Anna Jaques Hospital Inc

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

“Effective october 1, 2023, anna jaques hospital, inc. (ajh) made the following changes to its by-laws: removed the investment committee as an ajh board committee. Investment governance is now provided by beth israel lahey health, the sole member of ajh. Removed transitional language relating to the assistant clerk. The amendment did not impact ajh's primary mission, function or purposes.”

“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 anna jaques hospital, inc. Has the following rights, as designated in anna jaques hospital, inc.'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 member) or under these byla”

“As noted in various disclosures throughout this filing, beth israel lahey health, inc. (bilh) is the direct or indirect sole member of anna jaques hospital, inc. . 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 anna jaques hospital, inc. 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. Anna jaques hospital, inc. 's form 990 is reviewed internally by the bilh assistant vice president, taxation and externally by deloitte. Anna jaques hospital, inc. '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 anna jaques hospital, inc. 's board of trustees prior to submission to the internal revenue service.”

“As noted throughout this filing, anna jaques hospital, inc. 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 anna jaques hospital, inc. 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 anna jaques hospital, inc. Board of trustees as well as former officers and key employees. The coi-tq process is designed to gather the information necessary for anna jaques hospital, inc. 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, anna jaques hospital, inc. Is a member of the beth israel lahey health (bilh) network of affiliates with bilh serving as anna jaques hospital, inc. '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 anna jaques hospital, inc. '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, anna jaques hospital, inc. Is a member of the beth israel lahey health (bilh) network of affiliates with bilh serving as anna jaques hospital, inc. '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. Anna jaques hospital, inc. '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”

“As noted throughout this filing, beth israel lahey health (bilh) serves as the direct or indirect sole member of anna jaques hospital, inc. Although anna jaques hospital, inc's board has not formally adopted a written policy regarding investment in, contribution of assets to and/or participation in a joint venture with a taxable entity, procedurally if/when any such transaction is contemplated by any bilh affiliate, both the bilh office of general counsel and bilh tax department are involved to evaluate participation. Outside counsel is also consulted where needed. These steps are taken to ensure that participation in any joint venture arrangement has been reviewed under applicable federal tax law and to ensure that anna jaques hospital, inc's exempt status is safeguarded.”

“The mission of anna jaques hospital (ajh or hospital) is to provide the highest quality medical care and improve the health of the communities served by ajh in alliance with the ajh medical staff and ajh affiliates including seacoast affiliated group practice and others as noted in this filing. Ajh is recognized for delivering high quality community health care at a lower cost, with an emphasis on patient satisfaction. Ajh provides this care regardless of the patient's ability to pay, race, color, religion, sex, national origin, ancestry, age, or disability. Ajh aspires to be among the best community hospitals in eastern massachusetts. During the fiscal period covered by this filing, beth israel lahey health (bilh) served as the sole member of 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 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 eastern 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 and addiction treatment programs. Bilh's community of clinicians, caregivers and staff includes approximately 4,800 physicians and 38,000 employees. In addition to being a member of beth israel lahey health, anna jaques hospital is also a clinical affiliate and sister entity of beth israel deaconess medical center (bidmc or medical center), which is a nationally recognized tertiary care academic medical center and a teaching hospital of harvard medical school. 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.”

“Outpatient clinics and services anna jaques hospital provides a comprehensive program of clinical services encompassing general internal medicine and all the subspecialties of internal medicine, covering the gamut of services from primary to tertiary care as well as providing surgical services on an outpatient basis. The hospital's medical staff blends experienced primary care physicians and specialists in a wide variety of disciplines. The primary care and specialists at ajh provide outpatient primary care as well as gastrointestinal, ophthalmologic, orthopedic, cardiac, dermatologic, urological and podiatric procedures, pain management, cardiac rehabilitation, pulmonary rehabilitation, diabetes management services, and nutritional counseling. Diagnostic facilities at ajh include a complete 24-hour laboratory and blood banking services as well as diagnostic imaging including ct scanning, ultrasound, mri, 3d mammography, ultrasonic cardiography, bone densitometry, nuclear medicine, plain film radiology and fluoroscopy. The anna jaques cancer center cancer, affiliated with beth israel deaconess medical center, provides a full array of community-based cancer services in newburyport and when needed, advanced treatment options and specialists at bidmc in boston. During the period covered by this filing, anna jaques hospital had 212,666 outpatient encounters. This included 7,471 hospital clinic encounters, 1,456 observation cases, 9,638 pain clinic visits, 1,257 wound center visits, 3,466 outpatient ambulatory surgeries, 3,748 outpatient endoscopy visits, 5,558 outpatient oncology visits, 3,854 outpatient oncology infusions, 8,967 outpatient ekg exams, 1,084 outpatient orthopedic procedures, 24,662 outpatient radiology exams, 16,771 outpatient ct scans, 17,139 outpatient ultrasounds, 7,146 outpatient mris, 753 other nuclear medicine tests, 14,601 breast imaging exams, 515,130 outpatient lab tests, 16,481 outpatient rehabilitation/physical therapy visits, and 35,705 other tests and procedures.”

“Inpatient medical / surgical and intensive care anna jaques hospital (ajh or hospital) is a 119-bed acute care hospital that serves patients of all ages and serves communities in northern massachusetts and southern new hampshire. The hospital provides a wide range of inpatient care including medical surgical services, obstetrics, intensive and cardiac care and complete diagnostic facilities. Ajh inpatient facilities include 63 medical/surgical beds and an 8 bed intensive unit. The 12-bed birth center sees 597 deliveries annually and also supports mothers with high-risk pregnancies with the level iib neonatal care center. The hospital has a surgical suite with six fully equipped operating rooms including a cardiac catheterization laboratory, four ambulatory procedure rooms and a post-operative 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. Ajh is the only community hospital in the region to provide inpatient psychiatric services to adults, adolescents and children. Inpatient psychiatric care at anna jaques hospital provides short-term, acute inpatient care to adults and adolescents ages 16 and older with a broad spectrum of psychiatric problems. The inpatient program is a 20-bed acute care co-ed unit. The anna jaques child and adolescent psychiatry program provides structured and secure inpatient psychiatric services to children and adolescents ages 4-17. The 16-bed program offers short-term inpatient treatment and stabilization. Ajh's surgeons perform orthopedic procedures and implants, plastic reconstruction, gastrointestinal, general surgical (including breast) gynecological, ophthalmologic, podiatric, and urological procedures. 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, including intensivists in the icu. The nursing care team consists of registered nurses, surgical technicians and qualified ancillary personnel working collaboratively with surgical and anesthesia physicians. During the period october 1, 2023 to september 30, 2024, anna jaques hospital had 5,371 inpatient discharges with 25,024 patient days, and 578 total inpatient surgeries. Adult psych days were 3,851 and pedi psych days were 2,274.”

“Emergency department anna jaques hospital'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 physicians provide around the clock physician patient care coverage and medical direction of the ajh emergency department. A highly trained nursing staff also provides care to patients in the ed. Ajh operates as a level iii trauma center and certified stroke center. The hospital operates a tele-stroke program with beth israel deaconess medical center where neurological images can be transmitted between ajh and bidmc, meaning that patients in the greater newburyport area 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 fiscal period october 1, 2023 to september 30, 2024, anna jaques hospital had 23,825 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 anna jaques hospital, inc.. During this same period, anna jaques hospital, inc. 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 anna jaques hospital, inc.'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 anna jaques hospital, inc.'s balance sheet, anna jaques hospital, inc. Is including this disclosure in its form 990 because anna jaques hospital, inc. Is a member of the bilh obligated group.”

“Anna jaques hospital did not receive any contributions of intellectual property and as such, was not required to file form 8899.”

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

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

“Physician services: program service expenses 10,820,970. Management and general expenses 0. Fundraising expenses 0. Total expenses 10,820,970. Purchased services: program service expenses 8,935,893. Management and general expenses 327,635. Fundraising expenses 0. Total expenses 9,263,528. Outside labor: program service expenses 3,694,222. Management and general expenses 433,441. Fundraising expenses 0. Total expenses 4,127,663. Professional fees: program service expenses 441,836. Management and general expenses 151,991. Fundraising expenses 0. Total expenses 593,827. Clinical professional fees: program service expenses 12,024. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,024.”

“Net asset release from restrictions 48,215. Net assets released for capital 8,118. Trusts true-up & other adjustments 629,732. Pension expense -664,508. Change in funded status of benefits plans -2,201,625. Other”

“As noted throughout this form 990, anna jaques hospital, inc. 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 anna jaques hospital, inc. And anna jaques hospital, inc. 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.”