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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Anthony Consigli</PersonNm>
        <TitleTxt>Chair</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John Fernandes</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Brian Earley</PersonNm>
        <TitleTxt>Vice Chair</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Linda Mancini</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Denise Brookhouse</PersonNm>
        <TitleTxt>Clerk</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Shefali Desai</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jamie Doucette</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Sandra Clark</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jeffrey Nutting</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>4148715</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>807022</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>593755</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>303</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Alliance Healthcare Services</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 735714</AddressLine1Txt>
            <CityNm>Dallas</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75373</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>MRI Services/PET Services</ServicesDesc>
        <CompensationAmt>4653161</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>University of Massachusetts</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>55 Lake Ave N</AddressLine1Txt>
            <CityNm>Worcester</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01655</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician Services</ServicesDesc>
        <CompensationAmt>2077721</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Brigham &amp; Women's Physician Organization</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 3684</AddressLine1Txt>
            <CityNm>Boston</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02241</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Leased employee services</ServicesDesc>
        <CompensationAmt>1239355</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Laboratory Corporation of America</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 12140</AddressLine1Txt>
            <CityNm>Burlington</CityNm>
            <StateAbbreviationCd>NC</StateAbbreviationCd>
            <ZIPCd>27216</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Laboratory Supprt</ServicesDesc>
        <CompensationAmt>962187</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>UMass Memorial Medical Group</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>306 Belmont Street</AddressLine1Txt>
            <CityNm>Worcester</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>01604</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physician Services</ServicesDesc>
        <CompensationAmt>936838</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>30</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>360900</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>4010810</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>2000648</AllOtherContributionsAmt>
      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>6372358</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Inpatient/Outpatient Revenue</Desc>
        <BusinessCd>622000</BusinessCd>
        <TotalRevenueColumnAmt>277120988</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>276841970</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>279018</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>277120988</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>2323498</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2323498</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>13763518</SecuritiesAmt>
        <OtherAmt>18909</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>9056485</SecuritiesAmt>
        <OtherAmt>22791</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>4707033</SecuritiesAmt>
        <OtherAmt>-3882</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>4703151</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>4703151</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>117813</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>360900</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>451003</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-333190</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-333190</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <OtherRevenueMiscGrp>
        <Desc>Cancer Center</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>1232678</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1232678</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Rents</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>2860403</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2860403</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Cafeteria</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>891731</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>891731</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>1514163</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1514163</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>6498975</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>296685780</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>290367594</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>279018</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-333190</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
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      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1211808</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1211808</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <OtherSalariesAndWagesGrp>
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        <ProgramServicesAmt>101960586</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16366479</ManagementAndGeneralAmt>
        <FundraisingAmt>539721</FundraisingAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>2098869</TotalAmt>
        <ProgramServicesAmt>1847004</ProgramServicesAmt>
        <ManagementAndGeneralAmt>230876</ManagementAndGeneralAmt>
        <FundraisingAmt>20989</FundraisingAmt>
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      <OtherEmployeeBenefitsGrp>
        <TotalAmt>16732805</TotalAmt>
        <ProgramServicesAmt>14724868</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1840609</ManagementAndGeneralAmt>
        <FundraisingAmt>167328</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>9554994</TotalAmt>
        <ProgramServicesAmt>8408395</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1051049</ManagementAndGeneralAmt>
        <FundraisingAmt>95550</FundraisingAmt>
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      <FeesForServicesManagementGrp>
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        <ProgramServicesAmt>2420097</ProgramServicesAmt>
        <ManagementAndGeneralAmt>377442</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForServicesLegalGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>396980</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>96773</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>96773</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForServicesLobbyingGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
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        <ProgramServicesAmt>112190</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14024</ManagementAndGeneralAmt>
        <FundraisingAmt>1275</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>62267850</TotalAmt>
        <ProgramServicesAmt>60816635</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1362675</ManagementAndGeneralAmt>
        <FundraisingAmt>88540</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>4471379</TotalAmt>
        <ProgramServicesAmt>3888197</ProgramServicesAmt>
        <ManagementAndGeneralAmt>486025</ManagementAndGeneralAmt>
        <FundraisingAmt>97157</FundraisingAmt>
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      <RoyaltiesGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>12117421</TotalAmt>
        <ProgramServicesAmt>10672557</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1388489</ManagementAndGeneralAmt>
        <FundraisingAmt>56375</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>32878</TotalAmt>
        <ProgramServicesAmt>29449</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3375</ManagementAndGeneralAmt>
        <FundraisingAmt>54</FundraisingAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>4322199</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4322199</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
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        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>11533859</TotalAmt>
        <ProgramServicesAmt>10149796</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1268724</ManagementAndGeneralAmt>
        <FundraisingAmt>115339</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>1638692</TotalAmt>
        <ProgramServicesAmt>1442049</ProgramServicesAmt>
        <ManagementAndGeneralAmt>180256</ManagementAndGeneralAmt>
        <FundraisingAmt>16387</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Contracted Services</Desc>
        <TotalAmt>32138869</TotalAmt>
        <ProgramServicesAmt>27660011</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4455038</ManagementAndGeneralAmt>
        <FundraisingAmt>23820</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Collection Fee</Desc>
        <TotalAmt>1487190</TotalAmt>
        <ProgramServicesAmt>1487190</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Physician Fees</Desc>
        <TotalAmt>7175267</TotalAmt>
        <ProgramServicesAmt>7175267</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Health Safety Net</Desc>
        <TotalAmt>5532372</TotalAmt>
        <ProgramServicesAmt>5532372</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>294602019</TotalAmt>
        <ProgramServicesAmt>258326663</ProgramServicesAmt>
        <ManagementAndGeneralAmt>35052821</ManagementAndGeneralAmt>
        <FundraisingAmt>1222535</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>3340</BOYAmt>
        <EOYAmt>3340</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>45217991</BOYAmt>
        <EOYAmt>41385151</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 5-Milford Regional Medical Center Inc</FormAndLineReferenceDesc>
        <ExplanationTxt>For Fiscal Year 2023, the Community Benefits Leadership and Advisory Committee continued to focus on its priorities which included mental health, homelessness and food insecurity, access to care, and better health outcomes. * Mental Health: Milford Regional's Community Benefits Committee sponsored its second panel discussion, "Opening Doors to Youth Mental Health; A Focus on Homebased Health Services." The April 12 panel and networking event was free and held at Milford High School and qualified for one continuing education credit for social workers. Panelists included Commissioner for the Massachusetts Department of Mental Health Brooke Doyle; Vice President of Service Integration for Riverside Community Care Manny Oppong; Medway Police Officer and LGBTQ Liaison Meghan Casey; and Nurse Practitioner for Milford Regional and Blackstone Valley Tech.'s School Based Health Center Jenna Callahan. The program was moderated by Milford Regional Chief Quality Officer and Vice President Bert Thurlo-Walsh, MM, RN, CPHQ. Social workers, school administrators, public safety officials and representatives from community organizations attended the event. The purpose of the event was to focus on solutions that will help our youth in crisis access more homebased mental health services due to the lack of psychiatric beds available. Also, under the priority of mental health, a new Frontal Temporal Degeneration (FTD) Support Group began at Milford Regional in FY23. The facilitator, Christine Beauchaine from the Association for FTD, met with the group the last Saturday of each month at the hospital. The group is geared for caregivers and others impacted by FTD. *Homelessness and Food Insecurity: The Community Benefits Committee partnered with the Greater Milford Community Health Network Area 6 (CHNA 6) to produce a "Hope for the Homeless in Our Community" business card. CHNA 6, is comprised of multiple organizations working together to improve the health of the region. The card contains a QR Code and website directing users to multiple resources within the Franklin, Milford and other Blackstone Valley communities, listing contact information to social services, medical and behavioral services, homeless shelters, housing services, food insecurity resources and more. The card was handed out to public safety officials, social workers, those working to help migrant families and homeless individuals as well as social workers within the hospital. * Access to Care: Milford Regional's Childbirth Education instructor, Laura Laird, provided childbirth education to expecting students within the Milford School District. Over the course of the year, Laura traveled to two schools providing students information on childbirth and newborn care. The education was provided at no cost to the students or school district and the Milford schools provided a translator when needed. *Better Health Outcomes: Through the Hospital Care Transitions Report, Committee member and Milford Regional Director of Quality, Patient Safety and Experience Cheryl Bardetti, helped the Committee identify heart failure as a top health issue among Milford Regional patients. As a result, the Committee considered what impactful initiative would benefit patients of the hospital's Heart Failure Clinic. The Committee agreed to have newly created patient correspondence translated into the hospital's most requested languages. This initiative was completed in FY24. Throughout FY24, much of the focus of the Community Benefits Committee will be completing a new Community Health Needs Assessment. With the help of Holleran Consulting, data from online community surveys, focus groups and key informant surveys will be compiled and analyzed to determine the Committee's healthcare priorities for the next three years. Milford Regional's Community Benefits Leadership Team is comprised of hospital administration and staff, and the Community Benefits Advisory Committee is a group of dedicated community representatives. The two work together to develop and implement programming that impacts residents of all ages in our service area.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11-Milford Regional Medical Center Inc</FormAndLineReferenceDesc>
        <ExplanationTxt>Our community benefits programs for the next three years will focus on four priority areas identified in the 2021 Community Health Needs Assessment along with additional needs that are noted as part of our 2024 Community Health Needs Assessment, which is currently underway: * Mental Health and Substance Use * Health Care/Health Insurance Access * Improving Health Outcomes in Worcester County * Food Insecurity and Homelessness. Our Community Benefits Leadership Team is comprised of hospital administration and staff, and the Community Benefits Advisory Committee is a group of dedicated community representatives. The two work together to not only develop but deploy the programming that impacts residents of all ages in our region.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 13h-Milford Regional Medical Center Inc</FormAndLineReferenceDesc>
        <ExplanationTxt>Asset level is used for Medicare patients only. This follows Medicare guidelines.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 20d-Milford Regional Medical Center Inc</FormAndLineReferenceDesc>
        <ExplanationTxt>Milford Regional does not make presumptive determinations. The Hospital as a facility does not deny care to any patient regardless of their MAGI.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 24-Milford Regional Medical Center Inc</FormAndLineReferenceDesc>
        <ExplanationTxt>At the Hospital, all patients are charged the gross charges for any services. Upon contract from an uninsured patient, a discussion occurs which many result in the discounting of gross charges.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>Line 7 a/b/c were calculated using worksheets 1,23 provided in the instructions.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7, Column f</FormAndLineReferenceDesc>
        <ExplanationTxt>Line 7f was determined by the cost and reimbursement information on the Medicare Cost Report. It was calculated by dividing Column E, Net Community Benefit Expense by total of Part IX Line 25 Form 990 Core Form.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Section A, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital's bad debt expense on line 2 was estimated as the product of the Hospital's bad debt multiplied by the Hospital's overall cost-to-charge ratio calculated on Worksheet 2 of the instructions. The bad debt expense attributable to patients eligible for financial assistance on line 3 was calculated as the accounts for which patients were unemployed at the time multiplied by the Hospital's overall cost-to-charge ratio.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Section B, Line 8</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital's Medicare Cost Report was used to determine the amount report in line 6.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Section C, Line 9b</FormAndLineReferenceDesc>
        <ExplanationTxt>Once it has been determined that a patient qualifies for full or partial free care, all collection procedures cease for the bull balance or amount that qualifies under partial free care. Massachusetts hospitals are required to adopt a credit and collections policy under the Health Safety Net (HSN) regulations (114.6 CMR 13.08 (1) (c)) that outlines the specific process for determining eligibility for public assistance programs and hospital collection practices.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Milford Regional stays current with studies by other agencies, particularly the MetroWest Adolescent Health survey conducted by the MetroWest Health Foundation and the state and local data. The Office of Community Benefits is actively engaged with the Community Health Network (CHNA) and other community collections/committees focusing on substance abuse, access to services, interpersonal violence prevention, cancer prevention and nutrition/physician activity/wellness to address emerging health needs.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Patients are informed of the availability of financial assistance by way of payment statements printed with the financial assistance information. If uninsured patients are not able to meet with the on-site Financials Counselor, the patients are given or mailed a letter with contact information for our financial assistance department.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Milford Regional Medical Center services the healthcare needs of the residents of 18 communities in Central Massachusetts, spanning 3 separate counties: Worcester, Norfolk, and Middlesex. The Hospital's service area consists of Milford, Franklin, Bellingham, Northbridge, Uxbridge, Grafton, Holliston, Norfolk, Hopedale, Blackstone, Medway, Mendon, Douglas, Hopkinton, Millis, Wrentham, Upton, and Millville, a population of 247,388 according to 2020 US Census data. The population of the MRMC service area has grown almost 2.5% over the past decade. The residents of this region are primarily Caucasian, accounting for 89.4% of the population. Hispanics comprise 4.8% of the population, with Asians at 3.4% and Blacks at 2.3%. The population is nearly even in terms of gender with 50.4% females. The bulk of the adult population (73.2%) is between the ages of 20-70, slightly lower than the state precentage, which is 76.8%.</ExplanationTxt>
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        <PersonNm>Emily Quinn</PersonNm>
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        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Richard Daly MD</PersonNm>
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        <PersonNm>Diana Caragacianu MD</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
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        <TotalCompensationRltdOrgsAmt>481599</TotalCompensationRltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>James Papadakos</PersonNm>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>Payments made to some members of senior management for insurance premiums are grossed up.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>The President and Senior Leadership all participated in the a SERP consisting of the following contributions this year: Edward Kelly ($101,250.24), Bert Thurlo-Walsh ($16,559.92), Judy Kelly ($16,770), Emily Quinn ($12,127.44), Nicole Thyne ($36,766.08), Tricia Oliver ($9,000.16), Alice Hall ( $15,237.04), Elizabeth Cadle ($25,800), and Peter Smulowitz ($59,089.12)</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column f-01/29/2014 45,825,887 Massachusetts Development Finance Agency</FormAndLineReferenceDesc>
        <ExplanationTxt>The proceeds from the sale of the Series F Bonds and certain other available moneys will be used to finance and refinance the following: (I) the construction, furnishing and equipping of, and site preparation for, a two-story addition to the Institution's main hospital building, (ii) the refunding of the Massachusetts Health and Educational Facilities Authority Revenue Bonds, Milford Whitinsville Regional Hospital issue, Series C (the "Refunded Bonds") currently outstanding in the aggregate principal amount of $12,205,000, (iii) the funding of a Debt Service Reserve Fund for the Series F Bonds, and (iv) the payment of costs of issuance associated with the Series F Bonds (collectively, the "Project"). The Refunded Bonds are expected to be redeemed approximately thirty-five (35) days following the issuance of the Series F bonds at a redemption price equal to 100% of the principal amount thereof.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column f-09/03/2020 65,301,062 Massachusetts Development Finance Agency</FormAndLineReferenceDesc>
        <ExplanationTxt>The proceeds from the sale of the Series G Bonds and certain other available moneys will be used to finance and refinance the following: (i) the advanced refunding of the Massachusetts Health &amp; Education Facilities Authority Revenue Bond, Milford Regional Medical Center issue, Series E (the "Refunded Bonds"), (ii) the funding of a Debt Service Reserve Fund for the Series G Bonds, (iii) the payment of costs of issuance associated with the Series G Bonds, and (iv) the advanced refunding of a loan with Rockland Trust Bank (loan used to finance new ERP project).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part IV, Line 2c-01/29/2014 45,825,887 Massachusetts Development Finance Agency</FormAndLineReferenceDesc>
        <ExplanationTxt>The calculation is performed annually in July.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part IV, Line 2c-09/03/2020 65,301,062 Massachusetts Development Finance Agency</FormAndLineReferenceDesc>
        <ExplanationTxt>Calculation is performed annually in July.</ExplanationTxt>
      </SupplementalInformationDetail>
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      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Shefali Desai</PersonNm>
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        <RelationshipDescriptionTxt>Trusteee</RelationshipDescriptionTxt>
        <TransactionAmt>130889</TransactionAmt>
        <TransactionDesc>Majority of the Hospital's banking transactions are with Rockland Trust where Ms. Desai is an employee.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
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      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
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        <RelationshipDescriptionTxt>Trustee</RelationshipDescriptionTxt>
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        <TransactionDesc>MRMC purchases ER MD services from Orion where Dr. O'Neill is an employee.</TransactionDesc>
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      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Kevin Meehan</PersonNm>
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        <RelationshipDescriptionTxt>Former Trustree</RelationshipDescriptionTxt>
        <TransactionAmt>429585</TransactionAmt>
        <TransactionDesc>Mr. Meehan is the owner of the Imperial dealerships, the owner of an administrative building leased by the Hospital, and a shareholder in Rockland Trust. Mr. Meehan also made contributions to the Hospital.</TransactionDesc>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule M, Part I, Line 33</FormAndLineReferenceDesc>
        <ExplanationTxt>MRMC does not currently account for certain non-cash contributions of in-kind donations as revenue.</ExplanationTxt>
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    </IRS990ScheduleM>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Header, Line B</FormAndLineReferenceDesc>
        <ExplanationTxt>The title of Elizabeth Cadle was incorrect on the original return on Form 990 Part VII Section A and Schedule J.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 3b</FormAndLineReferenceDesc>
        <ExplanationTxt>Extension granted. Form 990T will be filed by 8/15/2024.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Milford Regional is a community hospital, and as such, draws its board members from the leaders of the communities it serves. Many of these people have business relationships that are not known my Milford Regional.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization is governed by a Board of Trustees. In addition, the organization has incorporators who serve as an advisory capacity to the Board of Trustees.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 was provided to the Board of Trustees prior to filing via link to the document.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization has a written Code of Business Conduct which includes its conflict of interest policy. The By-laws of the Organization also include a Conflict of Interest section. Conflict of interest disclosure statements are mailed annually to the Board of Trustees, senior management, and any person who is a member of the Board Committee. The completed form is submitted to the President and CEO who summarizes the results and provides them to the Board of Trustees for their review and discussion. A subcommittee of the Board has been created to review any potential conflict of interest matters as they arise.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The Compensation Committee reviews the compensation of the President and CEO. The committee may consult with a nationally recognized consultant to assist in determining that the organization's compensation structure and wages are reasonable.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization makes its governing documents available to the public, such as its bylaws which include the Organization's conflict of interest policy, through the annual filing of the Massachusetts Division of Public Charities Form PC. The Form PC is available for viewing by the public on the Massachusetts Attorney General's website and is also attached to the annual filing of the Massachusetts From 3ABC which is submitted to town offices where the Organization owns or leases property. The Organization's financial statements are included in the Form P and are also included in the quarterly filing to the Organization's bond holders. Documents are also made available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>The change in net assets result from transferring to affiliates ($8,256,416) and the change in market value of investments ($662,945)</ExplanationTxt>
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          <AddressLine2Txt>Suite 5</AddressLine2Txt>
          <CityNm>Milford</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
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        <PrimaryActivitiesTxt>Provides office space, support to satellite offices</PrimaryActivitiesTxt>
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