4A (Expenses $ 944324683 including grants of $ 0) (Revenue $ 1052438872)
TUFTS MEDICAL CENTER, INC. LOCATED IN BOSTON, MA OPERATES A 415 BED ACUTE-CARE GENERAL HOSPITAL ESTABLISHED TO PROVIDE HEALTHCARE SERVICES PRIMARILY IN THE GREATER BOSTON AREA, WHICH ALSO ATTRACTS PATIENTS FROM ELSEWHERE IN NEW ENGLAND AND BEYOND.NEW ENGLAND LONG-TERM CARE, INC. OPERATES AN 80 BED NURSING HOME SPECIALIZING IN THE CARE OF CHILDREN WHO ARE SEVERELY MENTALLY HANDICAPPED AND/OR MULTIPLY PHYSICALLY HANDICAPPED.

4B (Expenses $ 38702031 including grants of $ 0) (Revenue $ 496716)
TUFTS MEDICAL CENTER, INC. ADMINISTERS PROGRAMS FOR APPROXIMATELY 456 INDIVIDUALS: 282 RESIDENTS, 62 INTERNS AND 112 FELLOWS IN 47 SPECIALTIES AND SUBSPECIALTIES WHO ROTATE TO APPROXIMATELY 54 HOSPITALS AND OTHER ORGANIZATIONS LOCATED PRIMARILY IN THE GREATER BOSTON AREA.

4C (Expenses $ 10034416 including grants of $ 0) (Revenue $ 490900)
TUFTS MEDICAL CENTER, INC. ENGAGES IN RESEARCH ACTIVITIES FUNDED BY GRANTS AND CONTRACTS FOR U.S. GOVERNMENT AGENCIES AND OTHER PRIVATE SOURCES.

TUFTS MEDICAL CENTER, INC.
PART V, SECTION B, LINE 5: TUFTS MEDICAL CENTER (TUFTS MC) HAS UPDATED ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO GUIDE ITS COMMUNITY PROGRAMMING FOR THE NEXT THREE YEARS FROM 2023 TO 2025. THE CHNA WAS CONDUCTED FROM JANUARY TO MARCH 2022, AND INVOLVED 14 FOCUS GROUPS WITH 128 COMMUNITY RESIDENTS TO UNDERSTAND COMMUNITY NEEDS, STRENGTHS, PRIORITY HEALTH ISSUES, AND RECOMMENDATIONS. IN ADDITION, 927 RESIDENTS COMPLETED SURVEYS TO SHED LIGHT ON THE HEALTH NEEDS OF THE COMMUNITY. TUFTS MC ALSO SOUGHT INPUT AND UPDATED COMMUNITY MEMBERS THROUGHOUT THE CHNA PROCESS, PRESENTING FINDINGS AND SEEKING ADDITIONAL INPUT FROM 13 COMMUNITY GROUPS BEFORE FINALIZING OUR CHNA PRIORITIES. THE FOCUS GROUPS WERE CONDUCTED WITH RESIDENTS AND COMMUNITY STAKEHOLDERS FROM YOUTH TO SENIORS, VETERANS, LEADERS FROM NON-PROFIT ORGANIZATIONS IN SOUTH BOSTON, AFRICAN-AMERICAN AND HISPANIC TEENS IN HIGH SCHOOL AND COLLEGE, WOMEN OF DIFFERENT RACE/ETHNICITY TRAINED AS MEDICAL TRANSLATORS, SPANISH-SPEAKING WOMEN 60+, PARENTS OF SCHOOL-AGED KIDS, ADULTS AND PARENTS LIVING IN CHINATOWN, VIETNAMESE-SPEAKING ADULTS AND PARENTS, AND CHINESE IMMIGRANTS.TUFTS MC'S PRIOR CHNA WAS CONDUCTED IN 2019, AND HAS GUIDED HEALTH AND SOCIAL PRIORITIES AND COMMUNITY PROGRAMS, ACTIVITIES, AND PARTNERSHIPS FOR 2020-2022. TUFTS MC ALSO PARTICIPATED IN A CITYWIDE CHNA PROCESS, CALLED THE BOSTON CHNA COLLABORATIVE, CONSISTING OF BOSTON HOSPITALS AND VARIOUS COMMUNITY STAKEHOLDERS. THE COLLABORATIVE CONDUCTED 12 FOCUS GROUPS AND 39 KEY INFORMANT INTERVIEWS WITH 12 SUB-POPULATIONS WITHIN BOSTON, INCLUDING FEMALE LOW-WAGE WORKERS, RESIDENTS WITH HOUSING INSECURITY, IMMIGRANT PARENTS OF CHILDREN, PARENTS WHO LIVE IN PUBLIC HOUSING IN DORCHESTER, AND CHINESE RESIDENTS LIVING IN CHINATOWN. TUFTS MC SUPPLEMENTED THIS PROCESS WITH ITS OWN FOCUS GROUPS AND KEY INFORMANT INTERVIEWS, ESPECIALLY TO COVER GAPS IN THE COLLABORATIVE PROCESS OVERSAMPLING CHINATOWN, THE SOUTH END, AND SOUTH BOSTON RESIDENTS.TUFTS MC COLLECTED ADDITIONAL PRIMARY DATA COLLECTION IN CHINATOWN, SOUTH BOSTON, AND THE SOUTH END TO ENSURE ITS CHNA ADEQUATELY REFLECTED ITS PRIORITY COMMUNITIES. THIS INCLUDED 7 INTERVIEWS WITH SOCIAL SERVICE ORGANIZATION LEADERS AND 3 FOCUS GROUPS WITH CHINATOWN COMMUNITY MEMBERS. WITH THE HELP OF OUR COMMUNITY PARTNERS, TUFTS MC ALSO COLLECTED 100 COMMUNITY HEALTH SURVEYS FROM CHINESE-SPEAKING RESIDENTS OF THE NEIGHBORHOOD.PRIMARY AND SECONDARY DATA GATHERED THROUGH THE CHNA PROCESS WERE PRESENTED TO TUFTS MC'S COMMUNITY ADVISORY COMMITTEES, COMPRISED OF RESIDENTS AND REPRESENTATIVES WHO LIVE, WORK, OR ARE SUBJECT MATTER EXPERTS IN OUR PARTNER COMMUNITIES. COMMITTEE MEMBERS HELPED TUFTS MC STAFF HONE IN ON COMMUNITY HEALTH PRIORITIES TO FOCUS OUR GRANT-BASED COMMUNITY BENEFITS EFFORTS ON FOR THE NEXT THREE YEARS. THESE WERE REVIEWED AND APPROVED BY TUFTS MC'S COMMUNITY BENEFITS COMMITTEE, COMPRISED OF DIVERSE MEMBERS WITH WIDE-RANGING EXPERTISE INCLUDING LAW, HISTORY, SOCIAL SERVICE PROGRAMS, MEDICINE, AND PUBLIC AND COMMUNITY HEALTH.TUFTS MC ALSO CONDUCTED AN ABBREVIATED CHNA IN EARLY 2020 TO DETERMINE THE EMERGENT NEEDS IN RESPONSE TO THE COVID-19 PANDEMIC, WHICH LED TO AN AMENDED IMPLEMENTATION STRATEGY THROUGH FY2022. SEVERAL DOZEN COMMUNITY-BASED ORGANIZATIONS AND KEY STAKEHOLDERS INFORMED THE COVID-EXACERBATED PRIORITIES TUFTS MC FOCUSED ON IN FY20 AND FY21; WE CONTINUED COVID FUNDING IN FY22, FOCUSING ON RECOVERY EFFORTS. TUFTS MC ALSO HAS SEVERAL COMMUNITY BENEFITS ADVISORY COMMITTEES (CBACS) WHO PROVIDE INPUT AND FEEDBACK THROUGHOUT THE YEAR.

TUFTS MEDICAL CENTER, INC.
PART V, SECTION B, LINE 11: TUFTS MC COMPLETED ITS 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THIS PAST SUMMER, WHICH IDENTIFIED THREE MAJOR HEALTH NEEDS IN THE COMMUNITY: BEHAVIORAL HEALTH, FINANCIAL SECURITY AND MOBILITY, AND ACCESS TO CARE AND SERVICE. IN RESPONSE, TUFTS MC RELEASED A REQUEST FOR PROPOSALS TO ADDRESS THESE NEEDS AND WILL PARTNER WITH COMMUNITY-BASED ORGANIZATIONS TO IMPLEMENT PROGRAMMING TO IMPROVE COMMUNITY HEALTH AND WELLBEING. TUFTS MC CONTINUED ITS FINAL YEAR OF THE FOLLOWING PRIORITIES, IDENTIFIED IN ITS 2019 CHNA AND AN ABBREVIATED CHNA CONDUCTED IN THE SPRING OF 2020 IN RESPONSE TO IMMEDIATE IMPACTS OF THE COVID-19 PANDEMIC:BEHAVIORAL HEALTH (COMBINING MENTAL HEALTH, SUBSTANCE USE AND VIOLENCE DUE TO THEIR INTER-RELATEDNESS); TOBACCO AND NICOTINE CONTROL ALONG WITH THE HEALTH CONCERNS (LUNG CANCER, ASTHMA AND COPD); ACCESS TO CARE AND SOCIAL SERVICES; CHRONIC DISEASE MANAGEMENT; HOUSING; FOOD AND ECONOMIC INSECURITY; OTHER COVID-19 RELATED NEEDS.IN FY2022, ITS COVID RELIEF AND RECOVERY EFFORTS EMPHASIZED ECONOMIC AND FINANCIAL STABILITY AND MOBILITY WITHIN THE COMMUNITY. AS PART OF THIS EFFORT, AN ADDITIONAL ROUND OF FUNDING WAS AWARDED TO 22 COMMUNITY-BASED ORGANIZATIONS TO SUPPORT JOB TRAINING, WORKFORCE DEVELOPMENT, ESOL, HOUSING AND FINANCIAL LITERACY, AND FOOD INSECURITY INITIATIVES. IN FY22, THESE ORGANIZATIONS REACHED 4,073 BOSTON RESIDENTS, WITH 2,307 ATTENDING SKILL-BASED DEVELOPMENT TRAININGS, 1,305 INDIVIDUALS PARTICIPATING IN WORKFORCE DEVELOPMENT PROGRAMS, 1,188 INDIVIDUALS TAKING PART IN FINANCIAL LITERACY PROGRAMS, AND 696 INDIVIDUALS RECEIVING HOUSING COUNSELING.TUFTS MC RESPONDED QUICKLY TO THE COVID-19 PANDEMIC, PROVIDING ESSENTIAL CARE AND SERVICES TO THE COMMUNITY. IN FY22, THE ORGANIZATION PROVIDED TESTING TO APPROXIMATELY 46,000 RESIDENTS, HELPING TO IDENTIFY AND ISOLATE CASES OF COVID-19. ADDITIONALLY, TUFTS MC PLAYED A VITAL ROLE IN ADMINISTERING OVER 38,000 VACCINATIONS TO MEMBERS OF THE COMMUNITY, CONTRIBUTING TO THE OVERALL EFFORT TO MITIGATE THE SPREAD OF THE VIRUS. THROUGH ITS ASIAN HEALTH INITIATIVE (AHI), TUFTS MC CONTINUED TO ADDRESS THE REDUCTION AND PREVENTION OF TOBACCO AND NICOTINE USE, WHICH CONTRIBUTES TO THE LEADING CAUSES OF DEATH AMONG BOSTON'S CHINATOWN AND ASIAN COMMUNITY: HEART DISEASE AND LUNG CANCER. SCHOOL-AGED CHILDREN ALSO PRESENT WITH A HIGH PREVALENCE OF ASTHMA COMPARED TO OTHER AREAS OF BOSTON, WHICH CAN BE A RESULT OF SECOND-HAND SMOKE. THROUGH THE AHI INITIATIVE, FIVE COMMUNITY-BASED ORGANIZATIONS WHO WERE IN THEIR FINAL YEAR OF FUNDING PROVIDED EDUCATION, PREVENTION, AND SMOKING CESSATION SERVICES TO ENGLISH- AND CHINESE-SPEAKING COMMUNITY MEMBERS ACROSS A WIDE AGE SPECTRUM: PRE-SCHOOL STUDENTS TO SENIOR CITIZENS. IN FY 22, 1,126 COMMUNITY RESIDENTS WERE SERVED BY THE AHI. THE TUFTS MC 2019 CHNA IDENTIFIED BEHAVIORAL HEALTH AS A CONCERN ACROSS THE CITY OF BOSTON, WITH SOUTH BOSTON AND DORCHESTER OF PARTICULAR CONCERN. THIS THREE-YEAR FUNDING CYCLE FOCUSED ON PROMOTING BEHAVIORAL HEALTH AND THE SOCIAL-EMOTIONAL WELLNESS OF DORCHESTER COMMUNITY MEMBERS, PARTICULARLY YOUTH AND PARENTS OF YOUNG CHILDREN THAT WERE GREATLY IMPACTED THROUGH THE PANDEMIC. SIX COMMUNITY-BASED ORGANIZATIONS WERE SELECTED TO IMPLEMENT BEHAVIORAL HEALTH PROGRAMS. IN FY 22, 2,909 COMMUNITY MEMBERS WERE SERVED BY DHI. OF THESE INDIVIDUALS, 1,072 COMPLETED MENTAL HEALTH COUNSELING AND TREATMENT, 183 FATHERS RECEIVED TRAINING AND SUPPORT TO PROMOTE NURTURING AND POSITIVE CHILD DEVELOPMENT, AND 630 YOUTH RECEIVED EDUCATIONAL PROGRAMMING ON CONFLICT RESOLUTION AND VIOLENCE PREVENTION. IN SOUTH BOSTON, SUBSTANCE USE AROSE AS THE PRIMARY COMMUNITY HEALTH CONCERN. TUFTS MC PARTNERED WITH AND FUNDED THE SOUTH BOSTON COMMUNITY HEALTH CENTER TO IMPLEMENT THREE IMPACTFUL PROGRAMS THAT HAVE HELPED THE COMMUNITY. THE FIRST PROGRAM, OFFICE BASED ADDICTION TREATMENT, OFFERS A COMBINATION OF MEDICATION-ASSISTED TREATMENT AND COGNITIVE BEHAVIORAL THERAPY TO TREAT SUBSTANCE USE DISORDER. THIS APPROACH HAS RESULTED IN MANY SUCCESS STORIES, INCLUDING PATIENTS FINDING EMPLOYMENT AND PURCHASING THEIR FIRST CAR. THE SECOND PROGRAM, THE HEPATITIS C PROGRAM, OFFERS EDUCATION AND TREATMENT TO PREVENT ADVERSE HEALTH OUTCOMES FROM UNTREATED CHRONIC HEPATITIS C. THIS PROGRAM HAS EXPANDED SIGNIFICANTLY, IDENTIFYING PATIENTS THROUGH ROUTINE SCREENING AND OUTREACH. THE THIRD PROGRAM, THE YOUTH AMBASSADORS, IS A PRIMARY PREVENTION PROGRAM THAT EMPOWERS AT-RISK YOUTH TO RECOGNIZE THEMSELVES AS TEEN LEADERS/EDUCATORS, PROMOTING SUBSTANCE ABUSE PREVENTION, VIOLENCE PREVENTION, TEEN MENTAL HEALTH, AND GENDER EQUALITY ISSUES. THROUGH THESE PROGRAMS, THE SOUTH BOSTON HEALTH INITIATIVE SERVED 381 COMMUNITY MEMBERS IN FY 22.TUFTS MC RECOGNIZES THE IMPORTANCE OF FINANCIAL SECURITY AND MOBILITY TO OVERALL WELL-BEING. TO ADDRESS THIS, THE ORGANIZATION HAS SUPPORTED VARIOUS INITIATIVES AIMED AT PROVIDING JOB READINESS TRAINING, SOFT SKILLS DEVELOPMENT, AND CERTIFICATION PROGRAMS, AS WELL AS FINANCIAL LITERACY PROGRAMS COVERING BUDGETING, SAVING, AND INVESTING. IN FY22, 1,305 COMMUNITY RESIDENTS WERE EQUIPPED WITH VALUABLE WORKFORCE DEVELOPMENT SKILLS THROUGH TRAINING PROGRAMS, WHILE 44 DISADVANTAGED YOUTH GAINED HANDS-ON SKILLS AND JOB TRAINING THROUGH A YOUTH APPRENTICESHIP PROGRAM. TUFTS MC ALSO SUPPORTED THE GAVIN FOUNDATION, WHICH PROVIDED EMPLOYMENT ASSISTANCE TO CLIENTS WHO FACED UNEMPLOYMENT OR UNDER-EMPLOYMENT DUE TO ADDICTION OR COVID-19. ADDITIONALLY, TUFTS MC PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS TO PROVIDE FINANCIAL LITERACY PROGRAMS TO 1,188 COMMUNITY MEMBERS, HELPING THEM GAIN VALUABLE SKILLS AND KNOWLEDGE TO MANAGE THEIR FINANCES MORE EFFECTIVELY. THROUGH THESE EFFORTS, 56 COMMUNITY RESIDENTS WERE ABLE TO ACHIEVE FINANCIAL SUCCESS THROUGH CREDIT BUILDING, HOME OWNERSHIP, BUDGETING, AND BANKING. AT TUFTS MC, EMPOWERING YOUTH AND PROVIDING THEM WITH OPPORTUNITIES TO LEARN AND GROW IN THE HEALTHCARE FIELD IS A PRIORITY. DURING THE SUMMER OF 2022, 23 STUDENTS, 21 WITH BILINGUAL CAPACITY, INTERNED IN 13 DIFFERENT TUFTS MC DEPARTMENTS. THE PROGRAM HAS HAD A SIGNIFICANT IMPACT, WITH MOST STUDENTS ENTERING COLLEGE WITH A PLAN FOR A CAREER IN HEALTHCARE. AT THE JOSIAH QUINCY ELEMENTARY SCHOOL (JQES), TUFTS MC PROVIDED INTERACTIVE NUTRITION LESSONS THAT HAVE IMPROVED STUDENTS' KNOWLEDGE OF HEALTHY EATING HABITS AND HYGIENE. THE PROGRAM WAS LED BY DIETETIC INTERNS FROM THE STERN NUTRITION CENTER AND REACHED OVER 110 STUDENTS.THROUGH A PARTNERSHIP WITH THE ASIAN AMERICAN CIVIC ASSOCIATION (AACA), TUFTS MC SUPPORTED THEIR MULTI-SERVICE CENTER (MSC). THE MSC ADDRESSES THE NEEDS OF THE ASIAN IMMIGRANT POPULATION AND THE COMMUNITY AT LARGE FOR VARIOUS SOCIAL SERVICES. IN FY22, AACA PROVIDED SERVICES TO A TOTAL OF 2,215 PARTICIPANTS. AMONG THEM, 87 RECEIVED TAX COUNSELING/ASSISTANCE, 130 RECEIVED FUEL ASSISTANCE, 1,035 RECEIVED SNAP ASSISTANCE, 118 RECEIVED HOMELESSNESS PREVENTION ASSISTANCE, 194 RECEIVED HOUSING ASSISTANCE, 130 RECEIVED IMMIGRATION AND CITIZENSHIP COUNSELING, 139 RECEIVED TRANSLATION AND INTERPRETATION SERVICES, AND 382 RECEIVED OTHER SOCIAL SERVICE ASSISTANCE. ADDITIONALLY, 60 CLIENTS WERE REFERRED OUT TO OTHER ORGANIZATIONS. THE PROGRAM HAS BEEN ABLE TO HELP MANY FAMILIES AND INDIVIDUALS IN NEED, PROVIDING CRITICAL SUPPORT DURING THEIR MOST DIRE TIMES.TUFTS MC IS ALSO COMMITTED TO IMPROVING ACCESS TO CARE FOR VULNERABLE POPULATIONS, INCLUDING LINGUISTIC AND CULTURAL MINORITIES AND THE UNINSURED. TO ACHIEVE THIS GOAL, TUFTS MC PROVIDES VARIOUS PROGRAMS AND SERVICES, SUCH AS THE PATIENT NAVIGATION PROGRAM, WHICH SERVED 112 CHINESE-SPEAKING PATIENTS WITH CANCER AND/OR LOW SOCIOECONOMIC STATUS THROUGH 513 ENCOUNTERS, REDUCING CULTURAL AND LINGUISTIC BARRIERS TO QUALITY CANCER CARE. TUFTS MC ALSO HOSTS EVENTS, SUCH AS THE ANNUAL ASIAN HEALTH SYMPOSIUM, ATTENDED BY 77 HEALTHCARE PROFESSIONALS, RESEARCHERS, AND COMMUNITY MEMBERS, TO PROVIDE OPPORTUNITIES FOR DISCUSSING CRITICAL ISSUES AFFECTING VULNERABLE POPULATIONS. FINALLY, TUFTS MC EDUCATES THE COMMUNITY ON VARIOUS HEALTH TOPICS, INCLUDING SKIN CARE, MENTAL HEALTH AWARENESS, AND INTERVENTION STRATEGIES. FOR EXAMPLE, THE DERMATOLOGY DEPARTMENT EDUCATED 300 CHINATOWN RESIDENTS ABOUT SUNSCREEN AND SKIN CARE, WHILE THE PSYCHIATRY DEPARTMENT PROVIDED TRAINING AND RESOURCES ON MENTAL HEALTH AWARENESS AND INTERVENTION STRATEGIES TO TEACHERS, EQUIPPING THEM WITH THE KNOWLEDGE AND SKILLS TO SUPPORT THE MENTAL HEALTH AND WELL-BEING OF 36 STUDENTS.

PART I, LINE 7:
COSTS ARE ALLOCATED TO PATIENT ENCOUNTERS BASED ON COST ACCOUNTING SYSTEM, WHICH TAKES INTO CONSIDERATION ALL INPATIENT AND OUTPATIENT ACTIVITY FOR ALL AREAS OF THE HOSPITAL INCLUDING ALL PAYER SOURCES. THE COSTS UTILIZED ARE BASED ON ACTUAL COSTS FROM THIS SYSTEM, ALLOCATED TO INDIVIDUAL PATIENT ENCOUNTERS.

PART II, COMMUNITY BUILDING ACTIVITIES:
PART II, LINE 2: ECONOMIC DEVELOPMENTTUFTS MC PROMOTES THE COMMUNITY'S ECONOMIC, SOCIAL EMOTIONAL AND SPIRITUAL WELLNESS AND COMMUNITY BUILDING THROUGH ITS FREE PARKING PROGRAM. BY REMOVING THE FINANCIAL BURDEN OF PARKING FEES, THE PROGRAM AIMS TO INCREASE FOOT TRAFFIC TO LOCAL BUSINESSES AND FOSTER ECONOMIC DEVELOPMENT. THIS, IN TURN, CREATES A MORE VIBRANT LOCAL ECONOMY, WHICH BENEFITS THE HEALTH OF THE COMMUNITY AS A WHOLE. ADDITIONALLY, THE PROGRAM ENCOURAGES SOCIAL INTERACTIONS, WHICH CAN CONTRIBUTE TO IMPROVED MENTAL HEALTH AND WELLBEING, AND FOSTER A GREATER SENSE OF COMMUNITY SPIRIT. THIS EFFORT IS A VITAL COMPONENT OF OUR HOSPITAL'S EFFORTS TO PROMOTE ECONOMIC DEVELOPMENT AND ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE. TUFTS MC'S COMMUNITY-BUILDING ACTIVITIES EXTEND BEYOND OUR FREE PARKING PROGRAM. AS PART OF OUR COVID-19 GRANTS, WE PARTNERED WITH LOCAL ORGANIZATIONS TO SUPPORT LOCAL BUSINESSES WHILE MEETING URGENT COMMUNITY NEEDS, SUCH AS ADDRESSING RISING FOOD INSECURITY. FOR EXAMPLE, ONE OF OUR GRANTEES HOSTED A COVID CARE PACKAGE DRIVE THAT PROVIDED 103 HOUSEHOLDS/FAMILIES IN NEED WITH PPE SUPPLIES AND GROCERY STORE GIFT CARDS TO HELP WITH COVID-RELATED COSTS. ADDITIONALLY, SOME OF OUR GRANTEES FOCUSED ON SUPPORTING SMALL BUSINESSES THROUGH TECHNICAL ASSISTANCE FOR MARKETING AND PROMOTION, AND WAYS TO STAY OPEN AND SAFE THROUGH THE PANDEMIC. IN SOME CASES, WE PROVIDED RENTAL ASSISTANCE TO SMALL BUSINESSES TO PREVENT CLOSURES DURING THIS DIFFICULT TIME. THESE INITIATIVES HELPED PROVIDE ESSENTIAL SERVICES AND FOOD TO THE COMMUNITY WHILE ALSO GIVING BUSINESS OWNERS SOME FINANCIAL SECURITY. BY INVESTING IN OUR COMMUNITY PARTNERS, WE FOSTERED ECONOMIC DEVELOPMENT, PROMOTED SOCIAL INTERACTIONS, AND ENHANCED THE OVERALL HEALTH AND WELLBEING OF THE COMMUNITIES WE SERVE.PART II, LINE 8: WORKFORCE DEVELOPMENTTUFTS MC IS COMMITTED TO PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH VARIOUS COMMUNITY-BUILDING ACTIVITIES. IN FY22, WE PROVIDED VALUABLE WORKFORCE DEVELOPMENT SKILLS TO 1,305 COMMUNITY MEMBERS THROUGH TRAINING PROGRAMS. WE PARTNERED WITH ORGANIZATIONS TO PROVIDE EMPLOYMENT ASSISTANCE TO CLIENTS WHO FACED UNEMPLOYMENT DUE TO ADDICTION, AND SUPPORTED MEN PREVIOUSLY INCARCERATED AND/OR IN RECOVERY TO FIND CORI-FRIENDLY EMPLOYMENT. WE ALSO PROVIDED JOB SKILLS TRAINING IN AREAS OF NEED, SUCH AS MEDICAL INTERPRETER TRAINING AND MECHANICAL SKILLS TRAINING TO DISADVANTAGED YOUTH. HIGHER PAY AND BETTER BENEFITS ARE DIRECTLY CORRELATED WITH IMPROVED HEALTH OUTCOMES, AND OUR INITIATIVE AIMED TO PROVIDE JOB SUPPORT AND JOB SKILLS TO POPULATIONS MOST IN NEED OR AT-RISK, ESPECIALLY DURING THE COVID-19 PANDEMIC.TUFTS MC ALSO HAS A LONG-ESTABLISHED PARTNERSHIP WITH THE ASIAN AMERICAN CIVIC ASSOCIATION. OVER THE DECADES, THE STRUCTURE OF THE CLASS HAS CHANGED, BUT IN FY 22, 15 EMPLOYEES PARTICIPATED IN THE PROGRAM, WHICH IS OPEN TO ALL TUFTS MC EMPLOYEES AT NO COST TO THEM. THE ESOL PROGRAM OFFERS BEGINNER AND ADVANCED CLASSES, WITH FLEXIBLE MINIMUM PARTICIPANT REQUIREMENTS DUE TO COVID-19. THE CLASSES ARE OFFERED BOTH DURING WORK HOURS AND ON EMPLOYEE'S OWN TIME AND REQUIRE COMMITMENT AND MANAGER SUPPORT. THE PROGRAMS HELP IMPROVE EMPLOYEE/MANAGER RELATIONS, PATIENT EXPERIENCE, AND A CAREER PIPELINE FOR ALL TUFTS MC EMPLOYEES, WHILE ALSO ADDRESSING LITERACY BARRIERS THAT COULD LEAD TO SAFETY CONCERNS AND EXCLUSION. ADDITIONALLY, TUFTS MC'S SUMMER INTERNSHIP PROGRAM FOR BOSTON HIGH SCHOOL STUDENTS OFFERS OPPORTUNITIES FOR STUDENTS TO EXPLORE CAREER OPPORTUNITIES IN A HEALTHCARE SETTING AND OFTEN PROVIDES THEM WITH THEIR FIRST PAID EMPLOYMENT EXPERIENCE. DESPITE THE COVID PANDEMIC, WE OFFERED A FULLY ON-SITE SEVEN-WEEK EXPERIENCE TO 23 YOUTH WITH WEEKLY WORKSHOPS ON TOPICS SUCH AS PUBLIC HEALTH, COLLEGE READINESS, AND DIVERSITY, EQUITY, AND INCLUSION. THE SUMMER INTERNSHIP PROGRAM PROVIDES VALUABLE SKILLS AND EXPERIENCE TO THE STUDENTS, AND INCREASES YOUTHS LIKELIHOOD OF SECURING BETTER-PAYING JOBS IN THE FUTURE, PROMOTING THEIR OVERALL HEALTH AND WELLBEING. OVERALL, OUR COMMUNITY-BUILDING INITIATIVES AIM TO EQUIP COMMUNITY MEMBERS WITH THE NECESSARY SKILLS AND SUPPORT TO ACHIEVE FINANCIAL STABILITY, WHICH IN TURN PROMOTES BETTER HEALTH OUTCOMES AND FOSTERS A HEALTHIER COMMUNITY.

PART III, LINE 2:
THE HOSPITAL RECORDS BAD DEBTS BASED ON CHARGES. THE BAD DEBT COSTS PROVIDED HEREIN ARE BASED ON THESE CHARGES MULTIPLIED BY THE HOSPITAL'S COST-TO-CHARGE RATIO OF 53.00%.

PART III, LINE 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 VI, LINE 4:
LOCATED IN THE HEART OF THE CHINATOWN COMMUNITY, TUFTS MC IS COMMITTED TO RESPONDING TO THE SPECIFIC NEEDS OF THE COMMUNITY, MANY OF WHOM ARE NEW IMMIGRANTS IN NEED OF CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES TO HELP THEM NAVIGATE HEALTH CARE FOR THEMSELVES AND THEIR FAMILIES. TUFTS MC'S STRONG COMMITMENT TO THE ADJACENT NEIGHBORHOODS OF DORCHESTER, SOUTH BOSTON AND THE SOUTH END REFLECTS THE HISTORY OF THE FOUNDING OF THE BOSTON DISPENSARY TO PROVIDE QUALITY HEALTHCARE TO BOSTON'S WORKING AND LOW-INCOME FAMILIES.TUFTS MC HAS BEEN IN ITS CURRENT LOCATION SINCE ITS INCEPTION AS THE BOSTON DISPENSARY IN 1796. THE NEIGHBORHOOD, ORIGINALLY KNOWN AS THE SOUTH COVE, IS NOW RECOGNIZED AS BOSTON'S CHINATOWN NEIGHBORHOOD DUE TO THE GROWTH OF THE CHINESE AMERICAN COMMUNITY, WHO FIRST MOVED INTO THE NEIGHBORHOOD IN THE 1870S AND GREW IN NUMBERS AFTER THE LIFTING OF IMMIGRATION RESTRICTIONS ALLOWED FOR FAMILY REUNIFICATION IN THE 1960S AND HAS CONTINUED WITH ONGOING IMMIGRATION. TUFTS MC HAS BEEN AN INTEGRAL MEMBER OF THE COMMUNITY FOR GENERATIONS.SERVICE POPULATIONS:TUFTS MC'S PATIENT POPULATION IS DIVERSE AND REFLECTS THE DEMOGRAPHICS OF THE BOSTON AND GREATER BOSTON COMMUNITY FOR WHICH IT SERVES AS AN ACADEMIC AND TERTIARY/QUATERNARY HOSPITAL. APPROXIMATELY 60% OF THE PATIENT POPULATION IS WHITE, 10% BLACK/AFRICAN AMERICAN, 15% ASIAN AND 6% LATINX. TWENTY-FIVE PERCENT OF THE PATIENT POPULATION QUALIFY FOR MEDICAID, AND 25% OF PATIENTS ARE COVERED BY MEDICARE. APPROXIMATELY 24,500 PATIENTS REQUEST INTERPRETER SERVICES EACH YEAR AND RECEIVE ASSISTANCE IN CHINESE, VIETNAMESE, SPANISH, HAITIAN CREOLE, RUSSIAN, PORTUGUESE AND MANY OTHER LANGUAGES. PRIMARY SERVICE AREA COMMUNITIES: PLEASE NOTE THAT THE BOSTON PUBLIC HEALTH COMMISSION'S HEALTH OF BOSTON REPORT HAS NOT BEEN UPDATED SINCE 2017.BOSTON'S CHINATOWN IS THE SMALLEST OF THE CITY'S NEIGHBORHOODS. IT IS LOCATED IN DOWNTOWN BOSTON NEAR MAJOR TRANSPORTATION NODES AND THE CITY'S DOWNTOWN RETAIL, THEATER, HISTORIC AND FINANCIAL DISTRICTS. ITS 76 ACRES INCLUDE A ROBUST RESIDENTIAL, CULTURAL, ECONOMIC, AND SERVICE HUB FOR BOSTON'S CHINESE AND ASIAN COMMUNITY. THE 2017 AMERICAN COMMUNITY SURVEY (ACS) ESTIMATED THAT OVER 7,400 PEOPLE LIVED IN THE NEIGHBORHOOD, ONE OF THE MOST DENSELY POPULATED IN THE CITY OF BOSTON. THERE IS A DEARTH OF OPEN SPACE IN CHINATOWN, THOUGH THE BOSTON COMMON, PUBLIC GARDEN AND OTHER OPEN AND GREEN SPACE ARE IN CLOSE PROXIMITY.HISTORICALLY, BOSTON CHINATOWN HAS PLAYED AN IMPORTANT ROLE IN ECONOMIC, SOCIAL AND CULTURAL SUPPORT FOR ARRIVING IMMIGRANTS IN WHICH THEY CONTINUE TO LIVE, WORK, SHOP, FIND SERVICES, AND MAINTAIN SOCIAL CONNECTIONS. ACCORDING TO AMERICAN COMMUNITY SURVEY 2020 DATA, COMPARED TO OTHER COMMUNITIES IN TUFTS MC'S SERVICE AREA AND BOSTON AS A WHOLE, CHINATOWN HAS HIGHER PERCENTAGES OF RESIDENTS THAT IDENTIFY AS ASIAN OR PACIFIC ISLANDER (60%), ARE FOREIGN BORN (49%) AND SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME (59%). CHINATOWN ALSO HAS A LARGER PERCENTAGE OF OLDER ADULTS 65+ (18%) THAN TUFTS MC'S OTHER PRIORITY COMMUNITIES AS A WHOLE. ALTHOUGH THE MAJORITY OF CHINATOWN RESIDENTS HAVE BACHELOR'S DEGREES OR HIGHER (59%), ABOUT ONE IN FIVE DID NOT GRADUATE FROM HIGH SCHOOL.THE HEALTH PROFILE OF CHINATOWN, BASED ON TUFTS MC 2022 COMMUNITY SURVEY RESPONSES AND FOCUS GROUP INTERVIEWS, REVEALS SEVERAL KEY HEALTH CONCERNS AND CHALLENGES FACING THE COMMUNITY. THE TOP THREE HEALTH CONCERNS IDENTIFIED BY RESIDENTS WERE COVID-19, MENTAL HEALTH/DEPRESSION, AND ACCESS TO SPECIALTY CARE. ENVIRONMENTAL HEALTH, HOUSING STABILITY, AND EDUCATION WERE THE TOP SOCIAL ISSUES OF CONCERN, WHILE DISCRIMINATION BASED ON RACE, IMMIGRATION STATUS, AND CLASS/INCOME WERE THE TOP SAFETY ISSUES IDENTIFIED. FINANCIAL SECURITY WAS ALSO A KEY CONCERN, WITH GENTRIFICATION, HIGH HOUSING COSTS, AND ANTI-ASIAN DISCRIMINATION IN HOUSING PRACTICES MENTIONED AS BARRIERS TO ECONOMIC WELL-BEING.SEVERAL PREVALENT HEALTH CONDITIONS WERE MENTIONED, INCLUDING ASTHMA, CANCER, DIABETES, OSTEOPOROSIS/ARTHRITIS, DEMENTIA, HIGH BLOOD PRESSURE, AND CHOLESTEROL. POLLUTION AND HIGH RATES OF SMOKING (BOTH TOBACCO AND MARIJUANA) WERE IDENTIFIED AS EXACERBATING THESE HEALTH CONCERNS. LANGUAGE BARRIERS AND HIGH OUT-OF-POCKET COSTS WERE CITED AS BARRIERS TO ACCESSING HEALTHCARE, WITH BETTER ACCESS TO HEALTHCARE IDENTIFIED AS A TOP PRIORITY FOR 36% OF SURVEY RESPONDENTS. YOUNG PEOPLE ALSO EXPRESSED CONCERNS AROUND DEPRESSION, ANXIETY, AND SLEEP ISSUES, WHILE THE COVID-19 PANDEMIC WORSENED MENTAL HEALTH CONCERNS AND LED TO STRESS, ANXIETY, AND DEPRESSION FOR RESIDENTS OF ALL AGES.DORCHESTER IS THE LARGEST NEIGHBORHOOD IN BOSTON AND REFLECTS THE CITY'S ECONOMIC, LINGUISTIC, RACIAL, ETHNIC, AND CULTURAL DIVERSITY WITH A POPULATION OF OVER 140,000 RESIDENTS, APPROXIMATELY 20% OF BOSTON'S TOTAL POPULATION. AMERICAN COMMUNITY SURVEY DATA FOR 2020 INDICATE THAT 24.5% OF RESIDENTS WERE 19 YEARS OR YOUNGER AND 12% WERE SENIORS AGED 65 AND OLDER. 35-64 YEAR-OLDS MAKE UP THE LARGEST PERCENTAGE (36%) OR DORCHESTER RESIDENTS. DORCHESTER IS A RACIALLY DIVERSE NEIGHBORHOOD OVERALL, WITH BLACK/AFRICAN AMERICANS MAKING UP THE LARGEST PERCENTAGE OF THE POPULATION. 22.4 PERCENT OF THE POPULATION WAS WHITE, 35% BLACK/AFRICAN AMERICAN, 10.9% ASIAN, 20.7% LATINX, AND 11.0% OTHER. ABOUT ONE-THIRD OF RESIDENTS IN DORCHESTER ARE FOREIGN BORN AND 41% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, BOTH SLIGHTLY HIGHER THAN THE CITY OF BOSTON AS A WHOLE. DORCHESTER HAS ABOUT EQUAL PERCENTAGES OF HIGH SCHOOL GRADUATES (29%) AND THOSE WITH BACHELOR'S DEGREES OR HIGHER (30%). BPHC'S 2017 HEALTH OF BOSTON REPORT INDICATED THAT DORCHESTER CONTINUED TO HAVE A HIGH INCIDENCE OF VIOLENCE-RELATED INJURIES AND HIGH RATES OF HOMICIDE COMPARED TO THE CITY AS A WHOLE. THE RATE OF ASTHMA-RELATED HOSPITALIZATION AMONG CHILDREN AGES 5-17, AS WELL AS THE PREVALENCE OF OBESITY AND OF MANY CHRONIC DISEASES AMONG ADULTS, WERE ALSO ABOVE CITY AVERAGES, AS WERE RATES OF MORTALITY ATTRIBUTED TO SUBSTANCE MISUSE, INCLUDING OPIOIDS. THE HEALTH PROFILE OF DORCHESTER, BASED ON TUFTS MC 2022 COMMUNITY SURVEY RESPONSES, INDICATES THAT THE TOP HEALTH CONCERNS ARE MENTAL HEALTH/DEPRESSION, COVID-19, AND ACCESS TO SPECIALTY CARE. THE TOP SOCIAL ISSUES ARE HOUSING STABILITY, DOMESTIC/INTERPERSONAL VIOLENCE, AND EDUCATION, WHILE THE TOP SAFETY ISSUES ARE DRUG TRAFFICKING, DISCRIMINATION BASED ON RACE, AND DISCRIMINATION BASED ON CLASS/INCOME. PARTICIPANTS FELT THAT THE PANDEMIC EXACERBATED EXISTING SOCIAL NEEDS AND GAPS AS WELL AS HEALTH CONCERNS. MENTAL HEALTH WAS THE TOP COMMUNITY HEALTH CONCERN, WITH YOUTH AND ADULT PARTICIPANTS FEELING THAT THERE ARE NOT ENOUGH CLINICIANS TO FILL THE NEED FOR MENTAL HEALTH SERVICES. OTHER HEALTH CONCERNS INCLUDE OBESITY, DIABETES, HEART DISEASE, LATE DIAGNOSED CANCER, AND BLACK MATERNAL HEALTH. FINANCIAL INSECURITY IS THE PRIMARY SOCIAL CONCERN, WHICH IMPACTS OTHER SOCIAL DETERMINANTS OF HEALTH SUCH AS HOUSING AND FOOD INSECURITY. HOUSING AFFORDABILITY AND GENTRIFICATION HAVE BECOME A GROWING CONCERN, AND ACCESS TO JOBS AND JOB TRAINING HAS RISEN AS A PRIORITY NEED. MOREOVER, THE COMMUNITY FACES SAFETY CONCERNS AS WELL. DORCHESTER RESIDENTS REPORTED FEELING UNSAFE IN THEIR NEIGHBORHOOD AT A RATE 10 PERCENTAGE POINTS ABOVE THE 14% CITY AVERAGE IN SOUTH DORCHESTER (24%), AND 20 POINTS ABOVE THE AVERAGE IN NORTH DORCHESTER (34%) ACCORDING TO THE BOSTON BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM. THESE SAFETY CONCERNS CAN EXACERBATE THE ALREADY PRESENT HEALTH ISSUES AND CREATE ADDITIONAL STRESS AND ANXIETY FOR RESIDENTS. SOUTH BOSTON IS A NEIGHBORHOOD OF APPROXIMATELY 37,000 RESIDENTS THAT CONTINUES TO UNDERGO CHANGES. HISTORICALLY CONSIDERED A WORKING-CLASS COMMUNITY WITH A SIGNIFICANT NUMBER OF PUBLIC HOUSING DEVELOPMENTS, LONG-TIME RESIDENTS ARE NOW EXPERIENCING INCREASING RENTS AND/OR DISPLACEMENT, ALONG WITH AN INFLUX OF NEWER RESIDENTS, RESULTING FROM A SHARP INCREASE IN NEW CONSTRUCTION AND HOUSING DEVELOPMENT IN THE AREA.DATA FROM THE CENSUS BUREAU SHOW A 26% INCREASE IN THE POPULATION BETWEEN 2000 AND 2017. DURING THIS PERIOD, THE NUMBER OF CHILDREN UNDER AGE 18 AND SENIORS OVER AGE 65 (AND THE PROPORTION OF THE POPULATION THEY MADE UP) DROPPED; THUS, THE RISE IN POPULATION IS ATTRIBUTED LARGELY TO WORKING-AGE ADULTS. ACCORDING TO 2020 AMERICAN CENSUS DATA, COMPARED TO TUFTS MC'S OTHER PRIORITY NEIGHBORHOODS AS A WHOLE, SOUTH BOSTON HAS A MUCH LARGER PERCENTAGE OF WHITE NON-HISPANIC RESIDENTS (77%), AND MUCH SMALLER PERCENTAGES OF FOREIGN-BORN RESIDENTS (13%) AND RESIDENTS WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME (18%). SOUTH BOSTON HAS A BIGGER YOUNG ADULT POPULATION THAN TUFTS MC'S OTHER PRIORITY COMMUNITIES OR BOSTON AS A WHOLE, WITH 20-34-YEAR OLDS MAKING UP 44% OF THE POPULATION. IT ALSO HAS A SMALLER POPULATION OR CHILDREN AND TEENS, WITH ONLY 13% UNDER 20 YEARS. NEARLY THREE QUARTERS (71%) OF SOUTH BOSTON RESIDENTS HAVE BACHELOR'S DEGREES OR HIGHER.

PART VI, LINE 7, REPORTS FILED WITH STATES
MA

PART III, LINE 4:
"THE FOLLOWING IS FROM THE WELLFORCE, INC. AND CONSOLIDATED AFFILIATES (THE SYSTEM) AUDITED FINANCIAL STATEMENTS, OF WHICH TUFTS MEDICAL CENTER, INC. IS INCLUDED, RELATING TO CHARITY CARE AND BAD DEBT EXPENSE:2022 CHARITY CARE AND COMMUNITY BENEFIT FOOTNOTECHARITY CARE - THE SYSTEM'S COMMITMENT TO COMMUNITY SERVICE IS EVIDENCED BY SERVICES PROVIDED TO THE POOR AND BENEFITS PROVIDED TO THE PATIENTS THAT IT SERVES. THE SYSTEM PROVIDES HEALTH CARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. THESE PATIENTS MAY RECEIVE FULL ASSISTANCE OR MAY BE SUBJECT TO PARTIAL LIABILITY BASED ON INCOME AND FAMILY SIZE. BECAUSE THE SYSTEM DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE.THE SYSTEM PROVIDED CHARITY CARE, BASED ON CHARGES FORGONE AND THE ESTIMATED COST OF THE CHARITY CARE PROVIDED AMOUNTED TO $26,475K AND $12,518K, FOR THE YEAR ENDED SEPTEMBER 30, 2022 AND $43,544K AND $18,294K FOR THE YEAR ENDED SEPTEMBER 30, 2021, RESPECTIVELY. THE ESTIMATED COST OF CHARITY CARE IS BASED ON THE RELATIONSHIP OF PATIENT CARE SERVICE CHARGES TO THE RELATED COSTS APPLIED TO CHARITY CARE CHARGES RECOGNIZED DURING THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021.THE SYSTEM HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING 2022. HEALTH SAFETY NET FUND (HSN) - THE COMMONWEALTH OF MASSACHUSETTS (THE ""COMMONWEALTH"") OPERATES THE HSN, WHICH WAS CREATED BY THE COMMONWEALTH'S HEALTH CARE REFORM ACT TO REPLACE THE STATE'S UNCOMPENSATED CARE POOL. THE HSN ALLOCATES THE COST OF UNCOMPENSATED CARE AMONG THE HOSPITALS IN THE COMMONWEALTH. HOSPITALS HAVE BEEN ASSESSED A UNIFORM ALLOWANCE BASED ON ESTIMATES OF THE STATEWIDE COST OF UNCOMPENSATED CARE AND REIMBURSED FOR A PORTION OF THE COST OF UNCOMPENSATED CARE, SUBJECT TO CERTAIN LIMITATIONS. REIMBURSABLE UNCOMPENSATED CARE INCLUDES NET CHARITY CARE AND CERTAIN UNCOLLECTIBLE ACCOUNTS RELATED TO EMERGENCY SERVICES. HOSPITALS' RECOVERIES FROM THE HSN ARE BASED ON A CLAIMS-BASED PAYMENT METHOD THAT USES MEDICARE PRINCIPLES. REIMBURSEMENT FROM THE HSN FOR UNCOMPENSATED CARE IS RECORDED IN NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENT OF OPERATIONS. THE COMMONWEALTH HAS DETERMINED FINAL SETTLEMENTS WITH RESPECT TO THE HSN FOR ALL YEARS PRIOR TO 2014.COMMUNITY BENEFIT - IN FURTHERING ITS CHARITABLE PURPOSE, THE SYSTEM PROVIDES A WIDE VARIETY OF HEALTH CARE SERVICES TO THE COMMUNITY IN ORDER TO PROVIDE ACCESS TO APPROPRIATE CARE FOR POPULATIONS IN NEED. THE SYSTEM HAS DEVELOPED A FORMAL COMMUNITY BENEFIT PLAN THAT RESPONDS TO THE COMPREHENSIVE ASSESSMENT OF HEALTH CARE NEEDS IN THE COMMUNITY. THE COMMUNITY BENEFIT PLAN SUPPORTS SERVICES THAT TARGET NOT ONLY THE GENERAL POPULATION IN THE SYSTEM'S SERVICE AREA, BUT ALSO PARTICULAR POPULATIONS WITH SPECIAL HEALTH CARE NEEDS, INCLUDING THE POOR, ELDERLY, CHILDREN, AND MINORITY POPULATIONS. SUPPORTED SERVICES INCLUDE VARIOUS CLINICS, HEALTH SCREENING PROGRAMS, HEALTH EDUCATION PROGRAMS AND SUPPORT GROUPS OPERATED IN THE SYSTEM'S SERVICE AREA. THE SYSTEM WORKS ACTIVELY WITH OTHER AREA SERVICE PROVIDERS TO FACILITATE THE DEVELOPMENT OF AN EFFECTIVE COMMUNITY HEALTH NETWORK. THE SYSTEM ALSO PARTICIPATES IN ACTIVITIES DESIGNED TO FOSTER AND ENHANCE THE ECONOMIC AND CIVIC ENVIRONMENT AND TO IMPROVE THE HEALTH EQUITY OF ITS SERVICE AREA."

PART III, LINE 9B:
TUFTS MEDICAL CENTER'S FINANCIAL COORDINATION OFFICE IDENTIFIES AND ASSISTS THOSE PATIENTS THAT HAVE NO INSURANCE OR WHO ARE UNDERINSURED. WE WILL PROCESS ON-LINE APPLICATIONS FOR STATE PROGRAMS IN ACCORDANCE WITH THE ESTABLISHED MASS HEALTH GUIDELINES. THE GUIDELINES ARE BASED ON 200% OF THE FEDERAL POVERTY GUIDELINES.FINANCIAL ASSISTANCE IS ALSO EXTENDED TO OUT-OF-STATE/COUNTRY PATIENTS WITH NO INSURANCE IN ACCORDANCE WITH THE TUFTS MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. A NOTICE OF FINANCIAL ASSISTANCE IS LOCATED ON THE PATIENT BILL AND THE HOSPITAL WEB-SITE. IT IS ALSO POSTED IN VARIOUS STRATEGIC LOCATIONS THROUGHOUT THE HOSPITAL.THE FINANCIAL COORDINATION OFFICE IS OPEN MONDAY THRU FRIDAY FROM 8:00 A.M. TO 4:40 P.M. THE MAIN NUMBER FOR THE FINANCIAL COORDINATION OFFICE IS 617-636-6013.

PART VI, LINE 2:
TUFTS MC USES VARIOUS METHODS TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. AN IMPORTANT METHOD IS TO CONDUCT A CHNA, DONE SO EVERY THREE YEARS. THE MOST RECENT CHNA WAS CONDUCTED IN THE SPRING OF 2022, WHERE 927 COMMUNITY RESIDENTS PARTICIPATED IN A SURVEY TO UNDERSTAND THE COMMUNITY'S NEEDS, STRENGTHS, PRIORITY HEALTH ISSUES, AND RECOMMENDATIONS. THE CHNA PROCESS ALSO INCLUDED 14 FOCUS GROUPS WITH 128 COMMUNITY RESIDENTS AND INPUT FROM UPDATED COMMUNITY MEMBERS.TUFTS MC WORKS COLLABORATIVELY WITH COMMUNITY PARTNERS, INCLUDING NON-PROFIT ORGANIZATIONS, TO IDENTIFY AREAS OF NEED AND ADDRESS THEM EFFECTIVELY. IN ADDITION TO CONDUCTING A CHNA, TUFTS MC PARTICIPATES IN OTHER MEETINGS SUCH AS GRANTEE/CBAC MEETINGS AND OTHER COMMUNITY MEETINGS SUCH AS THE CHINATOWN COALITION, CHINATOWN NEIGHBORHOOD COUNCIL, AND THE SOUTH BOSTON ASSOCIATION OF NONPROFITS, AMONG OTHERS. THESE MEETINGS PROVIDE VALUABLE FEEDBACK AND INSIGHT INTO COMMUNITY NEEDS.FURTHERMORE, TUFTS MC REVIEWS DATA ON POPULATION HEALTH, EPIDEMIOLOGY, AND COMMUNITY HEALTH INDICATORS TO MONITOR TRENDS AND IDENTIFY EMERGING HEALTH CONCERNS DURING THE CHINA PROCESS. THE ORGANIZATION USES THIS DATA TO ENSURE THAT IT IS ADDRESSING THE MOST PRESSING HEALTH NEEDS OF THE COMMUNITY IN A COMPREHENSIVE AND EFFECTIVE MANNER.ONCE PRIORITY HEALTH NEEDS ARE IDENTIFIED, DATA ARE SUMMARIZED, REVIEWED, AND APPROVED BY TUFTS MC'S SENIOR LEADERSHIP AND ITS COMMUNITY BENEFITS GOVERNING BODY, TUFTS MC'S COMMUNITY BENEFITS COMMITTEE. THIS COLLABORATIVE APPROACH ENSURES THAT TUFTS MC IS ADDRESSING THE MOST PRESSING HEALTH NEEDS OF THE COMMUNITY IN A COMPREHENSIVE AND EFFECTIVE MANNER.THE HEALTH ISSUES IDENTIFIED AND PRIORITIZED IN THE 2019 CHNA AND IMPLEMENTATION STRATEGY SOUGHT TO ADDRESS THE HIGH INCIDENCE OF HEART DISEASE AND LUNG CANCER AMONG THE CHINATOWN AND BOSTON ASIAN COMMUNITY, FOCUSING ON SMOKING AND ITS HARMFUL EFFECTS; BEHAVIORAL HEALTH IN DORCHESTER; ACCESS TO SERVICES IN THE SOUTH END AND QUINCY; AND SUBSTANCE USE AND CHRONIC DISEASES IN SOUTH BOSTON. THE IDENTIFIED HEALTH ISSUES GUIDED THE ALLOCATION OF RESOURCES FOR BOTH COMMUNITY-BASED AND HOSPITAL-BASED RESPONSES. TUFTS MC DEVELOPED PROGRAMS TO ADDRESS THESE ISSUES AND ALLOCATED RESOURCES TO RESPOND TO THEM EFFECTIVELY, SUCH AS PROVIDING SMOKING CESSATION PROGRAMS, INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICES, AND OFFERING EDUCATIONAL PROGRAMS ON CHRONIC DISEASE MANAGEMENT.TUFTS MC ALSO CONDUCTED A CHNA IN 2020 TO IDENTIFY COMMUNITY NEEDS IN SEVERAL AREAS DUE TO COVID-19. THE IDENTIFIED THEMES WERE JOB SECURITY, BEHAVIORAL HEALTH, FOOD INSECURITY, AND TRANSITION/RE-OPENING SUPPORT. TUFTS MC PROVIDED GRANTS FOR COVID-19 RELATED ACTIVITIES AND SUMMER INTERNSHIPS FOR LOCAL YOUTH. THE GRANTS ALSO SUPPORTED LOCAL BUSINESSES AND PROVIDED JOB TRAINING FOR THOSE IN NEED, INCLUDING IMMIGRANTS AND NON-ENGLISH SPEAKING RESIDENTS.

PART VI, LINE 3:
PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE AND FINANCIAL COORDINATION RESOURCES OFFERED BY THE HOSPITAL THROUGH SEVERAL DIFFERENT MEDIUMS AND AT SEVERAL DIFFERENT POINTS IN THEIR EXPERIENCE WITH THE HOSPITAL. PATIENTS ARE PROVIDED AN OPPORTUNITY TO HAVE AN IN PERSON DISCUSSION WITH A FINANCIAL COORDINATOR ABOUT INSURANCE COVERAGE AND FINANCIAL HARDSHIP DURING THE INITIAL REGISTRATION PROCESS. IF A PATIENT EXPRESSES THE NEED FOR INSURANCE OR FINANCIAL ASSISTANCE A FINANCIAL COORDINATOR WILL WORK WITH THEM TO APPLY FOR ANY AVAILABLE AND APPROPRIATE SERVICES. SHOULD A PATIENT QUALIFY FOR MEDICARE OR MEDICAID ASSISTANCE OF ANY FORM, E.G. COMMONWEALTH CARE, THE COUNSELOR OR FINANCIAL COORDINATOR WILL ALSO ASSIST THE PATIENT IN APPLYING FOR ANY OTHER SOCIAL SERVICES THEY MAY FIND HELPFUL, SUCH AS FOOD AND NUTRITION SERVICES. PATIENTS ARE NOTIFIED OF THEIR RIGHTS AND AVAILABLE FINANCIAL RESOURCES THROUGH A VARIETY OF OTHER MEASURES AS WELL, INCLUDING INFORMATION ON SEVERAL DIFFERENT PAGES AND LANDING POINTS ON THE TUFTS MEDICAL CENTER AND FLOATING HOSPITAL FOR CHILDREN WEBSITE, IN WRITTEN INFORMATION PROVIDED AT DISCHARGE, ON ANY BILLING STATEMENTS THEY RECEIVE AND IN POSTINGS THROUGHOUT THE HOSPITAL IN ALL WAITING AREAS AND CLINICS.

PART VI, LINE 5:
IN ADDITION TO PROVIDING FINANCIAL RESOURCES TO COMMUNITY-BASED HEALTH AND SERVICE ORGANIZATIONS THAT ADDRESS HEALTH ISSUES SPECIFIC TO THEIR CONSTITUENTS, TUFTS MC ADVANCES ITS COMMITMENT TO THE HEALTH OF ITS PATIENT AND PRIORITY COMMUNITIES THROUGH A NUMBER OF HOSPITAL-LED EFFORTS. THESE INCLUDE CLINICS ESTABLISHED TO MEET THE NEEDS OF NON-NATIVE ENGLISH SPEAKERS; SCHOOL-BASED CURRICULA THAT HELP STUDENTS LEARN ABOUT SMOKING, ASTHMA, DENTAL HEALTH, NUTRITION, SEXUAL HEALTH, SUBSTANCE USE, AND STRESS MANAGEMENT; SCREENINGS AND WORKSHOPS FOR POPULATIONS WITH CRITICAL HEALTH DISPARITIES; ASSISTING ELIGIBLE PATIENTS WITH SECURING FINANCIAL AND SOCIAL BENEFITS SUCH AS PUBLIC HEALTH INSURANCE; AND A COLLABORATION WITH THE BOSTON CHNA-CHIP COLLABORATIVE TO DEEPEN AND EXPAND THE IMPACT OF MEMBER INSTITUTIONS' COMMUNITY BENEFITS ACTIVITIES. TUFTS MC ALSO PARTICIPATES IN COMMUNITY COALITIONS THAT WORK TO PRESERVE COMMUNITY ASSETS AND ADVANCE THE PHYSICAL, ECONOMIC, SOCIAL, AND CULTURAL HEALTH OF THE COMMUNITY. EXAMPLES OF THIS INCLUDE TUFTS MC'S ROLE IN PUBLIC SAFETY INITIATIVES, PROVIDING PARKING FOR FAITH-BASED INSTITUTIONS' CONGREGATION MEMBERS AND WEEKEND PARKING FOR LOCAL SMALL BUSINESS OWNERS' CUSTOMERS, AND VARIOUS WORKFORCE DEVELOPMENT ACTIVITIES TO HELP PREPARE AND/OR RECRUIT COMMUNITY MEMBERS FOR TUFTS MC EMPLOYMENT AND BEYOND.IN RESPONSE TO THE COVID-19 PANDEMIC, TUFTS MC PIVOTED IN ITS INTERNAL AND EXTERNAL PROGRAM FUNDING TO PROVIDE SUPPORT FOR WORKFORCE DEVELOPMENT, FOOD INSECURITY AND OTHER COVID RELATED NEEDS. THEY WERE ABLE TO PIVOT AND LEVERAGE TECHNOLOGY TO SUPPORT THE COMMUNITY AND INCREASE ACCESS TO UNDER-SERVED POPULATIONS.

PART VI, LINE 6:
COMMUNITY HOSPITAL PARTNERSHIPSTUFTS MEDICAL CENTER HAS A RICH HISTORY OF PROVIDING MEDICAL CARE TO THE BOSTON COMMUNITY SINCE ITS FOUNDING. IN 2009 TUFTS MEDICAL CENTER LAUNCHED ITS DISTRIBUTED ACADEMIC MEDICAL CENTER MODEL, WHICH PARTNERS WITH COMMUNITY HOSPITALS TO KEEP MORE CARE LOCALLY IN THE COMMUNITY. TUFTS MEDICAL CENTER IS PROUD TO PARTNER WITH EXCELLENT COMMUNITY HOSPITALS TO DELIVER THE HIGHEST QUALITY CARE IN THE MOST CONVENIENT MANNER FOR PATIENTS. WE STRONGLY BELIEVE THAT WHEN ACADEMIC MEDICAL CENTERS AND COMMUNITY HOSPITALS WORK SIDE-BY-SIDE, THE PATIENT AND THE HEALTH CARE SYSTEM BENEFIT. THROUGH OUR DISTRIBUTED ACADEMIC MEDICAL CENTER MODEL, WE BRING TUFTS MEDICAL CENTER PHYSICIANS TO THE COMMUNITY - SAVING PATIENTS THE DRIVE INTO DOWNTOWN BOSTON AND TAKING ADVANTAGE OF THE EXCELLENT HOSPITALS IN THE CITIES AND TOWNS SURROUNDING BOSTON. WE ALSO CONSULT CLOSELY WITH OUR TALENTED PHYSICIAN COLLEAGUES WHO ARE PROVIDING OUTSTANDING SERVICES IN THE COMMUNITY ALREADY. AND WHEN EXCEPTIONALLY COMPLEX CARE IS NEEDED, THESE PARTNERSHIPS MEAN THE TRANSFER TO BOSTON IS WELL COORDINATED BETWEEN PHYSICIANS AND COMFORTABLE FOR THE PATIENT AND FAMILY MEMBERS.THROUGH PARTNERSHIPS WITH OTHER AREA HOSPITALS AND MEDICAL CENTERS, DOCTORS FROM TUFTS MC STAFF VARIOUS COMMUNITY MEDICAL FACILITIES. THIS ALLOWS MORE PATIENTS TO RECEIVE TOP-QUALITY CARE IN A LOCATION CLOSE TO HOME. TUFTS MC SPECIALISTS SEE PATIENTS AND PERFORM SOME TREATMENTS AND PROCEDURES LOCALLY. WHEN HIGH-LEVEL ADVANCED CARE IS NEEDED, TUFTS MC DOCTORS WORK WITH THE COMMUNITY PHYSICIANS TO ENSURE A SMOOTH PATIENT TRANSITION TO TUFTS MEDICAL CENTER IN BOSTON.TUFTS MEDICAL CENTER MAKES AN EXCELLENT CLINICAL PARTNERS FOR TWO MAIN REASONS. FIRST, WE WORK WITH OUR PARTNER HOSPITALS TO KEEP MOST MEDICAL CARE LOCAL. THIS IS THE MOST CONVENIENT OPTION FOR PATIENTS AND THE MOST COST-EFFECTIVE OPTION FOR BOTH PATIENTS AND PROVIDERS. SECOND, TUFTS MEDICAL CENTER PROVIDES HIGH-QUALITY CARE AT REASONABLE COSTS. IN FACT, A REPORT BY THE MASSACHUSETTS ATTORNEY GENERAL'S OFFICE SAID THAT WE ARE THE MOST AFFORDABLE ADVANCED CARE OPTION IN BOSTON.PATIENTS MAY EXPERIENCE OUR AFFILIATION WITH COMMUNITY HOSPITALS IN ANY NUMBER OF WAYS, SUCH AS:- A PEDIATRIC HOSPITALIST CARING FOR A SICK CHILD ON THE PEDIATRIC UNIT OF A COMMUNITY HOSPITAL- A CARDIOLOGIST PERFORMING CARDIAC CATHETERIZATIONS IN THE COMMUNITY- OUR EXPERT WEIGHT AND WELLNESS CENTER TEAM PROVIDING SUPPORT AND SURGERIES IN THE COMMUNITY - OUR TRAUMA TEAM PREPARING FOR AN URGENT TRANSFER FROM A COMMUNITY HOSPITAL- OUR NEUROLOGY TEAM PROVIDING A CONSULT ON A STROKE PATIENT IN A COMMUNITY EMERGENCY DEPARTMENT- CARDIOLOGY EXPERTS FROM THROUGHOUT THE REGION MEETING TO DISCUSS BEST PRACTICE FOR TREATING HEART FAILURE PATIENTS- COORDINATED CARE PROTOCOLS BETWEEN INSTITUTIONS AND CARE SETTINGSADULT AFFILIATE HOSPITALSMETROWEST MEDICAL CENTER (FRAMINGHAM, MA)PEDIATRIC AFFILIATE HOSPITALSLAWRENCE GENERAL HOSPITAL (LAWRENCE, MA)LOWELL GENERAL HOSPITAL (LOWELL, MA)METROWEST MEDICAL CENTER (FRAMINGHAM, MA)SIGNATURE HEALTHCARE BROCKTON HOSPITAL (BROCKTON, MA)

PART VI, LINE 4, COMMUNITY INFORMATION (CONTINUED)
"THE TUFTS MC 2022 COMMUNITY SURVEY FOUND THAT COVID-19, MENTAL HEALTH/DEPRESSION, AND SUBSTANCE USE WERE THE TOP HEALTH CONCERNS FOR SOUTH BOSTON RESIDENTS, WITH SUBSTANCE USE BEING UNIQUE TO THIS NEIGHBORHOOD. THE TOP SOCIAL ISSUES WERE CRIME, EDUCATION, AND EMPLOYMENT, AND THE TOP SAFETY CONCERNS WERE DRUG TRAFFICKING, DISCRIMINATION BASED ON CLASS/INCOME, AND VANDALISM. THE COVID-19 PANDEMIC LED TO A SIGNIFICANT INCREASE IN BEHAVIORAL HEALTH ISSUES, PARTICULARLY IN MENTAL HEALTH CRISES, SUBSTANCE USE, AND ADDICTION. OTHER HEALTH ISSUES WORSENED BY THE PANDEMIC INCLUDED OBESITY, DIABETES, AND CANCER, AND HEALTHCARE ACCESS WAS ALSO IDENTIFIED AS AN ISSUE. FINANCIAL SECURITY WAS A PRIORITY, WITH GENTRIFICATION AFFECTING HOUSING AND JOBS, AND ECONOMIC WELL-BEING WAS IDENTIFIED AS THE TOP SOCIAL ISSUE. ACCORDING TO THE BOSTON BEHAVIOR RISK FACTOR SURVEILLANCE SYSTEM SURVEY, SOUTH BOSTON RESIDENTS REPORTED FEELING PERSISTENT ANXIETY AND SADNESS AT RATES SIMILAR TO THE CITYWIDE AVERAGE, AND WERE SLIGHTLY MORE FINANCIALLY SECURE THAN BOSTON RESIDENTS ON AVERAGE. TRANSPORTATION DIFFICULTIES WERE SLIGHTLY HIGHER, BUT SOUTH BOSTON HAD THE SECOND-HIGHEST INSURANCE RATE OF ALL NEIGHBORHOODS IN BOSTON. THE SOUTH END IS IMMEDIATELY SOUTH OF TUFTS MC, ADJACENT TO CHINATOWN. IT IS A NEIGHBORHOOD KNOWN FOR ITS LARGE VICTORIAN ROW HOUSES DISTRICT BUILT BY MIDDLE CLASS RESIDENTS OF ENGLISH ANCESTRY IN THE 1850S. THE NEIGHBORHOOD'S DEMOGRAPHICS BEGAN TO CHANGE IN THE 1880S WHEN THE ORIGINAL RESIDENTS BEGAN TO BE REPLACED BY MIDDLE CLASS AFRICAN AMERICANS, IRISH, JEWISH, GREEK, PUERTO RICAN, AND CHINESE IMMIGRANTS. IN THE 1960S, THE SOUTH END WAS CONSIDERED ONE OF THE POOREST NEIGHBORHOODS IN THE CITY OF BOSTON. ITS RENAISSANCE BEGAN IN THE MID-1970S WHEN INDIVIDUALS BEGAN TO BUY AND RESTORE VICTORIAN ROW HOUSES, AND NON-PROFITS PURCHASED AND REHABILITATED HOUSES AS AFFORDABLE RENTALS FOR FAMILIES. THERE WAS ALSO NEW CONSTRUCTION FOCUSED ON MEETING THE NEEDS OF VERY LOW-INCOME FAMILIES AND SENIORS.CURRENTLY, THE SOUTH END AND SOUTH BOSTON ARE EXAMPLES OF BOSTON'S ROBUST ECONOMY AND BUILDING BOOM, AND NEW RESIDENTIAL DEVELOPMENTS ARE BEING CONSTRUCTED ON PARCELS WHICH WERE ONCE DESIGNATED FOR LIGHT INDUSTRIAL USE.THE LINE BETWEEN THE SOUTH END AND CHINATOWN IS NOT FIXED, AND THERE IS A SIZABLE POPULATION OF CHINESE FAMILIES LIVING IN WHAT IS TRADITIONALLY CONSIDERED THE SOUTH END. ACCORDING TO THE 2017 ACS, THE SOUTH END HAD A POPULATION OF APPROXIMATELY 27,000 RESIDENTS. ACCORDING TO BPDA 2020 US CENSUS DATA, THE MAJOR RACIAL/ETHNIC GROUPS WERE: WHITE NON-HISPANIC (56.6%), ASIAN (15.9%, LATINX (12.9%), BLACK/AFRICAN AMERICAN (10.1%), AND OTHER (4.5%). ABOUT A QUARTER ARE FOREIGN-BORN (27%) AND 40% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, WHICH IS SIMILAR TO BOSTON AS A WHOLE. LIKE SOUTH BOSTON, THE SOUTH END HAS SMALLER PERCENTAGES OF YOUTH AND TEENS THAN THE CITY OF BOSTON AS A WHOLE, WITH 15% OR RESIDENTS UNDER 20 YEARS OLD. SLIGHTLY OVER HALF OF SOUTH END RESIDENTS (56%) HAVE BACHELOR'S DEGREES OR HIGHER. OVER THE EDUCATIONAL ATTAINMENT OF SOUTH END ROUGHLY MIRRORS THE CITY OF BOSTON AS A WHOLE. THE TUFTS MC 2022 COMMUNITY SURVEY AND SECONDARY DATA INDICATE THAT RESIDENTS OF THE SOUTH END IN BOSTON WERE PRIMARILY CONCERNED ABOUT COVID-19, ACCESS TO SPECIALTY CARE, MENTAL HEALTH/DEPRESSION, HOUSING STABILITY, DISASTER READINESS AND EMERGENCY PREPARATION, EDUCATION, DISCRIMINATION BASED ON RACE AND SEX/GENDER, AND SMOKING. FINANCIAL INSECURITY AND JOB TRAINING/RESOURCES ARE SEEN AS SIGNIFICANT CONTRIBUTORS TO THESE CONCERNS. GENTRIFICATION AND RISING HOUSING COSTS HAVE LED TO A CHANGING CULTURAL MIX, PUSHING OUT IMMIGRANT AND LOW-INCOME FAMILIES, AND CAUSING STRESS FOR LONG-TERM CHINESE RESIDENTS WHO FEEL LIKE THEY DON'T BELONG IN THEIR COMMUNITY. THE SOUTH END ALSO CONTAINS AN AREA KNOWN AS ""METHADONE MILE,"" WHERE HOMELESS ENCAMPMENTS AND OPEN-AIR SALE AND USE OF SUBSTANCES ARE PREVALENT. RISING PRICES FROM GENTRIFICATION HAVE CAUSED WEALTHIER FAMILIES TO LEAVE THE NEIGHBORHOOD, WHILE LOW-INCOME FAMILIES ARE PUSHED OUT.QUINCY HAS A SIGNIFICANT ASIAN POPULATION WITH STRONG SOCIAL AND CULTURAL TIES TO BOSTON'S CHINATOWN, COMPRISING ABOUT 6% OF TUFTS MC'S PATIENT POPULATION. IN 2017, QUINCY HAD A POPULATION OF 93,824 AND GREW 6.6% SINCE 2000. BETWEEN 2000 AND 2017, THE CITY SAW A GROWTH IN THE NUMBER OF BLACK AND LATINX RESIDENTS, AND MOST NOTABLY ASIAN RESIDENTS. QUINCY SITS JUST SOUTHEAST OF BOSTON AND IS HOME TO LARGE POPULATION OF CHINESE IMMIGRANTS, WITH 30.8% OF THE POPULATION IDENTIFYING AS ASIAN (2020 U.S. CENSUS). DATA FROM THE 2019 AMERICAN COMMUNITY SURVEY INDICATE THAT SLIGHTLY LESS THAN TWO-THIRDS OF QUINCY RESIDENTS ARE WHITE NON-HISPANIC (58%) AND NEARLY ONE-THIRD ARE ASIAN (30%). ONE-THIRDS (33%) OF QUINCY RESIDENTS ARE FOREIGN-BORN AND 38% SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. THE LARGEST AGE GROUP OF QUINCY RESIDENTS IS 35-65-YEAR-OLDS (40%). THERE ARE FEWER YOUNG ADULTS AGES 20-34 (27%) THAN IN THE CITY OF BOSTON AS A WHOLE (35%). AS A WHOLE, EDUCATIONAL ATTAINMENT OF QUINCY RESIDENTS LOOKS SIMILAR TO BOSTON, ALTHOUGH QUINCY HAS FEWER RESIDENTS WITH BACHELOR'S DEGREES OR HIGHER (45% VS 51%). IN TUFTS MC'S 2022 COMMUNITY SURVEY, COVID-19, ACCESS TO SPECIALTY CARE, AND MENTAL HEALTH/DEPRESSION WERE THE TOP HEALTH CONCERNS OF COMMUNITY RESIDENTS. THE TOP SOCIAL ISSUES WERE HOUSING STABILITY, EDUCATION, AND DOMESTIC/INTERPERSONAL VIOLENCE, WHILE THE TOP SAFETY CONCERNS WERE DISCRIMINATION BASED ON CLASS/INCOME, SEX/GENDER, AND IMMIGRATION STATUS. THE RISING POPULATION OF LIMITED ENGLISH SPEAKERS AND IMMIGRANTS IN QUINCY HAS WORSENED THESE CHALLENGES, WITH CHRONIC DISEASE AND CANCER REMAINING ONGOING HEALTH CONCERNS. FINANCIAL AND FOOD INSECURITY HAVE GROWN SIGNIFICANTLY DURING THE PANDEMIC, ALONG WITH MENTAL HEALTH ISSUES AND DOMESTIC VIOLENCE. THE LACK OF PROVIDERS WHO CAN SPEAK THE LANGUAGE AND UNDERSTAND THE CULTURE OF THEIR PATIENTS HAS ALSO BEEN IDENTIFIED AS A CHALLENGE. QUINCY HAS HIGHER MORTALITY RATES FOR CANCER, SUBSTANCE USE, AND OPIOID USE COMPARED TO THE STATE OF MASSACHUSETTS, WITH HIGHER RATES OF COPD-RELATED HOSPITALIZATIONS, POISONING-RELATED ED VISITS, AND MORTALITY ACCORDING TO DATA PROVIDED BY THE MASSACHUSETTS DEPARTMENT OF HEALTH.CARE TO BOSTON RESIDENTS AND SURROUNDING COMMUNITIES:TUFTS MC BELIEVES THAT CARING FOR OUR COMMUNITY HAPPENS BOTH WITHIN AND OUTSIDE THE WALLS OF THE INSTITUTION. DATA HAVE SHOWN THAT MANY BARRIERS EXIST WHICH HINDER PATIENT ACCESS TO HIGH QUALITY HEALTH CARE, INCLUDING THE LINGUISTIC AND CULTURAL COMPETENCY OF HEALTH CARE PROVIDERS. TO REMOVE THE BARRIERS AND INCREASE ACCESS TO HOSPITAL SERVICES, TUFTS MC CONTINUES A LONG-STANDING COMMITMENT TO HEALTH EQUITY WHICH INVOLVES INCREASING CULTURAL COMPETENCY AMONG OUR MEDICAL PROVIDERS AND TO REMOVE LANGUAGE BARRIERS WHEREVER POSSIBLE. THE WORKING DEFINITION OF CULTURAL COMPETENCY THAT HELPS TO SHAPE AND DRIVE POLICIES AND CARE DELIVERY AT TUFTS MC IS AS FOLLOWS:THE ABILITY TO UNDERSTAND AND RESPECT THE DIFFERENCES AMONG PEOPLE AND USE OUR UNDERSTANDING TO INFLUENCE OUR INTERACTIONS WITH ONE ANOTHER; THIS INVOLVES DEVELOPING OUR CAPABILITY OF DELIVERING PATIENT-CENTERED SERVICES CONSISTENT WITH THE NEEDS AND EXPECTATIONS OF VARIOUS CULTURES."