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      </Form990PartVIISectionA>
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        <NamePerson>JOSEPH J MULLANY</NamePerson>
        <Title>PAST TREASURER</Title>
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        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
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        <NamePerson>WALTER H ETTINGER MD</NamePerson>
        <Title>PAST SECRETARY</Title>
        <AverageHoursPerWeek>0.7</AverageHoursPerWeek>
        <IndividualTrusteeOrDirector>X</IndividualTrusteeOrDirector>
        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
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        <NamePerson>DALE M LODGE</NamePerson>
        <Title>IMMEDIATE PAST CHAIRMAN</Title>
        <AverageHoursPerWeek>0.7</AverageHoursPerWeek>
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        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
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        <NamePerson>JOHN W POLANOWICZ MBA</NamePerson>
        <Title>PAST CIAC CHAIR</Title>
        <AverageHoursPerWeek>0.6</AverageHoursPerWeek>
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        <OtherCompensation>0</OtherCompensation>
      </Form990PartVIISectionA>
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        <NamePerson>R DAVID RICHER</NamePerson>
        <Title>SPECIALTY HOSPITAL CHAIR</Title>
        <AverageHoursPerWeek>0.6</AverageHoursPerWeek>
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        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
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      </Form990PartVIISectionA>
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        <NamePerson>ELAINE L BRIDGE RN MBA DNP</NamePerson>
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        <ReportableCompFromOrganization>0</ReportableCompFromOrganization>
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        <Title>FMR NON TYPE I MEMBER AT LARGE</Title>
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        <NamePerson>PAUL J ANDREWS</NamePerson>
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        <NamePerson>RICHARD H AUBUT RN</NamePerson>
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        <NamePerson>DELIA O'CONNOR FACHE</NamePerson>
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        <NamePerson>MARK J RICH</NamePerson>
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        <NamePerson>TIMOTHY GENS</NamePerson>
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      </Form990PartVIISectionA>
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        <NamePerson>KAREN NELSON</NamePerson>
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        <OtherCompensation>19296</OtherCompensation>
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        <NamePerson>JAMES KIRKPATRICK</NamePerson>
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        <NamePerson>CHRISTINE BARATTA</NamePerson>
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        <NamePerson>PATRICIA CROWLEY</NamePerson>
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        <NamePerson>MICHAEL SROCZYNSKI</NamePerson>
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        <NamePerson>PATRICIA NOGA</NamePerson>
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        <NamePerson>ANUJ GOEL</NamePerson>
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        <NamePerson>DAVID SMITH</NamePerson>
        <Title>SR. DIR. HEALTH DATA ANALYSIS</Title>
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      <NumberIndividualsGT100K>11</NumberIndividualsGT100K>
      <FormersListed>false</FormersListed>
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      <GrantsToDomesticOrgs>
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      <GrantsToDomesticIndividuals>
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      </GrantsToDomesticIndividuals>
      <ForeignGrants>
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      </ForeignGrants>
      <BenefitsToMembers>
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      <FeesForServicesLobbying>
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      <FeesForServicesProfFundraising>
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      </Advertising>
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      </OfficeExpenses>
      <InformationTechnology>
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      <Travel>
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      <TravelEntrtnmntPublicOfficials>
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        <Total>319058</Total>
      </ConferencesMeetings>
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      <PaymentsToAffiliates>
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      <AuditCommittee>true</AuditCommittee>
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        <Description>LOAN ORIGINATION FEES</Description>
        <BookValue>18460</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>AMORTIZATION RESERVE</Description>
        <BookValue>-4385</BookValue>
      </OtherAssets>
      <OtherAssets>
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      <OtherAssets>
        <Description>457 F ASSETS</Description>
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      </OtherAssets>
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      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
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        <Amount>320827</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>LT RETIREMENT PLAN OBLIGATION</Description>
        <Amount>1387376</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>INTEREST RATE SWAP</Description>
        <Amount>1083563</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>2791766</TotalOfAmounts>
      <Form990ScheduleDPartXIV>
        <Identifier>SCHEDULE D, PART X, LINE 2</Identifier>
        <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 AT SEPTEMBER 30, 2012 AND 2011 THAT REQUIRE ACCRUAL OR DISCLOSURE.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="IRS990ScheduleG">
      <EventsInformation>
        <NameOfEvent1>GOLF OUTING</NameOfEvent1>
        <GrossReceiptsEvent1>40615</GrossReceiptsEvent1>
        <GrossRevenueEvent1>40615</GrossRevenueEvent1>
        <NonCashPrizesEvent1>4565</NonCashPrizesEvent1>
        <RentFacilityCostsEvent1>20573</RentFacilityCostsEvent1>
        <OtherDirectExpensesEvent1>775</OtherDirectExpensesEvent1>
        <NameOfEvent2>GOLF OUTING</NameOfEvent2>
        <GrossReceiptsEvent2>54795</GrossReceiptsEvent2>
        <GrossRevenueEvent2>54795</GrossRevenueEvent2>
        <NonCashPrizesEvent2>500</NonCashPrizesEvent2>
        <RentFacilityCostsEvent2>8795</RentFacilityCostsEvent2>
        <FoodAndBeverageEvent2>1194</FoodAndBeverageEvent2>
        <OtherDirectExpensesEvent2>2571</OtherDirectExpensesEvent2>
        <TotalNumberOfOtherEvents>0</TotalNumberOfOtherEvents>
        <GrossReceiptsTotal>95410</GrossReceiptsTotal>
        <GrossRevenueTotalEvents>95410</GrossRevenueTotalEvents>
        <NonCashPrizesTotalEvents>5065</NonCashPrizesTotalEvents>
        <RentFacilityCostsTotalEvents>29368</RentFacilityCostsTotalEvents>
        <FoodAndBeverageTotalEvents>1194</FoodAndBeverageTotalEvents>
        <OtherDirectExpensesTotalEvents>3346</OtherDirectExpensesTotalEvents>
        <DirectExpenseSummaryEvents>38973</DirectExpenseSummaryEvents>
        <NetIncomeSummary>56437</NetIncomeSummary>
      </EventsInformation>
    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ">
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <Form990OfOtherOrganizations>X</Form990OfOtherOrganizations>
      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <Form990ScheduleJPartII>
        <NamePerson>PATRICIA LYNN NICHOLAS</NamePerson>
        <BaseCompensationFilingOrg>532205</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>107580</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>16500</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>120925</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>36963</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>814173</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>WALTER RAMOS</NamePerson>
        <BaseCompensationFilingOrg>176023</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>20400</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>7424</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>203847</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>TIMOTHY GENS</NamePerson>
        <BaseCompensationFilingOrg>260143</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>47174</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>16500</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>20458</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>344275</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>KAREN NELSON</NamePerson>
        <BaseCompensationFilingOrg>125704</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>28640</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>16500</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>19296</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>190140</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JAMES KIRKPATRICK</NamePerson>
        <BaseCompensationFilingOrg>107781</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>31840</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>16500</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>16955</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>173076</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>CHRISTINE BARATTA</NamePerson>
        <BaseCompensationFilingOrg>178262</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>28583</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>16500</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>18388</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>241733</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>PATRICIA CROWLEY</NamePerson>
        <BaseCompensationFilingOrg>135727</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>17492</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>7183</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>160402</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MICHAEL SROCZYNSKI</NamePerson>
        <BaseCompensationFilingOrg>145433</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>20858</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>17262</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>183553</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>PATRICIA NOGA</NamePerson>
        <BaseCompensationFilingOrg>105274</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>33357</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>5838</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>20115</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>8340</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>131227</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>41697</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ANUJ GOEL</NamePerson>
        <BaseCompensationFilingOrg>141626</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>17989</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>17219</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>176834</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>DAVID SMITH</NamePerson>
        <BaseCompensationFilingOrg>139477</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>2813</BonusFilingOrg>
        <BonusRelatedOrgs>0</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>0</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>0</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>0</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>0</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>17021</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>0</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>159311</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>Supplemental nonqualified retirement plan</Identifier>
        <ReturnReference>Schedule J, Part I, Line 4b</ReturnReference>
        <Explanation>The following participated in a 457(F) plan - $120,925: Patricia Lynn Nicholas</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Robert Gibbons</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Former Key Employee</Relationship>
        <AmountOfTransaction>18334</AmountOfTransaction>
        <DescriptionOfTransaction>Consulting for grassroots</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, SECTION A, Line 4</Identifier>
        <Explanation>Included statutory protection for trustees to the Articles of Organization.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, SECTION A, Line 6</Identifier>
        <Explanation>The Organization has dues paying members.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 7A</Identifier>
        <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>FORM 990, PART VI, SECTION A, LINE 7B</Identifier>
        <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, PART VI, SECTION B, LINE 11</Identifier>
        <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 MEMBERS OF THE BOARD OF TRUSTEES.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION B, LINE 12C</Identifier>
        <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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION B, LINE 15A</Identifier>
        <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>FORM 990, PART VI, SECTION B, LINE 15B</Identifier>
        <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 EXECUTIVES 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>FORM 990, PART VI, SECTION C, LINE 19</Identifier>
        <Explanation>THE ASSOCIATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART XI, LINE 5</Identifier>
        <Explanation>RECONCILIATION OF NET ASSETS LOSS ON INTEREST RATE SWAPS (42,834) UNREALIZED GAIN ON INVESTMENTS 610,674 SUBSIDIARY EARNINGS 118,037 TOTAL 685,877</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:PATRICIA NOGA TITLE:VP CLINICAL AFFAIRS HOURS:15</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>MA HOSPITAL RESEARCH 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>9</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>MHA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>true</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>NEW ENGLAND HEALTHCARE ASSEMBLY 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>7</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 AGENCY</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>MHA SUBHOLD</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C CORP</TypeOfEntity>
        <ShareOfTotalIncome>963844</ShareOfTotalIncome>
        <ShareOfEOYAssets>306701</ShareOfEOYAssets>
        <PercentageOwnership>1.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>MHA SUBHOLD INC</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>5 NEW ENGLAND EXECUTIVE PARK</AddressLine1>
          <City>BURLINGTON</City>
          <State>MA</State>
          <ZIPCode>01803</ZIPCode>
        </AddressUS>
        <EIN>042986641</EIN>
        <PrimaryActivity>HOLDING COMPANY</PrimaryActivity>
        <LegalDomicileState>MA</LegalDomicileState>
        <DirectControllingEntityName>
          <BusinessNameLine1>MHA</BusinessNameLine1>
        </DirectControllingEntityName>
        <TypeOfEntity>C CORP</TypeOfEntity>
        <ShareOfTotalIncome>118037</ShareOfTotalIncome>
        <ShareOfEOYAssets>283508</ShareOfEOYAssets>
        <PercentageOwnership>1.00000</PercentageOwnership>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>true</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>true</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>true</LoansOrGuaranteesFromOtherOrg>
      <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>MHAIA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>193004</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHAIA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>P</TransactionType>
        <AmountInvolved>28000</AmountInvolved>
        <MethodOfAmtDetermination>CASH</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHAIA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>A</TransactionType>
        <AmountInvolved>50700</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHAIA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>R</TransactionType>
        <AmountInvolved>137600</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHAIA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>Q</TransactionType>
        <AmountInvolved>142160</AmountInvolved>
        <MethodOfAmtDetermination>CASH</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHREA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>108284</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHREA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>R</TransactionType>
        <AmountInvolved>326895</AmountInvolved>
        <MethodOfAmtDetermination>CASH</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHA SUBHOLD</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>R</TransactionType>
        <AmountInvolved>118036</AmountInvolved>
        <MethodOfAmtDetermination>CASH</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MHA SUBHOLD</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>Q</TransactionType>
        <AmountInvolved>118037</AmountInvolved>
        <MethodOfAmtDetermination>CASH</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>NEHA</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>Q</TransactionType>
        <AmountInvolved>1530</AmountInvolved>
        <MethodOfAmtDetermination>CASH</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>