TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)
(1) David Ament...................................................................... Trustee	1.0 ................. 2.0	X	0	0
(2) Karen Antman MD...................................................................... Trustee	1.0 ................. 2.0	X	0	0
(3) Anita Bekenstein...................................................................... Trustee	1.0 ................. 0.0	X	0	0
(4) Barry Bock...................................................................... Trustee	1.0 ................. 0.0	X	0	0
(5) David Coleman MD...................................................................... Trustee	1.0 ................. 54.0	X	755,693	33,764
(6) Enrique Colbert...................................................................... Trustee (as of 5/14/19)	1.0 ................. 0.0	X	0	0
(7) Sandra Cotterell...................................................................... Trustee	1.0 ................. 1.0	X	0	0
(8) Pierre Cremieux...................................................................... Trustee	1.0 ................. 1.0	X	0	0
(9) Randi Cutler...................................................................... Trustte	1.0 ................. 1.0	X	0	0
(10) Paul Egerman...................................................................... Trustee	1.0 ................. 0.0	X	0	0
(11) Ruth Ellen Fitch...................................................................... Trustee	1.0 ................. 0.0	X	0	0
(12) Melanie Foley...................................................................... Trustee	1.0 ................. 0.0	X	0	0
(13) Eileen Grayken...................................................................... Trustee	1.0 ................. 0.0	X	0	0
(14) John T Hailer...................................................................... Trustee (until 5/14/2019)	1.0 ................. 0.0	X	0	0
(15) William J Halpin Jr...................................................................... Trustee	1.0 ................. 1.0	X	0	0
(16) Karen Kames...................................................................... Trustee	1.0 ................. 0.0	X	0	0
(17) Azra Kanji...................................................................... Trustee	1.0 ................. 0.0	X	0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Manuel Lopes........................................................................ Trustee	1.0 .......................2.0	X					0	0	0
(19) Monica Valdes Lupi........................................................................ Trustee	1.0 .......................0.0	X					0	0	0
(20) Richard Marks........................................................................ Trustee	1.0 .......................1.0	X					0	0	0
(21) Jerod Mayo........................................................................ Trustee	1.0 .......................0.0	X					0	0	0
(22) Tricia Patrick........................................................................ Trustee	1.0 .......................0.0	X					0	0	0
(23) Claire Perlman........................................................................ Trustee	1.0 .......................0.0	X					0	0	0
(24) James S Phalen........................................................................ Trustee	1.0 .......................1.0	X					0	0	0
(25) Susannah Rowe MD........................................................................ Trustee (as of 10/1/18)	1.0 .......................0.0	X					0	210,293	50,874
(26) Martha Samuelson........................................................................ Trustee/Chair	1.0 .......................1.0	X					0	0	0
(27) Richard Slifka........................................................................ Trustee (until 5/14/2019)	1.0 .......................1.0	X					0	0	0
(28) Jennifer Tseng MD........................................................................ Trustee	1.0 .......................54.0	X					0	936,767	6,840
(29) Kathleen Walsh........................................................................ President and CEO	50.0 .......................7.5	X	X				2,535,523	0	19,357
(30) Rev Liz Walker........................................................................ Trustee	1.0 .......................0.0	X					0	0	0
(31) Andrew Youniss........................................................................ Trustee	1.0 .......................1.0	X					0	0	0
(32) David Beck........................................................................ SVP/Chief Legal Counsel/Clerk	50.0 .......................13.5		X				496,971	0	87,198
(33) Charles Orlando........................................................................ SVP/CFO/TREAS	36.0 .......................23.0		X				860,299	0	70,380
(34) Alastair Bell........................................................................ SVP Ops & Strategy/COO	50.0 .......................2.0			X			1,113,711	0	104,719
(35) Ravin Davidoff MD........................................................................ SVP MEDICAL AFFAIRS AND CMO	50.0 .......................1.5			X			713,194	0	40,788
(36) Nancy Gaden........................................................................ SVP CHIEF NURSING OFFICER	50.0 .......................0.0			X			517,761	0	92,537
(37) Lisa A Kelly-Croswell........................................................................ SVP/CHRO	50.0 .......................0.0			X			556,969	0	71,960
(38) Bob Biggio........................................................................ SVP Facility & Supt Svcs	50.0 .......................0.0				X		564,010	0	105,647
(39) Joe Camillus........................................................................ SVP Ambulatory & Prf Svc	50.0 .......................0.5				X		454,456	0	89,496
(40) Norman Stein........................................................................ SVP Chief Development Officer	50.0 .......................0.0				X		570,206	0	46,270
(41) Arthur Harvey........................................................................ VP/CIO	50.0 .......................0.0				X		458,978	0	46,034
(42) Julie Joncas........................................................................ VP Finance	50.0 .......................1.0				X		415,714	0	43,001
(43) Richard Silveria........................................................................ Former SVP Fin/CFO/Treas	0.0 .......................0.0					X	293,669	0	18,834
(44) MARY BETH BEGLEY........................................................................ FORMER OFFICER	0.0 .......................0.0					X	225,407	0	15,434
(45) Stanley Hochberg MD........................................................................ SVP Qual, Sfty, & Tech	0.0 .......................0.0					X	406,456	0	21,823

(A) Name and business address	(B) Description of services	(C) Compensation
Boston University, One Silber Way BOSTON,MA02215	SHARED RESEARCH SVCS	63,048,551
Suffolk Construction Company, 69 Allerton Street BOSTON,MA02119	Construction	34,977,871
Walsh Brothers Incorporated, 210 Commercial Street BOSTON,MA02109	Construction Service	21,747,278
Accenture LLP, 161 N Clark Street CHICAGO,IL60601	EHR Implementation	15,682,501
SCH Services Inc, 1640 W Redstone CTR DR PARK CITY,UT84098	Temporary Staffing	15,664,483
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 395

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	21,671,288	22,129,256	41,186,207	24,563,859	25,615,642	135,166,252
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....						0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
4	Total. Add lines 1 through 3	21,671,288	22,129,256	41,186,207	24,563,859	25,615,642	135,166,252
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..						8,181,628
6	Public support. Subtract line 5 from line 4.						126,984,624

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..	21,671,288	22,129,256	41,186,207	24,563,859	25,615,642	135,166,252
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	17,746,128	16,401,528	12,553,229	37,639,990	23,179,858	107,520,733
9	Net income from unrelated business activities, whether or not the business is regularly carried on..				273,343	1,867,255	2,140,598
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	5,441,957	5,093,586	6,346,770	6,259,300	15,535,712	38,677,325
11	Total support. Add lines 7 through 10						283,504,908

Gross receipts from related activities, etc. (see instructions) ..................

6,646,277,259

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

44.791 %

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

42.687 %

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization Boston Medical Center

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization Boston Medical Center		Employer identification number 04-3314093

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization Boston Medical Center			Employer identification number 04-3314093
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................
d	Other exempt purpose expenditures ........................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

69,000

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

13,830

Total. Add lines 1c through 1i ....................................................................................................

82,830

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1	Boston Medical Center pays dues to Massachusetts Hospital Association and the Conference of Boston Teaching Hospitals and a portion of these dues are allocated to lobbying efforts. The portion of dues that was allocated to lobbying efforts was $13,830. BMC also paid Robert White Associates $15,000 and Dempsey, Lucey & Associates $54,000 to represent the organization. These fees were paid to the lobbyists listed to advance Boston Medical Center's mission: "to consistently provide excellent and accessible health care services to all in need of care, regardless of status or ability to pay" as set out in Chapter 147 of the Acts and Resolves of 1996 of the Commonwealth of Massachusetts.

Return Reference

Explanation

Schedule C, Part II-B, Line 1

Boston Medical Center pays dues to Massachusetts Hospital Association and the Conference of Boston Teaching Hospitals and a portion of these dues are allocated to lobbying efforts. The portion of dues that was allocated to lobbying efforts was $13,830. BMC also paid Robert White Associates $15,000 and Dempsey, Lucey & Associates $54,000 to represent the organization. These fees were paid to the lobbyists listed to advance Boston Medical Center's mission: "to consistently provide excellent and accessible health care services to all in need of care, regardless of status or ability to pay" as set out in Chapter 147 of the Acts and Resolves of 1996 of the Commonwealth of Massachusetts.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	709,074,381	697,009,021	642,296,242	618,328,530	671,956,753
b	Contributions ...	285,759,688	21,885,406	127,298,970
c	Net investment earnings, gains, and losses	25,210,971	40,783,482	71,375,617	42,882,728	9,615,073
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	292,657,917	47,477,741	142,059,930	16,736,661	60,452,156
f	Administrative expenses ....	2,525,081	3,125,787	1,901,878	2,178,355	2,791,140
g	End of year balance ......	724,862,042	709,074,381	697,009,021	642,296,242	618,328,530

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

54.390 %

Permanent endowment SchDMd Bullet

5.140 %

Temporarily restricted endowment SchDMd Bullet

40.470 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	14,949,000		14,949,000
b	Buildings ....	1,203,712,000	347,364,000	856,348,000
c	Leasehold improvements	30,866,000	15,766,000	15,100,000
d	Equipment ....
e	Other .....	954,225,000	741,961,000	212,264,000
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,098,661,000

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) DONOR RESTRICTED INVESTMENTS	265,079,000	F
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	265,079,000

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) OTHER L-T ASSETS				47,911,000
(2) FUNDS HELD BY TRUSTEES				40,057,000
(3) BRD-DES. INVEST FOR FUNDED DEP				394,247,000
(4) NONCURRENT NOTES RECEIVABLE				3,941,000
(5) INSURANCE RECOVERY RECEIVABLES				35,793,000
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				521,949,000

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
EST SETTLEMENT W/3RD PARTY PAY	55,755,000
CAPITAL LEASE OBLIGATIONS	43,222,000
OTHER LONG-TERM LIABILITIES	122,072,000
PROFESSIONAL LIABILITY CLAIMS	35,793,000
TAXABLE BONDS PAYABLE	180,411,000
RELATED PARTY LIABILITIES	27,396,000
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	464,649,000
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Schedule D, Part V, Line 2

Presentation of endowment assets Boston Medical Center HAS ADOPTED ASU 2016-14, PRESENTATION OF THE FINANCIAL STATEMENTS FOR NOT-FOR-PROFIT ENTITIES. AS A RESULT, THE SEPTEMBER 30, 2019 AUDITED FINANCIAL STATEMENTS CLASSIFY NET ASSETS AS EITHER NET ASSETS WITHOUT DONOR RESTRICTIONS, OR NET ASSETS WITH DONOR RESTRICTIONS. FOR PURPOSES OF SCHEDULE D, LINE 2, BOSTON MEDICAL CENTER HAS REPORTED ENDOWMENT FUNDS WITHOUT DONOR RESTRICTIONS AS BOARD DESIGNATED OR QUASI-ENDOWMENT AND ENDOWMENT FUNDS WITH DONOR RESTRICTIONS AS PERMANENT ENDOWMENT OR TEMPORARILY RESTRICTED ENDOWMENT, RESPECTIVELY. Schedule D, Part V, Line 4 General Endowment The general endowment includes funds from a number of sources with various restrictions on use and treatment. The endowment funds have been contributed for specific purposes including construction, maintenance, research, clinical care, education, development, staffing, salaries, laboratory equipment and supplies, and convalescent care.

Schedule D, Part X, Line 2

The Health Ststem Corporation, the Medical Center, BMCHP, UDF, ECMF, BUAP, Faculty and the Plans, BACO, BMCICS, and BMCIC of Vermont are all nonprofit corporations that have been recognized as tax-exempt pursuant to Section 501(C)(3) of the Internal Revenue Code. The shareholders of NAB, before it was terminated, were nonprofit, tax-exempt corporations. The Health System recognizes income tax positions when it is more likely than not that the position will be sustainable based on the merits of the position. Management has concluded that there are no material uncertain tax positions that need to be recorded as of September 30, 2019 and 2018. The Health System annually assesses whether it must recognize an unrelated business income tax expense (UBIT). The amounts recognized as UBIT expense were not material to the Health System's consolidated operations or changes in net assets for the years ended September 30, 2019 and 2018.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
Boston Medical Center

Employer identification number

04-3314093

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	South America			Grantmaking		84,079
	Russia and the Newly Independent States			Grantmaking		236,213
	South Asia			Grantmaking		149,107
	Sub-Saharan Africa	2	8	Grantmaking		650,752
	North America			Grantmaking		153,447
	East Asia and the Pacific			Investments		2,077,757
	Europe (Including Iceland and Greenland)			Investments		11,168,677
	Middle East and North Africa			Investments		73,482
	North America			Investments		3,165,480
	South America			Investments		1,765,344
	Sub-Saharan Africa			Investments		216,061
	Central America and the Caribbean			Program Services	PREMIUMS	13,372,402





3a	Sub-total .....	2	8			33,112,801
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	2	8			33,112,801

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018

Schedule F (Form 990) 2018

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement
South America	SUBAWARD	84,079	WIRE
Russia and the Newly Independent States	SUBAWARD	236,213	WIRE
South Asia	SUBAWARD	149,107	WIRE
North America	SUBAWARD	153,447	WIRE
Sub-Saharan Africa	SUBAWARD	650,752	WIRE

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................	9

Schedule F (Form 990) 2018

Schedule F (Form 990) 2018Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2018

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2018

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation
Schedule F, Part I, Line 2	The principal investigator and administrator approve all subcontract invoices, including those from a foreign country. The foreign subcontract recipient has a budget to which invoices are matched to ensure that all spending is appropriate. Additionally, the organizations principal investigators regularly contact the foreign subcontract recipients to monitor the progress of the recipients work.
Schedule F, Part II, Line 1	Foreign expenditures are separately identified on the organization's General Ledger.

Schedule F (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
Boston Medical Center

Employer identification number

04-3314093

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2018

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Gala (event type)	(b) Event #2 Food 4 Thought (event type)	(c) Other events 6 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	2,868,883	804,555	1,662,886	5,336,324
2	Less: Contributions . . . .	2,674,968	789,055	1,377,943	4,841,966
3	Gross income (line 1 minus line 2) . . . . . .	193,915	15,500	284,943	494,358

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	224,733			224,733
7	Food and beverages . . .	39,533	112,912		152,445
8	Entertainment . . . .	87,487			87,487
9	Other direct expenses . . .	68,908	4,792	373,563	447,263
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				911,928
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-417,570

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities: MA

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2018

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		128,615,128	46,812,373	81,802,755	4.960 %
b	Medicaid (from Worksheet 3, column a) . . . . .		771,648,062	569,460,311	202,187,751	12.260 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		900,263,190	616,272,684	283,990,506	17.220 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).		24,875,381	12,339,543	12,535,838	0.760 %
f	Health professions education (from Worksheet 5) . . .		64,315,179	15,936,188	48,378,991	2.930 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	683	101,425,850	83,019,285	18,406,565	1.120 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	683	190,616,410	111,295,016	79,321,394	4.810 %
k	Total. Add lines 7d and 7j .	683	1,090,879,600	727,567,700	363,311,900	22.030 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	2	208,366		208,366	0.010 %
2	Economic development	2	15,830,000		15,830,000	0.960 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	11	1,366,117	300,000	1,066,117	0.060 %
8	Workforce development	1	901,130		901,130	0.050 %
9	Other	1	146,822		146,822	0.010 %
10	Total	17	18,452,435	300,000	18,152,435	1.090 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

9,289,162

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

217,482,121

Enter Medicare allowable costs of care relating to payments on line 5.....

192,033,854

Subtract line 6 from line 5. This is the surplus (or shortfall)........

25,448,267

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	Boston Medical Center One Boston medical Center Place Boston,MA02118 http://www.bmc.org	X	X	X	X	X

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Boston Medical Center
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, PAGE 8

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, PAGE 8

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Boston Medical Center
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.% and FPG family income limit for eligibility for discounted care of 0.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

See Part V, Page 8

The FAP application form was widely available on a website (list url):

See Part V, Page 8

A plain language summary of the FAP was widely available on a website (list url):
See Part V, Page 8

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	Boston Medical Center
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Boston Medical Center
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5	Focus Groups: Thirteen focus groups were conducted with specific populations of interest: 12 focus groups conducted specifically for the collaborative CHNA and one additional focus group conducted by work group members who submitted notes for the CHNA. Focus groups were 90-minute semi-structured conversations with approximately 8-12 participants per group and aimed to delve deeply into community's needs, strengths, and opportunities for the future. Focus groups were conducted with the following population groups, including residents of specific neighborhoods: Female low-wage workers (for example, housekeepers, child care workers, hotel service workers, etc.); Male low-wage workers (for example, janitorial staff, construction, etc.); Seniors (ages 65+) with complex, challenging issues (for example, homebound, medical complications); Residents who are housing insecure (no permanent address or close to eviction); Latino residents in East Boston (in Spanish); LGBTQ youth and young adults at risk of being homeless; Immigrant parents of school age children (5-18 years); Survivors of violence; mothers who have been affected by violence; Parents who live in public housing in Dorchester; Chinese residents living in Chinatown (in Chinese); Haitian residents living in Mattapan (in Haitian Creole); Residents in active substance use recovery; and Additional focus group with notes provided: Chinese residents living in Chinatown. A total of 104 community residents participated in focus groups, representing 13 neighborhoods across the city. Nearly half of focus group participants identified as Black or African American (45%), a third of participants identified as Hispanic or Latino (34%), and 10% identified as White. The majority of participants identified as female (57%), male 36%, and transgender or genderqueer are 7%. Fifteen community and social service organizations located throughout Boston assisted with recruiting participants and hosting focus groups. Key Informant Interviews: A total of 45 key informant interviews were completed, six of which were additional interviews submitted by work group volunteers. Interviews were 45-60-minute semi-structured discussions 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. Sectors represented in these interviews included: public health, health care, housing and homelessness, transportation, community development, faith, education, public safety, environmental justice, government, workforce development, social services, and food insecurity, and business organizational staff who work with specific population such as youth, seniors, disabled, LGBTQ, and immigrants. Schedule H, Part V, Section B, lines 6a Boston Medical Center conducted the CHNA with the following hospital facilities: Beth Israel Deaconess Medical Center, Boston Children's Hospital, Brigham and Women's Faulkner Hospital, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, and Tufts Medical Center. Schedule H, Part V, Section B, lines 6b Boston Medical Center conducted the CHNA with the following organizations: Boston Health Care for the Homeless Program, Boston Public Health Commission, Jamaica Plain Neighborhood Development Corporation, Community Labor United, Fenway Community Health Center, Health Leads, Madison Park Development Corporation, Massachusetts League of Community Health Centers, Uphams Corner Health Center, and Urban Edge. Schedule H, Part V, Section B, Line 7A https://www.bmc.org/about-us/commitment-our-community Schedule H, Part V, Section B, Line 10A https://www.bmc.org/about-us/commitment-our-community
Schedule H, Part V, Section B, Line 11	Unwavering in our commitment to address the health needs of our community, BMC provides a wide range of programs beyond the traditional medical model. Core to fulfilling our public health mission and consistent with the CHNA findings, the goals of our community benefits program are to improve access to health services and improve health outcomes for underserved populations in our community. Key findings that emerged from the CHNA included health care access and utilization, chronic diseases and risk factors, mental health and substance abuse, violence, housing affordability, environmental health. For detailed information about each of the programs and initiatives that addressed the needs last year, please see schedule h, part vi, supplemental information, promotion of community health below.
Schedule H, Part V, Section B, Line 13a	For patients who fall outside commonwealth assistance programs, patients are charged at the same levels as insurers are charged; however, they are offered a prompt-pay discount of 40% (regardless of income level, etc.) if the payments are made within the first 30 days from service.
Schedule H, Part V, Section B, Line 13h	By the definition of BMC's financial assistance policy, patients who qualify for financial assistance have applied for one of the Commonwealth's financial assistance programs (connectorcare, medicaid, or health safety net) or have been provided urgent/emergent services. In those instances, patients are viewed as unable to pay for these charges and the hospital submits the charge for reimbursement from the health safety net.
Schedule H, Part V, Line 16a	FAP Website: HTTP://WWW.BMC.ORG/SERVICES/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM Schedule H, Part V, Line 16b FAP Application Website: HTTP://WWW.BMC.ORG/SERVICES/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM Schedule H, Part V, Line 16c FAP Plain Language Summary Website: HTTP://WWW.BMC.ORG/SERVICES/PATIENT-FINANCIAL-ASSISTANCE-PROGRAM

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address		Type of Facility (describe)
1	MARGARET M SHEA RN ADULT HEALTH PROGR RIVER STREET MATTAPAN,MA02126	ADULT DAYCARE
2	SUPPORTING PARENTS & RESILIENT KIDS CT 225 RIVER STREET MATTAPAN,MA02126	THERAPEUTIC CENTER
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, PART I, LINE 3C	For patients who fall outside Commonwealth assistance programs, patients are charged at the same levels as insurers are charged; however, they are offered a prompt-pay discount of 40% (regardless of income level, etc.) if the payments are made within the first 30 days from service. Introduction The statute that provided the authority to create Boston Medical Center (BMC) requires it to serve all populations. BMC is a private, not-for-profit, 514-bed, urban academic medical center which emphasizes community-based, accessible care. its mission is to provide consistently accessible health services to all in need of care regardless of status and ability to pay. BMC is the largest safety-net hospital in New England and provides a full spectrum of pediatric and adult care services from primary to family medicine to advanced specialty care. Driven by the recognition that certain social determinants affect health outcomes among our patients and community, the goal of our community health improvement activities, or community benefits, is to improve community health. Approximately 57% of our patients are from underserved populations, such as the low-income and elderly, who rely on government payers such as Medicaid, the Health Safety Net and Medicare for their coverage, and 32% do not speak English as a primary language. To address the health needs of its diverse patient population, BMC provides a wide range of services beyond the traditional medical model. These programs, including patient navigation and a food pantry, help reduce barriers to gaining access to health services and eliminate disparities in health care among the various populations BMC serves. With more than 25,000 admissions and 1 million patient visits per year, BMC provides a comprehensive range of inpatient, clinical and diagnostic services in more than 70 areas of medical specialties and subspecialties. The largest 24-hour Level I trauma center in New England, BMC's Emergency Department has more than 130,000 patient visits annually. BMC serves the urban community of Greater Boston. The majority of the communities that BMC serves are Boston census tracts that are federally-designated medically underserved areas/populations. Although individuals in Massachusetts can seek care at any hospital, BMC remains the largest safety net provider in Boston and New England. The implementation of healthcare reform in massachusetts did not reduce the real number or percent of underserved communities served by BMC. An estimated 20.5% of Boston residents live below the federal poverty level. According to the Massachusetts Health Insurance Survey's 2019 research brief, an estimated 4% of residents were uninsured and 96% of Massachusetts residents had coverage during the survey of which 62.7% reported employer-sponsored insurance and 37.3% reported other (non-employer-sponsored) insurance. Still, insured residents in fair or poor health struggle to afford health care with 25% reporting challenges paying their medical bills. OF BMC'S PATIENTS IN 2019, APPROXIMATELY 2.3% WERE UNINSURED AND COVERAGE RATES FOR PRIMARY INSURANCE WERE APPROXIMATELY: 30.6% MEDICARE; 42.0% MEDICAID; 18.3% PRIVATE OR EMPLOYER-SPONSORED INSURANCE; 5.9% COMMONWEALTH CONNECTOR AND 0.9% OTHER.
Schedule H, PART I, LINE 5C	The organization's charity care did not exceed budgeted amounts. The budgeted amounts are predicted charity care amounts. The organization did not have any excess funds.
Schedule H, PART I, LINE 7	FOR THE CALCULATION OF COSTS OF CHARITY CARE (LINE 7A) & MEDICAID COST (LINE 7B), AN OVERALL COST TO CHARGE RATIO WAS USED. A COST TO CHARGE RATIO IS DETERMINED BY DIVIDING THE TOTAL CHARGES FOR ALL SERVICES INTO THE TOTAL COST OF PROVIDING THE SERVICES. THE RATIO IS MULTIPLIED BY THE CHARGES FOR CHARITY CARE and MEDICAID TO OBTAIN THEIR RESPECTIVE COSTS. FOR THE CALCULATION OF COMMUNITY HEALTH IMPROVEMENT SERVICES (LINE 7E) DISCRETE COSTING WAS USED. FOR THE CALCULATION OF HEALTH PROFESSIONS EDUCATION COST (LINE 7F) THE CENTERS FOR MEDICARE & MEDICAID services (CMS) COST ALLOCATION METHODOLOGY (CMS FORM 2552) WAS USED. CMS FORM 2552 IS A REQUIRED ANNUAL FILING TO THE FEDERAL GOVERNMENT.
Schedule H, PART I, LINE 7, COLUMN F	THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE WAS $0. DURING FISCAL YEAR 2019, BMC RECOGNIZED NET FAVORABLE SETTLEMENTS FROM MEDICARE, MEDICAID, BMCHP, BLUE CROSS AND OTHER PAYORS RELATED TO PRIOR YEARS OF APPORXIMATELY $2,099,000.
Schedule H, PART II, COMMUNITY BUILDING ACTIVITIES:	BMC CONTRIBUTES TO THE COMMUNITY THROUGH ITS PAYMENT OF LINKAGE FEES TO THE CITY OF BOSTON. THOSE LINKAGE FEE FUNDS SUPPORT PROGRAMS FOR AFFORDABLE HOUSING AND NEIGHBORHOOD HEALTH CARE. BMC ALSO PROVIDES SUBSIDIES TO BOSTON HEALTHNET, WHICH SUPPORTS COMMUNITY-BASED SERVICES. PHYSICAL IMPROVEMENTS AND HOUSING: ACCORDING TO THE DEVELOPMENT IMPACT PROJECT AGREEMENT FOR THE MOAKLEY CENTER ADDITION AND INPATIENT BUILDING PHASE I TRANSPORT BRIDGE PROJECT BETWEEN BOSTON MEDICAL CENTER AND THE BOSTON REDEVELOPMENT AUTHORITY, DATED MAY 5, 2014, BMC AGREES TO PAY LINKAGE FEES OF $22,746.14, ENDING IN 2022 TO THE NEIGHBORHOOD JOBS TRUST. MATTAPAN COMMUNITY HEALTH CENTER, A COMMUNITY HEALTH CENTER AFFILIATED WITH BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $8,200,000 FROM BOSTON MEDICAL CENTER DURING 2009 AND 2010 IN THE FORM OF A LOAN THAT WAS ORIGINATED ON SEPTEMBER 30, 2010. EFFECTIVE JUNE 30, 2009, $1,000,000 OF THE 2009 PORTION OF THE MATTAPAN LOAN WAS FORGIVEN. COMMENCING NOVEMBER 1, 2011, BOSTON MEDICAL CENTER AGREED TO FORGIVE TEN PERCENT OF THE REMAINING PRINCIPAL AMOUNT ($7,200,000) OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING COULD BE FORGIVEN IN TEN YEARS. IN FISCAL YEAR 2018, BOSTON MEDICAL CENTER INCURRED AN EXPENSE OF $2,220,000 TO FULLY RESERVE AGAINST THE NOTE RECEIVABLE AS IT WAS DETERMINED THAT NO FUTURE PAYMENTS WERE ANTICIPATED ON THE LOAN. THE LOAN AND RESPECTIVE RESERVE IS ACCOUNTED FOR ON THE BALANCE SHEET, ANNUALLY, EACH IS REDUCED BY THE FORGIVABLE AMOUNT. EAST BOSTON NEIGHBORHOOD HEALTH CENTER, A COMMUNITY HEALTH CENTER AFFILIATED WITH BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $1,000,000 FROM BOSTON MEDICAL CENTER DURING 2013 IN THE FORM OF A LOAN THAT WAS ORIGINATED EFFECTIVE JANUARY 15, 2013. COMMENCING SEPTEMBER 30, 2013, BOSTON MEDICAL CENTER AGREED TO FORGIVE TEN PERCENT OF THE ORIGINAL PRINCIPAL AMOUNT OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING COULD BE FORGIVEN IN TEN YEARS. IN FISCAL YEAR 2018, BOSTON MEDICAL CENTER INCURRED AN EXPENSE OF $500,000 TO FULLY RESERVE AGAINST THE NOTE RECEIVABLE AS IT WAS DETERMINED THAT NO FUTURE PAYMENTS WERE ANTICIPATED ON THE LOAN. THE LOAN AND RESPECTIVE RESERVE IS ACCOUNTED FOR ON THE BALANCE SHEET, ANNUALLY, EACH IS REDUCED BY THE FORGIVABLE AMOUNT. SOUTH BOSTON COMMUNITY HEALTH CENTER, A COMMUNITY HEALTH CENTER AFFILIATED WITH BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $600,000 FROM BOSTON MEDICAL CENTER DURING 2016 IN THE FORM OF A LOAN THAT WAS ORIGINATED EFFECTIVE JANUARY 26, 2016. COMMENCING JANUARY 26, 2017, BOSTON MEDICAL CENTER AGREED TO FORGIVE TEN PERCENT OF THE ORIGINAL PRINCIPAL AMOUNT OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING COULD BE FORGIVEN IN TEN YEARS. IN FISCAL YEAR 2018, BOSTON MEDICAL CENTER INCURRED AN EXPENSE OF $540,000 TO FULLY RESERVE AGAINST THE NOTE RECEIVABLE AS IT WAS DETERMINED THAT NO FUTURE PAYMENTS WERE ANTICIPATED ON THE LOAN. THE LOAN AND RESPECTIVE RESERVE IS ACCOUNTED FOR ON THE BALANCE SHEET, ANNUALLY, EACH IS REDUCED BY THE FORGIVABLE AMOUNT. SOUTH END COMMUNITY HEALTH CENTER, A COMMUNITY HEALTH CENTER AFFILIATED WITH BOSTON MEDICAL CENTER, RECEIVED A TOTAL OF $200,000 FROM BOSTON MEDICAL CENTER DURING 2017 IN THE FORM OF A LOAN THAT WAS ORIGINATED EFFECTIVE JUNE 16, 2017. COMMENCING JUNE 16, 2017, BOSTON MEDICAL CENTER AGREED TO FORGIVE ONE-THIRD OF THE ORIGINAL PRINCIPAL AMOUNT AND ACCRUED INTEREST OF THE NOTE EACH YEAR, WITH THE RESULT THAT THE ENTIRE LOAN OUTSTANDING COULD BE FORGIVEN IN THREE YEARS. IN FISCAL YEAR 2018, BOSTON MEDICAL CENTER INCURRED AN EXPENSE OF $200,000 TO FULLY RESERVE AGAINST THE NOTE RECEIVABLE AS IT WAS DETERMINED THAT NO FUTURE PAYMENTS WERE ANTICIPATED ON THE LOAN. THE LOAN AND RESPECTIVE RESERVE IS ACCOUNTED FOR ON THE BALANCE SHEET, ANNUALLY, EACH IS REDUCED BY THE FORGIVABLE AMOUNT. CAPITAL INVESTMENTS IN BOSTON HEALTHNET: WHILE THE NEED FOR COMMUNITY-BASED SERVICES CONTINUES TO GROW, IT HAS BECOME INCREASINGLY DIFFICULT FOR COMMUNITY HEALTH CENTERS TO MEET THE DEMAND. REIMBURSEMENT OFTEN DOES NOT COVER THE FULL COST OF CARING FOR THE COMPLEX NEEDS OF HEALTH CENTERS' DIVERSE PATIENT POPULATION. COMPOUNDING THIS PROBLEM, IN THE MID-LATE 1990S, MANY HEALTH CENTERS FOUND THEMSELVES OPERATING IN FACILITIES THAT WERE IN DESPERATE NEED OF RESTORATION OR EXPANSION. COSTLY INFORMATION TECHNOLOGY UPGRADES WERE ALSO REQUIRED TO ENHANCE MANAGEMENT EFFICIENCIES AND PATIENT CARE. IN RESPONSE TO THE HEALTH CENTERS' NEEDS, BMC PROVIDED APPROXIMATELY $15.8 MILLION IN OPERATING SUPPORT TO THE BOSTON HEALTHNET HEALTH CENTERS EACH YEAR. OTHER NET SUBSIDIES INCLUDE MOSTLY ECONOMIC DEVELOPMENT, COMMUNITY HEALTH IMPROVEMENT AND WORKFORCE DEVELOPMENT. HEALTH IMPROVEMENT AND WORKFORCE DEVELOPMENT. RESPONSE TO THE HEALTH CENTERS' NEEDS, BMC PROVIDED APPROXIMATELY $15.8 MILLION IN OPERATING SUPPORT TO THE BOSTON HEALTHNET HEALTH CENTERS EACH YEAR. OTHER NET SUBSIDIES INCLUDE MOSTLY ECONOMIC DEVELOPMENT, COMMUNITY HEALTH IMPROVEMENT AND WORKFORCE DEVELOPMENT. HEALTH IMPROVEMENT AND WORKFORCE DEVELOPMENT.
Schedule H, PART III, LINE 2:	SCHEDULE H, PART III, LINE 3 REPORTS BAD DEBT EXPENSE AT COST. PATIENT PAYMENTS ON ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AND RECORDED AS A BAD DEBT RECOVERY, REDUCING THE GROSS BAD DEBT WRITE-OFF.
Schedule H, PART III, LINE 3:	THE ORGANIZATION ESTIMATED $0 OF THE ORGANIZATION'S BAD DEBT EXPENSE (AT COST) AS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY DUE TO THE MANNER IN WHICH THE DETAIL OF THE BAD DEBT EXPENSE IS PROCESSED IN ITS SYSTEM.
Schedule H, PART III, LINE 4:	THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED IN FOOTNOTES 1(R)(III) AND 1(T) FOUND ON PAGES 15 AND 16 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS.
Schedule H, PART III, LINE 8:	MEDICARE ALLOWABLE COSTS OF $192,033,854 WERE CALCULATED USING THE CMS FORM 2552 METHODOLOGY OF DETERMINING MEDICARE COSTS. THIS USES THE STEP DOWN METHOD OF DETERMINING FULLY-ALLOCATED COSTS BY DISTINCT CLINICAL COST CENTERS AS DEFINED BY CMS. THESE FULLY-ALLOCATED COSTS ARE APPLIED AGAINST TOTAL CHARGES TO CALCULATE A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES IS APPLIED TO MEDICARE CHARGES BY DISTINCT CLINICAL COST CENTERS TO DETERMINE THE MEDICARE COSTS.
Schedule H, PART III, LINE 9B:	POPULATIONS EXEMPT FROM COLLECTION ACTIVITIES THE HOSPITAL WILL NOT REQUIRE PRE-ADMISSION OR PRE-TREATMENT DEPOSITS FROM INDIVIDUALS REQUIRING EMERGENCY SERVICES OR DETERMINED TO BE LOW-INCOME. THE FOLLOWING INDIVIDUALS AND PATIENT POPULATIONS ARE EXEMPT FROM ANY COLLECTION OR BILLING PROCEDURES BEYOND THE INITIAL BILL PURSUANT TO STATE REGULATIONS: A. PATIENTS WITH MASSHEALTH, Emergency Aid to the Elderly, Disabled and Children of THE DISABLED, CHILDREN, AND FULL Health Safety Net OR PATIENTS WITH County Medical Services Program OR PARTIAL hepatosplenomegaly BELOW THE PROGRAM-DEFINED Federal Poverty Level OR Modified Adjusted Gross Income GUIDELINE, OR OTHERS DETERMINED TO BE LOW-INCOME PATIENTS ARE EXEMPT FROM COLLECTION SUBJECT TO: 1. THE HOSPITAL MAY SEEK COLLECTION ACTION AGAINST ANY LOW-INCOME PATIENT FOR THEIR REQUIRED CO-PAYMENTS AND DEDUCTIBLES THAT ARE SET FORTH BY EACH SPECIFIC PROGRAM. 2. THE HOSPITAL MAY SEEK COLLECTION TO ALLOW A PATIENT TO MEET THE COMMONWEALTH ONE-TIME DEDUCTIBLE. 3. THE HOSPITAL MAY ALSO INITIATE BILLING OR COLLECTION FOR A LOW-INCOME PATIENT WHO ALLEGES THAT HE OR SHE IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM THAT COVERS THE COSTS OF THE HOSPITAL SERVICES, BUT WHO FAILS TO PROVIDE PROOF OF HIS OR HER PARTICIPATION AND WHOSE INSURANCE CANNOT BE VERIFIED IN THE HOSPITAL ELIGIBILITY SYSTEM. UPON RECEIPT OF SATISFACTORY PROOF THAT A PATIENT IS A PARTICIPANT IN A FINANCIAL ASSISTANCE PROGRAM, INCLUDING RECEIPT OR VERIFICATION FROM THE INSURANCE CARRIER, THE HOSPITAL SHALL CEASE ITS BILLING OR COLLECTION ACTIVITIES. 4. THE HOSPITAL MAY CONTINUE COLLECTION ACTION ON ANY LOW-INCOME PATIENT FOR SERVICES RENDERED PRIOR TO THE LOW-INCOME PATIENT DETERMINATION, PROVIDED THAT THE CURRENT LOW-INCOME PATIENT STATUS HAS BEEN TERMINATED OR EXPIRED. HOWEVER, ONCE A PATIENT IS DETERMINED ELIGIBLE AND ENROLLED IN THE HEALTH SAFETY NET, MASSHEALTH, OR CERTAIN FINANCIAL ASSISTANCE PROGRAMS, THE HOSPITAL WILL CEASE COLLECTION ACTIVITY FOR SERVICES PROVIDED PRIOR TO THE BEGINNING OF THE PATIENT'S ELIGIBILITY. 5. THE HOSPITAL MAY SEEK COLLECTION ACTION AGAINST ANY OF THE PATIENTS PARTICIPATING IN THE PROGRAMS LISTED ABOVE FOR NON-COVERED SERVICES THAT THE PATIENT HAS AGREED TO BE RESPONSIBLE FOR, PROVIDED THAT THE HOSPITAL OBTAINED THE PATIENT'S PRIOR WRITTEN CONSENT TO BE BILLED FOR THE SERVICE.
Schedule H, PART V, SECTION A	THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH HAS LICENSED BOSTON MEDICAL CENTER TO OPERATE A HOSPITAL AT ONE BOSTON MEDICAL CENTER PLACE, BOSTON, MA 02118. THIS LOCATION IS (1) A LICENSED HOSPITAL, (2) PROVIDES GENERAL MEDICAL & SURGICAL TREATMENT, (3) IS A TEACHING HOSPITAL, AND (4) OPERATES AN ER 24 HOURS. WHILE THE HOSPITAL LICENSE LISTS TWO CAMPUSES, ONLY ONE CAMPUS OPERATES: 1. BOSTON MEDICAL CENTER CORPORATION, MENINO PAVILION, 830-840 HARRISON AVENUE, BOSTON MA 02118 BOSTON MEDICAL CENTER ALSO OPERATES THE FOLLOWING OUTPATIENT CENTERS, WHICH ARE UNDER THE HOSPITAL'S LICENSE: CODMAN SQUARE HEALTH CENTER BRIGHTON HIGH SCHOOL STUDENT HEALTH CENTER BOSTON MEDICAL CENTER RADIOLOGY AT RYAN CENTER BOSTON UNIVERSITY EAST BOSTON NEIGHBORHOOD HEALTH CENTER (10 GOVE STREET) DOTHOUSE HEALTH MADISON PARK HIGH SCHOOL STUDENT HEALTH CENTER JEREMIAH E. BURKE STUDENT HEALTH CENTER GREATER ROSLINDALE MEDICAL & DENTAL LATIN ACADEMY STUDENT HEALTH CENTER TECHBOSTON ACADEMY SCHOOL HEALTH CENTER BOSTON MEDICAL CENTER RADIOLOGY AT WHITTIER STREET HEALTH CENTER BOSTON MEDICAL CENTER RADIOLOGY AT UPHAM'S CORNER HEALTH CENTER MURIEL SNOWDEN INTERNATIONAL HIGH SCHOOL HEALTH CENTER SOUTH BOSTON COMMUNITY HEALTH CENTER 386 WEST BROADWAY SOUTH BOSTON COMMUNITY HEALTH CENTER 409 WEST BROADWAY BOSTON MEDICAL CENTER SCHOOL-BASED HEALTH CENTER AT BOSTON COMMUNITY LEADERSHIP ACADEMY EAST BOSTON NEIGHBORHOOD HEALTH CENTER - 20 MAVERICK SQUARE BOSTON MEDICAL CENTER RADIOLOGY AT MATTAPAN COMMUNITY HEALTH CENTER EAST BOSTON NEIGHBORHOOD HEALTH CENTER (79 PARIS STREET) EBHS SCHOOL BASED HEALTH CENTER WINTHROP COMMUNITY HEALTH CENTER SOUTH BOSTON COMMUNITY HEALTH CENTER SEAPORT PRIMARY CARE BOSTON MEDICAL CENTER - DEPARTMENT OF FAMILY MEDICINE BOSTON MEDICAL CENTER - CROSSTOWN
Schedule H, PART VI, LINE 2	NEEDS ASSESSMENT In 2019, BMC conducted a comprehensive Community Health Needs Assessment (CHNA) in collaboration with community organizations, Boston residents, health centers, hospitals and the Boston Public Health Commission. The Boston Community Health Needs Assessment-Community Health Improvement Plan Collaborative formed to undertake the first Boston-wide CHNA and COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). Focusing on the social determinants of health and using a health equity lens, the Collaborative employed a participatory approach that engaged the community in every step of the CHNA. This CHNA focuses on the social determinants of health using a health equity lens. The influences of race, ethnicity, income, and geography on health patterns are often intertwined. In the United States, social, economic, and political processes ascribe social status based on race and ethnicity, which may influence opportunities for educational and occupational advancement and housing options, two factors that profoundly affect health. Institutional racism, economic inequality, discriminatory policies, and historical oppression of specific groups are many of the root factors that drive the health inequities we see in the U.S. today. The CHNA used a participatory, collaborative approach that engaged the community through different avenues. Over 100 Collaborative members representing health care, public health, education, community development, social service, and community-based organizations provided input throughout the CHNA process and played an integral role in data collection efforts. Data collection efforts were focused on engaging hard-to-reach populations who are not typically engaged in these processes or represented in the secondary data. Existing data were drawn from national, state, and city sources, such as the U.S. Census, Massachusetts Department of Public Health, and Boston Public Health Commission, including datasets such as the Boston Behavioral Risk Factor Surveillance System (BBRFSS). For new data collection, over 91 organizations and 2,500 individuals were engaged in a CHNA community survey (N=2,404) administered online and in-person in seven languages, 13 focus groups with community residents (N=104), and 45 interviews with organizational and community leaders to gauge their perceptions of the community's needs, strengths, and opportunities. Like all data gathering efforts, there are limitations to the CHNA data. Secondary data have a time lag, and various sources may use different definitions for similar topics. Data may be aggregated across time, geographies, or population groups to provide large enough sample sizes. More granular analysis for specific neighborhoods or ethnic groups within larger racial/ethnic categories is not possible. Primary data such as the survey and focus groups use a convenience sample which may not be representative of the larger population. Thirteen focus groups were conducted with specific populations of interest: 12 focus groups conducted specifically for the collaborative CHNA and one additional focus group conducted by work group members who submitted notes for the CHNA. Focus groups were 90-minute semi-structured conversations with approximately 8-12 participants per group and aimed to delve deeply into community's needs, strengths, and opportunities for the future. Focus groups were conducted with the following population groups, including residents of specific neighborhoods: Female low-wage workers (FOR EXAMPLE, housekeepers, child care workers, hotel service workers, etc.); Male low-wage workers (FOR EXAMPLE, janitorial staff, construction, etc.); Seniors (ages 65+) with complex, challenging issues (FOR EXAMPLE, homebound, medical complications); Residents who are housing insecure (no permanent address or close to eviction); Latino residents in East Boston (in Spanish); LGBTQ youth and young adults at risk of being homeless; Immigrant parents of school age children (5-18 years); Survivors of violence; mothers who have been impacted by violence; Parents who live in public housing in Dorchester; Chinese residents living in Chinatown (in Chinese); Haitian residents living in Mattapan (in Haitian Creole); Residents in active substance use recovery; and Additional focus group with notes provided: Chinese residents living in Chinatown. A total of 104 community residents participated in focus groups, representing 13 neighborhoods across the city. Nearly half of focus group participants identified as Black or African American (45%), a third of participants identified as Hispanic or Latino (34%), and 10% identified as White. The majority of participants identified as female (57%), 36% identified as male, and 7% identified as transgender or genderqueer. Fifteen community and social service organizations located throughout Boston assisted with recruiting participants and hosting focus groups. A total of 45 key informant interviews were completed, six of which were additional interviews submitted by work group volunteers. Interviews were 45-60-minute semi-structured discussions 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. Sectors represented in these interviews included public health, health care, housing and homelessness, transportation, community development, faith, education, public safety, environmental justice, government, workforce development, social services, AND food insecurity, AND business organizational staff WHO work with specific populationS such as youth, seniors, disabled, LGBTQ, and immigrants. Key findings that emerged from the CHNA included health care access and utilization, chronic diseases and risk factors, mental health and substance abuse, violence, housing affordability, environmental health. Unwavering in our commitment to address the health needs of our community, BMC provides a wide range of programs beyond the traditional medical model. Core to fulfilling our public health mission and consistent with the CHNA findings, the goals of our community benefits program are to improve access to health services and improve health outcomes for underserved populations in our community.
Schedule H, PART VI, LINE 3:	THE HOSPITAL POSTS NOTICES OF AVAILABILITY OF FINANCIAL ASSISTANCE IN: I. INPATIENT, CLINIC, AND EMERGENCY DEPARTMENT AND WAITING AREAS; II. PATIENT FINANCIAL COUNSELOR AREAS; III. CENTRAL ADMISSION/REGISTRATION AREAS; AND IV. BUSINESS OFFICE AREAS THAT ARE OPEN TO PATIENTS. POSTED NOTICES ARE CLEARLY VISIBLE AND LEGIBLE TO PATIENTS VISITING THESE AREAS. THE HOSPITAL ALSO INCLUDES A NOTICE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN ALL INITIAL BILLS. WHEN THE PATIENT CONTACTS THE HOSPITAL, THE PATIENT FINANCIAL SERVICES STAFF NOTIFIES THE PATIENT IF THEY QUALIFY FOR A PAYMENT PLAN. A PATIENT WHO IS ENROLLED IN A PUBLIC FINANCIAL ASSISTANCE PROGRAM (FOR EXAMPLE, MASSHEALTH, HEALTH SAFETY NET, OR FOR MEDICAL HARDSHIP) MAY QUALIFY FOR CERTAIN PLANS. PATIENTS MAY ALSO QUALIFY FOR ADDITIONAL ASSISTANCE BASED ON THE HOSPITAL'S OWN INTERNAL CRITERIA FOR FINANCIAL ASSISTANCE. FOR CASES WHERE THE HOSPITAL IS USING THE VIRTUAL GATEWAY APPLICATION, THE HOSPITAL ASSISTS THE PATIENT IN COMPLETING THE APPLICATION FOR MASSHEALTH CONNECTORCARE, CHILDREN'S MEDICAL SECURITY PLAN, HEALTH START, HEALTH SAFETY NET, OR OTHER FORMS OF FINANCIAL ASSISTANCE PROGRAMS AS THEY BECOME PART OF THE VIRTUAL GATEWAY PROGRAM. ALL SIGNS AND NOTICES ARE TRANSLATED INTO LANGUAGES OTHER THAN ENGLISH IF A LANGUAGE IS SPOKEN BY 10% OR MORE OF THE POPULATION RESIDING IN THE HOSPITAL SERVICE AREA. CURRENTLY, THE HOSPITAL TRANSLATES THE NOTICES INTO ENGLISH, PORTUGUESE, SPANISH, AND HAITIAN CREOLE.
Schedule H, PART VI, LINE 4:	COMMUNITY INFORMATION PLEASE SEE INTRODUCTION
Schedule H, PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTH Health Care Access Birth Sisters and Centering Pregnancy: BMC has developed two programs, Birth Sisters and Centering Pregnancy, to improve health outcomes of childbearing women at risk for poor maternal and infant outcomes. Birth Sisters are women who are trained to provide social support and education to mothers from their own communities during pregnancy, labor, and the postpartum period. The Birth Sisters program has been linked to significantly higher breastfeeding rates and fewer cesarean deliveries. Centering Pregnancy is an innovative and proven model of care that offers prenatal care in 12 two-hour group sessions using a curriculum modified to meet the complex social needs of BMC's population. At these sessions, beginning early in the second trimester, patients receive health visits, prenatal and parenting education, and peer group support all in one visit. The programs served 253 patients in FISCAL YEAR 2019. Boston Center for Refugee Health and Human Rights: The mission of the BOSTON CENTER FOR REFUGEE HEALTH AND HUMAN RIGHTS is to provide comprehensive health care for refugees and survivors of torture and related trauma, coordinated with legal aid and social services; to educate and train agencies and professionals who serve these communities; to advocate for the promotion of health and human rights in the United States and worldwide; and to conduct clinical, epidemiological, and legal research for the better understanding and promotion of health and quality of life for survivors of torture and related trauma. The CENTER served 484 patients in FISCAL YEAR 2019. CATALYST Clinic: In May 2016, Boston Medical Center launched the CATALYST Clinic (Center for Addiction Treatment for Adolescent/Young adults who use Substances), a program designed to treat young people aged 25 and under who are struggling with substance use, or who have experimented with drugs and alcohol and may be at risk for developing an addiction. The CATALYST Clinic team works to provide interdisciplinary, team-based care that includes physicians, a nurse, a social worker, a community outreach navigator and a program manager. The CATALYST Clinic team works together to offer assessment, diagnosis, and treatment of various substance use disorders, as well as a transition from adolescent to adult care when appropriate. In Fiscal Year 2019, the CATALYST Clinic received approximately 98 referrals to the clinic; 552 have been received since the program's inception. Child Life Program: The Child Life Program assists children and families in managing the stresses associated with hospitalization and illness. The PROGRAM team members are all trained developmental specialists, aiming to support children and families through the hospital experience. The goals of the PROGRAM are to help children express their feelings through play in a safe and supportive environment; advocate for children, offering support to effectively work through pain management; offer children developmentally appropriate choices that increase feelings of independence, self-esteem, and trust; and assist with implementation of coping techniques during stressful situations. The PROGRAM currently covers the areas of inpatient Pediatrics and the Pediatric Intensive Care Unit, Pediatric Ambulatory Care Clinic, Pediatric Emergency Department, and Pediatric Otolaryngology/OR; THE PROGRAM will be adding a position for Radiology. The team remains a consult service to children of adult families as needed. Clothing Bank: BMC's social workers use the clothing bank in real time when a provider contacts Social Work about a basic clothing need (sweatpants, shirts, underwear, socks, shoes, and winter coats) for a low-income patient. The Center for the Urban Child and Healthy Family, launched in 2016, is working to implement Boston Medical Center's vision of making Boston one of the healthiest cities in the world by ensuring every child has an equal opportunity to be healthy and achieve their full potential. The Center is creating a system of pediatric health care that actively promotes health equity and eradicates disparities. As an innovation hub within the Department of Pediatrics, the Center creates and tests innovative health care delivery models, working in partnership with families, communities and other child- and family-serving sectors. The Center has set a goal that by 2028, all children cared for by BMC Pediatrics are healthy and ready to learn with adequate supports to thrive by age five. To achieve this goal, the Center co-developed a new model of pediatric primary care- the Pediatric Practice of the Future - with families and pediatric providers. This model supports whole family development with attention to factors influencing well-being and bringing together care in a systematic, equitable way to promote wellness throughout the life course. In addition, the Center is partnering with BMC HealthNet Plan, BMC's health insurance program, to test alternative payment models to ultimately redefine value in pediatric care. Elders Living at Home Program: The goal of THE ELDERS LIVING AT HOME PROGRAM is to help older adults who are homeless or at risk for homelessness secure and maintain a permanent residence and live as independently as possible. THE PROGRAM served 262 clients during the 2019 fiscal year. Of this number, 128 received housing search and placement services; 101 received housing stabilization services; 72 received homelessness prevention assistance; 38 received nutritional assistance; and 75 clients were served through the Living Well at Home Project, a community-based complex care management pilot designed to improve health outcomes for frail residents of an elderly/disabled housing complex in Roxbury. Some clients received more than one type of service. All clients suffer from at least one chronic illness, and 252 suffer from two or more disabling medical conditions. Remarkably, all of the program clients who were placed in housing and all who received stabilization services have remained safely housed during this period. Of those clients who received homelessness prevention services, all but one case was successfully resolved. One client was too far along in the eviction process for us to intervene successfully; however, we were able to assist her in relocating to Maine to live with her daughter. Over the last ten years, the success rate of THE PROGRAM'S stabilization services is 98%. Grow Clinic: The Grow Clinic was founded in 1984 within BMC's Pediatrics DEPARTMENT. The primary goal of the Grow Clinic is to provide comprehensive multidisciplinary medical, nutritional, social services and developmental support to children from the Greater Boston area diagnosed with Failure to Thrive. Children with FAILURE TO THRIVE have significant difficulty growing because of malnutrition associated with illness, poverty, and other family stressors. The effects of FAILURE TO THRIVE include shortened attention spans, emotional problems, delayed cognitive development, lasting growth failure, and frequent serious illness, which can result in hospitalization. The Grow Clinic provides medical treatment, nutritional assessment, home health education, social service advocacy, developmental referrals, access to BMC's PREVENTATIVE food pantry, nutritional supplements, children's clothes, diapers, books and educational toys. THE GROW CLINIC TREATS approximately 200 children EACH YEAR. In FISCAL YEAR 2019 there were 90 new patients. Twenty-three percent (23%) of clinic patients were 12 months of age or younger; the average age at referral was 32 months; and the average length of treatment was 24 months. There were 1,010 total clinic visits during this period. Approximately 6% of patient families were homeless and living in shelters. Clinicians made 523 home visits in FISCAL YEAR 2019. All patients demonstrated improved growth, and 80% demonstrated significant weight improvement. Immigrant and Refugee Health Program: The Immigrant & Refugee Health Program provides comprehensive primary care services to immigrant and refugee patients. The team of clinicians takes care of general healthcare needs through regular check-ups, immunizations, and screenings, as well as through providing care for illnesses and injuries. If needed, the team will coordinate patient care with a specialist for a more serious health issue. Foreign and sign language interpreters are available to help patients communicate with the staff. The practice provides on-site interpreters and over the phone interpreters for more than 250 languages. The program also offers access to psychiatric and case management support to provide care for the wide range of patient needs. Boston Medical Center's Immigrant and Refugee Health Program sees over 400 new immigrant, refugee, and asylum seeker patients per year and has an overall long-term primary care patient population of about 2,200. Integrative Medicine: Started in 2004, the
Schedule H, PART VI, LINE 6	BMC HealthNet Plan BMC HealthNet Plan is a non-profit health plan that provides health insurance coverage to Massachusetts residents, including low income, underserved, disabled and elderly populations. It was established in 1997 by Boston Medical Center, the largest safety net hospital in New England, and has more than 20 years of experience delivering accessible care to complex populations. BMC HealthNet Plan also provides health coverage to Medicaid members in New Hampshire, where it operates as Well Sense Health Plan. BMC HealthNet Plan serves over 330,000 members across Massachusetts. Boston HealthNet (BHN) Established in 1995, Boston HealthNet is an integrated health care delivery system comprised of BMC, the Boston University School of Medicine, and 14 community health centers. The partnership has become a national model for community health care networks. Physicians who practice at HealthNet locations provide a wide range of comprehensive health care services to adult and pediatric patients, with a focus on disease prevention and health education. All physicians working in the health centers must be credentialed as members of BMC medical staff. Patients receiving primary care at HealthNet sites have access to highly trained specialists and cutting-edge technology at BMC while maintaining individualized and culturally sensitive care in their neighborhoods. Now in its TWENTY-FIFTH year, BOSTON HEALTHNET and its COMMUNITY HEALTH CENTER partners have extended BMC's presence into Boston-area neighborhoods, significantly IMPROVING the health of their residents. The accomplishments of the network are evidenced by the high volume of COMMUNITY HEALTH CENTER admissions to BMC; the collaborative development of quality improvement initiatives, clinical protocols, and standards of practice; increased access to specialty services; and the significant coordination of BOSTON HEALTHNET'S information technology programs and services. In 2015 and in collaboration with BMC, nine of the BOSTON HEALTHNET COMMUNITY HEALTH CENTERS began the process of implementing a new ELECTRONIC HEALTH RECORD and practice management system. The implementation of the new ELECTRONIC HEALTH RECORD system, OCHIN EPIC, greatly enhanced the care coordination efforts between Boston HealthNet COMMUNITY HEALTH CENTERS and the specialty clinics at Boston Medical Center. Grants: Boston HealthNet partners with the Massachusetts League of Community Health Centers to participate in a federal Health Center Controlled Network grant, a $900,000 three year grant (2019 - 2022) that supports quality improvement, data quality, reporting, and clinical EMR training. Research: A BOSTON HEALTHNET Research Subcommittee was set up in 2005 to review research projects that are proposed at the health centers with over 250 projects reviewed to-date. Increasing Patient Access: Community Access to BMC is enhanced through a free shuttle bus service and the UBER Health program. One shuttle bus is provided to East Boston Neighborhood Health Center that circulates twice an hour and the UBER program is to allow patients greater access to appointments for patients at 10 other health centers. On average, the shuttle bus transports over 210,000 patients and their families between BMC and EAST BOSTON EACH YEAR. The UBER Health program, implemented to SERVE 10 Boston HealthNet Health Centers, transports about 2,200 patients to BMC each year. Advancing Medical Education: A number of Boston HealthNet community health centers also serve as the primary community-based training sites for Boston University School of Medicine pediatric, family medicine, psychiatry and general medicine residents. Boston HealthNet COORDINATES community health center engagement with nearly 240 Boston University School of Medicine students to provide community-based education programs. BUSM students and physician assistants round at community health centers to supplement their training with direct patient contact. Community health center participation in the BMC residency training program has placed 80 residents at community health centers in the 2020 academic year. Boston Accountable Care Organization: Currently, nine Boston HealthNet community health centers participate in BOSTON ACO. BOSTON ACO enters into risk arrangements with government programs and commercial insurers and the BOSTON ACO participants are collectively accountable for the quality and cost of the care they provide. BOSTON ACO's most significant risk arrangement is with the MassHealth ACO program. With its participation in the MassHealth ACO program BOSTON ACO became clinically and financially integrated with BMC Health System - which includes Boston Medical Center, Boston University Medical Group, and BMC HealthNet Plan - and the parties engage in joint decision making over all substantive decisions regarding participation in the program.
Schedule H, PART VI, LINE 7	BMC DOES NOT FILE A COMMUNITY BENEFITS REPORT WITH THE COMMONWEALTH OF MASSACHUSETTS.

Schedule H (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Boston Medical Center

Employer identification number
04-3314093

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) Brockton Neighborhood 63 Main Street Brockton,MA02301	04-3165044	501(c)(3)	21,063	Subaward
(2) Academic Pediatric Association 6728 Old Mclean Village Drive Mclean,VA22101	51-0202446	501(c)(3)	61,667	Subaward
(3) Action For Boston Community Development Inc 621 W LOMBARD ST 3RD FL BOSTON,MA02111	04-2304133	501(c)(3)	15,884	Subaward
(4) African Community Health Initiatives Inc 1290 Tremont St 2Nd Floor ROXBURY,MA02120	43-2017013	501(c)(3)	81,938	Subaward
(5) Albert Einstein College Of Med 500 West 185Th Street New York,NY10033	13-1624225	501(c)(3)	67,955	Subaward
(6) American Academy Of Pediatrics 141 Northwest Point Blvd Elk Grove Village,IL60007	36-2275597	501(c)(3)	146,439	Subaward
(7) Arkansas Children'S Hospital 800 Marshall Slot 512 Little Rock,AR72202	71-0694931	501(c)(3)	178,687	Subaward
(8) Asian Women For Health Inc 83 Wallace St Somerville,MA02144	32-0390494	501(c)(3)	40,879	Subaward
(9) Bay Cove Human Service 66 Canal Street Boston,MA02114	04-2518575	501(c)(3)	7,555,586	Subaward
(10) Baystate Medical Center 759 Chestnut St Springfield,MA01199	04-2790311	501(c)(3)	6,254	Subaward
(11) Becker College 61 Sever Street Worcester,MA01609	04-2108346	501(c)(3)	24,000	Subaward
(12) Berkeley County First 6215 Murray Drive Room 114 Hannah,SC29410	57-1097780	501(c)(3)	35,000	Subaward
(13) Beth Israel Deaconess Po Box 3784 Boston,MA02241	04-2103881	501(c)(3)	566,977	Subaward
(14) Boston Health Care For The Homeless Prog Inc 780 Albany St Boston,MA02118	04-3160480	501(c)(3)	10,000	Subaward
(15) Boston Housing AuthorITY 52 Chauncy Street BOSTON,MA02111	04-6001907	501(c)(3)	39,679	Subaward
(16) Boston Senior Home Care Inc 89 South St Ste 501 Boston,MA02111	04-2546251	501(c)(3)	125,715	Subaward
(17) Boston University 715 Albany Street Boston,MA02118	04-2103547	501(c)(3)	3,171,328	Subaward
(18) Brazelton Touchpoints 1295 Bolyston St Suite 320 Boston,MA02115	04-3327682	501(c)(3)	68,030	Subaward
(19) Brigham & Womens HospITAL Po Box 3149 Boston,MA02241	04-2312909	501(c)(3)	87,042	Subaward
(20) Brockton Area Multi-Services 10 ChristyS Drive Brockton,MA02301	04-2562377	501(c)(3)	158,473	Subaward
(21) Brown University Off Of Cont Box J Providence,RI02912	05-0258809	501(c)(3)	26,736	Subaward
(22) Cambridge Health AlliANCE 1493 Cambridge Street Cambridge,MA02139	04-3320571	501(c)(3)	230,055	Subaward
(23) Cape Cod Hospital 27 Park St Hyannis,MA02601	04-2103600	501(c)(3)	17,636	Subaward
(24) Center For Community 360 Huntington Ave 222 Ymca Boston,MA02115	04-3286409	501(c)(3)	24,305	Subaward
(25) Centering Healthcare Institute Inc 89 South Street Boston,MA02111	06-1622668	501(c)(3)	11,417	Subaward
(26) Central Boston Elder Services Inc 2315 Washington Street Boston,MA02119	04-2546441	501(c)(3)	117,724	Subaward
(27) Child & Family Service 3057 Acushnet Avenue New Bedford,MA02745	04-2104754	501(c)(3)	579,000	Subaward
(28) Children'S Defense Fund 555 Park Street Saint Paul,MN55105	52-0895622	501(c)(3)	35,000	Subaward
(29) Colorado Statewide Parent Coalition 7150 Hooker St Ste B Denver,CO80030	74-2563848	501(c)(3)	35,000	Subaward
(30) Comagine Health 10700 Meridian Ave N Seattle,WA98133	91-1072875	501(c)(3)	149,812	Subaward
(31) Community Outreach An 208 West Coal Gallup,NM87301	46-5551998	501(c)(3)	35,000	Subaward
(32) Cooper Health System 1 Cooper Plz Camden,NJ08103	21-0634462	501(c)(3)	45,000	Subaward
(33) Corporation For Supportive Housing 61 Broadway Suite 2300 New York,NY10006	13-3600232	501(c)(3)	25,000	Subaward
(34) Dana Farber Cancer InSTITUTE 450 Brookline Ave Bp418 Boston,MA02115	04-2263040	501(c)(3)	70,015	Subaward
(35) Dimock Chc 55 Dimock St Roxbury,MA02119	04-3487835	501(c)(3)	6,456	Subaward
(36) Dothouse Health Inc 1353 Dorchester Avenue Dorchester,MA02122	23-7125970	501(c)(3)	73,826	Subaward
(37) Drexel School Of Publ Nesbitt Hl 3215 Market St Philadelphia,PA19104	23-1352630	501(c)(3)	51,094	Subaward
(38) Drexel University Nesbitt Hl 3215 Market St Philadelphia,PA19104	23-1352630	501(c)(3)	189,300	Subaward
(39) Emory University 1762 Clifton Rd Suite 1400 Atlanta,GA30322	58-0566256	501(c)(3)	160,793	Subaward
(40) General Electric Medi 5517 Collectiions Ctr Dr Chicago,IL60693	14-0689340	Corp	21,944	Subaward
(41) Harvard Pilgrim Health 1600 Crown Colony Dr Quincy,MA02169	04-2452600	501(c)(3)	7,908	Subaward
(42) Harvard University 677 Huntington Avenue Boston,MA02115	04-2103580	501(c)(3)	167,667	Subaward
(43) Healthinsight 756 Winchester St Suite 200 Salt Lake City,UT84107	87-0303872	501(c)(3)	125,395	Subaward
(44) Institute For Health 349 Broadway Cambridge,MA02139	04-3086647	501(c)(3)	49,808	Subaward
(45) John Hopkins University 600 Wolfe Street Baltimore,MD21287	52-0595110	501(c)(3)	175,482	Subaward
(46) Katherine Flaherty Consulting 33 Winter Street 2 Franklin,MA02038	82-0811788		204,953	Subaward
(47) Kelley-Ross & Associates Inc 2324 Eastlake Ave Ste 400 Seattle,WA98102	91-0688719		35,969	Subaward
(48) Mass Institute Of TeCHNOLOGY 77 Massachusetts Avenue Ne 49-4097 Cambridge,MA02139	04-2103594	501(c)(3)	32,569	Subaward
(49) Massachusetts General 55 Fruit Street Boston,MA02114	04-2697983	501(c)(3)	321,275	Subaward
(50) Massachusetts Housing Shelter Alliance Inc 25 Kington St 3rd Fl Boston,MA02111	22-3068653	501(c)(3)	10,000	Subaward
(51) Mgh Neurogenetics Dna 185 Cambridge Street Boston,MA02110	04-2807148	501(c)(3)	329,167	Subaward
(52) Minneapolis Med ReseaRCH 600 Shapiro Building Minneapolis,MN55404	41-1677920	501(c)(3)	225,570	Subaward
(53) National League Of Ci 660 N Capitol St Nw Ste 450 Washington,DC20001	52-6055762	501(c)(3)	52,500	Subaward
(54) North Suffolk Mental 301 Broadway Avenue Chelsea,MA02150	04-2317215	501(c)(3)	2,627,361	Subaward
(55) Northeast Behavioral Health Co 199 Rosewood Drive Suite 250 Danvers,MA01923	04-2777145	501(c)(3)	12,992	Subaward
(56) Northeastern University 360 Huntington Avenue Boston,MA02115	04-1679980	501(c)(3)	236,385	Subaward
(57) Northwestern University Tarry Bldg 3-707 303 E Chicago Ave Chicago,IL60611	36-2167817	501(c)(3)	467,940	Subaward
(58) Nuestra Comunidad Dev 56 Warren Street Suite 200 Roxbury,MA02119	04-2741543	501(c)(3)	15,446	Subaward
(59) Oregon State University A312 Kerr Admin Corvallis,OR97331	61-1730890	115	101,207	Subaward
(60) Partners In Health 888 Comm Ave 3Rd Floor Boston,MA02215	04-3567502	501(c)(3)	15,348	Subaward
(61) Pine Street Inn 444 Harrison Avenue Boston,MA02118	04-2516093	501(c)(3)	10,000	Subaward
(62) Program For Parents I 570 Broad Street Newark,NJ07102	22-2504469	501(c)(3)	35,000	Subaward
(63) Project Hope 550 Dudley Street Roxbury,MA02119	04-2748880	501(c)(3)	54,904	Subaward
(64) Rand Corporation 1776 Main St Santa Monica,CA90407	95-1958142	501(c)(3)	112,170	Subaward
(65) Reaching Our Sisters 3614 Columbia Pkwy Decatur,GA30034	45-2803568	501(c)(3)	65,000	Subaward
(66) Regents Of The U Of C 2760 Fifth Avenue San Diego,CA92103	95-6006144	501(c)(3)	78,638	Subaward
(67) Rhode Island Hospital 593 Eddy St Providence,RI02903	05-0258954	501(c)(3)	62,397	Subaward
(68) Riverside Research InSTITUTE 156 William St 9Th Flr New York,NY10038	13-2593244	501(c)(3)	19,921	Subaward
(69) Rutgers The State UnIVERSITY OF NEW JERSEY 65 Davidson Road Piscataway,NJ08854	46-2354111	501(c)(3)	632,251	Subaward
(70) Seattle Biomedical Re 307 Westlake Ave N Ste 500 Seattle,WA98109	91-0961784	501(c)(3)	28,453	Subaward
(71) Seattle Children'S Hospital 4800 Sand Point Way Ne Seattle,WA98105	91-0564748	501(c)(3)	15,582	Subaward
(72) Social Science Research And Evaluation Inc 84 Mill Street Lincoln,MA01773	22-2551337	501(c)(3)	38,819	Subaward
(73) Southwest Boston Senior Svc 555 Amory Street Jamaica Plain,MA02130	23-7304163	501(c)(3)	99,759	Subaward
(74) Steward St Anne'S Hospital Co 1900 N Pearl Street 2400 Dallas,TX75201	27-2473637		261,078	Subaward
(75) The Board Of Trustee Of Univ Of Alabama 651 Peter Bryce Blvd Tusscaloosa,AL35401	63-0803491	501(c)(3)	35,000	Subaward
(76) The Miriam Hospital 164 Summit Avenue Providence,RI02906	05-0258905	501(c)(3)	14,627	Subaward
(77) The New York Immigrant 131 West 33Rd St Ste 610 New York,NY10001	13-3573409	501(c)(3)	35,000	Subaward
(78) The Regents Of The University Of Colorado 1800 Grant St Ste 600 Denver,CO80203	84-6000555	501(c)(3)	43,123	Subaward
(79) The University Of Rhode Island 75 Lower College Road Kingston,RI02881	22-3011455	115	13,369	Subaward
(80) Univ Of Texas Health Science Center At Houston 700 Fannin Street Houston,TX77030	74-1761309	115	95,172	Subaward
(81) Third Sector New EnglAND 89 South Street 7Th Floor Boston,MA02111	04-2261109	501(c)(3)	64,093	Subaward
(82) Touro College 500 Seventh Ave 5Th Fl New York,NY10018	13-2676570	501(c)(3)	15,938	Subaward
(83) Trustees Of The University 3451 Walnut Street Suite 305 Philadelphia,PA19104	23-1352685	501(c)(3)	14,400	Subaward
(84) Tufts University 715 Albany Street Boston,MA02118	04-2103634	501(c)(3)	627,529	Subaward
(85) US Civilian ReSEARch 1776 Wilson Blvd Ste 300 Arlington,VA22209	54-1773406	501(c)(3)	470,886	Subaward
(86) United Way Of MetropoLITAN CHIGAGO 333 South Wabash Avenue Chicago,IL60604	30-0200478	501(c)(3)	35,000	Subaward
(87) United Way Of Tucson And Southern Arizona 330 N Commerce Park Loop Suite 20 Tucson,AZ85745	86-0098932	501(c)(3)	70,000	Subaward
(88) Univ Of Maryland Baltimore Foundation Inc 621 W Lombard St 3Rd Fl Baltimore,MD21201	31-1678679	501(c)(3)	194,869	Subaward
(89) University Of Massachusetts 55 Lake Avenue North Worcester,MA01655	04-3167352	115	165,451	Subaward
(90) University Of North Carolina Cb 13501 Chapel Hill,NC27599	56-6001393	501(c)(3)	121,502	Subaward
(91) University Of Pittsburgh 200 Meyran Ave Ste 200 Pittsburgh,PA15213	25-0965591	115	20,004	Subaward
(92) University Of Washington Box 359505 Gift Services Seattle,WA98195	91-6001537	115	92,115	Subaward
(93) Vanderbilt University Gift Processing Vu Station B 3577 Nashville,TN37235	62-0476822	501(c)(3)	111,985	Subaward
(94) Vinfen Corp Po Box 5059 Boston,MA02206	04-2632219	501(c)(3)	594,589	Subaward
(95) Washington University School Of Medicine 700 Rosedale Ave Cb1034 Saint Louis,MO63112	43-0653611	501(c)(3)	20,661	Subaward
(96) Weill Medical College Of Cornell University 100 Broadway 8Th Fl New York,NY10005	13-1623978	501(c)(3)	69,633	Subaward
(97) Whatcom County 311 Grand Ave Bellingham,WA98225	91-6001383	115	35,000	Subaward
(98) Yale University School Po Box 1873 New Haven,CT06508	06-0646973	501(c)(3)	86,580	Subaward

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
Schedule I, Part I, Line 2	Grants Administration uses Lawson general ledger and LBI reporting to monitor all grant funding. In addition, each Principal Investigator and Department Administrator have desktop access so they are able to review their funding and expenditures on a daily basis.

Schedule I (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1David Beck SVP/Chief Legal Counsel/Clerk	(i) (ii)	374,943 -------------	119,700 -------------	2,328 -------------	64,850 -------------	22,348 -------------	584,169 -------------	-------------
2Richard Silveria Former SVP Fin/CFO/Treas	(i) (ii)	-------------	-------------	293,669 -------------	-------------	18,834 -------------	312,503 -------------	-------------
3Alastair Bell SVP Ops & Strategy/COO	(i) (ii)	727,883 -------------	383,500 -------------	2,328 -------------	99,268 -------------	5,451 -------------	1,218,430 -------------	-------------
4Bob Biggio SVP Facility & Supt Svcs	(i) (ii)	412,807 -------------	148,875 -------------	2,328 -------------	64,750 -------------	40,897 -------------	669,657 -------------	-------------
5Joe Camillus SVP Ambulatory & Prf Svc	(i) (ii)	341,878 -------------	110,250 -------------	2,328 -------------	55,750 -------------	33,746 -------------	543,952 -------------	-------------
6Charles Orlando SVP/CFO/TREAS	(i) (ii)	606,746 -------------	251,225 -------------	2,328 -------------	56,038 -------------	14,342 -------------	930,679 -------------	-------------
7David Coleman MD Trustee	(i) (ii)	------------- 749,021	-------------	------------- 6,672	------------- 31,800	------------- 1,964	------------- 789,457	-------------
8Susannah Rowe MD Trustee (as of 10/1/18)	(i) (ii)	------------- 204,679	------------- 5,062	------------- 552	------------- 25,440	------------- 25,434	------------- 261,167	-------------
9Jennifer Tseng MD Trustee	(i) (ii)	------------- 934,313	-------------	------------- 2,454	-------------	------------- 6,840	------------- 943,607	-------------
10Kathleen Walsh President and CEO	(i) (ii)	1,294,489 -------------	573,300 -------------	667,734 -------------	13,750 -------------	5,607 -------------	2,554,880 -------------	436,000 -------------
11Ravin Davidoff MD SVP MEDICAL AFFAIRS AND CMO	(i) (ii)	493,366 -------------	157,500 -------------	62,328 -------------	16,958 -------------	23,830 -------------	753,982 -------------	-------------
12Nancy Gaden SVP CHIEF NURSING OFFICER	(i) (ii)	389,433 -------------	126,000 -------------	2,328 -------------	56,250 -------------	36,287 -------------	610,298 -------------	-------------
13Stanley Hochberg MD SVP Qual, Sfty, & Tech	(i) (ii)	-------------	-------------	406,456 -------------	-------------	21,823 -------------	428,279 -------------	-------------
14Lisa A Kelly-Croswell SVP/CHRO	(i) (ii)	420,766 -------------	133,875 -------------	2,328 -------------	61,542 -------------	10,418 -------------	628,929 -------------	-------------
15Norman Stein SVP Chief Development Officer	(i) (ii)	394,446 -------------	126,000 -------------	49,760 -------------	20,625 -------------	25,645 -------------	616,476 -------------	-------------
16Arthur Harvey VP/CIO	(i) (ii)	346,400 -------------	110,250 -------------	2,328 -------------	36,250 -------------	9,784 -------------	505,012 -------------	-------------
17Julie Joncas VP Finance	(i) (ii)	316,301 -------------	97,150 -------------	2,263 -------------	32,717 -------------	10,284 -------------	458,715 -------------	-------------
18MARY BETH BEGLEY FORMER OFFICER	(i) (ii)	152,776 -------------	-------------	72,631 -------------	8,487 -------------	6,947 -------------	240,841 -------------	-------------

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 4a	The amount of severance compensation paid to Richard Silveria is $293,669 and Stanley Hochberg is $406,456 which is reported in Schedule J, Part II, Column B(iii). Both Richard Silveria and Stanley Hochberg received the standard severance package, which is twelve months of salary plus medical and dental benefits. The amount of severance compensation paid to Mary Beth Begley is $72,381 which is reported in Schedule J, Part II, Column (B)(iii). Mary Beth Begley received severance equivalent to sixteen weeks of weekly base wages.
Schedule J, Part I, Line 4b	Boston Medical Center Provides A Supplemental Executive Retirement Plan To Certain Executives. Amounts Are Credited To Participants' Accounts Each Year. Plan Amounts Are Subject To Forfeiture And Payment Only If Certain Conditions Are Met, As Outlined In The Plan Agreement. Boston Medical Center Maintains An Executive Benefit Plan Which Offers Participating Executives The Option Of Annually Allocating Benefit Dollars To A Supplemental Retirement/Pre-Tax Savings Account. Amounts Vest On Specified Dates Based On Continued Employment But No Later Than The Executive's SIXTY-SECOND Birthday. Amounts Accrued In The Plan Are Reported In Schedule J, Part II, Column C. The Following Amounts Became Vested And Were Paid To The Following Executives In Calendar Year 2018: Walsh - $191,250 Davidoff - $60,000 Stein - $47,432 BMC Provided A Supplemental Executive Retirement Plan To Kathleen Walsh, President And CEO As Of March 1, 2010. Pursuant To The Terms Of The Agreement, Certain Amounts Were Credited To The President And CEO's Account In Prior Years. These Amounts Are Subject To Forfeiture And Payment Will Be Made Only If Certain Conditions Are Met, As Outlined In The Agreement. For Calendar Year 2018, $461,050 was vested and is reflected in Schedule J, Part II, Column B (iii).
Schedule J, Part I, Line 7	BMC Has An Annual Executive Performance Incentive Plan. Performance Targets And Payout Metrics Are Established And Approved By The Compensation Committee At The Beginning Of Each Performance Cycle. FISCAL YEAR 2018 Performance Bonus Payouts were Approved By The Committee after it reviewed the 2018 Performance Results Against Pre-Established Performance Targets, And Approved The Formula-Based Payouts Accordingly.

Schedule J (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Boston Medical Center

Employer identification number
04-3314093

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MDFA 2012 Series C	04-3431814	57583URP5	06-14-2012	117,490,498	Refunding of 1998 Bonds	X			X		X
B	MDFA 2015 Series D	04-3431814	57583U6Q6	04-08-2015	167,471,151	FINANCE CAPITAL PROJECTS		X		X		X
C	MDFA 2016 Series E	04-3431814	57584XWT4	09-22-2016	203,977,951	FINANCE NEW PROJECTS		X		X		X
D	MDFA 2017 Series F	04-3431814	57584x6z9	12-20-2017	45,272,849	FINANCE CAPITAL PROJECTS		X		X		X
	MHEFA 2009 Series O-1	04-2456011	57586ELD1	08-14-2009	101,485,000	Refunding of Series M3-B		X		X	X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	40,690,000		0		1,580,000		1,545,000
2 Amount of bonds legally defeased ..............	35,340,000		0		0		0
3 Total proceeds of issue ..................	117,498,730		168,727,807		206,430,670		45,971,835
4 Gross proceeds in reserve funds .............	4,416,013		15,703,190		0		0
5 Capitalized interest from proceeds .............	0		430,032		16		9,238
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	1,684,889		2,007,035		1,673,571		272,257
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		150,386,240		29,083,402		45,690,339
11 Other spent proceeds .............	115,813,841		201,311		175,673,681		0
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X	X			X
16 Has the final allocation of proceeds been made? ..........	X			X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X	X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X	X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?			X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0.600 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............					0.600 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X			X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X	X		X		X
b Exception to rebate? ........	X			X		X		X
c No rebate due? .........	X			X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?	X			X		X		X
b Name of provider ..........	AIG Matched Funding		0		0		0
c Term of GIC .........	2719 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........	X
6 Were any gross proceeds invested beyond an available temporary period?	X			X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Column A	Part I(F): The prior bonds were issues on July 8, 1998, by the Massachusetts Health and Educational Facilities Authority. Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS. Part II, Line 4: Debt service reserve fund was funded by proceeds of the prior bonds. Part II, Line 13: Since the proceeds of the 2012 bonds were used for refunding purposes, the year of substantial completion is not applicable. Part III: Because proceeds of the bonds were used to refund bonds issued before January 1, 2003, the issuer is not required to complete Part III. Part IV, Line 1: Boston Medical Center remitted an arbitrage rebate payment, along with Form 8038-T, to the IRS on or before August 13, 2017 (within 60 days of the fifth bond year). COLUMN B Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS.
Column C	Part I(F): The prior bonds were issued on July 1, 2008, by the Massachusetts Health and Educational Facilities Authority. Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS. Part II, Line 12: Unspent bond proceeds deposited to the project and expense funds. COLUMN D PART II, LINE 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS.
Column A, Page 2	THE BONDS ARE PART OF A POOLED FINANCING (TOTAL PAR $101,485,000) AND THUS, EXCEPT FOR PART I, ONLY THE BORROWER'S ALLOCABLE PORTION OF $13,688,734 IS REPRESENTED. PART I(F): THE BORROWER'S PORTION OF THE BONDS REFINANCED THE PORTION OF THE ISSUER'S SERIES M3-B (2005) BONDS (ISSUES ON OCTOBER 3, 2005) ALLOCABLE TO THE BORROWER. PART II, LINE 4: THE RESERVE HAS BEEN FUNDED BY THE PROCEEDS OF THE PRIOR BONDS. PART II, LINE 13: SINCE THE PROCEEDS OF THE BONDS WERE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART IV, LINE 2(B): BOND PROCEEDS WERE EXPENDED TO FINANCE A CURRENT REFUNDING, WHICH HAS MET AN EXCEPTION TO THE REBATE REQUIREMENT. THE BOND PROCEEDS WERE SPENT WITHIN SIX MONTHS OF THE ISSUE DATE.

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Boston Medical Center

Employer identification number
04-3314093

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MDFA 2012 Series C	04-3431814	57583URP5	06-14-2012	117,490,498	Refunding of 1998 Bonds	X			X		X
B	MDFA 2015 Series D	04-3431814	57583U6Q6	04-08-2015	167,471,151	FINANCE CAPITAL PROJECTS		X		X		X
C	MDFA 2016 Series E	04-3431814	57584XWT4	09-22-2016	203,977,951	FINANCE NEW PROJECTS		X		X		X
D	MDFA 2017 Series F	04-3431814	57584x6z9	12-20-2017	45,272,849	FINANCE CAPITAL PROJECTS		X		X		X
	MHEFA 2009 Series O-1	04-2456011	57586ELD1	08-14-2009	101,485,000	Refunding of Series M3-B		X		X	X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	40,690,000		0		1,580,000		1,545,000
2 Amount of bonds legally defeased ..............	35,340,000		0		0		0
3 Total proceeds of issue ..................	117,498,730		168,727,807		206,430,670		45,971,835
4 Gross proceeds in reserve funds .............	4,416,013		15,703,190		0		0
5 Capitalized interest from proceeds .............	0		430,032		16		9,238
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	1,684,889		2,007,035		1,673,571		272,257
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		150,386,240		29,083,402		45,690,339
11 Other spent proceeds .............	115,813,841		201,311		175,673,681		0
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X		X		X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X	X			X
16 Has the final allocation of proceeds been made? ..........	X			X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X	X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X	X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?			X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0.600 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............					0.600 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X			X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X	X		X		X
b Exception to rebate? ........	X			X		X		X
c No rebate due? .........	X			X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?	X			X		X		X
b Name of provider ..........	AIG Matched Funding		0		0		0
c Term of GIC .........	2719 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........	X
6 Were any gross proceeds invested beyond an available temporary period?	X			X	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Column A	Part I(F): The prior bonds were issues on July 8, 1998, by the Massachusetts Health and Educational Facilities Authority. Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS. Part II, Line 4: Debt service reserve fund was funded by proceeds of the prior bonds. Part II, Line 13: Since the proceeds of the 2012 bonds were used for refunding purposes, the year of substantial completion is not applicable. Part III: Because proceeds of the bonds were used to refund bonds issued before January 1, 2003, the issuer is not required to complete Part III. Part IV, Line 1: Boston Medical Center remitted an arbitrage rebate payment, along with Form 8038-T, to the IRS on or before August 13, 2017 (within 60 days of the fifth bond year). COLUMN B Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS.
Column C	Part I(F): The prior bonds were issued on July 1, 2008, by the Massachusetts Health and Educational Facilities Authority. Part II, Line 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS. Part II, Line 12: Unspent bond proceeds deposited to the project and expense funds. COLUMN D PART II, LINE 3: THE DIFFERENCE BETWEEN TOTAL PROCEEDS IN PART II, LINE 3 AND THE ISSUE PRICE OF THE BOND ISSUE IS DUE TO INTEREST EARNED ON BOND PROCEEDS.
Column A, Page 2	THE BONDS ARE PART OF A POOLED FINANCING (TOTAL PAR $101,485,000) AND THUS, EXCEPT FOR PART I, ONLY THE BORROWER'S ALLOCABLE PORTION OF $13,688,734 IS REPRESENTED. PART I(F): THE BORROWER'S PORTION OF THE BONDS REFINANCED THE PORTION OF THE ISSUER'S SERIES M3-B (2005) BONDS (ISSUES ON OCTOBER 3, 2005) ALLOCABLE TO THE BORROWER. PART II, LINE 4: THE RESERVE HAS BEEN FUNDED BY THE PROCEEDS OF THE PRIOR BONDS. PART II, LINE 13: SINCE THE PROCEEDS OF THE BONDS WERE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART IV, LINE 2(B): BOND PROCEEDS WERE EXPENDED TO FINANCE A CURRENT REFUNDING, WHICH HAS MET AN EXCEPTION TO THE REBATE REQUIREMENT. THE BOND PROCEEDS WERE SPENT WITHIN SIX MONTHS OF THE ISSUE DATE.

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) HANNAH LEAVER	Daughter of Trustee	190,949	EMPLOYMENT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
SCHEDULE L, PART IV	BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: HANNAH LEAVER, DAUGHTER OF TRUSTEE MARKS, IS EMPLOYED BY BMC. LEAVER HAS BEEN EMPLOYED BY BMC SINCE BEFORE TRUSTEE MARKS JOINED THE BMC BOARD IN 2016.

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....	X	1	900	Donor Estimate
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..	X		35	DONOR ESTIMATE
5 Clothing and household goods .......	X		31,715	DONOR ESTIMATE
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	40	1,372,418	stock sale proceeds
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....	X	5	1,250	DONOR ESTIMATE
19 Food inventory ...	X	17	335	DONOR ESTIMATE
20 Drugs and medical supplies .	X	1	533,508	DONOR ESTIMATE
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Gift Certificate )	X	100	40,738	Donor Estimate
26 Other ( Tickets )	X	50	21,370	Donor Estimate
27 Other ( Jewelry )	X	3	2,629	Donor Estimate
28 Other ( Toys )	X	17	12,624	Donor Estimate
Other ( Travel )	X	22	24,461	DONOR ESTIMATE
Other ( Miscellaneous )	X	11	10,750	DONOR ESTIMATE
Other ( Beauty )	X	3	9,355	Donor Estimate

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which is not required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2018)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
Schedule M, Part I, Column b	The organization is reporting the number of items contributed.

Schedule M (Form 990) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Return Reference	Explanation
Form 990, Part III, Line 4a	THE STATUTE THAT AUTHORIZED THE CREATION OF BOSTON MEDICAL CENTER REQUIRES IT TO SERVE ALL POPULATIONS. BMC IS A PRIVATE, NOT-FOR-PROFIT, 514-LICENSED BED, URBAN ACADEMIC MEDICAL CENTER WHICH EMPHASIZES COMMUNITY-BASED, ACCESSIBLE CARE AND THE MISSION TO PROVIDE CONSISTENTLY ACCESSIBLE HEALTH SERVICES TO ALL IN NEED OF CARE REGARDLESS OF STATUS AND ABILITY TO PAY. BMC IS THE LARGEST SAFETY NET HOSPITAL IN NEW ENGLAND AND PROVIDES A FULL SPECTRUM OF PEDIATRIC AND ADULT CARE SERVICES FROM PRIMARY TO FAMILY MEDICINE TO ADVANCED SPECIALTY CARE. APPROXIMATELY 72% OF BMC'S PATIENT VISITS COME FROM UNDERSERVED POPULATIONS, SUCH AS THE LOW-INCOME AND ELDERLY, WHO RELY ON GOVERNMENT PAYERS SUCH AS MEDICAID, THE HEALTH SAFETY NET AND MEDICARE FOR THEIR COVERAGE, AND 32% DO NOT SPEAK ENGLISH AS A PRIMARY LANGUAGE. TO ADDRESS THE HEALTH NEEDS OF DIVERSE PATIENT POPULATION, BMC PROVIDES A WIDE RANGE OF SERVICES BEYOND THE TRADITIONAL MEDICAL MODEL. THESE PROGRAMS, INCLUDING PATIENT NAVIGATION AND A FOOD PANTRY, HELP TO REDUCE BARRIERS TO ACCESS TO HEALTH SERVICES AND ELIMINATE DISPARITIES IN HEALTH CARE AMONG VARIOUS POPULATIONS THAT BMC SERVES.
Form 990, Part IV, Line 12	Boston Medical Center is included in the consolidated financial statements for BMC Health System, Inc.
Form 990, Part VI, Section A, Line 2	Karen Antman, M.D. David Coleman, M.D. Susannah Rowe, M.D. Jennifer Tseng, M.D. Business relationship - Karen Antman, M.D., is a key employee at Boston University; Boston University also employs Drs Coleman, Rowe, and Tseng. Monica Valdes Lupi, JD, MPH Kathleen E. Walsh Business Relationship - Ms. Valdes Lupi was executive director of the Boston Public Health Commission during this fiscal year and Ms. Walsh serves on the board of health that governs the Commission. Karen Antman, M.D. David Beck David Coleman, M.D. Susannah Rowe, M.D. Jennifer Tseng, M.D. Kathleen E. Walsh Business Relationship - Each serves as an officer or director of Faculty Practice Foundation, Inc. David Coleman, M.D. Melanie Foley Charles Orlando Jennifer Tseng, M.D. Kathleen E. Walsh Business Relationship - Each serves as a director of Boston Medical Center Insurance Company, LTD. Martha Samuelson Pierre Cremieux BUSINESS RELATIONSHIP - Martha Samuelson is CEO/Chairman and Trustee, and Pierre Cremieux is President of Analysis Group. David Beck Alastair Bell Barry Bock Sandra Cotterell Ravin Davidoff, M.D. William J. Halpin, JR. Charles Orlando BUSINESS RELATIONSHIP - Each serves as an officer or director of Boston Accountable Care Organization. David Beck is an officer of each Faculty Practice foundation corporation that employs David Coleman, M.D., Susannah Rowe, M.D., AND Jennifer Tseng, M.D. David Beck Manuel Lopes Kathleen Walsh BUSINESS RELATIONSHIP - Each serves as an officer or trustee of Univer Development Foundation, Inc. David Beck (until 9/10/2019) Joe Camillus Ravin Davidoff, M.D. CHARLES ORLANDO Kathleen Walsh BUSINESS RELATIONSHIP - Each serves as an officer or trustee of Boston University Affiliated Physicians.
Form 990, Part VI, Section A, Line 6	The sole member of the organization is BMC Health System, Inc.
Form 990, Part VI, Section A, Line 7B	BMC Health System has the right to take certain actions including, but not limited to, the approval of budgets, mergers, acquisitions, and indebtedness.
Form 990, Part VI, Section B, Line 11B	Boston Medical Center's Form 990 is prepared by KPMG LLP and Reviewed by BMC's internal management. Following that review, BMC'S internal management and KPMG present the Form 990 to the audit AND COMPLIANCE committee for review and comment. The completed Form 990 is provided to all members of the board of trustees prior to the Form being filed with the IRS.
Form 990, Part VI, Section B, Line 12C	Conflict of interest questionnaires for the fiscal year ending September 30, 2019 were distributed by BMC's corporate compliance department. The Chief Compliance Officer of BMC or the Chief Compliance Officer's designee queries trustees, officers, and directors on at least an annual basis regarding relationships that may create potential conflicts of interest. The Chief Compliance Officer or the Chief Compliance Officer's designee reviews all disclosures and determines whether there are actual or potential conflicts of interest. The Chief Compliance Officer or the Chief Compliance Officer's designee informs the Chief Legal Counsel of any actual or potential conflicts of interest. The Chief Legal Counsel advises the board of trustees and officers of the corporation accordingly.
Form 990, Part VI, Section B, Line 15	An independent committee, formed of individuals whose compensation is not in issue, determines the compensation of officers, key employees, and the highest compensated employees. The committee members are not under the control or direction of any BMC executive seeking compensation. The compensation plan is supported by comparable data, which includes compensation paid for comparable positions by similarly situated organizations, both taxable and tax-exempt, compensation surveys compiled independently, and actual written offers from similar institutions competing for the services of the BMC executive. The independent committee's assessment of these considerations are contained in the minutes of the committee meeting. The review process includes - and minutes indicate - discussions and evaluations of each executive's prior performance, qualification, and experience. Executives are not present for the independent committee's discussions and vote on compensation. The minutes reflect the fact that no executive was present.
Form 990, Part VI, Section C, Line 19	Boston Medical Center does not make its governing documents, conflict of interest policy, and financial statements publically available. However, the restated articles of the organization are posted on the Secretary of the Commonwealth's CORPORATIONS website.
FORM 990, PART X, LINES 27, 28, AND 29	PRESENTATION OF NET ASSETS BOSTON MEDICAL CENTER HAS ADOPTED ASU 2016-14, PRESENTATION OF THE FINANCIAL STATEMENTS OF NOT-FOR-PROFIT ENTITIES. AS A RESULT, THE SEPTEMBER 30, 2019 AUDITED FINANCIAL STATEMENTS CLASSIFY NET ASSETS AS EITHER NET ASSETS WITHOUT DONOR RESTRICTIONS, OR NET ASSETS WITH DONOR RESTRICTIONS. FOR PURPOSES OF FORM 990, PART X, LINES 27, 28, AND 29, BOSTON MEDICAL CENTER HAS REPORTED NET ASSETS WITHOUT DONOR RESTRICTIONS AS UNRESTRICTED NET ASSETS AND NET ASSETS WITH DONOR RESTRICTIONS AS TEMPORARILY RESTRICTED NET ASSETS AND PERMANENTLY RESTRICTED NET ASSETS, RESPECTIVELY.
Form 990, Part XI, Line 9	Other changes in net assets or fund balances Transfer to Affiliates $ (25,100,000) Pension related changes other than Periodic pension costs $ (26,196,907) Rounding $ 885 Total $ (51,296,022)

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Boston Medical Center

Employer identification number

04-3314093

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)BMC Health System Inc One Boston Medical Center Pl Boston,MA02118 46-3556853	Support Svcs.	MA	501(c)(3)	12 B-II	NA		No
(2)BMC Insurance Co LTD Of Vermont PO BOX 530 100 BANK STREET Burlington,VT05401 20-1810549	Insurance	VT	501(c)(3)	12 A-I	BMC	Yes
(3)BMC Integrated Care Services Inc One Boston Medical Center Pl Boston,MA02118 04-3414914	Healthcare	MA	501(c)(3)	12 A-I	BMC	Yes
(4)Boston Emergency Physician Fdn Inc One Boston Medical Center Pl Boston,MA02118 04-3286156	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(5)Boston Medical Center Health Plan Inc 529 Main Street Suite 500 Charlestown,MA02129 04-3373331	Insurance	MA	501(c)(3)	12 A-I	BMCHS	Yes
(6)Boston Rehabilitation Medicine Assoc Inc One Boston Medical Center Pl Boston,MA02118 04-3286641	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(7)Boston Univ Neurology Associates Inc One Boston Medical Center Pl Boston,MA02118 04-3428462	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(8)Boston Univ Plastic Surgery Assoc Inc One Boston Medical Center Pl Boston,MA02118 04-3555478	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(9)Boston Univ Surgical Associates Inc One Boston Medical Center Pl Boston,MA02118 04-3291148	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(10)Boston University Affiliated Physicians One Boston Medical Center Pl Boston,MA02118 04-3218267	Healthcare	MA	501(c)(3)	3	BMC	Yes
(11)Boston University Dermatology Inc One Boston Medical Center Pl Boston,MA02118 04-3335166	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(12)Boston University Eye Associates Inc One Boston Medical Center Pl Boston,MA02118 04-3137333	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(13)Boston University Family Medicine Inc One Boston Medical Center Pl Boston,MA02118 04-3354353	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(14)Boston University Psychiatry Assoc Inc One Boston Medical Center Pl Boston,MA02118 04-3355267	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(15)BU Cardiac & Thoracic Surgical Fdn Inc One Boston Medical Center Pl Boston,MA02118 04-2966416	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(16)BU Dermatology Support Services I Inc One Boston Medical Center Pl Boston,MA02118 04-3452877	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(17)BU Dermatology Support Services II Inc One Boston Medical Center Pl Boston,MA02118 04-3452874	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(18)BU General Surgical Associates Inc One Boston Medical Center Pl Boston,MA02118 04-3265008	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(19)BU Mallory Pathology Associates Inc One Boston Medical Center Pl Boston,MA02118 04-2794543	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(20)BU Medical Center Radiologists Inc One Boston Medical Center Pl Boston,MA02118 04-3283573	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(21)BU Medical Center Urologists Inc One Boston Medical Center Pl Boston,MA02118 04-3286643	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(22)BU Medical Ctr Anesthesiologists Inc One Boston Medical Center Pl Boston,MA02118 04-3276227	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(23)BU Neurosurgical Associates Inc One Boston Medical Center Pl Boston,MA02118 04-3296068	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(24)BU Obstetrics & Gynecology Fdn Inc One Boston Medical Center Pl Boston,MA02118 04-3067465	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(25)BU Orthopaedic Surgical Associates Inc One Boston Medical Center Pl Boston,MA02118 04-3354360	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(26)BU Radiation Oncology Inc One Boston Medical Center Pl Boston,MA02118 81-0716773	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(27)BUMC Otolaryngologic Foundation Inc One Boston Medical Center Pl Boston,MA02118 04-3156471	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(28)Child Health Foundation of Boston Inc One Boston Medical Center Pl Boston,MA02118 04-2472758	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(29)Evans Medical Foundation Inc One Boston Medical Center Pl Boston,MA02118 51-0172171	Healthcare	MA	501(c)(3)	12C III-FI	NA		No
(30)Faculty Practice Foundation Inc One Boston Medical Center Pl Boston,MA02118 04-3289381	Medical Svcs.	MA	501(c)(3)	12 B-II	NA		No
(31)The Boston Healthnet Corporation One Boston Medical Center Pl Boston,MA02118 04-3279836	Support Svcs.	MA	501(c)(3)	12B-II	NA		No
(32)Univer Development Foundation Inc One Boston Medical Center Pl Boston,MA02118 04-3101957	Real Estate	MA	501(c)(3)	12 A-I	BMC	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) BMC NAB BUS TR 85 Concord Street Boston,MA02118 26-6368869	Property Mgmt	MA	BMC	RELATED	-3,533,666	0		No	0			90.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) BMC Insurance Company LTD First Carribean House 10 Main St Grand Cayman,Cayman Islands CJ 98-0375219	Insurance	CJ	BMC	C Corp	188,738	85,854,341	70.000 %	Yes
(2) Charitable Remainder Trust - MA (3)	Support	MA	BMC	Trust				Yes

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) BOSTON MEDICAL CENTER HEALTH PLAN INC	L	381,227,000	FMV
(2) BOSTON MEDICAL CENTER HEALTH PLAN INC	J	4,089,591	FMV
(3) BOSTON MEDICAL CENTER HEALTH PLAN INC	P	1,385,673	FMV
(4) Boston University Affiliated Physicians Inc	Q	1,966,000	FMV
(5) BMC Insurance Company LTD	p	2,832,000	FMV
(6) BOSTON MEDICAL CENTER HEALTH PLAN INC	Q	837,000	FMV
(7) BMC Integrated Care Services	M	381,000	FMV
(8) BMC Integrated Care Services	Q	436,549	FMV
(9) BMC Integrated Care Services	P	140,228	FMV

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Boston Medical Center's mission is to provide consistently excellent and accessible health services to all in need of care regardless of status and ability to pay.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	29
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	25
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	9,255
6	Total number of volunteers (estimate if necessary) .............	6	731
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	3,294,866
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	1,047,508

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	24,563,859	25,615,642
9	Program service revenue (Part VIII, line 2g) .........	1,451,452,658	1,620,141,878
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	39,167,021	82,976,388
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	5,979,248	17,727,347
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,521,162,786	1,746,461,255
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	24,328,888	25,423,342
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	632,054,238	681,772,082
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	96,475	0
b	Total fundraising expenses (Part IX, column (D), line 25) 5,769,035
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	786,511,648	942,072,320
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,442,991,249	1,649,267,744
19	Revenue less expenses. Subtract line 18 from line 12.......	78,171,537	97,193,511
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,480,375,000	2,427,982,000
21	Total liabilities (Part X, line 26).............	1,136,309,000	1,100,514,000
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,344,066,000	1,327,468,000

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,471,195,981 including grants of $ ) (Revenue $ 1,620,141,878 )
	See Schedule O.

4b	(Code: ) (Expenses $ 24,149,744 including grants of $ 24,149,744 ) (Revenue $ )
	Boston Medical Center provides research support to organizations within the US.

4c	(Code: ) (Expenses $ 1,273,598 including grants of $ 1,273,598 ) (Revenue $ )
	Boston Medical Center provides research support to foreign organizations.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,496,619,323

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	10,183,324	1,902,753	964,956

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	4,841,966
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	20,773,676

g	Noncash contributions included in lines 1a - 1f:$ 2,062,088
h Total. Add lines 1a-1f.......		25,615,642

		Business Code
2a	PATIENT SERVICE REVENUE	900099	1,131,959,048	1,131,959,048
b	PHARMACY REVENUE	900099	364,278,422	360,983,571	3,294,851
c	GRANT & CONTRACT REVENUE	900099	105,266,814	105,266,814
d	OTHER PROGRAM REVENUE	900099	18,637,594	18,637,594
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		1,620,141,878

3 Investment income (including dividends, interest, and othersimilar amounts) ......			17,454,236		15	17,454,221
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		5,725,622
b	Less: rental expenses		3,116,417
c	Rental income or (loss)	0	2,609,205
d	Net rental income or (loss)......			2,609,205			2,609,205
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		65,522,152
b	Less: cost or other basis and sales expenses
c	Gain or (loss)		65,522,152
d	Net gain or (loss).....			65,522,152			65,522,152
8a	Gross income from fundraising events (not including $ 4,841,966of contributions reported on line 1c). See Part IV, line 18 ....
	a		494,358
b	Less: direct expenses ...b		911,928
c	Net income or (loss) from fundraising events..			-417,570			-417,570
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA		900099	4,290,813			4,290,813
b	PARKING		812930	11,244,899			11,244,899
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			15,535,712
12	Total revenue. See Instructions......			1,746,461,255	1,616,847,027	3,294,866	100,703,720

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	24,149,744	24,149,744
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	1,273,598	1,273,598
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	13,301,749	11,439,504	1,249,994	612,251
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	190,949	190,949
7	Other salaries and wages	527,008,564	453,227,365	70,993,919	2,787,280
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	20,817,414	17,902,976	2,795,362	119,076
9	Other employee benefits .......	76,020,819	65,377,904	10,210,848	432,067
10	Payroll taxes ...........	44,432,587	38,212,025	5,982,663	237,899
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	1,465,742		1,465,742
c	Accounting ...........	1,530,372		1,530,372
d	Lobbying ...........	82,830	71,234	11,596
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	1,159,823		1,159,823
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	86,207,529	74,138,474	11,937,381	131,674
12	Advertising and promotion ....	1,381,078	649,719		731,359
13	Office expenses .......	17,610,511	15,145,039	2,378,911	86,561
14	Information technology ......	4,500,106	3,870,091	629,995	20
15	Royalties ..	28,699,008	24,681,147	4,017,861
16	Occupancy ...........	22,694,143	19,516,963	3,167,190	9,990
17	Travel ............	1,065,535	916,360	124,142	25,033
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	1,790,255	1,539,619	231,808	18,828
20	Interest ...........	21,439,863	18,438,282	2,952,706	48,875
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	90,975,755	78,239,149	12,318,404	418,202
23	Insurance ...	6,873,210	5,910,961	962,249
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	DRUGS	306,700,911	306,700,911
b	PHYSICIAN SERVICES	104,745,430	104,745,430
c	PATIENT RELATED SUPPLIES	89,355,547	89,355,547
d	DIRECT RESEARCH EXPENSE	61,877,961	61,877,961
e	All other expenses	91,916,711	79,048,371	12,758,420	109,920
25	Total functional expenses. Add lines 1 through 24e	1,649,267,744	1,496,619,323	146,879,386	5,769,035
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			80,906,000	1	22,241,000
2	Savings and temporary cash investments .........			225,996,000	2	176,410,000
3	Pledges and grants receivable, net ......			15,963,000	3	17,585,000
4	Accounts receivable, net .............			133,064,000	4	170,244,000
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
				0	6	0
7	Notes and loans receivable, net ....			71,458,000	7	72,628,000
8	Inventories for sale or use ........			13,568,000	8	12,714,000
9	Prepaid expenses and deferred charges ......			33,957,000	9	4,525,000
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,203,752,000
b	Less: accumulated depreciation	10b	1,105,091,000	884,319,000	10c	1,098,661,000
11	Investments—publicly traded securities .			140,950,000	11	65,536,000
12	Investments—other securities. See Part IV, line 11 .....			191,706,000	12	265,079,000
13	Investments—program-related. See Part IV, line 11 ..			337,000	13	410,000
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			688,151,000	15	521,949,000
16	Total assets. Add lines 1 through 15 (must equal line 34)...			2,480,375,000	16	2,427,982,000

17	Accounts payable and accrued expenses .....	190,452,000	17	164,526,000
18	Grants payable ...	0	18	0
19	Deferred revenue .........	24,873,000	19	23,075,000
20	Tax-exempt bond liabilities .........	455,568,000	20	448,264,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	79,270,000	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	386,146,000	25	464,649,000
26	Total liabilities. Add lines 17 through 25..	1,136,309,000	26	1,100,514,000

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	1,001,922,000	27	989,342,000
28	Temporarily restricted net assets ...........	305,054,000	28	300,891,000
29	Permanently restricted net assets	37,090,000	29	37,235,000
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	1,344,066,000	33	1,327,468,000
34	Total liabilities and net assets/fund balances ........	2,480,375,000	34	2,427,982,000

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No