4A (Expenses $ 155804878 including grants of $ 124509) (Revenue $ 139557603)
SEE SCHEDULE O

4B (Expenses $ 33248363 including grants of $ 0) (Revenue $ 36077881)
SEE SCHEDULE O

4C (Expenses $ 26752002 including grants of $ 0) (Revenue $ 32331549)
SEE SCHEDULE O

4D (Expenses $ 106344662 including grants of $ 0) (Revenue $ 134969275)
SEE SCHEDULE O

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.

FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS
COMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSMOUNT AUBURN HOSPITAL (MAH) AFFILIATIONBETH ISRAEL LAHEY HEALTH (BILH) IS THE SOLE MEMBER OF MOUNT AUBURN HOSPITAL (MAH). THE BILH NETWORK OF AFFILIATES IS AN INTEGRATED HEALTH CARE SYSTEM COMMITTED TO EXPANDING ACCESS TO EXTRAORDINARY PATIENT CARE ACROSS EASTERN MASSACHUSETTS AND ADVANCING THE SCIENCE AND PRACTICE OF MEDICINE THROUGH GROUNDBREAKING RESEARCH AND EDUCATION. THE BILH SYSTEM IS COMPRISED OF ACADEMIC AND TEACHING HOSPITALS, A PREMIER ORTHOPEDICS HOSPITAL, PRIMARY CARE AND SPECIALTY CARE PROVIDERS, AMBULATORY SURGERY CENTERS, URGENT CARE CENTERS, COMMUNITY HOSPITALS, HOMECARE SERVICES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, ADDICTION TREATMENT PROGRAMS. THE BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 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.MAH COMMUNITY BENEFITS MISSION STATEMENT MOUNT AUBURN HOSPITAL IS STEADFAST IN ITS COMMITMENT TO IMPROVING THE HEALTH AND WELLBEING 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.MAH'S COMMUNITY BENEFITS MISSION IS FULFILLED BY:- INVOLVING MAH'S STAFF, INCLUDING ITS LEADERSHIP AND DOZENS OF COMMUNITY PARTNERS, IN THE CHNA PROCESS AS WELL AS IN THE DEVELOPMENT, IMPLEMENTATION AND OVERSIGHT OF THE HOSPITAL'S THREE-YEAR IMPLEMENTATION STRATEGY;- ENGAGING AND LEARNING FROM RESIDENTS THROUGHOUT MAH'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 NEEDS AND IDENTIFY COMMUNITIES AND POPULATION SEGMENTS DISPROPORTIONATELY IMPACTED BY HEALTH ISSUES AND OTHER SOCIAL, ECONOMIC AND SYSTEMIC FACTORS;- IMPLEMENTING COMMUNITY HEALTH PROGRAMS AND SERVICES IN MOUNT AUBURN HOSPITAL'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 ADDRESSING SOCIAL AND INSTITUTIONAL INEQUITIES, RACISM AND BIGOTRY AND ENSURING THAT ALL PATIENTS ARE WELCOMED AND RECEIVE CARE THAT IS RESPECTFUL AND CULTURALLY RESPONSIVE; AND- FACILITATING COLLABORATION AND PARTNERSHIP WITHIN AND ACROSS SECTORS (E.G., STATE/LOCAL PUBLIC HEALTH AGENCIES, HEALTH CARE PROVIDERS, SOCIAL SERVICE ORGANIZATIONS, BUSINESSES, ACADEMIC INSTITUTIONS, COMMUNITY HEALTH COLLABORATIVES, AND OTHER COMMUNITY HEALTH ORGANIZATIONS) TO ADVOCATE FOR, SUPPORT AND IMPLEMENT EFFECTIVE HEALTH POLICIES, COMMUNITY PROGRAMS AND SERVICES.COMMUNITY BENEFITS 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 $1,276,448 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE MAH 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, THE LATTER OF WHOM REPORTS DIRECTLY TO THE BILH CHIEF DIVERSITY, EQUITY AND INCLUSION OFFICER. 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'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT MAH'S COMMUNITY BENEFITS MISSION TO IMPROVE THE HEALTH AND WELLBEING 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. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF MAH'S COMMUNITY BENEFITS PROGRAMS IN 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, INCLUDING THOSE FROM DIVERSE RACIAL AND ETHNIC BACKGROUNDS, AGE, GENDER, SEXUAL ORIENTATION AND GENDER IDENTITY, AS WELL AS THOSE FROM CORPORATE AND NON-PROFIT COMMUNITY ORGANIZATIONS. MAH'S HOSPITAL'S CBAC MEMBERS INCLUDE:- CARLA BEAUDOIN, DIRECTOR OF DEVELOPMENT, METRO HOUSING BOSTON- CHRISTINE BONGIORNO, DIRECTOR, ARLINGTON HEALTH AND HUMAN SERVICES- LIZ BROWNE, CEO, CHARLES RIVER COMMUNITY HEALTH- RENEE CAMMARATA HAMILTON, DIRECTOR OF THE COMMUNITY HEALTH IMPROVEMENT TEAM, CAMBRIDGE HEALTH ALLIANCE- STACY CARRUTH, PLANNING DIRECTOR, CHNA17- WESLEY CHIN, DIRECTOR, BELMONT HEALTH DEPARTMENT- PATTY CONTENTE, DIRECTOR OF COMMUNITY OUTREACH, HELP, AND RECOVERY, SOMERVILLE POLICE DEPARTMENT- LISA COOK, DIRECTOR, SOMERVILLE CENTER FOR ADULT LEARNING EXPERIENCE- MARY DECOURCEY, DIRECTOR OF COMMUNITY BENEFITS, MOUNT AUBURN HOSPITAL- MICHELLE FEELEY, DIRECTOR, WALTHAM HEALTH DEPARTMENT- NANCY BACCI, DIRECTOR, SOMERVILLE HEALTH AND HUMAN SERVICES- LAURA KURMAN, SENIOR PROGRAM DIRECTOR, WAYSIDE YOUTH AND FAMILY SUPPORT NETWORK- MIKE LIBBY, EXECUTIVE DIRECTOR, SOMERVILLE HOMELESS COALITION- JULIA LONDERGAN, DIRECTOR OF DEVELOPMENT, CAMBRIDGE AND SOMERVILLE PROGRAMS FOR ADDICTION RECOVERY, INC. MYRIAM MICHEL, EXECUTIVE DIRECTOR, HEALTHY WALTHAM COLLEEN MORRISSEY, DIRECTOR OF VOLUNTEERS AND SPECIAL PROJECTS, SOMERVILLE CAMBRIDGE ELDER SERVICES NAVA NIV-VOGEL, DIRECTOR, BELMONT COUNCIL ON AGING LARRY RAMDIN, DIRECTOR OF PUBLIC HEALTH, TOWN OF WATERTOWN JACKIE SPENCER, MD, DIRECTOR OF PRIMARY CARE, VA NEW ENGLAND HEALTHCARE SYSTEM ROBERT TORRES, DIRECTOR OF COMMUNITY BENEFITS, BOSTON REGION, BETH ISRAEL LAHEY HEALTH STEPHANIE VENIZELOS, MANAGER OF COMMUNITY WELLNESS, TOWN OF WATERTOWN JOSE WENDEL, DIRECTOR OF POPULATION HEALTH INITIATIVES, CAMBRIDGE PUBLIC HEALTH DEPARTMENTCOMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYMOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENTINTERNAL REVENUE CODE SECTION 501(R)INTERNAL REVENUE CODE SECTION 501(R), ENACTED AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT, REQUIRES EACH HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND TO FORMALLY ADOPT AN IMPLEMENTATION STRATEGY PURSUANT TO FEDERAL GUIDELINES, IN ORDER 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 SEPTEMBER 2022
THAT CHNA WAS APPROVED BY THE MAH BOARD OF TRUSTEES ON SEPTEMBER 13, 2022. THE ACCOMPANYING IMPLEMENTATION STRATEGY FOR THE MOST RECENT CHNA WAS ALSO ADOPTED BY THE BOARD ON SEPTEMBER 13, 2022, WHICH IS WITHIN THE TIMELINE REQUIRED BY THE TREASURY REGULATIONS UNDER 501(R). THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THE ASSOCIATED IMPLEMENTATION STRATEGY (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 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.2022 COMMUNITY HEALTH NEEDS ASSESSMENTPRIORITY GEOGRAPHY AND COHORTSAS NOTED ABOVE, MAH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF MAH'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT 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). DUE TO THE MERGER OF MAH WITH BILH, MAH CHOSE TO CONDUCT ITS MOST RECENT CHNA DURING THIS FISCAL YEAR (FY22) IN ORDER TO ALIGN WITH CHNA CYCLE WITH OTHER HOSPITALS IN THE BILH SYSTEM.MAH'S COMMUNITY BENEFITS INVESTMENTS AND RESOURCES WILL 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:- LGBTQIA+- LOW-RESOURCED- OLDER ADULTS- RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS- YOUTH2022 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSMAH'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, STATE AND NATIONAL 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 PROCESSDETAIL 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 PROCESSKEY 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 PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)MAH CONDUCTED 3 COMMUNITY FOCUS GROUPS, AND HELD TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED OVER 75 RESIDENTS 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 THE LOCAL COMMUNITY HEALTH NETWORK AREA 17, A LOCAL COALITION, THE ARLINGTON LGBTQ+ COMMISSION AND SOMERVILLE CENTER FOR ADULT LEARNING EXPERIENCES (SCALE).MAH HAS BEEN 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, CITY AND TOWN AGENCIES, PUBLIC LIBRARIES, AND COMMUNITY EVENTS 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 PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTS

2021 COMMUNITY HEALTH NEEDS ASSESSMENT-SUMMARY OF APPROACH AND METHODS
THE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND COMMUNITY MEETINGS. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE SIX CITIES AND TOWNS THAT COMPRISE THE MAH CBSA AND WITH A RANGE OF PEOPLE REPRESENTING DIFFERENT AUDIENCES, INCLUDING LEADERS IN EMERGENCY RESPONSE, EDUCATION, HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS (E.G., OLDER ADULTS) (SCHEDULE H, PART V, SECTION B, QUESTIONS 3 AND 5). ULTIMATELY, THE QUALITATIVE RESEARCH ENGAGED OVER 100 PEOPLE. MAH HIRED JOHN SNOW, INC. AN OUTSIDE FIRM TO CONDUCT AND MANAGE THE CHNA PROCESS UNDERTAKEN DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2021 (TAX YEAR 2020). THE MAH COMMUNITY HEALTH DEPARTMENT WORKED CLOSELY THROUGHOUT THE ENTIRE PROCESS WITH STAFF MEMBERS FROM JOHN SNOW INC. TO COMPLETE THE PROJECT. MAH'S COMMUNITY BENEFITS ADVISORY COMMITTEE CONSISTS OF OVER 16 COMMUNITY MEMBERS AND/OR COMMUNITY ORGANIZATION REPRESENTATIVES INCLUDING CITY/TOWN PUBLIC HEALTH OFFICIALS AND GUIDED THE CHNA AND IS. MAH CONDUCTED ITS CHNA IN THREE PHASES, WHICH ALLOWED MAH TO: -COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA; -ENGAGE AND INVOLVE KEY STAKEHOLDERS, MAH CLINICAL AND ADMINISTRATIVE STAFF AND THE COMMUNITY AT-LARGE; -DEVELOP A REPORT AND DETAILED STRATEGIC PLAN; AND -COMPLY WITH ALL COMMONWEALTH ATTORNEY GENERAL AND FEDERAL IRS COMMUNITY BENEFITS REQUIREMENTS IT IS IMPORTANT TO NOTE THE FY21 CHNA WAS CONDUCTED ENTIRELY DURING THE COVID-19 PANDEMIC AND EVERY EFFORT WAS MADE TO HEAR FROM A WIDE RANGE OF COMMUNITY MEMBERS. THE COVID 19 PANDEMIC LIMITED OPPORTUNITIES TO ENGAGE PEOPLE IN PERSON AT COMMUNITY SETTINGS. ALL MEETINGS, INTERVIEWS AND FOCUS GROUPS WERE COMPLETED VIA VIDEO CONFERENCING AND PARTICIPANTS WERE ENGAGED IN VIRTUAL ACTIVITIES. 2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSDETAIL OF APPROACH AND METHODSMAH RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT ITS 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 (2015-2019) -FBI UNIFORM CRIME REPORTS (2017) -MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2017) -MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF SUBSTANCE ABUSE SERVICES (2017) -MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, ANNUAL REPORTS ON BIRTHS (2016) -MASSACHUSETTS BUREAU OF INFECTIOUS DISEASE AND LABORATORY SERVICES, (20199) -MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY 2016-2018) -MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL DISCHARGES (2018) -MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018) -YOUTH RISK BEHAVIOR SURVEYS (2017 AND 2018) -MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH COVID-19 DASHBOARD (JANUARY 2021) -CENTER FOR DISEASE CONTROL COVID 19 DASHBOARD (2020) 2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5)MAH'S CHNA WAS INFORMED BY 23 KEY INFORMANT INTERVIEWS AND 7 FOCUS GROUPS THAT ENGAGED INSTITUTIONAL, ORGANIZATION AND COMMUNITY LEADERS AND FRONT-LINE STAFF ACROSS SECTORS. 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 WHICH IS POSTED ON THE MAH WEBSITE (SEE LINK WITHIN THIS REPORT TO THE FORM 990 SCHEDULE H). 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 SERVICE AREA. DUE TO COVID-19, INTERVIEWS WERE CONDUCTED VIRTUALLY AND/OR ON THE PHONE USING A STANDARD INTERVIEW GUIDE. INTERVIEWS FOCUSED ON IDENTIFYING MAJOR HEALTH ISSUES, INCLUDING POSSIBLE STRATEGIES TO ADDRESS THOSE CONCERNS, AND TARGET POPULATIONS. 2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)MAH CONDUCTED A SERIES OF SEVEN COMMUNITY AND PROVIDER FOCUS GROUPS IN MAH'S SERVICE AREA TO GATHER CRITICAL COMMUNITY INPUT FROM SERVICE PROVIDERS, COMMUNITY LEADERS AND RESIDENTS. THESE FOCUS GROUPS WERE ORGANIZED IN COLLABORATION WITH MAH'S EXISTING COMMUNITY HEALTH PARTNERS TO LEVERAGE THEIR COMMUNITY CONNECTIONS AND TO HELP ENSURE ROBUST COMMUNITY PARTICIPATION. IN ADDITION, MAH COORDINATED ONE COMMUNITY FORUM WITH THE PARTNERSHIP AND HELP OF COMMUNITY HEALTH NETWORK AREA 17 (CHNA 17). CHNA 17 IS A COMMUNITY LEAD COALITION IN THE AREA. JSI LEAD THE DISCUSSIONS DURING THE COMMUNITY FORUM, WHICH WAS OPEN AND MARKETED TO THE PUBLIC AT-LARGE. MAH MADE EVERY EFFORT TO PROMOTE THE FORUM TO THE COMMUNITY AT LARGE IN ORDER TO RECRUIT PARTICIPANTS. THE MAH COMMUNITY BENEFITS ADVISORY COMMITTEE WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEED AND PRIORITIZING THE LEADING HEALTH ISSUES. THE COMMUNITY BENEFITS ADVISORY COMMITTEE MET FOUR TIMES DURING THE COURSE OF THE ASSESSMENT TO REFINE THE APPROACH, PROVIDE INPUT REGARDING THE ASSESSMENT, AND TO GUIDE THE PRIORITIZATION AND PLANNING PHASE. A FULL LISTING OF ALL COMMUNITY ENGAGEMENT ACTIVITIES IS INCLUDED IN THE CHNA ON THE MAH WEBSITE. 2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTSAS NOTED ABOVE, THE CHNA PROCESS WAS DIVIDED INTO THREE PHASES. THE FINAL PHASE, PHASE III, INCLUDED THE FOLLOWING STEPS: -REVIEW OF THE ASSESSMENT'S MAJOR FINDINGS. -IDENTIFY MAH'S COMMUNITY BENEFITS PRIORITY POPULATIONS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. -ANALYZE MAH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2018 CHNA AND SUBSEQUENT IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY MAH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2020 (TAX YEAR 2019). -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, 2018 (TAX YEAR 2017). 2021 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY FINDINGSTHE KEY PRIORITY POPULATIONS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2021, WERE: -BLACK, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC) -IMMIGRANT AND/OR DUAL-LANGUAGE LEARNERS -INDIVIDUALS EXPERIENCING MATERIAL POVERTY -OLDER ADULTS -LGBTQ+ MAH'S CHNA RESULTED IN KEY FINDINGS IN THE FOLLOWING AREAS: RACIAL EQUITY A DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND COMMUNITY FORUM WAS RACIAL EQUITY. IT IS IMPORTANT TO UNDERSTAND THAT ACHIEVING RACIAL EQUITY BENEFITS ALL OF SOCIETY. PRIORITIZING THE NEEDS OF CERTAIN POPULATIONS SHOULD NOT BE VIEWED AS NEGLECTING OTHERS, BUT RATHER PRIORITIZING SEEKS TO ADDRESS DISPROPORTIONATE NEEDS, WHICH IN TURN IMPROVES OVERALL ACCESS AND QUALITY OF LIFE FOR EVERYONE. RACISM IS INTERLINKED WITH OTHER SYSTEMIC ISSUES, THEREFORE IN PURSUING RACE-RELATED CONCERNS OTHER HEALTH EQUITY CONCERNS RELATED TO GENDER, AGE, ABILITY, ETC. ARE NOT DEVALUED, BUT RATHER MORE THOROUGHLY ADDRESSED THROUGH AN INTERSECTIONAL APPROACH. MAH IS COMMITTED TO ADDRESSING SYSTEMIC RACISM TO ENSURE THAT THE ROOT CAUSES TO INEQUITIES ARE ADDRESSED IN A COLLABORATIVE AND THOUGHTFUL WAY, ENSURING SUSTAINABILITY AND EFFECTIVE CHANGE. SOCIAL DETERMINANTS OF HEALTH - THE SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY HOUSING, TRANSPORTATION, AND FOOD INSECURITY, HAVE A TREMENDOUS IMPACT ON RESIDENTS WITHIN MAH'S CBSA, ESPECIALLY THOSE WHO ARE LOW TO MODERATE INCOME, AS FOUND DURING THE 2021 CHNA. THE SOCIAL DETERMINANTS OF HEALTH ARE OFTEN THE DRIVERS OF OUR UNDERLYING FACTORS THAT CREATE OR EXACERBATE MENTAL HEALTH ISSUES, SUBSTANCE MISUSE, AND CHRONIC AND COMPLEX CONDITIONS. THESE SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY POVERTY, ALSO UNDERLIE MANY OF THE ACCESS-TO-CARE ISSUES THAT WERE PRIORITIZED IN THE ASSESSMENT: NAVIGATING THE HEALTH SYSTEM (INCLUDING HEALTH INSURANCE), CHRONIC DISEASE MANAGEMENT, AND AFFORDING CARE.

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, 2022 (TAX YEAR 2021). THAT CHNA AND APPENDIX WITH DETAILED INFORMATION IS AVAILABLE ON THE MAH WEBSITE AT:2022 COMMUNITY HEALTH NEEDS ASSESSMENT (MOUNTAUBURNHOSPITAL.ORG)IN ADDITION TO THE CHNA, MAH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE MAH WEBSITE AT: 2023-2025 IMPLEMENTATION STRATEGY (COMMUNITY HEALTH NEEDS) (MOUNTAUBURNHOSPITAL.ORG)IN ADDITION, AS NOTED ABOVE, MAH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2021 (TAX YEAR 2020). THAT CHNA IS AVAILABLE ON THE MAH WEBSITE AT: MOUNT AUBURN HOSPITAL 2021 COMMUNITY HEALTH NEEDS ASSESSMENTFINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING MAH'S FISCAL YEAR ENDED SEPTEMBER 30, 2021 (TAX YEAR 2020) IS AVAILABLE ON THE MAH WEBSITE AT: MOUNT AUBURN HOSPITAL 2021 COMMUNITY HEALTH IMPLEMENTATION STRATEGYEACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).COMMUNITY HEALTH NEEDS ASSESSMENTADDRESSING COMMUNITY HEALTH NEEDS(SCHEDULE H, PART V, SECTION B, LINE 11)AS NOTED ABOVE, MAH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 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, 2022 WHICH ARE REPORTED HERE. A SUMMARY OF MAH'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2021 AND PRIORITIZED IN THE RELATED IMPLEMENTATION STRATEGY ARE PROVIDED 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: RACIAL EQUITY GOAL 1: PROMOTE HEALTH EQUITY AND REDUCE DISPARITIES FOR THOSE FACING RACISM AND DISCRIMINATION, PARTICULARLY FOR COMMUNITIES OF COLOR PRIORITY AREA 2: MENTAL HEALTH AND SUBSTANCE USE DISORDER GOAL 1: REDUCE THE IMPACT OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS AMONG RESIDENTS OF MAH'S COMMUNITY BENEFITS SERVICE AREA PRIORITY AREA 3: CHRONIC AND COMPLEX CONDITIONS AND RISK FACTORS GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, AND REFERRAL SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS GOAL 2: ENHANCE ACCESS TO SELF-MANAGEMENT AND OTHER SUPPORTIVE SERVICES FOR INDIVIDUALS WITH OR RECOVERING FROM CHRONIC/COMPLEX CONDITIONS AND THEIR CAREGIVERS PRIORITY AREA 4: SOCIAL DETERMINANTS OF HEALTH GOAL 1: PROVIDE SUPPORTIVE SERVICES FOR THOSE WHO ARE UNSTABLY HOUSED GOAL 2: IMPROVE ACCESS TO HEALTHY AND NUTRITIOUS FOOD FOR THOSE WHO EXPERIENCE FOOD INSECURITY GOAL 3: PROMOTE TRANSPORTATION EQUITYPRIORITY AREA 5: ACCESS TO CARE AND COMMUNITY NAVIGATION GOAL 1: ADDRESS THE SOCIAL DETERMINANTS OF ACCESS TO CARE GOAL 2: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO ARE DUAL-LANGUAGE LEARNERS GOAL 3: PROMOTE HEALTH EQUITY FOR LGBTQ+ POPULATIONS GOAL 4: PROMOTE RESILIENCE AND EMERGENCY PREPAREDNESS GOAL 5: PROMOTE RESILIENCY FOR NEW MOMSCOMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH 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 MAH 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 THE FOOD ACCESS PROGRAMS SUCH AS ARLINGTON EATS AND WORKING TO INCREASE SNAP MATCH BENEFITS, PROGRAMS TO ADDRESS RACIAL EQUITY SUCH AS COMMUNITY HEALTH NETWORK AREA 17, COLLABORATIONS WITH LOCAL HEALTH DEPARTMENTS, DONATIONS TO SUPPORT HIGH NEED POPULATIONS, AND HEALTHY AGING PROGRAMS. IN FY22, MAH PILOTED A COMMUNITY HEALTH GRANT PROGRAM AND SUPPORTED EIGHT ORGANIZATIONS WITH GRANT FUNDS. THESE ORGANIZATIONS WORKED ON PROGRAMS WHICH COINCIDED WITH THE FIVE HEALTH PRIORITIES IDENTIFIED IN THE FY22 IS. MAH IS ROOTED IN PROVIDING HEALTHCARE TO POPULATIONS WHO HAVE HISTORICALLY NOT HAD PROPER ACCESS TO CARE. MAH CONTINUES TO EXPAND ACCESS THROUGHOUT THEIR CBSA BY SUPPORTING CHNA 17 AND LOCAL COALITIONS. MAH CONTRACTED WITH METRO HOUSING BOSTON AND CREATED A CO-LOCATION PROGRAM AT MAH. THIS PROGRAM PROVIDES A COMMUNITY RESOURCE SPECIALIST WHO HELPS TO EASE TRANSITIONS FOR PATIENTS AND TO CONNECT HOUSING UNSTABLE PATIENTS TO A CASE MANAGER. THE CO-LOCATION PROGRAM IS NOW UP AND RUNNING AND PROVIDES RESOURCES AND INFORMATION FOR HOUSING UNSTABLE COMMUNITY MEMBERS.A FULL UPDATE ON MAH'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.MAH ALSO CONTINUED TO DEDICATE SIGNIFICANT TIME AND RESOURCES TO RESPOND TO NEEDS RELATED TO COVID-19, SUCH AS FOOD INSECURITY. FOR EXAMPLE, USING THE HOSPITAL'S PURCHASING POWER WE PURCHASED AND DELIVERED FRESH PRODUCE AND FRESH BREAD TO COMMUNITY FOOD DISTRIBUTION LOCATIONS ON A MONTHLY CYCLE.A FULL UPDATE ON MAH'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW.FY21 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: RACIAL EQUITYA DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND COMMUNITY FORUM WAS RACIAL EQUITY. IT IS IMPORTANT TO UNDERSTAND THAT ACHIEVING RACIAL EQUITY BENEFITS ALL OF SOCIETY. PRIORITIZING THE NEEDS OF CERTAIN POPULATIONS SHOULD NOT BE VIEWED AS NEGLECTING OTHERS, BUT RATHER PRIORITIZING SEEKS TO ADDRESS DISPROPORTIONATE NEEDS, WHICH IN TURN IMPROVES OVERALL ACCESS AND QUALITY OF LIFE FOR EVERYONE. RACISM IS INTERLINKED WITH OTHER SYSTEMIC ISSUES, THEREFORE IN PURSUING RACE-RELATED CONCERNS OTHER HEALTH EQUITY CONCERNS RELATED TO GENDER, AGE, ABILITY, ETC. ARE NOT DEVALUED, BUT RATHER MORE THOROUGHLY ADDRESSED THROUGH AN INTERSECTIONAL APPROACH. MAH IS COMMITTED TO ADDRESSING SYSTEMIC RACISM TO ENSURE THAT THE ROOT CAUSES TO INEQUITIES ARE ADDRESSED IN A COLLABORATIVE AND THOUGHTFUL WAY, ENSURING SUSTAINABILITY AND EFFECTIVE CHANGE. GOAL 1: PROMOTE HEALTH EQUITY AND REDUCE DISPARITIES FOR THOSE FACING RACISM AND DISCRIMINATION, PARTICULARLY FOR COMMUNITIES OF COLOR A. PROGRAMMATIC OBJECTIVES / STRATEGIES I. WORK INTERNALLY AT MAH AND EXTERNALLY WITH COMMUNITY PARTNERS TO IDENTIFY AND IMPLEMENT PROJECTS TO PROMOTE RACIAL EQUITY AND IMPROVE OUTCOMES, PARTICULARLY FOR PRIORITIZED POPULATION SEGMENTSII. SUPPORT AND PARTNER WITH CHNA 17 TO HELP THEM BUILD THEIR CAPACITY BY SUPPORTING THEIR WORK TO PROMOTE RACIAL EQUITY IN THE MENTAL HEALTH FIELD AND PRACTICE. B. COMMUNITY ACTIVITIES/STRATEGIES:I. COLLABORATE WITH INTERNAL COMMITTEES AT MAH, DETERMINE A GOAL AND OBJECTIVE FOR IMPROVING RACIAL HEALTH DISPARITIESII. RESEARCH OPTIONS FOR STAFF ORIENTATION THAT INCLUDES CONTENT ON UNDERSTANDING AND ADDRESSING RACIAL EQUITYIII. PARTICIPATE AS A MEMBER OF THE STEERING COMMITTEE FOR CHNA 17IV. PROVIDE GRANT SUPPORT TO CHNA 17 TO PROMOTE ITS FELLOWSHIP GRANT PROGRAMV. PROVIDE GRANT SUPPORT AND FUNDING FOR LOCAL PUBLIC HEALTH DEPARTMENTS TO PROMOTE RACIAL EQUITY METRICS AND STATUS UPDATES: COLLECTING AND ANALYZING HOSPITAL DATA: MAH DISPARITIES COMMITTEE HAS DEVELOPED ACTION ITEMS TO IMPROVE CARE/SERVICES TO BIPOC AND LGBTQ+ COMMUNITY MEMBERS BY EXPANDING DISPARITY METRICS AND COLLECTING BASELINE DATA ON THESE POPULATIONS. PROVIDED STAFF EDUCATION ON PROMOTING DEI PRINCIPLES WITH WORKSHOPS/TRAININGS. 318 STAFF MEMBERS COMPLETED THE TRAINING CLASS ""PROVIDING QUALITY CARE TO LGBTQ PATIENTS"". COMMUNITY BENEFITS DIRECTOR IS A MEMBER OF THE CHNA 17 STEERING COMMITTEE. CONTINUED TO GIVE GRANT FUNDING TO CHNA 17 TO SUPPORT ITS WORK ON RACIAL EQUITY IN MENTAL HEALTH. BY THE END OF THE 2022 PROGRAMMING YEAR, 91% OF CHNA 17 MEMBERS CONSIDER CHNA 17 TO BE A SOURCE OF PEER SUPPORT IN IMPROVING RACIAL EQUITY IN MENTAL HEALTH AND 53% OF TRAINING PARTICIPANTS IMPROVED THEIR SKILLS TO INCORPORATE RACIALLY EXPLICIT PROGRAMMING, POLICY, OR ORGANIZATIONAL CHANGES."

CREATED A COMMUNITY HEALTH GRANT OPPORTUNITY
"OPPORTUNITY FOR COMMUNITY BASED ORGANIZATIONS AND MUNICIPALITIES RATHER THAN ONLY OFFERING IT TO LOCAL HEALTH DEPARTMENTS. FUNDED EIGHT ORGANIZATIONS WITH UP TO $10,000 IN GRANT FUNDS TO ADDRESS HEALTH AND RACIAL EQUITY.PRIORITY AREA 2: MENTAL HEALTH AND SUBSTANCE USE DISORDERAS IT IS THROUGHOUT THE COMMONWEALTH AND THE NATION, THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON INDIVIDUALS, FAMILIES, COMMUNITIES, AND SERVICE PROVIDERS IN MAH'S CBSA IS OVERWHELMING. NEARLY EVERY KEY INFORMANT INTERVIEW AND FOCUS GROUP INCLUDED DISCUSSIONS ON THESE TOPICS. FROM A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION, DEPRESSION, ANXIETY/STRESS, AND SOCIAL ISOLATION WERE THE LEADING ISSUES IN THIS DOMAIN. THERE WERE CONCERNS REGARDING THE IMPACT OF DEPRESSION, ANXIETY, AND E-CIGARETTE USE/VAPING ON YOUTH AND SOCIAL ISOLATION AMONG OLDER ADULTS. MAH RECOGNIZES THE IMPORTANCE OF PRIMARY PREVENTION THE HOSPITAL WILL CONTINUE TO WORK WITH COMMUNITY PARTNERS TO OFFER EDUCATIONAL PROGRAMS AROUND MENTAL HEALTH AND SUBSTANCE MISUSE. THE HOSPITAL WILL ALSO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE ACTIVITIES WITH INTERNAL COLLEAGUES AND EXTERNAL PARTNERS. MAH WILL CONTINUE TO INCREASE ACCESS TO NAVIGATION AND OTHER SUPPORTIVE SERVICES FOR THOSE WITH MENTAL ILLNESS AND OR SUBSTANCE USE. MAH WILL CONTINUE TO PARTNER AND COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS THAT WORK WITH OLDER ADULTS TO REDUCE SOCIAL ISOLATION AND ENHANCE ACCESS TO SUPPORTIVE SERVICES. GOAL 1: REDUCE THE IMPACT OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS AMONG RESIDENTS OF MAH'S COMMUNITY BENEFITS SERVICE AREAA. PROGRAMMATIC OBJECTIVES: I. EXPAND ACCESS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT/SUPPORT SERVICESII. EXPAND ACCESS TO LINGUISTICALLY/CULTURALLY SENSITIVE MENTAL HEALTH AND SUBSTANCE USE TREATMENT/SUPPORT SERVICESIII. INCREASE AND ENHANCE SUPPORT FOR THOSE AFFECTED BY TRAUMA, AND OR EMOTIONAL STRESSIV. INCREASE ACCESS TO ""CARE NAVIGATION"" SERVICES FOR THOSE WITH MENTAL ILLNESS AND SUBSTANCE USE DISORDERSV. PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE ACTIVITIES INTERNALLY AT MAH AND EXTERNALLY WITH COMMUNITY PARTNERSB. COMMUNITY ACTIVITIES/STRATEGIES: I. ED SOCIAL WORK NAVIGATOR TO SUPPORT THE START PROGRAM (SUBSTANCE TREATMENT AND REFERRAL TEAM) II. ORGANIZE AND FACILITATE SUPPORT GROUPS TO ADDRESS EMOTIONAL DISTRESS, MENTAL HEALTH, AND SUBSTANCE USE RECOVERY AND OR PEER SUPPORT GROUPS FOR THOSE IN RELATIONSHIPS WITH SUBSTANCE USERSIII. ORGANIZE AND SUPPORT MINDFULNESS BASED PROGRAMS FOR COMMUNITY MEMBERS IN RESPONSE TO COVID-19IV. SOCIAL WORKERS TO ATTEND COMMUNITY MEETINGS WHERE THEY SHARE BEST PRACTICES, IDENTIFY OPPORTUNITIES TO IMPROVE COLLABORATIONS AND OPTIMIZE HEALTH FOR VULNERABLE COMMUNITY MEMBERSV. PROVIDE GRANT SUPPORT AND FUNDING FOR LOCAL PUBLIC HEALTH DEPARTMENTS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT PROMOTE MENTAL HEALTH AND SUBSTANCE USE EDUCATION AND PREVENTION SERVICESVI. SUPPORT CHNA 17 WITH FUNDING IN ITS EFFORTS TO ADDRESS MENTAL HEALTH IN AFRICAN AMERICAN/BLACK POPULATION AND OTHER VULNERABLE SEGMENTS FACING DISCRIMINATION METRICS AND STATUS UPDATES: 517 CONSULTS TO THE START PROGRAM. 423 PATIENTS SCREENED BY SOCIAL WORK NAVIGATOR AND COMPLETED START PROGRAM ASSESSMENTS. SUPPORT GROUPS THIS YEAR INCLUDED CAREGIVER SUPPORT GROUP, BEREAVEMENT SUPPORT GROUP AND A BREAST CANCER SUPPORT GROUP. OVER 50 PEOPLE PARTICIPATED IN THESE GROUPS IN FY22. MINDFULNESS BASED STRESS REDUCTION CLASS OFFERED TO COMMUNITY MEMBERS AND FACILITATED BY A CERTIFIED INSTRUCTOR. 100% OF THOSE WHO TOOK THE CLASS REPORTED THAT THEY WOULD BE ABLE TO TAKE WHAT THEY LEARNED AND USE IT TO IMPROVE THEIR OWN HEALTH AND WELLBEING. 100% OF THOSE WHO TOOK THE CLASS REPORTED THEY HAD SOME OR A GREAT DEAL OF POSITIVE CHANGE WHEN IT CAME TO THEIR ABILITY TO HANDLE STRESSFUL SITUATIONS APPROPRIATELY. OVER 50 PEOPLE PARTICIPATED IN THESE SUPPORT GROUPS THIS YEAR. EVALUATION DATA FROM SUPPORT GROUPS: 92% OF THE CAREGIVERS SUPPORT GROUP GAINED NEW KNOWLEDGE THAT WILL HELP THEM MOVE FORWARD IN THE GRIEVING PROCESS AS A RESULT OF THE GROUP. 100% OF PARTICIPANTS AGREED OR STRONGLY AGREED THAT THEY WERE GIVEN THE OPPORTUNITY TO EXPRESS THEIR FEELINGS IN THE GROUP. 92% OF THE RESPONDENTS IN THE CAREGIVING GROUP WERE SATISFIED OR VERY SATISFIED WITH THE PROGRAM. SOCIAL WORKERS SPENT OVER 100 HOURS EITHER PROVIDING REFERRALS IN THE COMMUNITY OR TIME SPENT AT COMMUNITY MEETINGS. SUPPORTED CHNA 17 WITH FUNDING IN ITS EFFORTS TO ADDRESS MENTAL HEALTH IN AFRICAN AMERICAN/BLACK POPULATION AND OTHER COHORTS FACING DISCRIMINATION. PRIORITY AREA 3: CHRONIC AND COMPLEX CONDITIONS AND RISK FACTORSTHE ASSESSMENT'S QUALITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN MAH'S CBSA HAVE HIGH RATES OF MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). HEART DISEASE, STROKE, AND CANCER CONTINUE TO BE THE LEADING CAUSES OF DEATH IN THE NATION AND THE COMMONWEALTH AND PLACE A SIGNIFICANT BURDEN ON COMMUNITIES. APPROXIMATELY SIX IN TEN DEATHS CAN BE ATTRIBUTED TO THESE THREE CONDITIONS COMBINED. IF RESPIRATORY DISEASE (E.G., ASTHMA, COPD) AND DIABETES, WHICH ARE TWO OF THE TOP 10 LEADING CAUSES OF DEATH ACROSS ALL GEOGRAPHIES, ARE INCLUDED, ONE CAN ACCOUNT FOR MOST CAUSES OF DEATH. MANY OF THE RISK FACTORS FOR THESE CONDITIONS ARE THE SAME PHYSICAL INACTIVITY, POOR NUTRITION, OBESITY, AND TOBACCO/ALCOHOL USE. MAH HAS A LONG HISTORY OF WORKING WITH COMMUNITY PARTNERS TO CREATE AWARENESS OF AND EDUCATION ABOUT RISK FACTORS AND THEIR LINKS TO CHRONIC AND COMPLEX HEALTH CONDITIONS. THE HOSPITAL WILL CONTINUE TO SUPPORT PROGRAMS THAT PROVIDE OPPORTUNITIES FOR PEOPLE TO ACCESS LOW-COST, HEALTHY FOODS. BEYOND ADDRESSING THE RISK FACTORS, MAH IS ALSO COMMITTED TO PROVIDING SCREENING AND EDUCATIONAL OPPORTUNITIES, SUPPORTING INDIVIDUALS AND CAREGIVERS THROUGHOUT THE SERVICE AREA TO ENGAGE IN CHRONIC DISEASE MANAGEMENT PROGRAMS AND SUPPORTIVE SERVICES (E.G., INTEGRATIVE THERAPIES, SUPPORT GROUPS), AND PROVIDING LINKS TO CARE. GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, AND REFERRAL SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS A. PROGRAMMATIC OBJECTIVES: I. INCREASE THE NUMBER OF ADULTS WHO RECEIVE HEALTH EDUCATION AND SCREENING, FOR CHRONIC/COMPLEX CONDITIONSII. INCREASE THE NUMBER OF ADULTS PARTICIPATING IN CANCER EDUCATION, SCREENING, AND REFERRAL EVENTSIII. PROMOTE HEALTHY AGING AND ONE'S ABILITY TO AGE IN PLACE.B. COMMUNITY ACTIVITIES/STRATEGIES:I. PROVIDE ADULTS WITH HEALTH EDUCATION REGARDING RISK FACTORS AND HEALTHY BEHAVIORS IN SETTINGS CONVENIENT TO THOSE COMMUNITY MEMBERS WHO ARE MOST VULNERABLEII. FACILITATE AN ELDER SERVICE PROVIDER WORKING GROUP IN ORDER TO SHARE BEST PRACTICES, LISTEN TO NEEDS TO IMPROVE PROGRAMING AND TO PROMOTE HEALTHY AGINGIII. PARTNER WITH AREA COUNCILS ON AGING (COA) AND AGING SERVICES ACCESS POINTS(ASAPS) TO PROVIDE MONTHLY HEALTH EDUCATION AND VENUE SPACE FOR OLDER ADULTSIV. COLLABORATE WITH CRCH TO PROVIDE FREE MAMMOGRAM EVENT/S FOR THOSE WHO ARE UNINSURED OR UNDERINSUREDV. ORGANIZE BLOOD PRESSURE SCREENING EVENTS IN THE COMMUNITY VI. PROVIDE EMERGENCY RESPONSE SERVICES (LIFELINE) AT BELOW COST TO UNDERSERVED ELDERS AND DISABLED PERSONS WHO ARE IN NEED, AS IDENTIFIED BY REGIONAL ELDER SERVICES AGENCIESVII. PROVIDE AN OPPORTUNITY FOR OLDER ADULTS TO VOLUNTEER AT THE HOSPITALVIII. PROVIDE GRANT SUPPORT AND FUNDING FOR LOCAL PUBLIC HEALTH DEPARTMENTS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT INCREASE ACCESS TO HEALTH EDUCATION, SCREENING, AND CHRONIC DISEASE MANAGEMENTMETRICS AND STATUS UPDATES: PROVIDED 3 HEALTH EDUCATION PROGRAMS WITH A TOTAL OF 70 PEOPLE ATTENDING. EVALUATION DATA: - 79% OF PARTICIPANTS INCREASED THEIR KNOWLEDGE OF THEIR RISKS FOR BREAST CANCER. - 79% INCREASED THEIR KNOWLEDGE OF SCREENING BREAST CANCER (WAYS TO FIND A LUMP EARLY). - 100% OF PARTICIPANTS SURVEYED GAINED NEW KNOWLEDGE ABOUT THE HEALTHY EATING PLATE, - 100% GAINED NEW KNOWLEDGE ABOUT WAYS TO REDUCE THE RISK OF CANCER. PROVIDED FOUR HEALTHY AGING PRESENTATIONS WITH A TOTAL OF 149 PARTICIPANTS EVALUATION DATA: - 100% REPORTED ABLE TO TAKE WHAT I LEARNED AND CHANGE OR IMPROVE MY OWN ADVANCE CARE PLANNING. 100% GAINED SOME NEW KNOWLEDGE ABOUT ADVANCE CARE PLANNING.- 83% REPORTED THAT AFTER THE HEART HEALTH PRESENTATION THEY WERE MORE LIKELY TO CHANGE THEIR BEHAVIORS TO IMPROVE THEIR OVERALL HEALTH. 83% REPORTED THAT BY PARTICIPATING IN THE PRESENTATION THEY LEARNED SOME NEW INFORMATION ABOUT HOW TO IMPROVE THEIR HEART HEALTH. 92% REPORTED THAT THEY LEARNED STRATEGIES OR INFORMATION TO HELP THEM MAKE CHOICES THAT COULD POSITIVELY IMPACT THEIR OVERALL HEALTH."

METRICS AND STATUS UPDATES:
"5,060 POUNDS OF FOOD DISTRIBUTED TO FOOD INSECURE COMMUNITY MEMBERS (1,086 DOZEN EGGS, 1,134 LOAVES OF BREAD, 60 JARS OF JUICE, 672 JARS OF PEANUT BUTTER, AND 504 CANS OF BLACK BEANS). INCREASE IN THE NUMBER OF SNAP MATCH SHOPPERS AT THE FARMERS MARKETS WAS 434. AN INCREASE OF 35% AT THE WATERTOWN FARMERS MARKET AND AN INCREASE OF 54% AT THE BELMONT FARMERS MARKET. PROVIDED FUNDING FOR ARLINGTON EATS TO INCREASE THE NUMBER OF SNAP VOUCHERS GIVEN OUT AT THE ARLINGTON FARMERS MARKET FOR CLIENTS WHO QUALIFY. THERE WAS A 130% INCREASE IN THE NUMBER OF SNAP VOUCHERS GIVEN OUT COMPARED TO PREVIOUS YEAR. PARTNERED WITH WALTHAM FIELDS COMMUNITY FARM AND CONTRIBUTED TO THE 100 FREE BOX SHARES OF FRESH PRODUCE DELIVERED WEEKLY TO AFFORDABLE HOUSING DEVELOPMENTS (13 WEEK PROGRAM). GOAL 3: PROMOTE TRANSPORTATION EQUITYA. PROGRAMMATIC OBJECTIVES: I. WORK INTERNALLY AT MAH AND WITH COMMUNITY PARTNERS TO IDENTIFY THOSE WHO HAVE LIMITED ACCESS TO SAFE, AFFORDABLE, ACCESSIBLE TRANSPORTATIONII. INCREASE ACCESS TO SAFE, AFFORDABLE, ACCESSIBLE TRANSPORTATION WHERE TRANSPORTATION IS A BARRIER TO HEALTH CAREIII. PARTICIPATE IN THE CAMBRIDGE TRANSPORTATION TASK FORCEB. COMMUNITY ACTIVITIES/STRATEGIES: I. PROVIDE TRANSPORTATION VOUCHERS TO PRIORITY POPULATIONS (E.G., LOW INCOME, OLDER ADULTS, AND OTHER SEGMENTS)II. PARTICIPATE IN CAMBRIDGE'S TRANSPORTATION TASK FORCE METRICS AND STATUS UPDATES: OVER 2,300 RIDES PROVIDED THROUGH TRANSPORTATION VOUCHERS AND WITH CHARLIE CARDS FOR INDIVIDUALS WHERE TRANSPORTATION IS A BARRIER TO CARE. COMMUNITY AFFAIRS DIRECTOR PARTICIPATED IN 12 TRANSPORTATION TASK FORCE MEETINGS IN CAMBRIDGE.PRIORITY AREA 5: ACCESS TO CARE AND COMMUNITY NAVIGATIONISSUES REGARDING HEALTH CARE ACCESS, NAVIGATION, AND COMMUNICATIONS CONTINUE TO IMPACT RESIDENTS WITHIN MAH'S CBSA, ESPECIALLY YOUTH, THOSE WITHOUT EASILY ATTAINABLE TRANSPORTATION, AND THOSE LEARNING ENGLISH AS A SECOND LANGUAGE. MANY KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS IDENTIFIED A LACK OF UNDERSTANDING ON THE VARIOUS SERVICES THAT MAH PROVIDES AS WELL AS SOCIAL SERVICES THAT ARE AVAILABLE IN THE HOSPITAL'S CBSA. MAH WILL CONTINUE TO PROMOTE CROSS COMMUNICATION AND INCREASE ACCESS TO COMMUNITY RESOURCE INFORMATION AND NAVIGATION. GOAL 1: ADDRESS THE SOCIAL DETERMINANTS OF ACCESS TO CAREA. PROGRAMMATIC OBJECTIVES: I. WORK INTERNALLY AT MAH AND WITH COMMUNITY PARTNERS TO IDENTIFY THE COMMUNITY ASSETS AND BARRIERS THAT EITHER PROMOTE OR HINDER ACCESS TO NEEDED SERVICESB. COMMUNITY ACTIVITIES/STRATEGIES: I. SUPPORT ENROLLMENT ASSISTANCE ACTIVITIES TO ASSIST COMMUNITY MEMBERS TO ASSESS ELIGIBILITY AND APPLY FOR PUBLIC ASSISTANCE PROGRAMS.II. SUPPORT CHNA 17'S WORK TO ADDRESS RACISM, PARTICULARLY WITH RESPECT TO BEHAVIORAL HEALTH SERVICES III. COLLABORATE WITH CHNA 17 IN ITS EFFORTS TO PROVIDE GRANT OPPORTUNITIES/FUNDING FOR COMMUNITY BASED ORGANIZATIONS TO INCREASE AWARENESS AND BREAK DOWN BARRIERS FOR PRIORITY POPULATIONS IV. PROVIDE GRANT SUPPORT AND FUNDING FOR LOCAL PUBLIC HEALTH DEPARTMENTS TO SUPPORT EVIDENCE-BASED PROGRAMS THAT ADDRESS ACCESS, COMMUNITY NAVIGATION OR IMPROVED COMMUNICATIONSMETRICS AND STATUS UPDATES: CERTIFIED APPLICATION COUNSELORS PROVIDED ENROLLMENT ASSISTANCE TO 148 INDIVIDUALS WITH GOVERNMENT APPLICATION FORMS INCLUDING HELP WITH HEALTH INSURANCE APPLICATIONS. SUPPORTED THE UPSTREAM INTERVENTION MODEL AT SOMERVILLE HOMELESS COALITION WHICH TO DATE HAS PROVIDED 40 LOW INCOME HOUSEHOLDS WITH CASE MANAGEMENT SERVICES. SUPPORTED THE MENTAL HEALTH COUNSELING INITIATIVE WITH MASSACHUSETTS ALLIANCE OF PORTUGUESE SPEAKERS. DURING THIS FILING PERIOD, THEY HAVE PROVIDED 29 FREE MENTAL HEALTH COUNSELING SESSIONS FOR PEOPLE WHO WERE IN NEED OF SHORT-TERM MENTAL HEALTH COUNSELLING. GOAL 2: PROMOTE EQUITABLE CARE AND SUPPORT FOR THOSE WHO ARE DUAL-LANGUAGE LEARNERSA. PROGRAMMATIC OBJECTIVES: I. PROMOTE HEALTH LITERACY INTERNALLY AT MAH AND EXTERNALLY WITH COMMUNITY PARTNERSB. COMMUNITY ACTIVITIES/STRATEGIES: I. PROVIDE HEALTH EDUCATION INCLUDING NAVIGATING THE HEALTH CARE SYSTEM TO OUR COMMUNITY PARTNERS, AND OTHER ORGANIZATIONS WHICH WORK WITH THOSE WITH LIMITED ENGLISH PROFICIENCY.II. CONDUCT HEALTH EQUITY/DIVERSITY TRAININGS AT MAH AND INCLUDE OTHER CLINICAL AND NON-CLINICAL PARTNERS, AS POSSIBLE AND APPROPRIATEIII. PROVIDE ACCESS TO INTERPRETER SERVICES INTERNALLY AT MAH AND WORK TO IMPROVE ACCESS FOR PATIENTS AND COMMUNITY MEMBERSMETRICS AND STATUS UPDATES: PROVIDED 3 HEALTH LITERACY EDUCATION PROGRAMS AT 2 DIFFERENT ENGLISH LANGUAGE LEARNING COMMUNITY PROGRAMS. A TOTAL OF 70 PEOPLE ATTENDED THESE PROGRAMS.- 100% OF PARTICIPANTS SURVEYED REPORTED GAINING NEW KNOWLEDGE ABOUT THE HEALTHY EATING PLATE THAT WILL HELP THEM MAKE BETTER FOOD CHOICES.- 100% OF PARTICIPANTS SURVEYED REPORTED THEY GAINED NEW KNOWLEDGE ABOUT WAYS THEY CAN REDUCE THEIR RISK OF CANCER.- 79% OF PARTICIPANTS REPORTED INCREASING THEIR KNOWLEDGE OF THEIR OWN RISKS FOR BREAST CANCER AFTER THE PROGRAM.- 79% OF PARTICIPANTS IN THE PROGRAM REPORTED AN INCREASE IN KNOWLEDGE OF SCREENING METHODS FOR BREAST CANCER AND REPORTED AN INCREASE IN HOW TO FIND A LUMP EARLY. PROVIDED 18,455 INDIVIDUAL INTERPRETER SERVICES ENCOUNTERS EITHER FACE TO FACE, VIDEO, OR TELEPHONIC ENCOUNTERS. GOAL 3: PROMOTE HEALTH EQUITY FOR LGBTQ+ POPULATIONSA. PROGRAMMATIC OBJECTIVES:I. PROMOTE BEST PRACTICES WITH RESPECT TO COLLECTING ACCURATE INFORMATION ON SEXUAL ORIENTATION AND GENDER IDENTITY INTERNALLY AT MAH AND EXTERNALLY WITH COMMUNITY PARTNERSII. REDUCE BARRIERS TO HEALTH CARE AND DISPARITIES IN HEALTH OUTCOMES III. SHARE LGBTQ+ RESOURCES WITH EXTERNAL PARTNERS B. COMMUNITY ACTIVITIES/STRATEGIES:I. PROVIDE OR SUPPORT PROGRAMS AND INITIATIVES TO IMPROVE HEALTH AND WELLBEING OF THE LGBTQ+ POPULATION II. CONTINUE TO MEET THE STANDARDS FOR LEADER STATUS FOR THE HUMAN RIGHTS COMMISSION FOR THE LGBTQ+ HEALTHCARE EQUALITY INDEXIII. PARTNER WITH COMMUNITY ORGANIZATIONS WHICH SUPPORT THE LGBTQ+ COMMUNITYMETRICS STATUS UPDATES: MAH CONTINUES TO MEET THE STANDARDS OF LEADER STATUS FOR THE HUMAN RIGHT COMMISSION FOR THE LGBTQ+ HEALTHCARE EQUALITY INDEX. LGBTQ+ RESOURCES FOR PATIENTS ARE LISTED ON THE MAH WEBSITE AND SHARED WITH PATIENTS AND ORGANIZATIONS ROUTINELY. ALLOCATED FUNDING TO THE LGBTQ+ ALLIANCE OF BELMONT FOR EXPANDING RESOURCES FOR LGBTQ+ COMMUNITY IN THE SCHOOLS. FOCUS GROUP CONDUCTED WITH ARLINGTON RAINBOW COALITION TO ASSESS NEEDS. GOAL 4: PROMOTE RESILIENCE AND EMERGENCY PREPAREDNESSA. PROGRAMMATIC OBJECTIVES: I. SUPPORT CITIES/TOWNS TO PROMOTE RESILIENCE, EMERGENCY CARE AND EMERGENCY PREPAREDNESSB. COMMUNITY ACTIVITIES/STRATEGIES: I. PROVIDE EMERGENCY SERVICES TRAINING TO LOCAL CITY/TOWN POLICE AND FIRE DEPARTMENTS.II. SERVE AS EMS MEDICAL DIRECTORS FOR CAMBRIDGE, ARLINGTON AND BELMONT MEDICAL DISPATCHERS, MIT EMS AND HARVARD UNIVERSITY EMSIII. SERVE ON STATE AND REGIONAL EMS ADVISORY BOARDS TO LEND MEDICAL OVERSIGHT TO THE REGIONMETRICS AND STATUS UPDATES: MAH EMERGENCY DEPARTMENT STAFF CREATED A WHAT TO DO: LIFE THREATENING EMERGENCY CLASS PRESENTATION TO EDUCATE COMMUNITY MEMBERS ON THE IMPORTANCE OF ACTING FAST AND WHAT TO DO IN THE FIRST MINUTES OF A MEDICAL EMERGENCY TO SAVE A LIFE. MAH EMERGENCY PHYSICIANS PROVIDED 3 CLASSES IN THE COMMUNITY AND TRAINED 70 PEOPLE IN ""LIFE THREATENING EMERGENCIES - WHAT TO DO."" MAH PHYSICIANS SERVED AS EMS MEDICAL DIRECTORS TO MIT EMS, HARVARD UNIVERSITY EMS AND PRO AMBULANCE EMS. THE EMERGENCY DEPARTMENT PROVIDED MONTHLY EDUCATION SESSIONS TO CAMBRIDGE, ARLINGTON, BELMONT WATERTOWN FIRE DEPARTMENTS. A TOTAL OF 20 - 30 STAFF WERE IN ATTENDANCE EACH MONTH (ALL TOWNS). GOAL 5: PROMOTE RESILIENCY FOR NEW MOMSA. PROGRAMMATIC OBJECTIVES:I. SUPPORT OUTREACH AND ASSISTANCE TO NEW MOMS TO INCREASE AWARENESS ABOUT HOW TO CREATE A HEALTHY AND SAFE ENVIRONMENT FOR BABIES AND FAMILIESB. COMMUNITY ACTIVITIES/STRATEGIES:I. ORGANIZE AND/OR SUPPORT PROGRAMS TO SUPPORT PRENATAL PATIENTS AND NEW MOMS THAT PROMOTE A HEALTHY AND SAFE ENVIRONMENT AND/OR FOSTER HEALTHY BIRTHS AND GROWTH AND DEVELOPMENT FOR NEWBORNS AND INFANTSII. PROVIDE DOULA SUPPORT DURING DELIVERYIII. COLLABORATE WITH THE CRCH PRE/POSTNATAL DEPARTMENT TO ADDRESS ACCESS ISSUES THAT MAY AFFECT THEIR CARE.METRICS AND STATUS UPDATES: A DOULA WAS PROVIDED FOR 5 BIRTHS. WE WERE NOT ABLE TO MEET OUR GOAL OF 20 BIRTHS DUE TO STAFFING SHORTAGES AND THE EFFECTS OF THE PANDEMIC WITH RESPECT TO ADDITIONAL PEOPLE IN THE BIRTHING ROOM. A LATINA COMMUNITY OUTREACH WORKER IS AVAILABLE TO PROVIDE ACCESSIBILITY HELP WITH RESOURCES AND PROVIDES EMOTIONAL SUPPORT."

DURING THE FISCAL PERIOD COVERED BY THIS FILING
MAH GENERATED $7,816,119 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY MAH FOR SUCH SERVICES BY $3,203,534 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING, 13.4% OR 42,214 OF MAH'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION, 43.8% OR 138,529 CASES OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICARE PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND MAH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, MAH GENERATED $93,099,644 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $6,583,874. OF THESE AMOUNTS, REVENUE OF $6,687,952 IS RELATED TO THE PROVISION OF INPATIENT PSYCHIATRY UNIT, OUTPATIENT PSYCHIATRY SERVICE, 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 $14,831,046. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH MAH 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, MAH HAS SEPARATELY REPORTED THIS AMOUNT IN SCHEDULE H, PART III, LINE 7, AS REQUIRED. HOWEVER, IF THE MEDICARE SHORTFALL WERE INCLUDED IN THE SCHEDULE H PART I LINE 7 CALCULATION, IT WOULD INCREASE TO 14.36%.BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, MAH ALSO INCURS LOSSES RELATED TO SELF-PAY PATIENTS WHO FAIL TO MAKE PAYMENTS FOR SERVICES OR INSURED PATIENTS WHO FAIL TO PAY COINSURANCE OR DEDUCTIBLES FOR WHICH THEY ARE RESPONSIBLE UNDER INSURANCE CONTRACTS. BAD DEBT EXPENSE IS INCLUDED IN UNCOMPENSATED CARE EXPENSE IN THE CONSOLIDATED FINANCIAL STATEMENTS AND INCLUDES THE PROVISION FOR ACCOUNTS ANTICIPATED TO BE UNCOLLECTIBLE. CHARGES FOR THOSE SERVICES DURING THE FISCAL PERIOD COVERED BY THIS FILING OF $3,496,536 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. AND AFFILIATES FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 INCLUDE THE ACCOUNTS OF: BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (BIDMC), MOUNT AUBURN HOSPITAL (MAH), NEW ENGLAND BAPTIST HOSPITAL (NEBH), BETH ISRAEL DEACONESS HOSPITAL MILTON, INC. (MILTON), BETH ISRAEL DEACONESS HOSPITAL NEEDHAM, INC. (NEEDHAM), BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. (PLYMOUTH), LAHEY CLINIC FOUNDATION (LCF) , LAHEY CLINIC (LCI), LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER (LHMC), WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NORTHEAST), ANNA JAQUES HOSPITAL (AJH) AND AFFILIATES. THE FINANCIAL STATEMENTS OF THE SYSTEM ALSO INCLUDE A CONTROLLED AFFILIATE, HARVARD MEDICAL FACULTY PHYSICIANS AT BETH ISRAEL DEACONESS MEDICAL CENTER, INC. (HMFP).FINANCIAL STATEMENT FOOTNOTESREVENUES 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.EMERGENCY CARE ACCESSTHE MAH DEPARTMENT OF EMERGENCY MEDICINE PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OFFERS THIS CARE FOR ALL PATIENTS THAT COME TO THIS FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, AND 365 DAYS A YEAR.FINANCIAL ASSISTANCE POLICYINTERNAL REVENUE CODE SECTION 501(R)(4)FINANCIAL ASSISTANCE POLICY PURPOSE MAH IS DEDICATED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM OR OTHERWISE UNABLE TO PAY FOR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. THIS FINANCIAL ASSISTANCE POLICY IS INTENDED TO BE IN COMPLIANCE WITH APPLICABLE FEDERAL AND STATE LAWS FOR OUR SERVICE AREA. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL RECEIVE DISCOUNTED CARE FROM MAH AS WELL AS PROVIDERS WHO FOLLOW MAH'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN MAH AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW MAH'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. MAH DOES NOT DISCRIMINATE BASED ON THE PATIENT'S AGE, GENDER, RACE, CREED, RELIGION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN OR IMMIGRATION STATUS WHEN DETERMINING ELIGIBILITY.FINANCIAL ASSISTANCE POLICY, CREDIT AND COLLECTION POLICY AND EMERGENCY CARE POLICYAS REQUIRED BY IRC SECTION 501(R)(4) AND THE REGULATIONS PROMULGATED THEREUNDER, THE HOSPITAL MAINTAINS A WRITTEN FINANCIAL ASSISTANCE POLICY (FAP) 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 THE HOSPITAL'S BOARD PRIOR TO SEPTEMBER 30, 2017 AND THESE DOCUMENTS WERE ALL EFFECTIVE AS OF OCTOBER 1, 2017, THE FIRST DAY OF THE HOSPITAL'S FISCAL YEAR IN WHICH THE HOSPITAL WAS REQUIRED TO BE IN COMPLIANCE WITH THE REGULATIONS PROMULGATED BY THE TREASURY AND RELATED TO IRC SECTION 501(R). FINANCIAL ASSISTANCE POLICYAPPLYING FOR ASSISTANCE THE HOSPITAL'S FAP INCLUDES INFORMATION ON THE METHOD FOR APPLYING FOR FINANCIAL ASSISTANCE UNDER THE FAP. IN ADDITION, THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION INCLUDES A LIST OF INFORMATION/DOCUMENTATION REQUIRED AS PART OF A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. (SCHEDULE H PART V SECTION B QUESTION 15).

FINANCIAL ASSISTANCE 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 ASSISTANCEPUBLIC ASSISTANCE PROGRAMS (SCHEDULE H PART I QUESTION 3C)IN ADDITION TO FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FAP, FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE AND APPROPRIATE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR A SERVICE, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.HOSPITAL PATIENTS MAY BE ELIGIBLE FOR FREE OR REDUCED COST OF HEALTH CARE SERVICES THROUGH VARIOUS STATE PUBLIC ASSISTANCE PROGRAMS AS WELL AS THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS (INCLUDING BUT NOT LIMITED TO MASSHEALTH, THE PREMIUM ASSISTANCE PAYMENT PROGRAM OPERATED BY THE HEALTH CONNECTOR, THE CHILDREN'S MEDICAL SECURITY PROGRAM, THE HEALTH SAFETY NET, AND MEDICAL HARDSHIP). SUCH PROGRAMS ARE INTENDED TO ASSIST LOW-INCOME PATIENTS TAKING INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF 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 POLICYTRANSLATIONS THE HOSPITAL'S FAP, CREDIT AND COLLECTION POLICY AND PLAIN LANGUAGE SUMMARY OF THE FAP (SEE DETAIL BELOW) HAVE ALL BEEN TRANSLATED INTO THE LANGUAGES SPOKEN BY THOSE IN THE HOSPITAL'S COMMUNITY WHO MAY COMMUNICATE IN A LANGUAGE OTHER THAN ENGLISH. THE HOSPITAL HAS TRANSLATED THESE DOCUMENTS INTO THE LANGUAGES OF LIMITED ENGLISH PROFICIENCY (LEP) OF ITS PATIENTS, 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: ARMENIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, FRENCH, GREEK, HAITIAN CREOLE, PORTUGUESE, RUSSIAN AND SPANISH. (SCHEDULE H PART V SECTION B QUESTION 16I)FINANCIAL ASSISTANCE POLICYWIDELY PUBLICIZING AND AVAILABILITYCOPIES OF THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN BOTH ENGLISH AND ALL LEP LANGUAGES AT THE HOSPITAL, 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) AT HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ IN ADDITION, THE FAP, CREDIT AND COLLECTION POLICY, FAP SUMMARY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE ALL AVAILABLE IN THE HOSPITAL'S EMERGENCY DEPARTMENT AND FINANCIAL COUNSELING OFFICE. (SCHEDULE H PART V SECTION B QUESTION 16F AND SCHEDULE H PART VI QUESTION 3).THE HOSPITAL MAINTAINS SIGNAGE AND CONSPICUOUS PUBLIC DISPLAYS ABOUT FINANCIAL ASSISTANCE AND THE FAP DESIGNED TO ATTRACT THE ATTENTION OF PATIENTS AND VISITORS, INCLUDING BOTH THE EMERGENCY DEPARTMENT AND ADMISSIONS. SUCH SIGNAGE IS POSTED BOTH IN ENGLISH AND THE LEP LANGUAGES NOTED ABOVE. IN ADDITION, FINANCIAL COUNSELING PERSONNEL ROUTINELY VISIT LOCATIONS DESIGNATED FOR SIGNAGE TO ENSURE THAT SUCH SIGNAGE REMAINS VISIBLE TO PATIENTS AND VISITORS AS ATTENDED. THE HOSPITAL PROVIDES INFORMATION ABOUT THE FAP TO PATIENTS 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 POLICYPLAIN 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 MAH 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 ARMENIAN, SIMPLIFIED CHINESE, TRADITIONAL CHINESE, FRENCH, GREEK, HAITIAN CREOLE, PORTUGUESE, RUSSIAN AND SPANISH, CAN BE FOUND ON THE MAH WEBSITE AT: HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/LIMITATION ON CHARGESINTERNAL 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 BILLEDLOOK 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 COLLECTIONS501(R)(6)
EXTRAORDINARY COLLECTION ACTIVITIESTHE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) FOR FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. SPECIFICALLY, THE HOSPITAL DOES NOT REPORT TO CREDIT AGENCIES, ENGAGE IN LEGAL OR JUDICIAL PROCESSES OR SELL A PATIENT'S OUTSTANDING AMOUNTS OWED FOR PATIENT CARE. IN ADDITION, THIS EXTENDS TO ANY THIRD PARTY CONTRACTED WITH THE HOSPITAL RELATED TO BILLING AND COLLECTIONS. (SCHEDULE H PART V SECTION B QUESTIONS 18 AND 19).APPLICATION PERIOD PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME UP TO TWO HUNDRED FORTY (240) DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS AVAILABLE. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS RESEARCHAS NOTED THROUGHOUT THIS FILING MAH IS PART OF THE BETH ISRAEL LAHEY HEALTH NETWORK OF AFFILIATES. BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) IS A TERTIARY CARE ACADEMIC MEDICAL CENTER IN BOSTON AND A SISTER ENTITY OF MAH. AS PART OF THE SAME NETWORK, THE RESEARCH IN WHICH BIDMC ENGAGES SUPPORTS NOT ONLY THE MISSION AND CARE FOR BIDMC PATIENTS AND COMMUNITIES BUT ALSO HELPS TO IMPROVE PATIENT CARE FOR THE COMMUNITIES OF OTHER BILH AFFILIATES AND BEYOND. THE DETAIL BELOW PROVIDES BACKGROUND ON THE RESEARCH ACTIVITIES AT BIDMC DURING THE FISCAL PERIOD COVERED BY THIS FILING.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 1,800 ACTIVE FEDERAL, INDUSTRY AND FOUNDATION SPONSORED PROJECTS AND MORE THAN 2,400 ACTIVE EXEMPT, EXPEDITED, AND FULL BOARD-REVIEWED CLINICAL RESEARCH STUDIES. BIDMC RESEARCH IS LED BY MORE THAN 260 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- CENTER FOR VIROLOGY AND VACCINE 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 INSTITUTEFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL EDUCATION MOUNT AUBURN HOSPITAL'S CENTRAL LONGSTANDING ACADEMIC FOCUS IS MEDICAL EDUCATION, AND 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, RESIDENTS AND FELLOWS, ALONG WITH OTHER ALLIED HEALTH PROFESSIONALS FROM ACROSS THE AREA.MAH HAS SEVERAL RESIDENCY AND FELLOWSHIP PROGRAMS, WITH APPROXIMATELY 50 INTERNAL MEDICINE INTERNS AND RESIDENTS, 12 RADIOLOGY RESIDENTS, 6 PODIATRY RESIDENTS, AND 3 UROGYNECOLOGY FELLOWS DURING MAH'S ACADEMIC YEAR JULY 1, 2021 JUNE 30, 2022 WHICH OVERLAPS WITH A PORTION OF MAH'S FISCAL YEAR ACTIVITIES REPORTED IN THIS FILING. THE HOSPITAL ALSO HOSTS ROTATING RESIDENTS AND FELLOWS IN SURGERY, EMERGENCY MEDICINE, GERIATRICS, GENETICS, OBSTETRICS AND GYNECOLOGY, NEONATOLOGY, AND ANESTHESIA, 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 NORTHEAST. STAFF PHYSICIANS AT MAH WHO HOLD FACULTY APPOINTMENTS AT HARVARD MEDICAL SCHOOL INSTRUCT THE DOCTORS OF TOMORROW 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 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 ARE ABLE TO 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 STUDENTS FROM MEDICAL SCHOOLS AROUND THE COUNTRY, AND A MAJOR STRENGTH, AS WELL AS A MAJOR ATTRACTION, IS THE FACT THAT THE YEAR IS LARGELY IDENTICAL IN STRUCTURE AND CONTENT TO THE FIRST YEAR FOR PHYSICIANS WHO TRAIN AT MOUNT AUBURN HOSPITAL FOR THREE YEARS IN THE CATEGORICAL INTERNAL MEDICINE TRACK. THE ONLY DIFFERENCE BETWEEN THE PRELIMINARY AND CATEGORICAL TRACKS BEING THE QUANTITY OF AMBULATORY MEDICINE EXPERIENCE, AS PRELIMINARY INTERNS ARE NOT ASSIGNED A CONTINUITY CLINIC DURING THEIR YEAR.THE MAH RADIOLOGY RESIDENCY PROGRAM HAS A LONG AND PROUD HISTORY AS AN ELITE PROGRAM AND EXCEPTIONAL PLACE TO TRAIN. RESIDENTS ARE TYPICALLY ASSIGNED IN ONE-MONTH BLOCKS TO ONE OF THE DIFFERENT 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, AND SOUND JUDGMENT AS A RADIOLOGIST IS ESTABLISHED DURING OVERNIGHT CALL. 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 CLOSE CONTACT BETWEEN THE STAFF 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 TRAINING PROGRAM IN PODIATRY, AND IS A SITE FOR OTHER POST-GRADUATE MEDICAL EDUCATION DISCIPLINES. IT IS ALSO A CORE SITE FOR THE BETH ISRAEL DEACONESS MEDICAL CENTER SURGICAL TRAINING PROGRAM. MAH ALSO WELCOMES ROTATING GERIATRIC FELLOWS FROM THE BETH ISRAEL DEACONESS / HARVARD MEDICAL SCHOOL DIVISION ON AGING PROGRAM, AND PEDIATRIC AND NEONATOLOGY RESIDENTS FROM MASSACHUSETTS GENERAL HOSPITAL / CAMBRIDGE HOSPITAL PROGRAM. DURING THE FISCAL YEAR COVERED BY THIS FILING, MAH HAD NET EXPENDITURES OF $21,778,506 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 5.98% OF MAH'S TOTAL EXPENSES.MAH-ADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)OPEN MEDICAL STAFF AND COMMUNITY BOARDTHE 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.AFFILIATED HEALTH CARE SYSTEMAS NOTED BELOW AND THROUGHOUT THIS FILING, MAH 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 4,000 PHYSICIANS AND 35,000 EMPLOYEES.DURING THE FISCAL PERIOD COVERED BY THIS FILING, 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. (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), ANNA JAQUES HOSPITAL (AJH), THE BETH ISRAEL LAHEY HEALTH PERFORMANCE NETWORK (BILHPN) 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 HOSPITAL & MEDICAL CENTER (LHMC). THE ENTITIES LISTED HERE MAY HAVE ALSO, IN TURN, SERVED AS MEMBER TO OTHER NETWORK AFFILIATES. AS A SUPPORT ORGANIZATION OF THESE ENTITIES, BILH PROVIDES CENTRALIZED SERVICES AND SUPPORT TO ITS AFFILIATES IN AREAS SUCH AS MANAGEMENT, STRATEGIC PLANNING, HUMAN RESOURCES AND BENEFITS, DEVELOPMENT AND FUNDRAISING, LEGAL SERVICES, FINANCE, TREASURY, INVESTMENT, INSURANCE, COMPLIANCE AND TAXATION AS WELL AS PATIENT CARE CONTRACTING AND OTHER SERVICES.BILH'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. 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.BILH IS DELIVERING ON THE PROMISE TO BILH PATIENTS AND COMMUNITIES TO EXPAND ACCESS AND PROVIDE EXTRAORDINARY CARE, WHILE ALSO ADVANCING MEDICINE THROUGH DISCOVERY AND EDUCATION. 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 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 NEW 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.

BILH BEHAVIORAL HEALTH SERVICES
"THE 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. BILHBS (WHICH INCLUDES THE ACTIVITIES OF BILH'S TAX-EXEMPT AFFILIATE NORTHEAST BEHAVIORAL HEALTH CORP) IS THE LARGEST NETWORK OF MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES IN EASTERN MASSACHUSETTS. BILHBS' NETWORK OF BEHAVIORAL HEALTH CARE INCLUDES SERVICES FOR CHILDREN AND ADULTS RANGING FROM INPATIENT TREATMENT TO COMMUNITY-BASED PROGRAMS. SERVICES INCLUDE: INPATIENT PSYCHIATRIC AND DETOXIFICATION TREATMENT; EMERGENCY PSYCHIATRIC AND MOBILE EMERGENCY SERVICES TEAMS; OUTPATIENT MENTAL HEALTH AND ADDICTION TREATMENT; INDIVIDUAL/COUPLE/FAMILY THERAPY; MEDICATION ASSISTED TREATMENT PROGRAMS; AND SCHOOL-BASED AND HOME-BASED COUNSELING FOR YOUTH AND THEIR FAMILIES.AS NOTED PREVIOUSLY, SINCE ITS CREATION IN MARCH 2019, BILH HAS CONTINUED TO INVEST SIGNIFICANTLY IN IMPROVING ACCESS TO BEHAVIORAL HEALTH CARE THROUGH A SYSTEM-WIDE APPROACH TO CARE DELIVERY. AS ONE OF SEVERAL ONGOING INITIATIVES, BILH HAS MADE A MULTI-YEAR COMMITMENT TO PROVIDE BEHAVIORAL HEALTH SUPPORT TO ITS EMPLOYED PRIMARY CARE PRACTICES USING AN EVIDENCE-BASED APPROACH KNOWN AS THE IMPACT MODEL. BY THE END OF FY 2022, BILH HAD IMPLEMENTED THE IMPACT MODEL IN 74.36% OF ITS EMPLOYED PRIMARY CARE PRACTICES AS PART OF ITS COLLABORATIVE CARE PROGRAM IMPLEMENTATION. IN MARCH 2021, BILHBS LAUNCHED ITS CENTRALIZED BED FINDING TEAM. THIS TEAM IS PART OF A BILHBS CENTRAL CALL CENTER, WHICH CENTRALIZES CALLS TO BILHBS' THREE EMERGENCY SERVICE PROGRAM (ESP) CATCHMENT AREAS REDUCING REDUNDANCIES ACROSS THE AGENCY AND STREAMLINING ALL CALLS TO ONE CENTRAL SERVICE. THIS CENTRALIZED BED FINDING TEAM IS RESPONSIBLE FOR CONDUCTING BED SEARCHES FOR PATIENTS SEEN THROUGH THE ESP AND WHO ARE AWAITING AN INPATIENT PSYCHIATRIC PLACEMENT. THIS TEAM DIRECTLY INCREASES THE AVAILABILITY OF CLINICIANS TO CONTINUE TO SEE PATIENTS IN THE EMERGENCY DEPARTMENT (ED) AND THE COMMUNITY WHO ARE EXPERIENCING A BEHAVIORAL HEALTH AND/OR CO-OCCURRING SUBSTANCE USE DISORDER CRISIS WHILE OTHER TEAM MEMBERS SEARCH FOR AVAILABLE INPATIENT PLACEMENTS. THIS INITIATIVE SUPPORTS DECREASED RESPONSE TIME TO RESPONDING TO NEW PATIENTS IN CRISIS AND REDUCES ED BOARDING TIME FOR PATIENTS WHO CAN BE SAFELY MANAGED IN THE COMMUNITY.IN FY2022, THE STATE OF MASSACHUSETTS SET FORTH THE MASSACHUSETTS BEHAVIORAL HEALTH ROADMAP TO INCLUDE FOUR PRIMARY OUTCOMES IN EFFORTS TO ADVANCE HEALTH EQUITY: (1) THE DEVELOPMENT OF COMMUNITY BEHAVIORAL HEALTH CENTERS (CBHCS); (2) SHIFTING BEHAVIORAL HEALTH EMERGENCY SERVICES TO THE COMMUNITY FROM THE EMERGENCY DEPARTMENTS; (3) TREATMENT ON DEMAND (OUTPATIENT EVALUATION AND TREATMENT); AND (4) BEHAVIORAL HEALTH HELP LINE. IN RESPONSE TO THIS MOVEMENT, BILHBS RECEIVED AN AWARD TO OPERATE A CBHC IN THE LAWRENCE LOCATION AND BEGAN THE PLANNING TO PIVOT EMERGENCY SERVICES TEAMS TO SERVE THE BILH SYSTEM EMERGENCY DEPARTMENTS. BILHBS SERVES APPROXIMATELY 35,000 UNDUPLICATED INDIVIDUALS ANNUALLY, OFFERING A FULL CONTINUUM OF CARE FOR CHILDREN AND ADULTS. SERVICES RANGE FROM INPATIENT TO HOME AND COMMUNITY-BASED SERVICES. BILHBS OPERATES OVER 250 BEDS IN 9 FACILITIES FOR CLIENTS REQUIRING ACUTE PSYCHIATRIC CARE, DETOXIFICATION AND RESIDENTIAL STEP-DOWN SERVICES. DURING THE PERIOD COVERED BY THIS FILING, COMMUNITY-BASED SERVICES INCLUDED MOBILE EMERGENCY SERVICES TEAMS IN THREE CATCHMENT AREAS AND HOME-BASED COUNSELING FOR ADULTS, YOUTH AND THEIR FAMILIES. BILHBS ALSO PROVIDED SERVICES IN 63 MIDDLE AND HIGH SCHOOLS, AS WELL AS 9 POLICE DEPARTMENTS. IN ADDITION, BILH'S COMMUNITY CRISIS STABILIZATION (""CCS"") UNITS IN LAWRENCE AND SALEM, WHICH TYPICALLY CARE FOR PATIENTS WITH MENTAL HEALTH ISSUES, INCREASED THEIR ABILITY TO TREAT PERSONS WITH CO-OCCURRING SUBSTANCE USE DISORDERS. THE CCS UNITS CONTINUE TO BE ABLE TO INDUCT PATIENTS WITH OPIOID USE DISORDER (OUD) ON BUPRENORPHINE AND ARE ALSO ABLE TO MAINTAIN PATIENTS WHO ARE ALREADY ON ANY OF THE THREE FDA APPROVED MEDICATIONS FOR THE TREATMENT OF OUD. THESE UNITS ARE SEEING AN INCREASE IN THE NUMBER OF PATIENTS WITH METHAMPHETAMINE DISORDERS AND HAVE DEVELOPED A PROTOCOL TO MANAGE WITHDRAWAL SYMPTOMS IN THIS POPULATION."

AS NOTED ABOVE, THE 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 PROCESSKEY FINDINGSTHE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2022, WERE:- YOUTH AND ADOLESCENTS - OLDER ADULTS- LOW-RESOURCE INDIVIDUALS AND FAMILIES- LESBIAN, GAY, BISEXUAL, TRANSGENDER AND QUEER OR QUESTIONING (LGBTQ) INDIVIDUALS- RACIALLY AND ETHNICALLY DIVERSE POPULATIONS AND NON-ENGLISH SPEAKERSMAH'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, THE MENTAL HEALTH IMPACTS OF RACISM, DISCRIMINATION, AND 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.- RACIAL EQUITY. A DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND COMMUNITY FORUMS WAS RACIAL EQUITY. IT IS IMPORTANT TO UNDERSTAND THAT ACHIEVING RACIAL EQUITY BENEFITS ALL OF SOCIETY. PRIORITIZING THE NEEDS OF CERTAIN POPULATIONS SHOULD NOT BE VIEWED AS NEGLECTING OTHERS, BUT RATHER PRIORITIZING SEEKS TO ADDRESS DISPROPORTIONATE NEEDS, WHICH IN TURN IMPROVES OVERALL ACCESS AND QUALITY OF LIFE FOR EVERYONE. RACISM IS INTERLINKED WITH OTHER SYSTEMIC ISSUES, THEREFORE IN PURSUING RACE-RELATED CONCERNS OTHER HEALTH EQUITY CONCERNS RELATED TO GENDER, AGE, ABILITY, ETC. ARE NOT DEVALUED, BUT RATHER MORE THOROUGHLY ADDRESSED THROUGH AN INTERSECTIONAL APPROACH. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, 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, 2023; SEPTEMBER 30, 2024; AND SEPTEMBER 30, 2025. 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 2022 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, 2023. THE PRIOR CHNA AND CHIP PROCESS WHICH WAS COMPLETED BY MAH IN 2021 INFORMED THE COMMUNITY BENEFITS OPERATIONS AND ACCOMPLISHMENTS REPORTED IN THIS FORM 990 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 AS DESCRIBED IN DETAIL BELOW. 2021 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONMAH COMPLETED ITS 2021 ASSESSMENT IN SEPTEMBER 2021. THE GEOGRAPHICAL FOCUS OF MAH'S 2021 CHNA ENCOMPASSES ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN.TARGET POPULATIONS FOR MAH'S COMMUNITY BENEFITS INITIATIVES WERE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS AND A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).MAH'S TARGET POPULATIONS FOCUSED ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES IN ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN AREAS AS FOLLOWS:- BLACK, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC)- IMMIGRANT AND/OR DUAL LANGUAGE LEARNERS- INDIVIDUALS EXPERIENCING MATERIAL POVERTY- OLDER ADULTS- LGBTQ+ INDIVIDUALSTHE GEOGRAPHICAL FOCUS OF MAH'S 2021 CHNA ENCOMPASSES ARLINGTON, BELMONT, CAMBRIDGE, SOMERVILLE, WALTHAM AND WATERTOWN.

MAH IS COMMITTED TO ADDRESSING SOCIAL DETERMINANTS
MAH IS COMMITTED TO ADDRESSING SOCIAL DETERMINANTS AND BREAKING DOWN BARRIERS TO CARE. THE HOSPITAL WILL CONTINUE TO COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS TO ENGAGE INDIVIDUALS IN SERVICES, REDUCE FINANCIAL BURDENS, INCREASE ACCESS TO APPROPRIATE PRIMARY AND SPECIALTY CARE SERVICES, AND SUPPORT HEALTHY FAMILIES AND COMMUNITIES. MAH IS ALSO COMMITTED TO STRENGTHENING THE LOCAL WORKFORCE AND EXPLORING OPPORTUNITIES FOR THE HOSPITAL TO ADDRESS LOCAL UNEMPLOYMENT ISSUES. CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS THE ASSESSMENT'S QUALITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN MAH'S CBSA HAVE HIGH RATES OF MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). HEART DISEASE, STROKE, AND CANCER CONTINUE TO BE THE LEADING CAUSES OF DEATH IN THE NATION AND THE COMMONWEALTH AND PLACE A SIGNIFICANT BURDEN ON COMMUNITIES. APPROXIMATELY SIX IN TEN DEATHS CAN BE ATTRIBUTED TO THESE THREE CONDITIONS COMBINED. IF RESPIRATORY DISEASE (E.G., ASTHMA, COPD) AND DIABETES, WHICH ARE TWO OF THE TOP 10 LEADING CAUSES OF DEATH ACROSS ALL GEOGRAPHIES, ARE INCLUDED, ONE CAN ACCOUNT FOR MOST CAUSES OF DEATH. MANY OF THE RISK FACTORS FOR THESE CONDITIONS ARE THE SAME PHYSICAL INACTIVITY, POOR NUTRITION, OBESITY, AND TOBACCO/ALCOHOL USE. MAH HAS A LONG HISTORY OF WORKING WITH COMMUNITY PARTNERS TO CREATE AWARENESS OF AND EDUCATION ABOUT RISK FACTORS AND THEIR LINKS TO CHRONIC AND COMPLEX HEALTH CONDITIONS. THE HOSPITAL WILL CONTINUE TO SUPPORT PROGRAMS THAT PROVIDE OPPORTUNITIES FOR PEOPLE TO ACCESS LOW-COST, HEALTHY FOODS. BEYOND ADDRESSING THE RISK FACTORS, MAH IS ALSO COMMITTED TO PROVIDING SCREENING AND EDUCATIONAL OPPORTUNITIES, SUPPORTING INDIVIDUALS AND CAREGIVERS THROUGHOUT THE SERVICE AREA TO ENGAGE IN CHRONIC DISEASE MANAGEMENT PROGRAMS AND SUPPORTIVE SERVICES (E.G., INTEGRATIVE THERAPIES, SUPPORT GROUPS), AND PROVIDING LINKS TO CARE. ACCESS TO CARE AND COMMUNITY NAVIGATION - ISSUES REGARDING HEALTH CARE ACCESS, NAVIGATION, AND COMMUNICATIONS CONTINUE TO IMPACT RESIDENTS WITHIN MAH'S CBSA, ESPECIALLY YOUTH, THOSE WITHOUT EASILY ATTAINABLE TRANSPORTATION, AND THOSE LEARNING ENGLISH AS A SECOND LANGUAGE. MANY KEY INFORMANTS AND FOCUS GROUP PARTICIPANTS IDENTIFIED A LACK OF UNDERSTANDING ON THE VARIOUS SERVICES THAT MAH PROVIDES AS WELL AS SOCIAL SERVICES THAT ARE AVAILABLE IN THE HOSPITAL'S CBSA. MAH WILL CONTINUE TO PROMOTE CROSS COMMUNICATION AND INCREASE ACCESS TO COMMUNITY RESOURCE INFORMATION AND NAVIGATION. MENTAL HEALTH AND SUBSTANCE USE DISORDER - AS IT IS THROUGHOUT THE COMMONWEALTH AND THE NATION, THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON INDIVIDUALS, FAMILIES, COMMUNITIES, AND SERVICE PROVIDERS IN MAH'S CBSA IS OVERWHELMING. NEARLY EVERY KEY INFORMANT INTERVIEW AND FOCUS GROUP INCLUDED DISCUSSIONS ON THESE TOPICS. FROM A REVIEW OF THE QUANTITATIVE AND QUALITATIVE INFORMATION, DEPRESSION, ANXIETY/STRESS, AND SOCIAL ISOLATION WERE THE LEADING ISSUES IN THIS DOMAIN. THERE WERE CONCERNS REGARDING THE IMPACT OF DEPRESSION, ANXIETY, AND E-CIGARETTE USE/VAPING ON YOUTH AND SOCIAL ISOLATION AMONG OLDER ADULTS. MAH RECOGNIZES THE IMPORTANCE OF PRIMARY PREVENTION THE HOSPITAL WILL CONTINUE TO WORK WITH COMMUNITY PARTNERS TO OFFER EDUCATIONAL PROGRAMS AROUND MENTAL HEALTH AND SUBSTANCE MISUSE. THE HOSPITAL WILL ALSO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE ACTIVITIES WITH INTERNAL COLLEAGUES AND EXTERNAL PARTNERS. MAH WILL CONTINUE TO INCREASE ACCESS TO NAVIGATION AND OTHER SUPPORTIVE SERVICES FOR THOSE WITH MENTAL ILLNESS AND OR SUBSTANCE USE. MAH WILL CONTINUE TO PARTNER AND COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS THAT WORK WITH OLDER ADULTS TO REDUCE SOCIAL ISOLATION AND ENHANCE ACCESS TO SUPPORTIVE SERVICES. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2021, WILL INFORM MAH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2022. INTERIM CHANGES AND UPDATES TO 2021 IMPLEMENTATION STRATEGY BASED ON NEWLY IDENTIFIED COMMUNITY NEEDS COVID PANDEMICAS PREVIOUSLY NOTED IN THIS FILING, IRC SECTION 501(R)(3) AND THE PROMULGATED REGULATIONS REQUIRE THAT A TAX-EXEMPT HOSPITAL CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADOPT AN IMPLEMENTATION STRATEGY ADDRESSING COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA AT LEAST ONCE EVERY THREE YEARS. THE PREAMBLE TO THE REGULATIONS PROMULGATED UNDER IRC SECTION 501(R)(3) NOTES THAT THE TREASURY AND THE IRS INTENDED FOR THE CHNA AND IMPLEMENTATION STRATEGY REQUIREMENT TO ESTABLISH CONTINUAL FEEDBACK ON CHNA REPORTS AND A HOSPITAL IS REQUIRED TO CONSIDER COMMENTS RECEIVED RELATED TO THE EXISTING CHNA AND IMPLEMENTATION STRATEGY WHEN ENGAGING IN THE NEXT CHNA PROCESS NOT MORE THAN THREE YEARS AFTER ADOPTION. IN ADDITION, FINAL REGULATIONS DO NOT PROHIBIT IMPLEMENTATION STRATEGIES FROM DISCUSSING HEALTH NEEDS IDENTIFIED THROUGH MEANS OTHER THAN A CHNA, PROVIDED THAT THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA ARE ALSO DISCUSSED. FINALLY, THERE IS NOTHING IN THE REGULATIONS THAT PROHIBITS A HOSPITAL FROM UPDATING ITS IMPLEMENTATION STRATEGY BASED ON AN OFF-CYCLE CHANGE TO THE COMMUNITY HEALTH NEEDS THAT ARISE. DURING THE PERIOD COVERED BY THIS FILING, OCTOBER 1, 2021 TO SEPTEMBER 30, 2022 THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY MAH, WERE IMPACTED BY AN UNEXPECTED GLOBAL PANDEMIC. ON JANUARY 9, 2020, THE WORLD HEALTH ORGANIZATION (WHO) ANNOUNCED THE IDENTIFICATION OF A NEW AND NOVEL CORONAVIRUS-RELATED PNEUMONIA IN WUHAN, CHINA. ON JANUARY 21, 2020 THE UNITED STATES CENTER FOR DISEASE CONTROL CONFIRMED THE FIRST CASE OF THIS NEW CORONA VIRUS IN THE UNITED STATES. ON JANUARY 31, 2020, THE WHO ISSUED A GLOBAL HEALTH EMERGENCY AND ON FEBRUARY 3 THE UNITED STATES DECLARED A PUBLIC HEALTH EMERGENCY BECAUSE OF THE COVID-19 VIRUS. ON MARCH 11, 2020, THE WHO DECLARED COVID-19 A PANDEMIC AND TWO DAYS LATER, THE PRESIDENT OF THE UNITED STATES DECLARED COVID-19 A NATIONAL EMERGENCY. THE HEALTH OF THE COMMUNITIES SERVED BY MAH WERE IMPACTED BY THIS UNFORESEEN HEALTH CRISIS AND IN THE ABSENCE OF REGULATORY GUIDANCE TO THE CONTRARY, MAH NEEDED TO QUICKLY REASSESS AND PIVOT TO MEET THE NEW AND PREVIOUSLY UNEXPECTED COMMUNITY NEEDS. AS SUCH, IN RESPONSE TO THE COVID-19 CRISIS MAH'S COMMUNITY BENEFITS STAFF ALONG WITH THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND IN RESPONSE TO COVID, EXPANDED GOALS RELATED TO ACCESS TO CARE AND SOCIAL DETERMINANTS OF HEALTH TARGETED PRIMARILY AT LOW INCOME AND MINORITY POPULATIONS WHO HAVE BEEN DISPROPORTIONATELY IMPACTED BY COVID-19. MAH DEDICATED SIGNIFICANT TIME AND RESOURCES TO RESPOND TO NEEDS RELATED TO COVID-19. MAH WORKED WITH COMMUNITY PARTNERS AND THE HOSPITAL'S STAFF TO EXPAND ACCESS TO TESTING, PERSONAL PROTECTIVE EQUIPMENT, VACCINES AND ACCESS TO TANGIBLE NEEDS SUCH AS FOOD AND OTHER ITEMS. THE HOSPITAL ALSO PROVIDED COVID-19 TEST KITS TO CHARLES RIVER COMMUNITY HEALTH DURING THE PANDEMIC TO HELP MITIGATE THE SPREAD OF THE VIRUS THROUGHOUT THE YEAR.THE ADDITIONAL AND NEWLY URGENT HEALTH NEEDS IN RESPONSE TO COVID-19 WERE: FOOD INSECURITY AND HOUSING STABILITYFOOD INSECURITY: RECOGNIZING THE INCREASE IN FOOD INSECURE FAMILIES, MAH IS USING IT'S PURCHASING POWER, TO PURCHASE EGGS AND FRESH BREAD ON A MONTHLY BASIS AND DISTRIBUTES IT TO LOCAL FOOD PANTRIES. MAH HAS ALSO COLLABORATED WITH LOCAL ORGANIZATIONS TO HELP SUPPORT THEIR SNAP MATCH PROGRAMS AT LOCAL FARMER'S MARKETS TO HELP INCREASE THE PURCHASING POWER OF FAMILIES AND INDIVIDUALS. BOTH THESE PROGRAMS WERE CREATED IN RESPONSE TO COVID 19 TO RESPOND TO THE GROWING NEEDS OF COMMUNITY MEMBERS.HOUSING STABILITY: OUR HOUSING COLLABORATION WITH METRO HOUSING BOSTON (MHB) WAS DEVELOPED DUE TO AN INCREASING NEED FOR TRANSITIONAL CARE FOR RESIDENTS WITH PARTICULARLY CHALLENGING HOUSING NEEDS THAT WERE EXACERBATED BY COVID.THE ACTIONS TAKEN TOWARD ADDRESSING THESE NEEDS ARE INCLUDED FURTHER IN THIS NARRATIVE SUPPORT ALONG WITH MAH'S DETAILED DESCRIPTION OF ACTIVITIES UNDERTAKEN TO MEET THE COMMUNITY NEEDS.

85% OF PARTICIPANTS REPORTED THAT
BY PARTICIPATING IN THE MINDFULNESS PRESENTATION THEY LEARNED STRATEGIES OR INFORMATION TO HELP THEM MAKE CHOICES THAT WOULD POSITIVELY IMPACT THEIR OVERALL HEALTH. 79% LEARNED SOME NEW INFORMATION ABOUT MINDFULNESS AND HOW TO PRACTICE IT. 72% REPORTED THAT THEY WILL TAKE WHAT THEY LEARNED OR SKILLS THEY LEARNED ABOUT MINDFULNESS AND TRY TO INCORPORATE THEM INTO THEIR WEEKLY ROUTINE.O 86% OF PARTICIPANTS SURVEYED REPORT THAT THEY LEARNED SOME NEW INFORMATION ABOUT PLANT BASED FOODS. 100% OF PARTICIPANTS SURVEYED REPORTED THEY LEARNED STRATEGIES OR INFORMATION TO HELP THEM MAKE FOOD CHOICES THAT WOULD POSITIVELY IMPACT THEIR OVERALL HEALTH. OVER 850 ELIGIBLE ELDERS AND OR DISABLED ADULTS RECEIVED A PERSONAL EMERGENCY RESPONSE SYSTEM AT BELOW COST. THE VOLUNTEER PROGRAM WAS UNABLE TO RUN DURING FY 22 DUE TO THE HOSPITAL'S COVID RESTRICTIONS POLICY. PROVIDED FREE MAMMOGRAM SCREENING OPPORTUNITY FOR WOMEN WITHOUT INSURANCE OR LIMITED INSURANCE. THE BLOOD PRESSURE SCREENING EVENTS DID NOT OCCUR DUE TO COVID 19 RESTRICTIONS. GOAL 2: ENHANCE ACCESS TO SELF-MANAGEMENT AND OTHER SUPPORTIVE SERVICES FOR INDIVIDUALS WITH OR RECOVERING FROM CHRONIC/COMPLEX CONDITIONS AND THEIR CAREGIVERSA. PROGRAMMATIC OBJECTIVES:I. ENHANCE ACCESS AND PROMOTE EQUITABLE CARE FOR VULNERABLE INDIVIDUALS WITH CHRONIC AND COMPLEX CONDITIONSII. INCREASE ACCESS TO SUPPORTIVE SERVICES TO REDUCE STRESS AND ANXIETY, REDUCE NEGATIVE SYMPTOMS AND SIDE EFFECTS, AND INCREASE OVERALL WELLBEINGIII. INCREASE THE ABILITY OF OLDER ADULTS TO LIVE INDEPENDENTLY AND AGE IN PLACEB. COMMUNITY ACTIVITIES/STRATEGIES: I. PROVIDE A SURVIVORSHIP DAY EVENT FOR PATIENTS AND COMMUNITY MEMBERSII. PROVIDE AN ONGOING SUPPORT GROUP FOR BREAST CANCER PATIENTS AND COMMUNITY MEMBERSIII. PROVIDE AN ONGOING SUPPORT GROUP FOR CAREGIVERS OF THOSE WITH ALZHEIMER'S AND DEMENTIAIV. STROKE NURSE NAVIGATOR PROVIDES ONGOING STROKE EDUCATION AND SUPPORT FOR PATIENTS AND THEIR FAMILIESMETRICS AND STATUS UPDATES: ORGANIZED AND RAN A SURVIVORSHIP DAY EVENT WITH 65 PEOPLE ATTENDINGO 100% OF THOSE SURVEYED REPORTED THEY WILL BE ABLE TO TAKE WHAT THEY LEARNED OR A SKILL THEY PRACTICED DURING THE EVENT AND USE IT TO IMPROVE THEIR OWN HEALTH AND WELLBEING. 94% OF THOSE SURVEYED REPORTED THEY LEARNED SOMETHING OF LASTING VALUE BY PARTICIPATING. PROVIDED A FREE BREAST CANCER SUPPORT GROUP WHICH MET TWICE A MONTH THROUGHOUT THE YEAR FACILITATED BY A CLINICAL SOCIAL WORKER. AN ONGOING SUPPORT GROUP WAS PROVIDED TWO TIMES PER WEEK FOR CAREGIVERS TO DROP IN ANYTIME. AN AVERAGE OF 12 PARTICIPANTS WEEKLY PARTICIPATED. PROVIDED STROKE EDUCATION AND SUPPORT TO OVER 225 PATIENTS AND THEIR FAMILY MEMBERS BY THE STROKE NURSE COORDINATOR. PROVIDED OVER 1,000 STROKE EDUCATION MATERIALS TO OUR LOCAL VISITING NURSE ASSOCIATION IN 6 DIFFERENT LANGUAGES IN ADDITION TO ENGLISH WHICH WERE DISTRIBUTED TO RESIDENTS WHEN CONDUCTING HOME VISITS. DISTRIBUTED OVER 2,000 STROKE EDUCATIONAL PIECES IN 6 DIFFERENT LANGUAGES IN ADDITION TO ENGLISH TO VARIOUS COMMUNITY ORGANIZATIONS FOR DISTRIBUTION TO COMMUNITY MEMBERS AND FOR POSTING IN COMMON AREAS. PRIORITY AREA 4: SOCIAL DETERMINANTS OF HEALTHTHE SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY HOUSING, TRANSPORTATION, AND FOOD INSECURITY, HAVE A TREMENDOUS IMPACT ON RESIDENTS WITHIN MAH'S CBSA, ESPECIALLY THOSE WHO ARE LOW TO MODERATE INCOME, AS FOUND DURING THE 2021 CHNA. THE SOCIAL DETERMINANTS OF HEALTH ARE OFTEN THE DRIVERS OF OUR UNDERLYING FACTORS THAT CREATE OR EXACERBATE MENTAL HEALTH ISSUES, SUBSTANCE MISUSE, AND CHRONIC AND COMPLEX CONDITIONS. THESE SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY POVERTY, ALSO UNDERLIE MANY OF THE ACCESS-TO-CARE ISSUES THAT WERE PRIORITIZED IN THE ASSESSMENT: NAVIGATING THE HEALTH SYSTEM (INCLUDING HEALTH INSURANCE), CHRONIC DISEASE MANAGEMENT, AND AFFORDING CARE. MAH IS COMMITTED TO ADDRESSING SOCIAL DETERMINANTS AND BREAKING DOWN BARRIERS TO CARE. THE HOSPITAL WILL CONTINUE TO COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS TO ENGAGE INDIVIDUALS IN SERVICES, REDUCE FINANCIAL BURDENS, INCREASE ACCESS TO APPROPRIATE PRIMARY AND SPECIALTY CARE SERVICES, AND SUPPORT HEALTHY FAMILIES AND COMMUNITIES. MAH IS ALSO COMMITTED TO STRENGTHENING THE LOCAL WORKFORCE AND EXPLORING OPPORTUNITIES FOR THE HOSPITAL TO ADDRESS LOCAL UNEMPLOYMENT ISSUES. GOAL 1: PROVIDE SUPPORTIVE SERVICES FOR THOSE WHO ARE UNSTABLY HOUSEDA. PROGRAMMATIC OBJECTIVES: I. WORK INTERNALLY AT MAH AND WITH COMMUNITY PARTNERS TO IDENTIFY THOSE WHO ARE EXPERIENCING HOUSING INSECURITYII. INCREASE ACCESS TO HOUSING AND EVICTION PREVENTION SERVICESB. COMMUNITY ACTIVITIES/STRATEGIES: I. PROVIDE SCREENING FOR PATIENTS IN ORDER TO IDENTIFY HOUSING INSECURITYII. CONTRACT WITH METRO HOUSING BOSTON (MHB) TO FACILITATE CASE MANAGEMENT AND TO SUPPORT THOSE WHO ARE STRUGGLING WITH HOUSING INSECURITY OR HOMELESSNESSIII. PROVIDE HOUSING STABILITY RESOURCES AND INFORMATION FOR COMMUNITY MEMBERSIV. INCREASE PARTNERSHIPS AND COLLABORATIONS WITH COMMUNITY-BASED ORGANIZATIONS TO ADDRESS THE LACK OF SAFE AND AFFORDABLE HOUSINGMETRICS AND STATUS UPDATES: PARTNERED WITH METRO HOUSING BOSTON (MHB) TO IMPROVE TRANSITIONAL ASSISTANCE TO PATIENT WHO ARE HOUSING INSECURE/UNSTABLE. 31 INDIVIDUALS RECEIVED A SERVICE OR INTERACTION WHICH INCLUDED INCREASED KNOWLEDGE OF EVICTION PREVENTION, HOUSING SEARCH STRATEGIES AND OR FINANCIAL ASSISTANCE PROGRAMS. CREATED A SOCIAL DETERMINANTS OF HEALTH (SDOH) WORKGROUP TO DETERMINE HOW BEST TO IDENTIFY PATIENTS WHO ARE MOST AFFECTED BY SOCIAL DETERMINANTS OF HEALTH AND DEVELOP A SYSTEM TO REFER PATIENTS TO COMMUNITY RESOURCES. THE WORKGROUP IMPLEMENTED A SYSTEM TO IDENTIFY PATIENTS WHO CAN BENEFIT FROM COMMUNITY RESOURCES THROUGH THE SCREENING PROCESS. GOAL 2: IMPROVE ACCESS TO HEALTHY AND NUTRITIOUS FOOD FOR THOSE WHO EXPERIENCE FOOD INSECURITYA. PROGRAMMATIC OBJECTIVES:I. WORK INTERNALLY AT MAH AND WITH COMMUNITY PARTNERS TO IDENTIFY THOSE WHO ARE EXPERIENCING FOOD INSECURITYII. INCREASE ACCESS TO HEALTHY FOODS FOR THOSE WHO ARE EXPERIENCING FOOD INSECURITYB. COMMUNITY ACTIVITIES/STRATEGIES: I. PARTNER WITH COMMUNITY BASED ORGANIZATIONS/PROGRAMS THAT ADDRESS FOOD INSECURITY AND PROMOTE ACCESS TO HEALTHY FOODS.II. PROVIDE FUNDING FOR LOCAL ORGANIZATIONS WHICH ARE SUPPORTING FOOD INSECURE FAMILIES/RESIDENTSIII. PROVIDE FUNDING TO SUPPORT SNAP MATCH PROGRAMS IV. PROVIDE HEALTHY AND NUTRITIOUS FOOD THAT CAN BE DELIVERED TO FOOD DISTRIBUTION LOCATIONS

PROVIDED OVER 200 ENCOUNTERS,
WHICH PROVIDED NAVIGATIONAL AND EMOTIONAL SUPPORT AS WELL AS REFERRALS TO COMMUNITY RESOURCES FOR LATINAS. THIS INCLUDED HELPING WITH GOVERNMENTAL ASSISTANCE PROGRAMS, BIRTH CERTIFICATES, SSI OFFICE VISITS, IMMIGRATION STATUS, BABY'S FIRST APPOINTMENTS, BILLING ISSUES AND HELPING TO PREPARE MOMS FOR APPOINTMENT AND HOSPITAL FOLLOW-UP VISITS. PROVIDED 15 NEW MOMS WITH A NEW INFANT CAR SEAT TO ASSIST IN TRANSPORTING THEIR NEWBORN SAFELY HOME.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: AFRICANO WALTHAM AMERICAN CANCER SOCIETY ARLINGTON COUNCIL ON AGING ARLINGTON HEALTH AND HUMAN SERVICES ARLINGTON FIRE DEPARTMENT BELMONT COUNCIL ON AGING BELMONT DEPARTMENT OF PUBLIC HEALTH BELMONT FIRE DEPARTMENT BILH AT HOME CAMBRIDGE COMMUNITY LEARNING CENTER CAMBRIDGE COUNCIL ON AGING CAMBRIDGE DEPARTMENT OF PUBLIC HEALTH CAMBRIDGE FIRE DEPARTMENT CAMBRIDGE HEALTH ALLIANCE CASPAR CHARLES RIVER COMMUNITY HEALTH CENTER COMMUNITY HEALTH NETWORK AREA 17 DENOVO CENTER FOR JUSTICE AND HEALING HARVARD UNIVERSITY EMS HEALTHY WALTHAM LIFELINE IN HOME SERVICES LIVE WELL WATERTOWN MASSACHUSETTS ALLIANCE OF PORTUGUESE SPEAKERS MASS BAY TRANSIT AUTHORITY METRO CAB OF BOSTON METRO HOUSING BOSTON PROFESSIONAL AMBULANCE EMS RAINBOW COMMISSION OF ARLINGTON SCM COMMUNITY TRANSPORTATION SOMERVILLE CAMBRIDGE ELDER SERVICES SOMERVILLE CENTER FOR ADULT LEARNING EXPERIENCE SOMERVILLE COUNCIL ON AGING SOMERVILLE HEALTH AND HUMAN SERVICES SOMERVILLE HOMELESS COALITION SOMERVILLE POLICE DEPARTMENT SOMERVILLE STAKEHOLDERS COALITION SPRINGWELL ELDER SERVICES TRANSITION HOUSE WALTHAM COMMUNITY DAY CENTER WALTHAM COUNCIL ON AGING WALTHAM DEPARTMENT OF PUBLIC HEALTH WALTHAM FAMILY SCHOOL WALTHAM FIELDS COMMUNITY FARM WALTHAM PARTNERSHIP FOR YOUTH WATERTOWN CARES WATERTOWN COUNCIL ON AGING WATERTOWN DEPARTMENT OF PUBLIC HEALTH WAYSIDE YOUTH AND FAMILY SERVICESAS 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 CHNA THAT ARE NOT INCLUDED IN THE IS. IN THE FY 2023 - 2025 IS, WHICH WILL GUIDE THE MAH'S COMMUNITY BENEFITS ACTIVITIES FOR THE FISCAL PERIODS SEPTEMBER 30, 2023, SEPTEMBER 30, 2024 AND SEPTEMBER 30, 2025, EXAMPLES OF IDENTIFIED NEEDS THAT WILL NOT BE MET IN THESE YEARS ARE ADDRESSING THE DIGITAL DIVIDE (I.E., PROMOTING EQUITABLE ACCESS TO THE INTERNET), SUPPORTING EDUCATION ACROSS THE LIFESPAN, AND STRENGTHENING THE BUILT ENVIRONMENT (I.E., IMPROVING ROADS/SIDEWALKS AND ENHANCING ACCESS TO SAFE RECREATIONAL SPACES/ACTIVITIES). IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE 2021 CHNA THAT ARE NOT INCLUDED IN THE 2021 IS AND WHICH HAVE GUIDED MAH'S COMMUNITY BENEFITS ACTIVITIES THE PERIOD FOR THE FISCAL PERIOD COVERED BY THIS FILING. MAH WILL BE UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES AS NOTED IN DETAIL ABOVE, THE MAH'S PRIMARY TOOL FOR ASSESSING THE HEALTH CARE 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, 12.55% 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 BENEFITSANNUAL 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, 2022, AS REQUIRED PURSUANT TO THE REGULATIONS UNDER INTERNAL REVENUE CODE SECTION 501(R). IN ADDITION, AS NOTED IN THIS FORM 990 SCHEDULE H, PART I, LINES 6A AND 6B, THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFITS REPORT THAT IS SUBMITTED TO THE MASSACHUSETTS ATTORNEY GENERAL (SCHEDULE H, PART VI, LINE 7). THAT FILING IS AVAILABLE FOR PUBLIC INSPECTION AT THE ATTORNEY GENERAL'S OFFICE, ON THE ATTORNEY GENERAL'S WEBSITE AND ON THE HOSPITAL WEBSITE AT HTTPS://WWW.MOUNTAUBURNHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH/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, MAH IS A GENERAL MEDICAL AND SURGICAL HOSPITAL AND TEACHING HOSPITAL, PROVIDING 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCEMAH'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 $4,620,942 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, AND HAS BEEN REPORTED ON THIS SCHEDULE H, PART I, LINE 7A.AS PREVIOUSLY NOTED IN THIS FORM 990, MAH IS ONE OF TEN 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 PAYMENTS TO THE HEALTH SAFETY NET TRUST, WAS $55,879,719 FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022. AS REPORTED IN SCHEDULE H PART I LINE 3 AND AGAIN IN SCHEDULE H PART V SECTION B LINE 13, ELIGIBILITY FOR FREE CARE TO LOW-INCOME INDIVIDUALS IS DETERMINED USING FEDERAL POVERTY GUIDELINES OF 400% FOR FULL FREE CARE AND 400% FOR PARTIAL FREE CARE. ELIGIBILITY FOR DISCOUNTED CARE IS DETERMINED BY REVIEWING THE INDIVIDUAL'S EMPLOYMENT STATUS, FAMILY SIZE AND MONTHLY EXPENSES, INCLUDING MEDICAL HARDSHIP REVIEW.OTHER UNCOMPENSATED CHARITY CAREMEDICAID AND MEDICAREIN ADDITION TO THE CHARITY CARE REPORTED ABOVE, MAH 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 ENSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED.