Beth Israel Deaconess Hospital - Milton

“For the period covered by this filing, beth israel lahey health, inc. (bilh) served as direct or indirect sole member to: 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), beth israel lahey health pharmacy, joslin diabetes center and to affiliates of these entities. Effective july 1, 2023, bilh also became the sole member of exeter health resources, inc. (ehri) and its affiliates', including exeter hospital. Each of these affiliates may have, in turn, served as member of additional entities within the bilh network of affiliates. In addition, harvard medical faculty physicians at beth israel deaconess medical center, inc. (hmfp) is the dedicated physician practice of bidmc and an entity integrally related to helping bidmc and other affiliates in the bilh network accomplish their charitable purposes. For this same period hmfp served as the sole member of affiliated physicians of harvard medical faculty physicians at beth israel deaconess medical center (aphmfp) as well as several additional entities. Two or more of the persons listed in this form 990 part vii have a business relationship with each other by virtue of sitting on one or more boards of directors/trustees or by serving in an employment relationship with one or more entities within the network of the affiliated organizations noted above. Additional detail is provided in the explanatory notes to this form 990 schedule j.”

“For the period covered by this filing, beth israel lahey health, inc. (bilh) served as direct or indirect sole member of: beth israel deaconess medical center, inc. (bidmc), mount auburn hospital (mah), new england baptist hospital (nebh), beth israel deaconess hospital milton, inc. (milton), beth israel deaconess hospital needham, inc. (needham), beth israel deaconess hospital plymouth, inc. (plymouth), lahey 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), beth israel lahey health pharmacy, joslin diabetes center, exeter health resources, inc. (ehri), exeter hospital and to affiliates of these entities.”

“The member has the exclusive authority to (a) appoint and reappoint trustees, (b) fill any vacancies in the offices of trustees, and (c) acting by vote of not less than three quarters (3/4) of the member's trustees then in office, remove, with or without cause, a trustee.”

“The member of beth israel deaconess hospital - milton has the following rights, as designated in beth israel deaconess hospital - milton's by-laws: subject to the provisions of the articles of organization and these bylaws, the member shall have the right to exercise all powers, both positive and negative, conferred by massachusetts general laws ("m.g.l.") chapter 180, as amended, on members of corporations organized under m.g.l. Chapter 180. In addition, except as are expressly granted to the board of trustees of the corporation ("board") in these bylaws, the member shall have the right to exercise all powers, positive and negative, conferred by m.g.l. Chapter 180 on boards of corporations organized under m.g.l. Chapter 180. Notwithstanding the foregoing, the member may not take any of the following actions without the approval of the board: (a) approve or require any change in, or consolidation of philanthropic gifts, assets, and programs of the corporation, which shall remain under the corporation's control and be used for the benefit of the corporation and not for other components of the member's system, except to the extent that such changes involve back-office consolidation with other direct or indirect subsidiaries of the member; (b) approve or require any change in the name, brand, or trademark of the corporation or any of its subsidiaries, except such complementary changes as the member may determine are reasonably appropriate in establishing a system-wide identity for the affiliated entities; or (c) amend or restate these bylaws to change or eliminate either of the foregoing limitations on its powers. For the period ending on the third anniversary of the date the member becomes the sole corporate member of the corporation, the member's authority to change the medical school affiliation of the corporation or any of its subsidiaries is subject to the requirement that it obtain the unanimous consent of the corporation's designated trustees (as defined in the bylaws of the member) and the approval of the member's board of trustees (the "member's board"). The member may not cause the corporation to cease operating a separately licensed hospital facility, or close any essential service of such hospital facility, without consulting with the board prior to taking such action. The powers and responsibilities of the board include the following: (a) providing recommendations to the member regarding (i) appointment, reappointment and removal of trustees, (ii) the establishment of the corporation's policies, (iii) the maintenance of patient care quality, and (iv) the provision of clinical services and community service planning in a manner responsive to local community needs; (b) ensuring compliance with all licensure and accreditation requirements, including credentialing and other medical staff matters; (c) providing oversight for institutional planning, making recommendations for new clinical services, and participating in an annual review of the corporation's strategic and financial plan and goals; (d) reviewing and recommending approval of operating and capital budgets as well as making recommendations with respect to capital expenditures; (e) making recommendations with respect to quality assessment and improvement programs; (f) providing oversight of risk management programs relating to patient care and safety; (g) reviewing disaster plans that deal with both internal (e.g., fire) and external disasters; and (h) evaluating recruitment needs to ensure adequate medical staff capacity to continue to meet community needs. Except as otherwise provided in these bylaws, the board shall act in an advisory capacity and consistent therewith shall have only the following powers: (a) powers expressly granted by the member from time to time; (b) power to exercise its authority as a member of other corporations; (c) power to enforce any rights vested in the corporation under the bylaws of the member (as defined under the bylaws of the m”

“As noted in various disclosures throughout this filing, beth israel lahey health, inc. (bilh) is the direct or indirect sole member of beth israel deaconess hospital - milton . This form 990 is prepared by the bilh tax department in conjunction with deloitte tax, llp (deloitte). As part of this process, the bilh tax department works with other disciplines and functions within bilh and beth israel deaconess hospital - milton to ensure that all financial and non-financial disclosures are complete and accurate. Examples of such departments include but are not limited to: finance and accounting, human resources and payroll, treasury, compliance, legal, community benefits, financial assistance and reimbursement, governance, development, graduate medical education, government relations, research and/or research finance. Beth israel deaconess hospital - milton 's form 990 is reviewed internally by the bilh assistant vice president, taxation and externally by deloitte. Beth israel deaconess hospital - milton 's form 990, along with the forms 990 of all entities in the bilh network, are discussed with the bilh audit and compliance committee. Deloitte signs the final returns. A copy of the complete return is then provided to each member of beth israel deaconess hospital - milton 's board of trustees prior to submission to the internal revenue service.”

“As noted throughout this filing, beth israel deaconess hospital - milton is a member of the beth israel lahey health (bilh) system of affiliates. All entities in the bilh network adhere to the bilh conflict of interest policy and maintain a written, comprehensive conflict of interest policy at the entity level. Pursuant to these policies, bilh entities' officers, trustees and key employees as well as certain other individuals are required to complete the annual conflict of interest and tax questionnaire (coi-tq). The coi-tq is designed to require disclosure of any business and family relationships and affiliations maintained by officers, trustees, or key employees and their family members and which may result in a real or perceived conflict of interest. The bilh office of integrity and compliance, in conjunction with the bilh tax department, administers the coi-tq process annually. Bilh integrity and compliance collects and reviews all disclosures. Disclosures for bilh executives and key employees are assigned appropriate follow-up action in accordance with the bilh policy. A summary of positive responses for each bilh affiliate is provided to the compliance officer for that entity for review final determination of any potential or actual conflict. Any activity that requires action under the conflict of interest policies is subject to ongoing review by beth israel deaconess hospital - milton as well as the bilh integrity and compliance office. Pursuant to the bilh conflict of interest policy, certain activities which could create conflicts of interest are prohibited while other types of relationships are permitted, subject to compliance with a management plan to require disclosure and recusal, including appropriate documentation in the minutes. In addition, as noted above, the annual coi-tq process outlined above is jointly issued by the bilh tax department, to ensure that the questionnaire is distributed to all current and former members of the beth israel deaconess hospital - milton board of trustees as well as former officers and key employees. The coi-tq process is designed to gather the information necessary for beth israel deaconess hospital - milton to completely and accurately complete form 990 schedule l, transactions with interested persons and form 990, part vi, question 2, family and business relationships between officers, directors/trustees and key employees.”

“As noted throughout this filing, beth israel deaconess hospital - milton is a member of the beth israel lahey health (bilh) network of affiliates with bilh serving as beth israel deaconess hospital - milton 's sole member, or if not as direct sole member, indirectly as the member in its capacity as parent of the beth israel lahey health network. In this role bilh maintains the responsibility for setting compensation for executives and senior management of the entities which comprised the beth israel lahey health network. The bilh compensation committee is therefore responsible for assuring that the total compensation provided to these individuals is fair and reasonable using current and credible market practice information and is responsible for ensuring compliance with applicable legal and regulatory guidelines, the bilh compensation committee is composed of independent members of its board of trustees and except as otherwise noted below or in form 990 schedule j, the compensation reported in this form 990 for beth israel deaconess hospital - milton 's officers, trustees and key employees was set by the bilh compensation committee. The bilh compensation committee process for setting compensation is below. The beth israel lahey health (bilh) compensation committee establishes the policies and the compensation structure, including benefits, for the beth israel lahey health network of affiliates including the bilh chief executive officer as well as other members of senior management at bilh and its affiliates. The compensation committee is responsible for assuring that the total compensation provided to these individuals is fair and reasonable using current and credible market practice information and is responsible for ensuring compliance with applicable legal and regulatory guidelines. The bilh compensation committee is composed of independent members of its board of trustees in setting compensation, the compensation committee relies upon published compensation surveys and studies produced by independent compensation consulting firms that regularly assess executive compensation and benefits of substantially similar organizations. The compensation committee meets to review the compensation structure of the individuals described above and at that time reviews the compensation survey details prepared by the independent compensation consulting firm. For some categories of positions, the compensation committee will review the compensation structure and targets as a group, rather than by individual. Compensation for the bilh ceo and other senior executives is reviewed on an individual basis. The compensation committee then votes to approve the compensation arrangements of all individuals described above except for the bilh ceo. The compensation package for the bilh ceo as voted by the compensation committee is submitted to the full board of trustees for approval. All deliberations for both the compensation committee and the board of trustees are contemporaneously documented in minutes. The compensation committee processes and procedures as described above are designed to meet the requirements of treasury regulation section 53.4958-6(c), rebuttable presumption that a transaction is not an excess benefit transaction.”

“As noted throughout this filing, beth israel deaconess hospital - milton is a member of the beth israel lahey health (bilh) network of affiliates with bilh serving as beth israel deaconess hospital - milton 's sole member, or if not as direct sole member, indirectly as the member in its capacity as parent of the beth israel lahey health network. Beth israel deaconess hospital - milton 's governing documents, conflict of interest policy and financial statements are available to the general public upon request at the following location: beth israel lahey health tax department schrafft's city center, 4th floor, 529 main street charlestown, ma 02129”

“The mission of the beth israel deaconess hospital-milton, inc. (bid-milton or hospital) is to provide safe, high-quality, community-based health care and access to tertiary care in close collaboration with its sister hospital, beth israel deaconess medical center (bidmc or medical center) and other beth israel lahey health affiliates. Bid-milton provides this care regardless of the patient's ability to pay, race, color, religion, sex, sexual orientation, national origin, ancestry, age, or disability. Bid-milton aspires to be among the best community hospitals in eastern massachusetts. Beth israel deaconess hospital - milton (bid-milton or hospital), is a 102-bed acute care hospital that serves patients of all ages and serves the communities of milton, quincy, braintree, randolph, canton, hyde park dorchester and other local communities. The hospital provides a comprehensive program of clinical services and delivers care in accordance with bid-milton's core values of patient comfort, confidentiality and convenience with the ultimate goal of playing an integral role in improving the overall health of the communities served. During the fiscal period covered by this filing, beth israel lahey health (bilh) served as the sole member of beth israel deaconess hospital - milton, inc., beth israel deaconess medical center, inc. (bidmc), mount auburn hospital (mah), new england baptist hospital (nebh), beth israel deaconess hospital - needham, inc. (needham), beth israel deaconess hospital - plymouth, inc. (plymouth), lahey health shared services (lhss), lahey clinic foundation (lcf), winchester hospital (winchester), northeast hospital corporation (nhc) which includes beverly, addison gilbert and bayridge hospitals, northeast behavioral corporation (nbhc), anna jaques hospital (ajh), the beth israel lahey health performance network (bilhpn), joslin diabetes center and the beth israel lahey health pharmacy. The lahey clinic foundation in turn served as the sole member of lahey clinic inc, and lahey clinic hospital d/b/a lahey hospital and medical center (lhmc). In addition, as of july 1, 2023, bilh became the sole member of exeter health resources, inc which in turns serves as the sole member of exeter hospital. The entities listed here may have also, in turn, served as member to other network affiliates. Bilh is an integrated health care system committed to expanding access to extraordinary patient care across eeastern massachusetts and southern new hampshire and advancing the science and practice of medicine through groundbreaking research and education. The bilh system is comprised of academic and teaching hospitals, a premier orthopedics hospital, primary care and specialty care providers, ambulatory surgery centers, urgent care centers, community hospitals, homecare services, outpatient behavioral health centers, addiction treatment programs. Bilh's community of clinicians, caregivers and staff includes approximately 4,800 physicians and 38,000 employees. Beth israel deaconess medical center (bidmc or medical center), is a nationally recognized tertiary care academic medical center, is a teaching hospital of harvard medical school and affiliate of bid-milton. Bidmc is exempt from income tax under section 501(c)(3) of the internal revenue code of 1986, as amended and is recognized nationally for the clinical excellence of its faculty and the patient care provided, as well as for the magnitude and breadth of its research and for its commitment to medical education. Many bid-milton physicians also hold appointments at harvard or other major medical schools and are tied closely with their colleagues at other academic medical centers.”

“Outpatient clinics and services beth israel deaconess hospital - milton (bid-milton) provides a comprehensive program of clinical services encompassing general internal medicine and all the subspecialties of internal medicine, covering the gamut of services from primary to tertiary care as well as providing surgical services on an outpatient basis. The hospital's medical staff blends experienced primary care physicians and specialists in a wide variety of disciplines. The primary care and specialists at bid-milton provide outpatient primary care as well as endoscopic, ophthalmologic, orthopedic, dermatologic and podiatric procedures, cardiac rehabilitation, diabetes management services, nutritional counseling and elder assessment programs. Diagnostic facilities at bid-milton include a complete 24-hour histopathology laboratory and blood banking services as well as diagnostic imaging including ct scanning, ultrasound, mri, 3d mammography, ultrasonic cardiology, bone densitometry, nuclear medicine, plain film radiology and fluoroscopy. In addition, the hospital's picture archival and communication system (pacs) can instantaneously transmit radiologic images between bid-milton and bidmc, meaning that patients in milton have access to the same world-class specialists as patients at bidmc in boston. The system facilitates, when necessary, multi-disciplinary evaluation of images, resulting in improved technical performance and feedback and diagnoses with greater diagnostic accuracy. During the period covered by this filing, bid-milton had 192,939 outpatient encounters. This included 14,769 urgent care visits, 17,296 hospital clinic encounters, 2,576 observation cases, 2,210 pain clinic visits, 3,818 outpatient ambulatory surgeries, 5,754 outpatient endoscopy visits, 12,612 outpatient ekg exams, 970 outpatient orthopedic procedures, 49,903 outpatient radiology exams, 19,956 outpatient ct scans, 12,534 outpatient ultrasounds, 4,557 outpatient mris, 1,403 other nuclear medicine tests, 8,361 breast imaging exams, 536,000 outpatient lab tests, 6,836 outpatient rehabilitation/physical therapy visits, and 27,929 other tests and procedures.”

“Inpatient medical / surgical and intensive care bid-milton or hospital is a 102-bed acute care hospital that serves patients of all ages and serves the communities of milton, quincy, braintree, randolph, canton, hyde park dorchester and other local communities. Bid-milton provides a wide range of inpatient care including surgical services, intensive and cardiac care and complete diagnostic facilities. Bid-milton's inpatient facilities include medical/surgical beds and an eight-bed intensive and cardiac care unit. The hospital has a fully renovated state-of-the art surgical suite with seven fully equipped operating rooms, one minor surgery room and a post-operative anesthesia care unit. Surgical services are available 24 hours a day for critically ill or injured patients requiring immediate surgical intervention, or for other patients on a non-emergent or elective basis. Bid-milton's highly qualified surgeons perform orthopedic procedures and implants, plastic reconstruction, gastrointestinal, bariatric, general surgical (including breast) gynecological, ophthalmologic, podiatric, and urological procedures. Limited vascular and thoracic surgery is also performed. Patients are under the care of the hospital's medical staff, hospitalists and/or general surgeons along with nurses and physician assistants who are trained in caring for patients with complex medical needs. The nursing care team consists of registered nurses, surgical technicians and qualified ancillary personnel working collaboratively with surgical and anesthesia physicians. The scope of nursing practice in the perioperative area includes preoperative assessment and planning, intra-operative intervention, postoperative assessment and intervention, discharge planning and documentation to ensure high quality patient care and safety. The inpatient population that is served includes individuals who are 15 years and older who require minor or major surgical intervention. During the fiscal period october 1, 2023 to september 30, 2024, bid-milton had 6,593 inpatient discharges with 26,868 patient days, and 1,581 total inpatient surgeries.”

“Emergency department bid-milton's emergency department (ed) is open 24 hours a day, 7 days a week and provides emergency care to all patients, regardless of ability to pay. The ed is staffed by associated physicians of harvard medical faculty physicians at beth israel deaconess medical center (aphmfp), an integrally related physician practice of bidmc and bidmc affiliated entities which is exempt from income tax under section 501(c)(3) of the internal revenue code of 1986, as amended. Aphmfp physicians provide around the clock physician patient care coverage and medical direction of the bid-milton emergency department. A highly trained nursing staff also provides care to patients in the ed. Critically injured patients needing the services of a level i trauma center are stabilized and transferred to beth israel deaconess medical center in boston. A rapid cardiac transfer program with the medical center also facilitates the transfer of patients needing emergency cardiac catheterization. During the fiscal period october 1, 2023 to september 30, 2024, bid-milton had more than 37,887 emergency department visits. In addition to the program service accomplishments noted above, the bilh network had significant activities across entities related to both behavioral health and other healthcare initiatives. See the narrative support for schedule h for additional details.”

“The boston, ma office of kpmg issued an unqualified opinion on the consolidated audited financial statements of the beth israel lahey health, inc. And affiliates for fiscal period ended september 30, 2024. These statements were prepared in accordance with generally accepted accounting principles (gaap) and included the accounts of the beth israel lahey health, inc. (bilh), and the entities for which beth israel lahey health, inc. (bilh) served as sole member during the fiscal period covered by this filing, (anna jaques hospital (ajh), beth israel deaconess medical center, inc. (bidmc), mount auburn hospital (mah), new england baptist hospital (nebh), beth israel deaconess hospital -- milton, inc. (milton), beth israel deaconess hospital -- needham, inc. (needham), beth israel deaconess hospital -- plymouth, inc. (plymouth), lahey health shared services (lhss), lahey clinic foundation (lcf), winchester hospital (winchester), northeast hospital corporation (nhc) which includes beverly, addison gilbert and bayridge hospitals, northeast behavioral corporation (nbhc), the beth israel lahey health performance network (bilhpn), the joslin diabetes center, exeter health resources, inc. (ehri) and the beth israel lahey health pharmacy. The lahey clinic foundation in turn served as the sole member of lahey clinic inc, and lahey clinic hospital d/b/a lahey hospital and medical center (lhmc). Ehri in turn served as the sole member of exeter hospital and other affiliates of ehri. Each of these bilh affiliates may in turn serve as member of additional entities within the network of affiliates, and whose accounts are included in the bilh audited financial statements. In addition, the bilh financial statements also include the accounts of harvard medical faculty physicians at beth israel deaconess medical center, inc. (hmfp), the dedicated physician practice of beth israel deaconess medical center and an entity integrally related to helping bidmc and other affiliates in the bilh network accomplish their charitable purposes. The accounts of the entities for which hmfp serves as member are also included in the hmfp and bilh audited financial statements. The audit and compliance committee of bilh's board of trustees assumes responsibility for oversight of the consolidated audit for the network as a whole.”

“As described in this form 990 and for the period covered by this filing, beth israel lahey health, inc. (bilh) is an entity exempt from income tax under section 501(c)(3) of the internal revenue code of 1986, as amended and served as a support organization of and direct or indirect sole member of beth israel deaconess hospital - milton. During this same period, beth israel deaconess hospital - milton was a member of the bilh obligated group which has issued tax-exempt bond financing through either the bilh obligated group or through a previous obligated group which is now a part of the bilh obligated group. The schedule k as included in this form 990 includes all of the bilh obligated group outstanding tax-exempt debt for bonds issued after december 31, 2002, only a portion of which is allocable to and reported on beth israel deaconess hospital - milton's balance sheet.”

“As reported on the form 990 schedule k, the lahey health system inc. (lhsi) series f bonds which were issued in 2015 are now part of the beth israel lahey health (bilh) obligated group debt. The bonds were issued in 2015 and as of september 30, 2023 there was a balance remaining in the construction fund. Proceeds in the construction fund were unexpectedly held beyond the three-year temporary period, and were yield restricted in compliance with federal tax requirements. Although these bonds are not on the beth israel deaconess hospital - milton's balance sheet, beth israel deaconess hospital - milton is including this disclosure in its form 990 because beth israel deaconess hospital - milton is a member of the bilh obligated group.”

“As noted throughout this filing, beth israel lahey health (bilh) served as a support organization and the direct or indirect sole member of beth israel deaconess hospital - milton, inc. As part of that relationship, bilh provided centralized support to its network of supported organizations, including among other things, operational support such as processing payroll and accounts payable. In this capacity bilh issued all forms 1099 to not only its own vendors and service providers, but also to those who provided services to beth israel deaconess hospital - milton, inc. Forms 1099 were all issued in the bilh name and under the bilh ein. However, in accordance with instructions to this form 990, beth israel deaconess hospital - milton, inc. Is reporting the number of forms 1099 related to services performed for and payments related to, its service providers as if they were processed directly by beth israel deaconess hospital - milton, inc. Each other affiliate is similarly reporting the number of forms 1099 which are attributable to their own service providers.”

“Beth israel deaconess hospital - milton did not receive any contributions of intellectual property and as such, was not required to file form 8899.”

“Beth israel deaconess hospital - milton did not receive any contributions of cars, boats, airplanes or other vehicles and as such, was not required to file form 1098-c.”

“Outside labor: program service expenses 7,246,462. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,246,462. Physician services: program service expenses 14,114,789. Management and general expenses 0. Fundraising expenses 0. Total expenses 14,114,789. Professional fees: program service expenses 95,892. Management and general expenses 214,300. Fundraising expenses 0. Total expenses 310,192. Purchased services: program service expenses 8,162,028. Management and general expenses 213,002. Fundraising expenses 0. Total expenses 8,375,030. Clinical professional fees: program service expenses 190. Management and general expenses 0. Fundraising expenses 0. Total expenses 190.”

“Pledge and fund adjustments -533,570. Pension expense -469,238. Change in funded status of benefits 1,617,665. Transfer of net assets -3,880,490. Restricted fund adjustments 0. Pension adjustments investment adjustments”

“As noted throughout this form 990, beth israel deaconess hospital - milton is a member of the beth israel lahey health network of affiliates. Beth israel lahey health (bilh) serves as the direct or indirect member of beth israel deaconess hospital - milton and beth israel deaconess hospital - milton is included in the consolidated audited financial statements of beth israel lahey health. The audit and compliance committee of bilh's board of trustees assumes responsibility for oversight of the consolidated audit for the network as a whole.”