTED BY VIOLENCE CHILD PROTECTION TEAM (CPT): A SPECIAL SERVICES DIVISION OF THE DEPARTMENT OF PEDIATRICS, CPT SERVES ALL OF BMC'S MALTREATED PEDIATRIC PATIENTS. THE CPT HAS THREE MAJOR AREAS OF RESPONSIBILITY: 1) SUPPORTING BMC PROVIDERS TO ENSURE THAT MALTREATED CHILDREN TREATED AT BMC ARE PROTECTED; 2) IMPROVING THE EFFECTIVE IDENTIFICATION AND RESPONSE TO MALTREATMENT THROUGH INNOVATIVE RESEARCH AND PROGRAM DEVELOPMENT AT BMC AND NATIONALLY; AND 3) PROVIDING TRAINING AND EDUCATION TO PEDIATRIC HEALTH AND OTHER PROFESSIONALS IN THE RECOGNITION AND MANAGEMENT OF CHILD MALTREATMENT. CPT COLLABORATES WITH COMMUNITY AND STATE AGENCIES, LAW ENFORCEMENT PERSONNEL AND THE JUDICIARY SYSTEM TO ENSURE THE BEST POSSIBLE OUTCOME FOR CHILDREN AND FAMILIES. CHILD WITNESS TO VIOLENCE PROJECT (CWVP): CWVP IS A NATIONALLY-RECOGNIZED AND AWARD-WINNING COUNSELING, OUTREACH, AND CONSULTATION PROGRAM THAT FOCUSES ON YOUNG CHILDREN UNDER THE AGE OF EIGHT WHO ARE EXPOSED TO DOMESTIC OR COMMUNITY VIOLENCE. THE CWVP OFFERS A FLEXIBLE COMBINATION OF SERVICES TO CHILDREN AND THEIR FAMILIES, INCLUDING: INTENSIVE TRAUMA-FOCUSED COUNSELING THAT IS DEVELOPMENTALLY TAILORED TO VERY YOUNG CHILDREN AND THEIR PARENTS; ACCESS TO LEGAL ADVOCACY; AND ASSISTANCE WITH LINKING TO OTHER NECESSARY SERVICES INCLUDING HEALTH CARE, CHILD CARE, HOUSING, AND AFTER-SCHOOL PROGRAMS. IN 2011, THE CWVP PROVIDED TRAUMA-FOCUSED COUNSELING SERVICES TO 90 CHILDREN, AND BRIEF CONSULTATION/ADVOCACY FOR AN ADDITIONAL 200 FAMILIES. THE TRAINING/CLINICAL CONSULTATION COMPONENT OF THE PROGRAM DELIVERED 100 TRAININGS ACROSS MASSACHUSETTS AND 12 STATES. DOMESTIC VIOLENCE PROGRAM (DVP): THE DVP PROVIDES TRAINING AND EDUCATION FOR STAFF, ASSISTANCE WITH HOSPITAL POLICY AND PROTOCOL DEVELOPMENT, CONSULTATION ON A VARIETY OF CLINICAL AND RESEARCH INITIATIVES, AS WELL AS DIRECT ADVOCACY/SUPPORT SERVICES FOR SURVIVORS OF DOMESTIC AND DATING ABUSE. IN 2009, A SAFETY AND SUPPORT ADVOCATE POSITION WAS CREATED TO PROVIDE A RANGE OF ADVOCACY AND SUPPORT SERVICES TO PATIENTS REFERRED FROM A RANGE OF ADULT AND ADOLESCENT SETTINGS AND PROVIDERS. THE DVP SERVED 200 INDIVIDUALS IN FY11 BY PROVIDING SERVICES SUCH AS CRISIS INTERVENTION/COUNSELING; RISK ASSESSMENT AND SAFETY PLANNING; ASSISTANCE WITH ACCESSING PROTECTIVE ORDERS, VICTIM COMPENSATION; ACCOMPANIMENT TO COURT, LEGAL, MEDICAL, HOUSING AND OTHER APPOINTMENTS; REFERRAL TO COMMUNITY-BASED DV ADVOCACY/RAPE CRISIS COUNSELING, MEDICAL/MENTAL HEALTH SERVICES AND OTHER SUPPORT AS NEEDED. VIOLENCE INTERVENTION ADVOCATE PROGRAM (VIAP): IN APRIL 2006, BMC PILOTED VIAP TO PROVIDE SPECIALIZED SERVICES TO VICTIMS OF VIOLENCE, USING TWO COMMUNITY HEALTH WORKERS, VIOLENCE INTERVENTION ADVOCATES, TO PROVIDE INDIVIDUAL COUNSELING, TRIAGE AND REFERRAL SERVICES FOR VICTIMS OF VIOLENCE BROUGHT TO THE BMC EMERGENCY DEPARTMENT. VIAP STAFF COLLABORATE WITH PUBLIC AND PRIVATE AGENCIES TO OFFER A BROAD SPECTRUM OF CONCRETE SERVICES TO PATIENTS RECOVERING FROM VIOLENT INJURY. EACH VIAP SITE HAS HIRED A PEER VIOLENCE INTERVENTION ADVOCATE VIA WITH STRONG COMMUNITY KNOWLEDGE. IN FY11, VIAP PROVIDED SERVICES TO A TOTAL OF 415 VICTIMS: 178 GUNSHOT VICTIMS AND 237 STABBING VICTIMS. OF THESE VICTIMS, 34 WERE FEMALE. VIAP PROVIDED THE FOLLOWING DIRECT SERVICES AND REFERRALS TO SERVICES TO VICTIMS AND 34 FAMILIES: CRISIS INTERVENTION AND STABILIZATION; HOUSING AND TRANSPORTATION; LEGAL; EDUCATIONAL; VOCATIONAL AND LIFE SKILLS DEVELOPMENT; MENTAL HEALTH; EMPLOYMENT; AND HEALTH AND WELLNESS. COMMUNITY OUTREACH CANCER SCREENINGS: BMC OFFERS AN ANNUAL FREE CANCER SCREENING EVENT TO VULNERABLE, UNDERSERVED INDIVIDUALS IN ORDER TO PROMOTE THE EARLY DETECTION OF CANCER. BECAUSE BMC SERVES A PREDOMINANTLY MINORITY AND LOW-INCOME POPULATION, INCLUDING MANY NON-ENGLISH-SPEAKING CITIZENS AND IMMIGRANTS, THE DELIVERY OF EXCEPTIONAL CARE REQUIRES A KEEN SENSITIVITY TO THE CHALLENGES FOR OUR PATIENT POPULATION. THE SATURDAY CANCER SCREENINGS EFFECTIVELY REACH OUR TARGET POPULATION BECAUSE THEY CREATE A CONVENIENT TIME FOR PEOPLE WHO WORK TO ACCESS SCREENINGS, AND ALLOW HUSBANDS AND WIVES TO SUPPORT EACH OTHER AS THEY BOTH ARE SCREENED. A TOTAL OF 240 PEOPLE FROM BOSTON AND SURROUNDING AREAS ATTENDED THE 2011 SCREENING EVENT. FLU VACCINE DAY: BMC BEGAN ITS 2010-2011 INFLUENZA VACCINATION CAMPAIGN IN SEPTEMBER OF 2010 MAKING INFLUENZA VACCINE AVAILABLE TO ALL PATIENTS IN BOTH THE INPATIENT AND AMBULATORY CARE SETTINGS. TO DATE, BMC HAS ADMINISTERED MORE THAN 31,348 DOSES OF VACCINE. A SAFETY NET FOR SPECIAL AT-RISK POPULATIONS THE METRO BOSTON JAIL DIVERSION PROGRAM (JDP): SINCE 2006, THE JDP HAS WORKED WITH 529 INDIVIDUALS WITH MENTAL HEALTH AND/OR CO-OCCURRING MENTAL HEALTH AND SUBSTANCE DEPENDENCE WHOSE ASSOCIATED BEHAVIOR BRINGS THEM TO THE ATTENTION OF LAW ENFORCEMENT AND COURTS. THE JDP COLLABORATES WITH THE POLICE AND COURTS TO BOTH IDENTIFY INDIVIDUALS WITH THESE RISK FACTORS AND CONNECT THEM WITH APPROPRIATE SERVICES AND TREATMENT AS ALTERNATIVES TO ARREST AND INCARCERATION. THE JDP IS TRAINING BOSTON POLICE DEPARTMENT AND MASSACHUSETTS BAY TRANSIT AUTHORITY OFFICERS TO IDENTIFY INDIVIDUALS WITH MENTAL ILLNESS AND HOW TO REFER INDIVIDUALS TO SERVICES INSTEAD OF ARRESTING THEM. AT THE COURT LEVEL, 56 JDP PARTICIPANTS HAVE SUCCESSFULLY COMPLETED PROBATION RATHER THAN BEING INCARCERATED. BOSTON CENTER FOR REFUGEE HEALTH AND HUMAN RIGHTS (BCRHHR): THE MISSION OF THE BCRHHR IS TO PROVIDE COMPREHENSIVE HEALTH CARE FOR REFUGEES AND SURVIVORS OF TORTURE AND RELATED TRAUMA, COORDINATED WITH LEGAL AID AND SOCIAL SERVICES; EDUCATE AND TRAIN AGENCIES AND PROFESSIONALS WHO SERVE THESE COMMUNITIES; ADVOCATE FOR THE PROMOTION OF HEALTH AND HUMAN RIGHTS IN THE UNITED STATES AND WORLDWIDE; AND CONDUCT CLINICAL, EPIDEMIOLOGICAL, AND LEGAL RESEARCH FOR THE BETTER UNDERSTANDING AND PROMOTION OF HEALTH AND QUALITY OF LIFE FOR SURVIVORS OF TORTURE AND RELATED TRAUMA. IN FY11, THE BCRHHR SERVED MORE THAN 500 PATIENTS. ELDERS LIVING AT HOME PROGRAM (ELAHP): IN FY11, ELAHP PROVIDED HOUSING SEARCH AND PLACEMENT TO 14 HOMELESS OLDER ADULTS, AND HOUSING STABILIZATION SERVICES TO AN ADDITIONAL 60 FORMERLY HOMELESS INDIVIDUALS. NONE OF THE VULNERABLE CLIENTS SERVED DURING THE YEAR RELAPSED INTO HOMELESSNESS, ALTHOUGH TWO INDIVIDUALS DID REQUIRE NURSING HOME PLACEMENT DUE TO SIGNIFICANT DECLINES IN THEIR COGNITIVE ABILITIES. THE GOAL OF ELAHP IS TO HELP OLDER ADULTS LOCATE AND MAINTAIN A PERMANENT RESIDENCE AND ALLOW THEM TO LIVE AS INDEPENDENTLY AS POSSIBLE. HEALTHY NUTRITION AND EXERCISE FOOD PANTRY: THE PREVENTIVE FOOD PANTRY AND DEMONSTRATION KITCHEN ADDRESS HUNGER-RELATED ILLNESS AND MALNUTRITION AMONG A LOW-INCOME, LARGELY UNDERSERVED AND VULNERABLE PATIENT POPULATION OF GREATER BOSTON. INDIVIDUALS AT RISK OF MALNUTRITION ARE REFERRED TO THE PROGRAM BY BMC OR BOSTON HEALTHNET PHYSICIANS OR NUTRITIONISTS WHO PROVIDE "PRESCRIPTIONS" FOR SUPPLEMENTAL FOOD THAT BEST PROMOTES PHYSICAL HEALTH, PREVENTS FUTURE ILLNESS, AND FACILITATES RECOVERY. THE FOOD PANTRY NOW PROVIDES NUTRITIONAL FOOD PRESCRIPTIONS TO APPROXIMATELY 7,000 PEOPLE EACH MONTH. OVER THE PAST FIVE YEARS THE PANTRY HAS SEEN AN 87% INCREASE IN DEMAND FOR ITS SERVICES. IN 2011, THE PANTRY PROVIDED 252,228-WORTH OF FOOD TO AN ESTIMATED 13,902 PEOPLE. THIS NUMBER IS EXPECTED TO RISE BY 5% IN 2012. APPROXIMATELY 10,000 POUNDS OF FOOD SUPPLIES ARE REQUIRED WEEKLY TO STOCK THE PANTRY SHELVES AT BMC. THE DEMONSTRATION KITCHEN COMPLEMENTS THE WORK OF THE PANTRY BY EDUCATING PATIENTS ABOUT NUTRITION THROUGH COOKING METHODS THAT ARE COMPATIBLE WITH THEIR MEDICAL AND DIETARY NEEDS, AS PRESCRIBED BY THEIR PHYSICIANS. GROW CLINIC: AS PART OF BMC'S PEDIATRICS DEPARTMENT, THE PRIMARY GOAL OF THE GROW CLINIC IS TO PROVIDE COMPREHENSIVE MULTIDISCIPLINARY MEDICAL, NUTRITIONAL, SOCIAL SERVICES AND DIETARY ASSISTANCE TO CHILDREN FROM THE GREATER BOSTON AREA DIAGNOSED WITH FAILURE TO THRIVE (FTT). CHILDREN WITH FTT HAVE SIGNIFICANT DIFFICULTY GROWING BECAUSE OF MALNUTRITION ASSOCIATED WITH POVERTY, ILLNESS AND FAMILY STRESS. THE EFFECTS OF FTT INCLUDE SHORTENED ATTENTION SPANS, EMOTIONAL PROBLEMS, DELAYED COGNITIVE DEVELOPMENT, LASTING GROWTH FAILURE, AND FREQUENT AND SERIOUS ILLNESS, WHICH CAN RESULT IN HOSPITALIZATION. IN 2011, THE GROW CLINIC PROVIDED MEDICAL TREATMENT, NUTRITIONAL ASSESSMENT, HOME HEALTH EDUCATION, FAMILY ADVOCACY, ACCESS TO A THERAPEUTIC FOOD PANTRY AND OTHER SERVICES, CHILDREN'S CLOTHES, DIAPERS, BOOKS AND EDUCATIONAL TOYS TO A TOTAL OF 225 PATIENTS/FAMILIES. ADULT WEIGHT MANAGEMENT: THE NUTRITION AND WEIGHT MANAGEMENT CENTER OFFERS SEVERAL PROGRAMS, SUCH AS WEEKLY SUPPORT GROUPS FOR WEIGHT MANAGEMENT AND A CANCER SURVIVOR'S WEIGHT MANAGEMENT GROUP, FOR THE COMMUNITY AIMED AT SUPPORTING HEALTHY LIFESTYLES AND NUTRITION. MORE THAN 500 PATIENTS BENEFITED FROM THESE SERVICES IN FY11. NUTRITION AND FITNESS FOR LIFE PROGRAM (NFL): THE DEPARTMENT OF PEDIATRICS WORKS TO PREVENT THE ONSET OF ADULT DIABETES IN YOUNG, UNDERSERVED, AND OVERWEIGHT AND OBESE PATIENTS THROUGH ITS NFL, WHICH PROVIDES CLINICAL AND COMMUNITY-BASED SERVICES TO CHILDREN AND THEIR FAMILIES. THE NFL MODEL FEATURES THREE PRIMARY COMPONENTS: 1) CLINICAL SERVICES TARGETING CHILDREN WITH >95 PERCENTILE OF BODY MASS INDEX; 2) THE FANTASTIC KIDS AFTER SCHOOL PROGRAM WHICH PROVIDES TEEN-MENTORED NUTRITION EDUCATION AND FITNESS ACTIVITIES FOR OVERWEIGHT AND OBESE YOUTH WHO ARE REFERRED TO THE PROGRAM BY THEIR PHYSICIANS; AND 3) CONTINUING MEDICAL EDUCATION FOR CLINICIANS TO INCREASE THEIR CAPACITY TO TREAT PEDIATRIC OVERWEIGHT PATIENTS IN THE PRIMARY CARE SETTING. THESE PROGRAMS FILL A LARGE GAP IN SERVICES TO POPULATIONS MOST STRONGLY IMPACTED BY THE PEDIATRIC OBESITY EPIDEMIC. BASIC NEEDS CLOTHING BANK: BMC'S SOCIAL WORKERS ACCESS THE CLOTHING BANK IN REAL TIME WHEN A PROVIDER CONTACTS SOCIAL WORK ABOUT A BASIC CLOTHING NEED (SWEAT PANTS, SHIRTS, UNDERWEAR, SOCKS, SHOES, AND WINTER COATS) FOR A LOW-INCOME PATIENT. SOCIAL WORK EMERGENCY FUND (SWEF): THE SWEF PROVIDED SHORT-TERM, IMMEDIATE ASSISTANCE TO APPROXIMATELY 700 PATIENTS WHO FACED CRISES IN FY11 AND HAD NOWHERE ELSE TO TURN. THE FUND ENABLES BMC TO COVER THE COSTS OF EMERGENCY EXPENSES WHILE ITS SOCIAL WORKERS HELP INDIVIDUALS AND FAMILIES FIND THE RESOURCES AND SERVICES THEY NEED TO STABILIZE THEIR LIVES AFTER PERSONAL CRISES. WE PROVIDE CAB VOUCHERS FOR THOSE UNABLE TO ACCESS PUBLIC TRANSPORTATION TO GET TO BMC, AND CAR SEATS AND CLOTHING TO YOUNG FAMILIES. SWEF HAS THE FLEXIBILITY TO PROVIDE FOR A RANGE OF NEEDS AND THE JUDICIOUS USE OF FUNDS HELPS IN A NUMBER OF UNIQUE SITUATIONS WHEN, TOO OFTEN, INDIVIDUALS AND FAMILIES HAVE NO ALTERNATIVE. REMOVING BARRIERS TO ACCESSING CARE NEW ENGLAND FLIGHT: BMC IS A BOSTON MEDFLIGHT (BMF) PARTNER. BMF IS A COMMISSION ON ACCREDITATION OF MEDICAL TRANSPORT SERVICES (CAMTS) ACCREDITED CRITICAL CARE TRANSPORT SERVICE. BOSTON MEDFLIGHT COMMITS TO EXCELLENCE IN CRITICAL CARE TRANSPORT BY PROVIDING THE HIGHEST QUALITY REGIONAL CRITICAL CARE TRANSPORT SYSTEM. AS A NON-PROFIT ORGANIZATION, BOSTON MEDFLIGHT TRANSPORTS EMERGENT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND IS FINANCIALLY SUPPORTED IN PART BY A CONSORTIUM OF BOSTON HOSPITALS INCLUDING BMC. FOR OVER 25 YEARS, BOSTON MEDFLIGHT HAS PLAYED AN INTEGRAL ROLE AS PART OF THE MASSACHUSETTS EMS SYSTEM AND THE COMMUNITY HOSPITALS OF NEW ENGLAND. PATIENT NAVIGATION: THE PATIENT NAVIGATION PROGRAM IS DESIGNED FOR PATIENTS WITH CANCER AND CHRONIC ILLNESSES, SUCH AS DIABETES, WHO NEED SPECIAL ASSISTANCE IN NAVIGATING THE HEALTH CARE SYSTEM. PATIENT NAVIGATORS ARE INDIVIDUALS FROM THE COMMUNITIES SERVED BY BMC AND WHO HAVE SPECIAL LANGUAGE SKILLS, TRAINING IN SCHEDULING, AND REFINED COMPASSION/COMMUNICATION SKILLS. PEER NAVIGATORS CONTACT OUR MOST VULNERABLE PATIENTS AND HELP THEM TO ACCESS THE DOCTOR VISITS AND TREATMENT THAT THEY NEED IN THE MOST EFFICIENT MANNER POSSIBLE, ARRANGING TRANSPORTATION FOR PATIENTS, REMINDING PATIENTS ABOUT APPOINTMENTS THAT THEY HELPED THE PATIENTS TO SCHEDULE, AND CONNECTING PATIENTS TO COMMUNITY RESOURCES SUCH AS THE BMC FOOD PANTRY. SHUTTLE BUSES/TAXIS: COMMUNITY ACCESS TO BMC IS ENHANCED THROUGH A FREE SHUTTLE BUS SERVICE. FOUR BUSES CIRCULATE THROUGHOUT THE SYSTEM ON ESTABLISHED ROUTES, FROM 7AM-7PM, MONDAY THROUGH FRIDAY, BRINGING PATIENTS TO BMC. IN FY11, THESE SHUTTLE BUSES TRANSPORTED 199,936 PATIENTS AND THEIR FAMILIES BETWEEN BMC AND THE BOSTON HEALTHNET CHCS. THERE IS ALSO A DIRECT TAXI AND VAN HOSPITAL-TO-HOME SERVICE FOR SPECIFIC CASES. INTERPRETER SERVICES: BMC VALUES ITS DIVERSE PATIENT POPULATION AND IS COMMITTED TO HONORING THEIR ETHNIC, RELIGIOUS AND CULTURAL DIFFERENCES. THE INTERPRETER SERVICES DEPARTMENT IS THE MOST EXTENSIVE IN NEW ENGLAND. IN ADDITION TO PROVIDING PERSON-TO-PERSON INTERPRETERS ON-SITE IN MORE THAN 30 LANGUAGES, 24-HOURS-A DAY, THE DEPARTMENT UTILIZES THE LATEST ADVANCES IN TECHNOLOGY SUCH AS TELEPHONIC AND VIDEO INTERPRETING. INTERPRETER SERVICES GOES ABOVE AND BEYOND WHAT IS MANDATED BY LAW TO PROVIDE VIDEO INTERPRETING, NON-ESSENTIAL DOCUMENT TRANSLATION (SUCH AS APPOINTMENT REMINDER LETTERS, BEREAVEMENT LETTERS), TRANSLATION AND RECORDING OF CLINIC PHONE MENUS, AND 24/7 ON-CALL FACE-TO-FACE COVERAGE FOR OUR TOP FOUR LANGUAGES OUR INTERPRETERS HELP TO BREAK LANGUAGE BARRIERS AS WELL AS SERVE AS CULTURAL BROKERS TO PATIENTS AND STAFF. LAST YEAR, THEY ASSISTED IN 190,647 INTERACTIONS WITH PATIENTS AND VISITORS. ADDRESSING SIGNIFICANT PUBLIC HEALTH PROBLEMS DIABETES: THE BMC DIABETES CENTER PROVIDES INNOVATIVE AND UP-TO-DATE DIABETES EDUCATION AND CARE TO HELP PATIENTS BETTER UNDERSTAND AND MANAGE THEIR DIABETES. LOCATED IN THE ENDOCRINOLOGY CLINIC, THE DIABETES CENTER PROVIDES CULTURALLY AND LITERACY-APPROPRIATE EDUCATION ABOUT NUTRITION, MENU PLANNING, EXERCISE AND MEDICATION MANAGEMENT TO THE MOST CHRONICALLY ILL PATIENTS WITH DIABETES. CARE PROVIDERS ALSO TRAIN PATIENTS TO BETTER MANAGE THEIR INSULIN REGIMENS. A PATIENT NAVIGATOR ON THE TEAM ASSISTS PATIENTS IN APPOINTMENT SCHEDULING AND TRANSPORTATION NEEDS, FOR PATIENTS WITH CHALLENGES IN RETAINING THEIR APPOINTMENTS (SEE PATIENT NAVIGATION). SMOKING CESSATION: BMC'S DIVISION OF PSYCHIATRY OFFERS A MEDICALLY SUPERVISED SMOKING CESSATION PROGRAM. THE PROGRAM IS AN EIGHT WEEK, ONE HOUR PER WEEK CLASSROOM MODEL WITH A CURRICULUM THAT INCLUDES PHARMACOTHERAPY, NICOTINE REPLACEMENT (GUM AND PATCHES), STRESS REDUCTION TRAINING, COGNITIVE RESTRUCTURING, SOCIAL SUPPORT, AND RELAPSE PREVENTION COUNSELING. THIS CLINICAL RESOURCE FOR BMC PATIENTS ALSO SERVES AS A CENTER FOR TRAINING AND RESEARCH IN TOBACCO CONTROL AVAILABLE TO THE ENTIRE BMC COMMUNITY. IMPROVING QUALITY OF LIFE ACUPUNCTURE: ACUPUNCTURE SERVICES AT BMC ARE PROVIDED FREE OF CHARGE TO MORE THAN 600 PATIENTS ANNUALLY WHO DO NOT HAVE AFFORDABLE ACCESS TO COMPLEMENTARY ALTERNATIVE MEDICINE (CAM). CANCER SUPPORT GROUPS: IN 2006, BMC ESTABLISHED THE CANCER PATIENT SUPPORT SERVICES FUND TO PROVIDE CRUCIAL SERVICES AND PROGRAMS TO COMPLEMENT PATIENTS' CLINICAL CARE. THE FUND IS USED FOR SURVIVORSHIP PROGRAMS SUCH AS SUPPORT GROUPS AND CELEBRATIONS, ASSISTANCE WITH TRANSPORTATION COSTS TO AND FROM THE HOSPITAL, PATIENT NAVIGATION, AND THE PROVISION OF COMPLEMENTARY THERAPIES SUCH AS YOGA AND MASSAGE. IN FY11, THERE WERE 15 CANCER SUPPORT GROUPS THAT MET REGULARLY AND AS MANY AS 650 PATIENTS WHO PARTICIPATED IN THE SURVIVORSHIP PROGRAMS. INTEGRATIVE MEDICINE: THE MISSION OF THE INITIATIVE FOR INTEGRATIVE MEDICINE AND HEALTH DISPARITIES WITHIN THE DEPARTMENT OF FAMILY MEDICINE, WHICH SERVED APPROXIMATELY 250 PATIENTS ON A ROTATING BASIS IN FY11, IS TO SUBSTANTIALLY IMPACT THE QUALITY OF LIFE FOR THE URBAN UNDERSERVED THROUGH PROVIDING ACCESS TO INTEGRATIVE MEDICINE CLINICAL SERVICES, RESEARCH AND EDUCATION. SERVICES PROVIDED, PRIMARILY FREE OF CHARGE, INCLUDE YOGA CLASSES, INTEGRATIVE CANCER CARE, ACUPUNCTURE CLINICS, CHI GUNG CLASS, MUSIC THERAPY, AND INTEGRATIVE MEDICINE CONSULTS. EMPOWERING INDIVIDUALS WITH DISABILITIES STEPPING FORWARD-STAYING INFORMED CONSUMER EDUCATION PROGRAM: THE STEPPING FORWARD-STAYING INFORMED IS A TWO-PRONGED CONSUMER EDUCATION PROGRAM CONSISTING OF AN ANNUAL ONE-DAY RESEARCH CONFERENCE TAILORED TO CONSUMERS AND A BI-MONTHLY EVENING LECTURE SERIES. STEPPING FORWARD-STAYING INFORMED PRESENTS TOPICS THAT DIRECTLY RELATE TO LIVING WITH SPINAL CORD INJURY (SCI), SUCH AS CURRENT RESEARCH FINDINGS AND EMERGING EFFECTIVE TREATMENT TECHNIQUES, IN EASILY UNDERSTOOD, LAY TERMINOLOGY. INDIVIDUALS LIVING WITH SCI AND THEIR FAMILIES SEEK CURRENT INFORMATION ABOUT SPINAL CORD INJURY RESEARCH AND EMERGING TREATMENTS BECAUSE IT ENABLES THEM TO ADVOCATE ON THEIR BEHALF, MAKE INFORMED DECISIONS ABOUT CARE, AND SHARE INFORMATION WITH OTHER INDIVIDUALS. THE STEPPING FORWARD-STAYING INFORMED CONFERENCE IS A SOURCE OF INFORMATION FOR CONSUMERS AND HEALTHCARE PROFESSIONALS. COMMUNITY INITIATIVES/DETERMINATION OF NEED THE DETERMINATION OF NEED (DON) PROGRAM, ADMINISTERED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REQUIRES HEALTH CARE FACILITIES PLANNING SUBSTANTIAL CAPITAL EXPENDITURES OR SUBSTANTIAL CHANGES IN SERVICES TO SEEK REVIEW AND APPROVAL FROM THE STATE PRIOR TO IMPLEMENTING A PLANNED EXPENDITURE/CHANGE IN SERVICES. ONE CONDITION OF APPROVAL IS THAT THE HOLDER OF AN APPROVED DON SHALL EXPEND, TYPICALLY OVER A FIVE-YEAR PERIOD, AN AMOUNT REASONABLY RELATED TO THE COST OF THE PROJECT, FOR THE PROVISION OF PRIMARY AND PREVENTIVE HEALTH CARE SERVICES NECESSARY FOR UNDERSERVED POPULATIONS IN THE PROJECT'S SERVICE AREA. THIS PROGRAM, THE "COMMUNITY HEALTH INITIATIVES (CHI) PROGRAM" IS COMMONLY REFERRED TO AS "FACTOR 9" SINCE IT IS REQUIRED UNDER SECTION 9 OF SUBSECTION 100.533(B) OF THE DETERMINATION OF NEED REGULATION. BMC HAS SOUGHT AND RECEIVED APPROVAL FOR A NUMBER OF DONS RELATING TO MAJOR CLINICAL TECHNOLOGIES, WHICH ARE REGULATED BY THE DON PROGRAM. THESE TECHNOLOGIES ARE LISTED IN THE CHART BELOW, AND INDICATE THE RECIPIENTS OF THE REQUIRED "FACTOR 9" DONATIONS. ALL OF THESE PROJECTS ARE TO BE PAID OVER A 5-YEAR PERIOD, TYPICALLY IN EQUAL AMOUNTS EACH YEAR. DETERMINATION OF THE AMOUNT, SET BY THE DEPARTMENT OF PUBLIC HEALTH, WAS BASED ON 5% OF THE MAXIMUM CAPITAL EXPENDITURE (MCE) FOR EACH PROJECT. BMC'S DONATIONS HAVE BEEN MADE TO A COMBINATION OF COMMUNITY HEALTH CENTERS IN BMC'S SERVICE AREA AS WELL AS TO THE ALLIANCE FOR COMMUNITY HEALTH (COMMUNITY HEALTH NETWORK AREA 19 - "CHNA 19") - WHICH IS A COALITION OF AGENCIES, ORGANIZED WITH THE ASSISTANCE OF THE DEPARTMENT OF PUBLIC HEALTH AND SERVING THE BOSTON AREA. (NOTE: THE ALLIANCE'S FISCAL AGENT WAS HEALTH RESOURCES IN ACTION/COMMUNITY BENEFITS DEPARTMENT DURING FY 2011). PHARMACY (FREE RX) THE HEALTH SAFETY NET SYSTEM IN MASSACHUSETTS IS THE SUCCESSOR SYSTEM TO THE FREE CARE POOL. ESTABLISHED SO UNINSURED MASSACHUSETTS RESIDENTS WITHOUT FINANCIAL RESOURCES WOULD HAVE ACCESS TO QUALITY NO COST HEALTH CARE SERVICES. EVEN THOUGH MASSACHUSETTS REQUIRES EVERYONE IN THE STATE TO HAVE HEALTH INSURANCE, WE STILL HAVE MANY UNINSURED PEOPLE ACCORDING TO STATE STATISTICS. THE BMC OUTPATIENT PHARMACIES SERVE THE FREECARE POPULATION ON A DAILY BASIS WITH DIGNITY AND RESPECT WHILE MEETING OUR HOSPITAL'S MISSION OF EXCEPTIONAL AND ACCESSIBLE HEALTH SERVICES TO ALL IN NEED OF CARE REGARDLESS OF STATUS AND ABILITY TO PAY. IN FISCAL YEAR 2011 THE PHARMACIES FILLED OVER 200,000 FREECARE PRESCRIPTIONS FOR PATIENTS WITHOUT INSURANCE. NOT ONE PERSON LEFT THE BMC PHARMACIES WITHOUT THEIR PRESCRIPTIONS WHETHER IT WAS FOR OUTPATIENT CHEMOTHERAPY OR ASPIRIN TABLETS, IF THEY DID NOT HAVE INSURANCE OR THE MEANS TO PAY FOR IT. LINE 6: AFFILIATED HEALTH CARE SYSTEM ESTABLISHED IN 1995, BOSTON HEALTHNET (BHN) IS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM COMPRISED OF BMC, THE BOSTON UNIVERSITY SCHOOL OF MEDICINE, AND 15 COMMUNITY HEALTH CENTERS (CHCS). PHYSICIANS WHO PRACTICE AT HEALTHNET LOCATIONS PROVIDE A WIDE RANGE OF COMPREHENSIVE HEALTH CARE SERVICES TO ADULT AND PEDIATRIC PATIENTS, WITH A FOCUS ON DISEASE PREVENTION AND HEALTH EDUCATION. PATIENTS RECEIVING PRIMARY CARE AT HEALTHNET SITES HAVE ACCESS TO HIGHLY TRAINED SPECIALISTS AND CUTTING-EDGE TECHNOLOGY AT BMC WHILE MAINTAINING INDIVIDUALIZED AND CULTURALLY SENSITIVE CARE IN THEIR NEIGHBORHOODS. NOW IN ITS 17TH YEAR, BHN AND ITS CHC PARTNERS HAVE EXTENDED BMC'S PRESENCE INTO BOSTON-AREA NEIGHBORHOODS, SIGNIFICANTLY IMPACTING THE HEALTH OF THEIR RESIDENTS. THE ACCOMPLISHMENTS OF THE NETWORK ARE EVIDENCED BY: THE GROWTH OF CHC ADMISSIONS TO BMC; THE ESTABLISHMENT OF AN INPATIENT ROUNDER SYSTEM FOR CHC PATIENTS; THE COLLABORATIVE DEVELOPMENT OF QUALITY IMPROVEMENT INITIATIVES, CLINICAL PROTOCOLS, AND STANDARDS OF PRACTICE; INCREASED ACCESS TO SPECIALTY SERVICES; A SUCCESSFUL PUBLIC HEALTH OUTREACH CAMPAIGN; AND THE SIGNIFICANT DEVELOPMENT AND COORDINATION OF BHN'S INFORMATION TECHNOLOGY PROGRAMS AND SERVICES. IN 1997, BOSTON HEALTHNET ESTABLISHED A COMMUNITY PHYSICIAN GROUP INPATIENT ROUNDER SYSTEM AT BMC. THE ROUNDER SYSTEM BRINGS TOGETHER PHYSICIANS FROM THE CHCS AND THE BMC DEPARTMENT OF FAMILY MEDICINE TO CARE FOR PATIENTS FROM THESE CENTERS WHILE THEY ARE IN THE HOSPITAL, THEREBY COORDINATING AND ENHANCING THE QUALITY AND CONTINUITY OF CARE. TODAY, 12 CHCS AND BMC'S DEPARTMENT OF FAMILY MEDICINE PARTICIPATE IN THE ROUNDER SYSTEM. THE SYSTEM WAS RECONFIGURED IN 2008 INTO THREE TEAMS, COMPRISED OF BMC AND CHC ATTENDING PHYSICIANS ASSISTED BY THREE NURSE PARTNERS AND FOUR PHYSICIAN ASSISTANTS. IN 2008 THE ROUNDER SYSTEM WAS EXTENDED TO EVENINGS AND SEVEN DAY COVERAGE. THE AVERAGE LENGTH OF STAY FOR THE ROUNDER SYSTEM WAS 4.39 DAYS, WHICH COMPARES FAVORABLY WITH OTHER NATIONAL AND LOCAL INDICES. BOSTON HEALTHNET CHC PARTNERS ARE ACTIVE COLLABORATORS ON A NUMBER OF PROJECTS AND PROGRAMS DESCRIBED IN THIS REPORT, INCLUDING THE PROSTATE CANCER SCREENING INITIATIVE, PATIENT NAVIGATION RESEARCH, THE FANTASTIC KIDS PROGRAM TO ADDRESS PEDIATRIC OVERWEIGHT, AND MEDICAL-LEGAL PARTNERSHIP. ADDITIONAL EXAMPLES OF PROJECTS ON WHICH BMC AND BOSTON HEALTHNET HAVE COLLABORATED INCLUDE: INFORMATION TECHNOLOGY SIGNIFICANT STRIDES HAVE BEEN MADE IN THE AREA OF INFORMATION TECHNOLOGY ACROSS THE NETWORK. ALL OF BOSTON HEALTHNET'S PRIMARY CHC PARTNERS ARE CONNECTED TO BMC OVER HIGH-SPEED T-1 LINES THAT PUT BMC'S CLINICAL SYSTEMS AT THE FINGERTIPS OF CHC PROVIDERS AND OTHER STAFF. IN 2001, THE PARTNERSHIP BETWEEN BMC AND THE CHCS, COUPLED WITH A SUBSTANTIAL GRANT FROM AN ANONYMOUS FOUNDATION, SUPPORTED THE IMPLEMENTATION OF THE CENTRICITY ELECTRONIC MEDICAL RECORD (EMR) AT EIGHT OF THE PRIMARY PARTNER CHCS. IN 2008 IMPLEMENTATION WAS COMPLETED AT ONE SECONDARY PARTNER CHC. ADDITIONALLY, ELECTRONIC PRESCRIBING WAS IMPLEMENTED AT THE NINE CENTRICITY SITES. A WORKING GROUP MEETS MONTHLY TO ADDRESS DEVELOPMENTAL ISSUES AND TO EVALUATE AND PRIORITIZE FUTURE PROJECTS. A THREE YEAR, $746,246 HRSA AWARD TO BOSTON HEALTHNET IN FY07 SUPPORTED THE VERTICAL INTEGRATION OF ELECTRONIC MEDICAL RECORDS AT EIGHT CHCS WITH THAT OF BMC. THIS INTEGRATION TOOK PLACE VIA IMPLEMENTATION OF A CLINICAL INFORMATION EXCHANGE (CIE) THAT NOW ALLOWS CHC PROVIDERS TO VIEW INFORMATION IN BOTH BMC AND OTHER CHC SYSTEMS THROUGH THE LOCAL PATIENT RECORD. THE CIE ALSO ALLOWS PHYSICIANS IN THE CHCS TO BETTER TRACK PATIENTS RECEIVING CARE AT BMC. IN 2008, THE NETWORK WAS A RECIPIENT OF A ONE-YEAR, $543,000 HIGH IMPACT HEALTH INFORMATION TECHNOLOGY GRANT FROM HRSA THAT ALLOWS STAFF TO IMPLEMENT AN ELECTRONIC REFERRAL MANAGEMENT SYSTEM BETWEEN THE 10 BHN PRIMARY PARTNER CHCS AND SPECIALISTS IN THE BMC DEPARTMENT OF MEDICINE. BY LEVERAGING THE TECHNOLOGY OF THE CIE, THE EREFERRAL SYSTEM ALSO MAKES IT POSSIBLE FOR THE CHCS TO SCHEDULE APPOINTMENTS, ELECTRONICALLY SUBMIT REQUIRED CLINICAL INFORMATION TO SPECIALISTS, RECEIVE ELECTRONIC INFORMATION ABOUT REFERRALS, TRACK PATIENTS' NO-SHOW RATES, AND RECEIVE RETURN SPECIALIST REPORTS THROUGH THE LOCAL EMR OR BY OPENING A WEB-BASED PRACTICE PORTAL. IN 2010, BOSTON HEALTHNET RECEIVED A TWO-YEAR, $2,986,872 GRANT FROM HRSA TO HELP COMPLETE THE TRANSFORMATION OF CURRENT HEALTH INFORMATION TECHNOLOGY CAPABILITIES INTO A TRULY INTEGRATED, HIGH-PERFORMANCE HEALTH INFORMATION EXCHANGE WITH THE CAPACITY TO HANDLE ALL NECESSARY CLINICAL, ADMINISTRATIVE AND FINANCIAL FUNCTIONS. TO THIS END, PROJECT FUNDS ARE BEING USED TO INSTALL THE CENTRICITY PRACTICE SOLUTION AT FIVE CHCS; TO IMPLEMENT IMMUNIZATION AND DIABETES REGISTRIES FOR THE ENTIRE BHN NETWORK, INCLUDING BMC; TO FULLY AUTOMATE LABORATORY ORDER ENTRY AND RESULTS RETRIEVAL FOR 12 OF THE CHCS; TO AUTOMATE REPORTING OF UNIFORM DATA SYSTEM MEASURES AND HRSA CLINICAL PERFORMANCE MEASURES IN ALL 15 CHCS; AND TO CREATE A DATA WAREHOUSE FOR THE CHCS. IN 2011, THE YANKEE ALLIANCE, INC. AWARDED BMC $454,967 FOR THE BALANCED SCORECARD/SAFE SIGN-OUTS PROJECT, TO BEGIN RETROACTIVELY ON OCTOBER 1, 2011 AND FINISH SEPTEMBER 30, 2012. BMC BALANCED SCORECARD IS A CONTINUATION PROJECT TO MOVE TO THE NEXT LEVEL IN DEVELOPING A COMPUTER DASHBOARD SYSTEM TO DRILL DOWN ON PATIENT SAFETY AND QUALITY. THIS PROJECT WILL FOCUS ON THE PROVIDER LEVEL METRICS DEVELOPMENT AND TESTING. SAFE SIGN-OUTS IS A NEW SYSTEMS DEVELOPMENT PROJECT TO CREATE A SOFTWARE SYSTEM AND PROTOCOL FOR RESIDENT SAFE SIGN-OUTS TO PREVENT PATIENT ADVERSE EVENTS. ALSO IN 2011, BOSTON HEALTHNET RECEIVED A TWO-YEAR HRSA GRANT TO IMPLEMENT A SERIES OF HEALTH INFORMATION TECHNOLOGY INITIATIVES THAT INTEGRATE DATABASES AND ELECTRONIC ALERTS IN STANDARDIZED SYSTEMS IN ORDER TO IMPROVE THE QUALITY, EFFECTIVENESS AND EFFICIENCY OF PRIMARY CARE. THE PROJECT WILL IMPLEMENT CLINICAL AND FINANCIAL PRACTICE MANAGEMENT SOFTWARE THAT IS FULLY INTEGRATED WITH THE ELECTRONIC HEALTH RECORDS AT FIVE CHCS, REDUCING THE NUMBER OF CUSTOMIZED INTERFACES AND LICENSES NEEDED AND PROVIDING CRUCIAL BUSINESS INTELLIGENCE; CREATE SYSTEM-WIDE CHILDHOOD IMMUNIZATION AND DIABETES REGISTRIES; AUTOMATE REPORTING OF UNIFORM DATA SYSTEM DATA, HRSA CLINICAL PERFORMANCE MEASURES AND SELECTED PRACTICE MANAGEMENT METRICS; AND CREATE A DATA WAREHOUSE FOR THE CHCS.THE PROJECT WILL BENEFIT THE MORE THAN 334,000 BOSTON HEALTHNET PATIENTS AND THE CLINICAL IMPACT OF THE PROPOSED WILL INCLUDE SIGNIFICANT INCREASES IN THE NUMBER OF CHILDREN FULLY IMMUNIZED BY AGE TWO YEARS AND ADHERENCE TO THE STANDARDS OF THE NATIONAL COMMITTEE ON QUALITY ASSURANCE FOR DIABETES CARE, AND A SIGNIFICANT DECREASE IN THE PERCENT OF PATIENTS WITH UNCONTROLLED DIABETES (HBA1C > 9). INCREASING PATIENT ACCESS COMMUNITY ACCESS TO BMC IS ENHANCED THROUGH A FREE SHUTTLE BUS SERVICE. FOUR BUSES CIRCULATE THROUGHOUT THE SYSTEM ON ESTABLISHED ROUTES, FROM 7AM-7PM, MONDAY THROUGH FRIDAY, BRINGING PATIENTS TO BMC. LAST YEAR, THESE SHUTTLE BUSES TRANSPORTED 199,936 PATIENTS AND THEIR FAMILIES BETWEEN BMC AND THE BOSTON HEALTHNET CHCS. ADVANCING MEDICAL EDUCATION A NUMBER OF HEALTHNET CHCS ALSO SERVE AS THE PRIMARY COMMUNITY-BASED TRAINING SITES FOR BOSTON UNIVERSITY SCHOOL OF MEDICINE PEDIATRIC, FAMILY MEDICINE, AND GENERAL MEDICINE RESIDENTS. LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT BMC DOES NOT SUBMIT A COMMUNITY BENEFITS REPORT TO THE COMMONWEALTH OF MASSACHUSETTS. true ARKANSAS CHILDREN'S HOSPITAL 800 Marshall Slot 512 RESEARCH INSTITUTE Little Rock AR 72202 710694931 501(c)(3) 45847 Subaward BAY COVE HUMAN SERVICES 66 Canal Street Boston MA 02114 042518575 501(c)(3) 2773536 Subaward BETH ISRAEL DEACONESS HOSPITAL PO Box 3784 Boston MA 02241 042103881 501(c)(3) 408506 Subaward BETH ISRAEL MEDICAL CENTER 555 West 57th Street 5TH FLOOR New York NY 10019 135564934 501(c)(3) 56192 Subaward BOSTON PUBLIC HEALTH COMMISSION 1010 Massachusetts Avenue Boston MA 02118 043316655 115 5021368 Subaward BOSTON UNIVERSITY 715 Albany Street Boston MA 02118 042103547 501(c)(3) 2915974 Subaward Brigham & Womens Hospital PO Box 3149 Boston MA 02241 042312909 501(c)(3) 437747 Subaward BROCKTON AREA MULTI-SERVICES 10 Christys Drive Brockton MA 02301 042562377 501(c)(3) 16790 Subaward BROCKTON NEIGHBORHOOD HEALTH 63 Main Street Brockton MA 02301 043165044 501(c)(3) 19252 Subaward BUTLER HOSPITAL 345 Blackstone Blvd Providence RI 02906 050258812 501(c)(3) 41104 Subaward CALIFORNIA STATE UNIVERSITY 4910 N CHESTNUT AVENUE Fresno CA 93726 946003272 501(c)(3) 32462 Subaward CAMBRIDGE HEALTH ALLIANCE 1493 Cambridge Street Cambridge MA 02139 043320571 501(c)(3) 261174 Subaward CENTER FOR COMMUNITY HEALTH EDUCATION & RESEARCH 420 Washington Street Dorchester MA 02124 043112225 501(c)(3) 69552 Subaward CHILDREN'S HOSPITAL OF BOSTON 300 Longwood Avenue Boston MA 02115 042774441 501(c)(3) 30041 Subaward CITIZENS UTILITY BOAR 309 W Washington 800 Chicago IL 60606 363306846 501(c)(3) 24795 Subaward CODMAN SQUARE HEALTH CTR INC 637 Washington Street Boston MA 02124 042678774 501(c)(3) 40801 Subaward COOPER HEALTH SYSTEM One Cooper Place Camden NJ 08103 210634462 501(c)(3) 16961 Subaward DORCHESTER HOUSE MULTI SVC CTR 1353 Dorchester Avenue Dorchester MA 02122 237125970 501(c)(3) 65733 Subaward DOTWELL PO Box 220803 Dorchester MA 02122 043433538 501(c)(3) 39671 Subaward DOUGLAS A THOM CLINIC INC 251 West Street Natick MA 01760 042104268 501(c)(3) 11810 Subaward EAST BOSTON NHC 10 Gove Street East Boston MA 02128 237425849 501(c)(3) 55016 Subaward ENERGY PROGRAMS CONSORTIUM 1232 31st Street NW Washington DC 20007 522101783 501(c)(3) 14966 Subaward GAYLORD HOSPITAL PO Box 400 Wallingford CT 06492 060646649 501(c)(3) 66134 Subaward GEISINGER CLINIC WEIS CENTER FOR RESEARCH 100 N ACADEMY AVENUE Danville PA 17822 236291113 501(c)(3) 25666 Subaward GROUP HEALTH COOPERATIVE 521 Wall Street Seattle WA 98121 910511770 501(c)(3) 145795 Subaward HARVARD UNIVERSITY 677 Huntington Avenue Boston MA 02115 042103580 501(c)(3) 127427 Subaward HEALTH PARTNERS RESEARCH FOUNDATION PO Box 1524 MAILSTOP 21111R Minneapolis MN 55440 411670163 501(c)(3) 50805 Subaward HEBREW REHABILITATION 300 First Avenue Needham MA 02494 042104298 501(c)(3) 10154 Subaward INSTITUTE FOR HEALTH One New England Exec Park Burlington MA 01803 113764559 501(c)(3) 85201 Subaward JOHN HOPKINS UNIVERSITY 600 Wolfe Street Baltimore MD 21287 520595110 501(c)(3) 10388 Subaward JONATHAN O COLE MENTAL HEALTH 115 Mill Street C/O MCLEAN HOSPITAL Belmont MA 02178 043282088 501(c)(3) 12161 Subaward JOSLIN DIABETES CENTER One Joslin Place Boston MA 02215 042203836 501(c)(3) 84507 Subaward Kaiser Foundation ResEARCH 1800 Harrison Street 16TH FLOOR Oakland CA 94612 941105628 501(c)(3) 319301 Subaward LAHEY CLINIC 41 Mall Road Burlington MA 01805 042704683 501(c)(3) 99641 Subaward LOVELACE BIOMEDICAL & ENVIRONMENTAL RESEARCH INST 2425 Ridge Street Albuquerque NM 87108 510154068 501(c)(3) 69578 Subaward MAINE MEDICAL CENTER 22 Bramhall Street Portland ME 04102 010238552 501(c)(3) 10884 Subaward MARTIN'S POINT HEALTH PO Box 9746 Portland ME 04104 010353275 501(c)(3) 14664 Subaward MASSACHUSETTS GENERAL HOSPITAL 55 Fruit Street Boston MA 02114 042697983 501(c)(3) 144620 Subaward MATTAPAN COMMUNITY HEALTH CTR 1425 Blue Hill Avenue Mattapan MA 02126 042544151 501(c)(3) 34320 Subaward MEMORIAL SLOAN-KETTERING PO Box 26338 GENERAL POST OFFICE New York NY 10087 131924236 501(c)(3) 13976 Subaward MGH NEUROGENETICS DNA DIAG LAB 185 Cambridge Street Boston MA 02110 042807148 501(c)(3) 242054 Subaward MINNEAPOLIS MED RESEARCH FND 600 SHAPIRO BUILDING 914 SOUTH EIGHT STREET Minneapolis MN 55404 411677920 501(c)(3) 69554 Subaward MOUNT AUBURN HOSPITAL 330 Mount Auburn Cambridge MA 02138 042103606 501(c)(3) 53607 Subaward NATIONAL ALLIANCE ON MENTAL ILLNESS OF MASS 400 West Cummings Park Woburn MA 01801 042777012 501(c)(3) 10000 Subaward NATIONAL CENTER FOR HEALTHY HOUSING INC 10320 Little Patuxent Parkway Columbia MD 21044 521792579 501(c)(3) 92818 Subaward NEW YORK UNIVERSITY MEDICAL CENTER 550 First Avenue New York NY 10016 135562309 501(c)(3) 98252 Subaward NORTH SUFFOLK MENTAL HEALTH 301 Broadway Avenue Chelsea MA 02150 042317215 501(c)(3) 1928081 Subaward NORTHEASTERN UNIVERSITY 360 Huntington Avenue Boston MA 02115 041679980 501(c)(3) 178317 Subaward NORTHWESTERN UNIVERSITY 633 Clark Street Evanston IL 60208 362167817 501(c)(3) 91319 Subaward REGENTS OF UNIV OF MINNESOTA 1300 South Street Minneapolis MN 55454 416007513 501(c)(3) 35642 Subaward RESEARCH TRIANGLE INSTITUTE PO Box 900002 Raleigh NC 27675 560686338 501(c)(3) 19873 Subaward SOUTH BOSTON CHC 409 West Broadway South Boston MA 02127 042682152 501(c)(3) 48701 Subaward ST ELIZABETH'S MEDICAL CENTER 736 Cambridge Street OLH 3-G Boston MA 02135 272473667 501(c)(3) 80000 Subaward STANFORD UNIVERSITY 450 Serra Mall Palo Alto CA 94304 941156365 501(c)(3) 21545 Subaward THE PENNSYLVANIA STATE UNIVERSITY 110 Tech Center University Park PA 16802 246000376 501(c)(3) 55420 Subaward TRUSTEES OF BU 715 Albany Street Boston MA 02118 042103547 501(c)(3) 176090 Subaward TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA 3451 Walnut Street Philadelphia PA 19104 231352685 501(c)(3) 23956 Subaward Tufts University 171 Harrison Avenue Boston MA 02111 042103634 501(c)(3) 746826 Subaward USCIVILIAN RESEARCH PO Box 630622 Baltimore MD 21263 541773406 501(c)(3) 171825 Subaward UNIV OF ALABAMA AT BIRMINGHAM 1530 3rd Avenue South AP 990 Birmingham AL 35294 636005396 501(c)(3) 54916 Subaward UNIVERSITY OF CALIFORNIA 505 Parnassus Ave San Francisco CA 94413 946036493 501(c)(3) 12843 Subaward UNIVERSITY OF MARYLAND PO Box 41428 BALTIMORE FOUNDATION Baltimore MD 21203 311678679 501(c)(3) 54482 Subaward UNIVERSITY OF MASSACHUSETTS BOSTON 55 Lake Avenue North Worcester MA 01655 043167352 115 285378 Subaward UNIVERSITY OF MICHIGAN 1301 Catherine Road Ann Arbor MI 48109 386006309 501(c)(3) 33232 Subaward University Of Rhode ISLAND 2 Chafee Road Kingston RI 02881 056000522 501(c)(3) 157881 Subaward UNIVERSITY OF WISCONSIN 21 N Park Street Suite 6401 Madison WI 53715 396006492 501(c)(3) 18572 Subaward VINFEN CORP PO Box 5059 Boston MA 02206 042632219 501(c)(3) 67557 Subaward VISIONS INC 48 Juniper Street Roxbury MA 02119 521378064 501(c)(3) 34325 Subaward WAKE FOREST UNIVERSITY HEALTH 1834 Wake Forest Rd WinstonSalem NC 27157 223849199 501(c)(3) 12371 Subaward WASHINGTON UNIVERSITY 700 ROSEDALE AVENUE St Louis MO 63112 430653611 501(c)(3) 37295 Subaward WEILL MEDICAL COLLEGE 1300 York Avenue New York NY 10005 131623978 501(c)(3) 47810 Subaward YMCA OF GREATER BOSTON 776 Washington Street Dorchester MA 02124 042103551 501(c)(3) 120453 Subaward YOUTH & FAMILY ENRICHMENT SVC 1234 Hyde Park Avenue Hyde Park MA 02136 050588064 501(c)(3) 108021 Subaward 73 0 SCHEDULE I, PART I, LINE 2 Boston Medical Center monitors all sponsored program grants utilizing internal electronic tracking systems. Department staff monitor the systemY. Grants Administration works closely with the department staff to ensure that expenditures are appropriate and allowable per the award contract and notice of grant award. X false true X X X X X X true true false false false false true false true true ELAINE ULLIAN 76405 0 0 0 1934648 0 169433 0 24502 0 2204988 0 0 0 EDWARD CHRISTIANSEN JR 272404 0 0 0 11782 0 19600 0 11415 0 315201 0 0 0 RONALD BARTLETT 528686 0 0 0 41917 0 68983 0 45963 0 685549 0 0 0 STEPHANIE LOVELL 445334 0 0 0 62027 0 99951 0 18625 0 625937 0 0 0 JAMES M BECKER MD 0 442871 0 0 0 547813 0 32540 0 17731 0 1040955 0 0 david coleman md 0 449322 0 0 0 171028 0 32540 0 2592 0 655482 0 0 RAVIN DAVIDOFF 414874 0 0 0 112822 0 94321 0 34734 0 656751 0 0 0 PAUL DREW 0 0 0 0 459369 0 0 0 16628 0 475997 0 0 0 PETER HEALY 253359 0 0 0 22456 0 39590 0 31929 0 347334 0 0 0 LISA O'CONNOR 259438 0 25000 0 19164 0 59444 0 26917 0 389963 0 0 0 NORMAN STEIN 313058 0 100800 0 60906 0 105568 0 25474 0 605806 0 0 0 THOMAS TRAYLOR 383290 0 182750 0 76084 0 153760 0 26429 0 822313 0 0 0 KATHLEEN E WALSH 730163 0 150000 0 29169 0 414958 0 17034 0 1341324 0 0 0 MEG ARANOW 334316 0 0 0 53737 0 107501 0 21047 0 516601 0 0 0 WILLIAM BARRON 402083 0 0 0 123354 0 63098 0 39996 0 628531 0 0 0 THEA JAMES MD 0 241014 0 0 0 24129 0 32540 0 12949 0 310632 0 0 SCHEDULE J, PART I, LINE 1A AND 1B UNDER THE TERMS OF HER EMPLOYMENT AGREEMENT, THE ORGANIZATION'S PRESIDENT AND CEO RECEIVED REIMBURSEMENT FOR CERTAIN PERSONAL PROFESSIONAL SERVICES FEES INCLUDING LEGAL, TAX AND FINANCIAL PLANNING ADVICE. SUCH REIMBURSEMENTS WERE INCLUDED IN THE PRESIDENT'S TAXABLE INCOME. SCHEDULE J, PART I, LINE 4A PURSUANT TO HIS SEVERANCE AGREEMENT, PAUL DREW RECEIVED TWENTY FOUR MONTHS OF SALARY CONTINUATION. AMOUNTS INCLUDED IN COLUMN (B)(III) REPRESENT AMOUNT PAID UNDER THE AGREEMENT. SCHEDULE J, PART I, LINE 4B BOSTON MEDICAL CENTER PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN TO CERTAIN EXECUTIVES. AMOUNTS ARE CREDITED TO PARTICIPANTS' ACCOUNTS EACH YEAR. PLAN AMOUNTS ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET, AS OUTLINED IN THE PLAN AGREEMENT. BOSTON MEDICAL CENTER MAINTAINS AN EXECUTIVE BENEFIT PLAN WHICH OFFERS PARTICIPATING EXECUTIVES THE OPTION OF ANNUALLY ALLOCATING BENEFIT DOLLARS TO A SUPPLEMENTAL RETIREMENT/PRE-TAX SAVINGS ACCOUNT. AMOUNTS VEST ON SPECIFIED DATES BASED ON CONTINUED EMPLOYMENT BUT NO LATER THAN THE EXECUTIVE'S 68TH BIRTHDAY. THE FOLLOWING AMOUNTS BECAME VESTED AND WERE PAID TO THE FOLLOWING EXECUTIVES IN CALENDAR YEAR 2010: ARANOW - $41,520 BARRON - $101,813 DAVIDOFF - $86,730 HEALY - $20,130 LOVELL - $58,739 STEIN - $37,392 TRAYLOR - $52,761 ULLIAN - $1,873,631 BMC PROVIDED A SEPARATE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN TO KATHLEEN E. WALSH, PRESIDENT AND CEO AS OF MARCH 1, 2010. PURSUANT TO THE TERMS OF THE AGREEMENT, THE PRESIDENT AND CEO WAS CREDITED A ONE TIME PAYMENT THAT SUBJECT TO CERTAIN CONDITIONS WILL VEST EFFECTIVE DECEMBER 1, 2011. IN ADDITION, CERTAIN AMOUNTS ARE CREDITED TO PRESIDENT AND CEO'S ACCOUNT EACH YEAR. THESE AMOUNTS ARE SUBJECT TO FORFEITURE AND PAYMENT WILL BE MADE ONLY IF CERTAIN CONDITIONS ARE MET, AS OUTLINED IN THE AGREEMENT. THE APPLICABLE ACCRUED AMOUNTS ARE REFLECTED IN SCHEDULE J, PART II, COLUMN C. BMC PROVIDED A NON-QUALIFIED DEFINED BENEFIT PLAN TO CERTAIN EXECUTIVES. THE ESTIMATED ANNUAL INCREASE IN ACTUARIAL VALUE FOR THE FOLLOWING EXECUTIVES ARE REFLECTED IN SCHEDULE J, PART II, COLUMN C. Aranow - $50,359 Davidoff - $36,628 Healy - $10,948 Lovell - $17,265 O'Connor - $15,478 Stein - $53,963 Traylor - $99,375 SCHEDULE J, PART I, LINE 6B AN INDIVIDUAL LISTED IN SCHEDULE J, PART II WAS PAID COMPENSATION CONTINGENT ON THE NET EARNINGS OF A RELATED ORGANIZATION. THIS COMPENSATION IS REFLECTED IN SCHEDULE J, PART II, COLUMN B(II). SCHEDULE J, PART I, LINE 8 KATHLEEN E. WALSH ENTERED INTO AN EMPLOYMENT CONTRACT WITH BMC IN MARCH 2010. THE TERMS OF HER CONTRACT INCLUDE BASE SALARY, INCENTIVE PROGRAM, DEFERRED COMPENSATION, EXECUTIVE BENEFITS, AND SEVERANCE PROVISION. RICHARD SILVERIA ENTERED INTO AN EMPLOYMENT CONTRACT WITH BMC IN DECEMBER 2010. THE TERMS OF HIS CONTRACT INCLUDE A BASE SALARY, INCENTIVE PROGRAM, EXECUTIVE BENEFITS, AND SEVERANCE PROVISION. SCHEDULE J, PART II EDWARD CHRISTIANSEN, JR IS COMPENSATED FOR HIS ROLE AS VP & CHIEF RISK MANAGEMENT OFFICER AND NOT AS THE FORMER CLERK. RONALD BARTLETT'S COMPENSATION AS REPORTED IN SCHEDULE J, COLUMN B(III) INCLUDES A GAIN ON INVESTMENT ON HIS PREVIOUSLY TAXED DEFERRED COMPENSATION. MASS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 042456011 57586ELD1 2009-08-14 13688734 REFUND OF SERIES M3-B (2005) false false true MASS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 042456011 57586C7T6 2008-07-01 239309847 FINANCE CONSTRUCTION/RENOVATION false false false 1989944 0 13688734 116788 0 0 0 0 0 0 13688734 0 2006 true false true true 0 0 252790694 24344574 31156547 0 2592758 0 0 143127381 0 51569434 false false false false false false false true 0.00000 0.00000 0.00000 true false true true true true 0.00440 0.00000 0.00440 true false true false false false true false false false false true false SEE SCHEDULE O BOSTON MEDICAL CENTER INSURANCE CO SEE PART V 14999000 INSURANCE false LANGUAGE LINE SERVICES TTEE KOENIG IS ON BOARD 212439 TRANSLATION SERVICES false SUFFOLK CONSTRUCTION COMPANY TTEE PASSAFARO IS VP 23791939 CONSTRUCTION false SCHEDULE L, PART IV, LINE 1 NAME OF INTERESTED PERSON: BOSTON MEDICAL CENTER INSURANCE CO, LTD. RELATIONSHIP: TRUSTEES PASSAFARO, DONAHUE, BECKER AND COLEMAN AND THE VP/CHIEF RISK MANAGEMENT OFFICER, CHRISTIANSEN, SERVE ON THE BOARD. AMOUNT OF TRANSACTION: BMC AND BMCIC HAVE SIGNIFICANT TRANSACTIONS WITH EACH OTHER FOR THE PURPOSE OF PROVIDING PROFESSIONAL AND GENERAL LIABILITY INSURANCE. TOTAL EXPENSES INCURRED BY THE MEDICAL CENTER RELATED TO THE INSURANCE PROVIDED BY BMCIC WAS $2,000,000 FOR THE YEAR ENDED SEPTEMBER 30, 2011. THE MEDICAL CENTER HAS $12,999,000 OF PREPAID PREMIUMS AND RETROSPECTIVE PREMIUM CREDITS THAT ARE PREPAID BY THE MEDICAL CENTER TO BMCIC AT SEPTEMBER 30, 2011. X 8 5552 FMV X 3575 FMV X 49245 FMV X 1 6000 FMV X 4 65910 PROCEEDS OF STOCK X 29 38044 FMV X 2 20413 FMV X COLLECTIBLES 10 1950 FMV X COMPUTERS/EQUIPMENT 6 53359 FMV X GIFT CERTIFICATES 199 162104 FMV false true false SCHEDULE M, PART I, COLUMN (B) THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART III, LINE 4A BOSTON MEDICAL CENTER'S MISSION IS TO PROVIDE CONSISTENTLY EXCELLENT AND ACCESSIBLE HEALTH SERVICES TO ALL IN NEED OF CARE REGARDLESS OF STATUS OR ABILITY TO PAY. APPROXIMATELY 200,000 OF OUR PATIENTS HAVE MASSHEALTH, COMMONWEALTH CARE OR NO INSURANCE AT ALL. APPROXIMATELY 70 PERCENT OF OUR PATIENTS COME FROM UNDERSERVED POPULATIONS, INCLUDING LOW-INCOME FAMILIES, ELDERS, PEOPLE WITH DISABILITIES AND IMMIGRANTS. SEVENTY PERCENT OF ALL PATIENTS ARE FROM RACIAL AND ETHNIC MINORITY POPULATIONS, AND 30 PERCENT DO NOT SPEAK ENGLISH AS A PRIMARY LANGUAGE. TO ADDRESS THE HEALTH NEEDS OF OUR DIVERSE PATIENT POPULATION, BOSTON MEDICAL CENTER PROVIDES A WIDE RANGE OF SERVICES BEYOND THE TRADITIONAL MEDICAL MODEL SUCH AS BUT NOT LIMITED TO PATIENT NAVIGATION, INTERPRETER SERVICES, PROGRAMS THAT ADDRESS THE NEEDS OF PATIENTS AFFECTED BY VIOLENCE, HEALTH NUTRITION AND EXERCISE PROGRAMS, AND OTHERS. PART IV, LINE 12 BOSTON MEDICAL CENTER HAS SEPARATE FINANCIAL STATEMENTS AND IS ALSO INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR BOSTON MEDICAL CENTER AND AFFILIATES. FORM 990, PART V, LINE 4B BERMUDA CANADA CAYMAN ISLANDS LESOTHO FORM 990, PART VI, LINE 2 KAREN ANTMAN, M.D. JAMES M. BECKER, M.D. DAVID COLEMAN, M.D. BUSINESS RELATIONSHIP - KAREN ANTMAN, M.D. IS A KEY EMPLOYEE AT BOSTON UNIVERSITY, WHICH ALSO EMPLOYS JAMES M. BECKER, M.D. AND DAVID COLEMAN, M.D. EDWARD J. CHRISTIANSEN DAVID A. PASSAFARO SUSAN DONAHUE JAMES M. BECKER, M.D. DAVID COLEMAN, M.D. BUSINESS RELATIONSHIP - SERVE ON THE BOARD OF BMC INSURANCE COMPANY. EDWARD J. CHRISTIANSEN RONALD BARTLETT RICHARD SILVERIA BUSINESS RELATIONSHIP - SERVE AS OFFICER/BOARD MEMBER OF BMC COMMUNITY PHYSICIAN RRG, INC. FORM 990, PART VI, LINE 11A BOSTON MEDICAL CENTER'S (BMC) FORM 990 IS PREPARED BY PRICEWATERHOUSECOOPERS (PWC) AND REVIEWED BY BMC'S INTERNAL MANAGEMENT. FOLLOWING THAT REVIEW, BMC'S INTERNAL MANAGEMENT AND PWC PRESENT THE FORM 990 TO THE AUDIT COMMITTEE FOR REVIEW AND COMMENT. THE COMPLETED FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE FORM BEING FILED WITH THE IRS. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST QUESTIONNAIRES FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2011 WERE DISTRIBUTED BY THE ORGANIZATION'S LEGAL DEPARTMENT. THE CHIEF COMPLIANCE OFFICER OR HIS OR HER DESIGNEE QUERIES TRUSTEES, OFFICERS AND DIRECTORS ON AT LEAST AN ANNUAL BASIS REGARDING RELATIONSHIPS THAT MAY CREATE POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER OR HIS OR HER DESIGNEE REVIEWS ALL DISCLOSURES AND DETERMINES WHETHER THERE ARE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE CHIEF COMPLIANCE OFFICER OR HIS OR HER DESIGNEE INFORMS THE GENERAL COUNSEL OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNSEL ADVISES THE BOARD OF TRUSTEES AND OFFICERS OF THE CORPORATION ACCORDINGLY. FORM 990, PART VI, LINE 15A&B AN INDEPENDENT COMMITTEE, FORMED OF INDIVIDUALS WHOSE COMPENSATION IS NOT IN ISSUE, DETERMINES THE COMPENSATION OF OFFICERS, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES. THE COMMITTEE MEMBERS ARE NOT UNDER THE CONTROL OR DIRECTION OF ANY BMC EXECUTIVE SEEKING COMPENSATION. THE COMPENSATION PLAN IS SUPPORTED BY COMPARABLE DATA, WHICH INCLUDES COMPENSATION PAID FOR COMPARABLE POSITIONS BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, COMPENSATION SURVEYS COMPILED INDEPENDENTLY, AND/OR ACTUAL WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE SERVICES OF THE BMC EXECUTIVE. THE INDEPENDENT COMMITTEE'S ASSESSMENT OF THESE CONSIDERATIONS ARE CONTAINED IN THE MINUTES OF THE COMMITTEE MEETING. THE REVIEW PROCESS INCLUDES - AND MINUTES INDICATE - DISCUSSIONS AND EVALUATIONS OF EACH EXECUTIVE'S PRIOR PERFORMANCE, QUALIFICATIONS, AND EXPERIENCE. EXECUTIVES ARE NOT PRESENT FOR THE INDEPENDENT COMMITTEE'S DISCUSSION AND VOTE ON COMPENSATION. THE MINUTES REFLECT THE FACT THAT NO EXECUTIVE WAS PRESENT. FORM 990, PART VI, LINE 19 BOSTON MEDICAL CENTER DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS PUBLICLY AVAILABLE. HOWEVER, THE RESTATED ARTICLES OF THE ORGANIZATION ARE POSTED ON THE SECRETARY OF THE COMMONWEALTH'S WEBSITE. FORM 990, PART VII, SECTION A EDWARD CHRISTIANSEN, JR IS COMPENSATED FOR HIS ROLE AS VP AND CHIEF RISK MANAGEMENT OFFICER AND NOT AS THE FORMER CLERK. THE FOLLOWING INDIVIDUALS DEVOTED THE FOLLOWING HOURS PER WEEK TO RELATED ORGANIZATIONS DURING THE YEAR: RAVIN DAVIDOFF - 5 HOURS JAMES M. BECKER, MD - 50 HOURS DAVID COLEMAN, MD - 50 HOURS PETER HEALY - 10 HOURS THEA JAMES, MD - 50 HOURS STEPHANIE LOVELL - 14 HOURS THOMAS TRAYLOR - 25 HOURS FORM 990, PART XI, LINE 5 UNREALIZED LOSS ($ 24,592,000) TERMINATION OF NEIDL AGREEMENT ($ 68,015,000) TRANSFER FROM BMCHP $ 23,000,000 OTHER ADJUSTMENTS $ 1,836,000 PENSION RELATED CHANGES OTHER THAN PERIODIC PENSION COSTS ($ 8,580,000) -------------- TOTAL ($ 76,351,000) SCHEDULE K, PART II BOND A THE BONDS ARE PART OF A POOLED (TOTAL PAR $101,485,000) FINANCING AND THUS ONLY THE BORROWER'S ALLOCABLE PORTION OF THE BONDS IS REPRESENTED IN PART I AND II. THE BORROWER'S PORTION OF THE BONDS REFINANCED THE PORTION OF THE ISSUER'S SERIES M3-B (2005) BONDS (ISSUED ON OCTOBER 3, 2005) ALLOCABLE TO THE BORROWER. BOND B THE DIFFERENCE BETWEEN PART I (E) AND PART II 3 IS DUE TO INTEREST EARNINGS ON BOND PROCEEDS. QUESTION 12 INCLUDES UNSPENT PROJECT FUND AND EXPENSE FUND INTEREST EARNINGS. BONDS A&B QUESTION 4 - The reserve proceeds represented are transferred proceeds from the refunded bonds. SCHEDULE K, PART III, LINE 4 BOND B Although the Project has not been substantially completed certain portions of the Project have been placed in service. The private use percentage listed in Part III Line 4 reflects the use of only those portions of the project that have been placed in service. 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