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      <GrantsToDomesticOrgs>
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      <GrantsToDomesticIndividuals>
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      <ForeignGrants>
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      <BenefitsToMembers>
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      <FeesForServicesAccounting>
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      <FeesForServicesLobbying>
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      <InformationTechnology>
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      <Travel>
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      <TravelEntrtnmntPublicOfficials>
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      <PaymentsToAffiliates>
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      <GrassrootsNontaxableAmount />
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      <FootnoteInPartXIII>X</FootnoteInPartXIII>
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        <Identifier>ASC 740 Footnote</Identifier>
        <ReturnReference>Schedule D Part XIII Line 2</ReturnReference>
        <Explanation>The association follows ASC 740, income taxes under ASC 740. The organization recognizes the financial statement benefit of a tax position only after determining that the relevant tax authority would more-likely-than-not sustain the position following an audit. For tax positions meeting the more-likely-than-not threshold, the amount recognized in the consolidated financial statements is the largest benefit that has a greater than 50 percent likelihood of being realized upon ultimate settlement with the relevant tax authority. As a result of the association's assessment of its tax positions, the association does not have any uncertain tax positions as at September 30, 2013 that require accrual or disclosures.</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
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      </EventsInformation>
    </IRS990ScheduleG>
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        <NamePerson>Christine Baratta</NamePerson>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>Supplemental nonqualified retirement plan</Identifier>
        <ReturnReference>Schedule J, Part I, Line 4b</ReturnReference>
        <Explanation>The President and CEO Patricia Lynn Nicholas participates in a supplemental nonqualified retirement plan. No amounts were paid to Ms. Nicholas. Amounts contributed to the plan during the year, subject to substantial risk of forfeiture, totaled $125,042, and are reported as retirement in Column C of Part II.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>Delegation of Authority</Identifier>
        <ReturnReference>Form 990, Part VI, Line 1a</ReturnReference>
        <Explanation>Executive Committee meets six times each year to address internal operational policies which are later reviewed by the full governing body.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Members or Stockholders</Identifier>
        <ReturnReference>Form 990, Part VI, Line 6</ReturnReference>
        <Explanation>The organization has dues paying members.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Members or Stockholders Who May Elect</Identifier>
        <ReturnReference>Form 990, Part VI, Line 7a</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Decisions Subject to Approval</Identifier>
        <ReturnReference>Form 990, Part VI, Line 7b</ReturnReference>
        <Explanation>Any changes to the MHA bylaws 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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990 Review Process</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11b</ReturnReference>
        <Explanation>THE FORM 990 WAS PREPARED BY THE ORGANIZATION?S TAX SERVICE PROVIDER WITH INFORMATION PROVIDED BY THE CONTROLLER. THE FORM WAS REVIEWED BY THE CHIEF EXECUTIVE OFFICER AND GENERAL COUNSEL PRIOR TO BEING PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE REVIEWED THE FORM 990 IN DETAIL AND APPROVED FOR SUBMISSION TO THE INTERNAL REVENUE SERVICE. PRIOR TO THE FINAL FORM BEING ELECTRONICALLY SUBMITTED TO THE INTERNAL REVENUE SERVICE, A COPY WAS PROVIDED TO ALL THE MEMBERS OF THE BOARD OF TRUSTEES.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Conflict of Interest Policy Monitoring &amp; Enforcement</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c</ReturnReference>
        <Explanation>THE ASSOCIATION MAINTAINS A WRITTEN CONFLICT OF INTEREST POLICY THAT IS INCLUDED IN THE ASSOCIATION'S POLICIES AND PROCEDURES MANUAL WHICH IS UPDATED AND DISSEMINATED TO EMPLOYEES AND TRUSTEES ANNUALLY. AT THE START OF EACH FISCAL YEAR, THE SENIOR DIRECTOR OF HUMAN RESOURCES OF THE ORGANIZATION 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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Process for Determining Compensation</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15a</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Process for Determining Compensation</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b</ReturnReference>
        <Explanation>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 KEY EMPLOYEE COMPENSATION RECOMMENDATIONS. ON A BIENNIAL BASIS, 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 KEY EMPLOYEES IS RECORDED.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>How Documents are Made Available to the Public</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19</ReturnReference>
        <Explanation>THE ASSOCIATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Other Changes in Net Assets</Identifier>
        <ReturnReference>Form 990, PArt XI, Line 9</ReturnReference>
        <Explanation>Subsidiary Earnings: $(398,545) Gain on Interest Rate Swaps: $362,801 Legal Settlement: $270,987 ------------- Total $235,243</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MA Hospital Research &amp; Ed Association</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5 New England Executive Park</AddressLine1>
          <City>Burlington</City>
          <State>MA</State>
          <ZIPCode>01803</ZIPCode>
        </AddressUS>
        <EIN>237039401</EIN>
        <PrimaryActivities>EDUCATION</PrimaryActivities>
        <LegalDomicileState>MA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>09</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>MHA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>New England Healthcare Assmebly Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5 New England Executive Park</AddressLine1>
          <City>Burlington</City>
          <State>MA</State>
          <ZIPCode>01803</ZIPCode>
        </AddressUS>
        <EIN>237418007</EIN>
        <PrimaryActivities>SUPPORT</PrimaryActivities>
        <LegalDomicileState>MA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>07</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>MHA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>MHA Insurance Agency Inc</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>5 New England Executive Park</AddressLine1>
          <City>Burlington</City>
          <State>MA</State>
          <ZIPCode>01803</ZIPCode>
        </AddressUS>
        <EIN>042915488</EIN>
        <PrimaryActivity>Insurance</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>MHA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C-Corp</TypeOfEntity>
        <ShareOfTotalIncome>82362</ShareOfTotalIncome>
        <ShareOfEOYAssets>525838</ShareOfEOYAssets>
        <PercentageOwnership>1.00000</PercentageOwnership>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>true</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>true</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>true</LoansOrGuaranteesFromOtherOrg>
      <DividendsRelatedOrganization>false</DividendsRelatedOrganization>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>false</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>false</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>true</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>false</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>true</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>true</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHA IA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
        <AmountInvolved>158340</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHA IA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
        <AmountInvolved>73085</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHa IA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>q</TransactionType>
        <AmountInvolved>20000</AmountInvolved>
        <MethodOfAmtDetermination>Cash</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHA IA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>a</TransactionType>
        <AmountInvolved>50700</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHA IA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>q</TransactionType>
        <AmountInvolved>8000</AmountInvolved>
        <MethodOfAmtDetermination>CASH</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHA IA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>l</TransactionType>
        <AmountInvolved>53004</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHA IA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>r</TransactionType>
        <AmountInvolved>135000</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHA IA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>r</TransactionType>
        <AmountInvolved>118100</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHREA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>o</TransactionType>
        <AmountInvolved>213652</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHREA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>l</TransactionType>
        <AmountInvolved>12380</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHREA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>s</TransactionType>
        <AmountInvolved>702825</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>