2026-08-14T16:55:34-05:00 2025-09-30 861065772 DELOITTE TAX LLP 7900 TYSONS ONE PLACE SUITE 800 MCLEAN VA 221024219 990 2024-10-01 042103606 MOUNT AUBURN HOSPITAL MOUN 7817448924 CO BILH TAX 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 SCOTT HERNDON TREASURER 7817448924 2026-08-13 0 0 RACHEL KAUFMAN P01485017 7032511000 2026-08-11 2024 2025-03-06 01:10:19Z KEVIN TABB MD C/O BILH TAX 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 397826662 0 X WWW.MOUNTAUBURNHOSPITAL.ORG X 1871 MA SEE SCHEDULE O 23 20 1982 62 1853623 27436 4015179 7793931 342256368 368355486 3101996 7742137 10348127 13489075 359721670 397380629 614479 594498 0 0 150635686 158819232 44342 27924 1620146 219314646 213705921 370609153 373147575 -10887483 24233054 409856849 450354549 209168074 204421761 200688775 245932788 X SEE SCHEDULE O 0 0 317896230 594498 189699228 SEE SCHEDULE O 163010433 SEE SCHEDULE O 21585053 SEE SCHEDULE O 317896230 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 1 1 0 0 1 X 405 0 1 1982 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 23 20 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CO FL IL KY MA MD MN NH NJ NY OH PA RI SC UT X KAREN WOLFSON AVP TAXATION 7817448924 BILH SCHRAFFTS CITY CTR 4TH FL 529 CHARLESTOWN MA 02129 HEALY PETER TTEE (EXO) (DIV PRES, METRO BOSTON) 1.00 64.00 X 0 1396570 60310 HUANG MD EDWIN TRUSTEE (EX-OFFICIO) & PRESIDENT 55.00 1.00 X X 620662 0 57035 SPIVAK MD BARBARA TTEE (EX-OFF) (PRES, MACIPA) 1.00 55.00 X 0 363421 38146 BEAMS MARY ELIZABETH TRUSTEE & VICE CHAIR 1.00 0.00 X X 0 0 0 MACOMBER JOHN TRUSTEE & CHAIR 1.00 0.00 X X 0 0 0 ALLISON ELISABETH TRUSTEE 1.00 0.00 X 0 0 0 BERMAN MANDY LEE TRUSTEE 1.00 0.00 X 0 0 0 BOWMAN MANIKKA TRUSTEE 1.00 0.00 X 0 0 0 CALANO DANIEL TRUSTEE 1.00 0.00 X 0 0 0 DIGIOVANNI JOHN TRUSTEE 1.00 0.00 X 0 0 0 ELKINS BRENT A TRUSTEE 1.00 0.00 X 0 0 0 GREENWALD ROY TRUSTEE 1.00 0.00 X 0 0 0 HAFT MD RACHEL TRUSTEE; PRIMARY CARE PHYSICIAN 1.00 0.00 X 0 0 0 LAPP KATHERINE TRUSTEE 1.00 0.00 X 0 0 0 MAHIGA MALIVA TRUSTEE 1.00 0.00 X 0 0 0 POND MD KYLE TRUSTEE; CARDIOLOGIST 1.00 0.00 X 0 0 0 SAAL MD KIM A TRUSTEE 1.00 0.00 X 0 0 0 SHACHOY CHRISTOPHER TTEE (EXOFF) (PRES, BOARD ADVISORS) 1.00 0.00 X 0 0 0 SHORTSLEEVE MD MICHAEL TRUSTEE; CHAIR, DEPT OF RADIOLOGY 1.00 0.00 X 0 0 0 SMERLAS DONNA TTEE (EX-OFF) (PRES, AUXILIARY) 1.00 0.00 X 0 0 0 SPENCER MD JACQUELINE TRUSTEE 1.00 1.00 X 0 0 0 SPURLOCK SUSAN TRUSTEE 1.00 0.00 X 0 0 0 WOLFE LESLIE TRUSTEE 1.00 0.00 X 0 0 0 TABB MD KEVIN CEO (EX-OFF) (CEO, BILH) 1.00 64.00 X 0 3665891 1068480 RIOS CINDY TREAS (EX-OFF) (EXEC VP & CFO, BILH) 1.00 64.00 X 0 1386253 2208450 KATZ ESQ JAMIE CLERK (EX-OFF); BILH GENERAL COUNSEL 1.00 63.00 X 0 1001061 33790 FRANCIOLI CARL TREAS EX-OF; BILH INTRM CFO/BSTN CFO 1.00 64.00 X 0 558652 54959 SMITH MBA BRIAN ASST TREAS EXOF & METRO BSTN MKT CFO 1.00 58.00 X 0 331409 41215 GEVITZ ESQ KATHRYN ASST CLERK; ASSOC GEN COUNSEL, BILH 1.00 57.00 X 0 184241 19255 HERNDON MBA CPA FACHE SCOTT TREAS (EX-OFF) (EXEC VP & CFO, BILH) 1.00 40.00 X 0 0 0 GOLEN MD TONI CHIEF MEDICAL OFFICER 55.00 1.00 X 454736 0 104818 BOYD DNP MHA RN KIRSTEN CHIEF NURSING OFFICER 35.00 30.00 X 181747 163009 42949 KAPFHAMMER STEVEN CHIEF OPERATING OFFICER 55.00 0.00 X 198742 0 18438 ERDMAN MD JONATHAN ANESTHESIOLOGIST 55.00 0.00 X 758892 0 51534 STARNBACH MD AILEEN G COMMUNITY CHIEF OF ANESTHESIA 55.00 0.00 X 641544 0 36586 GLICKSMAN MD ZACHARY S ANESTHESIOLOGIST 55.00 0.00 X 605267 0 35639 KAPOOR MD SONIA ANESTHESIOLOGIST 55.00 0.00 X 560684 0 76436 FIDROCKI MD DIANA M ANESTHESIOLOGIST 55.00 0.00 X 539681 0 50774 FISHMAN AARON FMR ASST TREAS EXO & CFO; CFO BILHMG 0.00 62.00 X 0 344818 7554 BONO DIANE FORMER VP, HUMAN RESOURCES 0.00 0.00 X 331144 0 221824 TUSALEM RN GERI FRMR INTERIM CNO; DIR OF NURSING 0.00 0.00 X 251485 0 11158 CEDERQUIST ELIZABETH FRMR INTERIM VP, HR BUSINESS PARTNER 0.00 55.00 X 0 260265 0 O'BRIEN BETH FORMER INTERIM COO 0.00 0.00 X 226425 0 0 BAKER RN DEBORAH FRMR SVP, PATIENT CARE SVCS AND CNO 0.00 0.00 X 147503 0 0 5518512 9655590 4239350 403 1 1 0 BETH ISRAEL LAHEY HEALTH INC 529 MAIN STREET 4TH FL CHARLESTOWN MA 02129 MGMT/FIN/LEGAL/HR/OTHER 154698945 HEALTHCARE WORKFORCE LOGISTICS LLC 2655 NORTHWINDS PARKWAY ALPHARETTA GA 30009 HEALTHCARE SERVICES 10917980 WALSH BROTHERS INC 210 COMMERCIAL STREET BOSTON MA 02109 CONSTRUCTION SERVICES 7597528 THOMAS G GALLAGHER INC 309 WAVERLEY OAKS RD STE 200 WALTHAM MA 02452 MECHANICAL SERVICES 3626152 SODEXO INC PO BOX 360170 PITTSBURGH PA 15251 FOOD & FACILITIES MGMT SERVICES 3452255 67 436813 7357118 1528876 7793931 INPATIENT CARE NPSR 622110 163010433 163010433 OUTPATIENT CARE NPSR 622110 154862544 154862544 EMERGENCY CARE NPSR 622110 21585053 21585053 OUTPATIENT LABS NPSR 622110 20676173 19448002 1228171 SERVICES TO AFFILIATES 622110 6823566 6823566 1397717 1397717 368355486 7498626 -54355 7552981 841633 262506 579127 579127 579127 243511 0 243511 243511 243511 138280 436813 183527 -45247 -45247 PARKING REVENUE 812930 3185486 3185486 INSURANCE PREM REBATE 525100 2765115 2765115 REBATES AND REFUNDS 622110 2492900 2492900 4511694 1909384 436296 2166014 12955195 397380629 374294714 1853623 13438361 X 594498 594498 1670696 1624410 46286 1189539 1156583 32956 124202625 120761658 3440967 5462895 5311548 151347 17069400 16596501 472899 9224077 8968529 255548 58914409 13136380 44185807 1592222 71030 71030 27924 27924 37625578 37007449 618129 521638 505275 16363 15394000 14236378 1157622 127194 127194 2678382 2678382 23967969 21092189 2875780 1870455 1870455 MEDICAL SUPPLIES 45333587 45333587 PHARMACEUTICALS 14083449 14083449 MAINTENANCE CONTRACTS 4920866 4699184 221682 MEDICAID ASSESSMENT 4065637 4065637 4131727 4046944 84783 373147575 317896230 53631199 1620146 275647 -32514 8728862 11005604 176946 1427095 36822779 38927228 5694688 4414467 1828925 1657249 660785269 504969859 156032219 155815410 197253 268160 174227235 194454003 25872295 42417847 409856849 450354549 37574760 29770171 741531 77536209 99730180 93315574 74921410 209168074 204421761 X 181192464 219525233 19496311 26407555 200688775 245932788 409856849 450354549 X 24233054 21040117 -37820 -10000 18662 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1 0 0 0 1 0 1 71030 71030 0 PART II-B, LINE 1: MOUNT AUBURN HOSPITAL ENGAGED IN SOME LOBBYING EFFORTS ON BEHALF OF ITSELF AND OTHER NETWORK AFFILIATES AND/OR PAYS DUES TO CERTAIN MEMBERSHIP ORGANIZATIONS OF WHICH A PORTION MAY BE USED BY SUCH ORGANIZATIONS FOR LOBBYING ACTIVITIES ON BEHALF OF THIS INSTITUTION AND OTHER SIMILARLY SITUATED ORGANIZATIONS. LOBBYING COSTS ASSOCIATED WITH THESE COMBINED LOBBYING ACTIVITIES WAS $71,030 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. TOTAL LOBBYING EXPENDITURES ARE MINIMAL AND NOT SUBSTANTIAL BASED ON REVENUES. 19496320 7753858 2197116 3039739 26407555 17159954 4137681 2050007 3851322 19496320 23531195 7340805 1469532 15181578 17159954 23209802 2960626 -986830 1652403 23531195 20155576 4850504 1750229 3546507 23209802 0.00000 0.26000 0.74000 0 0 169000 169000 282958622 179379723 103578899 5184462 3166833 2017629 362214949 319107108 43107841 10258236 3316195 6942041 155815410 INVEST HELD THRU CGCIE EIN 04-3278109 194454003 F 194454003 DEFERRED COMPENSATION 2598993 LEASE ASSETS 31437670 DEPOSITS 375000 PROFESSIONAL LIABILITY INSURANCE RECOVERY 8006184 42417847 DEFERRED COMPENSATION 2598993 ASSET RETIREMENT OBLIGATION 902962 PROFESSIONAL LIABILITY 10421026 DUE TO AFILIATES 16566751 ANNUITY PAYABLE 23595 OPERATING LEASED LIABILITIES 36258821 ESTIMATED THIRD PARTY SETTLEMENTS 7005121 POST RETIREMENT MEDICAL BENEFITS 76761 WORKERS COMPENSATION 1067380 74921410 X PART V, LINE 4: ENDOWMENT/SPECIAL FUND MONIES ARE HELD TO SUPPORT THE OPERATING AND CAPITAL NEEDS OF VARIOUS PATIENT CARE PROGRAM SERVICES. IN ADDITION, THE INCOME FROM THE PERMANENT ENDOWMENT IS USED TO FUND FREE CARE. ANNUALLY, THE BOARD ALSO APPROPRIATES 5% OF THE ACCUMULATED APPRECIATION ON THE PERMANENT ENDOWMENT TO FUND FREE CARE. PART X, LINE 2: BETH ISRAEL LAHEY HEALTH, INC., WHICH SERVES AS THE PARENT OF THE SYSTEM, HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE AN ORGANIZATION DESCRIBED UNDER INTERNAL REVENUE CODE (THE "CODE") SECTION 501(C)(3) AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ALSO DETERMINED THAT THE OTHER ENTITIES IN THE SYSTEM, EXCLUDING ITS FOR-PROFIT SUBSIDIARIES, QUALIFY AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, MEET THE CODE'S REQUIREMENTS UNDER SECTION 509(A), AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION HAS BEEN RECORDED FOR INCOME TAXES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY TO BE REALIZED UPON SETTLEMENT. CHANGES IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM DID NOT RECOGNIZE THE EFFECT OF ANY INCOME TAX POSITIONS FOR THE YEARS ENDED SEPTEMBER 30, 2025 AND 2024, RESPECTIVELY. X X X X X X 1 DOING GOOD DIGITAL LLC 668 N COAST HWY 224 LAGUNA BEACH CA 92651 MARKETING CONSULTING 0 0 7730 -7730 ZURI GROUP LLC 331 PARK AVE S 12TH FLOOR NEW YORK NY 10010 STRATEGY CONSULTING 0 0 20194 -20194 27924 -27924 CO FL IL KY MA MD MN NH NJ NY OH PA RI SC UT PINK PAGES 451010 341480 109530 3735 60609 61361 GOLF TOURNAMENT 101700 72950 28750 48111 9711 1 22383 22383 575093 436813 138280 3735 108720 71072 183527 -45247 SCHEDULE G, PART II, (C) OTHER EVENTS THE BOSTON MARATHON EVENT REPORTED IN THIS FORM 990 SCHEDULE G IS COORDINATED BY THE BETH ISRAEL LAHEY HEALTH ("BILH") DEVELOPMENT TEAM AS AN EVENT FOR THE BILH HEALTHCARE SYSTEM. RUNNERS PARTICIPATE IN THE MARATHON AND RAISE FUNDS FOR A SPECIFIC ENTITY WITHIN THE BILH SYSTEM. BILH REPORTS ALL EXPENSES FOR THE MARATHON ON ITS FORM 990, WHILE CONTRIBUTIONS RAISED BY RUNNERS ARE REPORTED AS REVENUE ON THE FORM 990 FOR EACH HOSPITAL OR OTHER HEALTHCARE ORGANIZATION DESIGNATED BY PARTICIPATING RUNNERS. THE BOSTON MARATHON AMOUNT OF $22,383 IS INCLUDED IN COLUMN (C) "OTHER EVENTS." 1 1 1 X 400.000000000000 1 X 1 0 1 1 10035240 2495180 7540060 0.02020 11433838 10235229 1198609 0.00320 21469078 12730409 8738669 0.02340 608224 608224 0.00160 26480846 3514942 22965904 0.06150 146484398 105011403 41472995 0.11110 113678 113678 0.00030 173687146 108526345 65160801 0.17450 195156224 121256754 73899470 0.19790 43231 43231 0.00010 43231 43231 0.00010 1 3927238 101518095 104337817 -2819722 1 1 1 1 MOUNT AUBURN HOSPITAL 330 MOUNT AUBURN HOSPITAL CAMBRIDGE MA 02138 MA STATE LICENSE #2071 X X X X MOUNT AUBURN HOSPITAL 1 0 0 1 X X X X X X X X X 24 1 1 0 1 X SEE PART VI 1 24 1 SEE PART VI 0 1 X 400.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART VI X SEE PART VI X SEE PART VI X X X X X X 1 X 0 X X X 1 X 0 0 MOUNT AUBURN HOSPITAL 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. MOUNT AUBURN HOSPITAL 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. 6 1 - MAH RADIOLOGY AT ARLINGTON 22 MILL STREET SUITE 106 ARLINGTON MA 02476 OUTPATIENT 2 - MOUNT AUBURN HOSPITAL MRI CENTER 725 CONCORD AVENUE GROUND FLOOR CAMBRIDGE MA 02138 OUTPATIETN 3 - MAH REHAB SVS-OUTPATIENT PHYS & OCC 625 MOUNT AUBURN STREET 1ST STREET CAMBRIDGE MA 02138 OUTPATIENT 4 - MOUNT AUBURN HOSPITAL MOBILE PET UNIT 799 CONCORD AVENUE 1ST FLOOR CAMBRIDGE MA 02138 OUTPATIENT 5 - MAH OCCUPATIONAL HEALTH & REHAB SVS 725 CONCORD AVENUE SUITE 511 CAMBRIDGE MA 02238 OUTPATIENT 6 - MAH IMAGING & SPECIMEN COLLECTION 355 WAVERLY OAKS ROAD WALTHAM MA 02452 OUTPATIENT FORM 990 SCHEDULE H PART V, SECTION C: SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION B:FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS--COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSMOUNT AUBURN HOSPITAL AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF MOUNT AUBURN HOSPITAL. THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND PARTS OF SOUTHERN NEW HAMPSHIRE AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,900 PHYSICIANS AND 39,000 EMPLOYEES. AT THE HEART OF BILH IS THE BELIEF THAT EVERYONE DESERVES HIGH-QUALITY, AFFORDABLE HEALTH CARE, AND THIS BELIEF IS WHAT DRIVES EACH AFFILIATE TO WORK WITH COMMUNITY PARTNERS ACROSS THE REGION TO PROMOTE HEALTH, EXPAND ACCESS, AND DELIVER THE BEST CARE IN THE COMMUNITIES BILH SERVES. BILH'S COMMUNITY BENEFITS STAFF ARE COMMITTED TO WORKING COLLABORATIVELY WITH BILH'S COMMUNITIES TO ADDRESS THE LEADING HEALTH ISSUES AND CREATE A HEALTHY FUTURE FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES.BILH'S PURPOSE STATEMENT ARTICULATES THE IMPACT BILH AND EACH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. BILH'S SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER, AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES - ONE PERSON AT A TIME - THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS.EQUITY. EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.ADDITIONAL INFORMATION ABOUT THE BILH SYSTEM AND ITS ACCOMPLISHMENTS ARE FURTHER BELOW IN THIS FORM 990 SCHEDULE H NARRATIVE SUPPORT IN THE SECTION NOTED AS "AFFILIATED HEALTH CARE SYSTEM AND ACCOMPLISHMENTS."MOUNT AUBURN HOSPITAL COMMUNITY BENEFITS MISSION STATEMENT MOUNT AUBURN HOSPITAL IS STEADFAST IN ITS COMMITMENT TO IMPROVING THE HEALTH AND WELL-BEING OF COMMUNITY MEMBERS, THROUGH COLLABORATION WITH COMMUNITY PARTNERS TO REDUCE BARRIERS TO HEALTH CARE AND TO CONTINUALLY STRIVE TO REDUCE HEALTH DISPARITIES AND HEALTH INEQUITIES FOR THOSE WHO ARE MOST VULNERABLE IN OUR COMMUNITY. WE SEEK TO IDENTIFY CURRENT AND EMERGING HEALTH NEEDS AND ADDRESS THESE NEEDS THROUGH EDUCATION, PREVENTION, TREATMENT, AND THE PROMOTION OF HEALTHY BEHAVIORS. MORE BROADLY, MAH'S COMMUNITY BENEFITS MISSION IS FULFILLED BY- INVOLVING MAH STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE THREE-YEAR IMPLEMENTATION STRATEGY; - ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT THE HOSPITAL'S COMMUNITY BENEFITS SERVICE AREA (CBSA) IN ALL ASPECTS OF THE COMMUNITY BENEFITS PROCESS, WITH SPECIAL ATTENTION FOCUSED ON ENGAGING DIVERSE PERSPECTIVES, FROM THOSE, PATIENTS AND NON-PATIENTS ALIKE, WHO ARE OFTEN LEFT OUT OF SIMILAR ASSESSMENT, PLANNING AND PROGRAM IMPLEMENTATION PROCESSES; - ASSESSING UNMET COMMUNITY NEED BY COLLECTING PRIMARY AND SECONDARY DATA (BOTH QUANTITATIVE AND QUALITATIVE) TO UNDERSTAND UNMET HEALTH-RELATED AND IDENTIFY COMMUNITIES AND POPULATIONS SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL AND ECONOMIC FACTORS; - IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN MAH'S CBSA THAT ADDRESS THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO ACCESSING CARE, AS WELL AS PROMOTE HEALTH EQUITY TO IMPROVE THE HEALTH STATUS OF THOSE WHO ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, EXPERIENCE POVERTY, AND HAVE BEEN HISTORICALLY UNDERSERVED; - PROMOTING HEALTH EQUITY BY ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND - FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTHCARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES. COMMUNITY BENEFITS FINANCIAL SUMMARY DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $721,902 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMMAH'S BOARD OF TRUSTEES, ALONG WITH ITS CLINICAL AND ADMINISTRATIVE STAFF, IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF RESIDENTS THROUGHOUT ITS CBSA AND BEYOND. WORLD-CLASS CLINICAL EXPERTISE, EDUCATION, AND RESEARCH ALONG WITH AN UNDERLYING COMMITMENT TO HEALTH EQUITY ARE THE PRIMARY TENETS OF ITS MISSION. MAH'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF MAH'S BOARD OF TRUSTEES, IS DEDICATED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS AND WILL CONTINUE TO DO SO IN ORDER TO MEET ITS COMMUNITY BENEFITS OBLIGATIONS. HOSPITAL SENIOR LEADERSHIP IS ACTIVELY ENGAGED IN THE DEVELOPMENT AND IMPLEMENTATION OF MAH'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. THE MAH'S COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE DIRECTOR OF COMMUNITY BENEFITS. THE DIRECTOR OF COMMUNITY BENEFITS HAS DIRECT ACCESS AND IS ACCOUNTABLE TO MAH'S PRESIDENT AND THE BILH VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS. IT IS THE RESPONSIBILITY OF THESE LEADERS TO ENSURE THAT COMMUNITY BENEFITS IS ADDRESSED BY THE ENTIRE ORGANIZATION AND THAT THE NEEDS OF COHORTS WHO HAVE BEEN HISTORICALLY UNDERSERVED ARE CONSIDERED EVERY DAY IN DISCUSSIONS ON RESOURCE ALLOCATION, POLICIES, AND PROGRAM DEVELOPMENT. THE MAH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH MAH HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT MAH'S COMMUNITY BENEFITS MISSION TO SERVE ITS PATIENTS COMPASSIONATELY AND EFFECTIVELY, AND TO CREATE A HEALTHY FUTURE FOR THEM, THEIR FAMILIES, AND MAH'S COMMUNITY. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF MAH'S COMMUNITY BENEFITS PROGRAMS IN THE FURTHERANCE OF MAH'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF MAH'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY MAH'S PROGRAMMATIC ENDEAVORS, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. MAH'S CBAC MEMBERS INCLUDE:- ELIZABETH AGUILO, EXECUTIVE DIRECTOR, PAINE SENIOR SERVICES - FELICITY BEAL, DIRECTOR OF DEVELOPMENT, SOMERVILLE HOMELESS COALITION - ERIC BURTON, INTERIM CHIEF FINANCIAL OFFICER, CHARLES RIVER COMMUNITY HEALTH - KARIN CARROLL, DIRECTOR, SOMERVILLE HEALTH AND HUMAN SERVICES - PIETRA CHECK, INTERIM DIRECTOR, CORE MH WESLEY CHIN, DIRECTOR, BELMONT HEALTH DEPARTMENT - WESLEY CHIN, DIRECTOR, BELMONT HEALTH DEPARTMENT- STACY CARRUTH, EXECUTIVE DIRECTOR, ARLINGTON YOUTH COUNSELING CENTER - MICHELLE FEELEY, DIRECTOR, WALTHAM HEALTH DEPARTMENT - DR. DINAH GORELIK, PRIMARY CARE PROVIDER, MOUNT AUBURN HOSPITAL - CLAIRE HOFFMAN, SENIOR PUBLIC HEALTH PLANNER, MAPC - DOUG KRESS, CHIEF COMMUNITY OFFICER, CAMBRIDGE HEALTH ALLIANCE - LAURA KURMAN, SENIOR PROGRAM DIRECTOR, WAYSIDE MULTI-SERVICE CENTER - COLLEEN LEGER, DIRECTOR OF HEALTH AND HUMAN SERVICES, TOWN OF ARLINGTON - DERRICK NEAL, CHIEF PUBLIC HEALTH OFFICER, CAMBRIDGE HEALTH DEPARTMENT - BJ OSUAGWU, EXECUTIVE DIRECTOR, HEALTHY WALTHAM - JENICA PHELPS, LICSW, SOCIAL WORK TEAM LEAD, MOUNT AUBURN HOSPITAL - DR. JACKIE SPENCER, DIRECTOR OF PRIMARY CARE, VA NEW ENGLAND HEALTHCARE SYSTEM; MOUNT AUBURN HOSPITAL BOARD OF TRUSTEES - RACHEL TANENHAUS, ADA COORDINATOR/EXECUTIVE DIRECTOR, COMMISSION FOR PERSONS WITH DISABILITIES - VIET VAN, COMMUNITY SUPPORT SERVICE MANAGER, SOMERVILLE CAMBRIDGE ELDER SERVICES - STEPHANIE VENIZELOS, COMMUNITY WELLNESS PROGRAM MANAGER, CITY OF WATERTOWN - STEVEN KAPFHAMMER, MAH CHIEF OPERATING OFFICER - KATHERINE RAFFERTY, MAH DIRECTOR OF COMMUNITY AFFAIRS- HEATHER GIBBONS-PEREZ, MAH DIRECTOR OF PERFORMANCE- IMPROVEMENT AND REGULATORY AFFAIRS - MARIE MCCUNE, RN, MAH STROKE NURSE COORDINATOR - MARY DECOURCEY, MAH DIRECTOR, COMMUNITY BENEFITCOMMUNITY HEALTH NEEDS ASSESSMENT & IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT-INTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY (IS) PURSUANT TO FEDERAL GUIDELINES, IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS AS A HOSPITAL UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) OF 1986, AS AMENDED.MAH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN THE SEPTEMBER OF 2025. THAT CHNA WAS APPROVED BY THE MAH BOARD OF TRUSTEES ON SEPTEMBER 9, 2025. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 9, 2025, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). (SCHEDULE H, PART V, SECTION B, LINE 3)THE CHNA AND THE ASSOCIATED IS REPRESENT THE CULMINATION OF A YEAR OF WORK AND WERE BORNE LARGELY OF MAH'S COMMITMENT TO BETTER UNDERSTAND AND ADDRESS THE HEALTH-RELATED NEEDS OF THOSE LIVING IN ITS COMMUNITY BENEFITS SERVICE AREA (CBSA) WITH AN EMPHASIS ON THOSE WHO ARE MOST DISADVANTAGED. THE PROJECT ALSO FULFILLS THE COMMONWEALTH ATTORNEY GENERAL'S OFFICE AND FEDERAL INTERNAL REVENUE SERVICE (IRS) REGULATIONS THAT REQUIRE THAT MAH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW MAH, IN COLLABORATION WITH THE COMMUNITY AND LOCAL HEALTH DEPARTMENT(S), WILL ADDRESS THE NEEDS AND THE PRIORITIES IDENTIFIED BY THE CHNA. 2025 COMMUNITY HEALTH NEEDS ASSESSMENT-PRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, MAH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2025. THE GEOGRAPHICAL FOCUS OF MAH'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENCOMPASSES ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN. COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR MAH'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R). MAH'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN IN ITS CBSA, AS FOLLOWS: - YOUTH- LOW-RESOURCED POPULATIONS - LGBTQIA+ - OLDER ADULTS - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS 2025 COMMUNITY HEALTH NEEDS ASSESSMENT-SUMMARY OF APPROACH AND METHODSMAH'S CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING MAH'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. MAH'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL AND STATE LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, ACCOUNTABILITY, COMMUNITY ENGAGEMENT, AND IMPACT.BETWEEN JUNE 2024 AND FEBRUARY 2025, MAH CONDUCTED 15 ONE-ON-ONE INTERVIEWS WITH COLLABORATORS IN THE COMMUNITY, FACILITATED FIVE FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 700 RESIDENTS, AND ORGANIZED A COMMUNITY LISTENING SESSION. IN TOTAL, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM 800 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS, AND OTHER KEY COMMUNITY PARTNERS. IN THE SPIRIT OF COLLABORATION MAH COMMUNITY BENEFIT STAFF WORKED WITH CAMBRIDGE HEALTH ALLIANCE, THE CITY OF CAMBRIDGE AND THE TOWN OF ARLINGTON AS EACH ENTITY WAS SIMILARLY CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS AT THE SAME TIME. THIS COLLABORATION INCLUDED ATTENDING REGULARLY SCHEDULED MEETINGS TOGETHER TO UPDATE EACH OTHER ON OUR COMMUNITY ENGAGEMENT ACTIVITIES AND TO SHARE QUANTITATIVE AND QUALITATIVE DATA WITH EACH OTHER. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5) THIS 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT IS AN INTEGRAL PART OF MAH'S POPULATION HEALTH AND COMMUNITY ENGAGEMENT EFFORTS. IT SUPPLIES VITAL INFORMATION THAT IS APPLIED TO MAKE SURE THAT THE SERVICES AND PROGRAMS THAT MAH PROVIDES ARE APPROPRIATELY FOCUSED, DELIVERED IN WAYS THAT ARE RESPONSIVE TO THOSE IN ITS CBSA, AND ADDRESS UNMET COMMUNITY NEEDS. THIS ASSESSMENT, ALONG WITH THE ASSOCIATED PRIORITIZATION AND PLANNING PROCESSES, ALSO PROVIDES A CRITICAL OPPORTUNITY FOR MAH TO ENGAGE THE COMMUNITY AND STRENGTHEN THE COMMUNITY PARTNERSHIPS THAT ARE ESSENTIAL TO MAH'S SUCCESS NOW AND IN THE FUTURE. THE ASSESSMENT ENGAGED MORE THAN 800 PEOPLE FROM ACROSS THE CBSA, INCLUDING LOCAL PUBLIC HEALTH OFFICIALS, CLINICAL AND SOCIAL SERVICE PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, MUNICIPAL EMPLOYEES AND COMMUNITY RESIDENTS.2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-DETAIL OF APPROACH AND METHODSMAH RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. MAH COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT MAH LEVERAGED INCLUDED:- BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2021-2022) - CENTERS FOR DISEASE CONTROL GEOSPATIAL RESEARCH, ANALYSIS, AND SERVICES PROGRAM (2018-2022) - CENTERS FOR DISEASE CONTROL AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY (2022) - CENTERS FOR MEDICARE AND MEDICAID SERVICES GEOSPATIAL RESEARCH, ANALYSIS AND SERVICES PROGRAM (2018-2022) - MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) - FBI UNIFORM CRIME REPORTS (2019) - MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2024) - MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) - MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2024) - MASSACHUSETTS DEATH REPORT, COMMUNITY PROFILES (2024) - ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2022, 2023, 2024) - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2019-2023) - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2019-2023) - U.S. DEPARTMENT OF AGRICULTURE: AGRICULTURE MARKETING SERVICE (2023) - U.S. DEPARTMENT OF AGRICULTURE: RETAILER LOCATOR (2024) 2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS-COMMUNITY INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN JUNE 2024 AND FEBRUARY 2025, MAH WORKED WITH COLLABORATORS TO CONDUCT 15 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS FROM THE COMMUNITY, INCLUDING REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS AND OTHERS THROUGHOUT MAH'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF COMMUNITY INTERVIEWEES IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON MAH'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN MAH'S CBSA. INTERVIEWS WERE CONDUCTED USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS. 2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS- FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)ACROSS ALL FOUR COMPONENTS OF THE CHNA, MAH CONDUCTED 5 COMMUNITY FOCUS GROUPS AND HELD A COMMUNITY LISTENING SESSION THAT ENGAGED 34 PEOPLE IN MAH'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS AND LISTENING SESSIONS WERE ORGANIZED IN COLLABORATION WITH OTHER BETH ISRAEL LAHEY HEALTH (BILH) HOSPITALS. MAH WAS INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF MAH'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN THIRTEEN LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, COMMUNITY EVENTS, AND PUBLIC AND/OR SENIOR HOUSING BUILDINGS TO HELP ENSURE APPROPRIATE REPRESENTATION IN THE CHNA. THE MAH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES. 2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSTHE MAH'S CBAC WAS ENGAGED AT THE OUTSET OF THE STRATEGIC PLANNING AND REPORTING PHASE OF THE PROJECT. THE CBAC WAS UPDATED ON ASSESSMENT PROGRESS AND WAS PROVIDED THE OPPORTUNITY TO VET AND COMMENT ON PRELIMINARY FINDINGS. THE CBAC THEN PARTICIPATED IN A PRIORITIZATION PROCESS USING A SET OF ANONYMOUS POLLS, WHICH ALLOWED THEM TO IDENTIFY A SET OF COMMUNITY HEALTH PRIORITIES AND POPULATION COHORTS THAT THEY BELIEVED SHOULD BE CONSIDERED FOR PRIORITIZATION AS MAH DEVELOPED ITS IMPLEMENTATION STRATEGY (IS). AFTER PRIORITIZATION WITH THE CBAC, A COMMUNITY LISTENING SESSION WAS ORGANIZED WITH THE PUBLIC-AT-LARGE, INCLUDING COMMUNITY RESIDENTS, REPRESENTATIVES FROM CLINICAL AND SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY-BASED ORGANIZATIONS THAT PROVIDE SERVICES THROUGHOUT THE CBSA. USING THE SAME SET OF ANONYMOUS POLLS, COMMUNITY LISTENING SESSION PARTICIPANTS WERE ASKED TO PRIORITIZE THE ISSUES THAT THEY BELIEVED WERE MOST IMPORTANT. THE SESSION ALSO ALLOWED PARTICIPANTS TO SHARE THEIR IDEAS ON EXISTING COMMUNITY STRENGTHS AND ASSETS, AS WELL AS THE SERVICES, PROGRAMS, AND STRATEGIES THAT SHOULD BE IMPLEMENTED TO ADDRESS THE ISSUES IDENTIFIED. THE CBAC ANALYZED LISTENING SESSION DATA AND INTEGRATED COMMUNITY INPUT INTO THE FINAL PRIORITIZATION. AFTER THE PRIORITIZATION PROCESS, A CHNA REPORT WAS DEVELOPED AND MAH'S EXISTING IS WAS AUGMENTED, REVISED, AND TAILORED. WHEN DEVELOPING THE IS, MAH'S COMMUNITY BENEFITS STAFF RETAINED COMMUNITY HEALTH INITIATIVES THAT WORKED WELL AND ALIGNED WITH THE PRIORITIES FROM THE 2025 CHNA. AFTER DRAFTS OF THE MAH CHNA REPORT AND IS WERE DEVELOPED, THEY WERE SHARED WITH MAH'S SENIOR LEADERSHIP TEAM FOR INPUT AND COMMENT. THE HOSPITAL'S COMMUNITY BENEFITS STAFF THEN REVIEWED THESE INPUTS AND INCORPORATED ELEMENTS, AS APPROPRIATE, BEFORE THE FINAL 2025 CHNA REPORT AND 2026-2028 IS WERE SUBMITTED TO MAH'S BOARD OF TRUSTEES FOR APPROVAL. AFTER THE BOARD OF TRUSTEES FORMALLY APPROVED THE 2025 CHNA REPORT AND ADOPTED 2026-2028 IS, THESE DOCUMENTS WERE POSTED ON MAH'S WEBSITE, ALONGSIDE THE AMENDED 2022 CHNA REPORT AND AMENDED 2023-2025 IS, FOR EASY VIEWING AND DOWNLOAD. AS WITH ALL MAH CHNA PROCESSES, THESE DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC WHENEVER REQUESTED, ANONYMOUSLY AND FREE OF CHARGE. IT SHOULD ALSO BE NOTED THAT THE HOSPITAL'S COMMUNITY BENEFITS STAFF HAVE MECHANISMS IN PLACE TO RECEIVE WRITTEN COMMENTS ON THE MOST RECENT CHNA AND IS, ALTHOUGH NO COMMENTS HAVE BEEN RECEIVED SINCE THE LAST CHNA AND IS WERE MADE AVAILABLE. 2025 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--KEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDING SEPTEMBER 30, 2025, WERE: - YOUTH - LOW-RESOURCED POPULATIONS - OLDER ADULTS- LGBTQIA+ - RACIALLY, ETHNICALLY, AND LINGUISTICALLY DIVERSE POPULATIONS MAH'S CHNA RESULTED IN KEY FINDINGS RELATED TO: - EQUITABLE ACCESS TO CARE: IN THE CONTEXT OF THE HEALTHCARE SYSTEM, SYSTEMIC FACTORS INCLUDE A BROAD RANGE OF DIFFERENT CONSIDERATIONS THAT INFLUENCE A PERSON'S ABILITY TO ACCESS TIMELY, EQUITABLE, ACCESSIBLE, AND HIGH-QUALITY SERVICES. THERE IS A GROWING APPRECIATION FOR THE IMPORTANCE OF THESE FACTORS AS THEY ARE SEEN AS CRITICAL TO ENSURING THAT PEOPLE CAN FIND, ACCESS, AND ENGAGE IN THE SERVICES THEY NEED, COMMUNICATE WITH CLINICAL AND SOCIAL SERVICE PROVIDERS, AND TRANSITION SEAMLESSLY FROM ONE SERVICE SETTING TO ANOTHER. THE ASSESSMENT GATHERED INFORMATION RELATED TO PERCEPTIONS OF SERVICE GAPS, BARRIERS TO ACCESS (E.G., COST OF CARE, HEALTH INSURANCE STATUS, LANGUAGE ACCESS, CULTURAL COMPETENCE), CARE COORDINATION, AND INFORMATION SHARING. - SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE "THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS." THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEYS, AND THE LISTENING SESSION REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC STABILITY.- HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY, AND STRESS). SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE MAH'S CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INTERVIEWEES, FOCUS GROUPS, AND COMMUNITY LISTENING SESSION PARTICIPANTS IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS).- HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN THE COMMONWEALTH, CHRONIC CONDITIONS LIKE CANCER, HEART DISEASE, CHRONIC LOWER RESPIRATORY DISEASE, AND STROKE ACCOUNT FOR FOUR OF THE SIX LEADING CAUSES OF DEATH STATEWIDE, AND IT IS ESTIMATED THAT THERE ARE MORE THAN $41 BILLION IN ANNUAL COSTS ASSOCIATED WITH CHRONIC DISEASE. PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM MAH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2026, SEPTEMBER 30, 2027, AND SEPTEMBER 30, 2028. MAH'S COMMUNITY BENEFITS ACTIVITIES AND ACCOMPLISHMENTS WHICH ARE REPORTED IN THIS FORM 990 SCHEDULE H WERE INFORMED BY THE HOSPITAL'S PREVIOUS CHNA AND IMPLEMENTATION STRATEGY AND ARE PROVIDED IN MORE DETAIL BELOW. PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFITS ACTIVITIES REPORTED IN THIS FORM 990 SCHEDULE HAS NOTED THROUGHOUT THIS FORM 990 SCHEDULE H, MAH MOST RECENTLY COMPLETED CHNA WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024) AND THE FIRST YEAR OF ACCOMPLISHMENTS UNDER THAT CHNA AND IMPLEMENTATION STRATEGY (IS) WILL BE REPORTED IN THE FORM 990 FOR THE FISCAL YEAR ENDING SEPTEMBER 30, 2026. THE PRIOR CHNA AND IS PROCESS WHICH WAS COMPLETED BY MAH DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 WAS AMENDED ON JUNE 10, 2025. THE AMENDED 2022 CHNA AND 2023-2025 IMPLEMENTATION STRATEGY INFORMED MAH'S COMMUNITY BENEFITS OPERATIONS AND ACCOMPLISHMENTS REPORTED IN THIS FORM 990. 2022 COMMUNITY HEALTH NEEDS ASSESSMENT-- PRIORITY GEOGRAPHY AND COHORTSMAH COMPLETED ITS 2022 ASSESSMENT IN SEPTEMBER 2022 AND AMENDED THE REPORT AND IMPLEMENTATION STRATEGY IN JUNE 20254. THE GEOGRAPHICAL FOCUS OF MAH'S 2022 CHNA ENCOMPASSES ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN. COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR MAH'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS FROM A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R). MAH'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES FOCUS ON IMPROVING THE HEALTH STATUS OF THOSE WHO ARE MEDICALLY-UNDERSERVED, EXPERIENCE POVERTY OR FACE THE GREATEST HEALTH DISPARITIES IN THE COMMUNITIES OF ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN IN IT'S CBSA, AS FOLLOWS: - YOUTH- LOW-RESOURCED POPULATIONS - OLDER ADULTS - LGBTQIA+ - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT-SUMMARY OF APPROACH AND METHODSSIMILAR TO MAH'S APPROACH AND METHODS FOR THE CHNA ADOPTED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025, THE MAH'S PRIOR CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING MAH'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. MAH'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL, AND STATE LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY.MAH'S 2022 CHNA APPROACH INVOLVED EXTENSIVE DATA COLLECTION ACTIVITIES, SUBSTANTIAL EFFORTS TO ENGAGE THE HOSPITAL'S PARTNERS AND COMMUNITY RESIDENTS, AND THOUGHTFUL PRIORITIZATION, PLANNING, AND REPORTING PROCESSES. THROUGHOUT THE CHNA PROCESS, EFFORTS WERE MADE TO UNDERSTAND THE NEEDS OF THE COMMUNITIES ENCOMPASSING MAH'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. MAH'S UNDERSTANDING OF THESE COMMUNITIES' NEEDS IS DERIVED FROM COLLECTING A WIDE RANGE OF QUANTITATIVE DATA TO IDENTIFY DISPARITIES AND CLARIFY THE NEEDS OF SPECIFIC COMMUNITIES AND COMPARING IT AGAINST DATA COLLECTED AT THE REGIONAL AND STATE LEVELS WHEREVER POSSIBLE TO SUPPORT ANALYSIS AND THE PRIORITIZATION PROCESS, AS WELL AS EMPLOYING A VARIETY OF STRATEGIES TO ENSURE COMMUNITY MEMBERS WERE INFORMED, CONSULTED, INVOLVED, AND EMPOWERED THROUGHOUT THE ASSESSMENT PROCESS. THE CHNA AND IS DEVELOPMENT PROCESS WAS GUIDED BY THE FOLLOWING PRINCIPLES: EQUITY, COLLABORATION, ENGAGEMENT, CAPACITY BUILDING, AND INTENTIONALITY. BETWEEN OCTOBER 2021 AND FEBRUARY 2022, MAH CONDUCTED 18 ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, FACILITATED 3 FOCUS GROUPS WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, ADMINISTERED A COMMUNITY HEALTH SURVEY INVOLVING MORE THAN 260 RESIDENTS, AND ORGANIZED TWO COMMUNITY LISTENING SESSIONS. (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE ASSESSMENT PROCESS COLLECTED INFORMATION FROM MORE THAN 300 COMMUNITY RESIDENTS, CLINICAL AND SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY PARTNERS. 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--DETAIL OF APPROACH AND METHODSMAH RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. MAH COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT MAH LEVERAGED INCLUDED: - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2016-2020) - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY POPULATION CHANGE (2010-2020) - U.S. CENSUS BUREAU, COVID-19 HOUSEHOLD PULSE SURVEY (2021) - BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (2019) - MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2020-2021) - FBI UNIFORM CRIME REPORTS (2019) - MASSACHUSETTS DEPARTMENT OF ECONOMIC RESEARCH, LABOR MARKET INFORMATION (2020-2021) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2019) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2015-2017) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 DASHBOARD (2021) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, COVID-19 COMMUNITY IMPACT SURVEY (2021) - MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES (2019) - MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2019) - MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2020) - MASSACHUSETTS INSTITUTE OF TECHNOLOGY, EVICTION LAB (2018) - ROBERT WOOD JOHNSON COUNTRY HEALTH RANKINGS (2019, 2020, 2021) 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--KEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)BETWEEN OCTOBER 2021 AND FEBRUARY 2022, MAH CONDUCTED 18 KEY INFORMANT INTERVIEWS THAT ENGAGED COMMUNITY-BASED ORGANIZATIONS, CLINICAL AND SOCIAL SERVICE PROVIDERS, PUBLIC HEALTH OFFICIALS, AND OTHER KEY COLLABORATORS THROUGHOUT MAH'S CBSA. DISCUSSIONS EXPLORED INTERVIEWEES' EXPERIENCES OF ADDRESSING COMMUNITY NEEDS AND OPPORTUNITIES FOR FUTURE ALIGNMENT, COORDINATION AND EXPANSION OF SERVICES, INITIATIVES AND POLICIES. A LIST OF KEY INFORMANTS IS INCLUDED IN APPENDIX A OF THE CHNA REPORT THAT IS POSTED ON MAH'S WEBSITE. THESE INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN MAH'S CBSA. INTERVIEWS WERE CONDUCTED VIRTUALLY USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING THE BIGGEST HEALTH-RELATED CONCERNS/ISSUES, AS WELL AS THE BARRIERS AND/OR CHALLENGES FOR ACCESSING RESOURCES AND SERVICES AMONG THOSE THEY SERVE AND/OR THOSE LIVING IN THE COMMUNITY, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS. 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--FOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)ACROSS ALL FOUR COMPONENTS OF THE CHNA, MAH CONDUCTED 5 COMMUNITY FOCUS GROUPS AND HELD COMMUNITY LISTENING SESSIONS THAT ENGAGED MORE THAN 300 RESIDENTS IN MAH'S COMMUNITY BENEFITS SERVICE AREA (CBSA) TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. MAH WAS INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF MAH'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IS PROCESS. TO REACH A BROAD RANGE OF COMMUNITY MEMBERS, ALL COMMUNITY SURVEYS, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH A FOCUS ON COMMUNITY REPRESENTATIVENESS. FOR EXAMPLE, THE SURVEY WAS ADMINISTERED ONLINE AND VIA HARD COPY IN TWELVE LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, PUBLIC LIBRARIES, COMMUNITY EVENTS AND LARGE APARTMENT BUILDINGS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE MAH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE CBAC MET FIVE TIMES DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE, CONDUCTING OUTREACH TO COMMUNITY VOICES THAT HAVE HISTORICALLY BEEN LEFT OUT OF SIMILAR PROCESSES. 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--REVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE 2022 CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: - REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS WITH THE MAH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS.- IDENTIFY MAH'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES.- ANALYZE MAH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2021 CHNA AND SUBSEQUENT 2021 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY MAH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2021 (TAX YEAR 2020).- DETERMINE IF THE RANGE OF COMMUNITY BENEFITS ACTIVITIES ESTABLISHED DURING THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY PROCESS NEEDED TO BE AUGMENTED OR CHANGED TO RESPOND TO THE ASSESSMENT COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021).2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS--KEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2022, WERE: - YOUTH - LOW-RESOURCED POPULATIONS- LGBTQIA+- OLDER ADULTS - RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONSMAH'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: - EQUITABLE ACCESS TO CARE: INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS WERE AT THE SYSTEM LEVEL, MEANING THAT THE ISSUES STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM LEVEL ISSUES INCLUDED PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTHCARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE. THERE WERE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FOREGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY. - SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, EDUCATION, AND COMMUNITY/SOCIAL CONTEXT) CONTINUE TO HAVE A MASSIVE IMPACT ON MANY SEGMENTS OF THE POPULATION. THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO ECONOMIC INSECURITY, EDUCATION, FOOD INSECURITY, ACCESS TO CARE/NAVIGATION ISSUES, AND OTHER IMPORTANT SOCIAL FACTORS. THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, SURVEY, AND LISTENING SESSIONS SUGGESTED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION - ESPECIALLY ISSUES RELATED TO HOUSING, FOOD SECURITY/NUTRITION, AND ECONOMIC STABILITY.- HIGH RATES OF SUBSTANCE USE (E.G., ALCOHOL, PRESCRIPTION DRUG/OPIOIDS, MARIJUANA) AND MENTAL HEALTH ISSUES (E.G., DEPRESSION, ANXIETY, AND STRESS). ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THE ASSESSMENT IDENTIFIED SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, TRAUMA, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19. IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT ON THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES, INCLUDING MENTAL HEALTH, HOUSING, AND HOMELESSNESS. INDIVIDUALS ENGAGED IN THE ASSESSMENT IDENTIFIED STIGMA AS A BARRIER TO TREATMENT AND REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES (E.G., MENTAL HEALTH ISSUES, HOMELESSNESS). - HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN THE COMMONWEALTH AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETY. COMMUNITY HEALTH NEEDS ASSESSMENT--MAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLEMAH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY. AS NOTED ABOVE, MAH COMPLETED ITS MOST RECENT CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE MAH WEBSITE AT: HTTPS://MOUNTAUBURNHOSPITAL.ORG/-/MEDIA/FILES/MOUNT-AUBURN/MAH-2025-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDFIN ADDITION TO THE CHNA, MAH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE MAH WEBSITE AT: HTTPS://MOUNTAUBURNHOSPITAL.ORG/-/MEDIA/FILES/MOUNT-AUBURN/MAH-2026-2028-IMPLEMENTATION-STRATEGY.PDFMAH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021) AND AMENDED THE CHNA ON JUNE 10, 2025. THAT CHNA IS AVAILABLE ON THE MAH WEBSITE AT: HTTPS://MOUNTAUBURNHOSPITAL.ORG/-/MEDIA/FILES/MOUNT-AUBURN/MAH-2022-COMMUNITY-HEALTH-NEEDS.PDF FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING MAH'S FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021) IS AVAILABLE ON THE MAH WEBSITE AT: HTTPS://MOUNTAUBURNHOSPITAL.ORG/-/MEDIA/FILES/MOUNT-AUBURN/MAH-2023-2025-CHNA-IMPLEMENTATION.PDFEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A). COMMUNITY HEALTH NEEDS ASSESSMENT--ADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, MAH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 BUT IT IS THE PREVIOUS CHNA AND IMPLEMENTATION STRATEGY WHICH INFORMED THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF MAH FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024) AND WHICH ARE REPORTED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. GIVEN THE COMPLEX HEALTH ISSUES IN THE COMMUNITY, MAH HAS BEEN STRATEGIC IN IDENTIFYING ITS COMMUNITY HEALTH PRIORITIES IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS PROGRAM AND WORK TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF RESIDENTS IN ITS CBSA. GOALS FOR EACH PRIORITY AREA ARE LISTED BELOW. PRIORITY AREA 1: EQUITABLE ACCESS TO CARE - GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AS WELL AS URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC AND ECONOMIC BARRIERS PRIORITY AREA 2: SOCIAL DETERMINANTS OF HEALTH - GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENT WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY OF LIFE. PRIORITY AREA 3: MENTAL HEALTH AND SUBSTANCE USE - GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE. PRIORITY AREA 4: COMPLEX AND CHRONIC CONDITIONS - GOAL: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES COMMUNITY HEALTH NEEDS ASSESSMENT-APPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)MAH HAS TAKEN A HOLISTIC AND STRATEGIC APPROACH IN ADDRESSING THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY BY CREATING, SUPPORTING AND INVESTING IN HEALTH PROGRAMMING AND INITIATIVES THROUGHOUT THEIR CBSA. BELOW IS A SUMMARY OF SOME OF THE COMMUNITY BENEFITS PROGRAMS AND INITIATIVES OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES OF THEIR TARGET POPULATIONS THROUGHOUT THEIR SERVICE AREA. MAH HAS BEEN A LEADER IN CREATING A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE FOOD ACCESS PROGRAMS SUCH AS THE FARMER'S MARKET INCENTIVE PROGRAM AT LOCAL FARMER'S MARKETS, PROGRAMS TO ADDRESS ACCESS TO MENTAL HEALTH RESOURCES AND SERVICES, DONATIONS TO SUPPORT HIGH NEED POPULATIONS, AND HEALTHY AGING PROGRAMS. IN FY25, MAH PROVIDED A NEW GRANT OPPORTUNITY ENABLING 5 COMMUNITY BASED ORGANIZATIONS WITH FUNDING TO SUPPORT ONE OR MORE OF THE HEALTH PRIORITIES IDENTIFIED IN THE FY23-FY 25 IS. THROUGH THE MAH COLLABORATIVE CARE MODEL BEHAVIORAL HEALTH SERVICES WERE PROVIDED TO 1,771 PATIENTS ACROSS 11 SITES. IN FY25 MAH CREATED A NEW PARTNERSHIP WITH HOMEOWNERS REHAB TO SUPPORT THEIR WORK TO SUPPORT RESIDENTS WITH HOUSING STABILIZATION ASSISTANCE. IN FY25, 371 HOUSEHOLDS RECEIVED HOUSING STABILIZATION ASSISTANCE, 69 HOUSEHOLDS COMPLETED BENEFITS APPLICATIONS INCLUDING SUPPLEMENTAL NUTRITIONAL ASSISTANT PROGRAMS (SNAP) AND MASS HEALTH, AND 42 HOUSEHOLDS CONNECTED WITH RAFT OR OTHER HOUSING STABILIZATION FUNDS.MAH CONTINUES TO PROVIDE A HEALTH LITERACY EDUCATION PROGRAM. AUDIENCES FOR THIS PROGRAM INCLUDE ENGLISH LANGUAGE LEARNERS AND OLDER ADULTS. THESE PRESENTATIONS HELP PARTICIPANTS NAVIGATE OUR HEALTHCARE SYSTEM AS WELL AS GAIN KNOWLEDGE ON VARIOUS HEALTH AND WELLNESS TOPICS. A TOTAL OF 220 ENGLISH LANGUAGE LEARNERS AND OLDER ADULTS PARTICIPATED IN THIS PROGRAM. MAH CONTINUES TO DEDICATE SIGNIFICANT TIME AND RESOURCES TO OUR NEIGHBORS WHO ARE FOOD INSECURE. FOR EXAMPLE, THE HOSPITAL USED ITS' PURCHASING POWER TO PURCHASE AND DELIVER FRESH EGGS AND FRESH BREAD TO COMMUNITY FOOD DISTRIBUTION LOCATIONS. IN TOTAL 300 DOZEN EGGS AND 300 LOAVES OF BREAD AMONG OTHER FOOD ITEMS WERE DISTRIBUTED THROUGH THIS PROGRAM. TO SUPPORT INCREASED ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SERVICES AND SUPPORTS, MAH PARTICIPATED WITH OTHER BILH HOSPITALS TO OFFER MENTAL HEALTH FIRST AID (MHFA) TRAININGS TO BOTH COMMUNITY MEMBERS AND STAFF, AND ALSO PROVIDED BEHAVIORAL HEALTH NAVIGATION AND DIGITAL LITERACY TRAININGS TO BILH PHYSICAL HEALTH NAVIGATORS. BILH HOSPITALS INCLUDING MAH AMPLIFIED ITS ANTI-STIGMA MESSAGING, AND DISTRIBUTION OF RESOURCES AND SUPPORTS. A FULL UPDATE ON MAH'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW. SCHEDULE H-COMMUNITY BENEFITS ACCOMPLISHMENTS - IMPLEMENTATION STRATEGY UPDATEKEY: BASELINE-2023, YEAR 1-2024, YEAR 2-2025PRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH THE SOCIAL DETERMINANTS OF HEALTH ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS. THESE CONDITIONS INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN THE CBSA. RESEARCH SHOWS THAT SUSTAINED SUCCESS IN COMMUNITY HEALTH IMPROVEMENT AND ADDRESSING HEALTH DISPARITIES RELIES ON ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT LEAD TO POOR HEALTH OUTCOMES AND DRIVE HEALTH INEQUITIES. THE ASSESSMENT GATHERED A RANGE OF INFORMATION RELATED TO HOUSING, FOOD INSECURITY, ECONOMIC INSECURITY, EDUCATION AND OTHER IMPORTANT SOCIAL FACTORS.THERE IS LIMITED QUANTITATIVE DATA IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. DESPITE THIS, INFORMATION GATHERED THROUGH INTERVIEWS, FOCUS GROUPS, LISTENING SESSIONS, AND THE MAH COMMUNITY HEALTH SURVEY REINFORCED THAT THESE ISSUES HAVE THE GREATEST IMPACT ON HEALTH STATUS AND ACCESS TO CARE IN THE REGION ESPECIALLY ISSUES RELATED TO HOUSING, FOOD INSECURITY/NUTRITION, TRANSPORTATION, AND ECONOMIC INSTABILITY.GOAL: ENHANCE THE BUILT, SOCIAL, AND ECONOMIC ENVIRONMENT WHERE PEOPLE LIVE, WORK, PLAY, AND LEARN IN ORDER TO IMPROVE HEALTH AND QUALITY-OF-LIFE OUTCOMES. KEY: BASELINE-2023, YEAR 1-2024, YEAR 2-2025 STRATEGIES1.1 PROVIDE COMMUNITY HEALTH GRANTS TO SUPPORT IMPACTFUL PROGRAMS THAT ADDRESS ISSUES ASSOCIATED WITH THE SOCIAL DETERMINANTS OF HEALTH1.2 PARTICIPATE IN MULTI-SECTOR COMMUNITY COALITIONS TO CONVENE STAKEHOLDERS TO IDENTIFY AND ADVOCATE FOR POLICY, SYSTEMS, AND ENVIRONMENTAL CHANGES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH 1.3 SUPPORT EDUCATION, SYSTEMS, PROGRAMS, AND ENVIRONMENTAL CHANGES TO INCREASE HEALTHY EATING AND ACCESS TO AFFORDABLE, HEALTHY FOODS 1.4 SCREEN, ASSESS, AND CONNECT PATIENTS WITH HEALTH-RELATED SOCIAL NEEDS1.5 SUPPORT PROGRAMS THAT STABILIZE OR CREATE ACCESS TO AFFORDABLE HOUSINGINITIATIVES TO ADDRESS THE PRIORITY - SUPPORT LOCAL COALITIONS WITH PARTICIPATION AND FUNDING - COMMUNITY FOOD DISTRIBUTION PROGRAM TO PROVIDE FOOD AND OR INCREASE ACCESS TO AFFORDABLE HEALTHY FOODS - PRODUCE PRESCRIPTION PROGRAM - PARTNERSHIPS AND FUNDING SUPPORT TO LOCAL SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) MATCH PROGRAMS AND THE FRESH BUCKS PROGRAM AT LOCAL FARMER'S MARKETS - HEALTHCARE CAREERS PATHWAY PROGRAM WITH LAMPLIGHT WOMEN'S LITERACY CENTER- COMMUNITY DEVELOPMENT AND HOUSING SUPPORT PROGRAM WITH HOMEOWNER'S REHAB INC.- CO-LOCATION PROGRAM - COMMUNITY HEALTH GRANT PROGRAMS FOCUSING ON HOMELESSNESS PREVENTION AND EVICTION PREVENTIONMETRICS AND STATUS UPDATES: - PROVIDE ORGANIZATIONS FUNDING TO CONTINUE THEIR WORK ON IDENTIFIED PROJECTS WHICH REFLECT THE HEALTH PRIORITIES IDENTIFIED IN OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. (BASELINE: 11 ORGANIZATIONS; $150,000 TOTAL FUNDS DISPERSED; YEAR 1: 5 ORGANIZATIONS; $40,000 TOTAL FUNDS DISPERSED; YEAR 2; 5 ORGANIZATIONS; $84,000 FUNDS DISPERSED).- MAH STAFF ATTEND COMMUNITY COALITIONS, COMMUNITY BUILDING AND OR COMMUNITY TASK FORCE MEETINGS IN ITS SERVICE AREA.(BASELINE: 52 MEETINGS, $20,000 FUNDING FOR COMMUNITY COALITIONS; YEAR 1: 43 MEETINGS, $20,000 FUNDING FOR COMMUNITY COALITIONS; YEAR 2: 46 MEETINGS, $12,000 FUNDING FOR COMMUNITY COALITIONS.)- USING THE HOSPITAL'S PURCHASING POWER, PURCHASE FOOD AND DELIVER TO FOOD INSECURE FAMILIES THROUGHOUT THE YEAR. (BASELINE: 9 DELIVERIES CONTAINING 900 DOZEN EGGS AND 900 LOAVES OF FRESH BREAD; YEAR 1: PROVIDED 9 DELIVERIES CONTAINING 900 DOZEN EGGS AND 900 LOAVES OF FRESH BREAD; YEAR 2: PROVIDED 3 DELIVERIES CONTAINING 300 DOZEN EGGS AND 300 LOAVES OF FRESH BREAD.) - THROUGH A PARTNERSHIP WITH WALTHAM FIELDS COMMUNITY FARM, COMMUNITY SUPPORTED AGRICULTURE (CSA) PURCHASE/PROVIDE SHARES TO LOW INCOME MEDICALLY IDENTIFIED FAMILIES WEEKLY FOR 20 WEEKS (BASELINE: 30 HOUSEHOLDS, REPRESENTING 4,861 POUNDS OF FRESH PRODUCE; YEAR 1: 30 HOUSEHOLDS, REPRESENTING 6,561 POUNDS OF FRESH PRODUCE; YEAR 2: 30 HOUSEHOLDS, REPRESENTING 5,000 POUNDS OF FRESH PRODUCE.) - COLLABORATED WITH LOCAL FARMERS MARKETS TO HELP SUPPORT ACCESS TO FRESH PRODUCE FOR THOSE WHO ARE LOW RESOURCED. (BASELINE: 3 MARKETS; YEAR 1: 4 MARKETS; YEAR 2: 4 MARKETS.) (BASELINE: SNAP MATCH CUSTOMERS INCREASED BY 25% AT THE WATERTOWN FARMERS MARKET AS COMPARED TO THE PREVIOUS YEAR; YEAR 1: SNAP MATCH CUSTOMERS INCREASED BY 15% AT THE WATERTOWN FARMERS MARKET AS COMPARED TO THE PREVIOUS YEAR; YEAR 2: SNAP MATCH USAGE WAS APPROXIMATELY EQUAL TO THE WATERTOWN FARMERS MARKET USAGE FROM THE PREVIOUS YEAR.) (BASELINE: FRESH BUCKS (FOOD VOUCHER PROGRAM) CUSTOMERS INCREASED BY 40% AT THE ARLINGTON FARMER'S MARKET AS COMPARED TO THE PREVIOUS YEAR; YEAR 1: 43 OF THOSE USING THE FRESH BUCKS (FOOD VOUCHER PROGRAM) AT THE ARLINGTON FARMER'S MARKET WERE NEW TO THE PROGRAM; YEAR 2: AN 11% INCREASE IN THE NUMBER OF HOUSEHOLDS UTILIZING THE FRESH BUCKS INCENTIVE PROGRAM AT THE FARMER'S MARKET.) (BASELINE: IN BELMONT, SNAP MATCH SHOPPERS INCREASED BY 12% FROM THE PREVIOUS YEAR; YEAR 1: 48% OF THE SNAP SHOPPERS WERE EITHER NEW TO THE MARKET OR WERE PEOPLE WHO HAD GONE OFF THE PROGRAM AND WERE INCENTIVIZED TO RETURN TO THE PROGRAM; YEAR 2: 17% OF THE SNAP MATCH BENEFIT DOLLARS INCREASED BY 17%.)- THE CO-LOCATION PROGRAM IN PARTNERSHIP WITH METRO HOUSING BOSTON (MHB): PROVIDE A DEDICATED CASE WORKER WHO WILL MEET WITH PATIENTS AND COMMUNITY MEMBERS AND PROVIDE ASSISTANCE AND REFERRALS TO COMMUNITY PROGRAMS AND GOVERNMENTAL ASSISTANCE PROGRAMS. (BASELINE: 95 INDIVIDUALS WITH 6 INDIVIDUALS RECEIVING A CONSULTATION THAT RESULTED IN AVOIDING EVICTION FROM THEIR HOME; YEAR 1: 45 INDIVIDUALS, OVER 60% OF PARTICIPANTS WHO RECEIVED SERVICES WERE ABLE TO STABILIZE THEIR HOUSING SITUATION AND REPORTED AN INCREASED KNOWLEDGE OF THE HOUSING SEARCH PROCESS; YEAR 2: 70 INDIVIDUALS RECEIVED CONSULTATION WHICH PROVIDED ASSISTANCE AND REFERRALS TO COMMUNITY PROGRAMS AND GOVERNMENT ASSISTANCE PROGRAMS. THROUGH A PARTNERSHIP WITH HOUSING CORPORATION OF ARLINGTON (HCA): SUPPORT HOUSEHOLDS IN RESOLVING URGENT FINANCIAL, HOUSING, EMPLOYMENT, OR OTHER ISSUES THROUGH THE PROVISION OF DIRECT SOCIAL SERVICES AND REFERRALS TO PARTNER AGENCIES AS NEEDED TO CREATE MORE STABLE TENANCIES FOR AT LEAST 45 FAMILIES. (BASELINE: 39 HOUSEHOLDS; YEAR 1: 48 HOUSEHOLDS; YEAR 2: 38 HOUSEHOLDS.) ENGAGE TENANTS AND SOCIAL SERVICE CLIENTS IN ADVOCACY. (BASELINE: 26 TENANTS ENGAGED IN ADVOCACY; YEAR 1: OVER 25 TENANTS ENGAGED IN ADVOCACY; YEAR 2: 41 HOUSEHOLDS HAVE BEEN ACTIVE WITH THE TENANT COUNCIL.)- THROUGH A NEW PARTNERSHIP WITH HOMEOWNERS REHAB, INC: PROVIDE FUNDING TO SUPPORT HOUSEHOLD STABILIZATION ASSISTANCE, MOVING INDIVIDUALS/FAMILIES INTO STABLE HOUSING. (BASELINE: 371 HOUSEHOLDS RECEIVED HOUSING STABILIZATION ASSISTANCE: 69 HOUSEHOLDS COMPLETED BENEFITS APPLICATIONS INCLUDING FOOD STAMPS AND MASSHEALTH. 42 HOUSEHOLDS CONNECTED WITH RAFT OR OTHER HOUSING STABILIZATION FUNDS.)- THROUGH A NEW PARTNERSHIP WITH LAMPLIGHT WOMEN'S LITERACY CENTER: PROVIDE FUNDING TO ADDRESS BARRIERS TO CAREER ADVANCEMENT FACING ENTRY LEVEL HEALTH CARE WORKERS. THIS PROGRAM PREPARES CLINICAL NURSE ASSISTANTS (CNAS) FOR THE ENGLISH PORTIONS OF THE TEST OF ESSENTIAL ACADEMIC SKILLS (TEAS) EXAM. (BASELINE: 16 ENTRY-LEVEL HEALTH CARE WORKERS PARTICIPATED IN PRE-TEAS OR TEAS PREPARATION COURSES AND 18 ENTRY-LEVEL HEALTH CARE WORKERS RECEIVED INDIVIDUAL CAREER ADVISING TAILORED TO THEIR PARTICULAR SITUATION AND HAVE AN ACTIONABLE PLAN FOR PURSUING THEIR CAREER IN NURSING.)- BILH GOVERNMENT AFFAIRS ADVOCATED, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, FOR BILLS THAT SUPPORTED ACCESS TO SERVICES TO ADDRESS THE ROOT CAUSES OF POOR HEALTH OUTCOMES FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DID NOT COUNT; YEAR 1: 9; YEAR 2: 12).PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONS CHRONIC CONDITIONS SUCH AS CANCER, DIABETES, CHRONIC LOWER RESPIRATORY DISEASE, STROKE, AND CARDIOVASCULAR DISEASE CONTRIBUTE TO 56% OF ALL MORTALITY IN MASSACHUSETTS AND OVER 53% OF ALL HEALTH CARE EXPENDITURES ($30.9 BILLION A YEAR). PERHAPS MOST SIGNIFICANTLY, CHRONIC DISEASES ARE LARGELY PREVENTABLE DESPITE THEIR HIGH PREVALENCE AND DRAMATIC IMPACT ON INDIVIDUALS AND SOCIETYGOAL: IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES FOR INDIVIDUALS AT-RISK FOR OR LIVING WITH CHRONIC AND/OR COMPLEX CONDITIONS AND CAREGIVERS BY ENHANCING ACCESS TO SCREENING, REFERRAL SERVICES, COORDINATED HEALTH AND SUPPORT SERVICES, MEDICATIONS, AND OTHER RESOURCES.STRATEGIES1.1 ENSURE OLDER ADULTS HAVE ACCESS TO COORDINATED HEALTHCARE, SUPPORTIVE SERVICES AND RESOURCES THAT SUPPORT OVERALL HEALTH AND THE ABILITY TO AGE IN PLACE1.2 PROVIDE PREVENTIVE HEALTH INFORMATION, SERVICES, AND SUPPORT FOR THOSE AT RISK FOR COMPLEX AND/OR CHRONIC CONDITIONS AND SUPPORT EVIDENCE-BASED CHRONIC DISEASE TREATMENT AND SELF-MANAGEMENT PROGRAMSINITIATIVES TO ADDRESS THE PRIORITY- HEALTHY AGING PROGRAM- PROVIDE SUPPORT FOR COMMUNITY MEMBERS WITH CANCER- PROVIDE A FREE BREAST CANCER SUPPORT GROUP- PROVIDE A STROKE NURSE NAVIGATOR- EXECUTE A STROKE AWARENESS CAMPAIGNMETRICS AND STATUS UPDATE:- COORDINATE AND PROVIDE PRESENTATIONS GEARED TOWARDS EDUCATING OLDER ADULTS ON HEALTH TOPICS. (BASELINE: 4 PRESENTATIONS, 152 OLDER ADULTS IN ATTENDANCE. PRESENTATION TOPICS INCLUDED: BRAIN HEALTH, HEALTHY EATING/HEALTHY AGING, AND HEART HEALTH INCLUDING STROKE AWARENESS; YEAR 1: 9 PRESENTATIONS, 179 OLDER ADULTS ATTENDED. PRESENTATION TOPICS INCLUDED: FALL PREVENTION, HEALTHY EATING/HEALTHY AGING, AND HEART HEALTH INCLUDING STROKE AWARENESS; YEAR 2: 4 PRESENTATIONS, 50 OLDER ADULTS ATTENDED. PRESENTATION TOPICS INCLUDED: DIABETES, BREAST HEALTH AND CANCER PREVENTION, AND HEART HEALTH INCLUDING STROKE AWARENESS.)- BRAIN HEALTH (BASELINE ONLY): 83% OF PARTICIPANTS REPORTED THEY WILL TAKE LESSONS AND SKILLS LEARNED AND INCORPORATE THEM INTO THEIR WEEKLY ROUTINE. 87% OF PARTICIPANTS REPORTED LEARNING NEW INFORMATION ABOUT KEEPING THEIR BRAINS HEALTHY. 93% OF PARTICIPANTS REPORTED THAT THEY LEARNED STRATEGIES TO HELP THEM MAKE CHOICES THAT WILL POSITIVELY IMPACT THEIR OVERALL HEALTH.- HEALTHY EATING/HEALTHY AGING (BASELINE: 87% OF PARTICIPANTS REPORTED LEARNING NEW TIPS AND IDEAS THEY WILL USE WHEN THEY GO GROCERY SHOPPING; YEAR 1: 100% OF PARTICIPANTS REPORTED LEARNING SOME NEW HEALTHY TIPS AND IDEAS THEY WILL USE WHEN THEY GO GROCERY SHOPPING; YEAR 2: 100% OF PARTICIPANTS REPORTED THEY LEARNED SOME NEW HEALTHY EATING TIPS OR IDEAS THEY WILL USE WHEN THEY GO GROCERY SHOPPING.) (BASELINE: 87% OF PARTICIPANTS REPORTED LEARNING NEW TIPS OR IDEAS ABOUT HOW TO SUBSTITUTE HEALTHIER FOODS IN THEIR DIET; YEAR 1: 80% OF PARTICIPANTS REPORTED LEARNING NEW TIPS OR IDEAS ABOUT HOW TO SUBSTITUTE FOODS IN THEIR DIET WITH HEALTHIER FOODS; YEAR 2: 85% OF PARTICIPANTS REPORTED THEY LEARNED SOME NEW HEALTHY EATING TIPS OR IDEAS THEY WILL USE WHEN THEY GO GROCERY SHOPPING.)- HEART HEALTH: (BASELINE: 73% OF PARTICIPANTS REPORTED INCREASED KNOWLEDGE OF THE RISKS OF HEART DISEASE; YEARS 1: 94% OF PARTICIPANTS REPORTED THEY INCREASED THEIR KNOWLEDGE OF THE RISKS OF HEART DISEASE; YEARS 2: 92% OF PARTICIPANTS REPORTED THEY INCREASED THEIR KNOWLEDGE OF THE RISKS OF HEART DISEASE.) (BASELINE: 73% OF PARTICIPANTS REPORTED INCREASING THEIR KNOWLEDGE OF THE SIGNS AND SYMPTOMS OF HEART DISEASE; YEAR 1: 94% OF PARTICIPANTS REPORTED INCREASING THEIR KNOWLEDGE OF THE SIGNS AND SYMPTOMS OF HEART DISEASE; YEAR 2: 92% OF PARTICIPANTS REPORTED THEY INCREASED THEIR KNOWLEDGE OF THE RISKS OF HEART DISEASE.)- FALL PREVENTION (BASELINE ONLY): 94% OF PARTICIPANTS REPORTED THEY LEARNED SOME NEW INFORMATION ON HOW TO HELP THEMSELVES PREVENT A FALL. 98% OF PARTICIPANTS REPORTED THEY WOULD BE ABLE TO TAKE WHAT THEY LEARNED FROM THE PRESENTATION AND IMPROVE THEIR OWN HEALTH AND WELL-BEING.- DIABETES EDUCATION (YEAR 2 ONLY): 100% OF PARTICIPANTS REPORTED THAT THEY LEARNED SOMETHING NEW ABOUT THE SIGNS AND SYMPTOMS OF DIABETES. 100% OF PARTICIPANTS REPORTED THEY LEARNED SOMETHING NEW ABOUT HOW TO HELP THEMSELVES PREVENT DIABETES. - ORGANIZE A SURVIVORSHIP DAY EVENT. (BASELINE: 48 PEOPLE ATTENDING; YEAR 1: 60 PEOPLE ATTENDING.; YEAR 2: 82 PEOPLE ATTENDING.) (BASELINE: 97% OF PARTICIPANTS REPORTED LEARNING SOMETHING OF LASTING VALUE.: YEAR 1: 100% OF PARTICIPANTS REPORTED LEARNING SOMETHING OF LASTING VALUE.; YEAR 2: 100% OF THOSE WHO TOOK THE SURVEY REPORTED THEY LEARNED SOMETHING OF LASTING VALUE.) (BASELINE: 95% OF PARTICIPANTS REPORTED THEY WOULD BE ABLE TO TAKE WHAT THEY LEARNED AND APPLY IT TO IMPROVE THEIR OWN HEALTH AND WELLBEING; YEAR 1: 100% OF THOSE PARTICIPATING REPORTED THEY WOULD BE ABLE TO TAKE WHAT THEY LEARNED AND USE IT TO IMPROVE THEIR OWN HEALTH AND WELLBEING; YEAR 2: 100% OF THOSE PARTICIPATING REPORTED THEY WOULD BE ABLE TO TAKE WHAT THEY LEARNED AND USE IT TO IMPROVE THEIR OWN HEALTH AND WELLBEING.) - PROVIDED A FREE BREAST CANCER SUPPORT GROUP TO THOSE WHO HAVE COMPLETED TREATMENT, THIS GROUP MET TWICE A MONTH THROUGHOUT THE YEAR. (BASELINE: 24 SESSIONS; YEAR 1: 24 SESSIONS; YEAR 2: 24 SESSIONS.)- PROVIDED STROKE EDUCATION AND SUPPORT TO PATIENTS AND FAMILIES BY STROKE NURSE COORDINATOR (BASELINE: 225 PATIENTS AND THEIR FAMILY MEMBERS; YEAR 1: 240 PATIENTS AND THEIR FAMILY MEMBERS; YEAR 2: 180 PATIENTS AND FAMILY MEMBERS.)- CONDUCT A STROKE AWARENESS CAMPAIGNBASELINE ONLY: - CREATED AND DEVELOPED A PUBLIC SERVICE ANNOUNCEMENT (VIDEO), DISTRIBUTED STROKE EDUCATION MATERIALS AND CONDUCTED STROKE AWARENESS PRESENTATIONS FOR COMMUNITY MEMBERS.- THE VIDEO IS AVAILABLE IN FIVE LANGUAGES. LANGUAGES INCLUDE ARMENIAN, ENGLISH, HAITIAN CREOLE, PORTUGUESE AND SPANISH. THE VIDEO IS POSTED ON THE HOSPITAL'S WEBSITE AND SHARED WITH OUR COMMUNITY PARTNERS. THE VIDEO WAS AIRED ON LOCAL CABLE NETWORK STATIONS. IT HAS BEEN DISTRIBUTED WIDELY ON SOCIAL MEDIA.- DISTRIBUTED OVER 2,000 STROKE EDUCATIONAL MATERIALS, INCLUDING MAGNETS IN FIVE DIFFERENT LANGUAGES IN ADDITION TO ENGLISH TO VARIOUS COMMUNITY ORGANIZATIONS FOR DISTRIBUTION TO COMMUNITY MEMBERS AND FOR POSTING IN COMMON AREAS.- PROVIDED EIGHT STROKE AWARENESS PRESENTATIONS WITH 127 PEOPLE IN ATTENDANCE.- 98% OF PRESENTATION PARTICIPANTS REPORTED AN INCREASE IN THEIR KNOWLEDGE OF THE RISKS OF HAVING A STROKE.- 89% OF PRESENTATION PARTICIPANTS REPORTED AN INCREASE IN THEIR KNOWLEDGE OF THE SIGNS AND SYMPTOMS OF STROKE.YEAR 1:- DISTRIBUTED OVER 5,000 STROKE EDUCATIONAL MATERIALS INCLUDING MAGNETS IN 5 DIFFERENT LANGUAGES IN ADDITION TO ENGLISH THROUGH THE LOCAL MEALS ON WHEELS PROGRAMS, FARMER'S MARKETS, AT LIBRARIES AND OTHER COMMUNITY ORGANIZATIONS THROUGH EDUCATIONAL TABLING. - PROVIDED 9 STROKE AWARENESS PRESENTATIONS WITH 110 PEOPLE IN ATTENDANCE. 98% OF PRESENTATION PARTICIPANTS REPORTED AN INCREASE IN THEIR KNOWLEDGE OF THE RISKS OF HAVING A STROKE. 97% OF PRESENTATION PARTICIPANTS REPORTED AN INCREASE OF THEIR KNOWLEDGE OF THE SIGNS AND SYMPTOMS OF STROKE. YEAR 2: - DISTRIBUTED STROKE EDUCATION MATERIALS AND CONDUCTED STROKE AWARENESS PRESENTATIONS FOR COMMUNITY MEMBERS. ENGAGED OVER 250 COMMUNITY MEMBERS WITH STROKE EDUCATION MATERIALS. - PROVIDED 5 STROKE AWARENESS PRESENTATIONS WITH 93 PEOPLE IN ATTENDANCE. 88% OF PRESENTATION PARTICIPANTS REPORTED AN INCREASE IN THEIR KNOWLEDGE OF THE RISKS OF HAVING A STROKE. 90% OF PRESENTATION PARTICIPANTS REPORTED AN INCREASE OF THEIR KNOWLEDGE OF THE SIGNS AND SYMPTOMS OF STROKE.- BILH GOVERNMENT AFFAIRS ADVOCATED, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, FOR BILLS SUPPORTING ACCESS TO SERVICES TO PREVENT OR ADDRESS CHRONIC AND COMPLEX CONDITIONS FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DID NOT COUNT; YEAR 1: 5; YEAR 2:5)PRIORITY AREA 3: EQUITABLE ACCESS TO CARE INDIVIDUALS IDENTIFIED A NUMBER OF BARRIERS TO ACCESSING AND NAVIGATING THE HEALTH CARE SYSTEM. MANY OF THESE BARRIERS ARE AT THE SYSTEM LEVEL, AND STEM FROM THE WAY IN WHICH THE SYSTEM DOES OR DOES NOT FUNCTION. SYSTEM-LEVEL ISSUES INCLUDE PROVIDERS NOT ACCEPTING NEW PATIENTS, LONG WAIT LISTS, AND AN INHERENTLY COMPLICATED HEALTH CARE SYSTEM THAT IS DIFFICULT FOR MANY TO NAVIGATE.THERE ARE ALSO INDIVIDUAL LEVEL BARRIERS TO ACCESS AND NAVIGATION. INDIVIDUALS MAY BE UNINSURED OR UNDERINSURED, WHICH MAY LEAD THEM TO FORGO OR DELAY CARE. INDIVIDUALS MAY ALSO EXPERIENCE LANGUAGE OR CULTURAL BARRIERS - RESEARCH SHOWS THAT THESE BARRIERS CONTRIBUTE TO HEALTH DISPARITIES, MISTRUST BETWEEN PROVIDERS AND PATIENTS, INEFFECTIVE COMMUNICATION, AND ISSUES OF PATIENT SAFETY.GOAL: PROVIDE EQUITABLE AND COMPREHENSIVE ACCESS TO HIGH-QUALITY HEALTH CARE SERVICES INCLUDING PRIMARY CARE AND SPECIALTY CARE, AND URGENT AND EMERGING CARE, PARTICULARLY FOR THOSE WHO FACE CULTURAL, LINGUISTIC AND ECONOMIC BARRIERS.STRATEGIES1.1 PROVIDE AND PROMOTE CAREER SUPPORT SERVICES AND CAREER MOBILITY PROGRAMS TO HOSPITAL EMPLOYEES1.2 PROMOTE ACCESS TO HEALTHCARE, HEALTH INSURANCE, PATIENT FINANCIAL COUNSELORS, AND NEEDED MEDICATIONS FOR PATIENTS WHO ARE UNINSURED OR UNDERINSURED1.3 SUPPORT PARTNERSHIPS WITH REGIONAL TRANSPORTATION PROVIDERS AND COMMUNITY PARTNERS TO ENHANCE ACCESS TO AFFORDABLE AND SAFE TRANSPORTATION1.4 PROMOTE EQUITABLE CARE, HEALTH EQUITY, HEALTH LITERACY, AND CULTURAL HUMILITY FOR PATIENTS, ESPECIALLY THOSE WHO FACE CULTURAL AND LINGUISTIC BARRIERS1.5 PROMOTE RESILIENCY FOR NEW MOMS1.6 SUPPORT CITIES/TOWNS TO PROMOTE RESILIENCE, EMERGENCY CARE AND EMERGENCY PREPAREDNESSINITIATIVES TO ADDRESS THE PRIORITY- CAREER AND ACADEMIC ADVISING- HOSPITAL SPONSORED ENGLISH CLASSES- SOCIAL ENTERPRISE YOUTH DEVELOPMENT PROGRAM- HEALTH COVERAGE AND PUBLIC ASSISTANCE ENROLLMENT PROGRAMS AT BOTH MAH AND CHARLES RIVER COMMUNITY HEALTH- FACILITATE THE CONNECTION TO HEALTH CARE BY PROVIDING TRANSPORTATIONS CONNECTIONS AT NO COST WHEN TRANSPORTATION IS A BARRIER TO MEDICAL CARE - PROVIDE FREE INTERPRETER SERVICES- HEALTH LITERACY AND EDUCATION PROGRAM- PRENATAL AND POSTPARTUM BILINGUAL OUTREACH WORKER PROGRAM- FREE DOULA PROGRAM- BREAST FEEDING EDUCATION AND SUPPORT PROGRAM- EMERGENCY SERVICES TRAINING - COMMUNITY TRAINING FOR EMERGENCY MEDICAL EVENTSMETRICS AND STATUS UPDATES: - NUMBER OF EVENTS WORKFORCE DEVELOPMENT TEAM ATTENDED AND HOSTED AND GAVE PRESENTATIONS ABOUT EMPLOYMENT OPPORTUNITIES TO (BASELINE: 67; YEAR 1: 33; YEAR 2: 42) - WORKFORCE DEVELOPMENT WILL OFFER INTERNSHIPS IN BILH HOSPITALS TO COMMUNITY MEMBERS OVER THE AGE OF 18. (BASELINE: 54; YEAR 1: 107; YEAR 2: 131) MAH PARTICIPATED IN OFFERING THESE INTERNSHIPS.- MAH PROVIDED CAREER DEVELOPMENT AND HEALTH CARE TRAINING INFORMATION TO COLLEGE LEVEL STUDENTS AND HIGH SCHOOLS STUDENTS (BASELINE: NO DATA COLLECTED; YEAR 1: 225 COLLEGE LEVEL STUDENTS; 40 HIGH SCHOOL STUDENTS; YEAR 2: 70 COLLEGE LEVEL STUDENTS AND 10 ADULTS) - WORKFORCE DEVELOPMENT WILL OFFER CITIZENSHIP, CAREER DEVELOPMENT WORKSHOPS, AND FINANCIAL LITERACY CLASSES TO BILH EMPLOYEES. (CITIZENSHIP CLASSES, BASELINE: 20; YEAR 1: 14; YEAR 2:12) (CAREER DEVELOPMENT WORKSHOPS, BASELINE:135; YEAR 1:15; YEAR 2: 102) (FINANCIAL LITERACY CLASSES; BASELINE 189; YEAR 1: 207; YEAR 2: 138.) (MOUNT AUBURN HOSPITAL EMPLOYEES PARTICIPATED IN THESE OFFERINGS)- WORKFORCE DEVELOPMENT OFFERED ENGLISH FOR SPEAKERS OF OTHER LANGUAGES (ESOL) CLASSES TO BILH EMPLOYEES. (BASELINE: 45; YEAR 1: 82 YEAR 2: 126 EMPLOYEES ACROSS BILH ENROLLED IN ESOL CLASSES.) MAH EMPLOYEES PARTICIPATED IN THESE CLASSES.- WORKFORCE DEVELOPMENT WILL ENCOURAGE COMMUNITY REFERRALS AND HIRES. (BASELINE: 225 REFERRALS AND 70 HIRES; YEAR 1: 412 REFERRALS AND 111 HIRES. YEAR 2: 306 JOB REFERRALS AND 79 HIRES. MAH PARTICIPATED IN THESE HIRINGS.- WORKFORCE DEVELOPMENT WILL HIRE INTERNS AFTER INTERNSHIPS AND PLACE IN BILH HOSPITALS. (BASELINE: NO DATA; YEAR 1: 37 INTERNS WERE HIRED PERMANENTLY IN BILH HOSPITALS. MAH PARTICIPATED IN THESE HIRINGS; YEAR 2: 36 INTERNS WERE HIRED PERMANENTLY IN BILH HOSPITALS. MAH PARTICIPATED IN THESE HIRINGS.- WORKFORCE DEVELOPMENT WILL OFFER EMPLOYEES CAREER DEVELOPMENT SERVICES. (BASELINE: NO DATA; YEAR 1: 1,044 BILH EMPLOYEES RECEIVED CAREER DEVELOPMENT SERVICES; YEAR 2: 831 BILH EMPLOYEES RECEIVED CAREER DEVELOPMENT SERVICES. MAH PARTICIPATED IN THESE SERVICES.- WORKFORCE DEVELOPMENT WILL OFFER PAID TRAINING FOR COMMUNITY MEMBERS ACROSS BILH. (BASELINE: 89; YEAR 1: 99; YEAR 2: 97.) MAH PARTICIPATED IN OFFERING THESE TRAININGS. - THROUGH A PARTNERSHIP WITH MORE THAN WORDS (MTW) IN WALTHAM HELPED FUND THE SOCIAL ENTERPRISE YOUTH DEVELOPMENT PROGRAM:- PROVIDED JOB TRAINING, YOUTH DEVELOPMENT PROGRAMMING, INTENSIVE CASE MANAGEMENT EDUCATION AND EMPLOYMENT COACHING AND INDIVIDUAL ADVOCACY TO YOUNG PEOPLE IN WALTHAM. (BASELINE: 110; YEAR 1: 105; YEAR 2: 52.)- AT LEAST 90% OF GRADUATES OF THE YOUTH DEVELOPMENT PROGRAM WILL HAVE OR BE ON TRACK TO EARN THEIR HIGH SCHOOL DIPLOMA OR HISET CERTIFICATION (HIGH SCHOOL EQUIVALENCY.) (BASELINE: 96%; YEAR 1: 98%; YEAR 2: 99%.) - MAH FINANCIAL COUNSELORS ASSISTED INDIVIDUALS WITH GOVERNMENT APPLICATION FORMS INCLUDING HELP WITH HEALTH INSURANCE APPLICATIONS AND REFERRING THEM TO GOVERNMENT PROGRAMS AT BOTH MAH AND CHARLES RIVER COMMUNITY HEALTH LOCATIONS. (BASELINE: 954; YEAR 1: 3,922; YEAR 2: 5,209.)- PROVIDE FREE MEDICATIONS FOR OUR MOST UNDER-RESOURCED POPULATIONS WHO OTHERWISE WOULD NOT BE ABLE TO PAY FOR OR HAVE ACCESS TO MEDICATION WHEN BEING DISCHARGED FROM THE HOSPITAL. (BASELINE: 51; YEAR 1: 225; YEAR 2: 229.)- FACILITATE THE CONNECTION TO HEALTH CARE BY PROVIDING TRANSPORTATION CONNECTIONS AT NO COST WHEN TRANSPORTATION IS A BARRIER TO MEDICAL CARE. (BASELINE: APPROXIMATELY 1,609; YEAR 1: APPROXIMATELY 897; YEAR 2: APPROXIMATELY 820.)PROVIDE FREE, TIMELY, MEDICAL PROFESSIONAL INTERPRETER SERVICES FOR PATIENTS OF ALL CULTURAL AND LINGUISTIC BACKGROUNDS WITH LIMITED ENGLISH PROFICIENCY, NON-ENGLISH SPEAKING, AND DEAF OR HARD OF HEARING PATIENTS (ASL). (BASELINE:18,899; FY24: 23,345; YEAR 2: 23,789). - PROVIDE HEALTH LITERACY EDUCATION PROGRAMS IN THE COMMUNITY FOR THOSE WHO ARE ENGLISH LANGUAGE LEARNERS: (BASELINE: 7 PROGRAMS, 143 PEOPLE ATTENDED; YEAR 1: 7 PROGRAMS, 172 PEOPLE ATTENDED; YEAR 2: 6 PROGRAMS, 170 PEOPLE ATTENDED.)- BASELINE: 90%; YEAR 1: 96%; YEAR 2: 89% OF PARTICIPANTS REPORTED INCREASING THEIR KNOWLEDGE ABOUT NAVIGATING OUR HEALTH CARE SYSTEM.- BASELINE: 77%, YEAR 1: 96% AND YEAR 2: 88% REPORTED THEY INCREASED THEIR KNOWLEDGE ON HOW TO PREPARE FOR THEIR DOCTORS APPOINTMENT.- A COMMUNITY OUTREACH WORKER IS AVAILABLE TO PRENATAL AND POSTPARTUM PATIENTS TO PROVIDE ACCESSIBILITY HELP WITH RESOURCES AND TO PROVIDE EMOTIONAL SUPPORT IN THE COMMUNITY. (BASELINE: OVER 280 WOMEN; YEAR 1: OVER 250 WOMEN; YEAR 2: 300 WOMEN.)- PROVIDE INFANT CAR SEATS TO PARENTS WHO ARE IN NEED OF TRANSPORTING THEIR NEWBORN HOME AFTER DELIVERY. (BASELINE: 18; YEAR 1: 40; YEAR 2: NO LONGER ABLE TO SUPPORT.) - PROVIDE A DOULA FOR THOSE WHO REQUEST THIS SUPPORT DURING BIRTH. (BASELINE: 21 BIRTHS; YEAR 1: 14 BIRTHS; YEAR 2: NO DATA COLLECTED).- MAH PHYSICIANS SERVE AS EMS MEDICAL DIRECTORS TO MIT EMS, HARVARD UNIVERSITY EMS AND PRO AMBULANCE EMS. THE EMERGENCY DEPARTMENT PROVIDED 12 EDUCATION SESSIONS AND CASE REVIEW SESSIONS TO CAMBRIDGE, ARLINGTON, BELMONT, CAMBRIDGE AND WATERTOWN (FIRE AND POLICE) DEPARTMENTS. (BASELINE: 12 SESSIONS AND AN AVERAGE OF 25 STAFF ATTENDED EACH MONTH (ALL TOWNS); YEAR 1: 6 SESSIONS AND AN AVERAGE OF 25 STAFF IN ATTENDANCE; YEAR 2: 6 SESSIONS AND AN AVERAGE OF 25 STAFF IN ATTENDANCE.)- MAH EMERGENCY PHYSICIANS WILL PROVIDE AT LEAST 2 "LIFE THREATENING EMERGENCY - WHAT TO DO" CLASSES TO COMMUNITY ORGANIZATIONS WHO ARE REQUESTING TRAINING. (BASELINE: 6 SESSIONS, 165 IN ATTENDANCE; YEAR 1: 6 SESSIONS, 120 IN ATTENDANCE; YEAR 2: 3 SESSIONS AND 50 PEOPLE IN ATTENDANCE.)- BILH GOVERNMENT AFFAIRS ADVOCATED, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, FOR BILLS SUPPORTING EQUITABLE HEALTH CARE ACCESS FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DID NOT COUNT; YEAR 1: 23: YEAR 2: 24).PRIORITY AREA 4: MENTAL HEALTH AND SUBSTANCE USE ANXIETY, CHRONIC STRESS, DEPRESSION, AND SOCIAL ISOLATION WERE LEADING COMMUNITY HEALTH CONCERNS. THERE WERE SPECIFIC CONCERNS ABOUT THE IMPACT OF MENTAL HEALTH ISSUES FOR YOUTH AND YOUNG ADULTS, AND SOCIAL ISOLATION AMONG OLDER ADULTS. THESE DIFFICULTIES WERE EXACERBATED BY COVID-19.IN ADDITION TO THE OVERALL BURDEN AND PREVALENCE OF MENTAL HEALTH ISSUES, RESIDENTS IDENTIFIED A NEED FOR MORE PROVIDERS AND TREATMENT OPTIONS, ESPECIALLY INPATIENT AND OUTPATIENT TREATMENT, CHILD PSYCHIATRISTS, PEER SUPPORT GROUPS, AND MENTAL HEALTH SERVICES. INTERVIEWEES, FOCUS GROUP, AND COMMUNITY LISTENING SESSION PARTICIPANTS REFLECTED ON THE STIGMA, SHAME, AND ISOLATION THAT THOSE WITH MENTAL HEALTH CHALLENGES FACE THAT LIMIT THEIR ABILITY TO ACCESS CARE AND COPE WITH THEIR ILLNESS.SUBSTANCE USE CONTINUED TO HAVE A MAJOR IMPACT IN THE CBSA; THE OPIOID EPIDEMIC CONTINUED TO BE AN AREA OF FOCUS AND CONCERN, AND THERE WAS RECOGNITION OF THE LINKS AND IMPACTS ON OTHER COMMUNITY HEALTH PRIORITIES. INTERVIEWEES REPORTED A NEED FOR PROGRAMS THAT ADDRESS COMMON CO-OCCURRING ISSUES, INCLUDING MENTAL HEALTH ISSUES AND HOMELESSNESS. INTERVIEWEES ALSO REFLECTED ON THE NEED FOR TRANSITIONAL HOUSING AND OTHER RECOVERY SUPPORT SERVICES.GOAL: PROMOTE SOCIAL AND EMOTIONAL WELLNESS BY FOSTERING RESILIENT COMMUNITIES AND BUILDING EQUITABLE, ACCESSIBLE, AND SUPPORTIVE SYSTEMS OF CARE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE ISSUES AND CONDITIONS.STRATEGIES1.1 ADDRESS THE UNIQUE MENTAL HEALTH NEEDS OF HISTORICALLY UNDERSERVED YOUTH 1.2 PROVIDE ACCESS TO HIGH-QUALITY AND CULTURALLY AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE USE SERVICES THROUGH SCREENING, MONITORING, COUNSELING, NAVIGATION, AND TREATMENT1.3 PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE ACTIVITIES INTERNALLY AT MAH AND EXTERNALLY WITH COMMUNITY PARTNERS1.4 ADVOCATE FOR AND SUPPORT POLICIES AND SYSTEMS THAT IMPROVE BEHAVIORAL HEALTH SERVICESINITIATIVES TO ADDRESS THE PRIORITY- SUPPORT INCREASED ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SERVICES AND SUPPORTS. - COLLABORATE WITH DE NOVO CENTER FOR JUSTICE AND HEALING (DE NOVO) TO SUPPORT COUNSELING PROGRAMS FOR SURVIVORS OF TORTURE, GENDER-BASED VIOLENCE, WAR CRIMES OR OTHER HUMAN RIGHTS VIOLATIONS- PROVIDE FREE SUPPORT GROUPS- PROVIDE A SUBSTANCE USE NAVIGATOR TO PROVIDE SUPPORT AND CARE TO THOSE PATIENTS IN THE ED WHO SHOW SIGNS OF SUBSTANCE USE DISORDER AND TO HELP WITH CONTINUITY OF CARE- COLLABORATIVE CARE MODEL - EXPANSION OF TRAUMA-INFORMED CARE (TIC)- TRAINING ACROSS HOSPITALMETRICS AND STATUS UPDATES- CULTURALLY INFORMED PSYCHOLOGICAL COUNSELING WITH DE NOVO CENTER FOR JUSTICE AND HEALING: PROVIDE SPECIALIZED SERVICES THROUGH THE TORTURE TREATMENT PROGRAM TO SURVIVORS OF TORTURE, GENDER-BASED VIOLENCE, WAR CRIMES OR OTHER HUMAN RIGHTS VIOLATIONS (BASELINE: 90 SURVIVORS; YEAR 1: 117 SURVIVORS; YEAR 2: 32 SURVIVORS). PROVIDE FORENSIC PSYCHOLOGICAL EVALUATIONS, AND IN-COURT TESTIMONY AS NEEDED, TO SUPPORT THEIR HUMANITARIAN RELIEF APPLICATIONS. (BASELINE: 27 CLIENTS; YEAR 1: 32 CLIENTS; YEAR 2: UNABLE TO COLLECT.) PROVIDE CASE MANAGEMENT SUPPORTS, SUCH AS SAFETY PLANNING, FOOD OR CLOTHING ASSISTANCE, HOUSING NAVIGATION, TECHNOLOGY ASSISTANCE, HELP COMPLETING PAPERWORK, REFERRAL FOR LEGAL OR MEDICAL SERVICES, AND ACCOMPANIMENT TO COURT HEARINGS, AMONG OTHER SERVICES. (BASELINE: 159 CLIENTS; YEAR 1: 62 CLIENTS; YEAR 2: 55 CLIENTS.) PROVIDE ACCESS TO HEALING FOR ADULTS BY DELIVERING FREE OR LOW-COST MENTAL HEALTH SERVICES, INCLUDING LONG-TERM INDIVIDUAL THERAPY, GROUP COUNSELING, ASSESSMENTS AND REFERRALS. (YEAR 3 ONLY: 222 CLIENTS.)- THROUGH A PARTNERSHIP WITH THE COMMUNITY DAY CENTER OF WALTHAM SUCCESSFULLY PLACE CLIENTS INTO STABLE HOUSING. (YEAR 2 (ONLY): 29 CLIENTS SUCCESSFULLY PLACED INTO STABILIZED HOUSING.)- THROUGH A PARTNERSHIP WITH ADOLESCENT CONSULTATION SERVICES, PROVIDE INDIVIDUAL AND OR GROUP TREATMENT TO CHILDREN AND TEENS WHO ARE COURT-INVOLVED OR AT RISK OF COURT INVOLVEMENT. (YEAR 2 ONLY: 55 YOUTH WERE SERVED THROUGH INDIVIDUAL OR GROUP TREATMENT.)- PARTNERED WITH WHOLE TO HELP PROVIDE SUPPORT TO THEIR CLIENTS:BASELINE: PROVIDED "JUST BREATHE" CAREGIVER SUPPORT GROUP SESSIONS. HIRED A PROGRAM MANAGER TO OVERSEE OPERATIONAL FUNCTIONS, LEAD IN DEVELOPING EVALUATION PROCESS FOR ALL PROGRAM ACTIVITIES, AND REPRESENT WHOLE AT EXTERNAL COMMUNITY MEETINGS.YEAR 1: PROVIDED TWO WORKSHOPS FOR CAREGIVERS TO DISCUSS STRESS, CHALLENGES AND REWARD OF PROVIDING CARE FOR AN ADULT. 75 PEOPLE PARTICIPATED.YEAR 2: OFFERED "THINGS WE CARRY" MEN'S GROUP. 100% OF THE MEN SAID THAT THEY FELT AFFIRMED AS A PERSON, SUPPORTED BY THE OTHER PARTICIPANTS, AND SUPPORTED BY THE FACILITATOR, WHO THEY BELIEVED WAS KNOWLEDGEABLE AND HELPFUL. PARTICIPANTS SHARED THAT THEY LEARNED SKILLS THAT THEY COULD APPLY TO IMPROVE THEIR OWN WELLBEING. - PARTNERED WITH TRANSITION HOUSE TO HELP PROVIDE SUPPORT TO THEIR CLIENTS:BASELINE: TRANSITION HOUSE HIRED THREE NEW CLINICIANS. THIRTEEN TRAUMA SURVIVORS ENGAGED IN COUNSELING AND TEN OF THESE CLIENTS HAVE PARTICIPATED IN MORE THAN THREE SESSIONS OF COUNSELING. ALL OF THESE CLIENTS REPORTED BEING SATISFIED WITH THEIR EXPERIENCE WITH THE SEMI-ANNUAL CLIENT SATISFACTION SURVEY.YEAR 1: TRANSITION HOUSE CONTINUES TO MAINTAIN AND EMPLOY 3 CLINICIANS TO SUPPORT AND IMPROVE ACCESS TO COUNSELING SERVICES FOR CLIENTS. THE COUNSELING PROGRAM RECEIVED 16 REFERRALS AND PROVIDED COUNSELING AND OR REFERRALS FOR ALL 16 PEOPLE.YEAR 2: TRANSITION HOUSE CONTINUES TO MAINTAIN AND EMPLOY 3 DIVERSE CLINICIANS. ONE CLINICIAN IS AN AMERICAN BORN BLACK WOMAN, ANOTHER IS BRAZILIAN BORN BILINGUAL PORTUGUESE AND ENGLISH SPEAKER, AND ANOTHER IS A CHILEAN BORN BILINGUAL SPANISH AND ENGLISH SPEAKER. THE COUNSELING PROGRAM ACTIVELY ENGAGED 18 CLIENTS IN COUNSELING, AND ALL HAD A FIRST SESSION WITHIN 2 WEEKS OF THEIR REFERRAL.- PROVIDED BEREAVEMENT SUPPORT GROUP, EIGHT-WEEK LONG SESSIONS FOR COMMUNITY MEMBERS. (BASELINE: 2 SUPPORT GROUPS WITH 23 COMMUNITY MEMBERS ATTENDING; YEAR 1: 3 SUPPORT GROUPS WITH 26 COMMUNITY MEMBERS ATTENDING; YEAR 2: 3 SUPPORT GROUPS WITH 26 COMMUNITY MEMBERS ATTENDING.)- PROVIDED AN ONGOING SUPPORT GROUP FOR NEW PARENTS INCREASING ACCESS BY 2 WEEKLY OPTIONS BOTH IN PERSON AND/OR VIRTUAL GROUPS (BASELINE:23, 125 COMMUNITY MEMBERS; YEAR 1: 138 COMMUNITY MEMBERS; YEAR 2: 195 COMMUNITY MEMBERS.) (BASELINE AND YEAR 1: 100% OF PARTICIPANTS REPORTED THAT THEY GAINED CONFIDENCE IN CARING FOR THEMSELVES AND THEIR BABY AS A RESULT OF THEIR PARTICIPATION IN THE POSTPARTUM SUPPORT GROUP. YEAR 2: 99% OF PARTICIPANTS REPORT THAT THEY GAINED CONFIDENCE IN CARING FOR THEMSELVES AND THEIR BABY BECAUSE OF THEIR PARTICIPATION IN THE POSTPARTUM SUPPORT GROUP.) (BASELINE, YEAR 1 AND YEAR 2: 100% OF PARTICIPANTS REPORTED THAT THEY FELT SUPPORTED AND IT FELT LIKE A SAFE SPACE FOR THEM TO SHARE THEIR FEELINGS AND EXPERIENCES.) EXPERIENCES.) - INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES THROUGH OUR COLLABORATIVE CARE MODEL PROVIDED BEHAVIORAL HEALTH SERVICES (BASELINE: 1,308 ; YEAR 1: 1,395 PATIENTS ACROSS 12 SITES. YEAR 2: 1,771 PATIENTS ACROSS 11 SITES.)- INCREASE ACCESS TO CLINICAL AND NON-CLINICAL SUPPORT SERVICES FOR THOSE WITH MENTAL HEALTH AND SUBSTANCE USE ISSUES, BY PROVIDING BEHAVIORAL HEALTH CRISIS CONSULTATION SERVICES IN THE HOSPITAL. (STARTED IN YEAR 1: 25 SCREENINGS; YEAR 2: 1,802 SCREENINGS.)- SUBSIDIZED INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES. - OFFERED MENTAL HEALTH FIRST AID (MHFA) TRAININGS TO COMMUNITY RESIDENTS AND BILH STAFF ACROSS THE BILH COMMUNITY BENEFITS SERVICE AREA. (BASELINE: DID NOT COUNT; YEAR 1: MORE THAN 350 COMMUNITY RESIDENTS AND BILH STAFF ATTENDED ONE OF THE 21 MHFA TRAININGS; YEAR 2: MORE THAN 146 COMMUNITY RESIDENTS AND BILH STAFF ATTENDED ONE OF 11 MHFA TRAININGS - BILH GOVERNMENT AFFAIRS ADVOCATED, DIRECTLY OR THROUGH THE STATE HOSPITAL ASSOCIATION OR COMMUNITY COALITIONS, FOR BILLS SUPPORTING ACCESS TO MENTAL HEALTH AND SUBSTANCE USE SERVICES FOR ALL MASSACHUSETTS RESIDENTS (BASELINE: DID NOT COUNT; YEAR 1: 8; YEAR 2: 10).COMMUNITY PARTNERSMAH IS COMMITTED TO IMPROVING THE HEALTH AND WELLBEING OF RESIDENTS WITHIN ITS SERVICE AREA BY COLLABORATING WITH A DIVERSE GROUP OF COMMUNITY PARTNERS. THE HOSPITAL WORKS TOGETHER WITH THESE PARTNERS TO REDUCE BARRIERS TO HEALTH, INCREASE PREVENTION AND/OR SELF-MANAGEMENT OF CHRONIC DISEASE AND INCREASE THE EARLY DETECTION OF ILLNESS. THE HOSPITAL'S COMMUNITY PARTNERS INCLUDE: - ADOLESCENT CONSULTATION SERVICES- AFRICANO WALTHAM- ARLINGTON EATS- ARLINGTON YOUTH COUNSELING SERVICES- BELMONT FOOD COLLABORATIVE- CAMBRIDGE ENGAGEMENT CENTER- CAMBRIDGE HEALTH ALLIANCE - CAMBRIDGE NEIGHBORS- CITY OF CAMBRIDGE COMMISSION FOR PERSONS WITH DISABILITIES - COMMUNITY DAY CENTER OF WALTHAM- CORE MENTAL HEALTH- CORE MENTAL HEALTH- COUNCILS ON AGING- CHARLES RIVER COMMUNITY HEALTH- DATA PLUS SOUL CONSULTING- DE NOVO CENTER FOR JUSTICE AND HEALING- FIND IT CAMBRIDGE- GREATER BOSTON PFLAG - HEALTHY WALTHAM- HOMEOWNER'S REHAB INC- HOUSING CORP OF ARLINGTON- KINGDOM EMPOWERMENT CENTER CAMBRIDGE- LAMPLIGHT LITERACY CENTER- LOCAL MUNICIPALITIES AND HEALTH DEPARTMENTS- METRO HOUSING BOSTON- METRO CAB- MORE THAN WORDS, WALTHAM- PAINE SENIOR SERVICES- PROJECT LITERACY, WATERTOWN- RAINBOW COALITION, ARLINGTON- SOMERVILLE CAMBRIDGE ELDER SERVICES- SCM TRANSPORTATION- SOMERVILLE FARMER'S MARKET- SOMERVILLE HOMELESS COALITION- SPRINGWELL (AREA AGENCY ON AGING) WALTHAM- TRANSITION HOUSE, CAMBRIDGE- WALTHAM CONNECTIONS FOR HEALTHY AGING- WALTHAM FAMILY SCHOOL- WALTHAM FIELDS COMMUNITY FARM- WATERTOWN WELLNESS- WAYSIDE YOUTH AND FAMILY SERVICES- Y2Y NETWORKAS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, MAH IS DEEPLY DEDICATED TO ITS COMMUNITY BENEFITS OPERATIONS AND TO IMPROVING THE HEALTH OF ITS COMMUNITY. HOWEVER, IN RESPONSE TO SCHEDULE H, PART V, SECTION B, QUESTION 11, THERE WERE SOME NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY MOST RECENTLY ADOPTED BY MAH DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 (TAX YEAR 2024) AND WHICH WILL INFORM MAH'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2026, SEPTEMBER 30, 2027 AND SEPTEMBER 30, 2028. NEEDS IDENTIFIED IN THAT CHNA WHICH WILL NOT BE ADDRESSED ARE: SUPPORTING LAW ENFORCEMENT'S INVOLVEMENT IN BEHAVIORAL HEALTH INITIATIVES AND STRENGTHENING THE BUILT ENVIRONMENT (I.E., IMPROVING ROADS/SIDEWALKS) WERE IDENTIFIED AS COMMUNITY NEEDS BUT WERE NOT INCLUDED IN MAH'S IS. MAH IS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES WHILE THESE ISSUES ARE IMPORTANT, MAH'S CBAC AND SENIOR LEADERSHIP TEAM DECIDED THAT THESE ISSUES WERE OUTSIDE OF THE ORGANIZATION'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHERS AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. HOWEVER, MAH REMAINS OPEN AND WILLING TO WORK WITH THE OTHER BILH HOSPITALS AND/OR COMMUNITY PARTNERS TO ADDRESS THESE ISSUES. IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE PREVIOUS CHNA THAT WERE NOT INCLUDED IN THE PREVIOUS IMPLEMENTATION STRATEGY, BOTH OF WHICH GUIDED MAH'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIOD COVERED BY THIS FILING. MAH WAS UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES. MAH WAS OPEN TO, WILLING TO AND MAY HAVE WORKED WITH THE OTHER BILH HOSPITALS AND/OR COMMUNITY PARTNERS TO ADDRESS THESE ISSUES AS DESCRIBED IN THIS NARRATIVE SUPPORT TO FORM 990 SCHEDULE H. AS NOTED IN DETAIL ABOVE MAH'S PRIMARY TOOL FOR ASSESSING THE HEALTHCARE NEEDS OF THE COMMUNITIES SERVED IS THROUGH THE CHNA AND IS (SCHEDULE H PART VI QUESTION 2).FORM 990 SCHEDULE H PART VI SUPPLEMENTAL INFORMATIONTHE PURPOSE OF THIS FORM 990 SCHEDULE H NARRATIVE DISCLOSURE IS TO HELP THE READER UNDERSTAND IN MORE DETAIL HOW MAH CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 19.80% OF MAH'S TOTAL EXPENSES AS REPORTED ON FORM 990 PART IX, LINE 24, ARE INCURRED IN PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. COMMUNITY BENEFITS--ANNUAL COMMUNITY BENEFITS REPORTAS PREVIOUSLY NOTED IN THIS FILING, MAH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY WERE COMPLETED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://MOUNTAUBURNHOSPITAL.ORG/ABOUT/COMMUNITY-BENEFITS-NEEDS THERE ARE SOME DIFFERENCES BETWEEN THE MASSACHUSETTS ATTORNEY GENERAL DEFINITION OF CHARITY CARE AND COMMUNITY BENEFITS AND THE INTERNAL REVENUE SERVICE DEFINITION OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS. AS SUCH, THERE ARE VARIANCES BETWEEN THIS SCHEDULE H DISCLOSURE AND THE REPORT MAH FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSIN ADDITION, AS NOTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A ,MOUNT AUBURN HOSPITAL IS A GENERAL MEDICAL AND SURGICAL HOSPITAL AND TEACHING HOSPITAL PROVIDING EMERGENCY MEDICAL CARE TO ALL PATIENTS 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR WITHOUT REGARD TO ABILITY TO PAY (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21).FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS--CHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEMOUNT AUBURN HOSPITAL'S NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $7,530,060 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, MOUNT AUBURN HOSPITAL IS ONE OF ELEVEN HOSPITALS WITHIN THE BETH ISRAEL LAHEY HEALTH NETWORK. COMBINED THESE HOSPITALS' NET COST OF CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING FOR THE MASSACHUSETTS HOSPITALS, PAYMENTS TO THE MASSACHUSETTS HEALTH SAFETY NET TRUST, WAS MORE THAN $62 MILLION FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, FOR THE PERIOD COVERED BY THIS FILING, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE. ELIGIBILITY IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CARE--MEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, MOUNT AUBURN HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MOUNT AUBURN HOSPITAL GENERATED $10,235,229 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY MOUNT AUBURN HOSPITAL FOR SUCH SERVICES WHICH RESULTED IN A MEDICAID SHORTFALL OF $1,198,609 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 11.9% OR APPROXIMATELY 45,299 PATIENT ENCOUNTERS OF MOUNT AUBURN HOSPITAL'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION 33.5% OR APPROXIMATELY 127,929 PATIENT CASES OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. IN ADDITION EACH OF THE OTHER BILH HOSPITALS ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM AND AS NOTED ABOVE, PAYMENTS FROM MEDICAID FOR LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ACROSS THE BILH HOSPITALS THE COST OF PROVIDING CARE TO MEDICAID PATIENTS EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL OF APPROXIMATELY $104 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND MOUNT AUBURN HOSPITAL PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MOUNT AUBURN HOSPITAL GENERATED $101,518,095 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE WHICH RESULTED IN A MEDICARE SHORTFALL OF $2,819,722. OF THESE AMOUNTS, REVENUE OF $66,761,01 IS RELATED TO THE PROVISION OF CARDIOLOGY, BEHAVIORAL HEALTH, AND NEONATOLOGY & NEWBORN AND IS INCLUDED ON THIS SCHEDULE H, PART I, LINE 7G, AS PART OF SUBSIDIZED HEALTH SERVICES BECAUSE THE COST OF THOSE SERVICES EXCEEDED REVENUES BY $778,334. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH MOUNT AUBURN HOSPITAL CONSIDERS THE PROVISION OF CLINICAL CARE TO ALL MEDICARE PATIENTS AS PART OF ITS COMMUNITY BENEFIT, THE REMAINING CARE TO MEDICARE PATIENTS IS NOT QUANTIFIED ON PAGE 1 OF THE SCHEDULE H. INSTEAD, PER THE IRS INSTRUCTIONS TO SCHEDULE H, MOUNT AUBURN HOSPITAL HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, MOUNT AUBURN HOSPITAL ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. COSTS FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $3,927,238 AND ARE REPORTED AS BAD DEBT ON FORM 990, SCHEDULE H, PART III, LINE 2. AS REQUIRED BY THE INSTRUCTIONS TO THIS FORM 990 SCHEDULE H, LOSSES RELATED TO BAD DEBTS HAVE NOT BEEN INCLUDED IN THE CALCULATION OF FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS IN SCHEDULE H PART I LINE 7. RATHER IT HAS BEEN SEPARATELY REPORTED IN SCHEDULE H PART III AS REQUIRED.THE PERCENTAGES CALCULATED IN PART I, LINE 7, COLUMN F WERE BASED ON EACH ITEM OF FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT AS A PERCENTAGE OF TOTAL EXPENSES REPORTED IN PART IX OF THIS FORM 990. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH) AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 INCLUDE THE ACCOUNTS OF: BETH ISRAEL LAHEY HEALTH (BILH), BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI), EXETER HOSPITAL (EH), BETH ISRAEL LAHEY HEALTH PHARMACY, THE ENTITIES WHICH COMPRISE, AMONG OTHER OPERATIONS, BETH ISRAEL LAHEY HEALTH CONTINUING CARE AND BETH ISRAEL LAHEY HEALTH MEDICAL GROUP AS WELL AS OTHER ENTITIES FOR WHICH BILH SERVES AS DIRECT OR INDIRECT SOLE MEMBER. THE BILH CONSOLIDATED FINANCIAL STATEMENTS ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) AND THE ENTITIES FOR WHICH HMFP SERVES AS DIRECT OR INDIRECT SOLE MEMBER. SEE FORM 990 SCHEDULE R AND A COPY OF THE AUDITED FINANCIAL STATEMENTS ATTACHED TO THIS FORM 990 FOR ADDITIONAL INFORMATIONFINANCIAL STATEMENT FOOTNOTESBAD DEBTSTHE BETH ISRAEL LAHEY HEALTH INC. CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE REGARDING BAD DEBT EXPENSE.PATIENT ACCOUNTS RECEIVABLE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTSTHE SYSTEM'S PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING MANAGED CARE PAYORS AND GOVERNMENT PROGRAMS), AND OTHERS AND INCLUDE AN ESTIMATE OF VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. GENERALLY, THE SYSTEM BILLS THE PATIENTS AND THIRD-PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE SYSTEM'S FACILITY.REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE SYSTEM. REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED (OR ACTUAL) CHARGES. THE SYSTEM BELIEVES THAT THIS METHOD PROVIDES A REASONABLE REPRESENTATION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO INPATIENT SERVICES. THE SYSTEM MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL, OR COMMENCEMENT OF A PATIENT SERVICE, TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TOTHAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE OR COMPLETION OF THE OUTPATIENT SERVICES. PATIENT ENCOUNTERS AND RELATED EPISODES OF CARE AND PROCEDURES QUALIFY AS DISTINCT GOODS AND SERVICES, PROVIDED SIMULTANEOUSLY TOGETHER WITH OTHER READILY AVAILABLE RESOURCES, IN A SINGLE INSTANCE OF SERVICE, AND THEREBY CONSTITUTE A SINGLE PERFORMANCE OBLIGATION FOR EACH PATIENT ENCOUNTER AND, IN MOST INSTANCES, OCCUR AT READILY DETERMINABLE TRANSACTION PRICES. ALL SERVICES PROVIDED ARE EXPECTED TO RESULT IN CASH FLOWS AND ARE THEREFORE REFLECTED AS NET REVENUE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. THE ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS ARE BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES AND HISTORICAL CASH COLLECTION EXPERIENCE. DIFFERENCES BETWEEN STANDARD CHARGES AND ESTIMATED TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE AND ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. ADJUSTMENTS ARISING FROM A CHANGE IN THE TRANSACTION PRICE WERE NOT SIGNIFICANT DURING THE YEARS ENDED SEPTEMBER 30, FOR 2025 OR 2024.REVENUES UNDER THE TRADITIONAL FEE FOR SERVICE MEDICARE AND MEDICAID PROGRAMS ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS. RETROSPECTIVELY DETERMINED COST-BASED REVENUES UNDER THESE PROGRAMS, WHICH WERE MORE PREVALENT IN EARLIER PERIODS, AND CERTAIN OTHER PAYMENTS, SUCH AS DISPROPORTIONATE SHARE HOSPITAL AND BAD DEBT EXPENSE REIMBURSEMENT, WHICH ARE BASED ON OUR HOSPITALS' COST REPORTS, ARE ESTIMATED USING HISTORICAL TRENDS AND CURRENT FACTORS. COST REPORT SETTLEMENTS UNDER THESE PROGRAMS ARE SUBJECT TO AUDIT BY MEDICARE AND MEDICAID AUDITORS AND ADMINISTRATIVE AND JUDICIAL REVIEW, AND IT CAN TAKE SEVERAL YEARS UNTIL FINAL SETTLEMENT OF SUCH MATTERS IS DETERMINED AND COMPLETELY RESOLVED. THE SYSTEM RECORDS ACCRUALS TO REFLECT THE EXPECTED FINAL SETTLEMENTS ON COST REPORTS. FOR FILED COST REPORTS, THE ACCRUAL IS RECORDED BASED ON THOSE COST REPORTS AND SUBSEQUENT ACTIVITY. THE ACCRUAL FOR PERIODS FOR WHICH A COST REPORT IS YET TO BE FILED IS RECORDED BASED ON ESTIMATES OF WHAT THE SYSTEM EXPECTS TO REPORT ON THE FILED COST REPORTS. AFTER THE COST REPORT IS FILED, THE ACCRUAL MAY NEED TO BE ADJUSTED.SETTLEMENTS WITH THIRD-PARTY PAYORS FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS OR INVESTIGATIONS ARE CONSIDERED VARIABLE CONSIDERATION AND ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE USING THE MOST LIKELY OUTCOME METHOD. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE PAYMENT AGREEMENT WITH THE PAYOR, CORRESPONDENCE FROM THE PAYOR AND HISTORICAL SETTLEMENT ACTIVITY, INCLUDING AN ASSESSMENT TO ENSURE THAT IT IS PROBABLE THAT A SIGNIFICANT REVERSAL IN THE AMOUNT OF CUMULATIVE REVENUE RECOGNIZED WILL NOT OCCUR WHEN THE UNCERTAINTY ASSOCIATED WITH THE RETROACTIVE ADJUSTMENT IS SUBSEQUENTLY RESOLVED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN, OR AS YEARS ARESETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS.THE SYSTEM IS NOT AWARE OF ANY MATERIAL CLAIMS, DISPUTES, OR UNSETTLED MATTERS WITH ANY PAYORS THATWOULD AFFECT REVENUES THAT HAVE NOT BEEN ADEQUATELY PROVIDED FOR AND DISCLOSED IN THE ACCOMPANYINGCONSOLIDATED FINANCIAL STATEMENTS. BECAUSE THE LAWS, REGULATIONS, INSTRUCTIONS AND RULE INTERPRETATIONSGOVERNING MEDICARE AND MEDICAID REIMBURSEMENT ARE COMPLEX, SUBJECT TO INTERPRETATION AND CANCHANGE FREQUENTLY, THE ESTIMATES RECORDED COULD CHANGE BY MATERIAL AMOUNTS.CONSISTENT WITH THE SYSTEM'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THESYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTSWITH OTHER UNINSURED BALANCES (E.G., COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDEDIN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THEAMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. PATIENTS WHOMEET THE SYSTEM'S CRITERIA FOR CHARITY CARE ARE PROVIDED CARE WITHOUT CHARGE OR AT AMOUNTS LESS THANESTABLISHED RATES. THE SYSTEM HAS DETERMINED THAT IT HAS PROVIDED SUFFICIENT IMPLICIT PRICE CONCESSIONSFOR THESE ACCOUNTS. PRICE CONCESSIONS, INCLUDING CHARITY CARE, ARE NOT REPORTED AS REVENUE.PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED CO-PAYS, CO-INSURANCE ANDDEDUCTIBLES, WHICH VARY IN AMOUNT. THE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITHCO-PAYS, CO-INSURANCE AND DEDUCTIBLES AND FOR THOSE WHO ARE UNINSURED BASED ON HISTORICAL COLLECTIONEXPERIENCE AND CURRENT MARKET CONDITIONS. THE DISCOUNT OFFERED TO CERTAIN UNINSURED PATIENTS ISRECOGNIZED AS A CONTRACTUAL ALLOWANCE, WHICH REDUCES NET OPERATING REVENUES AT THE TIME THE SELF-PAYACCOUNTS ARE RECORDED. THE UNINSURED PATIENT ACCOUNTS, NET OF CONTRACTUAL ALLOWANCES RECORDED, ARE FURTHER REDUCED TO THEIR NET REALIZABLE VALUE AT THE TIME THEY ARE RECORDED THROUGH IMPLICIT PRICECONCESSIONS BASED ON HISTORICAL COLLECTION TRENDS FOR SELF-PAY ACCOUNTS AND OTHER FACTORS THAT AFFECT THEESTIMATION PROCESS. ALTHOUGH OUTCOMES VARY, THE SYSTEM'S POLICY IS TO ATTEMPT TO COLLECT AMOUNTS DUEFROM PATIENTS, INCLUDING CO-PAYS, CO-INSURANCE AND DEDUCTIBLES DUE FROM PATIENTS WITH INSURANCE, AT THETIME OF SERVICE WHILE COMPLYING WITH ALL FEDERAL AND STATE STATUTES AND REGULATIONS.OTHER REVENUE INCLUDES CONTRIBUTIONS AND NET ASSETS RELEASED FROM RESTRICTIONS AS WELL AS CAFETERIA ANDPARKING INCOME. ADDITIONALLY, PHARMACY SALES AND OTHER CONTRACTS RELATED TO HEALTH CARE SERVICES AREINCLUDED IN OTHER REVENUE AND CONSIST OF CONTRACTS WHICH VARY IN DURATION AND IN PERFORMANCE. REVENUEIS RECOGNIZED WHEN THE PERFORMANCE OBLIGATIONS IDENTIFIED WITHIN THE INDIVIDUAL CONTRACTS ARE SATISFIEDAND COLLECTIONS ARE PROBABLE. OTHER REVENUE FOR THE YEARS ENDED SEPTEMBER 30, 2025 AND 2024 ALSOINCLUDED FUNDING RECEIVED FROM FEDERAL AND STATE SOURCES RELATED TO THE COVID-19 PANDEMIC AMOUNTINGTO $21,248 AND $17,500, RESPECTIVELY. FINANCIAL ASSISTANCE POLICY--INTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE MOUNT AUBURN HOSPITAL IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTHCARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION AND MAINTAINS A FINANCIAL ASSISTANCE POLICY (FAP) WHICH IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE FREE OR DISCOUNTED CARE FROM MOUNT AUBURN HOSPITAL AS WELL AS PROVIDERS WHO FOLLOW MOUNT AUBURN HOSPITAL'S FAP. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN MOUNT AUBURN HOSPITAL AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW MOUNT AUBURN HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. MOUNT AUBURN HOSPITAL DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION OR DISABILITY WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) THAT APPLIES TO ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY THE HOSPITAL FACILITY. (SCHEDULE H PART I QUESTIONS 1A AND 1B). DETAIL RELATED TO EMERGENCY AND OTHER MEDICALLY NECESSARY CARE COVERED BY THE POLICY IS INCLUDED WITHIN THE POLICY AND THE DEFINITION OF EMERGENCY CARE MEETS THE DEFINITION OF THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), SECTION 1867 OF THE SOCIAL SECURITY ACT (42 USC 1395DD). (SCHEDULE H PART V SECTION B QUESTION 21). THE FAP INCLUDES A LIST OF PROVIDERS OTHER THAN THE HOSPITAL ITSELF, WHICH ARE COVERED BY THE FAP AND SPECIFIES ELIGIBILITY CRITERIA FOR BOTH FREE AND DISCOUNTED CARE. THE FAP ALSO INCLUDES THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS. THE PROVIDER LIST IS UPDATED NOT LESS THAN QUARTERLY. THE HOSPITAL MAINTAINS A SEPARATE CREDIT AND COLLECTION POLICY AS PERMITTED UNDER THE TREASURY REGULATIONS AND THIS CREDIT AND COLLECTION POLICY IS REFERENCED WITHIN THE FAP AS REQUIRED, ALONG WITH INFORMATION ON HOW TO OBTAIN A FREE COPY OF THE CREDIT AND COLLECTION POLICY. (SCHEDULE H PART III SECTION C QUESTIONS 9A AND 9B AND PART V SECTION B QUESTION 17). THE HOSPITAL'S FAP AND CREDIT & COLLECTION POLICY WERE ADOPTED BY AN AUTHORIZED BODY AS REQUIRED PURSUANT TO THE IRC SECTION 501(R) TREASURY REGULATIONS.FINANCIAL ASSISTANCE POLICY--APPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15)FINANCIAL ASSISTANCE POLICY--ELIGIBILITY GUIDELINES THE HOSPITAL'S FAP USES THE FEDERAL POVERTY GUIDELINES IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. (SCHEDULE H PART I QUESTION 3A AND 3B AND PART V SECTION B QUESTION 13). IN ADDITION, THE HOSPITAL'S FAP PROVIDES FOR FINANCIAL ASSISTANCE BASED ON MEDICAL HARDSHIP AND ASSET LEVEL (SCHEDULE H PART I QUESTIONS 3C AND 4, PART V SECTION B QUESTION 13 AND PART VI QUESTION 3). FINALLY, THE HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT/GUARANTOR'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE APPLICATION FORM. OTHER INFORMATION MAY BE USED BY THE HOSPITAL TO DETERMINE WHETHER A PATIENT/GUARANTOR'S ACCOUNT IS UNCOLLECTIBLE, AND THIS INFORMATION WILL BE USED TO DETERMINE PRESUMPTIVE ELIGIBILITY AS OUTLINED IN THE HOSPITAL'S FAP. (SCHEDULE H PART I QUESTIONS 3C).FINANCIAL ASSISTANCE--PUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL OFFER ALL INDIVIDUALS A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. FOR THOSE INDIVIDUALS THAT ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL, WHEN REQUESTED, HELP THEM WITH APPLYING FOR EITHER COVERAGE THROUGH PUBLIC ASSISTANCE PROGRAMS OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER ALL OR SOME OF THEIR UNPAID HOSPITAL BILLS. THE HOSPITAL IS AVAILABLE TO ASSIST PATIENTS IN ENROLLING INTO STATE HEALTH COVERAGE PROGRAMS. THESE INCLUDE MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE STATE'S HEALTH CONNECTOR, AND THE CHILDREN'S MEDICAL SECURITY PLAN. FOR THESE PROGRAMS, APPLICANTS CAN SUBMIT AN APPLICATION THROUGH AN ONLINE WEBSITE (WHICH IS CENTRALLY LOCATED ON THE STATE'S HEALTH CONNECTOR WEBSITE), A PAPER APPLICATION, OR OVER THE PHONE WITH A CUSTOMER SERVICE REPRESENTATIVE LOCATED AT EITHER MASSHEALTH OR THE CONNECTOR. INDIVIDUALS MAY ALSO ASK FOR ASSISTANCE FROM HOSPITAL FINANCIAL COUNSELORS (ALSO CALLED CERTIFIED APPLICATION COUNSELORS) WITH SUBMITTING THE APPLICATION EITHER ON THE WEBSITE OR THROUGH A PAPER APPLICATION.FINANCIAL ASSISTANCE POLICY-TRANSLATIONS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 5% OF THE POPULATION OR 1000 PERSONS, WHICHEVER IS LESS, IN ACCORDANCE WITH THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R). BASED ON THE HOSPITAL'S REVIEW OF THIS SAFE HARBOR, THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE FOLLOWING LANGUAGES: SPANISH, RUSSIAN AND PORTUGUESE. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICY-WIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FINANCIAL ASSISTANCE POLICY (FAP), CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, BY MAIL FREE OF CHARGE AND/OR ON THE HOSPITAL'S WEBSITE: (SCHEDULE H PART V SECTION B QUESTIONS 16A, 16B, 16C, 16D, 16E, 16H) ATHTTPS://MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/ASSISTANCE.IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS BEFORE DISCHARGE AND CONSPICUOUSLY WITHIN BILLING STATEMENTS. INFORMATION PROVIDED TO PATIENTS IN THESE COMMUNICATIONS INCLUDE CONTACT INFORMATION FOR THOSE THAT CAN HELP PROVIDE ADDITIONAL INFORMATION ABOUT THE FAP, INFORMATION ON THE APPLICATION PROCESS AND THE WEBSITE WHERE THE FAP CAN BE OBTAINED. ADDITIONALLY, A PLAIN LANGUAGE SUMMARY OF THE FAP IS PROVIDED TO PATIENTS AS PART OF THE INTAKE PROCESS. (SCHEDULE H PART V SECTION B QUESTION 16G). FINANCIAL ASSISTANCE POLICY-PLAIN LANGUAGE SUMMARYAS NOTED IN THIS NARRATIVE SUPPORT TO THE FORM 990 SCHEDULE H, THE HOSPITAL HAS A PLAIN LANGUAGE SUMMARY OF ITS FAP. THIS IS A WRITTEN STATEMENT DESIGNED TO NOTIFY PATIENTS AND VISITORS THAT THE HOSPITAL HAS A WRITTEN FAP AND PROVIDES FINANCIAL ASSISTANCE. THIS PLAIN LANGUAGE SUMMARY INCLUDES INFORMATION ON FREE AND DISCOUNTED CARE, HOW TO OBTAIN A COPY OF THE FAP POLICY AND APPLICATION, INCLUDING THE WEBSITE ADDRESS, THE LOCATION AND PHONE NUMBER OF THE FINANCIAL COUNSELING OFFICE. THE PLAIN LANGUAGE SUMMARY ALSO INCLUDES THE LIST OF LANGUAGES INTO WHICH THE FAP AND SUMMARY HAVE BEEN TRANSLATED AS WELL AS HOW TO ACCESS INFORMATION ON PROVIDERS NOT COVERED BY THE FAP AND TO WHICH OTHER RELATED HOSPITALS APPROVAL UNDER THE FAP WILL APPLY. LINKS TO FINANCIAL ASSISTANCE POLICY AND RELATED DOCUMENTSTHE LINK TO THE MOUNT AUBURN HOSPITAL FINANCIAL ASSISTANCE POLICY (FAP) AND THE FOLLOWING RELATED DOCUMENTS CAN BE FOUND ON THE HOSPITAL'S WEBSITE. - CREDIT AND COLLECTION POLICY- APPLICATION FOR FINANCIAL ASSISTANCE- MEDICAL HARDSHIP APPLICATION- FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ADDITIONAL INFORMATION ON PATIENT FINANCIAL ASSISTANCE AND BILLING, ALL IN SPANISH, RUSSIAN AND PORTUGUESE, CAN BE FOUND ON MOUNT AUBURN HOSPITAL WEBSITE AT: HTTPS://MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/ASSISTANCELIMITATION ON CHARGES--INTERNAL REVENUE CODE SECTION 501(R)(5)LIMITATION ON CHARGESAS REQUIRED BY IRC SECTION 501(R)(5) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL LIMITS THE AMOUNTS CHARGED FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IT PROVIDES TO A FINANCIAL ASSISTANCE-ELIGIBLE PATIENT, TO NOT MORE THAN AMOUNTS GENERALLY BILLED (AGB) AND LIMITS THE AMOUNTS CHARGED TO ANY FINANCIAL ASSISTANCE ELIGIBLE PATIENT FOR ALL OTHER MEDICAL CARE TO LESS THAN GROSS CHARGES. AMOUNTS GENERALLY BILLED--LOOK BACK METHODTHE HOSPITAL CALCULATES ITS AGB, USING THE LOOK BACK METHOD, DIVIDING THE TOTAL PAYMENTS RECEIVED FROM ALL COMMERCIAL PLANS AND MEDICARE BY THE TOTAL CHARGES SENT TO THOSE SAME PAYERS FOR THE PREVIOUS FISCAL YEAR. CALCULATED AGB IS INCLUDED IN THE HOSPITAL'S FAP AS REQUIRED UNDER THE REGULATIONS DETAILING THE REQUIREMENTS UNDER IRC SECTION 501(R)(5). (SCHEDULE H PART V SECTION B QUESTION 22). PATIENT REFUNDS FOR CHARGES IN EXCESS OF AMOUNTS GENERALLY BILLEDTHE HOSPITAL REGULARLY MONITORS THE FINANCIAL ACCOUNTS OF FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. WHERE A PATIENT SUBMITS A COMPLETED APPLICATION FOR FINANCIAL ASSISTANCE AND IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL REFUNDS ANY AMOUNTS PREVIOUSLY PAID FOR CARE THAN EXCEEDS THE AMOUNT THAT THE PATIENT IS PERSONALLY RESPONSIBLE FOR PAYING WHERE SUCH AMOUNTS ARE EQUAL TO OR EXCEED $5.00. BILLING AND COLLECTIONS--501(R)(6)EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL HAS NOT ENGAGED IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).THE HOSPITAL MAY DEFER OR REQUIRE PAYMENT BEFORE PROVIDING MEDICALLY NECESSARY SERVICES (OTHER THAN EMERGENCY MEDICAL SERVICES) TO PATIENTS WITH UNPAID BALANCES WHO HAVE FAILED TO PROVIDE REQUESTED INFORMATION FOR PROCESSING A FINANCIAL ASSISTANCE APPLICATION OR WITH RESPECT TO A PAYMENT PLAN. THE HOSPITAL DOES NOT PROVIDE A 30-DAY WRITTEN NOTICE IN ADVANCE OF TAKING SUCH ACTION, AS SUCH NOTICE IS NOT REQUIRED BY THE SECTION 501(R) REGULATIONS. (SCHEDULE H PART V SECTION B QUESTION 20).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS NOTED THROUGHOUT THIS FORM 990, MOUNT AUBURN HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. ALTHOUGH MOUNT AUBURN HOSPITAL DOES NOT DIRECTLY ENGAGE IN RESEARCH, BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), LAHEY CLINIC, NEW ENGLAND BAPTIST HOSPITAL AND JOSLIN DIABETES CENTER ALL ENGAGE IN RESEARCH ACTIVITIES DESIGNED TO CARE FOR PATIENTS NOT ONLY AT THESE HOSPITALS, BUT ACROSS THE COMMUNITIES SERVED BY BILH AND BEYOND. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $398 MILLION IN RESEARCH EXPENSES, APPROXIMATELY $94 MILLION OF WHICH WERE INTERNALLY FUNDED. ALTHOUGH THE RESEARCH ACTIVITIES OF BIDMC AND OTHER BILH AFFILIATES ARE NOT QUANTIFIED HERE IN MOUNT AUBURN HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY MOUNT AUBURN HOSPITAL, BILH AND BEYOND. INFORMATION ON THE RESEARCH ENGAGED IN AT BIDMC AND JOSLIN , A SISTER ENTITIES TO MOUNT AUBURN HOSPITAL, DURING THE PERIOD COVERED BY THIS FILING, IS INCLUDED BELOW. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION. TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. THE RESEARCH PROGRAM STRIVES TO BE RENOWNED FOR ITS BENCH-TO-BEDSIDE MODEL OF TRANSLATIONAL RESEARCH AND FOR ITS COLLABORATION WITH INDUSTRY AS A PATHWAY FOR TRANSFERRING THE FRUITS OF RESEARCH INTO PRODUCTS AND TREATMENTS THAT IMPROVE THE QUALITY OF LIFE.THE MEDICAL CENTER'S NOTABLE RESEARCH ACCOMPLISHMENTS INCLUDE CONSISTENTLY BEING RANKED IN THE TOP TIER OF INDEPENDENT HOSPITALS IN NATIONAL INSTITUTES OF HEALTH (NIH) FUNDING. THE MEDICAL CENTER SCIENTISTS CONTINUE TO SEARCH FOR IMPROVED UNDERSTANDING OF DISEASES AND BETTER TREATMENTS FOR PATIENTS, WHICH IN TURN DIRECTLY IMPACT THE LIVES OF OUR PATIENTS AND IMPROVE THE MEDICAL CENTER'S PATIENT CARE. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MORE THAN 1,220 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,500 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 280 PRINCIPAL INVESTIGATORS, THE MAJORITY OF WHOM ARE HARVARD MEDICAL SCHOOL FACULTY. THE KEY AREAS OF RESEARCH INCLUDE VASCULAR BIOLOGY, MOLECULAR IMAGING, TRANSPLANTATION, SIGNAL TRANSDUCTION, CANCER BIOLOGY, METABOLIC DISEASE, NEUROBIOLOGY, AIDS, VACCINE DEVELOPMENT AND VIROLOGY, INFECTION CONTROL AND INFECTIOUS DISEASES AND CARDIOLOGY/CARDIAC SURGERY. AS NOTED IN THIS FILING, THE MEDICAL CENTER IS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL AND IS COMMITTED TO MAINTAINING A COLLABORATIVE CULTURE; TO MAINTAINING MODERN, HIGH-QUALITY FACILITIES, AND TO TAKING FULL ADVANTAGE OF THE UNIQUE RELATIONSHIPS THAT EXIST AMONG THE HARVARD MEDICAL SCHOOL AND THE HARVARD TEACHING HOSPITALS. THE MEDICAL CENTER DESIGNS AND IMPLEMENTS MANY INTERDEPARTMENTAL AND INTERDISCIPLINARY RESEARCH PROGRAMS WITHIN THE INSTITUTION. THE MEDICAL CENTER ALSO COLLABORATES WITH OTHER NATIONALLY RECOGNIZED AND WORLD-RENOWNED EXPERTS IN VARIOUS FIELDS IN AN EFFORT TO TRANSLATE NEW KNOWLEDGE INTO NOVEL MEDICAL TREATMENTS AND PATIENT CARE. THE MEDICAL CENTER PARTICIPATES IN HARVARD CATALYST, THE HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER, WHICH BRINGS TOGETHER THE INTELLECTUAL FORCE, TECHNOLOGIES, AND CLINICAL EXPERTISE AT HARVARD UNIVERSITY AND ITS ACADEMIC, HEALTH CARE, AND COMMUNITY PARTNERS TO CREATE CONNECTIONS, ENABLE RESEARCH AT THE CUTTING EDGE OF DISCOVERY, AND NURTURE CLINICAL AND TRANSLATIONAL RESEARCHERS WITH THE GOAL OF IMPROVING HUMAN HEALTH.STUDIES BY MEDICAL CENTER RESEARCHERS ARE ROUTINELY PUBLISHED IN THE WORLD'S LEADING SCIENTIFIC JOURNALS, INCLUDING NATURE, SCIENCE, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION AND THE NEW ENGLAND JOURNAL OF MEDICINE, WHICH HELPS TO BRING THE RESEARCH FINDINGS TO CLINICIANS AND PATIENTS BEYOND THE MEDICAL CENTER. THE MEDICAL CENTER ENGAGES IN RESEARCH IN ALL OF THE FOLLOWING DISCIPLINES:- ANESTHESIA, CRITICAL CARE, AND PAIN MEDICINE - EMERGENCY MEDICINE - MEDICINE - ALLERGY AND INFLAMMATION- CARDIOVASCULAR MEDICINE- CENTER FOR VASCULAR BIOLOGY RESEARCH- CLINICAL INFORMATICS- CLINICAL NUTRITION- ENDOCRINOLOGY- EXPERIMENTAL MEDICINE- GASTROENTEROLOGY- GENERAL MEDICINE AND PRIMARY CARE- GENETICS- GERONTOLOGY- HEMATOLOGY AND ONCOLOGY- HEMOSTASIS AND THROMBOSIS- IMMUNOLOGY- INFECTIOUS DISEASE- INTERDISCIPLINARY MEDICINE AND BIOTECHNOLOGY- MOLECULAR AND VASCULAR MEDICINE- NEPHROLOGY- PULMONOLOGY- RHEUMATOLOGY- SIGNAL TRANSDUCTION- TRANSLATIONAL RESEARCH- TRANSPLANT IMMUNOLOGY- NEONATOLOGY - NEUROLOGY - OBSTETRICS AND GYNECOLOGY - ORTHOPAEDIC SURGERY - PATHOLOGY - PSYCHIATRY - RADIOLOGY - SURGERY - CARDIAC SURGERY- CENTER FOR MINIMALLY INVASIVE SURGERY- NEUROSURGERY- PLASTIC AND RECONSTRUCTIVE SURGERY- VASCULAR SURGERY- TRANSPLANT INSTITUTEDURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $398 MILLION IN RESEARCH EXPENSES, APPROXIMATELY $94 MILLION OF WHICH WERE INTERNALLY FUNDED AND REPORTED ON THE BIDMC SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE.RESEARCH ENGAGED IN AT THE MEDICAL CENTERTHE REAL CORNERSTONES OF THE MEDICAL CENTER'S SUCCESS CAN BE DESCRIBED IN THREE KEY WORDS: INNOVATION, CULTIVATION, AND TRANSFORMATION. BEGINNING WITH SUPPORT OF BOLD AND INNOVATIVE IDEAS, EXTENDING TO CULTIVATION AND NURTURING OF PROMISING YOUNG SCIENTISTS, AND CULMINATING IN THE TRANSFORMATION OF NOVEL DISCOVERIES INTO THERAPIES AND DIAGNOSTICS, THE MEDICAL CENTER'S RESEARCH PROGRAM HAS EMERGED AS A UNIQUE AND SUCCESSFUL MODEL FOR TODAY'S RAPIDLY CHANGING HEALTH CARE LANDSCAPE.EXAMPLES OF THE RESEARCH ENGAGED IN AT BIDMCBELOW IS INFORMATION RELATED TO JUST A HANDFUL OF THE CUTTING-EDGE RESEARCH STUDIES AND PRINCIPAL INVESTIGATORS AT THE MEDICAL CENTER. THE DETAIL BELOW IS DESIGNED TO PROVIDE THE READER WITH A TASTE OF THE MANY CONTRIBUTIONS THE MEDICAL CENTER IS MAKING TO PATIENT CARE TODAY AND TOMORROW. EXPENSES FROM THE RESEARCH ACTIVITIES NOTED BELOW ARE INCLUDED IN THE MEDICAL CENTER'S FORM 990 SCHEDULE H, PART I LINE 7H COLUMN C AND MAY OR MAY NOT BE QUANTIFIED IN FORM 990 SCHEDULE H, PART I, LINE 7H COLUMN E, DEPENDING ON FUNDING SOURCE. DETAIL ON RESEARCH EFFORTS WHICH WERE UNDERTAKEN AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING ARE BELOW. 1. MORE AMERICANS ARE UNAWARE THEY HAVE DIABETES, HIGH BLOOD PRESSURE, CHOLESTEROLIN A NEW REPORT PUBLISHED IN JAMA CARDIOLOGY, HEALTH POLICY EXPERTS AT BIDMC'S RICHARD A. AND SUSAN F. SMITH CENTER FOR OUTCOMES RESEARCH SHOWED THAT MANY U.S. ADULTS ARE UNAWARE THEY HAVE HIGH BLOOD PRESSURE, DIABETES OR HIGH CHOLESTEROL -- THREE MAJOR RISK FACTORS FOR CARDIOVASCULAR DISEASE AND DEATH. THE PROPORTION OF AMERICANS UNAWARE THEY HAVE HYPERTENSION HAS RISEN OVER THE PAST DECADE, ESPECIALLY AMONG YOUNGER ADULTS AND WOMEN."YOUNG ADULTS WERE THE MOST LIKELY TO NOT REALIZE THAT THEY HAD HIGH BLOOD PRESSURE, DIABETES, OR HIGH CHOLESTEROL," SAID RISHI WADHERA, MD, MPP, MPHIL, ASSOCIATE DIRECTOR OF THE SMITH CENTER. "IT'S ESPECIALLY CONCERNING THAT ONE IN THREE YOUNG ADULTS WERE UNAWARE OF THEIR HIGH BLOOD PRESSURE, TWO IN FIVE DIDN'T KNOW THEY HAD DIABETES, AND ONE IN FOUR WERE UNAWARE OF HAVING HIGH CHOLESTEROL. THAT'S A MAJOR PUBLIC HEALTH ISSUE."THE ANALYSIS INCLUDED MORE THAN 15,000 ADULTS, MOSTLY MIDDLE-AGED, WHO HAD AT LEAST ONE RISK FACTOR IDENTIFIED THROUGH PHYSICAL EXAMS OR LAB TESTING. THE PROPORTION WITH HYPERTENSION -- A CONDITION THAT'S OFTEN SYMPTOMLESS -- WHO WERE UNAWARE OF IT ROSE SIGNIFICANTLY OVER THE DECADE-LONG STUDY PERIOD; AWARENESS OF DIABETES AND HIGH CHOLESTEROL DIDN'T CHANGE.BUT WHEN WADHERA AND COLLEAGUES BROKE DOWN THE DATA BY AGE, THE RISE IN HYPERTENSION UNAWARENESS APPEARED ONLY AMONG ADULTS AGES 20 TO 44, WITH NO CHANGE AMONG THOSE OLDER THAN 45. BY SEX, UNAWARENESS ROSE AMONG WOMEN BUT NOT MEN."GIVEN DECLINING HEART HEALTH IN YOUNG ADULTS, IT'S CRITICAL THAT WE INTENSIFY PUBLIC HEALTH MESSAGING TO THIS GROUP ON THE IMPORTANCE OF SCREENING FOR HIGH BLOOD PRESSURE, DIABETES, AND HIGH CHOLESTEROL," SAID DANIEL JOHNSON, LEAD AUTHOR OF THE STUDY AND RESEARCH FELLOW AT THE SMITH CENTER. "WE NEED TO ADDRESS GAPS IN AWARENESS EARLY IN LIFE TO PREVENT THE ONSET OF CARDIOVASCULAR DISEASE, OR WORSE, LATER IN LIFE."2. STUDY MIMICKING LIFE-THREATENING CONDITION COMMON IN ICU PATIENTS SHOWS POTENTIAL PROTECTIVE ROLE OF IMMUNE CELLSACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) DREW WIDE ATTENTION DURING THE COVID-19 PANDEMIC AS A LEADING CAUSE OF DEATH IN PATIENTS WITH SEVERE CASES. NOW, A PRECLINICAL STUDY FROM BIDMC REVEALS A NOVEL APPROACH TO MITIGATING LUNG DAMAGE CAUSED BY PROLONGED EXPOSURE TO HIGH OXYGEN LEVELS--A CONDITION THAT MIMICS KEY FEATURES OF ARDS, INCLUDING WIDESPREAD INFLAMMATION AND DAMAGE TO THE LUNGS.IN FINDINGS PUBLISHED IN ANESTHESIA AND ANALGESIA, THE INVESTIGATORS DEMONSTRATED THAT A SINGLE ADMINISTRATION OF B CELLS DECREASED THE SEVERITY OF LUNG INJURY, IMPROVED OXYGENATION AND PROMOTED A MORE BALANCED IMMUNE RESPONSE (IMPROVED IMMUNE FUNCTION WITHOUT THE RISK OF RUNAWAY INFLAMMATION) IN A SMALL ANIMAL MODEL OF ARDS. B CELLS ARE A TYPE OF WHITE BLOOD CELL THAT PLAY A CENTRAL ROLE IN THE IMMUNE SYSTEM BY PRODUCING ANTIBODIES, BUT THEY ALSO HELP REGULATE IMMUNE RESPONSES BY COORDINATING WITH OTHER CELLS OF THE IMMUNE SYSTEM AND CALMING EXCESSIVE INFLAMMATION. ARDS DEVELOPS IN AT LEAST ONE IN TEN MECHANICALLY VENTILATED PATIENTS IN THE INTENSIVE CARE UNIT, AND HAS A HIGH MORTALITY RATE," SAID LEAD AUTHOR DUSAN HANIDZIAR, MD, PHD, A POSTDOCTORAL RESEARCH FELLOW IN THE CENTER FOR INFLAMMATION RESEARCH AT BIDMC. "NEW, TARGETED TREATMENTS NEED TO BE DEVELOPED FOR CLINICAL USE, AND WE'RE EXCITED THAT OUR DATA SUGGEST HARNESSING THE FUNCTIONS OF THE B CELL MAY REPRESENT A NOVEL THERAPY FOR ARDS."IN THIS FIRST-OF-ITS-KIND STUDY, HANIDZIAR AND COLLEAGUES SHOWED THAT, IN MICE EXPOSED TO HIGH OXYGEN LEVELS, THE NUMBER OF B CELLS DROPPED SHARPLY IN BOTH THE LUNGS AND THE BLOODSTREAM. ADMINISTERING B CELLS INTRAVENOUSLY 24 HOURS AFTER THE ONSET OF HIGH OXYGEN EXPOSURE, IMPROVED IMMUNE REGULATION, REDUCED HARMFUL INFLAMMATION, AND PARTIALLY RESTORED THE DIVERSITY OF IMMUNE CELLS IN THE ANIMALS' LUNGS."WE'VE KNOWN THAT HIGH OXYGEN LEVELS CAN SEVERELY DISRUPT IMMUNE BALANCE IN THE LUNGS, BUT THIS STUDY SHOWS THAT INFUSING B CELLS CAN HELP CORRECT THAT IMBALANCE AND REDUCE LUNG INJURY," SAID SENIOR AUTHOR SIMON C ROBSON, MD, PHD, DIRECTOR OF THE CENTER FOR INFLAMMATION RESEARCH. "THIS WORK LAYS IMPORTANT GROUNDWORK FOR EXPLORING B-CELL THERAPY AS A POTENTIAL TREATMENT FOR ARDS AND RELATED CONDITIONS."3. MORE THAN HALF OF U.S. ADULTS COULD BENEFIT FROM GLP-1 MEDICATIONS, RESEARCHERS FINDIN AN ANALYSIS OF NATIONAL DATA, RESEARCHERS AT THE RICHARD A. AND SUSAN F. SMITH CENTER FOR OUTCOMES RESEARCH AT BIDMC ESTIMATED THAT 137 MILLION U.S. ADULTS, MORE THAN HALF OF ALL ADULTS, ARE ELIGIBLE FOR SEMAGLUDTIDE FOR WEIGHT LOSS, DIABETES MANAGEMENT, OR PREVENTION OF RECURRENT CARDIOVASCULAR EVENTS. THE FINDINGS, PUBLISHED IN JAMA CARDIOLOGY, UNDERSCORE THE NEED TO INCREASE EQUITABLE ACCESS TO THIS NEW CLASS OF PHARMACEUTICALS.SEMAGLUTIDE, WHICH BELONGS TO A CLASS OF DRUGS KNOWN AS GLP-1 RECEPTOR AGONISTS, IS CURRENTLY APPROVED FOR THE MANAGEMENT OF DIABETES, TREATMENT OF OVERWEIGHT OR OBESITY, AND PREVENTION OF RECURRENT CARDIOVASCULAR DISEASE (E.G., IN PATIENTS WHO HAVE ALREADY EXPERIENCED A HEART ATTACK OR STROKE OR ARE LIVING WITH PERIPHERAL ARTERY DISEASE). ABOUT 15 MILLION ADULTS CURRENTLY TAKE SEMAGLUTIDE. BUT DATA IS RAPIDLY EMERGING ABOUT ITS EFFECTIVENESS FOR OTHER HEALTH CONDITIONS.IVY SHI, MD, WHO IS A RESIDENT IN INTERNAL MEDICINE AT BIDMC, WORKED WITH DHRUV S. KAZI, MD, MS, ASSOCIATE DIRECTOR OF THE SMITH CENTER AND DIRECTOR OF THE CARDIAC CRITICAL CARE UNIT AT BIDMC TO PRODUCE THE ANALYSIS. THEY USED FIVE YEARS' WORTH OF RECENT DATA FROM A LONG-RUNNING SURVEY OF THE U.S. POPULATION RUN BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO IDENTIFY U.S. ADULTS AGED 18 YEARS OR OLDER WHO WOULD BE ELIGIBLE FOR SEMAGLUTIDE TREATMENT BASED ON CURRENTLY APPROVED INDICATIONS.THEY FOUND THAT OF THE 136.8 MILLION US ADULTS ELIGIBLE FOR SEMAGLUTIDE, 35.0 MILLION ADULTS WOULD BE ELIGIBLE FOR THE MEDICATION FOR DIABETES MANAGEMENT, 129.2 MILLION ADULTS FOR WEIGHT LOSS, AND 8.9 MILLION ADULTS FOR SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE. THE SEMAGLUTIDE-ELIGIBLE POPULATION INCLUDES 26.8 MILLION ADULTS COVERED BY MEDICARE, 13.8 MILLION COVERED BY MEDICAID, AND 61.1 MILLION COVERED BY COMMERCIAL INSURANCE."THESE STAGGERING NUMBERS MEAN THAT WE ARE LIKELY TO SEE LARGE INCREASES IN SPENDING ON SEMAGLUTIDE AND RELATED MEDICATIONS IN YEARS TO COME," SAID KAZI. "ENSURING EQUITABLE ACCESS TO THESE EFFECTIVE BUT HIGH-COST MEDICATIONS, AS WELL AS SUPPORTING INDIVIDUALS SO THAT THEY CAN STAY ON THE THERAPY LONG-TERM, SHOULD BE A PRIORITY FOR OUR CLINICIANS AND POLICYMAKERS."4. SKIP THE EXTRA SALT: STUDY SHOWS HEART HEALTHY DIET AND SODIUM REDUCTION LOWER RISK OF HEART DISEASEMOST AMERICANS CONSUME FAR MORE SODIUM THAN RECOMMENDED, WITH THE AVERAGE INTAKE TOPPING 3,400 MILLIGRAMS (MG) PER DAY-WELL ABOVE THE RECOMMENDED FEDERAL GUIDELINE OF 2,300 MG AND THE AMERICAN HEART ASSOCIATION'S GOAL OF 1,500 MG. THE BULK OF AMERICAN'S DAILY SODIUM DOESN'T COME FROM THE SALTSHAKER, BUT FROM PROCESSED AND RESTAURANT FOODS LIKE BREADS, DELI MEATS, AND CANNED SOUPS. HEALTH EXPERTS WARN THIS EXCESS IS FUELING A NATIONAL EPIDEMIC OF HIGH BLOOD PRESSURE, A MAJOR RISK FACTOR FOR HEART DISEASE AND STROKE.A NEW ANALYSIS LED BY INVESTIGATORS AT BIDMC HAS FOUND THAT REDUCING DIETARY SODIUM, OR FOLLOWING THE EVIDENCED-BASED HEART-HEALTHY DASH DIET EACH INDEPENDENTLY LOWERED THE 10-YEAR ESTIMATED RISK OF DEVELOPING ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD)-HARDENING OF THE ARTERIES THAT CAN LEAD TO CHEST PAIN, HEART ATTACK OR STROKE-AMONG ADULTS WITH ELEVATED BLOOD PRESSURE BUT NO PRIOR CARDIOVASCULAR DISEASE.MOREOVER, THE COMBINATION OF THE DASH DIET AND REDUCING SODIUM INTAKE HAD ADDITIVE EFFECTS, RESULTING IN THE GREATEST REDUCTION IN ASCVD RISK. THE FINDINGS APPEAR IN THE AMERICAN JOURNAL OF PREVENTIVE CARDIOLOGY."COMPARED TO THE TYPICAL AMERICAN, HIGH-SODIUM DIET, REDUCING SODIUM TO THE RECOMMENDED LEVELS OR EVEN LOWER MARKEDLY DECREASED CARDIOVASCULAR DISEASE RISK SCORES, WITH THE GREATEST EFFECTS AMONG WOMEN, BLACK ADULTS AND PARTICIPANTS WITH BASELINE STAGE II HYPERTENSION," SAID SENIOR AUTHOR STEPHEN P. JURASCHEK, MD. "THESE DATA UNDERSCORE THE NEED FOR STRONGER DIETARY GUIDELINES AND PUBLIC HEALTH INTERVENTIONS THAT CAN BE REALISTICALLY IMPLEMENTED AND SUSTAINED OVER TIME-ESPECIALLY AMONG GROUPS AT HIGHEST RISK."TO EVALUATE THE IMPACT OF SODIUM REDUCTION ON BLOOD PRESSURE-ALONE AND IN COMBINATION WITH THE DASH DIET-JURASCHEK AND COLLEAGUES RANDOMIZED 390 ADULTS WITH ELEVATED BLOOD PRESSURE TO THE DASH DIET AND A TYPICAL AMERICAN DIET.AFTER THE 12-WEEK PERIOD, ANALYSIS REVEALED THAT BOTH THE DASH DIET AND LOWER SODIUM INTAKE INDEPENDENTLY REDUCED PARTICIPANTS' ASCVD RISK SCORES. LOWERING SODIUM INTAKE LED TO MEANINGFUL RISK REDUCTIONS EVEN WHEN NOT MEETING THE MOST AGGRESSIVE TARGETS. BUT THE GREATEST BENEFIT OCCURRED WHEN THE TWO INTERVENTIONS WERE COMBINED.5. PRIVATE EQUITY MAY HAVE NEGATIVE EFFECT ON PATIENT CARE, STUDY SHOWSIN A PAPER PUBLISHED IN JAMA, BIDMC HEALTH POLICY EXPERTS REPORT THAT PATIENT CARE EXPERIENCE AND STAFF RESPONSIVENESS WORSENED AFTER PRIVATE EQUITY (PE) ACQUISITION OF U.S. HOSPITALS. RISHI WADHERA, MD, MPP, ANJALI BHATLA, MD, AND COLLEAGUES FOUND THAT CARE CONTINUED TO DECLINE WITH EACH ADDITIONAL YEAR AFTER ACQUISITION, SUGGESTING THAT PROFIT-DRIVEN CHANGES MAY COMPOUND OVER TIME."PATIENTS PROVIDE THE MOST IMPORTANT PERSPECTIVE ON WHETHER A HOSPITAL IS PROVIDING GOOD OR BAD CARE, AS THEY HAVE A 360-DEGREE VIEW OF THE ENTIRE CARE EXPERIENCE," SAID WADHERA, ASSOCIATE DIRECTOR OF THE SMITH CENTER FOR OUTCOMES RESEARCH AT BIDMC. "AFTER PRIVATE EQUITY TAKES OVER A HOSPITAL, PATIENT CARE EXPERIENCE SIGNIFICANTLY WORSENS. THAT'S VERY CONCERNING, GIVEN THE SURGE IN PE ACQUISITIONS OF HEALTH CARE FACILITIES OVER THE PAST DECADE."WADHERA AND COLLEAGUES IDENTIFIED 73 U.S. HOSPITALS NEWLY ACQUIRED BY PRIVATE EQUITY AND 293 MATCHED, NON-ACQUIRED HOSPITALS FROM 2008 TO 2019, AND FOUND THAT PATIENTS' OVERALL RATINGS, WILLINGNESS TO RECOMMEND THE HOSPITAL, AND REPORTED STAFF RESPONSIVENESS, DOCTOR AND NURSE COMMUNICATION, AND HOSPITAL ENVIRONMENT ALL WORSENED IN THE THREE YEARS AFTER ACQUISITION."THE RELATIVE DECLINE IN OVERALL PATIENT CARE EXPERIENCE SCORES AFTER PE ACQUISITION WAS LARGE," SAID ANJALI BHATLA, MD, A RESEARCH FELLOW AT THE SMITH CENTER. "POOR PATIENT EXPERIENCES ARE ASSOCIATED WITH SLOWER RECOVERY FROM ILLNESS, MEDICATION NONADHERENCE, AND GREATER HEALTH CARE UTILIZATION.""THE EVIDENCE TO DATE SUGGESTS THAT WHEN PRIVATE EQUITY TAKES OVER A HOSPITAL, THINGS GENERALLY GET WORSE FOR PATIENTS," SAID WADHERA, WHO IS ALSO AN ASSOCIATE PROFESSOR AT HARVARD MEDICAL SCHOOL. "AS PRIVATE EQUITY'S PRESENCE IN HEALTH CONTINUES TO GROW, THERE'S A PRESSING NEED FOR GREATER TRANSPARENCY, MONITORING, AND REGULATORY OVERSIGHT, TO ENSURE THAT PATIENTS ARE PROTECTED."PE INVESTORS SPENT MORE THAN $200 BILLION ON HEALTH CARE ACQUISITIONS IN 2021 ALONE - $1 TRILLION OVER THE PAST DECADE, PER THE COMMONWEALTH FUND - YET LITTLE RESEARCH HAS EVALUATED PE'S IMPACT ON THE PATIENT CARE EXPERIENCE.IN AN EARLIER STUDY, WADHERA FOUND THAT PE FIRMS DISPROPORTIONATELY ACQUIRED OUTPATIENT CARDIOLOGY PRACTICES IN WEALTHY COMMUNITIES, OFTEN FLIPPING THEM WITHIN A FEW YEARS - A PATTERN THAT CAN INCENTIVIZE CARE CHANGES THAT MAXIMIZE PROFIT OVER QUALITY. 6. RACIAL DISPARITIES IN PAIN ASSESSMENT EXPOSE AI'S FLAWED BELIEFS ABOUT RACEA STUDY LED BY ADAM RODMAN, MD, MPH, DIRECTOR OF AI PROGRAMS AT BIDMC, REVEALS THAT, RATHER THAN HELPING TO REDUCE RACIAL AND ETHNIC BIASES, AI-DRIVEN CHATBOTS MAY INSTEAD PERPETUATE AND EXACERBATE DISPARITIES IN MEDICINE. THE STUDY APPEARED IN JAMA NETWORK OPEN.IT'S WELL-DOCUMENTED THAT PHYSICIANS UNDERTREAT BLACK PATIENTS' PAIN VERSUS WHITE PATIENTS', A DISPARITY OFTEN ATTRIBUTED TO UNDERASSESSMENT OF THEIR PAIN. AI WAS INITIALLY SEEN AS A WAY TO ELIMINATE SUCH BIASES, WITH DATA-DRIVEN ALGORITHMS EXPECTED TO OFFER OBJECTIVE ASSESSMENTS FREE FROM HUMAN PREJUDICE."THESE MODELS ARE VERY GOOD AT REFLECTING HUMAN BIASES -- AND NOT JUST RACIAL BIASES -- WHICH IS PROBLEMATIC IF YOU'RE GOING TO USE THEM TO MAKE ANY SORT OF MEDICAL DECISION," RODMAN SAID. "IF THE SYSTEM IS BIASED THE SAME WAY HUMANS ARE, IT'S GOING TO SERVE TO MAGNIFY OUR BIASES OR MAKE HUMANS MORE CONFIDENT IN THEIR BIASES."TO INVESTIGATE, RODMAN AND COLLEAGUES REPLICATED A 2016 STUDY IN WHICH 222 MEDICAL STUDENTS AND RESIDENTS RATED PAIN LEVELS FOR TWO MEDICAL VIGNETTES -- ONE DESCRIBING A WHITE PATIENT, ONE BLACK -- ON A 10-POINT SCALE, AND RATED THEIR AGREEMENT WITH FALSE BELIEFS ABOUT RACIAL BIOLOGY, SUCH AS THE INACCURATE BUT WIDESPREAD NOTION THAT BLACK PEOPLE HAVE THICKER SKIN.IN THEIR STUDY, RODMAN'S TEAM APPLIED THE SAME SETUP TO THE AI MODELS GEMINI PRO AND GPT-4 TO SEE HOW THEY WOULD ASSESS PAIN ACROSS RACE AND ETHNICITY AND GAUGE THEIR UNDERSTANDING OF RACIAL BIOLOGY.THE RACIAL DISPARITIES PERSISTED. ACROSS THE BOARD, BLACK PATIENTS WERE UNDERASSESSED FOR THEIR PAIN COMPARED WITH WHITE PATIENTS, REGARDLESS OF WHETHER THE RATER WAS HUMAN OR AI. AS FOR FALSE BELIEFS ABOUT RACIAL BIOLOGY: THE GEMINI PRO AI MODEL EXHIBITED THE HIGHEST PERCENTAGE OF FALSE BELIEFS (24 PERCENT), FOLLOWED BY THE HUMAN TRAINEES (12 PERCENT), AND GPT-4 WITH THE LOWEST (9 PERCENT).AS MORE HOSPITALS AND CLINICS ADOPT AI FOR CLINICAL DECISION SUPPORT, THE FINDINGS SUGGEST CHATBOTS COULD PERPETUATE RACIAL AND ETHNIC BIASES IN MEDICINE, DEEPENING HEALTH CARE INEQUALITIES -- PARTICULARLY IF CONFIRMATION BIAS LEADS PHYSICIANS TO TRUST AI OUTPUTS ONLY WHEN THEY MATCH PRE-EXISTING BELIEFS.7. BIDMC-LED STUDY FINDS MOST CANCER PHYSICIANS-IN-TRAINING FEEL UNDERPREPARED TO ADVISE PATIENTS ABOUT MEDICAL MARIJUANAEVIDENCE SUGGESTS AS MANY AS 40 PERCENT OF ADULTS WITH CANCER TURN TO MARIJUANA -- MORE PROPERLY KNOWN AS CANNABIS -- TO MANAGE SYMPTOMS LIKE PAIN, NAUSEA AND ANXIETY, AND MANY WANT GUIDANCE FROM THEIR PHYSICIANS. YET A NATIONAL STUDY LED BY BIDMC INVESTIGATORS FINDS THAT MOST ONCOLOGISTS-IN-TRAINING, OR FELLOWS, FEEL UNDERPREPARED TO MANAGE THIS INCREASINGLY COMMON ASPECT OF PATIENT CARE."PERSONALIZED, PATIENT-CENTERED CARE STARTS WITH UNDERSTANDING AND COMMUNICATING THE BEST AVAILABLE EVIDENCE," SAID CO-LEAD AUTHOR KIAN TEHRANCHI, MD, A CLINICAL FELLOW IN HEMATOLOGY ONCOLOGY AT BIDMC. "AS MEDICAL CANNABIS BECOMES MORE WIDELY USED AND ACCEPTED, IT'S CRITICAL THAT FELLOWSHIP TRAINING EQUIPS FUTURE ONCOLOGISTS WITH THE KNOWLEDGE THEY NEED TO HAVE INFORMED, THOUGHTFUL CONVERSATIONS AND SUPPORT SHARED DECISION-MAKING WITH THEIR PATIENTS."PUBLISHED IN THE JOURNAL OF CANNABIS RESEARCH, THE STUDY SURVEYED 189 ONCOLOGY FELLOWS ACROSS 40 TRAINING PROGRAMS IN 25 STATES. ABOUT ONE IN FIVE HAD RECOMMENDED MEDICAL CANNABIS TO MORE THAN FIVE PATIENTS IN THE PREVIOUS YEAR. ABOUT A QUARTER HAD RECEIVED PRIOR TRAINING IN MEDICAL CANNABIS, AND THOSE WITH TRAINING WERE TWICE AS LIKELY TO RECOMMEND IT -- AND SIGNIFICANTLY MORE LIKELY TO HOLD INFORMED OPINIONS ABOUT ITS RISKS, BENEFITS, PREFERRED USE, AND WHICH PATIENTS MIGHT BENEFIT MOST.THE FINDINGS UNDERSCORE HOW EVEN BASIC TRAINING BUILDS FELLOWS' CONFIDENCE IN HAVING EVIDENCE-BASED CONVERSATIONS ABOUT CANNABIS USE, DESPITE LIMITED SAFETY AND EFFICACY DATA IN CANCER CARE.THE RESEARCHERS NOTE THAT EVIDENCE IS STRONGEST FOR CANNABIS RELIEVING CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING, WITH LESS SUPPORT FOR OTHER SYMPTOMS LIKE CHRONIC PAIN OR APPETITE LOSS, AND VIRTUALLY NONE FOR ISSUES LIKE DIARRHEA. THEY STRESS THE IMPORTANCE OF TRAINING ON ITS SIDE EFFECTS, DRUG INTERACTIONS, AND RISKS FOR PATIENTS RECEIVING IMMUNOTHERAPY."THIS IS ABOUT PREPARING THE NEXT GENERATION OF CANCER PHYSICIANS TO MEET PATIENTS WHERE THEY ARE," SAID LEAD AUTHOR DEEPA RANGACHARI, MD, DIRECTOR OF GRADUATE MEDICAL EDUCATION & HEMATOLOGY ONCOLOGY FELLOWSHIP PROGRAM DIRECTOR AT BIDMC. "WELL-INFORMED, PATIENT-CENTERED CARE STARTS WITH GIVING OUR TRAINEES THE TOOLS THEY NEED TO ENGAGE IN NUANCED, EVIDENCE-BASED CONVERSATIONS."8. COVID-19 EXACERBATED AN ALREADY WIDENING GAP BETWEEN RURAL AND URBAN HEART HEALTH OVER LAST DECADEEXISTING SOCIOECONOMIC DISPARITIES LEFT THE U.S. RURAL POPULATION MORE VULNERABLE TO THE DIRECT AND INDIRECT CARDIOVASCULAR EFFECTS OF COVID-19, ACCORDING TO INVESTIGATORS AT BIDMC'S RICHARD A. AND SUSAN F. SMITH CENTER FOR OUTCOMES RESEARCH. IN A STUDY PRESENTED AT THE AMERICAN HEART ASSOCIATION SCIENTIFIC SESSIONS AND PUBLISHED IN THE JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, THE SCIENTISTS SHOWED THAT THE GAP IN HEALTH OUTCOMES BETWEEN RURAL AND URBAN POPULATIONS WIDENED MORE QUICKLY AFTER THE PANDEMIC.RESEARCHERS EVALUATED CARDIOVASCULAR MORTALITY IN THE UNITED STATES FROM 2010 TO 2022, FOCUSING ON THE IMPACT OF THE PANDEMIC ON EXISTING RURAL-URBAN DISPARITIES IN CARDIOVASCULAR HEALTH. PRIOR TO THE PANDEMIC, AGE-ADJUSTED CARDIOVASCULAR DEATH RATES HAD BEEN DECREASING IN URBAN AREAS OF THE UNITED STATES. IN CONTRAST, CARDIOVASCULAR DEATH RATES WERE INCREASING IN RURAL AREAS, DRIVEN LARGELY BY AN ALARMING RISE AMONG YOUNGER ADULTS.THE INVESTIGATORS FOUND THAT FOLLOWING THE ONSET OF THE PANDEMIC, WHILE THERE WAS AN INCREASE IN THE CARDIOVASCULAR MORTALITY RATE IN URBAN AREAS, THERE WAS A STEEPER INCREASE IN RURAL AREAS, PARTICULARLY AMONG RURAL ADULTS AGED 25-64. BY 2022, CARDIOVASCULAR MORTALITY RATES WERE 1.5 TIMES HIGHER IN RURAL COMPARED WITH URBAN AREAS.OTHER STUDIES SUGGEST THAT FOR MANY PEOPLE, RISK FACTORS SUCH AS HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, DIABETES, AND OBESITY WORSENED DURING THE PANDEMIC, AND RURAL AREAS MAY HAVE BEEN MORE SEVERELY AFFECTED DUE TO GREATER INTERRUPTIONS IN ACCESS TO HEALTH CARE. THE PANDEMIC-RELATED SURGE IN SUBSTANCE USE, DEPRESSION, AND SUICIDALITY ALSO DISPROPORTIONATELY IMPACTED RURAL POPULATIONS; THESE "DISEASES OF DESPAIR" CONFER AN INCREASED RISK OF CARDIOVASCULAR EVENTS."DETERIORATING SOCIOECONOMIC CONDITIONS AND HEALTH SYSTEM CHALLENGES THAT WERE EXACERBATED BY THE PANDEMIC MAY HAVE MADE RURAL ADULTS MORE VULNERABLE TO POOR CARDIOVASCULAR OUTCOMES," SAID CORRESPONDING AUTHOR RISHI K. WADHERA, MD, MPP, MPHIL, ASSOCIATE DIRECTOR OF THE SMITH CENTER AT BIDMC. "THERE'S A CARDIOMETABOLIC HEALTH CRISIS HAPPENING IN RURAL AMERICA -- ESPECIALLY AMONG YOUNG ADULTS -- AND IT'S VITAL THAT WE START TACKLING THE UNDERLYING SOCIOECONOMIC CONDITIONS THAT ARE DRIVING THIS PERSISTENT RISE IN CARDIOVASCULAR MORTALITY."9. MPOX VACCINE ANTIBODY RESPONSES WANED WITHIN A YEAR, STUDY SHOWSTHE 2022 OUTBREAK OF MPOX, FORMERLY KNOWN AS MONKEYPOX, MARKED THE FIRST TIME THE VIRUS SPREAD WIDELY ACROSS MULTIPLE COUNTRIES BEYOND ITS HISTORICALLY ENDEMIC REGIONS IN AFRICA. BOSTON REPORTED THE FIRST U.S. CASE IN MAY; BY AUGUST, ALL 50 STATES HAD DOCUMENTED INFECTIONS. SPREAD PRIMARILY THROUGH CLOSE SKIN-TO-SKIN CONTACT, ESPECIALLY DURING SEXUAL ACTIVITY, THE INFECTION MANIFESTS AS FEVER, SWOLLEN LYMPH NODES, AND PAINFUL RASHES OR SORES.TO CONTAIN THE OUTBREAK, PUBLIC HEALTH OFFICIALS PRIORITIZED VACCINATION FOR POPULATIONS AT HIGHER RISK OF EXPOSURE, INCLUDING PEOPLE WHO HAVE NEW OR MULTIPLE SEXUAL PARTNERS; HEALTHCARE WORKERS AND LABORATORY PERSONNEL; AND PEOPLE WHO HAVE TRAVELED TO A COMMUNITY WHERE MPOX HAS BEEN IDENTIFIED.IN A STUDY PUBLISHED IN JAMA, BIDMC RESEARCHERS DEMONSTRATED THAT MPOX ANTIBODY LEVELS DECLINED RAPIDLY AND NEARLY RETURNED TO BASELINE SIX TO 12 MONTHS AFTER RECEIVING THE MPOX VACCINATION. THE FINDINGS SUGGEST THAT PROTECTIVE IMMUNITY MAY WANE IN PREVIOUSLY VACCINATED INDIVIDUALS AND THAT BOOSTING MAY BE REQUIRED TO MAINTAIN ROBUST PROTECTION."IT IS IMPORTANT TO ASSESS THE INFECTION RISK FOR INDIVIDUALS WHO WERE VACCINATED AGAINST THE DISEASE DURING THE 2022 OUTBREAK," SAID CORRESPONDING AUTHOR DAN H. BAROUCH, MD, PHD, DIRECTOR OF THE CENTER FOR VACCINE AND VIROLOGY RESEARCH AT BIDMC."OUR STUDY ALSO HIGHLIGHTS THE IMPORTANCE OF COMPLETING THE RECOMMENDED TWO-DOSE MPOX VACCINE, WHETHER SUBCUTANEOUS OR INTRADERMAL, TO BOOST IMMUNITY -- REGARDLESS OF THE TIME BETWEEN DOSES," SAID LEAD AUTHOR AI-RIS YONEKURA COLLIER, MD, CO-DIRECTOR OF THE CLINICAL TRIALS UNIT AT BIDMC. "IN THIS MPOX OUTBREAK, ENSURING BROAD ACCESS TO THE FULL VACCINE SERIES IS CRUCIAL." 10. INVESTIGATIONAL MRNA VACCINE PROTECTED MICE BETTER THAN THE CENTURY-OLD VACCINE -- LIMITING INFECTION AND SLOWING DISEASE SPREADTUBERCULOSIS, AN AIRBORNE BACTERIAL INFECTION, IS ONE OF HUMANITY'S OLDEST FOES AND TODAY THE WORLD'S TOP INFECTIOUS-DISEASE KILLER, CLAIMING 1.2 MILLION LIVES A YEAR. THE ONE AVAILABLE VACCINE PROTECTS YOUNG CHILDREN FROM SEVERE TB BUT DOES LITTLE TO STOP ITS SPREAD AMONG ADOLESCENTS AND ADULTS.NOW, BIDMC SCIENTISTS HAVE CREATED A NEW TB VACCINE CANDIDATE USING NEWLY IDENTIFIED ANTIGENS DELIVERED BY MRNA TECHNOLOGY -- THE SAME APPROACH BEHIND THE RAPID DEVELOPMENT OF COVID-19 VACCINES. THE TEAM, REPORTING IN CELL, PLANS CLINICAL TESTING IN ADULTS, A POTENTIAL ADVANCE IN TB PREVENTION FOR ALL AGE GROUPS."WE SYSTEMATICALLY EVALUATED MULTIPLE POTENTIAL TB VACCINE ANTIGENS TO DEVELOP A NOVEL TB VACCINE CANDIDATE," SAID CORRESPONDING AUTHOR DAN H. BAROUCH, MD, PHD, DIRECTOR OF THE CENTER FOR VIROLOGY AND VACCINE RESEARCH AT BIDMC, WHO CONTRIBUTED TO THE DEVELOPMENT OF JOHNSON & JOHNSON'S COVID-19 VACCINE. "WE USED THE MRNA PLATFORM THAT IS FLEXIBLE, SCALABLE, AND CAN COMBINE MULTIPLE ANTIGENS INTO ONE SHOT."TB LACKS AN OBVIOUS VACCINE TARGET. USING IMMUNE-RESPONSE DATA FROM PEOPLE EXPOSED TO TB, BAROUCH AND COLLEAGUES BUILT A SCREENING PIPELINE TO RANK CANDIDATE ANTIGENS BY IMMUNE RESPONSE, THEN SELECTED TOP CONTENDERS TO DESIGN A TRIVALENT VACCINE -- COMBINING THREE TB ANTIGENS -- TESTED IN AN ANIMAL MODEL."CHOOSING WHICH ANTIGENS TO TARGET IS A SIGNIFICANT CHALLENGE IN TB VACCINE DEVELOPMENT," SAID LEAD AUTHOR SAMUEL J. VIDAL, MD, PHD, A STAFF SCIENTIST IN THE BAROUCH LABORATORY AT BIDMC. "THE THREE ANTIGENS WE CHOSE HAVE NOT PREVIOUSLY BEEN EVALUATED IN CLINICAL TRIALS. OUR TRIVALENT MRNA VACCINE CONCEPT IMPROVED UPON THE CENTURY-OLD BCG SHOT IN ANIMAL MODELS -- IT REDUCED INFECTION RATES, REDUCED BACTERIAL SPREAD, AND LOWERED BACTERIAL LEVELS IN THE LUNGS."THE TRIVALENT VACCINE ANTIGENS ALSO TRIGGERED IMMUNE RESPONSES IN HUMANS EXPOSED TO TB, SUGGESTING THE APPROACH COULD WORK IN PEOPLE."TAKEN TOGETHER, OUR FINDINGS OPEN THE DOOR TO A NEW VACCINE CANDIDATE FOR TB," SAID BAROUCH, WHO IS ALSO A PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL. "WE'RE EXCITED TO BE MOVING THIS NOVEL TB VACCINE CANDIDATE TOWARD CLINICAL TRIALS."RESEARCH AT JOSLIN DIABETES CENTERTHE JOSLIN DIABETES CENTER (JDC), IN CONJUNCTION WITH ITS AFFILIATE THE JOSLIN CLINIC, PROVIDES WORLD CLASS LEADING EDGE PATIENT CARE IN THE SPECIALTY AREA OF DIABETES AND CARING FOR PATIENTS THROUGH A RELENTLESS TEAM OF CLINICIANS, SKILLED HEALTH EDUCATORS, AND ACCESS TO PIONEERING DIABETES RESEARCH. JOSLIN IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND OFFERS A RICH EDUCATIONAL ENVIRONMENT INVOLVING COURSES, LECTURES, FELLOWSHIP OPPORTUNITIES AND CME COURSES. JDC ALSO PROVIDES INFRASTRUCTURE, MANAGEMENT AND SUPPORT SERVICES TO ITS AFFILIATE, THE JOSLIN CLINIC. IN ADDITION, JOSLIN'S MISSION IS NOT ONLY TO PROVIDE OUTSTANDING PATIENT CARE, BUT ALSO TO BRING BEST PRACTICES TO THE LARGER MEDICAL COMMUNITY. JOSLIN ENGAGES IN RESEARCH RELATED TO BETTER UNDERSTANDING DIABETES, HOW TO TREAT IT AND HOW TO HELP PATIENTS MANAGE AND LIVE HEALTHIER LIVES WITH THE DISEASE. JOSLIN DIABETES RESEARCH CENTER IS ONE OF ONLY 16 NIH-DESIGNATED DIABETES RESEARCH CENTERS IN THE UNITED STATES. JOSLIN'S RESEARCH TEAM IS WORLD-RENOWNED AND PASSIONATE ABOUT IMPROVING THE LIVES OF PEOPLE WITH DIABETESMILLIONS OF PEOPLE WITH DIABETES THROUGHOUT THE WORLD BENEFIT DIRECTLY FROM BASIC AND CLINICAL RESEARCH CONDUCTED AT THE CENTER. APPROXIMATELY 300 RESEARCHERS EMPLOYED AT THE JOSLIN DIABETES CENTER ARE WORKING ON VARIOUS ASPECTS OF DIABETES, SEARCHING FOR WAYS TO PREVENT AND TREAT DIABETES IN ALL ITS FORMS AND ULTIMATELY FIND A CURE FOR THE DISEASE.THE RESEARCH ENGAGED IN AT JDC HELPS IMPROVES THE LIVES AT JDC, ACROSS BILH AND IN THE WIDER COMMUNITY BEYOND EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE COMMUNITIES. AS NOTED ABOVE RELATED TO BIDMC, ALTHOUGH JOSLIN'S RESEARCH ACTIVITIES ARE NOT QUANTIFIED HERE IN THIS HOSPITAL'S FORM 990 SCHEDULE H, PART I, 7H, AS ALREADY NOTED, THESE ACTIVITIES ARE IMPORTANT TO THE COMMUNITIES SERVED BY THIS HOSPITAL, ALL OF BILH AND BEYOND. SOME EXAMPLES OF RESEARCH ENGAGED IN BY JOSLIN DURING THE PERIOD COVERED BY THIS FILING ARE BELOW. BRAIN INSULIN SIGNALING IMPACT ON DIABETES AND NEUROLOGICAL DISORDERSA STUDY FROM JOSLIN DIABETES CENTER EXPLORES THE ROLE OF INSULIN SIGNALING IN THE BRAIN'S IMMUNE CELLS, AND HOW IT MAY MEDIATE THE RELATIONSHIP BETWEEN TYPE 2 DIABETES AND ALZHEIMER'S DISEASE (AD). THE FINDINGS, PUBLISHED IN PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES, COULD HELP IDENTIFY POTENTIAL TARGETS TO TREAT DIABETES PATIENTS WITH AD."TYPE 2 DIABETES, OBESITY, AND METABOLIC SYNDROME ARE MAJOR CAUSES OF ILLNESS AND DEATH WORLDWIDE, AND INSULIN RESISTANCE, ESPECIALLY BRAIN INSULIN RESISTANCE, FEATURES PROMINENTLY IN ALL THESE CONDITIONS," SAID LEAD AUTHOR WENQIANG CHEN, PHD, INSTRUCTOR OF MEDICINE AT JOSLIN DIABETES CENTER. "A GROWING BODY OF EVIDENCE LINKS INSULIN RESISTANCE WITH INCREASED RISKS OF BRAIN DISORDERS, INCLUDING AD AND DEPRESSION, BUT EXACTLY HOW BRAIN INSULIN RESISTANCE LINKS TO THESE DISEASES REMAINS INCOMPLETELY UNDERSTOOD."TO BETTER UNDERSTAND INSULIN'S ROLE IN THE BRAIN, CHEN AND COLLEAGUES IN THE LAB OF RONALD KAHN, MD, CREATED A MOUSE MODEL IN WHICH THEY COULD "TURN OFF" INSULIN RECEPTORS IN CERTAIN BRAIN CELLS. THESE "KNOCKOUT MICE" GAVE THE SCIENTISTS A PRECISE TOOL TO STUDY HOW SPECIFIC BRAIN CELLS BEHAVE WITHOUT INSULIN'S INFLUENCE.THE JOSLIN INVESTIGATORS LOOKED SPECIFICALLY AT MICROGLIA--THE BRAIN'S RESIDENT IMMUNE CELLS. MOST IMPORTANTLY IN THE CONTEXT OF ALZHEIMER'S, THEY HELP CLEAR AWAY AMYLOID-BETA (A), A STICKY PROTEIN THAT CAN BUILD UP TO FORM THE DAMAGING PLAQUES IN THE BRAIN.THEIR FINDINGS:- MICE WITHOUT INSULIN SIGNALING IN MICROGLIA SHOWED DEPRESSIVE-LIKE BEHAVIORS AND ALTERED SOCIAL INTERACTION- WHEN THESE MICE WERE CROSSED WITH A WIDELY USED ALZHEIMER'S DISEASE MODEL, THE RESULTANT MICE DEVELOPED MORE SEVERE DISEASE- IN THE TEAM'S CELLULAR MODEL OF MICROGLIA LACKING INSULIN RECEPTORS, THE CELLS SHIFTED TO A LESS EFFICIENT WAY OF PRODUCING ENERGY AND BECAME LESS EFFECTIVE AT CLEARING AMYLOID-BETA."OUR FINDINGS POINT TO THE IMPORTANCE OF UNDERSTANDING A CELL TYPE SPECIFIC REGULATION OF INSULIN ACTION AND INSULIN RESISTANCE IN BRAIN HOMEOSTASIS AND DISEASE PATHOGENESIS," SAID SENIOR AUTHOR KAHN, WHO IS ALSO JOSLIN'S CHIEF ACADEMIC OFFICER. "THESE INSIGHTS WILL HELP IDENTIFY THE CELLULAR AND MOLECULAR MECHANISMS UNDERLYING THE LINK BETWEEN TYPE 2 DIABETES AND BRAIN DISORDERS, THUS BRINGING THE POTENTIAL FOR BETTER THERAPEUTICS FOR PATIENTS WITH THESE COMORBID CONDITIONS."JOSLIN SCIENTISTS UNCOVER CLUES TO MYSTERIOUS POST-BARIATRIC COMPLICATIONJOSLIN DIABETES CENTER RESEARCHERS HAVE IDENTIFIED METABOLIC CHANGES THAT MAY EXPLAIN WHY NEARLY 30 PERCENT OF PATIENTS WHO UNDERGO WEIGHT LOSS SURGERY DEVELOP POST-BARIATRIC HYPOGLYCEMIA (PBH). THIS SERIOUS CONDITION OCCURS WHEN THE BODY OVERPRODUCES INSULIN AFTER MEALS, CAUSING DANGEROUS BLOOD SUGAR CRASHES THAT CAN LEAD TO CONFUSION, FAINTING, AND SEIZURES."WHILE SOME PATIENTS CAN MANAGE PBH WITH DIET AND MEDICATION, SEVERE CASES DON'T ALWAYS RESPOND TO TREATMENT--OR EVEN TO REVERSING THE SURGERY," SAID CO-CORRESPONDING AUTHOR MARY-ELIZABETH PATTI, MD, DIRECTOR OF JOSLIN'S HYPOGLYCEMIA CLINIC. "THAT'S WHY FINDING TREATMENT OPTIONS IS SO IMPORTANT."BARIATRIC SURGERIES, SUCH AS GASTRIC BYPASS AND SLEEVE GASTRECTOMY, ARE POWERFUL TOOLS FOR TREATING TYPE 2 DIABETES (T2D), A CONDITION THAT AFFECTS MORE THAN 500 MILLION PEOPLE WORLDWIDE AND INCREASES THE RISK OF HEART DISEASE, KIDNEY FAILURE, AND NERVE DAMAGE. IN SOME INDIVIDUALS, GLUCOSE LEVELS CAN DROP TO LEVELS BELOW NORMAL, OR HYPOGLYCEMIA.IN PREVIOUS STUDIES, PATTI AND COLLEAGUES FOUND THAT PATIENTS WITH PBH HAD SIGNIFICANTLY HIGHER LEVELS OF A HORMONE CALLED FGF19 COMPARED TO POST-SURGICAL INDIVIDUALS WITHOUT HYPOGLYCEMIA. PEOPLE WITH OBESITY TEND TO HAVE LOWER LEVELS OF THIS HORMONE, BUT AFTER BARIATRIC SURGERY, ITS LEVELS RISE--SOMETIMES TOO MUCH.TO UNDERSTAND WHAT TRIGGERS THIS SPIKE IN FGF19, PATTI'S TEAM, WORKING WITH THE LABORATORY OF CO-CORRESPONDING AUTHOR SLOAN DEVLIN, ANALYZED BILE ACIDS--DIGESTIVE COMPOUNDS THAT HELP BREAK DOWN FATS. COMPARING SAMPLES FROM PATIENTS WITH PBH AND INDIVIDUALS WITHOUT THE CONDITION, THEY FOUND DISTINCT DIFFERENCES IN BILE ACID COMPOSITION, SUGGESTING THESE DIFFERENCES MAY BE RESPONSIBLE FOR THE EXCESSIVE INSULIN RESPONSE AND HYPOGLYCEMIA AFTER MEALS. THROUGH A SERIES OF EXPERIMENTS, THE RESEARCHERS MAPPED OUT THE METABOLIC STEPS LIKELY DRIVING PBH. BY IDENTIFYING SPECIFIC PROTEINS INVOLVED IN THE PROCESS, THEY UNCOVERED A POTENTIAL TREATMENT STRATEGY: BLOCKING A TRANSPORTER IN THE GUT RESPONSIBLE FOR SHUTTLING BILE ACIDS FROM INTESTINES INTO BLOOD. BY INHIBITING THIS TRANSPORTER IN MICE, THE RESEARCHERS WERE ABLE TO REDUCE THE BLOOD SUGAR DROP THAT HAPPENS AFTER A MEAL. MORE BROADLY, THIS WORK MAY HAVE IMPLICATIONS FOR PATIENTS STRUGGLING WITH HYPOGLYCEMIA IN OTHER CONTEXTS. THE FINDINGS APPEARED IN NATURE METABOLISM.FIRST-OF-ITS KIND STUDY COMPREHENSIVELY CHARACTERIZED COGNITIVE FUNCTION AND BRAIN PATHOLOGY IN AGING PEOPLE WITH T1DINVESTIGATORS AT JOSLIN DIABETES CENTER HAVE CONDUCTED THE FIRST COMPREHENSIVE CLINICAL CHARACTERIZATION OF COGNITIVE DECLINE IN PEOPLE WITH LONG-DURATION TYPE 1 DIABETES (T1D). PUBLISHED IN JCI INSIGHT, THE STUDY HELPS ANSWER QUESTIONS ABOUT THIS UNDERSTUDIED POPULATION AND HINTS THAT PRESERVING EYESIGHT MAY HELP PREVENT COGNITIVE DECLINE IN PEOPLE WITH T1D."COGNITIVE DYSFUNCTION IS RECOGNIZED AS A POTENTIAL COMPLICATION ASSOCIATED WITH DIABETES, BUT STUDIES HAVE MOSTLY FOCUSED ON TYPE 2 DIABETES OR YOUNGER TYPE 1 POPULATIONS," SAID CORRESPONDING AUTHOR GEORGE KING, CHIEF SCIENTIFIC OFFICER, JOSLIN DIABETES CENTER."DETAILED CLINICAL CHARACTERIZATION OF COGNITIVE DYSFUNCTION IN A LARGE COHORT OF PEOPLE WITH A LONG HISTORY OF LIVING WITH T1D HAS BEEN LIMITED GIVEN THAT LIVING LONGER THAN 55 YEARS WITH THE DISEASE HAS ONLY RECENTLY BECOME POSSIBLE," SAID CO-CORRESPONDING AUTHOR HETAL SHAH, JOSLIN DIABETES CENTER.ENTER THE MEDALISTS: SINCE 1970, JOSLIN HAS AWARDED MEDALS TO MORE THAN 7,000 PEOPLE, KNOWN AS THE MEDALISTS, FOR LIVING WITH THE CONDITION FOR 50 YEARS.KING AND COLLEAGUES RECRUITED MORE THAN 1,000 MEDALISTS WITH TYPE 1 DIABETES. PARTICIPANTS HAD A MEAN AGE OF 66 YEARS AND HAD BEEN LIVING WITH T1D AN AVERAGE OF 53 YEARS.BUT WHEN SHAH, KING AND COLLEAGUES ASSESSED THEIR COGNITIVE FUNCTION AND CONDUCTED BRAIN AND RETINAL IMAGING, THEY FOUND THE MEDALISTS PERFORMED WORSE THAN PEOPLE WITHOUT DIABETES IN MANY CATEGORIES, INCLUDING RECALL AND PSYCHOMOTOR CONTROL. NEUROIMAGING REVEALED THE MEDALISTS HAD LOWER TOTAL BRAIN VOLUME, EQUIVALENT TO NINE YEARS ACCELERATED AGING, THE RESEARCHERS CALCULATED.RETINAL IMAGING REVEALED THAT WORSE COGNITIVE FUNCTION, LOWER BRAIN VOLUMES, AND DIABETIC RETINOPATHY WERE LINKED WITH THE THINNING OF RETINAL TISSUES. TOGETHER, THESE FINDINGS SUGGEST THAT MAINTAINING EYESIGHT COULD BE ONE WAY TO MODIFY THE COURSE OF COGNITIVE DECLINE IN THIS POPULATION."OUR FINDINGS ARE VERY DIFFERENT FROM THOSE REPORTED FOR PEOPLE WITH TYPE 2 DIABETES," SAID KING. "THIS LINK BETWEEN BETTER VISUAL ACUITY AND THE PRESERVATION OF COGNITIVE FUNCTION AND HIGHER BRAIN VOLUMES IS NOVEL AND SUGGESTS A POTENTIAL THERAPEUTIC APPROACH TO PREVENT COGNITIVE DECLINE IN T1D THAT MAY EVEN BE APPLICABLE BEYOND THIS POPULATION TO AGE-RELATED DEMENTIA," SAID SHAH.STUDY EXPLORES INSTAGRAM'S ROLE IN SUPPORTING YOUNG ADULTS LIVING WITH TYPE 1 DIABETESFOR MANY 18- TO 25-YEAR-OLDS WITH TYPE 1 DIABETES (T1D), MANAGING THEIR CONDITION DURING A TIME OF LIFE ALREADY MARKED BY CHANGE AND STRESS POSES A SIGNIFICANT CHALLENGE. FOR THESE SAME YOUNG ADULTS, SOCIAL MEDIA IS A DAILY HABIT, AND A POTENTIAL SOURCE OF SUPPORT. A QUALITATIVE STUDY PUBLISHED IN JMIR DIABETES EXPLORES HOW INSTAGRAM POSTS FOCUSED ON DIABETES MAY AFFECT YOUNG PEOPLE'S SELF-CARE BEHAVIORS AND EMOTIONAL WELL-BEING."OUR RESULTS DEMONSTRATE THAT SOCIAL MEDIA HAS THE POTENTIAL TO PROVIDE SUPPORT TO YOUNG PEOPLE WITH T1D AS WELL AS IMPACT THEIR WELL-BEING BY FOSTERING A SENSE OF COMMUNITY AND INCREASING ACCESS TO INFORMATION ABOUT DIABETES," SAID LEAD AUTHOR TARA MAXWELL, MD, MSHP, FORMERLY AT JOSLIN DIABETES CENTER. "WE ALSO DESCRIBE THE POTENTIAL NEGATIVE EFFECTS OF SOCIAL MEDIA ON DIABETES, SELF-MANAGEMENT, AND EMOTIONAL STATE."IN ONE-ON-ONE VIDEO INTERVIEWS, PARTICIPANTS REACTED TO A CURATED SET OF 10 INSTAGRAM POSTS REFLECTING COMMON DIABETES THEMES. POSTS WERE VIEWED MORE POSITIVELY WHEN THEY WERE MEDICALLY ACCURATE, EMOTIONALLY RELATABLE, AND VISUALLY APPEALING. BUT CONTENT THAT DRAMATIZED THE CONDITION OR IDEALIZED LIFE WITH T1D SOMETIMES UNDERMINED SELF-CARE OR WORSENED EMOTIONAL WELL-BEING.TO BETTER UNDERSTAND HOW SOCIAL MEDIA INFLUENCES PEOPLE WITH T1D, MAXWELL AND COLLEAGUES, INCLUDING SENIOR AUTHOR LORI LAFFEL, MD, MPH, RECRUITED 26 YOUNG ADULTS WHO RECEIVED REGULAR CARE AT JOSLIN AND HAD LIVED WITH T1D FOR AT LEAST A YEAR. WHILE ALL REPORTED DAILY SOCIAL MEDIA USE, MOST SAID THEY ONLY OCCASIONALLY VIEWED DIABETES-RELATED CONTENT AND RARELY POSTED ABOUT THEIR CONDITION THEMSELVES.THE RESEARCHERS ASKED PARTICIPANTS TO DESCRIBE HOW EACH POST MADE THEM FEEL, WHAT IT EMPHASIZED, AND HOW IT MIGHT INFLUENCE THEIR SELF-CARE. SOCIAL MEDIA SERVED TO HIGHLIGHT THE EXISTENCE OF A COMMUNITY OF PEOPLE WITH T1D; PROVIDE DIABETES INFORMATION; POTENTIALLY REINFORCE GOOD HABITS; AND INFLUENCE EMOTIONAL STATE, FOR BETTER OR FOR WORSE."SOCIAL MEDIA MAY NOT NECESSARILY BE GOOD OR BAD FOR YOUNG PEOPLE WITH T1D," SAID LAFFEL. "IT HAS THE POTENTIAL TO FOSTER COMMUNITY, SPARK REFLECTION, SUPPORT SELF-CARE, AND POSITIVELY AFFECT EMOTIONAL WELL-BEING. WITH THOUGHTFUL DESIGN AND MEANINGFUL ENGAGEMENT, SOCIAL MEDIA COULD BE A POWERFUL TOOL FOR IMPROVING OUTCOMES IN THIS POPULATION."CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS HEALTH PROFESSIONS EDUCATIONMOUNT AUBURN HOSPITAL'S (MAH) CENTRAL LONGSTANDING ACADEMIC FOCUS IS MEDICAL EDUCATION THROUGH A COMMITMENT TO TEACHING STUDENTS AND TRAINEES IN A RESPECTFUL AND COLLABORATIVE ACADEMIC ENVIRONMENT. THIS COMMITMENT, COUPLED WITH THE INSTITUTION'S WILLINGNESS TO EMBRACE TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION, MAKE MAH A TOP CHOICE AMONG STUDENTS AND TRAINEES IN THE HEALTH CARE PROFESSIONS. THE HOSPITAL TRAINS MEDICAL STUDENTS, INTERNS, NURSE MIDWIFERY STUDENTS, MEDICAL RESIDENTS AND FELLOWS, ALONG WITH OTHER ALLIED HEALTH PROFESSIONALS FROM ACROSS THE AREA.MAH SPONSORS SEVERAL RESIDENCY PROGRAMS, WITH 52 INTERNAL MEDICINE RESIDENTS, 12 RADIOLOGY RESIDENTS, AND 6 PODIATRY RESIDENTS DURING MAH'S ACADEMIC YEAR JULY 1, 2024 JUNE 30, 2025 WHICH OVERLAPS WITH A PORTION OF MAH'S FISCAL YEAR ACTIVITIES REPORTED IN THIS FILING. THE HOSPITAL ALSO HOSTS ROTATING TRAINEES IN GENERAL SURGERY, EMERGENCY MEDICINE, UROLOGY, UROGYNECOLOGY AND OBSTETRICS AND GYNECOLOGY, AND SUPPORTS THE EDUCATION OF MEDICAL STUDENTS FROM HARVARD MEDICAL SCHOOL, AND THE BOSTON UNIVERSITY SCHOOL OF MEDICINE. FINALLY, THE HOSPITAL SERVES AS A TRAINING SITE FOR PHARMACY STUDENTS FROM THE MASSACHUSETTS COLLEGE OF PHARMACY, PHYSICIAN'S ASSISTANT STUDENTS FROM NORTHEASTERN UNIVERSITY, CLINICAL NURSE ANESTHETISTS FROM BOSTON COLLEGE, AND CLINICAL NURSE MIDWIVES FROM MULTIPLE PROGRAMS ACROSS THE EAST COAST. STAFF PHYSICIANS AT MAH WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL OR BOSTON UNIVERSITY INSTRUCT PHYSICIAN TRAINEES THROUGH SUPERVISION OF DAILY PATIENT CARE AND A RANGE OF INTERACTIVE EDUCATIONAL EXPERIENCES. AS PART OF THE HOSPITAL'S COMMITMENT TO MEDICAL STUDENT EDUCATION AND LONGSTANDING AFFILIATION WITH HARVARD MEDICAL SCHOOL, MAH IS A CORE SITE FOR THE HARVARD MEDICAL SCHOOL SUB-INTERNSHIP IN MEDICINE. THE HOSPITAL ALSO PARTICIPATES IN THE INTRODUCTORY COURSES IN CLINICAL MEDICINE FOR PRE-CLINICAL HARVARD MEDICAL SCHOOL STUDENTS, AS WELL AS IMMERSIVE TRAINING IN CLINICAL MEDICINE FOR BIOMEDICAL DOCTORAL STUDENTS FROM THE JOINT HARVARD MEDICAL SCHOOL / MASSACHUSETTS INSTITUTE OF TECHNOLOGY'S HEALTH SCIENCES AND TECHNOLOGY PROGRAM. IN ADDITION, THE HOSPITAL HOSTS THIRD-YEAR MEDICAL STUDENTS FROM THE BOSTON UNIVERSITY SCHOOL OF MEDICINE ON THE OBSTETRICS AND NEUROLOGY SERVICES, AS WELL AS MEDICAL STUDENTS FROM HARVARD AND OTHER SCHOOLS WHO CHOOSE TO DO SUB-INTERNSHIPS AND SUBSPECIALTY ELECTIVES DURING THEIR THIRD AND FOURTH YEARS. THE MAH INTERNAL MEDICINE TRAINING PROGRAM THE LARGEST OF ALL MAH RESIDENCIES, OFFERS A THREE-YEAR CATEGORICAL MEDICINE TRACK AND A ONE-YEAR PRELIMINARY MEDICINE TRACK. THE RESIDENCY CELEBRATED ITS 50TH ANNIVERSARY IN 2024 WHICH ATTESTS TO THE LONGSTANDING COMMITMENT TO MEDICAL EDUCATION AT MAH. THE THREE-YEAR CATEGORICAL TRACK PREPARES RESIDENTS FOR CERTIFICATION BY THE AMERICAN BOARD OF INTERNAL MEDICINE AND CAREERS THAT COVER THE FULL SPECTRUM OF OPPORTUNITIES IN BOTH GENERAL INTERNAL MEDICINE AND THE MEDICAL SUB-SPECIALTIES. RESIDENTS CAN TAILOR THEIR 36 MONTHS OF TRAINING TO OBTAIN THE KNOWLEDGE, SKILLS, AND INSIGHT REQUIRED TO PURSUE SUBSEQUENT CAREERS IN PRIMARY CARE OR HOSPITALIST MEDICINE. IN ADDITION, THEY ARE PREPARED TO CONTINUE THEIR TRAINING IN COMPETITIVE SUB-SPECIALTY FELLOWSHIP TRAINING PROGRAMS ACROSS THE COUNTRY. MAH SUPPORTS TRAINEES IN THEIR INTENDED CAREER GOALS THROUGH THE USE OF DEFINED PATHWAYS. THESE PATHWAYS, IN PRIMARY CARE, HOSPITALIST MEDICINE, OR SUB-SPECIALTY MEDICINE, OUTLINE THE MILESTONES THAT THE TRAINEE SHOULD MEET THROUGHOUT THE COURSE OF TRAINING. THE PRELIMINARY MEDICINE INTERNSHIP TRACK OFFERS ONE YEAR OF TRAINING IN MEDICINE FOR PHYSICIANS WHO WILL CONTINUE THEIR TRAINING IN SPECIALTIES OTHER THAN INTERNAL MEDICINE, SUCH AS RADIOLOGY, OPHTHALMOLOGY, ANESTHESIOLOGY, RADIATION ONCOLOGY, NEUROLOGY, DERMATOLOGY, PHYSICAL MEDICINE & REHABILITATION, AND OTHERS. THIS PROGRAM IS HIGHLY SOUGHT AFTER BY TOP MEDICAL STUDENTS AROUND THE COUNTRY GIVEN THE RIGOR OF THE TRAINING. ALL INTERNAL MEDICINE TRAINEES ARE APPOINTED AS CLINICAL FELLOWS AT HARVARD MEDICAL SCHOOL. GRADUATES HAVE PURSUED CAREERS IN BOTH ACADEMIA AND PRIVATE PRACTICE.THE MAH RADIOLOGY RESIDENCY PROGRAM WAS ESTABLISHED IN 1947 AND HAS A LONGSTANDING HISTORY AS A COMPETITIVE TRAINING PROGRAM. RESIDENTS ARE TYPICALLY ASSIGNED IN ONE-MONTH BLOCKS TO ONE OF THE DIFFERENT IMAGING MODALITIES. EARLY IN TRAINING, RESIDENTS ARE EXPECTED TO READ EXTENSIVELY, MASTER ANATOMY, PARTICIPATE IN THE PROTOCOLLING AND INTERPRETATION OF PATIENT EXAMINATIONS, AND TO PARTICIPATE IN DISCUSSIONS CONCERNING DIAGNOSTIC PROBLEMS. RESIDENTS ADVANCE TO INCREASED LEVELS OF RESPONSIBILITY WITH APPROPRIATE SUPERVISION. THREE RESIDENTS ARE CHOSEN EACH YEAR FOR A FOUR-YEAR PROGRAM, AND ARE APPOINTED AS CLINICAL FELLOWS AT HARVARD MEDICAL SCHOOL. THE HIGH RATIO OF STAFF RADIOLOGISTS TO RESIDENTS RESULTS IN OPTIMAL MENTORSHIP BETWEEN THE ATTENDINGS AND RESIDENTS THROUGHOUT THE TRAINING PROGRAM. AFTER THE RESIDENT HAS OBTAINED THE NECESSARY FIRM FOUNDATIONS IN THE FUNDAMENTALS OF RADIOLOGY, THEY ARE ENCOURAGED TO TAKE INCREASING RESPONSIBILITY IN BOTH ROUTINE AND SPECIALIZED EXAMINATIONS AND PROCEDURES. THE MAJORITY OF OUR RESIDENTS PURSUE SUBSPECIALTY FELLOWSHIP TRAINING; HOWEVER, THE GOAL OF THE RADIOLOGY RESIDENCY PROGRAM IS TO TRAIN RESIDENTS TO BE FULLY QUALIFIED IN DIAGNOSTIC RADIOLOGY AND SPECIAL PROCEDURES BY THE TIME THEY HAVE COMPLETED THE FOUR-YEAR PROGRAM. GRADUATES HAVE PURSUED CAREERS IN BOTH ACADEMIA AND PRIVATE PRACTICE.IN ADDITION TO THE INTERNAL MEDICINE AND RADIOLOGY TRAINING PROGRAMS, MOUNT AUBURN HOSPITAL HAS A NATIONALLY RECOGNIZED THREE-YEAR TRAINING PROGRAM IN PODIATRY WITH TWO RESIDENTS PER YEAR THAT TRAINS PODIATRIC RESIDENTS IN FULL SPECTRUM SURGICAL PODIATRIC TRAINING. ADDITIONALLY, MAH IS A SITE FOR OTHER POST-GRADUATE MEDICAL EDUCATION DISCIPLINES INCLUDING NURSE PRACTITIONERS, PHYSICIAN ASSISTANTS AND CERTIFIED NURSE MIDWIVES. MAH IS ALSO A CORE SITE FOR THE BETH ISRAEL DEACONESS MEDICAL CENTER GENERAL SURGERY RESIDENCY PROGRAM, OBSTETRICS-GYNECOLOGY RESIDENCY PROGRAM AND THE EMERGENCY MEDICINE RESIDENCY PROGRAM. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $22,965,904 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO MAH'S RESIDENCY PROGRAM AND TO TEACHING OTHER STUDENTS RELATED TO ALLIED HEALTH PROFESSIONS WHICH REPRESENTED 6.15 % OF MAH'S TOTAL EXPENSES.IRC 501(R) REPORTING UNDER REVENUE PROCEDURE 2015-21 AND REG. 1.501(R)-2(B) DURING A REVIEW OF MOUNT AUBURN HOSPITAL'S IRC SECTION 501(R) COMPLIANCE IN FY25, IT WAS DETERMINED THAT (1) HOSPITAL WAS NOT CONSISTENTLY OFFERING A COPY OF ITS FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY (PLS) AS PART OF PATIENT INTAKE OR DISCHARGE, (2) THAT HOSPITAL DID NOT MAKE PAPER COPIES OF THE FINANCIAL ASSISTANCE POLICY (FAP), FAP APPLICATION FORM AND PLS AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH BY MAIL AND IN PUBLIC LOCATIONS IN THE HOSPITAL, AND (3) THAT HOSPITAL HAD NOT BEEN TAKING ACTIONS TO NOTIFY AND INFORM MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL ABOUT THE FAP IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. THE HOSPITAL HAS WORKED AND IS CONTINUING TO WORK ON TRAINING ITS INTAKE AND DISCHARGE TEAMS TO ENSURE THAT A COPY OF THE PLS IS OFFERED AND THAT FREE PAPER COPIES OF ITS FAP, FAP APPLICATION AND PLS ARE MADE AVAILABLE BY MAIL AND IN THE HOSPITAL. LASTLY, THE HOSPITAL HAS HISTORICALLY WORKED TO ENSURE THAT COPIES OF ITS PLS AND FAP APPLICATION ARE DISTRIBUTED TO LOCATIONS IN THE COMMUNITY SUCH AS STAFF PHYSICIANS' OFFICES, COMMUNITY HEALTH CENTERS AND OTHER NONPROFITS IN THE COMMUNITY AND IS TAKING ACTION TO ENSURE THAT THOSE HISTORIC EFFORTS ARE RENEWED. THE HOSPITAL IS NOT AWARE OF ANY PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE THAT WERE ADVERSELY AFFECTED BY THE ABOVE. HOSPITAL HAS ADOPTED PROCEDURES THAT REQUIRE IT TO REVIEW, ON A REGULAR BASIS, ITS POLICIES AND PROCEDURE TO ENSURE COMPLIANCE WITH THE REQUIREMENTS OF SECTION 501(R) AND THE REGULATIONS ISSUED THEREUNDER. THOSE PROCEDURES INCLUDE REVIEWING A SECTION 501(R) COMPLIANCE CHECKLIST.ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)OPEN MEDICAL STAFFTHE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND AS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. COMMUNITY BOARDAS NOTED IN THIS FORM 990 PARTS I AND VI, THE MAJORITY OF BOARD MEMBERS ARE INDEPENDENT COMMUNITY MEMBERS. AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, MOUNT AUBURN HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. AS NOTED IN VARIOUS NARRATIVE DISCLOSURES THAT SUPPORT THIS FORM 990 AND RELATED SCHEDULES FOR THE PERIOD COVERED BY THIS FILING, BILH IS A MASSACHUSETTS NON-PROFIT CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. BETH ISRAEL LAHEY HEALTH'S (BILH) MISSION IS TO SUPPORT ITS AFFILIATES AND THOSE AFFILIATES' MISSIONS TO IMPROVE THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. BILH STRIVES TO ACCOMPLISH THIS MISSION BY PROVIDING SERVICES TO ITS AFFILIATES WHICH SUPPORT THE DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO ACCESS SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE.BETH ISRAEL LAHEY HEALTH (BILH) IS THE PARENT AND A SUPPORT ORGANIZATION OF THE BILH NETWORK OF AFFILIATES. THE NETWORK COMPRISES AN INTEGRATED HEALTH CARE DELIVERY SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM INCLUDES ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS AND ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,900 PHYSICIANS AND 39,000 EMPLOYEES.THE BILH PURPOSE STATEMENT ARTICULATES THE IMPACT THAT EACH BILH AFFILIATE STRIVES TO MAKE IN THE COMMUNITIES SERVED. THESE SHARED VALUES GUIDE EACH ENTITY'S DAILY EFFORTS AND KEEP EACH AFFILIATE ALIGNED IN THE PURSUIT OF THE BILH PURPOSE, SHOWING HOW "WE CARE" FOR PATIENTS, EACH OTHER AND THE COMMUNITIES SERVED.PURPOSE STATEMENT: BILH CREATES HEALTHIER COMMUNITIES - ONE PERSON AT A TIME - THROUGH SEAMLESS CARE AND GROUND-BREAKING SCIENCE, DRIVEN BY EXCELLENCE, INNOVATION AND EQUITY.BILH WE CARE VALUES:WELLBEING. WE PROVIDE A HEALTH-FOCUSED WORKPLACE AND SUPPORT A HEALTHY WORK-LIFE BALANCE.EMPATHY. WE DO OUR BEST TO UNDERSTAND OTHERS' FEELINGS, NEEDS AND PERSPECTIVES.COLLABORATION. WE WORK TOGETHER TO ACHIEVE EXTRAORDINARY RESULTS.ACCOUNTABILITY. WE HOLD OURSELVES AND EACH OTHER TO BEHAVIORS NECESSARY TO ACHIEVE OUR COLLECTIVE GOALS.RESPECT. WE VALUE DIVERSITY AND TREAT ALL MEMBERS OF OUR COMMUNITY WITH DIGNITY AND INCLUSIVENESS. EQUITY EVERYONE HAS THE OPPORTUNITY TO ATTAIN THEIR FULL POTENTIAL IN OUR WORKPLACE AND THROUGH THE CARE WE PROVIDE.BILH IS ACCOMPLISHING THIS MISSION BY PROVIDING SUPPORT TO ITS AFFILIATES WHICH INCLUDE:1. A PHYSICIAN ENTERPRISE THAT ENCOMPASSES THE SYSTEM'S NETWORK OF EMPLOYED PRIMARY CARE AND SPECIALTY PHYSICIANS LOCATED THROUGHOUT OUR REGION;2. A HOSPITAL AND AMBULATORY SERVICES GROUP THAT INCLUDES WORLD-CLASS ACADEMIC MEDICAL CENTERS AND TEACHING HOSPITALS WITH AFFILIATIONS WITH HARVARD MEDICAL SCHOOL, THE UNIVERSITY OF MASSACHUSETTS CHAN MEDICAL SCHOOL AND TUFTS UNIVERSITY SCHOOL OF MEDICINE; LEADING COMMUNITY HOSPITALS; A RENOWNED ORTHOPEDICS HOSPITAL; AND COMPREHENSIVE AMBULATORY CENTERS;3. A POPULATION HEALTH ENTERPRISE THAT EMBRACES A MODEL OF CARE TO IMPROVE THE HEALTH OF ALL THOSE SERVED BY BILH; THE POPULATION HEALTH DOMAIN INCLUDES THE SYSTEM'S CLINICALLY INTEGRATED NETWORK OF AFFILIATED PROVIDERS AND VITAL SERVICES, INCLUDING BEHAVIORAL HEALTH AND HOME CARE SERVICES; 4. A ROBUST NETWORK OF ADMINISTRATIVE AND OPERATIONAL SERVICES TO ADVANCE STRATEGIC GOALS, BOTH LOCALLY AND AT THE SYSTEM LEVEL, THAT OFFERS EXPERTISE AND STANDARDIZED RESOURCES BASED ON BEST PRACTICES.DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI) AND BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS, EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND LHSS IN TURN SERVED AS THE SOLE MEMBER OF THE ENTITIES WHICH COMPRISE, AMONG OTHER OPERATIONS, BETH ISRAEL LAHEY HEALTH CONTINUING CARE AND BETH ISRAEL LAHEY HEALTH MEDICAL GROUP. TO ACCOMPLISH ITS MISSION, BILH PROVIDES CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS. BILH SUPPORT INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING SERVICES: EXECUTIVE MANAGEMENT AND OPERATIONAL LEADERSHIP, STRATEGIC PLANNING, HUMAN RESOURCES AND BENEFIT PLAN STRUCTURING, DEVELOPMENT AND FUNDRAISING, COMPLIANCE, GOVERNANCE AND LEGAL, PAYOR CONTRACTING, REVENUE CYCLE MANAGEMENT, FINANCIAL PLANNING & ANALYSIS, CAPITAL PLANNING, FINANCE AND ACCOUNTING INCLUDING PROCESSING PAYROLL AND ACCOUNTS PAYABLE, INTERNAL AND EXTERNAL AUDIT, INSURANCE, DEBT STRUCTURING SUPPORT AND FINANCING OF CAPITAL PROJECTS THROUGH ITS OBLIGATED GROUP DEBT, TAX SERVICES, INVESTMENT MANAGEMENT SERVICES, SUPPLY CHAIN MANAGEMENT AND PURCHASING AND NETWORK-WIDE CASH MANAGEMENT. FOR THE FISCAL PERIOD COVERED BY THIS FILING BILH, INC. PROVIDED SERVICES AND SUPPORT TO ITS AFFILIATES, IN THE AMOUNT OF $ 9,814,478,826.SEE FORM 990 SCHEDULE R FOR ADDITIONAL INFORMATION. ADDITIONAL DETAIL ABOUT ACCOMPLISHMENTS ACROSS BILH ARE BELOW. BILH NETWORK ACCOMPLISHMENTS AND ACTIVITIES FISCAL YEAR ENDED SEPTEMBER 30, 2025BILH'S SUPPORT OF ITS AFFILIATES ENABLES THE NETWORK AS A WHOLE TO ACCOMPLISH ITS PRIMARY MISSION OF IMPROVING THE HEALTH OF PATIENTS, THEIR FAMILIES AND THE COMMUNITIES SERVED. AS NOTED PREVIOUSLY IN THIS FILING, BILH STRIVES TO ACCOMPLISH THIS MISSION BY DELIVERING THE HIGH-QUALITY HEALTH CARE THAT EVERY PATIENT DESERVES. BILH BELIEVES THAT EFFECTIVE CARE IS EASILY ACCESSIBLE AND SIMPLE TO USE SO IT IS BILH'S FOCUS TO PROVIDE PATIENTS WITH CARE THAT IS IN CLOSE PROXIMITY AND CONVENIENT REGARDLESS OF WHERE PATIENTS LIVE, THEIR HEALTH HISTORY OR STAGE OF LIFE AND BILH IS ACCOMPLISHING THIS GOAL BY PROVIDING SUPPORT TO EACH OF ITS AFFILIATES, PROVIDING AN ORGANIZATIONAL STRUCTURE AND OPERATING MODEL WHICH IS DRIVEN BY FOUR DEEPLY INTERCONNECTED DOMAINS DESIGNED TO ADVANCE MEANINGFUL PARTNERSHIPS ACROSS ORGANIZATIONS, CARE SETTINGS, SPECIALTIES, AND GEOGRAPHIES TO ENSURE BILH PATIENTS RECEIVE THE CARE THEY NEED IN THE COMMUNITIES WHERE THEY LIVE AND WORK.PATIENT CARE DELIVERY ACROSS THE BILH NETWORK - FISCAL YEAR ENDED SEPTEMBER 30, 2025HOSPITAL CARE:DURING THE PERIOD COVERED BY THIS FILING, THE BILH HOSPITALS PROVIDED CARE TO PATIENTS IN A FULL SPECTRUM OF SPECIALTIES AND UTILIZING A WIDE RANGE OF MODALITIES. BELOW IS A SAMPLE OF THE HOSPITAL CARE PROVIDED TO BILH PATIENTS ACROSS THE NETWORK. DURING THE FISCAL YEAR COVERED BY THIS FILING, BILH HOSPITALS HAD APPROXIMATELY 4.9 MILLION OUTPATIENT ENCOUNTERS. MORE THAN 83,000 OUTPATIENT/AMBULATORY SURGERIES AND OVER 114,000 ENDOSCOPIES WERE PERFORMED. IN ADDITION, ACROSS BILH HOSPITALS PATIENTS HAD APPROXIMATELY 125,000 OUTPATIENT ONCOLOGY VISITS OR ONCOLOGY INFUSIONS, 110,000 EKGS, OVER 13,000 OUTPATIENT ORTHOPEDIC PROCEDURES, MORE THAN 417,000 OUTPATIENT RADIOLOGY EXAMS, OVER 333,000 CT EXAMS, MORE THAN 137,000 ULTRASOUND PROCEDURES, OVER 150,000 MRIS, OVER 160,000 OUTPATIENT BREAST IMAGING EXAMS, APPROXIMATELY 366,000 OUTPATIENT REHABILITATION AND PHYSICAL THERAPY VISITS AND MORE THAN 11.9 MILLION OUTPATIENT LAB TESTS AND APPROXIMATELY 560,000 OTHER PROCEDURES AND TESTS WERE PERFORMED. THE BILH HOSPITALS ALSO HAD MORE THAN 436,000 EMERGENCY DEPARTMENT VISITS, MORE THAN 36,000 OBSERVATION CASES AND MORE THAN 131,000 INPATIENT DISCHARGES WITH APPROXIMATELY 715,000 INPATIENT DAYS, INCLUDING MORE THAN 50,000 INPATIENT ADULT AND PEDIATRIC PSYCHIATRIC DAYS. DURING THIS PERIOD MORE THAN 28,000 INPATIENT SURGERIES WERE PERFORMED AND APPROXIMATELY 13,000 NEWBORNS WERE DELIVERED. THERE WERE ALSO APPROXIMATELY 63,000 PAIN CLINIC VISITS AND BILH HOSPITALS ALSO HAD MORE THAN 73,000 URGENT CARE VISITS DURING THIS PERIOD. ACCESS TO AND FUNDING OF PRIMARY AND SPECIALTY CARE:DURING THE PERIOD COVERED BY THIS FILING, PHYSICIANS ACROSS BILH ENTITIES AFFILIATES PROVIDED CARE TO PATIENTS OUTSIDE OF THE HOSPITALS AND IN PHYSICIAN OFFICE OR OTHER CLINICAL SETTINGS. BELOW ARE A SAMPLE OF THE OTHER PHYSICIAN SERVICES PROVIDED TO BILH PATIENTS. DURING THE PERIOD COVERED BY THIS FILING AND ACROSS BILH ENTITIES, APPROXIMATELY 490 PRIMARY CARE AND FAMILY PRACTICE PROVIDERS HAD MORE THAN 1.2 MILLION PATIENT VISITS AND PROVIDERS ACROSS THE FULL SPECTRUM OF SPECIALTIES HAD MORE THAN 813,000 PATIENT VISITS. IN ADDITION, JOSLIN DIABETES CENTER HAD APPROXIMATELY 27,000 PATIENT VISITS RELATED TO DIABETES CARE AND THERE WERE MORE THAN 90,000 URGENT CARE VISITS TO NON-HOSPITAL URGENT CARE LOCATIONS. THE COST TO PROVIDE THIS CARE EXCEEDED REVENUE BY MORE THAN $282 MILLION. COMMUNITY BENEFITS, UNCOMPENSATED CARE, COSTS TO PROVIDE CARE TO MEDICAID AND MEDICARE PATIENTS FISCAL YEAR ENDED SEPTEMBER 30, 2025DURING THE FISCAL YEAR COVERED BY THIS FILING BILH HOSPITALS PROVIDED MORE THAN $62 MILLION IN NET COST OF UNREIMBURSED CHARITY CARE, INCLUDING CARE FOR EMERGENT SERVICES PROVIDED TO NON-PAYING PATIENTS AND INCLUDING PAYMENTS TO THE MASSACHUSETTS HEALTH SAFETY NET TRUST (HSN).IN ADDITION TO THE CHARITY CARE REPORTED ABOVE, EACH OF THE BILH HOSPITALS 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. PAYMENTS FROM MEDICAID FOR LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, ACROSS THE BILH HOSPITALS THE COST OF PROVIDING CARE TO MEDICAID PATIENTS EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE RESULTING IN A COMBINED SHORTFALL OF APPROXIMATELY $104 MILLION RELATED TO TREATING MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS. PAYMENTS FROM MEDICARE DO NOT COVER THE COST OF SERVICES PROVIDED. ALL BILH HOSPITALS PROVIDE CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, THE COST OF PROVIDING CARE TO MEDICARE PATIENTS ACROSS BILH EXCEEDED PAYMENTS RECEIVED FOR PROVIDING THAT CARE, RESULTING IN A COMBINED SHORTFALL EXCEEDING $251 MILLION RELATED TO TREATING MEDICARE PATIENTS. IN ADDITION TO THE COSTS NOTED ABOVE , DURING THE FISCAL YEAR COVERED BY THIS FILING BILH, INC. AND BILH HOSPITALS PROVIDED COMBINED COMMUNITY BENEFITS, COMMUNITY HEALTH IMPROVEMENT SERVICES, CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY HEALTH CENTERS AND OTHER GROUPS AS WELL AS COSTS INCURRED RELATED TO SUBSIDIES FOR BEHAVIORAL HEALTH CARE AT A COST OF OVER $64 MILLION. FOR ADDITIONAL INFORMATION ON THESE ACTIVITIES AS WELL AS EACH HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY, PLEASE SEE FORM 990 SCHEDULE H FOR EACH OF THE BILH HOSPITALS LISTED BELOW:1. ANNA JAQUES HOSPITAL, INC. EIN: 04-21043382. BETH ISRAEL DEACONESS HOSPITAL MILTON EIN: 04-21036043. BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. EIN: 0432296794. BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. EIN: 22-26673545. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. EIN: 04-21038816. EXETER HOSPITAL, INC. EIN: 22-26740147. LAHEY CLINIC HOSPITAL, INC. D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS EIN: 04-27046868. MOUNT AUBURN HOSPITAL EIN: 04-21036069. NEW ENGLAND BAPTIST HOSPITAL EIN: 04-XXX-XX-XXXX. NORTHEAST HOSPITAL CORPORATION EIN: 04-XXX-XX-XXXX. WINCHESTER HOSPITAL EIN: 04-2104434 EDUCATION AND RESEARCH FISCAL YEAR ENDED SEPTEMBER 30, 2025RESEARCH ACTIVITIES ACROSS BILH SERVE AND FURTHER PATIENT CARE BOTH AT BILH AND BEYOND AS PART OF THE ADVANCEMENT OF SCIENCE. BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC OR MEDICAL CENTER) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER PROVIDING LEADING EDGE PATIENT CARE, IS A WORLD CLASS RESEARCH INSTITUTION AND IS DEVOTED TO TEACHING AND TRAINING THE MEDICAL PROFESSIONALS OF TOMORROW, EMBRACING TECHNOLOGICAL AND CLINICAL PRACTICE INNOVATION AND TO THAT END, PART OF THE MEDICAL CENTER'S MISSION IS TO BE A WORLD-CLASS RESEARCH INSTITUTION WHERE OUTSTANDING SCIENTISTS WORK TO DEVELOP NEW KNOWLEDGE FOR THE BETTERMENT OF THE HEALTH OF OUR LOCAL AND EXTENDED COMMUNITIES. BIDMC HAS THE LARGEST RESEARCH OPERATIONS ACROSS BILH AND DURING THE FISCAL YEAR COVERED BY THIS FILING, THE MEDICAL CENTER INCURRED OVER $398 MILLION IN RESEARCH EXPENSES, APPROXIMATELY $94 MILLION OF WHICH WERE INTERNALLY FUNDED.ACROSS BILH HOSPITALS, COSTS FOR TRAINING MEDICAL PROFESSIONALS EXCEEDED $216 MILLION. REIMBURSEMENT FROM MEDICARE FOR THESE ACTIVITIES WAS APPROXIMATELY $70 MILLION WHICH LEFT A COMBINED SHORTFALL RELATED TO THESE ACTIVITIES ACROSS BILH OF OVER $145 MILLION.THESE COSTS FOR MEDICAL EDUCATION AND RESEARCH ARE AN INVESTMENT IN THE FUTURE OF HEALTH CARE ACROSS BILH AND BEYOND. ADDITIONAL BILH NETWORK ACTIVITIES -- EXPANDING ACCESS AND SERVICES; CONTINUING TO PROVIDE HIGH QUALITY CARE AT A LOWER COST; COMMUNITY INVESTMENTS FISCAL YEAR ENDED SEPTEMBER 30, 2025THROUGHOUT THE PERIOD COVERED BY THIS FILING, BILH REMAINED COMMITTED TO DELIVERING HIGH-QUALITY CARE AT A LOWER COST BY LEVERAGING COMMUNITY SETTINGS AND MAINTAINING CARE WITHIN THE BILH PERFORMANCE NETWORK (BILHPN), WHEN APPROPRIATE. THE FOLLOWING HIGHLIGHTS SOME OF THESE ONGOING EFFORTS. IN ADDITION TO THE ACCOMPLISHMENTS NOTED ABOVE, BILH CONTINUED THIS COMMITMENT WITH THE FOLLOWING ACTIVITIES: CONTINUED GROWTH FOR BILHPN BILHPN ADVANCED SYSTEM-WIDE EFFORTS BY CONSOLIDATING FOUR LEGACY SHARED SAVINGS PROGRAM ACCOUNTABLE CARE ORGANIZATIONS (ACOS) INTO TWO ACOS. ALIGNING MEDICARE ACO CONTRACTS UNDER BILHPN FOSTERS A COORDINATED STRATEGY THAT IMPROVES OPERATIONAL EFFICIENCY AND ENHANCES CARE QUALITY FOR MEDICARE PATIENTS THROUGH CENTRALIZED PROGRAMMING AND RESOURCES. A RENEWED FOCUS ON DATA INTEGRITY AND ALIGNMENT INCLUDED REDESIGNING THE POPULATION HEALTH REGISTRY, IMPROVING STRUCTURED DATA CAPTURE, AND CONSOLIDATING MULTIPLE DATA SOURCES INTO ONE REGISTRY. THESE EFFORTS SUPPORTED INITIATIVES THAT DROVE YEAR-OVER-YEAR IMPROVEMENT ACROSS KEY MEASURES, INCLUDING: - EXPANSION OF THE CENTRAL HOME BLOOD PRESSURE (BP) CUFF DISTRIBUTION PROGRAM, OFFERING FREE HOME BP CUFFS TO PATIENTS IN NEED; - TARGETED PATIENT OUTREACH TO ADDRESS ACUTELY HIGH IN-OFFICE BP READINGS WITH CONSISTENT MONITORING THAT POSITIVELY CORRELATED TO LOWERED BP READINGS; - THE LAUNCH OF A REFRESHED INTEGRATED CARE MANAGEMENT PROGRAM, ENABLING CARE MANAGEMENT NURSES TO INTERVENE CLINICALLY WITH PATIENTS WHO HAVE CHRONIC AND COMPLEX CARE NEEDS; AND- CENTRALIZED REFERRAL MANAGEMENT RESULTING IN IMPROVED CARE COORDINATION, STRENGTHENED CARE CONTINUITY, AND LOWERED TOTAL MEDICAL EXPENSE.BILHPN ALSO STRENGTHENED ITS COMMITMENT TO CLINICAL DOCUMENTATION IMPROVEMENT, TRANSITIONING TO PROACTIVE EDUCATION SCHEDULING, EXPANDING PHYSICIAN-LED TRAINING, AND INCREASING PROVIDER PARTICIPATION. THROUGH ENHANCED DOCUMENTATION AND CODING SUPPORT, BILHPN HELPED REDUCE ADMINISTRATIVE DEMANDS ON CLINICIANS, ALLOWING FOR GREATER FOCUS ON DIRECT PATIENT CARE AND ENSURING ACCURATE REPRESENTATION OF THE CLINICAL COMPLEXITY OF THE POPULATIONS SERVED.EXPANDING PHARMACY ACCESSDURING THE PERIOD COVERED BY THIS FILING, BILH PHARMACY ACHIEVED SIGNIFICANT MILESTONES THAT REFLECT ITS COMMITMENT TO EXPANDING ACCESS TO CARE, REDUCING ADMINISTRATIVE BURDEN, AND SUPPORTING OUR PRIMARY CARE AND SPECIALTY PROVIDERS WHILE IMPROVING CLINICAL OUTCOMES AND MEDICAL ADHERENCE. ITS ACHIEVEMENTS INCLUDE:- EXPANDED PRESCRIPTION MEDICATION AFFORDABILITY AND ASSISTANCE SERVICES, PROVIDING OVER $2.4 MILLION IN COPAY SUPPORT TO PATIENTS;- FACILITATED FREE ACCESS TO POST-EXPOSURE PROPHYLAXIS MEDICATIONS FOR ALL SEXUAL ASSAULT PATIENTS PRESENTING TO BILH HOSPITAL EMERGENCY DEPARTMENTS;- STRENGTHENED THE QUALITY OF CARE FOR PATIENTS USING WEIGHTLOSS MEDICATIONS BY EXPANDING SERVICES WITHIN A PHARMACISTLED WEIGHTMANAGEMENT CLINIC; AND- ACHIEVED CONTINUED SUCCESS AND GROWTH OF THE CARDIOMETABOLIC PROGRAM AND CENTRAL ANTICOAGULATION PROGRAM, SUPPORTING IMPROVED PATIENT OUTCOMES.INCREASED ACCESS TO COMMUNITY CAREAS PART OF ITS 2030 GOAL TO PROVIDE 70% OF CARE IN THE COMMUNITY, BILH OPENED URGENT CARE CENTERS IN HAVERHILL AND WATERTOWN, EXPANDING SAME-DAY ACCESS FOR LOWER-ACUITY NEEDS. ADDITIONALLY, BILH OPENED NINE NEW LABORATORY DRAW STATIONS ACROSS EASTERN MASSACHUSETTS, INCREASING COMMUNITY ACCESS TO LAB SERVICES AND IMPROVING SATISFACTION AMONG PATIENTS AND PROVIDERS. THESE SYSTEM INITIATIVES STRENGTHENED THE QUALITY OF PHLEBOTOMY SERVICES AND ENHANCED THE PATIENT EXPERIENCE.BILH ALSO CONTINUED TO ADVANCE ITS POSTACUTE AND ALTERNATIVE CARE MODELS BY EXPANDING SKILLED NURSING FACILITY TRANSITION SUPPORT AND FURTHER DEVELOPING HOSPITAL AT HOME PROGRAMMING. TOGETHER, THESE MODELS PROVIDE SAFE, HIGHQUALITY CARE IN LOWERCOST SETTINGS, REDUCE PREVENTABLE READMISSIONS, AND ENHANCE PATIENT SATISFACTION.ELECTRONIC MEDICAL RECORD SYSTEM IMPROVEMENTS (ONEBILH EPIC)A CORE BILH STRATEGIC INITIATIVE IS THE TRANSITION TO A UNIFORM, SINGLE ELECTRONIC HEALTH RECORD (EHR) FOR ALL BILH ENTITIES ACROSS THE SYSTEM. A CONSOLIDATED EHR ENHANCES CARE QUALITY BY GIVING CLINICIANS SEAMLESS ACCESS TO COMPREHENSIVE AND COMPLETE PATIENT RECORDS, MINIMIZING DUPLICATIVE TESTING, AND ACCELERATING CARE DELIVERY THROUGH MORE EFFICIENT INFORMATION ACCESS.BILH BEHAVIORAL HEALTH SERVICESTHE BETH ISRAEL LAHEY HEALTH NETWORK (BILH) IS COMMITTED TO THE BEHAVIORAL HEALTH NEEDS OF THE PATIENTS AND COMMUNITIES SERVICED. BELOW ARE SOME OF ACTIVITIES THAT BILH BEHAVIORAL SERVICES (BILHBS) HAS PROVIDED TO THE PATIENTS AND COMMUNITIES SERVED BY BILH AND ITS AFFILIATED ENTITIES. ADDICTION SERVICES NORTHEAST BEHAVIORAL HEALTH CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH BEHAVIORAL SERVICES (NBHC OR BILH BS) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS, PROVIDING HIGH-QUALITY MENTAL HEALTH AND ADDICTION TREATMENT. THIS INCLUDES A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TO COMMUNITY-BASED SERVICES. TREATMENT OFFERINGS INCLUDE MOBILE CRISIS TEAMS FOR BEHAVIORAL AND SUBSTANCE-RELATED EMERGENCIES; INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; RESIDENTIAL PROGRAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION CLINICS; AND MEDICATION-ASSISTED TREATMENT PROGRAMS FOR PERSONS WITH OPIOID USE DISORDERS. NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) HAS OVER 220 BEDS IN 7 FACILITIES FOR PATIENTS REQUIRING ACUTE PSYCHIATRIC, DETOXIFICATION AND POST-ACUTE DIVERSIONARY SERVICES. OTHER OFFERINGS INCLUDE MANY COMMUNITY-BASED SERVICES SUCH AS MOBILE EMERGENCY SERVICES TEAMS, SCHOOL AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES. BILHBS SERVES APPROXIMATELY 17,000 INDIVIDUALS ANNUALLY, PROVIDING OVER 415,000 UNITS OF SERVICE, IN A VAST ARRAY OF SETTINGS BASED ON THEIR NEEDS. NBHC PROVIDED ADDICTION TREATMENT SERVICES WITH MORE THAN 220 INPATIENT AND RESIDENTIAL BEDS, OPERATING 24/7 FOR ADDICTION TREATMENT. ADDICTION TREATMENT INCLUDES BOTH OUTPATIENT AND INPATIENT TREATMENT AND PREVENTION. SUBSTANCE ABUSE COUNSELING AND GROUP THERAPY IS OFFERED FOR BOTH ADULTS AND TEENS, AS ARE A RANGE OF COURT-ORDERED PROGRAMS INCLUDING OPERATING UNDER THE INFLUENCE (OUI) EDUCATION AND EVALUATIONS. MEDICATION-ASSISTED TREATMENT FOR MEN AND WOMEN ADDICTED TO HEROIN OR PRESCRIPTION OPIOIDS IS PROVIDED AT LOCATIONS IN GLOUCESTER AND DANVERS, MASSACHUSETTS. ACUTE TREATMENT PROGRAMS PROVIDING INPATIENT DETOXIFICATION SERVICES FROM DRUGS AND/OR ALCOHOL IN MEDICAL SETTINGS ARE AVAILABLE AT TREATMENT CENTERS IN DANVERS AND TEWKSBURY, MASSACHUSETTS. IN FY25 THESE CENTERS SERVED APPROXIMATELY 2,600 PATIENTS. NBHC ALSO PROVIDED POST-DETOXIFICATION RESIDENTIAL SETTINGS AT MULTIPLE LOCATIONS SERVING BOTH MEN AND WOMEN. IN FY25 NBHC'S OUTPATIENT ADDICTION PROGRAMS PROVIDED 191,449 UNITS OF SERVICE, INCLUDING 5,800 VIA TELEHEALTH, WHILE INPATIENT AND RESIDENTIAL PROGRAMS RECORDED 75,732 BED DAYS. AMBULATORY SERVICES BILH BS' AMBULATORY DIVISION SERVES NEARLY 4,500 PATIENTS EVERY YEAR, DELIVERING MORE THAN 111,000 UNITS OF SERVICES IN VARIOUS SETTINGS. MORE THAN 45,000 WERE DELIVERED BY TELEHEALTH AMBULATORY PROGRAMS AND SERVICES OFFERED UNDER THE CHILDREN'S BEHAVIORAL HEALTH INITIATIVE (CBHI) INCLUDING A BROAD RANGE OF COUNSELING AND THERAPY AS WELL AS MORE INTENSIVE TREATMENT MODALITIES. OUTPATIENT MENTAL HEALTH CLINICS IN SALEM, LAWRENCE, GLOUCESTER AND BEVERLY, MASSACHUSETTS AND AN OUTREACH CLINIC IN HAVERHILL, MASSACHUSETTS ASSIST INDIVIDUALS AND FAMILIES THROUGH PERIODS OF STRESS AND ADJUSTMENT, PROVIDING THERAPY FOR DEPRESSION, ANXIETY, TRAUMA, BIPOLAR DISEASE, AND CHRONIC MENTAL ILLNESS. OUTREACH COUNSELORS OFFER SHORT AND LONG-TERM THERAPY IN HOMES, SCHOOLS, AND OTHER APPROPRIATE COMMUNITY SETTINGS. ALL THERAPY PROGRAMS ARE SUPPORTED BY MEDICATION CLINICS IF THAT IS DETERMINED TO BE AN APPROPRIATE ADJUNCT TO TREATMENT. IN FY25, NBHC DELIVERED 103,421 UNITS OF AMBULATORY SERVICES, SUPPORTED BY 8,036 PSYCHOPHARMACOLOGY VISITS. EMERGENCY SERVICES THE EMERGENCY SERVICES DIVISION PROVIDES EMERGENCY PSYCHIATRIC ASSESSMENTS AND SUPPORTIVE SERVICES 24/7 WITHIN THE EMERGENCY DEPARTMENTS OF THE BILH SYSTEM AND AT THE COMMONWEALTH OF MASSACHUSETTS' IMPLEMENTED BEHAVIORAL HEALTH REDESIGN COMMUNITY BEHAVIORAL HEALTH CENTER (CBHC), LOCATED IN LAWRENCE. THIS INCLUDES PATIENT ACCESS TO URGENT, ROUTINE AND SHORT-TERM INPATIENT PROGRAMS. MOBILE CRISIS CLINICIANS ARE AVAILABLE FOR WALK-IN APPOINTMENTS AND TO RESPOND TO SCHOOLS, HOMES AND OUTPATIENT CLINICS. NBHC ALSO OPERATES AN INPATIENT 8-BED COMMUNITY CRISIS STABILIZATION UNIT, WHICH OFFERS SHORT-TERM (3-5 DAY) CRISIS BEDS IN LIEU OF HOSPITALIZATION. DURING THE FISCAL PERIOD COVERED BY THIS FILING, EMERGENCY SERVICE PROGRAMS HAD 15,097 INITIAL ASSESSMENT ENCOUNTERS, AND THE CCS PROGRAM RECORDED 2,454BED DAYS. NBHC IS ALSO ON THE FOREFRONT OF EXPANDING TREATMENT FOR OPIOID USE DISORDER (OUD). SEVERAL BILH ORGANIZATIONS HAVE TAKEN STEPS TO ENHANCE CARE FOR PATIENTS WITH OPIOID USE DISORDER (OUD) WHO PRESENT IN EMERGENCY DEPARTMENTS, PARTICULARLY AS THESE PATIENTS TRANSITION FROM THE HOSPITAL TO A LONG-TERM TREATMENT PROGRAM. THE NBHC BRIDGE CLINIC IN GLOUCESTER ACCEPTS PATIENTS REFERRED FROM ITS AFFILIATE NORTHEAST HOSPITAL CORP (NHC) EMERGENCY DEPARTMENTS AT BOTH BEVERLY HOSPITAL AND ADDISON GILBERT HOSPITAL AND OFFERS CONTINUATION OF MEDICATION ASSISTED TREATMENT AND SUPPORT FROM RECOVERY COACHES. BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH (BID-PLYMOUTH) TREATS PATIENTS WITH OUD THROUGH MEDICATION-ASSISTED TREATMENT IN THE EMERGENCY DEPARTMENT, AND THE HOSPITAL WORKS CLOSELY WITH COMMUNITY PARTNERS TO PROVIDE ONGOING SUPPORT TO PATIENTS. THESE PROGRAMS ARE SIMILAR TO SERVICES AT MOUNT AUBURN HOSPITAL WHICH ALSO OFFERS MEDICATION-ASSISTED TREATMENT IN ITS EMERGENCY DEPARTMENT. PATIENTS CAN THEN BE REFERRED TO THE BRIDGE CLINIC AT MOUNT AUBURN HOSPITAL OR BID-PLYMOUTH FOR CONTINUED OR ADDITIONAL TREATMENT. NORTHEAST HOSPITAL CORPORATION, BID-PLYMOUTH AND MOUNT AUBURN HOSPITALS ARE ALL PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK AND SISTER ENTITIES TO NBHC. 1 ADOLESCENT CONSULTATION SERVICES INC 189 CAMBRIDGE STREET CAMBRIDGE MA 02141 043263996 501(C)(3) 20000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS COMMUNITY DAY CENTER OF WALTHAM 16 FELTON STREET WALTHAM MA 02453 562325323 501(C)(3) 12000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS DE NOVO CENTER FOR JUSTICE AND HEALING INC 47 THORNDIKE STREET CAMBRIDGE MA 021411799 042470335 501(C)(3) 20000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS HARVARD MEDICAL SCHOOL 1033 MASS AVENUE SUITE 406 CAMBRIDGE MA 02138 042103580 501(C)(3) 426270 0 MEDICAL EDUCATION AND RESEARCH HOMEOWNER'S REHAB INC 280 FRANKLIN STREET CAMBRIDGE MA 02139 042519279 501(C)(3) 10000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS LAMPLIGHT WOMEN'S LITERACY CENTER PO BOX 404 ARLINGTON MA 02476 853899226 501(C)(3) 20000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS ON THE RISE INC 341 BROADWAY CAMBRIDGE MA 02139 043290689 501(C)(3) 10000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS SPONSER INC DBA MISSION EARTH 1257 WORCESTER ROAD FRAMINGHAM MA 01701 810741435 501(C)(3) 6000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS WALTHAM FIELDS COMMUNITY FARM 240 BEAVER STREET WALTHAM MA 02542 043261186 501(C)(3) 12000 0 CARE ACCESS AND/OR TO ADDRESS OTHER IDENTIFIED COMMUNITY HEALTH NEEDS MOUNT AUBURN PROFESSIONAL SERVICES INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 043026897 501(C)(3) 14522971 0 ACCESS TO PATIENT CARE 10 0 PART I, LINE 2: COMMUNITY BENEFITS GRANTS - AS PREVIOUSLY NOTED IN THIS FILING MOUNT AUBURN HOSPITAL MAINTAINS STRONG RELATIONSHIPS WITH MANY COMMUNITY PARTNERS AND MOUNT AUBURN HOSPITAL WORKS WITH THOSE PARTNERS AS PART OF ITS COMMUNITY BENEFITS MISSION AND ACTIVITIES. PURSUANT TO THOSE RELATIONSHIPS, GRANTS MAY BE DISTRIBUTED TO THESE PARTNERS FOR THE PURPOSES AS NOTED IN SCHEDULE I PART II. MOUNT AUBURN HOSPITAL ENSURES THAT FUNDS GRANTED ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THESE COMMUNITY PARTNERS. ADDITIONAL INFORMATION ABOUT COMMUNITY BENEFITS IS INCLUDED IN FORM 990 SCHEDULE H. ACCESS TO CARE SUBSIDIES AS PREVIOUSLY NOTED THROUGHOUT THIS FILING, MOUNT AUBURN HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. BILH, MOUNT AUBURN HOSPITAL AND ALL ENTITIES WITHIN THE BILH NETWORK ARE DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. MOUNT AUBURN HOSPITAL ENSURES THESE SUBSIDIES ARE USED FOR THE INTENDED PURPOSES AS PART OF ITS ON-GOING AND CLOSE CONNECTIONS WITH THE RECIPIENT ENTITIES. X 1 1 1 1 0 0 0 0 0 1 1 1 TABB MD KEVIN CEO (EX-OFF) (CEO, BILH) 0 2267647 0 1000000 0 398244 0 1021480 0 47000 0 4734371 0 0 RIOS CINDY TREAS (EX-OFF) (EXEC VP & CFO, BILH) 0 1031770 0 125000 0 229483 0 2171401 0 37049 0 3594703 0 0 HEALY PETER TTEE (EXO) (DIV PRES, METRO BOSTON) 0 1189163 0 63138 0 144269 0 19830 0 40480 0 1456880 0 0 KATZ ESQ JAMIE CLERK (EX-OFF); BILH GENERAL COUNSEL 0 870522 0 0 0 130539 0 24780 0 9010 0 1034851 0 0 ERDMAN MD JONATHAN ANESTHESIOLOGIST 731903 0 22000 0 4989 0 34500 0 17034 0 810426 0 0 0 STARNBACH MD AILEEN G COMMUNITY CHIEF OF ANESTHESIA 588356 0 22000 0 31188 0 34500 0 2086 0 678130 0 0 0 HUANG MD EDWIN TRUSTEE (EX-OFFICIO) & PRESIDENT 595230 0 0 0 25432 0 17239 0 39796 0 677697 0 0 0 GLICKSMAN MD ZACHARY S ANESTHESIOLOGIST 555300 0 22000 0 27967 0 34500 0 1139 0 640906 0 0 0 KAPOOR MD SONIA ANESTHESIOLOGIST 533489 0 17600 0 9595 0 34500 0 41936 0 637120 0 0 0 FRANCIOLI CARL TREAS EX-OF; BILH INTRM CFO/BSTN CFO 0 531632 0 1095 0 25925 0 13814 0 41145 0 613611 0 0 FIDROCKI MD DIANA M ANESTHESIOLOGIST 489955 0 22000 0 27726 0 34500 0 16274 0 590455 0 0 0 GOLEN MD TONI CHIEF MEDICAL OFFICER 439800 0 0 0 14936 0 64688 0 40130 0 559554 0 0 0 BONO DIANE FORMER VP, HUMAN RESOURCES 171098 0 0 0 160046 0 214495 0 7329 0 552968 0 0 0 SPIVAK MD BARBARA TTEE (EX-OFF) (PRES, MACIPA) 0 146091 0 216720 0 610 0 27600 0 10546 0 401567 0 0 BOYD DNP MHA RN KIRSTEN CHIEF NURSING OFFICER 181317 98704 0 0 430 64305 24924 2431 9594 6000 216265 171440 0 0 SMITH MBA BRIAN ASST TREAS EXOF & METRO BSTN MKT CFO 0 321570 0 0 0 9839 0 3543 0 37672 0 372624 0 0 FISHMAN AARON FMR ASST TREAS EXO & CFO; CFO BILHMG 0 280000 0 49493 0 15325 0 5169 0 2385 0 352372 0 0 TUSALEM RN GERI FRMR INTERIM CNO; DIR OF NURSING 221005 0 30000 0 480 0 0 0 11158 0 262643 0 0 0 CEDERQUIST ELIZABETH FRMR INTERIM VP, HR BUSINESS PARTNER 0 260265 0 0 0 0 0 0 0 0 0 260265 0 0 O'BRIEN BETH FORMER INTERIM COO 187500 0 0 0 38925 0 0 0 0 0 226425 0 0 0 KAPFHAMMER STEVEN CHIEF OPERATING OFFICER 165304 0 10000 0 23438 0 0 0 18438 0 217180 0 0 0 GEVITZ ESQ KATHRYN ASST CLERK; ASSOC GEN COUNSEL, BILH 0 184092 0 0 0 149 0 6734 0 12521 0 203496 0 0 BAKER RN DEBORAH FRMR SVP, PATIENT CARE SVCS AND CNO 0 0 0 0 147503 0 0 0 0 0 147503 0 0 0 PART I, LINE 1A FROM TIME TO TIME AND UNDER CERTAIN CIRCUMSTANCES, MOUNT AUBURN HOSPITAL OR ONE OF IT'S AFFILIATES MAY CHOOSE TO GROSS-UP A PAYMENT TO MAKE THE EMPLOYEE WHOLE FROM A TAX PERSPECTIVE. AS EXPLAINED FURTHER BELOW, ACROSS BILH THESE SITUATIONS ARE REVIEWED ON A CASE-BY-CASE BASIS AND THE COST OF ANY GROSS-UP IS CONSIDERED WHEN REVIEWING AN EMPLOYEE'S OVERALL COMPENSATION PACKAGE FOR REASONABLENESS. EXAMPLES OF THE TYPES OF EXPENSES WHICH MAY FALL INTO THIS CATEGORY ARE REIMBURSEMENT FOR RELOCATION AND TEMPORARY HOUSING. PART I, LINE 3 MOUNT AUBURN HOSPITAL'S CHIEF EXECUTIVE OFFICER AND PRESIDENT ARE EMPLOYED THROUGH BETH ISRAEL LAHEY HEALTH (BILH), WHICH AS NOTED THROUGHOUT THIS FILING, IS THE DIRECT OR INDIRECT SOLE MEMBER OF MOUNT AUBURN HOSPITAL. IN THIS CAPACITY, THE BILH COMPENSATION COMMITTEE SETS COMPENSATION FOR THE CEO AND PRESIDENT OF MOUNT AUBURN HOSPITAL. AS NOTED IN RESPONSE TO THIS FORM 990 PART VI QUESTIONS 15A AND 15B, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF EXECUTIVE AND SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER MEMBERS OF EXECUTIVE MANAGEMENT IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO AS VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BILH BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS FOR BOTH THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES ARE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION. PART I, LINES 4A-B ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, RECEIVED SEVERANCE PAYMENTS. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. BILH AND ITS AFFILIATES MAINTAIN CERTAIN SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANS. DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING PLANS, WHICH UNDER THE DEFINITION TO THIS FORM 990 ARE SUPPLEMENTAL NONQUALIFIED PLANS: BETH ISRAEL DEACONESS MEDICAL CENTER EXECUTIVE RETIREMENT PROGRAM AND, BETH ISRAEL LAHEY HEALTH, INC. SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. IN ADDITION, DURING THE PERIOD COVERED BY THIS FILING, ONE OR MORE INDIVIDUALS LISTED IN THIS FORM 990, SCHEDULE J, COMPENSATION INFORMATION, MAY HAVE PARTICIPATED IN ONE OR MORE OF THESE ADDITIONAL IRC 457(B) PLANS AND BENEFITS FROM PARTICIPATING IN ONE OF THESE PLANS IS ALSO REPORTED IN THIS FORM 990: BETH ISRAEL LAHEY HEALTH, INC. 457(B) DEFERRED COMPENSATION PLAN, EXETER HEALTH RESOURCES, INC. 457(B) RETIREMENT SAVINGS PLAN, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. 457(B) DEFERRED COMPENSATION PLAN. THESE PLANS ARE NON-QUALIFIED DEFERRED COMPENSATION PLANS AND PURSUANT TO THE PLANS, ELIGIBLE EMPLOYEES RECEIVE CERTAIN RETIREMENT BENEFITS AND/OR CAN MAKE THEIR OWN EMPLOYEE DEFERRALS. AMOUNTS RECEIVED BY PARTICIPANTS AND DEFERRED BY PARTICIPANTS ARE INCLUDED IN FORM 990 SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION AND/OR FORM 990, SCHEDULE J, PART II, COLUMN C, DEFERRED COMPENSATION IN ACCORDANCE WITH THE INSTRUCTIONS TO THIS FORM 990. ADDITIONAL INFORMATION IS INCLUDED WITH THE EXPLANATORY NOTES TO SCHEDULE J BELOW. PART I, LINE 7 AS NOTED ABOVE, THE BILH COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES. DURING THE 2024 CALENDAR YEAR, BILH MAINTAINED EXECUTIVE COMPENSATION PACKAGES WHICH INCLUDED OPPORTUNITIES TO EARN INCENTIVE COMPENSATION BASED ON A COMBINATION OF VARIOUS FACTORS, INCLUDING BUT NOT LIMITED TO, MEETING OR EXCEEDING THE EMPLOYING ENTITY'S OBJECTIVES FOR QUALITY AND PATIENT SAFETY, BUDGETED CONSOLIDATED OPERATING MARGIN, AND MEETING INDIVIDUAL GOALS AND OBJECTIVES. IN EACH CASE, INCENTIVE COMPENSATION WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE, AND FOR THE BILH CEO AS NOTED ABOVE, THE FULL BILH BOARD OF TRUSTEES. ADDITIONAL INFORMATION IS INCLUDED IN THE EXPLANATORY NOTES TO THIS SCHEDULE J. ADDITIONAL EXPLANATORY NOTES: DIRECTORS AND TRUSTEES SERVE WITHOUT COMPENSATION: ALL DIRECTORS/TRUSTEES SERVE WITHOUT COMPENSATION OR BENEFITS. COMPENSATION PAID TO OFFICERS, DIRECTORS/TRUSTEES OR KEY EMPLOYEES WAS EARNED FOR WORK PERFORMED IN A CAPACITY OTHER THAN THAT OF DIRECTOR/TRUSTEE, AS DENOTED BY THE LISTED TITLES IN THE NOTES BELOW. REPORTING PERIOD: AS REQUIRED BY FORM 990, COMPENSATION REPORTED IN THE FILING FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025 IS CALENDAR YEAR 2024 COMPENSATION. COMPENSATION SOURCES: COMPENSATION REPORTED FOR INDIVIDUALS MAY INCLUDE COMPENSATION PAID BY THE REPORTING ENTITY, AN AFFILIATE OF THE REPORTING ENTITY AND IN SOME CASES UNRELATED ENTITIES AS REQUIRED BY FORM 990. REPORTABLE COMPENSATION: REPORTABLE COMPENSATION LISTED IN FORM 990 PART VII INCLUDES BASE COMPENSATION, INCENTIVE COMPENSATION AND OTHER REPORTABLE COMPENSATION AS REPORTED IN FORM 990 SCHEDULE J. OTHER COMPENSATION: OTHER COMPENSATION LISTED IN FORM 990 PART VII INCLUDES DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS AS REPORTED IN FORM 990 SCHEDULE J. BASE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN BASE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: ORDINARY WAGES, EMPLOYEE DEFERRALS TO A 401(K) AND/OR 403(B) PLAN OTHER REPORTABLE COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED IN THIS RETURN BUT QUANTIFIED IN OTHER REPORTABLE COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: TAXABLE EMPLOYER SUBSIDIZED PARKING; TAXABLE LIFE, DISABILITY, OR LONG-TERM CARE INSURANCE. DEFERRED COMPENSATION: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN DEFERRED COMPENSATION INCLUDE AMOUNTS FROM ONE OR MORE OF THE FOLLOWING ITEMS: EMPLOYER CONTRIBUTIONS TO 401(K) RETIREMENT PLAN, EMPLOYER CONTRIBUTIONS TO 403(B) RETIREMENT PLAN, EMPLOYER CONTRIBUTION TO PENSION PLAN AND/OR THE CHANGE IN ACTUARIAL VALUE OF THE PENSION PLAN BENEFIT. NON-TAXABLE BENEFITS: AMOUNTS NOT OTHERWISE SEPARATELY NOTED BUT QUANTIFIED IN NON-TAXABLE BENEFITS INCLUDE, AMONG OTHER THINGS, AMOUNTS FROM ONE OR MORE OF THE FOLLOWING NON-TAXABLE BENEFITS: EMPLOYEE CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYER CONTRIBUTIONS TO HEALTH INSURANCE, EMPLOYEE CONTRIBUTIONS TO FLEXIBLE SPENDING ACCOUNTS FOR DEPENDENT CARE AND/OR MEDICAL REIMBURSEMENT, ADOPTION ASSISTANCE, TUITION ASSISTANCE PURSUANT TO AN EMPLOYER PLAN, GROUP TERM LIFE INSURANCE, DISABILITY INSURANCE ADDITIONAL INDIVIDUAL SPECIFIC INFORMATION IS INCLUDED BELOW. SCHEDULE J FOOTNOTES (CONTINUED): BAKER, RN, DEBORAH - FORMER SENIOR VICE PRESIDENT, PATIENT CARE SERVICES AND CHIEF NURSING OFFICER - MOUNT AUBURN HOSPITAL MS. BAKER'S TERM ENDED IN THE ABOVE POSITION ON JUNE 9, 2023, DURING THE PRIOR FISCAL PERIOD. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MS. BAKER INCLUDES SEVERANCE PAYMENTS PAID IN CALENDAR YEAR 2024 IN THE AMOUNT OF $147,503. PART OR ALL OF THIS AMOUNT WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION. BONO, DIANE - FORMER VICE PRESIDENT, HUMAN RESOURCES - MOUNT AUBURN HOSPITAL MS. BONO'S TERM ENDED IN THE ABOVE POSITION ON JUNE 29, 2024, DURING THE PRIOR FISCAL PERIOD. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MS. BONO INCLUDES SEVERANCE PAYMENTS PAID IN CALENDAR YEAR 2024 IN THE AMOUNT OF $147,692. DEFERRED COMPENSATION FOR MS. BONO INCLUDES DEFERRED SEVERANCE PAYMENTS IN THE AMOUNT OF $198,974 TO BE PAID AFTER DECEMBER 31, 2024. BOYD, DNP, MHA, RN, KIRSTEN - CHIEF NURSING OFFICER - MOUNT AUBURN HOSPITAL - TERM BEGAN ON MAY 5, 2024 - ASSOCIATE CHIEF NURSING OFFICER OF AMBULATORY & EMERGENCY SERVICES - BETH ISRAEL DEACONESS MEDICAL CENTER - TERM ENDED ON MAY 4, 2024 AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MS. BOYD INCLUDES PAYMENTS IN THE AMOUNT OF $64,305 FOR CASHED OUT PTO. CEDERQUIST, ELIZABETH - FORMER INTERIM VICE PRESIDENT, HR BUSINESS PARTNER - MOUNT AUBURN HOSPITAL - FORMER INTERIM VICE PRESIDENT, HR BUSINESS PARTNER - MOUNT AUBURN PROFESSIONAL SERVICES, INC. MS. CEDERQUIST SERVED IN THE ROLES ABOVE THROUGH SEPTEMBER 30, 2024, IN A PRIOR FISCAL YEAR. IN THOSE POSITIONS, MS. CEDERQUIST MET THE DEFINITION OF KEY EMPLOYEE FOR MOUNT AUBURN HOSPITAL AND MOUNT AUBURN PROFESSIONAL SERVICES AND AS SUCH, SHE IS LISTED AS A FORMER IN THIS FILING. BEGINNING OCTOBER 1, 2024, MS. CEDERQUIST COMMENCED IN THE POSITION OF DIRECTOR, HUMAN RESOURCES BUSINESS PARTNER FOR LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS. IN THESE CURRENT POSITIONS, MS. CEDERQUIST DOES NOT MEET THE DEFINITION OF KEY EMPLOYEE FOR THESE ENTITIES. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. ERDMAN, M.D., JONATHAN - ANESTHESIOLOGIST - MOUNT AUBURN HOSPITAL DR. ERDMAN SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. FIDROCKI, M.D., DIANA M - ANESTHESIOLOGIST - MOUNT AUBURN HOSPITAL DR. FIDROCKI SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. FISHMAN, AARON UNLESS OTHERWISE NOTED, MR. FISHMAN SERVED IN THE FOLLOWING ROLES DURING THE PERIOD ENDED SEPTEMBER 30, 2025: - CHIEF FINANCIAL OFFICER BETH ISRAEL LAHEY HEALTH MEDICAL GROUP BETH ISRAEL LAHEY HEALTH, INC. - TERM BEGAN FEBRUARY 23, 2025 - ASSISTANT TREASURER, TRUSTEE (EX-OFFICIO), & CHIEF FINANCIAL OFFICER - NORTHEAST MEDICAL PRACTICE, INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - ASSISTANT TREASURER, TRUSTEE (EX-OFFICIO), & CHIEF FINANCIAL OFFICER - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - ASSISTANT TREASURER, TRUSTEE, & CHIEF FINANCIAL OFFICER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP IN ADDITION, AS NOTED ABOVE AND EFFECTIVE FEBRUARY 23 2025, MR. FISHMAN COMMENCED THE POSITION OF CHIEF FINANCIAL OFFICER OF BETH ISRAEL LAHEY HEALTH MEDICAL GROUP. IN THAT CAPACITY, HE IS A KEY EMPLOYEE OF THE FOLLOWING ENTITIES: - COMMUNITY PHYSICIANS ASSOCIATES, INC. - SEACOAST AFFILIATED GROUP PRACTICE, INC. - JORDAN PHYSICIAN ASSOCIATES, INC. - MOUNT AUBURN PROFESSIONAL SERVICES, INC. AS REQUIRED IN FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. INCENTIVE COMPENSATION FOR MR. FISHMAN INCLUDES A MILESTONE PAYMENT IN THE AMOUNT OF $30,000. PART OR ALL OF THIS PAYMENT REPRESENTS AMOUNTS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION AS REQUIRED. FRANCIOLI, CARL MR. FRANCIOLI HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - CHIEF FINANCIAL OFFICER OF METRO BOSTON DIVISION - BETH ISRAEL LAHEY HEALTH, INC. - TREASURER (EX-OFFICIO) & CHIEF FINANCIAL OFFICER - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. MR. FRANCIOLI SERVED IN THE FOLLOWING ADDITIONAL ROLES FROM OCTOBER 20, 2024 THROUGH AUGUST 3, 2025: - TREASURER (EX-OFFICIO) AND INTERIM CHIEF FINANCIAL OFFICER BETH ISRAEL LAHEY HEALTH, INC. -TRUSTEE & TREASURER (EX-OFFICIO)- ADDISON GILBERT SOCIETY, INC. - TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TREASURER - BETH ISRAEL DEACONESS MILTON PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. - TREASURER (EX-OFFICIO) - CORE PHYSICIANS, LLC - TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TREASURER - EXETER HOSPITAL, INC. - TREASURER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - TREASURER - EXETER MED REAL, INC. - TREASURER - HEALTH AND EDUCATION HOUSING SERVICES, INC. - TREASURER - JOSLIN CLINIC, INC. - TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - TREASURER - THE JORDAN HEALTH SYSTEMS, INC. - TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TREASURER - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - TREASURER - LAHEY CLINIC, INC. - TRUSTEE & TREASURER - LAHEY HEALTH SHARED SERVICES, INC. - TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE, INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - TREASURER - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE - TREASURER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL - TRUSTEE & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - TREASURER - WINCHESTER HEALTHCARE MANAGEMENT, INC. MR. FRANCIOLI BEGAN SERVING IN THE FOLLOWING ROLE ON SEPTEMBER 11, 2025: -TRUSTEE (EX-OFFICIO) - BAIM INSTITUTE FOR CLINICAL RESEARCH, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. SCHEDULE J FOOTNOTES (CONTINUED): BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. DEFERRED COMPENSATION INCLUDES AN UNVESTED CONTRIBUTION TO A NONQUALIFIED PLAN IN THE AMOUNT OF $5,534. GEVITZ, ESQ., KATHRYN - ASSOCIATE GENERAL COUNSEL BETH ISRAEL LAHEY HEALTH, INC. - ASSISTANT CLERK (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - ASSISTANT CLERK (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - ASSISTANT CLERK (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL - TERM BEGAN MARCH 1, 2025 MS. GEVITZ SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. GLICKSMAN, M.D., ZACHARY S. - ANESTHESIOLOGIST - MOUNT AUBURN HOSPITAL DR. GLICKSMAN SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. GOLEN, MD., TONI - CHIEF MEDICAL OFFICER - MOUNT AUBURN HOSPITAL - CHIEF MEDICAL OFFICER, SPECIALTY CARE - MOUNT AUBURN PROFESSIONAL SERVICES, INC. MS. GOLEN SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J OTHER REPORTABLE COMPENSATION INCLUDES PAYMENTS FOR OTHER TAXABLE INSURANCE BENEFITS IN THE AMOUNT OF $10,738. HEALY, PETER UNLESS OTHERWISE NOTED BELOW, MR. HEALY HELD THE POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - DIVISIONAL PRESIDENT, METRO BOSTON BETH ISRAEL LAHEY HEALTH, INC. - PRESIDENT & TRUSTEE (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - DIRECTOR (EX-OFFICIO) - HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION, INC. - DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER OBSTETRICS AND GYNECOLOGY FOUNDATION, INC. - DIRECTOR (EX-OFFICIO) - BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNEE) AND CO-CHAIR - CARL SHAPIRO INSTITUTE FOR EDUCATION AND RESEARCH AT HARVARD MEDICAL SCHOOL - DIRECTOR (EX-OFFICIO) (NON-VOTING) - BETH ISRAEL ANAESTHESIA FOUNDATION, INC. - DIRECTOR (EX-OFFICIO) (NON-VOTING) - BETH ISRAEL DERMATOLOGY FOUNDATION, INC. - TRUSTEE (EX-OFFICIO) (CEO DESIGNEE) NEW ENGLAND BAPTIST HOSPITAL - TRUSTEE (EX-OFFICIO) (CEO DESIGNEE) MOUNT AUBURN HOSPITAL - TRUSTEE (EX-OFFICIO) (CEO DESIGNEE) JOSLIN DIABETES CENTER, INC. - TRUSTEE JOSLIN CLINIC, INC. MR. HEALY SERVED IN THE POSITIONS ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. HEALY INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $106,547. PART OR ALL OF THE PAYMENTS REPRESENT AMOUNTS REPORTED IN PRIOR YEARS AS OTHER REPORTABLE COMPENSATION OR DEFERRED COMPENSATION. OTHER REPORTABLE COMPENSATION FOR MR. HEALY ALSO INCLUDES PAYMENTS IN THE AMOUNT OF $15,222 FOR GROUP TERM LIFE INSURANCE. HERNDON, MBA, CPA, FACHE, SCOTT MR. HERNDON BEGAN SERVING IN THE FOLLOWING ROLES ON AUGUST 4, 2025: - TREASURER (EX-OFFICIO), EXECUTIVE VICE PRESIDENT, AND CHIEF FINANCIAL OFFICER - BETH ISRAEL LAHEY HEALTH, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. - TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TREASURER - BID - MILTON PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. - TREASURER (EX-OFFICIO) - CORE PHYSICIANS, LLC - TREASURER - EXETER HOSPITAL, INC. - TREASURER - EXETER HEALTH RESOURCES, INC. - TREASURER - EXETER MED REAL, INC. - TREASURER - HEALTH AND EDUCATION HOUSING SERVICES, INC. - TREASURER - JOSLIN CLINIC, INC. - TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - TREASURER - THE JORDAN HEALTH SYSTEMS, INC. - TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TREASURER - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - TREASURER - LAHEY CLINIC, INC. - TRUSTEE AND TREASURER - LAHEY HEALTH SHARED SERVICES, INC. - TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE AND TREASURER - NORTHEAST HEALTH SYSTEM, INC. - TREASURER (EX-OFFICIO) NORTHEAST MEDICAL PRACTICE, INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - TREASURER - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. - TRUSTEE AND TREASURER - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE AND TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE - TREASURER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE AND TREASURER (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL - TRUSTEE AND TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - TREASURER - WINCHESTER HEALTHCARE MANAGEMENT, INC. AS NOTED, MR. HERNDON BEGAN SERVING IN THE POSITION(S) ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. ACCORDINGLY, SINCE MR. HERNDON DID NOT BEGIN SERVING IN HIS/HER POSITION(S) UNTIL CALENDAR YEAR 2025, THERE IS NO COMPENSATION TO REPORT IN THIS FILING. HUANG, MD., EDWIN UNLESS OTHERWISE NOTED BELOW, DR. HUANG HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2025: - TRUSTEE (EX-OFFICIO) AND PRESIDENT MOUNT AUBURN HOSPITAL - TRUSTEE (EX-OFFICIO) AND PRESIDENT MOUNT AUBURN PROFESSIONAL SERVICES, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. KAPFHAMMER, STEVEN - CHIEF OPERATING OFFICER MOUNT AUBURN HOSPITAL AS NOTED, MR. KAPFHAMMER SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. INCENTIVE COMPENSATION FOR MR. KAPFHAMMER INCLUDES A MILESTONE PAYMENT IN THE AMOUNT OF $10,000. KAPOOR, M.D., SONIA - ANESTHESIOLOGIST - MOUNT AUBURN HOSPITAL DR. KAPOOR SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. KATZ, ESQ., JAMIE UNLESS OTHERWISE NOTED BELOW, MR. KATZ HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDED SEPTEMBER 30, 2025: - GENERAL COUNSEL AND CLERK (EX-OFFICIO), - BETH ISRAEL LAHEY HEALTH, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. SCHEDULE J FOOTNOTES (CONTINUED): - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - CLERK (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - CLERK (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - CLERK - COMMUNITY PHYSICIANS ASSOCIATES, INC. - CLERK - BID - MILTON PHYSICIAN ASSOCIATES, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - CLERK - JORDAN PHYSICIAN ASSOCIATES, INC. - CLERK - THE JORDAN HEALTH SYSTEMS, INC. - CLERK (EX-OFFICIO) - ANNA JAQUES HOSPITAL - CLERK - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. - TRUSTEE (EX-OFFICIO) AND CLERK (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - CLERK (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TRUSTEE AND CLERK (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - TRUSTEE AND CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - CLERK - WINCHESTER HEALTHCARE MANAGEMENT, INC. - CLERK (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - CLERK - LAHEY CLINIC, INC. - CLERK - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - CLERK (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TRUSTEE AND CLERK (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - CLERK - CAB HEALTH AND RECOVERY SERVICES, INC. - CLERK - HEALTH AND EDUCATION HOUSING SERVICES, INC. - CLERK (EX-OFFICIO) - WINCHESTER HOSPITAL - CLERK - JOSLIN CLINIC, INC. - CLERK (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - CLERK (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - CLERK - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - CLERK (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - CLERK (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - CLERK - EXETER HOSPITAL, INC. - CLERK (EX-OFFICIO) - CORE PHYSICIANS, LLC AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MR. KATZ INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $76,830. OTHER REPORTABLE COMPENSATION FOR MR. KATZ ALSO INCLUDES COMBINED PAYMENTS FOR GROUP TERM LIFE INSURANCE IN THE AMOUNTS OF $31,209. O'BRIEN, BETH - FORMER INTERIM CHIEF OPERATING OFFICER - MOUNT AUBURN HOSPITAL MS. O'BRIEN'S TERM ENDED IN THE ABOVE POSITION ON MARCH 29, 2024, DURING THE PRIOR FISCAL PERIOD. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MS. O'BRIEN INCLUDES PAYMENTS IN THE AMOUNT OF $38,925 FOR TEMPORARY HOUSING. RIOS, CINDY UNLESS OTHERWISE NOTED BELOW, MS. RIOS SERVED IN THE FOLLOWING POSITIONS UNTIL OCTOBER 19, 2024: - EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER & TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. - TREASURER - MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE A/K/A AFFILIATED PHYSICIANS GROUP - TREASURER - NORTHEAST PROFESSIONAL REGISTRY OF NURSES, INC. - TRUSTEE & TREASURER - CAB HEALTH AND RECOVERY SERVICES, INC. - TREASURER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TREASURER (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - TREASURER - BID - MILTON PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - TREASURER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. - TREASURER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - TREASURER - JOSLIN CLINIC, INC. - TREASURER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - TREASURER - THE JORDAN HEALTH SYSTEMS, INC. - TREASURER - JORDAN PHYSICIAN ASSOCIATES, INC. - TREASURER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TREASURER - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - TREASURER - LAHEY CLINIC, INC. - TREASURER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - TREASURER (EX-OFFICIO) - MOUNT AUBURN PROFESSIONAL SERVICES, INC. - TREASURER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - TREASURER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - TREASURER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - TREASURER - WINCHESTER HEALTHCARE MANAGEMENT, INC. - TRUSTEE & TREASURER (EX-OFFICIO) ADDISON GILBERT SOCIETY, INC. - TRUSTEE & TREASURER - HEALTH AND EDUCATION HOUSING SERVICES, INC. - TRUSTEE & TREASURER - LAHEY HEALTH SHARED SERVICES, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST BEHAVIORAL HEALTH CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST MEDICAL PRACTICE, INC. (NOW KNOWN AS BETH ISRAEL LAHEY HEALTH SPECIALTY CARE, INC.) - TRUSTEE & TREASURER (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE & TREASURER (EX-OFFICIO) - SEACOAST NURSING & REHABILITATION CENTER, INC. - TREASURER (EX-OFFICIO) - WINCHESTER HOSPITAL - TREASURER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - TREASURER - EXETER HOSPITAL, INC. - TREASURER - EXETER MED REAL, INC. - TRUSTEE & TREASURER (EX-OFFICIO) - ROCKINGHAM VISITING NURSE ASSOC AND HOSPICE - TREASURER (EX-OFFICIO) - CORE PHYSICIANS, LLC AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR MS. RIOS INCLUDES SEVERANCE PAYMENTS PAID IN CALENDAR YEAR 2024 IN THE AMOUNT OF $203,538. DEFERRED COMPENSATION FOR MS. RIOS INCLUDES DEFERRED SEVERANCE PAYMENTS IN THE AMOUNT OF $2,118,462 TO BE PAID AFTER DECEMBER 31, 2024. IN ADDITION, DEFERRED COMPENSATION INCLUDES AN UNVESTED CONTRIBUTION TO A NONQUALIFIED PLAN IN THE AMOUNT OF $42,199. SMITH, MBA, BRIAN MR. SMITH SERVED IN THE FOLLOWING POSITIONS ABOVE FOR THE FULL FISCAL YEAR ENDED SEPTEMBER 30, 2025. - MARKET CHIEF FINANCIAL OFFICER, METRO BOSTON BETH ISRAEL LAHEY HEALTH, INC. - ASSISTANT TREASURER (EX-OFFICIO) & CHIEF FINANCIAL OFFICER - NEW ENGLAND BAPTIST HOSPITAL - TREASURER, TRUSTEE (EX-OFFICIO) & CHIEF FINANCIAL OFFICER - NEW ENGLAND BAPTIST MEDICAL ASSOCIATES, INC. - ASSISTANT TREASURER (EX-OFFICIO) & CHIEF FINANCIAL OFFICER - MOUNT AUBURN HOSPITAL - ASSISTANT TREASURER (EX-OFFICIO) & CHIEF FINANCIAL OFFICER - MOUNT AUBURN PROFESSIONAL SERVICES, INC. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. SPIVAK, M.D., BARBARA - TRUSTEE (EX-OFFICIO) AND PRESIDENT OF THE MOUNT AUBURN CAMBRIDGE INDEPENDENT PRACTICE ASSOCIATION (MACIPA) - MOUNT AUBURN HOSPITAL - STAFF PHYSICIAN - MOUNT AUBURN PROFESSIONAL SERVICES, INC. DR. SPIVAK SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. STARNBACH, M.D., AILEEN G - COMMUNITY CHIEF OF ANESTHESIA - MOUNT AUBURN HOSPITAL DR. STARNBACH SERVED IN THE POSITION ABOVE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. TABB, MD., KEVIN UNLESS OTHERWISE NOTED BELOW, DR. TABB HELD THE FOLLOWING POSITIONS FOR THE FULL FISCAL PERIOD ENDING SEPTEMBER 30, 2025: SCHEDULE J FOOTNOTES (CONTINUED): - PRESIDENT AND CHIEF EXECUTIVE OFFICER; TRUSTEE (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - CHIEF EXECUTIVE OFFICER - LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - CHIEF EXECUTIVE OFFICER - LAHEY CLINIC, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY CLINIC FOUNDATION, INC. - TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO), PRESIDENT AND CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - LAHEY HEALTH SHARED SERVICES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL LAHEY HEALTH PHARMACY, INC. - PRESIDENT (EX-OFFICIO) AND TRUSTEE (EX-OFFICIO) - ADDISON GILBERT SOCIETY, INC. - TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST HEALTH SYSTEM, INC. - TRUSTEE (EX-OFFICIO), BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - NORTHEAST SENIOR HEALTH CORPORATION - TRUSTEE, BOARD CHAIR (EX-OFFICIO) AND PRESIDENT (EX-OFFICIO) - SEACOAST NURSING AND REHABILITATION CENTER, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - WINCHESTER HOSPITAL - TRUSTEE AND PRESIDENT (EX-OFFICIO) - WINCHESTER HOSPITAL FOUNDATION, INC. - CHIEF EXECUTIVE OFFICER - WINCHESTER HEALTHCARE MANAGEMENT, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NORTHEAST HOSPITAL CORPORATION - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION - CHIEF EXECUTIVE OFFICER - CAB HEALTH AND RECOVERY SERVICES, INC. - CHIEF EXECUTIVE OFFICER - HEALTH AND EDUCATION HOUSING SERVICES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. - CHIEF EXECUTIVE OFFICER - BID - MILTON PHYSICIAN ASSOCIATES, INC. - CHIEF EXECUTIVE OFFICER - COMMUNITY PHYSICIANS ASSOCIATES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - MOUNT AUBURN HOSPITAL - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - NEW ENGLAND BAPTIST HOSPITAL - CHIEF EXECUTIVE OFFICER - THE JORDAN HEALTH SYSTEMS, INC. - CHIEF EXECUTIVE OFFICER - JORDAN PHYSICIAN ASSOCIATES, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - ANNA JAQUES HOSPITAL, INC. - CHIEF EXECUTIVE OFFICER - SEACOAST AFFILIATED GROUP PRACTICE, INC. - CHIEF EXECUTIVE OFFICER - JOSLIN CLINIC, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - JOSLIN DIABETES CENTER, INC. - CHIEF EXECUTIVE OFFICER (EX-OFFICIO) - EXETER HEALTH RESOURCES, INC. - CHIEF EXECUTIVE OFFICER - EXETER HOSPITAL, INC. IN ADDITION TO THE POSITIONS NOTED ABOVE, DR. TABB HELD THE FOLLOWING POSITIONS FOR WHICH HE WAS ENTITLED TO AND DID APPOINT A DESIGNEE WHO THEN BECAME THE VOTING TRUSTEE IN HIS PLACE: - TRUSTEE (EX-OFFICIO) NORTHEAST HOSPITAL CORPORATION - TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL MILTON, BID-MILTON PHYSICIAN ASSOCIATES AND COMMUNITY PHYSICIANS ASSOCIATES - TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL NEEDHAM - TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, THE JORDAN HEALTH SYSTEMS, INC AND JORDAN PHYSICIAN ASSOCIATES, INC. - TRUSTEE (EX-OFFICIO) MOUNT AUBURN HOSPITAL - TRUSTEE (EX-OFFICIO) NEW ENGLAND BAPTIST HOSPITAL - TRUSTEE (EX-OFFICIO) WINCHESTER HOSPITAL AND WINCHESTER HEALTHCARE MANAGEMENT - TRUSTEE (EX-OFFICIO) ANNA JAQUES HOSPITAL, INC. AND SEACOAST AFFILIATED GROUP PRACTICE - TRUSTEE (EX-OFFICIO) JOSLIN DIABETES CENTER - TRUSTEE (EX-OFFICIO) JOSLIN CLINIC - TRUSTEE (EX-OFFICIO) EXETER HEALTH RESOURCES, INC. - TRUSTEE (EX-OFFICIO) EXETER HOSPITAL, INC. - TRUSTEE (EX-OFFICIO) BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - TRUSTEE (EX-OFFICIO) LAHEY CLINIC FOUNDATION, INC. - TRUSTEE (EX-OFFICIO) LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - TRUSTEE (EX-OFFICIO) LAHEY CLINIC, INC. - TRUSTEE (EX-OFFICIO) CAB HEALTH AND RECOVERY SERVICES, INC. - TRUSTEE (EX-OFFICIO) HEALTH AND EDUCATION HOUSING SERVICES, INC. - TRUSTEE (EX-OFFICIO) NORTHEAST BEHAVIORAL HEALTH CORPORATION ALTHOUGH DR. TABB SERVED IN THE POSITIONS ABOVE FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2025. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. OTHER REPORTABLE COMPENSATION FOR DR. TABB INCLUDES COMBINED PAYMENTS FROM NONQUALIFIED RETIREMENT PLANS IN THE AMOUNT OF $352,380. OTHER REPORTABLE COMPENSATION FOR DR. TABB ALSO INCLUDES PAYMENTS IN THE AMOUNT OF $23,364 FOR GROUP TERM LIFE INSURANCE. DEFERRED COMPENSATION IN THE AMOUNT OF $1,000,000 IS INCLUDED IN THIS FILING FOR DR. TABB. THIS AMOUNT RELATES TO MILESTONE PAYMENTS WHICH, AS OF DECEMBER 31, 2024, WERE NOT FUNDED, WERE NOT VESTED AND FOR WHICH THERE WAS NO GUARANTEE OF PAYMENT. THIS AMOUNT IS INCLUDED HERE AS DEFERRED COMPENSATION AS REQUIRED BASED ON THE INSTRUCTIONS TO THE FORM 990. TUSALEM, RN, GERI - FORMER INTERIM CHIEF NURSING OFFICER; DIRECTOR OF NURSING - MOUNT AUBURN HOSPITAL MS. TUSALEM'S TERM ENDED IN THE ABOVE POSITION ON MAY 4, 2024, DURING THE PRIOR FISCAL PERIOD. AS REQUIRED IN THIS FORM 990, COMPENSATION REPORTED HERE IS CALENDAR YEAR 2024 COMPENSATION. BASE COMPENSATION, INCENTIVE COMPENSATION, OTHER REPORTABLE COMPENSATION, DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED AS REQUIRED IN FORM 990, SCHEDULE J. ALL COMPENSATION REPORTED IN THIS RETURN WAS PAID TO MS. TUSALEM WHILE SHE WAS PERFORMING SERVICES IN HER ROLE AS INTERIM CHIEF NURSING OFFICER FOR MOUNT AUBURN HOSPITAL. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57585BPD4 2025-08-14 923737714 MDFA - SERIES 2025N - SEE PART VI 0 0 0 B MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584Y7K9 2023-12-12 442970000 MDFA - SERIES 2023M - SEE PART VI 0 0 0 C MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584YTK5 2019-07-31 211922775 MDFA - SERIES 2019K - SEE PART VI 0 0 0 D MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584YJW0 2018-06-26 479594374 MDFA - SERIES 2018J-1,J-2 - SEE PART VI 0 0 0 A 925222558 5454992 3304135 28217460 169812693 718433278 1 0 0 1 B 457215735 3559000 430865374 22791361 0 0 0 1 C 44260000 211922775 2931137 19714020 189277618 2019 0 0 1 1 D 20455000 504358641 4594374 499764267 2021 0 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 0 1 1 0 0 0 0 1 D 0 0 0 1 0 0 0 1 1 A 1 B 1 C 1 D 1 BOND A, ENTITY 1: PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 10/21/2015 AND 09/02/2015. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO INVESTMENT EARNINGS. BOND B, ENTITY 1: PART I, ROW B, COLUMN F: THE ISSUE'S PROCEEDS WILL BE USED TO FINANCE PROJECTS AND PAY ISSUANCE COSTS. PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO INVESTMENT EARNINGS. BOND C, ENTITY 1: PART I, ROW C, COLUMN F: FOR TAX PURPOSES (PURSUANT TO PROPOSED TREASURY REGULATIONS SECTION 1.150-1(D)(2)(II)(C)), THE ISSUE'S PROCEEDS OTHER THAN THOSE ALLOCATED TO COSTS OF ISSUANCE WERE ALLOCATED TO CAPITAL EXPENDITURES ON THE DATE OF CLOSING. THE PRESENTATION SHOWN HERE DEPARTS FROM THE TAX TREATMENT, REFLECTING THE CHARACTERIZATION OF THE TRANSACTION FOR OTHER PURPOSES, AND IS MORE IN ACCORDANCE TO THE FINANCIAL ACCOUNTING PRESENTATION. PART IV, COLUMN C, LINE 2C: ARBITRAGE REBATE CALCULATION PERFORMED ON 11/12/2024. BOND D, ENTITY 1: PART I, ROW D, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE AN OUTPATIENT AMBULATORY CARE BUILDING, FACILITY UPGRADES, AND COMPUTER UPGRADES AT CERTAIN BIDMC AFFILIATES. PART II, COLUMN D, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $24,764,267 OF INVESTMENT EARNINGS. PART IV, COLUMN D, LINE 2C: FINAL REBATE CALCULATION SHOWING NO REBATE DUE COMPLETED ON 09/30/2023. BOND A, ENTITY 2: PART I, ROW A, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 6/9/2008; 7/13/2004; 2/11/1998. PART II, COLUMN A, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $6,493 OF INVESTMENT EARNINGS. PART II, COLUMN A, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER IN ESCROW. PART IV, COLUMN A, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021. BOND B, ENTITY 2: PART I, ROW B, COLUMN F: THE ISSUE'S PURPOSE WAS TO FINANCE CAPITAL PROJECTS AND REFUND ISSUES DATED 08/17/2007 AND 07/14/2005. PART II, COLUMN B, LINE 3: THE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO THE $125,030 OF INVESTMENT EARNINGS. PART IV, COLUMN B, LINE 2C: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON 09/30/2021. BOND C, ENTITY 2: PART I, ROW C, COLUMN F: THE ISSUE'S PURPOSE WAS TO REFINANCE SEVERAL DIFFERENT ISSUES (DATED 06/09/2008; 11/30/2005; 07/16/2003; AND 06/04/1998), FUND TERMINATION PAYMENTS, AND FUND BUILDING IMPROVEMENTS, EQUIPMENT AND LAND IMPROVEMENTS. PART II, COLUMN C, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW PART IV, COLUMN C, LINE 2(C): ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 29, 2019. BOND D, ENTITY 2: PART I, ROW D, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW D, COLUMN F: REFINANCING AND REFUNDING PRIOR BONDS ISSUED ON 11/20/2003 AND 12/19/2001. PART II, COLUMN D, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. BOND A, ENTITY 3: PART I, ROW A, COLUMN A: NEW HAMPSHIRE HEALTH AND EDUCATION FACILITIES AUTHORITY. PART I, ROW A, COLUMN F: REFINANCING AND REFUNDING PRIOR BOND ISSUANCE 12/19/2001. PART II, COLUMN A, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. BOND B, ENTITY 3: PART I, ROW B, COLUMN A: MASSACHUSETTS HEALTH AND EDUCATIONAL FACILITIES AUTHORITY. PART I, ROW B, COLUMN F: DESCRIPTION OF PURPOSE - REFUND ISSUE DATED 06/28/2000. PART II, COLUMN B, LINE 11: THE OTHER SPENT PROCEEDS ARE THE REFUNDING PROCEEDS OF THE ISSUE NO LONGER IN ESCROW. PART IV, ROW 2C, COLUMN B: ARBITRAGE REBATE & YIELD RESTRICTION LIABILITY CALCULATION PERFORMED ON OCTOBER 10, 2009. PART III, LINE 9 AND PART IV, LINE 7: THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP WHICH WAS ORIGINALLY FORMED IN JUNE 2020 AND EXPANDED WITH THE ADDITION OF EXETER HOSPITAL (EIN: 22-2674014) IN JULY 2024. THE MAJORITY OF BILH OBLIGATED GROUP MEMBERS HAVE ADOPTED FORMAL WRITTEN POLICIES AND PROCEDURES TO REVIEW AND MONITOR ARRANGEMENTS WHICH COULD GENERATE PRIVATE USE OF BOND FINANCED AND COMPLIANCE RELATED TO INTERNAL REVENUE CODE (IRC) SECTION 141 AND ARBITRAGE RULES UNDER IRC SECTION 148. ALTHOUGH NOT EVERY MEMBER OF THE BILH OBLIGATED GROUP HAS FORMALLY ADOPTED THESE WRITTEN POLICIES AND PROCEDURES, THOSE THAT HAVE NOT NEVERTHELESS FOLLOW THE POLICIES AND PROCEDURES ADOPTED BY OTHER MEMBERS OF THE BILH OBLIGATED GROUP TO ENSURE COMPLIANCE WITH THESE SECTIONS OF THE IRC AND THE REGULATIONS PROMULGATED THEREUNDER. SUCH POLICIES AND PROCEDURES INCLUDE, AMONG OTHER THINGS, THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS, IF ANY, ARE TIMELY IDENTIFIED AND CORRECTED THROUGH THE VOLUNTARY CLOSING AGREEMENT PROGRAM IF SELF-REMEDIATION ISN'T AVAILABLE UNDER APPLICABLE REGULATIONS. THIS FORM 990 SCHEDULE K REPRESENTS TAX-EXEMPT DEBT OF ALL MEMBERS OF THE BETH ISRAEL LAHEY HEALTH (BILH) OBLIGATED GROUP. THE OBLIGATED GROUP INCLUDES THE FOLLOWING ENTITIES: BETH ISRAEL DEACONESS MEDICAL CENTER, INC., MOUNT AUBURN HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC., NEW ENGLAND BAPTIST HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL MILTON, INC., BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC., MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, MOUNT AUBURN PROFESSIONAL SERVICES, INC., LAHEY CLINIC FOUNDATION, INC., LAHEY CLINIC, INC., NORTHEAST HOSPITAL CORPORATION, WINCHESTER HOSPITAL, ANNA JAQUES HOSPITAL AND EXETER HOSPITAL. THE OBLIGATED GROUP IS AWARE OF THE INSTRUCTIONS TO SCHEDULE K THAT STATE THAT "IF THE ORGANIZATION HAS ONE OR MORE RELATED ORGANIZATIONS (FOR EXAMPLE, PARENT AND SUBSIDIARY RELATIONSHIP), IT MUST COMPLETE SCHEDULE K (FORM 990) CONSISTENT WITH THE FILINGS(S) OF ITS RELATED ORGANIZATION(S). THE SAME LIABILITY SHOULDN'T BE REPORTED BY MORE THAN ONE OF THE RELATED ORGANIZATIONS." THE OBLIGATED GROUP IS CURRENTLY WORKING TOWARD A DETERMINATION REGARDING THE REPORTING OF TAX-EXEMPT DEBT AMONG ITS MEMBERS WITH RESPECT TO SCHEDULE K. IN THE ABSENCE OF SUCH A DETERMINATION, FOR THE REPORTING PERIOD ENDING ON 09/30/2025, THE OBLIGATED GROUP HAS INCLUDED ALL TAX-EXEMPT BOND ISSUES ON EACH OF ITS MEMBER'S FORM 990 SCHEDULES K, WHICH IS CONSISTENT WITH THE APPROACH THAT HAS BEEN TAKEN SINCE THE OBLIGATED GROUP'S FORMATION. A MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584XMT5 2016-05-12 257611877 MDFA - SERIES 2016I - SEE PART VI 0 0 0 B MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584XFW6 2015-10-21 262828878 MDFA - LAHEY SERIES F - SEE PART VI 0 0 0 C MASSACHUSETTS DEVELOPMENT FINANCE AGENCY 043431814 57584XDH1 2015-09-02 203702204 MDFA - SERIES 2015 H-1 - SEE PART VI 0 0 0 D NH HEALTH AND EDUCATION FACILITIES AUTHORITY 020279866 000000000 2015-03-02 24020000 EXETER SERIES 2015 - SEE PART VI 0 0 0 A 68715000 257618370 2515889 19006493 236095988 2016 0 1 1 1 B 168545000 262953908 4857465 3129474 94764737 160202232 2021 1 1 1 1 C 173200000 203702204 2348479 201353725 1 1 1 1 D 15240000 24020000 162154 23857846 2015 1 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 1 1 C 0 0 0 1 0 0 0 0 1 D 1 1 0 0 0 1 A 1 B 1 C 1 D 1 A NH HEALTH AND EDUCATION FACILITIES AUTHORITY 020279866 000000000 2012-03-09 32565000 EXETER SERIES 2012 - SEE PART VI 0 0 0 B MASS HEALTH & EDUCATIONAL FACILITIES AUTHORITY 042456011 57586CDD4 2004-07-08 30340000 MHEFA - WINCHESTER F - ADV REFUND 0 0 0 A 16685000 32565000 215404 32349596 2012 1 0 1 1 B 13590000 30340000 365445 47003 29927552 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 1 1 0 0 0 1 B 0 0 0 1 1 1 MORGAN STANLEY 20.000000000000 0 0 0 0 1 A 1 B 1 SUBSTANTIAL CONTRIBUTOR INDEPENDENT CONTRACTOR 625040 FROM TIME TO TIME, MOUNT AUBURN HOSPITAL'S SERVICE PROVIDERS AND/OR VENDORS MAY MAKE A CHARITABLE CONTRIBUTION TO MOUNT AUBURN HOSPITAL TO SUPPORT MOUNT AUBURN HOSPITAL'S TAX EXEMPT MISSION. ALL OF MOUNT AUBURN HOSPITAL'S AGREEMENTS WITH VENDORS AND SERVICE PROVIDERS ARE REVIEWED BY THE BETH ISRAEL LAHEY HEALTH (BILH) OFFICE OF GENERAL COUNSEL AND OTHER BILH FUNCTIONS PURSUANT TO BILH'S POLICIES AND PROCEDURES BEFORE THEY ARE SIGNED. NO AGREEMENTS INCLUDE QUID PRO QUO PROVISIONS REQUIRING SERVICE PROVIDERS AND/OR VENDORS TO MAKE CONTRIBUTIONS TO MOUNT AUBURN HOSPITAL NOR ARE ANY CONTRIBUTIONS TAKEN INTO ACCOUNT AS AN INDUCEMENT TO SIGN AN AGREEMENT. ALL SUCH CONTRIBUTIONS ARE GIFTS MADE OUT OF GENEROSITY OF THE SERVICE PROVIDER/VENDOR. TRANSACTIONS WITH THOSE DONORS ARE REPORTED IN THIS FORM 990 SCHEDULE L AS REQUIRED. 0 SUBSTANTIAL CONTRIBUTOR INDEPENDENT CONTRACTOR 7597528 FROM TIME TO TIME, MOUNT AUBURN HOSPITAL'S SERVICE PROVIDERS AND/OR VENDORS MAY MAKE A CHARITABLE CONTRIBUTION TO MOUNT AUBURN HOSPITAL TO SUPPORT MOUNT AUBURN HOSPITAL'S TAX EXEMPT MISSION. ALL OF MOUNT AUBURN HOSPITAL'S AGREEMENTS WITH VENDORS AND SERVICE PROVIDERS ARE REVIEWED BY THE BETH ISRAEL LAHEY HEALTH (BILH) OFFICE OF GENERAL COUNSEL AND OTHER BILH FUNCTIONS PURSUANT TO BILH'S POLICIES AND PROCEDURES BEFORE THEY ARE SIGNED. NO AGREEMENTS INCLUDE QUID PRO QUO PROVISIONS REQUIRING SERVICE PROVIDERS AND/OR VENDORS TO MAKE CONTRIBUTIONS TO MOUNT AUBURN HOSPITAL NOR ARE ANY CONTRIBUTIONS TAKEN INTO ACCOUNT AS AN INDUCEMENT TO SIGN AN AGREEMENT. ALL SUCH CONTRIBUTIONS ARE GIFTS MADE OUT OF GENEROSITY OF THE SERVICE PROVIDER/VENDOR. TRANSACTIONS WITH THOSE DONORS ARE REPORTED IN THIS FORM 990 SCHEDULE L AS REQUIRED. 0 SUBSTANTIAL CONTRIBUTOR INDEPENDENT CONTRACTOR 338700 FROM TIME TO TIME, MOUNT AUBURN HOSPITAL'S SERVICE PROVIDERS AND/OR VENDORS MAY MAKE A CHARITABLE CONTRIBUTION TO MOUNT AUBURN HOSPITAL TO SUPPORT MOUNT AUBURN HOSPITAL'S TAX EXEMPT MISSION. ALL OF MOUNT AUBURN HOSPITAL'S AGREEMENTS WITH VENDORS AND SERVICE PROVIDERS ARE REVIEWED BY THE BETH ISRAEL LAHEY HEALTH (BILH) OFFICE OF GENERAL COUNSEL AND OTHER BILH FUNCTIONS PURSUANT TO BILH'S POLICIES AND PROCEDURES BEFORE THEY ARE SIGNED. NO AGREEMENTS INCLUDE QUID PRO QUO PROVISIONS REQUIRING SERVICE PROVIDERS AND/OR VENDORS TO MAKE CONTRIBUTIONS TO MOUNT AUBURN HOSPITAL NOR ARE ANY CONTRIBUTIONS TAKEN INTO ACCOUNT AS AN INDUCEMENT TO SIGN AN AGREEMENT. ALL SUCH CONTRIBUTIONS ARE GIFTS MADE OUT OF GENEROSITY OF THE SERVICE PROVIDER/VENDOR. TRANSACTIONS WITH THOSE DONORS ARE REPORTED IN THIS FORM 990 SCHEDULE L AS REQUIRED. 0 X 157 1528151 COST OR SELLING PRICE X ITEMS FOR PATIENT/MEMBERS 2 725 COST OR SELLING PRIC 0 1 0 PART I, COLUMN (B): THE NUMBERS REPORTED IN COLUMN B REPRESENT THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: THE MISSION OF MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) IS TO IMPROVE THE HEALTH OF THE RESIDENTS OF CAMBRIDGE, MASSACHUSETTS AND THE SURROUNDING COMMUNITIES IN COLLABORATION WITH ITS AFFILIATES IN THE BETH ISRAEL LAHEY HEALTH NETWORK. THE HOSPITAL'S SERVICES ARE DELIVERED IN A PERSONABLE AND COMPASSIONATE MANNER WITH RESPECT FOR EACH PATIENT'S DIGNITY, IN A LOCATION WHERE THESE PATIENTS LIVE AND WORK. IN ADDITION, AS PART OF ITS DEDICATION TO PROVIDING COMMUNITY BENEFITS, MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) IS COMMITTED TO WORKING IN PARTNERSHIP WITH RESIDENTS AND COMMUNITY LEADERS AS WELL AS CIVIC, SOCIAL AND MEDICAL ORGANIZATIONS FROM THE COMMUNITIES IT SERVES. MAH IS DEDICATED TO THE PLANNING, DEVELOPMENT, IMPLEMENTATION AND MONITORING OF PROGRAMS THAT ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITY AND OFFER CLINICAL, EDUCATIONAL AND FINANCIAL RESOURCES. THESE PROGRAMS ARE DESIGNED TO IMPROVE AWARENESS OF THE HEALTH CARE ISSUES IN THE COMMUNITIES SERVED AND INCREASE PARTICIPATION IN WELLNESS AND PREVENTATIVE HEALTH ACTIVITIES. FOR ADDITIONAL DETAIL, SEE FORM 990 SCHEDULE H. THE HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK AND WORKS IN CLOSE COLLABORATION WITH BILH AND ITS AFFILIATES TO ACCOMPLISH ITS MISSION. BETH ISRAEL LAHEY HEALTH (BILH) IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,900 PHYSICIANS AND 39,000 EMPLOYEES. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI) AND BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS, EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND LHSS IN TURN SERVED AS THE SOLE MEMBER OF THE ENTITIES WHICH COMPRISE, AMONG OTHER OPERATIONS, BETH ISRAEL LAHEY HEALTH CONTINUING CARE AND BETH ISRAEL LAHEY HEALTH MEDICAL GROUP. SEE FORM 990 SCHEDULE R FOR ADDITIONAL INFORMATION. FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: THE MISSION OF MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) IS TO IMPROVE THE HEALTH OF THE RESIDENTS OF CAMBRIDGE, MASSACHUSETTS AND THE SURROUNDING COMMUNITIES IN COLLABORATION WITH ITS AFFILIATES IN THE BETH ISRAEL LAHEY HEALTH NETWORK. THE HOSPITAL'S SERVICES ARE DELIVERED IN A PERSONABLE AND COMPASSIONATE MANNER WITH RESPECT FOR EACH PATIENT'S DIGNITY, IN A LOCATION WHERE THESE PATIENTS LIVE AND WORK. IN ADDITION, AS PART OF ITS DEDICATION TO PROVIDING COMMUNITY BENEFITS, MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) IS COMMITTED TO WORKING IN PARTNERSHIP WITH RESIDENTS AND COMMUNITY LEADERS AS WELL AS CIVIC, SOCIAL AND MEDICAL ORGANIZATIONS FROM THE COMMUNITIES IT SERVES. MAH IS DEDICATED TO THE PLANNING, DEVELOMENT, IMPLEMENTATION AND MONITORING OF PROGRAMS THAT ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITY AND OFFER CLINICAL, EDUCATIONAL AND FINANCIAL RESOURCES. THESE PROGRAMS ARE DESIGNED TO IMPROVE AWARENESS OF THE HEALTH CARE ISSUES IN THE COMMUNITIES SERVED AND INCREASE PARTICIPATION IN WELLNESS AND PREVENTATIVE HEALTH ACTIVITIES. FOR ADDITIONAL DETAIL, SEE FORM 990 SCHEDULE H. THE HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK AND WORKS IN CLOSE COLLABORATION WITH BILH AND ITS AFFILIATES TO ACCOMPLISH ITS MISSION. BETH ISRAEL LAHEY HEALTH (BILH) IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND SOUTHERN NEW HAMPSHIRE ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,900 PHYSICIANS AND 39,000 EMPLOYEES. DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS THE SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI) AND BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS, EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND LHSS IN TURN SERVED AS THE SOLE MEMBER OF THE ENTITIES WHICH COMPRISE, AMONG OTHER OPERATIONS, BETH ISRAEL LAHEY HEALTH CONTINUING CARE AND BETH ISRAEL LAHEY HEALTH MEDICAL GROUP. SEE FORM 990 SCHEDULE R FOR ADDITIONAL INFORMATION. FORM 990, PART III, LINE 4A, DESCRIPTION OF PROGRAM SERVICE: OUTPATIENT CLINICS AND SERVICES MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) PROVIDES A COMPREHENSIVE PROGRAM OF CLINICAL SERVICES ENCOMPASSING GENERAL INTERNAL MEDICINE AND ALL THE SUBSPECIALTIES OF INTERNAL MEDICINE, COVERING THE GAMUT OF SERVICES FROM PRIMARY TO TERTIARY CARE AS WELL AS PROVIDING SURGICAL SERVICES ON AN OUTPATIENT BASIS. MAH OFFERS COMPREHENSIVE SERVICES AND EXPERTISE IN ADDICTION RECOVERY/ ARTHRITIS CARE & RHEUMATOLOGY, BEHAVIORAL HEALTH, BREAST HEALTH, CANCER CARE/ONCOLOGY, DIABETES & ENDOCRINOLOGY, DIGESTIVE CARE/ GASTROENTEROLOGY, OTOLARYNGOLOGY, OPHTHALMOLOGY, WOMEN'S HEALTH INCLUDING OBSTETRICS, GYNECOLOGY AND FERTILITY CARE, CARDIOLOGY AND CARDIOVASCULAR CARE, HEMATOLOGY, HOME INFUSION THERAPY, HOSPICE CARE, NEPHROLOGY, PULMONOLOGY, NEUROLOGY, NUTRITION, OCCUPATIONAL MEDICINE, ORAL & MAXILLOFACIAL SURGERY, ORTHOPEDICS, PEDIATRICS, PLASTIC & RECONSTRUCTIVE SURGERY, PODIATRY & PODIATRIC, PRIMARY CARE, UROLOGY AND OTHER SPECIALTIES. MOUNT AUBURN HOSPITAL PROVIDES SAME DAY SURGICAL SERVICES IN BOTH THE MAIN OPERATING ROOM WHERE IT HAS 10 OPERATING ROOMS AND A DEDICATED PRE-SURGICAL AREA AND PACU AS WELL AS IN A SEPARATE SURGICAL DAY CARE AREA WITH AN ADDITIONAL 3 OPERATING ROOMS AND DEDICATED PACU SPACE. SAME DAY OUTPATIENT SURGERIES INCLUDE PROCEDURES IN THE FOLLOWING SPECIALTIES: OPHTHALMOLOGY, PODIATRY, GENERAL SURGERY, ORTHOPEDIC, GYNECOLOGY, HAND, UROLOGY, ENT, AND PLASTICS/COSMETICS. DURING THE PERIOD COVERED BY THIS FILING, MOUNT AUBURN HOSPITAL HAD 370,182 OUTPATIENT ENCOUNTERS. THIS INCLUDED 2,806 OBSERVATION CASES, 5,991 OUTPATIENT AMBULATORY SURGERIES, 8,366 OUTPATIENT ENDOSCOPY VISITS, 6,278 OUTPATIENT ONCOLOGY VISITS, 1,549 OUTPATIENT ONCOLOGY INFUSIONS, 22,584 OUTPATIENT EKG EXAMS, 824 OUTPATIENT ORTHOPEDIC PROCEDURES, 50,945 OUTPATIENT RADIOLOGY EXAMS, 20,285 OUTPATIENT CT SCANS, 18,581 OUTPATIENT ULTRASOUNDS, 11,606 OUTPATIENT MRIS, 1,069 OTHER NUCLEAR MEDICINE TESTS, 44,223 BREAST IMAGING EXAMS, 938,297 OUTPATIENT LAB TESTS, 15,622 OUTPATIENT REHABILITATION/PHYSICAL THERAPY VISITS, AND 51,519 OTHER TESTS AND PROCEDURES. FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICE: INPATIENT MEDICAL / SURGICAL AND INTENSIVE CARE MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) PROVIDES A WIDE RANGE OF INPATIENT CARE INCLUDING SURGICAL SERVICES, INTENSIVE AND CARDIAC CARE AND COMPLETE DIAGNOSTIC FACILITIES. MAH'S INPATIENT FACILITIES INCLUDE 153 LICENSED MEDICAL/SURGICAL BEDS, 20 INTENSIVE CARE UNIT BEDS, 28 OBSTETRICS BEDS AND 16 PSYCHIATRIC BEDS. SURGICAL SERVICES ARE AVAILABLE 24 HOURS A DAY FOR CRITICALLY ILL OR INJURED PATIENTS REQUIRING IMMEDIATE SURGICAL INTERVENTION, OR FOR OTHER PATIENTS ON A NON-EMERGENT OR ELECTIVE BASIS. MAH'S HIGHLY QUALIFIED SURGEONS PERFORM A WIDE RANGE OF SURGERIES COVERING MANY SURGICAL SUBSPECIALTIES. MAH SURGEONS FOCUS ON A DUAL MISSION OF CLINICAL CARE AND PATIENT EDUCATION. AS A TEACHING HOSPITAL OF HARVARD MEDICAL SCHOOL, IT IS ABLE TO OFFER A WIDER RANGE OF SURGICAL SERVICES THAN MOST HOSPITALS OF SIMILAR SIZE, INCLUDING NEUROSURGERY AND CARDIOVASCULAR SURGICAL PROCEDURES, AS WELL AS CONTINUAL SURGICAL RESPONSES IN ALL DISCIPLINES. MAH IS ALSO SMALL ENOUGH TO OFFER PERSONALIZED CARE THROUGHOUT A PATIENT'S SURGERY, INCLUDING PREPARATION AND RECOVERY. THE HOSPITAL IS ENRICHED BY THE ENTHUSIASM OF OUR MEDICAL RESIDENTS. ALONG WITH PRIMARY CARE (INTERNAL MEDICINE) AND GENERAL SURGERY, MOUNT AUBURN HOSPITAL STAFFS PHYSICIANS WHO SPECIALIZE IN A WIDE VARIETY OF MEDICAL AND SURGICAL DISCIPLINES INCLUDING, ALLERGY, ANESTHESIOLOGY, CARDIOLOGY, CARDIOVASCULAR AND THORACIC SURGERY, DERMATOLOGY, EAR NOSE AND THROAT, EMERGENCY MEDICINE, ENDOCRINOLOGY AND METABOLISM, FAMILY MEDICINE, GASTROENTEROLOGY, GERIATRIC MEDICINE, HAND SURGERY, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASES, NEPHROLOGY, NEUROLOGY, NEUROSURGERY, OCCUPATIONAL HEALTH, OPHTHALMOLOGY, ORAL SURGERY, ORTHOPEDIC SURGERY, PATHOLOGY, PLASTIC SURGERY, PODIATRY, PULMONARY MEDICINE, RHEUMATOLOGY, UROLOGY AND VASCULAR SURGERY. DURING THE PERIOD COVERED BY THIS FILING MOUNT AUBURN HAD 9,461 INPATIENT DISCHARGES WITH 43,922 INPATIENT DAYS, 2,371 NORMAL NEWBORN DISCHARGES WITH 5,612 NORMAL NEWBORN PATIENT DAYS, PERFORMED 1,335 INPATIENT SURGERIES, HAD 2,525 INPATIENT PSYCH DAYS AND HAD 2,599 NEWBORN DELIVERIES. FORM 990, PART III, LINE 4C, DESCRIPTION OF PROGRAM SERVICE: MOUNT AUBURN HOSPITAL (MAH OR HOSPITAL) OPERATES AN EMERGENCY DEPARTMENT (ED) WHICH IS OPEN TO ALL PATIENTS IN NEED OF EMERGENT CARE, REGARDLESS OF ABILITY TO PAY. THE ED IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD 32,722 EMERGENCY DEPARTMENT VISITS. IN ADDITION TO THE PROGRAM SERVICE ACCOMPLISHMENTS NOTED ABOVE, THE HOSPITAL ENGAGED IN SIGNIFICANT COMMUNITY BENEFITS ACTIVITIES. ALSO AS PREVIOUSLY NOTED, THE HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES. THE BILH NETWORK HAD SIGNIFICANT ACTIVITIES ACROSS ITS ENTITIES RELATED TO BOTH BEHAVIORAL HEALTH AND OTHER HEALTHCARE INITIATIVES. SEE THE NARRATIVE SUPPORT FOR SCHEDULE H FOR ADDITIONAL DETAILS. FORM 990, PART IV, LINE 12A AND 12B: THE BOSTON, MA OFFICE OF KPMG ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE BETH ISRAEL LAHEY HEALTH, INC. AND AFFILIATES FOR FISCAL PERIOD ENDED SEPTEMBER 30, 2025. THESE STATEMENTS WERE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND INCLUDED THE ACCOUNTS OF THE BETH ISRAEL LAHEY HEALTH, INC. (BILH), AND THE ENTITIES FOR WHICH BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS SOLE MEMBER DURING THE FISCAL PERIOD COVERED BY THIS FILING, (ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL -MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), THE JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC. (EHRI) AND THE BETH ISRAEL LAHEY HEALTH PHARMACY. THE LAHEY CLINIC FOUNDATION IN TURN SERVED AS THE SOLE MEMBER OF LAHEY CLINIC INC, AND LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, AND LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS. EHRI IN TURN SERVED AS THE SOLE MEMBER OF EXETER HOSPITAL AND OTHER AFFILIATES OF EHRI. EACH OF THESE BILH AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES, AND WHOSE ACCOUNTS ARE INCLUDED IN THE BILH AUDITED FINANCIAL STATEMENTS. IN ADDITION, THE BILH FINANCIAL STATEMENTS ALSO INCLUDE THE ACCOUNTS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP), THE DEDICATED PHYSICIAN PRACTICE OF BETH ISRAEL DEACONESS MEDICAL CENTER AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. THE ACCOUNTS OF THE ENTITIES FOR WHICH HMFP SERVES AS MEMBER ARE ALSO INCLUDED IN THE HMFP AND BILH AUDITED FINANCIAL STATEMENTS. THE AUDIT AND COMPLIANCE COMMITTEE OF BILH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE CONSOLIDATED AUDIT FOR THE NETWORK AS A WHOLE. FORM 990, PART V, LINE 1A: AS NOTED THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH (BILH) SERVED AS A SUPPORT ORGANIZATION AND THE DIRECT OR INDIRECT SOLE MEMBER OF MOUNT AUBURN HOSPITAL. AS PART OF THAT RELATIONSHIP, BILH PROVIDED CENTRALIZED SUPPORT TO ITS NETWORK OF SUPPORTED ORGANIZATIONS, INCLUDING AMONG OTHER THINGS, OPERATIONAL SUPPORT SUCH AS PROCESSING PAYROLL AND ACCOUNTS PAYABLE. IN THIS CAPACITY BILH ISSUED ALL FORMS 1099 TO NOT ONLY ITS OWN VENDORS AND SERVICE PROVIDERS, BUT ALSO TO THOSE WHO PROVIDED SERVICES TO MOUNT AUBURN HOSPITAL. FORMS 1099 WERE ALL ISSUED IN THE BILH NAME AND UNDER THE BILH EIN. HOWEVER, IN ACCORDANCE WITH INSTRUCTIONS TO THIS FORM 990, MOUNT AUBURN HOSPITAL IS REPORTING THE NUMBER OF FORMS 1099 RELATED TO SERVICES PERFORMED FOR AND PAYMENTS RELATED TO, ITS SERVICE PROVIDERS AS IF THEY WERE PROCESSED DIRECTLY BY MOUNT AUBURN HOSPITAL. EACH OTHER AFFILIATE IS SIMILARLY REPORTING THE NUMBER OF FORMS 1099 WHICH ARE ATTRIBUTABLE TO THEIR OWN SERVICE PROVIDERS. FORM 990, PART VI, SECTION A, LINE 2 MARY ELIZABETH BEAMS, BOARD TRUSTEE & VICE CHAIR, AND DR. MICHAEL SHORTSLEEVE, BOARD TRUSTEE, HAVE A FAMILY RELATIONSHIP. FOR THE PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS DIRECT OR INDIRECT SOLE MEMBER OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS (LCH), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS (NHC), NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), BETH ISRAEL LAHEY HEALTH PHARMACY, JOSLIN DIABETES CENTER, EXETER HEALTH RESOURCES, INC. (EHRI) AND EXETER HOSPITAL. EACH OF THESE AFFILIATES MAY HAVE, IN TURN, SERVED AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE BILH NETWORK OF AFFILIATES. IN ADDITION, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP) IS THE DEDICATED PHYSICIAN PRACTICE OF BIDMC AND AN ENTITY INTEGRALLY RELATED TO HELPING BIDMC AND OTHER AFFILIATES IN THE BILH NETWORK ACCOMPLISH THEIR CHARITABLE PURPOSES. FOR THIS SAME PERIOD HMFP SERVED AS THE SOLE MEMBER OF ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER D/B/A LONGWOOD SPECIALTY PHYSICIANS (LSP) AS WELL AS THE DIRECT OR INDIRECT MEMBER OF SEVERAL ADDITIONAL ENTITIES. TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS/TRUSTEES OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES WITHIN THE NETWORK OF THE AFFILIATED ORGANIZATIONS NOTED ABOVE. ADDITIONAL DETAIL IS PROVIDED IN THE EXPLANATORY NOTES TO THIS FORM 990 SCHEDULE J. FORM 990, PART VI, SECTION A, LINE 4 SUMMARY OF MOUNT AUBURN HOSPITAL, INC. (MAH) AMENDMENTS TO BY-LAWS MOUNT AUBURN HOSPITAL AMENDED AND RESTATED ITS BY-LAWS TWICE SINCE THE BEGINNING OF THE FISCAL PERIOD COVERED BY THIS FORM 990, ON BOTH MARCH 28, 2025 AND AGAIN EFFECTIVE OCTOBER 1, 2025. A SUMMARY OF THE AMENDMENTS TO THE BY-LAWS ARE LISTED BELOW. 1. CHANGE TO EX-OFFICIO TRUSTEES - THE PRESIDENT OF THE MOUNT AUBURN HOSPITAL AUXILIARY NO LONGER SERVES AS AN EX- OFFICIO TRUSTEE. 2. BOARD OF ADVISORS - THE REFERENCE TO THE "BOARD OF ADVISORS/OVERSEERS" WAS CHANGED TO THE "BOARD OF ADVISORS" 3. CHANGES TO THE COMPOSITION OF THE QUALITY/PATIENT EXPERIENCE AND CARE ASSESSMENT COMMITTEE, A MANDATORY STANDING COMMITTEE OF THE BOARD. - REPLACED REFERENCE TO "CHIEF NURSING EXECUTIVE" WITH "CHIEF NURSING OFFICER" TO REFLECT THE CURRENT LEADERSHIP STRUCTURE OF THE HOSPITAL - CLARIFIED THAT AT LEAST ONE TRUSTEE IN ADDITION TO THE PRESIDENT AND BOARD CHAIR MUST BE A COMMITTEE MEMBER - REMOVED THE CHAIR OF QUALITY AND SAFETY AND THE PATIENT CARE ASSESSMENT COORDINATOR AS EX-OFFICIO COMMITTEE MEMBERS THE AMENDMENTS DID NOT IMPACT MAH'S PRIMARY MISSION, FUNCTION OR PURPOSES. FORM 990, PART VI, SECTION A, LINE 6 DURING THE FISCAL PERIOD COVERED BY THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) SERVED AS THE SOLE DIRECT MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL - MILTON, INC. (BID-MILTON), BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM, INC. (BID-NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH, INC. (BID-PLYMOUTH), LAHEY HEALTH SHARED SERVICES (LHSS), LAHEY CLINIC FOUNDATION (LCF), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC) WHICH INCLUDES BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS, NORTHEAST BEHAVIORAL CORPORATION (NBHC) D/B/A BILH BEHAVIORAL SERVICES, ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN), JOSLIN DIABETES CENTER (JDC), EXETER HEALTH RESOURCES, INC (EHRI) AND BETH ISRAEL LAHEY HEALTH PHARMACY. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE DIRECT OR INDIRECT MEMBER OF THE FILING ENTITY, WITH RESERVED POWERS TO BILH. SEE ADDITIONAL INFORMATION IN FORM 990 PART VI QUESTIONS 7A AND 7B. FORM 990, PART VI, SECTION A, LINE 7A SEE FORM 990, PART VI SECTION A LINE 7B BELOW FORM 990, PART VI, SECTION A, LINE 7B AS NOTED PREVIOUSLY IN THIS FORM 990, BETH ISRAEL LAHEY HEALTH, INC. IS MOUNT AUBURN HOSPITAL'S SOLE MEMBER. THE MEMBER OF MOUNT AUBURN HOSPITAL HAS THE RIGHTS AND POWERS DELINEATED BELOW, AS DESIGNATED IN MOUNT AUBURN HOSPITAL'S BY-LAWS. MOUNT AUBURN HOSPITAL MAY BE REFERRED TO AS "THE CORPORATION" IN THE PARAGRAPHS BELOW. RESERVED POWERS SUBJECT TO THE PROVISIONS OF THE ARTICLES OF ORGANIZATION AND MOUNT AUBURN HOSPITAL'S BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, BOTH POSITIVE AND NEGATIVE, CONFERRED BY MASSACHUSETTS GENERAL LAWS ("M.G.L.") CHAPTER 180, AS AMENDED, ON MEMBERS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. IN ADDITION, EXCEPT AS ARE EXPRESSLY GRANTED TO MOUNT AUBURN HOSPITAL'S BOARD OF TRUSTEES ("BOARD") IN THE BYLAWS, THE MEMBER SHALL HAVE THE RIGHT TO EXERCISE ALL POWERS, POSITIVE AND NEGATIVE, CONFERRED BY M.G.L. CHAPTER 180 ON BOARDS OF CORPORATIONS ORGANIZED UNDER M.G.L. CHAPTER 180. NOTWITHSTANDING THE FOREGOING, THE MEMBER MAY NOT TAKE ANY OF THE FOLLOWING ACTIONS WITHOUT THE APPROVAL OF MOUNT AUBURN HOSPITAL'S BOARD: (A) APPROVE OR REQUIRE ANY CHANGE IN, OR CONSOLIDATION OF PHILANTHROPIC GIFTS, ASSETS, AND PROGRAMS OF THE CORPORATION, WHICH SHALL REMAIN UNDER THE CORPORATION'S CONTROL AND BE USED FOR THE BENEFIT OF THE CORPORATION AND NOT FOR OTHER COMPONENTS OF THE MEMBER'S SYSTEM, EXCEPT TO THE EXTENT THAT SUCH CHANGES INVOLVE BACK-OFFICE CONSOLIDATION WITH OTHER DIRECT OR INDIRECT SUBSIDIARIES OF THE MEMBER; (B) APPROVE OR REQUIRE ANY CHANGE IN THE NAME, BRAND, OR TRADEMARK OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES, EXCEPT SUCH COMPLEMENTARY CHANGES AS THE MEMBER MAY DETERMINE ARE REASONABLY APPROPRIATE IN ESTABLISHING A SYSTEM-WIDE IDENTITY FOR THE AFFILIATED ENTITIES; OR (C) AMEND OR RESTATE MOUNT AUBURN HOSPITAL'S BYLAWS TO CHANGE OR ELIMINATE EITHER OF THE FOREGOING LIMITATIONS ON ITS POWERS. THE MEMBER MAY NOT CAUSE THE CORPORATION TO CEASE OPERATING A SEPARATELY LICENSED HOSPITAL FACILITY, OR CLOSE ANY ESSENTIAL SERVICE OF SUCH HOSPITAL FACILITY, WITHOUT CONSULTING WITH THE BOARD PRIOR TO TAKING SUCH ACTION. APPOINTMENT, REAPPOINTMENT AND REMOVAL OF BOARD MEMBERS AND CERTAIN EX-OFFICIO STATUS THE MEMBER SHALL HAVE THE EXCLUSIVE AUTHORITY, AFTER CONSULTATION WITH THE CHAIR OF MOUNT AUBURN HOSPITAL'S BOARD AND THE MOUNT AUBURN HOSPITAL PRESIDENT AND REVIEW OF RECOMMENDATIONS, IF ANY, MADE BY THE BOARD, TO: (A) APPOINT AND REAPPOINT TRUSTEES (B) FILL ANY VACANCIES IN THE OFFICES OF TRUSTEES, AND (C) ACTING BY VOTE OF NOT LESS THAN THREE QUARTERS (3/4) OF THE MEMBER'S TRUSTEES THEN IN OFFICE, REMOVE, WITH OR WITHOUT CAUSE, A TRUSTEE. NOTWITHSTANDING THE FOREGOING, ANY REMOVAL SHALL BE FOLLOWING NOTICE TO THE CHAIR (OR THE VICE-CHAIR IF THE CHAIR IS THE SUBJECT OF REMOVAL) AND AN OPPORTUNITY FOR THE CHAIR TO BE HEARD BY THE MEMBER'S BOARD OR A STANDING OR AD HOC COMMITTEE THEREOF, EXCEPT IN CIRCUMSTANCES WHERE THE MEMBER DETERMINES THAT IMMEDIATE REMOVAL IS IN THE BEST INTEREST OF THE CORPORATION. IN ADDITION, THE FOLLOWING SERVE EX-OFFICIO ON MOUNT AUBURN HOSPITAL'S BOARD: - PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE MEMBER OR HIS OR HER DESIGNEE - THE PRESIDENT OF THE CORPORATION, WHO REPORTS TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE MEMBER BOARD POWERS AND RESPONSIBILITIES THE POWERS AND RESPONSIBILITIES OF THE BOARD INCLUDE THE FOLLOWING: (A) PROVIDING RECOMMENDATIONS TO THE MEMBER REGARDING (I) APPOINTMENT, REAPPOINTMENT AND REMOVAL OF TRUSTEES, (II) THE ESTABLISHMENT OF THE CORPORATION'S POLICIES, (III) THE MAINTENANCE OF PATIENT CARE QUALITY, AND (IV) THE PROVISION OF CLINICAL SERVICES AND COMMUNITY SERVICE PLANNING IN A MANNER RESPONSIVE TO LOCAL COMMUNITY NEEDS; (B) ENSURING COMPLIANCE WITH ALL LICENSURE AND ACCREDITATION REQUIREMENTS, INCLUDING CREDENTIALING AND OTHER MEDICAL STAFF MATTERS; (C) PROVIDING OVERSIGHT FOR INSTITUTIONAL PLANNING, MAKING RECOMMENDATIONS FOR NEW CLINICAL SERVICES, AND PARTICIPATING IN AN ANNUAL REVIEW OF THE CORPORATION'S STRATEGIC AND FINANCIAL PLAN AND GOALS; (D) REVIEWING AND RECOMMENDING APPROVAL OF OPERATING AND CAPITAL BUDGETS AS WELL AS MAKING RECOMMENDATIONS WITH RESPECT TO CAPITAL EXPENDITURES; (E) MAKING RECOMMENDATIONS WITH RESPECT TO QUALITY ASSESSMENT AND IMPROVEMENT PROGRAMS; (F) PROVIDING OVERSIGHT OF RISK MANAGEMENT PROGRAMS RELATING TO PATIENT CARE AND SAFETY; (G) REVIEWING DISASTER PLANS THAT DEAL WITH BOTH INTERNAL (E.G., FIRE) AND EXTERNAL DISASTERS; AND (H) EVALUATING RECRUITMENT NEEDS TO ENSURE ADEQUATE MEDICAL STAFF CAPACITY TO CONTINUE TO MEET COMMUNITY NEEDS. LIMITATIONS ON BOARD POWERS EXCEPT AS OTHERWISE PROVIDED IN MOUNT AUBURN HOSPITAL'S BYLAWS, THE BOARD SHALL ACT IN AN ADVISORY CAPACITY AND CONSISTENT THEREWITH SHALL HAVE ONLY THE FOLLOWING POWERS: (A) POWERS EXPRESSLY GRANTED BY THE MEMBER FROM TIME TO TIME; (B) POWER TO EXERCISE ITS AUTHORITY AS A MEMBER OF OTHER LEGAL ENTITIES; (C) POWER TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THE BYLAWS OF THE MEMBER (AS DEFINED UNDER THE BYLAWS OF THE MEMBER) OR UNDER MOUNT AUBURN HOSPITAL'S BYLAWS WITH RESPECT TO THE MEMBER; AND (D) POWERS TO ENFORCE ANY RIGHTS VESTED IN THE CORPORATION UNDER THAT AGREEMENT DATED JUNE 30, 2017 BY AND AMONG LAHEY HEALTH SYSTEM, INC., BETH ISRAEL DEACONESS MEDICAL CENTER, INC., NEW ENGLAND BAPTIST HOSPITAL, INC., MOUNT AUBURN HOSPITAL, CAREGROUP, INC., AND SEACOAST REGIONAL HEALTH SYSTEMS, INC. THE POWERS OF THE BOARD IN CLAUSES (A) AND (B) IMMEDIATELY ABOVE SHALL BE SUBJECT TO THE RESERVED POWERS OF THE MEMBER AS NOTED ABOVE. NOTWITHSTANDING CLAUSE (B) ABOVE, THE POWER OF THE CORPORATION TO EXERCISE ITS AUTHORITY AS A MEMBER OF ANOTHER LEGAL ENTITY SHALL BE SUBJECT TO THE FOLLOWING LIMITATIONS: (X) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER LEGAL ENTITY UNDER MASSACHUSETTS LAW MAY BE EXERCISED BY THE CORPORATION ONLY AT THE EXPRESS AND EXPLICIT DIRECTION OF, AND WITH THE APPROVAL OF, ENTITY-NAME}}'S MEMBER; (Y) ALL STATUTORY POWERS THAT RESIDE IN THE CORPORATION AS A MEMBER OF ANOTHER LEGAL ENTITY UNDER MASSACHUSETTS LAW MAY BE EXERCISED DIRECTLY BY MOUNT AUBURN HOSPITAL'S MEMBER AFTER CONSULTATION WITH THE CHAIR BUT OTHERWISE WITHOUT THE APPROVAL OR PARTICIPATION OF THE CORPORATION; AND (Z) OTHER THAN STATUTORY POWERS, THE CORPORATION SHALL HAVE ONLY THOSE POWERS AND AUTHORITIES OVER AND WITH RESPECT TO THE LEGAL ENTITIES OF WHICH IT IS A MEMBER AS ARE EXPRESSLY AND EXPLICITLY DELEGATED OR DIRECTED TO THE CORPORATION BY ACTION OF MOUNT AUBURN HOSPITAL'S MEMBER'S BOARD. OFFICERS APPOINTED BY PERSONS OTHER THAN THE GOVERNING BODY: THE FOLLOWING OFFICERS EACH SERVE EX-OFFICIO, DO NOT HAVE TERMS AND RETAIN THEIR RESPECTIVE POSITIONS AS OFFICERS SO LONG AS THEY RETAIN THE POSITIONS WITH THE MEMBER UPON WHICH EX-OFFICIO STATUS IS CONFERRED: - THE CEO, WHO SHALL BE THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE MEMBER; - THE TREASURER, WHO SHALL BE THE TREASURER OF THE MEMBER AND WHO IS ALSO THE CHIEF FINANCIAL OFFICER OF THE MEMBER; - ASSISTANT TREASURER, WHO SHALL BE THE CHIEF FINANCIAL OFFICER (OR COMPARABLE POSITION) OF THE CORPORATION - THE CLERK, WHO SHALL BE THE CLERK OF THE MEMBER AND WHO ALSO SERVES AS GENERAL COUNSEL OF THE MEMBER; - THE ASSISTANT CLERK, WHO SHALL BE THE ATTORNEY IN THE BETH ISRAEL LAHEY HEALTH OFFICE OF GENERAL COUNSEL SUPPORTING THE CORPORATION THE PRESIDENT OF THE CORPORATION SHALL BE APPOINTED, AND MAY BE REMOVED, BY THE CEO AFTER CONSULTATION WITH MOUNT AUBURN HOSPITAL'S BOARD CHAIR. COMPENSATION: COMPENSATION FOR THE PRESIDENT SHALL BE SET BY THE MEMBER AFTER CONSULTATION WITH MOUNT AUBURN HOSPITAL'S BOARD CHAIR. COMPENSATION FOR SENIOR EXECUTIVES OF THE CORPORATION SHALL BE SET IN ACCORDANCE WITH POLICIES AND PROCEDURES ESTABLISHED BY THE MEMBER. SEE FORM 990 PART VI SECTION B QUESTIONS 15A AND 15B AS WELL AS FORM 990 SCHEDULE J PART I FOR ADDITIONAL DETAILS. STANDING COMMITTEES OF THE BOARD: MOUNT AUBURN HOSPITAL'S BOARD SHALL HAVE THE FOLLOWING MANDATORY STANDING COMMITTEES UNLESS OTHERWISE AUTHORIZED BY THE MEMBER: - FINANCE - QUALITY/PATIENT EXPERIENCE AND CARE ASSESSMENT - GOVERNANCE/NOMINATING - MEDICAL STAFF APPOINTMENT - PHILANTHROPY CONFLICT OF INTEREST AND CONFIDENTIALITY OFFICERS, TRUSTEES AND NON-TRUSTEE COMMITTEE MEMBERS SHALL COMPLY IN ALL RESPECTS WITH THE CONFLICT OF INTEREST POLICIES AND PROCEDURES AND THE STATEMENT OF CONFIDENTIALITY OBLIGATIONS ADOPTED BY THE MEMBER FOR APPLICABILITY TO ALL SUBSIDIARIES AND AFFILIATES OF THE MEMBER. SEE FORM 990 PART VI SECTION B QUESTIONS 12A, 12B AND 12C FOR ADDITIONAL DETAILS FORM 990, PART VI, SECTION B, LINE 11B AS NOTED IN VARIOUS DISCLOSURES THROUGHOUT THIS FILING, BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS THE DIRECT OR INDIRECT SOLE MEMBER OF MOUNT AUBURN HOSPITAL. THIS FORM 990 IS PREPARED BY THE BILH TAX DEPARTMENT IN CONJUNCTION WITH DELOITTE TAX, LLP (DELOITTE). AS PART OF THIS PROCESS, THE BILH TAX DEPARTMENT WORKS WITH OTHER DISCIPLINES AND FUNCTIONS WITHIN BILH AND MOUNT AUBURN HOSPITAL TO ENSURE THAT ALL FINANCIAL AND NON-FINANCIAL DISCLOSURES ARE COMPLETE AND ACCURATE. EXAMPLES OF SUCH DEPARTMENTS INCLUDE BUT ARE NOT LIMITED TO: FINANCE AND ACCOUNTING, HUMAN RESOURCES AND PAYROLL, TREASURY, COMPLIANCE, LEGAL, COMMUNITY BENEFITS, FINANCIAL ASSISTANCE AND REIMBURSEMENT, GOVERNANCE, DEVELOPMENT, GRADUATE MEDICAL EDUCATION, GOVERNMENT RELATIONS, RESEARCH AND/OR RESEARCH FINANCE. MOUNT AUBURN HOSPITAL'S FORM 990 IS REVIEWED INTERNALLY BY THE BILH ASSISTANT VICE PRESIDENT, TAXATION AND EXTERNALLY BY DELOITTE. MOUNT AUBURN HOSPITAL'S FORM 990, ALONG WITH THE FORMS 990 OF ALL ENTITIES IN THE BILH NETWORK, ARE DISCUSSED WITH THE BILH AUDIT AND COMPLIANCE COMMITTEE. DELOITTE SIGNS THE FINAL RETURNS. A COPY OF THE COMPLETE RETURN IS THEN PROVIDED TO EACH MEMBER OF MOUNT AUBURN HOSPITAL'S BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C AS NOTED THROUGHOUT THIS FILING, MOUNT AUBURN HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) SYSTEM OF AFFILIATES. ALL ENTITIES IN THE BILH NETWORK ADHERE TO THE BILH CONFLICT OF INTEREST POLICY AND MAINTAIN A WRITTEN, COMPREHENSIVE CONFLICT OF INTEREST POLICY WHICH HAS BEEN ADOPTED AT THE ENTITY LEVEL. PURSUANT TO THESE POLICIES, BILH ENTITIES' OFFICERS, TRUSTEES AND KEY EMPLOYEES AS WELL AS CERTAIN OTHER INDIVIDUALS ARE REQUIRED TO COMPLETE THE ANNUAL CONFLICT OF INTEREST AND TAX QUESTIONNAIRE (COI-TQ). THE COI-TQ IS DESIGNED TO REQUIRE DISCLOSURE OF ANY BUSINESS AND FAMILY RELATIONSHIPS AND AFFILIATIONS MAINTAINED BY OFFICERS, TRUSTEES, OR KEY EMPLOYEES AND THEIR FAMILY MEMBERS AND WHICH MAY RESULT IN A REAL OR PERCEIVED CONFLICT OF INTEREST. THE BILH OFFICE OF INTEGRITY AND COMPLIANCE, IN CONJUNCTION WITH THE BILH TAX DEPARTMENT, ADMINISTERS THE COI-TQ PROCESS ANNUALLY. BILH INTEGRITY AND COMPLIANCE COLLECTS AND REVIEWS ALL DISCLOSURES. A SUMMARY OF POSITIVE RESPONSES FOR EACH BILH AFFILIATE IS PROVIDED TO THE COMPLIANCE OFFICER FOR THAT ENTITY FOR REVIEW FINAL DETERMINATION OF ANY POTENTIAL OR ACTUAL CONFLICT. ANY ACTIVITY THAT REQUIRES ACTION UNDER THE CONFLICT OF INTEREST POLICIES IS SUBJECT TO ONGOING REVIEW BY MOUNT AUBURN HOSPITAL AS WELL AS THE BILH INTEGRITY AND COMPLIANCE OFFICE. PURSUANT TO THE BILH CONFLICT OF INTEREST POLICY, CERTAIN ACTIVITIES WHICH COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED WHILE OTHER TYPES OF RELATIONSHIPS ARE PERMITTED, SUBJECT TO COMPLIANCE WITH A MANAGEMENT PLAN INCLUDING DISCLOSURE AND RECUSAL WHICH REQUIRES APPROPRIATE DOCUMENTATION IN THE MINUTES. IN ADDITION, AS NOTED ABOVE, THE ANNUAL COI-TQ PROCESS OUTLINED ABOVE IS JOINTLY ISSUED BY THE BILH TAX DEPARTMENT, TO ENSURE THAT THE QUESTIONNAIRE IS DISTRIBUTED TO ALL CURRENT AND FORMER MEMBERS OF THE MOUNT AUBURN HOSPITAL BOARD OF TRUSTEES AS WELL AS CURRENT AND FORMER OFFICERS AND KEY EMPLOYEES. THE COI-TQ PROCESS IS DESIGNED TO GATHER THE INFORMATION NECESSARY FOR MOUNT AUBURN HOSPITAL TO COMPLETELY AND ACCURATELY COMPLETE FORM 990 SCHEDULE L, TRANSACTIONS WITH INTERESTED PERSONS AND FORM 990, PART VI, QUESTION 2, FAMILY AND BUSINESS RELATIONSHIPS BETWEEN OFFICERS, DIRECTORS/TRUSTEES AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 AS NOTED THROUGHOUT THIS FILING, MOUNT AUBURN HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS MOUNT AUBURN HOSPITAL'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. IN THIS ROLE BILH MAINTAINS THE RESPONSIBILITY FOR SETTING COMPENSATION FOR EXECUTIVES, SENIOR MANAGEMENT, OFFICERS AND KEY EMPLOYEES OF THE ENTITIES WHICH COMPRISED THE BETH ISRAEL LAHEY HEALTH NETWORK. THE BILH COMPENSATION COMMITTEE IS THEREFORE RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES, THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES AND EXCEPT AS OTHERWISE NOTED BELOW OR IN FORM 990 SCHEDULE J, THE COMPENSATION REPORTED IN THIS FORM 990 FOR MOUNT AUBURN HOSPITAL'S OFFICERS AND KEY EMPLOYEES WAS SET BY THE BILH COMPENSATION COMMITTEE. THE BILH COMPENSATION COMMITTEE PROCESS FOR SETTING COMPENSATION IS BELOW. THE BETH ISRAEL LAHEY HEALTH (BILH) COMPENSATION COMMITTEE ESTABLISHES THE POLICIES AND THE COMPENSATION STRUCTURE, INCLUDING BENEFITS, FOR THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES INCLUDING THE BILH CHIEF EXECUTIVE OFFICER AS WELL AS OTHER MEMBERS OF SENIOR MANAGEMENT AT BILH AND ITS AFFILIATES. THE COMPENSATION COMMITTEE IS RESPONSIBLE FOR ASSURING THAT THE TOTAL COMPENSATION PROVIDED TO THESE INDIVIDUALS IS FAIR AND REASONABLE USING CURRENT AND CREDIBLE MARKET PRACTICE INFORMATION AND IS RESPONSIBLE FOR ENSURING COMPLIANCE WITH APPLICABLE LEGAL AND REGULATORY GUIDELINES. THE BILH COMPENSATION COMMITTEE IS COMPOSED OF INDEPENDENT MEMBERS OF ITS BOARD OF TRUSTEES. IN SETTING COMPENSATION, THE COMPENSATION COMMITTEE RELIES UPON PUBLISHED COMPENSATION SURVEYS AND STUDIES PRODUCED BY INDEPENDENT COMPENSATION CONSULTING FIRMS THAT REGULARLY ASSESS EXECUTIVE COMPENSATION AND BENEFITS OF SUBSTANTIALLY SIMILAR ORGANIZATIONS. THE COMPENSATION COMMITTEE MEETS TO REVIEW THE COMPENSATION STRUCTURE OF THE INDIVIDUALS DESCRIBED ABOVE AND AT THAT TIME REVIEWS THE COMPENSATION SURVEY DETAILS PREPARED BY THE INDEPENDENT COMPENSATION CONSULTING FIRM. FOR SOME CATEGORIES OF POSITIONS, THE COMPENSATION COMMITTEE WILL REVIEW THE COMPENSATION STRUCTURE AND TARGETS AS A GROUP, RATHER THAN BY INDIVIDUAL. COMPENSATION FOR THE BILH CEO AND OTHER MEMBERS OF EXECUTIVE MANAGEMENT IS REVIEWED ON AN INDIVIDUAL BASIS. THE COMPENSATION COMMITTEE THEN VOTES TO APPROVE THE COMPENSATION ARRANGEMENTS OF ALL INDIVIDUALS DESCRIBED ABOVE EXCEPT FOR THE BILH CEO. THE COMPENSATION PACKAGE FOR THE BILH CEO AS VOTED BY THE COMPENSATION COMMITTEE IS SUBMITTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. ALL DELIBERATIONS FOR BOTH THE COMPENSATION COMMITTEE AND THE BOARD OF TRUSTEES ARE CONTEMPORANEOUSLY DOCUMENTED IN MINUTES. THE COMPENSATION COMMITTEE PROCESSES AND PROCEDURES AS DESCRIBED ABOVE ARE DESIGNED TO MEET THE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-6(C), REBUTTABLE PRESUMPTION THAT A TRANSACTION IS NOT AN EXCESS BENEFIT TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 AS NOTED THROUGHOUT THIS FILING, MOUNT AUBURN HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH (BILH) NETWORK OF AFFILIATES WITH BILH SERVING AS MOUNT AUBURN HOSPITAL'S SOLE MEMBER, OR IF NOT AS DIRECT SOLE MEMBER, INDIRECTLY AS THE MEMBER IN ITS CAPACITY AS PARENT OF THE BETH ISRAEL LAHEY HEALTH NETWORK. MOUNT AUBURN HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST AT THE FOLLOWING LOCATION: BETH ISRAEL LAHEY HEALTH TAX DEPARTMENT SCHRAFFT'S CITY CENTER, 4TH FLOOR, 529 MAIN STREET CHARLESTOWN, MA 02129 FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 12,662,108. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,662,108. OUTSIDE LABOR: PROGRAM SERVICE EXPENSES 10,829,331. MANAGEMENT AND GENERAL EXPENSES 79,314. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,908,645. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 462,546. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 462,546. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 11,470,203. MANAGEMENT AND GENERAL EXPENSES 538,815. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,009,018. CLINICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,686. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,686. LAB SERVICES FROM AFFILIATES: PROGRAM SERVICE EXPENSES 1,581,575. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,581,575. FORM 990, PART XI, LINE 9: CHANGE IN FUNDED STATUS OF BENEFITS -44,713. PLEDGE AND FUND ADJUSTMENTS 20,540. DEFINED BENEFIT POST RETIREMENT PERIODIC BENEFIT COST 42,835. FORM 990, PART XII, LINE 2C: AS NOTED THROUGHOUT THIS FORM 990, MOUNT AUBURN HOSPITAL IS A MEMBER OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL LAHEY HEALTH (BILH) SERVES AS THE DIRECT OR INDIRECT MEMBER OF MOUNT AUBURN HOSPITAL AND MOUNT AUBURN HOSPITAL IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF BETH ISRAEL LAHEY HEALTH. THE AUDIT AND COMPLIANCE COMMITTEE OF BILH'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE CONSOLIDATED AUDIT FOR THE NETWORK AS A WHOLE. ADDISON GILBERT SOCIETY INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 464371382 PROFESSIONAL SERVICES & FINANCIAL SUPPORT MA 501(C)(3) 10 LAHEY HEALTH SHARED SERVICES INC 1 ANNA JAQUES HOSPITAL 25 HIGHLAND AVE NEWBURYPORT MA 01950 042104338 HEALTHCARE MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 ASSOC PHYS HARVARD MED FAC PHY AT BIDMC 375 LONGWOOD AVE BOSTON MA 02215 320058309 TO PROVIDE EMERGENCY MEDICAL SERVICES MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BAIM INSTITUTE FOR CLINICAL RESEARCH INC DBA BAIM INSTITUTE 930 COMMONWEALTH AVE BOSTON MA 02215 043521077 SCIENTIFIC & MEDICAL RESEARCH MA 501(C)(3) 10 N/A 0 BETH ISRAEL ANAESTHESIA FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042997215 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL COMMUNITY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042776678 INACTIVE CORPORATION MA 501(C)(3) 7 N/A 0 BETH ISRAEL DEACONESS DEPARTMENT OF EMERGENCY MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 364803234 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF MEDICINE FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043079630 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF NEONATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 208253452 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF NEUROLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043030397 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF ORTHOPAEDIC SURGERY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 204974585 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF RADIATION ONCOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 873655583 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HMFP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS DEPARTMENT OF SURGERY FOUNDATION INC 110 FRANCIS ST BOSTON MA 02215 020671240 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL DEACONESS HOSPITAL MILTON INC 199 REEDSDALE RD MILTON MA 02186 042103604 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DEACONESS HOSPITAL NEEDHAM INC 148 CHESTNUT ST NEEDHAM MA 02492 043229679 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH INC 275 SANDWICH ST PLYMOUTH MA 02360 222667354 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DEACONESS MEDICAL CENTER INC 330 BROOKLINE AVE BOSTON MA 02215 042103881 THE OPERATION OF A WORLD CLASS ACADEMIC MEDICAL CENTER IN BOSTON, MA MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL DERMATOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 043117601 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BETH ISRAEL LAHEY HEALTH PHARMACY INC 80 WILSON WAY WESTWOOD MA 02090 822526816 TO OPERATE A SPECIALTY PHARMACY AND 340B PROGRAM FOR BIDMC MA 501(C)(3) 10 BETH ISRAEL DEACONESS MEDICAL CENTER INC 1 BETH ISRAEL LAHEY HEALTH PRIMARY CARE 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 472248298 HEALTHCARE MA 501(C)(3) 10 LAHEY HEALTH SHARED SERVICES INC 1 BETH ISRAEL LAHEY HEALTH INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 832671600 MANAGEMENT PROFESSIONAL & IT SUPPORT SERVICES MA 501(C)(3) 12C, III-FI N/A 0 BIDMC AND CHILDREN'S HOSPITAL MEDICAL CARE CORP 300 LONGWOOD AVE BOSTON MA 02215 043200113 OUTPATIENT AMBULATORY CENTER - INACTIVE MA 501(C)(3) 12A, I N/A 0 BIDMC OBSTETRICS AND GYNECOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042794855 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BID-MILTON PHYSICIAN ASSOCIATES INC 199 REEDSDALE ROAD MILTON MA 02186 222566792 PROMOTE HEALTHCARE MA 501(C)(3) 10 BETH ISRAEL DEACONESS HOSPITAL - MILTON 1 BIH PATHOLOGY FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 222548374 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 BIH RADIOLOGIC FOUNDATION INC 330 BROOKLINE AVE BOSTON MA 02215 042571853 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 CAB HEALTH AND RECOVERY SERVICES INC 529 MAIN STREET 4TH FL CHARLESTOWN MA 02129 042400270 SUBSTANCE ABUSE - INACTIVE MA 501(C)(3) 12A, I NORTHEAST BEHAVIORAL HEALTH CORPORATION 1 CENTER FOR MEDICAL SIMULATION 100 FIRST AVE BUILDING 39 4TH CHARLESTOWN MA 02129 043486127 TO IMPROVE PATIENT SAFETY AND HEALTH CARE QUALITY MA 501(C)(3) 10 BETH ISRAEL ANAESTHESIA FOUNDATION INC 1 COMMUNITY PHYSICIANS ASSOCIATES INC 199 REEDSDALE RD MILTON MA 02186 043243146 OUTPATIENT AND PRIMARY CARE SERVICES MA 501(C)(3) 3 BETH ISRAEL DEACONESS HOSPITAL - MILTON 1 CONTINUING EDU PROGRAM DBA BID DEPT OF PSYCH FDN 375 LONGWOOD AVE BOSTON MA 02215 043242952 SUPPORT PATIENT CARE, RESEARCH AND TEACHING MISSIONS OF BIDMC, HFMP AND HMS MA 501(C)(3) 12A, I HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER 1 CORE PHYSICIANS LLC 4 ALUMNI DRIVE EXETER NH 03833 870807914 PHYSICIAN PRACTICES NH 501(C)(3) 10 EXETER HEALTH RESOURCES INC 1 CPHCH INC DBA BILH AT HOME - WATERTOWN C/O NRPN 600 CUMMINGS CTR BEVERLY MA 01915 473111453 HOME CARE & HOSPICE - INACTIVE MA 501(C)(3) 12A, I NORTHEAST SENIOR HEALTH CORPORATION 1 EXETER HEALTH RESOURCES SELF-INSURANCE TRUST 5 ALUMNI DRIVE EXETER NH 03833 200753662 SELF-INSURANCE TRUST NH 501(C)(3) 12A, I EXETER HEALTH RESOURCES INC 1 EXETER HEALTH RESOURCES INC 5 ALUMNI DRIVE EXETER NH 03833 020222126 SUPPORT COMMUNITY HEALTH & NETWORK MGMT SVCS NH 501(C)(3) 12A, I BETH ISRAEL LAHEY HEALTH INC 1 EXETER HOSPITAL INC 5 ALUMNI DRIVE EXETER NH 03833 222674014 HOSPITAL FOR THE TREATMENT, CARE AND RELIEF OF SICK AND SUFFERING PERSONS. NH 501(C)(3) 3 EXETER HEALTH RESOURCES INC 1 EXETER MED REAL INC 5 ALUMNI DRIVE EXETER NH 03833 020418718 REAL ESTATE HOLDING COMPANY NH 501(C)(25) EXETER HEALTH RESOURCES INC 1 HARVARD MEDICAL FACULTY PHYSICIANS AT BIDMC INC 375 LONGWOOD AVE BOSTON MA 02215 222768204 GENERAL AND SPECIALIZED MEDICAL SERVICES TO THE PATIENTS OF BIDMC AND OTHERS MA 501(C)(3) 10 BETH ISRAEL DEACONESS MEDICAL CENTER INC 1 HEALTH AND EDUCATION HOUSING SERVICES INC 529 MAIN STREET 4TH FL CHARLESTOWN MA 02129 223232914 HUD HOUSING - INACTIVE MA 501(C)(3) 10 NORTHEAST BEHAVIORAL HEALTH CORPORATION 1 JORDAN PHYSICIAN ASSOCIATES INC 275 SANDWICH ST PLYMOUTH MA 02360 043228556 OUTPATIENT AND PRIMARY CARE SERVICES MA 501(C)(3) 10 BETH ISRAEL DEACONESS HOSPITAL-PLYMOUTH INC 1 JOSLIN CLINIC INC 330 BROOKLINE AVENUE BOSTON MA 02215 222984590 PREVENTION, TREATMENT, AND CURE OF DIABETES MA 501(C)(3) 12A, I JOSLIN DIABETES CENTER INC 1 JOSLIN DIABETES CENTER INC 330 BROOKLINE AVENUE BOSTON MA 02215 042203836 PREVENTION, TREATMENT, AND CURE OF DIABETES MA 501(C)(3) 7 BETH ISRAEL LAHEY HEALTH INC 1 LAHEY CLINIC CANADIAN FOUNDATION 130 KING ST WEST TORONTO ONTARIO CA FUNDRAISING ORG CA N/A 0 LAHEY CLINIC FOUNDATION INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 042323457 FINANCIAL & OPERATIONAL SUPPORT TO LCI AND LCH MA 501(C)(3) 7 BETH ISRAEL LAHEY HEALTH INC 1 LAHEY CLINIC HOSPITAL INC DBA LAHEY HOSPITAL & MEDICAL CENTER AND LMC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 042704686 HEALTHCARE MA 501(C)(3) 3 LAHEY CLINIC FOUNDATION INC 1 LAHEY CLINIC INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 042704683 HEALTHCARE MA 501(C)(3) 10 LAHEY CLINIC FOUNDATION INC 1 LAHEY HEALTH SHARED SERVICES INC 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 043178972 ADMIN MA 501(C)(3) 10 BETH ISRAEL LAHEY HEALTH INC 1 MED CARE OF BOSTON MGMT CORP DBA BILH PRIMARY CARE 464 HILLSIDE AVE NEEDHAM MA 02494 042810972 OUTPATIENT, PRIMARY CARE AND SPECIALTY SERVICES MA 501(C)(3) 10 BETH ISRAEL LAHEY HEALTH PRIMARY CARE 1 MOUNT AUBURN PROFESSIONAL SERVICES INC 330 MOUNT AUBURN ST CAMBRIDGE MA 02138 043026897 OFFERING MEDICAL CARE IN GENERAL AND SPECIALIZED PRACTICES MA 501(C)(3) 12A, I MOUNT AUBURN HOSPITAL 1 NEW ENGLAND BAPTIST HOSPITAL 125 PARKER HILL AVE BOSTON MA 02120 042103612 ORTHOPEDIC SPECIALTY HOSPITAL MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 NEW ENGLAND BAPTIST MEDICAL ASSOCIATES INC 125 PARKER HILL AVE BOSTON MA 02120 043235796 OUTPATIENT MEDICAL SERVICES TO THE VARIOUS COMMUNITIES SERVICED BY NEBH MA 501(C)(3) 3 NEW ENGLAND BAPTIST HOSPITAL 1 NORTHEAST BEHAVIORAL HEALTH CORP DBA BILH BEHAVIORAL HEALTH SERVICES 529 MAIN STREET 4TH FL CHARLESTOWN MA 02129 042777145 HEALTHCARE MA 501(C)(3) 10 BETH ISRAEL LAHEY HEALTH INC 1 NORTHEAST HEALTH SYSTEMS INC 85 HERRICK ST BEVERLY MA 01915 043240453 FINANCIAL & OPERATIONAL SUPPORT MA 501(C)(3) 12B, II LAHEY HEALTH SHARED SERVICES INC 1 NORTHEAST HOSPITAL CORPORATION 85 HERRICK ST BEVERLY MA 01915 042121317 HEALTHCARE MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 BETH ISRAEL LAHEY HEALTH SPECIALTY CARE INC 85 HERRICK ST BEVERLY MA 01915 043201853 HEALTHCARE MA 501(C)(3) 10 NORTHEAST HOSPITAL CORPORATION 1 NORTHEAST PROFESSIONAL REGISTRY OF NURSES INC DBA BILH AT HOME 800 CUMMINGS CENTER BEVERLY MA 01915 201287349 HEALTHCARE MA 501(C)(3) 10 NORTHEAST SENIOR HEALTH CORPORATION 1 NORTHEAST SENIOR HEALTH CORPORATION 85 HERRICK ST BEVERLY MA 01915 042731137 HEALTHCARE MA 501(C)(3) 10 LAHEY HEALTH SHARED SERVICES INC 1 ROCKINGHAM VISITING NURSE ASSOCIATION AND HOSPICE 5 ALUMNI DRIVE EXETER NH 03833 020274905 HOME CARE & HOSPICE NH 501(C)(3) 10 EXETER HEALTH RESOURCES INC 1 SEACOAST AFFILIATED GROUP PRACTICE INC 25 HIGHLAND AVE NEWBURYPORT MA 01915 043485648 PHYSICIAN GROUP MA 501(C)(3) 10 ANNA JAQUES HOSPITAL INC 1 SEACOAST NURSING AND REHABILITATION CENTER INC 300 WASHINGTON ST GLOUCESTER MA 01930 041305001 HEALTHCARE MA 501(C)(3) 10 LAHEY HEALTH SHARED SERVICES INC 1 THE JORDAN HEALTH SYSTEMS INC 275 SANDWICH ST PLYMOUTH MA 02360 042103805 PROMOTE HEALTHCARE MA 501(C)(3) 7 BETH ISRAEL DEACONESS MEDICAL CENTER INC 1 WINCHESTER COMMUNITY ACCOUNTABLE CARE ORGANIZATION INC 41 HIGHLAND AVE WINCHESTER MA 01890 223137856 ACO - INACTIVE MA 501(C)(3) 12A, I WINCHESTER HEALTHCARE MANAGEMENT INC 1 WINCHESTER HEALTHCARE MANAGEMENT INC 41 HIGHLAND AVE WINCHESTER MA 01890 222701817 MANAGEMENT MA 501(C)(3) 12A, I LAHEY HEALTH SHARED SERVICES INC 1 WINCHESTER HOSPITAL 41 HIGHLAND AVE WINCHESTER MA 01890 042104434 HEALTHCARE MA 501(C)(3) 3 BETH ISRAEL LAHEY HEALTH INC 1 WINCHESTER HOSPITAL FOUNDATION INC 41 HIGHLAND AVE WINCHESTER MA 01890 043399570 PROFESSIONAL SERVICES & FINANCIAL SUPPORT MA 501(C)(3) 12A, I WINCHESTER HEALTHCARE MANAGEMENT INC 1 BETH ISRAEL LAHEY HEALTH SURGERY CENTER PLYMOUTH LLC 41 RESNIK ROAD PLYMOUTH MA 02360 883871838 SURGERY CENTER MA N/A 0 0 BIDCO HOSPITAL LLC 247 STATION DRIVE NORTHWEST 1 WESTWOOD MA 02090 461643790 COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BIDMC MA N/A 0 0 BIDCO PHYSICIAN LLC 600 UNICORN PARK DRIVE 4TH FL WOBURN MA 01801 461589743 COORDINATED SAFE AND COST EFFECTIVE PATIENT CARE AT BILH MA N/A 0 0 BILH INVESTMENT PARTNERSHIP LLP 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 043278109 INVESTMENT PARTNERSHIP MA BETH ISRAEL DEACONESS MEDICAL CENTER EXCLUDED 12071933 150396595 0 190763 0 0.11520 NEBSC HOSPITAL HOLDINGS LLC 125 PARKER HILL AVE BOSTON MA 02120 874293833 INVESTMENT PARTNERSHIP MA N/A 0 0 NEW ENGLAND BAPTIST SURGERY CENTER LLC 100 AVON MEADOW LANE AVON CT 06001 874311329 AMBULATORY SURGERY CENTER MA N/A 0 0 PHYSICIANS PROFESSIONAL SERVICES LLP 200 RIVERS EDGE DRIVE MEDFORD MA 02155 043275078 TO PROVIDE MEDICAL BILLING SERVICES MA N/A 0 0 SHIELDS IMAGING AT ANNA JAQUES HOSPITAL LLC 700 CONGRESS ST STE 204 QUINCY MA 02169 383989358 MRI SERVICES MA N/A 0 0 WINCHESTER HOSPITALSHIELDS MRI LLC 700 CONGRESS ST STE 204 QUINCY MA 02169 462523117 MRI SERVICES MA N/A 0 0 BOSS HOLDINGS LLC 840 WINTER ST WALTHAM MA 02451 271976270 OUTPATIENT SURGICAL SUITES MA N/A 0 0 GREATER NEWBURYPORT MANAGEMENT SERVICES ORGANIZATION INC 25 HIGHLAND AVE NEWBURYPORT MA 01950 161744477 MANAGEMENT SERVICES MA N/A C 0 HUNTINGFIELD CORPORATION C/O LCF 529 MAIN ST 4TH FL CHARLESTOWN MA 02129 520717412 TO HOLD OWNERSHIP OF SUBTERRANEAN RIGHTS DE N/A C 0 LAHEY CLINIC INSURANCE CO LTD CRAIG APPIN HOUSE PO BOX HM 2450 HAMILTON BD INSURANCE BD N/A C 0 LEDGEWOOD HEALTH CARE CORPORATION 87 HERRICK STREET BEVERLY MA 01915 042855189 NURSING HOME MA N/A C 0 NORTHEAST PROPRIETARY CORP 85 HERRICK STREET BEVERLY MA 01915 042855191 MEDICAL SERVICES MA N/A C 0 WINCHESTER HEALTHCARE ENTERPRISES INC 41 HIGHLAND AVE WINCHESTER MA 01890 042932059 MANAGEMENT SERVICES MA N/A C 0 WINCHESTER PHYSICIAN ASSOCIATES INC 41 HIGHLAND AVE WINCHESTER MA 01890 043262963 PHYSICIAN GROUP MA N/A C 0 INSCRIPTRX INC 80 WILSON WAY WESTWOOD MA 02090 934223952 PHARMACY BENEFITS MANAGEMENT MA N/A C 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 1 1 1 1 1 SEE PART VII M 6760965 FMV SEE PART VII Q 210469 FMV SEE PART VII E 31888173 FMV SEE PART VII J 63444 FMV SEE PART VII L 81194 FMV SEE PART VII M 1444334 FMV SEE PART VII O 154434 FMV SEE PART VII P 130609 FMV SEE PART VII R 2715971 FMV SEE PART VII M 306922167 FMV SEE PART VII O 820741 FMV SEE PART VII P 24600344 FMV SEE PART VII Q 790816 FMV SEE PART VII R 446164114 FMV SEE PART VII S 47658443 FMV SEE PART VII P 158805 FMV SEE PART VII M 24916802 FMV SEE PART VII S 56518 FMV SEE PART VII J 1928950 FMV SEE PART VII K 640465 FMV SEE PART VII L 6017278 FMV SEE PART VII M 11781280 FMV SEE PART VII O 1116391 FMV SEE PART VII Q 5783667 FMV SEE PART VII R 2016739 FMV SEE PART VII S 2517550 FMV SEE PART VII M 1098786 FMV SEE PART VII D 2738368938 FMV SEE PART VII E 99730180 FMV SEE PART VII M 1427070 FMV SEE PART VII P 1600228 FMV SEE PART VII Q 71438 FMV FORM 990, SCH R, PART V, LN 1D - LOANS OR LOAN GUARANTEES TO OR FOR RO MOUNT AUBURN HOSPITAL ("MAH") IS A MEMBER OF THE BILH OBLIGATED GROUP AND AS SUCH IS JOINTLY AND SEVERALLY LIABLE FOR ALL DEBT OF THE OBLIGATED GROUP. IN THIS CAPACITY, MAH HAS MADE LOAN GUARANTEES TO THE FOLLOWING OTHER MEMBERS OF THE OBLIGATED GROUP TOTALING $2,738,368,938: 1. ANNA JAQUES HOSPITAL 2. BETH ISRAEL DEACONESS MEDICAL CENTER 3. LAHEY CLINIC FOUNDATION 4. NORTHEAST HOSPITAL CORP. D/B/A BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS 5. WINCHESTER HOSPITAL 6. BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH 7. NEW ENGLAND BAPTIST HOSPITAL 8. BETH ISRAEL DEACONESS HOSPITAL - MILTON 9. BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 10. EXETER HOSPITAL FORM 990, SCH R, PART V, LN 1R - OTHER TRANSFER OF CASH/PROP TO RO AS NOTED THROUGHOUT THIS FILING, MAH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, MAH TRANSFERRED CASH TO ONE OR MORE OF ITS AFFILIATED ENTITIES AS PART OF NETWORK-WIDE CASH MANAGEMENT AND IN FURTHERANCE OF THE EXEMPT PURPOSE OF MAH AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, MAH TRANSFERRED THE FOLLOWING CASH OR PROPERTY TO ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH, INC. - SEE NOTE ABOVE IN CODE M SUPPORTING DETAIL: $446,164,114 2. BETH ISRAEL DEACONESS MEDICAL CENTER - OTHER CASH TRANSFERS: $2,715,971 3. MOUNT AUBURN PROFESSIONAL SERVICES, INC. - INVENTORY TRANSFERS AND INSURANCE PREMIUM REBATE: $2,016,739 FORM 990, SCH R, PART V, LN 1S - OTHER TRANSFER OF CASH/PROP FROM RO AS NOTED THROUGHOUT THIS FILING, MAH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, ONE OR MORE OF ITS AFFILIATED ENTITIES MADE CASH PAYMENTS TO MAH AS PART OF NETWORK-WIDE CASH MANAGEMENT AND IN FURTHERANCE OF THE EXEMPT PURPOSE OF MAH AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, THE FOLLOWING CASH OR PROPERTY WAS TRANSFERRED TO MAH BY ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL LAHEY HEALTH, INC. - OTHER CASH TRANSFERS: $47,658,443 (SEE CODE M ABOVE FOR ADDITIONAL DETAILS) 2. LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS - OTHER TRANSFERS: $56,518 3. MOUNT AUBURN PROFESSIONAL SERVICES, INC. - CASH AND OTHER TRANSFERS: $2,517,550 FORM 990, SCH R, PART V, LN 1E - LOANS OR LOAN GUARANTEES BY RO MAH IS A MEMBER OF THE BILH OBLIGATED GROUP AND AS SUCH ALL OTHER MEMBERS OF THE BILH OBLIGATED GROUP ARE JOINTLY AND SEVERALLY LIABLE FOR THE OBLIGATED GROUP DEBT OUTSTANDING AT MAH. IN THIS CAPACITY, THE ENTITIES LISTED BELOW HAVE LOAN GUARANTEES TO MAH TOTALING $99,730,180 1. ANNA JAQUES HOSPITAL 2. BETH ISRAEL DEACONESS MEDICAL CENTER 3. LAHEY CLINIC FOUNDATION 4. LAHEY CLINIC HOSPITAL D/B/A LAHEY CLINIC, LAHEY CLINIC PEABODY AND LAHEY CLINIC OUTPATIENT REHABILITATION SERVICES AT DANVERS 5. LAHEY CLINIC, INC. 6. MOUNT AUBURN PROFESSIONAL SERVICES 7. NORTHEAST HOSPITAL CORP. D/B/A BEVERLY, ADDISON GILBERT AND BAYRIDGE HOSPITALS 8. WINCHESTER HOSPITAL 9. BETH ISRAEL DEACONESS HOSPITAL - PLYMOUTH 10. NEW ENGLAND BAPTIST HOSPITAL 11. BETH ISRAEL DEACONESS HOSPITAL - MILTON 12. BETH ISRAEL DEACONESS HOSPITAL - NEEDHAM 13. EXETER HOSPITAL 14. MEDICAL CARE OF BOSTON MANAGEMENT CORP. D/B/A BETH ISRAEL LAHEY HEALTH PRIMARY CARE FORM 990, SCH R, PART V, LN 1J - LEASE OF FAC/EQUIP/OTHER ASSETS TO RO MAH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THE CLOSE CONNECTION BETWEEN MAH, MOUNT AUBURN PROFESSIONAL SERVICES, INC. (("MAPS"), A RELATED ENTITY EXEMPT UNDER IRC 501(C)(3)) AND BETH ISRAEL DEACONESS MEDICAL CENTER (("BIDMC"), A RELATED ENTITY EXEMPT UNDER IRC 501(C)(3)), MAPS AND BIDMC LEASE SPACE FROM MAH TO USE IN FURTHERANCE OF THE MAPS, MAH, BIDMC AND BILH TAX-EXEMPT PURPOSES. 1. MAPS PAID MAH $1,928,950 FOR SPACE RENTAL. 2. BIDMC PAID MAH $63,444 FOR SPACE RENTAL. FORM 990, SCH R, PART V, LN 1K - LEASE OF FAC/EQUIP/OTHER ASSETS FROM RO AS NOTED ELSEWHERE IN THIS FILING, MAH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THE CLOSE CONNECTION BETWEEN MAH AND MAPS, MAH LEASES SPACE FROM MAPS TO USE IN FURTHERANCE OF THE MAPS, MAH, AND BILH TAX-EXEMPT PURPOSES. MAH PAID MAPS $640,465 FOR SPACE RENTAL. FORM 990, SCH R, PART V, LN 1L - PERF OF SVCS/MEMBERSHIP/FUNDRAISING FOR RO AS NOTED THROUGHOUT THIS FILING, MAH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, MAH PROVIDES SERVICES TO OTHER NETWORK ENTITIES IN FURTHERANCE WITH ITS EXEMPT PURPOSE AND IN FURTHERANCE OF THE EXEMPT PURPOSE OF ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, MAH PROVIDED THE FOLLOWING SERVICES TO ITS TAX EXEMPT AFFILIATES: 1. BETH ISRAEL DEACONESS MEDICAL CENTER - ENVIRONMENTAL SERVICES FOR INFUSION SPACE: $81,194 2. MOUNT AUBURN PROFESSIONAL SERVICES, INC. - EPIC IMPLEMENTATION AND OTHER SERVICES: $6,017,278 FORM 990, SCH R, PART V, LN 1M - PERF OF SVCS/MEMBERSHIP/FUNDRAISING BY RO AS NOTED THROUGHOUT THIS FILING, MAH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, ONE OR MORE OF MAH'S AFFILIATES PROVIDED SERVICES TO MAH IN FURTHERANCE OF THE EXEMPT PURPOSE OF MAH AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, MAH RECEIVED THE FOLLOWING SERVICES FROM ITS TAX-EXEMPT AFFILIATES: 1. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER D/B/A LONGWOOD SPECIALTY PHYSICIANS - PHYSICIAN AND OTHER SERVICES: $6,760,965 2. BETH ISRAEL DEACONESS MEDICAL CENTER - PHYSICIAN AND LAB SERVICES: $1,444,334 3. BETH ISRAEL LAHEY HEALTH, INC. - 4. AS A SUPPORT ORGANIZATION OF MAH, BILH PROVIDES CENTRALIZED SUPPORT TO, AND OVERSEES THE FINANCIAL WELL-BEING OF, ITS NETWORK OF SUPPORTED ORGANIZATIONS. THESE ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING AREAS: EXECUTIVE MANAGEMENT AND OPERATIONAL LEADERSHIP, STRATEGIC PLANNING, HUMAN RESOURCES AND BENEFIT PLAN STRUCTURING, DEVELOPMENT AND FUNDRAISING, COMPLIANCE, GOVERNANCE AND LEGAL, PAYOR CONTRACTING, REVENUE CYCLE, FINANCIAL PLANNING & ANALYSIS, CAPITAL PLANNING, FINANCE AND ACCOUNTING INCLUDING PROCESSING PAYROLL AND ACCOUNTS PAYABLE, INTERNAL AND EXTERNAL AUDIT, INSURANCE, DEBT STRUCTURING SUPPORT AND FINANCING OF CAPITAL PROJECTS THROUGH ITS OBLIGATED GROUP DEBT, TAX SERVICES, INVESTMENT MANAGEMENT SERVICES, SUPPLY CHAIN MANAGEMENT AND PURCHASING AND NETWORK-WIDE CASH MANAGEMENT. A. NETWORK ASSESSMENT FEE FOR SERVICES ABOVE: $50,603,091 B. OPERATION OF PAYROLL AND PROVISION OF EMPLOYEE BENEFITS: $104,095,854 C. OPERATION OF ACCOUNTS PAYABLE AND PAYMENT FOR THIRD PARTY SERVICES: $152,223,222 D. SEE OTHER CODES FOR ADDITIONAL DETAILS. 5. HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. - PHYSICIAN COVERAGE: $24,916,802 6. MOUNT AUBURN PROFESSIONAL SERVICES, INC. - SUPPORT SERVICES: $11,781,280 7. NORTHEAST BEHAVIORAL HEALTH CORP - BEHAVIORAL HEALTH SERVICES: $1,098,786 8. WINCHESTER HOSPITAL - LAB SERVICES: $1,427,070 FORM 990, SCH R, PART V, LN 1O - SHARING OF PAID EMPLOYEES WITH RO 1. BETH ISRAEL DEACONESS MEDICAL CENTER - $154,434 2. BETH ISRAEL LAHEY HEALTH, INC. - $820,741 3. MOUNT AUBURN PROFESSIONAL SERVICES, INC. - $1,116,391 FORM 990, SCH R, PART V, LN 1P - REIMBURSEMENT PAID TO RO FOR EXPENSES AS NOTED THROUGHOUT THIS FILING, MAH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, MAH REIMBURSED ONE OR MORE OF ITS AFFILIATED ENTITIES FOR EXPENSES INCURRED ON BEHALF OF MAH IN FURTHERANCE OF THE EXEMPT PURPOSE OF MAH AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, MAH MADE THE FOLLOWING REIMBURSEMENTS FOR EXPENSES TO ITS TAX-EXEMPT AFFILIATES: 1. BETH ISRAEL DEACONESS MEDICAL CENTER - INFUSION RELATED COSTS: $130,609 2. BETH ISRAEL LAHEY HEALTH, INC. - EXPENSE REIMBURSEMENT FOR SALARIES & BENEFITS: $24,600,344 3. BETH ISRAEL LAHEY HEALTH PHARMACY - EXPENSE REIMBURSEMENT FOR OPERATIONAL COSTS: $158,805 4. WINCHESTER HOSPITAL - EXPENSE REIMBURSEMENT FOR LAB EXPENSES: $1,600,228 FORM 990, SCH R, PART V, LN 1Q - REIMBURSEMENT PAID BY RO FOR EXPENSES AS NOTED THROUGHOUT THIS FILING, MAH IS A MEMBER OF THE BILH NETWORK OF AFFILIATES. AS PART OF THAT RELATIONSHIP, MAH WAS REIMBURSED BY ONE OR MORE OF ITS AFFILIATED ENTITIES FOR EXPENSES INCURRED IN FURTHERANCE OF THE EXEMPT PURPOSE OF MAH AND ITS AFFILIATES. DURING THE PERIOD COVERED BY THIS FILING, MAH RECEIVED THE FOLLOWING REIMBURSEMENTS FOR EXPENSES FROM ITS TAX-EXEMPT AFFILIATES: 1. ASSOCIATED PHYSICIANS OF HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER D/B/A LONGWOOD SPECIALTY PHYSICIANS - EXPENSE REIMBURSEMENTS FOR OPERATIONAL COSTS AND MALPRACTICE INSURANCE): $210,469 2. MOUNT AUBURN PROFESSIONAL SERVICES, INC. - EXPENSE REIMBURSEMENT FOR SALARIES & BENEFITS, OPERATIONAL AND ADMIN COSTS: $ 5,783,667 3. BETH ISRAEL LAHEY HEALTH, INC. - EXPENSE REIMBURSEMENT FOR OPERATIONAL AND ADMINISTRATIVE COSTS: $790,816 4. WINCHESTER HOSPITAL - EXPENSE REIMBURSEMENT FOR SALARIES & BENEFITS, OPERATIONAL AND ADMINISTRATIVE COSTS: $71,438