TY 2021 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/1099-NEC)
(1) REGINA ROCKEFELLER...................................................................... TRUSTEE	1.00 ................. 1.00	X		0	0	0
(2) KAREN FREUND MD...................................................................... TRUSTEE	1.00 ................. 39.00	X		0	587,094	51,963
(3) KRISTINE M HANSCOM...................................................................... SVP/CFO/TREAS. (UNTIL 4/22)	39.00 ................. 1.00	X	X	706,225	0	97,526
(4) JACK MCDONALD...................................................................... ASSOCIATE EXECUTIVE DIRECTOR- NELTC	39.00 ................. 1.00	X	X	179,208	0	12,263
(5) ZACHARY REDMOND ESQ...................................................................... SECRETARY	39.00 ................. 1.00	X	X	329,743	0	77,308
(6) ERIKA WERNER...................................................................... TRUSTEE	1.00 ................. 39.00	X		0	196,406	6,319
(7) F CLARISSA YANG MD...................................................................... TRUSTEE (UNTIL 2/22)	1.00 ................. 39.00	X		0	669,856	31,187
(8) STANLEY GOLDSTEIN...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(9) GENIA LONG...................................................................... TRUSTEE/CHAIR	1.00 ................. 0.00	X		0	0	0
(10) GERALD COHEN...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(11) ASSAD SIDDIQI...................................................................... SVP/TREASURER	1.00 ................. 39.00	X	X	0	367,674	15,683
(12) HELEN BOUCHER MD...................................................................... TRUSTEE	1.00 ................. 39.00	X		0	181,178	25,600
(13) MICHAEL DANDORPH...................................................................... TRUSTEE/PRESIDENT/CEO	1.00 ................. 39.00	X	X	0	1,905,698	260,012
(14) PAUL SUMMERGRAD MD...................................................................... TRUSTEE	1.00 ................. 39.00	X		0	513,848	51,407
(15) MARK ROSEN...................................................................... TRUSTEE/VICE CHAIR	1.00 ................. 0.00	X		0	0	0
(16) MARVIN A KONSTAM MD...................................................................... TRUSTEE	1.00 ................. 39.00	X		0	798,360	51,989
(17) JEFF SHAMES...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) MARGARET BROWN ESQ........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(19) MICHAEL TARNOFF MD........................................................................ CEO/TRUSTEE	1.00 .......................39.00	X	X				897,987	474,580	54,852
(20) JASON HALL........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(21) PAUL NASSER........................................................................ TRUSTEE	1.00 .......................0.00	X					0	0	0
(22) THERESE HUDSON-JINKS........................................................................ SENIOR VP & CNO	40.00 .......................0.00			X			564,472	0	70,791
(23) DIANA RICHARDSON........................................................................ SENIOR VP & COO	40.00 .......................0.00			X			709,772	0	112,053
(24) SARAH MCKAY........................................................................ VP OF PATIENT CARE	40.00 .......................0.00				X		341,581	0	71,574
(25) MAURA LYNCH........................................................................ VP FOR DEVELOPMENT (UNTIL 10/8/21)	40.00 .......................0.00				X		609,369	0	61,991
(26) MARCY CASS........................................................................ VP RISK MANAGEMENT	40.00 .......................0.00				X		389,175	0	19,102
(27) DEBORAH FIUMEDORA........................................................................ VP OF STRATEGY, PLANNING AND BUSINESS DEVELOPMENT	40.00 .......................0.00				X		397,352	0	51,599
(28) KARA GREER........................................................................ SVP CHIEF TALENT OFFICER	40.00 .......................0.00				X		448,628	0	53,735
(29) MICHAEL APKON........................................................................ FORMER TRUSTEE/PRESIDENT/CEO	0.00 .......................0.00					X	1,088,744	0	0
(30) DEEB N SALEM MD........................................................................ FORMER TRUSTEE	0.00 .......................40.00					X	0	563,292	24,917
(31) MICHAEL WAGNER........................................................................ FORMER TRUSTEE/PRESIDENT	0.00 .......................50.00					X	0	1,964,592	177,648
(32) JEFFREY WEINSTEIN........................................................................ FORMER TRUSTEE	0.00 .......................50.00					X	0	702,069	33,246
(33) CHARLES CASSIDY........................................................................ FORMER TRUSTEE	0.00 .......................40.00					X	0	1,108,651	51,989
(34) WILLIAM SHICKOLOVICH........................................................................ FORMER KEY EMPLOYEE	0.00 .......................50.00					X	0	404,000	0
(35) NIOBIS DEL CARMEN QUEIRO........................................................................ FORMER KEY EMPLOYEE	0.00 .......................40.00					X	0	463,393	58,556

(A) Name and business address	(B) Description of services	(C) Compensation
PRATT ANESTHESIOLOGY ASSOCIATION INC 800 WASHINGTON STREET BOSTON,MA02111	PHYSICIAN SERVICES	13,941,303
WYNDEN STARK LLC 1038 PRINCETON DRIVE SUITE B MARINA DEL REY,CA90292	NURSING SERVICES	11,575,850
MEDICAL SOLUTIONS 1010 N 102ND STREET 300 OMAHA,NE68114	NURSING SERVICES	11,192,975
OPTIMUM HEALTHCARE IT 1300 MARSH LANDING PKWY 105 JACKSONVILLE BEACH,FL32250	PROFESSIONAL SERVICES	8,868,844
ETTAIN GROUP 100 CUMMINGS CENTER SUITE 225C BEVERLY,MA01915	PROFESSIONAL SERVICES	8,811,310
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 67

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Part I

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

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

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

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

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 33 1/3% 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 33 1/3% 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 on 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 5 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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 5 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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).

Yes

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) .

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

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 on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

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 0.015 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 0.035	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) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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, GENERAL INFORMATION:	PUBLIC CHARITY STATUS OF THE GROUP MEMBERS IS AS FOLLOWS : TUFTS MEDICAL CENTER, INC. - LINE 3 NEW ENGLAND LONG-TERM CARE, INC. - LINE 3

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2021

Name of the organization

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization TUFTS MEDICAL CENTER GROUP RETURN

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) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization TUFTS MEDICAL CENTER GROUP RETURN		Employer identification number 27-0440772

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization TUFTS MEDICAL CENTER GROUP RETURN			Employer identification number 27-0440772
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2021)

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

2021

Open to Public Inspection

Name of the organization

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under 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) 2021

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 ....	7,328,000	6,832,000	6,667,000	6,201,000	6,071,000
b	Contributions ...	433,000	391,000	118,000	463,000	107,000
c	Net investment earnings, gains, and losses	-85,000	120,000	47,000	12,000	33,000
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	13,000	15,000		9,000	10,000
f	Administrative expenses ....
g	End of year balance ......	7,663,000	7,328,000	6,832,000	6,667,000	6,201,000

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

97.800 %

Term endowment SchDMd Bullet

2.200 %

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

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

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

1a	Land .....	11,712,367		11,712,367
b	Buildings ....	282,282,782	152,615,096	129,667,686
c	Leasehold improvements	17,232,320	14,058,784	3,173,536
d	Equipment ....	447,234,603	291,757,691	155,476,912
e	Other .....	42,495,045		42,495,045
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				342,525,546

Schedule D (Form 990) 2021

Page 3

Part VII

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

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

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value
(1)DUE FROM AFFILIATES				56,945,678
(2)DEPOSIT ADVANCE				11,425,916
(3)OTHER MISC. RECEIVABLES & ASSETS				30,302,486
(4)ESTIMATED THIRD PARTY RECEIVABLES				202,742
(5)RIGHT OF USE ASSETS				59,791,822
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				158,668,644

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.)	468,263,295
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) 2021

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference

Explanation

PART V, LINE 4:

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

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

Attach to Form 990. Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Part I

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

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

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

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

Yes

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

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

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	PROGRAM SERVICES	SELF-INSURANCE	24,231,255
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	INVESTMENTS		80,000















3a	Sub-total ....	0	0			24,311,255
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	0			24,311,255

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021

Schedule F (Form 990) 2021

Page 2

Part II

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

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

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

Schedule F (Form 990) 2021

Schedule F (Form 990) 2021Page 3

Part III

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

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2021

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2021

Page 5

Part V

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

ReturnReference	Explanation
PART III ACCOUNTING METHOD:

Schedule F (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			11,063,778	0	11,063,778	0.870 %
b	Medicaid (from Worksheet 3, column a) . . . . .			289,304,044	171,800,487	117,503,557	9.260 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			300,367,822	171,800,487	128,567,335	10.130 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			13,349		13,349	0 %
f	Health professions education (from Worksheet 5) . . .	39	644,899	41,235,271	18,463,535	22,771,736	1.790 %
g	Subsidized health services (from Worksheet 6) . . . .			536,571,817	418,838,320	117,733,497	9.270 %
h	Research (from Worksheet 7) .			64,573,269	45,334,052	19,239,217	1.520 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .		577,470	7,601,960		7,601,960	0.600 %
j	Total. Other Benefits . .	39	1,222,369	649,995,666	482,635,907	167,359,759	13.180 %
k	Total. Add lines 7d and 7j .	39	1,222,369	950,363,488	654,436,394	295,927,094	23.310 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1		341,638	341,638	0.030 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	2	38	98,956	98,956	0.010 %
9	Other
10	Total	3	38	440,594	440,594	0.040 %

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? ..........................

Yes

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

12,546,339

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).....

58,012,395

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

122,213,718

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

-64,201,323

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) 2021

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	TUFTS MEDICAL CENTER INC 800 WASHINGTON STREET BOSTON,MA02111	X	X	X	X	X	X

Schedule H (Form 990) 2021

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	TUFTS MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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

Yes

6 a

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

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

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

Yes

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

Hospital facility’s website (list url): WWW.TUFTSMEDICALCENTER.ORG/ABOUT-US/COMMUNITY-PARTNERS-PROGRAMS

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

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 21

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

Yes

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

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	TUFTS MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 150.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

WWW.TUFTSMEDICALCENTER.ORG/FINANCIALASSISTANCE

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

WWW.TUFTSMEDICALCENTER.ORG/FINANCIALASSISTANCE

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

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	TUFTS MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (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) 2021

Page 7

Part VFacility Information (continued)

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

	TUFTS MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

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
TUFTS MEDICAL CENTER, INC.	PART V, SECTION B, LINE 5: TUFTS MEDICAL CENTER (TUFTS MC) HAS UPDATED ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO GUIDE ITS COMMUNITY PROGRAMMING FOR THE NEXT THREE YEARS FROM 2023 TO 2025. THE CHNA WAS CONDUCTED FROM JANUARY TO MARCH 2022, AND INVOLVED 14 FOCUS GROUPS WITH 128 COMMUNITY RESIDENTS TO UNDERSTAND COMMUNITY NEEDS, STRENGTHS, PRIORITY HEALTH ISSUES, AND RECOMMENDATIONS. IN ADDITION, 927 RESIDENTS COMPLETED SURVEYS TO SHED LIGHT ON THE HEALTH NEEDS OF THE COMMUNITY. TUFTS MC ALSO SOUGHT INPUT AND UPDATED COMMUNITY MEMBERS THROUGHOUT THE CHNA PROCESS, PRESENTING FINDINGS AND SEEKING ADDITIONAL INPUT FROM 13 COMMUNITY GROUPS BEFORE FINALIZING OUR CHNA PRIORITIES. THE FOCUS GROUPS WERE CONDUCTED WITH RESIDENTS AND COMMUNITY STAKEHOLDERS FROM YOUTH TO SENIORS, VETERANS, LEADERS FROM NON-PROFIT ORGANIZATIONS IN SOUTH BOSTON, AFRICAN-AMERICAN AND HISPANIC TEENS IN HIGH SCHOOL AND COLLEGE, WOMEN OF DIFFERENT RACE/ETHNICITY TRAINED AS MEDICAL TRANSLATORS, SPANISH-SPEAKING WOMEN 60+, PARENTS OF SCHOOL-AGED KIDS, ADULTS AND PARENTS LIVING IN CHINATOWN, VIETNAMESE-SPEAKING ADULTS AND PARENTS, AND CHINESE IMMIGRANTS.TUFTS MC'S PRIOR CHNA WAS CONDUCTED IN 2019, AND HAS GUIDED HEALTH AND SOCIAL PRIORITIES AND COMMUNITY PROGRAMS, ACTIVITIES, AND PARTNERSHIPS FOR 2020-2022. TUFTS MC ALSO PARTICIPATED IN A CITYWIDE CHNA PROCESS, CALLED THE BOSTON CHNA COLLABORATIVE, CONSISTING OF BOSTON HOSPITALS AND VARIOUS COMMUNITY STAKEHOLDERS. THE COLLABORATIVE CONDUCTED 12 FOCUS GROUPS AND 39 KEY INFORMANT INTERVIEWS WITH 12 SUB-POPULATIONS WITHIN BOSTON, INCLUDING FEMALE LOW-WAGE WORKERS, RESIDENTS WITH HOUSING INSECURITY, IMMIGRANT PARENTS OF CHILDREN, PARENTS WHO LIVE IN PUBLIC HOUSING IN DORCHESTER, AND CHINESE RESIDENTS LIVING IN CHINATOWN. TUFTS MC SUPPLEMENTED THIS PROCESS WITH ITS OWN FOCUS GROUPS AND KEY INFORMANT INTERVIEWS, ESPECIALLY TO COVER GAPS IN THE COLLABORATIVE PROCESS OVERSAMPLING CHINATOWN, THE SOUTH END, AND SOUTH BOSTON RESIDENTS.TUFTS MC COLLECTED ADDITIONAL PRIMARY DATA COLLECTION IN CHINATOWN, SOUTH BOSTON, AND THE SOUTH END TO ENSURE ITS CHNA ADEQUATELY REFLECTED ITS PRIORITY COMMUNITIES. THIS INCLUDED 7 INTERVIEWS WITH SOCIAL SERVICE ORGANIZATION LEADERS AND 3 FOCUS GROUPS WITH CHINATOWN COMMUNITY MEMBERS. WITH THE HELP OF OUR COMMUNITY PARTNERS, TUFTS MC ALSO COLLECTED 100 COMMUNITY HEALTH SURVEYS FROM CHINESE-SPEAKING RESIDENTS OF THE NEIGHBORHOOD.PRIMARY AND SECONDARY DATA GATHERED THROUGH THE CHNA PROCESS WERE PRESENTED TO TUFTS MC'S COMMUNITY ADVISORY COMMITTEES, COMPRISED OF RESIDENTS AND REPRESENTATIVES WHO LIVE, WORK, OR ARE SUBJECT MATTER EXPERTS IN OUR PARTNER COMMUNITIES. COMMITTEE MEMBERS HELPED TUFTS MC STAFF HONE IN ON COMMUNITY HEALTH PRIORITIES TO FOCUS OUR GRANT-BASED COMMUNITY BENEFITS EFFORTS ON FOR THE NEXT THREE YEARS. THESE WERE REVIEWED AND APPROVED BY TUFTS MC'S COMMUNITY BENEFITS COMMITTEE, COMPRISED OF DIVERSE MEMBERS WITH WIDE-RANGING EXPERTISE INCLUDING LAW, HISTORY, SOCIAL SERVICE PROGRAMS, MEDICINE, AND PUBLIC AND COMMUNITY HEALTH.TUFTS MC ALSO CONDUCTED AN ABBREVIATED CHNA IN EARLY 2020 TO DETERMINE THE EMERGENT NEEDS IN RESPONSE TO THE COVID-19 PANDEMIC, WHICH LED TO AN AMENDED IMPLEMENTATION STRATEGY THROUGH FY2022. SEVERAL DOZEN COMMUNITY-BASED ORGANIZATIONS AND KEY STAKEHOLDERS INFORMED THE COVID-EXACERBATED PRIORITIES TUFTS MC FOCUSED ON IN FY20 AND FY21; WE CONTINUED COVID FUNDING IN FY22, FOCUSING ON RECOVERY EFFORTS. TUFTS MC ALSO HAS SEVERAL COMMUNITY BENEFITS ADVISORY COMMITTEES (CBACS) WHO PROVIDE INPUT AND FEEDBACK THROUGHOUT THE YEAR.
TUFTS MEDICAL CENTER, INC.	PART V, SECTION B, LINE 11: TUFTS MC COMPLETED ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THIS PAST SUMMER, WHICH IDENTIFIED THREE MAJOR HEALTH NEEDS IN THE COMMUNITY: BEHAVIORAL HEALTH, FINANCIAL SECURITY AND MOBILITY, AND ACCESS TO CARE AND SERVICE. IN RESPONSE, TUFTS MC RELEASED A REQUEST FOR PROPOSALS TO ADDRESS THESE NEEDS AND WILL PARTNER WITH COMMUNITY-BASED ORGANIZATIONS TO IMPLEMENT PROGRAMMING TO IMPROVE COMMUNITY HEALTH AND WELLBEING. TUFTS MC CONTINUED ITS FINAL YEAR OF THE FOLLOWING PRIORITIES, IDENTIFIED IN ITS 2019 CHNA AND AN ABBREVIATED CHNA CONDUCTED IN THE SPRING OF 2020 IN RESPONSE TO IMMEDIATE IMPACTS OF THE COVID-19 PANDEMIC:BEHAVIORAL HEALTH (COMBINING MENTAL HEALTH, SUBSTANCE USE AND VIOLENCE DUE TO THEIR INTER-RELATEDNESS); TOBACCO AND NICOTINE CONTROL ALONG WITH THE HEALTH CONCERNS (LUNG CANCER, ASTHMA AND COPD); ACCESS TO CARE AND SOCIAL SERVICES; CHRONIC DISEASE MANAGEMENT; HOUSING; FOOD AND ECONOMIC INSECURITY; OTHER COVID-19 RELATED NEEDS.IN FY2022, ITS COVID RELIEF AND RECOVERY EFFORTS EMPHASIZED ECONOMIC AND FINANCIAL STABILITY AND MOBILITY WITHIN THE COMMUNITY. AS PART OF THIS EFFORT, AN ADDITIONAL ROUND OF FUNDING WAS AWARDED TO 22 COMMUNITY-BASED ORGANIZATIONS TO SUPPORT JOB TRAINING, WORKFORCE DEVELOPMENT, ESOL, HOUSING AND FINANCIAL LITERACY, AND FOOD INSECURITY INITIATIVES. IN FY22, THESE ORGANIZATIONS REACHED 4,073 BOSTON RESIDENTS, WITH 2,307 ATTENDING SKILL-BASED DEVELOPMENT TRAININGS, 1,305 INDIVIDUALS PARTICIPATING IN WORKFORCE DEVELOPMENT PROGRAMS, 1,188 INDIVIDUALS TAKING PART IN FINANCIAL LITERACY PROGRAMS, AND 696 INDIVIDUALS RECEIVING HOUSING COUNSELING.TUFTS MC RESPONDED QUICKLY TO THE COVID-19 PANDEMIC, PROVIDING ESSENTIAL CARE AND SERVICES TO THE COMMUNITY. IN FY22, THE ORGANIZATION PROVIDED TESTING TO APPROXIMATELY 46,000 RESIDENTS, HELPING TO IDENTIFY AND ISOLATE CASES OF COVID-19. ADDITIONALLY, TUFTS MC PLAYED A VITAL ROLE IN ADMINISTERING OVER 38,000 VACCINATIONS TO MEMBERS OF THE COMMUNITY, CONTRIBUTING TO THE OVERALL EFFORT TO MITIGATE THE SPREAD OF THE VIRUS. THROUGH ITS ASIAN HEALTH INITIATIVE (AHI), TUFTS MC CONTINUED TO ADDRESS THE REDUCTION AND PREVENTION OF TOBACCO AND NICOTINE USE, WHICH CONTRIBUTES TO THE LEADING CAUSES OF DEATH AMONG BOSTON'S CHINATOWN AND ASIAN COMMUNITY: HEART DISEASE AND LUNG CANCER. SCHOOL-AGED CHILDREN ALSO PRESENT WITH A HIGH PREVALENCE OF ASTHMA COMPARED TO OTHER AREAS OF BOSTON, WHICH CAN BE A RESULT OF SECOND-HAND SMOKE. THROUGH THE AHI INITIATIVE, FIVE COMMUNITY-BASED ORGANIZATIONS WHO WERE IN THEIR FINAL YEAR OF FUNDING PROVIDED EDUCATION, PREVENTION, AND SMOKING CESSATION SERVICES TO ENGLISH- AND CHINESE-SPEAKING COMMUNITY MEMBERS ACROSS A WIDE AGE SPECTRUM: PRE-SCHOOL STUDENTS TO SENIOR CITIZENS. IN FY 22, 1,126 COMMUNITY RESIDENTS WERE SERVED BY THE AHI. THE TUFTS MC 2019 CHNA IDENTIFIED BEHAVIORAL HEALTH AS A CONCERN ACROSS THE CITY OF BOSTON, WITH SOUTH BOSTON AND DORCHESTER OF PARTICULAR CONCERN. THIS THREE-YEAR FUNDING CYCLE FOCUSED ON PROMOTING BEHAVIORAL HEALTH AND THE SOCIAL-EMOTIONAL WELLNESS OF DORCHESTER COMMUNITY MEMBERS, PARTICULARLY YOUTH AND PARENTS OF YOUNG CHILDREN THAT WERE GREATLY IMPACTED THROUGH THE PANDEMIC. SIX COMMUNITY-BASED ORGANIZATIONS WERE SELECTED TO IMPLEMENT BEHAVIORAL HEALTH PROGRAMS. IN FY 22, 2,909 COMMUNITY MEMBERS WERE SERVED BY DHI. OF THESE INDIVIDUALS, 1,072 COMPLETED MENTAL HEALTH COUNSELING AND TREATMENT, 183 FATHERS RECEIVED TRAINING AND SUPPORT TO PROMOTE NURTURING AND POSITIVE CHILD DEVELOPMENT, AND 630 YOUTH RECEIVED EDUCATIONAL PROGRAMMING ON CONFLICT RESOLUTION AND VIOLENCE PREVENTION. IN SOUTH BOSTON, SUBSTANCE USE AROSE AS THE PRIMARY COMMUNITY HEALTH CONCERN. TUFTS MC PARTNERED WITH AND FUNDED THE SOUTH BOSTON COMMUNITY HEALTH CENTER TO IMPLEMENT THREE IMPACTFUL PROGRAMS THAT HAVE HELPED THE COMMUNITY. THE FIRST PROGRAM, OFFICE BASED ADDICTION TREATMENT, OFFERS A COMBINATION OF MEDICATION-ASSISTED TREATMENT AND COGNITIVE BEHAVIORAL THERAPY TO TREAT SUBSTANCE USE DISORDER. THIS APPROACH HAS RESULTED IN MANY SUCCESS STORIES, INCLUDING PATIENTS FINDING EMPLOYMENT AND PURCHASING THEIR FIRST CAR. THE SECOND PROGRAM, THE HEPATITIS C PROGRAM, OFFERS EDUCATION AND TREATMENT TO PREVENT ADVERSE HEALTH OUTCOMES FROM UNTREATED CHRONIC HEPATITIS C. THIS PROGRAM HAS EXPANDED SIGNIFICANTLY, IDENTIFYING PATIENTS THROUGH ROUTINE SCREENING AND OUTREACH. THE THIRD PROGRAM, THE YOUTH AMBASSADORS, IS A PRIMARY PREVENTION PROGRAM THAT EMPOWERS AT-RISK YOUTH TO RECOGNIZE THEMSELVES AS TEEN LEADERS/EDUCATORS, PROMOTING SUBSTANCE ABUSE PREVENTION, VIOLENCE PREVENTION, TEEN MENTAL HEALTH, AND GENDER EQUALITY ISSUES. THROUGH THESE PROGRAMS, THE SOUTH BOSTON HEALTH INITIATIVE SERVED 381 COMMUNITY MEMBERS IN FY 22.TUFTS MC RECOGNIZES THE IMPORTANCE OF FINANCIAL SECURITY AND MOBILITY TO OVERALL WELL-BEING. TO ADDRESS THIS, THE ORGANIZATION HAS SUPPORTED VARIOUS INITIATIVES AIMED AT PROVIDING JOB READINESS TRAINING, SOFT SKILLS DEVELOPMENT, AND CERTIFICATION PROGRAMS, AS WELL AS FINANCIAL LITERACY PROGRAMS COVERING BUDGETING, SAVING, AND INVESTING. IN FY22, 1,305 COMMUNITY RESIDENTS WERE EQUIPPED WITH VALUABLE WORKFORCE DEVELOPMENT SKILLS THROUGH TRAINING PROGRAMS, WHILE 44 DISADVANTAGED YOUTH GAINED HANDS-ON SKILLS AND JOB TRAINING THROUGH A YOUTH APPRENTICESHIP PROGRAM. TUFTS MC ALSO SUPPORTED THE GAVIN FOUNDATION, WHICH PROVIDED EMPLOYMENT ASSISTANCE TO CLIENTS WHO FACED UNEMPLOYMENT OR UNDER-EMPLOYMENT DUE TO ADDICTION OR COVID-19. ADDITIONALLY, TUFTS MC PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS TO PROVIDE FINANCIAL LITERACY PROGRAMS TO 1,188 COMMUNITY MEMBERS, HELPING THEM GAIN VALUABLE SKILLS AND KNOWLEDGE TO MANAGE THEIR FINANCES MORE EFFECTIVELY. THROUGH THESE EFFORTS, 56 COMMUNITY RESIDENTS WERE ABLE TO ACHIEVE FINANCIAL SUCCESS THROUGH CREDIT BUILDING, HOME OWNERSHIP, BUDGETING, AND BANKING. AT TUFTS MC, EMPOWERING YOUTH AND PROVIDING THEM WITH OPPORTUNITIES TO LEARN AND GROW IN THE HEALTHCARE FIELD IS A PRIORITY. DURING THE SUMMER OF 2022, 23 STUDENTS, 21 WITH BILINGUAL CAPACITY, INTERNED IN 13 DIFFERENT TUFTS MC DEPARTMENTS. THE PROGRAM HAS HAD A SIGNIFICANT IMPACT, WITH MOST STUDENTS ENTERING COLLEGE WITH A PLAN FOR A CAREER IN HEALTHCARE. AT THE JOSIAH QUINCY ELEMENTARY SCHOOL (JQES), TUFTS MC PROVIDED INTERACTIVE NUTRITION LESSONS THAT HAVE IMPROVED STUDENTS' KNOWLEDGE OF HEALTHY EATING HABITS AND HYGIENE. THE PROGRAM WAS LED BY DIETETIC INTERNS FROM THE STERN NUTRITION CENTER AND REACHED OVER 110 STUDENTS.THROUGH A PARTNERSHIP WITH THE ASIAN AMERICAN CIVIC ASSOCIATION (AACA), TUFTS MC SUPPORTED THEIR MULTI-SERVICE CENTER (MSC). THE MSC ADDRESSES THE NEEDS OF THE ASIAN IMMIGRANT POPULATION AND THE COMMUNITY AT LARGE FOR VARIOUS SOCIAL SERVICES. IN FY22, AACA PROVIDED SERVICES TO A TOTAL OF 2,215 PARTICIPANTS. AMONG THEM, 87 RECEIVED TAX COUNSELING/ASSISTANCE, 130 RECEIVED FUEL ASSISTANCE, 1,035 RECEIVED SNAP ASSISTANCE, 118 RECEIVED HOMELESSNESS PREVENTION ASSISTANCE, 194 RECEIVED HOUSING ASSISTANCE, 130 RECEIVED IMMIGRATION AND CITIZENSHIP COUNSELING, 139 RECEIVED TRANSLATION AND INTERPRETATION SERVICES, AND 382 RECEIVED OTHER SOCIAL SERVICE ASSISTANCE. ADDITIONALLY, 60 CLIENTS WERE REFERRED OUT TO OTHER ORGANIZATIONS. THE PROGRAM HAS BEEN ABLE TO HELP MANY FAMILIES AND INDIVIDUALS IN NEED, PROVIDING CRITICAL SUPPORT DURING THEIR MOST DIRE TIMES.TUFTS MC IS ALSO COMMITTED TO IMPROVING ACCESS TO CARE FOR VULNERABLE POPULATIONS, INCLUDING LINGUISTIC AND CULTURAL MINORITIES AND THE UNINSURED. TO ACHIEVE THIS GOAL, TUFTS MC PROVIDES VARIOUS PROGRAMS AND SERVICES, SUCH AS THE PATIENT NAVIGATION PROGRAM, WHICH SERVED 112 CHINESE-SPEAKING PATIENTS WITH CANCER AND/OR LOW SOCIOECONOMIC STATUS THROUGH 513 ENCOUNTERS, REDUCING CULTURAL AND LINGUISTIC BARRIERS TO QUALITY CANCER CARE. TUFTS MC ALSO HOSTS EVENTS, SUCH AS THE ANNUAL ASIAN HEALTH SYMPOSIUM, ATTENDED BY 77 HEALTHCARE PROFESSIONALS, RESEARCHERS, AND COMMUNITY MEMBERS, TO PROVIDE OPPORTUNITIES FOR DISCUSSING CRITICAL ISSUES AFFECTING VULNERABLE POPULATIONS. FINALLY, TUFTS MC EDUCATES THE COMMUNITY ON VARIOUS HEALTH TOPICS, INCLUDING SKIN CARE, MENTAL HEALTH AWARENESS, AND INTERVENTION STRATEGIES. FOR EXAMPLE, THE DERMATOLOGY DEPARTMENT EDUCATED 300 CHINATOWN RESIDENTS ABOUT SUNSCREEN AND SKIN CARE, WHILE THE PSYCHIATRY DEPARTMENT PROVIDED TRAINING AND RESOURCES ON MENTAL HEALTH AWARENESS AND INTERVENTION STRATEGIES TO TEACHERS, EQUIPPING THEM WITH THE KNOWLEDGE AND SKILLS TO SUPPORT THE MENTAL HEALTH AND WELL-BEING OF 36 STUDENTS.

Schedule H (Form 990) 2021

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address		Type of Facility (describe)
1	1 - NEW ENGLAND LONG-TERM CARE INC 78 BOSTON ROAD BILLERICA,MA01862	LONG-TERM ACUTE-CARE FACILITY
2
3
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5
6
7
8
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10

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 7:	COSTS ARE ALLOCATED TO PATIENT ENCOUNTERS BASED ON COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL INPATIENT AND OUTPATIENT ACTIVITY FOR ALL AREAS OF THE HOSPITAL INCLUDING ALL PAYER SOURCES. THE COSTS UTILIZED ARE BASED ON ACTUAL COSTS FROM THIS SYSTEM, ALLOCATED TO INDIVIDUAL PATIENT ENCOUNTERS.
PART II, COMMUNITY BUILDING ACTIVITIES:	PART II, LINE 2: ECONOMIC DEVELOPMENTTUFTS MC PROMOTES THE COMMUNITY'S ECONOMIC, SOCIAL EMOTIONAL AND SPIRITUAL WELLNESS AND COMMUNITY BUILDING THROUGH ITS FREE PARKING PROGRAM. BY REMOVING THE FINANCIAL BURDEN OF PARKING FEES, THE PROGRAM AIMS TO INCREASE FOOT TRAFFIC TO LOCAL BUSINESSES AND FOSTER ECONOMIC DEVELOPMENT. THIS, IN TURN, CREATES A MORE VIBRANT LOCAL ECONOMY, WHICH BENEFITS THE HEALTH OF THE COMMUNITY AS A WHOLE. ADDITIONALLY, THE PROGRAM ENCOURAGES SOCIAL INTERACTIONS, WHICH CAN CONTRIBUTE TO IMPROVED MENTAL HEALTH AND WELLBEING, AND FOSTER A GREATER SENSE OF COMMUNITY SPIRIT. THIS EFFORT IS A VITAL COMPONENT OF OUR HOSPITAL'S EFFORTS TO PROMOTE ECONOMIC DEVELOPMENT AND ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE. TUFTS MC'S COMMUNITY-BUILDING ACTIVITIES EXTEND BEYOND OUR FREE PARKING PROGRAM. AS PART OF OUR COVID-19 GRANTS, WE PARTNERED WITH LOCAL ORGANIZATIONS TO SUPPORT LOCAL BUSINESSES WHILE MEETING URGENT COMMUNITY NEEDS, SUCH AS ADDRESSING RISING FOOD INSECURITY. FOR EXAMPLE, ONE OF OUR GRANTEES HOSTED A COVID CARE PACKAGE DRIVE THAT PROVIDED 103 HOUSEHOLDS/FAMILIES IN NEED WITH PPE SUPPLIES AND GROCERY STORE GIFT CARDS TO HELP WITH COVID-RELATED COSTS. ADDITIONALLY, SOME OF OUR GRANTEES FOCUSED ON SUPPORTING SMALL BUSINESSES THROUGH TECHNICAL ASSISTANCE FOR MARKETING AND PROMOTION, AND WAYS TO STAY OPEN AND SAFE THROUGH THE PANDEMIC. IN SOME CASES, WE PROVIDED RENTAL ASSISTANCE TO SMALL BUSINESSES TO PREVENT CLOSURES DURING THIS DIFFICULT TIME. THESE INITIATIVES HELPED PROVIDE ESSENTIAL SERVICES AND FOOD TO THE COMMUNITY WHILE ALSO GIVING BUSINESS OWNERS SOME FINANCIAL SECURITY. BY INVESTING IN OUR COMMUNITY PARTNERS, WE FOSTERED ECONOMIC DEVELOPMENT, PROMOTED SOCIAL INTERACTIONS, AND ENHANCED THE OVERALL HEALTH AND WELLBEING OF THE COMMUNITIES WE SERVE.PART II, LINE 8: WORKFORCE DEVELOPMENTTUFTS MC IS COMMITTED TO PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH VARIOUS COMMUNITY-BUILDING ACTIVITIES. IN FY22, WE PROVIDED VALUABLE WORKFORCE DEVELOPMENT SKILLS TO 1,305 COMMUNITY MEMBERS THROUGH TRAINING PROGRAMS. WE PARTNERED WITH ORGANIZATIONS TO PROVIDE EMPLOYMENT ASSISTANCE TO CLIENTS WHO FACED UNEMPLOYMENT DUE TO ADDICTION, AND SUPPORTED MEN PREVIOUSLY INCARCERATED AND/OR IN RECOVERY TO FIND CORI-FRIENDLY EMPLOYMENT. WE ALSO PROVIDED JOB SKILLS TRAINING IN AREAS OF NEED, SUCH AS MEDICAL INTERPRETER TRAINING AND MECHANICAL SKILLS TRAINING TO DISADVANTAGED YOUTH. HIGHER PAY AND BETTER BENEFITS ARE DIRECTLY CORRELATED WITH IMPROVED HEALTH OUTCOMES, AND OUR INITIATIVE AIMED TO PROVIDE JOB SUPPORT AND JOB SKILLS TO POPULATIONS MOST IN NEED OR AT-RISK, ESPECIALLY DURING THE COVID-19 PANDEMIC.TUFTS MC ALSO HAS A LONG-ESTABLISHED PARTNERSHIP WITH THE ASIAN AMERICAN CIVIC ASSOCIATION. OVER THE DECADES, THE STRUCTURE OF THE CLASS HAS CHANGED, BUT IN FY 22, 15 EMPLOYEES PARTICIPATED IN THE PROGRAM, WHICH IS OPEN TO ALL TUFTS MC EMPLOYEES AT NO COST TO THEM. THE ESOL PROGRAM OFFERS BEGINNER AND ADVANCED CLASSES, WITH FLEXIBLE MINIMUM PARTICIPANT REQUIREMENTS DUE TO COVID-19. THE CLASSES ARE OFFERED BOTH DURING WORK HOURS AND ON EMPLOYEE'S OWN TIME AND REQUIRE COMMITMENT AND MANAGER SUPPORT. THE PROGRAMS HELP IMPROVE EMPLOYEE/MANAGER RELATIONS, PATIENT EXPERIENCE, AND A CAREER PIPELINE FOR ALL TUFTS MC EMPLOYEES, WHILE ALSO ADDRESSING LITERACY BARRIERS THAT COULD LEAD TO SAFETY CONCERNS AND EXCLUSION. ADDITIONALLY, TUFTS MC'S SUMMER INTERNSHIP PROGRAM FOR BOSTON HIGH SCHOOL STUDENTS OFFERS OPPORTUNITIES FOR STUDENTS TO EXPLORE CAREER OPPORTUNITIES IN A HEALTHCARE SETTING AND OFTEN PROVIDES THEM WITH THEIR FIRST PAID EMPLOYMENT EXPERIENCE. DESPITE THE COVID PANDEMIC, WE OFFERED A FULLY ON-SITE SEVEN-WEEK EXPERIENCE TO 23 YOUTH WITH WEEKLY WORKSHOPS ON TOPICS SUCH AS PUBLIC HEALTH, COLLEGE READINESS, AND DIVERSITY, EQUITY, AND INCLUSION. THE SUMMER INTERNSHIP PROGRAM PROVIDES VALUABLE SKILLS AND EXPERIENCE TO THE STUDENTS, AND INCREASES YOUTHS LIKELIHOOD OF SECURING BETTER-PAYING JOBS IN THE FUTURE, PROMOTING THEIR OVERALL HEALTH AND WELLBEING. OVERALL, OUR COMMUNITY-BUILDING INITIATIVES AIM TO EQUIP COMMUNITY MEMBERS WITH THE NECESSARY SKILLS AND SUPPORT TO ACHIEVE FINANCIAL STABILITY, WHICH IN TURN PROMOTES BETTER HEALTH OUTCOMES AND FOSTERS A HEALTHIER COMMUNITY.
PART III, LINE 2:	THE HOSPITAL RECORDS BAD DEBTS BASED ON CHARGES. THE BAD DEBT COSTS PROVIDED HEREIN ARE BASED ON THESE CHARGES MULTIPLIED BY THE HOSPITAL'S COST-TO-CHARGE RATIO OF 53.00%.
PART III, LINE 4:	THE FOLLOWING IS FROM THE WELLFORCE, INC. AND CONSOLIDATED AFFILIATES (THE SYSTEM) AUDITED FINANCIAL STATEMENTS, OF WHICH TUFTS MEDICAL CENTER, INC. IS INCLUDED, RELATING TO CHARITY CARE AND BAD DEBT EXPENSE:2022 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 $26,475K AND $12,518K, FOR THE YEAR ENDED SEPTEMBER 30, 2022 AND $43,544K AND $18,294K FOR THE YEAR ENDED SEPTEMBER 30, 2021, 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, 2022 AND 2021.THE SYSTEM HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2022. 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 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 CLINICS, HEALTH SCREENING PROGRAMS, HEALTH EDUCATION PROGRAMS 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.
PART III, LINE 8:	COSTS ARE ALLOCATED TO PATIENT ENCOUNTERS BASED ON COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL INPATIENT AND OUTPATIENT ACTIVITY FOR ALL AREAS OF THE HOSPITAL INCLUDING ALL PAYER SOURCES. THE COSTS UTILIZED ARE BASED ON ACTUAL COSTS FROM THIS SYSTEM, ALLOCATED TO INDIVIDUAL PATIENT ENCOUNTERS.
PART III, LINE 9B:	TUFTS MEDICAL CENTER'S FINANCIAL COORDINATION OFFICE IDENTIFIES AND ASSISTS THOSE PATIENTS THAT HAVE NO INSURANCE OR WHO ARE UNDERINSURED. WE WILL PROCESS ON-LINE APPLICATIONS FOR STATE PROGRAMS IN ACCORDANCE WITH THE ESTABLISHED MASS HEALTH GUIDELINES. THE GUIDELINES ARE BASED ON 200% OF THE FEDERAL POVERTY GUIDELINES.FINANCIAL ASSISTANCE IS ALSO EXTENDED TO OUT-OF-STATE/COUNTRY PATIENTS WITH NO INSURANCE IN ACCORDANCE WITH THE TUFTS MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. A NOTICE OF FINANCIAL ASSISTANCE IS LOCATED ON THE PATIENT BILL AND THE HOSPITAL WEB-SITE. IT IS ALSO POSTED IN VARIOUS STRATEGIC LOCATIONS THROUGHOUT THE HOSPITAL.THE FINANCIAL COORDINATION OFFICE IS OPEN MONDAY THRU FRIDAY FROM 8:00 A.M. TO 4:40 P.M. THE MAIN NUMBER FOR THE FINANCIAL COORDINATION OFFICE IS 617-636-6013.
PART VI, LINE 2:	TUFTS MC USES VARIOUS METHODS TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. AN IMPORTANT METHOD IS TO CONDUCT A CHNA, DONE SO EVERY THREE YEARS. THE MOST RECENT CHNA WAS CONDUCTED IN THE SPRING OF 2022, WHERE 927 COMMUNITY RESIDENTS PARTICIPATED IN A SURVEY TO UNDERSTAND THE COMMUNITY'S NEEDS, STRENGTHS, PRIORITY HEALTH ISSUES, AND RECOMMENDATIONS. THE CHNA PROCESS ALSO INCLUDED 14 FOCUS GROUPS WITH 128 COMMUNITY RESIDENTS AND INPUT FROM UPDATED COMMUNITY MEMBERS.TUFTS MC WORKS COLLABORATIVELY WITH COMMUNITY PARTNERS, INCLUDING NON-PROFIT ORGANIZATIONS, TO IDENTIFY AREAS OF NEED AND ADDRESS THEM EFFECTIVELY. IN ADDITION TO CONDUCTING A CHNA, TUFTS MC PARTICIPATES IN OTHER MEETINGS SUCH AS GRANTEE/CBAC MEETINGS AND OTHER COMMUNITY MEETINGS SUCH AS THE CHINATOWN COALITION, CHINATOWN NEIGHBORHOOD COUNCIL, AND THE SOUTH BOSTON ASSOCIATION OF NONPROFITS, AMONG OTHERS. THESE MEETINGS PROVIDE VALUABLE FEEDBACK AND INSIGHT INTO COMMUNITY NEEDS.FURTHERMORE, TUFTS MC REVIEWS DATA ON POPULATION HEALTH, EPIDEMIOLOGY, AND COMMUNITY HEALTH INDICATORS TO MONITOR TRENDS AND IDENTIFY EMERGING HEALTH CONCERNS DURING THE CHINA PROCESS. THE ORGANIZATION USES THIS DATA TO ENSURE THAT IT IS ADDRESSING THE MOST PRESSING HEALTH NEEDS OF THE COMMUNITY IN A COMPREHENSIVE AND EFFECTIVE MANNER.ONCE PRIORITY HEALTH NEEDS ARE IDENTIFIED, DATA ARE SUMMARIZED, REVIEWED, AND APPROVED BY TUFTS MC'S SENIOR LEADERSHIP AND ITS COMMUNITY BENEFITS GOVERNING BODY, TUFTS MC'S COMMUNITY BENEFITS COMMITTEE. THIS COLLABORATIVE APPROACH ENSURES THAT TUFTS MC IS ADDRESSING THE MOST PRESSING HEALTH NEEDS OF THE COMMUNITY IN A COMPREHENSIVE AND EFFECTIVE MANNER.THE HEALTH ISSUES IDENTIFIED AND PRIORITIZED IN THE 2019 CHNA AND IMPLEMENTATION STRATEGY SOUGHT TO ADDRESS THE HIGH INCIDENCE OF HEART DISEASE AND LUNG CANCER AMONG THE CHINATOWN AND BOSTON ASIAN COMMUNITY, FOCUSING ON SMOKING AND ITS HARMFUL EFFECTS; BEHAVIORAL HEALTH IN DORCHESTER; ACCESS TO SERVICES IN THE SOUTH END AND QUINCY; AND SUBSTANCE USE AND CHRONIC DISEASES IN SOUTH BOSTON. THE IDENTIFIED HEALTH ISSUES GUIDED THE ALLOCATION OF RESOURCES FOR BOTH COMMUNITY-BASED AND HOSPITAL-BASED RESPONSES. TUFTS MC DEVELOPED PROGRAMS TO ADDRESS THESE ISSUES AND ALLOCATED RESOURCES TO RESPOND TO THEM EFFECTIVELY, SUCH AS PROVIDING SMOKING CESSATION PROGRAMS, INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICES, AND OFFERING EDUCATIONAL PROGRAMS ON CHRONIC DISEASE MANAGEMENT.TUFTS MC ALSO CONDUCTED A CHNA IN 2020 TO IDENTIFY COMMUNITY NEEDS IN SEVERAL AREAS DUE TO COVID-19. THE IDENTIFIED THEMES WERE JOB SECURITY, BEHAVIORAL HEALTH, FOOD INSECURITY, AND TRANSITION/RE-OPENING SUPPORT. TUFTS MC PROVIDED GRANTS FOR COVID-19 RELATED ACTIVITIES AND SUMMER INTERNSHIPS FOR LOCAL YOUTH. THE GRANTS ALSO SUPPORTED LOCAL BUSINESSES AND PROVIDED JOB TRAINING FOR THOSE IN NEED, INCLUDING IMMIGRANTS AND NON-ENGLISH SPEAKING RESIDENTS.
PART VI, LINE 3:	PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE AND FINANCIAL COORDINATION RESOURCES OFFERED BY THE HOSPITAL THROUGH SEVERAL DIFFERENT MEDIUMS AND AT SEVERAL DIFFERENT POINTS IN THEIR EXPERIENCE WITH THE HOSPITAL. PATIENTS ARE PROVIDED AN OPPORTUNITY TO HAVE AN IN PERSON DISCUSSION WITH A FINANCIAL COORDINATOR ABOUT INSURANCE COVERAGE AND FINANCIAL HARDSHIP DURING THE INITIAL REGISTRATION PROCESS. IF A PATIENT EXPRESSES THE NEED FOR INSURANCE OR FINANCIAL ASSISTANCE A FINANCIAL COORDINATOR WILL WORK WITH THEM TO APPLY FOR ANY AVAILABLE AND APPROPRIATE SERVICES. SHOULD A PATIENT QUALIFY FOR MEDICARE OR MEDICAID ASSISTANCE OF ANY FORM, E.G. COMMONWEALTH CARE, THE COUNSELOR OR FINANCIAL COORDINATOR WILL ALSO ASSIST THE PATIENT IN APPLYING FOR ANY OTHER SOCIAL SERVICES THEY MAY FIND HELPFUL, SUCH AS FOOD AND NUTRITION SERVICES. PATIENTS ARE NOTIFIED OF THEIR RIGHTS AND AVAILABLE FINANCIAL RESOURCES THROUGH A VARIETY OF OTHER MEASURES AS WELL, INCLUDING INFORMATION ON SEVERAL DIFFERENT PAGES AND LANDING POINTS ON THE TUFTS MEDICAL CENTER AND FLOATING HOSPITAL FOR CHILDREN WEBSITE, IN WRITTEN INFORMATION PROVIDED AT DISCHARGE, ON ANY BILLING STATEMENTS THEY RECEIVE AND IN POSTINGS THROUGHOUT THE HOSPITAL IN ALL WAITING AREAS AND CLINICS.
PART VI, LINE 4:	LOCATED IN THE HEART OF THE CHINATOWN COMMUNITY, TUFTS MC IS COMMITTED TO RESPONDING TO THE SPECIFIC NEEDS OF THE COMMUNITY, MANY OF WHOM ARE NEW IMMIGRANTS IN NEED OF CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES TO HELP THEM NAVIGATE HEALTH CARE FOR THEMSELVES AND THEIR FAMILIES. TUFTS MC'S STRONG COMMITMENT TO THE ADJACENT NEIGHBORHOODS OF DORCHESTER, SOUTH BOSTON AND THE SOUTH END REFLECTS THE HISTORY OF THE FOUNDING OF THE BOSTON DISPENSARY TO PROVIDE QUALITY HEALTHCARE TO BOSTON'S WORKING AND LOW-INCOME FAMILIES.TUFTS MC HAS BEEN IN ITS CURRENT LOCATION SINCE ITS INCEPTION AS THE BOSTON DISPENSARY IN 1796. THE NEIGHBORHOOD, ORIGINALLY KNOWN AS THE SOUTH COVE, IS NOW RECOGNIZED AS BOSTON'S CHINATOWN NEIGHBORHOOD DUE TO THE GROWTH OF THE CHINESE AMERICAN COMMUNITY, WHO FIRST MOVED INTO THE NEIGHBORHOOD IN THE 1870S AND GREW IN NUMBERS AFTER THE LIFTING OF IMMIGRATION RESTRICTIONS ALLOWED FOR FAMILY REUNIFICATION IN THE 1960S AND HAS CONTINUED WITH ONGOING IMMIGRATION. TUFTS MC HAS BEEN AN INTEGRAL MEMBER OF THE COMMUNITY FOR GENERATIONS.SERVICE POPULATIONS:TUFTS MC'S PATIENT POPULATION IS DIVERSE AND REFLECTS THE DEMOGRAPHICS OF THE BOSTON AND GREATER BOSTON COMMUNITY FOR WHICH IT SERVES AS AN ACADEMIC AND TERTIARY/QUATERNARY HOSPITAL. APPROXIMATELY 60% OF THE PATIENT POPULATION IS WHITE, 10% BLACK/AFRICAN AMERICAN, 15% ASIAN AND 6% LATINX. TWENTY-FIVE PERCENT OF THE PATIENT POPULATION QUALIFY FOR MEDICAID, AND 25% OF PATIENTS ARE COVERED BY MEDICARE. APPROXIMATELY 24,500 PATIENTS REQUEST INTERPRETER SERVICES EACH YEAR AND RECEIVE ASSISTANCE IN CHINESE, VIETNAMESE, SPANISH, HAITIAN CREOLE, RUSSIAN, PORTUGUESE AND MANY OTHER LANGUAGES. PRIMARY SERVICE AREA COMMUNITIES: PLEASE NOTE THAT THE BOSTON PUBLIC HEALTH COMMISSION'S HEALTH OF BOSTON REPORT HAS NOT BEEN UPDATED SINCE 2017.BOSTON'S CHINATOWN IS THE SMALLEST OF THE CITY'S NEIGHBORHOODS. IT IS LOCATED IN DOWNTOWN BOSTON NEAR MAJOR TRANSPORTATION NODES AND THE CITY'S DOWNTOWN RETAIL, THEATER, HISTORIC AND FINANCIAL DISTRICTS. ITS 76 ACRES INCLUDE A ROBUST RESIDENTIAL, CULTURAL, ECONOMIC, AND SERVICE HUB FOR BOSTON'S CHINESE AND ASIAN COMMUNITY. THE 2017 AMERICAN COMMUNITY SURVEY (ACS) ESTIMATED THAT OVER 7,400 PEOPLE LIVED IN THE NEIGHBORHOOD, ONE OF THE MOST DENSELY POPULATED IN THE CITY OF BOSTON. THERE IS A DEARTH OF OPEN SPACE IN CHINATOWN, THOUGH THE BOSTON COMMON, PUBLIC GARDEN AND OTHER OPEN AND GREEN SPACE ARE IN CLOSE PROXIMITY.HISTORICALLY, BOSTON CHINATOWN HAS PLAYED AN IMPORTANT ROLE IN ECONOMIC, SOCIAL AND CULTURAL SUPPORT FOR ARRIVING IMMIGRANTS IN WHICH THEY CONTINUE TO LIVE, WORK, SHOP, FIND SERVICES, AND MAINTAIN SOCIAL CONNECTIONS. ACCORDING TO AMERICAN COMMUNITY SURVEY 2020 DATA, COMPARED TO OTHER COMMUNITIES IN TUFTS MC'S SERVICE AREA AND BOSTON AS A WHOLE, CHINATOWN HAS HIGHER PERCENTAGES OF RESIDENTS THAT IDENTIFY AS ASIAN OR PACIFIC ISLANDER (60%), ARE FOREIGN BORN (49%) AND SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME (59%). CHINATOWN ALSO HAS A LARGER PERCENTAGE OF OLDER ADULTS 65+ (18%) THAN TUFTS MC'S OTHER PRIORITY COMMUNITIES AS A WHOLE. ALTHOUGH THE MAJORITY OF CHINATOWN RESIDENTS HAVE BACHELOR'S DEGREES OR HIGHER (59%), ABOUT ONE IN FIVE DID NOT GRADUATE FROM HIGH SCHOOL.THE HEALTH PROFILE OF CHINATOWN, BASED ON TUFTS MC 2022 COMMUNITY SURVEY RESPONSES AND FOCUS GROUP INTERVIEWS, REVEALS SEVERAL KEY HEALTH CONCERNS AND CHALLENGES FACING THE COMMUNITY. THE TOP THREE HEALTH CONCERNS IDENTIFIED BY RESIDENTS WERE COVID-19, MENTAL HEALTH/DEPRESSION, AND ACCESS TO SPECIALTY CARE. ENVIRONMENTAL HEALTH, HOUSING STABILITY, AND EDUCATION WERE THE TOP SOCIAL ISSUES OF CONCERN, WHILE DISCRIMINATION BASED ON RACE, IMMIGRATION STATUS, AND CLASS/INCOME WERE THE TOP SAFETY ISSUES IDENTIFIED. FINANCIAL SECURITY WAS ALSO A KEY CONCERN, WITH GENTRIFICATION, HIGH HOUSING COSTS, AND ANTI-ASIAN DISCRIMINATION IN HOUSING PRACTICES MENTIONED AS BARRIERS TO ECONOMIC WELL-BEING.SEVERAL PREVALENT HEALTH CONDITIONS WERE MENTIONED, INCLUDING ASTHMA, CANCER, DIABETES, OSTEOPOROSIS/ARTHRITIS, DEMENTIA, HIGH BLOOD PRESSURE, AND CHOLESTEROL. POLLUTION AND HIGH RATES OF SMOKING (BOTH TOBACCO AND MARIJUANA) WERE IDENTIFIED AS EXACERBATING THESE HEALTH CONCERNS. LANGUAGE BARRIERS AND HIGH OUT-OF-POCKET COSTS WERE CITED AS BARRIERS TO ACCESSING HEALTHCARE, WITH BETTER ACCESS TO HEALTHCARE IDENTIFIED AS A TOP PRIORITY FOR 36% OF SURVEY RESPONDENTS. YOUNG PEOPLE ALSO EXPRESSED CONCERNS AROUND DEPRESSION, ANXIETY, AND SLEEP ISSUES, WHILE THE COVID-19 PANDEMIC WORSENED MENTAL HEALTH CONCERNS AND LED TO STRESS, ANXIETY, AND DEPRESSION FOR RESIDENTS OF ALL AGES.DORCHESTER IS THE LARGEST NEIGHBORHOOD IN BOSTON AND REFLECTS THE CITY'S ECONOMIC, LINGUISTIC, RACIAL, ETHNIC, AND CULTURAL DIVERSITY WITH A POPULATION OF OVER 140,000 RESIDENTS, APPROXIMATELY 20% OF BOSTON'S TOTAL POPULATION. AMERICAN COMMUNITY SURVEY DATA FOR 2020 INDICATE THAT 24.5% OF RESIDENTS WERE 19 YEARS OR YOUNGER AND 12% WERE SENIORS AGED 65 AND OLDER. 35-64 YEAR-OLDS MAKE UP THE LARGEST PERCENTAGE (36%) OR DORCHESTER RESIDENTS. DORCHESTER IS A RACIALLY DIVERSE NEIGHBORHOOD OVERALL, WITH BLACK/AFRICAN AMERICANS MAKING UP THE LARGEST PERCENTAGE OF THE POPULATION. 22.4 PERCENT OF THE POPULATION WAS WHITE, 35% BLACK/AFRICAN AMERICAN, 10.9% ASIAN, 20.7% LATINX, AND 11.0% OTHER. ABOUT ONE-THIRD OF RESIDENTS IN DORCHESTER ARE FOREIGN BORN AND 41% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, BOTH SLIGHTLY HIGHER THAN THE CITY OF BOSTON AS A WHOLE. DORCHESTER HAS ABOUT EQUAL PERCENTAGES OF HIGH SCHOOL GRADUATES (29%) AND THOSE WITH BACHELOR'S DEGREES OR HIGHER (30%). BPHC'S 2017 HEALTH OF BOSTON REPORT INDICATED THAT DORCHESTER CONTINUED TO HAVE A HIGH INCIDENCE OF VIOLENCE-RELATED INJURIES AND HIGH RATES OF HOMICIDE COMPARED TO THE CITY AS A WHOLE. THE RATE OF ASTHMA-RELATED HOSPITALIZATION AMONG CHILDREN AGES 5-17, AS WELL AS THE PREVALENCE OF OBESITY AND OF MANY CHRONIC DISEASES AMONG ADULTS, WERE ALSO ABOVE CITY AVERAGES, AS WERE RATES OF MORTALITY ATTRIBUTED TO SUBSTANCE MISUSE, INCLUDING OPIOIDS. THE HEALTH PROFILE OF DORCHESTER, BASED ON TUFTS MC 2022 COMMUNITY SURVEY RESPONSES, INDICATES THAT THE TOP HEALTH CONCERNS ARE MENTAL HEALTH/DEPRESSION, COVID-19, AND ACCESS TO SPECIALTY CARE. THE TOP SOCIAL ISSUES ARE HOUSING STABILITY, DOMESTIC/INTERPERSONAL VIOLENCE, AND EDUCATION, WHILE THE TOP SAFETY ISSUES ARE DRUG TRAFFICKING, DISCRIMINATION BASED ON RACE, AND DISCRIMINATION BASED ON CLASS/INCOME. PARTICIPANTS FELT THAT THE PANDEMIC EXACERBATED EXISTING SOCIAL NEEDS AND GAPS AS WELL AS HEALTH CONCERNS. MENTAL HEALTH WAS THE TOP COMMUNITY HEALTH CONCERN, WITH YOUTH AND ADULT PARTICIPANTS FEELING THAT THERE ARE NOT ENOUGH CLINICIANS TO FILL THE NEED FOR MENTAL HEALTH SERVICES. OTHER HEALTH CONCERNS INCLUDE OBESITY, DIABETES, HEART DISEASE, LATE DIAGNOSED CANCER, AND BLACK MATERNAL HEALTH. FINANCIAL INSECURITY IS THE PRIMARY SOCIAL CONCERN, WHICH IMPACTS OTHER SOCIAL DETERMINANTS OF HEALTH SUCH AS HOUSING AND FOOD INSECURITY. HOUSING AFFORDABILITY AND GENTRIFICATION HAVE BECOME A GROWING CONCERN, AND ACCESS TO JOBS AND JOB TRAINING HAS RISEN AS A PRIORITY NEED. MOREOVER, THE COMMUNITY FACES SAFETY CONCERNS AS WELL. DORCHESTER RESIDENTS REPORTED FEELING UNSAFE IN THEIR NEIGHBORHOOD AT A RATE 10 PERCENTAGE POINTS ABOVE THE 14% CITY AVERAGE IN SOUTH DORCHESTER (24%), AND 20 POINTS ABOVE THE AVERAGE IN NORTH DORCHESTER (34%) ACCORDING TO THE BOSTON BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM. THESE SAFETY CONCERNS CAN EXACERBATE THE ALREADY PRESENT HEALTH ISSUES AND CREATE ADDITIONAL STRESS AND ANXIETY FOR RESIDENTS. SOUTH BOSTON IS A NEIGHBORHOOD OF APPROXIMATELY 37,000 RESIDENTS THAT CONTINUES TO UNDERGO CHANGES. HISTORICALLY CONSIDERED A WORKING-CLASS COMMUNITY WITH A SIGNIFICANT NUMBER OF PUBLIC HOUSING DEVELOPMENTS, LONG-TIME RESIDENTS ARE NOW EXPERIENCING INCREASING RENTS AND/OR DISPLACEMENT, ALONG WITH AN INFLUX OF NEWER RESIDENTS, RESULTING FROM A SHARP INCREASE IN NEW CONSTRUCTION AND HOUSING DEVELOPMENT IN THE AREA.DATA FROM THE CENSUS BUREAU SHOW A 26% INCREASE IN THE POPULATION BETWEEN 2000 AND 2017. DURING THIS PERIOD, THE NUMBER OF CHILDREN UNDER AGE 18 AND SENIORS OVER AGE 65 (AND THE PROPORTION OF THE POPULATION THEY MADE UP) DROPPED; THUS, THE RISE IN POPULATION IS ATTRIBUTED LARGELY TO WORKING-AGE ADULTS. ACCORDING TO 2020 AMERICAN CENSUS DATA, COMPARED TO TUFTS MC'S OTHER PRIORITY NEIGHBORHOODS AS A WHOLE, SOUTH BOSTON HAS A MUCH LARGER PERCENTAGE OF WHITE NON-HISPANIC RESIDENTS (77%), AND MUCH SMALLER PERCENTAGES OF FOREIGN-BORN RESIDENTS (13%) AND RESIDENTS WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME (18%). SOUTH BOSTON HAS A BIGGER YOUNG ADULT POPULATION THAN TUFTS MC'S OTHER PRIORITY COMMUNITIES OR BOSTON AS A WHOLE, WITH 20-34-YEAR OLDS MAKING UP 44% OF THE POPULATION. IT ALSO HAS A SMALLER POPULATION OR CHILDREN AND TEENS, WITH ONLY 13% UNDER 20 YEARS. NEARLY THREE QUARTERS (71%) OF SOUTH BOSTON RESIDENTS HAVE BACHELOR'S DEGREES OR HIGHER.
PART VI, LINE 5:	IN ADDITION TO PROVIDING FINANCIAL RESOURCES TO COMMUNITY-BASED HEALTH AND SERVICE ORGANIZATIONS THAT ADDRESS HEALTH ISSUES SPECIFIC TO THEIR CONSTITUENTS, TUFTS MC ADVANCES ITS COMMITMENT TO THE HEALTH OF ITS PATIENT AND PRIORITY COMMUNITIES THROUGH A NUMBER OF HOSPITAL-LED EFFORTS. THESE INCLUDE CLINICS ESTABLISHED TO MEET THE NEEDS OF NON-NATIVE ENGLISH SPEAKERS; SCHOOL-BASED CURRICULA THAT HELP STUDENTS LEARN ABOUT SMOKING, ASTHMA, DENTAL HEALTH, NUTRITION, SEXUAL HEALTH, SUBSTANCE USE, AND STRESS MANAGEMENT; SCREENINGS AND WORKSHOPS FOR POPULATIONS WITH CRITICAL HEALTH DISPARITIES; ASSISTING ELIGIBLE PATIENTS WITH SECURING FINANCIAL AND SOCIAL BENEFITS SUCH AS PUBLIC HEALTH INSURANCE; AND A COLLABORATION WITH THE BOSTON CHNA-CHIP COLLABORATIVE TO DEEPEN AND EXPAND THE IMPACT OF MEMBER INSTITUTIONS' COMMUNITY BENEFITS ACTIVITIES. TUFTS MC ALSO PARTICIPATES IN COMMUNITY COALITIONS THAT WORK TO PRESERVE COMMUNITY ASSETS AND ADVANCE THE PHYSICAL, ECONOMIC, SOCIAL, AND CULTURAL HEALTH OF THE COMMUNITY. EXAMPLES OF THIS INCLUDE TUFTS MC'S ROLE IN PUBLIC SAFETY INITIATIVES, PROVIDING PARKING FOR FAITH-BASED INSTITUTIONS' CONGREGATION MEMBERS AND WEEKEND PARKING FOR LOCAL SMALL BUSINESS OWNERS' CUSTOMERS, AND VARIOUS WORKFORCE DEVELOPMENT ACTIVITIES TO HELP PREPARE AND/OR RECRUIT COMMUNITY MEMBERS FOR TUFTS MC EMPLOYMENT AND BEYOND.IN RESPONSE TO THE COVID-19 PANDEMIC, TUFTS MC PIVOTED IN ITS INTERNAL AND EXTERNAL PROGRAM FUNDING TO PROVIDE SUPPORT FOR WORKFORCE DEVELOPMENT, FOOD INSECURITY AND OTHER COVID RELATED NEEDS. THEY WERE ABLE TO PIVOT AND LEVERAGE TECHNOLOGY TO SUPPORT THE COMMUNITY AND INCREASE ACCESS TO UNDER-SERVED POPULATIONS.
PART VI, LINE 6:	COMMUNITY HOSPITAL PARTNERSHIPSTUFTS MEDICAL CENTER HAS A RICH HISTORY OF PROVIDING MEDICAL CARE TO THE BOSTON COMMUNITY SINCE ITS FOUNDING. IN 2009 TUFTS MEDICAL CENTER LAUNCHED ITS DISTRIBUTED ACADEMIC MEDICAL CENTER MODEL, WHICH PARTNERS WITH COMMUNITY HOSPITALS TO KEEP MORE CARE LOCALLY IN THE COMMUNITY. TUFTS MEDICAL CENTER IS PROUD TO PARTNER WITH EXCELLENT COMMUNITY HOSPITALS TO DELIVER THE HIGHEST QUALITY CARE IN THE MOST CONVENIENT MANNER FOR PATIENTS. WE STRONGLY BELIEVE THAT WHEN ACADEMIC MEDICAL CENTERS AND COMMUNITY HOSPITALS WORK SIDE-BY-SIDE, THE PATIENT AND THE HEALTH CARE SYSTEM BENEFIT. THROUGH OUR DISTRIBUTED ACADEMIC MEDICAL CENTER MODEL, WE BRING TUFTS MEDICAL CENTER PHYSICIANS TO THE COMMUNITY - SAVING PATIENTS THE DRIVE INTO DOWNTOWN BOSTON AND TAKING ADVANTAGE OF THE EXCELLENT HOSPITALS IN THE CITIES AND TOWNS SURROUNDING BOSTON. WE ALSO CONSULT CLOSELY WITH OUR TALENTED PHYSICIAN COLLEAGUES WHO ARE PROVIDING OUTSTANDING SERVICES IN THE COMMUNITY ALREADY. AND WHEN EXCEPTIONALLY COMPLEX CARE IS NEEDED, THESE PARTNERSHIPS MEAN THE TRANSFER TO BOSTON IS WELL COORDINATED BETWEEN PHYSICIANS AND COMFORTABLE FOR THE PATIENT AND FAMILY MEMBERS.THROUGH PARTNERSHIPS WITH OTHER AREA HOSPITALS AND MEDICAL CENTERS, DOCTORS FROM TUFTS MC STAFF VARIOUS COMMUNITY MEDICAL FACILITIES. THIS ALLOWS MORE PATIENTS TO RECEIVE TOP-QUALITY CARE IN A LOCATION CLOSE TO HOME. TUFTS MC SPECIALISTS SEE PATIENTS AND PERFORM SOME TREATMENTS AND PROCEDURES LOCALLY. WHEN HIGH-LEVEL ADVANCED CARE IS NEEDED, TUFTS MC DOCTORS WORK WITH THE COMMUNITY PHYSICIANS TO ENSURE A SMOOTH PATIENT TRANSITION TO TUFTS MEDICAL CENTER IN BOSTON.TUFTS MEDICAL CENTER MAKES AN EXCELLENT CLINICAL PARTNERS FOR TWO MAIN REASONS. FIRST, WE WORK WITH OUR PARTNER HOSPITALS TO KEEP MOST MEDICAL CARE LOCAL. THIS IS THE MOST CONVENIENT OPTION FOR PATIENTS AND THE MOST COST-EFFECTIVE OPTION FOR BOTH PATIENTS AND PROVIDERS. SECOND, TUFTS MEDICAL CENTER PROVIDES HIGH-QUALITY CARE AT REASONABLE COSTS. IN FACT, A REPORT BY THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE SAID THAT WE ARE THE MOST AFFORDABLE ADVANCED CARE OPTION IN BOSTON.PATIENTS MAY EXPERIENCE OUR AFFILIATION WITH COMMUNITY HOSPITALS IN ANY NUMBER OF WAYS, SUCH AS:- A PEDIATRIC HOSPITALIST CARING FOR A SICK CHILD ON THE PEDIATRIC UNIT OF A COMMUNITY HOSPITAL- A CARDIOLOGIST PERFORMING CARDIAC CATHETERIZATIONS IN THE COMMUNITY- OUR EXPERT WEIGHT AND WELLNESS CENTER TEAM PROVIDING SUPPORT AND SURGERIES IN THE COMMUNITY - OUR TRAUMA TEAM PREPARING FOR AN URGENT TRANSFER FROM A COMMUNITY HOSPITAL- OUR NEUROLOGY TEAM PROVIDING A CONSULT ON A STROKE PATIENT IN A COMMUNITY EMERGENCY DEPARTMENT- CARDIOLOGY EXPERTS FROM THROUGHOUT THE REGION MEETING TO DISCUSS BEST PRACTICE FOR TREATING HEART FAILURE PATIENTS- COORDINATED CARE PROTOCOLS BETWEEN INSTITUTIONS AND CARE SETTINGSADULT AFFILIATE HOSPITALSMETROWEST MEDICAL CENTER (FRAMINGHAM, MA)PEDIATRIC AFFILIATE HOSPITALSLAWRENCE GENERAL HOSPITAL (LAWRENCE, MA)LOWELL GENERAL HOSPITAL (LOWELL, MA)METROWEST MEDICAL CENTER (FRAMINGHAM, MA)SIGNATURE HEALTHCARE BROCKTON HOSPITAL (BROCKTON, MA)
PART VI, LINE 7, REPORTS FILED WITH STATES	MA
PART VI, LINE 4, COMMUNITY INFORMATION (CONTINUED)	THE TUFTS MC 2022 COMMUNITY SURVEY FOUND THAT COVID-19, MENTAL HEALTH/DEPRESSION, AND SUBSTANCE USE WERE THE TOP HEALTH CONCERNS FOR SOUTH BOSTON RESIDENTS, WITH SUBSTANCE USE BEING UNIQUE TO THIS NEIGHBORHOOD. THE TOP SOCIAL ISSUES WERE CRIME, EDUCATION, AND EMPLOYMENT, AND THE TOP SAFETY CONCERNS WERE DRUG TRAFFICKING, DISCRIMINATION BASED ON CLASS/INCOME, AND VANDALISM. THE COVID-19 PANDEMIC LED TO A SIGNIFICANT INCREASE IN BEHAVIORAL HEALTH ISSUES, PARTICULARLY IN MENTAL HEALTH CRISES, SUBSTANCE USE, AND ADDICTION. OTHER HEALTH ISSUES WORSENED BY THE PANDEMIC INCLUDED OBESITY, DIABETES, AND CANCER, AND HEALTHCARE ACCESS WAS ALSO IDENTIFIED AS AN ISSUE. FINANCIAL SECURITY WAS A PRIORITY, WITH GENTRIFICATION AFFECTING HOUSING AND JOBS, AND ECONOMIC WELL-BEING WAS IDENTIFIED AS THE TOP SOCIAL ISSUE. ACCORDING TO THE BOSTON BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM SURVEY, SOUTH BOSTON RESIDENTS REPORTED FEELING PERSISTENT ANXIETY AND SADNESS AT RATES SIMILAR TO THE CITYWIDE AVERAGE, AND WERE SLIGHTLY MORE FINANCIALLY SECURE THAN BOSTON RESIDENTS ON AVERAGE. TRANSPORTATION DIFFICULTIES WERE SLIGHTLY HIGHER, BUT SOUTH BOSTON HAD THE SECOND-HIGHEST INSURANCE RATE OF ALL NEIGHBORHOODS IN BOSTON. THE SOUTH END IS IMMEDIATELY SOUTH OF TUFTS MC, ADJACENT TO CHINATOWN. IT IS A NEIGHBORHOOD KNOWN FOR ITS LARGE VICTORIAN ROW HOUSES DISTRICT BUILT BY MIDDLE CLASS RESIDENTS OF ENGLISH ANCESTRY IN THE 1850S. THE NEIGHBORHOOD'S DEMOGRAPHICS BEGAN TO CHANGE IN THE 1880S WHEN THE ORIGINAL RESIDENTS BEGAN TO BE REPLACED BY MIDDLE CLASS AFRICAN AMERICANS, IRISH, JEWISH, GREEK, PUERTO RICAN, AND CHINESE IMMIGRANTS. IN THE 1960S, THE SOUTH END WAS CONSIDERED ONE OF THE POOREST NEIGHBORHOODS IN THE CITY OF BOSTON. ITS RENAISSANCE BEGAN IN THE MID-1970S WHEN INDIVIDUALS BEGAN TO BUY AND RESTORE VICTORIAN ROW HOUSES, AND NON-PROFITS PURCHASED AND REHABILITATED HOUSES AS AFFORDABLE RENTALS FOR FAMILIES. THERE WAS ALSO NEW CONSTRUCTION FOCUSED ON MEETING THE NEEDS OF VERY LOW-INCOME FAMILIES AND SENIORS.CURRENTLY, THE SOUTH END AND SOUTH BOSTON ARE EXAMPLES OF BOSTON'S ROBUST ECONOMY AND BUILDING BOOM, AND NEW RESIDENTIAL DEVELOPMENTS ARE BEING CONSTRUCTED ON PARCELS WHICH WERE ONCE DESIGNATED FOR LIGHT INDUSTRIAL USE.THE LINE BETWEEN THE SOUTH END AND CHINATOWN IS NOT FIXED, AND THERE IS A SIZABLE POPULATION OF CHINESE FAMILIES LIVING IN WHAT IS TRADITIONALLY CONSIDERED THE SOUTH END. ACCORDING TO THE 2017 ACS, THE SOUTH END HAD A POPULATION OF APPROXIMATELY 27,000 RESIDENTS. ACCORDING TO BPDA 2020 US CENSUS DATA, THE MAJOR RACIAL/ETHNIC GROUPS WERE: WHITE NON-HISPANIC (56.6%), ASIAN (15.9%, LATINX (12.9%), BLACK/AFRICAN AMERICAN (10.1%), AND OTHER (4.5%). ABOUT A QUARTER ARE FOREIGN-BORN (27%) AND 40% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, WHICH IS SIMILAR TO BOSTON AS A WHOLE. LIKE SOUTH BOSTON, THE SOUTH END HAS SMALLER PERCENTAGES OF YOUTH AND TEENS THAN THE CITY OF BOSTON AS A WHOLE, WITH 15% OR RESIDENTS UNDER 20 YEARS OLD. SLIGHTLY OVER HALF OF SOUTH END RESIDENTS (56%) HAVE BACHELOR'S DEGREES OR HIGHER. OVER THE EDUCATIONAL ATTAINMENT OF SOUTH END ROUGHLY MIRRORS THE CITY OF BOSTON AS A WHOLE. THE TUFTS MC 2022 COMMUNITY SURVEY AND SECONDARY DATA INDICATE THAT RESIDENTS OF THE SOUTH END IN BOSTON WERE PRIMARILY CONCERNED ABOUT COVID-19, ACCESS TO SPECIALTY CARE, MENTAL HEALTH/DEPRESSION, HOUSING STABILITY, DISASTER READINESS AND EMERGENCY PREPARATION, EDUCATION, DISCRIMINATION BASED ON RACE AND SEX/GENDER, AND SMOKING. FINANCIAL INSECURITY AND JOB TRAINING/RESOURCES ARE SEEN AS SIGNIFICANT CONTRIBUTORS TO THESE CONCERNS. GENTRIFICATION AND RISING HOUSING COSTS HAVE LED TO A CHANGING CULTURAL MIX, PUSHING OUT IMMIGRANT AND LOW-INCOME FAMILIES, AND CAUSING STRESS FOR LONG-TERM CHINESE RESIDENTS WHO FEEL LIKE THEY DON'T BELONG IN THEIR COMMUNITY. THE SOUTH END ALSO CONTAINS AN AREA KNOWN AS "METHADONE MILE," WHERE HOMELESS ENCAMPMENTS AND OPEN-AIR SALE AND USE OF SUBSTANCES ARE PREVALENT. RISING PRICES FROM GENTRIFICATION HAVE CAUSED WEALTHIER FAMILIES TO LEAVE THE NEIGHBORHOOD, WHILE LOW-INCOME FAMILIES ARE PUSHED OUT.QUINCY HAS A SIGNIFICANT ASIAN POPULATION WITH STRONG SOCIAL AND CULTURAL TIES TO BOSTON'S CHINATOWN, COMPRISING ABOUT 6% OF TUFTS MC'S PATIENT POPULATION. IN 2017, QUINCY HAD A POPULATION OF 93,824 AND GREW 6.6% SINCE 2000. BETWEEN 2000 AND 2017, THE CITY SAW A GROWTH IN THE NUMBER OF BLACK AND LATINX RESIDENTS, AND MOST NOTABLY ASIAN RESIDENTS. QUINCY SITS JUST SOUTHEAST OF BOSTON AND IS HOME TO LARGE POPULATION OF CHINESE IMMIGRANTS, WITH 30.8% OF THE POPULATION IDENTIFYING AS ASIAN (2020 U.S. CENSUS). DATA FROM THE 2019 AMERICAN COMMUNITY SURVEY INDICATE THAT SLIGHTLY LESS THAN TWO-THIRDS OF QUINCY RESIDENTS ARE WHITE NON-HISPANIC (58%) AND NEARLY ONE-THIRD ARE ASIAN (30%). ONE-THIRDS (33%) OF QUINCY RESIDENTS ARE FOREIGN-BORN AND 38% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THE LARGEST AGE GROUP OF QUINCY RESIDENTS IS 35-65-YEAR-OLDS (40%). THERE ARE FEWER YOUNG ADULTS AGES 20-34 (27%) THAN IN THE CITY OF BOSTON AS A WHOLE (35%). AS A WHOLE, EDUCATIONAL ATTAINMENT OF QUINCY RESIDENTS LOOKS SIMILAR TO BOSTON, ALTHOUGH QUINCY HAS FEWER RESIDENTS WITH BACHELOR'S DEGREES OR HIGHER (45% VS 51%). IN TUFTS MC'S 2022 COMMUNITY SURVEY, COVID-19, ACCESS TO SPECIALTY CARE, AND MENTAL HEALTH/DEPRESSION WERE THE TOP HEALTH CONCERNS OF COMMUNITY RESIDENTS. THE TOP SOCIAL ISSUES WERE HOUSING STABILITY, EDUCATION, AND DOMESTIC/INTERPERSONAL VIOLENCE, WHILE THE TOP SAFETY CONCERNS WERE DISCRIMINATION BASED ON CLASS/INCOME, SEX/GENDER, AND IMMIGRATION STATUS. THE RISING POPULATION OF LIMITED ENGLISH SPEAKERS AND IMMIGRANTS IN QUINCY HAS WORSENED THESE CHALLENGES, WITH CHRONIC DISEASE AND CANCER REMAINING ONGOING HEALTH CONCERNS. FINANCIAL AND FOOD INSECURITY HAVE GROWN SIGNIFICANTLY DURING THE PANDEMIC, ALONG WITH MENTAL HEALTH ISSUES AND DOMESTIC VIOLENCE. THE LACK OF PROVIDERS WHO CAN SPEAK THE LANGUAGE AND UNDERSTAND THE CULTURE OF THEIR PATIENTS HAS ALSO BEEN IDENTIFIED AS A CHALLENGE. QUINCY HAS HIGHER MORTALITY RATES FOR CANCER, SUBSTANCE USE, AND OPIOID USE COMPARED TO THE STATE OF MASSACHUSETTS, WITH HIGHER RATES OF COPD-RELATED HOSPITALIZATIONS, POISONING-RELATED ED VISITS, AND MORTALITY ACCORDING TO DATA PROVIDED BY THE MASSACHUSETTS DEPARTMENT OF HEALTH.CARE TO BOSTON RESIDENTS AND SURROUNDING COMMUNITIES:TUFTS MC BELIEVES THAT CARING FOR OUR COMMUNITY HAPPENS BOTH WITHIN AND OUTSIDE THE WALLS OF THE INSTITUTION. DATA HAVE SHOWN THAT MANY BARRIERS EXIST WHICH HINDER PATIENT ACCESS TO HIGH QUALITY HEALTH CARE, INCLUDING THE LINGUISTIC AND CULTURAL COMPETENCY OF HEALTH CARE PROVIDERS. TO REMOVE THE BARRIERS AND INCREASE ACCESS TO HOSPITAL SERVICES, TUFTS MC CONTINUES A LONG-STANDING COMMITMENT TO HEALTH EQUITY WHICH INVOLVES INCREASING CULTURAL COMPETENCY AMONG OUR MEDICAL PROVIDERS AND TO REMOVE LANGUAGE BARRIERS WHEREVER POSSIBLE. THE WORKING DEFINITION OF CULTURAL COMPETENCY THAT HELPS TO SHAPE AND DRIVE POLICIES AND CARE DELIVERY AT TUFTS MC IS AS FOLLOWS:THE ABILITY TO UNDERSTAND AND RESPECT THE DIFFERENCES AMONG PEOPLE AND USE OUR UNDERSTANDING TO INFLUENCE OUR INTERACTIONS WITH ONE ANOTHER; THIS INVOLVES DEVELOPING OUR CAPABILITY OF DELIVERING PATIENT-CENTERED SERVICES CONSISTENT WITH THE NEEDS AND EXPECTATIONS OF VARIOUS CULTURES.

Schedule H (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes 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? .........

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1MICHAEL DANDORPH TRUSTEE/PRESIDENT/CEO	(i) (ii)	0 ------------- 1,249,455	0 ------------- 641,252	0 ------------- 14,991	0 ------------- 231,161	0 ------------- 28,851	0 ------------- 2,165,710	0 ------------- 0
2MICHAEL WAGNER FORMER TRUSTEE/PRESIDENT	(i) (ii)	0 ------------- 859,806	0 ------------- 615,435	0 ------------- 489,351	0 ------------- 140,771	0 ------------- 36,877	0 ------------- 2,142,240	0 ------------- 473,302
3MICHAEL TARNOFF MD CEO/TRUSTEE	(i) (ii)	532,722 ------------- 459,602	358,050 ------------- 0	7,215 ------------- 14,978	0 ------------- 29,000	16,332 ------------- 9,520	914,319 ------------- 513,100	0 ------------- 0
4CHARLES CASSIDY FORMER TRUSTEE	(i) (ii)	0 ------------- 693,085	0 ------------- 398,869	0 ------------- 16,697	0 ------------- 29,000	0 ------------- 22,989	0 ------------- 1,160,640	0 ------------- 0
5MICHAEL APKON FORMER TRUSTEE/PRESIDENT/CEO	(i) (ii)	0 ------------- 0	0 ------------- 0	1,088,744 ------------- 0	0 ------------- 0	0 ------------- 0	1,088,744 ------------- 0	0 ------------- 0
6MARVIN A KONSTAM MD TRUSTEE	(i) (ii)	0 ------------- 615,924	0 ------------- 164,198	0 ------------- 18,238	0 ------------- 29,000	0 ------------- 22,989	0 ------------- 850,349	0 ------------- 0
7DIANA RICHARDSON SENIOR VP & COO	(i) (ii)	543,777 ------------- 0	163,989 ------------- 0	2,006 ------------- 0	83,088 ------------- 0	28,965 ------------- 0	821,825 ------------- 0	0 ------------- 0
8KRISTINE M HANSCOM SVP/CFO/TREAS. (UNTIL 4/22)	(i) (ii)	478,101 ------------- 0	144,049 ------------- 0	84,075 ------------- 0	76,023 ------------- 0	21,503 ------------- 0	803,751 ------------- 0	81,247 ------------- 0
9JEFFREY WEINSTEIN FORMER TRUSTEE	(i) (ii)	0 ------------- 462,958	0 ------------- 149,649	0 ------------- 89,462	0 ------------- 5,326	0 ------------- 27,920	0 ------------- 735,315	0 ------------- 0
10F CLARISSA YANG MD TRUSTEE (UNTIL 2/22)	(i) (ii)	0 ------------- 565,603	0 ------------- 76,203	0 ------------- 28,050	0 ------------- 29,000	0 ------------- 2,187	0 ------------- 701,043	0 ------------- 0
11MAURA LYNCH VP FOR DEVELOPMENT (UNTIL 10/8/21)	(i) (ii)	273,412 ------------- 0	73,194 ------------- 0	262,763 ------------- 0	51,781 ------------- 0	10,210 ------------- 0	671,360 ------------- 0	145,367 ------------- 0
12KAREN FREUND MD TRUSTEE	(i) (ii)	0 ------------- 517,760	0 ------------- 56,001	0 ------------- 13,333	0 ------------- 29,000	0 ------------- 22,963	0 ------------- 639,057	0 ------------- 0
13THERESE HUDSON-JINKS SENIOR VP & CNO	(i) (ii)	390,955 ------------- 0	102,820 ------------- 0	70,697 ------------- 0	63,636 ------------- 0	7,155 ------------- 0	635,263 ------------- 0	68,374 ------------- 0
14DEEB N SALEM MD FORMER TRUSTEE	(i) (ii)	0 ------------- 557,302	0 ------------- 0	0 ------------- 5,990	0 ------------- 0	0 ------------- 24,917	0 ------------- 588,209	0 ------------- 0
15PAUL SUMMERGRAD MD TRUSTEE	(i) (ii)	0 ------------- 433,392	0 ------------- 39,758	0 ------------- 40,698	0 ------------- 29,000	0 ------------- 22,407	0 ------------- 565,255	0 ------------- 0
16NIOBIS DEL CARMEN QUEIRO FORMER KEY EMPLOYEE	(i) (ii)	0 ------------- 357,712	0 ------------- 94,462	0 ------------- 11,219	0 ------------- 32,294	0 ------------- 26,262	0 ------------- 521,949	0 ------------- 0
17KARA GREER SVP CHIEF TALENT OFFICER	(i) (ii)	355,963 ------------- 0	91,560 ------------- 0	1,105 ------------- 0	46,680 ------------- 0	7,055 ------------- 0	502,363 ------------- 0	0 ------------- 0
18DEBORAH FIUMEDORA VP OF STRATEGY, PLANNING AND BUSINES	(i) (ii)	170,438 ------------- 0	48,632 ------------- 0	178,282 ------------- 0	34,455 ------------- 0	17,144 ------------- 0	448,951 ------------- 0	101,114 ------------- 0
19SARAH MCKAY VP OF PATIENT CARE	(i) (ii)	277,721 ------------- 0	63,027 ------------- 0	833 ------------- 0	40,540 ------------- 0	31,034 ------------- 0	413,155 ------------- 0	0 ------------- 0
20MARCY CASS VP RISK MANAGEMENT	(i) (ii)	289,757 ------------- 0	60,882 ------------- 0	38,536 ------------- 0	7,201 ------------- 0	11,901 ------------- 0	408,277 ------------- 0	0 ------------- 0
21ZACHARY REDMOND ESQ SECRETARY	(i) (ii)	254,461 ------------- 0	64,873 ------------- 0	10,409 ------------- 0	46,536 ------------- 0	30,772 ------------- 0	407,051 ------------- 0	0 ------------- 0
22WILLIAM SHICKOLOVICH FORMER KEY EMPLOYEE	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 404,000	0 ------------- 0	0 ------------- 0	0 ------------- 404,000	0 ------------- 0
23ASSAD SIDDIQI SVP/TREASURER	(i) (ii)	0 ------------- 308,680	0 ------------- 58,707	0 ------------- 287	0 ------------- 0	0 ------------- 15,683	0 ------------- 383,357	0 ------------- 0
24HELEN BOUCHER MD TRUSTEE	(i) (ii)	0 ------------- 164,808	0 ------------- 10,000	0 ------------- 6,370	0 ------------- 14,500	0 ------------- 11,100	0 ------------- 206,778	0 ------------- 0
25ERIKA WERNER TRUSTEE	(i) (ii)	0 ------------- 192,408	0 ------------- 0	0 ------------- 3,998	0 ------------- 0	0 ------------- 6,319	0 ------------- 202,725	0 ------------- 0
26JACK MCDONALD ASSOCIATE EXECUTIVE DIRECTOR- NELTC	(i) (ii)	179,208 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	12,263 ------------- 0	191,471 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

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, LINES 4A-B	LINE 4A: MICHAEL APKON RECEIVED $1,088,269 IN SEVERANCE PAY DURING CALENDAR YEAR 2021. MAURA LYNCH RECEIVED $81,874 IN SEVERANCE PAY DURING CALENDAR YEAR 2021. DEBORAH FIUMEDORA RECEIVED $54,480 IN SEVERANCE PAY DURING CALENDAR YEAR 2021. WILLIAM SHICKOLOVICH RECEIVED $404,000 IN SEVERANCE PAY DURING CALENDAR YEAR 2021.
PART 1, LINE 4B:	SECTION 457(F) RETIREMENT PLAN EMPLOYER DEFERRALS: DIANA RICHARDSON: 73,783 KRISTINE HANSCOM: 67,323 MAURA LYNCH: 43,345 THERESE HUDSON-JINKS: 54,936 KARA GREER: 38,307 DEBORAH FIUMEDORA: 28,842 SARAH MCKAY: 31,840 ZACHARY REDMOND: 37,875 MICHAEL DANDORPH: 222,461 NIOBIS QUEIRO: 26,708 MICHAEL WAGNER: 137,509

Schedule J (Form 990) 2021

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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

2021

Open to Public
Inspection

Name of the organization
TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number
27-0440772

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MASSACHUSETTS DEVELOPMENT FINANCE AUTHORITY	04-3431814	57584YPN3	02-20-2019	230,260,000	SEE SUPPLEMENTAL INFORMATION		X		X	X
B	MASSACHUSETTS DEVELOPMENT FINANCE AUTHORITY	04-3431814	000000000	07-16-2020	53,992,966	SEE SUPPLEMENTAL INFORMATION		X		X	X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	12,555,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	247,886,139		59,998,457
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............			1,673,153
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	54,389,317
11 Other spent proceeds .............	159,332,179		58,325,053
12 Other unspent proceeds .............	34,164,643		251
13 Year of substantial completion .............			2022
	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 2020, a current refunding issue)? ........	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		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
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 %
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 %
6 Total of lines 4 and 5 .............	0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		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
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

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
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X		X
b Exception to rebate? ........		X		X
c No rebate due? .........		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

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		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
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part Ⅵ

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

Return Reference

Explanation

PART I, LINE A, COLUMN F

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

PART II, LINE 7

THE AMOUNTS REPORTED AS TOTAL PROCEEDS EXCEED THE RESPECTIVE ISSUE PRICE DUE TO BOND PREMIUM.

Schedule K (Form 990) 2021

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	6	43,493	FMV
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

30a

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

30a

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

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

Yes

32a

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

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

32a

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

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

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

Schedule M (Form 990) (2021)

Additional Data

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SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Return Reference	Explanation
FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:	WE STRIVE TO HEAL, TO COMFORT, TO TEACH, TO LEARN, AND TO SEEK THE KNOWLEDGE TO PROMOTE HEALTH AND PREVENT DISEASE. OUR PATIENTS AND THEIR FAMILIES ARE AT THE CENTER OF EVERYTHING WE DO. WE DEDICATE OURSELVES TO FURTHERING OUR RICH TRADITION OF HEALTH CARE INNOVATION, LEADERSHIP, CHARITY AND THE HIGHEST STANDARD OF CARE TO ALL IN OUR COMMUNITY. TO PROVIDE LONG-TERM CARE FOR CHILDREN WHO ARE SEVERELY MENTALLY HANDICAPPED AND/OR MULTIPLY PHYSICALLY HANDICAPPED. RENTAL SERVICE PROGRAMS TO PROMOTE THE INTEREST OF TUFTS MEDICAL CENTER, INC. AND ITS AFFILIATED ORGANIZATIONS BY ACQUIRING, MANAGING, MAINTAINING, DEVELOPING, LEASING AND DISPOSING OF REAL ESTATE PROPERTIES.
FORM 990, PART III, LINE 3	EFFECTIVE JULY 1, 2022, TUFTS MEDICAL CENTER CLOSED OUR PEDIATRIC INPATIENT UNITS AND CHILDREN WHO NEED OVERNIGHT HOSPITALIZATION WILL BE CARED FOR AT BOSTON CHILDREN'S HOSPITAL. THE MAJORITY OF OUR AMBULATORY SERVICES REMAIN OPEN AND UNCHANGED.
FORM 990, PART VI, SECTION B, LINE 11B	THE CFO AND CONTROLLER REVIEW THE FORM 990 WITH TAX ADVISORS FROM A NATIONAL ACCOUNTING FIRM. A COPY OF THE FORM 990 AS IT WILL BE ULTIMATELY FILED IS POSTED TO AN INTERNAL WEBSITE. PRIOR TO FILING, THE ORGANIZATION EMAILS ALL OF ITS GOVERNING BODY MEMBERS A LINK TO A PASSWORD PROTECTED WEBSITE, ADVISING THEM THAT THE FORM 990 IS AVAILABLE FOR REVIEW ON THAT SITE.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION ENFORCES COMPLIANCE BY PROCEDURES INCLUDING ANNUAL DISCLOSURE AND REVIEW OF SUCH DISCLOSURE BY MANAGEMENT. CONFLICTS ARE RESOLVED BY THE APPROPRIATE HEAD OF THE DEPARTMENT AND REVIEWED BY LEGAL. THE JOINT COMPLIANCE COMMITTEE WILL DISCUSS ANY APPEAL.
FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE COMPENSATION COMMITTEE OF THE TUFTS MEDICINE, INC. BOARD MEETS ANNUALLY TO REVIEW EXECUTIVE COMPENSATION. SULLIVAN AND COTTER, AN INDEPENDENT CONSULTANT TO THE BOARD, PROVIDED A COMPETITIVENESS ASSESSMENT BASED ON COMPARATOR INFORMATION INCLUDING NATIONAL, NORTHEAST AND BOSTON AREA DATA. TOTAL COMPENSATION FOR THE EXECUTIVE GROUP, INCLUDING THE PRESIDENT/CEO , COO AND VICE PRESIDENTS, WAS DETERMINED TO BE CONSERVATIVE AND WELL WITHIN MARKET AVERAGES, THE PROCESS HAS NOT CHANGED SINCE THEN.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS WILL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST EITHER BY MAIL OR IN PERSON AT THE OFFICE, DEPENDING ON THE FORM OF THE REQUEST.
FORM 990, PART VI, SECTION B., LINE 16A:	TUFTS MEDICAL CENTER, INC. OWNS A 65% INTEREST IN SHIELDS-TUFTS MEDICAL CENTER IMAGING MANAGEMENT, LLC.
FORM 990, PART VI, SECTION B., LINE 16B:	THE ORGANIZATION ROUTINELY CONSULTS WITH INTERNAL AND OUTSIDE COUNSEL PRIOR TO ENTERING INTO JOINT VENTURE ARRANGEMENTS. THE ORGANIZATION IS CURRENTLY CONSIDERING IMPLEMENTATION OF WRITTEN POLICIES AND PROCEDURES TO EVALUATE PARTICIPATION OF JOINT VENTURE ARRANGEMENTS TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS WITH RESPECT TO SUCH ARRANGEMENTS.
FORM 990, PART XI, LINE 9:	TRANSFER OF NET ASSETS -129,129,000. PENSION-RELATED ADJUSTMENTS -15,608,000. OTHER COMPONENTS OF NET PERIODIC PENSION COSTS 4,680,000. NET ASSETS RELEASED FROM RESTRICTION -1,504,000. OTHER ADJUSTMENTS -700,226.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TUFTS MEDICAL CENTER GROUP RETURN

Employer identification number

27-0440772

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)MELROSEWAKEFIELD HEALTHCARE INC 170 GOVERNORS AVE MEDFORD,MA02155 04-2767880	HOSPITAL	MA	501(C)(3)	LINE 3	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(2)HALLMARK HEALTH MEDICAL ASSOCIATES INC 170 GOVERNORS AVE MEDFORD,MA02155 04-3140938	MD OFFICES	MA	501(C)(3)	LINE 10	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(3)LM LONG TERM CARE SERVICES INC 170 GOVERNORS AVE MEDFORD,MA02155 04-2938772	LONG-TERM CARE	MA	501(C)(3)	LINE 12B, II	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(4)SAVIN LONG TERM CARE CORPORATION 170 GOVERNORS AVE MEDFORD,MA02155 04-3012616	LONG-TERM CARE	MA	501(C)(3)	LINE 10	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(5)HALLMARK HEALTH VISITING NURSE ASSOCIATION AND HOSPICE INC 178 SAVIN ST SUITE 300 MALDEN,MA02148 04-2437064	VISITING NURSE	MA	501(C)(3)	LINE 10	TUFTS MEDICINE CARE AT HOME PARENT INC	Yes
(6)HALLMARK HEALTH PROPERTIES 170 GOVERNORS AVE MEDFORD,MA02155 22-2580542	PROPERTY	MA	501(C)(3)	LINE 12B, II	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	Yes
(7)MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION 170 GOVERNORS AVE MEDFORD,MA02155 04-2103587	PARENT	MA	501(C)(3)	LINE 12A, I	TUFTS MEDICINE INC	Yes
(8)THE LOWELL GENERAL HOSPITAL 295 VARNUM AVENUE LOWELL,MA01854 04-2103590	HEALTH CARE	MA	501(C)(3)	LINE 3	CIRCLE HEALTH INC	Yes
(9)CIRCLE HEALTH PHYSICIANS INC 295 VARNUM AVENUE LOWELL,MA01854 27-3902914	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	CIRCLE HEALTH INC	Yes
(10)LGH PHYSICIAN ASSOCIATES INC 295 VARNUM AVENUE LOWELL,MA01854 04-3190747	MEDICAL SERVICES	MA	501(C)(3)	PF	CIRCLE HEALTH PHYSICIANS INC	Yes
(11)CIRCLE HEALTH INC 295 VARNUM AVENUE LOWELL,MA01854 22-2579798	PARENT/SUPPORTING ORGANIZATION	MA	501(C)(3)	LINE 12B, II	TUFTS MEDICINE INC	Yes
(12)TUFTS MEDICINE INC 1600 DISTRICT AVE SUITE 125 BURLINGTON,MA01803 45-2250732	PARENT/SUPPORTING ORGANIZATION	MA	501(C)(3)	LINE 12A, I	N/A		No
(13)TUFTS MEDICINE INTEGRATED NETWORK INC 800 DISTRICT AVENUE BURLINGTON,MA01803 87-1600172	HEALTH CARE	MA	501(C)(3)	LINE 10	TUFTS MEDICINE INC	Yes
(14)CNS NURSING HOME CARE INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE,MA01843 37-1836433	HOME CARE SERVICES	MA	501(C)(3)	LINE 10	CIRCLE HOME INC	Yes
(15)CIRCLE HOME INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE,MA01843 04-2103812	HOME CARE SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICINE CARE AT HOME PARENT INC	Yes
(16)TUFTS MEDICAL CENTER PARENT INC 800 WASHINGTON STREET BOSTON,MA02111 04-2810022	FUNDRAISING, ADMIN. PLANNING & OTHER ACTIVITIES	MA	501(C)(3)	LINE 12B, II	TUFTS MEDICINE INC	Yes
(17)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
(18)NEW ENGLAND LONG-TERM CARE INC 800 WASHINGTON STREET BOSTON,MA02111 04-2912578	PEDIATRIC LONG-TERM CARE FACILITY	MA	501(C)(3)	LINE 3	TUFTS MEDICAL CENTER PARENT INC	Yes
(19)NEW ENGLAND QUALITY CARE ALLIANCE INC 800 WASHINGTON STREET BOSTON,MA02111 04-3040427	MEDICAL PROGRAMS & SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICINE INTEGRATED NETWORK INC	Yes
(20)NEQCA ACCOUNTABLE CARE INC 325 WOOD RD SUITE 210 BRAINTREE,MA02184 80-0824142	ACO	MA	501(C)(3)	LINE 10	TUFTS MEDICINE INTEGRATED NETWORK INC	Yes
(21)TUFTS MEDICAL CENTER COMMUNITY CARE INC 325 WOOD RD SUITE 210 BRAINTREE,MA02184 47-3046563	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(22)THE CAMERON M NEELY FOUNDATION 800 WASHINGTON STREET BOSTON,MA02111 04-3265628	CHARITABLE	MA	501(C)(3)	LINE 7	TUFTS MEDICAL CENTER PARENT INC	Yes
(23)HEART CENTER OF METROWEST INC 99 LINCOLN STREET FRAMINGHAM,MA01702 03-0390670	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(24)PRATT ANESTHESIOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3418395	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(25)PRATT MEDICAL AND SURGICAL ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148397	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(26)PRATT NEUROLOGY ASSOICATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148384	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(27)PRATT OBGYN ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148385	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(28)PRATT OPHTHALMOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148392	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(29)PRATT ORTHOPEDIC ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 20-5129051	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(30)PRATT OTOLARYNGOLOGY 800 WASHINGTON STREET BOSTON,MA02111 04-3148381	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(31)PRATT PATHOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148393	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(32)PRATT PEDIATRIC ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148394	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(33)PRATT PSYCHIATRIC ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148387	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(34)PRATT RADIOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148388	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(35)PRATT RADIATION ONCOLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148389	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(36)PRATT REHABILITATION MEDICINCE 800 WASHINGTON STREET BOSTON,MA02111 04-3148378	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(37)PRATT SURGICAL ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148376	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(38)PRATT UROLOGY ASSOCIATES INC 800 WASHINGTON STREET BOSTON,MA02111 04-3148379	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(39)NEW ENGLAND MEDICAL CENTER 800 WASHINGTON STREET BOSTON,MA02111 04-3096445	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(40)PRATT MEDICAL GROUP INC 800 WASHINGTON STREET BOSTON,MA02111 04-2743894	MEDICAL SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICAL CENTER PHYSICIANS ORG INC	Yes
(41)TUFTS MEDICAL CENTER PHYSICIANS ORG INC 800 WASHINGTON STREET BOSTON,MA02111 04-3044706	ADMIN.	MA	501(C)(3)	LINE 12B, II	TUFTS MEDICAL CENTER PARENT INC	Yes
(42)LOWELL GENERAL HOSPITAL AUXILIARY 295 VARNUM AVENUE LOWELL,MA01854 22-3459303	SUPPORTING ORGANIZATION	MA	501(C)(3)	LINE 12A, I	N/A		No
(43)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
(44)TUFTS MEDICINE CARE AT HOME PARENT INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE,MA01843 22-2587225	MANAGEMENT SERVICES	MA	501(C)(3)	LINE 12B, II	TUFTS MEDICINE INC	Yes
(45)HOME HEALTH VNA INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE,MA01843 04-2435675	HOME HEALTH CARE	MA	501(C)(3)	LINE 10	TUFTS MEDICINE CARE AT HOME PARENT INC	Yes
(46)TUFTS MEDICINE CARE AT HOME INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE,MA01843 04-3024278	HOSPICE SERVICES	MA	501(C)(3)	LINE 10	TUFTS MEDICINE CARE AT HOME PARENT INC	Yes
(47)HOME CARE INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE,MA01843 04-2854358	HOME HEALTH SUPPORTIVE SERIVCES	MA	501(C)(3)	LINE 10	TUFTS MEDICINE CARE AT HOME PARENT INC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(k) Percentage ownership
(1) HALLMARK HEALTH INVESTMENTS LLC 170 GOVERNORS AVE MEDFORD,MA02155 02-0657666	INVESTMENT	MA	MELROSEWAKEFIELD HEALTHCARE INC	EXCLUDED				No			No
(2) MONTVALE PETCT LLC 100 BAYVIEW CIRCLE SUITE 400 NEWPORT BEACH,CA92660 27-0325022	CAT SCAN	DE	MELROSEWAKEFIELD HEALTHCARE INC	RELATED				No			No
(3) SHIELDS-TUFTS MEDICAL CENTER IMAGING MANAGEMENT LLC 800 WASHINGTON STREET BOSTON,MA02111 32-0558307	MEDICAL SERVICES (MRI)	MA	TUFTS MEDICAL CENTER INC	RELATED	-35,346			No		Yes		65.000 %

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	(h) Percentage ownership	Yes	No
(1) HALLMARK HEALTH ENTERPRISES INC 585 LEBANON STREET MELROSE,MA02176 04-2475660	OTHER HEALTH SERVICES	MA	MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	C					No
(2) HALLMARK HEALTH PHO INC 170 GOVERNORS AVE MEDFORD,MA02155 46-1134759	PHYSICIAN HOSPITAL ORGANIZATION	MA	MELROSEWAKEFIELD HEALTHCARE INC	C					No
(3) LAWRENCE MELROSE MEDICAL ELECTRONICS RECORD INC 170 GOVERNORS AVE MEDFORD,MA02155 42-1685777	ELECTRONIC MEDICAL RECORDS	MA	MELROSEWAKEFIELD HEALTHCARE INC	C					No
(4) LGH MANAGEMENT SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 04-2919244	MEDICAL SERVICES	MA	LGH SERVICES INC	C					No
(5) LGH MEDICAL BUILDING SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 04-3058954	MEDICAL OFFICE BUILDING	MA	LGH SERVICES INC	C					No
(6) LGH MEDICAL SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 26-1889904	MEDICAL SERVICES	MA	LGH SERVICES INC	C					No
(7) LGH SERVICES INC 295 VARNUM AVENUE LOWELL,MA01854 04-2854673	MEDICAL SERVICES	MA	CIRCLE HEALTH INC	C					No
(8) TUFTS MEDICINE INDEMNITY COMPANY LTD 800 WASHINGTON STREET BOSTON,MA02111 98-0444573	CAPTIVE INSURANCE	CJ	TUFTS MEDICAL CENTER INC	C	11,503,037	89,816,942	80.000 %	Yes

Schedule R (Form 990) 2021

Page 3

Part V

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

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

Yes

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

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

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

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

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

Yes

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

Yes

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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

Yes

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) PRATT OPTHAMOLOGY ASSOCIATES INC	D	732,832	BOOK BASIS
(2) NEW ENGLAND QUALITY CARE ALLIANCE INC	D	14,763,049	BOOK BASIS
(3) TUFTS MEDICAL CENTER COMMUNITY CARE INC	D	4,220,917	BOOK BASIS
(4) TUFTS MEDICINE CARE AT HOME PARENT INC	D	128,198	BOOK BASIS
(5) TUFTS MEDICINE CARE AT HOME PARENT INC	D	2,470,771	BOOK BASIS
(6) PRATT RADIOLOGY ASSOCIATES INC	D	949,346	BOOK BASIS
(7) PRATT UROLOGY ASSOCIATES INC	D	167,081	BOOK BASIS
(8) PRATT PSYCHIATRIC ASSOCIATES INC	D	192,751	BOOK BASIS
(9) MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION	D	339,806	BOOK BASIS
(10) TUFTS MEDICAL CENTER PHYSICIANS ORGANIZATION	E	5,550,452	BOOK BASIS
(11) THE LOWELL GENERAL HOSPITAL	E	1,731,943	BOOK BASIS
(12) PRATT ANESTHESIOLOGY ASSOCIATES INC	E	1,103,271	BOOK BASIS
(13) CARDIOVASCULAR CENTER AT TUFTS MEDICAL CENTER INC	E	653,005	BOOK BASIS
(14) NEW ENGLAND MEDICAL CENTER GROUP	E	567,705	BOOK BASIS
(15) PRATT PEDIATRIC ASSOCIATES INC	E	395,274	BOOK BASIS
(16) TUFTS MEDICINE INC	E	56,164,497	BOOK BASIS
(17) PRATT NEUROLOGY ASSOCIATES INC	E	140,247	BOOK BASIS
(18) PRATT MEDICAL & SURGICAL DERMATOLOGY ASSOC	E	71,382	BOOK BASIS
(19) TUFTS MEDICINE CLINICALLY INTEGRATED NETWORK	E	139,282	BOOK BASIS
(20) PRATT SURGICAL ASSOCIATES INC	E	200,140	BOOK BASIS
(21) TUFTS MEDICINE CARE AT HOME PARENT INC	E	72,930	BOOK BASIS
(22) PRATT PATHOLOGY ASSOCIATES INC	E	194,542	BOOK BASIS
(23) HEART CENTER METROWEST	E	156,444	BOOK BASIS
(24) TMC PHYSICIAN ORGANIZATION INC	J	454,233	BOOK BASIS
(25) PRATT RADIOLOGY ASSOCIATES INC	L	708,550	BOOK BASIS
(26) PRATT UROLOGY ASSOCIATES INC	L	1,161,383	BOOK BASIS
(27) TMC PHYSICIAN ORGANIZATION INC	L	5,852,165	BOOK BASIS
(28) PRATT RADIATION ONCOLOGY ASSOCIATES INC	L	302,285	BOOK BASIS
(29) PRATT PSYCHIATRIC ASSOCIATES INC	L	5,730,273	BOOK BASIS
(30) PRATT OPTHAMOLOGY ASSOCIATES INC	L	11,528,852	BOOK BASIS
(31) PRATT MEDICAL GROUP INC	M	7,497,920	BOOK BASIS
(32) PRATT ANESTHESIOLOGY ASSOCIATES INC	M	13,941,303	BOOK BASIS
(33) PRATT PEDIATRIC ASSOCIATES INC	M	5,467,795	BOOK BASIS
(34) PRATT OTOLARYNGOLOGY ASSOCIATES INC	L	131,477	BOOK BASIS
(35) PRATT NEUROLOGY ASSOCIATES INC	M	109,531	BOOK BASIS
(36) PRATT SURGICAL ASSOCIATES INC	M	3,858,603	BOOK BASIS
(37) PRATT NEUROSURGERY ASSOCIATES INC	M	2,499,787	BOOK BASIS
(38) PRATT PATHOLOGY ASSOCIATES INC	M	2,368,478	BOOK BASIS
(39) PRATT DERMATOLOGY ASSOCIATES INC	M	1,192,550	BOOK BASIS
(40) PRATT ORTHOPEDIC ASSOCIATES INC	M	926,811	BOOK BASIS
(41) PRATT OBGYN ASSOCIATES INC	M	646,731	BOOK BASIS
(42) PRATT REHABILITATION MEDICINE ASSOCIATES INC	M	230,442	BOOK BASIS
(43) CARDIOVASCULAR CENTER AT TUFTS MEDICAL CENTER INC	M	4,603,697	BOOK BASIS
(44) TUFTS MEDICINE INC	R	8,561,000	BOOK BASIS

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: WE STRIVE TO HEAL, TO COMFORT, TO TEACH, TO LEARN, AND TO SEEK THE KNOWLEDGE TO PROMOTE HEALTH AND TO PREVENT DISEASE. OUR PATIENTS AND THEIR FAMILIES ARE AT THE CENTER OF EVERYTHING WE DO. SEE PART III.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	19
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	7,569
6	Total number of volunteers (estimate if necessary) .............	6	41
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	176,797
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	58,889,410	76,198,105
9	Program service revenue (Part VIII, line 2g) .........	1,070,084,108	1,053,426,488
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	75,317,136	28,235,994
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	9,309,816	1,828,403
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,213,600,470	1,159,688,990
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)	497,238,353	561,476,073
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	3,000
b	Total fundraising expenses (Part IX, column (D), line 25) 3,591,796
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	578,867,478	708,132,952
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,076,105,831	1,269,612,025
19	Revenue less expenses. Subtract line 18 from line 12.......	137,494,639	-109,923,035
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,224,233,367	939,808,476
21	Total liabilities (Part X, line 26).............	829,357,133	881,842,503
22	Net assets or fund balances. Subtract line 21 from line 20.....	394,876,234	57,965,973

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 944,324,683 including grants of $ ) (Revenue $ 1,052,438,872 )
	TUFTS MEDICAL CENTER, INC. LOCATED IN BOSTON, MA OPERATES A 415 BED ACUTE-CARE GENERAL HOSPITAL ESTABLISHED TO PROVIDE HEALTHCARE SERVICES PRIMARILY IN THE GREATER BOSTON AREA, WHICH ALSO ATTRACTS PATIENTS FROM ELSEWHERE IN NEW ENGLAND AND BEYOND.NEW ENGLAND LONG-TERM CARE, INC. OPERATES AN 80 BED NURSING HOME SPECIALIZING IN THE CARE OF CHILDREN WHO ARE SEVERELY MENTALLY HANDICAPPED AND/OR MULTIPLY PHYSICALLY HANDICAPPED.

4b	(Code: ) (Expenses $ 38,702,031 including grants of $ ) (Revenue $ 496,716 )
	TUFTS MEDICAL CENTER, INC. ADMINISTERS PROGRAMS FOR APPROXIMATELY 456 INDIVIDUALS: 282 RESIDENTS, 62 INTERNS AND 112 FELLOWS IN 47 SPECIALTIES AND SUBSPECIALTIES WHO ROTATE TO APPROXIMATELY 54 HOSPITALS AND OTHER ORGANIZATIONS LOCATED PRIMARILY IN THE GREATER BOSTON AREA.

4c	(Code: ) (Expenses $ 10,034,416 including grants of $ ) (Revenue $ 490,900 )
	TUFTS MEDICAL CENTER, INC. ENGAGES IN RESEARCH ACTIVITIES FUNDED BY GRANTS AND CONTRACTS FOR U.S. GOVERNMENT AGENCIES AND OTHER PRIVATE SOURCES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses993,061,130

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	6,662,256	10,900,691	1,523,310

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	65,193,335

f	All other contributions, gifts, grants, and similar amounts not included above		1f	11,004,770

g	Noncash contributions included in lines 1a - 1f:$		1g	43,493

h Total. Add lines 1a-1f.......		76,198,105

		Business Code
2a	NET PATIENT SERV. REV.	900099	849,854,655	849,854,655
b	RESEARCH & MISC. REV.	900099	201,748,549	201,748,549
c	OVERHEAD RECOVERY	900099	1,326,568	1,326,568
d	RESIDENTS & INTERN REV	900099	496,716	496,716
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,053,426,488

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,390,250		176,797	3,213,453
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			798,589			798,589
		(ii) Personal	(i) Real
6a	Gross rents		1,503,528	6a
b	Less: rental expenses		473,714	6b
c	Rental income or (loss)		1,029,814	6c
d	Net rental income or (loss).......			1,029,814			1,029,814
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		24,845,744	7a
b	Less: cost or other basis and sales expenses		0	7b
c	Gain or (loss)		24,845,744	7c
d	Net gain or (loss).........			24,845,744			24,845,744
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.....			1,159,688,990	1,053,426,488	176,797	29,887,600

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 ...........	6,739,960	1,498,940	4,678,503	562,517
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........	449,038,881	369,907,605	77,853,428	1,277,848
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	-1,684,042	-1,164,109	-519,933
9	Other employee benefits .......	44,436,167	32,248,322	11,691,360	496,485
10	Payroll taxes ...........	62,945,107	43,511,344	19,433,763
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	882,089	304,333	577,756
c	Accounting ...........	594,495		594,495
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17	3,000			3,000
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	160,963,366	99,525,536	60,517,203	920,627
12	Advertising and promotion ....	2,431,918	1,647,221	783,696	1,001
13	Office expenses .......	7,971,734	4,905,789	3,051,974	13,971
14	Information technology ......	1,669,783	1,278,535	287,059	104,189
15	Royalties ..
16	Occupancy ...........	39,805,172	11,263,150	28,541,003	1,019
17	Travel ............	1,591,069	1,006,222	581,487	3,360
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	18,796	18,796
20	Interest ...........	19,456,992	5,268,741	14,188,251
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	31,611,879	13,163,736	18,447,701	442
23	Insurance ...	901,705	1,338	900,367
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	284,458,267	276,344,080	8,114,187
b	PHYSICIAN PRACTICE FEES	95,009,326	97,499,547	-2,490,221
c	BAD DEBT	22,328,955	22,328,955
d	EQUIPMENT	12,327,782	5,738,700	6,578,702	10,380
e	All other expenses	26,109,624	6,764,349	19,148,318	196,957
25	Total functional expenses. Add lines 1 through 24e	1,269,612,025	993,061,130	272,959,099	3,591,796
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 ........			8,684,855	1	5,956,914
2	Savings and temporary cash investments .........			19,965,371	2	-2,011,282
3	Pledges and grants receivable, net ......			12,381,654	3	13,810,300
4	Accounts receivable, net .............			116,924,007	4	145,519,259
5	Loans and other receivables from 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 ............			17,384,098	8	18,461,072
9	Prepaid expenses and deferred charges ......			13,245,658	9	10,206,209
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	800,957,117
b	Less: accumulated depreciation	10b	458,431,571	249,218,582	10c	342,525,546
11	Investments—publicly traded securities .			571,378,751	11	246,671,814
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			215,050,391	15	158,668,644
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,224,233,367	16	939,808,476

17	Accounts payable and accrued expenses .....	99,193,597	17	102,899,355
18	Grants payable ...		18
19	Deferred revenue .........	16,106,740	19	22,048,284
20	Tax-exempt bond liabilities .........	295,302,270	20	288,631,569
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 ..		23
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	418,754,526	25	468,263,295
26	Total liabilities. Add lines 17 through 25..	829,357,133	26	881,842,503

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	381,172,551	27	46,163,871
28	Net assets with donor restrictions ...........	13,703,683	28	11,802,102
	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 ...........	394,876,234	32	57,965,973
33	Total liabilities and net assets/fund balances ........	1,224,233,367	33	939,808,476

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

Name	Address	EIN	Name control
NEW ENGLAND LONG-TERM CARE INC	800 WASHINGTON STREET BOX 468 BOSTON, MA 021111533	04-2912578	NEWE
TUFTS MEDICAL CENTER INC	800 WASHINGTON STREET BOX 468 BOSTON, MA 021111533	04-3400617	TUFT