2022-08-15T11:52:01-05:00 2021-09-30 263753134 CBIZ MHM LLC 500 BOYLSTON STREET BOSTON MA 02116 990 2020-10-01 472250732 WELLFORCE INC WELL 9789422220 800 DISTRICT AVENUE NO 520 BURLINGTON MA 01803 SUSAN GREEN EXEC. VP AND CFO 9789422220 2022-08-12 1 SUSAN GREEN XXX-XX-XXXX BRENDA L BOOTH P01342395 6177610600 2022-08-12 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z MICHAEL DANDORPH 800 DISTRICT AVENUE NO 520 BURLINGTON MA 01803 918614 0 X WWW.TUFTSMEDICINE.ORG X 2014 MA CARE INTEGRATION, POPULATION HEALTH MANAGEMENT, PATIENT ACCESS AND OPERATIONAL PERFORMANCE. 13 11 76 24 28139 27139 0 0 503640 794875 26511 123739 0 0 530151 918614 6000 0 0 0 11840237 11780730 0 0 0 11003165 9376618 22849402 21157348 -22319251 -20238734 334551155 254762428 222997074 160634596 111554081 94127832 X HEALTHCARE IS TRANSFORMING AS IT CONTINUES TO RESPOND TO NUMEROUS PRESSURES (I.E., REIMBURSEMENT REDUCTIONS; GOVERNMENT MANDATES; SYSTEM CONSOLIDATION; TECHNOLOGY AND RETAIL ENTRANTS). WELLFORCE IS RESPONDING PROACTIVELY TO ADDRESS THESE PRESSURES AND POSITION THE HEALTH SYSTEM TO:DELIVER ON ITS MISSION: TO RELENTLESSLY FOCUS ON HELPING PEOPLE ACHIEVE BETTER HEALTH.REALIZE ITS VISION: TO CREATE A HEALTHIER SYSTEM OF CARE THAT ANTICIPATES PEOPLE'S NEEDS AND IS CONSTANTLY INNOVATING TO DELIVER HIGH-QUALITY, AFFORDABLE CARE LOCALLY AND CONVENIENTLY.INTERNALIZE ITS VALUES:-COLLABORATION-RESPECT-INNOVATION-SERVICE-EXCELLENCE 0 0 8012816 794875 TUFTS MEDICAL CENTER PARENT, INC. AND CONSOLIDATED AFFILIATES ("TUFTS MC"), CIRCLE HEALTH, INC. AND CONSOLIDATED AFFILIATES ("CIRCLE HEALTH"), MELROSEWAKEFIELD HEALTHCARE, INC. AND CONSOLIDATED AFFILIATES, FORMERLY HALLMARK HEALTH CORPORATION ("MELROSEWAKEFIELD"), AND HOME HEALTH FOUNDATION, INC. AND ITS AFFILIATES ("HHF") ARE THE MEMBERS OF WELLFORCE, INC. ("WELLFORCE"), WHICH IS HEREINAFTER REFERRED TO AS THE "SYSTEM". THE SYSTEM REPRESENTS A UNIQUE MODEL THAT SERVES THE HEALTH NEEDS OF COMMUNITIES WHILE ENHANCING THE AFFORDABILITY OF CARE. THE SYSTEM FOCUSES ON CARE INTEGRATION, POPULATION HEALTH MANAGEMENT, PATIENT ACCESS, AND OPERATIONAL PERFORMANCE.WELLFORCE IS DESIGNED TO ENHANCE THE DELIVERY OF PATIENT-CENTERED CARE AND IMPROVE ACCESS TO HIGH-QUALITY, CLINICALLY INTEGRATED HEALTHCARE SERVICES FOR PATIENTS THROUGHOUT MANY COMMUNITIES IN THE COMMONWEALTH OF MASSACHUSETTS. WELLFORCE IS WORKING TO FACILITATE IMPLEMENTATION OF A COMMON, COORDINATED APPROACH, ACROSS THE THREE AFFILIATING HEALTH CARE SYSTEMS, TO POPULATION HEALTH MANAGEMENT. THIS WILL ALLOW FOR INNOVATION IN CARE MANAGEMENT MODELS, DISSEMINATION OF BEST PRACTICES, SHARED INFRASTRUCTURE AND INFORMATION SYSTEMS, AND INCREASED SCALE TO SERVE A GREATER POPULATION BASE. THE ROLE OF WELLFORCE FOR TUFTS MC, CIRCLE HEALTH, MELROSEWAKFIELD AND HHF WILL FACILITATE RATIONALIZING CARE DELIVERY TO ASSURE THAT SERVICES ARE PROVIDED IN THE MOST EFFICIENT SETTING, WITH INCENTIVES FOR CLOSE COLLABORATION AMONG PHYSICIANS, FACILITIES AND OTHER HEALTH CARE PROVIDERS. THE ROLE OF WELLFORCE WILL ALSO SERVE TO FOSTER EFFECTIVE CLINICAL INTEGRATION ACROSS THE CONTINUUM OF CARE, INCLUDING IMPLEMENTING STRATEGIES PROMOTING RISK-SHARING AND HIGH PERFORMANCE OUTCOMES. THROUGH WELLFORCE, TUFTS MC, CIRCLE HEALTH, MELROSEWAKFIELD AND HHF WILL DEFINE A COMMON SET OF RESPONSIBILITIES THAT HONORS THEIR RESPECTIVE AUTONOMY WHILE PROMOTING A COLLABORATIVE AND COMPREHENSIVE FUTURE-LOOKING STRATEGIC VISION PROACTIVELY RESHAPING HOW HEALTH CARE IS PROVIDED.WELLFORCE CARE PLAN, LLC IS AN ACCOUNTABLE CARE ORGANIZATION FORMED FOR THE PURPOSE OF ENTERING INTO AN AGREEMENT WITH A MANAGED CARE ORGANIZATION TO PARTICIPATE COLLECTIVELY IN THE MASSHEALTH ACCOUNTABLE CARE ORGANIZATION PROGRAM. 8012816 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 754 0 1 76 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 13 11 0 0 1 0 0 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MA X X SUSAN GREEN 9789422220 800 DISTRICT AVE BURLINGTON MA 01803 MICHAEL DANDORPH PRESIDENT & CEO 49.00 1.00 X X 1514157 0 32232 PATRICIA CAMPBELL TRUSTEE 1.00 0.00 X 0 0 0 MICHELE CRAGE TRUSTEE 1.00 1.00 X 0 0 0 DAVID CRISS TRUSTEE 1.00 39.00 X 0 199582 3167 GARY CAMPBELL CHAIR 1.00 1.00 X X 0 0 0 DAMIAN FOLCH TRUSTEE 1.00 0.00 X 0 0 0 ANTHONY MONACO TRUSTEE 1.00 0.00 X 0 0 0 SCOTT COLLINS TRUSTEE 1.00 1.00 X 0 0 0 RAYMOND ANSTISS JR TRUSTEE 1.00 1.00 X 0 0 0 JEFFREY SHAMES TRUSTEE 1.00 0.00 X 0 0 0 GENIA LONG TRUSTEE 1.00 1.00 X 0 0 0 CLARISSA YANG MD TRUSTEE 1.00 39.00 X 0 651766 16437 CHRISTOPHER VINCZE TRUSTEE 1.00 0.00 X 0 0 0 PAUL BARDARO TRUSTEE (UNTIL FEB. 2021) 1.00 1.00 X 0 0 0 PETER BATES MD TRUSTEE (UNTIL FEB. 2021) 1.00 1.00 X 0 0 0 JOSEPH CAMPANELLI TRUSTEE (UNTIL FEB. 2021) 1.00 1.00 X 0 0 0 JOHN CARSON PH D TRUSTEE (UNTIL FEB. 2021) 1.00 1.00 X 0 0 0 JACK CLANCY TRUSTEE (UNTIL FEB. 2021) 1.00 1.00 X 0 0 0 K ERIC HENRIKSON MD TRUSTEE (UNTIL FEB. 2021) 1.00 6.00 X 0 0 0 JAMES HERRINGTON TRUSTEE (UNTIL FEB. 2021) 1.00 0.00 X 0 0 0 JOHN KEENAN TRUSTEE (UNTIL FEB. 2021) 1.00 0.00 X 0 0 0 JOSEPH PENNACCHIO MD TRUSTEE (UNTIL FEB. 2021) 1.00 42.00 X 0 486485 28076 DAVID PICKUL MD TRUSTEE (UNTIL FEB. 2021) 1.00 0.00 X 0 0 0 NAOMI PRENDERGAST TRUSTEE (UNTIL FEB. 2021) 1.00 1.00 X 0 0 0 PETER ROMAN MD TRUSTEE (UNTIL FEB. 2021) 1.00 0.00 X 0 0 0 SUSAN M SANDBERG TRUSTEE (UNTIL FEB. 2021) 1.00 42.00 X 0 767143 37182 ROBERT SWANSON TRUSTEE (UNTIL FEB. 2021) 1.00 0.00 X 0 0 0 MICHAEL TARNOFF MD TRUSTEE (UNTIL FEB. 2021) 1.00 39.00 X 0 936578 35372 JOSEPH WHITE TRUSTEE (UNTIL FEB. 2021) 1.00 49.00 X 0 1049758 23820 ELLEN ZANE CHAIR (UTNIL FEB. 2021) 1.00 2.00 X X 0 0 0 WILLIAM SHICKOLOVICH EXEC. VP & CIO (UNTIL SEPT. 2020) 49.00 1.00 X 729726 0 103279 JEFFREY WEINSTEIN ESQ EXEC. VP & GENERAL COUNSEL & SEC. 49.00 1.00 X 626878 0 39409 DEBORAH JOELSON EXEC. VP & CSO (UNTIL DEC. 2020) 49.00 1.00 X 588505 0 47008 SUSAN GREEN EXECUTIVE VP & CFO 49.00 1.00 X 818747 0 40823 SABRINA GRANVILLE CHIEF HUMAN RESOURCE OFFICER 38.00 12.00 X 356652 118885 29839 MICHAEL WAGNER MD CHIEF PHYSICIAN EXECUTIVE 49.00 1.00 X 1178641 0 184679 CHARLES WHIPPLE SR. VP, DEPUTY GENERAL COUNSEL & SEC. 1.00 39.00 X 0 361220 40435 JEFFREY GROSS SR. VP, BUSINESS DEVELOPMENT 30.00 20.00 X 200402 133601 79162 CHRISTOPHER JOHNSON SR. VP, SUPPLY CHAIN (UNTIL MAY 2021) 49.00 1.00 X 304539 0 43747 SYED SHAFIQUR RAB EXEC VP, CHIEF DIGITAL TRANS OFFICER & CIO 49.00 1.00 X 226235 0 6258 JOHN GUGLIOTTA VP, SUPPLY CHAIN 40.00 0.00 X 270609 0 38327 JOSEPH GARBIEL DIR. OF TALENT ACQUISITION 40.00 0.00 X 265242 0 14894 MICHAEL NICKEY VP, PUBLIC PAYER STRATEGY 40.00 0.00 X 294591 0 25333 BROOKE TYSON-HYNES STRATEGIC COMM. CONSULTANT 25.00 25.00 X 209040 0 0 DUDLEY ABBE SR. VP, BUSINESS DEVELOPMENT 40.00 0.00 X 356163 0 67393 MICHAEL APKON MD TRUSTEE (UNTIL SEPT. 2020) 1.00 49.00 X 0 1960571 196160 PAUL SUMMERGRAD MD TRUSTEE (UNTIL FEB. 2020) 1.00 39.00 X 0 506685 38447 7940127 7172274 1171479 24 1 1 0 ALVAREZ & MARSAL HEALTHCARE IND GROUP 260 FRANKLIN STREET SUITE 210 BOSTON MA 02110 MANAGEMENT CONSULTING 1699255 CENTER FOR APPLIED RESEARCH INC 4001 SOUTH DAHLIA STREET ENGLEWOOD CO 80113 CONSULTING 1462032 VISANTE INC 101 EAST FIRTH STREET 2220 ST PAUL MN 55101 CONSULTING 871804 HURON CONSULTING SERVICES LLC 100 HIGH ST 2301 BOSTON MA 02110 CONSULTING 758936 SULLIVAN COTTER INC 300 TRADECENTER SUITE 5690 WOBURN MA 01801 INTEGRATED WORKFORCE STRATEGIES 387810 5 HEALTH CARE SERVICES 621300 794875 794875 794875 123739 28139 95600 918614 794875 28139 95600 X 7762832 7762832 3233579 3233579 296822 87283 209539 191490 56309 135181 296007 87043 208964 243542 243542 272120 272120 6544618 3408369 3136249 93851 93851 433010 433010 100001 100001 44381 44381 79119 79119 DUES & FEES 1034706 1034706 BANK & MERCHANT FEES 119314 119314 DEVELOPMENT & TRAINING 38509 38509 BOOKS & SUBSCRIPTIONS 26408 26408 347039 347039 21157348 8012816 13144532 0 6175640 7462619 18214 66816 475932 1028701 430378 111149 532045 225543 440080 306502 323721796 243025292 3289115 2761349 334551155 254762428 69723976 82768736 153273098 77865860 222997074 160634596 X 111554081 94127832 111554081 94127832 334551155 254762428 X -20238734 2812485 X 0 1 X 1 0 X X 3 THE LOWELL GENERAL HOSPITAL 042103590 3 1 0 0 TUFTS MEDICAL CENTER INC 043400617 3 1 0 0 MELROSEWAKEFIELD HEALTHCARE INC 042767880 3 1 0 0 3 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 SECTION A. ALL SUPPORTING ORGANIZATIONS EFFECTIVE JANUARY 1, 2018 TUFTS MEDICAL CENTER PARENT, INC. AND CONSOLIDATED AFFILIATES ("TUFTS MC"), CIRCLE HEALTH, INC. AND CONSOLIDATED AFFILIATES ("CIRCLE HEALTH") AND MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION AND CONSOLIDATED AFFILIATES ("MELROSEWAKEFIELD"), BECAME THE FOUNDING MEMBERS OF WELLFORCE, INC. ("WELLFORCE"), WHICH IS HEREINAFTER REFERRED TO AS THE "SYSTEM." WELLFORCE WILL PROVIDE ASSISTANCE IN POPULATION HEALTH MANAGEMENT AS A SUPPORTING ORGANIZATION TO TUFTS MEDICAL CENTER, MELROSEWAKEFIELD, AND THE LOWELL GENERAL HOSPITAL, ALL OF WHICH ARE 501(C)(3) TAX EXEMPT ORGANIZATIONS. THIS WILL ALLOW FOR INNOVATION IN CARE MANAGEMENT MODELS, DISSEMINATION OF BEST PRACTICES, AND SHARED INFRASTRUCTURE AND INFORMATION SYSTEMS. TUFTS MC, MELROSEWAKEFIELD AND THE LOWELL GENERAL HOSPITAL WOULD CARRY OUT THESE ACTIVITIES ON THEIR OWN IF THEY WERE NOT PERFORMED BY WELLFORCE. WELLFORCE IS THE COMMON PARENT, INC. ("TUFTS MC PARENT") CIRCLE HEALTH, INC. ("CIRCLE HEALTH") AND MELROSEWAKEFIELD, ALL 501(C)(3) ORGANIZATIONS. UNTIL SEPTEMBER 30, 2020, EACH OF TUFTS MC PARENT AND CIRCLE HEALTH WILL APPOINT 7 OF THE 22 TRUSTEES OF WELLFORCE, AND THE 22ND TRUSTEE WILL BE APPOINTED BY TUFTS MC PARENT, MELROSEWAKEFIELD AND CIRCLE HEALTH JOINTLY. THEREAFTER, EACH OF TUFTS MC PARENT, MELROSEWAKEFIELD AND CIRCLE HEALTH WILL APPOINT 3 TRUSTEES OF WELLFORCE, AND THE REMAINING TRUSTEES WILL BE ELECTED BY THE TRUSTEES OF WELLFORCE THEN IN OFFICE. WHILE WELLFORCE'S GOVERNING DOCUMENTS DO NOT EXPRESSLY REQUIRE THAT A MAJORITY OF ITS GOVERNING BOARD CONSISTS OF INDIVIDUALS WHO ALSO SERVE ON THE GOVERNING BOARD(S) OF THE SUPPORTED ORGANIZATION(S), WELLFORCE BELIEVES THAT IT MEETS TEST 1 BECAUSE, DURING AN INITIAL TRANSITION PERIOD OF SIX YEARS, A MAJORITY OF ITS CURRENT GOVERNING BOARD ALSO SERVE ON THE GOVERNING BOARD(S) OF THE SUPPORTED ORGANIZATION(S), AND THE APPOINTMENT PROCESS WILL ALLOW FOR A MAJORITY OF THE GOVERNING BOARD TO CONTINUE TO CONSIST OF INDIVIDUALS WHO ALSO SERVE ON THE GOVERNING BOARD(S) OF THE SUPPORTED ORGANIZATION(S). AFTER THE INITIAL TRANSITION PERIOD, (I) THREE OF THE TRUSTEES WILL BE APPOINTED BY CIRCLE HEALTH, (II) THREE OF THE TRUSTEES WILL BE APPOINTED BY TUFTS MC PARENT, (III), THREE OF THE TRUSTEES WILL BE APPOINTED BY MELROSEWAKEFIELD, THE PRESIDENT AND CEO OF WELLFORCE SHALL BE AN EX OFFICIO TRUSTEE, AND (IV) THE REMAINING TRUSTEES SHALL BE ELECTED BY A MAJORITY VOTE OF THE TRUSTEES OF WELLFORCE THEN IN OFFICE. CURRENTLY, A SIGNIFICANT NUMBER OF THE WELLFORCE TRUSTEES ARE ALSO ON THE GOVERNING BOARD OF LGH, MELROSEWAKEFIELD AND TUFTS MC, RESULTING IN MAJORITY WHO ALSO SERVE ON THE GOVERNING BOARD(S) OF THE SUPPORTED ORGANIZATION(S), WITH ONE VACANCY. IN APPOINTING FUTURE TRUSTEES, TUFTS MC PARENT, MELROSEWAKEFIELD, CIRCLE HEALTH AND THE TRUSTEES OF WELLFORCE WILL ENSURE THAT A MAJORITY OF THE TRUSTEES OF WELLFORCE ALSO SERVE ON THE GOVERNING BOARD(S) OF THE SUPPORTED ORGANIZATION(S). 0 0 0 0 0 0 1 272120 0 0 272120 0 PART II-B, LINE 1(G), DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY: A PORTION OF WELLFORCE'S MASSACHUSETTS HOSPITAL ASSOCIATION (MHA) DUES SUPPORTS LOBBYING ACTIVITIES. THE MHA WORKS ON BEHALF OF THE INDUSTRY TO INFLUENCE MATTERS OF IMPORTANCE TO MASSACHUSETTS HEALTHCARE. 145328 47892 97436 386717 177651 209066 306502 INVESTMENT IN SUBSIDIARY 119905606 F INVESTMENT IN UNCONSOLIDATED AFFILIATE 16329919 F OTHER INVESTMENTS 106789767 F 243025292 DUE TO AFFILIATES 74463359 LEASE LIABILITY 2697392 OTHER LIABILITIES 705109 77865860 3731099 2812485 2812485 918614 0 918614 21157348 0 21157348 0 21157348 PART XI, LINE 2D - OTHER ADJUSTMENTS: INTERENTITY NET ASSET TRANSFERS 2,812,485. X X X X X X 1 1 0 0 0 0 0 1 0 MICHAEL APKON MD TRUSTEE (UNTIL SEPT. 2020) 0 793804 0 500000 0 666767 0 178230 0 17930 0 2156731 0 0 MICHAEL DANDORPH PRESIDENT & CEO 1104636 0 395000 0 14521 0 0 0 32232 0 1546389 0 0 0 MICHAEL WAGNER MD CHIEF PHYSICIAN EXECUTIVE 875149 0 160500 0 142992 0 148388 0 36291 0 1363320 0 126728 0 JOSEPH WHITE TRUSTEE (UNTIL FEB. 2021) 0 795692 0 184449 0 69617 0 8550 0 15270 0 1073578 0 0 MICHAEL TARNOFF MD TRUSTEE (UNTIL FEB. 2021) 0 811673 0 90000 0 34905 0 16625 0 18747 0 971950 0 0 SUSAN GREEN EXECUTIVE VP & CFO 594206 0 109704 0 114837 0 12001 0 28822 0 859570 0 87557 0 WILLIAM SHICKOLOVICH EXEC. VP & CIO (UNTIL SEPT. 2020) 300836 0 75750 0 353140 0 74398 0 28881 0 833005 0 248363 0 SUSAN M SANDBERG TRUSTEE (UNTIL FEB. 2021) 0 619843 0 137700 0 9600 0 14292 0 22890 0 804325 0 0 CLARISSA YANG MD TRUSTEE 0 549561 0 76508 0 25697 0 14250 0 2187 0 668203 0 0 JEFFREY WEINSTEIN ESQ EXEC. VP & GENERAL COUNSEL & SEC. 454496 0 85875 0 86507 0 11924 0 27485 0 666287 0 71200 0 DEBORAH JOELSON EXEC. VP & CSO (UNTIL DEC. 2020) 425264 0 81000 0 82241 0 11560 0 35448 0 635513 0 67200 0 PAUL SUMMERGRAD MD TRUSTEE (UNTIL FEB. 2020) 0 410740 0 53438 0 42507 0 16625 0 21822 0 545132 0 0 JOSEPH PENNACCHIO MD TRUSTEE (UNTIL FEB. 2021) 0 436475 0 0 0 50010 0 8441 0 19635 0 514561 0 0 SABRINA GRANVILLE CHIEF HUMAN RESOURCE OFFICER 266429 88810 53801 17934 36422 12141 6413 2138 15966 5322 379031 126345 0 0 DUDLEY ABBE SR. VP, BUSINESS DEVELOPMENT 300238 0 44627 0 11298 0 34305 0 33088 0 423556 0 0 0 JEFFREY GROSS SR. VP, BUSINESS DEVELOPMENT 166243 110829 25609 17072 8550 5700 27952 18635 19545 13030 247899 165266 2217 1478 CHARLES WHIPPLE SR. VP, DEPUTY GENERAL COUNSEL & SEC 0 306020 0 45600 0 9600 0 8359 0 32076 0 401655 0 0 CHRISTOPHER JOHNSON SR. VP, SUPPLY CHAIN (UNTIL MAY 2021 256745 0 37574 0 10220 0 39204 0 4543 0 348286 0 0 0 MICHAEL NICKEY VP, PUBLIC PAYER STRATEGY 264948 0 29250 0 393 0 1350 0 23983 0 319924 0 0 0 JOHN GUGLIOTTA VP, SUPPLY CHAIN 235229 0 33978 0 1402 0 34218 0 4109 0 308936 0 0 0 JOSEPH GARBIEL DIR. OF TALENT ACQUISITION 224627 0 40424 0 191 0 4443 0 10451 0 280136 0 0 0 SYED SHAFIQUR RAB EXEC VP, CHIEF DIGITAL TRANS OFFICER 148106 0 75000 0 3129 0 0 0 6258 0 232493 0 0 0 BROOKE TYSON-HYNES STRATEGIC COMM. CONSULTANT 189040 0 20000 0 0 0 0 0 0 0 209040 0 3695 0 DAVID CRISS TRUSTEE 0 187082 0 12500 0 0 0 3167 0 0 0 202749 0 0 PART I, LINES 4A-B WILLIAM SHICKOLOVICH RECEIVED SEVERANCE IN THE AMOUNT OF $96,338 DURING CALENDAR YEAR 2020. SECTION 457(F) RETIREMENT PLAN EMPLOYER DEFERRALS: MICHAEL APKON - 169,680 DR. MICHAEL WAGNER, M.D. - $134,400 WILLIAM SCHICKOLOVICH - $64,480 JEFFREY GROSS - $39,077 CHRISTOPHER JOHNSON - $33,880 DUDLEY ABBE - $27,004 JOHN GUGLIOTTA - $26,316 MICHAEL NICKEY - $1,200 PART I, LINE 7 BONUSES ARE PAID AS INDICATED ON SCHEDULE J, PART II. BONUS PAID TO OFFICERS ARE APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD. OTHER BONUSES ARE APPROVED BY THE OFFICERS OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 4 WELLFORCE AMENDED ITS BYLAWS AND THE BYLAWS OF ITS MEMBERS TO UPDATE THE RESERVE POWERS HELD BY WELLFORCE. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES SHALL CONSIST OF MEMBERS OF TUFTS MC PARENT, MELROSEWAKEFIELD HEALTHCARE AND CIRCLE HEALTH. EACH WILL APPOINT 3 TRUSTEES OF WELLFORCE, AND THE REMAINING TRUSTEES WILL BE ELECTED BY THE TRUSTEES OF WELLFORCE THEN IN OFFICE. FORM 990, PART VI, SECTION B, LINE 11B WELLFORCE, INC'S 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM IN ACCORDANCE WITH INFORMATION PROVIDED BY THE FINANCE DEPARTMENT. THE FINANCE DEPARTMENT REVIEWED AND MADE RECOMMENDATIONS BASED UPON THE DRAFT PRIOR TO ITS PRESENTATION TO THE FULL BOARD OF DIRECTORS. BASED UPON THIS REVIEW, THE FINANCE DEPARTMENT FORMED A RECOMMENDATION TO THE BOARD OF DIRECTORS AS TO THE ACCEPTABILITY AND CONTENT OF THE FILING. ALL MEMBERS OF THE BOARD OF DIRECTORS WERE PROVIDED A COPY OF THE COMPLETED 990 BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C WELLFORCE, INC. FOLLOWS THE CONFLICT OF INTEREST POLICY OF LOWELL GENERAL HOSPITAL. ALL TRUSTEES, OFFICERS AND KEY EMPLOYEES SIGN AN ANNUAL CONFLICT OF INTEREST STATEMENT FOLLOWING THE POLICY OF LOWELL GENERAL HOSPITAL AS OUTLINED BELOW: ALL OFFICERS, BOARD MEMBERS, AND KEY EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY. ANY ACTUAL OR POTENTIAL CONFLICTS ARE FORWARDED TO THE COMPLIANCE COMMITTEE FOR CONSIDERATION. IN THE EVENT OF AN ACTUAL OR POTENTIAL CONFLICT, THE CONFLICTED INDIVIDUAL IS PROHIBITED FROM PARTICIPATING IN DELIBERATIONS OR DECISIONS RELATING TO THE MATTER. A COMPLIANCE COMMITTEE MEETING IS HELD EVERY OTHER MONTH TO ADDRESS CONCERNS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CEO AND OTHER OFFICERS FOLLOWS THE PROCESS OF LOWELL GENERAL HOSPITAL AS OUTLINED BELOW: A THIRD PARTY CONSULTANT IS HIRED FOR AN INDEPENDENT ASSESSMENT OF APPROPRIATE SALARY RANGES FOR THE OFFICERS OF THE ORGANIZATION SUCH AS THE CEO, COO, AND CFO. THIS ASSESSMENT IS REVIEWED BY THE COMPENSATION COMMITTEE AND A RECOMMENDATION IS GIVEN TO THE EXECUTIVE COMMITTEE ON SALARY INCREASES AND BONUSES. FORM 990, PART VI, SECTION C, LINE 19 WELLFORCE, INC'S FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE MASSACHUSETTS'S ATTORNEY GENERAL'S WEBSITE. WELLFORCE, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS OR ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE 990 IS AVAILABLE ON THE MASSACHUSETT'S ATTORNEY GENERAL'S WEBSITE AND WWW.GUIDESTAR.ORG. FORM 990, PART IX, LINE 11G PROFESSIONAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 3,408,369. MANAGEMENT AND GENERAL EXPENSES 3,136,249. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,544,618. FORM 990, PART XI, LINE 9: INTERENTITY NET ASSET TRANSFERS 2,812,485. LGH MEDICAL GROUP LLC 295 VARNUM AVE LOWELL MA 01854 205671277 MEDICAL SERVICES MA 0 0 CIRCLE HEALTH PHYSICIANS INC LGH CANCERCARE ASSOCIATES LLC 295 VARNUM AVE LOWELL MA 01854 043483462 MEDICAL SERVICES MA 0 0 CIRCLE HEALTH PHYSICIANS INC CIRCLE HEALTH OBGYN 295 VARNUM AVE LOWELL MA 01854 262057970 MEDICAL SERVICES MA 0 0 CIRCLE HEALTH PHYSICIANS INC LGH MERRIMACK VALLEY CARDIOLOGY ASSOCIATES LLC 295 VARNUM AVE LOWELL MA 01854 452014433 MEDICAL SERVICES MA 0 0 CIRCLE HEALTH PHYSICIANS INC CIRCLE HEALTH URGENT CARE LLC 295 VARNUM AVE LOWELL MA 01854 471122896 MEDICAL SERVICES MA 0 0 CIRCLE HEALTH PHYSICIANS INC CIRCLE HEALTH PHARMACY LLC 295 VARNUM AVE LOWELL MA 01854 001352934 MEDICAL SERVICES MA 0 0 CIRCLE HEALTH PHYSICIANS INC LGH PROFESSIONAL SERVICES LLC 295 VARNUM AVE LOWELL MA 01854 611844933 MEDICAL SERVICES MA 0 0 CIRCLE HEALTH PHYSICIANS INC WELLFORCE CARE PLAN LLC 800 DISTRICT AVE BURLINGTON MA 01803 001274839 ACO MA 0 8247519 WELLFORCE INC MELROSEWAKEFIELD HEALTHCARE INC 170 GOVERNORS AVE MEDFORD MA 02155 042767880 HOSPITAL MA 501(C)(3) LINE 3 MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION 1 HALLMARK HEALTH MEDICAL ASSOCIATES INC 170 GOVERNORS AVE MEDFORD MA 02155 043140938 MD OFFICES MA 501(C)(3) LINE 10 MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION 1 LM LONG TERM CARE SERVICES INC 170 GOVERNORS AVE MEDFORD MA 02155 042938772 LONG-TERM CARE MA 501(C)(3) LINE 12B, II MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION 1 SAVIN LONG TERM CARE CORPORATION 170 GOVERNORS AVE MEDFORD MA 02155 043012616 LONG-TERM CARE MA 501(C)(3) LINE 10 MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION 1 HALLMARK HEALTH VISITING NURSE ASSOCIATION AND HOSPICE INC 178 SAVIN ST SUITE 300 MALDEN MA 02148 042437064 VISITING NURSE MA 501(C)(3) LINE 10 HOME HEALTH FOUNDATION INC 1 HALLMARK HEALTH PROPERTIES 170 GOVERNORS AVE MEDFORD MA 02155 222580542 PROPERTY MA 501(C)(3) LINE 12B, II MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION 1 MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION 170 GOVERNORS AVE MEDFORD MA 02155 042103587 PARENT MA 501(C)(3) LINE 12A, I WELLFORCE INC 1 THE LOWELL GENERAL HOSPITAL 295 VARNUM AVENUE LOWELL MA 01854 042103590 HEALTH CARE MA 501(C)(3) LINE 3 CIRCLE HEALTH INC 1 CIRCLE HEALTH PHYSICIANS INC 295 VARNUM AVENUE LOWELL MA 01854 273902914 MEDICAL SERVICES MA 501(C)(3) LINE 10 CIRCLE HEALTH INC 1 LGH PHYSICIAN ASSOCIATES INC ONE HOSPITAL DRIVE LOWELL MA 01852 043190747 MEDICAL SERVICES MA 501(C)(3) PF CIRCLE HEALTH PHYSICIANS INC 1 CIRCLE HEALTH INC 295 VARNUM AVENUE LOWELL MA 01854 222579798 PARENT/SUPPORTING ORGANIZATION MA 501(C)(3) LINE 12B, II WELLFORCE INC 1 WELLFORCE INC 1600 DISTRICT AVE SUITE 125 BURLINGTON MA 01803 452250732 PARENT/SUPPORTING ORGANIZATION MA 501(C)(3) LINE 12A, I N/A 0 WELLFORCE CLINICALLY INTEGRATED NETWORK 800 DISTRICT AVENUE BURLINGTON MA 01803 871600172 HEALTH CARE MA 501(C)(3) LINE 10 WELLFORCE INC 1 CNS NURSING HOME CARE INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE MA 01843 371836433 HOME CARE SERVICES MA 501(C)(3) LINE 10 CIRCLE HOME INC 1 CIRCLE HOME INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE MA 01843 042103812 HOME CARE SERVICES MA 501(C)(3) LINE 10 HOME HEALTH FOUNDATION INC 1 TUFTS MEDICAL CENTER PARENT INC 800 WASHINGTON STREET BOSTON MA 02111 042810022 FUNDRAISING, ADMIN. 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MA 501(C)(3) LINE 12B, II TUFTS MEDICAL CENTER PARENT INC 1 LOWELL GENERAL HOSPITAL AUXILIARY 295 VARNUM AVENUE LOWELL MA 01854 223459303 SUPPORTING ORGANIZATION MA 501(C)(3) LINE 12A, I N/A 0 CARDIOVASCULAR CENTER AT TUFTS MEDICAL CENTER INC 800 WASHINGTON STREET BOSTON MA 02111 823315703 MEDICAL SERVICES MA 501(C)(3) LINE 10 TUFTS MEDICAL CENTER PHYSICIANS ORG INC 1 HOME HEALTH FOUNDATION INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE MA 01843 222587225 MANAGEMENT SERVICES MA 501(C)(3) LINE 12B, II WELLFORCE INC 1 HOME HEALTH VNA INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE MA 01843 042435675 HOME HEALTH CARE MA 501(C)(3) LINE 10 HOME HEALTH FOUNDATION INC 1 MERRIMACK VALLEY HOSPICE INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE MA 01843 043024278 HOSPICE SERVICES MA 501(C)(3) LINE 10 HOME HEALTH FOUNDATION INC 1 HOME CARE INC 360 MERRIMACK STREET BUILDING 9 LAWRENCE MA 01843 042854358 HOME HEALTH SUPPORTIVE SERIVCES MA 501(C)(3) LINE 10 HOME HEALTH FOUNDATION INC 1 HALLMARK HEALTH INVESTMENTS LLC 170 GOVERNORS AVE MEDFORD MA 02155 020657666 INVESTMENT MA MELROSEWAKEFIELD HEALTHCARE INC EXCLUDED 0 0 MONTVALE PETCT LLC 100 BAYVIEW CIRCLE SUITE 400 NEWPORT BEACH CA 92660 270325022 CAT SCAN DE MELROSEWAKEFIELD HEALTHCARE INC RELATED 0 0 CIRCLE HEALTH ALLIANCE LLC 295 VARNUM AVE LOWELL MA 01854 800782682 ACCOUNTABLE CARE ORGANIZATION MA WELLFORCE CLINICALLY INTEGRATED NETWORK RELATED 0 0 SHIELDS-TUFTS MEDICAL CENTER IMAGING MANAGEMENT LLC 800 WASHINGTON STREET BOSTON MA 02111 320558307 MEDICAL SERVICES (MRI) MA TUFTS MEDICAL CENTER INC RELATED 0 0 HALLMARK HEALTH ENTERPRISES INC 585 LEBANON STREET MELROSE MA 02176 042475660 OTHER HEALTH SERVICES MA MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION C 1 HALLMARK HEALTH PHO INC 170 GOVERNORS AVE MEDFORD MA 02155 461134759 PHYSICIAN HOSPITAL ORGANIZATION MA MELROSEWAKEFIELD HEALTHCARE INC C 0 LAWRENCE MELROSE MEDICAL ELECTRONICS RECORD INC 170 GOVERNORS AVE MEDFORD MA 02155 421685777 ELECTRONIC MEDICAL RECORDS MA MELROSEWAKEFIELD HEALTHCARE INC C 0 LGH MANAGEMENT SERVICES INC 295 VARNUM AVENUE LOWELL MA 01854 042919244 MEDICAL SERVICES MA LGH SERVICES INC C 1 LGH MEDICAL BUILDING SERVICES INC 295 VARNUM AVENUE LOWELL MA 01854 043058954 MEDICAL OFFICE BUILDING MA LGH SERVICES INC C 1 LGH MEDICAL SERVICES INC 295 VARNUM AVENUE LOWELL MA 01854 261889904 MEDICAL SERVICES MA LGH SERVICES INC C 1 LGH SERVICES INC 295 VARNUM AVENUE LOWELL MA 01854 042854673 MEDICAL SERVICES MA CIRCLE HEALTH INC C 1 WELLFORCE INDEMNITY COMPANY LTD 800 WASHINGTON STREET BOSTON MA 02111 980444573 CAPTIVE INSURANCE CJ TUFTS MEDICAL CENTER INC C 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 THE LOWELL GENERAL HOSPITAL R 1654828 BOOK VALUE TUFTS MEDICAL CENTER INC S 1341172 BOOK VALUE MELROSEWAKEFIELD HEALTHCARE INC R 2498828 BOOK VALUE THE LOWELL GENERAL HOSPITAL E 57786750 BOOK VALUE TUFTS MEDICAL CENTER INC E 33876902 BOOK VALUE MELROSEWAKEFIELD HEALTHCARE INC D 16893109 BOOK VALUE HOME HEALTH FOUNDATION INC E 299393 BOOK VALUE NEW ENGLAND QUALITY CARE ALLIANCE D 171493 BOOK VALUE NEQCA ACCOUNTABLE CARE INC E 64917 BOOK VALUE