TY 2023 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)	(F) Estimated amount of other compensation from the organization and related organizations
(1) MICHAEL K LAUF...................................................................... PRESIDENT/CEO/TRUSTEE	55.0 ................. 5.0	X	X				0	1,821,543	-186,604
(2) ANNE MORRIS MD...................................................................... PHYSICIAN	40.0 ................. 0.0				X		1,482,376	0	45,346
(3) ACHILLES PAPAVASILIOU MD...................................................................... PHYSICIAN	40.0 ................. 0.0				X		1,290,706	0	48,336
(4) ALEXANDER ADDUCI MD...................................................................... TRUSTEE/PHYSICIAN	40.0 ................. 2.0	X					1,233,592	0	47,346
(5) GORDON NAKATA MD...................................................................... PHYSICIAN	40.0 ................. 0.0				X		1,128,846	0	48,336
(6) NICHOLAS COPPA MD...................................................................... PHYSICIAN	40.0 ................. 0.0				X		1,090,585	0	48,436
(7) PAUL HOULE MD...................................................................... PHYSICIAN	40.0 ................. 0.0				X		1,057,711	0	46,486
(8) LORI JEWETT...................................................................... CHIEF OPERATING OFFICER	45.0 ................. 5.0			X			0	649,685	75,636
(9) RICHARD SILVERIA...................................................................... SVP FINANCE/CFO	55.0 ................. 5.0		X				0	621,401	66,667
(10) JOHN HOSTETTER MD...................................................................... TRUSTEE/PHYSICIAN	40.0 ................. 2.0	X					629,181	0	48,196
(11) WILLIAM AGEL MD...................................................................... CHIEF MEDICAL OFFICER	45.0 ................. 5.0			X			0	583,471	63,978
(12) JOHN PAUL SOLVERSON...................................................................... SVP/CHIEF INFORMATION OFFICER	45.0 ................. 5.0			X			0	546,119	63,867
(13) MICHAEL G JONES ESQ...................................................................... SVP/CLO/CO-CLERK	55.0 ................. 5.0		X				0	517,829	71,962
(14) BENJAMIN LEVIN MD...................................................................... PHYSICIAN	40.0 ................. 0.0					X	469,435	0	45,236
(15) JEAN BUTLER...................................................................... SVP FINANCE	45.0 ................. 5.0			X			0	413,144	52,037
(16) CHRISTOPHER M LAWSON...................................................................... SVP/CHIEF DEVELOPMENT OFFICER	45.0 ................. 5.0			X			0	393,224	61,069
(17) MICHELLE SKARBEK...................................................................... VP HUMAN RESOURCES	45.0 ................. 5.0			X			0	365,840	59,545

(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) CARTER HUNT........................................................................ CHIEF OPERATING OFFICER FH	45.0 .......................5.0			X		0	340,026	62,590
(19) CHRISTIAN BROWN........................................................................ SVP MANAGED CARE	36.0 .......................4.0			X		0	355,402	45,346
(20) ELIZABETH DUNTON........................................................................ VP EMPLOYED PHYSICIAN GROUP	45.0 .......................5.0			X		0	354,934	26,524
(21) MICHAEL BACHSTEIN........................................................................ VP FACILITIES MANAGEMENT	45.0 .......................5.0			X		0	341,157	26,603
(22) KUMARA SIDHARTHA........................................................................ SEE SCHEDULE O	45.0 .......................5.0			X		0	341,207	26,078
(23) MARY CALLOE........................................................................ VP REVENUE CYCLE	45.0 .......................5.0			X		0	314,814	40,998
(24) MARY JOHNSON........................................................................ VP PATIENT CARE, CNO	45.0 .......................5.0			X		0	301,397	38,567
(25) ANNE MARIE PECKHAM........................................................................ PRESIDENT VNA	45.0 .......................5.0			X		0	303,828	34,404
(26) JOSEPH GERGYES MD........................................................................ TRUSTEE (UNTIL 1/24)/PHYSICIAN	40.0 .......................2.0	X				295,718	947	41,003
(27) KEVIN MULROY........................................................................ PHYSICIAN	40.0 .......................0.0				X	283,750	0	11,350
(28) C JEFFREY SIEGERT MD........................................................................ TRUSTEE (AS OF 1/24)/PHYSICIAN	40.0 .......................2.0	X				104,866	176,750	63
(29) REBEKAH DAY........................................................................ SEE SCHEDULE O	45.0 .......................5.0			X		218,169	0	44,878
(30) DONALD A GUADAGNOLI MD........................................................................ CHIEF MED OFFICER FH	45.0 .......................5.0			X		0	238,227	10,081
(31) STEPHEN BROOKS MD........................................................................ TRUSTEE (AS OF 8/24)/PHYSICIAN	10.0 .......................2.0	X				0	87,463	0
(32) BRUCE JOHNSTON........................................................................ SEE SCHEDULE O	5.0 .......................5.0	X	X			0	0	0
(33) RAMANI AYER........................................................................ TREASURER (UNTIL 5/24)/TRUSTEE	5.0 .......................5.0	X	X			0	0	0
(34) LAWRENCE CAPODILUPO........................................................................ TRUSTEE	2.0 .......................2.0	X				0	0	0
(35) SHARON KENNEDY........................................................................ TRUSTEE	2.0 .......................2.0	X				0	0	0
(36) E JAMES MULCAHY JR........................................................................ TRUSTEE (UNTIL 5/24)	2.0 .......................2.0	X				0	0	0
(37) NATHAN RUDMAN MD........................................................................ TRUSTEE	2.0 .......................2.0	X				0	0	0
(38) ROBERT TALERMAN........................................................................ SEE SCHEDULE O	5.0 .......................5.0	X	X			0	0	0
(39) ROBERT WILSTERMAN MD........................................................................ TRUSTEE	2.0 .......................2.0	X				0	0	0
(40) KEVIN VILSAINT MD........................................................................ TRUSTEE	2.0 .......................2.0	X				0	0	0
(41) ROBIN DEVEREUX........................................................................ SEE SCHEDULE O	5.0 .......................5.0	X	X			0	0	0
(42) LINDA TILTON GIBSON........................................................................ TRUSTEE	2.0 .......................2.0	X				0	0	0
(43) GARY SHEEHAN........................................................................ TRUSTEE (AS OF 5/24)	2.0 .......................2.0	X				0	0	0

- 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.
right arrow

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	69,840,468	42,848,214	39,547,726	27,202,526	16,439,005	195,877,939
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....						0
3	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
4	Total. Add lines 1 through 3	69,840,468	42,848,214	39,547,726	27,202,526	16,439,005	195,877,939
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) ..						2,994,393
6	Public support. Subtract line 5 from line 4.						192,883,546

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..	69,840,468	42,848,214	39,547,726	27,202,526	16,439,005	195,877,939
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	8,025,505	6,691,992	8,089,012	12,584,061	12,449,747	47,840,317
9	Net income from unrelated business activities, whether or not the business is regularly carried on..	-91,180	-133,849	1,110,219	47,918	21,390	954,498
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	1,645,231	835,990	782,806	943,973	1,420,996	5,628,996
11	Total support. Add lines 7 through 10						250,301,750

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

4,863,006,606

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 2023 (line 6, column (f) divided by line 11, column (f)) .........

77.060 %

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

77.590 %

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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).

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) 2023

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) 2023

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	0
2	Recoveries of prior-year distributions	2	0
3	Other gross income (see instructions)	3	0
4	Add lines 1 through 3	4	0
5	Depreciation and depletion	5	0
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	0
7	Other expenses (see instructions)	7	0
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8	0

	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	0
b	Average monthly cash balances	1b	0
c	Fair market value of other non-exempt-use assets	1c	0
d	Total (add lines 1a, 1b, and 1c)	1d	0
e	Discount claimed for blockage or other factors (explain in detail in Part VI): 0
2	Acquisition indebtedness applicable to non-exempt use assets	2	0
3	Subtract line 2 from line 1d	3	0
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4	0
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5	0
6	Multiply line 5 by 0.035	6	0
7	Recoveries of prior-year distributions	7	0
8	Minimum Asset Amount (add line 7 to line 6)	8	0

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1	0
2	Enter 85% of line 1	2	0
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3	0
4	Enter greater of line 2 or line 3	4	0
5	Income tax imposed in prior year	5	0
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6	0

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) 2023

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	0
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2	0
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3	0
4 Amounts paid to acquire exempt-use assets	4	0
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5	0
6 Other distributions (describe in Part VI). See instructions	6	0
7Total annual distributions. Add lines 1 through 6.	7	0
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8	0
9 Distributable amount for 2023 from Section C, line 6	9	0
10 Line 8 amount divided by Line 9 amount	10	0 %

Section E - Distribution Allocations (see instructions)	(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6			0
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.		0
3 Excess distributions carryover, if any, to 2023:
a From 2018.......0
b From 2019.......0
c From 2020.......0
d From 2021.......0
e From 2022.......0
fTotal of lines 3a through e	0
g Applied to underdistributions of prior years		0
h Applied to 2023 distributable amount			0
i Carryover from 2018 not applied (see instructions)	0
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.	0
4Distributions for 2023 from Section D, line 7:
$ 0
a Applied to underdistributions of prior years		0
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.	0
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.		0
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.			0
7 Excess distributions carryover to 2024. Add lines 3j and 4c.	0
8 Breakdown of line 7:
a Excess from 2019.....0
b Excess from 2020.....0
c Excess from 2021.....0
d Excess from 2022.....0
e Excess from 2023.....0

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

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

2023

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization CAPE COD HEALTHCARE INC & AFFILIATES

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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization CAPE COD HEALTHCARE INC & AFFILIATES		Employer identification number 90-0054984

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization CAPE COD HEALTHCARE INC & AFFILIATES			Employer identification number 90-0054984
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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

right arrow

Complete if the organization is described below. right arrow

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

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

OMB No. 1545-0047

2022

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

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

A Check right arrow

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

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

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

64,721

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

64,721

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1I	CAPE COD HOSPITAL AND FALMOUTH HOSPITAL ASSOCIATION, INC. PAY MEMBERSHIP DUES TO THE MASSACHUSETTS HOSPITAL ASSOCIATION WHICH ENGAGES IN LOBBYING PURPOSES AS DEFINED BY MEDICARE. PER THE MHA ADVISORY, $52,171, WHICH IS 15.40% OF DUES PAID, SHOULD BE ALLOCATED TO LOBBYING ACTIVITY. CAPE COD HEALTHCARE, INC. AND AFFILIATES ALSO PAID MEMBERSHIP DUES TO VARIOUS HEALTHCARE-RELATED NOT-FOR-PROFIT ASSOCIATIONS, OF WHICH $12,550 IS CONSIDERED LOBBYING.

Return Reference

Explanation

PART II-B, LINE 1I

CAPE COD HOSPITAL AND FALMOUTH HOSPITAL ASSOCIATION, INC. PAY MEMBERSHIP DUES TO THE MASSACHUSETTS HOSPITAL ASSOCIATION WHICH ENGAGES IN LOBBYING PURPOSES AS DEFINED BY MEDICARE. PER THE MHA ADVISORY, $52,171, WHICH IS 15.40% OF DUES PAID, SHOULD BE ALLOCATED TO LOBBYING ACTIVITY. CAPE COD HEALTHCARE, INC. AND AFFILIATES ALSO PAID MEMBERSHIP DUES TO VARIOUS HEALTHCARE-RELATED NOT-FOR-PROFIT ASSOCIATIONS, OF WHICH $12,550 IS CONSIDERED LOBBYING.

Schedule C (Form 990) 2022

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.
right arrow

Attach to Form 990.
right arrow

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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 ....	43,684,073	41,204,632	50,134,744	43,621,531	42,236,761
b	Contributions ...	45,000	75,430	384,054	1,039,075	846,322
c	Net investment earnings, gains, and losses	8,560,438	3,581,952	-8,152,097	6,590,633	1,612,615
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,165,901	1,177,941	1,162,069	1,116,495	1,074,167
f	Administrative expenses ....
g	End of year balance ......	51,123,610	43,684,073	41,204,632	50,134,744	43,621,531

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

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

81.500 %

Term endowment right arrow

18.500 %

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)

Yes

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

Yes

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 .....	15,885,159		15,885,159
b	Buildings ....	442,862,708	255,725,033	187,137,675
c	Leasehold improvements	9,630,359	4,933,955	4,696,404
d	Equipment ....	271,947,386	223,708,395	48,238,991
e	Other .....	171,813,275	19,340,838	152,472,437
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				408,430,666

Schedule D (Form 990) 2022

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) UNRESTRICTED INVESTMENTS	301,924,379	F
(B) TEMP RESTRICTED INVESTMENTS	2,408,472	F
(C) INTEREST IN FDN UNRESTRICTED	195,638,905	F
(D) INTEREST IN FDN TEMP RESTRCTD	16,281,357	F
(E) INTEREST IN FDN PERM RESTRCTD	38,387,575	F
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	554,640,688

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				113,357,741
(2)ROU ASSETS - OPERATING LEASES				2,362,440
(3)EPIC IMPLEMENTATION PROJECT				1,779,421
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				117,499,602

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
DUE TO AFFILIATES	100,384,909
THIRD PARTY RESERVES	29,485,852
COVID-19 GRANT RESERVE	14,069,086
OPERATING LEASES	2,375,625
MISC OTHER LIABILITIES	1,617,034




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	147,932,506
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) 2022

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference	Explanation
SCHEDULE D, PART V, LINE 4	THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO FURTHER THE HEALTHCARE MISSION OF CAPE COD HEALTHCARE AND ITS AFFILIATES.
SCHEDULE D, PART X, LINE 2	THE ORGANIZATION DOES NOT HAVE A FIN 48 FOOTNOTE AS ANY UNCERTAIN TAX POSITIONS WERE DEEMED IMMATERIAL.

Schedule D (Form 990) 2022

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 arrow

Attach to Form 990. Right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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	CAPTIVE INSURANCE	4,784,394
















3a	Sub-total ....	0	0			4,784,394
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	0			4,784,394

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2023

Schedule F (Form 990) 2023

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) 2023

Schedule F (Form 990) 2023Page 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) 2023

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2023

Page 5

Part V

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

ReturnReference	Explanation
SCHEDULE F, PART I, COLUMN F	EXPENSES REPORTED IN THIS SECTION REPRESENT THOSE INCLUDED IN THE ORGANIZATION'S GENERAL LEDGER RELATED TO THE CAPTIVE INSURANCE COMPANY.

Schedule F (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

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

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

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

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

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

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

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

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

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

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)		(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
			Yes	No
	FIVE MAPLES 78 RIVER ROAD SOUTH PUTNEY, VT05346	DIRECT MAIL		No	278,816	34,985	243,831









Total . . . . . . . . . . . . . . . . . . . .					278,816	34,985	243,831

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

AZ, DE, FL, ID, IL, IN, IA, MI, MT, NE, NH, NJ, NY, NC, PA, SC, SD, UT, VT, WI, WY

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

Cat. No. 50083H

Schedule G (Form 990) 2023

Page 2

Part II

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

		(a) Event #1 Cummaquid Golf (event type)	(b) Event #2 Eastward Ho Gol (event type)	(c) Other events 1 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	231,884	143,083	240,562	615,529
2	Less: Contributions . . . .	18,726	17,643	159,017	195,386
3	Gross income (line 1 minus line 2) . . . . . .	213,158	125,440	81,545	420,143

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .	5,437	12,191	20,130	37,758
8	Entertainment . . . .			400	400
9	Other direct expenses . . .	17,204	13,630	24,580	55,414
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				93,572
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				326,571

Part III

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

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

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

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

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

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

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

YesNo

If "No," explain:

10a

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

YesNo

If "Yes," explain:

Schedule G (Form 990) 2023

Page 3

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

YesNo

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

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

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

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

13b

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

Name

Address

15a

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

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

YesNo

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

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

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

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

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

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

YesNo

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

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

Part IV

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

Return Reference	Explanation

Schedule G (Form 990) 2023

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 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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		(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) . . .	8,936,459	2,175,638	6,760,821	0.630 %
b	Medicaid (from Worksheet 3, column a) . . . . .	143,662,945	132,683,112	10,979,833	1.020 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	16,877,541	9,922,492	6,955,049	0.650 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	169,476,945	144,781,242	24,695,703	2.300 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	5,234,949		5,234,949	0.490 %
f	Health professions education (from Worksheet 5) . . .	3,188,153		3,188,153	0.300 %
g	Subsidized health services (from Worksheet 6) . . . .	489,877,904	439,088,421	50,789,483	4.740 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	691,784		691,784	0.060 %
j	Total. Other Benefits . .	498,992,790	439,088,421	59,904,369	5.590 %
k	Total. Add lines 7d and 7j .	668,469,735	583,869,663	84,600,072	7.890 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing			53,000		53,000
2	Economic development			34,000		34,000
3	Community support
4	Environmental improvements
5	Leadership development and training for community members			25,000		25,000
6	Coalition building			51,759		51,759
7	Community health improvement advocacy			107,527		107,527
8	Workforce development			50,000		50,000
9	Other
10	Total			321,286		321,286

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. ......

20,374,329

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. ......

4,771,456

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).....

345,800,460

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

295,127,706

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

50,672,754

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) 2023

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?2Name, 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)					Facility reporting group
1	CAPE COD HOSPITAL 27 PARK STREET HYANNIS,MA02601 SEE PART V, SECTION C 2135	X	X	X	A
2	FALMOUTH HOSPITAL ASSOCIATION INC 100 TER HEUN DRIVE FALMOUTH,MA02540 SEE PART V, SECTION C 2289	X	X	X	A

Schedule H (Form 990) 2023

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)

	A
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 23

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

Yes

If "Yes" (list url): SEE PART V, SECTION C

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 300.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

SEE PART V, SECTION C

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

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

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) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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) 2023

Page 7

Part VFacility Information (continued)

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

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION A	WEBSITES PART V, SECTION A, LINE 1 - CAPE COD HOSPITAL WWW.CAPECODHEALTH.ORG/LOCATIONS-AND-DIRECTIONS/PROFILE/CAPE-COD-HOSPITAL/
PART V, SECTION A, LINE 2 - FALMOUTH HOSPITAL	WWW.CAPECODHEALTH.ORG/LOCATIONS-AND-DIRECTIONS/PROFILE/FALMOUTH-HOSPITAL/
PART V, SECTION B, LINE 5	MANY SOURCES AND DATA COLLECTION METHODOLOGIES WERE USED TO OBTAIN A COMPREHENSIVE VIEW OF THE HEALTH AND HEALTHCARE NEEDS OF THE REGION AND THE PEOPLE SERVED BY CCH AND FH. INPUT ON THE DESIGN OF DATA COLLECTION INSTRUMENTS WAS SOLICITED FROM PUBLIC HEALTH EXPERTS, HEALTHCARE CONSUMERS, AND PERSONS REPRESENTING VULNERABLE AND MEDICALLY UNDERSERVED POPULATIONS AND MINORITIES. CONSCIENTIOUS EFFORTS WERE MADE TO REACH A WIDE-RANGING POPULATION OF RESIDENTS DURING DATA COLLECTION TO ENSURE BROAD REPRESENTATION OF COMMUNITY INTERESTS AND PERSPECTIVES IN THE FOLLOWING WAYS. . SECONDARY DATA REVIEW. EXISTING DATA FROM NATIONAL, STATE, AND LOCAL SOURCES WERE REVIEWED. THE TYPES OF DATA COLLECTED INCLUDED DEMOGRAPHICS, VITAL STATISTICS, AND PUBLIC HEALTH SURVEILLANCE. THE SELECTION OF SECONDARY DATA POINTS WAS GENERALLY BASED ON THE PRIOR CHNAS TO ALLOW FOR EXAMINATION OF TRENDS OVER TIME. HOWEVER, ADDITIONAL SECONDARY DATA SOURCES WERE EXPLORED WHEN MAJOR THEMES OR ISSUES AROSE FROM QUALITATIVE DATA COLLECTION. WHEN AVAILABLE, DATA WERE STRATIFIED BY AGE GROUP OR BY INCOME/POVERTY LEVEL TO IDENTIFY AREAS OF DISPARITY. . KEY INFORMANT INTERVIEWS. TWENTY-FIVE VIRTUAL INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS FROM ORGANIZATIONS ACROSS ALL OF BARNSTABLE COUNTY, REPRESENTING HEALTH CENTERS, PUBLIC SAFETY ORGANIZATIONS, HOUSING ORGANIZATIONS, AND OTHER HUMAN SERVICE GROUPS. KEY INFORMANTS WERE IDENTIFIED FOR PARTICIPATION BASED ON THEIR IN-DEPTH KNOWLEDGE OF THE HEALTH NEEDS AND RESOURCES OF THE REGION AND DRAWN FROM THE BROADER LIST OF ORGANIZATIONS AND AGENCIES COLLABORATING WITH CCHC FOR THIS CHNA. DISCUSSIONS FOCUSED ON STRENGTHS AND NEEDS IN THE COMMUNITY AND OPPORTUNITIES AND CHALLENGES TO ADDRESSING COMMUNITY NEEDS. THEY WERE ALSO ASKED TO DESCRIBE ORGANIZATIONAL PARTNERSHIPS WITHIN BARNSTABLE COUNTY, PERCEPTION OF COMMUNITY SERVICES, AND PERCEPTIONS OF CCHC. . COMMUNITY FOCUS GROUPS. FOUR VIRTUAL FOCUS GROUPS WERE HELD WITH RESIDENTS TO GATHER INFORMATION ABOUT THE COMMUNITY, HEALTH CHALLENGES AND NEEDS, AND EXISTING AND NEEDED SERVICES. THESE GROUPS WERE TARGETED BASED UPON INPUT OF CCHC'S COMMUNITY HEALTH COMMITTEE AND THE DATA COLLECTION GAPS IDENTIFIED IN THE PRIOR CHNA PROCESS. COMPLETED GROUPS INCLUDED RESIDENTS OF FALMOUTH, RESIDENTS OF THE OUTER CAPE, PARENTS AND/OR CAREGIVERS TO CHILDREN WITH BEHAVIORAL HEALTH CONCERNS, AND PORTUGUESE-SPEAKING RESIDENTS. A TOTAL OF 20 RESIDENTS PARTICIPATED ACROSS THE FOUR FOCUS GROUPS. . COMMUNITY SURVEY. A COMMUNITY SURVEY ASKING ABOUT COMMUNITY AND INDIVIDUAL HEALTH AND HEALTHCARE NEEDS WAS DEVELOPED AND MADE AVAILABLE ON-LINE AND ON PAPER TO RESIDENTS OF BARNSTABLE COUNTY. THE SURVEY INCLUDED QUESTIONS THAT FOCUSED ON RESIDENTS' PERCEPTIONS OF THEIR OWN HEALTH, THE HEALTH OF THEIR COMMUNITY, HEALTHCARE UTILIZATION, AND SOCIAL NEEDS IN THE COMMUNITY. THE SURVEY WAS AVAILABLE IN ENGLISH, SPANISH, HAITIAN CREOLE, AND PORTUGUESE AND WAS COMPLETED BY 1,096 TOTAL RESIDENTS. A LIST OF PARTICIPANTS AND DEMOGRAPHIC CHARACTERISTICS CAN BE FOUND IN APPENDIX A AND B OF THE 2023-2025 CHNA.
PART V, SECTION B, LINE 6 (A)	CAPE COD HOSPITAL AND FALMOUTH HOSPITAL JOINTLY CONDUCTED THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORT.
PART V, SECTION B, LINE 7(A)	HTTPS://WWW.CAPECODHEALTH.ORG/APP/FILES/PUBLIC/93EED64B-658B-4677-A567-C29 4F1066683/2023-2025-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF
PART V, SECTION B, LINE 10(A)	https://www.capecodhealth.org/about/caring-for-our-community/
PART V, SECTION B, LINE 11	IN FALL 2022 THE CONSULTING FIRM HRIA LED A FACILITATED PROCESS WITH CCHC LEADERSHIP AND COMMUNITY STAKEHOLDERS TO IDENTIFY PRIORITIES, GOALS AND OBJECTIVES FOR CCHC'S STRATEGIC IMPLEMENTATION PLAN. THROUGH THOUGHTFUL CONSIDERATION OF THE DATA PRESENTED AND CONTAINED IN THE 2023-2025 COMMUNITY HEALTH NEEDS ASSESSMENT, THE PRIORITIZATION CRITERIA AND KNOWLEDGE OF THE EXISTING AND PLANNED PROGRAMS, ALREADY IN PLACE, PARTICIPANTS WERE POLLED TO IDENTIFY THE TOP THREE THEMES THEY WOULD SELECT AS A PRIORITY. FOLLOWING DISCUSSION OF THE POLLING RESULTS AND CONSIDERATION BY CCHC LEADERSHIP, THREE PRIORITIES WERE IDENTIFIED WITH TWO CROSS-CUTTING THEMES TO BE INCLUDED IN THE OBJECTIVES AND/OR STRATEGIES IN EACH OF THE PRIORITY AREAS. PRIORITIES: BEHAVIORAL HEALTH, HEALTHCARE ACCESS, HOUSING. CROSS-CUTTING THEMES: HEALTH EQUITY, ECONOMIC STRESS AND STABILITY. TO ADDRESS THESE NEEDS, CCHC COLLABORATES WITH COMMUNITY PARTNERS ACROSS THE REGION TO ASSESS COMMUNITY NEEDS, IDENTIFY PROMISING PROGRAMS AND IMPLEMENT STRATEGIES TO IMPROVE PEOPLE'S HEALTH. THROUGH AN OPEN AND COMPETITIVE ANNUAL STRATEGIC GRANT PROGRAM, CCHC FUNDS PROJECTS ADDRESSING A VARIETY OF HEALTH NEEDS, BASED ON THE PRIORITIES AND THEMES LISTED ABOVE. ADDITIONALLY, CCHC HAS INVESTED IN NEW AND EXPANDED HOSPITAL PROGRAMS IN AREAS SUCH AS CANCER SUPPORT, BEHAVIORAL HEALTH SUPPORT IN COMMUNITY-BASED SETTINGS, SUPPORT FOR NEW FAMILIES, AND MORE. CCHC'S COMMUNITY BENEFITS FUNDING ALSO SUPPORT MEDICAL INTERPRETER SERVICES FOR LIMITED ENGLISH-SPEAKING PATIENTS, HOSPITAL SOCIAL WORKERS AND CASE MANAGERS, AND FINANCIAL COUNSELORS. CCHC ALSO PLAYS A LEADERSHIP ROLE THROUGH PARTICIPATION IN, AMONG OTHERS, THE REGIONAL NETWORK ON HOMELESSNESS, THE BARNSTABLE COUNTY HUMAN SERVICES ADVISORY COUNCIL AND THE CAPE COD CHAMBER OF COMMERCE.`
PART V, SECTION B, LINE 16(A), 16(B), 16(C)	HTTPS://WWW.CAPECODHEALTH.ORG/PATIENTS-VISITORS/PAYING-FOR-CARE/FINANCIAL- ASSISTANCE/

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?94
Name and address		Type of Facility (describe)
1	CAPE COD HEALTHCARE INC 297 NORTH STREET BLDG 3 HYANNIS,MA02601	ADMINISTRATIVE
2	Fontaine Primary Care 525 Long Pond Drive HARWICH,MA02645	medical group practice
3	CCHC Neurosurgery 46 NORTH ST STE 4 HYANNIS,MA02601	medical group practice
4	Fal Hosp Medical Center at Bramblebush 21 Bramblebush Park FALMOUTH,MA02540	medical group practice
5	Seaside Pediatrics 150 Ansel Hallet Road West Yarmouth,MA02673	medical group practice
6	Fontaine OUTPATIENT CENTER 525 Long Pond Drive Harwich,MA02645	medical group practice
7	Guo X Y David MD PhD-GASTROENTEROLOGY 90 TER HEUN DRIVE STE 302 Falmouth,MA02540	medical group practice
8	CCHC Stoneman Primary Care 2 Jan Sebastian Way Suite 100 Sandwich,MA02563	medical group practice
9	CCHC Gastroenterology - Hyannis 700 ATTUCKS LANE STE 1E Hyannis,MA02601	medical group practice
10	CCHC Plastic Surgery 160 Falmouth Road Suite B MASHPEE,MA02649	medical group practice
11	CAPE COD OBSTETRICS & GYNECOLOGY 90 Ter Heun Drive SUITE 100 Falmouth,MA02540	medical group practice
12	Endocrine Center of Cape Cod - Hyannis 1030 FALMOUTH RD STE 201 Hyannis,MA02601	medical group practice
13	CARDIOVASCULAR CENTER - FALMOUTH 90 Ter Heun Drive Suite 300 Falmouth,MA02540	medical group practice
14	Nauset Family Practice 81 Old Colony Way STE D ORLEANS,MA02653	medical group practice
15	Cape Health Insurance Company - FOREIGN 297 NORTH ST 3 HYANNIS,MA02601	administrative
16	JML Care Center 184 Ter Heun Drive falmouth,MA02540	skilled nur & rehab
17	Cape & Islands Health Services II Inc 14 Yellow Brick Road HYANNIS,MA02601	COLLECTION CENTER
18	Cape & Islands Health Services II 5 Industrial Drive Suite 102 MASHPEE,MA02649	COLLECTION CENTER
19	Cape & Islands Health Services II 525 Long Pond Drive HARWICH,MA02645	COLLECTION CENTER
20	Cape & Islands Health Services II 81 Old Colony Way ORLEANS,MA02653	COLLECTION CENTER
21	Cape & Islands Health Services II 2 Jan Sebastian Way Route 130 SANDWICH,MA02563	COLLECTION CENTER
22	Cape & Islands Health Services II 860 Route 134 Unit 2 South Dennis,MA02660	COLLECTION CENTER
23	Cape Cod Healthcare Lab Services 1 Trowbridge Place Bourne,MA02532	COLLECTION CENTER
24	Cape & Islands Health Services II 27 PARK STREET HYANNIS,MA02601	COLLECTION CENTER
25	Heritage at Falmouth 140 Ter Heun Drive FALMOUTH,MA02540	ASSISTED LIVING
26	Cape Cod Human Services 460 West Main Street HYANNIS,MA02601	outpatient clinic
27	Cape Cod Human Services 525 Long Pond Drive HARWICH,MA02645	outpatient clinic
28	Cape Cod Medical Office Building Inc 20 Gleason Street HYANNIS,MA02601	MEDICAL GROUP PRACTICE
29	CAPE COD Dermatology 134 Ansel Halet Road W Yarmouth,MA02673	Medical Group Practice
30	Cape Cod Rheumatology Center - Hyannis 1030 FALMOUTH RD STE 201 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
31	CCHC Cardiovascular Center - Hyannis 25 Main Street HYANNIS,MA02601	MEDICAL GROUP PRACTICE
32	Endocrine Center of Cape Cod - Harwich 525 Long Pond Drive HARWICH,MA02645	MEDICAL GROUP PRACTICE
33	Fontaine Urgent Care Center 525 Long Pond Drive HARWICH,MA02645	MEDICAL GROUP PRACTICE
34	Vascular & Vein Center Of Cape Cod - FAL 90 Ter Heun Drive 3RD Fl MOB STE Falmouth,MA02540	Medical Group Practice
35	CCHC General & Specialty Surgery 105 Park Street Hyannis,MA02601	Medical Group Practice
36	GASTROENTEROLOGY HYANNIS - PARK STREET 105 PARK STREET HYANNIS,MA02601	Medical Group Practice
37	STONEMAN OUTPATIENT CENTER - URGENT CARE 2 JAN SEBASTIAN DRIVE SUITE 101 SANDWICH,MA02563	Medical Group Practice
38	MASHPEE SURGICAL CENTER 160 FALMOUTH ROAD SUITE A MASHPEE,MA02649	MEDICAL GROUP PRACTICE
39	SOUTHEASTERN SURGICAL ASSOCIATES 100 CAMP STREET HYANNIS,MA02601	MEIDCAL GROUP PRACTICE
40	UPPER CAPE EAR NOSE THROAT 200 A JONES ROAD FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
41	CCHC PODIATRIC MEDICINE & FOOT SURGERY 1030 FALMOUTH RD RTE 28 SUITE 20 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
42	VNA of Cape Cod - Harwich 1 AUSTON RD F HARWICH,MA02645	HOME HEALTH
43	VNA OF CAPE COD - EASTHAM 3960 STATE HWY RD 6 2 EASTHAM,MA02642	HOME HEALTH
44	VNA OF CAPE COD - FALMOUTH 67 TER HEUN DR FALMOUTH,MA02540	HOME HEALTH
45	VNA OF CAPE COD - MARTHA'S VINEYARD 49 STATE RD VINEYARD HAVEN,MA02568	HOME HEALTH
46	VNA OF CAPE COD - NANTUCKET 40 Sherburne Commons Sherburne Hou NANTUCKET,MA02554	HOME HEALTH
47	VNA OF CAPE COD - PROVINCETOWN 26 ALDEN ST PROVINCETOWN,MA02657	HOME HEALTH
48	VNA OF CAPE COD - SOUTH DENNIS 434 ROUTE 134 BLDG D 3 SOUTH DENNIS,MA02660	HOME HEALTH
49	CAPE & ISLANDS HEALTH SERVICES II 35 WILKENS LANE HYANNIS,MA02601	COLLECTION CENTER
50	North Falmouth Primary Care 33 Edgerton Drive Falmouth,MA02556	MEDICAL GROUP PRACTICE
51	Cape Cod Ear Nose and Throat Specialist 65 Cedar Street Hyannis,MA02601	MEDICAL GROUP PRACTICE
52	Cape Cod Pulmonary Medicine 46 North Street Unit 7 Hyannis,MA02601	Medical Group Practice
53	VNA of Cape Cod - Sagamore Beach 110 State Road Unit 3 Sagamore Beach,MA02562	Home Health
54	CAPE COD RHEUMATOLOGY CENTER - FALMOUTH 90 TER HEUN DRIVE SUITE 302 3RD FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
55	FALMOUTH PRIMARY CARE 90 TER HEUN DRIVE SUITE 2300 FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
56	MASHPEE PRIMARY CARE 5 INDUSTRIAL DRIVE SUITE 205 MASHPEE,MA02649	MEDICAL GROUP PRACTICE
57	OSTERVILLE PRIMARY CARE 770 MAIN STREET OSTERVILLE,MA02655	MEDICAL GROUP PRACTICE
58	STRAWBERRY HILL PRIMARY CARE 1030 FALMOUTH ROAD 1ST FLOOR STE HYANNIS,MA02601	MEDICAL GROUP PRACTICE
59	FALMOUTH ORTHOPEDIC CARE 360 GIFFORD STREET FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
60	YARMOUTH PRIMARY CARE 495 STATION AVE SOUTH YARMOUTH,MA02664	MEDICAL GROUP PRACTICE
61	CAPE COD HEALTHCARE LAB SERVICES CHATHAM 1629 Main St CHATHAM,MA02633	REHABILITATION
62	IMAGING & RADIOLOGY - URGENT CARE - FAL 273 Teaticket Highway FALMOUTH,MA02540	RADIOLOGY
63	STRAWBERRY HILL DERMATOLOGY 1030 FALMOUTH ROAD HYANNIS,MA02601	DERMATOLOGY
64	IMAGING & RADIOLOGY URGENT CARE HYANNIS 1220 Iyannough Road HYANNIS,MA02601	RADIOLOGY
65	CCHC GENERAL & THORACIC SURGERY 130 NORTH STREET HYANNIS,MA02601	THORACIC SURGERY
66	CCHC - URGENT CARE - OSTERVILLE 770 Main Street OSTERVILLE,MA02655	URGENT CARE
67	CCHC - CARDIOVASCULAR CENTER - SANDWICH 2 Jan Sebastian Drive SANDWICH,MA02563	CARDIOVASCULAR CENTER
68	Neurologists of Cape Cod 2 Jan Sebastian Drive SANDWICH,MA02563	MEDICAL PRACTICE GROUP
69	SANDWICH PRIMARY CARE 2 Jan Sebastian Drive SANDWICH,MA02563	PRIMARY CARE
70	Bourne Primary Care 1 Trowbridge Place Bourne,MA02532	COLLECTION CENTER
71	Cape Obstetrics & Gynecology 1 Trowbridge Place Bourne,MA02532	MEDICAL GROUP PRACTICE
72	Cape Cod Healthcare Orthopedic Surgery 1220 Iyannough Road Hyannis,MA02601	MEDICAL GROUP PRACTICE
73	Cape Cod Healthcare Urgent Care -Orleans 42 Route 6A Orleans,MA02653	URGENT CARE
74	Falmouth Hospital Med Ctr - Bramblebush 5 Bramblebush Drive Falmouth,MA02540	MEDICAL GROUP PRACTICE
75	McCarthy Care Center 73 Service Road East Sandwich,MA02537	MEDICAL GROUP PRACTICE
76	Cape Cod Human Services 100 Ter Heun Drive Falmouth,MA02540	OUTPATIENT CLINIC
77	CAPE & ISLANDS HEALTH SERVICES II 100 Ter Heun Drive Falmouth,MA02540	COLLECTION CENTER
78	CAPE OBSTETRICS & GYNECOLOGY 2 JAN SEBASTIAN DRIVE SANDWICH,MA02563	MEDICAL GROUP PRACTICE
79	CAPE COD HEALTHCARE DEMENTIA & ALZHEIMER 1019 IYANNOUGH ROAD HYANNIS,MA02601	EDUCATIONAL
80	NEUROLOGISTS OF CAPE COD 1019 IYANNOUGH ROAD SUITE 1 HYANNIS,MA02601	MEDICAL GROUP PRACTICE
81	FALMOUTH ORTHOPEDIC CENTER 2 JAN SEBASTIAN DRIVE SUITE 103 SANDWICH,MA02563	MEDICAL GROUP PRACTICE
82	FALMOUTH ORTHOPEDIC CENTER 770 MAIN STREET OSTERVILLE,MA02655	MEDICAL GROUP PRACTICE
83	CAPE COD EAR NOSE AND THROAT SPECIALIST 20 INDIAN HILL ROAD WEST TISBURY,MA02575	MEDICAL GROUP PRACTICE
84	CAPE COD EAR NOSE AND THROAT SPECIALIST 5 INDUSTRIAL DRIVE SUITE 107 MASHPEE,MA02649	MEDICAL GROUP PRACTICE
85	VNA OF CAPE COD - HYANNIS 25 COMMUNICATION WAY HYANNIS,MA02601	HOME HEALTH
86	ORLEANS PRIMARY CARE 42 ROUTE 6A UNIT 2 ORLEANS,MA02653	PRIMARY CARE
87	CCHC GOLF PERFORMANCE CENTER 46 NORTH STREET SUITE 5 HYANNIS,MA02601	REHABILITATION
88	CCHC CARDIOVASCULAR SURGICAL SERVICES 60A PARK STREET HYANNIS,MA02601	MEDICAL GROUP PRACTICE
89	HEALTHCARE FOUNDATION 4 BAYVIEW WEST YARMOUTH,MA02673	ADMINISTRATIVE
90	FALMOUTH BREAST CARE CENTER AT CCHC 90 TER HEUN DRIVE SUITE 302 FALMOUTH,MA02540	MEDICAL GROUP PRACTICE
91	CAPE COD HEALTHCARE CARDIOVASCULAR CTR 1629 MAIN STREET CHATHAM,MA02633	MEDICAL GROUP PRACTICE
92	PTDIETICIANS 22 LEWIS BAY ROAD HYANNIS,MA02601	EDUCATIONAL
93	CCHC GENERAL & VASCULAR SURGERY 6 Main Street Bldg B HYANNIS,MA02601	Medical Group Practice
94	SEASIDE PEDIATRICS 42 Route 6A ORLEANS,MA02653	Medical Group Practice

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 3C	N/A
PART I, LINE 6A	N/A
PART I, LINE 7, COLUMN F	THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN F WAS $20,374,329. THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED FOLLOWING THE FORM 990, SCHEDULE H INSTRUCTIONS, AND USED THE RATIO OF PATIENT CARE COST TO CHARGES FOR LINES 7(A), (B), (C) AND (G), AND USED ACTUAL EXPENSES FOR LINES 7(E), (F) AND (I). THE TOTAL PERCENTAGE OF CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST IN THE TABLE WAS CALCULATED ON A GROUP RETURN BASIS AS REQUIRED BY THE FORM 990 INSTRUCTIONS, AND NOT ON A HOSPITAL-ONLY BASIS.
PART II LINES 1, 2, 5, 6, 7 AND 8	PHYSICAL IMPROVEMENTS AND HOUSING CCHC HAS PARTNERED WITH SEVERAL LOCAL ORGANIZATIONS THAT ARE WORKING TO ADDRESS THE HOUSING CRISIS ON CAPE COD. THESE INCLUDE: BELONGING TO EACH OTHER'S TEMPORARY WINTER HOUSING PROGRAM, HABITAT FOR HUMANITY, AND DUFFY HEALTH CENTER'S IN FROM THE STREETS PROGRAM. ECONOMIC DEVELOPMENT CCHC SUPPORTS THE CAPE COD COMMERCIAL FISHERMAN'S HEALTHY SEAFOOD AND A HEALTHY SEAFOOD INDUSTRY, WHICH PAYS LOCAL FISHERMEN A FAIR, PREDICTABLE PRICE FOR PRODUCT WHILE ALSO SUPPORTING COMMUNITIES FACING FOOD INSECURITY. THE CHOWDER AND STEW THAT IS PRODUCED FROM THIS PROGRAM IS DISTRIBUTED TO FOOD BANKS, ASSISTED LIVING FACILITIES, NURSING HOMES, ETC. CCHC ALSO SUPPORTS AMPLIFY POC CAPE COD, AND WE CAN ON THEIR ECONOMIC STABILITY AND EMPOWERMENT PROGRAMS. AMPLIFY POC SERVES PEOPLE OF COLOR ON CAPE COD, AND WE CAN SERVES WOMEN EXPERIENCING TRANSITION ON CAPE COD. COALITION BUILDING CCHC CLINICAL STAFF, COMMUNITY BENEFITS STAFF AND OTHER SUPPORT STAFF PARTICIPATED IN A VARIETY OF COALITION BUILDING ACTIVITIES TO ADDRESS AND IMPROVE CARE RELATED TO BEHAVIORAL HEALTH, CARE COORDINATION, DISEASE PREVENTION, MATERNAL CHILD HEALTH, HOUSING AND SUBSTANCE USE. REGIONAL COALITIONS SERVE AS ALLIANCES FOR COMBINED AND COORDINATED ACTION TO IMPROVE KEY HEALTH ISSUES. COALITION ACTIVITIES RANGED FROM IMPLEMENTATION OF NEW PROGRAMS TO PROVIDER COORDINATION TO THE DEVELOPMENT OF MULTI-SECTOR PARTNERSHIPS. COMMUNITY HEALTH IMPROVEMENT ADVOCACY LEADERSHIP FROM CCHC'S BEHAVIORAL HEALTH DEPARTMENT SERVE ON THE MA DEPARTMENT OF MENTAL HEALTH'S EXPEDITED PSYCHIATRIC INPATIENT ADMISSIONS POLICY AND WORKGROUP, WHICH IS A STATEWIDE INITIATIVE TO ADDRESS EMERGENCY DEPARTMENT BOARDING OF PATIENTS NEEDING INPATIENT PSYCHIATRIC CARE. WORKFORCE DEVELOPMENT CCHC ENGAGES IN WORKFORCE DEVELOPMENT IN A VARIETY OF WAYS. CCHC PHYSICIAN RECRUITMENT PROGRAM STRIVES TO IDENTIFY AREAS OF UNMET NEED AND IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE FOR VULNERABLE POPULATIONS, ESPECIALLY THOSE OVER 65 WITH PUBLIC HEALTH INSURANCE COVERAGE. THROUGH RIGOROUS EFFORTS, HIGHLY QUALIFIED PHYSICIANS AND PHYSICIAN EXTENDERS ARE RECRUITED AND RETAINED TO MEET THE HEALTH CARE NEEDS OF OUR COMMUNITY. CCHC ALSO HAS PARTNERSHIPS WITH LOCAL ORGANIZATIONS TO DEVELOP THE WORKFORCE IN OUR AREA, INCLUDING WITH BARNSTABLE HIGH SCHOOL ON THEIR CERTIFIED NURSING ASSISTANT PROGRAM RIVERVIEW SCHOOL ON THEIR JOB TRAINING PROGRAM AND THE CAPE COD FISHERMAN'S COMMERCIAL ALLIANCE ON FISHING CAREERS FOR IMMIGRANT FAMILIES.
PART III, LINES 2-3	THE ORGANIZATION IS REPORTING $4,771,456 OF BAD DEBT EXPENSE THAT MEETS ITS FINANCIAL ASSISTANCE POLICY. THIS AMOUNT IS RELATED TO BAD DEBT FROM BOTH HOSPITALS DURING FY24 OF UNINSURED PATIENTS WHO WERE SEEN IN THE ER AND RECEIVED MEDICALLY NECESSARY SERVICES. CAPE COD HEALTHCARE RECEIVES PAYMENTS FOR SERVICES RENDERED FROM FEDERAL AND STATE AGENCIES (UNDER THE MEDICARE AND MEDICAID PROGRAMS), MANAGED CARE PAYORS, COMMERCIAL INSURANCE COMPANIES, AND PATIENTS. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF CONTRACTUAL ALLOWANCES AND RESERVES FOR DENIALS, UNCOMPENSATED CARE, AND DOUBTFUL ACCOUNTS. THE LEVEL OF RESERVES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL AND PRIVATE EMPLOYER HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. IF A PATIENT IS INELIGIBLE FOR CHARITY CARE BECAUSE HIS OR HER INCOME EXCEEDS THE ELIGIBILITY GUIDELINES, ANY UNCOLLECTIBLE ACCOUNTS RECEIVABLE BALANCE IS WRITTEN OFF TO BAD DEBT AS REPORTED IN PART III, LINE 2.
PART III, LINE 4	THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE RELATED TO BAD DEBT OR ALLOWANCE FOR DOUBTFUL ACCOUNTS.
PART III LINE 9(B)	THE HOSPITAL PROVIDES PATIENTS WITH INFORMATION ABOUT THE AVAILABILITY FOR FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE THROUGH THE COMMONWEALTH OF MASSACHUSETTS AND THROUGH THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM, WHICH MAY COVER ALL OR A PORTION OF THEIR HOSPITAL BILL. WHEN APPLICABLE THE HOSPITAL MAY ALSO ASSIST PATIENTS IN APPLYING FOR COVERAGE OF SERVICES SUCH AS MEDICAL HARDSHIP BASED ON THE PATIENT'S DOCUMENTED INCOME AND ALLOWABLE MEDICAL EXPENSES.
PART VI, LINE 2	NEEDS ASSESSMENT: THE 2023-2025 CAPE COD HOSPITAL AND FALMOUTH HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT REPORT (CHNA) WAS RELEASED AND MADE WIDELY AVAILABLE TO THE PUBLIC IN SEPTEMBER 2022. THE PURPOSE OF THE CHNA IS TO UNDERTAKE A DATA-DRIVEN AND COMMUNITY-LED PROCESS THAT IDENTIFIES AND PRIORITIZES THE HEALTH NEEDS OF RESIDENTS OF THE REGION BASED ON THE FREQUENCY, SIZE, SCOPE, AND MAGNITUDE OF THE ISSUES. IN ADDITION, THE CHNA PROCESS PROVIDES CCH AND FH THE OPPORTUNITY TO: . IDENTIFY VULNERABLE, DISADVANTAGED, AND MEDICALLY UNDERSERVED TARGET POPULATIONS . IDENTIFY KEY AREAS OF SIGNIFICANT COMMUNITY NEED AND VULNERABLE POPULATIONS . EXAMINE THE IMPACT AND ROLE OF SOCIAL DETERMINANTS OF HEALTH IN THE COMMUNITY . MONITOR REGIONAL HEALTH DATA AND MAINTAIN AN INVENTORY OF AVAILABLE RESOURCES . FACILITATE THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES TO GUIDE HOSPITAL COMMUNITY HEALTH INITIATIVES AND COMMUNITY INVESTMENTS TO IMPROVE HEALTH . PROMOTE PARTNERSHIP AND DIALOGUE BETWEEN THE HOSPITALS AND COMMUNITY ORGANIZATIONS IN ADDITION TO THE CHNA, CCHC WORKS CLOSELY WITH THE COMMUNITY HEALTH COMMITTEE. THIS 25-MEMBER ADVISORY GROUP REPRESENTS THE DIVERSITY OF THE CAPE COD COMMUNITY AND MEMBERS INCLUDE PHYSICIANS, PUBLIC HEALTH EXPERTS, COMMUNITY ORGANIZATIONS AND PATIENTS. THIS COMMITTEE HELPS TO INFORM CCHC STAFF ABOUT CURRENT HEALTH CARE NEEDS OF OUR COMMUNITY AND PROVIDES GUIDANCE ON COMMUNITY BENEFIT PROGRAMS.
PART VI, LINE 3	FOR THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED THE HOSPITAL WILL WORK WITH PATIENTS TO ASSIST THEM IN APPLYING FOR PUBLIC ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE PROGRAMS THAT MAY COVER SOME OR ALL OF THEIR UNPAID HOSPITAL BILLS. IN ORDER TO HELP UNINSURED AND UNDERINSURED INDIVIDUALS FIND AVAILABLE OPTIONS, THE HOSPITAL WILL PROVIDE ALL INDIVIDUALS WITH A GENERAL NOTICE OF THE AVAILABILITY OF PUBLIC ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAMS DURING THE PATIENT'S INITIAL IN-PERSON REGISTRATION AT A HOSPITAL LOCATION FOR SERVICE, IN BILLING INVOICES THAT ARE SENT TO A PATIENT OR GUARANTOR AND WHEN THE PROVIDER IS NOTIFIED OR THROUGH ITS OWN DUE DILIGENCE BECOMES AWARE OF A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS FOR PUBLIC OR PRIVATE INSURANCE COVERAGE.
PART VI, LINE 4	DEMOGRAPHICS OF THE SERVICE AREA CCHC'S PRIMARY SERVICE AREA IS BARNSTABLE COUNTY. BARNSTABLE COUNTY IS A GEOGRAPHICALLY ISOLATED REGION LOCATED ON THE EASTERN SEABOARD OF MASSACHUSETTS. THE NARROW PENINSULA SPANS OVER 70 MILES IN LENGTH AND NOW HOSTS A YEAR-ROUND POPULATION OF 228,996 RESIDENTS. BARNSTABLE COUNTY CONSISTS OF 15 TOWNS THAT VARY IN THEIR CURRENT POPULATION SIZE FROM ABOUT 49,000 RESIDENTS (BARNSTABLE) TO SLIGHTLY MORE THAN 2,500 RESIDENTS (TRURO). IN ADDITION TO SERVING YEAR-ROUND RESIDENTS, THE REGIONAL COMMUNITY INFRASTRUCTURE, INCLUDING CCH AND FH, MUST MEET THE DEMANDS OF A SIGNIFICANT INFLUX OF SEASONAL RESIDENTS AND VISITORS EACH YEAR, WHICH HAS HISTORICALLY BEEN ESTIMATED TO INCLUDE ABOUT SEVEN MILLION VISITORS AND RESIDENTS ON CAPE COD IN THE SUMMER SEASON. NEARLY HALF OF THE TOTAL POPULATION OF BARNSTABLE COUNTY RESIDE IN THE THREE LARGEST TOWNS (BARNSTABLE, FALMOUTH, AND YARMOUTH) AND POPULATION SIZE BECOMES INCREASINGLY SMALLER IN TOWNS OF THE LOWER CAPE (HARWICH, BREWSTER, CHATHAM, AND ORLEANS) AND OUTER CAPE (EASTHAM, WELLFLEET, TRURO, AND PROVINCETOWN), MANY OF WHICH ARE CONSIDERED RURAL. BETWEEN 2010 AND 2020, THE OVERALL POPULATION OF BARNSTABLE COUNTY HAS INCREASED BY 6.1%. IN COMPARISON, THE STATE POPULATION GREW BY 7.4% DURING THAT TIME. THESE FINDINGS ARE IN CONTRAST TO THE PRIOR CHNA, WHICH SHOWED LITTLE TO NO POPULATION GROWTH BETWEEN 2011 AND 2016. THE POPULATION OF BARNSTABLE COUNTY IS OLDER THAN THE STATE OVERALL. THE OVERALL MEDIAN AGE IN BARNSTABLE COUNTY IS 53.7 YEARS COMPARED TO 39.6 YEARS AT THE STATE LEVEL. ALL TOWNS WITHIN BARNSTABLE COUNTY HAVE SMALLER PERCENTAGES OF RESIDENTS IN THE UNDER 18 AND 18- TO 24- YEAR-OLD AGE GROUPS THAN THE STATE OVERALL AND LARGER PERCENTAGES OF RESIDENTS IN THE 65 YEARS AND OLDER AGE GROUP. PUBLIC SCHOOL ENROLLMENT DATA FROM 2014 TO 2022 INDICATES THAT THE SIZE OF THE YOUTH POPULATION IN GRADES 1 THROUGH 8 IN BARNSTABLE COUNTY HAS DECLINED BY 15% OVER THE PAST 8 YEARS. THE LARGEST DECREASES IN THIS AGE GROUP WERE SEEN IN ON THE UPPER CAPE (SANDWICH, BOURNE, MASHPEE & FALMOUTH) WITH MOST DISTRICTS LOSING CLOSE TO 20% OF THEIR GRADES 1-8 POPULATION. THE ONLY DISTRICT WITH A MEASURABLE GAIN IN YOUTH OVER THIS TIME (AND NOT ATTRIBUTED TO REDISTRICTING) WAS PROVINCETOWN. BARNSTABLE COUNTY, WHEN COMPARED TO THE STATE, HAS A HIGHER PERCENTAGE OF RESIDENTS WHO ARE WITHIN THE 'OLDEST' AGE CATEGORIES, INCLUDING THOSE AGE 75 TO 84 (8.8% VS. 4.4%, RESPECTIVELY) AND THOSE AGE 85 YEARS AND OLDER (3.9% VS. 2.3%, RESPECTIVELY). SEVERAL TOWNS HAVE NOTABLY LARGE PERCENTAGES OF THEIR POPULATION IN THESE OLDER AGE GROUPS, SPECIFICALLY EASTHAM, ORLEANS, AND CHATHAM. RELATED IN PART TO THE OLDER AGE OF THE POPULATION, BARNSTABLE COUNTY ALSO HAS LARGER PERCENTAGES OF VETERANS AND RESIDENTS WITH DISABILITIES THAN THE STATE OVERALL. NEARLY NINE PERCENT (8.8%) OF COUNTY RESIDENTS IDENTIFIED AS VETERANS COMPARED TO 5.3% FOR THE STATE. APPROXIMATELY 13% OF RESIDENTS IN BARNSTABLE HAVE AT LEAST ONE DISABILITY, COMPARED TO 12% FOR THE STATE -- THIS PERCENTAGE DOES INCREASE WITH AGE, 20.5% OF RESIDENTS AGED 65 TO 74 YEARS AND 38.5% OF RESIDENTS AGED 75 YEARS AND OLDER HAVING AT LEAST ONE DISABILITY. BASED ON SELF-IDENTIFIED RACE AND ETHNICITY, THE POPULATION OF BARNSTABLE COUNTY IS LESS DIVERSE THAN THE STATE OVERALL. EIGHTY-EIGHT PERCENT (88.3%) OF BARNSTABLE COUNTY RESIDENTS IDENTIFY AS WHITE, NON-HISPANIC COMPARED TO 70.8% IN THE STATE OVERALL. THOUGH COMPRISING A SMALL PROPORTION OF THE OVERALL POPULATION, APPROXIMATELY 25,000 BARNSTABLE COUNTY RESIDENTS IDENTIFY AS A RACIAL OR ETHNIC MINORITY. WHEN EXAMINED GEOGRAPHICALLY, THE MAJORITY OF RESIDENTS IDENTIFYING AS A RACIAL OR ETHNIC MINORITY RESIDE WITHIN THE TOWNS OF THE UPPER CAPE (BOURNE, FALMOUTH, MASHPEE, AND SANDWICH) AND THE MID CAPE (BARNSTABLE, DENNIS, AND YARMOUTH). THE PERCENT OF BARNSTABLE COUNTY RESIDENTS WHO ARE FOREIGN-BORN IS CURRENTLY ESTIMATED TO BE 8.4%, ABOUT HALF THAT IN THE STATE OVERALL (16.9%), HOWEVER, THIS PERCENTAGE DOES REFLECT AN INCREASE SINCE 2016. WHEN EXAMINED BY TOWN, BARNSTABLE (15.3%), PROVINCETOWN (11.7%), AND YARMOUTH (11.0%) ALL HAD PERCENTAGES OF FOREIGN-BORN RESIDENTS THAT WERE LARGER THAN THE COUNTY AS A WHOLE. BRAZIL IS THE COUNTRY OF ORIGIN FOR THE LARGEST PERCENTAGE OF FOREIGN-BORN RESIDENTS ACROSS BARNSTABLE COUNTY (21%) FOLLOWED BY JAMAICA (10.9%), CANADA (4.9%), AND ECUADOR (4.5%). A SMALLER PERCENTAGE (9.4%) OF BARNSTABLE COUNTY RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH COMPARED TO THE STATE OVERALL (23.9%), THOUGH INCREASES WERE ALSO OBSERVED SINCE 2016. WHEN EXAMINED BY TOWN, BARNSTABLE (17.4%), WELLFLEET (13.2%), YARMOUTH (13.2%), AND PROVINCETOWN (10.6%) HAD PERCENTAGES OF NON-ENGLISH SPEAKERS THAT WERE LARGER THAN THE COUNTY. SPANISH IS SPOKEN BY THE LARGEST PERCENTAGE OF NON-ENGLISH SPEAKERS ACROSS BARNSTABLE COUNTY (22%) FOLLOWED BY FRENCH/HAITIAN (10%), AND RUSSIAN/POLISH/OTHER SLAVIC LANGUAGE (9%). PORTUGUESE, WHILE NOT SINGLED OUT IN THE US CENSUS LANGUAGE CATEGORIES, IS A KNOWN LANGUAGE GROUP WITHIN BARNSTABLE COUNTY. THIS FALLS WITHIN THE GROUPING 'OTHER INDO-EUROPEAN LANGUAGES' WHICH ACCOUNTS FOR ANOTHER 39% OF NON-ENGLISH SPEAKERS ALONG WITH ITALIAN, PERSIAN, GUJARATI, HINDI, AND A NUMBER OF SLAVIC LANGUAGES. ABOUT 3% OF NON-ENGLISH SPEAKERS ACROSS BARNSTABLE COUNTY ARE ESTIMATED TO LACK PROFICIENCY IN ENGLISH.
PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: CCHC, THROUGH ITS COMMUNITY BENEFITS INITIATIVES, IS COMMITTED TO ENHANCING THE QUALITY OF AND ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES FOR ALL RESIDENTS OF CAPE COD THROUGH CONTINUOUS ASSESSMENT OF COMMUNITY NEEDS, COORDINATED PLANNING AND THE ALLOCATION OF RESOURCES, THIS COMMITMENT INCLUDES A SPECIAL FOCUS ON THE UNMET NEEDS OF THE FINANCIALLY DISADVANTAGED AND UNDERSERVED POPULATIONS. WE WILL TAKE A LEADERSHIP ROLE IN COLLABORATIVE EFFORTS JOINING OUR RESOURCES, TALENT, AND COMMITMENT WITH THAT OF OTHER PROVIDERS, ORGANIZATIONS AND COMMUNITY MEMBERS. THE COMMUNITY BENEFITS MISSION STATEMENT WAS AFFIRMED BY THE CCHC COMMUNITY HEALTH COMMITTEE AND THE BOARD OF TRUSTEES IN 2000 AND REMAINS IN EFFECT.
PART VI, LINE 6	AS AN INDEPENDENT HEALTH SYSTEM, CAPE COD HEALTHCARE IS NOT PART OF AN AFFILIATED SYSTEM. HOWEVER, CCHC DOES COOPERATE IN PROVIDING HEALTH CARE SERVICES TO OUR COMMUNITY THROUGH OUR COMMUNITY BENEFITS PROGRAM AND THROUGH THE VISITING NURSING ASSOCIATION (VNA) WHICH IS PART OF CCHC. THE VNA ACTS AS HEALTH AGENT FOR 14 OUT OF THE 15 TOWNS ON CAPE COD. ALSO, THROUGH THE COMMUNITY BENEFITS PROGRAM, CCHC PROVIDES FINANCIAL SUPPORT TO DOZENS OF AREA NON-PROFIT ORGANIZATIONS THAT DO WORK IN THE COMMUNITY THAT ALIGNS WITH OUR ORGANIZATION'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT IS PUBLISHED EVERY THREE YEARS.
PART VI, LINE 7	ALL STATES WHERE ORGANIZATION FILES A COMMUNITY BENEFITS REPORT: MA

Schedule H (Form 990) 2023

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number
90-0054984

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) DUFFY HEALTH CENTER INC 94 MAIN ST HYANNIS,MA02601	04-3373741	501(c)(3)	125,000	HEALTH CARE FOR THE HOMELESS
(2) CAPE COD FOUNDATION INC 261 WHITES PATH UNIT 2 S YARMOUTH,MA02664	51-0140462	501(c)(3)	100,000	SUBSTANCE USE PREVENTION
(3) OUTER CAPE HEALTH SERVICES INC PO BOX 1413 WELLFLEET,MA02667	04-2509828	501(c)(3)	100,000	SPECIALTY HEALTH NAVIGATORS
(4) BARNSTABLE COUNTY RESOURCE DEV OFFICE PO BOX 427 BARNSTABLE,MA02630	04-6001419	Gov't	60,500	HEALTH INSURANCE ACCESS
(5) THE FAMILY PANTRY OF CAPE COD CORP 133 QUEEN ANNE RD HARWICH,MA02645	22-3079904	501(c)(3)	35,000	FOOD ACCESS
(6) TOWN OF BARNSTABLE 367 MAIN STREET HYANNIS,MA02601	04-6001079	Gov't	35,000	SCHOOL BASED C.N.A. TRAINING PROGRAM
(7) HEALTH IMPERATIVES INC 942 W CHESTNUT ST BROCKTON,MA02301	04-2609177	501(c)(3)	30,000	WIC SERVICES IN HOSPITALS
(8) BIG BROTHERS BIG SISTERS OF MASSACHUSETTS BAY 184 HIGH ST BOSTON,MA02110	04-2074462	501(c)(3)	25,000	MENTORING PROGRAM
(9) HELPING OUR WOMEN INC 34 CONWELL ST PROVINCETOWN,MA02657	04-3179955	501(c)(3)	25,000	TELEHEALTH ACCESS
(10) HOMELESS PREVENTION COUNCIL INC PO BOX 828 ORLEANS,MA02653	04-3104858	501(c)(3)	25,000	HOMELESS PREVENTION PROGRAM
(11) AMPLIFY POC CAPE COD INC PO BOX 284 HYANNIS,MA02601	85-2092234	501(c)(3)	20,000	HEALTH EQUITY
(12) LOWER CAPE OUTREACH COUNCIL INC 19 BREWSTER CROSS RD ORLEANS,MA02653	04-2864255	501(c)(3)	20,000	FOOD PANTRY
(13) TEAM MAUREEN INC PO BOX 422 N FALMOUTH,MA02556	45-2473500	501(c)(3)	18,354	CANCER PREVENTION
(14) BARNSTABLE COUNTY SHERIFF'S OFFICE 6000 SHERIFFS PL BOURNE,MA02532	04-6002284	Gov't	17,500	SUMMER PROGRAM
(15) BEHAVIORAL HEALTH INNOVATORS INC 90 MORTNO RD S CHATHAM,MA02659	81-0755250	501(c)(3)	15,000	ALTERNATIVE PEER GROUPS
(16) BELONGING TO EACH OTHER INC 101 TOWN HALL SQ FALMOUTH,MA02541	81-3692267	501(c)(3)	15,000	EMERGENCY HOUSING
(17) CALMER CHOICE INC 23 WEST BAY RD OSTERVILLE,MA02655	27-2836997	501(c)(3)	15,000	WELLNESS AND MINDFULLNESS
(18) CAPE COD CHILDRENS PLACE INC 10 BALLWICK RD N EASTHAM,MA02651	04-3265972	501(c)(3)	15,000	POST PARTUM DEPRESSION PREVENTION
(19) CHAMP HOMES INC 82 SCHOOL ST HYANNIS,MA02601	04-3006010	501(c)(3)	15,000	YOUTH HOMELESS SERVICES
(20) COMMUNITY ACTION COMMITTEE OF CAPE COD & ISLANDS 88 NORTH ST HYANNIS,MA02601	04-2396835	501(c)(3)	15,000	HEALTHCARE ACCESS
(21) LOWER CAPE COD COMMUNITY DEVELOPMENT CORPORATION PO BOX 2786 ORLEANS,MA02653	22-3191450	501(c)(3)	15,000	HOUSING INITIATIVES
(22) SHARING KINDNESS INC 20 GESNER RD ORLEANS,MA02653	38-4038215	501(c)(3)	15,000	SUICIDE RESPONSE AND PREVENTION
(23) WE CAN CORPORATION 783 ROUTE 28 HARWICHPORT,MA02646	31-1777179	501(c)(3)	15,000	ECONOMIC EMPOWERMENT FOR WOMEN
(24) YMCA CAPE COD INC (CAPE COD YOUNG MENS CHRISTIAN 2245 IYANNOUGH RD W BARNSTABLE,MA02668	04-2394925	501(c)(3)	15,000	CHILDCARE EMPLOYMENT INITIATIVE
(25) HEROES IN TRANSITION INC 22 BATES RD STE 135 MASHPEE,MA02649	27-1981637	501(c)(3)	12,000	FOOD ACCESS
(26) ALZHEIMERS FAMILY CAREGIVER SUPPORT CENTER INC 2095 MAIN ST BREWSTER,MA02631	45-5545397	501(c)(3)	10,000	CAREGIVER SUPPORT SERVICES
(27) CAPE ABILITIES INC 895 MARY DUNN RD HYANNIS,MA02601	04-2453166	501(c)(3)	10,000	FOOD ACCESS
(28) CAPE COD COMMERCIAL FISHERMENS ALLIANCE INC 1566 MAIN ST CHATHAM,MA02633	04-3138784	501(c)(3)	10,000	HEALTHY SEAFOOD, HEALTHY SEAFOOD INDUSTRY PROGRAM
(29) CAPE COD TOY LIBRARY INC PO BOX 555 E HARWICH,MA02645	81-4954350	501(c)(3)	10,000	CHILDRENS' PROGRAMMING
(30) HABITAT FOR HUMANITY OF CAPE COD INC 411 MAIN ST YARMOUTH PORT,MA02675	22-2900430	501(c)(3)	10,000	HOUSING DEVELOPMENT
(31) NAUSET INTERFAITH ASSOCIATION 5 PEACE LN SO ORLEANS,MA02662	80-0502326	501(c)(3)	10,000	CAPE & ISLANDS TRANS RESOURCE FUND
(32) MASSACHUSETTS AUDUBON SOCIETY INC 208 SOUTH GREAT RD LINCOLN,MA01773	04-2104702	501(c)(3)	7,500	CHILDRENS' PROGRAMMING
(33) CAPE ORGANIZATION FOR RIGHTS OF THE DISABLED INC 765 ATTUCK LN HYANNIS,MA02601	04-2901347	501(c)(3)	6,000	TRANSLATION OF MATERIALS

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

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

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

(1) MEDICAL SERVICES	5		5,000	FMV	INDIVIDUAL SUPPORT
(2) TRANSPORTATION SERVICES	185		20,441	FMV	INDIVIDUAL SUPPORT
(3) INTERPRETER SERVICES	708		4,514	FMV	INDIVIDUAL SUPPORT
(4) BREAST CANCER RECON FUND	6	29,011
(4)
(5)
(6)
(7)

Part IV

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

Return Reference

Explanation

SCHEDULE I, PART I, LINE 2

CAPE COD HEALTHCARE MONITORS THE USE OF GRANT FUNDS IT PROVIDES TO OTHER ORGANIZATIONS THROUGH DOCUMENTATION AND MEASUREMENT REQUIREMENTS AND METRIC REPORTING. THE RECIPIENT ORGANIZATION AGREES TO SUBMIT AN ANNUAL SUMMARY & OUTCOMES REPORT TO CAPE COD HEALTHCARE FOR INCLUSION IN CAPE COD HEALTHCARE'S COMMUNITY BENEFITS STATE ATTORNEY GENERAL'S REPORTING. AN OUTLINE OF SPECIFIC REPORTING REQUIREMENTS IS INCLUDED AS AN ATTACHMENT IN EACH AGREEMENT. THE RECIPIENT ORGANIZATION AGREES TO SEND A COMPLETED REPORT TO CAPE COD HEALTHCARE BY NOVEMBER 1ST OF THE YEAR THE GRANT IS AWARDED (CCHC GRANT PROGRAM SCHEDULES RUN FROM JANUARY 1 - SEPTEMBER 30). ADDITIONALLY, CAPE COD HEALTHCARE MAY REQUEST AN ANNUAL SUMMARY & OUTCOMES REPORT OR DOCUMENTATION OF OUTCOMES RELATED TO SERVICES OUTLINED IN THE AGREEMENT AT ANY TIME DURING THE DURATION OF THE GRANT. CAPE COD HEALTHCARE IS COMMITTED TO PROVIDE NEED-BASED ASSISTANCE TO INDIVIDUALS ON BEHALF OF THE INDIVIDUALS AND THEIR FAMILIES BY PROCURING SERVICES THAT IMPROVE COMMUNICATION, CARE DELIVERY AND ENSURE SAFE DISCHARGE. THE SOCIAL WORKERS AND CASE MANAGEMENT STAFF IS RESPONSIBLE FOR DETERMINING PATIENT ELIGIBILITY FOR THE ASSISTANCE.

Schedule I (Form 990) 2023

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2023

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 K LAUF PRESIDENT/CEO/TRUSTEE	(i) (ii)	0 ------------- 1,030,960	0 ------------- 525,000	0 ------------- 265,583	0 ------------- -218,750	0 ------------- 32,146	0 ------------- 1,634,939	0 ------------- 199,200
2JOSEPH GERGYES MD TRUSTEE (UNTIL 1/24)/PHYSICIAN	(i) (ii)	246,066 ------------- 947	25,346 ------------- 0	24,306 ------------- 0	12,159 ------------- 0	28,844 ------------- 0	336,721 ------------- 947	0 ------------- 0
3ALEXANDER ADDUCI MD TRUSTEE/PHYSICIAN	(i) (ii)	716,716 ------------- 0	493,410 ------------- 0	23,466 ------------- 0	13,200 ------------- 0	34,146 ------------- 0	1,280,938 ------------- 0	0 ------------- 0
4JOHN HOSTETTER MD TRUSTEE/PHYSICIAN	(i) (ii)	468,109 ------------- 0	160,106 ------------- 0	966 ------------- 0	13,200 ------------- 0	34,996 ------------- 0	677,377 ------------- 0	0 ------------- 0
5C JEFFREY SIEGERT MD TRUSTEE (AS OF 1/24)/PHYSICIAN	(i) (ii)	104,769 ------------- 176,750	0 ------------- 0	97 ------------- 0	0 ------------- 0	63 ------------- 0	104,929 ------------- 176,750	0 ------------- 0
6MICHAEL G JONES ESQ SVP/CLO/CO-CLERK	(i) (ii)	0 ------------- 367,290	0 ------------- 99,500	0 ------------- 51,039	0 ------------- 36,301	0 ------------- 35,661	0 ------------- 589,791	0 ------------- 18,000
7RICHARD SILVERIA SVP FINANCE/CFO	(i) (ii)	0 ------------- 474,254	0 ------------- 121,875	0 ------------- 25,272	0 ------------- 43,663	0 ------------- 23,004	0 ------------- 688,068	0 ------------- 0
8WILLIAM AGEL MD CHIEF MEDICAL OFFICER	(i) (ii)	0 ------------- 456,754	0 ------------- 112,125	0 ------------- 14,592	0 ------------- 40,974	0 ------------- 23,004	0 ------------- 647,449	0 ------------- 13,417
9DONALD A GUADAGNOLI MD CHIEF MED OFFICER FH	(i) (ii)	0 ------------- 183,068	0 ------------- 34,543	0 ------------- 20,616	0 ------------- 8,551	0 ------------- 1,530	0 ------------- 248,308	0 ------------- 0
10CHRISTIAN BROWN SVP MANAGED CARE	(i) (ii)	0 ------------- 268,691	0 ------------- 67,434	0 ------------- 19,277	0 ------------- 13,200	0 ------------- 32,146	0 ------------- 400,748	0 ------------- 0
11KEVIN MULROY PHYSICIAN	(i) (ii)	283,750 ------------- 0	0 ------------- 0	0 ------------- 0	11,350 ------------- 0	0 ------------- 0	295,100 ------------- 0	0 ------------- 0
12JOHN PAUL SOLVERSON SVP/CHIEF INFORMATION OFFICER	(i) (ii)	0 ------------- 419,154	0 ------------- 103,594	0 ------------- 23,371	0 ------------- 38,263	0 ------------- 25,604	0 ------------- 609,986	0 ------------- 21,250
13LORI JEWETT CHIEF OPERATING OFFICER	(i) (ii)	0 ------------- 472,883	0 ------------- 125,875	0 ------------- 50,927	0 ------------- 43,490	0 ------------- 32,146	0 ------------- 725,321	0 ------------- 17,084
14ANNE MARIE PECKHAM PRESIDENT VNA	(i) (ii)	0 ------------- 232,507	0 ------------- 45,000	0 ------------- 26,321	0 ------------- 11,400	0 ------------- 23,004	0 ------------- 338,232	0 ------------- 0
15CARTER HUNT CHIEF OPERATING OFFICER FH	(i) (ii)	0 ------------- 247,265	0 ------------- 52,500	0 ------------- 40,261	0 ------------- 26,904	0 ------------- 35,686	0 ------------- 402,616	0 ------------- 12,000
16REBEKAH DAY SEE SCHEDULE O	(i) (ii)	192,217 ------------- 0	25,000 ------------- 0	952 ------------- 0	13,296 ------------- 0	31,582 ------------- 0	263,047 ------------- 0	0 ------------- 0
17ELIZABETH DUNTON VP EMPLOYED PHYSICIAN GROUP	(i) (ii)	0 ------------- 278,268	0 ------------- 56,264	0 ------------- 20,402	0 ------------- 25,158	0 ------------- 1,366	0 ------------- 381,458	0 ------------- 10,250
18JEAN BUTLER SVP FINANCE	(i) (ii)	0 ------------- 294,691	0 ------------- 78,000	0 ------------- 40,453	0 ------------- 30,444	0 ------------- 21,593	0 ------------- 465,181	0 ------------- 16,000
19CHRISTOPHER M LAWSON SVP/CHIEF DEVELOPMENT OFFICER	(i) (ii)	0 ------------- 290,073	0 ------------- 77,125	0 ------------- 26,026	0 ------------- 28,923	0 ------------- 32,146	0 ------------- 454,293	0 ------------- 13,250
20MARY CALLOE VP REVENUE CYCLE	(i) (ii)	0 ------------- 257,021	0 ------------- 33,487	0 ------------- 24,306	0 ------------- 25,590	0 ------------- 15,408	0 ------------- 355,812	0 ------------- 0
21MARY JOHNSON VP PATIENT CARE, CNO	(i) (ii)	0 ------------- 223,021	0 ------------- 46,876	0 ------------- 31,500	0 ------------- 24,159	0 ------------- 14,408	0 ------------- 339,964	0 ------------- 8,875
22BENJAMIN LEVIN MD PHYSICIAN	(i) (ii)	409,015 ------------- 0	60,000 ------------- 0	420 ------------- 0	13,200 ------------- 0	32,036 ------------- 0	514,671 ------------- 0	0 ------------- 0
23MICHELLE SKARBEK VP HUMAN RESOURCES	(i) (ii)	0 ------------- 299,652	0 ------------- 61,651	0 ------------- 4,537	0 ------------- 27,399	0 ------------- 32,146	0 ------------- 425,385	0 ------------- 4,167
24MICHAEL BACHSTEIN VP FACILITIES MANAGEMENT	(i) (ii)	0 ------------- 263,564	0 ------------- 54,669	0 ------------- 22,924	0 ------------- 25,237	0 ------------- 1,366	0 ------------- 367,760	0 ------------- 12,250
25KUMARA SIDHARTHA SEE SCHEDULE O	(i) (ii)	0 ------------- 287,237	0 ------------- 53,004	0 ------------- 966	0 ------------- 14,354	0 ------------- 11,724	0 ------------- 367,285	0 ------------- 0
26PAUL HOULE MD PHYSICIAN	(i) (ii)	1,012,405 ------------- 0	21,000 ------------- 0	24,306 ------------- 0	13,200 ------------- 0	33,286 ------------- 0	1,104,197 ------------- 0	0 ------------- 0
27NICHOLAS COPPA MD PHYSICIAN	(i) (ii)	1,010,455 ------------- 0	57,000 ------------- 0	23,130 ------------- 0	13,200 ------------- 0	35,236 ------------- 0	1,139,021 ------------- 0	0 ------------- 0
28ACHILLES PAPAVASILIOU MD PHYSICIAN	(i) (ii)	1,010,555 ------------- 0	256,685 ------------- 0	23,466 ------------- 0	13,200 ------------- 0	35,136 ------------- 0	1,339,042 ------------- 0	0 ------------- 0
29GORDON NAKATA MD PHYSICIAN	(i) (ii)	1,010,555 ------------- 0	94,825 ------------- 0	23,466 ------------- 0	13,200 ------------- 0	35,136 ------------- 0	1,177,182 ------------- 0	0 ------------- 0
30ANNE MORRIS MD PHYSICIAN	(i) (ii)	495,383 ------------- 0	986,363 ------------- 0	630 ------------- 0	13,200 ------------- 0	32,146 ------------- 0	1,527,722 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
SCHEDULE J, PART I, LINE 3	THE ORGANIZATION'S CEO IS PAID THROUGH ITS PARENT ORGANIZATION, CAPE COD HEALTHCARE INC. THE PARENT ORGANIZATION ESTABLISHES COMPENSATION OF THE ORGANIZATION'S CEO THROUGH THE USE OF A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, THE FORM 990 OF OTHER ORGANIZATIONS, A COMPENSATION SURVEY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
SCHEDULE J, PART I, LINE 4B - 457(F)	CAPE COD HEALTHCARE, INC. AND AFFILIATES SPONSORS A 457(F) VOLUNTARY PERSONAL DEFERRAL PLAN ("THE PLAN") FOR KEY EXECUTIVES. VESTING IS DEFERRED FOR AT LEAST TWO YEARS FROM THE DATE OF THE AWARD, AND ALSO WHEN THE PARTICIPANTS REACH AGE 65. THE PLAN OFFERS PARTICIPATING EMPLOYEES AN ANNUAL DEFERRAL OF CASH COMPENSATION. AMOUNTS DEFERRED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND AMOUNTS PAID UNDER THE PLAN DURING CALENDAR YEAR 2023 WERE AS FOLLOWS: - MICHAEL K. LAUF - $80,205 - WILLIAM AGEL, M.D. - $11,820 - JOHN PAUL SOLVERSON - $20,599 - LORI JEWETT - $17,846 - CHRISTIAN BROWN - $13,699 - MICHAEL G. JONES, ESQ - $18,074 - JEAN BUTLER - $15,181 - CHRISTOPHER M. LAWSON - $13,141 - MICHELLE SKARBEK - $3,571 - CARTER HUNT - $11,411 - ANN MARIE PECKHAM - $12,124 - ELIZABETH DUNTON - $10,750 - DONALD A. GUADAGNOLI, M.D. - $9,034 - MICHAEL BACHSTEIN - $11,701 - MARY JOHNSON - $8,370 CAPE COD HEALTHCARE, INC. AND AFFILIATES ALSO SPONSOR A NONQUALIFIED PENSION RESTORATION ACCOUNT PLAN FOR KEY EXECUTIVES. THE ORGANIZATION MAKES CONTRIBUTIONS OF TWO PERCENT OF THE INDIVIDUAL'S ANNUAL SALARY (INCLUDING BONUS) ABOVE THE HIGHLY COMPENSATED LIMITS AS DEFINED BY THE IRS THROUGHOUT THE PLAN YEAR. AMOUNTS DEFERRED ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND UNDER THE PLAN, PARTICIPANTS ARE ENTITLED TO CERTAIN BENEFITS UPON REACHING AGE 65, RETIREMENT, TERMINATION, OR DEATH. AMOUNTS PAID UNDER THE PLAN DURING CALENDAR YEAR 2023 WERE AS FOLLOWS: - CHRISTIAN BROWN - $244 DURING CALENDAR YEAR 2023, MICHAEL LAUF ALSO PARTICIPATED IN A SECTION 457(F) SUPPLEMENTAL PLAN. TWELVE PERCENT OF HIS BASE SALARY WAS CONTRIBUTED AND EACH CONTRIBUTION IS SUBJECT TO A THREE YEAR VESTING SCHEDULE. THE AMOUNT DEFERRED IN CALENDAR YEAR 2023 WAS $130,200 AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN (C). IN ADDITION, $137,913 WAS PAID OUT FROM HIS CEO SUPPLEMENTAL PLAN, AND IS INCLUDED IN SCHEDULE J, PART II, COLUMN B(III). MICHAEL LAUF PREVIOUSLY PARTICIPATED IN A LONG-TERM INCENTIVE PLAN. THE PLAN PROVIDED FOR MERIT-BASED COMPENSATION. IN CALENDAR YEARS 2022 AND 2021, $375,000 AND $93,750 WAS ACCRUED RELATED TO THIS PLAN. THESE AMOUNTS WERE INCLUDED IN PREVIOUSLY FILED FORMS 990 IN SCHEDULE J, PART II, COLUMN (C). NO AMOUNTS WERE PAID OUT AND THE REVERSAL OF PREVIOUSLY ACCRUED AMOUNTS IS INCLUDED IN SCHEDULE J, PART II, COLUMN (C) BECAUSE MICHAEL LAUF IS NO LONGER ELIGIBLE FOR THE INCENTIVE.
SCHEDULE J, PART I, LINE 7	DISCRETIONARY BONUSES ARE AWARDED ANNUALLY BASED UPON BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PAID BONUSES ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B(II). THE INDIVIDUALS REPORTED IN SCHEDULE J, PART II REPORTED AS BEING PAID FROM A RELATED ORGANIZATION WERE EMPLOYEES OF, AND COMPENSATED BY CAPE COD HEALTHCARE, INC., THE PARENT CORPORATION.

Schedule J (Form 990) 2023

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number
90-0054984

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	MDFA REVENUE BONDS SERIES 2017	04-3431814	000000000	02-01-2017	52,315,359	REFUND SERIES D (2/16/2010)		X		X		X
B	MDFA REFUNDING REVENUE BONDS SERIES 2021B	04-3431814	000000000	05-07-2021	19,400,000	REFUND SERIES 2014 (09/29/2014)		X		X		X
C	MDFA REFUNDING REVENUE BOND SERIES 2021A-2	04-3431814	000000000	08-18-2023	43,614,000	REFUND TAXABLE SERIES 2021A-1 (5/7		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	21,887,149		9,032,443		3,270,858
2 Amount of bonds legally defeased ..............	0		0		0
3 Total proceeds of issue ..................	54,216,669		19,400,000		43,614,000
4 Gross proceeds in reserve funds .............	0		0		0
5 Capitalized interest from proceeds .............	0		0		0
6 Proceeds in refunding escrows ...............	0		0		0
7 Issuance costs from proceeds ...............	302,138		0		0
8 Credit enhancement from proceeds .............	0		0		0
9 Working capital expenditures from proceeds .............	0		0		0
10 Capital expenditures from proceeds .............	106,973		0		0
11 Other spent proceeds .............	53,807,558		19,400,000		43,614,000
12 Other unspent proceeds .............	0		0		0
13 Year of substantial completion .............	2017		2021		2023
	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			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	X
16 Has the final allocation of proceeds been made? ..........	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

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		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X	X
b Exception to rebate? ........		X	X		X
c No rebate due? .........	X		X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X		X		X

Schedule K (Form 990) 2023

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		X
b Name of provider ..........	0		0		0
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		X
b Name of provider ..........	0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
PART II, LINE 3	TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS.
PART IV, LINE 2(C)	THE DATE THE REBATE COMPUTATIONS WERE LAST PERFORMED FOR EACH ISSUE ARE: A: SERIES 2017 BONDS: 11/15/2019 B: SERIES 2021B BONDS: 11/7/2021 FOR BOTH ISSUES, ALL BOND PROCEEDS HAVE BEEN SPENT AND DEBT SERVICE FUNDS OPERATE ON A BONA FIDE BASIS; THEREFORE, NO FURTHER REBATE CALCULATIONS ARE NEEDED.

Schedule K (Form 990) 2023

Additional Data

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Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Part I

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

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

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

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

Part II

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

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




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

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990) 2023

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) KIRA JONES	SPOUSE OF OFFICER	117,512	FH EMPLOYEE		No
(2) STACY HOSTETTER	SPOUSE OF KEY EMPLOYEE	37,659	FH EMPLOYEE		No
(3) MICHAELA PIMENTEL	DAUGHTER OF KEY EMPLOYEE	97,975	CCH EMPLOYEE		No
(4) MEGAN TITAS	SPOUSE OF TRUSTEE	497,950	MACC EMPLOYEE		No
(5) KAREN SKARBEK	SISTER IN LAW OF KEY EMPLOYEE	30,950	CCH EMPLOYEE		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2023

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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

2023

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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	18	1,953,715	VALUE OF STOCK REC'D
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

Yes

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) (2023)

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
SCHEDULE M, PART I, COLUMN (B)	THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. SCHEDULE M, PART I, LINE 32(A) ON OCCASION THE ORGANIZATION UTILIZES A BROKER TO DISPOSE OF NONCASH CONTRIBUTIONS (OTHER THAN PUBLICLY TRADED SECURITIES).

Schedule M (Form 990) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

Return Reference	Explanation
FORM 990, PART I, LINE 1 AND PART III, LINE 1	CAPE COD HEALTHCARE, THE LEADING PROVIDER OF HEALTHCARE SERVICES ON CAPE COD, COORDINATES AND DELIVERS THE HIGHEST QUALITY, ACCESSIBLE HEALTH SERVICES WHICH ENHANCE THE HEALTH OF ALL CAPE COD RESIDENTS AND VISITORS. THE MISSION OF CAPE COD HEALTHCARE IS TO COORDINATE AND DELIVER THE HIGHEST QUALITY, ACCESSIBLE HEALTH SERVICES, WHICH ENHANCE THE HEALTH OF ALL CAPE COD RESIDENTS AND VISITORS.
FORM 990, PART III, LINE 4A	Cape Cod Healthcare (CCHC) is the leading provider of healthcare services for residents and visitors of Cape Cod. With more than 550 physicians, nearly 5,000 employees and 300 volunteers, Cape Cod Healthcare has two acute care hospitals, Cape Cod Hospital and?Falmouth Hospital; VNA of Cape Cod, the Cape's leading provider of homecare and hospice services; six urgent care centers; a primary and specialty care network; a skilled nursing and rehabilitation facility (JML Care Center); an assisted living facility (Heritage at Falmouth); and numerous health services and programs. Major service areas include Cardiovascular services with interventional cardiology suites for emergency and elective angioplasty, electrophysiology and cardiac rehabilitation; inpatient and outpatient surgery including cardiac, orthopedic and neurosurgery; cancer services - medical oncology and radiation therapy; women's health services, including imaging, maternity, breast health and gynecological care; advanced diagnostic imaging services, including MRI, low-dose CT, digital x-ray, PET, ultrasound and nuclear medicine; a behavioral health?center with inpatient and outpatient mental health and behavioral health services; infectious disease clinical services; physical and occupational rehabilitation?programs that feature cardiac and pulmonary rehabilitation programs. In FY24, the two hospitals had 23,551 admissions, 659,603 outpatient visits, 958 births, 15,019 surgeries, and 112,716 emergency room visits. The urgent care centers had 127,810 visits over the same period. Through its Community Benefits initiative, CCHC is committed to enhancing the quality of and access to comprehensive healthcare services for all Cape Cod residents. Through continuous assessment of community needs, coordinated planning and the allocation of resources, this commitment includes a special focus on the unmet needs of the financially disadvantaged and underserved populations on Cape Cod. From the period 10/1/2023 - 9/30/2024, CCHC Community Benefits provided support to health and human services organizations and addressed barriers to care by adding supportive connectors in the continuum of care. We continued to implement programs and partner with community-based organizations to address the key themes and priorities listed in the current Community Health Needs Assessment (CHNA). CCHC supported partnerships with over 60 local nonprofit health and human service organizations and a network of Federally Qualified Health Centers through project support and grant investments to improve the health of Barnstable County residents. Hospital staff dedicated time and expertise to strategic partnerships, coalitions, and task force efforts locally, regionally and across Massachusetts. This year (FY24) represented the mid-way point of our current CHNA. The key themes identified in the 2023-2025 CHNA include healthcare access, housing, behavioral health, health equity, economic stress and instability, food access, transportation, aging, chronic disease, and COVID impact. At the halfway mark in the current CHNA, CCHC has targeted many of these needs. One of the key accomplishments of this year is setting and meeting Health Equity Community Benefits Investment goals. CCHC Community Benefits has benchmarks in place to hit each year to ensure the financial investments we make in the community align with the percentage of the County's population that identify as the following historically underinvested groups: Black, Brazilian/Hispanic, LGBTQ+, people with disabilities, and non-English speaking and/or migrant individuals. Other key accomplishments include providing millions of dollars in charity care to the Cape Cod community, as well as increasing the diversity of our programs and partnerships to ensure we work with a broad range of organizations and partners that are inclusive along the lines of geography, service line, race and ethnicity, organization type, etc. These key accomplishments, as well as the many other Community Benefits activities CCHC conducted this year, were guided by the FY24 Strategic Implementation Plan (SIP). Each year, the SIP is put together with input and guidance from CCHC leadership, the Community Health Committee, and other community stakeholders including Barnstable County Human Services and behavioral health specialists. It identifies the priorities, potential partners, and goals and objectives for the Implementation Plan which will be followed in the next reporting year. The provision of Community Benefits is an important component of CCHC's charitable activities to ensure CCHC remains steadfast to the mission and remains a steward of the valuable community.
FORM 990, PART I AND PART IX	FORM 990, PART I AND PART IX FUNDRAISING IS CONDUCTED ON BEHALF OF CAPE COD HEALTHCARE, INC. BY CAPE COD HEALTHCARE FOUNDATION, INC. CERTAIN OFFICERS ARE COMPENSATED BY CAPE COD HEATHCARE, INC. FUNDS RAISED ARE REPORTED AT CAPE COD HEALTHCARE, INC. AND AFFILIATES.
FORM 990, PART I, LINE 6	CAPE COD HEALTHCARE, INC.'S VOLUNTEERS INCLUDE ITS TRUSTEES.
FORM 990, PART VI, LINE 2	TRUSTEES AND OFFICERS SIT ON THE BOARDS OF THE FOLLOWING: CAPE HEALTH INSURANCE COMPANY: MICHAEL K LAUF MICHAEL G JONES BRUCE JOHNSTON RICHARD SILVERIA ROBIN DEVEREUX THE MEMBERS OF CAPE COD HEALTHCARE, INC.'S BOARD ALSO SIT ON THE BOARD OF CAPE COD MEDICAL OFFICE BUILDING, INC., A FOR-PROFIT RELATED ORGANIZATION.
FORM 990, PART VI, LINES 6 & 7(A)	THE ORGANIZATION HAS MEMBERS/INCORPORATORS WHO ELECT THE ORGANIZATION'S TRUSTEES.
FORM 990, PART VI, LINE 7(B)	THE DECISIONS OF THE GOVERNING BODY THAT NEED APPROVAL BY ITS MEMBERS/INCORPORATORS INCLUDE APPROVAL OF CHANGES MADE TO THE CORPORATION'S BYLAWS AND APPROVAL WHEN THERE IS A DIVESTING OF ONE OF THE MAJOR AFFILIATES OF THE ORGANIZATION.
FORM 990, PART VI, LINE 11(B)	THE ORGANIZATION'S FORM 990 IS REVIEWED AT SEVERAL LEVELS. THE ORGANIZATION ENGAGES A PUBLIC ACCOUNTING FIRM TO ASSIST IN THE PREPARATION AND REVIEW OF ITS FORM 990 AND WHO SIGNS AS PAID PREPARER. SENIOR MANAGEMENT OF THE ORGANIZATION IS RESPONSIBLE FOR THE TIMELY PREPARATION OF FORM 990. THE COMPLETED FORM 990 IS PROVIDED TO THE FINANCE COMMITTEE AND THE ENTIRE BOARD IN ADVANCE OF THE FILING DEADLINE.
FORM 990, PART VI, LINE 12	THE ORGANIZATION MAINTAINS A CONFLICT OF INTEREST POLICY AND REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THIS POLICY. ON AN ANNUAL BASIS, EACH TRUSTEE, OFFICER AND EMPLOYEE AT THE SENIOR MANAGEMENT LEVEL COMPLETES A CONFLICT OF INTEREST DISCLOSURE FORM. THE FORMS ARE REVIEWED BY CAPE COD HEALTHCARE, INC.'S ("CCHC") DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE WHO PREPARES A SUMMARY FOR CCHC'S COMPLIANCE OFFICER. ANY MATERIAL INTERESTS SO DISCLOSED ARE PRESENTED TO THE CORPORATION'S GOVERNANCE COMMITTEE FOR REVIEW AND RESOLUTION. ALL DISCLOSURE STATEMENTS SUBMITTED BY EMPLOYEES WILL BE REVIEWED BY HUMAN RESOURCES AND/OR CCHC'S DIRECTOR OF CLINICAL AND RESEARCH COMPLIANCE. FOR ANY DISCLOSURE THAT IS CONSIDERED SUBSTANTIVE THE EMPLOYEE'S AREA MANAGER WILL BE CONSULTED TO DETERMINE IF THE SITUATION IS GENERALLY ACCEPTABLE, REQUIRES FURTHER EXAMINATION AND POSSIBLE ACTION OR IS GENERALLY NOT ACCEPTABLE. ANY ACTION PLAN CREATED TO MANAGE A CONFLICT OF INTEREST WILL BE MONITORED BY THE EMPLOYEE'S AREA MANAGER OR SUPERVISOR.
FORM 990, PART VI, LINE 15	THE ANNUAL PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, OFFICERS, EXECUTIVES AND KEY EMPLOYEES INCLUDE THE FOLLOWING: CEO - COMPENSATION WILL BE DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, AND WILL INCLUDE CONSIDERATION OF RELEVANT MARKET DATA FURNISHED BY A DISINTERESTED COMPENSATION CONSULTANT, AND A REVIEW OF JOB PERFORMANCE. OFFICERS, EXECUTIVES AND KEY EMPLOYEES - OFFICER, EXECUTIVE, AND KEY EMPLOYEE COMPENSATION WILL BE DETERMINED BY THE CEO AND WILL INCLUDE CONSIDERATION OF RECENT RELEVANT MARKET DATA, AND A REVIEW OF JOB PERFORMANCE. THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES WILL APPROVE ALL BONUS AND INCENTIVE RECOMMENDATIONS FOR DISQUALIFIED PERSONS. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED IN THE MEETING MINUTES.
FORM 990, PART VI, LINE 19	THE ORGANIZATION MAKES ITS BYLAWS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON APPROPRIATE REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THE ANNUALLY FILED FORM PC, A PUBLICLY DISCLOSED TAX-EXEMPT ORGANIZATION FILING FOR THE STATE OF MASSACHUSETTS.
FORM 990, PART VII, COLUMN (B)	THE INDIVIDUALS REPORTED AS RECEIVING COMPENSATION FROM A RELATED ORGANIZATION IN COLUMNS (E) AND (F) IN PART VII ARE EMPLOYEES AT CAPE COD HEALTHCARE, INC., A TAX-EXEMPT RELATED ORGANIZATION.
FORM 990, PART VII, SECTION A & Schedule J, Part II	THE FULL TITLE FOR BRUCE JOHNSTON IS CHAIR (UNTIL 5/24)/CLERK (AS OF 5/24)/TRUSTEE THE FULL TITLE FOR ROBERT TALERMAN IS CLERK (UNTIL 5/24)/VICE CHAIR & TREASURER (AS OF 5/24)/TRUSTEE THE FULL TITLE FOR ROBIN DEVEREUX IS VICE CHAIR (UNTIL 5/24)/CHAIR (AS OF 5/24)/TRUSTEE THE FULL TITLE FOR REBEKAH DAY IS DIRECTOR EMERGENCY SERVICES (UNTIL 1/23), CHIEF NURSING OFFICER FALMOUTH HOSPITAL (AS OF 1/23) THE FULL TITLE FOR KUMARA SIDHARTHA IS MEDICAL DIRECTOR PHO (UNTIL 5/23), CHIEF HEALTH EQUITY & WELLNESS OFFICER (AS OF 5/23)
FORM 990, PART VII, SECTION B	CAPE COD HEALTHCARE, INC. PAYS INDEPENDENT CONTRACTORS ON BEHALF OF ITS AFFILIATES WHO FILE AS PART OF A GROUP FORM 990 AS CAPE COD HEALTHCARE, INC. AND AFFILIATES.
FORM 990, PART XI, LINE 9	CHANGE IN VALUE SPLIT INTEREST AGREEMENT $ 2,673 CHANGE IN PERPETUAL TRUSTS $ 4,001,894 TRANSFER TO/FROM AFFILIATE $ (17,726) NET ASSETS RELEASED FROM RESTRICTIONS $ (290,716) ------------- OTHER CHANGES IN NET ASSETS $ 3,696,126 =============

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

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CAPE COD HEALTHCARE INC & AFFILIATES

Employer identification number

90-0054984

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)CAPE COD HEALTHCARE INC 297 NORTH STREET BLDG 3 HYANNIS,MA02601 22-2600704	PARENT CORP	MA	501(c)(3)	10	NA	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

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	(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) CAPE AND ISLAND ENDOSCOPY CENTER 700 ATTUCKS LANE HYANNIS,MA02601	ENDOSCOPY CENTER	MA	NA

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) CAPE HEALTH INSURANCE COMPANY PO BOX 1051GT GRAND CAYMAN CJ 98-1230418	INSURANCE	CJ	CAPE COD HLTHCR	C CORP	0	0		Yes
(2) CAPE COD MEDICAL OFFICE BUILDING INC 27 PARK STREET HYANNIS,MA02601 04-2423073	RENTAL SRVCE	MA	NA	C CORP	0	15,000	100.000 %	Yes
(3) POOLED INCOME FUNDS (2)	SUPPORT	MA	NA					Yes
(4) CHARITABLE REMAINDER TRUSTS (8)	SUPPORT	MA	NA					Yes

Schedule R (Form 990) 2023

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

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

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

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

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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) CAPE HEALTH INSURANCE COMPANY	R	4,784,394	FMV

Schedule R (Form 990) 2023

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) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation
PART IV, LINE 4, COLUMN (C)	THE LEGAL DOMICILES OF THE CHARITABLE REMAINDER TRUSTS INCLUDE: IN, MA, NJ, AND RI.
PART V	IN ADDITION TO ANY TRANSACTIONS DISCLOSED IN SCHEDULE R, PART V, CAPE COD HEALTHCARE, INC. AND AFFILIATES MAY SHARE USE OF ITS PAID EMPLOYEES, FACILITIES, EQUIPMENT, INVESTMENTS OR OTHER ASSETS WITH ITS TAX-EXEMPT AFFILIATES, THE VALUE OF WHICH ARE BOOKED AS INTERCOMPANY TRANSACTIONS AND ELIMINATING ENTRIES WITHIN THE AUDITED FINANCIAL STATEMENTS AND ARE NOT SEPARATELY QUANTIFIED.

Schedule R (Form 990) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	5,236
6	Total number of volunteers (estimate if necessary) .............	6	301
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	5,992,755
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	92,993

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	27,202,526	16,439,005
9	Program service revenue (Part VIII, line 2g) .........	1,048,957,423	1,075,245,177
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	12,096,222	24,203,119
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	901,744	1,327,424
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,089,157,915	1,117,214,725
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,007,359	992,620
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)	581,141,956	594,882,752
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	42,806	34,985
b	Total fundraising expenses (Part IX, column (D), line 25) 2,989,192
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	476,664,242	496,339,964
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,058,856,363	1,092,250,321
19	Revenue less expenses. Subtract line 18 from line 12.......	30,301,552	24,964,404
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,088,584,236	1,260,952,242
21	Total liabilities (Part X, line 26).............	233,671,669	306,708,716
22	Net assets or fund balances. Subtract line 21 from line 20.....	854,912,567	954,243,526

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 996,467,237 including grants of $ 992,620 ) (Revenue $ 1,075,245,177 )
	PATIENT SERVICES - SEE SCHEDULES H AND O

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses996,467,237

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	8,382,432	8,565,021	1,006,985

(A) Name and business address	(B) Description of services	(C) Compensation
CAPE COD HEALTHCARE INC, 297 NORTH STREET BLDG 3 HYANNIS,MA02601	PURCHASED SERVICES	93,171,769




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 1

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	195,386
d	Related organizations		1d
e	Government grants (contributions)		1e	765,191

f	All other contributions, gifts, grants, and similar amounts not included above		1f	15,478,428

g	Noncash contributions included in lines 1a - 1f:$		1g	1,953,715

h Total. Add lines 1a-1f.......		16,439,005

		Business Code
2a	PATIENT SERVICE REVENUE	900099	1,033,669,212	1,033,437,326	231,886
b	SPECIMEN COLLECTION SERVICES	621500	5,760,869	0	5,760,869
c	PROGRAM RELATED RENTAL INCOME	900099	3,267,780	3,267,780
d	JOINT VENTURE REVENUE	900099	2,418,445	2,418,445
e	QUALITY EARNED PAYMENTS	900099	24,756,030	24,756,030
f	All other program service revenue.		5,372,841	5,372,841
g	Total. Add lines 2a–2f .....		1,075,245,177

3 Investment income (including dividends, interest, and othersimilar amounts) ......			12,449,747			12,449,747
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	0	0
d	Net rental income or (loss).......			0
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	11,753,372
b	Less: cost or other basis and sales expenses	7b
c	Gain or (loss)	7c	11,753,372
d	Net gain or (loss).........			11,753,372			11,753,372
8a	Gross income from fundraising events (not including $ 195,386of contributions reported on line 1c). See Part IV, line 18 ....
			8a	420,143
b	Less: direct expenses ...		8b	93,572
c	Net income or (loss) from fundraising events..			326,571			326,571
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0

Business Code
11a	CAFETERIA INCOME		900099	664,943			664,943
b	THRIFT SHOP INCOME		900099	264,735			264,735
c	MEDICAL RECORDS		900099	71,175			71,175
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,000,853
12	Total revenue. See instructions.....			1,117,214,725	1,069,252,422	5,992,755	25,530,543

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	933,654	933,654
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	58,966	58,966
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	3,732,120	3,732,120		0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	1,650,632	1,650,632		0
7	Other salaries and wages........	482,242,544	444,407,685	36,374,825	1,460,034
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	13,129,083	11,615,689	1,454,993	58,401
9	Other employee benefits .......	64,840,637	59,753,343	4,863,958	223,336
10	Payroll taxes ...........	29,287,736	26,244,448	2,935,448	107,840
11	Fees for services (non-employees):
a	Management ......	8,659,912	4,824,948	3,833,585	1,379
b	Legal .........	-6,068		-6,068
c	Accounting ...........	829,802		829,802
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	34,985			34,985
f	Investment management fees ......	796,864	68,828	728,036
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	63,597,657	62,843,021	754,636	0
12	Advertising and promotion ....	610,512	556,914	48,132	5,466
13	Office expenses .......	3,871,822	3,573,101	249,623	49,098
14	Information technology ......	2,720,095	2,472,001	194,546	53,548
15	Royalties ..	0
16	Occupancy ...........	17,361,615	16,248,189	1,063,526	49,900
17	Travel ............	1,929,991	1,782,788	90,070	57,133
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	497,079	447,642	49,437	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	26,151,682	23,741,095	2,403,905	6,682
23	Insurance ...	4,804,145	4,531,434	272,711	0
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	MEDICAL SUPPLIES	185,150,903	185,150,903	0	0
b	ADMIN OFFICE OVERHEAD	92,665,730	70,459,494	21,673,627	532,609
c	PURCHASED SERVICES	27,028,411	24,947,812	2,075,022	5,577
d	REPAIRS AND MAINTENANCE	17,246,511	15,803,290	1,421,253	21,968
e	All other expenses	42,423,301	30,619,240	11,482,825	321,236
25	Total functional expenses. Add lines 1 through 24e	1,092,250,321	996,467,237	92,793,892	2,989,192
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 ........			35,938,361	1	13,475,206
2	Savings and temporary cash investments .........			1,433,570	2	16,576,530
3	Pledges and grants receivable, net ......			20,402,984	3	17,352,768
4	Accounts receivable, net .............			101,616,565	4	105,526,798
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 .......
				0	5	0
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) ...
				0	6	0
7	Notes and loans receivable, net ...........			3,859,195	7	6,485,446
8	Inventories for sale or use ............			17,167,025	8	17,355,969
9	Prepaid expenses and deferred charges ......			3,067,962	9	3,481,569
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	912,138,887
b	Less: accumulated depreciation	10b	503,708,221	311,159,583	10c	408,430,666
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			523,919,052	12	554,640,688
13	Investments—program-related. See Part IV, line 11 ..			411,000	13	127,000
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			69,608,939	15	117,499,602
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,088,584,236	16	1,260,952,242

17	Accounts payable and accrued expenses .....	78,812,775	17	77,224,740
18	Grants payable ...	0	18	0
19	Deferred revenue .........	817,696	19	450,308
20	Tax-exempt bond liabilities .........	89,724,227	20	80,633,210
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
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 .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	2,205,450	23	467,952
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	62,111,521	25	147,932,506
26	Total liabilities. Add lines 17 through 25..	233,671,669	26	306,708,716

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	765,758,211	27	857,894,668
28	Net assets with donor restrictions ...........	89,154,356	28	96,348,858
	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 ...........	854,912,567	32	954,243,526
33	Total liabilities and net assets/fund balances ........	1,088,584,236	33	1,260,952,242

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