4A (Expenses $ 95233025 including grants of $ 128596) (Revenue $ 98313215)
SEE SCHEDULE O

4B (Expenses $ 70181903 including grants of $ 0) (Revenue $ 72451846)
SEE SCHEDULE O

4C (Expenses $ 48871914 including grants of $ 0) (Revenue $ 50452613)
SEE SCHEDULE O

4D (Expenses $ 4211444 including grants of $ 0) (Revenue $ 4381823)

NEW ENGLAND BAPTIST HOSPITAL
PART V, SECTION B, LINE 5: 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.

NEW ENGLAND BAPTIST HOSPITAL
PART V, SECTION B, LINE 11: NEW ENGLAND BAPTIST 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.

NEW ENGLAND BAPTIST HOSPITAL
PART V, SECTION B, LINE 21D: NEW ENGLAND BAPTIST 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.

SCHEDULE H-NARRATIVES
FORM 990 SCHEDULE H PART V, SECTION C, SUPPLEMENTAL INFORMATION FOR SCHEDULE H PART V, SECTION BFINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCOMMUNITY HEALTH IMPROVEMENT SERVICES AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPSNEW ENGLAND BAPTIST HOSPITAL AFFILIATIONNEW ENGLAND BAPTIST HOSPITAL (NEBH) IS A MEMBER OF BETH ISRAEL LAHEY HEALTH (BILH).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.NEW ENGLAND BAPTIST HOSPITAL BENEFITS MISSION STATEMENT NEW ENGLAND BAPTIST HOSPITAL (NEBH) IS COMMITTED TO COLLABORATING WITH COMMUNITY PARTNERS AND RESIDENTS ACROSS BOSTON TO IDENTIFY AREAS OF SPECIAL NEED IN MUSCULOSKELETAL DISEASE AND COLLABORATE ON PROGRAMS TO ADDRESS THESE NEEDS, WITH SPECIAL FOCUS ON UNDERSERVED POPULATIONS THROUGH OUTREACH, EDUCATION AND PROVISION OF SERVICES TO ADDRESS MUSCULOSKELETAL HEALTH. NEW ENGLAND BAPTIST HOSPITAL'S COMMUNITY BENEFITS MISSION IS FULFILLED BY:-INVOLVING NEBH 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 NEBH' 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 NEBH 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, NEBH PROVIDED COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFITS OPERATIONS AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS OF $900,076 AS REPORTED ON THIS SCHEDULE H, PART I, LINES 7E AND 7I. COMMUNITY BENEFITS LEADERSHIP/TEAMTHE NEBH 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 ORTHOPEDIC CLINICAL EXPERTISE, EDUCATION AND RESEARCH ALONG WITH AN UNDERLYING COMMITMENT TO HEALTH EQUITY ARE THE PRIMARY TENETS OF ITS MISSION. NEBH'S COMMUNITY BENEFITS DEPARTMENT, UNDER THE DIRECT OVERSIGHT OF NEBH'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 NEBH'S IMPLEMENTATION STRATEGY, ENSURING THAT HOSPITAL POLICIES AND RESOURCES ARE ALLOCATED TO SUPPORT PLANNED ACTIVITIES. NEBH'S COMMUNITY BENEFITS PROGRAM IS SPEARHEADED BY THE DIRECTOR OF COMMUNITY AND GOVERNMENT AFFAIRS. THE DIRECTOR OF COMMUNITY AND GOVERNMENT AFFAIRS HAS DIRECT ACCESS AND IS ACCOUNTABLE TO NEBH'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 NEBH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) WORKS IN COLLABORATION WITH NEBH'S HOSPITAL LEADERSHIP, INCLUDING THE HOSPITAL'S GOVERNING BOARD AND SENIOR MANAGEMENT TO SUPPORT NEBH'S COMMUNITY BENEFITS MISSION TO TRANSFORM THE LIVES OF THOSE WE SERVE BY PROMOTING WELLNESS, RESTORING FUNCTION, LESSENING DISABILITY, ALLEVIATING PAIN, AND ADVANCING KNOWLEDGE IN MUSCULOSKELETAL DISEASES AND RELATED DISORDERS. THE CBAC PROVIDES INPUT INTO THE DEVELOPMENT AND IMPLEMENTATION OF NEBH'S COMMUNITY BENEFITS PROGRAMS IN FURTHERANCE OF NEBH'S COMMUNITY BENEFITS MISSION. THE MEMBERSHIP OF NEBH'S CBAC ASPIRES TO BE REPRESENTATIVE OF THE CONSTITUENCIES AND PRIORITY COHORTS SERVED BY NEBH'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. NEBH CBAC MEMBERS INCLUDE:- ELAINE ADAMS, REGISTERED NURSE, NEBH AND MISSION HILL RESIDENT- LAURA ADAMS, DIRECTOR OF SENIOR SERVICES, ROXBURY TENANTS OF HARVARD AND MISSION HILL RESIDENT- MELISSA CARLSON, DEPUTY COMMISSIONER OF PROGRAMS AND PARTNERSHIPS, BOSTON AGE STRONG COMMISSION- SOPHIE DEUNG, SENIOR PROGRAMS LEADER, ROXBURY TENANTS OF HARVARD AND MISSION HILL RESIDENT- KAREN GATELY, EXECUTIVE DIRECTOR, ROXBURY TENANTS OF HARVARD- JOHN JACKSON, ADMINISTRATIVE COORDINATOR, BOSTON CENTER FOR YOUTH AND FAMILIES TOBIN COMMUNITY CENTER; BOARD MEMBER, NEBH BOARD OF TRUSTEES- TONI KOMST, BOARD MEMBER, MISSION HILL MAIN STREETS AND MISSION HILL RESIDENT- PAIGE LEGASSIE MAIN, VICE PRESIDENT OF HUMAN RESOURCES, NEBH- BRIAN MILLER, SPECIAL EDUCATION TEACHER, BOSTON PUBLIC SCHOOLS- DAVID PASSAFARO, PRESIDENT, NEBH- PATRICIA PETERS, REGISTERED NURSE, NEBH- LYNN STEWART, MANAGER OF AMENITIES AND STUDENT SERVICES, NEBH- ELLEN WALKER, EXECUTIVE DIRECTOR, MISSION MAIN STREETS- DAVID WELCH, BOARD MEMBER, MISSION HILL NEIGHBORHOOD HOUSING SERVICES AND MISSION HILL RESIDENTCOMMUNITY 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. NEBH COMPLETED ITS MOST RECENT NEEDS ASSESSMENT IN SEPTEMBER 2022. THAT CHNA WAS APPROVED BY THE NEBH 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).

2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY FINDINGS
THE KEY PRIORITY COHORTS IDENTIFIED THROUGH THE CHNA CONDUCTED DURING THE PERIOD ENDED SEPTEMBER 30, 2022, WERE:- YOUTH- OLDER ADULTS- INDIVIDUALS WITH DISABILITIES- RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS- LOW-RESOURCED POPULATIONSNEBH'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.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 NEBH'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, NEBH 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 NEBH IN 2019 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. 2019 COMMUNITY HEALTH NEEDS ASSESSMENTTARGETED GEOGRAPHY AND POPULATIONNEBH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2019. THE GEOGRAPHICAL FOCUS OF NEBH'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES THE MISSION HILL/ROXBURY NEIGHBORHOODS OF BOSTON, AS WELL AS THE CITIES OF DEDHAM, CHESTNUT HILL (NEWTON) AND BROOKLINE. THESE COMMUNITIES DEFINE NEBH'S COMMUNITY BENEFITS SERVICE AREA (CBSA). IN RECOGNITION OF THE CONSIDERABLE HEALTH DISPARITIES THAT EXIST IN SOME COMMUNITIES, NEBH FOCUSES THE BULK OF ITS COMMUNITY BENEFITS RESOURCES ON IMPROVING THE HEALTH STATUS OF LOW-INCOME AND UNDERSERVED POPULATIONS LIVING IN THE BOSTON NEIGHBORHOODS OF ROXBURY/MISSION HILL. WHILE THERE ARE CERTAINLY SEGMENTS OF THE POPULATIONS IN THE CITIES OF DEDHAM, CHESTNUT HILL (NEWTON), AND DEDHAM THAT ARE VULNERABLE AND UNDERSERVED, THE GREATEST DISPARITIES EXIST IN BOSTON. IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS RESOURCES, NEBH'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) VOTED TO PRIORITIZE AND FOCUS NEBH'S ATTENTION ON THE MORE URBAN, HIGH-NEED COMMUNITIES IN NEBH'S CBSA. TARGET POPULATIONS FOR NEBH'S COMMUNITY BENEFITS INITIATIVES ARE 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). NEBH'S TARGET POPULATIONS FOCUS ON MEDICALLY-UNDERSERVED AND VULNERABLE GROUPS AS FOLLOWS: - CHILDREN AND FAMILIES - LOW-AND MODERATE-INCOME POPULATIONS - OLDER ADULTS - RACIALLY AND ETHNICALLY DIVERSE POPULATIONS/NON-ENGLISH SPEAKERS 2019 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSTHE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. RATHER THAN CONDUCTING A SINGLE ASSESSMENT, NEBH'S COMMUNITY BENEFITS STAFF CONDUCTED THEIR OWN ASSESSMENT AND CO-LED AND/OR PARTICIPATED IN A SERIES OF ADDITIONAL, CONCURRENT AND COMPREHENSIVE ASSESSMENTS THAT WERE THEN AGGREGATED TO CREATE THE 2019 CHNA REPORT. THESE CONCURRENT ASSESSMENTS WERE CONDUCTED IN PARTNERSHIP WITH THE BOSTON COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY HEALTH IMPROVEMENT PLAN (CHNA-CHIP) COLLABORATIVE. THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM 4,219 SURVEYS, 74 KEY INFORMANT INTERVIEWS, 35 FOCUS GROUPS AND 5 COMMUNITY MEETINGS. COMMUNITY DIALOGUES AND KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH INDIVIDUALS FROM ACROSS THE BOSTON AND NEIGHBORING CITIES THAT COMPRISE THE GREATER BOSTON REGION 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 APPROXIMATELY 1,085 PEOPLE. NEBH HIRED JOHN SNOW, INC. (JSI), TO CONDUCT AND MANAGE THE CHNA PROCESS UNDERTAKEN DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND JSI WORKED CLOSELY WITH NEBH'S COMMUNITY BENEFITS STAFF THROUGHOUT THE PROCESS. NEBH CONDUCTS ITS CHNAS IN THREE PHASES, WHICH ALLOWS NEBH TO: - COMPILE AN EXTENSIVE AMOUNT OF QUANTITATIVE AND QUALITATIVE DATA; - ENGAGE AND INVOLVE KEY STAKEHOLDERS, NEBH 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.

2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS DETAIL OF APPROACH AND METHOD
THE ASSESSMENT PROCESS INCLUDED SYNTHESIZING EXISTING REGIONAL DATA ON SOCIAL, ECONOMIC AND HEALTH INDICATORS AS WELL AS INFORMATION FROM THE DISSEMINATION AND ANALYSIS OF A COMMUNITY HEALTH SURVEY TO CAPTURE RESIDENTS' PERCEPTIONS OF BARRIERS TO GOOD HEALTH, LEADING HEALTH ISSUES, VULNERABLE POPULATIONS, ACCESSIBILITY OF HEALTH SERVICES AND OPPORTUNITIES FOR THE HOSPITAL TO IMPROVE THE SERVICES THEY OFFER TO THE COMMUNITY. QUANTITATIVE DATA FROM A BROAD RANGE OF SOURCES WAS COLLECTED AND ANALYZED TO CHARACTERIZE COMMUNITIES IN NEBH'S CBSA, MEASURE HEALTH STATUS, AND INFORM A COMPREHENSIVE UNDERSTANDING OF THE HEALTH-RELATED ISSUES. SOURCES INCLUDED: - U.S. CENSUS BUREAU, AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES (2013-2017) - MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION: SCHOOL AND DISTRICT PROFILES (2017 AND 2018-2019) - FBI UNIFORM CRIME REPORTS (2017) - MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, REGISTRY OF VITAL RECORDS AND STATISTICS (2015) - 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 SCIENCES (2017) - MASSACHUSETTS CENTER FOR HEALTH INFORMATION ANALYSIS (CHIA) HOSPITAL PROFILES (FY 2013-2017) - MASSACHUSETTS HEALTHY AGING COLLABORATIVE, COMMUNITY PROFILES (2018) 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSKEY INFORMANT INTERVIEWS WITH INTERNAL AND EXTERNAL STAKEHOLDERS (SCHEDULE H, PART V, SECTION B, LINE 5) NEBH'S CHNA WAS INFORMED BY 74 KEY INFORMANT INTERVIEWS THAT ENGAGED INSTITUTIONAL, ORGANIZATIONAL 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. APPENDIX A IN THE NEBH CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED. INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN NEBH'S CBSA. INTERVIEWS WERE CONDUCTED IN PERSON AND 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. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5) NEBH PARTICIPATED IN 35 COMMUNITY FOCUS GROUPS IN THEIR SERVICE AREA TO GATHER CRITICAL COMMUNITY INPUT FROM COMMUNITY RESIDENTS AND STAKEHOLDERS. THESE FOCUS GROUPS WERE ORGANIZED IN COLLABORATION WITH THE BOSTON CHNA-CHIP COLLABORATIVE AND OTHER BILH HOSPITALS. NEBH HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF NEBH'S CBSA AND THE COMMUNITY AT LARGE, WERE SHARED THROUGHOUT THE CHNA AND IMPLEMENTATION STRATEGY 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 SENT OUT AS PART OF THE BOSTON CHNA-CHIP COLLABORATIVE'S CHNA WAS ADMINISTERED ONLINE AND VIA HARD COPY IN SEVEN LANGUAGES. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO LARGE NETWORKS, WAITING ROOMS, BOSTON PUBLIC LIBRARY NEIGHBORHOOD BRANCHES, COMMUNITY EVENTS AND LARGE APARTMENT BUILDINGS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. AS AN EXAMPLE OF NEBH'S EXTENSIVE AND SUCCESSFUL COMMUNITY OUTREACH, NEARLY HALF (45%) OF FOCUS GROUP PARTICIPANTS IDENTIFIED AS BLACK OR AFRICAN-AMERICAN AND 34% IDENTIFIED AS HISPANIC/LATINO. THE NEBH COMMUNITY BENEFITS ADVISORY COMMITTEE WAS ALSO INTEGRALLY INVOLVED IN PROVIDING INPUT ON COMMUNITY NEEDS AND PRIORITIZING THE LEADING HEALTH ISSUES. THE COMMUNITY BENEFITS COMMITTEE MET QUARTERLY DURING THE COURSE OF THE ASSESSMENT. THEY PROVIDED INPUT REGARDING THE CHNA OVERALL AND GUIDED THE PRIORITIZATION AND PLANNING PHASE. 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSREVIEWING RESULTS AND COMPILING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY DOCUMENTS 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. - IDENTIFY NEBH'S COMMUNITY BENEFITS PRIORITY POPULATIONS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES. - ANALYZE NEBH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2016 CHNA AND SUBSEQUENT IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY NEBH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2016 (TAX YEAR 2015). - 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, 2019 (TAX YEAR 2018). THE NEBH COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS DEVELOPED BY A TEAM COMPRISED OF HOSPITAL LEADERSHIP, PATIENT ADVOCACY, MEDICAL STAFF, PUBLIC RELATIONS AND COMMUNITY REPRESENTATION. THE GROUP REVIEWED PROGRESS TOWARD GOALS AND OBJECTIVES OF THE PRIOR THREE-YEAR PERIOD, AS WELL AS THE CURRENT DATA COLLECTED THROUGH THE CHNA, TO HELP ENVISION AND DEFINE PRIORITY AREAS FOR THE FUTURE. THE IMPLEMENTATION STRATEGY IDENTIFIED PRIORITY AREAS AND DEFINED GOALS, ALONG WITH OBJECTIVES FOR EACH GOAL AND DRAFTED STRATEGIES TO OPERATIONALIZE THESE OBJECTIVES.

2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS KEY FINDINGS
- SOCIAL DETERMINANTS OF HEALTH CONTINUE TO HAVE A TREMENDOUS IMPACT ON MANY SEGMENTS OF THE POPULATION. THE DOMINANT THEME FROM THE ASSESSMENT'S KEY INFORMANT INTERVIEWS AND COMMUNITY FORUMS WAS THE CONTINUED IMPACT THAT THE UNDERLYING SOCIAL DETERMINANTS OF HEALTH ARE HAVING ON THE CBSA'S LOW-INCOME, UNDERSERVED, DIVERSE POPULATION COHORTS. MORE SPECIFICALLY, DETERMINANTS SUCH AS POVERTY, EMPLOYMENT OPPORTUNITIES, VIOLENCE, TRANSPORTATION, RACIAL SEGREGATION, LITERACY, PROVIDER LINGUISTIC/CULTURAL COMPETENCY, SOCIAL SUPPORT, AND COMMUNITY COHESION LIMIT MANY PEOPLE'S ABILITY TO CARE FOR THEIR OWN AND/OR THEIR FAMILIES' HEALTH. - DISPARITIES IN HEALTH OUTCOMES EXIST IN NEBH'S CBSA BY RACE/ETHNICITY, FOREIGN BORN STATUS, INCOME AND LANGUAGE. THERE ARE MAJOR HEALTH DISPARITIES FOR RESIDENTS LIVING IN NEBH'S CBSA. THIS IS PARTICULARLY TRUE FOR RACIALLY/ETHNICALLY DIVERSE, FOREIGN BORN, LOW-INCOME, AND NON-ENGLISH SPEAKING RESIDENTS LIVING IN THE BOSTON NEIGHBORHOODS OF MISSION HILL AND ROXBURY. THE IMPACT OF RACISM, BARRIERS TO CARE, AND DISPARITIES IN HEALTH OUTCOMES THAT THESE POPULATIONS FACE ARE WIDELY DOCUMENTED IN THE LITERATURE AND CONFIRMED BY THE DATA CAPTURED BY THIS ASSESSMENT. - HIGH RATES OF CHRONIC AND ACUTE PHYSICAL HEALTH CONDITIONS. THE ASSESSMENT'S QUANTITATIVE DATA CLEARLY SHOWS THAT MANY COMMUNITIES IN NEBH'S CBSA HAVE HIGH RATES FOR MANY OF THE LEADING PHYSICAL HEALTH CONDITIONS (E.G., HEART DISEASE, HYPERTENSION, CANCER, AND ASTHMA). IN MANY COMMUNITIES, THESE RATES ARE STATISTICALLY HIGHER THAN COMMONWEALTH RATES, INDICATING A PARTICULARLY SIGNIFICANT PROBLEM. HOWEVER, EVEN FOR THOSE COMMUNITIES WHERE THE RATES ARE NOT STATISTICALLY HIGHER, THESE CONDITIONS ARE STILL THE LEADING CAUSES OF PREMATURE DEATH. - HIGH RATES OF THE LEADING HEALTH RISK FACTORS. ONE OF THE LEADING FINDINGS FROM THE ASSESSMENT IS THAT MANY COMMUNITIES AND/OR POPULATION SEGMENTS IN NEBH'S CBSA HAVE HIGH RATES OF CHRONIC PHYSICAL AND BEHAVIORAL HEALTH CONDITIONS. IN SOME PEOPLE, THESE CONDITIONS HAVE UNDERLYING GENETIC ROOTS THAT ARE HARD TO COUNTER. HOWEVER, FOR MOST PEOPLE THESE CONDITIONS ARE WIDELY CONSIDERED PREVENTABLE OR MANAGEABLE. ADDRESSING THE LEADING RISK FACTORS IS AT THE ROOT OF A SOUND CHRONIC DISEASE PREVENTION AND MANAGEMENT STRATEGY. - HIGH RATES OF SUBSTANCE USE AND MENTAL HEALTH ISSUES. THE IMPACT OF SOCIAL DETERMINANTS WAS THE LEAD FINDING, BUT A CLOSE SECOND WAS THE PROFOUND IMPACT OF BEHAVIORAL HEALTH ISSUES (I.E., SUBSTANCE USE AND MENTAL HEALTH) ON INDIVIDUALS, FAMILIES AND COMMUNITIES IN EVERY GEOGRAPHIC REGION AND EVERY POPULATION SEGMENT IN NEBH'S CBSA. DEPRESSION/ANXIETY, SUICIDE, ALCOHOL USE, OPIOID AND PRESCRIPTION DRUG USE, AND MARIJUANA USE ARE MAJOR HEALTH ISSUES AND ARE HAVING A SIGNIFICANT IMPACT ON THE POPULATION AS WELL AS A BURDEN ON THE SERVICE SYSTEM. THE FACT THAT PHYSICAL AND BEHAVIORAL HEALTH ARE SO INTERTWINED COMPOUNDS THE IMPACT OF THESE ISSUES. OF PARTICULAR CONCERN ARE THE INCREASING RATES OF OPIOID USE AND THE IMPACTS OF TRAUMA. - LIMITED ACCESS TO BEHAVIORAL HEALTH SERVICES, PARTICULARLY FOR LOW-INCOME, MEDICAID COVERED, UNINSURED, FOREIGN BORN, NON-ENGLISH SPEAKERS, AND THOSE WITH COMPLEX/MULTI-FACETED ISSUES. DESPITE THE BURDEN OF MENTAL HEALTH AND SUBSTANCE USE ON ALL SEGMENTS OF THE POPULATION, THERE IS AN EXTREMELY LIMITED SERVICE SYSTEM AVAILABLE TO MEET THE NEEDS THAT EXIST FOR THOSE WITH MILD TO MODERATE EPISODIC ISSUES OR THOSE WITH MORE SERIOUS AND COMPLEX, CHRONIC CONDITIONS. EFFORTS NEED TO BE MADE TO EXPAND ACCESS, REDUCE BARRIERS TO CARE (INCLUDING STIGMA), AND IMPROVE THE QUALITY OF PRIMARY CARE AND SPECIALIZED BEHAVIORAL HEALTH SERVICES. THE CHNA THAT WAS COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, AND THE ASSOCIATED IMPLEMENTATION STRATEGY ADOPTED FROM THIS PROCESS WERE DESIGNED TO INFORM NEBH'S COMMUNITY BENEFITS INITIATIVES DURING THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022 INTERIM CHANGES AND UPDATES TO 2019 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 FISCAL PERIOD, OCTOBER 1, 2019 TO SEPTEMBER 30, 2022, THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY NEBH, 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 NEBH WERE IMPACTED BY THIS UNFORESEEN HEALTH CRISIS AND IN THE ABSENCE OF REGULATORY GUIDANCE TO THE CONTRARY, NEBH NEEDED TO QUICKLY REASSESS AND PIVOT TO MEET THE NEW AND PREVIOUSLY UNEXPECTED COMMUNITY NEEDS. AS SUCH, IN RESPONSE TO THE COVID-19 CRISIS NEBH'S COMMUNITY BENEFITS STAFF ALONG WITH THE HOSPITAL'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND IN RESPONSE TO COVID-19, 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.THE ADDITIONAL AND NEWLY URGENT HEALTH NEEDS IN RESPONSE TO COVID-19 WERE:EMERGENCY FOOD PANTRIESTHE ACTIONS TAKEN TOWARD ADDRESSING THESE NEEDS ARE INCLUDED FURTHER IN THIS NARRATIVE SUPPORT ALONG WITH NEBH'S DETAILED DESCRIPTION OF ACTIVITIES UNDERTAKEN TO MEET THE COMMUNITY NEEDS. COMMUNITY HEALTH NEEDS ASSESSMENTMAKING THE CHNA AND IMPLEMENTATION STRATEGY WIDELY AVAILABLENEBH STRIVES TO ADDRESS THE PRIORITY AREAS IN ITS CHNA AND IMPLEMENTATION STRATEGY.AS NOTED ABOVE, NEBH 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 NEBH WEBSITE AT: COMMUNITY BENEFITS NEW ENGLAND BAPTIST HOSPITAL (NEBH.ORG)IN ADDITION TO THE CHNA, NEBH COMPLETED ITS MOST RECENT IMPLEMENTATION STRATEGY DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2022 (TAX YEAR 2021). THE IMPLEMENTATION STRATEGY IS AVAILABLE ON THE NEBH WEBSITE AT: COMMUNITY BENEFITS NEW ENGLAND BAPTIST HOSPITAL (NEBH.ORG)IN ADDITION, AS NOTED ABOVE, NEBH COMPLETED ITS PREVIOUS CHNA DURING ITS FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018). THAT CHNA IS AVAILABLE ON THE NEBH WEBSITE AT: COMMUNITY BENEFITS NEW ENGLAND BAPTIST HOSPITAL (NEBH.ORG).FINALLY, THE IMPLEMENTATION STRATEGY ASSOCIATED WITH THE CHNA COMPLETED DURING NEBH'S FISCAL YEAR ENDED SEPTEMBER 30, 2019 (TAX YEAR 2018) IS AVAILABLE ON THE NEBH WEBSITE AT: COMMUNITY BENEFITS NEW ENGLAND BAPTIST HOSPITAL (NEBH.ORG) EACH OF THESE DOCUMENTS IS ALSO AVAILABLE ON REQUEST (SCHEDULE H, PART V, SECTION B, LINE 7A).

COMMUNITY HEALTH NEEDS ASSESSMENT ADDRESSING COMMUNITY HEALTH NEEDS
AS NOTED ABOVE, NEBH'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 NEBH FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2022 WHICH ARE REPORTED HERE. A SUMMARY OF NEBH'S COMMUNITY BENEFITS ACTIVITIES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 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, NEBH 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: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE - GOAL 1: ENHANCE ACCESS TO CARE AND REDUCE THE IMPACT OF SOCIAL DETERMINANTS - GOAL 2: REDUCE ELDER FALLS AND PROMOTE AGING IN PLACE - GOAL 3: INCREASE ACCESS TO HEALTHY FOODS AND OTHER BASIC HOUSEHOLD NEEDS - GOAL 4: PROMOTE VIOLENCE PREVENTION AND ADDRESS TRAUMA (SAFE NEIGHBORHOODS/COMMUNITY COHESION) - GOAL 5: INCREASE JOB OPPORTUNITIES FOR YOUTH AND ADULTS GOAL 6: DECREASE TRANSPORTATION BARRIERS PRIORITY AREA 2: CHRONIC/COMPLEX CONDITIONS AND THEIR RISK FACTORS - GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, REFERRAL, AND CHRONIC DISEASE MANAGEMENT SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS - GOAL 2: REDUCE THE PREVALENCE OF TOBACCO USE - GOAL 3: INCREASE PHYSICAL ACTIVITY AND HEALTHY EATING COMMUNITY HEALTH NEEDS ASSESSMENTAPPROACH TO ADDRESSING HEALTH NEEDS (SCHEDULE H, PART V, SECTION B, LINE 11)COMMUNITY BENEFITS PROGRAMS AND INITIATIVES NEBH OPERATES AND SUPPORTS TO IMPROVE HEALTH OUTCOMES OF THEIR TARGET POPULATIONS THROUGHOUT THEIR PRIORITY NEIGHBORHOODS. NEBH HAS BEEN A LEADER IN CREATING AND SUPPORTING A MYRIAD OF COMMUNITY BENEFITS PROGRAMS THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. PROGRAMS INCLUDE THE NEBH SENIOR CELTICS PROGRAM, HIGH SCHOOL PARTNERSHIPS THAT LEAD TO CAREERS, PARTNERSHIPS WITH LOCAL AFFORDABLE HOUSING ORGANIZATIONS, PROGRAMS ADDRESSING FOOD INSECURITY AND PROGRAMS RELATING TO TRANSPORTATION ACCESS. AS NOTED ABOVE, NEBH'S MOST RECENT CHNA AND IMPLEMENTATION STRATEGY WERE CONDUCTED AND APPROVED BY THE BOARD OF TRUSTEES DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019. THAT CHNA AND IMPLEMENTATION STRATEGY WILL INFORM THE COMMUNITY BENEFITS MISSION AND ACTIVITIES OF NEBH FOR THE FISCAL YEARS ENDED SEPTEMBER 30, 2020; SEPTEMBER 30, 2021; AND SEPTEMBER 30, 2022. THIS FORM 990 COVERS NEBH'S FISCAL YEAR ENDED SEPTEMBER 30, 2021. NEBH'S IMPLEMENTATION STRATEGY FOR ITS COMMUNITY BENEFITS ACTIVITIES IS PROVIDED HERE ALONG WITH THE ENTITIES THAT THE HOSPITAL PARTNERS WITH ON THESE EFFORTS. A FULL UPDATE ON NEBH'S HEALTH PRIORITIES AND ASSOCIATED GOALS IS INCLUDED BELOW. FY20 SCHEDULE HIMPLEMENTATION STRATEGY UPDATEPRIORITY AREA 1: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE DURING NEBH'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), DATA SHOWED CLEAR GEOGRAPHIC AND DEMOGRAPHIC DISPARITIES RELATED TO THE LEADING SOCIAL DETERMINANTS OF HEALTH (E.G., ECONOMIC STABILITY, HOUSING TRANSPORTATION, VIOLENCE, FOOD ACCESS, EDUCATION, AND COMMUNITY COHESION). THESE ISSUES INFLUENCE AND DEFINE QUALITY OF LIFE FOR MANY SEGMENTS OF THE POPULATION IN NEBH'S SERVICE AREA. TO IMPROVE NEBH'S COMMUNITY BENEFITS SERVICE AREA'S POPULATION HEALTH, EFFORTS MADE FOCUSED ON REDUCING THE IMPACT OF SOCIAL DETERMINANTS BY COMMITTING DIRECT COMMUNITY HEALTH PROGRAM INVESTMENTS, AND IN-KIND RESOURCES OF STAFF TIME AND MATERIALS. GOAL 1: ENHANCE ACCESS TO CARE AND REDUCE THE IMPACT OF SOCIAL DETERMINANTS TARGET POPULATION: YOUTH, OLDER ADULTS, LOW TO MODERATE INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS PROGRAMMATIC OBJECTIVES: 1. INCREASE PARTNERSHIPS AND COLLABORATION WITH SOCIAL SERVICE AND OTHER COMMUNITY-BASED ORGANIZATIONS 2. INCREASE EDUCATIONAL OPPORTUNITIES RELATED TO THE IMPORTANCE AND IMPACT OF SOCIAL DETERMINANTS 3. DECREASE THE NUMBER OF PEOPLE WHO STRUGGLE WITH FINANCIAL INSECURITY 4. INCREASE ACCESS TO LOW COST HEALTHY FOODS WITH AN EMPHASIS ON PRIORITY POPULATIONS SEGMENTS 5. INCREASE ACCESS TO AFFORDABLE, SAFE TRANSPORTATION OPTIONS WITH AN EMPHASIS ON PRIORITY POPULATION SEGMENTS 6. INCREASE TRAINING AND EMPLOYMENT OPPORTUNITIES FOR LOW TO MODERATE INCOME RESIDENTS WITH AN EMPHASIS ON PRIORITY POPULATION SEGMENTS 7. INCREASE ACCESS TO SOCIAL EXPERIENCES FOR THOSE WHO ARE ISOLATED AND LACK FAMILY/CAREGIVER AND OTHER SUPPORTS 8. EDUCATE INDIVIDUALS AND FAMILIES ABOUT HEALTHY EATING, MEAL PLANNING, HOUSEHOLD BUDGETING, ETC. 9. DECREASE THE NUMBER OF INDIVIDUALS AND FAMILIES WHO SUFFER FROM FOOD INSECURITY AND/OR LACK BASIC HOUSEHOLD ITEMS COMMUNITY ACTIVITIES/STRATEGIES: - COMMUNITY BENEFITS AND OTHER HOSPITAL STAFF (E.G., NURSING) PARTICIPATE IN COALITIONS AND OTHER COMMUNITY MEETINGS TO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE COMMUNITY HEALTH IMPROVEMENT ACTIVITIES - MAINTAIN MCLAUGHLIN FIELD TO ENGAGE YOUTH AND PROMOTE PHYSICAL ACTIVITY - MAKE COMMUNITY IMPROVEMENTS TO WALKWAYS AND OTHER PUBLIC AREAS TO ADDRESS TRANSPORTATION ISSUES AND PROMOTE PHYSICAL ACTIVITY - PROVIDE TRASH TRUCK AND CLEAN PUBLIC AREAS AFTER MOVE-IN DAY TO PROMOTE COMMUNITY ENGAGEMENT AND PHYSICAL ACTIVITY - SUPPORT FOOD ACCESS AND NUTRITION PROGRAMMING TO LOW AND MODERATE INCOME POPULATIONS LIVING IN PUBLIC HOUSING, COUNCILS ON AGING, AND OTHER COMMUNITY VENUES - PROVIDE ESSENTIAL HOUSEHOLD ITEMS TO SUPPORT THOSE LIVING IN POVERTY OR LOW INCOME HOUSEHOLDS - PROVIDE TRANSPORTATION SUPPORT TO COMMUNITY RESIDENTS TO ENHANCE ACCESS TO AFFORDABLE, SAFE, ACCESSIBLE TRANSPORTATION OPTIONS - ORGANIZE AND SUPPORT WORKFORCE MENTORSHIP AND TRAINING PROGRAMS FOR YOUTH AND ADULTS TO JOB TRAINING, SKILLS DEVELOPMENT, AND CAREER ADVANCEMENT WITH AN EMPHASIS ON PRIORITY POPULATIONS - CONTINUE TO SUPPORT THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP PROGRAM TO SUPPORT SKILLS DEVELOPMENT AND CAREER ADVANCEMENT - PROVIDE LINGUISTICALLY AND CULTURALLY APPROPRIATE HEALTH EDUCATION AND CARE MANAGEMENT SUPPORT THOUGH TARGETED COMMUNITY EVENTS FOR THOSE WITH OR IDENTIFIED AS AT-RISK OF CHRONIC/ COMPLEX CONDITIONS WITH AN EMPHASIS ON PRIORITY POPULATIONS - SUPPORT ACTIVITIES SPONSORED BY MISSION HILL SENIOR LEGACY PROJECT - SUPPORT COMMUNITY FOOD PANTRIES FY22 METRICS AND STATUS UPDATES: - DUE TO COVID-19, MANY PROGRAMS FOR OLDER ADULTS WERE SUSPENDED IN FY20 AND FY21.- MCLAUGHLIN FIELD WAS MAINTAINED DURING SPRING, SUMMER AND FALL FOR FY20, FY21 AND FY22 (OVER 30 WEEKS), AND WAS MAINTAINED DURING THE WINTER AS NEEDED. - IN FY20, FY21 AND FY22, NEBH STAFF CLEANED THE MISSION HILL STREETS DURING THE SPRING, SUMMER AND FALL AND HELPED WITH SNOW REMOVAL DURING THE WINTER. - IN FY20, (6,748), FY21, (7,400) AND FY22, (7,000) MISSION HILL RESIDENTS USED THE MISSION LINK BUS FOR TRANSPORTATION. - IN FY22, NEBH DISTRIBUTED $181,272 IN CASH TO ORGANIZATIONS IN MISSION HILL. - CLOTHING, SHOES, HOUSEHOLD ESSENTIALS, ETC. WERE DISTRIBUTED TO FAMILIES/INDIVIDUALS EACH YEAR. FY20 (200), FY21 (224), FY22 (300).- IN FY20, FY21 AND FY22, NEBH PROVIDED FOOD, MEALS AND GIFT CARDS TO GROCERY STORES TO INDIVIDUALS AND FAMILIES LIVING IN MISSION HILL. FY20 (300), FY21 (500), FY22 (550) - IN FY20, FY21 AND FY22, NEBH PROVIDED FINANCIAL SUPPORT TO THE ABCD-PARKER HILL FENWAY COMMUNITY SERVICE CENTER'S FOOD PANTRY. THE FOOD PANTRY PROVIDES EMERGENCY FOOD FOR LOW INCOME FAMILIES IN THE COMMUNITY. THE PANTRY SUPPLIES FOOD TO OVER 3,000 FAMILIES EACH YEAR. - NEBH PROVIDED ELEMENTARY AND HIGH SCHOOL CHILDREN LIVING IN LOW-INCOME HOUSING IN MISSION HILL THE SUPPLIES THEY NEED TO LEARN, SO THAT THEY CAN RETURN TO THE CLASSROOM PREPARED AND ON TRACK FOR SUCCESS. FY20 (129), FY21 (150), FY22 (200) - TWO WORKFORCE DEVELOPMENT PROGRAMS, PROJECT SEARCH AND THE MEREDITH CAMERON YOUTH OPPORTUNITY INTERNSHIP WERE NOT HELD IN FY20 AND FY21 DUE TO COVID-19 BUT WERE RE-ESTABLISHED IN FY22. SEVEN PROJECT SEARCH STUDENTS AND SEVEN MEREDITH CAMERON STUDENTS WERE MENTORED AND GAINFULLY EMPLOYED.- IN FY22, NEBH HAS COLLABORATED WITH STOP & SHOP TO SUPPORT A FOOD PANTRY AT THE MAURICE J. TOBIN ELEMENTARY SCHOOL.

NEW ENGLAND BAPTIST HOSPITAL BIBLIOGRAPHY 2022
MANY PHYSICIANS AT NEBH AUTHOR OR CO-AUTHOR ARTICLES AS THE RESEARCH IN WHICH THEY ENGAGE. A LIST OF ARTICLES PUBLISHED DURING THE PERIOD COVERED BY THIS FILING AND RELATED TO RESEARCH EFFORTS ARE LISTED BELOW.1. AGAINST SURGEONS' ADVICE: THE RETURN TO SPORT IN HIGH DEMAND WEIGHTLIFTERS FOLLOWING ANATOMIC TOTAL SHOULDER ARTHROPLASTY AT AVERAGE 3.6 YEARS FOLLOW-UP. AMES A, SHAH SS, PETTIT R, LI L, CHILTON M, GAYLORD B, ALNUSIF N, CHRISTENSEN A, IVES K, ROSS G. JOURNAL OF SHOULDER AND ELBOW SURGERY. EPUB 2022 OCT 29.2. GLUTEUS MAXIMUS TENDON REFERENCE: A NOVEL METHOD TO RESTORE LEG LENGTH IN TOTAL HIP ARTHROPLASTY WITH FEMORAL BONE LOSS.AMES AR, MEYERS AL, BALLARD ET, SORSCHER MJ.J AM ACAD ORTHOP SURG GLOB RES REV. 2022 DEC 12;6(12):E22.00149. DOI: 10.5435/JAAOSGLOBAL-D-22-00149. PMID: 36508326 3. INAPPROPRIATE PRESCRIBING OF OPIOIDS FOR PATIENTS UNDERGOING SURGERY.VARADY NH, WORSHAM CM, CHEN AF, SMITH EL, WOO J, JENA AB.PROC NATL ACAD SCI U S A. 2022 DEC 6;119(49):E2210226119. DOI: 10.1073/PNAS.2210226119. PMID: XXX-XX-XXXX. IMPACT OF THE COVID-19 PANDEMIC ON SHOULDER ARTHROPLASTY: SURGICAL TRENDS AND POSTOPERATIVE CARE PATHWAY ANALYSIS.AVANT-GARDE HEALTH AND CODMAN SHOULDER SOCIETY VALUE BASED CARE GROUP; KHAN AZ, BEST MJ, FEDORKA CJ, BELNIAK RM, HAAS DA, ZHANG X, ARMSTRONG AD, JAWA A, O'DONNELL EA, SIMON JE, WAGNER ER, MALIK M, GOTTSCHALK MB, UPDEGROVE GF, MAKHNI EC, WARNER JJP, SRIKUMARAN U, ABBOUD JA.J SHOULDER ELBOW SURG. 2022 DEC;31(12):2457-2464. DOI: 10.1016/J.JSE.2022.07.020. PMID: 36075547 5. ONLINE CROWDSOURCING SURVEY OF UNITED STATES POPULATION PREFERENCES AND PERCEPTIONS REGARDING OUTPATIENT HIP AND KNEE ARTHROPLASTY.PAGANI NR, PUZZITIELLO RN, STAMBOUGH JB, SAXENA A.J ARTHROPLASTY. 2022 DEC;37(12):2323-2332. DOI: 10.1016/J.ARTH.2022.06.011. PMID: XXX-XX-XXXX. PATIENTS WITH LIMITED HEALTH LITERACY HAVE WORSE PREOPERATIVE FUNCTION AND PAIN CONTROL AND EXPERIENCE PROLONGED HOSPITALIZATIONS FOLLOWING SHOULDER ARTHROPLASTY.PUZZITIELLO RN, COLLITON EM, SWANSON DP, MENENDEZ ME, MOVERMAN MA, HART PA, ALLEN AE, KIRSCH JM, JAWA A.J SHOULDER ELBOW SURG. 2022 DEC;31(12):2473-2480. DOI: 10.1016/J.JSE.2022.05.001. PMID: XXX-XX-XXXX. NEIGHBORHOOD SOCIOECONOMIC DISADVANTAGE DOES NOT PREDICT OUTCOMES OR COST AFTER ELECTIVE SHOULDER ARTHROPLASTY.MOVERMAN MA, SUDAH SY, PUZZITIELLO RN, PAGANI NR, HART PA, SWANSON D, KIRSCH JM, JAWA A, MENENDEZ ME.J SHOULDER ELBOW SURG. 2022 DEC;31(12):2465-2472. DOI: 10.1016/J.JSE.2022.04.023. PMID: XXX-XX-XXXX. THE IMPACT OF THE COVID-19 PANDEMIC ON RACIAL DISPARITIES IN PATIENTS UNDERGOING TOTAL SHOULDER ARTHROPLASTY IN THE UNITED STATES.AVANT-GARDE HEALTH AND CODMAN SHOULDER SOCIETY VALUE BASED CARE GROUP; BEST MJ, FEDORKA CJ, BELNIAK RM, HAAS DA, ZHANG X, ARMSTRONG AD, ABBOUD JA, JAWA A, O'DONNELL EA, SIMON JE, WAGNER ER, MALIK M, GOTTSCHALK MB, KHAN AZ, UPDEGROVE GF, MAKHNI EC, WARNER JJ, SRIKUMARAN U.JSES INT. 2022 NOV 12. DOI: 10.1016/J.JSEINT.2022.10.014. ONLINE AHEAD OF PRINT. PMID: 36405932 9. RELATIONSHIP OF SUBTALAR JOINT RANGE OF MOTION TO ANKLE INJURIES IN NBA G LEAGUE AND COLLEGIATE BASKETBALL PLAYERS.SHAH SS, AMES A, SAINI SS, LEE S, LI L, BROTHERS C, AUSTIN T, BONACUM T, METCALFE M, WEITZEL P, MCKEON B, GILLESPIE H.FOOT ANKLE INT. 2022 NOV 3:10711007221126731. DOI: 10.1177/10711007221126731. ONLINE AHEAD OF PRINT. PMID: 3632962510. CLINICAL FACEOFF: ANATOMIC VERSUS REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF GLENOHUMERAL OSTEOARTHRITIS.MENENDEZ ME, GARRIGUES GE, JAWA A.CLIN ORTHOP RELAT RES. 2022 NOV 1;480(11):2095-2100. DOI: 10.1097/CORR.0000000000002408 PMID: 3611189011. THE EFFECT OF TRANEXAMIC ACID FOR VISUALIZATION ON PUMP PRESSURE AND VISUALIZATION DURING ARTHROSCOPIC ROTATOR CUFF REPAIR: AN ANONYMIZED, RANDOMIZED CONTROLLED TRIAL.NICHOLSON TA, KIRSCH JM, CHURCHILL R, LAZARUS MD, ABBOUD JA, NAMDARI S.J SHOULDER ELBOW SURG. 2022 NOV;31(11):2211-2216. DOI: 10.1016/J.JSE.2022.06.027. PMID: 35970278 12. REDUCED NARCOTIC UTILIZATION IN TOTAL JOINT ARTHROPLASTY PATIENTS IN AN URBAN TERTIARY CARE CENTER.LENTINE B, BEESLEY H, DICKEN Q, NIU R, FRECCERO DM, SMITH EL.ARTHROPLAST TODAY. 2022 OCT 26;18:125-129. DOI: 10.1016/J.ARTD.2022.09.008. PMID: 36325518 13. INTRAOSSEOUS REGIONAL ADMINISTRATION OF ANTIBIOTIC PROPHYLAXIS FOR TOTAL KNEE ARTHROPLASTY: A SYSTEMATIC REVIEW.MILTENBERG B, LUDWICK L, MASOOD R, MENENDEZ ME, MOVERMAN MA, PAGANI NR, PUZZITIELLO RN, SMITH EL.J ARTHROPLASTY. 2022 OCT 22:S0883-5403(22)00960-3. DOI: 10.1016/J.ARTH.2022.10.023. ONLINE AHEAD OF PRINT. PMID: 3628015814. SIMPLE SOFT TISSUE BICEPS TENODESIS.STAPLETON EJ, GHOBRIAL I, CURTIS AS.ARTHROSC TECH. 2022 OCT 20;11(11):E1951-E1956. DOI: 10.1016/J.EATS.2022.07.011. PMID: 36457383 15. STRONG PUBLIC DESIRE FOR QUALITY AND PRICE TRANSPARENCY IN SHOULDER ARTHROPLASTY.MENENDEZ ME, PAGANI NR, PUZZITIELLO RN, MOVERMAN MA, SUDAH SY, NAMDARI S, JAWA A.CUREUS. 2022 OCT 17;14(10):E30396. DOI: 10.7759/CUREUS.30396. ECOLLECTION 2022 OCT. PMID: 3640727216. SOCIAL DETERMINANTS OF HEALTH INFLUENCE CLINICAL OUTCOMES OF PATIENTS UNDERGOING ROTATOR CUFF REPAIR: A SYSTEMATIC REVIEW.MANDALIA K, AMES A, PARZICK JC, IVES K, ROSS G, SHAH S.J SHOULDER ELBOW SURG. 2022 OCT 14:S1058-2746(22)00756-X. DOI: 10.1016/J.JSE.2022.09.007. ONLINE AHEAD OF PRINT. PMID: 36252786 17. CRITICAL CRITERIA RECOMMENDATIONS: RETURN TO SPORT AFTER ACL RECONSTRUCTION REQUIRES EVALUATION OF TIME AFTER SURGERY OF 8 MONTHS, >2 FUNCTIONAL TESTS, PSYCHOLOGICAL READINESS, AND QUADRICEPS/HAMSTRING STRENGTH.TURK R, SHAH S, CHILTON M, THOMAS TL, ANENE C, MOUSAD A, LE BRETON S, LI L, PETTIT R, IVES K, RAMAPPA A.ARTHROSCOPY. 2022 OCT 7:S0749-8063(22)00611-9. DOI: 10.1016/J.ARTHRO.2022.08.038. ONLINE AHEAD OF PRINT. PMID: 36216133 18. COSTS OF NONOPERATIVE PROCEDURES FOR KNEE OSTEOARTHRITIS IN THE YEAR PRIOR TO PRIMARY TOTAL KNEE ARTHROPLASTY.NIN DZ, CHEN YW, TALMO CT, HOLLENBECK BL, MATTINGLY DA, NIU R, CHANG DC, SMITH EL.J BONE JOINT SURG AM. 2022 OCT 5;104(19):1697-1702. DOI: 10.2106/JBJS.21.01415. PMID: 3612614019. DRIVERS OF UNEQUAL HEALTHCARE COSTS IN THE NONOPERATIVE TREATMENT OF LATE-STAGE KNEE OSTEOARTHRITIS PRIOR TO PRIMARY TOTAL KNEE ARTHROPLASTY.NIN DZ, CHEN YW, TALMO CT, HOLLENBECK BL, MATTINGLY DA, NIU R, CHANG DC, SMITH EL.J ARTHROPLASTY. 2022 OCT;37(10):1967-1972.E1. PMID: 3552541920. THE COST-EFFECTIVENESS OF EXTENDED ORAL ANTIBIOTIC PROPHYLAXIS FOR INFECTION PREVENTION AFTER TOTAL JOINT ARTHROPLASTY IN HIGH-RISK PATIENTS.LIPSON S, PAGANI NR, MOVERMAN MA, PUZZITIELLO RN, MENENDEZ ME, SMITH EL.J ARTHROPLASTY. 2022 OCT;37(10):1961-1966. PMID: 3547243621. BASEPLATE RETROVERSION DOES NOT AFFECT POSTOPERATIVE OUTCOMES AFTER REVERSE SHOULDER ARTHROPLASTY.ELMALLAH R, SWANSON D, LE K, KIRSCH J, JAWA A.J SHOULDER ELBOW SURG. 2022 OCT;31(10):2082-2088. PMID: 3542963122. EXAMINATION OF FACTORS AFFECTING THERAPEUTIC ATTITUDE AND EMPOWERMENT OF PERIANESTHESIA NURSES WHO CARE FOR PATIENTS WITH OPIOID USE DISORDER.BELL CAF, MCCURRY MK, TYO MB, VIVEIROS J.J PERIANESTH NURS. 2022 OCT;37(5):669-677. DOI: 10.1016/J.JOPAN.2021.11.014. EPUB 2022 APR 4.PMID: 3538775623. CHRONIC ISCHIAL AVULSION FRACTURE EXCISION WITH PRIMARY PROXIMAL HAMSTRING REPAIR: A TECHNIQUE.STAPLETON EJ, WINN J, KIMBALL HL, MILLER SL.ARTHROSC TECH. 2022 SEP 17;11(10):E1801-E1809. DOI: 10.1016/J.EATS.2022.06.017. PMID: 3631132724. A NOVEL COMORBIDITY RISK SCORE FOR PREDICTING POSTOPERATIVE 30-DAY COMPLICATIONS IN TOTAL SHOULDER ARTHROPLASTY AND ELUCIDATION OF POTENTIAL RACIAL DISPARITIES.TURK RD, LI LT, SAINI S, MACASKILL M, ROSS G, SHAH SS.JSES INT. 2022 SEP 15;6(6):867-873. DOI: 10.1016/J.JSEINT.2022.08.013. PMID: 36353420 25. AN ENHANCED UNDERSTANDING OF CULTURE-NEGATIVE PERIPROSTHETIC JOINT INFECTION WITH NEXT-GENERATION SEQUENCING: A MULTICENTER STUDY.GOSWAMI K, CLARKSON S, PHILLIPS CD, DENNIS DA, KLATT BA, O'MALLEY MJ, SMITH EL, GILILLAND JM, PELT CE, PETERS CL, MALKANI AL, PALUMBO BT, LYONS ST, BERNASEK TL, MINTER J, GOYAL N, MCDONALD JF 3RD, CROSS MB, PRIETO HA, LEE GC, HANSEN EN, BINI SA, WARD DT, SHOHAT N, HIGUERA CA, NAM D, DELLA VALLE CJ, PARVIZI J; ORTHOPEDIC GENOMICS WORKGROUP.J BONE JOINT SURG AM. 2022 SEP 7;104(17):1523-1529. PMID: 3572688226. THE ACCURACY OF IN-STATE PRESCRIPTION MONITORING PROGRAM DATABASE AND ELECTRONIC MEDICAL RECORDS COMPARED TO URINE TOXICOLOGY SCREENING IN TOTAL JOINT ARTHROPLASTY PREOPERATIVE EVALUATION.CURRY E, NIU R, BURAPACHAISRI A, MAURICIO P, MCALPINE K, SMITH EL.ORTHOP NURS. 2022 SEP-OCT 01;41(5):355-362. PMID: 3616661227. SINGLE-POSITION CIRCUMFERENTIAL LUMBAR SPINAL FUSION: AN OVERVIEW OF TERMINOLOGY, CONCEPTS, RATIONALE AND THE CURRENT EVIDENCE BASE.THOMAS JA, MENEZES C, BUCKLAND AJ, KHAJAVI K, ASHAYERI K, BRALY BA, KWON B, CHENG I, BERJANO P.EUR SPINE J. 2022 SEP;31(9):2167-2174. PMID: 35913621

NEW ENGLAND BAPTIST HOSPITAL BIBLIOGRAPHY 2022 (CONTINUED)
28. SPINAL EXPOSURE FOR ANTERIOR LUMBAR INTERBODY FUSION (ALIF) IN THE LATERAL DECUBITUS POSITION: ANATOMICAL AND TECHNICAL CONSIDERATIONS.BUCKLAND AJ, LEON C, ASHAYERI K, CHENG I, ALEX THOMAS J, BRALY B, KWON B, MAGLARAS C, EISEN L.EUR SPINE J. 2022 SEP;31(9):2188-2195. PMID: 35552530 29. LATERAL DECUBITUS SINGLE POSITION ANTERIOR-POSTERIOR (AP) FUSION SHOWS EQUIVALENT RESULTS TO MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION AT ONE-YEAR FOLLOW-UP.ASHAYERI K, ALEX THOMAS J, BRALY B, O'MALLEY N, LEON C, CHENG I, KWON B, MEDLEY M, EISEN L, PROTOPSALTIS TS, BUCKLAND AJ.EUR SPINE J. 2022 SEP;31(9):2227-2238. PMID: 3555148330. ANTERIOR COLUMN RECONSTRUCTION OF THE LUMBAR SPINE IN THE LATERAL DECUBITUS POSITION: ANATOMICAL AND PATIENT-RELATED CONSIDERATIONS FOR ALIF, ANTERIOR-TO-PSOAS, AND TRANSPSOAS LLIF APPROACHES.BUCKLAND AJ, ASHAYERI K, LEON C, CHENG I, THOMAS JA, BRALY B, KWON B, EISEN L.EUR SPINE J. 2022 SEP;31(9):2175-2187. PMID: 3523505131. THE ASSOCIATION BETWEEN ANTERIOR SHOULDER JOINT CAPSULE THICKENING AND GLENOID DEFORMITY IN PRIMARY GLENOHUMERAL OSTEOARTHRITIS.MENENDEZ ME, PUZZITIELLO RN, MOVERMAN MA, KIRSCH JM, LITTLE D, JAWA A, GARRIGUES GE.J SHOULDER ELBOW SURG. 2022 SEP;31(9):E413-E417. PMID: 3533185732. CANNABIDIOL AS A TREATMENT FOR ARTHRITIS AND JOINT PAIN: AN EXPLORATORY CROSS-SECTIONAL STUDY.FRANE N, STAPLETON E, ITURRIAGA C, GANZ M, RASQUINHA V, DUARTE R.J CANNABIS RES. 2022 AUG 24;4(1):47..PMID: 3599958133. PREVALENCE AND CLINICAL IMPACT OF INCIDENTAL FINDINGS ON PREOPERATIVE 3D PLANNING COMPUTED TOMOGRAPHY FOR TOTAL SHOULDER ARTHROPLASTY.CHEN Y, SHAH SS, ROCHE AM, LI LT, CHILTON M, SAKS B, MACASKILL M, ROSS G.J AM ACAD ORTHOP SURG GLOB RES REV. 2022 AUG 5;6(8):E21.00291. DOI: 10.5435/JAAOSGLOBAL-D-21-00291. ECOLLECTION 2022 AUG 1. PMID: 35944103 34. CONTINUOUS FEMORAL NERVE BLOCK REDUCES THE NEED FOR MANIPULATION FOLLOWING TOTAL KNEE ARTHROPLASTY.FRECCERO DM, VAN STEYN P, JOSLIN PMN, ROBBINS CE, LI X, EFREMOV K, SHUKLA P, TALMO CT, BONO JV.JBJS OPEN ACCESS. 2022 AUG 4;7(3):E21.00155. DOI: 10.2106/JBJS.OA.21.00155. ECOLLECTION 2022 JUL-SEP. PMID: 35935602 35. OUTCOMES AFTER ANATOMIC AND REVERSE SHOULDER ARTHROPLASTY FOR THE TREATMENT OF GLENOHUMERAL OSTEOARTHRITIS: A PROPENSITY SCORE-MATCHED ANALYSIS.KIRSCH JM, PUZZITIELLO RN, SWANSON D, LE K, HART PA, CHURCHILL R, ELHASSAN B, WARNER JJP, JAWA A.J BONE JOINT SURG AM. 2022 AUG 3;104(15):1362-1369. PMID: 3586770536. THE GERIATRIC NUTRITIONAL RISK INDEX IS AN INDEPENDENT PREDICTOR OF ADVERSE OUTCOMES FOR TOTAL JOINT ARTHROPLASTY PATIENTS.FANG CJ, SAADAT GH, BUTLER BA, BOKHARI F.J ARTHROPLASTY. 2022 AUG;37(8S):S836-S841. PMID: 3509103337. SUBSTANTIAL INCONSISTENCY AND VARIABILITY EXISTS AMONG MINIMUM CLINICALLY IMPORTANT DIFFERENCES FOR SHOULDER ARTHROPLASTY OUTCOMES: A SYSTEMATIC REVIEW.KOLIN DA, MOVERMAN MA, PAGANI NR, PUZZITIELLO RN, DUBIN J, MENENDEZ ME, JAWA A, KIRSCH JM.CLIN ORTHOP RELAT RES. 2022 JUL 1;480(7):1371-1383. PMID: 35302970 38. A VALIDATED ALGORITHM USING CURRENT LITERATURE TO JUDGE THE APPROPRIATENESS OF ANATOMIC TOTAL SHOULDER ARTHROPLASTY UTILIZING THE RAND/UCLA APPROPRIATENESS METHOD.LE BRETON S, SYLVIA S, SAINI S, MOUSAD A, CHILTON M, LEE S, LI L, MACASKILL M, ROSS G, GENTILE J, OTTO RJ, KAAR SG, PINNAMANENI S, JAWA A, KIRSCH J, ODE G, AIBINDER W, GREIWE RM, DEANGELIS J, KING JJ, SHAH SS.J SHOULDER ELBOW SURG. 2022 JUL;31(7):E332-E345. DOI: 10.1016/J.JSE.2021.12.025. PMID: 3506611839. LETTER TO THE EDITOR FOR STATE OF THE ART: PROXIMAL JUNCTIONAL KYPHOSIS; DIAGNOSIS, MANAGEMENT AND PREVENTION.SARDAR ZM, KIM Y, LAFAGE V, RAND F, LENKE L, KLINEBERG E; SRS ADULT SPINAL DEFORMITY COMMITTEE.SPINE DEFORM. 2022 JUL;10(4):971-972. PMID: 35438390 40. SINGLE-STAGE REVISION ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE STACKED SCREWS TECHNIQUE.ENGLER ID, SYLVIA SM, SALZLER MJ, FORLIZZI JM, GILL TJ 4TH.ARTHROSC TECH. 2022 JUN 21;11(7):E1341-E1345. PMID: 35936852 41. THE ASSOCIATION OF IMMEDIATE-USE STEAM STERILIZATION WITH THE INCIDENCE OF ORTHOPAEDIC SURGICAL SITE INFECTIONS: A PROPENSITY SCORE-MATCHED COHORT STUDY.TANTILLO TJ, STAPLETON EJ, FRANE N, GORLIN M, SCHILLING ME, ARMELLINO D, KATSIGIORGIS G, BITTERMAN AD.J BONE JOINT SURG AM. 2022 JUN 1;104(11):988-994. DOI: 10.2106/JBJS.21.01275. PMID: 3564806542. TOTAL JOINT ARTHROPLASTY IN HOMELESS PATIENTS AT AN URBAN SAFETY NET HOSPITAL.NIU R, EGAN C, FANG C, DURU N, ALLEY MC, FRECCERO DM, SMITH EL.J AM ACAD ORTHOP SURG. 2022 JUN 1;30(11):523-527. DOI: 10.5435/JAAOS-D-21-00651. PMID: 3529440843. EFFECT OF THE COVID-19 PANDEMIC ON RATES OF NINETY-DAY PERI-PROSTHETIC JOINT AND SURGICAL SITE INFECTIONS AFTER PRIMARY TOTAL JOINT ARTHROPLASTY: A MULTICENTER, RETROSPECTIVE STUDY.HUMPHREY T, DANIELL H, CHEN AF, HOLLENBECK B, TALMO C, FANG CJ, SMITH EL, NIU R, MELNIC CM, HOSSEINZADEH S, BEDAIR HS.SURG INFECT (LARCHMT). 2022 JUN;23(5):458-464. DOI: 10.1089/SUR.2022.012. PMID: 3559433144. ACCELERATED NEUTRAL ATOM BEAM (ANAB) MODIFIED POLYETHYLENE FOR DECREASED WEAR AND REDUCED BACTERIA COLONIZATION: AN IN VITRO STUDY.KHOURY J, EDELMAN ER, TALMO C, WEBSTER TJ.NANOMEDICINE. 2022 JUN;42:102540. DOI: 10.1016/J.NANO.2022.102540. PMID: 3518152845. REDUCING NARCOTIC USAGE WITH 0.5% BUPIVACAINE PERIARTICULAR INJECTIONS IN TOTAL KNEE ARTHROPLASTY.HAGAR AD, FANG CJ, DANNENBAUM JH, SMITH EL, BONO JV, TALMO CT.J ARTHROPLASTY. 2022 MAY;37(5):851-856. DOI: 10.1016/J.ARTH.2022.01.026. PMID: 3506521546. PRIMARY REVERSE TOTAL SHOULDER ARTHROPLASTY PERFORMED FOR GLENOHUMERAL ARTHRITIS: DOES GLENOID MORPHOLOGY MATTER?PETTIT RJ, SAINI SB, PUZZITIELLO RN, HART PJ, ROSS G, KIRSCH JM, JAWA A.J SHOULDER ELBOW SURG. 2022 MAY;31(5):923-931. DOI: 10.1016/J.JSE.2021.10.022. PMID: 3480066947. THE MAJORITY OF PATIENTS AGED 40 AND OLDER HAVING ALLOGRAFT ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION ACHIEVE A PATIENT ACCEPTABLE SYMPTOMATIC STATE.SYLVIA SM, PERRONE GS, STONE JA, MILTENBERG B, NEZWEK TA, ZHANG Y, GOLENBOCK SW, RICHMOND JC, SALZLER MJ.ARTHROSCOPY. 2022 MAY;38(5):1537-1543. DOI: 10.1016/J.ARTHRO.2021.09.024. PMID: 3460100848. TREATMENT OF POST-MENISCECTOMY KNEE SYMPTOMS WITH MEDIAL MENISCUS REPLACEMENT RESULTS IN GREATER PAIN REDUCTION AND FUNCTIONAL IMPROVEMENT THAN NON-SURGICAL CARE.ZASLAV KR, FARR J, ALFRED R, ALLEY RM, DYLE M, GOMOLL AH, LATTERMANN C, MCKEON BP, KAEDING CC, GIEL T, HERSHMAN EB.KNEE SURG SPORTS TRAUMATOL ARTHROSC. 2022 APR;30(4):1325-1335. DOI: 10.1007/S00167-021-06573-0. PMID: 33884442 49. COMPARING THE RISK OF OSTEONECROSIS OF THE FEMORAL HEAD FOLLOWING INTRA-ARTICULAR CORTICOSTEROID AND HYALURONIC ACID INJECTIONS.VARADY NH, ABRAHAM PF, KUCHARIK MP, FRECCERO DM, SMITH EL, MARTIN SD.J BONE JOINT SURG AM. 2022 MAR 11. DOI: 10.2106/JBJS.21.01043. ONLINE AHEAD OF PRINT. PMID: 3527589150. CORE MUSCLE INJURY: EVALUATION AND TREATMENT IN THE ATHLETE.FORLIZZI JM, WARD MB, WHALEN J, WUERZ TH, GILL TJ 4TH.AM J SPORTS MED. 2022 MAR 2:3635465211063890. DOI: 10.1177/03635465211063890. ONLINE AHEAD OF PRINT. PMID: 3523453851. VARIATION IN THE PROFIT MARGIN FOR DIFFERENT TYPES OF TOTAL JOINT ARTHROPLASTY.FANG CJ, SHAKER JM, HART PA, CASSIDY C, MATTINGLY DA, JAWA A, SMITH EL.J BONE JOINT SURG AM. 2022 MAR 2;104(5):459-464. DOI: 10.2106/JBJS.21.00223. PMID: 3476753852. SINGLE POSITION LATERAL DECUBITUS ANTERIOR LUMBAR INTERBODY FUSION (ALIF) AND POSTERIOR FUSION REDUCES COMPLICATIONS AND IMPROVES PERIOPERATIVE OUTCOMES COMPARED WITH TRADITIONAL ANTERIOR-POSTERIOR LUMBAR FUSION.ASHAYERI K, LEON C, TIGCHELAAR S, FATEMI P, FOLLETT M, CHENG I, THOMAS JA, MEDLEY M, BRALY B, KWON B, EISEN L, PROTOPSALTIS TS, BUCKLAND AJ.SPINE J. 2022 MAR;22(3):419-428. DOI: 10.1016/J.SPINEE.2021.09.009. PMID: 3460011053. BILATERAL HIP ARTHROSCOPY FOR TREATING FEMOROACETABULAR IMPINGEMENT: A SYSTEMATIC REVIEW.KUMAR MV, SHANMUGARAJ A, KAY J, SIMUNOVIC N, HUANG MJ, WUERZ TH, AYENI OR.KNEE SURG SPORTS TRAUMATOL ARTHROSC. 2022 MAR;30(3):1095-1108. DOI: 10.1007/S00167-021-06647-Z. PMID: 34165631 54. PREOPERATIVE SINGLE ASSESSMENT NUMERIC EVALUATION SCORE PREDICTS POOR OUTCOMES AFTER REVERSE SHOULDER ARTHROPLASTY FOR MASSIVE ROTATOR CUFF TEARS WITHOUT ARTHRITIS.KIRSCH JM, PATEL M, HILL BW, MCPARTLAND C, NAMDARI S, LAZARUS MD.ORTHOPEDICS. 2022 MAR 4:1-6. DOI: 10.3928/01477447-20220225-07. ONLINE AHEAD OF PRINT.PMID: 3524514155. CLINICAL OUTCOMES AFTER REVERSE TOTAL SHOULDER ARTHROPLASTY IN PATIENTS WITH PRIMARY GLENOHUMERAL OSTEOARTHRITIS COMPARED WITH ROTATOR CUFF TEAR ARTHROPATHY: DOES PREOPERATIVE DIAGNOSIS MAKE A DIFFERENCE?SAINI SS, PETTIT R, PUZZITIELLO RN, HART PA, SHAH SS, JAWA A, KIRSCH JM.J AM ACAD ORTHOP SURG. 2022 FEB 1;30(3):E415-E422. DOI: 10.5435/JAAOS-D-21-00797. PMID: 34890386

FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS GRADUATE MEDICAL
NEW ENGLAND BAPTIST HOSPITAL'S CENTRAL LONGSTANDING ACADEMIC FOCUS IN ORTHOPEDIC 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 NEBH A TOP CHOICE AMONG STUDENTS AND TRAINEES IN THE HEALTH CARE PROFESSIONS. THE HOSPITAL TRAINS MEDICAL RESIDENTS AND FELLOWS.NEBH IS A TEACHING HOSPITAL, WITH APPROXIMATELY 20 ORTHOPEDIC AND RADIOLOGY INTERNS WHO ROTATE THROUGHOUT THE YEAR FROM MULTIPLE INSTITUTIONS, AND 3 SPORTS FELLOWS DURING ACADEMIC YEAR JULY 1, 2021 JUNE 30, 2022 WHICH OVERLAPS WITH A PORTION OF NEBH'S FISCAL YEAR ACTIVITIES REPORTED IN THIS FILING. DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH HAD NET EXPENDITURES OF $673,814 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO NEBH'S RESIDENCY PROGRAM WHICH REPRESENTED 0.13%% OF NEBH'S TOTAL EXPENSES.CORE CLINICAL TRAINING PROGRAMSTHE MEDICAL CENTER SPONSORS CORE CLINICAL TRAINING PROGRAMS IN THE FOLLOWING FIELDS:- ANESTHESIOLOGY- EMERGENCY MEDICINE- INTERNAL MEDICINE- NEUROLOGY- NEUROSURGERY- OBSTETRICS AND GYNECOLOGY- PATHOLOGY- PSYCHIATRY- RADIOLOGY- SURGERY- TRANSITIONAL YEARDURING THE FISCAL YEAR COVERED BY THIS FILING, THE NEBH HAD NET EXPENDITURES OF $828,302 REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO THE TEACHING FUNCTION WHICH REPRESENTED 0.35% OF NEBH'S TOTAL EXPENSES.RESIDENCY PROGRAMSTHE MEDICAL CENTER SPONSORS ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME) APPROVED RESIDENCY PROGRAMS IN EACH OF THE CORE CLINICAL TRAINING PROGRAMS LISTED ABOVE. FELLOWSHIP PROGRAMSIN ADDITION TO THE RESIDENT TRAINING PROGRAMS LISTED ABOVE, THE MEDICAL CENTER SPONSORS A WIDE VARIETY OF FELLOWSHIP TRAINING PROGRAMS FOR ELIGIBLE DOCTORS WHO HAVE COMPLETED THEIR RESIDENCY AND WANT TO ENGAGE IN MORE SPECIALIZED STUDY. OVER HALF OF THESE PROGRAMS (59 OF 109) ARE ACGME APPROVED OR APPROVED BY A COMPARABLE BODY RELATED TO THE PARTICULAR SUBSPECIALTY. THE MEDICAL CENTER SPONSORS THE FOLLOWING FELLOWSHIP PROGRAMS:- ANESTHESIA: ADULT CARDIOTHORACIC ANESTHESIOLOGY, ADVANCED CLINICAL ANESTHESIA, ANESTHESIA FOR OUTPATIENT SURGERY, CRITICAL CARE MEDICINE, NEUROANESTHESIA, NEURO CRITICAL CARE, OBSTETRIC ANESTHESIOLOGY, PAIN MEDICINE, REGIONAL ANESTHESIA, VASCULAR ANESTHESIA, PATIENT SAFETY AND QUALITY IMPROVEMENT IN ANESTHESIA- DERMATOLOGY: CUTANEOUS ONCOLOGY, DERMATOLOGY RESEARCH FELLOWSHIP IN CLINICAL TRIALS AND OUTCOMES RESEARCH (CLEARS)- EMERGENCY MEDICINE: EMERGENCY MEDICAL SERVICES, EMERGENCY ULTRASOUND, DISASTER MEDICINE, ACADEMIC EMERGENCY MEDICINE- INTERNAL MEDICINE: ADVANCED CARDIAC NON-INVASIVE IMAGING, ADVANCED ENDOCRINE, DIABETES AND METABOLISM, ADVANCED ENDOSCOPY, ADVANCED INFECTIOUS DISEASE, ADVANCED NEPHROLOGY, CARDIAC MAGNETIC RESONANCE IMAGING, CARDIOVASCULAR DISEASE, CELIAC DISEASE, CLINICAL CARDIAC ELECTROPHYSIOLOGY, CLINICAL INFORMATICS, ENDOCRINOLOGY, DIABETES, AND METABOLISM, GASTROENTEROLOGY, GENERAL MEDICINE, GERIATRIC MEDICINE, GERIATRIC AND DIABETES, GI MOTILITY/FUNCTIONAL BOWEL DISORDERS, GLOBAL HEALTH, HEMATOLOGY AND MEDICAL ONCOLOGY, HEPATOLOGY, HOSPICE AND PALLIATIVE CARE, INFECTIOUS DISEASE, INFLAMMATORY BOWEL DISEASE, INTERVENTIONAL CARDIOLOGY, INTERVENTIONAL PULMONOLOGY, NEPHROLOGY, PULMONARY CRITICAL CARE, RHEUMATOLOGY, SLEEP MEDICINE, SLEEP RESPIRATION, STRUCTURAL HEART DISEASE, TRANSPLANT HEPATOLOGY, TRANSPLANT NEPHROLOGY- NEUROLOGY: AUTONOMIC DISORDERS, COGNITIVE BEHAVIORAL NEUROLOGY, CLINICAL NEUROPHYSIOLOGY, EPILEPSY, MOVEMENT DISORDERS, MULTIPLE SCLEROSIS, NEUROLOGY-HIV, NEUROMUSCULAR MEDICINE, NEURO-ONCOLOGY, VASCULAR NEUROLOGY- OBSTETRICS AND GYNECOLOGY: FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY, GYNECOLOGIC ONCOLOGY, MATERNAL FETAL MEDICINE, REPRODUCTIVE ENDOCRINOLOGY- PATHOLOGY: BLOOD BANKING/TRANSFUSION MEDICINE, CYTOPATHOLOGY, DERMATOPATHOLOGY, HEMATOPATHOLOGY, MEDICAL MICROBIOLOGY, MEDICAL MICROBIOLOGY CPEP, NEUROPATHOLOGY, SELECTIVE PATHOLOGY - PSYCHIATRY- RADIOLOGY-DIAGNOSTIC: ABDOMINAL RADIOLOGY, BREAST IMAGING RADIOLOGY, INTERVENTIONAL RADIOLOGY-INDEPENDENT, INTERVENTIONAL RADIOLOGY-INTEGRATED, MRI, MUSCULOSKELETAL IMAGING MSK, NEURORADIOLOGY, THORACIC IMAGING RADIOLOGY, - RADIATION ONCOLOGY: BRACHYTHERAPY, STEREOTATIC- SURGERY: ABDOMINAL TRANSPLANT SURGERY/KIDNEY, ACUTE CARE SURGERY, ANTERIOR SEGMENT OPHTHALMOLOGY, COLON AND RECTAL SURGERY, CORNEA AND REFRACTIVE SURGERY, CEREBROVASCULAR AND ENDOVASCULAR NEUROSURGERY, HEAD & NECK SURGICAL ONCOLOGY & RECONSTRUCTION, INTERDISCIPLINARY BREAST SURGERY, MINIMALLY INVASIVE BARIATRIC SURGERY, NEUROSURGERY/ORTHO SPINE, ORTHOPAEDIC HAND SURGERY, ORTHOPAEDIC SPINE SURGERY, PLASTIC SURGERY, PLASTIC SURGERY/AESTHETIC RECONSTRUCTION, PLASTIC SURGERY/BREAST RECONSTRUCTION, PODIATRY, SURGICAL CRITICAL CARE, THORACIC SURGERY, UROLOGY, UROLOGY MALE INFERTILITY/SEXUAL DYSFUNCTION, VASCULAR SURGERY, VASCULAR SURGERY-INTEGRATEDADDITIONAL INFORMATION ON CLINICAL RESIDENCY AND FELLOWSHIPS -- EXAMPLESBELOW IS MORE DETAIL ON JUST A FEW OF THE SPECIFIC GRADUATE MEDICAL EDUCATION PROGRAMS OFFERED AT THE MEDICAL CENTER:HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY AT BIDMCTHE BETH ISRAEL DEACONESS MEDICAL CENTER HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY IS A THREE-YEAR PROGRAM (PGY-1 TO PGY-3) IS AFFILIATED WITH HARVARD MEDICAL SCHOOL AND IS BASED AT BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC), A 57,000 VISIT PER YEAR LEVEL I TRAUMA CENTER. RESIDENTS ROTATE AT CHILDREN'S HOSPITAL BOSTON, BROCKTON HOSPITAL, CAMBRIDGE HOSPITAL, TUFTS MEDICAL CENTER, ST. VINCENT HOSPITAL, ST. LUKE'S HOSPITAL, MOUNT AUBURN HOSPITAL AND BETH ISRAEL DEACONESS HOSPITAL-NEEDHAM.THE EDUCATIONAL GOALS OF THE RESIDENCY ARE TO PROMOTE EXCELLENCE IN THE CLINICAL, ACADEMIC, AND ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE. RESIDENTS ARE TAUGHT HOW TO BE OUTSTANDING CLINICIANS. THIS IS ACCOMPLISHED THROUGH CLINICAL EXPERIENCE IN SEVERAL BUSY EMERGENCY DEPARTMENTS AS WELL AS THROUGH A HIGH QUALITY DIDACTIC PROGRAM. DURING THE CLINICAL EXPERIENCE, THE RESIDENTS ARE CLOSELY SUPERVISED AND GIVEN GRADED RESPONSIBILITY FOR PATIENT CARE AND ULTIMATELY FOR PATIENT FLOW IN THE EMERGENCY DEPARTMENT. ADDITIONALLY, RESIDENTS ARE TAUGHT HOW TO SUPERVISE MEDICAL STUDENTS AND OTHER RESIDENTS AND HOW TO TEACH THE PRACTICE OF EMERGENCY MEDICINE. RESIDENTS TEACH MEDICAL STUDENTS AND PREHOSPITAL PERSONNEL AND CONTRIBUTE TO THE DIDACTIC PROGRAM. SENIOR RESIDENTS TAKE ON THE RESPONSIBILITY OF SUPERVISING JUNIOR RESIDENTS IN THE CLINICAL ARENA. THE FOCUS OF THE RESIDENCY PROGRAM IS ON TEACHING THE LEADERSHIP SKILLS NECESSARY TO DIRECT A BUSY EMERGENCY DEPARTMENT IN ANY SETTING.THE OTHER MAJOR EDUCATIONAL GOAL OF THE RESIDENCY IS TO DEVELOP THE RESEARCH AND ACADEMIC SKILLS REQUIRED FOR A CAREER IN ACADEMIC EMERGENCY MEDICINE. PARTICIPATION IN RESEARCH IS PROMOTED THROUGH A SYSTEM OF MENTORSHIP, JOURNAL CLUB PARTICIPATION, AND A DIDACTIC PROGRAM THAT TEACHES RESEARCH DESIGN AND STATISTICAL METHODS. RESIDENTS ARE REQUIRED TO COMPLETE A RESEARCH OR ACADEMIC PROJECT THAT RESULTS IN A PAPER SUITABLE FOR PUBLICATION. FUNDING IS AVAILABLE WITHIN THE DIVISION OF EMERGENCY MEDICINE AT HARVARD MEDICAL SCHOOL AND THE DEPARTMENT OF EMERGENCY MEDICINE AT BIDMC. PROMOTING THE ADMINISTRATIVE ASPECTS OF EMERGENCY MEDICINE IS ANOTHER GOAL OF THE BIDMC HARVARD AFFILIATED EMERGENCY MEDICINE RESIDENCY. THROUGH AN EMS/ADMINISTRATIVE ROTATION AND A LONGITUDINAL EXPERIENCE IN PREHOSPITAL ADMINISTRATION, RESIDENTS GAIN EXPERIENCE IN RUNNING A LOCAL PREHOSPITAL SYSTEM.THIS PROGRAM TAKES ADVANTAGE OF THE UNIQUE ACADEMIC OPPORTUNITIES AT HARVARD MEDICAL SCHOOL, THE HARVARD TEACHING HOSPITALS, AND THE HARVARD SCHOOL OF PUBLIC HEALTH. THESE OPPORTUNITIES INCLUDE THE OUTSTANDING EXPERIENCE AVAILABLE THROUGH BOSTON CHILDREN'S HOSPITAL AND THE DEPARTMENTS OF MEDICINE, SURGERY, OBSTETRICS AND GYNECOLOGY, AND ANESTHESIA AT BETH ISRAEL DEACONESS MEDICAL CENTER. INTERNAL MEDICINE EDUCATION AT BIDMCTHE GOAL OF THIS PROGRAM IS TO DEVELOP EACH RESIDENT'S JUDGMENT AND SKILLS TO PROVIDE THE HIGHEST QUALITY MEDICAL CARE. THE MEDICAL CENTER TRAINS RESIDENTS AS ACADEMIC INTERNISTS AND PROVIDES THE FOUNDATION FOR THE PRACTICE OF INTERNAL MEDICINE OR FOR SUBSEQUENT CLINICAL AND RESEARCH TRAINING IN MEDICAL SUBSPECIALTIES. RESIDENTS ARE EXPOSED TO A WIDE ARRAY OF PATIENTS IN VARIOUS INPATIENT AND OUTPATIENT SETTINGS, INCLUDING DIFFERENT UNITS WITHIN BIDMC, DANA FARBER CANCER INSTITUTE, AND WEST ROXBURY VETERANS AFFAIRS MEDICAL CENTER. CLINICAL TEACHING IS A FOCUS AT BIDMC AND IS COMPRISED OF FORMAL AND INFORMAL DAILY ROUNDS AND NOONTIME CONFERENCES. THIS TEACHING PROVIDES THE BASIS OF AN ORGANIZED CURRICULUM FOR ALL MEDICAL INTERNS AND RESIDENTS AT BIDMC.

PATHOLOGY EDUCATION AT BIDMC
"THE DEPARTMENT OF PATHOLOGY AT BETH ISRAEL DEACONESS MEDICAL CENTER IS COMMITTED TO PROVIDING STATE-OF-THE-ART TRAINING TO PREPARE PHYSICIANS FOR LEADERSHIP ROLES IN PATHOLOGY AND ACADEMIC MEDICINE. THE PROGRAM OFFERS THREE RESIDENT TRAINING PATHWAYS: FIRST, A COMBINED ANATOMIC PATHOLOGY/CLINICAL PATHOLOGY (AP/CP) PATHWAY PROVIDES COMPREHENSIVE TRAINING IN ALL AREAS OF TISSUE DIAGNOSTICS AND LABORATORY MEDICINE. SECOND, THE AP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS ACADEMIC SURGICAL PATHOLOGISTS. THIRD, THE CP ONLY PATHWAY PREPARES RESIDENTS FOR CAREERS AS FUTURE LEADERS IN LABORATORY MEDICINE. ALL PATHWAYS INCLUDE EXTENSIVE OPPORTUNITIES TO PARTICIPATE IN RESEARCH PROJECTS WITH WORLD-RENOWNED EXPERTS IN PATHOLOGY OR RELATED DISCIPLINES. KNOWLEDGE COMES THROUGH EXPERIENCE AND EXTENSIVE INTERACTION WITH FACULTY. IN ANATOMIC PATHOLOGY SIGN OUT, RESIDENTS PREPARE THEIR OWN DIAGNOSES AND ARE THEN IN A POSITION TO TAKE FULL ADVANTAGE OF SIGN OUT WITH STAFF MEMBERS. IN CLINICAL PATHOLOGY, RESIDENTS GAIN EXPERIENCE DURING DAILY ROUNDS WITH ATTENDINGS, SOCRATIC TUTORIALS, AND THROUGH POSITIONING OF RESIDENTS AS AN INTERMEDIARY BETWEEN CLINICIAN AND LABORATORY. THERE ARE DAILY TEACHING AND CASE MANAGEMENT CONFERENCES COVERING THE DIFFERENT PATHOLOGY SPECIALTIES. GIVEN THE IMPORTANT ROLE PATHOLOGISTS PLAY IN TEACHING MEDICAL STUDENTS AND COLLEAGUES IN OTHER SPECIALTIES, THE PROGRAM PROVIDES GUIDANCE FOR RESIDENTS AS THEY HONE THEIR TEACHING SKILLS. SUCH ""RESIDENT-AS-TEACHER"" PROGRAMS ARE COMMON IN OTHER SPECIALTIES BUT NOT AS WELL-DEVELOPED IN PATHOLOGY. THE CURRICULUM INCLUDES SESSIONS DESIGNED TO IMPROVE SKILLS RELATED TO GIVING FEEDBACK AND SMALL GROUP TEACHING. THERE IS A SESSION ON DEVELOPING PRESENTATION SKILLS WITH CLOSE MENTORING OF FIRST YEAR RESIDENTS, BY SPECIFIC FACULTY WHO HAVE ALSO BEEN THROUGH THE CURRICULUM, AS THEY PREPARE FOR THEIR FIRST PRESENTATION. THERE ARE ALSO OPPORTUNITIES FOR RESIDENTS TO TEACH MEDICAL STUDENTS BOTH WITHIN OUR DEPARTMENT AND AT HARVARD MEDICAL SCHOOL, AS WELL AS TO RECEIVE FEEDBACK ON THEIR TEACHING SKILLS. RECOGNIZING THE NEED TO INTEGRATE TECHNOLOGY INTO RESIDENCY TRAINING, ALL FIRST YEAR RESIDENTS ARE PROVIDED WITH IPADS. THESE TABLETS ALLOW RESIDENTS TO MORE EASILY PREVIEW THE SLIDES THAT ARE ROUTINELY SCANNED FOR OUR SURGICAL SLIDE CONFERENCE. GENOMIC TECHNOLOGY WILL AFFECT THE PRACTICE OF ALL MEDICAL PRACTITIONERS. AS THE PHYSICIANS WHO MANAGE THE HOSPITAL LABORATORIES, PATHOLOGISTS MUST UNDERSTAND NEXT-GENERATION SEQUENCING TECHNOLOGY AND ITS APPLICATION TO PATIENT CARE. IN 2009, THE PROGRAM CREATED, TO OUR KNOWLEDGE, THE FIRST GENOMIC PATHOLOGY CURRICULUM IN THE COUNTRY. THE CURRICULUM HAS BEEN PUBLISHED AND HAS SERVED AS THE BASIS FOR A COLLABORATIVE EFFORT TO DEVELOP A NATIONAL GENOMICS CURRICULUM (WWW.ASCP.ORG/TRIG).TRAINING IN EVIDENCE-BASED MEDICINE IS CRITICAL. A FIRST-YEAR RESIDENT JOURNAL CLUB ALLOWS AN INTRODUCTION TO CRITICAL REVIEW OF THE MEDICAL LITERATURE. IN LATER YEARS, RESIDENTS LEAD SMALL-GROUP DISCUSSIONS IN MONTHLY JOURNAL CLUBS. THERE IS ALSO AN EVIDENCE-BASED TRANSFUSION MEDICINE CURRICULUM TO HONE THESE SKILLS DURING CP TRAINING. *****RADIOLOGY EDUCATION AT BIDMCTHE RADIOLOGY RESIDENCY PROVIDES FOUR YEARS OF TRAINING IN DIAGNOSTIC IMAGING. APPOINTMENTS ARE HELD JOINTLY AS A RESIDENT AT THE MEDICAL CENTER AND AS A CLINICAL FELLOW AT HARVARD MEDICAL SCHOOL. WITH A CENTRAL ROLE IN CLINICAL SERVICE, TEACHING, AND RESEARCH, THE RADIOLOGY DEPARTMENT PERFORMS OVER 400,000 RADIOLOGIC EXAMINATIONS EACH YEAR. THE DEPARTMENT PROVIDES RADIOGRAPHY, CT, ULTRASOUND, MRI, NUCLEAR MEDICINE, MAMMOGRAPHY, ANGIOGRAPHY, AND INTERVENTIONAL RADIOLOGY SERVICES TO BOTH THE MEDICAL CENTER AS WELL AS OUR AFFILIATED HEALTH CARE FACILITIES. A RADIOLOGY RESEARCH AND ANIMAL LABORATORY IS HOUSED ADJACENT TO THE RADIOLOGY DEPARTMENT. ALL RESIDENTS, FELLOWS, AND FACULTY HAVE APPOINTMENTS AT HARVARD MEDICAL SCHOOL. ALL RADIOLOGIC STUDIES ARE INTERPRETED UNDER THE SUPERVISION OF STAFF RADIOLOGISTS. THE NUCLEAR MEDICINE PROGRAM IS A PART OF THE JOINT PROGRAM IN NUCLEAR MEDICINE AT HARVARD MEDICAL SCHOOL. THE DEPARTMENT PLACES STRONG EMPHASIS ON THE QUALITY OF TEACHING-BOTH IN DIDACTIC LECTURES AND IN INDIVIDUAL CASE-BASED TEACHING.WITH THE ADVENT OF RECENT CHANGES IN RESIDENCY TRAINING, THE CURRICULUM HAS RECENTLY BEEN REVISED SO THAT RESIDENTS UNDERTAKE A COURSE OF STUDY WHICH WILL PERMIT THEM TO OBTAIN EXPERTISE NOT JUST IN CLINICAL SUBSPECIALTIES BUT ALSO IN OTHER KEY AREAS SUCH AS RESEARCH, EDUCATION, GLOBAL HEALTH, QUALITY IMPROVEMENT, AND HEALTH POLICY. RADIOLOGIC PHYSICS HAS BEEN INTEGRATED INTO DAILY DIDACTIC SESSIONS. IN ADDITION, MANY DIDACTIC SESSIONS UTILIZE AUDIENCE RESPONSE TECHNOLOGY, VIDEO-RECORDING, AND IPAD2 TECHNOLOGY.THERE ARE NINE FORMAL SECTIONS IN THE DEPARTMENT: ABDOMINAL IMAGING, BREAST IMAGING, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY (CVIR), MRI, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, AND THORACIC IMAGING. MOST NON-ANGIOGRAPHIC INTERVENTIONAL PROCEDURES ARE PERFORMED BY THE RESPECTIVE SERVICES. RESIDENTS ROTATING THROUGH THESE SECTIONS ARE PROVIDED WITH READING SUGGESTIONS AND MATERIAL. ACADEMIC ROTATIONS ARE MADE UP OF THIRTEEN 4-WEEK BLOCKS ANNUALLY. AT THE END OF EACH ROTATION RESIDENTS RECEIVE WRITTEN EVALUATIONS AND HAVE THE OPPORTUNITY TO EVALUATE THE STAFF.FIRST YEAR ROTATIONS EMPHASIZE FUNDAMENTALS AND COMMON RADIOLOGIC EXAMINATIONS IN PREPARATION FOR INPATIENT AND EMERGENCY DEPARTMENT RESPONSIBILITIES. PRIOR TO TAKING CALL, ALL FIRST YEAR RESIDENTS ROTATE THROUGH ABDOMINAL IMAGING, BREAST IMAGING, EMERGENCY RADIOLOGY, FLUOROSCOPY, MUSCULOSKELETAL IMAGING, NEURORADIOLOGY, NUCLEAR MEDICINE, THORACIC IMAGING, AND ULTRASOUND.DURING THE SECOND YEAR, RESIDENTS CONTINUE TO GAIN EXPERIENCE IN THESE SECTIONS, PERFORMING AND INTERPRETING MORE ADVANCED EXAMINATIONS AND INTERVENTIONS AS THEIR LEVELS OF EXPERTISE INCREASE. ADDITIONAL ROTATIONS IN MORE SPECIALIZED TOPICS OCCUR THROUGHOUT THE SECOND THROUGH FOURTH YEARS, INCLUDING INTERVENTIONAL RADIOLOGY, MRI, HEAD AND NECK IMAGING, AND PEDIATRIC RADIOLOGY. IN ADDITION, ALL RESIDENTS PARTICIPATE IN A TWO-WEEK ROTATION IN QUALITY ASSURANCE WHICH PROVIDES THEM WITH ESSENTIAL SKILLS FOR EVENTUAL BOARD RE-CERTIFICATION.ROTATIONS AT OTHER TRAINING LOCATIONS DURING THE SECOND AND THIRD YEARS OF TRAINING INCLUDE:- THREE MONTHS OF TRAINING IN PEDIATRIC RADIOLOGY AT THE BOSTON CHILDREN'S HOSPITAL DURING THE SECOND YEAR.- FOUR WEEK PROGRAM IN RADIOLOGIC-PATHOLOGIC CORRELATION AT THE ARMED FORCES INSTITUTE OF PATHOLOGY (AIRP) SPONSORED BY THE AMERICAN COLLEGE OF RADIOLOGY IN SILVER SPRINGS, MARYLAND DURING THE THIRD YEAR.- ONE MONTH ROTATION AT THE MASSACHUSETTS EYE AND EAR INFIRMARY IN HEAD-AND-NECK RADIOLOGY DURING THE THIRD YEAR.UPON COMPLETION OF THE SECOND YEAR OF RESIDENCY TRAINING, RESIDENTS SELECT AN AREA OF ACADEMIC FOCUS FOR THEIR FOURTH YEAR WHICH WILL GUIDE CHOICES FOR THE 3-MONTH MINI-FELLOWSHIPS AND THE OTHER TWO MONTHS OF ELECTIVE TIME.OUR UNIQUE EDUCATIONAL TRACKSCURRENTLY, SIX TRACKS ARE OFFERED:- CLINICAL- EDUCATION- RESEARCH- GLOBAL HEALTH- QUALITY IMPROVEMENT- HEALTH POLICY/HEALTH ECONOMICSEACH OF THESE TRACKS HAS SPECIFIC CURRICULAR OFFERINGS AND EDUCATIONAL GOALS. MOST OF THE TRACKS ARE LINKED TO SPECIFIC EDUCATIONAL ENDEAVORS. FOR EXAMPLE, A RESIDENT SELECTING THE GLOBAL HEALTH TRACK WILL ENROLL IN THE GLOBAL EFFECTIVENESS CURRICULUM OFFERED BY THE HARVARD SCHOOL OF PUBLIC HEALTH AND WILL SPEND TIME ABROAD PROVIDING CLINICAL RADIOLOGY SERVICES AND UNDERTAKING A GLOBAL HEALTH PROJECT. A RESIDENT SELECTING THE EDUCATION TRACK WILL PURSUE ADVANCED TRAINING IN EDUCATIONAL THEORY AND ADULT LEARNING BY PARTICIPATING IN THE HARVARD MACY PROGRAM FOR PHYSICIAN EDUCATORS AND UNDERTAKE AN EDUCATIONAL PROJECT BASED AT BIDMC OR HARVARD MEDICAL SCHOOL. A RESIDENT CHOOSING THE RESEARCH TRACK WILL PARTICIPATE IN GRANT WRITING WORKSHOPS AND DELVE DEEPLY INTO A RESEARCH PROJECT OF THEIR CHOICE.NO MATTER WHICH TRAINING TRACK, THE EXPECTATION IS THAT EVERY RESIDENT WILL HAVE THE OPPORTUNITY TO UNDERTAKE A SUBSTANTIAL PROJECT DURING RESIDENCY THAT WILL CULMINATE IN PRESENTATION AT A NATIONAL MEETING AND/OR PUBLICATION."

THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)
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 NEBH'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 NEBH ASSESS COMMUNITY HEALTH NEEDS, ENGAGE THE COMMUNITY, IDENTIFY PRIORITY HEALTH ISSUES AND CREATE A COMMUNITY HEALTH STRATEGY THAT DESCRIBES HOW NEBH, 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, NEBH COMPLETED ITS LAST ASSESSMENT IN SEPTEMBER 2022. THE GEOGRAPHICAL FOCUS OF NEBH'S MOST RECENTLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT ENCOMPASSES THE MISSION HILL/ROXBURY NEIGHBORHOODS OF BOSTON, AS WELL AS THE CITIES OF DEDHAM, CHESTNUT HILL (NEWTON) AND BROOKLINE. THESE COMMUNITIES DEFINE NEBH'S COMMUNITY BENEFITS SERVICE AREA (CBSA). IN RECOGNITION OF THE CONSIDERABLE HEALTH DISPARITIES THAT EXIST IN SOME COMMUNITIES, NEBH FOCUSES THE BULK OF ITS COMMUNITY BENEFITS RESOURCES ON IMPROVING THE HEALTH STATUS OF LOW-INCOME AND UNDERSERVED POPULATIONS LIVING IN THE BOSTON NEIGHBORHOODS OF MISSION HILL/ROXBURY. WHILE THERE ARE CERTAINLY SEGMENTS OF THE POPULATIONS IN DEDHAM, CHESTNUT HILL (NEWTON), AND BROOKLINE THAT ARE VULNERABLE AND UNDERSERVED, THE GREATEST DISPARITIES EXIST IN BOSTON. IN ORDER TO MAXIMIZE THE IMPACT OF ITS COMMUNITY BENEFITS RESOURCES, NEBH'S COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) VOTED TO PRIORITIZE AND FOCUS NEBH'S ATTENTION ON THE MORE URBAN, HIGH-NEED COMMUNITIES IN NEBH'S CBSA. COMMUNITY HEALTH ISSUES AND PRIORITY COHORTS FOR NEBH'S COMMUNITY BENEFITS INITIATIVES ARE IDENTIFIED THROUGH A COLLABORATIVE COMMUNITY ENGAGEMENT AND PLANNING PROCESS THROUGH A CHNA THAT IS CONDUCTED EVERY THREE YEARS IN ACCORDANCE WITH THE REQUIREMENTS UNDER IRC SECTION 501(R).NEBH'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 MISSION HILL/ROXBURY IN ITS CBSA, AS FOLLOWS:- YOUTH- OLDER ADULTS- INDIVIDUALS WITH DISABILITIES- RACIALLY, ETHNICALLY AND LINGUISTICALLY DIVERSE POPULATIONS- LOW-RESOURCED POPULATIONS2022 COMMUNITY HEALTH NEEDS ASSESSMENTSUMMARY OF APPROACH AND METHODSNEBH'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 NEBH'S CBSA, ESPECIALLY THE POPULATION SEGMENTS THAT ARE OFTEN DISADVANTAGED, FACE DISPARITIES IN HEALTH-RELATED OUTCOMES, AND WHO HAVE BEEN HISTORICALLY UNDERSERVED. NEBH'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.THE CHNA USED A PARTICIPATORY, COLLABORATIVE APPROACH TO LOOK AT HEALTH IN ITS BROADEST CONTEXT. RATHER THAN CONDUCTING A SINGLE ASSESSMENT, NEBH'S COMMUNITY BENEFITS STAFF CONDUCTED THEIR OWN ASSESSMENT AND PARTICIPATED IN A SERIES OF ADDITIONAL, CONCURRENT AND COMPREHENSIVE ASSESSMENTS THAT WERE THEN AGGREGATED TO CREATE THE 2022 CHNA REPORT. THESE CONCURRENT ASSESSMENTS WERE CONDUCTED IN PARTNERSHIP WITH THE BOSTON COMMUNITY HEALTH NEEDS ASSESSMENT-COMMUNITY HEALTH IMPROVEMENT PLAN COLLABORATIVE (BOSTON CHNA-CHIP COLLABORATIVE). THE BOSTON CHNA-CHIP COLLABORATIVE, CONSISTING OF BOSTON'S HOSPITALS AND COMMUNITY HEALTH CENTERS, THE BOSTON PUBLIC HEALTH COMMISSION, COMMUNITY-BASED ORGANIZATIONS, AND COMMUNITY RESIDENTS, CONDUCTED A ROBUST AND COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE CITY OF BOSTON AS A WHOLE. FACILITATED THROUGH THE CONFERENCE OF BOSTON TEACHING HOSPITALS (COBTH) AND THE CITY OF BOSTON'S HUMAN SERVICES DEPARTMENT, THE BOSTON CHNA-CHIP COLLABORATIVE ASSESSMENT FOCUSED ON THE SOCIAL DETERMINANTS OF HEALTH THROUGH THE LENS OF HEALTH EQUITY; IT AIMED TO UNCOVER AND UNDERSTAND HOW AND WHY INDIVIDUALS IN CERTAIN BOSTON NEIGHBORHOODS OR POPULATION GROUPS EXPERIENCE INEQUITIES IN HEALTH OUTCOMES AND BARRIERS TO CARE BASED ON SOCIOECONOMIC STATUS, RACE AND ETHNICITY, LANGUAGE, HEALTH STATUS, SEXUAL ORIENTATION, GENDER IDENTITY, AND OTHER FACTORS. THE OVERALL APPROACH WAS PARTICIPATORY AND COLLABORATIVE, ENGAGING COMMUNITY RESIDENTS AND COLLABORATORS THROUGHOUT THE CHNA PROCESS. NANCY KASEN, BILH'S VICE PRESIDENT OF COMMUNITY BENEFITS AND COMMUNITY RELATIONS, SERVED AS THE FOUNDING CO-CHAIR OF THE BOSTON CHNA-CHIP COLLABORATIVE STEERING COMMITTEE, AND CONTINUES TO SERVE ON ITS STEERING COMMITTEE AND WORKGROUPS. ROBERT TORRES, BILH'S DIRECTOR OF COMMUNITY BENEFITS FOR THE BOSTON REGION, SERVED AS THE CO-CHAIR OF THE COMMUNITY ENGAGEMENT WORKGROUP. NEBH COMMUNITY BENEFITS STAFF PARTICIPATED IN NUMEROUS BOSTON CHNA-CHIP COLLABORATIVE MEETINGS. NEBH AND THE BOSTON CHNA-CHIP COLLABORATIVE SHARED INFORMATION WITH EACH OTHER TO SUPPORT EACH OTHER'S ASSESSMENT EFFORTS.FINALLY, NEBH PARTICIPATED IN THE BETH ISRAEL LAHEY HEALTH (BILH) CHNA AND COLLABORATED WITH BETH ISRAEL DEACONESS NEEDHAM HOSPITAL (BID NEEDHAM) AND BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC). WITH RESPECT TO BID NEEDHAM, NEBH AND BID NEEDHAM BOTH INCLUDE DEDHAM IN THEIR CBSA, AND BOTH GATHERED AND SHARED INFORMATION ON THIS MUNICIPALITY AS PART OF THEIR ASSESSMENT PROCESSES. WITH RESPECT TO BIDMC, NEBH AND BIDMC BOTH INCLUDE THE ROXBURY AND MISSION HILL NEIGHBORHOODS OF BOSTON AND THE VILLAGE OF CHESTNUT HILL IN THEIR CBSAS. SIMILARLY, BOTH NEBH AND BIDMC SHARED THE INFORMATION GATHERED IN THESE AREAS AS PART OF THEIR PROCESSES. BIDMC ALSO SHARED INFORMATION FROM THE EXTENSIVE COMMUNITY ENGAGEMENT AND PLANNING ACTIVITIES THAT THEY ARE CONDUCTING AS PART OF BIDMC'S MASSACHUSETTS DETERMINATION OF NEED NEW INPATIENT BUILDING COMMUNITY-BASED HEALTH INITIATIVE (NIB-CHI).COMBINED, THESE EFFORTS HELPED TO ENSURE THAT A SOUND, OBJECTIVE, AND INCLUSIVE CHNA PROCESS WAS CONDUCTED ACROSS NEBH'S ENTIRE CBSA.BETWEEN OCTOBER 2021 AND FEBRUARY 2022, NEBH'S ASSESSMENT INCLUDED 85 (20 BY NEBH/BIDMC) ONE-ON-ONE INTERVIEWS WITH KEY COLLABORATORS IN THE COMMUNITY, 24 FOCUS GROUPS (5 BY NEBH/BIDMC) WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, AND TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED OVER 40 PARTICIPANTS. IN ADDITION, BID NEEDHAM CONDUCTED A COMMUNITY HEALTH SURVEY, WHICH GATHERED INFORMATION FROM MORE THAN 450 COMMUNITY RESIDENTS FROM BID NEEDHAM'S CBSA, INCLUDING 86 RESIDENTS FROM DEDHAM. BID NEEDHAM SHARED THIS INFORMATION WITH NEBH. THE BOSTON PUBLIC HEALTH COMMISSION FIELDED A COVID-19 HEALTH EQUITY SURVEY IN DECEMBER 2020/JANUARY 2021; AS SUCH, NEBH AND BIDMC, BASED ON RECOMMENDATIONS FROM THE BOSTON CHNA-CHIP COLLABORATIVE STEERING COMMITTEE, OPTED NOT TO FIELD A SURVEY IN BOSTON. THIS SURVEY OF A RANDOM SAMPLE OF OVER 1,650 RESIDENTS EXAMINED ISSUES RELATED TO JOB LOSS, FOOD INSECURITY, ACCESS TO SERVICES, MENTAL HEALTH, VACCINATION, AND PERCEPTIONS OF RISK AROUND COVID-19.

2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS DETAIL OF APPROACH AND METHOD
NEBH RELIED ON NUMEROUS PRIMARY AND SECONDARY DATA SOURCES TO ANALYZE THE HEALTH STATUS AND NEED LEVEL THROUGHOUT THEIR CBSA. NEBH COLLECTED DATA FROM A NUMBER OF SOURCES INCLUDING PRIMARY QUANTITATIVE AND QUALITATIVE DATA, AS WELL AS SECONDARY DATA. EXAMPLES OF SECONDARY DATA SOURCES THAT NEBH 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)NEBH'S ASSESSMENT INCLUDED 85 (20 BY NEBH/BIDMC) KEY INFORMANT INTERVIEWS THAT ENGAGED INSTITUTIONAL, ORGANIZATIONAL 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. APPENDIX A IN THE NEBH CHNA INCLUDES DETAILS ON SESSION DATES, PARTICIPANTS, SECTORS, AND THE QUESTIONS ASKED. INDIVIDUALS WERE CHOSEN TO AMASS A REPRESENTATIVE GROUP OF PEOPLE WHO HAD THE EXPERIENCE NECESSARY TO PROVIDE INSIGHT ON THE HEALTH OF COMMUNITIES IN NEBH'S CBSA. INTERVIEWS WERE CONDUCTED IN PERSON AND 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.2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSFOCUS GROUPS AND COMMUNITY FORUMS (SCHEDULE H, PART V, SECTION B, LINE 5)NEBH'S ASSESSMENT INCLUDED 24 FOCUS GROUPS (5 BY NEBH/BIDMC) WITH SEGMENTS OF THE POPULATION FACING THE GREATEST HEALTH-RELATED DISPARITIES, AND TWO COMMUNITY LISTENING SESSIONS THAT ENGAGED OVER 40 PARTICIPANTS. IN ADDITION, BID NEEDHAM CONDUCTED A COMMUNITY HEALTH SURVEY, WHICH GATHERED INFORMATION FROM MORE THAN 450 COMMUNITY RESIDENTS FROM BID NEEDHAM'S CBSA, INCLUDING 86 RESIDENTS FROM DEDHAM. BID NEEDHAM SHARED THIS INFORMATION WITH NEBH. THE BOSTON PUBLIC HEALTH COMMISSION FIELDED A COVID-19 HEALTH EQUITY SURVEY IN DECEMBER 2020/JANUARY 2021; AS SUCH, NEBH AND BIDMC, BASED ON RECOMMENDATIONS FROM THE BOSTON CHNA-CHIP COLLABORATIVE STEERING COMMITTEE, OPTED NOT TO FIELD A SURVEY IN BOSTON. THIS SURVEY OF A RANDOM SAMPLE OF OVER 1,650 RESIDENTS EXAMINED ISSUES RELATED TO JOB LOSS, FOOD INSECURITY, ACCESS TO SERVICES, MENTAL HEALTH, VACCINATION, AND PERCEPTIONS OF RISK AROUND COVID-19.NEBH HAS BEEN INTENTIONAL IN ENSURING THAT VARIED EXPERIENCES AND PERSPECTIVES, REFLECTIVE OF NEBH'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 FOCUS GROUPS AND LISTENING SESSIONS WERE HELD VIA ZOOM AND AVAILABLE WITH SPANISH AND CHINESE TRANSLATION. FURTHERMORE, EXTENSIVE OUTREACH WAS CONDUCTED VIA SOCIAL MEDIA, INSTITUTIONAL NEWSLETTERS, EMAILS TO COMMUNITY RESIDENTS, COMMUNITY EVENTS AND HOUSING DEVELOPMENTS TO HELP ENSURE DIVERSE REPRESENTATION IN THE CHNA. THE NEBH 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 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 WITH THE NEBH COMMUNITY BENEFITS ADVISORY COMMITTEE (CBAC) AND HELD A VIRTUAL COMMUNITY FORUM PRESENTING RESULTS.- IDENTIFY NEBH'S COMMUNITY BENEFITS PRIORITY COHORTS, GEOGRAPHIC FOCUS, AND COMMUNITY HEALTH PRIORITIES.- ANALYZE NEBH'S EXISTING COMMUNITY BENEFITS ACTIVITIES WHICH WERE INFORMED BY THE 2019 CHNA AND SUBSEQUENT 2020 2022 IMPLEMENTATION STRATEGY THAT WERE COMPLETED BY NEBH DURING THE FISCAL PERIOD ENDED SEPTEMBER 30, 2019 (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, 2022 (TAX YEAR 2021).

GOAL 2: REDUCE ELDER FALLS AND PROMOTE AGING IN PLACE
"TARGET POPULATION: OLDER ADULTS PROGRAMMATIC OBJECTIVES: 1. REDUCE FEAR OF FALLING 2. REDUCE FALLS 3. INCREASE ACTIVITY LEVELS 4. INCREASE THE NUMBER OF OLDER ADULTS LIVING INDEPENDENTLY IN THEIR HOMES COMMUNITY ACTIVITIES/STRATEGIES: - SUPPORT OR ORGANIZE MATTER OF BALANCE WORKSHOPS FOR PRIORITY POPULATIONS METRICS AND STATUS UPDATE: - IN FY20 AND FY21, NEBH HAS FINANCIALLY SUPPORTED HEALTHY MOVES, A 12-WEEK PROGRAM FOR OLDER ADULTS THAT CONCENTRATES ON EXERCISE, STRENGTH, BALANCE, FLEXIBILITY, AND ENDURANCE, AND EDUCATION ABOUT FALL PREVENTION. DUE TO COVID-19, THE PROGRAM WAS HELD VIRTUALLY, HYBRID, AND THEN OFFERED IN PERSON OUTDOORS, SOCIALLY DISTANCING IN FY 21. OVER 40 PARTICIPANTS UTILIZED FITNESS EQUIPMENT WHILE VIRTUAL ON ZOOM USING CHROMEBOOKS. IN FY22, ROXBURY TENANTS OF HARVARD DID NOT OFFER THE HEALTHY MOVES PROGRAM. PRIORITY AREA 2: CHRONIC AND COMPLEX CONDITIONS AND THEIR RISK FACTORS HEART DISEASE, STROKE AND CANCER ARE BY FAR THE LEADING CAUSES OF DEATH IN THE NATION, THE COMMONWEALTH, AND IN NEBH'S SERVICE AREA. ROUGHLY 7 IN 10 DEATHS CAN BE ATTRIBUTED TO THESE THREE CONDITIONS. IF YOU INCLUDE RESPIRATORY DISEASE (E.G., ASTHMA, CONGESTIVE HEART FAILURE, AND COPD) AND DIABETES, WHICH ARE IN THE TOP 10 LEADING CAUSES ACROSS NEARLY ALL GEOGRAPHIES THAN ONE CAN ACCOUNT FOR ALL BUT A SMALL FRACTION OF CAUSES OF DEATH. ALL OF THESE CONDITIONS ARE GENERALLY CONSIDERED TO BE CHRONIC AND COMPLEX AND CAN STRIKE EARLY IN ONE'S LIFE, QUITE OFTEN ENDING IN PREMATURE DEATH. IN THIS CATEGORY, HEART DISEASE, DIABETES, AND HYPERTENSION WERE THOUGHT TO BE OF THE HIGHEST PRIORITY, ALTHOUGH CANCER WAS ALSO DISCUSSED FREQUENTLY IN THE FOCUS GROUPS AND FORUMS. HIV/AIDS, OTHER SEXUALLY TRANSMITTED DISEASES AND HEPATITIS C WERE ALSO MENTIONED IN THE ASSESSMENT'S INTERVIEWS AND FOCUS GROUPS AND SHOULD CERTAINLY BE INCLUDED IN THE CHRONIC/COMPLEX CONDITION DOMAIN. IT IS ALSO IMPORTANT TO NOTE THAT THE RISK AND PROTECTIVE FACTORS FOR NEARLY ALL CHRONIC/COMPLEX CONDITIONS ARE THE SAME, INCLUDING TOBACCO USE, LACK OF PHYSICAL ACTIVITY, POOR NUTRITION, OBESITY, AND ALCOHOL USE. GOAL 1: ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING, REFERRAL, AND CHRONIC DISEASE MANAGEMENT SERVICES IN CLINICAL AND NON-CLINICAL SETTINGS TARGET POPULATION: YOUTH, OLDER ADULTS, LOW AND MODERATE INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC / COMPLEX CONDITIONS PROGRAMMATIC OBJECTIVES: 1. INCREASE THE NUMBER OF PEOPLE WHO ARE EDUCATED ABOUT CHRONIC DISEASE RISK FACTORS AND PROTECTIVE BEHAVIORS 2. INCREASE THE NUMBER OF ADULTS WHO ARE ENGAGED IN EVIDENCE-BASED SCREENING, COUNSELING, SELF-MANAGEMENT SUPPORT, CHRONIC DISEASE MANAGEMENT, REFERRAL SERVICES, AND/OR SPECIALTY CARE SERVICES FOR DIABETES, HYPERTENSION, ASTHMA, CANCER, AND OTHER CHRONIC/COMPLEX CONDITIONS 3. INCREASE THE NUMBER OF PEOPLE WITH CHRONIC/COMPLEX CONDITIONS WHOSE CONDITIONS ARE UNDER CONTROL COMMUNITY ACTIVITIES/STRATEGIES: - SUPPORT AND OFFER OPPORTUNITIES FOR CHRONIC DISEASE SELF-MANAGEMENT COURSES - COMMUNITY BENEFIT AND OTHER HOSPITAL STAFF (E.G., NURSING) PARTICIPATE IN COALITION AND OTHER COMMUNITY MEETINGS TO PROMOTE COLLABORATION, SHARE KNOWLEDGE, AND COORDINATE COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. - SUPPORT LITTLE LEAGUE AND SUMMER CAMP PROGRAMS TO ENGAGE YOUTH AND PROMOTE PHYSICAL ACTIVITY - SUPPORT SR. CELTICS PROGRAM TO PROMOTE COMMUNITY ENGAGEMENT - PROVIDE EVIDENCE-BASED HEALTH EDUCATION ON RISK/PROTECTIVE FACTORS, AND SELF MANAGEMENT SUPPORT PROGRAMS THROUGH PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS WITH AN EMPHASIS ON PRIORITY POPULATION SEGMENTS - FITNESS CLASSES - SUPPORT SCREENING, EDUCATION, AND REFERRAL PROGRAMS IN CLINICAL AND NONCLINICAL SETTINGS THAT SCREEN, EDUCATE, AND REFER PATIENTS IN NEED OF FURTHER ASSESSMENT AND CHRONIC DISEASE MANAGEMENT SUPPORTS (E.G., BLOOD PRESSURE, DIABETES, STROKE, CANCER) - ORGANIZE NEBH ""HOUSE CALL"" EVENTS HOSTED BY HOSPITAL CLINICAL STAFF RELATED TO AWARENESS, EDUCATION, AND THE MANAGEMENT OF CHRONIC AND COMPLEX CONDITIONS IN TARGETED COMMUNITY-BASED SETTINGS - SUPPORT YOGA FOR OLDER ADULTS - SUPPORT AND PROMOTE THE DEVELOPMENT OF COMMUNITY WORKSHOPS, WEIGHT LOSS CLASSES, AND EDUCATIONAL SESSIONS. METRICS AND STATUS UPDATE: - IN FY20, NEBH DONATED 10 CHROMEBOOKS FOR OLDER ADULTS TO ROXBURY TENANTS OF HARVARD (RTH). THE CHROMEBOOKS WERE USED IN FY20, FY21 AND FY22 BY OLDER ADULTS FOR TELEHEALTH VISITS, MEETINGS, EXERCISE PROGRAM HEALTHY MOVES, ARTS AND CRAFTS, AND CHAIR YOGA. OVER 220 OLDER ADULTS RESERVED THE CHROMEBOOKS FOR APPOINTMENTS, ARTS AND CRAFTS AND EXERCISE. RESIDENTS HAVE RETURNED TO IN PERSON EVENTS AND APPOINTMENTS.- IN FY20 AND FY21, NEBH PROVIDED FINANCIAL SUPPORT FOR A WALKING GROUP FOR OLDER ADULTS TO HELP WITH ISOLATION, KEEP THEM ACTIVE AND MOVING. OVER 60 OLDER ADULTS PARTICIPATE IN THE WALKING GROUP THAT WALKED TWICE A WEEK. - IN FY20, FY21 AND FY22, NEBH PROVIDED FINANCIAL SUPPORT FOR THE SUMMER CAMP AT THE TOBIN COMMUNITY CENTER. THE SUPPORT ALLOWS 15 YOUTH TO PARTICIPATE IN THE SUMMER CAMP. THE CAMP ENCOURAGES YOUNG CHILDREN TO EXERCISE AND KEEP ACTIVE HELPING IN THE PREVENTION OF OBESITY. - IN FY22, NEBH PROVIDED FINANCIAL SUPPORT FOR THE AFTER SCHOOL PROGRAM AT THE TOBIN COMMUNITY CENTER. THIS ALLOWS YOUTH TO PARTICIPATE IN TUTORING, AND EXTRACURRICULAR ACTIVITIES INCLUDING SPORTS PROGRAMS.- IN FY20, FY21 AND FY22, NEBH PROVIDED FINANCIAL SUPPORT FOR MINDFUL MOVEMENT, A WEEKLY YOGA CLASS FOR OLDER ADULTS LIVING IN MISSION HILL. - NEBH ALSO PROVIDED FINANCIAL ASSISTANCE TO THE MIGHTY MISSION BASKETBALL YOUTH TEAMS AS WELL AS THE MISSION HILL LITTLE LEAGUE IN FY20, FY21 AND FY22. - NEBH COLLABORATED WITH THE BOSTON CELTICS HELD 3 SR. CELTICS PROGRAMS FOR OLDER ADULTS IN FY22. THE PROGRAM WAS SUSPENDED IN FY 20 AND FY21 DUE TO COVID-19. GOAL 2: REDUCE THE PREVALENCE OF TOBACCO USE TARGET POPULATION: YOUTH, OLDER ADULTS, LOW TO MODERATE INCOME POPULATIONS, INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS PROGRAMMATIC OBJECTIVES: 1. INCREASE THE NUMBER OF PEOPLE WHO ARE ABLE TO STOP SMOKING CIGARETTES VAPING, OR USING E-CIGARETTES 2. INCREASE ACCESS TO TOBACCO, VAPING/E-CIGARETTE CESSATION PROGRAMS COMMUNITY ACTIVITIES/STRATEGIES: - ORGANIZE, FACILITATE, OR SUPPORT SMOKING CESSATION PROGRAMS GEARED TO REDUCING TOBACCO, VAPING AND E-CIGARETTE USE METRICS AND STATUS UPDATE: - PROGRAM WAS NOT HELD DUE TO COVID-19 AND LACK OF COMMUNITY INTEREST. TWO FACTORS THAT MAY HAVE CONTRIBUTED TO THIS, THE PANDEMIC CUT DOWN SOCIAL INTERACTION WITH PEERS AND YOUTH HAD MORE PARENTAL OVERSIGHT WITH FAMILIES BEING HOME TOGETHER. NEBH KNOWS THIS IS IMPORTANT TO THE HEALTH AND WELLBEING OF RESIDENTS, NEBH OFFERED TO FINANCIALLY SUPPORT THE PROGRAM IN ITS CBSA, BUT YOUTH AND OLDER ADULTS WERE NOT INTERESTED IN PARTICIPATING IN A PROGRAM."

COMMUNITY PARTNERS
NEBH 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:- ABCD PARKER HILL/FENWAY NEIGHBORHOOD SERVICE CENTER- ALICE HEYWARD TAYLOR HOUSING DEVELOPMENT- BOSTON BUILDING MATERIALS RESOURCE CENTER- BOSTON CELTICS - BOSTON CENTER FOR YOUTH AND FAMILY SERVICES- BOSTON POLICE DEPARTMENT- BOSTON PUBLIC HEALTH COMMISSION- BOSTON PUBLIC LIBRARY, MISSION HILL BRANCH- CITY OF BOSTON AGE STRONG COMMISSION- CITY OF BOSTON MAYOR'S OFFICE- CITY OF BOSTON, PARKS AND RECREATION DEPARTMENT- FRIENDS OF MCLAUGHLIN PARK - MADISON PARK HIGH SCHOOL- MARIA SANCHEZ HOUSE- MAURICE J. TOBIN SCHOOL- MISSION CHURCH- MISSION GRAMMAR SCHOOL- MISSION HILL CRIME COMMITTEE- MISSION HILL HEALTH MOVEMENT- MISSION HILL LITTLE LEAGUE- MISSION HILL MAIN STREETS- MISSION HILL NEIGHBORHOOD HOUSING SERVICES- MISSION HILL ROAD RACE- MISSION HILL SENIOR LEGACY PROJECT- MISSION LINK- MISSION MAIN TASK FORCE- MORGAN MEMORIAL GOODWILL INDUSTRIES- ONE GURNEY STREET APARTMENTS- PRIVATE INDUSTRY COUNCIL- PROJECT SEARCH- ROXBURY TENANTS OF HARVARD- SOCIEDAD LATINA- STOP & SHOP- TOBIN COMMUNITY CENTER- WENTWORTH INSTITUTE OF TECHNOLOGY AS DESCRIBED IN DETAIL IN THIS SUPPORTING NARRATIVE TO THE FORM 990 SCHEDULE H, NEBH 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 NEBH'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: DIGITAL DIVIDE (I.E., PROMOTING EQUITABLE ACCESS TO THE INTERNET) SUPPORTING EDUCATION ACROSS THE LIFESPAN, ADDRESSING POOR AIR QUALITY, AND ADDRESSING GENTRIFICATION. WHILE THESE ISSUES ARE IMPORTANT, NEBH'S CBAC AND SENIOR LEADERSHIP TEAM DECIDED THAT THESE ISSUES WERE OUTSIDE OF THE ORGANIZATION'S SPHERE OF INFLUENCE AND INVESTMENTS IN OTHERS AREAS WERE BOTH MORE FEASIBLE AND LIKELY TO HAVE GREATER IMPACT. AS A RESULT, NEBH RECOGNIZED THAT OTHER PUBLIC AND PRIVATE ORGANIZATIONS IN ITS CBSA AND THE COMMONWEALTH WERE BETTER POSITIONED TO FOCUS ON THESE ISSUES. NEBH REMAINS OPEN AND WILLING TO WORK WITH COMMUNITY RESIDENTS, OTHER HOSPITALS, AND OTHER PUBLIC AND PRIVATE PARTNERS TO ADDRESS THESE ISSUES, PARTICULARLY AS PART OF A BROAD, STRONG COLLABORATIVE.IN ADDITION, THERE WERE SOME NEEDS IDENTIFIED IN THE 2019 CHNA THAT ARE NOT INCLUDED IN THE 2019 IS AND WHICH HAVE GUIDED THE NEBH'S COMMUNITY BENEFITS ACTIVITIES THE PERIOD FOR THE FISCAL PERIOD COVERED BY THIS FILING. NEBH WILL BE UNABLE TO ADDRESS THESE NEEDS DUE TO LIMITED FINANCIAL RESOURCES. IT IS IMPORTANT TO NOTE THAT THERE ARE COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED BY NEBH'S ASSESSMENT THAT, DUE TO THE LIMITED BURDEN THAT THESE ISSUES PRESENT AND/OR THE FEASIBILITY OF HAVING AN IMPACT IN THE SHORT- OR LONG-TERM ON THESE ISSUES, WERE NOT PRIORITIZED FOR INVESTMENT. NAMELY, EDUCATION AND BEHAVIORAL HEALTH WERE IDENTIFIED AS COMMUNITY NEEDS BUT THESE ISSUES WERE DEEMED BY THE CBC AND THE COMMUNITY BENEFITS LEADERSHIP TEAM TO BE OUTSIDE OF NEBH'S PRIMARY SPHERE OF INFLUENCE AND HAVE OPTED TO ALLOW OTHERS IN ITS CBSA AND THE COMMONWEALTH TO FOCUS ON THESE ISSUES. THIS IS NOT TO SAY THAT NEBH WILL NOT SUPPORT EFFORTS IN THESE AREAS. NEBH REMAINS OPEN AND WILLING TO WORK WITH HOSPITALS ACROSS BETH ISRAEL LAHEY HEALTH'S NETWORK AND OTHER PUBLIC AND PRIVATE PARTNERS TO ADDRESS THESE ISSUES, PARTICULARLY AS PART OF A BROAD, STRONG COLLABORATIVE.AS NOTED IN DETAIL ABOVE, THE NEBH'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 NEBH CARES FOR ITS COMMUNITY BY PROVIDING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS. AS DEMONSTRATED IN THIS SCHEDULE H, 5.40% OF NEBH'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, NEBH'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 COMMUNITY BENEFITS NEW ENGLAND BAPTIST HOSPITAL (NEBH.ORG). 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 NEBH FILED WITH THE ATTORNEY GENERAL'S OFFICE. EMERGENCY CARE ACCESSAS REPORTED IN THIS FORM 990, SCHEDULE H, PART V, SECTION A, NEBH IS A GENERAL MEDICAL AND SURGICAL HOSPITAL AND TEACHING HOSPITAL. AS ALSO PREVIOUSLY NOTED IN THIS FORM 990, NEBH IS NOT LICENSED TO OPERATE AN EMERGENCY DEPARTMENT, HOWEVER, NEBH STILL PROVIDES CARE TO ALL WHO NEED URGENT CARE, REGARDLESS OF THEIR ABILITY TO PAY. ALL PATIENTS WHO PRESENT AT NEBH ARE TRIAGED TO THE APPROPRIATE VENUE FOR THEIR CARE DEPENDING UPON THEIR CLINICAL PRESENTATION. A CLINICAL RESOURCE NURSE AND HOSPITALIST COLLABORATE TO IDENTIFY VENUE PRIOR TO THE ARRIVAL OF THE PATIENT IF POSSIBLE. THE HOSPITALIST WILL MAKE A DETERMINATION AS TO THE BEST PATIENT DISPOSITION. CLINICAL SITUATIONS RECEIVED BY PHONE OR WALK-IN REQUIRING EMERGENCY MANAGEMENT ARE DIRECTED TO THE NEAREST EMERGENCY DEPARTMENT, SUCH AS BETH ISRAEL DEACONESS MEDICAL CENTER (BIDMC) WHICH IS LOCATED APPROXIMATELY ONE MILE FROM NEBH. BIDMC AND NEBH ARE BOTH MEMBER HOSPITALS OF BETH ISRAEL LAHEY HEALTH AND BIDMC IS A TERTIARY CARE ACADEMIC MEDICAL CENTER WHICH OPERATES A LEVEL 1 TRAUMA EMERGENCY DEPARTMENT 24 HOURS A DAY, 7 DAYS A WEEK. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS TESTED GOVERNMENT PROGRAMSFINANCIAL ASSISTANCENEBH'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 $1,284,070 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, NEBH 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.

CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS HEALTH PROFESSIONS EDUCA
NEW ENGLAND BAPTIST HOSPITAL'S CENTRAL LONGSTANDING ACADEMIC FOCUS IN ORTHOPEDIC 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 NEBH A TOP CHOICE AMONG STUDENTS AND TRAINEES IN THE HEALTH CARE PROFESSIONS. THE HOSPITAL TRAINS MEDICAL RESIDENTS AND FELLOWS.NEBH IS A TEACHING HOSPITAL, WITH APPROXIMATELY 20 ORTHOPEDIC AND RADIOLOGY INTERNS WHO ROTATE THROUGHOUT THE YEAR FROM MULTIPLE INSTITUTIONS, AND 3 SPORTS FELLOWS DURING ACADEMIC YEAR JULY 1, 2021 JUNE 30, 2022 WHICH OVERLAPS WITH A PORTION OF NEBH'S FISCAL YEAR ACTIVITIES REPORTED IN THIS FILING. DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH HAD NET EXPENDITURES OF $ REPORTED ON THIS SCHEDULE H, PART I, LINE 7F RELATED TO NEBH'S RESIDENCY PROGRAM WHICH REPRESENTED X% OF NEBH'S TOTAL EXPENSES.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, NEBH ALSO PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN OTHER PROGRAMS DESIGNED TO SUPPORT LOW-INCOME FAMILIES, INCLUDING PARTICULARLY THE MEDICAID PROGRAM, WHICH IS JOINTLY FUNDED BY FEDERAL AND STATE GOVERNMENTS. THE MASSACHUSETTS HEALTH REFORM LAW PROVIDED AN INITIATIVE FOR EXPANSION OF MEDICAID COVERAGE TO GREATER POPULATIONS AND FOR ENROLLMENT OF UNINSURED PATIENTS IN OTHER INSURANCE PROGRAMS. PAYMENTS FROM MEDICAID AND OTHER PROGRAMS THAT INSURE LOW-INCOME POPULATIONS DO NOT COVER THE COST OF SERVICES PROVIDED. DURING THE FISCAL PERIOD COVERED BY THIS FILING, NEBH GENERATED $1,452,551 RELATED TO TREATING MEDICAID PATIENTS WHICH WAS LESS THAN THE COST OF CARE PROVIDED BY NEBH FOR SUCH SERVICES BY $1,983,724 AS REPORTED ON THIS SCHEDULE H, PART I LINE 7B. DURING THE FISCAL PERIOD COVERED BY THIS FILING,1.9% OR 2,267 OF NEBH'S PATIENT ENCOUNTERS WERE WITH MEDICAID PATIENTS. IN ADDITION. 51% OR 60,329 OF THE HOSPITAL'S PATIENT CASES WERE WITH MEDICAID PATIENTS. MEDICARE IS THE FEDERALLY SPONSORED HEALTH INSURANCE PROGRAM FOR ELDERLY OR DISABLED PATIENTS, AND NEBH PROVIDES CARE TO PATIENTS WHO PARTICIPATE IN THE MEDICARE PROGRAM. DURING THE FISCAL PERIOD COVERED BY THIS FILING, NEBH GENERATED $77,042,731 RELATED TO TREATING MEDICARE PATIENTS. THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS EXCEEDED REVENUE BY $17,672,318. OF THESE AMOUNTS, REVENUE OF $3,386,968 IS RELATED TO THE PROVISION OF NEBH SURGICAL HOUSE OFFICER, NEBH HOSPITALISTS, NEBH ORTHOPEDIC SPECIALTY PRACTICE, AND PSYCHIATRIC CARE & COUNSELING 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 $3,200,396. IN RESPONSE TO THE FORM 990, SCHEDULE H, PART III, LINE 8, ALTHOUGH NEBH 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, NEBH 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 0.79%.BAD DEBTSIN ADDITION TO CHARITY CARE AND SHORTFALLS IN PROVIDING SERVICES TO PATIENTS INSURED UNDER STATE AND FEDERAL PROGRAMS, NEBH 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 $669,448 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, 2020 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).EMERGENCY CARE ACCESSBETH ISRAEL DEACONESS MEDICAL CENTER IS A TERTIARY CARE LICENSED ACADEMIC MEDICAL CENTER, PROVIDING MEDICAL AND SURGICAL CARE, TEACHING AND RESEARCH AND AS NOTED ELSEWHERE IN THIS RETURN, PROVIDES 24 HOUR EMERGENCY MEDICAL CARE TO ALL PATIENTS WITHOUT REGARD TO ABILITY TO PAY. THE ED'S MISSION, ALIGNED WITH BIDMC'S MISSION, IS TO DISTINGUISH ITSELF FROM OTHER PROVIDERS THROUGH EXCELLENCE IN PATIENT CARE, EDUCATION, RESEARCH AND THROUGH IMPROVED HEALTH IN THE COMMUNITIES SERVED. BIDMC'S DEPARTMENT OF EMERGENCY MEDICINE, PROVIDES MEDICALLY NECESSARY CARE FOR ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY 24 HOURS A DAY, SEVEN DAYS A WEEK, AND 365 DAYS A YEAR (SCHEDULE H, PART V, SECTION A AND SECTION B QUESTION 21).THE NEBH 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 POLICY-INTERNAL REVENUE CODE SECTION 501(R)(4)
FINANCIAL ASSISTANCE POLICY PURPOSE NEBH 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 NEBH AS WELL AS PROVIDERS WHO FOLLOW NEBH'S FINANCIAL ASSISTANCE POLICY. A LIST OF ALL PROVIDERS WHO PROVIDE CARE WITHIN NEBH AS WELL AS INFORMATION INDICATING IF THE LISTED PROVIDERS FOLLOW NEBH'S FINANCIAL ASSISTANCE POLICY IS INCLUDED IN APPENDIX 5 TO THE FINANCIAL ASSISTANCE POLICY. NEBH 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 POLICYELIGIBILITY 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: TRADITIONAL CHINESE, SIMPLIFIED CHINESE, KOREAN, AND SPANISH. SCHEDULE H PART V SECTION B QUESTION 16I)

FINANCIAL ASSISTANCE POLICY-WIDELY PUBLICIZING AND AVAILABILITY
COPIES 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 FINANCIAL SERVICES GUIDE NEW ENGLAND BAPTIST HOSPITAL (NEBH.ORG). 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 NEBH 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 ENGLISH, SPANISH, CHINESE, CAN BE FOUND ON THE NEBH WEBSITE AT: HTTPS://WWW.NEBH.ORG/PATIENTS-CARE-PARTNERS/FINANCIAL-RESOURCES/FINANCIAL-SERVICES-GUIDE/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 RESEARCHTHE NEBH DIVISION OF RESEARCH SUPPORTS EXISTING RESEARCH GROUPS WITHIN AND OUTSIDE OF THE HOSPITAL IN CLINICAL, TRANSACTIONAL, AND PATIENT-CENTERED RESEARCH, WITH A FOCUS ON THREE KEY AREAS: JOINT REPLACEMENT, OSTEOARTHRITIS, AND SPINE RESEARCH. DURING THE FISCAL YEAR COVERED BY THIS FILING, NEBH REPORTED $811,299 OF NET INTERNALLY FUNDED RESEARCH ON THIS SCHEDULE H, PART I, LINE 7H RELATED TO RESEARCH TO FURTHER SCIENCE AND PATIENT CARE. DURING FY 2022, THE NEBH DEPARTMENT OF RESEARCH PROVIDED SUPPORT TO RESEARCHERS, INCLUDING ORTHOPAEDIC SURGEONS (ARTHROPLASTY, SPINE, AND SPORTS), PHYSICIANS (INFECTION DISEASE AND RADIOLOGY), NURSES, AND PHYSICAL THERAPISTS ARE 1) CONSULTATION ON IRB APPLICATION; 2) CONSULTATION ON STUDY DESIGN AND METHODOLOGY; 3) BUILDING DATABASES OR DATA COLLECTION TOOLS; 4) COLLECTION OF STUDY DATA; 5) DATA ANALYSIS; 6) WRITING SCIENTIFIC MANUSCRIPT; 7) JOURNAL AND CONFERENCE SUBMISSIONS; 8) ORGANIZING RESEARCH MEETINGS AND MONITOR PROJECT TIMELINE; 9) MANAGEMENT OF SPONSORED CLINICAL TRIALS; 10) ORGANIZING THE COLLABORATION WITH RESEARCHERS AT OTHER LOCAL RESEARCH AND TEACHING INSTITUTIONS).SPECIFIC RESEARCH PROJECTS AND AREAS OF RESEARCH WERE:A. MARKETSCAN DATABASE RESEARCH SERIES ALSO A COLLABORATION WITH MGH CODMAN FELLOWSHIP PROGRAM: I. HEALTH SERVICES UTILIZATION AND COST IN A VARIETY OF ORTHOPAEDIC SURGERY SETTINGSII. SURGICAL OUTCOMES OF TOTAL JOINT ARTHROPLASTY AND SPINE SURGERIES AMONG PATIENT POPULATIONS WITH DIFFERENT PREOPERATIVE HEALTH CONDITIONSIII. COMPARING COST OF CARE OF ELECTIVE ORTHOPAEDIC SURGERIES BETWEEN INPATIENT AND OUTPATIENT SETTINGSIV. EFFICIENCY OF INTERVENTIONS AND POLICIES ON PREVENTION OF PROSTHETIC JOINT INFECTIONSB. INNOVATIVE TREATMENT OPTIONS ON CHRONIC INFECTIONS IN ORTHOPAEDIC SURGERYC. RARE POSTOPERATIVE COMPLICATIONS (INCL. SCIATIC NERVE PALSY, CORROSION, URINARY RETENTION, ETC.) AMONG TOTAL JOINT ARTHROPLASTY PATIENTSD. PATIENT REPORTED OUTCOMES (PROS) IMPROVEMENTS AMONG SPINE PATIENTS;E. SURGEON'S ENERGY EXPENDITURE DURING TOTAL JOINT ARTHROPLASTYF. PERCEIVED VALUE OF NURSE SPECIALTY CERTIFICATION IN AN ORTHOPAEDIC SPECIALTY HOSPITAL.

NEW ENGLAND BAPTIST HOSPITAL BIBLIOGRAPHY 2022 (CONTINUED)
56. REVISION ARTHROSCOPIC BANKART REPAIR FOR ANTERIOR SHOULDER INSTABILITY AFTER A FAILED ARTHROSCOPIC SOFT-TISSUE REPAIR YIELDS COMPARABLE FAILURE RATES TO PRIMARY BANKART REPAIR: A SYSTEMATIC REVIEW.SHANMUGARAJ A, SAKHA S, TEJPAL T, LEROUX T, KIRSCH JM, KHAN M.HSS J. 2022 FEB;18(1):145-155. DOI: 10.1177/15563316211030606.PMID: 3508256057. RISK FACTORS FOR SURGICAL SITE INFECTIONS IN KNEE AND HIP ARTHROPLASTY PATIENTS.SIMON S, HOLLENBECK B.AM J INFECT CONTROL. 2022 FEB;50(2):214-216. DOI: 10.1016/J.AJIC.2021.11.006. PMID: 3479388958. PREDICTORS OF POOR AND EXCELLENT OUTCOMES AFTER REVERSE TOTAL SHOULDER ARTHROPLASTY.FORLIZZI JM, PUZZITIELLO RN, HART PA, CHURCHILL R, JAWA A, KIRSCH JM.J SHOULDER ELBOW SURG. 2022 FEB;31(2):294-301.PMID: 3441172559. ROTATOR CUFF FATTY INFILTRATION AND MUSCLE ATROPHY: RELATION TO GLENOID DEFORMITY IN PRIMARY GLENOHUMERAL OSTEOARTHRITIS.MOVERMAN MA, PUZZITIELLO RN, MENENDEZ ME, PAGANI NR, HART PJ, CHURCHILL RW, KIRSCH JM, JAWA A.J SHOULDER ELBOW SURG. 2022 FEB;31(2):286-293.PMID: 3439084060. ASPIRIN THROMBOPROPHYLAXIS IN JOINT REPLACEMENT SURGERY.SHARDA AV, FATOVIC K, BAUER KA.RES PRACT THROMB HAEMOST. 2022 JAN 24;6(1):E12649. DOI: 10.1002/RTH2.12649. PMID: 35106432 61. ACUTE PROXIMAL HAMSTRING TEARS CAN BE DEFINED USING AN IMAGED-BASED CLASSIFICATION.FORLIZZI JM, NACCA CR, SHAH SS, SAKS B, CHILTON M, MACASKILL M, FANG CJ, MILLER SL.ARTHROSC SPORTS MED REHABIL. 2022 JAN 19;4(2):E653-E659. DOI: 10.1016/J.ASMR.2021.12.007. PMID: 35494306 62. SHARED DECISION-MAKING IS ASSOCIATED WITH BETTER OUTCOMES IN PATIENTS WITH KNEE BUT NOT HIP OSTEOARTHRITIS: THE DECIDE-OA RANDOMIZED STUDY.SEPUCHA KR, VO H, CHANG Y, DORRWACHTER JM, DWYER M, FREIBERG AA, TALMO CT, BEDAIR H.J BONE JOINT SURG AM. 2022 JAN 5;104(1):62-69. PMID: 3443730863. INVESTIGATING A POTENTIAL LIMIT TO ACCESS TO CARE: PREOPERATIVE CUTOFF VALUES FOR BODY MASS INDEX FOR SHOULDER ARTHROPLASTY.SAINI S, BONO O, LI L, MACASKILL M, CHILTON M, ROSS G, SHAH S.J AM ACAD ORTHOP SURG. 2022 JAN 1;30(1):E67-E73. PMID: 3428890264. FUNCTIONAL SOMATIC SYNDROMES ARE ASSOCIATED WITH SUBOPTIMAL OUTCOMES AND HIGH COST AFTER SHOULDER ARTHROPLASTY.MOVERMAN MA, PUZZITIELLO RN, PAGANI NR, MOON AS, HART PA, KIRSCH JM, JAWA A, MENENDEZ ME.J SHOULDER ELBOW SURG. 2022 JAN;31(1):48-55. PMID: 3411619465. COMBINED TREATMENT OF INTRAOPERATIVE CELL-SALVAGE AND TRANEXAMIC ACID FOR PRIMARY UNILATERAL TOTAL HIP ARTHROPLASTY: ARE THERE ADDED BENEFITS?MILLER TM, FANG C, HAGAR A, ANDERSON M, GAD B, TALMO CT.J ORTHOP SCI. 2022 JAN;27(1):158-162. PMID: 3334135666. BONY HYPERTROPHY IN VASCULARIZED FIBULAR GRAFTS.SHI LL, GARG R, JAWA A, WANG Q, CHAI Y, ZENG B, JUPITER JB.HAND (N Y). 2022 JAN;17(1):106-113. PMID: 3198480367. NONOPERATIVE TREATMENT OF SINGLE-TENDON PROXIMAL HAMSTRING AVULSIONS IN RECREATIONAL ATHLETES. BONO OJ, FORLIZZI J, SHAH SS, NACCA CR, MANZ E, IVES K, MILLER SL. SPORTS MEDICINE INTERNATIONAL OPEN. 2022 DEC 8(AAM).68. REDUCING THE PRICE OF TOTAL HIP ARTHROPLASTY IMPLANT COSTS THROUGH REFERENCE PRICING: AN ECONOMIC EVALUATION.FANG CJ, SHAKER JM, WARD DM, TALMO CT, JAWA A, MATTINGLY DA, SMITH EL. AMERICAN HEALTH & DRUG BENEFITS. 2022 DEC 1;15(4).69. HIGH LEVELS OF SATISFACTION AND ADEQUATE PATIENT-REPORTED OUTCOMES AFTER OPERATIVE RECONSTRUCTION OF MULTILIGAMENT KNEE INJURY WITH ALLOGRAFT AMONG PATIENTS AGED 40 YEARS AND OLDER. TOPPO AJ, PERRONE GS, SYLVIA SM, MILTENBERG BH, POWER LH, RICHMOND JC, SALZLER MJ. ARTHROSCOPY, SPORTS MEDICINE, AND REHABILITATION. 2022 DEC 16.70. SPINE SURGEON ASSESSMENTS OF PATIENT PSYCHOLOGICAL DISTRESS ARE INACCURATE AND BIAS TREATMENT RECOMMENDATIONS. MOON, ANDREW S. MDA; MENENDEZ, MARIANO E. MDA; MOVERMAN, MICHAEL A. MDA; PROAL, JOSHUA D BSB; KIM, DAVID H. MDC; OHAEGBULAM, CHIMA MDC; KWON, BRIAN MDC. SPINE ():10.1097/BRS.0000000000004567, DECEMBER 28, 2022. 71. THE TREND AND FUTURE PROJECTION OF TECHNOLOGY-ASSISTED TOTAL KNEE ARTHROPLASTY IN THE UNITED STATES.LAN YT, CHEN YW, NIU R, CHANG DC, HOLLENBECK BL, MATTINGLY DA, SMITH EL, TALMO CT. INT J MED ROBOT. 2023 FEB;19(1):E2478. DOI: 10.1002/RCS.2478. EPUB 2022 NOV 15. PMID: 36321582.72. THE COST OF STIFFNESS AFTER TOTAL KNEE ARTHROPLASTY. OLSEN AA, NIN DZ, CHEN YW, NIU R, CHANG DC, SMITH EL, TALMO CT. THE JOURNAL OF ARTHROPLASTY. DOI.ORG/10.1016/J.ARTH.2022.10.040. EPUB 2022 OCT 29.

INTERNSHIP
"THE INTERNSHIP YEAR EMPHASIZES THE CARE OF PATIENTS IN GENERAL INPATIENT MEDICINE, INTENSIVE CARE MEDICINE, ONCOLOGY, CARDIOLOGY, EMERGENCY MEDICINE AND AMBULATORY CARE UTILIZING BOTH CAMPUSES AND SELECTED OUTSIDE SITES. WORKING AS PART OF A 2-4 PHYSICIAN TEAM WHICH INCLUDES AN OVERSEEING RESIDENT, ATTENDING STAFF AND OFTEN MEDICAL STUDENTS, INTERNS GAIN EXPERIENCE IN THE MANAGEMENT OF PATIENTS WITH A BROAD RANGE OF MEDICAL DISEASES. INTERNS HAVE PRIMARY RESPONSIBILITY FOR THE CARE OF ALL PATIENTS ADMITTED TO THE MEDICAL WARD SERVICE AND ARE CONSIDERED THEIR PATIENT'S PRIMARY INPATIENT DOCTOR FOR THE DURATION OF THE HOSPITALIZATION. THROUGHOUT INTERN YEAR, INTERNS MAINTAIN A LONGITUDINAL CONTINUITY CLINIC EXPERIENCE WHERE THEY DEVELOP A PANEL OF THEIR OWN PRIMARY CARE PATIENTS. DURING MOST OF THE YEAR, WITH THE EXCEPTION OF INTENSIVE CARE ROTATIONS, AN INTERN WILL HAVE CLINIC ONE HALF-DAY PER WEEK. DISTRIBUTED THROUGHOUT THE YEAR ARE FOUR ""AMBULATORY BLOCKS"" OF TWO WEEKS DURATION. DURING THIS TIME THE INTERN IS IN THEIR CONTINUITY CLINIC EVERY AFTERNOON AND ATTENDS OUTPATIENT SPECIFIC DIDACTIC LECTURES DURING THE MORNING HOURS. AS MEMBERS OF THE HARVARD FACULTY, INTERNS PLAY AN IMPORTANT ROLE IN TEACHING, BOTH OF THEIR PEERS AND OF ROTATING MEDICAL STUDENTS. WHILE ON THE MEDICAL WARDS, INTERNS PROVIDE DAILY CLINICAL GUIDANCE AND TEACHING TO THIRD AND FOURTH YEAR MEDICAL STUDENTS. AS PART OF THE AMBULATORY CARE CURRICULUM, INTERNS WILL ALSO HAVE THE OPPORTUNITY TO LEAD PRE-CLINIC CONFERENCES. DURING THE YEAR, THERE ARE SPECIAL INTERN-ONLY EDUCATIONAL ACTIVITIES INCLUDING THE TWICE-WEEKLY INTERN REPORT, MONTHLY INTERN FORUM SESSIONS AND BI-ANNUAL 24-HOUR INTERN RETREATS.JUNIOR AND SENIOR RESIDENCYRESIDENCY SOLIDIFIES CLINICAL AND TEACHING SKILLS AND ALLOWS TRAINEES TO EXPERIENCE LEADERSHIP OF A MEDICAL TEAM. JUNIOR RESIDENCY PROVIDES THE FIRST OPPORTUNITY FOR RESIDENTS TO SUPERVISE HOUSESTAFF TEAMS ON GENERAL MEDICAL SERVICES AND IN THE MEDICAL AND CARDIAC INTENSIVE CARE UNITS. SENIOR RESIDENCY PROMOTES CONSOLIDATION AND REFINEMENT OF THESE SKILLS, WITH ATTENDINGS ALLOWING INCREASING AUTONOMY. THE RESIDENT ON THE SERVICE IS LOOKED ON AS THE TEAM LEADER AND ASSUMES PRIMARY RESPONSIBILITY FOR TEACHING OF THE TEAM. RESIDENCY ALSO PROVIDES OPPORTUNITIES FOR INCREASED ELECTIVE TIME TO SAMPLE SUBSPECIALTY ROTATIONS. THIS PROVIDES ADDITIONAL SPECIALTY TRAINING IN AREAS OF INTEREST. THE ELECTIVE OPPORTUNITIES ARE DIVERSE, RANGING FROM ELECTROPHYSIOLOGY TO MUSCULOSKELETAL MEDICINE TO HEALTH POLICY. RESIDENTS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN ONE OF SEVERAL ""TRACKS"" WITHIN THE RESIDENCY PROGRAM IF INTERESTED IN ADDITIONAL SPECIFIC TRAINING RESOURCES AND EXPERIENCES.TEACHING AS A RESIDENTAS MENTIONED ABOVE, RESIDENTS ARE VIEWED AS SOME OF THE PRIMARY TEACHERS WITHIN THE DEPARTMENT OF MEDICINE. SOME OF THESE TEACHING OPPORTUNITIES WILL ALSO BE OBSERVED BY DEPARTMENT FACULTY TO HELP THE RESIDENT REFINE THE STYLE AND EFFECTIVENESS OF THEIR TEACHING. TEACHING OPPORTUNITIES WILL INCLUDE:LEADING INPATIENT MEDICINE ROUNDS: - RESIDENTS ARE IN CHARGE OF RUNNING WARD ROUNDS. MEDICAL STUDENTS AND INTERNS PRESENT TO THE RESIDENT DURING ROUNDS. THE ATTENDING HOSPITALIST IS CONSIDERED THE RESIDENT'S CONSULTANT, WITH THE RESIDENT RETAINING THE PRIMARY DECISION-MAKING ROLE FOR THE PATIENTS ON THEIR SERVICE.- DURING THE MONTHS ON MEDICAL WARDS, THE CHIEF RESIDENTS AND FIRM CHIEFS ARE ASSIGNED TO DO WALK ROUND ONCE EACH WEEK WITH ONE OF THE RESIDENTS ON THEIR FIRM. THEY WILL OBSERVE THE RESIDENT RUNNING THE WARD ROUNDS AND PROVIDE FEEDBACK ON THE TEACHING SKILLS OBSERVED DURING ROUNDS.LEADING TEACHING ATTENDING ROUNDS: - DURING EVERY ROTATION ON THE MEDICAL WARDS, EACH RESIDENT WILL LEAD ONE TO THREE ATTENDING ROUNDS SESSIONS. THE TWO TEACHING ATTENDINGS HELP PROVIDE FEEDBACK ON THE RESIDENT'S SMALL GROUP DISCUSSION AND TEACHING SKILLS. SMALL GROUP PRESENTATIONS: - DURING AMBULATORY WEEKS, RESIDENTS WILL LEAD A MAJORITY OF THE PRE-CLINIC CONFERENCES, TYPICALLY PRESENTING EITHER A CHALLENGING AMBULATORY CASE OR AMBULATORY-BASED TOPIC.- ONCE DURING RESIDENCY, EACH JUNIOR RESIDENT WILL ALSO PRESENT A JOURNAL ARTICLE OF AMBULATORY CARE SIGNIFICANCE AT AMBULATORY JOURNAL CLUB TO A SMALL GROUP OF THEIR PEERS. INTERNAL MEDICINE GLOBAL HEALTH PROGRAMOUR MISSION IS TO TRAIN LEADERS IN GLOBAL HEALTH TO BE EFFECTIVE PRACTITIONERS IN UNDERSERVED, RESOURCE-LIMITED SETTINGS AND TO DESIGN, MANAGE, IMPROVE AND EVALUATE GLOBAL PUBLIC HEALTH PROGRAMS THAT ADDRESS THE HEALTH PROBLEMS OF THE WORLD'S NEEDIEST POPULATIONS.PROGRAM OBJECTIVES - INTRODUCE GLOBAL HEALTH ISSUES TO BIDMC MEDICAL RESIDENTS - CONTRIBUTE TO THE HEALTH AND WELL-BEING OF UNDERSERVED POPULATIONS IN BOSTON AND AROUND THE WORLD - ENRICH THE MEDICAL KNOWLEDGE AND ENHANCE THE CLINICAL SKILLS OF RESIDENTS BY PRACTICING IN UNIQUE SETTINGS WITH LIMITED RESOURCES - EXPAND RESEARCH OPPORTUNITIES - ADVANCE THE CAREERS OF BIDMC RESIDENTS IN THE FIELDS OF INTERNATIONAL HEALTH, PUBLIC POLICY AND RESEARCH SITE LOCATIONS - BOTSWANA: THE DEPARTMENT HAS A PERMANENT PRESENCE IN BOTSWANA WITH A MEMBER OF OUR DEPARTMENT FULL-TIME AT SCOTTISH LIVINGSTONE HOSPITAL IN MOLEPOLOLE, BOTSWANA. - VIETNAM: THE MEDICAL CENTER HAS A PERMANENT PRESENCE IN VIETNAM. PHYSICIAN AND NURSE TRAINING ON HIV/AIDS CARE IN VIETNAM TAKES PLACE THROUGH FUNDING FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. - ADDITIONAL LOCATIONS: THE DEPARTMENT OFFERS ROTATIONS AT THE ALBERT SCHWEITZER HOSPITAL IN GABON AND OTHER INTERNATIONAL SITES. RESIDENTS CAN ALSO DO ROTATIONS THROUGH THE INDIAN HEALTH SERVICE OR AT BIDMC-AFFILIATED COMMUNITY HEALTH CENTERS. GLOBAL HEALTH TRACK LEARNING HOW TO WORK EFFECTIVELY IN RESOURCE-LIMITED SETTINGS REQUIRES BOTH TRAINING AND EXPERIENCE. PARTICIPANTS IN THE GLOBAL HEALTH TRACK WILL PARTICIPATE WITH LEARNERS FROM AROUND THE WORLD IN THE GLOBAL HEALTH EFFECTIVENESS PROGRAM AT THE HARVARD SCHOOL OF PUBLIC HEALTH; THEY WILL ENGAGE IN OUR HOSPITAL-WIDE, YEAR-LONG GLOBAL HEALTH CURRICULUM AND JOURNAL CLUB, AND THEY WILL BE GIVEN THE OPPORTUNITY FOR TWO FIELD EXPERIENCES DURING RESIDENCY. HOSPITAL-WIDE GLOBAL HEALTH PROGRAM THE BIDMC GLOBAL HEALTH PROGRAM IS A HOSPITAL-WIDE PROGRAM AVAILABLE TO ALL BIDMC RESIDENTS. WHILE REQUIREMENTS AND TIMELINES MAY DIFFER BETWEEN DEPARTMENTS AND SPECIALTIES, THE OVERARCHING GOAL IS TO PROVIDE RESIDENTS WITH FURTHER TRAINING AND EDUCATION IN THE DISCIPLINE OF GLOBAL HEALTH. NEUROLOGY EDUCATION AT BIDMCTHE HARVARD MEDICAL SCHOOL NEUROLOGY PROGRAM AT BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL IN BOSTON, MASSACHUSETTS WAS FOUNDED IN 1996 AS THE SUCCESSOR TO THE HARVARD-LONGWOOD NEUROLOGY PROGRAM. THE PROGRAM CONCENTRATES ON THE TRAINING AND RESEARCH OPPORTUNITIES AVAILABLE ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS, BY COMBINING THE RESOURCES OF TWO MAJOR HARVARD TEACHING HOSPITALS, BETH ISRAEL DEACONESS MEDICAL CENTER AND CHILDREN'S HOSPITAL. THESE COMBINED HOSPITALS, WITH OVER 800 INPATIENT BEDS AND EXTENSIVE OUTPATIENT CLINICS, PROVIDE THE SETTING FOR TRAINING PHYSICIANS IN THE ART AND SCIENCE OF CLINICAL NEUROLOGY.THE COMBINED FACULTY CONSISTS OF MORE THAN 80 NEUROLOGISTS AT THE TWO PARTICIPATING HOSPITALS, AND PROVIDES CORE EXPERIENCES IN INPATIENT AND OUTPATIENT NEUROLOGY, AS WELL AS TRAINING IN ELECTROPHYSIOLOGY (INCLUDING EEG, EMG, AND SLEEP POLYSOMNOGRAPHY) AND NEUROPATHOLOGY. THE KEY DISTINGUISHING FEATURE OF THE PROGRAM IS THE CLOSE RELATIONSHIP BETWEEN THE CLINICAL FACULTY, NEARLY ALL OF WHOM ARE FULL-TIME ACADEMIC NEUROLOGISTS ENGAGED IN SUBSTANTIVE RESEARCH AND TEACHING EFFORTS, AND A SELECT GROUP OF RESIDENTS WHO ARE KEENLY INTERESTED IN FORGING ACADEMIC CAREERS IN NEUROLOGY. VIRTUALLY ALL OF THE CLINICAL TRAINING TAKES PLACE WITHIN A 2 BLOCK RADIUS ON THE HARVARD MEDICAL SCHOOL LONGWOOD CAMPUS. A CRITICAL COMPONENT OF THE PROGRAM IS THE OPPORTUNITY FOR RESIDENTS TO HAVE A MENTORED TEACHING EXPERIENCE AS WELL AS THE OPPORTUNITY TO UNDERTAKE A MENTORED PROJECT, WHICH MAY ENTAIL EITHER CLINICAL OR LABORATORY BASED INVESTIGATION OR PREPARATION OF INNOVATIVE TEACHING MATERIALS OR METHODS."

SURGERY EDUCATION AT BIDMC
THE ROBERTA AND STEPHEN R. WEINER DEPARTMENT OF SURGERY OFFERS EDUCATION OPPORTUNITIES FOR RESIDENTS, FELLOWS AND MEDICAL STUDENTS IN CARDIAC SURGERY, GENERAL SURGERY, NEUROSURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PODIATRY, TRAUMA SURGERY, MINIMALLY INVASIVE SURGERY, UROLOGY, AND VASCULAR SURGERY. STUDENTS LEARN THE MOST ADVANCED TECHNIQUES IN A STATE-OF-THE-FACILITY. STUDENTS ALSO HAVE THE OPPORTUNITY TO LEARN MINIMALLY INVASIVE TECHNIQUES AT THE CARL J. SHAPIRO SIMULATION AND SKILLS CENTER, THE FIRST OF ITS KIND TO BE ACCREDITED IN THE COUNTRY AND LOCATED WITHIN THE MEDICAL CENTER.THE MEDICAL CENTER'S DEPARTMENT OF SURGERY IS ONE OF THREE MAJOR TEACHING AND RESEARCH UNITS OF HARVARD MEDICAL SCHOOL'S DEPARTMENT OF SURGERY. AT ALL LEVELS, THE HOUSESTAFF GAIN TRAINING AND PRACTICAL EXPERIENCE IN THE PREOPERATIVE, OPERATIVE, AND POST-OPERATIVE CARE OF PATIENTS. THE PROGRAM EMPHASIZES RESIDENT-FACULTY INTERACTION FOR EDUCATIONAL PURPOSES. TEACHING CONFERENCES AND SEMINARS FOR THE HOUSESTAFF CAPITALIZE ON WORKING RELATIONSHIPS DEVELOPED WITH THE ATTENDING STAFF. UPON COMPLETION OF FIVE YEARS OF SURGICAL TRAINING, RESIDENTS ARE ELIGIBLE FOR THE AMERICAN BOARD OF SURGERY EXAMINATION. DIDACTIC TEACHINGTHE PROGRAM HAS DEDICATED EDUCATION TIME, INCLUDING A STRONG DIDACTIC CONFERENCE SCHEDULE, TO PROVIDE A BASIC FOUNDATION OF SURGICAL KNOWLEDGE AND SKILLS. REQUIRED WEEKLY CONFERENCES INCLUDE:- RESIDENT CURRICULUM CONFERENCE / MIS SKILLS LAB - SURGICAL SERVICE MORBIDITY/MORTALITY & SURGICAL GRAND ROUNDS - COMBINED GI CONFERENCETHROUGHOUT TRAINING, A PRIMARY RESPONSIBILITY OF SENIOR RESIDENTS IS TEACHING MORE JUNIOR RESIDENTS AND THE STUDENTS ON THEIR SERVICE. THEY ARE ALSO RESPONSIBLE FOR THE ASSIGNMENT OF CASES, CLINICAL SUPERVISION OF MEDICAL STUDENTS AND RESIDENTS, AND PREPARING MATERIAL FOR SERVICE AND TEACHING CONFERENCES.NEBHADDITIONAL INFORMATION REGARDING PROMOTING THE HEALTH OF THE COMMUNITY (SCHEDULE H, PART VI, QUESTIONS 5 AND 6)THE 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. ON MARCH 1, 2019, THE BETH ISRAEL LAHEY HEALTH SYSTEM WAS FORMED THROUGH THE COMBINATION OF THE HOSPITALS AND OTHER AFFILIATES OF THREE LEGACY HEALTH CARE SYSTEMS BASED PRIMARILY IN EASTERN MASSACHUSETTS, INCLUDING THE FORMER CAREGROUP HEALTH SYSTEM, THE FORMER LAHEY HEALTH SYSTEM, AND THE SEACOAST HEALTH SYSTEM. BETH ISRAEL LAHEY HEALTH, INC. (BILH) IS NOW THE SOLE MEMBER OF THE HOSPITAL AND NINE ADDITIONAL AFFILIATED HOSPITALS. EACH OF THESE ENTITIES MAY HAVE, IN TURN, SERVED AS THE SOLE MEMBER OF ADDITIONAL AFFILIATES. THE BILH HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. AFFILIATED HEALTH CARE SYSTEMAS 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. BILH 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. BILH'S COMMUNITY OF CLINICIANS, CAREGIVERS AND STAFF INCLUDES APPROXIMATELY 4,000 PHYSICIANS AND 35,000 EMPLOYEES. BILH SERVES AS SOLE MEMBER OF BETH ISRAEL DEACONESS MEDICAL CENTER (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, LAHEY HEALTH SHARED SERVICES, WINCHESTER HOSPITAL (WINCHESTER), NORTHEAST HOSPITAL CORPORATION (NHC), NORTHEAST BEHAVIORAL HEALTH CORPORATION (NBHC) AND ANNA JAQUES HOSPITAL). LAHEY CLINIC FOUNDATION SERVES AS THE SOLE MEMBER OF LAHEY CLINIC, INC. AND LAHEY CLINIC HOSPITAL D/B/A LAHEY HOSPITAL AND MEDICAL CENTER. EACH OF THESE AFFILIATES MAY IN TURN SERVE AS MEMBER OF ADDITIONAL ENTITIES WITHIN THE NETWORK OF AFFILIATES.