SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public Inspection
Name of the organization
TUFTS MEDICAL CENTER GROUP RETURN
 
Employer identification number

27-0440772
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    12,590,345 1,168,250 11,422,095 1.370 %
b Medicaid (from Worksheet 3, column a) . . . . .     190,837,761 158,844,068 31,993,693 3.830 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     203,428,106 160,012,318 43,415,788 5.200 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).   40,770 326,265   326,265 0.040 %
f Health professions education (from Worksheet 5) . . . 37 586,722 29,925,099 10,026,249 19,898,850 2.380 %
g Subsidized health services (from Worksheet 6) . . . .     188,630,618 184,118,287 4,512,331 0.540 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .   76,507 7,225,038   7,225,038 0.870 %
j Total. Other Benefits . . 37 703,999 226,107,020 194,144,536 31,962,484 3.830 %
k Total. Add lines 7d and 7j . 37 703,999 429,535,126 354,156,854 75,378,272 9.030 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2016
Schedule H (Form 990) 2016
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development     247,214   247,214 0.030 %
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development   486 262,148   262,148 0.030 %
9 Other            
10 Total   486 509,362   509,362 0.060 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
6,655,624
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
128,277,684
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
137,065,808
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-8,788,124
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2016
Schedule H (Form 990) 2016
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 TUFTS MEDICAL CENTER INC
800 WASHINGTON STREET
BOSTON,MA02111 		X X X X   X X      
Schedule H (Form 990) 2016
Page 4
Schedule H (Form 990) 2016
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
TUFTS MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.tuftsmedicalcenter.org/commhealth
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2016
Page 5
Schedule H (Form 990) 2016
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
TUFTS MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
www.tuftsmedicalcenter.org/financialassistance
b
www.tuftsmedicalcenter.org/financialassistance
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2016
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Schedule H (Form 990) 2016
Page 6
Part VFacility Information (continued)

Billing and Collections
TUFTS MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2016
Page 7
Schedule H (Form 990) 2016
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
TUFTS MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2016
Page 8
Schedule H (Form 990) 2016
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
TUFTS MEDICAL CENTER, INC. Part V, Section B, Line 5: In conducting its tri-annual CHNA, Tufts Medical Center solicited and incorporated input from community leaders, community service providers and long-time residents some of whom provide health care services or are involved in addressing critical health issues such as substance use and/or recovery. Key community stakeholders' insights on the critical health issues for community members were incorporated into the CHNA which was then reviewed by the Medical Center's leadership and community advisors who approved priorities for neighborhood focused grant-funded initiatives and guided departmental efforts to address identified health disparities and inequities within the hospital's catchment area.
TUFTS MEDICAL CENTER, INC. Part V, Section B, Line 7d: The Medical Center's CHNA was made available to anyone who requested a copy. It was also posted on the Medical Center's website.
TUFTS MEDICAL CENTER, INC. Part V, Section B, Line 11: Tufts Medical Center is addressing significant health needs identified in the most recent CHNA, including smoking, youth violence, substance abuse, barriers to healthcare services and access, and infant and maternal health, in several Boston neighborhoods, including Chinatown, South Boston, Dorchester and South End. Through its Asian Health Initiative (AHI), Tufts MC is tackling cigarette smoking reduction and prevention, which contributes to the leading cause of mortality of Boston's Chinatown and Asian community: lung cancer. Six grantees were selected through an open and competitive application process for three-year grants to provide educational, prevention, and smoking cessation services to both English and Chinese speaking community members across a wide age spectrum: pre-school students to senior citizens.The 2016 CHNA identified substance use disorder as a concern across the City of Boston, with South Boston and Dorchester of particular concern. Youth violence is also of particular concern.The Dorchester Health Initiative's (DHI) three year funding cycle focuses on two priorities: preventing and/or treating substance use, and youth violence prevention. Six grantees were selected through an open and competitive application process. Three health centers are focused on reduction of substance use and assisting patients to obtain treatment and recovery services. Three community-based organizations are supporting youth development and the skills needed for risk reduction, resiliency and positive experiences.Tufts MC is addressing substance use disorder through community partnerships and hospital-based programs. Tufts MC initiatives include the Adolescent Opioid Dependence Treatment Program, and recovery and mental health services at the South Boston Behavioral Health Clinic. Community partners in South Boston are providing treatment and services in clinic and residential treatment facilities. Increasing access to healthcare by removing cultural and language barriers is reflected in the creation and continued efforts of hospital-based programs and clinics, including: Asian Pediatrics and Adolescent Services, Asian Lung Clinic, OB/GYN's Asian Access Clinic, and the Asian Flex (Psychiatry) Program. Partnerships or funding community partners are working on: case management services to assist community members to identify and access healthcare resources, hospital re-admissions reductions, psychiatric case consultations for a Boston Public elementary school, medical providers authoring health education columns for a bilingual, bicultural community newspaper, and physician house calls to home bound Chinese seniors.In the South End the population includes enclaves of lower income Spanish speaking families and older Chinese speaking adults for whom cardiovascular and cerebrovascular diseases are a major health issue, a partnership with the South End Community Health Center offers linguistically and culturally appropriate outreach, education, and health services that reflect a coordinated care approach.The 2016 CHNA highlighted a number of pressing health issues in the communities served which were discussed in the CHNA. Through the implementation plan, Tufts MC has been able to address identified issues through various hospital-based efforts, hospital-community partnerships, and community-based interventions. Smoking prevention and cessation programs, youth violence prevention and substance abuse efforts are priorities for several community health initiatives as noted above. Chronic diseases were also broadly highlighted in the data analysis as issues impacting the communities we serve, with programs around asthma, diabetes and cardiovascular disease, in particular, and internal programs and community partnerships to work on some aspects of those. Limited financial and staffing resources are a barrier to focusing intense resources on these efforts, but we hope to maximize collective impact by working together with community partners.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2016
Page 9
Schedule H (Form 990) 2016
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address Type of Facility (describe)
1 1 - NEW ENGLAND LONG-TERM CARE INC
78 BOSTON ROAD
BILLERICA,MA01862 		LONG-TERM ACUTE-CARE FACILITY
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2016
Page 10
Schedule H (Form 990) 2016
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Part I, Line 7: Costs are allocated to patient encounters based on cost accounting system, which takes into consideration all inpatient and outpatient activity for all areas of the hospital including all payer sources. The costs utilized are based on actual costs from this system, allocated to individual patient encounters.
schedule h, part vi, line 1, required descriptions: Medical Center HistoryTufts Medical Center's proud and distinguished tradition began in 1796, when a group of public-spirited Bostonians, including Samuel Adams and Paul Revere, established the Boston Dispensary as the first permanent medical facility in New England, and one of the first in the nation. Floating Hospital for Children was founded in 1894 as a hospital ship, sailing in Boston Harbor until it moved to land permanently in 1931. In 1965 the Boston dispensary, Floating Hospital for Children and the Pratt Clinic/New England Center Hospital merged to form the New England Medical Center Hospitals. In 1971 the institution changed its name to Tufts - New England Medical Center. Tufts Medical Center became the official name of the medical center in 2008, highlighting its role as the principal teaching hospital for the Tufts University School of Medicine.Tufts Medical Center TodayToday, Tufts Medical Center is a renowned 415-bed academic medical center with an adult hospital and a children's hospital in downtown Boston. We are engaged in advanced patient care, teaching tomorrow's physicians, and conducting groundbreaking basic, clinical, and public policy research. We are the principal adult and pediatric teaching hospital for Tufts University School of Medicine and conduct $50 million in research each year. Tufts Medical Center and Floating Hospital for Children carry out a tripartite mission every day, pursuing excellence in care for adult and pediatric patients, teaching the next generations of care givers and pursuing ground breaking research. Compassionate, patient-centered care is one of the Medical Center's hallmarks. The Medical Center offers a full range of services from primary care to some of the most complex treatments. A multidisciplinary approach ensures both complete and thorough consideration of treatment options for our patients. Tufts Medical Center is an American College of Surgeons Certified Level 1 Adult and Level 1 Pediatric Trauma Center. Our CardioVascular Center performs the most heart transplants in New England and is among the top 10 in the country for number of transplants and the quality outcomes. Tufts MC partners with a broad network of high-quality, value community hospital providers in eastern Massachusetts. Our strategy has resulted in Tufts MC regularly treating the highest percentage of the sickest patients of any hospital in Boston. In addition, our partnering institutions are able to treat more patients in their own hospitals. This strategy is both cost-effective for Massachusetts and convenient for patients.Tufts MC is recognized as the region's value provider-achieving outstanding quality, safety, and patient experience ratings while maintaining a lower cost. Our high-quality, lower-cost profile is an advantageous position in a health reform environment that is demanding greater value from the healthcare dollar.We are have received numerous quality honors including being a Blue Cross Blue Shield Distinction Center + Total Value Designation in cardiac care, hip and knee replacement, bariatric surgery and spine surgery; the American Stroke Association Gold Plus and Target Stroke Awards and the American Heart Association SCORE Award. In 2015, we received the University Health System Consortium's 5-star quality award. Patients regularly rate us as 4-stars on CMS's Hospital Compare. Mission Statement"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 and service to all in our community."Patient Care, Teaching and TrainingNew England Quality Care AllianceFor more than 10 years, Tufts Medical Center has been the preferred academic medical center for New England Quality Care Alliance (NEQCA), the nearly 1,800-physician network, which stretches from the Merrimack Valley to the Cape. NEQCA is a leader in helping physician practices of all sizes manage change, build population health capabilities, control costs and improve the quality of patient care. Tufts MC and our NEQCA physician network consistently deliver the highest quality of care at a lower cost, putting us in the best position for patients and employers.WellforceFormed in 2014, Wellforce is an organization comprised of Tufts MC, Floating Hospital, Hallmark Health, Circle Health, NEQCA, Lowell General PHO and Hallmark PHO. Wellforce was created to provide Massachusetts hospitals and physicians with a new option for collaboration. Wellforce brings together the strengths of academic medicine and community care in a model that respects both equally. Floating Hospital also leads a five-hospital distributed pediatric network, reaching across eastern Massachusetts with hospitalists, neonatologists and specialists seeing patients in Brockton, Lowell, Lawrence, Cape Cod and MetroWest.Educating the Next Generation of PhysiciansUndergraduate and graduate medical educations are key to the academic mission of Tufts Medical Center. We are the principal teaching hospital for Tufts University School of Medicine (TUSM), and each year we train approximately 450 residents and fellows in 43 graduate medical training programs approved by the Accreditation Council for Graduate Medical Education. All full-time physicians at Tufts MC and Floating Hospital for Children hold faculty appointments at TUSM, and 17 of TUSM's 19 department chairs reside at Tufts Medical Center. Our partnership with TUSM, our highly complex patient population, and our connection with community affiliates provide a diverse, hands-on experience for aspiring doctors and for physicians seeking advanced specialization.ResearchTufts Medical Center and Floating Hospital for Children have been engaged in research to improve the lives of patients, almost since our inception. Our $50 million annual research portfolio ranges from the molecular basis of cancer and heart disease to the efficacy of tai chi in treating the symptoms of osteoarthritis. Tufts Medical Center is among the top 10% of all institutions receiving National Institutes of Health (NIH) funding.
Part II, Community Building Activities: Part II, Line 2: Economic DevelopmentTufts Medical Center is located in the center of the Chinatown neighborhood, one of Boston's most densely populated neighborhoods with much of its housing stock and commercial buildings dating back to the 18th century, a time before automobiles and the need for parking. Tufts Medical Center provides parking for community service organizations' vehicles and parking for weekend visitors who come to visit family members, or social/cultural or worship services, and then patronize the many small independently owned businesses located in Chinatown. Part II, Line 8: WORKFORCE DEVELOPMENT AND TRAININGTUFTS MEDICAL CENTER IS ONE OF THE LARGEST EMPLOYERS IN THE CITY OF BOSTON AND EMPLOYS OVER 5,000 PEOPLE. TUFTS MEDICAL CENTER EMPLOYS A DIVERSE WORKFORCE TO FILL POSITIONS RANGING FROM ADMINISTRATIVE, TECHNICAL, AND HOSPITALITY RELATED, SUCH AS PATIENT TRANSPORT, FOOD SERVICES, AND ENVIRONMENTAL SERVICES TO RESEARCH AND DIRECT PATIENT CARE ROLES. APPROXIMATELY 32% OF THE MEDICAL CENTER'S WORKFORCE IS DERIVED FROM RESIDENTS OF THE CITY OF BOSTON.THE MEDICAL CENTER HAS CONSISTENTLY PUT AN EMPHASIS ON RECRUITING FROM THE CHINATOWN COMMUNITY. THE EDUCATIONAL AND LINGUISTIC REQUIREMENTS OF POSITIONS AT THE MEDICAL CENTER HAVE OFTEN MADE it DIFFICULT TO RECRUIT LARGE NUMBERS OF LOCAL RESIDENTS INTO POSITIONS IN THE MEDICAL FIELD. THE MEDICAL CENTER HAS SOUGHT TO ADDRESS THESE ISSUES BY WORKING WITH LOCAL COMMUNITY ORGANIZATIONS TO PROVIDE LANGUAGE SKILLS AND BASIC EDUCATION CLASSES FOR COMMUNITY MEMBERS AND CURRENT EMPLOYEES. TUFTS MEDICAL CENTER CONDUCTS AND PARTICIPATES IN MANY WORKFORCE DEVELOPMENT AND TRAINING INITIATIVES TO ADDRESS SOME OF THE EDUCATIONAL, SKILL AND LINGUISTIC ISSUES. TO PROVIDE CAREER TRAINING AND PROMOTION OPPORTUNITIES SOME OF THE PROGRAMS TUFTS MEDICAL CENTER HAS EMBARKED UPON ARE:THE CAREER EXPLORATION EVENTAN ANNUAL EVENT WHERE EMPLOYEES HAVE THE OPPORTUNITY TO MEET WITH DEPARTMENT REPRESENTATIVES WHO SHARE THEIR EXPERIENCES. EDUCATIONAL PARTNERS, TERI COLLEGE ACCESS AND THE TUFTS MEDICAL CENTER BENEFITS DEPARTMENT PROVIDE INFORMATION ABOUT OUR ONSITE WORKPLACE EDUCATION PROGRAM FOR ESOL, THE COLLEGE ENTRANCE PROCESS, CERTIFICATE AND ASSOCIATE DEGREE PROGRAMS AND EDUCATIONAL FINANCING OPTIONS.TUFTS MEDICAL CENTER EXTERNSHIP PROGRAMA CAREER TRAINING PROGRAM ESTABLISHED TO ASSIST INNER-CITY ADULT STUDENTs TO PREPARE FOR THE WORKFORCE BY PROVIDING CERTIFICATE PROGRAMS THAT TYPICALLY TEACH MEDICAL ASSISTANT, MEDICAL ADMINISTRATIVE ASSISTANT, ADMINISTRATIVE ASSISTANT, CODING AND BILLING SKILLS TO MEMBERS OF THE FOLLOWING COMMUNITY ORGANIZATIONS:- ASIAN AMERICAN CIVIC ASSOCIATION- BOSTON CAREER INSTITUTE- BUNKER HILL COMMUNITY COLLEGE- EVEREST INSTITUTE- GIBBS COLLEGE- HEALTH TRAINING CENTER- HORIZON LEARNING CENTER- JEWISH VOCATIONAL SERVICES- TARE TRAINING CENTER- MEDICAL PROFESSIONAL INSTITUTE- SALTER SCHOOL- YMCA TRAINING, INC.THE STUDENTS FROM THESE PROGRAMS COME TO TUFTS MEDICAL CENTER TO COMPLETE A REQUIRED INTERNSHIP IN PREPARATION FOR THEIR CERTIFICATION, TYPICALLY 160 HOURS, DURING WHICH TIME THEY WORK IN A SUPERVISED ENVIRONMENT, UTILIZING THE SKILLS FROM THEIR RESPECTIVE PROGRAMS WITH A GOAL OF FUTURE EMPLOYMENT. THESE INTERNSHIPS WILL TYPICALLY LEAD TO JOB OPPORTUNITIES FOR ADMINISTRATIVE ASSISTANT, PATIENT SERVICES COORDINATOR, UNIT COORDINATOR, AND PHLEBOTOMIST POSITIONS. IN FISCAL YEAR 2016, APPROXIMATELY 53 STUDENTS COMPLETED THE PROGRAM. HIRING OPPORTUNITIES ARE POSSIBLE FOLLOWING THE EXTERNSHIPS.Additionally, Tufts Medical Center participated in the Boston private industry council's summer internship program for Boston high School students. Each year, 40-50 students are hired to work with various hospital departments to introduce them to career opportunities in the health care field, or to provide them with the work experiences to confirm their career interests. For many of the high School students, this is their first paid work experience. Students work 6 weeks learning and performing actual tasks to support their respective departments. The internships include weekly workshops to enhance job knowledge and job retention skills, introduce personal finance skills and support the development of networks between students from different high schools and adult colleagues. Some summer interns continue in part-time or weekend employment during the academic year. OTHER WORKFORCE DEVELOPMENT ACTIVITIESPARTICIPATION IN THE HIGHER EDUCATION/REGIONAL HOSPITAL WORKING GROUP SPONSORED BY THE DEPARTMENT OF EDUCATION AND THE BOSTON HEALTHCARE CAREERS CONSORTIUM SPONSORED BY THE BOSTON PRIVATE INDUSTRY COUNCIL. THESE GROUPS INCLUDE REPRESENTATIVES OF GOVERNMENT AGENCIES, ACADEMIC INSTITUTIONS, WORKFORCE DEVELOPMENT REPRESENTATIVES FROM LOCAL HOSPITALS AND COMMUNITY HEALTH CENTERS, AND OTHER WORKFORCE DEVELOPMENT ORGANIZATIONS. THESE GROUPS FOCUS ON ADDRESSING HIGHER EDUCATION, TRAINING AND EMPLOYER NEEDS.TUFTS MEDICAL CENTER IS COMMITTED TO A DIVERSE WORKFORCE AND TO PROVIDING EQUAL OPPORTUNITIES TO ALL MEMBERS OF THE COMMUNITY AND BEYOND. THROUGH ITS REGULAR RECRUITMENT CHANNELS THE MEDICAL CENTER REACHES OUT TO THE GENERAL EMPLOYMENT POPULATION, AS WELL as TARGETED MINORITY POPULATIONS, INCLUDING THE LOCAL CHINATOWN COMMUNITY. THESE EFFORTS ARE MADE THROUGH EMPLOYMENT POSTING COMPANIES, SUCH AS MONSTER.COM AND LOCAL OUTLETS SUCH AS THE BILINGUAL SAMPAN NEWSPAPER.IN THE NEXT SEVERAL YEARS THE HEALTHCARE INDUSTRY WILL CONTINUE TO SEE SIGNIFICANT CHANGES TO THE INDUSTRY PROPELLING IT FORWARD WITH ADVANCES IN MEDICAL SCIENCE, TECHNOLOGY, PATIENT DEMOGRAPHICS AND ECONOMICS, AS WELL AS CHANGES TO MODELS OF CARE DELIVERY WHICH WILL CHALLENGE EVEN THE MOST PREPARED AND ORGANIZED WORKFORCE. THESE CHANGES WILL MEAN A TRUE DEDICATION TO EMPLOYEE RECRUITMENT, RETENTION AND TRAINING; IT WILL MEAN TRAINING IN MANY DIFFERENT SETTINGS, FROM EXPERIENTIAL LEARNING IN A TEAM ENVIRONMENT, WEB-BASED INSTRUCTION AND INCREASED SIMULATION-TRAINING. THE FUTURE DEVELOPMENT PROPOSED IN THIS IMPORTANT AREA WILL HELP ENSURE TUFTS MEDICAL CENTER HAS THE FACILITIES TO MEET THE DEMANDS OF AN EVER CHANGING INDUSTRY AND WORKFORCE.
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 45.10%.
Part III, Line 4: the organization's provision for bad debt is described on page 15 of the audited financial statements (attached). the following is excerpted from that footnote..."Provision for bad debts - accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the organization analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party coverage, the organization analyzes contractually due amounts and historic payment trends and records estimated contractual allowances. the organization records a provision for uncollectible amounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts."
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 Medical Center conducts community health needs assessments (CHNA) every three years to identify community needs and critical health issues. The focus of the CHNA includes: Boston's Chinatown, Dorchester, South Boston and South End. Health issues were identified through review of health data for the City of Boston from the Boston Public Health Commission's annual report on "The Health of Boston", data from the Commonwealth of Massachusetts' Community Health Information Profile, demographic data from the Census, American Community Survey, Nielsen-Caritas, patient geographic data, interviews with community stakeholders, and insights and recommendations from community representatives and leaders, some of whom serve as advisors to the Medical Center. Data was summarized and reviewed and approved by Tufts MC's senior leadership and its community benefits governing body, the Board of Governors. The health issues identified and prioritized in the 2016 CHNA and Implementation Plan sought to address the high incidence of lung cancer among the Chinatown and Boston Asian community, focusing on smoking and its harmful effects, substance use and youth violence for the communities of Dorchester and South Boston, and chronic disease prevention and management for the South End community. The identified health issues guided the allocation of resources for both community-based and hospital-based responses.
Part VI, Line 3: PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE AND FINANCIAL COORDINATION RESOURCES OFFERED BY THE HOSPITAL THROUGH SEVERAL DIFFERENT MEDIUMS AND AT SEVERAL DIFFERENT POINTS IN THEIR EXPERIENCE WITH THE HOSPITAL. PATIENTS ARE PROVIDED AN OPPORTUNITY TO HAVE AN IN PERSON DISCUSSION WITH A FINANCIAL COORDINATOR ABOUT INSURANCE COVERAGE AND FINANCIAL HARDSHIP DURING THE INITIAL REGISTRATION PROCESS. IF A PATIENT EXPRESSES THE NEED FOR INSURANCE OR FINANCIAL ASSISTANCE A FINANCIAL COORDINATOR WILL WORK WITH THEM TO APPLY FOR ANY AVAILABLE AND APPROPRIATE SERVICES. SHOULD A PATIENT QUALIFY FOR MEDICARE OR MEDICAID ASSISTANCE OF ANY FORM, E.G. COMMONWEALTH CARE, THE COUNSELOR OR FINANCIAL COORDINATOR WILL ALSO ASSIST THE PATIENT IN APPLYING FOR ANY OTHER SOCIAL SERVICES THEY MAY FIND HELPFUL, SUCH AS FOOD AND NUTRITION SERVICES. PATIENTS ARE NOTIFIED OF THEIR RIGHTS AND AVAILABLE FINANCIAL RESOURCES THROUGH A VARIETY OF OTHER MEASURES AS WELL, INCLUDING INFORMATION ON SEVERAL DIFFERENT PAGES AND LANDING POINTS ON THE TUFTS MEDICAL CENTER AND FLOATING HOSPITAL FOR CHILDREN WEBSITE, IN WRITTEN INFORMATION PROVIDED AT DISCHARGE, ON ANY BILLING STATEMENTS THEY RECEIVE AND IN POSTINGS THROUGHOUT THE HOSPITAL IN ALL WAITING AREAS AND CLINICS.
Part VI, Line 4: Tufts Medical Center has been located 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 that began in the 1960s. Tufts Medical Center has been an integral member of the community. Located in the heart of the Chinatown community, the Medical Center has been 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 Medical Center'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. Many patients come from these neighborhoods.Service populations:Tufts Medical Center'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 and quaternary hospital. Approximately 68% of the patient population is White, 12% Black/African American, 13% Asian and 7% Hispanic. Twenty-five percent of the patient population receives care through Medicaid, and 32% of patients are covered by Medicare. Over 23,000 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: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 42 acres includes a robust residential, cultural, economic and service hub for Boston's Chinese and Asian community. In 2010 demographic data, based upon the Neighborhood Statistical Area, indicated that over 6,300 people lived in the neighborhood where approximately one-third of the land was dedicated to institutional use making Chinatown one of the most densely populated neighborhoods in the City of Boston. There is a dearth of open space in Chinatown. the Boston Common, Public Garden and other open and green space are in close proximity.Based upon 2010 NSA data 65% of residents were Asian, 7% were 14 or younger, 22% were between the ages of 15 and 19 years, and 15% were 65 years of age or older and historically 39% of residents indicated that they spoke English not well". Much of the increase in number of households between the 2000 and 2010 reflects the construction of new housing in and along the perimeter of Chinatown, and increase in the non-Asian residents, and increases in the educational attainment and income levels for the new residents. Health data for the Chinatown neighborhood is integrated with health data for the South End in each year's annual "Health of Boston" report prepared by the Boston Public Health Commission (BPHC). It is therefore difficult to separate out and bring to the surface health issues or trends specific to neighborhood residents. The BPHC does, however, provide health data for Asians across Boston which illustrates that cancer, heart disease and stroke continue to be particular concerns. Lung cancer has been the leading cause of mortality for Asians over an eight year period.All of the available data, along with input from community stakeholders and advisory committee members led to a singular priority for the Medical Center's Asian Health Initiative in 2016 and the three year funding cycle beginning in FY 2017: preventing cigarette smoking and its consequences (lung cancer).Dorchester is the largest neighborhood in the city of Boston and reflects the city's economic, linguistic, racial, ethnic and cultural diversity with a population of over 120,000 residents, approximately 20% of Boston's total population. Census data indicates that 27% was 17 years or younger, and 9.2% were seniors aged 65 and older. Twenty-six percent of the population was White, 47% Black/African American, 9% Asian, and 17% Hispanic or Latino.2010 health data from the BPHC indicated that Dorchester continued to have a high incidence of violence related injuries, and high rates of homicide. The average rate for the city of Boston was 7.9 per 100,000 and the respective rates for North Dorchester and South Dorchester were 17.9 per 100,000 and 19.4 per 100,000. The rates of asthma related hospitalization among children younger than 5 years, and obesity and chronic disease for adults were also above city averages. Based on review of available data and input of community partners, stakeholders and advisors, the Dorchester Health Initiative priorities for this 3-year funding cycle were substance use (prevention and treatment), and youth violence prevention.South Boston is a neighborhood of approximately 32,000 residents that continues to undergo changes. Historically considered a working class community with a significant number of public housing developments, long-time residents are experiencing increasing rents and/or displacement, along with newer residents as a result of new construction and housing development.Comparative data from the 2000 and 2010 Census indicates a 7% increase in the population, a 5% increase for the 25-34 year old age group, a 9% increase for the age group between 18 and 34 years and decreases in the 5-17 years, and 65-84 years age groups, a 14% increase in the number of residents with a bachelor's degree, and a 6.4% increase in the number of individuals with graduate or professional degrees. Median household incomes increased from $40,865 to $58,611 from 2000 to 2010. The changes in South Boston's demographics are due to the increase in the availability of market and luxury housing. As more new housing becomes available in the Seaport District, the new residents and their social determinants of health will be reflected in future health needs assessments and potentially mask the health needs of long-time residents for whom substance abuse, substance use/mental health issues, and chronic diseases are major health concerns.The priorities for the South Boston community have been to provide support for education and prevention services for asthma, substance use, chronic disease/hepatitis C, and youth violence prevention.South End is immediately south of Tufts Medical Center, adjacent to and in some respects with overlapping borders to Chinatown. It is a neighborhood known for its large Victorian home 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 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.Based upon the 2000 Census, the South End had a population of approximately 35,000 residents, median household income was $51,870, and the major racial/ethnic groups were: White (49.5%), Black/African American (17.1%), Hispanic/Latino (16.6%) and Asian (13.9%).The two leading health issues/causes of death for Asians, Black and Latinos were cancer and diseases of the heart. For Asians, the third leading cause of death was cerebrovascular disease, while other injuries represented the third leading cause of death for Blacks and Latinos. For Whites, the leading cause of death was diseases of the heart, followed by cancer and other injuries. Diabetes hospitalizations for South End residents was greater than the average incidence, Blacks experienced the highest incidence of emergency department visits for children under the age of 5, while Latinos experienced the second highest incidence of asthma related emergency department visits for children under the age of 5, Blacks accounted for the highest number of substance abuse deaths and Asians experienced the highest rate of cerebrovascular disease deaths.(see continuation later)
Part VI, Line 5: In addition to providing financial resources to community-based health and service organizations to provide educational, prevention and treatment to address health issues specific to their constituents, Tufts MC advances its commitment to the health of its patient and priority communities, through hospital-based efforts to address specific diseases for specific populations, such as clinics established to meet the needs of non-native English speakers, screenings and workshops for populations with critical health disparities, a collaboration with the Conference of Boston Teaching Hospitals to deepen and expand the impact of each institution's community benefits activities, participation in community coalitions in their efforts to preserve community assets and advance the health of the community, with health being defined broadly beyond the health of individuals to include the 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.(see continuation later)
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 AND FLOATING HOSPITAL FOR CHILDREN 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 AND FLOATING HOSPITAL 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 AND FLOATING HOSPITAL MAKE 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 AND FLOATING HOSPITAL PROVIDE 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 (continued): Care to Boston Residents and Surrounding Communities:Tufts Medical Center believes that caring for our community happens both within and outside the walls of the institution. A great deal of data has shown that many barriers exist which hinders patient access to high quality health care. To remove the barriers and increase access to hospital services the Medical Center continues a long standing commitment to increase 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 the hospital 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 the capability to deliver patient-centered services consistent with the needs and expectations of various cultures.
Part Vi, Line 5: (continued) Community Benefit PrioritiesEvery three years Tufts MC conducts a Community Health Needs Assessment (CHNA) to identify and prioritize health needs of our priority communities and to guide our community health improvement efforts. Tufts MC's 2016 CHNA reviewed multiple sources of data including health data from the Boston Public Health Commission's (BPHC) "Health of Boston" reports and available neighborhood-specific reports from the BPHC, census data, Tufts MC patient data, informant interviews with key community stakeholders, and other relevant social determinants of health data such as employment and socioeconomic information. Guided by the 2016 CHNA, Tufts MC focused resources in Chinatown, Dorchester, South Boston, and the South End. Health data for the communities was summarized and then reviewed and approved by members of the Medical Center's senior leadership and Tufts MC's Board of Governors. Tufts MC has in place community advisory committees to further guide two of its community health initiatives, the Asian Health Initiative (AHI) and the Dorchester Health Initiative (DHI), each of which is comprised of representatives from the community, representatives from public health and representatives from Tufts MC. Based on review of available data, thoughtful discussion, and knowledge of the respective communities, Tufts MC identified three significant health priorities. Tobacco Use Cessation, Education and Prevention The 2016 CHNA identified tobacco use as a primary health concern in Boston, especially within the Asian and Asian American community and those residing in the Chinatown neighborhood. The Boston Public Health Commission's Health of Boston 2014-2015 report identified cancer as the leading cause of death among Boston's Asian population from 2008-2012, and lung cancer as the leading type of cancer death. In addition to the numerous health risks associated with tobacco use and second hand smoke exposure, community members expressed concerns about tobacco-related litter and tobacco advertisements targeting youth. Tufts MC addressed this challenging and pervasive health issue through departmental programs and by supporting area nonprofit organizations' tobacco use cessation, education, and prevention programs as part of its AHI. AHI programs support the whole health of, and reach a broad spectrum of, the community where they live and work. The AHI also promotes social service programs, education, and healthcare, for all ages, from kids and adolescents to adults and seniors. With support from and in partnership with Tufts MC's AHI, Josiah Quincy Elementary School introduced tobacco education curriculum for its 3rd, 4th and 5th grade students led by a full-time health educator. Over 400 students learned about the dangers of tobacco use and nicotine addiction over the course of four months, and their families attended evening health events where they were offered smoking cessation resources and education. After just one semester of the curriculum, 98% of the students were able to identify the addictive properties of tobacco, the health risks of all tobacco products, and the benefits of being tobacco free. The Boston Asian Youth Essential Service implemented a tobacco education program for Chinatown teenagers, who are at a critical and vulnerable age for picking up smoking since they are susceptible to peer pressure and external influences. The program engaged 13 teenagers in an intensive tobacco education series intended to train the teens to be peer educators. The teen cohort then created presentations, quizzes, games, and displays to educate their fellow Chinatown teens about the dangers of tobacco use, harmful cigarette ingredients, and how to identify and resist tobacco marketing aimed at youth. The teens reached over 700 individuals through their awareness campaign and distributed 950 anti-smoking materials and items in FY2017. For active smokers, the Asian American Civic Association (AACA) and the Rose Kennedy Greenway Conservancy (Greenway) partnered to target tobacco use and the resulting cigarette-butt induced litter in the popular Mary Soo Hoo Park in Chinatown, by referring smokers in the park and the larger community to smoking cessation resources. The Greenway posted information to discourage smoking in the park; AACA identified active smokers, offering them nicotine replacement therapy, group counseling, and one-on-one case management. Tobacco use cessation can be a long and challenging process; AACA is playing a critical role in the Chinatown community by providing consistent, personalized support for those on the road to quitting. Three program participants have reported quitting successfully with no relapses since engaging in the program. In a designated area of the Mary Soo Hoo Park, the number of cigarette butts dropped from 9.6 per visit to 5.75 per over a three-month period. The Asian American Civic Association's Sampan biweekly community newspaper disseminated bilingual tobacco-related health articles to its readership to provide education about the health risks associated with tobacco and nicotine. Sampan consolidated its first six months of tobacco-related health articles into a booklet distributed around Chinatown to educate residents about tobacco and will continue to do so for the duration of the current initiative. Sampan estimated that it reached 24,000 readers per issue in FY2017, and received approximately 10,000 website hits per month as well.The Boston Chinatown Neighborhood Center implemented the Smoke-Free Chinatown program, an agency-wide effort to directly engage members of the Chinatown community in educational activities on the health effects of smoking and smoking cessation resources. The program provided tobacco education and prevention information to 166 participants in its existing programming for children, adults, and seniors in FY2017. The Greater Boston Chinese Golden Age Center's Smoke-Free Living Program provided eight workshops to 200 Chinese American seniors at senior housing centers to help them understand the problems of tobacco usage and its negative effects on the body. Workshop attendees were able to refer education and cessation services to other tobacco users, including family members and friends.
Part Vi, Line 5 CONTINUED: Asthmatic youth with smokers in the household are susceptible to exposure to second hand smoke, a common environmental trigger of asthma. Tufts MC's Asthma Prevention and Management Initiative (APMI) provided asthma education classes at Josiah Quincy Elementary School to teach students about proper medication use and strategies to minimize exposure to asthma triggers, including second hand smoke. Physicians at Tufts MC also referred asthma cases to APMI who they felt would benefit from home visits, inpatient and/or outpatient clinic education. APMI offered home visits to identify asthma triggers in the home or discussed through hospital-based education In FY2017, 41% of patients who received home visits had a smoker living in the home, potentially exacerbating the patients' asthma. Families with smokers in the household were given recommendations for reducing the patients' exposure to second hand smoke and referred to tobacco cessation resources. Substance Use Prevention and Treatment The 2016 Community Health Needs Assessment identified substance use disorder as a primary health concern across Boston, particularly in Dorchester and South Boston neighborhoods. Tufts MC has worked with impacted communities to establish and support substance use prevention and treatment programs since the early 1990s, and has increased its support in response to the re-emerging opioid crisis, via its Dorchester and South Boston health funding initiatives, departmental programs, and health center support. With support from the Dorchester Health Initiative (DHI) six programs addressed youth violence prevention and wellness, including those aimed to promote an understanding of the harms of substance abuse. Codman Square Health Center focused more exclusively on substance use programming and added a Community Health Worker, who connects patients to local resources and assists patients in navigating services for prevention and treatment. The Community Health Worker assisted over 180 patients seeking substance use treatment and other social and community resources in the Codman Square neighborhood of Dorchester in FY2017. Tufts MC continued to support Gavin Foundation's Cushing House for Boys in South Boston. The Cushing House is a residential substance use treatment program for young men who are unable to be served in a less restrictive environment. The program implements a holistic approach to substance use treatment, emphasizing physical and emotional health support to target the underlying issues that may influence substance use and other risky behaviors. The program served 50 young men in the residential program; 46% of residents achieved 6 months or more free from alcohol and other substances in FY2017. Tufts MC's support of South Boston Community Health Center's Office-Based Opioid Treatment facilitated screening and identification of 144 patients taking narcotics for substance use disorder and referral of patients to a licensed alcohol and drug counselor on staff. In some cases, patients self-referred to the treatment program as well. The program had success with gradually decreasing the number of patients on chronic opioids with strict monitoring and follow-up. Tufts MC's South Boston Behavioral Health outpatient walk-in clinic provides comprehensive evaluation and treatment for adults and children for an array of psychiatric issues and substance use disorders. Its Opioid Dependence Treatment Program provided youth patients with medication-assisted treatment with buprenorphine-naloxone, individual counseling, and treatment of comorbid psychiatric issues. The program provided this critical treatment for 19 young men and women in FY2017. Additionally, the Psychiatry department provided support and treatment for adults with substance use disorder and mental health issues. The outpatient services included individual, group, and medication management treatment services as well as suboxone treatment for opiate-addicted individuals. The clinic offered these services to 1,300 individuals in FY2017.Youth Violence PreventionOur 2016 Community Health Needs Assessment also identified youth violence as a health concern particularly in Dorchester, where the rates of non-fatal gunshot/stabbing emergency department visits and of homicides are more than double the city-wide rates. Tufts MC responded to these concerns with community partnerships through our Dorchester Health Initiative (DHI) and internal youth violence prevention programming to offer alternate paths, safe spaces, positive role models, and improved police-youth relations for local youth. With support from Tufts MC's DHI, Boys & Girls Clubs of Dorchester and Sportsmens' Tennis and Enrichment Center provided youth programming for children and teens in Dorchester neighborhoods. In addition to mentoring, physical activity, and after school and summer programming, both organizations included activities in partnership with members of the Boston Police Department, in order to foster trust and positive relationships between Dorchester youth and police. More than 1,700 Dorchester youth and teens benefitted from programs at the two organizations in FY2017. Neponset Health Center focused on educating teenage male athletes about relationship violence. The Coaching Boys into Men program recruited high school athletic coaches in Dorchester schools to provide ongoing skill building and role-modeling to students participating in sports, reaching a total of 30 students who may have otherwise been bystanders and/or potential perpetrators of violence in FY2017. The Salvation Army's Kroc Center's Bridging the Gap Between Youth and Community Services program is a life skills diversion program that provides safe alternatives to violent and risky behavior for court-involved youth between the ages of 12 and 18. The program focuses on reducing the risk factors and increasing protective factors for youth at high-risk for experiencing violence in their lives, reducing the potential for youth to re-offend, and reducing the number of youth in the juvenile justice system by providing them with the tools to achieve a more promising future. In FY2017, the program achieved a 75% success rate in youth who did not reoffend within one year of completing the program. DotHouse Health grew its popular Generation Next Academy program for Dorchester teens by adding behavioral health support around violence and addiction, supporting summer work opportunities for teens, and expanding its media arts program to engage teens in self-reflective media and journaling. In FY2017, 62 teens were assisted in obtaining summer employment and improved their interviewing and presentation skills. DotHouse also held 24 group sessions with a behavioral health clinician and offered one-on-one sessions for teens.Tufts Medical Center provided in-house programming to respond to social determinants of health that may impact the community's youth, providing employment and learning opportunities in a safe space, within the hospital and nonprofit community settings. The high school summer internship program helped students to stay out of troubled environments by giving them an opportunity to earn money and develop new skills. In FY2017, 39 Boston Public School high school students interned in departments across the Medical Center. The internship program provided youth with the opportunity to explore different career opportunities in the health care field while learning from positive role models and mentors in the workplace. Other Community Benefit ProgrammingThe 2016 CHNA also identified that the South End neighborhood's most vulnerable populations include linguistic minorities (Chinese and Spanish speakers), whose incomes fall well below the median household income and for whom cancer and diseases of the heart are the leading causes of death. In FY2017, the South End Community Health Center focused on increasing health knowledge and prevention, and supported at-risk individuals with screenings and access to early treatment to improve health outcomes for cancer, heart disease and diabetes. Additionally, through our youth internship program, asthma education, AHI and other Chinatown partnerships we provided education and treatment services to Chinese-speaking residents in the South End. We served 62,571 individuals in FY2017 through community benefits programs. In addition to the three major health priorities of smoking, substance use disorder, and youth violence described earlier, chronic diseases and health disparities were also issues of concern in our CHNA, which were addressed through hospital- and community-based programs. Below is a snapshot of our other community benefit programs.
Part Vi, Line 5 CONTINUED: FY2017 Community Benefits by the Numbers 2,442 - Patients and community members received maternal and infant health services including screenings and prenatal, intrapatrum and postpartum care. 8,973 - Formerly uninsured patients received proactve assistance in identifying and enrolling in appropriate insurance coverage. 1,968 - Community members received free blood pressure screenings and educational materials about cardiovascular health. 73 - Patients received proactive interventions at South Cove Manor following hospitalization in order to prevent readmission. 267 - Patients and community members received cancer screenings and cancer survivorship care, including prevention and detection of new and recurring cancers. 57 - Patients and community members received services for kidney diseases, including home blood pressure monitors for uninsured patients. 23,147 - Patients received translation and intrepretation services while receiving care at Tufts Medical Center. 779 - Community members received social services including housing assistance and SNAP enrollment through the Asian American Civic Association's Multi-Service counselor. 2,804 - Community Members including youth, received mental health and psychiatry services through community benefit programming. 1,894 - Patient and Community members participated in asthma education and management programs, including home visits, inpatient education, and school-based asthma classes. 428 - Patients with complex and chronic diseases received free specialty medications through Tufts Medical Center's Pharmacy co-pay assistance program. 348 - Job seekers attended a Tufts Medical Center career fair, 78% of whom were referred from a partner community organization. 80 - Patients and community members participated in diabetes screenings and management programs, inclding self-management classes. 117 - Community members in underserved populations received proactive opthalmology services including vision tests and screenings for eye diseases. Addressing Community Health Concerns in FY2018 In FY2018, Tufts MC will continue to support the priorities identified in the 2016 Community Health Needs assessment, including the ongoing AHI, DHI, and departmental programs targeting substance use disorder, tobacco use, and youth violence. In addition, Tufts MC will be preparing to conduct research for its 2019 Community Health Needs assessment to determine current and emerging health concerns in Chinatown, Dorchester, South Boston, and the South End.
Schedule H (Form 990) 2016
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