﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://www.irs.gov/efile" returnVersion="2022v5.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-04-25T09:23:53-04:00</ReturnTs>
    <TaxPeriodEndDt>2022-12-31</TaxPeriodEndDt>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>010540180</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>HOSPICE OF SOUTHERN MAINE</BusinessNameLine1Txt>
      </BusinessName>
      <InCareOfNm>% Daryl J Cady</InCareOfNm>
      <BusinessNameControlTxt>HOSP</BusinessNameControlTxt>
      <PhoneNum>2072893640</PhoneNum>
      <USAddress>
        <AddressLine1Txt>390 US ROUTE 1</AddressLine1Txt>
        <CityNm>SCARBOROUGH</CityNm>
        <StateAbbreviationCd>ME</StateAbbreviationCd>
        <ZIPCd>040746713</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Nick Paquette</PersonNm>
      <PersonTitleTxt>Finance &amp; HC Operations Director</PersonTitleTxt>
      <SignatureDt>2023-04-25</SignatureDt>
      <DiscussWithPaidPreparerInd>false</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="IRS990" softwareId="22016104" softwareVersionNum="V1.0" documentName="IRS990" referenceDocumentName="IRS990ScheduleO ReasonableCauseExplanation BinaryAttachment">
      <PrincipalOfficerNm>Daryl J Cady</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>390 US ROUTE 1</AddressLine1Txt>
        <CityNm>SCARBOROUGH</CityNm>
        <StateAbbreviationCd>ME</StateAbbreviationCd>
        <ZIPCd>040746713</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>19305626</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.hospiceofsouthernmaine.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>2003</FormationYr>
      <LegalDomicileStateCd>ME</LegalDomicileStateCd>
      <ActivityOrMissionDesc>Hospice Services: To provide compassion care and comfort through end of life.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>13</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>13</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>182</TotalEmployeeCnt>
      <TotalVolunteersCnt>155</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>2048792</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1715524</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>16845382</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>17103736</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>281301</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>232158</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>-44505</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>-66138</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>19130970</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>18985280</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>12728369</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>13458081</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>327293</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>5475998</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>5643091</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>18204367</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>19101172</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>926603</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-115892</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>28517026</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>26486292</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>3722777</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>2665676</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>24794249</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>23820616</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>Compassion care and comfort through end of life.</MissionDesc>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>15228631</ExpenseAmt>
      <GrantAmt>0</GrantAmt>
      <RevenueAmt>17103736</RevenueAmt>
      <Desc>Hospice of Southern Maine's HSM Mission is to provide compassion care and comfort through end-of-life for patients with life-limiting illnesses and support for their families. As the leader in hospice care in Southern Maine our focus is quality and excellence in patient and family centered care. We are the hospice provider of choice for patients families colleagues healthcare professionals and referral sources. Working with patients and their family through the process of dying death grief and loss we work to shift social attitudes and practices to ease the difficult journey of patients and loved ones. To meet our Mission HSM offers comprehensive hospice care to patients in York and Cumberland counties by an interdisciplinary team of physicians nurses hospice aides social workers chaplains grief counselors and volunteers. Our patients have life-limiting illnesses with a prognosis of six months or less. In addition to providing medical emotional social and spiritual support to our patients we also provide care before and after the death for their loved ones. Our bereavement program which is an important part of our mission offers support for 13 months following the death of a loved one. Our program is unique in that it offers one-on-one counseling at no cost. We also offer eight-week group sessions for people who are interested in connecting with others in a similar situation. Additionally we provide counseling and group support to anyone in the community who is grieving whether or not their loved one died while under our care. Formed through a collaborative effort among York and Cumberland County community leaders and health care providers HSM began providing direct patient services in 2004. In 2007 HSM opened the area's first inpatient hospice facility - the Gosnell Memorial Hospice House. Today HSM is the only free-standing state licensed Medicare-certified nonprofit in Maine that is solely focused on providing this hospice care.</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>0</ExpenseAmt>
        <GrantAmt>0</GrantAmt>
        <RevenueAmt>0</RevenueAmt>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>0</ExpenseAmt>
        <GrantAmt>0</GrantAmt>
        <RevenueAmt>0</RevenueAmt>
      </ProgSrvcAccomActy3Grp>
      <TotalOtherProgSrvcExpenseAmt>0</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>0</TotalOtherProgSrvcGrantAmt>
      <TotalOtherProgSrvcRevenueAmt>0</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>15228631</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentName="IRS990ScheduleA">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentName="IRS990ScheduleB">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentName="IRS990ScheduleC">false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentName="IRS990ScheduleC">true</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentName="IRS990ScheduleC">false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentName="IRS990ScheduleD">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentName="IRS990ScheduleD">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentName="IRS990ScheduleD">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentName="IRS990ScheduleD">false</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentName="IRS990ScheduleD">true</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentName="IRS990ScheduleD">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentName="IRS990ScheduleD">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentName="IRS990ScheduleD">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentName="IRS990ScheduleD">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentName="IRS990ScheduleD">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentName="IRS990ScheduleD">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentName="IRS990ScheduleD">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentName="IRS990ScheduleD">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd referenceDocumentName="IRS990ScheduleE">false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd referenceDocumentName="IRS990ScheduleF">false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd referenceDocumentName="IRS990ScheduleF">false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd referenceDocumentName="IRS990ScheduleF">false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd referenceDocumentName="IRS990ScheduleG">false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd referenceDocumentName="IRS990ScheduleG">true</FundraisingActivitiesInd>
      <GamingActivitiesInd referenceDocumentName="IRS990ScheduleG">false</GamingActivitiesInd>
      <OperateHospitalInd referenceDocumentName="IRS990ScheduleH">false</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentName="IRS990ScheduleI">false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentName="IRS990ScheduleI">false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentName="IRS990ScheduleJ">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd referenceDocumentName="IRS990ScheduleK">false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd referenceDocumentName="IRS990ScheduleL">false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentName="IRS990ScheduleL">false</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentName="IRS990ScheduleL">false</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentName="IRS990ScheduleL">false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentName="IRS990ScheduleL">false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentName="IRS990ScheduleL">false</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd referenceDocumentName="IRS990ScheduleL">false</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd referenceDocumentName="IRS990ScheduleM">true</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd referenceDocumentName="IRS990ScheduleM">false</DeductibleArtContributionInd>
      <TerminateOperationsInd referenceDocumentName="IRS990ScheduleN">false</TerminateOperationsInd>
      <PartialLiquidationInd referenceDocumentName="IRS990ScheduleN">false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentName="IRS990ScheduleR">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentName="IRS990ScheduleR">false</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentName="IRS990ScheduleR">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentName="IRS990ScheduleR">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>39</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>182</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>true</QuidProQuoContributionsInd>
      <QuidProQuoContriDisclInd>true</QuidProQuoContriDisclInd>
      <Form8282PropertyDisposedOfInd>false</Form8282PropertyDisposedOfInd>
      <Form8282FiledCnt>0</Form8282FiledCnt>
      <RcvFndsToPayPrsnlBnftCntrctInd>false</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>false</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>false</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>false</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>13</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>13</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>true</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>true</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>true</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>true</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>true</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>true</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Nick Paquette</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>2072893640</PhoneNum>
        <USAddress>
          <AddressLine1Txt>390 US ROUTE 1</AddressLine1Txt>
          <CityNm>SCARBOROUGH</CityNm>
          <StateAbbreviationCd>ME</StateAbbreviationCd>
          <ZIPCd>040746713</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Daryl J Cady</PersonNm>
        <TitleTxt>CEO Ex Officio</TitleTxt>
        <AverageHoursPerWeekRt>55.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>276866</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23214</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Kyra Chamberlain</PersonNm>
        <TitleTxt>Clinical Operations Director</TitleTxt>
        <AverageHoursPerWeekRt>45.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>135319</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15460</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jason Libby</PersonNm>
        <TitleTxt>NP Supervisor</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>141085</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>7617</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stewart Steel</PersonNm>
        <TitleTxt>IT Director</TitleTxt>
        <AverageHoursPerWeekRt>45.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>159420</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>2114</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Nick Paquette</PersonNm>
        <TitleTxt>Finance Healthcare Operations Director</TitleTxt>
        <AverageHoursPerWeekRt>45.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>126982</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>1021</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Loretta Moody</PersonNm>
        <TitleTxt>On Call Triage RN</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>111922</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10117</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Madelyn Tyack</PersonNm>
        <TitleTxt>Nurse Practitioner</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>115297</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>1285</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Annette Gosnell</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mark Jones</PersonNm>
        <TitleTxt>Director Vice Chair</TitleTxt>
        <AverageHoursPerWeekRt>1.30</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Laura Madigan-McCown</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>0.70</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Frank McGinty</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Pat Weigel</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Nathan Wilson MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>0.70</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mark Wrona MD</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>0.70</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Paul Wolf</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.30</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Melanie Feinberg</PersonNm>
        <TitleTxt>Director Chair</TitleTxt>
        <AverageHoursPerWeekRt>4.60</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Chris Coon</PersonNm>
        <TitleTxt>Director Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>1.30</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Heidi N Hansen</PersonNm>
        <TitleTxt>Director Secretary</TitleTxt>
        <AverageHoursPerWeekRt>0.70</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Nathan Howell</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>0.70</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Moya Elliot</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>0.70</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1066891</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>60828</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>19</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Crows Nest Property Management</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>7 Wright Way</AddressLine1Txt>
            <CityNm>Falmouth</CityNm>
            <StateAbbreviationCd>ME</StateAbbreviationCd>
            <ZIPCd>04105</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Property Management Services</ServicesDesc>
        <CompensationAmt>208182</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Partners Printing</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress />
        <CompensationAmt>0</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Crows Nest</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress />
        <CompensationAmt>0</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Maine Medical Center</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>22 Bramhall Street</AddressLine1Txt>
            <CityNm>Portland</CityNm>
            <StateAbbreviationCd>ME</StateAbbreviationCd>
            <ZIPCd>04102</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Physicians, IP and OP/ER Services</ServicesDesc>
        <CompensationAmt>661982</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>4</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>124095</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>550200</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>1041229</AllOtherContributionsAmt>
      <NoncashContributionsAmt>54324</NoncashContributionsAmt>
      <TotalContributionsAmt>1715524</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Services</Desc>
        <BusinessCd>621610</BusinessCd>
        <TotalRevenueColumnAmt>17103736</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>17103736</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>17103736</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>155919</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>155919</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>
      <GrossRentsGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>330447</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>254208</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>76239</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>76239</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>76239</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <FundraisingGrossIncomeAmt>0</FundraisingGrossIncomeAmt>
      <ContriRptFundraisingEventAmt>124095</ContriRptFundraisingEventAmt>
      <FundraisingDirectExpensesAmt>66138</FundraisingDirectExpensesAmt>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>-66138</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-66138</ExclusionAmt>
      </NetIncmFromFundraisingEvtGrp>
      <GamingGrossIncomeAmt>0</GamingGrossIncomeAmt>
      <GamingDirectExpensesAmt>0</GamingDirectExpensesAmt>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetIncomeFromGamingGrp>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>18985280</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>17103736</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>166020</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
        <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>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>428083</TotalAmt>
        <ProgramServicesAmt>356543</ProgramServicesAmt>
        <ManagementAndGeneralAmt>71540</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </CompDisqualPersonsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>10281265</TotalAmt>
        <ProgramServicesAmt>8371977</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1646257</ManagementAndGeneralAmt>
        <FundraisingAmt>263031</FundraisingAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>211629</TotalAmt>
        <ProgramServicesAmt>176262</ProgramServicesAmt>
        <ManagementAndGeneralAmt>35367</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1623850</TotalAmt>
        <ProgramServicesAmt>1327980</ProgramServicesAmt>
        <ManagementAndGeneralAmt>295870</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>913254</TotalAmt>
        <ProgramServicesAmt>758967</ProgramServicesAmt>
        <ManagementAndGeneralAmt>154287</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>21786</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>21786</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>41950</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41950</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>31850</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>31850</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>130339</TotalAmt>
        <ProgramServicesAmt>41401</ProgramServicesAmt>
        <ManagementAndGeneralAmt>88938</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>68083</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>68083</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>432239</TotalAmt>
        <ProgramServicesAmt>137795</ProgramServicesAmt>
        <ManagementAndGeneralAmt>230356</ManagementAndGeneralAmt>
        <FundraisingAmt>64088</FundraisingAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>362845</TotalAmt>
        <ProgramServicesAmt>351145</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11700</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </RoyaltiesGrp>
      <OccupancyGrp>
        <TotalAmt>401964</TotalAmt>
        <ProgramServicesAmt>257435</ProgramServicesAmt>
        <ManagementAndGeneralAmt>144529</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>242767</TotalAmt>
        <ProgramServicesAmt>219551</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23042</ManagementAndGeneralAmt>
        <FundraisingAmt>174</FundraisingAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>113278</TotalAmt>
        <ProgramServicesAmt>2922</ProgramServicesAmt>
        <ManagementAndGeneralAmt>110356</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>38877</TotalAmt>
        <ProgramServicesAmt>34773</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4104</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>780067</TotalAmt>
        <ProgramServicesAmt>241798</ProgramServicesAmt>
        <ManagementAndGeneralAmt>538269</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>87558</TotalAmt>
        <ProgramServicesAmt>60594</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26964</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Patient Related Expense</Desc>
        <TotalAmt>2664770</TotalAmt>
        <ProgramServicesAmt>2664770</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Bad Debt Expense</Desc>
        <TotalAmt>224718</TotalAmt>
        <ProgramServicesAmt>224718</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>19101172</TotalAmt>
        <ProgramServicesAmt>15228631</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3545248</ManagementAndGeneralAmt>
        <FundraisingAmt>327293</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <TotalJointCostsGrp>
        <TotalAmt>0</TotalAmt>
        <ProgramServicesAmt>0</ProgramServicesAmt>
        <ManagementAndGeneralAmt>0</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalJointCostsGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>10506781</BOYAmt>
        <EOYAmt>6807757</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>723677</BOYAmt>
        <EOYAmt>3725631</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>439908</BOYAmt>
        <EOYAmt>252407</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>2249192</BOYAmt>
        <EOYAmt>1789203</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>319700</BOYAmt>
        <EOYAmt>209746</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>14901068</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>4873126</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>10501227</BOYAmt>
        <EOYAmt>10027942</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>3705118</BOYAmt>
        <EOYAmt>3595118</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>71423</BOYAmt>
        <EOYAmt>78488</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>28517026</BOYAmt>
        <EOYAmt>26486292</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>2071611</BOYAmt>
        <EOYAmt>1622192</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>550200</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>1029543</BOYAmt>
        <EOYAmt>964996</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>71423</BOYAmt>
        <EOYAmt>78488</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>3722777</BOYAmt>
        <EOYAmt>2665676</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>22011087</BOYAmt>
        <EOYAmt>21846909</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>2783162</BOYAmt>
        <EOYAmt>1973707</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>24794249</BOYAmt>
        <EOYAmt>23820616</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>28517026</BOYAmt>
        <EOYAmt>26486292</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-115892</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-860072</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <InvestmentExpenseAmt>0</InvestmentExpenseAmt>
      <PriorPeriodAdjustmentsAmt>0</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>2331</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA1" documentName="IRS990ScheduleA">
      <PublicOrganization170Ind>X</PublicOrganization170Ind>
      <GiftsGrantsContriRcvd170Grp>
        <CurrentTaxYearMinus4YearsAmt>4200289</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3845104</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3845016</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2048792</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1715524</CurrentTaxYearAmt>
        <TotalAmt>15654725</TotalAmt>
      </GiftsGrantsContriRcvd170Grp>
      <TotalCalendarYear170Grp>
        <CurrentTaxYearMinus4YearsAmt>4200289</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>3845104</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>3845016</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2048792</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>1715524</CurrentTaxYearAmt>
        <TotalAmt>15654725</TotalAmt>
      </TotalCalendarYear170Grp>
      <SubstantialContributorsTotAmt>3117286</SubstantialContributorsTotAmt>
      <PublicSupportTotal170Amt>12537439</PublicSupportTotal170Amt>
      <GrossInvestmentIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>102853</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>158648</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>94160</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>91384</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>155919</CurrentTaxYearAmt>
        <TotalAmt>602964</TotalAmt>
      </GrossInvestmentIncome170Grp>
      <UnrelatedBusinessNetIncm170Grp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </UnrelatedBusinessNetIncm170Grp>
      <OtherIncome170Grp>
        <CurrentTaxYearMinus4YearsAmt>0</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>0</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>0</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>0</TotalAmt>
      </OtherIncome170Grp>
      <TotalSupportAmt>16257689</TotalSupportAmt>
      <GrossReceiptsRltdActivitiesAmt>77963332</GrossReceiptsRltdActivitiesAmt>
      <PublicSupportCY170Pct>0.77</PublicSupportCY170Pct>
      <PublicSupportPY170Pct>0.78</PublicSupportPY170Pct>
      <ThirtyThrPctSuprtTestsCY170Ind>X</ThirtyThrPctSuprtTestsCY170Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Part II - Line 10</FormAndLineReferenceDesc>
        <ExplanationTxt>| Year:, Amount:, Description:| 2018, , | 2019, | 2020, | 2021, | 2022, |</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB1" documentName="IRS990ScheduleB">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="IRS990ScheduleC1" documentName="IRS990ScheduleC">
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MediaAdvertisementsAmt>0</MediaAdvertisementsAmt>
      <MailingsMembersInd>false</MailingsMembersInd>
      <MailingsMembersAmt>0</MailingsMembersAmt>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <PublicationsOrBroadcastAmt>0</PublicationsOrBroadcastAmt>
      <GrantsOtherOrganizationsInd>true</GrantsOtherOrganizationsInd>
      <GrantsOtherOrganizationsAmt>2855</GrantsOtherOrganizationsAmt>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <DirectContactLegislatorsAmt>0</DirectContactLegislatorsAmt>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <RalliesDemonstrationsAmt>0</RalliesDemonstrationsAmt>
      <OtherActivitiesInd>false</OtherActivitiesInd>
      <OtherActivitiesAmt>0</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>2855</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part2SectionBLine1f</FormAndLineReferenceDesc>
        <ExplanationTxt>Membership dues</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD1" documentName="IRS990ScheduleD">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>2783162</BeginningYearBalanceAmt>
        <ContributionsAmt>236736</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-417738</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>628453</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>1973707</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>3230166</BeginningYearBalanceAmt>
        <ContributionsAmt>263129</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>296095</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>1006228</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>2783162</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>8025443</BeginningYearBalanceAmt>
        <ContributionsAmt>1014174</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>296768</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>6106219</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>3230166</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>4718373</BeginningYearBalanceAmt>
        <ContributionsAmt>3268351</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>366805</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>328086</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>8025443</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>2394426</BeginningYearBalanceAmt>
        <ContributionsAmt>3432689</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-131012</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>977730</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>4718373</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0.53</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.33</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.14</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>1269950</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1269950</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>10811649</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3861955</DepreciationAmt>
        <BookValueAmt>6949694</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp />
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>2748239</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1011171</DepreciationAmt>
        <BookValueAmt>1737068</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>71230</OtherCostOrOtherBasisAmt>
        <BookValueAmt>71230</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>10027942</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>457b Plan</Desc>
        <Amt>78488</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>78488</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>17934778</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-860072</NetUnrealizedGainsInvstAmt>
      <OtherRevenueAmt>66138</OtherRevenueAmt>
      <RevenueNotReportedAmt>-793934</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>18728712</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>31850</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>224718</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>256568</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>18985280</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>18910742</TotExpnsEtcAuditedFinclStmtAmt>
      <OtherExpensesIncludedAmt>66138</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>66138</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>18844604</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>31850</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>224718</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>256568</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>19101172</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization is exempt from income taxes under section 501c3 of the Internal Revenue Code. Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items including unrelated business income or tax status. Under guidance issued by the Financial Accounting Standards Board assets and liabilities are established for uncertain tax positions taken or positions expected to be taken income tax returns when such positions are judged to not meet the "more-likely-than-not" threshold based upon the technical merits of the position. Estimated interest and penalties if applicable related to uncertain tax positions are included as a component of income tax expense. The Organization has evaluated the positions taken on its filed tax returns. The Organization has concluded no uncertain income tax positions exist at December 31 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>To ensure the long-term financial viability of the Organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, line 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>Special Events Expense $66,138</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad Debt Expense $224,718</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, line 2d</FormAndLineReferenceDesc>
        <ExplanationTxt>Special Events Expense $66,138</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XII, line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Bad Debt Expense $224,718</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="IRS990ScheduleG" documentName="IRS990ScheduleG">
      <FundraisingEventInformationGrp>
        <Event1Nm>Twilight in the Park</Event1Nm>
        <GrossReceiptsEvent1Amt>55141</GrossReceiptsEvent1Amt>
        <CharitableContriEvent1Amt>55141</CharitableContriEvent1Amt>
        <GrossRevenueEvent1Amt>0</GrossRevenueEvent1Amt>
        <CashPrizesEvent1Amt>0</CashPrizesEvent1Amt>
        <NonCashPrizesEvent1Amt>0</NonCashPrizesEvent1Amt>
        <RentFacilityCostsEvent1Amt>4565</RentFacilityCostsEvent1Amt>
        <FoodAndBeverageEvent1Amt>500</FoodAndBeverageEvent1Amt>
        <EntertainmentEvent1Amt>0</EntertainmentEvent1Amt>
        <OtherDirectExpensesEvent1Amt>25168</OtherDirectExpensesEvent1Amt>
        <Event2Nm>Trail of Memories</Event2Nm>
        <GrossReceiptsEvent2Amt>36275</GrossReceiptsEvent2Amt>
        <CharitableContriEvent2Amt>36275</CharitableContriEvent2Amt>
        <GrossRevenueEvent2Amt>0</GrossRevenueEvent2Amt>
        <CashPrizesEvent2Amt>0</CashPrizesEvent2Amt>
        <NonCashPrizesEvent2Amt>0</NonCashPrizesEvent2Amt>
        <RentFacilityCostsEvent2Amt>1225</RentFacilityCostsEvent2Amt>
        <FoodAndBeverageEvent2Amt>0</FoodAndBeverageEvent2Amt>
        <EntertainmentEvent2Amt>0</EntertainmentEvent2Amt>
        <OtherDirectExpensesEvent2Amt>11179</OtherDirectExpensesEvent2Amt>
        <OtherEventsTotalCnt>1</OtherEventsTotalCnt>
        <GrossReceiptsOtherEventsAmt>32679</GrossReceiptsOtherEventsAmt>
        <CharitableContriOtherEventsAmt>32679</CharitableContriOtherEventsAmt>
        <GrossRevenueOtherEventsAmt>0</GrossRevenueOtherEventsAmt>
        <CashPrizesOtherEventsAmt>0</CashPrizesOtherEventsAmt>
        <NonCashPrizesOtherEventsAmt>0</NonCashPrizesOtherEventsAmt>
        <RentFcltyCostsOtherEventsAmt>1560</RentFcltyCostsOtherEventsAmt>
        <FoodAndBeverageOtherEventsAmt>136</FoodAndBeverageOtherEventsAmt>
        <EntertainmentOtherEventsAmt>0</EntertainmentOtherEventsAmt>
        <OthDirectExpnssOtherEventsAmt>21805</OthDirectExpnssOtherEventsAmt>
        <GrossReceiptsTotalAmt>124095</GrossReceiptsTotalAmt>
        <CharitableContributionsTotAmt>124095</CharitableContributionsTotAmt>
        <GrossRevenueTotalEventsAmt>0</GrossRevenueTotalEventsAmt>
        <CashPrizesTotalEventsAmt>0</CashPrizesTotalEventsAmt>
        <NonCashPrizesTotalEventsAmt>0</NonCashPrizesTotalEventsAmt>
        <RentFcltyCostsTotalEventsAmt>7350</RentFcltyCostsTotalEventsAmt>
        <FoodAndBeverageTotalEventsAmt>636</FoodAndBeverageTotalEventsAmt>
        <EntertainmentTotalEventsAmt>0</EntertainmentTotalEventsAmt>
        <OthDirectExpnssTotalEventsAmt>58152</OthDirectExpnssTotalEventsAmt>
        <DirectExpenseSummaryEventsAmt>66138</DirectExpenseSummaryEventsAmt>
        <NetIncomeSummaryAmt>-66138</NetIncomeSummaryAmt>
      </FundraisingEventInformationGrp>
    </IRS990ScheduleG>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ1" documentName="IRS990ScheduleJ">
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>true</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Daryl J Cady</PersonNm>
        <TitleTxt>CEO Ex Officio</TitleTxt>
        <BaseCompensationFilingOrgAmt>221143</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>55327</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>396</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>20500</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2714</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>300080</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>In 2022, six individuals listed in Form 990, Part VII were paid a bonus. The payment of these awards is discretionary and is subject to meeting the pre-determined goals of the Organization.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleM documentId="IRS990ScheduleM1" documentName="IRS990ScheduleM">
      <SecuritiesPubliclyTradedGrp>
        <NonCashCheckboxInd>X</NonCashCheckboxInd>
        <ContributionCnt>3</ContributionCnt>
        <NoncashContributionsRptF990Amt>54324</NoncashContributionsRptF990Amt>
        <MethodOfDeterminingRevenuesTxt>Stock Exchange Price</MethodOfDeterminingRevenuesTxt>
      </SecuritiesPubliclyTradedGrp>
      <Form8283ReceivedCnt>0</Form8283ReceivedCnt>
      <AnyPropertyThatMustBeHeldInd>false</AnyPropertyThatMustBeHeldInd>
      <ReviewProcessUnusualNCGiftsInd>true</ReviewProcessUnusualNCGiftsInd>
    </IRS990ScheduleM>
    <IRS990ScheduleO documentId="IRS990ScheduleO1" documentName="IRS990ScheduleO">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Chris Coon Nathan Wilson Nathan Howell Heidi Hansen and Laura Madigan-McCown have a business relationship with each other through their affiliation with MaineHealth a 501c3 public charity and its affiliates.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Initial Members of the Corporation were established in 2003. Thereafter Members shall include all other persons who may be admitted to membership from time to time by vote of the Members at an annual or special meeting. The Governance Committee of the Board of Directors shall present a report to propose new Members to be admitted for membership.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Provisions in bylaws pertaining to Members of the Corporation: -individuals may be admitted to membership from time to time by vote of Members at annual or special meetings. -Nominating Committee of the Board of Directors proposes new members. -Members must have an interest in and ability to contribute to the advancement of the mission and goals of the Corporation -powers include election of the Board of Directors election of new members changes in the corporate structure and action on any matters brought to them by the BOD at the annual meeting or at special meetings. Purpose: to strengthen links to the community and ensure that effective governing bodies are elected. Responsibilities: -understanding and affirmation of HSM's mission principles and objectives. -advocacy in the community fostering of public awareness and support for the Organization's goals and programs and its fundraising efforts -attendance at the annual meeting election of Board and Members of the Corporation and action on any other matters brought by the Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>See response for Form 990 Part VI line 7a.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Annually all persons are required to review and sign the conflict of interest policy statement which is then kept on file.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>| Description:, Explanation:, Amount:| Present Value Discount on Pledges Receivable, Present Value Discount on Pledges Receivable, $2331|</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4a</FormAndLineReferenceDesc>
        <ExplanationTxt>| Explanation:| HSM provides professional and volunteer support for dying patients and their families regardless of their ability to pay. Demand for our services continues to grow. In 2022 we provided hospice care to over 1,800 patients and their families. We employ approximately 160 staff and engage 155 volunteers. Our highly skilled multidisciplinary team includes physicians nurses social workers home health aides chaplains and grief counselors. This team works together to provide direct patient care in alignment with our mission to provide compassion care and comfort through the end of life.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IV, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>| Explanation:| Lobbying activities: National Hospice and Palliative Care Organization portion of dues paid allocated to lobbying activities was $110. Home Care and Hospice Alliance of Maine portion of dues paid allocated to lobbying activities was $2,745.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>