Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc.

“Although hmfp had not adopted a formal joint venture policy for the fiscal period covered by this filing, any hmfp activity as a participant in a joint venture is reviewed with legal counsel to ensure hmfp's tax-exempt status is protected.”

“As noted in various narrative disclosures, which support this form 990 and related schedules, for the period covered by this filing, caregroup, inc.(caregroup) was a massachusetts non-profit corporation exempt from income tax under section 501(c)(3) of the internal revenue code of 1986, as amended. Caregroup's purpose was to oversee the financial well-being of the affiliated entities that make up the caregroup system. For the period covered by this filing, caregroup served as the sole member and a support organization of beth israel deaconess medical center (bidmc or medical center). In turn, for this same period bidmc served as the sole member of medical care of boston management corporation, d/b/a beth israel deaconess healthcare a/k/a affiliated physicians group (apg), beth israel deaconess hospital - needham, inc. (bid-needham), beth israel deaconess hospital - milton, inc. (bid-milton), milton hospital foundation, beth israel deaconess hospital - plymouth, inc. (bid-plymouth), and jordan health systems, inc. In addition, harvard medical faculty physicians at beth israel deaconess medical center, inc. (hmfp) is the dedicated physician practice of the medical center and an entity integrally related to helping the medical center and its affiliates accomplish their charitable purposes. Caregroup also served as the sole member and a support organization of new england baptist hospital (nebh) and mount auburn hospital (mah). Each of the entities listed in this paragraph may have, in turn, served as member of additional entities within the caregroup network of affiliates. Two or more of the persons listed in this form 990 part vii may have a business relationship with each other by virtue of sitting on one or more boards of directors/trustees or by having served in an employment relationship with one or more entities within the caregroup network of affiliated organizations. Additional detail is provided in the explanatory notes to this form 990 schedule j.”

“The preparation and the filing of harvard medical faculty physicians at beth israel deaconess medical center inc. (hmfp) form 990 and supporting schedules are the responsibility of the hmfp chief financial officer. For fiscal year 2018, the accounting firm deloitte tax llp prepared the form 990 with assistance and guidance from hmfp's accounting and finance staff. The director of taxation of caregroup, inc/beth israel deaconess medical center (bidmc) also oversaw the tax preparation process. As previously noted, for the period covered by this filing caregroup served as the sole member of bidmc and hmfp is an entity integrally related to bidmc. The complete form 990 is presented to the independent hmfp directors for discussion and review at an audit committee and/or board of directors meeting. A copy of the complete return is then provided to each member of the board of directors prior to submission to the internal revenue service. The completed form 990 is filed with the proper authorities by hmfp's cfo and her team.”

“Harvard medical faculty physicians at beth israel deaconess medical center, inc. (hmfp) is committed to pursuing its charitable missions and conducting business in a responsible and ethical manner. Many individuals serve hmfp in a variety of capacities that involve making or influencing significant decisions. Some of these individuals may have or develop personal interests which create a conflict between those personal interests and the interests of hmfp or which could be perceived as creating such a conflict. Hmfp has adopted a comprehensive conflict of interest policy which applies to hmfp directors, staff and non-voting members of board level committees, officers, senior management, chiefs of service, division chiefs, medical directors and other employees and professional staff categories as identified from time to time by the chief executive officer and/or directors of hmfp and as filed with the medical center's office of compliance and business conduct. The standards in the policy require that hmfp officers and management (as described above) shall not vote on, influence, or make recommendations regarding a transaction or decision when the individual or a member of his or her family has a material interest in an entity or property involved in the transaction or decision. A material interest includes, but is not limited to an individual or family member having a combined investment interest of greater than 5% of an entity or property, an individual or family member serving as a director, trustee, officer, partner, employee, consultant, agent, member of the active professional staff, researcher or advisor (whether in a paid or voluntary capacity) of or to an entity (including but not limited to health care providers) other than harvard medical faculty physicians at bidmc, inc and its affiliates, an individual holding an elected or appointed office or position in a branch of government or in a regulatory agency having authority or jurisdiction over providers of health care (for members of the judiciary, areas of conflict will be defined in the code of judicial conduct, and an individual (or member of his or her family) competing with hmfp in the purchase or sale or any property right, interest or service. An individual, member of his or her family, or an entity in which one or more of them has a material interest may not do business with, or compete with hmfp unless expressly authorized by the appropriate governing body or officer after full disclosure. The standards also require that an individual or member of his or her family not accept gifts or other favors of value greater than fifty dollars under circumstances that might lead to the inference that the gift or favor was intended to influence his or her decision-making while serving hmfp. An individual should not disclose or use the hmfp information for personal profit or advantage or use or disclose confidential and/or strategic information in advance of its authorized release. Hmfp has prepared a formal conflict of interest disclosure statement that is required to be completed annually by all individuals to whom the conflict of interest policy applies (see above) and other key hmfp personnel. In addition, any individual covered by this policy is required to immediately update their disclosure statement at any time during the year that the information requested on the statement changes. The policy also requires any hmfp employee who is in a position to approve or influence a particular transaction or decision in which the employee (or his/her family member) has a material interest to disclose such relationship(s) to his or her supervisor and as appropriate then to the hmfp compliance department for review and resolution prior to any action by hmfp. The hmfp compliance department shall seek guidance in these matters from the hmfp ceo or his or her designee and hmfp legal counsel as appropriate. A report documenting the results of any such review shall be prepared by hmfp”

“Hmfp has a compensation committee comprised of independent members of the hmfp board of directors. The compensation committee conducts the process of determining compensation of all individuals employed by hmfp and for specifically the chief executive officer, chiefs/chairs of service and other officers and key employees of the organization. The compensation committee utilizes comparative industry data, outside consultants, and other outside market data to help determine compensation. Hmfp has formal compensation policies that are documented and reviewed by the board of directors. The compensation committee pre-approves compensation plans which are documented in a formalized manner before being presented to employees. The compensation committee was responsible for assuring that the total compensation complied with applicable legal and regulatory guidelines and that compensation provided to these individuals was fair and reasonable using current and credible market practice information, national data benchmarking and harvard medical school guidelines. In setting compensation, the hmfp compensation committee also relied upon written compensation surveys and studies that regularly assess compensation and benefits for clinical chiefs of service compared with similar organizations.”

“Harvard medical faculty physicians at beth israel deaconess medical center, inc.'s (hmfp) governing documents, its conflict of interest policy, and its financial statements are available to the public upon request at the offices of hmfp located at 375 longwood avenue, boston, ma 02215.”

“Here are no members, stockholders or other persons who may elect one or more members of the governing body.”

“No. The members of the governing body have the following rights by a supermajority vote: - to approve the sale, transfer or other disposition of all or substantially all of the hmfp's assets; - to approve the petition for voluntary dissolution or bankruptcy of hmfp; - to approve any amendment of hmfp's articles of organization; - to approve any action that would cause, or could reasonably be expected to cause, hmfp to breach, with or without notice or the passage of time, any provision of the affiliation agreement dated as of october 1, 2006, between hmfp and bidmc; - to approve any merger or consolidation of hmfp; - to approve certain amendments to hmfp's bylaws; - to approve the adoption or implementation of any plan for the solicitation of charitable contributions by hmfp, or the acceptance by hmfp of any charitable contribution, donation, award or gift of any type that would, or could reasonably be expected to, impose a material obligation on bidmc or would, or could reasonably be expected to, have an adverse impact hmfp's or bidmc's rights and obligations under the affiliation agreement, provided however, that this shall not apply to unsolicited donations; - to approve the incurrence of indebtedness by hmfp that would result in a consolidated debt to capitalization ratio greater than 0.4:1.0; - to approve any capital expenditure or commitment by hmfp that is reasonably expected to result in days of unrestricted consolidated cash on hand being less than 60 days; - to approve the transfer by hmfp to any other entity or entities, individually or in the aggregate, in any fiscal year of more than 5% of the consolidated unrestricted net assets (determined as of the end of the immediately preceding fiscal year) for less than fair market value; - to approve of the budgeting of a consolidated operating loss by hmfp; and, - other powers and rights as vested by law.”

“According to the by-laws, the members of the harvard medical faculty physicians at beth israel deaconess medical center (hmfp) are the individuals serving on the board of directors.”

“The mission of harvard medical faculty physicians at beth israel deaconess medical center, inc. (hmfp) is to provide extraordinary care, where the patient comes first, supported by world-class education, research and training. Hmfp supports medical research, provides teaching instruction and participates in clinical activities designed to improve the general public health of patients served by the beth israel deaconess medical center and its affiliates. Hmfp uses its funds to support the physician work in the departments of anesthesia, dermatology, emergency medicine, medicine, neonatology, neurology, obstetrics and gynecology, orthopedics, pathology, psychiatry, radiology, radiation oncology, and surgery to provide extraordinary healthcare services, world class education, and research and training initiatives.”

“As previously noted in this form 990, the mission of harvard medical faculty physicians at beth israel deaconess medical center, inc. Is to provide extraordinary healthcare services, where the patient comes first, supported by world-class education, research and training.”

“Patient services harvard medical faculty physicians at beth israel deaconess medical center, inc.'s (hmfp) provides medical care and improves the health of patients of the beth israel deaconess medical center (bidmc) and affiliates, as well as in the communities in which we serve. Some of hmfp's key statistics for fy2018 regarding patient volume are identified below: hospital based clinic visits 57,747 emergency visits 57,364 neonatal visits 25,616 outpatient visits 468,876 anesthesia cases 71,282 surgical cases 79,600 ob deliveries 2,423 cardiac cauterizations procedures 5,016 dermatology procedures 49,040 gastrointestinal procedures 32,570 surgical pathology exams 133,619 radiation oncology treatments 25,714 other uncompensated care harvard medical faculty physicians at beth israel deaconess medical center, inc. (hmfp) 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, which insure low-income populations, do not cover the full cost of services provided. Hmfp also provides care to patients who participate in the medicare program, the federally sponsored government health insurance program for elderly or disabled patients. Because payments to hospitals have not kept pace with inflation in recent years, payments to the harvard medical faculty physicians for those services also do not cover the full costs of services provided to the patients served. In aggregate, the cost of care provided by hmfp for such services exceeded reimbursement by approximately $3.6 million in fy 2018. In addition, total bad debt expense was $12.9 million in fy 2018. Bad debts in addition to the shortfalls in providing services to patients insured under state and federal government programs, harvard medical faculty physicians also incurs losses related to self-pay patients who fail to make payments for services or insured patients who fail to pay coinsurance and/or deductible amounts for which they are responsible under insurance contracts. Bad debt expense is included in uncompensated care expense in the financial statements and includes the provision for accounts anticipated to be uncollectible.”

“Teaching teaching is a major component of the work done by harvard medical faculty physicians at beth israel deaconess medical center, inc. (hmfp) physicians and staff. The faculty of hmfp is extremely active in medical school education as lecturers, tutors, teaching attendees, and small group leaders. The staff of hmfp is an impressive course leadership group, as staff physicians at hmfp hold faculty appointments at harvard medical school. The hmfp physicians instruct the doctors of tomorrow through supervision of their daily patient care activities and a range of interactive learning experiences. The major teaching mission of the physician group at hmfp includes developing future leaders in clinical care, education, and research by fostering a culture of quality informed by cutting edge knowledge, humane physician role models, and an emphasis on curiosity and lifelong learning. Particular courses include patient doctor i and patient doctor ii, which are both yearlong courses to teach students interviewing skills and physical diagnosis. Other courses are designed to focus on health care quality, research, physiology, and global health initiatives. In the healthcare quality course, residents rotate on geographic units and work in multidisciplinary groups to improve quality in their "base units." training clinical residents includes teaching residents how to do research to foster research careers and to gain an understanding of how research impacts the overall medical field. One particular research course entitled "research for residents" is completed by three-quarters of the residents in the internal medicine residency program. For example, the department of medicine has developed an intensive course in comparative physiology. The goals of the course are to increase appreciation for physiology and to enhance residents' routine incorporation of pathophysiology into their teaching and clinical roles. Training in global health is done to encourage residents to expand their medical education beyond traditional roles and to develop a more global vision of health care. Through world-class teaching, hmfp is able to improve the health status of the communities served, and the residents are able to gain knowledge and self-reliance and enrich their medical knowledge and clinical skills by practicing in unique settings with limited resources.”

“Research part of harvard medical faculty physicians at beth israel deaconess medical center, inc.'s (hmfp) three-prong mission is to participate with bidmc as a world-class research institution where outstanding scientists work to develop new knowledge for the betterment of the health of our local and extended communities. The research program strives to be renowned for its bench-to-bedside model of translational research and for its collaboration with industry as a pathway for transferring the fruits of research into medical products and treatments that improve the quality of life. Hmfp commits to maintain a collaborative culture and modern, high-quality facilities, and to take full advantage of the unique relationships that exist among harvard medical school and the harvard teaching hospitals, as well as reaching out and collaborating with nationally recognized and world-renowned experts in various fields. Hmfp scientists continually search for improved understanding of diseases and better treatments for patients, which in turn directly impact both fundamental research and clinical trials. This research is led by more than 275 principal investigators who are harvard medical school faculty and key areas of research include vascular biology, molecular imaging, transplantation, signal transduction, cancer biology, metabolic disease, neurobiology, aids and cardiology/cardiac surgery. Our extraordinary faculty has established a culture that is collaborative and oriented toward translating new knowledge into novel medical treatments and patient care.”

“Other medical services other revenue consists of support received from beth israel deaconess medical center (bidmc) and harvard medical school for administrative services that hmfp employees perform for related organizations. Also, included in other revenue is a management fee from the consolidated entities of hmfp and the revenues generated from external organizations of hmfp for administrative and clinical services performed at locations in the community. In addition to the services outlined above, hmfp performed educational related activities research initiatives overseas. The revenues received for work performed abroad is included in the financial statements as other revenue.”

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

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

“The boston, ma office of kpmg issued an unqualified opinion on the consolidated audited financial statements of harvard medical faculty physicians at beth israel deaconess medical center (hmfp) and subsidiaries for fiscal year ended september 30, 2018. These statements were prepared in accordance with generally accepted accounting principles (gaap) and included the accounts of hmfp and all entities for which hmfp serves as sole member.”

“Other changes in net assets 915,254.”