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        <AppointElectMajorityOfficerInd>true</AppointElectMajorityOfficerInd>
        <ExerciseDirectionPoliciesInd>true</ExerciseDirectionPoliciesInd>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part IV, Section A, Line 5a Added, Substituted, or Removed Sup. Org.</FormAndLineReferenceDesc>
        <ExplanationTxt>Organizations removed during the year as a result of Articles of Amendment: UMass Memorial Behavioral Health System, Inc. 04-3374724 UMass Memorial Accountable Care Organization, Inc. 46-2871359 UMass Memorial Health Ventures, Inc. 22-2605679 UMass Memorial Behavioral Health System, Inc. 04-3374724</ExplanationTxt>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part IV, Section A, Line 6 Support to other supported orgs</FormAndLineReferenceDesc>
        <ExplanationTxt>See details on Schedule I. Prior to Articles of Amendment, support services provided to UMass Memorial Realty, Inc. 04-2805630, $271,664</ExplanationTxt>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part IV, Section D, Line 3 Supp. Org. Have Significant Voice In Investment Policies</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATIONS SUPPORTED HAVE A SIGNIFICANT VOICE IN THE ORGANIZATION'S INVESTMENT POLICIES, AS WELL AS IN DIRECTING THE USE OF THE ORGANIZATION'S INCOME OR ASSETS. THE SUPPORTING ORGANIZATIONS PARTICIPATE ON THE INVESTMENT COMMITTEE TO DIRECT THE INVESTMENTS OF THE UMASS MEMORIAL INVESTMENT PARTNERSHIP, IN WHICH THE SUPPORTING ORGANIZATION'S FUNDS ARE INVESTED</ExplanationTxt>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part IV, Section E, Line 3a Power To Appoint/Elect Majority of Officer/Director/Trustee</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PARENT ORGANIZATION HAS THE POWER TO REGULARLY APPOINT OR ELECT A MAJORITY OF THE OFFICERS, DIRECTORS, OR TRUSTEES OF EACH SUPPORTED ORGANIZATION.</ExplanationTxt>
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      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part IV, Section E, Line 3b Substantial Direction Over Policies/Programs/Activities</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION EXERCISES A SUBSTANTIAL DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS, AND ACTIVITIES OF EACH OF ITS SUPPORTED ORGANIZATIONS THROUGH THE DIRECTION OF THE OFFICERS AND DIRECTORS OF THE SUPPORTED ORGANIZATIONS. THERE ARE RESERVED POWERS OF THE PARENT OVER ITS SUBSIDIARIES FOR SIGNIFICANT CORPORATE ACTIONS RELATED TO SUCH ITEMS AS AGREEMENTS TO SELL ASSETS, MERGERS, CAPITAL AND OPERATING BUDGETS, LOAN AGREEMENTS, ELECTION OF THE PRESIDENT, CHANGES TO ARTICLES OF ORGANIZATION/BYLAWS, ADOPTION OF STRATEGIC PLAN, ETC.</ExplanationTxt>
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      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
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        <FormAndLineReferenceDesc>Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY</FormAndLineReferenceDesc>
        <ExplanationTxt>Amounts represent percentage of lobbying expenses included in membership dues paid to the following associations: Americas Essential Hospitals $20,497 Risk and Insurance Management Society $114 The New England Council $107 Total $20,718</ExplanationTxt>
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        <EndYearBalanceAmt>50634682</EndYearBalanceAmt>
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        <InvestmentEarningsOrLossesAmt>2338097</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>2479457</OtherExpendituresAmt>
        <EndYearBalanceAmt>48384545</EndYearBalanceAmt>
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        <InvestmentEarningsOrLossesAmt>4215185</InvestmentEarningsOrLossesAmt>
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      <BoardDesignatedBalanceEOYPct>0.0</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.55</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.45</TermEndowmentBalanceEOYPct>
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      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
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        <BookValueAmt>188766945</BookValueAmt>
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      <CloselyHeldEquityInterestsGrp>
        <BookValueAmt>2521967</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
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      <OtherSecuritiesGrp>
        <Desc>Investment in captive insurance company</Desc>
        <BookValueAmt>120000</BookValueAmt>
        <MethodValuationCd>C</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Units in investment partnership</Desc>
        <BookValueAmt>300342429</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>302984396</TotalBookValueSecuritiesAmt>
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        <Desc>Due from related parties</Desc>
        <BookValueAmt>65809231</BookValueAmt>
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      <OtherAssetsOrgGrp>
        <Desc>Cash value of life insurance policies</Desc>
        <BookValueAmt>36932</BookValueAmt>
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      <OtherAssetsOrgGrp>
        <Desc>Beneficial interest</Desc>
        <BookValueAmt>676257</BookValueAmt>
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        <Desc>Other assets</Desc>
        <BookValueAmt>263334</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>66785754</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Due to UMass Medical School</Desc>
        <Amt>2292</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Due to related parties</Desc>
        <Amt>13220937</Amt>
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        <Desc>Outstanding loss and self insured reserves</Desc>
        <Amt>58007243</Amt>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Other liabilities</Desc>
        <Amt>17710324</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Contribution payable</Desc>
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      <OtherLiabilitiesOrgGrp>
        <Desc>Accrued pension &amp; postretirement obligations</Desc>
        <Amt>405590677</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Accrued incentive compensation</Desc>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Purchase commitments</Desc>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>494531473</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part V, Line 4 Intended uses of endowment funds</FormAndLineReferenceDesc>
        <ExplanationTxt>The intended use of the organization's endowment funds are directed in accordance with the donor's intent including the preservation of the original gift and various purposes including charity care, medical education, research, health care services, buildings and equipment.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>The System follows a two-step approach for the financial statement recognition and measurement of a tax position taken or expected to be taken on a tax return. The substantial majority of UMass Memorial and its affiliate entities are recognized by the Internal Revenue Service as tax-exempt under Section 501(c)(3) of the Internal Revenue Code. Accordingly, these entities will not incur any liability for federal income taxes except for tax on unrelated business taxable income ("UBTI"). Certain affiliates are taxable entities. The measurement of the amounts recorded as a provision for income taxes based upon the aforementioned approach was $433,000 and $197,000 for the years ended September 30, 2020 and 2019, respectively, and is recorded as part of supplies and other expense in the accompanying consolidated statements of operations. The Tax Cuts and Jobs Act (the "Act") was enacted on December 22, 2017. The Act impacts the System in several ways, including new excise taxes on executive compensation, increases to UBTI by the amount of certain fringe benefits for which a deduction is not allowed, changes to the net operating loss rules, repeal of the alternative minimum tax ("AMT"), and the computation of UBTI separately for each unrelated trade or business. Further, the Act reduces the U.S. federal corporate tax rate and federal corporate unrelated business income tax rate from 35% to 21%. The overall impact of the Act has not been material to the System. For the years ended September 30, 2020 and 2019, the System had approximately $14,900,000 and $11,520,000 of net operating loss ("NOL") carryforwards for federal income tax purposes primarily related to its previously discontinued laboratory outreach business. The NOL carryforwards have expiration dates from 2030 through 2035. In compliance with the Tax Cuts and Jobs Act of 2017, the federal components of the deferred tax assets were revalued from 35% to 21%. For the year ended September 30, 2020, the System believes the deferred tax assets of $997,000 will be fully utilized and recognized an income tax expense of $1,414,000 which has been recorded in supplies and other expense in the accompanying consolidated statements of operations. The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of September 30, 2020.</ExplanationTxt>
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        <SpecificServicesProvidedTxt>Reimbursement of claims paid</SpecificServicesProvidedTxt>
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      <AccountActivitiesOutsideUSGrp>
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        <SpecificServicesProvidedTxt>Insurance premiums paid</SpecificServicesProvidedTxt>
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      <TotalSpentAmt>50749635</TotalSpentAmt>
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      <InterestInForeignTrustInd>false</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>true</ForeignCorpOwnershipInd>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
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      <RecipientTable>
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          <ZIPCd>01608</ZIPCd>
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      <RecipientTable>
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        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
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      <RecipientTable>
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        <USAddress>
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          <CityNm>Waltham</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02454</ZIPCd>
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        <RecipientEIN>223234975</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
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        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>Support for Caring for Physicians Health Campagin. Provides confidential consultation and support to physicians, residents, and medical students-Malpractice captive's portion of the aggregate contribution.</PurposeOfGrantTxt>
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      <RecipientTable>
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        </RecipientBusinessName>
        <USAddress>
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          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01536</ZIPCd>
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        <RecipientEIN>043424018</RecipientEIN>
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        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>Support to Community Benefits for Food Insecurity</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>VNA Care Network</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>120 Thomas Street</AddressLine1Txt>
          <CityNm>Worcester</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
        </USAddress>
        <RecipientEIN>042794849</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
        <CashGrantAmt>10000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>Support for Home Health and Hospice - Worcester Benefit Salute to Nurses</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>Worcester Railers HC Charitable Fnd</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>900 Cummings Ctr</AddressLine1Txt>
          <CityNm>Beverly</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01608</ZIPCd>
        </USAddress>
        <RecipientEIN>811645767</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
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        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <ValuationMethodUsedDesc>N/A</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>N/A</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>Hockey Sponsorship</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
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        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>60 Hospital Road</AddressLine1Txt>
          <CityNm>Leominster</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01453</ZIPCd>
        </USAddress>
        <RecipientEIN>042103555</RecipientEIN>
        <IRCSectionDesc>501(c)(3)</IRCSectionDesc>
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        <ValuationMethodUsedDesc>n/a</ValuationMethodUsedDesc>
        <NonCashAssistanceDesc>n/a</NonCashAssistanceDesc>
        <PurposeOfGrantTxt>Transfer to related organization for golf tournament</PurposeOfGrantTxt>
      </RecipientTable>
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      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>EMERGENCY ASSISTANCE SUPPORT FOR EMPLOYEES (EASE)</GrantTypeTxt>
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        <CashGrantAmt>116255</CashGrantAmt>
        <ValuationMethodUsedDesc>BOOK</ValuationMethodUsedDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.</FormAndLineReferenceDesc>
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    </IRS990ScheduleI>
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        <TitleTxt>VP HEALTH SYSTEM CONTRACTING</TitleTxt>
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          <BusinessNameLine1Txt>TOD G WIESMAN</BusinessNameLine1Txt>
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        <DeferredCompensationFlngOrgAmt>52675</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part II COMPENSATION TO EMPLOYEES</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ABOVE 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 University of Massachusetts Medical School, an unrelated entity for tax purposes.</ExplanationTxt>
      </SupplementalInformationDetail>
      <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 $67,024 Weymouth, Deborah $100,229</ExplanationTxt>
      </SupplementalInformationDetail>
      <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 $36,098 BROWN, DOUGLAS S. $57,832 DICKSON, ERIC W., MD $115,656 FINBERG, ROBERT W., MD $65,579 SUBTOTAL OFF, DIR, TRUSTEES $275,165 KEY EMPLOYEES: CORBETT, WILLIAM, MD $41,981 CYR, JAMES P. $26,138 DAY, THERESE $35,872 FELDMANN, ROBERT $80,972 GAGNE, NICOLE $15,974 GREENWOOD, JOHN $31,754 LAPRIORE, CHERYL M. $31,576 METZGER, BART $126,539 RANDOLPH, JOHN T. $231,682 ROACH, STEVEN $36,356 SALZBERG, JOHN R. $18,128 SHAKMAN, ALICE $30,758 STREETER, MICHELE $25,520 TARNOWSKI, TIMOTHY $45,204 TOSI, STEPHEN E., MD $65,094 SUBTOTAL KEY EMPLOYEES $843,548 FORMER: FISHER, BARBARA $230,284 WEYMOUTH, DEBORAH $441,471 SUBTOTAL FORMER $671,755 PARENT TOP 5 HIGHEST PAID: ALPER, MD, ERIC J $29,583 WESTON, ALAN R. $44,310 SODANO, ROBIN L. $22,408 ROSSI, CATHERINE M. $13,333 WIESMAN, TOD G. $13,128 SUBTOTAL TOP 5 HIGHEST PAID $122,762 TOTAL $1,913,230 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE REPORTING PERIOD (no distribution received): OFFICERS, DIRECTORS, TRUSTEES: MELGAR, SERGIO KEY EMPLOYEES: BAILEY, JACK W. GUSTAFSON, MD, MICHAEL KARSON, ANDREW PRECOURT, JUSTIN SWENSON, DANA E.</ExplanationTxt>
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        <BondIssuedDt>2016-12-07</BondIssuedDt>
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        <FormAndLineReferenceDesc>Schedule K, Part I, Column (e)</FormAndLineReferenceDesc>
        <ExplanationTxt>DIFFERENCES BETWEEN THE ISSUE PRICE (PART I COLUMN (E)) AND TOTAL PROCEEDS (PART II LINE 3) ARE DUE TO INVESTMENT EARNINGS.</ExplanationTxt>
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        <TransactionDesc>Independent Contractor Arrangement, donation of $75,000</TransactionDesc>
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    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="19010655" softwareVersionNum="2019v5.0">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 4 Significant changes to organizational documents</FormAndLineReferenceDesc>
        <ExplanationTxt>Article II: THE CORPORATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITA BLE, SCIENTIFIC AND EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"), AND IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF OR TO CAR RY OUT THE PURPOSES OF UMASS MEMORIAL MEDICAL CENTER, INC., MARLBOROUGH H OSPITAL, UMASS MEMORIAL HEALTH ALLIANCE-CLINTON HOSPITAL, INC., UMASS MEMO RIAL MEDICAL GROUP, INC., COMMUNITY HEALTHLINK, INC., CENTRAL NEW ENGLAND H EALTHALLIANCE, INC., HEALTHALLIANCE HOME HEALTH AND HOSPICE, INC. AND SUCH O THER AFFILIATED CHARITABLE ORGANIZATIONS OR HOSPITALS THAT (I) ARE EXEMPT FRO M TAXATION UNDER SECTION 501(C)(3) OF THE CODE AND (II) ARE CLASSIFIED AS OTHER THAN PRIVATE FOUNDATIONS UNDER SECTION 509(A)(1) OR 509(A)(2) OF THE CODE (COLL ECTIVELY, THE "SUPPORTED ORGANIZATIONS"). IN THIS CAPACITY, THE CORPORATION W ILL ENGAGE IN THE FOLLOWING ACTIVITIES: (1) TO DEVELOP AND COORDINATE AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT INCLUDES MULTIPLE HEALTH CARE PROVI DERS AND PROVIDES OPPORTUNITIES FOR AND SUPPORTS MEDICAL EDUCATION AND TR AINING; TO SUPPORT THE ADVANCEMENT OF THE KNOWLEDGE AND PRACTICE OF, AND E DUCATION AND RESEARCH IN, MEDICINE, SURGERY, NURSING AND ALL OTHER SUBJECTS RELATING TO THE CARE, TREATMENT AND HEALING OF HUMANS AND IN THAT CONNECTI ON TO SUPPORT, PROMOTE AND ENHANCE THE ACADEMIC MEDICAL PROGRAMS AND AC TIVITIES OF THE UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL; TO IMPROVE THE H EALTH AND WELFARE OF ALL PERSONS; TO DEVELOP, SPONSOR AND PROMOTE SERVICES AND PROGRAMS THAT ARE CHARITABLE, SCIENTIFIC OR EDUCATIONAL AND THAT ADDRE SS THE PHYSICAL AND MENTAL NEEDS OF THE COMMUNITY AT LARGE, PROVIDED THAT T HE CORPORATION SHALL NOT ENGAGE IN THE PRACTICE OF MEDICINE; (2) TO RECEIVE IN TRUST OR OTHERWISE AND FROM WHATEVER SOURCE, AND ADMINISTER, GIFTS, LEGACIE S AND DEVISES, GRANTS AND GRANTS-IN-AID, WHETHER UNRESTRICTED OR FOR SPECIFI C PURPOSES; TO COOPERATE WITH, CONTRIBUTE TO AND SUPPORT THE SUPPORTED ORG ANIZATIONS IN PROMOTING THE PURPOSES OF THIS CORPORATION, AND TO DO ALL THI NGS INCIDENTAL TO THE FOREGOING; AND (3) TO CONDUCT ANY BUSINESS THAT MAY L AWFULLY BE CARRIED ON BY A CORPORATION FORMED UNDER CHAPTER 180 OF THE GE NERAL LAWS OF MASSACHUSETTS AND THAT IS NOT INCONSISTENT WITH THIS CORPOR ATION'S QUALIFICATION AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. ARTICLE IV: ARTICLE 4 OF THE CORPORATION'S ARTICLES REMAIN UNCHANGED EXCEPT ARTICLE 4.9 OF THE CORPORATION'S ARTICLES IS AMENDED AS FOLLOWS: 4.9 UPON THE LIQUIDATIO N OR DISSOLUTION OF THE CORPORATION, AFTER PAYMENT OF ALL OF THE LIABILITIES OF THE CORPORATION OR DUE PROVISION THEREFOR, ALL OF THE ASSETS OF THE CORPO RATION SHALL BE DISPOSED OF PURSUANT TO MASSACHUSETTS GENERAL LAWS, CHAPT ER 180, SECTION 11A, TO UMASS MEMORIAL MEDICAL CENTER, INC. SO LONG AS IT IS THE N EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE CODE AND OTH ERWISE 50% TO THE UNIVERSITY OF MASSACHUSETTS AND 50% TO ONE OR MORE SUPPO RTED ORGANIZATIONS THAT ARE THEN EXEMPT FROM FEDERAL INCOME TAX UNDER SEC TION 501(C)(3) OF THE CODE AND ARE SELECTED BY A MAJORITY OF THE TRUSTEES THEN I N OFFICE OR, IF NONE OF SUCH ENTITIES ARE THEN EXEMPT FROM FEDERAL INCOME TA X UNDER SECTION 501(C)(3) OF THE CODE, TO SUCH ONE OR MORE OTHER ENTITIES EXEM PT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE CODE OR AN INSTRUM ENTALITY OF THE COMMONWEALTH OF MASSACHUSETTS SELECTED BY A MAJORITY OF THE TRUSTEES THEN IN OFFICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHANCELLOR OF THE UNIVERSITY OF MASSACHUSETTS 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 AND SCHEDULE J RELATED TO EXECUTIVE COMPENSATION are REVIEWED IN DETAIL WITH THE ORGANIZATION'S BOARD COMPENSATION COMMITTEE WHICH OVERSEES ALL UMASS MEMORIAL HEALTH CARE EXECUTIVE COMPENSATION. THE ORGANIZATION'S COMPLIANCE COMMITTEE REVIEWS ALL CONTENT ASSOCIATED WITH SCHEDULE L. THE AUDIT 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 FINANCE 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>
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      <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 2020. All other key personnel were voted on and approved at the annual meeting in December 2019.</ExplanationTxt>
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      <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 2020 Tier B - PRESIDENT MEDICAL CENTER - December 2019 Tier B - EXEC VP, CFO - December 2019 Tier B - CHIEF PHYSICIAN EXECUTIVE - December 2019 Tier B - PRESIDENT,UMMH &amp; CAO/CLO,UMMHC - December 2019 Tier B - EXEC VP/COO UMMMG - December 2019 Tier C - SVP CMO-UMMMC - December 2019 Tier C - PRESIDENT MARLBORO HOSPITAL - December 2019 Tier C - SVP CHIEF HR OFFICER - December 2019 Tier C - SVP COMMUNITY PRACTICES - December 2019 Tier C - SVP GENERAL COUNSEL-PGL - December 2019 Tier C - SVP &amp; CHIEF PHILANTHROPY OFC - December 2019 Tier C - SVP CHF OF STAFF&amp;CHF MKTG OFC - December 2019 Tier C - SVP PATIENT CARE SVCS &amp; CNO - December 2019 Tier C - VP/CHIEF FINANCIAL OFFICER - December 2019 Tier C - SVP POP HLTH &amp; PRESIDENT, ACO - December 2019 Tier C - SVP FINANCE/CORP CONTROLLER - December 2019 Tier C - SVP SYSTEM REV CYCLE OPS &amp; CRO - December 2019 Tier C - SVP AMBULATORY SVCS - December 2019 Tier C - SVP CLINICAL SVCS - December 2019 Tier C - SVP SURGICAL&amp;PROCEDURAL SVCS - December 2019 Tier C - SVP CLINICAL SVCS - December 2019 Tier C - VP CHIEF CORPORATE COMPLIANCE - December 2019 Tier C - PRESIDENT COMMUNTY HLTH LINK - December 2019</ExplanationTxt>
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      <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: 14639127, Program Service Expense: 14639127, Management and General Expenses: , Fundraising Expenses: ; Billing, collection and transcription services - Total Expense: 12096734, Program Service Expense: 12096734, Management and General Expenses: , Fundraising Expenses: ; Transformation and risk management consulting - Total Expense: 3708332, Program Service Expense: 3708332, Management and General Expenses: , Fundraising Expenses: ; Purchasing management services - Total Expense: 2015186, Program Service Expense: 2015186, Management and General Expenses: , Fundraising Expenses: ; Other fees for services - Total Expense: 35882942, Program Service Expense: 33709649, Management and General Expenses: 2120943, Fundraising Expenses: 52350; - 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>
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        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9 Other changes in net assets or fund balances</FormAndLineReferenceDesc>
        <ExplanationTxt>Transfers (to) from related parties - -XXX-XX-XXXX; Transfers to unrestricted - revenue - 239099; Transfers to unrestricted - expenditures - -2164064; Nonoperating net pension periodic cost and other pension-related changes - -70032928; Change in Wachusett liability - -90637;</ExplanationTxt>
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        <MethodOfAmountDeterminationTxt>Fair Value</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>UMass Memorial Medical Group Inc</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>2420608</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Fair Value</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
