2025-08-15T07:24:20-05:00 2024-09-30 263753134 CBIZ ADVISORS LLC 53 STATE STREET 17TH FLOOR BOSTON MA 02109 990 2023-10-01 270440772 TUFTS MEDICAL CENTER GROUP RETURN TUFT 6176365000 800 WASHINGTON STREET BOX 468 BOSTON MA 021111533 ANDREW DEVOE CHIEF FINANCIAL OFFICER 6176365000 2025-08-14 1 0 CRAIG KLEIN P00734640 6178075000 2025-08-14 2023 2025-03-06 01:10:19Z ANDREW DEVOE 800 WASHINGTON STREET BOX 468 BOSTON MA 021111533 1379931751 1 0 5466 X HTTPS://WWW.TUFTSMEDICINE.ORG/ X WE STRIVE TO HEAL, TO COMFORT, TO TEACH, TO LEARN, AND TO SEEK THE KNOWLEDGE TO PROMOTE HEALTH AND TO PREVENT DISEASE. OUR PATIENTS AND THEIR FAMILIES ARE AT THE CENTER OF EVERYTHING WE DO. SEE PART III. 17 9 7982 90 191221 31242 123298744 93715996 1138548904 1262314090 37276728 22550953 1517272 1030209 1300641648 1379611248 0 0 0 0 579326781 591270928 3000 0 3119066 743826647 790041158 1323156428 1381312086 -22514780 -1700838 1132376673 965407026 920950444 1172186879 211426229 -206779853 SEE SCHEDULE O 0 0 1063537783 1261416087 TUFTS MEDICAL CENTER, INC. LOCATED IN BOSTON, MA OPERATES A 415 BED ACUTE-CARE GENERAL HOSPITAL ESTABLISHED TO PROVIDE HEALTHCARE SERVICES PRIMARILY IN THE GREATER BOSTON AREA, WHICH ALSO ATTRACTS PATIENTS FROM ELSEWHERE IN NEW ENGLAND AND BEYOND.NEW ENGLAND LONG-TERM CARE, INC. OPERATES AN 80 BED NURSING HOME SPECIALIZING IN THE CARE OF CHILDREN WHO ARE SEVERELY MENTALLY HANDICAPPED AND/OR PHYSICALLY HANDICAPPED. 38670492 518029 TUFTS MEDICAL CENTER, INC. ADMINISTERS PROGRAMS FOR APPROXIMATELY 453 INDIVIDUALS: 268 RESIDENTS, 74 INTERNS AND 111 FELLOWS IN 43 SPECIALTIES AND SUB-SPECIALTIES WHO ROTATE TO APPROXIMATELY 47 HOSPITALS AND OTHER ORGANIZATIONS LOCATED PRIMARILY IN THE GREATER BOSTON AREA. 11450735 379974 TUFTS MEDICAL CENTER, INC. ENGAGES IN RESEARCH ACTIVITIES FUNDED BY GRANTS AND CONTRACTS FOR U.S. GOVERNMENT AGENCIES AND OTHER PRIVATE SOURCES. 1113659010 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 0 0 1 7982 1 1 1 0 0 0 0 1 1 0 0 0 0 1 0 X 17 9 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 MA X KATHLEEN DAVIS 6176365000 800 WASHINGTON STREET BOSTON MA 02111 HELEN BOUCHER MD TRUSTEE 1.00 39.00 X 0 0 0 MARGARET BROWN ESQ TRUSTEE 1.00 0.00 X 0 0 0 GERALD COHEN TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL DANDORPH TRUSTEE 1.00 39.00 X X 0 1726150 359711 KAREN FREUND MD TRUSTEE 1.00 39.00 X 0 594888 57687 STANLEY GOLDSTEIN TRUSTEE 1.00 0.00 X 0 0 0 JASON HALL TRUSTEE 1.00 39.00 X 0 914117 822 MARVIN A KONSTAM MD TRUSTEE (UNTIL 2/24) 1.00 39.00 X 0 687908 57687 BRIAN KAVOOGIAN CHAIR/TRUSTEE 1.00 0.00 X X 0 0 0 PAUL NASSER TRUSTEE 1.00 0.00 X 0 0 0 EMMA REEVE TRUSTEE (UNTIL 2/24) 1.00 0.00 X 0 0 0 REGINA ROCKEFELLER TRUSTEE 1.00 1.00 X 0 0 0 MARK ROSEN TRUSTEE/VICE CHAIR (UNTIL 2/24) 1.00 0.00 X 0 0 0 JEFF SHAMES TRUSTEE (UNTIL 2/24) 1.00 0.00 X 0 0 0 MICHAEL TARNOFF MD CEO/TRUSTEE (UNTIL 3/24) 1.00 39.00 X X 1193833 0 196769 ERIKA WERNER TRUSTEE 1.00 39.00 X 0 690427 34407 ASSAD SIDDIQI SVP/TREASURER (UNTIL 7/24) 1.00 39.00 X X 439812 0 67900 THERESE HUDSON-JINKS SENIOR VP & CNO 40.00 0.00 X 492208 0 73947 ANDREW DEVOE TREASURER 1.00 39.00 X X 0 0 0 ANN LOUISE PUOPOLO TRUSTEE 1.00 0.00 X 0 0 0 GAUTAM SHRIKHANDE MD TRUSTEE 1.00 0.00 X 0 0 0 PHIL OKALA TRUSTEE/INTERIM PRESIDENT/COO 1.00 39.00 X X 0 1121244 16258 REZA VAGEFI MD TRUSTEE 1.00 39.00 X 0 704151 18041 ZACHARY REDMOND ESQ SECRETARY 39.00 1.00 X 0 599263 70149 LAUREN RIPLEY ESQ ASSISTANT SECRETARY 1.00 39.00 X 0 210093 12727 DIANA RICHARDSON SENIOR VP & COO (UNTIL 3/24) 40.00 0.00 X 888036 0 118026 ERIK GARPESTAD CMO/SVP MEDICAL STAFF 40.00 0.00 X 673230 0 24968 SARAH MCKAY VP OF PATIENT CARE 40.00 0.00 X 430587 0 76946 KARA GREER SVP CHIEF TALENT OFFICER 40.00 0.00 X 522818 0 74694 DOUGLAS CIVIELLO CHIEF PERFUSIONIST 40.00 0.00 X 415785 0 36471 NANCY WEATHERBEE DIRECTOR OF RESEARCH 40.00 0.00 X 397419 0 12028 DEEB N SALEM MD FORMER TRUSTEE 0.00 40.00 X 0 174112 27646 PAUL SUMMERGRAD MD FORMER TRUSTEE 1.00 39.00 X 0 360672 57022 F CLARISSA YANG FORMER TRUSTEE 0.00 40.00 X 0 704980 35187 JEFFREY WEINSTEIN FORMER TRUSTEE 0.00 50.00 X 0 601188 0 NIOBIS DEL CARMEN QUEIRO FORMER KEY EMPLOYEE 0.00 40.00 X 0 516028 2081 5453728 9605221 1431174 1430 1 1 1 LABORATORY CORP OF AMERICA HOLDINGS PO BOX 12140 BURLINGTON NC 27216 CONSULTING 35175708 MEDICAL SOLUTIONS 1010 N 102ND STREET 300 OMAHA NE 68114 NURSING SERVICES 15359791 PRATT ADMINISTRATIVE SERVICES 800 WASHINGTON STREET BOSTON MA 02111 PHYSICIAN SERVICES 14770738 PRATT MEDICAL GROUP 800 WASHINGTON STREET BOSTON MA 02111 PHYSICIAN SERVICES 8242379 PREMIER HEALTHCARE SOLUTIONS 5882 COLLECTIONS CTR DR CHICAGO IL 60693 PROFESSIONAL SERVICES 7949181 72 80350546 13365450 543678 93715996 NET PATIENT SERV. REV. 900099 1032804858 1032804858 RESEARCH & MISC. REV. 900099 226979904 226979904 OVERHEAD RECOVERY 900099 2011299 2011299 RESIDENTS & INTERN REV 900099 518029 518029 1262314090 9024659 191221 8833438 333462 333462 1017250 320503 696747 696747 696747 13526294 0 13526294 13526294 13526294 1379611248 1262314090 191221 23389941 2858494 534327 2324167 478816673 412681639 64608994 1526040 12242245 9191718 3050527 58388563 45137572 12796889 454102 38964953 29255652 9709301 1868183 411831 1456352 560062 560062 178052328 108665456 68437559 949313 87365 23227 64138 7281062 4076602 3188248 16212 1066511 989552 -57985 134944 34357681 6444533 27913148 1154533 904367 245934 4232 15986 15986 23493466 4990454 18503012 38623564 13576329 25047235 2873880 14133 2859747 SUPPLIES 341284386 333393566 7890820 PHYSICIAN PRACTICE FEES 73646333 73083713 562620 BAD DEBT 52784707 52784707 REPAIRS AND MAINTENANCE 10695716 5082320 5613396 22195395 12401326 9759846 34223 1381312086 1113659010 264534010 3119066 7269391 7519580 68646108 73627396 17280193 15903901 156844312 165077267 17266678 21050596 11822928 17769751 885687066 533599964 355941850 352087102 317103428 210469000 180201785 101902433 1132376673 965407026 90228028 103163413 22583437 21531519 281717536 500892269 526421443 546599678 920950444 1172186879 X 193016050 -223954524 18410179 17174671 211426229 -206779853 1132376673 965407026 X -1700838 6721828 -423227072 X 0 1 X 1 1 1 X SCHEDULE A, GENERAL INFORMATION: PUBLIC CHARITY STATUS OF THE GROUP MEMBERS IS AS FOLLOWS : TUFTS MEDICAL CENTER, INC. - LINE 3 NEW ENGLAND LONG-TERM CARE, INC. - LINE 3 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7820000 94000 90000 -8000 8012000 7663000 103000 84000 30000 7820000 7328000 433000 -85000 13000 7663000 6832000 391000 120000 15000 7328000 6667000 118000 47000 6832000 0.00000 0.96400 0.03600 0 0 11712367 11712367 335029649 172160891 162868758 21195604 16067968 5127636 505879355 345371105 160508250 11870091 11870091 352087102 DUE FROM AFFILIATES 13527647 DEPOSIT ADVANCE 6307120 OTHER MISC. RECEIVABLES & ASSETS 32092370 ESTIMATED THIRD PARTY RECEIVABLES 13031000 RIGHT OF USE ASSETS 36944296 101902433 PENSION OBLIGATIONS 19886796 DUE TO AFFILIATES 120235768 PROFESSIONAL LIABILITY COSTS 9691771 ESTIMATED THIRD PARTY PAYABLES 10202022 TAXABLE BONDS 333593845 WORKERS COMPENSATION 6428840 CAPITAL LEASE PAYABLE 2222055 LEASE LIABILITY 44338581 546599678 PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT CONSISTS OF APPROXIMATELY 50 FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. FOR THE PURPOSES OF DISCLOSURE, ENDOWMENT FUNDS INCLUDE DONOR-RESTRICTED ENDOWMENT FUNDS. THE ORGANIZATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO THE PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 80000 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES SELF-INSURANCE 21921680 0 0 0 0 0 0 22001680 0 22001680 1 0 1 1 1 0 1 1 X 1 X 1 X 1 1 0 1 1 9618477 0 9618477 0.00700 302777874 205550042 97227832 0.07040 312396351 205550042 106846309 0.07740 2772534 0 2772534 0.00200 45 554094 43231824 16859038 26372786 0.01910 404051989 341389703 62662286 0.04540 78633152 58232000 20401152 0.01480 52769 3862828 0 3862828 0.00280 45 606863 532552327 416480741 116071586 0.08410 45 606863 844948678 622030783 222917895 0.16150 1 346029 346029 0.00030 3 51 159951 159951 0.00010 4 51 505980 505980 0.00040 1 24866147 0 123902819 167282501 -43379682 X 1 1 1 1 TUFTS MEDICAL CENTER INC 800 WASHINGTON STREET BOSTON MA 02111 X X X X X X TUFTS MEDICAL CENTER INC 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTPS://WWW.TUFTSMEDICINE.ORG/SITES/DEFAULT/FILES/2023-10/TUFTS-CHNA-REPORT 1 21 1 HTTPS://WWW.TUFTSMEDICINE.ORG/SITES/DEFAULT/FILES/2023-10/TUFTS-CHNA-REPORT 0 1 X 150.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X WWW.TUFTSMEDICALCENTER.ORG/FINANCIALASSISTANCE X WWW.TUFTSMEDICALCENTER.ORG/FINANCIALASSISTANCE X WWW.TUFTSMEDICALCENTER.ORG/FINANCIALASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 TUFTS MEDICAL CENTER, INC. PART V, SECTION B, LINE 5: TUFTS MEDICAL CENTER (TUFTS MC) HAS CONTINUED TO FOLLOW THE IMPLEMENTATION PLAN OUTLINED IN ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO GUIDE ITS COMMUNITY PROGRAMMING IN FY24. THE 2022 CHNA WAS CONDUCTED FROM OCTOBER 2021 TO JUNE 2022 AND INVOLVED 927 SURVEYS AS WELL AS 8 STAKEHOLDER INTERVIEWS AND 14 FOCUS GROUPS WITH 128 COMMUNITY RESIDENTS TO UNDERSTAND COMMUNITY NEEDS, STRENGTHS, PRIORITY HEALTH ISSUES, AND RECOMMENDATIONS. IN AUGUST 2024, TUFTS MC BEGAN TO ENGAGE RESIDENTS AND STAKEHOLDERS IN ITS 2025 CHNA PROCESS. THE PROCESS INCLUDES COMMUNITY SURVEY DATA COLLECTION, ANALYSIS OF LOCAL PUBLIC HEALTH DATA, AND FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS.AS WITH THE 2022 CHNA, TUFTS MC WILL SUPPLEMENT ITS CHNA FINDINGS WITH ADDITIONAL DATA COLLECTED THROUGH THE CITYWIDE CHNA PROCESS, CALLED THE BOSTON CHNA COLLABORATIVE, CONSISTING OF BOSTON HOSPITALS AND VARIOUS COMMUNITY STAKEHOLDERS. THE COLLABORATIVE LAUNCHED ITS CITYWIDE CHNA AT THE SAME TIME AS TUFTS MC, AND ITS PROCESS HAS INVOLVED ADDITIONAL SURVEY DATA COLLECTION AS WELL AS FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. TUFTS MC HAS ALSO SHARED SURVEY DATA WITH THE COLLABORATIVE AND PARTICIPATES AS A MEMBER INSTITUTION ON THE COLLABORATIVE'S STEERING COMMITTEE.TUFTS MC ENGAGED ITS COMMUNITY BENEFITS ADVISORY COMMITTEES (CBAC), COMPRISED OF RESIDENTS AND REPRESENTATIVES WHO LIVE, WORK, OR ARE SUBJECT MATTER EXPERTS IN OUR PARTNER COMMUNITIES OR OUR PRIORITIES, THROUGHOUT THE YEAR. TUFTS MC'S CBACS PROVIDE INPUT AND FEEDBACK ON COMMUNITY HEALTH INITIATIVES, RECEIVE AND REVIEW GRANTEE PROGRESS REPORTS, AND PARTICIPATE IN COMMUNITY BENEFITS GRANTEE PROGRESS MEETINGS. TUFTS MEDICAL CENTER, INC. PART V, SECTION B, LINE 11: TUFTS MC COMPLETED ITS LAST COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2022, WHICH ELEVATED THREE PRIMARY HEALTH AND SOCIAL NEEDS IN THE COMMUNITY: BEHAVIORAL HEALTH, FINANCIAL SECURITY AND MOBILITY, AND ACCESS TO CARE AND SERVICES. SECONDARY NEEDS RAISED BY THE COMMUNITY INCLUDED CHRONIC STRESS, CHRONIC DISEASE, ACCESS TO HEALTHY FOOD, AND HOUSING INSECURITY, SOME OF WHICH WERE THEMATICALLY CONNECTED TO THE PRIMARY NEEDS AND ARE BEING ADDRESSED TO LESSER EXTENTS. TUFTS MC RELEASED A REQUEST FOR PROPOSALS TO ADDRESS THESE NEEDS AND PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS TO IMPLEMENT PROGRAMMING TO IMPROVE COMMUNITY HEALTH AND WELLBEING. COMMUNITY-BASED ORGANIZATIONS WERE FUNDED ACROSS THE NEIGHBORHOODS OF CHINATOWN, DORCHESTER, THE SOUTH END, AND SOUTH BOSTON TO ADDRESS THE SUBSTANTIVE NEEDS IDENTIFIED IN THE CHNA.WITHIN THE ACCESS TO CARE AND SERVICES PRIORITY, THEMES INCLUDED ENSURING THAT ALL RESIDENTS CAN ACCESS CARE REGARDLESS OF LINGUISTIC BACKGROUND OR INCOME, CONNECTING COMMUNITY MEMBERS TO SERVICES, AND ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH THAT INFLUENCE THE HEALTH OF COMMUNITY MEMBERS.TO ADDRESS ACCESS TO CARE AND SERVICES, THE TUFTS MC INTERPRETER SERVICES DEPARTMENT PROVIDED MEDICAL INTERPRETATION TO 14,301 PATIENTS IN OVER 14 LANGUAGES IN FY24, ENCOMPASSING 270,495 TOTAL ENCOUNTERS. AN ADDITIONAL 10,062 PATIENTS WERE ABLE TO ACCESS CARE AND SERVICES FOR VULNERABLE POPULATIONS, INCLUDING PREVENTATIVE SCREENINGS, CANCER PATIENT NAVIGATION SUPPORT, PATIENT EDUCATION, SOCIAL SERVICES AND FOOD ACCESS THROUGH TUFTS MC INITIATIVES TO CONNECT PATIENTS TO CARE.THROUGH A PARTNERSHIP WITH UPHAMS COMMUNITY CARE, TUFTS MC SUPPORTED THEIR CHRONIC DISEASE MANAGEMENT PROGRAM FOR 5,884 LOW-INCOME COMMUNITY MEMBERS WITH HYPERTENSION, DIABETES, AND ASTHMA. THE PROGRAM PROVIDED BLOOD PRESSURE MONITORING AND COUNSELING, NUTRITIONAL CONSULTS, AND MONTHLY DROP-IN GROUPS FACILITATED BY A REGISTERED NURSE AND A NUTRITIONIST. THROUGH EDUCATION AND COUNSELING, 71% OF PARTICIPANTS WITH HYPERTENSION ACHIEVED A CONTROLLED DISEASE STATE, 79% OF DIABETIC PATIENTS HAD THEIR BLOOD SUGAR UNDER CONTROL, AND 85% OF ASTHMA PATIENTS ACHIEVED APPROPRIATE REFILL PATTERNS. THE PROGRAM ALSO CONNECTS COMMUNITY MEMBERS TO FREE GYM MEMBERSHIPS AND SNAP BENEFITS AS NEEDED IN ORDER TO PROMOTE HEALTHY DIET AND PHYSICAL ACTIVITY. ADDITIONAL PARTNERSHIPS BETWEEN TUFTS MC AND COMMUNITY ORGANIZATIONS CONNECTED 2,114 FAMILIES IN BOSTON TO RENTAL AND UTILITY ASSISTANCE, LEGAL SUPPORT, SNAP BENEFITS, AND EARLY CHILDHOOD SERVICES, ADDRESSING SOCIAL DETERMINANTS OF HEALTH.THE 2022 CHNA ALSO IDENTIFIED BEHAVIORAL HEALTH, TRAUMA, AND SUBSTANCE USE AS SIGNIFICANT CONCERNS IN ALL PRIORITY NEIGHBORHOODS. AS A RESPONSE TO THIS NEED, TUFTS MC FUNDED COMMUNITY-BASED ORGANIZATIONS TO ADDRESS BEHAVIORAL AND MENTAL HEALTH NEEDS. THROUGH THESE GRANTEES' WORK IN FY24, 1,889 BOSTON RESIDENTS RECEIVED BEHAVIORAL HEALTH SERVICES IN THE COMMUNITIES THEY LIVE IN. OF THESE INDIVIDUALS, 28 CHINESE EXPECTANT PARENTS RECEIVED COUNSELING AND PSYCHOSOCIAL SUPPORT, 322 SOUTH BOSTON RESIDENTS RECEIVED SUBSTANCE USE SUPPORT AND TREATMENT THROUGH COMMUNITY PARTNERSHIPS, 600 CHINATOWN RESIDENTS WERE REACHED BY A TOBACCO PREVENTION CAMPAIGN, 316 ASIAN SENIORS RECEIVED CASE MANAGEMENT AND ACCESS TO BILINGUAL SUPPORT GROUPS, 570 DORCHESTER FAMILIES RECEIVED SERVICES TO ADDRESS THE EFFECTS OF TOXIC STRESS, 67 UNHOUSED WOMEN AND CHILDREN RECEIVED CASE MANAGEMENT, AND 123 INDIVIDUALS WITH SUBSTANCE USE DISORDER IN THE "MASS & CASS" AREA WERE DIVERTED FROM THE JUSTICE SYSTEM TO RECOVERY-ORIENTED TREATMENT. SUCCESS STORIES FROM THESE INITIATIVES INCLUDE COMMUNITY MEMBERS BEING PLACED INTO SAFE HOUSING AS WELL AS SHOWING SIGNIFICANT DECREASES IN DEPRESSION AND ANXIETY.TUFTS MEDICAL CENTER PARTNERSHIPS ALSO ADDRESSED BEHAVIORAL HEALTH AND SOCIAL EMOTIONAL NEEDS WITHIN THE WALLS OF THE MEDICAL CENTER, SERVING 2,796 PATIENTS AND FAMILIES. CHILD LIFE SERVICES ORGANIZED A BOOK DRIVE TO COLLECT 2,000 MULTILINGUAL BOOKS FOR NICU FAMILIES TO PROMOTE FAMILY ENGAGEMENT AT THE BEDSIDE AND POST-PARTUM WELLBEING FOR MOTHERS. OTHER EXAMPLES INCLUDE TUFTS MC DEPARTMENT OF PSYCHIATRY'S FREE PSYCHIATRIC CONSULTATIONS TO 36 STUDENTS AT A LOCAL ELEMENTARY SCHOOL, AND A MULTI-DISCIPLINARY COLLABORATION BETWEEN THE TUFTS PHARMACY DEPARTMENT, EMERGENCY MEDICINE, ADDICTION PSYCHIATRY AND SOCIAL WORK THAT DISTRIBUTED THE OVERDOSE REVERSAL DRUG NALOXONE AND FENTANYL TEST STRIPS TO 119 COMMUNITY MEMBERS WITH SUBSTANCE USE DISORDER.TO ADDRESS FINANCIAL SECURITY AND HOUSING STABILITY TO SUPPORT OVERALL WELL-BEING, TUFTS MC SUPPORTED FINANCIAL LITERACY PROGRAMS COVERING BUDGETING, SAVING, AND INVESTING. IN FY24, 2,677 LOW-INCOME RESIDENTS, PRIMARILY BLACK AND LATINA WOMEN, BENEFITED FROM FINANCIAL LITERACY PROGRAMS OFFERED BY GRANTEES. PARTICIPANTS IN THESE PROGRAMS DEMONSTRATED SIGNIFICANT INCREASES IN THEIR EARNINGS AND SAVINGS, PROMOTING HOUSING STABILITY AS WELL AS RESISTING THE "CLIFF EFFECT" THROUGH PUBLIC ASSISTANCE WAIVERS. TO ADVANCE THIS PRIORITY, TUFTS MC'S CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE ALSO CONDUCTED RESEARCH TO BETTER UNDERSTAND THE SOCIAL AND FINANCIAL WELL-BEING OF LOW-INCOME ASIAN HOUSEHOLDS ON PUBLIC ASSISTANCE IN GREATER BOSTON AND THEIR EXPERIENCE WITH THE CLIFF EFFECT. THIS RESEARCH FOUND THAT ONE-FIFTH OF EMPLOYED PARTICIPANTS REPORTED LOSING PUBLIC ASSISTANCE DUE TO INCREASED WAGES, JOB PROMOTIONS, AND/OR MODIFIED WORK HOURS. AMONG EMPLOYED PARTICIPANTS WHO REPORTED HAVING EVER EXPERIENCED THE CLIFF EFFECT, A HIGH PROPORTION REPORTED CHANGING JOBS (44%), FOLLOWED BY QUITTING JOBS (7%) AND REDUCING WORKING HOURS (5%) TO AVOID THE CLIFF EFFECT. IN ADDITION, MANY PARTICIPANTS IN THE STUDY WERE UNAWARE ABOUT THE CLIFF EFFECT, AND MANY REPORTED INCREASED STRESS AS A RESULT OF FINANCIAL STRAIN. THROUGH RESEARCH LIKE THIS, TUFTS MC CONTRIBUTED TO PUBLIC KNOWLEDGE ON THE CONNECTION BETWEEN FINANCIAL STABILITY AND HEALTH.TUFTS MC SUPPORTED TRAINING AND WORKFORCE DEVELOPMENT TO PROMOTE THE UPWARD MOBILITY OF COMMUNITY MEMBERS. 54 LOW-INCOME YOUTH OF COLOR COMPLETED BIKE MECHANIC TRAINING, AND 30 WENT ON TO COMPLETE A PAID YOUTH APPRENTICESHIP. 236 ADDITIONAL STUDENTS PARTICIPATED IN HEALTHCARE CAREER TRAINING PROGRAMS INCLUDING PHARMACY INTERNSHIP OPPORTUNITIES, EMT TRAINING, AND SKILL-BUILDING WORKSHOPS TO PREPARE YOUTH FOR CAREERS IN THE HEALTHCARE FIELD. WORKFORCE DEVELOPMENT PROGRAMS WITHIN THE WALLS OF TUFTS MC ALSO PROMOTED FINANCIAL SECURITY AND MOBILITY OF COMMUNITY MEMBERS. THROUGH A PARTNERSHIP WITH THE ASIAN AMERICAN CIVIC ASSOCIATION, 23 TUFTS MC EMPLOYEES BENEFITED FROM ENGLISH FOR SPEAKERS OF OTHER LANGUAGES COURSES TO FURTHER THEIR PROFESSIONAL CAREERS AND IMPROVE COMMUNICATION WITH PATIENTS, WHILE 28 BOSTON PUBLIC SCHOOL STUDENTS COMPLETED SEVEN-WEEK INTERNSHIPS AT TUFTS MC COMBINED WITH PROFESSIONAL DEVELOPMENT SEMINARS.AT TUFTS MC, EMPOWERING YOUTH AND PROVIDING THEM WITH OPPORTUNITIES TO LEARN AND GROW IS A PRIORITY. 14,667 PEDIATRIC PATIENTS AND FAMILIES RECEIVED MULTILINGUAL EDUCATIONAL MATERIALS ON BIKE SAFETY, INJURY PREVENTION, AND THE IMPORTANCE OF READING TO YOUR CHILD. AT THE JOSIAH QUINCY ELEMENTARY SCHOOL (JQES), TUFTS MC PROVIDED INTERACTIVE NUTRITION LESSONS THAT HAVE IMPROVED STUDENTS' KNOWLEDGE OF HEALTHY EATING HABITS AND HYGIENE. THE PROGRAM WAS LED BY DIETETIC INTERNS FROM THE STERN NUTRITION CENTER AND REACHED 120 STUDENTS. THROUGH COMMUNITY-BASED PARTNERSHIPS, 379 LOW-INCOME YOUTH BENEFITED FROM EMPOWERMENT, EDUCATION, AND POSITIVE YOUTH DEVELOPMENT ACTIVITIES DURING THE FISCAL YEAR. MANY OF THESE ACTIVITIES ADDRESSED MULTIPLE DIMENSIONS OF YOUTH WELL-BEING INCLUDING BEHAVIORAL, SOCIAL, AND FINANCIAL WELL-BEING TO PROMOTE HOLISTIC YOUTH DEVELOPMENT.OUR DEPARTMENTAL EFFORTS AND GRANT FUNDED PROJECTS HAVE ADDRESSED THE 2022 CHNA PRIORITIES THROUGH ROBUST PARTNERSHIPS THAT INFLUENCE HEALTH OUTCOMES AT THE INDIVIDUAL, NEIGHBORHOOD, AND COMMUNITY LEVEL. 1 1 - NEW ENGLAND LONG-TERM CARE INC 78 BOSTON ROAD BILLERICA MA 01862 LONG-TERM ACUTE-CARE FACILITY PART I, LINE 7: COSTS ARE ALLOCATED TO PATIENT ENCOUNTERS BASED ON COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL INPATIENT AND OUTPATIENT ACTIVITY FOR ALL AREAS OF THE HOSPITAL INCLUDING ALL PAYER SOURCES. THE COSTS UTILIZED ARE BASED ON ACTUAL COSTS FROM THIS SYSTEM, ALLOCATED TO INDIVIDUAL PATIENT ENCOUNTERS. PART II, COMMUNITY BUILDING ACTIVITIES: PART II, LINE 2: ECONOMIC DEVELOPMENTTUFTS MC PROMOTES THE COMMUNITY'S ECONOMIC, SOCIAL EMOTIONAL AND SPIRITUAL WELLNESS AND COMMUNITY BUILDING THROUGH ITS FREE PARKING PROGRAM. BY REMOVING THE FINANCIAL BURDEN OF PARKING FEES, THE PROGRAM AIMS TO INCREASE FOOT TRAFFIC TO LOCAL BUSINESSES AND FOSTER ECONOMIC DEVELOPMENT. THIS, IN TURN, CREATES A MORE VIBRANT LOCAL ECONOMY, WHICH BENEFITS THE HEALTH OF THE COMMUNITY AS A WHOLE. ADDITIONALLY, THE PROGRAM ENCOURAGES SOCIAL INTERACTIONS, WHICH CAN CONTRIBUTE TO IMPROVED MENTAL HEALTH AND WELLBEING, AND FOSTER A GREATER SENSE OF COMMUNITY SPIRIT. THIS EFFORT IS A VITAL COMPONENT OF OUR HOSPITAL'S EFFORTS TO PROMOTE ECONOMIC DEVELOPMENT AND ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE. PART II, LINE 8: WORKFORCE DEVELOPMENTTUFTS MC IS COMMITTED TO PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH VARIOUS COMMUNITY-BUILDING ACTIVITIES. IN FY24, WE PROVIDED VALUABLE WORKFORCE DEVELOPMENT SKILLS TO 417 COMMUNITY MEMBERS THROUGH TRAINING PROGRAMS. WE PROVIDED JOB SKILLS TRAINING IN AREAS OF NEED, SUCH AS MEDICAL INTERPRETER TRAINING, EMT TRAINING, PHARMACY INTERNSHIPS, AND MECHANICAL SKILLS TRAINING TO DISADVANTAGED YOUTH. HIGHER PAY AND BETTER BENEFITS ARE DIRECTLY CORRELATED WITH IMPROVED HEALTH OUTCOMES, AND OUR INITIATIVE AIMED TO PROVIDE JOB SUPPORT AND JOB SKILLS TO POPULATIONS MOST IN NEED OR AT-RISK.TUFTS MC ALSO HAS A LONG-ESTABLISHED PARTNERSHIP WITH THE ASIAN AMERICAN CIVIC ASSOCIATION. OVER THE DECADES, THE STRUCTURE OF THE CLASS HAS CHANGED, BUT IN FY24, 23 EMPLOYEES PARTICIPATED IN THE PROGRAM, WHICH IS OPEN TO ALL TUFTS MC EMPLOYEES AT NO COST TO THEM. THE ESOL PROGRAM OFFERS BEGINNER AND ADVANCED CLASSES, WHICH ARE OFFERED BOTH DURING WORKS HOURS AND ON EMPLOYEE'S OWN TIME AND REQUIRE COMMITMENT AND MANAGER SUPPORT. THE PROGRAMS HELP IMPROVE EMPLOYEE/MANAGER RELATIONS, PATIENT EXPERIENCE, AND A CAREER PIPELINE FOR ALL TUFTS MC EMPLOYEES. PROMOTING EMPLOYEES' LITERACY AND COMPREHENSION CAN ALSO IMPROVE UNDERSTANDING OF AND ADHERENCE TO HOSPITAL SAFETY MEASURES.ADDITIONALLY, TUFTS MC'S SUMMER INTERNSHIP PROGRAM FOR BOSTON HIGH SCHOOL STUDENTS OFFERS OPPORTUNITIES FOR STUDENTS TO EXPLORE CAREER OPPORTUNITIES IN A HEALTHCARE SETTING AND OFTEN PROVIDES THEM WITH THEIR FIRST PAID EMPLOYMENT EXPERIENCE. WE OFFERED A FULLY ON-SITE SEVEN-WEEK EXPERIENCE TO 28 YOUTH, 24 WITH BILINGUAL CAPACITY, WHO INTERNED IN 22 DIFFERENT TUFTS MC DEPARTMENTS. INTERNS ADDITIONALLY PARTICIPATED IN WEEKLY WORKSHOPS ON TOPICS SUCH AS PUBLIC HEALTH AND COLLEGE READINESS. STUDENTS ALSO PRESENTED ON RELEVANT HEALTH TOPICS SUCH AS ACCESS TO CARE, BEHAVIORAL HEALTH, YOUTH MENTAL HEALTH, AND FINANCIAL SECURITY IN BOSTON WHILE ALSO LEARNING ABOUT TUFTS MC'S ACTIVITIES IN THESE PRIORITY AREAS. THE PROGRAM HAS LONG-TERM IMPACTS IN PROMOTING CAREERS IN HEALTHCARE. THE SUMMER INTERNSHIP PROGRAM PROVIDES VALUABLE SKILLS AND EXPERIENCE TO THE STUDENTS AND INCREASES YOUTHS LIKELIHOOD OF SECURING BETTER-PAYING JOBS IN THE FUTURE, PROMOTING THEIR OVERALL HEALTH AND WELLBEING.OVERALL, OUR COMMUNITY-BUILDING INITIATIVES AIM TO EQUIP COMMUNITY MEMBERS WITH THE NECESSARY SKILLS AND SUPPORT TO ACHIEVE FINANCIAL STABILITY, WHICH IN TURN PROMOTES BETTER HEALTH OUTCOMES AND FOSTERS A HEALTHIER COMMUNITY. PART III, LINE 2: THE HOSPITAL RECORDS BAD DEBTS BASED ON CHARGES. THE BAD DEBT COSTS PROVIDED HEREIN ARE BASED ON THESE CHARGES MULTIPLIED BY THE HOSPITAL'S COST-TO-CHARGE RATIO OF 44.00%. PART III, LINE 4: THE FOLLOWING IS FROM THE TUFTS MEDICINE, INC. AND CONSOLIDATED AFFILIATES (THE SYSTEM) AUDITED FINANCIAL STATEMENTS, OF WHICH TUFTS MEDICAL CENTER, INC. IS INCLUDED, RELATING TO CHARITY CARE AND BAD DEBT EXPENSE:2024 CHARITY CARE AND COMMUNITY BENEFIT FOOTNOTECHARITY CARE - THE SYSTEM'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE PATIENTS THAT IT SERVES. THE SYSTEM PROVIDES HEALTH CARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. THESE PATIENTS MAY RECEIVE FULL ASSISTANCE OR MAY BE SUBJECT TO PARTIAL LIABILITY BASED ON INCOME AND FAMILY SIZE. BECAUSE THE SYSTEM DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE.THE SYSTEM PROVIDED CHARITY CARE, BASED ON ESTIMATED COST OF THE CHARITY CARE PROVIDED, OF $10,919K, AND $3,237K FOR THE YEARS ENDED SEPTEMBER 30, 2024 AND 2023, RESPECTIVELY. THE ESTIMATED COST OF CHARITY CARE IS BASED ON THE RELATIONSHIP OF PATIENT CARE SERVICE CHARGES TO THE RELATED COSTS APPLIED TO CHARITY CARE CHARGES RECOGNIZED DURING THE YEARS ENDED SEPTEMBER 30, 2024 AND 2023. THE SYSTEM HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2024.HEALTH SAFETY NET FUND (HSN) - THE COMMONWEALTH OF MASSACHUSETTS (THE "COMMONWEALTH") OPERATES THE HSN, WHICH WAS CREATED BY THE COMMONWEALTH'S HEALTH CARE REFORM ACT TO REPLACE THE STATE'S UNCOMPENSATED CARE POOL. THE HSN ALLOCATES THE COST OF UNCOMPENSATED CARE AMONG THE HOSPITALS IN THE COMMONWEALTH. HOSPITALS HAVE BEEN ASSESSED A UNIFORM ALLOWANCE BASED ON ESTIMATES OF THE STATEWIDE COST OF UNCOMPENSATED CARE AND REIMBURSED FOR A PORTION OF THE COST OF UNCOMPENSATED CARE, SUBJECT TO CERTAIN LIMITATIONS. REIMBURSABLE UNCOMPENSATED CARE INCLUDES NET CHARITY CARE AND CERTAIN UNCOLLECTIBLE ACCOUNTS RELATED TO EMERGENCY SERVICES. HOSPITALS' RECOVERIES FROM THE HSN ARE BASED ON A CLAIMS-BASED PAYMENT METHOD THAT USES MEDICARE PRINCIPLES. REIMBURSEMENT FROM THE HSN FOR UNCOMPENSATED CARE IS RECORDED IN NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENT OF OPERATIONS. THE COMMONWEALTH HAS DETERMINED FINAL SETTLEMENTS WITH RESPECT TO THE HSN FOR ALL YEARS PRIOR TO 2021.COMMUNITY BENEFIT - IN FURTHERING ITS CHARITABLE PURPOSE, THE SYSTEM PROVIDES A WIDE VARIETY OF HEALTH CARE SERVICES TO THE COMMUNITY IN ORDER TO PROVIDE ACCESS TO APPROPRIATE CARE FOR POPULATIONS IN NEED. THE SYSTEM HAS DEVELOPED A FORMAL COMMUNITY BENEFIT PLAN THAT RESPONDS TO THE COMPREHENSIVE ASSESSMENT OF HEALTH CARE NEEDS IN THE COMMUNITY. THE COMMUNITY BENEFIT PLAN SUPPORTS SERVICES THAT TARGET NOT ONLY THE GENERAL POPULATION IN THE SYSTEM'S SERVICE AREA, BUT ALSO PARTICULAR POPULATIONS WITH SPECIAL HEALTH CARE NEEDS, INCLUDING THE POOR, ELDERLY, CHILDREN, AND MINORITY POPULATIONS. SUPPORTED SERVICES INCLUDE VARIOUS CLINICS, HEALTH SCREENING PROGRAMS, HEALTH EDUCATION PROGRAMS, AND SUPPORT GROUPS OPERATED IN THE SYSTEM'S SERVICE AREA. ADDITIONALLY, CERTAIN PATIENT SERVICES ARE PROVIDED WITHOUT COMPENSATION. THE SYSTEM WORKS ACTIVELY WITH OTHER AREA SERVICE PROVIDERS TO FACILITATE THE DEVELOPMENT OF AN EFFECTIVE COMMUNITY HEALTH NETWORK. THE SYSTEM ALSO PARTICIPATES IN ACTIVITIES DESIGNED TO FOSTER AND ENHANCE THE ECONOMIC AND CIVIC ENVIRONMENT OF ITS SERVICE AREAS. PART III, LINE 8: COSTS ARE ALLOCATED TO PATIENT ENCOUNTERS BASED ON COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL INPATIENT AND OUTPATIENT ACTIVITY FOR ALL AREAS OF THE HOSPITAL INCLUDING ALL PAYER SOURCES. THE COSTS UTILIZED ARE BASED ON ACTUAL COSTS FROM THIS SYSTEM, ALLOCATED TO INDIVIDUAL PATIENT ENCOUNTERS. PART III, LINE 9B: TUFTS MEDICAL CENTER'S FINANCIAL COORDINATION OFFICE IDENTIFIES AND ASSISTS THOSE PATIENTS THAT HAVE NO INSURANCE OR WHO ARE UNDERINSURED. WE WILL PROCESS ON-LINE APPLICATIONS FOR STATE PROGRAMS IN ACCORDANCE WITH THE ESTABLISHED MASS HEALTH GUIDELINES. THE GUIDELINES ARE BASED ON 200% OF THE FEDERAL POVERTY GUIDELINES.FINANCIAL ASSISTANCE IS ALSO EXTENDED TO OUT-OF-STATE/COUNTRY PATIENTS WITH NO INSURANCE IN ACCORDANCE WITH THE TUFTS MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. A NOTICE OF FINANCIAL ASSISTANCE IS LOCATED ON THE PATIENT BILL AND THE HOSPITAL WEB-SITE. IT IS ALSO POSTED IN VARIOUS STRATEGIC LOCATIONS THROUGHOUT THE HOSPITAL.THE FINANCIAL COORDINATION OFFICE IS OPEN MONDAY THRU FRIDAY FROM 8:00 A.M. TO 4:40 P.M. THE MAIN NUMBER FOR THE FINANCIAL COORDINATION OFFICE IS 617-636-6013. PART VI, LINE 2: TUFTS MC USES VARIOUS METHODS TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. AN IMPORTANT METHOD IS TO CONDUCT A CHNA, DONE SO EVERY THREE YEARS. TUFTS MC IS IN THE LAST YEAR OF ITS IMPLEMENTATION PLAN GUIDED BY THE CHNA WAS CONDUCTED IN THE SPRING OF 2022, WHERE 927 COMMUNITY RESIDENTS PARTICIPATED IN A SURVEY TO UNDERSTAND THE COMMUNITY'S NEEDS, STRENGTHS, PRIORITY HEALTH ISSUES, AND RECOMMENDATIONS. THE CHNA PROCESS ALSO INCLUDED 8 KEY INFORMANT INTERVIEWS AND 14 FOCUS GROUPS WITH 128 COMMUNITY RESIDENTS AND INPUT FROM UPDATED COMMUNITY MEMBERS. IN FY24, TUFTS MC ALSO EMBARKED ON ITS 2025 CHNA, COLLECTING SURVEYS WHILE PLANNING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS.TUFTS MC WORKS COLLABORATIVELY WITH COMMUNITY PARTNERS, INCLUDING NON-PROFIT ORGANIZATIONS, TO IDENTIFY AREAS OF NEED AND ADDRESS THEM EFFECTIVELY. IN ADDITION TO CONDUCTING A CHNA, TUFTS MC PARTICIPATES IN OTHER MEETINGS SUCH AS GRANTEE/CBAC MEETINGS AND OTHER COMMUNITY MEETINGS SUCH AS THE CHINATOWN COALITION, CHINATOWN NEIGHBORHOOD COUNCIL, JOSIAH QUINCY ELEMENTARY SCHOOL PARENT ORIENTATION, AND THE SOUTH BOSTON ASSOCIATION OF NONPROFITS, AMONG OTHERS. THESE MEETINGS PROVIDE VALUABLE FEEDBACK AND INSIGHT INTO COMMUNITY NEEDS.FURTHERMORE, TUFTS MC REVIEWS DATA ON POPULATION HEALTH, EPIDEMIOLOGY, AND COMMUNITY HEALTH INDICATORS TO MONITOR TRENDS AND IDENTIFY EMERGING HEALTH CONCERNS DURING THE CHINA PROCESS; IT USES THIS DATA TO ENSURE THAT IT IS ADDRESSING THE MOST PRESSING HEALTH NEEDS OF THE COMMUNITY IN A COMPREHENSIVE AND EFFECTIVE MANNER. ADDITIONALLY, WHEN URGENT ISSUES ARISE, SUCH AS THE COVID-19 PANDEMIC, TUFTS MC HAS COLLECTED DATA IN BETWEEN THE TRIENNIAL CHNA TO ASSESS AND ACT UPON IMMEDIATE NEEDS THAT ARISE IN THE COMMUNITY.ONCE PRIORITY HEALTH NEEDS ARE IDENTIFIED, DATA ARE SUMMARIZED, REVIEWED, AND APPROVED BY TUFTS MC'S SENIOR LEADERSHIP AND ITS COMMUNITY BENEFITS GOVERNING BODY, TUFTS MC'S COMMUNITY BENEFITS COMMITTEE AND THE TMC BOARD OF TRUSTEES. THIS COLLABORATIVE APPROACH ENSURES THAT TUFTS MC IS ADDRESSING THE MOST PRESSING HEALTH NEEDS OF THE COMMUNITY IN A COMPREHENSIVE AND EFFECTIVE MANNER. PART VI, LINE 3: PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE AND FINANCIAL COORDINATION RESOURCES OFFERED BY THE HOSPITAL THROUGH SEVERAL DIFFERENT MEDIUMS AND AT SEVERAL DIFFERENT POINTS IN THEIR EXPERIENCE WITH THE HOSPITAL. PATIENTS ARE PROVIDED AN OPPORTUNITY TO HAVE AN IN PERSON DISCUSSION WITH A FINANCIAL COORDINATOR ABOUT INSURANCE COVERAGE AND FINANCIAL HARDSHIP DURING THE INITIAL REGISTRATION PROCESS. IF A PATIENT EXPRESSES THE NEED FOR INSURANCE OR FINANCIAL ASSISTANCE A FINANCIAL COORDINATOR WILL WORK WITH THEM TO APPLY FOR ANY AVAILABLE AND APPROPRIATE SERVICES. SHOULD A PATIENT QUALIFY FOR MEDICARE OR MEDICAID ASSISTANCE OF ANY FORM, E.G. COMMONWEALTH CARE, THE COUNSELOR OR FINANCIAL COORDINATOR WILL ALSO ASSIST THE PATIENT IN APPLYING FOR ANY OTHER SOCIAL SERVICES THEY MAY FIND HELPFUL, SUCH AS FOOD AND NUTRITION SERVICES. PATIENTS ARE NOTIFIED OF THEIR RIGHTS AND AVAILABLE FINANCIAL RESOURCES THROUGH A VARIETY OF OTHER MEASURES AS WELL, INCLUDING INFORMATION ON SEVERAL DIFFERENT PAGES AND LANDING POINTS ON THE TUFTS MEDICAL CENTER'S WEBSITE, IN WRITTEN INFORMATION PROVIDED AT DISCHARGE, ON ANY BILLING STATEMENTS THEY RECEIVE AND IN POSTINGS THROUGHOUT THE HOSPITAL IN ALL WAITING AREAS AND CLINICS. PART VI, LINE 4: LOCATED IN THE HEART OF BOSTON'S CHINATOWN COMMUNITY, TUFTS MC IS COMMITTED TO RESPONDING TO THE SPECIFIC NEEDS OF THE COMMUNITY, MANY OF WHOM ARE NEW IMMIGRANTS IN NEED OF SERVICES IN THEIR OWN LANGUAGE TO HELP THEM NAVIGATE HEALTH CARE FOR THEMSELVES AND THEIR FAMILIES. TUFTS MC'S STRONG COMMITMENT TO THE ADJACENT NEIGHBORHOODS OF DORCHESTER, SOUTH BOSTON AND THE SOUTH END REFLECTS THE HISTORY OF THE FOUNDING OF THE BOSTON DISPENSARY TO PROVIDE QUALITY HEALTHCARE TO BOSTON'S WORKING AND LOW-INCOME FAMILIES.TUFTS MC HAS BEEN IN ITS CURRENT LOCATION SINCE ITS INCEPTION AS THE BOSTON DISPENSARY IN 1796. THE NEIGHBORHOOD, ORIGINALLY KNOWN AS THE SOUTH COVE, IS NOW RECOGNIZED AS BOSTON'S CHINATOWN NEIGHBORHOOD DUE TO THE GROWTH OF THE CHINESE AMERICAN COMMUNITY, WHO FIRST MOVED INTO THE NEIGHBORHOOD IN THE 1870S AND GREW IN NUMBERS AFTER THE LIFTING OF IMMIGRATION RESTRICTIONS ALLOWED FOR FAMILY REUNIFICATION IN THE 1960S AND HAS CONTINUED WITH ONGOING IMMIGRATION. TUFTS MC HAS BEEN AN INTEGRAL MEMBER OF THE COMMUNITY FOR GENERATIONS.SERVICE POPULATIONS:TUFTS MC'S PATIENT POPULATION IS DIVERSE AND REFLECTS THE DEMOGRAPHICS OF THE BOSTON AND GREATER BOSTON COMMUNITY FOR WHICH IT SERVES AS AN ACADEMIC AND TERTIARY/QUATERNARY HOSPITAL. APPROXIMATELY 58% OF THE PATIENT POPULATION IS WHITE, 11% BLACK/AFRICAN AMERICAN, 17% ASIAN AND 8% LATINX. 26% OF THE PATIENT POPULATION QUALIFY FOR MEDICAID, AND 26% OF PATIENTS ARE COVERED BY MEDICARE. APPROXIMATELY 14,000 PATIENTS REQUESTED INTERPRETER SERVICES IN FY24 IN CHINESE, VIETNAMESE, SPANISH, HAITIAN CREOLE, RUSSIAN, PORTUGUESE AND MANY OTHER LANGUAGES, ENCOMPASSING 270,495 ENCOUNTERS. PRIMARY SERVICE AREA COMMUNITIES: BOSTON'S CHINATOWN IS THE SMALLEST OF THE CITY'S NEIGHBORHOODS. IT IS LOCATED IN DOWNTOWN BOSTON NEAR MAJOR TRANSPORTATION NODES AND THE CITY'S DOWNTOWN RETAIL, THEATER, HISTORIC AND FINANCIAL DISTRICTS. ITS 76 ACRES INCLUDE A ROBUST RESIDENTIAL, CULTURAL, ECONOMIC, AND SERVICE HUB FOR BOSTON'S CHINESE AND ASIAN COMMUNITY. THE 2023 AMERICAN COMMUNITY SURVEY (ACS) ESTIMATED THAT OVER 8,000 PEOPLE LIVED IN THE NEIGHBORHOOD, ONE OF THE MOST DENSELY POPULATED IN THE CITY OF BOSTON. WITHIN AND WALKING DISTANCE TO CHINATOWN ARE A NUMBER OF OPEN AND GREEN SPACES, INCLUDING THE MARY SOOHOO AND UNCLE FRANK AND AUNT KAY CHIN PARKS, AND THE REST OF THE ROSE KENNEDY GREENWAY; THE BOSTON COMMON; THE BOSTON PUBLIC GARDEN; AND SMALLER SPACES INCLUDING TAI TUNG PARK, ELIOT NORTON PARK, AND OTHER ACCESSIBLE PUBLIC AND PRIVATE PLAYGROUNDS; AND PHILLIPS SQUARE.HISTORICALLY, BOSTON CHINATOWN HAS PLAYED AN IMPORTANT ROLE IN ECONOMIC, SOCIAL AND CULTURAL SUPPORT FOR ARRIVING IMMIGRANTS IN WHICH THEY CONTINUE TO LIVE, WORK, SHOP, FIND SERVICES, AND MAINTAIN SOCIAL CONNECTIONS. ACCORDING TO AMERICAN COMMUNITY SURVEY 2023 DATA, COMPARED TO OTHER COMMUNITIES IN TUFTS MC'S SERVICE AREA AND BOSTON AS A WHOLE, CHINATOWN HAS HIGHER PERCENTAGES OF RESIDENTS THAT IDENTIFY AS ASIAN OR PACIFIC ISLANDER (56%), ARE FOREIGN BORN (46%) AND SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME (57%). ALTHOUGH THE MAJORITY OF CHINATOWN RESIDENTS HAVE BACHELOR'S DEGREES OR HIGHER (59%), ABOUT ONE IN FIVE DID NOT GRADUATE FROM HIGH SCHOOL. THE BOSTON PUBLIC HEALTH COMMISSION'S 2023 HEALTH OF BOSTON REPORT FOUND THAT CHINATOWN/SOUTH END HAD A HIGHER PREMATURE MORTALITY RATE THAN THE CITY AVERAGE. IT ALSO HAS THE HIGHEST RATE OF ASTHMA IN THE CITY, WITH NEARLY 1 IN 5 (17.4%) OF ADULTS AFFECTED. CHINATOWN AND THE SOUTH END ALSO EXPERIENCE A SIGNIFICANTLY HIGHER RATE OF MENTAL HEALTH EMERGENCY ROOM VISITS; EVEN ADJUSTING FOR SUBSTANCE-USE RELATED EMERGENCY ROOM VISITS DUE TO THE PREVALENCE OF SUBSTANCE USE DISORDER IN THE NEIGHBORHOODS, THE RATE STILL REMAINED SIGNIFICANTLY HIGHER THAN THE BOSTON AVERAGE. ADDITIONALLY, CHINATOWN AND THE SOUTH END WERE FOUND TO HAVE A HIGHER RATE OF AGE-ADJUSTED DIABETES HOSPITALIZATIONS AND HEART DISEASE HOSPITALIZATIONS COMPARED TO THE BOSTON AVERAGE. THE HEALTH PROFILE OF CHINATOWN, BASED ON TUFTS MC 2022 COMMUNITY SURVEY RESPONSES AND FOCUS GROUP INTERVIEWS, REVEALS SEVERAL KEY HEALTH CONCERNS AND CHALLENGES FACING THE COMMUNITY. THE TOP THREE HEALTH CONCERNS IDENTIFIED BY RESIDENTS WERE COVID-19, MENTAL HEALTH/DEPRESSION, AND ACCESS TO SPECIALTY CARE. ENVIRONMENTAL HEALTH, HOUSING STABILITY, AND EDUCATION WERE THE TOP SOCIAL ISSUES OF CONCERN, WHILE DISCRIMINATION BASED ON RACE, IMMIGRATION STATUS, AND CLASS/INCOME WERE THE TOP SAFETY ISSUES IDENTIFIED. FINANCIAL SECURITY WAS ALSO A KEY CONCERN, WITH GENTRIFICATION AND HIGH HOUSING COSTS MENTIONED AS IMPEDIMENTS TO ECONOMIC WELL-BEING.SEVERAL PREVALENT HEALTH CONDITIONS WERE MENTIONED, INCLUDING ASTHMA, CANCER, DIABETES, OSTEOPOROSIS/ARTHRITIS, DEMENTIA, HIGH BLOOD PRESSURE, AND CHOLESTEROL. POLLUTION AND HIGH RATES OF SMOKING (BOTH TOBACCO AND MARIJUANA) WERE IDENTIFIED AS EXACERBATING THESE HEALTH CONCERNS. DIFFICULTIES FINDING PROVIDERS WHO SPEAK THEIR LANGUAGE AND HIGH OUT-OF-POCKET COSTS WERE CITED AS DETERRENTS TO ACCESSING HEALTHCARE, WITH BETTER ACCESS TO HEALTHCARE IDENTIFIED AS A TOP PRIORITY FOR 36% OF SURVEY RESPONDENTS. YOUNG PEOPLE ALSO EXPRESSED CONCERNS AROUND DEPRESSION, ANXIETY, AND SLEEP ISSUES, WHILE THE COVID-19 PANDEMIC WORSENED MENTAL HEALTH CONCERNS AND LED TO STRESS, ANXIETY, AND DEPRESSION FOR RESIDENTS OF ALL AGES.DORCHESTER IS THE LARGEST NEIGHBORHOOD IN BOSTON AND REFLECTS THE CITY'S ECONOMIC, LINGUISTIC, RACIAL, ETHNIC, AND CULTURAL DIVERSITY WITH A POPULATION OF OVER 140,000 RESIDENTS, APPROXIMATELY 20% OF BOSTON'S TOTAL POPULATION. BOSTON PLANNING AND DEVELOPMENT AGENCY DATA FOR 2024 INDICATE THAT 19% OF RESIDENTS WERE LESS THAN 18 YEARS OLD AND 19% WERE SENIORS AGED 60 AND OLDER. 30-59 YEAR-OLDS MAKE UP THE LARGEST PERCENTAGE (39%) OF DORCHESTER RESIDENTS. DORCHESTER IS A RACIALLY DIVERSE NEIGHBORHOOD OVERALL, WITH BLACK/AFRICAN AMERICANS MAKING UP THE LARGEST PERCENTAGE OF THE POPULATION. 23.4 PERCENT OF THE POPULATION WAS WHITE, 34.1% BLACK/AFRICAN AMERICAN, 11.4% ASIAN, 20.2% LATINO/A, AND 10.8% OTHER. ABOUT ONE-THIRD OF RESIDENTS IN DORCHESTER ARE FOREIGN BORN AND 40% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, BOTH SLIGHTLY HIGHER THAN THE CITY OF BOSTON AS A WHOLE. DORCHESTER HAS ABOUT EQUAL PERCENTAGES OF HIGH SCHOOL GRADUATES (27%) AND THOSE WITH BACHELOR'S DEGREES OR HIGHER (31%). DORCHESTER'S MEDIAN INCOME OF $67,500 IS LOWER THAN THE CITY'S AVERAGE.THE BOSTON PUBLIC HEALTH COMMISSION'S 2023 HEALTH OF BOSTON REPORT INDICATED THAT DORCHESTER CONTINUED TO EXPERIENCE PREMATURE MORTALITY RATES HIGHER THAN THE CITY AVERAGE AND TWICE AS HIGH AS THAT OF MORE AFFLUENT NEIGHBORHOODS LIKE BACK BAY AND BEACON HILL. ALL-CAUSE MORTALITY INCREASED BY 24.5% FOR NORTH DORCHESTER RESIDENTS AND 19.7% FOR SOUTH DORCHESTER RESIDENTS BETWEEN 2017-2021.DORCHESTER CONTINUED TO HAVE A HIGH INCIDENCE OF VIOLENCE-RELATED INJURIES AND HIGH RATES OF HOMICIDE COMPARED TO THE CITY AS A WHOLE, ALTHOUGH VIOLENCE HAS BEEN TRENDING DOWNWARD BOTH IN DORCHESTER AND THE CITY. THE 2023 BPHC REPORT FOUND THAT DORCHESTER EXPERIENCED PREMATURE MORTALITY RATES TWICE AS HIGH. ADDITIONALLY, THE RATE OF ASTHMA-RELATED HOSPITALIZATION AMONG CHILDREN AGES 5-17 IN DORCHESTER WAS AMONG THE HIGHEST IN THE CITY, AND THE NEIGHBORHOOD'S RESIDENTS EXPERIENCE A HIGH PREVALENCE OF CHRONIC DISEASES LIKE OBESITY AMONG ADULTS. COMPARED TO THE CITY AVERAGE, DORCHESTER HAD HIGH RATES OF INFANTS BORN WITH LOW BIRTHWEIGHT AS WELL AS HIGH RATES OF INFANT MORTALITY COMPARED TO THE CITY AVERAGE. FINALLY, DORCHESTER'S AGE-ADJUSTED SUBSTANCE USE MORTALITY RATE HAS RISEN 64.9% FROM 2017 TO 2022 AND IS THREE TIMES AS HIGH AS THAT OF MORE AFFLUENT BOSTON NEIGHBORHOODS.THE HEALTH PROFILE OF DORCHESTER, BASED ON TUFTS MC 2022 COMMUNITY SURVEY RESPONSES, INDICATES THAT THE TOP HEALTH CONCERNS ARE MENTAL HEALTH/DEPRESSION, COVID-19, AND ACCESS TO SPECIALTY CARE. THE TOP SOCIAL ISSUES ARE HOUSING STABILITY, DOMESTIC/INTERPERSONAL VIOLENCE, AND EDUCATION, WHILE THE TOP SAFETY ISSUES ARE DRUG TRAFFICKING, DISCRIMINATION BASED ON RACE, AND DISCRIMINATION BASED ON CLASS/INCOME. PARTICIPANTS FELT THAT THE PANDEMIC EXACERBATED EXISTING SOCIAL NEEDS AND GAPS AS WELL AS HEALTH CONCERNS. MENTAL HEALTH WAS THE TOP COMMUNITY HEALTH CONCERN, WITH YOUTH AND ADULT PARTICIPANTS FEELING THAT THERE ARE NOT ENOUGH CLINICIANS TO FILL THE NEED FOR MENTAL HEALTH SERVICES. OTHER HEALTH CONCERNS INCLUDE OBESITY, DIABETES, HEART DISEASE, LATE DIAGNOSED CANCER, AND BLACK MATERNAL HEALTH. FINANCIAL INSECURITY IS THE PRIMARY SOCIAL CONCERN, WHICH IMPACTS OTHER SOCIAL DETERMINANTS OF HEALTH SUCH AS HOUSING AND FOOD INSECURITY. HOUSING AFFORDABILITY AND GENTRIFICATION HAVE BECOME A GROWING CONCERN, AND ACCESS TO JOBS AND JOB TRAINING HAS RISEN AS A PRIORITY NEED. PART VI, LINE 5: IN ADDITION TO PROVIDING FINANCIAL RESOURCES TO COMMUNITY-BASED HEALTH AND SERVICE ORGANIZATIONS THAT ADDRESS HEALTH ISSUES SPECIFIC TO THEIR CONSTITUENTS, TUFTS MC ADVANCES ITS COMMITMENT TO THE HEALTH OF ITS PATIENT AND PRIORITY COMMUNITIES THROUGH HOSPITAL-LED EFFORTS. THESE INCLUDE CLINICS ESTABLISHED TO MEET THE NEEDS OF NON-NATIVE ENGLISH SPEAKERS; SCHOOL-BASED CURRICULA THAT HELP STUDENTS LEARN ABOUT SMOKING, ASTHMA, DENTAL HEALTH, NUTRITION, SEXUAL HEALTH, SUBSTANCE USE, AND STRESS MANAGEMENT; SCREENINGS AND WORKSHOPS FOR VULNERABLE POPULATIONS; ASSISTING ELIGIBLE PATIENTS WITH SECURING FINANCIAL AND SOCIAL BENEFITS SUCH AS PUBLIC HEALTH INSURANCE; AND A COLLABORATION WITH THE BOSTON CHNA COLLABORATIVE TO DEEPEN AND EXPAND THE IMPACT OF MEMBER INSTITUTIONS' COMMUNITY BENEFITS ACTIVITIES. TUFTS MC ALSO PARTICIPATES IN COMMUNITY COALITIONS THAT WORK TO PRESERVE COMMUNITY ASSETS AND ADVANCE THE PHYSICAL, ECONOMIC, SOCIAL, AND CULTURAL HEALTH OF THE COMMUNITY. EXAMPLES OF THIS INCLUDE TUFTS MC'S ROLE IN PUBLIC SAFETY INITIATIVES, PROVIDING PARKING FOR FAITH-BASED INSTITUTIONS' CONGREGATION MEMBERS AND WEEKEND PARKING FOR LOCAL SMALL BUSINESS OWNERS' CUSTOMERS, AND VARIOUS WORKFORCE DEVELOPMENT ACTIVITIES TO HELP PREPARE AND/OR RECRUIT COMMUNITY MEMBERS FOR TUFTS MC EMPLOYMENT AND BEYOND. PART VI, LINE 6: COMMUNITY HOSPITAL PARTNERSHIPSTUFTS MEDICAL CENTER HAS A RICH HISTORY OF PROVIDING MEDICAL CARE TO THE BOSTON COMMUNITY SINCE ITS FOUNDING. IN 2009 TUFTS MEDICAL CENTER LAUNCHED ITS DISTRIBUTED ACADEMIC MEDICAL CENTER MODEL, WHICH PARTNERS WITH COMMUNITY HOSPITALS TO KEEP MORE CARE LOCALLY IN THE COMMUNITY. TUFTS MEDICAL CENTER IS PROUD TO PARTNER WITH EXCELLENT COMMUNITY HOSPITALS TO DELIVER THE HIGHEST QUALITY CARE IN THE MOST CONVENIENT MANNER FOR PATIENTS. WE STRONGLY BELIEVE THAT WHEN ACADEMIC MEDICAL CENTERS AND COMMUNITY HOSPITALS WORK SIDE-BY-SIDE, THE PATIENT AND THE HEALTH CARE SYSTEM BENEFIT. THROUGH OUR DISTRIBUTED ACADEMIC MEDICAL CENTER MODEL, WE BRING TUFTS MEDICAL CENTER PHYSICIANS TO THE COMMUNITY - SAVING PATIENTS THE DRIVE INTO DOWNTOWN BOSTON AND TAKING ADVANTAGE OF THE EXCELLENT HOSPITALS IN THE CITIES AND TOWNS SURROUNDING BOSTON. WE ALSO CONSULT CLOSELY WITH OUR TALENTED PHYSICIAN COLLEAGUES WHO ARE PROVIDING OUTSTANDING SERVICES IN THE COMMUNITY ALREADY. AND WHEN EXCEPTIONALLY COMPLEX CARE IS NEEDED, THESE PARTNERSHIPS MEAN THE TRANSFER TO BOSTON IS WELL COORDINATED BETWEEN PHYSICIANS AND COMFORTABLE FOR THE PATIENT AND FAMILY MEMBERS.THROUGH PARTNERSHIPS WITH OTHER AREA HOSPITALS AND MEDICAL CENTERS, DOCTORS FROM TUFTS MC STAFF VARIOUS COMMUNITY MEDICAL FACILITIES. THIS ALLOWS MORE PATIENTS TO RECEIVE TOP-QUALITY CARE IN A LOCATION CLOSE TO HOME. TUFTS MC SPECIALISTS SEE PATIENTS AND PERFORM SOME TREATMENTS AND PROCEDURES LOCALLY. WHEN HIGH-LEVEL ADVANCED CARE IS NEEDED, TUFTS MC DOCTORS WORK WITH THE COMMUNITY PHYSICIANS TO ENSURE A SMOOTH PATIENT TRANSITION TO TUFTS MEDICAL CENTER IN BOSTON.TUFTS MEDICAL CENTER MAKES AN EXCELLENT CLINICAL PARTNER FOR TWO MAIN REASONS. FIRST, WE WORK WITH OUR PARTNER HOSPITALS TO KEEP MOST MEDICAL CARE LOCAL. THIS IS THE MOST CONVENIENT OPTION FOR PATIENTS AND THE MOST COST-EFFECTIVE OPTION FOR BOTH PATIENTS AND PROVIDERS. SECOND, TUFTS MEDICAL CENTER PROVIDES HIGH-QUALITY CARE AT REASONABLE COSTS. IN FACT, A REPORT BY THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE SAID THAT WE ARE THE MOST AFFORDABLE ADVANCED CARE OPTION IN BOSTON.PATIENTS MAY EXPERIENCE OUR AFFILIATION WITH COMMUNITY HOSPITALS IN ANY NUMBER OF WAYS, SUCH AS:- A PEDIATRIC HOSPITALIST CARING FOR A SICK CHILD ON THE PEDIATRIC UNIT OF A COMMUNITY HOSPITAL- A CARDIOLOGIST PERFORMING CARDIAC CATHETERIZATIONS IN THE COMMUNITY- OUR EXPERT WEIGHT AND WELLNESS CENTER TEAM PROVIDING SUPPORT AND SURGERIES IN THE COMMUNITY - OUR TRAUMA TEAM PREPARING FOR AN URGENT TRANSFER FROM A COMMUNITY HOSPITAL- OUR NEUROLOGY TEAM PROVIDING A CONSULT ON A STROKE PATIENT IN A COMMUNITY EMERGENCY DEPARTMENT- CARDIOLOGY EXPERTS FROM THROUGHOUT THE REGION MEETING TO DISCUSS BEST PRACTICE FOR TREATING HEART FAILURE PATIENTS- COORDINATED CARE PROTOCOLS BETWEEN INSTITUTIONS AND CARE SETTINGSADULT AFFILIATE HOSPITALSMETROWEST MEDICAL CENTER (FRAMINGHAM, MA)PEDIATRIC AFFILIATE HOSPITALSLAWRENCE GENERAL HOSPITAL (LAWRENCE, MA)LOWELL GENERAL HOSPITAL (LOWELL, MA)METROWEST MEDICAL CENTER (FRAMINGHAM, MA)SIGNATURE HEALTHCARE BROCKTON HOSPITAL (BROCKTON, MA) PART VI, LINE 7, REPORTS FILED WITH STATES MA PART VI, LINE 4, COMMUNITY INFORMATION (CONTINUED) MOREOVER, THE COMMUNITY FACES SAFETY CONCERNS AS WELL. DORCHESTER RESIDENTS REPORTED FEELING UNSAFE IN THEIR NEIGHBORHOOD AT A RATE 10 PERCENTAGE POINTS ABOVE THE 14% CITY AVERAGE IN SOUTH DORCHESTER (24%), AND 20 POINTS ABOVE THE AVERAGE IN NORTH DORCHESTER (34%) ACCORDING TO THE BOSTON BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM. THESE SAFETY CONCERNS CAN EXACERBATE THE ALREADY PRESENT HEALTH ISSUES AND CREATE ADDITIONAL STRESS AND ANXIETY FOR RESIDENTS. SOUTH BOSTON IS A NEIGHBORHOOD OF APPROXIMATELY 37,000 RESIDENTS THAT CONTINUES TO UNDERGO CHANGES. HISTORICALLY CONSIDERED A WORKING-CLASS COMMUNITY WITH A SIGNIFICANT NUMBER OF PUBLIC HOUSING DEVELOPMENTS, LONG-TIME RESIDENTS ARE NOW EXPERIENCING INCREASING RENTS AND/OR DISPLACEMENT, ALONG WITH AN INFLUX OF NEWER RESIDENTS, RESULTING FROM A SHARP INCREASE IN NEW CONSTRUCTION AND HOUSING DEVELOPMENT IN THE AREA.DATA FROM THE CENSUS BUREAU SHOW A 26% INCREASE IN THE POPULATION BETWEEN 2000 AND 2017. DURING THIS PERIOD, THE NUMBER OF CHILDREN UNDER AGE 18 AND SENIORS OVER AGE 65 (AND THE PROPORTION OF THE POPULATION THEY MADE UP) DROPPED; THUS, THE RISE IN POPULATION IS ATTRIBUTED LARGELY TO WORKING-AGE ADULTS. ACCORDING TO 2024 BOSTON PLANNING & DEVELOPMENT AGENCY DATA, COMPARED TO TUFTS MC'S OTHER PRIORITY NEIGHBORHOODS AS A WHOLE, SOUTH BOSTON HAS A MUCH LARGER PERCENTAGE OF WHITE NON-HISPANIC RESIDENTS (76.8%), AND MUCH SMALLER PERCENTAGES OF FOREIGN-BORN RESIDENTS (12%) AND RESIDENTS WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME (16%). HOWEVER, SOUTH BOSTON HAS A SIZABLE COMMUNITY OF HISPANIC AND LATINO/A RESIDENTS (10.4%) AND ASIAN RESIDENTS (5.5%). SOUTH BOSTON HAS A BIGGER YOUNG ADULT POPULATION THAN TUFTS MC'S OTHER PRIORITY COMMUNITIES OR BOSTON AS A WHOLE, WITH 18-29-YEAR OLDS MAKING UP 34% OF THE POPULATION. IT ALSO HAS A SMALLER POPULATION OR CHILDREN AND TEENS, WITH ONLY 9% UNDER 18 YEARS. NEARLY THREE QUARTERS (72.3%) OF SOUTH BOSTON RESIDENTS HAVE BACHELOR'S DEGREES OR HIGHER. THE HEALTH OF BOSTON'S 2023 REPORT FOUND THAT SOUTH BOSTON RESIDENTS EXPERIENCE THE FOURTH HIGHEST RATES OF SUBSTANCE USE MORTALITY IN THE CITY, AND THE RATE OF SUBSTANCE USE MORTALITY HAS INCREASED BY 33.9% FROM 2017 TO 2022. SOUTH BOSTON ALSO EXPERIENCED HIGHER AGE-ADJUSTED RATES OF CANCER MORTALITY COMPARED TO THE CITY AVERAGE.THE TUFTS MC 2022 COMMUNITY SURVEY FOUND THAT COVID-19, MENTAL HEALTH/DEPRESSION, AND SUBSTANCE USE WERE THE TOP HEALTH CONCERNS FOR SOUTH BOSTON RESIDENTS, WITH SUBSTANCE USE BEING UNIQUE TO THIS NEIGHBORHOOD. THE TOP SOCIAL ISSUES WERE CRIME, EDUCATION, AND EMPLOYMENT, AND THE TOP SAFETY CONCERNS WERE DRUG TRAFFICKING, DISCRIMINATION BASED ON CLASS/INCOME, AND VANDALISM. THE COVID-19 PANDEMIC LED TO A SIGNIFICANT INCREASE IN BEHAVIORAL HEALTH ISSUES, PARTICULARLY IN MENTAL HEALTH CRISES, SUBSTANCE USE, AND ADDICTION. OTHER HEALTH ISSUES WORSENED BY THE PANDEMIC INCLUDED OBESITY, DIABETES, AND CANCER, AND HEALTHCARE ACCESS WAS ALSO IDENTIFIED AS AN ISSUE. FINANCIAL SECURITY WAS A PRIORITY, WITH GENTRIFICATION AFFECTING HOUSING AND JOBS, AND ECONOMIC WELL-BEING WAS IDENTIFIED AS THE TOP SOCIAL ISSUE. ACCORDING TO THE BOSTON BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM SURVEY, SOUTH BOSTON RESIDENTS REPORTED FEELING PERSISTENT ANXIETY AND SADNESS AT RATES SIMILAR TO THE CITYWIDE AVERAGE, AND WERE SLIGHTLY MORE FINANCIALLY SECURE THAN BOSTON RESIDENTS ON AVERAGE. TRANSPORTATION DIFFICULTIES WERE SLIGHTLY HIGHER, BUT SOUTH BOSTON HAD THE SECOND-HIGHEST INSURANCE RATE OF ALL NEIGHBORHOODS IN BOSTON. THE SOUTH END IS IMMEDIATELY SOUTH OF TUFTS MC, ADJACENT TO CHINATOWN. IT IS A NEIGHBORHOOD KNOWN FOR ITS LARGE VICTORIAN ROW HOUSES DISTRICT BUILT BY MIDDLE CLASS RESIDENTS OF ENGLISH ANCESTRY IN THE 1850S. THE NEIGHBORHOOD'S DEMOGRAPHICS BEGAN TO CHANGE IN THE 1880S WHEN THE ORIGINAL RESIDENTS BEGAN TO BE REPLACED BY MIDDLE CLASS AFRICAN AMERICANS, IRISH, JEWISH, GREEK, PUERTO RICAN, AND CHINESE IMMIGRANTS. IN THE 1960S, THE SOUTH END WAS CONSIDERED ONE OF THE POOREST NEIGHBORHOODS IN THE CITY OF BOSTON. ITS RENAISSANCE BEGAN IN THE MID-1970S WHEN INDIVIDUALS BEGAN TO BUY AND RESTORE VICTORIAN ROW HOUSES, AND NON-PROFITS PURCHASED AND REHABILITATED HOUSES AS AFFORDABLE RENTALS FOR FAMILIES. THERE WAS ALSO NEW CONSTRUCTION FOCUSED ON MEETING THE NEEDS OF VERY LOW-INCOME FAMILIES AND SENIORS.CURRENTLY, THE SOUTH END AND SOUTH BOSTON ARE EXAMPLES OF BOSTON'S ROBUST ECONOMY AND BUILDING BOOM, AND NEW RESIDENTIAL DEVELOPMENTS ARE BEING CONSTRUCTED ON PARCELS WHICH WERE ONCE DESIGNATED FOR LIGHT INDUSTRIAL USE.THE LINE BETWEEN THE SOUTH END AND CHINATOWN IS NOT FIXED; THERE IS A SIZABLE POPULATION OF CHINESE FAMILIES LIVING IN WHAT IS TRADITIONALLY CONSIDERED THE SOUTH END. ACCORDING TO THE 2023 ACS, THE SOUTH END HAD A POPULATION OF APPROXIMATELY 28,000 RESIDENTS. ACCORDING TO 2024 BOSTON PLANNING AND DEVELOPMENT AGENCY DATA, THE MAJOR RACIAL/ETHNIC GROUPS WERE: WHITE NON-HISPANIC (55.4%), ASIAN (16.7%), LATINO/A (12.7%), BLACK/AFRICAN AMERICAN (10.7%), AND OTHER (4.4%). ABOUT A QUARTER ARE FOREIGN-BORN (23%) AND 38% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, WHICH IS SIMILAR TO BOSTON AS A WHOLE. LIKE SOUTH BOSTON, THE SOUTH END HAS SMALLER PERCENTAGES OF YOUTH AND TEENS THAN THE CITY OF BOSTON AS A WHOLE, WITH 10% OR MORE RESIDENTS UNDER 18 YEARS OLD. SLIGHTLY OVER HALF OF SOUTH END RESIDENTS (56%) HAVE BACHELOR'S DEGREES OR HIGHER. OVERALL, THE EDUCATIONAL ATTAINMENT OF SOUTH END ROUGHLY MIRRORS THE CITY OF BOSTON AS A WHOLE. ACCORDING TO THE 2023 HEALTH OF BOSTON REPORT, THE SOUTH END/CHINATOWN EXPERIENCES THE HIGHEST RATES OF MENTAL HEALTH EMERGENCY VISITS IN THE CITY, AS WELL AS SUBSTANCE USE MORTALITY RATES SIGNIFICANTLY ABOVE THE CITY AVERAGE. ASTHMA RATES ARE ALSO THE HIGHEST IN THE CITY, AND AGE-ADJUSTED DIABETES AND HEART DISEASE HOSPITALIZATIONS IN THE SOUTH END/CHINATOWN ARE HIGHER THAN THE CITY AVERAGE.THE TUFTS MC 2022 COMMUNITY SURVEY AND SECONDARY DATA INDICATE THAT RESIDENTS OF THE SOUTH END IN BOSTON WERE PRIMARILY CONCERNED ABOUT COVID-19, ACCESS TO SPECIALTY CARE, MENTAL HEALTH/DEPRESSION, HOUSING STABILITY, DISASTER READINESS AND EMERGENCY PREPARATION, EDUCATION, DISCRIMINATION BASED ON RACE AND SEX/GENDER, AND SMOKING. FINANCIAL INSECURITY AND JOB TRAINING/RESOURCES ARE SEEN AS SIGNIFICANT CONTRIBUTORS TO THESE CONCERNS. GENTRIFICATION AND RISING HOUSING COSTS HAVE LED TO A CHANGING CULTURAL MIX, PUSHING OUT IMMIGRANT AND LOW-INCOME FAMILIES, AND CAUSING STRESS FOR LONG-TERM CHINESE RESIDENTS WHO FEEL LIKE THEY DON'T BELONG IN THEIR COMMUNITY. THE SOUTH END ALSO CONTAINS AN AREA KNOWN AS "METHADONE MILE," WHERE HOMELESS ENCAMPMENTS AND OPEN-AIR SALE AND USE OF SUBSTANCES ARE PREVALENT. RISING PRICES FROM GENTRIFICATION HAVE CAUSED WEALTHIER FAMILIES TO LEAVE THE NEIGHBORHOOD, WHILE LOW-INCOME FAMILIES ARE PUSHED OUT.QUINCY HAS A SIGNIFICANT ASIAN POPULATION WITH STRONG SOCIAL AND CULTURAL TIES TO BOSTON'S CHINATOWN, COMPRISING ABOUT 6% OF TUFTS MC'S PATIENT POPULATION. IN 2023, QUINCY HAD A POPULATION OF 101,607. BETWEEN 2000 AND 2017, THE CITY SAW A GROWTH IN THE NUMBER OF BLACK AND LATINX RESIDENTS, AND MOST NOTABLY ASIAN RESIDENTS. QUINCY SITS JUST SOUTHEAST OF BOSTON AND IS HOME TO LARGE POPULATION OF CHINESE IMMIGRANTS, WITH ASIAN RESIDENTS MAKING UP 32.5% OF THE POPULATION (2023 AMERICAN COMMUNITY SURVEY). DATA FROM THE 2023 AMERICAN COMMUNITY SURVEY INDICATE THAT JUST OVER HALF OF QUINCY RESIDENTS ARE WHITE NON-HISPANIC (52%) AND NEARLY ONE-THIRD ARE ASIAN (32.5%). ONE-THIRD (32%) OF QUINCY RESIDENTS ARE FOREIGN-BORN AND 36.6% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THE LARGEST AGE GROUP OF QUINCY RESIDENTS IS 35-64-YEAR-OLDS (348.8%). THERE ARE FEWER YOUNG ADULTS AGES 20-34 (27.2%) THAN IN THE CITY OF BOSTON AS A WHOLE (33.3%). EDUCATIONAL ATTAINMENT OF QUINCY RESIDENTS IS SIMILAR TO BOSTON, ALTHOUGH QUINCY HAS MORE RESIDENTS WITH ASSOCIATE'S DEGREES (7.5% VS 4.6%). PART VI, LINE 4, COMMUNITY INFORMATION (CONTINUED) IN TUFTS MC'S 2022 COMMUNITY SURVEY, COVID-19, ACCESS TO SPECIALTY CARE, AND MENTAL HEALTH/DEPRESSION WERE THE TOP HEALTH CONCERNS OF COMMUNITY RESIDENTS. THE TOP SOCIAL ISSUES WERE HOUSING STABILITY, EDUCATION, AND DOMESTIC/INTERPERSONAL VIOLENCE, WHILE THE TOP SAFETY CONCERNS WERE DISCRIMINATION BASED ON CLASS/INCOME, SEX/GENDER, AND IMMIGRATION STATUS. THE RISING POPULATION OF LIMITED ENGLISH SPEAKERS AND IMMIGRANTS IN QUINCY HAS WORSENED THESE CHALLENGES, WITH CHRONIC DISEASE AND CANCER REMAINING ONGOING HEALTH CONCERNS. FINANCIAL AND FOOD INSECURITY HAVE GROWN SIGNIFICANTLY DURING THE PANDEMIC, ALONG WITH MENTAL HEALTH ISSUES AND DOMESTIC VIOLENCE. THE LACK OF PROVIDERS WHO CAN SPEAK THE LANGUAGE AND UNDERSTAND THE CULTURE OF THEIR PATIENTS HAS ALSO BEEN IDENTIFIED AS A CHALLENGE. QUINCY HAS HIGHER MORTALITY RATES FOR CANCER, SUBSTANCE USE, AND OPIOID USE COMPARED TO THE STATE OF MASSACHUSETTS, WITH HIGHER RATES OF COPD-RELATED HOSPITALIZATIONS, POISONING-RELATED ED VISITS, AND MORTALITY ACCORDING TO DATA PROVIDED BY THE MASSACHUSETTS DEPARTMENT OF HEALTH.CARE TO BOSTON RESIDENTS AND SURROUNDING COMMUNITIES:TUFTS MC BELIEVES THAT CARING FOR OUR COMMUNITY HAPPENS BOTH WITHIN AND OUTSIDE THE WALLS OF THE INSTITUTION. DATA HAVE SHOWN THAT MANY FACTORS CAN HINDER PATIENT ACCESS TO HIGH QUALITY HEALTH CARE, INCLUDING THE LINGUISTIC AND CULTURAL COMPETENCY OF HEALTH CARE PROVIDERS. TO INCREASE ACCESS TO HOSPITAL SERVICES, TUFTS MC CONTINUES A LONG-STANDING COMMITMENT TO HEALTH EQUITY WHICH INVOLVES INCREASING CULTURAL COMPETENCY AMONG OUR MEDICAL PROVIDERS AND TO IMPROVE LANGUAGE ACCESS WHEREVER POSSIBLE. THE WORKING DEFINITION OF CULTURAL COMPETENCY THAT HELPS TO SHAPE AND DRIVE POLICIES AND CARE DELIVERY AT TUFTS MC IS AS FOLLOWS:THE ABILITY TO UNDERSTAND AND RESPECT THE DIFFERENCES AMONG PEOPLE AND USE OUR UNDERSTANDING TO INFLUENCE OUR INTERACTIONS WITH ONE ANOTHER; THIS INVOLVES DEVELOPING OUR CAPABILITY OF DELIVERING PATIENT-CENTERED SERVICES CONSISTENT WITH THE NEEDS AND EXPECTATIONS OF VARIOUS CULTURES. X X X X X 1 1 0 0 0 0 0 0 0 MICHAEL DANDORPH TRUSTEE 0 1330398 0 381250 0 14502 0 335493 0 24218 0 2085861 0 0 MICHAEL TARNOFF MD CEO/TRUSTEE (UNTIL 3/24) 1021741 0 157590 0 14502 0 168685 0 28084 0 1390602 0 0 0 PHIL OKALA TRUSTEE/INTERIM PRESIDENT/COO 0 514551 0 600000 0 6693 0 5018 0 11240 0 1137502 0 0 DIANA RICHARDSON SENIOR VP & COO (UNTIL 3/24) 693514 0 165372 0 29150 0 103704 0 14322 0 1006062 0 16203 0 JASON HALL TRUSTEE 0 825000 0 86875 0 2242 0 0 0 822 0 914939 0 0 MARVIN A KONSTAM MD TRUSTEE (UNTIL 2/24) 0 629030 0 47754 0 11124 0 33000 0 24687 0 745595 0 0 F CLARISSA YANG FORMER TRUSTEE 0 588350 0 114820 0 1810 0 33000 0 2187 0 740167 0 0 ERIKA WERNER TRUSTEE 0 588034 0 61250 0 41143 0 13750 0 20657 0 724834 0 0 REZA VAGEFI MD TRUSTEE 0 643611 0 60000 0 540 0 0 0 18041 0 722192 0 0 ERIK GARPESTAD CMO/SVP MEDICAL STAFF 539606 0 55682 0 77942 0 10710 0 14258 0 698198 0 73997 0 ZACHARY REDMOND ESQ SECRETARY 0 458977 0 88250 0 52036 0 46240 0 23909 0 669412 0 41693 KAREN FREUND MD TRUSTEE 0 546405 0 41625 0 6858 0 33000 0 24687 0 652575 0 0 JEFFREY WEINSTEIN FORMER TRUSTEE 0 32364 0 0 0 568824 0 0 0 0 0 601188 0 73524 KARA GREER SVP CHIEF TALENT OFFICER 373652 0 140000 0 9166 0 60510 0 14184 0 597512 0 8575 0 THERESE HUDSON-JINKS SENIOR VP & CNO 406842 0 52364 0 33002 0 66559 0 7388 0 566155 0 30131 0 NIOBIS DEL CARMEN QUEIRO FORMER KEY EMPLOYEE 0 41596 0 0 0 474432 0 0 0 2081 0 518109 0 131293 ASSAD SIDDIQI SVP/TREASURER (UNTIL 7/24) 398632 0 40800 0 380 0 59289 0 8611 0 507712 0 0 0 SARAH MCKAY VP OF PATIENT CARE 354626 0 40000 0 35961 0 49230 0 27716 0 507533 0 35404 0 DOUGLAS CIVIELLO CHIEF PERFUSIONIST 414357 0 1031 0 397 0 8783 0 27688 0 452256 0 0 0 PAUL SUMMERGRAD MD FORMER TRUSTEE 0 350248 0 0 0 10424 0 32917 0 24105 0 417694 0 0 NANCY WEATHERBEE DIRECTOR OF RESEARCH 183690 0 90000 0 123729 0 6930 0 5098 0 409447 0 0 0 LAUREN RIPLEY ESQ ASSISTANT SECRETARY 0 198429 0 11500 0 164 0 5319 0 7408 0 222820 0 0 DEEB N SALEM MD FORMER TRUSTEE 0 98505 0 0 0 75607 0 5500 0 22146 0 201758 0 74577 PART I, LINES 4A-B LINE 4A: JEFFREY WEINSTEIN RECEIVED $495,300 IN SEVERANCE PAY DURING CALENDAR YEAR 2023. NANCY WETHERBEE RECEIVED $80,731 IN SEVERANCE PAY DURING CALENDAR YEAR 2023. NIOBIS DEL CARMEN QUEIRO RECEIVED $341,835 IN SEVERANCE PAY DURING CALENDAR YEAR 2023. 990, PART VII, SECTION A. LINE 5 HELEN BOUCHER, M.D. RECEIVED COMPENSATION FROM TUFTS UNIVERSITY, AN UNRELATED ORGANIZATION, FOR SERVICES RENDERED TO TUFTS MEDICINE, INC. PART 1, LINE 4B: SECTION 457(F) RETIREMENT PLAN EMPLOYER DEFERRALS: ASSAD SIDDIQI: $52,365 DIANA RICHARDSON: $88,247 KARA GREER: $51,870 MICHAEL DANDORPH: $321,300 SARAH MCKAY: $39,330 THERESE HUDSON-JINKS: $56,659 ZACHARY REDMOND: $39,447 MICHAEL TARNOFF $156,689 A MASSACHUSETTS DEVELOPMENT FINANCE AUTHORITY 043431814 57584YPN3 2019-02-20 348515000 SEE SUPPLEMENTAL INFORMATION 0 0 1 B MASSACHUSETTS DEVELOPMENT FINANCE AUTHORITY 043431814 000000000 2020-07-16 181020000 SEE SUPPLEMENTAL INFORMATION 0 0 1 A 41419440 375193686 128242504 233627942 13323240 1 0 1 1 B 15764211 201154365 5609511 137697815 57847039 2022 1 0 1 1 A 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 1 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: MASSACHUSETTS DEVELOPMENT FINANCE AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2024 PART I TUFTS MEDICAL CENTER, INC. HEREIN REPORTS, FOR FY 24, THE FULL AMOUNT OF THE 2019 AND 2020 BOND ISSUES, CONSISTENT WITH THE INTERNAL ACCOUNTING FOR THE INDEBTEDNESS AMONGST THE MEMBERS OF THE OBLIGATED GROUP AS OF SEPTEMBER 30, 2024. THE BOND INDEBTEDNESS WAS ALLOCATED DIFFERENTLY, FOR INTERNAL ACCOUNTING PURPOSES, AMONGST THE OTHER MEMBERS OF THE OBLIGATED GROUP IN PRIOR YEARS. THE VARIOUS MEMBERS OF THE OBLIGATED GROUP FILED SEPARATE FORMS 990 SCHEDULE K FOR SUCH PRIOR YEARS TO REPORT THEIR THEN ALLOCATED SHARES OF THE BOND ISSUES. PART I, LINE A, COLUMN F DESCRIPTION OF BOND PURPOSE: A. THE ISSUANCE OF BONDS AND THE LOAN OF THE PROCEEDS THEREOF IS TO (1) REFINANCE CERTAIN OUTSTANDING INDEBTEDNESS OF OR ISSUED FOR THE BENEFIT OF THE INSTITUTION, AS FUTHER IDENTIFIED BELOW, (2) FINANCE CONSTRUCTION, RENOVATION AND IMPROVEMENTS AT AND ACQUISTIONS AND EQUIPMENT FOR THE ACUTE CARE HOSPITAL AND RELATED FACILITIES OWNED AND/OR OPERATED BY TUFTS MEDICAL CENTER, (3) FUND A DEBT SERVICE RESERVE FUND, AND (4) PAY CERTAIN COSTS OF ISSUANCE OF THE BONDS. FURTHER IDENTIFICATION OF BOND PURPOSE - REFINANCINGS SERIES A BONDS WERE ISSUED FOR THE WELLFORCE OBLIGATED GROUP, WHICH INCLUDES TUFTS MEDICAL CENTER, INC., THE LOWELL GENERAL HOSPITAL, AND MELROSEWAKEFIELD HEALTHCARE. SERIES C BONDS WERE ISSUED FOR THE WELLFORCE OBLIGATED GROUP, WHICH INCLUDES TUFTS MEDICAL CENTER, INC., THE LOWELL GENERAL HOSPITAL, AND MELROSEWAKEFIELD HEALTHCARE. PART II, LINE 7 THE AMOUNTS REPORTED AS TOTAL PROCEEDS EXCEED THE RESPECTIVE ISSUE PRICE DUE TO BOND PREMIUM. X 2 543678 FMV 0 0 1 0 PART I, COLUMN (B): THE NUMBER REPORTED IN COLUMN (B) OF SCHEDULE M REPRESENTS THE NUMBER OF CONTRIBUTIONS OF EACH ITEM. FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: WE STRIVE TO HEAL, TO COMFORT, TO TEACH, TO LEARN, AND TO SEEK THE KNOWLEDGE TO PROMOTE HEALTH AND PREVENT DISEASE. OUR PATIENTS AND THEIR FAMILIES ARE AT THE CENTER OF EVERYTHING WE DO. WE DEDICATE OURSELVES TO FURTHERING OUR RICH TRADITION OF HEALTH CARE INNOVATION, LEADERSHIP, CHARITY AND THE HIGHEST STANDARD OF CARE TO ALL IN OUR COMMUNITY. TO PROVIDE LONG-TERM CARE FOR CHILDREN WHO ARE SEVERELY MENTALLY HANDICAPPED AND/OR MULTIPLY PHYSICALLY HANDICAPPED. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND CONTROLLER REVIEW THE FORM 990 WITH TAX ADVISORS FROM A NATIONAL ACCOUNTING FIRM. A COPY OF THE FORM 990 AS IT WILL BE ULTIMATELY FILED IS POSTED TO AN INTERNAL WEBSITE. PRIOR TO FILING, THE ORGANIZATION EMAILS ALL OF ITS GOVERNING BODY MEMBERS A LINK TO A PASSWORD PROTECTED WEBSITE, ADVISING THEM THAT THE FORM 990 IS AVAILABLE FOR REVIEW ON THAT SITE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ENFORCES COMPLIANCE BY PROCEDURES INCLUDING ANNUAL DISCLOSURE AND REVIEW OF SUCH DISCLOSURE BY MANAGEMENT. CONFLICTS ARE RESOLVED BY THE APPROPRIATE HEAD OF THE DEPARTMENT AND REVIEWED BY LEGAL. THE JOINT COMPLIANCE COMMITTEE WILL DISCUSS ANY APPEAL. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES MET ON JUNE 14, 2023 TO REVIEW INCENTIVE PAYOUTS FOR 2023. SULLIVAN AND COTTER, AN INDEPENDENT CONSULTANT TO THE BOARD, PROVIDED A COMPETITIVENESS ASSESSMENT BASED ON COMPARATOR INFORMATION INCLUDING NATIONAL, NORTHEAST AND BOSTON AREA DATA. TOTAL COMPENSATION FOR THE EXECUTIVE GROUP, INCLUDING THE PRESIDENT/CEO, COO AND VICE PRESIDENTS, WAS DETERMINED TO BE WITHIN MARKET AVERAGES, THE PROCESS HAS NOT CHANGED SINCE THEN. THE LAST MEETING WAS HELD JUNE 14, 2023. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS WILL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST EITHER BY MAIL OR IN PERSON AT THE OFFICE, DEPENDING ON THE FORM OF THE REQUEST. FORM 990, PART VI, SECTION B., LINE 16A: TUFTS MEDICAL CENTER, INC. OWNS A 65% INTEREST IN SHIELDS-TUFTS MEDICAL CENTER IMAGING MANAGEMENT, LLC. FORM 990, PART VI, SECTION B., LINE 16B: THE ORGANIZATION ROUTINELY CONSULTS WITH INTERNAL AND OUTSIDE COUNSEL PRIOR TO ENTERING INTO JOINT VENTURE ARRANGEMENTS. THE ORGANIZATION IS CURRENTLY CONSIDERING IMPLEMENTATION OF WRITTEN POLICIES AND PROCEDURES TO EVALUATE PARTICIPATION OF JOINT VENTURE ARRANGEMENTS TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS WITH RESPECT TO SUCH ARRANGEMENTS. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS -414,376,000. PENSION-RELATED ADJUSTMENTS -5,933,000. OTHER COMPONENTS OF NET PERIODIC PENSION COSTS -2,307,000. NET ASSETS RELEASED FROM RESTRICTION -1,237,000. OTHER ADJUSTMENTS 625,928. 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