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        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CAROL SOBELSON</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ROBERT STEIGMEYER</PersonNm>
        <TitleTxt>EX OFFICIO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JULIE STONE</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHANE TELGENER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREA BEAUDOIN</PersonNm>
        <TitleTxt>ASSISTANT SE</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1765265</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>123059</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>216357</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>8</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>FELLOWSHIP HOUSING</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>36 PLEASANT STREET</AddressLine1Txt>
            <CityNm>CONCORD</CityNm>
            <StateAbbreviationCd>NH</StateAbbreviationCd>
            <ZIPCd>033014055</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>M. HEALTH SERV.</ServicesDesc>
        <CompensationAmt>948826</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>JH SPAIN COMMERCIAL SVS LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>189 N MAIN ST SUITE 101</AddressLine1Txt>
            <CityNm>CONCORD</CityNm>
            <StateAbbreviationCd>NH</StateAbbreviationCd>
            <ZIPCd>03301</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSTRUCTION</ServicesDesc>
        <CompensationAmt>629055</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>NETSMART</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>11100 NALL AVENUE</AddressLine1Txt>
            <CityNm>OVERLAND PARK</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>66211</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>SOFTWARE</ServicesDesc>
        <CompensationAmt>462569</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>FIRSTLIGHT</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 1301</AddressLine1Txt>
            <CityNm>WILLISTON</CityNm>
            <StateAbbreviationCd>VT</StateAbbreviationCd>
            <ZIPCd>05495</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>FIBER</ServicesDesc>
        <CompensationAmt>144289</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ECKHARDT &amp; JOHNSON LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>6 EASTPOINT DRIVE</AddressLine1Txt>
            <CityNm>HOOKSETT</CityNm>
            <StateAbbreviationCd>NH</StateAbbreviationCd>
            <ZIPCd>03106</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MECHANICAL</ServicesDesc>
        <CompensationAmt>108779</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>7</CntrctRcvdGreaterThan100KCnt>
      <FundraisingAmt>21704</FundraisingAmt>
      <GovernmentGrantsAmt>4847185</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>598390</AllOtherContributionsAmt>
      <TotalContributionsAmt>5467279</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAID</Desc>
        <BusinessCd>621420</BusinessCd>
        <TotalRevenueColumnAmt>21883226</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>21883226</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PROGRAM SALES - SERVICE</Desc>
        <BusinessCd>621420</BusinessCd>
        <TotalRevenueColumnAmt>2887438</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2887438</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>OTHER PROGRAM FEES</Desc>
        <BusinessCd>621420</BusinessCd>
        <TotalRevenueColumnAmt>1579538</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1579538</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>NET CLIENT FEES</Desc>
        <BusinessCd>621420</BusinessCd>
        <TotalRevenueColumnAmt>964904</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>964904</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>BLUE CROSS/BLUE SHIELD</Desc>
        <BusinessCd>621420</BusinessCd>
        <TotalRevenueColumnAmt>932599</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>932599</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>1280023</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1280023</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>29527728</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>410599</TotalRevenueColumnAmt>
        <ExclusionAmt>410599</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>1474300</SecuritiesAmt>
        <OtherAmt>907000</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>1240956</SecuritiesAmt>
        <OtherAmt>652173</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>233344</SecuritiesAmt>
        <OtherAmt>254827</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>488171</TotalRevenueColumnAmt>
        <ExclusionAmt>488171</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <ContriRptFundraisingEventAmt>21704</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>12710</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-12710</TotalRevenueColumnAmt>
        <ExclusionAmt>-12710</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISC. INCOME</Desc>
        <TotalRevenueColumnAmt>172041</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>172041</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>CHANGE IN SWAP</Desc>
        <TotalRevenueColumnAmt>61064</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>61064</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>233105</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>36114172</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>29760833</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>886060</ExclusionAmt>
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      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>685511</TotalAmt>
        <ManagementAndGeneralAmt>685511</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>20648533</TotalAmt>
        <ProgramServicesAmt>17137615</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3510918</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>5037519</TotalAmt>
        <ProgramServicesAmt>4173490</ProgramServicesAmt>
        <ManagementAndGeneralAmt>864029</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1528913</TotalAmt>
        <ProgramServicesAmt>1223808</ProgramServicesAmt>
        <ManagementAndGeneralAmt>305105</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>56561</TotalAmt>
        <ProgramServicesAmt>56561</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>65851</TotalAmt>
        <ProgramServicesAmt>65851</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>58498</TotalAmt>
        <ManagementAndGeneralAmt>58498</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1198056</TotalAmt>
        <ProgramServicesAmt>999522</ProgramServicesAmt>
        <ManagementAndGeneralAmt>198534</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>60079</TotalAmt>
        <ProgramServicesAmt>74</ProgramServicesAmt>
        <ManagementAndGeneralAmt>60005</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>205892</TotalAmt>
        <ProgramServicesAmt>199143</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6749</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>974253</TotalAmt>
        <ProgramServicesAmt>901921</ProgramServicesAmt>
        <ManagementAndGeneralAmt>72332</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>290270</TotalAmt>
        <ProgramServicesAmt>270074</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20196</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>127455</TotalAmt>
        <ProgramServicesAmt>76207</ProgramServicesAmt>
        <ManagementAndGeneralAmt>51248</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>123861</TotalAmt>
        <ProgramServicesAmt>123861</ProgramServicesAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1259189</TotalAmt>
        <ProgramServicesAmt>750843</ProgramServicesAmt>
        <ManagementAndGeneralAmt>508346</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>300560</TotalAmt>
        <ProgramServicesAmt>359251</ProgramServicesAmt>
        <ManagementAndGeneralAmt>-58691</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>OTHER EXPENSES</Desc>
        <TotalAmt>1177900</TotalAmt>
        <ProgramServicesAmt>1138820</ProgramServicesAmt>
        <ManagementAndGeneralAmt>39080</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>COMMUNICATIONS</Desc>
        <TotalAmt>405243</TotalAmt>
        <ProgramServicesAmt>405243</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL</Desc>
        <TotalAmt>98172</TotalAmt>
        <ProgramServicesAmt>98104</ProgramServicesAmt>
        <ManagementAndGeneralAmt>68</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BUILDING/HOUSEHOLD</Desc>
        <TotalAmt>68211</TotalAmt>
        <ProgramServicesAmt>58864</ProgramServicesAmt>
        <ManagementAndGeneralAmt>9347</ManagementAndGeneralAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>186654</TotalAmt>
        <ProgramServicesAmt>165739</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20915</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>34557181</TotalAmt>
        <ProgramServicesAmt>28204991</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6352190</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>2428063</BOYAmt>
        <EOYAmt>5877953</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>873233</BOYAmt>
        <EOYAmt>337557</EOYAmt>
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      <AccountsReceivableGrp>
        <BOYAmt>2175528</BOYAmt>
        <EOYAmt>1224862</EOYAmt>
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      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>2518730</BOYAmt>
        <EOYAmt>1218916</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>360931</BOYAmt>
        <EOYAmt>282397</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>30163796</LandBldgEquipCostOrOtherBssAmt>
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      <LandBldgEquipBasisNetGrp>
        <BOYAmt>15531364</BOYAmt>
        <EOYAmt>14495767</EOYAmt>
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      <OtherAssetsTotalGrp>
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        <EOYAmt>12841859</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>36279311</EOYAmt>
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        <EOYAmt>179309</EOYAmt>
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        <EOYAmt>5902832</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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      <DonorRestrictionNetAssetsGrp>
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      <TotalNetAssetsFundBalanceGrp>
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        <EOYAmt>30376479</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
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        <CurrentTaxYearMinus1YearAmt>538337</CurrentTaxYearMinus1YearAmt>
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      <GrossReceiptsRltdActivitiesAmt>151166254</GrossReceiptsRltdActivitiesAmt>
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      <PublicSupportPY170Pct>0.92570</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART II, LINE 10</FormAndLineReferenceDesc>
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    <IRS990ScheduleB documentId="RetDoc1">
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        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc3">
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        <BookValueAmt>1677884</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
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        <DepreciationAmt>10306691</DepreciationAmt>
        <BookValueAmt>10332927</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
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        <DepreciationAmt>418724</DepreciationAmt>
        <BookValueAmt>304582</BookValueAmt>
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