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) HARRIS BERMAN MD...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	0	0
(2) CRAIG BEST MD...................................................................... TRUSTEE/PRESIDENT & CEO - PO	1.00 ................. 39.00	X	0	658,022	36,129
(3) MARGARET BROWN ESQ...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	0	0
(4) ELIZABETH BURBA MD...................................................................... TRUSTEE (UNTIL AUG. 2019)	1.00 ................. 0.00	X	0	0	0
(5) CHESTER BLACK...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	0	0
(6) JOSEPH P CAMPANELLI...................................................................... TRUSTEE/CHAIR	1.00 ................. 0.00	X	0	0	0
(7) JENNY S CHIANG MD...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	0	0
(8) MARK COLLINS MD...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	0	0
(9) THOMAS COSTELLO MD...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	0	0
(10) MICHELE CRAGE MD...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	0	0
(11) DAVID CRISS MD...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	0	0
(12) JATIN DAVE MD...................................................................... TRUSTEE	40.00 ................. 0.00	X	437,275	0	49,140
(13) ROBERT D'AGOSTINO MD...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	0	0
(14) DAN DRISCOLL MD...................................................................... TRUSTEE	1.00 ................. 39.00	X	0	347,755	46,632
(15) KAREN FREUND MD...................................................................... TRUSTEE	1.00 ................. 39.00	X	0	340,685	48,529
(16) YVONNE GARCIA...................................................................... TRUSTEE (UNTIL DEC. 2018)	1.00 ................. 0.00	X	0	0	0
(17) STEVE GOLDEN MD...................................................................... TRUSTEE	1.00 ................. 0.00	X	0	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) STANLEY GOLDSTEIN........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(19) K ERIK HENRIKSON MD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(20) KELLI KENNEDY MD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(21) MARVIN A KONSTAM MD........................................................................ TRUSTEE	1.00 .......................39.00	X					0	408,161	32,576
(22) MATTHEW LARKIN........................................................................ TRUSTEE	1.00 .......................39.00	X					0	406,487	48,495
(23) GENIA LONG........................................................................ TRUSTEE/VICE CHAIR	1.00 .......................0.00	X					0	0	0
(24) WILLIAM C MACKEY MD........................................................................ TRUSTEE	1.00 .......................39.00	X					0	557,319	48,864
(25) ELEANOR MORESCO........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(26) ANTHONY P MONACO MD PHD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(27) JOHN MOORE........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(28) PAUL NASSER........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(29) MICHAEL NEWMAN MD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(30) KANU PATEL MD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(31) REGINA ROCKEFELLER........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(32) ANDREW ROMANOWSKY MD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(33) MARK ROSEN........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(34) DEEB N SALEM MD........................................................................ TRUSTEE	1.00 .......................39.00	X					0	756,812	48,343
(35) DAVID SCHROEDER MD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(36) JEFF SHAMES........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(37) ERIC SILVERMAN MD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(38) MARK SINGH MD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(39) PAUL SUMMERGRAD MD........................................................................ TRUSTEE	1.00 .......................39.00	X					0	539,567	48,303
(40) DHIREN SUTARIA........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(41) TIMOTHY TIERNEY MD........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(42) ELLEN M ZANE........................................................................ TRUSTEE/VICE CHAIR	1.00 .......................1.00	X					0	0	0
(43) MARGARET COSTELLO........................................................................ TRUSTEE/COO	40.00 .......................0.00	X	X				405,066	0	47,803
(44) JEFFREY A WEINSTEIN........................................................................ TRUSTEE/SENIOR VP/SECRETARY	1.00 .......................49.00	X					0	683,777	23,100
(45) JOSEPH FROLKIS MD........................................................................ TRUSTEE/PRESIDENT/CEO	40.00 .......................0.00	X	X				703,664	0	9,999
(46) NATHAN GAGNE........................................................................ CFO/TREASURER	40.00 .......................0.00	X	X				305,012	0	28,057
(47) ZACHARY REDMOND........................................................................ SECRETARY	40.00 .......................0.00	X	X				276,785	0	33,405
(48) KRISTINE M HANSCOM........................................................................ SENIOR VP/TREASURER/CFO/TRUSTEE	39.00 .......................1.00	X	X				592,820	0	97,020
(49) ELLEN O'GORMAN........................................................................ CEO	1.00 .......................39.00	X	X				156,178	0	0
(50) MICHAEL APKON........................................................................ TRUSTEE/CEO/PRESIDENT	39.00 .......................1.00	X	X				227,177	0	23,413
(51) CHARLES R WHIPPLE ESQ........................................................................ TRUSTEE/SECRETARY	1.00 .......................42.00	X	X				0	415,254	32,148
(52) THERESE HUDSON-JINKS........................................................................ SENIOR VP AND CNO	40.00 .......................0.00			X			634,774	0	60,076
(53) WILLIAM SHICKOLOVICH THRU 118........................................................................ SENIOR VP OPERATIONS MGMT/CIO	1.00 .......................49.00			X			0	617,730	89,983
(54) DEBORAH JOELSON UNTIL 118........................................................................ SR. VP STRATEGIC SERVICES	1.00 .......................49.00			X			0	641,357	91,681
(55) SUSAN BLANCHARD........................................................................ VP FOR RESEARCH ADMINISTRATION	40.00 .......................0.00			X			321,265	0	63,256
(56) KELLY DOUGHERTY........................................................................ VP CARDIOVASCULAR	40.00 .......................0.00			X			262,935	0	48,818
(57) SEAN SULLIVAN........................................................................ VP HUMAN RESOURCES (UNTIL 1/19)	40.00 .......................0.00			X			405,336	0	73,796
(58) BROOKE TYSON-HYNES........................................................................ VP PUBLIC AFFAIRS	25.00 .......................25.00			X			200,888	200,889	36,186
(59) MAURA LYNCH........................................................................ VP FOR DEVELOPMENT	40.00 .......................0.00			X			414,605	0	60,018
(60) MICHAEL CROWLEY UNTIL 1118........................................................................ VP REAL ESTATE & FACILITIES	40.00 .......................0.00			X			318,118	0	52,334
(61) CATHERINE BUKOWSKI UNTIL 719........................................................................ VP REVENUE CYCLE	40.00 .......................0.00			X			343,633	0	46,332
(62) JEFFREY SYREK........................................................................ VP SYS CONTRACTING	40.00 .......................0.00			X			268,133	0	48,342
(63) SAUL WEINGART........................................................................ CHEIF MEDICAL OFFICER	1.00 .......................39.00			X			0	601,463	48,864
(64) NANCY WETHERBEE........................................................................ DIRECTOR OF ORBIT	40.00 .......................0.00				X		341,048	0	14,277
(65) ROSS THOMPSON........................................................................ VP & CHIEF PHARMACY OFFICER	40.00 .......................0.00				X		311,595	0	12,816
(66) SARAH MCKAY........................................................................ VP PERIOPERATIVE SERVICES	40.00 .......................0.00				X		290,322	0	35,496
(67) JUSTIN PRECOURT........................................................................ ASSOCIATE CHIEF NURSING OFFICER	40.00 .......................0.00				X		286,026	0	31,705
(68) MARCY CASS........................................................................ VP RISK MANAGEMENT	40.00 .......................0.00				X		284,517	0	10,269
(69) NORMAND DESCHENE........................................................................ FORMER TRUSTEE	0.00 .......................50.00					X	0	1,656,224	20,921
(70) RASHED DURGHAM MD........................................................................ FORMER TRUSTEE	0.00 .......................0.00					X	0	498,565	37,462
(71) MICHAEL WAGNER MD........................................................................ FORMER TRUSTEE/PRESIDENT/CEO	0.00 .......................50.00					X	0	1,380,542	189,615
(72) CHARLES CASSIDY MD........................................................................ FORMER TRUSTEE	0.00 .......................0.00					X	0	1,110,661	48,864
(73) PATRICIA HAYWARD........................................................................ FORMER VP HUMAN RESOURCES/RISK MG	0.00 .......................0.00					X	283,407	0	7,012

(A) Name and business address	(B) Description of services	(C) Compensation
TUFTS SHARED SERVICES 171 HARRISON AVE BOSTON,MA02111	UTILITIES & PARKING	16,686,446
PRATT MEDICAL GROUP INC 800 WASHINGTON STREET BOSTON,MA02111	PHYSICIAN SERVICES	9,221,502
PRATT ANESTHESIOLOGY ASSOCIATION INC 800 WASHINGTON STREET BOSTON,MA02111	PHYSICIAN SERVICES	7,248,332
CARDIOVASCULAR CENTER AT TUFTS MEDICAL C 800 WASHINGTON STREET BOSTON,MA02111	PHYSICIAN SERVICES	6,478,803
TUFTS UNIVERSITY SCHOOL OF MEDICINE 145 HARRISON AVE BOSTON,MA02110	RESEARCH SERVICES	5,555,339
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 122

- 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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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 ...............................5

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

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 10 above (see instructions))	(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)
(A) TUFTS MEDICAL CENTER INC	043400617	3	Yes		0	0
(B) NEW ENGLAND LONG-TERM CARE INC	042912578	3	Yes		0	0
(C) THE CAMERON M NEELY FOUNDATION FOR CANCER CARE INC	043265628	7	Yes		0	0
(D) TUFTS MEDICAL CENTER COMMUNITY CARE INC	473046563	10	Yes		0	0
(E) NEQCA ACCOUNTABLE CARE INC	800824142	7	Yes		0	0
Total 5					0	0

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.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
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)..
6	Public support. Subtract line 5 from line 4.

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..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

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)) .........

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

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).

Yes

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
PART IV, SECTION A, LINE 1:	TUFTS MEDICAL CENTER REAL ESTATE COMPANY, INC. WAS ORGANIZED TO PROMOTE THE INTERESTS OF TUFTS MEDICAL CENTER, INC. AND ITS AFFILIATED ORGANIZATIONS. ENTITY WAS MERGED IN TUFTS MEDICAL CENTER INC. AS OF JANUARY 1, 2019. NEW ENGLAND QUALITY CARE ALLIANCE, INC. IS ORGANIZED TO SUPPORT THE ACTIVITIES OF TUFTS MEDICAL CENTER PARENT, INC. AND THOSE ORGANIZATIONS THAT IT DIRECTLY OR INDIRECTLY OWNS OR CONTROLS.
SCHEDULE A, GENERAL INFORMATION:	PUBLIC CHARITY STATUS OF THE GROUP MEMBERS IS AS FOLLOWS : TUFTS MEDICAL CENTER, INC. - LINE 3 NEW ENGLAND LONG-TERM CARE, INC. - LINE 3 TUFTS MEDICAL CENTER REAL ESTATE COMPANY, INC. - LINE 12B ENTITY WAS MERGED IN TUFTS MEDICAL CENTER INC. AS OF JANUARY 1, 2019 NEW ENGLAND QUALITY CARE ALLIANCE, INC. - LINE 12B TUFTS MEDICAL CENTER COMMUNITY CARE, INC. - LINE 10 NEW ENGLAND QUALITY CARE ALLIANCE ACCOUNTABLE CARE INC . - LINE 7
PART IV, SECTION A, LINE 2:	AS MEMBERS OF THE SAME GROUP EXEMPTION (GEN 5466), THE SUPPORTED ORGANIZATIONS DO NOT HAVE SEPARATE IRS DETERMINATION LETTERS. HOWEVER, AS PART OF THE TAX PREPARATION PROCESS, CONSIDERATION IS GIVEN TO EACH SUPPORTED ORGANIZATION'S STATUS UNDER SECTION 509(A)(1) OR 509(A)(2) .
PART IV, SECTION C, LINE 1:	AS TYPE II SUPPORTING ORGANIZATIONS, TUFTS MEDICAL CENTER REAL ESTATE COMPANY, INC. AND NEW ENGLAND QUALITY CARE ALLIANCE, INC. MUST HAVE BEEN UNDER COMMON SUPERVISION OR CONTROL WITH THEIR SUPPORTED ORGANIZATIONS TO ENSURE THAT THE SUPPORTING ORGANIZATIONS WOULD BE RESPONSIVE TO THE NEEDS AND REQUIREMENTS OF THE SUPPORTED ORGANIZATIONS. IN THE CASE OF TUFTS MEDICAL CENTER REAL ESTATE COMPANY, INC. AND NEW ENGLAND QUALITY CARE ALLIANCE, INC., THESE ENTITIES HAVE HAD BROTHER/SISTER RELATIONSHIP WITH THEIR SUPPORTED ORGANIZATIONS, ALL UNDER THE COMMON SUPERVISION OR CONTROL OF PARENT ENTITY, TUFTS MEDICAL CENTER PARENT, INC. TUFTS MEDICAL CENTER PARENT, INC. IS THE SOLE CORPORATE MEMBER OF TUFTS MEDICAL CENTER, INC., TUFTS MEDICAL CENTER REAL ESTATE COMPANY, INC. (UNTIL MERGED INTO TUFTS MEDICAL CENTER, INC. ON JANUARY 1, 2019), THE CAMERON M. NEELY FOUNDATION FOR CANCER CARE, INC., NEW ENGLAND QUALITY CARE ALLIANCE, INC., NEW ENGLAND LONG-TERM CARE, INC. AND TUFTS MEDICAL CENTER COMMUNITY CARE, INC. MOREOVER, TUFTS MEDICAL CENTER PARENT, INC. HAS RECEIVED A GROUP EXEMPTION RULING (GEN 5466) BASED UPON ITS SUPERVISION OR CONTROL OVER ITS SUBORDINATE ORGANIZATIONS, ALL ENUMERATED ABOVE. CONSEQUENTLY, THE SUPPORTING ORGANIZATIONS HAVE BEEN UNDER COMMON SUPERVISION OR CONTROL WITH THEIR SUPPORTED ORGANIZATIONS, ENSURING RESPONSIVENESS TO THE NEEDS AND REQUIREMENTS OF THE SUPPORTED ORGANIZATIONS.

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

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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 TUFTS MEDICAL CENTER GROUP RETURN

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 TUFTS MEDICAL CENTER GROUP RETURN		Employer identification number 27-0440772

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 TUFTS MEDICAL CENTER GROUP RETURN			Employer identification number 27-0440772
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

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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)? ........

Yes

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

494,241

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

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

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

494,241

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 (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

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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 ....	6,201,000	6,071,000	5,485,000	5,462,000	5,418,000
b	Contributions ...	463,000	107,000	562,000	13,000	51,000
c	Net investment earnings, gains, and losses	12,000	33,000	43,000	27,000	8,000
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	9,000	10,000	19,000	17,000	15,000
f	Administrative expenses ....
g	End of year balance ......	6,667,000	6,201,000	6,071,000	5,485,000	5,462,000

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

98.600 %

Temporarily restricted endowment SchDMd Bullet

1.400 %

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 .....	11,712,367		11,712,367
b	Buildings ....	230,440,395	132,094,083	98,346,312
c	Leasehold improvements	14,002,233	11,546,725	2,455,508
d	Equipment ....	284,345,334	235,371,872	48,973,462
e	Other .....	28,178,339		28,178,339
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				189,665,988

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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) DUE FROM AFFILIATES				26,509,306
(2) DEPOSIT ADVANCE				19,304,550
(3) OTHER MISC. RECEIVABLES & ASSETS				33,470,996
(4) ESTIMATED THIRD PARTY RECEIVABLES				569,250
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				79,854,102

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
PENSION OBLIGATIONS	67,114,975
DUE TO AFFILIATES	11,970,492
PROFESSIONAL LIABILITY COSTS	31,804,222
ESTIMATED THIRD PARTY PAYABLES	72,070,922
LCO RESERVES	16,811,685
TAXABLE BONDS	159,909,872
WORKERS COMPENSATION	5,398,454
CAPITAL LEASE PAYABLE	1,896,634
RESERVE FOR TERTIARTY DISCOUNT	263,084
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	367,240,340
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

PART V, LINE 4:

THE ORGANIZATION'S ENDOWMENT CONSISTS OF APPROXIMATELY 50 FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. FOR THE PURPOSES OF DISCLOSURE, ENDOWMENT FUNDS INCLUDE DONOR-RESTRICTED ENDOWMENT FUNDS. THE ORGANIZATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO THE PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS.

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
TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	PROGRAM SERVICES	SELF-INSURANCE	22,970,768
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	INVESTMENTS		80,000















3a	Sub-total .....	0	0			23,050,768
b	Total from continuation sheets to Part I ...					0
c	Totals (add lines 3a and 3b)	0	0			23,050,768

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.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

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 .......................

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 (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
TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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 WORKING WONDERS (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	1,274,100	1,274,100
2	Less: Contributions . . . .	1,151,475	1,151,475
3	Gross income (line 1 minus line 2) . . . . . .	122,625	122,625

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	24,000	24,000
7	Food and beverages . . .	128,912	128,912
8	Entertainment . . . .	6,270	6,270
9	Other direct expenses . . .	252,614	252,614
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		411,796
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		-289,171

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:

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

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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: . . . . . . . .

Yes

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? . . . . . . . . .

Yes

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

Yes

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)	(b) Persons served (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) . . .			10,931,422	1,051,327	9,880,095	1.010 %
b	Medicaid (from Worksheet 3, column a) . . . . .			188,502,898	168,116,708	20,386,190	2.080 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			199,434,320	169,168,035	30,266,285	3.090 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			958,131		958,131	0.100 %
f	Health professions education (from Worksheet 5) . . .	37	621,309	31,290,054	11,383,569	19,906,485	2.030 %
g	Subsidized health services (from Worksheet 6) . . . .			129,955,341	120,654,081	9,301,260	0.950 %
h	Research (from Worksheet 7) .			62,826,692	41,878,758	20,947,934	2.140 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .		180,294	5,043,101		5,043,101	0.510 %
j	Total. Other Benefits . .	37	801,603	230,073,319	173,916,408	56,156,911	5.730 %
k	Total. Add lines 7d and 7j .	37	801,603	429,507,639	343,084,443	86,423,196	8.820 %

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)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1		271,161	271,161	0.030 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	7	215	398,262	398,262	0.040 %
9	Other
10	Total	8	215	669,423	669,423	0.070 %

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. ......

10,752,373

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).....

157,787,020

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

179,401,957

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

-21,614,937

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	TUFTS MEDICAL CENTER INC 800 WASHINGTON STREET BOSTON,MA02111	X	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)

	TUFTS MEDICAL CENTER INC
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..................................

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. ............................

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): WWW.TUFTSMEDICALCENTER.ORG/ABOUT-US/COMMUNITY-PARTNERS-PROGRAMS

Other website (list url): HTTP://BOSTONCHNA.ORG/CURRENT/HTML

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 18

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

Yes

If "Yes" (list url): WWW.TUFTSMEDICALCENTER.ORG/ABOUT-US/COMMUNITY-PARTNERS-PROGRAMS

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)

	TUFTS MEDICAL CENTER INC
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 150.000000000000% and FPG family income limit for eligibility for discounted care of 300.000000000000%

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):

WWW.TUFTSMEDICALCENTER.ORG/FINANCIALASSISTANCE

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

WWW.TUFTSMEDICALCENTER.ORG/FINANCIALASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
WWW.TUFTSMEDICALCENTER.ORG/FINANCIALASSISTANCE

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

	TUFTS MEDICAL CENTER INC
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)

	TUFTS MEDICAL CENTER INC
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
TUFTS MEDICAL CENTER, INC.	PART V, SECTION B, LINE 5: BEGINNING IN THE SUMMER OF 2018, TUFTS MEDICAL CENTER (TUFTS MC) PARTICIPATED IN AND SUPPORTED THE BOSTON CHNA-CHIP COLLABORATIVE (THE COLLABORATIVE). THIS WAS A COMBINED EFFORT BY MULTIPLE HOSPITALS, HEALTH CENTERS, AND COMMUNITY ORGANIZATIONS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE CITY OF BOSTON. THE COLLABORATIVE CONDUCTED 12 FOCUS GROUPS WITH 12 SUB-POPULATIONS WITHIN BOSTON AND 39 KEY INFORMANT INTERVIEWS. THIRTY-FIVE ORGANIZATIONS HELPED TO DISTRIBUTE A SURVEY PERTAINING TO THE SOCIAL DETERMINANTS OF HEALTH, HEALTH BEHAVIORS, AND HEALTH OUTCOMES TO THOUSANDS OF CITY RESIDENTS IN SEVEN LANGUAGES. TUFTS MC SHARED THIS SURVEY WITH MORE THAN 300 ORGANIZATIONS AND AGENCIES IN OUR PRIORITY COMMUNITIES AND HOSPITAL EMPLOYEES RESIDING IN BOSTON. ULTIMATELY, MORE THAN 2,500 PEOPLE PROVIDED PRIMARY DATA TO THE COLLABORATIVE CHNA, WHICH INFORMED TUFTS MC'S OWN CHNA REPORT.TUFTS MC CONDUCTED ADDITIONAL PRIMARY DATA COLLECTION IN CHINATOWN, SOUTH BOSTON, AND THE SOUTH END, THREE OF ITS PRIORITY COMMUNITIES. THIS INCLUDED 7 INTERVIEWS WITH SOCIAL SERVICE ORGANIZATION LEADERS AND 3 FOCUS GROUPS WITH CHINATOWN COMMUNITY MEMBERS. WITH THE HELP OF OUR COMMUNITY PARTNERS, TUFTS MC ALSO COLLECTED 100 COMMUNITY HEALTH SURVEYS FROM CHINESE-SPEAKING RESIDENTS OF THE NEIGHBORHOOD. ADDITIONALLY, SECONDARY AND PRIMARY DATA GATHERED THROUGH THE CHNA PROCESS WERE PRESENTED TO TUFTS MC'S COMMUNITY BENEFITS ADVISORY COMMITTEES, COMPRISED OF RESIDENTS AND REPRESENTATIVES WHO LIVE, WORK, OR ARE SUBJECT MATTER EXPERTS IN OUR PARTNER COMMUNITIES. COMMITTEE MEMBERS HELPED TUFTS MC STAFF IDENTIFY COMMUNITY HEALTH PRIORITIES TO FOCUS OUR GRANT-BASED COMMUNITY BENEFITS EFFORTS FOR THE NEXT THREE YEARS. THESE WERE REVIEWED AND APPROVED BY TUFTS MC'S BOARD OF GOVERNORS' COMMUNITY BENEFITS COMMITTEE, COMPRISED OF DIVERSE MEMBERS WITH WIDE-RANGING EXPERTISE IN LAW, HISTORY, COMMUNITY ORGANIZING, MEDICINE, AND OTHER RELEVANT FIELDS.
TUFTS MEDICAL CENTER, INC.	PART V, SECTION B, LINE 11: TUFTS MEDICAL CENTER IS ADDRESSING SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE MOST RECENT CHNA, INCLUDING TOBACCO USE, YOUTH VIOLENCE, SUBSTANCE ABUSE, CHRONIC DISEASE MANAGEMENT, AND ACCESS TO CARE, IN SEVERAL BOSTON NEIGHBORHOODS, INCLUDING CHINATOWN, SOUTH BOSTON, DORCHESTER AND THE SOUTH END, AS WELL AS THE GREATER BOSTON ASIAN COMMUNITY. THROUGH ITS ASIAN HEALTH INITIATIVE, TUFTS MC IS PURSUING REDUCTION AND PREVENTION OF TOBACCO USE, WHICH CONTRIBUTES TO ONE OF THE LEADING CAUSES OF DEATH AMONG BOSTON'S CHINATOWN AND ASIAN COMMUNITY: LUNG CANCER. SIX COMMUNITY-BASED ORGANIZATIONS WERE SELECTED THROUGH AN OPEN AND COMPETITIVE APPLICATION PROCESS FOR THREE-YEAR GRANTS FROM TUFTS MC TO PROVIDE EDUCATION, PREVENTION, AND SMOKING CESSATION SERVICES TO BOTH ENGLISH- AND CHINESE-SPEAKING COMMUNITY MEMBERS ACROSS A WIDE AGE SPECTRUM: PRE-SCHOOL STUDENTS TO SENIOR CITIZENS.THE 2018 CHNA IDENTIFIED SUBSTANCE USE DISORDER AS A CONCERN ACROSS THE CITY OF BOSTON, WITH SOUTH BOSTON AND DORCHESTER OF PARTICULAR CONCERN. YOUTH VIOLENCE IS ALSO A LEADING CONCERN IN DORCHESTER.THE DORCHESTER HEALTH INITIATIVE'S THREE-YEAR FUNDING CYCLE FOCUSES ON BOTH OF THESE PRIORITIES: YOUTH VIOLENCE PREVENTION AND PREVENTING AND/OR TREATING SUBSTANCE USE. SIX COMMUNITY-BASED ORGANIZATIONS WERE SELECTED THROUGH AN OPEN AND COMPETITIVE GRANT APPLICATION PROCESS. AMONG THEM, FIVE PARTNERS ARE SUPPORTING YOUTH DEVELOPMENT THROUGH DIVERSE PROGRAMS THAT HELP YOUNG PEOPLE BUILD THE SKILLS NEEDED TO REDUCE THEIR RISK OF EXPOSURE TO VIOLENCE, IMPROVE THEIR RESILIENCY, AND PURSUE POSITIVE EXPERIENCES. ALL PARTNERS INCORPORATE EDUCATION AROUND SUBSTANCE ABUSE AND RESOURCES AVAILABLE TO HELP PREVENT IT INTO THEIR PROGRAMS, AND TWO PARTNERS ARE IMPLEMENTING PROGRAMS TO REDUCE SUBSTANCE USE AND ASSIST PATIENTS WITH OBTAINING TREATMENT AND RECOVERY SERVICES. SIMILARLY, COMMUNITY PARTNERS IN SOUTH BOSTON PROVIDE TREATMENT AND SERVICES TO PATIENTS STRUGGLING WITH ADDICTION IN BOTH OUTPATIENT CLINICAL AND RESIDENTIAL FACILITIES AND WORK WITH YOUTH AND ADULTS. IN THE SOUTH END, THE POPULATION INCLUDES ENCLAVES OF LOWER-INCOME SPANISH-SPEAKING FAMILIES AND OLDER CHINESE-SPEAKING ADULTS FOR WHOM CARDIOVASCULAR AND CEREBROVASCULAR DISEASES ARE MAJOR HEALTH ISSUES. A PARTNERSHIP WITH THE SOUTH END COMMUNITY HEALTH CENTER OFFERS LINGUISTICALLY AND CULTURALLY APPROPRIATE OUTREACH, EDUCATION, AND HEALTH SERVICES THAT REFLECT A COORDINATED CARE APPROACH.TUFTS MC IMPROVES ACCESS TO CARE FOR LINGUISTIC AND CULTURAL MINORITIES, THE UNINSURED, AND OTHER VULNERABLE GROUPS IN MANY WAYS: PSYCHIATRIC AND SOCIAL SUPPORT TO ASIAN RESIDENTS, INCLUDING PSYCHIATRIC CONSULTATIONS IN CHINATOWN'S PUBLIC ELEMENTARY SCHOOL; FREE PRIMARY CARE, HEALTH EDUCATION, SCREENINGS, AND REFERRALS FOR LOW-INCOME AND UNINSURED PATIENTS IN GREATER BOSTON; CARE NAVIGATORS FOR CHINESE-SPEAKING AND OTHER ASIAN PATIENTS BEGINNING CANCER TREATMENT; AND PROGRAMS DESIGNED TO ASSIST ELIGIBLE PATIENTS WITH SECURING HEALTH INSURANCE, FINANCIAL ASSISTANCE, SOCIAL SECURITY BENEFITS, AND DISCOUNTS ON SPECIALTY MEDICATIONS. ADDITIONALLY, TUFTS MC PROVIDERS ORGANIZE AND PARTICIPATE IN NUMEROUS PROGRAMS AND EVENTS THROUGHOUT THE YEAR THAT PROVIDE HEALTH EDUCATION AND SCREENINGS TO COMMUNITY MEMBERS ON ISSUES INCLUDING ASTHMA, NUTRITION, HEART HEALTH, SEXUAL HEALTH, DIABETES, AND MANY OTHER TOPICS.

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?1
Name and address		Type of Facility (describe)
1	1 - NEW ENGLAND LONG-TERM CARE INC 78 BOSTON ROAD BILLERICA,MA01862	LONG-TERM ACUTE-CARE FACILITY
2
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
PART I, LINE 7:	COSTS ARE ALLOCATED TO PATIENT ENCOUNTERS BASED ON COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL INPATIENT AND OUTPATIENT ACTIVITY FOR ALL AREAS OF THE HOSPITAL INCLUDING ALL PAYER SOURCES. THE COSTS UTILIZED ARE BASED ON ACTUAL COSTS FROM THIS SYSTEM, ALLOCATED TO INDIVIDUAL PATIENT ENCOUNTERS.
PART II, COMMUNITY BUILDING ACTIVITIES:	PART II, LINE 2: ECONOMIC DEVELOPMENTPARKING IN THE CITY OF BOSTON IS DIFFICULT AND EXPENSIVE, AND SMALL COMMUNITY-BASED ORGANIZATIONS HAVE LIMITED RESOURCES TO DEVOTE TO COSTS SUCH AS THESE. TUFTS MC DONATED HUNDREDS OF PARKING SPACES FOR A NUMBER OF COMMUNITY-BASED ORGANIZATIONS AND EVENTS, THEREBY FREEING UP THEIR RESOURCES TO BE USED FOR DELIVERING SERVICES TO COMMUNITY MEMBERS.PART II, LINE 8: WORKFORCE DEVELOPMENTTUFTS MEDICAL CENTER'S (TUFTS MC'S) WORKFORCE DEVELOPMENT ACTIVITIES HAVE INCLUDED COLLABORATIONS WITH LOCAL NON-PROFITS PROVIDING JOB TRAINING FOR BOSTON AND GREATER BOSTON RESIDENTS. THESE COLLABORATIONS PROVIDED CAREER EXPERIENCES AND EXTERNSHIPS WITHIN TUFTS MC DEPARTMENTS FOR 148 ADULT TRAINEES, HELPING THEM TO GAIN EXPERIENCE AND LEARN SKILLS THAT BOOST OPPORTUNITIES FOR HIGHER-PAYING JOBS AND FOR JOB ADVANCEMENT. SIXTY-FIVE OF THESE INDIVIDUALS WERE SUBSEQUENTLY HIRED FULL-TIME AT TUFTS MC. OTHER COLLABORATIONS OFFERED EMPLOYMENT SUPPORT AND CAREER AND PROFESSIONAL DEVELOPMENT OPPORTUNITIES IN THE FORM OF MOCK INTERVIEWS, CAREER PRESENTATIONS, TRAINING PROGRAMS, AND ENGLISH CLASSES TO CURRENT TUFTS MC EMPLOYEES. THESE EFFORTS SUPPORTED 877 INDIVIDUALS IN THEIR CAREER JOURNEYS.TUFTS MC'S PARTICIPATION WITH THE BOSTON PRIVATE INDUSTRY COUNCIL'S SUMMER EMPLOYMENT PROGRAM FOR BOSTON HIGH SCHOOL STUDENTS OFTEN OFFERS THE FIRST PAID EMPLOYMENT FOR MANY YOUNG ADULTS AND OPPORTUNITIES TO EXPLORE THE MANIFOLD CAREER OPPORTUNITIES IN A MEDICAL SETTING. AS WITH THE ADULT WORKFORCE DEVELOPMENT PROGRAMS DESCRIBED ABOVE, OFFERING YOUTH (MANY OF WHOM SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME) THIS EXPERIENCE INCREASES THE LIKELIHOOD OF THEM SECURING BETTER-PAYING JOBS; A WEALTH OF RESEARCH HAS DEMONSTRATED THAT HIGHER PAY AND BETTER BENEFITS ARE DIRECTLY CORRELATED WITH IMPROVED HEALTH OUTCOMES.
PART III, LINE 2:	THE HOSPITAL RECORDS BAD DEBTS BASED ON CHARGES. THE BAD DEBT COSTS PROVIDED HEREIN ARE BASED ON THESE CHARGES MULTIPLIED BY THE HOSPITAL'S COST-TO-CHARGE RATIO OF 39.90%.
PART III, LINE 4:	THE ORGANIZATION'S PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS DESCRIBED ON PAGE 18 OF THE AUDITED FINANCIAL STATEMENTS (ATTACHED). THE FOLLOWING IS EXCERPTED FROM THAT FOOTNOTE..."ACCOUNTS RECEIVABLE ARE STATED AT ESTIMATED NET REALIZED AMOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND HISTORIC PAYMENT TRENDS AND RECORDS ESTIMATED CONTRACTUAL ALLOWANCES. THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THIER BILLS FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS."
PART III, LINE 8:	COSTS ARE ALLOCATED TO PATIENT ENCOUNTERS BASED ON COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL INPATIENT AND OUTPATIENT ACTIVITY FOR ALL AREAS OF THE HOSPITAL INCLUDING ALL PAYER SOURCES. THE COSTS UTILIZED ARE BASED ON ACTUAL COSTS FROM THIS SYSTEM, ALLOCATED TO INDIVIDUAL PATIENT ENCOUNTERS.
PART III, LINE 9B:	TUFTS MEDICAL CENTER'S FINANCIAL COORDINATION OFFICE IDENTIFIES AND ASSISTS THOSE PATIENTS THAT HAVE NO INSURANCE OR WHO ARE UNDERINSURED. WE WILL PROCESS ON-LINE APPLICATIONS FOR STATE PROGRAMS IN ACCORDANCE WITH THE ESTABLISHED MASS HEALTH GUIDELINES. THE GUIDELINES ARE BASED ON 200% OF THE FEDERAL POVERTY GUIDELINES.FINANCIAL ASSISTANCE IS ALSO EXTENDED TO OUT-OF-STATE/COUNTRY PATIENTS WITH NO INSURANCE IN ACCORDANCE WITH THE TUFTS MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. A NOTICE OF FINANCIAL ASSISTANCE IS LOCATED ON THE PATIENT BILL AND THE HOSPITAL WEB-SITE. IT IS ALSO POSTED IN VARIOUS STRATEGIC LOCATIONS THROUGHOUT THE HOSPITAL.THE FINANCIAL COORDINATION OFFICE IS OPEN MONDAY THRU FRIDAY FROM 8:00 A.M. TO 4:40 P.M. THE MAIN NUMBER FOR THE FINANCIAL COORDINATION OFFICE IS 617-636-6013.
PART VI, LINE 2:	TUFTS MEDICAL CENTER (TUFTS MC) CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS TO IDENTIFY COMMUNITY NEEDS AND CRITICAL HEALTH ISSUES. THE FOCUS OF THE CHNA INCLUDES BOSTON'S CHINATOWN, DORCHESTER, SOUTH BOSTON, SOUTH END, QUINCY, AND THE GREATER BOSTON ASIAN COMMUNITY. IN ADDITION TO KEY STAKEHOLDER INTERVIEWS, FOCUS GROUPS, MULTILINGUAL SURVEYS, AND INPUT FROM COMMUNITY BENEFITS ADVISORY COMMITTEE MEMBERS, HEALTH ISSUES WERE IDENTIFIED THROUGH A REVIEW OF DATA COMPILED BY THE BOSTON CHNA-CHIP COLLABORATIVE FOR ITS CITY-WIDE NEEDS ASSESSMENT. DATA WERE ALSO GATHERED FROM THE AMERICAN COMMUNITY SURVEY, THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, THE YOUTH RISK BEHAVIOR SURVEY, BOSTON POLICE DEPARTMENT, BOSTON PUBLIC SCHOOLS, HEALTH RESOURCES AND SERVICES ADMINISTRATION, MA REGISTRY OF VITAL RECORDS AND STATISTICS, CHNAS CONDUCTED IN RECENT YEARS BY COMMUNITY HEALTH CENTERS AND OTHER INSTITUTIONS, AND NUMEROUS PAPERS AND PRESENTATIONS PERTAINING TO COMMUNITY HEALTH RESEARCH CONDUCTED IN OUR PARTNER COMMUNITIES. DATA WERE SUMMARIZED, REVIEWED, AND APPROVED BY TUFTS MC'S SENIOR LEADERSHIP AND ITS COMMUNITY BENEFITS GOVERNING BODY, THE BOARD OF GOVERNORS' COMMUNITY BENEFITS COMMITTEE. THE HEALTH ISSUES IDENTIFIED AND PRIORITIZED IN THE 2019 CHNA AND IMPLEMENTATION STRATEGY SOUGHT TO ADDRESS THE HIGH INCIDENCE OF HEART DISEASE AND LUNG CANCER AMONG THE CHINATOWN AND BOSTON ASIAN COMMUNITY, FOCUSING ON SMOKING AND ITS HARMFUL EFFECTS; BEHAVIORAL HEALTH IN DORCHESTER; ACCESS TO SERVICES IN THE SOUTH END AND QUINCY; AND SUBSTANCE USE AND CHRONIC DISEASES IN SOUTH BOSTON. THE IDENTIFIED HEALTH ISSUES GUIDED THE ALLOCATION OF RESOURCES FOR BOTH COMMUNITY-BASED AND HOSPITAL-BASED RESPONSES.
PART VI, LINE 3:	PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE AND FINANCIAL COORDINATION RESOURCES OFFERED BY THE HOSPITAL THROUGH SEVERAL DIFFERENT MEDIUMS AND AT SEVERAL DIFFERENT POINTS IN THEIR EXPERIENCE WITH THE HOSPITAL. PATIENTS ARE PROVIDED AN OPPORTUNITY TO HAVE AN IN PERSON DISCUSSION WITH A FINANCIAL COORDINATOR ABOUT INSURANCE COVERAGE AND FINANCIAL HARDSHIP DURING THE INITIAL REGISTRATION PROCESS. IF A PATIENT EXPRESSES THE NEED FOR INSURANCE OR FINANCIAL ASSISTANCE A FINANCIAL COORDINATOR WILL WORK WITH THEM TO APPLY FOR ANY AVAILABLE AND APPROPRIATE SERVICES. SHOULD A PATIENT QUALIFY FOR MEDICARE OR MEDICAID ASSISTANCE OF ANY FORM, E.G. COMMONWEALTH CARE, THE COUNSELOR OR FINANCIAL COORDINATOR WILL ALSO ASSIST THE PATIENT IN APPLYING FOR ANY OTHER SOCIAL SERVICES THEY MAY FIND HELPFUL, SUCH AS FOOD AND NUTRITION SERVICES. PATIENTS ARE NOTIFIED OF THEIR RIGHTS AND AVAILABLE FINANCIAL RESOURCES THROUGH A VARIETY OF OTHER MEASURES AS WELL, INCLUDING INFORMATION ON SEVERAL DIFFERENT PAGES AND LANDING POINTS ON THE TUFTS MEDICAL CENTER AND FLOATING HOSPITAL FOR CHILDREN WEBSITE, IN WRITTEN INFORMATION PROVIDED AT DISCHARGE, ON ANY BILLING STATEMENTS THEY RECEIVE AND IN POSTINGS THROUGHOUT THE HOSPITAL IN ALL WAITING AREAS AND CLINICS.
PART VI, LINE 4:	TUFTS MEDICAL CENTER (TUFTS MC) HAS BEEN IN ITS CURRENT LOCATION SINCE ITS INCEPTION AS THE BOSTON DISPENSARY IN 1796. THE NEIGHBORHOOD, ORIGINALLY KNOWN AS THE SOUTH COVE, IS NOW RECOGNIZED AS BOSTON'S CHINATOWN NEIGHBORHOOD DUE TO THE GROWTH OF THE CHINESE AMERICAN COMMUNITY THAT BEGAN IN THE 1960S AND HAS CONTINUED WITH ONGOING IMMIGRATION. TUFTS MC HAS BEEN AN INTEGRAL MEMBER OF THE COMMUNITY FOR GENERATIONS.LOCATED IN THE HEART OF THE CHINATOWN COMMUNITY, TUFTS MC HAS BEEN COMMITTED TO RESPONDING TO THE SPECIFIC NEEDS OF COMMUNITY MEMBERS, MANY OF WHOM ARE NEW IMMIGRANTS IN NEED OF CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES TO HELP THEM NAVIGATE HEALTH CARE FOR THEMSELVES AND THEIR FAMILIES. TUFTS MC'S STRONG COMMITMENT TO THE ADJACENT NEIGHBORHOODS OF DORCHESTER, SOUTH BOSTON AND THE SOUTH END REFLECTS THE HISTORY OF THE FOUNDING OF THE BOSTON DISPENSARY TO PROVIDE QUALITY HEALTHCARE TO BOSTON'S WORKING AND LOW-INCOME FAMILIES.SERVICE POPULATIONS:TUFTS MC'S PATIENT POPULATION IS DIVERSE AND REFLECTS THE DEMOGRAPHICS OF THE BOSTON AND GREATER BOSTON COMMUNITY FOR WHICH IT SERVES AS AN ACADEMIC AND TERTIARY/QUATERNARY HOSPITAL. APPROXIMATELY 60% OF THE PATIENT POPULATION IS WHITE, 10% BLACK/AFRICAN AMERICAN, 15% ASIAN AND 6% LATINX. TWENTY-FIVE PERCENT OF THE PATIENT POPULATION RECEIVES CARE THROUGH MEDICAID, AND 32% OF PATIENTS ARE COVERED BY MEDICARE. APPROXIMATELY 23,000 PATIENTS REQUEST INTERPRETER SERVICES EACH YEAR AND RECEIVE ASSISTANCE IN CHINESE, VIETNAMESE, SPANISH, HAITIAN CREOLE, RUSSIAN, PORTUGUESE AND MANY OTHER LANGUAGES. PRIMARY SERVICE AREA COMMUNITIES:BOSTON'S CHINATOWN IS THE SMALLEST OF THE CITY'S NEIGHBORHOODS. IT IS LOCATED IN DOWNTOWN BOSTON NEAR MAJOR TRANSPORTATION NODES AND THE CITY'S DOWNTOWN RETAIL, THEATER, HISTORIC AND FINANCIAL DISTRICTS. ITS 42 ACRES INCLUDE A ROBUST RESIDENTIAL, CULTURAL, ECONOMIC AND SERVICE HUB FOR BOSTON'S CHINESE AND ASIAN COMMUNITY. THE 2017 AMERICAN COMMUNITY SURVEY (ACS) ESTIMATED THAT OVER 7,400 PEOPLE LIVED IN THE NEIGHBORHOOD, ONE OF THE MOST DENSELY POPULATED IN THE CITY OF BOSTON. THERE IS A DEARTH OF OPEN SPACE IN CHINATOWN, THOUGH THE BOSTON COMMON, PUBLIC GARDEN AND OTHER OPEN AND GREEN SPACE ARE IN CLOSE PROXIMITY.BASED UPON 2017 ACS DATA, ABOUT HALF OF RESIDENTS WERE ASIAN. ELEVEN PERCENT WERE AGE 17 OR YOUNGER, AND 12% WERE 65 YEARS OF AGE OR OLDER. FIFTY-FOUR PERCENT OF RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, AND 61% OF RESIDENTS INDICATED THAT THEY SPOKE ENGLISH LESS THAN "VERY WELL." MUCH OF THE INCREASE IN NUMBER OF HOUSEHOLDS SINCE THE YEAR 2000 REFLECTS THE CONSTRUCTION OF NEW HOUSING IN AND ADJACENT TO CHINATOWN. THESE DEVELOPMENTS HAVE ATTRACTED NEW HIGHER-INCOME, MORE HIGHLY EDUCATED RESIDENTS, MANY OF WHOM ARE NON-ASIAN. HEALTH DATA FOR THE CHINATOWN NEIGHBORHOOD ARE INTEGRATED WITH HEALTH DATA FOR THE SOUTH END IN THE SEMI-ANNUAL "HEALTH OF BOSTON" REPORT PREPARED BY THE BOSTON PUBLIC HEALTH COMMISSION (BPHC). IT IS THEREFORE DIFFICULT TO SEPARATE OUT AND SURFACE HEALTH ISSUES OR TRENDS SPECIFIC TO CHINATOWN AND NON- AND LIMITED-ENGLISH SPEAKING RESIDENTS USING THIS REPORT, AS BPHC SELF-REPORTED SURVEYS ARE OFFERED IN ENGLISH AND SPANISH ONLY. HEALTH DATA FOR CHINATOWN FOR TUFTS MC'S 2019 CHNA, THEREFORE, WERE DRAWN LARGELY FROM OTHER SOURCES. THE BPHC DOES, HOWEVER, PROVIDE HEALTH DATA FOR ASIANS ACROSS BOSTON, WHICH ILLUSTRATES THAT CANCER, HEART DISEASE AND STROKE CONTINUE TO BE PARTICULAR CONCERNS. LUNG CANCER HAS BEEN THE LEADING CAUSE OF CANCER MORTALITY, AND AMONG THE LEADING CAUSES OF ALL MORTALITY FOR ASIANS FOR AT LEAST THE PAST 30 YEARS.ALL OF THE AVAILABLE DATA, ALONG WITH INPUT FROM COMMUNITY STAKEHOLDERS AND ADVISORY COMMITTEE MEMBERS, LED TO A SINGULAR PRIORITY FOR TUFTS MC'S ASIAN HEALTH INITIATIVE IN 2019 AND ITS THREE YEAR FUNDING CYCLE: PREVENTING AND REDUCING NICOTINE AND TOBACCO USE, WITH AN EMPHASIS ON THE BEHAVIORAL HEALTH UNDERPINNINGS THAT DRIVE SUCH USE, IN ORDER TO REDUCE THE BURDEN OF CONSEQUENT HEALTH CONDITIONS INCLUDING HEART DISEASE AND LUNG CANCER.DORCHESTER IS THE LARGEST NEIGHBORHOOD IN BOSTON AND REFLECTS THE CITY'S ECONOMIC, LINGUISTIC, RACIAL, ETHNIC, AND CULTURAL DIVERSITY WITH A POPULATION OF OVER 140,000 RESIDENTS, APPROXIMATELY 20% OF BOSTON'S TOTAL POPULATION. ACS DATA FOR 2017 INDICATE THAT 23% OF RESIDENTS WERE 17 YEARS OR YOUNGER AND 11% WERE SENIORS AGED 65 AND OLDER. TWENTY-FIVE PERCENT OF THE POPULATION WAS WHITE, 52% BLACK/AFRICAN AMERICAN, 8% ASIAN, AND 19% LATINX.BPHC'S 2017 HEALTH OF BOSTON REPORT INDICATED THAT DORCHESTER CONTINUED TO HAVE A HIGH INCIDENCE OF VIOLENCE-RELATED INJURIES AND HIGH RATES OF HOMICIDE COMPARED TO THE CITY AS A WHOLE. THE RATE OF ASTHMA-RELATED HOSPITALIZATION AMONG CHILDREN AGES 5-17, AS WELL AS THE PREVALENCE OF OBESITY AND OF MANY CHRONIC DISEASES AMONG ADULTS, WERE ALSO ABOVE CITY AVERAGES, AS WERE RATES OF MORTALITY ATTRIBUTED TO SUBSTANCE MISUSE, INCLUDING OPIOIDS. BASED ON REVIEW OF AVAILABLE DATA AND INPUT FROM COMMUNITY PARTNERS, STAKEHOLDERS AND ADVISORS, THE DORCHESTER HEALTH INITIATIVE PRIORITY FOR THE 2020-2022 FUNDING CYCLE IS BEHAVIORAL HEALTH, WHICH ENCOMPASSES COMMUNITY VIOLENCE, MENTAL HEALTH, AND SUBSTANCE USE.SOUTH BOSTON IS A NEIGHBORHOOD OF APPROXIMATELY 37,000 RESIDENTS THAT CONTINUES TO UNDERGO CHANGES. HISTORICALLY CONSIDERED A WORKING CLASS COMMUNITY WITH A SIGNIFICANT NUMBER OF PUBLIC HOUSING DEVELOPMENTS, LONG-TIME RESIDENTS ARE NOW EXPERIENCING INCREASING RENTS AND/OR DISPLACEMENT, ALONG WITH AN INFLUX OF NEWER RESIDENTS, RESULTING FROM A SHARP INCREASE IN NEW CONSTRUCTION AND HOUSING DEVELOPMENT IN THE AREA.DATA FROM THE CENSUS BUREAU SHOW A 26% INCREASE IN THE POPULATION BETWEEN 2000 AND 2017. DURING THIS PERIOD, THE NUMBER OF CHILDREN UNDER AGE 18 AND SENIORS OVER AGE 65 (AND THE PROPORTION OF THE POPULATION THEY MADE UP) DROPPED; THUS, THE RISE IN POPULATION IS ATTRIBUTED LARGELY TO WORKING-AGE ADULTS. AT THE SAME TIME, THE PERCENT OF THE POPULATION HOLDING A BACHELOR'S DEGREE OR HIGHER ROSE FROM 19% IN 2000 TO 62% IN 2017; THOSE HOLDING MASTER'S DEGREES OR HIGHER ROSE FROM 7% TO 20%. MEDIAN HOUSEHOLD INCOME ROSE 131% TO $91,597 IN THIS PERIOD. THE CHANGES IN SOUTH BOSTON'S DEMOGRAPHICS ARE LIKELY DUE TO THE INCREASE IN THE AVAILABILITY OF MARKET-RATE AND LUXURY HOUSING. AS IS HAPPENING IN CHINATOWN, THE INCREASING AVAILABILITY OF NEW UPSCALE HOUSING IN SOUTH BOSTON AND THE CORRESPONDING INFLUX OF RESIDENTS WITH A HIGHER SOCIOECONOMIC STATUS WILL BE REFLECTED IN FUTURE HEALTH NEEDS ASSESSMENTS IN THE FORM OF MORE FAVORABLE SOCIAL DETERMINANTS OF HEALTH; THIS RISKS MASKING THE HEALTH NEEDS OF LONG-TIME RESIDENTS FOR WHOM SUBSTANCE USE, MENTAL HEALTH, AND CHRONIC DISEASES ARE MAJOR HEALTH CONCERNS.THE PRIORITIES FOR THE SOUTH BOSTON COMMUNITY ARISING FROM THE 2019 CHNA ARE SUBSTANCE USE, CHRONIC DISEASE MANAGEMENT, AND FOOD SECURITY.THE SOUTH END IS IMMEDIATELY SOUTH OF TUFTS MC, ADJACENT TO CHINATOWN. IT IS A NEIGHBORHOOD KNOWN FOR ITS LARGE VICTORIAN HOME DISTRICT BUILT BY MIDDLE CLASS RESIDENTS OF ENGLISH ANCESTRY IN THE 1850S. THE NEIGHBORHOOD'S DEMOGRAPHICS BEGAN TO CHANGE IN THE 1880S WHEN THE ORIGINAL RESIDENTS BEGAN TO BE REPLACED BY MIDDLE CLASS AFRICAN AMERICANS, IRISH, JEWISH, GREEK, PUERTO RICAN AND CHINESE IMMIGRANTS. IN THE 1960S, THE SOUTH END WAS CONSIDERED ONE OF THE POOREST NEIGHBORHOODS IN THE CITY OF BOSTON. ITS RENAISSANCE BEGAN IN THE MID-1970S WHEN INDIVIDUALS BEGAN TO BUY AND RESTORE VICTORIAN HOUSES, AND NON-PROFITS PURCHASED AND REHABILITATED HOUSES AS AFFORDABLE RENTALS FOR FAMILIES. THERE WAS ALSO NEW CONSTRUCTION FOCUSED ON MEETING THE NEEDS OF VERY LOW-INCOME FAMILIES AND SENIORS.CURRENTLY, THE SOUTH END AND SOUTH BOSTON ARE EXAMPLES OF BOSTON'S ROBUST ECONOMY AND BUILDING BOOM, AND NEW RESIDENTIAL DEVELOPMENTS ARE BEING CONSTRUCTED ON PARCELS WHICH WERE ONCE DESIGNATED FOR LIGHT INDUSTRIAL USE.THE LINE BETWEEN THE SOUTH END AND CHINATOWN IS NOT FIXED, AND THERE IS A SIZABLE POPULATION OF CHINESE FAMILIES LIVING IN WHAT IS TRADITIONALLY CONSIDERED THE SOUTH END. ACCORDING TO THE 2017 ACS, THE SOUTH END HAD A POPULATION OF APPROXIMATELY 27,000 RESIDENTS, MEDIAN HOUSEHOLD INCOME WAS $70,575, AND THE MAJOR RACIAL/ETHNIC GROUPS WERE: WHITE (54%), LATINX (19%), BLACK/AFRICAN AMERICAN (16%), AND ASIAN (16%).DATA FROM THE CITY OF BOSTON SHOW THAT IN 2015, THE LEADING CAUSES OF DEATH IN THE SOUTH END WERE CANCER AND DISEASES OF THE HEART, FOLLOWED BY UNINTENTIONAL INJURIES. THE BOSTON CHNA-CHIP COLLABORATIVE'S 2019 CITY-WIDE CHNA FOUND THAT RESIDENTS OF THIS NEIGHBORHOOD EXPERIENCE A HIGHER RATE OF ASTHMA-RELATED EMERGENCY DEPARTMENT VISITS, ADULT SMOKING BEHAVIOR, HIV/AIDS, AND INFANT MORTALITY THAN THE CITY AS A WHOLE. IN ADDITION, THE SOUTH END EXPERIENCES SIGNIFICANTLY HIGHER RATES OF HEART DISEASE HOSPITALIZATION THAN THE CITY OF BOSTON AS A WHOLE; HOWEVER, THEY HAVE COMPARABLE RATES OF ADULT HYPERTENSION.
PART VI, LINE 5:	IN ADDITION TO PROVIDING FINANCIAL RESOURCES TO COMMUNITY-BASED HEALTH AND SERVICE ORGANIZATIONS THAT ADDRESS HEALTH ISSUES SPECIFIC TO THEIR CONSTITUENTS, TUFTS MEDICAL CENTER (TUFTS MC) ADVANCES ITS COMMITMENT TO THE HEALTH OF ITS PATIENT AND PRIORITY COMMUNITIES THROUGH A NUMBER OF HOSPITAL-LED EFFORTS. THESE INCLUDE CLINICS ESTABLISHED TO MEET THE NEEDS OF NON-NATIVE ENGLISH SPEAKERS; SCHOOL-BASED CURRICULA THAT HELP STUDENTS LEARN ABOUT ASTHMA, DENTAL HEALTH, NUTRITION, SEXUAL HEALTH, SUBSTANCE USE, AND STRESS MANAGEMENT; SCREENINGS AND WORKSHOPS FOR POPULATIONS WITH CRITICAL HEALTH DISPARITIES; ASSISTING ELIGIBLE PATIENTS WITH SECURING FINANCIAL AND SOCIAL BENEFITS SUCH AS PUBLIC HEALTH INSURANCE; AND A COLLABORATION WITH THE BOSTON CHNA-CHIP COLLABORATIVE TO DEEPEN AND EXPAND THE IMPACT OF MEMBER INSTITUTIONS' COMMUNITY BENEFITS ACTIVITIES. TUFTS MC ALSO PARTICIPATES IN COMMUNITY COALITIONS THAT WORK TO PRESERVE COMMUNITY ASSETS AND ADVANCE THE PHYSICAL, ECONOMIC, SOCIAL, AND CULTURAL HEALTH OF THE COMMUNITY. EXAMPLES OF THIS INCLUDE TUFTS MC'S ROLE IN PUBLIC SAFETY INITIATIVES, PROVIDING PARKING FOR FAITH-BASED INSTITUTIONS' CONGREGATION MEMBERS AND WEEKEND PARKING FOR LOCAL SMALL BUSINESS OWNERS' CUSTOMERS, AND VARIOUS WORKFORCE DEVELOPMENT ACTIVITIES TO HELP PREPARE AND/OR RECRUIT COMMUNITY MEMBERS FOR TUFTS MC EMPLOYMENT AND BEYOND.
PART VI, LINE 6:	COMMUNITY HOSPITAL PARTNERSHIPSTUFTS MEDICAL CENTER HAS A RICH HISTORY OF PROVIDING MEDICAL CARE TO THE BOSTON COMMUNITY SINCE ITS FOUNDING. IN 2009 TUFTS MEDICAL CENTER LAUNCHED ITS DISTRIBUTED ACADEMIC MEDICAL CENTER MODEL, WHICH PARTNERS WITH COMMUNITY HOSPITALS TO KEEP MORE CARE LOCALLY IN THE COMMUNITY. TUFTS MEDICAL CENTER IS PROUD TO PARTNER WITH EXCELLENT COMMUNITY HOSPITALS TO DELIVER THE HIGHEST QUALITY CARE IN THE MOST CONVENIENT MANNER FOR PATIENTS. WE STRONGLY BELIEVE THAT WHEN ACADEMIC MEDICAL CENTERS AND COMMUNITY HOSPITALS WORK SIDE-BY-SIDE, THE PATIENT AND THE HEALTH CARE SYSTEM BENEFIT. THROUGH OUR DISTRIBUTED ACADEMIC MEDICAL CENTER MODEL, WE BRING TUFTS MEDICAL CENTER AND FLOATING HOSPITAL FOR CHILDREN PHYSICIANS TO THE COMMUNITY - SAVING PATIENTS THE DRIVE INTO DOWNTOWN BOSTON AND TAKING ADVANTAGE OF THE EXCELLENT HOSPITALS IN THE CITIES AND TOWNS SURROUNDING BOSTON. WE ALSO CONSULT CLOSELY WITH OUR TALENTED PHYSICIAN COLLEAGUES WHO ARE PROVIDING OUTSTANDING SERVICES IN THE COMMUNITY ALREADY. AND WHEN EXCEPTIONALLY COMPLEX CARE IS NEEDED, THESE PARTNERSHIPS MEAN THE TRANSFER TO BOSTON IS WELL COORDINATED BETWEEN PHYSICIANS AND COMFORTABLE FOR THE PATIENT AND FAMILY MEMBERS.THROUGH PARTNERSHIPS WITH OTHER AREA HOSPITALS AND MEDICAL CENTERS, DOCTORS FROM TUFTS MC AND FLOATING HOSPITAL STAFF VARIOUS COMMUNITY MEDICAL FACILITIES. THIS ALLOWS MORE PATIENTS TO RECEIVE TOP-QUALITY CARE IN A LOCATION CLOSE TO HOME. TUFTS MC SPECIALISTS SEE PATIENTS AND PERFORM SOME TREATMENTS AND PROCEDURES LOCALLY. WHEN HIGH-LEVEL ADVANCED CARE IS NEEDED, TUFTS MC DOCTORS WORK WITH THE COMMUNITY PHYSICIANS TO ENSURE A SMOOTH PATIENT TRANSITION TO TUFTS MEDICAL CENTER IN BOSTON.TUFTS MEDICAL CENTER AND FLOATING HOSPITAL MAKE EXCELLENT CLINICAL PARTNERS FOR TWO MAIN REASONS. FIRST, WE WORK WITH OUR PARTNER HOSPITALS TO KEEP MOST MEDICAL CARE LOCAL. THIS IS THE MOST CONVENIENT OPTION FOR PATIENTS AND THE MOST COST-EFFECTIVE OPTION FOR BOTH PATIENTS AND PROVIDERS. SECOND, TUFTS MEDICAL CENTER AND FLOATING HOSPITAL PROVIDE HIGH-QUALITY CARE AT REASONABLE COSTS. IN FACT, A REPORT BY THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE SAID THAT WE ARE THE MOST AFFORDABLE ADVANCED CARE OPTION IN BOSTON.PATIENTS MAY EXPERIENCE OUR AFFILIATION WITH COMMUNITY HOSPITALS IN ANY NUMBER OF WAYS, SUCH AS:- A PEDIATRIC HOSPITALIST CARING FOR A SICK CHILD ON THE PEDIATRIC UNIT OF A COMMUNITY HOSPITAL- A CARDIOLOGIST PERFORMING CARDIAC CATHETERIZATIONS IN THE COMMUNITY- OUR EXPERT WEIGHT AND WELLNESS CENTER TEAM PROVIDING SUPPORT AND SURGERIES IN THE COMMUNITY - OUR TRAUMA TEAM PREPARING FOR AN URGENT TRANSFER FROM A COMMUNITY HOSPITAL- OUR NEUROLOGY TEAM PROVIDING A CONSULT ON A STROKE PATIENT IN A COMMUNITY EMERGENCY DEPARTMENT- CARDIOLOGY EXPERTS FROM THROUGHOUT THE REGION MEETING TO DISCUSS BEST PRACTICE FOR TREATING HEART FAILURE PATIENTS- COORDINATED CARE PROTOCOLS BETWEEN INSTITUTIONS AND CARE SETTINGSADULT AFFILIATE HOSPITALSMETROWEST MEDICAL CENTER (FRAMINGHAM, MA)PEDIATRIC AFFILIATE HOSPITALSLAWRENCE GENERAL HOSPITAL (LAWRENCE, MA)LOWELL GENERAL HOSPITAL (LOWELL, MA)METROWEST MEDICAL CENTER (FRAMINGHAM, MA)SIGNATURE HEALTHCARE BROCKTON HOSPITAL (BROCKTON, MA)
PART VI, LINE 7, REPORTS FILED WITH STATES	MA
PART VI, LINE 4, COMMUNITY INFORMATION (CONTINUED)	QUINCY HAS A SIGNIFICANT ASIAN POPULATION WITH STRONG SOCIAL AND CULTURAL TIES TO BOSTON'S CHINATOWN, COMPRISING ABOUT 6% OF TUFTS MC'S PATIENT POPULATION. IN 2017, QUINCY HAD A POPULATION OF 93,824 AND GREW 6.6% SINCE 2000. BETWEEN 2000 AND 2017, THE CITY SAW A GROWTH IN THE NUMBER OF BLACK AND LATINX RESIDENTS, AND MOST NOTABLY ASIAN RESIDENTS; THE NUMBER OF ASIAN RESIDENTS DOUBLED FROM 13,500 TO 27,200 IN THIS PERIOD AND NOW CONSTITUTE 29% OF THE POPULATION, SECOND ONLY TO WHITE RESIDENTS. THIRTY-ONE PERCENT OF QUINCY RESIDENTS ARE FOREIGN-BORN AND 35% LIVE IN LIMITED-ENGLISH-SPEAKING HOMES, 24.7% OF WHOM SPEAK AN ASIAN LANGUAGE.DATA FROM THE CITY OF BOSTON SHOW THAT IN 2015, CANCER AND HEART DISEASE WERE AMONG THE LEADING CAUSES OF DEATH IN QUINCY. CHRONIC DISEASE MANAGEMENT, PARTICULARLY HEART DISEASE AND HYPERTENSION, WAS IDENTIFIED AS A TOP HEALTH PRIORITY IN QUINCY. IN ADDITION, ACCESS TO HEALTH CARE AND OTHER SOCIAL SERVICES HAS REMAINED A PRIORITY HEALTH CONCERN SINCE 2013. WITH THE INCREASING POPULATION OF IMMIGRANTS AND LIMITED ENGLISH SPEAKERS, AND AN INCREASING PREVALENCE OF CHRONIC DISEASE, ACCESS TO LINGUISTICALLY AND CULTURALLY APPROPRIATE HEALTH CARE AND SOCIAL SERVICES ARE A CRITICAL NEED. CARE TO BOSTON RESIDENTS AND SURROUNDING COMMUNITIES:TUFTS MEDICAL CENTER BELIEVES THAT CARING FOR OUR COMMUNITY HAPPENS BOTH WITHIN AND OUTSIDE THE WALLS OF THE INSTITUTION. DATA HAVE SHOWN THAT MANY BARRIERS EXIST WHICH HINDER PATIENT ACCESS TO HIGH QUALITY HEALTH CARE, INCLUDING THE LINGUISTIC AND CULTURAL COMPETENCY OF HEALTH CARE PROVIDERS. TO REMOVE THE BARRIERS AND INCREASE ACCESS TO HOSPITAL SERVICES, TUFTS MC CONTINUES A LONG-STANDING COMMITMENT TO INCREASE CULTURAL COMPETENCY AMONG OUR MEDICAL PROVIDERS AND TO REMOVE LANGUAGE BARRIERS WHEREVER POSSIBLE. THE WORKING DEFINITION OF CULTURAL COMPETENCY THAT HELPS TO SHAPE AND DRIVE POLICIES AND CARE DELIVERY AT TUFTS MC IS AS FOLLOWS:THE ABILITY TO UNDERSTAND AND RESPECT THE DIFFERENCES AMONG PEOPLE AND USE OUR UNDERSTANDING TO INFLUENCE OUR INTERACTIONS WITH ONE ANOTHER; THIS INVOLVES DEVELOPING OUR CAPABILITY OF DELIVERING PATIENT-CENTERED SERVICES CONSISTENT WITH THE NEEDS AND EXPECTATIONS OF VARIOUS CULTURES.

Schedule H (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

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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 ............

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)
1CRAIG BEST MD TRUSTEE/PRESIDENT & CEO - PO	(i) (ii)	0 ------------- 548,900	0 ------------- 103,125	0 ------------- 5,997	0 ------------- 27,500	0 ------------- 8,629	0 ------------- 694,151	0 ------------- 0
2JATIN DAVE MD TRUSTEE	(i) (ii)	377,317 ------------- 0	59,441 ------------- 0	517 ------------- 0	23,787 ------------- 0	25,353 ------------- 0	486,415 ------------- 0	0 ------------- 0
3DAN DRISCOLL MD TRUSTEE	(i) (ii)	0 ------------- 263,319	0 ------------- 73,787	0 ------------- 10,649	0 ------------- 25,666	0 ------------- 20,966	0 ------------- 394,387	0 ------------- 0
4KAREN FREUND MD TRUSTEE	(i) (ii)	0 ------------- 280,991	0 ------------- 50,141	0 ------------- 9,553	0 ------------- 27,500	0 ------------- 21,029	0 ------------- 389,214	0 ------------- 0
5MARVIN A KONSTAM MD TRUSTEE	(i) (ii)	0 ------------- 387,186	0 ------------- 0	0 ------------- 20,975	0 ------------- 18,333	0 ------------- 14,243	0 ------------- 440,737	0 ------------- 0
6MATTHEW LARKIN TRUSTEE	(i) (ii)	0 ------------- 329,954	0 ------------- 66,268	0 ------------- 10,265	0 ------------- 27,499	0 ------------- 20,996	0 ------------- 454,982	0 ------------- 0
7WILLIAM C MACKEY MD TRUSTEE	(i) (ii)	0 ------------- 480,931	0 ------------- 60,000	0 ------------- 16,388	0 ------------- 27,500	0 ------------- 21,364	0 ------------- 606,183	0 ------------- 0
8DEEB N SALEM MD TRUSTEE	(i) (ii)	0 ------------- 556,727	0 ------------- 160,415	0 ------------- 39,670	0 ------------- 27,500	0 ------------- 20,843	0 ------------- 805,155	0 ------------- 0
9PAUL SUMMERGRAD MD TRUSTEE	(i) (ii)	0 ------------- 448,658	0 ------------- 71,250	0 ------------- 19,659	0 ------------- 27,500	0 ------------- 20,803	0 ------------- 587,870	0 ------------- 0
10MARGARET COSTELLO TRUSTEE/COO	(i) (ii)	350,403 ------------- 0	53,904 ------------- 0	759 ------------- 0	23,900 ------------- 0	23,903 ------------- 0	452,869 ------------- 0	0 ------------- 0
11JEFFREY A WEINSTEIN TRUSTEE/SENIOR VP/SECRETARY	(i) (ii)	0 ------------- 455,168	0 ------------- 139,549	0 ------------- 89,060	0 ------------- 3,768	0 ------------- 19,332	0 ------------- 706,877	0 ------------- 0
12JOSEPH FROLKIS MD TRUSTEE/PRESIDENT/CEO	(i) (ii)	552,259 ------------- 0	143,371 ------------- 0	8,034 ------------- 0	5,400 ------------- 0	4,599 ------------- 0	713,663 ------------- 0	0 ------------- 0
13NATHAN GAGNE CFO/TREASURER	(i) (ii)	268,613 ------------- 0	36,321 ------------- 0	78 ------------- 0	23,900 ------------- 0	4,157 ------------- 0	333,069 ------------- 0	0 ------------- 0
14ZACHARY REDMOND SECRETARY	(i) (ii)	228,575 ------------- 0	39,780 ------------- 0	8,430 ------------- 0	5,615 ------------- 0	27,790 ------------- 0	310,190 ------------- 0	0 ------------- 0
15KRISTINE M HANSCOM SENIOR VP/TREASURER/CFO/TRUSTEE	(i) (ii)	453,135 ------------- 0	98,234 ------------- 0	41,451 ------------- 0	66,350 ------------- 0	30,670 ------------- 0	689,840 ------------- 0	0 ------------- 0
16ELLEN O'GORMAN CEO	(i) (ii)	156,178 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	156,178 ------------- 0	0 ------------- 0
17MICHAEL APKON TRUSTEE/CEO/PRESIDENT	(i) (ii)	221,028 ------------- 0	0 ------------- 0	6,149 ------------- 0	0 ------------- 0	23,413 ------------- 0	250,590 ------------- 0	0 ------------- 0
18CHARLES R WHIPPLE ESQ TRUSTEE/SECRETARY	(i) (ii)	0 ------------- 297,282	0 ------------- 49,248	0 ------------- 68,724	0 ------------- 0	0 ------------- 32,148	0 ------------- 447,402	0 ------------- 0
19THERESE HUDSON-JINKS SENIOR VP AND CNO	(i) (ii)	489,965 ------------- 0	83,885 ------------- 0	60,924 ------------- 0	53,403 ------------- 0	6,673 ------------- 0	694,850 ------------- 0	0 ------------- 0
20WILLIAM SHICKOLOVICH THRU 118 SENIOR VP OPERATIONS MGMT/CIO	(i) (ii)	0 ------------- 426,080	0 ------------- 116,177	0 ------------- 75,473	0 ------------- 60,050	0 ------------- 29,933	0 ------------- 707,713	0 ------------- 0
21DEBORAH JOELSON UNTIL 118 SR. VP STRATEGIC SERVICES	(i) (ii)	0 ------------- 421,327	0 ------------- 125,803	0 ------------- 94,227	0 ------------- 61,450	0 ------------- 30,231	0 ------------- 733,038	0 ------------- 0
22SUSAN BLANCHARD VP FOR RESEARCH ADMINISTRATION	(i) (ii)	238,304 ------------- 0	41,933 ------------- 0	41,028 ------------- 0	36,225 ------------- 0	27,031 ------------- 0	384,521 ------------- 0	0 ------------- 0
23KELLY DOUGHERTY VP CARDIOVASCULAR	(i) (ii)	219,710 ------------- 0	42,482 ------------- 0	743 ------------- 0	32,561 ------------- 0	16,257 ------------- 0	311,753 ------------- 0	0 ------------- 0
24SEAN SULLIVAN VP HUMAN RESOURCES (UNTIL 1/19)	(i) (ii)	343,901 ------------- 0	58,769 ------------- 0	2,666 ------------- 0	44,970 ------------- 0	28,826 ------------- 0	479,132 ------------- 0	0 ------------- 0
25BROOKE TYSON-HYNES VP PUBLIC AFFAIRS	(i) (ii)	156,570 ------------- 156,570	40,198 ------------- 40,198	4,120 ------------- 4,121	4,017 ------------- 4,018	14,075 ------------- 14,076	218,980 ------------- 218,983	0 ------------- 0
26MAURA LYNCH VP FOR DEVELOPMENT	(i) (ii)	351,937 ------------- 0	57,685 ------------- 0	4,983 ------------- 0	48,030 ------------- 0	11,988 ------------- 0	474,623 ------------- 0	0 ------------- 0
27MICHAEL CROWLEY UNTIL 1118 VP REAL ESTATE & FACILITIES	(i) (ii)	181,157 ------------- 0	0 ------------- 0	136,961 ------------- 0	41,827 ------------- 0	10,507 ------------- 0	370,452 ------------- 0	37,351 ------------- 0
28CATHERINE BUKOWSKI UNTIL 719 VP REVENUE CYCLE	(i) (ii)	289,432 ------------- 0	51,992 ------------- 0	2,209 ------------- 0	36,453 ------------- 0	9,879 ------------- 0	389,965 ------------- 0	0 ------------- 0
29JEFFREY SYREK VP SYS CONTRACTING	(i) (ii)	236,913 ------------- 0	31,103 ------------- 0	117 ------------- 0	23,400 ------------- 0	24,942 ------------- 0	316,475 ------------- 0	0 ------------- 0
30SAUL WEINGART CHEIF MEDICAL OFFICER	(i) (ii)	0 ------------- 459,041	0 ------------- 110,375	0 ------------- 32,047	0 ------------- 27,500	0 ------------- 21,364	0 ------------- 650,327	0 ------------- 0
31NANCY WETHERBEE DIRECTOR OF ORBIT	(i) (ii)	239,592 ------------- 0	100,000 ------------- 0	1,456 ------------- 0	8,199 ------------- 0	6,078 ------------- 0	355,325 ------------- 0	0 ------------- 0
32ROSS THOMPSON VP & CHIEF PHARMACY OFFICER	(i) (ii)	262,264 ------------- 0	48,061 ------------- 0	1,270 ------------- 0	8,250 ------------- 0	4,566 ------------- 0	324,411 ------------- 0	0 ------------- 0
33SARAH MCKAY VP PERIOPERATIVE SERVICES	(i) (ii)	232,709 ------------- 0	41,500 ------------- 0	16,113 ------------- 0	8,250 ------------- 0	27,246 ------------- 0	325,818 ------------- 0	0 ------------- 0
34JUSTIN PRECOURT ASSOCIATE CHIEF NURSING OFFICER	(i) (ii)	263,356 ------------- 0	22,467 ------------- 0	203 ------------- 0	8,250 ------------- 0	23,455 ------------- 0	317,731 ------------- 0	0 ------------- 0
35MARCY CASS VP RISK MANAGEMENT	(i) (ii)	227,776 ------------- 0	51,299 ------------- 0	5,442 ------------- 0	0 ------------- 0	10,269 ------------- 0	294,786 ------------- 0	0 ------------- 0
36NORMAND DESCHENE FORMER TRUSTEE	(i) (ii)	0 ------------- 1,092,300	0 ------------- 366,053	0 ------------- 197,871	0 ------------- 8,250	0 ------------- 12,671	0 ------------- 1,677,145	0 ------------- 0
37RASHED DURGHAM MD FORMER TRUSTEE	(i) (ii)	0 ------------- 480,201	0 ------------- 0	0 ------------- 18,364	0 ------------- 25,000	0 ------------- 12,462	0 ------------- 536,027	0 ------------- 0
38MICHAEL WAGNER MD FORMER TRUSTEE/PRESIDENT/CEO	(i) (ii)	0 ------------- 906,375	0 ------------- 307,500	0 ------------- 166,667	0 ------------- 120,250	0 ------------- 69,365	0 ------------- 1,570,157	0 ------------- 0
39CHARLES CASSIDY MD FORMER TRUSTEE	(i) (ii)	0 ------------- 693,537	0 ------------- 402,427	0 ------------- 14,697	0 ------------- 27,500	0 ------------- 21,364	0 ------------- 1,159,525	0 ------------- 0
40PATRICIA HAYWARD FORMER VP HUMAN RESOURCES/RISK MG	(i) (ii)	0 ------------- 0	0 ------------- 0	283,407 ------------- 0	0 ------------- 0	7,012 ------------- 0	290,419 ------------- 0	0 ------------- 0

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
PART 1, LINE 4A:	THE LOWELL GENERAL HOSPITAL HAS ENTERED INTO A SPLIT-DOLLAR LIFE INSURANCE AGREEMENT WITH NORMAND DESCHENE - PRESIDENT OF BOARD & CEO - THE LOWELL GENERAL HOSPITAL. PREMIUMS PAID IN CALENDAR 2018 WERE $125,648. ALL PREMIUMS WILL BE REPAID TO THE HOSPITAL.
PART 1, LINE 4B:	SECTION 457(F) RETIREMENT PLAN EMPLOYER DEFERRALS: MICHAEL WAGNER, M.D., $112,000 DEBORAH C. JOELSON, $53,200 WILLIAM J. SHICKOLOVICH, $51,800 THERESE HUDSON-JINKS, $45,153 SEAN SULLIVAN, $36,720 MAURA LYNCH, $39,780 MICHAEL CROWLEY, $34,272 SUSAN BLANCHARD, $27,975 KELLY DOUGHERTY, $26,928 KRISTINE HANSCOM, $58,100 CATHERINE BUKOWSKI, $28,203 JEFFREY GROSS, $3,270

Schedule J (Form 990) 2018

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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
TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number
27-0440772

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	MASSACHUSETTS DEVELOPMENT FINANCE AUTHORITY	04-3431814	57584YPN3	02-20-2019	230,260,000	SEE SUPPLEMENTAL INFORMATION		X		X	X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	247,886,139
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	2,591,218
11 Other spent proceeds .............	159,332,179
12 Other unspent proceeds .............	85,962,742
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
15 Were the bonds issued as part of an advance refunding issue? .....		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		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
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?
c Are there any research agreements that may result in private business use of bond-financed property? .............		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?
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 %
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 .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		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
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? .............
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

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
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........		X
c No rebate due? .........		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
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
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
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part Ⅵ

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

Return Reference

Explanation

PART I, LINE A, COLUMN F

DESCRIPTION OF BOND PURPOSE: A. THE ISSUANCE OF BONDS AND THE LOAN OF THE PROCEEDS THEREOF IS TO (1) REFINANCE CERTAIN OUTSTANDING INDEBTEDNESS OF OR ISSUED FOR THE BENEFIT OF THE INSTITUTION, AS FUTHER IDENTIFIED BELOW, (2) FINANCE CONSTRUCTION, RENOVATION AND IMPROVEMENTS AT AND ACQUISTIONS AND EQUIPMENT FOR THE ACUTE CARE HOSPITAL AND RELATED FACILITIES OWNED AND/OR OPERATED BY TUFTS MEDICAL CENTER, (3) FUND A DEBT SERVICE RESERVE FUND, AND (4) PAY CERTAIN COSTS OF ISSUANCE OF THE BONDS. FURTHER IDENTIFICATION OF BOND PURPOSE - REFINANCINGS: SERIES J BONDS ISSUED 9/22/17 SERIES A BONDS WERE ISSUED FOR THE WELLFORCE OBLIGATED GROUP, WHICH INCLUDES TUFTS MEDICAL CENTER, INC., THE LOWELL GENERAL HOSPITAL, AND MELROSEWAKEFIELD HEALTHCARE.

Schedule K (Form 990) 2018

Additional Data

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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

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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 ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	12	257,145	FMV
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 .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

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
PART I, COLUMN (B):	THE NUMBER REPORTED IN COLUMN (B) OF SCHEDULE M REPRESENTS THE NUMBER OF CONTRIBUTIONS OF EACH ITEM.

Schedule M (Form 990) (2018)

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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

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Return Reference	Explanation
FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:	WE STRIVE TO HEAL, TO COMFORT, TO TEACH, TO LEARN, AND TO SEEK THE KNOWLEDGE TO PROMOTE HEALTH AND PREVENT DISEASE. OUR PATIENTS AND THEIR FAMILIES ARE AT THE CENTER OF EVERYTHING WE DO. WE DEDICATE OURSELVES TO FURTHERING OUR RICH TRADITION OF HEALTH CARE INNOVATION, LEADERSHIP, CHARITY AND THE HIGHEST STANDARD OF CARE TO ALL IN OUR COMMUNITY. TO PROVIDE LONG-TERM CARE FOR CHILDREN WHO ARE SEVERELY MENTALLY HANDICAPPED AND/OR MULTIPLY PHYSICALLY HANDICAPPED. RENTAL SERVICE PROGRAMS TO PROMOTE THE INTEREST OF TUFTS MEDICAL CENTER, INC. AND ITS AFFILIATED ORGANIZATIONS BY ACQUIRING, MANAGING, MAINTAINING, DEVELOPING, LEASING AND DISPOSING OF REAL ESTATE PROPERTIES. NEW ENGLAND QUALITY CARE ALLIANCE, INC. OPERATES FOR THE PURPOSE OF SUPPORTING ACTIVITIES OF TUFTS MEDICAL CENTER PARENT, INC. AND ITS AFFILIATES. NEW ENGLAND QUALITY CARE ALLIANCE ACCOUNTABLE CARE, INC. WAS FORMED TO IMPROVE THE HEALTH OF PATIENTS AND TO ENHANCE THE PATIENT'S EXPERIENCE OF CARE. TUFTS MEDICAL CENTER COMMUNITY CARE, INC. WORKS JOINTLY WITH TUFTS MEDICAL CENTER PARENT, INC. AND ITS AFFILIATES TO DEVELOP, IMPLEMENT, AND OPERATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM AND TO PROVIDE COST-EFFECTIVE AND HIGH-QUALITY PATIENT CARE WITHIN SUCH SYSTEM.
FORM 990, PART VI, SECTION B, LINE 11B	THE CFO AND CONTROLLER REVIEW THE FORM 990 WITH TAX ADVISORS FROM A NATIONAL ACCOUNTING FIRM. A COPY OF THE FORM 990 AS IT WILL BE ULTIMATELY FILED IS POSTED TO AN INTERNAL WEBSITE. PRIOR TO FILING, THE ORGANIZATION EMAILS ALL OF ITS GOVERNING BODY MEMBERS A LINK TO A PASSWORD PROTECTED WEBSITE, ADVISING THEM THAT THE FORM 990 IS AVAILABLE FOR REVIEW ON THAT SITE.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION ENFORCES COMPLIANCE BY PROCEDURES INCLUDING ANNUAL DISCLOSURE AND REVIEW OF SUCH DISCLOSURE BY MANAGEMENT. CONFLICTS ARE RESOLVED BY THE APPROPRIATE HEAD OF THE DEPARTMENT AND REVIEWED BY LEGAL. THE JOINT COMPLIANCE COMMITTEE WILL DISCUSS ANY APPEAL.
FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES MET ON DECEMBER 12, 2018 TO REVIEW EXECUTIVE COMPENSATION FOR 2018. SULLIVAN AND COTTER, AN INDEPENDENT CONSULTANT TO THE BOARD, PROVIDED A COMPETITIVENESS ASSESSMENT BASED ON COMPARATOR INFORMATION INCLUDING NATIONAL, NORTHEAST AND BOSTON AREA DATA. TOTAL COMPENSATION FOR THE EXECUTIVE GROUP, INCLUDING THE PRESIDENT/CEO , COO AND VICE PRESIDENTS, WAS DETERMINED TO BE CONSERVATIVE AND WELL WITHIN MARKET AVERAGES, THE PROCESS HAS NOT CHANGED SINCE THEN. THE LAST MEETING WAS HELD DECEMBER 12, 2018.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS WILL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST EITHER BY MAIL OR IN PERSON AT THE OFFICE, DEPENDING ON THE FORM OF THE REQUEST.
FORM 990, PART VI, SECTION B., LINE 16A:	TUFTS MEDICAL CENTER, INC. HOLDS A 65% INTEREST IN SHIELDS-TUFTS MEDICAL CENTER IMAGING MANAGEMENT, LLC.
FORM 990, PART XI, LINE 9:	TRANSFER OF NET ASSETS -19,788,000. PENSION-RELATED ADJUSTMENTS -34,712,000. LOSS ON EXTINGUISHMENT OF DEBT -7,435,000. OTHER COMPONENTS OF NET PERIODIC PENSION COSTS 202,000. NET ASSETS RELEASED FROM RESTRICTION 1,669,000. OTHER ADJUSTMENTS 5,782.

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

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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

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

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)MELROSEWAKEFIELD HEALTHCARE INC 170 GOVERNORS AVE MEDFORD,MA02155 04-2767880	HOSPITAL	MA	501(C)(3)	LINE 3	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(2)HALLMARK HEALTH MEDICAL ASSOCIATES INC 170 GOVERNORS AVE MEDFORD,MA02155 04-3140938	MD OFFICES	MA	501(C)(3)	LINE 10	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(3)LM LONG TERM CARE SERVICES INC 170 GOVERNORS AVE MEDFORD,MA02155 04-2938772	LONG-TERM CARE	MA	501(C)(3)	LINE 12B, II	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(4)SAVIN LONG TERM CARE CORPORATION 170 GOVERNORS AVE MEDFORD,MA02155 04-3012616	LONG-TERM CARE	MA	501(C)(3)	LINE 10	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(5)HALLMARK HEALTH VISITING NURSE ASSOCIATION AND HOSPICE INC 178 SAVIN ST SUITE 300 MALDEN,MA02148 04-2437064	VISITING NURSE	MA	501(C)(3)	LINE 10	HOME HEALTH FOUNDATION INC	Yes
(6)HALLMARK HEALTH PROPERTIES 170 GOVERNORS AVE MEDFORD,MA02155 22-2580542	PROPERTY	MA	501(C)(3)	LINE 12B, II	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(7)MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION 170 GOVERNORS AVE MEDFORD,MA02155 04-2103587	PARENT	MA	501(C)(3)	LINE 12A, I	WELLFORCE INC	Yes
(8)THE LOWELL GENERAL HOSPITAL 295 VARNUM AVENUE LOWELL,MA01854 04-2103590	HEALTH CARE	MA	501(C)(3)	LINE 3	CIRCLE HEALTH INC	Yes
(9)CIRCLE HEALTH PHYSICIANS INC 295 VARNUM AVENUE LOWELL,MA01854 27-3902914	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	CIRCLE HEALTH INC	Yes
(10)LGH PHYSICIAN ASSOCIATES INC ONE HOSPITAL DRIVE LOWELL,MA01852 04-3190747	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	CIRCLE HEALTH PHYSICIANS INC	Yes
(11)CIRCLE HEALTH INC 295 VARNUM AVENUE LOWELL,MA01854 22-2579798	PARENT/SUPPORTING ORGANIZATION	MA	501(C)(3)	LINE 12B, II	WELLFORCE INC	Yes
(12)WELLFORCE INC 1600 DISTRICT AVE SUITE 125 BURLINGTON,MA01803 45-2250732	PARENT/SUPPORTING ORGANIZATION	MA	501(C)(3)	LINE 12A, I	N/A		No
(13)CNS NURSING HOME CARE INC 847 ROGERS STREET SUITE 201 LOWELL,MA01852 37-1836433	HOME CARE SERVICES	MA	501(C)(3)	LINE 10	CIRCLE HOME INC	Yes
(14)CIRCLE HOME INC 847 ROGERS STREET SUITE 201 LOWELL,MA01852 04-2103812	HOME CARE SERVICES	MA	501(C)(3)	LINE 10	HOME HEALTH FOUNDATION INC	Yes
(15)TUFTS MEDICAL CENTER PARENT INC 800 WASHINGTON STREET BOSTON,MA02111 04-2810022	FUNDRAISING, ADMIN. PLANNING & OTHER ACTIVITIES	MA	501(C)(3)	LINE 12B, II	WELLFORCE INC	Yes
(16)TUFTS MEDICAL CENTER INC 800 WASHINGTON STREET BOSTON,MA02111 04-3400617	HOSPITAL SERVICES	MA	501(C)(3)	LINE 3	TUFTS MEDICAL CENTER PARENT INC	Yes
(17)TUFTS MEDICAL CENTER REAL ESTATE COMPANY INC 800 WASHINGTON STREET BOSTON,MA02111 04-2772654	ACQUIRING REAL PROPERTY	MA	501(C)(3)	LINE 12B, II	TUFTS MEDICAL CENTER PARENT INC	Yes
(18)NEW ENGLAND LONG-TERM CARE INC 800 WASHINGTON STREET BOSTON,MA02111 04-2912578	PEDIATRIC LONG-TERM CARE FACILITY	MA	501(C)(3)	LINE 3	TUFTS MEDICAL CENTER PARENT INC	Yes
(19)NEW ENGLAND QUALITY CARE ALLIANCE INC 800 WASHINGTON STREET BOSTON,MA02111 04-3040427	MEDICAL PROGRAMS & SERVICES	MA	501(C)(3)	LINE 12B, II	TUFTS MEDICAL CENTER PARENT INC	Yes
(20)NEQCA ACCOUNTABLE CARE INC 325 WOOD RD SUITE 210 BRAINTREE,MA02184 80-0824142	ACO	MA	501(C)(3)	LINE 7	NEW ENGLAND QUALITY CARE ALLIANCE INC	Yes
(21)TUFTS MEDICAL CENTER COMMUNITY CARE INC 325 WOOD RD SUITE 210 BRAINTREE,MA02184 47-3046563	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PARENT INC	Yes
(22)THE CAMERON M NEELY FOUNDATION 800 WASHINGTON STREET BOSTON,MA02111 04-3265628	CHARITABLE	MA	501(C)(3)	LINE 7	TUFTS MEDICAL CENTER PARENT INC	Yes
(23)HEART CENTER OF METROWEST INC 99 LINCOLN STREET FRAMINGHAM,MA01702 03-0390670	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(24)PRATT ANESTHESIOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3418395	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(25)PRATT MEDICAL AND SURGICAL ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148397	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(26)PRATT NEUROLOGY ASSOICATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148384	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(27)PRATT OBGYN ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148385	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(28)PRATT OPHTHALMOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148392	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(29)PRATT ORTHOPEDIC ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 20-5129051	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(30)PRATT OTOLARYNGOLOGY 800 WASHINGTON STREET BOSTON,MA02111 04-3148381	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(31)PRATT PATHOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148393	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(32)PRATT PEDIATRIC ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148394	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(33)PRATT PSYCHIATRIC ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148387	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(34)PRATT RADIOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148388	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(35)PRATT RADIATION ONCOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148389	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(36)PRATT REHABILITATION MEDICINCE 800 WASHINGTON STREET BOSTON,MA02111 04-3148378	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(37)PRATT SURGICAL ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148376	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(38)PRATT UROLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148379	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(39)NEW ENGLAND MEDICAL CENTER 800 WASHINGTON STREET BOSTON,MA02111 04-3096445	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(40)PRATT MEDICAL GROUP INC 800 WASHINGTON STREET BOSTON,MA02111 04-2743894	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(41)TUFTS MEDICAL CENTER PHYSICIANS ORG INC 800 WASHINGTON STREET BOSTON,MA02111 04-3044706	ADMIN.	MA	501(C)(3)	LINE 12B, II	TUFTS MEDICAL CENTER PARENT INC	Yes
(42)CARDIOVASCULAR CENTER AT TUFTS MEDICAL CENTER INC 800 WASHINGTON STREET BOSTON,MA02111 82-3315703	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(43)HOME HEALTH FOUNDATION INC 360 MERRMIACK STREET LAWRENCE,MA01843 22-2587225	MANAGEMENT SERVICES	MA	501(C)(3)	LINE 12B, II	WELLFORCE INC	Yes
(44)HOME HEALTH VNA INC 360 MERRMIACK STREET LAWRENCE,MA01843 04-2435675	HOME HEALTH CARE	MA	501(C)(3)	LINE 10	HOME HEALTH FOUNDATION INC	Yes
(45)MERRIMACK VALLEY HOSPICE INC 360 MERRMIACK STREET LAWRENCE,MA01843 04-3024278	HOSPICE SERVICES	MA	501(C)(3)	LINE 10	HOME HEALTH FOUNDATION INC	Yes
(46)HOME CARE INC 360 MERRMIACK STREET LAWRENCE,MA01843 04-2854358	HOME HEALTH SUPPORTIVE SERIVCES	MA	501(C)(3)	LINE 10	HOME HEALTH FOUNDATION INC	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) HALLMARK HEALTH INVESTMENTS LLC 170 GOVERNORS AVE MEDFORD,MA02155 02-0657666	INVESTMENT	MA	MELROSEWAKEFIELD HEALTHCARE INC	EXCLUDED				No			No
(2) MONTVALE PETCT LLC 100 BAYVIEW CIRCLE SUITE 400 NEWPORT BEACH,CA92660 27-0325022	CAT SCAN	DE	MELROSEWAKEFIELD HEALTHCARE INC	RELATED				No			No
(3) CIRCLE HEALTH ALLIANCE LLC 295 VARNUM AVE LOWELL,MA01854 80-0782682	ACCOUNTABLE CARE ORGANIZATION	MA	CIRCLE HEALTH INC	RELATED				No			No
(4) SHIELDS-TUFTS MEDICAL CENTER IMAGING MANAGEMENT LLC 800 WASHINGTON STREET BOSTON,MA02111 32-0558307	MEDICAL SERVICES (MRI)	MA	TUFTS MEDICAL CENTER INC	RELATED	2,420,371	802,594		No			No	65.000 %
(5) MEDFORD LAWRENCE REAL ESTATE LLC 55 CHRISTYS DRIVE BROCKTON,MA02301 32-0553759	MEDICAL OFFICE BUILDING	MA	MELROSEWAKEFIELD HEALTHCARE INC	RELATED				No			No

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) WELLFORCE INDEMNITY COMPANY LTD 800 WASHINGTON STREET BOSTON,MA02111 98-0444573	CAPTIVE INSURANCE	CJ	TUFTS MEDICAL CENTER INC	C	15,951,387	87,079,674	80.000 %	Yes
(2) HALLMARK HEALTH ENTERPRISES INC 585 LEBANON STREET MELROSE,MA02176 04-2475660	OTHER HEALTH SERVICES	MA	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	C				Yes
(3) LAWRENCE MELROSE MEDICAL ELECTRONICS RECORD INC 170 GOVERNORS AVE MEDFORD,MA02155 42-1685777	ELECTRONIC MEDICAL RECORDS	MA	MELROSEWAKEFIELD HEALTHCARE INC	C					No
(4) HALLMARK HEALTH PHO INC 170 GOVERNORS AVE MEDFORD,MA02155 46-1134759	PHYSICIAN HOSPITAL ORGANIZATION	MA	MELROSEWAKEFIELD HEALTHCARE INC	C					No
(5) LGH SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 04-2854673	MEDICAL SERVICES	MA	CIRCLE HEALTH INC	C				Yes
(6) LGH MEDICAL BUILDING SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 04-3058954	MEDICAL OFFICE BUILDING	MA	LGH SERVICES INC	C				Yes
(7) LGH MANAGEMENT SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 04-2919244	MEDICAL SERVICES	MA	LGH SERVICES INC	C				Yes
(8) LGH MEDICAL SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 26-1889904	MEDICAL SERVICES	MA	LGH SERVICES INC	C				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) ............................

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

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

Yes

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

Yes

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) ...................

Yes

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

Yes

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

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

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) PRATT ORTHOPEDIC ASSOCIATES INC	M	948,745	BOOK BASIS
(2) PRATT NEUROLOGY ASSOCIATES INC	M	641,417	BOOK BASIS
(3) PRATT NEUROSURGERY ASSOCIATES INC	M	2,807,095	BOOK BASIS
(4) PRATT ANESTHESIOLOGY ASSOCIATES INC	M	7,248,332	BOOK BASIS
(5) PRATT OBGYN ASSOCIATES INC	M	1,541,622	BOOK BASIS
(6) PRATT OPTHAMOLOGY ASSOCIATES INC	L	3,852,044	BOOK BASIS
(7) PRATT PATHOLOGY ASSOCIATES INC	M	1,718,087	BOOK BASIS
(8) PRATT PEDIATRIC ASSOCIATES INC	M	5,040,722	BOOK BASIS
(9) PRATT PSYCHIATRIC ASSOCIATES INC	L	203,511	BOOK BASIS
(10) PRATT RADIOLOGY ASSOCIATES INC	M	2,192,746	BOOK BASIS
(11) PRATT RADIATION ONCOLOGY ASSOCIATES INC	M	40,583	BOOK BASIS
(12) PRATT REHABILITATION MEDICINE ASSOCIATES INC	M	213,230	BOOK BASIS
(13) PRATT SURGICAL ASSOCIATES INC	M	3,247,127	BOOK BASIS
(14) PRATT UROLOGY ASSOCIATES INC	M	51,022	BOOK BASIS
(15) PRATT DERMATOLOGY ASSOCIATES INC	M	1,384,653	BOOK BASIS
(16) PRATT MEDICAL GROUP INC	M	9,221,502	BOOK BASIS
(17) TMC PHYSICIAN ORGANIZATION INC	L	12,167,511	BOOK BASIS
(18) TMC PHYSICIAN ORGANIZATION INC	J	324,641	BOOK BASIS
(19) NEW ENGLAND MEDICAL CENTER GROUP	M	211,507	BOOK BASIS
(20) NEW ENGLAND MEDICAL CENTER GROUP	E	1,401,948	BOOK BASIS
(21) PRATT ANESTHESIOLOGY ASSOCIATES INC	E	727,825	BOOK BASIS
(22) PRATT PATHOLOGY ASSOCIATES INC	E	163,233	BOOK BASIS
(23) PRATT PEDIATRIC ASSOCIATES INC	E	626,429	BOOK BASIS
(24) PRATT RADIOLOGY ASSOCIATES INC	E	195,127	BOOK BASIS
(25) PRATT SURGICAL ASSOCIATES INC	E	252,616	BOOK BASIS
(26) TUFTS MEDICAL CENTER PHYSICIANS ORGANIZATION	E	1,392,804	BOOK BASIS
(27) PRATT OPTHAMOLOGY ASSOCIATES INC	D	1,367,181	BOOK BASIS
(28) PRATT OBGYN ASSOCIATES INC	E	153,430	BOOK BASIS
(29) PRATT ORTHOPEDIC ASSOCIATES INC	E	117,594	BOOK BASIS
(30) PRATT NEUROLOGY ASSOCIATES INC	E	443,770	BOOK BASIS
(31) WELLFORCE INC	D	3,472,018	BOOK BASIS
(32) MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	D	339,363	BOOK BASIS
(33) WELLFORCE INDEMNITY COMPANY LTD	R	2,483,249	BOOK BASIS
(34) WELLFORCE INC	R	10,788,849	BOOK BASIS
(35) CARDIOVASCULAR CENTER AT TUFTS MEDICAL CENTER INC	M	6,478,803	BOOK BASIS
(36) CIRCLE HEALTH INC	E	236,049	BOOK BASIS
(37) PRATT MEDICAL & SURGICAL DERMATOLOGY ASSOC	E	185,323	BOOK BASIS
(38) CAMERON NEELY FOUNDATION FOR CANCER CARE	D	165,402	BOOK BASIS
(39) CARDIOVASCULAR CENTER AT TUFTS MEDICAL CENTER INC	E	488,124	BOOK BASIS
(40) HALLMARK HEALTH VISITING NURSE ASSOCIATION AND HOSPICE	D	57,341	BOOK BASIS
(41) TUFTS MEDICAL CENTER PHYSICIANS ORGANIZATION	R	9,000,000	BOOK BASIS

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: WE STRIVE TO HEAL, TO COMFORT, TO TEACH, TO LEARN, AND TO SEEK THE KNOWLEDGE TO PROMOTE HEALTH AND TO PREVENT DISEASE. OUR PATIENTS AND THEIR FAMILIES ARE AT THE CENTER OF EVERYTHING WE DO. SEE PART III.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	49
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	31
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	6,712
6	Total number of volunteers (estimate if necessary) .............	6	199
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	-367,248
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-367,248

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	46,952,059	46,728,560
9	Program service revenue (Part VIII, line 2g) .........	886,161,623	959,004,182
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	9,154,690	8,112,667
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	834,966	982,465
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	943,103,338	1,014,827,874
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	447,090,000	469,710,767
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	3,000	3,000
b	Total fundraising expenses (Part IX, column (D), line 25) 2,391,776
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	465,709,312	509,863,603
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	912,802,312	979,577,370
19	Revenue less expenses. Subtract line 18 from line 12.......	30,301,026	35,250,504
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	850,185,949	944,608,833
21	Total liabilities (Part X, line 26).............	629,650,351	748,899,949
22	Net assets or fund balances. Subtract line 21 from line 20.....	220,535,598	195,708,884

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 761,342,126 including grants of $ ) (Revenue $ 958,101,964 )
	TUFTS MEDICAL CENTER, INC. LOCATED IN BOSTON, MA OPERATES A 415 BED ACUTE-CARE GENERAL HOSPITAL ESTABLISHED TO PROVIDE HEALTHCARE SERVICES PRIMARILY IN THE GREATER BOSTON AREA, WHICH ALSO ATTRACTS PATIENTS FROM ELSEWHERE IN NEW ENGLAND AND BEYOND.NEW ENGLAND LONG-TERM CARE, INC. OPERATES AN 80 BED NURSING HOME SPECIALIZING IN THE CARE OF CHILDREN WHO ARE SEVERELY MENTALLY HANDICAPPED AND/OR MULTIPLY PHYSICALLY HANDICAPPED.NEW ENGLAND QUALITY CARE ALLIANCE, INC. OPERATES FOR THE PURPOSE OF SUPPORTING ACTIVITIES OF TUFTS MEDICAL CENTER PARENT, INC. AND ITS AFFILIATES. NEQCA INTEGRATES COMMUNITY AND ACADEMIC PHYSICIANS DEDICATED TO PROVIDING COMPREHENSIVE, INNOVATIVE, HIGH QUALITY AFFORDABLE HEALTH CARE THAT BRINGS VALUE TO THEIR PATIENTS AND THE COMMUNITY, AND EXPANDS THE TEACHING AND RESEARCH MISSION OF TUFTS MEDICAL CENTER, INC.TUFTS MEDICAL CENTER REAL ESTATE COMPANY, INC. PROVIDES RENTAL SERVICE PROGRAMS TO PROMOTE THE INTEREST OF TUFTS MEDICAL CENTER, INC. AND ITS AFFILIATED ORGANIZATIONS BY ACQUIRING, MAINTAINING, MANAGING, DEVELOPING, LEASING, AND DISPOSING OF REAL ESTATE PROPERTY. EFFECTIVE JANUARY 1, 2019, TUFTS MEDICAL CENTER REAL ESTATE COMPANY, INC. MERGED INTO TUFTS MEDICAL CENTER, INC.NEW ENGLAND QUALITY CARE ALLIANCE ACCOUNTABLE CARE, INC. IS A NONPROFIT ACCOUNTABLE CARE ORGANIZATION FORMED TO IMPROVE THE HEALTH OF PATIENTS, AND TO ENHANCE THE PATIENT'S EXPERIENCE OF CARE AND THE REDUCTION OF THE PER CAPITA COST OF CARE, THROUGH INTEGRATED CARE COORDINATION, SHARED SAVINGS, AND QUALITY INCENTIVES.TUFTS MEDICAL CENTER COMMUNITY CARE, INC. WORKS JOINTLY WITH TUFTS MEDICAL CENTER PARENT, INC. AND AFFILIATES TO DEVELOP, IMPLEMENT, AND OPERATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM AND TO PROVIDE COST-EFFECTIVE AND HIGH-QUALITY PATIENT CARE WITHIN SUCH SYSTEM.

4b	(Code: ) (Expenses $ 33,837,286 including grants of $ ) (Revenue $ 490,362 )
	TUFTS MEDICAL CENTER, INC. ADMINISTERS PROGRAMS FOR APPROXIMATELY 280 RESIDENTS, 73 INTERNS AND 104 FELLOWS IN 44 SPECIALTIES AND SUBSPECIALTIES WHO ROTATE TO APPROXIMATELY 54 HOSPITALS AND OTHER ORGANIZATIONS LOCATED PRIMARILY IN THE GREATER BOSTON AREA.

4c	(Code: ) (Expenses $ 7,635,660 including grants of $ ) (Revenue $ 411,856 )
	TUFTS MEDICAL CENTER, INC. ENGAGES IN RESEARCH ACTIVITIES FUNDED BY GRANTS AND CONTRACTS FOR U.S. GOVERNMENT AGENCIES AND OTHER PRIVATE SOURCES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses802,815,072

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,070,579	11,821,270	1,830,079

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	1,151,475
d	Related organizations		1d
e	Government grants (contributions)		1e	38,300,591

f	All other contributions, gifts, grants, and similar amounts not included above		1f	7,276,494

g	Noncash contributions included in lines 1a - 1f:$ 257,145
h Total. Add lines 1a-1f.......		46,728,560

		Business Code
2a	NET PATIENT SERV. REV.	900099	829,307,594	829,307,594
b	RESEARCH & MISC. REV.	900099	128,288,795	128,288,795
c	OVERHEAD RECOVERY	900099	917,431	917,431
d	RESIDENTS & INTERN REV	900099	490,362	490,362
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		959,004,182

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,381,489		-367,248	3,748,737
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			313,270			313,270
		(ii) Personal	(i) Real
6a	Gross rents		1,399,214
b	Less: rental expenses		440,848
c	Rental income or (loss)		958,366
d	Net rental income or (loss)......			958,366			958,366
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		4,731,178
b	Less: cost or other basis and sales expenses		0
c	Gain or (loss)		4,731,178
d	Net gain or (loss).....			4,731,178			4,731,178
8a	Gross income from fundraising events (not including $ 1,151,475of contributions reported on line 1c). See Part IV, line 18 ....
	a		122,625
b	Less: direct expenses ...b		411,796
c	Net income or (loss) from fundraising events..			-289,171			-289,171
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			1,014,827,874	959,004,182	-367,248	9,462,380

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to domestic individuals. See Part IV, line 22
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	8,510,577	1,217,000	6,875,457	418,120
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	373,024,141	318,223,254	53,882,641	918,246
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	8,954,071	6,656,136	2,297,935
9	Other employee benefits .......	47,834,208	36,656,238	10,817,151	360,819
10	Payroll taxes ...........	31,387,770	23,139,307	8,248,463
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	2,522,084	470,177	2,051,907
c	Accounting ...........	401,998		401,998
d	Lobbying ...........	494,241		494,241
e	Professional fundraising services. See Part IV, line 17	3,000			3,000
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	75,388,183	47,042,320	27,786,743	559,120
12	Advertising and promotion ....	3,274,877	2,376,590	898,287
13	Office expenses .......	8,180,838	5,214,692	2,922,009	44,137
14	Information technology ......	2,173,628	1,697,536	467,390	8,702
15	Royalties ..
16	Occupancy ...........	39,608,580	18,738,289	20,869,090	1,201
17	Travel ............	1,876,239	1,601,647	250,672	23,920
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	6,343	6,343
20	Interest ...........	18,355,619	18,355,619
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	23,738,381	14,055,922	9,679,496	2,963
23	Insurance ...	3,078,883	2,987,891	90,992
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	SUPPLIES	198,161,663	196,977,024	1,184,639
b	PHYSICIAN PRACTICE FEES	65,659,156	65,659,156
c	BAD DEBT	26,337,538	26,310,208	27,330
d	EQUIPMENT	13,272,692	5,897,409	7,374,780	503
e	All other expenses	27,332,660	9,532,314	17,749,301	51,045
25	Total functional expenses. Add lines 1 through 24e	979,577,370	802,815,072	174,370,522	2,391,776
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 ........			19,639,109	1	20,829,965
2	Savings and temporary cash investments .........			45,837,141	2	39,378,705
3	Pledges and grants receivable, net ......			10,092,816	3	10,425,570
4	Accounts receivable, net .............			111,881,421	4	100,534,958
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
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 ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			12,814,276	8	14,042,695
9	Prepaid expenses and deferred charges ......			5,772,798	9	6,719,474
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	568,678,668
b	Less: accumulated depreciation	10b	379,012,680	153,313,304	10c	189,665,988
11	Investments—publicly traded securities .			400,407,053	11	476,280,468
12	Investments—other securities. See Part IV, line 11 .....			4,400,000	12	6,758,000
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			159,871	14	118,908
15	Other assets. See Part IV, line 11 ...........			85,868,160	15	79,854,102
16	Total assets. Add lines 1 through 15 (must equal line 34)...			850,185,949	16	944,608,833

17	Accounts payable and accrued expenses .....	108,437,605	17	107,685,279
18	Grants payable ...		18
19	Deferred revenue .........	29,749,629	19	30,591,240
20	Tax-exempt bond liabilities .........	220,550,494	20	243,383,090
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
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..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..	35,552	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	270,877,071	25	367,240,340
26	Total liabilities. Add lines 17 through 25..	629,650,351	26	748,899,949

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	209,566,172	27	183,478,059
28	Temporarily restricted net assets ...........	4,837,450	28	5,636,146
29	Permanently restricted net assets	6,131,976	29	6,594,679
	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 ...........	220,535,598	33	195,708,884
34	Total liabilities and net assets/fund balances ........	850,185,949	34	944,608,833

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

Name	Address	EIN	Name control
NEW ENGLAND QUALITY CARE ALLIANCE INC	800 WASHINGTON STREET BOX 468 BOSTON, MA 021111533	04-3040427	NEWE
NEW ENGLAND LONG-TERM CARE INC	800 WASHINGTON STREET BOX 468 BOSTON, MA 021111533	04-2912578	NEWE
TUFTS MEDICAL CENTER REAL ESTATE COMPANY INC	800 WASHINGTON STREET BOX 468 BOSTON, MA 021111533	04-2772654	TUFT
TUFTS MEDICAL CENTER INC	800 WASHINGTON STREET BOX 468 BOSTON, MA 021111533	04-3400617	TUFT
TUFTS MEDICAL CENTER COMMUNITY CARE INC	800 WASHINGTON STREET BOX 468 BOSTON, MA 021111533	47-3046563	TUFT
NEQCA ACCOUNTABLE CARE INC	800 WASHINGTON STREET BOX 468 BOSTON, MA 021111533	80-0824142	NEQC