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        <RelatedOrExemptFuncIncomeAmt>12085340</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICAID</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>183283</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>183283</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>INSURANCE</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>4086428</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4086428</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PRIVATE</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>-185</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-185</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PROVISION FOR UNCOLLECTIBLE ACCOUNTS</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>-25916</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-25916</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>16328950</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>702</TotalRevenueColumnAmt>
        <ExclusionAmt>702</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
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      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
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      </RoyaltiesRevenueGrp>
      <RentalIncomeOrLossGrp>
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        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetRentalIncomeOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <FundraisingDirectExpensesAmt>0</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>UNITED WAY</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>281</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>281</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>1698</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1698</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>FLU SHOT</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>3976</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3976</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>5955</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>16335607</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>16334905</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>702</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
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      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
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      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>162517</TotalAmt>
        <ManagementAndGeneralAmt>162517</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>10649679</TotalAmt>
        <ProgramServicesAmt>9184216</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1465463</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>140403</TotalAmt>
        <ProgramServicesAmt>119343</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21060</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1176615</TotalAmt>
        <ProgramServicesAmt>1004093</ProgramServicesAmt>
        <ManagementAndGeneralAmt>172522</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>786701</TotalAmt>
        <ProgramServicesAmt>668696</ProgramServicesAmt>
        <ManagementAndGeneralAmt>118005</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>2438756</TotalAmt>
        <ManagementAndGeneralAmt>2438756</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>21054</TotalAmt>
        <ProgramServicesAmt>21054</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>711184</TotalAmt>
        <ProgramServicesAmt>604093</ProgramServicesAmt>
        <ManagementAndGeneralAmt>107091</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>27571</TotalAmt>
        <ManagementAndGeneralAmt>27571</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>473919</TotalAmt>
        <ManagementAndGeneralAmt>473919</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>21699</TotalAmt>
        <ManagementAndGeneralAmt>21699</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
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        <ProgramServicesAmt>240214</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7429</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>8958</TotalAmt>
        <ManagementAndGeneralAmt>8958</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
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      </InterestGrp>
      <PaymentsToAffiliatesGrp>
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        <ManagementAndGeneralAmt>508307</ManagementAndGeneralAmt>
      </PaymentsToAffiliatesGrp>
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        <ManagementAndGeneralAmt>12743</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
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      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES</Desc>
        <TotalAmt>313299</TotalAmt>
        <ProgramServicesAmt>221069</ProgramServicesAmt>
        <ManagementAndGeneralAmt>92230</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>MISCELLANEOUS</Desc>
        <TotalAmt>344171</TotalAmt>
        <ProgramServicesAmt>271236</ProgramServicesAmt>
        <ManagementAndGeneralAmt>72935</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PAYROLL PROCESSING</Desc>
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        <ManagementAndGeneralAmt>21901</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>18067120</TotalAmt>
        <ProgramServicesAmt>12334014</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5733106</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>722298</BOYAmt>
        <EOYAmt>1358769</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>0</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
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        <EOYAmt>2108271</EOYAmt>
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      <ReceivablesFromOfficersEtcGrp>
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        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
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        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>137436</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>333192</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>289096</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>14589</BOYAmt>
        <EOYAmt>44096</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>0</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
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        <EOYAmt>0</EOYAmt>
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      <InvestmentsProgramRelatedGrp>
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        <EOYAmt>0</EOYAmt>
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      <IntangibleAssetsGrp>
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        <EOYAmt>0</EOYAmt>
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      <OtherAssetsTotalGrp>
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        <EOYAmt>0</EOYAmt>
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      <TotalAssetsGrp>
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        <EOYAmt>3648572</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>0</EOYAmt>
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      <DeferredRevenueGrp>
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        <EOYAmt>0</EOYAmt>
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      <TaxExemptBondLiabilitiesGrp>
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        <EOYAmt>0</EOYAmt>
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      <EscrowAccountLiabilityGrp>
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        <EOYAmt>0</EOYAmt>
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      <LoansFromOfficersDirectorsGrp>
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      <MortgNotesPyblScrdInvstPropGrp>
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      <UnsecuredNotesLoansPayableGrp>
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      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>1378554</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
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        <EOYAmt>2270018</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
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        <EOYAmt>0</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
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      <TotLiabNetAssetsFundBalanceGrp>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1731513</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>1798288</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
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        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
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      <GrossReceiptsAdmissionsGrp>
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      <GrossReceiptsNonUnrltBusGrp>
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      <TaxRevLeviedOrgnztnlBnft509Grp>
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      <GovtFurnSrvcFcltsVl509Grp>
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      <Total509Grp>
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        <CurrentTaxYearAmt>702</CurrentTaxYearAmt>
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      <InvestmentIncomeAndUBTIGrp>
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        <CurrentTaxYearMinus3YearsAmt>1379</CurrentTaxYearMinus3YearsAmt>
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        <CurrentTaxYearMinus1YearAmt>179</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>702</CurrentTaxYearAmt>
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      <NetIncomeFromOtherUBIGrp>
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      <OtherIncome509Grp>
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        <CurrentTaxYearMinus3YearsAmt>454</CurrentTaxYearMinus3YearsAmt>
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      <PublicSupportCY509Pct>0.99965</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99970</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00006</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00008</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
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      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
      <LandGrp />
      <BuildingsGrp />
      <LeaseholdImprovementsGrp />
      <EquipmentGrp>
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        <DepreciationAmt>289096</DepreciationAmt>
        <BookValueAmt>44096</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp />
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      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <TotalLiabilityAmt>0</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>UNDER ASC 740, AN ORGANIZATION MUST RECOGNIZE THE FINANCIAL STATEMENT EFFECTS OF A TAX POSITION TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL NOT BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY. THE ORGANIZATION DOES NOT BELIEVE IT HAS TAKEN ANY MATERIAL UNCERTAIN TAX POSITIONS, AND ACCORDINGLY, IT HAS NOT RECORDED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. FOR THE YEARS ENDED DECEMBER 31, 2019 AND 2018, THERE WERE NO INTEREST OR PENALTIES RECORDED OR INCLUDED IN THE CONSOLIDATED STATEMENT OF ACTIVITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
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      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Shawn Potter</PersonNm>
        <TitleTxt>President/CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>417020</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>3633</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>256212</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>28092</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>704957</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Daniel Meyler</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>184811</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>2293</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>4834</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>26374</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>218312</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Mary Winters</PersonNm>
        <TitleTxt>VP of Operations</TitleTxt>
        <BaseCompensationFilingOrgAmt>155203</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2643</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>3861</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>810</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>162517</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4B:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's President/CEO Shawn Potter participates in a supplemental non-qualified retirement plan through the organization's sole corporate member, Health Management Services, Inc. deferred compensation reported for the year ended December 31, 2019 under this plan is $250,000.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Column C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE DEFERRED COMPENSATION REPORTED REFLECTS THE EMPLOYER MATCH PORTIONS OF THE 401K OFFERED TO QUALIFYING EMPLOYEES. THE AMOUNTS REPORTED FOR SHAWN POTTER, CEO AND DANIEL MEYLER, CFO WERE PAID FOR BY HEALTH MANAGEMENT SERVICS, INC. THE AMOUNTS REPORTED FOR THE KEY EMPLOYEE AND HIGHEST PAID EMPLOYEES WERE PAID FOR BY ALL CARE VISITING NURSE ASSOCIATION OF GREATER LYNN, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Column D:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE NONTAXABLE BENEFITS REFLECT THE EMPLOYER PAID PORTIONS OF EMPLOYER SPONSORED HEALTH AND LIFE INSURANCE PLANS. THE AMOUNTS REPORTED FOR SHAWN POTTER, CEO AND DANIEL MEYLER, CFO WERE PAID FOR BY HEALTH MANAGEMENT SERVICES, INC. THE AMOUNTS REPORTED FOR THE KEY EMPLOYEE AND HIGHEST PAID EMPLOYEES WERE PAID FOR BY ALL CARE VISITING NURSE ASSOCIATION OF GREATER LYNN, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's management duties are handled by one of its related entities, Health Management Services, Inc.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is provided to the organization's governing body at the HMS, Inc. executive committee meeting before it is signed and filed.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12C:</FormAndLineReferenceDesc>
        <ExplanationTxt>The policy is monitored through organization and annual training. Enforcement has not been an issue, but would occur if necessary.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15:</FormAndLineReferenceDesc>
        <ExplanationTxt>All director salaries are reviewed and approved by a vote of the Board of Directors.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 18:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's Form 990 is available to the public upon request and can be found at the Massachusetts Attorney General website.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19:</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's financial statements are available to the public upon request and can be found at the Massachusetts Attorney General website. The governing documents are conflict of interest policy are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9, Changes in Net Assets:</FormAndLineReferenceDesc>
        <ExplanationTxt>Intercompany Equity Transfer</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>All Care Resources Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>042805564</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HMS Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>All Care Adult Day Health Center Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>760799712</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HMS Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>The Visiting Nurse Association Foundatio</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>222581936</EIN>
        <PrimaryActivitiesTxt>Development</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HMS Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Health Management Services Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>222581863</EIN>
        <PrimaryActivitiesTxt>Management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>All Care Hospice Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>352231860</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HMS Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>VNA Ventures Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>042942852</EIN>
        <PrimaryActivitiesTxt>Real Estate M</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>hms inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C-Corp</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>0</ShareOfEOYAssetsAmt>
        <OwnershipPct>0.00000</OwnershipPct>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>All Care Infusion Therapy Company</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>210 Market Street</AddressLine1Txt>
          <CityNm>Lynn</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01901</ZIPCd>
        </USAddress>
        <EIN>043120267</EIN>
        <PrimaryActivitiesTxt>Health Servic</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>vna ventures</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C-Corp</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>0</ShareOfEOYAssetsAmt>
        <OwnershipPct>0.00000</OwnershipPct>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II, Column G and Part IV, Column I:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization has checked "yes" as a Section 512(B)(13) controlled entity. Although the filing organization does not directly control each of the organizations listed, as part of its affiliation with Health Management Services (parent organization), all organizations related under HMS are defined as a controlled entity within the meaning of IRC Section 512(B)(13).</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>