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      <MissionDesc>NOTRE DAME HEALTH CARE CENTER (NDHCC), ROOTED IN THE HERITAGE OF SAINT JULIE BILLIART AND SPONSORED BY THE SISTERS OF NOTRE DAME DE NAMUR, IS DEDICATED TO THE HEALING MINISTRY PROCLAIMED IN THE GOSPEL AND BY THE CATHOLIC CHURCH.</MissionDesc>
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      <Desc>SKILLED NURSING FACILITY, ASSISTED LIVING RESIDENCE, ADULT PALLIATIVE CARE AND HOSPICE, AND PEDIATRIC PALLIATIVE CARE AND HOSPICE PROGRAMS:NOTRE DAME LONG TERM CARE AND REHABILITATION CENTER IS A LICENSED SKILLED NURSING FACILITY THAT PROVIDES TRADITIONAL LONG TERM CARE, POST-ACUTE AND SHORT TERM REHABILITATION, SPECIALIZED MEMORY CARE, AND END OF LIFE CARE TO ACHIEVE THE INDIVIDUAL'S MAXIMUM QUALITY OF LIFE AND WELL-BEING WITHIN THE CHARITABLE MISSION OF THE SISTERS OF NOTRE DAME DE NAMUR. INDIVIDUALIZED CARE PLANS INCLUDE PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY, THERAPEUTIC RECREATIONAL PROGRAMS, INTRAVENOUS THERAPY, SPIRITUAL CARE, AND MEDICALLY RELATED SOCIAL SERVICES. (SEE SCHEDULE O)LICENSED NURSING SERVICES ARE PROVIDED 24 HOURS PER DAY TO NURSING HOME CAPACITY OF 123 INDIVIDUALS, AND THE FACILITY IS CERTIFIED BY THE CENTERS FOR MEDICAID AND MEDICARE SERVICES AS A PROVIDER, AND HOLDS CONTRACTS WITH A NUMBER OF HMOS.NOTRE DAME DU LAC ASSISTED LIVING RESIDENCE IS A CARING COMMUNITY THAT PROVIDES ASSISTED LIVING AND MEMORY SUPPORT FOR SENIORS. CHOICE, CONVENIENCE AND PEACE OF MIND ARE THE HALLMARKS OF THIS PROGRAM. NOTRE DAME DU LAC IS A HOME WHERE INDIVIDUAL NEEDS ARE MET AND COMMUNAL LIFE IS HONORED THROUGH A RICH AND DIVERSE RANGE OF PROGRAMS THAT ARE DESIGNED TO ENHANCE THE LIVES OF OUR RESIDENTS AND FAMILIES THROUGH ACTIVITIES, MEALS, AND PERSONAL ASSISTANCE. OUR MISSION OF CARE AND COMPASSION EXTENDS TO CARING FOR THOSE WITH MEMORY LOSS. THE HARMONY PROGRAM AT NOTRE DAME DU LAC IS DESIGNED TO MEET THE UNIQUE NEEDS OF THOSE WITH MEMORY LOSS, ALZHEIMER'S DISEASE, AND OTHER FORMS OF DEMENTIA. WE PROVIDE A COMFORTABLE, HOMELIKE SETTING, AS WELL AS THE SUPPORTIVE CARE NECESSARY TO INSURE SAFETY, DIGNITY, AND INDIVIDUALITY, WHEREBY RESIDENTS HAVE THE RIGHT TO MAKE CHOICES IN ALL ASPECTS OF THEIR LIVES. OUR FACILITY IS CERTIFIED BY THE EXECUTIVE OFFICE OF ELDER AFFAIRS OF THE COMMONWEALTH OF MASSACHUSETTS, AND PARTICIPATES IN THE MASSACHUSETTS GROUP ADULT FOSTER CARE (GAFC) PROGRAM UNTIL APRIL 2022 WHEN THE GAFC CONTRACT EXPIRED.THE AT HOME DIVISION OF NOTRE DAME HEALTH CARE PROVIDES COMMUNITY BASED SERVICES TO INDIVIDUALS IN NEED IN THEIR OWN HOMES OR THAT OF A LOVED ONE, AS WELL AS IN FACILITIES INCLUDING ASSISTED LIVING, SKILLED NURSING, AND REST HOMES, IN GREATER WORCESTER COUNTY. THESE SERVICES INCLUDE NOTRE DAME HOSPICE AND PALLIATIVE CARE AND PEDI PALS.NOTRE DAME HOSPICE AND PALLIATIVE CARE CONSISTS OF A TEAM OF SPECIALISTS WITH EXPERTISE DEVOTED TO COMPASSIONATE AND PROFESSIONAL END-OF-LIFE CARE. NOTRE DAME ASSISTS PATIENTS WITH TERMINAL ILLNESS FIND DIGNITY, MEANING, AND PEACE DURING HIS OR HER FINAL MONTHS, WEEKS, AND DAYS. NOTRE DAME CAN PROVIDE HOSPICE AND PALLIATIVE CARE SERVICES TO ALL AGE GROUPS, STARTING AT BIRTH. THESE SERVICES ARE COVERED BY MEDICARE, MEDICAID AND MOST PRIVATE INSURANCES.NOTRE DAME PEDI PALS IS A CONTRACT PROVIDER FOR THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH PEDIATRIC PALLIATIVE CARE NETWORK, AND IT IS A COST-BASED REIMBURSEMENT PROGRAM. ND PEDI PALS ENHANCES EXISTING SERVICES TO MEET THE NEEDS OF ELIGIBLE CHILDREN WITH ANY LIFE-LIMITING ILLNESS, EVEN WHEN A CURE REMAINS POSSIBLE. THE GOAL OF THE PEDIATRIC PALLIATIVE CARE NETWORK IS TO IMPROVE THE QUALITY OF LIFE FOR THE ENTIRE FAMILY THROUGH ITS SUPPORT SERVICES.</Desc>
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        <Desc>EDUCATION PROGRAM:THE EDUCATIONAL BRIDGE CENTER AT NOTRE DAME HEALTH CARE IS A LIFELINE SUPPORTING ADULT LEARNERS PSYCHOLOGICALLY AND FINANCIALLY, AND HELPING THEM TO OVERCOME OVERWHELMING CHALLENGES. STAFF ARE EDUCATED THROUGH HEALTH CARE SKILLS CLASSES DESIGNED TO MEET THE NEEDS OF RESIDENTS AND PATIENTS SERVED BY NDHC AND OTHER HEALTH CARE FACILITIES IN THE REGION. ADULT BASIC EDUCATION, TUTORING, CAREER AND LIFE COACHING, AND CITIZENSHIP SERVICES ENABLE PEOPLE TO EARN CERTIFICATIONS AND DEGREES, AND OBTAIN FAMILY-SUSTAINING WAGES. DUE TO THE COVID-19 PANDEMIC, CLASSES WERE CONVERTED TO A HYBRID, ONLINE AND IN PERSON STRUCTURE, IN SEPTEMBER 2020.</Desc>
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        <PersonNm>MR JOHN MANNILA</PersonNm>
        <TitleTxt>BOARD MEMBER- CHAIR A/O 9/22</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SR ELLEN AGRITELLEY SND</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS MARIA BUNKER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS ELIZABETH MURPHY</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SR MARY ROSE CROWLEY SND</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MR KEVIN KOZAK</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MR R THOMAS MANNING</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MR KEVIN MCGOVERN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS BRENDA RIVARD</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR MARY ROCHE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
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        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SR MARIE VERRILLI SND</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS TARA O'CONNER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DR PATRICIA O'BRIEN SND</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SR PATRICIA TOCE SND</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SR LORRAINE CONNELL SND</PersonNm>
        <TitleTxt>CHAIR - UNTIL 9/22</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MS RACHEL EGAN</PersonNm>
        <TitleTxt>BOARD MEMBER - UNTIL 9/22</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SR EVELYN MCKENNA SND</PersonNm>
        <TitleTxt>BOARD MEMBER - UNTIL 9/22</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>998251</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>86380</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>19</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CUTLER ASSOCIATES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>43 HARVARD STREET</AddressLine1Txt>
            <CityNm>WORCESTER</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01609</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ARCHITECT, DESIGN AND CONSTRUCTION SERVI</ServicesDesc>
        <CompensationAmt>989104</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>AEGIS ENERGY SERVICES LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>59 JACKSON STREET</AddressLine1Txt>
            <CityNm>HOLYOKE</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01040</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>INSTALLATION OF COGEN UNIT</ServicesDesc>
        <CompensationAmt>276824</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PRO EMS SOLUTIONS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>31 SMITH PLACE</AddressLine1Txt>
            <CityNm>CAMBRIDGE</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02138</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LAB TESTING SERVICES</ServicesDesc>
        <CompensationAmt>274545</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CARE PLUS HEALTHCARE STAFFING</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>101 PLEASANT ST SUITE 101</AddressLine1Txt>
            <CityNm>WORCESTER</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01609</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>STAFFING AGENCY SERVICES</ServicesDesc>
        <CompensationAmt>189050</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>RETROFIT TECHNOLOGIES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>350 MYLES STANDISH BLVD</AddressLine1Txt>
            <CityNm>TAUNTON</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02780</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>COMPUTER AND IT SERVICES</ServicesDesc>
        <CompensationAmt>157267</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>7</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>91943</FundraisingAmt>
      <RelatedOrganizationsAmt>35500</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>2802390</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>167027</AllOtherContributionsAmt>
      <NoncashContributionsAmt>64045</NoncashContributionsAmt>
      <TotalContributionsAmt>3096860</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>21537433</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>21537433</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RESIDENT SERVICE REVENUE</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>4522890</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4522890</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER INCOME</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>223695</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>223695</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>COMMUNITY FEES</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>135000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>135000</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>EDUCATION CENTER</Desc>
        <BusinessCd>611430</BusinessCd>
        <TotalRevenueColumnAmt>123459</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>123459</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>26542477</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>547295</TotalRevenueColumnAmt>
        <ExclusionAmt>547295</ExclusionAmt>
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      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>6236121</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>5189885</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>1046236</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1046236</TotalRevenueColumnAmt>
        <ExclusionAmt>1046236</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>91943</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>25618</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-25618</TotalRevenueColumnAmt>
        <ExclusionAmt>-25618</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>31207250</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>26542477</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1567913</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>383080</TotalAmt>
        <ManagementAndGeneralAmt>383080</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>16622364</TotalAmt>
        <ProgramServicesAmt>15095764</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1435527</ManagementAndGeneralAmt>
        <FundraisingAmt>91073</FundraisingAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>51531</TotalAmt>
        <ProgramServicesAmt>48036</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3495</ManagementAndGeneralAmt>
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      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1970261</TotalAmt>
        <ProgramServicesAmt>1678000</ProgramServicesAmt>
        <ManagementAndGeneralAmt>285290</ManagementAndGeneralAmt>
        <FundraisingAmt>6971</FundraisingAmt>
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      <PayrollTaxesGrp>
        <TotalAmt>1063960</TotalAmt>
        <ProgramServicesAmt>961670</ProgramServicesAmt>
        <ManagementAndGeneralAmt>95508</ManagementAndGeneralAmt>
        <FundraisingAmt>6782</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>49374</TotalAmt>
        <ManagementAndGeneralAmt>49374</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>118187</TotalAmt>
        <ManagementAndGeneralAmt>118187</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>181040</TotalAmt>
        <ManagementAndGeneralAmt>181040</ManagementAndGeneralAmt>
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      <FeesForServicesOtherGrp>
        <TotalAmt>411905</TotalAmt>
        <ProgramServicesAmt>15139</ProgramServicesAmt>
        <ManagementAndGeneralAmt>396766</ManagementAndGeneralAmt>
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      <AdvertisingGrp>
        <TotalAmt>267327</TotalAmt>
        <ProgramServicesAmt>164380</ProgramServicesAmt>
        <ManagementAndGeneralAmt>102947</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>510799</TotalAmt>
        <ProgramServicesAmt>184443</ProgramServicesAmt>
        <ManagementAndGeneralAmt>307265</ManagementAndGeneralAmt>
        <FundraisingAmt>19091</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>277978</TotalAmt>
        <ProgramServicesAmt>277899</ProgramServicesAmt>
        <ManagementAndGeneralAmt>79</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>877053</TotalAmt>
        <ProgramServicesAmt>864553</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12500</ManagementAndGeneralAmt>
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      <TravelGrp>
        <TotalAmt>21381</TotalAmt>
        <ProgramServicesAmt>20570</ProgramServicesAmt>
        <ManagementAndGeneralAmt>811</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>719147</TotalAmt>
        <ProgramServicesAmt>703620</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15527</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1519253</TotalAmt>
        <ProgramServicesAmt>1497172</ProgramServicesAmt>
        <ManagementAndGeneralAmt>22081</ManagementAndGeneralAmt>
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      <InsuranceGrp>
        <TotalAmt>269086</TotalAmt>
        <ProgramServicesAmt>220124</ProgramServicesAmt>
        <ManagementAndGeneralAmt>48962</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>PATIENT CARE EXPENSES</Desc>
        <TotalAmt>2920778</TotalAmt>
        <ProgramServicesAmt>2920778</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>USER FEE</Desc>
        <TotalAmt>946504</TotalAmt>
        <ProgramServicesAmt>946504</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>HOSPICE EXPENSES</Desc>
        <TotalAmt>380938</TotalAmt>
        <ProgramServicesAmt>380938</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>FOOD</Desc>
        <TotalAmt>296203</TotalAmt>
        <ProgramServicesAmt>296203</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>216902</TotalAmt>
        <ProgramServicesAmt>59815</ProgramServicesAmt>
        <ManagementAndGeneralAmt>140802</ManagementAndGeneralAmt>
        <FundraisingAmt>16285</FundraisingAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>30075051</TotalAmt>
        <ProgramServicesAmt>26335608</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3599241</ManagementAndGeneralAmt>
        <FundraisingAmt>140202</FundraisingAmt>
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      <CashNonInterestBearingGrp>
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        <EOYAmt>15791</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>2032365</BOYAmt>
        <EOYAmt>1749668</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>1912885</BOYAmt>
        <EOYAmt>2226076</EOYAmt>
      </AccountsReceivableGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>145867</BOYAmt>
        <EOYAmt>64251</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>238680</BOYAmt>
        <EOYAmt>224290</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>50430760</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>23179873</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>27826468</BOYAmt>
        <EOYAmt>27250887</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>20114931</BOYAmt>
        <EOYAmt>16536201</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1375141</BOYAmt>
        <EOYAmt>7195496</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>53795634</BOYAmt>
        <EOYAmt>55262660</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2364545</BOYAmt>
        <EOYAmt>2170080</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>18381</BOYAmt>
        <EOYAmt>71744</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>20905112</BOYAmt>
        <EOYAmt>21891627</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>1134444</BOYAmt>
        <EOYAmt>1089679</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>201025</BOYAmt>
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        <NontaxableBenefitsFilingOrgAmt>11360</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>164469</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>164469</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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    </IRS990ScheduleJ>
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          <BusinessNameLine1Txt>MASSACHUSETTS DEVELOPMENT FINANCE AGENCY</BusinessNameLine1Txt>
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        <PurposeDesc>REFUND SERIES 1999 BONDS AND NURSING AND ASSISTED LIVING RENOVATIONS</PurposeDesc>
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      </TaxExemptBondsIssuesGrp>
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        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>64400</RetiredAmt>
        <TotalProceedsAmt>31668081</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>597353</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>10458397</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>10853661</OtherSpentProceedsAmt>
        <UnspentAmt>9758670</UnspentAmt>
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        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <PrivateBusUseByOthersPct>0.00000</PrivateBusUseByOthersPct>
        <PrivateBusConcerningUBIPct>0.00000</PrivateBusConcerningUBIPct>
        <TotalPrivateBusinessUsePct>0.00000</TotalPrivateBusinessUsePct>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>1</HedgeIdentifiedInBksAndRecInd>
        <HedgeProviderName>
          <BusinessNameLine1Txt>M&amp;T BANK</BusinessNameLine1Txt>
        </HedgeProviderName>
        <TermOfHedgePct>7.800000000000</TermOfHedgePct>
        <SuperintegratedHedgeInd>0</SuperintegratedHedgeInd>
        <HedgeTerminatedInd>0</HedgeTerminatedInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
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        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>GIFTS FOR CHILDREN IN PEDI-PALS PROGRAM</Desc>
        <ContributionCnt>445</ContributionCnt>
        <NoncashContributionsRptF990Amt>40611</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>COST OR SELLING PRIC</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>ITEMS DONATED FOR ONLINE AUCTION AND RAFFLE</Desc>
        <ContributionCnt>192</ContributionCnt>
        <NoncashContributionsRptF990Amt>11055</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>COST OR SELLING PRIC</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>MEDIA SPONSORSHIP DONATIONS</Desc>
        <ContributionCnt>4</ContributionCnt>
        <NoncashContributionsRptF990Amt>8947</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>COST OR SELLING PRIC</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <OtherNonCashContriTableGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <Desc>GIFTS FOR DU LAC AND LTC PROGRAMS</Desc>
        <ContributionCnt>200</ContributionCnt>
        <NoncashContributionsRptF990Amt>3432</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>COST OR SELLING PRIC</MethodOfDeterminingRevenuesTxt>
      </OtherNonCashContriTableGrp>
      <AnyPropertyThatMustBeHeldInd>0</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>1</ReviewProcessUnusualNCGiftsInd>
      <ThirdPartiesUsedInd>0</ThirdPartiesUsedInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, COLUMN (B):</FormAndLineReferenceDesc>
        <ExplanationTxt>CONSIDERED EACH ITEM (GIFT CARD, GIFT BASKETS, LEGO WORKSHOP KIT, TICKET, ETC) AS AN INDIVIDUAL CONTRIBUTION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING BODY (BOARD OF DIRECTORS) DELEGATES CERTAIN AUTHORITY TO ACT ON ITS BEHALF TO SEVERAL COMMITTEES WHICH INCLUDE: GOVERNANCE, HUMAN RESOURCES, ETHICS, FINANCE, INVESTMENT, MISSION, ADVANCEMENT, NOMINATING, AND STRATEGIC DEVELOPMENT COMMITTEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>THE LEADERS OF THE SISTERS OF NOTRE DAME DE NAMUR EAST-WEST PROVINCE ARE THE MEMBERS OF NOTRE DAME HEALTH CARE CENTER, INC.; THEY HOLD AND EXERCISE RESERVED POWERS/CONTROLS AS WRITTEN IN THE NDHCC BYLAWS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S MEMBERS, THE SNDDEN PROVINCE EAST-WEST LEADERSHIP TEAM, ELECT THE NDHCC BOARD OF DIRECTORS TO THREE YEAR TERMS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE ARE ORGANIZATIONAL GOVERNANCE DECISIONS THAT ARE SUBJECT TO THE "RESERVED POWERS AND APPROVAL BY THE SNDDEN MEMBERS AS THEY ARE OUTSIDE OF THE SCOPE OF AUTHORITY OF THE NDHCC BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCE DIRECTOR SENDS A DRAFT COPY OF THE TAX RETURN TO EACH BOARD MEMBER FOR REVIEW. THE COMPLETED REVISED FORM 990 IS ELECTRONICALLY PROVIDED TO THE BOARD OF DIRECTORS FOR FINAL REVIEW VIA EMAIL, WITH RECEIPTS RETURNED AND SAVED, AND APPROVED AND FINALIZED BY THE CEO PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>NOTRE DAME HEALTH CARE RETAINS A WRITTEN CONFLICT OF INTEREST AND RELATED PARTY POLICY AND UTILIZES A DISCLOSURE FORM. THE WRITTEN POLICY AND DISCLOSURE FORM IS PROVIDED TO EACH BOARD DIRECTOR, COMMITTEE MEMBER, AND KEY EMPLOYEE ANNUALLY. THE RECIPIENTS COMPLETE THE FORM INCLUDING AN ATTESTATION THAT THEY HAVE NOT ENTERED INTO ANY AGREEMENTS INFLUENCED BY A CONFLICT OF INTEREST. THE CEO EXECUTIVE ASSISTANT IS RESPONSIBLE FOR DISTRIBUTING THE CONFLICT OF INTEREST FORMS AND ENSURING COLLECTION OF THE COMPLETED FORMS. THE COMPLETED FORMS ARE THEN FORWARDED TO THE CHAIR OF THE BOARD'S GOVERNANCE COMMITTEE, AND THEN REVIEWED BY THE GOVERNANCE COMMITTEE TO ASCERTAIN IF ANY CONFLICT OF INTEREST OR RELATED PARTY RELATIONSHIP EXISTS. IF THE GOVERNANCE COMMITTEE IDENTIFIES A PERCEIVED CONFLICT OF INTEREST, THE INFORMATION IS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND FINAL DETERMINATION OF PERCEIVED PRESENCE OR ABSENCE OF A CONFLICT OF INTEREST. AFTER A CONFLICT OR DUALITY OF INTEREST HAS BEEN ACKNOWLEDGED, THE BOARD MAY DETERMINE THAT IT IS IN THE ORGANIZATION'S BEST INTEREST TO CONDUCT BUSINESS WITH SAID BOARD MEMBER. A VOTE OF A MAJORITY OF THE BOARD MEMBERS AT A MEETING IN WHICH A QUORUM IS PRESENT (EXCLUSIVE OF THE MEMBER HAVING SAID CONFLICT, AS THEY ARE REQUIRED TO RECUSE THEMSELF) MAY AUTHORIZE THE CONTRACTING OR CONDUCTING OF BUSINESS WITH THE BOARD MEMBER. THE PROCEEDINGS, DELIBERATIONS, AND VOTE(S) OF THE BOARD ARE CAPTURED IN THE MINUTES OF THE BOARD MEETING BY THE EXECUTIVE ASSISTANT, AND APPROVED BY THE BOARD AT A SUBSEQUENT MEETING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS USED TO ESTABLISH THE COMPENSATION OF THE CEO INCLUDES A REVIEW AND THE APPROVAL OF COMPARABLE DATA BY THE BOARD OF DIRECTORS. THE CEO SALARY REVIEW IS INCORPORATED INTO THE ANNUAL PERFORMANCE REVEW PROCESS, WHICH IS CONDUCTED BY THE BOARD GOVERNANCE COMMITTEE AND DELIVERED BY THE BOARD CHAIR. IN THE EVENT THE BOARD DETERMINES THAT A REVIEW OF COMPENSATION IS REQUIRED FOR EQUITY AND COMPARABILITY, THE BOARD SEEKS COMPARABLE INFORMATION FROM THE EXECUTIVE DIRECTOR OF HUMAN RESOURCES FOR SIMILAR NON-PROFIT ORGANIZATIONS AS REPORTED ON THE IRS 990 FORM, AND MARKET SALARY SURVEYS WHICH ARE AVAILABLE TO HUMAN RESOURCES. THE MOST RECENT EQUITY AND COMPARABILITY REVIEW OF CEO COMPENSATION WAS PERFORMED IN FY 2019. AT THAT TIME THE ORGANIZATION REVIEWED THE SALARY INFORMATION REPORTED IN SCHEDULE J OF THE IRS 990 FOR SIMILARLY SIZED AND STRUCTURED ORGANIZATIONS IN THE SAME LABOR MARKET THROUGH A COMPARATIVE ANALYSIS OF EACH ORGANIZATIONS CEO COMPENSATION AS A PERCENTAGE OF TOTAL REVENUE; THIS ANALYSIS WAS COMPLETED TO PROVIDE INTERORGANIZATIONAL COMPARABILITY. THE LAST BOARD REVIEW OCCURRED DURING AN EXECUTIVE SESSION OF THE BOARD MEETING IN 2021. ON OCCASION, THE BOARD HAS UTILIZED DISCRETION IN AWARDING MARGINALLY HIGHER PERCENT WAGE ADJUSTMENTS IN RECOGNITION OF BETTER THAN EXPECTED PERFORMANCE, OR IN RESPONSE TO EXTRAORDINARY CIRCUMSTANCES NAVIGATED. OTHER EMPLOYEE SALARIES AND BENEFITS ARE REVIEWED ANNUALLY BY THE CEO, COMPARED TO OTHER SIMILAR ENTITIES IN THE REGION, AND DOCUMENTED AS PART OF THE ANNUAL REVIEW PROCESS, WHICH IS DONE ON THE ANNIVERSARY DATE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 18</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S FED FORM 990 IS AVAILABLE UPON REQUEST AND ON GUIDESTAR.ORG AND THE MA ATTORNEY GENERAL'S OFFICE WEBSITE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>UNREALIZED GAIN ON INTEREST RATE SW 3,122,690.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROCESS FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <BusinessNameLine1Txt>BOSTON PROVINCE SISTERS OF NOTRE DAME DE NAMUR</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <CityNm>EVERETT</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02149</ZIPCd>
        </USAddress>
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        <PublicCharityStatusTxt>LINE 1</PublicCharityStatusTxt>
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        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NOTRE DAME TRAINING SCHOOL INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>30 JEFFREYS NECK ROAD</AddressLine1Txt>
          <CityNm>IPSWICH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01938</ZIPCd>
        </USAddress>
        <PrimaryActivitiesTxt>RELIGIOUS ORGANIZATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 1</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>SISTERS OF NOTRE DAME DE NAMUR US EAST-WEST PROVINCE</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>30 JEFFREYS NECK ROAD</AddressLine1Txt>
          <CityNm>IPSWICH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01938</ZIPCd>
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        <PrimaryActivitiesTxt>RELIGIOUS ORGANIZATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 1</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
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      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
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</Return>
