TY 2019 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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) MEHREEN BUTT...................................................................... DIRECTOR	3.00 ................. 3.00	X		0	0
(2) PATRICIA CAMPBELL...................................................................... DIRECTOR	3.00 ................. 3.00	X		0	0
(3) ANDREW FREED...................................................................... DIRECTOR	3.00 ................. 3.00	X		0	0
(4) TARA GIBSON...................................................................... DIRECTOR	3.00 ................. 3.00	X		0	0
(5) THOMAS GRAF...................................................................... DIRECTOR	3.00 ................. 3.00	X		0	0
(6) JOSEPH PENNACCHIO MD...................................................................... DIRECTOR	3.00 ................. 40.00	X		420,321	24,408
(7) SUSAN M SANDBERG...................................................................... PRESIDENT & CEO/DIRECTOR	3.00 ................. 40.00	X	X	708,368	29,475
(8) JOHN KEENAN...................................................................... FIRST VICE CHAIRMAN/DIRECTOR	3.00 ................. 3.00	X	X	0	0
(9) ROBERT L SWANSON JR...................................................................... ASSITANT CLERK/DIRECTOR	3.00 ................. 3.00	X	X	0	0
(10) PAUL BARDARO...................................................................... TREASURER/DIRECTOR	3.00 ................. 3.00	X	X	0	0
(11) K ERICK HENRIKSON MD...................................................................... CLERK/DIRECTOR	3.00 ................. 3.00	X	X	0	0
(12) JAMES HERRINGTON...................................................................... CHAIRMAN/DIRECTOR	3.00 ................. 3.00	X	X	0	0
(13) SUSAN GLASSER...................................................................... DIRECTOR	3.00 ................. 3.00	X		0	0
(14) MICHAEL P CONNELLY...................................................................... CFO/ASSISTANT TREASURER (UNTIL 10/2020)	3.00 ................. 40.00	X	X	476,528	9,585
(15) MICHAEL DANDORPH...................................................................... DIRECTOR	3.00 ................. 40.00	X		0	0
(16) GAIL INFURNA...................................................................... DIRECTOR	3.00 ................. 3.00	X		0	0
(17) PHILIP LEMBO...................................................................... DIRECTOR	3.00 ................. 3.00	X		0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) ALAN MACDONALD........................................................................ DIRECTOR	3.00 .......................3.00	X					0	0	0
(19) CHARLES R WHIPPLE ESQ........................................................................ ASSISTANT SECRETARY/GENERAL COUNSEL	3.00 .......................40.00		X				0	345,133	30,770
(20) LISA RUSSELL........................................................................ ASSISTANT CLERK	40.00 .......................3.00		X				67,298	0	10,846
(21) CARYL A BEISON........................................................................ PHYSICIAN DIRECTOR	3.00 .......................40.00			X			0	271,089	8,040
(22) NANCY BITTNER........................................................................ VP, EDUCATION	3.00 .......................40.00			X			0	192,896	20,270
(23) RYAN FULLER........................................................................ DIRECTOR OF PLANNING	3.00 .......................40.00			X			0	261,322	351
(24) STEVE SBARDELLA........................................................................ VP, MEDICAL AFFAIRS & CMO	3.00 .......................40.00			X			0	488,200	396
(25) CHERYL WARREN........................................................................ INTERGRATION ADMIN.	3.00 .......................40.00			X			0	239,053	33,378
(26) LAURALEE HOWLEY........................................................................ CHIEF MARKETING & COMMUNICATIONS	40.00 .......................0.00			X			207,542	0	33,088
(27) ANTHONY ALLEY........................................................................ ACNO, CLINICAL OPS	40.00 .......................0.00			X			220,934	0	18,489
(28) DAWN NEE........................................................................ EXECUTIVE DIRECTOR - LMMER	40.00 .......................0.00			X			228,307	0	35,509
(29) DEBORAH CRONIN-WAELDE........................................................................ SYSTEM V.P./CNO	3.00 .......................40.00			X			0	344,950	8,156
(30) JOHN G GIRAGOS MD........................................................................ PSYCH M.D.	40.00 .......................0.00				X		315,062	0	37,022
(31) TERRY SMITH........................................................................ PSYCH M.D.	40.00 .......................0.00				X		255,296	0	22,016
(32) DANIEL CARAT MD........................................................................ CHAIR, DEPT. OF PSYCHIATRY	40.00 .......................0.00				X		196,346	0	46,109
(33) ELISA SCHER........................................................................ EXECUTIVE DIRECTOR, CANCER SERVICES	40.00 .......................0.00				X		185,604	0	5,212
(34) WARREN TURRINO........................................................................ DIRECTOR, INFOSEC/SISO	40.00 .......................0.00				X		174,171	0	15,269
(35) LAURENCE CONWAY MD........................................................................ FORMER DIRECTOR	3.00 .......................40.00					X	0	192,442	1,925
(36) DAVID RYAN........................................................................ FMR. SYSTEM VP, HUMAN RESOURCES	0.00 .......................0.00					X	0	164,662	0
(37) MICHELLE CORRADO........................................................................ FMR. VP, CLINICAL ADMIN. (UNTIL 7/18)	3.00 .......................40.00					X	0	114,692	0

(A) Name and business address	(B) Description of services	(C) Compensation
HOSPITAL MEDICINE ASSOCIATES PO BOX 634850 CINCINATTI,OH45263	PHYSICIAN SERVICES	2,142,384
MEDICAL SOLUTIONS 1010 NORTH 102ND ST SUITE 300 OMAHA,NE68114	NURSING SERVICES	1,207,590
RESTORIX HEALTH INC 155 WHITE PLAINS RD SUITE 222 TARRYTOWN,NY10591	MANAGEMENT WOUND CARE	996,866
ARAMARK SERVICES INC PO BOX 978839 DALLAS,TX753978839	MANAGEMENT SERVICES	983,895
LOCUMTENENSCOM PO BOX 405547 ATLANTA,GA303845547	PHYSICIAN SERVICES	978,084
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 30

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

MELROSEWAKEFIELD HEALTHCARE INC

Employer identification number

04-2767880

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

Page 4

Part IV

Supporting Organizations

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

Section A. All Supporting Organizations

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

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) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, 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 2019. 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 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

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

2019

Name of the organization

MELROSEWAKEFIELD HEALTHCARE INC

Employer identification number

04-2767880

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization MELROSEWAKEFIELD HEALTHCARE INC

Part I Contributors	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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization MELROSEWAKEFIELD HEALTHCARE INC		Employer identification number 04-2767880

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization MELROSEWAKEFIELD HEALTHCARE INC			Employer identification number 04-2767880
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) (2019)

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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

MELROSEWAKEFIELD HEALTHCARE INC

Employer identification number

04-2767880

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 FASB 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 FASB 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 FASB 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) 2019

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 ....	22,792,261	21,899,362	20,872,047	17,977,835	17,182,983
b	Contributions ...	523,727	1,167,316	1,163,388	2,117,238	708,411
c	Net investment earnings, gains, and losses	1,557,759	499,237	1,139,921	1,625,664	1,170,049
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,125,217	773,654	1,275,994	848,690	1,083,608
f	Administrative expenses ....
g	End of year balance ......	23,748,530	22,792,261	21,899,362	20,872,047	17,977,835

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

68.020 %

Term endowment SchDMd Bullet

31.980 %

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 .....	3,871,119		3,871,119
b	Buildings ....	235,652,051	198,024,950	37,627,101
c	Leasehold improvements	10,206,678	9,913,526	293,152
d	Equipment ....	171,464,910	156,146,560	15,318,350
e	Other .....	21,467,484	5,142,912	16,324,572
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				73,434,294

Schedule D (Form 990) 2019

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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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				49,185,663
(2)OTHER ASSETS				10,716,067
(3)FEDERAL STUDENT LOANS				583,687
(4)RIGHT OF USE ASSETS				10,005,919
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				70,491,336

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
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	83,287,677
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) 2019

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 ENDOWMENT FUNDS ARE USED TO FURTHER THE EXEMPT PURPOSE OF THE ORGANIZATION IN PROVIDING HEALTHCARE TO THE SURROUNDING COMMUNITIES.

Schedule D (Form 990) 2019

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

2019

Open to Public Inspection

Name of the organization

MELROSEWAKEFIELD HEALTHCARE INC

Employer identification number

04-2767880

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 30100.0000000000 %

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) . . .			1,836,807	926,309	910,498	0.390 %
b	Medicaid (from Worksheet 3, column a) . . . . .			26,781,411	26,505,888	275,523	0.120 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			28,618,218	27,432,197	1,186,021	0.510 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	36	1,934,075	3,840,405	1,466,687	2,373,718	1.030 %
f	Health professions education (from Worksheet 5) . . .	16	7,961	13,736,912	8,942,657	4,794,255	2.070 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	2	5,442	169,791	0	169,791	0.070 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	6	1,859	72,027	1,000	71,027	0.030 %
j	Total. Other Benefits . .	60	1,949,337	17,819,135	10,410,344	7,408,791	3.200 %
k	Total. Add lines 7d and 7j .	60	1,949,337	46,437,353	37,842,541	8,594,812	3.710 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	2	320	1,359	0	1,359	0 %
4	Environmental improvements
5	Leadership development and training for community members	1	20	175	0	175	0 %
6	Coalition building	1	240	4,150	0	4,150	0 %
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	4	580	5,684		5,684	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

2,303,188

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).....

61,100,882

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

70,626,133

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

-9,525,251

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) 2019

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?10Name, 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)					Other (describe)	Facility reporting group
1	MELROSEWAKEFIELD HOSPITAL 585 LEBANON STREET MELROSE,MA02176	X	X	X		A
2	LAWRENCE MEMORIAL HOSPITAL 170 GOVERNORS AVENUE MEDFORD,MA02155	X	X			A
3	MELROSEWAKEFIELD BREAST HEALTH CENTER 41 MONTVALE AVENUE STONEHAM,MA02180				OUTPATIENT MEDICAL	A
4	CHEM CENTER RADIATION & MRI 48 MONTVALE AVENUE STONEHAM,MA02180				OUTPATIENT MEDICAL	A
5	HALLMARK HEALTH AT 101 MAIN 101 MAIN STREET MEDFORD,MA02155				OUTPATIENT MEDICAL	A
6	HALLMARK OUTPAT DIAGNOSTIC & REHAB 30 NEWCROSSING ROAD READING,MA01867				OUTPATIENT MEDICAL	A
7	HEALTH IMAGE WOMAN'S IMAGING CENTER 830 MAIN STREET MELROSE,MA02176				IMAGING CENTER	A
8	MELROSEWAKEFILED HOSPITAL REHAB SERVICES 22 COREY STREET MELROSE,MA02176				PT & REHAB SERVICE	A
9	LAWRENCE MEMORIAL HOSPITAL PROGRAM 200 GOVERNORS AVENUE MEDFORD,MA02155				PSYCHIATRIC SERVICE	A
10	COMMUNITY COUNSELING CENTER 178 SAVIN STREET MALDEN,MA02148				OUTPATIENT COUNSELING	A

Schedule H (Form 990) 2019

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)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

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

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): HTTP:/WWW.MELROSEWAKEFIELD.ORG

Other website (list url): WWW.MELROSEWAKEFIELD.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFITS/

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

Other (describe in Section C)

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

Yes

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

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

Yes

If "Yes" (list url): WWW.MELROSEWAKEFIELD.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFITS/

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - A
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 301.000000000000%

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.MELROSEWAKEFIELD.ORG

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

WWW.MELROSEWAKEFIELD.ORG

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

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) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORTING GROUP - A
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?..................................

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 (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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) 2019

Page 7

Part VFacility Information (continued)

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

	FACILITY REPORTING GROUP - A
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) 2019

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, 20a, 20b, 20c, 20d, 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
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: MELROSEWAKEFIELD HOSPITAL, - FACILITY 2: LAWRENCE MEMORIAL HOSPITAL, - FACILITY 3: MELROSEWAKEFIELD BREAST HEALTH CENTER, - FACILITY 4: CHEM CENTER RADIATION & MRI, - FACILITY 5: HALLMARK HEALTH AT 101 MAIN, - FACILITY 6: HALLMARK OUTPAT DIAGNOSTIC & REHAB, - FACILITY 7: HEALTH IMAGE WOMAN'S IMAGING CENTER, - FACILITY 8: MELROSEWAKEFILED HOSPITAL REHAB SERVICES, - FACILITY 9: LAWRENCE MEMORIAL HOSPITAL PROGRAM, - FACILITY 10: COMMUNITY COUNSELING CENTER
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5:	MWHC SOUGHT COMMUNITY INPUT THROUGH KEY STAKEHOLDER INTERVIEWS, STAKEHOLDER SURVEYS, CONVENING A BREAKFAST MEETING WITH LOCAL BOARD OF HEALTH DIRECTORS AND LEADERS, AND THROUGH ON-LINE AND PAPER SURVEYS TRANSLATED INTO THE MOST COMMON LANGUAGES SPOKEN IN THE SERVICE AREA. IN ADDITION, LOCAL COMMUNITY COALITIONS, THE MWHC PATIENT FAMILY ADVISORY COUNCIL, AND COMMUNITY TEAMS WERE ALSO INVITED TO PARTICIPATE. OTHER LOCAL HEALTH SYSTEMS AND COLLABORATING AGENCIES PROVIDED INPUT INCLUDING BETH ISRAEL/LAHEY HEALTH, CAMBRIDGE HEALTH ALLIANCE, AND MASSACHUSETTS GENERAL HOSPITAL. A FULL LIST OF PARTNERS IS INCLUDED IN APPENDIX A ON PAGE 44 OF THE 2019 MWHC COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE SECONDARY CHNA WORK INCLUDED COMMUNITY FOCUS GROUPS AND LISTENING SESSIONS.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A:	MELROSEWAKEFIELD HEALTHCARE ALSO CONDUCTED A SECONDARY CHNA FOR EVERETT AND MALDEN (THE TWO LARGEST AND MOST DIVERSE CITIES IN OUR OVERLAPPING SERVICE AREA) IN CONJUNCTION WITH CAMBRIDGE HEALTH ALLIANCE AND MASSACHUSETTS GENERAL HOSPITAL. A SEPARATE REPORT WAS COMPLETED FOR THIS DEEPER REVIEW OF SOCIAL DETERMINANTS' IMPACT ON HEALTH. THIS REPORT IS ALSO POSTED/REFERENCED ON THE HEALTH SYSTEM'S WEBSITE AND THE WEBSITES FOR THE OTHER SYSTEMS: HTTPS://WWW.MASSGENERAL.ORG/COMMUNITY-HEALTH/CCHI/ASSESSMENTS/ AND HTTPS://WWW.CHALLIANCE.ORG/UPLOADS/PUBLIC/DOCUMENTS/COMMUNITY/EVERETT-MALDEN-CHNA-REPORT-FINAL.PDF.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B:	MELROSEWAKEFIELD HEALTHCARE HIRED THE INSTITUTE FOR COMMUNITY HEALTH TO ASSIST US IN DEVELOPING BOTH CHNA REPORTS.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11:	THE RESOURCES AVAILABLE FOR COMMUNITY PROGRAMMING ARE LIMITED; HOWEVER, MWHC MAKES EVERY EFFORT TO USE THE FUNDS AVAILABLE TO CONTINUE TO SUPPORT UPSTREAM HEALTH IMPACTS AND PROGRAMS WITH DEMONSTRATED SUCCESS SUCH AS THOSE FUNDED BY STATE GRANTS AND SERVING VULNERABLE POPULATIONS. OTHER PROGRAMMING WILL BE IMPLEMENTED THROUGH PARTNERSHIPS WITH OTHER LIKE-MINDED ORGANIZATIONS, AND AS DONATIONS, GRANTS, AND OTHER FUNDS ARE SECURED TO ENSURE THEIR SUSTAINABILITY. WHILE THE SYSTEM WILL TOUCH ON MOST OF THE HEALTH AND SOCIAL PRIORITIES IDENTIFIED IN THE 2019 CHNA, THE CHIP IS LIMITED IN BREADTH OF PROGRAMMING AND WILL NOT BE FULLY FUNDED TO ADDRESS ALL ASPECTS OF THE IDENTIFIED NEEDS. IN EACH YEAR OF THE THREE YEAR CHIP, THE RESOURCES AVAILABLE WILL BE REEVALUATED AND ALLOCATED AS NEEDED. SOME EXAMPLES ARE HOUSING AND HOMELESSNESS; WHILE MWHC DOES NOT OFFER HOUSING SERVICES, IT IS AN ACTIVE MEMBER OF THE LOCAL HUNGER, HOMELESSNESS, AND HOUSING TASK FORCE, SCREENS FOR HOUSING INSECURITY IN PRIMARY CARE, PROVIDES HOUSING RESOURCES THROUGH COMMUNITY HEALTH WORKERS, AND INCLUDES AGENCIES SUCH AS HOUSING FAMILIES AND THE LOCAL CAP AGENCY ON OUR COMMUNITY BENEFITS ADVISORY COUNCIL. ANOTHER EXAMPLE IS FOR IDENTIFYING AND TREATING TUBERCULOSIS: IN PAST YEARS MWHC OFFERED A COLLABORATIVE CLINIC WITH OUR THREE LARGEST CITIES EVERETT, MALDEN, AND MEDFORD. TODAY WE REFER PATIENTS TO THE HIGHER ACUITY CLINIC AT CAMBRIDGE HEALTH ALLIANCE, WHICH IS ABLE TO PROVIDE MORE COMPREHENSIVE SERVICES TO PATIENTS IN OUR AREA. THROUGH OUR COMMUNITY PARTNERSHIPS WE ARE SERVING THE IDENTIFIED NEEDS AS A TEAM.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 20A:	MWHC DOES NOT PERFORM ECA EXTRAORDINARY COLLECTION ACTIONS. AND WE DO NOT REPORT TO THE CREDIT AGENCIES OR BUREAUS.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 20D:	PRESUMPTIVE ELIGIBILITY DETERMINATIONS WERE DEEMED IMPRACTICAL FOR OUR PURPOSES BECAUSE THEY: DO NOT PROVIDE 10 DAY RETROACTIVE COVERAGE AVAILABLE THROUGH TRADITIONAL MH APPLICATIONS; END ON THE LAST DAY OF THE MONTH FOLLOWING APPLICATION; REQUIRE THAT THE PATIENT COMPLETE THE TRADITIONAL APPLICATION WITHIN 30 DAYS; FAXING AFTER WORKING HOURS/WEEKENDS CHANGE EFFECTIVE DATE TO THE FOLLOWING BUSINESS DAY THUS NULLIFYING OUR EFFORTS TO COVER A SPECIFIC DATE.

Schedule H (Form 990) 2019

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

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 3C:	IN ADDITION TO THE FEDERAL POVERTY GUIDELINE, MELROSEWAKEFIELD HEALTHCARE REVIEWS, AMONG OTHER ITEMS, AN INDIVIDUAL'S HOUSEHOLD INCOME, ASSETS, FAMILY SIZE, EXPENSES, MEDICAL NEEDS, CURRENT INSURANCE COVERAGE, CITIZENSHIP AND RESIDENCY WHEN EVALUATING A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE AS PART OF ITS FINANCIAL ASSISTANCE POLICY. FOR MASSACHUSETTS RESIDENTS, THE APPLICABLE INFORMATION IS SUBMITTED TO THE STATE AS PART OF THE APPLICATION PROCESS FOR PUBLIC PROGRAM ASSISTANCE TO DETERMINE COVERAGE FOR SERVICES PROVIDED TO THE INDIVIDUAL.MASSACHUSETTS RESIDENTS ARE INFORMED, ENCOURAGED AND ASSISTED IN APPLYING FOR STATE SPONSORED HEALTH INSURANCE PLANS THAT MAY RESULT IN FULL COVERAGE PROSPECTIVELY AND IN THE CASE OF MASSHEALTH, RETROACTIVELY. ONCE THE PATIENT HAS BEEN INSURED, FINANCIAL COUNSELORS EVALUATE INDIVIDUAL SITUATIONS FOR POSSIBLE APPLICATION FOR HARDSHIP THROUGH THE HEALTH SAFETY NET. IF APPROVED, HARDSHIP APPLICATIONS MAY COVER SERVICES THAT DATE BACK ONE YEAR FROM THE DATE OF APPLICATION.IF OR WHEN ANY OF THE AFOREMENTIONED MECHANISMS FAIL OR DO NOT OFFER ADEQUATE RELIEF TO THE PATIENT GIVEN HIS/HER INDIVIDUAL NEEDS, THE FINANCIAL ASSISTANCE APPLICATION (FAP) APPLICATION MAY BE COMPLETED; AND IF APPROVED, MAY ALSO OFFER FREE OR DISCOUNTED CARE BASED ON THE INDIVIDUAL'S HOUSEHOLD INCOME, AS DETERMINED BY FEDERAL POVERTY GUIDELINES (FPL); ASSETS, FAMILY SIZE, EXPENSES, MEDICAL NEEDS, AMOUNT OF MEDICAL DEBT, CURRENT INSURANCE COVERAGE, CITIZENSHIP AND MA RESIDENCY. WHEN A FAP DETERMINATION DOES NOT COVER THE FULL AMOUNT OF THE OUTSTANDING BILLS, THE PATIENT WILL BE CONTACTED TO MAKE SUITABLE PAYMENT ARRANGEMENTS. FOR CLARIFICATION PURPOSES, IT MUST BE NOTED THAT THE FAP APPLICATION IS NOT INTENDED FOR, NOR DOES IT COVER BALANCES AFTER INSURANCE PAYMENTS SUCH AS COPAYS, COINSURANCES AND/OR DEDUCTIBLES; THESE REMAIN THE PATIENT'S RESPONSIBILITY UNLESS THE COINSURANCE AND/OR DEDUCTIBLE IS GREATER THAN 20% OF THE PATIENTS HOUSEHOLD INCOME AND THEREFORE CONSTITUTES A HARDSHIP ELIGIBLE FOR A FAP APPLICATION.
PART I, LINE 7:	CHARITY CARE COSTS FROM WORKSHEETS 1 & 2 AND UNREIMBURSED MEDICAID FROM WORKSHEET 3 AND HEALTH PROFESSIONS EDUCATION FROM WORKSHEET 5 WERE APPLIED TO ALL PATIENT SEGMENTS. (COST TO CHARGE RATIO).
PART I, QUESTION 6A:	IN ADDITION TO THE FORM 990 SCHEDULE H, MELROSEWAKEFIELD HEALTHCARE IS PREPARING A FY 2020 COMMUNITY BENEFITS REPORT TO THE COMMONWEALTH OF MASSACHUSETTS, IN COMPLIANCE WITH THE REQUIREMENTS OF THE MA ATTORNEY GENERAL (THE "MA AGO") FOR REPORTING COMMUNITY BENEFITS. THIS YEAR THE FILING HAS BEEN DELAYED UNTIL JULY 1, 2021 DUE TO THE COVID- 19 PANDEMIC. THE COMMUNITY BENEFITS PROCESS AND ACTIVITIES, IS ALSO AVAILABLE ONLINE, WITH THE CHNA AND THE 2017-2019 AND 2020-2022 COMMUNITY BENEFITS IMPLEMENTATION PLANS (CHIP) WHICH ARE ALSO AVAILABLE IN PRINT VERSIONS AT EACH HOSPITAL CAMPUS AND AT OTHER COMMUNITY SITES IN THE SERVICE AREA.MWHC PROMOTES COMMUNITY BENEFITS PROGRAMS THROUGH NEWS RELEASES, CALENDAR POSTINGS, FACEBOOK, TWITTER, EMAIL MESSAGING, CONSTANT CONTACT, AND BULLETINS FOR LOCAL HOUSE OF WORSHIP AND SERVICE ORGANIZATIONS, AND LOCAL CABLE ACCESS TELEVISION STATIONS. FLYERS AND POSTCARDS ARE ALSO DISSEMINATED WIDELY IN THE COMMUNITY TO NOTIFY RESIDENTS OF UPCOMING COMMUNITY BENEFITS PROGRAMS AND SERVICES. THE ANNUAL COMMUNITY BENEFITS REPORT IS DISTRIBUTED TO THE MWHC BOARD OF TRUSTEES, LEADERS, LOCAL LEGISLATORS AND COMMUNITY PARTNERS. THE REPORT IS ALSO POSTED ON THE MELROSEWAKEFIELD HEALTHCARE WEBSITE FOR THE GENERAL PUBLIC TO VIEW AND COMMENT. THIS YEAR, ONE OF THE COMMUNITY BENEFITS PROGRAMS IS FEATURED IN THE HEALTH SYSTEMS' ANNUAL REPORT.
PART II, COMMUNITY BUILDING ACTIVITIES:	AS PART OF ITS EFFORTS TO IMPROVE THE HEALTH STATUS OF ITS CORE COMMUNITIES, MELROSEWAKEFIELD HEALTHCARE (MWHC) PARTICIPATES IN A VARIETY OF BROAD-BASED COMMUNITY COALITIONS AND INITIATIVES THAT WORK TOWARDS ADDRESSING THE SPECIFIC AND GENERAL HEALTH NEEDS IN THESE CITIES AND TOWNS. A SAMPLE OF CURRENT ACTIVITIES INCLUDE: THE JOINT COMMITTEE FOR CHILDREN'S HEALTHCARE IN EVERETT; THE MALDEN'S PROMISE COALITION; MEDFORD HEALTH MATTERS; LOCAL COUNCILS ON AGING; THE MELROSE COMMUNITY COALITION; LOCAL SUBSTANCE ABUSE PREVENTION COALITIONS IN MALDEN, MELROSE, MEDFORD, READING, STONEHAM, AND WAKEFIELD; AS WELL AS THE REGIONAL MASSACHUSETTS OPIOID ABUSE PREVENTION COLLABORATE (MOAPC) AND SUBSTANCE ABUSE PREVENTION COLLABORATIVE (SAPC), BOTH PROGRAMS OF THE MYSTIC VALLEY PUBLIC HEALTH COALITION. MWHC ALSO FORMALLY PARTNERS WITH THE NORTH SUBURBAN CHILD AND FAMILY RESOURCE NETWORK, SERVING LYNNFIELD, MALDEN, MELROSE, NORTH READING, READING, STONEHAM, WAKEFIELD, AND WINCHESTER; AND THE EVERETT, AND MEDFORD COORDINATED FAMILY AND COMMUNITY ENGAGEMENT (CFCE) GRANT PROGRAMS FUNDED BY THE MA DEPARTMENT OF EARLY EDUCATION AND CARE; THE TRI-CITY HUNGER NETWORK AND A HOST OF OTHER COMMUNITY-BASED AND GUIDED COALITIONS AND INITIATIVES. A SPECIFIC EXAMPLE OF THIS COMMUNITY BUILDING INCLUDES MWHC'S REPRESENTATION ON THE MELROSE ALLIANCE AGAINST VIOLENCE (MAAV). MAAV IS A NON-PROFIT, COMMUNITY-BASED ORGANIZATION THAT FOCUSES ON OUTREACH, EDUCATION AND COMMUNITY COLLABORATION IN ORDER TO RAISE AWARENESS OF THE PROBLEMS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT IN MELROSE. WORKING CLOSELY WITH THE MELROSE POLICE DEPARTMENT, THE BOARD OF DIRECTORS OF MAAV INCLUDES A REPRESENTATIVE FROM MWHC, AS WELL AS MEMBERS FROM THE MELROSE SCHOOLS, CLERGY, HEALTH DEPARTMENT, STUDENTS, AND COMMUNITY MEMBERS AT LARGE. MELROSE-WAKEFIELD HOSPITAL IS A FOUNDING MEMBER OF THIS IMPORTANT COMMUNITY-BASED AGENCY.IN ADDITION, MWHC HAS CONTINUED TO CONVENE A NUMBER OF COMMUNITY OUTREACH TEAMS TO ASSIST WITH THE COLLECTION OF COMMUNITY HEALTH NEEDS INFORMATION TO OPTIMIZE THE BENEFITS OF COMMUNITY HEALTH EDUCATION AND SCREENINGS. THE TEAMS HAVE SPONSORED AND PARTICIPATED IN EVENTS RANGING FROM INFORMAL (PLANNING HEALTH EVENTS AND SCREENINGS) TO MORE FORMAL (PARTICIPATION ON HEALTHY MELROSE, STONEHAM SUMMER SAFETY DAY, AND THE MOBILE FOOD MARKET IN MALDEN), OFFERING MULTIPLE OPPORTUNITIES TO INTERACT WITH A WIDE RANGE OF COMMUNITY MEMBERS TO FORM TRUSTING RELATIONSHIPS, LISTEN TO THE VOICES OF INDIVIDUAL COMMUNITY MEMBERS, AND FOSTER THE DEVELOPMENT OF RESILIENCE WITHIN EACH COMMUNITY. AS MWHC BEGINS THE FIRST YEAR OF ITS COMMUNITY HEALTH IMPROVEMENT PLAN FOR 2020-2022, IT CONTINUES TO UTILIZE THE COLLECTIVE KNOWLEDGE OF THE TEAM CAPTAINS. THE TEAM'S ORGANIZING CHARTER GUIDES THE MEMBERSHIP TOWARD SALIENT ACTIVITIES. RELEVANT HEALTH DATA AND THE IDENTIFIED TARGET POPULATION LISTS ARE PROVIDED TO EACH TEAM CAPTAIN TO ASSIST THEM IN PLANNING PROGRAMS IN THEIR COMMUNITIES. CURRENTLY, THERE ARE SIX (6) COMMUNITY OUTREACH TEAMS NAMED FOR MALDEN/EVERETT, MEDFORD, MELROSE, WAKEFIELD, READING/NORTH READING AND STONEHAM. SAUGUS DID NOT HAVE A TEAM IN 2018, BUT WAS SERVED BY THE MWHC COMMUNITY SERVICES DEPARTMENT. THE TEAMS CONTINUOUSLY SOLICIT INPUT FROM COMMUNITY LEADERS INCLUDING SUPERINTENDENTS OF SCHOOLS, STATE REPRESENTATIVES, BUSINESS LEADERS, FIRE AND POLICE OFFICIALS AND LOCAL HEALTH DEPARTMENTS. MANY EMPLOYEES SERVING ON TEAMS ALSO PARTICIPATE IN OTHER COMMUNITY GROUPS AND CIVIC ORGANIZATIONS. MORE THAN 40 EMPLOYEES, VOLUNTEERS, AND PHYSICIANS WERE INVOLVED IN TEAM-SPONSORED EVENTS IN FISCAL YEAR 2020/TAX YEAR 2019 (FY 2020/TY 2019).THE COMMUNITY TEAM EFFORTS HAVE BEEN ACKNOWLEDGED BY FOUR AREA CHAMBERS OF COMMERCE, OTHER CIVIC ORGANIZATIONS, THE AMERICAN HOSPITAL ASSOCIATION, AND THE MASSACHUSETTS HOSPITAL ASSOCIATION. UNFORTUNATELY, DUE TO THE WORLDWIDE COVID 19 PANDEMIC, MOST COMMUNITY-BASED ACTIVITIES WERE EITHER SUSPENDED OR MOVED TO A REMOTE FORMAT.
PART III, LINE 2:	MELROSEWAKEFIELD HEALTHCARE, INC. DEVELOPED A COST TO CHARGE RATIO AND APPLIED IT TO THE BAD DEBT ACCOUNT CHARGES THAT WERE ACTUALLY WRITTEN OFF.
PART III, LINE 4:	THE FOLLOWING IS FROM THE WELLFORCE, INC. AND CONSOLIDATED AFFILIATES (THE SYSTEM) AUDITED FINANCIAL STATEMENTS, OF WHICH MELROSEWAKEFIELD HEALTHCARE, INC. IS INCLUDED, RELATING TO CHARITY CARE AND BAD DEBT EXPENSE:2020 CHARITY CARE AND COMMUNITY BENEFIT FOOTNOTECHARITY CARE - THE SYSTEM'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE PATIENTS THAT IT SERVES. THE SYSTEM PROVIDES HEALTH CARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. THESE PATIENTS MAY RECEIVE FULL ASSISTANCE OR MAY BE SUBJECT TO PARTIAL LIABILITY BASED ON INCOME AND FAMILY SIZE. BECAUSE THE SYSTEM DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE.THE SYSTEM PROVIDED CHARITY CARE, BASED ON CHARGES FORGONE AND THE ESTIMATED COST OF THE CHARITY CARE PROVIDED AMOUNTED TO $36,402K AND $16,237K, FOR THE YEAR ENDED SEPTEMBER 30, 2020 AND $42,553K AND $16,904K FOR THE YEAR ENDED SEPTEMBER 30, 2019, RESPECTIVELY. THE ESTIMATED COST OF CHARITY CARE IS BASED ON THE RELATIONSHIP OF PATIENT CARE SERVICE CHARGES TO THE RELATED COSTS APPLIED TO CHARITY CARE CHARGES RECOGNIZED DURING THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019.ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER 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 THEIR 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.MWHC'S ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR ALL PATIENTS WAS 31% OF ACCOUNTS RECEIVABLE AS OF SEPTEMBER 30, 2020 AND 25% OF ACCOUNTS RECEIVABLE AS OF SEPTEMBER 30, 2019. IN ADDITION, THE SYSTEM'S WRITE-OFFS, NET OF RECOVERIES, WERE $7,635K AND $8,904K, RESPECTIVELY, FOR THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019. THE CHANGES WERE A RESULT OF MANAGEMENT'S REVIEW OF HISTORICAL TRENDS IN UNCOLLECTIBLE ACCOUNTS AND DETERMINATION OF RESERVES, INCLUDING THE IMPACT OF THE PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT.THE SYSTEM HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2020. THE SYSTEM DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FROM THIRD-PARTY PAYERS, NOR DID IT HAVE SIGNIFICANT BAD DEBT WRITE-OFFS FROM THIRD-PARTY PAYERS.HEALTH SAFETY NET FUND (HSN) - THE COMMONWEALTH OF MASSACHUSETTS (THE "COMMONWEALTH") OPERATES THE HSN, WHICH WAS CREATED BY THE COMMONWEALTH'S HEALTH CARE REFORM ACT TO REPLACE THE STATE'S UNCOMPENSATED CARE POOL. THE HSN ALLOCATES THE COST OF UNCOMPENSATED CARE AMONG THE HOSPITALS IN THE COMMONWEALTH. HOSPITALS HAVE BEEN ASSESSED A UNIFORM ALLOWANCE BASED ON ESTIMATES OF THE STATEWIDE COST OF UNCOMPENSATED CARE AND REIMBURSED FOR A PORTION OF THE COST OF UNCOMPENSATED CARE, SUBJECT TO CERTAIN LIMITATIONS. REIMBURSABLE UNCOMPENSATED CARE INCLUDES NET CHARITY CARE AND CERTAIN UNCOLLECTIBLE ACCOUNTS RELATED TO EMERGENCY SERVICES. HOSPITALS' RECOVERIES FROM THE HSN ARE BASED ON A CLAIMS-BASED PAYMENT METHOD THAT USES MEDICARE PRINCIPLES. REIMBURSEMENT FROM THE HSN FOR UNCOMPENSATED CARE IS RECORDED IN NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENT OF OPERATIONS. THE COMMONWEALTH HAS DETERMINED FINAL SETTLEMENTS WITH RESPECT TO THE HSN FOR ALL YEARS PRIOR TO 2014.COMMUNITY BENEFIT - IN FURTHERING ITS CHARITABLE PURPOSE, THE SYSTEM PROVIDES A WIDE VARIETY OF HEALTH CARE SERVICES TO THE COMMUNITY IN ORDER TO PROVIDE ACCESS TO APPROPRIATE CARE FOR POPULATIONS IN NEED. THE SYSTEM HAS DEVELOPED A FORMAL COMMUNITY BENEFIT IMPLEMENTATION PLAN THAT RESPONDS TO THE COMPREHENSIVE ASSESSMENT OF HEALTH CARE NEEDS IN THE COMMUNITY. THE COMMUNITY BENEFIT PLAN SUPPORTS SERVICES THAT TARGET NOT ONLY THE GENERAL POPULATION IN THE SYSTEM'S SERVICE AREA, BUT ALSO PARTICULAR POPULATIONS WITH SPECIAL HEALTH CARE NEEDS, INCLUDING THE POOR, ELDERLY, CHILDREN, AND MINORITY POPULATIONS. SUPPORTED SERVICES INCLUDE VARIOUS DIRECT CARE PROGRAMS, HEALTH SCREENING, HEALTH EDUCATION AND SUPPORT GROUPS OPERATED IN THE SYSTEM'S SERVICE AREA. THE SYSTEM WORKS ACTIVELY WITH OTHER AREA SERVICE PROVIDERS TO FACILITATE THE DEVELOPMENT OF AN EFFECTIVE COMMUNITY HEALTH NETWORK. THE SYSTEM ALSO PARTICIPATES IN ACTIVITIES DESIGNED TO FOSTER AND ENHANCE THE ECONOMIC AND CIVIC ENVIRONMENT AND TO IMPROVE THE HEALTH EQUITY OF ITS SERVICE AREA.TOTAL MELROSEWAKEFIELD HEALTHCARE, INC. UNCOMPENSATED CARE FOR THE YEARS ENDED SEPTEMBER 30, 2020 AND 2019, WAS AS FOLLOWS: PROVISION FOR CHARITY CARE (AT COST)$579,000 (2020) ; $536,000 (2019)PROVISIONS FOR BAD DEBTS (AT COST)$4,314,000 (2020) ; $4,238,000 (2019)HSN (ASSESSMENTS NET OF REIMBURSEMENT)$25,000 (2020) ; $546,000 (2019)TOTAL UNCOMPENSATED CARE$4,918,000 (2020) ; $5,320,000 (2019)
PART III, LINE 8:	THE MEDICARE ALLOWABLE COSTS ON LINE 6 WAS DETERMINED BY USING INFORMATION FROM THE MEDICARE COST REPORT. IT IS MELROSEWAKEFIELD HEALTHCARE, INC.'S POLICY TO EXCLUDE ANY MEDICARE SHORTFALL FROM THE COMMUNITY BENEFIT INFORMATION.
PART III, LINE 9B:	POLICY - IT IS MELROSEWAKEFIELD HEALTHCARE, INC.'S POLICY TO EXEMPT CERTAIN INDIVIDUALS AND PATIENT POPULATIONS WHO ARE ENROLLED IN MASSHEALTH, CERTAIN OTHER GOVERNMENT BENEFIT PROGRAMS AND FINANCIAL ASSISTANCE PROGRAMS FROM ANY COLLECTION OR BILLING PROCEDURES, SUBJECT TO ALLOWABLE EXCEPTIONS, PURSUANT TO MASSACHUSETTS STATE REGULATIONS AND POLICIES.
PART VI, LINE 2:	MELROSEWAKEFIELD HEALTHCARE IS A NOT-FOR-PROFIT HOSPITAL THAT OPERATES TO FURTHER THE IMPROVEMENT OF THE HEALTH STATUS OF THE COMMUNITIES THAT WE SERVE THROUGH THE DELIVERY OF HEALTHCARE SERVICES AND EDUCATION. THIS EFFORT IS ACHIEVED BY:-INVESTING FUNDS INTO COMMUNITIES THROUGH EVIDENCE-BASED AND EVIDENCE-INFORMED PROGRAMS AND SERVICES, INCLUDING THOSE BASED ON THE SOCIAL DETERMINANTS OF HEALTH.-MAKING SURE THAT CARE IS AVAILABLE TO EVERYONE - REGARDLESS OF THE ABILITY TO PAY.-USING COMPASSION AS A CORNERSTONE IN IMPROVING THE HEALTH OF OUR COMMUNITIES.-ATTENDING TO THE NEEDS OF PATIENTS AND THEIR FAMILY MEMBERS BY ADDRESSING THE NEEDS OF THE WHOLE PERSON NOT JUST AS A FACTOR OF THEIR DISEASE OR A DIAGNOSIS.-PROVIDING A RANGE OF SPECIAL BENEFITS TO THE COMMUNITY, SUCH AS PROGRAMS TO MANAGE CARE FOR PERSONS WITH CHRONIC DISEASES, HEALTH EDUCATION AND DISEASE PREVENTION INITIATIVES, PROGRAMS FOR FAMILIES WITH CHILDREN, OUTREACH FOR THE ELDERLY, AND CARE FOR PERSONS OF COLOR, IMMIGRANTS, OR THOSE WHO ARE POOR OR UNINSURED.- ACTING AS A CATALYST, PARTICIPANT, AND LEADER IN IMPROVING THE HEALTH OF THE COMMUNITY THROUGH LOCAL PARTNERSHIPS SUCH AS WITH MALDEN OVERCOMING ADDICTION, MEDFORD HEALTH MATTERS, AND FOOD SECURITY TASKS FORCES BOTH REGIONALLY AND LOCALLY.-OFFERING SPACE AND OTHER IN-KIND SERVICES TO AGENCIES SUCH AS ALCOHOLICS ANONYMOUS, PORTAL TO HOPE, AND MANY OTHERS WHOSE PROGRAMS ALIGN WITH THE HEALTH SYSTEM'S HEALTH PRIORITIES.IN COMPLIANCE WITH IRS GUIDELINES, A YEAR-LONG PROCESS TO DEVELOP A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS COMPLETED BY MELROSEWAKEFIELD HEALTHCARE (FORMERLY HALLMARK HEALTH SYSTEM, INC.) IN AUGUST 2019, IN COLLABORATION WITH THE INSTITUTE FOR COMMUNITY HEALTH (ICH), A NON-PROFIT ORGANIZATION RECOGNIZED FOR COMMUNITY-BASED PARTICIPATORY RESEARCH, ASSESSMENT, AND DISSEMINATION. THIS PROCESS INCLUDED A REVIEW OF REPUTABLE PUBLIC HEALTH, SOCIO-ECONOMIC, AND FOUNDATION DATA; INPUT FROM THE MELROSEWAKEFIELD HEALTHCARE COMMUNITY BENEFITS ADVISORY COUNCIL, COMMUNITY OUTREACH TEAMS, PATIENT/FAMILY ADVISORY COUNCIL, LOCAL COMMUNITY COALITIONS, AND COMMUNITY RESIDENTS. STAKEHOLDER INTERVIEWS AND SURVEYS, COMMUNITY SURVEYS AND COMMUNITY FORUMS WERE ALSO COMPLETED. SOME OF THE COMMUNITY FORUMS WERE HELD IN COLLABORATION WITH OTHER HEALTH SYSTEMS SERVING THE AREA SUCH AS BETH ISRAEL/LAHEY HEALTH, CAMBRIDGE HEALTH ALLIANCE, THE LOCAL SAFETY NET HEALTH SYSTEM, AND MASSACHUSETTS GENERAL HOSPITAL. IN ADDITION, CAMBRIDGE HEALTH ALLIANCE, MASSACHUSETTS GENERAL HOSPITAL, AND MELROSEWAKEFIELD HEALTHCARE COMPLETED AN ADDITIONAL CHNA FOCUSED ON DETERMINING THE SOCIAL DETERMINANT NEEDS IN EVERETT AND MALDEN. ALL SYSTEMS SERVE THESE CITIES WHICH HAS SOME OF THE LARGEST AND MOST DIVERSE COMMUNITIES IN OUR SERVICE AREA.REFLECTING IRS REQUIREMENTS, AND TO FOSTER TRANSPARENCY, THE ENTIRE CHNA AND PRIOR CHNA AS WELL AS THE EVERETT/MALDEN REPORT ARE POSTED ON THE MWHC WEBSITE AND IN PRINTED VERSIONS AT EACH HOSPITAL CAMPUS AND OTHER KEY EASILY ACCESSIBLE LOCATIONS IN EACH COMMUNITY IN THE CATCHMENT AREA. THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) FOR 2020-2022 IS ALSO POSTED ON MWHC'S WEBSITE. THIS CHIP WAS BOARD APPROVED IN FEBRUARY 2020. THE BOARD APPROVED CHIPS AND CHNA'S ARE PLACED ON THE SYSTEM'S WEBSITE AT HTTPS://WWW.MELROSEWAKEFIELD.ORG/IN-THE-COMMUNITY/COMMUNITY-BENEFITS/COMMUNITY-BENEFITS-PROGRAMS/. PAPER COPIES OF THE REPORTS ARE LOCATED CENTRALLY IN EACH COMMUNITY SERVED AS WELL.DUE TO THE COVID-19 GLOBAL PANDEMIC, MANY OF THE COMMUNITY BENEFITS PROGRAMMING WERE PAUSED OR WERE RUNNING IN A DIFFERENT CAPACITY, SUCH AS REMOTE, AS OF THE END OF MARCH 2020. THESE PROGRAMS WILL BEGIN AGAIN ONCE THE PANDEMIC HAS ENDED AND IT IS SAFE TO RESUME IN-PERSON ACTIVITIES. MWHC IS CURRENTLY RUNNING THE PROGRAMS LISTED ON OUR WEBSITE. DESPITE THE CHANGES IN SERVICES, THE SYSTEM WILL TOUCH ON THE MAJORITY OF THE HEALTH AND SOCIAL PRIORITIES IDENTIFIED IN THE 2020-2022 CHNA. THE COMMUNITY BENEFITS ADVISORY COUNCIL (CBAC) UNDERSTANDS AND APPROVES THE CHANGES TO THE CHIP. THE CBAC VOTED TO AMEND THE CHIP ON AUGUST 20, 2020. IN FISCAL YEAR 2020, THE CHIP WAS AMENDED TO REFLECT THESE CHANGES. THE CHANGES ARE POSTED ON THE HEALTH SYSTEMS' WEBSITE.ONGOING MONITORING OF THE CHNA AND ITS IDENTIFIED HEALTH PRIORITIES IS THE RESPONSIBILITY OF THE COMMUNITY BENEFITS ADVISORY COUNCIL (CBAC). AS OF THE END OF FY 2020/TY 2019, THE MWHC COUNCIL INCLUDED: A TRUSTEE OF MELROSEWAKEFIELD HEALTHCARE; CHIEF MARKETING OFFICER; A MWHC EMPLOYED PHYSICIAN; FISCAL CONTROLLER; DIRECTOR, COMMUNITY SERVICES; DIRECTOR, CASE MANAGEMENT; MANAGER, CENTRAL SCHEDULING, INSURANCE COORDINATION, AND INTERPRETER SERVICES; MANAGER, COMMUNITY BENEFITS AND OPERATIONS; THE CHIEF COMPLIANCE OFFICER OF MWHC; AND 16 COMMUNITY REPRESENTATIVES.THE CBAC PROVIDES OVERSIGHT FOR THE CHNA, AND THE PROCESSES FOR RECOGNIZING CURRENT AND EMERGING HEALTH NEEDS IN THE COMMUNITY, AS WELL AS DEVELOPING A MULTI-YEAR COMMUNITY HEALTH IMPLEMENTATION/IMPROVEMENT PLAN (CHIP) TO RESPOND TO THESE NEEDS. THE CBAC MEETS SIX TIMES PER YEAR TO ENSURE COMPLIANCE WITH THE CHIP, REVIEW PROGRAM OUTCOMES, DISCUSS IMPORTANT COMMUNITY HEALTH ISSUES, AND OFFER RECOMMENDATIONS TO THE BOARD OF TRUSTEES RELATED TO COMMUNITY HEALTH NEEDS AND DISPARITIES. THE COUNCIL IS ALSO AVAILABLE ON-LINE TO ADDRESS ANY ISSUES THAT MIGHT ARISE BETWEEN SCHEDULED MEETING TIMES. THE CBAC APPROVES ANY AND ALL AMENDMENTS TO THE CHIP RESULTING FROM EMERGING HEALTH ISSUES OR UNPLANNED CHANGES IN CAPACITY, BUT SIGNIFICANT AMENDMENTS ALSO RECEIVE BOARD APPROVAL.THE COUNCIL ALSO ENGAGES NEW MEMBERS FROM THE COMMUNITIES SERVED TO JOIN THE GROUP, PRIORITIZING CANDIDATES WHO CAN ASSIST THE CBAC AND MWHC TO BETTER UNDERSTAND COMMUNITY HEALTH NEEDS AND BARRIERS TO ACCESS. THE COUNCIL IS CURRENTLY COMPRISED OF 25 MEMBERS.THE COUNCIL REPORTS TO THE GOVERNANCE COMMITTEE OF THE BOARD OF TRUSTEES AND THE FULL BOARD IS RESPONSIBLE FOR FINAL APPROVAL ON THE CHNA, CHIP, AND OTHER MATTERS OF IMPORTANCE SUCH AS REVIEWING COUNCIL RECOMMENDATIONS FOR SIGNIFICANT AMENDMENTS TO THE COMMUNITY HEALTH IMPLEMENTATION/IMPROVEMENT PLAN.MWHC ALSO ACTIVELY PARTICIPATES WITH THE COMMUNITY THROUGH ITS COMMUNITY OUTREACH TEAMS, SOLICITING INPUT FROM KEY COMMUNITY LEADERS, INCLUDING SUPERINTENDENTS OF SCHOOLS, STATE REPRESENTATIVES, BUSINESS LEADERS, FIRE AND POLICE PERSONNEL AND LOCAL HEALTH DEPARTMENTS. ADDITIONAL APPROACHES INCLUDE WORK AS MEMBERS OF COMMUNITY COALITIONS AND WITH THE COMMUNITY HEALTH NETWORK AREAS (CHNA 15 AND 16) DESIGNATED BY THE MA DEPARTMENT OF PUBLIC HEALTH. THESE STRATEGIES HAVE PROVEN EFFECTIVE IN GAINING VITAL PERSPECTIVE AROUND THE HEALTH NEEDS OF LOCAL RESIDENTS, AND IN TAILORING OUTREACH MESSAGES AND PROGRAMMING BASED ON WHAT CONSTITUENCIES AND COMMUNITIES VALUE MOST. WHILE CHNA 16 IS NO LONGER VERY ACTIVE, THE MEMBERS OF THE CHNA ARE STILL CLOSELY ALIGNED WITH MWHC.(COMMUNITY TEAMS FUNCTIONS ARE FURTHER EXPLAINED IN THE DESCRIPTION OF COMMUNITY ACTIVITIES IN PART II.)ANOTHER WAY THAT MWHC ASSESSED NEEDS WITHIN THE COMMUNITY IS THROUGH THE PATIENT/FAMILY ADVISORY COUNCIL (PFAC). THIS COUNCIL WAS FORMED TO OBTAIN FEEDBACK AND IDEAS FROM COMMUNITY MEMBERS ON HOW THE HOSPITALS CAN BE MORE RECEPTIVE TO THE UNIQUE NEEDS OF COMMUNITY RESIDENTS, ESPECIALLY THOSE OF DIVERSE BACKGROUNDS, AND TO PROMOTE THE HIGHEST QUALITY OF PATIENT-CENTERED SERVICES BY FOSTERING A STRONG PARTNERSHIP THROUGH OUTREACH ACTIVITIES WITH COMMUNITY RESIDENTS. THE PFAC COUNCIL OFTEN ASSISTS MWHC STAFF BY PROVIDING INPUT INTO THE PLANNING OF FUTURE COMMUNITY ACTIVITIES AND INITIATIVES.(SEE CONTINUATION LATER)
PART VI, LINE 3:	MASSACHUSETTS HOSPITALS AND MWHC PROVIDE PATIENTS WITH INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS THROUGH THE COMMONWEALTH OF MASSACHUSETTS OR THROUGH THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM AS OUTLINED IN THE FINANCIAL ASSISTANCE POLICY AND THE CREDIT AND COLLECTION POLICY OF MELROSEWAKEFIELD HEALTHCARE AND AT THE MELROSEWAKEFIELD HEALTHCARE WEBSITE HTTP://WWW.MELROSEWAKEFIELDHEALTHCARE.ORG. FOR THOSE PATIENTS THAT REQUEST SUCH ASSISTANCE MWHC'S CERTIFIED FINANCIAL COUNSELORS ASSIST PATIENTS BY SCREENING THEM FOR ELIGIBILITY IN AVAILABLE PUBLIC ASSISTANCE PROGRAMS OR THE MWHC'S FINANCIAL ASSISTANCE PROGRAM. THIS INFORMATION IS WIDELY SHARED WITH ORGANIZATIONS REPRESENTING THE MOST UNDERSERVED RESIDENTS IN THE COMMUNITY SUCH AS THE LOCAL POVERTY AGENCY, ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD) A COMMUNITY ACTION PROGRAM (CAP), THE JOINT COMMITTEE FOR CHILDREN'S HEALTH CARE IN EVERETT, SOUTH COVE, AND EAST BOSTON NEIGHBORHOOD HEALTH CENTERS AND MANY OTHERS.MWHC FINANCIAL COUNSELORS PROVIDED 24,824 INTERACTIONS WITH COMMUNITY MEMBERS AND COMPLETED APPLICATIONS FOR INDIVIDUALS IN THE STATE HEALTH PROGRAMS; SUCH AS MASS HEALTH, HEALTH CONNECTOR CHILDREN'S MEDICAL SECURITY PLAN AND THE HEALTH SAFETY NET. MASSHEALTH APPLICATIONS WERE DETERMINED TO BE ELIGIBLE FOR A VARIETY OF CATEGORIES SUCH AS: STANDARD, CAREPLUS, COMMONHEALTH, FAMILY ASSISTANCE, LIMITED, CHILDREN'S MEDICAL SECURITY PLAN, PREMIUM ASSISTANCE, BUY-IN, AND HEALTH SAFETY NET. ADDITIONALLY, LONG TERM CARE AS WELL AS HARDSHIP APPLICATIONS WERE COMPLETED. IN THE HEALTH CONNECTOR PLANS, WHICH ARE MAINLY DETERMINED BASED ON THE HOUSEHOLD INCOME, THE APPLICATIONS RESULTED IN APPROVALS FOR CONNECTOR CARE PLANS (1, 2A, 2B, 3A AND 3B) AS WELL AS UNSUBSIDIZED HEALTH CONNECTOR PLANS DIFFERENTIATED BY METALLIC TIERS (BRONZE, SILVER, GOLD AND PLATINUM). ADDITIONAL INTERACTIONS, WHICH ARE NOT QUANTIFIED ABOVE, INCLUDED APPLICATIONS FOR MEDICARE PART D AND EXTRA HELP. THE FINANCIAL COUNSELING DEPARTMENT ALSO PROCESSES FINANCIAL ASSISTANCE APPLICATIONS FOR UNINSURED AND UNDERINSURED APPLICANTS THAT ARE NOT ELIGIBLE FOR STATE SPONSORED ASSISTANCE. THE MWHC FINANCIAL ASSISTANCE POLICY (FAP) AND THE APPLICATION ARE OUTLINED IN OUR WEBSITE AND ARE AVAILABLE IN MULTIPLE LANGUAGES. APPLICATIONS ARE REVIEWED AND DETERMINED USING FEDERAL POVERTY GUIDELINES.OTHER FORMS OF COUNSELING INCLUDED EDUCATION FOR RISING MEDICARE ELIGIBLE COMMUNITY MEMBERS TO HELP THEM UNDERSTAND THEIR RIGHTS AND BENEFITS AND TO MEET DEADLINES THAT WOULD OTHERWISE LEAVE THEM UNINSURED AT CRITICAL TIMES. COUNSELORS ALSO PLAYED A VITAL ROLE IN HELPING PATIENTS UNDERSTAND AND DIFFERENTIATE BETWEEN TRADITIONAL MEDICARE AND ADVANTAGE PLANS. CONSEQUENTIALLY, COUNSELORS ALSO SUPPORTED RESIDENTS TO BETTER UNDERSTAND MEDICARE SUPPLEMENTAL INSURANCES FOR THOSE UNWILLING TO APPLY OR UNABLE TO QUALIFY FOR MASSHEALTH BENEFITS.SERVICES PROVIDED BY FINANCIAL COUNSELORS INCLUDED CONTACTING DOCTORS TO COMPLETE FORMS THAT WERE NEEDED TO PROVIDE EMERGENCY MEDICATION OR FREE MEDICINE FROM MANUFACTURERS, ADVOCATING WITH INSURANCE COMPANIES ON THEIR BEHALF, HELPING THEM SETTLE BILLS OR SETTING UP PAYMENT PLANS, CONTACTING OTHER PROVIDERS AND ADVOCATING FOR A REDUCTION OR WRITE OFF OF CHARGES, HELPING THEM SORT THROUGH REAMS OF DOCUMENTS TO HELP THEM PROVIDE REQUIRED DOCUMENTATION FOR INSURANCE OR UTILITY DISCOUNTS.MWHC HAS NO ROLE IN SPECIFICALLY DETERMINING THE ELIGIBILITY FOR ENROLLMENT IN A PUBLIC ASSISTANCE PROGRAM, BUT AT THE PATIENT'S REQUEST MAY TAKE A DIRECT ROLE IN APPEALING OR SEEKING INFORMATION RELATED TO THE COVERAGE DECISION.MWHC PROVIDES ALL SELF-PAY INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING A PATIENT'S INITIAL IN-PERSON PRE-REGISTRATION AT A HOSPITAL LOCATION FOR NON-EMERGENCY SERVICES, BY PHONE CALL OR IN-PERSON INTERVIEWS ONCE A PATIENT IS ADMITTED TO THE HOSPITAL FROM THE EMERGENCY ROOM OR DISCHARGED FROM THE EMERGENCY ROOM, IN ALL BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR, AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.IN ADDITION, MWHC ALSO POSTS INFORMATIONAL FLYERS WITH A LIST OF DOCUMENTS NEEDED FOR APPLICATIONS AND THE TELEPHONE NUMBER TO SCHEDULE AN APPOINTMENT THROUGH CENTRAL SCHEDULING.WHEN COMMUNICATING WITH PATIENTS REGARDING FINANCIAL ASSISTANCE, ESPECIALLY DURING SCHEDULED INTERVIEWS, OR ON THE TELEPHONE, MWHC ATTEMPTS TO DO SO IN THE PRIMARY LANGUAGE OF THE PATIENT IF REASONABLY POSSIBLE, AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. ADDITIONALLY, THE FAP IS DISTRIBUTED IN MULTIPLE LANGUAGES AT NON-TRADITIONAL LOCATIONS SUCH AS THE MOBILE FOOD MARKET AND FAMILY NETWORKS IN OUR SERVICE AREA. THE FAP IS AVAILABLE ON THE MWHC WEBSITE WHICH ALSO OFFERS A TRANSLATION FEATURE TO ACCOMMODATE VISITORS.WHEN LANGUAGE IS AN ISSUE THAT IMPEDES PROPER UNDERSTANDING OF THE APPLICATION PROCESS FOR HEALTH INSURANCE OR ADDITIONAL FINANCIAL ASSISTANCE, FINANCIAL COUNSELORS USE THE LANGUAGE LINE, A TRANSLATION SERVICE, TO ENSURE THAT THE PATIENT UNDERSTANDS ALL ASPECTS OF THE PROCESS IN HIS/HER NATIVE LANGUAGE. THIS IS OF SPECIAL IMPORTANCE AS APPROVALS FOR SOME CATEGORIES REQUIRE THE PATIENT TO CHOOSE A PLAN OR MAKE A PAYMENT AFTER THE INITIAL ENCOUNTER WITH THE FINANCIAL COUNSELOR.
PART VI, LINE 4:	MELROSEWAKEFIELD HEALTHCARE (MWHC) IS A COMMUNITY HOSPITAL SYSTEM, LOCATED ON TWO HOSPITAL CAMPUSES APPROXIMATELY TEN (10) MILES NORTH OF BOSTON, MASSACHUSETTS. MWHC'S OVERALL SERVICE AREA IS PRIMARILY WITHIN MIDDLESEX COUNTY, WITH SOME SLIGHT OVERLAP INTO ESSEX AND SUFFOLK COUNTIES.THE MWHC COMMUNITY BENEFIT CATCHMENT AREA (AS DEFINED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS) INCLUDES THE NINE COMMUNITIES OF EVERETT, MALDEN, MEDFORD, MELROSE, READING, NORTH READING, SAUGUS, STONEHAM, AND WAKEFIELD. THESE COMMUNITIES WERE SELECTED AND APPROVED BY THE COMMUNITY BENEFITS ADVISORY COUNCIL AND SYSTEM LEADERSHIP BASED ON AN ASSESSMENT OF COMMUNITIES FROM WHICH MWHC DRAWS ITS PATIENT POPULATION, COMMUNITIES WHERE MWHC HAS AN EXISTING PHYSICAL OR PROGRAM PRESENCE, AS WELL AS LONG-STANDING RELATIONSHIPS WITH COMMUNITY STAKEHOLDERS OR ORGANIZATIONS.ADDITIONAL COMMUNITIES ARE SERVED BY THE HOSPITAL'S COMMUNITY-BASED PROGRAMS THAT ARE PROXIMATE TO THE CATCHMENT AREA. FOR EXAMPLE, THE NORTH SUBURBAN WOMEN, INFANTS, AND CHILDREN (WIC) NUTRITION PROGRAM SERVES THE TOWNS OF BURLINGTON, WILMINGTON, WINCHESTER, AND WOBURN IN ADDITION TO EIGHT OTHER CATCHMENT AREA CITIES AND TOWNS, AND THE NORTH SUBURBAN CHILD AND FAMILY RESOURCE NETWORK SERVES LYNNFIELD AND WINCHESTER, IN ADDITION TO SIX OTHER CATCHMENT AREA COMMUNITIES.FOR PURPOSES OF MONITORING LANGUAGE NEEDS AND THE HOSPITAL'S INTERPRETER SERVICES PROGRAM, THE MA DEPARTMENT OF PUBLIC HEALTH DEFINES A 12-COMMUNITY ASSESSMENT AREA FOR REVIEW, CONSISTING OF THE NINE CATCHMENT AREA CITIES AND TOWNS, PLUS THE ADDITION OF THE COMMUNITIES OF REVERE, LYNNFIELD, AND WINTHROP, REFLECTING THEIR RELATIVE UTILIZATION OF EMERGENCY DEPARTMENT AND INPATIENT SERVICES OF THEIR POPULATIONS.THE FOLLOWING STATISTICAL AND DEMOGRAPHIC PROFILE OF THE CATCHMENT AREA IS EXCERPTED FROM THE COMPREHENSIVE MWHC FY 2019 COMMUNITY HEALTH NEEDS ASSESSMENT:POPULATION SIZE AND DENSITYTHE MELROSEWAKEFIELD HEALTHCARE, INC. COMMUNITY BENEFITS (CB) NINE-COMMUNITY SERVICE AREA COVERS 71.7 SQUARE MILES, WITH A TOTAL POPULATION OF 310,450. SIZE AND POPULATION DENSITY VARY BY COMMUNITY, WITH MALDEN AND MEDFORD HAVING THE LARGEST POPULATION AT 61,212 AND 57,700 RESPECTIVELY, AND NORTH READING THE SMALLEST, AT 15,598. EVERETT IS THE MOST DENSELY POPULATED COMMUNITY AT 13,199.9 PEOPLE PER SQUARE MILE, AND NORTH READING THE LEAST DENSELY POPULATED AT 1,187.1 PEOPLE PER SQUARE MILE. EVERY COMMUNITY IS MORE DENSELY POPULATED THAN THE STATE AS A WHOLE (870.4 PEOPLE PER SQUARE MILE). OVER HALF OF THE RESIDENTS IN THE CATCHMENT AREA LIVE IN EVERETT, MALDEN OR MEDFORD.RACE/ETHNICITYCOMPARED TO MASSACHUSETTS AS A WHOLE, THE MWHC COMMUNITY BENEFITS SERVICE AREA HAS A SMALLER HISPANIC POPULATION (8%, COMPARED TO 11% IN MA) AND LARGER POPULATIONS OF ASIAN RESIDENTS (9%, COMPARED TO 6% IN MA) AND BLACK/AFRICAN-AMERICAN RESIDENTS (9%, COMPARED TO 7% IN MA). HOWEVER, BREAKING IT DOWN BY COMMUNITY, MORE VARIATION IS OBSERVED. MALDEN HAS THE HIGHEST RATE OF PEOPLE DESCRIBING THEMSELVES AS ASIAN (24%, COMPARED TO A MA RATE OF 6%), AND EVERETT HAS THE HIGHEST RATES OF PEOPLE IDENTIFYING AS HISPANIC (23%, VERSUS THE MA RATE OF 11%) AND BLACK/AFRICAN-AMERICAN (19%, VERSUS A MA RATE OF 6%). DISTRIBUTIONS FOR OTHER TOWNS ARE IN EACH OF THE COMMUNITY PROFILES.FOREIGN-BORN RESIDENTSTHE MELROSEWAKEFIELD HEALTHCARE, INC. CB SERVICE AREA ALSO HAS A HIGHER POPULATION OF FOREIGN-BORN RESIDENTS COMPARED TO THE STATE OF MASSACHUSETTS AS A WHOLE: 24% COMPARED TO 16% STATEWIDE. WITHIN THE SERVICE AREA, THE RATES VARY FROM A HIGH OF 43% IN MALDEN TO A LOW OF 7.5% IN NORTH READING.LANGUAGES SPOKENTHE MWHC COMMUNITY BENEFITS SERVICE AREA ALSO HAS A LOWER POPULATION OF RESIDENTS WHO SPEAK ONLY ENGLISH AT HOME: 70% COMPARED TO 77% STATEWIDE. WITHIN THE SERVICE AREA, THE RATES VARY FROM A HIGH OF 90% IN READING AND NORTH READING TO AS LOW AS 44% IN EVERETT.INCOME AND POVERTYINCOME LEVELS IN THE COMMUNITY BENEFITS SERVICE AREA EXHIBIT WIDE VARIATION. ALTHOUGH THE TOTAL SERVICE AREA HAS A SLIGHTLY HIGHER MEDIAN INCOME THAN THE STATE ($78,192 VERSUS $74,192 STATEWIDE), THIS CONCEALS VARIATIONS BETWEEN A HIGH MEDIAN INCOME OF $124,750 IN NORTH READING AND A LOW OF $57,254 IN EVERETT.WITHIN THE OVERALL MWHC COMMUNITY BENEFITS SERVICE AREA, POVERTY RATES FOR ADULTS OVER AGE 65 ARE SIMILAR TO MA AND LOWER FOR FAMILIES AND CHILDREN UNDER AGE 18. HOWEVER, THERE ARE SIGNIFICANT DIFFERENCES IN THE RATES OF POVERTY THROUGHOUT THE SERVICE AREA WITH EVERETT AND MALDEN HAVING THE HIGHEST RATES, FOLLOWED BY SAUGUS AND MEDFORD.CRIMETHE VIOLENT AND PROPERTY CRIME RATES FOR ALL TOWNS WITHIN THE MWHC COMMUNITY BENEFITS SERVICE AREA ARE LOWER THAN THE STATE. HOWEVER, THE RATES ARE VERY VARIABLE ACROSS THE TOWNS. VIOLENT CRIME RATES RANGED FROM 8 PER 100,000 RESIDENTS IN READING, UP TO 207 PER 100,000 RESIDENTS IN MALDEN. PROPERTY CRIMES RATES RANGED FROM 65 PER 100,000 RESIDENTS IN NORTH READING, TO 780 PER 100,000 RESIDENTS IN MALDEN.EDUCATIONAL ATTAINMENTTHE MWHC COMMUNITY BENEFITS SERVICE AREA AS A WHOLE HAS EDUCATIONAL ATTAINMENT RATES SIMILAR TO MASSACHUSETTS. HOWEVER, THE INDIVIDUAL COMMUNITIES PRESENT MORE VARIATION. WITHIN THE MWHC SERVICE AREA, EVERETT AND MALDEN HAVE THE HIGHEST PERCENTAGES OF RESIDENTS WITH LESS THAN A HIGH SCHOOL DEGREE. EVERETT AND SAUGUS HAVE THE HIGHEST PERCENTAGES OF RESIDENTS WITH A HIGH SCHOOL DEGREE OR SOME COLLEGE. THEY ALSO HAVE THE LOWEST PERCENTAGE OF RESIDENTS WITH A BACHELOR'S DEGREE OR OTHER ADVANCED DEGREES. MELROSE, NORTH READING, AND READING HAVE THE HIGHEST PERCENTAGE OF RESIDENTS WITH A BACHELOR'S DEGREE OR HIGHER AND THE LOWEST PERCENTAGE OF RESIDENTS WITH LESS THAN A HIGH SCHOOL DEGREE.UNEMPLOYMENTIN THE MWHC SERVICE AREA, UNEMPLOYMENT IS BELOW THE MASSACHUSETTS RATE. ALL COMMUNITIES ARE BELOW THE STATE RATE.PUBLIC SCHOOL DEMOGRAPHICSEVERETT AND MALDEN HAVE THE HIGHEST PROPORTIONS OF STUDENTS WHOSE FIRST LANGUAGE IS NOT ENGLISH AND WHO HAVE LIMITED ENGLISH PROFICIENCY. NORTH READING, READING AND WAKEFIELD HAVE VERY FEW STUDENTS IN THESE CATEGORIES.THE HIGH SCHOOL 4-YEAR GRADUATION AND DROP-OUT RATES IN THE OVERALL COMMUNITY BENEFITS SERVICE AREA ARE CLOSE TO THE RATES OF THE STATE AS A WHOLE. VARIATION WITHIN THE SERVICE AREA RANGES FROM A GRADUATION RATE HIGH OF 98%IN MELROSE, READING AND NORTH READING, TO A LOW OF 78% AND 83% IN EVERETT AND MALDEN, RESPECTIVELY. DROPOUT RATES RANGE FROM A HIGH OF 12% IN EVERETT TO A LOW OF LESS THAN 1% IN MELROSE, WAKEFIELD, AND NORTH READING.(SEE CONTINUATION LATER)
PART VI, LINE 5:	MWHC HAS A 15 MEMBER BOARD OF TRUSTEES, COMPRISED OF A MAJORITY OF COMMUNITY MEMBERS. ONLY THREE (3) OF 15 TRUSTEES ARE EMPLOYED BY MELROSEWAKEFIELD HEALTHCARE OR THE HOSPITAL'S PARENT, MELROSEWAKEFIELD HEALTHCARE CORPORATION (I.E. THE CHIEF EXECUTIVE OFFICER, THE CHIEF FINANCIAL OFFICER, AND AN EMPLOYED PHYSICIAN LEADER). MEDICAL STAFF MEMBERSHIP AND PRIVILEGES ARE OPEN AND AVAILABLE TO ALL QUALIFIED PHYSICIANS, INCLUDING A LARGE AND DIVERSE MEDICAL STAFF OF MORE THAN 400 MEMBERS (EMPLOYED AND AFFILIATED). MWHC OPERATES AN ACTIVE EMERGENCY DEPARTMENT AT MELROSEWAKEFIELD HOSPITAL AND URGENT CARE AT LAWRENCE MEMORIAL HOSPITAL. THEY ARE ACCESSIBLE TO ANYONE NEEDING CARE REGARDLESS OF THEIR ABILITY TO PAY. NO PART OF THE INCOME OF MWHC INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED. ALL SURPLUS FUNDS ARE REINVESTED INTO THE FACILITIES, EQUIPMENT OR PROGRAMS OF MWHC TO IMPROVE THE QUALITY OF PATIENT CARE, ACCESS TO CARE, ADVANCE MEDICAL PRACTICE AND TO IMPROVE THE COMMUNITIES HEALTH AND WELLBEING. IN FY 2020/TY 2019, MWHC FINANCIAL COUNSELORS HELPED PATIENTS TO ENROLL IN SNAP (FORMALLY FOOD STAMPS) AND OTHER SOCIAL SERVICE PROGRAMS. IN ADDITION, MWHC STAFF ATTENDED SEVERAL COMMUNITY OUTREACH EVENTS TO ASSIST PARTICIPANTS AND PROVIDE ENROLLMENT INFORMATION. OTHER SERVICES PROVIDED INCLUDE ADVOCATING FOR RESIDENTS, MAKING APPOINTMENTS, PROCURING OTHER SERVICES AND PROVIDING INFORMATION ABOUT PROGRAMS SUCH AS THE MOBILE FOOD MARKET. BILLING AND COLLECTIONS PRACTICES ARE POSTED ON THE SYSTEM WEB SITE. MWHC ALSO PROVIDED MEETING SPACE IN-KIND AND SUBSIDIZED OR PROVIDED RENT AND UTILITIES IN-KIND FOR KEY COMMUNITY PARTNERS, SUCH AS PORTAL TO HOPE, WHICH PROVIDES DOMESTIC VIOLENCE PREVENTION AND SUPPORT SERVICES. MEETING SPACE IS OFFERED TO COMMUNITY AGENCIES ON A REGULAR BASIS, WHEN MISSION AND GOALS ALIGN WITH THE PRIORITIES OF THE COMMUNITY HEALTH IMPLEMENTATION PLAN, SUCH AS ALCOHOLICS/OVEREATERS ANONYMOUS GROUPS, RED CROSS FOR BLOOD DRIVES, DISTRICT ATTORNEY MARIAN RYAN'S EASTERN MIDDLESEX OPIOID TASK FORCE, MASSACHUSETTS OPIOID PREVENTION COALITION (MOAPC), SUBSTANCE ABUSE PREVENTION COALITION (SAPC) AND MELROSE ALLIANCE AGAINST VIOLENCE AND PORTAL TO HOPE FOR COMMUNITY SUPPORT GROUPS.IN ADDITION TO PROVIDING A RANGE OF PROGRAMS TO ADDRESS PRIMARY AND SECONDARY HEALTH PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE HEALTH SYSTEM HAS ALSO, AS PART OF ITS MULTI-YEAR IMPLEMENTATION PLAN, IDENTIFIED AND IMPLEMENTED EFFORTS THAT MORE PROACTIVELY ADDRESS FACTORS THAT HAVE BEEN DEMONSTRATED TO ADVERSELY IMPACT HEALTH STATUS, INCREASE HEALTH DISPARITIES, AND REDUCE OVERALL HEALTH IN VULNERABLE POPULATIONS. THESE SO CALLED SOCIAL DETERMINANTS OF HEALTH, SUCH AS AVAILABILITY OF HEALTHY FOOD, EMPLOYMENT, AND SAFE HOUSING, REFLECT THE OPPORTUNITY TO HAVE MEASUREABLE IMPACT ON POPULATION HEALTH STATUS, AND ARE BECOMING A MEANINGFUL PART OF EFFORTS TO ADDRESS PRIMARY AND SECONDARY HEALTH PRIORITIES.MWHC ALSO SUPPORTS AND AT TIMES CONVENES MANY LOCAL AND REGIONAL COALITIONS TO SUPPORT UPSTREAM HEALTH IMPACTS SUCH AS POLICY AND STRATEGIC PLANNING. THIS INCLUDES WORKING THROUGH THE MA COURT SYSTEM, THE GREATER BOSTON FOOD BANK'S EFFORT TO ERADICATE HUNGER IN OUR COMMUNITIES BY 2028, AND MANY OTHERS.EXAMPLES OF THESE EFFORTS, AND THEIR IMPACT BOTH DIRECTLY AND INDIRECTLY ON THE HEALTH PRIORITIES IDENTIFIED IN THE CHNA AND BY OTHER COMMUNITY STAKEHOLDERS, INCLUDE:INTEGRATED BREASTFEEDING SERVICESAS A BABY FRIENDLY HOSPITAL, PROVIDING NEW MOTHERS WITH AN INTEGRATED APPROACH TO ENCOURAGING BREASTFEEDING SUPPORTS A NUMBER OF KEY FACTORS IN REDUCING A NUMBER OF ISSUES FOR MOTHER AND CHILD ALIKE. LACTATION SERVICES FOR POST-PARTUM MOTHERS ARE AVAILABLE BOTH AT MELROSE-WAKEFIELD HOSPITAL, AND AT THREE BABY CAFES IN MELROSE, MALDEN, AND EVERETT. ALL MATERNAL/CHILD HEALTH STAFF, CHILDBIRTH EDUCATION STAFF, AND NORTH SUBURBAN WIC NUTRITIONIST AND FAMILY SUPPORT STAFF ARE CERTIFIED IN LACTATION (CLC OR IBCLC DEPENDING ON OTHER CLINICAL TRAINING). CONTINUING MEDICAL EDUCATION PROGRAMS ARE PROVIDED TO PHYSICIANS AND CLINICIANS ANNUALLY. BREASTFEEDING HAS BEEN SHOWN TO REDUCE RISK FOR CANCER AND OTHER CHRONIC DISEASES LATER IN LIFE. ENCOURAGING HEALTHY FOOD CONSUMPTIONSEVERAL HOSPITAL DEPARTMENTS AND CLINICAL AREAS, INCLUDING DIABETES, REHABILITATION SERVICES, NUTRITION, AND WIC, ALL SUPPORT HEALTHY EATING-REDUCING CONSUMPTION OF ADDED SUGAR, EATING AMPLE FRUITS AND VEGETABLES, AND PROVIDING EDUCATION PROGRAMS TARGETING THE DIETARY NEEDS AND CHALLENGES OF STUDENT ATHLETES, CANCER PATIENTS, AND OTHERS IN THE COMMUNITY LIVING WITH CHRONIC DISEASES SUCH AS HYPERTENSION AND DIABETES.THE HEALTH SYSTEM WORKS WITH ORGANIZATIONS SUCH AS THE GREATER BOSTON FOOD BANK AND BREAD OF LIFE, AROUND ADDRESSING FOOD INSECURITY AND ACCESS TO HEALTHY FOODS. NUTRITION AND DIETARY STAFF SUPPORT THE CREATION OF HEALTHY MENU OPTIONS, NOT ONLY FOR HOSPITAL INPATIENTS AND IN CAFETERIAS, BUT ALSO THROUGH PROGRAMS SUCH AS MASS IN MOTION OFFERING GUIDANCE TO LOCAL RESTAURANTS ON HEALTHFUL EATING AND NUTRITIONAL INFORMATION. EFFORTS ALSO EXTEND TO DIRECTLY SUPPORTING INCREASED ACCESS TO HEALTHY FOODS, INCLUDING FRESH FRUITS AND VEGETABLES PROVIDED THROUGH A FREE MOBILE FOOD MARKET SERVING APPROXIMATELY 650 FAMILIES PER MONTH, PRIOR TO THE COVID-19 PANDEMIC, WITH APPROXIMATELY 30 LBS. EACH OF FRESH, HEALTHY FOODS. IN APRIL 2020, THE MOBILE FOOD MARKET DISTRIBUTION FORMAT CHANGED TO BETTER PROTECT STAFF, VOLUNTEERS, AND CUSTOMERS ADHERING TO COVID-19 SAFETY PROTOCOLS. STAFF AND VOLUNTEERS PACK REUSABLE BAGS FOR DISTRIBUTION TO FOOD INSECURE VULNERABLE POPULATIONS, INCLUDING FAMILIES, ELDERS, IMMIGRANTS, AND INDIVIDUALS AFFECTED BY CHRONIC HEALTH ISSUES, UNEMPLOYMENT, OR OTHER ADVERSE SITUATIONS SUCH AS HOUSING OR FAMILY SITUATIONS. ADDITIONALLY, VOUCHERS FROM WIC TO ITS PROGRAM PARTICIPANTS ARE ALSO PROVIDED FOR USE AT LOCAL FARMERS' MARKETS DURING SUMMER MONTHS. THE NORTH SUBURBAN CHILD AND FAMILY RESOURCE NETWORK (NSFRN) OFFERS STORYBOOK WALKS AND MEET-UP GROUPS PROMOTING PHYSICAL ACTIVITY WHILE CONNECTING WITH NATURE AND FOSTERING LITERACY SKILLS. THE NSFRN ALSO HOSTS FITNESS, FOOD AND FRIENDS GROUP FOR FAMILIES WITH YOUNG CHILDREN TO PROMOTE A HEALTHY LIFESTYLE, LEARN ABOUT HEALTHY EATING HABITS AND FUN PHYSICAL ACTIVITIES TO DO AS A FAMILY. SOME PROGRAMS HAVE BEEN OFFERED OUTDOORS AND OTHERS THROUGH ON-LINE FORMATS DURING THE PANDEMIC.WORKPLACE WELLNESS EFFORTS, IN TERMS OF INCREASING PHYSICAL ACTIVITY, AS WELL AS PROMOTING WEIGHT LOSS AND HEALTHIER EATING, HAVE BEEN CONTINUED DURING FY 2020/TY 2019 THROUGH THE WORK OF THE EMPLOYEE WELLNESS COMMITTEE. CORRELATING GREATER PHYSICAL HEALTH AND WELLBEING THROUGH REDUCTIONS IN OBESITY, CARDIOVASCULAR AND OTHER RELATED HEALTH PROBLEMS, SUPPORTS A WHOLE-HEALTH APPROACH TO REDUCING CHRONIC DISEASE AND THE IMPACTS OF TREATMENT BY PRESENTING OPPORTUNITIES TO IDENTIFY AND REDUCE THESE HEALTH RISKS. WHILE THESE EFFORTS ARE NOT COMMUNITY BENEFIT, THE MODELING OF HEALTHY BEHAVIOR IS IMPORTANT IN A COMMUNITY HOSPITAL WHERE THE EMPLOYEES ARE OFTEN ALSO LOCAL RESIDENTS.MELROSEWAKEFIELD HEALTHCARE, INC. LEADERS ARE MEMBERS OF THE GREATER BOSTON FOOD BANK (GBFB) FOOD INSECURITY RESEARCH TASK FORCE AND MEDFORD FOOD INSECURITY TASK FORCE AND ALSO THE MALDEN AND MELROSE WAKEFIELD TASK FORCES TO ADDRESS THE NEED TO STRATEGIZE AND SHARE BEST PRACTICE IDEAS IN ADDRESSING FOOD INSECURITY IN THE AREA.(SEE CONTINUATION LATER)
PART VI, LINE 6:	MELROSEWAKEFIELD HEALTHCARE IS A COMMUNITY HOSPITAL SYSTEM WITH MULTIPLE CAMPUSES AND IS A MEMBER OF THE MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION WHICH HAS OTHER MEMBER ORGANIZATIONS THAT INCLUDE A PHYSICIAN PRACTICE ORGANIZATION. ALL AFFILIATED ENTITIES PROVIDE PATIENT CARE WITHOUT CONSIDERATION OF A PATIENT'S ABILITY TO PAY. ALL SURPLUS FUNDS OF THE AFFILIATED ENTITIES ARE REINVESTED IN PROVIDING ACCESS TO HEALTH SERVICES AND IMPROVING HEALTH STATUS OF COMMUNITIES SERVED.MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION IS A MEMBER OF WELLFORCE, INC.
PART VI, LINE 7, REPORTS FILED WITH STATES	MA
PART VI, LINE 2 NEEDS ASSESSMENT CONTINUED	AS PART OF ITS EFFORTS TO IMPROVE HEALTH STATUS IN THE CATCHMENT AREA, MWHC ALSO PARTICIPATES IN A VARIETY OF BROAD-BASED COMMUNITY COALITIONS AND INITIATIVES THAT WORK TOWARDS ADDRESSING THE SPECIFIC AND GENERAL HEALTH NEEDS IN THESE CITIES AND TOWNS. A SAMPLE OF THESE MEMBERSHIPS INCLUDE: LOCAL COUNCILS ON AGING; THE MIDDLESEX COUNTY DISTRICT ATTORNEY'S OPIOID TASK FORCE: THE SAFE BABY/SAFE KIDS TASK FORCE THROUGH THE MIDDLESEX COUNTY DISTRICT ATTORNEY'S OFFICE; THE PORTAL TO HOPE DOMESTIC VIOLENCE COUNCIL, MEDFORD'S BIG TABLE; THE TRI-CITY HUNGER NETWORK; THE TRI-CITY HOUSING AND HOMELESSNESS COALITION, THE CHINESE CULTURE CONNECTION; SUBSTANCE ABUSE PREVENTION COALITIONS IN MALDEN, MELROSE, MEDFORD, READING, WAKEFIELD, AND STONEHAM; THE MALDEN'S PROMISE COALITION, MA DEPARTMENT OF PUBLIC HEALTH MASS IN MOTION PROGRAMS IN MELROSE-WAKEFIELD, MALDEN, AND EVERETT; AND THE MELROSE, STONEHAM, AND WAKEFIELD ALLIANCES AGAINST VIOLENCE. ONE CENTRAL FOCUS OF MWHC'S COMMUNITY BENEFITS GROUPS AND LOCAL LEADERS, INCLUDES ENHANCING RELATIONSHIPS WITH FAITH-BASED AND GRASSROOTS ORGANIZATIONS. SUCH RELATIONSHIPS PROVIDE INSIGHT INTO HOW THESE GROUPS VIEW MWHC'S ROLE IN THEIR COMMUNITY, HOW OUR SYSTEM CAN IMPROVE THE WAYS WE SERVE DIVERSE RESIDENTS, AND HOW THE SYSTEM SHOULD STRENGTHEN COLLABORATION TO BEST MEET DIVERGENT HEALTH NEEDS. IN 2020, THE HEALTH SYSTEM MADE MANY FAITH-BASED CONNECTIONS INCLUDING THROUGH THE FOOD SECURITY TASK FORCE IN MEDFORD, AND THE WARMING STATION IN MALDEN.ALSO BEGINNING IN 2019-2020, MWHC SPONSORED LISTENING SESSIONS FOCUSED ON COMMUNITY BEHAVIORAL HEALTH NEEDS. THE THREE SESSIONS RESULTED IN THE DEVELOPMENT OF THE MYSTIC VALLEY REGIONAL BEHAVIORAL HEALTH COALITION. THE REGIONAL BEHAVIORAL HEALTH COALITION CONVENING PARTNERS INCLUDE MIDDLESEX DISTRICT ATTORNEY MARIAN RYAN, MELROSE WAKEFIELD HEALTHCARE, THE MYSTIC VALLEY PUBLIC HEALTH COALITION, AND THE NATIONAL ALLIANCE ON MENTAL ILLNESS. MEMBER AGENCIES INCLUDE LOCAL POLICE, FIRE AND MUNICIPAL LEADERS, ELIOT COMMUNITY HUMAN SERVICES, WAYSIDE YOUTH AND FAMILY SUPPORT NETWORK, MYSTIC VALLEY ELDER SERVICES, REGIONAL AMBULANCE COMPANIES (ACTION, ARMSTRONG AND CATALDO), RIVERSIDE COMMUNITY CARE, ADCARE HOSPITAL, RESPOND, PORTAL TO HOPE, THE SAMARITANS, BOSTON AREA RAPE CRISIS CENTER, MALDEN WARMING CENTER, THE EVERETT, MALDEN AND MEDFORD YMCA, AND THE ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD). THE MEMBERSHIP REFLECTS THE ONGOING NEED FOR ADDRESSING BEHAVIORAL HEALTH NEEDS IN OUR COMMUNITY. THE GOAL OF THE COALITION IS TO OFFER COMMUNITY EDUCATIONAL EVENTS AND COORDINATE AND DISSEMINATE BEHAVIORAL HEALTH RESOURCES AND SUPPORT.THE COALITION HAS ALSO BEEN INSTRUMENTAL IN SUPPORTING THE CBAC'S ROLE TO PROVIDE COMMUNITY GRANTS THROUGH THE MA DETERMINATION OF NEED PROCESS. THESE GRANTS WILL BE FOCUSED ON SERVING UNMET NEEDS IN COMMUNITY BEHAVIORAL HEALTH.
PART VI, LINE 4 COMMUNITY INFORMATION CONTINUED	ORGANIZATIONS CONTRIBUTING TO THE ASSESSMENT-ACTION FOR BOSTON COMMUNITY DEVELOPMENT (ABCD)-AMERICAN CANCER SOCIETY-AMERICAN DIABETES ASSOCIATION -AMERICAN HEART ASSOCIATION-AMERICAN LUNG ASSOCIATION-AMERICAN RED CROSS-ASIAN AMERICAN CIVIC ASSOCIATION-BABY CAF USA-BABY FRIENDLY AMERICA-BOYS AND GIRLS CLUBS OF MIDDLESEX COUNTY-BREAD OF LIFE-BURBANK YMCA OF READING-CAMBRIDGE HEALTH ALLIANCE-CATHOLIC CHARITIES-CHILDREN'S TRUST OF MASSACHUSETTS-CHINESE CULTURE CONNECTION-COMMUNITY FAMILY HUMAN SERVICES INC.-COMMUNITY HEALTH NETWORK AREA 15 & 16-COMMUNITY SERVINGS INC.-CRITERION EARLY INTERVENTION-CROSS CULTURAL COMMUNICATIONS INC.-CUSTOMIZED COMMUNICATION INC.-DOUCET'S REMODELING-EAST BOSTON NEIGHBORHOOD HEALTH CENTER-ELDER SERVICES OF MERRIMACK VALLEY-ELDER SERVICES OF THE NORTH SHORE-ELIOT COMMUNITY HUMAN SERVICES-EMARC-EVERETT CFCE GRANT PROGRAM-FAMILIES FIRST-FRIENDS OF MIDDLESEX FELLS RESERVATION-FRIENDS OF OAK GROVE-THE GREATER BOSTON FOOD BANK-GREATER BOSTON STAGE COMPANY (STONEHAM THEATRE)-GREATER LYNN SENIOR SERVICES-HALLMARK HEALTH VNA AND HOSPICE-HEALTH CARE FOR ALL-HEALTH CARE WITHOUT HARM-HOUSING FAMILIES INC.-IMMIGRANT LEARNING CENTER OF MALDEN-INSTITUTE FOR COMMUNITY HEALTH (ICH)-JEWISH FAMILY AND CHILDREN'S SERVICE-JOINT COMMITTEE FOR CHILDREN'S HEALTH CARE IN EVERETT (JCCHCE)-JOSLIN DIABETES CENTER-LOCAL ARTS COUNCILS-LOCAL BOARDS OF HEALTH -LOCAL CHAMBERS OF COMMERCE-LOCAL CIVIC GROUPS (ROTARY, KIWANIS) -LOCAL COUNCILS ON AGING -LOCAL EARLY INTERVENTION (EI) PROGRAMS-LOCAL FAITH-BASED ORGANIZATIONS-LOWELL COMMUNITY HEALTH CENTER-MA EXECUTIVE OFFICE OF ELDER AFFAIRS-MA HEALTH POLICY COMMISSION-MALDEN EARLY LEARNING CENTER (CFCE)-MALDEN HOMELESSNESS TASK FORCE-MALDEN'S PROMISE COALITION-MALDEN YMCA-MASSACHUSETTS DEPARTMENTS OF: CHILDREN AND FAMILIES (DCF) CONSERVATION AND RECREATION (DCR) EARLY EDUCATION AND CARE (EEC) PUBLIC HEALTH (DPH) TRANSITIONAL ASSISTANCE (DTA)-MASSACHUSETTS HOSPITAL ASSOCIATION-MASSACHUSETTS OPIOID ABUSE PREVENTION COLLABORATIVE (MOAPC)-MASS IN MOTION (EVERETT, MALDEN, MEDFORD, MELROSE/WAKEFIELD)-MEDFORD FAMILY NETWORK (CFCE)-MEDFORD HEALTH MATTERS -MEDFORD SUBSTANCE ABUSE TASK FORCE-MELROSE ALLIANCE AGAINST VIOLENCE-MELROSE BIRTH TO FIVE -MELROSE COMMUNITY COALITION-MELROSE FAMILY YMCA-MELROSE HUMAN RIGHTS COMMISSION-MELROSE SUBSTANCE ABUSE PREVENTION COALITION-METROPOLITAN AREA PLANNING COUNCIL -MIDDLESEX COUNTY DISTRICT ATTORNEY-MYSTIC VALLEY ELDER SERVICES-MYSTIC VALLEY PUBLIC HEALTH COALITION-MYSTIC VALLEY TOBACCO AND ALCOHOL PROGRAM (MVTAP)-NORTHEASTERN UNIVERSITY-NORTH SHORE ELDER SERVICES-OAK GROVE IMPROVEMENT ORGANIZATION-PHILIPS LIFELINE-PORTAL TO HOPE-READING COALITION AGAINST SUBSTANCE ABUSE (RCASA)-READING RESPONSE-REGIONAL EMS PROVIDERS-REGIS COLLEGE-RESPOND INC.-THE SALVATION ARMY-THE SHAREWOOD PROJECT-SOMERVILLE CAMBRIDGE ELDER SERVICES-SOUTH BAY MENTAL HEALTH CENTER-STONEHAM ALLIANCE AGAINST VIOLENCE-SUBSTANCE ABUSE PREVENTION COLLABORATIVE (SAPC)-TAILORED FOR SUCCESS-TRI-CITY HOMELESSNESS TASK FORCE-TRI-CITY HUNGER NETWORK-TUFTS MEDICAL CENTER-TUFTS MEDICAL CENTER COMMUNITY CARE -TUFTS UNIVERSITY-WAKEFIELD ALLIANCE AGAINST VIOLENCE-WAKE-UP: WAKEFIELD UNIFIED PREVENTION-WEST MEDFORD COMMUNITY CENTER-WINCHESTER HOSPITAL/LAHEY HEALTH-YOUTHHARBORS @ JRI -YWCA OF MALDEN-ZONTA CLUBS OF MALDEN AND MEDFORD -ZOO NEW ENGLAND - STONE ZOOPUBLICLY REPORTED DATA WAS UTILIZED FROM THE FOLLOWING SOURCES:-US CENSUS BUREAU AMERICAN COMMUNITY SURVEY (ACS)-FBI UNIFORM CRIME REPORT-US DEPT. OF LABOR BUREAU OF LABOR AND STATISTICS, LOCAL UNEMPLOYMENT STATISTICS-MASSACHUSETTS DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT (DHCD)-THE GREATER BOSTON FOOD BANK MAP THE MEAL GAP 2018: A REPORT ON COUNTY AND CONGRESSIONAL DISTRICT FOOD INSECURITY AND COUNTY FOOD COST IN THE UNITED STATES-FOOD BANK OF WESTERN MASSACHUSETTS-MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION (DESE)-MA DESE AND MA DEPARTMENT OF PUBLIC HEALTH (MDPH), 2017 HEALTH AND RISK BEHAVIORS OF MASSACHUSETTS YOUTH REPORT-LOCAL YOUTH RISK BEHAVIOR SURVEYS OR COMMUNITIES THAT CARE SURVEYS WHERE AVAILABLE (EVERETT 2016-2017; MALDEN 2018; MEDFORD 2017; MELROSE 2017; READING 2017; SAUGUS 2017; STONEHAM 2017; WAKEFIELD 2017)-MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (MDPH) -MDPH REGISTRY OF VITAL RECORDS-MA DIVISION OF HEALTH CARE FINANCE AND POLICY UNIFORM HOSPITAL DISCHARGE DATASET SYSTEM (UHDDS)-MDPH BUREAU OF COMMUNICABLE DISEASE CONTROL (BCDC) REGISTRIES, DIVISION OF EPIDEMIOLOGY AND IMMUNIZATION-MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, BUREAU OF INFECTIOUS DISEASE AND LABORATORY SCIENCES, HIV/AIDS SURVEILLANCE PROGRAM
PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH CONTINUED	SUPPORTING REGIONAL AND LOCAL SUBSTANCE USE PREVENTION EFFORTSTHE HEALTH SYSTEM WORKS ACTIVELY WITH THE MYSTIC VALLEY PUBLIC HEALTH COALITION INCLUDING MASSACHUSETTS OPIOID ABUSE PREVENTION COALITION (MOAPC) AND SUBSTANCE ABUSE PREVENTION COALITION (SAPC), THE DISTRICT ATTORNEY'S EASTERN MIDDLESEX OPIOID TASK FORCE AS WELL AS LOCAL ORGANIZATIONS IN MALDEN, MEDFORD, MELROSE, READING, STONEHAM AND WAKEFIELD. IN FY 2020, MWHC STAFF AND LEADERS SPENT EXTENSIVE HOURS AT MEETINGS AND EVENTS WORKING TOWARDS PREVENTION, AWARENESS, TREATMENT AND INTERVENTIONS TO REDUCE THE IMPACT OF SUBSTANCE USE DISORDER IN THE COMMUNITY. MWCH PROVIDES SPACE AND FOOD FOR THE DISTRICT ATTORNEY'S EASTERN MIDDLESEX OPIOID TASK AT LAWRENCE MEMORIAL HOSPITAL OF MEDFORD AS WELL AS EMPLOYEE MEMBERSHIP. THE OPIOID TASK FORCE FOCUSES ON COMBATING THE INCREASE IN DRUG OVERDOSES IN THE EASTERN REGION OF MIDDLESEX COUNTY, SERVING THE COMMUNITIES OF MALDEN, MEDFORD, MELROSE, NORTH READING, READING, STONEHAM, AND WAKEFIELD. LED BY MIDDLESEX COUNTY DISTRICT ATTORNEY, MARIAN RYAN, THE EASTERN MIDDLESEX OPIOID TASK FORCE INCLUDES FIRST RESPONDERS, POLICE AND FIRE OFFICIALS, MUNICIPAL HEALTH WORKERS, DOCTORS, NURSES, SOCIAL WORKERS, SUBSTANCE ABUSE COUNSELORS, COMMUNITY-BASED ADVOCATES AND PROBATION OFFICERS. THIS GROUP IS NOW REMOTE DUE TO THE PANDEMIC. RAISING AWARENESS OF THE SEVERITY OF DOMESTIC VIOLENCE, WORKING WITH LOCAL GROUPS, ORGANIZATIONS AND COALITIONS TO PREVENT AND END DOMESTIC VIOLENCE, SEXUAL ASSAULT AND STALKING CRIMESIN FY 2020, MWHC STAFF SPENT COUNTLESS HOURS AT MEETINGS AND EVENTS PROVIDING SUPPORT AND WORKING TOWARDS PREVENTION, EDUCATION, AWARENESS, MENTORING, AND SERVICE TO REDUCE THE IMPACT OF DOMESTIC VIOLENCE BY PARTNERING WITH THE FOLLOWING GROUPS AND PROGRAMS: WAKEFIELD ALLIANCE AGAINST VIOLENCE (WAAV), A COMMUNITY BASED VOLUNTEER ORGANIZATION, DEDICATED TO CREATING A LIFESTYLE FREE FROM VIOLENCE IN WAKEFIELD BY REACHING OUT TO THE COMMUNITY, RAISING AWARENESS, PROVIDING EDUCATION RESOURCES, AND SUPPORT TO FAMILIES AND INDIVIDUALS, WITH AN EMPHASIS ON PREVENTION. A MELROSEWAKEFIELD HEALTHCARE EMPLOYEE REPRESENTS MWHC ON THE WAAV BOARD OF DIRECTORS. THE DIRECTOR OF MEDICAL STAFF DEVELOPMENT AND SERVICES FOR MWHC SERVES AS THE VICE PRESIDENT OF MELROSE ALLIANCE AGAINST VIOLENCE (MAAV). MAAV'S MISSION IS TO RAISE COMMUNITY AWARENESS OF DOMESTIC AND TEEN DATING VIOLENCE, PROMOTE PROGRAMS THAT WORK TO REDUCE VIOLENCE AND ENCOURAGE HEALTHY RELATIONSHIPS THROUGH COMMUNITY AWARENESS ACTIVITIES, EDUCATION AND PREVENTION PROGRAMS IN THE SCHOOLS, INCLUDING BULLYING PREVENTION, MENTORING AND PEER LEADERSHIP PROGRAMS; AND INFORMATION, SUPPORT, RESOURCE AND REFERRAL SERVICES. ADDITIONALLY, MWHC ALSO PROVIDES SPACE FOR MAAV'S RELATIONSHIP DISCUSSION GROUP AT MELROSE-WAKEFIELD HOSPITAL. IN OCTOBER 2019, MWHC HELPED TO SPONSOR MAAV'S ANNUAL WALK AND CANDLELIGHT VIGIL.A COMMUNITY HEALTH EDUCATOR FOR MWHC SERVES AS A MEMBER OF THE STONEHAM ALLIANCE AGAINST VIOLENCE (SAAV), A DIVERSE GROUP WHOSE MEMBERS CARE ABOUT STONEHAM AND ITS QUALITY OF LIFE. NOTING AN UPSWING IN REPORTED INCIDENCES OF VIOLENCE IN THE TOWN, THE GROUP CAME TOGETHER TO ADDRESS THIS ISSUE. THE HOSPITAL MEMBER HAS NOW BEEN HIRED BY THE TOWN OF STONEHAM AS THEIR DOMESTIC VIOLENCE LIAISON.MWHC HAS A STRONG PARTNERSHIP WITH PORTAL TO HOPE (PTH), AN AGENCY THAT SERVED PEOPLE IMPACTED BY DOMESTIC VIOLENCE DURING FY 2020. OUR UNIQUE COLLABORATION HELPS TO PROVIDE CONFIDENTIAL, COMPREHENSIVE SERVICES TO VICTIMS OF DOMESTIC VIOLENCE AND RELATED INTIMATE PARTNER ASSAULT CRIMES. SERVICES INCLUDE: THE BENEVOLENCE PROJECT; CRISIS INTERVENTION AND EMERGENCY SHELTER; THE HEALING & RECOVERY PROGRAM, INCLUDING SUPPORT GROUPS; LEGAL AID; JOB AND HOUSING SEARCH ASSISTANCE; YOUTH SUPPORT; SAFETY PLANNING; AND OTHER DIRECT CARE SERVICES. MWHC PROVIDES OFFICE SPACE, PHONE AND INTERNET SERVICE CAPABILITIES TO PTH AT THE MALDEN FAMILY HEALTH CENTER (PTH'S CENTRAL OPERATIONS SITE) AND THE LAWRENCE MEMORIAL HOSPITAL, WHERE PTH OFFERS SUPPORT GROUPS, AND IN PARTNERSHIP WITH MWHC, FACILITATES TRI-CITY DOMESTIC VIOLENCE TASK FORCE MEETINGS, BOARD AND ADVISORY COMMITTEE MEETINGS AND OTHER PUBLIC EDUCATIONAL EFFORTS. IN ADDITION, PTH AND MWHC PARTNER TO PROVIDE VIOLENCE PREVENTION EDUCATION TO THE PUBLIC AND TRAINING TO MEDICAL STAFF ONSITE AT THESE LOCATIONS, AT MELROSE-WAKEFIELD HOSPITAL AND ON THE GRASSROOTS LEVEL IN THE COMMUNITIES PTH SERVES. PTH CONTINUES TO BE ONE OF A SMALL NUMBER OF DOMESTIC VIOLENCE INTERVENTION AGENCIES WORKING ONSITE AT MEDICAL FACILITIES IN MASSACHUSETTS. THIS WORK HAS CONTINUED REMOTELY DURING THE PANDEMIC.

Schedule H (Form 990) 2019

Additional Data

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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

2019

Open to Public Inspection

Name of the organization

MELROSEWAKEFIELD HEALTHCARE INC

Employer identification number

04-2767880

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 on 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 on 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? .........

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) 2019

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)
1JOSEPH PENNACCHIO MD DIRECTOR	(i) (ii)	0 ------------- 416,154	0 ------------- 0	0 ------------- 4,167	0 ------------- 5,204	0 ------------- 19,204	0 ------------- 444,729	0 ------------- 0
2SUSAN M SANDBERG PRESIDENT & CEO/DIRECTOR	(i) (ii)	0 ------------- 596,100	0 ------------- 101,745	0 ------------- 10,523	0 ------------- 6,000	0 ------------- 23,475	0 ------------- 737,843	0 ------------- 0
3MICHAEL P CONNELLY CFO/ASSISTANT TREASURER (UNTIL 10/20	(i) (ii)	0 ------------- 436,956	0 ------------- 39,572	0 ------------- 0	0 ------------- 6,000	0 ------------- 3,585	0 ------------- 486,113	0 ------------- 0
4CHARLES R WHIPPLE ESQ ASSISTANT SECRETARY/GENERAL COUNSEL	(i) (ii)	0 ------------- 289,325	0 ------------- 46,208	0 ------------- 9,600	0 ------------- 0	0 ------------- 30,770	0 ------------- 375,903	0 ------------- 0
5CARYL A BEISON PHYSICIAN DIRECTOR	(i) (ii)	0 ------------- 248,854	0 ------------- 22,235	0 ------------- 0	0 ------------- 6,000	0 ------------- 2,040	0 ------------- 279,129	0 ------------- 0
6NANCY BITTNER VP, EDUCATION	(i) (ii)	0 ------------- 192,896	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 20,270	0 ------------- 213,166	0 ------------- 0
7RYAN FULLER DIRECTOR OF PLANNING	(i) (ii)	0 ------------- 246,593	0 ------------- 14,729	0 ------------- 0	0 ------------- 0	0 ------------- 351	0 ------------- 261,673	0 ------------- 0
8STEVE SBARDELLA VP, MEDICAL AFFAIRS & CMO	(i) (ii)	0 ------------- 488,200	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 396	0 ------------- 488,596	0 ------------- 0
9CHERYL WARREN INTERGRATION ADMIN.	(i) (ii)	0 ------------- 227,458	0 ------------- 11,595	0 ------------- 0	0 ------------- 0	0 ------------- 33,378	0 ------------- 272,431	0 ------------- 0
10LAURALEE HOWLEY CHIEF MARKETING & COMMUNICATIONS	(i) (ii)	196,427 ------------- 0	11,115 ------------- 0	0 ------------- 0	3,243 ------------- 0	29,845 ------------- 0	240,630 ------------- 0	0 ------------- 0
11ANTHONY ALLEY ACNO, CLINICAL OPS	(i) (ii)	209,307 ------------- 0	11,627 ------------- 0	0 ------------- 0	0 ------------- 0	18,489 ------------- 0	239,423 ------------- 0	0 ------------- 0
12DAWN NEE EXECUTIVE DIRECTOR - LMMER	(i) (ii)	198,607 ------------- 0	29,700 ------------- 0	0 ------------- 0	4,160 ------------- 0	31,349 ------------- 0	263,816 ------------- 0	0 ------------- 0
13DEBORAH CRONIN-WAELDE SYSTEM V.P./CNO	(i) (ii)	0 ------------- 308,155	0 ------------- 36,795	0 ------------- 0	0 ------------- 6,000	0 ------------- 2,156	0 ------------- 353,106	0 ------------- 0
14JOHN G GIRAGOS MD PSYCH M.D.	(i) (ii)	250,834 ------------- 0	3,000 ------------- 0	61,228 ------------- 0	6,357 ------------- 0	30,665 ------------- 0	352,084 ------------- 0	0 ------------- 0
15TERRY SMITH PSYCH M.D.	(i) (ii)	245,296 ------------- 0	10,000 ------------- 0	0 ------------- 0	4,916 ------------- 0	17,100 ------------- 0	277,312 ------------- 0	0 ------------- 0
16DANIEL CARAT MD CHAIR, DEPT. OF PSYCHIATRY	(i) (ii)	186,346 ------------- 0	10,000 ------------- 0	0 ------------- 0	0 ------------- 0	46,109 ------------- 0	242,455 ------------- 0	0 ------------- 0
17ELISA SCHER EXECUTIVE DIRECTOR, CANCER SERVICES	(i) (ii)	182,604 ------------- 0	3,000 ------------- 0	0 ------------- 0	5,212 ------------- 0	0 ------------- 0	190,816 ------------- 0	0 ------------- 0
18WARREN TURRINO DIRECTOR, INFOSEC/SISO	(i) (ii)	171,171 ------------- 0	3,000 ------------- 0	0 ------------- 0	2,425 ------------- 0	12,844 ------------- 0	189,440 ------------- 0	0 ------------- 0
19LAURENCE CONWAY MD FORMER DIRECTOR	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 192,442	0 ------------- 1,925	0 ------------- 0	0 ------------- 194,367	0 ------------- 0
20DAVID RYAN FMR. SYSTEM VP, HUMAN RESOURCES	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 164,662	0 ------------- 0	0 ------------- 0	0 ------------- 164,662	0 ------------- 0
21MICHELLE CORRADO FMR. VP, CLINICAL ADMIN. (UNTIL 7/18	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 114,692	0 ------------- 0	0 ------------- 0	0 ------------- 114,692	0 ------------- 0

Schedule J (Form 990) 2019

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 I, LINE 3	ANNUALLY, THE HUMAN RESOURCES COMMITTEE OF THE ORGANIZATION COMPRISED OF INDEPENDENT DIRECTORS, REVIEWS THE COMPENSATION OF THE PRESIDENT AND EXECUTIVE LEADERSHIP TEAM USING DATA FROM AN INDEPENDENT THIRD PARTY EVALUATION OF COMPARABLE COMPENSATION DATA TO ASSESS AND SET COMPENSATION. COMPENSATION IS PAID BY A RELATED CORPORATION.
PART I, LINE 4A	THESE EMPLOYEES RECEIVED SEVERANCE PAYMENTS: LAWRENCE CONWAY WAS PAID $192,442 IN 2019. MICHELLE CORRADO WAS PAID $114,692 IN 2019. DAVID RYAN WAS PAID $164,662 IN 2019.

Schedule J (Form 990) 2019

Additional Data

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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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
MELROSEWAKEFIELD HEALTHCARE INC

Employer identification number
04-2767880

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 AGENCY	04-3431814	000000000	03-01-2013	20,000,000	FINANCE CAPITAL		X		X		X
B	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	000000000	06-05-2015	30,000,000	FINANCE CAPITAL		X		X		X
C	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	575B4YQK8	02-20-2019	94,740,000	SEE SUPPLEMENTAL INFORMATION		X		X	X
D	MASSACHUSETTS DEVELOPMENT FINANCE AGENCY	04-3431814	000000000	07-16-2020	24,098,320	FINANCE CAPITAL		X		X	X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	18,484,094		4,295,744		1,640,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	20,000,000		30,000,000		101,992,524		26,778,711
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	98,939		268,250				746,767
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	19,901,061		29,731,750		17,933,938
11 Other spent proceeds .............					48,980,740
12 Other unspent proceeds .............					35,077,846		26,031,944
13 Year of substantial completion .............	2014		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........		X		X	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

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

Part Ⅳ

Arbitrage

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

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
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		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference

Explanation

DATE REBATE COMPUTATION PERFORMED

ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY DATE THE REBATE COMPUTATION WAS PERFORMED: 10/30/2014 ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AGENCY DATE THE REBATE COMPUTATION WAS PERFORMED: 10/10/2017

PART I, LINE C, COLUMN F

DESCRIPTION OF BOND PURPOSE: C. 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, (3) FUND A DEBT SERVICE RESERVE FUND, AND (4) PAY CERTAIN COSTS OF ISSUANCE OF THE BONDS. 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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

MELROSEWAKEFIELD HEALTHCARE INC

Employer identification number

04-2767880

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION IS THE SOLE CORPORATE MEMBER OF MELROSEWAKEFIELD HEALTHCARE, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE BOARD OF TRUSTEES CONSISTS OF THOSE PERSONS THAT SERVE ON THE BOARD OF TRUSTEES OF MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION. WELLFORCE, INC., AS SOLE MEMBER OF MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION, HAS THE POWER TO APPOINT MELROSEWAKEFIELD HEALTHCARE PARENT TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION HAS CERTAIN RIGHTS TO APPROVE DECISIONS OF THE BOARD AS REQUIRED BY THE ORGANIZATION'S ARTICLES AND BYLAWS AND LAWS OF THE COMMONWEALTH OF MASSACHUSETTS.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 WAS REVIEWED BY MANAGEMENT AND PROVIDED TO THE GOVERNING BODY PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUALLY THE GOVERNING BODY AND KEY EMPLOYEES ARE SENT THE POLICY AND REQUIRED TO COMPLETE A DISCLOSURE FORM THAT IS SUBMITTED TO THE OFFICE OF GENERAL COUNSEL FOR REVIEW. THE CONTENTS OF THE DISCLOSURES AND ACTIONS NECESSARY TO ADDRESS CONFLICTS ARE REVIEWED WITH THE CHAIR OF THE GOVERNING BOARD AND ITS PRESIDENT.
FORM 990, PART VI, SECTION B, LINE 15	ANNUALLY, THE HUMAN RESOURCES COMMITTEE OF THE ORGANIZATION COMPRISED OF INDEPENDENT DIRECTORS, REVIEWS THE COMPENSATION OF THE PRESIDENT AND EXECUTIVE LEADERSHIP TEAM USING DATA FROM AN INDEPEDENT THIRD PARTY. COMPENSATION IS PAID BY A RELATED CORPORATION.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST TO THE OFFICE OF THE GENERAL COUNSEL. THE ORGANIZATION'S FINANCIAL STATEMENTS AND FORM 990 ARE ALSO MADE AVAILABLE TO THE PUBLIC ON THE WEBSITE OF THE PUBLIC CHARITIES DIVISION OF MASSACHUSETTS ATTORNEY GENERAL.
FORM 990, PART XI, LINE 9:	NET ASSETS RELEASED FROM RESTRICTIONS- OPERATIONS -621,420. NET ASSETS TRANSFERS TO AFFILIATES -22,762,259. NET ASSETS RELEASED FROM AUXILLARY -25,743. PENSION LIABILITY ADJUSTMENT -129,948. CHANGES IN BENEFICIAL INTERESTS IN PERPETUAL TRUST 354,466.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

MELROSEWAKEFIELD HEALTHCARE INC

Employer identification number

04-2767880

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
(1) MELROSEWAKEFIELD HEALTHCARE AUXILIARY 170 GOVERNORS AVENUE MEDFORD,MA02155 04-2767880	GIFT SHOP	MA	0	0	MELROSEWAKEFIELD HEALTHCARE INC
(2) MELROSEWAKEFIELD HEALTHCARE FRIENDS OF LMH 170 GOVERNORS AVENUE MEDFORD,MA02155 04-2767880	GIFT SHOP	MA	0	0	MELROSEWAKEFIELD HEALTHCARE INC

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)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
(2)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
(3)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
(4)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
(5)HALLMARK HEALTH PROPERTIES 170 GOVERNORS AVE MEDFORD,MA02155 22-2580542	PROPERTY	MA	501(C)(3)	LINE 12B, II	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(6)MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION 170 GOVERNORS AVE MEDFORD,MA02155 04-2103587	PARENT	MA	501(C)(3)	LINE 12A, I	WELLFORCE INC	Yes
(7)THE LOWELL GENERAL HOSPITAL 295 VARNUM AVENUE LOWELL,MA01854 04-2103590	HEALTH CARE	MA	501(C)(3)	LINE 3	CIRCLE HEALTH INC	Yes
(8)CIRCLE HEALTH PHYSICIANS INC 295 VARNUM AVENUE LOWELL,MA01854 27-3902914	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	CIRCLE HEALTH INC	Yes
(9)LGH PHYSICIAN ASSOCIATES INC ONE HOSPITAL DRIVE LOWELL,MA01852 04-3190747	MEDICAL SERVICES	MA	501(C)(3)	PF	CIRCLE HEALTH PHYSICIANS INC	Yes
(10)CIRCLE HEALTH INC 295 VARNUM AVENUE LOWELL,MA01854 22-2579798	PARENT/SUPPORTING ORGANIZATION	MA	501(C)(3)	LINE 12B, II	WELLFORCE INC	Yes
(11)WELLFORCE INC 1600 DISTRICT AVE SUITE 125 BURLINGTON,MA01803 45-2250732	PARENT/SUPPORTING ORGANIZATION	MA	501(C)(3)	LINE 12A, I	N/A		No
(12)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
(13)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
(14)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
(15)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
(16)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
(17)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
(18)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
(19)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 PHYSICIANS ORG INC	Yes
(20)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
(21)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
(22)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
(23)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
(24)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
(25)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
(26)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
(27)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
(28)PRATT OTOLARYNGOLOGY 800 WASHINGTON STREET BOSTON,MA02111 04-3148381	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(29)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
(30)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
(31)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
(32)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
(33)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
(34)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
(35)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
(36)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
(37)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
(38)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
(39)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
(40)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
(41)HOME HEALTH FOUNDATION INC 360 MERRIMACK STREET LAWRENCE,MA01843 22-2587225	MANAGEMENT SERVICES	MA	501(C)(3)	LINE 12B, II	WELLFORCE INC	Yes
(42)HOME HEALTH VNA INC 360 MERRIMACK STREET LAWRENCE,MA01843 04-2435675	HOME HEALTH CARE	MA	501(C)(3)	LINE 10	HOME HEALTH FOUNDATION INC	Yes
(43)MERRIMACK VALLEY HOSPICE INC 360 MERRIMACK STREET LAWRENCE,MA01843 04-3024278	HOSPICE SERVICES	MA	501(C)(3)	LINE 10	HOME HEALTH FOUNDATION INC	Yes
(44)HOME CARE INC 360 MERRIMACK STREET LAWRENCE,MA01843 04-2854358	HOME HEALTH SUPPORTIVE SERVICES	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) 2019

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 AVENUE MEDFORD,MA02155 02-0657666	INVESTMENT	MA	MELROSEWAKEFIELD HEALTHCARE INC	EXCLUDED	7,471,654	172,180,601		No			No	96.590 %
(2) MONTVALE PETCT LLC 100 BAYVIEW CIRCLE SUITE 400 NEWPORT BEACH,CA92660 27-0325022	CAT SCAN	CA	MELROSEWAKEFIELD HEALTHCARE INC	RELATED	325,677	154,878		No			No	50.000 %
(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				No			No
(5) MEDFORD LAWRENCE REAL ESTATE LLC 55 CHRISTYS DRIVE BROCKTON,MA02301 32-0553759	MEDICAL OFFICE BUILDING	MA	MELROSEWAKEFIELD HEALTHCARE INC	RELATED				No			No	55.000 %
(6) MEDFORD SURGERY CENTER LLC 55 CHRISTYS DRIVE BROCKTON,MA02301 38-4079196	MEDICAL SERVICES	MA	MELROSEWAKEFIELD HEALTHCARE INC	RELATED	-222,443	1,350,250		No			No	45.000 %

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) HALLMARK HEALTH ENTERPRISES INC 585 LEBANON STREET MELROSE,MA02176 04-2475660	OTHER HEALTH SERVICES	MA	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	C				Yes
(2) LAWRENCE MELROSE MEDICAL ELECTRONICS RECORD INC 170 GOVERNORS AVE MEDFORD,MA02155 42-1685777	ELECTRONIC MEDICAL RECORDS	MA	MELROSEWAKEFIELD HEALTHCARE INC	C			50.000 %		No
(3) HALLMARK HEALTH PHO INC 170 GOVERNORS AVE MEDFORD,MA02155 46-1134759	PHYSICIAN HOSPITAL ORGANIZATION	MA	MELROSEWAKEFIELD HEALTHCARE INC	C			50.000 %		No
(4) LGH SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 04-2854673	MEDICAL SERVICES	MA	CIRCLE HEALTH INC	C				Yes
(5) LGH MEDICAL BUILDING SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 04-3058954	MEDICAL OFFICE BUILDING	MA	LGH SERVICES INC	C				Yes
(6) LGH MANAGEMENT SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 04-2919244	MEDICAL SERVICES	MA	LGH SERVICES INC	C				Yes
(7) LGH MEDICAL SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 26-1889904	MEDICAL SERVICES	MA	LGH SERVICES INC	C				Yes
(8) WELLFORCE INDEMNITY COMPANY LTD 800 WASHINGTON STREET BOSTON,MA02111 98-0444573	CAPTIVE INSURANCE	CJ	TUFTS MEDICAL CENTER INC	C				Yes

Schedule R (Form 990) 2019

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

Yes

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

Yes

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

Yes

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

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

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

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) HALLMARK HEALTH MEDICAL ASSOCIATES INC	J	750,819	FAIR MARKET VALUE
(2) HALLMARK HEALTH PROPERTIES INC	K	348,540	FAIR MARKET VALUE
(3) MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	K	1,406,220	FAIR MARKET VALUE
(4) HALLMARK HEALTH PROPERTIES INC	L	117,797	COST & TIME ALLOCATION
(5) HALLMARK HEALTH MEDICAL ASSOCIATES INC	L	176,984	COST & TIME ALLOCATION
(6) HALLMARK HEALTH MEDICAL ASSOCIATES INC	L	1,272,775	ACTUAL COST
(7) MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	L	559,039	COST & TIME ALLOCATION
(8) MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	M	3,539,950	COST & TIME ALLOCATION
(9) HALLMARK HEALTH MEDICAL ASSOCIATES INC	M	773,618	COST & TIME ALLOCATION
(10) HALLMARK HEALTH MEDICAL ASSOCIATES INC	R	18,422,522	AUDITED BOOK VALUE
(11) TUFTS MEDICAL CENTER INC	D	8,000,000	AUDITED BOOK VALUE
(12) WELLFORCE INC	D	28,504,869	AUDITED BOOK VALUE
(13) HALLMARK HEALTH PROPERTIES INC	D	2,817,917	AUDITED BOOK VALUE
(14) HALLMARK HEALTH MEDICAL ASSOCIATES INC	D	673,909	AUDITED BOOK VALUE
(15) MERRIMACK VALLEY HOSPICE INC	D	379,749	AUDITED BOOK VALUE
(16) WELLFORCE INDEMNITY COMPANY LTD	D	8,155,538	AUDITED BOOK VALUE
(17) TUFTS MEDICAL CENTER INC	E	553,332	AUDITED BOOK VALUE
(18) TUFTS MEDICAL CENTER PHYSICIANS ORG	E	229,106	AUDITED BOOK VALUE
(19) WELLFORCE INC	E	4,972,110	AUDITED BOOK VALUE
(20) THE LOWELL GENERAL HOSPITAL	E	319,675	AUDITED BOOK VALUE
(21) MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	E	277,862	AUDITED BOOK VALUE
(22) LM LONG TERM CARE SERVICES INC	E	2,891,526	AUDITED BOOK VALUE
(23) SAVIN LONG TERM CARE CORPORATION	E	1,731,058	AUDITED BOOK VALUE
(24) WELLFORCE INC	R	4,339,738	AUDITED BOOK VALUE

Schedule R (Form 990) 2019

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) 2019

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) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO OPERATE HOSPITALS ON TWO CAMPUSES (ONE WITH 24 HOUR ER SERVICES) ALONG WITH A HOSPITAL SCHOOL OF NURSING. MELROSEWAKEFIELD HEALTHCARE PROVIDES INPATIENT AND OUTPATIENT MEDICAL CARE AND ANCILLARY MEDICAL SERVICES AND TESTING.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	19
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	2,386
6	Total number of volunteers (estimate if necessary) .............	6	185
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,741,524	32,484,534
9	Program service revenue (Part VIII, line 2g) .........	236,892,277	210,253,360
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,838,495	8,485,390
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,985,755	1,947,417
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	249,458,051	253,170,701
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)	124,451,785	125,774,168
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	102,908,810	105,305,199
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	227,360,595	231,079,367
19	Revenue less expenses. Subtract line 18 from line 12.......	22,097,456	22,091,334
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	364,382,440	453,532,534
21	Total liabilities (Part X, line 26).............	186,071,835	273,634,037
22	Net assets or fund balances. Subtract line 21 from line 20.....	178,310,605	179,898,497

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 180,762,996 including grants of $ ) (Revenue $ 210,253,360 )
	TO OPERATE A HOSPITAL WITH 24 HOUR ER SERVICES ON ONE CAMPUS ALONG WITH A HOSPITAL SCHOOL OF NURSING. MELROSEWAKEFIELD HEALTHCARE PROVIDED INPATIENT AND OUTPATIENT MEDICAL, SURGICAL AND PSYCHIATRIC CARE. ANCILLARY MEDICAL SERVICES AND TESTING WERE ALSO PROVIDED ON AN INPATIENT AND OUTPATIENT BASIS IN AREAS SUCH AS LABORATORY, RADIOLOGY, EKG, EEG, PHARMACY, NUCLEAR MEDICINE, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, RESPIRATORY THERAPY AND I.V. THERAPY.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses180,762,996

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,850,560	4,219,656	390,314

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	31,819,641

f	All other contributions, gifts, grants, and similar amounts not included above		1f	664,893

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		32,484,534

		Business Code
2a	MEDICAL SERVICES	622110	209,927,683	209,927,683
b	MONTVALE PET/CT K1	621512	325,677	325,677
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		210,253,360

3 Investment income (including dividends, interest, and othersimilar amounts) ......			6,966,883			6,966,883
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,947,417	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		1,947,417	6c
d	Net rental income or (loss).......			1,947,417			1,947,417
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		1,518,507	7a
b	Less: cost or other basis and sales expenses		0	7b
c	Gain or (loss)		1,518,507	7c
d	Net gain or (loss).........			1,518,507			1,518,507
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
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.....			253,170,701	210,253,360	0	10,432,807

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, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,148,779	903,400	245,379
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........	104,046,076	81,821,834	22,224,242
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,936,220	1,592,928	343,292
9	Other employee benefits .......	9,817,227	8,076,633	1,740,594
10	Payroll taxes ...........	8,825,866	7,261,040	1,564,826
11	Fees for services (non-employees):
a	Management ......	11,971,616	8,260,415	3,711,201
b	Legal .........	511,973		511,973
c	Accounting ...........	326,080		326,080
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
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)	20,907,043	14,425,860	6,481,183
12	Advertising and promotion ....	1,089,234	751,571	337,663
13	Office expenses .......	2,545,342	1,756,286	789,056
14	Information technology ......	3,607,344		3,607,344
15	Royalties ..
16	Occupancy ...........	9,811,484	7,417,482	2,394,002
17	Travel ............	84,378	63,790	20,588
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	5,417,797	4,063,348	1,354,449
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	13,153,602	10,280,855	2,872,747
23	Insurance ...
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	23,106,397	23,106,397
b	PHYSICIAN PRACTICE FEES	6,544,653	6,544,653
c	CONTRACT LABOR	2,516,368	1,736,294	780,074
d	REPAIRS & MAINTENANCE	1,597,172	1,102,049	495,123
e	All other expenses	2,114,716	1,598,161	516,555
25	Total functional expenses. Add lines 1 through 24e	231,079,367	180,762,996	50,316,371	0
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 ........			2,183,663	1	1,849,712
2	Savings and temporary cash investments .........			7,412,534	2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			28,212,283	4	27,744,327
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			1,967,952	8	1,928,528
9	Prepaid expenses and deferred charges ......			2,385,275	9	2,359,998
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	442,662,242
b	Less: accumulated depreciation	10b	369,227,948	73,999,391	10c	73,434,294
11	Investments—publicly traded securities .			212,623,889	11	262,739,804
12	Investments—other securities. See Part IV, line 11 .....			10,884,994	12	11,239,461
13	Investments—program-related. See Part IV, line 11 ..			3,054,688	13	1,745,074
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			21,657,771	15	70,491,336
16	Total assets. Add lines 1 through 15 (must equal line 33)...			364,382,440	16	453,532,534

17	Accounts payable and accrued expenses .....	31,041,298	17	26,821,693
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	131,460,235	20	151,295,982
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	990,000	23	12,228,685
24	Unsecured notes and loans payable to unrelated third parties ..		24
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	22,580,302	25	83,287,677
26	Total liabilities. Add lines 17 through 25..	186,071,835	26	273,634,037

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	155,518,344	27	156,149,966
28	Net assets with donor restrictions ...........	22,792,261	28	23,748,531
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	178,310,605	32	179,898,497
33	Total liabilities and net assets/fund balances ........	364,382,440	33	453,532,534