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        <Desc>Employee Retention Tax Credit</Desc>
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        <Desc>Lease Obligation</Desc>
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      <TotalLiabilityAmt>49634</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
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      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>20776179</RevenueSubtotalAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>20776179</TotalRevenuePerForm990Amt>
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      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>19280823</ExpensesSubtotalAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>19280823</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>All income earned used to support hospice services.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Association is a public charity under Section 501(c)(3) of the Internal Revenue Code. As a public charity, the Association is exempt from state and federal income taxes on income earned in accordance with its tax exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Association's tax positions and concluded that the Association has no unrelated business income or uncertain tax positions that require adjustment to the financial statements.</ExplanationTxt>
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    </IRS990ScheduleD>
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      <SpecialFundraisingEventsInd>X</SpecialFundraisingEventsInd>
      <AgrmtProfFundraisingActyInd>0</AgrmtProfFundraisingActyInd>
      <FundraisingEventInformationGrp>
        <Event1Nm>Executive Breakfast</Event1Nm>
        <GrossReceiptsEvent1Amt>61850</GrossReceiptsEvent1Amt>
        <GrossRevenueEvent1Amt>61850</GrossRevenueEvent1Amt>
        <FoodAndBeverageEvent1Amt>4954</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>2000</EntertainmentEvent1Amt>
        <GrossReceiptsTotalAmt>61850</GrossReceiptsTotalAmt>
        <GrossRevenueTotalEventsAmt>61850</GrossRevenueTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>4954</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>2000</EntertainmentTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>6954</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>54896</NetIncomeSummaryAmt>
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      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
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        <PersonNm>Elaine T Fluet</PersonNm>
        <TitleTxt>Past CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>183458</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Holly A Chaffee</PersonNm>
        <TitleTxt>President/CEO</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kristin Mattson</PersonNm>
        <TitleTxt>Homecare Director - South</TitleTxt>
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        <TotalCompensationFilingOrgAmt>192278</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Lisa J Sabacinski</PersonNm>
        <TitleTxt>CFO</TitleTxt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Crystal Marsh</PersonNm>
        <TitleTxt>Physical Therapist</TitleTxt>
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        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Kelly Loescher</PersonNm>
        <TitleTxt>Hospice Director</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>4027</BonusFilingOrganizationAmount>
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        <DeferredCompensationFlngOrgAmt>9100</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
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        <TotalCompensationFilingOrgAmt>163666</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>The President &amp; CEO, Holly Chaffee, shall be eligible to receive, at the discretion of the Board of Directors, an annual incentive compensation award. Other bonuses are paid out at the discretion of the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization made the following changes to their bylaws: 1. Reduced the minimum number of directors to 7 and the maximum number of directors to 15. 2. Reduced the length of the term for board members to 2 years 3. Reduced the number of board members needed for a quorum to 5 4. The CEO shall present to the Corporation an annual report of its work; shall appoint all chairpersons of the committees unless otherwise specified by these bylaws, with the approval of the Board of Directors; shall be an ex-officio member of all committees with the deciding vote; and shall perform all duties generally incident to the office. 5. The CFO shall, subject to the direct of the Directors, have general charge of the financial affairs of the corporation and shall cause to be kept accurate books of account. He/she shall have access to all funds, securities, and valuable documents of the corporation, except as Directors may otherwise provide. The CFO shall make reports of the finances fo the corporation at each Annual Meeting and when called upon by the chair/CEO and shall perform such duties as are customarily incident to his/her office. The funds, books and financial records shall at all times be subject to the inspection, supervision, and control of the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is reviewed by the CEO and CFO and sent to the Finance Committee prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Policy is reviewed annually with the board of directors. Each member is asked to sign an affidavit acknowledging they have read the policy, understand the policy, and are in compliance with the policy.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The CEO is reviewed annually by the Board of Directors. The CFO is reviewed annually by the CEO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Upon Request</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part X, Line 10: Land, Buildings, and Equipment:</FormAndLineReferenceDesc>
        <ExplanationTxt>Section 1.263(a)-3(n) Election: Care Central VNA &amp; Hospice, Inc. 34 Pearly Lane Gardner, MA 01440 EIN: 04-2104246 Section 1.263(a)-3(n) Election: Care Central VNA &amp; Hospice, Inc. is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
