4A (Expenses $ 256378914 including grants of $ 196001) (Revenue $ 292140588)
LOWELL GENERAL HOSPITAL'S OUTPATIENT AND ANCILLARY SERVICES INCLUDE EMERGENCY DEPARTMENT (LEVEL III TRAUMA SERVICES), IMAGING/RADIOLOGY (INCLUDING MRI, CT, ULTRASOUND, MAMMOGRAPHY), LABORATORY, CARDIAC TESTING AND CATHETERIZATION, ENDOSCOPY, SURGERY, REHABILITATION THERAPIES, RADIATION ONCOLOGY AND CHEMOTHERAPY, AND A NUMBER OF OTHER SERVICES NEEDED TO SUPPORT INPATIENT AND OUTPATIENT CARE.OUTPATIENT STATISTICSEMERGENCY ROOM VISITS: 88,048OUTPATIENT VISITS: 423,576OUTPATIENT SURGERIES: 9,192RADIATION TREATMENTS: 14,357

4B (Expenses $ 235993877 including grants of $ 0) (Revenue $ 205543420)
"LOWELL GENERAL HOSPITAL'S PRIMARY SERVICE AREA (""PSA"") IS COMPRISED OF THE FOLLOWING NINE COMMUNITIES: BILLERICA, CHELMSFORD, DRACUT, DUNSTABLE, LOWELL, TEWKSBURY, TYNGSBORO AND WESTFORD, MASSACHUSETTS, AND PELHAM, NEW HAMPSHIRE, WITH A TOTAL OF APPROXIMATELY 291,000 RESIDENTS. THE HOSPITAL'S SECONDARY SERVICE AREA (""SSA"") HAS A POPULATION OF ALMOST 340,000 AND INCLUDES THE SURROUNDING MUNICIPALITIES OF ANDOVER, CARLISLE, GROTON, LAWRENCE, LITTLETON, METHUEN, NORTH ANDOVER, PEPPERELL AND WILMINGTON, MASSACHUSETTS, AND HOLLIS, HUDSON AND NASHUA, NEW HAMPSHIRE.THE HOSPITAL OFFERS THE LATEST TECHNOLOGY AND A FULL RANGE OF MEDICAL, SURGICAL AND CRITICAL CARE SERVICES FOR PATIENTS, FROM NEWBORNS TO SENIORS. IT IS CURRENTLY LICENSED BY THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH TO OPERATE A TOTAL OF 434 ACUTE CARE BEDS (301 ADULT MEDICAL/SURGICAL, 29 INTENSIVE CARE, 40 PEDIATRIC, 26 OBSTETRICAL, 10 LEVEL IIB SPECIAL CARE NURSERY BASSINETS AND 28 WELL-NEWBORN BASSINETS).INPATIENT STATISTICSINPATIENT ADMISSIONS: 18,065DELIVERIES: 1,699OBSERVATION STAYS: 5,402PATIENT DAYS: 89,418SURGERIES: 2,669"

PART V, SECTION B
FACILITY REPORTING GROUP A

FACILITY REPORTING GROUP A CONSISTS OF:
- FACILITY 1: THE LOWELL GENERAL HOSPITAL, - FACILITY 2: THE LOWELL GENERAL HOSPITAL

THE LOWELL GENERAL HOSPITAL PART V, SECTION B, LINE 3J:
LOWELL GENERAL HOSPITAL COMPLETES A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS, WITH THE MOST RECENT BEING COMPLETED IN 2022. INFORMATION FOR THE NEEDS ASSESSMENT WAS COLLECTED IN THE FOLLOWING WAYS: (1) COMMUNITY SURVEYS, (2) LISTENING SESSIONS, (3) A REVIEW OF PUBLIC HEALTH DEMOGRAPHIC DATA, AND (4) KEY INFORMANT INTERVIEWS. THE CHNA IS CONDUCTED IN PARTNERSHIP WITH THE GREATER LOWELL HEALTH ALLIANCE (GLHA), AND THE UNIVERSITY OF MASSACHUSETTS-LOWELL.

THE LOWELL GENERAL HOSPITAL PART V, SECTION B, LINE 5:
AS PART OF THE ASSESSMENT, THERE WERE 2,055 SURVEYS COMPLETED, 26 FOCUSED LISTENING SESSIONS COMPLETED, AND 30 KEY INFORMANT INTERVIEWS COMPLETED. SURVEYS WERE TRANSLATED INTO 6 LANGUAGES (SPANISH, PORTUGUESE, KHMER, ARABIC, FRENCH AND SWAHILI, AND COULD BE COMPLETED ON-LINE OR ON PAPER. THE LISTENING SESSIONS WERE CONDUCTED BY RESEARCH STUDENTS FROM THE UNIVERSITY OF MASSACHUSETTS-LOWELL AND HAD OVER 230 PARTICIPANTS. THE LISTENING SESSIONS WERE HELD WITH POPULATION GROUPS OF PARTICULAR INTEREST, INCLUDING SPANISH AND KHMER SPEAKING COMMUNITY MEMBERS, THE ELDERLY, RECENT IMMIGRANTS, AND COMMUNITY MEMBERS IN RECOVERY. MULTIPLE PUBLIC HEALTH DEMOGRAPHIC DATA SOURCES WERE REVIEWED FROM THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH POPULATION HEALTH INFORMATION TOOL (PHIT). LASTLY, 30 KEY COMMUNITY MEMBERS WERE INTERVIEWED, INCLUDING PHYSICIANS, COMMUNITY LEADERS, AND FIRST RESPONDERS. THE TOP HEALTH PRIORITIES IDENTIFIED IN THIS COMPREHENSIVE ARE 1) MENTAL HEALTH, 2) CHRONIC HEALTH AND WELLNESS (INCLUDING HEART HEALTH AND NUTRITION), 3) SUBSTANCE AND ALCOHOL USE, 4) COVID-19 AND OTHER INFECTIOUS DISEASES, AND 5) REPRODUCTIVE, SEXUAL AND PREGNANCY HEALTH. IN ADDITION, THE ASSESSMENT IDENTIFIED THE TOP SOCIOECONOMIC FACTORS INCLUDING HOUSING COSTS, THE COST OF INSURANCE AND LOW WAGES AS BARRIERS TO THE ABILITY TO ACCESS HEALTH SERVICES.THE TOP RESOURCES IDENTIFIED WERE 1) A ROBUST AND ACCESSIBLE HEALTHCARE SERVICE INFRASTRUCTURE, 2) SUBSTANCE USE PREVENTION AND TREATMENT SERVICES, 3) NUTRITION AND FOOD SECURITY, 4) AFFORDABLE, SAFE HOUSING, AND 5) SERVICES FOR CHILDREN AND YOUTH.RECOMMENDATIONS FROM THE SURVEYS, LISTENING SESSIONS, AND KEY INFORMANT INTERVIEWS INCLUDED INCREASING THE ACCESSIBILITY OF EXISTING HEALTHCARE SERVICES, ENGAGING WITH LOCAL AND STATE OFFICIALS TO REDUCE THE COST OF LIVING, AND IMPROVEMENTS IN COMMUNICATION TO THE COMMUNITY BY INCREASING THE NUMBER OF TRANSLATED PRINTED AND ON-LINE HEALTHCARE RELATED INFORMATION.

THE LOWELL GENERAL HOSPITAL PART V, SECTION B, LINE 6B:
LOWELL GENERAL HOSPITAL CONDUCTED THE 2022 COMMUNITY HEALTH ALLIANCE WITH THE GREATER LOWELL HEALTH ALLIANCE (GLHA) AND THE UNIVERSITY OF MASSACHUSETTS-LOWELL.

THE LOWELL GENERAL HOSPITAL PART V, SECTION B, LINE 11:
THE TOP HEALTH PROBLEMS THAT WERE IDENTIFIED IN THE FOCUS GROUPS AND INTERVIEWS AND SUPPORTED BY PUBLIC HEALTH DATA INCLUDE MENTAL HEALTH, CHRONIC HEALTH ISSUES (HEART DISEASE, HYPERTENSION, ETC.), SUBSTANCE AND ALCOHOL DISORDER, COVID-19 AND OTHER INFECTIOUS DISEASES, AND REPRODUCTIVE AND SEXUAL HEALTH. THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN THE LATEST COMMUNITY HEALTH NEEDS ASSESSMENT BY INCORPORATING THESE INTO THE ORGANIZATION'S ANNUAL COMMUNITY BENEFIT PLAN. THE COMMUNITY BENEFIT PLAN IS AN ACTION PLAN DEVELOPED ANNUALLY BY HOSPITAL LEADERS TO ADDRESS PRIORITY HEALTH NEEDS WITHIN THE GREATER LOWELL REGION. LOWELL GENERAL HOSPITAL AND THE GREATER LOWELL HEALTH ALLIANCE ARE COMMITTED TO A COLLABORATIVE APPROACH INVOLVING OTHER COMMUNITY STAKEHOLDERS WITH THE GOAL TO IDENTIFY TOP PRIORITIES AND FORMULATE ACTION STEPS THAT WILL IMPROVE THE AREA HEALTHCARE SYSTEM AND OVERALL COMMUNITY HEALTH.THE MAJOR SOCIAL ISSUES IDENTIFIED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDE MENTAL AND BEHAVIORAL HEALTH NEEDS THAT ARE NOT BEING MET, LACK OF SUBSTANCE ABUSE RESOURCES, DIFFICULT AND/OR LACK OF ACCESS TO CARE FOR MANY LOWELL AND GREATER LOWELL RESIDENTS, NEED FOR ADDITIONAL INTERPRETATION AND TRANSLATION SERVICES, AND BARRIERS TO ACCESS SERVICES DUE TO TRANSPORTATION, CULTURAL CONCERNS AND LIMITED ACCESS TO PRIMARY CARE PHYSICIANS.LOWELL GENERAL HOSPITAL WORKS CLOSELY WITH THE GREATER LOWELL HEALTH ALLIANCE TO WORK WITH THE COMMUNITY TO FORM A COMMUNITY HEALTH IMPROVEMENT PLAN(CHIP) TO ADDRESS THESE ISSUES AND WORK COLLABORATIVELY TO ASSIST OUR COMMUNITY. THIS CHIP PROVIDES A GUIDE FOR COMMUNITY AGENCIES TO FOCUS RESOURCES AND PROGRAMMING TO RESPOND TO THE NEEDS OF OUR PATIENTS AND COMMUNITY MEMBERS.

THE LOWELL GENERAL HOSPITAL PART V, SECTION B, LINE 13B:
PATIENTS WHOSE HOUSEHOLD INCOME EXCEEDS 400% OF THE FEDERAL POVERTY GUIDELINES AND WHO MEET HEALTH SAFETY NET INCOME CRITERIA FOR MEDICAL HARDSHIP AND HAVE BALANCES (AFTER FREE CARE) OF $10,000 OR MORE. SPECIFICALLY, THESE PATIENTS MAY (1) BE ELIGIBLE FOR MEDICAL HARDSHIP ASSISTANCE UNDER THE HEALTH SAFETY NET BUT HAVE PATIENT CONTRIBUTION REQUIREMENTS GREATER THAN $10,000 OR (2) MEET THE MEDICAL HARDSHIP INCOME CRITERIA, BUT ARE INELIGIBLE FOR FREE CARE BECAUSE THE SERVICES RECEIVED ARE NOT HOSPITAL-LICENSED SERVICES. IN SUCH CIRCUMSTANCES:(I)FINANCIAL ASSISTANCE WILL BE DETERMINED AFTER A REVIEW OF ALL FINANCIAL INFORMATION AND CIRCUMSTANCES.(II)FINANCIAL ASSISTANCE WILL GENERALLY REDUCE AN OUTSTANDING BALANCE TO 15% OF ANNUAL INCOME ABSENT SIGNIFICANT ASSETS. (III)FINANCIAL ASSISTANCE UP TO 100% WILL BE CONSIDERED BASED ON THE PATIENT'S PARTICULAR MEDICAL AND FINANCIAL CIRCUMSTANCES AND MUST BE APPROVED BY THE LOWELL GENERAL HOSPITAL VICE PRESIDENT OF REVENUE OR VP FINANCE/CFO OR HIS/HER DESIGNEE.

SCHEDULE H-PART I
PART I, LINE 6A & B: THE ORGANIZATION PREPARES A COMMUNITY BENEFIT REPORT EVERY YEAR. THE COMMUNITY BENEFIT ANNUAL REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE OR UPON REQUEST.PART I, LINE 7: THE COST ALLOCATION IS BASED OFF THE FY2022 TOTAL PATIENT CARE EXPERIENCE (NOT INCLUDING BAD DEBT AND LESS THE MEDICAID PROVIDER TAX) DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS PERCENTAGE IS APPLIED TO THE SPECIFIC LINE ITEMS TO REFLECT THE MOST ACCURATE COST CALCULATION.

PART II, COMMUNITY BUILDING ACTIVITIES:
LOWELL GENERAL HOSPITAL COMPLETES A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS, WITH THE MOST RECENT BEING COMPLETED IN 2022. INFORMATION FOR THE NEEDS ASSESSMENT WAS COLLECTED IN THE FOLLOWING WAYS: (1) COMMUNITY SURVEYS, (2) LISTENING SESSIONS, (3) A REVIEW OF PUBLIC HEALTH DEMOGRAPHIC DATA, AND (4) KEY INFORMANT INTERVIEWS. THE CHNA IS CONDUCTED IN PARTNERSHIP WITH THE GREATER LOWELL HEALTH ALLIANCE (GLHA), AND THE UNIVERSITY OF MASSACHUSETTS-LOWELLTHE LOWELL GENERAL HOSPITAL HAS A CLOSE WORKING RELATIONSHIP THAT INCLUDES FINANCIAL SUPPORT TO LOWELL COMMUNITY HEALTH CENTER (LCHC) WHICH SERVES THE LOW-INCOME, MEDICALLY UNDERSERVED POPULATION, MANY OF WHOM HAVE NO OTHER ACCESS TO HEALTHCARE SERVICES. SOME OF THE MAJOR SERVICES THAT LCHC PROVIDES ARE - CARINO, WHICH PROVIDES SPECIAL CARE FOR PATIENTS WITH HIV/AIDS; PROMOTORAS PROGRAMS, WHICH ARE TRAINED COMMUNITY HEALTH WORKERS AND VOLUNTEERS WHO SPEAK SPANISH AND/OR PORTUGUESE AND GO THROUGH AN INTENSIVE TRAINING WITH LCHC STAFF ON SPECIFIC HEALTH TOPICS TO EDUCATE THE COMMUNITY; LCHC TEEN COALITION AND ADOLESCENT HEALTH PROGRAM, WHICH COVERS EVERYTHING FROM MENTAL HEALTH AND SELF-ESTEEM ISSUES AMONG GIRLS TO EDUCATING AND INVOLVING YOUTH IN SUBSTANCE ABUSE PREVENTION AND A JOURNEY TO HEALING PROGRAM FOR REFUGEE CHILDREN AND CHILDREN OF REFUGEES. WITHOUT THE LOWELL GENERAL'S FINANCIAL SUPPORT TO LCHC'S PENSION AND WORKER'S COMPENSATION PROGRAM, MANY OF THESE PROGRAMS WOULD NOT HAVE ADEQUATE FUNDING. THE HEALTH AND DEMOGRAPHIC DATA AVAILABLE WITHIN THE GREATER LOWELL AREA WAS THOROUGHLY INVESTIGATED, FOCUSING SUBSTANTIALLY ON THE ISSUES OR PROBLEMS INDICATED FROM THE PERSONAL AND FOCUS GROUP INTERVIEWS, AS WELL AS THE PUBLIC HEALTH DATA AND STATISTICS.

PART III, LINE 2:
THE BAD DEBT EXPENSE AMOUNT DETAILED ON LINE 2 IS BASED ON THE COST TO CHARGE RATIO CALCULATED FROM THE MEDICARE COST REPORT. REGARDING THE RATIONALE FOR INCLUDING THE AMOUNT ON LINE 3 AS CHARITY CARE, THE HOSPITAL PROVIDES AN ESTIMATE OF HOW MUCH IS ATTRIBUTABLE TO PERSONS WHO WOULD NORMALLY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICIES, BUT HAVE NOT TAKEN ADVANTAGE OF THE FINANCIAL ASSISTANCE THAT IS AVAILABLE TO THEM. CURRENTLY THROUGH MANUAL PROCESSES IT IS IMPOSSIBLE TO SCREEN EVERY PATIENT TO MAKE AN INCOME STATUS DETERMINATION FOR QUALIFICATION TO THE HOSPITAL'S CHARITY PROGRAM UNDER A PRESUMPTIVE CHARITY POLICY. THESE INDIVIDUALS THAT DO NOT SEEK OUT CHARITY PROGRAMS ARE OFTEN UNDERINSURED OR LOW INCOME AND DO NOT NECESSARILY CONSIDER THE BENEFIT OF THE PROCESS OF SUBMITTING AN APPLICATION TO THE HOSPITAL. THE HOSPITAL CONTINUES TO PROVIDE CARE TO THOSE INDIVIDUALS THAT HAVE A HISTORY OF POOR CREDIT WITH THE FACILITY AND NEED MEDICALLY NECESSARY SERVICES AS WE UNDERSTAND THAT THE ABILITY FOR THE COMMUNITY TO SEEK OUT QUALITY MEDICAL SERVICES IS OF THE UTMOST IMPORTANCE AND EXTENDS OUR CHARITABLE BENEFIT TO THE COMMUNITY. WE BELIEVE THAT HAD THE QUALIFICATION PROCESS TAKEN PLACE THIS BAD DEBT WOULD BE CLASSIFIED IN THE CHARITY CARE OF THE HOSPITAL. SINCE THE QUALIFICATION PROCESS HAS NOT BEEN PERFORMED WE PROPERLY REPORT THIS AS BAD DEBT AS THE ACTUAL COST TO OUR HOSPITAL.

PART III, LINE 3:
THE BAD DEBT EXPENSE AMOUNT DETAILED ON LINE 2 IS BASED ON THE COST TO CHARGE RATIO CALCULATED FROM THE MEDICARE COST REPORT. REGARDING THE RATIONALE FOR INCLUDING THE AMOUNT ON LINE 3 AS CHARITY CARE, THE HOSPITAL PROVIDES AN ESTIMATE OF HOW MUCH IS ATTRIBUTABLE TO PERSONS WHO WOULD NORMALLY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICIES, BUT HAVE NOT TAKEN ADVANTAGE OF THE FINANCIAL ASSISTANCE THAT IS AVAILABLE TO THEM. CURRENTLY THROUGH MANUAL PROCESSES IT IS IMPOSSIBLE TO SCREEN EVERY PATIENT TO MAKE AN INCOME STATUS DETERMINATION FOR QUALIFICATION TO THE HOSPITAL'S CHARITY PROGRAM UNDER A PRESUMPTIVE CHARITY POLICY. THESE INDIVIDUALS THAT DO NOT SEEK OUT CHARITY PROGRAMS ARE OFTEN UNDERINSURED OR LOW INCOME AND DO NOT NECESSARILY CONSIDER THE BENEFIT OF THE PROCESS OF SUBMITTING AN APPLICATION TO THE HOSPITAL. THE HOSPITAL CONTINUES TO PROVIDE CARE TO THOSE INDIVIDUALS THAT HAVE A HISTORY OF POOR CREDIT WITH THE FACILITY AND NEED MEDICALLY NECESSARY SERVICES AS WE UNDERSTAND THAT THE ABILITY FOR THE COMMUNITY TO SEEK OUT QUALITY MEDICAL SERVICES IS OF THE UTMOST IMPORTANCE AND EXTENDS OUR CHARITABLE BENEFIT TO THE COMMUNITY. WE BELIEVE THAT HAD THE QUALIFICATION PROCESS TAKEN PLACE THIS BAD DEBT WOULD BE CLASSIFIED IN THE CHARITY CARE OF THE HOSPITAL. SINCE THE QUALIFICATION PROCESS HAS NOT BEEN PERFORMED WE PROPERLY REPORT THIS AS BAD DEBT AS THE ACTUAL COST TO OUR HOSPITAL.

PART III, LINE 8:
THERE WAS A DECLINE IN MEDICARE VOLUME FOR BOTH INPATIENT AND OUTPATIENT COMPARING FISCAL YEARS. ALSO CONTRIBUTING WAS A DECREASE IN THE MEDICARE INPATIENT BASE RATE WHICH WOULD EXPLAIN THE LOWER REVENUE IN FY'22.

PART VI, LINE 7, REPORTS FILED WITH STATES
MA

PART III, LINE 4:
"THE ORGANIZATION'S PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS DESCRIBED ON PAGE 18 OF THE AUDITED FINANCIAL STATEMENTS ATTACHED. THE FOLLOWING IS EXCERPTED FROM THAT FOOTNOTE:ACCOUNTS RECEIVABLE ARE STATED AT ESTIMATED NET REALIZABLE AMOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND HISTORIC PAYMENT TRENDS AND RECORDS ESTIMATED CONTRACTUAL ALLOWANCES. THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILLS FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COVERED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.THE FOLLOWING IS FROM THE TUFTS MEDICINE, INC. AND CONSOLIDATED AFFILIATES (THE SYSTEM) AUDITED FINANCIAL STATEMENTS, OF WHICH THE LOWELL GENERAL HOSPITAL IS INCLUDED, RELATING TO CHARITY CARE AND BAD DEBT EXPENSE:CHARITY CARE AND COMMUNITY BENEFITS FOOTNOTECHARITY CARE - THE SYSTEM'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE PATIENTS THAT IT SERVES. THE SYSTEM PROVIDES HEALTH CARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. THESE PATIENTS MAY RECEIVE FULL ASSISTANCE OR MAY BE SUBJECT TO PARTIAL LIABILITY BASED ON INCOME AND FAMILY SIZE. BECAUSE THE SYSTEM DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE.THE SYSTEM PROVIDED CHARITY CARE, BASED ON CHARGES FORGONE AND THE ESTIMATED COST OF THE CHARITY CARE PROVIDED AMOUNTED TO $26,475K AND $12,518K, FOR THE YEAR ENDED SEPTEMBER 30, 2022 AND $43,554K AND $18,294K FOR THE YEAR ENDED SEPTEMBER 30, 2021, RESPECTIVELY. THE ESTIMATED COST OF CHARITY CARE IS BASED ON THE RELATIONSHIP OF PATIENT CARE SERVICE CHARGES TO THE RELATED COSTS APPLIED TO CHARITY CARE CHARGES RECOGNIZED DURING THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021. THE SYSTEM HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2022. THE SYSTEM DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FROM THIRD-PARTY PAYERS, NOR DID IT HAVE SIGNIFICANT BAD DEBT WRITE-OFFS FROM THIRD-PARTY PAYERS.HEALTH SAFETY NET FUND (HSN) - THE COMMONWEALTH OF MASSACHUSETTS (THE ""COMMONWEALTH"") OPERATES THE HSN, WHICH WAS CREATED BY THE COMMONWEALTH'S HEALTH CARE REFORM ACT TO REPLACE THE STATE'S UNCOMPENSATED CARE POOL. THE HSN ALLOCATES THE COST OF UNCOMPENSATED CARE AMONG THE HOSPITALS IN THE COMMONWEALTH. HOSPITALS HAVE BEEN ASSESSED A UNIFORM ALLOWANCE BASED ON ESTIMATES OF THE STATEWIDE COST OF UNCOMPENSATED CARE AND REIMBURSED FOR A PORTION OF THE COST OF UNCOMPENSATED CARE, SUBJECT TO CERTAIN LIMITATIONS. REIMBURSABLE UNCOMPENSATED CARE INCLUDES NET CHARITY CARE AND CERTAIN UNCOLLECTIBLE ACCOUNTS RELATED TO EMERGENCY SERVICES. HOSPITALS' RECOVERIES FROM THE HSN ARE BASED ON A CLAIMS-BASED PAYMENT METHOD THAT USES MEDICARE PRINCIPLES. REIMBURSEMENT FROM THE HSN FOR UNCOMPENSATED CARE IS RECORDED IN NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENT OF OPERATIONS. THE COMMONWEALTH HAS DETERMINED FINAL SETTLEMENTS WITH RESPECT TO THE HSN FOR ALL YEARS PRIOR TO 2014.COMMUNITY BENEFIT - IN FURTHERING ITS CHARITABLE PURPOSE, THE SYSTEM PROVIDES A WIDE VARIETY OF HEALTH CARE SERVICES TO THE COMMUNITY IN ORDER TO PROVIDE ACCESS TO APPROPRIATE CARE FOR POPULATIONS IN NEED. THE SYSTEM HAS DEVELOPED A FORMAL COMMUNITY BENEFIT IMPLEMENTATION PLAN THAT RESPONDS TO THE COMPREHENSIVE ASSESSMENT OF HEALTH CARE NEEDS IN THE COMMUNITY. THE COMMUNITY BENEFIT PLAN SUPPORTS SERVICES THAT TARGET NOT ONLY THE GENERAL POPULATION IN THE SYSTEM'S SERVICE AREA, BUT ALSO PARTICULAR POPULATIONS WITH SPECIAL HEALTH CARE NEEDS, INCLUDING THE POOR, ELDERLY, CHILDREN, AND MINORITY POPULATIONS. SUPPORTED SERVICES INCLUDE VARIOUS DIRECT CARE PROGRAMS, HEALTH SCREENING, HEALTH EDUCATION AND SUPPORT GROUPS OPERATED IN THE SYSTEM'S SERVICE AREA. THE SYSTEM WORKS ACTIVELY WITH OTHER AREA SERVICE PROVIDERS TO FACILITATE THE DEVELOPMENT OF AN EFFECTIVE COMMUNITY HEALTH NETWORK. THE SYSTEM ALSO PARTICIPATES IN ACTIVITIES DESIGNED TO FOSTER AND ENHANCE THE ECONOMIC AND CIVIC ENVIRONMENT OF ITS SERVICE AREAS."

PART III, LINE 9B:
THERE ARE TWO DISTINCTIONS THAT ARE MADE FOR PATIENTS THAT ARE CONSIDERED EITHER LOW INCOME BY DEFINITION OF THE STATE OF MASSACHUSETTS ELIGIBILITY PROGRAM OR UNDER THE HOSPITAL'S INTERNAL FINANCIAL ASSISTANCE PROGRAM FOR CHARITY CARE. IF THE PATIENT IS DEEMED TO BE LOW INCOME BY THE STATE OF MASSACHUSETTS, ALL COLLECTION EFFORTS ARE CEASED ON PRIOR AND CURRENT BALANCE ACCOUNTS. WHERE APPROPRIATE, ACCOUNTS WILL BE WRITTEN OFF TO HOSPITAL CHARITY FOR THOSE ACCOUNTS THAT EXCEED THE RETROACTIVE LOOK BACK PERIOD. FOR PATIENTS WHO QUALIFY FOR THE HOSPITAL'S INTERNAL FINANCIAL ASSISTANCE PROGRAM, THE PROGRAM WILL QUALIFY THE PATIENT FOR MEDICALLY NECESSARY SERVICES FOR THE PERIOD OF ONE YEAR IN WHICH THE ACCOUNT ACTIVITY OF THE PATIENT WILL BE WRITTEN OFF TO THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND REPORTED AS CHARITY CARE. ALL COLLECTION ACTIVITIES ON PRIOR BALANCE ACCOUNTS CEASES AT THE POINT OF THIS QUALIFICATION. FINANCIAL COUNSELORS WORK CLOSELY WITH PATIENTS TO MONITOR THEIR CURRENT FINANCIAL STATUS TO DETERMINE ANY CHANGES IN QUALIFICATIONS FOR BOTH THE STATE AND HOSPITAL PROGRAMS.

PART VI, LINE 2:
ON BEHALF OF LOWELL GENERAL HOSPITAL, UNIVERSITY OF MASSACHUSETTS LOWELL (UML) AND THE GREATER LOWELL HEALTH ALLIANCE (GLHA), A TEAM OF UMASS LOWELL RESEARCHERS AND STUDENTS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT STUDY TO DISTINGUISH THE UNMET MEDICAL AND PUBLIC HEALTH NEEDS WITHIN THE GREATER LOWELL COMMUNITY. THE GEOGRAPHIC AREA ASSESSED INCLUDED THE COMMUNITIES OF LOWELL, BILLERICA, CHELMSFORD, DRACUT, DUNSTABLE, TEWKSBURY, TYNGSBOROUGH AND WESTFORD. THE STUDY HAD SEVERAL OBJECTIVES, WHICH WERE TO: ASSESS THE OVERALL HEALTH OF AREA RESIDENTS, IDENTIFY THE STRENGTHS AND WEAKNESSES OF THE LOCAL HEALTHCARE SYSTEM, DETERMINE THE TOP HEALTH PROBLEMS FACING AREA RESIDENTS AND THE POPULATIONS AT GREATEST RISK, INVOLVE A BROAD SPECTRUM OF PROFESSIONALS AND RESIDENTS, INCLUDING NEWER IMMIGRANT COMMUNITIES, PROVIDE RECOMMENDATIONS TO IMPROVE THE HEALTHCARE SYSTEM AND ADDRESS UNMET HEALTH NEEDS, AND INFORM THE PROCESS TO IDENTIFY PRIORITY HEALTH NEEDS AND DEVELOP ACTION PLANS TO ADDRESS THESE PRIORITY NEEDS. LOWELL GENERAL HOSPITAL COMPLETES A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS, WITH THE MOST RECENT BEING COMPLETED IN 2022. INFORMATION FOR THE NEEDS ASSESSMENT WAS COLLECTED IN THE FOLLOWING WAYS: (1) COMMUNITY SURVEYS, (2) LISTENING SESSIONS, (3) A REVIEW OF PUBLIC HEALTH DEMOGRAPHIC DATA, AND (4) KEY INFORMANT INTERVIEWS. THE CHNA IS CONDUCTED IN PARTNERSHIP WITH THE GREATER LOWELL HEALTH ALLIANCE (GLHA), AND THE UNIVERSITY OF MASSACHUSETTS-LOWELL. THE GREATER LOWELL REGION INCLUDES EIGHT COMMUNITIES: BILLERICA, CHELMSFORD, DRACUT, DUNSTABLE, LOWELL, TEWKSBURY, TYNGSBORO, AND WESTFORD. THERE IS SIGNIFICANT SOCIO-ECONOMIC VARIATION IN GREATER LOWELL. APPROXIMATELY 9.6% OF RESIDENTS LIVE BELOW THE FEDERAL POVERTY LINE, BUT THE MEDIAN INCOME RANGES FROM A HIGH OF $158,523 IN DUNSTABLE TO A LOW OF $62,196 IN LOWELL. THE PREMATURE MORTALITY RATE (PMR) IS A MEASURE OF DEATHS THAT OCCUR BEFORE AGE 75, CALCULATED AS A RATE PER 100,000 RESIDENTS. THE PMR OF GREATER LOWELL (295.7 PER 100,000) IS HIGHER THAN THE STATE RATE OF (272.8 PER 100,000). THE GREATER LOWELL REGION ALSO IDENTIFIED MENTAL HEALTH AS THE TOP HEALTH PRIORITY IN THE 2022 CHNA.

PART VI, LINE 3:
FOR THOSE PATIENTS WHO ARE UNINSURED OR UNDERINSURED, THE HOSPITAL WORKS WITH THEM TO ASSIST WITH APPLYING FOR AVAILABLE FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED PATIENTS FIND AVAILABLE AND APPROPRIATE FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL PROVIDES ALL PATIENTS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PROGRAMS IN BOTH THE BILLS THAT ARE SENT TO PATIENTS AS WELL AS IN GENERAL NOTICES THAT ARE POSTED THROUGHOUT THE HOSPITAL. IN ADDITION TO GENERAL NOTICES, THERE ARE INFORMATIONAL BROCHURES AVAILABLE IN ACCESS AREAS AND DURING THE PROCESS OF REGISTRATION ANYONE THAT INDICATES THEY ARE HAVING TROUBLE PAYING THEIR BILLS OR WHO ARE UNINSURED ARE PROVIDED WITH A BUSINESS CARD THAT IDENTIFIES HOW TO CONTACT A PATIENT FINANCIAL COUNSELOR. ALL SIGNS AND NOTICES ARE TRANSLATED INTO LANGUAGES OTHER THAN ENGLISH IF SUCH LANGUAGE IS SPOKEN BY 10% OR MORE OF THE POPULATION RESIDING IN THE HOSPITAL SERVICE AREA. CURRENTLY, THE HOSPITAL TRANSLATES THE NOTICES INTO THE FOLLOWING LANGUAGES - SPANISH, PORTUGUESE, AND KHMER. THE HOSPITAL TRIES TO IDENTIFY AVAILABLE COVERAGE OPTIONS FOR PATIENTS WHO MAY BE UNINSURED OR UNDERINSURED WITH THEIR CURRENT INSURANCE PROGRAM WHEN THE PATIENT IS SCHEDULING THEIR SERVICES, WHILE THE PATIENT IS IN THE HOSPITAL, UPON DISCHARGE, AND FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THE HOSPITAL PATIENT ACCESS STAFF DIRECTS ALL PATIENTS SEEKING AVAILABLE COVERAGE OPTIONS OR FINANCIAL ASSISTANCE TO THE HOSPITAL'S PATIENT FINANCIAL COUNSELING OFFICE TO DETERMINE IF THEY ARE ELIGIBLE AND THEN TO SCREEN FOR ELIGIBILITY IN AN APPROPRIATE COVERAGE OPTION. THE HOSPITAL ASSISTS THE PATIENT IN APPLYING FOR THE APPROPRIATE COVERAGE OPTIONS THAT ARE AVAILABLE OR NOTIFY THEM OF THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGH THE HOSPITAL'S OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM.

PART VI, LINE 6:
"MEMBERS AND OFFICERS OF LOWELL GENERAL HOSPITAL ARE ACTIVELY SERVING ON THE BOARDS OF MANY LOCAL COMMUNITY AREA AGENCIES AND AS HEADS OF THE GREATER LOWELL HEALTH ALLIANCE. IN 2014, LOWELL GENERAL HOSPITAL OFFICIALLY BECAME A MEMBER OF CIRCLE HEALTH. CIRCLE HEALTH IS A PROGRESSIVE COLLABORATION OF PHYSICIANS, HOSPITALS, OTHER HEALTH PROVIDERS, AND OTHER COMMUNITY-BASED ORGANIZATIONS WITH A SHARED VISION FOR EMPOWERING PEOPLE AND COMMUNITIES TO BE THE HEALTHIEST THEY CAN BE. WITH OUR INNOVATIVE PROGRAMS AND APPROACH TO CARE MANAGEMENT, OUR PROMISE TO YOU IS AN EXPERIENCE OF COMPLETE CONNECTED CARESM. CIRCLE HEALTH IS ABOUT SUPPORTING COMMUNITIES WITH A COMPREHENSIVE RANGE OF SERVICES SO THAT INDIVIDUALS HAVE EASY ACCESS TO THE EXPERTISE AND RESOURCES THEY NEED IN ORDER TO ACHIEVE THE BEST POSSIBLE HEALTH THROUGHOUT THEIR LIVES.CIRCLE HEALTH IS A MASSACHUSETTS NONPROFIT CORPORATION AND MEMBER OF THE TUFTS MEDICINE SYSTEM THAT OVERSEES AND COORDINATES A SERIES OF AFFILIATED CORPORATIONS THAT PROVIDE A BROAD RANGE OF HEALTH CARE AND RELATED SERVICES IN LOWELL, MASSACHUSETTS. THE CONSOLIDATED AFFILIATED ENTITIES OF CIRCLE HEALTH INCLUDE THE LOWELL GENERAL HOSPITAL, A NONPROFIT GENERAL ACUTE CARE HOSPITAL; LGH SERVICES, INC. AND CONSOLIDATED AFFILIATES, A FOR-PROFIT ENTITY AND SOLE SHAREHOLDER OF LGH MANAGEMENT SERVICE, INC., LGH MEDICAL BUILDING SERVICES (""LGH MEDICAL BUILDING""), AND LGH MEDICAL SERVICES, INC.; CIRCLE HEALTH PHYSICIANS, A NONPROFIT ENTITY AND SOLE SHAREHOLDER OF A NUMBER OF PHYSICIAN PRACTICES AND CIRCLE HEALTH PHARMACY LLC; AND CIRCLE HEALTH ALLIANCE, LLC (""ALLIANCE""), AN ACCOUNTABLE CARE ORGANIZATION."

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THE CITY OF LOWELL WAS FOUNDED IN 1820 AS A PLANNED INDUSTRIAL COMMUNITY ALONG THE BANKS OF THE MERRIMACK RIVER WHOSE ECONOMY WAS BASED ON TEXTILE MANUFACTURING. BY THE 1850'S, IT HAD BECOME THE LARGEST INDUSTRIAL CENTER IN THE UNITED STATES AND THE SECOND LARGEST CITY IN NEW ENGLAND. MUCH OF THE POPULATION GROWTH IN LOWELL WAS ATTRIBUTABLE TO IMMIGRATION, WHICH NEW RESIDENTS COMING FROM MANY PARTS OF EUROPE AND FRENCH-SPEAKING CANADA, CREATING AN ETHNICALLY DIVERSE COMMUNITY. DURING THIS PERIOD, LOWELL SERVED AS A REGIONAL ECONOMIC ENGINE, PROVIDING GOODS AND SERVICES TO THE SURROUNDING COMMUNITIES, WHICH RETAINED A LARGELY AGRICULTURAL ECONOMY INTO THE EARLY 1900'S. BY THE 1920'S, HOWEVER, LOWELL HAD GONE INTO ECONOMIC DECLINE AS THE U.S. TEXTILE INDUSTRY MOVED SOUTH, AND BY THE END OF THE 1950'S ALL OF THE TEXTILE MILLS HAD CLOSED. IN THE 1970'S, WANG LABORATORIES LOCATED ITS HEADQUARTERS IN THE CITY AND SPURRED A TEMPORARY ECONOMIC REVIVAL, WHICH COLLAPSED WHEN THE COMPANY FILED FOR BANKRUPTCY IN 1992. WHILE THE URBAN CORE HAS BEEN REDEVELOPED AS A RESIDENTIAL COMMUNITY, WITH FORMER TEXTILE MILLS BEING REHABILITATED AS CONDOMINIUMS AND APARTMENTS, LOWELL LACKS A STRONG INDUSTRIAL BASE. IN A LARGE MEASURE, THE EMERGENCE OF A HIGH TECHNOLOGY AND BIOMEDICAL ECONOMIC BASE IN EASTERN MASSACHUSETTS COINCIDED WITH A DECENTRALIZATION OF DEVELOPMENT AND URBAN PLANNING, WITH MANY NEW BUSINESSES LOCATING OUTSIDE CITY CENTERS, ALONG TRANSPORTATION CORRIDORS (E.G., ROUTES 128 AND 495). WHILE LOWELL STILL PROVIDES REGIONAL SERVICES NOT AVAILABLE IN THE SMALLER COMMUNITIES - HEALTHCARE, EDUCATION AND ENTERTAINMENT - MUCH OF THE AREA'S RECENT JOB GROWTH HAS COME FROM THE HIGH TECHNOLOGY SECTOR IN NEARBY TOWNS SUCH AS BILLERICA, CHELMSFORD, TEWKSBURY AND WESTFORD. IN THE 1980'S, THE CITY OF LOWELL WAS DESIGNATED AS A REFUGEE AND RESETTLEMENT AREA FOR CAMBODIANS IN THE WAKE OF THE ATROCITIES COMMITTED BY THE KHMER ROUGE REGIME. TODAY, LOWELL IS HOME TO THE SECOND LARGEST CAMBODIAN POPULATION WITHIN THE U.S. IN ADDITION, MANY OF THE AMENITIES THAT HAD SERVED PREVIOUS GENERATIONS OF LOWELL IMMIGRANTS, SUCH AS PLENTIFUL RENTAL HOUSING AND A HIGH GEOGRAPHIC DENSITY OF RETAIL BUSINESSES AND SERVICES CONTINUE TO ATTRACT IMMIGRANTS. IN THE 2000 CENSUS, MORE THAN ONE IN FIVE LOWELL RESIDENTS WAS FOREIGN BORN. CONTRASTED WITH THE PREDOMINANTLY NORTHERN AND WESTERN EUROPEAN IMMIGRATION DURING THE CITY'S MANUFACTURING HEYDAY, RECENT FIGURES SHOW THAT THE FOREIGN BORN IN LOWELL TODAY HAVE MORE DIVERSE ORIGINS. IN 2000, APPROXIMATELY HALF OF ALL LOWELL IMMIGRANTS WERE ASIAN, NEARLY A QUARTER FROM LATIN AMERICA, 16 PERCENT FROM EUROPE (WITH MANY ARRIVING FROM PORTUGAL), AND APPROXIMATELY SIX PERCENT FROM AFRICA. WITH THEIR ARRIVAL, THESE IMMIGRANTS HAVE ALSO ALTERED THE SERVICE ENVIRONMENT, WITH SOME HEALTHCARE FACILITIES, NOTABLY THE LOWELL COMMUNITY HEALTH CENTER, ADAPTING THEIR SERVICES TO ACCOMMODATE INDIVIDUALS WITH IDIOSYNCRATIC CULTURAL AND HEALTH NEEDS, AS WELL AS PROVIDING SERVICES IN AN INCREASING NUMBER OF LANGUAGES.IMMIGRANTS ARRIVING IN LOWELL TODAY ARE GREETED WITH A STARKLY DIFFERENT ECONOMIC REALITY THAN THOSE ARRIVING DURING THE INDUSTRIAL REVOLUTION. THERE ARE ESSENTIALLY NO MANUFACTURING JOBS REMAINING IN LOWELL, AND THE MAJORITY OF JOBS IN THE NEW HIGH TECHNOLOGY SECTOR REQUIRE A COLLEGE EDUCATION. AS A RESULT, MOST JOBS AVAILABLE TO NEW IMMIGRANTS WITHOUT AN ADVANCED EDUCATION ARE SERVICE JOBS, MANY OF WHICH DO NOT PAY A LIVING WAGE. GREATER LOWELL'S DEMOGRAPHIC PROFILE FROM THE MASSACHUSETTS EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT, AS OF SEPTEMBER 2022 INDICATES A 4.2% UNEMPLOYMENT RATE COMPARED TO 3.7% FOR THE STATE OF MASSACHUSETTS. THE COMMUNITIES SURROUNDING LOWELL HAVE ATTRACTED FAR FEWER IMMIGRANTS, WITH IMMIGRANTS ACCOUNTING FOR JUST THREE TO SEVEN PERCENT OF THEIR POPULATIONS. OF THE SUBURBAN COMMUNITIES IN THE GREATER LOWELL AREA, ONLY WESTFORD HAS A HIGHER PROPORTION FOREIGN BORN (12.6%), BUT THESE IMMIGRANTS ARE PREDOMINANTLY WELL EDUCATED AND DRAWN TO THE TOWN'S HIGH TECHNOLOGY JOBS.WHILE LOWELL IS NO LONGER THE ECONOMIC CENTER THAT IT ONCE WAS, LOWELL IS STILL A CULTURAL AND INSTITUTIONAL CENTER FOR THE REGION. IT IS HOME TO THE UNIVERSITY OF MASSACHUSETTS LOWELL, MIDDLESEX COMMUNITY COLLEGE AND THE LOWELL NATIONAL HISTORICAL PARK, AS WELL AS LOWELL GENERAL HOSPITAL, SUPERIOR AND DISTRICT COURTS, THE MERRIMACK REPERTORY THEATER, THE LOWELL MEMORIAL AUDITORIUM, THE TSONGAS CENTER AND LALACHEUR STADIUM.IN 2020, THE GREATER LOWELL AREA, AS DEFINED HEREIN, HAD A POPULATION OF 310,000 RESIDENTS, INCLUDING AN ESTIMATED 113,000 PEOPLE IN THE CITY OF LOWELL ALONE. THUS, THE CITY OF LOWELL ITSELF ACCOUNTS FOR LESS THAN 50 PERCENT OF THE AREA'S POPULATION. FOUR OTHER COMMUNITIES - BILLERICA, CHELMSFORD, DRACUT AND TEWKSBURY - EACH HAVE A POPULATION OF NEARLY 30,000 OR MORE. WE ALSO SEE THAT THE CITY OF LOWELL DIFFERS FROM ITS SUBURBAN NEIGHBORS IN IMPORTANT RESPECTS - A GREATER PERCENTAGE NON-HISPANIC WHITE, A GREATER PERCENTAGE FOREIGN BORN AND A HIGHER POVERTY RATE.LOWELL GENERAL HOSPITAL'S PRIMARY SERVICE AREA (PSA) IS COMPRISED OF APPROXIMATELY 300,000 RESIDENTS FROM THE FOLLOWING NINE COMMUNITIES: BILLERICA, CHELMSFORD, DRACUT, DUNSTABLE, LOWELL, TEWKSBURY, TYNGSBOROUGH, WESTFORD, AND PELHAM, NEW HAMPSHIRE. THE HOSPITAL'S SECONDARY SERVICE AREA (SSA) HAS A POPULATION OF APPROXIMATELY 371,000 AND INCLUDES THE SURROUNDING TOWNS OF ANDOVER, CARLISLE, GROTON, LAWRENCE, LITTLETON, METHUEN, NORTH ANDOVER, PEPPERELL, WILMINGTON, AND HOLLIS, HUDSON AND NASHUA, NEW HAMPSHIRE.

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"LOWELL GENERAL HOSPITAL PARTICIPATES IN COMMUNITY BUILDING ACTIVITIES IN MANY WAYS. TO HELP IMPROVE THE HEALTH STATUS OF OUR COMMUNITY WE RECOGNIZE THE IMPORTANCE OF ACCESS TO CARE. TO HELP MEET THIS NEED, LOWELL GENERAL HOSPITAL EVALUATES THE AVAILABILITY OF PRIMARY CARE AND SPECIALISTS TO OUR COMMUNITY MEMBERS AND ACTIVELY RECRUITS PHYSICIANS TO FILL GAPS. THESE GAPS OFTEN INCLUDE RECRUITMENT OF MULTI-LINGUAL PHYSICIANS AND THOSE WHO HAVE SPECIALTIES IN IDENTIFIED HEALTH NEEDS FOR OUR COMMUNITY. LOWELL GENERAL PROVIDES BOTH FINANCIAL AND PRACTICE MANAGEMENT SUPPORT TO THESE PHYSICIANS. THIS ENHANCES THE COMMUNITIES' ABILITY TO ACCESS EXCELLENT PRIMARY AND SPECIALTY CARE IN A LOCAL SETTING. LOWELL GENERAL HOSPITAL HAS A CLOSE WORKING RELATIONSHIP THAT INCLUDES FINANCIAL SUPPORT TO LOWELL COMMUNITY HEALTH CENTER (LCHC) WHICH SERVES THE LOW-INCOME, MEDICALLY UNDERSERVED POPULATION, MANY OF WHOM HAVE NO OTHER ACCESS TO HEALTHCARE SERVICES. THE MAJORITY OF PATIENTS SERVED BY LCHC HAVE MASSHEALTH, ANOTHER 10% HAVE PRIVATE HEALTH INSURANCE OR HMO COVERAGE, 7% HAVE MEDICARE, AND 20% ARE UNINSURED; AND 95% LIVE AT OR BELOW THE POVERTY LEVEL. ALMOST HALF OF LCHC'S PATIENT POPULATION IS UNDER 18 YEARS OF AGE, AND THE MAJORITY OF WOMEN ARE IN THEIR CHILDBEARING YEARS. IN 2007, 37% OF PATIENTS WERE WHITE/NON-HISPANIC; 28% WERE LATINO; 27% WERE ASIAN (PRIMARILY CAMBODIANS) AND 8% WERE AFRICAN IMMIGRANTS. ALMOST 60% OF PATIENTS WERE BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH. SOME OF THE MAJOR SERVICES THAT LCHC PROVIDES ARE - CARINO, WHICH PROVIDES SPECIAL CARE FOR PATIENTS WITH HIV/AIDS; PROMOTORAS PROGRAMS, WHICH ARE TRAINED COMMUNITY HEALTH WORKERS AND VOLUNTEERS WHO SPEAK SPANISH AND/OR PORTUGUESE AND GO THROUGH AN INTENSIVE TRAINING WITH LCHC STAFF ON SPECIFIC HEALTH TOPICS TO EDUCATE THE COMMUNITY; LCHC TEEN COALITION AND ADOLESCENT HEALTH PROGRAM, WHICH COVERS EVERYTHING FROM MENTAL HEALTH AND SELF-ESTEEM ISSUES AMONG GIRLS TO EDUCATING AND INVOLVING YOUTH IN SUBSTANCE ABUSE PREVENTION AND A JOURNEY TO HEALING PROGRAM FOR REFUGEE CHILDREN AND CHILDREN OF REFUGEES. WITHOUT LOWELL GENERAL'S FINANCIAL SUPPORT TO LCHC'S PENSION AND WORKER'S COMPENSATION PROGRAM, MANY OF THESE PROGRAMS WOULD NOT HAVE ADEQUATE FUNDING. THE HOSPITAL DEDICATES EXTENSIVE RESOURCES THROUGHOUT THE ORGANIZATION IN ITS COMMITMENT TO THE COMMUNITY BENEFIT PROGRAM. THE BOARD OF DIRECTORS, IN PARTNERSHIP WITH THE SENIOR MANAGEMENT TEAM AND THE PLANNING AND RESEARCH DEPARTMENT, CREATED A FORMAL STRUCTURE TO SUPPORT THE HOSPITAL'S OUTREACH INTO THE COMMUNITY, DEDICATING RESOURCES AND INVESTING IN A THREE-PRONGED APPROACH THROUGH THE CREATION OF THREE MAJOR INITIATIVES: THE CENTER FOR COMMUNITY HEALTH & WELLNESS, THE GREATER LOWELL HEALTH ALLIANCE, AND THE LGH BALL FOR COMMUNITY HEALTH INITIATIVES, WHICH IS NOW KNOWN AS THE CIRCLE HEALTH BALL FOR COMMUNITY HEALTH INITIATIVES. CENTER FOR COMMUNITY HEALTH & WELLNESSTHE CENTER FOR COMMUNITY HEALTH & WELLNESS (CCHW) WAS CREATED IN 2006 TO MEET THE EVER-CHANGING HEALTHCARE NEEDS THROUGHOUT GREATER LOWELL. PROGRAMS AND EVENTS ARE CREATED BY THE STAFF TO ADDRESS UNMET PUBLIC HEALTH NEEDS INCLUDING PHYSICAL ACTIVITY, NUTRITION, MENTAL HEALTH, PREVENTION, AND OVERALL HEALTH AND WELLNESS. MANY OF THESE PROGRAMS TARGET OUR COMMUNITY'S UNDERSERVED AND VULNERABLE POPULATIONS, INCLUDING CHILDREN, ELDERLY, AND IMMIGRANTS.TODAY, OUR CENTER FOR COMMUNITY HEALTH AND WELLNESS PLANS AND SUPPORTS MORE THAN 50 EVENTS ANNUALLY, INCLUDING HEALTH FAIRS AND COMMUNITY SCREENINGS, AND PROVIDES MORE THAN 15 SUPPORT GROUPS. IN ADDITION, WE PARTICIPATE IN 15-20 COMMITTEES AND COALITIONS IN THE GREATER LOWELL AREA, SUCH AS THE ASTHMA COALITION OF GREATER LOWELL, CITY MANAGER'S HOMELESSNESS TASK FORCE, THE HOUSING AND BUILT ENVIRONMENT TASK FORCE, LOWELL'S EARLY CHILDHOOD ADVISORY COUNCIL, AND THE HEALTH EQUITY TASK FORCE. OUR LEADERSHIP ROLE IN THESE INITIATIVES ENABLES US TO INCREASE COMMUNITY BUILDING AND CAPACITY, BROADENING THE IMPACT OF OUR REACH. GREATER LOWELL HEALTH ALLIANCEAS THE CENTER FOR COMMUNITY HEALTH & WELLNESS THRIVED, OUR RESEARCH INDICATED THAT THE SCOPE OF THE REGION'S HEALTHCARE NEEDS REQUIRED RESOURCES AND COLLABORATION BEYOND THOSE THAT COULD BE PROVIDED BY A SINGLE INSTITUTION. THIS FINDING LED LOWELL GENERAL HOSPITAL TO CREATE THE GREATER LOWELL HEALTH ALLIANCE (GLHA), AN INDEPENDENT NON-PROFIT ALLIANCE WITH A MISSION TO SUSTAIN A STRATEGIC ALLIANCE OF COMMUNITY ORGANIZATIONS THAT IMPROVES THE OVERALL HEALTH AND WELLNESS OF THOSE LIVING IN THE GREATER LOWELL REGION. BY RAISING AWARENESS AND PROVIDING RESOURCES FOR OUR HEALTH CARE PROVIDERS, COMMUNITIES, SCHOOLS AND CIVIC AND BUSINESS LEADERS, WE EMPOWER THEM TO MAKE DECISIONS AND TAKE ACTIONS THAT WILL LEAD TO AN IMPROVEMENT IN THE OVERALL HEALTH OF OUR COMMUNITIES.A MAJOR GOAL OF THE GLHA IS TO REDUCE DUPLICATION OF EFFORTS. THEREFORE, IN 2008 GLHA MERGED WITH THE COMMUNITY HEALTH NETWORK AREA (CHNA) 10, A COALITION OF PUBLIC, NON-PROFIT AND PRIVATE SECTORS CREATED BY THE DEPARTMENT OF PUBLIC HEALTH IN 1992. THE UNIFICATION OF THE TWO ORGANIZATIONS STRENGTHENED OUR ABILITY TO WORK WITH OTHERS TO ENRICH THE GREATER LOWELL COMMUNITY; NETWORK AND SHARE IDEAS WITH PEOPLE OF SIMILAR INTEREST IN BUILDING A HEALTHIER GREATER LOWELL COMMUNITY; GAIN MORE KNOWLEDGE ABOUT HEALTH-RELATED ISSUES AND TOPICS; AND INCREASE CULTURAL COMPETENCY OF THE SERVICES PROVIDED TO THE COMMUNITY.SINCE 2006, GLHA HAS GROWN FROM 13 PARTICIPATING ORGANIZATIONS TO MORE THAN 100, AND FROM ONE TASK FORCE TO SIX (SUBSTANCE USE & PREVENTION, MENTAL HEALTH, CULTURAL COMPETENCE, HEALTHY EATING & LIVING, HOUSING AND BUILT ENVIRONMENT, AND MATERNAL CHILD HEALTH). LOWELL GENERAL HOSPITAL CONTINUES TO PROVIDE LEADERSHIP AND FINANCIAL SUPPORT TO THE GLHA. CIRCLE HEALTH BALL FOR COMMUNITY HEALTH INITIATIVESWITH THE GROWING NEED FOR COMMUNITY HEALTH PROGRAMS AND SUPPORT CAME THE NEED FOR ADDITIONAL FUNDING TO SUPPORT THEM. LOWELL GENERAL HOSPITAL DEVELOPED THE ANNUAL ""LGH BALL FOR COMMUNITY HEALTH INITIATIVES"", TO RAISE AWARENESS AND FUNDS FOR COMMUNITY OUTREACH AND EDUCATION. THE BALL EVENT DID NOT OCCUR BETWEEN 2020 AND 2022 DUE TO COVID. IN THE FIVE YEARS BEFORE THAT, LOWELL GENERAL HOSPITAL RAISED MORE THAN $1.7 MILLION FOR COMMUNITY INITIATIVES, INCLUDING THE HEALTHY BABIES INITIATIVE, A BREASTFEEDING EDUCATION AND SUPPORT PROGRAMS FOR NEW MOMS; THE ""BEDS FOR KIDS"" PROGRAM OF THE LOWELL WISH PROJECT, WHICH PROVIDES NEW BEDS AND BEDDING FOR AT-RISK CHILDREN IN THE CITY; A PUBLIC SERVICE CAMPAIGN TO PROMOTE MENTAL HEALTH AWARENESS AND RESOURCES; THE ""HEART AND SOLES"" MALL WALKING PROGRAM; AN OUTDOOR RIVER PATH WALKING PROGRAM; A CHILDREN'S LITERACY PROGRAM; A SMOKING PREVENTION PROGRAM IN THE LOWELL PUBLIC SCHOOLS; AND A COMPREHENSIVE HEALTH RISK ASSESSMENT PROGRAM. LOWELL GENERAL HOSPITAL IS DEDICATED TO THE PROMOTION OF THE HEALTH IN THE COMMUNITY BY PROVIDING EDUCATIONAL OPPORTUNITIES FOR LOCAL SENIOR CENTERS, HOSTING QUARTERLY BLOOD DRIVES IN PARTNERSHIP WITH THE AMERICAN RED CROSS, RUNNING ANNUAL FOOD DRIVES TO BENEFIT THE LOCAL FOOD BANKS, AND PARTICIPATING IN COUNTLESS HEALTH FAIRS WHERE WE PROVIDE VALUABLE HEALTH PROMOTION INFORMATION AND OFTEN PROVIDE FREE HEALTH SCREENINGS."