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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr John Hallberg</PersonNm>
        <TitleTxt>Orthopedic Surgeon</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>555424</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>34522</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr John Hotchkiss</PersonNm>
        <TitleTxt>Radiologist</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>550338</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>21399</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Michael Sullivan</PersonNm>
        <TitleTxt>Chief Medical Officer/Hospitalist</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>529766</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>36718</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Mark Overton</PersonNm>
        <TitleTxt>Psychiatrist</TitleTxt>
        <AverageHoursPerWeekRt>50.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>529217</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24297</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>4216763</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>272321</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>56</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 359</AddressLine1Txt>
            <CityNm>Fairfield</CityNm>
            <StateAbbreviationCd>ME</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Building Contractor</ServicesDesc>
        <CompensationAmt>1876915</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Cerner Corporation</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 959156</AddressLine1Txt>
            <CityNm>St Louis</CityNm>
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          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Software Services</ServicesDesc>
        <CompensationAmt>506869</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>The Aroostook Medical Center</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
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            <StateAbbreviationCd>ME</StateAbbreviationCd>
            <ZIPCd>04412</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Outsourced Physician Services</ServicesDesc>
        <CompensationAmt>467989</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Medhost Of Tennessee Inc</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2739 Momentum Place</AddressLine1Txt>
            <CityNm>Chicago</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
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          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Software &amp; Support Services</ServicesDesc>
        <CompensationAmt>427352</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Cary Medical Center</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>163 Van Buren Rd</AddressLine1Txt>
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            <StateAbbreviationCd>ME</StateAbbreviationCd>
            <ZIPCd>04736</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Off-Site Laboratory Services</ServicesDesc>
        <CompensationAmt>425454</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>18</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>2384429</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>612478</AllOtherContributionsAmt>
      <TotalContributionsAmt>2996907</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Service Revenue</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>93886406</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>91024666</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>2861740</UnrelatedBusinessRevenueAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>Miscellaneous Revenue</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>5969807</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>5788544</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>181263</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Meaningful Use Revenue</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>-161500</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-161500</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Provision for Bad Debt</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>-1686040</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-1686040</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Contractual/Char. Adj.</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>-36987898</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-36987898</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>61020775</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>209290</TotalRevenueColumnAmt>
        <ExclusionAmt>209290</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossRentsGrp>
        <RealAmt>39790</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>0</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>39790</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>39790</TotalRevenueColumnAmt>
        <ExclusionAmt>39790</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>2727968</SecuritiesAmt>
        <OtherAmt>8500</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
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        <OtherAmt>8510</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>0</SecuritiesAmt>
        <OtherAmt>-10</OtherAmt>
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      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-10</TotalRevenueColumnAmt>
        <ExclusionAmt>-10</ExclusionAmt>
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      <TotalRevenueGrp>
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        <RelatedOrExemptFuncIncomeAmt>57977772</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>2861740</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>430333</ExclusionAmt>
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      <GrantsToDomesticIndividualsGrp>
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        <ProgramServicesAmt>2000</ProgramServicesAmt>
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      <CompCurrentOfcrDirectorsGrp>
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        <ProgramServicesAmt>771649</ProgramServicesAmt>
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        <ProgramServicesAmt>30472229</ProgramServicesAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>451030</ProgramServicesAmt>
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      <OtherEmployeeBenefitsGrp>
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        <ProgramServicesAmt>2486611</ProgramServicesAmt>
        <ManagementAndGeneralAmt>243818</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
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        <ProgramServicesAmt>1864366</ProgramServicesAmt>
        <ManagementAndGeneralAmt>230427</ManagementAndGeneralAmt>
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      <FeesForServicesLegalGrp>
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        <ManagementAndGeneralAmt>29948</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ProgramServicesAmt>69420</ProgramServicesAmt>
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      <FeesForServicesOtherGrp>
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        <ProgramServicesAmt>1779568</ProgramServicesAmt>
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      <AdvertisingGrp>
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        <ProgramServicesAmt>65232</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7248</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>449837</ProgramServicesAmt>
        <ManagementAndGeneralAmt>205402</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
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        <ProgramServicesAmt>102827</ProgramServicesAmt>
        <ManagementAndGeneralAmt>289404</ManagementAndGeneralAmt>
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      <OccupancyGrp>
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        <ProgramServicesAmt>2822680</ProgramServicesAmt>
        <ManagementAndGeneralAmt>238328</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
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        <ProgramServicesAmt>96963</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15216</ManagementAndGeneralAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>296962</ProgramServicesAmt>
        <ManagementAndGeneralAmt>32996</ManagementAndGeneralAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>2237174</ProgramServicesAmt>
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      <InsuranceGrp>
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        <ProgramServicesAmt>719492</ProgramServicesAmt>
        <ManagementAndGeneralAmt>79944</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>9437232</ProgramServicesAmt>
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      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Healthcare Provider Tax</Desc>
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        <ProgramServicesAmt>1139289</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Miscellaneous</Desc>
        <TotalAmt>978350</TotalAmt>
        <ProgramServicesAmt>427116</ProgramServicesAmt>
        <ManagementAndGeneralAmt>551234</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
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        <ProgramServicesAmt>68812</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7646</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
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        <ProgramServicesAmt>55760489</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6561487</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
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      <InfoInScheduleOPartXInd>X</InfoInScheduleOPartXInd>
      <CashNonInterestBearingGrp>
        <BOYAmt>278009</BOYAmt>
        <EOYAmt>275463</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>38784108</EOYAmt>
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      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>20205</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
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        <EOYAmt>6078391</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>10897</BOYAmt>
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      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>155000</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1280226</BOYAmt>
        <EOYAmt>1333739</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>433486</EOYAmt>
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      <LandBldgEquipCostOrOtherBssAmt>62266931</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>34855365</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>19646299</BOYAmt>
        <EOYAmt>27411566</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
        <BOYAmt>751868</BOYAmt>
        <EOYAmt>810563</EOYAmt>
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      <IntangibleAssetsGrp>
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        <EOYAmt>165143</EOYAmt>
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      <OtherAssetsTotalGrp>
        <BOYAmt>2669284</BOYAmt>
        <EOYAmt>4713323</EOYAmt>
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      <TotalAssetsGrp>
        <BOYAmt>50243775</BOYAmt>
        <EOYAmt>80180987</EOYAmt>
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      <AccountsPayableAccrExpnssGrp>
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        <EOYAmt>7946644</EOYAmt>
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      <TaxExemptBondLiabilitiesGrp>
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        <BOYAmt>6891991</BOYAmt>
        <EOYAmt>171477</EOYAmt>
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      <OtherLiabilitiesGrp>
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        <EOYAmt>19066874</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>41344944</EOYAmt>
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      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
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        <EOYAmt>38016999</EOYAmt>
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      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>734182</BOYAmt>
        <EOYAmt>819044</EOYAmt>
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      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>36855120</BOYAmt>
        <EOYAmt>38836043</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>50243775</BOYAmt>
        <EOYAmt>80180987</EOYAmt>
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      <ReconcilationRevenueExpnssAmt>1944776</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>36147</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <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="RetDoc1039700001">
      <VolunteersInd>0</VolunteersInd>
      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>0</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>1</OtherActivitiesInd>
      <OtherActivitiesAmt>8119</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>8119</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II-B, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital pays dues to various organizations, a portion of which is attributable to lobbying expenses.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>235224</OtherCostOrOtherBasisAmt>
        <BookValueAmt>235224</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>29066059</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>14305151</DepreciationAmt>
        <BookValueAmt>14760908</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>21288907</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>19708478</DepreciationAmt>
        <BookValueAmt>1580429</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>11676741</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>841736</DepreciationAmt>
        <BookValueAmt>10835005</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>27411566</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Deferred Compensation</Desc>
        <BookValueAmt>1860343</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Cash Surrender Value of Life Insurance</Desc>
        <BookValueAmt>409101</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Estimated Third-Party Payor Settlements</Desc>
        <BookValueAmt>1643879</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Insurance Claims Receivable</Desc>
        <BookValueAmt>800000</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>4713323</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred Compensation</Desc>
        <Amt>1860343</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Medicare advanced payments</Desc>
        <Amt>8667933</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>CARES Act Funding</Desc>
        <Amt>8538598</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>19066874</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Medical Center and VMA are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Medical Center's tax positions and concluded the Medical Center has maintained its tax-exempt status, does not have any significant unrelated business income and has taken no uncertain tax positions that require adjustment or disclosure in the consolidated financial statements.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 3j: The Community Health Needs Assessment was developed by the Eastern Maine Health System (EMHS) utilizing a consulting firm called JSI to support member organizations and community partners' work to conduct the needs assessments and to develop strategies to improve the health of the people we serve. The consultants who developed the survey tool worked with individuals from a broad spectrum of backgrounds as follows: the Maine Center for Disease Control and Prevention, the District Public Health Liaisons, Federally Qualified Health Centers, Public Health and Community Services across the state of Maine and others who provided generous support and insights. Target audience was anyone with a vested interest in public health and healthcare including medical staff, community board members, volunteers, donors and members of the general public. The surveys were conducted across the eight participating Maine Counties of Aroostook, Cumberland, Hancock, Kennebec, Penobscot, Piscataquis, Somerset, Washington by 17 partnering Maine Hospitals, 5 local Public Health Districts and 11 Healthy Maine Partnerships. The following sectors were represented: - Healthy Aroostook- Northern Maine Medical Center- Public Health Nursing- Aroostook Mental Health Services- Wabanaki Public Health- Town of Madawaska- UMFK Student- Power of Prevention- Fish River Rural Health - Maine Quality Counts- U. Maine Cooperative Extension- Visiting Nurses of Aroostook- Town of Fort Kent- The Aroostook Medical Center- Fiddlehead Focus News- Maine CDC- Pines Health Services- University of Maine at Fort Kent- Northern Maine Development Commission- Community Voices- Community Members</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 5: Attention was taken to include a broad representation from the community. This took place in two ways. First, the stakeholders were invited to participate in public forums. Second, four work groups were convened to address each of the four priorities selected. A facilitator was identified for each group to lead the ongoing discussion and work to address strategies and action plans for each of the priorities. The following sectors were represented:- AMHC- UMFK Nursing Division- NMMC Director of Nursing- NMMC Pharmacist- Life by Design- Agency on Aging- NMMC Care Manager- Valley School Substance Abuse Counselor- UMFK Behavioral Health- U. Maine Cooperative Extension- NMMC Social Worker- NMMC NDPP Trainer PA - Hope &amp; Justice- NMMC Financial Counselor- NMMC Practice Coordinator- NMMC Community Educator- Power of Prevention- FK High School Wellness- NMMC Psych Unit Leader- FK Recreation Director- UMFK Student- NMMC Communications- Catholic Charities- FK Community Development</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 6a: The following hospitals were included in the collaborative community health assessment: Cary Medical Center, Down East Community Hospital, Houlton Regional Hospital, Maine Coast Memorial Hospital, Mayo Regional Hospital, Millinocket Regional Hospital, Mount Desert Island Hospital, Northern Maine Medical Center, and Redington-Fairview General Hospital.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Northern Maine Medical Center</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 6b: Aroostook Mental Health Center - St. John Valley Public Schools - University of Maine, Fort Kent, Behavioral Health and Nursing Divisions - Fish River Rural Health Center - Healthy Maine Partnerships - University of Maine Cooperative Extension Service - Town Government and Recreation Departments - Life by Design Mental Health - Clergy - Aroostook Agency on Aging</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Northern Maine Medical Center</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 7d: The St. John Valley assessment has been posted on the NMMC website since late 2014, as soon as it became available. The report is also available free upon request. Each year, thereafter, 2015-2016, 2016-2017, 2017-2018, an updated report was posted on the Northern Maine Medical Center website with instructions on how to access the updates. For the newest identified priorities for the start of the new cycle: 2017-2021, the same process will be used to keep the public apprised of the priorities and the actions. The hospital's Community Liaison Committee of the Board of Trustees is also provided a summary on an annual basis. In addition, contact information is provided on the website for individuals who wish to request a free paper copy. Individuals may also call NMMC to request a free copy.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Northern Maine Medical Center</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 11: The CHNA cycle completed in 2017 reported several successes related to the three priorities from the previous CHNA cycle of: substance abuse, healthy food and nutrition and cardiovascular health. With similar priorities, with the addition of a new priority in the area of mental health, requiring continued strategies for improvement, actions will be expanded based on need, community interaction and lessons learned. The NMMC Board of Trustees approved high level action plan has begun moving forward as follows:Priority #1 Physical Activity, Nutrition and Weight- Focus on gaps identified to provide physical activity opportunities and develop a plan to engage local students- Expand food insecurity assessments in order to identify and serve a greater portion of the population- Create a mechanism to better communicate available physical activity and nutrition programsPriority #2 Mental Health and Access- Create community partnerships to support the school age population dealing with mental illness- Promote public education through interagency collaboration- Develop a framework of agency resources- Utilize local university for grant writing resources- Create more opportunities to screen for mental illness- Develop community-wide speaker's bureauPriority #3 Substances and Alcohol Use (includes tobacco use)- Collaborate with the National Alliance on Mental Health for services not currently in place- Funnel community events through a central point to reach more of the public- Offer an annual retreat to convene community partners for brainstorming and strategic planning to address substance and alcohol usePriority #4 Cardiovascular Disease- Create a network of public education using multiple formats- Implement a collaborative tobacco cessation program- Implement a feasibility study for reintroducing cardiac rehabilitation- Promote heart health in conjunction with American Heart Association initiativesPriority #1 Physical Activity, Nutrition and Weight2018-2019 Actions1. Through an education outreach program at a hospital owned community retail pharmacy, monthly education is provided to the public, free of charge, on topics that included: selecting herbal and natural supplements 6/25/19, summer health and wellness 7/16/19, healthy holiday eating on 11/19/19, healthy eating and understanding food labels 12/17/19. 2. Community events were hosted to encourage physical activity at all age levels: Superhero 5K walk and run event and Summer Rally in the Valley mountain bike festival. 3. NMMC participated in Rumpus for Reading with the local elementary school. The event focused around physical activity to raise money for books. 4. An additional site (in St. Agatha, ME) was added to offer free Bone Builder classes. NMMC provided the instructor training and the weights (at no cost) for all participants. 5. Access to diabetes education classes was expanded using available technology to make it easier for more participants to attend the classes, removing the barrier of travel to attend classes. To support diabetes awareness, weekly diabetes education segments were posted on NMMC social media. Priority #2 Mental Health and Access2018-2019 Actions1. Through an education outreach program at a hospital owned community retail pharmacy, monthly education is provided to the public, free of charge, on topics that included mental health wellness.2. An NMMC mental health provider was the guest speaker at a hospital Guild meeting in March 2019 where she spoke on mental health wellness. 3. In June 2019, NMMC Psychiatrist, Dr. Mark Overton and Nurse Practitioner, Ryan Conley, taught a mental health class for the nursing students at the University of Maine at Fort Kent. 4. NMMC social workers hosted the annual Suicide Awareness Walk on 9/7/19. 5. In April of 2019, NMMC, along with community partners, launched the Yellow Tulip Project, community-wide. The event was covered by local media and will continue annually. The purpose of the project is to raise awareness for suicide prevention and to 'smash the stigma' of mental illness. 6. Mental health Nurse Practitioner, Melissa Stoliker, offered a free public presentation on Seasonal Affective Disorder in partnership with the University of Maine at Fort Kent Student Nurses Organization. Priority #3 Substances and Alcohol Use (includes tobacco use)2018-2019 Actions1. On March 11, 2019, Family Practitioner, Dr. Silwana Sidorczuk and Licensed Substance Abuse Counselor, Katia Sirois, were part of a guest panel at the University of Maine at Fort Kent. The topic for the free program to educate the public covered the topic of the opioid epidemic. 2. Through an education outreach program at a hospital owned community retail pharmacy, monthly education is provided to the public, free of charge, on topics that included opioid resources and tobacco cessation 7/23/19.3. NMMC partnered with the local schools to host a presentation for school aged children about the dangers of the opioid epidemic. 4. The head of Maine's opioid program, Gordon Smith, was a guest speaker on 9/9/19 when he spoke with the medical community on the status of the epidemic and strategies to stem the increasing epidemic.5. Medical student from the Frank Netter Medical School visited the Madawaska high school to speak with students on the dangers of vaping. 6. NMMC's Opioid Committee created a comprehensive booklet of resources for patients on the effects of opioids along with resources available in Aroostook County.7. NMMC partnered with the University of Maine at Fort Kent and the local mental health agency, AMHC, to host a recovery event to coincide with National Recovery Month in September 2019. The event was free to the public and included activities for individuals of all ages to attend the event. Priority #4 Cardiovascular Disease2018-2019 Actions1. On 1/5/19, Beat the Pack tobacco cessation classes were offered to the public free of charge. 2. Through an education outreach program at a hospital owned community retail pharmacy, monthly education is provided to the public, free of charge, on topics that included heart health and knowledge about how to identify one's risks in February 2019, free blood sugar screening during National Diabetes Month in November 2019.3. One of NMMC's ED physicians provided free Citizen CPR classes to the public in June 2019. The use of automated defibrillator devices was also included in the education. 4. NMMC clinical personnel had a presence at a health and safety fair held at the Madawaska high school. 5. In May of 2019, NMMC clinical staff and providers were provided training in tobacco intervention skills by Karina Alexander. 6. On 9/16, 9/18 and 9/30/19, NMMC Community Educator, Erin Pelletier and Family Practice provider, Dr. Silwana Sidorczuk launched the annual Tar Wars tobacco awareness program in all St. John Valley schools at the fifth-grade level. The program includes continues work in the classroom after the initial presentations and a poster project to follow which is recognized at the state of Maine level.7. Third year medical students from the Netter School of Medicine participated in a large health and wellness event geared toward school age children. The day-long program promoted fun with physical activity, facts about sugary drinks and the effects of tobacco. The program was held in partnership with the Student Nurses Organization of the University of Maine at Fort Kent. Other areas of need identified for the most recent CHNA cycle, besides the top four priorities listed above, will remain on the table to be addressed as resources become available. These are: cancer care, diabetes and elder health. In terms of cancer care, the data reported reduced cases. Related to diabetes, priority #1 indirectly addresses this area with the education and resources on healthy eating and physical activity. Lastly, elder health was not specifically listed, however, several of the physical activity and healthy eating initiatives do address the older population so although it was not selected as a top priority, it is being addressed on multiple fronts.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 24: Individuals are billed at gross amounts and charges are adjusted accordingly, if they qualify for assistance.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part I, Line 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>The amounts reported on Lines 7a &amp; 7b were computed using a cost-to-charge ratio. Amounts on line 7g are derived from internal financial/cost accounting systems.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part I, Line 7g:</FormAndLineReferenceDesc>
        <ExplanationTxt>Subsidized health services on line 7g include physician clinics, rural health centers, a skilled nursing facility, and emergency room.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part II, Community Building Activities:</FormAndLineReferenceDesc>
        <ExplanationTxt>N/A</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>In evaluating the collectibility of accounts receivable, the Medical Center analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for doubtful accounts. Management regularly reviews data about these major payor sources in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Medical Center analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for doubtful accounts, if necessary. For receivables associated with self-pay patients (which include both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Medical Center records a provision for doubtful accounts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>Our collection policy stipulates that NMMC makes reasonable efforts to identify those individuals that may qualify for assistance. In the first 120 days, patients may request to begin the Financial Assistance process and collection activity is put on hold until the process is completed. If the patient qualifies, no further collection activity will occur going forward for that account. If patient does not qualify, collection activity resumes from point it was put on hold.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Please see Schedule H, Part V, Section B, Line 5 for a description of NMMC's assessment process.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>We notify patients and customers about access to assistance in various ways. The simplest way is the signage, pamphlets, and educational material located around the Organization and in various offices. In every patient access/patient financial services area is a sign explaining the availability of free/discounted care and the Federal Poverty Guidelines. There are also pamphlets located in the outpatient areas explaining free/discounted care and providing information on Mainecare. For inpatients, there is a book in each room which provides all the information on all programs available.Through the patient accounting department, we provide information aboutthese statements. We also counsel patients on the phone about all theprograms available whether it is Medicaid or a hospital program.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Northern Maine Medical Center is a 94 licensed bed (27 A&amp;P which includes swing beds, 6 ICU beds, 16 Psych beds, and 45 SNF beds), full-service, acute-care, not-for profit hospital located in Fort Kent, Maine (Aroostook County). The Hospital is accredited by the joint commission and its mission is to serve its communities with excellence in health care. Its services include acute inpatient, psych inpatient, SNF, 24-hour emergency center, diagnostic, and surgical services. Along with these hospital services, the Hospital employs/contracts with the majority of primary and specialty care physicians in the area.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>Northern Maine Medical Center is a local, not-for-profit hospital that serves its local communities and people regardless of their ability to pay. Northern Maine provides financial assistance and sliding scale discounts to self-pay and low-income patients. Also the Hospital participates in government-sponsored health care programs including Medicare, Medicaid, VA, and Tricare. The volunteer board of trustees sets the strategic direction for the Hospital and is comprised of community members from the Hospital's service area. This group is made up of local business owners, professionals, and retirees. Northern Maine's non-profit status allows the Hospital to reinvest any excess of revenues over expense back into the Hospital to continuously improve the medical care it delivers. The Hospital allows access to healthcare that would otherwise be difficult. The Hospital is the main employer for the local physicians, including specialty physicians that would otherwise have to be accessed out of the area.</ExplanationTxt>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Peter J Sirois</PersonNm>
        <TitleTxt>President/CEO</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>30000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>23413</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8400</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>26178</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>372404</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Cindy L Daigle</PersonNm>
        <TitleTxt>Treasurer/CFO</TitleTxt>
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        <OtherCompensationFilingOrgAmt>14092</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6131</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24815</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>244034</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Alain Bois</PersonNm>
        <TitleTxt>Secretary/COO</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>2796</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>19400</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>2073</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15864</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>208426</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Anoushfar Shahriar</PersonNm>
        <TitleTxt>General Surgeon</TitleTxt>
        <BaseCompensationFilingOrgAmt>478475</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>11312</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>84606</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8400</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>28097</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>610890</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr John Hallberg</PersonNm>
        <TitleTxt>Orthopedic Surgeon</TitleTxt>
        <BaseCompensationFilingOrgAmt>521181</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>13543</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>20700</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8400</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>26122</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>589946</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr John Hotchkiss</PersonNm>
        <TitleTxt>Radiologist</TitleTxt>
        <BaseCompensationFilingOrgAmt>525068</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>25270</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8400</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12999</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>571737</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Michael Sullivan</PersonNm>
        <TitleTxt>Chief Medical Officer/Hospitalist</TitleTxt>
        <BaseCompensationFilingOrgAmt>278864</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>224832</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>26070</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>8400</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>28318</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>566484</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Mark Overton</PersonNm>
        <TitleTxt>Psychiatrist</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>36676</BonusFilingOrganizationAmount>
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        <OtherCompensationFilingOrgAmt>1980</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24297</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>553514</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>The bonus paid to Peter Sirois, CEO, has set point criteria for earning specific bonus levels/amounts. The Board awards points based on the accomplishment of pre-established objectives/targets. Points are tabulated with the final score determining bonus level achieved. The Board meets with the CEO to discuss performance including those objectives/targets and based on that meeting award the points and derive the bonus amount. Dr. Erik St. Pierre, Dr. Anoushfar Shahriar, Dr. John Hallberg, Dr. John Hotchkiss, Dr. Michael Sullivan and Dr. Mark Overton received annual bonuses based on their performance. Cindy Daigle and Alain Bois received Christmas bonuses.</ExplanationTxt>
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    </IRS990ScheduleJ>
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      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Maine Health and Higher Education Facilities Authority</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>010314384</BondIssuerEIN>
        <CUSIPNum>56042RUP5</CUSIPNum>
        <BondIssuedDt>2019-11-06</BondIssuedDt>
        <IssuePriceAmt>40862459</IssuePriceAmt>
        <PurposeDesc>To refinance existing debt and fund new construction</PurposeDesc>
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        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>1</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <RetiredAmt>320452</RetiredAmt>
        <TotalProceedsAmt>15820042</TotalProceedsAmt>
        <InReserveFundAmt>981150</InReserveFundAmt>
        <CapitalizedInterestAmt>293305</CapitalizedInterestAmt>
        <IssuanceCostsFromProceedsAmt>209443</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>7361187</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>6974957</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2020</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>1</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>1</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Michelle L Plourde</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Family member of Peter Sirois, Hospital CEO</RelationshipDescriptionTxt>
        <TransactionAmt>98829</TransactionAmt>
        <TransactionDesc>Employment</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Nicole Marquis</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Family member of Peter Sirois, Hospital CEO</RelationshipDescriptionTxt>
        <TransactionAmt>108384</TransactionAmt>
        <TransactionDesc>Employment</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Robin Werntgen</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Family member of Peter Sirois, Hospital CEO</RelationshipDescriptionTxt>
        <TransactionAmt>84174</TransactionAmt>
        <TransactionDesc>Employment</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is prepared by the Organization's independent public accounting firm and thoroughly reviewed by the CFO and Controller. The completed form is sent electronically to Board members prior to the form being filed. In addition, CEO has documents for review prior to sending to the Board members and has opportunity to request any edits. When the forms are sent to Board members, they are instructed to contact CEO or CFO with questions. Any questions are responded to and at the following Finance or Board meetings, CFO provides ability for anyone to ask any additional questions. Finance Committee may request a formal/detailed presentation by consultants if deemed necessary but have not requested that level of review recently.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>On an annual basis, Board Members must read the Organization's conflict of interest policy, disclose any potential conflicts, and return the signed statement to Administration. If topics arise where a Member has an actual or potential conflict, the group will determine the level to which the individual may be involved in discussions and the member with the conflict will not have a vote. In some instances, the member will be excused from the meeting and can only rejoin when the Board has moved on to a different topic.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board of Directors determines the compensation of the CEO using compensation studies and comparability data. The CEO determines the compensation of other officers and key employees in a similar manner.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part X, Line 10: Land, Buildings, and Equipment</FormAndLineReferenceDesc>
        <ExplanationTxt>Section 1.263(a)-3(n) Election: Northern Maine Medical Center 194 East Main Street Fort Kent, ME 04743 EIN: 01-0234189 Northern Maine Medical Center is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n).</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Valley Medical Association</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>194 East Main Street</AddressLine1Txt>
          <CityNm>Fort Kent</CityNm>
          <StateAbbreviationCd>ME</StateAbbreviationCd>
          <ZIPCd>04743</ZIPCd>
        </USAddress>
        <EIN>223245434</EIN>
        <PrimaryActivitiesTxt>Medical Physician Practice</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ME</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Northern Maine Medical Center</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>