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        <PersonNm>Michael J Widmer PhD</PersonNm>
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        <PersonNm>Maureen Banks FACHE MBA MS</PersonNm>
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        <PersonNm>Christine C Schuster RN</PersonNm>
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        <PersonNm>Kevin Tabb MD</PersonNm>
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      </InterestGrp>
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      </DepreciationDepletionGrp>
      <InsuranceGrp>
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        <Desc>DUES &amp; MEMBERSHIPS</Desc>
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      <OtherExpensesGrp>
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        <EOYAmt>192180</EOYAmt>
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      <EscrowAccountLiabilityGrp>
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        <EOYAmt>3649648</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>27453176</EOYAmt>
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      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
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        <EOYAmt>981082</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>981082</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
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      <ReconcilationRevenueExpnssAmt>-12231212</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-98706</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
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      <AuditCommitteeInd>true</AuditCommitteeInd>
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    <IRS990ScheduleC documentId="IRS990ScheduleC">
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      <TotalDirectLobbyingGrp />
      <TotalLobbyingExpendGrp />
      <OtherExemptPurposeExpendGrp />
      <TotalExemptPurposeExpendGrp />
      <LobbyingNontaxableAmountGrp />
      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <SubstantiallyAllDuesNondedInd>false</SubstantiallyAllDuesNondedInd>
      <OnlyInHouseLobbyingInd>false</OnlyInHouseLobbyingInd>
      <AgreeCarryoverPriorYearInd>false</AgreeCarryoverPriorYearInd>
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      <TaxableAmt>0</TaxableAmt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>NON-DEDUCTIBLE DUES</FormAndLineReferenceDesc>
        <ExplanationTxt>DURING FISCAL YEAR 18, THE ORGANIZATION PROVIDED SUPPORT TO THE BALLOT QUESTION COMMITTEE TO PROTECT PATIENT SAFETY WHICH SEEKS TO SUPPORT AND PROTECT PATIENT SAFETY THROUGH OPPOSITION TO 2018 MASSACHUSETTS BALLOT 'QUESTION 1' WHICH WOULD REGULATE NURSING STAFF TO PATIENT RATIOS IN HOSPITALS AND DISREGARD PROFESSIONAL JUDGMENT NEEDED TO ENSURE PATIENT CARE AND SAFETY. THE PORTION OF MEMBER DUES EXPENDED TO SUPPORT THE COALITION TO PROTECT PATIENT SAFETY, ALONG WITH OTHER NORMAL LOBBYING EXPENSES INCURRED, WERE CONSIDERED NON-DEDUCTIBLE TO MEMBERS AND WERE CONSISTENT WITH THE ORGANIZATIONS MISSION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
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      <HeldWorksArtGrp />
      <CYMinus3YrEndwmtFundGrp />
      <CYMinus4YrEndwmtFundGrp />
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        <BookValueAmt>132000</BookValueAmt>
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      <BuildingsGrp>
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        <DepreciationAmt>1196684</DepreciationAmt>
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        <BookValueAmt>1269039</BookValueAmt>
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      <EquipmentGrp>
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        <DepreciationAmt>2331029</DepreciationAmt>
        <BookValueAmt>373193</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp />
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      <OtherAssetsOrgGrp>
        <Desc>OTHER INVESTMENTS</Desc>
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      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>CASH VALUE OF LIFE INSURANCE</Desc>
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      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>RETIREMENT PLAN OBLIGATION</Desc>
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      <OtherLiabilitiesOrgGrp>
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      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>ASC 740 FOOTNOTE</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE D, PART X, LINE 2 MHA IS A NOT-FOR-PROFIT ORGANIZATION DESCRIBED IN SECTION 501(C)(6) OF THE INTERNAL REVENUE CODE, AS AMENDED (THE CODE), AND IS GENERALLY EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. MHREA IS A NOT-FOR-PROFIT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE, AND IS GENERALLY EXEMPT FROM INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE INSURANCE AGENCY IS A FOR-PROFIT SUBSIDIARY OF MHA, AND ANY INCOME TAX IS NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. MHA AND AFFILIATES ARE REQUIRED TO ASSESS UNCERTAIN TAX POSITIONS AND HAVE DETERMINED THAT THERE WERE NO SUCH POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. MHA IS RESPONSIBLE FOR MAINTENANCE OF ITS TAX-EXEMPT STATUS; IDENTIFYING AND REPORTING UNRELATED INCOME; DETERMINING ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS IN WHICH IT HAS NEXUS; AND IDENTIFYING AND EVALUATING OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. MHA IS REQUIRED TO ASSESS UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT THERE WERE NO SUCH POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS.</ExplanationTxt>
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    <IRS990ScheduleI documentId="IRS990ScheduleI">
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          <BusinessNameLine1Txt>Coalition to Protect Patient Safety</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO Box 15</AddressLine1Txt>
          <CityNm>Boston</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>02137</ZIPCd>
        </USAddress>
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        <PurposeOfGrantTxt>See Part IV</PurposeOfGrantTxt>
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        <ExplanationTxt>MHA MAKES GENERAL CONTRIBUTIONS, NOT GRANTS, TO CERTAIN ORGANIZATIONS SUPPORTING THE FOLLOWING EFFORTS: -ORGANIZATION OF NURSE LEADERS FOR ANNUAL MEETING SPONSORSHIP -AMERICAN NURSES ASSOCIATION MASSACHUSETTS FOR ANNUAL CONFERENCE SPONSORSHIP -ARTHRITIS FOUNDATION FOR ANNUAL DINNER SPONSORSHIP -CALIFORNIA HOSPITAL ASSOCIATION TO SUPPORT HOSPITAL WORKERS AFFECTED BY THE FIRES -COALITION TO PROTECT PATIENT SAFETY TO SUPPORT PATIENT SAFETY</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
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        <ExplanationTxt>During fiscal year 18, the organization provided support to the Coalition to Protect Patient Safety which seeks to support and protect patient safety through opposition to 2018 Massachusetts ballot 'Question 1' which would regulate nursing staff to patient ratios in hospitals and disregard professional judgment needed to ensure patient care and safety.</ExplanationTxt>
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    </IRS990ScheduleI>
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        <TotalCompensationFilingOrgAmt>980941</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
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      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Timothy Gens</PersonNm>
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        <DeferredCompensationFlngOrgAmt>16200</DeferredCompensationFlngOrgAmt>
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        <PersonNm>Nancy Siopes MBA CPCU CIC</PersonNm>
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        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>6841</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>253108</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL SROCZYNSKI</PersonNm>
        <TitleTxt>VP GOVT. ADVOCACY</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
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        <DeferredCompensationFlngOrgAmt>14767</DeferredCompensationFlngOrgAmt>
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        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>275648</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Steven Defossez</PersonNm>
        <TitleTxt>VP, Clinical Integration</TitleTxt>
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        <DeferredCompensationFlngOrgAmt>16200</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>17524</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>362496</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Patricia Noga</PersonNm>
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        <DeferredCompensationFlngOrgAmt>13287</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15223</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>247682</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
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        <PersonNm>Anuj Goel</PersonNm>
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        <OtherCompensationFilingOrgAmt>1328</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13514</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18644</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>252863</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Christine Baratta</PersonNm>
        <TitleTxt>VP, Marketing &amp; Communications</TitleTxt>
        <BaseCompensationFilingOrgAmt>191176</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>31403</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20508</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13130</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>16822</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>273039</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SEVERENCE AGREEMENTS</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE J, PART I, LINE 4 THE OUTGOING PRESIDENT AND CEO HAS A SEVERANCE AGREEMENT WITH MHA. IF MHA SEVERS THE CEO'S EMPLOYMENT, MHA WILL PROVIDE SEVERANCE BENEFITS EQUAL TO ONE YEAR OF BASE SALARY AND ASSOCIATED BENEFITS, WITHOUT OFFSET, AND AN ADDITIONAL SIX MONTHS' SEVERANCE, OFFSET BY SALARY OF SUBSEQUENT EMPLOYMENT. SEVERANCE BENEFITS WILL NOT APPLY IF THE CAUSE OF THE TERMINATION IS DUE TO GROSS NEGLIGANCE, FRAUD, OR AN ILLEGAL ACT. THE INCOMING PRESIDENT AND CEO HAS A SEVERANCE AGREMENT WITH MHA. IF MHA SEVERS THE CEO'S EMPLOYMENT, MHA WILL PROVIDE SEVERANCE BENEFITS EQUAL TO SIX MONTHS OF BASE SALARY AND ASSOCIATED BENEFITS, WITHOUT OFFSET, AND AN ADDITIONAL SIX MONTHS SEVERANCE OFFSET BY SALARY OF SUBSEQUENT EMPLOYMENT. SEVERANCE BENEFITS WILL NOT APPLY IF THE CAUSE OF THE TERMINATION IS DUE TO FRAUD, EMBEZZLEMENT, WILLFULL MISCONDUCT OR OTHER ILLEGAL ACTS. THE EXECUTIVE VICE PRESIDENT AND GENERAL COUNSEL, THE VICE PRESIDENT OF CLINICAL INTEGRATION AND THE VICE PRESIDENT OF MARKETING &amp; COMMUNICATIONS HAVE SEVERANCE AGREEMENTS WITH MHA. IF MHA SEVERS THEIR EMPLOYMENT, MHA WILL PROVIDE SEVERANCE BENEFITS EQUAL TO THIRTY-NINE WEEKS OF BASE SALARY AND ASSOCIATED BENEFITS, WITHOUT OFFSET, AND AN ADDITIONAL THIRTEEN WEEKS' SEVERANCE, OFFSET BY SALARY OF SUBSEQUENT EMPLOYMENT. SEVERANCE BENEFITS WILL NOT APPLY IF THE CAUSE OF THE TERMINATION IS DUE TO WILLFUL MISCONDUCT, GROSS NEGLIGENCE, OR AN ILLEGAL ACT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE J, PART I, LINE 4B THE OUTGOING PRESIDENT AND CEO, PARTICIPATES IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. NO AMOUNTS WERE PAID OUT DURING CALENDAR YEAR 2017 OR FISCAL YEAR ENDED SEPTEMBER 30, 2018. AMOUNTS CONTRIBUTED TO THE PLAN DURING THE CALENDAR YEAR TOTALED $141,878 AND ARE REPORTED AS OTHER REPORTABLE COMPENSATION IN COLUMN C OF PART II. THE INCOMING PRESIDENT AND CEO PARTICIPATES IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. NO AMOUNTS WERE PAID OUT DURING CALENDAR YEAR 2017 OR FISCAL YEAR ENDED SEPTEMBER 30, 2018. NO AMOUNTS WERE CONTRIBUTED TO THE PLAN DURING CALENDAR YEAR 2017.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>DELEGATION OF AUTHORITY</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, LINE 1A THE EXECUTIVE COMMITTEE MEETS SIX TIMES EACH YEAR TO ADDRESS INTERNAL OPERATIONAL POLICIES WHICH ARE LATER REVIEWED BY THE FULL GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>MEMBERS OR STOCKHOLDERS</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, LINE 6 THE ASSOCIATION HAS SIX TYPES OF MEMBERS PER ITS BYLAWS: 1. INSTATE HOSPITALS 2. OTHER HEALTH CARE PROVIDERS 3. AFFILIATED MEMBERS 4. ALLIED MEMBERS 5. HONORARY/LIFETIME MEMBERS 6. HOSPITALS LICENSED OUTSIDE OF MASSACHUSETTS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>MEMBERS OR STOCKHOLDERS WHO MAY ELECT MEMBERS OF GOVERNING BODY</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, LINE 7A MHA HOLDS A GOVERNANCE COMMITTEE MEETING EACH YEAR TO DEVELOP A LIST OF OFFICERS WHO ARE PRESENTED TO THE ANNUAL MEMBERSHIP MEETING (WHICH IS HELD IN JUNE) FOR VOTING OF THE MHA BOARD OF TRUSTEES FOR EACH YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>DECISIONS SUBJECT TO APPROVAL</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, LINE 7B ANY CHANGES TO THE MHA BY-LAWS OR CORPORATE GOVERNANCE DOCUMENTS MUST BE APPROVED AT THE ANNUAL MEMBERSHIP MEETING HELD IN JUNE OF EACH YEAR. OTHER CHANGES TO CORPORATE POLICIES AND PROCEDURES ARE APPROVED BY THE BOARD OR OTHER GOVERNANCE COMMITTEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 REVIEW PROCESS</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, LINE 11B THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX SERVICE PROVIDER WITH INFORMATION PROVIDED BY THE CONTROLLER. THE FORM GOES THROUGH REVIEW BY THE CHIEF EXECUTIVE OFFICER PRIOR TO BEING PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE REVIEWS THE FORM 990 IN DETAIL AND APPROVES IT FOR SUBMISSION. PRIOR TO THE FINAL FORM BEING ELECTRONICALLY SUBMITTED TO THE INTERNAL REVENUE SERVICE, A COPY IS ALSO PROVIDED TO ALL THE MEMBERS OF THE BOARD OF TRUSTEES TO REVIEW AND PROVIDE ANY FINAL COMMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>CONFLICT OF INTEREST POLICY MONITORING &amp; ENFORCEMENT</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, LINE 12C THE ASSOCIATION MAINTAINS A WRITTEN CONFLICT OF INTEREST POLICY INCLUDED IN THE ASSOCIATION'S POLICIES AND PROCEDURES MANUAL. THIS MANUAL IS UPDATED AND DISSEMINATED TO EMPLOYEES AND TRUSTEES ANNUALLY. AT THE START OF EACH FISCAL YEAR, THE MANAGER OF HUMAN RESOURCES REQUIRES THAT EACH KEY EMPLOYEE, OFFICER AND TRUSTEE COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE TRUSTEES AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS. INDIVIDUALS WITH A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN THE DISCUSSION AND RESOLUTION OF THE CONFLICT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PROCESS FOR DETERMINING COMPENSATION</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, LINE 15A THE ORGANIZATION'S COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES IS AN INDEPENDENT COMMITTEE THAT DOES NOT HAVE ANY CONFLICTS OF INTEREST WITH RESPECT TO THE COMPENSATION PAID TO THE ORGANIZATION'S EXECUTIVES. THIS COMMITTEE REVIEWS THE CHIEF EXECUTIVE OFFICER'S ANNUAL GOALS AND PERFORMANCE. THE COMMITTEE SETS AND APPROVES THE COMPENSATION PACKAGE OF THE CHIEF EXECUTIVE OFFICER EACH YEAR. THE COMMITTEE HIRES A COMPENSATION CONSULTING FIRM TO PROVIDE EXPERTISE AND GUIDANCE REGARDING COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PEOPLE IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILAR SIZED ORGANIZATIONS, AND PERIODIC UPDATES AS PRUDENT. THE COMPENSATION REVIEW IS AN ANNUAL PROCESS AND IS DOCUMENTED EACH YEAR IN THE COMPENSATION COMMITTEE MINUTES, IN WHICH THE DELIBERATION AND DECISION REGARDING THE COMPENSATION ARRANGEMENT FOR THE CEO IS RECORDED. THE COMPENSATION COMMITTEE REPORTS ON ITS MEETINGS AND ACTIONS TO THE FULL BOARD OF TRUSTEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PROCESS FOR DETERMINING COMPENSATION</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, LINE 15B THE CHIEF EXECUTIVE OFFICER MAKES RECOMMENDATIONS FOR REVIEW AND APPROVAL OF OFFICERSKEY EMPLOYEES' COMPENSATION TO THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE ORGANIZATION'S COMPENSATION COMMITTEE IS AN INDEPENDENT COMMITTEE THAT DOES NOT HAVE ANY CONFLICTS OF INTEREST WITH RESPECT TO THE COMPENSATION PAID TO THE ORGANIZATION'S EXECUTIVES. FROM TIME TO TIME, THE COMMITTEE HIRES A COMPENSATION CONSULTING FIRM TO PROVIDE EXPERTISE AND GUIDANCE REGARDING COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PEOPLE IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILAR SIZED ORGANIZATIONS, AND PERIODIC UPDATES AS PRUDENT. THE COMPENSATION REVIEW IS DOCUMENTED IN THE COMPENSATION COMMITTEE MINUTES, IN WHICH THE DELIBERATION AND DECISION REGARDING THE COMPENSATION ARRANGEMENT FOR OFFICERS AND KEY EMPLOYEES IS RECORDED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT ITS PLACE OF BUSINESS. THE FORM 990 AND AUDITED FINANCIAL STATEMENTS ARE LIKEWISE PUBLISHED ON NRCD'S WEBSITE AT WWW.NRDC.ORG. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY MAY BE PROVIDED AT MANAGEMENT'S DISCRETION, IF REQUESTED.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <BusinessNameLine1Txt>MA Hospital Research &amp; Ed Association</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>500 District Ave</AddressLine1Txt>
          <CityNm>Burlington</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01803</ZIPCd>
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        <EIN>237039401</EIN>
        <PrimaryActivitiesTxt>EDUCATION</PrimaryActivitiesTxt>
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        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>MHA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
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          <BusinessNameLine1Txt>MHA Solutions Inc</BusinessNameLine1Txt>
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          <AddressLine1Txt>500 District Ave</AddressLine1Txt>
          <CityNm>Burlington</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01803</ZIPCd>
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        <EIN>042915488</EIN>
        <PrimaryActivitiesTxt>Insurance</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>MHA Subhold</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>1022055</ShareOfTotalIncomeAmt>
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      <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>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>true</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>true</ReimbursementPaidByOtherOrgInd>
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      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
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          <BusinessNameLine1Txt>MHA Solutions INC</BusinessNameLine1Txt>
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        <TransactionTypeTxt>a</TransactionTypeTxt>
        <InvolvedAmt>50700</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
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        <OtherOrganizationName>
          <BusinessNameLine1Txt>MHA Solutions INC</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>MHA Solutions INC</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>MHA Solutions INC</BusinessNameLine1Txt>
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        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
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          <BusinessNameLine1Txt>MHREA</BusinessNameLine1Txt>
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  </ReturnData>
</Return>