﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2019v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2020-08-13T11:23:17-05:00</ReturnTs>
    <TaxPeriodEndDt>2019-12-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>410746749</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>CLIFTONLARSONALLEN LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>227 WEST TRADE STREET SUITE 800</AddressLine1Txt>
        <CityNm>CHARLOTTE</CityNm>
        <StateAbbreviationCd>NC</StateAbbreviationCd>
        <ZIPCd>28202</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2019-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>043185003</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>MARIE ESTHER HEALTH CENTER INC</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>MARI</BusinessNameControlTxt>
      <PhoneNum>6173323366</PhoneNum>
      <USAddress>
        <AddressLine1Txt>144 TURNPIKE ROAD NO 220</AddressLine1Txt>
        <CityNm>SOUTHBOROUGH</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>01772</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>PAUL KEMP</PersonNm>
      <PersonTitleTxt>TREASURER &amp; CFO</PersonTitleTxt>
      <PhoneNum>6173323366</PhoneNum>
      <SignatureDt>2020-07-28</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>JOHN NORMAN</PreparerPersonNm>
      <PTIN>P01506766</PTIN>
      <PhoneNum>7049985200</PhoneNum>
    </PreparerPersonGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>67.137.57.251</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2020-07-28</IPDt>
      <IPTm>12:58:15</IPTm>
      <IPTimezoneCd>ED</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>E6BE2FC7BDF6415C53E2430FF741795AA272F00C</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>D353FB23EEE2D018D41B9D78F944E7F27E0E4970</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2019</TaxYr>
    <BuildTS>2020-09-23 17:36:50Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <InitialReturnInd>X</InitialReturnInd>
      <PrincipalOfficerNm>FRANCIS J GRADY</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>144 TURNPIKE ROAD NO 220</AddressLine1Txt>
        <CityNm>SOUTHBOROUGH</CityNm>
        <StateAbbreviationCd>MA</StateAbbreviationCd>
        <ZIPCd>01772</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>3932158</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>WWW.ALLIANCEHHS.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1993</FormationYr>
      <LegalDomicileStateCd>MA</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO PROMOTE AND PROVIDE SAFE, HEALTHY, QUALITY SERVICES AND LIVING ENVIRONMENTS FOR ELDERS.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>13</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>12</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>121</TotalEmployeeCnt>
      <TotalVolunteersCnt>12</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <CYProgramServiceRevenueAmt>3904571</CYProgramServiceRevenueAmt>
      <CYInvestmentIncomeAmt>0</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>27587</CYOtherRevenueAmt>
      <CYTotalRevenueAmt>3932158</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <CYSalariesCompEmpBnftPaidAmt>3034633</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <CYOtherExpensesAmt>2165905</CYOtherExpensesAmt>
      <CYTotalExpensesAmt>5200538</CYTotalExpensesAmt>
      <CYRevenuesLessExpensesAmt>-1268380</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>831948</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>4127160</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>496314</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>1589816</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>335634</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>2537344</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>THE COMPANY SHALL PROMOTE AND PROVIDE SAFE, HEALTHY, QUALITY SERVICES AND LIVING ENVIRONMENTS FOR ELDERS WHO CANNOT CARE FOR THEMSELVES.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>1</SignificantChangeInd>
      <ExpenseAmt>4040614</ExpenseAmt>
      <RevenueAmt>3932158</RevenueAmt>
      <Desc>SKILLED NURSING &amp; REHABILITATION SERVICES - OUR SKILLED NURSING AND REHABILITATION FACILITY PROVIDES A WIDE RANGE OF MEDICAL AND REHABILITATIVE SERVICES, INCLUDING POST ACUTE CARE, SHORT-TERM REHABILITATION, RESPITE CARE, HOSPICE CARE, AND LONG-TERM CARE. WORKING DIRECTLY WITH EACH RESIDENT AND THEIR FAMILY MEMBERS, OUR STAFF WILL CUSTOMIZE A COMPREHENSIVE PLAN OF CARE DESIGNED TO TREAT MEDICAL COMPLICATIONS AND ACHIEVE FUNCTIONAL INDEPENDENCE. OUR FACILITY PROVIDES THE HIGHEST STANDARDS OF CARE AND RESIDENTS ENJOY AN ACTIVE AND FULFILLING LIFESTYLE IN AN ATMOSPHERE OF WARMTH, RESPECT AND UNDERSTANDING.</Desc>
      <TotalProgramServiceExpensesAmt>4040614</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>17</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>121</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>13</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>12</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>1</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>MA</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH MANAGEMENT SERVICES LLC</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>7743482000</PhoneNum>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>FRANCIS J GRADY</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>444394</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26339</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LINDA CORRIDAN RN</PersonNm>
        <TitleTxt>CHAIRMAN</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANDREW CALKINS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JANICE HOCKENSMITH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>REV JEROME J JANISKO</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL O JENNINGS ESQ</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIK M JONES</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ARTHUR MOURTZINOS MD</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAMES BRUCE RILEY CPA</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTOPHER ROBBINS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PETE ZAMPINE</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TAMMY BRUNETTI</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALFRED GRAY</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAUL KEMP</PersonNm>
        <TitleTxt>TREASURER &amp; CFO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>335729</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26714</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS LAVALLEE</PersonNm>
        <TitleTxt>CLERK &amp; COO</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>335729</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26714</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL DODOS</PersonNm>
        <TitleTxt>CONTROLLER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>249796</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WILLIAM FARINA</PersonNm>
        <TitleTxt>DIRECTOR OF REHAB SERVICES</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>184034</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY KILLCOMMONS</PersonNm>
        <TitleTxt>DIRECTOR OF OPERATIONS</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>170979</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>10131</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ELAINE HANSON</PersonNm>
        <TitleTxt>DIRECTOR OF CLINICAL SERVICES</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>174283</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24098</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DORIS DAVILA</PersonNm>
        <TitleTxt>VICE PRESIDENT OF OPERATIONS</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>189223</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>486</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD CANTY</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>40.00</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>183538</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26714</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CLAUDIA PAUL</PersonNm>
        <TitleTxt>DON</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>101948</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>20390</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>101948</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>2267705</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>161586</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>1</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PERFORMANCE HEALTHCARE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>47 RIVER STREET</AddressLine1Txt>
            <CityNm>WELLESLEY</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02481</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HOUSEKEEPING &amp; LAUNDRY SERVICES</ServicesDesc>
        <CompensationAmt>320625</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SODEXO INC &amp; AFFILIATES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>9801 WASHINGTONIAN BLVD</AddressLine1Txt>
            <CityNm>GAITHERSBURG</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>20878</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>DIETARY SERVICES</ServicesDesc>
        <CompensationAmt>205768</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HEALTHCARE SERVICES GROUP INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3220 TILLMAN DRIVE SUITE 300</AddressLine1Txt>
            <CityNm>BENSALEM</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19020</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>HOUSEKEEPING &amp; LAUNDRY SERVICES</ServicesDesc>
        <CompensationAmt>204057</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>3</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>PROGRAM SERVICE REVENU</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>3904571</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3904571</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>3904571</TotalProgramServiceRevenueAmt>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS INCOME</Desc>
        <BusinessCd>623000</BusinessCd>
        <TotalRevenueColumnAmt>27587</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>27587</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>27587</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>3932158</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3932158</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>2602485</TotalAmt>
        <ProgramServicesAmt>2070916</ProgramServicesAmt>
        <ManagementAndGeneralAmt>531569</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>906</TotalAmt>
        <ProgramServicesAmt>721</ProgramServicesAmt>
        <ManagementAndGeneralAmt>185</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>202963</TotalAmt>
        <ProgramServicesAmt>161507</ProgramServicesAmt>
        <ManagementAndGeneralAmt>41456</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>228279</TotalAmt>
        <ProgramServicesAmt>181652</ProgramServicesAmt>
        <ManagementAndGeneralAmt>46627</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>175000</TotalAmt>
        <ManagementAndGeneralAmt>175000</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>38699</TotalAmt>
        <ManagementAndGeneralAmt>38699</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>38000</TotalAmt>
        <ManagementAndGeneralAmt>38000</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>1018950</TotalAmt>
        <ProgramServicesAmt>914778</ProgramServicesAmt>
        <ManagementAndGeneralAmt>104172</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>26476</TotalAmt>
        <ManagementAndGeneralAmt>26476</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>129296</TotalAmt>
        <ProgramServicesAmt>32683</ProgramServicesAmt>
        <ManagementAndGeneralAmt>96613</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>239834</TotalAmt>
        <ProgramServicesAmt>213689</ProgramServicesAmt>
        <ManagementAndGeneralAmt>26145</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>4057</TotalAmt>
        <ManagementAndGeneralAmt>4057</ManagementAndGeneralAmt>
      </TravelGrp>
      <InterestGrp>
        <TotalAmt>14458</TotalAmt>
        <ProgramServicesAmt>13159</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1299</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>144704</TotalAmt>
        <ProgramServicesAmt>131816</ProgramServicesAmt>
        <ManagementAndGeneralAmt>12888</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>25385</TotalAmt>
        <ProgramServicesAmt>23100</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2285</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>FOOD</Desc>
        <TotalAmt>114320</TotalAmt>
        <ProgramServicesAmt>114320</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SUPPLIES EXPENSE</Desc>
        <TotalAmt>101517</TotalAmt>
        <ProgramServicesAmt>87064</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14453</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>ANCILLARY EXPENSES</Desc>
        <TotalAmt>95209</TotalAmt>
        <ProgramServicesAmt>95209</ProgramServicesAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>5200538</TotalAmt>
        <ProgramServicesAmt>4040614</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1159924</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>413582</BOYAmt>
        <EOYAmt>247865</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <EOYAmt>32154</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>178679</BOYAmt>
        <EOYAmt>157476</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>8423</BOYAmt>
        <EOYAmt>13296</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>3980439</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>593388</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>231264</BOYAmt>
        <EOYAmt>3387051</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <IntangibleAssetsGrp>
        <EOYAmt>270000</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>19318</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>831948</BOYAmt>
        <EOYAmt>4127160</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>464474</BOYAmt>
        <EOYAmt>751418</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>31840</BOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <EOYAmt>675000</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>163398</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>496314</BOYAmt>
        <EOYAmt>1589816</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>335634</BOYAmt>
        <EOYAmt>2537344</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>335634</BOYAmt>
        <EOYAmt>2537344</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>831948</BOYAmt>
        <EOYAmt>4127160</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-1268380</ReconcilationRevenueExpnssAmt>
      <OtherChangesInNetAssetsAmt>3470090</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>1</AccountantCompileOrReviewInd>
      <AcctCompileOrReviewBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </AcctCompileOrReviewBasisGrp>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>4314051</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4254238</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4239957</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4208308</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3904571</CurrentTaxYearAmt>
        <TotalAmt>20921125</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>4314051</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4254238</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4239957</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4208308</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3904571</CurrentTaxYearAmt>
        <TotalAmt>20921125</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>20921125</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>38649</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>16408</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1216</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2553</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>58826</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>38649</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>16408</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>1216</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>2553</CurrentTaxYearMinus1YearAmt>
        <TotalAmt>58826</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>59725</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>64734</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>61413</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>32025</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>27587</CurrentTaxYearAmt>
        <TotalAmt>245484</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>4412425</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>4335380</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>4302586</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>4242886</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>3932158</CurrentTaxYearAmt>
        <TotalAmt>21225435</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.98570</PublicSupportCY509Pct>
      <InvestmentIncomeCYPct>0.00280</InvestmentIncomeCYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>MISCELLANEOUS OTHER PROGRAM INCOME - 2015 AMOUNT: $ 59,725. 2016 AMOUNT: $ 64,734. 2017 AMOUNT: $ 61,413. 2018 AMOUNT: $ 32,025. 2019 AMOUNT: $ 27,587.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LandGrp>
        <OtherCostOrOtherBasisAmt>1300000</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1300000</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>1710000</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>35625</DepreciationAmt>
        <BookValueAmt>1674375</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>78588</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>9036</DepreciationAmt>
        <BookValueAmt>69552</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>891851</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>548727</DepreciationAmt>
        <BookValueAmt>343124</BookValueAmt>
      </EquipmentGrp>
      <TotalBookValueLandBuildingsAmt>3387051</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>MEDICAID COST SETTLEMENT</Desc>
        <Amt>2849</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO RELATED PARTIES</Desc>
        <Amt>13700</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER LIABILITIES</Desc>
        <Amt>146849</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>163398</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>6978239</TotalRevEtcAuditedFinclStmtAmt>
      <RevenueNotReportedAmt>0</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>6978239</RevenueSubtotalAmt>
      <OtherRevenuesNotIncludedAmt>-3046081</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>-3046081</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>3932158</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>4440895</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>4440895</ExpensesSubtotalAmt>
      <OtherExpensesNotIncludedAmt>759643</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>759643</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>5200538</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XI, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>REVENUE FROM 1/1/10-2/23/19 GAIN ON ACQUISITION OF ASSETS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII, LINE 4B - OTHER ADJUSTMENTS:</FormAndLineReferenceDesc>
        <ExplanationTxt>EXPENSES FROM 1/1/19-2/23/19</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>FRANCIS J GRADY</PersonNm>
        <TitleTxt>PRESIDENT &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>360615</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>83779</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>26339</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>470733</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAUL KEMP</PersonNm>
        <TitleTxt>TREASURER &amp; CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>269169</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>66560</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>26714</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>362443</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS LAVALLEE</PersonNm>
        <TitleTxt>CLERK &amp; COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>269169</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>66560</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>26714</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>362443</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL DODOS</PersonNm>
        <TitleTxt>CONTROLLER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>209796</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>40000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>249796</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>WILLIAM FARINA</PersonNm>
        <TitleTxt>DIRECTOR OF REHAB SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>157009</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>27025</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>184034</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARY KILLCOMMONS</PersonNm>
        <TitleTxt>DIRECTOR OF OPERATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>160979</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>10000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>10131</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>181110</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ELAINE HANSON</PersonNm>
        <TitleTxt>DIRECTOR OF CLINICAL SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>164283</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>10000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>24098</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>198381</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DORIS DAVILA</PersonNm>
        <TitleTxt>VICE PRESIDENT OF OPERATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>176223</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>13000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>486</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>189709</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RICHARD CANTY</PersonNm>
        <TitleTxt>VICE PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>170538</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>13000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>26714</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>210252</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION OF THE PRESIDENT/CEO IS DETERMINED AND PAID OUT BY A RELATED ORGANIZATION, ALLIANCE HEALTH, INC. ALLIANCE HEALTH, INC.'S BOARD SHALL CONDUCT A PERFORMANCE EVALUATION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER, TREASURER/CHIEF FINANCIAL OFFICER, AND SECRETARY/CHIEF OPERATING OFFICER OF THE COMPANY ON AN ANNUAL BASIS. SUCH EVALUATION SHALL BE USED AS THE BASIS FOR DETERMINING COMPENSATION AND SHALL INCLUDE AN ASSESSMENT OF COMPANY GOALS AND PERFORMANCE. THE BOARD WILL REVIEW YEAR OVER YEAR PERFORMANCE AND EVALUATE COMPANY RESULTS WITH RESPECT TO FINANCIAL PERFORMANCE, ATTAINMENT OF GOALS, PROGRAM AND OPERATIONAL QUALITY AND GOVERNANCE. THE BOARD WILL ALSO CONSIDER ORGANIZATIONAL STRENGTH AND DEVELOPMENT AND BOARD-OFFICER RELATIONSHIP MANAGEMENT. IN MAKING A COMPENSATION DETERMINATION, THE BOARD SHALL CONSIDER CURRENT INDEPENDENT MARKET ASSESSMENT OF AND RELIABLE DATA FROM COMPARABLE ORGANIZATIONS. THE BOARD MAY FROM TIME TO TIME SPECIFICALLY ENGAGE THIRD PARTY PROFESSIONALS TO CONDUCT COMPENSATION STUDIES OR TO REVIEW AND ASSESS CURRENT PRACTICES WHEN DEEMED USEFUL TO KEEP ITS KNOWLEDGE AND INFORMATION CURRENT. ALL EXTERNAL STUDIES WILL FOLLOW THE IRS GUIDELINES FOR DETERMINING "EXCESS BENEFIT". THE BOARD SHALL APPOINT A COMPENSATION COMMITTEE WHO WILL BE RESPONSIBLE FOR LEADING THE COMPENSATION AND EVALUATION PROCESS. THE COMMITTEE SHALL CONSIDER INPUT FROM THE PRESIDENT FOR TREASURER AND SECRETARY IN EVALUATING ATTAINMENT OF GOALS. THE COMMITTEE WILL REPORT ITS RECOMMENDATIONS TO THE BOARD, WHICH WILL PARTICIPATE IN FULL IN THE DECISION MAKING.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>ON FEBRUARY 24, 2019, ALLIANCE HEALTH, INC. AFFILIATED WITH THE ORGANIZATION FROM AN UNRELATED NONPROFIT ORGANIZATION THROUGH A CHANGE IN GOVERNANCE. AS PART OF THE TRANSACTION, ALL PROPERTY RELATED TO THE FACILITY (EXCEPT FOR SPECIFICALLY EXCLUDED PROPERTY DETAILED IN SCHEDULE 1 OF THE BILL OF SALE) WAS TRANSFERRED TO THE ORGANIZATION EFFECTIVE FEBRUARY 24, 2019. THE ORGANIZATION WAS ALSO ASSIGNED A NUMBER OF CONTRACTS RELATED TO OPERATIONS ON FEBRUARY 24, 2019. PRIOR TO THE AFFILIATION WITH ALLIANCE HEALTH, INC., MARIE ESTHER WAS CONSIDERED A RELIGIOUS ORGANIZATION AND DID NOT HAVE A FORM 990 FILING REQUIREMENT PRIOR TO THE AFFILIATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION DELEGATED CONTROL OVER MANAGEMENT AND FINANCIAL DUTIES TO A RELATED ORGANIZATION, ALLIANCE HEALTH MANAGEMENT SERVICES, LLC. THE MANAGEMENT COMPANY IS A NON-PROFIT SUPPORTING ORGANIZATION WHICH ENGAGES IN THE BUSINESS OF PLANNING, DEVELOPING, CONSTRUCTING, OWNING, AND MANAGING NON-PROFIT ORGANIZATIONS WHICH PROVIDE SERVICES THAT RANGE FROM POST-ACUTE CARE FACILITIES, SKILLED NURSING FACILITIES TO ASSISTED LIVING COMMUNITIES. ALLIANCE HEALTH MANAGEMENT SERVICES, LLC IS LOCATED AT 144 TURNPIKE ROAD, SUITE 220, SOUTHBOROUGH, MA 01772. MANAGEMENT FEES PAID IN 2019 TOTALED $175,000.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDIT COMMITTEE SHALL REVIEW AND APPROVE THE IRS FORM 990 ANNUAL TAX FILINGS PRIOR TO SUBMISSION, AND THE BOARD SHALL RECEIVE A COPY AND REVIEW THE IRS FORM 990 TAX FILINGS WITHIN 30 DAYS LEADING UP TO ITS SUBMISSION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CONFLICT OF INTEREST FORM IS DISTRIBUTED TO ALL DIRECTORS ANNUALLY AT THE DECEMBER QUARTERLY MEETING. EACH DIRECTOR MUST PROVIDE THE BOARD OF DIRECTORS WITH AN ANNUAL WRITTEN DISCLOSURE OF THE FOLLOWING: (I) THE DIRECTOR'S BUSINESS INVOLVEMENTS WITH THE ORGANIZATION AND RELATED ORGANIZATIONS; (II) THE DIRECTOR'S OTHER BOARD MEMBERSHIPS, WHETHER OF FOR-PROFIT OR NON-PROFIT CORPORATIONS; AND (III) THE TOTAL AMOUNT RECEIVED BY THE DIRECTOR FROM THE ORGANIZATION AND RELATED ORGANIZATIONS FOR SERVICES RENDERED AS A VENDOR OF GOODS OR SERVICES TO THE RELATED ORGANIZATIONS. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING THAT THE POLICY IS UPDATED AND SIGNED BY ALL DIRECTORS AND REVIEWS FOR CONFLICTS. IF A CONFLICT ARISES, THE COMMON OR INTERESTED PERSONS MAY BE COUNTED IN DETERMINING THE PRESENCE OF A QUORUM AT A MEETING OF THE DIRECTORS OR OF A COMMITTEE THEREOF WHICH AUTHORIZES, APPROVES OR RATIFIES THE CONTRACT OR TRANSACTION. HOWEVER, THE COMMON OR INTERESTED PERSON MUST WITHDRAW FROM THE DISCUSSION AND VOTING OF THE INTERESTED CONTRACT OR TRANSACTION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMPENSATION OF THE PRESIDENT/CEO IS DETERMINED AND PAID OUT BY A RELATED ORGANIZATION, ALLIANCE HEALTH, INC. ALLIANCE HEALTH, INC.'S BOARD SHALL CONDUCT A PERFORMANCE EVALUATION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER, TREASURER/CHIEF FINANCIAL OFFICER, AND SECRETARY/CHIEF OPERATING OFFICER OF THE COMPANY ON AN ANNUAL BASIS. SUCH EVALUATION SHALL BE USED AS THE BASIS FOR DETERMINING COMPENSATION AND SHALL INCLUDE AN ASSESSMENT OF COMPANY GOALS AND PERFORMANCE. THE BOARD WILL REVIEW YEAR OVER YEAR PERFORMANCE AND EVALUATE COMPANY RESULTS WITH RESPECT TO FINANCIAL PERFORMANCE, ATTAINMENT OF GOALS, PROGRAM AND OPERATIONAL QUALITY AND GOVERNANCE. THE BOARD WILL ALSO CONSIDER ORGANIZATIONAL STRENGTH AND DEVELOPMENT AND BOARD-OFFICER RELATIONSHIP MANAGEMENT. IN MAKING A COMPENSATION DETERMINATION, THE BOARD SHALL CONSIDER CURRENT INDEPENDENT MARKET ASSESSMENT OF AND RELIABLE DATA FROM COMPARABLE ORGANIZATIONS. THE BOARD MAY FROM TIME TO TIME SPECIFICALLY ENGAGE THIRD PARTY PROFESSIONALS TO CONDUCT COMPENSATION STUDIES OR TO REVIEW AND ASSESS CURRENT PRACTICES WHEN DEEMED USEFUL TO KEEP ITS KNOWLEDGE AND INFORMATION CURRENT. ALL EXTERNAL STUDIES WILL FOLLOW THE IRS GUIDELINES FOR DETERMINING "EXCESS BENEFIT". THE BOARD SHALL APPOINT A COMPENSATION COMMITTEE WHO WILL BE RESPONSIBLE FOR LEADING THE COMPENSATION AND EVALUATION PROCESS. THE COMMITTEE SHALL CONSIDER INPUT FROM THE PRESIDENT FOR TREASURER AND SECRETARY IN EVALUATING ATTAINMENT OF GOALS. THE COMMITTEE WILL REPORT ITS RECOMMENDATIONS TO THE BOARD, WHICH WILL PARTICIPATE IN FULL IN THE DECISION MAKING.</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 IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 914,778. MANAGEMENT AND GENERAL EXPENSES 104,172. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,018,950.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>GAIN ON ACQUISITION OF ASSETS 3,470,090.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII, LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION BEGAN ITS OVERSIGHT PROCESS AND SELECTION PROCESS IN 2019.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>043468274</EIN>
        <PrimaryActivitiesTxt>SUPPORTING ORGANIZATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH MANAGEMENT SERVICES LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>364639819</EIN>
        <PrimaryActivitiesTxt>SUPPORTING ORGANIZATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF BRAINTREE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>651310230</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF BROCKTON INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>043455405</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF CENTERVILLE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249886</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF EAST PROVIDENCE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249896</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF LYNN INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249859</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF MARBLEHEAD INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249854</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF MASSACHUSETTS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>311712039</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF PLYMOUTH INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249891</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF PROVIDENCE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249901</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF QUINCY INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>043468149</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF SANDWICH INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249868</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF SOUTHBRIDGE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249840</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF SOUTHEASTERN MA INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>043582078</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH OF WORCESTER INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249850</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE HUMAN SERVICES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>043476887</EIN>
        <PrimaryActivitiesTxt>FOSTER CARE CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE OF THE CHESAPEAKE BAY INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>010672105</EIN>
        <PrimaryActivitiesTxt>HUMAN SERVICE ORGANIZATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE SPECIALTY HOSPITAL INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>800249832</EIN>
        <PrimaryActivitiesTxt>HOSPITAL CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>DEPOT POND VILLAGE INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>203883388</EIN>
        <PrimaryActivitiesTxt>RESIDENTIAL FACILITY FOR ELDERLY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE HOSPITAL COTTAGES FOR CHILDREN</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>042104323</EIN>
        <PrimaryActivitiesTxt>SKILLED NURSING CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ALLIANCE CHILDREN'S SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>144 TURNPIKE ROAD SUITE 220</AddressLine1Txt>
          <CityNm>SOUTHBOROUGH</CityNm>
          <StateAbbreviationCd>MA</StateAbbreviationCd>
          <ZIPCd>01772</ZIPCd>
        </USAddress>
        <EIN>042691041</EIN>
        <PrimaryActivitiesTxt>FOSTER CARE CORPORATION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ALLIANCE HEALTH INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>