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        <ProgramServices>152171</ProgramServices>
        <ManagementAndGeneral>15059</ManagementAndGeneral>
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      <OtherEmployeeBenefits>
        <Total>878552</Total>
        <ProgramServices>796477</ProgramServices>
        <ManagementAndGeneral>82075</ManagementAndGeneral>
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        <ProgramServices>415894</ProgramServices>
        <ManagementAndGeneral>41157</ManagementAndGeneral>
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      <FeesForServicesLegal>
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        <ManagementAndGeneral>1615</ManagementAndGeneral>
      </FeesForServicesLegal>
      <FeesForServicesAccounting>
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        <ManagementAndGeneral>54100</ManagementAndGeneral>
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        <ProgramServices>353460</ProgramServices>
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        <ProgramServices>8431</ProgramServices>
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        <ProgramServices>54690</ProgramServices>
        <Fundraising>3359</Fundraising>
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        <Total>17528</Total>
        <ProgramServices>17528</ProgramServices>
      </InformationTechnology>
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        <Total>385204</Total>
        <ProgramServices>385204</ProgramServices>
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        <ProgramServices>8492</ProgramServices>
        <Fundraising>254</Fundraising>
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        <ProgramServices>2433</ProgramServices>
        <Fundraising>3597</Fundraising>
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      <Interest>
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        <ProgramServices>251598</ProgramServices>
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        <Total>662986</Total>
        <ProgramServices>662986</ProgramServices>
      </DepreciationDepletion>
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        <ProgramServices>29311</ProgramServices>
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        <Description>PATIENT CARE EXPENSES</Description>
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        <ProgramServices>1137884</ProgramServices>
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        <ProgramServices>634639</ProgramServices>
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        <ProgramServices>268672</ProgramServices>
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      <OtherExpenses>
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        <ManagementAndGeneral>55154</ManagementAndGeneral>
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      <OtherExpenses>
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        <ProgramServices>52247</ProgramServices>
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      <AllOtherExpenses>
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        <ProgramServices>48368</ProgramServices>
        <Fundraising>10095</Fundraising>
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        <Fundraising>141402</Fundraising>
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        <EOY>5738107</EOY>
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        <EOY>110155</EOY>
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        <EOY>75355</EOY>
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        <EOY>4925495</EOY>
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        <EOY>15158</EOY>
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        <EOY>973326</EOY>
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      <InfoInScheduleOPartXII>X</InfoInScheduleOPartXII>
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      <AuditCommittee>1</AuditCommittee>
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        <CurrentTaxYearMinus3Years>1719064</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>776850</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>2058316</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>1445108</CurrentTaxYear>
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        <CurrentTaxYearMinus1Year>10376513</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>10557028</CurrentTaxYear>
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        <CurrentTaxYear>12002136</CurrentTaxYear>
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      <AmtsRecdFromDisqualPersons>
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      <SupportFromDQPsEtc>
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        <CurrentTaxYearMinus2Years>11107</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>4174</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>4025</CurrentTaxYear>
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      </GrossInvestmentIncome509>
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        <CurrentTaxYearMinus1Year>4174</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>4025</CurrentTaxYear>
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        <CurrentTaxYearMinus1Year>35796</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>44696</CurrentTaxYear>
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        <CurrentTaxYearMinus3Years>11445361</CurrentTaxYearMinus3Years>
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        <CurrentTaxYearMinus1Year>12474799</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>12050857</CurrentTaxYear>
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      <PublicSupportPercentage509>0.99540</PublicSupportPercentage509>
      <PriorYearSupportPercentage>0.94840</PriorYearSupportPercentage>
      <InvestmentIncomePercentage>0.00130</InvestmentIncomePercentage>
      <PriorYrInvestIncomePercentage>0.00210</PriorYrInvestIncomePercentage>
      <ThirtyThreePercntTestsCY509>X</ThirtyThreePercntTestsCY509>
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        <ContributorNameBusiness>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorNameBusiness>
        <ContributorAddressUS>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorAddressUS>
        <AggregateContributions>RESTRICTED</AggregateContributions>
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    </IRS990ScheduleB>
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      <PaidStaffOrManagement>0</PaidStaffOrManagement>
      <MediaAdvertisements>0</MediaAdvertisements>
      <MailingsMembers>0</MailingsMembers>
      <PublicationsOrBroadcast>0</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>0</GrantsOtherOrganizations>
      <DirectContactLegislators>0</DirectContactLegislators>
      <RalliesDemonstrations>0</RalliesDemonstrations>
      <OtherActivities>1</OtherActivities>
      <OtherActivitiesAmount>187</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>187</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>0</NotDescribedIn501c3>
      <Form990ScheduleCPartIV>
        <Identifier>EXPLANATION OF OTHER LOBBYING ACTIVITIES:</Identifier>
        <ReturnReference>PART II-B, LINE 1I:</ReturnReference>
        <Explanation>PART OF MEMBERSHIP DUES PAID TO STATE HEALTHCARE ORGANIZATIONS</Explanation>
      </Form990ScheduleCPartIV>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
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        <Depreciation>5513811</Depreciation>
        <BookValue>4949585</BookValue>
      </Buildings>
      <Equipment>
        <OtherCostOrOtherBasis>2967458</OtherCostOrOtherBasis>
        <Depreciation>2178936</Depreciation>
        <BookValue>788522</BookValue>
      </Equipment>
      <TotalOfBookValueLandBuildings>5738107</TotalOfBookValueLandBuildings>
      <OtherLiabilities>
        <Description>OTHER LIABILITIES</Description>
        <Amount>15158</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>15158</TotalOfAmounts>
      <TotalRevenue>11183657</TotalRevenue>
      <TotalExpenses>12143600</TotalExpenses>
      <ExcessOrDeficitForYear>-959943</ExcessOrDeficitForYear>
      <NetUnrealizedGLOnInvestments>5858</NetUnrealizedGLOnInvestments>
      <OtherAmount>845000</OtherAmount>
      <TotalAdjustments>850858</TotalAdjustments>
      <ExcessOrDeficitPerFS>-109085</ExcessOrDeficitPerFS>
      <TotRevenueEtcAuditedFinclStmt>11327328</TotRevenueEtcAuditedFinclStmt>
      <NetUnrealizedGainsInvestments>5858</NetUnrealizedGainsInvestments>
      <DonatedSrvcAndUseOfFacilities>80603</DonatedSrvcAndUseOfFacilities>
      <OtherRevenues>57210</OtherRevenues>
      <RevenueNotRptdF990>143671</RevenueNotRptdF990>
      <RevenueSubtotal>11183657</RevenueSubtotal>
      <RevenueNotRptdOnFinStmt>0</RevenueNotRptdOnFinStmt>
      <TotalRevenuePerForm990>11183657</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>12281413</TotExpensesEtcAuditedFinclStmt>
      <DonatedServicesUseOfFacilities>80603</DonatedServicesUseOfFacilities>
      <OtherExpensesIncluded>57210</OtherExpensesIncluded>
      <ExpensesNotRptdF990>137813</ExpensesNotRptdF990>
      <ExpensesSubtotal>12143600</ExpensesSubtotal>
      <ExpensesNotRptdOnFinStmt>0</ExpensesNotRptdOnFinStmt>
      <TotalExpensesPerForm990>12143600</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIV>
        <Identifier>PART XI, LINE 8 - OTHER ADJUSTMENTS:</Identifier>
        <Explanation>EQUITY TRANSFER 845,000.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>PART XII, LINE 2D - OTHER ADJUSTMENTS:</Identifier>
        <Explanation>FUNDRAISING EVENT EXPENSE INCLUDED IN REVENUES 57,210.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>PART XIII, LINE 2D - OTHER ADJUSTMENTS:</Identifier>
        <Explanation>FUNDRASING EVENTS EXPENSES INCLUDED IN REVENUES 57,210.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="RetDoc1041300001">
      <EventsInformation>
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        <GrossReceiptsEvent1>100999</GrossReceiptsEvent1>
        <CharitableContributionsEvent1>22200</CharitableContributionsEvent1>
        <GrossRevenueEvent1>78799</GrossRevenueEvent1>
        <CashPrizesEvent1>300</CashPrizesEvent1>
        <NonCashPrizesEvent1>19977</NonCashPrizesEvent1>
        <RentFacilityCostsEvent1>11450</RentFacilityCostsEvent1>
        <FoodAndBeverageEvent1>15002</FoodAndBeverageEvent1>
        <OtherDirectExpensesEvent1>10481</OtherDirectExpensesEvent1>
        <TotalNumberOfOtherEvents>1</TotalNumberOfOtherEvents>
        <GrossReceiptsTotal>100999</GrossReceiptsTotal>
        <CharitableContributionsTotal>22200</CharitableContributionsTotal>
        <GrossRevenueTotalEvents>78799</GrossRevenueTotalEvents>
        <CashPrizesTotalEvents>300</CashPrizesTotalEvents>
        <NonCashPrizesTotalEvents>19977</NonCashPrizesTotalEvents>
        <RentFacilityCostsTotalEvents>11450</RentFacilityCostsTotalEvents>
        <FoodAndBeverageTotalEvents>15002</FoodAndBeverageTotalEvents>
        <OtherDirectExpensesTotalEvents>10481</OtherDirectExpensesTotalEvents>
        <DirectExpenseSummaryEvents>57210</DirectExpenseSummaryEvents>
        <NetIncomeSummary>21589</NetIncomeSummary>
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    </IRS990ScheduleG>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 7A</Identifier>
        <Explanation>THE TRUSTEES ELECT MEMBERS OF THE GOVERNING BOARD.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION A, LINE 7B</Identifier>
        <Explanation>DECISIONS OF THE GOVERNING BOARD ARE SUBJECT TO APPROVAL BY THE TRUSTEES.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FORM 990, PART VI, SECTION B, LINE 11</Identifier>
        <Explanation>A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT WAS FILED.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15</ReturnReference>
        <Explanation>MERIT RAISE REVIEW IS PERFORMED BY THE BOARD OF DIRECTORS FOR THE CEO. FOR OFFICERS AND KEY EMPLOYEES A MERIT BASED RAISE REVIEW IS PERFORMED BY THE CEO/ADMINISTRATOR.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CHANGES IN NET ASSETS OR FUND BALANCES:</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5:</ReturnReference>
        <Explanation>NET UNREALIZED GAINS ON INVESTMENTS: 5,858. EQUITY TRANSFER 845,000. TOTAL TO FORM 990, PART XI, LINE 5: 850,858.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <ReturnReference>FORM 990 PART XI LINE 2C</ReturnReference>
        <Explanation>THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT SUPERVISES THE AUDIT AND ENGAGES THE AUDITOR.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
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        </NameOfDisregardedEntity>
        <EIN>999999999</EIN>
        <LegalDomicileState>MA</LegalDomicileState>
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      <ReceiptOfIntAnnRentsRoyalties>0</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>0</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>0</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>0</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>0</LoansOrGuaranteesFromOtherOrg>
      <SaleOfAssetsToOtherOrg>0</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>0</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>0</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>0</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>0</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>1</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>1</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>1</SharingOfFacilities>
      <SharingOfPaidEmployees>1</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>1</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>1</ReimbursementPaidByOtherOrg>
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      <OtherTransferFromOtherOrg>1</OtherTransferFromOtherOrg>
      <TransactionsRelatedOrgsTable>
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          <BusinessNameLine1>THE RELATED ORGANIZATION IS RELIGIOUS BASED AND HAVE NO FILING REQUIREMENT</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>C</TransactionType>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
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</Return>