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        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>1. Donation to establish Worcester Health Equity Fund</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UMass Chan Medical School</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>55 Lake Ave N</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01655</ZIPCd>
        </USAddress>
        <RecipientEIN>043167352</RecipientEIN>
        <IRCSectionDesc>501 (C)(1)</IRCSectionDesc>
        <CashGrantAmt>137444</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>2. Promote the career development of junior faculty</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Community Legal Aid Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>405 Main Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
        </USAddress>
        <RecipientEIN>042446242</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>60000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>3. Support Medical Legal Partnership between Umass Memorial &amp; Community Legal Aid</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UMass Memorial Foundation Inc The</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>333 South Street</AddressLine1Txt>
          <CityNm>Shrewsbury</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01545</ZIPCd>
        </USAddress>
        <RecipientEIN>043108190</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>4. Support Cancer</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Regional Environmental Council Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO Box 255</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01613</ZIPCd>
        </USAddress>
        <RecipientEIN>046364350</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>5. Support to address food insecurity</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Worcester Common Ground Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>5 Piedmont Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01610</ZIPCd>
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        <RecipientEIN>222976657</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>15000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>6. Support to address food insecurity</PurposeOfGrantTxt>
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          <BusinessNameLine1Txt>Marlborough Hospital</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>57 Union Street</AddressLine1Txt>
          <CityNm>Marlborough</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01752</ZIPCd>
        </USAddress>
        <RecipientEIN>042104693</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>15000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>7. Transfer to related organization for golf tournament</PurposeOfGrantTxt>
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          <BusinessNameLine1Txt>HealthAlliance-Clinton Hospital</BusinessNameLine1Txt>
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          <AddressLine1Txt>60 Hospital Road</AddressLine1Txt>
          <CityNm>Leominster</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01453</ZIPCd>
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        <RecipientEIN>042103555</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>12000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>8. Transfer to related organization for golf tournament</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>The Francis Ouimet Scholarship Fund Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>300 Arnold Palmer Boulevard</AddressLine1Txt>
          <CityNm>Norton</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02766</ZIPCd>
        </USAddress>
        <RecipientEIN>042234126</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>9. Support Youth Employment &amp; Education Tuition Awards</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>VNA Care Network Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>016081280</ZIPCd>
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        <RecipientEIN>042103825</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>10. Support for Home Health and Hospice - Worcester Benefit Salute to Nurses</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>The Health Foundation Fund Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>446 Main Street</AddressLine1Txt>
          <AddressLine2Txt>20th Floor</AddressLine2Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
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        <RecipientEIN>043521743</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>11. Support Worcester's Redevelopment</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Worcester Art Museum</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>55 Salisbury Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01609</ZIPCd>
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        <RecipientEIN>041988530</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>12. Support Business Partner Membership at Sponsor Level</PurposeOfGrantTxt>
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      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Worcester State Foundation Inc</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>486 Chandler Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01602</ZIPCd>
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        <RecipientEIN>223248067</RecipientEIN>
        <IRCSectionDesc>501 (c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>13. Support our COVID19 testing, education and outreach program at Worcester State University</PurposeOfGrantTxt>
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      <Total501c3OrgCnt>13</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>EMERGENCY ASSISTANCE SUPPORT FOR EMPLOYEES (EASE). Eligible employees can receive an EASE grant for up to $1,500 to lessen the financial burden caused by an unplanned emergency.</GrantTypeTxt>
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        <CashGrantAmt>20373</CashGrantAmt>
        <ValuationMethodUsedDesc>Book</ValuationMethodUsedDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.</FormAndLineReferenceDesc>
        <ExplanationTxt>AT REASONABLE INTERVALS, RE-EVALUATION OF THE GRANTS WILL OCCUR TO ENSURE THAT THE ARRANGEMENTS ARE EXPECTED TO CONTINUE TO SATISFY THE STANDARD SET FORTH.</ExplanationTxt>
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    </IRS990ScheduleI>
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        <TitleTxt>EXEC VP/COO UMMMG</TitleTxt>
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          <BusinessNameLine1Txt>STEPHEN E TOSI MD</BusinessNameLine1Txt>
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        <TitleTxt>CHIEF PHYSICIAN EXECUTIVE</TitleTxt>
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          <BusinessNameLine1Txt>DIANNA J CAFFARENA</BusinessNameLine1Txt>
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        <TitleTxt>SVP, AMBULATORY SVCS</TitleTxt>
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        <BusinessName>
          <BusinessNameLine1Txt>ERIC J ALPER MD</BusinessNameLine1Txt>
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        <TitleTxt>SVP CQO &amp; CHF INFORMATICS OFF</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>KATHLEEN DRISCOLL</BusinessNameLine1Txt>
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        <TitleTxt>SVP, CHIEF PHILANTHROPHY OFC</TitleTxt>
        <BaseCompensationFilingOrgAmt>296707</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>CATHERINE M ROSSI</BusinessNameLine1Txt>
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        <TitleTxt>VP HEALTH SYSTEM CONTRACTING</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <BusinessName>
          <BusinessNameLine1Txt>ROBIN L SODANO</BusinessNameLine1Txt>
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        <TitleTxt>VP, INFORMATION SYSTEMS</TitleTxt>
        <BaseCompensationFilingOrgAmt>310137</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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          <BusinessNameLine1Txt>ALAN R WESTON</BusinessNameLine1Txt>
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        <TitleTxt>VP, HUMAN RESOURCES</TitleTxt>
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        <TitleTxt>VP, OPD,CHIEF LEARNING OFFICER</TitleTxt>
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        <TitleTxt>VP FINANCE/ASST TREASURER</TitleTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4a Severance or change-of-control payment</FormAndLineReferenceDesc>
        <ExplanationTxt>The following individuals received severance in the reporting period: Included in Sch J Col Biii: Fisher, Barbara $286,476 Weymouth, Deborah $258,924</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUALS RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE REPORTING PERIOD: OFFICERS, DIRECTORS, TRUSTEES: BOLLAND ESHGHI, KATHARINE $39,379 BROWN, DOUGLAS S. $70,832 DICKSON, ERIC W., MD $143,644 FINBERG, ROBERT W., MD $467,040 MELGAR, SERGIO $87,152 SUBTOTAL OFF, DIR, TRUSTEES $808,047 KEY EMPLOYEES: ALPER, MD, ERIC J $32,452 FELDMANN, ROBERT $97,956 LAPRIORE, CHERYL M. $42,715 METZGER, BART $85,514 RANDOLPH, JOHN T. $159,625 CORBETT, WILLIAM, MD $47,260 CYR, JAMES P. $26,733 KARSON, ANDREW $25,691 SHAKMAN, ALICE $33,593 DAY, THERESE $40,111 GREENWOOD, JOHN $32,443 GUSTAFSON, MD, MICHAEL $36,707 ROACH, STEVEN $40,647 STREETER, MICHELE $27,708 TOSI, STEPHEN E., MD $63,893 SALZBERG, JOHN R. $18,580 SUBTOTAL KEY EMPLOYEES $811,628 FORMER: COLOMBO, LISA $104,728 SWENSON, DANA E. $98,340 FISHER, BARBARA $29,774 MULDOON, PATRICK $1,421,276 WEYMOUTH, DEBORAH $38,974 SUBTOTAL FORMER $1,693,092 PARENT TOP 5 HIGHEST PAID: WESTON, ALAN R. $49,008 SODANO, ROBIN L. $25,792 ROSSI, CATHERINE M. $17,503 WIESMAN, TOD G. $13,601 LAROCHE, JUDY A. $15,821 SUBTOTAL TOP 5 HIGHEST PAID $121,725 TOTAL $3,434,492 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE REPORTING PERIOD (no distribution received): KEY EMPLOYEES: DRISCOLL, KATHLEEN BAILEY, JACK W. CAFFARENA, DIANNA J. PRECOURT, JUSTIN</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part II COMPENSATION TO DIRECTORS</FormAndLineReferenceDesc>
        <ExplanationTxt>THE DIRECTORS RECEIVE NO COMPENSATION FOR THEIR ROLE AS DIRECTORS. ALL COMPENSATION RECEIVED RELATES TO THEIR POSITION AS A PHYSICIAN/ADMINISTRATOR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part II Compensation to employees</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation to employees reported in Part VII and Schedule J is paid by UMass Memorial Health Care, Inc. and Affiliates only. Some of our physicians are also employed by the UMass Chan Medical School - University of Massachusetts, an unrelated entity for tax purposes.</ExplanationTxt>
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        <BondIssuedDt>2016-12-07</BondIssuedDt>
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        <PurposeDesc>Series J/Master Lease: purchase and implement new electronic medical record and billing system</PurposeDesc>
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        <PurposeDesc>Series F: to refund (reissue) bonds originally issued 5/22/2009 and reissued 5/21/2015</PurposeDesc>
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        <BondIssuedDt>2017-02-01</BondIssuedDt>
        <IssuePriceAmt>56751941</IssuePriceAmt>
        <PurposeDesc>Series K: to refund (reissue) bonds orig. issued 5/22/2009 &amp; reissued 5/21/2015; reimburse equip</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>45209223</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>125085627</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>341000</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>124744627</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>0</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2017</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <RetiredAmt>4660000</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>25725000</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>0</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>0</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>25725000</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <RetiredAmt>14210000</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>194856159</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>2529172</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>61969810</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>130357177</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2019</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>56926833</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>1026941</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>30174892</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>25725000</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2018</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>true</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>false</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>true</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>D</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 3 ALL</FormAndLineReferenceDesc>
        <ExplanationTxt>DIFFERENCES BETWEEN THE ISSUE PRICE (PART I COLUMN (E)) AND TOTAL PROCEEDS (PART II LINE 3) ARE DUE TO INVESTMENT EARNINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 6 BONDS ISSUED 12/27/2017</FormAndLineReferenceDesc>
        <ExplanationTxt>UNTIL THE REPORTING FOR 9/30/22 (AND THEREAFTER), THE ISSUE PRICE (PART I COLUMN (E) WILL NOT AGREE TO TOTAL EXPENDITURES (PART II, LINES 6-12) DUE TO THE SPECIFIC ACCOUNTING USED FOR THE REFUNDING ESCROW.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part IV, Line 6 BONDS ISSUED 12/27/2017</FormAndLineReferenceDesc>
        <ExplanationTxt>SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleK documentId="IRS990ScheduleK2" softwareId="20011424" softwareVersionNum="2020v4.0">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Massachusetts Development Finance Agency</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>043431814</BondIssuerEIN>
        <CUSIPNum>57584YAH2</CUSIPNum>
        <BondIssuedDt>2017-12-27</BondIssuedDt>
        <IssuePriceAmt>118297225</IssuePriceAmt>
        <PurposeDesc>Series L: to advance refund bonds issued 8/10/2011; reimburse capital costs of equip &amp; other costs</PurposeDesc>
        <DefeasedInd>false</DefeasedInd>
        <OnBehalfOfIssuerInd>false</OnBehalfOfIssuerInd>
        <PoolFinancingInd>false</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>0</RetiredAmt>
        <BondDefeasedAmt>0</BondDefeasedAmt>
        <TotalProceedsAmt>121004570</TotalProceedsAmt>
        <InReserveFundAmt>0</InReserveFundAmt>
        <CapitalizedInterestAmt>0</CapitalizedInterestAmt>
        <RefundingEscrowAmt>0</RefundingEscrowAmt>
        <IssuanceCostsFromProceedsAmt>1549482</IssuanceCostsFromProceedsAmt>
        <CreditEnhancementAmt>0</CreditEnhancementAmt>
        <WorkingCapitalExpendituresAmt>0</WorkingCapitalExpendituresAmt>
        <CapitalExpendituresAmt>92707345</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>26747743</OtherSpentProceedsAmt>
        <UnspentAmt>0</UnspentAmt>
        <SubstantialCompletionYr>2021</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>false</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>true</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>true</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>true</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>false</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.0</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.0</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.0</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>false</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>false</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>true</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>false</Form8038TFiledInd>
        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
        <NoRebateDueInd>false</NoRebateDueInd>
        <VariableRateIssueInd>false</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>false</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>false</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>true</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="20011424" softwareVersionNum="2020v4.0">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Substantial Contributor</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
        <TransactionAmt>17018655</TransactionAmt>
        <TransactionDesc>Independent Contractor Arrangement, donation of $50,000</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Substantial Contributor</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
        <TransactionAmt>10896018</TransactionAmt>
        <TransactionDesc>Independent Contractor Arrangement, donation of $9,500</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Substantial Contributor</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
        <TransactionAmt>5883360</TransactionAmt>
        <TransactionDesc>Independent Contractor Arrangement, donation of $5,000</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Substantial Contributor</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
        <TransactionAmt>4405299</TransactionAmt>
        <TransactionDesc>Independent Contractor Arrangement, donation of $5,000</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Substantial Contributor</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
        <TransactionAmt>3091736</TransactionAmt>
        <TransactionDesc>Independent Contractor Arrangement, donation of $50,000</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Substantial Contributor</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
        <TransactionAmt>581595</TransactionAmt>
        <TransactionDesc>Independent Contractor Arrangement, donation of $10,000</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Substantial Contributor</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
        <TransactionAmt>263196</TransactionAmt>
        <TransactionDesc>Independent Contractor Arrangement, donation of $5,000</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <BusinessName>
            <BusinessNameLine1Txt>Substantial Contributor</BusinessNameLine1Txt>
          </BusinessName>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Substantial Contributor</RelationshipDescriptionTxt>
        <TransactionAmt>149561</TransactionAmt>
        <TransactionDesc>Independent Contractor Arrangement, donation of $7,500</TransactionDesc>
        <SharingOfRevenuesInd>false</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="20011424" softwareVersionNum="2020v4.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHANCELLOR OF THE UMASS CHAN MEDICAL SCHOOL HAS CONTROL OVER 4 TRUSTEE SEATS OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>There are no committees with authority to act on behalf of the governing body, thus the "no" response for Part VI, Line 8b. THE ORGANIZATION DOCUMENTS THE BOARD AND COMMITTEE MEETINGS BY TAKING MINUTES, WHICH INCLUDE ALL MEETING DISCUSSIONS AND ACTIONS. THESE WRITTEN MINUTES ARE THEN APPROVED AT THE FOLLOWING BOARD AND COMMITTEE MEETINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>SECTIONS OF THE CORE FORM 990 RELATED TO EXECUTIVE COMPENSATION AND SCHEDULE J RELATED TO EXECUTIVE COMPENSATION IS REVIEWED IN DETAIL WITH THE ORGANIZATION'S BOARD COMPENSATION COMMITTEE WHICH OVERSEES ALL UMASS MEMORIAL HEALTH CARE EXECUTIVE COMPENSATION. THE ORGANIZATION'S AUDIT &amp; COMPLIANCE COMMITTEE REVIEWS ALL CONTENT ASSOCIATED WITH SCHEDULE L. THE ORGANIZATION'S COMMUNITY BENEFITS COMMITTEE (THAT OVERSEES ALL BOARDS) REVIEWS ALL CONTENT ASSOCIATED WITH SCHEDULE H. THE AUDIT &amp; COMPLIANCE COMMITTEE OF THE BOARD REVIEWS THE FORM 990 AND RECOMMENDS THE FORM 990 TO THE FULL BOARD FOR APPROVAL. THE FULL BOARD IS GIVEN ACCESS TO THE FORM 990. CROWE (TAX PREPARERS) PRESENTS THE FORM 990 TO THE AUDIT &amp; COMPLIANCE COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CONFLICT OF INTEREST POLICY REQUIRES BOARD MEMBERS AND MANAGEMENT TO COMPLETE ANNUAL DISCLOSURE STATEMENTS AND, TO UPDATE THESE DISCLOSURE STATEMENTS FOR SIGNIFICANT CHANGES IN THEIR OUTSIDE GOVERNANCE AND PROFESSIONAL ACTIVITIES OR, FINANCIAL RELATIONSHIPS AS APPROPRIATE. ADDITIONALLY, ALL TRANSACTIONS INVOLVING BOARD MEMBERS OR MANAGEMENT AND THE ORGANIZATION ARE REQUIRED TO BE APPROVED BY THE COMPLIANCE COMMITTEE OF THE BOARD. The following groups of individuals are covered by this policy: a. All Trustees/Directors: all UMM entities b. UMMHC/UMMMC/UMMMG: Dept Heads and above; selected others c. Physicians: all employed physicians, members of any board committee, members of Medical Staff Executive Committees; others as determined appropriate THERE IS ACTIVE MONITORING by the UMMHC Compliance office AND COMMUNICATION TO ENSURE INDIVIDUALS WITH OUTSIDE RELATIONSHIPS DO NOT INAPPROPRIATELY PARTICIPATE IN BUSINESS DECISIONS OF THE ORGANIZATION, PURCHASING OR RESEARCH ACTIVITIES/DECISIONS. Any conflicts identified are MANAGED AND reported to the appropriate officer and/or governing body. We have an appropriate management plan with any individuals with outside relationships that require mitigation. Where it is necessary, individuals may provide subject matter expertise however they have no influence or authorization of decisions for the organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a Process to establish compensation of top management official</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation matters involving the CEO and Senior Executives are overseen by the Compensation Committee of the Board, which was designated this authority by the Organization's Board of Trustees. The Compensation Committee approved a Compensation Philosophy and Policy which govern compensation matters. THE PHILOSOPHY INCLUDES THE OBJECTIVES OF THE PROGRAM COMPONENTS OF EXECUTIVE COMPENSATION, THE RELEVANT MARKET POSITIONING IN THE MARKET, FACTORS CONSIDERED IN SETTING EXECUTIVE COMPENSATION AND THE IMPORTANCE OF TYING SUCH COMPENSATION TO PERFORMANCE. Independent outside compensation consultants are hired by and report to the Compensation Committee of the Board and provide advice to the Committee on compensation matters. THE COMMITTEE WORKS WITH THESE CONSULTANTS AND WITH LEGAL COUNSEL TO ENSURE THAT ALL COMPENSATION PAID, AS WELL AS THE PROCESS FOLLOWED TO DETERMINE SUCH COMPENSATION IS REASONABLE, MEETS ALL REGULATORY REQUIREMENTS AND IS COMPETITIVE WITH THE RELEVANT MARKET. During the fiscal year, the Compensation Committee met to review and vote on the compensation for the CEO and key personnel. The Compensation Committee voted and approved the CEO's compensation at their annual meeting in March 2021. All other key personnel were voted on and approved at the annual meeting in December 2020.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b Process to establish compensation of other employees</FormAndLineReferenceDesc>
        <ExplanationTxt>Please refer to the above narrative for Part VI, Line 15a for a description of the compensation review process. Dates of the reviews for other officers and key employees are noted below, along with the title for reference and tier (internal management hierarchy). Tier - Title - Review date: Tier A - PRESIDENT, CEO - March 2021 Tier B - PRESIDENT MEDICAL CENTER - December 2020 Tier B - EXEC VP, CFO - December 2020 Tier B - CHIEF PHYSICIAN EXECUTIVE - December 2019 Tier B - PRESIDENT,UMMH &amp; CAO/CLO,UMMHC - December 2020 Tier B - EXEC VP/COO UMMMG - December 2020 Tier C - SVP CMO-UMMMC - December 2020 Tier C - PRESIDENT HEALTHALLIANCE &amp; MARLBORO HOSPITAL - December 2020 Tier C - SVP CHIEF HR OFFICER - December 2020 Tier C - SVP COMMUNITY PRACTICES - December 2020 Tier C - SVP GENERAL COUNSEL-PGL - December 2020 Tier C - SVP &amp; CHIEF PHILANTHROPY OFC - December 2020 Tier C - SVP CHF OF STAFF&amp;CHF MKTG OFC - December 2020 Tier C - SVP PATIENT CARE SVCS &amp; CNO - December 2020 Tier C - SVP/CHIEF FINANCIAL OFFICER - December 2020 Tier C - SVP POP HLTH &amp; PRESIDENT, ACO - December 2020 Tier C - SVP FINANCE/CORP CONTROLLER - December 2020 Tier C - SVP SYSTEM REV CYCLE OPS &amp; CRO - December 2020 Tier C - SVP AMBULATORY SVCS - December 2020 Tier C - SVP CLINICAL SVCS - December 2020 Tier C - SVP SURGICAL&amp;PROCEDURAL SVCS - December 2020 Tier C - SVP CLINICAL SVCS - December 2020 Tier C - VP CHIEF CORPORATE COMPLIANCE - December 2020 Tier C - PRESIDENT COMMUNTY HLTH LINK - December 2020</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>UMASS MEMORIAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AS REQUIRED BY APPLICABLE STATE AND FEDERAL LAWS AND BY REQUEST ON A CASE BY-CASE BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>Clinical Engineering Services - Total Expense: 15443874, Program Service Expense: 15443874, Management and General Expenses: , Fundraising Expenses: ; Billing, collection and transcription services - Total Expense: 9971807, Program Service Expense: 9971807, Management and General Expenses: , Fundraising Expenses: ; Purchasing management services - Total Expense: 4258351, Program Service Expense: 4258351, Management and General Expenses: , Fundraising Expenses: ; Other fees for services - Total Expense: 31487125, Program Service Expense: 29976087, Management and General Expenses: 1402831, Fundraising Expenses: 108207; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>Transfers (to) from related parties - -1048417; Transfers to unrestricted - revenue - 35231; Transfers to unrestricted - expenditures - -3130600; Nonoperating net pension periodic cost and other pension-related changes - XXX-XX-XXXX; Change in Wachusett liability - -411581;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VII, Section A ex officio members without vote</FormAndLineReferenceDesc>
        <ExplanationTxt>MICHAEL D. MURPHY ROBERT J. PAULHUS, JR. JOHN SHEA, ESQ.</ExplanationTxt>
      </SupplementalInformationDetail>
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